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HomeMy WebLinkAbout03-0833 PETITION FOR PROBATE and GRANT OF LETTERS Estate of GLADYS d. COTTON NO. ~ }'-'~,3-~?~ also known as GLADYS JULIA COTTON To: , Deceased. Social Security No. 079-18-2079 The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the executor in the last will of the above decedent, dated JUNE 4, 1998 and codicil(s) dated NONE Register of Wills for the County of CUMBERLAND Commonwealth of Pennsylvania in the named (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, with h er last family or principal residence at 335 Wesley Drive~ Lower Allen Township, Mechanicsburfl PA 17055 (list street, number and municipality) Decedent, then 03 years of age, died 9/30/03 at Holy Spirit Hosl~ital. Camp Hill, Pennsyvlania 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 ora killing and was never ajudicated incompetent: NONE Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania /" $ situated as follows: / NONE // WHEREF~)P~, petit')6h¢(s~trespe~fuily request(s)the probate of the last will and codicil(s) presented he/e)~lth, an~flh~tg)~nt of~l~tters tostamontary thereon, y~/~/,/// ////f / (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) u'~ M U R R EL R. WALTE R SI ~,~. ~ 5'-~ EAS T M A I~S T RE E~ '~ ~, MECHANICSBURG PA 17055 ~ O 20,000.00 0.00 0.00 0.00 OATH OF PERSONAL REPRESENTATIV COMMONWEALTH OF PENNSYLVANIA ~ ss / / COUNTY OF CUMBERLAND j / The petitioner(s) above-named swear(s) or affirm(s) that ~e~atem~s in the/~ff(~egoing petition are tree and correct to the best of the knowledge and belief of l~et~oner~/~aj~ tha~s personal represen- tative(s) of the above decedent petitioner(s) will well and t/h/~3d~,,the/kstate accj;}rding to law. Swom to or affirmed and subscribed ,- //////fi/F~//.,,//~---~ ~ before me this 14th day of [ ~' '~ [ ' / ~ ( 'D~^ ~o~.October_2003 .~ J Murrel~ R. WalteL/rs III i7-1&q-/ g °nna M. Otto,±st Depur. y ,J~egiO~r' ~L No. 21-2003-833 Estate of GLADYS J. COTTON , ark_/a , Deceased Glaff/s Julia Cotton DECREE OF PROBATE AND GRANT OF LETTERS AND NOW October ir]th 2003 , 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 014t98 described therein be admitted to probate and filed of record as the last will of G,ADYS J. COTTON. a!k/a c~] ~ j,, ] ~ a Cotton and Letters TESTAMENTARY are hereby granted to MURREL R. WALTERS III; ESQ. FEES Probate, Letters, Etc ......... $ 50.00 Short Certificates ( 2 ) ...... $ 6.00 ~ x~Pages.(.2.).. $ 6.00 JCP 10.00 $ TOTAL_ $ .~._~.',~} Filed· .Qc.tober. l~t.h,. 20.03 ........ Put in Attorney Murrel Waiters ~ile in Prothonotary on 10-15-03. Donna M. Otto, 1st Deputy MURREL R. WALTERS III, ESQ. 24849 ATTORNEY (Sup. Ct. I.D. No.) 54 EAST MAIN STREET MECHANICSBURG PA 17055 ADDRESS 717-697-4650 PHONE 21-2003-833 L~ST #'rLL ~ TEST~4ENT BE IT REMEMBERED THAT I, GLADY S J. Pennsylvania, being COTTON, a resident of Cumberland County, of sound and disposing mind, memory and understanding, do make, publish and declare this to be my LAST WILL and TESTAMENT, hereby previously made by me. revoking any and all Wills and Codicils my beloved husband having sons, WILLIAM C. COTTON, paid from my residuary estate decease. as soon as practicable after my III I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. IV I give, devise and bequeath all of my property, whether real or personal, wherever situate, including any property over which I may have a power of appointment, as follows: TEN PERCENT (10%) to KIM M. GETZ, per stirpes; EIGHTY PERCENT (80%) to my son, CHARLES, per stirpes; TEN PERCENT (10%) to MURREL R. WALTERS, III, ESQUIRE. This shall be in lieu of any and all attorney's fees and/or Executor's commission that would be payable from my estate. I declare that I am not married, predeceased me, and that I have two (2) JR. and CHARLES F. COTTON. II I direct that all my just debts and funeral expenses shall be V I nominate, constitute and appoint MURREL R. WALTERS, ESQUIRE, as Executor of this LAST WILL, to serve without bond. III, IN WITNESS WHEREOF, I, GLADYS J. COTTON, have set my hand to this LAST WILL this 4th day of June, 1998. Signed, sealed, published and declared by the above-n~med /'' GLADYS J. COTTON, as and for her Last Will and Testament, in t~ presence of us, who, at her request and in her presence, and in/~he presence of each other, have hereunt~ subscribed our na~e~s as witnesses. V~//~ /~ ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA : ss. COUNTY OF CUMBERLAND : I, GLADYS J. COTTON, Testatrix, 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 instrument as my LAST WILL; that I signed it as my free and voluntary act for the purposes therein expressed. COTTON Sworn or affirmed to and acknowledged before me by GLADYS J. COTTON, Testatrix, this L/~ day of -~i~.~-C , 1998. Notary Public Notarial Seal .... Diane M. Smith, NOtary Public Mechanlcsburg Boro, Cumberland County Commission Expires June 22, 2000 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA : ss. COUNTY OF CUMBERLAND : We, /) I~ri'~ / ~- LL-~-~ ~, ~7 and the witnesses whose names are signed to the attached or ~oregoing instrument being duly qualified according to law, do depose and say that we were present and saw Testatrix sign and execute the instrument as her LAST WILL; that GLADYS J. COTTON signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and/- sight of the Testatrix signed the Will as witnesses; and that,/to/ the best of our knowledge, the Testatrix was at the ~me 18~a~ of age or more, of sound mind and under, no constraint or//u~glue influence ~~~ Sworn or affirmed to and acknowledged before(Jme this ~/~ day of ,~%~ , 1998. Notary Public Diane M, 6_mith,_N0t.~ry.Public Nlechanicsburg ~o~o, ~umoarland County My CommissiOn Expires June 22, 2000 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Gladys J. Cotton Date of Death: September 30, 2003 Will No. Admin. No. 21-2003-833 To the Register: I certify that notice of (beneficial interest) estate administration 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 October 17, 2003. Name Address Charles Cotton 1919 W. Colter C-7, Phoenix, AZ 85015 Williams C. Cotton, Jr. 1310 Strathmore Ct., Concord, CA 94518 ~ Notice has now been given to all persons entitled t3er/~under ~.6(a)/e, ffcept: Date: October 17, 2003 Murrel R. Walters, III, Esquire 54 East Main Street Mechanicsburg, PA 17055 (717) 697-4650 Capacity: X __ _ Personal Representative __ Counsel for personal representative CLAIM FORM ESTATE OF GLADYS J. COTTON THE BON TON No=ice of claim by ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY NO. 21-03-833 in the aznount of $ 491.68 filed pursuant to section 3384, Probate, Es=ares and Fiduciaries Code Laws of 1972, Act No. 1D4 effective July 1, 1972 as amended. Date 19 9441 LBJ FREEWAY To ~ CLSR× oF T~E O.P~U~S' COURT D~VISm~, LOCk Box 30 THE BON TON (Claimant and Address) --- in the amount of $ 491,68 against the above entitled Estate. The decedent who resided at335 WESLEY DR. APT. 524 ,MECHANICSBURG PA 17055 (Address} died on (Date) Written notice of said claim was given to MURREL T. WALTERS III, ESQ. -(Personal Representative or Counsel) at 54 E. MAIN ST., MECHANICSBURG, PA 17013 (Address) on (Date) The basis of aforesaid claim is as follows: (Itemize fully to enable personal representative to make proper investigation). Acct. #050-324-912 Claimant's Counsel (Name) (Address) 9441 LBJ FREEWAY Lock Box 30 D/~,P~,~'t~ 75243 PROBATE COURT Cumberland County, State of Pennsyl~a Gladys J. Cotton, Deceased Case #21-03-833 Proof of Mailing I mailed the creditors claim to the fiduciary (and attorney, follows: if applicable) as I deposited a copy/copies of the claim with the United States Postal Service in a sealed envelope with the postage fully pre-paid. I used first-class mail. I am employed in the county where the mailing occurred. The envelope (s) was/were addressed and mailed as follows: Mr. Murrel Walters Iii Esq. 54 E. Main St. Mechanicsburg, PA 17013 Date of Mailing: County of Mailing: Dallas, Texas I declare un~r ~Dalty of penury that the foregoing is true and correct. Date: P.O. Box 741026 Dallas, TX 75374 PACKE GE: 22 BTS-CO. ~1F-001 RUN ON: 12/ 3/2003 00:35:44 EMPLOYER ADDRESS CZTY STATE PHONE: EXT: COMMENTS: PREV-BAL PURCHASE CUR 491 . 68 . O0 PRV A~. 92 491 . 68 NAME GLADYS d COTTON HOME PHONE + ADDRESS DATE OPEN ADDRESS 335 WESLEY DR APT 524 OTHER ACCT CITY STATE MECHANICSBURG PA17055 REQ PAYMENT SPOUSE A/R BAL CURR PAY MEMO PUR MEMO CR HOL-BON TOTAL THE .~-TON MEC NRA - LOP ACCT# 050-324-912 F COLLECTOR 12 ~ 717/761-3758 LZMIT 0 WAC 09/56 ADd CODE ADd AMT 00000000 [N/COLL 12/03 STATUS &DLTH 500 CYCLE 79 0 MP! I ~ 0 HZMP~TY 1 ._. 0 HZMP~LY 0 HZMPIMO 11 5O0 PAY/RET F[N-CHRG NEW BAL PAST/DUE AMT-DUE .00 8.85 500.53 .00 .00 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 0O3931 WALTERS MURREL R III 54 E MAIN STREET MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN: 079-18-2079 FILE NUMBER: 2103-0833 DECEDENT NAME: COTTON GLADYS J DATE OF PAYMENT: 05/12/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 09/30/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $592.00 TOTAL AMOUNT PAID' $592.00 REMARKS: SEAL INITIALS' JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS REV-1500 EX * (6-00) Z Z 0 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) COTTONy GLADY$ J. DATE OF DEATH (MM-DD-Year) I DATE OF BIRTH (MM-DD-Year) 09/3012003 I 03~01/1910 (IF APPLICABLE) SURVIVING SPOUSE'S NAME {LAST, FIRST, AND MIDDLE INITIAL) OFFICIAL USE OflLY FILE NUMBER 2 I -0 3 0 0 8 3 3 COUNTY COOE YEAR NUMBER SOCIAL SECURITY NUMBER O 7 9 - I 8 -- 2 O 7 9 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER [~'~ 1. Original Return [~]4. Limited Estate r-~6. Decedent Died Testate (Attach copy of Will) r-'~ 9. Litigation Proceeds Received D2. Supplemental Return r-'-] 4a. Future Interest Compromise (date of death after 12-12-82) D7. Decedent Maintained a Living Trust (Altoch copy of Trust) [~10. Spousal Poverty Credit (date of death between 12.31-91 and 1-1-95) r'-] 3. Remainder Return (date of death pdor to 12-13-82) O5. Federal Estate Tax Return Required 1__ 8. Total Number of Safe Deposit Boxes I--~11. Election to tax under Sec. 9113(A) (Attach Sch O) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: COMPLETE MAILING ADDRESS NAME MURREL R. WALTERS II1~ ESQ. FIRM NAME (If Applicable) TELEPHONE NUMBER 717-697-4650 54 EAST MAIN STREET MECHANICSBURG PA 17055 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B)i (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4, Mortgages & 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 Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9, Funeral Expenses & Administrative Costs (Schedule H) (9) 10. (10) 11. 12. 13. (8) 10;393.32 1;098.07 1~671.67 Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) Total Deductions (total Lines 9 & 10) Net Value of Estate (Line 8 minus Line 11) 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) OFFICIAL USE ONLY 13;163.06 (11) 1;549.00 631.06 2,180.06 10;983.00 10;983.00 (12) (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 X __ (15) 10~051.87 X .O45 (16) 452.33 139.67 592.00 17. Amount of Line 14 taxable at sibling rate X .12 (17) 18. Amount of Line 14 taxable at collateral rate 931.13 X ,15 (18) 19. Tax Bue (19) 20. > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < Decedent's Complete Add,'ess: IScTREET ADDRESS 335 WESLEY DRIVE, APT. 524 ' MECHANICSBURG STATE PA IZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (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 tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 592.00 592.00 592.00 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ........................................................................... [] [] b. retain the right to designate who shall use the property transferred or its income; ........................................ [] [] c. retain a reversionary interest; or ...................................................................................................... [] [] d. receive the promise for life of either payments, benefits or care? ............................................................. [] [] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ............................................................................................... [] [] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. [] [] 4. Did decedent own an I~dividual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation ............. /. ......................................................................................... [] [] IF THE ANSWER TO ANY OF TH,,E ~OVE O S IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, J~ec~re that l ha. ye~.ex~linj~d this ret~, in~l~g accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer ot~r, rl~n the per~a~r,~ntative i~ase~n all information of which preparer has any knowledge. SIGNATURE OF P E,~/~,~/./~P/,~/B~p/~ F~ G/~ URN DA TE Y l/~/ ~ /// ~//~r/~'/ L _ 4130104 ADDRESS MURREL I~. WALTERS III, ESQC 54 EAST MAIN STREET~ MECHANICSBURG PA 17055 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to 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, 1,995, 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-1503 EX ~' (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RI~IDENT I[;)ECEOENT SCHEDULE B STOCKS & BONDS ESTATE OF COTTON, GLADYS J, All property jointly-owned with right of survivorship must be disclosed on Schedule F. FILE NUMBER 2~1 03 00833 ITEM NUMBER DESCRIPTION U.S. SAVINGS BONDS LIQUIDATION VALUE TOTAL (Also enter on line 2, Recapitulation) VALUE AT DATE OF DEATH 10,393.32 10~393.32 (If mom space is needed, insert additional sheets of the same size) REV-I~8 EX + (1-9~ ~ COMMONWEALTH OF PENNSYLVANIA INNERITANCETAXRETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER COTTON, GLADY$ J, 21 0:~ 0~3~ Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 18.00 5 6 ALLSTATE RENTER'SINSURANCE REFUND ALLSTATE AUTOMOBILEINSURANCE REFUND BETHANY DEVELOPMENT CORP REFUND BETHANY DEVELOPMENT CORP. REFUND-SECURITY DEPOSIT AUTOMOBILE 1991 PLYMOUTH ACCLAIM BON TON CREDIT BALANCE FROM CHARGE CARD 2.30 39.00 53.09 540.00 445.68 TOTAL (Also enter on line 5, Recapitulation) $ 1,098.07 (if more space is needed, insert additional sheets of the same size) REV-1509 EX + (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER COTTON, GLADYS J. ~1 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. 00833 SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. CHARLES F. COTTON SON B C 1919 W. COLTER C-7 PHEONIX, AZ 85015 JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH iTEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTERES 1. A. 11119/79 MEMBERS 1ST F.C.U. 514.021 50. 257,01 SAVINGS 2 A 9/15/97 MEMBERS 1ST F.C.U. 2,829.32 50. 1,414.66 CHECKING TOTAL (Also enter on line 6, Recapitulation) $ 1~671.63 (If more space is needed, insert additional sheets of the same size) REV-1511EX <' (1-~7) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF COTTON. GLADYS J. Debts of decedent must be reported on Schedule I. FILE NUMBER ;~1 03 00833 ITEM NUMBER DESCRIPTION AMOUNT PREPAID FUNERAL EXPENSES: MYERS-HARNER FUNERAL HOME OBITUARY ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Pemonal Representative (s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Year(s) Commission Paid: Attorney Fees MURREL R. WALTERS III, ESQ Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Zip Street Address C~ty State Relationship of Claimant to Decedent Probate Fees REGISTER OF WILLS CUMBERLAND COUNTY Accountant's Fees AL WHITCOMB, P.A. 43 W. MAIN ST., MECHANICSBURG, PA 17055 Tax Retum Preparers Fees Zip 33.00 931.00 90.00 495.00 TOTAL (Also enter on line g, Recapitulation) $ 1~$49.00 (If more space is needed, insert additional sheets of the same size) REV-1512 EX + (1~7). , ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES~ & LIENS ESTATE OF COTTON, GLADYS J. Include unreimbursed medical expenses. FILE NUMBER ~1 0:~ 00833 ITEM NUMBER DESCRIPTION AMOUNT 1. 45.29 BOSCOV'S CREDIT CARD VERIZON TELEPHONE ALERT PHYSCIANS AT BETHANY VILLAGE PRESCRIPTIONS AT&T UNIVERSAL CARD CREDIT CARD THE BON TON CREDIT CARD 33.56 18.78 32.90 500.53 TOTAL (Also enter on line 10, Recapitulation) $ 631.06 (If more space is needed, insert additional sheets of the same size) REV-1513 EX + (9-nm COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF COTTOI~ , GLADYS J, NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY 1. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. CHARLES F. COTTON 1919 W. COLTER C-7 PHOENIX, AZ 85015 2. KlM M. GETZ 6300 SMITH STREET MECHANICSBURG, PA 17055 II. 1. FILE NUMBER RELATIONSHIP TO DECEDENT SON NONE 00833 AMOUNT OR SHARE OF ESTATE ~ESIDUE Do Not List Trustee(s) 931.13 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, 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 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) BUREAU OF TNDTVTDUAL TAXES TNHERTTANCE TAX DTv'rSIDN DEPT. Z80601 HARRTSBURG, PA 171Z8-0601 COMMONNEALTH OF PENNSYLVANXA DEPARTMENT OF REVENUE NOTZCE OF ZNHERZTANCE TAX APPRAZSEMENT, ALLONANCE OR DZSALLOWANCE OF DEDUCTZONS AND ASSESSMENT OF TAX RE¥-IG4? EX AFP COl-OS) MURREL e WALTERS 5q E MAIN ST MECHANICSBURG PA 17055 DATE ESTATE OF DATE OF DEATH FXLE NUMBER COUNTY ACN 07-05-200q COTTON 09-50-2005 Z1 05-0855 CUMBERLAND 101 Amount: Remi~:edd GLADYS J MAKE CHECK PAYABLE AND REM/T PAYMENT TO.' REGISTER OF MILLS CUMBERLAND CO COURT HOUSE CARL/SLE, PA 1701:3 CUT ALONG THZS LZNE ~ RETAZN LONER PORTZON FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTZCE OF ZNHERZTANCE TAX APPRAZSEMENT, ALLONANCE OR DZSALLONANCE OF DEDUCTZONS AND ASSESSMENT OF TAX ESTATE OF COTTON GLADYS J FZLE NO. 21 05-08:35 ACN 101 DATE 07-05-200q TAX RETURN WAS: (X) ACCEPTED AS FZLED ( ) CHANGED RESERVATZON CONCERNZNG FUTURE ZNTEREST - SEE REVERSE APPRA/SED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es~a~e (Schedule A) (1) 2. S~ocks and Bonds (Schedule B) (2) $. Closely Held S~ock/Par~narship Zn*eres~ (Schedule C) ($) q. Mar*gages/No,es Receivable (Schedule D) (q) S. Cash/Bank Deposits~Misc. Personal Proper~y (Schedule E) (S) 6. Jointly Owned Propar~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To,al Asse~s APPROVED DEDUCTXONS AND EXENPTZONS: 9. Funeral Expenses/Adm. Cos~s/Misc. Expanses (Schedule H) (9) 10. Dab~s/Mor~gage Liabil/~ias/Lians (Schedule Z) (10) 11. To,al Deduc~/ons 12. Na~ Value of Tax Re~urn 10~$95.32 .00 1/098.07 1/671.67 .00 .00 NOTE: To /nsura proper cred/~ ~o your account, subei~ ~he upper por~/on .00 of ~his form w/~h your ~ax payment. 1,5q9.00 651.06 (e) 15,165.06 15. NOTE: (11) 2.180. O& (la) 10,985.00 Charitable/Governmental Bequests; Non-elected 911:5 Trusts (Schedule J) (15) Ne~ Value of Es~a~:e Sub,~ec~: ~:o Tax (lq) :If an assesseent was issued previously, lines 14, 15 and/or 16, 17, reflect figures that include the total of ALL returns assessed to date. .00 10,98~.00 ASSESSMENT OF TAX: 15. Amoun* of Line lq a~ Spousal ra~e 16. Amoun~ of Line lq ~axable a~ Lineal/Class A ra~e 17. Amoun~ of L/ne lq a~ S/bl/ng ra~e 18. Amoun~ of L/ne lq ~axable a~ Collateral/Class B ra~e 19. Princ/pal Tax Due TAX CREDZTS: PAYMENT RECEZPT DI$COUNT DATE NUMBER ZNTEREST/PEN PAZD (-) 0S-12-200~ CD005951 .00 18 and 19 will IF PAZD AFTER DATE /NDZCATED, SEE REVERSE FOR CALCULATZON OF ADDZT/ONAL ZNTEREST. (15) .00 x O0 = .00 (16) 10,051.87 x Oq5 = q52.33 (17) . O0 x 12 = . O0 (18) 9:31.1:3 x 15 : 139.67 (19)= 592. O0 AMOUNT PAZD 592.00 TOTAL TAX CREDZT 592.00 BALANCE OF TAX DUEI .00 ZNTEREST AND PEN. .00 TOTAL DUE .00 ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REgUZRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDZT" (CR), YOU NAY BE A REFUND. SEE REVERSE SZDE OF THZS FORM FOR ZNSTRUCTZONS.)/_~2 RESERVATION: PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 1Z, 198Z -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B [collateral) rate on any such future interest. To ~ulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (TI P.S. Section 91¢0). Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the reversm side. --Make check or money order payable to: REGISTER OF #ILLS, AGENT A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-IS13). Applications are available at the Office of the Register of Nills, any of the Z$ Revenue District Offices, or by calling the special Iq-hour answering service for forms ordering: 1-BO0-36Z-20SO~ services for taxpayers with special hearing and / or speaking needs: 1-BOO-qq7-30ZO iTT only). Any party in interest not satisfied ~ith the appraisement, allowance, 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 Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. gelOZ1, Harrisburg, PA 171Z8-1021, OR --election to have 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 writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Raviee Unit, Dept. 280601, Harrisburg, PA 171Z8-0601 Phone [717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid eithin three (5) calendar months after the dacedant's death, a five percent (SI) discount of the tax paid is alloNed. 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 end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same tiaa period as you ~ould appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes Nhich became delinquent before January 1, 198Z bear interest at the rate of six (BI) percent per annum calculated at a daily rate of .00016q. All taxes which became delinquent on and after January 1, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOO4 are: Interest Da|ly Interest Daily Year Rate Factor Year Rate Factor 1982 ZOZ . O005qB ~Y~'~- 1991 11Z .000301 1983 162 .000438 1992 92 .000247 19~4 112 .000301 1993-199~. 7Z .000192 1985 13Z .000356 199~5-1995 92 .000247 1986 lOX .000Z74 1999 7Z .00019Z 1957 IOZ .000Z74 ZOO0 7Z .00019Z --Interest is calculated as follo~s: INTEREST = BALANCE OF TAX UNPAID Interest Daily Year Rate Factor ~ 9Z .O00Zq7 ZOOZ 6Z .000164 2003 52 .000137 2004 4Z .000110 X NUNBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent ~ill reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must 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: GLADYS J. COTTON Date of Death: 9/30/03 Estate No.: 21-03-00833 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 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete (date) 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' Court No. (if any) for the personal representative's account is: (Not Applicable in Dauphin County) C. Did the personal representative state an account informally to the parties in interest: Yes_X_ No D. , Copies of receipts, releases, joinders and approvals of for or informal accounts may be filed with the Clerk of the Orphans' Co rt and may be attached to this report. r- U.: C:::l ~-.'~, . LL 1.-,-. , C) . C--J L co I Datef~;~pte~r 7}2005 C:' ,,-, . L. ( t)~ c-:_~> c~) MURREL R. W ALTERS, III, ESQUIRE 54 East Main Street Mechanicsburg, PA 17055 717-697-4650 c-=... c....; Capacity: Personal Representative _X_ Counsel for Personal Representative ~ Cumberland County - Register Of wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 8/30/2005 WALTERS MURREL RIll 54 E MAIN STREET MECHANICSBURG, PA 17055 RE: Estate of COTTON GLADYS J File Number: 2003-00833 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 9/30/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ~~~~ GLENDA FARNER STRASBAlfGH REGISTER OF WILLS cc: File Personal Representative(s) Judge ep