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HomeMy WebLinkAbout03-0604 PETITION FOR PROBATE and GRANT OF LETTERS also known as To: Register of Wills for the County of Commonwealth of Pennsylvania ., Deceased. Social Security No. jq,~- D ~7 -- The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or pldFr an the executr,*~ in the last wilt of the above decedent, dated and codicil(s) dated in the · named ,19__ (state relevant circnmstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Ctanb~rland County, Pennsylvania, with h ~r last family or principal residence at F-~o~tr~-/-r'ot t)Of:~'~t,-,,,25, I ' ' (list street~ nu-m/ber and muncipality) Decendent, then ~/ years of age, died July 7 , ~ ?003 , at Country M~acln~ 48~q 2'h"'incllm Pal_ Mmr'hanqr-eh, lWn ¢[ 17055 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: N/A 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 request(s) the probate o'f the last will and codicil(s) presented herewith and the grant of letters Testamentary theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF Ct~nberland 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 w~e,l~, tru~_nister the estate according to law. Sworn to or affirrn~e_d..and subscribed Donna M.Ott~, i~'t D~l~uty I--- ~ ~egbt& ~- No. 21-2003-604 CATHERINE R. JUMPER , Deceased Estate Of DECREE OF PROBATE AND GRANT OF LETTERS AND NOW July 25th t~ 2005 in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated June 14th 1994 described therein be admitted to probate and filed of record as the last will of CATHERINE R. JUMPER ; and Letters TESTAMENTARY are hereby granted to LOUISE W. TH~ FEES Probate, Letters, Etc .......... $ 60,00 Short Certificates(1) .......... $ 3. O0 ~ .X~.~ge..8..(.3.). .... $ 9. O0 JCP $10.00 TOTAL __ $ 82.00 Filed July 25th,2003 Mailed Letters to Executrix on 7/25/2003. ATTORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE E~.: 6 !/ fi~7 Ii-Ir his is to certify that the infbrmation 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. ;43R.v 2~a7 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH ~ I~. I~ I~c--.m~.~' I .h~te ~ ~CE~'SUSUAL~U~ J ~O~BUSI~S~N~RY~ ' I~CE~NTEVER~U I ............. 1~' ~t0. ~m's ~t~ ~ ~. cq~.~ z.c~ I~CE~m'S I~a- Im u I b*'w1OOweO '. 1~20 LisDurn Rd Camp Hill. Pa ~ ~ ~ c,~ ~,~s,~.~ ~.~.~k _ I.~ ~c ....... ~.c,~ Ic~m.C~.~.~ ~,~u ~,~ ~/du~y ~, Z003 ~Roll-ing Green Mem. Park~ Camp Hill, Pa. ~1~~~ ~,,b 001248 L 324 mussel~an~neral Home & C.S. INc. ImRi~mmo/ Arm _ T,~mDv~o. ,/r/ I 21-2003-604 lAST WILL AND TESTAMENT OF CATHERINE R. JUMPER I, CATHERINE R. JUMPER, Widow woman, of Summerdale, East Pennsboro Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any and all Wills and Codicils previously made by me at any time heretofore. FIRST: I hereby direct that my personal representative, hereinafter named, to pay all of my just debts, funeral and testamentary expenses, including Pennsylvania Inheritance Taxes, as soon after my demise as may be practicable. SECOND: BE IT KNOWN, that despite previous plans for cremation, I DO NOT WANT TO BE CREMATED. I direct that my body be interred in the Rolling Green Cemetery. THIRD: I hereby bequeath my diamond ring to my sister, LOUISE W. THOMAS. FOURTH: All the rest, residue and remainder of my estate, I hereby bequeath as follows: A. FORTY (40%) PER CENT to my sister, LOUISE W. THOMAS. B. FORTY (40%) PER CENT to my brother's wife, DOROTHY SAWYER, with whom I live in Summerdale, Pennsylvania. TEMPLE. C. TEN (10%) PER CENT to my granddaughter, CASSANDRA TEMPLE. D. TEN (10%) PER CENT to my granddaughter, CHRISTINA FIFTH: Should either of my granddaughters not have attained the age of THIRTY (30) before my demise, I direct that their individual TEN (10%) PER CENT shares be held in trust until each attains the age of THIRTY (30) respectively. SIXTH: I hereby nominate and appoint my sister, LOUISE W. THOMAS, as "Trustee" of said accounts for my granddaughters, CASSANDRA and CHRISTINA ~ .~,~, TEMPLE. ~' SEVENTH: I hereby nominate, constitute and appoint my sister, LOUIS W. THOMAS, as Executrix of this my, Last Will and Testament. In the event that my sister, LOUISE, predeceases me, fails to qualify, ceases to act, or for some reason is ~ incapable of performing such task, I then nominate, constitute and appoint my sister-in- law, DOROTHY SAWYER, as alternate Executrix of this my, Last Will and Testament. EIGHTH: None of the above named persons shall be required to post bond or surety in this or any other jurisdiction for faithful compliance of the office of Executrix and/or Trustee. IN WITNESS WHEREOF, I hereby set my hand and seal and declare this to be my, LAST WILL AND TESTAMENT, consisting of this and two (2) other typewritten pages, identified by my signature, dated on this, the /'z-'//. day of CATHERINE R. JUMPEFI(/ (Testatrix) The preceding instrument, consisting of this and two (2) other typewritten pages, identified by the signature of the Testatrix, CATHERINE R. JUMPER, as and for her Last Will; who at her request, in her presence and in the presence of each other have subscribed our names as WITNESSES hereto. ~/~~ c'~..~~?___Residing At ~-[/~ ~.~ ~¢,~ Residing At COMMONWEALTH OF PENNSYLVANIA ) ) COUNTY OF CUMBERLAND ) T ........ AND ~ ~ -% r~~ .__the estatrix, and the witnesses, respectively, whose names are signe~t to the attached and foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix, CATHERINE R. JUMPER, signed and executed the instrument as her Last Will, and that she signed and executed it willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, that each of the Witnesses, in the presence and hearing of the Testatrix, CATHERINE R. JUMPER, signed the Will as witnesses, and that to the best of our knowledge and sight,, was at the time eighteen (18) or more years of age, of sound and disposing mind, memory and under no constraint or undue influence. CATHERINE R. JUMId~R (Testatrix) WITNESS WITNESS Subscribed, sworn to and acknowledged before me by CATHERINE R. JUMPER, Testatrix, who personally appeared before...me, the undersigned officer, and s/a~cri~ed to...ancl~worn to by th _P~ t _~F_~'~,S__, , ~ ~ ~--~g~va,~,.and C_~ I~_-u k_.~'~ , on this. / the ~'~-'-day of %.~.Fo~.~ , 19 ~. '-'--I~R Y PUBLIC My Commission Expires: the Notarial Seal . Donald. B. Owen, Notary Public cast Pennst)oro TWl3., Cumberland Countyl ,My Commission Expires Nov. 24, 1996 Milliner, PeftnsyNmia ,~ of Netaries LAST WILL AND TESTAMENT OF CATHERINE R. JUMPER LAST WILL AND TESTAMENT COUN$£LOR-AT-LAW 105 MT Vll~W DI~ ENOLA. Pa, 17025 PHONE. 1717) 732-3552 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: Will No. Catherine R. Jumper 4 July 2003 Admin. No. 21-03-0604 To the Register: I certify that notice of beneficial interest 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 23 September 2003: TO: Dorothy Sawyer, 312 4th Street, Summerdale, PA 17090 Cassandra Temple, 8355 Coventry Court, Granite Bay, CA 95746 Christina Temple, 8355 Coventry Court, Granite Bay, CA 95746 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None Date: Name: Samuel L. Andes Address: 525 N. 1 2th Street Lemoyne, PA 17043 Telephone//717-~761-5361 Capacity: Personal Representative Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 004048 THOMAS LOUISE W APT # 709 820 LISBURN ROAD CAMP HILL, PA 17011 ........ fold ESTATE INFORMATION: SSN: 19§-07-4586 FILE NUMBER: 2103-0604 DECEDENT NAME: JUMPER CAHTERINE R DATE OF PAYMENT: 06/15/2004 POSTMARK DATE: 06/1 5/2004 COUNTY: CUMBERLAND DATE OF DEATH: 07/04/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 82,659.32 REMARKS: TOTAL AMOUNT PAID: $2,659.32 SEAL CHECK# 95 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS  COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT C)?FICt,£~L USE ©NLY FILE NUMBER 21-03 COUNTYCODE YEAR 0 0604 NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Jumper, Catherine R. j.,,,. SOCIAL SECURITY NUMBER z 195 - 07 - 4586 LU . ~ DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH T o~ 07-04-2003 05-03-1912 REGISTER OF WILLS LLJ (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER none _ _ UJ r"., Z o U~ O r~l. Odginal Return F-14. Limited Estate E~]6. Decedent Died Testate (A~tac~ copy of w'~) r--] 9. Litigation Proceeds Received E~]2. Supplemental Return --"] 4a. Future Interest Compromise (d,~e of death afte~ 12.12-82) ~-]7. Decedent Maintained a Living Trust (AUach copy of Trust) F--Il0. Spousal Poverty Credit (date of dea'~ between 12-31-91 and 1-1-95} NAME Samuel L. Andes FIRM NAME TELEPHONE NUMBER (717) 761-5361 -'-'] 3. Remainder Return (date of death prior lo 12-13..82) F-J5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes E~] 11. Election to tax under Sec. 9113(A) (X~ch Sch COMPLETE MAILING ADDRE88 525 North 12th Street Lemoyne, PA 17043 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Padnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) E:] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous NomProbata Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. 14. 26,458.50 1,131.65 OFFICIAL USE ONLY Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) Net Value Subject to Tax (Line 12 minus Line 13) 26,458.50 (11) 1,131.65 (12) 25,326.85 (13) 25,326.85 (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) $5,O65.37 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate $20,261.48 x .12 (15) ¢6) $227.94 (17) $2,431.38 18. Amount of Line 14 taxable at collateral rate x .15 (18) X 19. Tax Due (19) $2,659.32 I~ecedent's Complete Address: STREET ADDRESS Country Meadows 4833 E. Trindle Road CITY Mechanicsburg J STATE PA I ZIF' 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A, Spousal Poverty Credit B. Pdor Payments C. Discount Interest/Penalty if applicable D. Interest E. Penalty (1) ~&.5~% ~Jz Total Credits (A + B + C ) (2) Z. G -~-~/, 3 ~ Total Interest/Penalty ( D + E ) 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 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (3) (4) (5) -T..,G~'-'% % "z (SA) (5B) 'Z_I~'=I, ~'2. Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; .......................................................................................... [] b. retain the right to designate who shall use the property transferred or its income; ............................................ [] c. retain a reversionary interest; or ..... . ........................................ [] d. receive the promise for life of either payments, benefits or care? ...................................................................... [] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. [] 3. Did decedent own an "in trust for'' or payable upon death bank account or security at his or her death? .............. [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penatlies of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is/rue, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGI~RE ~,~. ON RESPO~c,E FOR FILING RETURN ADDRESS"J- - - - 820 Lisburn Road, Apt. 709, Camp Hill, PA 17011 SIGNATUR~RER OTH E~E~NTA~r~E ADDRES~,,.~-'''''~'''~'''''''~5,J' ~ - ·"; 525 No~ 12~ Street, L~e, PA 17043 DATE For dates of death on or alter 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.8. §9116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 RS. §9116(1.2) [72 RS. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the 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. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY RE"V- I ~08 EX + (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATEOF Catherine R. Jumper FILENUMBER 21-03-00604 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Checking account No. 10436758 with M&T Bank Refund from Country Meadows Home $24,596.84 $1,861.66 TOTAL (Also enter on line 5, Recapitulation) $ 26,458.50 (If more space is needed, insert additional sheets of the same size) October 22, 2003 Samuel L. Andes Attorney at Law 525 North Twelfth Street P.O. Box 168 Lemoyne, PA 17043 499 Mitchell Street, Millsboro, DE 19966 Estate of Catherine R. Jumper Date of Death: July 4, 2003 Social Security Number: 195-07-4586 Dear Mr. Andes: In response to your request, please be advised that at the time of death, the above- named decedent had on deposit with this bank the following accounts. Account DJpe ........................... Checking Account Account Number. ...................... 10436758 Ownership (Names oj') .............. Catherine S. Jumper Opening Date ........................... 10/18/93 (account closed 09/04/03) 'Balance on Date of Deatk .........$24,596.84 Accrued Interest $ 0.00 Total ....................................... $24,596.84 Sincerely, Charlene Warrington, Associate I (302) 934-2722 SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS REV-1511 EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Catherine R. Jumper FILE NUMBER 21-03-00604 Debts of decedent must be reporled on Schedule [. ITEM NUMBER DESCRIPTION AMOUNT A, 1, FUNERAL EXPENSES: Musselman Funeral Home (balance prepaid) ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s). Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Year(s) Commission Paid: Attorney Fees Samuel L. Andes Family Exemption: (If decedent's address is not the same as claimanrs, attach explanation) Claimant Zip Street Address City State__ Relationship of Claimant to Decedent Probate Fees Register of Wills Accountant's Fees Tax Return Preparer's Fees Cumberland Law Journal (advertising) The Sentinel (advertising) Zip $187.32 $500.00 $284.32 $75.00 $85.01 TOTAL (Also enter on line 9, Recapitulation) $ 1,131.65 (If more space is needed, insert additional sheets of the same size) ]~nneral Heine & Crema6~n Ser~ces~ ][nc. Established 1895 Brian C. Musselman, ED. Supervisor William G. Pegan, ED. P.O. Box 137 324 Hummel Avenue Lemoyne, PA 17043-0137 (717) 763-7440 · Fax: 717-730-9798 www. musselmanfuneral.com To Funeral Expenses of Catherine S. JumDer Aug. 25, 2003 Items not on Original Contract; Harrisburg Patriot Obit. $ 81.32 Flowers with Tax 106.00 Total 187 32 FOR APPOINTMENT PHONE 717-763-7440 REV4513 EX + (I,97J ~ SCHEDULE J co..o.w~.T, oF ,~E..sYLv^.,^ B E N E F IC IA RI E S INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Catherine R. Jumper FILENUMBER NUMBER II. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions) Louise W. Thomas 820 Lisburn Road, Apt. 709, Camp Hill, PA Dorothy Sawyer 312 4th Street, Summerdale, PA 17093 Cassandra Temple 8355 Coventry Court, Granite Bay, CA 95746 Christina Temple 8355 Coventry Court, Granite Bay, CA 95746 17011 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) sister sister granddaughter granddaughter ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 91t3 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE None B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART I! - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET (If more space is needed, insert additional 'sheets of the same size) 21-03-00604 AMOUNT OR SHARE OF ESTATE 40 % 40 % 10% 10% ON REV 1500 COVER SHEEi : $ 0.00 BUREAU OF TNDI'VTDUAL TAXES INHERITANCE TAX DIVISION DEPT. ZBD601 HARRISBURG,, PA 1712:8-0601 SAHUEL L ANDES 525 N 1ZTH ST LEHOYNE COMMONWEALTH OF 'PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLONANCE OR DZSALLO#ANCE OF DEDUCTIONS ,AND ASSESSMENT OF TAX ~...-_.~-~ :. ? ~-!' = DATE ESTATE OF DATE OF DEATH '0~ JUL ~0 ~ :30 FXLE NUH~ER COUNTY ACM 08-02-200~ JUHPER 07-0~-2005 21 05-060~ CUMBERLAND 101 Aeoun~ ReeA~ed REV-lSd? EX ~FP (01-05) CATHERINE R HAKE CHECK PAYA~tLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG TH'rS L'rNE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-15&? EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSENENT~ ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF dUHPER CATHERINE R FILE NO. 21 05-060~ ACM 101 DATE 08-02-200~ TAX RETURN I/AS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVAT'rON CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN ~ASED ON: ORIGINAL RETURN 1. Reel Es~e~e (Schedule A) (1} .00 2. S~ocks end Bonds (Schedule B) (2) .00 $. Closely Held S~ook/Par~nershAp Zn~eres~ (Schedule C) ($} .00 ~. Hor~gages/No~es ReceAvable (Schedule D) (~) .00 5. Cash/Bank DeposA~s/NAsc. Personal Proper~y (Schedule E) (5) 26;~58.50 6. JoAn~ly Owned Proper~y (Schedule F) (6) .00 7. Transfers (Schedule ~) (7) .00 8. To,al Asse~s (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 1,131.65 9. FuneraZ Expenses/Adm. Cos~s/Hisc. Expenses (Schedule H) (9) 10. Deb~s/Nor~gage LAabAZA~Aes/LAens (Schedule Z) (10) .00 11. To,al Deduc~Aons (11) 12. Ne~ Value of Tax Re~urn (12) NOTE: To Ansura proper credA~ ~o your accoun*, subeA~ ~he upper por*Aon of ~hAs fore ~A*h your ~ax payeen~. 26,~58.50 1.12tl .~5 25~$26.85 13. 1~. NOTE: ASSESSHENT OF TAX: 15. Aeoun~ of LAne 1~ a~ Spousal ra~e 16. Aeoun~ of LAne 1~ ~axable a~ LAneal/Class A ra~e 17. Amoun~ of LAne 1~ a~ SAblAng ra~e 18. Amoun~ of LAne 1~ ~axable e~ Collateral/Class B ra~e 19. PrAncApal Tax Due TAX CREDZTS: PAYMENT RECEIPT . DZ~COUNT (+) Chari~able/governeen*al Bequests; Non-elected 9115 Trusts (Schedule J) (13) . O0 Na~ Value of Es~a*e Sub~ec~ ~o Tax (lq) 25,$26.85 Zf an assess;ant ~as Assued prev~ousZy, l~nes 14, 15 and/or 16, 17, 18 and 19 reflect fAgures that Anclude the total of ALL returns assessed to date. (15) .00 X O0 = .00 (16) 5,065.37 X Off5= 227.9q (17) 20,261.~8 X 12 = 2,631.:58 (18) .00 x 15 : .00 (19)= 2,659.$2 DATE 06-15-200~ NUHBER CDO0~O~8 INTEREST/PEN PAID (-) .00 BALANCE OF UNPAID INTEREST/PENALTY AS OF 06-16-200R IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. AMOUNT PAID 2,659 .$2 TOTAL TAX CREDIT · ALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 2,659.$2 .00 21.06 21.06 ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT IS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE .~ A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ~\ RESERVATION: PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: iNTEREST: Estates of decedents dying on or before December 1Z, 198Z -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Ceemonmaalth 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 Section ZlqO of the Inheritance and Estate Tax Act, Act Z5 of ZOO0. (7Z P.S. Section 91qO). Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side. --Make check or money order payable to: REGISTER OF NILES, AGENT A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-iS15). Applications ara available at the Office of the Register of Nills, any of the Z3 Revenue District Offices, or by calling the special Zq-hour answering service for forms ordering: 1-800-36Z-ZO50; services far taxpayers with special hearing and / or speaking needs: 1-800-~q7-5020 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disalloaance 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. ZBIOZ1, Harrisburg, PA 171ZS-lOZ1, 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. ZB0601, Harrisburg, PA 171Z8-0601 Phone (7173 787-6505. Sea page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-15013 for an explanation of administratively correctable errors. If any tax due is paid within three (33 calendar months after the decadent's death, a five percent (SZ) discount of the tax paid is allowed. The 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 period 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 (l) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6X) percent per annum calculated at a daily rate of .00016~. A11 taxes which became delinquent on and after January 1, 198Z eill bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZO0~ ere: Interest Daily Interest Daily Interest Year Rate Factor Year Rate Factor ~ ZOZ .0005q8 ~J~'8 - 1991 117. .000501 1983 16Z . 000q-38 199Z 9Z . O00Zq7 198q 11Z .O00~Ol 1993-199q 7Z .000192 1985 13Z .000~56 1995-1998 92 .0002~7 1986 IOZ .O00Z7~, 1999 7Z .O0019Z 1987 IOZ . O00Z7q ZOOO 7Z .00019Z --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID Daily Year Rate Factor ~ 9x .oooz~7 ZOOZ 6Z .00016~ 2005 5X .0001~7 ZO0~ ~Z .000110 X NUtlBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent mill 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. BUREAU OF ZNDZVTDUAL TAXES TNHERTTANCE TAX DTyTSTON DEPT. 280601 HARRISBURG, PA 17128-060! COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLO#ANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-lgIi7 EX AFP C01-05) SAHUEL L ANDES 525 N 12TH ST LENOYNE n!?'~e';.~_ :'' ESTATE OF DATE OF DEATH FILE NUHBER '04 AU~ 20 ~2 ]43 COUNTY ACN 08-OZ-ZOOq JUHPER 07-Oq-ZO0$ Z1 05-060~ CUHBERLAND 101 Amount CATHERINE R HAKE CHECK PAYABLE AND REHZT PAYHENT TO= REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF JUHPER CATHERINE R FILE NO. 21 05-060~ ACN 101 DATE 08-02-200~ TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: 1. Real Estate (Schedule A) 2. $. q. 5. 6. 7. 8. ORIGINAL RETURN (1) Stocks and Bonds (Schedule B) CZosaly Held Stock/Partnership Interest (Schedule C) (5) Mortgages/Notes Receivable (Schedule D) (q) Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) Jointly Owned Property (Schedule F) (6) Transfers (Schedule $) (7} Total Assets APPROVED DEDUCTIONS AND EXEHPTZONS: 9. Funeral Expenses/Ada. Costs/Hisc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule Z) 11. Total Deductions 12. Net Value of Tax Return 15. lq. (9) (10) Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) Net Value of Estate Sub~ect to Tax 26/~58.50 .00 .00 NOTE: To insure proper .00 credit to your account, .00 submit the upper portion .00 of this form with your tax payment. .00 (8) 1,131.65 .0O NOTE 26,q58.50 (11) ]. 131.65 (12) 25,526.85 (15) . O0 (1~,) 25, $26.85 Z~ an assessment ~as issued previously, 11nes lq, 15 and/or 16, 17, reflect figures that include the total of ALL returns assessed to date. ASSESSHENT OF TAX: 15. Amount of L/ne 1~ at Spousal rate (15) 16. Amount of Line lq taxable at Lineal/Class A rata (16) 17. Amount of Line 1~ at Sibling rata (17) 18. Amount of Line 1~ taxable at Collateral/Class B rate (18) · O0 x O0 = 5,065.37 x Oq5= 20,261.~8 x 12 = · O0 x 15 = (19)= AMOUNT pA'rD 18 and 19 Hill ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF TH/S FORM FOR /NSTRUCT/ONS.) ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 2,659.32 .00 21.06 21.06 2,659.~2 19. Principal Tax Due TAX CREDITS: PAYMENT I DATE 06-15-200q RECETpT I DISCOUNT (+) NUMBER I INTEREST/PEN PAID (-) CDOOqOq8 . O0 BALANCE OF UNPAID INTEREST/PENALTY AS OF 06-16-200q .00 227.9q 2,q31.$8 .00 2,659.32 RESERVATION: Estates of decedents dying an or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonaealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the laaful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To ~ulfi11 the requirements of Section 1140 of the Inheritance and Estate Tax Act, Act 23 of ZOO0. (71 P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. --Make check or money order payable to: REGISTER OF #ILLS, AGENT A refund of a tax credit, ahich was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications ars available at the Office of the Register of Rills, any of the Z$ Revenue District Offices, or by calling the special Z4-hour ansaering service for forms ordering: 1-800-361-Z050; services for taxpayers aith special hearing and / or speaking needs: 1-800-447-3010 (TT only). Any party in interest not satisfied with the appraisement, alloaance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object aithin sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA i71ZD-IOZ1, 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 Reviee Unit, Dept. 260601, Harrisburg, PA 17118-0601 Phone (717) 787-6505. See page S of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) far an explanation of administratively correctable errors. If any tax due is paid within three ($) calendar months after the decedent's death, a five percent (5Z) discount of the tax paid is allowed. The 1SI 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 cf the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same ties period as you would appeal the tax and interest that has been assessed as indicated on this notice. Zntermst is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the data 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 .000164. All taxes which became delinquent on and after January 1, 1981 ail1 bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. Tho applicable interest rates for 1982 through Z004 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 ZOZ .000548 ~)'~-1991 llZ .000301 ~ 91 .000247 1983 16Z .000438 1991 91 .000247 ZOOZ 61 .000164 1984 111 .000301 1993-1994 7Z .000192 2003 51 .000137 1985 132 .000356 1995-1998 9Z .000247 Z004 4Z .O001lO 1986 102 .000274 1999 7Z .OOO19Z 1987 IOZ .000Z74 ZOOO 72 .000192 --Interest is calculated as folloas: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELIN~iUENT 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. Tf payment is made after the interest computation date shown on the Notice, additional interest must be calculated. 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 0O4295 ANDES SAMUEL L ESQUIRE 525 N 12TH STREET LEMOYNE, PA 17043 ........ fold ACN ASSESSMENT CONTROL NUMBER AMOUNT ESTATE INFORMATION: SSN: 195-07-4586 FILE NUMBER: 2103-0604 DECEDENT NAME: JUMPER CAHTERINE R DATE OF PAYMENT: 08/20/2004 POSTMARK DATE: 08/20/2004 COUNTY: CUMBERLAND DATE OF DEATH: 07/04/2003 101 I $26.06 I REMARKS: SAMUEL L ANDES TOTAL AMOUNT PAID: $26.06 SEAL CHECK//5264 INITIALS: SK RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS 525 N. 12TH STREET LEMOYNE, PA 17043 BUREAU OF TND'rVZDUAL TAXES ZNHERTTANCE TAX DTVI'STON DEPT. 28060]. HARRTSBURG, PA ].7].28-0601 SAMUEL L ANDES 525 N 12TH ST LEMOYNE PA 170q$ COMNONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ZNHERTTANCE TAX STATEHENT OF ACCOUNT DATE 09-Z7-ZOOq ESTATE OF JUMPER DATE OF DEATH 07-0~-2005 FILE NUMBER 21 0:5-060~ COUNTY CUMBERLAND ACN 101 Amoun~ Remi~ed REV-1607 EX AFP (Di-OS) CATHERINE R HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF MILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 1701:5 NOTE: To insure proper cred/~ ~o your accoun~c, submi~ ~he upper portion of ~hAs form wi4:h your ~ax payment. CUT ALONG THIS LINE ~ RETAIN LONER PORTZON FOR YOUR RECORDS REV-1607 EX AFP (01-03) ~ INHERITANCE TAX STATEMENT OF ACCOUNT ESTATE OF JUMPER CATHERINE R FILE NO. 21 0:5-060~ ACN 101 DATE 09-27-Z00~ THIS STATEHENT ZS PROVTDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACM ZN THE NAMED ESTATE. SHONN BELON TS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, ZF APPLTCABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-02-200q PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): 2,659.32 PAYHENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID .00 06-15-200~ 08-20-200~ CDO0~O~8 CDOOqZ95 21.06- 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), 2,659.:52 26:o6 TOTAL TAX CRED'rT 2,66q.:52 BALANCE OF TAX DUE 5.0OCR INTEREST AND PEN. .00 TOTAL DUE 5.0OCR YOU NAY BE DUE A REFUND. SEE REVERSE STDE OF THIS FORH FOR TNSTRUCTZONS. \...UllL.I..Jt:::l.J.ctUU \...oum:y - Keglster Ot Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 6/06/2005 THOMAS LOUISE W APT # 709 820 LISBURN ROAD CAMP HILL, PA 17011 RE: Estate of JUMPER CAHTERINE R File Number: 2003-00604 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.1, for decedents dying on or after July 1, 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: 7/04/2005 Your prompt attention to this matter will be appreciated. Thank You. z:eL~ GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Counsel Judge uJ - Estate of JUMPER CAHTERINE R Late of HAMPDEN TOWNSHIP ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA Estate No.: 21-03-00604 Date: 6/16/2005 NO.: 21-03-00604 THOMAS LOUISE W APT # 709 820 LISBURN ROAD CAMP HILL PA 17011 NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE Personal Representative: THOMAS LOUISE W Personal Representative Counsel: ** NO INFORMATION FOUND ** Date of Decedent's Death: 7/04/2003 Date of Delinquency Notice: 7/04/2005 The undersigned, Glenda Farner Strasbaugh, Clerk of Orhans' Court, in accordance with rule 6.12, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor their counsel, have filed with the Register of Wills or Clerk of Orphans' Court, his/her Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule, and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orhans' Court Rules, was given by the Clerk of Orphans' Court on 8/16/2005 and that the ten (10) day notice to file the status report has expired. Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or their counsel. cc: File Personal Representative Counsel ~~~~ Glenda Farner Strasbaugn Clerk of Orhans' Court A hearing is scheduled for October 07, 2005 at 9:30 ~~ in Courtroom No. 03. If the Status Report is filed prior to the hearing date, the hearing will automatically be cancelled. P.Jf ~ vR STATUS REPORT UNDER RULE 6.12 Name of Decedent: Catherine R. Jumper Date of Death: 07-04-2003 Will No. Admin. No. 21-03-604 To the Register: 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_ 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 'j.. -- B. The separate Orphans' Court No. (if any) for the personal representative's account is: C. Did the personal representative state an account informally to the parties in interest? Yes~ No_ D. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: 8! 2. sf V 5' ~~ Name: Address: Samuel L. Andes 525 N. 12th Street Lemoyne, PA 17043 Telephone # 717 761-5361 Capacity: ~ Counsel for Personal Representative cPf