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HomeMy WebLinkAbout03-0105 Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of Irene R. Hippensteel No. ~ J" 0 ,~ ' 105 also known as , Deceased Social Security No. 205-09-9411 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE "A" OR "B" BELOW:) E A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut or named in the Last Will of the Decedent, dated 11/10/94 and codicil(s) dated State relevant circumstances, e.g., renunciation, death of executor, etc Except as follows, Decedent did not marry, was not divorced and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: B. Grant of Letters of Administration (c.t.a., d.b.n.c.t.a.: pendente lite, durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence at 620 N. Front Street, Wormleysbur~], PA 17043 (Borough/ (list street, number and municipality) Decedent, then 87 years of age, died Januan/21 ,200:3, at Holy Spirit Hospital (Location) Decedent at death owned property with estimated values as follows: (if domiciled in PA) All personal property ......................................... $ 110,916.00 (if not domiciled in PA) Personal property in Pennsylvania .................... $ (If not domiciled in PA) Personal property in County .............................. $ Value of real estate in Pennsylvania ........................................................................................ $ 78,584.00 Total ..................................................................................................................... $ 189,500.00 Real Estate situated as follows: 620 N. Front St., Wormleysburg, PA 17043 Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: Signature Typed or printed name and residence Ronald W. Hippenstee, 526 N. 2nd Street Wormleysburg, PA 17043 RW-7 Oath of Personal Representative Commonwealth of Pennsylvania County of The Petitioner(s) above-named swear(s) and 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 Decedent, Petitioner(s) will well and truly administer the estate according to law. " Sworn to and affirmed and subscribed before me this t day of . -- DECREE OF REGISTER Estate of Irene R. Hippensteel Deceased No. 21-03-105 also known as Social Security No: 205-09-9411 Date of Death: 1/21/03 AND NOW, Februar7 ,5th , 2003 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters ~] Testamentary I-I of Administration (c.t.a., d.b.n.c.t; pendente lite; durante absentia; durante minoritate) are hereby granted to Ronald W. Hippensteel in the above estate and that the instrument(s), if any, dated November 10, 1994 ..... ._ described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters .................................... $ 235.00 ~¢£,,,T'~z)/)').(~..)~ l~'b~zV ~.~ .~¢~.~Z.¢/~,,~-~-,..~ · -if'~ F R~gister of Wills ' ' if Shod Certificate(s) ...(.5.). ....... $ 1.5,00 Renunciation .......................... $ Affidavit ( ) ....................... $ Extra Pages ( 4 ) .............. $ Codicil ................................. $ JCP Fee ................................. $ 10.~i: ': :; .... "~" ! '~'~ Attornay: James D. Campbell, Jr., Esquire Inventory & Tax Forms ............. $ I.D. No: 07051 Other ...................................... $ Address: 3631 North Front Street Harrisburg PA 17110 TOTAL ............................. $ 272.00 Telephone: (717) 232-7661 MAILED LETTERS TO ATTORNEY 2-05-03 DATE FILED: FEBRUARY 5, 2003 MAILED SHORT CERTIFICATES TO EXECUTOR 2-5-03 RW-7A This is to certify that the infbrmation here given is correctly copied from an original Cel'tificate of death duh' filed with me as Local Registrar. The original certificate will be tbrwarded to the State Vital Record: Ofl]cc tbr permanent filing WARNING: It is illegal to duplicate this copy by photostat or photograph. COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH ,, VITAL RECORDS CERTIFICATE OF DEATH ~CE~ S USUAL ~U~ I KI~ ~ ~NES~IN~STRy ~ ~ OEC~N~ EVER IN ~ ~EDENT'S ED~AT~  CE~NT'S 620 N. Se~nd St. ,,. Wo~eysb~g, PA17043 ,~.~.~ ,,,~~ Wo~eysb~g ,,. ~ Foltz '~ .......... ~ ...... ~26 N. ~o~ St. ,Wo~leysb~g,PA~ 7043 ~ c,_,.~ .~.~,.a I,~f''~ I~~-,-,~.-,~.~,~ ~,~.c~.~...~.~ :~ta ~=~ ul,,J~.24,2oo3 I Rolling Gr~ ~t~ ]~r ~len ~.,PA17011 .......... I /~ NO~ ~ ~ ~ ~ ~ ~ ~lerm,n~ ~ I~'p~E ~ ImURY - ~ ~. fa*m. ~r~l. ~. o~e[~' M. . . 'MED~AL~AMINER/CORONE. jlem21}An~re~z.~. ~' Walker '"""""""~ ............................................................................................ ~ 108 Lowther Rd. Lemoyne,PA1 7043 21-03-105 21-03-105 LAST WILL AND TESTAMENT OF IRENE R. HIPPENSTEEL I, IRENE R. HIPPENSTEEL, presently of the Borough of Wormleysburg,, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare the following to be my Last Will and Testament, hereby revoking all former Wills by me at any time made. ITEM ONE: I direct that all my just debts and funeral expenses be paid as soon after my decease as may be practicable. ITEM TWO: I give, devise and bequeath the sum of $5,000 unto my granddaughter, Rhonda L. Strawser of New Cumberland, Pennsylvania. ITEM THREE: I give, devise and bequeath the sum of $5,000 unto my grandson, Michael B. Hippensteel of Enola, Pennsylvania. ITEM FOUR: I give, devise and bequeath the sum of $5,000 unto my grandson, Charles F. Johnson, III, of Hoboken, New Jersey. ITEM FIVE: I give, devise and bequeath the sum of $5,000 unto my grandson, Eric W. Johnson, of Richmond, Virginia. ITEM SIX: I give, devise and bequeath the sum of $5,000 unto my grandson, Douglas B. Johnson, of Camp Hill, Pennsylvania. ITEM SEVEN: I give devise and bequeath all the rest, residue and remainder of my property and estate, both real and personal, of whatsoever kind and wheresoever situated, unto my son, Ronald W. Hippensteel of Wormleysburg, Pennsylvania, and my daughter, Saundra L. Johnson, of Camp Hill, Pennsylvania, in equal portions, share and share alike, per stirpes. ITEM EIGHT: I direct that all taxes that may be assessed against my estate in consequence of my death, of whatever nature and by whatever taxing authority, shall be paid from my estate as part of the expenses of the administration of my estate without reimbursement or contribution from any beneficiary, legatee or devise. ITEM NINE: I hereby nominate, constitute and appoint my son, Ronald W. Hippensteel, to be the Executor of my estate with the power to sell all real and personal property at private or public sale. In the event my son shall not survive me, or shall otherwise fail to qualify as my Executor, I then nominate, constitute and appoint my daughter, Saundra L. Johnson, as Executrix, to serve in his place and stead. IN WITNESS WHEREOF, I, IRENE R. HIPPENSTEEL, the Testatrix, have to this my Last Will and Testament, written on one side only of three (3) sheets of paper, set my hand and seal this /~day of ~¢~ &~/ , 1994. Irene 1 Signed, sealed, published and declared as and for the Last Will and Testament of the Testatrix, in our presence; who in her presence, and in the presence of each other, and at hers request, have hereunto set our hands and seals as subscribing witnesses. ~ COMMONWEALTH OF PENNSYLVANIA : ., : SS. COUNTY OF DAUPHIN : I, Irene R. Hippensteel, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. SWORN OR AFFIRMED TO AND ACKNOWLEDGED, BEFORE ME THIS /~ DAY OF /~v ~ ~ , 19 9 4. -- - (N~R~UBLIC) MY COMMISSION EXPIRES: NOTARIAL SEAL EUNICE J. BURKET]', Notary Public Harrisburg, Dauphin County Commission Expires Feb. 4, 1997 G: \DATA\JDC\99999\900\39986.1 COMMONWEALTH OF PENNSYLVANIA: : SS. COUNTY OF DAUPHIN : We, ~ ~ ~-~-~-~ [/, ~f and ~ ~/~ ~.~ ~y~ , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testatrix sign and execute the instrument as her Last Will, that Testatrix signed willingly and that Testatrix executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to the best of our knowledge the Testatrix was at that time eighteen or more years of age, of sound mind and under no constraint or undue influence. SWORN OR AFFIRMED TO AND ACKNOWLEDGED, BEFORE ME THIS /~ DAY OF ~0~~ , 1994. (NOTAP6Y/PUBLI~) MY COMMISSION EXPIRES: i NOTARIAL SEAL EUNtCE g. BURKETT, Notary Public ". Harrisburg, Dauphin County ~ My Commission Expires Feb. 4, 1997 " lill LAST WILL AND TESTAMENT OF IRENE R. HIPPENSTEEL CALDWELL & KEARN$ A PROFESSIONAL CORPORATION ATTORNEYS AT LAW :3631 NORTH FRONT STREET HARRISBURG. PENNSYLVANIA 17110-1533 REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Irene R. Hippensteel Date of Death: 1/21/03 Will No. 2003-00105 Admin. No. To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on 2/12/03 : Name Address Rhonda L. Strawser 322 6th Street New Cumberland PA 17070 Michael B. Hippensteel 143 Locust Grove Road Dillsburq PA 17019 Charles F. Johnson, III 9 Crescent Place Allendale NJ 07401 Eric W. Johnson 5321 Sylvan Road Richmond VA 23225 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: Date: 2/12/03 ~ ~ ~.~v~ / Signature Name: James D. Campbell, Jr., Esquire Address: 3631 North Front Street Harrisburq PA 17110 Telephone(717) - 2327661 Capacity: Personal Representative X Counsel for Personal Representative Continuation of Certification of Notice Under Rule 5.6(a) Irene R. Hippensteel 1/21/03 Page 1 Names and addresses Name Address Saundra L. Johnson 2924 Cumberland Boulevard Camp Hill PA 17011 Ronald W. Hippensteel 526 North Second Street Wormleysbur~ PA 17043 CAlDWell & KeARn$ a PROFESSIONAL CORPORATION JAMES R. CIIPPINGER ATTORNEYS AT LAW of COUNSEL CHARLES J. DEhARt. Iii RICHARD L. KEARNS JAMES D. CAMPBELL. JR. CARL G. WASS JAMES L. GOLDSMITH 3631 NORTh fRONT STREet STANLEY J, a. LaSKOWSKI HARRISBURG, PENNSYLVANIA 17110-1533 ThOMaS D. CALDWELL. JR. JEFFREY t. McGUIRE~ DOUGLAS K. MARSICO H928- BRETT M. WOODBURN DOUGLAS E. HERMAN RAY J. MtCHAIOWSKI '^L$OAME~BEROFNJBAR April 3, 2003 thefirm@caldwellkeams.com Mary C. Lewis, Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013-3387 Re: Estate of Irene R. Hippensteel PA File No. 21-03-0105 Dear Ms. Lewis: Please find enclosed a check in the sum of $7,500 as payment on account of Pennsylvania inheritance tax in the above matter. Very truly yours, ~ames D. Campbell, Gr. CALDWELL & KEARNS ~DCYr:nb /Enclosure 55047-1 COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) '"' DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 002391 CAMPBELL JAMES D JR ESQ 3631 N FRONT ST HARRISBURG, PA 17110 ACN ASSESSMENT AMOUNT CONTROL NUMBER ........ fold .......... 101 $7,500.00 ESTATE INFORMATION: SSN: 205-09-9411 FILE NUMBER: 2103-0105 DECEDENT NAME: HIPPENSTEEL IRENE R DATE OF PAYMENT: 04/03/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUM BERLAN D DATE OF DEATH: 01/21/2003 TOTAL AMOUNT PAID: $7,500.00 REMARKS: JAMES D CAMPBELL ESQUIRE CHECK# 110 INITIALS: JA SEAL RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS / REV-1500 T /R '~;EN E TAX RE - o 1 o ~ __ DE.,,RTM~NT OF R~V~NUE INHERITANC ...... ~ 2 ~-~ ~ ~ ~ ~ HARRISBURG, PA 17128~u3 ~1~~" ~ ~ ~ ~ sOQAL SECURI~ NUMU~ ~ ~~T~ LEINITJAL) 2 0 5- 0 9- 9 4__~ .... ~ .... ~-Dg-Ye~r) REGISTER OF WILLS MM-O~Year) ~ ~ NUMBER ~ INITIAL) ~ 3. Remainder Return (d~ of dea~ p~r D 12-13-82) ~ 1. Original Return ~ 2. Supplemental Return ~ 4a. Future Interest Compromise (~a~ of d,~ ~r1242-82) ~ 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 4. Limited Estate  6. De~dentDiedTes~te (A~hcopyo~Will) ~ 7. De~dentMaintained aLivingTmSt(A~hc°py°fTrust) ~ 9. Litigation Pro~eds Re~ived ~ 10. Spousal Pove~ Credit (d~ of de~ ~,n~2-31-9~ an~ ~4-95) ~ 11. Et~tion to tax under Sec. 9113(A) )RESS 3631 NoAh Front Street NAME NAME ~ Applicable) PA 17110 : ONLY -7661 78 :r~ ~ 1. Real es~te (Schedule A) (1) 68,~2,'16 ~ ?~'. (2) 2. Stocks and Bonds (Schedule B) ~ ~ ... 3. Closely Held Cor~mtion, Padnemhip or Sole-Propdetomhip (3) ? .,. 4. Modgages & Notes Receivable (Schedule D) (4) 32;~3~.62 ~ ~'~ ' 5. Cash, Bank Deposi~ & Miscellaneous Pemonal Prope~ (5) 2~ ': ~ (Schedule E) 10,635.45 6. JoinUy ~ned Prope~ (Schedule F) (6) ~ Separate Billing R~uested - 190,335.2~ 7. inter-Vivos Transfem & Mis~ltaneous Non-Probate Prope~ (7) (Schedule G or L) (8) 8. To~l Gross Asse~ (to~l Lin~ 1-7) 12,907.22 1,529.14 9. Funeral Expenses & Administrative Cos~ (Schedule H) (9) 10. Deb~ of De,dent Mo~gage Liabilities, & Liens (Schedule I) (10) 14,436.36 ' ~) ~~,8~8.8~ 11. Total Dedu~ions (total Lines 9 & 10) (12) 12. Net Value of Es~te (Line 8 minus Line 11) 13. Chari~bie and Governmental Bequest/Sec 9113 Tms~ for which an ele~ion to tax has not been (13) 175,898.87 made (Schedule J) (14) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE ~TES  15. Amount of Line14 ~xable at the sp°usal tax X ~ (15) rate, or tmnsfem under Sec. 9116 (a)(1.2) 7,91 5.4~ 175,898.8~ x ~ ¢6) ~ 16. Amount of Line 14 taxable at lineal rate X 42 ¢7) ~ 17. Amount of Line 14 taxable at sibling rate ~ X 45 O 18. Amount of Line 14 ~able at ~llateral rate 7,9 ~9. Tax Due 20. REV-1500 EX + (6-0~) REV-1500 PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE T. 0( RETURN F,LE.UMBER DEPT. 280601 ,ARR,SBURG, PA1,128-0601 RESIDENT DECEDENT 2 1 - 0 3 COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL SOCIAL SECURITY NUMBER z Hippensteel, lreneR. 2 0 5- 0 9- 9 4 1 1 t'~ DATE OF DEATH (MM-DD-Year) I DATE OF BIRTH (MM-DD-Year) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE ILl I REGISTER OF WILLS O 01/21/2003 11/16/1915 1,1.1 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER ~_'" [] 1. Odginal Retum [~ 2. Supplemental Retum [] 3. Remainder Retum (date of death prior to 12-13-82) ~ r,, ,,,,r~L_.j 4. Limited Estate [] 4a. Future Interest Compromise (date of death after 12o12-82) [] 5. Federal Estate Tax Retum Required ~- (..3 OD iz..j ~ [ m [] 6. Decedent Died Testate IAttach copy of Wi,) [] 7. Decedent Maintained a Living Trust (A~ach copy 01Trust) ~ 8. Total Number of Safe Deposit Boxes < [] 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) [] 1 I. Election to tax under Sec. 9113(A) (Attach Sch O) z NAME COMPLETE MAILING ADDRESS U.I z"' James D. Campbell, Jr., Esquire .3631 North Front Street a. FIRM NAME (If Applicable) "' CALDWELL & KEARNS "' TELEPHONE NUMBER o . ~ (717) 232-7661 Harrisbur~ ~] ~. PA 17110 1. Real Estate (Schedule A) (1) 78, 00 ONLY 2. Stocks and Bonds (Schedule B) (2) 68 ~;92,'16 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) "." ,' 5. Cash, Bank Deposits & Miscellaneous Pemonal Property (5) 32;'737.62 (Schedule E) O 6. Jointly Owned Property (Schedule F) (6) 10,635.45 '"J [] Separate Billing Requested :::3 7. Inter-Vivos Transfem & Miscellaneous Non-Probate Property (7) ~ (Schedule G or L) ~ 8. Total Gross Assets (total Lines 1-7) (8) 190,335.23 ILl 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 12,907.22 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 1,529.14 11. Total Deductions (total Lines 9 & 10) (11) 14,436.36 12. Net Value of Estate (Line 8 minus Line 11) (12) 175,898.87 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) 175,898.87 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES Z 15. Amount of Line 14 taxable at the spousal tax O ~__ rate, or transfers under Sec. 9116 (a)(12) X ~ (15) <1: 175,898.87 x .045 (16) 7,915.45 ~ 16. Amount of Line 14 taxable at lineal rate I~. 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) 7,915.45 20. ~11 ~ ~1 ~ ~ I~1 I Decedent's Complete Address: STREET ADDRESS 620 North Front Street CITY Wormleysburg I STATE PA IzIP 17043 Tax Payments and Credits: 1. Tax Due(Page 1 Line 19) (1) 7,915.45 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments 7T500.00 C. Discount 394.74 Total Credits ( A + B + C ) (2) 7,894.74 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( 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 TAX DUE. (5) 20.71 A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SB) 20.71 Make Check Payab/e to: REGISTE,' 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 properly 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 I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIC,~I,~.T. DRE OF PERSON RESPQNSIBJ,.E~"OR FILING RETZIR[~ DATE ADDRESS ' ' · ' olo ? ADDR~__~~ .~¥- , 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 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 P.S. §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. REV,-1502 EX + (6-98) SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE ,NHER,TANCE TAX RETU.N RESIDENT DECEDENT ESTATE OF FILE NUMBER Hiooensteel. Iren~ R. :~1 Q:~ (~1~)~ All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the pdce at which prope~ would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointl~/-owned with ri~]ht of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 620 N. Front Street, Wormleysburg, PA 78,870.00 (Assessed value) TOTAL (Also enter on line 1, Recapitulation) I $ 78,870.00 (If more space is needed, insert additional sheets of the same size) Cumberland County Board of Assessment APpeals.* · As of ?' ,-4, ,- (; (~-) (date), I/we have requested an appeal of our asSessment. · As of the above date. I/we have met with an official assessment representative to discuss my/our property assessment in question. · The parcel/account number of the subject property is as follows: Parcel/AccoUnt Number · The current Market Value of this property is $ '" · The current Clean and Green value (if applicable) of this property is $ Review Appraiser's Recommendation: Property Owner's Decision: I~. I/we accept the recommendation of the review appraiser and Understand that if the Board approves the recommendation, a formal appeal headng will not be scheduled and any previous request for a appeal will be considered to be withdrawn. Checking this box constitutes an' appeal of my/our assessment and a withdraw of that appeal by my/our acceptance of the recommendation. I/we further understand that if the Board does not approve the recommendation, an appeal headng will be scheduled. ~ I/we reject the recommendation of the review appraiser and understand that if I/we have filed a read;est for a formal headng by the appeal deadline, as stated on the notice, an appeal headng will be scheduled. Property,.~ Owner(s) Signature(s): Review Appraiser's Signature: Certification Number ,,3 I/we acknowledge receipt of a duplicate signed copy of this form. ~ ~/..-.~/4 (initials) Form 216 (v. 1.2) REV,-1503 EX ~, (6-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER HiDDensteel. Irene R;, 21 03 0105 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Morgan Stanley account (Detailed statement attached) 68,092.16 TOTAL (Also enter on line 2, Recapitulation) $ 68,092.16 (If more space is needed, insert additional sheets of the same size) Richard M. Beltram 695 Route 46 West Vice President Fairfield, NJ 07004 Financial Advisor toll free 800 659 6665 tel 973 276 5453 Morga Stanley fax 973 276 5550 February 20; 2003 Caldwell & Kearns 3631 North Front Street Harrisburg PA 17110 Attn: James D. Campbell, Jr Re: Estate of Irene R. Hippensteel Dear Mr. Campbell: I have enclosed below a description of the security positions held in Irene Hippensteel's account and the value as of January 21,2003 per your request. Description Qty Price Value Active Assets Trust 12,038.38 $1.00 $12,038.38 Putnam PA '1'ax Inc B 1133 $9.02 $10,219.66 Pimco Total Return B 1436 $10.67 $15,322.12 Public Storage Sers V 500 $25.85 $12,925.00 Nuveen Ins Muni Fd 300 $15.56 $4,668.00 Abbey Nat'l PLC Ser 340 $26.05 $8,.857.00 Putnam Master Inc Tr 600 $6.77 $4,062.00 If you need additional information please feel free to contact me or my Assistant, Karen Monroe Richard Beltram Vice President Investments and services are offered through Morgan Stanley DW Inc, member SIPC RE.V-1508 EX ~- (6-98) ~ SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER HiDoensteel. Irene R. ;~1 ~):~ ~)1~)~ 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 VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1, Personal effects 500.00 2. 2000 Honda automobile 10,000.00 3. PA Income Tax refund 43.00 4. Federal Income Tax refund 557.00 5. Waypoint Checking Account #1000036317 1,146.25 6. Waypoint Checking Account #1003015707 19,358.98 7. Cash in home 120.00 8. Patriot News refund 69.75 9. Erie Insurance Refund 434.00 10. Pension reimbursement 356.64 11. Sealco refund 152.00 TOTAL (Also enter on line 5, Recapitulation) $ 32,737.62 (If more space is needed, insert additional sheets of the same size) LOOK FOR US. WE'LL GET YOU THERE. 02/25/2003 CALDWELL & KEARNS 3631 N FRONT ST HARRISBURG PA 17110 The information which you requested on the account(s) of IRENE HIPPENSTEEL (Social Security Number 205-09-9411 ) is/are as follows: Account Number 1000036317 1003015707 463273783 Class of Account CHECKING CHECKING CERTIFICATE Date Opened 10/26/99 10/26/99 10/16/95 Principal Balance 1146.13 19356.33 20014.85 Accrued Interest .12 2.65 35.64 Balance at Date of 1146.25 19358.98 20049.99 Death Account Ownership SOLE SOLE JTO Name of Joint RONALD Owner, if any HIPPENSTEEL Date Ownership Was Established 10/16/95 Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name of Joint Owner, if any Date Ownership Was Established Additional Information Sincerely, __ Requested ~ ' ~ ~ SENIOR SERVICES REP. RO. Box 171 I. HARRISBURG, PENNSYLVANIA 17105-1711 Toll Free 1-866-WAYPOINT (I-866-929-7646) · IN YORK AREA 717/815-4500 · w~vvv, wa~Jpointbank, com (6-98) RE¥-1509 EX~ SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY'OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Hiooensteel. Irerl~ R, ;~1 ~);~ Q1Q~ 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. Ronald H. Hippensteel 526 N. Second Street Son Wormleysburg, PA 17043 B Saundra L. Johnson 2924 Cumberland Boulevard Daughter Camp Hill, PA 17011 c JOINTLY-OWNED PROPERTY: LEI i l:R DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION 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 DECEDENT'S INTERES 1. A. & B. 10/16/9.~ Waypoint CD fl463273783 20,049.99 33.33 6,682.66 2. A.&B. 2/12/98 PNC Checking Account #5140029094 9,727.38 33.33 3,242.14 3. A.&B. 5/17/93 PNC Savings Account #5130134202 2,132.17 33.33 710.65 TOTAL (Also enter on line 6, Recapitulation) $ 10,635.45 (If more space is needed, insert additional sheets of the same size) wau LOOK FOR US. Wt?LL GI~T YOU THERE. 02/25/2003 CALDWELL & KEARNS 3631 N FRONT ST HAR~SBURG PA 17110 The information which you requested on the account(s) of IRENEHIPPENSTEEL (Social Security Number 205-09-9411 ) is/are as follows: Account Number 1000036317 1003015707 463273783 Class of Account CHECKING CHECKING ~ CERTIFICATE Date Opened 10/26/99 10/26/99 10/16/95 Principal Balance 1146.13 19356.33 20014.85 Accrued Interest .12 2.65 35.64 Balance at Date of 1146.25 19358.98 20049.99 Death Account Ownership SOLE SOLE JTO Name of Joint RONALD ~/l ~6~tJ,~o?~ Owner, if any HIPPENSTEEL .T~ftdS~,¥ Date ownership 10/16/95 Was Established Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name of Joint Owner, if any Date Ownership Was Established Additional Sincerely, __ Information KA Requested SENIOR SERVICES REP. RO. Box 1711. HARRISBURG, P(ENNSYI.VANIA 17105-1711 Toll Fv~ I-S(~(5-WAYPOINT (I-866-9;~9-764(5) · IN YORK AREA 717/815-4E;00 · www. waupointbank.com PNCBAN( February 20, 2003 James D Campbell, Jr scp Attorney at Law 3631 N Front St Harrisburg, PA 17110 RE: Estate of Irene R. Hippensteel (Deceased) SSN: 205-09-9411 DOD: 01-21-2003 Dear Mr. Campbell: In response to your request for Date of Death balances for the customer noted above, our records show the following: Checking Account Account-g5140029094 Established 02-12-1998 IRENE R HIPPENSTE]EL SAUNDRA L JOHNSON RONALD W HIPP£NSTEEL DOD balance: $9,726.80 + $0.58 accrued interest Savings Account Accountg5130134202 Established 05-17-1993 IRENE R HIPPENSTEEL RONALD W HIPPENSTEEL SAUNDRA L $OHNSON DOD balance; $2,131,88 + $0,29acmmed interest Page I of 2 FEB-19-2003 20:08 PNC~RNK 412 ?68 3458 P.02 Please note that this office only provides date of death balances for deposit accounts (IR. As, CDs, Checking and Savings accounts). We do not process any financial ~'ansactions or provide statements. If you need assistance with any of thee items, please call 1-gg8-PNC-BANK (1-885-762-2265) or stop by your local PNC Bank branch office. Sincerely, Erica L Schlegel PNC Decedent Reporting Firstside C~ter 500 First Ave, 4"' F1 CIF Pittsburgh PA 15219-3128 1-800-762-1775 Member FDIC Page 2 of 2 TOTRL P.02 RE~-1511 EX ~- (12-99) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER HiDDensteel. Irene R. ;~1 Q:~ Q1Q~ Debts of decedent must be reported on Schedule i. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Musselman Funeral Home 6,264.90 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City. State Zip Year(s) Commission Paid: 2. AttomeyFees Caldwell & Kearns 5,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Register of Wills, Cumberland County 312.00 5. Accountant's Fees 6. Tax Retum Prepamr's Fees 7. Bank Checks 8.75 8. Cumberland Law Journal - legal advertising 75.00 9. Carlisle Sentinel - legal advertising 91.85 10. Morgan Stanley - Commissions and fees 1,112.72 11. Photocopies 42.00 TOTAL (Also enter on line 9, Recapitulation) $ 12,907.22 (If more space is needed, insert additional sheets of the same size) RE'~-1512 EX'+ (6-98)  SCHEDULE I COMMONWEALTH OF PENNSYLVANIA DEBTS OFDECEDENT, INHERITANCE TAX RETURN RESIDENT DECEDENT MORTGAGE LIABILITIES~ & LIENS ESTATE OF FILE NUMBER HiDDensteel. Irene R. 21 03 010,,5 Include unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. UGI Utilities 550.00 2. Boscov's 222.58 3. West Shore EMS - BLS 74.40 4. Texaco 14.50 5. ComCast 41.73 6. PP&L 68.46 7. PAWL 46.78 8. Verizon 94.48 9. Dennis P. Freistak, Tax Collector 292.79 10. Borough of Wormleysburg (Sewage & refuse) 112.00 11. AT&T 11.42 TOTAL (Also enter on line 10, Recapitulation) $ 1,529.1 ,!. (If more space is needed, insed additional sheets of the same size) REV;1513 EX + ~8-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER HiDoenst,.~el. Irene R. RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE [. TAXABLE DISTRIBUTIONS [include outdght spousal distributions, and transfers under Sec. 9116 (a)(1.2)] 1. Rhonda L. Strawser Granddaughter 322 6th Street New Cumberland, PA 17070 2. Michael B. Hippensteel Grandson 143 Locust Grove Road Dillsburg, PA 17019 3. Charles F. Johnson, III Grandson 9 Crescent Place Allendale, NJ 07401 4. Eric W. Johnson Grandson 5321 Sylvan Road Richmond, VA 23225 5. Saundra L. Johnson Daughter 2924 Cumberland Boulevard Camp Hill, PA 17011 6. Ronald W. Hippensteel Son 526 North Second Street Wormleysburg, PA 17043 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART ]! - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REVo1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA INVENTORY Estate of Irene R. Hippensteel No. 21 03 0105 also known as Date of Death 1/21/03 , Deceased Social Security No. 205-09-9411 Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/VVe vedfy that the statements made in this inventory are true and correct. INVe understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Personal Representative: Name of Attorney: James D. Campbell, Jr., Esquire Ronald W. Hippensteel, I.D. NO.: 07051 Address: 3631 North Front Street Dated Harrisburcj PA 17110 Telephone: (717/ 232-7661 Description Value 1. 620 N. Front Street, Wormleysburg, PA (assessed value) 78,870.00 2. Morgan Stanley Account 68,092.16 3. Personal effects 500.00 4. 2000 Honda automobile 10,000.00 5. PA Income Tax refund 43.00 6. Federal Income Tax refund 557.00 L;E: ~8 0~' ~.VI~ £0. Total '~,~: ..... ? ;i:~;:~H. ~. 190,335.23 (Attach Additional Sheets if ne~ssaw) ~,-~ ,, .......; ~ ¢:-~.~ NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventor. RW4 . Continuation of Inventory Irene R. Hippensteel 21 03 0105 Pa,cje 1 Description of Inventory Description Value 7. Waypoint Checking Account #1000036317 1,146.25 8. Waypoint Checking Account #1003015707 19,358.98 9. Cash in home 120.00 10. Patriot News refund 69.75 11. Erie Insurance refund 434.00 12. Pension reimbursement 356.64 13. Sealco refund 152.00 14. Waypoint CD #463273783 (1/3 interest) 6,682.66 15. PNC Checking Account #5140029094 (1/3 interest) 3,242.14 16. PNC Savings Account #5130134202 (1/3 interest) 710.65 Subtotal $ 32,273.07 Grand Total $ 190,335.23 COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 002626 CAMPBELL JAMES D JR ESQ 3631 N FRONT ST HARRISBURG, PA 17110 ACN ASSESSMENT AMOUNT CONTROL NUMBER ........ fold .................. 101 $20.71 ESTATE INFORMATION: SSN: 205-09-9411 FILE NUMBER: 2103-01 05 DECEDENT NAME: HIPPENSTEEL IRENE R DATE OF PAYMENT: 05/30/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 01/21/2003 TOTAL AMOUNT PAID: $20.71 REMARKS: RONALDW HIPPENSTEEL C/O JAMES D CAMPBELL ESQUIRE CHECK# 126 INITIALS: JA SEAL RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS COHNONWEALTH OF PENNSYLVANIA BUREAU OF INDZV/DUAL TAXES DEPARTHENT OF REVENUE ZHHERITAHCE TAX DIV~S/DN DEPT. 180601 HARRISBURG, PA 17128-0601 NOTZCE OF INHERITANCE TAX APPRAISENENT, ALLOWANCE OR D/SALLOHANCE OF DEDUCT/ONS AND ASSESSNENT OF TAX r'~._,,,. DATE 07-07-2003 ESTATE OF HZPPENSTEEL IRENE R DATE OF DEATH 01-21-2003 · r~" ~il .... FILE NUNBER 21 03-0105 COUNTY CUNBERLAND JANES D CANPBELL JR ESQ ACN 101 CALDWELL 8 KEARNS I Aeoun~ Reei~ed 3631N FRONT ST H~G PA 17110 HAKE CHECK PAYABLE AND RENIT PAYNENT TO: REGISTER OF WILLS CUN~ERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSNENT OF TAX ESTATE OF HIPPENSTEEL IRENE R FILE NO. 21 03-0105 ACN 101 DATE 07-07-2003 TAX RETURN NAS: (X) ACCEPTED AS F/LED ( ) CHANGED RESERVATION CONCERNING FUTURE /NTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 78z870.00 NOTE: To insure proper 2. S~ocks end Bonds (Schedule B) (2) 68;091.16 cred/~ ~o your account, $. Closely Held S~ock/Par~nershlp /n~eras~ (Schedule C) ($) .00 sube/~ tho upper pore/on ~. Nor~gages/No~es Race/vable (Schedule D) (~) .00 of ~h/s fore ~/~h your 5. Cash/Bank Depos/~s/H/sc. Personal Proper~y (Schedule E) (5) 52;757.62 ~ax payment. 6. Jo/n~lyO~ned Propar~y (Schedule F) (6) 107635.~5 7. Transfers (Schedule G) (7) .00 8. Total Assets (8) 190,335.23 APPROVED DEDUCTIONS AND EXENPTIONS: 12,907 22 9. Funeral Expenses/Ada. Cos~s/N/sc. Expenses (Schedule H) (9) ' 10. Debts/Hortgage Liabilities/Liens (Schedule Z) (10) 1,529.11 11. Total Deductions (11) ll.~.~ 12. Ne~ Value of Tax Re~urn (12) 175,898.87 15. Chari~able/govarneen~al Beques*s; Non-elec~ed 9115 Trusts (Schedule J) (15) .00 lq. Na~ Value of Es~a~e Sub,ac* ~o Tax (1~) 175,898.87 NOTE: If an assessment ~as issued previously, lines 1~, 15 and/or 16, 17, 18 and 19 ~ill reflect figures that include the total of ALL returns assessed to date. ASSESSHENT OF TAX: 15. Aeoun* of L/no 1~ a~ Spousal ra~e (15). .00 X O0 = .00 16. Aeoun~ of L/nm 1~ ~axabZe a~ Lineal/Class A ra~e (16) 175,898.87 x 0~5 = 7,915.fi5 17. Aeoun~ of L/nm 1~ a~ S/bl/ng ra~a (17). .00 X 1~ = .00 18. Aeoun~ of L/nm 1~ ~exeble a~ Collateral/Class B ra~e (18). .00 X 15 = .00 19. Pr/nc/paZ Tax Duo (19)= 7,915.q5 TAX CREDITS: PAYMENT RECEIPT DISCOUNT AHOUNT PA/D DATE NUNBER INTEREST/PEN PAID (-) 0~-03-2003 CD002391 39~.7~ 7,500.00 05-$0-2003 CD002626 .00 20.71 TOTAL TAX CREDIT 7,915.q5 BALANCE OF TAX DUEI .00 INTEREST AND PEN. . O0 TOTAL DUE . O0 IF PA/D AFTER DATE /ND/CATED, SEE REVERSE ( ZF TOTAL DUE TS LESS THAN $1, NO PAYNENT TS REi)U/RED. FOR CALCULATION OF ADD/TZONAL INTEREST. /F TOTAL DUE TS REFLECTED AS A "CRED/T" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE S/DE OF TH/S FORH FOR /NSTRUCT/ONS.) RESERVATION: Estates of decedents dying on or before December 1Z, 198Z -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collataral) beneficiaries of the decedent after the expiration of any astata for life or for years, the Coelonaealth hereby expressly reserves the right to appraise and assess transfer inheritance Taxes at the lawful Class B (coliatarat) rate on any such future interest. PURPOSE OF NOT]CE: To ~ulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act 25 of ZOO0. (TZ P.S. Section 9140). PAYHEHT: Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. --Hake check or money order payable to: REGZSTER OF HZLLS, AGENT REFUND (CR): 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-1515). Applications ara available at the Office of the Register of Hills, any of the Z3 Revenue District Offices, or by calling the special ]4-hour answering service for fores ordering: ]-BOO-56Z-ZO50; services for taxpayers eith special hearing and / or speaking needs: 1-800-447-3020 (TT only). OBJECT]OHS: Any partY in interest not satisfied aith the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --arittan protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 171Z8-]021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. ADH]N- ]STRAT]VE CORRECTIONS: Factual errors discovered on this assesseant should be addressed in eriting to: PA Department of Revenue, Bureau of individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6505. See page 5 of the booklet "instructions for inheritance Tax Return for a Resident Decedent" (RE¥-IS01) for an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid aithin three (3) calendar months after the dacedant's death, a five percent (SZ) discount of the tax paid is allowed. PENALTY: The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before 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 the same time period as you mould appeal the tax and interest that has been assessed as indicated on this notice. INTEREST: interest is charged beginning aith 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 1, 198Z bear interest at the rate of six (BZ) percent per annum calculated at e daily rate of .0001&4. All taxes which became delinquent on and after January ], 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rata announced by the PA Department of Revenue. The applicable interest rates for 19aZ through ZOO3 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ]982 ZOZ .000548 1987 9X .000247 1999 7Z .O00ZgZ 1983 lB] .000458 1988-1991 ZXZ .00030l 2000 8Z .000219 1984 Ill .00030X 1992 9Z .0002~7 2001 92 .0002~7 1985 13Z .000556 1993-199~ 72 .000192 2002 62 .00016~ zgB6 XOZ .000274 1995-1998 92 .0002~7 2005 52 --Interest is calculated as follows: XNTEREST = BALANCE OF TAX UNPAXD X NUHBER OF DAYS DELXNQUENT X DALLY XNTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. Zf payment is made after the interest computation data sho~n on the Notice, additional interest must be calculated. STATUS REPORT UNDER RULE 6.12 Name of Decedent · Irene R. Hippensteel Date of Death · 1/21/03 Will No 2003-00105 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 whether administration of the estate is complete' Yes X 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 follov,4~g: 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 ~ d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date · '~ ! 't-I q I o ~ Sighature James D. Campbell, Jr., Esquire Name (Please type or print ) 3631 North Front Street Harrisburg PA 17110 Address ( 717 ) -2327661 Tel. No. Capacity' ~ Personal Representative Counsel for personal representative IN RE: ESTATE OF IRENE R. : IN THE COURT OF COMMON PLEAS OF HIPPENSTEEL, DECEASED : CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO: 2003-0105 RECEIPT AND RELEASE The undersigned, SAUNDRA L. JOHNSON, intending to be legally bound hereby, does hereby acknowledge that she has this day had and received of and from Ronald W. Hippensteel, Executor of the Estate of Irene R. Hippensteel, deceased, one-half (~) of the residue of the Estate, in final distribution of the residue of the Estate as provided for under the Will of Irene R. Hippensteel. AND THEREFORE, the said Saundra L. Johnson does by these presents remise, release, quit-claim and forever discharge the said Ronald W. Hippensteel, his heirs, successors and assigns, of and from any and all actions, liabilities, claims and demands relating in any way to this final distribution of the said Estate of Irene R. Hippensteel. The undersigned verifies that the statements made in the foregoing document are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. §4909 relating to unsworn falsification to authorities. WITNESS: ~ Dated: 03-85/63486-1 IN RE: ESTATE OF IRENE R. : IN THE COURT OF COMMON PLEAS OF HIPPENSTEEL, DECEASED : CUMBERLAND COUNTY, PENNSYLVANIA : ORPHANS' COURT DIVISION : NO: 2003-0105 RECEIPT AND RELEASE The undersigned, RONALD W. HIPPENSTEEL, intending to be legally bound hereby, does hereby acknowledge that he has this day had and received of and from Ronald W. Hippensteel, Executor of the Estate of Irene R. Hippensteel, deceased, one-half (~) of the residue of the Estate, in final distribution of the residue of the Estate as provided for under the Will of Irene R. Hippensteel. AND THEREFORE, the said Ronald W. Hippensteel does by these presents remise, release, quit-claim and forever discharge the said Ronald W. Hippensteel, his heirs, successors and assigns, of and from any and all actions, liabilities, claims and demands relating in any way to this final distribution of the said Estate of Irene R. Hippensteel. The undersigned verifies that the statements made in the foregoing document are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. §4909 relating to unsworn falsification to authorities. WITNESS: RONALD W. HIPPENSTEEL Dated: // 63 - / ~. '~ ~ ~ IN RE: ESTATE OF IRENE R. : IN THE COURT OF COMMON PLEAS OF HIPPENSTEEL, DECEASED : CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO: 2003-0105 RECEIPT AND RELEASE The undersigned, CHARLES F. JOHNSON, III, intending to be legally bound hereby, does hereby acknowledge that he has this day had and received of and from Ronald W. Hippensteel, Executor of the Estate of Irene R. Hippensteel, deceased, the sum of Five Thousand ($5,000.00) Dollars, in final distribution of the specific bequest provided for under the Will of Irene R. Hippensteel. AND THEREFORE, the said Charles F. Johnson, III, does by these presents remise, release, quit-claim and forever discharge the said Ronald W. Hippensteel, his heirs, successors and a.ss±gns, of and from any and all actions, liabilities, claims and demands relating in any way to this final distribution of the said Estate of Irene R. Hippensteel. The undersigned verifies that the statements made in the foregoing document are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. §4909 relating to unsworn falsification to authorities. WITNESS: CHARLES' F. JOHNSON, III Dated: o3-85/5517o-1 IN RE: ESTATE OF IRENE R. : IN THE COURT OF COMMON PLEAS OF HIPPENSTEEL, DECEASED : CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO: 2003-0105 RECEIPT AND RELEASE The undersigned, ERIC W. JOHNSON, intending to be legally bound hereby, does hereby acknowledge that he has this day had and received of and from Ronald W. Hippensteel, Executor of the Estate of Irene R. Hippensteel, deceased, the sum of Five Thousand ($5,000.00) Dollars, in final distribution of the specific bequest provided for under the Will of Irene R. Hippensteel. AND THEREFORE, the said Eric W. Johnson does by these presents remise, release, quit-claim and forever discharge the said Ronald W. Hippensteel, his heirs, successors and assigns, of and from any and all actions, liabilities, claims and demands relating in any way to this final distribution of the said Estate of Irene R. Hippensteel. The undersigned verifies that the statements made in the foregoing document are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. §4909 relating to unsworn falsification to authorities. WITNESS: 03-85/55170-1 IN RE: ESTATE OF IRENE R. : IN THE COURT OF COMMON PLEAS OF HIPPENSTEEL, DECEASED : CUMBERLA/~D COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO: 2003-0105 RECEIPT AND RELEASE The undersigned, RHONDA L. STRAWSER, intending to be legally bound hereby, does hereby acknowledge that she has this day had and received of and from Ronald W. Hippensteel, Executor of the Estate of Irene R. Hippensteel, deceased, the sum of Five Thousand ($5,000.00) Dollars, in final distribution of the specific bequest provided for under the Will of Irene R. Hippensteel. AND THEREFORE, the said Rhonda L. Strawser does by these presents remise, release, quit-claim and forever discharge the said Ronald W. Hippensteel, his heirs, successors and assigns, of and from any and all actions, liabilities, claims and demands relating in any way to this final distribution of the said Estate of Irene R. Hippensteel. The undersigned verifies that the statements made in the foregoing document are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. §4909 relating to unsworn falsification to authorities. WITNESS: RHONDA L. STRAWSER Dated: ~- ~-- Q~ ~ 03-85/55170-1 IN RE: ESTATE OF IRENE R. : IN THE COURT OF COMMON PLEAS OF HIPPENSTEEL, DECEASED : CUMBERLAND COUNTY, PENNSYLVANIA : ORPHANS' COURT DIVISION : NO: 2003-0105 RECEIPT AND RELEASE The undersigned, MICHAEL B. HIPPENSTEEL, intending to be legally bound hereby, does hereby acknowledge that he has this day had and received of and from Ronald W. Hippensteel, Executor of the Estate of Irene R. Hippensteel, deceased, the sum of Five Thousand ($5,000.00) Dollars, in final distribution of the specific bequest provided for under the Will of Irene R. Hippensteel. AND THEREFORE, the said Michael B. Hippensteel does by these presents remise, release, quit-claim and forever discharge the said Ronald W. Hippensteel, his heirs, successors and assigns, of and from any and all actions, liabilities, claims and demands relating in any way to this final distribution of the said Estate of Irene R. Hippensteel. The undersigned verifies that the statements made in the foregoing document are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. §4909 relating to unsworn falsification to authorities. WITNESS: MICHAEL/~~. HIPPENSTEEL Dated: o3-85/5517o-1 Cumberland County Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 12/01/2004 CAMPBELL JAMES D JR ESQ 3631 N FRONT ST HARRISBURG, PA 17110 RE: Estate of HIPPENSTEEL IRENE R File Number: 2003-00105 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: 1/21/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, GLENDA FARNER STRASBAUGH REGISTER OF WILLS CC: File Personal Representative(s) Judge