HomeMy WebLinkAbout03-0016PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
also known as ~ - "~ To:
Social Security
'Register of Wills for the
Deceased. County of C,,~,~he--r-l,~,~ in thc
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older, appl (~-~
(d.b.n.; pendeme lite; durante absentia: durante minoritate)
the above decedent.
for letters of administration
on the estate of
Decedent was domiciled at death in ~_~ov~ Ioe_c t,a..~,d-. County, Pennsylvania, with
h ~ $ last family or principal residence at ,-~/~ '~c'e-,~,o.~'~,~oe- I~otz,. ~-I'.tOe,~,t, lo~rv'l'~0.
- (~t s~t, n~, ~ or Bo~.} '
D~edent, then ~ ~ y~ of ~e, ~ ~' ~~ er /~ ,~ ~ ~
Decedent at death owned property with estimated values as follows:
(If domiciled in Pa.) Ail 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:
Petitioner after a proper search ha
the following spouse (if any) and heirs:
Name
ascertained that decedent left no will and was survived by
Relationship
_ Residence
THEREFORE,
appropriate form to the undersigned.
petitioner(s) respectfully request(s) the grant of letters of administration in the
I~ ~0_ + C.--I~, ,ffo,,.~. "0,'.'o,..
OATH OF PERSONAL REPRESENTATIVE
The petitioner(s) above-named swear(s) or affum(s) that the
statements in the foregoin~ petition are true and correct to the best
of the knowledge and belief of petitioner(s) and that as personal
representative(s) of the above decedent petitioner(s) will well and
truly administer the estate according to law.
Sworn to or affirmed and subscribed
before.me this 20 da~r of
No. 21-2003-16
~[e Of John J. Younq
GRANT OF LETTERS OF ADMINISTRATION
AND NOW January_ ath ~ 2003, in consideration of the petition on
.. ~ the: revekse side-hereof, satisfnC't~ry proof having been. presented before me, : -.. ~ '
IT IS DECREED~ that '. ~/-~rm~- ~l:~__t~t~' -.lt~.m~n~_ Vrm3~_] .~-~o -. ..... · ....
is/are entitled to Letters of Administration, and in accord with such f'mdin~, Letters of Administration
are hereby granted to
in the estate of
FEES
Letters of Administration... ,.... $18.
Short Certificates(1) ..... ,..... $, 3.00
~-~n-~fi°n. ~',
szo.o0
Jc~ ' ' ": "'2"'"'""'s~o:o_0___
TOTAL
Filed ..J..~9.u..e~...8.t.h. ...... A.D.
' Ott~?~rs(~- - f V~uty'
Donna M.
ATTORNEY (Sup. Ct. I.D. No.)
PHONE
Called Attorney on 1-8-03
21-03-16
decee~.
3?
RENUNCIATION
21-03-16
The~ of
the above decedmt, hereby renounce{s) the rJsht.to administer the estate and rupectfuny ask(s) that Letms'
~)
(~)
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. $2.00
Local Registrar
P 8 S 8 8 1 S 0 SEP 2 0 2002
No. ~ Date
)5144 Rev. 1191
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
(Coroner)
dAME OF DECEDENT {F ~'$I, M~dd~e. La~} STATE F~LE NUMBER
[S~X ISOCiAL S£CURiIY NUMBER IDATEOFDEATH{ D ) ....... .....
John J Young =.Male 3. 187-38-5066 4. September 16, 2002
55 ~ug. 17,1947 Pittsburgh~ ~.,-.,~ ~,, ......G ~ ~"~
CumberlandDEcE~NT.SUSUAL~CUPATiON ~East. Pennsboro .. 209 R Four Seasons Lane i~..~...p. .... , ...... ,:. ~s~,,,,,,. White
~one ~. ~,2~ nk '4~s'~ ,~. ~arriod ~uzanne ~auss
{~t ,,..s,.,. Pennsylvania
209 R Four Seasons Lan~m~,c~ _ o~ ,~..~.~.~...~.~ East Pennsboro
,,. E~la, Pa 17025 [-'~'-~, ~ co~.~umberland *'~? ~.~-~-~-~
Unk ~
INFOR~7'S NAME {l y~Pr,n0 Unk
Bu*~l ~ Crema{~ ~vallt~State~ (Mu. In Oay. rear) ~he*P~e ' ' -
m~t=n~ a~<S~.,~ ~ ~=,b. 9/20/02 2,.. East Hb9 Crematory =,, Hbg, Pa
,,~.F.D.011897-L ==~ullivan F.H.r51 N. Enola Dr~ Enola,Pa
~ ..... ,o~o~c.~.,h. UNKNOWN P'M {- r- - -- Sentemher IR,
2002
,~,~.~,,,~m~---~ ,. Presumed Myocardial Infarction
WA~CASEREFERREDTOMEDICA E MINER/CO61ONER?
_ Hyperlipodemia
DUE TO
OF DEATH? Natucal
~.. ~ .,_~ .. ~n r-n IAcctde""
...............................
'MEDICALEXAM~O~ER liar, 2') ry~o,P,..H~c~aeA ~. ~o~s) Co~one~
~ t~ il of examl~t~n I~or Investl~tl~, tn ~ o~n. ~ath ~cu~r~ at t~ lime, date, ~ place, a~ tu. to t~ c.u.l~j .ha
m..~...,.,~..' ...................................................]2Mechanicsburg, Pa. 17050
21-03-16
IN RE:
SUZANNE JO (NAUSS) YOUNG
ALLEGED INCAPACITATED PERSON
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS COURT DIVISION
NO. 21-93-770
FIN~ ORDER OF COURT APPOINTING PLENARY
GUARDIAN OF THE PERSON AND ESTATE
AND NOW, this ~~,~ day of ~?~.~e~.,')) , 1993, a hearing
in this case having been held on October 18, 1993 and it appearing to
the Court that SUZANNE JO (NAUSS) YOUNG was served with a citation and
Notice of this Petition and hearing on September 23, 1993, and the
Court finds that the physical or mental condition of SUZANNE JO
(NAUSS) YOUNG would be harmed by her presence at the hearing, and
further finds from the testimony:
~. That SUZANNE JO (NAUSS) YOUNG presently suffers from
chronic paranoid schizophrenia and borderline
intellectual functioning conditions or disabilities
which totally impair her capacity to receive and
evaluate information effectively and to make or
communicate decisions concerning her management of
financial resources or to meet the essential
requirements for her physical health and safety.
2. That there are insufficient supports available to
assist SUZANNE JO (NAUSS) YOUNG in overcoming such
limitations and that there exists no less restrictive
alternative mechanism for decision making.
3. That based on the total incapacity of SUZANNE JO
(NAUSS) YOUNG to receive and evaluate information and
to make or communicate decisions, a plenary Guardian of
the Person and a plenary Guardian of the Estate are
required on a permanent basis.
NOW THEREFORE, based on the clear and convincing evidence
supporting the foregoing findings, it is ORDERED, ADJUDGED and DECREED
that SUZANNE JO (NAUSS) YOUNG be and is hereby adjudged a totally
incapacitated person and JEANNE VOGELSONG is appointed Plenary
Permanent Guardian of the Person and JEANNE VOGELSONG is appointed
Plenary Permanent Guardian of the Estate.
An Inventory must be filed within ninety (90) days. A report by
each Guardian shall be filed within ninety (90) days and annually
thereafter. ~) ~~~~~
A Surety Bond3~-th~-a~oUn~
p~ by - ~ ~ .~th~ f (~5~
csant=d for approval th~
SUZANNE JO (NAUSS) YOUNG, an incapacitated person, has the right
to appeal this Order of Court by filing exceptions within ten days of
this date or to petition this Court for a review hearing to modify or
terminate the guardianship herein established. If SUZANNE JO (NAUSS)
YOUNG was not present at this hearing on appointment of a guardian,
then petitioner shall serve upon and read to SUZANNE JO (NAUSS) YOUNG
the Statement of Rights, a copy of which is attached to this Order as
- 2 -
Exhibit "A", and file proof of such service with this Court within ten
(10) days.
BY THE COURT:
Je
- 3 -
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: .-~ I,~ ~ ~". ~ o ,~ v-, o
DateofDeath: ~¢~ I~_, _--D.-O__~ ~
Will No.
To the Register:
Admin. No. ~[~ t9 ~ -- t:>C)/~
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on :
Name Address
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
~Signature-- ~]/
Name ~_~t_~___~,,"~. '~. :.]--/~_.~. rYh~
Address ~ ~CO ; ~ ~ ~
~ Personal Representative
~unsel for personal representative
Capacity:
Cumberland County Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 8/03/2004
HARTMAN SUSAN j
1 IRVINE ROW
CARLISLE, PA 17013
RE: Estate of YOUNG JOHN j
File Number: 2003-00016
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: 9/16/2004
Your prompt attention to this matter will be appreciated.
Thank You.
cc:
File
Personal Representative(s)
Judge
Sincerely,
~G~L_~_NDA FARNER STR~BAUGH
~GISTER OF WILLS
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Date of Death:
Will 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~w__.hfither administration of the estate is complete:
Yes~ No [-'-1
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 r,x~resentative file a final account with the Court?
Yes _ No
b. The separate Orphans' Court No. (if any) for the personal representative's
account is: ~
Co
Did the personal representative state an account informally to the parties
in interest? Yes'I~ No [--1 (~o,~o~")
c. Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the Orphans' Court
and may be attached to this report.
/~i~ature (-J /
Name
LlZ:. try ¢- 9RV ~0.
Address
Telephone No.
Capacity:,~__~ Personal Representative
'~,~el for personal representative
' 15056041125
REV-1500 ~ Cos-o5) OFFICUIL USE ONLY
PA DepaMient ~ Revenue
Bureau of Individual Taxes County Code Year File Number
Po Box 2eosol INHERITANCE TAX RETURN 2 1 0 3 0 0 1 6
_ Hanisbulg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT 1lN:ORMATION BELOW
Social Security Number Date of Death Date of Birth
0 9 1 6 2 0 0 2 0 8 1 7 1 9 4 7
Decedent's Last Name Suffix Deoederlt"s First Name MI
YOU N G J O H N J
(If Applfcafbls) Enbar Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Y O U N G S U Z A N N E J
Spouse's Socal Security Number
2 0 2 4 6 5 4 8 7 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRUITE OVALS BELOW
1. Original Retum
^ 4. Limited Estate
^ 6. Decedent Died Testate
(Attach Copy of Will)
^ 9. Litigation Proceeds Received
^ 2. Supplemental Retum ^
^ 4a. Futuna Interest Compromise (date of ^
death after 12-12-82)
^ 7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
^ 10. Spousal Poverty Credit (date of death ^
between 12-31-91 and 1-1-95)
3. Remainder Retum (date of death
prior to 12-13-82)
5. Federal Estate Tax Retum Required
8. Total Number of Safe Deposit Boxes
11. Election to tax under Sec. 9113(A)
(Attach Sch. O)
CORRESP'ONDENIT - THIS SECTION ~iST BE COLLETED. ALL GORRESPONDENGt AND GVNFR7tN1 tAL IA7~ IIN'VIiM11VN SI'IVUW tat Da~:l t:D 1 V:
Name Daytime Telephone Number
S U S A N J H A R T M A N 7 1 7 2 4 9 7 7 8 0
ry
Firm Name (If Applicable) ( REGISTER ~LLS USE Y
D U N C A N & H A R T M A N , P C ~ c... r ~T 1>
First line of address ... ~---
1 I R V I N E R O W
Second line of address
City or Post Office
C A R L I S L E
State ZIP Code
e ;..p.`1
..~~ C*J
+ ;~ ~ t`r~
D~'rE FILED .._ `~ ~~'
P A 1 7 0 1 3
Corrosporldent's e-mafi addness: SusanhartmanCc~pa.net
Under penal~es of peljuly, t dediere that I bare eocan>illed riffs n~nl, indudi~g aooomparlying sclledllbs and stalsme111a, and b the best of my krawledge and tlelief,
it is tll,e, oonect and oompiele. Dedaraf~on of plepener other than the personal representative is based on afl infonrlalion of,st-ich pleperer has any lalo+wledge.
SIGNA OF PERSON RE ~ ~FIL~IG RETURN PATE
1 IRVINE
CARLISLE
PA 17013
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
PLEASE USE ORKi1NAL FORM ONLY
15056091125
Side 1
15056091125
r~' ~"1.
15056042126
REV-1500 EX Decedent's Social Security Number
Deoedenrs Name: JOHN J. YOUNG
RECAPITULATION
1. Real estate (Schedub A) ........................................ 1 • •
2. Stocks and Bonds (Schedub B) .................................. 2• •
3. Closely Held Corporation, Partnersh~ or Sole-Proprietorship (Schedub C) ..... 3. •
4. Mortgages 8~ Notes Receivabb (Schedub D) ........................ 4. •
0 0
~ 0 0
5. Cash, Bank Deposits & Misoeilaneous Personal Property (Sd~edub E) ....... 5. ~
6. Jointly Owned Property (Sd~edub ~ ^ Separate Billing Requested ....... C• •
7. Inter-Vivos Transfers 8 Misoelianeous N
robate Property
~
(Schedub G) Separate Billing Requested ....... 7. •
8. Total Gross Assets (total lines 1-7) ........................... 8. 7 0 0 • 0 0
9. Funeral Expenses 8 Administrative Costs (Schedub H) ................ 9. 1 1 6 9. 0 0
10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedub I) ..... ....... 10. •
11. Total Dsductlon: (total Lines 9 8 10) .................... ....... 11. 1 1 6 9. 0 0
12. Net Value of Estabs (Line 8 minus Line 11) .................. ....... 12. - 4 6 9. 0 0
13. Charitabb and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedub J) ........... ....... 13. •
14. Net Value Subject to Tax (Line 12 minus Line 13) ........... ....... 1a. - 4 6 9. 0 0
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxabb
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2> x .o - 4 6 9. 0 0 15. 0. 0 0
16. Amount of Line 14 taxabb
0
0
0
0
0
0
.
at lineal rate X .0 1 g .
17. Amount of Line 14 taxable
0 ~
~
0
0
0
at sibling rate X .12 17. .
18. Amount of Line 14 taxable
~ ~
0
~
~
~
at collateral rate X .15 18 •
19. Tax Due ......................................... ....... 19. 0 . 0 0
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Sids 2
15056092126 15056092126
REV 1500 EX Page 3
Decedent's Complete Address:
Fib Number
21 03 0016
DECEDENTS NAME
JOHN J. YOUNG
STREETADDRESS -- - -- --_ _.-___- __---------_---..__---
209 RFOUR SEASONS LANE
CfTY STATE ZIP
ENOLA PA 17025
Tax Payments and Credits:
1. Taos Due (Page 2 Line 19) (1) 0.00
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Total Credits (A + B + C) (2) 0.00
3. Interest/Penalty if appiic~le
D. Interest
E. Penalty
Total Interest/Penalty (D + E) (3) 0.00
4. ff Line 2 is greater than Line 1 + Line 3, enter the difference. This is the t3VEl~AYMENT.
F81 M oval on Pps 2, LMe ZO to roquest a rotund. (4) 0.00
5. ff Line 1 + line 3 is greater than line 2, enter the difference. This is the TAX DUE. (5) 0.00
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 0.00
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred : ...................................................................... ^
b. retain the right to designate who shall use the property transferred or its inoorne• ............................... ^
c. r~ettain a reversionary interest; or ................................................................................................ ^
d. receive the promise for life of either payments, benefits or care? ....................................................... ^
2. ff death oocumed after December 12,1982, did decedent transfer property within one year of death
without receiving adequate oonsider'ation? ....................................................................................... ^ X^
3. Did decedent own an 'in trust for• or payable upon death bank account or security at his or her death? ......... ^ Q
4. Did decedent own an Inciivi~al Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ..................................................................... ...... ^ 0
.......................
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE R AS PART OF THE RETURN.
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 three (3) percent (72 P.S. §9116 (a) (1.1) (l)].
For dates of death on or afar January 1,1995, the tax rate imposed on the n~ value of transfers ~ or for the use of the surviving spouse is zero (O) peroerit
[T2 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 twentyone 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 zero (0) percent (72 P.S. §9116(aX1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedents lineal beneficiaries is four and one-half (4.5) percent, except as noted in
72 P.S. §9116(1.2) [72 P.S. §9116(aK 1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's sidings is twelve (12) percent [72 P.S. §9116(aX1.3)]. A sibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by Mood or adoption.
REV-1508 EX + (6-96)
CONMONWFALTH OF PENNSYLVANW
INHERITANCE TAX RETURN
SCHEDVLE E
CASH, BANK DEPOSITS, ~ MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
JOHN J. YOUNG 21 03 0016
- - Include the gnoeeds of Nligatbn and tl~e dale the wane received by the estate.
AN anoosrty foi~Nhaow~Nd with ri0ht of swvivorsi~b nwet be dadossd on &MduN F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. CHECKING ACCOUNT - ALLFIRST 400.00
2. I DODGE ARIES
300.00
TOTAL (Also enter on line 5, Recapitulation) ~ = 700.00
REV-1511 EX + (12-99)
` SCHEDlJLE H
COIUN1AONVYEALTH OF PENNSYLVANw FUNERAL EXPENSES ~
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
JOHN J. YOUNG 21 03 0016
Debts of decedent nwst be npo~ed on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. SULLIVAN FUNERAL HOME -SEE ATTACHED BILL 1,110.00
B. ADMINISTRATIVE COSTS:
~ . Personal Representative's Commissions
Name of Personal Representative (s)
Soaal Security Numt>er(s1rEIN Number of Personal Representative(s)
Street Address
City Stale Zip
Year(s) Corrnnission Paid:
2, Atlomey Fees
3. Family Exemption: (tf decedent's address is rat the same as daimanl!s, attach explanation)
Claimant
Street Address
4.
5.
6.
7
City State Zip
Relationship of Claimant b Decedent
Probate Fees PETITION FOR LETTERS OF ADMINISTRATION, RENUNCIATION,
SHORT CERTIFICATES
AcoountanCs Fees
Tax Retum Preparers Fees
REGISTER OF WILLS -FILING FEE
TOTAL (Also enter on line 9, Recapitulation) I =
1.1
44.00
15.00
REV-1513 EX + (9-00)
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERfTANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
InNN _I vnl INS 21 03 0016
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Tnaysbea(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS ('rock 9e 16 le M )spousal d'stnbuti~ons, and trat~ers under
1. SUZANNE JO YOUNG Spousal
13 EAST GLENWOOD DRIVE 100%
CAMP HILL, PA 17011
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON UNES 15 T HROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II, NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET =
Itf rrxxR c~ara is ni incest ar~riitinn~ ch~!ic ~f tha carr~a ci~Pl
,........+~a.~ r utr.era.L .E•fU~1t9
'a1 ~1. Fnola Drive
~:no1a, pa 17U25
?32-5400
' STATEMENT OF FUNERAL GOODS AND SERVICES SELECTED
Charges are only for those items that you selected or that are required. if we are required by law or by a cemetery or crematory to use any items, we wW
explain the reason in writing below
tf you selected a funeral that may require embahnLtg, such as a funeral with viewing, you may have to pay for embalming. You do not have to pay forembalm-
ingyou did not approve iE you selected arrangem su as on or immediate burial. If we cltatged for entbalmiag, we,~rW lain below
For the Service of .. II,,,,.. ~~ ~ ~ Date of Death r I
Charge to: =,G.IC~~t }` - 2 '~!~ .~.Y~z.~-~t2"" -
Name Address y State
A. CHARGE FOR SERVICES SELECTED: Other clothing
1. PROFESSIONAL SERVICES ,- ~ { 1 f
Services of Funeral Director/Staff .... f ~~ ~ f
F.mbalmin f -" Cremation urn ................... f
g ......................
Other preparation of body (Description)
OTHER f
...... f -~" sJ f
......................... s" ~ ;,~, f
SUB-TOTAL OF PROFESSIONAL SERVICES ......... A t f ~ ~ ~'
TOTAL MBRCIIANDISE SELECTED .................. B i
2. FACILITIES AND SERVICES C. SPECIAL CHARGES:
Usc of facilities and services for Forwuding of remains to
viewing (YisitatioNWake)......... f f `~-,......"
Use of facilities and services (Funeral Home)
for funeral ceremony ............ f Receiving of remains from
Use of facilities and services for f """'
Memorial Service (Funeral Homt)
Use of equipment and services Immediate Buccal ................. i_,.,T.,.._
for graveside service ............. f Direct Cremation ................. f „~-~_C'~
Other ust of facilities f -.,.~ ~~
SUB-TOTAL OF SPECIAL CHARGES ................ C f ~
D. CASK ADVANCED
...: Opening Grave ............ . ..... f
SUB-TOTAL OF FACtL[TIES/EQUIPMENT ........... A2 f Cemetery Equipment .............. i
Got and Deed .................... f
3. AUTOMOTIVE EQU{PMENT Newspaper Notices-Local ......... f
Vehicle t transfer remains to Funeral Home. Newspaper Notices-Out-of-town .... f
Local . ?*'..,•~~.. ~,L.•.'1cti:3 .. • .. • . • . • • f ~~'''~ Telephone & Telegrams ........... f
Hearse (Casket Coach} Airfare ......................... i
Lucal ........................... t Clergy/Mass Offering.............. f
Limousine •- Pallbeuers ...................... f
Local ........................... t Certified Copies of the Death i r
Family car Certificate ...................... f '~ ~ '~
Loral ........................... f Police Escort.................... f
Flower cu or floral disposition Flowers ........................ f
Local ........................... f Vault Service Chuge .............. f
Lead culclergy car f
Loxal ........................... f f
Cu for pallbearers f
Local ........................... f f
Out of town transportation ......... f f
t ,
_ ~,,Q SUB-TOTAL OF ADVANCES ....................... D f~,JCV
SUBTOTAL OF AUTOMOTIVE EQUIPMENT........ A3 f of l~• We Chuge you for our services in obtaining:
TOTAL OF PROFESSIONAL SERVICES, (sptctfy crib advances tbat are mantel-up)
FAC[LITIE5 AND AUTOMOTIVE r' ; ~ `~
EQUIPMENT ................................... A f ...
SUMMARY OF CHARGES
8. CHARGE FOR MERCHANDISE SELECTED: A . Professional Services, Facilities and
Casket .......................... f `""`~ Equipment, and Automotive ~ it ' ~
(Description) Equipment ...................... i•-' ~ ~~
B . Merchandise ..................... f ~ ~~~
Other Receptacle ................. f `""`"""'~ C . Special Charges .................. 3 ~~
~ ,
(Description) D. Cash Advances ... . ............... f ~ 1 , ~ u/~
TOTAL OF ALL SECTIONS ........................ f ~ f
Outer burial container ............. f - J PAID AT TIME OF OR PRIOR TO
itkscription) A.RRANGEMEIVT3 ................................ f
BALANCE DUE .................................. f
Acknowledgement cods ........... f REASON FOR EMBALMING
Register book(s) .................. f "" "
Memory folders .................. f ' i t-- [f any law, cemetery, or crematory requirements have required the purchase
Pnyrr suds ..................... f """'-~ of any of the items listed above the law or requirement is cxpiahted below.
Temporary grave maker ........... f """'~
Burial clothing ................... f "" "`
I agree that t have r:amined the items of goods and services selected above and found them to be correct and ucocding to the arrangemrnts 1 have requested.) xktwwledgt
rrcript u(a copy of this Statement of Funeral Goods and Services Selected. [represent thu t have sufficirnt funds available for payment of the cash price for the goods
Ind servicts selected. I also agree to make payment off within days. !agree to be jointly and severally liable with anyone else who
signs below. A late charge of per month amounting to per yeti wiU be applied to the uapaM batattce beginning days
from the date of this agreetttent. I will also pay to the Funeral Director aU reasonable costs paid by the Funeral Director to co amounts t owe under this agreement.
Those costs may include attorneys' Ices, court costs and other costs. Any additional services or roercenndise ordered or rrgitested alter the date of this agreement will
tx considtrtd part of this agrct~gt and the~ost thereof will be reflected on the final bill or statement.
I~r1l) '
j i Purc)faser} ( tt~
iSral! -`~ ~ .-..._
iPurchaser) Director)
Prnmrl~~nu Funeral Uvtt gun ~+Wxiatwn 'QNITE Fungal Dtrtc YELLUw Funeral Dltcctw 1tNK Cu~totner
RECEIPT FOR PAYMENT
-------------------
-------------------
Cumberland County - Re ister Of Wills
Hanover and High Stree~
Carlisle, PA 17013
YOUNG JOHN J
File Number 2003-00016
Remarks YOUNG JEANNE
SK
Distribution Of Receipt
Receipt Date 1/08/2003
Receipt Time 15:52:26
Receipt No. 1031599
Transaction Description Payment Amount Payee Name
PETITION LTRS ADM 18.00 CUMBERLAND COUNTY GENERAL FUN
SHORT CERTIFICATE 3.00 CUMBERLAND COUNTY GENERAL FUN
RENUNCIATION HEIRS 10.00 CUMBERLAND COUNTY GENERAL FUN
JCP FEE 10.00 BUREAU OF RECEIPTS & CNTR M.D
Check# 0679 $41.00
Total Received......... $41.00
~~
1
~~ ~ /
~~
~~
RECEIPT FOR PAYMENT
-------------------
-------------------
Cumberland County - Re ister Of Wills
Hanover and High Stree~
Carlisle, PA 17013
YOUNG JOHN J
Receipt Date 10/06/2003
Receipt Time 14:57:03
Receipt No. 1034268
File Number 2003-00016
Remarks DUNCAN ET AL
JA
------------------------ Distribution Of Receipt ------------------------
Transaction Description Payment Amount Payee Name
SHORT CERTIFICATE 3.00 CUMBERLAND COUNTY GENERAL FUN
Cash $3.00
Total Received......... $3.00
K
15056041125
REV-1500 EX (06-05) OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number
PO BOX 280601 2 1 0 3 0 0 1 6
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW.
Social Security Number. ' I Date of Death Date of Birth
0 9 1 6 2 0 0 2 0 8 1 7 1 9 4 7
Decedent's Last Name Suffix Decedent's First Name MI
Y O U N G J 0 H N J
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Y 0 U N G S U Z A N N E J
Spouse's Social Security Number
2 0 2 4'` 6 5 4 8 7 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
1.Original Return �. 2.Supplemental Return 3.Remainder Return(date of death
prior to 12-13-82)
4. Limited Estate 4a.Future Interest Compromise(date of El 5.Federal Estate Tax Return Required
death after 12-12-82)
6.Decedent Died Testate El 7. Decedent Maintained a Living Trust 8.Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
9.Litigation Proceeds Received 10.Spousal Poverty Credit(date of death ❑ 11. Election to tax under Sec.9113(A)
between 12-31-91 and 1-1-95) . (Attach Sch.O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
S U S A N J H A R T M A N 7 1 7 2 4 9 7 7 8 0
Firm Name(If Applicable)
D U N C A N & H A R T M A N P C --
REGISTER OF WILLS USE ONLY
First line of address RECORDED OFFICE OF
REGISTER OF WILLS
1 IRVINE ROW 2014 ]FT 21
Second line of address CLERK OFORPI-LANS'COURT
CUMBERLAND COUNTY
City or Post Office State ZIP Code I DATE FILED
C A R L I S L E P A . 1 7 0 1 3
Correspondent's e-mail address:susanhattman .pa.net
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.
SIG RE OF PERSO E ONSIBLE FOR FILING RETURN DATE
ADD j 0G
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 15056041125 15056041125
REW1500 EX Page 3 File Number
Decedent's Complete Address: 21 03 0016
DECEDENTS NAME
JOHN J.YOUNG
STREET ADDRESS
209 R FOUR SEASONS LANE
CITY STATE ZIP
ENOLA PA 17025
Tax Payments and Credits:
I. Tax Due(Page 2 Line 19) (1) 0.00
2. Credits/Payments
A.Spousal Poverty Credit
B.Prior Payments
C.Discount
Total Credits(A+B+C) (2) 0.00
3. Interest/Penalty if applicable -
D.Interest
E.Penalty
(
4. If Une 2 is greater than Line 1+Line 3,enter the difference.This is the OVERPAYMENT.Total Interest/Penalty D+E) (3) 0.00
Fill in oval on Page 2,Line 20 to request a refund. (4) 0.00
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 0.00
A.Enter the interest on the tax due. (5A)
B.Enter the total of Line 5+SA.This is the BALANCE DUE. (58) 0.00
Make Check Payable to: REGISTER OF IMLLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN"VIN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ....................................................................... ❑ X❑
b. retain the right to designate who shall use the property transferred or its income; ............................... ❑ X❑
c. retain a reversionary interest;or ................................................................................................. ❑ ❑X
d. receive the promise for life of either payments,benefits or care? ....................................................... ❑ ❑X
2. If death occurred after December 12,1982,did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... ❑ ❑X
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?.................................................................................................. ❑ ❑X
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE R AS PART OF THE RETURN.
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 three(3)percent[72 P.S.§9116(a)(1.1)(i)].
For dates of death an 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 zero(0)percent
(72 P.S.§9116(a)(1.1)(I11].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 zero(0)percent[72 P.S.§9116(aXI.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedents lineal beneficiaries is four and one-half(4.5)percent,except as noted in
72 P.S.§9116(1.2)[72 P.S.§9116(aK1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve(12)percent[72 P.S.§9116(aXI.3)].A sibling is defined,under
Section 9102,as an individual who has at least one parent In cornmon with the decedent,whether by blood or adoption.
REV-1508 EX+(6-98)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
JOHN J. YOUNG 21 03 0016
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property joiMty-owned with right of.survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. CHECKING ACCOUNT-ALLFIRST 400.00
2. DODGE ARIES 300.00
J
TOTAL(Also enter on line 5,Recapitulation) S 700.00
4 a '- u,r r1°" , 1 �aT' a - ... c�d.N a a� kF -�� �. r. �,;
* �.�T'i9: - ,' t - -ra t i : �, -, .{• r v}� 4-+. '4 ,i f' a t t 4 t r 4
REV-1 511 EX+(12-99} �t '
f
� 4 `, � t�.y,�b `• ,'�11;. "�' ` *.3: L , ?-- i ,'t .y f f1 .` r ' rr f 5
SCHEDULE
e COhMONMALTH OF PENNSYLVANIA- ti
F FUNERAL EXPENSES
t
INHERITANCE TAX RETURN r ° '
RESIDENT DECEDENT ADMINISTRATIVE COSTS
„ESTATE OF ,.
;, -- - - -
FILE NUMBER'.
{; .JOHN . YOUNG 21 `03 . 0016
J
L Debts of decedent must be reported on Schedule L t ",
E
-%'ITEM
F NUMBER DESCRIPTION AMOUNT,, .
t =" FUNERAL EXPENSES:
SULLIVAN FUNERAL HOME, SEE-ATTACHED BILL ,.1;11000
..4:x'2,1 • H , � � c y 1• ,
'B ADMINISTRATIVE COSTS:
Personal Representative's Commissions' ,4
Nam@ of Personal ReprUmitaUYe
So&a Seeuny Nuin syEIN Numberof Personal ReMwntaWs)• F +
,f r Street Address " +'
y
City rr; Sfax
Yeai(s)Commis 1*ad
i 4 •S. - -• 1. i'
2 Attoniey Fees '
Family Exemptron'(If decedents address s noti same as dakhanf> attach explanation)
t k i Cilaknant :• ✓,:r,', f .
Jw Street Address
Staff
a* 7 Cry Zrp i.
Reladoriship of Claimant 10 Oeoedertt t ` .:A
'4'=. Pmba*Fees.PETITION FOR LETTERS OF ADMINISTRATION;"RENUNCIATION, , 44.00
SHORT CERTIFICATES r
Accountant's Fees c t t. v• t t y i ti
'i g;° Taz Return Preparers Fees 4
7. ' REGISTER OF WILLS FILING FEE ;` 15 00
;f
TOTAL(Also enter on line 9,Recapitulation) f 1 169.00
REV-1513 EX+(9-00)
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
JOHN J. YOUNG 21 03 0016
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [ndude outright spousal distributions,and transfers under
Sec.9116(a)(1.2)1
1. SUZANNE JO YOUNG Spousal
13 EAST GLENWOOD DRIVE 100%
CAMP HILL, PA 17011
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18,AS APPROPRIATE,ON REV-1500 COVER SHEET
II, NON-TAXABLE DISTRIBUTIONS:
A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If mnn?cnarp is np..aAIarf incvrt nMifinnal chaatc of tha cams±1.67al
.v.a �•uaa�ardi notne.. ..
51 N. Enola Drive
Enola, Pa 17025
732-5400
STATEMENT OF FUNERAL GOODS AND SERVICES SELECTED
Charges are only for those items that you selected or that are required.If we are required by law or by a cemetery or crematory to use any items,we will
explain the reason in writing below.
If you selected a funeral that may require embalming,such as a funeral with viewing,you may have to pay for embalming.You do not have to pay for embalm-
ing you did not approve If you selected arrangem1� {ect c►emadon or immediate burial.If we charged for embalming,we�tiil expWn below.
For the Service of �_tk {}�(� i� 1 j
'—� Date of Death
Charge to: i i
Name Address State ley A.CHARGE FOR SERVICES SELECTED: Ocher clothing
1. PROFESSIONAL SERVICES
Services of Funeral Director/Staff , f �v
FJ f
Embalming...................... f f
Other preparation of body Cremation turn............ ...... f
o (Description)
OTHER f
SUB-TOTAL OF PROFESSIONAL SERVICES...
2.FACILITIES AND SERVICES TOTAL MERCHANDISE SELECTED.................. B f
Use of facilities and services for C.SPECIAL CHARGE&
viewing(Visitation/Wake)........, f Forwarding of remains to
Use of facilities and services f `�
for funeral ceremony (Funeral Home)
y'''''''''''' f Receiving of remains from
Use of facilities and services for
f
Memorial Service ............... f (Funeral Home)
Use of equipment and services Immediate Burial.................. i
for graveside service............. t Direct Cremation................. f
Other use of facilities f
SUBTOTAL OF SPECIAL CHARGES ................ C f��
D.CASH ADVANCED
............................... i Opening Grave ......... f
SUB-TOTAL OF FACILITiES/EQUIPMENT...,,..,..,A2 f Cemetery Equipment....,....,,••, f
3.AUTOMOTIVE EQUIPMENT Lot and Deed.................... f
Vehicle t transfer_remains to Funeral Home. Newspaper Notices—Local .......... f
Local....'.. t�;ti,,,,_,..,,, f � Newspaper Notices—Out-of-town.... f
Hearse(Casket Coach) Telephone A Telegrams ......,,,•, f
Local........................... i Airfare.......................... f
Limousine Clergy/Mass Offering.............. f
Local........................... f Pallbearers...................... f
Family car Certified Copies of the Death
Certificate ...................... f
Local........................... f Police Escort.................... f
Flower car or floral disposition Flowers ........................ f
Local........................... f Vault Service Charge.............. f
Lead car/clergy car f
Local S f
Car for pallbearers f
Local S f
Out of town transportation......... f f
f f
f �(� SUB-TOTAL OF ADVANCES....................... D 112q—Y(J
SUB-TOTAL OF AUTOMOTIVE EQUIPMENT..,..... A3 f �' We charge you for our services in obtaining:
TOTAL OF PROFESSIONAL SERVICES, (spec(y casb advances that are marked-up)
FACILITIES AND AUTOMOTIVE
EQUIPMENT ................................... A f `'r'LL s
B.CHARGE FOR MERCHANDISE SELECTED: SUMMARY OF CHARGES
A. Professional Services,Facihtics and
Casket.......................... S--.--. Equipment,and Automotive r
(Description) Equipment...................... fJ/Lv'D
B. Merchandise..................... f
Other Receptacle ............ C. S dal I"''�, Special Charges.................. f -.. CJ
(Description) D. Cash Advances................... s�. /U
TOTAL OF ALL SECTIONS........................ f ! D
Outer burial container............. f L�' PAID AT TIME OF OR PRIOR TO
(Description) ARRANGEMENTS................................ f
BALANCE DUE.................................. f
Acknowledgement cards ........... f REASON FOR EMBALMING
Register books).................. f�
Memory folders .................. f 1�)C.C. If any law,cemetery,or crematory requirements have required the purchase
Prayer cards..................... f of any of the Items listed above the law or requirement Is explained below.
Temporary grave marker........... f
Burial clothing................... f
I agree that I have examined the items of goods and services selected above and found them to be correct and according to the arrangements 1 have requested.I acimowledge
receipt of a copy of this Statement of Funeral Goods and Services Selected.1 represent that 1 have sufficient funds available for payment of the ash prig for the goods
and services selected.I also agree to make payment of within days.I agree to be jointly and severally liable with anyone else,who
signs below.A late charge of per month amounting to per year will be apphcd to the unpaid balance beginning
from the date of this agreement.I will also pay to the Funeral Director all reasonable costs paid by the Funeral Director to collect amowts 1 owe under this agreements
Those costs may Include attorneys'fees,court costs and other costs.Any additional services or merchandise ordered or requested after the date of this agreement will
be considered part of this agreement and the cost thereof will be reflected on the final bill of statement.
(seal) . // / - O 0
(Purc)taser) ( )
(Sea1)
(Purchaser)
T)Pennsylranu Funenl Directors AW Wion Dne DueetDr)
WHITE Funenl Direc YELLOW Funeral DUeesor pnVK eurromrr
form-600 Revised 4/94
RECEIPT FOR PAYMENT
Cumberland County - Re ister Of Wills Receipt Date 1/08/2003
Hanover and High Stree Receipt Time 15 : 52 : 26
Carlisle, PA 17013 Receipt No. 1031599
YOUNG JOHN J
File Number 2003-00016
Remarks YOUNG JEANNE
SK
- - - --- ------------------ Distribution Of Receipt ------------------------
Transaction Description Payment Amount Payee Name
PETITION LTRS ADM 18 . 00 CUMBERLAND COUNTY GENERAL FUN
SHORT CERTIFICATE 3 . 00 CUMBERLAND COUNTY GENERAL FUN
RENUNCIATION HEIRS 10 . 00 CUMBERLAND COUNTY GENERAL FUN
JCP FEE 10 . 00 BUREAU OF RECEIPTS & CNTR M.D
Check# 0679 41 . 00
Total Received. . . . . . . . . 41 . 00
0
RECEIPT FOR PAYMENT
Cumberland County - Register Of Wills Receipt Date 10/06/2003
Hanover and High Streef Receipt Time 14 : 57 : 03
Carlisle, PA 17013 Receipt No. 1034268
YOUNG JOHN J
File Number 2003-00016
Remarks DUNCAN ET AL
JA
- - - ------------- -------- Distribution Of Receipt ------------------------
Transaction Description Payment Amount Payee Name
SHORT CERTIFICATE 3 . 00 CUMBERLAND COUNTY GENERAL FUN
Cash $3 . 00
Total Received. $3 . 00
RECEIPT FOR PAYMENT
-------------------
-------------------
LISA M. GRAYSON, ESQ. Receipt Date : 3/03/2014
Cumberland County - Register Of Wills Receipt Time : 08 : 50 : 22
One Courthouse Sauare Receipt No. : 1077161
Carlisle, PA 17613
YOUNG JOHN J
Estate File No. : 2003-00016
Paid By Remarks : JEANNE PELAYO
DB1
--- --------------------- Receipt Distribution ------------------------
Fee/Tax Description Payment Amount Payee Name
INH TAX RETURN 15 . 00 CUMBERLAND COUNTY GENERAL FUN
----------------
Check# 2155 $15 . 00
Total Received. . . . . . . . . $15 . 00
i
NOTICE OF INHERITANCE TAX -] pennsylvania
BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE F DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX
PO BOX 280601 REV-1547 IX AFP (08-131
HARRISBURG PA 17128-0601
DATE 02-25-2014
ESTATE OF YOUNG JOHN J
DATE OF DEATH 09-16-2002
FILE NUMBER 21 03-0016
HARTMAN SUSAN J COUNTY CUMBERLAND
ACN 101
1 IRVINE ROW APPEAL DATE: 04-26-2014
CARLISLE PA 17013 (See reverse side under Objections)
Amount Remitted ��
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS t--
REV-I547 EX AFP f08-137 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: YOUNG JOHN JFILE N0. :21 03-0016 ACN: 101 DATE: 02-25-2014
TAX RETURN WAS: C X) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) .00 NOTE: To ensure proper
2. Stocks and Bonds (Schedule BI (2) .00 credit to your account,
00 submit the upper portion
3. Closoly Het tl.Skoc k/Partnership Interest (Schedule C) (3) . of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) .00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 700.00
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) .00
B. Total Assets C87 700.00
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 1 ,169.00
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00
11. Total Deductions (11) 11169.00
12. Net Value of Tax Return (12) 469.00-
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax C147 469,00-
NOTE: If an assessment was issued previously, Lines 14, 15, 16, 17, 18 and/or 19 will
reflect figures that include the total of all returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at spousal rate (15) .00 X 00 = .00
16. Amount of Line 14 taxable at lineal rate (16) .Dn x 045 = .00
17. Amount of Line 14 at sibling rate (17) .00 X 12 = 100
18. Amount of Line 14 taxable at collateral rate (18) .00 X 15 = .00
19. Principal Tax Due C19)= r. .00
TAX CREDITS: n 2
s _l
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID (� =k rs�C7)
DATE NUMBER INTEREST/PEN PAID C-) TTl 70 D"- �''(
_ � rr; '7)
( ;
TOTAL TAX PAYMEN
BALANCE OF TAX DUE .00
INTEREST AND PEN. .DO
TOTAL DUE .00
• IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A CREDIT (CR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE FOR INSTRUCTIONS. \J
NOTICE OF INHERITANCE TAX pennsyLvania
BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
RD BOX TAX DFYISION
OF DEDUCTIONS AND ASSESSMENT OF TAX DEPARTMENT OF REVENUE
PO BOX 280641 REV-1547 IX AFP (48-13)
HARRISBURG PA 1712E-0641
DATE 02-25-2014
ESTATE OF BRANDT EDNA E
DATE OF DEATH 08-06-2008
FILE NUMBER 21 08-0972
COUNTY CUMBERLAND
MULLAUGH ELIZABETHP ACN 101
100 PINE STREET APPEAL DATE: 04-26-2014
PO BOX 1166 (See reverse side under Objections)
HARRISBURG PA 17108-1166 Amount Remitted E - �-�
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS 4--
--'-----___---`------_'^_------'----_-'------------------------------------
-'-__-___`_---__
REY-1547 EX AFP CO8-132 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: BRANDT EDNA EFILE NO. :21 08-0972 ACN: 101 DATE: 02-25-2014
TAX RETURN WAS: (X) ACCEPTED AS FILED ( } CHANGED
APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN NO. 01
1. Real Estate (Schedule A) (1) . 00 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) (2) .00 credit to your account,
3. Closely Held Stock/Partnership Interact (Schedule CJ (3) 00 submit the upper Portion
of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) .00 tax payment.
S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 38,883.00
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers [Schedule G) (7) .00
8. Total Assets (8) 38,883.00
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (y) 1 ,865.00
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10)_ . 00
11. Total Deductions (11) 1,865.00
12, Net Value of Tax Return (12) 37,018.00
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (L4) 290,616.47
NOTE: If an assessment was issued previously, Lines 14, 15, 16, 17, IS and/or 19 will
reflect figures that include the total of all returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at spousal rate t15} .00 X 00 = .00
16. Amount of Line 14 taxable at lineal rate <lb) 2811,414 4R x 045 = 12,627.93
17. Amount of Line 14 at sibling rate (17) -00 X 12 = - .00
18. Amount of Line 14 taxable at collateral rate (18) 10,000.00 X 12 = t:;5
14. Principal Tax Due ( Iii",127:?93_?
TAX CREDITS: M me'
rn c 1�01 C,1`
rs
PAYMENT RECEIPT DISCOUNT C+7
AMOUNT PAID
DATE NUMBER INTERESTtFEN PAID C-}
11-07-2008 CDO10513 .00 10:616.25
12-30-2008 CDO10713 .00 1,845.68 �
10-17-2013 CD018283 260.92- 1,939.00 ., �1ry T
N
�L+
TOTAL TAX PAYMENT 14,140. 01
BALANCE OF TAX DUE 12.08CR
INTEREST AND PEN. .00
TOTAL DUE 12.08CR
IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A CREDIT (CR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND, SEE REVERSE SIDE FOR INSTRUCTIONS.