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HomeMy WebLinkAbout04-0514 PETITION FOR PROBATE and Estate of HELEN R. !dOOD also known as Social Security 'No. 19 ~' 2 [5- 0 7 ~ ~Deceased. The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the executOr in the last will of the above decedent, dated November 6~ and codicil(s) dated GRANT OF LETTERS To: Register of Wills for the County of Cumberland Commonwealth of Pennsylvania in the named 2001 (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumbe:Plaud County, Pennsylvania, with herpa 17~ family or principal residence at ~13p East Locust Street .. Mechanicsburg, (list street, number and muncipality) Decendent, then ~ years of age, died Ma~ 2©~ ,X~I: ~0©~, at Except as follows, deceden, t 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: House and parcels of laud situate Locust St., MechanicsburE, PA 1709~ 120,000,00 at 513 East WHEREFORE, petitioner(s) respectfully presented herewith and the grant of letters theron. Donald L, t:'~ood 524.0 Stratraore Drive Mechanics. burg, PA 170~0 reque~(s) .the prob. ate of the last will and codicil(s) '±'es (testamentary; administration L ~.' . . . c.t.a.~. Om~mstra~n d.b.n.c.t.a.) OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA '1 COUNTY OF Cumberland 3' 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 represen- tative(s) of the above decedent petitioner(s) will wel~and truly administer the estate according to law. Sworn to or affirmed and subscribed .- ~ ~C--'~/~ '" this ~_rto day of ! ~ before~ me Estate of No. ~- ~-'~Jt~ HELEN R. WOOD , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW J~--qe ~ l~l~00~, 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 ~,~ovember 6.. 2001 described therein be admitted to probate and filed of record as the last will of Helen R. Wood ; and Letters are hereby granted to Testamentary Donald L. Wood FEES Probate, Letters, Etc .......... Short Certificates( ) .......... ' ~, TOTAL Filed ...~..': ~..': .,0-..0.~ J. Robert Stauffer-~L6356 ATTORNEY (Sup. Ct. I.D. No.) Market Square Bldg. Mechanicsburg, PA 17099 ADDRESS 717-?&6-9673 PHONE l{}5 8{}5 REV 0/86 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, $2.00 P 10328591 MAY 2 12004 No. Local Registrar Date CERTIFIER (Check only or~) ~oERTIFYING HYSICIAN(P ~,~an ' ' '~O~1~ AND CER~F~NG pHy~mN (~y~ ~ ~ ~ ~ 'i REGIST~R'S S~TU~ AND ~ ifany'leadmgt°immed~ate { i" D~JETO(O~RASACON~'r'~IHENCEOF): ) LAST __ i OF DEATH? I Nature ~ 143 Rev 2/87 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH NAME OF DECEDENT (First. Mkldte. Laat) STATE FILE tilAMffiER I H e 1 en R Woo d I SEX I SOCIAL SECURITY NU~ER ~'~' I DATE OF D~ATH (Mon~ Day Year) AGE(L&at~i;~,) ~MHoo~E~R, 1Y~EAR ! UN~E?ID~y I ,,D, AT~O_FBIRTH I .,RmPL^CE,C,~,,~ I~L,[~e}a~,eT.,J~ck~,S~,. 28 -0765 c.¢ ..Hay 20. 2004 ~ I ] ~ayaI Hours I Minutes I [lo, lin, Uay, Year) J Stale ~ Foreig~ Country) i HOSPITAl. - I~ Inlf~llC~OO$ 0fl Ot~l~f ~ 5 Yrs - O~R: COUNTY OF DEATH ·' I· Ill. I CITY, BORO, TV~ OF [~TH J FACILITY NAME/If ~' i~18tJt'" ..... I .... ~ ISoe~fv) La I I [ ,~, m~,, g~ve a~reet and nutone0 IWAS._.~CEDENT OF HISPANIC ORIGIN? I RACE - American Indian. alack, White ~. Cumberland I~ Hechanicsburo I 51~ , ............ I.".°[~-"l'J~e'.~ .......... I · o lad. -J ~- I~u~u.~[. DEreeE I~ex~can.~uert°lq~can.elc. i ucbcuml~ll ,~ U~UAL OCCUPAT ON I KIND OF BUS NESS I INDUSTRY ~ .............. I ~, 110. wn ]. t e I o~c~',~.!._.,~ ~*- ~.~.~ I I~.~,~.~.~._L_t~R ~N I _~gEmNT'S EDUC^nON I MAR TAL STATUS Morned ,, S?CC Buyer I ~.--~ _~_~__~_ _l vD. F1 ,DEr i a....~-~..~ ~ - :~ I i~;~"7~'~ '" " ""' ......... "~'"ar~l~=' I".12~'~' I ~'~'"' I" .*ao.e~ ~CE~'S MNLING A~ESS (S~, Citron, S~, Zip ~) ~ ~n~N~S 513 East Locust Street JRta~t 17a. . ,. Mechanicsburg, PA 17055 Jl~m~ ,v,~n, ~a~) ~m. c~ Cumberl rand t~n~p9 17d'~wit~n~ua~m~s~ Mechanicsbur~ ,,. Alfred Rupp ~, Mar Ba ~NFOR~ANrS roME (ry~nt) I ' y rd ~. Dona ld Wood I~NFo~¢[s ~?m 5~ESS (St,~. O~a~,. S~. ~ .... I - ' ' - q of r.mator [,-- ~ a~s2~my~i~ ~ro ........... ' Iz~zww dunes[Own Koao. Harrisburo ~~% ..... ~. ~o ~,o, ~. ,.,~¢ ,oD LAST WILL AND TESTAMENT OF }~I,EN R. WOOD I, HEI,EN R. WOOD, of the Borough of Mechanicsburg, County of .... '-~ =~,~ C~nu,,~and and S%a%e of Pennsy]..v~n~.a, being'-of sound and disposing mind, memory and undePs2anding, do make, publish and declare %his my Last Will and Testament, hereby revoking and making void any and all prior Wills by me a~ any time heretofore made. I direct the 'payment of all my just debts and funeral expenses as soon after my decease as the same can be conveniently dope. e I give and bequeath my Desk and my small armless Rocker to my granddaughter, I~EI,I.,Y WENTZ. I give and bequeath my- Tab].e Lamp to my daughter-in-law, MILDRED E. WOOD. -1- Ali. the rest, residue and remainder of my estate shall be converted into cash and for this purpose I authorize, empower arid direct my Executor, hereinafter named, to sell any and all real estate which I may own at the time of my decease, as well as my personal belongings and household furnishi~gs a~,d not herein otherwise specifically bequeathed, at either public or private sale or sales. After my estate has thus been converted into cash and upon the pay~uent of all my just obligations, the costs of administration of my estate and all inheritance and succession taxes, I direct that the same be paid out and distributed as follows, to wit: (a) I give and bequeath fifty (50%) per cent thereof to my son, DONALD L. WOOD, absolutely. (b) I give and bequeath twenty-five (25%) per cent. thereof to my daug}~ter-in-l~w, MILDRED E. WOOD, absolutely. (c) I give and bequeath twenty-five (25%) per cent. thereof to my' granddaughter, KELLY WEI~TZ, absolutely. LASTLY, I nominate, constitute arid appoint my son, DONALD L. WOOD, Executor of this my Last Will and Testament -2- and direct that he be excused from posting bond or other security for the faithful ~erformance~ ' of his duties in any jurisdiction. IN WITNESS t,I~IMf(EOF, I have hereunto set my hand and seal this ~~a_y of '5lovember, .~. O., 2001. Helen R. Wood (SEAL) -3- COMMONWEALTH OF PENNSYLVANIA ) : COUNTY OF CUMBERLAND ) SS. i, HELEN R. WOOD , the testatrix whose name is signed to the attached or foregoing instrument, ~-aaving been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and volun- tary act and deed, for the purposes therein contained. ~=Sworn and affirmed to and ack.owledged before me L~!en R. Wood , the testatrix , this day of November , A. D. ~00].. .... Notary Public COMMONWEALTH OF PENNSYLVANIA ) : COUNTY OF CUMBERLAND ) SS. Sworn and su~sc~zibed to before me this (~ day of November , 2001. We, the undersigned, J. ROBEHT STAUFFF~R and KAT}'[5[ S. LITTLE , the witnesses whose names are signed to the attached or foregoi.g instrument, being duly qualified according to law, depose and say that we were present and saw the testat rix , I~LEN R. WOOD sign and exe- cute the instrument as ~her Last Will and Testament; that the said testatrix , }~I~'~ R. WOOD , executed it as ~/her free and volu.tary act for the purposes therein expressed; that each of ns, tn the hearing and sight of the testatrix , signed the Will as witnesses; and that to the best of our know'ledge, the testat rix was, at the time, e~ghteen (]8) or more years of age, of souud mind, aud under no constraint, duress or undue influence. Notary Public -4-- Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717)240-6345 Date: 09/01/2004 STAUFFER J ROBERT MARKET SQUARE BLDG MECHANICSBURG, PA 17055 RE: Estate of WOOD HELEN R File Number: 2004-00514 Dear Sir/Madam: It has come to my attention that you have not filed the Certification of Notice Under Rule 5.7 (a) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing will become delinquent on 09/12/2004 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, CC: File Personal Representative(s) Judge Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717)240-6345 Date: 09/01/2004 WOOD DONALD L 5240 STRATMORE DRIVE MECHANICSBURG, PA 17050 RE: Estate of WOOD HELEN R File Number: 2004-00514 Dear Sir/Madam: It has come to my attention that you have not filed the Certification of Notice Under Rule 5.7 (a) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing will become delinquent on 09/12/2004 Your prompt attention to this matter will be appreciated. Thank You. cc: File Counsel Judge Sincerely, GLENDA FARNER STRASBAUGH Clerk of the Orphans' Court COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OFINDIVIDUAL TAXES DEPT 280601 HARRISBURG, PA 17128 0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) NO. CD 00435O STAUFFER J ROBERT MARKET SQUARE BLDG MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN: 195-28-0765 FILE NUMBER: 2104-0514 DECEDENT NAME: WOOD HELEN R DATE OF PAYMENT: 09/08/2004 POSTMARK DATE: 09/08/2004 COUNTY: CUMBERLAND DATE OF DEATH: 05/20/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT :04120946 960.95 TOTAL AMOUNT PAID: 960.95 REMARKS: · SEAL CHECK# 0694 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS Name of Decedent: CERTIFICATION O~F NOTICE UNDER RULE HELEN R. WOOD Date of Death: May 20, 2004 Will No. 2004-00514 Admin. No. To the Register: I certify that notice of (beneficial interest) ~dt~te,~Lnlj!li~ation 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 Nam~ Donald L. Wood-~_~0 StPatmoPe Kelly[ Wentz-290! Mildred E. Addr?~ D~tve Mechanicsbur PA 1 0 0 01d Stone House Road~_~CarlislePA~ Wood-10?22 Leo~d nth San Antonio Texas 82 1 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except MOl'lO Date: September 8, 2004 Name J. Robert Stauffer Address Market Square Bldg. Mechanicsbupg, PA 17059 Telephone'/17) - 7 6 6 - 9 6 7 3 Capacity: ~ Personal Representative x ~Counsel for personal representative DONALD L WOOD 5240 STRATHMORE DR HECHANZCSBURG PA 17050 ZNFORMAT'rON .NOTZCE[ FiLE NO ;,10q AND J - -0SZq TAXPAYER RESPONSE I ACM 0~09q6 ,:~" ~.: ,~f TYPE OF ACCOUNT : ':g~, OF HELEN R ~OOD ~sAvz~s 8,'S. NO. 195-Z8-0765 ~ CHECKZNe DA~ OF OEAT~ 05-ZO-ZO0~ ~ TRUST REHIT PAYMENT AND FOR~ TO: REGISTER 0F ~ZLLS :: CUMBERLAN~ CO COUgT HOUSE .' 2., ,?:~.~ CARLISLE, PA 27015 PNC BANK has provided the Department ~Ith the Infatuation ltet~ bolo~ ahiah has bmen Used in calculating the POtential tax due. Their records Indicate ~et et the dea~ of the abo~ d~md~t, You Uer.. Ja~nt a~er/b~e¢lClar~ of ~is accost. If you feel ~Js information is Incorrect, plea~ obtain ~rltte. correction from the fJn~clal lnsti~tlon, attach . to this {ora and re~rn it ia ~e above a~rmss. This account Is ~x~le In accordance ul~ the [nhertt~ce Tax [l~l of the of PennsyLvania. Ouesti~s may ~ ~S~ered by ceiling (717) 787-a3ZT. COMPLETE PART I BELOg a g ~ SEE REVERSE SIDE FOR FILINg ANO PAYMENT ZNSTRUCTZONS Accost No. 21001012976 Oa~m 07-17-1987 Established To insure propor credit to Your account, two (2) copies cf this notice wuet mccompany your iccoun~ Bml~em 2,709.05 Paym~t to ~ Register o; WILls. Mmkm check Parcmn~ Table X 50. 000 payable to: -Registerer.' A~n~ Sub~mc~ ~o Tax ~ C~) m~ths of ~ ~0 ~5 -- ~Y ~erl~ncm ~ ~m .111 beco~ ~linq~nt A. ~T~ above 1nfar~tjan end tax d~ ~ ~orr~t. 1. Y~ ma~ ~osm ~ r~lt payment ia ~a Register of Mills .i~ ~o e~les of this notice to ~taln ~ CHECK ~ .dtsaoMntor.voldint.rest, oryou..y~ok~x.,.andr.~rnthls,iic, to~.R.ajstaro, ONE ~ills and mn o~lclal msses~ent .Ill ~LOC~ B. ~ The above asset has be~ or ~Jll be repor~g and ~x Paid .t~ ~e Pe~s~lvnnla Inherit~ce Tax return ONLY ,o bm flied by the dOCent's representative, C. ~ The You above information lust comp[ate PART ~ ~d/or PART ~ bmlov, dl~ti~s wrm Paid by you. TAX RETURN - COMPUTATION OF TAX ON JOiNT/TRUST ACCOUNTS LINE ~. ~tl Est~/tshed 2. Ae~un~ BaI~oa 3. Pe~c~ T~xable 3 X q. ~un~ Sub~c~ ~o Tax ~. O~s ~d Deductive S 6. ~n~ Tax~le 6 7. Tax Ra~a 8. ?ax ~. PART ~ DEBTa AND ~EDUCTZON8 CLASHED DATE PA~D PAYEE ~ ~ 0ESCRZPTZON ~ ~ AHOUHT PAID ~d belief ..... ~ ( None GENERAL ZNFORHAT]:ON 1. FAZLURE TO RESPOND #ZLL RESULT TN AN OFFZCZAL TAX ASSESSNENT eith epplioable interest baled on ]nfor~ation 2. %nherttlnee tax beagles delinquent nine cant{la after the decedent's date of death. 5. A joint aoemant is toxable even though the deGedent's none Nas Idded el · matter of oonvenjence. 4. Accounts (including those held betuaen humbond ~nd wife) which ~he decedent put in Jo/at na~es #ithJn one year prior to demth itl fully tlXabll is transfers. 6. Accounts held by · deq~dmnt 'in trust for' another or others ara taxable fully. REPORTING ZNSTRUCTIONS - PART I - TAXPAYER RESPONSE 1. BLOCK A - Zf the inforontton end computation tn the notice ara correct end dedu~tiuns or~ net being oleJeed, place in "X' (Furl ~V-lSq8 EX) ~on receipt of ~e return fr~ t~ RNlster ef ~velope prov~d. BLOCK C - If ~ notice in~rlatJ~ is i~orr~t a~/or de~ttnns are being ciailed, ~ b]o~ ~" ~d =O~e~ Parts R a~ ac=ording to ~ instructions ~1~. Si~ ~o COpies ~d SUblit thai .l~ Your chKk ~or ~e oount of ~x ~le to ~e R~Jstir of ,ills of ~e coun~ indicated. T~ PA ~plrteent of Revenue .ill ~s~e an off~e~a~ assesm~t CForl ~V-~ EX} Won re~ipt of the return froa the RegJvter of TAX RETURN - PART Z - TAX COMPUTATION LZNE 1, ~ter ~e dire t~ muc~t originally ~s es~li~ed or titled in ~ m~r existi~ at ~ Df For a deoident dylna i~ter ]Z/I~&~{ ioe~tl which ~e dKedint put In Joint nmos kirin mi C1] yeir of del~ are the Kc~t or ~ ~lr o~ Ioe~tl hlld. Zf a double ns~r3~ (~) ~peers be~re your first nan in ~ a~rass portl~ of ~ls note=e, ~e $3,000 exclusion The pe~int of t~ aec~nt ~at is taxable for each su~Jvor is ~terlJned us A. The percent ta~bll ~r Joint assets establi~ed more ~e o~ yilr prior to ~m deo~t's ~ DIVIDED aY TOTAL N~R ~ D~V~OED BY TOTAL ~ER DF X lDO - P~NT T~L~ ~ZNT ON.RS N~IVINC JOINT I DXVZDEB BY S (~ZNT ON.RS) ~XVXD~ ~Y 2 (S~VXVOflS] - .167 X ZgO = 16.7Z (TREBLE FOR E~ S~VIV~) B. T~ ~rc~t taxable ~r assets created .ithln one yiir of the ~o~flt's d~th or ~co~ts o~ld by ~e ~ce~t but held in trust for ano~ir indiv iduil(s) (~ust I DZVZDED BY TOTAL ~WBER OF SU~ZV~G JOINT g lO0 - P~C~T TAXABLE MERS OR TRUST ~E~FZCZAR~ES ~pZm: Joint acco~t re~lstet4d t~ ~ ~ of ~ M~dint ~d t~ o~r per.ns ~d mst~l/~hed ~lthJn ~m year of death ~ deGedent, I DIVIDED BY Z [S~V~S) - .~0 X 100 - 50~ CTAXAB~ F~ ~H The ameer s~6Gt to ~x El~ ~ ~s datelined by multJply~g ~e 8cc~t ~l~e ~l~nl ~) by the parc~t ~x~le ClOne Enter the tote1 of ~e ~ts m~ Mduet~onS l~ed tn Pert S. &. ~e ,ount tl,bll (line 6) Is ~terml~d ~ ~trKti~ ~m d~ts ~ de,orions (lJ~ 5) fro, ~e mount s~Ject tO tax (lin, 7. ~ter the 8ppr~riate iix rate (line T) l, deterliMd 07/01/~ to 12/$1/94 oz/oz/9s ~o 06/~o/oo '0~ 87/01/00 ~o present OX posed on iht net velum of ir; ;fats ~roe · decals ;d'chlLd toanty-ana years nY ara or younger ut death to or for ~e use a~ m neural pu~t, M ~tive parrot, or u st~plrmnt of ~m child is 0~. The Lineal cluss of heirs inu{u~s gri~mr~ts, p~ts, ~lldrun, and lineal desk,ts. ~ildr~' i~ludms ~1 ~ildrm uhat~r or not ~oy hove bm~ ~op~d ~ otMrs; u~pt~ chlldr~ and st~ ~tld~n. 'Li~IA doo~ndmts' l~l~os ILl chiJdr~ of the nsturui pur~ts K ~lr de~eflts) ~ihr or ~t ~.y h~e been I~tud by others) idoptld de~d~ts ~d end st~-dese~ts. "Slbli~s' itl difJn~ il 3nd~vt~.~s uho hove ut ~.8st ~e parent ~n c~ Mtt~ ~a ~Go~t, ~t~it bY b~ood ur a~ptlon. ~e "Co~latg~' c~ass of hairs t~3~as aL~ qtMr beneficiaries. CLAZMED OEDUCT~0NS - PA~T ~ - 0EATS AND DEDUCTZONS AAlu~b~e debts ~d ~duetlans irl determined us YOU ~lgl~[y Itl respmsible ~r puya~t; or the istlto s~Jeet to ~l~ntstratlon by u pers~u~ rlp~slntitlve Ls ~n~ff~etant to ply ~i duduottblm ~. You ac~y paid tho deb~* Iftlr death of t~ dKint ~d can fu~l~ proof Df C. Debts being GlUlaud must be lt~Jztd ~ In Part 3. ~f 8ddttl~ul ~ucu ~s ne~.d, use p~a~n paper 8 2/Z' X ~'. Pr~f of plyment may be re~ested by ~e PA D~Br~Mt 0T j~~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER _o 4 o 05 4 DECEDENTS NAME (LAST, FIRST, AND MIDDLE iNITIAL) UOOD, tIelen R. SOCIAL SECURITY NUMBER 195 - 28 - 0765 I.- z 14.1 /'! DATE OF DEATH (MM-OD-YEAR) DATE OF BIRTH (MM-DO-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE LU May 20, 2004 ,Tul_y 27, 1918 REGISTER OF WILLS ILl (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER C) II'/A - - [~]1. Original Return D4. Limited Estate [~6. De.dent Died Testate (A~ch copy of Willl []9. Litigation Proceeds Received I~2. Supplemental Return 1~4a. Future Interest Compromise (date of dealh after 12.1262) [~7~ Decedent Maintained a Living Trust (A~t ach ~}py of Tis0 [~10 Spousal Povedy Credit (dale el death hel~een i2-31-91 and 1-1-95) NAME J. Robert Stauffer, Atty. FrRM NAME (~f Aopj~ue) N/A TELEPHONE NUMBER 717-766-9673 ~}5. Federal Estate Tax Return Required __ 8. Total Number of Safe Deposit Boxes I~11. Election to tax under Sec. 9113(A) (A~c~ S~ O) COMPLETE MAILING ADDRESS Market Square Bldg. I West Main S~. Mechanicsburg, PA 17055 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnemhip or Sote-Pmpdetomhip (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Pemonal Property (5) (Schedule E) 5. Jointly Owned Properly (Schedule F) (6) r-] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probata 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, Chadtabts and Devemmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Lir~ 12 minus Line 13) 1~6,000. O0 0.00 O,OO O.OO 7,649.80 O. O0 O. OD (8) 30,576.19 (11) (12) (13) OD O0 163,649.80 30,576.19 133,073.61 0~00 (14) 133,073.61 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers ueder Sec. 9116 (a)(1.2) O, OD x .0 (15) 16. Amount of Line 14 taxable atlineal rate 133,073.61 x .o 45 (16) 17. Amount of Line 14 taxabhe at sibling rate O. O0 x .12 (17) 18. Amount of Line 14 taxable at ~llateral rote O ..00 x .I5 (18) 19. Tax Due (19) O.OO' 5,988.31 0.OO 0,OO 5,988.31 Decedent's Complete Address: Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments -'~ O. OD A. Spousal Poverty Credit B. Prior Payments O. OD C. Discount O. DO 3. Interest/Penalty if applicable O. Interest O. OD E. Penalty 0, O0 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 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. (f) 5; 988.31 Total Cradits (A + B + C) (2) O.OO Total Interest/Penalty ( D + E ) (3) O. OD (4) O. OD (~) 5,988.33. (5A) O. OD (SD) 5,988.31 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE, 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; ............................................ [] [] O. 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 bank account or security at his or her death? .............. [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate ProPertY which contains a beneficiary designation? ........................................................................................................................ [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and th the best of my knowledge and belief, it is t~ue, correct and completh. Declaration~r~j~,~re~repare~ other than the personal representative is based on all in~orrnaltan of which preparer has any kpowledge. sIGNA'~,:I/~LOF PERSON RESPONSIBLE FOR FlUnG RETURN DAT[ ADDRESS ~420 Strathmore Drive, MechanicsbUrg, ~A ~O50 Square ~g., ,.,echanicsburg, P 17055 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 transfem to or for the use of the surviving spouse is 0% [72 RS. §9116 (a) (l.f) (ii)] The statute does not exemut a transfer to e surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return ara still applicable, even it the surviving spouse is the only beneficiary. For dates of death on or after July l, 2000: · The tax rate imposed on the net value of transfers from a deceased chiid 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 lo or for the use of the decedenrs siblings is 12% [72 RS. §g116(a)(l.3)]. A sibling is defined, under Section 9102, as ap individual who has at least one parent in common with the decedent, whether by blood or adoption. RE2399 Case N~rnb~ ABST#6 02 JUDITH L. CUPP ESTATE OF HELEN R. WOOD $ HICKORY LANE DONALD L WOOD, EXECUTOR MECNANICSEURG, PA 17055 C/O J. ROBERTETAUFFER, ESQ. 1 WEST MAIN STREET ,~ MECHANICSRURG~ PA 17055 513 &SlS E. LOCUST STREET, MECHANICSEURG BOROUGH OF MECNANICSEURG CUMBERLAND COUNTY PARCEL NOS. 17-23-0S&3-003,008A N/A 5 Soulh Hanover St. 25-1730638 Carlisle, PA 17013 J. SU/Vd~4ARY OF BORROWER'S TRANSACTION December 20, 2004 10:00 A.M. Carllsle~ PA 17013 5 South Hanover Skeet K. SUMMARY OF SELLER'S TRANSACTION SEWER PAID 10/1/04 THROUGH 12/31/04. $191.24 SEWER PRORATION TO DECEMBER 20, 2004 1S6,0OO.O0 2,348.50 24.96 20.67 T ,007.77 404 SEWER PAID 10/1/04 THROUGH 12/31/04. $191.24 4o5 SEWER PRORATION TO DECEMBER 20, 2004 Io 12/20/04 156,000.00 24.96 20.&7 1,007.77 157,053.40 20,000.00 (20FOOO.O0] 139,401.90 23,710.40 157,063.40 (23~710.40) 133,343.0g g S~ eoo Ilems Payable In Connection Wllh Loan: ~o Ilems Requked Ey Lender To Be Paid In Advance: I~oo Resew~s Deposlfed Wlfh Lender: ~oe Aggregale Sefllemenl AdJus/men! .000 % Io .000 % lo FREY & T1LEY/CHARLE5 E. SHIELDS, III S Endmsemenb: $ Commonweallh L.a?d Tllfe Insurance Co. .14co Tolal Seltlemen! Charges (enlm oMInes 103, Section J and .S02, Section ti) 7ti0.00 38.60 I0$&O.O0 1,S&O.OO 3,710.40 ~EV-1502 ~X+ (6-98~/~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ]'I~T~I: R. ~OOD SCHEDULE A REAL ESTATE I FILE NUMBER 2004-00514 21-04-0514 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which proper[y would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. AI,L Tt[AT C~ITAII[ House and tract of land situate in the Borough of Hechanicsburg, County of. Cumberland and State of Pennsylvania and ~e~ng Lots I~os. 57, 56, 55~ 54, 53, 52, 51 and 50, located on the North side of East Locust Street as shown on a certain Plan of Lots known as "College Park", which said Plan is recorded in the Cumberland County Reeorder of Deeds Office in Deed Book "S", Volume 5, Page 600. }~VING thereon erected a two story brick and aluminum siding dwelling known aud numbered as ~13 and 515 East Locust Street, Hechanicsburg, Pennsylvania. Sold on December ~0, 2004 to Judith L. Cupp for $1~6,000.00. 156,000.00 TOTAL (Also enter on line 1, Recapitulation) $ 156,000. OO (If more space is needed, insert additional sheets of the same size) MY73 i0 --03) Harnsburg. PA 17104-2516 MOTOR VEHICLE VERIFICATION OF FAIR MARKET VALUE BY THE ISSUING AGENT This form is used in conjunction with Forms MV-1, MV-4ST. MV-217A and an on*line processing] Applicant Summary Statement. TYPE OR PRINT ALL INFORMATION AS REQUESTED FOR DEPARTMENT USE ONLY AGENT VERIFICATION OF FAIR MARKET VALUE - Check ( v' ) the appropriate block: "~ I certify that the average Fair Market Value for the vehicle described above is ~-o~/~.~', O vedfied by lhe current edition of a PENNDOT approved publication. J j:~ This vehicle or the fair market value for this vehicle was not lisled in a current a edition of PENNDOT approved publication in my possession. 'PURCHASER INFORMATION PRICE Explain In deloll why the purchase pnce Ii, led on Foam MV*t. MV-4ST or MV-217 is less than 80% of the average Fair Market Value. o~ d ~e vehicle is over 15 years old an the purchase prtce is lass than $500. explain how ~e purchase pdce was determined, or it the vehicJe is not listed in a PENNOOT a~3~oved puDlicafion; explain how th purchase price as lisled in Section A was dele~ined. Please use adddional paper if more space is required. NOTE TO PURCHASER: AIl addPJonal audi! of this vehh=l lale bY the Deoanment of Revenue may occur. Please retain copies of this form, your cancelled check or oHglnol c. lsh receipt, and your receipt from the seller c this vehicle, along with either your copy of the Appllcallon tot Certificate of Tthe (MV-1), the Vehicle Sales and Use Tax Return/Application for Registration (MV-4S1 or the Application by Financial Instilu~rUflcate of Title Alter Default by Owner IMV-217A}. I EI I . UN ISUBSCRIBED AND SWORN ._....~--~'~ OF SELLER - NOT REQUIRED FOR VEHICLES PURCHASED OUT-OF-STATE $ U B S C RIB E D AN D SWORN ....._.'7'~..~'./'l~' ~ ~ TO BEFORE ME: DAY YEAR I · I MyCoam on ,ms Jurm 15, 2e061 BEFORE M_E: ~ ~O.~NNTH~....--.~ DAY YEAR IDO LIS8s / THIS FORM MAY BE PHOTOCOPIED I/We s~ate that I/we have read and signed Ihis fo~m a~ter its completion, and IN swear of alfirm thai the stalemenls made herein are ~ and co,ecl, and that a~ ;l~temenl made on or pursuant Io this form is subject to the penalties o! 18 PA CJ SeclJon 4903(a)(2Xrelating to false swearing), which shall include punishment o! ~ne not exceeding $5.000. or to a term or imprisonmenl of not more than twoyear eth- nature o! Co-Seller Telephone Number( J....-~ 9/? nd thM a~ pursuant lo this term is subject to the penalties of 18 PA C. Io false swearing), which shall include punishment of $5.000. or Io alerm or Imprisonment o~ not more than Iwo yem .' of Purchasertr'(- 0'~.~'/~P~-~ Sig6alure of Co-Purchaser Telephone Number (7',/7') 75/- ~:~2//--~C>~-. Messenger No. Items of value mentioned in the LAST WILL AND TESTAMENT OF Helen R. Wood Date of death 5/20/04 She bequeath her dest and small armless rocker to her granddaughter Kelly Wentz. Desk value of $225.00 Small Armless Rocker value of $$65.00 She bequeath her table lamp to her daughter in law Mildred E. Wood Lamp value $500.00 Other items such as personal belongings and household furnishings were sold by public auction by Hanr's Inc. Dillsburg, Pa. Value of items sold were $535.50 of which 321.30 was deposited in her estate account. (Hanr's commission was 214.20 This submitted by Donald L. Wood executor Oat m: 08-03-2004. HAAR'S AUCTION 717-432-8246 Settlement HELEN WOOD ESTATE 761-3036 Page: 1 Seller: 6811 C/O DONALD [-'WOOD 5240 STIATHMORE DR MBG PA 17050 Item Description Price Qty Total Stand 1 '5.00 Wicker stand 1 0.2500 Plant stand 1 5.00 Board 1 ?.00 Saw-hose 1 2.00 Chairs 1 1.50 Blue chair-pink chair 1 3.00 Light 1 2.50 Lawn chair 1 0.5000 Beach chairs 1 0.5000 Chair 1 1.50 Card table 2.00 3 6.00 Swing 1 22.00 Floor lamp 1 0.2500 Table & 4 chairs 1 40.00 Chair(s) 3.50 4 14.00 Stool 1 8.00 Chair 1 3.00 Stand 1 5.00 Stand/record cabinet 1 9.00 Dresser-mirror 1 5.00 Coffee table 1 5.00 Chair 1 10.00 Dehumidifier-chair 1 1.00 Cabinet 1 0.5000 Chair 1 3.00 Vanity bench 1 ?.00 Chairs I 0.5000 Beach chair 1 0.2500 Walker-chairs 1 0.2500 Wicker chair 1 4.00 Dresser-mirror 1 13.00 Dresser-mirror 1 3.00 Bed-rails 1 0.2500 Tv 1 7.00 Bed complete 1 8.00 Wardrobe 30.00 2 60.00 Items: 37 Amount: 263.75 Commission at 40.000% 105.50 www. haars, com HAAR'S AUCTION Less adjustments: Net due to seller: 717-432-8246 -105.50 158.25 Date: 08-10-2004 www. haars, eom Settlement Sel le~: 6811 HAAR'S AUCTION HELEN WOOD C. 0 DONALD L WOOD 717-432-8246 Page: Item Description Price Qty Total Box lot 1 0.2500 Box lot,canister set,box lots, whole lot Wine rack Egg basket Shakers Bone dishes Plate I=igurines Hall bowl Soebel peep Minie~dogs Cassettes Tray lot Box lot Dog Pictures Cup and saucer Otc vase Picture Bag lot Bedspread Box lot Pictures Basket lot Creamer Box lot Dishes Hull as is Stool Fiesta plates Basket lot Stand Frames Elec knife Box lot Frames Rugs Head vase Corning dishes Corner shelf Knick knacks Head vase Fan Vase Dish lot 1 t 3.00 0.2500 9.00 26.00 0.2500 7.00 10.00 0.2500 3.50 12.00 0.1500 0.2500 0.2500 6.50 0.2500 0.2500 0.5000 0.~500 0.5000 0.2500 0.2500 0.~500 0.5000 4.00 1.25 1.00 0.~500 0.7500 5.00 ..... 0.?500 1.50 0.1500 0.2500 0.2500 0.1500, 2.00 ~2.00 0.2500 2.25 0.2500 ~30.00 1.50 1.00 0.8500 ~8- i 0"--~:004. ~/WW. haa~s, c2om HAAR'S AUCTION. Bert lement ~eller: 6811 HELEN WOOD C.D DONALD [. WOOD 5240 STIATHMORE DR MBG PA 17050 Item 1)escript Sweeper lot Tumblers Box lot Wind shield Box lot She 1 f T i n Derby glasses Tray 1 ot Jar Plaques Dishes Vases Box lot Tray 1 ot Tray lot Box lot Ladles Flatware Iron skillet Shakers Light Dish lot Box lot Glass lights Eye glasses Tray lot Dish lot Corningware Basket lot Cds Box records Sheet set Grinder 45rpm records Lot 45rpm records Light so 1 vent 717-432-8246 Commission at 40.000% HAAR'S AUCTION Price Dry 1 1 1 1 1 1 1 1 1 1 1 1 1 i 1 1 1 1 1 t 1 1 1 1 1 1 1 1 1 1 1 1 1 1 t Items: 83 Amount: 108.70 Less adjus~men~sl. Net due ~o seller~ 717-432-8246 Pagm: '8/5 Total ~,1.00 1.8~ 0. 5000 0. 1500 4.00 0. ~500 40.00 10.00' 0. 5000 0. ~500 0. 2500 0.5000 0. 1500 0.8~00 0. 8500 0. 7500 1.50 0. ~500 1.85 1.00 0. 5000 0. 5000 0.8500 0.2500 0.5000 .5.50. 3.50" 14.00 3.~0' 0.8500' 6.00 0.~000 6.00 0.2500 ~71.75 ,,, -108.70 163.05 Total Bmfldng Statement I'NC Bank_ For the period 05/0612004 to 06/0412004 HELEN R WOOD D£CD 513 E LOCUST ST HECHANICSBURG PA 17055-650Z PNCBAN Primary account number: 51-4007-0388 Page 1 of 2 Nt,~ber of enclosures: 4 .~. For 24 hour banking, customer service and ~ transaction or interest rate information, ~' sign-on to Account Link ® by Web on pncbank, com or call 1-888-PNC-BANK Para servicio en espanol, 1-866-HOLA*PNC Moving? Please contact us at 1-888-PNC-BANK Write to: Customer Service PO Box 609 Pittsburgh PA 15230-9738 ![~ Visit tls at pncbank.com i~I'DD iermi~al: 1-1~0~-~3 %1648- For hearing impaired clients Relatioqahip Overview Bank Deposit Accounts Description Regulm' (-:liecki,g C. et Ii{Ionic(s) ( )[ Deposit Total DeposHs Account Number 51-4007-0388 Total of ] Deposit Balance 1,325.80 2,712.97 4,0~8.27 Regular Cheoking Account Summary Accouut number: 51-4007-0388 Helen R Wood Decd Balance Summary Beginning Deposits and balance other additions 3,,t05..13 1,225.05 deductions 3.365.18 Average monthly 3,180.75 Tranaaotion Summary Checks pa)d~ Check Card POS Check Card/Bankcard withdrawals signed transactions POS PIN transaclions ........... 5 ...... 0 ......... 0 Tolef ATM PNC Bank Other Bank transactions ATM transactions ATM transactions Please see the Activity Detail section for  additional information. J · ~ p~l~ ~ 0 0 O Activity Detail Dopoeits a.d Other Additions Date Amount Description 06/01 1,003.05 Direct Deposit - CivU Selx, ~,~ LIS 'l'l'eastll3' 312 A 1706519 0 (:SA 00/01 222.O0 Dilect Deposit - C;ivil Sel~ US Treasury 312 F 0224585 W C~$F There were 2 Deposits and Other Additions totaling Cl,oeke Check Date Reference number Amount paid number 5,120 25.00 05/12 o25~r~,1~o 5'121 15.,11 05/17 028210933 Check Date Reference number Amount paid number 5422 42.24 05/18 o2~/t~t2~ 5423 57.48 05/21 003195778 Total Statement ~[~ ~0r 24-hour customer service information, sign-on to Account Unk ® by Web on pncbank.com or call 1-888-PNC-BANK Account number: ~ 1-4007.0888 - continued For the period 05/08/2004 to 08/04/2004 HELEN R WOOD DECD Primary account number:. 51-4007-0388 Page 2 of 2 Gap in check sequence Online and Eleotronle Banking Dod.orions )ate Amount Description )6/01 1,008,05 Direct Payment- Reversal US Treasury 312 A 1706510 0 CSA )6/01 222.00 Dh'act Payment - Reversal US Treasury 312 F 0224585 W CSF I)ther Deduotione )ate Amount Description )6/02 2,000.00 Withdrawal Tel 0400004101 0017 Therewere4checkslistedtotaling ~140.13, There were 2 Online or Electronic Banking Deductions totaling ~1,225.05. There was 1 Other Deduction totaling $2,OOO.OO. )5/06 S,465.4S 05/17 $,425.02 )5/12 s,440.45 05/lS. s,882.78 C®r~floet®e of Depoelt 05/21 ~,325.~0 06/02 1,325.30 06/01 $,$25.~0 H001012976 60 Month(s) Fixed Rate Donald L Wood Maturity date interest Original or Current 07/17/2007 3.78 % 2,526.74 .~ 2,712.g7 Total o~rrant valuo 2,712.97 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HEI,EI~ R. ~OOD SCHEDULE E CASH, BANK DEPOSITS,& MISC. PERSONAL PROPERTY 'FILE NUMBER 2oo4-00514 21-04-0~14 Include the proceeds of r~gatJon and the date the proceeds were received by the estate. All property jolntly-ovmad with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 7. 8. 9. P!~C !3,\i~IC, ?. A., Chec]rlng Accnunb I~o. 51-4007-03[{8. Haar'$ Auction, net ~roeeeds f~om sale of balance of household furnishings. ¥atue of furniture bequeath under the Will: To Granddaughter Kelly Wentz, as follows: Desk. Small armless llocker. To daughter-in-law, ~[ildred E. l{ood, as follows: Table Lamp. 1994 Oldsmobile, Cutlass sedan automobile~ sold to Marina Kacharova. Ohio Casualty Company, automobile insurance reruns. The Sentinel, refund. Barrett Appraisal Co., refund. Women's ]~orld, refund. Judibh L. Cupp, refunds as follows: Sewer and Refuse collection. County and Borough Taxes. School Tax. 3,382.78 321.30 225.o0 65.oo ~00.00 1,800.00 109.71 43.3 125.oo 20.6? 1,007.77 TOTAL (Also enter on line 5, Recapitutation) $ 7,6[I.9 · 8 0 (If more space is needed, insert additional sheets of the same size) .R EV-'1511 .EX+ (12-g9) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS 'FILE NUMBER 2004_0051~1- 21-o4-0514 Debts of decedent must be reported on Schedule L ITEM NUMBER DESCRIPTION AMOUNT A. 10. 11. 12. 13. FUNERAL EXPENSES: I~echanicsburg Cemetery As:!ocfation , opening and clos ~_ng granve. Cremation Society of Pennsylvania, balance due. St. Paul's ~h~ited Church of Chr'Lst, funeral luncheon. ADMINISTRATIVE COSTS; Personal Representative's Commissions Name ct Personal Representative(s) ~one Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: AttomeyFees J. Robert Stauffer, Esq., attorney fee. Family Exemption: (If decedenrs address is not the same as claimant's, attach explanation) Claimant ~/A Street Address City State __ Zip Relationship of Claimant to Decedent . ProbataFees Register of Wills of Cumberland County Penusylvania, Letters Testamentary. Accountants Fees Tax Return Preparer's Fees Cumberland Law Journal, Estate Notice. PP~ Electric utilities, April 200~ electric. United Water Pennsylvania, water for April 200~. Comcas$, eable ~or April 2004. · lai~ Credit Service, balance due on credit Card. Care for People, home care service. Breuda McIntire, nursing care. Barrett Appraisals, appraising real estate. James Gingrich Memorials, cemetery monument. Lester Erb, Inc., heating fuel. TOTAL (Aisc enter on line §, Recapitulation) 2OO.O0 310.98 3,500.00 266.00 75.00 25.00 , 15.41 36.00 240.00 7a5.oo 57o.oo 58.14 $ Carried Forwar, (if more space is needed, inseri additional sheets ol the same size) PAGE - I ESTATE OF ItELEN R. WOOD SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES Please Print or Type FILE NUMBER 21-04-0514 J~ AMOUNT ITEM NUMBER DESCRIPTION 17. 18. 19. 20. 21. 22. 23. 24. 25. 27. 28. 29. 30. 31. 32. 33. The Sentinel, Estate ~otice. State Automobile Insurance, Homeowners Policy. Borough of Mechauicsburg, Sewer and Refuse Collection. PMC Bank, N. A., checks. Patriot-~ews Co., advertising House for Sale._ AT & ~, due on leasing of telephone. Chuck Bricker, Auctioneer, commission of sale of Real Estate. Locust Point Paving, removing trash, top soil, lawn seeding and dump fee. Recorder of Deeds, real estate transfer tax. Barry L. Heckard, Sr., current real estate taxes. United Water Pennsylvania, final water bill. Verizon, final telephone bill. PPL Electric Utilities, final electric bill. Lester Erb, Inc., finald fuel bill. Charles E. Shields, III, Esquire, legal services. J. Robert Stauffer, Esquire, attorney fee. Register of Wills, filing inheritance tax return. Register of Wills, filing account.. Cash reserved to contingencies and filing final Fiduciary Tax Return. 95.27 420.00 172.i2 27.60 401.00 8.35 1,910.00 11,030.00 1,560.00 2,150.40 11.08 1.40 24.~7 253.50 1,446.00 3,500.00 15.oo 113.oo ~00. o0 Total ................ $ 30,576.19 PAGE-E ' REV-1513 F.X+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HELEN R. UOOD SCHEDULE J BENEFICIARIES FILE NUMBER 2004_00514 2!-04-0514 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not LIst Trustee(s) OF ESTATE ! 1. e 11 1. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. g116 ia) (1.2)] D0~TAI,D !,. ~.;OOD 5240 Strathmore Drive Mechanlcsburg, PA 17050 MILDRED w,. WOOD 3.0722 Leopart Path San Antonio, Texas 78251. KELLY 2901 Old Stone House Road Carlisle, PA 17013 Son Unremarried Daughter-in-Da Granddaughter 5~ of residuar[ estate. Table lamp valu~ at $500.00 and 25% of residuar? estate. Desk valued at $225.00 and Rocker valued at ~.00, plus of residuar~ estate. ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-t 500 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 TOTAL OF PART il - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET (If more space ~s needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA DEPARTMENTOFREVENUE BUREAU OFIND~V~DUAL TAXES DEPT. 280601 HARRISBURG, PA 1712B-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 004808 STAUFFER J ROBERT MARKET SQUARE BLDG MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN: 195-28-0765 FILE NUMBER: 2104-051 4 DECEDENT NAME: WOOD HELEN R DATE OF PAYMENT: 01/07/2005 POSTMARK DATE: 01/07/2005 COUNTY: CUMBERLAND DATE OF DEATH: 05/20/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $5,988.31 TOTAL AMOUNT PAID: $5,988.31 REMARKS: SEAL CHECK//1020 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '* BUREAU OF INDIVIDUA1ttTUES INHERITANCE TAX DIVISION, PO BOX 280601 HARRISBURG PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP 112-DO jj:45 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-21-2005 WOOD 05-20-2004 21 04-0514 CUMBERLAND 101 HElEN R J ROBERtiUSTAUFFER A:ftvF MARKET SQUARE BLDG 1 W MAIN ST MECHANICSBURG fA 17055 Allount RelliUed MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, fA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REv:r!W-EX--AFir-CBr:6J'--NoT'icE-OF-iNHERYfANCE-YAX-APPRA-isEM€N'~-Ar.lowlNcE-bR"-----_._-------_. DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF WOOD HElEN R FILE NO. 21 04-0514 ACN 101 DATE 03-21-2005 TAX RETURN WAS: (X) ACCEPTED AS FILED 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. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) 156.000.00 .00 .00 .00 7.649.80 .00 .00 (8) NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 163,649.80 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expanses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 30,576.19 .00 (11) (12) (13) (14) 30.576 19 133,073.61 .00 133,073.61 I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect figures that include the total o~ ~ returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due NOTE: .00 X 133,073.61 X .00 X .00 X 00 = 045 = 12 = 15 = (19)= .00 5,988.31 .00 .00 5,988.31 ~. TAX CREDITS: R........ . (+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 01-07-2005 CD004808 .00 5,988.31 TOTAL TAX CREDIT 5,988.31 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 IF PAID AFTER DATE INDICATED, SEE REVERSE 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), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) STATUS REPORT UNDER RULE 6.12 Name of Decedent: HELEN R. HOOD Date of Death: :r-1ay 20. 2004 Will No. 200L~-00514 Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes x No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No x b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes x No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may bejttached to this report. / / 7 / I / (/ .-1 /ignature L' J. Robert Stauffer Name (Please type or print) Market Square Bldg. Mechanicsburg. FA 17055 Address ("..J Date: April 20. 2005 L,.' ;.'..1 ,. (717 ) 766-9673 Tel. No. Capacity: Personal Representative x Counsel for personal representative cP (MAH:rmf/AM3) BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE RECOR~n~~~f1~L~~~T~:C~I~:~LONANCE PV:!::pt:!1Il!1l1ll:r~~, AND ASSESSHENT OF TAX ON ~," "'JOINTLY HELD OR TRUST ASSETS *' REV-1548 EX AFP (06-05) Z005 flUG - I PH \2: 27 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 08-01-2005 WOOD 05-20-2004 21 04-0514 CUMBERLAND 195-28-0765 04130946 APPEAL DATE: 09-30-2005 (See reverse side under Objections) ARount Remitted I I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 HELEN R DONALD L WOOD 5240 STRATHMORE MECHANICSBURG CLEH:( OfT: r: - DR J PA 17050 CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS - REY=is4i-EX-AFP-r03=Osi-------------------------------------------------------------------- NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS. AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 08-01-2005 ESTATE OF WOOD HELEN R DATE OF DEATH 05-20-2004 COUNTY CUMBERLAND FILE NO. 21 04-0514 TAX RETURN WAS: S.S/D.C. NO. 195-28-0765 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 04130946 FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. 21001012976 TYPE OF ACCOUNT: ()SAVINGS () CHECKING (>TRUST 0< )TIME CERTIFICATE DATE ESTABLISHED 07-17-1987 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 2,709.05 0.500 1,354.53 .00 1,354.53 .45 60.95 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." TAX CREDITS: " PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 09-08-2004 CD004350 .00 60.95 TOTAL TAX CREDIT 60.95 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER THIS DATE. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. . ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRI, YDU HAY BE DUE A REFUND. S~E REV~RSE SIDE OF THIS FORM FOR INSTRUCTIONS. )