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Home My WebLink About02-0155Register of Wills of CumberlandCounty, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of also known as CASEY E. CASSEL , ,. Deceased Social Security No. 162-60-1239 (COMPLETE "A" OR "B" BELOW:) A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut Decedent, dated and codicil(s) dated named in the Last Will of the 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: B. Grant of Letters of Administration 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 Robert C. Cassel Father Tanya K. Cassel (COMPLETE IN ALL CASES:) Attach additional., Mother beets if necessary, Decedent was domiciled at death in Cumberland residence at 23 Adams Street, Enola. PA Decedent, then 22 years of age, died December Residence 23 Adams g~.: Rnnl~ PA ?g Ad~m~ qw P.~I~ PA County, P~_.nnsylvaniar.~with ]~tyr last family or principal 17025 7. 2Q01~,at Holy Splvl~ Hospltal Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property .............................. $ 1 ~ 000 . 00 (If not domiciled in PA) Personal property in Pennsylvania ...................... $ (If not' domiciled in FA) Personal property in County .......................... $ Value of real estate in Pennsylvania ............................................... $ 10 ~(.)00.00 Total .............................................................. $ 11 , 000,00 Real Estate situated as follows: 2~ A(i~m.~ ,c;t .: F,,~,~l~ ~ PA 17025 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: 1702~ 1702: Signature Typed or printed name and residence Robert C. Cassel 23 Adams Street Enola, PA 17025 RW-7 Iq-Nl-II) Oath of Personal Representative Commonwealth of Pennsylvania County of The Petitioner(s) above-named swear(s) and affirm(s) that the statements in t,~he~f, oregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal '---~-~senti~ve(s)= .. Q3~ Decedent, Petitioner(s) will well and truly administer the estate according to law. :~ ~. ~ ",'~' ~ Sworn to and affirmed and subscribed before me this 7th day of FEBRUARY 2'302 ROBERT C CASSEL~!i' :: Cfi · Estate of also known as DECREE OF REGISTER CASEY E. CASSEL Deceased No. 21 -02-155 Social Security No: 162-60-1239 Da{e of Death: December 7, 2001 AND NOW, FEBRUARY 11 , 2002 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters [] Testamentary ~ of Administration are hereby granted to Robert C. Cassel in the above .estate and that the instrument(s), if any, dated described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters ........................... $ 50.00 Short Certificate(s) ...... 3.2. $ Renunciation .................. $ Affidavit ( ) ................. $ Extra Pages ( ) ............ Codicil .......................... JCP Fee ........................ Inventory & Tax Forms... Other ............................ ~6_00 5.00 5.00 TOTAL ................ $ 96.00 mailed to admin, on 2-11-02 ' -"MARY C -LEW~S ' / Register of Wills Attorney: Diane S. Baker, Esquire I.D. No: 53200 Address: 27 S. Arlene St., P.O. Box 6443 Harrisburg, PA 1711'2-0443 Telephone: (717) 671-9600 FEBRUARY 7, 2002 DATE FILED: 21-02-155 Register of Wills Of Cumber!and County, Pennsylvania Renunciation In Re Estate of CASEY E. CASSEL deceased. The undersigned Tanya K. Cassel of the above decedent· hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters of Administration be issued to Robert C. Cassel WITNESS ~7 hand this ~I~' day of (my, xotlcx) · 2002 23 Adams Street, Enola, PA 17025 (Address) (Signature) (Address) (Signature) (Address) (Signature) (Address) {Signature) (Address) Dhte Filed 2W_z3NOTE - Please have signature(s) notorized if signed outside Register of Wills office 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 permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 ~_~o_,,, ,,,~9 ~;~f~..4..~.~,~r.,.~-..~. ~ Local Registrar ~' No. ~ Date COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH ~oF ~ ; ~ , 2-2-1979 ,Harrisburg, PA ~ ~ .... = == I . . ~ o~. I~.~ w ~,-~. ~ ~,,~ ~, ~ ~ ......... i · and E. Pennsboro ~ . ~.~~ ~ ~u~ ,z,.~ ,~,.~ . - ~ast Pennsboro To, ship 23 Adams Street ~ ~ ~ ,t Enola, PA 17025 J~' Robert C. Cassel I I"* Tanya K. Englebright Robert C. Cassel [~.zo a~ums Street, Enola, PA 17025 ~m~e~ I~~. ~y. ~) Cremat 1on Society ~ ~ ~J,,~December 12, 2001 ~ ' · [,,~ of Pennsylvania ~,,~ Harrisburg, PA 17109 ~ ~ ~ ~. ~ 013376-L ] .... Zi~erman-Auer Funeral Home ~.41OO Jonesto~ Road~ Harrisburg~ PA 17109 ~-~-- J~"~'~) I~"~"~" '--'*~-~-- ~i~- -- - I I ~ AU~SY I~ AU~ F~m~S ~ ........ ~ OF ~ATH · J I~'' ~ "~,-. ~ I I I ~ m ~ o I · · .' · · .......................... L, 21-02-155 INRE: ESTATE OF CASEY E. CASSEL, DECEASED BEFORE THE REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA NO.2002-00155 CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) NAME OF DECEDENT: CASEY E. CASSEL TO THE REGISTER: I certify that notice of beneficial interest required under 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 November 26, 2001: Tanya K. Cassel 23 Adams Street Enola, PA 17025 Robert Cassel 23 Adams Street Enola, PA 17025 Notice except: none DATE; has now been given to all _ ,~ e 5.6(a) ~'"'~ane S. Baker, Esquire 27 South Arlene Street ~ P.O. Box 6443 Harrisburg, PA 17112-0443 717-671-9600 Counsel for Personal Representative ' k-'~k.. " COMMONWEALTH OF ' ~ PENNSYLVANIA · 1~~~1, DEPARTMENT OF REVENUE ,~'~l"~_~'j~,,~'~'~ DEPT. 280601 ~~,~.~ HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY /7-'//- /2 FILE NUMBER 21 - 02 0155 I- Z UJ LU ~:~oo, fl. I- Z LLI Z o LLI o COUNTY CODE YEAR NUMBER DECEDENT'SNAME(LAS~FIRS~ANDMIDDLEINITIAL) CASSEL, Casey E. D~EOFDE~H(MM-DD-YEAR) D~EOFBIRTH(MM-DD-YEAR) December 7, 2001 February 2, 1979 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 162- 60 -1239 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER ~-~1. Odginal Return r-j4. Limited Estate J-~6. Decedent Died Testate (Attach copy of Will) ~]9. Litigation Proceeds Received r~2. Supplemental Return ~--] 4a. Future Interest Compromise (date of death after 12-12-82) L---J7. Decedent Maintained a Living Trust (A~ch copy of Trust) L---'-~ 10. Spousal Poverty Credit (date of death belween 12-31-91 and 1-1-95) ~--] 3. Remainder Return (date of death prior to 12-13-82) ---]5. Federal Estate Tax Return Required 0 8. Total Number of Safe Deposit Boxes ~---] 11. Election to tax under Sec. 9113(A){Attach Sch O) NAME Diane S. Baker, Esquire FIRM NAME (IfApplicable) TELEPHONE NUMBER (717) 671-9600 COMPLETE MAILING ADDRESS 27 S. Arlene Street P.O. Box 6443 Harrisburg, PA 17112-0443 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) --]Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) (1)$67,150.00 (2) (3) (4) (5) $ 9,678.56 (6) (7) - 0 - (9) $11 ,020.21 (10) $68,841.48 OFFICIAL USE ONLY 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) (8) $76,828.56 (11) $79,861.69 (12) $( 3,033. 13) (13) (14) - 0 - SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 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. x .12 x .15 (15) (16) (17) (18) (19) -0- Decedent's Complete Address: . ISTREETADDRESS 23 Adams Street, Estate of ,C.a.~sey E. Cassel 23 Adams Street _Enola ~_~.PA 17025 c PRO. Ty 23 A.dams Street Cumberland D VALUATION DATA ~%~ ~,,,:,,~%~, ....... _..~7, ~0.00 E ----.~. ~,, ,~me, ~. bP directed ta the Foll'ow~' Diane S Baker ~ .... --" T.~ ~7 S. Arlene St.~ P.O. Box 64~ ~ .... ~ ~ ~j..c~:F.( 717 ] 671-9600 7,;; -- -~.q~T,~ ....... N~y_ 30. ~._ _ Robert C. Cassel and Ta~ya K. ~ssel -~ .-~Ad~ms Str~t Eno~ pA 17025 ..~as t Pennsboro ..1.09-15-1291-293 EXEMPTION DATA ...... 00% 2002-00155 "' I'B';-...:' ~ ............ [11 tOfl~mnnl~an or ;n lie~ O[ condemnal;o., olluzJ~ copy OI re~O~Ul;on.{ · REV-1508 EX + (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF CASSEL, Casey SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21-02-0155 Include the ITEM NUMBER )mceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of surv/vorshi ~ must be disclosed on Schedule F. DESCRIPTION 1996 Chevrolet Blazer Member's First Federal Credit Union No. 176892-00 Member's First Federal Credit Union No. 193600-00 Miscellaneous Household Possessions Erie Insurance, Refund of Homeowner's Policy Savings Account Savings Account TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH $ 9,000.00 $ 29.72 $ 26.84 $ 500.00 $ 122.00 $9,678.56 Membersl FEDERAL CREDIT UNION INSURANCE DEPARTMENT 5000 Louise Drive P. O. Box 40 Mechanicsburg, PA 17055 1-800-283-2328 or (717) 697-1161 REGULAR SAVINGS ACCOUNT: Account Number/Suffix Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Interest Earned from 1/1/02 to Date of Death Name of Joint Owner 176892 -00 193600 -00 06/30/1998 05/11/2000 $29.72 $26.84 $.0o $.oo $29.72 $26.84 $.00 $1.62 None None ~E~AL CREDIT UNION Denise A. Anders Insurance Products Supervisor May10,2002 Estate of: CASEY E. CASSEL Date of Death: 12/07/2001 Social Security Number: 162-60-1239 R~-1510 EX * (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER CASSEL, Casey E. 21-02-0155 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY % OF ITEM INCLUDETHE NAMEOFTHETRANSFEREE, THEIRRELATIONSHIPTO DECEDENTANDTHE DATE OETRANSFER. DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE NUMBER ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST {IF APPLICABLE) 1. Medco Cash Balance Retirement Plan $1,518.71 100% 100% 0 TOTAL (Also enter on line 7, Recapitulation) $ 0 (If more space ~s needed, insert additional sheets of the same size) MEDCO CASH BALANCE RETIREMENT PLAN OPTION ELECTION FORM Section 1: GeneralInformation BASIC DATA: BENEFICIARY INFORMATION: Name: CASSEL, CASEY E Beneficiary Name N/A Pay Code: LLPAI Relationship: N/A Social Security Number: 162-60-1239 Beneficiary Date of Birth: N/A Date of Birth: 02/02/1979 Date of Employment: 12/16/1996 Vested Percentage: 100% Years of Vesting Service: 3 Date of Death: 12/07/2001 NOTE: This Option Election Form is not valid if any of the information above is incorrect. Please contact Employee Services at 1-800-255-5794 to report any corrections. A new Option Election Form will be sent to yon shortly. Section 2: Benefit Option Election (Please initial option elected and sign Section 4 below) Based on the above information, we have calculated your retirement benefits payable on06/01/2002as follows: Since your benefit is under $5,000, your only option is to receive a lump sum benefit. NOTE: if we do not receive an election form from you within 60 days, your account balance,' less applicable tax withholding, will be automatically paid to you in a lump sum. LUMP SUM BENEFIT A single sum payment representing the full value of your benefit. $1,518.71 This will be the only payment made from the Plan. Benefits will be paid as soon as administratively feasible after06/01/2002 Page I 05/23/'2002 REV-15,11 EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER CASSEL, Casey E. 21-02-0155 ITEM NUMBER Debts of decedent must be reported on Schedule ]. DESCRIPTION FUNERAL EXPENSES: Zimmerman-Auer Funeral Home ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Year(s) Commission Paid: Zip Attorney Fees Diane S. Baker, Esquire Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Robert and Tanya Cassel~ Street Address 23 Adams Street City Enola State PA Relationship of Claimant to Decedent Father and Mother Probate Fees Accountant's Fees Tax Return Preparer's Fees Carlisle Sentinel, advertising cost Cumberland Law Journal, advertising cost __Zip 17025 TOTAL (Also enter on line 9, Recapitulation (If more space is needed, insert additional sheets of the same size) AMOUNT $6,100.74 $1,200.00 $3,500.00 $ 96.00 $ 48.47 $ 75.00 $11,020.21 REV*IS12 EX * 11-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX EETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER CASSEL, Casey E. 21-02-0155 Include unreimbursed medical expenses. ITEM NUMBER 2. 3. 4. 5. 6. 7. DESCRIPTION Acct. NO. 1931780560 Chase Manhattan Mortgage, mortgage on residence Mellon Bank (debt on car) Gateway computer, Account No. 601176970000700 Chase Mastercard, Account No. 5260311230308805 Holy Spirit Hospital Internal Revenue Service, 2001 taxes Internal Revenue Service, 2000 taxes AMOUNT $56,684.44 $ 9,011.29 $ 1,272.45 $ 1,330.92 $ 95.34 $ 418.00 $ 29.04 TOTAL (Also enter on line 10, Recapitulation) $6 8,8 4 1 . 4 8 (If more space is needed, insert additional sheets of the same size) ~REV-1513 EX + ~1-97), ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NUMBER H. SCHEDULE J BENEFICIARIES CASSEL, Casey E. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions) Robert C. Cassel 23 Adams Street Enola, PA 17025 Tanya Cassel 23 Adams Street Enola, PA 17025 FILE NUMBER 21-02-0155 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE Father Mother 50% 50% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET 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 [! - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) ATTORNEY AT LAW POST OFRCE BOX 6443 27 SOUTH ARLENE STREET HARRISBURG, PA 17112-0443 (717) 671-9600 FAX (717) 671-9601 DSBAKERLAW¢}aol.com October 16, 2002 Register of Wills Cumberland County Court House One Courthouse Square Carlisle, PA 17013 Estate of Casey E. Cassel No. 2002-00155 Dear Sir or Madam: Enclosed please find an original and two copies of an Inheritance Tax Return regarding the above-referenced estate. Please file the original, time-stamp the copies and return one copy to me in the self-addressed, stamped envelope which I have also enclosed. Thank you .for your cooperation. If you have any questions, please feel free to contact me. , ¥~ truly~.o.~rs, DSB:lsf Enclosure Cc: Robert C. Cassel 0 0 ~ Register of Wills Of CumberlandCOunty, INVENTORY Pennsylvania Estate of Casey E. Cassel No. 21-02-0155 also known as Date of Death December 7, 2001 , Deceased Social Security No. 162-60-1239 Personal Representative(s) of the adore Estate, deceasea, vemtV that the ~tems appearing ~n the tollowm§ inventory mclucle ail ,Jr [he personal assets wherever s~tuate and all of the real estate ~n the Commonwealth of Pennsylvama ol sa~d OeceQen[, ~he valuation Dlaced oPDoslte each ~em of smd ~nven~orv reDresen[s ~S fmr value as pt the date of ~he OeceQen~'s ~ea~n, and that Oeceden~ owneQ no real estate outside o¢ the Commonwealth of Pennsvlvama except that wmcn appears ~n a memoranQum at the end of this inventory. I/We VerlfV that the statements maae in this Inventory are true and correct. I/We unaers[anQ [alse statements herein are made sublect to the penalties of 18 Pa, C.S. Section 4904 relating to unsworn lals~flcabon ~o Attorney: Diane S. Baker, Esquire Robert C. Cassel ~.O. No.: 53200 23 Adams Street -Eno!a ~ PA 17025_ ~,Jc~ress: ')v e z,.,,.-~^ e~.-,^..,- 0~,~ October 24, 2002 P.O. Box 6443 Harrisburg, pA 17112-0443 ~ ~ ~~_ r~.,ephone: 717-671-9600 ._ 1. 23 Adams Street, Enola, PA 17025 2. 1996 Chevrolet Blazer 3. Member's First Federal Credit Union Account No. 176892-00 4. Member's First Federal Credit Union Account No. 193600-00 5. Miscellaneous Household Possessions 6. Erie Insurance, Refund of Homeowner's (Attach Addmonal Sheets ~f necessaryl Savings Savings policy $ 67,150.00 $ 9,000.00 $ 29.72 $ 26.84 $ 500.00 $ 122.00 Total: 76,828.56 '~, BUREAU OF ZNDZVZDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 DIANE S BAKER 27 S ARLENE ST PO BOX 6443 HBG PA 17112 COHHON#EALTH OF PENNSYLVANZA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOHANCE OR DZSALLOHANCE OF DEDUCTIONS AND ASSESSHENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUHBER COUNTY ACN 12-10-2002 CASSEL 12-07-2001 21 02-0155 CUNBERLAND 101 Amount RemJ. ttad CASEY E HAKE CHECK PAYABLE AND REHZT PAYNENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLONANCE OR ESTATE OF CASSEL DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX CASEY E FILE NO. 21 02-0155 ACN 101 DATE 12-10-2002 TAX RETURN HAS: (X)* ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE ( ) CHANGED APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schmdula A) 2. Stocks and Bonds (Schmdula B) 3. Closely Held Stock/Partnarsh/p Zntarest (Schedule C) 4. Hortgagas/Notes Receivable (Schedule D) 6. Cash/Bank Daposits/Hisc. Personal Property (Schedule E) 6. Jo/ntly Owned Property (Schmdule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTZONS AND EXEHPTZONS: 9. Funeral Expansas/Adm. Costs/Hisc. Expanses (Schedule H) 10. Debts/Hortgagm L/ab/1/t/ms/Liens (Schedule 1) 11. Total Deductions 12. Net Value of Tax Return 15. 14. (1) 67,,150.00 (~') .00 ($) .00 (4) .00 (5) 9~,678.56 (6) .00 (7) .00 NOTE: To /nsura proper credit to your account, subm/t thm upper port/on of this form w/th your tax Payment. 76,828.56 11,020.21 (;) (10) 68~841 (11) (12) Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) Nat VaZue of Estate Sub,act to Tax (14) 79.8~1.~ 3,033.13- .00 3,033.13- ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. DXSCOUNT XNTEREST/PEN PAZD (-) AHOUNT PAID (19)= .00 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 .00 .00 .00 ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS RE{IUXRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR ZNSTRUCTZONS.) TAX CREDITS: PAYMENT DATE RECEZPT NUHBER NOTE: Zf an assessment was issued previously, 11nas 14, 15 and/or 16, 17, 18 and 19 will reflect flgures that lnclude the totaZ of ALL returns assessed to date. ASSESSHENT OF TAX: ' 15. Amount of L/ne 14 at Spouse/ rata (15).. . O0 X O0 = . O0 16. Amount of L/ne 14 taxabZa at LineaX/Class A rata (16) . O0 X OEf5 = . O0 17. Amount of L/ne 1~ at Sibling rate (17) .00 X 12 = . O0 18. Amount of L/ne lq taxable at CoXlateral/Class B rata (18) .00 X 15 : O0 19. Principal Tax Due ' RESERVATION= Estates of decadents dying on or before December 1Z, 198Z -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise end assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such futura interest. PURPOSE OF NOTICE: To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act 25 of ZOO0. (72 P.S. Section 9140). PAYNENT: Detach the top portion of this Notice and submit eith your payment to the Register of Mills printed on the reverse side. --Hake check ar money order payable to: REGISTER OF NILES, AGENT REFUND (CR): A refund of a tax credit, which was nat requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISIS). Applications ara available at the Office of the Register of Hills, any of the Z5 Revenue District Offices, or by calling the special Z4-hour ansearing service for fores ordering; 1-800-56Z-ZOSO; services far taxpayers with special hearing and / or speaking needs: I-BOO-447-50ZO (TT onlY). OBJECTXONS: Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as sheen on this Notice must object within sixty (60) days of receipt of this Notice by: --erJttan protest to the PA Department of Revenue, Board of Appeals, Dept. ZBIOZ1, Harrisburg, PA 171ZB-IOZX, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. ADNIN- XSTRATIVE CORRECTIONS: Factual errors discovered on this assessment should ba addressed in writing to: PA Department of Revenue, Bureau of XndividuaX Taxes, ATTN: Post Assessment Review Unit, Dept. ZB0601, Harrisburg, PA XT1ZB-0601 Phone (7[7) 787-6505. Sam page S of the booklet "Instructions for Xnharitanca Tax Return for a Resident Decadent" (REV-lEO1) for an explanation of administratively correctable errors. DISCOUNT: Xf any tax due is paid within three (3) calendar months after the decadant's death, a five percent (51) discount of the tax paid is aXlowad. PENALTY: The 15Z tax amnesty non-participation panaXty is computed on the total of the tax and interest assassad, 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 with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes ehich became delinquent before January I, 198Z bear interest at the rate of six (el) percent par annum calculated at a daily rate of .000164. AXX taxes which became delinquent on and after January l, [98Z will bear interest at e rate which will vary free caXandar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1952 through ZOOZ ara: Year Intarmst Rate Daily Interest Factor Year xeBz ZOZ .000548 X99Z 1983 16Z .000458 1993-1994 1954 llZ .000501 1995-1998 1985 13X .000556 1999 1986 102 .000274 2000 1987 92 .000247 ZOOX 19BB-199! llZ .000501 ZOOZ --Interest is calculatad as follows: Interest Rate Daily Interest Factor 92 .000247 7Z .O0019Z 9Z ,000247 72 .O00Zgz 82 .000219 9Z .000247 6Z .000164 INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELI'NQUENT X DA~LY ~'NTEREST 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 sho~n on the Notice, additional interest must be calculated. STATUS REPORT UNDER RULE 6.12 Name of Decedent: CASEY E. CASSEL Date of Death: December 7, 2001 Will No. 21 02-0155 Admit. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: State whether administration o~ 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 .... · ~ .urt 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, r~~oinders and approvals of formal,or informal accou~e' fi~ed with the Cerk of the Orphans Court and~~a~this report. Date: Jan~'ary 2, 2003 · ( MAH: rm£ ,"AM3 ) Diane S. Baker, Esquire Name (Please type or print) 27 S. Arlene Street, P.O. Box 6443 Address ~jjHarrisburg, PA 17%12-0443 _ ) Tel. No. 717-671-9600 Cdpacity: __Personal Representative X Counsel for personal representative RW-27