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HomeMy WebLinkAbout02-0815 PETITION FOR PROBATE and GRANT OF LETTE~ Estate of JUSTINE L. FEDOW No. J ,- 0.2. - 1i'1. also known as To; Register of Wills for the , Deceased. County of CUMBERLAND in the Social Security No. 107.22.5508 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 executrix named in the last will of the above decedent, dated NOVEMBER 13. 1995 and codicil(s) dated NONE (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, with h er last family or principal residence at 5 East Marble Street. Mechanlcsbu..... PA 17055 . M rC Iv II A/,CI (JC/~C; BtJ /c 0 (list street, number and municipality) Decedent, then 75 years of age, died 9/2/02 at Holy Spirit HOsDlta'. East Pennsboro Township, Cumberland County. PA 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 ajudicated incompetent: NONE Decedent at death owned property with estimated values as follows; (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows; & s: Ih? Z? ,N.' tfI r- $ $ $ $ (J WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters testamentary thereon. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) ~~ /f fiI/IJ - o o " " ." 'r;;--;;;- ~i' ." " ii.S ~''fi 'E't il 0 . ffi, <ii Karen R. Catts, 12 Cromwell Court Mechanicsbur.. PA 17050 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYL VANIA } ss COUNTY OF CUM!lERLAND The petitioner(s) above-named i>wear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and beliefofpetitioner(s) and~at personal represen- tative(s) of the above decedent petitioner(s) will well and trul minist th ate,ccording to law. Sworn to or affinned and SUb. scribed {. 'L....-' .' '" ~. before me this ] ] r h day of ~ SEPTEMBER 2002 I(A~eOJ (2. C4(T S " OiPPlI2. off) 4.J11A1D'P1 'f>" (ill, ll/;;,1i,"'J fId".u ~ ,- Register .-'-, r?- &7- 6 '- No. 21-02-0815 Estate of JUSTINE L. FEDOW , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW SEPTEMBER 11. 2002 , in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, lT IS DECREED that the instrument(s) dated 11/13/95 described therein be admitted to probate and filed of record as the last will of JUSTINE L. FEDOW and Letters Testamentarv are hereby granted to Karen R. Catis, 12 Cromwell Court, Mechanlc.burg, PA 17050 CI::tYVr~\ .~'~I'" f..61 .lJ/L:[h^1~f Re ster of Wills U FEES Probate, Letters, Etc.. . . . . . . . $ 115. 00 Short Certificates ( 2 J . . . . . . $ h.OO ~.EX)::PI pg~ .2... $ 6.00 JCP $ 5.00 TOTAL _ $ 132.00 Filed. .~U:L)'. n.. ~QO.2. . . . . . . . . . . . Murre. R. Walters; III, Esquire 24849 ATTORNEY (Sup. Cl. LD. No.) 54 East Main Street Mechanicsbura PA 17055 ADDRESS (717) 697-4650 PHONE CALLED ATTORNEY SEPTEMBER 11, 2002 I"".' 21-02-0815 LAST WILL AND TESTAMENT BE IT REMEMBERED THAT I, JUSTINE L. FEDOW, a resident of Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this to be my LAST WILL and TESTAMENT, hereby revoking any and all wills and Codicils previously made by me. I I declare that I am not married, and that I have three (3) children, KAREN R. CATTS, MARK E. FEDOW and BRUCE D. FEDOW. II I direct that all my just debts and funeral expenses shall be paid from my residuary estate as soon as practicable after my decease. III I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. IV I give, devise and bequeath all my property, whether real or personal, wherever situate, including any property over which I may have a power of appointment to my children, KAREN, MARK and BRUCE, in equal shares, per capita. V I nominate, constitute and appoint my daughter, KAREN, as Executrix of this LAST WILL, to serve without bond. If KAREN is unable or unwilling to act in that capacity, then I nominate, constitute and appoint my son, MARK, as Executor of this LAST WILL, to serve without bond. IN WITNESS WHEREOF, I, JUSTINE L. FEDOW, have set my hand to this LAST WILL this (.3 ~ day of /1/0 U~ m 6<.r , 1995. !kk/~ tpSTINE L. FEDOW Signed, sealed, published and declared by the above-named JUSTINE L. FEDOW, as and for her Last will and Testament, in the presence of us, who, at her request and in her presence, and/in the presence of each other, have hereunto subscribed our nallles as witnesses. ' ~~~ 2 ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA ss. COUNTY OF CUMBERLAND I, JUSTINE L. FEDOW, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my LAST WILL; that I signed it as my free and voluntary act for the purposes therein expressed. p1f:?w- Sworn or affirmed to and acknowledged }?efore me by JUSTINE L. FEDOW, Testatrix, this /3'J.-1..- day of /1/" tJ-uYJ6-er , 1995. iJ~~)tl ~}~ Notary Public , Notarlal Seal Diane M. Smith. Notary Public Mil""""icsburg 80m. Cumbenand County "'1IThSsIon Expires June 22. 1996 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ss. COUNTY OF CUMBERLAND We, fYlarfd .R.lAJaihrs. i7T and R. fYlcul::.. >/1C))'J{V , the witnesses whose names are signed to the attached or foregoing instrument being duly qualified according to law, do depose and say that we were present and saw Testatrix sign and execute the instrument as her LAST WILL; that JUSTINE L. FEDOW signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the will as witnesses; and that ,~o the best of our knowledge, the Testatrix was at the time 18 y~rs of age or more, of sound mind and under 110 constraint or ,ndue inf1u.ne._ ~~~~~ K/:?~~ . Sworn or affirmed to and acknowledged before me this /3 ~ay of ;Voue.l1/kr , 1995. [Jta~M ~L Notary Public ~ ~Seal - ~~ll;".(NotaryPUblic "W mliiiiN;ii ....,c~...urnberlaJu I'd County ...,.... 11e22.1996 - .l- CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Justine L. Fedow Date of Death: September 2, 2002 WiliNo. 2002-00815 Admin. No. 21-02-0815 To the Register: I cenify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Otphans' Coun Rules was served on or mailed to the following beneficiaries of the above-captioned estate on September 23, 2002. Name Address Karen R. Catts Bruce Fedow Mark Fedow 12 Cromwell Coun, Mechanicsburg, P A 17050 5909 ? Avenue, Brooklyn, NY 11220 17 Cider Mill Circle, Flemington, NJ 08822 / None Notice has now been given to all persons entitled thereto Date: 9/23/02 Murre! R. Walters, III, Esquire 54 East Main Street Mechanicsburg, PA 17055 (717) 697-4650 Capacity: _ Personal Representative _X_Counsel for personal representative PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL T A.XES DEPT. 280601 HARRISBURG, PA 17128.0601 :CEIVED FROM: WALTERS MURREl R III ESQUIRE 54 E MAIN STREET MECHANICSBURG, PA 17055 -----Iold ESTATE INFORMATION: SSN: 107-22-5508 FILE NUMBER: 2102-0815 DECEDENT NAME: FEDOW JUSTINE l DATE OF PAYMENT: OS/28/2003 POSTMARK DATE: 00/00/0000 COUNTY; CUMBERLAND DATE OF DEATH: 09/02/2002 REV-1162 EX( f 1-96) NO. CD 002616 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $2,709.61 I I I I I I I I TOTAL AMOUNT PAID: $2,709.61 ~EMARKS: KAREN R CA TTS C/O MURREL R WALTERS III ESQ. CHECK# 1022 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS DONNA M. OTTO DEPUTY REGISTER OF WilLS REV..1500E:t..g-llOj COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128.0601 ~~l-S- o REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT I- Z W C W U W C W I- ::.:::$", " "'" w"''' ",00 ,,0:.... -"'<II '" .. DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAL) FEDOW JUSTINE L. DATE OF DEATH (MM-DD-Year) OFFICIAL USE ONLY FILE NUMBER 21 -D 2 081 5 cooNhGOOr ~Ar- - - NUMBER-- SOCIAL SECURITY NUMBER DATE OF BIRTH (MM-OD-Yearj 09/0212002 08/21/1927 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) [g] 1. Original Return o 4. Limited Estate [R] 6. Decedent Died Testate (Attach copy of Will) o 9. Litigation Proceeds Received 107-22-5508 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 2. Supplemental Return o 4a. Future Interest Compromise (da\eclde~h altel12-12-B2) o 7. Decedent Maintained a Living Trust (AtlachcopyofTrust) o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95} o 3. Remainder Return (dale of dea1l1 prior to 12-13-82) o 5. Federal Estate Tax Return Required .!.. 8. Total Number of Safe Deposit Boxes o 11. EJection to tax under Sec. 9113(A) (Attach Sch 0) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS MURREL R. WALTERS III ESQ FIRM NAME (If Applicable) z o i= <( ..J ::l l- ii: <( u W D::: z o i= ~ ::l 11. :E o U ~ I- I- Z W C Z o '" <n w 0: 0: o " TELEPHONE NUMBER 717/697-4650 54 EAST MAIN STREET MECHNICSBURG (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) nee -:: (.r: 11 ,i\;i:22 ~ ~' ~" 68,830.87 n" )> .c' 14,552.76 5,526.78 (11) (12) (13) (14) d w PA 17055 OFFICIAl3l'E ONLY :JJg> (T;) (,I ;'C' 1. Real Estate (Schedule A) 2. Slocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule 0) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage LiabjJjties, & Liens (Schedule I) 11. Total lnduc.tions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 14. Net Value Subject to Ta)( (Line 12 mimlsline 13) 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 19. Tax Due X _(15) 60,213.55 X .045 (16) X .12 (17) X .15 (18) (19) 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 3' ==< N CO ~ CO ~ L 80,293.09 20,079.54 60,213.55 60,213.55 2,709.61 2,709.61 > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < '0 , d C Ad ece ent's omplete dress: STREET ADDRESS 5 EAST MARBLE STREET CITY I STATE I ZIP MECHANICSBURG PA 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 2,709.61 Totai Credits (A + B + C) (2) 3. InteresVPenalty if applicable D. Interest E. Penalty T otai InteresVPenalty ( D + E ) (3) 4. If Line 21s greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT, Check box on Paget 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. (5) A. Enter the interest on the tax due. (5A) B. Enter the total 01 Line 5 + 5A. Th',s is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT 2,709.61 2,709.61 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X"'N THE APPROPRIATE BLOCKS 1. Did decedent make a transler and: Ves No a. retain the use or income of the property transferred; ........................................................................... 0 [Jg b. retain the right to designate who shall use the property transferred or its income; . ........................... 0 [Jg c. retain a reversionary interest; or ...................................................................................................... 0 00 d. receive the promise for life of either payments, benefits or care? ........................... ........................... 0 [Jg 2. If death occurred after December 12, 1982, did decedent transfer property within one year 01 death without receiving adequate consideration?............................................................................................... 0 [Jg 3. Did decedent own an 'in trust for" or payabie upon death bank account or security at his or her death? ................. 0 [Jg 4. Did decedent own an Individual Retirement Account, annuity, or other non.probate property which contains a beneficiary designation? ........... ...., ........................ .................................. ............................. 0 [g] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ADDRESS ADDRESS R R. WALTERS III ESQ 54 EAST MAIN STREET, MECHANICSBURG PA 1705S 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 (al (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 o!the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty.,me years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 99116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)]. The tax rate imposed on the net value ottransfers to or for the USe of the decedents siblings is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. ''''00'''''''971. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN I SCHEDULE B STOCKS & BONDS ESTATE OF FEDOW. JUSTINE L. All property jointly-owned with right of survivorship must be disclosed on Schedule F. FILE NUMBER 21 02 0815 DESCRIPTION ITEM NUMBER 1. US SAVINGS BONDS 129 MISCELLANEOUS REDEMPTION VALUE VALUE AT DATE OF DEATH 11,462.22 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheels of the same size) 11 462.22 R"'~'E"'P"'* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FEDOW JUSTINE L. FILE NUMBER 21 02 0815 Include the proceeds of litigation and the date the proceeds were received by the estate. All property Jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 60,184.89 3 PNC BANK CERTIFICATE OF DEPOSIT # 31100230418 PNC BANK CHECKING # 5080015167 PNC BANK SAVINGS # 5080016645 6,236.98 2 2,409.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert addltionai sheets of the same Size) 68 830.87 RE'''''';'''9''. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEr DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF FEDOW. JUSTINE L FILE NUMBER 21 02 0815 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1. CITIBANK MASTERCARD 2 MEDICAL BILLS WEST SHORE AMBULANCE 3 RESIDENTIAL RENT KENNETH SCHENK .JR. 4 THE STORAGE DEPOT PROPERTY STORAGE 5 WEST SHORE FAMILY PRACTICE MEDICAL 6 YOUNGS MEDICAL EQUIPMENT MEDICAL 7 SEIGELBAUM GASTROENTEROLOGY MEDICAL 8 HARRISBURG GASTROENTEROLOGY MEDICAL 9 MOFFITT GROUP MEDICAL 10 ASSOCIATED CARDIOLOGISTS MEDICAL 11 QUANTUM IMAGING MEDICAL 12 WILLIAM SULLIVAN MD MEDICAL 13 HOLY SPIRIT HOSPITAL MEDICAL 14 CONNER.RICH ASSOC MEDICAL 15 WEST SHORE EMS MEDICAL 812.88 1,021.95 1,070.00 260.04 15.09 25.56 57.59 149.36 61.13 3.48 868.54 7.50 56.04 194.41 469.12 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 5 526.78 Continuation of REV-1500 Inheritance Tax Return Resident Decedent FEDOW, JUSTINE L. 21 02 0815 PaQe 1 Schedule I . Debts of Decedent, Mortgage Liabilities, & Liens ITEM NUMBER DESCRIPTION AMOUNT 16 VERIZON 40.72 TELEPHONE 17 PPL 84.57 ELECTRIC 18 LERNER RETAIL 328.80 CREDIT CARD SUBTOTAL SCHEDULE I 454.09 GRAND TOTAL SCHEDULE r $ 5,526.78 """""~I"",I. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENl SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FEDOW. JUSTINE L FILE NUMBER 21 02 0815 Debts 01 decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. MYERS FUNERAL HOME MECHANICSBURG. PA 6,190.00 2 FLOWERS ROYERS FLORISTS 582.76 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) KAREN R. CATTS 4,000.00 Social Security Number(s) I EIN Number of Personal Representative(s) Street Address 12 CROMWELL COURT City MECHANICSBURG State PA Zip 17050 Year(s) Commission Paid: 2003 2. Attorney Fees MURREL R. WALTERS III ESQ 3,600.00 3. 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 4. Probate Fees REGISTER OF WILLS CUMBERLAND COUNTY 180.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. TOTAL (Also enter on line 9. Recapitulation) $ 14552.76 (If more space is neenen. insert addalonal sheets of the same size) . ~EV_151'EX'(. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER ./I/!':TINF I ?1 n? 0815 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [include out6ght spousal distributions, and transfers under Sec. 9116(a)(1.2)J 1. KAREN R. CATTS DAUGHTER 1/3 12 CROMWELL COURT MECHANICSBURG, PA 17055 2 MARK FEDOW SON 1/3 17 CIDER MILL CIRCLE FLEMINGTON,NJ 08822 3 BRUCE FEDOW SON 1/3 5909 7TH AVENUE BROOKLYN, NY 11220 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. 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) /"}-.f? '/?- S- BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG~ PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INNERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX Re,--':'-:','~'~ fDATE ESTATE OF DATE OF DEATH FILE NUMBER P 4 : ll!PUNTY ACN '03 ,IUL - 7 MURREL R WALTERS 54 E MAIN ST MECHANICSBURG III ESQ PA 1705~- l.t'':':, 07-07-2003 FEDOW 09-02-2002 21 02-0815 CUMBERLAND 101 AIIount Relll tt.d '* .EY~1541 EX iFf' UI-D5) JUSTINE L 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 ~ REV=i547-EX-i.Fi'--coFoiY-iioTicE--OF-YriiiEiiifANCE-TAitAPPRA"iSEMiii:r;-i.LLOWAHCE-O!i----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF FEDOW JUSTINE L FILE NO. 21 02-0815 ACN 101 DATE 07-07-2003 TAX RETURN WAS: \ X) ACCEPTED AS FILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Est.t. (Schedule A) 2. Stocks and Bonds (Schedule Bl 3~ Closely Held stock/Partnership Interest (Schedule C) ~. Hortgagas/Notes Receivable [Schedule DJ 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule f) 7. Transfers (Schedule Gl 8. Total Assets (1) (2) (3) (4) IS) (6) (7) .00 11,462.22 .00 .00 68.830.87 .00 .00 (8) 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 Vatu. of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. N.t Value of Estate Subject to Tax I~ an assessment was issued previously. lines 14. 15 and/or 16. 17. 18 and 19 will re~lect figures that include the total of ~ returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 16. Aaount of line 14 taxable at Lineal/Class A rat. (16) 17. Amount of line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class Brat. (18) 19. Principal Tax Due I S: (9) (10) NOTE: DATE 05-28-2003 NIIH8ER CD002616 INTEREST/PEN PAID (-) .00 14,552.76 5.526.78 Ill) (12) (13) (14) .00 X 60,213.55 X .00 X .00 X AHOUNT PAID 2,709.61 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 00 = 045 = 12 = 15 = (19)= NOTE: To insure proper credit to your account I submit the upper portion of this for. with your tax pay.ent. 80,293.09 ;;>0.079 54 60,213.55 .00 60,213.55 .00 2,709.61 .00 .00 2,709.61 2,709.61 .00 .00 .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 "CREDn" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 Date: 8/03/2004 WALTERS MURREL R III 54 E MAIN STREET MECHANICSBURG, PA 17055 RE: Estate of FEDOW JUSTINE L File Number: 2002-00815 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 complete~ or uncompleted administration. This filing will become delinquent on: 9/02/2004 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, GLENDA FARNER STRASBAUGH REGISTER OF WILLS CC: File Personal Representative(s) Judge PI~EASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE· IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY U~ITIL COMPLETION STATUS REPORT UNDER RULE 6.12 N ~tme of Decedent: JUSTINE L. FEDOW D ~tte of Death: 9/2/02 E::tate No.: 2002-00815 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court rules, I report the following with re Cpect to completion of the administration of the above-captioned estate: State wh~t..her administration of the estate is complete: Yes)~' No ° If the answer is No, state when the administration will be complete personal representative reasonably believes that the (date) o If the answer to No. 1 is yes, state the following: A.~ Did the personal representative fill a final account with the court? Yes No The separate Orphans' Court No. (if any) for the personal representative's account is: (Not Applicable in Dauphin County) Co Did the personal representative state an account informally to the parties in interest: Yes X No D ~te: AUg%it 5, 2004 Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Capacity: MURREL R. WALTERS, III, ESQUIRE 54 East Main Street Mechanicsburg, PA 17055 717-697-4650 Personal Representative X__ Counsel for Personal Representative