HomeMy WebLinkAbout03-1074 PETITION FOR PROBATE and GRANT OF LETTERS
Estate of'l~,J~-T~l_~x~ ~, ~]1~_1~ No..~-/--~- /t~7'~
also known as
Social Security No. t qB- ~ ~. - .~ ~D~c~sed.
To:
Register of Wills for the
County of/~l.lllflgtE]2/../l~
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitionergq, who is/a~ 18 years of age_ or ol~er an Ihe execut f' I ~
~-.:in the__last4, ,,._,will of.,_.the~ above decedent, dated ~ ~ ~ .'~---~A ~ ~
in the
named
,19'~. I
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in ~ ~1/~ ~' [ dS IflA .CounLY, Pennsylvania, wi~h
h ~ ~ last family or principal residence at
(list street, number and muncipality)
Decgqdeqt, then
Except as f$llows, decedent did not ~arry, wa~not divorced ~nd did not have a child born or aoptefi
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 $
(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: /k~ C~t,~ ~'
WHEREFORE, petitioner~ respectfully request(s_~.th_e probate of [he last will and
presented herewith and the grant of letters -1 ~ ~ g'~ ~1
theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF
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 and truly administer the estate according to law.
Sworn to or affirmed and subscribed
_be-sl~re me this k ;:::~'~et' day of
Estate 0f ~_ 7-,~,¢9~,F. /97 /~/oo~,,~ . , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated
described therein be admitted to probate and filed of record as the last will of
and Letters - ! ~'_~-r-m
are he. reby.granted to
~ in.consideration of the petition on
FEES
Probate, Letters, Etc ..........
Short Certificates( ) ..........
Re~unctatlon ................
~ TOTAL
ATTORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Re, gistrar. 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.
Local Registrar
P 9 6 4 0 913 ~ ~ ~"~~ ...¢,~,,. ~,~
No. ~ Date
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH * VITAL RECORDS
CERTIFICATE OF DEATH
i_._ ~erine M. H~ver -F~le
,. ~nlcsb~g, PA 17050 I~.,~
,,. Pa~
,,. Elsie Goodman
~. 3 W'hite Oak Blvd, Mochanicsb~q, PA 17050
Ia,. ~-014889
[m.~l~zzi 8 ~ plato ~
,~,. Judy K. Hoover
LAST WILL AND TESTAMENT
OF
KATHERINE M. HOOVER
I, KATHERINE M. HOOVER, of Allegheny Township, Blair
County, Pennsylvania, do hereby make this my Last Will and
Testament, hereby revoking any and all Wills and codicils at any
time heretofore made by me.
FIRST: I direct that the expenses of my last illness
and funeral be paid out of my estate as soon as may be convenient
after by death.
SECOND: I give and bequeath my tangible personal
property in equal shares to my daughters who survive me.
THIRD: Ail the residue of my estate I give to my
daughters, JUDY K. HOOVER, PATRICIA E. HOOVER and ANITA H.
ARBAGAST, the share of any daughter who predeceases me to go to
her issue who survive me per stirpes or, if she has none, to be
added to the share of the others. If I am not survived by any of
my issue, I give said residue to those persons who would be
entitled thereto if I had died intestate, unmarried and domiciled
in the Commonwealth of Pennsylvania.
For the purposes of this Will, adopted children shall
be considered the natural children of the adopting parents,
regardless of the date of adoption.
FOURTH: I hereby name and appoint my daughter,
JUDY K. HOOVER, Executrix of this my Will. If she is unable or
unwilling to act, I name and appoint my daughter, PATRICIA E.
HOOVER, Executrix. I give my Executrix, in addition to the
authority conferred by law, the power to sell any or all of my
property, real or personal, at public or private sale, at such
time and for such price and upon such terms and conditions as
they may see fit, or in their discretion to retain the same for
distribution in kind, and the power, but not the duty, to invest
any cash without being limited to "legal" investments.
No bond shall be required of any fiduciary hereunder in
any jurisdiction.
FIFTH: I appoint my daughter, JUDY K. HOOVER,
guardian of the estate of any minor child receiving any sums of
money, real property, or other intangible personal property by
- 2 -
reason of my death, and I authorize said guardian, in her sole
discretion and without order of court, to retain such property in
kind or sell the same, giving good title to any real estate, to
invest and reinvest without being limited to "legal" investments
and to use both income and principal for the minor's welfare,
comfortable support and education, including college expenses.
SIXTH: I direct that all estate, inheritance and
other taxes in the nature thereof, together with any interest and
penalties thereon, becoming payable because of my death with
respect to the property constituting my gross estate for death
tax purposes, whether or not such property passes under this
Will, shall be paid from the principal of my residuary estate;
and no person receiving or having a beneficial interest in any
such property, whether under this Will or otherwise, shall at any
time be required to contribute to or refund any part of such
taxes.
seal this
IN WITNESS WHEREOF, I have hereunto set my hand and
~ (/~ day of .~:~..~ 19~ ~
Katherine M. Hoover
(SEAL)
Signed, sealed, published and declared by
KATHERINE M. HOOVER, the Testatrix above named, as and for her
Last Will and Testament in the presence of us, who, at her
request, in her presence and in the presence of each other, have
hereunto subscribed our names as witnesses hereto.
Address:
- 4 -
Subscribed, sworn to and acknowledged before me by
KATHERINE M. HOOVER, the Testatrix, and subscribed and sworn to
b~f~e me by~7~ ~. ~~ , ~~/7~/~. ~ ~--~dL~9 and
~-.~ ............ , witnesses, this ~ ~ ' day of
/ Notary Pu/Dlic
My Commission Expires:
~ , / .;,T~I~,L SEAL ........ ' ....
i m~ m ~u ~ ~t~c
STATE OF PENNSYLVANIA )
)
COUNTY OF BLAIR )
ss:
We, KATHERINE M. HOOVER, ,i · _ ,
the Testatrix and the witnesses, respectively, whose names are
signed to the attached or foregoing instrument being first duly
sworn, do hereby declare to the undersigned authority that the
Testatrix signed and executed the instrument as her Last Will and
Testament and that she signed willingly, and that she executed it
as her free and voluntary act for the purposes therein expressed,
and that ~ach of the witnesses, in the presence and hearing of
the Testatrix, signed the Will as witness and that to the best of
his knowledge the Testatrix was at that time eighteen year of age
or older, of sound mind and under no constraint or undue
influence.
Katherine M. Hoover
(._ness - ~-U
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Kff~a~ir~ M. Hoover'
Date of Death:
10-23-03
Will No. 21-03-1074 Admin. No. 21-03-1074
To the Register:
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 !!-3-03 :
Name Address
Judy Hoover 3 White Oak Blvd., Mechanicsburg, PA 17050
Patricia Varner 2685 Highbrooke Trail, Duluth, GA 30097
Anita Arbogast 31 Royal Palm Drive, Mechanicsburg, PA 17055
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Not App] icabl e
Date: April 20, 2004
Name Judy Hoover
Address 3 White Oak Blvd
Capacity: __
Mechanicsburg, PA 17050
Telephone ( ) (717) 697-0452
Personal Representative
__Counsel for personal representative
Executrix of the Estate of Katherine M. Hoover
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX(11-96)
NO. CD 004201
HOOVER JUDY K
3 WHITE OAK BLVD
MECHANICSBURG, PA
17050
........ fold
STATE INFORMATION: SSN: 193-24-3735
FILE NUMBER: 2103- 1 074
)ECEDENT NAME: HOOVER KATHERINE M
DATE OF PAYMENT: 07/27/2004
POSTMARK DATE: 07/24/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 10/23/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101
$287.69
TOTAL AMOUNT PAID:
$287.69
REMARKS:
· SEAL
CHECK#4971
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
REV-1500 EX (6-00)
~ COMMONWEALTH OF
~ PENNSYLVANIA
.~.f~~~ DEPARTMENT OF REVENUE
~'~1~,-,-~~ ~ DEPT. 280601
*'~ HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
t o 7'-/
COUNTY CODE YEAR NUMBER
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
U.I ~TE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
~ THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
UJ J ~ - ,,3,,3 '~;:,..~ ~,,~ - L.~ J ' ,~.,.-5' REGISTER OF WILLS
Iii (iF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INiTiAL) SOCIAL SECURITY NUMBER
[~/1. Odginal Retum
[--"~ 4. Limited Estate
6. Decedent Died Testate (AUach c~py of Will)
[~9. Litigation Proceeds Received
~--~ 2. Supplemental Return
~---] 4a. Future Interest Compromise (da~e of death after 12-12-82)
E~]7. Decedent Maintained a Living Trust (Altac~ copy of Trust)
[~10. Spousal Povedy Credit (date of daath belween 12-31-91 and 1-1-95)
[~3. Remainder Return (date of death pdt- to 12-13-82)
[~5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
E~11. Election to tax under Sec. 9113(A) (^Uach Sch O)
FIRM NAME (If Applicable)
TELEPHONE NUMBER
-/~-'r-
COMPLETE MAILING ADDRESS
,3 ~J~ t--re__, c,~t< ~LVb.
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Paanership 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) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Govemmental 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)
~.3, gS&. 13
(8)
$8.~7
(11)
(12)
(13)
&~l~ £77. ~7
(14)
ql . gS'
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
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
x .12
.............. x .15
20. []
(15)
(16)
(17)
(1~)
(19)
Decedent's Complete Address:
STREET ADDRESS
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Povedy Credit
B. Prior Payments
C. Discount
Interest/Penalty if applicable
D. Interest
E. Penalty
PA
(1)
Total Credits ( A + B + C ) (2)
Total Intarest/Penalty ( D + E )
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
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(3)
(4)
(5)
(5A)
(5B)
A. Enter the interest on the tax due.
2, O. eo
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
IF 'I'HE ANSWER
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? ...................................................................... []
If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ......................... []
Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. []
Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ ~ []
TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete.
Declaration of preparer olher than the personal representative is based on all informalion of which preparer has any knowledge.
SIGNATURE F PE ON RESP .IBLE FILING RETURN
SIGNA'I:URE OF PREPARER OTHER THAN R'E-PRESENfATIVE
DATE
"7 - z..z, - ,./--
DATE
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 return are still applicable even if
the surviving spouse is the only beneficiary.
For datas 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 slepparent 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 RS. §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 sibJing is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1508 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
k'^T~, E~-.. ~ ~ F-.
FILE NUMBER
21 -03
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION
TOTAL (Also enter on line 5, Recapitulation) $
VALUE AT DATE
OF DEATH
q~.q7
/,7~ ~-9~
ClqL. 7(
(If more space is needed, insert additional sheets of the same size)
REV-1509 EX+ (6-98~
'~'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATEo[/^TH EI~//-J · FILE NUMBER
~ F'I t--I~,:=v~P-- vq I - o~ - lo7~
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT{S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A.
OA
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
ITEM FOR .JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTfON AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST BECEDENT'S INTEREST
33
O/3
:2:2..
~'T,/x3A V~ ~
lq~q.
~//~ ~'"~ore space is needed, insed additional sheets of the same size)
REV-1511 EX+ (12-99).~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
iTEM
NUMBER
5.
6.
7.
FILE NUMBER
Debts of decedent must be reported on Schedule I.
DESCRIPTION
FUNERAL EXPENSES:
ADMINJST~TIVE COSTS: F~ ~ ~ L ~ ~
Name of Personal Representative(s) J ~ ~ IT H F~ ~A ~
Social Securi~ Number(s)/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's, attach explanation)
Relationship of Claimant ,o Decedent ~ A L~ ~ ~,.I-'T~---"'~
Probate Fees
Accountant's Fees
Tax Retum Preparer's Fees
TOTAL (Also enter on line 9, Recapitulation)
AMOUNT
s II
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX+ (12-03)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
-
Re
ITEM
NUMBER
=ort debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
DESCRIPTION
TOTAL (Also enter on line 10, Recapitulation) $
VALUE AT DATE
OF DEATH
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX+ (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
W'AT~ ~AI N ~
FILE_NUMBER
NUMBER
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
3-'u W..
A ~ F'FA H · A P-- £~ 4.A 5T
51 i~,,/AU p^L. Fv~
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
DA u F.,/-t T~zF--
AMOUNT OR SHARE
OF ESTATE
3'{ ,tO
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
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, insed additional sheets of the same size)
BUREAU OF ZNDZVIDUAL TAXES
I'HHERTTANCE TAX DI'VZSZON
DEPT. Z80601
HARRISBURG, PA 17126-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLONANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
REV-1Sq7 EX AFP
JUDY K HOOVER
$ WHITE OAK BLVD
HECHANZCSBURG
17050
DATE 11-08-200q
ESTATE OF HOOVER
DATE OF DEATH 10-25-2005
FZLE NUMBER 21 05-107q
COUNTY CUHBERLAND
ACN 101
Amount Ram/"c~ed
KATHERINE H
HAKE CHECK PAYABLE AND REMIT PAYHENT TO:
REGISTER OF WILLS
CUH)ERLAND CO COURT HOUSE
CARLISLE, PA ITOI)
CUT ALONG THZS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HOOVER KATHERINE HFZLE NO. 21 05-107~ ACN 101 DATE 11-08-200~
TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (ScheduZe B) (2)
$. Closely Held Stock/Partnership Interest (Schedule C) ($)
q. Mortgages/Notes Rece/vabla (Schedule D) (q)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5)
6. Jo/ntly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expansas/Adm. Costs/M/sc. Expenses (Schedule H) (9)
10. Debts/Mortgage L/ab/lit/es/L/ans (Schedule I) (10)
11. TotaZ Daduct/ons
12. Net Value of Tax Return
.00
.00
.00
.O0
25z656.15
q5~gz1.5q
.00
(8)
11,178.55
988.q7
NOTE: To /nsure proper
cred/t to your account,
subm/t the upper port/on
of this form w/th your
tax payment.
13.
NOTE:
69,577.67
(11)
(12) 57,q10.65
Char/table/Governmental Bequests; Non-alacted 9115 Trusts (Schedule J) (15)
Nat Value of Estate Subject to Tax (lq)
Ze an assessment was issued previously, lines 14, 15 and/or 16, 17,
reelect figures that lnclude the total of ALL returns assessed to date.
ASSESSHENT OF TAX:
1E. Amount of Line lq at Spousal rate
16. Amount of Line lq taxable at L/naal/Class A rate
17. Amount of Line lq at Sibling rata
18. Amount of L/ne lq taxable at Collateral/Class B rate
19. Pr/nc/pal Tax Due
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+J
DATE NUMBER INTEREST/PEN PAID (-)
01-Z~-200q CO005q78
07-2q-200q CD00q201
115.79
.03-
.00
57,q10.65
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
18 and 19 w111
(15) .00 x O0 = .00
(16) 57,q10.65 x Oq5= 2,58~5.q8
(17) .00 x 12 = .00
(18) . O0 x 15 = .00
(19)= 2,583.q8
AMOUNT PAID
2,200.00
287.69
TOTAL TAX CREDIT Z,60:~.q5
BALANCE OF TAX DUEI 19.97CR
INTEREST AND PEN. .
TOTAL DUE 19.97CR
( TF TOTAL DUE ZS LESS THAN $1, NO PAYMENT IS RE~UZRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDIT' (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR TNSTRUCTZONS.
RESERVATION:
PURPOSE OF
NOTICE:
PAYNENT:
REFUND (CR):
OBJECTIONS:
ADNIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December IZ, 198Z -- if any future interest in the estate is transferred
in possassion or enjoyment to Class B (collateraI) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Coamonaealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rata on any such future interest.
To fulfill tho requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act Z5 of ZOO0. (TZ P.S.
Section
Detach the top portion of this Notica and submit with your payment to the Register of NILls printed on tho reverse side.
--Hake check or money order payable to: REGISTER OF NILLS~ AGENT
A refund of a tax credit, which mas not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax'" (REV-13133. Applications are available at the Office
of the Ragistar of Nills, any of the Z3 Revenue District Offices, or by calling the spacial Z~-hour
answaring service for fores ordering: 1-800-36Z-ZO50; servicas for taxpayers mith spacial hearing and / or
speaking needs: 1-800-q~7-30ZO (TT only).
Any party in intarast not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest) as sho~n on this Notice must object within sixty (60) days of receipt of
this Notice by:
--~ritten protest to the PA Department of Revenue, Board of Appaals, Dept. Z810Z1, Harrisburg, PA 17IlS-lOll, OR
--alaction to have fha matter datarminod 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 Raview Unit, Dept. 280601, Harrisburg, PA 171Z8-0601
Phone (717) 787-6505. Sea page S of tha booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1SO1) for an explanation of administratively correctable errors.
If any tax dua is paid ~ithin three (3) calendar months after the decedent's death, a five percent (SI) discount of
the tax paid is allo~ed.
The 15g tax amnesty non-participation penalty is computad on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penaltY is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning ~ith first day of delinquancy, or nina (9) months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of
six (6Z) percent per annum calculated at a daily rate of .00016q. All taxes which became delinquent on and after
January l, 198Z Nil1 bear interest at a rate Nhich will vary from calendar year to calendar year with that rate
announced by tha PA Department of Revenue. The applicabla intarast rates for 198Z through ZOOq ara:
Interest Daily Interest Daily Interest
Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1981 ZOZ .0005fi8 '~'~&-1991 llZ .000301 ZOO1 9Z .O00Zq7
1983 161 .O00qS8 1991 9Z .0002~7 2OOZ 6Z .O0016q
1984 IIX .000301 1993-199q 72 .000191 2003 SZ .000157
1985 132 .000356 1995-1998 92 .OOOZ~7 ZOOq 42 .000110
1986 lOX .O00Z7q 1999 72 .000191
1987 lOX .O00Z7q ZOO0 7Z .000192
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPATD X NUNBER OF DAYS DELINI~UENT X DALLY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (1S) days
beyond tha date of the assessment. If payment is made altar the interest computation date shown on tho
Notice, additional interast must be calculated.
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
'*
REY-1U7 EX AFP 112-041
JUDY K HOOVER
3 WHITE OAK BLVD
MECHANICS BURG
("'?
('")
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
02-07-2005
HOOVER
10-23-2003
21 03-1074
CUMBERLAND
101
KATHERINE M
Allount Rellitted
PA 17050
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NoTE:Jo inSUf~~proper credit to your account, subllit the upper portion of this forll with your tax paYllent.
... ...... :,;.':: Cr.:'.;
clJTILONct;THIS gNj ... RETAIN LOWER PORTION FOR YOUR RECORDS .....
ftV :1'&TI"~.'(I!~..r8,..-.cr!,............"ARUfn~er"'l!c"~tAytAW1'.b'J!'.l~l!'crOW........................ ...
ESTATE OF HOOVER KATHERINE M FILE NO.21 03-1074 ACN 101 DATE 02-07-2005
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 11-01-2004
PRINCIPAL TAX DUE:.
2,583.48
PAYMENTS (TAX CREDITS):
~
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
01-23-2004 CD003478 115.79 2,200.00
07-24-2004 CD004201 .03- 287.69
01-24-2005 REFUND .00 19.97-
TOTAL TAX CREDIT 2,583.48
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
.
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
STATUS REPORT UNDER RULE 6.12
Name of Decedent t:.-r1.",',I.. M. hI.'lI<1&-
Date of Death:
Was there a will
/()..-3-o.J
County file number: 47- -'~o3 - () 10' Y
j,-..5
.
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. Is administration of the estate complete X 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 number I is Yes, state the following:
A. Did personal representative f1le a final account with the court? _Yes ~No
B. The separate Orphans' Court number, (if any) for the personal representative's
;( fA
,
account is
interest?
C. Did the personal representative state an account informally to the parties in
X yes no
D. Copies of receipts, releases, joinders and approvals of formal or informal
accounts may be f1led with the Clerk of the Orphans' Court and may be attached to this report.
Cc;)
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Si c'
Name j';./" doVc.I'-
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Address .1/,),4:"1"' 0"',1: ,/U./
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DATE: /(J' 7-0'>
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Phone ( ')1' )
Capacity 'X
personal representative
Counsel for personal
representative
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CERTIFICATE OF NOTICE UNDER RULE 5.6(a)
Name of decedent: kA-r"~.'~~ h.
Date of Death: I c) -~ 3 ..Cot
AIo 0 lie I'-
Soc Sec number "3 - ~V. ~ ,.JS-
"'d~3 .. ()/O?y
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I certifY that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court \
I
Rules was served on or mailed to the following beneficiaries of the above captioned estate on \
., -;Jil.d~-
Number assigned by Register of Wills #47
TO THE REGISTER OF WILLS:
Name
:r"~/'" ~vc. It.
./
s/,,: J;i ..J ../- 0 t4 "iI
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jJlf/.i.' t: .. 4 I4/fAlc. tfL
Address
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3 4,)./.~ O.f-t tI/u/ 11tc.<'''~' '#~'~,.p~ l?oS'O
3:1 4VAI AI" "'b~. /ltcc,("N':<1: '~91 J>19W"oS'('J
.:l~'S AI:., /jUti)t:. -tM./ z>../-r~'~ ..?~~r\;>
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III
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Notice has now been given to all persons entitled thereto under Rule 5.6(a) except:
Date: /o-'.o~-
~~~
Signaturt! . . /
Name ::r;. j 1/ ~ - I/c. .t..-
-'"
Address 3 /C)..t:-A CJf.t. iJh,./.
/#t.c },,,: ~"...ty,)>/I 17()~O
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Phone(?I' ) ~<J'-o~6-.A..
Capacity X Personal Representative
Counsel for Personal
Representative
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Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 9/15/2005
HOOVER JUDY K
3 WHITE OAK BLVD
MECHANICSBURG, PA 17050
RE: Estate of HOOVER KATHERINE M
File Number: 2003-01074
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. I, for decedents dying on or after
July I, 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 is due by: 10/23/2005
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
;?; . (~' .' ~JL~uJJ
~~.lJWulR~j~~
. 7
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Counsel
Judge
L-~