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HomeMy WebLinkAbout04-0655PETITION FOR PROBATE and GRANT OF LETTERS Estateof C[4x~rl~'3l-jrq~ ~. '-~&~[I~t' No..~l-Oq- (~-~" also known as To: Deceased. Social Security No. ~(_A ~-- ~--c~_ ~7 [~ Register of Wills for the County of Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the executor- in the last will of the above decedent, dated and codicil(s) dated in the named O-,'t~ vn- ;7 ,19 '* ~ (state relevant circnmstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in ~ ~ ~ County, Pennsylvania, witk h '~.-,~' last family or principal residence at ~ ~ &t~-a.~ [x~',~t ~. ~ /a(,~l~.r~ ~ I~/ (list street, number and muncipality) Decer~dant, then ~/~ years of age, di. gd ~ ] ~ , Except ~s f~ws, deceden[ d~d not marry, was not divorced an~ did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ ~Cg. tO00. '~" (If not domiciled in Pa.) Personal property in Pennsylvania $. t (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters '-I~ ~4o. ~v~xe ~/ (testamentary; a~ministration c.t.~4'2 ~tministration d.b.n.c.t.a.) OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF ~.~o,,,,~.~. ~_ ~ f 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 knowled~.~ and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s~ ~andtrulya~n~is~rtheestate~tccordingtolaw.~k - Sworn tO or affknmd, and subscribed _~._~x~ ~-~ .... ~'--k.,~ ~ before me this rZ-~-~' day of - ~'- , ~ - ~' ~' No. ~t Estate0f Q,~c~'~ ~ DECREE OF PROBATE AND GRANT OF LETTERS , Deceased AND NOW~ ~k-~\'k \~"~" ~/~ ~0~V ~ , in consideration of the petition on the reverse side hereof, ~isfacto~ proof having been presented before me, IT IS DEC~ED that the inst~ment(s) dated ~-- [~- I~ described therein be admitted to probate ~d ~1~ of record as the l~t will of ~d Letters ~~~ ~xt ~ ~e hereby granted to~,a ~~&~ RENUNCIATION In Re Estate of To the Register of Wills of The undersigned deceased. County, Pennsylvania. of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters (Address) (Signature) (Address) (Signature) (Address) his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. P 10330071 Fee for this certificate, $2.00 ~ No. ~ Date ZI-0 -- 55 Local Registrar COMMONWEALTH OF PENNSYLVANIA · DEPARI~IENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH C NAME OF ~c~.c~rdT (Fk~t. Midcg,. Llll~) SEX I SOCIAL SECURITY NUE4BER .. - J ~ATE OF OEATH {Mof~th. D,y. y,r] Chaxlotte Taylor ~.Female =. 169- 54 - 4476~ 84v~ 4-10-1920 ~Mon~ose, PA ~D ~ g~chanicsb~g, PA 17050 (s~.~, ~"t~'~t'~'t'~} Davrd E. S~on .. Ed~ Unknomn Davrd B. St~ l~.5 Brandymlne ~lver Mtchanicsb~ PA 17050 012704L ~.4100 Jonestown Ro~. H~Alsb~a, PA 17109 LAST WILL AND TESTAMENT I, CHARLOTTE S. TAYLOR, of Montrose, Pennsylvania, declare this to be my Last Will and revoke any Will previously made by me. FIRST~ I direct that all my just debts and funeral expenses, including my gravemarker and all expenses of my last illness, shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. SECOND: I bequeath my automobiles, household and personal effects and other tangible personalty of like nature (not including cash or securities), together with any existing insurance thereon, to my husband, MAURICE D. TAYLOR. Should he not survive me, I bequeath such tangible personalty and insurance thereon to such of my son, DAVID B. STEWART. THIRD: I give and devise all the residue of my estate, real or personal, to my son, DAVID B. STEWART, per stirpes. FOURTH: My Personal Representative shall have the following powers in addition to those vested in them by law and by other provisions of my Will applicable to all property, whether principal or income, actual exercisable without court approval, and effective until distribution of all property; A. To retain any or all of the assets off.my estate, ~eal personal without regard to any principle of diversification risk. ~ 1 or or B. To invest in all forms of property or investments authorized for Pennsylvania fiduciaries, as they deem proper without regard to any principle of diversification or risk. C. To sell at public or private sale, to exchange or to lease, for any period of time, any real or personal property and to give options for sales, exchanges or leases, for such prices and upon ~uch terms or conditions as they deem proper. D. To allocate receipts and expenses to principal or income or ~artly to each as they from 'IFTH: I appoint my son, Personal Representatives of to qualify or cease to act survivor shall act alone. time to time think proper. DAVID S. STEWART and JOHN C. HAWLEY, this my Last Will. Should either fail as Personal Representative, then the SIXTH~ I direct that my Personal Representative or successor not be required to give bond for the faithful performance of their duties in any jurisdiction. day IN WITNESS WHEREOF, I have hereunto set my hand this C}{ARLOTTE S. TAY~R, Testatrix SIGNED, SEALED, PUBLISHED AND DECLARED by the above named CHARLOTTE B. TAYLOR as and for her Last Will and Testament in the )resence of us, who at her request, in her presence, and in the presence of each other, have hereunto subscribed our names as 2 COMMONWEALTH OF PENNSYLVANIA : SS= COUNTY OF ~-d~/~/~-c/~/',/~ : I, CHARLOTTE S. TAYLOR, the 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; and that I signed it willingly and as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged be~Qre me by CHARLOTTE S. TAYLOR, the testatrix, this ./~day of TESTATRIX z [/_~ (Signature of officer or attorney) (Seal and official capacity of officer of state of admission of attorney) COMMONWEALTH OF PENNSYLVANIA : SS: COUNTY OF We, ~/~JA//~/~ ,'~. ~/ff~F~m'~/'6:/)/ and NOTARIAL SEAL BRENDA E. MUSSARI. Notary Public Scranton City, Lackawanna County My Commission Expires Oct. t7, 1998 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 the testatrix sign and execute the instrument as her Last Will; that the testatrix signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testatrix signed the will as a witness; and that to the best of our knowledge the testatrix was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn to or affirmed and subscribed to before me by ~J~ ~ /~/c// and ~ //~ witnesses, this /~ day of~~ , 199 r~--. ' (Signature off offffic~r o~ (S~al and offfficial ga~aci~y off a~o~n~y) 'NOTARIAL SEAL E, MUSSARI, Nemry Public ~ C fy, Lackawanna County __r? ~ ?~2!.??asion Expires Oct. 17, 1998 COMMONWEALTH OF PENNSYLVANIA DEPARTMENTOEREVENUE BUREAU OFINDIVIDUAL TAXES DEPT. 2SOS01 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 004354 COYNE LISA MARIE 3901 MARKET ST CAMP HILL, PA 17011 ........ fold ESTATE INFORMATION: SSN: 169-54-4476 FILE NUMBER: 2104-0655 DECEDENT NAME: TAYLOR CHARLOTTE S DATE OF PAYMENT: 09/08/2004 POSTMARK DATE: 09/08/2004 COUNTY: CUMBERLAND DATE OF DEATH: 06/10/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $5,000.00 TOTAL AMOUNT PAID: $5,000.00 REMARKS: SEAL CHECK//2969 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS ~ Mechanicsbur~ PS. 17050 4~tem/on: T/C ~40 PA _D_EPAFrrMENT OF REV BUREAU 0 ENUE DE~ ~= '~ DIVISION HARRISBURG PA 1712~1 COMNONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU DF ZNDXVIDUAL TAXES DEPT* Ia0601 CHRISTINE K STENART 5 BRANDYNINE DR MECHANICSBURG PA 17055 '0 FILE NO. 210~ ~c~5~ 0q155261 09-14-2004 ZNFORMATZONAND NOTICE TAXPAYER RESPONSE ACN DATE TYPE OF ACCOUNT EST. ,,l~ CHARLOTTE S TAYLOR [] SAVTNSS S' S' 'r ~0 ' 169-5q-qq76 [] CHECK'rNG DATE OF DEATH 06-10-2004 [] TRUST _~OU~¥:~8 CUMBERLAND [] CERTTF. REMZT PAYMENT AND FORHS TO= REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 MEMBERS XST FEDERAL CREDIT UNN has provided the Department Nith the information listed bale. which has been used in COMPLETE PART 1 BELOM # # ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Ac¢oun, No. 21515911 Oa,e 05-14-2002 Es,eblAshed Accoun, Balanc~ 633.33 Percen, TaxmbZe X 16.667 Amoufl, Sub,ne, ,o Tax 105.56 Tax Ra'e X .045 Po'en'A;.! Tex Due 4.75 PART TAXPAYER RESPONSE YOU me~ c~ose to ro. lt payment to tho Register o~ Hills Nith tNu copt8s o~ thts notice to obtain CHECK a dJsco~t or avoid Jnt~rost~ or you .a~ chock box "A" and rotu~n this notice to the Register o~ BLOCK s. ~ The above asset has been or will be reported and tax paid with the Penn~lvania Inheritance Tax return ONLY to be ~[Xmd by ~e dmcedmnt*s representative. C. ~ The above in;ormation is incorrect end/er debts and deductions ~ere paid by you. You must co.late PART ~ and/or PANT ~ beto~. PART Xf you Z~icm~e a d~ffmren~ ~ax ra~e, please s~a~m your ] rexe'lonship 'o deceden,: TAX RETURN - COMPUTATION OF L/NE 1. Oa,e Es,~bltshed 1. 2. Accoun, Balance 3. Percen, Taxable 3 q. ~o~ S~ ~o Tax 5. D~s ~d Deductions 6. Amoun* Tax,la 6. 7. Tax Ra~e 7 8. Tax D~ 8 PART DATE PAID TAX ON JOINT/TRUST ACCOUNTS DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRTPTION AMOUNT PAID TOTAL (En,er on LAne $ of Tax Compu,e,lon} WORK ( ) TELEPHONE NUM)ER ~ COMHONREALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DAVID B STENART 5 BRANDYNZNE DR MECHANICSBURG PA 17055 INFORMATION NOTICE AND TAXPAYER RESPONSE IFZLE NO. az ACN 0~155260 DATE 09-1~-200~ EST. OF ~HARLOTTE S TAYLOR S.S. NO. 169-Sq-qq76 DATE OF DEATH 06-10-g00q ~.~I~U~T~Y ~ *~ :~UMBERLAND TYPE OF ACCOUNT ~]TRUST REHZT PAYHENT AND FORHS TO: REGZSTER OF NILLS ~h ,,CUMBERLAND CO COURT HOUSE · , ~ i~CARLZSLE, PA 17013 MEMBERS 1ST FEDERAL CREDTT URN has provided the Department with the Information listed below which has bean used in this account. [~ you Eaal this information is ~n¢orract~ please obtain mrJttan correction free the f~nancial institution) attach a copy COMPLETE PART [ SELO~/ ~ ~ ~ SEE REVERSE SIDE FOR FZLINO AND PAYMENT INSTRUCTIONS Account No. 21515911 Date 05-1~-200Z Established Account Balance 6~.~ Percent Taxable X 16.667 Amount Sub~ect ~o Tax 105.56 Tax Rate X .0q5 Po~en~iaZ Tax Due q.75 PART TAXPAYER RESPONSE ONE ONLY ' · You must completh PART [] and/or PART [] below. PART T~ you indioa~e a different tax rate) please s~ate your ] relationship to decedent: TAX RETURN - COMPUTATION OF LZNE 1. Date Established 2. Account Balance PART DATE PAID TAX ON JOZNT/TRUST ACCOUNTS DEBTS AND DEDUCTZONS CLATMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line -g of Tax Computation) Under penalties of perjury, T declare that the facts ! have reported above ara true, correct and comp~oL~__~t~best of .y ~l.dg. and b.lt.f. HOME ( ) TAXPAY~ SIGHt,RE - TELEPHONE NUHBER DATE COMMONWEALTH OF PENNSYLVANIA DEPARTMENTOEREVENUE BUREAU OFINDIVIDUAL TAXES DEPT2$O601 HARRISBURG, PA 17128 0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) NO. CD 004474 STEWART DAVID B 5 BRANDYWINE DRIVE MECHANICSBURG, PA 17050 ESTATE INFORMATION: SSN: 169-54-4476 FILE NUMBER: 2104-0655 DECEDENT NAME: TAYLOR CHARLOTTE S DATE OF PAYMENT: 10/06/2004 POSTMARK DATE: 09/25/2004 COUNTY: CUMBERLAND DATE OF DEATH: 06/10/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 04133261 I $4.75 04133260 I 84.75 REMARKS: TOTAL AMOUNT PAID: 89.50 CHECK//1110 · INITIALS: JA -' SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE *' BUREAU OF INDIVI~D 0'''." NOTICE OF INHERITANCE TAX INHERITANCE TAX DIVISim.vVntJC' FFlvE OfAPPRAISEHENT, ALLOWANCE OR DISALLOWANCE PO BOX lBD6Dl q}:('lQ'9'I<:P Ot I')H 1.0 OF DEDUCTIONS, AND ASSESSMENT OF TAX ON HARRISBURG PA 17lZ8-06Di,,--vv U t ; \'iL <..0 JOINTLY HELD OR TRUST ASSETS REY-1548 EX AFP <06-05) 2005 JUL 15 PH 12: 25 CLERK OF DAVID _.Q{l~T 5 BRAND~~'CO, PA MECHANICSBURG PA 17055 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 07-18-2005 TAYLOR 06-10-2004 21 04-0655 CUMBERLAND 169-54-4476 04133260 APPEAL DATE: 09-16-2005 (See reverse side under Objections) A.aunt Remitted I I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CHARLOTTE S CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS - REY=is4S-EX-AFP-r03=Osi-------------------------------------------------------------------- NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 07-18-2005 ESTATE OF TAYLOR CHARLOTTE S DATE OF DEATH 06-10-2004 COUNTY CUMBERLAND FILE NO. 21 04-0655 TAX RETURN WAS: S.S/D.C. NO. 169-54-4476 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1ST FEDERAL CREDIT UNN ACCOUNT NO. ACN 04133260 21515911 TYPE OF ACCOUNT: ()SAVINGS lX) CHECKING (HRUST (HIME CERTIFICATE DATE ESTABLISHED 03-14-2002 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 633.33 0.166 105.56 .00 105.56 .45 4.75 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 09-25-2004 CD004474 "' .00 4.75 TOTAL TAX CREDIT 4.75 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. · ( IF TOTAL DUE IS LESS THAN $1. NO PAYMENT IS RElIUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDlr' ( CRI, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOHN FOR INSTRUCTIONS. I ~~'L COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIV~iim!fOO r;~FiCE ('c NOTICE OF INHERITANCE TAX INtERITANCE TAX DIVIS~: c~,,_.:,.:,:: _ '. ~ :~; APPRAISEMENT, ALLOWANCE OR DISALLOWANCE PO BOX 280601 ,~:-i'_) ...".' " , ,I -', OF DEDUCTIONS, AND ASSESSMENT OF TAX ON HARRISBURG PA 17128-0601'~ - -- ' JOINTLY HELD OR TRUST ASSETS *' REV-1548 EX AFP (06-05) Z005 ;'\UG 12 PI'~ !: 09 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 08-15-2005 TAYLOR 06-10-2004 21 04-0655 CUMBERLAND 169-54-4476 04133261 APPEAL DATE: 10-14-2005 (See reverse side under Objections) Amount Remitted I I MAKE CHECK PAYABLE AND REMIT PAYMENT REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CHARLOTTE S CLEPf< C~ OFc .., CHRISTDYgKSTEWART 5 BRANDYWINE DR MECHANICSBURG PA 17055 TO: CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ..... REY=is4S-EX-AFP-r03=Osi-------------------------------------------------------------------- NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLONANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 08-15-2005 ESTATE OF TAYLOR CHARLOTTE S DATE OF DEATH 06-10-2004 COUNTY CUMBERLAND S.S/D.C. NO. 169-54-4476 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATtoK FINANCIAL INSTITUTION: MEMBERS 1ST FEDERAL CREDIT UNN ACCOUNT NO. FILE NO. 21 04-0655 TAX RETURN WAS: ACN 04133261 21515911 TYPE OF ACCOUNT: ()SAVINGS 0<) CHECKING (HRUST (HIME CERTIFICATE DATE ESTABLISHED 03-14-2002 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 633.33 0.166 105.56 .00 105.56 .45 4.75 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 09-25-2004 CD004474 .00 4.75 TOTAL TAX CREDIT 4.75 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. . ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRI, YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOHN FOR INSTRUCTIONS. I <;,~ q.. Cumberland County - Register Of wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 4/25/2006 COYNE LISA MARIE 3901 MARKET STREET CAMP HILL, PA 17011-4227 RE: Estate of TAYLOR CHARLOTTE S File Number: 2004-00655 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. 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 is due by: 6/10/2006 please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, Gl~r~~ Clerk of the Orphans' Court cc: File Personal Representative(s) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 4/25/2006 STEWART DAVID B 5 BRANDYWINE DRIVE MECHANICSBURG, PA 17050 RE: Estate of TAYLOR CHARLOTTE S File Number: 2004-00655 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 6/10/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel Register of Wills of Cumberland County Name of Decedent: STATUS REPORT UNDER RULE 6.12 /- tY- -; / . /Lc...z.GJiu.. I tI-'1/ c.v- / r: .~ /c/ ~- c.~ :../ Date of Death: Estate No.: -7 1- (I ,( - {' r:: 5 ;- Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes 0 No ~ 2. If the answer is No, state when the personal represenUj.tive reasonably believes that the administration MIl be complete: / -' -'~ i ': ~ 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 0 No 0 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 0 No 0 c. Copies of receipts, releases, joinders and approval offonnal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. ..:L X c;-- ~ture LrSr4 ftI,;hltE ~/VC:, E-s Q. Name Date: s-J 21} 0 C:. I o l' ui .M-tJ.vkJ- sf Address C~ ~ { ;? r1- / 70;/- l(;?:Z 7 (/7 - 7 '57-00/ b /./ Telephone No. 6 :; Gapacity: o Personal Representative ~Counsel for personal representative f1 REV .1500 EX + (-l - REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 2004 0655 COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 I- Z W Q W o W Q DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) TAYLOR, CHARLOTTE S. DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 06/1012004 04/10/1920 (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) W I- :.:::!(/) 011::':: wa-o xoo 011:-' a-m a- <( ~ 1. Original Return o ~ o o 2. Supplemental Return o o o 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach copy of Trust) 10. Spousal Poverty Credit (date of death between 1 1.91 and 1-1-95 D 3. Remainder Return (date of death prior to 12-13-82) o 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch 0) 4. Limited Estate 6. Decedent Died Testate (Attach copy of Will) 9. Litigation Proceeds Received ,,, 0(""\' ~ : ~........~ (;FFiCi:'.I. . ie." n".. I 169-54-4476 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER AME I- Lisa Marie Coyne z ~ IRM NAME (If applicable) z ~ Coyne & Coyne, P.C. ELEPHONE NUMBER 717/737-0464 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 3901 Market Street Camp Hill, PA 17011-4227 (1 ) None (2) 88,014.00 {3) None (4) None (5) 474,745.81 (6) 3,513.12 (7) 15,269.00 (8) (9) 30,223.20 (10) 3,807.04 OFFiCIAL USE ONLY ~ ~ "-.,.) (,) , I cS81,541.93 (11 ) 34,030.24 547,511.69 (12) (13) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 547,511.69 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) z 547,511.69 .045 (16) 0 16.Amount of Line 14 taxable at lineal rate x i= i5 ::;) a- 17.Amount of Line 14 taxable at sibling rate x .12 (17) :::Ii 0 0 S 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) 24,638.00 20. D. CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 24,638.00 Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) C) Decedent's Complete Address: STREET ADDRESS 5 Brandywine Drive Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount ISTATE PA I ZIP 17050 (1 ) 24,638.00 5,000.00 263.00 Total Credits (A + B + C) (2) 5,263.00 1,317.43 CITY Mechanicsburg 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + SA. This is theBALANCE DUE. (3) 1,317.00 (4) (5) 20,692.00 (SA) (5B) 20,692.00 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;..........................................................n................. 0 ~ b. retain the right to designate who shall use the property transferred or its income;................................ 0 ~ c. retain a reversionary interest; or............................._........................................................................... DO ~ 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?.. ..................... ................. ................. ..n................... ....... ..n....... ............... 0 ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... 0 ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?..........................................................n.. ............................. ............. ....... ~ 0 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 preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING ETURN ADDRESS ~VID WAR ,> .. SIGNATURE OF PERSON R DATE 5 Brandywine Drive Mechamcsburg, P A 17055 ~. ~ ~\.t. ~---DITE---- . - . ADDRESS SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE Lisa Marie Coyne ADDRESS DATE 3901 Market Street Camp Hill, PA 17011-4227 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. 99116 (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. 99116 (a) (1.1) (ii)]. The statutedoes not exemot 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. 99116 (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. 99116 1.2) [72 P.S. 99116 (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. 99116 (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. *' SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF TAYLOR, CHARLOTTE S. I FILE NUMBER I 21 - 2004 - 0655 All property jointly-owned with right of survivorship must be disclosed on Schedule F. , ITEM DESCRIPTION UNIT VALUE i VALUE AT DATE OF NUMBER DEATH 1 Reserve Primary Fund Class R-- Securities America 1.00 36,372.00 2 1022.058 Shares of One Group Equity Index Fund Class A 25.96 26,533.00 I 3 2,373.246 Shares of One Group Market Neutral Fund Class A 10.58 25,109.00 Cfo ftA/q ~7~ Pwz ~ 35 iicJ.l04~. ~ e,.... I I TOTAL (Also enter on line 2, Recapitulation) 88,014.00 ~1 Q.)11- -.:t O?LlJ 0 l'Ci :E 0 o..! N Q.) : 0.. -- t"-- .....,0 ~~ ....... l'Ci L/) -- "'01 .. Ll'l""" \0 OiL/) . Ll'l 00 0 ~\N ,.....0 VT-l -\0 0000 [\")0 till LI10 ciV oia '-!a biN 0'......... NOl .-4 ;1'- Ll'l0 10 s:...l,.....j Q.)I......... VOl If). till \0 Ll'lT-l .... M ill- ~;a T-l~ If) ~!- ill- .-4 i;! 0 UJi U'l 're "'0 Cl'I QJ N t"-- ~ c:i 0\ re "'0 qo 0\ 0- 10 N ::J \0 10 t"-- .... CD ~ Vl ~ r/J Q.) II 01 a ~ re 0\ 0.. ('Y') 0 ~ ,.....j a.. O! Q If) Q CD .-4 -< co 0 ~ ~ CD t7.l CD ~ .r:. -tit- 0 1: 000 ...... ... ....... 0 000 t7.l :; 01000 0 00'lLl'l ....iLl10 0... +J II Q) ill- N T-l Z ill- ill- Q = +J ~ 00010 = U s::.... VLl'lV ~ U G.I MaN u c:t: u NNM ~ G.I r-.Nr-. < -~ MOM C'-. IO~ T-l~ N t7.l ltl M ~ ::J 0 g'~ 00010 ...... "'0 VLl'lV ... ...... Z 'fii MaN t7.l NNM 0 "'0 0 r-.N,..... ~ C U MOM - IO~ T-l~ N~ 0 .r:. [\") ~ +J ro <( t7.l Q) ...J ~ 0 U C <(0 Cl) ~ 0 ~U'l5 c' 0 ~ ol M ~ VlU'lu.. __1 ~ Vl:S...J -roi Vl :SU~ t7.l c EI -- ltl UXf- "'d ~I ..0 I... ow::> .21 I- .21 c 8 o zOw 51 CI ._ ::> z z 1--11 .... u.. - f- 0 I .- >- ~ ~ till u a:: .u;t ~If)~- c' Q) 0 (/)1 u..<::>o:: 01 ~ ..J 01 lI)lII:EO<( ._1 ---l! G.lC_w:::E +J' Q ._1 > d o Eo::c..c.. (/)! t7.l 11( c' OJ ... I- --I ~a.::>::> o..J Cl) ro, IIIWOO I Cl) (91 .- C) > 0:: 0:: -:=i .tJ 1 5a.~l!)l!) t7.l U) ~ "'01 u'S~ww ro' 0.l Ot ~! +JI s:: Ot QJ wZZ L...' 1 0 'itii U) ~ ~ 0 0 01 N oJ. E \0 ....:........ EI ~ Q)j- U) 0, 0 0.. 1--11 I i .Q * Xi Xi ~! 0 ..J ~j E """ - X <:! <Cj iii ""::--i I- wi U) B ~ wJ zJ t7.l c.. .... w; €" en .-! >- =' C) u.. l!)! l.9, C) 51 >1 U). u ..- ct oi oi ..- ...s:::l *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT I FILE NUMBER 21 - 2004 - 0655 ESTATE OF TAYLOR, CHARLOTTE S. Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorshIp must be disclosed on schedule F. ITEM NUMBER 1 DESCRIPTION VALUE AT DATE OF DEATH 21,110.00 Peoples National Bank Checking Account No. 223436 2 Peoples National Bank Certificate of Deposit No. 70286 30,010.00 3 Peoples National Bank Certificate of Deposit No. 70601 50,102.00 4 Peoples National Bank Certificate of Deposit No. 73039 15,007.00 5 Community Bank Company Certificate of Deposit No. 130461923 10,000.00 6 Community Bank Company Certificate of Deposit No. 13046063 5,000.00 7 Community Bank Company Checking Acct. No. 100680061 12,691.00 8 Residual Interest in Trust of Maurice Taylor, Deceased 330,825.00 TOTAL (Also enter on Line 5, Recapitulation) 474,745.00 Checkin~ Accounts: Number: Date Opened: Balance at Date of Death: Name of Joint . Owner,-if any: Savim!s Accounts: Number: Date Opened: Balance at Date of Death: Name of Joint Owner, if any: Certificates of Denosit: Number: Date Opened: Name of Joint OVl-ller, if any: Balance at Date of Death: Maturity Date: Interest Rate: Interest Paid Q1.l:arterly, Semi-Annual, etc. Debts: ;).;].143 La q I g /CJ q , ,f;JJ, /O,-<t:.J.r}2 I -l ;,. ~~- ,f ' '/O~<Z(P '7 /30/9.5 ,. ., ~ 30, ()IO. 1../ 0 I JO/~% t./ I .. 1./5 ~ monlhj Estate of: Charlotte S. Taylor Date of Death: June 10, 2004 '70(p() I (p/; q /q7 I / ~ .~().I()d.4, I 2/;9 lor I I 3,'-/Oc~ . nxm!-h'J r;~o39 '6 / 4/q ~ rl I I ~ /5; 007. 3"? ,. ~ I~I/o (f I , 3.0()~ m~w/~ Name of Bank: PeonIes National Bank .eckinQ Accounts: Number: Date Opened: Balance at Date of Death: Name of Joint Owner, if any: SavinQs Accounts: Number: Date Opened: Balance at Date of Death: 100680061 01/18/1995 $12,690.84 N/A N/A Estate of: Charlotte S. Taylor Date of Death: June 10, 2004 Iwr : ~ID: 2 !~;i'il 11 n \ ! 1 . rU1 \\~ Name of Bank: Community Bank Cornanv LAW OFFICES DOUGLAS P. THOMAS SCRANTON OmCE: TUNKHANNOCK OmCE: 415 WYOMING AVE. SCRANTON, PA 18503 PHONE (570) 963-8880 FAX (570) 963-9372 P.O. BOX 358 TUNKHANNOCK, PA 18657 (570) 836-7500 June 8, 2005 Lisa Marie Coyne, Esquire Coyne & Coyne 3901 Market Street Camp Hill, PA 17011-4227 RE: ESTATE OF MAURICE TAYLOR, DECEASED ilr:~, . ~ :r-T:=:-l-i .;'; n' ~=:-' r---,,'~ l1i ~ ll.S (b f ~ I ' ,V! I::;:: ; 1'-<,.\: II~JI ~ ~ ;'~~~~1111r ;f:Ut\ ' !' l))l It;Y~c"":~'~;Ci~g';,:,~~l " Dear Ms. Coyne: In accordance with our recent telephone conversation concerning the captioned estate, I am enclosing herein a copy of the statement issued by Securities America for the Maurice D. Taylor Family Trust for the month ending May 31,2004. I understand. you are trying to ascertain the value of such trust attributable to Charlotte Taylor as of the date of her death, approximately ten (10) days' afte'r the' c10sebfthaf statement. As I mentioned when we spoke, although the bulk of that account will have to be reported as part of Charlotte's estate for death tax purposes, not all of it will be. I am also enclosing herein a copy of a letter I wrote to John and Betty Hawley in April in which I explained to them the source ot'those funds and how such would be distributed. In the fifth paragraph on the second page, I advised what I believed to the proper allocation of the funds in that account. Based on that proposition, Charlotte Taylor's interest in the Securities America Trust Flmn on May 31. 2004 was $330.825.071, Of course, adjustments may need to be made for the few days in June during which she lived. I hope to be in a position to finally close the administrations of the estate and trust in the [lext few weeks. At that time, we anticipate sending to you approximately $12,000.00 representing Charlotte's final distribution. We will make the check payable to the trust or her estate, however you instruct. Please call me if you think I may be of further assistance in this matter. Meanwhile, best regards. :~~~~~IY' - // ................-, ,l', ~-:::=-"--~ ~ () ~ _" ,,~,"-,,--'~'--'~-1Jo~91~s r@omas DPT:gmn Enclosure cc: John & Betty Hawley '* SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF TAYLOR, CHARLOTTE S. I FILE NUMBER 21 - 2004 - 0655 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 David B. Stewart 5 Brandywine Drive Mechanicsburg, P A 17055 Son JOINTLY OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM Include name of financial institution and bank account number DATE OF DEATH NUMBER FOR JOINT MADE or similar identifying number. Attach deed for jointly-held real VALUE OF ASSET DEeD'S VALUE OF TENANT JOINT estate. INTEREST DECEDENT'S INTEREST 1 A 12/11/1986 PennStar Bank 2,500.00 50% 1,250.00 Checking Acct. No. 35138137 2 A 03/01/1997 PennStar Bank: 4,526.24 50% 2,263.12 Checking Acct. No. 1416323369 I I I I TOTAL (Also enter on line 6, Recapitulation) 3,513.12 DECEASED PERSON'S NAME: SOCIAL SECURITY NUMBER: DATE - OF - DEATH: Charlotte S. Taylor 169-54-4476 06-10-04 CHECKING ACCOUNTS: TITLE Charlotte S. Taylor or David B. Stewart Charlotte S. Taylor or David B. Stewart SAVINGS ACCOUNTS: TITLE None ACCOUNT NUMBER 35138137 opened: 12-11-86 1416323369 opened: 03-01-97 ACCOUNT NUMBER MONEY MARKET ACCOUNTS: TITLE ACCOUNT NUMBER None SAFE DEPOSIT BOX: TITLE None CD'S TITLE None LOANS: TITLE None . IRA ACCOUNTS: TITLE None TRUST: None BOX NUMBER DATE-OF-DEATH BALANCE $2,500,00 $~,526.24 , closed: 08-20-04. DA TE - OF -'- DEATH BALANCE DAT~-OF-DEATH BALANCE BRANCH ACCOUNT NUMBER INT. D-O-D MATURITY RA TE VALUE ACCOUNT NUMBER BALANCE ACCOUNT NUMBER VALUE STOCK: None *' SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF TAYLOR, CHARLOTIE S. FILE NUMBER 21 - 2004 - 0655 This schedule must be completed and filed if the answer to any of auestions 1 throuc h 4 on page 2 is yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF NUMBER Indude the name of the transferee, their relationship to decedent and the date of transfer. VALUE OF ASSET DECD'S EXCLUSION TAXABLE VALUE Attach a copy of the deed for real estate. INTEREST (IF APPLICABLE) 1 AIG Annuity 15,268.51 100% 15,269.00 i I I I I ! TOTAL (Also enter on line 7, Recapitulation) 15,269.00 *' SCHEDULE H FUNERAL EXPENSES & ADIVINSTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT \ FILE NUMBER 21 - 2004 - 0655 ESTATE OF TAYLOR, CHARLOTTE S. ITEM NUMBER A. B. Debts of decedent must be reported on Schedule I. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: Zimmerman Auer Funeral Home 2,237.20 2. Honorarium--Clergy 100.00 3. Reception 400.00 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): 2. 3. Street Address City Year(s) Commission paid Attorney's Fees COYNE & COYNE, P.C. 15,000.00 3,500.00 State _ Zip Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant David B. Stewart Street Address 5 Brandywine Drive City Mechanicsburg State PA Zip 17055 Relationship of Claimant to Decedent Son 4. Probate Fees Register of Wills 1,000.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Other Administrative Costs Inheritance Tax Return 15.00 2 Cumberland Law Journal.- Legal Advertisement 75.00 Total of Continuation Schedule(s) 7,896.00 30,223.20 TOTAL (Also enter on line 9, Recapitulation) *' 5cheWIe H Funeral Expel ases & ActninistratNe Costs continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF TAYLOR, CHARLOTTE S. I FILE NUMBER 21 - 2004 - 0655 3 Patriot News-- Legal Advertisement 97.00 4 Final Income Tax Return 5 Reserves 6 Postage 7 Executor--Mileage @$.45/mile 8 Toll Calls 9 Estate Checks 300.00 7,000.00 37.00 405.00 32.00 25.00 Page 2 of Schedule H * SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF TAYLOR, CHARLOTTE S. I FILE NUMBER 21 - 2004 - 0655 Include unreimbursed medical expenses. ITEM NUMBER 1 PSERS-- overpayment of benefits DESCRIPTION AMOUNT 902.00 2 Uncleared Checks at DOD 1,293.00 3 Holy Spirit Hospital 229.00 4 West Shore Ambulance 583.00 5 East Pennsboro Ambulance 475.00 6 Manor Care 325.00 TOTAL (Also enter on Line 10, Recapitulation) 3,807.00 REV-15,13 EX+ (9-00) *' SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF TAYLOR, CHARLOTTE S. I FILE NUMBER 21 - 2004 - 0655 - ..._----- - ~ RELATIONSHIP TO AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT OF ESTATE nn Nnt I let Tn'et..../c\ I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1 David Stewart Son 100% of Residual Estate I ! 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 TAXIS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEEt /~.' . ." /_/0_ LAST WILL AND TESTAMENT I, CHARLOTTE S. TAYLOR, of Hontrose, Pennsylvania, declare this to be my Last Will and revoke any Will previously made by me. FIRST: I direct that all my just debts and funeral expenses, including my gravemarker"and all expenses of my last illness, shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. SECOND: I bequeath my automobiles, household and personal effects and o~her tangible personalty of like nature (not including cash or securities), together with any existing insurance thereon, to my husband, MAURICE D. TAYLOR. Should he not survive me, I bequeath such tangible personalty and insurance thereon to such of my son, DAVID B. STEWART. THIRD: OI give a?d devise all the residue of my estate, real or personal, to my son, DAVID B. STEWART, per stirpes. FOURTH: My Personal Representative shall have the following powers in addition to those vested in them by law and by other provisions of my Will applicable to all property, whether principal or income, exercisable without court approval, and effective until actual distribution of all property; A. To retain any or all of the assets of my estate, real or personal \..,ithout regard to any principle of diversification or risk. 1 B. To invest in all forms of property or investments authorized for Pennsylvania fiduciaries, as they deem proper without regard to any principle of diversification or risk. C. To sell at public or private sale, to exchange or to lease, for any period of time, any real or personal property and to give options for sales, exchanges or leases, for sueh prices and upon such terms or conditions as they deem proper. D. To allocate receipts and expenses to principal or income or partly to each as they from time to time think proper. FIFTH: I appoint my son, DAVID S. STEWART and JOHN C. HAWLEY, Personal Representatives of this my Last Will. Should either fail to qualify or cease to act as Personal Representative, then the survivor shall act alone. SIXTH: I direct that my Personal Representative or successor not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WI12LESS WHEREOF, day of ;::";r7111(}t1~V I I have hereunto set my hand , 19~. /'/ ,'" J. ~ Cd CHARLOTTE this /8 -IJ (SEAL) Testatrix SIGNED, CHARLOTTE B. presence of presence of w'tnesses. SEALED, PUBLISHED AND DECLARED by the above named TAYLOR as and for her Last Will and Testament in the us, who at her request, in her presence, and in the each other, have hereunto subscribed our names as of \~~ {>It (~1 1-(1 '7- t;/)CO - of I ~A_~// '- .jp 2 COMMONWEALTH OF PENNSYLVANIA COUNTY OF Lac.l!a:;,jOd/IA I, CHARLOTTE S. TAYLOR, the 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; and that I signed it willingly and as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged be~ore me .by CHARLOTTE S. TAYLOR, the testatrix, this /',f~day of - r-Ia/ll~I~;e./' , 199~. VJ. -;;: d/ .6 of S5: /.. officer or (Signature attorney) (Seal and official capacity of officer of state of admission attorney) of COMMONWEALTH OF PENNSYLVANIA ": NOTARIAL SEAL" S 5 : BRENDA E. MUSSAR" Notary Public COUNTY OF / c;-el1a-wc1.IY/</A' Scranton City. Lackawanna County ~ M Commission Ex ires Oct. 17. 1998 We, .....7\Jl'/ltLD ,=r: h?/'I]~"/?/c./.( and r-=r::;hl'fltfJ'c.uye- V' , 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 the testatrix sign and execute the instrument as her Last Will; that the testatrix signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testatrix signed the will as a witness; and that to the best of our knowledge the testatrix was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn to or affirmed and subscribed ... 7)11;V /-i ;(...l) ;:::r: ;.::;::. /l7JK I cd and witnesses, this /E'-t':.L; day of me by , 1 9 9 ,"":?-. ;42 . t/ (Sign'ture I atto ey) (Seal and official capacity of officer of state of admission of attorney) I NOT AR1AL SEAL ,"-'-'~~~NPA :. MUSSARI. Notary Public j ~\';fti:'\O{i City. Lacl<awanna County i ;'.\'j :>'"t~ml~,-ion Ex ires Oct. 17, 1998 ._____ __ _ _._..a.: 3 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT STEWART DAVID B 5 BRANDYWINE DRIVE MECHANICSBURG, PA 17050 ____nn fold ESTATE INFORMATION: SSN: 169-54-4476 FILE NUMBER: 2104-0655 DECEDENT NAME: TAYLOR CHARLOTTE S DA TE OF PAYMENT: 06/12/2006 POSTMARK DATE: 06/09/2006 COUNTY: CUMBERLAND DATE OF DEATH: 06/10/2004 NO. CD 006827 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $20,800.00 I I I I I I I I TOTAL AMOUNT PAID: $20,800.00 REMARKS: CHRISTINE K STEWART CHECK#1549 SEAL INITIALS: CM RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS . . COYNE & COYNE A PROFESSIONAL CORPORA nON ATTORNEYS AT LAW Henry F. Coyne Lisa Marie Coyne Office of the Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, P A 17013 Dear Sir or Madam: 717-737-0464 Fax: 717-737-5161 3901 Market Street Camp Hill, Pennsylvania 17011-4227 June 9, 2006 .....;-. Re: Estate of Charlotte S. Taylor, Deceaseq No. 21-2004-0655 C) c.n We represent the estate of the late Charlotte S. Taylor. Enclosed is an original and two copies of the Inheritance Tax Return for this Estate. Kindly docket the original and return to me a "clocked-in" copy with the enclosed envelope. Also enclosed is check no. 1549 in the amount of $20,800.00 (which represents payment of the Inheritance Tax) and check no. 1548 in the amount of$15.00 (which represents payment of the filing fee for the Return). Kindly issue receipts for payment of the tax and the filing fee. If you have any questions, please contact me. Thank you for your assistance. LMC/cmc Encls. Cc: Mr. David S. Stewart Very truly yours, a;~c; ; ,SS1 t.\,,, f~ i". ..' _.~,\'\;~t' ...>~t ~-~,~-' ~ t ~~ ~, ... , ;;, r:t ,1 -= , ! i. .~ ~ l \' '~~f; \f\:C:':,. " ,il'i '~.,~ ..~,.. ':~h~\, ~;':' ',;' " .,C1'1...,. ".s;;.".' ~,,~, ,.. " ~t:./,~~;~, ,,,>:~ ..-, ....... - .'.....";"Ij;~. .;t..,.'.. .,",,;;.;;>..:;. 5 ~.. ',.., _;;i",:~ \ ' 4/(, , .... . "or-,. ..' . "'. ..4" . . -.,1. t 1 \1.- \ ~:\ ,j', , .'~ '\. '. I' 'ii ", . t_ .'" .. - ji.. t,;~ · 'v ",", ~ ~.'<~ 1JII' . ...-;'? '~ ,,:.1 ~_. ~ .,\iJ" f. ~ ~ \ , . \ "'I \J ? .,( . >. ,l'. r~U~ ..~\ ..~,G .,' .,\t)~~ .~...... :;J .~. .- - ---- Register of Wi Us of Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedent: Q I.. fh'L 10 If e $', "r;"1 I () v Date of Death: Estate No.: /1= 20 0 if-err) (, .$-) 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 0 No~' 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: p-f b, U (/( J. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a fmal account with the Court? Yes 0 No 0 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 0 No 0 c. Copies of receipts, releases, joinders and approval of fomml or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. L,.s ~/t-tl j F (0-.; ;'VG: Name 3ftJ/ /'lrt.Jt.<-J-d , c."Y IJJj Address f 14- '7/7- 7'3 7- [) Li (p l I Telephone No. Date: 11/0; ! . 1'-'" n 7 . ~ I ~ 1 J lJ . 1 Capacity: 0 Personal Representative 7 )5?tounsel for personal representative yYJ COYNE & COYNE A PROFESSIONAL CORPORATION ATTORNEYS AT LAW Henry F. Coyne Lisa Marie Coyne 3901 Market Street Camp Hill, Pennsylvania 17011-4227 717-737-0464 Fax: 717-737-5161 November 3,2006 Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, P A 17013 Re: Estate of Charlotte S. Taylor, Deceased No. 21-04-0655 Dear Sir of Madam: We represent the Estate of the Late Charlotte S. Taylor. Enclosed are an original and one copy of the Status Report. Kindly docket the original and return to this office a "clocked-in" copy with the enclosed envelope. Thank you for your assistance. If you have any questions, please contact me. Very truly yours, COYNE & COYNE, P.c. LMC/amd Enclosure cc: Mr. David Stewart, w/encl. i'.,./ 02:1 :1:! 9-- J _ ._. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DF(' nr1 ~),~E OF INHERITANCE TAX I i ..~,)~ff8~J ~OWANCE OR DISALLOWANCE f:CC;I..)~",~Euu.c!~dN~ .AND ASSESSMENT OF TAX 08-07-2006 TAYLOR 06-10-2004 21 04-0655 CUMBERLAND 101 APPEAL DATE: 10-06-2006 ( See reverse side under Objections) A_ount R..ittedl I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR RECORDS +- ii,,:is47-ii-AFP-ioi:os3-NOTicE-OF-iNHiiiTANCE-TAi-APpiAisEMENT:-ALLOWANCE-oi--------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX CHARLOTTE S FILE NO. 21 04-0655 ACN 101 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 20U6 IHJG i L} 12: '4 LISA MARIE COYNE COYNE & COYNE 3901 MARKET ST CAMP HILL PA 17011 ESTATE OF TAYLOR . J REV-1547 EX AFP (06-05) CHARLOTTE S TAX RETURN WAS: (X) ACCEPTED AS FILED DATE 08-07-2006 ( ) CHANGED I~ an assess.ent was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect ~igures that include the total D~ 6kb returns assessed to date. ASSESSMENT OF TAX: 15. A.ount of Line 14 at Spousal rate (15) 16. A.ount of Line 14 texable at Lineal/Class A rate (16) 17. ~t of Line 14 at Sibling rate (17) 18. A.ount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due T : RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estete (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funerel Expenses/Ada. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Totel Deductions 12. Net Value of Tax Return 13. Cheritable/Gover~tal Bequests; Non-elected 9113 Trusts 14. Net Value of Estate Subject to Tax NOTE: DATE 09-08-2004 06-09-2006 NUHBER CD004354 CD006827 INTEREST/PEN PAID (-) 263.16 1,380.88- . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION DF ADDITIONAL INTEREST. (1) (2) (3) (4) (5) (6) (7) .00 88.014.00 .00 .00 474.745.81 3.513.12 15,269.00 (8) NOTE: To insure proper credit to your account, sub.it the upper portion of this for. with your tax payaent. 581,541.93 ~4.0~O 24 547,511.69 .00 547,511. 69 .00 24,638.00 .00 .00 24,638.00 24,682.28 44.28CR .00 44.28CR ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) (9) UO) 30,223.20 3.807.04 (11) (2) (3) (4) (Schedule J) .00 X 547,511. 69 X .00 X .00 X 00 = 045 = 12 = 15 = (9)= AMDUNT PAID 5,000.00 20,800.00 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE Pa. o.e. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent: CHARLOTTE S. TAYLOR Date of Death: June 10, 2004 File Number: 21-04-0655 Pursuant to Pa. O.c. Rule 6.12, 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: . . . . . . . . . . . . . . . . . . .. IZJ Yes 0 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? . . . . . .. DYes IZJNo 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? ............................... IZJYes DNo 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 attac1i:o this report. ~ ( ,,---- Date May 20, 2008 Capacity: Counsel LISA MARIE COYNE, ESQUIRE Name of Person Filing this Form 3901 Market Street Vd "OJ apNib38V~no lliOOJ S,NVHdOO :IO )I~310 *70 :21 Wd ..,- NOr 80al Address Camp Hill, PA 17011 (717) 737-0464 Telephone 'T' :() Form RW-Iol r;{'rlJ).J(J'][)6q/,/'\ , , ~~... ....Jvl-::,Jcr \.j....'-.,..;(;f",../;~.l,:,;;:~.;'