HomeMy WebLinkAbout04-0617 PETITION FOIl I'ROBATE and GRANT OF LETTERS
Estate of I.~r,,~ ~_ Day No. ~,.~}- 0~- LO]-[
also known as To:
Register of Wills for the
, Deceased. County of. Cumberland in the
Social Security No. 195-07-061 ? Commonwealth of Pennsylvania
The petition of the uudersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older all the executol: named
in tile last will of tile above decedent, dated ~ant'~mho'r' 1 q: 10~q ,19~
and codicil(s) dated
(state relevant circnmstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death itt Cumberland County, Pennsylvania, with
h er last family or principal residence at 100 Mt. Allen Drive, Mechanicsburg, Pa
(list street, number and munclpallty)
Decendent, then 87 years of age, died June 29, 2004 , 19. .,
at 100 Mt. Allen Drive, Mechanicsburg
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:
Deceudent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property $ 100 ~ 000. O0
(If not domiciled in Pa.) Personal property in Pennsylvania $
{If not domiciled in Pa.) Persoual property in County $
Value of real estate in Pennsylvania $
situated as follows: None
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
pre~ented herewith and tile grant of letters testamentary
theron. ~ ,q / (testamentary; admJnistratlon c.t.a.; administration d.b.n.e.t.a.)
200 Greenwich Drive. ~Mechanicsburg Pa 17050
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALT~I1 OF PENNSYIeVANI,,~
COUNTY OF ~(Lx.~c,x~_\c~,~.- ' J-
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petltlon are
true and correct to the best of the knowledge and behef of petmoner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer tile estate according to law.
before me this ~c~ ~ day of
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Larue H. Day
Date of Death: June 29, 2004
Will No. 21-04-617 Admin. No.
Pursuant to Rule 6. 12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes X No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes__ No__X
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest? Yes X No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
Date: Novemb'er~.. 10, 2004 Sig 'n~~re ~']' ~
John M. Eakin
Name (Please type or print)
Market Square Building, Mechanicsburg, PA 170
Address
(717) 766-3172
Tel. No.
Capacity: __Personal Representative
X Counsel for personal
representative
(MAH: rmf/AM3)
No. ~.l- O_~_~~-
Estate of ~'--~'-~-- ~ k~)~
(3 ) Deceased
DECREE OF PROBATE AND G~NT OF LETTERS
AND NOW -~eg.k ~. ~ t:;:~ ~., , ill consideration of the petition on
the reverse side bereo~, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated ~- 13- Iq ~
described therein be admitted to probate~d filed of record as the last will of
and Letters~~~,, ~ . ~ ;
are I,ereby granted to ~~~ ~~ ~ k~ ~
Probate, Letters, Etc .......... So)CO. c30
Short Certificates( ) .......... $ ~ . O<~:~ A'FFO~NI~Y (Sup. Ct. I.D. No.)
'.~_1~ $ !/3 . C_~-.~ ADDRP.$S
TOTAL. $~
Filed ...~. :.~. :..o~..O.-~q ..................
PllONg.
REGISTER OF WILLS OF CT.T~.RLA~D COUNTY
OATH OF SUBSCRIBING WITNESS
,.,.-.3_ l - ~d. -'tll L~ r"J
John M. Eakin
(each) a subscribing witness to the will presented herewith, (each) being duly qualified according to
law, depose(s) and say(s) that he was present and saw
Larue H. Day
the testatxtx , sign the same and that she signed as a witness at the
request of testa~ in b er presence and (in the presence of each other) (in the presence of the
other subscribing witness(es)).
Sworn to or affirme,~d'7 subscribed before -~f '~ [''~ ' (-~'~'~-~
me t~__~ '/-.' day of John M~ Eakin
-~'N-~:~~egiste;v~m q B~e~' Mechanicsburg' PA 17055(Name)
(Addre~2 ~
C
REGISTER OF WILLS OF CTJ~aT.A~D COUNT,~y
OATH OF NON-SUBSCRIBING WITNESS ~
Arthur R, Day, III
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
he is familiar with the signature of Larue H. Day
testat rix of (one of the subscribing witnesses to) the will presented herewith and
that he believes the signature on the will is in the handwriting of
Lathe H. Day
to the best of his knowledge and belief.
Sworn to or aff~i~ed and subscribed before ~_~ ~
mef~this ~) ' day of Arthur R. Day, I~me)~
~.~o~~~^ ~'z~_,/~_l,{~. 200 Greenwich Dr~res$)Mechanicsburg, PA17050
(Name)
(Address)
Thi>. is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
l.ocal 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, $2.00 ~
[~ Local Registrar
No. ~ Date
I
COMMONWEALIN
OF
PENNSYLVANIA
DEPARTMENT
OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
'- Larue H. Da7 ~.Female[~.. 195 --07 -- 0617~,. 6-29-04
~. 87 ~. ~ ,.8-26-16~. Harrisburg,PA ,~$ E~ ~B
~N~ ~ ~H ~.~.~H ' ' ~F~ NAME 1' ~ ~g~' G'~ ~ a~' ]~ ~CE~ ~ HI~N~ ~?
~ Cumberland~cE~m.susu~u~ ~. Upper Allen ~p ~. Messiah Village j,. '~'~' [,~ White
. EO F~ESl I (~ m~ ~ eac~I ~ S~- ~,~
'"- Secretary ,,L Business I,,. j,~. ~a 12 [ ("~" ,~. widowed
222 Messiah Circle ~TU~ ,7..~ PA ~ "~.~ ~.~' ' U~oer Allen
Mechanicsburg, PA 17055 ~
,~ ~ ,m.~ Cumberland ~, ,~.~ ~~
,.. Harry B. Hollenbaugh ,,. Ada May Sunday
~T'S ~ ~.~.
~ Arthur R. Day~ III ~200 Greenwich Drive,
' . Mechanicsburg, PA 17050
~ ~ ~lT~ I~E ~ ~T~ ~E ~ ~. ~ ~ C~. Cr~ [L~ -
~ c,~,~ ~.,.~ ~.~.~)
~ ~(~, ~/,~l, 7-2-04 ~Cremation Society of
I
· '~ - ~,,. PA Crematory ~,,~. Harrisburg, PA 17109
~O~~EL~E~E~gt,~S~ Jr~.~ sJ~~Cremation Society of PA
~ --~1~~~ m. ~.4100 Jonestown Road, Harrisburg, PA 17109
~, ~ ~ ~. ]O~E P~ED ~ (M~. Day, ~} ~8 ~ ~FE~O TO
~ ~ ~ A C~E~E ~:
~~ b ,
'~)~T I
~ ,
LAST WILL AND TESTAMENT OF LARUE H. DAY
I, LARUE H. DAY, of the Borough of Mechanicsburg,
County of Cumberland and State of Pennsylvania, being of
sound and disposing mind, memory and understanding, do make,
publish and declare this my Last Will and Testament, hereby
revoking and making void all former Wills by me at any time
heretofore made.
1.
I direct the payment of all my just debts a~t funeral
expenses as soon after my decease as the same can conyeniently
be done.
2.
Ail the rest, residue and remainder of my estate,
real, personal and mixed, of whatsoever nature and wheresoever
situate, I give, devise and bequeath to my husband, ARTHUR
REGINALD DAY, JR., absolutely and in fee simple.
3.
In the event my husband should predecease me or die
within thirty (30) days of my death, then I give, devise and
bequeath my entire estate, real, personal and mixed, to my',.
children, in equal shares.
4.
LASTLY, I nominate, constitute and appoint my husband,
ARTHUR REGINALD DAY, JR,, Executor of this, my Last Will and
Testament, and in the event he should be unable or unwilling for
any reason to serve in such capacity, then I nominate, constitute
and appoint my son, ARTHUR REGINALD DAY, III, to be the Executor
in his place and stead. In the event that he, also, should be
-1-
unable or unwilling for any reason to serve in such capacity,
then I nominate, constitute and appoint my daughter, .MARJORIE
ANN DAY HAMLETT Executrix in his place and stead. Further,
should my daughter also be unable or unwilling for any reason
to act as such Executrix, I nominate, constitute and appoint
my son, DONALD ALLAN DAY Executor in her place and stead.
IN WITNESS WHEREOF, I have hereunto set my hand
and seal this 13th day of September, A. D. 1985.
~'~-~-- f~/~ ~~ (SEAL)
Larue H. Day
Signed, sealed, published and declared by the
above-named LARUE H. DAY, as and for her Last Will and
Testament, in the presence of us, who, at her request and
in her presence, and in the presence of each other, have
hereunto subscribed our names as witnesses.
-2-
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Larue H. Day
Date of Death: Jun~ 2q~ 200/*
Will No. 21-0/.-0617 Admia. No.
To the Register:
I certify that notice of (benefieial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on July 27~ 2ilo/, :
Name Address
Marjorie D. Hamlett 914 Cabriole Court, Eugene OR 97401
Donald A. Day 10612 Sourwood Court, Laurel MD 20723
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None
Date: July 27, 2004
O ~,--CD' ~-~,g Name Jol~ Wt. '~2f~il~~
~ ~ '~L.) Address Market Square Building
< Mechanicsburg, PA 17055
O~
%lephone (717) 766-3172
Capacity: __ Personal Representative
XCounsel for personal representative
COMMONWEALTH OF PENNSYLVANIA REV 1162 EX(11-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 004385
EAKIN JOHN M
MARKET SQUARE BUILDING
MECHANICSBURG, PA 17055
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
........ fold ..................
101 $3,463.03
~ ESTATE INFORMATION: SSN: 195-07-0617
FILE NUMBER: 2104-061 7
DECEDENT NAME: DAY LARUE H
DATE OF PAYMENT: 09/15/2004
POSTMARK DATE: 09/15/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 06/29/2004
TOTAL AMOUNT PAID: $3,463.03
REMARKS:
CHECK#0997
INITIALS: JA
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
OFFICIAL USE ONLY
~ COMMONWEALTH QF K V-lbUU
~ PENNSYLVANIA
~~b~ DEPARTMENT OF REVENUE
OEP'E280601 INHERITANCE TAX RETURN
HARRISBURG, PA17128-0601 RESIDENT DECEDENT oou, coD,' ,u,,E, --
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
Z Day Larue H. 195 07 - 0617
LB
~-~ DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
LB 06/29/04 08/26/16 REGISTER OF WILLS
LB (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
omo ~ z [] 4 Limited Estate [] 4a. Future Interest Compromise (da~e of death user 1212 82) [] 5. Federal Estate Tax Return Required
o ~. m [] 6. Decedent Died Testate (A~ch copy of Will) [] 7 Decedent Maintained a Living Trust (At~ach copy of T,u~t) __ 8. Total Number of Safe Deposit Boxes
< [] 9. Litigation Proceeds Received [] 10. Spousal Povedy Credit (da,e ordeath be~een 12-31-91 a,d 1-1 95) [] 11. Election to tax under Sec. 9113(A)
uJ NAME COMPLETE MAILING ADDRESS
m John M. Eaktn
O
~' FIRM NAME itl Appli~ble)
~~ Market Square Building
~: TELEPHONE NUMBER Mechanicsbu..~o'- PA 17055
o
o (717) 766-3172 ~-~
OFFIC ISE ONLY
1, Real Estate (Schedule A) {1) c~, · .....
2. Stocks and Bonds (Schedule B) (2) i; -o ;;
3. Closely Held Corporation. Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4) ''
5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 7,14 3.5 4
(Schedule E)
~ 6. Jointly Owned Property (Schedule F) (6) 89,5 92.90
,~ Separate Billing Requested
,,.J
.~) 7~ Inter-Vivos Transfers & Miscellaneous Non-Probate Prope~ (7)
I'-- (Schedule G or L)
~ 8. Total Gross Assets (total Lines 1-7) (8) 9 6 ~ 7 3 6 · 44
O 8,013.88
LB 9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent. Mortgage Liabilities. & Liens (Schedule I) (10) 7.7 ],5.02
11. Total Deductions (total Lines 9 & 10) (11) 15,729.90
12. Net Value of Estate (Line 8 minus Line 11) (12) 8t, 006.5/+
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13)
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the tax
spousal
I'~ rate, or transfers under Sec. 9116 (a)(1.2) x .0 (15)
.. 16. Amount of Line14 taxable at lineal rata 81~006.54 x .0 45 (16) 3.645.29
O~ 17. Amount of Line 14 taxable at sibling rate x .12 (17)
(.3 18. Amount of Line 14 taxable at collateral rate x A5 (18)
19. Tax Due (19) %A45.2q
Decedent's Complete Address:
STREET ADDRESS
Messiah Cir~t~
CITY Mechanicsburg ISTATE Pa I ZIP 17055
Tax Payments and Credits:
1. Tax Due (Page1Line19) (1) 3,645~29
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount IUZ, Z6 182,26
Total Credits (A + B + C ) (2)
3. interest/Penalty if applicable
D. Interest 3,463.03
E. Penalty
Total Interest/Penalty ( D * E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the differenCe.-This, is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund' · {4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 3,463.03
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
II i,,, , _ I1'~1 I
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decadent 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; ............................................ []
o. 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 decadent 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-probata 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
SICN^T ¢R RESPONSISLE
SIGNATURE ( DATE
ADDRESS
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the i of transfers to or for the use of the surviving spouse is 3%
t72 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 exemct 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 RS. §9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal bene~ciaries 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 decadent'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.
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
INHERITANCE TAX RETURN
.ES~DENTDECEDENT PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Larue H. Day 2004-0617
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the ~ight of survivomhi ) must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Pearl Hollenbaugh Estate, Legacy $ 5,000.00
2. New York Life Inc. Co., Policy 855656 $ 2,126.51
3. Verizon Refund $ 17.03
TOTAL (Also enter on line 5, Recapitulation) $ 7,143,54
(If more space is needed, insert additional sheets of the same size)
~ SCHEDULE F
COM'~O~WE^LT. OF eEN~S~LV^N~^ JOINTLY-OWNED PROPERTY
ESTATE OF FILE NUMBER
Larue fi. Day 2004-0617
Joint tenant(s):
NAME ADDRESS RELATIONSHIP TO DECEDENT
A.
Arthur R. Day, III 200 Greenwich Drive Son
Mechanicsburg, Pa 17050
Bo
Jointly-owned property:
LETrER
ITEM FOR DATE
NUMBEF JOINT MADE DESCRIPTION OF PROPERTY TOTAL VALUE DECD'S DOLLAR VALUE OF
TENANT JOINT OF ASSET % INT. DECEDENT'S INTEREST
1. A Prior Citizens Bank, Account
to 1994 610069-888-8
Principal $171,668.90
Interest $ 17.54 171,686.44 50 $ 85,843.22
See attached
2. A Prior Citizens Bank Account
to 1994 610070-194-8 7,499.36 50 $ 3,749.68
See attached
I
TOTAL (Also enter on line 6, Recapitulation) S 89,592.90
(If more space is needed insert additional sheets of same size)
. ,. i iCITIZENS BANK Stateme.tCheck "g ^ccou.t
8 or 3
1~8OO~773~7373
Beginning 3une 10, 2004
through 3uiy lg, gO0~
Ch~cklng
SUHHARY LARUEHDAY
Balance CalculaUo~ Balance ARTHUR R DAY Iii
Circle Money Market
Ptev{o~ Balance 171,668~g0 Average ~iIy aalance IZ1.668.90 610069 885-8
Checks . O0 -
Withdrawats
Deposits & Additions
IntetesL Pa{d 306.~7
Current Balance 171.975.37 = ~umbero~D~ysl, terestEame~ 33
Interest ~arned 306.47
Interest Paid this Year ~ .996.76
tRANSACTION DETAILS 171,66~.g0
Interest
306,~7 Interest
306,
Oatly Balance 111,915,37
O1/~2 171,975,37
Checking Account
,,,~ ,. cITIzENs BANK ,-. Statement
3
tu~nt rotes ihd a~wen to ~ur ueestlon~, Beginning 3une ]0, 2004
through ~uly 12, 200~
Checking
SuBHARY , - , r ~ ~,'r~ ' ' LARUE H DAY
ARIHUR R DAY III
Balanta CllcalaBofl ldld~cl Circle Gold Checking Ht Interest
Cheeks 3,~8.62 -
Withdrawals 1,6~.~ -
Deposits & AddtUons 1.6~0.~ + Cu~nt~nterest Ra~e .~
~ntemst Patd 6.68 * Annua[ Percentage Y~eld Ee~e~
Cu,ent Balance 7,518.14 - Number o~ ~ays ~,teres~ Earned
Interest ~arned 6.68
~n~erest Paid this Year ~8. ~
tRANSAC~ION o~TAILS 10,983.9~
Checks* Th~ fs a br~k Jn ch~k sequ~ce
Check I Amount D~e
842 ~ / 21, 35 06~10
843 ~, 38.~ 06~15
8~ ~ 3,331.81 06/30
Withdrawals
Other Withdrawals
07/06 ~1,03~.00 Debit Memo ~ ~ ~_ ,ot~
Depost~ & AddtUons
_06Z30 ~ 6;14 PA Treasu~ Dept Annuitant 040630 19507
07/01 ~ 954.~ ' DFAS~C[evetaneAR Ann Pay 040701 195070617
07/02 680.00 US Treasu~ 303 Soc Sec 010204 1950706~7a SSA~ ~. Totg Deposits
Interest
07/]~ 6,68 ~ntems~ ~ TotM Interest tMd
7,5t8.14
Oaliy Balance
EV-1511 EX+ (12-99)
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNEEAL EXPENSES &
INHERITANCE TAX RETURN AD/VtlNISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Larue H. Day 2004-0617
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
Cremation Society. Obituaries 223.88
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
NameofPersona~Representative(s) A'r'~"n,.~-' R~ 13~y~ II'[ 5,000.00
Social Security Number{s)/EIN Number of Personal Representative(s) 206-32-2530
Street Address 200 Greenwich Drive
City Mechanicsbur,~ State Pa Zip 17050
Year(s) Commission Paid: half 2004 half 2005
2. Attorney Fees 2,500. O0
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees $ 225.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Filing Fee, Tax Return 15.00
8. Reserved for release, notary 50.00
TOTAL (Also enter on line 9, Recapitulation) 8,013.88
(If more space is needed, inse~t additional sheets of the same size)
SCHEDUI_E I
Larue H._p~ 2004-0617
l~l¢l~de unl~lml~llSed medical
I~EM
NUMBER
I. Messiah Village, Care for ~y 3,331.87
2. Citizens Bank, Deposit Box Rental 6.00
3. Cremation Society, Death Certificates & Coroners Fee 51.00
4. Messiah Village, Care for June 4,302.80
5. Verizon, TelephOne 24.35
1 O1 AL (Also enter on line 10, Recapitulation) $ 7,716.0 2
more $1:,ac~ is needed, insed addillolml sheels o! ~l~e same size)
REV-1513 EX+ (9-00). ~ .
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FII~E NUMBER
Larue H. Day 2004-061
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List l~ustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. Marjorie D. Hamlett 914 Cabriole Court Daughter 1/3 residue
Eugene, OR 97401
2. Donald A. Day 10612 Sourwood Court Son 1/3 residue
Laurel, MD 20723
3. A~thur R. Day III 200 Greenwich D~ive Son 1/3 residue
Mechanicsburg, PA
17050
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
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PAR3' 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)
LAST WILL AND TESTA~IENT OF LARUE H. DAY
I, LARUE H. DAY, of the B~rough of Mechanicsburg,
County of Cumberland and State of Pennsylvania, being of
sound and disposing mind, memory and understanding, do make,
publish and declare this my Last Will and Testament, hereby
revoking and making void all former Wills by me at any time
heretofore made.
1.
I direct the payment of all my just debts and funeral
expenses as soon after my decease as the same can conveniently
be done.
2.
Ail the rest, residue and remainder of my estate,
real, personal and mixed, of whatsoever nature and wheresoever
situate, I give, devise and bequeath to my husband, ARTHUR
REGINALD DAY, JR., absolutely and in fee simple.
3.
In the. event my husband should predecease me or die
within thirty (30) days of my death, then I give, devise and
bequeath my entire estate, real, personal and mixed, to my.,
children, in equal shares.
4.
LASTLY, I nominate, constitute and appoint my husband,
ARTHUR REGINALD DAY, JR,, Executor of this, my Last Will and
Testament, and in the event he should be unable or unwilling for
any reason to serve in such capacity, then I nominate, constitute
and appoint my son, ARTHUR REGINALD DAY, III, to be the Executor
in his place and stead. In the event that he, also, should be
unable or unwilling for any reason to serve in such capacity,
then I nominate, constitute and appoint my daughter, MARJORIE
ANN DAY HAMLETT Executrix in his place and stead. Further,
should my daughter also be unable or unwilling for any reason
to act as such Executrix, I nominate, constitute and appoint
my son, DONALD ALLAN DAY Executor in her place and stead.
IN WITNESS WHEREOF, I have hereunto set my hand
and seal this 13th day of September, A. D. 1985.
Larue H. Day
Signed, sealed, published and declared by the
above-named LARUE H. DAY, as and for her Last Will and
Testament, in the presence of us, who, at her request and
in her presence, and in the presence of each other, have
hereunto subscribed our names as witnesses.
COMMONNEALTH OF PENNSYLVANIA
BUREAU O~ INDIVIDUAL TAXES DEPARTMENT OF REVENUE
INHERITANCE-TAX DIVISION
BEPT. 250601
HARRISBURG, PA 171ZB-060! NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLONANCE OR DZSALLONANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX REV-I;47EXAFP(OZ-O$)
DATE 11-08-200q
~, ESTATE OF DAY LARUE H
DATE OF DEATH 06-29-200q
FILE NUMBER 21 0q-0617
.... ',.-}.? COUNTY CUMBERLAND
JOHN M EAKIN *04 I~L~'~ -9 ~, ./.:_ ACN 101
MARKET SQUARE BLDG Amount Remitted
MECHANZCSBURG PR 117055
HAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF MILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS
REV-15~? EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEMENT~ ALLONANCE OR
DISALLOgANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF DAY LARUE H FILE NO. 21 0~-0617 ACN 101 DATE 11-08-200~
TAX RETURN gAS: ( ) ACCEPTED AS FILED (X) CHANGED SEE ATTACHED NOTICE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORZG/NAL RETURN
1. Real Estate (Schedule A) (1) O0 NOTE: To insure proper
2. Stocks and Bonds (Schedule B) (2) O0 credit to your account,
$. Closely Held Stock/Partnership Interest (Schedule C) ($) O0 submit the upper portion
~. Hortgages/Notes Receivable (Schedule D) (q) O0 of this fore ~ith your
5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) (51 7;1~$.5~ tax payment.
6. Jointly Owned Property (Schedule F) (6) 89;592.90
7. Transfers (Schedule G) (7) O0
8. Total Assets (B) 96,7~6.~
APPROVED DEDUCTIONS AND EXEHPTZONS: 5,015.88
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9)
10. Debts/Mortgage Liabilities/Liens (Schedule Z) (10) 7.716.02
11. Total Deductions (11) 12.729.90
12. Net Value of Tax Return (12] 8q,006.5~
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
1~. Net Value of Estate Subject to Tax (lq) 8~,006.5~
NOTE: If an assessment ~as issued previously, llnes 1~, 15 and/or 16, 17, 18 and 19 ,ill
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line lq at Spousal rets (15) .00 X O0 = .00
16. Aeount of Line lq taxable et Lineal/Class A rets (16) 8~,006.5q X 0t5 = $,780.29
17. Amount of Line lq et Sibling rets (17) .00 X 12 = .00
18. Amount of Line lq taxable st Collateral/Class B rats (18) .00 X 15 = .00
19. Princi=al Tax Due (19)= ~,780.29
TAX CREDITS
PAYH~NT RECEIPT DISCOUNT (+1 AMOUNT PAID
DATE NUHBER INTEREST/PEN PAID (-)
09-15-200~ CD00~$85 182.26 $,~65.05
PAYHENT HUST BE HADE BY 05-29-2005~. TOTAL TAX CREDIT $,6R5.29
BALANCE OF TAX DUEI 155.00
INTEREST AND PEN. .00
TOTAL DUE 155. O0
IF PAID AFTER DATE ZNDZCATED~ SEE REVERSE ( ZF TOTAL DUE ZS LESS THAN $1~ NO PAYHENT ZS REIIUZRED.
FOR CALCULATTON OF ADDITIONAL TNTEREST. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR)~ YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) ~
RESERVATION: Estates of decedents dying on or before December II, [982 -- if any futura interest in the estate is transferred
in possession or enjoyment to Class D (coIIateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Comeonmaalth hereby expressly reserves the right to appraise and assess transfar Inheritance Taxes
at the lawful Class B (collateral) rate on any such futura interest.
PURPOSE OF
NOTICE: To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (71 P.S.
Sect[on 9140).
PAYMENT: Detach the top portion of this Notice and submit .ith your payment to fha Register of Hills printed on the reverse side.
--Make check or money order payable to: REGISTER OF HILLS, AGENT
REFUND (CR): A refund of a tax credit, which ems not requested on the Tax Raturn, amy ba requested by completing an "AppIication
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-I~I$). Applications ara available at the Office
of the Register of Mills, any of the Z$ Revenue District Offices, ar by calling the speciaI Z4-hour
ans,aring service for fores ordering: 1-SO0-36Z-ZOSO; services for taxpayers eith special hearing and / or
speaking needs: 1-800-q47-3010 (TT only).
OBJECTIONS: Any party in intarast not satisfiad with tha appraisement, alIoeanca, or disalloeance of deductions, or assessment
of tax (including discount or interast) as shown on this Notice must object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1011, OR
--election to have tha matter determined at audit of the account of the personal reprasentativa, OR
--appeal to the Orphans' Court.
ADMIN-
ISTRATIVE
CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601
Phone (7173 787-6S05. Sam page 5 of the booklet "Instructions for Inheritance Tax Return for a Res[dent
Decedent" (REV-IS01) for an explanation of administratively correctabla errors.
DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5Z) discount of
the tax paid is allowed.
PENALTY: The 15Z 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 nan-participation
penalty is appealable in fha same manner and in the the same time perlod as you would appeal the tax and interest
that has been assessed as indicated on this notice.
INTEREST: Interest is charged beginning eith 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 (61) percent per annum calcuIated at a daily rate of .000164. A11 taxes which became delinquent on and after
January 1, 1981 will hear interest at a rate which 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 200q are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
~ ZOZ .000548 ~'~'8-I991 11Z .000~01 ~ 9Z .O00Zq7
1983 161 .0004~8 1991 91 .000147 Z002 6Z .000164
1984 112 .000301 1993-1994 7Z .000191 Z003 52 .000137
1985 132 .000~56 1995-1998 9Z .000247 Z004 4Z .000110
1986 102 .000274 1999 72 .OO0192
1987 lOX .000174 ZOO0 7Z .OOO19Z
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (IS) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must bo calculated.
~EV-1470 EX (6-88)
INHERITANCE TAX
EXPLANATION
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
PO Box 280601
HARRISBURG, PA 17128-0601
DECEDENT'S NAME FILE NUMBER
DAY, LARUE H 2104-0617
ACN
REVIEWED BY Kathryn Harbilas 101
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
The deduction for personal representative commissions have been reduced from
H B-J
$5,000.00 to 2,000.00.
Personal representative fees can only be claimed against probate assets.
Row Page 1
,JOHN M. EAKIN
A'I-DORNEY AT LAW
MARKET S{~UARE BUILDING
MECHANIP. SBURG, PA. 1 ?055
November 8, 2004 ~x
Register of Wills
Cmberl~d Co~W Co~ouse
C~lisle, PA 17013
Re: Line H. Day Es~te 04-617
Gentlemen:
Enclosed is a check in ~e amount of $135.00 shown on the aRachefl audit.
Ve~ truly yo~s,
John M. Eakin
COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128 0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 004705
EAKIN JOHN M
MARKET SQUARE BUILDING
MECHANICSBURG, PA 17055
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
........ fold
101 $135.00
ESTATE INFORMATION: SSN: 195-07-0617
FILE NUMBER: 2104-061 7
DECEDENT NAME: DAY LARUE H
DATE OF PAYMENT: 12/07/2004
POSTMARK DATE: 1 2/07/2004
COUNTY: CUMBERLAND
DATF OF DEATH' 06/29/2004
TOTAL AMOUNT PAID' $135.00
REIVIARKS: DAY
CHECK//1000
INITIALS: CCP
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF INDIVIDUALpq~E$;:-/:O (YT!C~ OF
INHERITANCE TAX DIVISION! 1...VV' - . < ~l! C',
PO BOX 260601 ' ' ' ; ,',
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
'*'
REV-li07 EX AFP (l!~04)
CLEI:~\\ C.r
ORPt-f;:"J"~-~,
JOHN M EAI{Jt~r"
MARKET SQUARE BLDG
MECHANICSBURG PA 17055
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
01-10-2005
DAY
06-29-2004
21 04- 0617
CUMBERLAND
101
LARUE
H
20Q5 JM12l} Hi 8: 21
Allount Rellitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax pay..ent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ___
ft!\r:!&&~.!5r.~'~..r81~.6!'..........."fA~!~e!r",A5r.~tl"f!A~.b,r.Ac1!60~....ii.....................
ESTATE OF DAY LARUE H FILE NO.21 04-0617 ACN 101 DATE 01-10-2005
THIS STATEHENT IS PROVIOED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION DF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT DR RECORD ADJUSTMENT, 11-08-2004
PRINCIPAL TAX DUE,.
3,780.29
PAYMENTS (TAX CREDITS),
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
09-15-2004 CD004385 182.26 3,463.03
12-07-2004 CD004705 .00 135.00
TOTAL TAX CREDIT 3,780.29
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 "CREDIT" (Cft>,
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
,L
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