HomeMy WebLinkAbout04-0133 PETITION FOR PROBATE and GRANT OF LETTERS
Estate of' C~t~¥ ~0. -~oog)e_~ No.
also known as To:
Register of Wills for the
0 Deceased. County of C.~trnjxor..j tn013 in the
Social Security No. [ ~[ 0- ~ o~- ~ ~'3 Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut~l ~ named
in the last will of the above decedent, dated E3"~e_ 7 19
and codicil(s) dated '
(state relevant circnmstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in
County, Pennsylvania, with
h I s last family or principal residence at~lA
(list street, number and muncipality)
Decen..dent, then --<'D. years of age, died
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:
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property $
(If not domiciled in Pa.) Personal property in Pennsylvania $
(If not domiciled in Pa.) Personal property in County $
Value of real estate in Pennsylvania . .
situated as follows: ~,,~ ~t~O~
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters :'~sq~A~-t~Ate~
theron. (testamentary; ad/ninistration c.t.a.; administration d.b.n.c.t.a.)
OATH OF-PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed "~
before me this _/(~ 7-~ day of '~
Estate Of ~---7~.,, 1,3 .~,~-~ , Deceased
l
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW '~_e~.,5+qo.,d I I ~~. in consideration of the petition on
/
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated
described therein be admitted to probate and filed of record as the last will of
and Letters - ~s-r-~
are hereby granted to . ],el/V~-7- .50 o~'7-')7-£
Register of Wias
FEES
Probate, Letters, Etc ..........
Short Certificates( ) .......... $ ldO,ocr ^'rrORNEY (Sup. Ct. i.D. No.)
Renunciation ................ $
$ /CO. OdD ADDRESS
TOTAL .
Filed . ~,~&.. il... ~C7o..~. .............. PHONE
REGISTER OF WILLS OF COUNTY
OATH OF SUBSCRIBING WITNESS
codicil
(each) a subscribing witness to the will presented herewith, (each) being duly qualified according to
law, depose(s) and say(s) that S]~e_ L~ )~q_~ present and saw
the testat~ , sign the same and that ~'~ ~__ signed as a witness at the
request of testato~ in h ~5 presence and ~ thc p.~c.cc of~_~ ~.~'~--' (in the presence of the
other subscribing witness(es)).
Sworn to or affirmed and subscribed before
me this J~ ~ day of (Name)
~~'~~m,/' ~../~ Ax ~, (Address)
(Name~
(Address)
REGISTER OF WILLS OF "__%~OUNTY
%x~ATH OF NO N-SU~RIBING WITNE~fi, x%
(each) a subscriber hereto, (each)~ duly qualified according~aw, depose(s)and say(s)'~
c~-~ ---- famil~ the signature ° codicif ~1~
te~_ ___ of (one of the subscribing withes to) the will piX~xented herewith and
~ codic/Kx
that ~...~ believes the ~g~ure on thewillwill isis inin the~and~t handwriting of
to the best of __~.~ge and belief.
Sworn to or affirmed and subscribed~re
~'~ Register %%
(Address)
REGISTER OF WILLS OF COUNTY
OATH OF SUBSCRIBING WITNESS
v, o4ie~
_(.eat. h) a subscribing witness to the will presented herewith, ~ being duly qualified according to
law, depose(s) and say(s) that ~ t~,qs present and saw
the testatc':~ , sign the same and that S/.~e signed as a witness at the
request of testatczw, in h ~ -~ presence an~~..': .... L,,~ ~rc$cnce ~v. ~o~'~ .......... ..,~n~) (in the presence of the
other subscribing witness(es)).
Sworn to or affirmed and subscribed before f. LL.-(_ ~,4_ _~'_ fi,~. ~~~~
me this.] ('?'T~)~ day of (Name)
(Name)
(Address)
~ (each)a subscr~ hereto, (each)being ~ly q~ied according to law, ~ose(s)and say(s)~a;
~.. ~ famil~r with t~ature of
~ '"" ~ -~ codicil
t~~ o~ ~on~ oC~ s~s~ri~in~ witn~ss~ to~ ~ wi~ p~s~nt~a~r~with ~na ..~
to the best of ~ knowledge a~lief.
X
me this X d~ of X (Name')
(A
ddress)
Register
(NamO
(Address)
KNOW ALL MEN BY THESE PRESENTS: That I, GARY W. JONES ,
of the City/'r~mm of Her r i sbur g , County of Dauphin
and State of Pennsylvania , being of sound and disposing mind and memory, do make, publish and
declare the following to be my LAST WILL AND TESTAMENT, hereby revoking all Wills by me at any time heretofore made.
FIRST: I direct my Executor/Executrix, hereinafter named, to pay all my funeral expenses, administration expenses of my
estate, including inheritance and succession taxes, state or federal, which may be occasioned by the passage of or succession to
any interest in my estate under the terms of either this instrument or a separate inter vivos trust instrument, and all my just
debts, excepting mortgage notes secured by mortgages upon real estate.
SECOND: All the rest, residue and remainder of my estate, both real and personal, of whatsoever kind or character, and
wheresoever situated, lta~l~tol~~lf~x ~]i~, and I give, devise and bequeath
xm~rn~l~pma:xoc~ae~f~the following persons, to be ~0~(hers absolutely and forever:
JANET A. STITELER - fiancee'
or if such beneficxary be not~,survz¢!~t, for the use and benefit of
JENNIFER JONES,
( ORO .Y JONES
The share of any person above named who shall not survive me shall be divided among the other beneficiaries named above, in
equal shares.
THIRD: I hereby appoint JANET A. STITELER as Executor/Executrix of this my
LAST WILL AND TESTAMENT and I direct that such person shall'serve without bond.
IN WITNESS WHEREOF, I have hereunto set my hand and seal at ,
this ~ c~ day of .. ,~-~/-~-~'~
~// ( si g n h e ~~///~ ./~,/ ~'/_~_~'~_---V L.S.
Signed, sealed, published and declared to be his/her LAST WILL AND MENT by the within named Testator/
Testatrix in the presence of us, who in his/her presence and at his/her request, and in the presence of each other, have hereunto
subscribed our names as witnesses:
(1) (('~c_'~ A~"~-<~'/~/~ of ~-4.~J~cLrZe,City (~ ~
AFFIDAVIT
STATE OF j~t , / oC~ty
Personally a,peared (1) ~* ~- ~ / ,q + / P~_ Z ~ ~-- .
.o ~e,~ ~u,y ~wo~n. ~e~o. a~ sa~at t~y a,,~te~ t~e ~a,~ Wi,, an~ t~e~ ~u~c.,~ ,~ ~ame a' ,~ *~, an~ in
presence of the said Testator and in the presence of each other, and the said Testator signed said Will i~ their presence and
acknowledged that he/she had signed said Will an~ declared the same to be hidher LAST WILL AND TESTAMENT, and
deponents fuaher state that at the time of the execution of said Will the said Testator appeared to be of lawful age and sound
mind and memory and there was no evidence of undue influence. The deponents make this affidavit at the request of the
Testator.
(~)
(3)
su~c,i~eo ~ ~wo,~,o ~or~ met~i~ ~~ ~ay o~ ~:~ . ,9~
= ~:~.: ~
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.
P 9 9 90 8 ? 0 JAN a l ; 00&
No. ~ Date
HI05.144 R~v. 1~91 COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF HEALTH "VITAL RECORDS
,~m~.~ CERTIFICATE OF DEATH
,. (Coroner)
(MANItNT 2 9- 2 01 swE FiLE NUMBER
&CK INK (Fir~. M,Odie. ~ls~) SEX SOCIAL SECURITY NUMSER DATE OF D~ATH (Mop,th. Day,
W Jones ZMale 2. 190 - 42 - 2993 4. January 28, 2004
Gary Jan. 9, 1952 Scranton, PA I,p.m,n, [] E~Oum.,,em [] 00~ [] Home [] U~.~ [] (S~,yI []
and I~ .... Carlisle I~Carlisle Regional Medical Center I~.~ ..... ,~ ..... I,o ~ite
~nard W. Jones ,,. ~rothy A. ~11
~, J~et A. Stiteler [,~.620 ~s~ble Rd., ~rllsle, PA 17013
I
~ ~GN~ ~ SERV~E LICE~E~ PE~ ~1~ ~ SUCH I L'CENSE NUMBER NAME AND ADDRE~ OF FACtL~
~~~~ fi/ ~~ ,~,~.FD 012633 L ~inq Brothers F~eral H~, Inc., ~rlisle, PA
I 1,4. 5131 P M. I~s. January 28~ 2004 a. ~
,~;~ , Metastatic Esophageal Cancer :
~ef ~ Coroner
· ~aw~m~ Todd C. Eckenrode,Chf.Dep. Corono
~ .................................................................................................. ~ 6375 Basehore Rd., Su~t~ ~1
~ -.~~chan~csbur~ Pa. 17050
COHHONHEALTH OF PENNSYLVANIA ~ I
DEPARTMENT OF REVENUE INFORMATION NOTICE FILE NO. 21 0q-0133
BUREAU OF INDIVIDUAL TAXES AND
DEPT. ZOO601 ACH Oq1172~8
HARRISBURG, PA 171Z&-0601 TAXPAYER RESPONSE
DATE 0~-Z9-200~
REV-I~qS EX AFP C"9-00)
TYPE OF ACCOUNT
;:: EST. OF GARY H JONES [] SAVlNO$
= S.S. NO. 190-~2-2995 [] CHECK/NC
DATE OF DEATH 01-Z8-ZOOq [] TRUST
COUNTY CUHBERLAND [] CERTTF.
'0~ J'~/ ~'7 ~ ;~ ~'r ~ REH/T PAYHENT AND FORHS TO:
JANE~' A STITELER REGISTER OF HILLS
620 BARNSTABLE RD CUMBERLAND CO COURT HOUSE
CARLISLE PA 17015 [ .... CARLISLE, PA 17015
WAYPOINT BANK has provided the Department mith the inforeation listed baloa uhich has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, you ware a joint owner/beneficiary of
this account. If you feel this information is incorrect, please obtain written correction from the financial insti~tion, attach a copy
to this ~orm and return it to ~e above address. This account is ~xable in accordance ~ith the Inheritance Tax La~s of the Commonwealth
of Pennsy[van~a. ~uesttons may be ans~ere~ by calling (717) 767-BSZT.
COHPLETE PART 1 ~ELO~ ~ ~ - SEE REVERSE SIDE FOR FILING AND PAYHENT INSTRUCTIONS
Accoun~ No. 202152767 Da~e 0q-10-1995 To insure proper credit to your account, t,a
Established ~z) cap,es of th~s no~ca mus~ accompany your
paymen~ ~o ~ha Register of ~s. Hake check
Accoun~ Balance 7 ~ ~. ~ payable ~o: "Register of ~J~s, Agent".
Percen~ Taxable X 5 0 · 0 0 0
NOTE: if tax payments ara made ~ithin three
Amoun~ SubSec~ ~o Tax ~ ~67.7~ (5) months of the decedent's date of death~
Tax R~e X . [5 you may deduct a 5X discount of the ~x due.
Any inheritance tax due ~11 become delinquent
Po~en~ial Tax Due 550.1~ nine [9) ~on~s after the date of death.
PART TAXPAYER RESPONSE
A. ~he above information and tax due is correct.
~ I. You may choose to remit payment to the Register of Hills ~[~ t~o cop[es of this notice to obtain
a discount or avoid interest, or you =ay check box "A" and return this notice to the Register of
CHECK ~ ,~t~s and an off,rial assessment ,ill be issued by the Pk Department of Revenue.
ONE
BLOCK s. ~ The above asset has been or ~il[ be reported and tax paid ~ith ~e Pennsylvania Inheritance Tax return
ONLY to be filed by ~e decedent's representative.
C. ~ The above information is incorrect and/or debts and deductions Here paid by you.
You must complete PART ~ and/or PART ~ bela..
PART
TAX RETURN - COHPUTATZON OF TAX ON JOINT/TRUST ACCOUNTSJ~ ~~??=~=~[~[~[~[~[~~[~[~[}~[~[~
PART DEBTS AND DEDUCTIONS CLAZHED
DATE PAID PAYEE DESCRIPTION AMOUNT PAID
TOTAL (Enter on L/ne 5 of Tax Computation) $
Under penalties of perjury, I declare that the facts ! have reported above are true, correct and
complete to *he bes~ of ey knowledge and belief. HOME (
TAXPAYER S[6NATURE i TELEPHONE NUHBER DATE
GENERAL ~NFORHAT~ON
1. FAILURE TO RESPOND NILL RESULT IN AN OFFICIAL TAX ASSESSNENT with appllcabla interest based on information
submitted by the financial institution.
Z. Inheritance tax becomes delinquent nine months after the decedent's date of death.
$. A joint account is taxable even though the decadent's name was added as a matter of convenience.
4. Accounts (including those held between husband and wife) which the decedent put in joint names within one year prior to
death are fully taxable as transfers.
5. Accounts established jointly between husband and wife more than one year prior to death ara not taxable.
6. Accounts held by a decedent "in trust far" another or others are taxable fully.
REPORT[NG [NSTRUCT[ONS - PART ! - TAXPAYER RESPONSE
1. BLOCK A - If the information and computation in the notice are correct and deductions are not being claimed, place an "X"
in block "A" of Part 1 of the "Taxpayer Response" section. Sign two copies and submit them with your check for the amount of
tax to the Register of Hills of the county indicated. The PA Department of Revenue will issue an official assessment
(Form REV-1548 EX) upon receipt of the return from the Register of Hills.
2. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid with the Pennsylvania Inheritance
Tax Return filed by the decedant's representative, place an "X" in block "B" of Part I of the "Taxpayer Response" section. Sign cna
copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Dapt Z80601, Harrisburg, PA 171Z8-0601 in the
envelope provided.
$. BLOCK C - If the notice information is incorrect and/or deductions ara being claimed, check block "C" and complete Parts Z and 3
according to the instructions below. Sign two copies and submit them with your check for the amount of tax payable to the Register
of Hills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-1548 EX) upon receipt
o~ the return from the Register of Hills.
TAX RETURN - PART Z - TAX COHPUTATZON
LINE
1. Enter the date the account originally was established or titled in the manner existing at date of death.
NOTE: For a decedent dying after IZ/IZ/BZ: Accounts which the decedent put in joint names within cna (l) year of death ara
taxable fully as transfers. However, there is an exclusion not to exceed $3,000 par transferee regardless of the value of
the account or the number of accounts held.
If a double asterisk (ix) appears before your first nasa in the address portion of this notice, the $3,000 exclusion
already has been deducted from the account balance as reported by the financial institution.
Z. Enter the total balance of the account including interest accrued to the date of death.
3. The percent of the account that is taxable for each survivor is determined as follows:
A. The percent taxable for joint assets established more than one year prior to the decedent's death:
1 DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUNBER OF X 100 PERCENT TAXABLE
JOINT ONNERS SURVIVING JOINT OHNERS
Example: A joint asset registered in the name of the decedent and two other persons.
I DIVIDED BY 3 [JOINT ONNERS) DIVIDED BY Z (SURVIVORS) = .167 X lO0 = 16.7Z (TAXABLE FOR EACH SURVIVOR)
B. The percent taxable for assets created eithin one year of the decedant's death or accounts owned by the decedent but held
in trust for another individual(s) (trust beneficiaries):
i DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE
OWNERS OR TRUST BENEFICIARIES
Example: Joint account registered in the name of the decedent and two other persons and established within one year of death by
the decedent.
1 DIVIDED BY Z (SURVIVORS) = .50 X 100 = SOZ (TAXABLE FOR EACH SURVIVOR)
4. The amount subject to tax (line 4) is determined by muItiplying the account balance (line Z) by the percent taxable (line
5. Enter the toter of the debts and deductions listed in Part 3.
6. The amount taxable (1ina 6) is determined by subtracting the debts and deductions (Line 5) from the amount subject to tax (line
7. Enter the appropriate tax rate (Zinc 7) as determined below.
I Di~e Of Death Spouse I L/nee1 Sibl/ng Collateral
07/01/9q to 12/31/9q 3X 6X 15X
01/01/95 to 06/30/00 OX 6X 15X
07/01/00 to present OX ~.$Z~ 12Z
xTha tax rate imposed on the nat value of transfers fram 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 stapparent of the child is OZ.
The lineal class of hairs includes grandparents, parents, children, and lineal descendents. "Children" includes natural children
whether or not they have been adopted by others, adopted children and step children. "Lineal descendents" includes all children o~ the
natural parents and their descendents, ehather or not they have been adopted by others, adopted descendents and their descendants
and step-descendants. "Siblings" are defined as individuals who have at least one parent in common with the decedent, whether by blood
or adoption. The "Collateral" class of hairs includes all other beneficiaries.
CLAZHED DEDUCTIONS - PART $ - DEBTS AND DEDUCTIONS CLAZHED
Allocable debts and deductions ara determined as follows:
A. You legally are responsibZe for payment, or the estate subject to administration by a personal representative is insufficient
ta pay the deductible items.
B. You actually paid the debts after death of the decedent and can furnish proof of payment.
C. Debts being claimed must be itemized fully in Part 3. If additional space is needed, use plain paper B l/Z" x 11". Proof of
payment may be requested by the PA Department of Revenue.
COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96)
DEPARTMENT OF REVENUE
BUREAU OF iNDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 003982
STITELER JANET A
620 BARNSTABLE ROAD
CARLISLE, PA 17013
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
........ fold ..................
04117248 $550.16
ESTATE INFORMATION: SSN: 190-42-2993
FILE NUMBER: 2104-01 33
DECEDENT NAME: JONES GARY W
DATE OF PAYMENT: 05/27/2004
POSTMARK DATE: 05/26/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 01/28/2004
TOTAL AMOUNT PAID' ~550.16
REMARKS:
CHECK# 101
INITIALS: JA
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
Carlisle PA 17013-7425
COMMO.W 'LT. OF REV' 1500
~ PENNSYLVANIA
a~72,~'~ DEPARTMENT OF REVENUE
DEP 28O6O INHERITANCE TAX RETURN
21 _ 04 00133
,ARR S,UR .PA17 28-060 RESIDENT DECEDENT ov. oo e
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURI]Y NUMBER
I..- Jones, Gary W. 190-38-9810
Z
LU DATE OF DEATH (MM-DD-YEAR) [ DATE OF BIRTH (MM-oB)Y~Ri
J~ THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
LU 01/28/2004 J01/09/1952 REGISTER OF WILLS
JJ.J (IF APPLICABLE) ~URgiVI~ SPOUSE'A ~AME iL~$T, Fi~T, A~D MIDDL~ I~I~iAL) SOCIAL SECUBIT~ NUMBER
I~ Stiteler, Janet A. 181-38-9810
[] 1. Odginal Return [] 2. Supplemental Return [] 3. Remainder Return Nate
uJ
~'~ [] 4. kimitedEstate [] 4a. FuturelnterestCompromise/da~eo~dea,ha~erl,.l~) [] 5 Federal Estate Tax Return Required
:= ~o o, [] 6. Decedent Died Testate (Ar, ach ropy of Will) [] 7. Decedent Maintained a Living Trust (A~ach copy of Tr~l} 8. Total Number of Safe Deposit Boxes
[] 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (date of ~e~h betw~n ~-3~-~ and 1.1-95) [] 11. Election to tax under Sec. 9113(A)(^r~c~ sch o)
m NAME COMPLETE MAILING ADDRESS
z Janet ^. Stiteler
o 620 Barnstable Road
" Carlisle, PA 17013
a: TELEPHONE NUMBER
~ (717) 241-6486
1. Real Estate (ScheduleA) (1) ~ ~-~'
2, Stocks and Bonds (Schedule B) (2) ~ :,
3. Closely Held Cooperation, Partnership or Sole-Proprietorship (3) C
4. Mortgages & Notes Receivable (Schedule D) (4) --~
5. Dash, Bank Deposits & Miscellaneous Personal Property (5) 66,227.00 co
~ (Schedule E) : ,
6. Jointly Owned Property (Schedule F) (6) 106,842,00 i_; ~'~)
~ [] Separate Billing Requested ;! : ~";-
'-~ 7 Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
I-" (Schedule G or L)
~ 9 Total Gross Assets (total Lines 1-7) (8) 173,069.00
~ 9. Funeral Expenses & Adminislrative Costs (Schedule H) (9) 15,960.00
10~ Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)(10) 47,500.00
11. Total Deductions (total Lines 9 & 10) (11) 63,460.00
12. Net Value of Estate (Line 8 minus Line 11) (12) 109,609.00
13. Chedtable and Governmental Bequests/Bec 9113 Trusts for which an election to tax has not been (13) 0.00
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 109,609.00
BEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
Amount of Line 14 taxable the
at
tax
~_~ rata, ortransfereunderSec. 9116(a)(1.2) 109,609.00 x ,o (15) 0.00
~ 16. Amount of Line 14 taxable at lineal rate x .0 (16)
~= 17. Amount of Line 14 taxable at sibling rate x .lg (17)
O 18. Amount of Line 14 taxable at cogateral rata x .15 (18)
19. Tax Due (19) 0.00
Decedent's Complete Address:
ClTYcarlisle I STATEpA I ZIP 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19) (1)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
3. Interest/Penalty if applicable Total Credits ( A + B + C ) (2)
D, Interest
E. Penalty
Total interest/Penalty ( D * E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT,
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the differenca. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
BEn er he total of Line 5 + SA. This is the BALANCE DUE. (5B) 0.O0
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decadent 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 reversiona~7 interest; or .......................................................................................................................... []
d. recaive the promise for life of either payments, benefits or care? ...................................................................... []
2. If death occurred after Decamber 12, 1982, did decadent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. []
3. Did decadent own an "in trust for" or payable upon death bank accoun or secudty at his er her death? .............. []
4. Did decadent own an Individual Retirement Account, annuity, or other non-probate preperty 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 der. Jam that I have examined this rofum, including accor~anylng schedules and statements, and to the best of my kllowledge and belief, ~t is true, corTect and comptete.
Deciaratlo{t of preparer other than the personal representative is based on all information of which preparer has any knowledge,
SIGNATURE OF PERSON RESPONSIBLE FOR.FILING RETURN
ADDRESS
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 afler January 1, 1995, the tax rate imposed on the net value of transfem 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 RS. {9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 RS. §9116(1.2) [72 P.S. §9116(a)(1
The tax rate imposed on the net value of transfers to or for the use of the decadent's siblings is 12% [72 RS, §9116(a)(1.3)]. A sibring is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-~50a E×~ ~6-98~ SCHEDULE E
COMMONWEALTH OF PENNSYLVANIACASH, BANK DEPOSITS, & MISC.
' N '~' ~A~ ~OX ~T~T~ N PERSONAL PROPERTY
£$TATE OF FILE NUMBER
Jones, Gsry W. 21-04-0133
Include the proceeds of fitigation and the date the proceeds were received by the estate.
All property jothtly-owned with right of survivorship must be disclosed on Schedule F
ITEM VALUE AT CATE
NUMBER CESCRIPTION OF DEATH
Cash 7.00
2 Checking Account (Waypoint Sank #100425735) 1,823.00
3 Checking Account (PSECU #0190-42-2993) 2,093.00
4 Savings Account (PSECU #0190-42-2993) 1,147.00
5 Money Market (PSECU #0190-42-2993) 16,197.00
6 Automobile - 1990 Chevrolet Corsica 600.00
7 Personal Property(various 44,360.00
TOTAL (Also enter on line 5, Recapitulation) $ 66,227.00
(If more space is needed, insert additional sheets of the same size)
REV-1509 EX+ (6-98)
SCHEDULE F
COMMONVV~ALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Jones, Gary W. 21-04-0133
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
A. Janet A. Stiteler 620 Barnstable Road, Carlisle, PA 17013 Wife
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY ~,~ OF DA~E OF OEATH
I. A. 08/01/1999 Real Estate - Residence (620 Bamstable Road, Carlisle, PA) 181,350.00 50% 90,675.00
2 08/01/1999 Savings Account- Waypoint Bank (#202132767) 7,335.00 50% 3,667.00
3 08/01/1999 Automobile- 2003 Chevrolet Silvemdo 25,000.00 50% 12,500.00
TOTAL (Also enter on line 6, Recapitulation) $ 106,842.00
(If mere space is needed, insert additional sheets of the same size)
REV-1511 EX+ (12-99)
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Jones, Gary W. 21-04-0133
Debts of decedent must be reported on Schedule [.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Ewing Brothers Euneral Home, Carlisle, PA (including misc. expenses) 15,960.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)/ElN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees
3. 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
6. Tax Return Preparer's Fees
TOTAL (Also enter on line 9, Recapitulation) $ 15,960.00
(If more space is needed, insert additional sheets Ct the same size)
REV-1512 EX+ (12~3)
SCHEDULE I
COMMONWF~LTH OF PENNSYLVANIA DEBTS OF DECEDENT,
INHREERsI~)AENNCTEE'~A~ERDEETNUTRN MORTGAGE UABILITIES, & LIENS
ESTATE OF FILE NUMBER
Jones, Gay 21-04-0133
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unrelmbursed medical expenses,
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Auto Loan - 2003 Chevrolet Silverodo (PSECU #0190422993) @ 50% ownership 12,500,00
2 Home Mortgage. (PSECU] - 620 Barnstable Roan. Carlisle. PA @ 50% ownership 35,000.00
TOTAL (Also enter on line 10, Recapitulation) $ 47,500.00
(If more space is needed, inser~ additional sheets of the same size)
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Date of Death:
Will No.: 200q- 00 ~33 Admin. No.:
Pursuant to Rule 6.12 of the Supreme Cou~ O~hans' Cou~ Rules, I repo~ the
following with respect to completion of the adminis~ation of the above-captioned estate:
1. State whether administration of the estate is complete:
" 2. If the answer is No, state when the personal representative reasonably believes
that the adminis~ation 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 CouP?
b. The separate O~hans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an accost info.ally to the parties
in interest? Yes
c. Copies of receipts, releases, joinders and approval of focal or
info.al accounts may be filed with the Clerk of the O~hans' Court
and may be attached to this report.
Signature
Name
Address
Telephone No.
Capacity: [~Personal Representative
[] Counsel for personal representative
DEC 29 AHg:II
CLERK OF
ORPH/ N S COURt_.
6WW'v~'~RNSTABL E RD
CARLISLE PA 17015
COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT. ALLO#ANCE OR DISALLO#ANCE
OF DEDUCTION~, AND ASSESSNENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
DATE 12-27-2004
ESTATE OF JONES
DATE OF DEATH 01-28-2004
FILE NUHBER 21 04-0155
COUNTY CUMBERLAND
SSN/DC 190-42-2995
ACN 04117248
Amount Remitted
GARY W
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE
RETAIN LOWER PORTION FOR YOUR RECORDS
REV-1548 EX AFP (01-05)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 12-27-2004
ESTATE OF JONES
GARY
W DATE OF DEATH 01-28-2004 COUNTY CUMBERLAND
FILE NO. 21 04-0155 S.S/D.C. NO. 190-42-2995 ACN
04117248
TAX RETURN NAS= (X} ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: WAYPOINT BANK ACCOUNT NO. 202152767
TYPE OF ACCOUNT: (~ SAVINGS ( ) CHECKING ( ) TRUST ( ~ TIME CERTIFICATE
DATE ESTABLISHED 04-10-1995
Account Balance 7,555.44
Percent Taxable ~ 0.500
Amount Subject to Tax 5,667.72
Debts and Deductions - .00
Taxable Amount 5,667.72
Tax Rate ~ .15
Tax Due 550.16
TAX CREDZTS:
NOTE:
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
05-26-2004 CD005982 .00 550.16
TOTAL TAX CREDIT I
I
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
550.16
.00
.00
.00
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN 91, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR}, YOU HAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. }
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL ~~ifil=T\ cCnCE OF NOTICE OF INHERITANCE TAX
INHERITANCE TAX DIVISION Fir f, ," .,',\'" ; ~PPRAISEt1ENT, ALLOWANCE OR DISALLOWANCE
PO BOX 280601 tf>:';~: .-~' OF DEDUCTIONS AND ASSESSMENT OF TAX
HARRISIURG PA 17128-D6D1
2U05 JAW \ 0 Al1 9: 48
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
01-10-2005
JONES
01-28-2004
21 04-0133
CUMBERLAND
101
A"ount Ra.1i tt.d
ClfRK OF
ORPH"N'S COIJRl ,
JANET A STUtl!\!;R-:)\ I!;[) en , f-;\
620 BARNSTABLE RD
CARLISLE PA 17013
*'
UV-l"~1 'Ell _fP [12.04)
GARY
W
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
RW:is4-j"ix"-AFP"-riiFo31""No'TYcE""eiF-it.IHiR-ii'ANCE"i'A'X";.pjiR;'-isiH€NT~--Ar.tOWAiiCE-iiR-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF JONES GARY W FILE NO. 21 04-0133 ACN 101 DATE 01-10-2005
TAX RETURN HAS: (X I ACCEPTED AS FILED
I CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. stocks and Bonds (Schedule B)
3. Clos.1~ Held stock/Partnership Interest (Schedule Cl
4. Hortgages/Notes Receivable (Schedule OJ
S. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. ~ointlY Owned Property (S~hedule f)
7. T~ansf.rs (~hedule Gl
8. Total A5S.~S
III
121
I~I
(41
151
(61
(71
.00
.00
.00
.00
66.227.00
106.842.00
.00
181
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Exp.ns.s/Adn~ Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11~ Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental 8equestsj Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
191
1101
15,960.00
47.500.00
1111
1121
11~1
1141
NOTE: To insure proper
credit to your account~
submit the upper portion
of this form with your
tax paym.nt.
173,069.00
63.460 00
109,609.00
.00
109,609.00
14, 15 and/or 16, 17, 18 and 19 will
returns assessed to date.
TAX CREDITS:
Cft "'." , ,+J AHDUNT PAID
DATE NUI1BER INTEREST/PEN PAID (-I
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
NOTE: If an assessment was issued previously, lines
reflect figures that include the total of ALL
ASSESSMENT OF TAX:
15. Aaount of Line 14 at Spousal rate (15)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
17. A.ount of Line 14 at Sibling rate (17)
18. A.ount of Line l~ taxable at Collateral/Class B rate (18)
19. Principal Tax Due
109,609.00 X 00 ~
.00 X 045 ~
.00 X 12 ~
.00 X 15 ~
1191~
~
.00
.00
.00
.00
.00
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN $1, ND PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YDU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FDR INSTRUCTIONS. I
sr,-
D'"
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
'*
REY-1607 EX iFP U2-041
JANE A STITELER
620 BARNSTABLE RD
CARLISLE PA 17013
'0'")
c")
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
02-07-2005
JONES
01-28-2004
21 04-0133
CUMBERLAND
04117248
Allount RelliUed
GARY
W
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
~..;..
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: T~lnsuigp~o~.r credit to your account. subllit the upper portion of this forll with your tax paYllent.
C~'t AtJONG~HIS Lii~: ..... RETAIN LOWER PORTION FOR YOUR RECORDS ~
1~:r~~".~.i'~..(ft~!,........;..;rA~I~e1r~l1r.t'~1M!A~.b~.l~c:60~...ji......................
ESTATE OF JONES GARY W FILE NO.21 04-0133 ACN 04117248 DATE 02-07-2005
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE. APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE. AND. IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 01-19-2005
PRINCIPAL TAX DUE:.
.00
PAYMENTS (TAX CREDITS):
~
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
05-26-2004 CDo03982 .00 550.16
01-19-2005 REFUND .00 550.16-
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
IF PAID AFTER THIS DATE. SEE REVERSE TOTAL DUE .00
If
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1.
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR).
vnu MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )