HomeMy WebLinkAbout03-0149Estate of ROBERT F. LIVINGSTON
Register of Wills of Cumberland, County, Pennsylvania
PETITION FOR GRANT OF LETTERS
No.
A/K/A ROBERT F. LIVINGSTON, SR.
Deceased Social Security No. 206-10-8535
JAMES C. LIVINGSTON
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE "A" OR "B" BELOW:)
A. Probate and Grant of Letters and aver that Petitioner is the Executrix named in the Last Will of
the Decedent, dated September 12, 1990 and codicil(s) dated
State relevant circumstances, e.g. renunciation, death of Executor, etc.
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of
the documents offered for probate; was not to victim of a killing and was never adjudicated incompetent:
B. Grant of Letters of Administration
(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:
Name Relationship Residence
COMPD- 1 I:: IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or
principal residence at 22A Glenwood Drive West, East Pennsboro Township
(List street, number and municipality)
Decedent, then 78 years of age, died February 3, 2003, at
(Location)
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 ...................................................................................................................... $
TOTAL ................................................................................................... $
SCCI Hospital, Harrisburg
5,000.00
78,000.00
83~000.00
Real Estate situated as follows: 22A Glenwood Drive West, East Penn,qboro Township, Cumberland County, PA
Wherefore, Petitioners respectfully request the probate of the last Will presented with this Petition and the grant of letters in the
appropriate form to the undersigned:
. ..-~-'~ignatu re ~
Typed or printed name and residence
James C. Livingston
625 Erford Road
Camp Hill, PA 17011
OATH OF PERSONAL REPRESENTATIVE
Commonwealth of Pennsylvania
County of Cumberland
The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are
true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s)
of the Decedent, Petitioner(s) will well and truly administer the estate according to law,
Sworn to and affirmed and subscribed
before me this ~ O''t~ day of
/ JAMES C~IVINGSTON
DECREE OF REGISTER
Estate of ROBERT F. LIVINGSTON,
NWA ROBERT F. LIVINGSTON, SR., Deceased
No. 21-03-149
Social Security No: 206-10-8535
Date of Death: February 3, 2003
AND NOW, FEBRUARY 21st- ,2003, in consideration of the Petition on the reverse side hereon,
satisfactory proof having been presented before me,
IT IS DECREED that Letters Testamentary are hereby granted to James C. Livingston
in the above estate and that the instrument(s) dated September 12, 1990
described in the Petition be admitted to probate and filed of record as the last Will of the Decedent.
FEES
Letters ........................... $
200.00
Short Certificate(s)4 $ 12.00
Renunciation .............. $
Affidavit ( ) .................. $
Extra Pages (3) ....... $ 9.00
Codicil ............................ $
JCP Fee ....................... $ 10.00
Inventory ...................... $
Other .............................. $
TOTAL ......... $ 231.00
Registe-r-~f Wills'
Attorney: C. Roy Weidner, Jr.
I.D. No: 19530
Address: Johnson, Duffie, Stewart & Weidner,
301 Market Street, P.O. Box 109, Lemoyne, PA 17043-O109
Telephone: 717-761-4540
MAILED LETTERS TO ATTORNEY FEBRUARY 21, 2003
21-03-149
sip/wi/09 790/LivingstonW (1-4)
21-03-149
OF
ROB~ F. ~
I, ~ F. ~-V~G~, of the Township of East Pennsboro, County of
Cumberl~ndandCc~monwealthofPennsylvania, being of sound anddisposingmind,
memory and understanding, do hereby m~ke, p,_bli~h and declare this as and for
my last Will and Testament, hereby revoking all other Wills heretofore made by
me.
I direct the payment of my legal debts and the expenses of my last illness
and the disposition of my remains from my estate as soon after my death as
conveniently maybedone. All of the foregoing shall be consideredexpenses of
the administration of my estate.
I bequeath all of my tangible personal property (excluding cash or
securities), together with any existing insurance thereon, to my wife, ~ L.
I~V]~, if she survives me by thirty (30) days. If ~he dc~s not so survive
me, I bequeath such property, in as nearly equal shares as possible, to my
children, I./NDA L. HIVN~, BD~ F. LlVl]~GS~, JR., JAMES C. ~,
BAVID W. ~ ~ SANE~A E. I~¥i~C~gDC~. If any of my children do not
survive me, I bequeath the share of a deceased child to their issue per
stirpes. Should a deceased child leave no issue, I bequeath such share to my
other children or their issue per stirpes.
I devise and bequeath all of the residue of my estate to my wife, ~ L.
LIVll%~I~, if she survives me by thirty (30) days. If she does not so survive
me, I bequeath such property, in equal shares, to my children, T.~ L. ~,
~ F. LIV]A~k9!~, JR., JAMES C. LIVINGST-~, BAVID W. ~ and ~
E. I~-]~l~;. If any of my children do not survive me, I bequeath the share
of a deceased child to their issue per stirpes. Should a deceased child leave
no issue, I bequeath such share to ~M otl~er ~hildren Or their issue per
stir .
I appoint my son, ~ C. IA-v~~, Executor of this my last Will. In
the event of his inability or unwillingness to act or continue to act as
Executor, I appoint my son, ~ F. IA~r//~S~, JR., Executor.
I direct that my Executor, or his successors, shall not be required to give
bond for the faithful performance of their duties in any jurisdiction in which
they may be called upon to act, insofar as I am able by law to do so.
/N ~ ~OF, I hereunto set my h~nd ~nd seal this /~ day- of
Robert F. ~ivingstor~
Signed, sealed, published and declared by the above-named Testator as and
for his Last Will and Testament in the presence of us, who, at his request, in
his presence and in the presence of each other have hereunto subscribed our
names as witnesses.
O0~ZONWEALTH OF P~NSYLVANIA
COUNTY OF Ct~aB~LAND
I, Pobert F. Livingston, Testator, 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
purposes therein expressed.
,~ /t /~ ,
Robert F. L~vingston ~
Sworn or ~firmed to and acknowledged before me, by Robert F. Livingston,
the Testator, this /~- day of ~ ~7)6£/, 1990.
Notary Public
I" #OTAEIAL SEAL
SHARON L. PREBLE, I~OTAR¥ PUBLIC
LE#OY#E BORO. CUMBERU~ID COUNTY
fly COI~I[SS[Ofl EXPIRES ILAR. 24~ lg94
CC~2~DNWEALTH OF P2~NSYLVANIA
COUNTY OF Ct~4BERLAND
SS:
whose names are signed to the foregoing instrument, being duly qualified
accordingly to law, do depose and say that we were present and saw the Testator
sign and execute the foregoing instrument as his Last Will and Testament; that
he signed willingly and that he executed it as his free and voluntary act for
the purposes therein expressed; that each of us in the hearing and sight of the
Testator signed the Will as witnesses; and that to the best of our knowledge,
the Testator was that time at least 18 years of age, of sound mind .and under no
constraint or undue influence. _j~.~_~~~
Sworn to or affirmed to and subscribed to before me by ~. ~L(~/ /J)~ ~-~ ~j
Notary Public
I~IOT'A.~AL SEAL
JOHNSON. DUFFLE. STEWART
& WEIDNER
ATTORNEYS AT LAW
LEMOYN E, PENNSYLVANIA
CERTIFICATION OF NOTICE UNDER RULE 5.6 a
Name of Decedent: Robert F. Livingston alk/a Robert F. Livingston, Sr.
Date of Death: February 3, 2003
Admin. No.:
Will No.: 2003-00149
To the Register:
I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on
February ,.~.1 ~' z'~ 2003.
Name
Linda L. Hivner
Robert F. Livingston, Jr.
James C. Livingston
David W. Livingston
Sandra E. Nelson
Address
513 Erford Rd., Camp Hill, PA 17011
-~282 Allen St., Manassas, VA 20110
625 Erford Rd., Camp Hill, PA 17011
4604 Beretta Ct., Chesapeake, VA 23321
R.D. #2, Box 461, Annville, PA 17003
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None.
Name C. Roy Weidner, Jr., Esq.
Johnson, Duffle, Stewart & Weidner
Address 301 Market St.
P. O. Box 109
Lemoyne, PA 17043-0109
Telephone (717) 761-4540
Capacity: Personal Representative
X Counsel for personal representative
TO
Register of Wills Office
Cumberland County Courthouse
1 Courthouse Square
Carlisle, PA 17013-3387
SUBJECT:
Estate of Robert F. Livingston
No. 21-03-00149
Date of Death: 2/03/2003
FROM
3OHNSON, DUFFZE, STEWART & WE[DNER
Attorneys at Law
P.O. Box 109
Lemoyne, PA 17043
(717) 761-4540
Fax: (717) 761-3015
DATE: April 25, 2003
Enclosed is a check in the amount of $3,900.00 as a payment on account of Inheritance
Tax for the above-captioned Estate being made within the 90 days to allow for the 5% discount.
SIGNED: Cindy Hubler, Estate Administration
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Robert F. Livingston a/k/a Robert F. Livingston, Sr.
Date of Death: February 3, 2003
Will No.: 2003-00149 Admin. No.:
To the Register:
I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on
February ~-.~) Y ,¢'
,2003.
Name
Address
Linda L. Hivner 513 Erford Rd., Camp Hill, PA 17011
Robert F. Livingston, Jr. 9282 Allen St., Manassas, VA 20110
James C.~ Livingston 625 Erford Rd., Camp Hill, PA 17011
David W. Livingston 4604 Beretta Ct., Chesapeake, VA 23321
Sandra E. Nelson R.D. #2, Box 461, Annville, PA 17003
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None.
D a to: ~.~//,..~) ~///'~j2
Name C. Roy Weidner, Jr., Esq.
Johnson, Duffie, Stewart & Weidner
Address 301 Market St.
P. O. Box 109
Lemoyne, PA 17043-0109
Telephone (717) 761-4540
Capacity: Personal Representative
X 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
DUPLICATE
NO.
REV-1162 EX(11-96)
CD 002505
WEIDNER C. ROY JR ESQU. IRE
PO BOX 109
LDvDYNE, PA 17043
........ fold
ESTATE INFORMATION: SSN: 206-10-8535
:ILE NUMBER: 2103-01 49
DECEDENT NAME: LIVINGSTON ROBERT F
DATE OF PAYMENT: 04/28/2003
POSTMARK DATE: 04/25/2003
COUNTY: CUMBERLAND
DATE OF DEATH: 02/03/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $3,900.00
TOTAL AMOUNT PAID:
$3,900.00
REMARKS: JAMES C LIVINGSTON
C/O C ROY WEIDNER JR ESQUIRE
SEAL
CHECK# 11 6
INITIALS' CW
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
TAXPAYER
TO
Register of Wills Office
Cumberland County Courthouse
1 Courthouse Square
Carlisle, PA 17013-3387
SUBJECT:
Estate of Robed F. Livingston
No. 21-03-00149
FROM
3OHNSON, DUFF:[E, STEWART & WE:[DNER
Attorneys at Law
P.O. Box 109
Lemoyne, PA 17043
(717) 761-4540
Fax: (717) 761-3015
DATE: June 25, 2003
Enclosed for filing in the above-captioned Estate are the following:
1. Original Inventory.
2. Original and copy of Inheritance Tax Return.
3. Check in the amount of $28.00, filing charges.
4. Check in the amount of $487.36, balance of Inheritance Tax.
SIGNED: C. Roy Weidner, Jr. csh
JOHNSON,
DUFFLE] ?. TEWAR =
ATTOF~ N ;' V q AT I.A' I
301 M~-: !;T STREE
P. ~. ~ :~109
LEMOYNE, PEN ~',:
~"irst Class M
REGISTER OF WILLS OFFICE
CUMBERLAND COUNTY COURTHOUSE
1 COURTHOUSE SQUARE
CARLISLE, PA 17013-3387
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-1 t62 EX(11-96)
CD 002739
WEIDNER C ROY JR, ESQ.
P. O. BOX 109
LEMOYNE, PA 17043
........ fold
ESTATE INFORMATION: SSN: 206-10-8535
FILE NUMBER: 2103-01 49
DECEDENT NAME: LIVINGSTON ROBERT F
DATE OF PAYMENT: 06/26/2003
POSTMARK DATE: 06/25/2003
COUNTY: CUMBERLAND
DATE OF DEATH: 02/03/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $487.36
TOTAL AMOUNT PAID:
$487.36
REMARKS: JAMES C LIVINGSTON, EXECUTOR
C/O C. ROY WEIDNER, ESQ
SEAL
CHECK//120
INITIALS: JA
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
REV - 150Q EX * (6..O0)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG. PA 1712~0601
REV-1500 I
INHERITANCE TAX RETURN FI'ENUM
BER
RESIDENT DECEDENT COU21ODEN~'C 03 00149
YEAR NUMBER
DECEDENT'S NAME (LAST. FIRST. AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
LIVINGSTON, ROBERT F. 206-10- 8535
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-Y. EAR)
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
02/03/2003 09/20/1924 REGISTER OF WILLS
IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
[]
[]
[]
[]
12-31-91 and 1-1-95
NAME
C. ROY WEIDNER, JR.
1. Original Return E] 2. Supplemental Return [] 3. Remainder Return (dateof death prior to 12-13-82)
4. Limited Estate [] 4a. Future Interest Compromise (date of death after [] 5. Federal Estate Tax Return Required
12-12-82)
6. Decedent Died Testate (Attach copy [] 7. Decedent Maintained a Living Trust (Attach 8. Total Number of Safe Deposit Boxes
of Will) copy of Trust) --
9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (date of death between [] 11. Election to tax under Sec. 9113(A) (Attach Sch O)
COMPLETE MAILING ADDRESS
):tRM NAME (If applicable)
T Johnson, Duffle, Stewart & Weidner
717/761-4540
(1)
1. Real Estate (Schedule A)
(2)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
[] Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions(total Lines 9 & 10)
12. Net Value of Estate(Line 8 minus Line 11)
301 Market St., P. O. Box 109
Lemyne, PA 17043-0109
73,000.0(I~ !"' ~d OFFIClAL-'3Lg¢,~ UL'r
Nonel
Non~
None
13,371.64
29,588.95;!;:
None
13,074.90
827.41
(8)
(11)
(12)
115,960.59
13,902.31
102,058.28
102,058.28
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13)
made (Schedule J)
14. Net Value Subject to Tax(Line 12 minus Line 13) (14)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax rate, x .00 (15)
or transfers under Sec. 9116(a)(1.2)
1&Amount of Line 14 taxable at lineal rate x .045 (16)
17. Amount of Line 14 taxable at sibling rate x .12 (17)
18. Amount of Line 14 taxable at collateral rate x .15 (18)
19. Tax Due (19)
102,058.28
4,592.62
4,592.62
20. []
Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
22A Glenwood Drive, West
STATE ZIP
CITY Camp Hill PA i 1701
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
3,900.00
205.26
Total Credits (A + B + C) (2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (D + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENT. (4)
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 (5)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is theBALANCE DUE (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
(1) 4,592.62
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ............................................................................. ~ ~
b. retain the dght to designate who shall use the property transferred or its income; ................................
c. retain a reversionary interest; or. ...........................................................................................................
d. receive the promise for lifo of either payments, benefits or care? ...........................................................
4,105.26
0.00
487.36
487.36
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? ................................................................................................................. [] []
3. Did decedent own an "in trust for" or payable upon death bank account or secudty at his or her death2 ....... [] []
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation2 ............................................................................................................... [] []
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 RETURN
~GNATURE~,~F PE~S~q RESPON,~iE FOR FILING R~URN
C. ROY WEIDNER, ~. V
ADDRESS DATE
625 Erford Road ~,,~ .~//~
ADDRESS DATE
301 Market St., P. O. Box 109
Lemyne, PA 17043-0109
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 statutedoes 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.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF
LIVINGSTON, ROBERT F.
FILE NUMBER
21-03-00149
All real property owned solely or as a tenant in common must be rel3orted at fair market valu~air market value is defined as the pr ce
at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having
reasonable knowledge of the relevant facts.Real property which is jointly-owned with right of survivorship must be disclosed on
schedule F.
ITEM
NUMBER
DESCRIPTION
Real Estate - No. 22-A Glenwood Drive (West), East Pennsboro Township,
Cumberland County, PA.
Deed Book R, Volume 22, Page 233
Sale Price
TOTAL (Also enter on Line 1, Recapitulation)
VALUE AT DATE OF
DEATH
73,000.00
73,000.00
Settlement Statement
U.S. Department of Housing
and Urban Development
OMB Approval No. 2502-0265
513 ERFORD ROAD
CAMP HILL PA 17011
22-AGLENWOOD DRIVE - NEST
CAMP HILL
B. Typ~ ~f Loan
4. [] VA 5. [] Cony. Ins. . /
..................... ~0! 3_2_3_1870_~
C. Note~: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent am
shown. Items marked '(p.o.c.)" were paid outside dosing; they are shove here for informational purposes and not
included in the totals.
D. Name and Address of Bo*rower E. Name and Address of Seller F. Name and Add.ss of Lender
KAREN M. HIVNER JAMES C. LIVINGSTON, EXECUTOR MEMBERS 1ST
ROBERT L. LIVINGSTON ESTATE FEDERAL CREDIT UNION
15000 LOUISE DRIVE
_[MECHANICSBURG PA 17055
H. Seffiemeflt Agent MEMBERS 1ST SETTLEMENT SERVICES, LLC
PA 17011 5000 LOUISE DRIVE 4/412003
MECHANICSBURG PA 17055 Disbulsemenl Dele
4~4~2003
J. Summary of Borrower's Transaction
K. Summary of Seller'e Transaction
100. GrosS Amount Due From Borrower 400. Gross Amount Due To Seller
~sl~ pdc~_. _ _ ] 73,000.0~0 401. Cun~rect sales price
~0~.
CoBtracl
!_02. Personal property ............
~03. S~_"?enl~_~rges tO ~_r~wer
;05: ......................
Adjustments for Items p_al_d, bY se_Il_er In aclya_ _m=.e~ ................ AdJu_~tme_n. _t~ f_o_r _lfe~ms_~.~ by se er n advance
106. City/town taxes . ___19.__ _ 4_O6:_C_ity_/t__o~v_n taxes to
107. County taxes to ........................ _4_07._ Cou_n_ty taxes to
108. Assessm~ots . _ _to ................. ¢~0~._ A__ssa~ssments to
_1_06. S_C_H_OOL_T_~AX_4/_4/2003 to 6/30/2003 212.48 ~09.
110. to 410.
~_11 .......... to 41~1.
L~2. to ~2.
113. to 413.
114.. .... to 414.
115. . ..... _to ........................... 4_1~:
120. Gr~a Amount Due From Borrower 78,052.26
200. Amounts?aid By Or In Behalf Of Borrower
201. Deposit o_reemest mone~ 500.0~
202. Principal amount of new Ioan(S) ............... _69: 3~5p_. 0_0
203. Exlsti~ng_/oa~(s~ taken subject to
204.
205.
206.
207.
208.
209.
AdJaltme~l~s for Itam_s un_pa!d by~ seller
21__0. City/town taxes to
211. Cou_ntytsxes____ 1/1/2003 to 4/4/2003
21_2. Asse.~ssments to
213. to
214. to
21_5: sEWER/: -T 4i:1_/2_003_..__t_° 4~/4~/20.0_3 __
216. REFUSE to
217. - ....~0
218. to
219. 1o
220. Total Paid By/For Borrower
73,000.(~0
SCHOOL TAX 4/4/2003 to 6/30/2003 212.48
to
420. Gross Amount Due To Sailer 73,212.4R
500. Reductioue In Amount Due To Seller
501. Exsess_del~x~it (see Ins_lm_~_~ions)
~2._ ~Se_m~__ment cha _r~s. _to_~J~_r (!in~ 14OO)
_50_3. _Ex_ Isltn~g I~s~.~_l~_ _su_b_j~ to
--_~_. P~a)~_offi~mo~rtga~. loan
!_50_5. Payoff ol second rnortgal~e loan
506.
507,
508.
509.
_Adjustments for Items unpaid by seller
St_o._c_,y/tow~_ taxes to
59.57 5_~_1_: Co~xes 1/1/2003to4/4/2003
512. Assessments to
513. to
514. to
........ _3.1~_,_s1~. S_~W_ER/___ 4/1.~/.2__00_~_3 _to4/4/2003
_ 516.REFUSE to
517. to
518. to
519. 1o
520. Total Reduction Amount Due ~eller
736.00
59.57
3.16
798.73
300. Cash At Settlement Fromrl'o Borrower ................
...... BO0. C_se_h_At Settlement To/From Seller
301. Gross Amount due from borrower (line 120) ~. 78,052.261601.Gross amount due to seller (line 420)
3~_2. Less a?oun~ paid by/f0[_berro__we~l_ine _2~.~.~.~.~.~.~.~.~_) ~i ~.~,~t~02_. L__essreducfionsinamt duesaller (line520)
303. Cash [] From [] To B ...... / 8,139.53/603- Cash [] To [] From Seller
SUBSTITUTE FORM 1099 SELLER STATEMENT
The information contained in Blacks E, G. H, and I and on line 401 (or, line 403 and 404) is important t~x information and is being furnished to Ihs Intsmal Revenue
Service. If you are rer:luired 1o file a retom, a negligence penalty or olher sanction will be imposed on you if Ihis item is required to be reported arid fha IRS determines
that it has not been repoded. If this real estate is your principal residence, file Form 2119, Sale or Exchange of Principal Residence. for any gain. with your income tax
return; for other transactions, complete the applicable parts of Form 4797, Form 6232 and/or Schedule D, Form 1040). You are required to provide the Settlement Agent
(named above) with your correct taxpaydr identification number. If you do not provide the Sefflemen~Agent with your correct taxpayer idenSlice8on number, you may be
subjecl to civil or criminal penalties imposed by law. Under penalties of perjury. I certify that ~t~ flLimb~. ~' shown o~ this ~st~'r'r~nt is my correct taxpayer idenfifico§on number.
- (~eller's Si~'~lure)//
73,212.48
798.73)
72,413.75
L. ~,.ttle_m_ent_~harges _ ,__ ...................................
700~. Total~al._~e~/B_r_oker:sC__omml_s~io_n_ba_s~ed on_p_r_lce $ 73,000.00 Q % -
.__ Oi~sio~ o~ _C.(~m~_s~_[![~ 700) ~es__fo,_ows:
701. $ to
702. $ to
70_3.: ~(~.m_m?s_*_t~n_peid et Se~?ment~ ........
704.
Paid From
Bonower's
Funds At
Setttamenl
Paid From
Sellers
Funds At
Settlement
8QQ. Item? Pay_a_ble In Conn_ectlo?~Wl~.o_~?
8Q~.. Loan Odgin_afl.o_n?ee ....... 69_,_350_._0_0 ........ 1.00 % MEMBERS 1 ST
802. Loan Discount 69,350.00 1.125 % MEMBERS 1ST
80_3. Apl~_ isa_l F _ee ..... to
8~.. Credi~t Repo~l_ ..... to
8q~._ Len. _de~"s_l~l_s pection Fe~_
8~O6: Mortgage !n_$ura_ncQ ?ppiication Fee to
693.,~0-
780-~9:
807. Assu~p!!_on F._ee
_s~_:. A~p_LI_CATION F_E_E __ MEMBERS 1ST ~$325 P.O.C.).
8o~. DOCUMENT PREP FEE MEMBERS 1ST 75--~
~ i~:~_U. N_~_E_~_w _R IT-N G-~ E
811. _
!
813.
900. Item_l ~equ_lr~d By Len_d_?_T_0_Be Pal~d_ln__A_dva_ n_ _ce ....... _Exct_.u_d? last~ .d_a_y_ in calcs- line
~Ol. thtemstf~ 4/4/2003 to 4/30/2003 @$1~0.1135 ..... /.day
902. Mo~gage Insuranca Premium for monlhs to
90_3. Haz_a~M Ins?anca p rem!?~ to[ ....................... ye~m._._to ............
005.
1000. Reee?vee Deposited With .~e~nder ............
10~_1: Hazard insurance _.3 ............ ._mo_n~h~@$ .... _2_4.17__~r_mp_ n~
1002. Mortgage insurance ............. _n~__th~_ @ $_ ...... per~ _mo_n~.h~ .......
1003. City property ~axes ..........._mo¢lt~hs_~$ ........... . _p~_r~month
1004. Cou_nty property taxes _3 ......... mon~ths@$ 19.48 per month
1005. Annuel.a_ssessmont_s ............ m~_ths~$ per month
lOOS. SCHOOL TAX 11
......................... _mo~nt~s_~$ 74.29 per month
loo?~ .......... months~L per month
1008. Aggregate Accounting Adjustment
72.51
58.44
817.1~
-174.66
1 t_0.0.
1171:. Setttam_enl_p?_closing fee to
~102. Abs!mct o~ fil!e, eea_~ch to
'~103. Title examination to
1104. Title insurance_ binder to
1105. Document preparation to
.................. 8.00 6.00
'~1o7: Attorney's tees ......... to JOHNSON DUFFLE STEWART & WEIDNER - POC
(Includes above items numbers:
1108. Title!nsumnce ....... to MURREL R. WALTERS, III, ESQUIRE 771.75
(thdudesaboveiternsnumpers: 1101-1104, 1108 PENN ATTORNEYS TITLE INS. CO.
1109. Ler~_er's~__emge ...... $ 69,350.00 endorsements 100, 300, 8.1
1111.
1112.
1113.
$ 73,000.00
t200. Government Recording and_T_ ran_?f_e_E_C~arges
1 ~201: Re_co. rdi~gtee~[ Deed $ 38.50 ; Mortgage $
1202. Cily/counb/__ta~J_sla. mps: Deed $
64.50 ; Releases $
730.00; Mortgage $
_~2_p_3: _State ta.x/_~m_p_s: Deed $ 730.00 ; Mortgage $
1204. RECORD ASSIGNMENT OF MORTGAGE
1205.
730.00
1300. AdG;;.;~,ie_~ Sett!em_ent C~harg_e_s_ .....
1301: Survey ........... to
1302. Pes_t_!ns _~_ !_on_ to
1303.
1304.
13o5. 200_3 ~C _Q.UNTY/TWP. REAL ESATE TAX
13o~. 2ND QT_R.~ sEWIS_P,/~:-FLj~
1307.
t308.
ALICIA D. STINE
E. PENNSBORO TOWNSHIP
233.80
96.00
1400. Total Se;=ei~ii; C;iait,~ (enter on lines t03, Section J and S02, Section K} / 4,839.78 736.00
// Ct=l~ I IFICATION
Ionhamv~ eCaccor~Ju InltY~,..e bYlaW_meed nth~hil~l lUraD~ lsaSc~i~'ne.r~f n t Sta ta~r~t d to t ha pest.of my kn~ow.?~e~d.~.e, aun~?~J~e~.!?~/a_ _.t_.ru~e._a.n_d s._c_c~, j. rata statement of ,11 receipta and d sbursements
.._, . ~ . to.harcort,...:,,..ve ~.,~ ............... :_,,:~
Borrower
To t..h~, besl of~.y,l~vJ~lg~he~-IJ~l~*~/'~_eJ~ment Statement which I have prepared is a true and accurate accounl of the funds which were received and have b~en or will
.................... Seffiement Agent D
MEMBERS 1ST S~'~'T~-~MENT SERVICES, LLC __ ate
WARNING: II is s crime to knowingly make false statements to the United States on this or any oiher similar form. Penalties upon conviction can include a fine and
imprisonment. For petails see: Title 18 U.S. Code Section 1001 and Section 1010.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
LIVINGSTON, ROBERT F. 21 - 03 - 00149
Include the proceeds of litigation and the date the proceeds were received by the estate~,ll property jointly-owned with the right of
survivorshfp must be disclosed on schedule F.
ITEM DESCRIPTION VALUE AT DATE OF
NUMBER DEATH
1 7,969.47
PNC - Savings Account No. 51-30135-5774
Date of death balance, plus accrued interest
Automobile - 1997 Ford Contour
Sale Price
Household Goods- appraised value
TmGreen-ChemLawn - Service Contract refund
Internal Revenue Service/Treasury Department
Refund - 2002 Federal Income Tax
TOTAL (Also enter on Line 5, Recapitulation)
3,200.00
1,160.00
358.17
684.00
13,371.64
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF FILE NUMBER
LIVINGSTON, ROBERT F. 21 - 03 - 00149
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 James C. Livingston Son
625 Erford Road
Camp Hill, PA 17011
JOINTLY OWNED PROPERTY:
ITEM
NUMBER
A
3 A
DATE
MADE
JOINT
01/08/1993
01/08/1993
01/08/1993
DESCRIPTION OF PROPERTY
Include name of financial institution and bank account number
or similar identifying number. Attach deed for jointly-held real
estate.
PNC Bank - Checking Account
No. 51-4003-8548
Members 1 st Federal Credit Union
Regular Savings Account
No. 511-00
Members 1 st Federal Credit Union
Checking Account No. 511-11
DATE OF DEATH
VALUE OF ASSET
32,728.32
16,556.43
9,893.14
% OF
DECD'S
INTEREST
TOTAL (Also enter on line 6, Recapitulation)
DATE OFDEATH
VALUE OF
DECEDENT'SINTEREST
16,364.16
8,278.22
4,946.57
29,588.95
OMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULEH
FUNERAL EXPENSES &
ADMINES'3RATNE COSTS
ESTATE OF FILE NUMBER
LIVINGSTON, ROBERT F. 21 - 03 - 00149
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
FUNERAL EXPENSES:
Myers-Hamer Funeral Home, Inc.
Community Club - Indiantown Gap - funeral meal
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
James C. Livingston
Social Secudty Number(s) / EIN Number of Personal Representative(s):
Street Address 625 Erford Road
city Camp Hill State PA Zip 17011
Year(s) Commission paid 2003
Attorney's Fees Johnson, Duffle, Stewart & Weidner
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State
Relationship of Claimant to Decedent
Probate Fees Register of Wills - Cumberland County
Zip
Accountant's Fees
Tax Return Preparer's Fees
Other Administrative Costs
Cumberland Law Journal - Legal Advertisement
The Patriot-News - Legal Advertisement
Total of Continuation Schedule(s)
TOTAL (Also enter on line 9, Recapitulation)
6,312.00
1,060.31
850.00
3,000.00
231.00
75.00
105.73
1,440.86
13,074.90
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SchelA~ H
ESTATE OF FILE NUMBER
LIVINGSTON, ROBERT F. '
21 03- 00149
4
5
6
7
8
9
10
11
12
Chuck Bricker - household goods appraisal
Register of Wills - short certificates
Register of Wills - file Inventory and Inheritance Tax Remm
Recorder of Deeds - 1% transfer tax
Members 1st Federal Credit Union - notary fees
Members 1st Federal Credit Union - charge for Estate checks
Verizon - telephone charges
UGI - gas service
PP&L - electric service
PA Water Company - water service
60.00
6.00
28.00
730.00
6.00
9.95
95.69
411.09
52.80
41.33
Page 2 of Schedule H
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
LIABILITIES, & LIENS
ESTATE OF , FILE NUMBER
LIVINGSTON, ROBERT F. 21 - 03 - 00149
Include unreimbursed medical expenses.
ITEM DESCRIPTION AMOUNT
NUMBER
1 555.41
Checks that cleared after death - PNC Account No. 51-4003-8548
Texaco - $22.56; Verizon - $79.58; PA Water Co. - $20.23;
Comcast Cable - $36.93; Travelers Ins. - $292.00; Erie Insurance - $75.12;
Verizon - $28.99.
South Central EMS - decedent's account balance
H & R Block (Sears Location) - preparation of decedent's 2002 income tax
returns
TOTAL (Also enter on Line 10, Recapitulation)
145.00
127.00
827.41
REV-1515 EX+ (9-00) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF LIVINGSTON, ROBERT F. FILE NUMBER
21 - 03 - 00149
NUMBER
II.
NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (include outright spousal distributions)
ginda g. Hivner
513 Erford Rd., Camp Hill, PA 17011
Sandra E. Nelson
R. D. #2, Box 461, Annville, PA 17003
Robert F. Livingston, Jr.
9282 Allen Street, Manassas, VA 20110
James C. Livingston
625 Er£ord Road, Camp Hill, PA 17011
David W. Livingston
4604 Beretta Ct.,
Chesapeake, VA 23321
RELATIONSHIP TO
DECEDENT
Daughter
Daughter
Son
Son
Son
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover she(
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BE NG MADE
i B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEE
AMOUNT OR SHARE
OF ESTATE
One-fifth Residue
One-fifth Residue
One-fifth Residue
One-fifth Residue
One-fifth Residue
Register of Wills of Cumberland County,
INVENTORY
Estate of LIViNGSTON, ROBERT F.
also known as LIViNGSTON, SR., ROBERT F.
James C. Livingston
, Deceased
Pennsylvania
No. 21-03-00149
Date of Death 2/3/2003
Social Security No. 206-10-8535
The Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory
include all of the personal assets wherever situate and all of the real estate located in the Commonwealth of Pennsylvania
of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the
Decedent's death, and that the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that
which appears in a memorandum at the end of this Inventory. I/We verify that the statements made in this Inventory are true
and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904
relating to unsworn falsification to authorities.
Personal Represe[r)J~fl~
Attorney: C. ROY WEIDNER, JR. Signature:,~,~',~'~,.~.~_-_'~/
(,/
I.D. No.: 19530 Signature:
Signature:
Address: 301 Market Street Address: 625 ErfordRoad
P. O. Box 109 Camp Hill, PA 17011
Lemoyne, PA 17043-0109
Telephone: 717/761-4540 Telephone: (717) 732-3795
Dated:
Personal Property
PNC - Savings Account No. 51-30135-5774
Date of death balance, plus accrued interest
Automobile - 1997 Ford Contour
Sale Price
Household Goods- appraised value
TmGreen-ChemLawn - Service Contract refund
Internal Revenue Service/Treasury Department
Refund - 2002 Federal Income Tax
County of Cumberland - Burial Benefit
7,969.47
t,160.00
358.17
684.00
100.00
Total Personal Property
$13,471.64
(Attach additional sheets if necessary) Total Personal Property and Real Estate $86,471.64
Register of Wills of Cumberland County, Pennsylvania
INVENTORY
continued
Estate of LIViNGSTON, ROBERT F.
also known as LIViNGSTON, SR., ROBERT F.
, Deceased
No. 21 - 03- 00149
Date of Death 2/3/2003
Social Security No. 206-10-8535
Real Estate
Real Estate - No. 22-A Glenwood Drive (West), East Pennsboro Township,
Cumberland County, PA.
Deed Book R, Volume 22, Page 233
Sale Price
73,000.00
Total Real Estate
$73,000.00
2
INHERITANCE TAX DIVISION
DEPT. 180601
HARRISBURG, PA 17118-0601
C ROY WEIDNER JR
JOHNSON ETAL
PO BOX 109
LENOYNE
CONNONWEALTH OF PENNSYLVANIA
DEPARTNENT OF REVENUE
NOT/CE OF INHERKTANCE TAX
APPRA/SENENT, ALLO#ANCE OR DKSALLO#ANCE
OF DEDUCTIONS AND ASSESSNENT OF TAX
REV-154? EX AFP C01-03)
PA
DATE 08-11-2005
ESTATE OF LIVINGSTON
DATE OF DEATH 02-05-2005
FILE NUNBER 21 03-0149
~ COUNTY CUHBERLAND
ACN 101
I Amoun~ Rami~ad
ROBERT
HAKE CHECK PAYABLE AND REHZT PAYNENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17013
F
CUT ALONG THIS LINE ~ RETAIN LOWER PORT/ON FOR YOUR RECORDS ~
REV-1547 EX AFP (01-03) NOTICE OF ZNHERZTANCE TAX APPRAZSENENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSNENT OF TAX
ESTATE OF LIVINGSTON ROBERT F FILE NO. 21 03-0149 ACN 101 DATE 08-11-2003
TAX RETURN HAS: (X) ACCEPTED AS FKLED ( ) CHANGED
RESERVATION CONCERNZNG FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGTNAL RETURN
1. Real Es~a~a (Schedule A) (1)
2. S~ocks and Bonds (Schedule B) (2)
3. Closely Held S~ock/Par~narship ~n~arss~ (Schedule C) (3)
q. Mor~gagas/No:kas Receivable (Schedule D) (~)
5. Cash/Bank Deposi:~s/Nisc. Personal Proper~y (Schedule E) ($)
6. Jointly O~ned Proper~y (Schsdule F) (6)
7. Transfers (Schedule G) (7)
8. To,al Asse~s
APPROVED DEDUCTIONS AND EXEHPTZONS:
9. Funeral Expanses/Adm. Costs/Misc. Expenses (Schedule H) (9)
10. Dab~s/Mor~gags Liabilities/Liens (Schedule K) (10)
11. To,al Deductions
12. Ns~ Value of Tax Rs~urn
73,000.00
.00
.00
.00
13/371.64
29~588.95
.00
(8)
NOTE: To insure proper
crsd1* ~o your accoun*,
subai~ ~ha upper pore/on
of ~hLs form wL~h your
~ax payment.
115,960.59
13,074.90
827.41
(11) 13.902.31
(12) 102,058.28
Charitable~governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15)
Ne~ Value of Es~a~a Subjac~ ~o Tax
'r.F an assessnent was issued previously, lines 1~, 15 and/or 16, 17,
15.
1~.
NOTE:
reflect f/gures that include the total of ALL returns assessed to date.
.00
102,058.28
18 and 19 #ill
KF PAID AFTER DATE KNDICATED, SEE REVERSE
FOR CALCULATKON OF ADDKTKONAL KNTEREST.
ASSESSNENT OF TAX:
15. Amoun'l: of Line 1~ et Spousal ra~a
16. Amoun~ of LAne 1~ ~axable a~ Lineal~Class A ra*a
17. Amoun~ of Line lq a~ S1bllng ra~e
18. Amount of Line 1~ ~axabls a~ Collateral/Class B ra~a
19. Principal Tax Due
TAX CREDZTS:
PAYHENT RECEIPT DISCOUNT (+!
DATE NUMBER KNTEREST/PEN PAKD (-)
04-25-2003 CDOOZ505 205.26
06-25-Z005 CD00Z739 .00
TOTAL TAX CREDXT,I 4,59Z.6Z J
BALANCE OF TAX DUEI .00
INTEREST AND PEN. I .00
TOTAL DUE I .00
( IF TOTAL DUE KS LESS THAN $1, NO PAYMENT KS REQUIRED.
KF TOTAL DUE ZS REFLECTED AS A "CREDZT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THKS FORM FOR KNSTRUCTKONS.)
3,900.00
487.36
AMOUNT PAID
(15) .00 x O0 = .00
(16) 102,058.28 x 045= 4,592.62
(17) .00 x 12 = .00
(18) .00 x 15 = .00
(19)= 4,592.62
RESERVATION:
PURPOSE OF
NOTICE:
PAYMENT:
REFUND (CR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before Dec.abet 12, 19D2 -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (coZlateraZ) beneficiaries of the decedent after tho expiration of any estate for
life or for years, the Commonmealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
et the laaful Class B (collateral) rate on any such future interest.
To ~ulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of ZOO0. (72 P.S.
Section 91qO).
Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side.
--Make check or money order payable to: REGXSTER OF NXLLS, AOENT
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-ISIS). Applications ere available at the Office
of the Register of Hills, any of the 23 Revenue District Offices, or by calling the special Z4-hour
answering service for forms ordering: 1-800-562-2050; services for taxpayers with special hearing and / or
speaking needs: 1-800-447-$020 (TT only).
Any party in interest not satisfied with the appraisement, allowance, or dis. lice.mca of deductions, or assessment
of tax (including discount or interest) as sheen on this Not[co must object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 261021, Harrisburg, PA 17128-10Z1, OR
--election to have the .attar determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
Factual errors discovered on this assessment should be addressed in wrlting to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Reviea Unit, Dept. 280601, Harrisburg, PA 17128-0601
Phone (717) 767-6SOS. See page 5 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 dec.dent's death, a five percent (5Z) discount of
the tax paid is a11owed.
The 152 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
pan.ltv is appealable in the same manner end in the the saea time period as you would appeal the tax and interest
that has been assessed es 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, 198Z bear interest at the rate of
six (62) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January l, 1982 mill bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Depart"ant of Revenue. The applicable interest rates for 1982 through 2005 ara:
Interest Daily Interest Daily Interest Dally
Year Rate Factor Year Rate Factor Year Rate Factor
1982 202 .000548 1987 9Z .000247 1999 7X .000192
1985 162 .000¢5& 1988-1991 llZ .000501 ZOO0 8Z .000219
1984 112 .000501 1992 92 .000247 2001 9Z .000247
1985 132 .000556 1993-1994 72 .000192 2002 62 .000164
1986 lOZ .000274 1995-1998 9Z .000247 2005 5Z .000157
--Interest is calculated as folloes:
INTEREST = BALANCE OF TAX UNPATD
X NUNBER OF DAYS DELINQUENT X DAILY INTEREST 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, additional interest must be calculated.
PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF
THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM
YEARLY UNTIL COMPLETION.
STATUS REPORT UNDER RULE 6.12
Name of Decedent: ROBERT F. LIVINGSTON a/k/a ROBERT F. LIVINGSTON~ SR.
Date of Death: FEBRUARY 37 2003
Will No.: 21-03-00149 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
The separate Orphans' Court No. (if any) for the personal
representative's account is:.
Did the personal representative state an account informally to the
parties in interest? Yes X No
Copies of receipts, releases, joinders and approvals of formal or
informal accounts may be filed with the Clerk of the Orphans'
Court and may be attached to this report.
C. Roy Weidner, Jr.
Johnson, Duffle, Stewart & Weidner
301 Market Street, P.O. Box 109
Lemoyne, PA 17043-0109
Address
(717) 761-4540
Telephone No.
Capacity: Personal Representative
X Counsel for Personal Representative
Date: