HomeMy WebLinkAbout02-0809
PETITION FOR PROBAIli aDO utCANT O.lf ~L~~.B.N.C.T.A.
Estate 0/ Sara M. Holland No. ~ ,.. -
also known as To:
Recister of Wills (or the
Decetaed. County of Cumberland in the
Soc/al Security No. 207-28-1306 Commonweafth of Pennsylvania
The petition of the undersigned respectfully represents thaC
Your petitioner(s). who is/am 18 years of age or older an the excc:ur
in the last will of the above decedent. dated Auqust 2
and cOdicil(s) dated
~Qnlln("'i ation siaed bv son. James J. Holland. named Executor
named
,1977
(state rdevant c:iraIlDSranccs. Co&- reavneillrioa, deadI 0( 1DCIIIar. ea:.)
Decendenc was domiciled a.: .;..:.uh in Cumberland Cqunty Pcnnsylvani" with
her last family or principal residence at ~rhPrland County .Nurs~ng Haiie, Carl~sle,
(Middlesex Twp.) Cuinberland County, ~
(list street. number aDd JmI~) J C,
Decendent, r.hen ~_ y~s of age. died Auaust ..z&- ,19 92 .
at cumber land County Nurs~ng Hare, cumberland County, l'A
E.'{cept as foHows. decedent di.d not marry. was not divo~.and did not have a child born or adopted
~fter execution of the will offered for probate; was not the VictIm of a kiIlinl and was never adjudicated
mcompetent: -
Decendem. at de.:lth owned propeny with estimated values as follows:
(If domiciled in Pa.) All personal propertY
(If not domiciled in Pa.) Personal propertY in Pennsylvania
(If not domiciled in Pa.) Personal propertY in County
Value of real estate in Pennsylvania
situated as follows:
S 21,349.62
S
S
S
WHEREFORE. petitioner(s) respectfully rcq.u~t(s) ~ probaIC of the last will and codicil(s)
presented herewith and the grant of letters admimst.ri'lhnn d.b.n.e. t.a.
(tCSWDClluary; admiaisuaaon CoLa.; administration dob.n.c.I.a.)
theron.
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17070
OATH OF PERSONAL REPRESENTATIVE
COMMON\VEALTH OF PENNSYLVANIA } sa
COUNTY OF CUMBERLAND
The pecitioner(s) above-named swear(s) or affirm(s) that the SWements in the (orqoing petition are
[rue and correct [0 [he best of the knowledge and belief of petitio 5) tbat as personaJ represen-
[ative(s) of the above decedent petitioner(s) will well . the estate according to law.
Sworn [0 or affi.med and subscribed 1
before me this. lOth da.Y of Stone
~ber - ~ 2002
hI..~/;r~JD<'41h~I' ~t~
en
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N 21-2002-809
O.
Estate of Sara M. Hollan:}"
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS 'i'
D.B.N.C.T.A.
AND NOW September 13th ~ 2002, in coDSi~eration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated Auqust 2, 1977
described therein be admitted to probate and filed of record as the last wiD of Sara M. Holland
and Letters Administration d.b.n.e. t.a.
are hereby granted to David H. Stone
-
- .
i)~;m-8bw~
Rqiacr of Wills 'Uk
DJnna M. Otto, 1st Deputy ~
FEES
Probate, Letters, Etc. ......... S 60.00
Shorr Cerrificates(O ) .... . . . . .. S ...OJ
Renunciation.... .(.~~........ S 5.00
Extra Pages (1) S 5:88
JCP
TOTAL _ S 73.00
Filed . .$ept!=r!~~. P.~11r.~99~. . . . . . . . .. . .
David H. stone
#39785
AlTORNEY (Sup. a.I.D. No.)
414 Bridge st., New Cumberland, PA 17070
ADDRESS
(717) 774-7435
PHONE
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CALL ATIORNEY ON 9/13/2002
HIO\.80j REV 9-86
This 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.
\Ill~U~NING: 1'.sJllegal to duplicate this copy by photostat or photograph.
1330383
No.
~4w
...... .. Loc,! !{eg,,,m
Fee for thisd;rfificate,$2JOO
.t{~ I~ /9 P 2,
Date
H1G5.143 Rev. fJ87
COMMONWEALTH OF PENNSYUfANIA . DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
TYPEIP/llNT
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WlS CASE RefERlIEO lO IlEIlICAl
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not fetullng in 1M .....,inQ e-.- QIven in MAT I.
DUE m(OR AS A CONSEQUENCE Of):
DArE Of INJURY
_.Day. -I
TIME OF INJURY
INJURY 14J WORK? DESCRIBE HOW INJURY OCCURRED.
Homicide 0
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ColAd noI be deterf'RiMd 0 Pl.ACe OF INJURY -AI homt. Ienn. ..;.... IKtoIy, ofttcIt M.
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~ PHYIDAN cPhysician ClWtifyingcause of cIeaIh wn.n anocher physician has pl'OI'lOYnceddeaUl am fotl'lflleted Item 23)
To............,~......acoufIMllueao...cau.ec.)and..~..atMecI.'.............. '.:......... ..........................
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*PROMOWDHQ AHOCERfWYIHG PHYIICWrt (Physician boIh PfOOOl.lflCing d8att1 and cerWying 10 cause of deattl)
..........,~.....occurrM......_..... and". .......to" ceuMCa)and__........ ................. .......
.1IIDlCAL~
0lIl... ....01....................... _.........In my oplnlon. death OCCYf"" the ttme..... and pille., and clue &0 the cauM(e) Md
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M.
RENUNCIATION
21-2002-809
In Re Estate of
Sara M. Holland
deceased.
To the Register of Wills of
CUmber land
County, Pennsylvania.
The undersigned James J. Holland, son and named Executor
of
the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters
Administration d.b.n.c.t.a.
be issued to
David H. Stone
WITNESS
my
T.ff (7
hand this /~ day of vE",oT
, '}C ~ (5 t:?,;z.
~9~
(Signature)
C~\i!~ I PA
(Address)
(Signature)
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(Address)
1_,';
(Signature)
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(Address)
09/13/2002 16:19
7177743869
STONE LAFAVER SHEKLE
PAGE 01/01
PAVlD 1-1. S'TONE
G~RAWDJ.eHE~T$~
EI..J%A8ETH 8. SToNE
STONE L.FAVER 8: SREKLETSKI
AlTOIlNE:Y5 AT LAW
414 BRIDGE: STREIl:1'
POST OFr>ICE: BOX E
NBW CUHBSKLAtJD. J?A 17070
www.Stonelaw.net
OF COUNSEl,
C;:HAALES H. 8TQNE:
JON F. J.APAVE~
"'I.BPHONE: (717, 774-'7431!
/'"ACSIMlLE: (717) 7744888
September 13, 2002
FAX: 240-7796
Register of Wills
Cumberland County Courthouse
Carlisle, PA 17013
ATTN: Sue
Greetings:
This will verify that in the Estate of Ruth Holland,
probated at No. 21-02-809 the date of death listed on the
petition to probate should be August 16. 1992.
Very truly yours,
STONE LaFAVER & SHEKLETSKI
DHS/krl
,i.
.,.-
21-2002-809
REGISTER OF WILLS OF CUMBERLAND COUNTY
OATH OF SUBSCRIBING WITNESS
charles H. Stone
BDIliWl:
(DCb} a subscribing witness to the will presented herewith, (acil) being duly qualified according to
law, depose(s) and say(s) that he was present and saw
Sara M. Holland
the testatrix, sign the same and that
request of testat rix in h her presence and
other subscribing witness(es)).
he
signed as a witness at the
) (in the presence of the
Sworn to or a,ffi~d and subscribed before
me this /tJ - day of
~~/)~~ w~~a&.
~- .~~1~~
Register
(j;),~ a.~fl~
CHARLES H. STONE (Name)
414 Bridge st., New CUmberland, PA 17070
(Address)
(Name)
NOTARIAL SEAL.
KAYE R. LUCt<EY. Notary Publ1c
'I' New Cumberland Boro. C~Jand Co.
Mt Commission ExpIres MIn:h fl, m
(Address)
REGISTER OF WILLS OF CUMBERLAND COUNTY
OATH OF NON-SUBSCRIBING WITNESS
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
familiar with the signature of
oocHcik
will
testat
of (one of the subscribing witnesses to) the
presented herewith and
oodioikn
believes the signature on the will is in the handwriting of
that
to the best of
knowledge and belief.
Sworn to or affirmed and subscribed before
me this day of
19_
(Name)
(Address)
Register
(Name)
(Address)
REGISTER OF WILLS OF CUMBERLAND COUNTY
OATH OF SUBSCRIBING WITNESS
21-2002-809
Richard W. Stewart
~
~ a sUbscribing witness to the will presented herewith, ~) being duly qualified according to
law, depose(s) and say(s) that he was present and saw
Sara M. Holland
the testat rix . sign the same and that he
request of testal rix in b er presence and r
other SUbSCribing witness(es)).
signed as a witness at the
) (in the presence of the
Sworn to or affi~ed and subscribed before
~ ~yof
-It ~ I9c.J,Od 1--
. nl~
er
-p@ PJr~
(Name)
13 tr W~ $q- N'4J (.<J...L~l~ )'1~ t1~~
(Address)
Notarial seal
Kristee K. My8fll. Notary Public
lemOyne BolO. Cumb8rIand CountY
My CommlaS\On ElcpIre8 Dec. 2. 2002
Member, Pennsylvania A'soctatton ot Notaries
(Name)
(Address)
,-.
~::
REGISTER OF WILLS OF COUNTY
OATH OF NON..SUBSCRIBING WITNESS
(each) a subscriber hereto. (each) being duly qua!ifi~ according to law, depose(s) and say(s) that
familiar with the signature of
codicil
will
testat
of (one of the subscribing witnesses to) the
presented herewith and
codicil
believes the signature on the will is in the handWriting of
that
to the best of
knowledge and belief.
Sworn to or affirmed and subscribed before
me this day of
19
(Name)
(Address)
Register
(Name)
(Address)
21-2002-809
LAST WILL AND TESTAMENT
OF
SARA M. HOLLAND
I, SARA M. HOLLAND, of the Borough of New Cumberland, County of
Cumberland and Commonwealth of Pennsylvania, declare this to be my last will
previously made by me.
ITEM I: I devise and bequeath all of my estate of every nature
and wherever situate to my son, JAMES J. HOLLAND, if he survives me.
ITEM II: If my son, JAMES J. HOLLAND, fails to survive me, I
devise and bequeath all of my estate of every nature and wherever situate to
the issue of the said JAMES J. HOLLAND, per stirpes, who survive me.
ITEM III: I direct that all taxes that may be assessed in conse-
quence of my death, of whatever nature and by whatever jurisdiction imposed,
shall be paid from my residuary estate as a part of the expense of the
administration of my estate.
ITEM IV: I appoint my son, JAMES J. HOLLAND, executor of this my
last will.
ITEM V: I direct that my executor shall not be required to give
bond for the faithful performance of his duties in any jurisdiction.
IN WITNESS WHEREOF,
hand and seal this ~ day of
I, SARA M. HOLLAND, have hereunto set my
/-'
(~tfU~ · 1977.
...,
~J'asa~ H~dr4 (Sfu\Ll
SIGNED, SEALED, PUBLISHED and DECLARED, by SARA M. HOLLAND, the
LAW O"f'lC.ES
STONE 1Io SAJER
310 BRIDGE STREET
NEW CUMBERLAND. PA. 1707
Page 1 of 2 pages
LAW OP'P'lCES
STONE 1Io SAJER
310 BRIDGE STREET
....EW CUMBERLAND, PA. 1707
Testatrix above named, as and for her Last Will and Testament, and in the
presence of us, who, at her request, in her presence and in the presence of
each other, have subscribed our names as witnesses.
~ C~, ~c-
Address . Q
Ad~~r'<~1 ~
0~(J~
Page 2 of 2 pages
Inventory of the real and personal estate of
Sara M. Holland
deceased
Cash from sales agreement
21,349 62
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II
II
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
I
J
55:
David H. Stone
being duly
sworn
according to law, deposes and says that he
of the Estate of Sara M. Holland
is the Administrator DBNCTA
late of _~J.~_<:ll~~e~_,!,~:p_~_____ _______ , Cumberland County, Pa., deceased and that the
. h" . t d b David H. Stone h 'd Administrator DBNCTl
Wit In IS an Inven ory ma e y -- - -, t e sal
of the entire estate of said decedent, consisting of all the personal propt!rty and real estate, except real estate outside
the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value
as of the date of decedent's death.
19
David H. -E
Stone
and subscribed before me,
Street
17070
Address
Date of Death
16
08
1992
Day
Month
Year
INSTRUCTIONS
I. An inventory must be filed within three months after appointment of personal representative.
2. A supplement inventory must be filed within thirty days of discovery of additional assets.
3. Additional sheets may be attached as to personalty or realty
4. See Article IV. Fiduciaries Act of 1949.
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT_2B0601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
STONE DAVID HEAN ESQUIRE
414 BRIDGE STREET
NEW CUMBERLAND, PA 17070
-------- fold
ESTATE INFORMATION: SSN: 207-28-1306
FILE NUMBER: 2102-0809
DECEDENT NAME: HOLLAND SARA M
DATE OF PAYMENT: 11/18/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 08/16/1992
NO. CD 001854
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $1,130.98
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$1,130.98
REMARKS: DAVID HEAN STONE ESQUIRE
CHECK# 7497
SEAL
INITIALS: CW
RECEIVED BY:
REGISTER OF WILLS
MARY C. LEWIS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX( 11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
FREY ROBERT M ESQUIRE
5 S HANOVER STREET
CARLISLE, PA 17013
-------- fold
ESTATE INFORMATION: SSN: 197-40-5255
FILE NUMBER: 2100-0809
DECEDENT NAME: PALMER BRENDA J
DATE OF PAYMENT: 12/04/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 06/30/2000
NO. CD 001911
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $336.00
I
I
I
I
I
I
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TOTAL AMOUNT PAID:
$336.00
REMARKS: ROBERT M FREY ESQUIRE
CHECK# 3123
SEAL
INITIALS: AC
RECEIVED BY:
REGISTER OF WILLS
MARY C. LEWIS
REGISTER OF WILLS
JRD/June 30, 1992/17858
In Re: Estate of SARA M HOLLAND
Late of MIDDLESEX TOWNSHIP
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
Estate No.: 21-02-809
NO. 21-02-809
NOTICE OF FAILURE TO FILE CERTIFICATION AND REQUEST TO CONDUCT A
HEARING PURSUANT TO RULE 5.6(e), SUPREME COURT
ORPHANS' COURT RULE
Personal Representative: DAVID H STONE
Counsel for Personal Representative: DAVID HEAN STONE
Date of Grant of Original Letters: 09-13-2002
Date of Delinquency Notice: 12-23-2002
The undersigned, Mary C. Lewis, Register of Wills, in accordance with Rule 5.6,
Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of
Common Pleas of Cumberland County, that neither the above named personal representative nor
the above named counsel for the personal representative have filed with the Register of Wills or
Clerk of the Orphans' Court his, her or its certification required by Rule 5.6(e), Supreme Court
Orphans' Court Rule and that the requisite notice, pursuant to Rule 5.6(e), Supreme Court
Orphans' Court Rules, was given by the Register of Wills on DECEMBER 23,2002, and that
the ten (10) day notice to file the certification has expired. Accordingly, in accordance with Rule
5 .6( e) the Court is hereby notified of such delinquency and the undersigned requests that a Court
conduct a hearing to determine whether sanctions should be imposed upon the delinquent
personal representative or counsel for the delinquent personal representative.
Date: 01-02-2003
~~~"~~e-rt~
),b4!~ ~ 1. j;Uio, Register of W Is .
Distribution: Personal Representative
Counsel for Personal Representative
Estate File
A hearing is scheduled for CJ.. -I tf -().3 at ~; 30 A-.8?/In Courtroom No.3. If the
Certification of Notice is filed prior to the hearing date, the hearing will automatically be
cancelled.
o
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Sara M. Holland
Date of Death:
August 16, 1992
Will No. 2
To the Register:
I certify that notice of beneficial interest required by
Rule 5.6(a) of the Orphans' Court rules was served on or
mailed to the following beneficiaries of the above captioned
estate on January 8, 2003.
James J. Holland
1 West Penn St., Apt. 113
Carlisle, PA 17013
Notice has now been given to all persons entitled thereto
under Rule 5.6(a).
Date:
, -C\ - 0 ?-.
Capacity:
Personal Representative
x
Counsel for Personal
Representative
~
.
REV-150D EX. (6-00) OFFICIAL USE ONLY
COMMONWEALTH OF PENNSYLVANIA REV-1500 1 3" i i
DEPARTMENT OF REVENUE / - -
DEPT. 280601 INHERITANCE TAX RETURN F\U~ NUMBER
HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 21 02 0809
COUNTY CODE YEAR NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
Holland, Sara M. 207-28-1306
DECE- DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE
DENT
08/16/ 1 aa~ 12/26/1899 WITH THE REGISTER OF WILLS
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
8 3. Remainder Return
CHECK ~' '"'~-" ~" Supplemental Return (date of death prior to 12-13-82)
APPRO- 4. Limited Estate 4a. Future Interest CompromisB 5. Federal Estate Tax Return Required
(date of death after 12.-12-82\
PRIATE 6. Decedent Died Testate 7. Decedent MalOtalned a Living Trust 8. Total Number of Safe Deposit Boxes
(AttachcopyofWillj (Attach acopyofTrust)
BLOCKS 9. Litigation Proceeds Received 10. Spousal Poverty Credlt{date of death between 0 11. Election to tax under Sec. 9113(A}
12-31-91 and 1-1-95) (Attach 5eh 0)
'ffi1$i$gqnq~Mti$tjji;.pbiim'filj$Q;At10PQtjtjll$#Q\l\l;ill~i)iiq~Ejtii;IflIN#tA%jijtQFlMi\l!1QN$i'iQVQ:iiji;QWle&f$i:I(:rq:
NAME COMPLETE MAILING ADDRESS
COR- David H. Stone, ESQUire 414 Brid3e Street
RE- FIRM NAME (If Applicable) New Cl.nl1berland, PA 17070
SPON
DENT Stone laFaver & Shekletski
TELEPHONE NUMBER
717-774-7435
None OFFiCIAL USE ONLY
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2) None
3. Closely Held Corporation. Partnership orSola-Proprietorship (3) None
4. Mortgages & Notes Receivable (Schedule 0) (4) None -""
5. Cash, Bank Deposits & Miscellaneous Personal
Property (Schedule E) (5) 21,349.62
6. Jointly Owned Property (Schedule F)
0 Separate Billing Requested (6) None
RECA-
PITULA- 7. Inter-Vivos Transfers & Miscellaneous
TION Non-Probate Property (Schedule G or L) (7) None
8. Total Gross Assets (total Unes 1-7) (8) 21,349.62
9. Funeral Expenses & Administrative Costs (Schedule H){9) 2,500.00
10. Debts of Decedent, Mortgage Liabilities, &. Liens(Schedule I) (10) None
11. iotal Deductions (total Unes 9 & 10) (11) 2,500.00
12. Net Value of Estate (Una 8 minus Line 11) (12) 18,849.62
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax (13) None
has not been made (Schedule J)
14. Net Value SubJect to Tax (Line 12 minus Line 13) (14) 18,849.62
SEE INSTRUCTIONS ON PAGE 2 FOR APPLlCABLIE RATES
15. Amll",nt of Line 14 taxable at the spousal tax
rate,ortransfers",nderSec.9116(a}(1.2) X .0 (15)
TAX 16. Amo",nt of Line 14 taxable at lineal rate 18,849.62 X .06 (16) 1,130.9
COMPU- 17. AmountofLine 14 taxable at sibling rate 0.00 X .12 (17) 0.00
TATION 18. Amount of Line 14 taxable at collateral rate 0.00 X .15 (18) 0.00
19. Tax Due (19) 1,130.9
20. 0 tQl\I\CKija:!i;jl"i"'QV.AAi;iji;Q!!!1.\fflijG\\ij~ijP;!'1FM!'~iivMi;m:!1
8
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...... ...................... ............,,"\?),/.)'**'aei$!;)!l~TQ.ANS!."IeRA!JfQPE$T(QN!\J;lW!lAj;\i'lfA!iiPJ"liOl1eCRMAt!li%'.."'"",................
o PA15001
NTF 29755
Copyright 2000 Greatland/Nelcll LP - Forms Software Only
PA'REV-1500 EX (6-00)
Decedent's ComDlete Address:
STREET ADDRESS
908 2nd Street
Page 2
CITY
New Currberland
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
I STATE
PA
1 ZIP
17070
(1)
1.130.98
Total Credits (A + B + C)
(2)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (0 + E)
4. If Una 2. is greater than Line 1 + Una 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Une 20 to request a refund
5. If Line 1 + Une 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Una 5 + 5A. This is the BALANCE DUE.
Make Check
(3) 0.00
(4)
(5) 1,130.98
(5A) 0.00
(58) 1,130.98
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred; ..............
b. retain the right to designate who shall use the property transferred or its income; ....,.........
c. retain a reversionary interest; or. . . . . . . . . . . . . . . . . . . , . . . . . . . .
d. receive the promise for life of either payments, benefits or care? . . . . . . . .
2. If death occurred after December 12,1982, did decedent transfer property within one year of death
without receiving adequate consideration? . . . . . . . . . , . . . . . .
3. Did decedent own an "in trust for" or payable upon death 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 J h ve examined this return, including accompanying schedules and statements, and to the best of my
knowledge and belief, it is true, correct and omplets. Declaration of preparer other than the personal representative is based on information of
which ra knowled e.
SIGNAT I E OR FILING RETURN DATE
~-()"-
Yes No
~ I
B ~
o
ES
ADDRESS
See S
SIGNATURE OF P
DATE
t)~
ADDRESS
414 Bridge St eet, New Cumberland, PA 17070
;~:/~~~:~~::~:i:::~:~::~:~:::~~:::~:~:~~:~:/J~:i:V:::~:;\:~~:r~:~:~;::~:~n~:;:5~~:~:~~V~:\:~:~:~:::T~:;::~~::~~~;;::i:~:~:~:~;:t~:~\~:~::~~:{~~i:~:::~r~;~~~~~~::::~~:::~;)~;:~:~;:.~~:~:::~y~:~::~;~~:
~~::ti:g:~::;:p::~~:~:~::::riQ::;:;:::;:
[72 P.S.!i 9116(al(1.1)(i)].
For dates of death on or after January 1, 1995. the tal' rate is imposed on the net value of transhrs to or for the use of the surviving spouse is 0% [72 P.S. ij 9116 (a) (1.1) (iil].
The statute tin.." nnt ..\/..mnt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retl.lrn are still applicable e\{en
it
the $ur\living 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-ane years of a.ge or younger at deattl to or {or the use 01 a natural parent, an adoptive parent,
or a stepparent of the child isO% [72 P.S.li9116{a)(1.2l).
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. ij 9116(1.2) [72 P.S,i9116{a)(1\].
The ta:>l Tate imposed on the net value ot transfers to or for the use of the decedent's siblings is 12% [72 P.B. 6 9116(a)(1 ,3)]. A sibling is defined, under Section 9102, as an individual
who hasat least one parent in common with the decedent, whether by blood oradoptior'l.
o PA15002
NTF 29756
Copyright 2000 Greatland/Nelco loP - Forms Software Only
.
Estate of: Sara M. Holland
21-02-0809
TIle following person(s) are signing the return as representative(s) of the estate:
David H. Stone
414 Bridge St.
New Ct.nIDerland, PA 17070
,
REV-150B EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Sara M. Holland
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
21-02-0809
Include proceeds of litigation & date proceeds were received by the estate. All OrOD. faintly-owned with rlqht of survivorshIp must be disclosed on 5ch. F.
ITEM
NO. DESCRIPTION
VALUE AT
DATE OF DEATH
1 Cash fran sales agreerrent
21,349.62
7 CPA81 NTF 1090B
Copyright Forms Software Only, 1997 Nelco, Inc.
TOTAL (Also enter on line 5, Recapitulation) $
{If more space is needed, insert additional sheets of the same size}
21,349.62
REV-1511EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Sara M. Holland
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21-02-0809
Debts of decedent must be reDorted on Schedule I.
ITEM
NO. DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
None
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions 0.00
Name of Personal Representative(s)
Social Security Number(s)/E1N No. of Personal Representative(s}
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees Narre: David H. Stone 2,500.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 0.00
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees 0.00
5. Accountant's Fees 0.00
6. Tax Return Preparer's Fees 0.00
None
TOTAL (Alse enter en line 9, Recaeitulatien) $ 2,500.00
(If more space is needed, insert additional sheets of the same size)
7 CPA11 NTF 10911
Copyright Forms Software Only, 1997 Nelco, Inc,
REV-'5'3 EX + ('-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
Sara M. Holland
No. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I. TAXABLE DISTRIBUTIONS (include outright spousal distributions)
1 Jarres J. Holland
1 West Penn St., Apt. 113
carlisle, PA 17013
FILE NUMBER
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
son
21-02-0809
AMOUNT OR
SHARE OF ESTATE
18,849.62
ENTER DOLLAR AMTS. FOR DISTRIBS. SHOWN ABOVE ON LINES '5 THROUGH 17 AS APPROPRIATE ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9"3 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
None
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
None
7 CPA13 NTF 10913
TOTAL OF PART 11-- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE '3 OF REV '500 COVER SHEET $
0.00
Copyright Forms Software Only, 1997 Nelco, Inc.
(If more space is needed, insert additional sheets of the same size)
STONE LaPAVER & STONE
MORTGAGE AMORTIZATION SCHEDULE
PAGE
1
--------------------------------------------------------------------------------
Prepared for :0.
Re :SARA HOLLAND
Principal
Interest Rate
Compounded
STONE
ESTATE PAYOFF
23600.00
9.000
12
Years of
Interest
Payment
Amortization .00
factor 1.007500000000
200.30
--------------------------------------------------------------------------------
Payment Total
Date Number Payment
Interest
Payment
Principal
Payment
Balance of
Loan
Cum Int
Per Yr
Per
Diem
--------------------------------------------------------------------------------
May 01/86
Aug 01/92 75
Sep 01/92 76
200.30
200.30
159.80
159.49
40.50
40.81
23600.00
(21265.72 J
21224.91
12688.22
12847.71
5.26
5.25
FINAL PAYMENT
PRINCIPAL PAID TO DATE
INTEREST PAID TO DATE
TOTAL PAID TO DATE
$ 21224.91
$ 2375.09
$ 12847.71
$ 15222.80
E. & o. E.
/G J7 (? ~~.'i'w
>
'-I~\("l,l;,,-
. I?,R~- /y
~. BUREAU OF INDIVIDUAL
INHERITANCE TAX DIVISION
DEPT. 2B0601
HARRISBURG, PA 1712B-0601
TAXES
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
'*
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
R[V-1547 EX AFP (01-03)
t,/",-,
DAVID H STONE thQ ,c. .J;
STONE ETAL
414 BRIDGE SJ
NEW CUMBERLA~~ PA 17070-1410
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
01-06-2003
HOLLAND
08-16-1992
21 02-0809
CUMBERLAND
101
SARA
M
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~
RE-Y-=is4-j-EX-AFP--coY:iiij--NOYfcE--OF-YNHEitfTAN-CE-YAX-"A-PPR"A-fsEirENT-,--ALi-oWAN-CE-O-i-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HOLLAND SARA M FILE NO. 21 02-0809 ACN 101 DATE 01-06-2003
T AX RETURN WAS: (X) ACCEPTED AS F I LED
( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
21,349.62
.00
.00
(8)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
8.
Total Assets
21,349.62
APPROVED DEDUCTIONS AND EXEMPTIONS:
10.
11.
12.
13.
14.
Debts/Mortgage Liabilities/Liens (Schedule I)
Total Deductions
Net Value of Tax Return
Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule
Net Value of Estate Subject to Tax
(9)
(10)
2,500.00
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
.00
(11) ?500.00
(12) 18,849.62
J) (13) .00
(14) 18,849.62
If an assess.ent was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of !hh returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate
16. Amount of Line 14 taxable at Lineal/Class A rate
17. Amount of Line 14 at Sibling rate
18. Amount of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS:
NOTE:
.00 X 00 .00
18,849.62 X 06 1,130.98
.00 X 00 .00
.00 X 15 .00
(19)= 1,130.98
(15)
(16)
(17)
(18)
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
01-18-1996 AMNP PEN 205.04 .00 NOTE: AMNESTY N
11-18-2002 CDOO1854 .00 1,130.98 PENALTY ASSESSE
BALANCE OF UNPAID INTEREST/PENALTY AS OF 11-19-2002 TOTAL TAX CREDIT 1,130.98
BALANCE OF TAX DUE .00
INTEREST AND PEN. 1,073.76
TOTAL DUE 1,073.76
P
D
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
~
PENNSYLVANIA
%:
..
0
"-
STONE DAVID HEAN ...
c
414 BRIDGE STREET 1:l ee
~ 0::
NEW CUMBERLAND, ee
G en
-------- fold
ESTATE INFORMATION:
FILE NUMBER: 2
DECEDENT NAME: ~
DATE OF PAYMENT: (
POSTMARK DATE: (
COUNTY: I
DATE OF DEATH: I
REMARKS: DAVID t-
CHECK# 752~
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$1,073.76
/?- P6-/-Y
\,
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
'*
REV-1607 EX AFP 101-05>
/ ~
u.
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
coyt4TY
ACN
02-18-2003
HOLLAND
08-16-1992
21 02-0809
CUMBERLAND
101
SARA
M
DAVID H STONE ESQ
STONE ETAL
414 BRIDGE ST
NEW CUMBERLAND
Allount Rellitted
~, .
(".,
PA 17070."
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent.
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~
REv=i6cfj-E3f-AFi,--foY=o3Y------...-fNirERITANCE-YAX-STATEME-tiY-OF-AC-CouifT--...---------------- -----
ESTATE OF HOLLAND SARA M FILE NO.21 02-0809 ACN 101 DATE 02-18-2003
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 01-06-2003
PR I NCI PAL TAX DUE: ,..,...,....,............,...................."...."""..."...........,........,.."","",.....'.....,...,........"",..,.,..........................."",..."...,....................
....."......,.............,
1,130.98
PAYMENTS (TAX CREDITS):
AMN
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
01-18-1996 AMNP PEN 205.04 .00
11-18-2002 CDOO1854 .00 1,130.98
02-03-2003 CD002112 1,073.76- 1,073.76
TOTAL TAX CREDIT 1,130.98
BALANCE OF TAX DUE .00
ESTY NON-PARTICIPATION PENALTY HAS BEEN ASSESSED 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" (CRJ,
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 7/08/2004
STONE DAVID HEAi~
414 BRIDGE STREET
NEW CUMBERLAND, PA
17070
RE: Estate of HOLLAND SARA M
File Number: 2002-00809
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing will become delinquent on: 8/16/2004
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
CC:
File
Personal Representative(s)
Judge
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 7/08/2004
STONE DAVID H
414 BRIDGE STREET
NEW CUMBERLAND, PA
17070
RE: Estate of HOLLAND SARA M
File Number: 2002-00809
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing will become delinquent on: 8/16/2004
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Counsel
Judge
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Sara M. Holland
Date of Death: August 16, 1992
Will No. 21-02-0809
To the Register:
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:
Yes X
State whether administration of the estate is complete:
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
personal representative's account is: N/A
the
(c) Did the personal representative state an account
informally to the parties in interest? Yes X No
Date:
(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. ~Lu
ire
414 Bridge Street
New Cumberland, PA 17070
717-774-7435
Personal Representative
X
Counsel for Personal
Representative