HomeMy WebLinkAbout04-0246Register of Wills of
Estate of Earl F.
also known as
Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Mennin~ ~C<i i. 'i!
.o.
, Deceased Social Security No. 203 - 10- 2194
Jeanne Leabhart .,m
Petitioner(s), who is/are 18 years of age or older, apply(les) for: ~j~ Ilt%~ ~ P 3 ~ ]
(COMPLETE 'A' or 'B' BELOW:)
[] A. Probate and Grant of Letters Testamentary and ave[,~i~t~.t~i~ner($)iS/ak .the"e~kecut r ix
the Decedent, dated 10/23/2002 and codicil(s) dated None~,'t"' ........
Renunc i at i on
named in the last Will of
State relevant circumstances, e.g., renunciation, death of executor, etc.
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents
offered for probate; was not the victim of a killing and was never adjudicated incompetent:
N/^
B. Grant of Letters of Administration
(c.t.a.; d.b.n.c.t.a; pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and
heirs:
Name Relationship Residence
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland
County, Pennsylvania with his/her last family
or principal residence at
Decedent, then 84- years of age, died
1313 Mallard Road, East Pennsboro Township, Camp Hill, PA 17011
08/01/2003 Camp Hill, PA
(list street, number, and municipality)
at West Shore Health b Rehab.,
Decedent 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
(Location)
4,000.00
situated as follows:
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of
letters in the appropriate form to the undersigned:
Si~lnature Typed or printed name and residence
_ . 417 Cascade Road, Mechancisbur~, PA 17055
Prepared by the Pennsylvania E3ar Association
Copyright (c) 1996 form software only CPSystems, Inc. Form RW-1 (1991)
Commonwealth of Pennsylvania
County of Cumberland
Oath of Personal Representative
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 Decedent, Petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed
before me this///// day of
Je a~t e Lea[b~a~t\- -'
For the~egister _ / -
No.
Estate of Earl F. Mennin8 Deceased
Social Security No: 203-10- 2194 Date of Death: 08/01/2003
AND NOW, ~ ../// , ,~,,,'y~ ,~, in consideration
of the Petition on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters J-~ Testamentary J---J Of Administration
(c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate)
are hereby granted to Jeanne Leabhart
in the above estate and that the instrument(s) dated 10/23/2002
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters ........... $
Short Certificate(s) ..... $
Renunciation ........ $
Affidavits ( ) .... $
Extra Pages ( ) .... $
Codicil ........... $
JCP Fee .......... $
Inventory .......... $
Other ........... $
TOTAL ......... $
Prepared by the Pennsylvania Bar Association
Attorney: James D. Bo~ar, Esquire
I.D. No: 19475
Address: One West Main Street
Shiremanstown, PA 17011
Telephone: 717/737- 8761
Copyright (c) 1996 form software only CPSystems, Inc.
Form RW-1 (1991)
os.805 ~[v 9/86
This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
P 9505351
No.
Local Registrar
AUG 05 2003
[)ate
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
NAME OF DECEDENT (F ~rs~.
,. Earl F. Mennig
AGE (Las~ B.lhaa¥) J,, UNDER 1 YFo~I
'Male l' lc,August ~03
,203 _ 10 _ 2194
} I,. gHarrisburA, P
~.Camp Hill
~NTY O~ DiE~I'H CITY. ~ORO. BNp OF OEATH IPAC.~ NAME (ff e~ ~,lu~on. rove ~,~ a~ ~,
mCumberland ,.est Shore Health & Rehab. m .....~.,~.~ '
~CE~m'S USUAL ~U~ J ~O~ ~NES~INDUSTRY Wh i t eW
C~e~:~ Central Penn I -~.~p~F~Es, , ,s~,~,~.~l I
,,~ [,,~Railroad [,,. ~ ~ [,,. ~'~-1~' o,~, [.~arrie~' Ruth A Cox
1313 Mallard Road ,cm~ ,.m.,. renna.
Camp Hill, Pa. 17011 [~' Cumberland
~,~ ~ / ~pugust b,ZUO3 I~ott. ........ 11811 Carlisle Road
' '- i*~. ~t}
~u~E~~Ns~E~~,~s~c. ,~ ............. i- . Y I,,~ p il, Pa. 17011
' ~. /~/~t~ ~L//'/o~&~ ~N
,,, I/I.:' -- .. . , .~,
' k. q,~- a . J~ ~'/,/o5 I ~,o
~ E~ U~E~Y~ I ~ ....... "'
Id
................................ ~b, /~/~~~
DATE SIGNED .Oay. YeaO
,,~,..,-,.,,,~..~.,,.,7_. I.,,. 77r72;Z;
~tAME AND ADOFIESS OF PERSON WHO COMPLETED CAUSE OF DEATH
LAST WILL AND TESTAMENT
(Pour-Over Will)
OF
EARL F. MENNIG
'04 l'i/ R 11 P3:1]
IDENTITY
~':~:~;I, EARL' F. MENNIG, residing in the County of Cumberland, Commonwealth of Pennsylvania,
be~t~?~soUnd mind and memory, and not acting under duress or undue influence of any person
whomsoever, hereby declare this to be my Last Will and Testament, and I do hereby revoke all other
former Wills and Codicils to Wills heretofore made by me. My Social Security Number is 203-10-2194.
All reference made herein to "spouse or my spouse" refers to the person to whom I am currently
married, namely, RUTH C. MENNIG. By the ensuing provisions of this Will, it is my intention to
dispose of my interest in our property; I do not intend to dispose of anything belonging to my wife or to
put her to any election.
DEBTS, TAXES AND ADMINISTRATION EXPENSES
I have provided for the payment of all my debts, expenses of administration of property wherever
situated passing under this Will or otherwise, and estate, inheritance, transfer, and succession taxes, other
than any tax on a generation-skipping transfer that is not a liability of my Estate (including interest and
penalties, if any) that become due by reason of my death, under THE EARL F. MENNIG AND RUTH C.
MENNIG REVOCABLE LIVING TRUST executed on even date herewith (the "Revocable Trust"), or if
my spouse predeceases me, under the Survivor's Trust created by the said Revocable Trust. If the
Revocable Trust assets should be insufficient for these purposes, my Executor shall pay any unpaid items
from the residue of my Estate passing under this Will, without any apportionment or reimbursement. In
the alternative, my Executor may demand in a writing addressed to the Trustee of the Trust an amount
necessary to pay all or part of these items, plus claims, pecuniary legacies, and family allowances by court
order.
PERSONAL AND HOUSEHOLD EFFECTS
It is my intent that all my personal and household effects were transferred to the Revocable Trust
as a result of the Declaration of Intent signed this date. If there are any questions regarding the ownership
or disposition of these assets, it is my desire that such assets pour into the Revocable Trust, signed by me
this date in accordance with the provisions of the section titled "Residue of Estate."
RESIDUE OF ESTATE
I give, devise and bequeath all the rest, residue and remainder of my property of every kind and
description (including lapsed legacies and devices), wherever situated and whether acquired before or
after the execution of this Will, to the Trustee under that certain Trust executed by me on the same date of
the execution of this Will. The Trustee shall add the property bequeathed and devised by this item to the
corpus of the above described Trust and shall hold, administer and distribute said property in accordance
with the provisions of the said Trust, including any amendments thereto made before my death.
POUR-OVER WILLS
Page 1
If for any reason the said Trust shall not be in existence at the time of death, or if for any reason a
court of competent jurisdiction shall declare the foregoing testamentary disposition to the Trustee under
said Trust as it exists at the time of my death to be invalid, then I give all of my Estate including the
residue and remainder thereof to that person who would have been the Trustee under the Trust, as
Trustee, and to their substitutes and successors under the Trust, described herein above, to be held,
managed, invested, reinvested and distributed by the Trustee upon the terms and conditions pertaining to
the period beginning with the date of my death as are constituted in the Trust as at present constituted
giving effect to amendments, if any, hereafter made and for that purpose I do hereby incorporate such
Trust by reference into this my Will.
EXECUTOR
I hereby nominate and appoint Ruth C. Mennig as my Independent Executor of this, my Last
Will and Testament, to serve without bond.
In the event the first named Executor shall predecease me or is unable or unwilling to act as my
Executor for any reasons whatsoever, then and in that event, I hereby nominate and appoint Jeanne
Leabhart to serve without bond as my Independent Executor.
In the event the second named Executor shall predecease me or is unable or unwilling to act as
my Executor for any reasons whatsoever, then and in that event, I hereby nominate and appoint Ruth
Pottorffto serve without bond as my Independent Executor.
Whenever the word "Executor" or any modifying or substituted pronoun therefore is used in this
my Will, such words and respective pronouns shall be held and taken to include both the singular and the
plural, the masculine, feminine and neuter gender thereof, and shall apply equally to the Executor named
herein and to any successor to substitute Executor acting hereunder, and such successor or substitute
Executor shall possess all the rights, powers, duties, authority, and responsibility conferred upon the
Executor originally named herein.
EXECUTOR POWERS
By way of Illustration and not of limitation and in addition to any inherent, implied or statutory
powers granted to executors generally, my Executor is specifically authorized and empowered with
respect to any property, real or personal, at any time held under any provision of this my Will: to allot,
allocate between principal and income, assign, borrow, buy, care for, collect, compromise claims, contract
with respect to, continue any business of mine, convert, deal with, dispose of, enter into, exchange, hold,
improve, incorporate any business of mine, invest, lease, manage, mortgage, grant and exercise options
with respect to, take possession of, pledge, receive, release, repair, sell, sue for, make distributions in cash
or in kind of partly in each without regard to the income tax basis of such asset and in general, exercise all
of the powers in the management of my Estate which any individual could exercise in the management of
similar property owned in its own fight upon such terms and conditions as to my Executor may seem best,
and execute and deliver any and all instruments and do all acts which my Executor may deem proper or
necessary to carry out the purpose of this my Will, without being limited in any way by the specific grants
or power made, and without the necessity of a court order.
My Executor shall have absolute discretion, but shall not be required, to make adjustments in the
rights of any Beneficiaries, or among the principal and income accounts to compensate for the
consequences of any tax decision or election, or of any investment or administrative decision, that my
executor believes has had the effect, directly or indirectly, of preferring one Beneficiary or group of
Beneficiaries over others. In determining the Federal Estate and Income Tax liabilities of my Estate, my
POUR-OVER WILLS
Page 2
Testator
Executor shall have discretion to select the valuation date and to determine whether any or all of the
allowable administration expenses in my Estate shall be used as Federal Estate Tax deductions or as
Federal Income Tax deductions and shall have the discretion to file a joint income tax return with my
spouse.
SPECIFIC OMISSIONS
I have intentionally omitted any and all persons and entities from this, my Last Will and
Testament, except those persons and entities specifically named herein. If any person or entity shall
challenge any term or condition of this Will, or of the Living Trust to which I have made reference in the
sections "Household and Personal Effects" and "Residue of Estate," then, to that person or entity, I give
and bequeath the sum of only one dollar ($1.00) only in lieu and in place of any other benefit, grant,
bequest or interest which that person or interest may have in my Estate or the Living Trust and its Estate.
SIMULTANEOUS DEATH
If my spouse and I should die under circumstances such that the order of our deaths cannot be
determined, then it shall be conclusively presumed for the purpose of this Will that my spouse survived
me.
If any other Beneficiary should not survive me for sixty (60) days, then it shall be conclusively
presumed for the purpose of this my Will that said Beneficiary predeceased me.
EARL F. MENNIG
Testator
POUR-OVER WILLS
Page 3
This instrument consists of 5 typewritten pages, including the Attestation Clause, Self-Proving
Clause, signature of Witnesses, and acknowledgment of officer. I have signed my name at the battom of
..~ch _of thf preceding pag.~s. This instrument is being signed by me on this~.~__~_oS0~day of
ATTESTATION CLAUSE
The Testator whose name appears above declared to us, the undersigned, that the foregoing
instrument was his Last Will and Testament, and he requested us to act as witnesses to such instrument
and to his signature thereon. The Testator thereupon signed such instrument in our presence. At the
Testator's request, the undersigned then subscribed our names to the instrument in our own handwriting
in the presence of the Testator. The undersigned hereby declare, in the presence of each of us, that we
believe the Testator to be of sound and disposing mind and memory.
Signed by us on the same day and year as this Last Will and Testament was signed by the
Testator.
WITNESSES:
(Print/d-Name of Witness') / '
(Printed Name of-~Vitness) ' / -
ADDRESSES:
/
City,~il~ate, Zip '
City, State, Zip '
POUR-OVER WILLS
Page 4
Testator
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SELF-PROVING CLAUSE
~ip,.~.,, ~B. EFORE ~M.E, the.undersigned autho,r~ty, on this day persgnally ap31.e, arfdli~ARL F. MENNIG,
~,~r~r~ C).~J~~~nd l~3t~.T Q--.~in~l'~f'o ~ct~ ~ to me to be the
Testator and the witnesses, respectively, whose names are subscribed to th~ foregoing instrument in their
respective capacities, and all of them being by me duly sworn, EARL F. MENNIG, Testator, declared to
me and to the witnesses, in my presence, that the instrument is his Will and that he had willingly made
and executed it as his free act and deed for the purposes therein expressed; and the Witnesses, each on his
or her oath, stated to me in the presence and hearing of the Testator, that the Testator had declared to them
that the instrument is his Will and that he executed the same as such and wanted each of them to sign it as
a witness; and upon their oaths, each witness stated further that he did the same as a witness in the
presence of the Testator, and at his request and that he was at that time eighteen (18) years of age or over
and was of sound mind, and that each of the witnesses was then at least fourteen (14) years of age.
EARL F. MENNIG
Testator
(P'ri'r~t~3~N~me of WiPer'S)' - --
Witness
(Printed Name of Witness)
SUBSCRIBED AND ACKNOWLEDGED before me by EARL F. MENNIG, Testator, and
~sc~ and sworn to before me by'~l'~~f O. Shl~..~r'~ ~ __ and
W~_, ~h~lq ~rO t,c~. ,_"J~..~t~ witnesses, this the ~ ~ day of
~a~y Pul~li~C~mmon-weaffh' of ?~nnS~3.v.~ia
POUR-OVER WILLS
Page 5
Register of Wills of Cumberland County, Pennsylvania
Estate of
also known as
Earl F. Menni~
RENUNCIATION
, Deceased
The undersigned, Wi fe of
(Relationship) (Capacity)
the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that Letters be issued to
Jeanne Leabhart
WITNESS ~ hand this I U-IL' j'''-' day of ]~'~'lJ~,~.~ , Z~O~ ·
(Signature)
(Address)
Ruth C. Mennig
4837 E. Trindle Road, Room 316B
Mechanicsbur~, PA 17050
(Signature)
(Address)
(Signature)
Sworn to or affirmed and subscribed
before me this ~ ~L~ day
Notary Public
My Commission Expires:
(signature and seal of Notary or other official
qualified to administer oaths. Show date of
expiration of Nota~'s commission.)
(Address)
NOTARIAL SEAL I
BONNIE L WILLIAMS, NOTARY PUBLIC I
SHIREMANSTOWN BORO., CUMBERLAND CO.I
~ COMMISSION EXPIRES APRIL ]8, 2005..I
NOTE: Renunciations executed outside the Office of Register of Wills
in some counties are required to be notarized.
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, Inc. Form #RW-4 (1991)
REV- 1500 EX + {6-00)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REYENUE
OEPT, Z80601
HARRISBURG, PA 171Z8-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
21- 04- 0246
COUNTYCODE YEAR NUMBER
E
D
E
N
T
R 5.
E
C
A 6.
P
I
T
U 7.
L
A
T 8.
I
O 9.
N 10.
11.
12.
13.
14.
C
O
M
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Mennig Earl F.
CAPB
HpRL
EpIO
CRAC
KoTK
ES
Co.
T
I
O
N
DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR)
08/01/2003 04/04/1919
(IF APPL CABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Menni~, Ruth C.
4. Limited Estate 4a. Future lnterest Compromise (date of death after 1Z-1Z-8Z)
6, Decedent Died Testate 7, Decedent Maintained a Living Trust
(Attach copy of Will) (Attach copy of Trust)
I I 9. Litigation Proceeds Received U 10, Spousal Poverty Credit
(date of death between 1Z-31-91 and 1-1-95)
NAME
James D. Bosar Esquire
SOCIAL SECURITY NUMBER
203-10-2194
THIS RETURN MUST BE FILED IN DUPUCATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
H (date of death
3. Remainder Return prior to 1Z-13-82)
5. Federal Estate Tax Return Required
0 8. Total Number of Safe Deposit Boxes
r'--] 11. Election to tax under Sec. 9113(A)
(Attach $ch O)
FIRM NAME (If Applicable)
TELEPHONE NUMBER
717/737-876~
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or (3)
Sole-Proprietorship
Mortgages & Notes Receivable (Schedule D) (4)
Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
Jointly Owned Property (Schedule F) (6)
---] Separate Billing Requested
Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
Total Gross Assets (total Lines 1-7)
Funeral Expenses & Administrative Costs (Schedule H) (9)
Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
Total Deductions (total Lines 9 & 10)
Net Value of Estate (Line 8 minus Line 11)
COMPLETE MAILING ADDRESS
. OFFICIAL USE ONLY
One West Main Street
Shiremanstown, PA 17011
1,094 ?00
NOne
None
70O.OO
None
None
None
None
(8) 1,794.00
(11) 0.00
(12) 1,794.00
1,794.00
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13)
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line 13) (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) 1,794.00 X .0 0 (15) 0.00
16. Amount of Line 14 taxable at lineal rate X .0 45 (16) 0.00
17. Amount of Line 14 taxable at sibling rate X .12 (17) 0.00
18. Amount of Line 14 taxable at collateral rate X .15 (18). 0.00
19. Tax Due (19) O. O0
Copyright (c) Z000 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev6 00~
Decedent's Complete Address:
STREET ADDRESS
1313 Mallard Road
CITY
Camp Hill
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Interest/Penalty if applicable D. Interest
E. Penalty
I STATE I ZIP
PA 17011
(1) O. O0
Total Credits ( A + B + C ) (Z)
Total Interest/Penalty ( D * E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Pacje 1 Line 20 to recluest a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (55)
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. retaintheuseorincomeofthepropertytransferred; ......................... ~ ~
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
a beneficiary designation? ................................ [~ ~]
which
contains
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
0. O0
0.00
0.00
0.00
0.00
0.00
Under penalties of perjury, t declare that I have examined this return, Including accompanying schedules and statements, and to the best of my knowledge and belief, It Is true,
correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Jeanne Leabhart DATE
R:ZZDr . ~I ~ "
417
Cascade
Road
ER OTHER THAN REPRESENTATIVE ~es D. ~o~s~ ~sq~e DATE
/ / ~ /~. One West Main Street · · -
...................
te f death ;~a'ffer ]dl~ 1~ 1'994'a~ ~;~o';e' ];~u;,' 1~ 1995~ the tax rate imposed 0~
su~iving spouse is 3% [72 P.S. 9116 (a) (1.1) (i)].
For dates of death on or after Janua~ 1, 1995, the ~x rate imposed on the net value of tran~ers to or for the use of the sullying spouse is 0%
[72 P.S. 9116 (a) (1.1) (ii)]. The ~atute does not exempt a ~an~er to a surviving spouse from tax, and the statuto~ requiremenm for disclosure of asse~
and filing a ~x re~rn are still applicable even E the sullying spouse is the only beneficial.
For dates of death on or after July 1, 2000:
The ~x rate imposed on the net value of tra~ers from a deceased child ~en~-one yearn of age or younger at death to or for the use of a na~ral
parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2)].
The ~x rate imposed on the net value of tra~ers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 7Z P.S. 9116(1.2)
[72 P.S. 9116(aXl)].
~e tax rate imposed on the net value of tran~em 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.
Co,right (c) Z000 form sol,are on~ The Lackner Group, Inc. Form REV-1500 ~ (Rev. S-O0)
REV-1503 EX + (1-97)
COMMONWEALTHOFPENNSYLVANIA
INHERITANCETAXRETURN
RESIDENTDECEDENT
ESTATE OF
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
Earl F. Menni~ SS~ 203-10-2194 08/01/2003 21-04-0246
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION U. NIT VALUE OF DEATH
1 40 shares Metlife, Inc. shares 27.35 1,094.00
TOTAL (Also enter on line 2, Recapitulation) 1,094.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form R£V-I$03 EX (Rev. 1-97)
Statement of Trust Interests
February, 2000
At the time MetLife demutualizes, you will be allocated shares of MetLife, Inc. Common Stock, which will be held for you in the MetLife Policyholder Trust.
The number of Trust Interests you own is equal to the number of shares of MetLife, Inc. Common Stock held for you in the Trust.
This Statement of Trust Interests tells you how many Trust Interests you will own at the time MetLife demutualizes (in other words, how many
shares of MetLife, Inc. Common Stock will be allocated to you and held for you in the Trust).
If you want to buy more shares of MetLife, Inc. Common Stock to be held for you in the Trust, you should use the form printed below to submit
a Purchase Instruction. You are only eligible to purchase additional shares if you are being allocated less than 1,000 shares. Stock( can be
purchased through the Purchase and Sale Program on the first trading day following the gOth day after the date MetLife's demutualization
becomes effective. Purchase Instructions received before the purchase program begins will not be processed~ntil the commencement o! the
purchase program. If you want to sell the shares of MetLife, Inc. Common Stock held for you in the Trust, you should use the form printed on
the reverse side of this page to submit a Sell Instruction. Stod( held in the trust can be sold after the lPg distribution is completed, which
should be no more than 30 days after the plan effective date. Sell Instructions received before the sale program begins will not be processed
until the commencement of the sale program. All such purchases and sales will be on a commission-free basis.
AUTO ~~ 5-DIGIT 17001
EARL F HENNIG
1313 IIALLARD RD
CAHP HILL PA 17011-1224
h,,Uh,.Uh:,:,.lh,,lh,:U,,hh,hJ,h,J,,,ll,,lhh,,U
Please ia sar~ ;ha ;orrect address appears in
the window o~ ihe enveJope if you are
submitting a ?'.,~chase or Sale Instruction.
The attached inst;uc:ion c~rd identifies the
cor .... add, ~ ~or each b/pa of transaction.
LL4
N~969~
PLEASE RETAIN FOR YOUR RECORDS
future reference
Name
Investor ID
Number of Trust Interests
Sequence Number
EARL F HENNIG
8061 9567 0691
40
H00510171~
PLEASE READ THE IMPORTANT INFORMATION ON THE BACK OF THIS FORM AND IN THE ENCLOSED BROCHURE
Use ONLY if a transaction is requested. Unless you wish to initiate a transaction, no action is required.
PURCHASE INSTRUCTION 8061 9567 0691 Change of address:
EARL F NENNIG
ChaseMellon Shareholder Services
PO Box 382200
Pittsburgh PA 15250-8200
h,,ll,l,h,,hhl,l,lh,,h,h,,hlll,,,ih,,Ih,,ih,,I,,,ll
Please be sure this address appears in the
envelope window for Purchases ONLY!
SJonature; (if address beina chanoe~)
Make check, in U.S. dollars, payable to:
MetLife Purchase Program
Amount Enclosed
Minimum investment $250.00 (except as
described in the enclosed brochure)
0000101
102
806195670691 2
LL4 N.~9694
REV- 1508 EX
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Earl F. Menni~ SS# 203-10-2194 08/01/2003 21-04-0246
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
NUMBER
VALUE AT DATE
DESCRIPTION OF DEATH
700.00
1991 Ford, Vehicle Identification No. 3FAPP15J8M109724 - Sold at
Private Sale
TOTAL (Also enter on line 5, Recapitulation) $ 700.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc, Form REV-1508 EX (Rev. 1-97)
950060051005825-001
3 F A.P P~i'~J 8-N R'109724
10/10/90 1/13/95
REGISTERED OWNER(S)
EARL
1313
FIRST LJEN FAVOR OF:
DEPARTMENT OF TRANSPORTATION
CERTIFICATE OF TITLE'FOR A VEHICLE
j 91j
YEAR
UNLADEN WEIGH1
=RIOR TITLE STATE
FORD
M~KE OF VEHICLE
GVWR
ODOM PROC['} DATE
F MENNIG
MALLARD -RD
HILL PA 17011
ECOND MEN FAVOR OF
434666574.02 ME
I
039'9.7 ~t. 0
OOOM MILES O(~OM STATUS
ODOMETER STATUS
O - ACTUAL MILEAGE
I - MILCAGE EXCEEDS THE MECHANICAL
TITLE BRANOs
AN'~QUE VEHICLE
CLASSIC '¢EHICIE
OlSTRIBLJTION
R~CONSTRUCTED
BLUE CHIP FCU
5050 OERRY ST
HARRISBURG PA
17111
certify as of the date of iasue, the official recor~s of the Pennsylvania Department
of Tramoortadon rei!ect that the person(s) or company named {~emin is the iawtul owr~r
of the asid ve~icie. ,. :
HOWARD YERUSALIM
Secretary~ of Transportat[oa
SUBSCRIBED AND SWORN
TO BEFORE ME: '
&~.' OAY YEAR
When aoolying f~ title wffh a co-o~ner, other t~a ~r ~, ~ ~ of
UEN J IFNOUEN []
,~T~: CHECK BOX
UEN
QAT~:
SECONO UENHOLDER
STA~E
ZIP
REV-1513 EX * (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Earl F. Menni~ SS~; 203-10-2194
SCHEDULE J
BENEFICIARIES
08/01/2003
FILENUMBER
21-04-0246
NUMBER
II.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and
transfers under Sec. 9116~1.Z)]
Ruth C. Mennig
4837 E. Trindle Road
Room 316 B
Mechanicsburg, 17050
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Spouse
AMOUNT OR SHARE
OF ESTATE
Rest, residue
and remainder
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00
/If more space is needed, insert additional sheets of the same size)
Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-00)
LAST WILL AND TEST:~IENT
(Pour-Over Will)
OF
EARL F. ME.NY~'IG
IDENTITY
I, E,~UU_ F. MENNIG, residing in the County of Cumberland, Commonwealth of Pennsylvania,
being of sound mind and memory, and not acting under duress or undue influence of any person
whomsoever, hereby declare this to be my Last Will and Testament, and I do hereby revoke all other
former Wills and Codicils to Wills heretofore made by me. My Social Security Number is 203-10-2194.
-,
All reference made herein to "spouse or my spouse" refers to the person to whom I am currently
married, namely, RUTH C. MEN~'IG. By the ensuing provisions of this Will, it is my intention to
dispose of my interest in our property; I do not intend to dispose of anything belonging to my wife or to
put her to any election.
DEBTS, T.~X~ES A. ND :$~DMINISTtk~TION EXPENSES
I have provided for the payment of all my debts, expenses of administration of property wherever
situated passing under this Will or otherwise, and estate, inheritance, transfer, and succession taxes, other
than any tax on a generation-skipping transfer that is not a liability of my Estate (including interest and
penalties, if any) that become due by reason of my death, under THE EARL F. MENNIG AN'D RUTH C.
N[ENNIG REVOCABLE LIVING TRUST executed on even date herewith (the "Revocable Trust"), or if
my spouse predeceases me, under the Survivor's Trust created by the said Revocable Trust. If the
Revocable Trust assets should be insufficient for these purposes, my Executor shall pay any unpaid items
from the residue of my Estate passing under this Will, without any apportionment or reimbursement. In
the alternative, my Executor may demand in a writing addressed to the Trustee of the Trust an amount
necessary to pay all or part of these items, plus claims, pecuniary legacies, and family allo;vances by court
order.
PERSONAL AND HOUSEHOLD EFFECTS
It is my intent that all my personal and household effects were transferred to the Revocable Trust
as a result of the Declaration of Intent signed this date. If there are any questions regarding the ownership
or disposition of these assets, it is my desire that such assets pour into the Revocable Trust, signed by me
this date in accordance with the provisions of the section titled "Residue of Estate."
RESIDUE OF ESTATE
I give, devise and bequeath all the rest, residue and remainder of my property of every kind and
description (including lapsed legacies and devices), wherever situated and whether acquired before or
atSer the execution of this Will, to the Trustee under that certain Trust executed by me on the same date of
the execution of this Will. The Trustee shall add the property bequeathed and devised by this item to the
corpus of the above deschbed Trust and shall hold, administer and distribute said property in accordance
with the provisions of the said Trust, including any amendments thereto made before my death.
POLrR-OVER WILLS
Page 1
Testatort
If for any reason the said Trust shall not be in existence at the time of death, or if for any reason a
court of competent jurisdiction shall declare the foregoing testamentary disposition to the Trustee under
said Trust as it exists at the time of my death to be invalid, then I give all of my Estate including the
residue and remainder thereof to that person who would have been the Trustee under the Trust, as
Trustee, and to their substitutes and successors under the Trust. described herein above, to be held,
managed, invested, reinvested and distributed by the Trustee upon the terms and conditions pertaining to
the period be~nning with the date of my death as are constituted in the Trust as at present constituted
giving effect to amendments, if any, hereafter made and for that purpose I do hereby incorporate such
Trust by reference into this my Will.
EXECUTOR
I hereby nominate and appoint Ruth C Mennig as my Independent Executor of this, my Last
Will and Testament, to serve without bond.
In the event the first named Executor shall predecease me or is unable or unwilling to act as my
Executor for any reasons whatsoever, then and in that event, I hereby nominate and appoint Jeanne
Leabhart to serve without bond as my Independent Executor.
In the event the second named Executor shall predecease me or is unable or unwilling to act as
my Executor for any reasons whatsoever, then and in that event, I hereby nominate and appoint Ruth
Portorffto serve without bond as my Independent Executor.
Whenever the word "Executor" or any modifying or substituted pronoun therefore is used in this
my Will, such words and respective pronouns shall be held and taken to include both the singular and the
plural, the masculine, feminine and neuter gender thereof, and shall apply equally to the Executor named
herein and to any successor to substitute Executor acting hereunder, and such successor or substitute
Executor shall possess all the rights, powers, duties, authority, and responsibility conferred upon the
Executor ori~nally named herein.
EX2ECUTOR POWERS
By way of Illustration and not of Iimitation and in addition to any inherent, implied or statutory
powers granted to executors generally, my Executor is specifically authorized and empowered with
respect to any property, real or personal, at any t/me held under any provision of this my Will: to allot,
allocate between pr/ncipal and income, assign, borrow, buy, care for, collect, compromise claims, contract
w/th respect to, continue any business of mine, convert, deal with, dispose of, enter into, exchange, hold,
improve, incorporate any business of mine, invest, lease, manage, mortgage, grant and exercise options
w/th respect to, take possession of, pledge, receive, release, repair, sell, sue for, make distributions in cash
or in kind of partly in each without regard to the income tax basis of such asset and in general, exercise all
of the powers in the management of my Estate which any individual could exercise in the management of
similar property owned in its own right upon such terms and conditions as to my Executor may seem best,
and execute and deliver any and all instruments and do all acts which my Executor may deem proper or
necessary to carry out the purpose of this my Will, without being limited in any way by the specific grants
or power made, and without the necessity of a court order.
My Executor shall have absolute discretion, but shall not be required, to make adjustments in the
fights of any Beneficiaries, or among the principal and income accounts to compensate for the
consequences of any tax decision or election, or of any investment or administrative decision, that my
executor believes has had the effect, directly or indirectly, of preferring one Beneficiary or group of
Beneficiaries over others. In determining the Federal Estate and Income Tax liabilities of my Estate, my
POUR-OVER WILLS
Page 2
Testator
Executor shall have discretion to select the valuation date and to determine whether any or all of the
allowable administration expenses in my Estate shall be used as Federal Estate Tax deductions or as
Federal Income Tax deductions and shall have the discretion to file a joint income tax return w/th my
spouse.
SPECIFIC OMISSIONS
I have intentionally omit-ted any and all persons and entities from this, my Last Will and
Testament, except those persons and entities specifically named herein. If any pe..rson or entity shall
challenge any term or condition of this Will, or of the Living Trust to which I have made reference in the
sections "Household and Personal Effects" and "Residue of Estate," then, to that person or entity, I g-ive
and bequeath the sum of only one dollar ($1.00) only in lieu and in place of any other benefit, grant,
bequest or interest which that person or interest may have in my Estate or the Living Trust and its Estate.
SI*II-rLT.-LNE O US DEATH
If my spouse and I should die under circumstances such that the order of our deaths cannot be
determined, then it shall be conclusively presumed for the purpose of this Will that my spouse survived
me.
If any other Beneficiary. should not survive me for sixty (60) days, then it shall be conclusively
presumed for the purpose of this my Will that said Beneficiary predeceased me.
EARL F. MEN~'IG
Testator
POUR-OVER WILLS
Page 3
This instrument consists of 5 typewritten pages, including the Attestation Clause, Self-Proving
Clause, signature of Witnesses, and acknowled,m'nent of officer. I have signed my name at the bottom of
..,~ch of the preceding pa~s. This instrument is be/ne sianed by me on th~s,r~-. 5LAO[day of
ATTESTATION CLAUSE
The Testator whose name appears above declared to us, the undersigned, that the foregoing
instrument was his Last Will 'and Testament, and he requested us to act as witnes.s.es to such instrument
and to his signature thereon. The Testator thereupon signed such instrument in our presence. At the
Testator's request, the undersigned then subscribed our names to the instrument in our own handwriting
in the presence of the Testator. The undersigned hereby declare, in the presence of each of us, that we
believe the Testator to be of sound and disposing mind and memory.
Signed by us on the same day and year as this Last Will and Testament was signed by the
Testator.
WITN-ESSES:
(Prmt/d~'ame of Witness)
(Printed Name of Witness)
ADDRESSES:
Ciry,b~ate. Zip ' '
City, grate, Zip ~
POUR-OVER WILLS
Page 4
Testator
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CLrMBERLAND
SELF-PROVING CLAUSE
_ ~ , BEFORE LIE, the undersigned author/tv, on this day r>ersonallv aooeare~.E ARL F MEN~'IG
t4g-(~.PcI~.~--T ~ .~h-e-m~..~rt~nd ~,..:.~(t~.~t~C kL.5~-312 "~l"0c,.~~ to me to be the
Testator and ~e wimesses, respectively, whose names are subscribed to th'% ?oregoin~ ins~ment in their
respective capacities, ~d all of them being by me duly sworn, E.~ F. ME,G, Testator, declared to
me and to the wimesses, in my presence, that the ins~ment is his Will ~d that he had willingly made
and executed it as his flee act ~d deed for the pu~oses therein expressed; and the Wimesses, each on his
or her oath, stated to me in the ~resence and heating of the Testator, &at the Testator had declared to them
~at the ins~ment is his Will and that he executed the same as such and wanted each of them to si~ it as
a wimess; and upon ~eir oa~s, each wimess stated ~her that he did ~e same as a wimess in the
presence of the Testator, and at his request and that he was at that time eighteen (18) years of age or over
and was of sound mind, and ~at each of the wimesses was then at least fo~een (14) years of age.
E,~ F. MEN~G ~ ~
Testator
Witness
(P~inted Name of Witness)
SU'BSCRIBED
subscribed and sworn to before me
AxN-D ACKNOWLEDGED before me by EARL F. MEN~'NIG, Testator, and
by-rM~aff_C~a~_r O, Sh~.~c~ f~ ~ ~d
~ wimesses, ~is ~e ~~ day of
~: -
Nota~ PuSl~JC~onkeal[h of ~e~s~v~ia
POL,-R-OVER WILLS
Page 5
CERTIFICATION OF NOTICE UNDER RULE 5.6 (a)
Name of Decedent: Earl F. Mennig
Date of Death: August 1, 2003
Will No. 21-04-0246
To the Register:
Admin. No.
I certify that notice of estate administration required by
Rule 5.6(a) of th~ Orphans' Court Rules was served on or mailed
to the following beneficiaries of the above-captioned estate on
May 27, 2004:
Name
Address
Ruth C. Mennig
4837 E. Trindle Road
Room 316 B
Mechanicsburg, PA 17050
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except:
None
Date:
Capacity:
James D.
One West Ma~h~JStreet
Shiremanstown, PA 17011
(717) 737-8761
Personal Representative
X Counsel for Personal
Representative
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Rarl F. Mennig
Date of Death: August 1, 2003
Will No. 21-04-0246 Admin. No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes x No~
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes__ No X
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest? Yes X No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
Date: ~%~ -S~gnatur~_/
James D. ~gar, Esquire
Name (Please type or print)
One West Main St.
~ Shiremanstown, PA 17011
'~ Address
(717) 737-8761
Tel. No.
(MAH:rmf/AM3)
Capacity:
x
Personal Representative
Counsel for personal
representative
BUREAU OF ZNDZVTDUAL TAXES
ZNHERTTANCE TAX DZVTSTON
DEPT. 280601
HARR/SSURG, PA 17128-0601
COMMONNEALTH OF PENNSYLVANZA
DEPARTMENT OF REVENUE
NOTZCE OF iNHERiTANCE TAX
APPRAISEMENT, ALLONANCE OR DZSALLONANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
JANES D BOGAR ES(~04 JUL 30
1 N MAIN ST
SHIRENANSTONN (i~ I~A:-17011
:31
DATE
ESTATE OF
DATE OF DEATH
FZLE NUMBER
COUNTY
ACN
08-02-200q
NENNING
08-01-2005
21 0q-02~6
CUMBERLAND
101
Aeount Remitted
RE¥-15,~7 EX AFP
EARL F
HAKE CHECK PAYABLE AND REMIT PAYHENT TO:
REGISTER OF NILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THiS LZNE ~ RETAIN LONER PORTZON FOR YOUR RECORDS
REV-1547 EX AFP (01-03) NOTZCE OF ZNHERTTANCE TAX APPRAISEMENT, ALLONANCE OR
DZSALLONANCE OF DEDUCTZONS AND ASSESSMENT OF TAX
ESTATE OF MENNING EARL F FiLE NO. 21 0~-02q6 ACN 101 DATE
TAX RETURN NAS: (X) ACCEPTED AS F/LED ( ) CHANGED
RESERVATION CONCERNTNG FUTURE iNTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Stock/Partnership Interest (Schedule C) ($)
4. Hortgages/Notes Receivable (Schedule D) (4)
5. Cash/Bank Deposits/N/sc. Personal Property (Schedule E) (5)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G) (7)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adc. Costs/N/sc. Expenses (Schedule H) (9)
10. Debts/Hortgege Liabilities/Liens (Schedule 1) (10)
11. Tote1 Deductions
12. Net Value of Tax Return
15.
14.
Charitable/Governeental Bequests; Non-elected 9115 Trusts (Schedule J)
Ne~ Value of Estate Subject ~o Tax
· O0 NOTE: To insure proper
1; 09q. O0 credit to your eccount,
· 00 submit the upper portion
· O0 of this fore with your
700 · 00 tax peyeent.
.00
.00
(8) 1,79q.00
.00
.00
(11) . OO
(la) 1,79~.00
(15) . O0
(14) 1,79~.00
NOTE:
Zf an assessment was issued previously, 11nes 14, 15 and/or 16, 17, 18 and 19
reflect figures that /nclude the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Aeount of Line 14 at Spousal rate
16. Aeount of Line 14 taxable at Lineal/Class A rate
17. Aeount of Line 14 et Sibling re~e
16. Aeount of Line 14 taxable at CoXXateral/Class B rate
19. Princlpal Tax Due
TAX CREDITS:
PAYHENT RECE/PT D/SCOUNT (+)
DATE NUMBER iNTEREST/PEN PA/D (-)
w111
(15) 1,79~.00 x O0 = .00
(16) .00 x Oq5= .00
(17) . O0 x 12 = . O0
(18) .00 x 15 = .00
(19)= . O0
XF PAiD AFTER DATE XND/CATED~ SEE REVERSE
FOR CALCULATION OF ADDIT/ONAL iNTEREST.
AHOUNT PAZD
TOTAL TAX CREDZT
BALANCE OF TAX DUE]
XNTEREST AND PEN.
TOTAL DUE
.00
.00
.00
.00
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT KS REqUiRED.
ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SZDE OF THiS FORM FOR ZNSTRUCTZONS.)
RESERVATION:
Estates of decedents dying on or before December II, [982 -- if any future interest in the estate is transferred
in possession or enjoyment to CIass B (collateral) beneficiaries of the decedent after the expiration of any estate for
lifo or for years, the Commonwealth hereby expressly reserves tho right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (coIIatmral) rate on any such future interest.
PURPOSE OF
NOT[CE=
PAYHENT:
REFUND (CR):
OBJECTIONS:
ADNIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
To fulfil! the requirements of Section Il40 of the Inheritance and Estate Tax Act, Act 13 of ZOO0. (72 P.S.
Section 9140).
Detach tha top portion of this Notice and submit with your payment to the Register of gills printed on the reverse side.
--Hake check or money order payable to: REGISTER OF NZLLS, AGENT
A rafund of a tax credit, which was not requasted on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-13[3). Applications are avaiIable at the Office
of tha Register of Hills, any of the 13 Revenue District Offices, or by calling the special Z4-hour
answering service for forms ordering: 1-800-362-Z050; services for taxpayers with spacieX hearing and / or
speaking needs: 1-800-447-3010 (TT only).
Any party in interest not satisfiad with tha appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount ar interest) as sho~n on this Notice must object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. ZBiOZ1, Harrisburg, PA X71ZB-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 Review Unit, Dept. 280601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. Sea page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
If any tax due is paid ~ithin three (3) calendar months after the decedant's death, a five percent (SI) discount of
the tax paid is allowed.
The 151 tax amnesty non-participation penalty is computed on the totaI of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the and of tho tax amnesty period. This non-participation
penalty is appealable in the same manner and in tho fha same tiaa period as you ~culd appeaI the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning ~ith first day of delinquency, or nine (9) months and one (1) day from tha date of
death, to the date of payment. Taxes which became delinquent before January l, 198Z beer interest at the rate of
six (6Z) percent par annum calculated at a daily rata of .000164, AIl taxes which bacama delinquent on and after
January [, 198Z wi[I bear interest at a rate .hich .il! vary from caZandar year to colander year .ith that rate
announced by the PA Department of Revenue. The appIicable interest rates for 1982 through Z004 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
~ ZOZ .000548 T~-1991 111 .00030x ~r~ 91 .000247
1983 162 .000438 1992 92 .000247 ZOOZ 62 .000164
1984 IlZ .000301 1993-1994 72 .000191 2003 51 .000137
1985 X3Z .000356 1995-1998 91 .000247 2004 42 .000110
19B6 102 .000274 1999 7Z .O00leZ
1987 102 .000174 ZOO0 72 .000192
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (la) 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.