HomeMy WebLinkAbout03-0166 PETITION FOR PROBATE and GRANT OF LETTERS
Estate of' ~_ji4~-~ /~. C~-~f?,~o~a__ No. ~
also known as To:
Register of Wills for the
, Deceased. County of
Social Security No. ov, o.s~- o-/ -. os'/~- 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 execut
in the last will of the above decedent, dated /.z
and codicil(s) dated & [/cl [
in the
· named
,19 '7-7
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in O~.,,~r~o~_~
h ~ $ _ last family or p,rincipal residence at
(list street, number and muncipality)
Decendent, then ~ %t years of age, died
at (2n~-~, ~ -~,o,.~,~,.~
County, Pennsylvania, with
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property $
(If not domiciled in Pa.) Personal property in Pennsylvania $
(If not domiciled in Pa.) Personal property in County $
Value of real estate in Pennsylvania $
situated as follows:
WHEREFORE, petitioner(s) respectfully
presented herewith and the grant of letters
theron.
request(s) the probate of the last will and codicil(s)
(testamentary; admin~tration c.t.a.; administration d.b.n.c.t.a.)
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA q
· COUNTY OF ~~~ f ~s
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 estate according to law.
Sworn to or affirmed and subscribed
before me this oQr~-'~v~ day of
~', C~. ~Lk~.'sa.~....~. Regi~er
No.
Estate Of (.'~.~ ~. (~--~,~-~ , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW ~,~1,. ~, c~)D_~ ~ , in consideration of the petition on
the reverse side hereof, satisfactg~y ~roo~ having been presented before me, ' '
IT IS DEC~ED that the inst~ment(s) dated{~)~ ~ }~' I~' 1~3 ~ ~~ ~ ~ /O-l~- /~q~
therein be a~itted to orobate ~d filed of record as the last w~l of
~d Letters ~ ~a ~ ~-~
~e Oereby granted to ~
C~_ c'~_)-" ~ FEES
Probate, Letters, Etc .......... $ ] [ ~
Short Certificates( ) ' $
..3 c~P' $ /~.
To'r^L . $ /4/. ~-Q.
Filed . .c~..'.~ ..~. 2: .~..,--~. ..................
ATI'ORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
ii
REGISTER OF WILLS OF COUNTY
OATH OF SUBSCRIBING WITNESS
codicil'" "~
(each) a subscribing witness to the will pre'tinted herewi~"~) being duly qualified according to
law, depose(s) and say(s) that ·~ present and saw
and th'~ta-~,
the
testat.
, sign.thL'-~me... -. S~ed% asa witness at the
request of testat. ___ in h "'~,,.presence a~d~.he~_ presende of each
other)
(in
presence
of
the
other subscribing Witnessings)). ~
Sworn to or affirmed and ~'c~r~be~d befo~r
me this _~d'd'"a)~of ~, ~Name)
( AddrRegister
(Name)
(Address)
REGISTER OF WILLS OF Q.u~w~k-w~c/c,~o( COUNTY
OATH OF NON-SUBSCRIBING WITNESS
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
~ CL~ ~ familiar with the signature of ~ ~ ~' O~ ~/~ ~T-
D ,
testatOc- of (one of the subscribing witnesses to) the~ presented herewith and
that
to the best o~
Sworn to or affirmed and subscribed before
me this __c~C'~t~ day of
codicil
believes the signature on the will is in the handwriting of
knowledge and belief.
(Address)
(Name)
(Address)
LAST WILL AND TESTAMENT OF
CHARLES E. CLEPPER
KNOW ALL b~N BY THESE PRESENTS, that I, Charles E.
Clepper, of the Borough of Carlisle, Cumberland County,
Pennsylvania, being of sound mind, memory and understanding,
do make, publish and declare this to be my Last Will and
Testament and revoke all Wills and Codicils previously made
by me.
ITEM 1. I direct my Executrix hereinafter named to pay
my funeral expenses, costs of the administration of my estate
and all of my just debts as soon as may be convenient after
my death.
ITEM 2. I give, devise and bequeath all of my estate,
be the same real, personal or mixed and wheresoever situate,
to my wife, Elizabeth K. Clepper, provided~e survives me.
ITEM 3. Provided she survives me, I appoint Elizabeth K.
Clepper, as executrix of my estate.
ITEM 4. In the event my wife, Elizabeth K. Clepper,
predeceases me then and in that event I give, devise and
bequeath all of my estate be the real, personal or mixed
and wheresoever situate in equal shares to my three (3)
children, Charles M. Clepper, Martha Clepper Streett and
Mary Clepper Weaver.
ITEM 5. In the event my wife ! predeceases me,
I appoint my three (3) children or the survivor of them as
executors of my estate.
IN WITNESS WHEREOF, I have hereunto set my hand and
seal this /~-- day of ~eC~,~6~-~ , 1977.
(SEAL)
The preceding instrument, consisting of this and one other
typewritten page, each identified by the signature of the Testator,
was on the day and date thereof signed, published and declared by
CHARLES E. CLEPPER, the Testator therein named, as and for his
Last Will and Testament, in the presenct of us, who, at his request,
in his presence and in the presence of each other, have subscribed our
names as witnesses hereto.
names as
GARBER, FOWLER & ADDAMS
BM
-2-
CHARLES E. O.EPPER
Mark E. Garber, Jr., Esq.
G..~kI~BER, FOWLER & ADDA~I8
~0~8 ~ L~W
~8 SO~H. P~ S~BT
~RLISLE~ PB~A. l~OfO
AMENDMENT TO
THE LAST WILL AND TESTAMENT
OF
CHARLES E. CLEPPER
I, Charles E. Clepper, wish to amend Item 5 of my Last Will and Testament by
deleting Martha Clepper Streett as one of my executors. The two (2) remaining
executors will be my other children, Charles M. Clepper and Mary Clepper Weaver.
In witness whereof, I have hereunto set my hand and seal this
,,~,,._~ ,1998.
day of
(SEAL)
(w~rm~ss)
.o. fl~, s. I
Per~ j. Sa#hamer, Notary Public
_C.,~'ll~]e Bom, Cumbedancl County
My Commission Expires Feb. 18, 2002
Name of Decedent:
Date of Death:
Will No. ~-7//-- t:SP.-~ --/~/
To the Register:
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Admin. No.
I certify that notice of (beneficial interest) estate administration 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 :
Name
Address
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
Capacity:
Signature
Address ?
Telephone (7/])
~ Personal Representative
Counsel for personal representative
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 002533
WEAVER MARY CLEPPER
402 MT ROCK RD
NEWVILLE, PA 17241
........ fold
ESTATE INFORMATION: SSN: 205-07-0518
FILE NUMBER: 2103-01 66
DECEDENT NAME: CLEPPER CHARLES E
DATE OF PAYMENT: 05/07/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 02/22/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $2,700.00
REMARKS:
MARY C WEAVER
TOTAL AMOUNT PAID:
$2,700.00
SEAL
CHECK# 101
INITIALS: AC
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV- 1 500
INHERITANCE TAX RETURN /
RESIDENT DECEDENT i YEAR NUMBER
Z
LU
LU
O
UJ
f-
Z
W
Z
0
LU
0
0
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
Clepper, Charles E.
DATE OF DEATH (MM-DD-YEAR) DATE OF 81RTH (MM-DD-YEAR
2-22-03 4-30-18
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
N/A
SOCIAL SECURITY NUMBER
205 -04 - 0518
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
[~1. Original Return
[~4. Limited Estate
[~6. Decedent Died Testate (Attach copy of Will)
[~]9. Litigation Proceeds Received
NAME
C. Michael Clepper
FIRM NAME (If Applicable)
N/A
TELEPHONE NUMBER
717-243-5319
[~-] 2. Supplemental Return [] 3. Remainder Return (date of death prior to 12-13-82)
[] 4a. Future Interest Compromise (date ofdeath after 12-12-82) [] 5. Federal Estate Tax Return Required
[~7. Decedent Maintained a Living Trust (Attach copy of Trust) 8. Total Number of Safe Deposit Boxes
[] 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) [] 11. Election to tax under Sec. 9113(A) (Attach Sch O)
COMPLETE MAILING ADDRESS
C. Michael Clepper
9 Marilyn Dr.
Carlisle, Pa. 17013
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 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)
13.
14.
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line 13)
-0-
$62r951.65
--0--
--0--
(8)
$2,199.25
$1,757.50
:' OFF~Cl~'~ USE ONLY
I
(11)
(12)
(13)
$62,951.65
$ 3,956.75
$58~994.90
--0--
(14)
$58,994.90
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
-0- x .0_ (15)
$58,
994
.90 x .o45 (16)
--O-
X .12 (17)
--0-- x .15 (18)
(19)
19. Tax Due
20. []
$ 2,654.77
$ 2r654.77
Decedent's Complete Address:
STREET ADDRESS 213 Todd Circle
CiTY Carlisle
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
STATE
Pa
Interest/Penalty if applicable
D. Interest
E. Penalty
-0-
$2,700.00
$ 1~2:80
(1)
Total Credits ( A + B + C ) (2)
Total Interest/Penalty ( D + E ) (3)
If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
ZIP
17013
B. Enter the total of Line 5 + SA. This is the BALANCE DUE.
$2~654.77
$2,832.80
--0--
$ 178.03
(5)
(5A)
(5B)
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; ............................................ [] []
c. retain a reversionary interest; or .......................................................................................................................... [] []
d. receive the promise for life of either payments, benefits or care? ...................................................................... [] []
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. [] []
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. [] []
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ []
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE 6 AND FILE IT
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.
AS PART OF THE RETURN.
SIGNATURE_DF PERSON RESPONSIBLlii FOR FILING RETURN
ADDRESS ' v /
9 Marilyn Dr. Carlisle, Pa. 1 701 3
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
DATE
i/,- 7- ~'~ '3
11-7-03
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. §9116 (a)(1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.1) (ii)
The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even
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 paten
or a stepparent of the child is 0% [72 RS. §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 RS. §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 a
individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1508 EX + (1-97) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Charles E. Clepper
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
Include the
ITEM
NUMBER
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
)mceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorshi ) must be disclosed on Schedule F.
DESCRIPTION
Car
Checking Account
Statement Savings Members First
Investment Savings " "
CD ,, ,,
CD ,, ,,
Sarah A. Todd Memorial Home Security
State Farm Car Insurance Refund
State Farm Renters Insurance Refund
Checking Insterest
Withlacoochee River Electric Co-op
Interest on Estate Investment Savings
Federal Cred. Union
II II II
Deposit Refund
Feb. 2003
Mar. 2003
Apr. 2003
May 2003
VALUEAT DATE
OF DEATH
$ 450.00
3,048.94
25.70
17,757.89
10,032.15
30,084.23
1,170.57
150.63
43.38
.24
1 .31
11 .92
85.51
74.30
14.88
$62,951 . 65
TOTAL (Also enter on line 5, Recapitulation) I $
(If mole space is needed, insert additional sheets of the same size)
REV-1511EX + (1-97) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Charles E. Clepper
Debts of decedent must be reported on Schedule I.
FILE NUMBER
ITEM
NUMBER DESCRIPTION AMOUNT
5.
6.
7.
FUNERAL EXPENSES:
Hoffman Roth Funeral Home
Funeral Luncheon F. O. E.
1299
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s)
Social Secudty Number(s) / EIN Number of Personal Representative(s)
Street Address
City State
Year(s) Commission Paid:
Attorney Fees
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Zip
Street Address
City
Relationship of Claimant to Decedent
Probate Fees
Accountant's Fees
Tax Return Preparer's Fees
Postage & Cards
State Zip
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
$1,879.80
150.00
-0-
-0-
141.50
27.95
$2,199.25
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULEI
DEBTS OF DECEDENT,
MORTGAGELIABILITIES,& LIENS
ESTATE OF
Charles E. Clepper
FILE NUMBER
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION AMOUNT
2.
3.
4.
5.
6.
First U. S. A. Bank
Sarah A. Todd Memorial Home 1 Month Rent
Sprint
MCI
Masland Associates
Carlisle Regional Medical Center
& Extras
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
$ 48.49
1,630.65
16.04
24.54
20.70
17.08
1,757.50
REV-1513 EX+ (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
Charles E. Clepper
FILE NUMBER
NUMBER
I
1.
2
II
1.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
C. Michael Clepper
9 Marilyn Drive
Carlisle, Pa. 17013
Mary C. Weaver
402 Mt. Rock Road
Newville, Pa. 17241
Martha C. Street
5136 Anderson Road
Stewartstown, Pa. 17363
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Son
Daughter
Daughter
AMOUNT OR SHARE
OF ESTATE
1/3
1/3
1/3
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
(If more space is needed, insert additional sheets of the same size)
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DZVTS'rON
DEPT. 280601
HARRZSBURG, PA 1712/}-0601
COHNONNEALTH OF PENNSYLVANIA
DEPARTNENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAZSENENT, ALLOWANCE OR DZSALLO#ANCE
OF DEDUCTIONS AND ASSESSNENT OF TAX
C HICHAEL CLEPPER
9 HARILYN DR
CARLISLE
RE¥-1;47 EX &FP ¢01-0S}
DATE 12-29-2005
ESTATE OF CLEPPER
DATE OF DEATH OZ-ZZ-ZO0$
FILE NUNBER 21 05-0166
- COUNTY CUHBERLAND
ACN 101
PA 17013. ~ ~ I Amount Remitted
CHARLES E
HAKE CHECK PAYABLE AND RENZT PAYHENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~'~ RETAIN LONER PORTION FOR YOUR RECORDS ~
REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISENENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSNENT OF TAX
ESTATE OF CLEPPER CHARLES E FILE NO. 21 05-0166 ACN 101 DATE 12-29-2003
TAX RETURN NAS: (X) ACCEPTED AS FILED ( } CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSR
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. ReaZ Estate (Schedule A)
2. Stocks and Bonds (Schedule B}
3. Closely Held Stock/Partnership Interest (Schedule C) (3}
~. Hortgages/Notes Receivable (Schedule D) (~)
E. Cash/Bank Depos/ts/Nisc. Personal Property (Schedule E)
6. Jo/ntly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
APPROVED DEDUCTIONS AND EXENPTIONS:
9. Funeral Expansos/Adm. Costs/N/sc. Expenses (Schedule H) (9)
10. Debts/Nortgago L/ab/1/t/es/L/ens (Schedule I) (10)
11. TotaZ Deduct/ons
12. Net Value of Tax Return
6Zi951.65
.00
.00 NOTE: To /nsuro proper
.00 crod/t to your account,
· O0 subm/t the upper port/on
.00 of this form w/th your
tax payment.
.00
(8)
2,199.25
13.
14.
NOTE:
62,951.65
ZF PAID AFTER DATE ZNDZCATED~ SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
TAX CREDITS:
PAYI~FNT
DATE
05-07-2003
RECETP1
NUHBER
CDOOZ533
DZSCOUNT (+)
INTEREST/PEN PAID (-)
132.7~
reflect figures that lnclude the total of ALL returns assessed to date.
· O0 x O0 = . O0
58,99R.90 x 0~5= Z,65R.77
· 00 x 1Z = .00
· 00 x 15 = .00
(19)= Z,65~.77
AHOUNT PAID
2,700.00
ASSESSHENT OF TAX:
15. Amount of L/nm 1~ at Spousal rate (15).
16. Amount of L/no 14 taxable at L/neaZ/Class A rate (16)
17. Amount of L/nm 14 at S/bl/ng rate (17)
18. Aeount of L/nm 14 taxable at Collateral/Class B rate (18)
19. Pr/nc/pal Tax Due
TOTAL TAX CREDIT f Z,83Z.7,q. J
BALANCE OF TAX DUEI 177.97CR
TOTAL DUE I 177.97CR
( ZF TOTAL DUE IS LESS THAN $1~ NO PAYNENT ZS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR)~ YOU NAY BE DUE
A REFUND· SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.)
Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (15) .00
Net Value of Estate Subject to Tax (14) 58,994.90
If an assessment ~as issued previously, lines 1~, 15 and/or 16, 17, 18 and 19 ~ill
1,757.50
(11) 3.956.75
(12) 58,99R.90
RESERVATION:
Estates of decedents dying on or before December 12, 19BI -- 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 Inheritance Taxes
at the lawfu! Class B (collateral) rate on any such futura interest.
PURPOSE OF
NOT[CE:
PAYMENT:
REFUND (CA):
OBJECTIONS:
ADMiN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
To ~ulfill the requirements of Section 2160 of the inheritance and Estate Tax Act, Act 25 of ZOO0. (TI P.S.
Section
Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side.
--Make check or money order payable to: REGISTER OF HILLS, AGENT
A refund of a tax credit, which ams not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania inheritance and Estate Tax" (RE¥-1515). Applications are available at the Office
of the Register of Mills, any of the Z5 Revenue District Offices, or by calling the special IS-hour
answering service for fores ordering: 1-800-36Z-Z050; services for taxpayers eith special hearing end / or
speaking needs: 1-BOO-667-SOZO (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disalloaanca of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object within sixty (603 days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. [8lOll, Harrisburg, PA 17lIS-lO[I, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
Factual errors discovered on this assessment should be addressed in writing to: PA Dmpartment of Revenue,
Bureau of [ndividual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601
Phone (717) 787-6505. See page 5 of the booklet "instructions for [nheritanca Tax Return for a Resident
Decadent" (REV-1SOZ) 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 (SI) discount of
the tax paid is allowed.
Thm 157. tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January lB, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of
six (SI) percent per annum calculated at a daily rate of .000166. All taxes which became delinquent on and after
January l, 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 interest rates for 198Z through ZOO3 ara:
Interest Daily Interest Daily interest Daily
Year Rate Factor Yaa.~r Rate Factor Yea.~.r Rate Factor
198Z lOX .000568 1987 9Z .000Z67 1999 7Z .000192
1983 16Z .00065B 1988-1991 11Z .000301 ZOO0 8Z .000Z19
1986 11Z .000501 1992 97. .000Z67 ZOO 1 9X .000Z67
1985 132 .000556 1993-199q 7Z ,00019Z ZOOZ 6Z .000166
1986 107. .000276 1995-1998 97. .000267 ZOO3 52 .000157
--Interest is calculated as folloas:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (lB) days
beyond the date of the assessment. [f payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.
BUREAU OF ZND'rVTDUAL TAXES
TNHERTTANCE TAX D'ryTSTON
DEPT. 280601
HARRTSBURG, PA 171Z&-D601
C HICHAEL CLEPPER
9 HARILYN DR
CARLISLE PA
COHHONNEALTH OF PENNSYLVAN'rA
DEPARTHENT OF REVENUE
ZNHERZTANCE TAX
STATEHENT OF ACCOUNT
FEB 13 P3:32
DATE
ESTATE OF
DATE OF DEATH
FZLE NUHBER
COUNTY
ACN
REV-I~;0? EX AFP (01-05)
01-26-200~
CLEPPER CHARLES E
02-22-2005
21 05-0166
CUHBERLAND
101
Aeoun~ Reei~ed [
HAKE CHECK PAYABLE AND REHZT PAYNENT TO:
REGTSTER OF NTLLS
CUHiiERLAND CO COURT HOUSE
CARLTSLE, PA 1701:5
NOTE: To insure proper credit: ~o your accoun~:, submit: ~:he upper por~:ion of ~his fore wi~:h your ~ax payment.
CUT ALONG THZS LZNE ~'~ RETA'rN LONER PORTZON FOR YOUR RECORDS
REV-1607 EX AFP (01-03) ~#~ ZNHER]:TANCE TAX STATENENT OF ACCOUNT
ESTATE OF CLEPPER CHARLES E F'rLE NO. 21 0:5-0166 ACN 101 DATE 01-26-Z00~
TH'rS STATEHENT TS PROVZDED TO ADV'rSE OF THE CURRENT STATUS OF THE STATED ACN TN THE NAHED ESTATE. SHONN BELON
TS A SUHHARY OF THE PR'rNCI*PAL TAX DUE, APPL*rCAT'rON OF ALL PAYHENTS, THE CURRENT BALANCE, AND, 'rF APPLTCABLE,
A PROJECTED TNTEREST FZGURE.
DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT: 12-29-Z00:5
PRINCIPAL TAX DUE:
PAYHENTS (TAX CREDITS):
2,65R.77
PAYHENT RECEIPT DISCOUNT (+)
DATE NUNBER INTEREST/PEN PAID (-) AHOUNT PAID
05-07-200:5
01-07-Z00~
CD0025:5:5
REFUND
1:52.7R
.00
2,700.00
177.97-
IF PAID AFTER THZS DATE, SEE REVERSE
SZDE FOR CALCULATZON OF ADDZTZONAL INTEREST.
( ZF TOTAL DUE ZS LESS THAN $1,
NO PAYNENT 1S REQUZRED.
.rF TOTAL DUE ZS REFLECTED AS A 'CRED.rT'
TOTAL TAX CREDZT 2,65~.77
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
YOU HAY BE DUE A REFUND. SEE REVERSE S*rDE OF TH'rS FORH FOR .rNSTRUCT.rONSo )
PAYMENT:
Detach the top portion of this Notice and submit with your payment made payable to the name and address
printed on the reverse side.
-- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF NZLLS, AGENT.
-- Tf NON-RESIDENT DECEDENT make check or money order payable to: COHMONNEALTH OF PENNSYLVANIA.
REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an
"Applicatian for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1515). Applications are available at
the Office of the Register of Hills, any of the 25 Revenue District Offices or from the Department's 2q-hour
answering service for forms ordering: 1-&O0-36Z-ZOSO~ services for taxpayers aith special hearing and / or
speaking needs: l-BOO-~qT-3Ogg (TT only).
REPLY TO:
questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau
of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 2BO60l, Harrisburg, PA 171ZS-0601, phone
(7[7) 787-6505.
DISCOUNT:
Zf any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5Z) discount
of the tax paid is allowed.
PENALTY:
The 1SI tax amnesty non-participation penalty ts computed on the total of the tax and interest assessed, and not
paid before January lB, 1996, the first day after the end of the tax amnesty period.
INTEREST:
Interest is charred beginning with first day of delinquency, or nine (9) months and one (l) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of
six (6Z) percent per annum calculated at a daily rate of .O0016q. AIl taxes ahich became delinquent on and after
January l, 19BI 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 interest rates for 1982 through 2003 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year__ Rate Factor
1982 ZOZ .000518 1987 91 .O00Zq7 1999 7Z .OOO19Z
1983 16Z .000q38 1988-1991 111 .000301 ZOO0 81 .000219
198q IZZ .000301 1992 92 .O00Z~7 2001 9Z .O00Zq7
1985 132 .000356 1993-199q 7Z .O001R2 ZOOZ 62 .00016~
1986 102 .O00Z7~ 1995-1998 9Z .0002~7 2003 52 .000137
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes deIinquant will reflect an interest calculation to fifteen (1S) 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.
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 1/10/2005
WEAVER MARY CLEPPER
402 MT ROCK RD
NEWVILLE, PA 17241
RE: Estate of CLEPPER CHARLES E
File Number: 2003-00166
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: 2/22/2005
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
REGISTER OF WILLS
cc: File
Counsel
Judge
STATUS REPORT U1\1DER RULE 6.12
NameofDecedent: ('j/11i<Je.s' .6'- (!/f'7,o~~1C
Date ofDeath: :J.. - :J;). - CJ 3
WilINo.:;l (JC) 3 -OC'/ t 6
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 I8r No 0
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 ~sentative file a final account with the Court?
Yes _ No 0>l
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties
in interest? Y es ~ No 0
c. Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the Orphans' Court
and may be attached to this report.
Date:JgjoS- ~k.>t-k 7n, e~"
Signature
~j,rrtCJes /Y}. ekr>/f',f
Name
9 /Vlfle/' )y/o.I' f}/?.
Address '
CI1 R/;J/e
.2'13-53/ c;
Telephone No. .
SO :Z lid 81 f'!Vr ~aoz
Capacity:
~Personal Representative
o Counsel for personal representative
'., I'
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