HomeMy WebLinkAbout03-1014 PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
H.. FRANKLIN HICKS a/k/a
Estate of I~RY F. HI~KS No. 21-03-/~5)/w, wl'
also known as To:
Register of Wills for the
Deceased. County of Cumberland in the
Social Security No. 201-26-9400 Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older, applies for letters of administration
on the estate of
(d.b.n.; pendente lite; durante absentia; durante minoritate)
the above decedent.
Decendent was domiciled at death in Cumberland Countv, Pennsylvania, with
h is last family or principal residence at 929 N±xon Drive, Mechan£csburg Borough
(list street, number and municipality)
Decendent, then 65 years of age, died Septe~fDer l 2 ,1998 ,
at Holy Spirit Hospital, East Pennsboro Township, Cumb. Co, PA
Decendent at death owned property with estimated values as folllows:
(If domiciled in Pa.) All personal property $.500.00
(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:
Petitioner.__ after a proper search ha s ascertained that decedent left no will and was survived by
the following spouse (if any) and heirs:
Name Relationship Residence
Brenda L. High daughter 929 Nixon Drive
Mechanicsburg~ PA 17055
Bonnie L. Schult daughter 88 Mooredale Road, Apt. 1
Carlisle, PA 17013
THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the
appropriate form to the undersigned.
Bonnie L. Schult
88 Mooredale Road, Apt. 1
Carlisle, PA 17013
(717) 243-1267
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF
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
representative(s) of the above decedent petitioner(s) will well and
truly administer the estate according to law.
beforeSW°rn met° this°r afrO/_/ and subscribedday of ~ '~~
~eomhpr ~~ 8onn~ ~ T,.
No. 21-03-/L9/~/
It. FRAhqCLIN BILKS a/k/a
Estate of marry nUaaKi~m .xLKs , Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW December ~' 1:9 2003, in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that Bonnie L. Schult
is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration
are hereby granted to Bonnie L. Schult
in the estate of H. Franklin Hicks a/k/a Henry Franklin Hicks
~ IR%lIN & McKNIGMT
FEES (25476)
Letters of Administration ..... $18.00 Marcus A. McKnight III, Esq.
: , 'i~ ATTORNEY (Sup. Ct. I,D. No.)
Short Certificates( ) .......... $_3 ~ 00 = .
Renunciation ................ $5~b0 60 W. Pomfret St., Carlisle, PA 17013
JCP $10.00 ADDRESS
TOTAL .. $36.00
Filed ..................... A.D. f9 2003 (717) 249-2353
PHONE
RENUNCIATION
In regard to the Estate of H. FRANKLIN HICKS , deceased.
To the Register of Wills of Cumberland County, Pennsylvania.
The undersigned daughter of the above decedent hereby
renounce(s) the right to administer the estate and respectfully ask(s) that Letters of
Administration be issued to Bonnie L. Schult
WITNESS my hand this 6th day of December ,2003.
SIGNATURE ~/'
929 Nixon Drive
Mechanicsburg, PA 17055
ADDRESS
SIGNATURE
ADDRESS
SIGNATURE
ADDRESS
SIGNATURE
ADDRESS
WARNING: IT IS ILLEGAL TO ALTER THIS COPY OR
Ht0S.lmREV. 8-8~ TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH.
{FEE FOR THIS
CERTIFICATE $2.00) COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF HEALTH VITAL RECORDS
LOCAL OFDEA~
CERT. NO. 05 ;; '!i!:I :::Sept,;tuber 12, 1998
'D~e:et~:lssue of This Certification
Name of Decedent Henry F. Hi ck s
First Middle Last
Sex Male Social Security No. 201 - 26 - 9400 Date of Death September 12, 1998
Date of Birth January 25, 1933 Birthplace Coleburg, Tennessee
Place of Death Holy Spirit Hospital Cumberland County E. Pennsboro Township
Pennsylvania
Facitity Name County City, Borougl~ or Township
Race White .Occupation Truck Driver Armed Forces? (Yes or No)
Decedent's
Marital Status Widowed Mailing Address 929A Nixon Drive Mechanicsburg PA
Number Street City or Town State
Informant Brenda L. High Funeral Director J. Larry Cocklin, FD
Name and Address of
FuneralEstablishment Cocklin Funeral Home, [nc., 30 N. Chestnut Street, Dillsburg, PA 17019
' Interval Between
Part h Immediate Cause Onset and Death
(a) Renal Failure Months
(b) End Stage Renal Failure ', Years
(c) Hypertension I Years
(d)
Part Ih Other Significant Conditions
DM, Perph. Vasc. Disease, CAD
Manner of Death: Describe how injury occurred:
Natural j~X Homicide []
Accident [] Pending Investigation []
Suicide [] Could not be Determined []
Name and Title of Certifier Thomas A. Young, MD
Address 890 Poplar Church Road, Camp Hill, PA 17011 (M.D., D.C., Coroner, M.E.)
This is to certify that the information here given is correctly copied from an original certificate of
death duly filed with me as Local Registrar. The original certificate will be forwarded to the State
Vital Records Office for permanent filing.
September 12, 1998
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: HENRY F. HICKS
Date of Death: SEPTEMBER 12, 1998
Estate No.: 21-03-1014
To the Register:
I certify that notice of the beneficial interest required by Rule 5.6(a) of the Orphan's
Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate
on January 30, 2004 .
Name Address
Brenda L. High 929 Nixon Drive, Mechanicsburg, PA 17055
Bonnie L. Schult 88 Mooredale Road, Apt. 1, Carlisle, PA 17013
Notice has now been given to all persons entitled thereto under R~ 5.6(a) exit n~one...~__~.
//
Date: 01/30/04 /"Si"g~atur~e /d~/// ~
IRWIN
& McKNIGHT
Name Marcus A. McKnight III, Esquire
Address 60 West Pomfret Street
Carlisle, PA 17013
Telephone (717) 249-2353
· Capacity: __ Personal Representative
X Counsel for Personal Representative
uumoer±and County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 8/03/2004
MCKNIGHT MARCUS A III
60 W POMFRET STREET
CARLISLE, PA 17013
RE: Estate of HICKS H FRANKLIN
File Number: 2003-01014
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: 9/12/2004
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 REPORT UNDER RULE 6.12
Name of Decedent: H. FRANKLIN HICKS
Date of Death: SEPTEMBER 12, 1998
No. 21-03-1014
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: X 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 representative file a final account with the Court? Yes X No
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties in interest? ~ Yes X No
d. Copies of receipts, releases, joinders and a/p2provals of fo/ritual or informal
accounts may be filed with the Clej~/6f Orphan's/~7ourt and may be
2~ti~ched t° this rep°rt ~~~~.~~
Date: 09/23/-~
::.. ~ IRWIN[ & Mc ~KI~_ IGHT
~ :::" Marcus A. McKnight, HI, Esquire
c'_ Name (please type or print)
r~-~ 60 West Pomfret Street
C'q Address
~ Carlisle, PA 17013
City, State, Zip
-: xr - (717) 249-2353
~ ~-z Telephone Number
Capacity: Personal Representative
X Counsel for Personal Representative
OFFICIAL USE ONLY
REV :× E-00/ REV--1500
CO O WE*LT,OF,EN S LVAN,A INHERITANCE TAX RETURN F LENU B .
)E'ARTMENTOFREVENUE
RESIDENT DECEDENT 21- 03-1014
IAFRISBURG PA17128 0601 COUNTY CODE YEAR NUMBER
Jl DEDEOENTSNAME;LAST. FIRST. ANDMIDDLEiNiTiAL~, , SOCIAL SECURITY NUMBER
~ HLcks H. Franklin 201-26~9400
EC DA E QF DEATH (M M- D D-YEAR) CATE OF B~RTH (M M- DD YEAR) THIS R~URN MUST BE ~ILED IN DUPLICATE WITH THE
~ 0 )/12/1998 01/25/1933 REGISTER OF WILLS
N IF ~PPLICABLE) SURVIVINGSPOUSESNAME(LAST.FiRST, ANDM DDLE NITIAL SOCIAL SECURITY NUMBER
T
cRAC --
TF IS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE & CONFIDENTIAL
T~
INFORMATION
SHOULD
BE
DIRECTED
TO:
~A~ IE ~COMPLET. MA~LING ADDRESS
6i0 West Pomfret S~reet
~ ~ [R4NAMEilfApplic~ble~ ~est Pomfret Professional Bldg.
~ ~ R~IN & Mc~IG~ Oarlisle, PA 17013
[1) /249-2353
I. Real Estate (Schedule A) (1)
~. Stocks and Bonds (Schedule B) (2) ~ None
~. $1ose~y He~d Corporation. Partnership or (3) None
Sole Proprietorship
L ~ortgages & Notes Recewab~e (Sc~edo[e D) (4) None
~ L %ash. Bank Deposits g M~sceHaneous Persona~ Prape~y (5) ~ 500.00
C Schedule E)
~ ,. ~o~ntly Owned Property (Schedule F) (6) ~ None
nier-Vivos Iransfers & Miscellaneous Non Probate Prope~ (7) None
~ Schedule G or L)
~ ~otal Gro~s Assets (to~al Unes 1 7) (8) 500. O0
g :uneral Expenses & Administrative Costs (Schedule H) (~) 3 , 500.00
N ). )ebts of Decedent Mortgage hiab~[~ties. & [{e~s (Schedule I) (1~) ? None
I. ~ot~l D~d~ctio~ (~otal Unes 9 & 10) '
(11) 3,500.00
" ' (~a) ( 3,000.00
~ ~el Value of Estate (Une 8 m~nus Une 11)
l. I let Value Subject to Tax (t~e 12 m~nus Line ~3) (14) ( 3,000
~ ,
g ~ ,mount of Line 14 taxable at the spousal ~ax
T ~te. or transfers u~der Sec 9116(a~(12) 0.00 ~ X .0 0 (~) 0.00
g ~' moun~ of L~ne ~ ~ ~axabJe at sibling rate 0.O0 X 12 (1;) 0.00
N ~; mount of Li~e 14 taxable at collateral rate 0. O0 X 15 (18) 0. O0
CHECK HERE [~ YO~ ARE REQUESTING ~ REFUND OF
D,~cedent's Complete Address:
Sl 7EET ADDRESS
729 Nixon Drive
Cl' Y STATE ZIP
~echanicsbur~ ; PA 17055
T~ x Payments and Credits:
1. Tax Due (Page 1 Line 19) (1) 0.00
~'. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
TbtalCredits(A +B+C ) (2) 0
3. InterestJPenalty if applicable
D. Interest :
E. Penalty ,
Total I~terestJPenafty ( D + E ) (3) 0 .
4. If Line 2 is greater than Line t * Line 3. enter the difference This is the OVERPAYMENT,
Check box on Page 1 Line 20 to request a refund (4) 0
5. If Line 1 + Line 3 is greater than Line 2 enter the difference This is the FAX DUE. (5) 0.
A. Enter the interest on the tax due (SA) 0 .
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B) 0.00
Make Check Payable to: REGISTER OF WILLS, AGENT
.E ~SE 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 right to designate who shall use the property transferred er its income:
¢. 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 decedent transfer property within one year of death
without receiving adequate consideration? [] []
Did decedent own an "in trust for" or payable upon death bank accouqt or security at his
or her death? [] []
Did decedent own an Individual Retirement Account, annuity, or other non probate property
designation? ............. i
which
beneficiary
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS '(ES,
I YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN,
UnderpenaI es ~fperjury`~declarethat~haveexaminedthisreturn,including~cc~mpany~ngschedu~es~ndstatements andtothebestafmykno~edgeer~dbelief it is true
SLGNATUR~ OF ~ERSON RESPONSIBLE FOR FILING RETURN Bonnie L. Schult DATE
S[GNATURIE OF 'REPAREROTHERTHAN REPRESENTATIVE IRWIN & McKNIOHT!
/
/',~ ~ .-Z~J 60 West Pomfret Street '
survivingF°r dates' :od[' ~e~nc~o r. 72 p S 9116 (a)(! 1) (i)]'
,~ ,~ y , . , . t pi ed on the net alueott ansrerstoorror the use of the
For dates fd~athonorafter Januaryl 1995 the tax rate imDosed on the net value of transfers to or for the use of the surwvlng spouse is
72 PS 9~!6 a)(1 1)(ii)j The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of essa
and filing ta; return are stirl applicable even if the surviwng spouse is the only benefic!ary.
I
cdr dates ~ f d !ath on or after July 1, 2000:
The taxra~ ir- )osed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the useoCa natural
2arent, anI id( )rive parent, or a stepparent of the child is 0% [72 PS. 9116 (a) ~12)]
The taxra~, in )~sedonthenetvalueoftransferstoorfortheuseofthedecedentslinealbeneficiariesis45%`excep~asnotedin72PS 91f6(12)
72PS 9~ 61~)(~)}
The tax rat, in )osed on the net value of transfers to or for the use of the decedent's siblingsis 12% [72 PS 9116(a)(13)] A siblin9 is defined under
Sectio~ 91~ ,2 ~s an individual who has at least one parent in common with the decedent whe¢-~er by blood or adoption
SCHEDULE E~
COke ,40IWEALTHOFPENNSYLVANIA CASH, BANK DEPOSITS,~ & MISC.
NF ERITANCE T,A.X RETURN PERSONALPROPERTY
, / ESlDENT DECEDENT
ESTATE OI|' FILE NUMBER
T~. F~-~rk]_~.n H~_cl~s SS¢,~ 201-26-9400 09/12/1998 2~ 03 10~4
~ncl[ ~e :he proceeds of litigation and the date the proceeds were received by the estate All prope~y jointly-owned with the right of
sure vc ,ship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMB~ DESCRIPTION OF DEATH
1 ~e~so~l ~ope~ty 500.00
TOT~ (Also entor on lino 5~ Beca~itu~ation) $ 500. O0
~EV 1511~<+ 1 97! SCHEDULE H
FUNERAL EXPENSES &
CO 4M )NWEALTH OF PENNSYLVANIA
ih ~IERITANCE T,a¢( RETURN ADMINISTRATIVE COSTS
l RESIDENT DECEDENT I
--STATE ,F FILE NUMBER
H. F~arklin Hicks SS¢~ 201-26-9400 09/12/1998 21-03-1014
De ~ts of decedent must be reported on Schedule I.
ITEM
NUMBE DESCRIPTION AMOUNT
A. FUNERAL EXPENSES
B. ADMINISTRATIVE COSTS:
1· Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) / EIN Number of Personal RepresientatJve(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney's Fees
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3 . 500.00
Claimant Brenda L.Hi~h
Street Address 929 Nixon Drive
City Mechanicsburg State PA Zip 17055
Relationship of Claimant to Decedent Daughter
4. Probate Fees
5. Accour~tant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
TOTAL (Also enter on line 9, Recapitulation)
(If more space is needed insert additional sheets of the same size)
Cop¥¢iqht c) l)96formsoftwareonlyCPSystems Inc Form REV-1511 EX (Rev 1 9
SCHEDULE J
DNWEALTH OF PENNSYLVANIA BENEFICIARIES
ESTATI FILE NUMBER
H. Ft <lin Hicks SS(,~ 201-26-9400 09/12/1998 21-03-1014
~ RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
HUMBE~ NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. tAXABLE D[STRIBUTIONS !include outright spousal distributions, and
l. Brenda L. High Daughter 1/2 Remainder
929 Iqixon Drive
Mechanicsburg, PA 17055
2. Bonnie L. Schult Daughter 1/2 Remainder
88 Mooredale Road, Apt I
Carlisle, PA 17013
iNTER DOLLARAMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 5THRU 18, AS APPROPRIATE ON REV 1500 COVER SHEET
II. NON TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B, CHARITABLE AND GOVERNMENTAL DISTRLBUTIONS
AL OF PART II - ENTER TOTAL NON TAXABLE DISTRIBUTLONS ON LINE 13 OF REV 1500 COVER SHEET 0 · O0
(If more space is needed insert additional sheets of the same size)
C:~t,vridhl OO form $oftware only The Lackner Group Inc Form REV-1513 EX (Rev. 9 00)
Inventory of the real an personal estate of
H. FRANKLIN HICKS A/K/A HENRY F. HICKS , deceased
500 O0
1. Property .....................................
500 00
TOTAI· -...." · ..............
COMSI %'EALTI{ OF PENNSYLVANIA :
: SS
COCN~ )F CUMBERLAND :
L. Schult , being duly sworn according to law. deposes and sa.~s that she is thc
Executri tile Estate t)f H Franklin Flicks. 'a/b'a llenrv F HJcks . late of Mechanic~burg Bomu<h
Cumberl County, Pennsylvania. deceased ami that the ~tithin is an inventoo made by Bonnie L Sc/mit
the said mtrix of the entire estate of said decedent, consisting of all the personal property and rea/estate, except real
thc Commonx~ealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fuir
value as date of decedent's death.
S~or )scribed before me,
Bonnie L. Schult. Executrrix
this / of November . 2004.
88 XMorednle Road. Apt I
~ / ) Carlisle. PA 17013
}' ' ' Address
Date of [ 12 09 1988
Day Month Year
INSTRUCTIONS
1. An i~ ttory must be filed within three months after appointment of personal representative.
2. A su ment inventory must be filed within thirty days of discovery of additional assets.
3. Addi al sheets may be attached as to personalty or realty.
4. Sec :le IV, Fiduciaries Act of 1949.
I
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
. ,'r.T n,-"(\[ OC
BUREAU OF INDIV!iiiiJ(Li[t@V~'I"- i
INHERITANCE TAX Dl~t!AI.Dt(",--!. -- ','
PO BOX 280601 r.'i'!':.' ',_~; ,i
HARRISBURG PA 17128-d~b1
NDTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIDNS AND ASSESSMENT OF TAX
2005 JJ1H \ II PH 3: \ 4
01-17-2005
HICKS
09-12-1998
21 03-1014
CUMBERLAND
101
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
Clc.fW', 0;-
ORFHi\.i'-I':?, cotr~!_.
MARCUl{:'8,!llCKN 16HTE\S 15',\
IRWIN & MCKNIGHT
60 W POMFRET ST
CARLISLE PA 17013
'*'
kEV-1547 EX .FP n2-04)
HENRY
F
AJlount Re..itted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO CDURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
u..,; :m".Eic-.A~i>..Cll1":6~'..N6i'YcE..d".iNHErtii'ailcg.i'Ai1.A.PPIlAYSEiII!'NT~--ALL'i:iWANCg-OR.---....._... - --.
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
HENRY F FILE NO. 21 03-1014 ACN 101
ESTATE OF
HICKS
TAX RETURN WAS: (
) ACCEPTED AS FILED
( X) CHANGED
SEE
DATE 01-17-2005
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 Bl
3. Closely Held stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule DJ
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
500.00
.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Velue of Estate Subject to Tax
(9)
(10)
500.00
.00
Ill)
(12)
(13)
(14)
NOTE: To insure proper
credit to your account}
submit the upper portion
of this for~ with your
tax payment.
500.00
lion no
.00
.00
.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. Allount 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.
.00 X 00 = .00
.00 X 06 = .00
.00 X 00 = .00
.00 X 15 = .00
(19)= .00
T4Y CR~nITS:
l<' 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), YDU MAY BE DUE ~ ,L...
A REFUND. SEE REVERSE SIDE OF THIS FDRM FOR INSTRUCTIONS.)~~
REV-1470EX(S.SS) .
'* INHERITANCE TAX
EXPLANATION
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
PO Box 280601
HARRISBURG PA 17128.0601
DECEDENTS NAME FILE NUMBER
Franklin H. Hicks 2103-1014
REVIEWED BY ACN
Destiny 5.R.Brown 101
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
Reduced to $500.00. Family exemption can only be claimed against assets subject to
will or intestacy.
ROW
Page 1