The URL can be used to link to this page

Home My WebLink About03-0684WILLIAM P. DOUGLAS, ESQUIRE ATTORNEY I.D. # 37926 DOUGLAS, LAW OFFICE 27 West High St. P.O. Box 261 Carlisle, Pa. 17013 Telephone: 717-243-1790 ATTORNEY FOR PETITIONER IN RE: ESTATE OF RICHARD : LEON DRAUCKER, DECEASED: IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNA. Civil Action Law Orphans Court Division PETITION FOR CITATION TO COMPEL APPLICATION FOR LETTERS PURSUANT TO 20 PA. CONS. STAT. ANN. SECTION 3155 TO THE REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA. The Petition of William P. Douglas respectfully represents that: The decedent, Richard Leon Draucker, died intestate, a resident of Cumberland County on June 4, 1998. See attached death certificate marked Exhibit A. 2. Decedent was survived by his four adult children: Cathryn Moore, Richard Draucker, Jr., Theresa Anne Cullen and Jeanne Blanchard. 3. Decedent was divorced from his wife, Jean Anne Draucker, on July 3, 1970. See attached copy of divorce decree marked Exhibit B. Decedent owned an insurance policy with Cigna Group Insurance, under Policy Number FLX 50862, with an approximate value of $17,000.00, which was the only asset in his estate. See attached letter from Cigna marked Exhibit C. Petitioner is an attorney, who has been contacted by the daughters of Richard Leon Draucker to attempt to receive the insurance proceeds. The three daughters have signed renunciations permitting William P. Douglas to be named as Administrator of this estate for the purpose of accessing the aforesaid policy proceeds for distribution to Mr. Draucker's adult children. See 3 renunciations marked Exhibit D. Despite repeated requests to Richard Draucker, Jr., through his attorney Scott A. Stein, Esquire, Mr. Draucker has refused to sign a renunciation, and wishes to disclaim his beneficiary interest in the policy, as is evidenced by the attached letter from his attorney, dated January 29, 2003, and marked Exhibit E. WHEREFORE, Petitioner requests that a Citation be awarded pursuant to 20 Pa. Cons. Stat. Ann. Section 3155 directed to Cathryn Moore, Richard Draucker, Jr., Theresa Anne Cullen and Jeanne Blanchard, to show cause why they or either of them should not apply for and take out letters of administration on the Estate of Richard Leon Draucker, deceased, or failing this, to show cause why such letters should not issue to petitioner or his nominee. Wii'lidm P. Dot~glas, Es~tui~ DOUGLAS LAW OFFICE ~ 27 W. High St. Carlisle, PA 17013 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) :SS:, COUNTY OF CUMBERLAND ) William P. Douglas, being duly sworn according to law, deposes and says that the following is true and correct to the best of affiant's knowledge, information and belief: William P. Douglas Sworn to and subscribed before me this ~$ dayof ~a-~,2003. N6'tar~y Notarial Seal Anne M. Cox, Notary Public Carlisle Borough, Cumberland County My Commission Expires July 14, 2005 FV This is to certil5, that the in£ormal,on here given is correctly copied from an original certjfii::ate of death duly filed with me as Locai Regi~rar. The original certificate will b~ forwarded to lhe State Vital Records Office for l~rma, nent filing.. WARNING: It is illegal to duplicate this copy by photostat or photograph. No. ~' Date CERTIFICATE OF DEATH NAM[ Ol' -L;.~-_'~ ~T f,~. ~,~., t.,~ ,. Richard Leon D~ucker , , · ...... ~MM~ "~ ~ M ~_~. ~ M ~.~.~, , , _ ~ -~ ........ ~" ~ mcemm.s~--~ I~ ..... m I~c~ oK COq~,~ ~o , I~-~ .... I._ White ~.~) RO w 375 Claremont Drive .tCarlisle, Penna. 17013 Florence D. Hockenbe~ , Berlin. ~land218 Ken Harm MDo 375 Cl.~emon, Drive,Carliele,~13 Commonwealth of Pennsylvania County 6f Dauphin, ss: In the Court of Common Pleas of -~ 'D~iuphl~Q C6unty. Pen~;~nla' No. ~-~4 )larch Term, 1.9...~..0 Decree in Divorce AND NOW, to wa: ......................... .J..~.l.~....~.s. ........................................... ,10...~.0......, the Coa~ having referred this cause to a raaster, who after taking the testimony and considering the Mrae. has reported his findings of fact and conciosinns of Jaw thereon to the Court, the Court, upon due con- slderation thereof, hereby adopts the findings of facts end conclusions of law, as the findings and con- clusions of the Court, and does accordingly grant the prayer of the plaintiff and hereby adjudges and decrees that J'.~AN ANff~. Dll ...................... '.-' ........... ~ AUCK · is hereby divorced and comp]eteJy separated fwom'~l~-~-~$ rasltr~raony with ...... ~.~..l~..~...~.,. ............................................................ ue fuJiy as if the said defendant were naturally dead or os if the plaintiff had never been married; that every duty, ~t and claira heretofore necrdlng to either of the s~d parties ~y reosou of raarrlage does now cease and come to an e~rd; smd that each of the amid parties is ut liberty to mnr~ again as ~;ee]y au if the marriage had newer taken pines. AND IT IS FURTHER ORDERED, That the costs of this proceeding be paid by the defendant. ·. BY THE COURT, '....(..s. )........,.~ ~.~..L% ....c.~.~ .e.~ ~. .................... Judfe Cert~ied July 6, 1970 Lynda .Canava~. Life Claim Specialist Life Claim Administration July 10, 2003 William Douglas Attorneys at Law 27 W. High Street/P.O. Box 261 Carlisle, PA 17013 CIGNA Group Insurance Life * Accident * Disability PO Box 22328 Pittsburgh, PA 15222-0328 Telephone 1-800-238-2125 Facsimile 412-402-322! Insured Name: Date of Birth: Policy Number: Underwriting Company: Richard Draucker 05/24/1925 FLX 50862 Life Insurance Company of North America Dear Mr. Douglas: In looking over the claim for Richard Draucker, I noticed that I have not received the following information: · a copy of the executor papers for the estate of Richard Draucker Mr. Douglas, please send this letter with the requested information to me in the enclosed envelope, by July 30, 2003. If we do not receive this by July 30, 2003 the funds will be re-escheated to the state of Pennsylvania. If you have any questions, please call me. You can reach me at our toll free number 1.800.238.2125 extension 3146 from 7:30 a.m. to 4:00 p.m. Eastern Time, Monday through Friday or email me at Lynda. Canavan@CIGNA.com. If you call and get my voice mail, leave a message and your call will be returned within one business day. Sincerely, Lynda Canavan ,~ copy: Jeanne Blanchard Enclosure CIGNA Group Insurance products and services are provided exclusively by underwriting subsidiaries of CIGNA Corporation, including Life Insurance Company of North America, CIGNA Life Insurance Company of New York, and Connecticut General Life Insurance Company. "CIGNA~ is used to refer to these subsidiaries and is a registered service mark. 11-2G-02 O9:OOam From-UNLV Law Library ?028952410 T-233 P.02/02 F-SSS Dan Benefit Analys~ Consumer Financial Security October 25, 2002 Jeanlle Blanchard 35114 Surtrise Court Pittsville, MD. 21850 CIGI~IA Group Insurance Life · Accld~t · Dit, abtllty 1600 We.st Carson Stflte 300 Pittsburgh, PA 15219-3419 Telaphone 1-800-238-2128 Facsimile 412-402-3221 Insured Name: '~' ~ciar ~'curlxy2~ m_ _ im~. Policy Number: Underwriting Company: Dear Ms. Blanchard: Richard Draucker 195;1'~-~96 · - FLX 5O862 Life Insurance Company of North America I am writing to let you know this pending Group Term Life Insurance claim, has been reviewed by CIGNA Management. The following is the action that must be taken on this claim: It has been determined that since "the Estate of Richard Draucker" ii the beueficiary of record, and since nobody in the surviving family can agree on who will represent the estate in probate proceedings; a Petition must be ~ed by you or your siblings with the Pennsylvania Probate Court to have your father's estate relieved from administration. By doing so, a Court Order would allow us to disburse the proceeds as directed by them. This is ia accordance with the laws governing Pennsylvallia. CIGNA Group Insurance must be notified Within 31 days of the date of this letter that this petition is in process; otherwise, there is no alternative other than to .re-escheat these monies to the State Of Pennsylvania as Unclaimecld Abandoned Property, Ms,-l~fa~Jaard; ff ~t-l~ave' any questions, please call me. You can reach me at '0~tr t~fi ~e number 1.800.238.2125 extension 3525 from 8:00 a.m. to 4:30 p.m. Eastern Time, Monday through Friday or email me at DamShustock@CIGN/kcom. If you call and get my voice mail, leave a message'and your call will be' returned within one business day. Sincerely, Dan.Shtistock .. . Copy; ..Theresa Cullen -.,: Cathryn Moore Richard Draucker CIGNA Group lnau~nce .p~ucta &n(~ t. ezeices &m ~ eazllu~vely by m'ld~r~Mi~ ~u.i,~ of CIGI~A Cnrp~atJon, Inclu~tng L~e lmur~nce Company o~ N'or~ CIG'HA IMe Ir, aurance Company o! New Yov~ anti Cormqclloat 0~ei~l Llge lflpar&t~ce Co~npany. '~CIG'I%~,a is us~ to re. Icl Io rAx~e subsldhrlet ,nd is ~ re~s~tnvcl service RENUI CIATION In Re Estate of. RICHARD LEON DRAUCKER deceased. To the Register of Wills of~ Cumberland County, Pennsylvania. The undersigned Q ~'~% r'~ f'~ ~ o ~ u' ~ ' of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters o£ Admin±s tration be issuedto William P. Douglas, Esquire, 27 W. High St., Carlisle, PA 17013 WITNESS hand this day of , ~ 2002 (Signature) (Address) (Signature) (Address) RENUNCIATION In Re Estate of 'RICHARD LEON DRAUCKER To the Register of Wills of Cumberland County, Pennsylvania. of the above decedent, hereby renounce(s) the fight to administer the estate and respectfully ask(s) that Letters of Administration be issued to William P. Douglas, Esquire, 27 W. High St., Carlisle, PA 17013 (Signature) (Si~amre) (Address) (Sisnature) (Address) RENUNCIATION In Re Estate of 'RICHARD LEON DRAUCKER To the Register of Wills of Cumberland County, Pennsylvania. _ of the above d~_,~_ent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters of Administration bci~uedto William. P. Douglas, Esquire, 27 W. High St., Carlisle, PA 17013 ' 7 . ~'/~ ' (Signature) (~snature) (Ad&~) (Signature) (Ad&ess) LAW OFFICES OF 'PETER J. Rvsso; E C. ATTORNEYS AT LAW 3800 Market Street Camp Hill. PA 17011 ~ $. Russo, Esquire Melissa M. Mehaffey, Paralegal Scott A. Stein, Esquire Wednesday, January 29, 2003 Douglas, Douglas & Douglas 27 West High Street Carlisle, PA 17013 RE: ESTATE OF RICHARD DRAUCKER To Whom It May Concern: We have been asked by Richard Draucker to advise you that he wishes to renounce his beneficiary interest in the Life Insurance policy underwritten by Life Insurance Company of North America on the life of Richard Draucker, Social Security Number 195-16-3096. If you have any questions or need him to sign a formal declaration of this intent, please contact our office. Very truly yours, ~cott A.. Stein, Esqmre SAS~aw PHONE: (717) 591-1755 Tm~ CtmLSEA BuRoItqO FAX {'/I'/) ~:-s t~o DOUGLAS LAW OffiCE 27 W. HIGH STREET P O, BOX CARLISLE, PENNSYLVANIA 17OI3-O26I ('7 I 7) ;~43-1790 ii WILLIAM P. DOUGLAS, ESQUIRE ATTORNEY I.D. # 37926 DOUGLAS, LAW OFFICE 27 West High St. P.O. Box 261 Carlisle, Pa. 17013 Telephone: 717-243-1790 ATTORNEY FOR PETITIONER IN RE: ESTATE OF RICHARD · LEON DRAUCKER, DECEASED · IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, P NN^.. . . l 03- Orphans Court Division DECREE DIRECTION CITATION AND NOW, this ~q '~day of '-~E~3T. ,2003, upon consideration of the petition of William P. Douglas, Esquire, a citation is hereby awarded pursuant to 20 P.A. Cons. Stat. Ann. Section 3155, directing Cathryn Moore, Richard Draucker, Jr., Theresa Anne Cullen and Jeanne Blanchard, to appear before the Register of Wills for the County of Cumberland, at his office, First Floor, Cumberland County Court House, Carlisle, PA. on the ~ct 'r~4 day of Of LT. ,2003, at ~ ', 30 , o'clock, P M. and to show cause why they should not apply for and take out letters of administration on the Estate of Richard Leon Draucker, Deceased, or failing this to show cause why such letters should not be granted to William P. Douglas, Esquire, or his nominee. PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Estate of Richard Leon Draucker No. also known as To: · Deceased. Social Security No. 1 q ~- ] 6- 20 q 6 Register of Wills for the County of Cumberland Commonwealth of Pennsylvania in the The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older, app[ ~o~ (d.b.n.; pendente lite; durante absentia; durante minoritate) for letters of administration on the estate of the above decedent. Decendent w~s domiciled at death in Cumberland County, Pennsylvania, with h is last family or principal residence at . 375 Claremont Dr., Carlisle, PA 17013 (list street, number and municipality) Decendent, then 73 years of age, died June 4, 1998 , 19. at Claremont;Nursing and,Rehab Center of Cumberland County, PA. ' Decendent at death owned property with estimated values as folllows: (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: Petitioner after a proper search ha s the following spouse (if any) and heirs: Name ! Cathryn Moore Richard Draucko_r.. .Ir. 2. Theresa Ann. appropriate form to the undersigned. ascertained that decedent left no will and was survived by Relationship Hn,~Ehtor Residence 656 Tnmp~rme~mn Dr-:'Zephyr 2R6q tTnlnn nnpos~t fa_#103 n~rr~h,,r~. PA 17109 ]0TM ~nrly Morning Ave. Cove,NV. 89448 Jeanne Blanchard daughter 35114 Sunrise Ct.,Pittsville, MD. THEREFORE, petitioner(s) respect~lly request(s)the grant of letters of administration in the 21850 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OF C~E~LA~ The petitioner(s) above-named swear(s) or affirm(s).that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal 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 09th day of / .,. December . .-, ~I~ 2002 / Donna M. Oto, 1st, Deputy No. 21-?flfl3-na~a Estate of ,RICHARD LEON DRAUCKER ,Deceased GRANT OF LETTERS OF ADMINISTRATION AND NOW December 22nd, t9c2003 , in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that William P. Douglas, Esquire is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration are hereby granted to William P. Douglas, Esquire in the estate of Richard Leon Draucker FEES Donna lq. OttoR~e-l%~°~lty /,~, William P. DOUglas,Esquire Letters of Administration ..... $ 18.00 Short Certificates(~lJ .......... $ ~3.00 ~ ..... JCP. ....... $ lO_On $. TOTAL __ $ 31.ilo Filed .De. cembea:..22nd,.. A.D. ~ P003 ATTORNEY (Sup. Ct. I.D. No.) 37926 27 W. High St. ADDRESS Carlisle, PA 17013 717-2&q-]7qO PHONE Call Attorney when letters are ready. 12/22/2003 PJ=.V-1500 EX (6-00) · . ~ . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 Z ILl LLI Z Z O n UJ n~ 0 ~.rvs'oLV ~' ~v T' REV-I$O0 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)~ L. DATE Of DEATH (IVJM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) ( ) VIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAl') [~riginal Return r~ 2. Supplemental Return [] 4. Limited Estate [] 4a. Future Interest Compromise (date ofdeath after 12-12-82) ---]6. Decedent Died Testate (Attach copy of Will)[] 7. Decedent Maintained a Living Trust (Attach copy of Trust) [] 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) _ FI R M ,1~i¢~_ (If Applicable), TELEPHONE NUMBER OFFICIAL USE ONLY FILE NUMBER COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER tqS' - ~ c. -'~o9 L.. THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER ] 3. Remainder Return (date of death prierto 12-13-82) ~]5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes ]11. Election to tax under Sec. 9113(A) (Attach Sch O) COMPLETE MAILING ADDRESS 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) ]Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Modgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. 14. (9) ~1S'5.c~ Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) Net Value Subject to Tax (Line 12 minus Line 13) (8) (11) ~(12) (13) (14) OFFICIAL USE ONLY '2_.1 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate x .0_ (15) x .0_ (16) x .12 (17) O O 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) 20. [] Decedent's Complete Address: STREETADDRESS CITY STATE Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) Total Credits ( A + B + C ) 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page I Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. (2) (3) (4) (5) (5A) (5B) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. 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 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 ~ 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. S,GNAT RE t,, PE?S.,%RESP ,.L,NG ,fE,-URN SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE, DATE ADDRESS For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. {}9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. {}9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. {}9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. {}9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 RS. §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. · RE~-1508 EX + (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK BEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F, ITEM NUMBER DESCRIPTION TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH REV-1511 EX+ (12-99) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT FILE NUMBER Debts of decedent must be reported on Schedule ]. ITEM NUMBER 5. 6. 7. cl. DESCRIPTION FUNERALEXPENSES: ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Year(s) Commission Paid: Attorney Fees '~0"0''~%~ L~,J ~ Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant __ Zip Street Address City State Zip Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) AMOUNT 2000.00 oo !%.oo R~V-1513 EX + (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT TAXABLE DISTRIBUTIONS (include outfight spousal distributions) Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET U. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) IN RE: ESTATE OF RICHARD LEON DRAUCKER : IN THE COURT OF COMMON PLEAS : OF CUMBERLAND COUNTY,PENNA. : ORPHANS' COURT DIVISION : NO. 2103-684 PETITION FOR THE SETTLEMENT OF A SMALL E~qTATE TO THE HONORABLE, THE JUDGES OF SAID COURT: William P. Douglas, Administrator of the Estate of Richard Leon Draucker, respectfully represents: 1. Richard Leon Draucker, who resided at 375 Claremont Dr., Carlisle, PA 17013 died intestate on June 4, 1998. 2. Letters of Administration were granted to Petitioner on December 22, 2003. 3. The only asset in the estate was as follows: Cigna Life Insurance Policy valued at $17,500.00 4. The only expenses were $2,153.00, as set forth in paragraph 7 herein. 5. No inheritance tax was due on this estate. A copy of the insolvent inheritance tax return filed with the Department of Revenue is attached hereto as Exhibit A. 6. The said Richard Leon Draucker left surviving him four children as follows: Cathryn Moore, Richard Draucker, Jr., Theresa Anne Cullen Jeanne Blanchard 7. The said life insurance policy proceeds less costs of administration will be distributed as follows: Douglas Law Office, attorney fee Douglas Law Office, reimbursement for costs as follows: Register of Wills, Letters of Administsration Geiger & Loria, transcript Register of Wills, filing insolvent return Register of Wills, filing pet. to settle Cathryn Moore, 1/4 share Richard Draucker, Jr., 1/4 share Theresa Anne Cullen 1/4 share Jeanne Blanchard 1/4 share 55.00 74.00 10.00 14.00 $3,836.75 $3,836.75 $3,836.75 $3,836.75 RECAPITULATION Total Assets: Total Credits Balance distributed to heirs $ 2,153.00 $15,347.00 WHEREFORE, your Petitioner prays that Your Honorable Court approve the distribution of this estate as set forth herein, and prays that the said Administrator, William P. Douglas, Esquire, be discharged from the duties of his appointment. Dated: January l % 2004 Douglas Law Office William P. Douglas, Administrator and Attorney COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND William P. Douglas, Administrator, being duly sworn according to law, depos,es and says that the averments of the within Petition are true and correct to the best of affiant s knowledge, information and belief. Swom to and subscribed ~fore me t~ Notary ~ William P. Douglas Notarial Seal Anne M. Cox, Notary Public Carlisle Borough, Cumberland County My Commission Expires July 14, 2005 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'~S NAME (LAST, FIRST, AND MIDDLE INITIAL)__ -- L uA, ~- UI' DEATH (I~IUI-D~YEAR) ' DA~-~'dF 81RTH.(MM-DD-YEAR) ~ -- 'S NAME (LAST, RRST, AND MIDDLE INIT~L~-~ [~4. Limited Estate [~]6. Decedent Died Testate (,~ach cmy of w~) ~'-~ 9. Litigation Proceeds Received ~'~2. Supplemental Return E~] 4a. Future Interest Compromise (date o~dea~ aft~ 12-12-82) [-'-'~ 7. Decedent Maintained a Living Trust (Attach copy d Tn~) J~10. Spousal Poverty Credit (~t~ o~ath b~,~m 12-31-91 and 1-1-95) TELEPHONE N 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Propdetorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (sehedu~e E) 6. Join~ Owned Propert~ (Sched~ F) L_~ Separate ailing Requested 7. Intar-Vivos Trensfem & Miscellaneous Non-Probate Properly (Schedule G or L) S. Tota~ C, ross Assets (tota Lines 1.7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mixlgage Uabllilies, & Liens (Schedule I) ii. Total Deductions (total Unes 9 & 10) 12. Net Value of Estate (Une 8 minus Une 11) (1) (~) (3) (4) (8) (6) (7) (9) I S "5 . oo (lo) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INS?R. UCTIONS Off REVERSE SIDE FOR APPLICABLE RATES OFFICIAL USE ONLY FILE NUMBER SOCIAL SECURITY NUMBER ~ R~RN MUST BE FILED IN DUPUCA~ ~H THE REGISTER OF WILLS S~l~ SECURI~ NUMBER [~]3. Remainder Return (da~e o~deah ~ ~ 12-13-82) [---~ 5. Federal Estate Tax Retum Required __ 8. Total Number of Safe Deposit Boxes ~-'~11. Eleclino to tax under Sec. 9113(A) (A~ta~ Sca O) COMPLETE MAILING ADDRESS (11) (12) (13) (14) 15. Amount of Line 14 taxable at lfle ~1 tax rote, or transfers under Sec. 9116 (aX1.2) x .0 .. (15) 16. Amount of Line 14 taxable at lineal rote x .0 ~ (16) 17. Amount of Line 14 taxable at sibling rote x .12 (17) 18. Amoun! of Line 14 taxable a! collateral rate x .15 (18) _ 19. Tax Due 20. ~-~ (19) 0 COM~TH OF PENNSYLVANI~ INHERITNqCE T.,~X RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER Inc~de the ITEM NUMBER · ~:~cls of litigation and the date ~e proceeds were received by the estate. All properly jointly-owned with me right of sur~ivorshi ~ must be disclosed on Sc~___u~ F. 0,'% DESCRIPTION TOTAL (Also enter on line 5, Recapitulation) $ VALUE AT DATE OF DEATH REV-I,511 EX+ (12-99) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADA~INISTRATIVE COSTS RESIDENT DECEDENT I FILE NUMBER ITEM NUMBER A. 1. Debts of decedent must be reported on Schedule DESCRIPTION FUNERAL EXPENSES: ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Year(s) Commission Paid: AtlomeyFees "'~m~~ LO.~I ~ Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Zip Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Retum Preparer's Fees TOTAL (Also enter on line 9, Recapitulation), (If more space is needed, insert additional sheets of the same size) AMOUNT 1o-oo P~'V*ISf3 EX* (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER RELATIONSHIP TO DECEDENT NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Mst Trustee(s) NUMBER 1I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON UNE~ NON-TAXABLE DiSTRiBUTIONS: 15 THROUGH 17, AS APPROPRIATE A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART [[ - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET AMOUNT OR SHARE OF ESTATE . ON REV 1500 COVER SHEET (If more space is needed, insert additional sheets of the same size) JAN IN RE: ESTATE OF RICHARD LEON DRAUCKER · IN THE COURT OF COMMON PLEAS · OF CUMBERLAND COUNTY,PENNA. · ORPHANS' COURT DIVISION · NO. 2103-684 ORDER OF COURT AND NOW, this day of ,2004, after a review of the within Petition, the Petition to settle this small estate is approved and distribution directed as set forth in the said Petition. This Estate is closed and William P. Douglas, Esquire, is excused from his duties of Administrator of the Estate of Richard Leon Draucker. By the Court, COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENTS FIRST, AND MIDDLE I oo z z 0 Q. o DATE OF DEATH (IF APPLICABLE) 8 SPOUSE'S NAME (LAST, Return ~-'] 4. Limited Estate ~--~ 6. Decedent Died Testate (,~ac~ [~9. Litigation Proceeds Received REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DATE OF BIRTH (MM-DO-YEAR) ~---~ 2. Supplemental Return [~4a. Futura Interest Compromise (date []7. Decedent Maintained a Living Trust (.~ta~ c~oy dTmst) [~10. Spousal Poverty Credit (date o~ ~ 12-3~.91 and 1-1.95) I. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule 8) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Properly (Schedule E) (5) 6, J~n~y Owned Properly (Schedule F) ' (G) [~ Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Properly (7) (Sct~ule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administretive Costs (Schedule H) (9) 10. Debts of Decedent, Morlgnge Liabilities, & Liens (Schedule I) 11. Total Deductions (total Unes 9 & 10) 12. Net Value of Estate (Une 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election te lax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Une 13) SEE INS'rR. IJCTIONS ON REVERSE SIDE FOR APPLICABLE RATES OFFICIAL USE ONLY '7---I S "5 FILE NUMBER COUNT~ CODE YEA~ NU~ER S~l~ SECURI~ NUMBER ~IS R~ ~OST BE FILED IN DUPLICA~ ~TH THE REGISTER OF WILLS S~I~ SECURI~ NUMBER ~3. Remainder Retain (date of death p~or to 12-13-82) [~5. Federal Estate Tax Retum Required __ 8. Total Number of Safe Deposit Boxes r~11, Election to tax under Sec, 9113(A) (~ac~ (14) 15. Amount of Une 14 taxabie at the spousal tax rate, or transfers under Sec, 9116 (aX1.2) x .0~ (15) 16. Amount of Line 14 taxable at lineal role x .0~ (16)_ 17. Amount of Une 14 taxable at sibling rate x .12 (17) __ 18, Amount of Line 14 taxabte at collateral rate x .15 (18) 19. Tax Due 20.[~ ' · '' ' · · . · · , · .., (19) O O (11) (12) (13) COMPLETE MAILING ADDRESS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 Z I-- Z U.I o U.I o (.1 .JV 'oL V E '[" REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDEN~_~S NAME (LAST, FIRST, AND MIDDLE INITIAL) DATE OF DEATH (~M-DD-YEAR) I DATE O~-~-~) ~- (IF APPUCABLE) 51URVlVI[IG~ ~ FIRST, AND MIDD E INITIAL)" OFFICIAL USE ONLY FILE NUMBER COUNTY COOE YEAR NUMBS'----' ~ SOCIAL SECURITY NUMBER t'I5' - c. - THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER ~'--'~ 4. Liruited Estate []6. Decedent Died Testate (Atta,~ moy of wa) J-'-~ 9. Utigation Proceeds Received ~--~ 2. Supplemental Return J---] 4a. Future Interest Compromise (date of death after 12-12-82) J--"] 7. Decedent Maintained a Living Trust (Adac~ c~y of Trust) ['--~ 10. Spousal Poverty Credit (da~ r--~ 3. Remainder Return (date of daath pdor to 12-13-82) [~5. Federal Estate Tax Return Required __ 8. Total Number of Safe Deposit Boxes ~'--~ 11. Election to fax under Sec. 9113(A) (~a~ sc~ o) 11. 12. 13. 14. TELEPHONI 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule 8) (2) 3. Clnseiy Held Corporation, Partnership or Sole-Proprietorship (3) 4. Me,gages & Notes Receivable (Schedule D) (4) 5. Cash, Sank Deposits & M~scaaneous Persone~ Prupe~ (5) (Schedae E) 8. ~r.~ Owned Roperty (Sche~le F) ' (8) 7. Inter-V'n/os Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) Total Deductions (total Lines 9 & 10) Net Value of Estete (Une 8 ruinus Une 11) Charitable and Governmental Bequests/Sec 9113 Trusts for which an eteclion to tax has net been made (Schedule J) Net Value Subject to Tax (Une 12 ruinus Line 13) SEE INS?UCTIONS Off REVERSE SIDE FOE APPLICABLE RATES COMPLETE MAILING ADDRESS 'H OFFI~ (8) 0 (11) (12) (13) (14) 15. Amount of Une 14 taxable at the spousal tax rote, or lmnsfers under Sec. 9116 (aX1.2) 16. Amount of Line 14 taxable at lineal rote 17. Amount of Line 14 taxabie at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. x .o (15) (..) x .o 06) 0 x .12 (17) O x .15 (18). (19) ~ JRD/June 30, 1992/17858 ,JUL In Re: Estate of Richard Leon Draucker Late of Middlesex Township Estate No.: 2003-684 ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 21-Richard Leon Draucker NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE Personal Representative: William P. Douglas, Esquire Counsel for Personal Representative: William P. Douglas, Esquire Date of Decedent's Death: 06/04/98 Date of Delinquency Notice: 07/14/04 The undersigned, Glenda Farner-Strasbaugh, Clerk of Orphans' Court, in accordance with Rule 6.12, 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 Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, was given by the Clerk of the Orphans' Court on April 30, 2004, and that the ten (10) day notice to file the Status Report has expired. Accordingly, in accordance with Rule 6.12 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: 07/14/04 Distribution: ' Glenda Farner Strasbaugh Clerk of the Orphans' Court . ~ers'onal Representative ~,gst a~eSe/i~eOr Personal Representative A hearing is scheduled for at in Courtroom No. 3. If the Status Report is filed prior to the hearing date, the hearing will automatically be "*~ ~ - cancelled. .~ ,.,-~. ,,. ~ ~ George ~0:~r, ~J. [ Name of Decedent: STATUS REPORT UNDER RULE 6.12 Date of Death: Will No.: '~- 00% -'- to~Sq-' 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 w..~ether actministration of the estate is complete: Yes~ No 2. I/the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. I/the answer tO No. 1 is Yes, state the following: Did the personal representative file a final account with the Court? Yes _ No b. The separate Orphans' Court No. (if any) for the personal representative's acco=tis:__ /~.~~ b.,~.~-.-~ ~ ~ c. Did the personal representative state an account informally to the parties in interest? Yes r-] No ['"] Date: c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the. Orph~m~s' Court and may be attached to this report. Signature -' -" Nallle Telephone No. Capacity: [--] Personal Representative ,~ounsel for personal representative IN RE: ESTATE OF RICHARD LEON DRAUCKER · IN THE COURT OF COMMON PLEAS ' OF CUMBERLAND COUNTY,PENNA. · ORPHANS' COURT DIVISION · NO. 2103-684 ORDER OFCOURT ANDNOW, this q -i'-14- dayof ~'~l~l~LK~'~ ,2004, after a review of the within Petition, the Petition to settle this small estate is approved and distribution directed as set forth in the said Petition. This Estate is closed and William P. Douglas, Esquire, is excused from his duties of Administrator of the Estate of Richard Leon Draucker. By the Court, A TRUE COPY FROM RECORD In Testimony wherof, I hereunto set my hand and the seal of said Court at Carlisle, PA/~/{ /'~'~"' Ci'erkOltheOmhan~Cou'~ r~L~--~/-- BUREAU OF INDIVIDUAL TAXES /NHERXTAHCE TAX DTV/STON DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOT/CE OF INHERITANCE TAX APPRAXSEHENT, ALLO#ANCE OR DXSALLOHANCE OF DEDUCTIONS AND ASSESSHENT OF TAX REV-1647 EX AFP C01-03) WILLIAM P DOUGLAS 27 W HIGH ST CARLISLE '04 lIAR -5 P 3 : 12 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 05-08-2004 DRAUCKER 06-04-1998 21 03-0684 CUMBERLAND 101 Amoun'~ Remi*k'lced RICHARD L HAKE CHECK PAYABLE AND REM'rT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THXS LINE ~ RETA/N LOWER PORT/ON FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTZONS AND ASSESSMENT OF TAX ESTATE OF DRAUCKER RICHARD L FILE NO. 21 03-0684 ACN 101 DATE 03-08-2004 TAX RETURN HAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE ZNTEREST- SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es*e~e (Schedule A) (1) 2. S~ocks and Bonds (Schedule B) (2) $. Closely Held S~ock/Par~nership In~eras~ (Schedule C) ($) q. Nor~gagas/No~as Receivable (Schedule D) (q) 5. Cash/Bank Deposits/Misc. Personal Proper~y (Schedule E) (5) 6. Jointly Owned Propar~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To,al Asse~s APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expanses (Schedule H) (9) 10. Dab~s/Hor~gage L/abilities/Liens (Schedule I) (10) 11. To,al Deductions 12. Na~ Value of Tax Re~urn 1S. lq. Chari*able/Governmen~al Bequests; Non-alec*ed 9115 Trusts (Schedule J) Ne~ Value of Es~a~e Sub~ec~ ~o Tax .00 .00 .00 .00 .00 .00 .00 (8) 2,153.00 .00 (11) (12) (15) (lq) NOTE: Xf an assessment was /ssued previously, 1/nas 14, 15 and/or 16, 17, re~lect figures that include the total of ALL returns assessed to date. NOTE: To insure proper credi~ *o your eccoun*, submi~ *ha upper pot*ion of ~his ford wi~h your ~ax payment. ASSESSMENT OF TAX: 15. Amoun~ of LAne 1~ a~ Spousal re~e 16. Amoun~ of Line lq ~axablm a~ Lineal/Class A ra~e 17. Amoun~ of Line lq a~ Sibling ra~e 18. Amoun~ of Line 1~ ~axable a~ Collateral/Class B ra~a 19. Principal Tax Due TAX CREDITS: PAYMENT RECEIPT DATE NUMB E R DISCOUNT (+) INTEREST/PEN PAXD (-) .00 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 2.15~.0fl 2,153.00- .00 Z,153.00- 18 and 19 will (16) .§0 X O0 = .00 (16) .00 X 06 = .00 (17). .00 X O0 : .00 (18) .00 x 15 = .00 (19)= .00 AHOUNT pAID TOTAL TAX CREDIT BALANCE OF TAX DUE ZNTEREST AND PEN. TOTAL DUE .00 .00 .00 .00 ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR), YOU NAY DE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) RESERVATION: PURPOSE OF NOTICE: PAYNENT: REFUND (CR): OBJECTIONS: ADNIN- ISTRATZVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 12, 1962 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after tho expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at tho lawful Class B (collateral) rate on any such futura interest. To fulfill tho requirements of Section gl40 of tho Inheritance and Estate Tax Act, Act 23 of Z000. (72 P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on tho reverse side. --Make check or money order payable to: REGISTER OF HILLS, AGENT A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application For Refund of Pennsylvania Inheritance and Estate Tax" (REV-131$). Applications ara available at the Office of the Register of Hills, any of the 23 Revenue District Offices, or by calling tho special 24-hour answering service for fores ordering: 1-800-361-Z050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-3020 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assosssont of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to tho PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1011, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 160601, Harrisburg, PA 17118-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decedont's death, a five percent (5Z) discount of the tax paid is alloaed. The 15Z tax amnesty nan-participation penalty is computed on the total of tho tax and interest assessed, and not paid before January 18, 1996, tho first day after the and of tho tax amnesty period. This non-participation penalty is appealable in tho same manner and in the tho same time period as you mould appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, ar nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (67-) percent par annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rata which will vary fram calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through Z003 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 ZOZ . 000548 1987 91 . go 0247 1999 77. . 000192 1983 161 .000438 1988-1991 llX .000301 ZOO0 81 .000219 1984 Ill .000301 1991 9Z .000247 ZOOl 9Z .000247 1985 131 .000356 1993-1994 71 .000192 ZOOZ 61 .000164 1986 107. .000?74 1995-1996 91 .000147 2003 5Z .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DEL/NQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the data of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be caZculatad.