HomeMy WebLinkAbout02-0131PETITION FOR PROBATE and GRANT OF LETTERS
Estate oJ George Edward Myers
also known as
No. ZI -
Social Security No. 204-03-2363
To:
Register of Wills for the
, Deceased. County of Cumberland in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut or named
in the last will of the above decedent, dated April 1, 1980
and codicil(s) dated None (, 7
The deceased was preceded in death by his wife Minnie Jane Myers and his son Charles E. Myers is
filin~ a renunciation of his right to act as executor
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decedent was domiciled at death in Gumberland County, Pennsylvania, with
h is last family or principal residence at 15 Beidler Drive, Shippensburg, Pa. 17257
(North Newton Township)
(list street, number and municipality)
Decedent, then 87 years of age, died 12/29/01
at Shippensburq Health Care Center, Shippensburq, Cumberland County, Pennsylvania
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never ajudicated
incompetent:
Decedent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
$ 1,500.00
$
$ 0.00
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters testamentar~
thereon. (testamentary; administration c.t.a; administration d.b n.c.ta.)
'~o--~'D--x~ 15 Beidler Drive
3, ~7,~,.,..,,t Shippensburq Pa. 17257
?A ?¢.i~_/ ^ 3-.
Sworn to or affirmed and subscribed
before me this 5th __-- day of
/ '/ 7 /Regi;ter
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA }
ss
;
COUNTY OF Cumberland
The petitioncr(~) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the bes't of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedei:t petitioner(s) will well and truly administer the estate according to law.
Iq- qo-z
No. ~1 - 02.- I ~!
Estate of Georqe Edward Myers
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW February 6.,2002 , in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated 4/1/80
described therein be admitted to probate and filed of record as the last will of George Edward Myers
and Letters Testamentary
are hereby granted to
Patricia J. Myers
called
FEES
Probate, Letters, Etc ......... $ P ~ fl13
Short Certificates ( } ...... $ 6.0 0
Renunciation ............ $ 5 _ 00
JCP $ $. 00
EXTRA PATIE~A7~ __ $ ~ _ 1313
TOTAL 44.00
Filed. FEBRDAR~ '6 ,' '2'0'0'2 ........
attorney on 2-6-02
H. Anthony Adams
25505
ATTORNEY (Sup. Ct. I.D. No.)
128 East King Street
Shippensburg Pa. 17257
ADDRESS
717-532-3270
PHONE
RENUNCIATION
Estate of George Edward Myers
also known as
Deceased
No.
21-02-131
The undersigned, Charles E. Myers, being a child and named executor
(Relationship) (Capacity)
of
the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that
Letters Testamentary be issued to Patricia J. Myers
Witness hand this 30th ,-~ day of January ,2002 .
(Signature) ~ _
I '~ (Signature)
..... . ~ 3L~ (Address)
(Signature)
(Address)
Swo~ or affi~ibed
before m th~j~/ 5th day of
X
My Commission
(Signature and seal of Notary or other
official qualified to administer oaths. Show
date of expiration of Notary's commission.)
NOTE:
Renunciations executed outside the Office of Register of Wills are
required in some counties to be notarized.
RW-3
OATH OF NON-SUBSCRIBING WITNESS
H. Anthony Adams and Patricia J. Myers
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that they are
familiar with the signature of George Edward Myers
s -- ' the will presented herewith and that each
will is in the handwriting of testator
Sworn to or affirmed and sub-
scribed before me this 5th day of
February, 2002
, testat or of (onc of the
believes the signature on the
to the best of their
H. Anthony -,
-- Ad aT-n s --(~ ame-Y-- '---"-----
15 Peebles Road, Newbur,q,
(Address)
knowledge and belief.
Pa. 17240
Pa. 17257
/-- / ~'/ For t[~e Register ' / (Name)
Patricia J. Myers
15 Beidler Road, Shhippensbur,q
(Address)
his 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 permanen~
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
P 7997645
No.
Date
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH * VITAL RECORDS
CERTIFICATE OF DEATH
George E. Myera l~z. ale . 204-- 03 -- 2363 ,.12/29/2OOI
r I : I ,,08/31/1916 I,.N. Newton Twp.
~ Cumberland q,.Shippensburg Twp. J0d. Shippensburg Health Care Center It,
,,.Trackman b,lransportatzon Co. l- I. ~'" 6 ] ........ l- Widowed
J~c.~,r~ Pennsylvania ,~..~ ~.~, N Newton Twp.
15 Beidler Drive mmm~ ~
,~ Shippensburg, PA 17257 ~) ,m.~ C~berland ~' 1~.~ ~
,,. Edward M~ers ,,. Bessie Smith
~ Patricia J. Myers ~ 15 Bezdler Dr~ve, Shippensburg, PA 17257
~ ~ ~~ ~'~' ] ] Cumberland County,
~ ~ ~,~.01/03/2002 ],,,Prospect Hill Cemeter~ ],,, W. Pennsboro Twp., PA
m 0 2~84L I~F0gel~ e~Bric~r F.H.~
,oWhi1 te
William J. Keating, M.D.
3730 S¢otl.and~ad, Scotland, PA 172%
21-02-131
21-02-131
LAST WILL AND TESTAMENT
I, GEORGE EDWARD MYERS, being of sound mind, memory and understanding, do
make, publish and declare this my Last Will and Testament, hereby revoking all prior
wills and codicils made at any time before by me.
I direct that all my funeral expenses be paid as soon as practicable
FIRST.
after my death.
SECOND.
I give, devise, and bequeath all my property, real, mixed, or
personal, to my wife, MINNIE JANE MYERS.
THIRD. If my said wife should predecease me, or if we should die in a
common disaster, then in either of those Said events I give, devise, and bequeath
all my property, as follows:
a. I direct that all that furniture and their personal belongings in the
bedrooms of my children, PATRICIA JANE MYERS and RANDY LEE MYERS do belong to them,
and they shall be allowed to keep and remove the same.
b. I further direct that my daughter, PATRICIA JANE MYERS, be allowed to
remove her personal belongings from the attic of my residence.
c. I further direct that my son, RANDY LEE MYERS, be allowed to keep and
remove those guns which belong to him.
d. I give and bequeath to my son, CHARLES MYERS, that certain antique plank
bottom rocking chair.
FOURTH. I give, devise, and bequeath the rest and residue of my estate,
including any and all old monies and possessions in my lock box, to my children in
equal shares per stirpes.
FIFTH. I nominate and appoint my said wife, MINNIE JANE MYERS, as the
executrix of this, my Last Will and Testament, and shoUld she be unable to serve,
then in that event I nominate and appoint my son and daughter CHARLES E. MYERS and
PATRICIA J. MYERS, as the co-executors of this, my Last Will and Testament.
IN WITNESS WHEREOF, I, GEORGE EDWARD MYERS, to this my Last Will and
Testament, set my hand and seal this /~-~ day of ~~ , 1980.
Sworn to and subscribed,
declared and published by
GEORGE E. MYERS, as his
Last Will and Testament,
and so done in the presence of we
the witnesses, who sign at his
request, and in his presence and
in the presence of each other.
CONNONNEALTN OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. ID0601
HARRISBURG, PA 1712D-0601
RE¥-1~$ EX 4FP [09-lO)
PATRICIA J MYERS
15 BEIDLER DR ,~,_
SHIPPENSBURG PA 17~.~
ZNFORHATZON NOTZCE
AND
TAXPAYER RESPONSE
FILE NO. 21 02-015!
ACN 02107647
DATE O$-07-ZOOZ
TYPE OF ACCOUNT
EST. OF GEORGE E MYERS D SAVZN~S
S.S. NO. 204-03-2363 D CHECKZNG
DATE OF DEA?H 1Z-Zg-2001 ~TRUST
COUNTY CUMBERLAND ~]CERT~F.
REHZT PAYHENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PHC BANK has provided the Departaent with the inforaation listed below ahich has been used in
calculating the potanttal tax due. Their records indicate that at tho death of the above decedent, you were a joint o~ner/benefictary of
this account. If you feel this inforaation is incorrect, please obtain written correction free the financial institution, attach a copy
to this fora and return it to the above address. This account is taxable in accordance aith the Inheritance Tax Lams of the Coaaonwaalth
of Pennsylvania. Questions may be answered by calling (717) 787-8~Z7.
COMPLETE PART I BELOW # ~ ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Accoun~ No. 21001053102 De~a 07-11-1994 To insure proper credit to your account,
Established cz) copies of this notice must accompany your
payment to the Register of Hills. Hake check
Accoun~ Balance 3,558.43 payable to: 'Register of Hills, Agent'.
Percan~ Taxable X 50.000
NOTE: If tax payaents are made within three
Amoun~ Subjec~ ~o Tax 1,779.22 (~) months of the dacadant's date of death, /
Tax Ra~e X .045 you aay deduct a 5Z discount of the tax due.
Po~en~ial Tax Due -'80~0'6-- ,-- nine (9) months after the date cf death.
PART TAXPAYER RESPONSE
A. ~]Tha above inforaation and tax due is correct.
1. You may choose to remit payment to the Register of Mills with two copies of this notice to obtain
CHECK a discount or avoid interest, or you may check box 'A" and return this notice to the Register of
- --~ Hills end an official ossassaent will be issued by the PA Department of Revenue.
ONE
BLOCK~ B. [] The above asset has been or will bo reported and tax paid with the Pennsylvania Inheritance Tax return
ONLY to be filed by the dacedent's representative.
C. [~Tha above information is incorrect and/or debts and deductions .are paid by you.
You must complete PART [] and/or PART [] below.
PART Zf you indicate · differen~ ~ax ra~e, please s~a~e your
relationship ~o decedent:
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Data Established 1
2. Accoun~ Balance
$. Percen~ Taxable $
~. A.oun~ Subjec~ ~o Tax
5. Deb~s and Deductions 5 -
6. Amoun~ Taxable
7. Tax Ra~e 7
B. Tax Due 8
PART DEBTS AND DEDUCTIONS CLAIMED
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
TOTAL (Enter on L/ne $ of Tax Computation)
Under penalties of perjury, T declare ~ha~ ~he fac~s T have reported above ara ~rua, correc~ and
F:~c~t..,/.._..4.,c:.~.:,r._~ompze~:e ~:o ~h. bes~ of my knowZedg, and be~Lef
TAXPAYER SIGNATURE v TELEPHONE NUMBER DATE
6ENERAL INFORMATION
1. FAILURE TO RESPOND #ILL RESULT ZN AN OFFZCIAL TAX ASSESSMENT with applicable interest based on information
submitted by the financial institution.
Z. Inheritance tax becomes delinquent nine months after the decadant's data of death.
3. A joint account is taxable even though the decedent's nasa was added as a matter of convenience.
4. Accounts (including those held batsman husband and wife} which the decedent put in joint names within one year prior to
death ars fully taxable as transfers.
5. Accounts established jointly baleen husband and eifa more than one year prier to death are not taxable.
6. Accounts held by a decadent "in trust for" another or others ara taxable fully.
REPORTING INSTRUCTIONS - PART ! - TAXPAYER RESPONSE
1. BLOCK A - If the information and computation in the notice are correct and deductions are not being claimed, place an "X"
in block "A" of Part 1 of the "Taxpayer Response" section. Sign two copies and submit thee with your check for the amount of
tax to the Register of Mills of the count~ indicated. The PA Department af Revenue mil! issue an official assessment
(Fora REV-LB48 EX) upon receipt of the return free the Register of Hills.
Z. BLOCK B - If the asset specified on this notice has been or ~il! be reported and tax paid with the Pennsy!vania Tnheritance
Tax Return filed by the decadant's representative, place an "X" in block "B" of Part I of the "Taxpayer Response" section. Sign one
copy and return to the PA Department of Revenue) Bureau of [ndividual Taxes, Oept Z80601, Harrisburg, PA 171~)8-0601 in the
envelope provided.
3. BLOCK C - If the notice information is incorrect and/or deductions ara being claimed, check block "C" and complete Parts Z and 3
according to the instructions below. Sign two copies and submit thee .1th your chock for the amount of tax payable to tho Register
of llills of the count~ indicated. The PA Department of Revenue will issue an official assessment (Fora REV-1548 EX) upon receipt
of the return from the Register of Wills.
TAX RETURN - PART Z TAX COMPUTATION
LINE
1. Enter the data the account originally was established or titled in the manner existing at date of death.
NOTE: For · decadent dying after IZ/12/BZ: Accounts ,hich the decedent put in joint names ,ithin one (I) year of death are
taxable fully as transfers. However, there is an exclusion nat to exceed $3,000 par transferee regardless of the value of
the account or the number of accounts held.
If a double asterisk (xx) appears before your first name in the address portion of this notice, the $3,000 exclusion
already hms been deducted from the account balance as reported by the financial institution.
Z. Enter the tote[ balance of the account including interest accrued to the date of death.
3. The percent of the account that is taxable for each survivor is determined as follows;
A. The percent taxable for joint assets established more than one year prior to the dacedent's death:
I DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF X IO0 = PERCENT TAXABLE
JOINT ONNERS SURVIVING JOINT OWNERS
ExaMple: A joint asset registered in the name of the decedent and two other persons.
! DIVIDED BY 3 (JOINT ONNERS) DIVIDED BY Z (SURVIVORS) = .167 X IO0 = 16.7X (TAXABLE FOR EACH SURVIVOR)
B.The percent taxable ~or assets created within one year of the dacsdent's death or accounts owned by the decedent but held
in trust for another individual(s) (trust beneficiaries):
I DIVIDED BY TOTAL NUHBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE
ONNERS DR TRUST SENEFICIARIES
Example: Joint account registered in the name of the decedent and two other persons and esteblisbad uithin one year of death by
the decedent.
I DIVTDED BY 2 (SURVIVORS) = .So X 1nO = SOZ (TAXABLE FOR EACH SURVIVOR)
The amount subject to tax (line 4) is determined by aultipIying the account balance (line Z) by the percent taxabIe (line 3).
5. Enter the total of the debts and deductions listed in Part 3.
6. The aaount taxable (line 6) is datarainad by subtrecting the debts and deductions (1ina 5) frae the amount subject to rex (line 4).
7. Enter the appropriate tax ret. (Line 7) as determined below.
Da~e of Death Spouse Lineal SiblAng Collateral
07/01/94 '1:o 12/31/9q 3Z 6Z
01/01/95 ~o 06/30/00 OZ 6X 157. 157.
07/01/00 ~o proson~ OX
xThe tax rate imposed on th; nat va .aungar at
death to or for the use of e natural parent, an adoptive parent, or a stepparent of the child is OZ.
The lineal class of heirs includes grandparents, parents, children, end lineal descendents. "Children" includes natural children
ehether or not they have been adopted by others) adopted children and step children. "Lineal descendents" includes ail children of the
natural parents and their descendents; whether or not they have been adopted by others; adopted descendents and their descendants
and step-descendants. "Siblings" are defined as individuals who have at least one parent in common with the decedent, .bather by blood
or adoption. The "Collateral" class of heirs includes all other beneficiaries.
CLAIMED DEDUCTIONS - PART $ - DEBTS AND DEDUCTIONS CLAIMED
Allowable debts end deductions are determined as follows:
A. You legally are responsible for payment, or the estate subject to administration by a personal representative is insufficient
to pay the deductible items.
D. You actually paid the debts after death of the decedent end can RJrnish proof of payment.
C. Debts being clailed must be itelizad fully in Part 3. If additional space is needed, usa plain paper 8 Z/Z" x 11". Proof of
payment may be requested by the PA Oepartlent of Revenue.
COHHONNEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. Z80601
HARRISBURG, PA 171ZB-060!
REV-],545 EX AFP [09-DO)
ZNFORHATZON NOTZCE
AND
TAXPAYER RESPONSE
FILE NO. 21~:~-/5/
ACN 021076q6
])ATE 0$-07-Z00Z
EST. OF GEORGE E MYERS
S.S. NO. ZOq-OZ-Z365
DATE OF DEATH 12-29-2001
COUNTY CUMBERLAND
PATRTCTA J MYERS
15 BEIDLER DR
TYPE OF ACCOUNT
E~SAVINGS
[~]CHECKZNG
[]TRUST
~]CERTZF.
RENIT PAYHENT AND FORHS TO:
REGISTER OF NZLLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
PNC BANK has provided tho Department mJth the inforlation listed belom ~hich has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, you mare a ~oint caner/beneficiary of
this account. Zf you feel this information is incorrect, please obtain mrittan correction from the financial institution, attach a copy
to this form and return it to the above address. This account is taxable in accordance with the Tnheritancm Tax Laws of the Commonwealth
cf Pennsylvania. Questions cay be ansaerad by calling (717) 7ST-S3ZT.
COMPLETE PART 1 ~ELON x x x SEE REVERSE SZ])E FOR FZLZNG AN]) PAYMENT ZNSTRUCTZONS
Accoun* No. ZlOO105zgo~ De*e 11-03-1995
Es*ablished
Account: Balance 5,17~. 9 0
Percen~ Taxable X
Aeoun~ Subject: ~:o Tax Z,587.~5
Tax Re~e X ~/
Pod:end:ia1 Tax Due ~'/~
To insure proper credit to your account, tee
(Z) copies of this notice must accompany your
payment to the Register of Mills. Hake check
payable to: "Register of Nills, Agent".
50.000
NDTE: Tf tax payments are made mithin three
(~) months of the dacadant's date of death,
· 0~5 you may deduct a SZ discount of the tax due.
~'U (a*'~~'~''/1'//-)' Any inheritance tax due will become delinquent
~ nine (9) months after tha data of death.
PART TAXPAYER RESPONSE
A. [~ The above information and tax due is correct.
1. You may choose to remit payment to the Register of Mills aith tee capias of this notice to obtain
CHECK
ONE
~LOCK
ONLY
PART
TAX
LZNE
a discount or avoid interest, or you may check box "A" and return this notice to the Register of
Hills and an official assessment mill bo issued by the PA Department of Revenue.
B. [] The above asset has been or a~11 be reported and tax paid aith the Pennsylvania [nharitanca Tax return
to be fi[ed by the decedent's representative.
C. O The above information is incorract and/or debts and deductions .ere paid by you. You must compZete PART [~]and/or PART F-lbaloa.
Zf you indicate a differen~ ~ax ra~a, please s~a~e your
relationship ~o decedent:
RETURN - COMPUTATZON OF TAX ON JOiNT/TRUST ACCOUNTS
1. De~e Established 1
2. Accoun~ Balance 2
3. Percen~ Taxable 3
q. Amount Subjec~ ~o Tax
$. Debts and Deductions
6. Aeoun~ Taxable 6
7. Tax Ra~e 7
8. Tax Due 8
PART
DATE PAID
])EIITS AN]) ])EDUCTZONS CLAZMEO
PAYEE DESCRZPTZON
AMOUNT PAID
TOTAL (Enter on L/ne ~ of Tax Co~u~a~ion)
Under penal~:tes of perjury, ! decZere ~:ha~ the fac~:s T have reported above ara ~rue, correct: and
c~qmple~:e,~/~*o ~:he bas* or__ay knowledge and belief. ,HOME (-~/-f ) ~7-7 G- 5-~-~0
TAXPAYER STGNATI~E TELEPHONE NUMBER ])ATE
~ GENERAL INFORMATION
1. FAILURE TO RESPOND RILL RESULT IN AN OFFICIAL TAX ASSESSMENT eith applicable interest based on information
submitted by the financial institution.
g. Inheritance tax becomes delinquent nine months after the decedant's data of death.
3. A joint account is taxable even though the dacedant's name Nas added as a matter of convenience.
q. Accounts (including those held bat~eaan husband and wife) ahich the decadent put in joint names within one year prior to
death are fully taxable as transfers.
S. Accounts established jointly bat~4aen husband and wife more than one year prior to death are not taxable.
6. Accounts held by a decedent "in trust for" another or others are taxable fully.
REPORTING INSTRUCTIONS - PART ! - TAXPAYER RESPONSE
BLOCK A - if the information and computation in the notice are correct and deductions ara net being claimed, place an "X"
in block "A" of Part I of the "Taxpayer Response" section. Sign two copies and submit them with your check for the amount of
tax to the Register of Rills of the county indicated. The PA Department of Revenue will issue an official assessment
(Form REV-lSq8 EX) upon receipt of the return free the Register of Rills.
Z. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid eith the Pennsylvania Inheritance
Tax Return filed by the dacedent's representative, place an "X" in block "B" of Part I of the "Taxpayer Response" section. Sign one
copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Oapt Za0601, Harrisburg, PA I71ZB-0601 in the
envelope provided.
3. BLOCK C - If the notice information is incorrect and/or deductions are being claimed, check block "C" and complete Parts 2 and
according to the instructions below. Sign two copies and submit them mith your check for the amount of tax payable to the Register
of Hills of the county indicated. The PA Department of Revenue will issue an official assessment (Fora REV-lSq& EX) upon receipt
of the return free the Register of Hills.
TAX RETURN - PART Z - TAX COMPUTATION
LINE
1. Enter the date the account originally was established or titled in the manner existing at date of death.
NOTE: For a decedent dying after II/II/aZ: Accounts ehich the decedent put in joint names within one (1) year of death are
taxable fully as transfers. However, there is an exclusion not to exceed $3,000 per transferee regardless of the value of
the account or the number of accounts held.
If a double asterisk (mN) appears before your first name in the address portion of this notice, the $3,000 exclusion
already has been deducted free the account balance as reported by the financial institution.
g. Enter the total balance of the account including interest accrued to the date of death.
$. The percent of the account that is taxable for each survivor is determined as follows:
A. The percent taxable for joint assets established aDZe than one year prior to the decedent's death:
1 DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF X 100 PERCENT TAXABLE
JOINT O#NERS SURVIVING JOINT ONNERS
Example: A joint asset registered in the name of the decedent end tad other persons.
I DIVIDED BY 3 (JOINT ONNERS) DIVIDED BY Z (SURVIVORS) = .167 X 1gO = 16.7X (TAXABLE FOR EACH SURVIVOR)
B.The percent taxable for assets created within one year of the dacadant's death or accounts owned by tho decedent but held
in trust for another individual(s) (trust beneficiaries):
I DIVlDED BY TOTAL NUMBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE
OHNERS OR TRUST BENEFICIARIES
Example: Joint account registered in the name of the decedent and tad other persons and established within one year of death by
the decedent.
I DIVIDED BY Z (SURVIVORS) = .S0 X 100 = SOZ (TAXABLE FOR EACH SURVIVOR)
The amount subject to tax (line q) is determined by multiplying the account balance (ling Z) by the percent taxable (line
S. Enter the total of tho debts and deductions Listed in Part 3.
6. The amount taxable (line 6) is determined by subtracting the debts and deductions (11ne S) from the amount subject to tax (line
7. Enter the appropriate tax rate (line 7) es letermined below.
Da~e of Death Spouse Lineal Sibling Collateral
07/01/9q ~o 12/$1/9q SZ 6Z 157. 157.
01/01/95 ~o 06/30/00 OX 6Z l~Z lAX
07/01/00 ~o presen~ OX q.SZ~ 12Z 15Z
....... ~ .... z ~ -~.~ ~en, ~ .l..:--a~ad child ~en~-o~e years of age or ~
at
'he tax rate imposed on thl net younger
death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is OZ.
The lineal class of heirs includes grandparents, parents, children, and lineal descendents. "Children" incXudes natural children
whether or not they have been adopted by others, adopted children end step children. "Lineal descendents" includes 811 children of the
natural parents and their descendents, whether or not they have been adopted by others, adopted descendents and their descendants
end step-descendants. "Siblings" are defined as individuals who have et least one parent in common aith the decedent, whether by bided
or adoption. The "Collateral" class of heirs includes 811 other beneficiaries.
CLAIMED DEDUCTIONS - PART $ - DEBTS AND DEDUCTIONS CLAIMED
Allowable debts and deductions ara determined as follows:
A. You legally are responsible for payment, or the estate subject to administration by a personal representative is insufficient
to pay the deductible items.
B. You actually paid the debts after death of the decadent and can furnish proof of payment.
C. Debts being claimed must be itemized fully in Part 3. If additional space is needed, use plain paper 8 l/Z" x 11". Proof of
payment may be requested by the PA Department of Revenue.
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.
CD
REV-1162 EX(11-96)
000996
MYERS PATRICIA J
DUPLICATE
15 BEIDLER RD
SHIPPENSBURG, PA 17257
........ fold
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
02107647 $76.06
02107646 8110.62
ESTATE INFORMATION: SSN: 204-03-2363
FILE NUMBER: 2102-01 31
DECEDENT NAME: MYERS GEORGE EDWARD
DATE OF PAYMENT: 03/25/2002
POSTMARK DATE: 03/22/2002
COUNTY: CUMBERLAND
DATE OF DEATH: 1 2/29/2001
TOTAL AMOUNT PAID:
$186.68
REMARKS'
SEAL
CHECK# 512
INITIALS: AC
RECEIVED BY:
MARY C. LEWIS
REGISTER OF WILLS
REGISTER OF WILLS
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: George Edward Myers
Date of Death: 12/29/01
Will No. 2002-00131 Admin. No.
To the Register:
I certify that notice of (beneficial interest)estate administration required by Rule 5.6(a) of the Orphan's Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on 5/31/02 ·
Name Address
Randy Lee Myers
129 Centerville Road
Newville
Pa 17241
Charles Myers
Patricia Jane Myers
325 East Garfield Street
Shippensburq
15 Beidler Road
Shippensburg
Pa. 17257
Pa. 17257
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except:,
Date: 5/31/02
Signature
Name: H. Anthony Adams
Address: 49 West Oranqe Street, Suite 3
Shippensburg PA 17257
Telephone(717) - 532- 327
Capacity:
X
Personal Representative
Counsel for Personal
Representative
BUREAU OF TNDTVZDUAL
TAXES
INHERITANCE TAX DTyTSZON
DEPT. 180601
HARRTSBURG,, PA 17128-0601
PATRICIA J HYERS
15 BEIDLER DR
SHIPPENSBURG
COHHONgEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAZSEHENT, ALLOHANCE OR DZSALLO#ANCE
OF DEDUCTIONS, AND ASSESSHENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
REV-15~ EX AFP
~,~ DATE Oq-29-ZOOZ
ESTATE OF HYERS
DATE OF DEATH 12-29-2001
FILE NUHBER 21 02-0151
COUNTY CUHBERLAND
'0~~-~1 ~" ~} 29 P.'~ .~.'20 SSN/DC 20q-03-2365
ACN 021076~7
Amoun~ Rem/~od
PA ~57
GEORGE
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGISTER OF gILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 1701~
E
CUT ALONG THZS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS *'~
REV-1548 EX AFP (01-OE)
NOTICE OF INHERITANCE TAX APPRAXSEHENT, ALLOgANCE OR DZSALLOgANCE OF
DEDUCTIONS, AND ASSESSHENT OF TAX ON dOZNTLY HELD OR TRUST ASSETS
DATE O~-Z9-ZOOZ
ESTATE OF MYERS GEORGE E DATE OF DEATH 12-29-2001 COUNTY CUMBERLAND
FILE NO. 21 02-0131 S.S/D.C. NO. 20~-03-2363 ACN 011076~7
TAX RETURN gAS: (X) ACCEPTED AS FILED ¢ ) CHANGED
JOINT OR TRUST ASSET ZNFORHATZON
FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. 11001053102
TYPE OF ACCOUNT: ( ) SAVINGS ¢ ) CHECKING C ) TRUST ¢~ TIHE CERTIFICATE
DATE ESTABLISHED 07-11-199q
Account Balance 3,558.~3
Percent Taxable ~ 0.500
Amount Sub~ec~ ~o Tax 1,779.ZZ
Debts and Deductions - .00
Taxable Amoun~ 1,779.22
Tax Ra~e ~ .~5
Tax Due 80.06
TAX CREDZTS:
NOTE:
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
HITH YOUR TAX PAYMENT TO THE
REGISTER OF gILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF gILLS, AGENT."
PAYMENT
DATE
03-22-2002
RECEIPT
NUMBER
CD000996
DISCOUNT (+)
INTEREST/PEN PAID
q. O0
AMOUNT PAID
76.06
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN,
TOTAL DUE
80.06
XF PAID AFTER THIS DATE~ SEE REVERSE FOR CALCULATION OF ADDZTZONAL INTEREST.
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REgUZRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDZT"(CR), YOU NAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. )
.00
.00
.00
PURPOSE OF
NOTICE:
To ~ulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (TZ P.S.
Section 9140).
PAYNENT:
REFUND (CR):
OBJECTXONS:
ADH/N-
ISTRATIVE
CORRECTXDNS:
DISCOUNT:
PENALTY:
ZNTEREST:
Detach the top portion of this Notice and submit aith your payment to the Register of Hills printed on the
reverse side.
-- Hake check or money order payable to: REGISTER OF HILLS, AGENT.
A refund of a tax credit, which acs not requested on the tax return, may ba requested by completing an "Application
far Refund cf Pennsylvania XnherJtance end Estate Tax" (REV-1313). Applications are available at the Office of
the Register of Bills, any of the Z3 Revenue District Offices or by calling the special lq-hour ansaering service
for fores ordering: 1-800-36Z-Z050; services for taxpayers with special hearing and or speaking needs:
1-800-q47-30ZO (TT only).
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 may object aithin sixty (60) days of receipt of
this Notlca by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. ZB10Z1, Harrisburg, PA 17128-10Z1, OR
--electing to have the matter determined at the audit of the account of the personal representative, OR
--appeal to the Orphans' Court
Factual errors discovered on this assessment should ba addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, DEPT. ES0601, Harrisburg, PA 171Z8-0601
Phone (717) 787-6505. Sam page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-iS01) for an explanation of administratively correctable errors.
If any tax duo is paid within three (3) calendar months after the dacedent's death, a five percent (SI)
discount of the tax paid is atiowad.
The 1SI tax amnesty non-participation penalty is computed on the totml 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 tiaa 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 tho date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z
bear interest at the rata of six (6Z) percent par annum calculated at a daily rate of .O0016q.
AIl taxes ahich became delinquent on or after January 1, 1982 will bear interest at a rata which will vary free
calendar year to calendar year aith that rate announced by the PA Department of Revenue. The applicable
interest rates for 198Z through ZOO2 are:
Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor
198Z ZOZ .O00Sq8 199Z 9Z .OOOZq7
1983 16Z .OOOfi38 1993-1994 ?Z .O0019Z
1984 llZ .000301 1995-1998 9Z .O00Zq7
1985 13X .000356 1999 7Z .O0019Z
1986 lOX .O00Z7q ZOO0 8X .000Z19
1987 9Z .OOOZfi7 ZOO1 9Z .OOOgq7
1988-1991 11Z .000501 2002 6Z .000164
--Znterest is calculated as follows:
ZNTEREST= BALANCE OF TAX UNPAXD X NUNBER OF DAYS DELXNQUENT X DAZEY ZNTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (la) days
beyond tho date of the assessment. If payment is made after tho interest computation date sheen on the
Notice, additional interest must be calculated.
BUREAU OF TNDZVTDUAL TAXES
XNHERZTANCE TAX DZVTSXON
DEPT. 280601
HARRISBURG, PA 17128-0601
PATRICIA J HYERS
15 BEIDLER DR
SHIPPENSBURG
CONNONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOTXCE OF XNHERXTANCE TAX
APPRAXSEHENT. ALLO#ANCH OR DXSALLONANCE
OF DEDUCTIONS. AND ASSESSHENT OF TAX ON
JOXNTL¥ HELD OR TRUST ASSETS
7257
FILE NUHBER
COUNTY
SSN/DC
ACN
REV~16*t8 EX AFP
DATE 05-27-2002
ESTATE OF NYERS GEORGE
DATE OF DEATH 12-29-2001
21 02-0151
CUHBERLAND
20q-03-2363
021076q6
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE
REV-IS48 EX AFP (01-02)
RETAIN LOWER PORTION FOR YOUR RECORDS
NOTICE OF INHERITANCE TAX APPRAXSENENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSNENT OF TAX ON dOZNTLY HELD OR TRUST ASSETS
DATE 05-27-2002
ESTATE OF NYERS
GEORGE E DATE OF DEATH 12-29-2001 COUNTY CUHBERLAND
FILE NO. 21 02-0151 S.S/D.C. NO. 20q-05-2565 ACN 021076~6
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
dOXNT OR TRUST ASSET ZNFORHATZON
FINANCIAL INSTITUTION: PHC BANK ACCOUNT NO. 2100105290~
TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST (~ TIHE CERTIFICATE
DATE ESTABLISHED 11-05-1995
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deduct/ons
Taxable Amount
Tax Rate
Tax Due
TAX CREDZTS:
5,17~.90
X 0.500
2,587.~5
- .00
Z,587.q5
X .~5
116.~
NOTE:
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
**REGISTER OF WXLLS, AGENT.'*
PAYMENT
DATE
05-22-2002
RECEIPT
NUMBER
CD000996
DISCOUNT (+)
INTEREST/PEN PAID (-)
5.82
AMOUNT PAID
ZF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDZTZONAL ZNTEREST.
ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT" (CR), YOU HAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. )
110.62
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
116.qq
.00
.00
.00
PURPOSE OF
NOTICE:
To fulfill the requirements of Sect[on 2140 of the Inheritance end Estate Tax Act, Act 23 of 2000. (72 P.S.
Sect[on 91q0).
PAYNENT:
REFUND (CR):
OBJECTIONS:
ADNIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Detach the top portion of this Notice and submit #(th your payment to the Register of Hills printed on the
reverse side.
-- Hake check or money order payable to: REGISTER OF HILLS, AGENT.
A refund of a tax credit, which ams not requested on the tax return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-151$). Applications ere available mt the Off[ca of
the Register of Hills, any of the 23 Revenue District Offices or by calling the special Zq-haur ansaer[ng service
for fores ordering: 1-800-362-Z050; services for taxpayers eith special hearing and or spaak[ng needs:
1-800-~q7-3020 (TT only).
Any party in interest not satisfied aJth the appraisement, alloeance, or disalloeence of daduct[ons or assessment
of tax (including discount or interest) ms shown on this Notice may object a[thin sixty (60) days of receipt of
this Notice by:
--aritten protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 171Z8-1OZ1; OR
--electing to have the eattar determined at the audit of the account of the personal representative, OR
--appeal to the Orphans' Court
Factual errors discovered on this assessment should be addressed in erit[ng to: PA Department of Revenue,
Bureau of Individual Taxes, ATTR: Post Assessment Ray(em Unit, DEPT. 280601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. Sea page 5 of the booklet "Instructions for Inheritance Tax Return far a Resident
Decadent" (REV-IS01) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the decadent's death, a five percent (52)
discount of the tax paid [s allowed.
The 1SI tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and nat
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the sase manner end in the the same time period as you mould appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, ar nine (9) months and one (1) day
from the date of death; to the date of payment. Taxes mhich became delinquent before January 1, 1982
bear interest mt the rata of six (62) percent par annum calculated et a daily rate of .00016~.
All taxes ehich became delinquent on or after January 1, 1982 will bear interest et a rate ahich mill vary from
calendar year to calendar year eith that rate announced by the PA Department of Revenue. The applicable
interest rates for 1982 through 2002 are:
Year Interest Rata Daily Interest Factor Year Interest Rate Daily Interest Factor
1982 ZOZ .000ERE 1992 92 .OOOZq7
1983 16Z .000~38 1993-199~ 72 .000192
198q llZ .000501 1995-1998 9X .0002~7
1985 13Z .000356 1999 72 .000192
1986 IOZ .00027q 2000 az .000219
1987 92 .OOOZq7 ZOO1 92 .OOOZq7
1988-1991 lIE .O0030X 2002 62 .00016~
--Znterast [s calculated as folloes:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DALLY 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 shown on the
Notice, additional interest must ba calculated.
Name of Decedent:
Date of Death:
STATUS REPORT UNDER RULE 6.12
Will No.: Admin. No.: ~00 a ,---C~ I ~ /
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 ['-] No ~
2. If the answer is No, state when the personal represen, tafive~reasqnably believes
that the administration will be complete: _~ I I~ IC~ q
3. If the answer to No. 1 is Yes, state the following:
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 [-] No [-]
Co
Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the Orphans' Court
and may be attached to this report.
Signature
Address u \
Telephone No.
Capacity: [-] Personal Representative
/~l"Counsel for personal representative
JRD/June30, 1992/17858
JAN 1 2 2005 ..~
JrY
In Re: Estate of George Edward Myers
Late of North Newton Township
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
Estate No.: 21-02-0131
NO. 21-02-0131
NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A
HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE
Personal Representative: Patricia Myers
Counsel for Personal Representative: H. Anthony Adams, Esquire
Date of Decedent's Death: 12/29/2001
Date of Delinquency Notice: 01110/2005
The undersigned, Glenda Farner-Strasbaugh, Clerk of Orphans' Court, in accordance
with Rule 6.12, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court
Division, Court of Common Pleas of Cumberland County, that neither the above named personal
representative nor the above named counsel for the personal representative have filed with the
Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule
6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12,
Supreme Court Orphans' Court Rules, was given by the Clerk of the Orphans' Court on
November 10, 2004, and that the ten (10) day notice to file the Status Report has expired,
Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and
the undersigned requests that a Court conduct a hearing to determine whether sanctions should
be imposed upon the delinquent personal representative or counsel for the delinquent personal
representative.
Date: 01113/2005
.&m4 l~-'J~~~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
Distribution:
Personal Representative
Counsel for Personal Representative
Estate File
'YWu-Lcl.t.. 1t 1 'l 00 Iii q;:so 1\ ""
A hearing is scheduled for at in Courtroom No.3. If the Status Report is filed prior to
the hearing date, the hearing will automatically be cancelled.
uJ
.'
,^
.
.
Register of Wills of Cumberland County
STATUS REPORT UNDER RULE 6.12
Name of Decedent: free- ~I f? J:!;) lA )~c0
Date ofDeath: Id I d or I 0 (
Estate No.: ~ \- D;:+~ 0 13 (
~ '-\ e .cs,
\
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:
I. Stat~ther administration of the estate is complete:
Yes)!l.(, No 0
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. I is Yes, state the fo\lowing:
a. Did the personal representative file a final account with the Court?
Yes 0 No 0
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the perso~epresentative state an account informally to the parties in
interest? Yes ~ No 0
c. Copies of receipts, releases, joinders and approval of formal or informal
accounts may be filed with the Clerk of the Orphans' Court and may be
attached to this report.
~~
Date:~0
Signature
c
_.l\ ~~nv-- ~v'6
Name\{q W o-.r~ e S~
~W- ~
Address ( ~ e N 'S '-0 v'r~ \ ~.
r; n - S"");+ ~ '<:,~ '-76
Telephone No.
""-
I~"
Capacity: 0 Personal Representative
o Counsel for personal representative
cA
0.00 X _(15) 0.00
0.00 X _(16) 0.00
0.00 X .12 (17) 0.00
0.00 X .15 (18) 0.00
(19) 0.00
REV-1500 EX + (6-00)
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
'*
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENT'S NAME (LAST, FIRST. AND MIDDLE INITIAL)
I-
Z
W
C
W
o
W
C
Edward
M ers Geor e
DATE OF DEATH (MM-DD-Year)
DATE OF BIRTH (MM-DD-Year)
12/29/2001 08/31/1914
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
W
I-
l.: :$cn
uO::l.:
wo..u
J: 00
" O::...J
~0..1II
0..
<C
00 1. Original Return
D 4. Limited Estate
D 6. Decedent Died Testate (Attach copy of Will)
D 9. Litigation Proceeds Received
D 2. Supplemental Return
D 4a. Future Interest Compromise (date of death after 12-12-82)
D 7. Decedent Maintained a Living Trust (Attach copy ofTrust)
D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
I-
Z
W
o
z
o
0..
cn
W
0::
0::
o
U
COMPLETE MAILING ADDRESS
49 West Orange Street
NAME
H. Anthon Adams
FIRM NAME (If Applicable)
Suite 3
TELEPHONE NUMBER
717-532-3270
Shi
(1)
(2)
(3)
(4)
(5)
z
o
~
..J
::J
!:::
a..
<C
o
w
0::
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)
D 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 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
z
o
~
I-
::J
a..
:!
o
o
~
I-
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20. D
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> >SE SURE TO ANSWER ALL QUESTIONS Of{?"REVERSE SIDE AND RECHECK MATH < <
9:.
OFFICIAL USE ONLY
FILE NUMBER
2 1 -0 2 0 3 1
COUNTv"'C'ODE ---vEArr-- - - NUMBER- -
SOCIAL SECURITY NUMBER
2 04- 0 3 - 2 363
THIS RETURN MUST BE FilED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
D 3. Remainder Return (date 01 death prior to 12-13-82)
D 5. Federal Estate Tax Return Required
_ 8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
PA 17257
OFFICIAL USE ONLY
),
.i~
~ ! -::
r'....:
~
(~-')
c..::.'
C~l
C)
7,234.83
---i
["'.)
c~
cc;
~
-
7,234.83
(8)
10,147.83
(11)
(12)
(13)
10,147.83
-2,913.00
(14)
-2,913.00
....c\,cucln o:t VUIII",IClC ,",UUIC:>>:>>;
STREET ADDRESS
15 Beidler Drive
CITY I STATE I ZIP
Shippensburg PA 17257
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
0.00
Total Credits (A + B + C)
(2)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
4.
Total Interest/Penalty ( 0 + E)
If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund
If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(3)
0.00
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check
(4)
(5)
(5A)
(5B)
to: REGISTER OF WILLS, AGENT
0.00
0.00
5.
0.00
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; ........................................................................... 0 00
b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 00
c. retain a reversionary interest; or ...................................................................................................... 0 00
d. receive the promise for life of either payments, benefits or care? ............................................................. 0 00
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?.. ............................ ..................................... ........... ... ............. 0 00
3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ................. 0 00
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ....................................................................................................... 0 00
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 knowledge.
SIGNATU E OF,PERSON RESPONSIBLE FOR FILING RETURN DATE
"Ii-; .. < " 11')' 0 I
tLJ..J......-. ------<_,) '-"- A..L--/
ADDRESS
(() - ~ ,; -0<.0
SIGNATURE OF PRE PARER OTHER THAN REPRESENTATIVE
DATE
ADDRESS
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to orlor the use of the surviving spouse is 3%
[72 P.S. ~9116 (a) (1.1) (in.
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.
REV-1508 EX + (6-98)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Myers.
George
FILE NUMBER
Edward 21 02
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
0131
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
1,015.00
Northern Trust Company
Benefit Payment for Corrail Pension
2.
Hub City; VFW; Volunteer Relief Death Benefits
900.00
3.
Refund from automobile Insurance
300.00
4.
Irrevocable Burial Trust of George Myers
Orrstown Bank
5,019.83
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
7,234.83
Kt:V-10ll t:iI. + ll~-i:li:l)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Myers.
FILE NUMBER
George
Edward
21
02
0131
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Fogelsanger Bricker Funeral Home (paid by Burial Trust) 5,019.83
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees
3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) 1,500.00
Claimant Patricia Myers
Street Address 15 Beidler Drive
City Shippensburg State P A Zip 17257
Relationship of Claimant to Decedent daughter
4. Probate Fees 59.00
5. Accountanfs Fees
6. Tax Return Pre parer's Fees
7. Shippensburg Healthcare Center (nursing home care for last illness) 3,569.00
TOTAL (Also enter on line 9, Recapitulation) $ 10,147.83
(If more space is needed, insert additional sheets of the same size)
'~~"""'l_
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
M G
FILE NUMBER
Ivers eorae Edward 21 02 0131
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. Patricia J. Myers Lineal
15 Beidler Drive 1/3
Shippensburg, PA 17257
2. Charles E. Myers Lineal
325 East Garfield Street 1/3
Shippensburg, PA 17257
3. Randy Lee Myers Lineal
129 Centerville Road 1/3
Newville, PA 17241
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
..
(If more space IS needed, Insert addlllonal sheets of the same size)
Glenda Farner Strasbaugh
Register of Wills
and
Clerk of Orphans' Court
Marjorie A. Wevodau
First Deputy
Kirk S. Sohonage, Esq
Solicitor
Register of Wills and Clerk of the Orphans' Court
County of Cumberland
One Courthouse Square
Carlisle, PA 17013
(717) 240-6345
FAX (717)240-7797
INVOICE
Bill To:
InvoiceNo:
Invoice Date:
Estate of:
Estate No:
1109
10/26/2006
MYERS GEORGE EDWARD
21-02-0131
H. I\.NTHONY ADAMS, ESQ
49 W. ORANGE ST
SUITE 3
SHIPPENSBURG, P A 17257
ajW
Qty
1
Fee Description
Additional Probate
Fee
Total
15.00
$15.00
Total:
$15.00
Checks should be made payable to the Register of Wills. Terms: Net 30.
Please return one copy of this invoice with your payment. Thank you.
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BUREAU OF INDIVIDUAL
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
TAXES RECORDED O~~~~MENT, ALLOWANCE OR DISALLOWANCE
I rnlut MDUCTIONS AND ASSESSMENT OF TAX
P[(\I(,liT::
~ i tJ <...1 jll~' '''I
REV-1547 EX AFP (06-05)
DATE 12-11-2006
ESTATE OF MYERS GEORGE E
DATE OF DEATH 12-29-2001
FILE NUMBER 21 02-0131
COUNTY CUMBERLAND
ACN 1 0 1
APPEAL DATE: 02-09-2007
( See reverse side under Objections)
A.ount Re.lttedl I
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 (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MYERS GEORGE E FILE NO. 21 02-0131 ACN 101 DATE 12-11-2006
2006 DEe, 5 AM II: 32
H ANTHONY
STE 3
49 W ORANGE ST
SHIPPENSBURG
CLERK OF
ORP!-!M",S "(1: IRT
ADAM,S I I "'>", , ".",.",)i I
LI"-'-~ ',"
v .1"'" '.'
PA 17257
TAX RETURN WAS: (X) ACCEPTED AS FILED
) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
Closely Held Stock/Partnership Interest (Schedule C)
Mortgages/Notes Receivable (Schedule D)
Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8.
1. Real Estate (Schedule A)
2.
3.
4.
5.
Total Assets
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
7,234.83
.00
.00
(8)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
Stocks and Bonds (Schedule B)
APPROVED DEDUCTIONS AND EXEMPTIONS:
7,234.83
9.
10.
11.
12.
13.
14.
Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
Debts/Mortgage Liabilities/Liens (Schedule I)
Total Deductions
Net Value of Tax Return
(9)
(10)
10,147.83
.00
(11)
(12)
(13)
(14)
In.]47.8~
2,913.00-
.00
2,913.00-
Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
Net Value of Estate Subject to Tax
NOTE: If an assess.ent was Issued preViously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that Include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15) .00 X 00 .00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) .00 X 045 = .00
17. Amount of Line 14 at Sibling rate (17) .00 X 12 = .00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 = .00
19. Principal Tax Due (19)= .00
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00 r ~
\
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN *1, NO PAYMENT IS REQUIRED. '~
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)