HomeMy WebLinkAbout02-0162PETITION FOR PROBATE and GRANT OF LETTERS
Estate of CLYDE J. PEFFER No. 21-02-162
also known as To:
Deceased.
Social Security No. 19 8 - 2 2 - 8 '19 0
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut rix
in the last wilt of the above decedent, dated February 12
and codicil(s) dated
Register of Wills for the
County of CUMBERLAND
Commonwealth of Pennsylvania
in the
named
2001
Decendent, then 71 years of age, died
at 3309 Mdrket St., Camp Hill,
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in Cumberland County, Pennsylvania, with
is last family or principal residence at 3309 Market Street
Camp Hill Borough
(list street, number and muncipality)
January 13, 2002
PA ' '
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 adjudicated
incompetent:
Decendent at death owned property with estimated values as follows:
(If domiciled i.n 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:
165,000.00
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
pre~ented herewith and the grant of letters
theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
ene C. Pe'f~er f//
3309 Market St/ F
Camp Hill, PA 17011
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA 3
COUNTY OF CUMBERLAND; SS
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 k~owledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed ~_.~.~_~ C?, ~~ ~
before me this S th ~a~0°~ r
Febr~uary
'>' ! · -/ ''-' R;gis~er
Irene C. Peff~F
No. 21-02-162
Estate of CLYDE 0. PEFFER Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW FEBRUARY 13 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 February 12, 2001
described therein be admitted to probate and filed of record as the last will of
Clyde J. Peffer ;
and Letters Testamentary
are hereby granted to Irene C. Peffer
FEES
Probate, Letters, Etc .......... $. 235.00'
Short Certificates( ) $ i°~. 00
K-pages
enunciation ................ $
JCP $. 5.00
TOTAL__ $ 258.00
Filed .. FF.3.. l&,. 20~2 .................
Edmund G. Myers (20558)
Johnson, Duffie, Stewart & Weidner
A~ORNEY (Sup. Ct. I.D. No.)
301 Market St., P. O. Box
Lemoyne, PA 17043-0109
ADDRESS
(717) 761-4540
109
PHONE
t t: Eld B- t:13J Z0.
I05g0S P,Z~V 9/g6
This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent "filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
P 8010475
No.
21-02-162
Local Registrar
COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF HEALTH * VITAL RECORDS
CERTIFICATE OF DEATH
· · ~ ~ ~ zz 8190 I Janua~ zuo2
'-----~ ' ---- [" ?' -- -- I"
71 ~ / : , Apr 5 1930 Harrsburg ITZ% ~... ~ ~n I~
Cumberland / Camp Hill I 3309 Market Street l m~ ~,. ~ I,~,,, Whit
3309 Market Street I~u.~ ~.. s~.,.~ ~ ~..~ ~
Camp H~II, Pennsylvania 17011 J(~ Cumb~rl~_. ~. .....
. i~0,..,~,~ ~ ~,,u -~ ~.~ oamp Mill
Clyde J. Peffer St. ] ~' "" ~"~'"~'~ Elizabeth Kassen
...... .s ....~ ......, IrengC. Peffer ',l,~.'s ~ ~~~, pa
17011
ii ~s~,.~ ~ ...... s,.,.~ [~[ ....... a~n ~s, 2002 [~'~' ConoIRe Cremato~ 8cbme~erstown, Pa ~7088
~= .. f ~; ~ .... [ PO-OlZ/bb-L I ~rs Funeral Home Inc 37 East Main Streel Mechanicsburg Pa 17055
~, ~ m,~,. / ~~i~E ~ ......................... ~ ..............
.... ~-. I. ~ I~ --..~
099999-O0013/2/12/O1/EGM/KLT/143137.1
21-02-162
· aat lill aah stam mt
OF
CLYDE J. PEFFER
I, CLYDE J. PEFFER, of Camp Hill, Cumberland County, Pennsylvania, being of sound
and disposing mind, memory and understanding, do hereby make, publish and declare this as and
for my Last Will and Testament, hereby revoking and making void any and all Wills or Codicils at
any time heretofore made by me.
ARTICLE I
DEBTS
I direct the payment of all my legal debts, and the expenses of my last illness and funeral
from my Estate as soon after my death as conveniently may be done.
ARTICLE II
TANGLE PERSONAL PROPERTY
I give and bequeath my motor vehicle(s), household goods and personal effects and other
tangible personalty of like nature (not including cash or securities), together with any existing
insurance thereon, unto my wife, IRENE C. PEFFER, provided she survives me.
ARTICLE III
REST, RESIDUE AND REMAINDER
I give, devise and bequeath all the rest, residue, and remainder of my Estate, of whatsoever
nature and wheresoever situate unto my wife, IRENE C. PEFFER, provided she survives me.
099999-00013/2/6/01/EGM/KLT/143137.1
ARTICLE IV
ALTERNATE DISPOSITION OF REST, RESIDUE AND REMAINDER
If my wife, IRENE C. PEFFER, predeceases me, I give, devise and bequeath all the rest,
residue and remainder of my estate, of whatsoever nature and wheresoever situate, as follows:
mo
One-half (1/2) thereof unto my then-living issue, per stirpes; and
One-half (1/2) thereof unto the then-living issue, per stirpes of my wife, IRENE C.
PEFFER.
ARTICLE V
UNIFORM TRANSFERS TO MINORS
In the event that any beneficiary of my Will shall not have reached the age of twenty-one
(21) years at the time for distribution of his or her share, distribution of said share may be made in
the discretion of my Personal Representative after considering the age and needs of the beneficiary,
either directly to the beneficiary or to a Custodian under the Pennsylvania Uniform Transfers to
Minors Act, 20 Pa. C.S.A § 5301 et seq., or the applicable Uniform Gifts to Minors Act or Uniform
Transfers to Minors Act in the state of residence of such beneficiary as the case may be. My
Personal Representative may designate as such Custodian any institution or person, including my
Personal Representative, qualified to act as a Custodian for such beneficiary under such Act in
effect at the time such distribution is made. A receipt for any payment or distribution so made shall
be a full discharge therefor to my Personal Representative, who shall not be responsible to see to, or
be liable for, the application of such proceeds thereafter.
2
099999-00013/2/6/01/EGM/KLT/!43137.1
ARTICLE VI
POWERS OF PERSONAL REPRESENTATIVE
My Personal Representative(s) shall have the following powers in addition to those vested
in them by law and by other provisions of my Will applicable to all property, whether principal or
income, including property held for minors, exercisable without court approval and effective until
actual distribution of all property:
To make distribution in cash or in kind, or partly in cash and partly in kind, and in
such manner as they may determine.
To retain any or all of the assets of my estate, real or personal, without restriction to
investments authorized for Pennsylvania fiduciaries, as they deem proper, without
regard to any principle of diversification or risk.
Co
To invest in all forms of property without resthction to investments authorized for
Pennsylvania fiduciaries, as they deem proper, without regard to any principle of
diversification or risk.
Do
To sell at public or private sale, to exchange, or to lease for any period of time any
real or personal property and to give options for sales, exchanges or leases, for such
prices and upon such terms or conditions as they deem proper.
mo
To allocate receipts and expenses to principal or income or partly to each as they
from time to time think proper.
F. To compromise any claim or controversy.
099999-00013/2/6/01/EGM/KLT/143137.1
Go
To make such elections, decisions, concessions and settlements in connection with
all income, estate, inheritance, gift, generation skipping or other tax refunds and the
payment of such taxes without obligation to adjust the distributed share of any
person thereby affected.
ARTICLE ~ ~
APPOINTMENT OF PERSONAL REPI~SENTATIVE
I name, constitute and appoint my wife, IRENE C. PEFFER, Executrix of this my Last
Will and Testament. Should my wife, IRENE C. PEFFER, fail to qualify or cease to so act, I
name, constitute and appoint my wife's daughter, BARBARA D. STRATMEYER, altemate
Executrix to complete the administration of my Estate, and should my wife's daughter, BARBARA
D. STRATYMEYER, also fail to qualify or cease to so act, I name, constitute and appoint my
wife's daughter, SANDRA D. WILLIAMS, alternate Executrix to complete the administration of
my Estate. I direct that no fiduciary appointed herein shall be required to post bond for the faithful
administration of her duties required in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will
and Testament, this /,' 2 ~---'-day of ~ ,2001.
0999994)0013/2/6/01/EGM/KLT/143137.1
Signed, sealed, published and declared by the above-named Testator, as and for his Last
Will and Testament, in the presence of us, who at his request, in his presence and in the presence of
each other, have hereunto subscribed our names as witnesses.
AFFIDAVIT AND ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA ·
· SS
COUNTY OF CUMBERLAND ·
We, CLYDE Ji PEFFER, ~ ~- '"v.~ ~ and
K',x,,,a..~.~ "~."~ x~rw,,,.~ the Testator ~d the witnesses, respectively, who~ nines me
si~ed to the a~ached or foregoing ins~ment, being first duly sworn, do hereby decline to the
undersized authofiW that the Testator si~ed ~d executed the ins~ent ~ ~s Last Will ~d that
he had si~ed willingly and that he execmed it ~ ~s ~ee ~d vol~t~ act for the p~oses therein
expressed, ~d that each of the wimesses, in the presence ~d hemng of the Testator, si~ed the
Will as wi~ess ~d that to the best of hisser ~owledge the Testator was at that time ei~teen
ye~s of age or older, of sold mind ~d ~der no constraint or ~due influence.
Wi~ss /
W~ess
099999-00013/2/6/01/EGM/KLT/143137.1
subscribed and swom to
Subscribed, sworn to and acknowledged before me by CLYDE J. PEFFER, Testator, and
before me by ~-~-~~ and
,2001.
, wimesses, this ~ & 'x~"day of
Notary Public Q_~
NOTARIAL SEAL
DIANNE LENIG, Notary Public
Lemoyne Borough Cumberland Co.
,My Commission Expires Dec. 21, 2001
z~z~
Z ~
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: CLYDE J. PEFFER
Date of Death: January 13, 2002
Will No.: 2002-00162
Admin. No.:
To the Register:
I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on
Name
Address
Irene C. Peffer, Wife Ex Executrix 552 Brighton Place
Mechanicsburg, PA 17055
Sharon J. Schmidt, Daughter Corona Del Mar, CA 92625
C. Brian Peffer, Son 1102 Wansford Road
Mechanicsburg, PA 17055
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None.
Date: ~'/t~1o~,' ~.~¢t~
Signature '
Name Edmund G. Myers, Esq.
Johnson, Duffle, Stewart & Weidner
Address 301 Market Street
P. O. Box 109
Lemoyne, PA 17043-0109
Telephone (717) 761-4540
Capacity: Personal Representative
X Counsel for personal representative
EV- 15D0 EX + (6-00)
REV-1500
COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURI
DEPARTMENT OF REVENUE
DEP . :>8060 RESIDENT DECEDENT
HARRISBURG, PA 171:>8-0601
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Peffer Clyde J.
DATE OF DEATH (~M- DD-YEAR) J DATE OF BIRTH (M M-DD-YEAR)
01/13/2002 I 04/05/1930
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Peffer, Irene C.
I 1.original Return ~ 247! Supplemental Return
CAHpRL P B 4. Limited Estate · Future lnterest Compromise (date of death after
S P I O 6. Decedent Died Testate Decedent Maintained a Living Trust
CRAc
K O T K (Attach copy of Will) (Attach copy of Trust)
S S 9. Litigation Proceeds Received ]----"] 10. Spousal Poverty Credit
(date of death between 1:>-31-91 and 1-1-95)
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1.
2.
3.
4.
R 5.
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A 6.
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12.
13.
14.
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OFFICIAL USE ONLY
FILE NUMBER
21 02
COUNTYCODE YEAR
00162
NUMBER
SOCIAL SECURITY NUMBER
198-22-8190
THIS RETURN MUST BE FILED IN DUPflCATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
(date of death
3. Remainder Return priorto 1Z-13-8Z)
5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
11. Election to tax under Sec. 9113(A)
NAME
Edmund C, Myers
FIRM NAME (If Applicable)
Johnson, Duffie,
Stewart
TELEPHONE NUMBER
717/761-4540
Real Estate (Schedule A)
(Attach Sch O)
COMPLETE MAILING ADDRESS
P. O. Box 109
301 Market Street
& Weidner Lemoyne, PA 17043-0109
Non~7~
(1)
Stocks and Bonds (Schedule B) (2)
Closely Held Corporation, Partnership or (3)
Sole -Proprietorship
Mortgages & Notes Receivable (Schedule D) (4)
Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
Jointly Owned Property (Schedule F) (6)
[] Separate Billing Requested
Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
Total Gross Assets (total Lines 1-7)
Funeral Expenses & Administrative Costs (Schedule H) (9)
Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
Total Deductions (total Lines 9 & 10)
Net Value of Estate (Line 8 minus Line 11 )
OFFICIAL USE ONLY
None
None
None
156,146.83
None
None
11,015.67
None
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line 13)
(8) 156,146.83
(11) 11,015.67
(12) 145,131.16
(13)
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
145,131.16
(14) 145,131.16
X .00 (15) 0.00
X .045 (16) 0.00
X .12 (17) 0.00
X .15 (18) 0.00
(19) O. 00
, ........ ....;~i~!~ ......... ~;; ;~"""; ;;~i ..............
Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1600 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
3309 Market Street
ZIP
CITY
STATE
Camp Hill PA
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
(1)
Total Credits ( A + B + C ) (2)
Total Interest/Penalty ( D + 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
(3)
17011
(4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (hA)
B. Enter the total of Line 5 + hA. This is the BALANCE DUE. (hB)
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 benefts or care?
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ................................ r~ ~
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,
0.00
0.00
0.00
0.00
0.00
0.00
0.00
correct and complete, Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Trene C. Peffer DATE
OF PR EPAR ER OTI~ E R T~AJI~ EPRES ENT~TiVE Johnson D,,FF~q~-= ..... + ~. ~'~ ~ ~ ~ I
/~7 /// ...... , ........... ~ ,e r
f~ ~[- ~ P. O. Box 109 · .
~ V -- ~:- -~---~ ................................... J '~
~; 'd;tes ~f de'a~' ~' ~r' a~'e'r' ~;i~'~ ;'~ ~4 ;,a' b;f;'re* ~a~a~ 'i ,'~ 99'5/~e Ya'x ;~e 'i~p~;ed' 0~' [he',;~ 'v;l'u'e'~f' ~r;~fer; ~0';; ~;; 'th; 'dS;' ;f ih;' ' '
surviving spouse is 3% [72 P.S. 9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. 9116 (a) {1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statuto~ requirements for disclosure of assets
and filing a tax return are still applicable even if the surviving spouse is the only beneficial.
For dates of death on or a~er July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twen~-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.
Copyright (c) ZOOO form software only The Lackner Group, Inc. Form REV-1500 EX (Rev, 6-~)
REV~ 1508 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
Clyde J. Peffer SS# 198-22-8190 01/13/2002 21-02-00162
Include the proceeds of litigat on and the date the proceeds were received by the estate. All property jointly-OWlled with the right of
survivorship must be disclosed on Schedule F.
ITEM
VALUE AT DATE
NUMBEF DESCRIPTION OF DEATH
1 Cash - 307o of the residue Estate of Ceor~e W. [<assen 142,439.83
2 2001 OMC Sanoma Truck 13,000.00
3 Collectables on consignment - BJ'S Antiques 707.00
TOTAL (Also enter on line 5, Recapitulation) 156,146.83
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form RI~V- 1508 I=X (Rev. 1-97)
REV,- 1511 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Clyde J. Peffer SS~/ 198-22-8190
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
1
2
3
FUNERAL EXPENSES:
Myers Funeral Home, Inc.
01/13/2002
DESCRIPTION
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) / FIN Number of Personal Representative(s)
Street Address
City
State ~ Zip
Year(s) Commission Paid:
Attorney's Fees Johnson, Duffle, Stewart & Weidner
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant Irene C. Peffer
Street Address 3309 Market Street
City Camp Hill
Relationship of Claimant to Decedent Spouse
Probate Fees
Accountant's Fees
Tax Return Preparer's Fees
Other Administrative Costs
The Patriot-News
Register of Wills
Cumberland Law Journal
Register of Wills filing Inv. & Inh. Tx Return
FILE NUMBER
21-02-00162
State PA Zip 17011
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
AMOUNT
5,060.00
2,000.00
3,500. O0
258.00
102.67
75.00
20.00
11,015.67
Copyricjht (c) 1996 form software only CPSystems, Inc.
Form REV-1511 EX (Rev. 1-97)
REV~1513 EX + (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Clyde J. Peffer SS# 198-22-8190
SCHEDULE J
BENEFICIARIES
01/13/2002
FILE NUMBER
21-02-00162
NUMBER
II.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and
transfers under Sec. 9116(a)(1.2)]
Irene C. Peffer
552 Brighton Place
Mechanicsburg, PA 17055
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Spouse
AMOUNT OR SHARE
OF ESTATE
145,000.00
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SH~-~- ~
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 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
(If more space is needed, insert additional sheets of the same size)
$ 0.00
Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-00)
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Register of Wills of
Estate of Clyde J. Peffer
also known as
CUMBERLAND
INVENTORY
~ ~(~O
o
Date of Death 01/13/2002
, Deceased Social Security No. 198-22-8190
Irene C. Peffer,
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the
personal assets wherever situate and all of the real estate 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 Decedent owned
no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this
Inventory. I/VVe verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein
are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Personal Representative
UREAU OF iNDiViDUAL TAXES
ZNHERI'TANCE TAX D'rVZSTON
DEPT. 280601
HARRISBURG, PA l?1ZB-D601
CONHONNEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOT/CE OF INHERITANCE TAX
APPRAISENENT, ALLONANCE OR DISALLONANCE
OF DEDUCTIONS AND ASSESSNENT OF TAX
EDHUND G NYERS
JOHNSON ETAL
PO BOX 109
LEHOYNE
CUT ALONG THZS LiNE
REV-1547 EX AFP (01-02)
PA 170~ i
DATE 07-29-2002
ESTATE OF PEFFER
DATE OF DEATH 01-15-2002
FiLE NUNDER 21 02-0162
:;?iCOUNTY CUHBERLAND
ACH 101
f Amoun~ Remi~ed
CLYDE C
HAKE CHECK PAYABLE AND REHZT PAYNENT TO:
REGISTER OF HILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTICE OF iNHERiTANCE TAX APPRA'rSENENT,
RETAZN LONER PORTION FOR YOUR RECORDS
ALLONANCE OR
ESTATE OF PEFFER
DZSALLONANCE OF DEDUCTZONS AND ASSESSNENT OF TAX
CLYDE CFZLE NO. 21 02-0162 ACN 101
DATE 07-29-2002
TAX RETURN HAS: (X) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE iNTEREST - SEE REVERSE
( ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
Z. Real Es~e~e (Schedule A) (1)
2. S~ocks and Bonds (Schedule B) (2)
$. Closely Held S~ock/Par~nership In~eres~ (Schedule C) ($).
~. Nor~gages/No~es Receivable (Schedule D) (~)
$. Cash/Bank Deposi~s/Hisc. Personal Proper*y (Schedule E) (5)..
6. Jo/n~ly Owned Proper~y (Schedule F) (6}
7. Transfers (Schedule G)
8. To~el Asse~s (7)
APPROVED DEDUCTIONS AND EXENPTZONS:
9. Funeral Expenses/Ada. Cos~s/Hisc. Expenses (Schedule H) (9)
10. Deb~s/Nor~gege Liabilities/Liens (Schedule I) (10)
11. To,al Deductions '
12. Ne~ Value of Tax Re~urn
.00
.00
.00
.00
156~1~6.83
.00
.00
(8)
11,015.67
.00
(11) .
NOTE: To insure proper
credi~ ~o your account,
submi~ ~he upper portion
of ~his fore wi~h your
~ax payment.
156,1~6.83
]].ol~.~7
1~5,131.16
(15) 1~5,131.16 X O0 = .00
(16) .00 X 0~5= .00
(17). .00 X 12 = .00
(18). .00 x 15 = .00
(19)~ . O0
ANOUNT PAiD
IF PAiD AFTER DATE iNDiCATED, SEE REVERSE
FOR CALCULATION OF ADDiTiONAL iNTEREST.
TOTAL TAX CREDIT
BALANCE OF TAX DUE
iNTEREST AND PEN.
TOTAL DUE
· °°l
.00
.00
.00
( IF TOTAL DUE ZS LESS THAN $1) NO PAYNENT ZS REQUIRED.
ZF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE
A REFUND. SEE REVERSE SIDE OF THiS FORH FOR INSTRUCTIONS.)
D~$COUNT
INTEREST/PEN PAID (-)
15. Amoun* of Line 1~ a~ SpouseX ra~e
16. Amoun~ of Line lr~ ~axabXe a~ Lineml/CXass A ra*a
17. Amoun* of L/ne 1~ m* SibXing ra~a
lB. Aeoun~: of Line 1~ ~mxmble a~ Collateral/Class B ra~e
19. PrlncipaZ Tax Due
TAX CREDXTS:
PAYmeNT ~ RECEIPT
DATE NUHBER
(12)
15. Chmri*mble/Govarnman~al Bequests; Non-aXec*ad 9115 Trusts (Schadule J) (15) .00
1~. Ne* Value of Es~a~e Subjac~ *o Tax
(1~) 1~5,131.16
NOTE: If an assess;ant ~as issued PreYAously, Z~nes 14, 15 and/or 16, 17, 18 and 19 ~i1!
reflect figures that include the totaZ of ALL returns assessed to date.
ASSESSNENT OF TAX:
RESERVATION: Estates of decedents dying on or before December 1Z, 198Z -- [f any future interest in the estate is transferred
in possess[on or enjoyment to Class B (co[lateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer inheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
To fulfil! the requirements of Section Z140 of the inheritance and Estate Tax Act, Act Z$ of ZOO0. (Ti P.S.
Section 9140).
PAYHENT: Detach the top portion of this Notice and submit with your payment to the Rag[star of Hills printed on the revsrsa side.
--Hake check or money order payable to: REGISTER OF HILLS, AGENT
REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may bm requested by completing an "Application
for Refund of Pennsylvania inheritance and Estate Tax" (REV-1313). Applications ara available at the Office
of the Register of Wills, any of the 25 Revenue District Offices, or by calling the special Z4-hour
answering service for forms ordering: 1-800-362-Z050~ services for taxpayers with special hearing and / or
speaking needs: 1-BOO-44?-50ZO (TT only).
OBJECTIONS: Any party [n interest not satisfied with the appraisement, al[owaoce, or disallowance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of
this Hot[ce by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-[021, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
PURPOSE OF
NOT[CE:
ADHIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
iNTEREST:
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTH: Post Assessment Rev[aw Unit, Dept. [BO601, Harrisburg, PA 171Z6-0601
Phone (717) 7B7-6505. Sam page 5 of the booklet "instructions for Inheritance Tax Return for a Resident
Decedent" (REV-IS01) for an explanation of administratively correctable errors.
[f any tax due is paid within three (3) calendar months after the decedant's death, a five percent (ex) discount of
the tax paid is allowed.
The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation
penalty is appealable [n tho same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day cf delinquency, or nine (9) months and one (1) day from the date of
death~ to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of
six (6X) percent par annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January 1, 198Z wi[1 bear interest at a rate which wilt vary from calendar year to catendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOO[ are:
Year Interest Rate Dally interest Factor Year interest Rate Daily [nterest Factor
1982 ZOZ .OOOS48 199Z 9Z .O00Z47
1983 16Z .000458 1995-1994 7Z .O00XgZ
1964 IX[ .000301 1995-199B 9Z .000247
1985 15X .000556 1999 7X .00019Z
1986 lOX .000Z74 ZOO0 BZ .OOOZ19
1987 9Z .000247 ZOO1 9Z .000247
1988-1991 llZ .000301 ZOOZ 6Z .000164
--interest is calculated as follows:
XNTEREST = BALANCE OF TAX UNPATD X NUIIBER OF DAYS DELXNQUENT X DATLY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an [ntmrest calculation to fifteen (15) days
beyond the date of the assessment. [f payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.
PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF
THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM
YEARLY UNTIL COMPLETION.
STATUS REPORT UNDER RULE 6.12
Name of Decedent: ESTATE OF CLYDE J. PEFFEI~
Date of Death: _JANUARY 13, 200?
Will No.: 2002-00162 Admin No.:
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes X No
If the answer is No, state when the personal representative reasonably
believes that the administration will be complete:.
If the answer to No. 1 is yes, state the following:
A. Did the personal representative file a final account with the Court?
Yes No X
B. The separate Orphans' Court No. (if any) for the personal
representative's account is:.
C. Did the personal representative state an account informally to the
parties in nterest? Yes No X
The Executrix also the survivin souse was the sole
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.
Signature
Edmund G. Myers, Esq.
Johnson, Duffle, Stewart & Weidner
301 Market Street, P.O. Box 109
Lemoyne, PA 17043-0109
Address
(~717) 761-4540
Telephone No.
Capacity:
Personal Representative
X Counsel for Personal Representative