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Home My WebLink About04-0217F:\User Folder\Fim~ Docs~,states\3478-lcertification.wpd Name of Decedent: Date of Death: Will No. To the Register: CERTIFICATION OF NOTICE UNDER RULE 5.6(a) LOURENE W. COOKE, A/K/A LOURENE F. COOKE February 24, 2004 2004-00217 I certify that notice of beneficial interest 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 March , 2004. Name Address Thomas G. Cooke, IH Charles E. Cooke Joyce Reiner, a/k/a Joyce C. Reiner 9745 Carlisle Road, Dillsburg, Pennsylvania 17019 428 Miriam Avenue, Leesport, Pennsylvania 19533 2200 Gleim Court, Enola, Pennsylvania 17025 Notice has not been given to all persons entitled thereto under Rule 5.6(a) except: N/A Date: March ti ,2004 HANFT & KNIGHT, P.C. Attorney I.D. No. 57976 19 Brookwood Avenue, Suite 106 Carlisle, Pennsylvania 17013-9142 Telephone (717) 249-5373 Capacity: Counsel for personal representatives Z[:[d O t ~JV~I PETITION FOR PROBATE and GRANT OF LETTERS Estate of COOKE, LOURENE W., a/k/a COOKE, LOURENE F., Deceased. No. To: Register of Wills for Cumberland County, Pennsylvania Social Security No. 160-56-5538 The Petition of the undersigned respectfully represents that: Your Petitioner, who is 18 years of age or older and the Executrix named in the Last Will and Testament of the above decedent, dated April 11, 1996. Decedent was domiciled at death in Cumberland County, Pennsylvania, with her principal residence at 1 Longsdorf Way, Carlisle, Cumberland County, Pennsylvania. Decedent, then 88 years of age, died February 24, 2004, at Carlisle Regional Medical Center, Carlisle, Cumberland County, Pennsylvania. Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: N/A. 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 situated as follows: $ $ $ $ $ ~ tooo Total $ 2.O! OO~-OO WHEREFORE, Petitioner respectfully requests the probate of the Last Will and Testament presented herewith and the lt~tnt of letters TESTAMENTARY thereon. Jo~ce-C. Reiner, Executrix 2200 Gleim Court Enola, Pennsylvania 170125 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ) : SS COUNTY OF CUMBERLAND ) The Petitioner above-named swears or affirms that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of Petitioner and that as personal representative of the above decedent Petitioner will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me this--x/' 7-/''/ day of March, 2004 . ~ .... ~"-, DECREE OF PROBATE AND GRANT OF LETTERS AND NOW ~~,,. ~" ,2004, in consideration of the petition on the reverse side hereof, satisffactory proof having been presented before me, IT IS DECREED that the instrument(s) dated April 11, 1996, described therein be admitted to probate and filed of record as the last will of LOURENE W. COOKE, A/K/A LOURENE F. COOKE; and Letters Testamentary are hereby granted to Joyce C. Reiner. FEES Probate, Letters, Etc ............ $ '~l~oi~de~tificate(s) ............. $ / ~,';v~'~ Renunciation ....................... $ TOTAL $ Filed.~,.....~..,...~(;?...~..~ ...... : ........... Register of Will( MiChael J. Hanft, Esq~re Attorney I.D. No. 57976 19 Brookwood Avenue, Suite 106 Carlisle, Pennsylvania 17103-9142 (717) 249-5373 F:\User Folder\Firm Docs\Estates~3478- lpet.lts,wpd 105.805 REV 9/86 This is to certify that the information here given is correctly copied from 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 No. Local Registrar FE~ 2 6' 200~ Date .~o5.1~.1~ ~? COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH * VITAL RECORDS CERTIFICATE OF DEATH 4T < I" Lourene W. Cooke ,. Female '- 160 -- 56 -- 5538l" February 24~ 2004 B 88 ,-.I : I [ ..... IC~rland Co. [ .... ~ ,~--u ~O I~ O ~O ,~,O :*~ ~rl~d I I~rlisle ~rlisle R~ional M~ical Center ,,- I.,. I,,. I,,. I · · 2 I,.. ~m~s~,~m~.~.~c~ I~J~cEm~'s PA ,,.~ ~.~ S. ~[etoQ 1 Longs~rf Way ~1~' ,7..~.,. ,~ ~rliale PA 17013 ~ ,~.~ C~rland ~? ,,,.O ~ Clyde W~ ,,. Florence Black ~ Joyce Reiner ~. 22~ Gleim Court, Enola PA 17025 . ~ ~1 ..... I~rrln~ton Friends Meeting I Wetlsvllle PA ~%~ ~ ~/,~-- ~ I,, Olgl~-T I~ 219 N. Hanover St., ~rlisle PA 17013 ~~"--~"" '~'~ ~ ~ ' ' ' ' ~ ' '~ .... ~D*' -- '~'~'"" I I~ o ~,,~ D I I I I . ~, I~ ~- I~. I~, - I,- I-. I-. I, LOURENE W. COOKE, of the County of Cumberland and Commonwealth of Pennsylvania, being of sound mind, do hereby make this to be my Last Will and Testament, hereby revoking all Wills or Codicils by me at any time heretofore made. ARTICLE I I orde~ and direct the payment of all .my just debts and funeral expenses as soon as may be convenient after my decease. ~RTICLE II I give, devise and bequeath all the rest, .residue and remainder of my estate, real, personal or mixed, and wheresoever situate, unto my children, or their issue, per stirpes. ARTICLE III I direct that my Executrix shall not be required to enter security in any jurisdiction in which she may act. ~%RTICLE IV I nominate, constitute and appoint my daughter, JOYCE REINER, to be Executrix of this, my Last Will and Testament. In the event that she is unable or unwilling to serve in that capacity, then I nominate, constitute and appoint my son, THOMAS G. COOKE, as Alternate Executor of this, my Last Will and Testament. In the event that he is unable or unwilling to serve in that capacity, then I nominate, constitute and appoint my son, CHARLES EDWARD COOKE, to be Alternate Executor of this,my Last Will and Testament. this IN WITNESS WHERe, I have/ereunto set my hand and seal ~ day of ~ ~\5 ~ ( , A.D. 1996. Lourene W. Cooke SIGNED, SEALED, PUBLISHED and DECLARED by Lourene W. Cooke the above named Testatrix, as and for her Last Will and Testament, in the presence of us, who, at her request and in her presence and in the presence of each other, all being present at the same time, have subscribed our names as witnesses. Address: Address: Palmyra, PA Palmyra, PA COMMONWEALTH OF PENNSYLVANIA ) ) ss: COUNTY OF LEBANON ) I, LOURENE W. COOKE, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed the instrument as my Last Will; that I signed it willingly, and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn and acknowledged before me/~y Loure~e W. Cooke, the Testatrix on this the day of ~ ~ 1996. ~~ C_~ e., Notary P~bli~ ~/;~_ My Comm. Expires: 12/3/99 NOTAP,~L SEN, RNODA J LONG NOTARY PUBLIC, PALMYRA, LEB. ~0., !~ MY ,COMMISSION EXPIRES DEC. 3t 1999, COMMONWEALTH OF PENNSYLVANIA ) ) ss: COUNTY OF LEBANON ) We, William M. Brandt and Daryl J. Gerber, the witnesses whose names are signed to the attached instrument, being duly qualified according to law, do depose and say that we were present and saw Lourene W. Cooke sign and execute the instrument as her Last Will; that she signed 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 witnesses 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 and subscribed before me by Wil~am M.~randt and Daryl J. Gerber, witnesses, the ~ day of /~~' [ , 1996. Notary Pu~lib ~ ~C, ~(., v v~/ ' / My Comm. Exp.: 12/3/99 Witness C/ · ~o~ Pueuo, n~m~, i~. ~., m · N,~Y COUMiSSI~ EXPIRI[$ ~C. 3. 1999 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-O601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD REV-1162 EX(11-96) OO3967 HANFT MICHAEL J 19 BROOKWOOD AVENUE SUITE 1 O6 CARLISLE, PA 17013 ESTATE INFORMATION: SSN: 160-56-5538 FILE NUMBER: 2104-021 7 DECEDENT NAME: COOKE LOURENE W DATE OF PAYMENT: 05/21/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 02/24/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $750.00 TOTAL AMOUNT PAID: $750.00 REMARKS: HANFT& KNIGHT SEAL CHECK#1000 INITIALS: AC RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS z REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDEN3~S NAME (I~,ST, FIRST, ANO MIDDLE INITIAL) Cooke, Lourene W. 02/24/2004 12/09/1915 FILE NUMBER {~ 21 00217 $CCIAL SECURITY NUMSER 160-56-5538 THIS RETURN MUST BE FILED iN DUPUCATE WITH THE REGISTER OF WILLS IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST. FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMEER [] 1. Original Return [] 2. SupplementaIReturn [] 4. Limited Estate [] 4a. FuturelnterestC~promise{dateofdeathafter 12-12-82) [] 6, Decedent Died Testate (Aftach copy [] 7. DecedentMaintainedaLivingTrust(Aftach o~ Wil;) co{3y of Trust) [] 9. Litigation Proceeds Receiveq [] 10. SpousalPovedyCredit(dateoldeathbe~ween THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: ] 3. Remainder Return (date of death pd~r to 12-13-82) [] 5. Federal Estate T~x Return Required 8. Total Number of Safe Deposit Boxes [] 11.Election to tax under Sec. 9113(A) (Attach Sch O) Sean M. Shultz, Esquire Hanft & Knight, P.C. 'ELEPHONENUMBER 717/249-5373 OMPLETE MAILING ADDRESS 19 Brookwood Avenue, Suite 106 Carlisle, PA 17013 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or So[e-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) [] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Prsbate Property (Schedule G or L) 8. Total Gross Assets (total Lines %7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) (1) (2) (3) (4) (5) (6) (7) None None None 2 258.89 l:i 27,699.87 None (9) 1,905.80 (10) 3,274.01 12. Net Value of Estate (Line 8 minus Line 11) OFF_lC[AL USE ONLY (6) 29,958.76 (11) 5,179.81 (12) 24,778.95 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) made (Schedule J) 14, Net Value Subject to Tax (Line 12 minus Line 13) (14) 24,778.95 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate x .00 (15) Dr transfers under Sec. 9116(a)(1.2) 16.AmountofLine14taxableatlinealrate 24,778.95 x .045 (16) 1,115.05 17. Amount of Line 14 taxable at sibling rate x .12 (17) 18. Amount of Line 14 taxable at collateral rate x .t 5 (18) 19. Tax Due (19) >> BE suRE TO ANSWER ALL QUESTIONS 0N REVERSE ~J~)E ~ND RECHECK MATH ~< 1,115.05 Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedept's Complete Address: STREETADDRESS 1 LongsdorfWay CTY Carlisle ISTATE PA [zip 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 750.00 39.47 Total Credits (A + B + C) (1) 1,115.05 (2) ,789 47 3. InterestJPenaltyif applicable D. Interest E. Penalty Total IntarestJPenalty (D + E) (3) 0.00 4. If Line 2 is greater than Line I + Line 3, enter the difference. This is the OVERPAYMENT. (4) 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. (5) 325.58 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) ." 325,58 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 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 decadent own an "in trust for~ or payable upon death bankaccountorsecurityathisorherdeath? ......... [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-prebate 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. Joyce Reiner, a/~a Jo~ce C Relner_ ~} , ~ (~' ~ J"~C'~....~ 2200 Gleim Court ACORESS 17025 DATE DATE SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ADDRESS DATE 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 survid~ng 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 decadent'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 decadent's sibJin_,qs 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. SCHEDULE E CASH, BANK DEPOSITS,& MISC. PERSONALPROPERTY ESTATE OF FILE NUMBER Cooke, Lourene W. 21 - 03 - 00217 nclude the ~procoeds of litigation and the date the procoeds were received by the estate. All proper~y jointly-owned with the right of survivorship must be disc osed on schedule F. VALUE AT DATE O~- ITEM DESCRIPTION DEATH NUMBER Waypoint Bank Checking Account No. 100171370 Refund from Highraark Refund from Millers Mutual Insurance Refund from PA Department of Revenue Personal Property (estimated) 1,257.25 600.03 47.00 104.61 250.00 TOTAL (Also enter on Line 5, Recapitulation) 2,258.89 SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF Cooke, Lourene W. 21 - 03 - 00217 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S} NAME ADDRESS RELATIONSHIP TO DECEDENT son A Charles E. Cooke B Thomas G. Cooke, III C Joyce C. Reiner 428 Miriam Avenue Leesport, PA 19533 9745 Carlisle Road Dillsburg, PA 17019 2200 Gleim Court Enola, PA 17025 son daughter JOINTLY OWNED PROPERTY: DESCRIPTION OF PROPERTY % OF DATE OF DEATH .ETTER DATE nclude name of financial institution and bank account number DATE OF DEATH DECD'S VALUE OF ITEM FOR JOINT MADE }r similar identifying number. Attach deed for jointly-held realVALUE OF ASSET ,4TERES"f DECEDENT'S INTEREST NUMBER TENANT JOINT .=state. 1 A 04/24/1992 Fulton Bank Certificate of Deposit No. 400-1922808 30,000.0(~ 50°d 15,000.00 2 B 06/18/2001 Waypoint Bank Certificate of Deposit No. 6,796.0~ 50~ 3,398.03 7100009832 3 B 06/18/2001 Waypoint Bank Certificate of Deposit No. 6,796.0{ 50°3 3,398.03 i 100009834 4 B 06/18/2001 Waypoint Bank Certificate of Deposit No. 6,797.0( 50% 3,398.53 7100009835 5 B 11/19/2002 Waypoint Bank Certificate of Deposit No. 5,010.55 50% 2,505.28 )600004918 TOTAL (Also enter on line 6, Recapitulation) 27,699.87 SCHEDUI I= H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER ESTATE OF Cooke, Lourene W. 21 - 03 - 00217 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER 1 2 3 2 =UNERAL EXPENSES: Hoffman Roth Funeral Home ;t. Johns Lutheran Church - flowers Baughman Memoria! Works ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State -- Zip Year(s) Commission paid Attorney's Fees to Hanft & Knight, P.C. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State __ Zip Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs The Sentine! - advertise letters Cumberland Law Journal - advertise lel~ers TOTAL (Also enter on line 9, Recapitulation) 477.81 23.00 180.00 1,000.00 149,99 75.00 1,905.80 SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER Cooke, Lourene W. 21 - 03 - 00217 h~clude unreimbursed medical expenses. ITEM DESCRIPTION NUMBER 1 2 3 4 Continuing Care RX Cumberland Crossings Retirement Community Pinker & Associates Perry Village AMOUNT 2.99 3,093.55 10.47 167.00 TOTAL (Also enter on Line 10, Recapitulation) 3,274.01 ,~,-~.£x*'t.-~ ~ SCHEDULE J COMMO.WEALT. OF nE..SVLVAN'A BENEFICIARIES ESTATE OF FILE NUMBER Cooke, gourene W. 21 - 03 - 00217 RELATIONSHIP TO AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT OF ESTATE I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1 Thomas G. Cooke, III son 1/3 residue of estate 9745 Carlisle Road Dillsburg, PA 17019 2 Charles E. Cooke son l/3 residue of estate 428 Miriam Avenue Leesport, PA 19533 3 Joyce C. Reiner daughter 1/3 residue of estate 2200 Gleim Court Enola, PA 17025 Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet II. 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 I, LOURENE W. COOKE, of the County of Cumberland and Commonwealth of Pennsylvania, being of sound mind, do hereby make this to be my Last Will and Testament, hereby revoking all Wills or Codicils by me at any time heretofore made. ARTICLE I I orde~ and direct the paYment of all.my just debts and funeral expenses as soon as may be convenient after my decease. ARTICLE II I give, devise and bequeath all the rest, .residue and remainder of my estate, real, personal or mixed, and wheresoever situate, unto my children, or their issue, per stirpes. ~RTICLE III I direct that my Executrix shall not be required to enter security in any jurisdiction in which she may act. ARTICLE IV I nominate, constitute and appoint my daughter, JOYCE REINER, to be Executrix of this, my Last Will and Testament. In the event that she is unable or unwilling to serve in that capacity, then I nominate, constitute and appoint my son, THOMAS G. COOKE, as Alternate Executor of this, my Last Will and Testament. In the event that he is unable or unwilling to serve in that capacity, then I nominate, constitute and appoint my son, CHARLES EDWARD COOKE, to be Alternate Executor of this,my Last Will and Testament. this IN WITNESS WHER~I, I have~ereunto set my hand and seal ~ day of ~< ~ ( , A.D. 1996. Cooke the Testament, Lourene W. Cooke (sm ) SIGNED, SEALED, PUBLISHED and DECLARED by Lourene W. above named Testatrix, as and for her Last Will and in the presence of us, who, at her request and in her presence and in the presence of each other, all being present the same time, have subscribed our names as witnesses. at Address: Palmyra. PA Address: Palmyra. PA COMMONWEALTH OF PENNSYLVANIA ) ) ss: cOUNTY OF LEBANON ) I, LOURENE W. COOKE, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed the instrument as my Last Will; that I signed it willingly, and that I. signed it as my free and voluntary act for the purposes therein expressed. Sworn and acknowledged before me/~y Lo,ureW W. Cooke, the Testatrix on this the [~ day of ~ ~ ( ,1996' Lo~rene W. Cooke ! NOTARY PUBLIC. PALMYRA, L[". ~0., PA I No/cary P~li-c. ' ~_ · ~ MYCOM.~tS$10NEX?IRESDEC. 3.[999 ~ My Comm. Expzres:12/3/99 COMMONWEALTH OF PENNSYLVANIA ) ) ss: COUNTY OF LEBANON ) We, William M. Brandt and Daryl J. Gerber, the witnesses whose names are signed to the attached instrument, being duly qualified according to law, do depose and say that we were present and saw Lourene W. Cooke sign and execute the instrument as her Last Will; that she signed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses and that to the best of our knowledge, the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. . . Sworn an.d subscribed before me by Wfl~am M. ~randt and Daryl J. Gerber, witnesses, the ~¢ day of /~/-~' [ , 1996. Notary Pu~l'i~ ~J ' C.~2~_M-/ { I ,. "~ ~ ~ / My Comm. Exp.: 12/3/99 Witness [;,, N1¥ COMMI$'~ION F..XPIR~S DEC. 3, 1999 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT 28060~ HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT R£V-1162 EX(11 96) NO. CD 0O4329 ....... fold HANFT MICHAEL J 19 BROOKWOOD AVENUE SUITE 106 CARLISLE, PA 17013 ESTATE INFORMATION: SSN: 160-56-5538 :lEE NUMBER: 2104-021 7 DECEDENT NAME: COOKE LOURENE W DATE OF PAYMENT: 08/31/2004 POSTMARK DATE: 08/31 ~2004 COUNTY: CUMBERLAND )ATE OF DEATH: 02/24/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $325.58 TOTAL AMOUNT PAID: $325.58 REMARKS: SEAL CHECK# 1488 iNITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF /NDZVZDUAL TAXES TNHERZTANCE TAX DTVTSZON DEPT. 180601 HARRTSBURG, PA 17118-0601 SEAN M SHULTZ ESQ HANFT & KNIGHT 19 BROOKWOOD AVE 1Q~ CARLISLE COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOT/CE OF INHERITANCE TAX APPRA/SEMENT, ALLONANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSNENT OF TAX REV-1647 EX AFP (01-05) DATE 11-01-200q ESTATE OF COOKE DATE OF DEATH 02-2q-200~ FILE NUHBER 21 0~-0217 COUNTY CUHBERLAND ACN 101 I Amoun~ Rami~ed LOURENE W HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLI'SLE, PA 1701:5 CUT ALONG THIS LINE ~.~ RETAIN LOWER PORT/ON FOR YOUR RECORDS REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF COOKE LOURENE WFZLE NO. 21 0~-0217 ACN 101 DATE 11-01-200~ TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es~a~e (Schedule A) (1) 2. S~ocks and Bonds (Schedule B) (2) $. Closely Held S~ock/Par~nership In~eres~ (Schedule C) ($) q. Mortgages/No,es Receivable (Schedule D) (q) 5. Cash/Bank Deposi~s/Nisc. Personal Proper~y (Schedule E) (5) 6. Jointly Owned Proper~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To,al Asse~s APPROVED DEDUCTIONS AND EXEHPTZONS: 9. Funeral Expensas/Adm. Cos~s/Nisc. Expanses (Schedule H) (9) 10. Dab~s/Nor~gage Liabili~ias/Liens (Schedule [) (10) 11. To,al Deductions 12. Na~ Value of Tax Re~urn 00 oo oo oo 2~258 89 27z699.87 .oo (8) 1,905.80 NOTE: To insure proper cradi~ ~o your account, subei~ ~he upper portion of ~his form wi~h your ~ax payment. 15. 1~. NOTE: 29,958.76 3 ,Z7q. 01 (11) 5 , 179 .gl (1;) 2~,778.95 Charitable/Governmental Baques*s; Non-elected 9115 Trusts (Schedule J) (15) Na~ Value of Es~a~a Sub~ac~ ~o Tax (lq) ;f an assessment ~as lssued previously, lines 1~, 15 and/or 16, 17, reflect flgures that include the total of ALL returns assessed to date. ASSESSHENT OF TAX: 15. Amoun~ of Line 1~ a~ Spousal ra~a 16. Amoun~ of Line 1~ ~axable a~ Lineal/Class A re*a 17. Amoun~ of Lina 1~ a~ Sibling ra~e 18. Amoun* of LAne lq ~axable a~ Collateral/Class B ra~a 19. Principal Tax Due TAX CREDITS: PAYMENT RECEIPT DISCOUNT DATE NUHBER ~NTEREST/PEN PA~D (-) 05-21-200~ CD005967 $9.~7 08-~1-200~ CDOOq~29 .00 .0o 2q,778.95 ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDZTZONAL INTEREST. 18 and 19 Nill (1~) .00 X O0 : .00 (ze) 2q,778.95 x 0~5= 1,115.05 (17) . O0 x 12 = . O0 (18) . O0 x 15 : . O0 (19)= 1,115.05 AMOUNT PAID 750.00 325.58 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 1,115.05 .00 .oo .oo ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE TS REFLECTED AS A "CREDTT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF TH/S FORM FOR TNSTRUCTZONS.) RESERVATION: PURPOSE OF NOTICE: PAYNENT: REFUND (CR): OBJECTIONS: ADNZN- 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 enjoyment to Class D (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the CoamonHaalth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 cf ZOO0. (71 P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. --Make check or money order payable to: REGISTER OF NILES, AGENT A refund of a tax credit, ahich was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISIS). Applications ara available at the Office of the Register of Nills, any of the 15 Revenue District Offices) or by calling the special 24-hour answering service for forms ordering: 1-800-362-Z050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-S010 (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 oust 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 17118-1011, --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. OR Factual errors discovered an this assessment should be addressed in writing to: PA Department of Revenue) Bureau of Individual Taxes) ATTN: Post Assessment Review Unit) Dept. ZOO601, Harrisburg) PA 17118-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (2) calendar months after the decedent's death) a five percent (51) discount of the tax paid is allowed. The 151 tax aenasty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same tiaa period as you would appeal the tax and interest that has been assessed as indicated on this notice. 1982 1984 1985 1986 1987 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID 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, 1981 bear interest at the rate of six (SI) percent par annum calculated at a daily rate of .000164. A11 taxes which became delinquent on and after January 1, 1981 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. The applicable interest rates for 1982 through Z004 are: Interest Daily Interest Daily Interest Daily Rate Factor Year Rate Factor Year Rate Factor 201 .000548 "['~'8~-1991 1IX .O00$Ol ~"~ 91 .000247 162 .000458 1992 92 .000247 Z002 61 .000164 IiX .000301 1992-1994 72 .000192 ZOOS 52 .000137 ZSZ .000556 1995-1998 9Z .000247 2004 41 .000110 IOZ .000174 1999 7Z .000192 IOZ .000174 ZOOO 71 .O00IeZ X NUNBER OF DAYS DELING~UENT X DAILY INTEREST FACTOR --Any Notice issued after 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, additional interest must be calculated. ORPHANS' COURT DIVISION OF THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA STATUS REPORT UNDER RULE 6.12 Name of Decedent: Lourene W. Cooke, a/k/a Lourene F. Cooke Date of Death: February 24,2004 Admin. No. 21-04-0217 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration ofthe above-captioned estate: 1. State whether administration of the estate is complete: Yes~ No 2. Ifthe 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~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. Date: November -1L, 2005 Respectfully submitted, .::, . KNcr~A}(~ ~ Shultz, Esquire Attorney ill No. 90946 11 Roadway Drive, Suite B Carlisle, Pennsylvania 17013 (717) 249-5373 Counsel for personal representative '" , F:\User Foldcr\Firm Docs\Estatcs\3478-1status,report.wpd vt: