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HomeMy WebLinkAbout03-0119Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of also known as Susan Cunnin~ham Heins ~o ~, C_ . , Deceased Patricia Ann Heins .o, ,=,7./-03-11 9 Social Security No. 505 - 50 - 7344 Petitioner(s), who is/are 18 years of age or older, apply(les) for: (COMPLETE 'A' or 'B' BELOW:) A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut r ix the Decedent, dated 10/15/1991 and codicil(s) dated None none named in the last Will of 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 incompetent: none -'-1 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 that Decedent left no Will and was survived by the following spouse (if any) and heirs: I 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 604 Wayne Drive, Decedent, then 76 years of age, died 12/18/2002 at Holy Spirit Hospital, Decedent 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 Upper Allen Twsp., Mechanicsburs, PA 17055 (list street, number, and municipality) ~¢/ PA (Location) 11,500.00 situated as follows: 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: I ~ -~ Si~lnature Typed or printed name and residence ~,~__ /~/.~ Patricia Ann Heins ' 708 4th Street, New Cumberland, PA 17043 Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form RW-1 (1991) Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland 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) a/a/a/a/a/a/a/a/a~at as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the~ing to law. Sworn to or affirmed and subscribed /~/~',/~----~ /'~¢~--" /~t.~--~ Patricia Ann Heins before me this 5th day of February , 2003 Donna M.Otto, 1st Deputy No. Estate of Susan Social Security No: 21-2003-]]9 Cunninsham Heins,a/k/a Susan C. Heins 505-50- 7344 Date of Death: 12/18/2002 Deceased AND NOW, February_ '10t. h 2003 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters ~ Testamentary [---] Of Administration (c,t,a,; db.n,c.ta,; pendente lite; durante absentia; durante minoritate) are hereby granted to Patricia Ann Heins in the above estate and that the instrument(s) dated 10/15/1991 described in the Petition be admitted to probate and filed of record as the last Wilt of Decedent. FEES Letters ........... $ 50.00 Short Certificate(s) ..... $ 15.00 Renunciation ........ $ Register of Will~ ~' ~' ~//~ Donna M. Otto, 1st Deputy Attorney: Robert C. Saidis Affidavits ( ) .... $ I.D. No: 21458 Saidis, Shuff, Flower & Lindsay Extra Pages ( 4 ) .... $ 12.00 Address: 2109 Market Street Codicil ........... $ JCPFee .......... $ 10.00 Camp Hill, PA 17011 Telephone: 717/737-3405 Inventory .......... $ Other ........... $ TOTAL ......... $ 87.00 PUT LETTEF~ IN A~iT.)RNEY .~A!DIS'S,: "FI/t~E: IN PROTHONOTARY Prepared by t he Pennsylvania Bar Association Copyright {c) 1996 form software only CPSystems, inc. 02--10--03. Form RW-1(1991) ?17737~4B? SAIDIS SHUFF MA%LAND 567 Register of Wills of OATH Estate of also known as Cumberland County, Pennsylvania OF SUBSCRIBING WITNESS 21-2003-11q Deceased Cunningham He,ns Susan C. Heins Melvalene E. Ktn~ (each) a subscribing witness to the J--~ codicil(s) j~ will(s) presented herewith, (each) being duly qualified according to law depose(s) arid say(s) that she/h~/they was/were present and saw the above Testator(rix) sign the same and that she/he/they signed as a witness at the request of Testator(rix) in his/her/their presence and n-] in the presence of each other ~ in the presence of the other subscribing witness(es ) (Signature) Melvalene E. (Add~ess) (Signature) (Address) Sworn to or affirmed and sub3cribed before me this day Notary Public My Commission Expires: (Signature and $~,al of Notary or ~ther official qualified to mdminlater oaths Sl~,w aate of expiration of Ne, ruby's comml~sl~3n ) NO~ To be taken by officer authorized to administer oath5 Please have present the arlgtnal or cop,/of instrument(s) at time of notarization 21-2003-119 REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA OATH OF NON-SUBSCRIBING WITNESS Patrici~ A. Heins , Subscriber hereto, being duly qualified according to law, deposes and says that he/she is familiar with the signature of Susan Cunningham Heins, testatrix of the Will presented herewith and that he/she believes the signature on the Will is in the handwriting of Susan Cunningham Heins, to the best of his/her knowledge and belief. Sworn to or affirmed and / ~~--' ~-- /~ subscribed before me this 10th day of February ., 2003. For the Register '--/~ ~//~ / / ~- Donna M.Otto, 1st Deputy "q-t~z~~/~'~" his is to certi~7 that the information here given is correctly copied fi-om an original certificate of death duh.' Local R, egistrar. The original certificate will be fbrwarded to thc State Vital Records Office for permanent WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 8777829 No. [)atc ,.0s :~.~ wsz COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH * VITAL RECORDS CERTIFICATE OF DEATH Susan C. Hezns '-~emal~ ,. 505 -- 50 -- 7344 , 76,~[ : I : I 10/22/1926 ~,z~t. . I .... ~ =~,G ~ [~ ,,.. Clerk I,,..~k Cl~ I,, ...... ,, 8 ~'~ o...,., ,. Dimr~ ,. j ~cE~.s ~ylv~ia ,,,.~ ~.~ ~r Allen 604 Wa~e ~i~ <TUAL, Es,~ '"'~"' ~ -- M~ics~g, PA 17055 ~ .... ,,. ~d ~ng~ ,,. J~e Meig~n ,~. Pa~icia A. Hei~ ~08 4~ S~t New ~rl~. PA 17070 ~,,~r 20, 2002 ,,~.Hollin~ ~~ I~,,.Mt.Holly gpringA PA 17Ofiq 21-2003-119 LAST WILL AND TESTAMENT OF SUSAN CUNNINGHAM HEINS I, SUSAN CUNNINGHAM HEINS, of 604 Wayne Drive, Mechanicsburg, Pennsylvania 17055, do make, publish and declare this to be my last Will and Testament, hereby revokin9 all other wills and codicils previouSly made by me. ARTICLE I I direct that all my just debts and funeral expenses be paid from the assets of my estate as soon after my death as may be practicable. If there be no cemetary lot available for my interment owned by me at the time of mV death, I authorize my personal representative to purchase such cemetary lot with a contract for perpetual care, using therefore funds from my estate. Further, I authorize my personal representative(s) to expend funds from my estate, in such amount as (s)he shall consider necessary and desirable, for the purchase, erection and inscription of a suitable marker for my grave. ARTICLE II I give devise, and bequeath all tangible personal property that I shall own at the time of my death to my daughter, Patricia Ann Heins, provided that she is living on the thirtieth day after the date of my death. ARTICLE III I give, devise and bequeath all the rest, residue and remainder of my estate, whether real or personal wheresoever situated to my daughter, Patricia Ann Heins, provided that she is living on the thirtieth day after the date of my death. -1- ARTICLE IV In the event my daughter, Patricia Ann Heins, does not survive me or does not surviv~ me by said period of thirty days, I then give, devise and bequeath al~. the rest, residue and remainder of my estate unto Marie' Murphy of 37 Beechgrove Gardens, Belfast, NI, BT60NN. ARTICLE V I direct that no personal representative(s) or other fiduciary named, nominated or appointed in this, my Last Will and Testament, shall be required to post any bond or give any security of any type for any purpose whatsoever, any law or rules of court of the Commonwealth of Pennsylvania or any other jurisdiction to the contrary notwithstanding. ARTICLE VI My personal representative(s) shall have the following powers in addition to those vested in them by law and by other provisions of this will, applicable to all Droperty, real or personal, and mixed and wheresoever situate, Whether principal or income, exercisable without court approval, and effective, with respect to each item of said proDerty, until actual distribution thereof. A. To retain, as investments of my estate and trust, any or all assets of my estate, real, personal, or mixed, without regard to any principal or diversification, and to purchase and acquire real or personal property, and to hold any or all of such real and personal property retained or acquired without making the same productive of income. C. To pay all taxes, charges, and expenses of mainte- nance, upkeep, improvement, development, protection, preserva- and investment of any retained or acquired real or personal property, such payments to be made from either principal or income as my said personal representative(s) shall determine. D. To retain or invest any and all funds, whether principal or income, in any real or personal property without restriction to legal investments; to purchase investments at premiums; to exercise all rights of a secruitv holder or share holder in any corporation; and to lease, mortgage, pledge, give options upon or sell at public or private sale and without approval of any Court and without any responsibility to the buyer or buyers to see to the application of the purchase price, any real or personal property, or portion or portions thereof, irrespective of the manner or the means by which the same was acquired by my said personal representa-~, tive(s). E. To make any payment or distribution herein provided for in cash, kind, or partly in cash and partl~ in kind, at valuations fixed by my personal representative(s) at the time of distribution. ARTICLE VII It is hereby directed that my personal representative(s), hereafter named, shall pay all inheritance, state, successive and legacy taxes to which my estate or the transfer of any property hereunder may be subject and to charge such tax as part of the administration, payable out of my residuary estate. ARTICLE VIII Any and all payment or payments of any sum or sums, whether in cash or in kind and whether for principal or income, payable to any minor heirs shall be made upon the sole receipt of the respective individual or guardian to whom_.the payment is made, and free from anticipation, alienation, assignment, attachment, and pledge, and free -3- from control by the creditors of any such beneficiary. All shares of principal and income herein given shall be free from anticipation, assignment, pledge or obligations of any beneficiary, and shall not be subject to any execution or attachment. ARTICLE IX I nominate, constitute and appoint my daughter, Patricia Ann Heins, Executor of this, my Last Will and Testatment. Should my daughter, Patricia Ann Heins, predecease me or for any reason fail to qualify as such executor, or having qualified, fail to serve as such executor, or having qualified, fail to serve as such executor, then I nominate, constitute and appoint Marie' Murphy of 37 Beechgrove Gardens, Belfast, Northern Ireland, BT60NN as contingent executor. IN WITNESS WHEREOF, I hereafter sign my name, and publish and declare this to be my Last Will and Testament, consisting of 5 typewritten pagers, the first 3 of which bear my signature in the margin for the purpose of identification, this /~ day of ~ ~C¥~'~L~'~-~ 1991 SUSAN CUNNING~AM HEINS (SEAL) We, the witnesses whose names are signed to the foregoing instrument, being duly qualified according to law, do depose and state that we were present and saw the testatrix sign and execute the instrument as her will; that the testatrix signed willingly and executed the instrument as her Free and voluntary act for the ~ur~oses 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. residing at /3~P~~:~ ~~ ~.' ' ~' 173 7~_ I, SUSAN CUNNINGHAM HEINS, Testatrix, whose name is siqned to the foregoing instrument, having been duly qualified, according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purpose therein expressed. Sworn or affirmed to and acknowledged before me bV SUSAN CUNNINGHAM HEINS, Testatrix, this day of , 1991. N dt%a ry Public %., / ,k~ w. ~as, ~ PC".": ~ J l-4an'isbura Dauphin ~oun~ j ~ ~mi~' E~O~res June 26. lg93 ~ ( SEAL ) REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA CERTIFICATION OF NOTICE UNDER RULE 5.6(A) Name of Decedent: Susan Cunningham Heins Date of Death: December 18, 2002 Will No. 21-03- O//~ Admin. No. To the Register: I certify that notice of Estate Administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiary of the above- captioned estate on February iq, 2003. Name Address Patricia Ann Heins 708 4th Street, New Cumberland, PA 17043 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except none Date: ~7~ Z//o ,'~ ~ ~'/-~4-'~ -~'~/~/7 Robert C. Saidis, Esquire [ 2109 Market Street / Camp Hill, PA 17011 (717) 737-3405 Capacity: X Personal Representative Counsel for Personal Representative 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 NO. CD REV-1162 EX(11~96) 002305 SAIDIS ROBERT C 26 W HIGH STREET CARLISLE, PA 17013 ........ fold ESTATE INFORMATION: SSN: 505-50-7344 FILE NUMBER: 2103-011 9 DECEDENT NAME: HEINS SUSAN CUNNINGHAM DATE OF PAYMENT: 03/1 8/2003 POSTMARK DATE: 03/1 7/2003 COUNTY: CUM BERLAN D DATE OF DEATH: 1 2/18/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $3,700.00 REMARKS: C/O PATRICIA A HEINS TOTAL AMOUNT PAID: $3,700.00 SEAL CHECK//101 INITIALS: AC RECEIVED BY' DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS REV-1500 EX + (6-00) D E C E D E N T CAPB HpRL EpIO CRAC KoTK ES C O R R E S R E C A P I T U L A T I O N C O M 0 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Heins Susan C. DATE OF DEATH (MM-DD-YEAR) 12F-/W_'~O 02 DATE OF BIRTH (MM-DD-YEAR) 10/22/1926 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) JUL 8 OFFICIAL USE ONLY FILE NUMBER 21-03-0119 COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 505-50-7344 REGISTER OF WILLS  1. Odginal Retum ~ 247a.. 4. Limited Estate . 6. Decedent Died Testate (Attach copy of Will) r'--] 9. Litigation Proceeds Received~ 10. SOCIAL SECURITY NUMBER (dp Remainder Return pn Federal Estate Tax Return Total Number of Safe Depo Election to tax under Sec, 9 (Attach Sch O) NAME Robert C. Saidis FIRM NAME (If Applicable) Saidis, Shuff, Flower & Lindsay TELEPHONE NUMBER 717/737-3405 Supplemental Return I I 3. ~H~I~r~Jt.[~[SE~ Compromise (date of death after 12-12- 2)l~J 5. Beqeii~:lt Maintained a Living Trust 0 8. (~'tl~obesopy of Trust) Spousal Poverty Credit I I 11. ~l~f death between 12-31-91 and 1-1-95) 1Real Estate (Schedule A) (1) 2Stocks and Bonds (Schedule B) (2) 3Closely Held Corporation, Partnership or. (3) Sole-Proprietorship 4Mortgages & Notes Receivable (Schedule D) (4). 5Cash, Bank Deposits & Miscellaneous Personal Property (5)f- (Schedule E) 6Jointly Owned Property (Schedule F) (6) [~eparate Billing Requested 7Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8.Total Gross Assets (total Lines 1-7} 9Funeral Expenses & Administrative Costs (Schedule H) (9) llZ)ebts of Decedent, Mortgage Liabilities, & Uens (Schedule I) (10) 11Total Deductions (total Lines 9 & 10) 1;;~let Value of Estate (Line 8 minus Line 11) COMPLETE MAILING ADDRESS 2109 Market St. Camp Hill, PA 17011 306.50.: NoA% None 11,873.78 70,891.39 14,669.16 11,349.44 13Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) l~et Value Subject to Tax (Line 12 minus Line 13) OFFICIAL USE ONLY (8) 97,740.33 (11) (12) (13), (14) 12,325.66 85,414.67 85,414.67 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 150,mount of Line 14 taxable at the spousal tax rate. or transfers under Sec. 9116(a)(1.2) 161kmount of Line 14 taxable at lineal rate 17Amount of Line 14 taxable at sibling rate 18Amount of Line 14 taxable at collateral rate 85,414.67 976.22 x .0 0 (15) 0.00 x .0 45 (16) 3,843.66 x .12 (17) 0.00 X .15 (18). 0.00 19Tax Due (19) 3,843.66 Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV- 1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 604 Wayne Drive Mechanicsbur8 STATE ZIP ?^ Tax Payments and Credits: 1.Tax Due (Page 1 Line 19) 2Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3,700.00 192.18 17055 Total Credits ( A + B + C ) (1) 3,843.66 (2) 3,892.18 3Jnterest/Penalty ff applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 0o 00 4Jf Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT, Check box on Page I Line 20 to request a refund (4) 48.52 5If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 0.00 Make Check Payable to.' REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1Did 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? ................... 21f death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................ ~-] ~] 3Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............................................. [---] [-~ 4Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................ ~1 r-~ 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 retum, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. D~ratio/of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF P/~SON R~PONSIBLEr ; FOR FILING~ETURN ?atr ici a Ann He ins D ~ /~. / ]~ 708 4th Street . A / ................... Lo- T SIGNATURE OF PREPAREp,~O~HER PRESENTATIVE Saidis, Shuff, Flower & Lindsa 2109 Market St. ~/,C~ i,, ~ A ~'~ //(--,/~//~ ---d~--~[~-f:-~X--kV~ik- .......................... ,.' , ' T 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. Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev, 6-00) REV-1503 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE B STOCKS & BONDS Susan C. Heins SSf/ 505-50-7344 12/18/2002 All property jointly-owned with right of survivorship must be disclosed on Schedule F. FILE NUMBER 21-03-0119 ITEM VALUE AT DATE DESCRIPTION UNIT VALUE NUMBER OF DEATH 1 17 shares Waypoint Financial common stock 18 306.00 TOTAL (Also enter on line 2, Recapitulation) 3 0 6.0 0 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1503 EX (Rev. 1-97) REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER Susan C. Heins SS# 505-50-7344 12/18/2002 21-03-0119 Include the proceeds of litigation and the date theproceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 2 3 4 Members First FCU, CD #40897-42 accrued interest 1983 Chevy Lumina, value based on Household goods and furnishings PPL, refund sale price TOTAL (Also enter on line 5, Recapitulation) 8,511.05 13.08 1,700.00 1,500.00 149.65 11,873.78 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1508 EX (Rev. 1-97) REV-1509 EX + (1-97) SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY ,N.ER,T^.CE T*X RE~URN RESIDENT DECEDENT ESTATE OF Susan C. Heins SS# 505-50-7344 12/18/2002 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. FILE NUMBER 21-03-0119 SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Patricia Ann Heins daughter 708 4th St. New Cumberland, PA 17043 JOINTLY-OWNED PROPERTY: LEYrER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE ~nc~u~ name of financi~ instituti~ and ban DATE OF DEATH DECD'S VALUE OF account numar or similar identifying numbe NUMBEF TENANT JOINT Affach deed for jointly-held rea state. VALUE OF ASSET INTEREST 3ECEDENT'S INTERE~ 1 A 11/01/80 604 Wayne Drive 114,900.00 50.00% 57,450.00 Mechanicsburg, PA 17055 (later deed filed adding right of survivorship" Oct., 2000) based on sale price 2 A 11/ /00 115 shares Waypoint Fin. 2,070.00 50.00% 1,035.00 common stock at $18 per share 3 A 10/09/85 Members First FCU, money 22,711.33 50.00% 11,355.67 market savings #40897-05 4 A 10/09/84 Members First FCU 2,032.25 50.00% 1,016.13 checking acct. #40897-11 5 A 10/09/84 Members First FCU 69.18 50.00% 34.59 savings acct. 40897-00 TOTAt(AIsoenteronline6, Recapitulation) $ 70,891.39 RT (If more space is needed insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-I$09 EX (Rev. 1-97) REV*~S~0 EX + 0-97) SCHEDULE G INTER-VIVOS TRANSFERS & COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF Susan C. Heins SS~ 505-50-7344 12/18/2002 FILE NUMBER 21-03-0119 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. DESCRIPTION OF PROPERTY % OF ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. NUMBER A~TACH A COPY OF THE DEED FOR REAL ESTATE, VALUE OF ASSET INTEREST 0F APPLICABLE) 1 Members First FCU, IRA acct. 14,669.16 100.00% 14,669.16 f/40897-18 TOTAL (Also enter on line 7, Recapit~ation) 14,669.16 (If more space is needed, insert additional sheets of the same s~ze) Copyright (c) 1996 form software only CPSysterns, Inc. Form R Er- 1510 EX (Rev. 1-97) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS REV-1511 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Susan C. Heins SS~/ 505-50-7344 12/18/2002 21-03-0119 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. 5. 6. 7. :UNERALEXPENSES: Malpezzi Funeral Home Diocese of Harrisburg, cemetery plot ~DMINISTRATIVE COSTS: 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: A~orney's Fees Saidis, Shuff, Flower & Lindsay 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 Probate Fees Register of Wills Accountant's Fees Tax Return Preparer's Fees O~erAdministrativeCosts Filing fee for tax return Cumberland Law Journal, estate notice Patriot News, estate notice Costs incurred in sale of joint real estate: (one half of the following costs) seller assistance 2,500.00 commission 6,894.00 document preparation 125.00 sewer bill 100.00 transfer tax 1,149.00 record grant satisfaction 27.00 (credit for prorated taxes (209.39) TOTAL (Also enter on line 9, Recapitulation) 3,042.20 1,000.00 1,700.00 87.00 15.00 75.00 135.43 5,294.81 $ 11,349.44 (If more space is needed, insert additional sheets of the same size) Copyright (c)1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97) REV-1512 EX + (1-97) SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Susan C. Heins SS~/ 505-50-7344 12/18/2002 21-03-0119 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT AOL Timewarner, refund of overpayment of pension Holy Spirit Hospital, medical expense 1/2 of expenses related to joint real estate: Verizon, phone bill Upper Allen Township, water and sewer PPL, electric utility Waste Management, trash removal Comcast, cable West Shore Oil Jeffrey Bennett, snow removal TOTAL (Also enter on line 10, Recapitulation) $ 455.16 28.02 75.31 50.00 127.86 17.70 17.50 179.67 25.00 976.22 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97) REV-1513 EX + (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Susan C. Heins SS# 505-50-7344 12/18/2002 21-03-0119 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. 1 JTIONS [include outdght spousal distributions, and transfers under Sec. 9116(a)(1.2)] Patricia Ann Heins daughter entire estate and as surviving joint owner of real estate and bank accts. II. ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18 STRIBUTIONS: SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET ON REV 1500 COVER SHEET 0,00 (If more space is needed, insert additional sheets of the same size) Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-00) ?17-2d5 64~6 SAIDIS 5HUFF MASLAND ?79 PO~ APR 0~ '05 15:5~ ~D DEED p~CEL # 42 26 0245 0l! in the year of our Lurd single ~erson, of the Borough of MechanlcsbUr~, County of Cumberland, Co~monwealth of peDnsylvania, 8ingle pe~on, of the Borough of Mechanicsburg, County of Cumberland~ Commonwealth o~ pennsylvania. (Grantees) ........................ ($i.00; ................. in hand paid, the rsceipu whersO~ ia hereby acknowledged, the their heirs and &~cigne. as Joint tenant~ with thc right of survivorship Ugp~r Allen. CounU¥ of cumberland and St~te of ps--sylvania, b~nded a~ d~cribod a. follows, to BEGI~I~ at a poln~ on the South ~ld~ of a 40 foot at th~ oorner of Lot No. 11 in thc he~inafter Pla~ Of Lo~; thence along the lin~ o~ said Lo= No. 11 a~ve; Chance ~lon9 the ~outh ~id~ of eaid Street N~rth degrees 16 minut~m East 109.33 f~e~ to a point, the place of BEGI~ING. Jr., known ae 'Plan B of Holiday CreOC", W~ich pl~n r~co~d in thc Recordsz'~ office ~n ~nd for C~rl~ County in Plan Book 13, Pa~e 43. ?17-~43-64~6 SAIDIS SNUFF MAS[AND 779 P03 APR 02 '05 15:52 BEING thw ~a~ prflmiac~ which Richard L. Heine and Patc~ci& A. Heine by Deed dated November l, 1~80 which Deed Thi~ conveyance i~ a Corr~CttV~ D~ad for the pu~omcS Of clarifying the ~rant~'-'Ownership ~ Joint tenants w/th rtg~= of su~ivorehip.- This is a dmmd from mothu~ and child to ~the~ and ~hild AND the laid grantors hereby COVenant and agree that they 230 ,',kc~ 5141 ?q7-~43-64~6 SAIDIS SHUFF MASLAND 779 P04 APR IN #~TN~B ~0~, ,aid grantorm have hereunto ~et their hands and 8e&l~ the day and y~ar above written. coMMONWF~%LT~ OF p~$yLVANIA cOUNTY OF CUMB'RL~ND ~ :~pe~r~d' 2000 b~for- --,the · ~. '~, I d0 hereby c*rti~y ~hat ~he ~reci~ D~ive, Mec~anicsburg. PA 1~055 /~ AttOrney for ~L~ cOMMONW~An~ OF pEnNSYLVaNIA : RECOrDeD on this ~ _ day of ~~ .h'~ ' "~'Gg,~ maid County in Deed Book vol..~.__, ~,~'~ . ..~... _, . ~,...,~,~-:.-'~'.~:pW offic~ thc dat~ aOovm wr~ · ~,;~( '.-.~=~,-&~,:~'~ .j~ ~o~ 230 ,~c~ Membersl FEDERAL CREDIT UNION INSURANCE DEPARTMENT 5000 Louise Drive P. O. Box 40 Mechanicsburg, PA 17055 1-800-283-2328 or (717) 697-1161 REGULAR SAVINGS ACCOUNT: - Account Number/Suffix Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Created INVESTMENT SAVINGS ACCOUNT: Account Number/Suffix Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Created CHECKING ACCOUNT: Account Number/Suffix Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Created IRA CERTIFICATE: Account Number/Suffix --'Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Beneficiary CERTIFICATE OF DEPOSIT: Account Number/Suffix Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner 40897 -00 10/09/1984 $69.12 $.06 $69.18 Patricia A. Heins 10/09/1984 40897 -05 10/09/1985 $22,692.42 $18.91 $22,711.33 Patricia A. Heins 10/09/1985 40897 -11 10/09/1984 $2,032.25 $.oo $2,032.25 Patricia A. Heins 10/09/1984 40897 -18 O9/O5/2OO2 $14,649.65 $19.51 $14,669.16 Patricia A. Heins 4O897 -42 04/15/2000** $8,511.05 $13.08 $8,524.13 None **Certificate purchased with funds from certificate #40897-41 originally established 4/14/99 Denise A. Anders ~ -' Insurance Supervisor February 27, 2003 Estate of: SUSAN HEINS Date of Death: December 18, 2002 Social Security Number: 505-50-7344 Historical Prices Page 1 of 1 FINANCE Search -Finance Home - Yaho0.! - Help Historical Prices - VVYPT (WAYPOINT FINL) More Info: Quote I Chart J News I Profile S,a,~:lDec _~]118 12002 End: lDec _.~jli'9 12002 Daily Weekly Monthly Dividends Ticker Symbol: lwypt Get Data Date Dec- 19-02 · Download Spreadsheet Format I * adjusted fOr dividends and Splits Please see FAQ. As of Dec-19-02 Research I Messages I Insider ADVERTISEMENT · //'the peace [ at agreat ,,,u,, PLAN COMPARISONS BEST PRICES LIVE CUSTOMER CARE ONLINE APPLCATIONS Opestjpns or C;o n }~,ents? Copyright © 2003 Yahoo! Inc. All rights reserved. Privacy Policy -Terms of Service Historical chart data and daily updates provided byCommodity Systems, Inc. (cSI). Data and information is provided for informational purposes only, and is notintended for trading purposes. Neither Yahoo nor any of its data or content providers (suchas CSl) shall be liable for any errors or delays in the content, or for any actions taken in reliance thereon. LAST WILL AND TESTAMENT OF ~ ~ SUSAN CUNNINGHAM HEINS I, SUSAN CUNNINGHAM HEINS, of 604 Wayne Drive, Mechanicsburg, Pennsylvania 17055, do make, publish and declare this to be my last Will and Testament, herebv revoking all other wills and codicils previously made by me. ARTICLE I I .direct that all my just debts and funeral expenses be paid from the assets of my estate as soon after my 'death as may be practicable, if there be no cemetary lot available for my'interment owned by me at the time of my death, I authorize my personal, representative to purchase such cemetary lot with a contract for perpetual care, using therefore funds from my estate. Further, I authorize my personal representative(s) to expend funds from my estate, in such amount as (s)he shall consider necessary and desirable, for the purchase, erection and inscription of a suitable marker for my grave. ARTICLE II I give devise, and bequeath all tangible personal property that I shall own at the time of my death to my daughter, Patricia Ann Heins, provided that she is living on the thirtieth day after the date of my death. ARTICLE III I give, devise and bequeath all the rest, residue and remainder of my estate, whether real or personal wheresoever situated to my daughter, Patricia Ann Heins, provided that she is living on the thirtieth day after the date of my death. -1- nRT±~,,E IV In the event my daughter, Patricia Ann Heins, does not survive me or does not surviv~ me by said period of thirty days, I then give, devise and bequeath al~. the rest, residue and remainder of my estate unto Marie' Murphy of 37 Beechgrove Gardens, Belfast, NI, BT60NN. ARTICLE V I direct that no personal representative(s) or other fiduciary named, nominated or appointed in this, my Last Will and Testament, shall be required to post any bond or give any security of any type for any purpose whatsoever, any law or.rules of court of the Commonwealth of Pennsylvania or any other jurisdiction to the contrary notwithstanding. ARTICLE VI My personal representative(s) shall have'the following powers in addition to those vested in them by law and by other provisions of this will, applicable to all property, real or personal, and mixed and wheresoever situate, ~heth~~ pri~cipal~.or income~, exercisable without court approval, and effective, with respect to each'item of said property, until actual distribution thereof. A. To retain., as investments of my estate and trust, any or all assets of my estate, real, personal, or mixed, without regard to any principal or diversification, and to purchase and acquire' real or personal property, and to hold any or all of such real and personal property retained or acquired without making the same productive of income. C. To pay all taxes, charges, and expenses of mainte- nance, upkeep, improvement, development, protection, preserva- and investment of any retained or acquired real or personal -2- property, such payments to be made from either principal or income as my said personal representative(s) shall determine. D. To retain or invest any and all funds, whether principal or income, in any real or personal property without restriction to legal investments; to purchase investments at premiums; to exercise all rights of a secruitv holder or share holder in any corporation; and to lease, mortgage, pledge, give options'upon or sell at public or pri~te sale and without approval of any Court and without any responsibility to the buyer or buyers to see to the application of the purchase price, any real or personal property, or portion or pomtions thereof, irrespective of the manner or the means by which the same was acquired by my said personal representa~ tive(s). E. To make any payment or distribution herein provided for in cash, kind, or partly in cash and partt~ in ki~d, at valuations fixed by my personal representative(s) at the time of distribution. ARTICLE VII It is hereby directed that my personal representative(s), hereafter named, shall pay all inheritance, state, successive and legacy taxes to which my estate or the transfer of any property hereunder may be subject and to charge such tax as part of the administration, payable out of my residuary estate. ARTICLE VIII Any and all payment or payments of any sum or sums, whether in cash or in kind and whether for principal or income, payable to any minor heirs shall be made upon the sole receipt of the respective individual or guardian to whom~i~the payment is made, and free from anticipation, alienation, assignment, attachment, and pledge, and free -3- from control by the creditors of any such beneficiary. Ail shares of principal and income herein given shall be free from anticipation, assignment, pledge or obligations of any beneficiary, and shall not be subject to any execution or attachment. ARTICLE IX I nominate, constitute and appoint my daughter, Patricia Ann Heins, Executor of this' my Last Will and Testatment. Should my daughter, Patricia Ann Heins, predecease me or for any reason fail to qualify as such executor, or having qualified, fail to serve as such executor, or having qualified, fail to serve as such executor, then I nominate, constitute and appoint Marie' Murphy of 37 Beechgrove 'Gardens, Belfast, Northerh~ Ireland, BT60NN as contingent executor. IN WITNESS WHEREOF, I hereafter sign my name, and publish' and declare this to be my Last Will and Testament, consisting of 5 typewritten pagers, the first 3 of which bear my signature in the margin for the purpose of SUSAN CUNNINGHAM HEINS (SEAL) We, the witnesses whose names are signed to the foregoing instrument, being duly qualified according to law, do depose and state that we were present and saw the testatrix sign and execute the instrument 'as her will; that the testatrix signed willingly and executed the instrument as her Eree and voluntary act ¢or the ~ur~oses 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. /73 I, SUSAN CUNNINGHAM HEINS, Testatrix, whose name is signed to the foregoing instrument, having been duly qualified, according to law, do.hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purpose therein expressed. Sworn or affirmed.to and aCknowledged before me by SUSAN CUNNINGHAM HEINS, Testatrix, this day of , 1991. ~ EAL Nqt~ry Public %.. ,_____~ Judith W Farkas Notate Public HarrisbUrg. Dal}phin (.JOJ.Jrlty ,1 .~.:.-./.?.,. _ (SEAL) 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 NO. REV-1162 EX(11-96) CD 003018 SAIDIS ROBERT C ESQUIRE 26 W HIGH STREET CARLISLE, PA 17013 ........ fold ESTATE INFORMATION: SSN: 505-50-7344 FILE NUMBER: 2103-0119 DECEDENT NAME: HEINS SUSAN CUNNINGHAM DATE OF PAYMENT: 09/1 6/2003 POSTMARK DATE: 09/1 5/2003 COUNTY: CUMBERLAND DATE OF DEATH: 12/18/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $187.49 TOTAL AMOUNT PAID: $187.49 REMARKS: PATRICIA A HEINS C/O ROBERT C SAIDIS ESQUIRE SEAL CHECK//102 INITIALS: VZ RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES THHER/TANCE TAX DZVZSTON DEPT. 28D601 HARRISBURG,, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF /NHERZTANCE TAX APPRAZSEHENT, ALLO#ANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX REV-IgC? EX AFP [01-05) ROBERT C SAIDIS SAIDIS ETAL 2109 MARKET ST CAMP HILL CUT ALONG THIS LINE. PA 17dit~ DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN I 09-15-2005 HEINS 12-18-2002 21 05-0119 CUMBERLAND 101 SUSAN Amoun'l: Remi~ed HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAHD CO COURT HOUSE CARLISLE, PA 17015 RETAIN LOWER PORTION FOR YOUR RECORDS *-~ Law Offices of Saidis, Shuff, Flower & Lindsay 2109 Market Street Camp Hill, PA 17011 REGISTER OF WILLS OUMBERLAND OOUNTY OOURTHOUSE OARLISLE PA 17015 B1jREA~ OF INDIVIDUAL TAXES TNHERZTANCE TAX DTVZSZON DEPT. Z80601 HARRZSDURG., PA 171Z8-060! ROBERT C SAIDIS SAIDIS ETAL 2109 NARKET ST CAHP HILL COHHONNEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLO#ANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSNENT OF TAX REV-16,17 EX AFP (01-05) PA 17011'~:, DATE ESTATE OF DATE OF DEATH FILE NUHBER :~i~OUNTY ACN 09-15-2005 HEINS 12-18-2002 21 05-0119 CUHBERLAND 101 Amount Ree].tted SUSAN C HAKE CHECK PAYABLE AND REHZT PAYNENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~ REV-15&7 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLONANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF HEINS SUSAN CFZLE NO. 21 05-0119 ACH 101 DATE 09-15-Z005 TAX RETURN NAS: ( ) ACCEPTED AS FILED (X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedula A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) ($) ~. Hortgagas/Notas Receivable (Schedule D) (~+) 5. Cash/Bank Daposits/N1sc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXEHPT]:ONS: 9. Funeral Expanses/Ada. Costs/NAsc. Expanses (Schedule H) (9) 10. Debts/Hortgage LiabilltAes/Lians (Schedule 1) (10) 11. Total Deductions 12. Nat Value of Tax Return .00 $06.00 .00 .00 11z875.78 70z891 .$9 14~669.16 (8) 6,054.65 NOTE: To insure proper credit to your account, submit the upper portion of this fora with your tax payment. 97,740 .$$ 976.22 (11) 7.0-~0.85 (12) 90,709 15. 1~. NOTE: Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) Nat Value of Estate Subject to Tax (1~) Tf an assessment was issued prev/ously, lines 14, 15 and/or 16, 17, reflect figures that include the total of ALL returns assessed to date. ASSESSHENT OF TAX: 15. Amount of Line lq at Spousal rata 16. Amount of Line 1~ taxabZa at Lineal/Class A rata 17. Aaount of Line lfi at S~bllng rata 18. Amount of Line 1~ taxable at Collateral/Class B rata 19. Princlpal Tax Due TAX CREDITS: PAYHENT RECE/PT D/SCOUNT (+) DATE NUHBER INTEREST/PEN PAID (-) 05-17-200~ CD002~05 194.74 .00 90,709.48 18 and 19 will $,700.00 ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATZON OF ADDITIONAL INTEREST. TOTAL TAX CREDZT BALANCE OF TAX DUE ZNTEREST AND PEN. TOTAL DUE $,894.74 187.18 .31 187.49 ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS REI~UZRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) INTEREST IS CHARGED THROUGH 09-$0-2005 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM ANOUNT PAID (15) .00 X O0 = .00 (26) 90,709.48 x 045= 4,081.92 (17) .00 x 12 = .00 (18) .00 x 15 = . O0 (19)= 4,081.92 RESERVATION: PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CDRRECTIDNS: DISCOUNT: PENALTY: INTEREST: Estates of decadents dying on or before December ZZ, 198Z -- if any ~uture interest in the estate is transferred in possession or enjoyment to Class 8 (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 lawful Class 8 (collateral) rate on any such future interest. To ~ulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S. Section 9140), Detach the top portion of this Not[ce and submit with your payment to the Rag[star of #ills printed on the reverse side. --Make check or money order payable to: REGISTER OF NILLS, AGENT A refund of a tax credit, which was not requested on the Tax Return, may bm requested by completing an "Application for Refund of Pennsylvania Inheritance a~d Estate Tax" (REV-IS13). Applications ars available at the Office of the Register of Mills, any of the 23Rsvenus District Offices, or by calling the special Z4-hcur answering service for fores ordering: 1-800-$6Z-Z050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-SOZ0 (TT only}. Any party in interest not satisfied aith the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as sheen on this Notice must object within sixty (60) days of receipt of this Notice by: --aritten protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 171Z8-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment shauld be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Revise Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601 Phone (7173 787-6505. Sea page S of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decsdent's death, a five percent (SI) discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed an the total of the tax and interest assessed, and not paid be~ore 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 ties period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with 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, 1982 bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .000164. All taxes ehich became delinquent on and after January 1, 198Z will bear interest at a rate ehich will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOO3 ars: Interest Daily Interest Daily Interest Daily Year Rate Factor Yaa.~r Rate Factor Yea.~r Rate Factor 198Z ZOZ .000548 1987 97. .000Z47 1999 77. .000192 1983 167. .0004S8 1988-1991 117. .000301 ZOO0 87. .000Z19 1984 llZ ,000301 199Z 9Z .000247 2001 9Z .000247 1983 137. .000356 1993-1994 7Z .000192 2002 62 .000164 1986 107. .000Z74 1995-1998 97. . O00Z47 Z003 52 .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINGUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent mill reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date sheen on the Notice, additional interest must be calculated. REV-1470 EX (6-88)  INHERITANCE TAX EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDEN3'S NAME FILE NUMBER HEINS,SUSAN C 2103-0119 REVIEWED BY ACH Kathryn Harbilas 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES H B-7,4 Reduced to $0. Selling expenses are not allowable deductions when the real estate was jointly owned by right of survivorship. Row Page 1 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG,, PA 17128-0601 CONHON#EALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT RE¥-1;07 EX AFP (0~-05) ROBERT C SAIDIS SAIDIS ETAL 2109 HARKET ST ~- CAHP HILL PA 17011';~-~ DATE 09-29-2005 ESTATE OF HEINS DATE OF DEATH 12-18-2002 FILE NUHBER 21 05-0119 :~OUNTY CUHBERLAND ACN 101 Amount Remitted SUSAN C HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF gILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To Lnsure proper credit to your account, submit +he upper portion of th/s fore with your tax payment. CUT ALONG THIS L'rNE ~ RETA'rN LOgER PORT'rON FOR YOUR RECORDS REV-1607 EX AFP (01-03) #~ 'rNHER'rTANCE TAX STATENENT OF ACCOUNT ESTATE OF HEINS SUSAN C FILE NO. 21 03-0119 ACN 101 DATE 09-29-2003 THTS STATENENT TS PROVTDED TO ADVTSE OF THE CURRENT STATUS OF THE STATED ACN IN THE NANED ESTATE. SHO#N BELO# TS A SUHNARY OF THE PRINCIPAL TAX DUE,. APPL/CATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSNENT OR RECORD ADJUSTHENT: 09-15-2003 PRIHCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYHENTS (TAX CREDITS): PAYHENT RECEIPT DISCOUNT (+) DATE NUHBER INTEREST/PEN PAID (- 03-17-2003 09-15-2003 CDOOZ305 CD003018 194.74 .00 IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( ZF TOTAL DUE IS LESS THAN $1, NO PAYNENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), ANOUNT PAID 3,700.00 187.49 TOTAL TAX CREDIT 4,081.92 YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. ) 4,082.23 BALANCE OF TAX DUE .31CR INTEREST AND PEN. .00 TOTAL DUE .31CR PAYNENT: Detach the top portion of this No[ica and submit aith your payment made payable to the name and address printed on the reverse side. -- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF #ZLLSj AGENT. -- If NON-RESIDENT DECEDENT make check or money order payable to: COMHONNEALTH OF PENNSYLVANIA. 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-1313). Applications ara available et tho Office of tho Register of Wills, any of the 13 Revenue District Offices or from tho Department's Iff-hour answering service for fores ordering: 1-800-361-Z050; services for taxpayers with special hearing and / or speaking needs: 1-B00-447-3010 (TT only). REPLY TO: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of [ndividua! Taxes, ATTN: Post Assessment Review Unit, Dept. 180601, Harrisburg, PA 17118-0601, phone (717) 787-6505. DISCOUNT: any tax due is paid within three (3) calendar months after the decedant's death, a five percent (51) discount the tax paid is allomad. PENALTY: The 151 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January [8, 1996, the first day after the end of the tax amnesty period. 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 ehich became delinquent before January 1, 1981 bear interest at the rate of six (61) percent per annum calculated at a daily rate of .000164. All taxes ehich became delinquent on and after January 1, 19BI will bear interest at a rate which ail1 vary from calendar year to calendar year eith that rate announced by the PA Department of Revenue. The applicable interest rates for 1981 through Z003 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 ZOZ .000548 [987 9Z .000247 1999 71 .000192 1983 Z6Z .000438 1988-1991 Il[ .000301 2000 81 .000219 1984 llZ .000301 1991 91 .000247 2001 91 .000247 1985 X3Z .000356 1993-1994 7Z .000[92 2002 6Z .000164 198& lO[ .000274 [995-1998 9Z .000247 2003 5Z .000137 --Interest is calculated as follows: XNTEREST= BALANCE OF TAX UNPATD X NUNBER OF DAYS DELXNQUENT X DAXLY 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. If payment is made after the interest computation date shown on the Notice, additiona! interest must be calculated. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA STATUS REPORT UNDER RULE 6.12 Name of Decedent: Susan C. Heins Date of Death: December 18, 2002 Will No. 21-03-0119 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 following: a. Did the personal representative file a final account with the Court? Yes__; No X 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 X ; No d. Copies of receipts, releases, joinders and approvals of formal or informal acc~ay be filed with the Clerk of the Orphans' Court and may/~~ed to this report. Signa%ure / Date: Capacity: Name: Robert C. Saidis, Esquire I.D. No. 21458 SAIDIS, SHUFF, FLOWER &'LINDS~ 2109 Market Street Camp Hill, PA 17011 (717) 737-3405 Personal Representative X Counsel for Personal Representative