HomeMy WebLinkAbout03-0721Estate of
also known as
Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Emma R.sso
, Deceased
Social Security No. 201-16-1250
(COMPLETE "A" OR "B" BELOW:)
A. Probate and Grant of Letters and aver that Petitioner(s) is/are the executOr
Decedent, dated September 27, 2002 and codicil(s) dated
__ named in the Last Will of the
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 incompetent:
B. Grant of Letters of Administration
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse
(if any) and heirs:
Name Relationship Residence
(COMPLETE IN ALL CASES:) Attach additional~;heetsif necessary,
Decedent was domiciled at death in Cumberland
residence at 2004 Columbia Avenue, Camp Hill, PA 17011
Decedent, then 90 years of age, died Au,qust 22, 2003
County, Pennsylvania, with his/her last fantily or principal
at Camp Hill Care Center, Camp Hill, PA
Decedent at death owned propertv with estimated values as follows:
(If domiciled in PA) All personal propertv .............................. $
(If not domiciled in PA) Personal property ~n Pennsylvania .................... $
(If not domiciled in PA) Personal property in County ......................... $
Value of real estate in Pennsylvania .............................................. $
Total ........................................................... $
Real Estate situated as follows: 2004 Columbia Avenue, Camp Hill, PA 17011
35,000.00
105 000.00
140,000.00
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:
Signature
)[,yped or printed name and residence
Jay ~. Kendi~/~%.~0-
~ W. Willow Road
P. O. Box 305
Willow Street, PA 17584
RW-7
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 administer the estate according to law.
Sworn to and affirmed and subscribed
before me this ~Sg/_~, day of
September 2003
DFCR. EE OF REGISTER
Estate of Emma,: Russo
Deceased No.
also known as
Social Security No: 201-16-1250
Date of Death: August 22, 2003
AND NOW, ,__~J~-r~m~o~,~ -~ , 2003 , in consideration of the Petition
on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters [] Testamentary [] of Administration
are hereby granted to
Jay M. Kendiq.~___...~:~.
in the above estate and that the instrument(s), if any, dated ,~----~_~-~_m~_~
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters ...........................
Short Certificate(s) ..........
Renunciation .................. $
Affidavit ( ) ................. $
Extra Pages ( ) ............ $
Codicil .......................... $
JCP Fee ........................ $
Inventory & Tax Forms... $
Other ............................ $
q. OO
TOTAL ................ $ ~.~_~.
Attorney: J. Stephen Feinour, Esquire
I.D. No: 24580
Address: P. O. Box 840
Harrisbura. PA 17108-0840
Telephone: (717) 236-3010
DATE FILED: 9/3/03
his is to certify that the information here given is correctly copied f}om an original certificate of death duly filed ~vith 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,e~ ·
Fee for this certificate, $2.00
P 9572199
No.
Date
f, PRINT
4ANENT
CKINK
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH .~V I TA L. iRE C 0 R D.Si ~...¢t{_ ,
CERTIFICATE OF DEATH
,. ~ L~u~e Russo I"F°male ,. 201 -- 16 -- 12~ ,. ~ust 22, 2~3
.... ~ ..... ~, i nurses org~zat~o~ ~ ~ I ,~,~ ~o lo 0,~-, I
~okkee~r [,,,. . b,. I1,. ' "~' I' I,,.
2004 Columbia Avenue
C, amp Hill, PA 17011
Ervin Westheafer
[] August 27, 2003
Louise R. Holstine
319 Locust l.ane, Mt. Joy, PA 17552
I,,.RollingGreen Mm. Gardens[~,, ~p mi1, PA
17011
LICENSE NUMO~R
]etrick Fun. Home, Inc. 3125 Walnut St., Hbg. P~
! ~a. /,'/~: ' a~ ~ . '
I
~/~
I
LAST WILL AND TESTAMENT
OF
EMMA LOUISE RUSSO
I, EMMA LOUISE RUSSO, of 2004 Columbia Ave., Camp Hill, Cumberland County,
Pennsylvania, being of sound and disposing mind, hereby make, publish and declare this my Last
Will and Testament, hereby revoking and making void all prior Wills and other testamentary
writings at any time heretofore made by me.
I. I direct my Executor, hereinafter named, to pay all of my just debts, funeral and
testamentary expenses as soon as conveniently can be done after my demise.
II. I give, devise and bequeath $2,500.00 to Good Shepard Roman Catholic Church of Camp
Hill, Pennsylvania.
III. I give, devise and bequeath the rest, residue and remainder of my Estate of whatsoever
kind and whatsoever situate to my sister and brothers, HELEN KENDIG, of Willow Street,
Pennsylvania, CHARLES WESTHEAFER, of Turramurra, Australia, (only child of HARRY
WESTHEAFER, deceased) and WILLIAM WALLACE, of Landisburg, Pennsylvania, (only child
of WILLIAM WESTHEAFER, deceased) in equal shares, share and share alike, per stirpes. If any
of the above shall die without issue, his or her share shall lapse.
IV. Should there be any property of whatsoever kind and wheresoever situate which I have
the right to dispose of at the time of my death, including but not limited to any special or general
power of appointment or both, I hereby appoint the same to my legatees set forth in Paragraph
THIRD hereof.
V. I nominate, constitute and appoint JAY KENDIG, CPA as Executor of this my Last Will
and Testament and further direct that he shall serve without bond. Said Executor shall have the
power to discharge all the debts, liens and encumbrances upon my estate, as well as any taxes
thereon, to pay for the cost of the final disposition of my remains and final illness, if any, to receive
any and all commissions and other compensation for services rendered by me during my lifetime and
to perform any and all fiduciary duties authorized by statute. Further, I direct my Executor to
preserve my estate and any instructions pertaining to the distribution of the same from any
attachment or anticipation while in the hands of my said personal representative, it being my express
intent that all legacies shall be free from any attachment or anticipation while in the hands of the
accountant for my estate.
VI. I request my Executor to consult with GARY J. IMBLUM, ESQUIRE of KNUPP,
KODAK & IMBLUM, P.C., of Harrisburg, Pennsylvania, as attorneys to assist in the administration
and settlement of my affairs after death, they being acquainted with my affairs.
IN WITNESS WHEREOF, I have to this my Last Will and Testament, typewritten on three
(3) pages of paper, set my hand an seal at the end thereofth~s "/day of x~,~,-.-/..,~, 2002.
EMMA LOUISE RUSSO
SIGNED, SEALED, PUBLISHED and DECLARED by the above-named Testatrix, EMMA
LOUISE RUSSO, as and for her Last Will and Testament in the presence of us who, at her request,
in her presence and in the presence of each other, all being present at the same time, have hereunto
set our hands as witnesses.
/
(SEAL)
COMMONWEALTH OF PENNSYLVANIA :
:SS:
COUNTY OF 'CUMBERL,~qE~ '-~)/} U ~/4tA/ :
I, EMMA LOUISE RUSSO, Testatrix whose name is signed to the attached or foregoing
instrument, having been duly qualified according to law, do hereby acknowledge that I signed and
executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed
it as my free and voluntary act for the purposes therein expressed.
EMMA LOUISE RUSSO
Sworn to am1 subscribed J~efore
me thi~'7___~y o _f~~,, 2002·
Notary Public
My Commission Expires:
(SEAL) Notarial Seal J
~reno~ A. Aumill~r, Not~y Pffol~e
City of Harrisburg, Dau~in Oou~ty
My Commission Exlflr~ Mar. 16, ~
COMMONWEALTH OF PENNSYLVANIA
COUNTY rm~, T, ~,~oT
Member, Pennsylvania Association of Nolaries
:SS:
the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified
according to law, do depose and say that we were present and saw EMMA LOUISE RUSSO,
Testatrix, sign and execute the instrument as her Last Will and Testament; that she signed willingly
and that she executed it as her free and voluntary act for the purposes therein expressed; that each
of us in the hearing and sight of the Testatrix signed the Will as witness, and that to the best of our
knowledge, the Testatrix was at that time 18 or more years of age, of sound mind and under no
constraint or undue influence.
Sworn to and su?,s~!bed jy .
before me thisaq~7~ay o~., 2002.
),
(SEAL)
Notary Public
My Commission Expires:
Notarial Seal
_F. rances A. Aurniller, Notary Public
city of Harrisburg, Dauphin County
My Commission Expires Mar. 16, 2006
ORIGINAL
OF
LAST WILL AND TESTAMENT
OF
EMMA LOUISE RUSSO
LAW OFFICES OF
KNUPP, KODAK & IlVIBLUM, P.C.
CAMERON MANSION
407 NORTH FRONT STREET
P.O. BOX 11848
HARRISBURG, PA 17108-1848
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Emma L. Russo
Date of Death: August 22, 2003
Will No. 2003-00721 Admin. No.
To the Register:
I certify that notice of beneficial interest required by Rule 5.7(a) of the Orphans' Court Rules
was served on or mailed to the following Beneficiaries of the above-captioned estate on September 8,
2003.
Name:
Good Shepard Roman Catholic Church
Helen R. Kendig
Charles W. Westheafer
William B. Wallace
Address:
3435 Trindle Road, Camp Hill, PA 17011
300 Willow Valley Lakes Dr., F-308, Willow Street,
PA 17584
17 Raven Hill Road, Turramurra, New South Wales,
Australia 2074
P. O. Box 263, Landisburg, PA 17040-0263
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except N/A
Date:
September 8, 2003
n Feinour, Esquire
an, Smith, Shissler & Hall, LLP
Supreme Court I.D. No. 84906
200 N. 3rd Street, 18th Floor
P. O. Box 840
Harrisburg PA 17108-0840
Capacity:~
X
Personal Representative
Counsel for Personal Representative
Form 1500 Inheritance Tax Prepayment
The estate of Emma Louise Russo
Social Security Number 201-16-1250
Date of Death
Address
8-22-03
2004 Columbia Avenue
Camp Hill, PA 17011
File Number
Paid by
Amount of Prepayment
21-03-0721
Jay Kendig, Executor
(717) 464-3441
9 West Willow Road
Box 305
Willow Street, PA 17584
$17,100.00
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 003240
KENDIG JAY
P O BOX 305
WILLOW STREET, PA
17584
........ fold
ESTATE INFORMATION: SSN: 201-16-1250
FILE NUMBER: 2103-0721
DECEDENT NAME: RUSSO EMMA LOUISE
DATE OF PAYMENT: 11/17/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 08/22/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $17,100.00
TOTAL AMOUNT PAID:
$17,100.00
REMARKS' JAY KENDIG
SEAL
CHECK# 1003
INITIALS: AC
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
REV. 1500 EX (6-00)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV- 1500
I
INHERITANCE TAX RETURN
21 _ 03 0721
RESIDENTDECEDENT 0ou. C0DEYEAR --NUM'-'-'~ER~--
I--
Z
LU
LU
c.)
UJ
LU
-T-oo
fl.
<
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
Russo, Emma Louise 201-16-1250
DATE OF DEATH (MM DD YEAR) i DATE OF BIRTH (MM DD YEAR I THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
08/22/2003 i 11/20/1912 REGISTER OF WILLS
(IF APPLi~ABLEi SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER '
~-]1. Original Return
r--14. Limited Estate
r--16. Decedent Died Testate (Attach copy of Will)
m~9. Litigation Pr~eds Received
r~2. Supplemental Return
--] 4a. Future Interest Compromise (date of death after 12-12-82)
r'-~ 7. Decedent Maintained a Living Trust (AUach copy of Trust)
]--~10. Spousal Poverty Credit (date of death between 12-31-91 and 1-%95)
--]3. Remainder Return (dale of dealh prior to 12-~3-82)
[~5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
['~ 11. Election to tax under Sec. 9113(A) (AUach Sch O)
NAME
Jay Kendig
FIRM NAME
Huber, Drewes & Kendig
TELEPHONE NUMBER
(717) 464-3441
COMPLETE MAILING ADDRESS
P.O. BOX 305
9 West Willow Road
Willow Street, PA 17584
1. Real Estate (Schedule A)
2.
3.
4.
5.
(1)
Stocks and Bonds (Schedule B) (2)
Closely Held Corporation, Partnership or Sole-Proprietorship (3)
Mortgages & Notes Receivable (Schedule D) (4)
Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
r'~ 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.
14.
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)
104,900.00
40,899.70
(8)
145,799.70
32,610.26
3,171.05
(11)
35,781.31
110,018.39
(12)
(13)
(14)
2,500.00
107,518.39
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)
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
x.O
x.O
.... 35 839.46 x .12
71 678.93 x .15
(15)
(16)
(17)
(18)
(19)
4,300.74
10,751.84
15~052.58
Decedent's Complete Address:
STREETADDRESS
2_004 Columbia Avenue--
C~TYcamp Hill
STATEpA
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments (1)
A. Spousal Poverty Credit
B. Prior Payments 17,100.00
C. Discount 752.63
Interest/Penalty if applicable
D. Interest
E. Penalty
15,052.58
17,852.63
2,800.05
Total Credits ( A + B + C ) (2)
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
i
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 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? ........................................................................................................................ [] []
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 pedury, 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,
DATE
P.O. Box 305, Willow Street, PA 17584
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ' - DATE
ADDRES~
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%
[12 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 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 w th the decedent, whether by blood or adoption.
REV-1502 EX+ (6-98,~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF FILE NUMBER
Emma Louise Russo 21-03-0721
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 willing 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 DESCRIPTION
1. Single Family Residence, 2004 Columbia Avenue, Camp Hill, PA (Settlement Sheet Attached)
TOTAL (Also enter on line 1, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
VALUE AT DATE
OF DEATH
104,900.00
$ 104,900.00
REV-1508 EX+ (6-98) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Emma Louise Russo
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
21-03-0721
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION
6.
7.
8.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
PNC Bank Checking Account #5140118759
Accrued Interest on #1 above
PNC Bank Savings Account #5003668797
Accrued Interest on #2 above
Real Estate Tax Refund (Settlement Sheet Attached)
Sewer Refund (Settlement Sheet Attached)
Checks on Hand at Date of Death:
Radio Shack
Manulife Annuity
Comcast Cable
Esther Rhan Estate
1987 Oldsmobile
Coin Collection
Beverly Nursing Home, Camp Hill, PA - Refund
Susquehanna View Apartment Refund
Peerless Insurance Refund
AARP Health Insurance Refund
AT&T Refund
PA American Water Refund
PP&L Refund
Nursing Home Cost Reimbursement from Health Insurance
Prepaid Funeral Contract
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
VALUE AT DATE
OF DEATH
8,941.36
.61
20,111.33
8.34
665.05
2.63
10.00
43.85
34.35
2,223.35
750.00
25.38
820.29
186.00
8.00
148.75
18.39
11.23
18.79
1,785.00
5,087.00
40,899.70
REV-1511 EX+ (12-99) .~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Emma Louise Russo
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21-03-0721
Debts of decedent must be reported on Schedule [.
ITEM
NUMBER DESCRIPTION AMOUNT
A.
1.
8.
9.
10.
12.
13.
15.
FUNERAL EXPENSES:
Hetrick Funeral Home, Inc.
3125 Walnut Street
Harrisburg, PA 17109
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s) Jay Kendig
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address 9 West Willow Road, Box 305
City Willow Street State PA
Year(s) Commission Paid: 2004
Attorney Fees
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
__Zip
17584
Street Address
City State ~ Zip
Relationship of Claimant Io Decedent
Probate Fees
AccounLant's Fees
Tax Return Preparer's Fees
Century 21 Piscioneri, Real Estate Sales Commission (Settlement Sheet Attached)
Real Estate Transfer Tax (Settlement Sheet Attached)
Credit for Furnace, Air Conditioning and Floor Repairs (Settlement Sheet Attached)
Inspection & Sales Fees (Settlement Sheet Attached)
Penn Waster Inc, Manchester, PA - Trash Removal
Michael Hading Tax Collector, Camp Hill, PA - Real Estate Taxes
UGI, Reading, PA- Gas
PP&L, Allentown, PA - Electric
Timber Barn, Camp Hill, Pa - Lawn Care
Total From Continuation Sheet
TOTAL (Also enter on line 9, Recapitulation) i
(If more space is needed, insert additional sheets of the same size)
5,190.64
7,290.00
3,243.63
275.00
7,343.OO
1,049.00
3,663.50
537.00
40.74
1,258.99
13.46
14.85
493.72
2,196.73
$ 32,6'10.26
Commonwealth of Pennsylvania
Inheritance Tax Return
Resident Decedent
Schedule H
Administrative Costs Continuation Sheet
Estate of Emma Louise Russo
File Number 21-03-0721
Item
Number Description
Amount
16 PP&L, Allentown, PA - Electric
17 Michael Harling - Per Capita Tax
18 PA American Water
19 LG Connor Appraiser - Real Estate Appraiser
20 Penn Waste Inc. Manchester, PA - Trash Removal
21 Penn Waste Inc. Manchester, PA - Trash Removal
22 Timber Barn, Camp Hill, PA - Lawn Care
23 PA American Water
24 Borough of Camp Hill Sewer Authority
25 PNC Bank Check Charge
26 UGI, Reading, PA - Gas
27 Vital Record -Additional Death Certificates
28 Timber Barn, Camp Hill, PA - Lawn Care
29 PP&L, Allentown, PA- Electric
30 PA American Water
31 William Wallace, Landisburg, PA - Repairs
32 UGI, Reading, PA- Gas
33 PP&L, Allentown, PA - Electric
34 Timber Barn, Camp Hill, PA - Lawn Care
35 PA American Water
36 UGI, Reading, PA- Gas
37 PP&L, Allentown, PA - Electric
38 PA American Water
39 Jay Kendig, Willow Street, PA - Pest Control
40 Jay Kendig, Willow Street, PA - Travel
30.75
15.00
12.25
300.00
40.74
139.00
230.02
12.30
60.00
39.62
35.20
15.00
243.80
14.62
12.30
27O.O0
60.98
18.79
35.00
11.23
34.11
24.31
16.57
62.54
462.60
2,196.73
REV-1512 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Emma Louise Russo
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
21-03-0721
Include unreimbursed medical expenses.
ITEM
VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
2.
3.
4.
5.
6.
7.
8.
9.
10.
AARP Health Insurance Premium
Peerless Insurance Agency, Keene, NH - Homeowners Insurance
Beverly Nursing Home, Camp Hill, PA - Nursing Home Fee
Knupp, Kodak & Imblum - Attorney Fee
Verizon of PA - Telephone
AT&T - Telephone
AT&T - Telephone
Community Life EMS - Ambulance Fee
Susquehanna View Apartments and Utilities
R. Lynn Magargle MD - Physician Fee
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
148.75
375.00
1,500.00
140.62
49.94
18.39
18.30
460.00
430.05
30.00
3,171.05
REV-1513 EX+ (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF FILE NUMBER
Emma Louise Russo 21-03-0721
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
! TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
Helen R. Kendig
300 Willow Valley Lakes Drive Apr F-308
Willow Street, PA 17584
William B. Wallace
Box 263
Landisburg, PA 17040
Charles W. Westheafer
17 Raven Hill Road
Turramurra, New South Wales, Australia 2074
Sister
Nephew
Nephew
33%
33%
33%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
Good Shepard Roman Catholic Church of Camp Hill
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)
2,500.00
~05>05
This is to certify that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records in accordance
with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Charles Hardester
State Registrar
No.
' 3031525 ~~~ NOV 25 2003
Date
PERMANENT
BLACK INK
m05 ~3R,v Wa? COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH ·VlTAL. iRECOR_D~Stl,,.,O{
CERTIFICATEOF DEATH 0 7 9 7 41
;~, .... ~ ~,~Rsssg-.,~. o .... .., ,. Fmale ,. 201 -- 16 -- 1250 .. ~ust 22, 2003
. 90 . ~. 20, 12 ~[s~ PA /
C=~rl~ I ~st P~ns~ro T~ ~p Hlll =re ~t= I~ ~.,----~. I'~' --._
,.. Camp Hill, PA 17011
,t Ervin Wes theafer
Jay M. Kendi~
[] August 27,
2003
MOTHER'S NAME {F,~a~ M~. MaVen Surname)
~,. Louise R. Holstine
~ 319 Locust Lane~ Mt. Joy. PA 17552
1,1..Rolling Green Mem. Gardens[,,~ C~mp Hill, PA 17011
, ,~,,_,/~ ' O E PRONOUNCE D DF. AD (Month, D~y. Yeast )
.. ..~ ,c.~....
.etrick Fun. Home, Inc., 3125 Walnut St., Hbg. PA
DAT~ SIGNEO
...
I
A.. SettJement Statement
U.S. Department of Housing ~
and Urban Development
()MB No. 2502.-0265
B. Type of Loan
! i~] FHA 2.F'l FmHA 3. FI Couv. Unins~ 6. File Number ] 7. Loan Number i 8. Mortgage Insurance Case Number
, !
4I'-'] VA 5.[-1 Cony. Ins. ~ 33195 BURNETTE 0133903831 i .......................
C. NOTE: This form is furnished to give you a statement or' actual settlement costs. Amounts paid to and by the settlement agent are shown.
Items marked "(p.o.c.)" wer~ paid outside the clo~ing; they ar~ shown her~ for informational purposes and ar~ not included in the touals.
E. NAME OF SELLER:
ADDRESS OF SELLER:
~DRFi,~ O_~ LgNI~:
G. PROPERTY
LOCATION:
O~ L. Bumette
BOX R)8, 6301 Gray,on Rd., Hatvisbarg, PA ! 7H I
~te ofE. Loui~ R~o
9 W. Willow R~ Box 305, Willow S~eL PA 175~
~ F~ HO~ M~A~
2~1 ~~., S~. ~; BI~o~ ~ 55425
2~ Col~ia Ave.
C~p Hill, PA 17011
106,Olytto_v~Rtax~s .......... Jo
107 County lanes ....... J~23/03 ~o .1~31/03
108.A~s~.~ .~ .......
, l~.Sch~.l.T~ 1~/~ _t~ . ~_ .__
t 10. Sewer ...... 12,~/03 to. 1~3M03. _
112.
120.GROSS AMOUNT DUE FROM BO~OWER
2~.AMO[ INTS PAID BY OR IN BEHA~ OF BO~OWER
Al;~l~tll~uli.s_fo~s paid by seller iii. advance_ . .
..... 406.~wn taxes .............. tlZ .......
9~69. iO2,Co, un~..t~l~_ ...... 12~23/.03_ LI 2/31/_03 9.69
.6~ ~ 3-6_ _44~, Soho_ct l_Taxgs ........ 1_2.~l~3_. lo_
.2,63_~{.[0. S~w~ ...... 12723703 to_ 12/t1703.
· . 4LI ............... Io_ ......
41:L to
! I 1,382.46 420.GROSS AMOUNT DUE TO SELLER ~ 105,567.68
500. REDUCTIONS IN AMOUNT DUE TO SELLER
~0J_,Es_c~oait (se~qmtrdioaml
503.Eni~ng Ioanal taken sul~_t, lo ...............
_ ~0~ PaXoff~f_first mortgag~lo~t_
t ~.,?~J~r~~~i ....... '
t
_ 3,663.5.0_Js~7,Ci~[R to buyer for New f .... e, air eondifionir
5~ ....
_ ~d_justments for itms unp~__i~..b~?!l..?.
5_1.0. Cis~to_wn taxes ............... t~ .........
511 ,County_ taxes ................. to__
512,A~s_m~ .............. to.
51.3 ................. _to__
51.~ ..................... to.
515 ............................. .~
516 ................... to .......
517 ......................... to ......
51_$ ............................. t9
519. to
520. TOTAL REDUCTIONS IN
AMOUNT DUE SELLER ~ 12~92.S0
600. CASH AT S~MENT TO.ROM SELLER
601. Or0~ amount due to seller (line 420) 105,567.68
602.L~s reductions i~ mount due seller (line 520) 12~592.50
603.CASH [] To [] From SELLER ~ 92,975.18
20 !, D~or~ L o_r_ _earn~. mort ~ ..............
202, Princii~al_amo_unLo£ noar_loanii 1 i_4.4_10.00.
203. E~d~ ti_ng loauCq_{ak;u
204
205 .....................
......................
206, Pri_.n_c~I_~;~un t o f ;;gJ_{~l'_financing .........
207.£t~lit{o buy,.J2~,ia~_fumar~ a~
Z01L. and.iluo~ia~ ...................
209
20~b
~ 1.0 ,(3 t~/to.vau _taz~ ............... ~ ...........
2 { 2 .^ ss~,sm.~ia ...... to __
2l 3 ............ to ..
21~ ............ ~ ..........
2{7 ................ ~ ..........
2[9. to
230.'tOTAL AMOU~ PA[D
BY OR IN BEHALF OF ~OW~
3~.C~ AT S~ ~O~ ~RROW~
301 .Gr~ ~o~i ~e ~ ~ (li~ { 20) [ i I 1.382.~
302.~ ~ ~d by/for ~w~ (line 2201 ~ 1 ~,073.~0
303.C~H ~ From ~ To ~RRO~R I1~.~
[
PAGE I
tIUD-1 (3-86) RESPA, HB 4305.2
I I.. Settlempant Clnarges
7_00. _T.Q.TAL.S3LES/~RO~O--M- bnsed on pric~
DLvLsioa_of Commi~n_(Lin~ 7.01~aa foll~za:.
701 .... 4221
Id .si I)EPARTMEN F OF }K)USING AND URBAN DEVEI.OPMEN 1
SE'ITI.EMENT S'FATEMENT PAGE
. 104,300.00-~...._'L0~_Y~_~ .... 7.,3_43,00_ Paid From Paid From
Borrower's $cllex's
3entut3t. 21.Piacion~fi. ................ Funds At Funds At
703. Co~st~_p~~t
~o
8~. Ite~ P~ In Con~on ~ ~an
80L L~n~on F~ ........ 1~-~- t~ .~LLS F~~~~ .......... ~.10
8~, C~dit R~. LO ~~~OR~A~, 1NC ........... J ~.~.
{807, H~C~E~
810
j8!2 .......... to ..........................................
- to
8JL3
814 ........................... .to .......................... l' ....... J ....
815. to / l
900. Items Reqalred ~y Leader To ~e Paid In Advnnee
{ ~o_i, ~ r~m.__A2a310~__~o ..... 1/u04. ~ ............ 23A.~ .ldo_ ......................... [. .........
902,__~ Pmni~. .... months to [ ........... J _
903, J-L~.~e Premium~ ..... x~m.. to ........................ J. ..... J _
~ .................... yenra. ~o .......................... L ............ J__ ....
905. ygars to l
I000, Reserves i~ited With Leader
1100. Title Chaqt, es
um., S~L~.a_~,_r~ .......... lo ......................... J ........ J
11.02.. Ab~tcLOLtRle search ......... to ........................ .J ......... J. _.
1103. Iit~a~fi~ ......... -to .......................... J .... J
~l~. Iitl~~ .... to .......................... J. .......... J.
1105, D~~i~ ......... ~ ............................. _[ ........ [ _
Il Off. N~._~ ................ to Sh~i~ R~C .............. j_ ..... 6.~ J
t 108, ~ m$~ ................. to_~fl~.~ .................... ~3.75 I
. {m~l~c i~ u~;_... JiOZI t03 l.l~ ............................... 'J
I I~, L~s Cove== ....................... ]~T: 94,410.~ ........... ~
1110, Om~_~v~: ................ I~S~[~,~.~ .......... ~~]
1 ~ ~0a ~~~_8. t ......................................... ~S0.~ l ..... I
~ 12. to
~ll~. .... t;
1200. ~vernm~t R~or~ and Tr~er Cba~ J
~01..~ · · ~o;u-~,)~.~,~,). ;~ ................ }. . liar} }
12~. R~ Relm of M~I Clams - RECQRDER of DEEDS
1300. A~nal Settlement Charges
L30I, Sur~ ................ ~o ............
1302. E~st<om¢lamptctio. u&RadonI~t to I:tonmS~c.. $365.00_ ............. *P.O.C,*_
13O3~_Pest .T~ ........ to. Home. Paramount ....................
1304. T~snctign_E~ ............. ia .l~&n~tI~'JJ~ ....................
t 30.~. SeryJcr,.Et¢ ............ ~ C~Jllr~21_Pial:iolltt'i
1306. [:k:~ltg..&=Air condifioning.[lla{l~tiou .......... Lo..C_~._Fl:itr,.Co
1307. Pm~r_~hF. xtmor ........... .to l>mi¢ll~n,5~am.Cam ..................................
1308. to
1400. Total Settlement Charges (enter on lines 103, Section J and 502, SectionK) ~ 5,814.78 8,929.00 ]
CERTIFICATION DATE' ,'~rs~,n~
have carefully reviewed thc HUD - I ,S~tlemen[ Statement and to ~he. best of my.knowledge and be, lief, it is a truc and accurate statement'~)f a}'l~5~{~ and
disbursements made on my account or oy me in mis transaction. I furtl~er certify rant ! have receiven a copy of the HUD - 1 Settlement Statement.
~_: ~ Borrower 1,,~¥: . _ Seller
Olhm [.. Bumette Jny KIlff~l~ Execu~
........... ~.. Borrower ................. Seller
Tbe HUD-I Settlement Statement which I h._al~ prepa~l i~ a true and ac'curate account of this transaction. I have caused the funds to be disbursed in accord-
ance with this statemeamt. ./~ ' SIIUMAKER WILl.lAMS, P.C.
..........~~ Settlement Agent .... 1~'23Y03 Date
WARNING: It is a crime to knowingl ly nmagLe1~ ~ Io the United States on this or any other similar form, Pens{ties upon conviction can include a
fine and imprisonment. For details see: Title 18 U.S. Code Section lO01 and Section IOlO. 33195 BL'RNKTTE
PN CBANK
September 16, 2003
Jay M Kendig
P O Box 305
Willow Street, PA 17584
sep
RE:
Estate orE Louise Russo (Deceased)
SSN: 201-16-1250
DOD: 08-22-2003
Dear Mr. Kendig:
In response to your request for Date of Death balances for the customer noted
above, our records show the following:
Checking Account
Account~5140118759 Established 02-01 -1982
E LOUISE RUSSO
DOD balance: $8,941.36 + $0.61 accrued interest
Interest earned 01-01-03 thru 08-22-2003 $9.31 YTD
Savings Account
Aceountg5003668797 Established 03-10-2003
E LOUISE RUSSO
DOD balance: $20,111.33 + $8.34 accrued interest
Interest earned 01-01-03 thru 08-22-2003 $111.33 YTD
Please note that this office only provides date of death balances for deposit
accounts (IRAs, CDs, Checking and Savings accounts). We do not process any
financial transactions or provide statements. If you need assistance with any of
these items, please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local
PNC Bank branch office.
Erica L Schlegel
PNC Decedent Reporting
Firstside Center
500 First Ave, 4th F1 CIF
Pittsburgh PA 15219-3128
1-800-762-1775
Member FDIC
HETRICK FUNERAL HOME, INC
3125 Walnut Street
Harrisburg, Pennsylvania 17109
(717) 545-3774
TO:
Jay M. Kendig
319 Locust Lane
Mt. Joy, PA 17552
DATE:
TERMS:
September 9, 2003
Net 30 days
FOR FUNERAL EXPENSES OF: E. Louise Russo
Professional services,
equipment
Casket
including facilities, equipment,
Subtotal
Cash advances by funeral home:
Death certificates (5)
Flowers
Honorariums:
Clergy
Soloist
Organist
Altar servers
Patriot News charge for obituary
Subtotal
Final total
Less preneed account
Less earnings on cash advances included in preneed
Present balance
and motor
$ 3,035.00
1,675.00
4,710.00
10.00
150.00
100.00
75.00
75.00
15.00
55.64
480.64
$ 5,190.64
5,085.00
2.00
$ 103.64
LAST WILL AND TESTAMENT
OF
EMMA LOUISE RUSS()
1, EMMA LOIJISE RI JSSO. of 2004 Columbia Ave.. (_;amp ttill, Cumberland County,
Pennsylvania, being of sound and disposing mind. hereby make. publish and declare this my Last
Will and Testament, hereby revoking and making void all prior Wills and other testamentary
,~witings at any time heretolbre made by me.
1. I direct my Executor, hereinafter named, to pay all of my just debts, funeral and
testamentary, expenses as soon as conveniently,' can be done after my demise.
I1. 1 give, devise and bequeath $2.500.00 to Good Shepard Roman Catholic Church of Camp
Hill. Pennsylvania.
III. I give, devise and bequeath the rest. residue and remainder of my Estate of whatsoever
kind and whatsoever situate to my sister and brothers, ltELEN KENDIG, of Willow Street.
Pennsylvania, CHARLES WESTHEAFER. of Turramurra, Australia. (only child of HARRY
WESTHEAFER. deceased) and WILLIAM WALLACE. of Landisburg, Pennsylvania, (only child
of WILLIAM WESTHEAFER. deceased) in equal shares, share and share alike, per stirpes.. If any
of the above shall die without issue, his or her share shall lapse.
IV. Should there be ,'my property of whatsoever kind and wheresoever situate which I have
the right to dispose of at the time of my death, including but not limited to an)' special or general
power of appointment or both. I hereby appoint the stm~e to my legatees set forth in Paragraph
THIRD hereot:
V. I nominate, constitute and appoint JAY KENDIG. CPA as Executor of this my Last Will
and Testament and further direct that he shall serve without bond. Said Executor shall have the
power to discharge all the debts, liens and encumbrances npon my estate, as well as any taxes
thereon, to pay for the cost of the final disposition of my remains and final illness, if any. to receive
any and all commissions and other compensation fi)r services rendered by me during my lifetime and
to pertbrm any and all fiduciary duties attthorized by statute. Further. I direct my Executor to
preserve my estate and any instructions pertaining to the distribution of the same from any
attachment or anticipation while in the hands of my said personal representative, it being my express
intent that all legacies shall be tree from any attachment or anticipation while in the hands of the
accountant tbr my estate.
VI. I request my Executor to consult with GARY J. IMBLUM, ESQUIRE of KNUPP?
KODAK & IMBLUM, P.C., of Harrisburg, Pennsylvania, as attorneys to assist in the administration
and settlement of my affairs after death, they being acquainted with my affairs.
IN WITNESS WttEREOF, 1 have to this my Last Will and Testament, typewritten on three
(3) pages of paper, set my hand an seal at the end thereof this"~"I~day of .~'fl T' ,2002.
EMMA I,OUISE RUSSO
SIGNED. SEALED, PUBLISHED and DECLARED by the above-named Testatrix, EMMA
LOUISE RUSSO. as and for her Last Will and Testament in the presence of us who, at her request,
in her presence and in thc presence of each other, all being present at the same time. have heretmto
set our hands as witnesses.
I. EMMA LOUISE RIJSSO. Testatrix xvhose name is signed to the attached or tbregoing
insmm~ent, having been duly qualified according to law. do hereby acknowledge that I signed and
executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed
it as my free and voluntary act/hr the purposes therein expressed.
Sworn to and subscribed before
me thisdr/ day of ~F,,p-F', 2002.
EMMA LOUISE RUSSO
Notary Public
My Conunission Expires: Iv- $1 o o It,
WE.~$t~q:> ~1~/.'~-'50 and ~~ ~" ZmZ$~-"~
the wimesses whose names are signed to the attached or foregoing instrument, being duly qualified
according to law, do depose and say that we were present and saw EMMA LOUISE RUSSO.
Testatrix, sign and execute the instrument as her Last Will and Testament; that she signed willingly
and that she executed it as her free and voluntary act for the purposes therein expressed; that each
of us in the hearing and sight of the Testatrix signed the Will as wimess, and that to the best of our
knowledge, the Testatrix was at that time 18 or more years of age, of sound mind and under no
constraint or undue influence.
Sworn to and subscribed
before me this~r/day of~.~-°T', 2002.
NotaD, Public
My Commission Expires:
BUREAU OF INDIVIDUAL TAXES
INHERTTANCE TAX DTVTS/ON
DEPT. 280601
HARR/SBURG, PA 1712&-0601
COHNONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLO#ANCE OR DZSALLONANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
REV-15r~? EX AFP C01-03)
JAY KENDIG
HUBER ETAL
PO BOX $05
WILLOW STREET PA 1ffSBq
DATE 07-05-Z00q
ESTATE OF RUSSO
DATE OF DEATH 08-ZZ-2003
FILE NUNDER 21 03-0721
COUNTY CUHBERLAND
ACN 101
I Amount Remitted
EHHA
HAKE CHECK PAYABLE AND RENZT PAYNENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~"~
REV-15&7 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEHENT, ~[.-L-~-N'~-~)'~ ................. DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF RUSSO ENHA L FILE NO. 21 03-0721 ACN 101 DATE 07-05-200~
TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) 10q/900.00
2. Stocks and Bonds (Schedule B) (2) .00
$. Closely Held Stock/Partnership Interest (Schedule C) ($)
q. Mortgages/Notes Receivable (Schedule D) (q)
5. Cash/Bank Deposits/Misc. Personal Proper~y (Schedule E) (5) ~0/899.70
6. Jointly Owned Property (Schedule F) (6) .0~
7. Transfers (Schedule G} (7)
8. Total Assa~s (8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funera! Expanses/Adm. Costs/Misc. Expenses (Schedule H) (9}
10. Debts/Mortgage Liabilities/Liens (Schedule Z) (10) 3;171.05
11. To,al Deductions (11)
12. Ne~ Value of Tax Re~urn (12)
32,610.26
13.
1~.
NOTE:
11-17-2003
NOTE: To insure proper
credit ~o your account,
submit ~he upper portion
of this form wi~h your
tax payment.
lq5,799.70
110,018.39
2,500.00
AMOUNT PAID
17,100.00
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
TOTAL TAX CREDIT [ 17,852.63
BALANCE OF TAX DUEl Z,800.05CR
INTEREST AND PEN.: .00
TOTAL DUE 2,800.05CR
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REDU/RED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) lyT_~
ASSESSHENT OF TAX:
16. Amount of Line lfi at Spousal rate
16. Amount of Line lq taxable at Lineal/Class A rate
17. Amoun~ of Line lq et Sibling rate
18. Amount of Line lq ~axable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS:
PAYMENT RECEIPT DZSCOUNT
DATE NUMBER INTEREST/PEN PAID (-)
CDOO32qO 752.63
(ts) .00 x O0 = .00
(16) .00 x Oq5= .00
(17) 35,839.q6 x. 12 = q,300.7q
(i8) 71,678.93 x'15 = 10,751.8q
(19)= 15,052.58
reflect figures that include the total of ALL returns assessed to date.
Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (13)
Met Value of Estate Sub~act to Tax (lq) 107,518.39
If an assesseent was lssued previously, 11nas lI, 15 and/or 16, 17, 18 and 19 w111
RESERVATION:
PURPOSE OF
NOTICE:
PAYHENT:
REFUND (CR):
OBJECTIONS:
ADHIN-
ISTRATIVE
CORRECTIONS=
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December 11, 1982 -- if any future interest in the estate is transferred
in possession or enjoyeant to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
Life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lamful Class B (colLateral) rate on any such future interest.
To fulfil! the requirements of Section Zlo`O of the Inheritance and Estate Tax Act, Act Z:5 of ZOO0. (71 P.S.
Section 91O`0).
Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side.
--Hake check or money order payable to: REGISTER OF #/LES, AGENT
A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-Z:515). Applications are available at the Office
of the Register of Hills, any of the Z$ Revenue District Offices, or by calling the special Zo`-hour
answering service for forms ordering: 1-800-:561-2050; services for taxpayers with special hearing and / or
speaking needs: 1-BOO-~O`7-50ZO (TT only).
Any party in interest not satisfied with the appraisement, allowance, 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. 181021, Harrisburg, PA 17128-1011, 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 assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 180601, Harrisburg, PA 17118-0601
Phone (717) 787-6505. Sea page 5 of the booklet "Instructions far Inheritance Tax Return for a Resident
Decedent" (REV-ZSO1) far an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the decedent'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 time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of
six (613 percent par annum caIcuIatad at a daily rate of .00als~. All taxes which became delinquent on and after
January 1, 1981 wiII bear interest at a rate which wi11 vary from caIendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through ZO0~ are:
Interest DaiLy Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
~ ZOZ .0005o,8 1988-1991 111 .000301 ~ 91 .0002o,7
1983 16Z .000O`38 199:=. 9Z .000Z'O`7 ZOOZ 67. .00016O`
198o, 111 .000301 199:5-199~, 77. .000192 2005 57. .0001:57
1985 157. .000556 1995-1998 92 .0 OOZe`7 ZOOO` O`Z .000110
1986 102 .00027O` 1999 77. . OOO19Z
1987 107. · 0 O0 Z?O` ZOO0 77. . O0019Z
--Interest is calculatad as follows:
INTEREST = BALANCE OF TAX UNPATD X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent wi11 reflect an interest caXculation to fifteen (15) days
beyond the date of the assessment. Zf payment is made after the interest computation date shown on the
Notice, additional interest must ba caIcuZated.
CLAIM AGAINST DECEDENT'S ESTATE
CUMBERLAND COUNTY, PENNSYLVANIA
CASE # 21-2003-721
ESTATE OF: EMMA RUSSO
The undersigned hereby presents for filing against the above estate this statement of claim and alleges:
BEVERLY ENTERPRISES/DBA CAMP HILL CARE CENTER
PO BOX 180970 Fort Smith, AR. 72918-0970
The basis of claim is: SEE ATTACHED
The amount of the claim is $1,785.00
Under penalties of perjury, I declare that I have read the foregoing, and the facts alleged are tree
to the best of my knowledge and belief.
SIGNED ON: AUGUST 31, 2004
I SWEAR THIS STATEMENT IS CORRECT
Subscribed and sworn to before me
Notary Public
My Comrmssion Expires "~-
my O[ Sebastian
BEVERLY ENTERPRISES/DBA CAMP HILL CARE CENTER
P.O. Box 180970
Fort Smith, AR 72918
Itemized Resident Statement
EMMA RUSSO
64896-03959-91684
08131/04
DATE / PERIOD COVERE£ DESCRIPTION DAYS / QTY CHARGES CREDITS
811-8117103 MEDICARE PART A CO-INSURANCE 17 $1~785.00
$1,785.00 $0.00 $1,785.00
ESTATE OF EMMA RUSSO
CIO RAYMOND RUSSO
2603 MARKET STREET
CAMP HILL, PA 17011
Page 1 of I
BUREAU OF ZNDTVZDUAL TAXES
THH£R/TANCE TAX D/VZSTON
DEPT. 280601
HARRISBURG, PA 171Z8-0601
COMNON#EALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEHENT OF ACCOUNT
REV-1607 EX AFP C01-03)
HUBER ETAL
PO BOX $05 t'.i
WILLOW STREET PA ~,S84
~.~, DATE 09-20-2004
' ESTATE OF RUSSO EMMA L
DATE OF DEATH 08-22-2005
FILE NUMBER 21 05-0721
~-,~:;~} COUNTY CUMBERLAND
ACM 101
Amount: Remi~ed
MAKE CHECK PAYABLE AND REMZT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
NOTE: To insure proper cred:~ ~o your account, submi~ ~he upper por~:ion of ~:hJs form wi)ch your ~ax payment.
CUT ALONG THTS LTNE ~-- RETATN LOWER PORTION FOR YOUR RECORDS *"~
REV-1607 EX AFP (01-03)
#~x INHERITANCE TAX STATEMENT OF ACCOUNT
ESTATE OF RUSSO EMMA L FILE NO. 21 05-0721 ACM 101 DATE 09-20-2004
THIS STATEHENT TS PROVIDED TO ADV/SE OF THE CURRENT STATUS OF THE STATED ACM IN THE NAMED ESTATE. SHO#N BELO#
TS A SUHHARY OF THE PR/NCTPAL TAX DUE, APPLZCAT/ON OF ALL PAYHENTS, THE CURRENT BALANCE, AND, ZF APPLICABLE,
A PROJECTED INTEREST F/GURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 07-05-2004
PRINCIPAL TAX DUE: ...........................................................................................................................................................................................................................
PAYMENTS (TAX CREDITS):
15,052.58
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER ~NTEREST/PEN PAID (-)
752.65
11-17-2005
08-50-2004
CD005240
REFUND
.00
17,100.00
2,800.05-
ZF PAID AFTER THIS DATE, SEE REVERSE
S/DE FOR CALCULAT/ON OF ADDITIONAL INTEREST.
( /F TOTAL DUE /S LESS THAN $1,
NO PAYHENT /S REQUIRED.
/F TOTAL DUE /S REFLECTED AS A "CRED/T" (CR),
TOTAL TAX CREDIT 15,052.58
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
YOU NAY BE DUE A REFUND. SEE REVERSE S/DE OF THTS FORM FOR ZNSTRUCTTONS. )
PAYNENT:
Detach the top portion of this Notice and submit with your payment made payable to the name and address
printed on the reverse side.
-- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF NILLS, AGENT.
-- If NON-RESIDENT DECEDENT make check or money order payable to: COMMONNEALTH OF PENNSYLVANIA.
REFUNO (CR): 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-1313). Applications are available at
the Officm of the Register of NilIs, any of the 23 Revenue District Offices or from thm Oepartment's 24-hour
answering service for forms ordering: 1-B00-362-20S0; services for taxpayers with special hearing and / or
speaking needs: 1-B00-447-3020 (TT only).
REPLY TO:
Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau
of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. IS0601, Harrisburg, PA 17128-0601, phone
(717) 787-6505.
DISCOUNT:
If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (BZ) discount
of the tax paid is allowed.
PENALTY:
The 15Z 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.
INTEREST:
Interest is charged beginning with first day of delinquency, or nine (9) months and one (l) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of
six (6Z) percent per annum calculated at a daily rate of .000164. A11 taxes which became delinquent on and after
January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue.
Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year
1952 gOX .000548 1988-1991 llZ .000301 2001
1983 16Z .000q38 199Z 9Z .000Z47 ZOOZ
1984 llZ .000301 1995-1994 7Z .00019Z 2003
1985 13Z .000356 1995-1998 9Z .000Z47 2004
1986 IOZ .O00ZTq 1999 7Z .000192
1987 9Z .000Z47 ZOO0 8Z .000219
The applicable interest rates for 1982 through 2004 are:
Interest Daily
Rate Factor
9Z .000247
6Z .000164
5Z .000137
4Z .000110
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY 'rNTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. Xf payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Emma Louise Russo
Date of Death: August 22. 2003
Will No.: 2003-00721
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 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. Did the personal representative file a final account with the Court?
Yes
No X
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 -----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.
/
.L ~~
J tephe11 Feinour, Esquire
auman, Smith, Shissler & Hall, LLP
200 N. 3rd Street, 18th Floor
P. O. Box 840
Harrisburg P A 17108-0840
Date: August 5, 2005
L0
(0
.. .
u:
{__. i
l~l-
l.i
(
Capacity: _ Personal Representative
c:'~)
i
t.~- ':l
,.
(':;.:)
(."~j
c..
c):.
U
-----X.- Counsel for Personal
Representative
(p
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 7/27/2005
FEINOUR J STEPHEN ESQ
POBOX 840
HARRISBURG, PA 17108-0840
RE: Estate of RUSSO EMMA LOUISE
File Number: 2003-00721
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS 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 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:
8/22/2005
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
~D~~~~H
REGISTER OF WILLS
cc: File
Personal Representative(s)
Judge
~