HomeMy WebLinkAbout04-0591 PETITION FOR PROBATE and GRANT OF LETTERS
No. !
also known as To:
Register of/Wills for the
Deceased. County of(-;amd~7-~ t.~ M z~
Social Security No. --'~,~- D / - o6'~/~-- Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut ,~ ! ~
in the last wilt of the above decedent, dated
and codicil(s) dated / ~z /~p~4~ I/-- ~ g> d> !
in the
namec~
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in C- tt t~. r~E.~ t..~}/~ ~) ~County, Pennsylvania, with
last family or principal residence a~ '~
(list street, number and muncipality)
~ ~ years of age, died
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:
oo
WHEREFORE, petitioner(s) respectfully request(s)
presented herewith and the grant of letters
theron.
c~'~
the probate of the~]//st will and codicil(s)
¢2,
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
OATH OF' PERSONAL REPRESENTATIVE
COMMONWEALTIt OF PENNSYLVANIA
COUNTY OF C ccoq,13L4~t_Cr~t b. } ss
Thc petitioner(s) above-named swear(s) or affirm(s) that thc statements in the foregoing petition are
truc and correct to the best of the knowledge and belief of petitioner(s) and that as personal reprcscn-
tative(s) of the above decedent petitioner(s)will well, truly adminis~~ according to law.
Sworn to or affirmed and subscribed ~ '~/~ ~ /~
bede me this ~ day of~[ ~ ~ ~ ~
2-1-O -
Estate Of ~-~'~.. ~ ~] ~ Li¢
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW k..)~ I\11~ Z3 ~ , 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 <~' 13'01
described therein be admitted to probate and filed of record as the last will of
,.]-~E-~' I,xt ~ t 1 ~ ;
~d Letters ~ T~ ~ ~~ ,
are hereby granted to ~b~ ~-¢~0~
FEES
Probate, Letters, Etc ..........
Sho~ Ce~ificates( )...'.
Renunciation ....... ,.,.._~.. $
Filed ...................................
ATTORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
his is to certify that the information here given is correctly copied from an original certificate of death duly filed witt~ 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. 2i-0 5q i
Fee for this certificate, $2.00
P 10372199
No.
Local Registrar
Date
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
DECEDENT'S USUAL OCCUPA:rIoN
KiND O~ BUSINES~/INDLISTRY
OTHER:
E~O~*.,,.., E] Om 0 a.,~.~, ~ ~s~,, []
I~m~l E] c,m~l~rl [~ ReaDy. Jr om ,~ale E]
/ ~', ,4 0o q
'MEDICAL EXAMINER~CORONER ~
On the balfil of elimination and/or investigation in my opinion, dee h occu,red at the time. dale. and place, and due Io the CIUIe(I) and
manner Il eta I~J ........................................................................................
012421-00001/4/4/01/EGM/KLT/145042.1
OF
JEAN WYLIE ~"
I, JEAN W3fLIE, of Lower Allen Township, Cumberland County, Pennsylvania, being of
sound and disposing mind, memory and understanding, do hereby make, publish and'declare this as
and for my Last Will and Testament, hereby revoking and making void any and all Wills or
Codicils at any time heretofore made by me.
ARTICLE I
DEBTS
I direct the payment of all my legal debts, and the expenses of my last illness and funeral
fi.om my Estate as soon after my death as conveniently may be done.
ARTICLE II
TANGIBLE PERSONAL PROPERTY
I give and bequeath my motor vehicle(s), household and personal effects and other tangible
personalty of like nature (not including cash or securities), together with any existing insurance
thereon, unto my husband, THOMAS M. WYLIE. If my husband, THOMAS M. WYLIE, fails
to survive me, I give and bequeath the same unto my daughter, NANCY J. PAYTON.
012421-00001/4/4/01/EGM/KLT/145042.1
ARTICLE III
REST, RESIDUE AND REMAINDER
I give, devise and bequeath all the rest, residue, and remainder of my Estate, of whatsoever
nature and wheresoever situate unto my husband, THOMAS M. WYLIE. If my husband,
THOMAS M. WYLIE, fails to survive me, I give, devise and bequeath the same unto my
daughter, NANCY J. PAYTON, and if she also fails to survive me, I give, devise and bequeath the
same unto my son-in-law, JOHN D. PAYTON. If my son-in-law, JOHN D. PAYTON, also fails
to survive me, I give, devise and bequeath all the rest, residue and remainder of my estate as
follows:
A. One-half (1/2) thereof unto Emmaus Bible College, 2570 Asbury Road, Dubuque,
Iowa 52001; and
B. One-half (1/2) thereof unto Christian Missions in Many Lands, Inc., P.O. Box 13,
Spring Lake, New Jersey 07762-0013.
ARTICLE IV
APPOINTMENT OF PERSONAL REPRESENTATIVE
I name, constitute and appoint my husband, THOMAS M. WYLIE, Executor of this my
Last Will and Testament. Should my husband, THOMAS M. WYLIE, fail to qualify or cease to
so act, I name, constitute and appoint my daughter, NANCY J. PAYTON, altemate Executrix to
complete the administration of my Estate, and should my daughter, NANCY J. PAYTON, also fail
to qualify or cease to so act, I name, constitute and appoint my son-in-law, JOHN D. PAYTON,
alternate Executor to complete the administration of my Estate. I direct that no fiduciary appointed
herein shall be required to post bond for the faithful administration of her duties required in any
jurisdiction.
2
012421-000011414/0 I/EGM/KLT/145042.1
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will
and Testament, this /7~/~ day of ~ ,2001.
(SE L)
Signed, sealed, published and declared by the above-named Testatrix, as and for her Last
Will and Testament, in the presence of us, who at her request, in her presence and in the presence of
each other, have hereunto subscribed our names as witnesses.
012421-00001/4/4/01/EGM/KLT/145042.1
AFFIDAVIT AND ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA '
COUNTY OF CUMBERLAND ·
SS
Xam iCt e'/&; I ,the Testatrix and the wimesses, respectively,
who~e
signed to the attaahed or foregoing instrument, being first duly sworn, do hereby
declare to the undersigned authority that the Testatrix signed and executed the instrument as her
Last Will and that she had signed willingly and that she executed it as her free and voluntary act for
the purposes therein expressed, and that each of the wimesses, in the presence and hearing of the
Testatrix, signed the Will as wimess and that to the best of his/her knowledge the Testatrix was at
that time eighteen years of age or older, of sound mind and under no constraint or undue influence.
Witness
Subscribed,
subscribed and swom to
De. da C. Pamper, Notmy Public
Lemoyne Boro, Cu,'nt3~,lm~ County
Member, Pennsytvan~ ~ ot Notaries
swom to and acknowledged before me by JEAN WYLIE, Testatrix, and
before me by (-(~0/x~ ~, [~\!e£~ and
, wimesses, this ~[~-~ay of ~ ~0~i[ ,2001.
, Not~ PubliC~ C C ~(~~x~
4
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
Date of Death:
W'tll No. 2004-00591
To the Registen
JEAN WYLIE
JUNE 18, 2004
Admin. No. 21-04-0591
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the
Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned
estate on July 15, 2004
Name Address
Nancy J. Payton 906 Bunny Lane, Mechanicsburg, PA~5
all persons entitled theretfi'und~er ~le 5.6~(/~xcept: NONE
Date: July 15, 2004
Murrel R. Walters, III, Esquire
54 East Main Street
Mechanicsburg, PA 17055
(717) 697-4650
Capaci~ __ Personal Representative
X Counsel for personal representative
COMMONWEALTH OF PENNSYLVANrA
DEPARTMENT OF REVENUE
BUREAU OF INDIVrDUAL TAXES
D[PT 280601
HARRISBURG, PA 17128 0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 004675
PAYTON NANCY J
906 BONNY LANE
MECHANICSBURG, PA
17055
fold
ESTATE INFORMATION: SSN: 362-01-8912
FILE NUMBER: 2104-0591
DECEDENT NAME: WYLIE JEAN
DATE OF PAYMENT: 1 1/30/2004
POSTMARK DATE: 11/30/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 06/18/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 817,336.74
REMARKS:
TOTAL AMOUNT PAID:
$17,336.74
SEAL
CHECK#1001
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
REV-1SOC.I!<X+(6-00)
'.' COMMONWEALTH OF
PENNSYLVANIA
. DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
WYLIE, .JEAN
DATE OF DEATH (MM-DD-Y""I
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REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DATE OF BIRTH (MM-OO- 'fear)
08118/2004 09/1411916
(IF APPUCABlEj SURVIVING SPOUSE'S NAME (LAST. FIRST, AND MIDDLE INITIAL)
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00 1. Original Retum
o 4. Lim.ed Estate
00 6. Decedent Died Testate (AlIacO"",,,,..,
o 9. Litigation Proceeds Received
o 2. Supplemental Retum
o 40. Future 1n\el<!S\ Compromise I'" "'_... \2.\2-"1
o 7. Decedent Maintained a Living Trust (AltlcllcopyofTrust)
o 10. Spousal Poverty Credit (dale ofdea!h belWeen 12-31-91 ancl1-1-95j
OFFICIAL. USE ONLY
FILE NUMBER
2 1 -0 4 0 5 9 1
""55UiiTYCODE -YEAR---iiui:i'iiER--
SOCIAL SECURITY NUMBER
362-01-8912
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIA!. SECURJTY NUMBER
o 3. Remainder Retum (daleofdealhpriorIo12-1J.a2)
o 5. Federal Estate Tax Retum Required
_ 8. Total Number of Safe DepasitBoxes
o 11. EIectil!1 to tax under Sec. 9113(A)_" Soh 01
1. Real Estate (Sctledule A)
2. Stocl<s and Bonds (Sctledule B)
3. Close~ Held Corporation. Partnership or Sole-Proprietorship
4. Mortgages & Notes ReceiVable (Schedule 0)
5. Cash, Bank Deposils & Miscellaneous PelS<llal Property
(SctleduIeE)
6. Join1Iy <Hmed Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (toIlll Lines 1.7)
g. Funeral Expenses & AdministratiVe Cools (Sctledule H)
10. Debls of Oeceden~ Mortgage Liabilities. & Liens (Sctledule I)
11. Total Deductions (tolalLines9 & 10)
12. NotValue.fEstale (Line 8 minus Line 11)
13. Charttable and Govemmental BequeslslSec 9113 Trusta for which an election to tax has not been
malle (Sctledule J)
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NAME
MURREL R. WALTERS III ESQ
FIRM NAME (If Applicablel
TELEPHONE NUMBER
717/697-4650
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It:
C@MPLETE MAILING ADDRESS
54 EAST MAIN STREET
MECHANICSBURG
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(9)
(10)
14. Not Value SUbject \0 Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxab~ a11he spousal tax
<ate. orllansfenl under Sec. 9116 (aX1.2)
16. Amount of Line 14 taxab~ at lineal rate
17. Amount of Une 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rale
19. Tax Due
X _(15)
385,260.87 X ~(16)
X .12 (17)
X .15 (18)
(19)
PA 17055
\ OFFICIAL USE ONLY
54,943.45 t 1
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['.'~,'00
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I
327,841.16 !
I
10,000.00 i
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c_~:
I
r'-'
C)
01
W
(8)
392,784.61
6,467.98
1,055.76
(11)
(12)
(13)
7,523.74
385,260.87
(14)
385,260.87
17,338.74
17,336.74
Oecedent~s Comclete Address:
STREET ADDRESS
APARTMENT 3330
325 WESLEY DRIVE
CITY I STATE I ZIP
MECHANICSBURG PA 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Paymenls
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
17,336.74
Totai Credits (A + 8 +C) (2)
3. InteresUPenalty if applicable
0, Interest
E, Penalty
TotallnteresUPenalty (0 +E)
4. If Une 2 is greater than Line 1 + Line 3. enter the difference. This is the OVERPAYMENT,
Check box on Page 1 Line 20 to request a refund (4)
5. If Une 1 + Line 3 is greater than Une 2, enter the difference. This is the TAX DUE, (5)
A. Enter the interest on the tax due. (5A)
8. Enter the total of Une 5 + 5A. This iB the BAlANCE DUE, (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
~ijili_.:lIIlIiiJI." ,- '"~l!ri,,.!!IliJ1f~1lil!i1!!jHlil,"
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN oJ(" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes
a, retain the use or income of the property transfelTed; .................................,......................................... 0
b. retain the right to designate wl10 shall use the property transferred or.B income; ........................................ 0
c. retain a reversionary interest; or .........................,.....,....................................................................., 0
d. receive the promise for life of either payments, benefits or care? ............................................................. 0
2. If death occulTed after December 12. 1982, did decedent transfer property within one year of death
without receiving adequate consideration?.......... .............., ....,....... ........ ........... .............. ............ ............. 0
3. Old decedent own an 'In trust fo~ or payable upon death bank account or security at his or her death? .............,.., 0
4. Old decedent own an Individual Retirement Account. annuity, or other non-probate property which
contains a beneficiary designation? ......................................................................................................, 0
(3)
17,336.74
17,336.74
'?nJd~
No
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IF THE ANSWER TO ANY OF THE ABOVE QIilESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT I>J) PART OF THE RETURN,
ADDRESS
MECHANICSBURG
. ATIVE
PA
ADDRESS
M R. WALTERS III!SQ
54 EAST MAIN STREET, MI\CHANICSBURG
....,...."1il_._,,.
ili;j~h~~4@tiJ,).f~t}$1 ,
PA 17055
"..; '~?7hXl~0iL0ftjtr\~Eii1ttfJlmU~~i1f;Gi&*~Bi~1J~t~!1'A1'1;:,~filiWlfW~~1Iffitj,%'t1f!JtSE;
i>i0\..~_ ~J~$iU!~~)j:\l1ff![~Jf,~~ifl;;\1fiE%!iiM%ki~i",,^t~-~""Wd1K\L.'i{%;r;tiilil__~
For dates of death on or after July 1. 1994 and before January 1. 1995. the tax rate Imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. ~9116 (a) (1.1) (i)].
For dates of death on or after January 1.1995. the tax rate impOsed on the net value of transfers to or for the use of the surviving spouse Is 0% [72 P,S, ~9116 (a) (1.1) (ii)].
The statute does not exemot a transfer to a surviving spouse from tax. and the statutory requirements for disclosure of asBets and filing a tax return are stlil applicable even ~
the surviving spouse is the oniy beneficiary.
For dates of death on or after July 1. 2000:
The tax rate impoBed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent.
or a stepparent of the child is 0% [72 P:S. ~9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)].
The tax rate imposed on the net value of transfers to. orfor the use of the decedent's siblings is 12% [72 P.S, ~9116(a)(1.3)]. A sibling is defined. under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-15<J3 EX. (6-98)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
WYLIE JEAN
FILE NUMBER
21 04
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
0591
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
15,750.73
U S SAVINGS BONDS
13 SERIES E
2
U S SAVINGS BONDS
11 SERIES EE
13,764.72
3
U S SAVINGS BONDS
2 SERIES I
22,928,00
4
U.S, SAVINGS BONDS
4 SERIES H
2,500.00
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
54 943.45
REV-15()8 EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
WYLIE JEAN
FILE NUMBER
21 04
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
0591
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
14,653.15
PNC BANK
CHECKING
2
PNC BANK
MONEY MARKET
44,472.98
3
PNC BANK
CERTIFICATE
38,010.24
4
EDWARD JONES
INVESTMENT ACCOUNT
42,643.00
5
PNCINVESTMENTS
GLI!NBROOK ANNUITY $149,687.23
METLIFE ANNUITY $26,445.56
HOUSEHOLD CONTENTS
VALUED PER SALVATION ARMY
176,132.79
6
5,504.00
7
1999 BUICK PARK AVENUE
N,A,D,A, GUIDe BOOK VALUE
6,425.00
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
327841.16
REV-15G9 EX + (6-9B)
'.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY.OWNED PROPERTY
ESTATE OF
WYLIE .JEAN
FILE NUMBER
21 04
If an asset was made joint within one year of the decedenfs date of death, it must be reported on Schedule G.
0591
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A. NANCY J. PAYTON
906 BONNY LANE
MECHANICSBURG, PA 17055
DAUGHTER
B
c
JOINTl Y.QWNED PROPERTY:
LETTER DATE DESCRlPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECO'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST
1. A. 8/02103 TReASURY DIRECT 20,000.00 50. 10,000.00
NOTE
TOTAL (Also enter on line 6, Recapitulation) $ 10 000.00
(If more space is needed, insert additional sheets of the same size)
REV-15.11 EX+(12-99)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETLRN
RESIOENT OECEDENT
ESTATE OF
WYLIE .JEAN
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21
04
0591
ITEM
NUMBER DESCRIPTION AMOUNT
A, FUNERAL EXPENSES:
1. NEILL FUNERAL HOME 4,212.98
.
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Represenlative (s) NANCY J. PAYTON RENOUNCED
Social Security Numbe~s)IEIN Number of Personal Rep....ntative(s)
Street Address
City Slala Zip
Yea~s) Commission Paid:
2. Attorney Fees MURREL R. WALTERS III ESQ 1,330.00
3. Family Exemption: (W decedenls address is not the same as daiman!s, allach explanation)
Claimant
S1reet Address
City Stale Zip
Relationship of Claimant to Decedent
4. Pmbale Fees REGISTER ,OF WILLS 325.00
CUMBERLAND COUNTY
5. Accounlan!s Fees AL WHITCOMB P.A. 600.00
6, Tax Return Preparers Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $ 8,487.98
(If more space is needed, insert additional sheets of the same size)
-
!,EV-1512 EX+ (6-98)
*
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT OECEOENT
ESTATE OF
WYLIE JEAN
FILE NUMBER
21 04
0591
Include unreimbuI1led medical expenses.
ITEM
NUMBER DESCRIPTION
1. HOLY SPIRIT HOSPITAL
MEDICAL
VALUE AT DATE
OF DEATH
935.76
2 EAST PENNSBORO AMBULANCE
MEDICAL
120.00
TOTAL (Also enter on line 10, Recapituiation) $
(If more space is needed, insert additional sheets of the same size)
1 055.76
REV-1513EX+I*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE T/J.X RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
WYLlI= I=AN 71 n4 nS!l1
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Us! Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS pnclude outright spousal distributions, and lrensfe'" under
Sec. 9116 lal (1.2)]
1. NANCY". PAYTON DAUGHTER 100%
906 BONNY LANE
MECHANICSBURG, PA 17055
.
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 1 B, AS APPROPRIATE, ON REV-l500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART n - 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)
PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF
THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY
UNTIL COMPLETION
STATUS REPORT UNDER RULE 6.12
Name of Decedent: JEAN WYLIE
Date of Death: 6/18/04
Estate No.:
21-04-0591
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
(date)
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: (Not Applicable in Dauphin County)
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 Clerk of the Orphans' Court and may be
attached to this report.
Ii /
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MURREL R. W ALTERS, III, ESQUIRE
54 East Main Street
Mechanicsburg, P A 17055
717-697-4650
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Personal Representative
__X___ Counsel for Personal Representative
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVID~i]~~1[s[;
INHERITANCE TAX DIYISIQN
PO BOX 280601
HARRISBURG PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS, AND ASSESSMENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
REY-1548 EX AFP (06-05)
t"'! .; ('" ~~ r
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1 " ~
2
DATE 10-18-2005
ESTATE OF WYLIE JEAN
DATE OF DEATH 06-18-2004
FILE NUMBER 21 04-0591
COUNTY CUMBERLAND
SSN/DC 362-01-8912
ACN 04138411
APPEAL DATE: 12-17-2005
(See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NANCY J PAYTON
906 BONNY LN
MECHANICSBURG PA 17055
CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +--
REV=is4S-EX-AFP-roi=osi--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 10-18-2005
ESTATE OF WYLIE
JEAN
DATE OF DEATH 06-18-2004
COUNTY
CUMBERLAND
FILE NO. 21 04-0591
TAX RETURN WAS:
S.S/D.C. NO. 362-01-8912
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
04138411
FINANCIAL INSTITUTION: PNC BANK
ACCOUNT NO.
31100227498
TYPE OF ACCOUNT: ()SAVINGS () CHECKING ~ )TRUST ()TIME CERTIFICATE
DATE ESTABLISHED 11-25-2003
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
X
38,030.63
1. 000
38,030.63
.00
38,030.63
.45
1,711. 38
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
X
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
INTEREST IS CHARGED THROUGH 10-26-2005 TOTAL TAX CREDIT .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 1 , 711. 38
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 52.05
TOTAL DUE 1,763.43
. IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRJ, YOU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J
LJ'"
-
BUREAU OF INDIVIDUAL lAXE'$' :,'
INHERITANCE TAX DIVISION ,'_'v'u
PO BOX Z80601
HARRISBURG PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
. .-~ "
-r, r,--' -- r, I~ERITANCE TAX
i ., RECORD ADJUSTMENT
JOINTLY HELD OR TRUST ASSETS
REV-1604 EX AFP (03-05)
r'\.....,... .' -, _ ~ . _ r~
j 1.,.,.. ~;
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSNI'DC
ACN
10-27-2005
WYLIE
06-18-2004
21 04-0591
CUMBERLAND
362-01-8912
04138411
Allount Rellitted
JEAN
NANCY ~PAYTON
906 BONNY (N
MECHANICSBURG PA 17055
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE
--+ RETAIN LOWER PORTION FOR YOUR RECORDS
of-
-----------------------------------------------------------------------------------------------------------------------------------------------------------------
REV-1604 EX AFP (03-05)
-- INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __
DATE 10-27-2005
ESTATE OF WYLIE
JEAN
DATE OF DEATH 06-18-2004
COUNTY
CUMBERLAND
FILE NO. 21 04-0591
ADJUSTMENT BASED ON:
S.S/D.C. NO. 362-01-8912
ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
ACN
04138411
FINANCIAL INSTITUTION: PNC BANK
ACCOUNT NO. 31100227498
TYPE OF ACCOUNT: () SAVINGS () CHECKING (X) TRUST () TIME CERTIFICATE
DATE ESTABLISHED 11-25-2003
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
.00
1. 000
.00
.00
.00
.45
.00
NOTE: TO INSURE PROPER CREDIT TO YOUR
ACCOUNT, SUBMIT THE UPPER PORTION
OF THIS NOTICE WITH YOUR TAX
PAYMENT TO THE REGISTER OF WILLS
AT THE ADDRESS SHOWN ABOVE.
MAKE CHECK OR MONEY ORDER PAYABLE
TO: "REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE 00
· IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
e:J"\
REV-1470 EX (6-88)
.A
INHERITANCE TAX
EXPLANATION
OF CHANGES
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG PA 17128-0601
DECEDENrS NAME
JEAN WYLIE
FILE NUMBER
REVIEWED BY
ACN
2104-0591
04138411
SCHEDULE ITEM
NO.
EXPLANATION OF CHANGES
The above referenced ACN has been reduced to zero, as this account was reported on the
probate return.
Paqe 1