HomeMy WebLinkAbout02-0167PETITION FOR PROBATE and GRANT OF LETTERS
Estate of
also known as
John. N, Wolf, Sr.
Social Security No.
Deceased.
205-09-53 f3
No.
To:
Register of Wills for the
County of Cnmhmr'l and
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 executr±x
in the last will of the above decedent, dated Apr-i 'l 'l 2
and codicil(s) dated
in the
named
,190
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in Cumberland County, Pennsylvania, with
h ~ ~ last family or principal residence atM-u:zaa:m~<-e ~ Carl±sle, PA 17013
(list street, number and muncipality)
Decendent, then 94 years of age,_died 3an. 23, 2002
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 no~ the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) Ali 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:
59,000.00
75,000.00
1556 Newville~Rd., Carlisle, PA 17013
WHEREFORE, petitioner(s) respectfully
presented herewith and the grant of letters
theron.
request(s) the probate of the last will and codicil(s)
Testamentary
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
Sworn to or affirmed-,a~d subscribed
before mc tlfi& 12th a~f I
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ~
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 knowledge 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.
No. 21-2002-167
Estate of John N. Wolf. Sr. , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
.February 13, 2002
AND NOW 19 , 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 April 12~ 1990
described therein be admitted to orobate and filed of record as thc last will of
John N. Wolf, Sr.
.;
and Letters T e_~ t ament ary
are hereby granted to Dorothy W. Weary
FEES
Probate, Letters, Etc .......... $ 235o00
Short Certificates(4) .......... $- 12 o 00
Renunciation ................ $
x-Pacles (3) $ 9.00
JCP TOTAL __ $. 5.00
Filed FabruazT¢.. 13.th, 20112 .. $..261.110.
ATTORNEY (Sup. Ct. I.D. No.)
27 W. High ST.
ADDRESS
Carlisle, PA 17013
PHONE
717-243-1790
CALL A2~ORNEY GEONGE F.
DOUGLAS, JR.
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 f& permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
P 7913856
No.
Local Registrar
JAN 2 5 2002
Date
I,. John N. Wolf, Sr.
Cumberland
1556 Newville Rd. ~L..~__~~ ,7..~, PA ,,--.'w:Mw '~'~
Carlisle, PA 17013 ~ ,~.~ Cumberland
,,. Alfr~ P. Wolf ,,, Su~n - Jambs
~. 2096 Ritner Hio~v. ~rl~l~. PA 1701q
COMMONWEALTH OF PENNSYLVANIA o DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
5313
I'.
1/23/2002
Ik.~rlasle ~. I~rlisle mimal ~1 ~ter I~''-'~' ~ite
I ~ ~V~&l ~ ~ I .~ I ~
West Pennsboro
O1.~/26/2002 I,~.orth Middleton Church of G~t;l Cern. Carli.~le, PA 17013
FD 012633 L ~.Dging Brothers Puneral Hcme, Carlisle, PA 17013
. ~ .0,~ ~ '
21-2002-167
21-2002-167
LAST WILL AND TESTAMENT
I, John N. Wolf, Sr., of West Pennsboro Township, Cumberland
County, Pennsylvania, being of sound and disposing mind, memory
and understanding, declare the following to be my last will and.
testament, hereby revoking and making void any and all wills
heretofore made by me.
Item I. My executrix is directed to pay my debts and
funeral expenses.
Item II. I hereby devise and bequeath all of my property, to
my wife, Julia C. Wolf, provided that she survives me by 30 days.
Item III. In the event that my wife does not so survive me,
I direct that all my property, both real and personal, be divided
equally between my children Betty V. Wevodau, Geneva C. Long,
John N. Wolf, Jr., Richard A. Wolf, and Dorothy W. Weary. If any
of my said children do not survive me, that child's share shall
be added to my residuary estate and divided equally between my
surviving children.
Item IV. I nominate, constitute and appoint, my daughter,
Dorothy W. Weary, as my executrix. I direct that my executrix
shall be permitted to serve without bond.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
this thej~ day of ~~ ,1990.
John N. Wolf, Sr.
Signed, sealed, published and declared by the above named
testator as and for his last will and testament, who at his
request, in his presence, in our presence, and in the presence of
each other, have hereunto subscribed our names as attesting
wi tnesses: .~~~~
COMMONWEALTH OF PENNSYLVANIA )
COUNTY OF CUMBERLAND )
We ,~ ~'~¥~ and ~ ~ ~ ,
the witnesses whose names are signed to the attached or foregoing
instrument, being duly qualified according to law, do depose and
say that we were present and saw testator sign and execute the
instrument as his last will, and that he signed willingly and
that he executed it as his free and voluntary act for the pur-
poses therein contained; that each of us in the hearing and sight
of the testator signed the will as witnesses; and that to the
best of our knowledge, the testator was at that time 18 or more
years of age, of sound mind and under no constraint or undue
influence.
Sworn to and subscribed before
me this ,/~ day of~~ ,
Notary I ' NOTA"IA[ SEAL
· Anne M. Cox, Notary Public
Carlisle 8oro, CurnbeHand County
My Cornm!ssio,,n Ex~ire~l JUl~ '14, 1993
COMMONWEALTH OF PENNSYLVANIA)
COUNTY OF CUMBERLAND )
I, John N. Wolf, Sr., whose name is signed to the attached
or foregoing instrument, having been dul~7 qualified according to
law, do hereby acknowledge that I signed and executed the instru-
ment as my last will; that I signed it willingly; and that I
signed it as my free and voluntary act for the purposes therein
expressed.
"John N. Wolf, Sr.
Sworn to and subscribed to
before me this /~ day
of ~ ,1990.
Notary
~ ~, Cur. bm'land County
M~ Commission Expires July 14, 1993
Name of Decedent:
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
John N. Wolf, Sr.
Date of Death:
Jan. 23, 2002
2102-0167
Will No. Admin. No.
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a).~etl~e. OL~h,an~(~ Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on :
Name Address
See Attached.
Noticehasnow beengiventoallpersonsentitledtheretounderRule5.6(a) except
None
Date:
Name George. F. Douglas, IIr, Esquire
LJ.~J
Address 27 W. High St.
Carlisle, PA 17013
Telephone (71~ 243-1790
Capacity: __
PerSonal Representative
x Counsel for personal representative
NOTICE OF BENEFICIAL INTEREST IN ESTATE
BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND,
PENNSYLVANIA
IN RE: ESTATE OF JOHN N. WOLF, SR., DECEASED
No. 2102-0167
TO:
Geneva C. Long
310 North College St.
Carlisle, PA 17013
Please take notice of the death of decedent and the grant of letters to the
personal representative named below. You may have a beneficial interest in
the estate tmder the Last Will and Testament of John N. Wolf. Sr.
See attached copy of Will
Name of decedent: John N. Wolf, Sr.
Last known address of decedent: 1556 Newville Rd., Carlisle, Pa. 17013
Date of Death: Jan. 23, 2002
Place of Death: Carlisle Regional Medical Center, Carlisle, PA
County of Grant of Original Letters: Cumberland
Decedent died Testate, and a copy of the Will is attached hereto
Name, address and phone number of all personal representatives:
Dorothy W. Weary
2096 Rimer Highway
Carlisle, PA 17013
717-249-4593
Name, address and phone number of counsel:
George F. Douglas, III, Esquire
27 W. High St.
Carlisle, Pa. 17013
Phone: 717-243-1790
Additional information may be obtained from the undersigned:
Douglas, Douglas &,Douglas
By~ ~o ~k~x~*~-
@ .
George F. Efouglas, III, Esqmre
27 W. High St.
Carlisle, Pa. 17013
717-243-1790
Dated:
February 26, 2002
NOTICE OF BENEFICIAL INTEREST IN ESTATE
BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND,
PENNSYLVANIA
IN RE: ESTATE OF JOHN N. WOLF, SR., DECEASED
NO. 2102-0167
TO:
Betty Wevodau
1465 Jerusalem Rd.
Mechanicsburg,PA 17050
Please take notice of the death of decedent and the grant of letters to the
personal representative named below. You may have a beneficial interest in
the estate under the Last Will and Testament of John N. Wolf. Sr.
See attached copy of Will
Name of decedent: John N. Wolf, Sr.
Last known address of decedent: 1556 Newville Rd., Carlisle, Pa. 17013
Date of Death: Jan. 23, 2002
Place of Death: Carlisle Regional Medical Center, Carlisle,PA
County of Grant of Original Letters: Cumberland
Decedent died Testate, and a copy of the Will is attached hereto
Name, address and phone number of all personal representatives:
Dorothy W. Weary
2096 Ritner Highway
Carlisle, PA 17013
717-249-4593
Name, address and phone number of counsel:
George F. Douglas, III, Esquire
27 W. High St.
Carlisle, Pa. 17013
Phone: 717-243-1790
Additional information may be obtained from the undersigned:
Doul~os, Dougla& & J~ougl~ t'r[7
Geo"ge F. Douglas, III, Esq°uire
27 IN. High St.
Carlisle, Pa. 17013
717-243-1790
Dated:
February 26, 2002
NOTICE OF BENEFICIAL INTEREST IN ESTATE
BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND,
PENNSYLVANIA
IN RE: ESTATE OF JOHN N. WOLF, SR., DECEASED
No. 2102-0167
TO:
Dorothy Weary
2096 Rimer Highway
Carlisle,PA 17013
Please take notice of the death of decedent and the grant of letters to the
personal representative named below. You may have a beneficial interest in
the estate under the Last Will and Testament of John N. Wolf. Sr.
See attached copy of Will
Name of decedent: John N. Wolf, Sr.
Last known address of decedent: 1556 Newville Rd., Carlisle, Pa. 17013
Date of Death: Jan. 23, 2002
Place of Death: Carlisle Regional Medical Center, Carlisle,PA
County of Grant of Original Letters: Cumberland
Decedent died Testate, and a copy of the Will is attached hereto
Name, address and phone number of all personal representatives:
Dorothy W. Weary
2096 Ritner Highway
Carlisle, PA 17013
717-249-4593
Name, address and phone number of counsel:
George F. Douglas, III, Esquire
27 W. High St.
Carlisle, Pa. 17013
Phone: 717-243-1790
Additional information may be obtained from the undersigned:
Doue. las, Douglas & Douglas
Geo rg . 0ro gfa , --
27 W. High St.
Carlisle, Pa. 17013
717-243-1790
Dated: February 26, 2002
NOTICE OF BENEFICIAL INTEREST IN ESTATE
BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND,
PENNSYLVANIA
IN RE: ESTATE OF JOHN N. WOLF, SR., DECEASED
No. 2102-0167
TO:
John Nelson Wolf, Jr.
261 Arch St.
Carlisle, PA 17013
Please take notice of the death of decedent and the grant of letters to the
personal representative named below. You may have a beneficial interest in
the estate under the Last Will and Testament of John N. Wolf. Sr.
See attached copy of Will
Name of decedent: John N. Wolf, Sr.
Last known address of decedent: 1556 Newville Rd., Carlisle, Pa. 17013
Date of Death: Jan. 23, 2002
Place of Death: Carlisle Regional Medical Center, Carlisle,PA
County of Grant of Original Letters: Cumberland
Decedent died Testate, and a copy of the Will is attached hereto
Name, address and phone number of all personal representatives:
Dorothy W. Weary
2096 Ritner Highway
Carlisle, PA 17013
717-249-4593
Name, address and phone number of counsel:
George F. Douglas, III, Esquire
27 W. High St.
Carlisle, Pa. 17013
Phone: 717-243-1790
Additional information may be obtained from the undersigned:
Doug~a,s, Douglas & ~ouglq~
George F. DSuglas, Iii7 Esd~uire
27 W. High St.
Carlisle, Pa. 17013
717-243-1790
Dated: February 26, 2002
NOTICE OF BENEFICIAL INTEREST IN ESTATE
BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND,
PENNSYLVANIA
IN RE: ESTATE OF JOHN N. WOLF, SR., DECEASED
No. 2102-0167
TO:
Richard Wolf
314 North College St.
Carlisle,PA 17013
Please take notice of the death of decedent and the grant of letters to the
personal representative named below. You may have a beneficial interest in
the estate under the Last Will and Testament of John N. Wolf. Sr.
See attached copy of Will
Name of decedent: John N. Wolf, Sr.
Last known address of decedent: 1556 Newville Rd., Carlisle, Pa. 17013
Date of Death: Jan. 23, 2002
Place of Death: Carlisle Regional Medical Center, Carlisle,PA
County of Grant of Original Letters: Cumberland
Decedent died Testate, and a copy of the Will is attached hereto
Name, address and phone number of all personal representatives:
Dorothy W. Weary
2096 Ritner Highway
Carlisle, PA 17013
717-249-4593
Name, address and phone number of counsel:
George F. Douglas, III, Esquire
27 W. High St.
Carlisle, Pa. 17013
Phone: 717-243-1790
Additional information may be obtained from the undersigned:
Doualas, Douglas & Dougli~s
George Fi l:5o~gias, III"",-E-4uire -
27 W. High St.
Carlisle, Pa. 17013
717-243-1790
Dated: February 26, 2002
21-2002-167
LAST WILL AND TESTAMENT
I, John N. Wolf, Sr., of West Pennsboro Township, Cumberland
County, Pennsylvania, being of sound and disposing mind, memory
and understanding, declare the following to be my last will and
testament, hereby revoking and making void any and all wills
heretofore made by me.
Item I. My executrix is directed to pay my debts and
funeral expenses.
Item II. I hereby devise and bequeath all of my property, to
my wife, Julia C. Wolf, provided that she survives me by 30 days.
Item III. In the event that my wife does not so survive me,
I direct that all my property, both real and personal, be divided
equally between my children Betty V. Wevodau, Geneva C. Long,
John N. Wolf, Jr., Richard A. Wolf, and Dorothy W. Weary. If any
of my said children do not survive me, that child's share shall
be added to my residuary estate and divided equally between my
surviving children.
Item IV. I nominate, constitute and appoint, my daughter,
Dorothy W. Weary, as my executrix. I direct that my executrix
shall be permitted to serve without bond.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
this thej~ day of ,1990.
John N. Wolf, Sr.
Signed, sealed, published and declared by the above named
testator as and for his last will and testament, who at his
request, in his presence, in our presence, and in the presence of
each other, have hereunto subscribed our names as attesting
witnesses
OF PENNSYLVANIA )
~OUNTY OF CUMBERLAND
We ,~~--~ .~- ~~ and
, ,
the witnesses whose na s are signed to the attached or foregoing
instrument, being duly qualified according to law, do depose and
say that we were present and saw testator sign and execute the
instrument as his last will, and that he signed willingly and
that he executed it as his free and voluntary act for the pur-
poses therein contained; that each of us in the hearing and sight
of the testator signed the will as witnesses; and that to the
best of our knowledge, the testator was at that time 18 or more
years of age, of sound mind and under no constraint or undue
influence.
Sworn to and subscribed before
me this /~. day of~'~ ,
:Notary . , '
., NOTARIAL SEAL
Anne M. Cox, Notary Public
Carlisle Boro, Cumberland County
, My C, ommission Expires Jul~ !4,.1993
)NWEALTH OF PENNSYLVANIA)
COUNTY OF CUMBERLAND )
I, John N. Wolf, Sr., whose name is signed to the attached
or foregoing instrument, having been duly qualified according to
law, do hereby acknowledge that I signed and executed the instru-
ment as my last will; that I signed it willingly; and that I
signed it as my free and voluntary act for the purposes therein
expressed.
/John N. Wolf, Sr.
Sworn to and subscribed to
afore
Notary
I Ced~le Boro, Cur~bedond Cour~y
!~_ My C~)mmtss~, Expires July 14, 1993
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-O601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 001 O86
DOUGLAS GEORGE F III ESQ
27 W HIGH ST
CARLISLE, PA 17013
........ fold
ESTATE INFORMATION: SSN: 205-09-5313
FILE NUMBER: 2102-01 67
DECEDENT NAME: WOLF JOHN N SR
DATE OF PAYMENT: 04/18/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUM BERLAN D
DATE OF DEATH: 01/23/2002
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $8,500.00
TOTAL AMOUNT PAID:
$8,500.00
REMARKS: DOROTHY W WEARY
C/O GEORGE F DOUGLAS III ESQ
SEAL
CHECK//105
INITIALS: CW
RECEIVED BY:
MARY C. LEWIS
REGISTER OF WILLS
REGISTER OF WILLS
REV-1500 EX~ (6-OO)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAl. USE ONLY
FILE NUMBER
2 1 -0 2 0 1
6 7
COUNTYCODE YF-N~ NUMBER
I--
Z
U,J
L,LJ
O
LU
I-
UJ
0
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
John N. Wolf, Sr.
DATE OF DEATH (MM-DD-Year) I DATE OF BIRTH (MM-DD-Year)
01/23/2002 I 05/03/1907
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
2 0 5-0 9-5 3 1 3
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
r~l. Original Return
[--~ 4. Limited Estate
r-~6, Decedent Died Testate (~ach copy
---]9, Litigation Proceeds Received
r"-] 2. Supplemental Return
4a. Future Interest Compromise (date ofde~ after 12-12-82)
r"-] 7. Decedent Maintained a Living Trust (Altach copy ef Trust)
10. Spousal Povedy Credit (date of death beh~een 12-31-91 a~d 1-1-95)
NAME
George F. Douglas, III, Esquire
FIRM NAME (If Appicabb)
Douglas, Douglas & Douglas
TELEPHONE NUMBER
'17-243-1790
[~ 3. Remainder Return (date of dea~h pdor to12.13-82)
--]5. Federal Estate Tax Return Required
1-- 8. Total Number of Safe Deposit Boxes
[] 11. Election to tax under Sec. 9113(A) (Ntach Sch O)
COMPLETE MAILING ADDRESS
27 W. High St.
Carlisle PA 17013
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Padnership or Sole-Proprietorship (3)
4. Modgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
'-'] Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Properly (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, Modgage Liabilities, & Liens (Schedule I) (10)
11. Tolal 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) (14)
75,000.00
66,035.36
(8)
18,775.89
(11)
(12)
(13)
OFFICIAL USE ONLY
153,161.31
18,775.89
134,385.42
134,385.42
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
X __ (15)
134,385.42 X .045 (18)
6,047.34
17. Amount of Line 14 taxable at sibling rate
X .12 (17)
18. Amount of Line 14 taxable at collateral rate X .15 (18)
19. Tax Due (19)
6,047.34
Dececient's,Complete Address:
STREE~ ADDRESS
1556 Newville Road,
CITY
Carlisle
ISTATE PA
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
8.500.00
(1)
Total Credits ( A + B + C ) (2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + E ) (3)
4. 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 (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 lax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check Payab/e to: REGISTER OF WILLS, AGENT
17013
6,047.34
8,500.00
2,452.66
0.00
0.00
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN 'X' IN THE APPROPRIATE BLOCKS
1. Did decedent make a tTansfer and: Yes No
a. retain the use or income of the property transferred; ......................................................................... [] []
b. retain the right to designate who shall use the property transferred or its income; ...................................... [] []
c. retain a reversionary interest;.or .................................................................................................. [] []
d. receive the promise for life of either payments, benefits or care? .......................................................... [] []
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideratinn? .......................................................................................... [] []
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death2 ............... [] []
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designati~2 .................................................................................................. [] []
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETU
Under penalties of periury, I declare that I have examined this retum, incbdin~l accompanying schedubs and statements and to the best of my knowledge and belef, it is true, correct and compbte.
Declaration of preparer o~er than the personal representative is based on all ~nformatio~ of which prepaer has any knowbdge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
ADDRES~ 2096~itner Highway, ? ' -
Carlisle,
DATE
PA 17013
SIGNATURE O~D~EPARER OTHER THAN REt.~PRESENTATIV
ADDRESS 'George F."Douglas, III, Esquir~
27 W. High St., Carlisle,
DATE
PA 17013
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the 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 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-I $02EX + (.'-97~ j~~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF FILE NUMBER
John N. Wolf. Sr. 2,1 02 0167
All real property owned solely or as a tenant in common must be reported at fair market value. Fair markel value is defined as the price at which property would be exchanged
between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of
survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
Real Estate 1556 Newville Road, Carlisle, PA 17013
TOTAL (Also enter on line 1, Recapitulationl
VALUE AT DATE
OF DEATH
75,000.00
75~000.0r)
(If more space is needed, insert additional sheets of the same size)
REV-1503 ~X * {,1-97) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
John N. Wolf. Sr.
All properly jointly-owned with righl of survivorship musl be disclosed on Schedule F.
FILE NUMBER
21 O2 0167
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. U.S. Series E Sa~ngs Bonds, including interest of 10,363.45 12,125.95
TOTAL (Also enter on line 2, Recapitulation) $
12r125.9,~
(If more space is needed, insert additional sheets of the same size)
REV-1508 EX ~(4-97) j~~
COUMONWF_ALTN OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
John N. Wolf. Sr. 21 02 0167
Include the proceeds of litigation and the date the proceeds were received by the estate. All properly jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION
1. M&T Bank, Market IndexAccount #941597
M&T Bank, Checking Account
M&T Bank, Market IndexAccount #72621
Manor Care, refund
Manor Care, refund
Blue Cross, refund
Real Estate Tax Pro-ration received
TOTAL (Also enter on line 5, Recapitulation)
VALUE AT DATE
Of DEATH
23,596.47
4,781.08
35,437.97
986.40
773.00
155.54
304.90
66r035.36
(Ifmorespaceisneeded, inse~additionalshee~ofthesamesize)
~-V-1511EX +'(1-97) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
John N. Wolf. Sr.
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21 02
0167
ITEM
NUMBER DESCRIPTION AMOUNT
A, FUNERAL EXPENSES:
1.
8.
9.
10.
13.
15.
17.
18.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s) Dorothy W. Weary
Social Security Number(s) / EIN Number of Personal Representative(s)
Street Address 2096 Ritner Highway
city Carlisle~ State PA
Year(s) Commission Paid:
Attorney Fees Douglas, Douglas & Douglas
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
195-32-1733
Zip 17013
Slreet Address
city
Relationship of Claimant to Decedent
Probate Fees Register of Wills
State Zip
Accountant's Fees Greenawalt & Co., (estimated)
Tax Return Preparer's Fees
Carlisle Regional Medical Center
U.S. Treasury, 2001,1040 taxdue
Eby Granite Works, inscription on tombstone
Aesthetic and Reconstructive Surgery
Home Safe, Radon test
Masland Assoc, medical bill
Evening Sentinel, estate ad
Cumberland Law Journal, estate ad
Peck's Septic
Home Paramount, termite inspection and correction
Dan White Plumbing and Heating, ultraviolet light
Dorothy Weary, reimbursement for miscellaneous bills paid by her
TOTAL (Aisc enter on line 9, Recapitulation) $
4,500.00
4,500.00
261.00
600.00
142.12
141.00
85.00
72.00
100.00
255.35
93.83
75.00
4,087.50
1,414.04
635.00
276.34
18~775.89
(If more space is needed, insert additional sheets of the same size)
.~. Continuation of REV-1500 Inheritance Tax Return Resident Decedent
John N. Wolf, Sr.
Page 1
21 02 0167
Schedule H - Funeral Expenses & Administrative Costs - B7
ITEM
NUMBER
19.
20.
21.
22.
23.
24.
25.
DESCRIPTION
Douglas, Douglas & Douglas, attorney for real estate settlement
Recorder of Deeds, I% transfer tax
Recorder of Deeds, recording fees
Deborah Piper, tax certification charge
Register of Wills, reserved for filing final account
Register of Wills, filing inventory and appraisement
PP&L
SUBTOTAL SCHEDULE H-B7
AMOUNT
500.00
750.00
51.00
2.00
200.00
25.00
9.71
1,537.71
RE~-1513 EX ~ (1-97) ~
COMMONWEALTH OF PENNSYLVANIA
iNHERiTANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
John N. ~Volf. Sr.
NUMBER
II.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (include outright spousal distributions)
Dorothy W. Weary
2096 Ritner Highway
Carlisle, PA 17013
Geneva C. Long
310 N. College St.
Carlisle, Pa 17013
Betty Wevodau
1465 Jerusalem Road
Mechanicsburg, PA 17050
John Nelson Wolf, Jr.
261 Arch St.
Carlisle, PA 17013
Richard Wolf
314 N. College St.
Carlisle, PA 1701 $
FILE NUMBER
21 02
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
daughter
daughter
daughter
son
son
0167
AMOUNT OR SHARE
OF ESTATE
1/5 residue
1/5 residue
1/5 residue
1/5 residue
1/5 residue
(If more space is needed, insert additional sheets of the same size)
TOTAL OF PART [[ - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEE" $
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
A~,H.U.D. SE'~, LEMENT STATEMENT
File RE02~37
B. LOAN TYPE:
LENDER:
C.This form Is furnished to give you a statement of actual settlement costs. Amounts paid
to and by the settlement agent are shown. Items marked P.O.C. were paid outside closing.
D. NAME OF BORROWER:
Antonio Santana, Sr.
Antonio Santana, Jr.
G. PROPElUIYY LOCATION:
1556 Newville Road
Carlisle, Pennsylvania 17013
West Pennsboro Township
I E. NAME OF SELLER
John N. Wolf, Sr. Estate
IH. SEIII_~M~T AGENT: I I. SETII_EMENT DA'IH:
DUNCAN l HARTMAN, P.C. 17-May-02
1 IRVlNE ROW
CARUSLE, PA. 17013
J. SUMMARY OF BORROWER'S TRANSACTION I~ SUMMARY OF S;tlFR'S TI::LANSACTIOM
tO0 =kOSS ANOV~T O~ FROM ~O~ 400 ;ROSS ~ V~ ~ S~.~.~
102 Personal Pretty 0.~ 402 Persona~ Pro~gty 0.~
t03 Sott[~mnt Charges (llno 1400) ' 1~.~ 403
[04 0.00
Los 0.00
~d~ua~monte tt~ propa£d by soller~
LOS Co~s£ taxes to 31-Dec-02 176.76
L07 Assessments
L08 School taxes to 30-Juno02
L09
120 GROSS DUE FROM BORROWER
!00 AMOUNTS PAZD ST OR FOR BORROWER
128.14
76611.90
!01 Depos£t or Earnest Money 0.00
:02 Hew Hortgags A~ount: ~?;000.~
!03 Ex£sC£ng lomns taken subj~ to 0.~
~04 0.~
:06
404
Ad~us~B~nta items ~ropaid by Beliers
40s ~ocel taxes to 31-~c-02 176.76
'407 Sch~l taxes to 30-Juno02 128.14
408
409
420 GROSS DUE TO SELLI:::R
75304.90
500 REDUCTZONS IN AMOUNT DUE TO
501 Excess deposit
502 Settlement charges 1532.91
503 Zxistin~ loans taken 35000.00
504 Payoff 1st Mortgage
505
' 506
Payoff 2nd mor'r, gago
~07 507
~jus~Juontm for items unlMid by seller 508
:I0 Lo~sl Taxes to 17-May-02 0.00 Adjustments for irene unpaid by Seller
'11AasessMnts to SlO Lo. al taxes 17-May-02 0.00
12 School Taxes to 17-May-02 0.00 511 Assessments to
15
16
17
20 TOTAL PAID B[ SORROWER
00 CASH FROM/TO ~O~ROWER
512 School taxes to 17-May-02
513
514
01 ;ross amount duo from borrower
02 Less amounts paid by/for borrower
35000.00
76611.90
35OO0.00
$41,611.90
'520 TOTAL REDUCTIONS SFLL~R
600 CASH TO/FROM
601 ;ross amount to seller
602 Reductions to seller
36532.97'
75304.90
36532.97
$38,771.93
have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge
nd belief, it is a true and accurate statement of all receipts and disbursements made on
, ~~ on my b.~ and I have received a copy of ~i. HUD-1 for my records.
,n~p~.ntana,~r. / / John Ni'~;~Oifi'~rl ESta~
,ntonio Santana, Jr.
~AGE ~2 HUD DISCLOSURE/SETTLEMENT STATEMENT 7 PAID BY PAID BY
BORROWER
700 TOTAL REALTOR'S COMMISSION 0.00
701 Listing Agency: -..
702 Selling Agency:
703 Commission paid at settlement to
800 I'i'EMS PAYABLE IN CONNECTION WITH LOAN
801 Loan Origination fee - 0.00
802 Loan Discount 0.00
803 Appraisal Fee 0.00
804 Credit Report 0.00
805 Document Preparation Fee 0.00
806 Flood Certification 0.00
807 L/P Underwriting fee 0.00
808 Tax Service Fee
809 Satisfaction Fee 0.00
810 Overnight Mail Charges: Duncan & Hartman, P.C. 0.00
900 I I t-MS LENDER REQUIRES TO BE PAID IN ADVANCE
901 Interest from 0.00
902 Mortgage insurance
903 Hazard Insurance
904 0.00
1000 RESERVES DEPOSITED WITH LENDER
Escrows collected: # mos. due: X $ per mo.:
1001 Hazard insurance 0 0.00 0.00
1002 Mortgage insurance 0.00
1003 County/Local taxes 0 0.00 0.00
1004 School taxes 0 0.00 0.00
1005 Aggregate Adjustment (Initial Escrow Deposit $) 0.00
1100 TITLE CHARGES
1101 Settlement or closing fee:
1102 Abstract or title search:
1103 Title examination:
1104 Title insurance binder:
1105 Document preparation:
1106 Notary fees: 4.00
1107 Attorney's fees: Duncan & Hartman, P.C. 500.00 500.00
(includes above item numbers):
1108 Title Insurance: FIDELITY TITLE 0.00
(includes above item numbers): 1101 - 1104
1109 Owner's coverage $0.00
1110 Lender's coverage
1111
1200 GOVERNMENT RECORDING AND TRANSFER CHARGES
1201 Deed 25.50 Mortgage 25.50 51.00
1202 Release 0.00 Satisfaction 0.00 0.00 0.00
1202 County/Local transfer tax (1%) 750.00
1203 State transfer tax (1%) 0.00 750.00
1300 ADDITIONAL SETTLEMENT CHARGES
1301 Tax certification Deborah W. Piper, t~ 2.00.
1302 Co. & Twp. taxes Deborah W. Piper 282.97
1303 Water Certification or testing
1304 Final water & sewer Acct. #
1400 TOTAL SI: I ILEMENT CHARGES: 1 307.00 1532.97
7~,~--~. .... ~. ........... ~_ '~,_'__~' ',', .... ' .."
103 for Borrower; line 502 for Seller)
(o0/g) I, Sg-I::lg 01(].4 Jequ.~l~l
PLEASE
BE SURE
mOo'u .ofl3nJ3suoo)iO~u.~u~
TO DEDUCT CHARGES THAT AFFECT YOUR ACCOUN'
ITEM NO. OR
TRAN$ CODE
0093,
PLEASE BE SURE T~
DEDUCT CHARGES THAT AFFECT YOUR ACCOUN
/ (00~) 'l~-'g-l::18 OIO_-I Jeqtue~
Genuine Baraain on Genuine LeatheH
DI=SGRIPTION
(') $ .'a
REV-485 EX+ {1-92) ,~
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX D~VISION
DEPT. 280601
HARRISBURG, PA 17128-0601
SAFE DEPOSIT BOX
INVENTORY
COPY
Please Print or Type
MUST BE COMPLETED BY REPRESENTATIVE OF FINANCIAL INSTITUTION WHERE SAFE DEPOSIT BOX IS LOCATED AND RETURNED TO ABOVE ADDRESS
U COUNTY CODE ~ FILE NUMBER
21
02-0167
~! D~EDENT'S NAME (LAST, FIRS~ MIDDLE)
Wolf, John N. Sr.
~ol ADDR~ OF D~EDENT (STREE~ ·
1556 Newville,.Road
SOCIALSECURITY OR DEATH
205-09-5313 CERTIFICATE NUMBER
DATE OF DEATH
1/23/02
(CITY) (STATE) (ZiP CODE)
Carlisle, PA 17013
J~l NAME AND ADDRESS OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOX
Dorothy W. Weary, Executrix
(STREET ADDRESS) (CITY) (STATE) (ZIP CODE)
2096 Ritner Highway Carlisle, PA 17013
NAME, ADDRESS AND RELATIONSHIP (IF ANY) TO DECEDENT, OF PERSON(S) PRESENT AT THE BOX OPENING
a. (NAME)
(RELATIONSHIP)
Dorothy W. Weary daughter, executrix
(STREET ADDRESS)
(CITY) (STATE) (ZIP CODE)
2096 Ritner Highway Carlisle, PA 17013
b. ENAMEl (RELATiONSHiPi
George. F Douglas, III, Esquire attorney for estate
(STREET ADDRESS) (CITY) (STATE) (ZiP CODE)
27 W. High St., Carlisle, PA 17013
c. (NAME) (RELATIONSHIP)
(STREET ADDRESS) (CITY) (STATE) (ZiP CODE)
NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED :
M&T Bank
(STREET ADDRESS) (crrY) (STATE)
(ZIP CODE)
1 W. High St. Carlisle, PA 17013
NAME OF PERSON MAKING LAST Eh~Y
DAT~ N~ . DATI~ ANp TIME OF LAST ENTRY
ACT TO RENT BOX ~ NUM~ m BOX ~ ~DE~~ I'~--R~STER-~'~--- --
NAME AND ADDRESS OF PERSON(S) HAVING ACcEss TO BO~--'
a. (NAME)
Dorothy W. Weary, Executrix
(STREET ADDRESS)
2096 Ritner Highway
(CITY) (STATE) (ZiP CODE)
Carlisle, PA 17013
NAME AND TITLE OF EMPLOYE TAKING THE INVENTORY
b. (NAMEI
(STREET ADDRESS)
(c11~0 (STATE) (ZIP CODE)
A WILL IN THE BOX? I~'YES ~ If yes, a. Date of will: April' 12, 1990
b. Name and address of personal representufive, if named in the will
(NAME)
Dorothy W. Weary, 2096 Ritner Hwy., Carlisle, PA 17013
(STREET ADDRESS). (CITY)
(STATE) (ZIP CODE)
c. Name and aJJ qr:J$ of ~;;~,,.ey,
~r- if any
(NAME)
George. F. Douglas, III, Esquire, 27 W. High St.
(STREET ADDRESS) ' '
Carlisle, PA 17013
(CITY) (STATE) (ZiP CODE)
Page __ of_~
SAFE DEPOSIT BOX INVENTORY
INSTRUCTIONS
(1) Cash: Report total only.
(2) Stocks: List in detail every common or preferred certificate, warrant or other rights found in box. Stocks are
to be designated by name of company, certificate number, date of certificate, name in which stack is registered,
and number of shares and class of stock.
(3) Obligations of U. S. Government: Number of items, date of issue, face value, names in which registered
and type of oWnership, i.e., jointly held, payable on death, etc.
(4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds)
(5) Bank and Savings and Loan Passbooks: State name of depositor, number of book, last date appearing in
book, name of bank and branch, and balance.
(6) Jewelry, Coins, Stamps, Manuscripts, etc: List and describe as fully as possible.
(7) O~eds, Mortgages, Current Insurance Policies or other evidences of indebtedness: List and describe as
fblly as possible.
(8) All other contents.
ITEM
NO. ITEM DESCRIPTION
CERTIFY UNDER PENALTY OF PERJURY THAT THE ABOVE RECORD IS PERSON RECEIVING COPY OF
CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. SAFE DEPOSIT BOX INVENTORY:
SIGNATURE
IN~AME AND CF~CK APPROPRIATE BOX~__~OW:
PRINT TITLE I Cr~PPROPRIATE BOX:
L~ Executor(trix) [~ Admlnistrator (tri-x)
NI~TI:._ ~.tt.~'k ~,~d~F~If:------~ OIL ,I · · ,. . ..... []Estate Representative [] Joint owner of safe deposit box
ana 81/2" x I I" sheet (s) if necessary or use duplicates of this page of form.
0
0
Itl
C)
0
m C
0
0
0 7
· -!m
Z
113 :
~11
II
~111
113
0
0
-
0
0
Z
~ m
~ x
0 Z
(3)
Estate of John N. Wolf~ Sr.
also known as
INVENTORY
., Deceased
No. 21 02 0167
Date of Death January 23, 2002
Social Security No. 205-09-5313
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 the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We
verify that the statements made in this inventory are true and correct. I/We understand that false statements herein made are subject to the
penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Name of
Attorney:
I.D. No.:
Address:
George F. Douglas, III, Esquire
61886
27 W. High St.
Carlisle PA 17013
Personal Representative:
Dorothy W. Weary
2096 Ritner Hiflhway,Carlisle~ PA 17013
Dated May 21,2002
Telephone: 717-243-1790
Description
Real Estate with house located at 1556 Newville Road, Carlisle, PA
M&T Bank, Market IndexAccount #941597
M&T Bank, Checking Account
M&T Bank, Market IndexAccount #72621
U.S. Series E Savings Bonds, including interest of 10,363.45
Manor Care, refund
(Attach Additional Sheets if necessary)
Value
75,000.00
23,596.47
4,781.08
35,437.97
12,125.95
986.40
Total
153,161.31
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
RW-4
John N. Wolf, Sr.
Description of Inventory
Continuation of Inventory
Pa,qe 1
21
02
0167
Manor Care, refund
Description
Blue Cross, refund
Real Estate Tax Pro-ration received
Subtotal
Grand Total
Value
773.00
155.54
304.90
$ 1,233.44
$ 153,161.31
BUREAU OF INDIVIDUAL TAXES
TNHERZTANCE TAX DTVZSTON
DEPT. 280601
HARR'rSBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTNENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAZSENENT, ALLO#ANCE OR DZSALLO#ANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
GEORGE F DOUGLAS III"ESQ
DOUGLAS ETAL
Z7 W HIGH ST
CARLISLE PA~'~7~!3
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
06-2q-ZOOZ
WOLF
01-2:5-2002
21 02-0167
CUMBERLAND
101
Amoun~ Rem i'l:'l:ed
JOHN N
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAHD CO COURT HOUSE
CARLISLE, PA 1701:5
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-154? EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAZSENENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF WOLF JOHN N FILE NO. 21 02-0167 ACN 101 DATE 06-2q-2002
TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORZGINAL RETURN
1. Real Estate (Schedule A) (1)
2. S~ocks and Bonds (Schedule B) (2)
3. Closely Held S~ock/Par~narsh/p Zn~eres~ (Schedule C) (3)
q. Not,gages/No,es Reca/vable (Schedule D) (q)
$. Cash/Bank Daposl~s/NLsc. Personal Proper~y (SchBdule E) (5)
6. Jointly O~ned Proper~y (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. To~el Asse~s
APPROVED DEDUCTZONS AND EXEMPTZONS:
9. Funeral Expenses/Adm. Cos~s/Nisc. Expenses (Schedule H) (9)
10. Dab~s/Nor~gega Liabili~iss/Liens (Schedule 1) (10)
11. To*al Daduc*ions
Ne~ Value of Tax Re~urn
75~000
12z125
O0 NOTE: To insure proper
95 cred/* ~o your account,
O0 submi~ ~he upper portion
O0 of ~hLs form ~i~h your
~ax payment.
:56
O0
O0
(8)
18,775.89
.O0
13.
1~.
NOTE:
ASSESSMENT OF TAX:
15. Amoun~ of Line 1~ a~ Spousal ra~e
16. Amoun~ of Line 1~ ~axable a~ LLneal/Class A ra~e
17. Amoun~ of Line 1~ a* Sibling rate
18. Amoun~ of Line lfi ~axable a~ Collateral/Class B ra~e
19. Principal Tax Due
TAX CREDZTS:
PAYMENT RECEZPT D/SCOUNT (+)
DATE NUMBER ~NTEREST/PEN PAID (-)
0q-18-2002 CD001086 :502.37
15:5,161
IF PAID AFTER DATE /NDZCATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
(15), .00 x O0 = .00
(16). l:sq,:585.fi2 x 0~.5 = 6,0q7.:5~
(17) . O0 x 12 = . O0
(18) . O0 x 15 = · O0
(19)= 6,0q7.:sq
ANOUNT PAID
8,500.00
Charitable/Governmental Bequests; Non-elect:ed 911:5 Trusts (Schedule J) (13) . O0
Ne~: Value of Es~:a~:e Subject: ~:o Tax (1~.) 1:5~,:585.q2
Z~ an assessment was lssued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
TOTAL TAX CREDIT I
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
8,802.:57
2,755.03CR
.00
2,755.03CR
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS RE~UZRED.
ZF TOTAL DUE IS REFLECTED AS A 'CREDZT' (CR), YOU NAY BE DUE
A REFUND. SEE REVERSE SZDE OF TH/S FORN FOR /NSTRUCTZONS.)
reflect figures that include the total of ALL returns assessed to date.
(11) 18.77;.89
(12) 13q,:585. q2
RESERVATION:
Estates of decedents dying on or before December 1Z, 19BI -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
1ifa or for years, the Coemonmoalth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the 1aclu1 Class B (collateral) rate on any such future interest.
PURPOSE OF
NOTICE:
PAYMENT:
REFUND
OBJECT[OHS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
To ~ulfill the requirements of Section glqO of the Inheritance and Estate Tax Act, Act 25 of ZOO0. (7Z P.S.
Section 91qO).
Detach the top portion of this Notice and submit eith your payment to the Register of Nills printed an the reverse side.
--Hake check or money order payable to: REGISTER OF HILLS, AGENT
A refund of a tax credit, which mas not requested on the Tax Return, may be requested by completing on 'Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Appllcatiens are available at the Office
of the Register of Hills, any of the Z$ Revenue District Offices, or by calling the special Iq-hour
answering service for forms ordering: 1-800-$6Z-Z05O; services for taxpayers eith special hearing and / or
speaking needs: 1-800-q47-30ZO (TT only).
Any party in interest not satisfied ~ith the appraisement, a11oaance, or disallouance 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 Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 17liB-lO[l, OR
--election to hove the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
Factual errors discovered on this assessment should bo addressed in eriting to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 171Z8-0601
Phone (717) 787-6505. Sam PaRe 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-lSD1) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the dacadant's death, a five percent (eX) discount of
the tax paid is allowed.
Tho 15Z tax amnesty non-participation penalty is computed on tho 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 in the same manner and in the the same tiaa 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, or nine (93 months and one (1) day from tho date of
death, to the date of payment. Taxes ~hich became delinquent before January l, 198Z bear interest at the rate of
six (6g) percent par annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January 1, 19BI will bear interest at a rate ehich aiil vary from calendar year to calendar year aith that rate
announced by the PA Department cf Revenue. The applicable interest rates for 1982 through ZOOZ are:
Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor
198Z ZOZ .000548 199Z 9Z .000Z47
1983 16Z .000438 1993-1994 7Z .00019Z
1984 llZ .000301 1995-1998 9Z .000247
1985 13Z .000356 1999 7Z .O0019Z
1986 lO[ .000Z74 ZOO0 8Z .O00Z19
1987 9X .000Z47 ZOO1 9Z .O00Zq7
1988-1991 llZ .O0030X ZOO[ 6Z .000164
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELZNI~UENT X DATLY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent alii reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date sheen on the
Notice, additional interest must be calculated.
BUREAU OF TNDTVZDUAL TAXES
/NHERTTANCE TAX DIVISION
DEPT. 280601
HARRTSBURG, PA 17128-0601
COMHONWEALTH OF PENNSYLVAN'rA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEHENT OF ACCOUNT
REV-I;O? EX AFP (02-02)
GEORGE F DOUGLAS III ESQ
DOUGLAS ETAL
27 W HIGH ST ~..
CARLISLE PA~7015
DATE 07-22-2002
ESTATE OF WOLF
DATE OF DEATH 01-25-2002
FILE NUHBER 21 02-0167
COUNTY CUMBERLAND
ACN 101
Amount Remitted
JOHN N
HAKE CHECK PAYABLE AND REHZT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
NOTE: To insure proper credit to your account, subm/t the upper portion of thAs form with your tax payment.
CUT ALONG TH'rS L'rNE I1~ RETA'rN LOWER PORT'rON FOR YOUR RECORDS *~
ESTATE OF WOLF JOHN N FILE NO. 21 02-0167 ACN 101 DATE 07-22-2002
THTS STATEHENT TS PROVTDED TO ADVTSE OF THE CURRENT STATUS OF THE STATED ACN TN THE NAHED ESTATE. SHONN BELON
TS A SUMMARY OF THE PRTNCTPAL TAX DUE., APPLTCAT/ON OF ALL PAYMENTS, THE CURRENT BALANCE, AND., TF APPLTCABLE,
A PROJECTED /NTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 06-17-Z002
PRINCIPAL TAX DUE: ...........................................................................................................................................................................................................................
PAYMENTS (TAX CREDITS):
6,047.$4
PAYMENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID ¢-) AMOUNT PAID
04-18-2002
07-05-2002
CD001086
REFUND
IF PA/D AFTER TH/S DATE, SEE REVERSE
S/DE FOR CALCULATION OF ADDITIONAL INTEREST.
ZF TOTAL DUE ZS LESS THAN $1,
NO PAYMENT IS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' {CR),
:502.57
.00
8,500.00
2,755.03-
TOTAL TAX CREDIT
6,047.$4
BALANCE OF TAX DUE .00
ZNTEREST AND PEN. .00
TOTAL DUE .00
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. )
PAYMENT:
Detach the top portion of this Notice end submit with your payment mmda payable to the name and address
printed on tho reverse side.
-- If RESIDENT DECEDENT make chock or money order payable to: REGISTER OF WILLS, AGENT.
-- If NON-RESIDENT DECEDENT make check or money order payable to: COMMONWEALTH OF PENNSYLVANIA.
REFUND [CR): A refund of a tax cradit, which was not requested on tha Tax Return, may be requested by completing an
"Application for Rsfond of Pennsylvania Inheritance and Estate Tax" CREV-1315). Applications ara available at
the Office of the Register of Nills, any of the Z$ Revenue District Offices or from the Department's Z4-hour
answering service for forms ordering: 1-800-$62-Zg50; services for taxpayers with special hearing and / or
speaking needs: 1-BOO-447-50ZO (TT only).
REPLY TO:
Questions regarding errors contained on this notice should ba addressed to: PA Department of Revenue, Bureau
of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 17128-0601, phone
(717) 787-6SOS.
DISCOUNT:
If any tax due is paid within throo ES) calendar months altar the dacedant's death, a five percent [SI) discount
of the tax paid is aIlowad.
PENALTY:
The 15Z tax amnesty non-participation panalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period.
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 which became delinquent before January l, 198Z bear interast at the rate of
six ESI) percent per annum calcuZatad at a daily rate of .000164. All taxes which became delinquent on and after
January l, 1982 will bear interest at a rate which will vary from calandar year to calandar year with that rate
announced by the PA Department of Revenue. The applicable interast rates for 198Z through ZOOZ ara:
Year Interest Rate Daily Interest Factor Year Interest Rate
m
Daily Interest Factor
198Z 20Z .000548 Z99Z 9Z .000247
1983 16Z .0004S8 1995-1994 7Z .O00lgZ
1984 X1Z .000501 1995-1998 9Z .000247
1985 13Z .000356 1999 7Z ,OO019Z
1986 IOZ .000274 ZOO0 8Z .000219
1987 9Z .000247 ZOO1 9Z .0002~7
1988-1991 llZ .OOO~01 200Z 6Z .000164
--Interest is calculatad as follows:
INTEREST = BALANCE OF TAX UNPAID X NUXBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Noticej additional interest must be calculated.
DEC-18-2003 12:51 FROM:DUNCAN HARTMAN
7172497800
T0:7172438955
Name of Decedent;
Dale of Death:
STAT
'S I~.PORT tYJxrDER RULE 6.12
2.o0 ~ L
7
Will No.; ~2~ [ - 0 2-- -- ~ Admin, Ne.:
Pursuant to Rule 6.12 of tho Supreme Com't Orphans' Court Rul,;s, I report the
following with respect to completion of the adn~hfis~ration o£tho abov¢-baptioned estate:
/
1. State wh~her administration of the estat~ is complete:
2. If the aiswer is No, ,state when the personal representative r¢~onably believcs
thai the adwi~istrafibn will be complete:
P.5/5
If the an.ewer to No.
is Yes, state the following:
Did the p~rsona] opresmtafiv¢ fil~ a fin~! aooount
No
The s~e Or ,ang' Co~ No. (~my) for ~ p~monal
a~o~t is:,
Did ~e p~o~ r~res~tafiw ~ate m a~t i~o~al!y to ~e p~es
~ ~t~? Yes ~ No ~ '
' ~ o de. reda rovaloffo~flor
e. Copi~ of receipt, ~lem , j ~ pp ,'
~o~fl ~e$~ may be fil~ ~ ~e Clerk of the. ~hms'
Silage
Addross
Telephone No.
tpaeity: ~ P_..ersonal Representative
i=~Com~sel for p~rso,ial representative