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Home My WebLink About04-0469 REGISTER OF WILLS - CUMBERLAND COUNTY, PENNSYLVANIA i' M.~~f Estate of Michael Francis WaltersL~ PETITION FOR GRANT OF LETTERS No.~/-C)Jf- -</6f also known as '04 f1AY 17 P 2 :11 , Deceased Social Security No. 171-36-7856 Edith Jean Walters L.: , Petitioner(s). who is/are 18 years of age or older;\alipl~Qs) for: (COMPLETE "A" OR "B" BELOW:) [J A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut Decedent, dated and codicil(s) dated named in the Last Will of the State relevant circumstances. e.g.. renunciation. death of executor. etc Except as follows, Decedent did not marry. was not divorced and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: GJ B. Grant of Letters of Administration (c.t.a.. d.b.n.c.t.a.: pendente lite. durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: S Name Relationship Residence I dith Jean Walters Spouse 2241 S. Market St. Mechanicsburg, PA 17055 teven Walters Son 2241 S. Market St. Mechanicsburg, PA 17055 8th M. Walters Son 1103 Summerwood Dr.,Harrisburg PA [ E S (COMPLETE IN ALL CASES:) Attach additional sheets If necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence at 2241 S. Market St., Mechanicsburg, PA 17055 (list street, number and municipality) Decedent, then 59 years of age, died May 8 ,2004 ,at Holy Spirit Hospital, Camp Hill, PA (Location) 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 . ...................................................................................... $ Total ..................................................................................................................... $ 25,000.00 Real Estate situated as follows: Wherefore. Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: [ -1.' 25,000.00 Signature Typed or printed name and residence Edith Jean Walters 2241 S. Market St., Mechanicsbur , PA 17055 Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland 0'\'.' The Petitioner(s) above-named swear(s) and aWirm(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 representative(s) of the Decedent, Petitioner(s) will well and truly administer the estet.f amrdln1l tq.ll~.ll Sworn to and affirmed and subscribed befO;;;~~S I'} 74 day of ~ ~~~ I pi /// ~~; .) ~, / ( ~x'>'#!;- ';;:::;;;;::::{:<~t~ Estate of Michael Francis Walters DECREE OF REGISTER also known as Deceased No. ~/-O~- ~69 Social Security No: 171-36-7856 Date of Death: 5/8/2004 AND NOW, P7/J.y /J , ~.y, in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters 0 Testamentary ~ of Administration are hereby granted to Edith Jean Walters ((c.I.a., d.b.n.c.l.; pendente lite; durante absentia; durante minoriate) in the above estate and that the instrument(s), if any, dated described in the Petition be admitted to probate and filed of record as the Last Will of Decedent. FEES Letters.................................... $ Short Certificates(s) ............... Renunciation .......................... Extra Pages ( ) ............... I.T.R'....................................... JCP Fee ................................. Inventory......................... ....... Other ...................................... 6000 $ $ $ $ $ $ $ $ .-lS-:- r?::? 10,00 TOTAL .............................$ ~ L17 ~ Signature Attorney: R. Mark Thomas 1.0. No: 41301 Address: 101 S. Market St. Mechanicsburg Telephone: 717-796-2100 DATE FILED: 5/17/2004 PA 17055 "~ {~~.\":_~ ?T.S Thi<. i~ to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Regis,trar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 No. . <~ ~A1AA1~~ _ Local Registrar . P 2 :11 p 10371687 ~/IJ,~i Date hl05143 Rev 21a? COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS CERTIFICATE OF DEATH STATE FILE f\lJMBER TYPE/PRINT IN PERMANENT BLACK INt( 5, COUNTY OF DEATH J,{eading, PA NAME OF DECEDENT (First. Middle. last) SEX ..male SOCiAL SECURITY NUMBER .. 17 1 36 DECEDENT'S USUAL OCCUPATION C(~7:~.:.~~~:;r W.l~~aL~OnS HaSP! AL.: Inp~knl E2I ... FACIUTY NAME (If not institution, gil/e street and number) .;ast Pennsboro Tp lei. I-Ie Iy .){.I/:(; r fJ uS p; hi I KINO OF BUSINESS / INOUSTRY DECEDENT'S EOUCA lION do , ..... (1--4 or ~~l BIRTHPLACE (City and Slate or Foreign Country) 8b, 2241 S. Market street Mechanicsburg, PA 17055 !wp 16, FATHER'S NAME (First, Middle. last) 18, Leonard Walters INFORMANT'S NAME (T~peJPr1nt) 20., Edith Jean Walters METtiODOF DISPOSITION Bunal m Cremation Gemoval from Slate 0 0.... (Specify) FU E cllyfbofo H. , ApproxImate : interval betwee : onset and death //V' vA Sequentlally Itsl conditions if any, leading to knmediate cause Enter UNDERLYING CAUSE (Disease or irVUry lhat initiated events resulting on death ) LAST WAS AN AlJTOPSY W::RE AUTOPSY FINDtNGS PERFORMED? AVAILABLE PRIOR TO COMPlETION OF CAUSE OF DEATH? { : .h( 11" "T /'j I-/I/)(;"~ 4, /),rfll O( ASA Q,,",NCE Yes 0 No IiJ v.. 0 MANNER OF DEATH Natural . JIl A-.", ~, JJ Suicide 0 DATE OF INJURY (MonIl, OIlY. Ya.-) TIME OF INJURY INJURY AT lMJRK? DESCRIBE HOW INJURY OCCURRED Homicide 1./'")/ NOD Pending Investigation Could not ~ determined 2801. 28b. 21. CERTIFIER (Check only one) ~ .. '~~1J~F:~Gor~~~~~~=lh ~:t~J"f= 1r:1 ::~h':=:~~~~~~~~ah~f~~.~~.~.~~~.l~~~ .~~~~~~.~.i~~I~.~~~... 'PRONOUNCING AND CERTIFYING PHY$6CIAN (Physician both pt'"onouncing death end certIfying to cause of ooath) To Ihe beat of my knowledge, death occurred al the Urn., date, and place, and due 10 the e.u..a(a) and manner.. ..tated. 'MEDICAL EXAMIHERlCORONER On the bal" of eumlnltlon Indlor mvHUgaUon,1n my oplnlon, death occumtd It the Ume, date, and place. and due to the clUleI(l) and manner .. "ated 311. REGISTRAR' .0 IA/L2I/~ u a,1-o~- ~69 .----------------..................-------..-........-....-......-..------.........-....------------........-..........-...----------------..-------- REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: MICHAEL FRANCIS WALTERS Date of Death: 5/8/2004 Estate No. 21-04-00469 SSN: 171-36-7856 File No. 2004-00469 Date Letters Granted: 5/17/2004 Will or Administration No. To the Register: I certify that Notice of 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 6/8/2004 Name Seth M. Walters Address 1103 Summerwood Dr. Harrisburg 2241 S. Market St. Mechanicsburg PA 17111 Steven C. Walters PA 17055 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Capacity: Personal Representative X Counsel for Personal Representative \f' .) ~d}?~ Signature R.Mark Thomas, Esq. Name (Please type or print) 101 S. Market St. Address Date: 6/8/2004 Mechanicsburg PA 17055 Lj: ( S l ~1.nr vO. Telephone No. 717-796-2100 \> COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 REV-1162 EX(11-961 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT THOMAS R MARK 101 SOUTH MARKET STREET MECHANICSBURG, PA 17055 _nnU_ fold ESTATE INFORMATION: SSN: 171-36-7856 FILE NUMBER: 2104-0469 DECEDENT NAME: WAL TERS MICHAEL FRANCIS DATE OF PAYMENT: 03/18/2005 POSTMARK DATE: 03/18/2005 COUNTY: CUMBERLAND DATE OF DEATH: 05/08/2004 NO. CD 005084 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $77.88 I I I I I I I I TOTAL AMOUNT PAID: $77.88 REMARKS: CHECK# 2378 SEAL INITIALS: CCP RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS HI v 1 :,00 f: ~ , (6-00) '* COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT w I- ~::!;(/) ~ ex:~ UCl.u woo J: ex: -' UCl.al Cl. <( z o ~ <! ~ :> IJ.. ~ o () x <! ~ DECEDENT'S NAME (LAST, FIRST. AND MIDDLE INITIAL) ~ z w o w () UJ o WALTERS, MICHAEL F. DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) OFFICIAL USE ONL Y FILE NUMBER 2 1 -0 4 o 0 4 6 9 05/08/2004 01/02/1945 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) COuNTYCOoE ---vEA~ - - N'UMiiER-- SOCIAL SECURITY NUMBER 7 1 - 3 6 - 7 856 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 2 2 8 - 6 0 - 1 387 D 3. Remainder Return (date of death priorto 12-13-82) D 5, Federal Estate Tax Return Required _ 8. Total Number of Safe Deposit Boxes D 11, Election to tax under Sec. 9113(A) (Attach Sch 0) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS R. MARK THOMAS, ESQ. 101 S. MARKET STREET FIRM NAME (If Applicable) PA 17055 OFFICIAL USE ONLY 3,398.33 41,753.42 0.00 (, (8) 45,151.75 WALTERS, EDITH J. [R] 1, Original Return D 4, Limited Estate D 6, Decedent Died Testate (Attach copy of Will) D 9, Litigation Proceeds Received D 2, Supplemental Return D 4a, Future Interest Compromise (date of death after 12-12-82) D 7, Decedent Maintained a Living Trust {Attach copyofTrust) D 10, Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) 11,475.28 215.28 (11) (12) (13) 11,690.56 33,461.19 I- Z W o z o Cl. (/) w ex: ex: o U TELEPHONE NUMBER 717-796-2100 MECHANICSBURG (14) 33,461.19 1 Real Estate (Schedule A) 2, Stocks and Bonds (Schedule B) (1) (2) (3) (4) (5) 0.00 77.88 77.88 20, D 3, Closely Held Corporation, Partnership or Sole-Proprietorship 4, Mortgages & Notes Receivable (Schedule D) z o ~ <! ...J :> t:: c.. <! () UJ a: 5, Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6 Jointly Owned Property (Schedule F) (6) D 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. 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/See 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) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15, Amount of Line 14 taxable at the spousal tax rate, or transfers under See, 9116 (a)(12) 31,730.59 1,730.60 X L-(15) X .045 (16) X .12 (17) X ,15 (18) (19) 16, Amount of Line 14 taxable at lineal rate 17, Amount of Line 14 taxable at sibling rate 18, Amount of Line 14 taxable at collateral rate 19, Tax Due Add Decedent's Comolete ress: STREET ADDRESS 2241 S. MARKET ST. CITY I STATE PA I ZIP 17055 MECHANICSBURG Tax Payments and Credits: 1 T ax Due (Page 1 Line 19) 2, Credits/Payments A, Spousal Poverty Credit B, Prior Payments C, Discount (1 ) 77.88 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 77.88 77.88 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS No ~ ~ ~ ~ Did decedent make a transfer and Yes a, retain the use or income of the property transferred; ........................................................................... 0 b, retain the right to designate who shall use the property transferred or its income; ........................................ 0 c. retain a reversionary interest; or ...................................................................................................... 0 d, receive the promise for life of either payments, benefits or care? ............................................................. 0 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration?............................................................................. ................. 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. 0 4, Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... [8] ~ ~ o IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. /4 ?tJtJ~ 101 S. MARKET ST. MECHANICSBURG PA 17055 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 PS ~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. S9116(1.2) [72 P.S. s9116(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 PS. s9116(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. """^,,",,,,,, .- COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN T T SCHEDULE B STOCKS & BONDS ESTATE OF WALTERS MICHAEL F All property jointly-owned with right of survivorship must be disclosed on Schedule F. FILE NUMBER 21 04 00469 2. DESCRIPTION 23 Shares AT&T stock CUSIP No. 001957505 Sold 7/19/04 at 14.7098/share (See attached 1099-8) 204 Shares AT&T Wireless stock 10/26/2004 Merger Consideration @ 15.00 per share VALUE AT DATE OF DEATH 338.33 ITEM NUMBER 1, 3,060.00 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 3,398.33 m,,"""<'" '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF WALTERS MICHAEL F FILE NUMBER 21 04 00469 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 NUMBER 1, DESCRIPTION VALUE AT DATE OF DEATH BELCO Community Credit Union 403 N. 2nd St., PO Box 82, Harrisburg, PA 17108 1. Savings Acct. No. 946370 30,311.65 2. Money Market Acct. No. 946370 716.77 Vehicles - Values obtained on internet 1. 1987 Buick Century - Good condition 630.00 2. 1986 Volkswagen Golf - Fair condition 630.00 3. 1990 Chrysler Lebaron Convertible - Good condition 1,555.00 4. 1964 Chrysler New Yorker - Good condition 6,000.00 5. 1986 Lincoln Town Car - Good condtion - Sold for 1000.00 1,000.00 6. 1988 Chevy Celebrity - Good condition 910.00 TOTAL (Also enter on tine 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 41 ,753.42 "",'.C""",, *' COMMONWEALTH OF PENNSYLVANIA INHERIT ANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF WALTERS MICHAEL F FILE NUMBER 21 04 00469 II an asset was made joint within one year 01 the decedent's date 01 death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. EDITH J. WALTERS 2241 S. MARKET ST. MECHANICSBURG, PA 17055 WIFE B c JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY '10 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 INTEREST 1 A, MARITAL RESIDENCE LOCATED AT 175,324.00 O. 2241 S. MARKET ST. MECHANICSBURG, PA TOTAL (Also enter on line 6, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) ,,,,,"","" '" . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF WALTERS. MICHAEL F. FILE NUMBER 21 04 00469 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY %OF ITEM INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE NUMBER ATTACH A copy OF THE DEED FOR REAL ESTATE VALUE OF ASSET INTEREST (IF APPlICABLEI 1 AT&T PENSION PLAN 278,709.37 100. 0.00 TOTAL (Also enter on line 7, Recapitulation) $ 0.00 (If more space is needed, insert additional sheets of the same size) """""'''''''''. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF WALTERS. MICHAEL F FILE NUMBER 21 04 00469 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A FUNERAL EXPENSES 1 4,924.25 B ADMINISTRA TIVE COSTS 1 Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2 Attorney Fees R. MARK THOMAS, ESQ. 1,800.00 3 Family Exemption (If decedent's address is not the same as claimant's, attach explanation) 3,500.00 Claimant EDITH J. WALTERS Street Address 2241 S. MARKET ST. City MECHANICSBURG State PA Zip 17055 Relationship of Claimant to Decedent WIFE 4, Probate Fees 90.00 5 Accountant's Fees 6, Tax Return Preparers Fees 7 PUBLICATION - CUMBERLAND LAW JOURNAL 75.00 8. PUBLICATION - THE PATRIOT NEWS 109.30 9. VEHICLE TITLE TRANSFER (1986 LINCOLN TOWN CAR) 120.00 10. AUTO REPAIR - 1988 CHEVY 327.44 11 . AUTO REPAIR - 1988 CHEVY 221.97 12. AUTO REPAIR - 1986 VW (REPAIRS AND INSPECTION) 250.00 13. AUTO REPAIR - 1987 BUICK 28.57 14. SALE OF STOCK PROCESSING FEE 28.75 TOTAL (Also enter on line 9, Recapitulation) $ 11 ,4 75.28 (If more space is needed, insert additional sheets of the same size) ,,,",,,,,.,.,,,,,* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF WALTERS MICHAEL F. FILE NUMBER 21 04 00469 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 205.28 AT&T UNIVERSAL CARD 2. HERITAGE CARDIOLOGY ASSOCIATES 10.00 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 215.28 ,,, ,,,',,, '". COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER NUMBER I. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec, 9116 (a) (1.2)] 1, EDITH J. WALTERS 2241 S. MARKET ST. MECHANICSBURG, PA 17055 SETH WALTERS 2241 S. MARKET ST. MECHANICSBURG, PA 17055 STEVE WALTERS 2241 S. MARKET ST. MECHANICSBURG, PA 17055 WIFE 31730.59 2. SON 826.36 3. SON 826.36 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET J I. NON-TAXABLE DISTRIBUTIONS: A, SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1, 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) Glenda Farner Strasbaugh Register of Wills and Clerk of Orphans' Court Marjorie A. Wevodau First Deputy Kirk S. Sohonage, Esq Solicitor Register of Wills and Clerk of the Orphans' Court County of Cumberland One Courthouse Square Carlisle, PA 17013 (717) 240-6345 FAX (717)240-7797 INVOICE Bill To: InvoiceNo: Invoice Date: Estate of: Estate No: 262 3/22/2005 Michael F. Walters 21-04-469 R MARK THOMAS ESQ 101 SOUTH MARKET ST cep MECHANICSBURG, PA 17055 Qty 1 Fee Description Additional Probate Fee Total 20.00 $20.00 Total: ~20.00 'Pd ;2" 33l{ 0' ~s-+ Third Request *********** Please pay promptly. r"",~, <"".~ C::J C) Checks should be made payable to the Register of Wills. Terms: Net 30. Please return one copy of this invoice with your payment. Thank you. 10-03-2005 WALTERS 05-08-2004 21 04-0469 CUMBERLAND 101 APPEAL DATE: 12-02-2005 (See reverse side under Objections) Amount Remitted I I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 9~!_~~9~~_!~!~_~!~~______~___~g!~!~_~~~g~_~~~!!~~_E~~_y~~~_~~~~~~~__~____________________ REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX MICHAEL F FILE NO. 21 04-0469 ACN 101 ....,r"',.....,/"".,:-'r'.~......" BUREAU OF INDIVIDUAL iAXE~.""! INHERITANCE TAX DIVISIDN ' PD BDX Z8060 1 HARRISBURG PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX r) ~.'; -C (~ :) DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN '-',' r R MARK THOMAS ESQ 101 S MARKET ST MECHANICSBURG PA 17055 ESTATE OF WALTERS REV-1547 EX AFP (06-05) MICHAEl F TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED DATE 10-03-2005 RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule f) 7. Transfers (Schedule G) 8. Total Assets 11) (2) (3) (4) (5) (6) (7) .00 3.398.33 .00 .00 41.753.42 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governnental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) 110) 11,475.28 215.28 (11) (12) 113) (14) NOTE: I~ an assessment was issued previOUSly, lines rB~lect figures that include the total o~ ~ ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 45,151.75 11 .690 56 33,461.19 .00 33,461.19 14, 15 and/or 16, 17, 18 and 19 will returns assessed to date. 31.730.59 X 00 = 1,730.60 X 045 = .00x12= .00x 15 = (19)= .00 77.88 .00 .00 77 .88 TAX CREDITS: r,um:n, " (+} AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 03 18-2005 " CD005084 .00 77 .88 TOTAL TAX CREDIT 77 .88 BALANCE OF TAX DUE .00 INTEREST AND PEN. .41 TOTAL DUE .41 . If PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. ~ IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ~ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 3/29/2006 WALTERS EDITH JEAN 2241 S MARKET STREET MECHANICSBURG, PA 17055 RE: Estate of WALTERS MICHAEL FRANCIS File Number: 2004-00469 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 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: 5/08/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel Register of Wills of Cumberland County Estate No.: Wa /fer-7 IlJ,chlle/ /Y7a..V ff) ;Wilt;' ~ I ~5'-~ ;21 - tJ'I- '16'; Name of Decedent: Date of Death: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion ofthe administration of the above-captioned estate: 1, State whether administration of the estate is complete: Yes lpl No 0 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: a. Did the personal representative file a final account with the Court? Yes 0 No 0 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 0 c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk ofthe Orphans' Court and may be attached to this report. mJ~ Signature R ;Jkr( 771mll5 Date: Jj /~tJ~ Name /(}I 5. ~rkI5~ Md#~1 ~5 Address (7/7) 7f~ -;;</a:/ / Telephone No. j...... "'} "- .-" ~ I ; f Capacity: 0 Personal Representative o Counsel for personal representative !~/~....',', '{j'/