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HomeMy WebLinkAbout04-0161PETITION FOR PROBATE and GRANT OF LETTERS Estate of ~'~ l ,'m ~ ~. /'-4e/lev~ No. also known as To: Deceased. Social Security No. ,~ / - /.~ ~ ~. Jr,5~ The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut r.)r-D in the last wilt of the above decedent, dated ,~5--/~ r-C* ~ _ and codicil(s) dated__ Register of Wills for the County of Commonwealth of Pennsylvania in the named , 19 ,r-go (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in fi_arab er-/~,q d' County, Pennsylvania, with h V/f'. last_ family/sial.,5 P°r )~r?,~principals~oresidence'7~//~,.at ~/9 .q6'~/$~/_~9~,//~ Xeva~,,t~'/~/27WJ~/,~. . (list street, number and muncipality) Decendent, then ?~ years of age, died ,~7 7~ ~-~7 Z4 ~r'4/ 19~'7~/Z at d~r-/~.5/~ ./-/c,6,~',' 7~--7/ / ' " 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: WHEREFORE, petitioner(s) respectfully presented herewith and the grant of letters theron. request(s) the probate of the last will and codicil(s) (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) OATH OF' PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA '1 COUNTY OF ~ 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 well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me this ,/~ ~'~' day of Estate Of t~ £~ /-{cl/~_~ , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW I the .reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated described therein be admiged4o probate and filed of record as the last will of. and Letters -~/-~- ~-r~ are hereby granted to ~'-~r~-~ O_~ b[~ ilb_~ ~r~c~ '~,~o'~ .30 , in consideration of the petition on FEES Probate, Letters, Etc .......... Short Certificates( ) .......... ,~nunciation ................ TOTA~ Filed /~.~.F~.../.7. '. d~.'~/. .................. ATTORNEY (Sup. Ct. I.D. No.) ADDRESS 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 present and saw the testat request of testat__ other subscribing witness(es)). Sworn to or affirmed and subscribed before me this day of 19__ , sign the same and that signed as a witness at the in h presence and (in the presence of each other) (in the presence of the Register (Name) (Address) (Name) (Address) REGISTER OF WILLS OF COUNTY OATH OF NON-SUBSCRIBING WITNESS testat__ of (nne of that ---~ t~ to the best of D_~.~-, ~ (each) a subscriber hereto, (each) being duly qualified according~, law, depose~,~ and say~ that ~-L-~,, .~ familiar with the signature of~ul~n'~,J P ~6IIE ~ , the subscribing wRnesse~ the will presented herewith and codicil believe~he signature on the will is in the handwriting of knowledge and belief. Sworn to or affirmed and subscribed before me this [~ 77-/ day of (Name) (Addrqss) (Address) 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 9990852 No. Local Registrar JAN 3 Date mos.=~3;~ 2/.7 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH '. Pauline ,~ Plainfield t Pa ~ - ~ Brownawell ~.~ ~ ,,. ~ertha Fulton ~~ ~ ~ ~~ Ne~lle, Pa 1'7241 ~~ J c I - Te ~ ~ et ~ ~. ~,m w~ ~ ~ ~ c~ ~ ~ ,as ~ ~ath a~ c~ ,~ ~ S~N~URE ~O TIT~E ~ CERTIFIER ........... ~'...~ ~...~ d. ~,~ ~...(.).~ ~....,...,.,~. ............................. II LAW OFFICE5 LANDIS & BLACK CARLISLE, PEN NSYI-VANIA LAST WILL AND TESTAI~ENT OF 'PAULINE E HELLER I, PAULINE E. HELLER, of West Pennsboro Township, Cumberland County, Pennsylvania, declare this to be my Last Will and revoke any Will or Codicil previously made by me. ITEM I: I direct that all my just debts, funeral expenses and ad- ministra--~ expenses, including my grave marker, shall be paid from the assets of my estate as soon as practicable after my decease. ITEM II: I devise and bequeath the residue of my estate, of every nature ~---~wherever situate, to my husband, Arthur C. Heller, providing he shall survive me by thirty (30) days. ITEM III: Should my husband, Arthur C. Heller, predecease me or die on or before' the thirtieth day following my death, I devise and bequeath the residue of my estate, of every nature and. wherever situate, to my issue, per stirpes, living on the thirty-first day following my death. ITEM IV: I direct that all taxes that may be assessed in conse- quence o--~-----Jeath, of whatever nature and by whatever jurisdiction imposed, shall be paid frommy residuary estate as a part of the expense of the adminis- tration of my estate. ITEH V: I nominate and appoint Dauphin Deposit Bank and Trust Com- pany, Car~e, Pennsylvania, Trustee of the share and of any property of any beneficiary who may be a minor. The income and/or principal of said trust may be accumulated or expended for the maintenance, education and support of such beneficiary as my Trustee, in its discretion, may determine; and myTrustee, in the expenditure of income and/or principal for such purposes, may, in its discre tion, apply the same directly without the intervention of a guardian, or pay the same to any person having the care or control of said beneficiary or with whom ~e beneficiary resides, without d~aty on the part of the T~_~ste~ to s~e~rise or inquire into the application of the funds by any person to whom any payment is so made. The balance of such income and/or principal shall be paid to such bene ficiary upon reaching majority, or to such beneficiary's estate in the event of death prior thereto. ITEM VI: I appoint my husband, Arthur C. Heller, Executor of this, my Last Will. Should my husband, Arthur C. Heller, fail to qualify or cease to act as Executor, I appoint my children, Donald C. Heller and Donna Jo Zinn, or the survivor thereof, Executors of this, my Last Will. ITEM VII: I direct that my Executor or Trustee, or their successors, shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand this ~J~ day of Pauline E. Heller The preceding instrument, consisting of this one typewritten page identified by the signature of the Testatrix, Pauline E. Heller, was on the day and date thereof signed, published and declared by Pauline E. Heller, the Testa- trix therein named, as and for her Last Will, in the presence of us, who, at her request, in her presence and in the presence of each other, have subscribed our names as witnesses thereto. till PAULINE, E. I-IELLER LAW OFFICES LANDIS & BLACK CARLISLE, PENNSYLVANIA 17013 36 SOUTH HANOVER STREET Name of Decedent: CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Date of Death: Will No. ,~ ~ z/~ . E)E)/~ / Admin. No. To the Register: I certify that notice of (beneficial interest) estate administration 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 : Name Address Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Capacity: Signature Name t~~~/~~ Address "~/-//"gF ~'-J/~/_,?,4d~/~,' ~.-7 ~ ,4~ ?-///~ Telephone (~/~) ~97~ _ Personal Representative ~.Counsel for personal representative '04 ~T t5 DONNA J ZZNN 2q8 WH/SKEY RUN RD NEWV/LLE PA 17241 ZNFORMATZON NOTZCE AND TAXPAYER RESPONSE FILE NO. 21 04-0161 ACN 04116512 DATE 04-21-2004 '~ST. OF PAUL/NE E HELLER S.S. NO. 201-18-9685 DATE OF DEATH 01-17-Z004 :~Ok~¥ CUMBERLAND TYPE OF ACCOUNT E~SAV/NO$ ~]CHECKZNO E]TRUST E]CERTIF. REMIT PAYMENT AND FORMS TO: RESISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 MEMBERS 15T FCU has provided the Oepartlent .]th the inforlatJon ZJsthd belo~ .hich has been used Jn COMPLETE PART I BELON # w w SEE REVERSE SZDE FOR FILZNS AND PAYMENT INSTRUCT/ONS Account No. 14611-11 Data 06-01-1994 Established Account Balance 1,075.8q Percent Taxable X 16. 667 Amount Subject ~o Tax 179.31 T~ R~e X .0~5 Po~en~e~ Tax Due 8.07 PART TAXPAYER RESPONSE I. ~ The above Information and tax due is correct. ONE PART Tf you indicate a different tax rate, please state your TAX RETURN - COMPUTATION OF PART TAX ON JOINT/TRUST ACCOUNTS DEBTS AND DEDUCTIONS CLAXNED DATE PATD PAYEE DESCRTPTION AMOUNT PATD TOTAL (Enter on Line $ of Tax Computation) Under penalties of perjury, T d~clara that thl, facts T have reported ~ove ere ~rua, corre=~ and ~l WORK ( ) TELEPHONE NUHBER TAXPAYER ~G~URE CORRON#EALTH OF PEHNSYLVA#ZA DEPARTHENT OF REVEIRIE BUREAU OF XNDIVIDUAL TAXES DONNA J ZZNN Iq8 WHISKEY RUN RD ,~ NEWVILLE PA 1,~, INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. Z1 04-0161 ACN 0q116518 DATE 0q-21-2004 TYPE OF ACCOUNT ~ EST. OF PAULINE E HELLER []SAVINGS · S.S. NO. 201-18-9685 []CHECKZNB DATE OF DEATH 01-27-2004 E]TRUST COUNTY CUMBERLAND []CERTXF. ~ ~ REMIT PAYMENT AND FORMS TO: REGISTER OF MILLS CUMBERLAND CO COURT HOUSE r CARLISLE, PA 17015 MEMBERS 1ST FCU hms provided the Department with the information listed bmlow whlch has been used in COMPLETE PART 1 BELOH ~ ~ w SEE REVERSE SIDE FOR FILINS AND PAYMENT INSTRUCTIONS Account No. Xq611-05 Bate 05-16-1994 Account BaXanca 8q,Zq7.7$ Percent Taxable X 16. 667 Amount Sub~lect to Tax 14s 041 , 57 Tax Rata X .045 Potential Tax Due 651.87 PART TAXPAYER RESPONSE PART Zf you indicate a differen~ ~ax ra~e~ pXease s~a~e your TAX RETURH - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Data EstebXtshad 2. Account Balance 2. 3. Percent Taxable 3 ~,, bo~t Subject to Tax S, Debts md Dm~cttons S - 6. ~o~t Tax,la 6 7. Tax Ra~e 7 8. T~ ~e 8. PART DATE PAID DEBTS AND DEDUCT'tONS CLAZHED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Entmr on Line S of Tax Computation) $ Under pmnalttas of perjury, Z dacXare that the facts T have reported m~ova ere true, correct and c Xm~m to ~hm~ of ~ knowledge and belief. WORK ( ) ~ TAXPAYER ~N~RE TELEPHONE "UM~ER GENERAL ZNFDRHATZON 1. FA/LURE TO RESPOND WZLL RESULT /N AN OFF/C/AL TAX ASSESSHENT with applicable Interest based on Information REPORTING INSTRUCTIONS - PART I - TAXPAYER RESPONSE TAX RETURN - PART Z - TAX COHPUTATION Da~e of Death Spouse LAneal Sibling Co111~®ral 07/01/9q ~o 12/31/9~ 3Z 6Z 01/01/95 ~o 06/30/00 07/01/00 ~o prosen~ OZ q,SZa CLAIMED DEDUCTZONS - PART $ DEBTS AND DEDUCTIONS CLATMED DONNA J ZZNN *04 15 ZNFORNATZON NOTZCE AND TAXPAYER RESPONSE FILE NO. 21 0q-0161 ACN 0q116516 DATE Oq-Zl-ZOOq EST. OF PAULINE E HELLER S.S. NO. Z01-18-9685 DATE OF DEATH 01-27-Z00~ ~ 1N '1 ACOUNTY CUMBERLAND TYPE OF ACCOUNT ~]SAVZNGS [~CHECK/N6 r'"~TRUST r-']CERTZF. REHZT PAYHENT AND FORHS TO: REG'rSTER OF WILLS CUMBERLAND CO COURT HOUSE Z~*8 WHTSKEY RUN RD NENV'r LLE PA CARLISLE, PA 1701:5 COMPLETE PART I SELOH # # ~ SEE REVERSE SXDE FOR FXLXNG AND PAYMENT XNSTRUCTZONS Account No, 1~,611-0~, Oata 02-01-2001 Establ/shed Account BaZance 2,q86. OS Porc~t Taxab'l m X 16.667 Amount Subject to Tax ~,1~,.~55 Tax Rate X .0~'5 Pot~t'lal Tax D~o 18.6~ PART TAXPAYER RESPONSE UNE BLOCK /~ You aust complete PART [] and/ar PART [] be[oH. PART Zf you J. nd:~cate a different ~ax ra~e, please state your TAX RETURN - COMPUTATION OF PART DATE PAID TAX ON JOTNT/TRUST ACCOUNTS DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on L/ne 5 of Tax Computation} $ Under penalties of perjury, 1' declare that the facts I have reportad above are *rue, corrac~ and  ,o 'h. b.s' of my kno.l.~, and b.Z,.f. HOME (~,~) ~, '~ WORK ( ) /~KJ~ TA~AYER SI~AT~ TELEPHONE NUMBER GENERAL INFORHATZON 1. FAILURE TO RESPOND NZLL RESULT ZN AN OFFICIAL TAX ASSESSHENT .lth applicable ~nterast based~ infor.ation REPORTING INSTRUCTIONS - PART I - TAXPAYER RESPONSE TAX RETURN - PART Z - TAX CONPUTATION I Dire of Death Spouse 07/01/94 to 12/$1/94 SZ 6Z 01/01/95 to 06/50/00 OZ 6Z 07/01/00 to prosent OZ 4.SZ~ 12Z CLAIHED DEDUCTIONS - PART $ DEBTS AND DEDUCTTONS CLAIHED COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE j~'~ ~.~'~'~'~'~'~'~'~'~'~ DEPT 280601 HARRISBURG, PA 17128~601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ~ 2t_ 04 00161 DECEDENT~S NAME (LAST, FIRS[ AND MIDDLE INITIAL) Pauline E. Heller - DATE OF DEATH (MM-OD-YEAR) [ DATE OF BIRTH (MMcDD-YEAR) 01/27/2004 [ 06/14/1927 (IF APPLiCASLE} SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURI I'Y NUMBER 201-18-9685 THIS RETURN MD~,I DE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURI/~' NUMBER ~]5. Federal Bo[ata Tax Return Required 8 Total Number of Safe Deposil Boxes r~11. Election ~o tax under Sec. 9113(A) (AC~' Sa' O) o o NAME Donna J. Zinn and/or Donald C. Holler, co-executors ELEPHONE NUMBER 717) 776-6403 1. Real Estate (ScheduleA) /1) 2, Stocks Grid Bo~s (Bohedule B) (2) 3. Ctaseiy Held Corgerabon, Partnership or Boie-Propdetomhip (3) 4. Mortgages & Notes Rece~vabta (Schedule D) (4) 5 Cash, Bank Deposris & Misceflaneous Personal Properly (5) (Schedule E) 6. Jointly Owned Proper~ (Schedule F) (6) [~ Separate B[iiir~ Requested 7 icter-Vivos Transfers & Miscellaneous N on-Pm bste Prope~ (7) (Schedule G or L) 8 Total Gross Assets (tatar Lines 9 Funeral Expenses &Administrai~ve Cos[s (Bohedule H) 10 Debts of Decode ta. Mortgage Liabilities, & Liens (Schedule I)(10) 11 Total Deductions (to(al Lines 9 & 10) 12 Net Value of Estate (Line 8 minus Line 11 RESS DONNA J ZINN 248 WHISKEY RUN RD NEWVILLE PA 17241 made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) 79,780.00 2,57900 45,184.46 (8) 9,462.11 349.00 (11) (12) (t 3) (14) DONALD C HELLER PO BOX 116 SHERMANSDALE PA 17090 127,543.46 9,811.11 117,732.35 117,732.35 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or [ransfers u~ter Sec 9116 (a)(1.2) 16 Amoun[ of Line 14 taxable at lineal rate t7 Amount of Line 14 ta~able at staling ra[e 18 Amount o~ Line 14 taxable at col!atera[ rate 19 Tax Due × o __ (t5) .... 1~7j732.35 ×.0_45 (16) x 12 (17) __ _ x 15 (18) (19) 5,297.96 5,297.96 Decedent's Complete Address: I c~YPlainfield 2095 Ne,cNille IsT^TEPA I z~ 17081 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2, Credib/Payments A. Spousal Pove~ Credit B, Pdor Payments C. Discount (1) Total Credit~ ( A 4- B + C ) {2) interest/Penafty if applicable D. Interest E. Penalt~ Total Interast/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 1 Line 20 to request a refund (4) If Line 1 + Line 3 is greater than Line g, enter the difterence. This is the TAX DUE, (5) A Enter the interest on the tax due, (SA) B, Enter the total of Line 5 + 5A. This is the BALANCE DUE. (bB) Make Check Payable to: REGISTER OF WILLS, AGENT 5,297.96 5,297.96 5,297,96 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS I Did deceden~ make a transfer and: Yes No a. retain the use or income of the property tfansferred; ..................................................................................... [] [] b, retain the nght 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. [f death occurred after December 12, 1982, did decedent transfer property within one year of death 3, Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ............. [] [] 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 SIGNATU~'~OF PERSON RESPOI~JBLE FOR FILING RETURN BATE ADDRESS For dates of death on or after July 1, 1994 and before January t, 1995 the tax rate imposed on the net value of transfers to or for the use of the servrwng spouse is [72 PS §9116 (a)(1 1} (i)] For dates of death on or after January 1 1995, he tax rate imposed on the net value of transfers to or for the use of the survtwng spouse is 0% I72 PS §9116 (a) (1 1) (ii)j or a stepparent of the child is 0% [72 P.S §9116(a)(1 2)1 The tax rate imposed on the net value of transfers to or for the use of the decedent s lineal beneficianes is 45%, except as noted in 72 PS §9116(1 2) [72 PS §91~ 6(a)(1 The tax rate imposed on tbe net value of transfers to or for the use of the decedent's siblings is 12% [72 PS §9116(a)(1 3}]. A sibling is defined under Sect on 9102, as an individual who has at least one parent in common with the decedent, whether by hood or adoption REV-1502 EX+ SCHEDULE A OOMMONWE^LTH Or PENNS¥ -¥, I^ REAL ESTATE RESIDENT DECEOENT ESTATE OF FILE NUMBER Pauline E. Heller 2004-00161 All real property owned solely or as a tenant in common must be reported at fair mad(et value. Fair market value is defined as the price at which propedy would be exchanged between a willing buyer and a willing seller, neither being compell~ to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of sur~ivemhip must be disclosed on Scheitule F. VALUE AT DATE ITEM OF DEATH NUMBER DESCRIPTION 1. 79,780.00 3 bedroom, 1 bat~, 2 car garage, all brick rancher with full basement on .62 acres in West Pennsbora Twp., Cumberland Co., PA. located at 2095 Newville Rd., Plainfield, PA. TOTAL (Also enter on line 1, Recapitulation) $ 79,780.00 (if more space is needed, insert additional sheets of the same size) REV-1508 EX+ (6-98) ',¢i~' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Pauline E. Heller SCHEDULE E J CASH, BANK DEPOSITS, & MISC. IPERSONAL PROPERTY FILE NUMBER 2004-00161 ITEM NUMBER 1. 2. 3 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14 15. 16 17. 18. 19. 20. 21~ 22. 23. 24. 25 include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly.owned with ~ght of survivorship must be disclosed on Schedule F. DESCRIPTION 1992 Nissan Living Room Suit - sofa, Ioveseat, recliner, 3 e~d tables, coffie table, 2 table )amps 4 Cuckoo Clocks Television Dining Room Suit - table, 4 chairs, china cabinet (itchen Furniture - small table, 4 chaim Kitchen Ware - mixed set of eating & cooking utensils Dishes - mixed set of dishes, bowls, cups, baking & cooking bowls, miscellaneous dishware Refrigerator Chest Freezer Electric Mixer 2 Electric Frying Pans Bedroom Suit - bed, dresser w/mirror, chest of drawers, 2 bedside tables, 2 table lamps Bedroom Suit - bed, dresser w/mirror, bedside table, table lamp Sewing Machine Rainbow Sweeper Electrolux Carpet Cleaner Clethes -shirts, slacks, shoes Bedding - mixed sets of sheets, pillow cases, blankets BetJnroom Towels and Washcle~as Maytag Washer and Dryer Dehumidifier 4 Metal Tables Simplicity Riding Lawn Mower Self Propelled Walk-Behind Lawn Mower TOTAL (Also enter on line 5, Recapitulation) $ VALUE AT DATE OF DEATH 750.00 200.00 400.00 2500 5000 1000 1000 50.00 100.00 150.00 25.00 10.00 300 00 100.00 20 00 50 00 500 3000 200 200 50.00 25 00 20 00 50 00 2500 2,45900 (If more space is needed, insert addilional sheets of the same size) REV 1508 EX+ (6~98) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE T,~X RETURN RESIDENT DECEDENT ESTATE OF Pauline E. Heller SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 2004-00161 ITEM NUMBER 26, 27. 28 include the proceeds of litigation and the date the proceeds were received by the estate All property jointly-owned with rigM of su~Norship mt~t be disclosed on Schedule F 29. DESCRIPTION Lawn Spreader Tools - screw ddvers, pliem, hammers, shovel, rake, hoe, brooms Miscallane~us Decorations - pictures, plastic flowers, candies, "nick-hacks" Christmas Decorations - small adflicial tree, miscetianeoos decorations & ornaments TOTAL (Aisc enter on line 5, Recapitulation) $ VALUE AT DATE OF DEATH 25.00 25 O0 5000 20 O0 12000 (If more space is needed, insert additional sheels of the same size) REV-1509 EX* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT OECEDENT ESTATE OF Pauline E. Helter SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER 2004-00161 Donald C. Heller 8. Donna J. Zinn if an asset was made joint within one year of the decedent's date of death, it must be repo~ted on Scbeduh~ G1 SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT PO Box 116 son Shermansdale PA 17090 717) 582-8584 48 Whiskey Run Rd. daughter Newville PA 17241-8612 717) 776-6403 JOINTLY-OWNED PROPERTY: 1. A 06119/1995 Membem' 1st Feder~ Credit Union - N;CL# 14611-11 - checking 537.92 1/3 179.31 2. B. 06/1911995 Members' 1st Federal Credit Union - AccL# 14611-11 - checldng 537.92 1/3 179.31 3. A. 06/19/1995 Members' 1st Federal Credit Union -Acct# 14611-04 - sevings 1,243.02 1/3 414.35 4. B. 06116/1995 Members' 1st FedeceJ Credit Union - AccL# 14611-04 - sa~ings 1,243.02 1/3 41435 5. A. 06/1911995 Members' 1st Federal Credti Ur~on -Acct# 14811-05 - savings 42,123.87 1/3 14,041.57 6. B. )6/16/1995 Mernbers' 1st Federal Credit Union - AccL# 14811-05 - savings 42,123.87 1/3 14,04157 7. A. )4/11/1994 ~Orrstewn Bank-Common St~ck 15,914.00 1/2 7,957.00 8. B. 04/11/1994 Owstown Bank - Common Stock 15,914.09 1/2 7,957.00 TOTAL (Also enter on line 6, Recapitulation)$ 45,184.46 (if mom space is needed, insert additional sheets of ~he same size) ESTATE OF Pauline E. Heller SCHEDULE H FUNERAL EXPENSES & ADMINISTRA11VE COSTS RLE NUMBER 2004-00161 ITEM NUMBER A D~,ts of decedent ma~t be mf~e~ted e~ Schedule DESCRIPTION FUNERAL EXPENSES: Egger Funeral Home, Newv~lle, Cumberland Co., PA. - funeral servmes, casket, burial vault. cemetePj opening, death cer~cates, clergy, obituaries ADMINISTRATIVE COSTS: Personal Repmsentai~ve's Commissio~ Name of Personal Redresenta~ve(s) Sccial Secudty Number(s)/EIN Number of pemonal Representative(s) Sl~eet ^ddress City . State ~p Year(s) Commission Peid: Atthrney Fees Family Exemp~n: (If decedenfs address is ~ot the seine es claimen~s, at~ach explanation) Cleiman[ Sheet Address CH State Zip Relationship of Claimant to Decedent Probeta Fees Cad~sle Sentinel - Executors Not ce TOTAL (Also enter on line 9, Recapitulation) AMOUNT 8,988.00 37200 102.11 $ 9,462.11 (If more space is needed, insed add~ional sheets el the same size) COMMONWEALTH OF PENNSYLVANIA ESTATE OF SCHEDULE I DEBTS OF DECEDENT, MORTGAGE UABIUTIES, & UENS FILE NUMBER 2004-0O161 Pauline E. Heller NUMBER 2. 3. 4. DESCRIPTION Kough's Oil Sewice - heating oil - bill dated 12/12/2003 Sprint - phone service - hilt dated 1/13/2004 PPL Electric Utilities - electric service - bill dated 1119/2004 West Shore EMS - wheel chair transport wi oxygen - bill for service on 1/22/2004 OF DEATH 195.00 23 58 49.92 80.50 TOTAL (Also enter on line 10, Recapitulation) $ 34900 (if more space is needed, insert additional sheets of the same size) 7ax ¥~R O~IE ~SS~S~E~ ~uL NO. C 1 ~O04-~5~~TAX~OTICE ~ SCHOOL ** ~ JULY ~200~ BIG SPRING SCHOOL DISTRICT 79,780 887 DEBORAH W. PIPER, TAX COLLECTOR TUESDAY 1PM-6PM; THURSDAY 1PM-7PM 350 BARNSTABLE ROAD LOSED HOLIDAYS & JULY 22, SEPT 9, CARLISLE, PA 17013-7402 NOV 18 TEL. (717)243-5282 PEN SATURDAY AUGUST 28TH 10AM-NOON  'P MI ~P % ~' ISCOUNT ~ ?p~NALTY ~FTER OCT _ _ _ 8ORA~ '" P~ _..~C~895_.,,~ NEWVILLE ROAD C/O DONNA ZINN LAND 248 WHISKEY RUN ROAD Residential Building NEWVILLE PA 17241 IF UNPAID BY 12/31/04 TAKES WILL BE --,..,.,..~, .......--,~,.~ ....... . ................... __ TURNED OVER TO CUMBERLAND CO. IF 'fa~s~ a~ ~N ~C~OW. ~'U~Wa~U TAX CLAIM BUREAU. THIS BILL TO YOUR MORTGAGE COMPANY $1.00 FEE FOR ADD'L RECEIPTS REQUESTED ~ T~ !iu ESCROW, FORWARD TO MORTCAGE ~ TAX INFO IS NOT AUTOMATICALLY FRW'D BY THIS OFFICE DEBORAH W. PIPER, TAX COLLECTOR 350 BARNSTABLE ROAD CARLISLE PA 17013-7402 MAP NO: 46-18-1394-001 2095 NEWVILLE ROAD ACRES .620 TAX?AYER COPY Bill No: ~ LANO Residential Building RESIDENTIAL HELLER, ARTHUR C & PAULINE BOX 72 PLAINFIELD PA 17081 Control No: 046 - 001601 2(N)4 Statement of Real Estate Taxes Sill Date: 3/01/2004 Assessed Land ~ Improvement Mineral Total Values 29,700] 50,080 0 79,780 COUNI~ OF CUMBERLAND __ Discount Face Penally ~' 6.68 11.27 17.59 17.95 19.7' -" '- i~ TAX AMOONT DUE --> t.~ ~2o$.6o ~28.17 MAR 2 5 2004 ..id o, ooy ?/Ol/ OO If hid en o~ Before ~0/2~4 6/30/2004 DEBORAH W. PIPER"~ ~,o,~v. TAX COLLECTOR WEST PENNSBORO TOWNSHIP TUESDAY 1PM-6PM THURSDAY 1PM-7PM LAST SAT IN APRIL & AUG lO-NOON CLSD HLDYS & 1/22; 3/25; 5/27; 7/22; 9/9 & 11/18'*(717)243~5282 Return Rill with Payment. For a Receipt, Enclose Self Addressed Stau,ped Envelope. DATE 3/01/2004 BILL NO 1425 DESC DEBORAH W. PIPER, TAX COLLECTOR 350 BARNSTABLE ROAD CARLISLE, PA 17013-7402 2004 PERSONAL TAX NOTICE COUNTY OF CUMBERLAND TOWNSHIP OF WEST PENNSBORO CASH ONLY AFTER 12/15/04; $1.00 FEE-ADD'L RECEIPTS UNPAID TAXES SUBMITTED TO DELINQUENT COLL 12/31/04 CTL 46 1409 SSN 201-18-9685 P/C 5.0oooo 4.90 5.00 5.50 MAR 2004 HELLER, PAULINE E. BOX 72 DEBORAI PLAINFIELD PA 17081 TAX C0! WEST COLL TUESDAY 1PM-6PM THURSDAY 1PM-7PM 0mCE LAST SAT IN APR & AUG 10-NOON ~u,s CLSD HLDYS & 1/22;3/25;5/27; 7/22;9/9;11/18 PH: (717)243-5282 NSHlP~.0~ lo. o,, 4.90 5.00 5.50 4/30/2004 FACE PENALTY 5/01/2004 AFTER TO 6/30/2004 6/30/2004 0oC: 002 201 ~49 :- &-90 + 206' ~9 1, THIS IS NOT A TAX BILL Parcel ~n~ ~ ~0~ ~ean ~d ~me. value, ~ tO ~%~e ~ and for~ '~..~ values me e~ive 0~ u~n~a~i~on a~ ~proVaL All ~h~s must be m~[?d by the As~ent 0~ by ~:3~ P~m. on ~ 18, 2~. Those previously ~r~ed ~or Clean ~ Grm dO "0( ~ to ~ply. Penasylvania law requires that ail real estate be valued as of the most recent county-wide reassassmemt. The last rea$$e~srnent, or tax b,,,ase year, was 2000. ,~ince the last massessment tW 2000, prope~e$ have beem asseased at 100% of Year2000 value (the Pm-Determined Ratio'). The hew tax base year will be the Year 2004. with the mew assessed values becoming effective for the 2OO5 tax yeaK The Pre-Determined Ratio remains at l O0% Your new assemsed value equals your Year 2004 rearket value. When the new 2004 tax base is deterreined after this reassessment, alt taxing districts are requirmd by law ~o lower the millage rate by the saree proportion that the tax base went up. The/aw provides that in the first ye~ar after reassessment (2005), the county and all townships and boroughs may not increase overall revenue on their existing ta~xbaae by more than five percent (5%) and school districts may not increase overall revenue on their existing taxbase by metre than te~ percent (10%). The county and the othertaxing bodies will make these decisions next year and may choose n~ot to increase overall revenue. Of course, some individual's taxes wilt go up or down by more than those percentages. The ~ssential point is that an increase in market values does not necessarily mean a corresponding increase in taxes. Ind~idual changes in taxes will depend upon a specific property's change as compared to the overall change for the t~axing district. The ESTIMATED impact statement printed below is our best estimate of change, based on 2004 COUNITY tax figures. THIS ESTIMATE DOES NOT INCLUDE ANY BOROUGH, TOWNSHIP, OR SCHOOL DISTRICT IMPACT. ESTIMATED COUNTY TAX IMPACT: Current 2004 Coun~ mills = 2.352 Adjusted 2004 Coun~-y mills = 2.138 $ 188 : 2004 County Tax BEFORE Reassessment. $ 246 : 2004 County Tax AFTER Reaseessment. MEMBERSHIP/SIGNATURE CARD 14611 O0 ~ 6/20/95 DO NOT WRI~ ~VE THIS LINE ~ ~embe~hJp Infor~tion Type of Account ,~vings*, I-; Christmas Club E IRA*' C Share Cer~ficate** Single [~oict FI Single ~<~oint [ L Single } Other [] [] Overdraft Prote,~on (Number in order of preference---I, 2, 3) ~heck Digit Numbe~/ ..... ~/)l Savings (00) I Investment Savings (05) Designation of Beneficiary for Lite Savings Insurance (if other than Joint Owner) Name of Beneficiary(s} ~ddress ol Beneticiary Type of Ownership (Select one} [ i I ividual Accou~t [3 Minor Account L~ Trust Account J Sole Proprietorship ~ Corporation ~J Other ~o~nt Account L1Cuslodian Accounl iL Estate Account , ~ Partnership ~l Organizational W-9 Certification of Taxpayer Identification Number (Social Security Number) ARTHUR .~,EL ..... PLAINFIELD, PA 1708- i/i6./~3 2,' 5---/03 3,'4/0;; 4/2/0d S."q/03 PAYMENT RECEIVED .... ~':'/"~'~ i56 ~2 ~-UEL ~. ~¢ ~ PAYMENT RECeiVED PA CM~N ~ RECEIVED P 187.5 #i=' FUEL OIL ''~ ~ ~-m '~'~,~ $~90.63 P~YM~NT Rk~:~I V~D P - 181.4 ~2 FUEL OiL ~I.400 40'~0I ~,~53.96 PAYMENT RECEIVED P P 43804 $195~ ~0 ~8637 P - M'S3.96 -$158.73 $I'~5,08 $~,00 $0f00 Monthly statement: January 13, 2004 I of 5 Customer service Internet address Customer number 1-800-829-8009 sprist.eem/tecel 717-24~5723-080 Previous charges Payment January 7 - Thank you! 2§.93 25.93 .00 {~ Please recycle 14930-69007 Summary Page Balance as of Jan 19, 2004 $ 0.00 Charges: Total~PPL ELECTRIC UTILITIES Charges $ 49.92 Total Charges $ 49.92 Account Balance KWH - Average Per Day Meter Reading Information 42 I [Meter #63107131 l Jan /9 Actual 6051 35 IDec 17 Actual 5518 I 28 133 Days KWH Billed 533 I Average - Jan 2003 2004 21 ~empemture 30F 32F KWH Per Day 17, 16 14 Yearly Use: qolal Average 7 Use Monthly Feb 2002 Jau 2003 8088 674 0 Feb 2003 - Jan 2004 7744 645 J FMAMJ JASONDJ 2003 Monlhs 2004 Othcr important information on back INVOICE PATIENT NUMBER: CALL NUMBER: DATE OF CALL: TIME OF CALL: CALLER: FROM: TO: REASON(S) FOR TRANSPORT RECEIPT PAyMEI~T DATE AM0~ PLEASE PAY THIS AMOUNT .--~ ~-" .~'i MEMBERS 1" FEDERAL CREDIT UNION Send Inquires to: ~:i~ b u, PA 170~ Statement ~ / m ~*~ount I 14611 Io]-ol-o4 ~01-31-04~1 of 2 Main Switchboard: (717) 697-1181 or (800) 283-2328 Ca11-24: (717) 097-4372 or (800) 283-4372 TDD: (717) 897-5312 or (800) 283-2328 ext. 5312 TeleBranch: (717) 795-6049 or (800) 237-7288 PAULINE E HELLER C/O DONNA ZlNN/DONALD HELLER PO BOX 72 PLAINFIELD PA 17081-0072 477 ~i3~ANS ~[ . , TRANS~cTIO. D~S~RiPTION :. · : :. AMOUNT i B~NCE DATE SUFFIX=00 SAVINGS 108.~0 31020t PAYROLL DEDUCTION 808.07 916.47 US TREASURY 3t2 - CIVIL SERV 31020z PAYROLL OEDUCTION -808.07 108.40 US TREASURY 3]2 - - CIV L SERV 910204 PAYROLL DEDUCTtON '' 113.00 221.40 US TREASURY 303 - - 50C SEC D10204 PAYROLL DEDUCTION -113.00 108.40 U~ TREASURY 303 - - SOC SEC 013104 DIVIDEND ·~ 108.49 013104 LIFE DIV TRANSFER 2~ 110.91 JOINT OWNERS: DONALD C MELLER DONNA J ZINN Y-T-§ DIVIDENDS: .09 TRUTH IN SAVINGS NFORMATION ANNUAL PERCENTAGE yIELD 1.00~ ANNUAL PERCEN~AGE YIELD EARNED ~ .98~ SUFFIX=O~ LIFE SAVIN~$ ACCOUNT 28~.00 01310h DIVIDEND 2.42 2846.42 13104 LI~E DIV TRANSFER -~.42 2844.00 JOINT OWNERS: DONNA J ZINN/D~NALD C HELLER ?-T D DIVIDENDS:'i 2.42 TRUTH IN SAVINGS ~[ORMATION ANNUAL PERCENTAGE Y ELD~ '~ / 1.00~ ANNUAL PERCENTAGE YIELD',EARNEO/ 1.01~ SUFFIX:05 iNVESTRENT SVGS//~A 84560,3~ D10204 PAYROLL ALLOCATION FROM 14611-00 113.00 84673.33 US TREASURY 303 - ' - SOC sec 010204 TFR TO SHARES 14611-11 -300.00 84373.33 010804 SHARE WITHDRAWAL -200.00 84173.33 -9000.00 75173.33 012804 TFR TO SHARES lg611-1| 87.~8 75260.81 )13104 DIVIDEND JOINT OWNERS: DONALD C HELLER DONNA J ZINN Y-T-D DIVIDENDS: 87.48 TRUTH IN SAVINGS INFORMATION ANNUAL PERCENTAGE YIELD / 1.25~ ANNUAL PERCENTAGE YIELD EARNED/ 1.25% SEND ALL INQUIRES TO THE CREDIT UN[ON AT THE ADDRESS SHOWN ON PAGE # 1 14611 10,1-01-04 [01-31-04 12 of 2 T~ANSr ~F* TRANSACT ONDESCRIPTON AMouNT BALANCE DATE SUFFIX=Il CHECKING BEGINNING BALANCE 583.94 DEPOSITS 10108.07 DRAFTS 616.17 TOTAL NUMBER DRAFT~ CLEARED 6 DEBITS/FEES .00 MAINT/SERVICE CHGS .00 YOUR AVG DAILY BALANCE WAS 2292.88 ENDING BALANCE 10075.84 YOUR LOW MONTH BALANCE WAS 583.94 310204 PAYROLL ALLOCATION FROM 14611-00 808.0? 1392.01 US TREASURY 312 - CIVIL SERV 010204 TFR FROM SHAI~ES 14611-05 300.00 1692.01 0103 010204 SHARE DRAFT 676 0102022910 -12.36 i679.65 0106 010504 SHARE DRAFT I~ 674 0105040110 -500.00 1179.65 0107 )10604 SHARE DRAFT ~! 678 0106006761 -46.26 1133.39 0109 010804 SHARE DRAFT ~ 677 0)08017~87 -25.93 1107.46 679 -1 0115 011404 SHARE DRAFT ~I 0114015658 1.70 1095.76 0115 011)04 SHARE DRAFT ~'. 680 011~015661 -19.92 I075.84 012~04 T~R ~ROM S~ARES 14611-05 9000.00 10075.84 NO. A~O~NT NO. AROU#T NO, A~OUN? NQ, AROUNT 67, 500.0~ 6 7 ~.93 679 11.70 '67~ 12.3~ 6~8 T~AL: 19.92 8O ?~¥ D'DIVID~N~S: .00 ~ TRU~U A~HUAL P~RC[N?AGE FOR ~OOq DIVIDENDS DIVIDENDS DIVIDENDS WrTHHD[OING FORFEITO~ES .00 89.99 89.99 ,00 .00 COF,IMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT 280601 HARRISBURG PA 17128 0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV 1162 EX(11 961 NO. CD 004496 ZINN DONNA JO 248 WHISKEY RUN ROAD NEWVILLE, PA 17241 ESTATE INFORMATION: SSN: 201-18-9685 FILE NUMBER: 2104-01 61 DECEDENT NAME: HELLER PAULINE E DATE OF PAYMENT: 10/15/2004 POSTMARK DATE: 10/15/2001 COUNTY: CUMBERLAND DATE OF DEATH: 01/27/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $5,297.96 TOTAL AMOUNT PAID: $5,297.96 REMARKS: DONN J ZINN SEAL CHECK//6756 INITIALS: VZ RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDTVIDUAL TAXES TNHERTTANCE TAX DIVISTON PO BOX 280601 HARRISBURG, PA 17128-0601 DONNA J ZINN 248 WHISKEY RUN RD NEWVILLE COMMONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLONANCE OR DISALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-iG~i7 EX AFP · PA 17241 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 12-15-2004 HELLER 01-27-2004 21 04-0161 CUMBERLAND 101 Amount PAULINE E WAKE CHECK PAYABLE AND REN'rT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG TH/S L/NE ~ RETAIN LONER PORT/ON FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF HELLER PAULINE E FILE NO. 21 04-0161 ACN 101 DATE 12-15-2004 TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) $. Closely Held Stock/Pertnersh/p Interest (Schedule C) ($) ~. Her(gages/Notes Receivable (Schedule D) (~) 5. Cesh/Bank Depos/ts/H/sc. Personel Property (Schedule E) (5) 6. Jo/ntly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/H/sc. Expenses (Schedule H) (9) 10. Debts/Her(gage L/ab/1/t/es/L/ens (Schedule I) (10) 11. Total Deduct/ohs 12. Net Value of Tax Return 79~780.00 .00 .00 .00 2~579.00 .00 (8) 9,462.11 549.00 NOTE: To /nsure proper cred/t to your account, subm/t the upper port/on of th/s form wi~h your tax payment. 13. NOTE: 127,545.46 (11) 9 .Bll. 11 (1;~ 117,752.$5 Charitable/Governmental Bequests; Non-elected 911:3 Trusts (Schedule J) (1:3) Net Value of Estate Subject to Tax (lq) :If an assessaent was lssued previously, 11nes 14, 15 and/or 16, 17, reflect flgures that lnclude the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amoun~ of L/ne 1~ a~ Spousal rate 16. Amount of L/ne l~ taxable at Lineal/Class A rate 17. Amount of L/ne lq et Sibling rate 18. Amount of L/ne l~ taxable at Collatere2/Cless B rate 19. Pr/nc/pal Tax Due TAX CREDITS: PAYMENT RECE/PT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) 10-15-Z004 CD004496 .00 .00 117,752.$5 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 18 and 19 wlll (25), .00 x O0 = .00 (16). 117,752.55 x 045= 5,297.96 CL7). .00 X 12 = .00 (28) .00 x 15 = .00 (19)= 5,297.96 AHOUNT PAID 5,297.96 TOTAL TAX CREDIT I I BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 5,297.96 .00 .00 .00 ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR ZNSTRUCTZONS.)~-~ RESERVATION: PURPOSE OF NOTICE: PAYNENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decadent after the expiration of any estate for life or for years, the Commonmealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. To ~ulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of ZOO0. (72 P.S. Section 9140). Detach the top portion of this Notice and submit aith your payment to the Register of Nills printed on the reverse side. --Hake check or money order payable to: REGISTER OF HILLS, AGENT A refund of a tax credit, which was not requested on the Tax Return, may ba requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications era available online at www.ravmnum.state.pa.us, any Register of Hills or Revenue District Dffice, or from the Department's 24-hour answering service far farms orders: 1-800-36Z-2050; services far taxpayers with special hearing and/ur speaking needs: 1-800-447-~020 (TT only). Any party in interest nat satisfied with the appraismant, allowance or disallowance of deductions or assessment of tax (including discount or interest) as shown on this Notice may object aithin 60 days of the date of receipt of this notice by filing one of the fallowing: A) Protest to the PA Department of Revenue, Board of Appeals. You may object by filing a protest online at mww.boardofappaals.state.pa.us on or before the expiration of the sixty-day appeal period. In order for an electronic protest to be valid, you must receive a confirmation number and processed date from the Soard of Appeals aebsite. You may also send a aritten protest to PA Department of Revenue, Board of Appeals P.O. Box 281021, Harrisburg, PA 171ZB-lOZ1. Petitions may not ba foxed. B) Election to have the matter determined at the audit of the account of the personal representative. C) Appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, P.O. Box Z80601, Harrisburg, PA 17128-0601 Phone (7173 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decadent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three ($) calendar months after the dmcedent's death, a five percent (SI) discount of the tax paid is allowed. The 15Z tax amnesty nan-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time peried as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .000164. A11 taxes which became delinquent on and after January 1, 19BI will bear interest at a rate which will vary from calendar year to calendar year mith that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2004 are: Interest Daily Interest Daily Year Rate Factor Year Rate Factor ~ ZOZ .000548 ~-1991 112 .000301 1983 162 .000438 1992 92 .000247 1984 112 .000301 1993-1994 72 .000192 1985 132 .0003S6 1995-1998 92 .000247 1986 lOZ .000274 1999 77, .000192 1987 lOZ .000274 ZOO0 77. .000192 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID Interest Daily Year Rate Factor ~ 9Z .000Z47 ZOOZ 62 .000164 2003 52 .000137 Z004 42 .000110 X NUNBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. Cumberland County - Register Of wills One Courthouse Squa~e Carlisle, PA 17013 Phone: (717) 240-6345 Date: 12/16/2005 HELLER DONALD C PO BOX 116 S HERMANS DALE , PA 17090 RE: Estate of HELLER PAULINE E File Number: 2004-00161 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 1/27/2006 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ~dtL. ~'~#.A) 1~~ I" ~ ) GLENDA FAP~ER STRASBAUGH REGISTER OF WILLS cc: File Counsel Judge ~tI Cumberland County - Register Of Wills One Courthouse Square Carlislet FA 17013 phone: (717) 240-6345 Date: 12/16/2005 ZINN DONNA JO 248 WHISKEY RUN ROAD NEWVILLEt PA 17241 RE: Estate of HELLER PAULINE E File Number: 2004-00161 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS. COURT RULESt NO. 103 SUPREME COURT RULES DOCKET NO. 1t for decedents dying on or after July 1t 1992t the personal representative or his counselt within two (2) years of the decedent's deatht shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 1/27/2006 Your prompt attention to this matter will be appreciated. Thank You. SincerelYt 61_ / ,~. ;. ~k~lzru/ ff~p~ Lri>u;4('&.A,;.., ,j,<(t(~ ,I v 'GLENDA FAP~ER STRASBA~GH REGISTER OF WILLS cc: File Counsel Judge ~.{/ ~ ;.S:~~ f;:{ ~ v\ ~,\. ...., ~~ ~J ~ ~ _ ~ _."___.~. ~.-,'t.\'--=-^T~i1iJ _ ~.e ~....,____:i_ ~---.ii _...._...::.l .0_...,...,--.~- ~~(~~JliSl!..tt.!r V! \YW Jl.li..!:L~ Ol!. ~tUi.Jl~.ll.IUN:::.u.:llaL1UJ..U \\_ALVU.l.i.llll.J Name of Decedent: STATUS REPORT lJl\luER RULE 6.12 Po vJ I IV (' i, /Ie/ It I( , Estate No.: I/P~ i/.~ C>Q I~( Date of Death: . 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 ~ 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 t.1.e folbv';:::.g: a. Did the personal representative file a fmal accoi.rri.t with -the Court? Yes 0 No ~ b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account Lnformal1y to the parties in interest? Y es ~ 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. j)~1 c Jk~g, Signature Date: 1/3 Ie" , , ~" 'D(J/VA!q C, Ilel (~< Name f ,," &~ 11(. '.5 he~~N~])lJIe ~. I 7 {) 90 Address '717 5'i;. 'l5Y.V Telephone No. r.. ;"', !~ ,_J -, r Ca-pacitj: ~ PeLs()~al P...epresentati-ve o COllrlSel fOT perso~nal represeIltative {~ r.~' f~{, \'"'..\ g,.... \~\ \~ ~J ~ ~ _.--!_.n__..,~_ ~....17--:rl\T".::lltJ_ _.1!:.n...----T:---.....ii---...:::l .0_-....,-,~- K"...\elSJl.i9l!,tt;;Jr \UlJi 'If>;} Jl.J!.!L;si tUiJ!. '0IULJlJlilll.Ji!CJj:Jl.G::lLJlJitU 'l...AUlIUlJill.ll.Y Name of Decedent: STATUS REPORT Ul'luER RULE 6.12 'VdILI;YlI ~. _~~e-llL.V- Date of Death: ;27- Ten -,;:(004 &: tJf1 Estate No.: '.:IloLf 00/(.../ . 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 ~ 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 the following: a. Did the personal representative file a fmal accoU!l.t with'the CoUrt? . Yes 0 No B" 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 GY 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: ~ - ~n - tJb Jj~A 'i?;AA" Slgnature VOr7,'Jd X ZIr}'7 Name ~:" ~4tf fL}hl;',f~ ~"r; a Address (?/~) 1~? -t<;L&?~ T'elephone 1'10. (',. '" (>'uA [':'l'-C-y',' ~~.._~.~-1 DQ--PS~~+~+;"'P ~"'r-""- .. L-.J ~ \.I.!...;:)VllQ.l. J........""'}I.i...... .....l..l...CLL...l..Y,-, , .. ~ '_ ..J 0 C.oi..ll1se.l for persoTlal represerltative MtOv/& /J1 r7~o/' / ~~