HomeMy WebLinkAbout03-0040 STATUS REPORT UNDER RULE 6.12
Name ofDecedent: ~th( O~][{ ~), ~ t~t~ t1
Will No.: ~./ - O 5' C)0 ~) tq C) 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 administration of the estate is complete:
Yes ~ No ~]
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete:
3. If the answer to No. 1 is Yes, state the following:
a. 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
account is:
c. Did the personal representative state an account informally to the parties
in interest? Yes ['-] No
c. Copies of receipts, releases, joinders and approvat~ form~or
informal accounts may be filed with the Clerk of tiie Orphans' Court
and may be attached to this rep~.
Name
Address
~elep~o~e
Capacity: ~[-~Personal Representative
[--] Counsel for personal representative
STATUS REPORT UNDER RULE 6.12
Name of Decedent: '
Date of Death:
WillNo.' '~[ '"-0 % --0a~)~O Admin. No.:
Pursuant to Rule 6.12 of the Supreme Court Orphans' Cour~ Rules, I report the
followh~g with respect to completion of the administration of the above-captioned estate:
1. State.w~ther administration of the estate is complete:
Yes
2. If the answer is No, state when the personal representative reasonably bel/eves
that the administration will be complete:
3. If the answer to No. 1 is Yes, state the following:
a. Did the, p~rsonal representative file a final account with the Court?
Yes _,/ No ['-]
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account in.formally to the pm-ties
~ interest? Yes 1~ No ['-]. ~ __ .
c. t. op~es ofrece~p[s, releases, jomders and approval o££orma'l or
informal accounts may be filed with the Clerk o£the Orphans' Court
and may be attached tothis ~~/~~.~repo
Signature _ t
21 Name
,: .~ Address
-~ Telephone No.
Car)acity:. [X~ Personal Rep?~o .... en_~ve
[--] Counsel for personal representative
PETITION FOR PROBATE and GRANT OF LETTERS
also known a~ , To:
Register of Wills for the
, , Deceased. County of Cc~ r,, b~- {a ~ ~ in the
Social Security No. [ c../~ ~ I I~ .~ _/a--c/~.% Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut r~V ~ named
in the last wilt of the above decedent, dated ?1-~5 ~,4 $ ~-- z- 7 - , 19
and codicil(s) dated
(state relevant circumstances, e.g. renunciation, de~th of executor, etc.)
Decendent was domiciled at death in ~ ~, ~ ~ I~ ~~/~" ~ Count~, ?nngylvania, with
h ~ ~- last family or prin, cfl~l residen,.$.e at ~ q ~ ~ ~ c~ ~ ~C ~ ~
(list street, number and muncipality)
Decendent, then~~ years of age, died. ~-~ ~V ~00~
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property $ t0~0~G
(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:
WHEREFORE, petitioner(s) respectfully request(s),the probatel of the last will and codicil(s)
presented herewith and the grant of letters '
(testamentary; administratibn c.t.a.; administration d.b.n.c.t.a.)
theron.
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ~1
COUNTY OF ~ u ~,¥~ \ c~ ~ ~ f ss
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 represen-
tative(s) of the above decedent petitioner(s) will well at~! truly administer the estatq according to law.
Sworn to or affirmed~nd subscribed '~'~;~ ~ '~"(~:.~
b~ore me this /~ day ~ ' ~.~',~a ~"- . ~.~?~.~dL ~
Register-- ~
No. 21-03-40
Estate Of DOROTHY B. HEISEY , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW JANUARY 16, Y~j[ 2003, in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated AUGUST 27, 1997
described therein be admitted to probate and filed of record as the last will of
DOROTHY B. HEISEY ;
and Letters TESTAMENTARY
are hereby granted to SANDRA F. HOCKENSMITH AND RONALD R, HEISEY
FEES
Probate, Letters, Etc .......... $ 200.00
Short Certificates(5) .......... $ 15.00 ATTORNEY (Sup. Ct. I.D. No.)
JCP $ 10. O0 ADDRESS
TOTAL , $ 231.00
Filed ...J..ALq. U..A~..Y.. 1..6,..2. Q.0.3 .............. PHONE
MAILED TO EXECUTRIX JANUARY 17, 2003
This is to certify that the information here given is correcdy copied fi'om an original cc-rtificatc of death dt,lv filed with mc as
I.ocal Registrar. The original certificate will be. forwarded to the State Vital Records Office fi~r permancn~ fiiing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
/~ ~,,~ ~ ~_~ ~ Local Registrar
P 8869784 '~'*~ .... ~'"
~a~ ~ DE C 3 0 2002
No. ~ Date
mos.;,,,3 R~ z.'a7 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
,,.-t CERTIFICATE OF DEATH
' · I,F
,,- Clerk I~surance Co. ,,.
~u~ Pa ~ ,,,.~.~ Lower Frankford
2 ?q Mohawk Rd.
,, Newvtlle ~--*' ,,.~ Cumb ~, ~.~
,,. Arthur Lerov Brown
~.,~o,~v.~,; ,,. Ottie J. Wa~ner
~ ~ndva J. Mockensm~th [~70 Mohawk Rd, Newville, pa.
~ ~ ~[,~ec 30 2002 [~reentree Cern. [~ncaster, Pa.
.... ~er Funeral Home in~
~ ~ ~ 0 ~ 0 0 ~,~,~ O
21-03-40
LAST WILL AND TESTAMENT
I, DOROTHY B. HEISEY, of Lower Mifflin Township, Cumberland County,
Pennsylvania, declare this instrument to be my Last Will and Testament, hereby expressly
revoking all Wills and Codicils heretofore made by me.
ONE: I direct my Co-Executors to pay all of my debts, funeral and administrative
expenses as soon as may be done conveniently after my decease.
TWO: I give, devise and bequeath all of my estate of every nature and wherever situate
to the following:
a. To LINNETTE CHAREE FANUS ................... 5 %;
b. To SANDRA F. HOCKENSMITH ................. 47.5 %;
c. To RONALD R. HEISEY ........................ 47.5 %.
If LINNETTE CHAREE FANUS has predeceased me, her share will be distributed to
SANDRA F. HOCKENSMITH. If SANDRA F. HOCKENSMITH has predeceased me, her
share will be distributed to her husband, JOHN R. HOCKENSMITH. If RONALD R.
HEISEY, has predeceased me, his share will be distributed to his wife, LORRAINE HEISEY.
THREE: I nominate and appoint my two children, SANDRA F. HOCKENSMITH
and RONALD R. HEISEY, to serve as Co-Executors of this my Last Will.
FOUR: My Executors may, at their discretion, compromise claims, borrow money,
retain property for such length of time as they may deem proper; lease and sell property for such
prices, on such terms, at public or private sales, as they may deem proper; and invest estate
property and income without restriction to legal investments.
FIVE: No Executor acting hereunder shall be required to post bond or enter security in
this or any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~f~day of
August, 1997.
_~~__.(SEAL)
Signed, sealed, published and declared by DOROTHY B. HEISEY, the above named
Testatrix, as and for her Last Will and Testament, in the presence of us, who, at her request and
in her presence and in the presence of each other have subscribed our names as witnesses hereto.
A CKNO WLEDGMENT AND AFFIDAVIT
WE, DOROTHY B. HEISEY, CHERYL L. CLELAND and MARTHA L. NOEL,
thc testatrix and witnesses respectively, whose names arc signed to thc foregoing instrument,
being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed
and executed thc instrument as her Last Will and that she had signed willingly, and that she
executed it as her free and voluntary act for the purpose herein expressed, and that each of the
witnesses, in thc presence and hearing of thc testatrix, signed thc Will as a witness and that to thc
best of their knowledge the testatrix was, at that time, eighteen years of age or older, of sound
mind and under no constraint or undue influence.
1V~hT~IA ~iNOEL "
COMMONWEALTH OF PENNSYLVANIA :
: SS:
COUNTY OF CUMBERLAND :
Subscribed, sworn to and acknowledged before me by, DOROTHY B. HEISEY, the
testatrix herein and subscribed and sworn to before me by CHERYL L. CLELAND and
MARTHA L. NOEL, witnesses, this 27T~day of August, 1997.
Notarial Seal
Betzi A. Morrison, Notary Public
Carlisle Boro, Cumberland County
My Commission Exp~es Dec, 15, 2000
Member, Pennsylvania Asscciation of Notaries
DOROTHY B. HglSEY
LAW OFFICES
IRWIN, MCKNiGHT & HUGHES
WEST POMFRET PROFESSIONAL bUILDing
60 WEST POMFRET STREET
CARLISLE, PENNSYLVANIA 17013-3222
(717) 249-2353
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: ,x~/9 it~O -~7 ~,
Date of Death: I L/~/~(~ ~~' '
Will No. 7~/ ~ ~)3--~)t5)~r25) Admin. No.
To the Register:
I certify that notice of (beneficial inter~t) 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 ~//Z-V'~d2y -
Name Address
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date: ~~2(j')('~ ~Sign ~ ~t~. Name
Address
~ ' ~'~ ,~l~
' ~ ? Telephone ~{~
.....
:;.: .:~:, ~ -~:::: ~ Capacity: sonal Representative
Counsel for personal representative
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: ~ ~' C~"~c~ \,~ ~ ~'~ ~ ~ ~-> ~!~
Date of Death: ~ ~'C~'-~3 ~1 C} ~_
WillNo. ~- 5~" ~~q ¢ Admin. No.
To the Register:
I cemify ~at notice of (beneficial interest) es~te ad~ffistration required by Rule 5.6(a) of the OmlansLCoun Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on ~/0- ~/~ :
Name Address
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
/ V"' ~"
Signature
Name '~s ~30~ {' a f'' /'JO~.k ~ k ~ ~
r"- Address ~6 ~ ~ O ~'~ ~
":~ 5 :.5 ~ ':2~"' ~" Capacity: Personal Representative
Counsel for personal representative
~ COMMONWEALTH OF
~*~,, ~ PENNSYLVANIA
~j~:~'~ DEPARTMENT OF REVENUE
DEPT. 28060 INHERITANCE TAX RETURN
~.~ff~..~ HARRISBURG, PA 17128-0601 RESIDENT DECEDENT OUNTY
DECEDEN%S NAME (LAST, FIRST, AND MIDGE INITIAL) . ~ SOCIAL SECURITY NUMBER
DATE O~ DEAT~ (MM-Dp-YEA~) ~ ' ~ DAT~OF DIRT) (M~-D~YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
(IF APPLICABLE) S~VIVING SPOUSE'S NAME (LAST, FIRST, AN~IDDLE INITIAL) SOCIAL SECURI~ NUMBER
~ Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82)
~ 4. L m ted Estate ~ 4a, Future Interest Compromise (date of death after 12-12-82) ~ 5. Federal Estate Tax Return Required
~ 6, Decedent Died Testate (Anach copy of WEll) ~ 7. Decedent Maintained a Living Trust (Aaach copy of Trust) 8. Total Number ui Safe Deposit
Boxes
~ 9. Litigation Prooeeds Received ~ 10. Spousal Pove~y Credit (date of death between 12-3¥91 and 1-1-95) ~ 11. Bection to tax under Sec. 9i13(A)(A~ach Sch O)
COMPLETE MAILING ADDRESS
t 930 '
1. Real Estate (Schedule A) (1) .. <
2. Stocks and Bonds (Schedule B) (2) ~i .... / ~'~' ~
3. Closely Held Corporation, Pa~nership or Sole-Proprietorship (3)
4. Modgages & Notes Receivable (Schedule D) (4) ~0 O' O0
5. Cash, Bank Deposits & Miscellaneous Personal Prope~y (5) ~, 7 / ¢, ¢~
(Schedule E) ~¢ ]~ ~
6. Jointly Owned Prope~y (Schedule F) (6) , ¢
~ Separate Billing Requested i t
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Prope~y (7) L
(Schedul~ G or ~)
8. Total Gross Assets (total Lines 1-7) ~)~3¢ ¢~ (8)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
11. Total Deductions(total Lines 9 & 10) (11)
12. Net Value of Estate (Line 8 minus Line 11) (12)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13)
made (Schedule J)
14, Net Value Subject to Tax (Line 12 minus Line 13) (14)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE ~TES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2) ~ ~ x.O__ (15)
16. Amount of Line l4 taxable at lineal rate ~( ~' ~ x.0 ~ (16)
17. Amount of Line 14 taxable at sibling rate x .12 (17)
18, Amount of Line 14 taxable at collateral rate x .15 (18)
19. Tax Due (19)
Decedent's Complete Address:
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19) (1) ~
2. Credits/Payments
A. Spousal Pove~y Credit
B. Prior Payments
C. Discount
Total Credits ( A + B + C ) (2)
3. InteresFPenalty if appli~ble
D. Interest
E. Penalty
Total InteresFPenalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the T~ DUE. (5)
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) ~1 ¢~' ~'~
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
a. retain the use or income of the prope~y transferred; ..........................................................................................
b. retain the right to designate who shall use the prope~y transferred or its income; ............................................
c. retain a reversiona~ 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 properly 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 prope~y which
contains a beneficia~ 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 perju~, 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 prep~ other than the personal ~sentati~s based on all information of which preparer has any knowledge.
SIGNATU~PERSgN ~SPO~L~ ~ILING RETURN DATE
J,
ADDRESS ~ ' 'x ~ ' ~ / / ~ /
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE 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)
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
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 paren
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.§%, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as a~
individual who has at least one parent in common with the decedent, whether by blood or adoption.
~,.,~,.,,~7~ ~ SCHEDULE B
,:O~ON~'~LTH O~ ~ENNSYLV^N,^ STOC KS & BON DS
iNHERITANCE TAX RETURN
RESIDENT DECEDENT
~TEM VALUE AT DATE
N~JMBER DESCRIPTION OF DEATH
TOTAL (AIso enter on line 2, Recapitulatior}) $ "~) ~"~,
more space ts needed, insert ad0itional sheets of the same s~ze)
REV-1507 EX* (6-98)
,.~ SCHEDULE D
COMMONWEALTH OF PENNSYLVANIA MORTGAGES & NOTES
INHERITANCE TAX RETURN RECEIVABLE
RESIDENT DECEDENT
ESTATEOF? Pi P / / _' FILE NUMBER
~TEM /Alt prope~y jointly-owned with rig~f su~Jvorship must be disclosed on Schedule F.
NUMBER DESCRIPTION VALUE AT DATE
OF D~TH
TOTAL (Also enter on line 4, Recapitulatio¢) $ ~
more space ~s needed hqsed additronal siqeets of the same s~ze)
"~~'t~~ SCHEDULE E
:~,,,o~,,'~'-.'-.~_~s~..v~,,~ CASH, BANK DEPOSITS, & MISC.
~E~OE~' ;ECE;E~;~ PERSONAL PROPERTY
mclboe the ~ b I d the pr were recewed by the~state All prope~ jointly-owned with the right of su~ivorship must be disclosed on Schedule F
-~.'
VALUE AT DATE
"?/BER ~ DESCRIPTION OF DEATH
/.~
more space ~s needed ~nserl addil~ona~ sheels of the same s~ze)
~'~ I SCHEDULE F I
COMMONWEALT~OEPENNS~V^N,A I JOINTLY-OWNED PROPERTY
If an asset was made joint ~thin ne year of the decedent's date of d~, ~ must be reposed on Schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RE~TIONSHIP TO DECEDENT
C
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY
ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number Attach DATE OF DEATH % OF DATE OF DEATH
NUMBER TENANT JOtNT deed for jointly-held real estate DECD'S VALUE OF
VALUE OF ASSET INTEREST DECEDENT'S INTERESt
(If more space is needed in,¢~ 2dditlm~l ok~¢ ~¢ ~ ..........
the same s~ze)
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
~NHER,TANCE TAX RETU.N ADMINISTRATIVE COSTS
RESIDENT DECEDENT
Debts of decedent must b~ reported on Schedule I. /
ITEM
NUMBER DESCRIPTION AMOUNT
A FUNERAL EXPENSES:
1
ADMINISTRATIVE COSTS:
Personal RepresentatJve's Commissions
Name of Personal Representative (s)
Social Secunty Number(s) 1 EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
Attorney Fees
Family Exemption: (If decedent's address is not the same as claimant% attach explanation)
Claimant
Street Address
City State ~ Zip
Relationship of Claimant to Decedent
Probate Fees ,~ '"'~ /, O~)
Accountant's Fees
Tax Return Preparer's Fees ¢~, 00
TOTAL (Also enter on line 9, Recapitulation)$
(if more space is needed, insert additional sheets of the same size)
' q SCHEDULE I
CO'~'O~','~',EALTH OF PENNS~LWN,;, DEBTS OF DECEDENT,
~s,~o~c~ MORTGAGE LIABILITIES, & LIENS
Include unr ' r dical expenses.
ITEM
NUMBE~ DESCRIPTION AMOUNT
1
(If more space is needed, ~nsert additional sheets of the same size)
COMMONWEALTH OF PENNSYLVANIA l BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDF IF PERSON(S) RECEIVING PROI Do Not List Trustee(s) OF ESTATE
|. TAXABLE DISTRIBUTIONS (include outright spousal distributions)
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINE~, 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
[[. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1,
TOTAL OF PART ~'1'. 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)
COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIWDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 003043
HOCKENSMITH SANDRA F
270 MOHAWK ROAD
NEWVILLE, PA 17241
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
........ fold ..........
101 $2,833.69
ESTATE INFORMATION: SSN: 196-14-5423
FILE NUMBER: 2103-0040
DECEDENT NAME: HEISEY DOROTHY B
DATE OF PAYMENT: 09/22/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 12/27/2002
TOTAL AMOUNT PAID: $2,833.69
REMARKS' SANDRAFHOCKENSMITH
CHECK# 550
INITIALS: JA
SEAL RECEIVED BY: DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
COHHONNEALTH OF PENNSYLVANIA
BUREAU OF INDIVIDUAL TAXES DEPARTNENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 1712~-0601 NOTICE OF /NHERZTANCE TAX
APPRAISEHENT, ALLOHANCE OR DISALLOHANCE
OF DEDUCT/ONS AND ASSESSNENT OF TAX REV-1E4?EX&FP(01-OS)
DATE 11-10-2005
ESTATE OF HEISEY DOROTHY
DATE OF DEATH 12-27-2002
FILE NUHBER 21 03-0040
"' '~'; COUNTY CUHBERLAND
RONALD HEISEY ACN 101
1930 VICKI DR I Aaoun~ ReeX~ed
YORK PA 17403 '
I
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGISTER OF HILLS
CUN~ERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THZS LZNE ~ RETAIN LO#ER PORTZON FOR YOUR RECORDS
REV-1547 EX AFP (01-03) NOT/CE OF INHERITANCE TAX APPRAZSENENT, ALLO#ANCE OR
~DZSALLO#ANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF HEZSEY DOROTHY B FILE NO. 21 03-0040 ACN 101 DATE 11-10-2003
TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATZON CONCERNZNG FUTURE ZNTEREST- SEE REVERSE
APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Es~a~e (Schedule A) (1) .00 NOTE: To Ansure proper
2. S~ocks and Bonds (Schedule B) (2) 201103.42 credl~ *o your accoun*,
$. Closely Held S~ock/Par*nership In~eres~ (Schedule C) ($) .00 subei~ ~he upper pore/on
4. Hor~gagas/No~es Rece/vable (Schedule D) (q) 7;700.00 of ~h/s form w/~h your
$. Cash/Bank Deposits/H/sc. Personal Proper~y (Schedule E) ($) 5z414.43 ~ax payment.
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7) .00
8. To~el Asse~s (8) 71,400.$$
APPROVED DEDUCTIONS AND EXEHPTZONS: 6,339.90
9. Funeral Expenses/Ada. Costs/H/sc. Expenses (Schedule H) (9)
10. Deb~s/Hor~gage L/ab/1/~ies/L/ens (Schedule I) (10) 2,089.51
11. To,al Deductions (11)
12. Ne~ Value of Tax Re~urn (12) 62,970.92
15. Char/*able/Governman~al Bequests; Non-elected 9115 Trusts (Schedule J) (15) .00
14. Ne~ Value of Es~a~e Sub~ec~ *o Tax (14) 62,970.92
NOTE: Zf an assessment ~as lssued previously, lines 14, 15 and/on 16, 17, 18 and 19 ~ill
reflect flgures that lnclude the total of ALL returns assessed to date.
ASSESSNENT OF TAX:
15. Aeoun~ of L/ne 14 a~ Spousal ra~e (15) .00 X O0 = .00
16. Aeoun~ of LAne 14 *axable a* Lineal/Class A ra~e (16). 62,970.92 X 045 = 2,833.69
17. Amoun~ of Line 14 a~ S/bl/ng ra~e (17) .00 X 12 = .00
18. Aeoun~ of Llne 14 ~exeble a~ Collateral/Class B ra~e (18) .00 X 15 = .00
19. Pr/nc/)al Tax Due (19)= 2,833.69
TAX CREDITS=
PAYHENT RECEIPT D/SCOUNT (+) ANOUNT PAID
DATE NUNBER INTEREST/PEN PAID (-)
09-22-2003 CD003043 .00 2,833.69
TOTAL TAX CREDITI 2,833.69
BALANCE OF TAX DUEl .00
INTEREST AND PEN. .00
TOTAL DUE . O0
IF pAID AFTER DATE INDICATED, SEE REVERSE ( ZF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REi)UIRED.
FOR CALCULATTON OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.)
RESERVATION: Estates of decedents dying on or before December ZZ, 1982 -- if any future interest in the estate is transferred
in possession or anjoyaent to Class D (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the Zamfut Crass B (collataral) rate on any such future interest.
PURPOSE OF
NOTICE: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act E5 of 2000. (TI P.S.
Section 9140).
PAYHENT: Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side.
--Hake check or money order payable to: REGISTER OF.HILLS, AGENT
REFUND (CR): A refund of a tax credit) which was not requested an the Tax Return, may bm requested by completing an "Application
for Refund of Pennsylvania Xnharitanca and Estate Tax" (REV-1315). Applications are available at the Office
of the Register of Hills) any of the 25 Revenue District Offices) or by calling the special Z4-hour
answering service for forms ordering: l-BGO-36Z-Z050) services for taxpayers Hith special hearing and / or
speaking needs: 1-800-447-S020 iTT only).
OBJECTIONS: Any party in interest nat satisfied with the appraisement, allowance, or disalloHanca of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object Hithin sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. ZSIOZ1, Harrisburg, PA 171Z8-10Z1, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
ADMIN-
ISTRATIVE
CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. ZSO601, Harrisburg) PA 171E8-0601
Phone (717) 787-6505. Sam page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-15Ol) for an explanation of administratively correctable errors.
DISCOUNT: Zf any tax due is paid within three (33 calendar months after the dacadant's death, a five percent (SI) discount of
the tax paid is allowed.
PENALTY: The 15Z tax amnesty non-participation penalty ts computed on the total of the tax and interest assessed, and not
paid be~oro January 18, 1996, the first day after the and of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the tho same tiaa period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
INTEREST: Interest is charged beginning Hith first day of delinquency, or nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January l, lgSZ bear interest at the rate of
six ESl) percent par annum calculated at a daily rate of .OO016q. AIl taxes Hhich became delinquent on and after
January 1, 198Z will bear interest at a rate which Hill vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOOS are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Yea.~r Rate Factor Year Rate Factor
1982 ZOZ .000548 1987 9g .000247 1999 77. . Ooozez
1983 16Z .000458 1988-1991 11Z .O0030X ZOOO 8Z .O00Z19
198~ ZZZ .000301 199Z 97. .000Z47 2001 97. .000Z47
1985 13Z .000356 1993-1994 77. .00019Z ZOOZ 6Z .00016a,
1986 1gl .000Z74 1995-1998 97. .000Z47 ZOO3 5Z .000137
--Interest is calculated as follows:
TNT(REST = BALANCE OF TAX UNpATD X NU~IBER OF DAYS DELTNQUENT X DALLY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent aill reflect an interest calculation to fifteen El5) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest lust be calculated.
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 11/10/2004
HOCKENSMITH SANDRA F
270 MOHAWK ROAD
NEWVILLE, PA 17241
RE: Estate of HEISEY DOROTHY B
File Number: 2003-00040
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: 12/27/2004
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Counsel
Judge