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HomeMy WebLinkAbout04-0692 PETITION FOR PROBATE and GRANT OF LETTERS Esta,e of ~o/ec, e ,7:. tO/~,o~.~ No. X2 1 --0~t - la q A also known as To: Register of Wills for the ~ Deceased. County of ~t-~lr~.D in the Social Security No. J71- 2~- ~'~0~ 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 execuL~.'" named in the last will of the above decedent, dated '~n~'dm" Ct 19t~l_ and codicil(s) dated , (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cttm~J-~q/ (~ounty; Pennsylvani% with h~ . last family or principal residence at 75'0 ~,.~e ~o~. ,te~,,~',~,t~..-e~? ~-t.~.~,.] (list street, number and muncipality) Decendent, then g7 yearsofage died Except as follows,~ecedent did not marry, was not divorced and did not have a child born or adopteci after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania situt~ted ~s foJlows: U#/-iIt~I'OFe~ WHEREFORE, petitioner(s) respectfully .request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters ~-4/ff~t~t'~ theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) I ~o OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA '1 COUNTY OF Ctt~8~:Rt.~ntD f ~8 The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the esta. te acco[ding to law. worn to or affi m e and subscribed before alg.,j, his. I,,,0 ~ay of { ~ ~'. ~//~'.~.g' ~ No. d2 ~ - 0'4 - to,~ :x Estate Of ~5e ~' [,k_~&,~<c.a~ , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND Be reverse side hereof, satisfactors~ proof having been presented before me, IT IS DECREED that the instrument(s) dated [ (D - t-4 - ~ --~ described therein be ~will of and Letters ~ ~ ~e hereby ~ t ~ ~[ 0~ _,1~/""-~, in consideration of the petition on FEES Probate, Le~C .......... Short Certificates( ) .......... $ Renunciation ................ $ ~' TOTAL $ Filed .~..-.. ~..; .~ ~ ............. A'I~rORNEY (Sup. Ct. I.D. No.) ADDRESS 7/~'- 7~ PHONE RENUNCIATION ' In Re Estate of G~'OA~' To the Register of Wills of deceased. County, Pennsylvania. The undersigned ~'~/-/~V £. ~/2)DglqS: d~ ~]~te~'/la~ /~/ ~-e.,ge~t~.~r of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters 'Te s ~a me, o /,t , y be issued to ~c-'~'-D ~. ~J/bD ctO~'d' WITNESS hand this ~ ~ day of ~"LJ t~",./ , )~f, ff.~. (Addr~) (Signature) (Address) (Signature) (Address) RENUNCIATION In Re Estate of ~g~'qt~g' 0~. /~//~2~ J To the Register of Wi~s of C~~ ~e ~dersign~ ~ ~- ~/~, deceased. County, Pennsylvania. of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters be issued to (Signature) (Address) (Signature) (Address) REGISTER OF WILLS OF COUNTY OATH OF SUBSCRIBING WITNESS 'X x~ codicil (eac~Oxa subscribing witneNo the will presented taw, d~e(s) and say(s) thatX~ the testa _t_~, sign the same aNhat ~x request of testat,\ in ix~ preM,~ce and (in the X~er subscribing ~ess(es))' ~ Swo'-~xto or affirmed ~ subscribed before ~ _ __ me thiN 'NN day of N (Namej (A~ress; (each) being duly qualified according to present and saw signed as a witness at the each other) (in the presence of the ~REGISTER OF WILLS OF ~ COUNTY OATH OF NON-SUBSCRIBING WITNESS · -(ea~a subscriber hereto, (~t~*). being duly qualified according to law, depose(s) and say(s) that /~t~-- ~i~ famili~ with the signature of ~ ~ ~/~ , testat~ of ~ ~r .~ .... ~_:~: ..... :~ ...... ............... ~ ........... :*) the will presented herewith ~d codicil that ~ believes the signature on the will is in the handwriting of to the best of ills knowledge and belief. Sworn to or affirmed and subscribed before g.~c~i~ //}, (.4 }~~ me this ~ O~ .... day of ~~~. ~Oa~ L~ (Address; ~ ~ '~: Register ~ ~Name) (Address) REGISTER OF WILLS OF C~t~/~A'~ COUNTY OATH OF SUBSCRIBING WITNESS 2t- o q- b,q cc. dicil 4~.~q') a subscribing witness to the will presented herewith, ~cack} being duly qualified according to law, depose(s) and say(s) that ~ ~.o~g-~ present and saw the testat~ , sign the same and that ~ signed as a witness at the request of testat~ in ~ presence and (in the presence of each other) (in the presence of the other subscribing witness(es)). Sworn to or affirm~ and subscribed before me this ~0~ day of (Address) REGISTER OF WILLS OF ~ COUNTY eachOATH OF c~-SUBSCRIBI..~ ~SWITNESS ( )a subscriber~, (each) being duly qualifie, d'~ording to law, depose~nd say(s)tha: ~. familiar with the signatuYe, xof ~ , ~ X'~odicil ~ testat of (one of the st~cribing witnesses to) the ~will presented herev~h and that ~x. ~s the signature on the ~n the handwritin~ of to the best of x~ knowledge and belief. Sworn to or affirmed and su~o~ibed before ~.. x~ me this l~f ~ (Name) (Address) RegisterS_ (Namej (Address) his is to certify that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records in accordance with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953. WARNING: It is illegal to duplicate this copy by photostat or photograph. 1039521 No. Charles Hardester State Registrar BAR 0 h 2003 n ~ate C CERTIFICATE OF DEATH (Coroner) ~': = ~- ~..~.., ~,..,*.,,.. ~..~ L~e~ce ~ad and Neck ~ Notor Vehicle Crash 70, P~e Rd. C~t~e PA 17015 Ceer, ete.,q/ PA 17019 Carlisle PA 6375 Basehore Road, Suite liechanicsburg, Pa. 17050 MAR 0 3 2003 bond or other security in the office of the Register of Wills for the purpose of administering my Estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 4th day of October, A. D. 1983. (SEAL) Signed, sealed, published and declared by the above-named GEORGE J. ~,;IDDERS, as and for his Last Will and Testament, in the:presence of us, who, at his request and in his presence, and in the presence of each other, have h~reunto subscribed our names as witnesses. Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717)240-6345 Date: 10/05/2004 SHIELDS CHARLES E III 6 CLOUSER ROAD MECHANICSBURG, PA 17055 RE: Estate of WIDDERS GEORGE J File Number: 2004-00692 Dear Sir/Madam: It has come to my attention that you have not filed the Certification of Notice Under Rule 5.7 (a) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing will become delinquent on 10/16/2004 Your prompt attention to this matter will be appreciated. Thank You. cc: File Personal Representative(s) Judge GLENDA FARNER STR-ASBAUGH Clerk of the Orphans' Court Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717)240-6345 Date: 10/05/2004 WIDDERS FRED W 702 PINE RD CARLISLE, PA 17013 RE: Estate of WIDDERS GEORGE J File Number: 2004-00692 Dear Sir/Madam: It has come to my attention that you have not filed the Certification of Notice Under Rule 5.7 (a) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHkNS' 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 ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing will become delinquent on 10/16/2004 Your prompt attention to this matter will be appreciated. Thank You. CC: File Counsel Judge GLENDA FARNER STRASBAUGH Clerk of the Orphans' Court CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: Will No. TO THE REGISTER: George J. Widders December 12, 2002 Admin. No. 21-04-0692 I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court October 14, 2004 Name Edna M. Widders Address c/o Fred W. Widders, 702 Pine Road, Carlisle, PA Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: October 14, 2004 6 Clouser Road Mechanicsburg, PA ! 7055 Telephone: (717) 766-0209 Counsel for Personal Representative Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 Date: 11/10/2004 SHIELDS CHARLES E III 6 CLOUSER ROAD MECHANICSBURG, PA 17055 RE: Estate of WIDDERS GEORGE J File Number: 2004-00692 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 12/02/2004 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, GLENDA FARNER STRASBAUGH REGISTER OF WILLS CC: File Personal Representative(s) Judge STATUS R~PORT UNDER RULE 6.12 Name of Decedent: ~:~ C~ a'; ~o tt)bc~J Date of Death: Will No.: Pursuant to Rule 6.12 of the Supreme Cour~ Oq>hans' Coral 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 I-I No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: ~ rrna. 3. If the answer to No. 1 is Yes, state the following: Did the personal representative file a final account with the Court? Yes _ No b. The separate Orphans' Com't No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes [] No ~] Date: Copies of receipts, releases, joinders and approval of forma! or informal accounts may be filed with the Clerk of the Orphm~s' Court and may be attached to this report. Signature Address 7- 7'66 Telephone No. Capacity: [-~ Personal Renresentative ~Counsel for~personal representative COMMONWEALTH OF REV-1500 PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 INHERITANCE TAX RETURN HARRISBURG' PA 17128'0601 RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER · 2.1 - o~ C~TY~E ~EA~ NUMBER DECEDENTS NAME (LAST~ FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER I'-- z W~DDE'RS, C, EoRC~E 3'. 171 -,,~' - z/&o? DJ Q DATE Of D~TH (MM-DD-Y~R) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE ~ /~-/~- ~OO2 7 --/~- 1~1~ REGISTER OF WILLS ~ (iF APPLICABLE) SURVIVING SPOUSE'S NAME (~S~ FIRST. AND MIDDLE INITIAL) SOCIAL SECURI~ NUMBER ~] 1. Original Return [~4. Limited Estate [~6. Decedent Died Testate (At~ ~py of W,,) [~9. Litigation Proceeds Received [~2. Supplemental Return [~4a. Future Interest Compromise (date ordeat~ after 12-12~2) [~7. Decedent Maintained a Living Trust (Attach c~y of T~us~) [~10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) ~]3, Remainder R~tum (date of death pdor ~o 12-13~2) [~5. Federal Estate Tax Return Required ~) 8. Total Number of Safe Deposit Boxes [~11. Election to tax under Sec. 91'~3(A) (At~ach Sch O) FIRM NAME (If Applicable) ~/~ TELEPHONE NUMBER COMPLETE MAILING ADDRESS / 7~ 3"5- 1. Real Estate (Schedule A) (1) .OFFICIAL_USE ONLY 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash. Bank Deposits & Miscetia~eous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) [~ Separate Billing Requestad 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Properly (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities. & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election 1o tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (13) ~) (14) d~a ,,f' 7&, eo SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax I 00 rate, or transfers under Sec. 9116 (a)(1 2) x .0 ~) (15) 17. Amount of Line 14 taxable at sibling rate ~) x .12 (17) 18. Amount of Line 14 taxable at cottsteral rate x .15 (18) 19. Tax Due (19) Decedent's Complete Address: STREET ADDRESS "7~) ~/~4/~-~ I STATE ~ ZIP Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. thterest/Penalty if applicable ~ D. Interest E. Penalty ~ 4. if Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. (1) ~) Total Credits (A+ B + C) (2) ~;) Total Interest/Penalty ( D + E ) (3) (4) (5) (5A) (5B) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. 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; .......................................................................................... [] [] b. retain the right to designate who shall use the property transferred or its income; ............................................ [] [] e. retain a reversionary interest; or .......................................................................................................................... [] [] d. receive the premise for life of either payments, benefits or care? ...................................................................... [] [] 2. If death occurred after December 12, f 982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. [] [] 3. Did decadent own an "in trust for" or payable upon death bank account or security at his or her death? .............. [] [] 4. Did decadent own an Individual Retirement Account, annuity, or other non-prebeta property which contains a beneficiary designation? ........................................................................................................................ [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF ~ERSON RESPONSIBI~E FOR FILING RETURN DATE ADDRES5~,~:) I~J, ~Jlbb~l~'¢ SIGNATURF_..DF~REPARER OTHER THAN BEPRESENTATIVE ADDRESS (~,~,ctl~.~ ~.- --~.~.~.~.~.~.~.~.~/4r'~,~$ .~'". ~'~'~ DATE For dates of death on or after July 1; 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. {}9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) {1.1) (ii)]. The statute d~es not exemct 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 va~ue of transfers from a deceased child twenty-oce 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 ES. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 RS. §9116(a)(1.3)]. A 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 SCHEDULEA REAL ESTATE FILE NUMBER ESTATE OF All real properly ewned solely or as a tenant in common must be repo~ted at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonabte knowledge of the relevant facts Real properbj which is jointly.owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. TOTAL (Also enter on fine 1, Recapitulation) $ ,~, ~. ~&). O o (If more space is needed, insert additional sheets of the same size) COb COIY Pul: instn purpo I do hereby certify th.  in the year of our Lord t~o thousand ~IDD~ ..:~ GrantOr L~~ _~i~orSmy ~s~i~an~a, ' his hte~-"-~ untY, ~o 4ah~ o{ s~ CoUnW, pegU ~ _~ vested [~ _~er~and co -~ and Letter} '~mberlanU ~ . Widders ~ontOe, cum~ -- ~ember, 20~'04-692; ~ .~ ~eot~e ~' ~in of t~t ~ any olden a*o~O. ~' , a the sara .~ the To~SU r ~n the 2au ~ doc~eteu ' .~,~g~W -ctibed m ' qed, testate, ~¢xecutOr, ~o~, u,~ ~u~ ~,,m ox v~,., the saxo _, hereo[, ~ ~on~X~ ~ ~ ~S ~T ~ of the ~y"2d ~aid ~ ' ~ de~i~e~ '~ased, a~U ~'atieS goOU~.~ ~. ,[ a haSgt°'7 ~ome~ ~" , con~e~, x ~ID~y . aXXma~ ~bedhcre-- u,Z ..~i~orSUW._.erest as ~ mouata'7 .a deSCrm oX su)~ txl4th) n,~ _impto~eO,~oUndea ax,~ ~ nth six~ o~, ioUr~ *o ~¢' ~x of uu ~xcU~art~ cncg, ~o~ ,hence fob°~s'~ ~!~ patC~: motepa~ , M3oh~ atogeS;'" ~eSt,se - ~ c~gl~- ~.,Wan~a, '" c~eti~ ~- .cheS ~o ~_ aeoreeS 7. ~o~ -,~ at stOU~ , en~.~ .,.e~g~~ ~"c~et~ ~' u~s to st~: -eCs (6X x~,(, o[ 3ohn -~s' Ce~c~ ~eSt t~- 2(g~t a~° o- (or~er~ heS to stOU~ 6egre~ ~ ~e~ {or~eflY.~ the p~ace o pe~cheS t~ et, her hug ,x~enet a~° ~ Deeds ~' to LX°Yu ~.oh guth "-~eotdet ~ o~n~e~eu .., decease iseS ~ux~-- in the ~nte6 ann ~]aetS is ~ame prem -a teC°rde~e 4, g~" -Ge 1. is the o~ ~a messu = fio~ed au the o~Y V u~t° ~ the~ ne- ~o ~xeC~',~e S~xa ~r~.~er Ot N~ ., oro~ ~ot oo co~ en~m~antOr has Cat t~e ~ SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS REV*1511 EX+ (t2-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Debts of decedent must be reported on Schedule L ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 5. 6. 7, ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) F Social Security Number{s)/EIN Number of Personal Representative(s) Street Address City State Year(s) Commission Paid: Attorney Fees ~...l.~J~d~J.~c~, ~:, ~IEL'I~ ~ Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) C~aimant __ Zip Street Address City Relationship of Claimant to Decedent Probate Fees ~'R~J~ f~IG, IN~.. Accountant's Fees Tax Return Preparer's Fees State_ Zip TOTAL (Also enter on line 9, Recapitulatior $ (If more space is needed, insert additional sheets of the same size) OOMMONWEALTN OF INHER)TANCE TAX RETURN RESIDENT DECEDENT ES?ATE OF ~4) I D D~'/'~$t ~: ~)~G~ ,T. FILE NUMBER RELATIONSHIP TO DECEDENT NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) SCHEDULE J BENEFICIARIES AMOUNT OR SHARE OFESTATE II. 1. TAXABLE DISTRIBUTIONS (include outright spousal distributions) ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE NON-TAXABLE DISTRIBUTIONS: A, SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B, CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional 'sheets of the same size) ON REV 1500 COVER SHEET ~ST WILL AND TESTAMENT OF GEORGE J. WIDDERS I, GEORGE J. WIDDERS, of the Township of Dickinson, County of Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this to be my Last Will and Testament, hereby re- voking and making void all former Wills by me at any time heretofore made. I direct the payment of all my just debts and fune- ral expenses as soon as conveniently may be after my decease. Ail the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situate, I give, devise and bequeath to my wife, Edna M. Widders, to her own use and benefit absolutely. In the event, however, that my said wife should predecease me, or should die at about the same time as I die, such as in a disaster common to both of us, I give, devise and bequeath my said Estate to my sons, Fred W. Widders and John L. Widders, in equal shares. LASTLY, I nominate, constitute and appoint my wife, Edna M. Widders, to be the Executrix of this, my Last Will and Testament. If she should predecease me, or for any other reason be unable to act, or to continue to act, as such Executrix, I appoint my sons, Fred W. Widders and John L. Widders, to be the Executors in her place and stead. I further direct that none of them shall be required to file COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 ~HARRISBURG, PA 17128-0601 REV-1500 FILE NUMBER INHERITANCE TAX RETURN .Zl - o RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER ~ W'i~DE'i~<; C. EORC. E .1. 171 - Z iii DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE I.U I~.- I--.~ - .~.oO 2 7 - ! oe ' J ~'1 ~" REGISTER OF WILLS LU (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER W ,[~] 1. Original Return E~4, Limited Estate [~6. Decedent Died Testate (^~ch c~py of Will) ~9. Litigation Proceeds Received [~2, Supplemental Return ~]4a. Future Interest Compromise (date of death after 12-12-82) ~7. Decedent Maintained a Living Trust (A~ch copy of mr~st) [~10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) [~5. Federal Estate Tax Return Required ~) 8. Total Number of Safe Deposit Boxes ~]11. Election to tax under Sec, 9113(A) (Attach Sch O) FIRM NAME (ff Ap,plicable) ~/a~ TELEPHONE NUMBER 7/7- 76/---~Z~? 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 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 Propor[y (Schedule F) (6) E~ Separate Billing Requested 7. Inter-Vivce 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, Modgage Liabilitles, & Liens (Schedule I} {10) 11. Total Deductions (total Li~es 9 & 10) 12, Net Value of Estate (Line 8 minus Line 11) COMPLETE MAILING ADDRESS /I~/.~_./"/~4// C£Z~Z~,~-, ~,4' /7~.,~5- 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not bean made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) .OFFICIAL USE ONLY (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES Amount of Line 14 taxable at the spousal rote, or transfem under Sec. g~16 (a){1.2) (16) 16. Amount of Line 14 taxable at lineal rate X 17. Amount of Line 14 taxabte at sibling rate 18. Amount of Line 14 taxable at cellateral rate .12 (17) .15 (18) 19. Tax Due (19) Decedent's Complete Address ST~aa ~ ADDRESS -7~ CITY Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B, Prior Payments C. Discount 3. Interest/Penalty if applicable D. Interest E. Penalty ISTATE ~J~ I ZIP /70/~,~' Total Credits (A + B + C ) (2) Total Interest/Penalty ( D + E ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page '1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (1) ~ A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) ~' (4) ~ (5) ~ (5A) g) (5B) ~) Make Check Payable to: REGISTER OF WILLS, AGENT IF THE ANSWER PLEASE ANSWER THE FOLLOWING QUESTIONS BY PI. ACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ....................................... : .................................................. [] [] b. retain the right to designate who shall use the property transferred or its income; ............................................ [] [] o. retain a reversionary interest; or .......................................................................................................................... [] [] d. receive the promise for life of either payments, benefits or care? ...................................................................... [] [] If death occurred after December 12, 1982, did decadent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. [] [] Did decedent own an "in trust for" or payable upon death bank account or secudty at his or her death? .............. [] [] Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ [] TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penatiies of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge SIGNATURE OF ~ERSON RESPONSIB~.E FOR FILING RETURN DATE SIGNATURE.,OF.~REPARER OTHER THAN J~F..?RESENTATIVE ADDRESS ~ti',,a~/,~'~ ,~'~.- ..~.af/&~.O$ ,~..'. ~'3'a). DATE For dates of death on or after July f; 1994 and before January I, 1995, the tax rote 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 RS. §9116 (a) {1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net vaJue 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 RS. §9116(a)(1)], The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 RS. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decadent, whether by blood or adoption. SCHEDULE A COMMONWE^LT' OFPENNSYLVAN'^ REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FiLE NUMBER All real property owned solely or as a tenant in common must be repoded at fair market value. Fair market value is defined as the price at which properly would be exchanged suwivorship must be disclosed on Schedule F. 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 VALUE AT DATE DESCRIPTION ITEM NUMBER OF DEATH X 13, ~Ze ~ q = $,, Zg'O,O.e' TOTAL (Also enter on line 1, Recapitulation) (If more space is needed, insert additional sheets of the same size) Tax Parcel # ~ ~ /£-~,?b'99-,0~' MADETHE /,1~/~ dayof and four (2004). ~ , in the year of our Lord two thousand BETWEEN FRED W. WIDDERS, Executor of the Estate of GEORGE J. WIDDERS, Deceased, late of the Township of Dickinson, Cumberland County, Pennsylvania, Grantor AND LAWRENCE I. WIDDERS and WILLIAM J. WIDDERS, as joint tenants with the right of survivorship and not as tenants, in common, both of Mechanicsburg, Cumberland County, Pennsylvania, Grantees. WHEREAS, the said George J. Widders was vested in his lifetime with title to the premises hereinafter described in the Township of Monroe, Cumberland County, Commonwealth of Pennsylvania; and WHEREAS, the said George J. Widders died, testate, on the 2nd day of December, 2002, and Letters Testamentary were duly issued to Fred W. Widders, as Executor, and docketed to No. 21-04-692; and WHEREAS, the lands herein-mentioned were not specifically devised. NOW, THEREFORE, THIS INDENTURE WITNESSETH, that the said Fred W. Widders, Executor, as aforesaid, for and in consideration of the sum of ONE AND NO/100 ($1.00) DOLLAR and other good and valuable considerations, to him in hand paid by the said LAWRENCE I. WIDDERS and WILLIAM J. WIDDERS, at and before the ensealing and delivery hereof, the receipt whereof is hereby acknowledged, has granted, conveyed, bargained, sold, aliened, released, and confirmed, and by these presents, by virtue of the power and authority in him vested by the Fiduciaries Act of the Commonwealth of Pennsylvania, does grant, convey, bargain, sell, alien, release, and confirm unto the said LAWRENCE I. WlDDERS and WILLIAM J. WIDDERS, as joint tenants with the right of survivorship and not as tenants in common, their heirs and assigns, all that certain undivided one- fourth (l/4th) interest as a tenant in common to the premises more fully described hereinbelow as follows, to wit: ALL THAT CERTAIN parcel of unimproved mountain land situate in Monroe Township, Cumberland County, Pennsylvania, more particularly bounded and described as follows, to wit: BEGINNING at stones; thence by land now or formerly of John Enck, South sixty-one and one-half (61 1/2) degrees East twenty-two and three tenths (22.3) perches to stones; thence by land now or formerly of John Etter, South twenty-eight and three-fourths (28 3/4) degrees West, seventy-four (74) perches to stones; thence by lands now or formerly of C.W. Ahl and D. V. Ahl, North sixty-one and one-half (61 1/2) degrees West twenty-two (22) perches to stones; thence by land now or formerly of John Kauffman North twenty-eight and one-half (28 1/2) degrees East seventy-four (74) perches to the place of BEGINNING. BEING part of the same premises which Ruth Wagner and Charles Wagner, her husband, et al, by their deed dated May 9, 1973, and recorded in the Recorder of Deeds Office in and for Cumberland County in Deed Book "Y", Volume 26, Page 4, granted and conveyed to Lloyd B. Widders and George J. Widders, as tenants in common. The said George J. Widders is now deceased and his estate is the Grantor herein. TO HAVE AND TO HOLD the said messuage or tenement and tract of land, hereditaments and premises hereby granted and released, or mentioned and intended so to be, with the appurtenances unto the said Grantees, their heirs and assigns, to and for the only proper use and behoof of the said Grantees, their heirs and assigns, forever. AND THE SAID GRANTOR, Executor as aforesaid, his heirs, executors and administrators, do covenant, promise and agree to and with the said Grantees, their heirs and assigns, by these presents, that the Grantor has not done, committed any act, matter or thing whatsoever whereby the premises hereby granted, or any part thereof, is, are, shall or may be impeached, charged or encumbered in title, or otherwise howsoever. IN WITNESS WHEREOF, the said Executor of the Estate of George J. Widders, deceased, Grantor herein, has hereunto set his hand and seal the day and year first above written. WITNESS: FRED W. WIDDERS, Executor Estate of GEORGE J. WIDDERS (SEAL) COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND : SS. On this, the /ot:>/'~ day of ~-~<~ , A.D. 2004, before me, a Notary Public, in and for said County and State, the undersigned officer, personally appeared FRED W. WIDDERS, known to me (or satisfactorily proven) to be the person described in the foregoing instrument, and acknowledge that he executed the same in the capacity therein stated and for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Notary Public My Commission expires: (SEAL) --COM~LTH OF PENNSYLVANIA / wlarme Tv~.. Canbe,land ,.,_. ~ / k / CERTIFICATE OF RESIDENCE I do hereby certify that the precise and exact post office address of the within Grantee is: Attorney for Grantee REV-151/ EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Debts of decedent must be reported on Schedule ]. ITEM NUMBER DESCRIPTION AMOUNT A, FUNERAL EXPENSES: 1. 5. 6. 7. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) ~::=,l~.,,~c"~ ~_t. [Ji..I Ilb ~L~ Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State__Zip Year(s) Commission Paid: Attorney Fees ~..l'~lOt'~J-~m~ E:. ~I~"L~ "~ Family Exemption: {if decedent's address is not the same as claimant's, attach explanation} Claimant Street Address City State__Zip Relationship of Claimant to Decedent Probate Fees /~',N~ OI~IG,IN~. ,I'~.~U.I~' OF -~l~E"r' Accountant's Fees Tax Return Preparer's Fees TOTAL (Also enter on line 9, Recapitulation) more space is needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DO Not List Trustee(s) OF ESTATE II, TAXABLE DISTRIBUTIONS (include outright spousal distributions) ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B, CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS ON REV 1500 COVER SHEET TOTAL OF PART II · ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET (If more space is needed, inse~ additional sheets of the same size) LAST WILL AND TESTAMENT OF GEORGE J. WIDDERS I, GEORGE J. WIDDERS, of the Township of Dickinson, County of Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this to be my Last Will and Testament, hereby re- voking and making void all former Wills by me at any time heretofore made. I direct the payment of all my just debts and fune- ral expenses as soon as conveniently may be after my decease. e Ail the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situate, I give, devise and bequeath to my wife, Edna M. Widders, to her own use and benefit absolutely. In the event, however, that my said wife should predecease me, or should die at about the same time as I die, such as in a disaster common to both of us, I give, devise and bequeath my said Estate to my sons, Fred W. Widders and John L. Widders, in equal shares. LASTLY, I nominate, constitute and appoint my wife, Edna M. Widders, to be the Executrix of this, my Last Will and Testament. If she should predecease me, or for any other reason be unable to act, or to continue to act, as such Executrix, I appoint my sons, Fred W. Widders and John L. Widders, to be the Executors in her place and stead. I further direct that none of them shall be required to file bond or other security in the office of the Register of Wills for the purpose of administering my Estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 4th day of October, A. D. 1983. (SEAL) Signed, sealed, published and declared by the above-named GEORGE J. ~IDDERS, as and for his Last Will and Testament, in the:presence of us, who, at his request and in his presence, and in the presence of each other, have h~reunto subscribed our names as witnesses. CHARLES E. SHIELDS, III ATTORNEY-AT-LAW 6 CLOUSER ROAD Corner ofTrindle and Clouser Roads MECHANICSBURG, PA 17055 GEORGE M. HOUCK (1912-1991) TELEPHONE (717) 766-0209 FAX (717) 795-7473 February 14, 2005 ",) Mr. Daniel Heck Commonwealth of Pennsylvania Department of Revenue Inheritance Tax Division P.O. Box 28061 Harrisburg, PA 17128-0601 -, -,,_.1 RE: George J. Widders Estate Docket No. 21-04-0692 (Yj 4-:- Dear Mr. Heck: Please find enclosed a copy of the title analysis done by me and Richard C. Snelbaker, Esquire, attorney for the Grantee, from the Estate of George J. Widders. Please note that as originally reflected on the Inheritance Tax return, George J. Widders in fact owned a 1/4 undivided interest in the property in question. It is easy to get this matter confused because of the lengthy timeframe involved. Therefore, if you could make the appropriate adjustment on your zero balance sheet it would be sincerely appreciated. Thank you for your kind attention to this matter. Very truly yours, UrjtdJ~ Charles E. Shields, III Attorney-At-Law CES:slk Enclosure cc: Glenda Farner Strasbaugh, Register of Wills\ 0' , y /' /'" ./ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE *' NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-lS41EX AFP (12-04l CHARLES E SHIELDS III 6 CLOUSER RD MECHANICSBURG PA 17055 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 02-14-2005 WIDDERS 12-12-2002 21 04-0692 CUMBERLAND 101 GEORGE J AlIOunt R..1i tied 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 ... iE.V :r!4"f.E)t.AFp.-rol.-.6~'..N6i'.ici..d'j!.i:NHEFtI.fANci.TAX.A.PPRA.isiit.€NT~--ALtowANCE.trR--...._...._- -.-. DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF WIDDERS GEORGE J FILE NO. 21 04-0692 ACN 101 DATE 02-14-2005 TAX RETURN WAS: I ) ACCEPTED AS FILED I X} CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate {Schedule AJ 2. Stocks and Bonds (Schedule B) 3. Closely Held stock/Partnership Interest (Schedule C) ~. Mortgages/Notes Receivable (Schedule OJ 5. Cash/Bank Deposits/Misc. Personal Property {Schedule EJ 6. Jointly Owned Property (Schedule FJ 7. Transfers (Schedule GJ 8. Total Assets ll) 12} 13} 14} IS} 16} 17} 5.910.00 .00 .00 .00 .00 .00 .00 IS} NOTE: To insure proper credit to your account, submit the upper portion of this forR with your tax paYllent. 5,910.00 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ada. Costs/Misc. Expenses (Schedule H] 10. Debts/Mortgage Liabilities/liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governaental Bequestsj Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) IlO} 404.00 .00 Ill} 112} 113} 114} 404 00 5,506.00 .00 5,506.00 NOTE: If an assessment was issued previously, lines reflect figures that include the total of ALL ASSESSMENT OF TAX: 15. ARount of line 14 at Spousal rate (15) 16. A.ount of line 14 taxable at line.1/Class A rate (16] 17. A.ount of Line 14 at Sibling rat. (17) 18. A.ount of line 14 taxable at Collateral/Class 8 rate (18) 19. Principal Tax Due 14, lS and/or 16, 17, 18 and 19 will returns assessed to date. 5,506.00 X 00 = .00 X 045 = .00 X 12 = .00 X 15 = 119)= .00 .00 .00 .00 .00 TAX CR TS: -n' .. "J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ~ IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REqUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOHN FOR INSTRUCTIONS.) RESERVATION: PURPOSE OF NOTICE: PAYMENT: REFUND (eR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer InheritancaTaxes at the lawful Class B (collateral) rate on any such future interest. To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 200D. (72 P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side. --Make check or money order payable to: REGISTER OF KILLS} AGENT A refund of a tax credit, which was not requested on the Tax Return, mey be raquasted by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REY-1313). Applications are available online at www revenua.state.oa.us, any Registsr of Wills or Revenue District Office, or from the Depart.ent's 24-hour answering service for forms orders: 1-800-362-2050; services for taxpayers with special hearing and/or speaking needs: 1-800-447-3020 (TT only). Any party in interest not satisfied with the appraisment, allowance or disallowance of deductions or assessment of tax (including discount or interest) as shown on this Notice may object within 60 days of the date of receipt of this notice by filing one of the following: A) Protest to the PA Department of Revenue, Board of Appeals. You may object by filing a protest online at www.boardofappeals.state.pa.us on or before the expiration of the sixty-day appeal period. In order for an electronic protest to be valid, you must receive a confirmation nu.ber and processed data from the Board of Appeals website. You may also send a written protest to PA Department of Revenue, Board of Appeals P.O. Box 281021, Harrisburg, PA 17128-ID21. Petitions may not bs faxed. B) Election to have the mat tar determined at the audit of the account of the personal representative. C) Appeal to the Orphans' Court. Factual errors discovered on this assessment should be addrassed in writing to: PA Department of Revenue, BureBu of Individual Taxes, ATTN: Post Assessment Review Unit, P.O. Box 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet nInstructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of adMinistratively correctable errors. If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (57.) discount of the tax paid is allowed. The 157. tax amnesty non-participation penalty is computsd on the totsl of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in ths sa.s manner and in the the same time period as YOU would appaal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of pay.ant. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (67.) percent per annUM calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable intsrest rates for 1982 through 2005 are: Interest Daily Interest Daily Interest Rate Factor Year Rate Factor Yesr Rete ~ ~ Tml-1991 ---rrr-:1lm1l!" ~ ---.r- 167. .000438 1992: 97. .000247 2002: 67. 117. .000301 1993-1994 n .000192 2003 57. 137. .00D356 1995-1998 97. .000247 2004 47. 107. .000274 1999 n .000192 2005 57. 107. .000274 2000 n .000192 Vear ~ 1983 1984 1985 1986 1987 Daily Factor .~ .000164 .000137 .000110 .000137 --Interest is calculated as follows: INTEREST ~ BALANCE OF TAX UNPAIO X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an intarest calculation to fifteen (15) days beyond the date of the assessment. If pay.ent is made after the interest computation date shown an the Notice, additional interest must be calculated. - '* INHERITANCE TAX EXPLANATION OF CHANGES ,lONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARRISBURG PA 17128~0601 .DENT'S NAME FILE NUMBER ""VIEWED BY Widders, George J. Daniel Heck ACN 2104-0692 101 ITEM SCHEDULE NO. A 1 EXPLANATION OF CHANGES The value of the real estate is increased from $3,280.00 to $5,910.00 as the result of that the decedent owned a 1/2 interest in the real estate and not a 1/4th interest as stated on the return. ORIGINAL Page 1 '::< -r:. '--l ~ r-- :ntiUl ;0- . ~ ~ ~ ...... -. ..... ~ ..... ~~' '" o 'h ~ it> it> ~:1: ~ ~ r __ ~ .. ^ ~ t;:t ""'" "- -,..,. ul ~ ~ t t- I l>- S- :;; ... " j:) q, t T , "" L lJ"" ~ ~ p :> ~~ ~ ~ ):;< ""tE" ~ " }.l ~ LJ -. " ~ . Q.. .... 0- l" ~ (' t- ;J, ~' ~ ~ \J ~ ~ - ;;\ '" '" '" '" .. a 00 1r, C{~ ~ ',< ;.. ~c -,~ !.>..'" \:l ~~ - ~ ~~ ~ r f.- -r- ~r ~ ,. t~ ~ y v. ft' '. ... ~~ J'" '~ ~ ~" ll.. ~. ~ " ~ 't""t: "'~ "-\L }!'>> ;1, ~ c:J t ~ ~ ~ ll.. < (}, ~ ~ ~ ,~"- '1-- GJ " ~ ~ ~ ~ t;. I\l' i1\ ~ ~ --z ~ '" "" ~ '-' . .~. Iii ~ '" , ~ lA ~. , < ~. " ... r-- 'l' ~ t , iI:> . ;... ill Ii" ~ ~ r> ~ ':' Itj '" ~ tJ .... ' ~ ~ ~ t ~. ~ ~ b- ~} ~ Il. " c., , III -:: ~ ~ f' :- t-- ~ ~ ", ~ {; 1 --., '" N t~ J ~ ~ tA- ,,~ ~ ll.1'i ~~ ...-::t r-. p Ill' ~ ,., ",,<0::1 " , 1\' ~ .. .... ...... -.D ~~. ,,'> f} 'r " , - . ~~. !" , :;~ -'l-~ ~ :-. a:!.... ~ i'l R F : ~ tt ;:: ! (.-\ ~ .. L ~ _.J ~ ::1 ,\ \'- rt) ~ ~ ~ " c., \ ~ "- to, ~ ~ ~ ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE *' BUREAU~~f INDIVIDUAL TAXES INHERITANCE tAX DIVISIDN- PO BOX Z806Dl HARRISBURG PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR OISALLOWANCE OF DEDUCTIONS AND ASSESSMENT DF TAX REV-1541EX AFP (12-D4) CHARLES,ESHiELDS III 6 CLOUSER RD MECHANICSBURG PA 17055 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 02-14-2005 WIDDERS 12-12-2002 21 04-0692 CUMBERLAND 101 GEORGE J Allount Re..itted 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 ~ R1v:r!\"f.Eic--,{~"..rll1":6!')"NiiT.i'CE-'i:iI'.lNHEitI.i'AJ(CE.TAX-7il5'PRA.isE~'i':..ALLii.tlANCE.ijR--......_--_.. ... DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF WIDDERS GEORGE J FILE NO. 21 04-0692 ACN 101 DATE 02-14-2005 TAX RETURN WAS: I ) ACCEPTED AS FILED I X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule BJ 3. Closely Held stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule DJ 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. ~ointly Owned Property (Schedule f) 7. Transfers (Schedule G) 8. Total Assets II) (2) (3) (4) (5) (6) (7) 5.910.00 .00 .00 .00 .00 .00 .00 IB) NOTE: To insure proper credit to your account, submit the upper portion of this for. with your tax pay.ent. 5,910.00 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ad.. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Govern.ental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 404.00 .00 Ill) II2) (13) (14) 404 DO 5,506.00 .00 5,506.00 NOTE: I~ an assessment was issued previOUSly, lines re~lect ~igures that include the total o~ ALL ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rate (17) 18. A.ount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due 14, lS and/or 16, 17, 18 and 19 will returns assessed to date. 5,506.00 X 00 = .00 X 045 = .00 X 12 = .00x15= (19)= .00 .00 .00 .00 .00 ~ TAX CREDITS: n.~.u '" AMOUNT PAID DATE NUNBER INTEREST/PEN PAID 1-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. [ IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) REV-1470EX (6-116) . INHERITANCE TAX EXPLANATION OF CHANGES COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARRISBURG PA 17128-0601 DECEDENTS NAME FILE NUMBER REVIEWED BY ACN 2104-0692 101 Widders, George J. Daniel Heck ITEM SCHEDULE NO. A 1 EXPLANATION OF CHANGES The value of the real estate is increased from $3,280.00 to $5,910.00 as the result of that the decedent owned a 1/2 interest in the real estate and not a 1/4th interest as stated on the return. ROW Page 1 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU Of INDIVIOUIfGf'AffiED OFFICE QC INHERITANCE TAX INHERITANCE TAX DIVISIDNr'."....("I:C,..:i:' PO 8.X 28'6" r~',:',) '-,. RECORD ADJUSTMENT HARRISBURG PA 171Z8-D601 200S AUG 19 PM 12: 34 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN CLER:( C-:" r'':'G:-' - CHARLES~'c~'HIELDS III' 6 CLOUSER RD MECHANICS BURG PA 17055 * REY-1593 EX AFP (03-05) 08-10-2005 WIDDERS 12-12-2002 21 04-0692 CUMBERLAND 101 AIKNl\~ R_i tted GEORGE J MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax pay.ant. --+ RETAIN LOWER PORTION FOR YOUR RECORDS +-- REV-1593 EX AFP (03-05) ESTATE OF WIDDERS J FILE NO. 21 04-0692 .. INHERITANCE TAX RECORD ADJUSTMENT .. DATE GEDRGE ADJUSTMENT BASEO ON: VALUE OF ESTATE: 1. Real Estate (Schedule A) 2. stocks and Bonds (Schedule B) 3. Closely Held stock/Partnership Interest (Schedule C) 4. Kortgages/Notes Receivable (Schedule DJ 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) .,. ..Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets DEDUCTIONS AND EXEMPTIONS: PROTEST BOARD DECISION Il) (2) (3) (4) [5) (6) (7) 9. Funeral Expenses/Ad.inlstrativ. Costs/ Miscellaneous Expenses (Schedule H) Debts/Mortgage Liabilities/Liens (Schedule I) Total Deductions Net Value of Tax Return Charitable/Govern..ntal Bequestsi Non-elected Net Value of Estat. Subject to Tax (9) 1l0) 404.00 .00 10. 11. 12. 13. 14. TAX: 15. 16. 17. 18. 19. ACN 101 08-10-2005 3,280.00 .00 .00 .00 .00 .00 .00 (8) 3,280.00 Ill) 1121 9113 Trusts (Schedule ,J) (13) 1l4) 404.00 2,876.00 .00 2,876.00 A.ount of Line 14 at Spousal rat. Anount of Line 14 taxable at Line.l/Class A rate Amount 0'1 Line let at Sibling rat. A.ount of Line 14 taxable at Collateral/Class B Principal Tax Due 1l5) 1l6) 1l7l rat. (18) TAX CREDITS: K......r' \" AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 2.876.ooX DO = .00X 045= .00X 12 = .00X 15 = 1l9) .00 .00 .00 .00 DO . If PAlO AfTER DATE INDICATEO, SEE REVERSE FOR CALCULATION Of AODITIONAL INTEREST. I If TOTAL DUE IS LESS THAN 01, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REfLECTED AS A "CREOIT" (CR), YOU KAY BE OUE A REFUND. SEE REVERSE SIDE Of TMIS fORK fOR INSTRUCTIONS.) _ "'-. +- BOARD OF APPEALS DEPT. 281021 . HARRISBURG, PA 17128-1021 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE CHARLES E SHIELDS III ESO 6 CLOUSER RD MECHANICSBURG PA 17055 IN RE ESTATE OF: WIDDERS GEORGE J DOCKET NO.: TAX TYPE: APPEAL TYPE FILE NUMBER: ACN: APPRAISEMENT: PETITION FILED: EXAMINER: MAILING DATE: DECISION AND ORDER 0503427 Inheritance Protest 2104-0692 101 2/14/2005 2/14/2005 WILLIAM J ZDRADZINSKI Direct Dial: (717) 787-5761 Fax: (717) 787-7270 Email: wzdradzins@state.pa.us August2,2005 On February 14, 2005, the Department issued an appraisement and assessment that increased the taxable value of decedent's interest in the real estate reported as item 1 on Schedule A of the original inheritance tax retum from $3,280.00 to $5,910.00. The Department's action was based on the premise that decedent owned a one-half interest in the property and not a one-fourth interest. Petitioner has now supplied a copy of a May 9, 1973 deed which confirms the decedent held only a one-fourth interest in the real estate. The taxable value of decedent's interest should, therefore, be reduced to $3,280.00 or one-fourth of the $13,120,00 "computed value" of the realty. Accordingly, it is hereby, Ordered that the protest is sustained. The Department is directed to issue an amended appraisement and assessment reducing the taxable value of decedent's interest in the Schedule A Item 1 real estate to $3,280.00 as originally reported. FOR THE BOARD OF APPEALS JOSEPH R. SLEEK, MEMBER WIDDERS GEORGE J BOARD DOCKET NO. 0503427 Page 2 of 2 A STATEMENT OF ACCOUNT WILL BE MAILED TO YOU BY THE BUREAU OF INDIVIDUAL TAXES. ANY APPEAL FROM THIS DECISION MUST BE FILED WITH THE ORPHANS' COURT WITHIN SIXTY (60) DAYS OF RECEIPT OF THIS DECISION. IF YOU REQUIRE THIS INFORMATION IN AN ALTERNATE FORMAT UNDER THE PROVISIONS OF AMERICANS WITH DISABILITIES ACT OF 1990, PLEASE CALL (717) 783-3664, OR FOR SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND SPEAKING NEEDS: 1-800-447-3020 (IT ONLY). STATUS REPORT UNDER RULE 6.12 Name of Decedent: George 1. Widders Date of Death: December 12, 2002 Will No. Admin. No. 21-04-0692 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* 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 r~esentative account with the Court? Yes No . b. The separate Orphans' Court No. the personal representative's account is: file a final (if any) for c. Did the personal representative state an account informally to the parties in interest? Yes >< No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. ~f( s~2~p Date: o Charles E. Shields, III, Esquire Name (Please type or print) 6 Clouser Road, Mechanicsburg, PA 17055 Address I.l s... L' l . C_' (- r-:- I.l- (717 ) 766-0209 Tel. No. b-:~ t L' Lf"~) C:l c_..;.' C'--....i c. Capacity: Personal Representative x Counsel for personal representative (MAH:rmf/AM3) eQ