HomeMy WebLinkAbout03-0644PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Estate of f~..I o DEL I--. No.
also known as To:
Deceased.
Social Security No. ~0
Register of W)lls f~r th~ d
County of ~,-~rn~]~-t?C/ in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older, appl
for letters of administration
on the estate of
(d.b.n.; pendente lite; durante absentia; durante minoritate)
the above decedent.
Decendent was domiciled at death in (_~m~e..c [o.~ ~ County,-)Pennsylvania,-w, ith
h '~i/ lastfamilyorprincipalresidenceat ~qZ~ ~,Jadn~t~ ~~ I~. ~rlr~l~
(iist strut, number and muhicip~ity~
Decendent, ye~s of age, died ~ [q Z~ ' ~
Decendent at death owned property with estimated values as folllows:
(If domiciled in Pa.) All personal property $
(If not domiciled in Pa.) Personal. property in Pennsylvania $
(If not do~miciled in Pa.) Personal property in County $
Value of real estate in Pennsylvania $
situated as follows:
Petitioner Ef~after a proper search ha
the following spouse (if any) and heirs:
N e '
ascer.talne~d that decedent left no will and was survived by
E
I oo0~
THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the
appropriate form to the undersigned.
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ]
COUNTY OF ~,,r~[~-I~x~Y ss
The petitioner(s) above-named swear(s) or affirm(s) that the
statements in the foregoing petition are true and correct to the best
of the knowledge and belief of petitioner(s) and that as personal
representative(s) of the above decedent petitioner(s) will well and
truly administer the estate according to law.
Sworn to or affirmed and subscribed
before me this J~'~,~',~] day of
Reg~ter
No.
Estate of
, Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW (-~--~tzz~2-2 2 ~ in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that
is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration
are hereby granted to
in the estate of
FEES
Letters of Administration .....
Short Certificates( ) .......... $ /~..~o
)iation ................
$
.. TOTAL
Filed . ~ ............
ATTORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
RENUNCIATION
In Re Estate of _
ZELONA F.' MCBETH
To the Rcgi.~ter of Wills of
CUMBERLAND
County, Pennsylvania.
The undersigned MARK NEAL MCBETH of
the above decedent, hereby renounce(s) the right to administer the estate and respe~fully ask(s) that Letters
OF ADMINISTRATION
be issucd to DOLORES D. COHICK
WITNBS$
(Addre~)
(Signature)
(Addr~$)
-his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
l,ocal Registrar. The original certificate will be forwarded to the State Vital P, ecords Of-rice fbr permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
P 9374692
No.
PERMANENT
~ Cumberland
~.-:~ ~ m,~) Jacksonville
,,L Secretary ~,,~Ei~. School
442 Walnut Bottom Rd., D-9 ~o~,c~
,~ Carlisle, PA 17013 o~w~)
~. Lester E. Fogelsanger
Dolores D. Cohick
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
J2 Female 13. 202-- 20 --0483 I,. 07/26/2003
] ] la04/19/1927 I.~tnr,~.=g, Pa I'""'"-'~ ..,o~,..~ ~D I~
L. rl~sle I'. Carllsle Regional Medical Center I;.'-:'-~-~o~.= ' I,~ ~ite
- ~3. ~,a 12 0.~5+) ~. Widowed
~..~ Pennsylvania ~ ,~.~ ~.~
~m.~ C~berland ~ ~.~ ~.~
~ Carlisle
],,. Mary A. Fehl
[~. 579 E Street, Carlisle, PA 17013
~[,,, 07/31/2003 [ ~ V~ C~berland County,
- I~,~. ~.... }al ~ [~,tW. Pennsboro Twp. , PA
Name of Decedent:
Date of Death:
Will No.
· ' CERTIFICATION OF NOTICE
· UNDER RULE 5.6(a)'
ZELONA ~F. MCBETH
JULY 26, 2003
Adm. No. 2003-00644
To the Register:
I certify that notice of 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 8 / ~./.03 :
Name Address
SEE ATTACHED
Notice has now been given to all persons entitled thereto under Rule 5.6a) except:
NOT APPI,TCA Bl,l~
Date: g-?.~L-05
Address:407 NORTH FRONT STREET
HARRISBURG, PA 17101
Telephone (71)7 238-3686
Capacity:
Personal Representative
Counsel for Personal
Representative
NOTICE OF BENEFICIAL INTEREST IN ESTATE
BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND~
In re Estate of ZELONA F. MCBETH
No. D~4 of ~D83 ·
TO: RLCHARD M. MCB~T~;
932 ROCKLEDGE DRIVE
, PENNSYLVANIA
, deceased,
(beneficiary)
(address)
CARLISLE~ PA 17013
Please take notice'of the death of decedent and the grant of
letters to the personal representative(s) named below. You may have
a beneficial interest in the estate as follOws:
ONE-THIRD OF THE ESTATE
(if additional space is needed, use back of page)
Name of decedent ZEI,ONA F. MCBRTH
Last known address 442 WALNUT BOTTOM ROAD: CARLTSI,R= PA ]7013
of decedent
Date of death JULY 26: 2003
Place of death CUMR~RT-AND COUNTY, PENNSYLVAMIA
County of grant of original letters CUMBERLAND
Decedent died testate X intestate.
A copy of the will is X is not attached.
Name[s), address(es) and telephone number(s) of all personal
representatives appointed
Name Address Telephone
DOLORES D. COHIC~ 579 E ~TREET; ~API,ISL~, PA 17013 (717) 2~3-0922 -
Name(s), address(es) and telephone 'number(s) of all counsel
Name Address Telephone
ANTHONY T. MC. BETH 'A07 M(]PTW PPn~T~ .R'T.PE.~,T ~-APRT-qRTTP~_ DA !.7101 (7!7) 238+,
3686
Additional information may be obtained from .... '
Date ~' 2~- 0-~ Signature
Name ANTHONY T. MC~
Address 407 NORTH FRONT STREET :-
HARRISBURG, PA 17101
Telephone
(717) 238-3686
Capacity:
Personal Representative
Counsel for personal
representative,
.,:.~., :-. , , ,',.~.:.~,,~,, ,;:..~-~ .. ~. 2~)__..,~
" '' " ~0
a~nnE THE REGZS~ER' u~[ ' ., ~ .... .... ;,~
!:~:'~In' re Estate of~ .. ZELONA ~::MCB~ ."
_?DO3"
. -_ .. ,'~:; -,.
. , ~ ~t~'' .,., ;, . .
~ :;.;.,~:.~ ~ ,;,..,..~,:)~V~,~ .m~.' , 'mr,...-,:~ b,t:q ~'~:'~;',~.;~.: '::-~' ' ~'~:~>J ' '"~ ..... ~, .~ ~.~
""'~; 'g . 186 EAST'~ SE.COND.[STR'EET:"'~4 ,,(.,~,r',.. ....... -(
- ' ........ :b. : NEW ,yORK.~ fi?/'~'e'd~6g '" '~'
.... · ~ ........... ,. ~ ~ ' .; '~,, ,.
tte=s' to, t.~%<~e~,~'naz:re.P~esenta~zve(s')'~';~fla'~e~'''bel°w' You ..ma
.;,,,,;.f.,i.~,i~f,.Ltf~.~;~.~- ~n'."'~h~'."es~a~e' as ~onO'~';:'~. · ? .
· .,.,.: .......................... · ...... ::....,. . .
,ONE-THIRDiOF THE "ESTATE ........
. . . ,~.
':"-"~" me of"'deceden¢''--;~:~-
'"'L" .~as~ known add~ess, 442
,-
' Date of. death~
~].ace of deaC
. '-. ,.. '.' -,' _,~'--.2'..":~'~l~,'.~::~'~;~'~e~s' 'CUMBERLAN
Coun y oI gra~t oI, or~y~n ',.~
Decedent d~eo "-. L ~=~.-,.,'";".'~':.- ' - , ', .
. . - ..,. .::'., ,,', t,'~T ' ,.f.,':.~ ' '
~. copy off ~he wi'~ is4.(:Y.'-:Xq;'~ :~i'~ ~Ho~ a~¢aghed.
~ame(s), address(es) and ~e'~'he;~,n~be~(s) of all personai":~.2
representatives appointed,=/?,:';
"'.:': ........ 'L??:: 7'?AddreS s Te
Name ,,.
'"'~ ] · .-.
........ '[?~':,',..,;
Name(s), add~ess(es) and.telephone .number(s).of all counsel
Name Address T~lePh°ne
T-,T-b P 1~ T-q RTT P (2
ANTHONY T ~.'F:,,~'r. t0'7 ~'T'. ',;;"c,m'..',' (717)
17101
..................... - ~-:'"----~'~:- ..... "-" 3686
t~ 'under s ig~/~.
Additional information may be obtained from ?
Date ~' Z~- 0~ Signature_~. _
Name ANTHONY T. MC~ET~
Address 407' NORTH FRONT STREET
HARRISBURG, PA 17101
Telephone
Capacity:
X
(717) 238-3686
Personal Representative
Counsel for personal
representative
',:"~":(i~)ate of deat.~
- : ·
,,Place of death
"~ ~er~ . CUMBERLAND
COunty of ~rant ~Of' o'=~'na~'~[~
' ' Decedent dzed . ~. testate, ~ X zntestate
~..,.: . .. '? ?"
.'::, ;~ copy of the will is:'.
Name(s), address(es) and
· ~representatives appoint'ed..~
:i,i N.ame ,-:. ~i:i'
:i',7 :: :ii ": "'"' ...."
';: r{dt' .a{ta.cned.
~Umber(s,): of' all persoha, tli;
ess,
Name(s), address(es) and .telephone .number(s). of all counsel..~
Name Address Telephone
ANTHONY T MO.]%F.T~4 &07 Nf%PTN Vgf%~Tm .q.T.W]~.U.,T ~4·AgDT-qRIlDO- DA 171nl (717) 2384
3086
Date ~' ZT~- O~ Signature_ ¢~V~
Name ANTHQINY T.
Address 407 NORTH FRONT STREET
HARRISBURG, PA 17101
Telephone
Capacity:
X
(717) 238-3686
Personal Representative
Counsel for personal
representative.
407 NORTH FRONT STREET
CAMERON MANSION
HARRISBURG, PA 17101
E-mail: atmlaw ! @aol.com
ANTHONY T. McBETH
ATFORNEY AT LAW
PHONE (717) 238-3686
1-800-227-6916
(for 717 area)
FAX (717) 238-3575
November 11, 2003
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
Re: The Estate of Zelona F. McBeth, Deceased, No. 00644 of 2003
Ladies and Gentlemen:
Enclosed for filing is the original and three copies of the Inheritance Tax Return, along with
the original and three copies of the Inventory. Please time-stamp all copies and return two copies of
the Inheritance Tax Return and two copies of the Inventory in the enclosed, stamped self-addressed
envelope, along with our receipt.
We have enclosed estate account checks made payable to your order for $15.00 and $10.00
respectively, representing the required filing fees for the Inheritance Tax Return and the Invemory.
We have also enclosed a check made payable to your order as agent for $5,493.49, representing the
balance due on Inheritance Tax.
Many thanks for your fine work.
ATM:msm
Enclosures
Please contact our office if you need anything further.
/rffithony T. McB~.~sq.
cc: Dolores D. Cohick, Administratrix (without enclosures)
REV-t~OO EX (~,.00)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENT'S NAME (LAST, FIRST, AND MIDDLI
MCBETH, ZELONA F.
DATE OF DEATH (g,.~..*... DD-YEAR)
JULY 26, 2003
Rev-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
INITIAL)
IDATE OF BIRTH (MM-DD-YEAR)
APRIL 19, 1927
t SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
1. Odginal Return
4. Limited Estate
6. Decedent Died Testate (Attach copy of Will)
9. Litigation Proceeds Received
OFFICIAL USE ONLY
FILE NUMBER
21 2003 0644
County Code Year Number
SOCIAL SECURITY NUMBER
202-20-0483
THIS ~ETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
2. I I (dal~ ~f ~ ~ t~ 12-1~82)
Supplemental
Return
3.
Remainder
Return
4a. Future Interest Compdse (date of(team alter 12-12-82) Us. Federal Estate Tax Return Required
7. DecedentMalntainedaLivingTrust(~tachecop~ofT, ust)~1 8. Total Number of Safe Deposit Boxes
10. Spousal Poverty Credit (~te of ~eath bs~een 12-31-91 and 1-1-95) ~ ~ 11. Election to tax under
Sec.
91
1
3(A)
L..J(aamh s~h o)
THIS SECTION MUST BE COMPLE.¥~-D. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
H"~'¥'E ICOMPLF-¥1= MAILING ADDRESS
'H, ESQUIRE ~407 NORTH FRONT STREET
~CAMERON MANSION
I I'~RRISBURG, PA 17101
FIRM NAME (If Applicable)
TELEPHONE NUMBER
(717) 238-3686
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2) $105,2~82.001
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) ' ' $0.00 i
Z 4. Mortgages & Notes Receivable (Schedule D) :
O (4) $0.00:
~--- 5. Cash, Bank Deposits & Misc. Personal Property (Schedule E) (5) $145,738.00 i
~ 6. Jointly Owned Property (Schedule F) (6) $2,613.00 i
I---~) ~ Separate Billing Requested :
<:~ 7. Inter-Vivos Transfers & Misc. Nen-Probete Property (7)
O (Schedule G or L)
~ 8. Total Gross Assets (total Lines 1-7) (8)
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. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election fo tax has not been
made (schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIOI~ ON REVERSE SIDE FOR APPLICABLE RATES
$0.00 i OFFICIAL USE ONLY
$o.0o ~ :
$253,633.00
$14,337.00
$263.00
(11)
(12)
$14.60000
$239,033.00
(13)
$0.00
(14)
$23g,033.00
15. Amount of line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
x (15)
16. Amount of line 14 taxable at lineal rate $239,033.00 x .045
(16)
17. Amount of line 14 taxable at sibling rate
x .12 (17)
18. Amount of line 14 taxable at collateral rate
x .15 (18)
19. Tax Due
(19)
20. CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
$0.00
$10,756.49
$0.00
$10,756.49
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
Decedeot's Complete Address:
SH~EET ADDRESS 442 WALNUT BOTTOM ROAD, #D-9
CITY
CARLISLE
ISTATE
PA
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2, Credits/Payments
A. Spousal Poverly Credit
B. Prior Payments
C. Discount
Interest/Penalty if applicable
D. Interest
E. Pena~
~,s nnn n~l
(1)
Total Credits (A + B + C) (2)
Total Interest/Penalty (D + E) (3)
IZlP
17013
If line 2 is greater than line I + line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
If line I + line 3 is greater than line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
$107756.49
$5.263.00
$0.00
$5,493.49
$5,493.49
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN X IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred;
b. retain the dght to designate who shall use the property transferred or its income;
c. retain a revisionary 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 on year of death
without receiving adequate consideration?
3. Did decedent own an "in trust for' or payable upon death bank acc4~nt or security at his or her death?
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
Yes No
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.
Unde~ penalties of perjury, I declare that I have examined this retum, including accompanying sc~h,~.~ules and ~-[,.;~e,~L~, and to the best of my knowledge and belief, it is true, correct, and complete.
Declaration of preparer other than the personal mpresontative is based on all the information of which preparer has any knowledge.
SIGNATURE OF PERSO.~N RESPONSIBLE FOR FILING RETURN
ADDR~'~S
579 E STRF-~CARLISLE, PA 17013
ADD. - -
407 NORTH FRONT STREET, ¢~ON MANSION, HARRISBURG, PA 17101
DATE
NOV~%,"C~ER 5, 2003
DATE
NOVEMBER 5, 2003
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is
3% [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a)
(1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still
applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive
parent, or a stepparent of the child is 0% [72 P.S. §9116(a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 P.S.
§9116(a) (1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section
9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1503EX = (1-g7) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF MCBETH, ZELONA F.
SCHEDULE B
STOCKS & BONDS
FILE NUMBER 21-2003-0644
All property Jointly-owned with Hght of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
IRA - M&T BANK
IRA - AMERICAN EXPRESS
IRA - PNC BANK
TOTAL (Also enter on line 2, R_~_~,~ulation)
(If ~o~-e space is nee,~ed, insed additional shee~s of the same size)
$76,254.00
$22,932.00
$6,096.00
$105,282.00
REV-1508 EX + (1-97~1)
COMMONWF. ALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF MCBETH, ZF_.LONA F,
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
21-2003-0644
Include the proceeds of litigation and the date the proceeds were received by the es{ale. All property jointly-owned with the right of su~vorship must be disclosed on Schedule F.
iTI=M
NUMBER
2.
3.
4.
5.
DESCRIPTION
CASH - M&T BANK
CASH-PNC BANK
REFUND RECEIVABLE-UNITED CHURCH OF CHRIST HOMES
PREPAID FUNERAL EXPENSE-FOGELSANGER-BRICKER
UNITED STATES SAVINGS BONDS
TOTAL (Also enter on line 5, Reca
(If more space is needed, insert a~dliional sheets of the same size)
VALUE AT DATE
OF DEATH
$115,890.00
$19,579.00
$1,256.00
$6,006.00
$3,0O7.00
$145,738.00
~'V-1509 EX + ('1-97)(1)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF MCBETH, ZELONA F. FILE NUMBER 21-2003-0644
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A. DOLORES D. COHICK 579 E STREET, CARLISLE, PA 17013 DAUGHTER
B. RICHARD M. MCBETH, JR.
C. MARKN. MCBETH
932 ROCKLEDGE DRIVE, CARLISLE, PA 17013
186 EAST SECOND STREET, APT. #4, NEW YORK, NY
10009
SON
SON
JOINTLY-OWNED PROPERTY:
Lc ~ ~-R DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying num bar. DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT Attach deed fo~ jointly-held real estate. VALUE OF ASSET
INTEREST DECEDENTS INTEREST
1. A. 1993 SERIES EE U.S. SAVINGS BONDS $1,741.00 50.0% $871.0C
2. B. 1993 SERIES EE U.S. SAVINGS BONDS $1,741.00 50.0% $871.0~
3. C. 1993 SERIES EE U.S. SAVINGS BONDS $1,741.00 50.0% $871.0(]
TOTAL (Also enter on line 6, Recapitulation) $2,613.00
~[; ;, al sheets of the same size)
REV-1511 EX + (1-97)(1)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF MCBETH, ZELONA F.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21-2003-0644
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION
FUNERAL EXPENSES:
FOGELSANGER-BRICKER FUNERAL HOME, INC.,
112 WEST KING STREET
P.O. BOX 336
SHIPPENSBURG, PA 17257
~,DMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s) / EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
Attorney Fees
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
Relationship of Claimant to Decedent
Probate Fees
Accountant's Fees
Tax Return Preparer's Fees
~,DVERTISlNG - CUMBERLAND LAW JOURNAL
ADVERTISING - THE SENTINEL
State Zip
TOTAL (Also en~e~ on line 9, Recapitulation
AMOUNT
$5,843.00
$8,000.00
$327.00
$75.00
$92.00
$14,337.00
(Ifmorespaceis nee,:,ed, insert additionalsh~ofthesame s~e)
REV-1512 EX + (1-97)(1)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF MCBETH, ZELONA F.
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER 21-2003-0644
DESCRIPTION AMOUNT
Include unreimbursed medical expenses.
ITEM
NUMBER
1. PHARMERICA
2. SPRINT
3. COMMUNITY LIFE TEAM EMS
TOTAL (Also enter on line 10, Recapitulation
(If i~ore spa~ is needed, insert a~,~ional she~s of the same size)
$78.00
$23.00
$162.00
$263.00
REV-1513 EX + (9-00))
COMMONWEAL'RI OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF MCBETH, ZELONA F.
SCHEDULE J
BENEFICIARIES
FILE NUMBER 21-2003-0644
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
II.
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and
transfers under Sec. 9116 (a) (1.2)]
1. DOLORES D. COHICK
579 E STREET
CARLISLE, PA 17013
2. RICHARD M MCBETH, JR.
932 ROCKLEDGE DRIVE
CARLISLE, PA 17013
3. MARK N. MCBETH
186 EAST SECOND STREET, APT ~4
NEW YORK, NY 10009
DAUGHTER
SON
;ON
ENTER DOLLAR ,NVIOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
33.3%
33.3%
33.3%
(If more space is needed, insert additional sheets of the same size)
$0.00
COMMONWEALTH OF PENNSYLVANIA
DEPART,MENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 0O3148
MCBETH ANTHONY T ESQ
407 NORTH FRONT STREET
HARRISBURG, PA 17101
fold
ESTATE INFORMATION: SSN: 202-20~0483
FILE NUMBER: 2103-0644
DECEDENT NAME: MCBETH ZELONA F
DATE OF PAYMENT: 10/20/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 07/26/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 85,000.00
REMARKS:
TOTAL AMOUNT PAID:
DOLORES D COHICK
ANTHONY T MCBETH ESQUIRE
85,000.00
SEAL
CHECK# 103
INITIALS: AC
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
TAXPAYER
October 10, 2003
Joseph L Baird, CPA
Financial Advisor
Attorney Anthony McBeth
407 N. Front Street
Harrisburg, PA 17101
Re: Zelona McBeth estate
American Express
Financial Advisors Inc.
IDS Life Insurance Company.
Suite 100
116 Cocoa Avenue
Hershey, PA 17033
Bus: 717.534.9980
Fax: 717.520.9780
Bus: 888.995.4223
jbaird@epix.net
Dear Attorney McBeth:
Zelona McBeth owned one account with American Express. The account is an
immediate annuity established on June 4, 1997. The arrangement was a quarterly
payout of $780.48 gross with taxes withheld of $57.62 for life with a guaranteed period of
15 years ending April 15, 2012. The three 'beneficiaries have two options which are
mutually exclusive of each other regarding this account:
1. Continue distribution as was originally established in the contract or
Receive a commuted lump sum amount now for dollars to be received in the
future. The estimated !ump sum amount is $22,931.99 to be divided
between the three beneficiaries. This is not a guaranteed amount and the
final amount will be determined by the corporate office upon receipt of
all required documents.
I trust that this provides you with the information that you requested. The next step is for
the beneficiaries to decide on. above. I will need their full names including their middle
name, related social security number, married; yes or no.
Please advise if questions.
eph Li Baird, CPA
l inancial Advisor
Cc: file/cpm
American Express Financial
Advisors Inc. Member NASD.
An AEFA associated financial
advisor franchise. Insurance and
annuities are issued by IDS
Life Insurance Company, an
American Express company,
American Express Companyjs .
separate from American Exlsre~s".
.Financial Advisors Inc: and ¢ '.~:~
is not a broker-dealer.
(A) Services, including merchandise .......
Date
No.
Funeral of
August 4, 2003
Zelona F. McBeth
Mrs. Deloris D. Cohick
579 E Street
Carlisle, PA 17013
Personal, Staffand
Professional Services
Funeral Home
Facilities and Equipment
Automobile Equipment
Casket
Interment Receptacle t
$3,800.00
995.00
8O0.O0
(B) Cash Advanced. We have
advanced the following funds for
your convenience .......................
Clergy Honorarium
Certified copies
Flowers
Total'A' $5,595.00
$ 75.00
$ 40.00
$ 132.50
Total'B' $ 247.50
(C) Additional Items, ordered later .......
*Paid by Homesteaders Life
Due
Total 'C'
Complete Total $5,842,50
Amount Paid *$5,842.50
Balance -0-
ORIGINAL
4110
Funeral Services .: ~
~,~._ ~, o~ E.- ,
CREDIT
CARD
[-;'[.OTHER
~.--) -03
ACCT. NO.
~ ( _ r~_ .(~ Name of Oeceased
FOOELSANOER~BRICKER
FUNERAL HOME, INC.
LAS'I' BALANCE
[~ [NIEREST
LATE PAY M E.I~
SUB TOTAL
CREC [TS
LESS PAYMENT
NEW BALANCE
05320
Register of Wills CUMBERLAND County, Pennsylvania
INVENTORY
Estate of MCBETH, ZELONA F. No. 21-2003-0644
also known as Date of Death JULY 26, 2003
, Deceased Social Security No. 202-20-0483
DOLORES D. COHICK
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets
wherever situate end all of the real estate in the Commonwealth of Pennsylvania of said, Decedent that the valuation placed opposite each item
of said Inventory represents its fair value as of the date of the Decedent's death, end th Decedent owned no real estate outside of the Commonwealth
of Pennsylvania except that which appears in a memorandum at the end of this Inventory. I/We verify that the statements mede in this inventory
are true and correct. INVe understand that false statements herein are mede subject to the penalties of 18 Pa. C.S. Section 4904 relating to
unswom falsification to authorities.
i.D. No.: 53729
Address 407 NORTH FRONT STREET, CAMERON MANSION Dated NOVEMBER 5, 2003
HARRISBURG, PA 17101
(717) 238-3686
Telephone:
Description
Personal Property
IRA - M&T BANK
IRA - AMERICAN EXPRESS
IRA - PNC BANK
CASH - M&T BANK
CASH - PNC BANK
REFUND RECEIVABLE - UNITED CHURCH OF CHRIST HOMES
PREPAID FUNERAL EXPENSE - FOGELSANGER - BRICKER
UNITED STATES SAVINGS BONDS
SERIES EE U.S. SAVINGS BONDS
SERIES EE U.S. SAVINGS BONDS
SERIES EE U.S. SAVINGS BONDS
Value
Total from Continuation Page(s)
(Attach additional sheets if necessary) To{al:
NOTE: The Memo~-ai~dum of real estate outside the Co,~orrweaRh of Pe~r,~ylvenia may, at the election of personal representative, include the value of
each item, but such flcJures should not be extended into the total of the Inventor/.
$76,254.00
$22,932.00
$6,096.00
$115,890.00
$19,579.00
$1,256.00
$6,006.00
$3,007.00
$871.00
$871.00
$871.00
$6.00
$253,633.00
5!::'TO: , :'._MaP~,~ Ni' MC. RV-TG ~ · .,, '
.... :~ . 186 EAST'. SECOND :STR"EET':'~4 .~.. .__,:
ONE-THIRDiOF THE "ESTATE
needed,~,use back of' page)
i f ::: addit ionai~:.s pace is
'.i. :;:..Name'. o f'::..'.decedeht "- st known address.'442' WAL'
decedent ....
L,".,:i
ii'iiii"', Place of death
"~ 'County of gr'ant'. :0'f,'..'°'.~igf'na.1.'iii!~i~'~..'.e.i~,~,ers ' CUMBERLAND
.'.. Decedent died:
. A' copy of the wztl .. ~ ~X?.:..Z.,s~.not: attached
.. .Name(s), address(es) an'd. ti~etSl~$hO:~:~number{s)·of., ~ all
;~ representatives appoint'ed,':i ?.:..", '. ~' . --
:-.-
'" Name
persohal:.
Tel~
Name(s), addr~ess(es) and.telephone .number(s) of all counsel
Address TelePhone ,-.;::!~:
Name, ' [::~:~"
.................... - ...... 3686 ~.~
Additional information may be obtained from t~ndersi
Date ~' gT~- 0-~ ignature -
Name ANTHONY T. MC~
Address_40? NORTH FRONTSTREET
HARRISBURG, PA 17101
Telephone
Capacity:.
X
(717) 238-3686
Personal Representative
Counsel for personal
representative
/./ .~'
ANTHONY T. McBE'[H
40'7 NORTH FRONt STREET, cAMERON MANSiUN
HARRISBURG. PA 17101
(717) 238-3686 FAX (717~ 23g-35V5
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD OO3148
MCBETH ANTHONY T ESQ
407 NORTH FRONT STREET
HARRISBURG, PA 17101
........ fold
ESTATE INFORMATION: SSN: 202-20-0483
FILE NUMBER: 2103- 0644
DECEDENT NAME: MCBETH ZELONA F
DATE OF PAYMENT: 10/20/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 07/26/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $5,000.00
TOTAL AMOUNT PAID:
$5,000.00
REMARKS: DOLORES DCOHICK
ANTHONY T MCBETH ESQUIRE
SEAL
CHECK# 103
INITIALS: AC
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
Xv BUREAU OF INDIVIDUAL TAXES
TNHERTTANCE TAX DTVZSTON
DEPT. Z80601
HARRTSBURG, PA 171Z8-0601
COHHONNEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAZSEHENT, ALLO#ANCE OR DZSALLOHANCE
OF DEDUCTIONS AND ASSESSNENT OF TAX
REV-1;~i? EX &FP (DI-OS)
ANTHONY T MCBETH ESQ
q07 N FRONT ST
HBG PA 17L01
DATE 1Z-29-ZO05
ESTATE OF HCBETH
DATE OF DEATH 07-Z6-Z005
FILE NUNBER 210$-06qq
COUNTY CUHBERLAND
ACN 101
Amoun~ Remi~:~:ed
ZELONA F
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THZS L]:NE ~ RETA]:N LONER PORT]:ON FOR YOUR RECORDS -~
REV-1547 EX AFP (01-03) NOTZCE OF INHERITANCE TAX APPRA]:SEHENT, ALLONANCE OR D]:SALLONANCE OF DEDUCT]:ONS AND ASSESSHENT OF TAX
ESTATE OF HC~ETH ZELONA F F]:LE NO. 21 0:5-06q~ ACN 101 DATE 12-29-200:5
TAX RETURN HAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVAT]:ON CONCERNTNG FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Es~e~e (Schedule A) (1)
2. S~ocks and Bonds (Schedule B) (2)
3. Closely Held S~ock/Par~narship In~aras~ (Schedule C) (3)
q. Hor~gagas/No~as Raca/vable (Schedule D) (q)
5. Cash/Bank Dapos/~s/N/sc. Personal Propar~y (Schedule E) (5)
6. Jo/n~ly Owned Proper~y (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. To,al AssaYs
APPROVED DEDUCTIONS AND EXEHPTZONS:
9 Funeral Expanses/Ada. Cos~s/N/sc. Expanses (Schedule H) (9)
10 Dab~s/Hor~gaga L/ab/1/~/as/L/ans (Schedule I)
11 To~al Daduc~/ons
12 Na~ Value of Tax Ra~urn
.00
105~282.00
.00
.00
13
NOTE:
1q5z7:58.00
Z~61:5.00
.00
1~,:5:57.00
(lO) 26:5.00
NOTE: To /nsura proper
cred/~ ~o your account,
subm/~ ~ha upper pore/on
of ~h/s form w/~h your
~ax payaan~.
5,000.00
5,q95.q9
IF PA/D AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
ANOUNT PAID
(la) .00 x O0 = .00
(16) 239,03:5.00 x Oq5= 10,756.q9
(17) . O0 X 12 = . O0
(18) .00 x 15 = .00
(19)= 10,756.q9
ASSESSHENT OF TAX:
15. Amoun~ of L/ne lq a~ Spouse1 ra~e
16. Amoun~ of Line 1~ ~exabla a~ L/heal/Class A re~e
17. Amoun~ of L/ne 1~ e~ S/bling ra~a
18. Amoun~ of L/ne lq ~axebla a~ Collateral/Class B ra~a
19. Pr/nc/pal Tax Duo
TAX CREDITS:
PAYHENT RECE/PT DISCOUNT (+)
DATE NUHBER INTEREST/PEN PAID (-)
10-20-2005 CDOO:51q8 263.16
11-12-200:5 CD00:5225 .00
Charitable/Governmental Bequests; Non-elec~ed 9113 Trusts (Schedule J) (13) .00
Na~ Value of Es~a~:e Sub~ec~ ~:o Tax (lq) 2:59,0:5:5.00
Zf an assesseent was lssued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that lnclude the total of ALL returns assessed to date.
(11)
(12) 239,0:53. O0
TOTAL TAX CREDIT 10,756.65
BALANCE OF TAX DUEI .16CR
INTEREST AND PEN. .00
TOTAL DUE .16CR
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS REQUIRED.
IF TOTAL DUE 1S REFLECTED AS A 'CREDIT" (CR), YOU NAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.)
(8) Z53,633.00
RESERVATION:
PURPOSE OF
NOTICE:
PAYNENT:
REFUND (CR):
OBJECTIONS:
ABNIN-
ISTRATZVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December 12, 19BZ -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collatmral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
et the lawful Class B (collateral) rata on any such futura interest.
Ta fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of ZOO0. (7Z P.S.
Section 9140).
Detach the top portion of this Notice and submit with your payment to the Register of #ills printed on the reverse side.
--Hake check or money order payable to: REGZSTER OF gILLS, AGENT
A refund of a tax credit, which was not requested on the Tax Return, may bm requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (NE¥-1515). Applications are available at the Office
of the Register of Nills, any of the 25 Revenue District Offices, ar by calling the special Z4-hour
answering service for forms ordering: 1-800-562-Z050~ services for taxpayers with special hearing and / or
speaking needs: 1-800-447-5020 (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object within sixty (603 days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. ZalOZ1, Harrisburg, PA 17128-1021, OR
--election to have the matter determined at audit of the account of the personal representative) OR
--appeal to the Orphans' Court.
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-IS01) for an explanation of administratively correctable errors.
If any tax due is paid within three (5) calendar months after the decadent's death, a five percent (52) discount of
the tax paid is alloamd.
The 152 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same tiaa period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning aith 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 (62) percent per annum calculated at a daily rate of .000164. Ali taxes which became delinquent on and after
January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2005 ara:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1982 ZOZ .000548 1987 92 .000247 1999 72 .000192
1985 162 .000438 1988-1991 112 .000501 ZOO0 BZ .000219
1984 llZ .000301 1992 9Z .000247 2001 92 .000247
1985 152 .00055& 1995-1994 72 .O0019Z ZOOZ 6Z .000164
1986 102 .000274 1995-1998 92 .000247 2005 5Z .000157
--Interest is calculated
INTEREST = BALANCE OF
as follows:
TAX UNPAID X NUNBER OF DAYS DELINQUENT X DATL¥ 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 sheen on the
Notice, additional interest must be calculated.
407 NORTH FRONT STREET
CAMERON MANSION
HARRISBURG, PA 17101
E-mail: atmlawl @aol.com
ANTHONY T. McBETH
ATTORNEY AT LAW
PHONE (717) 238-3686
1-800-227-6916
(for 717 area)
FAX (717) 238-3575
February26,2004
Register of W'luls
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
Re: The Estate of Zelona F. McBeth, Deceased, No. 00644
Ladies and Gemlemen:
Encbsed for filing is the origLnal and three copies ofthe supplemental Inherita_n_ce Tax R~ttLm.
We have also enclosed two checks, one payable to your order directly for $15.00 from my operating
account. This represents the required filing fee. The other check is made payable to your order as
agent for $ ! 40~00, representing the additional tax due~
Please clock in all of the enclosed copies and return the two extra copies to us in the enclosed,
stamped self-addressed envelope.
Many thanks for your fine work.
ATM:msm
Enclosures
Please comact our office if you need anything further.
cc: Dolores D. Cohick, Administratrix (without enclosures)
ANTHONY T. McBETH
A'ITORNEY AT LAW
407 NORTH FRONT STREET
FIRST FLOOR
HARRISBURG, PA 17101
C~ MMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
MCBETH ANTHONY T ESQ
407 NORTH FRONT STREET
HARRISBURG, PA 17101
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
CD
REV-1162 EX(11-96)
OO361O
........ fold
ESTATE INFORMATION: SSN: 202-20-0483
FILE NUMBER: 2103-0644
DECEDENT NAME: MCBETH ZELONA F
DATE OF PAYMENT: 02/27/2004
POSTMARK DATE: 02/26/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 07/26/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $140.00
CHECK# 112
SEAL
TOTAL AMOUNT PAID'
$140.00
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
STATUS REPORT UNDER RULE 6.12
Name of Decedent: ZELONA F. MCBETH
Date of Death: JULY 26, 2003
Will No.
Admin. No. 2003-00644
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:
State whether administration oi the estate is complete:
Yes × 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
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 b~ttached to this report.
Date: ~,,~ //l/.,/.._~_~~~~_~
~q~gnatSreL
ANTHONY CBETH
Name (Ple sk~ type or print)
407 NORTH FRONT STREET
HARRISBURG: PA 17101
Address
(717) 238-3686
Tel. No.
Capacity:
__Personal Representative
X _.Counsel for personal
representative
( MAH: rmt/AM3 )
RW-27
RECEIPT AND RELEASE
KNOW ALL MEN BY THESE PRESENTS that I, Dolores D. Cohick, heir of the Estate of
Zelona F. McBeth, Deceased, do hereby acknowledge that I have this day had and received from
Anthony T. McBeth, Counsel for the Estate ofZelona F. McBeth, Deceased, the sum of $40,390.92,
in full and complete satisfaction and payment due me as said heir.
And therefore I, the said Dolores D. Cohick, do by these presents remise, release, quit-claim
and forever discharge the said Anthony T. McBeth, Counsel for the Estate of Zelona F. McBeth,
Deceased, his successors and assigns, of and from his actions as Counsel for the Estate ofZelona F.
McBeth, Deceased, of and from all actions, suits, payments, accounts, reckonings, claims and
demands whatsoever, for or by reason thereof, or of any other act, matter, cause or thing whatever.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this zT' day of
,,.Jt.~ r~ ¢_ ., 2004.
Dolores D. Cohick
Social Security Number
RECEIPT AND RELEASE
KNOW ALL MEN BY THESE PRESENTS that I, Mark N. McBeth, heir of the Estate of
Zelona F. McBeth, Deceased, do hereby acknowledge that I have this day had and received from
Anthony T. McBeth, Counsel for the Estate ofZelona F. McBeth, Deceased, the sum of $40,390.92,
in full and complete satisfaction and payment due me as said heir.
And therefore I, the said Mark N. McBeth, do by these presents remise, release, quit-claim
and forever discharge the said Anthony T. McBeth, Counsel for the Estate of Zelona F. McBeth,
Deceased, his successors and assigns, of and fi.om his actions as Counsel for the Estate ofZelona F.
McBeth, Deceased, of and from all actions, suits, payments, accounts, reckonings, claims and
demands whatsoever, for or by reason thereof, or of any other act, matter, cause or thing whatever.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this '~
day
of
~ , 2004.
/
'lV~ark N. McBeth
Social Security Number
RECEIPT AND RELEASE
KNOW ALL MEN BY THESE PRESENTS that I, R/chard M. McBeth, Jr., heir of the
Estate ofZelona F. McBeth, Deceased, do hereby acknowledge that I have this day had and received
fi.om Anthony T. McBeth, Counsel for the Estate of Zelona F. McBeth, Deceased, the sum of
$40,390.92, in full and complete satisfaction and payment due me as said heir.
And therefore I, the said R/chard M. McBeth, Jr., do by these presents remise, release, quit-
claim and forever discharge the said Anthony T. McBeth, Counsel for the Estate of Zelona F.
McBeth, Deceased, his successors and assigns, of and from his actions as Counsel for the Estate of
Zelona F. McBeth, Deceased, of and from all actions, suits, paymems, accounts, reckonings, claims
and demands whatsoever, for or by reason thereof, or of any other act, matter, cause or thing
whatever.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
-..-~,'%/~ , 2004.
day of
/l~ichard M~- "_M~'cB et ~r. /
BUREAU OF INDIVIDUAL TAXES
ZNHERTTANCE TAX DZVTSZON
DEPT. Z80601
HARR'rSBURG,, PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
ZNHERZTANCE TAX
STATEHENT OF ACCOUNT
REV-1607 EX AFP ¢$1-05)
PETER J RESSLER ESQ
METTE ETAL
PO BOX 5950
HBG PA 17110
DATE 07-26-2004
ESTATE OF HOLMES
DATE OF DEATH 08-0Z-ZO05
FILE NUMBER 21 05-0664
COUNTY CUMBERLAND
ACN 101
Amount Remittmd
ADELINE W
MAKE CMECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THZS LINE ~ RETAZN LOWER PORTION FOR YOUR RECORDS *~
REV-1607 EX AFP (01-03)
#-- INHERITANCE TAX STATEMENT OF ACCOUNT
ESTATE OF HOLMES ADELZNE W FILE NO. 21 05-0664 ACN 101 DATE 07-26-2004
THIS STATEHENT ZS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAHED ESTATE. SHONN BELOI,/
ZSA SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE., AND., ZF APPLZCABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTHENT: 06-21-2004
PRINCIPAL TAX DUE: ...........................................................................................................................................................................................................................
PAYMENTS (TAX CREDITS):
50,854.69
PAYMENT RECEIPT DISCOUNT C+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
10-25-2005
05-02-2004
CD005164
CD005894
ZF PAID AFTER THIS DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( ZF TOTAL DUE ZS LESS THAN $1,
NO PAYHENT ZS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT" (CR),
278.95
.00
5,500.00
25,275.74
Ur'
TOTAL TAX CREDIT
50,854.69
BALANCE OF TAX DUE .00
XNTEREST AND PEN. .00
TOTAL DUE .00
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF TH*rS FORH FOR ZNSTRUCT*rONS. )
RECEIPT AND RELEASE
KNOW ALL MEN BY THESE PRESENTS that I, Mark N. McBeth, heir of the Estate of
Zelona F. McBeth, Deceased, do hereby acknowledge that I have this day had and received from
Dolores D. Cohick, in her capacity as Administratrix for the Estate ofZelona F. McBeth, Deceased,
the sum of $36,775.92, in partial satisfaction and payment due me as said heir.
And therefore I, the said Mark N. McBeth, do by these presents remise, release, quit-claim
and forever discharge the said Dolores D. Cohick, in her capacity as Administratrix for the Estate of
Zelona F. McBeth, Deceased, her successors and assigns, of and fi:om her actions as Administratrix
for the Estate ofZelona F. McBeth, Deceased, of and fi:om all actions, suits, payments, accounts,
reckonings, claims and demands whatsoever, for or by reason thereof, or of any other act, matter,
cause or thing whatever, limited, however to the receipt of this partial payment, reserving
nevertheless my rights as an heir to the expectancy of complete payment that the amount of complete
payment remains undetermined, and that additional payment fi:om the Estate's assets may be minimal
or that there may not be additional payment form the assets.
WHEREOF, I have hereunto set my hand and seal this ,~day of
WITNESS
!~ .~ - !~ i; ,, Social Security 5Number
RECEIPT AND RELEASE
KNOW ALL MEN BY THESE PRESENTS that I, Richard M. McBeth, Jr., heir of the
Estate ofZelona F. McBeth, Deceased, do hereby acknowledge that I have this day had and received
fi;om Dolores D. Cohick, in her capacity as Administratrix for the Estate of Zelona F. McBeth,
Deceased, the sum of $36,775.92, in partial satisfaction and payment due me as said heir.
And therefore I, the said Richard M. McBeth, Jr., do by these presents remise, release, quit-
claim and forever discharge the said Dolores D. Cohick, in her capacity as Administratrix for the
Estate of Zelona F. McBeth, Deceased, her successors and assigns, of and from her actions as
Administratrix for the Estate ofZelona F. McBeth, Deceased, of and from all actions, suits, payments,
accounts, reckonings, claims and demands whatsoever, for or by reason thereof, or of any other act,
matter, cause or thing whatever, limited, however to the receipt of this partial payment, reserving
nevertheless my rights as an heir to the expectancy of complete payment that the amount of complete
payment remains undetermined, and that additional payment fi;om the Estate's assets may be minimal
or that there may not be additional payment form the assets.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this /.~ ~f- day of
~ ~, ., , 2003.
R~hard M'. l(de'~etl~ Jr.,/, f/,/
Social Security Number
RECEIPT AND RELEASE
KNOW ALL MEN BY THESE PRESENTS that I, Dolores D. Cohick, heir of the Estate of
Zelona F. McBeth, Deceased, do hereby acknowledge that I have this day had and received fi.om
Dolores D. Cohick, in her capacity as Administratrix for the Estate ofZelona F. McBeth, Deceased,
the sum of $36,775.92, in partial satisfaction and payment due me as said heir.
And therefore I, the said Dolores D. Cohick, do by these presents remise, release, quit-claim
and forever discharge the said Dolores D. Cohick, in her capacity as Administratrix for the Estate of
Zelona F. McBeth, Deceased, her successors and assigns, of and fi.om her actions as Administratrix
for the Estate ofZelona F. McBeth, Deceased, of and t~om all actions, suits, payments, accounts,
reckonings, claims and demands whatsoever, for or by reason thereof, or of any other act, matter,
cause or thing whatever, limited, however to the receipt of this partial payment, reserving
nevertheless my rights as an heir to the expectancy ofcomplete payment that the amount of complete
payment remains undetermined, and that additional payment fi.om the Estate's assets may be minimal
or that there may not be additional payment form the assets.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this [c] day of
/t,JOt,,'~rn be.r~ , 2003.
/Z~ESS:
!.!): ":! (')[ yq? ,.,0.
Dolores D. Cohick
Social Security Number
BUREAU OF INDIVIDUAL TAXES
INHER/TAHCE TAX DTVTSZON
DEPT. Z80601
HARRTSBURG, PA 171Z8-0601
CONMONNEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAZSEHENT, ALLONANCE OR DZSALLONANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
REV-1S~i7 El( &FP (01-05)
DATE 09-20-200q
ESTATE OF MCBETH ZELONA F
DATE OF DEATH 07-26-2005
FILE NUMBER 21 03-06qq
COUNTY CUMBERLAND
ANTHONY T MCBETN ESQ ACN 101
fi07 N FRONT ST Amount Remitted
I
HBG PA 17101
I
HAKE CHECK PAYABLE AND REMIT PAYMENT TO:
RESISTER OF HILLS
CUMBERLAND C03Ce0URT HOUSE
CARLISLE, PA~ ~7013~ ;:?;'
CUT ALONG THZS LZNE ~-- RETAIN LONER PORTZON FOR YOUR RECO
REV-:1547 EX AFP ¢0:1-03] NOTZCE OF ZNHERZTANCE TAX APPRAZSENENT, '~T.~-c=~b~--':"~ ..........
DZSALLONANCE OF DEDUCTZONS AND ASSESSMENT ~F TAX_~ '
ESTATE OF HCBETH ZELONA F FILE NO. 21 03-06~ ACN 101 ~DATE 0~-20-200~
TAX RETURN NAS:
RESERVATION CONCERNING FUTURE ZNTEREST- SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: I Real Estate (Schedule A)
2 Stocks and Bonds (Sohedule B)
$ Closely Held Stock/Pertnersh/p Interest (Schedule C)
Mortgages/Notes Receivable (Schedule D)
$ Cash/Bank Deposlts/Hisc. Personal Property (Schedule E)
6 Jointly O~ned Property (Schedule F)
7 Transfers (Schedule G)
8 Total Assets
APPROVED DEDUCTTONS AND EXENPTTONS:
9. Funeral Expenses/Ad.. Costs/Misc. Expenses (Schedule H)
10. Debts/Hortgage Liebilltles/Liens (Schedule T)
11. Total Deductions
Nat Value of Tax Return
(X) ACCEPTED AS FILED ( ) CHANGED --~ .
SUPPLEMENTAL RETURN NO. 01
(1). .00 NOTE: To insure proper
(2) . O0 cradlt to your account,
(3) . O0 submit the upper port/on
(q) . O0 of ~his form ~i~h your
(5) ~1~0~.00 ~ax payment.
(6) .00
(7) .00
(8)
.00
(9)
(lo) .00
3,101.00
13.
lq.
NOTE
(11) . OD
(12) 3,101. O0
Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
Net Value of Estate Sub,eot to Tax (lq) 2q2,13q. O0
Tf an assessment Nas 2ssued prev2ous2y, 22nes 1~, 15 and/or :16, :17, 18 and 19
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line lq at Spousal rate
16. Amount of Line lq taxable at Lineal/Class A rata (16)
17. Amount of Line lq at Sibl~ng rata (17)
18. Amount of Line lq taxable at Collateral/Class B rate (18)
DISCOUNT (+)
INTEREST/PEN PAID (-)
263.16
.00
.00
19. Principal Tax Due
TAX CREDITS:
PAYMENT RECEIPI'
DATE NUMBER
CD0031q8
CD003225
CD003610
.00 x 00 = .00
2qZ,13q.00 X 0q5= 10,896.0q
.00 x 12 = .00
.00 x 15 = .00
(19)= 10,896.0q
AMOUNT PAID
5,000.00
5,q93.~9
lqO.O0
TOTAL TAX CREDIT
BALANCE OF TAX DUE
1NTEREST AND PEN.
TOTAL DUE
10,896.65
.61CR
10-20-2003
11-12-2003
02-26-200~
.00
.61CR
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
RESERVATION:
PURPOSE OF
NOTICE:
PAYNENT:
REFUND (CR):
OBJECTIONS:
ADNIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December 1Z, 1982 -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Coamoneealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawfu! Class B (collateral) rate on any such future interest.
To fulfill the requirements of Sect[on Z1~0 of the Inheritance and Estate Tax Act, Act 23 of ZOO0. (72 P.S.
Sect[on 91~0).
Detach the top port[on of this Nat[ce and submit with your payment to the Register af Hills pr[nted on the reverse side.
--Hake check or money order payable to: REGISTER OF NILLS, AGENT
A refund of a tax credit, which aaa not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). AppZ[cations ara avaiZable at the Office
of the Register of Hills, any of the 23 Revenue District Offices, or by calling the special Z~-haur
anseering service for forms ordering: 1-800-562-2050; services for taxpayers ~[th special hearing and / or
speaking needs: 1-800-~7-5020 (TT only).
Any party [n interest not satisfied ~ith the appraisement, allowance, or disalloaance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of
this Notice by:
--arJttan protest to the PA Department of Revenue, Board of Appeals, Dept. 181021, Harrisburg, PA 17118-1011, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
Factual errors discovered on this assessment should be addressed [n ariting to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Ray[am Unit, Dept. 280601, Harrisburg, PA 17128-0601
Phone (717) 787-6S05. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Res[dent
Decadent" (REV-IS01) for an explanation of administratively correctable errors.
If any tax due is paid within three (5) calendar months after the dacedent's death, a five percent (5Z) discount of
tho tax paid is allowed.
Tho 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time per[od as you mould 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 (61) percent per annum calculated at a daily rate of .00016q. Ail taxes ah[ch became delinquent on and after
January 1, 1982 will bear interest at a rate Nhich will vary free calendar year to calendar year aJth that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through ZOOq are:
Interest Daily Interest Daily
Year Rate Factor Year Rate Factor
~ 20Z .0005q8 '~'~;~'8-1991 llZ .000301
1983 16Z . O00q~8 1991 9Z . O00Zq7
198q llZ .000301 1995-199q 77, .00019Z
1985 15Z .000356 1995-1998 97. .0002q7
1986 lOX . O0027~ 1999 7Z .000192
1987 107. , O00Z7q ZOO0 7Z . OOOI9Z
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID
Interest Daily
Year Rate Factor
~ 91 .O00Zq7
ZOOZ 6Z .O0016q
2003 5Z .000157
200~ ~Z .000110
X NURBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after tho interest computation date shoNn on the
Not[ca, addit[onaI interest must be calcu[ated.