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HomeMy WebLinkAbout02-0599PETITION FOR PROBATE and GRANT OF LETTERS Estate of ~~ ~ ~ti. Z~ '~ `~~ ~ `~ w.~, also known s Deceased. Social Security No. ~,m~ ' - •3~ - ~ ~~~ ~ No. 2 ~ - 0 2 - Sg4 To: Register of ills for the County of ~ztt ~2az'-w-'~"~~ in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), wh is~re 18 years of ag~ or older an the execut~~~ _ l~na_med in the last will of the above decedent, dated ~ t: ~% Z.1, `~ and codicil(s) dated (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in ~ ' y ~ -- ~ ~7 ~ ~_-- County, Pennsylvania, with h t'e~~ last family or principal residence at ~•~-~_._%~.~~-r~-'~=' ~/ I `~`~;" , _ _. 1, ._ . ~~ /.L i rLs ~"t - , (list street, number and muncipality) Decendent, then Years of age, died ~ ~ ~~ '~~ ~ ~ ~'~`' r~®~ "~"" . at ~- ~ "2.. %~ f ~ j C~ ~1 '~ ~ ~ cd C' ~ ~~ ~ Pt" G~1 .:~Y~ d ,~ ~- ~j ., ^rA ~"~ ~ -~ ~~ _a . Except as follows, decedent did not marry, was not divorced and did not ha~c~ild 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) ~e probate of the last will and codicil(s) presented herewith and the grant of letters ~'~ ~ ~~=~~~'N ~`/~z' (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. ~~r~~c~~ Gs~a 'L ~~Li?~A b ~ ~," ~~'~<~(~ ~~1<I~ir,~'I3 f EVE' `v b o Jul ('(HM'l~,C,y/'~•'A 1='~ l ~r~~J C -J cC ': .-. v ~0. a~ w a C C op OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OF ~v~~1N~n%~'~ 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 before me this 27th day of ~~ ~'~-^-~-.; ~~ ~ ~~x tai-~~, -~._. ~ , _'~- ~ 00 A ~o `. MARY ~~ LEWIS Register -~ ~- Estate of LYDIA Z HIRNEISEN ,Deceased DECREE OF PROBATE AND GRANT OF LETTERS ~,vD NOW _~- JUNE 28, 2002 _ ~~_ _, in consideration cif tl~e petztion can the reverse side h~,:reof, satisfactor,r proof having been presented before me, tT i DECREED that the instrument(s) dated_ 7-29-1997 _ described ?ierein be wdmitted to probat4 and filed of record as the last will of __d _~_ LYDIA Z HIRNEISEN ---- _ _ ~ , and 1_etter.s ____ TF.~TAMFT~I'T'~~ ______ are hereb granted to GLORIA KATHLEEN ESH _ _ _ _ FEES Probate, Letters, Etc. ......... ~ 305.00 Short Certificates'C 15.00 1~..~) .......... ~ Renunciation ,3 .............. $ 15.00 xtra page 3.00 llcp ~- TOTAI: $~~ Filed ......6-28-20D.2 .................. called exec 6-28-02 __ /' / f~ ~.~ :1 ~`t~. Y `i EWj~egister of Wllls i ATTORNEY (Sup. Ct. LD. Ne.) Ear .;~ _ l-1 re~]aCt /'i`:z I~aC( h~i~',~,<.~- )'r~ ~. ADDRESS PHONE ARNING: IT IS ILLEGAL TO ALTER THIS COPY OR TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH. ~D Z l~~/LVteca.u~c, ~~,Y~ l6!- 30-671 ~~/~"O°~ 7n~~ a C.~,,.2~.~ ~,.~ u lam, ~. ~~ ~`-° zJ.~,~t aa,t 7 ~~~~, rr~ ~ m ~A~~~ ~ ~~. ~~~ LAST WILL AND TESTAMENT OF LYDIA Z . HIRNEISEN .~) -~';,~ - jqc) BE IT REMEMBERED that I, LYDIA Z. HIRNEISEN of 10 Sharp Avenue, Denver, East Cocalico Township, Pennsylvania, being of sound mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making null and void any and all former Wills and Testaments or writings in the nature thereof, by me at any time heretofore made :in the manner following, to wit: ITEM I - I order and direct my Co-Executors hereinafter named, to pay all my just debts and funeral expenses as soon as conveniently possibly after my decease. ITEM II - I give, devise and bequeath my entire estate, real, personal and/or mixed, of whatsoever kind and nature and wheresoever situate of which I may die seized and possessed, or to which I may be entitled at the time of my decease to my husband, CLAYTON H. HIRNEISEN. ITEM III - In the event that my husband, CLAYTON H . HIRNEISEN, should predecease me then, in that event, I give devise and bequeath my entire estate, real, personal and/or mixed, of whatsoever kind and nature and wheresoever situate of which I may die seized and possessed, or to which I may be entitled at the time of my decease in four (4) equal shares, or to their issue, per stirpes, as follows: A. One share to my son, CARL M. HIRNEISEN of 16 Laurel Drive, Willow Street, Pennsylvania i75u4; B. One share to my daughter, ERLENE MAE HOLLINGER of 109 Hill Crest Lane, Elizabethtown, PA 17022; C. One share to my daughter, THELMA KAY SWEIGART of 295 Paradise Road, Denver, PA 17517; and D. One share to my daughter, GLORIA KATHLEEN ESH of 1600 Barbara Lane, Mechanicsburg, PA 17055. ITEM IV - Any fiduciaries named herein shall have the following powers to be exercised in their discretion without the ~ ~ ~ - 1 - ' a. To hold and retain any tangible personal property. b. To sell personal property or real property at public or private sale upon such terms and conditions including terms of credit as they may deem proper under the circumstances. c . To make distribution in cash or in kind or partly in each. d. To serve without being required to post a bond or other security in this or any other jurisdiction for the faithful performance of the fiduciary duties. e. To hold all interests so that they shall not be subject to voluntary or involuntary anticipation, encumbrance, alienation or assignment, in whole or in part, and so that the same shall not be subject to any judicial process, levy, attachment or execution for or on behalf of any beneficiary's creditors or claimants. ITEM V - Lastly, I nominate, constitute and appoint my children, CARL M. HIRNEISEN, ERLENE MAE HOLLINGER, THELMA KAY SWEIGART and GLORIA KATHLEEN ESH, Co-Executors of this, my Last Will and Testament. In the event that either Co-Executor is unable or unwilling to serve, fails to qualify or ceases to act, then the remaining Co-Executor shall serve alone. IN WITNESS WHEREOF, I, the within named Testatrix, LYDIA Z. HIRNEISEN, have to this, my Last Will and Testament, written on two (2) typewritten pages, subscribed my name to the first page and to this, the last page, subscribed my name and affixed my seal this 29th day of July, A.D., One Thousand Nine Hundred Ninety-Seven ~i9o~ ~ / 1 ` ~ • / IA Z.. RN ISEN SIGNED, SEALED, PUBLISHED and DECLARED, by the within named Testatrix, LYDIA Z. HIRNEISEN, as and for her Last Will and Testamen in the presence of us, who at her request and in her pre nc ~ and~in the presence of each other have hereunto subscribed o n s witn~ses thereto. ,--` 1-'~ ~ - of / __~ u .. . ~ ~ j RENUNCIATION ~~ l -- C%.,.t - ~'~~ c~ In Re Estate of /~-,L/ ,6v . ~'~~~~ . 'To the Register of Wills of '2'26 County, Pennsylvania. ..;...t r~ '~ - The undersigned ~' -~ of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters be issued to ~ ~ n f ~ CL~ 1 ~ f = ~~ ~1 WITNESS q, _ C~ -~--• llrl ~~~' S ~-S ` ~ (~C-~ ~~ -J C.Ar1 e o~-~~ o~. J ``,, ~~ T ~~'V I/ 'y v /l~ Notarial Seal Norma Enck, Notary Public bVest Cocalico Twp., Lancaster Cotutty ! PAy Commission Expires May 2, 2004 Mem;~r, ?enrsv~~~?^~?. a.~sociation of Notaries hand this day of deceased. 19 //„ _ (Signature) ~-= `~ 1 r (Address) (Signature) (Address) (Signature) (Address) RENUNCIATION I ° C~ ~ -- ~'cj~) In Re Estate of =5K ~ ~ ~ ~'~7'L1~:~~ To the Register of Wills of The undersigned deceased. County, Pennsylvania. of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters ~J ~ v rl be issued to ~ " `^' 1"L~ ~~ -~ ~~ , WITNESS ~ hand this ~ day of ~ ' ~ ->-- , Isy ~ t =- ~~ ~ ~~ (Signature) l f Y_ r;_ ,.,.~,..~'~, ~~ r _-~.._. ~ -.. (Address) ~-' (Signature) (Address) (Signature) (Address) County/r~i3~ c' ~ ~~ z fti'ztTi~.~ . -- ~ r~~,~;~mow~+eaitt~ a ~enns~lr~,ania ~~~ ~~!'?CkflOVdl~?ri(~E'(9ii't~`t ';C/a~I~ ;sG~.`rEr i (''~ftS~flJ(ll~fil. ~''' ~ ~'°~Z°.c rte`. ba6tArl' ~l.4hll~Y' f"~V1y ~",~)M11 SSIG i r; _ ~ f Koren Y. Boyer, Notary Public ° Mt. Joy 7wp., Lancaster County My Comm~ss~on Expttgs Jufy 11, 2002 RENUNCIATION In Re Estate of ~~~~~~ Z ~/'~~'~«'~~v To the Register of Wills of deceased. County, Pennsylvania. /; c ~ The undersigned _1~ -{ A~_1~~ ~~~~/ St=fti/ of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters be issued to 1`~ ~ (, ~ ~ ~ ~~ L s /7 WITNESS ° hand this Z `~~ day of ~~-~c~ ~>cx,~: 406i:'1T; ~c r~ '"^ ~}i4`~T1tr ~'Y":+hG:i (..'fif`.~/..'1:1t~ L.fi"G-~!it"L'_ (Signature) ~_~ ~~ L~~c'~ ~ U~J ~~ (Address) l-t.a/,1~~ u,~ s//~.~~~~ /~iJ /~s-~ f (Signature) (Address) (Signature) (Address) .- R :~ r. ~~1 CERTIFICATION OF NOTICE UNDER RULE 5.6(a)~ f Name of Decedent: ~_ t f~~ d~ _ ~ . ~ ~` ~~ r~'.w ~" ~~, ~ ~._' -, Date of Death: ~~:~ h,,~~_ l ~~ ~ L-1' ~' Will No. ~~~ <>~~ ~~_ - t-x-:~ Adm. 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 - , - ~' - ~`~' ~--- Name Address ~i>+~L l'd 1-~ /`."~: f=' /.b~I~./ ~ l L_J-r .- ~. ~ F ~ r~' r i' d" ~ ~- , I [-" '>, ~ ~' ~'' Ky -s i ~~r~~Fl ~E Z,;rt'(! f-~~"'~i ~N~~~>~ ~~~j /.~ i'~JP~-f - 1._fi?A_.~ _ [. f ~ ~'?~r' ' t~~'' - --- r~ -+ -f r~ ,f - _~ .~.- ~'f ( t:',i f~ f", i^«.~'~. ~sG-.~/. ~ ~t~ c r ~f'.n~ dY~ `~1/-. i 7-i s. ~v ,'l I_iE ~' /( 1 . / I7/ ~ -.^,j ~'~ d~~ t /~~ "~ /"l f~l~ Lt=C ~. ,/l.i ~- `, j..~ 1 L -~~L~ I~`~/~~'if> ~!~ ~1~; L--{'i /'.E`. /~?? ~ ! /' ' -.'~,_, ~ r Notice has now been given to all persons entitled thereto under Rule 5.6a) except: Date: i` - l - C' ;.- ~~~~~~L ,/~ ~-~---~~--~~' (Signature) Name: i r~ ~~ ,~,,~~ " .,'~ ~ ,~f _'`l,"r~ Address: r~~ ~ ri, r, f_ ; ,, c' ~ ,~;g ~-{,> 7 y f r ^. /s Telephone ( l ~~ r_ ~'~ f _. ~` ~~r~ ~_~~' Capacity: Personal Representative ;,,i Counsel for Personal Representative 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 ACN ASSESSMENT AMOUNT CONTROL NUMBER N0. CD 001616 AHRENS THOMAS J ESQUIRE 5521 CARLISLE PIKE MECHANICSBURG, PA 17050 fold ESTATE INFORMATION: SSty: i6i-3o-6271 FILE NUMBER: 2102-0599 DECEDENT NAME: HIRNEISEN LYDIA Z DATE OF PAYMENT: 09/13/2002 POSTMARK DATE: 00/00/0000 couNTY: CUMBERLAND DATE OF DEATH: 06/ 1 4/2002 101 ~ 517,413.82 REV-1162 EX(11-961 TOTAL AMOUNT PAID: REMARKS: GLORIA KATHLEEN ESH C/O THOMAS J AHRENS ESQUIRE CHECK# 1016 SEAL INITIALS: SK RECEIVED BY: MARY C. LEWIS 517,413.82 REGISTER OF WILLS REGISTER OF WILLS ~V.16G11EX'l8-lHl1 w ~ ::.:::!rn U"'~ w~g :r::~..J U~m ~ < *' /7 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 02 COMVIONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT,280601 HAR.~I~!J_~~,~~ ~_128-f!S~~ ~ Z W o w U w o , DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) r:~::;:~1~~D;EARi I D:;;O:/~';:~(MMDDYEARI ---- ---------- (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) J~..oJmI'( _COO_I;__ YEARn_ SOCIAL SECURITY NUMBER 161-30-6271 v' 00599 .tiLJ_M~t:B_ THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 5 Federal Estate Tax Return Required --n-'3-Rerriainder Retum-{dateofdeathpriOr-to 12-13-8i}- o ~ 1. -original Return------ D 2. Supplemental Return D 4. Limited Estate D 4a. Future Interest Compromise (date of death after 12-12-82) ~ 6 Decedent Died Testate (Attach copy D 7_ Decedent Maintained a Living Trust (Attach of Will) copy of Trust) D 9. Litigation Proceeds Received D 10. Spousal Poverty Credit (date of death between D 11.Election to tax under Sec. 9113{A) (Attach Sch 0) ____ __ _______J1.:~J:~I..!o.g.1-t-!l9L _ __ ___ _ __ _ __ i!l!I$.~.~CTI()I!~usIB~C()Ml'LETED. ALL.C()Fl~sP()~.l1.e~()~l'.N()()()I<IFJl1et.ITll'~.:rl'2tlt!f~OI!"'l'!I()N.SIl9l!~D!I~~PJ~e~'p.!(): . ..~_......_~ . ..... NAME COMPLETE MAILING ADDRESS Thomas J. Ahrens .~ 13z ",w ",0 OZ u~ FIRM NAME (If applicable) Ahrens Law Offices, P.C. TELEPHONE NUMBER 717/697-1800 1. Real Estate (Schedule A) 2. Slacks and Bonds (Schedule B) z o ~ 5 ~ ~ ~ < U W '" 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) D 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) 10. Debts a! Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 8 Total Number of Safe Deposit Boxes 5521 Carlisle Pike Mechanicsburg, PA 17055 (1) 121,000.00 (2) None (3) None (4) None (5) 315,275.54 (6) None (7) None (8) (g) 15,188.02 (10) 13,746.56 (11) )~,l< 436,275.54 28,934.58 407,340.96 (12) 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) (13) 407,340.96 (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES x .00 (15) 15.Amount of Line 14 taxable at the spousal tax rate, ortrans!ers under Sec. 9116(a)(1.2) z o ~ ~ ~ ~ ~ o U ~ 16.Amount of Une 14 taxable at lineal rate 17.Amount of Une 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 407,340.96 (16) x .045 x .12 (17) x .15 (18) 18,330.34 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. (19) 20. 0 .~. >.>. ~ SURETO ANll1l/EJl. A1..L QUE,$TION$ ON REVER~I! SID.E' AND .RECHECK "',Ai-H<<::=-. Copyright 2000 form software only The Lackner Group, Inc. 18,330.34 Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 222 Messiah village CITY Mechanicsburg ! STATE PA I ZIP 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) 18,330.34 916.52 Total Credits (A + 8 + C) (2) 9]6.52 3. Interest/Penalty if applicable D. Interest E. Penalty 8 Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) 0.00 (4) (5) 17,413.82 (5A) (58) 17,413.82 TotallnteresVPenalty (0 + E) 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 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. Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: 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 Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?. Yes No ~ II o 181 o 181 o 181 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of pe~ury, I declare that I have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief, il is true, correct and complete Declaration of .E...re...pil.~.r.~~_e:r.!~a~ ~he p~~~onaIT~presentat!ve ~_ based. on an inf?rmalion of which preparer has any knowledg.e SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS Gloria Kathleen Esh ~~F~~~.&~~RESS SIG-:z::!.OF4RE~THER THAN REPRESENTATIVE ADORESS Thomas J. Ahrens DATE 1600 Barbara Lane Mechanicsburg, PA 17055 Q'1-l'L DATE '1-/0-02- DATE 5521 Carlisle Pike 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 P.S. ~9116 (a) (1.1) (ill 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) (U)J. The statute does not exemot 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. 99116 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. 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. . SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Himeisen, Lydia Z I I I FILE NUMBER 21 - 02 - 00599 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a wimng seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. ITEM NUMBER 1 DESCRIPTION VALUE AT DATE OF DEATH 121,000.00 10 Sharp Avenue, Denver, PA 17517, Tax parcel # 080-93174-0-0000 TOTAL (Also enter on Line 1, Recapitulation) 121,000.00 ESTATE OF *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY I FILE NUMBER . U 21 - 02 - 00599 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 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Himeisen, Lydia Z DESCRIPTION Fulton Bank checking account # 5600-43403 2 Fulton Bank savings account # 1301-74070 3 Morgan Stanley investment account # 621 018952 214 4 Refund of property taxes & fire hydrant fee at real estate closing 5 Burial Reserve account at Fulton Bank. Account # 056-0177771 6 Pennsylvania State Employees Retirement system received after death - Final 7 Capital Blue Cross Reimbursements received after death 8 Refund of homeowners insurance 9 Bureau of unclaimed property VALUE AT DATE OF DEATH 28,029.98 106.48 278,475.00 1,618.48 6,251.22 42.85 612.63 76.00 62.90 TOTAL (Also enter on Line 5, Recapitulation) 315,275.54 ESTATE OF . SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Hirneisen, Lydia Z I FILE NUMBER ; 21 - 02 - 00599 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. B. DESCRIPTION AMOUNT FUNERAL EXPENSES: Muddy Creek Lutheran Church - funeral luncheon 2 'Roseboro Funeral Home 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions 200.00 6,254.24 6,150.00 378.00 150.00 200.00 1,374.91 125.00 355.87 15,188.02 Social Security Number(s) ! EIN Number of Personal Representative(s): Street Address City Year(s) Commission paid Zip State 2. Attorney's Fees Ahrens Law Offices, P.c. 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address State Zip 4. City Relationship of Claimant to Decedent Probate Fees Register of Wills of Cumberland County 5. Accountant's Fees 6. Tax Return Preparer's Fees Estimated cost affinal income tax returns Estimated cost of Fiduciary returns 7. 1 Other Administrative Costs 2002-2003 Property school tax due at closing 2 Travel, phone and postage incurred by executrix Total of Continuation Schedule(s) ____L_____ TOTAL (Also enter on line 9, Recapitulation) *' Schedule H Funeral Expenses & Administrative Costs continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ------------..------- ------ ESTATE OF 3 4 Himeisen, Lydia Z Estate notices in The Sentinel and Cumberland County Law Journal House maintenance costs FILE NUMBER 21 - 02 - 00599 Page 2 of Schedule H 155.87 200.00 ESTATE OF *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNS'I'lVANlA INHERITANCE TAX RETURN RESIDENT DECEDENT 1.__- Himeisen, Lydia Z Include unreimbursed medical expenses. ITEM NUMBER 1 DESCRIPTION I FILE NUMBER ..... 21~02 - 005~9 Deposit on real estate retained by seller prior to date of death, and included in the value of the real estate on schedule A 2 PP&L Electric - electric bill 3 Verizon - phone bill 4 Alert Phannacy - medicine 5 Ray Zimmerman - lawn maintenance 6 Messiah Village - Final payment due Nursing home 7 Dr. James D. Nash 8 Value of 1 check issued by decedent prior to death, but cashed after the decedent's death TOTAL (Also enter on Line 10, Recapitulation) AMOUNT 12,100.00 49.9] 1.79 152.38 300.00 1,074.48 10.00 58.00 13,746.56 .,- rleV-1513 EX+ (9-00) . SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF I FILE NUMBER 21 - 02 - 00599 RELATIONSHIP TO AMOUNT OR SHARE DECEDENT OF ESTATE _-.Do...NolLJst_~ Himeisen, Lydia Z NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) Gloria K. Esh 1600 Barbara Lane, Mechanicsburg, PA 17055 2 Carl M. Himeisen 116 Laurel Drive, Willow Street, PA 17584 3 Erlene Mae Hollinger 1109 Hill Crest Lane, Elizabethtown, P A 17022 4 Thelma Kay Sweigart ,295 Paradise Road, Denver, PA 17517 I I Daughter 125% , I Son 25% 125% Daughter Daughter 125% II. Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet 1 NON.TAXABLE DISTRIBUTIONS, I 'A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE I I lB. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I ~~' ~~' ~~ BUREAU OF INDIVIDUAL TAXES ' INHERITANCE TAX DIVISION DEPT. 28060]. HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX THOMAS J AHRENS AHRENS LAW OFFICES ~i521 CARLISLE PIKE MECHANICSBURG PA 17055 REV-1547 E% AFP c01-027 DATE 10-28-2002 ESTATE OF HIRNEISEN LYDIA Z DATE OF DEATH 06-14-2002 FILE NUMBER 21 02-0599 COUNTY CUMBERLAND ACN 101 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ --------------------------------------------- ------------- --- -------------------------- -------------------- REV-1547 EX AFP (01-02] NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE S AND ASSESSMENT OF TAX OR DISALLOWANCE OF DEDUCTION ESTATE OF HIRNEISEN LYDIA Z FILE N0. 21 02-0599 ACN 101 DATE 10-28-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED ( l CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 00 000 121 NOTE: To insure proper 1. Real Estate (Schedule A) (1) . , 00 credit to your account, 2. (2) Stocks and Bonds (Schedule B) , 00 submit the upper portion 3. Closely Held Stock/Partnership Interest (Schedule C) (3) . 00 of this form with your 4. Mortgages/Notes Receivable (Schedule D) (4) . 54 27 5 315 tax payment . 5 Cash/Bank Deposits/Misc. Personal Property [Schedule E) (5) . , . 6. Jointly Owned Property (Schedule F) (6) ,00 00 7. (7) Transfers [Schedule G) . (8) 436,275.54 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 15,188.02 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 56 7 46 13 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) . . 58 934 8 (11) _ . . 11. Total Deductions 407,340.96 12. Net Value of Tax Return (12) 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) [13) 407,34 0.96 14. Net Value of Estate Subject to Tax (14) NOTE: If an assessment was issued previously, lines 14, f ALL ret l 15 andior 16, 17, 18 and 19 will urns assessed to date. o reflect figures that include the tota ASSESS MENT OF TAX: .00 X 00 = .00 15 ., (15) Amount of Line 14 at Spousal rate 04 96 340 407 5 = 18,330.34 16. Amount of Line 14 taxable at Lineal/Class A rate (16) . , X 12 00 .00 17. (17) Amount of Line 14 at Sibling rate . X 00 15 = = . 00 18. Amount of Line 14 taxable at Collateral/Class B rate (18) , X 33 0.34 1 8 (1 , 9)= 19. Principal Tax Due DATE NUMBER -13-2002 CD0016: iCOUNT 1+1 I AMOUNT PAID T/PEN PAID (-) 916.52 17,413. TOTAL TAX CREDIT 18,330.34 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN S1, 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.) REGISTER OF WILLS OF CUMBERLAND COUNTY COMMONWEALTH OF PENNSYLVANIA IN RE: ESTATE OF Lydia Z Hirneisen * NO. 2002-0599 STATUS REPORT UNDER RULE 6.12 Name of Decedent: Lydia Z Hirneisen Date of Death: June 14, 2002 gill No.: 2002-0599 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: l . 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: 3. If the answer to No. 1 is Yes, state the following: a b c d /~. j '7 Date: ~f_, L_ Did the personal representative file a final account with the Court? Yes No X The separate Orphans' Court No. (if any) for the personal representative's account is: Did the personal representative state an account informally to the parties in interest? Yes X No Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. ,a ~;~ ~, --~ T ~ C~ ,,__---_ `J jif Signature ~ Thomas J. Ahrens, J.D. Name (Please type or print) 5521 Carlisle Pike Mechanicsbur~PA 17050 _ - Address - _ X717)697-1800 Telephone No. .; ._. Capacity: Personal Representative X Counsel for Personal Representative REGISTER OF WILLS OF CUMBERLAND COUNTY COMMONWEALTH OF PENNSYLVANIA IN RE: ESTATE OF Lydia Z Hirneisen NO. 2002-0599 STATUS REPORT UNDER RULE 6.12 1\fame of Decedent: Lydia Z Hirneisen Cate of Death: June 14, 2002 Will No.: 2002-0599 Copy ~~ C: 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: State wi~eti~er administration of the estate is complete: Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the z~dministration will be complete: 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 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 X No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. /- /J. Date: Cfi ' ~ Z ' CJ ~ / -~-__. Signature Thomas J. Ahrens. J.D. __ Name (Please type or print) 5521 Carlisle Pike Mechanicsburg PA 17050 Address (717) 697-1800 Telephone No. Capacity: Personal Representative X Counsel for Personal Representative