HomeMy WebLinkAbout04-0459PETITION FOR PROBATE and GRANT OF LETTERS
Estate of' gnn~t~ /T]tqE .--]-r_CbEnlf~et-r2.. No.
also known as ~m~nA ~ -TL~tA-~'IT'~-- To:
Deceased.
Social Security No./67-
Register of Wills for the
C0~ty of 0.xtm~eI~ v~( in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
· n~l ~i':" '/~, ......~£ _p_j.: .
Your petitioner(s), who is/are 18 years of age or older an t_he~xecttl:" '~'""L."/'t~l,,-~amed
in the last will of the above decedent, dated 5~ece~l~,t- ,~0. t'q~ 7 ~ 19
and codicil(s) dated e~et~,'~3¢r .~, /~67 ....
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in {r"~'.t~, J~'rt/ta,, ,o/ County, Pennsylvania, with
h last family or principal regidenc'"~-a't ~_~a~/
(list street, number and muncipality)
Decendent, then q(~ years of age, died [3fl ~ ~ , t~ ~oo irt,
0
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 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:
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
theron.
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ~ ss
COUNTY OF
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.
Sworn to or affirmed and subscribed r -77'. ~ ~.
before me this ,,/6Z~r,4/ day of {
No.
Estate Of ~/v~/q /~ ~7~//o~/~e/7-.~ , Deceased
!
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW ./~/0///
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated
described therein be admitted to probate and filed of record as the last will of
~d Letters ~~~W~ q
/
are hereby granted to ~///~/4~ ~ ~~A~/~. ~ '
A~°~in consideration of the petition on
FEES
Probate, Letters, Etc ..........
Short Certificates( ) .......... $
Renunciation ................ $
TOTAL ~ $
Filed ~~.. ~..~......~57..~:' ~... f .....
ATTORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
'his is. to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Ix,cai 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, $~j-O0 ' ::., ~ ~ ~.__ ?~k~%~.~.,~
~1" Local Registrar
No. ' '5 ~
(A,~ .... ' Date
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT 01~ HEALTH · VITAL RECORDS
CERTIFICATE OF DEAI'~I
'- Enlaa M. Ii~enfritz ],. Female I,. 167
~r ~d ~ ~rlisle ~rah ~a M~rial H~ ~.~.~ I ..._
} ,7..~ p~ ~ "'~~ ~uth Middleton
~ Lerew Rd. ,~s~. ~
,~rlisle, PA 17013
~.'s~ ~ '~'~ O~l~"d ~? '?~ ~!-~d, · =,~.
,~ Willi~ B~sser ,,. ~ Ellen Jac~on
~ ~ilIar~ ~. Ii~enf~i~z ~. [~ 1018 R~I~ ~., ~lisle, P~ 17013
--0 --~ O[,,..~y6, 2~ I:,..Let°rt C~te, {.,,. ~rlisle, PA
~ ~~ ~, ~~ ~ [.b. 0131~ b ,~,,o~~ HO~f~ ROth ~eral '
-- '~ ...... ~;;:,;~ Im~:,--~.~,~a,,~,~.~.m,~ I~c. 91Q ~ Ran~,,~
~egiSter of :ggill~ of tEuml~erlan~ t~nuntp ~enn~l,l~ania
OATH OF NON-SUBSCRIBING WITNESS
,Deceased
No.
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that (I a~we are)
familiar with the signature of -~f27/Y2/q /"fJA?,¥ ~-----7~o.o r~/Y-2-~- , testatO,e~ of (one of the
subscribing witnesses to) the will/codicil presented herewith and that _-_-_-_-_-_-_-_-_-_~_ believes the signature on the
will/codicil is in the handwriting of ~f-/2Y,/~),4 jg'J/9 ~' Z~,Oe. of',~/7-.2, to the best
knowledge and belief.
Sworn to or affirmed and subscribed
before me this ?/6Z day
of
f" - /"- ' Fo~Register
(Signamre) ~f
(signattl~) -
Swom to or affirmed and subscribed
before me this __ day of
,20
(Signature)
For the Register
(Signature)
LAST WILL AND TEST~,~ENT
I, Emma Mae Ilgenfritz of Carlisle, Cumberland
County, Pennsylvania, declare this to be my Last Will and
revoke any wills previously made by me.
1. I devise and bequeath all of my estate of
whatever nature and wherever situate to my husband,
Millard T. Ilgenfritz.
2. Should my husband not survive me, I devise
and bequeath my said estate to my children,
Millard I. Ilgenfritz, Jr. and
Carolyn M. Smith
in equal shares.
3. Should either of my children not survive me,
then that share shall be distributed to his or her children,
and in default of such children, then to my surviving child.
4. I appoint my son, iviillard ~. I19enfritz, Jr.,
to be executor of this my Last Will. Should he fail to
qualify or cease to act then I appoint my daughter, Carolyn
M. Smith, to be executrix.
IN WITNESS WHEREOF, I have hereunto set my hand
The preceding instrument was on the date hereof signed, pub-
lished and declared by ~ma ~ae Ilgenfritz as and for her
Last Will, in the presence of us who at heroquest, in her
presence, and in the presence of each other have subscribed
REV 1500 EX (6-00)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
t-"
Z
ill
1:3
LLI
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REV-1 500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
COUNTY CODE YEAR NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
rno-~I o ~.., ;z o4::) ~ ~..To~ e.
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
[~1. Original Return
~]4. Limited Estate
[~6. Decedent Died Testate (Attach copy of Will)
F'~9. Litigation Proceeds Received
F'-[ 2. Supplemental Return
SOCIAL SECURITY NUMBER
E~] 4a. Future Interest Compromise (date of death after 12-12-82)
[~7. Decedent Maintained a Living Trust (Attach copy of Trust)
[~10. Spousal Poverty Credit (date of death between 12-31-91 and 1-%95)
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
E~3. Remainder Return (date of death prior to 12-13-82)
[~5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
E~11. Election to tax under Sec. 9113(A) (Attach Sch O)
NAME
re,ilar'&
FIRM NAME (If Applicable)
TELEPHONE NUMBER
COMPLETE MAILING ADDRESS
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (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
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13.
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14)
(8)
.o0
(11)
(12)
(13)
OFFICIAL USE ONLY
F
1
I 5~5q I.OC)
z4 ~o,~ .o0
t.~ q(~ci, oD
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) x .0 __ (15)
16. Amount of Line 14 taxable at lineal rate { '''~-~ ~¢::~. OO x .0 ~ (16)
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)
Decedent's Complete Address:
STREET ADDRESS ,5 (~, ~- ~,~--_. r',..~
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Povedy Credit
B. Prior Payments
C. Discount
STATE
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)
z~Pi 70 t ~
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
(5) ._~ ~_ ~_. (,, 7...
(5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) ~ ~. ~ ~,.
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
IF THE ANSWER
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? ...................................................................... [] []
If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. [] []
Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ..............[] []
Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ []
TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete.
Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIG~ /,,. ~ATURE OF PERSON R..~ESPON LE FOR FI NG RETURN
SIGNATURE OF PREPARER OTHER ~AN 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 RS. {}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 RS. §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.
REid512 EX + (1-97) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF
FILE NUMBER
Include unreimbursed medical expenses.
ITEM
NUMBER ~) ~_C.F_._ ~ ~) £~3T'5 ~ F..-~T'~ DESCRIPTION
~¢~-._,~¢'d. CE.-
AMOUNT
~3.00
3 5; -00
I O0 o O0
TOTAL (Also enter on line 10, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+ (12-99)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
FUNERAL EXPENSES: 1 t t .oC)
~'0.oo
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State__Zip
Year(s) Commission Paid:
Attorney Fees
Family Exemption: (If decedent's address is not the same a~,~aimant's, attach explanation)
Claimant ~-lr"o I1~ fl ~" ~ ~
Street Address .~O~ Le_re~D
~
Relationship of Claimant to Decedent ~~
Probate Fees ~ ~~ G~. ~
State'Zip ~-'} OL'~
Accountant's Fees
Tax Return Preparer's Fees
TOTAL (Also enter on line 9, Recapitulation)
5" oo, oO
.5'0. oo
(If more space is needed, insed additional sheets of the same size)
REV-1508 EX + (1-97) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
' ESTATE OF FILE NUMBER
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.
~oaqs. oo
TOTAL (Also enter on line 5, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
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 004144
ILGENFRITZ MILLARD T JR
1018 ROCKLEDGE DRIVE
CARLISLE, PA 17013
........ fold
ESTATE INFORMATION: SSN: 167-40-0163
FILE NUMBER: 2104-0459
DECEDENT NAME: ILGENFRITZ EMMA MAE
DATE OF PAYMENT: 07/09/2004
POSTMARK DATE: 07/09/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 05/02/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $588.62
REMARKS:
CHECK# 101
SEAL
TOTAL AMOUNT PAID:
$588.62
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
Cumberland County - Register Of wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717)240-6345
Date: 08/02/2004
ILGENFRITZ MILLARD T JR
1018 ROCKLEDGE DRIVE
CARLISLE, PA 17013
RE: Estate of ILGENFRITZ EMMA MAE
File Number: 2004-00459
Dear Sir/Madam:
It has come to my attention that you have not filed the
Certification of Notice Under Rule 5.7 (a) in the above captioned
estate.
As per the kMENDMENTS 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 ten (10) days after giving proper notice to the
beneficiaries and intestate heirs as required by subdivision
(a) of Rule 5.7, shall file with the Register of wills or Clerk
of the Orphans' Court his/her Certification of Notice.
This filing will become delinquent on 08/24/2004
Your prompt attention to this matter will be appreciated.
Thank You.
cc:
File
Counsel
Judge
GLEN-DA FAi~NER STP~ASBAUGH
Clerk of the Orphans' Court
Name of Decedent:
Date of Death:
Will No. 2~oo
To the Register:
CERTIFICATION OF NOTICE UNDER RULE 5.6la/
Admin. No. --
I certify that notice of (beneficial interest) ~iltlg~llllla~llJ~ required by Rule 5.6(a) of the Otp ans Court Rules was
h '
served on or mailed to the following beneficiaries Of the above-captioned estate on
Name
Addres~
Notice has now been given to ail persons entitled thereto under Rule 5.6(a) except
Signature
· . ! 70/9
Telephone(7t'~ e~.~ . ~C~:~3
Capacity: ~ Personal Representative
__.Counsel for personal representative
BUREAU OF INDIVIDUAL TAXES
/NHERZTANCE TAX DZV/STON
DEPT. 2:80601
HARRTSBURG, PA 17128-0601
CONNONHEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTZCE OF ZNHERZTANCE TAX
APPRAISEMENT, ALLOHANCE OR DZSALLO#ANCE
OF DEDUCTZONS AND ASSESSMENT OF TAX
lqZLLARD ZLGENFRZTZ
1018 ROCKLEDGE DR
CARLISLE
PA 17015
DATE
ESTATE OF
DATE OF DEATH
FZLE NUMBER
COUNTY
ACN
REV-15~i7 EX AFP
08-$0-200~
ILGENFRZTZ ElqMA Iq
o5 o,2- 2o
C RLAN~ ~." .-
.:::'
HAKE CHECK PAYABkE~AND R~NZT ~YNENT TO:
REGZSTER OF ~[:iLLS
CUlqBERLAND ~"~OURT.~OUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LO#ER PORTION FOR YOUR RECORDS
REV-1547 EX AFP (01-03) NOTICE OF ZNHERZTANCE TAX APPRAZSElqENT, ALLONANCE OR
DZSALLONANCE OF DEDUCTZONS AND ASSESSMENT OF TAX
ESTATE OF ILGENFRITZ ElqMA lqFZLE NO. 21 0~-0~59 ACM 101 DATE 08-$0-2004
TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSF
APPRAISED VALUE OF RETURN BASED ON: ORTGTNAL RETURN
1. Real Estate (Schedule A) (1)
2. Stocks end Bonds (Schedula B) (2)
3. Closely Hold Stock/Partnership Znterest (Schedule C) ($}
fi. Mortgages/Notes Reca/vable (Schedule D} (~)
5. Cash/Bank Depos/~cs/Misc. Personal Property (Schedule E) (5)
6. JoAntly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
APPROVED DEDUCTIONS AND EXElqPTZONS:
9. Funeral Expansas/Adm. Costs/M/sc. Expenses (Schedule H) (9)
10. Debts/Hortgage Liabilities/Liens (Schedule I) (10)
11. Total Deduct/OhS
12. Net Value of Tax Return
18~571.00
.00
.00 NOTE: To insure proper
.00 cred/t ~o your account,
.00 submi~ the upper portion
.00 of thls form wi~h your
tax payment.
.00
(8)
3,880.00
13.
NOTE:
18,571.00
ZF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATZON OF ADDITIONAL INTEREST.
TAX CREDITS:
PAYMENT
DATE
07-09-2004
RECEIPT
NUHBER
DISCOUNT (+)
INTEREST/PEN PAID (-)
AMOUNT PAZD
CharitabZe/Governmental Bequests; Non-alec*ed 9115 Trusts (Schedule J) (15} . O0
Net Value of Estate Sub3ect to Tax (1~) 15,769.00
Zf an assessment ~as issued previously, lines 14, 15 and/or 16, 17, 18 and 19
reelect figures that include the total of ALL returns assessed to date.
.00
619.60
.00
.00
619.60
30.98
588.62
TOTAL TAX CREDIT I 619.60
BALANCE OF TAX DUE .00
ZNTEREST AND PEN. .00
TOTAL DUE . O0
( ZF TOTAL DUE IS LESS THAN $1, N,O, PAYNE,N,T ZS REI;)UZRED.
ZF TOTAL DUE ZS REFLECTED AS A CREDIT (CR), YOU MAY BE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR ZNSTRUCTZONS.)
ASSESSMENT OF TAX:
15. Amount of Line 1~ at Spousal rate (15) .00 X O0 =
16. Amount of Line lq taxable et L/neal/Class A rate (16) 13,769.00 x 045 =
17. Amount of L/ne 1~ et Sibl/ng rate (17) .00 X 12 =
18. Amount of Line 1~ taxable at Collateral/Class B rate (lB) .00 X 15 =
19. Print/pal Tax DuB (19)=
922.00
(11) ~.802. O0
(1~) 13,769. O0
RESERVATION:
Estates of decedents dying on or before December 11, 1982 -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Coemoneealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
PURPOSE OF
NOTICE:
PAYNENT:
REFUND (CR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
To fulfill the requirements of Section ZI~O of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (7Z P.S.
Section 91~0).
Detach the top portion of this Notice and submit eith your payment to the Register of gills printed on the reverse side.
--Make check or money order payable to: REGISTER OF NXLLS, AGENT
A refund of a tax credit, which ems not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-151S). Applications are available at the Office
of the Register of Nills, any of the 25 Revenue District Offices, or by calling the special Iq-hour
answering service for forms ordering: 1-800-361-Z050; services for taxpayers ~[th special hearing and / or
speaking needs: 1-800-qq7-3010 (TT only).
Any party in interest not satisfied ~ith the appraisement, alloaance, 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. 181011, Harrisburg, PA 17118-1011, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to tho Orphans' Court.
Factual errors discovered on this assessment should be addressed in ~riting to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 180601, Harrisburg, PA 1711D-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-IS01] for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the decadent's death, a five percent (51) discount of
the tax paid is allowed.
The 151 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 would appeal the tax and interest
that has been assessed as indicated on this not[ce.
Interest is charged beginning eith first day of delinquency, or nine (9] months and one (1) day free the date of
death, to the date of payment. Taxes ahich became delinquent before January 1, 1982 bear interest at the rate of
six (61) percent per annum calculated at a daily rate of .00016q. All taxes ahich became delinquent on and after
January 1, 198Z will bear interest at a rate which will vary from calendar year to calendar year aith that rate
announced by the PA Department of Revenue. The applicable interest rates for 1981 through 100~ are:
Interest Daily Interest Daily Interest
Daily
Year Rate Factor Year Rate Factor Year Rate Factor
~ ~ .O00Sq8 ~)'~'8-1991 1IX .000301 2001 9Z .O00Zq7'"
1985 162 .O00q3D 1991 92 .0001q7 2001 62 .00016~
198q llX .000501 1993-199q 71 .OOOlgZ Z003 52 .000137
1985 132 .000~56 1995-1998 92 .0002~7 ZO0~ qZ .000110
1986 102 .O00Z7q 1999 7Z .000191
1987 iOZ .O00Z7q ZOO0 7Z .00019Z
--Interest is calculated as folloas:
TNTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELTNQUENT X DATL¥ TNTEREST FACTOR
--Any Notice issued after the tax becomes delinquent mill reflect an interest calculation to fifteen (lq) 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.
Name of Decedent:
STATUS REPORT UNDER RULE 6.12
Date of Death: ,/77,0y ¢2, ~oo~"t/
Will No.: c,~oo ~ .- DO/--i/b-~' 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 J~ No
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete:
3. If the answer to No. 1 is Yes, state the following:
Did the personal representative file a final account with the Court?
Yes / No [--]
b. The separate Orphans' Court No. (if any) for the personal representative's
account is: .~
c. Did the personal representative state an account informally to the parties
in interest? Yes [~[ No [--1
Co
Date:~_~ff0~
Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the Orphans' Court
and may be attached to this report.
Signature
Name
Capacity:
Address
Telephone No.
[~ersonal Representative
[] Counsel for personal representative