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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 UJ uJ 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