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HomeMy WebLinkAbout03-0978PETITION FOR PROBATE and GRANT OF LETTERS Estate also known Deceased. Social Security No. _~0~' -, /,_~t -- ~'~'-~'~ / ,,~ To: Register of Wills for the County of t,~o,...~,~,/~ 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 a/-~ in the last wilt of the above decedent, dated ~'7.,~./~ / ~ and codicil(s) dated / in the named ,19 / (state relevant circnmstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in ,,'~,~...~,~z,.~.z_-~,,-,,_~ County, Pennsylvania, with h ¢'~' last family or principal residenc-~t - - (list street, number and muncipality) Decendent, then ~ ~ 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: /~'ZSo"-,'~/~,~_.~ ~ WHEREFORE, petitioner(s) respectfully request(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. OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ COUNTY OF ~wk:~c\6-~c\ f ss The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and.~''.~'{)~truly ad,ministe~ the est. a;t¢ accoj:ding to law. Sworn to or affirmed and subscribed,-~,~'/~_~e~.'/~.~~~,~ be[ore me this ~1,~"~ day of / ~' ~-~ ~ ~~--~xRegister [ i'-~ - I'~ - ~r ~ No. ~X- 0 $- c~"l q Estate Of KATHRYN M STAINS AKA MARGARET K STAIN~]Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW NnVFMR? _eS, 2003 the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated 7-17-1991 described therein be admitted to probate and filed of record as the last will of. KATHRYN M ~TATNq AKA ~ADGADET ~ STAINS ~d Letters TFSTAMFNTARY are hereby granted to WIllIAM £ qTAIN~ ., in consideration of the petition on FEES Probate, Letters, Etc .......... Short Certificates( ) .......... ~ion x._~,~,..c~.~. · · TOTAL Filed ...... 3.q.: ~ ~.~QQ ~ COUPLE PICKED OP ~ 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 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. ~ / Local Registrar / //' '7 4:9 5 6; 0 OCT 1 ,:.3 21703 No. '~ " Date H10~.144 Rev. 1/91 ,.ANmNV t;29--122 Margaret 79 w,. Cumberland S~lno COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH K Stains UNDER 1 DAY DATE OF BIRTH (MOm~. Day, Year) )ec. 7, 1923 North Newton 91 Dublin Gap Rd., Apt 108 Newville, PA 172-41 Shoe ~ECEOENT'S RESIDENCE ;A/HER'S NAME {Fa~, Frank E. Bennett L. Stains (Coroner) ~.~ STATE F~LE NUMBER SEX I -~3C- L~L $ECUR~'Y NUMBER E. Female 91 Dublin Gap Road ~*[] LATE O~ m*~*H ~o,~. O,y. ~ October 9, 2003 ~T..s,,,, PA ~ ~ ,?..[~ ~,.~,~ North Newton Cumberland m,,..,.,~,? ,,7..F'1 ~' ~" ~ Mem. Grds. PA 17013 10/14/'2603 FD 012633 L · ~ ~ Octobe~ 10, 2003 . ~"'~'~---- · O_c_lus~ve Coronar Artery Disease Carlisle, PA 17~013 Funeral Carlisle, PA 17013 Coroner October 2003 Michael L. Norris, Coroner 6375 Basehore Road, Suite ~i Mechanicsburg, Pa. 17050 LAST WILL AND TESTAMENT OF KATHRYN M. STAINS instruction or selected by my beneficiaries and to add the net proceeds from their sale to the residue of my estate. THIRD: I give and devise the residue of my estate, real, personal and mixed, of whatever kind and nature, and wherever situate at the time of my death, including any property over which I now have or hereafter acquire a power of appointment, to my husband, WILLIAM C. STAINS, SR., provided that my husband survives me by sixty (60) days. If my husband predeceases me or is not living on the sixty-first (61st) day after my death, I give, devise and bequeath the residue of my estate, in equal shares, to my children, provided that the share of any child who predeceases me or is not living on the sixty-first (61st) day after my death shall be distributed to his or her issue per stirpes living on the sixty- first (61st) day after my death and, in default of any such then- living issue, such share shall be added equally to the share or shares for my other children. FOURTH: I nominate, constitute and appoint WiLLiAM C. STAINS, SR., Executor of this my Last Will and Testament, to serve without bond or security, and to make distribution of my estate in cash or in kind, or partly in cash and partly in kind, and in such manner as he may determine. I authorize, empower and direct him to sell and convey, by good and sufficient deed, in fee simple estate, any and all of my real estate, at public or private sale, for such price or prices, upon such terms and conditions, as in his judgment 2 KATHRYN M. STAINS I, K~THRYN M. STAINS, declare this to be my Last Will and Testament and hereby revoke all prior wills and codicils made by me. FIRST: My Executor shall pay from the residue of my estate all my debts, funeral and administration expenses and all estate, inheritance, succession and transfer taxes imposed by the United States or any state, territory or possession which shall become payable by reason of my death. It shall not be necessary to file any claims therefor, nor to have them allowed by any court. SECOND: I give all of my tangible personal property to my husband, WILLIAM C. STAINS, SR., if he survives me by sixty (60) days. If my husband is not living on the sixty-first (61st) day after my death, then I give such of my tangible personal property as is set forth in a separate, dated and unsigned letter of instruction, which I shall place with my Will, to the persons therein designated. If I have not left a letter of instruction or for those articles not distributed under this letter of instruction, I direct that such items be distributed among my children living at the time of my death as they may select in as nearly equal shares as is practical. If there is any disagreement as to distribution, I direct my Executor to make such distribution. The decision of my Executor shall be final and binding. I direct my Executor to sell, or otherwise dispose of in his discretion, any such property not specifically distributed by my letter of LAST WILL AND TESTAMENT OF KATHRYN M. STAINS is best for my estate, and to that end to sign, seal, execute, acknowledge and deliver all deeds or other instruments necessary therefor, as effectively as I could do if I were personally present. In the event such person does not survive me, or refuses to act as Executor or does not complete the duties of Executor, then I nominate, constitute and appoint WILLIAM C. STAINS, JR., as the alternate Executor, to serve without bond or security. My alternate Executor shall have all of the powers, privileges, duties and immunities as provided herein. FIFTH: Should any distributee of my estate be a minor, or, in the opinion of my Executor, be mentally or physically incapacitated, my Executor may pay his or her share of my estate to the parent or guardian of the distributee, or to any person taking care of the distributee, or, in the case of a minor, may deposit the share in a savings account, made payable to the minor upon attaining majority, which I define as twenty-one (21) years of age. IN WITNESS WHEREOF, I, KATHRYN M. STAINS, the Testatrix, have to this my Last Will and Testament, set my hand and seal this /74 day of ~,L~/ ~ -~ , 1991. 'KAT~aYN/~. STAINS LAST WILL AND TESTAMENT OF KATHRYNM. STAINS Signed, sealed, published and declared by the above named Testatrix, as and for her Last Will and Testament, in the presence of us, who have hereunto subscribed our names at her request, as witnesses hereto, in the presence of the said Testatrix, and of each other. The preceding document consists of this and three (3) other consecutively numbered typewritten pages. residing at residing at ACKNOWLEDGMENT AND AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) ) ss.: COUNTY OF ) The Testatrix and the witnesses whose names are subscribed to the foregoing instrument, being first duly sworn and qualified according to law, do hereby acknowledge and declare to the undersigned authority that the Testatrix signed and executed the instrument as her last Will in the presence of the witnesses, that she signed willingly or willingly directed another to sign for her, that she executed it as her free and voluntary act for the purposes therein expressed, that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witnesses, and that to the best of their knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. TestAtrix //.Witness Witness Sworn to, subscribed and acknowledg, e~ before me ,by the above named1941. Testatrix and witnesses this !/cA day of ~~ otar~ Public __ ~ (SEAL) or Attorney-at-Law NOTARIAL ANN MAR!E B~AWITZ, NOTARY PUBLIC HARR~?~URG, DAUPI~IN COUNTY MY COM,~k~.'.~ON EXHNE$ DEC. 9, Member, Pe~nsy!vani; As=oc~ion of Notm~es unh Kathryn M. Stains THE LAW FIRM Of KILLIAN & GI:'PHART HARRISBURG, PENNSYLVANIA 17108 JRD/June 30, 1992/17858 In Re: Estate ofKATHRYN M STAINS Late of NORTH NEWTON TOWNSHIP Estate No.: 21-03-978 ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 21-2003-978 NOTICE OF FAILURE TO FILE CERTIFICATION AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 5.6(e), SUPREME COURT ORPHANS' COURT RULE Personal Representative: WILLIAM C STAINS, JR Counsel for Personal Representative: MICHAEL DAVID RENTSCHLER Date of Grant of Original Letters: 11-25-2003 Date of Delinquency Notice: 03-07-2004 The undersigned, Glenda Farner-Strasbaugh, Clerk of the Orphans' Court, in accordance with Rule 5.6, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its certification required by Rule 5.6(e), Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 5.6(e), Supreme Court Orphans' Court Rules, was given by the Clerk of the Orphans' Court on MARCH 7, 2004, and that the ten (10) day notice to file the certification has expired. Accordingly, in accordance with Rule 5.6(e) the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date: 04-15-2004 Glenda Farner Strasbaugh-~ Clerk of the Orphans' Court Distribution: Personal Representative Counsel for Personal Representative Estate File A hearing is scheduled forl,-~fi at CIl:~Ch in Courtroom No. 3. If the Certification of Notice is filed prior to the hearing da~,'the hearing will automatically Geor~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, P.A 17128-0,601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003424 RENTSCHLER MICHAEL DAVID 1300 MARKET STREET SUITE 200 LEMOYNE, PA 17043 ........ fold ESTATE INFORMATION: SSN: 209-12-5312 FILE NUMBER: 2103-0978 DECEDENT NAME: STAINS KATHRYN M DATE OF PAYMENT: 01/09/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 10/09/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $683.75 REMARKS: TOTAL AMOUNT PAID: $683.75 SEAL CHECK# 103 INITIALS: AC RECEIVED BY: GLENDA FARNER STRASBAUGH DEPUTY REGISTER OF WILLS REGISTER OF WILLS JUIW--24--28~4 89:42 PM P. 02 N~ ~ n~w be~n ~iv~n ~ MI pe~ou~ entM~d ~he~M undur Rule 5,6(a) except .- ..... FROM TO Renstshl, er law offi 612312004 3:37 PM PaGe 1 FAMILY SETTLEMENT AND FINAL RELEASE IN ESTATE OF KATHRYN M. STAINS, DECEASED No. 21030978 KNOW ALL MEN AND WOMEN BY THESE PRESENTS, that W~REAgl I4,,athryn M. Stains, late of Newville, Cumberland County, Pennsylvania, deceased, died testate on the 9th day of October, 2003, having first made her last will and testament, which was duly executed on July 17 1991 and is duly recorded in Cumberland County, Pennsylvania, No. 21030978; WHEREAS, the said Kathryn M. Stains, by the aforesaid last will and testament, named William C. Stains, Jr., as Executor of said last will and testament; WHEREAS, letters testamentary on the estate of the said decedent were duly issued by the Register of Wills of Cumberland County, Pennsylvania, to the said Executor, hereinafter called personal representative; WHEREAS, the said personal representative has gathered the assets of the estate of the said decedent and the assets consist of both real property and personal property, to a total value of $18,244.73, as set forth in Exhibit "A", which is a statement of account of the said personal representative, and which is attached hereto and made a part hereof, and marked Exhibit "A"; WHEREAS, the debts and deductions, including the payment of inheritance tax in the said estate, amount to $18,244.73, leaving a balance for distribution of $15,920.13, also as set forth in the statement of the said personal representative, which is attached hereto and marked Exhibit "A"; WHEREAS, the balance for distribution as shown in the said statement marked as Exhibit "A" has been reduced to cash and has been distributed as herein indicated in accordance with the terms of the last will and testament of the said decedent; NOW, THEREFORE, KNOW YE, that we, William C. Stains, Jr and Bany Stains, being all of the children of the said decedent, and heirs under the last will and testament of the said decedent, and being those persons entitled to inherit under said last will and testament, do hereby each of us, acknowledge that we have this day had and received from the aforesaid personal representative, in full satisfaction and payment of all sum or sums of money, legacies, bequests, and devises as are given, devised and bequeathed to each of us respectively by the said last will and testament, the amounts due us under the said last will and testament, which amount owe have received this day, and which amounts are in the amount set opposite our respective names in the table and schedule of distribution in said statement attached hereto and marked as Exhibit "A"; AND, each of us does hereby stipulate that in order to avoid the expense and time involved in the filing of a formal account and schedule of distribution, we each agree that no account is necessary and we do hereby agree that we do consent to distribution being made without the filing of an account and schedule of distribution, the same to be with the same fome and effect as if they had been filed and confirmed by the Orphan's Court Division of the Court of Common Pleas of Cumberland County. THEREFORE, we and each of us, do hereby remise, release, quitclaim and forever discharge the said personal representative, William C. Stains, Jr., heirs, executors, and administrators and assigns, and The Law Office of Michael D. Rentschler, P.C., its employees, officers, executors, heirs and assigns, the attorneys for the Estate of the Late Kathryn M. Stains of and form the said estate and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever for or by reason thereof, or for any other use, matter, cause or thing whatsoever, touching upon the estate of the said decedent, and each of use do further hereby covenant and agree that should any liability come due to the estate of the said decedent after the signing of this agreement, we and each of use do hereby covenant and agree with each other and the aforesaid personal representative, that we will contribute pro-rate, our share of the estate to satisfy any and all claims, demands, suits, or causes of action which may be successfully prosecuted against the said estate or the aforesaid personal representative after the signing, sealing and delivery of this family settlement agreement and final release. IN WITNESS WHEREOF, we have hereunto set our hands and seals this day of July, 2004, intending to be legally bound hereto. Estate of Kathryn M. Stains William Stains, l~xecuter SCHEDULE OF DISTRIBUTION OF ESTATE NUMBER 21-03-978 (KATHRYN M. STAINS) All personal property identified in the inheritance tax return for the Estate of Kathryn M. Stains is allocated and distributed evenly between her surviving sons, William C. Stains of 45 Wetherbum Road, Enola, Cumberland County, Pennsylvania and Barry Stains of 297 Sherwood Drive, Carlisle, Cumberland County, Pennsylvania FAMILY SETTLEMENT AND FINAL RELEASE IN ESTATE OF KATHRYN M. STAINS, DECEASED No. 21030978 KNOW ALL MEN AND WOMEN BY THESE PRESENTS, that WI~REAS, Kgthryn M. Stains, late of Newville, Cumberland County, Pennsylvania, deceased, died testate on the 9th day of October, 2003, having first made her last will and testament, which was duly executed on July 17 1991 and is duly recorded in Cumberland County, Pennsylvania, No. 21030978; WHEREAS, the said Kathryn M. Stains, by the aforesaid last will and testament, named William C. Stains, Jr., as Executor of said last will and testament; WHEREAS, letters testamentary on the estate of the said decedent were duly issued by the Register of Wills of Cumberland County, Pennsylvania, to the said Executor, hereinafter called personal representative; WHEREAS, the said personal representative has gathered the assets of the estate of the said decedent and the assets consist of both real property and personal property, to a total value of $18,244.73, as set forth in Exhibit "A", which is a statement of account of the said personal representative, and which is attached hereto and made a part hereof, and marked Exhibit "A'; WHEREAS, the debts and deductions, including the payment of inheritance tax in the said estate, amount to $18,244.73, leaving a balance for distribution of $15,920.13, also as set forth in the statement of the said personal representative, which is attached hereto and marked Exhibit "A"; WHEREAS, the balance for distribution as shown in the said statement marked as Exhibit "A" has been reduced to cash and has been distributed as herein indicated in accordance with the terms of the last will and testament of the said decedent; NOW, THEREFORE, KNOW YE, that we, William C. Stains, Jr and Barry Stains, being all of the children of the said decedem, and heirs under the last will and testament of the said decedent, and being those persons entitled to inherit under said last will and testament, do hereby each of us, acknowledge that we have this day had and received from the aforesaid personal representative, in full satisfaction and payment of all sum or sums of money, legacies, bequests, and devises as are given, devised and bequeathed to each of us respectively by the said last will and testament, the amounts due us under the said last will and testament, which amount owe have received this day, and which amounts are in the amount set opposite our respective names in the table and schedule of distribution in said statement attached hereto and marked as Exhibit "A"; AND, each of us does hereby stipulate that in order to avoid the expense and time involved in the filing of a formal account and schedule of distribution, we each agree that no account is necessary and we do hereby agree that we do consent to distribution being made without the filing of an account and schedule of distribution, the same to be with the same force and effect as if they had been filed and confirmed by the Orphan's Court Division of the Court of Common Pleas of Cumberland County. THEREFORE, we and each of us, do hereby remise, release, quitclaim and forever discharge the said personal representative, William C. Stains, Jr., heirs, executors, and administrators and assigns, and The Law Office of Michael D. Rentschler, P.C., its employees, officers, executors, heirs and assigns, the attorneys for the Estate of the Late Kathryn M. Stains of and form the said estate and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever for or by reason thereof, or for any other use, matter, cause or thing whatsoever, touching upon the estate of the said decedent, and each of use do further hereby covenant and agree that should any liability come due to the estate of the said decedent after the signing of this agreement, we and each of use do hereby covenant and agree with each other and the aforesaid personal representative, that we will contribute pro-rate, our share of the estate to satisfy any and all claims, demands, suits, or causes of action which may be successfully prosecuted against the said estate or the aforesaid personal representative after the signing, sealing and delivery of this family settlement agreement and final release. 1N WITNESS WHEREOF, we have hereunto set our hands and seals this day of July, 2004, intending to be legally bound hereto. Estate of Kathryn M. Stains Wdham Stmns, Executer SCHEDULE OF DISTRIBUTION OF ESTATE NUMBER 21-03-978 (KATHRYN M. STAINS) All personal property identified in the inheritance tax remm for the Estate of Kathryn M. Stains is allocated and distributed evenly between her surviving sons, William C. Stains of 45 Wetherbum Road, Enola, Cumberland County, Pennsylvania and Barry Stains of 297 Sherwood Drive, Carlisle, Cumberland County, Pennsylvania COMMONWEALTH Of PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 I-- Z LU ILl W REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OECEDENT'S NAME (MST, FIRST, AND MIDDLE INITIAL) DATE OF D~TH (MM-DD-YEAR) D~E OF BIRTH (MM-DD-YEAR) 10/09/2003 12/07/1923 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) OFFICIAL USE ONLY SOCIAL SECURITY NUMBER 209 - 12 - 5312 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER J~l. Odginal Return []4. Limited Estate [~6. Decedent Died Testate (Attach copy olW~ll) []9. Litigation Proceeds Received NAME FIRM NAME IIfApplicable) TELEPHONE NUMBER [~2. Supplemental Return E~4a, Future Interest Compromise (date of death user 12-12-82) E~7, Decedent Maintained a Living Trust (Attach copyof Trust) ~]10. Spousal Povedy Credit (date of death betw~er~ 12-31-91 and 1-1-95) COMPLETE MAILING ADDRESS Federal Estate Tax Return Requi~ed Total Number of Safe Deposit Boxes 1 Election to tax under Sec. 9113(A) (Attach 1. Real Estate (Schedule A) (1) - 0- ~ ~ 2 Stocks and Bonds (Schedule B) (2) 0 ;~': 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 0 4. Mortgages & Notes Receivable (Schedule D) (4) 0 i 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) ~ ~ _R ~ 2 ~ ~: ? ~ ; (Schedule E) 6, Jointly Owned Property (Schedule F) (6) ,,.-~ :. 0 i~ [~ Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) 0 (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) $1 ~ 4 6 7.1 5 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) $ 8 5 7.4 5 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) OFFICIAL USE ONLY (B) $18,244.73 (1~) $2r324.60 (12) $15:q20.13 (13) (14) $15,920.13 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) x .0 __ (15) 16, Amount of Line 14 taxable at lineal rate x .0 ~,.7 17. Amount of Line 14 taxable at sibling rate x .12 (17) 18. Amount of Line 14 taxable at,collateral rate x .15 (18) 19. Tax Due (19) $680.58 Decedent's Complete Address: STREETADDRESS 91 DOUBLIN GAP ROAD APARTMENT 108 CiTY NEWVTT,T,E Tax Payments and Credits: 1. Tax Due (Page f Line 19) 2. Credita/Paymenta A. Spousal Poverty Credit 0 B. Prior Payments $ 5 ~ 3.7 5 C, Discount 0 I STATE PA Interest/Penalty if applicable D, Interest E. Penalty (1) Total Credits (A + B + C ) (2) 0 Total Interest/Penalty ( D + E ) (3) 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 {4) ZIP 17241 $680.58 $683.75 0 $3.17 0 0 5. If Line 1 + Line 3 is greater than Ltae 2, enter the difterence. This is the TAX DUE, A. Enter the interest on the tax due. (5) (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 0 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the properly transferred; .......................................................................................... [] [] b. retain the right to designate who shall use the property transferred or its income; ............................................ [] [] c. retain a reversionary interest; or .......................................................................................................................... [] ~ d. receive the promise for life of either payments, benefits or care? ...................................................................... [] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. [] [] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-prebate 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 SIGNATURE OF. PERSON RESPONSIBLE FOR F.9,.Ir,JG RETURN ADDRESS ~ ~/ SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfem 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 RS. §9116 (a) (1.1) (ii) The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even 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 paten or a stepparent of the child is 0% [72 P.S. §9116(a)(12)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 RS. §9116(1.2) [72 P.S. §9116(e)(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 a individual who has at least one parent in common with the decedent, whether by blood or adoption. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER KATHRYN M. STAINS 2103-0978 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1, STARTING BALANCE CHRISTMAS CLUB MONEY DADS INSURANCE POLICY DADS INSURANCE POLICY DADS INSURANCE POLICY AARP REFUND DAD AARP REFUND MOM SECURITY FUND REFUND (SENIOR APT.) OVER PAYMENT REFUND (CARLISLE MED CTR) COMCAST CABLE BILL REFUND FURNITURE AND FIXTURES PER MCGEES APPRAISAL 2001 HONDA CIVIC MODEL LX(28,000 MILES) (PER MCGEES APPRAISAL ) $1,202.14 $2,033.30 $ 971.00 $ 100.00 $ 143.21 $ 141.21 $ 188.70 $ 55.70 $ 29.54 $1,200.00 $11,500.00 TOTAL (Also enter OR line 5, Recapitulation) $18,244.73 (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (12-99)~. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER KATHYRN M. STAINS 2103-0978 Debts of decedent must be reported on Schedule [. ITEM NUMBER DESCRIPTION AMOUNT 5. 6. 7. FUNERALEXPENSES: EWING BROTHERS (MOM AND DAD EXTRA FUNERAL EXP) LISA"S FLOWERS GEORGE'S FLOWERS ESTATE PUBLICATIONS PATRIOT NEWS ESTATE PUBLICATIONS CUMBERLAND LAW JOURNAL FILING FEE FOR OPENING ESTATE ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) N/A Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State __ Zip Year(s) Commission Paid: Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant N/A Street Address City State Zip Relationship of C~aimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees $ 391.59 $ 107.54 $ 132.50 $ 173.52 $ 75.00 $ 87.00 $500.00 TOTAL (Aisc enter on line 9, Recapitulation) I ¢ 4 6 7.1 5 (If more space is needed, insed additional sheets of the same size) COMMONWEALTH OF PENNSYLVANrA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGELIABILITIES,& LIENS ESTATE OF FILE NUMBER KATHRYN M. STAINS 2103-0978 Include unreimbursed medica~ expenses. ITEM NUMBER DESCRIPTION AMOUNT 1. ALLSTATE CAR INSURANCE PREMIUMS PRESBYTERIAN HOMES INC. (DADS ROOM) MCI FINAL BILL MAGEES AUCTIONS (ESTATE APPRAISAL) SPRINT FINAL BILL PPL ELECTRIC FINAL BILL WEST SHORE MEDICAL INSURANCE (AMBULANCE) TOTAL (Also enter on line 10, Recapitulation) (If more space is needed, insert additional sheets of the same size) $133.64 67.86 60.00 29.02 33.08 509.29 $ 857.45 MAGEE AUCTIONS 320 Cameron Street Marysviile, PA 17053 To: Michael Rentschler 1300 Sui~ #200 Lemoyne, PA 17043 ge~ Estate of Kathryn M. Stains, Mt. View Apartments, Apartment #108 91 Doubling Gap Road, Newville, PA 17241 This estate consists of the average household goods for a one-bedroom apartment with living room, kitchen and one bath. The apartment consists of the following: One sofa; reclining chair; rocker; bookcase; home-made clock; 20 year old television and VCR; various lamps, knick knacks; washbowl; pictures and wall hangers; dinette set with two chairs; two crocks; two jugs; every day pots and pans; dishes - service for eight; one large four gallon jug; small appliances; two dressers; two silver dollars; wardrobe; bed; television (15 years old; night stands; and bed linens. The items just listed (furniture and fixtures) have a value of approximately $1200 if sold at auction, after costs. The estate also includes a 2001 Honda Civic Model LX - Four door with 28,000 miles shown. This automobile includes automatic transmission; air conditioning; am/fm cassette radio and side and front air bags. The automobile is in excellent condition and may be worth $11,500. If you have any questions regarding the above, please don't hesitate to call 717- 9574087. MAGEE AUCTIONS 320 Cameron Street Marysville, PA 17053 INVOICE Appraisal for the Estate of Kathryn M. Stains, Mt. View Apartments, Apartment 4/108, 91 Doubling Gap Road, Newville, PA 17241 $60.00 Delivery Date ! DELIVER TO: Address City Phone ( FRESH SILK State ,,. Zip PLANTER DRIED BOXED LOOSE VASE ANN.~ SYM. ', G. W. HO[.. CONG. Boy/Girl T.O.Y. THANh~ Phone (work) zip (home) Amount Delivery Charge Service Charge Seles Tax ..... Credit Card # Expiration Authorization # Credit Card U~ FILLING FLORIST: TEL/FTD # Phone: Time: BUREAU OF INDIVIDUA",lt~DCf' ,"cr-lei: nr- INtERITANCE TAX DIVISION" lLJ::II."~ u,) '......1 I' L_ PO BOX 280601 . ,-- --, -',', "I f ': HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE :INHER:ITANCE TAX STATEMENT OF ACCOUNT *' REV-16D7 EX AFP (03-05) 2005 r.L1G I 2 ri\ I: I 0 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 07-25-2005 STAINS 10-09-2003 21 03-0978 CUMBERLAND 101 AIlount Renl tted KATHRYN M CU::,:I< MICHAEL Jrl~~~':~c~l~~ '~T~, ;.../,,) 1300 MARKET ST 200 LEMOYNE PA 17043 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, sub.it the upper portion of this for. with your tax payment. CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS - REV-1607 EX AFP (03-05) ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF STAINS KATHRYN M FILE NO.21 03-0978 ACN 101 DATE 07-25-2005 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY DF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 07-11-2005 PRINCIPAL TAX DUE: 716.41 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 01-09-2004 CD003424 35.82 683.75 07-11-2005 '" R~UND .00 3.16- :::::,,(~"'\, ~~, ~,\, ~\.,-( \"\.~W TOTAL TAX CREDIT 716.41 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATIDN DF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. I .~ Cl"'" r~",r-'-''l'-n nr'-'0r (\r BUREAU OF INDIVIDUAL ,'uns',):) i.F!'i,,: ,~:' INHERITANCE TAX DIVISION - ',- ',-"- PO BOX 260601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REY-16D7 EX AFP (03-05) 2u05 :~, UG ! 2 n.J I, !. O~ ;. 1 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 08-08-2005 STAINS 10-09-2003 21 03-0978 CUMBERLAND 101 Amount R_ltt.d KATHRYN M rd f'-"/ ~':...:: \ 0-,'-" '~),-"', MICHAEL DCRENTSCHLER 28 N 32ND ST CAMP HILL PA 17011 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account I submit the upper portion of this for. with your tax p8y~nt. CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS - REV-1607 EX AFP (03-05) ~~~ INHERrrANCE TAX STATEMENT OF ACCOUNT KKK ESTATE OF STAINS KATHRYN M FILE NO. 21 03-0978 ACN 101 DATE 08-08-2005 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT DR RECORD ADJUSTMENT: 07-18-2005 PRINCIPAL TAX DUE: 716.41 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 01-09-2004 CD003424 35.82 683.75 07-11-2005 "- REFUND .00 3.16- TOTAL TAX CREDIT 716.41 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. I IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRJ, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FDRH FOR INSTRUCTIONS. J --.;... -- ~ nC0nnrcf"' r ,~C, "c (,C" BUREAU OF INDIVIDUALlfD'ESl \):"-!I,.JL. IJ' INHERITANCE TAX DIVISION-,''''<,T'":- PO BOX 280601 r_~,_',,:, ',-. HARRISBURG PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT .. REV-16D7 EX AFP (03-05) DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 08-29-2005 STAINS 10-09-2003 21 03-0978 CUMBERLAND 101 Aaaunt R.d tteel KATHRYN M 2"1-"" 2 ~",J ,,.,. n7 u,,: ,)Er - _ r 'II',' U MICHAEU n 28 N 32ND CAMP HILL RENTSCHLER ST PA 17011 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER Of WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, sub.it the upper portion of this form with your tax payment. CUT ALONG THIS LINE --. RETAIN LOWER PORTION fOR YOUR RECORDS - ------------------------------------------------------.-------------------- REV-1607 EX AfP (03-05) *** INHERITANCE TAX STATEMENT Of ACCOUNT KKK ESTATE OF STAINS KATHRYN M FILE MO.21 03-0978 AC" 101 DATE 08-29-2005 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHONN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, TME CURRENT BALANCE, AND, IF APPLICABLE, A PRCUECTED INTEREST FIGURE. DATE Of LAST ASSESSMENT OR RECORD ADJUSTMENT: 07-18-2005 PRINCIPAL TAX DUE, 716.41 PAYMENTS (TAX CREDITS), PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 01-09-2004 CD003424 35.82 683.75 07-11-2005 REfUND .00 3.16- TOTAL TAX CREDIT 716.41 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 . SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIr' (CRI, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. I * Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 9/15/2005 STAINS WILLIAM C JR 45 WETHERBURN ROAD ENOLA, PA 17025 RE: Estate of STAINS KATHRYN M File Number: 2003-00978 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 10/09/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ~~lRAJx/!M~ .' ./ GLEI~A FAJU,ER STRASBAUGH REGISTER OF WILLS cc: File Counsel Judge ~ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 9/15/2005 RENTSCHLER MICHAEL DAVID 1300 MARKET STREET SUITE 200 LEMOYNE, PA 17043 RE: Estate of STAINS KATHRYN M File Number: 2003-00978 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 10/09/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ..~.L~"J~ /' I GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Personal Representative(s) Judge 'Lid-- Register of Wills of Cumberland County Name of Decedent: STATUS REPORT UNDER RULE 6.12 /~J7//2.YA~ k/?-~ ~7A/~ Date of Death: Estate No.: d~~ .3 - ~~ // g 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. Stat~ther administration of the estate is complete: YesA- No 0 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. I is Yes, state the following: a. Di~.~ perso~;presentative file a final account with the Court? Ye No ~ b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the perso~epresentative state an account informally to the parties in interest? Yes ~ No 0 c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. ~ Signature Date: J /t!)/c9b~ / / .~} L-) ~~~.1),~~ Name 2g /UJ ~ SJ; ~#C/A? Address ) ) ~/ I 7?-~-9/d~ Telephone No. Capacity: ~ Personal Representative ~ Counsel for personal representative \ft