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HomeMy WebLinkAbout03-0834Estate of Stephen R. March also known as PETITION FOR GRANT OF LETTERS / , Deceased Social Security No. 196481238 Petitioner(s), who is/are 18 years of age or older, apply)les) for: (COMPLETE "A" OR "B" BELOW:) 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, dealh of executor, etc Except as follows, Decedent did not marry, was not divorced and did not have a child born or adopted after execution cf the documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: 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: II,. Carrie March Name Relationship Residence wife (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland residence at 1271 A Boiling Springs Road, Boiling Springs, PA 17007 (list street, number and municipality) Decedent, then 30 years of age, died June 19~ ,2002 , at Harrisburg Hos@ital (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 ..................................................................................................................... $ Real Estate situated as follows: County, Pennsylvania, with his/her last family or principal 500.00 500.00 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: I . Signature Typed or printed name and residence /'~ /~A Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland The Petitioner(s) above-named swear(s) and 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 representative(s) of the Decedent, Petitioner(s) will well and truly administ~ ~..c~o (~w~ ~.~ Sworn to and affirmed and subscribed ~ .... before me this / ~ 7-~'/ day of DECREE OF REGISTER Estate of Stephen R. Marsh also known as Deceased Social Security No: 19648123{ Date of Death: 6/19/02 AND NOW, (~~ /~"~' ~ , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters [~ Testamentary [~Administration ((c.t.a., d b n c.t.; pendente lite' durante absentia; duranle minoriate) are hereby granted to Carrie March : :~ 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 ...................................... $. TOTAL .............................. $ Rc. gister of Wills Signature Attorney: William P. Douglas I.D. No: 37926 Address: 27 W. H',~h St. Cadisle PA 17013 Telephone: 717-243-1790 DATE FILED: _~o -1~--~3 105.805 REV 9/86 This is to certify that the information here given is correctly copied fi'om an original certificate of death duly filed with me as Local 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, $2.00 P 832006;1 JUN 20 al02 No. Date NENT INK Ste 30 ~Dauphin R. March | COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITA£ RECORDS CERTIFICATE OF DEATH Harrisburg 1271A Boiting Springs Rd. Bolting Springs, PA 17007 7/20/1971 Cartiste, PA ,,~,.~lO t,~,.,*. ~ oo.U Harrisburg Hospit~t ~.~ 12~-,m ,~,. c,~. Cumbertand E 6/22/2002 Mt. Hotty Springs Cem. ,,,.Mt. Hotly Sprin~%PAlT007 [~. ozz~nger F.H.8 Crematorylne.M~.Hott~ ~0 ,,,o0 Name of Decedent: CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Date of Death: Will No. To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of ge Orpl)ans, Court Rules was served on or mailed to the following beneficiaries of the above-caPtioned estate on I I { Name Address Notice has now been given t° all persons entitled thereto under Rule 5,6(a) except Date: 'Signature Address '~ ~ · ~-~k~ 5V Telephone Capacity: perSonal Representative ~.Counsel for personal representative NOTICE OF BENEFICIAL INTEREST IN ESTATE BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, PENNSYLVANIA IN RE: ESTATE OF STEVEN R. MARCH, DECEASED NO. 21-03-0834 TO: CARRIE L. MARCH 48 Kingswood Terrace Carlisle, PA 17013 Please take notice of the death of decedent and the grant of letters to the personal representative named below. You may have a beneficial interest in the estate of Steven R. March under the Intestate laws of the Commonwealth of Pennsylvania. Name of decedent: Steven R. March Last known address of decedent: 1271 A Boihng Springs Rd., Boiling Springs, PA 17007 Date of Death: June 9, 2002 Place of Death: Harrisburg, Pa. County of Grant of Original Letters: Cumberland Decedent died intestate Name, address and phone number of all personal representatives: Carrie L. March 48 Kingswood Terrace Carhsel, PA 17013 Name, address and phone number of counsel: William P. Douglas, Esquire 27 W. High St. Carhsle, Pa. 17013 Phone: 717-243-1790 Additional information may be obtained from the undersigned: November 25, 2003 Douglas Law Office-'x Wilham P. Douglas, Es-q~ir~?' 27 W. High St. Carlisle, Pa. 17013 ~-~ 717-243-1790 REV-1500 EX (6~00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 ,~r~ HARRISBURG, PA 17128-0601 I-- Z ILl LU LU ! N SoL. v' REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENTS NAME (LAS'~, FIRST, AND MIDDLE INITIAL) ~ DATE OF DEATH (MM-DD-YEAR) DATE O,~ BIRTH (,MM-DD-YEAR) (IF APPLE;ABLE) SURV V NG SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) OFFICIAL USE ONLY FILE NUMBER 2 l_m. 00%'5 C~-TY"~-E YEAR NUMBER SOCIAL SECURITY NUMBER THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIALSECURITYNUMBER I- Z UJ 1:3 Z 0 lEI 0 LU Return [] 2. Supplemental Return [] 4. Limited Estate [] 4a. Future Interest Compromise (date of death after '12-12-82) I-~6. Decedent Died Testate (Attach copy of Will)[] 7. Decedent Maintained a Living Trust (Attach copy of Trust) [] 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) FIRMI~AME (IfApplic~ble) ~ _ ~-.-~ __ L~ ,~/o,..S ~ L_J TELEPHONE NUI{1B'ER ] 3. Remainder Return {date of death pdor to 12-13~2) ~-~5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes ]11. Election to tax under Sec. 9113(A) (Attach Sch O) COMPLETE MAILING ADDRES/S~,,,,,,,,.~ ~1..~. ~l"'~t 4K~~1~'~ ST'-"' 14. 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) 3,5 5 9.2 5 (Schedule E) 6. Jointly Owned Property (Schedule F) (6) ~--] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7} (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 1 0 ~ 2 9 1. O0 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) Net Value Subject to Tax (Line 12 minus Line 13) (8) OFFICIAL USE ONLY 3,559.25 (11) 10.291.00 (12) -0- (13) (14) 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 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: STREETADDRESS CITY 20 East St., Apt. 12 Mt. Holly Springs, PA 17065 ISTATE ZIP Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Pdor Payments C. Discount (1) Total Credits ( A + B + C ) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT, Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE, (5) A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 +'SA. 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 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; .......................................................................................... [] [] b. retain the dght 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? ........................................................................................................................ [] 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 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 re~entative is base~'~li information of which preparer has any knowledge. SIGNATUR,E (3.F I~ERSON RESPJ~ilSIB~E iLaR FILIj~ RETURN DATE ~~ '~...~.,~~'"'--,,.," ~ William P. Douglas, Esq. Attorney ADDRESS "-""-' \ 27 W. High St., Ca~lisle, PA 17013 1/20/04 SIGNATURE OFPREPARER OTHERTHAN REPRESENTATIVE DATE ADDRESS For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 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 RS. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. · REV-1508EX+(1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21-03-00834 Stephen,R. March Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorshi ) must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 8 $50 savings bonds, UPMC Health System, check Readers Digest refund checks Cigna Insurance, 4 bhe~ks totaling TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) 302.72 2,304.50 207.03 745.00 3,559.25 $ REV-1511 EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Stephen. R. March FILENUMBER 21-03-0834 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION A. 1, 5. 6. 7. FUNERAL EXPENSES: Gibon Funeral Home 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 Year(s) Commission Paid: AttorneyFees Douglas Law Office Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees E. Pennsboro Ambulance Service State___ Zip TOTAL (Aisc enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) AMOUNT 9,000.00 745.00 $10,291.00 46.00 500.00 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES Stephen, R. March FIL~U-~-~0834 RELAIIONSHIP IO DECEDENI NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) TAXABLE DISTRIBUTIONS (include outdght spousal distributions) H. Carrie Lynne March ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINE~ wife 15 THROUGH 17, AS APPROPRIATE NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II- ENTER TOTAL NON*TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET (If more space is needed, insert additional sheets of the same size) AMOUNT OR SHARE OF ESTATE 100% ON REV 1500 COVER SHEET Name of Decedent: Date of Death: Will No.: STATUS REPORT UNDER RULE 6.12 Pursuant to Rule 6.12 of the Supreme Court Orpkgns' Court Rules, I report the following with respect to completion of the adminlstratidrltof the above-captioned estate: 1. State whether adm~.~sj;ration of the estate is complete: Yes ['~ No ]_~ 2. If the answer is No, state when the personal rep,resentative reasonably,~believes that the administration will be complete: 1~/¢,¥.1" ~ ~ 3. If the answer to No. 1 is Yes, state the following: a. Did the personal re~,p~tative 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 r-] No Date: 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. Name I Address } Telephone No. Capacity: 1--] Personal Representative Counsel for personal representative IN RE: ESTATE OF STEPHEN R. MARCH IN THE COURT OF COMMON PLEA~, ,, OF CUMBERLAND COUNTY, PENNA. ORPHANS' COURT DIVISION NO. 2103-0834 PETITION FOR THE SETTLEMENT OF AN ESTATE TO THE HONORABLE, THE JUDGES OF SAID COURT: CARRIE L. MARCH, Administratrix of the Estate of Stephen R. March, through her attorney, Douglas Law Office, respectfully represents: 1. Stephen R. March, the husband of Carrie L. March, who resided at 48 Kingswood Terrace, Carlisle, PA 17013, died intestate on June 19, 2002. 2. Letters of Administration were granted to Petitioner on October 15, 2003. 3. The assets in the estate were as follows: 2. 3. 4. 8 $50 savings bonds UPMC Health System, check, reimbursement Readers Digest refund checks Cigna Insurance, reimbursement Total 302.72 2,304.50 207.03 745.00 $3,559.25 Gibson Funeral Home, funeral and headstone William P. Douglas, Esquire, attorney fee Register of Wills, probate fee Cumberland Law Journal, adv. Sentinel, adv. Register of Wills, filing fees E. Pennsboro Ambulance fees Total expenses $9,000.00 $ 500.00 $ 46.00 $ 75.00 $ 102.11 $ 14.00 $ 745.00 $10~82.11 5. This is an insolvent estate and no inheritance tax was due. A copy of the Notice of Appraisement from the Department of Reveuue is attached hereto as Exhibit A. 6. The said Stephen R. March was survived by his wife, Carrie L. March, and two children, Nickolas March, date of birth, 7/18/00, and Kiera Nicole March, date of birth 12/21/98. 4. Expenditures as follows have been made on behalf of the said Stephen R. March Estate: RECAPITULATION Total Assets: Total Debts $ 3,559.25 $ 10,482.11 Insolvent WHEREFORE, your Petitioner prays that Your Honorable Court approve this Petition, and prays that the said Administratrix, Carrie L. March, be discharged from the duties of hers appointment. Douglas Ir,aw Offic~e Attorney for Petitioner Dated: June 1,2004 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND William P. Douglas, Esquire, attorney for the Estate of Stephen R. March, being duly sworn according to law, deposes and says that the averments of the within Petition are true and correct to the best of affiant's knowledge, information and belief. William P. Douglas N Sworn to and subscribed before me This the 1~ day of June, 2004. x N4'tary ' '" ! NOT~mU~. SF.~. JRNE'I' M. LA~, NOTARY I~ I C.~mU~E ~ CUM~Em,.em m~umY I BUREAU OF INDIVIDUAL TAXES WILLIAM P DOUGLAS DOUGLAS LAW OFFICE 27 W HIGH ST CARLISLE PA 17015 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE 05-15-200q ESTATE OF MARCH STEPHEN R DATE OF DEATH 06-19-200Z FILE NUMBER 21 03-083q COUNTY CUMBERLAND ACN 101 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA I70i$ CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-15r+7 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF MARCH STEPHEN R FTLE NO. ZL 03-085q ACN 101 DATE 05-15-200q TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN l. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) $. CLosely Held S{ock/Partnership Interes{ (Schedule C) (S) q. Mortgages/Notes ReceivabLe (Schedule D) B. Cash/Bank Deposits/Misc. Personal Property (Scheduie E) (S) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) B. Tote! Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (ScheduLe H) (9) 10. Debts/Mortgage Liabili*ies/Liens (Schedule Total Deductions 12. Net Value of Tax Return .00 3~559 .Z5 .00 .00 (S) .00 NOTE: To insure proper .00 credit to your account, .00 submi~ ~he upper portion of this form with your tax payment. 3,559.25 10,Z91.00 .00 (11) ~ (12) 6,731.75- NOTE: ASSESSNENT OF TAX: 19. Principal Tax Due TAX CREDITS: DATE NUMBER INTEREST/PEN PAID (-) Charitable/Governmental Bequests; Non-eLected 9113 Trusts (Schedule J) (15) .00 Net Value of Estate Subject ~o Tax (lq) 6,731 .75- Z"F an assessment was issued previously, lines Ir+, 15 and/er 16, 17, 18 and 19 wil1 reflect figures that incluOe the total of ALL returns assesseO to aate. .00 x OQ .OQ .00 x OqS= .O0 .0§ x 12 .00 x 15 .00 (19)= . O0 .00 AMOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE (15) (16) (17) (18) IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .O0 .00 .00 ( 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.) 1N RE: Estate of STEPHEN R. MARCH. : In the Court of Comon Pleas "of Cumberland County, Penna. : Orphans Court division : No. 2103-0834 AND NOW,this - _ .. review of the within Petition, the Pettt~on for tie Set~ent of this Estate is approved and distribution directed as set forth in the said Petition. ~!~~. This Estate is closed and Carrie L. March, is excused from ~ duties of Administratrix of the Estate of Stephen R. March. By the Court, STATUS REPORT UNDER RULE 6.12 Date of Death: Will No. '~--10~ - O~ ~ 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 ~_ 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. Did the.personal represen~tiv~ ~ile. a final account with the Court? Yes. ~~< . ~,~-~.~~~ a~rt~-~-~(.~ a~y)~for b. The separate Orph o. n the personal representative's account c. Did the personal representative state an account informally to the parties in interest? Yes No d. COpies of receipts, releases, joinders and approvals of formal or informal accounts maybe filed with the Cerk of the Orphans' Court and may be attached to this report. Signabure · ~ · ~ame (~ease ~type or p~i'nt) Tel. No. (MAH:rmf/AM3) Capacity: ._Personal Representative Counsel for personal representative -\ BUREAU OF TNDZVZDUAL TAXES ~.XNHERTTANCE TAX DXVZSZON --DEPT. 280601 HARRISBURG, PA 17118-0601 COHHONgEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSNENT OF TAX Rec~:4.~: "--i~-:~: cf DATE -' ESTATE OF '04 ~ii;~ 12 gILLIAH P DOUGLAS DOUGLAS LAg OFFICE Z7 g HIGH ST (/ * CARLISLE PA 170~'1$ DATE OF DEATH FILE NUHBER COUNTY ACN REV-I;¢7 EX AFP 05-15-2004 HARCH STEPHEN R 06-19-2002 21 05-0854 CUHBERLAND 101 Amount ReaAtted I HAKE CHECK PAYABLE AND REHIT PAYHENT TO: REGISTER OF gILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LagER PORTION FOR YOUR RECORDS REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOgANCE OR DZSALLOgANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF HARCH STEPHEN R FILE NO. 21 05-0854 ACN 101 DATE TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANOED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A} (1) 2. Stocks and Bonds (Schedule B) (2) $. Closely Held Stock/Partnership Interest (Schedule C) ($) ~. Hortgagas/No~es Receivable (Schedule D) (~) $. Cash/Bank Deposits/HAsc. Personal Property (Schedule E) ($) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXENPTZONS: 9. Funeral Expenses/Ada. Costs/NAsc. Expanses (Schedule H) (9) 10. Debts/Hortgaga Liabilities/Liens (Schedule 1) (10) 11. Total Deduct/ohs 12. Net Value of Tax Return 3/559.Z5 .00 .00 NOTE: To lnsure proper .00 credit to your account, .00 submit the upper portion .00 of this form with your tax payment. .O0 (8) 10,291.00 .O0 $,559.Z5 13. 1~. NOTE: (11) Iff .20!. Off (12) 6,731.75- Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (13) Net Value of Estate Subject to Tax (1~) If an assessment ~as lssued previously, lines 1~, 15 and/or 16, 17, reflect figures that lnclude the total of ALL returns assessed to date. ASSESSNENT OF TAX: 15. Amount of LAne 1~ et Spousal rata (15) 16. Amount of LAne 1~ taxable et Lineal/Class A rate (16) 17. Amount of Line 1~ at Sibling rate (17) 18. Amount of LAne 1~ taxable et Collateral/Class B rate (18) ~al Tax Due .0O 6,731.75- ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. RECExPI NUHBER AHOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 .00 .00 .00 ( ZF TOTAL DUE IS LESS THAN $1, NO PAYNENT ZS REgUZRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.) 19. Princi TAX CREDITS: PAY;E;~T DATE DXSCOUNT INTEREST/PEN PAID (-) · O0 X O0 = .00 · 00 X 045= .00 · O0 X 12 = . O0 · O0 X 15 = .00 (19)= . O0 18 and 19 will RESERVATION: Estates of decedents dying on or before December 1Z, 19DZ -- if any future interest in the estate is transferred in possassion or enjoyment to Class 8 (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: PAYHENT: REFUND (CR): OBJECTIONS: ADHIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section 1140 of the Inheritance and Estate Tax Act, Act 25 of 2000. (71 P.S. Section 9140). Detach the top portion of this Notice and submit with your paymant to the Register of Hills printed an the reverse side. --Hake check or money order payable to: REGISTER OF N~LLS, AGENT A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications era available at the Office of the Register of gills, any of tho 23 Revenue District Offices, or by calling the special 24-hour answering service for forms ordering: 1-800-361-2050; services for taxpayers aith specie1 hearing and / or speaking needs: 1-800-447-3020 (TT Any party in interest not satisfied with the appraisement, allowance, or disallomance of deductions, er assessment of tax (including discount or interest) as shown an this Notice must object aithin sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 181021, Harrisburg, PA 17118-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assassmant should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 180601, Harrisburg, PA 17128-0601 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 dacedent's death, a five percent (51) discount of the tax paid is allowed. The 15X 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 and of tho tax amnesty period. This non-participation penalty is appeaZable in tha same manner and in the the same time period as you gould appeal the tax and interest that has been assessed as indicated on this notice. Intarast is charged beginning with first day of delinquency, or nine (9) months end one (1) day from tha data of death, to the date of payment. Taxes which became daZinquent before January 1, 1982 bear interest at the rate of six (6X) percent per annum calculated at a daily rate of .000164. All taxes ahich became delinquent on and after January 1, 1982 will bear interest at a rate which will vary free calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1981 through 2004 are: Interest Daily Interest DaiIy Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 201 .000548 ~)'~'~-1991 111 .000301 ZO0~ 9X .000247 1983 161 .000438 1991 91 .000247 ZOOZ 6Z .000164 1984 llZ .000301 1993-1994 72 .000191 Z003 52 .000137 1985 131 .000356 1995-1998 91 .000147 2004 41 .000110 1986 101 .000274 1999 71 .000191 1987 101 .000274 ZOO0 71 .000192 --Interast is calculatmd as follaas: INTEREST TM BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAZL¥ INTEREST FACTOR --Any Notice issued altar the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additiona! interest must be calculated.