HomeMy WebLinkAbout03-0651IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
PETITION FOR GRANT OF LETTERS
Estate of RICHARD DAVID SMITH
also known as RICHARD D. SMITH
Eyvonne Louise Stuck
Petitioner(s), who is/are 18 years of age or older, apply(les) for:
, Deceased
Social Security No. 183-12-3184
(COMPLETE "A" OR "B" BELOW:)
A. Probate and Grant of Letters and aver that Petitioner0[0 is/a.)~ the execut rix
r'~ Decedent, dated 6/9/2003 and codicil(s) dated A////~ ~
named in the Last Will of the
State relevant circumstances, e.g., renunciation, death of executor, etc
Except as follows, Decedent did not marry, was not divorced and did not have a child born or adopted after execution of the documents offered
for probate; was not the victim of a killing and was never adjudicated incapacitated:
B. Grant of Letters of Administration
(c.t.a., d.b.n.c.t.a.: pendente lite, durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse
(if any) and heirs:
Name Relationship Residence
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland
residence at 213 Enola Street~ Enola~ East Pennsboro Township~ PA 17025
(list street, number and municipality)
Decedent, then 80 years of age, died July 20~ ,2003 , at Holy Spirit Hospital~ Camp Hillr PA 17011
(Location)
Decedent at death owned property with estimated values as follows:
(if domiciled in PA) All personal property ......................................... $
(if not domiciled in PA) Personal property in Pennsylvania .................... $
(If not domiciled in PA) Personal property in County .............................. $
Value of real estate in Pennsylvania ........................................................................................ $
Total ..................................................................................................................... $
Real Estate situated as follows:
213 Enola Street, Enola, PA 17025
County, Pennsylvania, with his/her last family or principal
46~000.00
72~000.00
118~000.00
Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in
the appropriate form to the undersigned:
Signature
RW-7
/7-/,5-2'-
Typed or pdnted name and residence
Louise Stuck
203 Reed Drive
Marysville~ PA 17053
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true
and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent,
Petitioner(s) will well and truly administer the estate a~_3;ording to law.
Sworn to and affirmed and subscribed .~-~¢J__..' ~,~'~-¢/_~_~, ~/--~
Ey~'nne Louise Stuck
before me this ?th day of
August 2003
D°n-na M' Ott°' 1st DeputY
DECREE OF REGISTER
Estate of RICHARD DAVID SMITH
also known as RICHARD D. SMITH
Deceased No. 21-2003-651
Social Security No: 183-12-;~1 ~4 Date of Death: 7~20~2003
AND NOW, Auqust 8th , 2003 , in consideration of the Petition
on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters I~ Testamentary I~ of Administration
(c.ta., d.b.n.c.t.; pendente lite; durante absentia; durante minoritate)
are hereby granted to Eyvonne Louise Stuck
in the above estate and that the instrument(s), if any, dated June 9, 2003
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters .................................... $
Short Certificate(s) ..... ~ ....... $
18.
00
Renunciation ..:.~ ..................... $
Affidavit ( ) ....................... $
Extra Pages( 2 ) .............. $ 6o00
Codicil ................................. $
JCPFee ................................. $ 10.00
Inventory & Tax Forms ............. $
Other ...................................... $
235.00
TOTAL ............................. $ 269.00
Mail~l Letters to Attorney on 8/8/03
RW-7A
Register of Wills ·
Otto, 1st Deputy
Attorney: Jill M. Wineka, Esquire
I.D. No: 58802
Address: 1719 North Front Street
Harrisburg,
PA 17102
Telephone: (717) 234-4178
DATE FILED: ~,~X .4';.,0_~ 7/
)_oo
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.
Fee for this certificate, $2.00
No.
Local Registrar
Date
21-2003-651
143 Rev. 2187 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
NAME OF DECEDENT (F rst Middle Las ) STATE FILE NUMBER
' ' Rich ' ]SEX ISOCIALSECURIT~NUMBER I DATE OF DEATH .,MonIh Da Y
A~EL, ard D. Smzth 2 Male ~183 --12 --3184 ', '
, .,S,.h.,,, U.DER,Y , UNDER,DA' ' D ........... I' I' I'
~ a/c vi' I311~/M BIRTHPLACE ' - ' -~ ~ ¢~" "
I Months I Da s I Hours I ' ,a.s ] Month Day Year1 J S ......... (.C~y_.~_n.d_ !PLACE OF DEATH (Check only one- see ins r~q 0ns on other side} ~ I
COUNTY OF DEATH I CITY BORO ............ ' - 3. I". - x I "~. LJ R.,m~. Cl (sp,~. U
m ...... ~ ~-H I FAC!LInTY ~ME (If notth*.,,,~., give slme~ and number) IWAS DECEDENT OF HIS~C OmGmN? I~ACE - A~rican Indian a'12ck Whim
cumberland18cE.. Pennsboro TW~d~coL~// #o- erT a ' ' '
DEC,~.N?. USUAL OCCUPATION I KIND O~ BUSINESS/~NDUSTRY IWAS D~EDENT EVER ,MI DECED .............. I '.. ' I 'g' wn 1 l:e
-'~-,,., ....... ',~,.,, I i' ,S. AR~EDFORCES? I '"~" ................ , I Ne..M..~ Wid~-~ ' I SE
Sta~e, ZipC~)JDECEDENVS 17a. Sm~e Pennsylvaniaoia -,. ~ Yes, de~entlivedm East PennsborQ
I ACTUAL
213 Enola Street IRESlDE.CE decedent ~p
I (~ ins~ns ~ve in a No. demdenl Hved
Pa 17025 I~om.,.i~e) ~Tb. co..~ Cumberlan~ lownship? 17d'O with~a~ual,mi,sof
FATHER'S NAME (FksL MiddY, Las[) ci~o.
~8. Oscar C. Smith I UOTHER'S NAME(F~m. UldOle. Ua~.n
~" Bertha Diller
J INFOR~N~S ~UNG ADDRESS (Str~, Ci~own, S[mte, Z~
20.. zvonne Stuck IzOb. 203 R~ed Dr.. Marvsv~l]e. Pa 17053
DATE OF DISPOSITION ~ P~CE OF DISPOSITION- Name of C~te~, Cre~m~ ~ LOCATI6N - C~n, State, ~p C~e
S'SNATORE Othe,(S~ci~) 3~b. July 24, 2003 Z,c. East Hbg Crematory 3,d. Hbg, Pa
~ ~k J22b. F.D~897-L l~ullivan F.H.,51 N. Enola Dr,Enola,Ra
phys~an is nol availeUe at 1~ of death ,o I (S~.., .... d ~,.¢~w'.?, d,,th .... u ~ m~., *.t~ pm .... ~,~. I LICENSE NUMBER I DATE SIGN
pp ~le PART II ~
IMMED~TE CAUSE (Final , inle~al beheer nol resulting ~ ~ underling ~use gNen ~ P~T I.
', onset and death
~use, Enl~ UNDERLYING
CAUSE (Disea~ ~ injuu c,
resulting ~ dea~ ) LAST d, ',
PERFORMED? I AVAILA,LE PR,OR TOI '~ ( ............. ) :
130e. ~ 30L
'CERTIFYING PHYSlC~N (Phys~iao ce~iRg ~use o[ death when ano~er physician has ronouncud death and competed item 23} ~ ~
DATE FILED (M~
of ~"~.~" 66/
RICHARD DAVID SMITH
I, RICHARD DAVID SMITH, of Enola, Cumberland County, Pennsylvania,
declare this to be my Last Will and Testament, and revoke any and all Wills and Codicils
previously made by me.
ITEM I: I direct that all my just debts, funeral expenses and last medical
expenses shall be paid from the assets of my estate as soon as practicable after my decease.
ITEM II: All federal, state and other death taxes payable because of my death
with respect to the property forming my gross estate for tax purposes, whether or not passing
under this Will, including any interest or penalty imposed in connection with such tax, shall be
considered a part of the expense of the administration of my estate and shall be paid out of the
principal of my estate, without apportionment or right of reimbursement.
ITEM III: I give, devise and bequeath all of my Estate of every name and nature
and wheresoever situate unto my daughters, Sandra Kay Myers and Eyvonne Louise Stuck, in
equal shares, or to their issue, per stirpes, provided they survive me by thirty (30) days.
ITEM IV: I appoint my daughter, Eyvonne Louise Stuck, as the Executrix of
this my Last Will and Testament. Should my daughter, Eyvonne Louise Stuck fail to qualify
or cease to act as Executrix, I appoint my son-in-law, George R. Stuck, as Executor of this my
Last Will and Testament.
ITEM V: I direct that my personal representative, and her successors, shall not
be required to give bond for the faithful performance of their duties in any jurisdiction.
day of
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
3 t/,~"~ ., 2003.
Richard David Sn~ith
The preceding instrument, consisting of this and one other typewritten page was,
on the date thereof, signed, published and declared by Richard David Smith, the testator
therein named, as and for his Last Will, in the presence of us, who, at his request, in his
and in the presence of each other, have subscribed our names as witnesses hereto.
~-~-. (~,~~ Residing at
Residing at
COMMONWEALTH OF PENNSYLVANIA
)SS:
COUNTY OF DAUPHIN
WE, Richard David Smith, and ~O\ ~ .~. ~f~_<,c-oxx,~, ,
~?,,¥o~ ~r- f~c'x~ ~ c_~. , the testator and the witnesses, respectively, whose names
are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to
the undersigned authority that the testator signed and executed the instrument as his last Will,
and that he had signed willingly that he executed it as his free and voluntary act for the purposes
therein expressed, and that each of the witnesses, in the presence and hearing of the testator,
signed the Will as witnesses and that to the best of their knowledge the testator was at that time
eighteen years of age or older, of sound mind and under no constraint or undue influence.
the testator,
Witness
Subscribed, s~vorn to and acknowledged before me, by Richard David Smith,
and subscribed and sworn to before me by ~s J~t'.,~1 ,~c-,~v~', and
witnessed, this ~) 7~ day of ~"(d~ve~ ,2003.
N6tary Public
NOTARIAL SEAL
BARBARA A.'SHADEL, Notary Public
city of Harrisburg, Dauphin County
My Commission Expires March 19, 2007.~
OF
RICHARD DAVID SMITH
LAW OFFICES
1719 N. FRONT STREET
HARRISBURG, PA 17102-2392
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: RICHARD DAVID SMITH a/k/e RICHARD D. SMITH
Date of Death: 7/20/2003
Will No. 2003-00651 Admin. No.
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphan's Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on 8/27/2003 '
Name Address
Sandra Kay Myers
Eyvonne Louise Stuck
8185 Spruce Drive
Harrisbur.q,
203 Reed Drive
Marysville,
PA 17111
PA 17053
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except:
Date:
Name: Jill M. Win(~ka. Esauire
Address: 1719 North Front Street
Harrisburq,
PA 17102
Telephone(717) 234- 4178
Capacity:
X
Personal Representative
Counsel for Personal
Representative
HOWARD B. KRUG
LEON P. HALLER
JOHN W. PURCELL JR.
JILL M. WINEKA
BRIAN J. TYLER
NICHOLE M. STALEY O'GORMAN
LAW OFFICES
1719 NORTH FRONT STREET
HARRISBURG, PENNSYLVANIA 17102-2392
TELEPHONE (717) 234-4178
FAX (717) 233-1149
HERSHEY
(717) 533-3836
JOSEPH N£SSLEY (1910-1982)
JOHN W, PURCELL
VALERIE A. GUNN
0£ Counsel
October 13, 2003
Register of Wills
Cumberland County Court House
Carlisle, PA 17013
Re:
Estate of Richard David Smith a/k/a Richard S. Smith
No. 2003-00651
Dear Register of Wills:
Enclosed please find a check in the amount of $4,500.00, payable to the Register of Wills, Agent, as
payment for the estimate of inheritance taxes due on the above-captioned Estate. I am enclosing a stamped,
self-addressed envelope for your convenience in returning the receipt to me. Thank you.
Sincerely,
JMW/bas
Enclosures
cc: Eyvonne Louise Stuck
(estates\smith\l 0-13-03 Itr to Register)
LAW OFFICES
1719 N. FRONT STREET
HARRISBURG. PA 17102-2392
Register of Wills
Cumberland County Court House
Carlisle, PA 17013
REV~"500 EX + (§-O0)
I-
Z
Z
~J
o
0
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
SMITH~ Richard David a/k/a SMITHr Richard D.
DATE OF DEATH (MM-DD-Year) ] DATE OF BIRTH (MM-DD*Year)
07/20/2003 I 05/12/1923
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
OFFICIAL USE ONLY
FILE NUMBER
2 1 -0 3 0 6 5
COUNTY CODE YEAR NUMBER
SOCIAL SECURITY NUMBER
1 8 3-- 1 2-3 1 8 4
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
r~l. Odginal Return
r'-] 4. Limited Estate
r~6. Decedent Died Testate (Attach copy of Will)
['"~ 9. Litigation Proceeds Received
r~2, Supplemental Return
r'-~ 4a. Future Interest Compromise (date of death after 12-12-82)
--]7. Decedent Maintained a Living Trust (Attach copy of Trust)
r'~ 10. Spousal Pover~ Credit (dateofdeath between 12-31-91 and 1.1-95)
r--] 3. Remainder Retum (date of death pdor to 12-13-82)
~--'] 5. Federal Estate Tax Return Required
0_._ 8. Total Number of Safe Deposit Boxes
["~11. Election to tax under Sec. 9113(A) (Attach Sch O)
THIS SECTION MUST BE COMPLy' II=D. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
Jill M. Wineka, Esquire
FIRM NAME (If Applicable)
Purcell~ Krug & Hailer
TELEPHONE NUMBER
(717) 234-4178
1719 North Front Street
Harrisburg~
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)
~1 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)
PA 17102
13. Charitable and Govemmental 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)
74~000.00
53~486.54
2~059.36I
2~286.91
(8)
12~538.52
2,324.84
OFFICIAL USE ONLY
131,832.81
(11)
(12)
(13)
14,863.36
116~969.45
(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)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20.
116,969.45
116r969'45 X .045 (15)
X (16)
X .12 (17)
X .15 (18)
(19)
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH
5,263.63
5~263.63
· ,Decedent's Complete Address:
STREET ADDRESS
213 Enola Street
CITY
Enola I STATE PA I zip 17025
Tax Payments and Credits:
1. Tax Due(Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
4,500.00
236.84
Interest/Penalty if applicable
D. Interest
E. Penalty
(1)
Total Credits ( A + B + C ) (2)
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)
If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SB)
Make Check Payable to: REGISTER OF WILLS, A GENT
5~263.63
4r736.84
0.00
526.79
0.00
526.79
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ........................................................................... [] []
b. retain the right to designate who shall use the property transferred or its income; ........................................[] []
c. retain a reversionary interest; or ...................................................................................................... [] []
d. receive the promise for life of either payments, benefits or care? ............................................................. [] []
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ............................................................................................... [] []
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. [] []
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ....................................................................................................... [] []
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that I have examined this return, includ ng accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete.
Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF, PERSON RESPONSIBLE-FOR FILING RETURN ~ DATE
DRE88 ,./Eyvonne Lo~is'e 8tuck, 203 Reed Drive,
Marysville,
SIGNATURE QF~PREPARER OTHER TH, AN REPRESENTATIVE
ADDRE88 /')lill M. Wineka, Esquire, 1719 North Front Street,
"Harrisburg~
PA 17053
DATE
///z
PA 17102
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 exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if
the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent,
or a stepparent of the child is 0% [72 P.S. §9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 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.
of
RICHARD DAVID SMITH
I, RICHARD DAVID SMITH, of Enola, Cumberland County, Pennsylvania,
declare this to be my Last Will and Testament, and revoke any and all Wills and Codicils
previously made by me.
ITEM h I direct that all my just debts, funeral expenses and last medical
expenses shall be paid from the assets of my estate as soon as practicable after my decease.
ITEM II: All federal, state and other death taxes payable because of my death
with respect to the property forming my gross estate for tax purposes, whether or not passing
under this Will, including any interest or penalty imposed in connection with such tax, shall be
considered a part of the expense of the administration of my estate and shall be paid out of the
principal of my estate, without apportionment or right of reimbursement.
ITEM III: I give, devise and bequeath all of my Estate of every name and nature
and wheresoever situate unto my daughters, Sandra Kay Myers and E3,wonne Louise Stuck, in
equal shares, or to their issue, per stirpes, provided they survive me by thirty (30) days.
ITEM IV: I appoint my daughter, Eyvonne Louise Stuck, as the Executrix of
this my Last Will and Testament. Should my daughter, Eyvonne Louise Stuck fail to qualify
or cease to act as Executrix, I appoint my son-in-law, George R. Stuck, as Executor of this my
Last Will and Testament.
ITEM V: I direct that my personal representative, and her successors, shall not
~ be required to
il: give bond for the faithful performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
day of ?: ' ,2003.
Richard David Smith
The preceding instrument, consisting of this and one other typewritten page was,
on the date thereof, signed, published and declared by Richard David Smith, the testator
therein named, as and for his Last Will, in the presence of us, who, at his request, in his
presence, and in the presence of each other, have subscribed our names as witnesses hereto.
Residing at
Residing at
COMMONWEALTH OF PENNSYLVANIA
)SS:
COUNTY OF DAUPHIN
WE, Richard David Smith,
, the testator and the witnesses, respectively, whose names
are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to
the undersigned authority that the testator signed and executed the instrument as his last Will,
and that he had signed willingly that he executed it as his free and voluntary act for the purposes
therein expressed, and that each of the witnesses, in the presence and hearing of the testator,
signed the Will as witnesses and that to the best of their knowledge the testator was at that time
eighteen years of age or older, of sound mind and under no constraint or undue influence.
Testator
Witness
Witness
Subscribed, sworn to and acknowledged before .me, by Richard David Smith,
[,he testator, and subscribed and sworn to before me by ':..'-~' 'i.. - . and
:~ .\ '~.-~,.-': 'witnessed, this "-:; ;' day of '~"' ,'. 2003.
N6tary Public
fqOTAR!AL SEAL
BARB¢~.RA A. o.i-~.,EL, Notary Public
City of Harrisburg, Eauphin Cou~t'j
My Commission Expire,~ March "'-~,, .-uu,l ......
,REV-1502EX + (1-97) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
~:STATE OF
SCHEDULE A
REAL ESTATE
FILE NUMBER
SMITH. Richard David a/k/a SMITH, Ri~hcr¢ D. 21 0;~ ¢6~1
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the pdce at which property would be exchanged
between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly.owned with right of
survivorship must be disclosed on Schedule F,
ITEM
NUMBER
DESCRIPTION
213 Enola Street, Enola, Cumberland County, Pennsylvania 17025, now known as 20
East Beale Avenue, Enola, Cumberland County, Pennsylvania 17025. Deed Book G,
Volume 27, Page 873. The Decedent owned the property alone because his wife,
Arlene E. Smith predeceased the Decedent on May 11,2001. (See attached Deed
and Settlement Statement).
TOTAL (Also enter on line 1, Recapitulation)
VALUEAT DATE
OF DEATH
74,000.00
74~000.00
(If more space is needed, insert additional sheets of the same size)
THIS INDENTURE, made this
EXECUTRIX DEED
/'~ Y"~day of
,2003, between
EYVONNE LOUISE STUCK, EXECUTRIX FOR THE ESTATE OF RICHARD DAVID SMITH
a/k/a RICHARD D. SMITH, late of East Pennsboro Township, Cumberland County,
Pennsylvania, party of the first part, Grantor
AND
TRACY R. MULLEN-HOON, a married woman, of Enola, Cumberland County,
Pennsylvania, party of the second part, Grantee
WITNESSETH:
WHEREAS, the said Richard D. Smith, became in his lifetime seized, of and in certain tracts and
parcels of land lying and being in East Pennsboro Township, Cumberland County, Pennsylvania, which are
more particularly described hereafter; and being so thereof seized, Richard D. Smith, a widower, died testate
on July 20, 2003. Letters Testamentary for the Estate of Richard David Smith a/k/a Richard D. Smith were
duly issued to Eyvonne Louise Stuck by the Register of Wills of Cumberland County on August 8, 2003 to
Estate No. 2003-00651.
NOW THIS INDENTURE WITNESSETH, that the said Grantor, for and in consideration of the sum
of SEVENTY FOUR THOUSAND ($74,000.00) DOLLARS to her in hand paid by the said Grantee at or before
the sealing and delivery hereof, receipt whereof is hereby acknowledged, has granted, bargained, sold,
aliened, released and confirmed, and by these presents does grant, bargain, sell, alien, release and confirm
unto the said Grantee, her heirs and assigns,
ALL that certain lot or piece of ground situate in the Township of East Pennsboro,
County of Cumberland and State of Pennsylvania, bounded and described in accordance
with a survey and plan made by Ernest J. Walker, Professional Engineer, dated March 9,
1965, as follows:--
BEGINNING at a point on the Western line of Enola Street at the dividing line
between Lots Nos. 23 and 24 as shown on hereinafter mentioned plan of lots; thence
extending along said dividing line South 62 degrees 37 minutes West 150 feet to the Eastern
line of Second Alley; thence along said alley, North 27 degrees 23 minutes West 50 feet to
a point on the Southern line of Beale Street North 62 degrees 37 minutes East 140 feet to
point of curve; thence in an Eastedy direction on a curve to the right having a radius of 10 feet
for the arc distance of 15.57 feet to a point on the Western line of Enola Street aforesaid;
thence along the same South 27 degrees 23 minutes East 40 feet to the point and place of
BEGINNING.
BEING Lots Nos. 22 and 23, Block "A" on the Plan of Lots of Arthur R. Rupley which
said plan is recorded in Deed Book "O", Vol. 6, Page 600, Cumberland County records.
HAVING thereon erected a one story frame dwelling house known as 20 East Beale
Avenue and formerly known as 213 Enola Street.
BEING the same premises which Charles W. Fisler, Jr. and Marlene D. Fisler, his
wife, by their Deed dated February 3, 1967 and recorded March 20, 1967 in Cumberland
County Deed Book "G", Volume 22, Page 873, granted and conveyed title unto Richard D.
Smith and Arlene E. Smith, his wife. The said Arlene E. Smith died on May 11, 2001, and
by operation of law, title vested solely in her husband, Richard D. Smith. The said Richard
D. Smith subsequently died testate on July 20, 2003 and Eyvonne Louise Stuck was
appointed Executrix for the Estate, docketed to No. 2003-00651 by the Register of Wills of
Cumberland County.
TOGETHER with all and singular, the buildings, improvements, ways, streets, alleys, passages,
waters, water-courses, rights, liberties, privileges, hereditaments and appurtenances whatsoever, thereunto
belonging or in any wise appertaining and the reversions and remainders, rents, issues and profits thereof,
and all the estate, right, title, interest, property, claim and demand whatsoever of him, the said Richard David
S~nith a/Ida Richard D. Smith, at and immediately before the time of his decease, in law, equity, or otherwise
howsoever, of, in, to or out of the same.
TO HAVE AND TO HOLD the said lot or piece of ground above described, with the buildings and
improvements thereon erected, hereditaments and premises hereby granted or mentioned, and intended so
to be, with the appurtenances, unto the said Grantee, her heirs and assigns, to and for the only proper use
and behoof of the said Grantee, her heirs and assigns, forever.
AND, the said Grantor, does covenant, promise and agree to and with the said Grantee, her heirs and
assigns, that she, the said Grantor, has not heretofore done, committed or knowingly or willingly suffered to
be done or committed any act, matter or thing whatsoever whereby the premises hereby granted, or any part
hereof, is, are, shall or may be impeached, charged, or encumbered in title, charge, estate of otherwise
howsoever.
2
IN WITNESS WHEREOF, the said Grantor has hereunto set her hand and seal, in her fiduciary
capacity as aforesaid, the day and year first above written.
WITNESS:
4;;Eyvonne Louise'Stuck, Executrix for the Estate
of Richard David Smith a/k/a Richard D. Smith
STATE OF PENNSYLVANIA
COUNTY or
On this, the /---~ ;,-¢,, day of
)
) SS:
)
,2003, before me, a Notary Public, the
undersigned officer, personally appeared Eyvonne Louise Stuck, Executrix for the Estate of Richard David
Smith a/k/a Richard D. Smith, known to me (or satisfactorily proven) to be the person described in the
foregoing instrument, and acknowledged that she executed the same in the capacity therein stated and for
the purposes thereon contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
Notary Public
My commission expires: -
(SEAL) ~ Notarial Seal
Diane M. Sm th, Nota~ Public
Mechanicsburg ,..Roro, Cumberland County~
My Commission Ez':'?~s June 22, 2004
I HEREBY CERTIFY the precise residence of the within named Grantee to be:
(estates\smith\deed)
A. Settlement Statement
U.S. Department of Housing
and Urban Development
OMB Approval No. 2502-0265
included in the totals.
D, Name and Address of Sorrower
TRACY R. MULLEN-HOON
425 PARKSIDE ROAD
CAMP HILL PA 17011
G. PropeHy Location
20 EAST BEALE AVENUE
ENOLA
B)ock:
B. Type o! Loan
1. [] FHA 2. [] FmHA 3. [] Cony. Un[ns. is File NLm,bar i7. Loan Number /8' Modgagel ........ C ...... bet
C. Note: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the setile~eni ag~ntare shown. Items marked "(p.o.c.)" were paid outside closing; they are shown here for informational purposes and not
EYVONNE LOUISE STUCK, iMEMBERS 1ST
EXECUTRIX I FEDERAL CREDIT UNION
ESTATE OF RICHARD DAVID SMITH 15000 LOUISE DRIVE
....... ~ ........... I MECH~N!C~B-URG .... PA. 17055
IH Se.~e~ne,~^gen~ MEMBERS 1ST SETTLEMENT SERVICES, LLC
PA 17025 5000 LOUISE DRIVE I11/13/2003
i MECHANICSBURG PA 17055 t11/13/2003
J, Summary of Borrower's Transaction K. Summary of Seller's Transaction
100. Gross Amount Due From Borrower 400. Gross Amount Due To Seller
101. Conlract sales pnce 74 000.00 401. Contract sa es price 74 ('1~ 0{3
102. Personal properly 402. Personal propedy
103Settlement charges ~o borrower (line 1400) ~ 2 ~649 ~.35 403.
104 [I 404. ' ..............
106City/towntaxes 11/13/20031o 12/31/2003 ' 28.36 406. City/towntaxes 11/13/20031o 12/31/2003 28136
108Assessments to I .... 408. Ass~ssn~eots
~09. SCHOOL T~ 11/13/20031o 6~30~2004 ........................ 539.1~ 409. SCHOOL T~ 11/13/20031o 6/30J200~ ........... ~ 539.14
110 . to ....... , ..... , ~.1~ ................ to
~ S~ER .... ~/!3~200~t~ !g/3?gPo~ _ ~ _ g~.8~ ~. SEWER 1~/13/20031o~/31/2~0~ ...... ~ ...... 2~.8~
114. to 414.
120. Grcss Amount Due From Borrower , 77,242.68 ~420. Gross Amount Due To Seller j 74 593 3R
200. Amounts Paid By Or In Behalf Of Borrower
. ~0. Reductions In Amount Due To Se er
201 Deposit or earnest money ; .. 7,400.00 501. Exess deposit se~ instructions ..... ~ 7,400.00
202 Principal amount o~ new loan(s) ~ _ _66,6~:~0 502. settlement charges to seller (line 1400) ~ 2,966.00
203. Existing loan(s) taken subject to - i ..... 503. Exisiing ~pap s}_t~k?~.sybject to .....
204 ~
....... ~ ....... 504:__Payo~p~ ~[sl mo~age Ioa~
205
208. , - ............................
~ ..............508.
Adjustments for Items unpaid by seller
~Ju~t~en~s for .l~m~ ~gP~ d by_se er
..... L 510 Cit/towo laxes to
211. County taxes ~ ........ 511. County taxes to
212. Assessments 1o .........................
2~4 REFUSE 101112003 to 1111312003 .......... ~.~3 ~ ~E~ ..... ~0/1/2~3 ~i~20~ ...........~ 21"7~
215. to
.............. ~ ~ 515. 1o
218 tO _j 5~S.
220. Total Paid By/For Borrower 74 021.73 s20. Total Reduction Amount Due Seller ~ 10 387 73
300. Cash At Settlement From/To Borrower 800. Cash _At Settlemen.t To/From Seller
' - i ' ''1 ' o , due to seller (li~e 420) ,
301.
Gross Amoun due from borrower ('ne 120) 77 242 68 601 Gross am un I
74159~133
302 Less amount paid by/for borrower line 220) [ 74 021.7311602 Less reductions in amt due se er ( ne 520 i 10 387 73)
Cash [] From [] To B ....... i 3,220.951 i
303. 603, Cash [] To [] From Saner 64,205.60
SUBSTITUTE FORM 1099 SELLER STATEMENT
The information contained in Blocks E, G. H, and I and on line 401 (or, line 403 and 404) is important tax information and is ~eing furnished to Ihe internal Revenue
So.ice It you are required to file a return, a negligence penalty or other sanction will be imposed on you if this item is required to be reported and the IRS determines
that it has not been reported. If this real estate is your principal residence, file Form 2119, Sale or Exchange of Principal Residence. for any gain, with your income tax
return; for other transactions, complete the applicable parts ot Form 4797, Form 6232 and/or Schedule D, Form 1040) You are required 1o provide lhe Setllement Agent
(named above) with your correct taxpayer identification number. If you do not provide the Settlement Agent with your correct taxpayer identification number, you may be
subject to civil or cdminal penalties imposed by law. Under penalties of perjury. I certify that the number shown on this statement is my correct taxpayer identification number.
L. S~Ulement Charges
Division ef Cemmlsslon (line 700) as follows: Bo~owe(s Seler's
70;. $ .... t0 ....................... ~ Funds Al ~ Funds At
702. $ to ........................... J Se~lement r ~ SeUlement
703 paid et SeIU .... t ¢ l
comm~s~o, CLAUDE C. WOLFE & ASSOC.
............... 2 220.00
704 -- ....... / ..... j
900. Items Payable In Connection With Loan
802. Loan Discount 66,600.00 % ............
803. Appraisal Fee ,o ' ....................... t ......... I .......
804: Cr~di! Report ........ t9
8o6. Mo,gage, ........ Ap,li tion Fee ,o
~07. Assumption Fee .... ! ] '
COs: APPLICATioN F:EI~ MI::MBI~RS .......... - .................
~o9. UNDERWRITING FEE MEMBERS 1ST
......
610. DOCUMENT PREP FEE ~EMBER§ isT
811. ....................
900. Items Required By Lender T.o Be Paid In Advance Exclude last day in calcs - line
901. ,nteres~!rem 11/13(2_003 ~ to 11/3~/2003@$91943~
902. Mortgage Insurance Premium for
903. Hazard Insurance Premium for
904
1000. Reserves Deposited With Lender ..
1001 Hazard i ........ 3 monlhs~$
t002. Mortgage insurance months@$ per month
1003. City propedy taxes months@$ per month
1004 County property t .... _ m0ntbS@$ ._. 17_.9_7...per ann!~ ................
lO05. Annual asses_sments ........ mont~_s@$ per month
lOO~ .... hs@$ p ..... th
1008. Aggregate Accountin~ Adjustment
1100. Title Charges
1101 .- Set:::ment or c;--sin-~ fee -,,u ,~g ................. lo- .......................................
03. Title examination to ~ J
1104. Title insurance binder to ..........
1105 Documenl preparaUon to .... - ........
1106. No a~ ees to CASH
.........................
1107. Attorney's fees to PURCELL, KRUG & HALLER P,O.C.
{Includes above items numbers:
1108 Title insurance to MURREL R. WALTERS, III, ESQUirE ..... ~ ...... 777.75
(Includesaboveilem~n~ber~ J~J:1.!04,1~8 ~ENN~ORN~ySTIT~EI~S~CO
11o9. Lender's coverage $ 66 600.00 endorsements 100 300 8 1
~1~o Owqer's coverage .... $ 74,000.00
1200. _ .......
Government Recording and Transfer Charges
1202. City/counly la.stamps: Deed $ 740.00 ; Modgage $ 740.00~
1300. Addltlona~ Sefllement Charges
1301 su~ey to
1302. Pest. inspection .... t~ ........................................
1303. '
1305. m
,306.4TH QTR RE~USE ~ ~ .~-'~ ~-- ~ ~ ~~BbR~'~owN~ip' .............
1308. ' ..................................................
1400, Total Settlement Charges (enter on lines 103, Section J and 502, Section K) ~ 2~649.35 2~966.0~
CERTIFICATION
TO the best of ~.[~g~e .~S~leme~l Stat .... t which I have prepared is al ..... da ..... t ....... f the [unds wh ch ........ ived end have ~ ..... ill
~--" ............. ~ Se~lement Agent ........ Dale
MEMBERS l ST S~LEMENT SERVICES, LLC
~ REV-1508EX+(1-97) ~
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT PERSONAL PROPERTY
ESTATE OF FILE NUMBER
SMITH. Richard David ~/k/a SMITH. Richard D. 21 ~);~ 0(~51
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. Credit on Settlement Statement for City Taxes 28.36
10.
11.
12.
13.
14.
15.
16.
Credit on Settlement Statement for School Taxes
Credit on Settlement Statement for Sewer bill
Medcohealth - refund
Allstate Insurance Company- refund
West Shore Oil Company - refund
Comcast - refund
Gross proceeds from Auction of Personal Property (See attached Statement.)
Allstate Insurance Company - refund
Comcast- refund
Blue Chip Federal Credit Union Savings Acct. #4106 (See attached Statement.)
Blue Chip Federal Credit Union Checking Acct. #4106 (See attached Statement.)
United States of America Railroad Retirement Board
United Transportation Union Insurance Assn. - refund
Verizon - refund
United Health Care - refund
TOTAL (Also enter on line 5, Recapitulation)
539.14
25.83
43.76
149.00
1,471.67
39.64
5,957.00
121.10
2.60
38,931.52
4,609.52
1,135.10
21.60
4.22
406.48
53~486.54
(If more space is needed, insert additional sheets of the same size)
CLAUDE C. WOLFE & ASSOCIATES
AUCTIONEERS & APPRAISERS
FAMILY OWNED SINCE 1912
2009 LINCOLN STREET · CAMP HILL, PA 17011
717-761-2763
Public Auction for Estate of Richard David Smith
Date October 11 ~ 2003
Address 213 Enola Street~ Enola, PA 17025
Auction Gross
5,957.00
EXPENSE S
Shoppers Guide Adv. & Sale Bills ..~,~ ........... $ 239.40
Patriot News Adv.
............................. 287.00
Paxton Herald Adv.
Other Adv.
Other Adv.
Other Adv.
Sign for Property 25.00
State Fumigation Tags 10.00
Registration Numbers
Tent/T~rp .......................... 10.00
Mi sc. Expenses
4 Clerks at $ 70.00 each ............... 280.00
4 Runners at $ 81.25 each 325.00
Labor Sale preparation ... 540.00
Labor
Labor
Labor
Personal Items Fee at 10
Total Expenses for Auction
595,70
........................ $ 2,312.10
Real Estate Gross
Real Estate Fee at 3 % (Due at Settlement)
$_5,957.00
-__2~312.10
3,644.90
-_.4~705.00
1.060.10
Auction Gross
Expenses
Net
Checks
Owed to/~Auctioneer
74~000.00
2,220.00
Auctioneer or Cashier:
Approved by:
FEDERAL
CREDIT UNION
5050 Derry Street
Harrisburg, PA 17111
Telephone (717) 564-3081
FAX (717) 564-1469
September 10, 2003
Jill M. Wineka
Purcell, Krug & Hailer
1719 North Front Street
Harrisburg, PA 17102
Re: Estate of Richard David Smith
SS#183-12-3184
Dear Miss Wineka,
The balances on Mr. Smith's account on July 20, 2003 were as follows:
Share account balance... $38,931,52
Share draft balance... $4,609.52
The share account was opened on 11/09/1978. The share draft account was opened
6/03/1991. The decedent's spouse, Mrs. Arlene Smith, was a joint owner on this account
from the time it was opened until the time of her death in 2001. There are no other
owners on this account.
If you require further information please call the credit union at the above number.
Sincerely,
Michele Pintarch
BCFCU
REV-I'509 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF FILE NUMBER
SMITH. Richard David a/k/a SMITH. Rich~r~ D. 21
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A. George Stuck 203 Reed Drive Son-in-law
Marysville, PA 17053
B
C
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTERES
1. A. 2/14/02 Commerce Bank Savings Acct. #616261252 4,118.71 50. 2,059.3~
(See attached Statement.)
TOTAL (Also enter on line 6, Recapitulation) $
.................. 2~059.36
(If more space ~s needed, insert additional sheets of the same size)
Commerce
k..
January 2, 2004
Purcell, Krug &Haller
1719 N Front St
Harrisburg, PA 17102-2392
RE:
Estate of: Richard D Smith
Social Security #: 183-12-3184
Date of Death: July 20, 2003
Dear Sir/Madam:
In reference to the letter regarding the above mentioned
Estate, we would like to inform you of the information that
we have researched and found.
Type: Savings
Account #: 616261252
Date Opened: 2/14/02
Date Closed: 7/28/03
Primary Owner: Richard D Smith
Secondary Owner: George R Stuck
Date of Death Balance: $4,117.81
Accrued Interest: $.90
If there are any questions or additional information that
is needed, please feel free to contact me at (717) 795-7118
ext. 3151.
Sincerely,
Wanda J. Morris
CIF Team Leader
Commerce Bank / Harrisburg, N.A.
P.O. Box 8599
100 Senate Avenue
Camp Hill, Pennsylvania 17001-8599
· REV-1510EX+(1-97) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF FILE NUMBER
SMITH, Richard David a/k/a SMITH, Richard D. 21 03 0651
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 les.
DESCRIPTION OF PROPERTY % OF
ITEM iNCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
NUMBER ATTACH A COPY OF THE DEED FOR REAL ESTATE VALUE OF ASSET INTEREST (IF APPLICABLE}
1. Conseco Services L.L.C. - Washington National Insurance 2,286.91 100. 2,286.91
Company Annuity Contract No. 000149771 (See attached
Statement.)
TOTAL (Also enter on line 7, Recapitulation) $ 2,286.91
(If more space is needed, insert additional sheets of the same size)
CONSECO SERVICES, L.L.C.
P.O. BOX 1982
CARMEL IN 46082-1982
October 22, 2003
Richard David Smith Estate
c/o 203 Reed Drive
Marysville, PA 17053
Re'
Washington National Insurance Company
Contract No. 000149771
Richard D. Smith - Annuitant
To Whom It May Concern:
We have completed a review of the recent claim for benefits under the above contract and
are pleased to enclose our check in the amount of $2,286.91. This represents the full
value of the benefit of this contract and requires the personal endorsement of the payee.
A From 1099 will be sent to you at year-end advising you of the amount of proceeds tha~
is taxable, if any.
Very truly yours,
HancyPat~c~gffay
Nancy Patricia May
Claims Examiner
Enclosure
cc: Jill M. Wineka
Purcell, Krug &Haller
1719 North Front Street
Han'isburg, PA 17102-2392
· REV-1511EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
SMITH. Richard David @/k/@ SMITH. Richard D.
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21 03 06~1
ITEM
NUMBER
8.
9.
DESCRIPTION AMOUNT
FUNERAL EXPENSES:
Dillsburg Cemetary Association
Gingrich Memorials
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s) / EIN Number of Personal Representative(s)
Street Address
City State
Year(s) Commission Paid:
Attorney Fees Purcell, Krug & Hailer
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Zip
Street Address
city
Relationship of Claimant to Decedent
Probate Fees Register of Wills
State Zip
Accountant's Fees
Tax Retum Preparer's Fees
Seller's charges to Estate on Settlement Statement
Refuse bill on Settlement Statement
Estate's expenses for Auction of Personal Property
Register of Wills - Short Certificates
Register of Wills - JCP fee
Register of Wills - Additional Short Certificates
Register of Wills - Fee to file PA Inheritance Tax Return
Register of Wills - Fee to file Inventory
Register of Wills - Fee to file Family Settlement Agreement
The Sentinel - Advertising
Cumberland Law Journal - Advertising
250.00
95.00
6,400.00
241.00
2,966.00
21.73
2,312.10
18.00
10.00
9.00
15.00
10.00
17.00
98.69
75.00
TOTAL (Also enter on line 9, Recapitulation) $ 12,538.52
(If more space is needed, insert additional sheets of the same size)
· REV-1512EX+(1-97) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
ESTATE OF
SMITH, Richard David a/k/a SMITH, Richard D.
Include unreimbursed medical expenses.
FILE NUMBER
21 03
0651
ITEM
NUMBER
o
10.
11.
12.
13.
14.
15.
DESCRIPTION
Social Security - refund
PP&L - electric bill
PA American Water - water bill
AT&T - phone bill
Texaco/Shell - credit card bill
The Patriot News - newspaper
UGI - gas bill
UGI - gas bill
Comcast - cable bill
George Stuck - reimbursement of costs advanced
PA American Water - water bill
PP&L - electric bill
East Pennsboro Township - sewer bill
PA American Water - water bill
PP&L - electric bill
TOTAL (Also enter on line 10, Recapitulation)
AMOUNT
1,781.47
208.00
13.33
11.69
41.00
14.95
22.00
10.89
39.64
28.60
11.19
33.99
49.50
13.92
25.40
(If more space is needed, insert additional sheets of the same size) 2~324.84
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
SMITH, Richard David a/k/a SMITH, Richard D. 21 03
Page 1
Schedule I - Debts of Decedent, Mortgage Liabilities, & Liens
0651
ITEM
NUMBER DESCRIPTION
16. PP&L - electric bill
17.
PA American Water - water bill
SUBTOTAL SCHEDULEI
GRANDTOTALSCHEDULEI
AMOUNT
6.43
12.84
19.27
$ 2,324.8d
.RE'~-J 513 EX + (g-nm
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFIClAEIES
ESTATE OF
SMITH, F~ichard David a/k/a SMITH, Richard D.
NUMBER
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a)(1.2)]
Sandra Kay Myers
8185 Spruce Drive
Harrisburg, PA 17111
Eyvonne Louise Stuck
203 Reed Drive
Marysville, PA 17053
FILE NUMBER
21
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Daughter
Daughter
5O%
5O%
AMOUNT OR SHARE
OF ESTATE
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, 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 II - 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)
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
INVENTORY
Estate of SMITH~ Richard David
also known as SMITH, Richard D.
, Deceased
No. 21 03 0651
Date of Death 7/20/2003
Social Security No. 183123184
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation
placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no
real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory, lANe
verify that the statements made in this inventory are true and correct, lANe understand that false statements herein made are subject to the
penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Name of
Attorney:
I.D. No.:
Address:
Jill M. Wineka~ Esquire
58802
1719 North Front Street
Harrisburg~ PA 17102
Personal Representative:
E~onne Louise Stuck
Telephone: (717) 234-4178
Description
213 Enola St., Enola, Cumberland Co., PA 17025, now known as 20
East Beale Ave., Enola, Cumberland Co., PA 17025
Credit on Settlement Statement for City Taxes
Credit on Settlement Statement for School Taxes
Credit on Settlement Statement for Sewer bill
Medcohealth o refund
Allstate Insurance Company- refund
(Attach Additional Sheets if necessary)
Value
74,000.00
28.36
539.14
25.83
43.76
149.00
Total
129,773.45
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
J-4
SMITH, Richard David
Description of Inventory
Continuation of Inventory
Description
West Shore Oil Company - refund
Comcast - refund
Page 1
21 03 0651
Gross proceeds from Auction of Personal Property
Allstate Insurance Company - refund
Comcast - refund
Value
1,471.67
39.64
5,957.00
Blue Chip Federal Credit Union Savings Acct. #4106
Blue Chip Federal Credit Union Checking Acct. #4106
121.10
2.60
United States of America Railroad Retirement Board
United Transportation Union Insurance Assn. - refund
Verizon - refund
United Health Care - refund
Conseco Services L.L.C. - Washington National Insurance Company
Annuity Contract No. 000149771
38,931.52
4,609.52
1,135.10
21.60
4.22
406.48
2,286.91
Subtotal $ 54,987.36
Grand Total $ 129,773.45
IN RE:
ESTATE OF RICHARD DAVID ,SMITH a/k/a
RICHARD D. ,SMITH
DECEASED
: IN THE COURT OF COMMON PLEAS
' CUMBERLAND CO., PENNSYLVANIA
: ORPHANS' COURT DIVISION
:
: NO. 2003-00651
: PA NO.: 21-03-0651
FAMILY SETTLEMENT AGREEMENT AND FINAL RELEASE IN ESTATE or'
RICHARD DAVID SMITH a/k/a RICHARD D. SMITH~ DECEASED
KNOW ALL MEN BY THESE PRESENTS, that:
WHEREAS, Richard David Smith a/k/a Richard D. Smith, late of East Pennsboro Township,
Cumberland County, Pennsylvania, died testate on July 20, 2003:
WHEREAS, Letters Testamentary on the Estate of the Decedent were duly issued by the Register of
Wills of Cumberland County to the Executrix, Eyvonne Louise Stuck on August 8, 2003;
WHEREAS, the Executrix has gathered the assets of the Estate of the Decedent and the assets
consist of personal and real property with a total liquidation value of $127,724.02, as set forth in the
Statement of Account which is attached hereto and marked Exhibit "A";
WHEREAS, the Executrix has paid the debts of the Estate in the amount of $18,423.68, as set forth
in the Statement of Account;
WHEREAS, the Decedent's two children, Eyvonne Louise Stuck and Sandra Kay Myers, who are
the only beneficiaries of the Estate and the only parties signing this Family Settlement Agreement and Final
Release, previously acknowledged in writing their individual receipt of $40,000.00 each paid on January 13,
2004 and January 14, 2004 respectively, as a partial distribution of their portions of the residuary Estate as
set forth in the Acknowledgments of Partial Distribution which are attached hereto and marked Exhibit "B";
WHEREAS, the balance for cash distribution is in the amount of~_~2,9,300.34' which will be
distributed in accordance with the Statement of Distribution which is attached'hereto a~ marked Exhibit
NOW, THEREFORE, we, Eyvonne Louise Stuck and Sandra Kay Myers, being the only two
beneficiaries of the assets of the Estate of Richard David Smith a/k/a Richard D. Smith, do hereby
acknowledge that we have received the liquidated proceeds of all assets due us by virtue of the
Decedent's Last Will and Testament, as set forth on the Statement of Distribution attached hereto as
Exhibit "C".
AND, we do hereby stipulate that in order to avoid the expense and time involved in the filing of a
formal account and proposed schedule of distribution, we agree that no account is necessary and we
consent to distribution being made without the formal filing of an account and schedule of distribution, the
same to be with the same force and effect as if the documents had been filed and confirmed by the
Orphans' Court Division of the Court of Cumberland County.
THEREFORE, we do hereby release and forever discharge Eyvonne Louise Stuck, the Executrix
and Jill M. Wineka, Esquire and the law firm of Purcell, Krug & Hailer, the Attorneys for the Estate, their
assigns, executors and administrators, from all actions, suits, payments, accounts, and claims whatsoev-
er, touching upon the Estate of the Decedent. We also agree that should any liability come due to the
Estate of the said Decedent after the signing of this Agreement, we covenant and agree that we will share
equally the financial responsibility for satisfying any and all taxes, liabilities, claims, demands, suits or
causes of action which may be successfully prosecuted or assessed against the Estate after the signing,
sealing and delivery of this Family Settlement Agreement and Final Release.
The parties acknowledge that this Family Settlement Agreement and Final Release will be signed
and notarized separately by each of the two beneficiaries. The two original signatures will be attached to
the original Family Settlement Agreement and Final Release and filed of record with the Cumberland
County Orphans' Court.
IN WITNESS WHEREOF, I have set my hand and seal to the Family Settlement Agreement and
Final Release on the date as indicated below.
WITNESS:
Eyvonne Louise Stuck
COMMONWEALTH OF PENNSYLVANIA
· SS:
COUNTY OF
On this, the _//~ day of ~/~~ 2004, before me, a Notary Public, the
~f- ,
undersigned officer, personally appeared Eyvonne Louise Stuck, known to me (or satisfactorily proven) to
be the person who name is subscribed to the within instrument, and acknowledged that she executed this
Family Settlement Agreement and Final Release for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
Notary Public
(SEAL)
My Commission Expires:
IN WITNESS WHEREOF, I have set my hand and seal to the Family Settlement Agreement and
Final Release on the date as indicated below.
WITNESS:
' "' Sandra K~ay~ers ~
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ~/)z~
On this, the ~ day of ,_.~,,,,-~:
· SS;
,2004, before me, a Notary Public, the
undersigned officer, personally appeared Sandra Kay Myers, known to me (or satisfactorily proven) to be
the person who name is subscribed to the within instrument, and acknowledged that she executed this
Family Settlement Agreement and Final Release for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Vesna M. Ran(k, Nolary Public
Lower Paxton Twp., Dauphin County
My Commission Expires Jan. 26, 2008
Member, Pennsylvania Association Of Notaries
Notary Public
My Commission Expires: / -,:=2 ¢.-~,¢,"
(SEAL)
ASSETS:
STATEMENT OF ACCOUNT
213 Enola Street, Enola, PA 17025 - gross proceeds
Credit on real estate Settlement Statement for taxes and sewer
Personal property at auction - gross proceeds
Blue Chip Federal Credit Union Savings & Checking Acct. No. 4106 -
liquidated value after Social Security funds recaptured
2003 Federal Income Tax Refund
Conseco Services, LLC - annuity proceeds
Medcohealth - refund
Allstate Insurance Company - refund
West Shore Oil Company - refund
Comcast - refund
Allstate Insurance Company - refund
Comcast ~ refund
United States of America Railroad Retirement Board
United Transportation Union Insurance Assn. - refund
Verizon - refund
United Health Care - refund
TOTAL ASSETS
$74,OO0.O0
593.33
5,957.00
40,931.61
560.00
2,286.91
43.76
149.00
1,471.67
39.64
121.10
2.60
1,135.10
21.60
4.22
406.48
DEBTS:
Dillsburg Cemetery Association
Gingrich Memorials
Purcell, Krug & Hailer- attorney's fees
EXHIBIT A
$ 250.00
95.00
6,400.00
Register of Wills - probate fees
Seller's charges to Estate on Settlement Statement
Refuse bill on Settlement Statement
Estate's expenses for Auction of Personal Property
Register of Wills - Shod Certificates
Register of Wills - JCP fee
Register of Wills - additional Shod Certificates
Register of Wills - fee to file PA Inheritance Tax Return
Register of Wills - fee to file Inventory
Register of Wills - fee to file Family Settlement Agreement
The Sentinel - advertising
Cumberland Law Journal - advertising
PP&L - electric bill
PA American Water - water bill
AT&T - phone bill
Texaco/Shell - credit card bill
The Patriot News - newspaper
UGI - gas bill
UGI - gas bill
Comcast - cable bill
George Stuck - reimbursement of costs advanced
PA American Water - water bill
PP&I - electric bill
East Pennsboro Township - sewer bill
PA American Water - water bill
PP&L - electric bill
241.00
2,966.00
21.73
2,312.10
18.00
10.00
9.00
15.00
13.00
17.00
98.69
75.00
208.00
13.33
11.69
41.00
14.95
22.00
10.89
39.64
28.60
11.19
33.99
49.50
13.92
25.40
PP&L - electric bill
PA American Water - water bill
PA Department of Revenue - estimate of inheritance taxes
PA Department of Revenue - balance due of inheritance taxes
Hamilton & Musser, PC - accountant's fees
Register of Wills - additional Shod Certificates
TOTAL DEBTS
6.43
12.84
4,500.00
526.79
300.00
12.00
IN RE:
ESTATE OF RICHARD DAVID SMITH a/ida
RICHARD D. SMITH, Deceased
IN THE COURT OF COMMON PLEAS
CUMBERLAND CO., PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 2003-00651
ACKNOWLEDGMENT OF PARTIAL DISTRIBUTION
KNOW ALL MEN, BY THESE PRESENTS, THAT the undersigned does hereby acknowledge that
she has received from the ESTATE OF RICHARD DAVID SMITH a/ida RICHARD D. SMITH, the sum of
FORTY THOUSAND ($40,000.00) DOLLARS as a partial distribution of the sums of money owed to her. The
acknowledgment of the partial distribution of Forty Thousand ($40,000.00) Dollars is made without prejudice
and in no way waives any objections Eyvonne Louise Stuck may wish to later assed against the administration
of the Estate of Richard David Smith a/ida Richard D. Smith.
IN WITNESS WHEREOF, Evyonne Louise Stuck does hereunto set her hand and seal the /J~ day
of ~',_/~,,~NI ~].~t ~ ~ .~" · ,2004.
Swom to before me this
dayof ,"~,t.'i~,A-)~/ ,2004.
t
/ - "'u'-"'c
/
My Commission Expires:
Ez~l(v°nne L'o-uise Stuck -
I B_A..RBA. Fj1 A. SHAD~, Not~x'y Public
I ~[Y o~ ~?rr~burg, Dauphin County
~My ,.;om,minion Expirss iVlarch '~9, 2007
(estates~smith~partial release)
EXHIBIT B
IN RE:
ESTATE OF RICHARD DAVID SMITH a/Ida
RICHARD D. SMITH, Deceased
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND CO., PENNSYLVANIA
: ORPHANS' COURT DIVISION
:
: NO. 2003-00651
,ACKNOWLEDGMENT OF PARTIAL DISTRIBUTIO:'
KNOW ALL MEN, BY THESE PRESENTS, THAT the undersigned does hereby acknowledge that
she has received from the ESTATE OF RICHARD DAVID SMITH a/ida RICHARD D. SMITH, the sum of
FORTY THOUSAND ($40,000.00) DOLLARS as a partial distribution of the sums of money owed to her. The
acknowledgment of the partial distribution of Forty Thousand ($40,000.00) Dollars is made without prejudice
and in no way waives any objections Sandra Kay Myers may wish to later assert against the administration
of the Estate of Richard David Smith a/Ida Richard D. Smith.
iIN WITNESS WHEREOF, Sandra Kay Myers does hereunto set her hand and seal the/ day of
,2oo .
Sandra Kay Myers'
l~aernb~, Permsy~ania Assoclaticm of Nota~
(estates~smil~partial release)
TOTAL GROSS ASSETS:
TOTAL GROSS DEBTS
~STATEMENT OF DISTRIBUTION
$127,724.02
TOTAL FOR DISTRIBUTION
Cash distribution previously made and acknowledged by beneficiary:
Eyvonne Louise Stuck- partial distribution on 1/13/04 $40,000.00
Sandra Kay Myers - partial distribution on 1/14/04 ~40,000.00
~109:300.34
Eyvonne Louise Stuck
Sandra Kay Myers
BALANCE FOR CASH DISTRIBUTION:
$ 14,650.17
$ 14,650.17
EXHIBIT C
STATUS REPORT UNDER RULE 6.12
Name of Decedent · RICHARD DAVID SMITH a/k/a RICHARD D. SMITH
Date of Death' 7/20/2003
Will No. 2003°00651
Admin. No.
Pursuant to Rule 6. 12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate'
State whether administration of the estate is complete'
Yes × No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete ·
3. If the answer to No. 1 is Yes, state the following:
account with the Court ?
Did the personal representative file a final
Yes
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest ? Yes × No ~
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Clerk of the Orphans' Court and may be attached to this report.
Jill M. Wineka, Esquire
Name (Please type or print)
1719 North Front Street
Harrisburq, PA 17102
Address
(717) 234-4178
Tel. No.
Capacity:
Personal Representative
Counsel for personal
representative
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 171Z8-0601
JILL M WINEKA ESQ
PURCELL ETAL
1719 N FRONT ST
HBG
CONNONNEALTH OF PENNSYLVANIA
BEPARTNENT OF REVENUE
NOT/CE OF INHERITANCE TAX
APPRAZSENENT, ALLO#ANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSNENT OF TAX
,.~ BATE 05-08-2004
R~,_;~;~. ii3 ESTATE OF SHITH
BATE OF BEATH 07-20-2005
FILE NUHBER 21 05-0651
'04 MAR-5 P3:4Z COUNTY CUNgERLAND
ACN 10 Z
Aeoun~ Rami~ed I
RICHARD D
HAKE CHECK PAYABLE ANB RENZT PAYHENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE BB~ RETAIN LONER PORTION FOR YOUR RECORDS --~
REV-Z547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSENENT, ALLONANCE OR
DZSALLONANCE OF BEBUCTZONS AND ASSESSHENT OF TAX
ESTATE OF SHITH R/CHARD D FILE NO. 21 0:5-0651 ACN 101 BATE 03-08-200~
TAX RETURN WAS: (X) ACCEPTED AS F/LED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON= ORIGINAL RETURN
1. Real Es~a~e (Schedule A) (1)
2. S~ocks and Bonds (Schedule B) (2)
$. CZosaly Held S~ock/Par~nership In~eres~ (ScheduZe C) ($)
~. Hor~gagas/No~es Receivable (Schedule D) (~)
$. Cash/Bank Deposi~s/Hisc. Personal Propar~y (Schedule E) (5)
6. Jointly O~ned Proper~y (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. To,al Asse~s
APPROVED DEDUCTZONS ANB EXEHPTZONS:
9. Funeral Expanses/Adm. Cos~s/Nisc. Expenses (Schedule H) (9)
10. Dab~s/Hor~gaga Liabilities/Liens (Schedule I) (10)
11. To,al Deductions
12. Na~ Value of Tax Ra~urn
7q;O00.O0
.00
.00
.00
2;059.:56
2;286.91
(8)
12,5:58.52
NOTE: To Lnsura proper
cred/~ ~o your account,
submi~ ~ho upper por~ion
of ~his form ~i~h your
~ax payment.
15.
NOTE:
1:51,8:52.81
Z.:52q.8q
(11) 1~.8~.~6
(12) 116,969.~5
.00
116,969.q5
Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15)
No~ Value of Es*a~o Subjec* ~o Tax
~f an assessment uas Assued prevSeusly, lSnes 1~, 15 and/er 16, 17,
refZect fAgures that Anclude the total of ALL returns assessed to date.
18 and 19 wlll
(15) .00 x O0 = .00
(16) 116,969.q5 x 0~5 = 5,26:5.6:5
(17) .00 x 12 = .00
(18) .00 x 15 : .00
(l~)= 5,26:5.6:5
ANOUNT PAZD
~,500.00
526.79
ASSESSNENT OF TAX:
15. Aeoun't of Line 14 a~ Spousal ra*o
16. Amoun~ of Line 14 ~axablo a~ Lineal/Class A re~o
17. Amoun~ of Line 1~ e~ Sibling ra~a
18. Aeoun~ of Line 14 ~axablo a~ Collateral/Class B ra~e
19. PrincipaZ Tax Duo
TAX CREBZTS:
PAYHENT RECEIPT DISCOUNT (+)
DATE NUHBER ZNTEREST/PEN PAZD (-)
10-1~-200:5 CD00:51:52 2:56.8~,
01-12-200~ CD00:5~56 . O0
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULAT/ON OF ADDITIONAL INTEREST.
TOTAL TAX CREDIT I 5,26:5.6:5
BALANCE OF TAX DUEl . o o
TNTEREST AND PEN. .00
TOTAL DUE .00
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT TS REQUTRED. ~ I
TF TOTAL DUE TS REFLECTED AS A "CREDTT' (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE STDE OF THTS FORH FOR TNSTRUCTTONS.)
RESERVATION:
PURPOSE OF
NOTICE:
PAYHENT:
REFUND (CR):
OBJECTIONS:
ADNIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decadents dying on or before December 1Z, 1982 -- if any futura interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rata an any such future interest.
To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (72 P.S.
Section 9140).
Detach the top portion of this Notice and submit aith your payment to the Register of Hills printed on the reverse side.
--Make check or money order payable to: REGISTER OF NZLLS, AGENT
A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1513). Applications ara available at the Office
of the Register of Mills) any of the 15 Revenue District Offices, or by calling the special Z4-hour
answering service for forms ordering: 1-800-561-Z050; services for taxpayers with special hearing and / or
speaking needs: 1-800-447-3010 (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disalloaance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object within sixty (80) days of receipt of
this Notice by:
--aritten protest to the PA Department of Revenue) Board of Appeals, Dept. 181021) Harrisburg, PA 17118-1011, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
Factual errors discovered an this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Reviea Unit, Dept. 280601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. Sam page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
If any tax due is paid within three (5) calendar months after the decedant's death, a five percent (51) discount of
the tax paid is allowed.
The 151 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning aith first day of delinquency, or nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 1981 bear interest at the rate of
six (6Z) percent per annum calculated at a daily rate of .000164. Ail taxes which became delinquent on and after
January 1, 1981 mill bear interest at a rate ahich will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1981 through Z003 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Yaa__r Rate Factor
1982 ZOZ . 000548 1987 9Z . 000247 1999 77. . 000192
1983 167. .000438 1988-1991 111 .000301 ZOO0 81 .000219
1984 117. . 000301 1992 9Z . 000247 2001 97. . 000247
1985 13Z .000356 1993-1994 71 .000192 ZOOZ 67. .000164
1986 107. .000Z74 1995-1998 97. .000247 2003 57. .000137
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.