HomeMy WebLinkAbout04-0164PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
.E3',tat'e ~./' Robert M. Fry
CHSO RRO wt~
104 - 3 O- 292D2e¢'eased.
Social Security No.
To.'
Register of Wills roi' tile
County of Cumberland
Commonwealth of Pennsylvania
in the
The petition of the undersigned respectfully represents that:
our petiti~w, ho is/are 18 years of age or older, appl i es
(~l,b.a,; p~nfl~nt~ lite; ~urant~ abs~nUa; flurante minocitat¢,)
the above decedent.
for letters of administration
on the estate of
Decendent was domiciled at death in Cumberland County, Pennsylvania, with
hls last family or principal residence at 25 Fry Road
(li~t sLrcet., number and mu:ficipality)
D'eeeRdenl,, ~he~ 74 years of age, died Feb. ruary 12, 192004
at uarllsle, FA ' '
Decendent at death owned property with estimated values as folllows:
(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
~ituated as follows:
$__20,ooo
$
$ --0--
Petitioner
the following spouse (if any) and heirs:
Name
' Susan e'. ~,uhn
-P~%-C-icza F. Sh~-arer
-lrO]5~rt B. Fry
Rebecca A. Fry
-R-f~ ah-~-Fd--W. Fry
after a proper search ha.~ ascertained that decedent left no will and was survived by
Relationship
daughter
da ffg~-f--
son
daughter
son
Residence
480 Doubl~h'g 'Gap Rd. Newville
806 Alexander Spring Rd., Carli
25 Fry Road, Newville, PA
14 Shea Court, CarliSle, PA
3~ Fry Road
THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the
appropriate form to the undersigned.
'-~OM._Ad~UD±a. ng t~ap _~oau
Newvtlle, ~a 17241
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ~!~?//~/~ ~5 ss
The petitioner(s) above-named swear(s) or affirm(s) that the
statements in the foregoing petition are true and correct to the best
of the knowledge and belief of petitioner(s) and that as personal
representative(s) of the above decedent petitioner(s) will well and
DC'
truly administer the estate according to law.
Sworn to or affirmed and subscribed r-
. before me this 19th ,~, ,,r
enda Farner Strasbaugh ~/ RegisterS;.
No. 21-2004-164
Estate of ROBERT M. FRY , Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW February 19th ~ 2004, in consideration of the petition on
the reverse side hereof, satisfactory oroof having been presented before me,
IT, I~S DECREED that _' ~_~. ~:/~-/;~,~,'~ ..L~"_~
is/a~o entitled to Letters of Aan~mstr.~ti0fi-, ~n'a u. a~cord with such finding, Letters of Administration
are hereby granted to. EDGAR R LUHN. III
in the estate of ROBERT M. FRY
FEES
Letters of Administration ..... $
50.00
Register of Wills ~ /
GLENDA FARNER STRASBAUGH .
Edgar R. Luhn, III EscoHre
Short Certificates(2q .......... $ 60.00
Renunciation .(.1) ............ $ 5.00
JCP Fee $ 10.00
TOTAL ~ $. 125.00
· Febru 19th, 2004
Flied ...... ~ ............ A.~x. ~
Administrator will wait for Letters
2/19/04.
ATTORNEY (Sup. Ct. I.D. No.)
480 Doublinq Gap Road
ADDRESS
Newv±lle, PA 17241
72666
PHONE
(717) 776-4856
RENUNCIATION
21-2004-164
In Re ;%tat~ of
Robert M. Fry
deccztscc[.
To the Register of Wills of
Cumberland
County, Pennsylvania,
· . Susan F. Luhn, Patricia A. Shearer, Robert B. Fry,
The unc~¢rstgneo
of
Rebecca A. Fry and Richard W. Fry
theab~vede~dent~herebyre~unce(s)th~rightt~administ~r~heestatea~dresDect~yask(s)thatLett~rs
of Administration
beissuedto Edgar R. Luhn, III, Esq..
WITNESS our
hand this 18th day of February . 20 04
480 Doubling Gap Road
Newville, PA 17241 ¢C . -.
(Signature)
Patrlcia A. Shearer
806 Alexander Spring Rd
Carlisle, PA 17013 ,
Robert ~. Fry
25 Fry Road
Newville, PA 17241
Rebecca A. Fry
14 Shea Court
Carlisle, PA 17013
Richard W. Fry
36 Fry Road
Newville, PA 17241
(Signature) ?~/
{Signature)
his 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, $2.00
P 9991299
No.
Local Registrar
FEB 1 6 2oo,
Date
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
Robert M. Fr
74 N e {~1~%
Cumberland Carlisle
U.S. ARMED
Hardwalre ~ ~O
25 Fry Rd. ,,~ PA
Newv:[lle PA 17241 Cumberland
Andrew Z. Fry
Susan F. Luhn
,.Male '. 164--30 --2922 Eebruary 12, ~04
Widowed
,~,.~ ~.~ North NewtoR
I=~'D~'E~~l~Z'~ville PA 17241
Cemetery [5,.ar lisle .PA 17013
Name of Decedent:
CERTIFICATION OFNOTICEUNDERRULE5.6(a)
ROBERT M. FRY
Date of Death:
FEBRUARY 12, 2004
21-2004-164
WillNo. Admin. No.
To the Register:
I certify that notice of (beneficial interest) estate admini$tration 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 8, 2004 :
Nallle
Susan F. Luhn
Patricia. F. Shearer
Address 480 Doubling Gap Rd., Newville, PA
806 Alexander Spring Rd., Carlisle, PA
Robert B. Fry 25 Fry Road, Newville, PA 17241
Rebecca A. Fry 14 Shea Court, Carlisle, PA 17013
Richard W. Fry 36 Fry Road, Newville, PA 17241
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
March 10, 2004
Name Edgar R. Luhn III
Address 480 Doubling Gap Road
ZV:Zla Zt
Newville, PA 17241
Telephone (717
776-4846
Capacity: X Personal Representative
X Counsel for personal representative
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 003974
LUHN EDGAR R III ESQUIRE
480 DOUBLING GAP ROAD
NEWVILLE, PA 17241
........ fold
ESTATE INFORMATION: SSN: 1 64-30-2922
FILE NUMBER: 2104-0164
DECEDENT NAME: FRY ROBERT M
DATE OF PAYMENT: 05/25/2004
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 02/12/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $2,834.53
REMARKS:
E LUHN III ESQ
TOTAL AMOUNT PAID:
$2,834.53
SEAL
CHECK#018
INITIALS: VZ
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
being duly according fo law, deposes and says that he
of the Estate of
late of ................................................. Cumberland County, Pa., deceased and fhaf fha
wifhln is an inventory made by ., the said
of the entire estate of said decedent, consisting of all the personal property and real estate, except real estate outside
fha Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value
as of the date of decedenf's death.
and subscrlbed be fo re me,_
Edgar R. Luhn III
480 Doubling Gap Rd., Newville, PA
Addras,
Dale of Deafh 12 February 2004
Day Month Year
INSTRUCTIONS
I. An inventory must be filed w;fh;n three months after appointment of personal representative.
2. A supplement inventory must be filed within thirty days of discovery of addiHonal assets.
3. Addlfional sheets may be attached as fo personalty or realty
4. See Article IV, Fiduciaries Act of 1949.
I
0
0
J~
0
m
Inventory of the real and personal estate of
Robert M. Fry
deceased
F&M Trust Checking Account 33-05783
F&M Trust Savings Account 70-32560
Oppenheimer Mutual Funds a09-0029699
Thrivent Financial for Lutherans Life Insurance 07377334
2,230.
5,648.
36,865.
~5,000.
)0
0
.8
)0
RE~,1500 EX (6-00)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 28O601
HARRISBURG, PA 17128-0601
Z
UJ
LU
UJ
LU
0
X
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
Fry, Robert M.
DATE Of DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
02/12/2004 08/14/192 9
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
OFFICIAL USE ONLY
FILE NUMBER
SOCIAL SECURITY NUMBER
164 - 30 - 2922
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
[]1. Original Return
[~4. Limited Estate
["~ 6. Decedent Died Testate (Ntach copy of Will)
r--~ 9. Litigation Proceeds Received
r--] 2. Supplemental Retum
j'~ 4a. Future Interest Compromise (date of death after 12-12-82)
[~7. Decedent Maintained a Living Trust (Attach copy of TnJsl)
~'~ 10. Spousal Povedy Credit (date of death between 12.31-91 and 1-1-95)
[~3. Remainder Return (date of death pdor to 12-13-82)
-'-]5. Federal Estate Tax Return Required
0 8. Total Number of Safe Deposit Boxes
[~11. Election to tax under Sec. 9113(A) (A~ch Sch O)
NAME Edgar R. Luhn III
FIRM NAME (ffApplicable) Attorney-At-Law
TELEPHONE NUMBER
(717) 776-4846
COMPLETE MAILING ADDRESS
480 Doubling Gap Road
Newville, PA 17241
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)
(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)
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.
0.00
0.00
0.00
0.00
69~744.98
0.00
O.OO
6,495.17
260.24
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)
(11)
(12)
(13)
(14)
OFFICIAL USE ONLY
69,744.98
6,755.41
62,989.57
62,989.57
15.
16.
17.
18.
19.
20.
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
Amount of Line 14 taxable at lineal rate
62,989.57
x .o 45
x .12
x .15
Amount of Line 14 taxable at sibling rate
Amount of Line 14 taxable at collateral rate
Tax Due
(15)
(16)
(17)
(18)
(19)
2,834.53
2,834.53
Decedent's Complete Address: ·
STREET ADDRESS 25 Fry Road
CITY Newville, PA
STATE PA
IZIP 17241
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Interest/Penalty if applicable
D. Interest
E. Penalty
(1)
Total Credits (A+ B +C) (2)
Total Interest/Penalty ( D + E ) (3)
If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page I Line 20 to request a refund (4)
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
2,834.53
0.00
0.00
2,834.53
0.00
2,834.53
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 perjury, I declare that I have examined this return, induding 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.
SIGNATURE OF PERSON RESPONSIE&E ~ FILING RETURN DATE
ADDRESS
48~Doubling Gap ~oad,
Newville, PA 17241
SIGNATURE OF PREPARER OTHER THAN 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 RS. §9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedenrs 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.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Robert
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
M. Fry 21-2004-164
Include the
ITEM
NUMBER
~roceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivomhi ~ must be disclosed on Schedule F.
DESCRIPTION
F&M Trust Checking Account 33-05783
F&M Trust Savings Account 70-32560
Oppenheimer Funds Money Market A09-0029699
Thriven Financial for Lutherans Life Insurance
Policy %07377334
TOTAL (Also enter on line 5, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
VALUE AT DATE
OF DEATH
2,230.90
5,648.50
36,865.58
25,000.00
69,744.98
$
REV-1511 EX+ (12-99)
,..' SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA / FUNERAL EXPENSES &
INHERITANCE TAX RETURN J ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF
Robert M. Fry
FILE NUMBER
21-2004-164
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
5.
6.
7.
FUNERAL EXPENSES:
DESCRIPTION
Egger Funeral Home
15 Big Spring Ave.
Newville, PA 17241
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s) Edgar R. Luhn II I
Social Security Number(s)/EIN Number of Personal Representative(si 1 6 6 4 6 3 91 5
StreetAddress 480 Doubling Gap Road
City Newv i 11 e, PA
State
Year(s) Commission Paid: no commissions paid
AttorneyFees Edgar R. Luhn III, Attorney-At-Law
Family Exemption: (It decedenl's address is not the same as claimant's, attach explanation)
Claimant
17241
Zip
Street Address
City
Relationship of Claimant to Decedent
State ~ Zip
Probate Fees
Accountant's Fees
Tax Return Preparer's Fees
Estate Advertisements
AMOUNT
4,190.88
0.00
2,000.00
0.00
137.44
0.00
0.00
166.85
TOTAL (Also enter on line 9, Recapitulation $ 6,495.17
{If more space is needed, insert additional sheets of the same size)
rC,~,~',WEkg'm O, ,E~ ~ V~ ~m~ DEBTS OF DEC EDENT,
~ :,,~r~''~'' ~ MORTGAGE LIABI~J~IE~& LIE~._I~._~;~
ESTATE OF 21-2004-164
L;UMSER
Inc ~ de L nre mbursed medica expenses
DE~CE P-'iON
Capital One Bank
Credit Card 4305721919709977
Bronstein & Jeffries, P.A.
4830 Londonderry Road
Harrisburg, PA 17109
Central Penn Medical Group
P.O. Box 619
East Petersburg, PA 17520
119.31
100.00
40.93
/
~ , J 260 24
TOTAL (A!~o enter crt Iir, e .C, Recapituiation~ I $ '
more space is neCed. ~nsert. additional sheets of the ,~ame s z.e)
REV-1513 EX+ (9-00~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
FILE NUMBER
ESTATE OF
Robert M. Fry 21-2004-164
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I
1.
2.
3.
4.
5.
II
1.
~XABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116(a)(1.2)]
Susan F. Luhn
480 Doubling Gap Rd., Newville, PA
Patricia F. Shearer
806 Alexander Spring Rd., Carlisle,
Robert B. Fry
25 Fry Road, Newville, PA
Rebecca A. Fry
14 Shea Court, Carlisle, PA
Richard W. Fry
36 Fry Road, Newville, PA
PA
1/5
1/5
1/5
1/5
1/5
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)
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
$
BUREAU OF INDIVIDUAL TAXES
ZNHERTTANCE TAX DTVTSZDN
DEPT. 180601
HARRISBURG, PA 171Z&-0601
EDGAR R LUHN III ATTY
480 DOUBLING GAP RD
NEWVILLE PA 17241
COHNONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISENENT, ALLO#ANCE OR DZSALLONANCE
OF DEDUCT/ONS AND ASSESSNENT OF TAX
DATE 07-26-2004
ESTATE OF FRY
DATE OF DEATH 01-11-1004
FILE NUMBER 21 04-0164
COUNTY CUMBER LAND
ACN 101
I Amount: Ram~.**ad
REV-154? EX AFP
ROBERT H
HAKE CHECK PAYABLE AND REHIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THZS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1547 EX AFP (01-03) NOTZCE OF ZNHERZTANCE TAX APPRAZSEMENT, ALLOWANCE OR
DZSALLOWANCE OF DEDUCTZONS AND ASSESSMENT OF TAX
ESTATE OF FRY ROBERT MFZLE NO. 21 04-0164 ACN 101 DATE 07-26-2004
TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATZON CONCERNING FUTURE ZNTEREST- SEE REVERSE
APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Es*a~e (Schedule A) ¢1) .00
2. S~ocks and Bonds (Schedule B) (2) . O0
3. Closely Held S*ock/Par*nership In,ares* (Schedule C) ($) . O0
~. Nor*gagas/No*as Receivable (Schedule D) (q} . O0
$. Cash/Bank Daposi*s/Nisc. Personal Proper~y (Schedule E) (5) 691744.98
6. Join*ly Ownad Proper*y (Schedule F) (6) .00
7. Transfers (Schedule G) (7) .00
8. To*al Asse*s (8) 69,744.98
APPROVED DEDUCTTONS AND EXEMPTTONS: 6,495--17
9. Funeral Expansas/Adm. Cos*s/Nisc. Expenses (Schedule H) (9) ~l("_ ?~. ~r~
10. Dab*s/Hot*gage Liabili*ias/Lians (Schedule Z) (10)
11. To*al Daduc*ions
12. Ne* Value of Tax Re~urn -~ ) (12)~- 'j~989.57
15. Char/*able/Govarnmen~al Baquas*s; Non-elected 9115 Trus*s (Schedule J)~ (15) O0
1~. Ne* Valua of Es*a~e Sub,ac* *o Tax ~' ~ (1~)~ ~Z;'989.57
NOTE: T~ an assess;ant ~as lssued previously, lines 14, 15 and/uP 16, 1~ 18 ~ 19 ~ill
reflect flgures that lnclude the total of ALL returns assds~d to, ate.
ASSESSMENT OF TAX:
15. Amoun~ of Line lq a* Spousal ra*a (1.;) '~' O0 ~1_ . O0
16. Amoun~ of Line lfi *axable a* Lineal/Class A ra*e (16) 62,989.57 X 045 = 2,854.55
17. Aeoun~ of Line lq a* Sibling ra*e (17) .00 x 12 = .00
18. Aeoun~ of L/ne 1~ *axabla a* Colla*aral/Class B ra*a (18) . O0 X ~5 = .00
19. Principal Tax Due (19)=
TAX CREDTTS:
PAYtlENT R~.CEIPT DISCOUNT (+~
ANOUNT PAID
DATE NUNBER INTEREST/PEN PAID (-)
05-15-2004 CD005974 .00 2,8:34.53
IF PAID AFTER DATE INDICATED~ SEE REVERSE
FOR CALCULATZON OF ADDITIONAL INTEREST.
NOTE: To insure proper
credi* *o your accoun*,
submi* *ha upper por*ion
of *his fore wi*h your
~ax paymon*.
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
2,834.55
.00
.00
.00
( IF TOTAL DUE ZS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR)~ YOU HAY BE DUE
A REFUND. SEE REVERSE S/DE OF THIS FORH FOR INSTRUCTIONS.)
RESERVATION:
Estates of decedents dying on or before December 1Z, 198Z -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for yaars, the Commonwealth hereby expressly reserves the right to appraise and assess transfer lnharitanca Taxes
at the lawful Class 8 (collateral) rate on any such future interest.
PURPOSE OF
NOTICE:
PAYNENT:
REFUND (CR):
OBJECTIONS:
ADNIN-
ZSTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
To fulfill the requirements of Section 2140 of the Inhmritanca and Estate Tax Act, Act Z3 of 2000. (TI P.S.
Section 9140).
Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side.
--Make check or money order payable to: REGISTER OF NZLLS, AGENT
A refund of a tax credit, which was not requested on the Tax Raturn, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications ara available at the Offica
of the Register of Hills, any of tha Z3 Revenue District Offices, or by calling the special 24-hour
enamoring service for forms ordering: 1-800-36Z-ZOSO; services for taxpayers with special hearing and / or
speaking needs: 1-800-447-30Z0 (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. Z810Z1, Harrisburg, PA 171Z8-1021, 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 assessment should bo addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Reviaw Unit, Dept. 280601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. Sea page S of tho 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 decadent's death, a five percent (SI) discount of
the tax paid is allowed.
The ISZ 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 the tax amnesty period. This nan-participation
penalty is appealable in the same manner and in the tha same time period as you would appeal tha 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 (6Z) percent par annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January l, 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. The applicable interest rates for 198Z through 2004 are:
Interest Daily Interest Daily Interest
Daily
Year Rate Factor Year Rate Factor Year Rate Factor
~ 2OZ .OOOSq8 19~-1991 Ill .O003Ol 200X 9Z .000247
1983 16Z .000438 199Z 92 .000247 2002 6Z .000164
1984 llZ .000301 1993-1994 72 .000192 2003 5Z .000137
1985 132 .000356 1995-1998 9Z .000247 2004 42 .000110
1986 lOX .000274 1999 72 .000192
1987 lOX .000Z74 ZOO0 7Z .O0019Z
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID
X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after tha tax becomes delinquent will reflect an interest calculation to fiftean tlS) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notica, additional interest must ba calculated.
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
ROBERT M. FRY
2/12/2004
Date of Death:
Will No.: File No. 2004-00164
21-04-0164
Admin. No.:
.
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion oithe administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes 0 No 0 .
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete:
3. If the answer to No.1 is Yes, state thefollowing:
a. Did the personal r!Eresentative file a :fi11aJ. account with the Court?
Yes _ No 1.]1 ,
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties
in interest? Yes @ No' 0
c. Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the, Orphans' Court
and may be attached to this report.
Date: 4/25/2005
Luhn III, Administrator
Name
480 Doubling Gap Road
Newville, PA 17241
f'-
C-,J
- ,
1..:"
,Address -
(717) 776-4846
Telephone No.
r:-
(
Capacity: kI Personal Representative
QU Counsel for personal representative
uA
BUREAU OF INDIVIO\lAL'TAXES'
IHtERITAHCE TAX DIVISION" . ' ,
PO BOX Z80601,.
HARRISBURG PA 171ze-0601-
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
:tNHERIfANCE TAX
RECORD ADJUSTMENT
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
05-17-2005
FRY
02-12-2004
21 04-0164
CUMBERLAND
101
AlIOUnt R..i ttlld
~"-5'''''2-
LLeU. fi;::, I I
C' r~,'.~ r\"-
t t-f<' j )!-
/_._, ,.\ ..~l
one" 1"",.0 ("'I I"
EDGAR ~I li,Vlili!:-1:'::r), IFtt '
480 DoujelNGGAPkD-
NEWVILLE PA 17241
'*
REY-lS93 EX AFP [D3-0S)
ROBERT
M
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credi to your account, subnit the upper portion of this form with your t.x payment.
CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS ~
A~-~~~i!!";r,~.~4!"-~'.... .~ii.!~~AR~1r~~.A~A1r.1B:nJ!~..".............................
ESTATE OF FRY
OBERT
M FILE NO. 21 04-0164
ACN 101
AD.lUSTlIENT BASEO ON:
VALUE OF ESTATE:
ON
1. R..I Estate (Schedule A
2. Stocks and Bonds IScno Ie BI
3. Closely Held Stock/Part ershlp Interest (Schedule C)
4. MOrtgages/Notes Recei Ie (Schedule D)
S. Cash/Bank Deposits/Hisc Personal Property (Schedule E)
6. JointlY Ownlld Property Schedule FI
7. Transfers (Schedule G)
8. Total Assets
DEDUCTIONS AND EXEMPTIONS
9. Funeral Expenses/Admin! trative Costs/
Miscellaneous Expenses Schedule H)
Debts/Hortgage Li8bilit es/Liens (Schedule I)
Tot.l Deductions
Net Value of Tax Ret rn
Cheritable/Govern-.n al Bequests; Non-elected 9113 Trusts (Schedule J)
Net Val... of Esteta ubject to Tax
III
121
131
1...1
151
161
171
.00
.00
.00
.00
44.744.98
.00
.00
181
10.
11.
12.
13.
1....
TAX:
1.5. AlIOUI'It of Line 14 at saJ rate
16. A.ount of Line 14 tax ..t Line.l/Cl.ss A rate
17. A~t of Line 14 at S. ling rat.
18. Amount of Line 14 tax 1_ at Collateral/Class Brat.
19. Principal Tax Due
TA CR DITS:
19l
1101
6,495.17
260.24
Ill)
1121
1131
11...1
1151
1161
1171
1181
.00x DO =
37 . 989.57 X 045 =
.00 X 12 =
.00X 15 =
119J
DATE
05-25-2004
AIIlIUNT PAID
2,834.53
~ER
CD003974
INTEREST/PEN PAID (-I
.00
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
. IF PAID AFTER DATE INDICAT 0, SEE REVERSE
FOR CALCULATION OF ADDITI AL INTEREST.
DATE
05-17-2005
44,744.98
6,755.41
37.989.57
.00
37.989.57
.00
1. 709.53
.00
.00
1. 709.53
2 834.53
1 125. OOCR
.00
1,125.00CR
IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REqUIRED.
IF TOTAL DUE IS REFLECTEO AS A "CREOITR ICRI, YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.I~~
REV.1470 EX (6-88)
*'
INHERITANCE TAX
EXPLANATION
OF CHANGES
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
PO Box 280601
HARRISBURG PA 17128-0601
DECEDENrS NAME
Robert M. Fry
FILE NUMBER
REVIEWED BY
Steven James
ACN
21 04-0164
101
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
The value oft e life insurance proceeds listed on Schedule E have been adjusted to $0 as
life insurance ~n the life of the decedent is not taxable upon their death. A request to
refund the OVI rpayment has been submitted.
ROW
PaQe 1
IUItEAU OF INDIVI_~D OFFICE OF
IlIlEIlITAIlCE TAX DIVISIONcF(::'c;-c':q r\i: \li:1 ! (;
PO lOX .-01 I :....\.....,V t t.~. L'I h ',_ '_',J
HARRISIUR8 PA 17121-1601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
*'
REV-1607 ElC AFP (03-05l
2005 JUL 22 P~l 2: 10
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
06-27-2005
FRY
02-12-2004
21 04-0164
CUMBERLAND
101
Aalaunt R_l tteel
ROBERT
M
CLERK OF
ORpw"'I'" Af"'RT
i lh!\ ..) vLJu
EDGAR RCUiftf'It:tTArT)' PA
480.DOUBLING GAP RD
NEWVILLE PA 17241
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To lJMure p,,-," credit to your _t, lIUbIIit the upper portion of this fON! with your tax p__t.
CUT ALONe THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
................~.........................~....,~..........~...I....'..........~.....,......................
REV-1607 EX AF~ (03-05) ... INHEKITANCE TAX STATEMENT of ACCOUNT ...
ESTATE OF FRY ROBERT M FILE NO.21 04-0164 ACN 101 DATE 06-27-2005
THIS STATEItENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF ,THE STATED ACH IN THE HAltED ESTATE. SIIOIIII BELOW
IS A SUItIlARY OF THE PRINCIPAL TAX DUE, AI'I'LICATI'" OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PRO.IECTED INTEREST FIllUIlE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-16-2005
PRINCIPAL TAX DUE, 1,709.53
PAYMENTS (TAX CREDITS),
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
05-25-2004 CD003974 .00 2,834.53
06-10-2005 REFUND .00 1,125.00-
I
TOTAL TAX CREDIT 1,709.53
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
. IF PAm AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
smE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LEIS TttAN '1,
NO PAYItENT IS REIlUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRJ,
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIl>>tS. J
~