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HomeMy WebLinkAbout03-0614 PETITION Estate of P~Z ~. also known as FOR PROBATE and GRANT OF LETTERS 27,,t No. To: Register of Wills for the County of Commonwealth of Pennsylvania Deceased. Social Security No. _/~ - ~/- 4[~,g'2 The petition of the undersigned respectfully represents that: Yotn petitioner(s), who is/are 18 years of age or older an the execnt or' in the last will ol the above decedent, dated and codicil(s) dated in the named (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent ,vas domiciled at death in ~./~,,ot,~- _,t¥,,~2~_ .~' County, Pen.nsylvania., with last family or pri.ncipal residence at t 13/ - g ' (list street, number and muncipality) Decendent, then yt// >,ears of age, died ~7"~ ~r 2~- , ~ .2.d:i03, at Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: ,'v./,4t WHEREFORE, petitioner(s) respectfully .recluest(s) the probate of the last will and codicil(s) presented herewith and the grant of letters (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. be3 o, OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ COUNTY OF Ctt~-/.~A//..3 J~ ss The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to [he best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly ~dminister the estate according to law. before me this __ ~q ~ day of [ ~/ ~.~$~e - ~ - ~' ~~ ~~* Register [ ~ No. ,-~'- Estate Of"--~,\ ~ , Deceased DECREE OF PROBATE AND GRANT OF LETTERS ~f~30. 2003 AND NOW the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated 3-28-20Q~ described therein be admitted to probate and filed of record as the last will of PAUL W STINE and Letters TESTAMENTARY , in consideration of the petition on are hereby granted to KARL R ST I N E FEES Probate, Letters, Etc .......... $~7/~, O0 Short Certificates( ) .......... $ i ~.O0 Renunciation ................ $. TOTAL __ $ Q%,oo Filed ...--!. :..3..0.-..o.~ ..................... k... _ Register of Wills"' ATTORNEY (Sup. Ct. I.D. No.) - ' ~DD~SS 7/7- 76& PHONE r-- REGISTER OF WILLS OF Cz~,~z~r,~z,,~b COUNTY OATH OF SUBSCRIBING WITNESS -(ea:h~ a subscribing witness to the will presented herewith, '(.ea~O being duly qualified according to law, depose(s) and say(s) that ./-,¢ ~.,,a,~ present and saw the testator- , sign the same and that ~a signed as a witness at the request of testator in hid presence and ~in thc ~rc~cncc cf each other) (k~ the ~rc~cncc of thc Sworn to or affirmed and subscribed before m~ ~C~ day of ~.~0~.,~' }~ ~Register (Address) (Name) (Address) REGISTER OF WILLS OF Cu,'~~/~ COUNTY OATH OF NON-SUBSCRIBING WITNESS --(-each.) a subscriber hereto, (each) being duly .~lified according to law, d~se(s) and say(s) thai -._ familiar with tl~q signature of ~N , % ~ codicil X testat___ of (one of th&x~ubscribing witnessesX[? the will presented~xherewith and that ~ believes the sig~ the wi~? ld'~cii~ th e h~a ingof n, n est °f ~-- kn°wledge an~elief' % ~ Swo~..~or affirmed and subscribed before X ~N me this day of X (Name) me tins % '~ 19 ~. % ~ (Address) Register (Name) (Address) REGISTER OF WILLS OF f~,A,,~q¢~ COUNTY OATH OF SUBSCRIBING WITNESS .-(each) a subscribing witness to the will presented herewith,4cach)-being duly qualified according to law, depose(s) and say(s) that .~ ~.~.c present and saw the testat or , sign the same and that ~ e signed as a witness at the request of testat or' in h is, presence and ~in tkc ~rc;cncc cf each c. tke~) (Ln t~e ~rc;cncc of the ...... w ....... ,~o)). Sworn to or affirmed and subscribed before me this _-?.~'~ day of I NOTARIAL SEAL- - I Charles E. Shields, Itl, Notary Public I Mon~oeTwp. C~mberla~'County ~ "-~' (Name) (Address) REGISTER OF WILLS OF N COUNTY on . (each) a~ubscriber hereto, (~~uly qu~ ~law, depose(s)anNay(s) tha; ~ familiar~th the signature of X ~ , ~ ..... N .. c°dic~N N testat~ o~one of the subscrib~g ~s to)the will ~resented herewith~nd ~ ,_ ~ . . .~Cil ~ that ~, ~ believes t~ature on the will is~andwriting o~ me this '~"~ (Name~ 19_~ (AddressJ Register (NamO (Address) !ais is to ceftin, that the information here given is correctly copied from an original certificate of death duly filed with me as Ix)cai Registrar. Tt~¢ original certificate will be forwarded to the State Vital Records Office for permanent ~ling. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee fbr this certificate, $2.00 P 933:1.538 No. Local Regtistrar /Date COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH Paul W. Stine 84~. I ; I ~ [ Apr6 1919 Cumberand I EastPennsboro I ,,~ e .- -., . : , ~ *~,~ ~Ct~m'S USU~ ~U~ I ~ ~ .USaES~lN~ ,~.y, . .... ~rogram~anager j.. ~e~era,~overnmen% ~t~ i,~~4 ,,~,, I ~rrieU j 7~ ~ .......... ~:':~ ....... I~''~' = ,,.. a-. ~ennsylvama ~ ,~=~ ~. 5flver ,~ Mechanicsburg, Pennsylvania 170~ ,~,.c~ Cumberland ~? ,;~ ~ ~.~.~ ,L · Charlotte U. Lucas ~NT'S ~ ~P ~ I~~ ~o,.s~a,~ Karl R. Stine I~ 's~~n~c~nicsburg, Pa 17050 ,~ ~x ....u ~....,.u ~ .... , I~ ~' '~ I ~ ~ ~/ Jul 25, 2003 I Mechanicsburg Cemete~ I Mechanicsburg Pennsylvania ~ ' t, .. ' ~ I - ~ ~mmVam~'~lm~mMMhh.~*~Ke.~d~hc,u~ll,Mminn,fH,tet~ ......................... ~ ate. ,~Oq t/O~t- 13,d. J~ Ll ~ ~E ~5S ~ PER~N ~ ~PLE TED ~AU~ ~ ~ UEOCA~ EXAH,~EmC~En (,,~ 2~y~ LAST WILL AND TESTAMENT OF PAUL W. STINE I, PAUL W. STINE, currently of the Borough of Mechamcsburg, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, pubhsh and declare this my Last Will and Testament, in contemplation of death, revoke and make void any and all prior Wills by me at any time heretofore made. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can conveniently be done. I give, devise and bequeath to my friend DONALD E. WILES, the sum of five thousand ($5,000.00) dollars. In the event he fails to survive me, this gift shall lapse and shall be considered part of the residue. All the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situate, I give, devise and bequeath to my nephew, KARL R. STINE. In the event he predeceases me, then to his wife, JOYCE M. STINE. In the event that they have both predeceased me, then to the children and step-children of my said nephew. I nominate, constitute and appoint my nephew, KARL R. STINE, to be the Executor of this my Last Will and Testament. In the event that he is unable or unwilling to act as Executor, I appoint my nephew's wife, JOYCE M. STINE to be the Executrix in his place and stead. I further direct that they shah not be required to file bond or other security in the Office of the Register of Wills for the purpose of administering my Estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this '~?]ff day of /~~ , A.D. 2003. PAUL W. STINE (SEAL) Signed, sealed, published and declared by the above-named PAUL W. STINE, as and for her Last Will and Testament, in the presence of us, who at her request and in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses. CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: Will No. Paul W. Stine July 22, 20021 Admin. No. 21-021-0614 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 August 5, 2003: Name Karl R. Stine Donald E. Wiles Address 717 Hogestown Road, Mechanicsburg, PA 17050 BZ7294, 1 Kelly Drive, Coal Township, PA 17866-1021 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: August 5, 2003 CHARLES E. SHIELDS, III 6 Clouser Road Mechamcsburg, PA 17055 Telephone: (717) 766-0209 Counsel for Personal Representative . ,OMMO; ~/EALTH OF PENNSYLVANIA DEPARTN' :NT OF REVENUE BUREAU O: INDIVIDUAL TAXES DEPT. 280~'i01 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 004084 SHIELDS CHARLES E III 6 CLOUSER ROAD MECHANICSBURG, PA 17055 fold ESTATE INFORMATION: SSN: 198-01-4952 FILE NUMBER: 2103-0614 DECEDENT NAME: STINE PAUL W DATE OF PAYMENT: 06/24/2004 POSTMARK DATE: 06/23/2004 COUNTY: CUMBERLAND DATE OF DEATH: 07/22/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $12,382.67 REMARKS: TOTAL AMOUNT PAID' KARL R STINE, EXECUTOR $12,382.67 SEAL CHECK# 525 INITIALS: AC RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS C©MMONVVEA/THOF J REV' 1 500 PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 28060 /INHERITANCE TAX RETURN HARRISBURG PA 17128-0601 RESIDENT DECEDENT ~ [ C0--~T~CO~E ---;E~*~--- -- NUU---~E~-- -- -- DECEDENT'S NAME {LAST, FIRST, AND MIDDLE INITIAL) I='- SOCIAL SECURITY NUMBER z ,S'-7'/,v ~- F,,~ u/ A). / qS C:) DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILEB IN DUPLICATE WITH THE I.U ,-/~'z;V ,~.~..2oo$ "¢-/:~"~/~' ~'" 75~/? REGISTER OF WILLS Iii (IF APPLICABLE) SURVIVING SPOUSE'S NAME {LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER -, [~ 1. Original Return o 4. Limited Estate u,I r..) 6. Decedent Died Testate (Attach copy of Will) < E~] 9. Litigation Proceeds Received F.- Z LU Z o o ~]2. Supplemental Retum E~4a. Future Interest Compromise (date of death after 12-12-82) J---~ 7. Decedent Maintained a Living Trust (Attach copy o¢ Truat) J----] 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) [~3. Remainder Return (date of death prior to 12-13-82) E~5. Federal Estate Tax Return Required ~)8. Total Number of Safe Deposit Boxes L[--] 11. Election to tax under Sec. 9113(A) (Attach Sch O) FIRM NAME (IfApplicable) TELEPHONE NUMBER 7/,~- 7~0 -- 0~0 ~ COMPLETE MAILING ADDRESS ILl 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership 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) ~"--~ Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate 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. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (8) 7/--/,¢', q7 OFFICIAL USE ONLY (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) ~:2 x .0 92 (15)  16. Amount of Line 14 taxable at lineal rate ~ x .0 ~ (16) O~ 17. Amount of Line 14 taxable at sibling rate / 0 x .12 (17) ,~, ~ 18. Amountof Line 14taxable at collateral rate ~1~,/ :~.~.j,, /~ x .15 (18) [.2,/, ¢ 19. Tax Due (19) /~:~J 26. ~ > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH Decedent's Complete Address: -------'---- DRESS '7/' 7' fl./'~ ,~'~'~..5 7'~/.~'vq.,) 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 O Total Credits (A + B + C ) (2) Total InterestJPenalty ( 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 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 + 5A. This is the BALANCE DUE. (3) 0 (4) (5) (SA) (5B) PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS Yes No 1. Did decedent make a transfer and: 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 bankaccount or security at his or her death? .............. [] ~' 4. Did decedent own an Individual Retirement Account, annuity, or othe[ non-probate property which [] [] contains a beneficiary designation? ........................................................................................................................ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and 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. DATE DATE SIGNATURF_./~FJ~REPAI~ER OTHF_R THAN_,,,I;~,P, ES~EN..TATIVE_,~.~__ ADDRESS ~-.~.,,4~,/~/.~".,-~' ~ ~/'~-"'7_~.~)..~' ~ · : -.: ::...~;;..:: ~..,: ............ * .......... . . . o 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 ~s 3 Yo [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 ~ 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 transfe: 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. '~' / SCHEDULE B COMMONW~LTHOFPENNSy~V^NI^/ STOCKS & BONDS INHERITANCE TAX RETURN ~ RESIDENT DECEDENT I ESTA'-'------~'E OF ~ FILE NUMBER .2/-o .3' - ~/~ Ail property jointly.owned with right of sun~ivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH TOTAL (Also enter on line 2, Recapitulation) (If more space is needed, insert additional sheets of the same size) Jul 29, 2003 7:37:22 AM CDT - Acct# 270-06311 ACCOUNT HOLDINGS EdwardJones IPAUL W STINE 524 E SIMPSON ST Single: 270-06311 Home: 717-766-3359 (p) Work: Information is Old, Last Updated - 7/25/03 ACCount Value Summary ,~ Market Value of Investments Held at Edward Jones t ~ Total Account Value 3,314.00J MUtual FUnds - Held ~ Acct Type NA~ Yesterday's Valm Amt InA Amt W/[ Shares "Cash(I) JOHN HANCOCK FINANCIAL 16.05( 206.491 3,314.0( 3,501~ _. INDUSTRIES FUND CL A FIDAX Subtotal: 3,314.00 3,501 The amounts invested and withdrawn for the first account type of this security are the total amounts that were invested and withdrawn for all account types of this security. This document is for informational purposes only. It may not reflect pending transactions or in-transit items. Prices/total values are from outside sources and are not guaranteed. Please refer to your most recent account statement. Page 1 of i '~" / SCHEDULE E / COMMONWEALTH OF PENNSYLVANIA / CASH, BANK DEPOSITS, & MISC. .2/-,~.~._~/~ 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 DESCRIPTION VALUE AT DATE OF DEATH .77 TOTAL (Also enter on line 5, Recapitulation) $ ~'~'t ~-'~ ~ ~ ~' (If more space is needed, insert additional sheets of the same size) CITIZENS BANK 525 William Penn Place Suite 153-2510 Pittsb~___gh, PA 15219 October 14, 2003 CHARLES E SHIELDS ffI 6 CLOUSER ROAD MECHANICSBURG, PA 17055 Estate of Paul W Stine Date of Death: Jul 22, 2003 SSN: 198-01-4952 Dear Sir/Madam: In accordance w/th your request, the attached information sheet has been provided in the above decedent's name as of his/her date of death. For IL or LC accounts, contact our Loan Department at 1-800-708-6680. For all other inquiries, please call 412.867.3884. Sincerely, Stepha e~T vers Operations Services CITIZENS BANK Account Number Account Title Date O_______pened Account T.ype Princi____._Epal Balance as of DOD Interest from Last Posting to DOD Account Balance as of DOD YTD Interest to DOD 6100700909 PAUL W STINE 12/18/1970 Checking $82032.80 $0 $82032.80 $0 CITIZENS BANK Account Number Account Title Date Opened Account Type ., Principal Balance as of DOD Interest from Last Posting to DOD Account Balance as of DOD YTD Interest to DOD 6140167833 PAUL W STINE 08/01/1971 Savings $600.90 $0.09 $600.99 $0.77 / SCHEDULE G I COMMONW~A~-~'~ ~SYLVAN,A / INTER-VIVOS TRANSFERS & / INHERIT^NCR TAX RETURN / MISC. NON-PROBATE PROPERTY ~TE OF ~ ~/~ ~~ ~ FlEE NUMBER ~/-o~ -~/~ ITEM NUMBI 1. 7. DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. % OF DATE OF DEATH DECD'S EXCLUSION "J)6~ ,e./_.D Ix) I z.E'5 . F,,,z ! TAXABLE VALUE TOTAL (Also enter on line 7, Recapitulation) (if more space is needed, insert additional sheets of the same size) JAMES SHEAFFER AUTO BODY SHOP r"-JESTIMATE P. O. BOX 74 1029 NEW KINGSTON. PA. 17072 r~ INVOICE Body Sltvle..~.~..i~__ii,.i~ ?y~ Lil~nl~ No P, in! No./~~___Trim No. '~I Adjuster Phone REMARKS TOTAL HRS. OF LABOR AT $. The estimQte is bQsecl on Our insgectiofl and does not co~r ~iti~l ~rts S~ i~ or lair ~ ~ ~ ~uir~ after t~ ~rk ~s ~n StartS. After the ~i~e ~rk ~s s~.~, Km ~ ~N~d ~ which are ~ ~ident on fi~t in- ~TIMATED BY~ ~ti~ ~y ~ di~. Noturolly t~ ~fi~e C~t C~e,' such con- ~ ~i~ies. Pa~s Dric~ ~bj~ to c~nge wit~ut ~e ~ ~timote is for ~ediate PER HR. $ PARTS $ PAINT MATERIALS $_ SUBLET $. SALES TAX $. TOWING $ SUB TOTAL $ S TOYAL $ REV-15'~1 EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER ITEM NUMBEF A. 5. 6. 7. ?. Debts of decedent must be reported on Schedule I. DESCRIPTION FUNERAL EXPENSES: ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address 7/~ ,/"'/z~ ¢~.c$ c~ty /"~..~ ~',,",,4,,v' / c $,~ 4, ~ ~. Year(s) Commission Paid: /'/,//,,~, Attorney Fees State ~,~ _Zip Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant ,,,~,,'~/~,'~' / 7o S'Z> Street Address City State ~ Zip Relationship of Claimant to Decedent Probate Fees ~ ,~,,;/;,,,~1 Accountant's Fees ~ ' Tax Return Preparer's Fees ) AMOUNT ~,~, o¥7. ~-I Z 7,~, oo 87. ?/ ~/3o.oo TOTAL (Also enter on line 9, Recapitulation $ ~,/ 0 0 7. ~o°~ (If more space is needed, insert additional sheets of the same size) SCHEDULE ! COUMON~;,LTHOFPE..SYLV^NI^ JDEBTS OF DECEDENT, INHERITANCE TAX RETURN ESTA~~E~ MORTGAGE LIABILITIE OF ~ ~/~ /~ ~. FILE NUMBER - ~/_~ Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION ct. a.d. clearance e~ check o~ er, w,,,.v, e;,t,'z~s AMOUNT TOTAL (Also enter on line 10, Recapitulation) $ ~ /g~. jgg) (If more space is needed, insert additional sheets of the same size) BENEFICIARIES ~ RESIDENT DECEDENT ESTAT NUMBER L II. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outdght spousal distributions) t3z 7,2 ~'/-]- FILE NUMBER RELATIONSHIP TO DECEDENT Do Not List Trustee(s) 2 / - AMOUNTORSHARE OF ESTATE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, 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 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) LAST~WILL AN__DD TESTAMENT OF PAUL W. STINE I, PAUL W. STINE, currently of the Borough of Mechanicsburg, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Wild and Testament, in contemplation of death, revoke and make void any and all prior Wills by mc at any time heretofore made. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can conveniently be done. I give, devise and bequeath to my friend DONALD E. WILES, the sum of five thousand ($5,000.00) dollars. In the event he fails to survive me, this gift shall lapse and shall be considered part of the residue. All the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situate, I give, devise and bequeath to my nephew, KARL R. STINE. In the event he predeceases me, then to his wife, JOYCE M. STINE. In the event that they have both predeceased me, then to the children and step-children of my said nephew. I nominate, constitute and appoint my nephew, KARL R. STINE, to be the Executor of this my Last Will and Testament. In the event that he is unable or unwilling to act as Executor, I appoint my nephew's wife, JOYCE M. STINE to be the Executrix in his place and stead. I further direct that they shall not be required to file bond or other security in the Office of the Register of Wills for the purpose of administering my Estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ,~j~/t/~ day of -- /P~~ _,A.D. 2003. ~ ' PAUL W. STINE _(SEAL) Signed, sealed, published and declared by the above-named PAUL W. STINE, as and for her Last Will and Testament, in the presence of us, who at her request and in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses. 171 \l · Attorney - At - Law 6 Clouser Road Mechanicsburg, PA 17055 Ms. Ann Capozzi Office of the Register of Wills Cumberland Co. Court House 1 Court 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 0O4084 SHIELDS CHARLES E III 6 CLOUSER ROAD MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN: 198-01-4952 FILE NUMBER: 2103-0614 DECEDENT NAME: STINE PAUL W DATE OF PAYMENT: 06/24/2004 POSTMARK DATE: 06/23/2004 COUNTY: CUMBERLAND DATE OF DEATH: 07/22/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I 812,382.67 I REMARKS: TOTAL AMOUNT PAID: KARL R STINE, EXECUTOR $12,382.67 SEAL CHECK# 525 INITIALS: AC RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS ~P'~-U 6°-723832 L W. STINE ESTATE ~f.D~'--~/'/'~ 2313 ~,,.. s~,.~ ~x~ ~ ~ o~oo~o~ 717 HOGESTOWN ROAD ~ MECHANICSBURG, PA 17050 ~ STATUS REPORT UNDER RULE 6.12 Name of Decedent: Paul W. Stine Date of Death: 07-22-2003 Will No. Admin. No. 21 03-0614 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~hether administration of the estate is complete: YeSvz~ 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 r~p~esentative file a final account with the Court? Yes__ No~ . b. The separate Orphans.' Court No~f any) fo~ the personal representative's account is: ~ ~ ?~? c. Did the personal representativ~!i:!s~aj~an account informally to the parties in interest? y~S ~ ~No d. Copies of receipts, releases, joinders and , approvals of formal or informal accounts may be filed w~ the Cerk of the Orphans' Court and may be attached to ~t~his r~ii'.~'I.~ Date: August 31, 2004 ~'~~~~ Signature Charles E. Shields, III, Esquire Name (Please type or print) 6 Clouser Road, Mechanicsburg, PA 17055 Address (717) 766-0209 Tel. No. Capacity: __Personal Representative X __Counsel for personal representative (MAH:rmf/AM3) Charles E. Shields III Attorney-At-Law 6 Clouser Road Mechanicsburg, PA 17055 Register of Wills Cumberland County Court House 1 Courthouse Square Carlisle, PA 17013 BUREAU OF iNDiViDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z8060I HARRISBURG, PA I?IZB-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF iNHERiTANCE TAX APPRAZSEHENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSHENT OF TAX CHARLES E SHIELDS III 6 CLOUSER RD HECHANICSBURG PA 17055 DATE ESTATE OF DATE OF DEATH FiLE NUMBER COUNTY ACN REV-15q7 EX AFP (Oi-OS) 08-16-200~ STINE PAUL W 07-22-2003 Z1 03-061~ CUMBERLAND 101 Amount RemL*~md r HAKE CHECK PAYABLE AND REMIT PAYNENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG: ~ZS L~E ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 ~'X~?~:~)--~'I-:§~')'-~I~D:I'-~k OF iNHERiTANCE TAX APPRAISEMENT, ALLOWANCE OR ~ ~* ~ ~ALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE O~ ~TINE ~ '~' PAUL WFZLE NO. 21 03-061~ ACN 101 DATE TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHAN~ED RESERVATION CONCERNING FUTURE iNTEREST - SEE REVERSE 08-16-200~ APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Ram1 Es~a~a (Schadule A} (1) 2. S~ocks and Bonds (Schedule B} (2) $. Closely Hald S~ock/Par~narsh/p in*eras* (Schedule C) ($} Q. Nor~gages/No~es Receivable (Schedule D] 5. Cash/Bank Deposi'cs/NLsc. Personal Proper~y (Schedule E) ($) 6. Jointly O~ned Proper~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 6;800.00 8. To~al Asse~s (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expansas/Adm. Cos~s/Hisc. Expenses (Schedule H) (9) 10. Deb~s/Hor~gaga Liabilitias/Lians (Schedule I) (10) q ~ 189.30 11. To*al Deduc~/ons (11) 12. Nm~ Value of Tax Rm~urn (12) 3~31~.00 .00 82163~.~7 .00 6,007.98 15. NOTE: .00 NOTE: To insure proper credi~ ~o your account, submi~ ~he upper portion .00 of thLs form wi~h your ~ax payment. 92,7~8.~7 10.197.28 82,551.19 Char/~mble/govarnmen~al Bequests; Non-eZec~md 9115 Trusts (Schedule J) (1~) . O0 Nat Value of Ese:ate Sub.~ec~: ~:o Tax (lq) 82,551.19 i.F an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 wil1 reflect flgures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amoun~ of L/ne 1~ a~ Spousal ra~e (15) 16. Amoun~ of L/ne lQ ~mxmble a~ LineaZ/CZass A ra~e (16) 17. Amoun~ of Line lq a~ Sibling ra~a (17) 18. Amoun~ of Line lq ~axabla m~ Collm~aral/Class B ra~m (18) 19. Principal Tax Due DISCOUNT INTEREST/PEN PAiD (-) TAX CREDZTS: PAYflENT DATE 06-23-200~ RECEIPT NUMBER · O0 X O0 = . O0 .00 X 0~5= .00 · O0 X 12 = . O0 82,551.19 X 15 = 12,382.67 (19)= ZZ, 382.67 AHOUNT PAiD 12,$82.67 TOTAL TAX CREDIT BALANCE OF TAX DUE iNTEREST AND PEN. TOTAL DUE .00 CDO0~08~ BALANCE OF UNPAID iNTEREST/PENALTY AS OF 06-2Q-200~ IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL iNTEREST. 12,:582.67 .00 8fi.f+5 { TF TOTAL DUE IS LESS THAN $1, NO PAYNENT IS RE{~UTRED. IF TOTAL DUE TS REFLECTED AS A "CREDTT' (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) RESERVATION: Estates of decedents dying on or before December iZ, 1982 -- if any future interest in tha estate is transferred in possession or enjoyment to Class D [collateral) beneficimrias 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 at tha laaful Class D (collateral) rate on any such future interest. PURPOSE OF NOTICE: PAYMENT: REFUND (CA): OBJECTIONS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To ~ulfill the requirements of Section Zl~O of the Inharitanca and Estate Tax Act) Act Z5 of 2000. (TZ P.S. Section 91qO). Detach tha top portion of this Notica and submit aith your payment to fha Register of Nills printed on the reverse side. --Make check or money order payable to: REGISTER OF NZLLS~ AGENT A refund of a tax credit, ahich mas not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritanca and Estate Tax" (REV-1513). Applications are available at the Office of the Register of Nills, any of the 25 Revenue District Officas, or by caZling tha special Z4-hour answering servica for forms ordering: 1-BOO-56Z-ZOSO; sarvicas for taxpayers mith special hearing and / or speaking needs: 1-800-qqT-3OZO (TT only). Any party in interest not satisfied aith the appraisement) allowance, or disallowance of deductions, or assessment of tax (including discount or interast) as shown on this Notice must eb~ect within sixty (60) days of receipt of this Notice by: --aritten pretest to the PA Department of Revenue, Board of Appeals, Dept. gB1ggl, Harrisburg) PA 171ZB-lOZl, OR --election to have the matter determined at audit of the account of the personal representative) OR --appeal to tha 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 171Z8-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions far Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively carrectebla errors. If any tax dua is paid within three (5) calendar months after the decedent's death, a five percent (SI) discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest essassed) 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 tha same manner and in the fha same time pariod as you would appeal the tax and interest that has been assessed as indicated on this notice. Intarast is charged beginning aith first day of dalinquancy, or nina (9) months and one (1) day from the date of death, to the date of payment. Taxes which became daZinquent before January 1, 198Z bear interest at the rate of six (OX) percent per annum caIcuIated at a daily rate of .O0016q. All taxes which became delinquent on and after January 1, 1982 will bear Jnterast at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable intarest rates for 198Z through ZO0~ ara: Interest Daily Interest Daily Interest Oaily Year Rate Factor Year Rate Factor Year Rate Factor [r~ 20Z .O005qB ~Y~-8-1991 XXX .000301 ~ 9Z .o00gq7 1985 162 .000~58 1992 9Z .O00Zq7 ZOOZ 62 .000164 1984 112 .000301 1995-1994 72 .00019Z 2003 5Z .000137 1985 132 .000556 1995-1998 92 .O00Zq7 2004 qZ .000110 1986 ZOZ .00027~ 1999 7Z .O00Zgz 1987 IOZ .000274 ZOO0 7Z .O0019Z --Interest is calculated as folloas: INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAZLY ZNTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fiftaen (15) days beyond the date of the assessment. If payment is made altar tha interest computation date shown on the Notica, additional interest must be calculated. GEORGE M. HOUCK (1912-1991) CHARLES E. SHIELDS, III A TTORNEY-AT-LA W 6 CLOUSER ROAD Comer of Trindle and C lou~er Roads MECHANICSBURG, PA 17055 August24,2004 TELEPHONE (717) 766-0209 FAX (717) 795-7473 Register of Wills Cumberland County Court House 1 Courthouse Square Carlisle, PA 17013 Re: Estate of Paul W. Stine No. 21-03-0614 Dear Register of Wills: Please find enclosed check number 535 from the above estate, in the amount of $84.45 for interest and penalty due. Thank you for your kind attention to this matter. CES:slk Enclosure Very truly yours, Charles E. Shields, III Attorney-At-Law BUREAU OF INDIVIDUAL TAXES CHARLES E SHIELDS 6 CLOUSER RD MECHANICSBURG PA 17055 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLORANCE OR DZSALLOHANCE OF DEDUCTIONS AND ASSESSHENT OF TAX DAT~; 08-Z6-200,~ E-~T~Air E OF STINE Di~'ril OF DEATH 07-22-2003 FILE NUMBER ZZ 05-06Iq 101 PAUL W HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 ..... YOUR ReCO.DS REV 1S~7 EX AFP (0! 03) NOTICE OF INHERITANCE TAX A~ ....................... ~=~'%-; ................ PRAZSEHENT. ALLO~AN~ ~n - ~ZSALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF STINE PAUL WFZLE NO. 2I 05-061q ACN 101 DATE 08-16-200~ TAX RETURN RAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN l. Reel Es~m~e (Schmdulm A) (1) .0O 2. S{o~s and Bonds ($=hodul= B) ~. Closmly Held S~ock/Per{norship ln{mres~ (Schedule C) 4. Hor~g~os/No~os RocoAvmblo (Schedule D) S. Cash/B~ D~osA~s/H~sc. Personal Proper*~ (Schedule E) 6. Join*ly Owed Proper~ (Scho~lo F) 7. T~nsfers (S~odulo G} 8. To,al Asso~s APPROVED DEDUCTIONS AND EXEHPTZONS: 9. F~oral E~ensos/Adm. Cos~s/H~sc. Expenses (Scho~lo H) lO. Dob*s/Hor~gage Llubll~*ios/Ltons (Scho~le Z) 11. To*aZ Dod~*lons 12. ~ Venue of Tax Ro~u~ (~) . O0 (4)_ .00 (s) 82~634.~7 (6). .00 (7) 6~800.00 (8) (9)_ 6,007.98 (lO) 'q,189.~0 (11) credt~ ~o your account, subm1~ ~ho upper por~ton of ~hts form wt~h your ~ax paymmn~. 92,7~8.47 TAX CREDITS: DATE "06-Z3-ZOOr~ NUHBER INTEREST/PEN PAID CD00q08,q .00 BALANCE OF UNPATD INTEREST/PENALTY AS OF 06-2~-~00~ IF PAID AFTER DATE ZNDZCATED~ SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .00 x O0 .00 .00 x Oq5_- .00 .00 x 12 .00 82,551.19 x 15 = 12,382.67 (19)= 12,382.67 AMOUNT PAID 12, $82.67 TOTAL TAX CREDIT ~ALANCE OF TAX cueI Z.TE.eST A.D Pm.. TOTAL DUE 12,381.67 .00 8~.i5 8t.q5 ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT IS REQUIRED. ZF TOTAL DUE 1S REFLECTED AS A 'CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) 10.197.2~ (12}, 82,551.19 13. Cheri*abll/Bovorrmen~al Bmqu~s*s; Non-elected 911S Trusts (Schedule J) (15) .00 14. No~ Velum of Es*a*e SubJoc~ ~o Tax (14) 82,551.19 NOTE: Z~ an asssssment ~as issued previously, lines 1~, 15 and/er 16, 17, 18 and 19 uti1 reflect flgures that include the total Of ALL returns assessed to date. ASSESSMENT OF TAX: COMMONWEALTH OF PENNSYLVANIA DEPARTMENTOFREVENUE BUREAU OFIND~VIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 0O4309 SHIELDS CHARLES E Iii 6 CLOUSER ROAD MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN: 198-01-4952 FILE NUMBER: 2103-0614 DECEDENT NAME: STINE PAUL W DATE OF PAYMENT: 08/26/2004 POSTMARK DATE: 08/25/2004 COUNTY: CUM BERLAN D DATE OF DEATH: 07/22/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $84.45 REMARKS: CHECK# 535 SEAL TOTAL AMOUNT PAID: INITIALS: JA RECEIVED BY: $84.45 GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF TND'rVTDUAL TAXES *rNHERTTANCE TAX DTVTS]'ON DEPT. Z80601 HARRTSBURG, PA 171Z8-0601 COMMONNEALTH OF PENNSYLVANZA DEPARTMENT OF REVENUE ZNHERTTANCE TAX STATEHENT OF ACCOUNT REV-1607 EX &FP (01-05) CHARLES E SHIELDS II! 6 CLOUSER RD MECHANICSBURG PA 17055 DATE 09-27-Z00q ESTATE OF STINE DATE OF DEATH 07-22-200:5 F'rLE NUHBER 21 05-061q COUNTY CUMBERLAND ACM 101 I Amoun~ Rem'; 'l:~:ed PAUL N HAKE CHECK PAYABLE AND REMZT PAYMENT TO: REGISTER OF MILLS CUMBERLAND CO COURT HOUSE CARLTSLE, PA 17015 NOTE: To insure proper credi~ ~co your accoun~c, subm/~: ~he upper portion of ~his fore wi~h your ~ax payment. CUT ALONG TH'rS LTNE ~ RETA'rN LONER PORT/ON FOR YOUR RECORDS ~ REV-1607 EX AFP (01-03) ~ ZNHERZTANCE TAX STATEMENT OF ACCOUNT ~ ESTATE OF STTNE PAUL N FZLE NO. 21 05-061q ACN 101 DATE 09-27-Z00~ THZS STATEHENT 'rs PROVZDED TO ADVZSE OF THE CURRENT STATUS OF THE STATED ACM ZN THE NAMED ESTATE. SHONN BELOt/ ZS A SUMMARY OF THE PRZNCZPAL TAX DUE, APPLZCATZON OF ALL PAYMENTS, THE CURRENT BALANCE, AND, ZF APPLZCABLE, A PROJECTED ZNTEREST FZGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-16-200~ PRINCIPAL TAX DUE= ........................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): 12,$82.67 PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) .00 06-25-ZOOq 08-25-200q CDOOqO8q CDOOq$09 8q.q5- ZF PA'rD AFTER TH'rS DATE, SEE REVERSE S/DE FOR CALCULAT'rON OF ADD'rT/ONAL 'rNTEREST. ( ZF TOTAL DUE 1S LESS THAN $1~ NO PAYMENT 'rS REQU'rRED. ZF TOTAL DUE 'rS REFLECTED AS A "CREDZT" (CR), TOTAL TAX CREDZT 12,382.67 BALANCE OF TAX DUE .00 ZNTEREST AND PEN. .00 TOTAL DUE .00 YOU HAY BE DUE A REFUND. SEE REVERSE STDE OF THTS FORH FOR 'rNSTRUCT'rONS. )