HomeMy WebLinkAbout02-0859
Estate of . fY\o-R.
also known as
PETITION FOR PROBATE and GRANT OF LETTE~
E, ......\ole No. c9 \ -O;l..85c\
To:
Register of Wills for the
County of in
Social Security No.:'- Commonwealth of Pennsylva ia
The petition of the und rsigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut.....
in the last will of the abov decedent, dated -:S-'" I 'i 3 ()
and codicil(s) dated "
the
I named
I ,19-.:LL
I
(5ta relevant circnmstances. e.g. renunciation, death of executor, etc.) i
d I
Decendent was domicil d at death in {YI/koR.('o.l1.e (''''''I' H; II f ..~.k.-16'County^ P~nns Ivania, with
last family or rin ipal residence at MO:"" ~ (J. k Ii e. I 1..,'" t:~ hit
"-"- e.~S+ ... . "'- - tl
Oist street, number and muncipality)
Decendent, then years of age, died So e p +e M. be ,z Ck) J PK ;+ 00 ~
at
Except as follows, dec dent did not marry, was not divorced and did not have a child botn or adopted
after execution of the wil offered for probate; was not the victim of a killing and was nevtjr adjudicated
incompetent:
Decendent at death own d 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 nnsylvania
situated as follows:
$ ~'3 ~ ~ ()c)
i -}~~ ih',B/b)
WHEREFORE, peti oner(s) respectfully request(s) the probate of the last will ~nd codicil(s)
presented herewith and he grant of letters
(testamentary; administration c.t.a.; administnhion d.b.D.c.l,a.)
theron.
~
"
~
"
:2-;::;-
~~
"~
"'"
C
-00
=';::
C'3'';:'
-"
",,0-
.~
~o
;;
c
'"
00
~-I So
ie ..0
1+ 1'711
q-.~~~
o TH OF PERSONAL REPRESENTATIVE
COMMONWEAL H OF PENNSYLVANIA } S8
COUNTY OF UMBERLRNJil
The petitioner(s) ab ve-named swear(s) or affirm(s) that the statements in the foregding petition are
true and correct to th best of the knowledge and belief of petitioner(s) and that as petsonal represen-
tative(s) of the above ecedent petitioner(s) will w d truly admini er the tate aqcording to law.
Sworn to or
before me this
P E
affir cd and
23rd
subscribed {
day of
)Q< .
Register
'"
00'
"
'"
-
'"
~
~
I'"l- -Gin _ 4
No. 2.\-O~-'i5C\
DEe
. D~ceased
!
OF PROBATE AND GRANT OF LETTEiRS
Estate of
MARY E HUBLEY
AND NOW IKPr_, in consideration o~ the petition on
the reverse side hereof, satisfactory proof having been presented before me, .
IT IS DECREED that the instrument(s) dated 7 - 30- 1 991 i
described therein be ad itted to probate and filed of record as the last will of MAR~ FI H[JRT.F.Y
and Letters
are hereby granted to
LAWRENCE J VUXTA
Probate, Letters, Etc. .........
Short Certificates( )..........
~~ ~xt~~ p'~g~~
$
$
$
$ C; 00
TO AL _ $ 84.00
.. .9:-.23.-:2.QO ...................
mailed t exec 9-23-2002
70.00
3.00
6.00
AITORNEY (Sup. Ct. IJD. No.)
ES
ADDRESS
Filed
PHONE
:-.......
;"Y',
\"J
...;''-
HJO'j.805 I\EV 9/H6
This is to certifY that the informatio hete given is correctly copied from an original certificate of de4th duly filed with
Local Registrar. The original certific te will be forwarded to the Stare Vital Records Office for perm,pent filing.
me as
p
83
i
is illegal to duplicate this copy by photostat or Photogr+h.
,
,
I
~*'~~r
. oeaf i istrar ~
,
SEP 12:6 2002
ate
,
,
I
!
i
!
,
II"'"''''''''''''''''''''
\'II'lt~~\1\\ OF Pfi~----.._
"",~~.r.i."-
f~~-' . ~'\.
,~. . ~. . \....,
~Qlf ::"[ ",!:~
~c.-)~ --~T, .i:b.~
~ *' ." ," "~., ,~ *1
\*, -'-'-' . ....~l
'\.~' ", -' ~l
"" ~1.lffN1 ~\ ~\"""
""""""''',,,,,#1/1111'11
WARNING: I
Fee for this certificate, $ .00
No.
;43Ae_2J81
COMMON EAlTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
NAME OFOEcrDENT(FoSl Mdale. L....l
.. !my E. Hubley
AGEtl,", a_YI UNDEA 1 YEN!
- .,...
'"
2;female
ST.o.fE~ILE~EI'I
SOCIAL SECURITY NUMBER
..204 - 03 -600
DATE OF DEATH ,McnIh, Ca~. _I
j?ept. 20,2002
1700 Market St.
"Camp Hill, PA 17011
FRHER'SNAME CF.$!. MoOdIe. last)
,.. John F.. Hubley
:NFORMANT'SNAMC(T1'Jl8I'PrinII
. Lawrence V~xta
r.4ETHODOFOISPOSlTION
.....
"'"'
''''.
Cumberland
""
-
live"'.
_1hip1
~IO
81 v",.
COUNTY OF oeRH
UNDER 1 DAY
Hour'l~
""""'"
Oaoi '__I
BIRTHI't..ACi:IC,ry;Olld
SIaMOt Fc,"'ll" C.......IIYI
PlACE OF DfRH(Cl><<k~""""- _,,,,,".uc;t.oo..onOlIoer_1
HOSPITAL
11>jl81....0 ER/OulpIl_U
arrisburg,PA
,.
F"ACIUTY NAME (W nOl "'''>Moon. iO'.e "Ire<!! ~odnumt>8l',
...
Cumberland
..Camp Hill kManorCare Health & Rehab.
KlNOOFIlUSlNE S/lNDUSTRV -S DECEDENT EVER IN DECEDENT'SEOUCRlON
us, ARMEDFOACES1 ~
O 1'WI E~S<<.onoWy
... NI;I.,... 12 (().12)
n.
vanla
SUl'MVINGSPOUSE
(II"'. ""..."-......e!
DECEDENT'S USUAl OCCUMllOM
(~~~'::.::~:r
tJ.n. inventory acct lIJ1aval
DECEDENT'S WAIlING AOOAESS CSuIllll. C"YflOwn. s.. lipCadel
-
Re_~'romSlal.O
OAJEOFOISPQSITlON
(MonIh.O'y,....1
o Sept. 25,2002
21D.
No...........
----.,.
MOTHER'S NAME1F"t'" M". M8I!lf"Sur'lilJWl
Margare c. ~nyaer
".
"ll""...."'......"""'.."..~._....""-
~~L Mountalnvew ~t.,Harr.sburg,PA17112
Pl..ACEOFOlSPOSlTION.N_oI~C.....-y l -Cify(l'olooft.~.llp~
<<-.....
ROiling Green Cern. L weAllen Twp.,PA1701l
21c. 21d.
Hill
'......
24. //:3,
l1.""'"I:E_INl.........injufiMOIcornpIiQII~..hichClllJHdINl
l.llIIIrOlWCIl_on__.....
DAlE PRONOUNCED OEAD(Monln. Cay._1
PM. 25. ~/2~' C.!.
OOnot.nl..IhoI~oldying.su::h""cardiKo',..spilalllfY.".Il.shocllorlulanl........
....
wo.s CASE AEFERRED 10 ME
_0
~m
RSONACTINGAS
tulYEAHOAOORESSOFFACLJTY
. selman FH & CS,324
lICENSE NUMBER
.
.~ f: T A j r J4 nc ('A,I. C (N C.... A
OUElO(OFlASACONSE ENCEOF):
t:..A~.rlf,.~ .;>t;v<&'c ,tC..-v':>-'1A
OUElOlORASACONSE ENaOf);
...
, .........
'.........'*-
:__dMIh
,
l ~..s.
MRTn,
OIhaf~condilionI.~lOdHlh.bul
not......iwgin....~_gMninf'l'.RT1
~.J
-I
l:
WERE AUTOPSY FlNOlNGS
~PRIORlO
COMP\.ETION 01' CAUSE
""~,
OUE 10 lOR ASACONSE
NCEOF):
MANNER Of OEM
OArE OF INJURV
(~m_o...y.Year)
TlMEOFINJURY
IHJURY RWORK1
DESCRIBE HOW lNJURV OCCURRED.
--
P<l
o
o
--
o
o
o PLACE OF INJURY. A\hom., liI.m. w....I.ctory.oIb M.
_g. Me. lSpeoIVl
_.
...
....
J.:,;1,/,.{,/,1'1
D:llD.
lICENSE NUMBE
~:ll. 1JJ{).~:'.llf - '-
NAME AHO AQOAESS OF PERSON COUPI.ETED C.o\USE OF OEA:rH
(lleml7JT~orPrtnI
mAltyJ;.. ~"'-fi/)1 ,.....0
o .!I If I ~. r A (. "f S r-
32. ..,) r.:c. ~/"" /~# /7/,.3
DREFIlED(MOIW>.D.ly,Y<t<lIf
k_
PaIldirlQ_lligMlOO
~1lI
_0
~Q;l
Couldnotblo....rm~
,Ie. JIlt.
:fRTIPIIftIChidlonyonal
'CUITIFY1NG PffY5ICIAH (Ptly5"'.ancerulyonqC&uSol 01.,...'" Ml""""""'''' phY5"O'anl\;t5prOl"lOUl>Cfl<ldeal!> ano"""""e1Il/lIl...... 23)
TO.........."'Ykno..wg.....___dualOl...C...-{.I..... n...........l..,...
...
.PftONOUHClNQANDCERTln..o PttYSIClAH(Plwsoc..n lXll~llr""""r>C OOlNlrl.nd<:~Kl,"""...oIdNlt>\
To...._ol...'klIow'-dg.....alhocc".rlldlSl.lhal_.""ta.a....p1 . and d... 10 Ih.ca\lM(.j.nd....nn.,....l.lltd..
REGISTRAR'S
athoccurr.dlllhellm..d.I.,i1ndplllt;e.andduetolhocau..(.)i1nd
'MEDICAL EXAMINER/CORONER
Qn1tlobasl.olu.,..in.,lon.ndlOrlnv..llgatlon.inmyopinion.
mann.. I. Slated..
..,
".
"-
acting
WILL AND TESTAMENT OF MARY E. HUBLEY
21-02-859
I, MARY E.
UBLEY, of the Township of Lower Allen, County
I
nd State of Pennsylvania, being in g09d bodily
und and disposing mind and memory, an~ not
ess, menace, fraud, or undue influenc~ of any
of Cumberland,
health
person whomsoev r, merely calling to mind the frailty lof human
life, and being desirous of disposing of my worldly gdods while
,
I have the stre gth and capacity so to do, I do make, IpUbliSh
and declare thi my LAST WILL AND TESTAMENT. I hereb~ revoke,
cancel and annu
all my former Wills and Testaments, ~ncIUding
,
, by me at any time made, and declare jthis
I
AST WILL AND TESTAMENT. I
codicils
alone to be my
I
AS TO SUCH STATE AS IT HAS PLEASED GOD TO ENTRUSTI ME WITH
IN THIS LIFETIM , I DISPOSE OF THE SAME AS FOLLOWS, VIlz:
,
ITEM 1. direct that my Executors hereinafter hamed pay
I
and discharge a 1 of my just debts, funeral and testam~ntary
expenses.
,
ITEM 2. order and direct that I be buried in ~ lot
I
which I own, si uate at the Rolling Green Cemetery, lopated in
Camp Hill, Penn ylvania.
ITEM 3. 11 the rest, residue and remainder of FY entire
estate, whereso ver situate, and whatsoever it may confist of,
I give, devise, and bequeath, absolutely, and in fee, to
LAWRENCE J. VUX A, CHARLES VUXTA, and PATRICIA DAVIS, Fhare and
~h~v~ ~l~~~ ~~ ~~~~~~~
ITEM 4.
,
nominate and appoint LAWRENCE J. VUXT~, as
Executor of thi my Last Will. Should the Executor na~ed fail
to qualify or case to act as Executor, then I appoint! BECKI
VUXTA as Execut ix in his stead.
ITEM 5.
direct that my personal representatives, as
well as their s ccessors, shall not be required to giv~ bond
for the faithfu performance of their duties in any
jurisdiction.
ITEM 6. direct that all estate, succession, l~gacy,
I
inheritance or ther transfer taxes, however designate~ that
shall become pa able by reason of my death in respect
I
pf all
,
khether
property compri ing my gross estate for tax purposes,
or not such pro erty passesunder this Last Will, shall be paid
by my Executor ut of my residuary estate.
ITEM 7. grant to my personal representatives herein
named, in addit on to, but not in limitation of those powers
vested by law, 0 be exercised without prior applicati~n to or
approval of any court, the power and authority to reta~n
I
indefinitely an property, to invest and reinvest any assets or
I
the proceeds de ived from the sale of assets, although I said
,
investments may not be of the character prescribed by ~aw, to
sell, convey, a sign, transfer and encumber any proper~y, to
I
i
pay, settle or ompromise all claims, to make distribu~ion or
I
divisions in ca h or in kind, and in general to exercife all
powers in the m nagement of any property hereunder which any
individual coul exercise in the management of similar property
own~a in hi~ ow riaht. and to execute and deliver anv and all
...."......-......
~~-''''
1j'
COMMONWEALTH F PENNSYLVANIA
ss
COUNTY OF CUM
I, MA Y E. HUBLEY ,TESTATRIX, whose
signed to the attached or foregoing instrument, havi
duly qualifie according to law, do hereby acknowled
signed and ex cuted the instrument as my LAST WILL;
signed it wil ingly; and that I signed it as my free
voluntary act for the purpose therein expressed.
Sworn r affirmed to and acknowledged before $e,
,
, the TESTATRIX, this ~~_
I
ame is
9 been
e t ha t I
hat I
and
by
MARY E. HUBLEY
day
of
Jul
, 191.l.
~'J-:~r")~L\L S~,~L "
AiTORm:Y,,~:~s .';'. L ";"l'Y FJblic
'1::l:~io;l'; :',.'d ~ 'c' ~
My Commi .,,'1 C'T" '." ; JJ Ig95 I
"..:_~=_~ _....:..:.t i __.._'--._:....:-_...'~.
~
NO A Y PUBLIC
Me nicsburg,
My Commission E
A
pires:
The pre eding instrument consisting of this a d two (2)
other typewrit en pages, identified by the signature of the
TESTATRIX, was on the date thereof signed. published and
declared by M RY E. HUBLEY , the TESTATRIX therein named
as and for er LAS W LL AND TESTAMENT.
Residing at 352 S. S orti g Hill Road
Mechanicsburg,' pj\-==:~?,6:>'~'-
Residing at 352 S. Sporti 9 Hill Road
Mechanicsburg, PA 17055
A F F I D A V I T
COMMONWEALTH 0 PENNSYLVANIA
ss
COUNTY OF CUMB
We GLA YS B. SPRAMELLI and CHRISTINE M. FORTI , the
witnesses whose names are signed to the attached or f regoing
instrument, bei g duly qualified accord~ng to law, do depose and
say that we wer present and saw TES~ATRIX sign and e ecute the
instrument as h r LAST WILL; that she signed willingl and that she
executed it as er free and voluntary act fori the pur ose therein
expressed; that each of us in the hearing and sight 0 the
TESTATRIX signe the WILL as witnes~es; and that to t e best of our
knowledge the T STATRIX was at the time 18 or more ye rs of age, of
sound mind and nder no constraint or undue ~fluence.
i
Sworn o~ affirmed to and subscribed to bef6re
J
Name of Decedent:
Admin. No. ,;) 1- 0 d.- 0 g.t?
i
Date of Death:
Will No.
To the Register:
I certify that notice of (benefic interest) estate administration required by Rule 5.6(a) of he
served on or mailed to the follo ing beneficiaries of the above-captioned estate on
~
Address
--k1'C1'4Il
t:t 1'.5
Ilwf!.eIlC( :r.
3
gO llJoaA~ '/I 1h'cJ<J :;-t,
'.sJa
Notice has now been given 10 all
i
I
'00"""" """" """" R." ,..., ~"" C I..W'5 + ..-1..-
-see a--I-k.~ecl de...'f"- ee~..f-j'~.'cd-c.
Date:
",.,,"~~~
Name Law~ellce ;r tlJ,Y..--Ia..
-'
Telephone (71'/1
i~;
-'.'
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV -1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFIC~L USE ONLY e.,
/7- 'It) - '-I
F~lM~E~o~ ~ 0 2 S-q
COLNTY CODE YEAR tUABER f-
REV-l~ EX (6-00)
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INrTIAL) SCCIAL SECURrTY NUMBER
I-
Z Hubley, Marv E. 204.03.6002
w DATE OF DEATH (MM-DD- YEAR) DATE OF BIRTH (MM-DD- YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
C
W 09.20.02 03.08.21 REGISTER OF WILLS
0
W (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INrTIAL) SOCIAL SECURrTY NUMBER
C
w I1iI ,. Original Retum 0 2. Supplemental Retum 0 3. RemainderRetum(dateofdealhpriorto12"13-82)
:!o::~U) o 4. Limiled E~ate 0 4a. Future Interest Compromise (date of death after 12-12-82) 0 5. Federal Estate Tax Return Required
u"''''
w"-u 06. 0
:x; 0 0 Decedent Died Testate (Attach copy of ""~ 7. Decedent Maintained a Living Trust (Attach copy of Tn.sl) _ 6. Total Number of Safe Deposil Boxes
u"'~
,,-co
"- Og Litigation Proceeds Received D 10. Spousal Poverty Crec!n (date of death ootweeIl12-31-91 aoo 1-1-95) o 11. ElectionlotaxunderSec.gl13(A)("""',,"ol
<(
f- THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
z NAME COMPLETE MAILING ADDRESS
w
Cl Frank H. Kellv, EA Kelly Financial Services, Inc.
z
0
"- FIRM NAME {' -'PI'ica"', 400 Bridge Street, Suite #4
co Kellv Financial Services, Inc.
w
'" New Cumberland, PA 17070
'" TELEPHONE NUMBER
0
u 717.774.7536
1. Real ~ate (Schedule A) (1) OFFICIAL USE ONLY
2. Stocl<s 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) 38,309.00
Z (Schedule E)
0 6. Jointly 0M1ed Property (Schedule F) (6)
!;i: o Separate Billing Requested
...J 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
::>,
I- (Schedule G 0' L)
ii: 6. Total Gross Assets (Iotal Lines 1 - 7) (8) 38,309.00
<l:
0 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 4,545.00
W
~ 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (Iotal Lines 9 & 10) (11) 4,545.00
12. Net Value of Estate (Line 8 minus Line 11) (12) 33,764.00
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been (13)
made (Schedule J)
-
14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 33,764.00
SEE INSTRUCTIONS FOR APPLICABLE RATES
Z 15. Amount of Line 14 taxable at the spousal lax
0
!ci: rate, or transfers under Sec. 9116 (a)(1.2) X.O_ (15)
I- 16. Amount of Une 14 taxable at lineal rate X.O_ (16)
::>
D.. 17. Amount of Line 14 taxable at sibling rate X .12 (17)
::iE
. 0 18. Amount of Line 14 taxable at collateral rate 33,764 x .15 (18) 5,064.60
0 ..
X 19. Tax Due (19) 5,064.60
~ 20. 0 I CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT I
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
STFPA42021F.1
Decedent's Complete Address:
STREET ADDRESS 1700 Market Street
CrTY Camp Hill
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Pnor Payments
C. Discount
I STATE PA
I ZIP 17011
(1)
5,064.60
253
Total Credits (A + B + C) (2)
253.00
3. InteresUPenalty if applicable
D. Interest
E. Penalty
TotallnteresUPenalty (0 + E) (3)
4. II 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. (5)
0.00
4,811.60
A. Enter the interest on the tax due.
(5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
4,811.60
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 01 the property transferred; ........................................ D lliI
b. retain the nght to designate who shall use the property transferred or its income; . . . . . . . . . . . . .. D lliI
c. retain a reversionary interest; or .......... .............. ........... D lliI
d. receive the promise for iife of either payments, benefits or care? ............................... D lliI
2. If death occurred afier December 12,1982, did decedent transfer property within one year of death
without receiving adequate consideration? . . .. . . .. .. .. . . . . .. .. . . . . . . . . . . . . . . . . . . .. D lliI
3. Did decedent own an 'in trust fo( or payable upon death bank account or secunty at his or her death? . . . .. D 5a
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? . ....................... ................... D lliI
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 pEhalties cj perjury, I declare that I have examined this m, including accoolpanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and
complete.
Decla-atioo of other thoo th al r res tative i sed on all information of which preparer has any knowledge.
SI URE OF PER N RE DATE
~'
FA 17112-2239
DATE
Bridge Street, Suite #4, New Cumberland, FA 17070
For dates of death on or afier July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value 01 transfers to or for the use 01 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 oftransfers to or for the use ofthe 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
il the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
-The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive
parent, or a stepparent of the child is 0% [72 P.S. ~9116(a)(I.2)].
The tax rate imposed on the net value oftransfers to or for the use ofthe decedent's lineal beneficianes is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1 )].
The tax rate imposed on the net value of transfers to or lor the use 01 the decedent's siblings is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an
individuai who has at least one parent in common with the decedent, whether by blood or adoption.
STF PA42021F.2
RE'J'~1502 EX + (1-97} (I)
COMMON'NEALTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF FILE NUMBER
Mary E. Hubley 2002.00859
All real property owned solely or as a tenant in common must be reported at fair market value, Fair martet value is defined as the price at which propertywoold be exchMged between a
willing buyer and a willing seller, neither being compelled 10 buy or sell, both having reasonable knowledge of the relevalt facts. Real property which is jointly-owned with right of
survivorship
must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
None
TOTAL (Also enter on line 1, Recapitulation) $
(If more space is needed, Insert additional sheets of the same sIZe)
STF PA42021 F.3
RE\7-1503 EX + (1-97) (I)
C()ylMQNVVEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
Mary E. Hubley
FILE NUMBER
2002.00859
All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION
VALUE AT DATE
OF DEATH
1. None
STFPA42021FA
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
RE'l-1504 EX + (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX. RETURN
RESIDENT DECEDENT
SCHEDULE C
CLOSELY-HELD CORPORATION,
PARTNERSHIP or SOLE-PROPRIETORSHIP
ESTATE OF
Mary E. Hubley
FILE NUMBER
2002.00859
Schedule G-1 or C-2 (~cluding all supporting information) must be attached for ead1 dos~y-held corporation/partnership interest of the decedent, other than a sol..proprietorship.
See instructions for the supporting information to be submitted for sole-proprietorships.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. None
STFPA42021F.5
TOTAL (Also enter on line 3, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
RE'V-1505 EX + (1-97) (1)
COMMON\'\IEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE C-1
CLOSELY-HELD CORPORATE
STOCK INFORMATION REPORT
ESTATE OF
Mary E. Hubley
FILE NUMBER
2002.00859
Zip Code
State of Incorporation
Date of Incorporation
Total Number of Shareholders
Business Reporting Year
1. Name of Corporation Non e
Address
City
2. Federal Employer LD. Number
3. Type of Business
State
ProducVService
4.
TYPE TOTAL NUMBER OF NUMBER OF SHARES VALUE OF THE
STOCK Voting f Non-Voting SHARES OUTSTANDING PAR VALUE OWNED BY THE DECEDENT DECEDENT'S STOCK
Com man $
Preferred $
Provide all rights and restrictions pertaining to each class of stock.
5. Was the decedent employed by the Corporation? 0 Yes 0 No
If yes, Position Annual Saiary $
6. Was the Corporation indebted to the decedent? 0 Yes 0 No
If yes, provide amount of indebtedness $
Time Devoted to Business
7. Was there life insurance payable to the corporation upon the death of the decedent?
DYes DNa
If yes, Cash Surrender Value $
Owner of the policy
6. Did the decedent sellar transfer stock of this company within one year prior to death or within two years ilthe date of death was prior to 12-31-82?
Net proceeds payabie $
DYes DNa If yes, OTransfer
o Sale
Number of Shares
Transferee or Purchaser
Attach a separate sheet for addijional transfers and/or sales.
Consideration $
Date
9. Was there a written shareholder's agreement in effect at the time of the decedent's death?
If yes, provide a copy of the agreement.
10. Was the decedent's stock sold? 0 Yes 0 No
If yes, provide a copy of the agreement of sale, etc.
11. Was the corporation dissolved or liquidated after the decedent's death?
DYes DNa
DYes DNa
If yes, provide a breakdown of distributions received by the estate, including dates and amounts received.
12. Did the corporation have an interest in other corporations or partnerships?
DYes DNa
If yes, report the necessary information on a separate sheet, including a Schedule C-1 or C-2 for each interest.
THE FOLLOWING INFORMATION MUST BE SUBMITTED WITH THIS SCHEDULE
A. Detailed calculations used in the valuation of the decedent's stock.
B. Complete copies of financial statements or Federal Corporate Income Tax returns (Form 1120) for the year of death and 4 preceding years.
C. If the corporation owned real estate, submit a list showing the complete addressles and estimated fair market value/s. If real estate appraisals have been
secured, attach copies.
D. List of principal stockholders at the date of death, number of shares held and their relationship to the decedent.
E. List of officers, their salaries, bonuses and any other benefits received from the corporation.
F. Statement of dividends paid each year. List those declared and unpaid.
G. Any other information relating to the valuation of the decedent's stock.
STFPA42021F,6
RE\1'-1S06 EX + (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE C-2
PARTNERSHIP
INFORMATION REPORT
ESTATE OF
Mary E. Hubley
1. Name of Partnership Non e
Address
City
2. Federai Employer 1.0. Number
3. Type of Business
FILE NUMBER
2002.00859
Date Business Commenced
Business Reporting Year
State
Zip Code
ProducVService
4. Decedent was a o General 0 Limited partner. If decedent was a limited partner, provide initial investment $
5.
PERCENT OF PERCENT OF BALANCE OF
PARTNER NAME INCOME OWNERSHIP CAPITAL ACCOUNT
A.
B.
C.
D.
6. Value of the decedent's interest $
7. Was the Partnership indebted to the decedent? DYes 0 No
If yes, provide amount of indebtedness $
8. Was there life insurance payable to the partnership upon the death of the decedent? DYes DNo
If yes, Cash Surrender Value $ Net proceeds payable $
Owner of the pDlicy
9. Did the decedent sell or transfer an interest in this partnership within one year prior to death or within two years if the date of death was prior to 12-31-82?
DYes DNo
If yes, 0 Transfer
o Sale
Percentage transferred/sold
Consideration $
Trnn~ereeorPu~haser
Attach a separate sheet fer GKidniooal transfers and/er sales.
Date
10. Was there a written partnership agreement in effect at the time of the decedent's death?
If yes, provide a copy of the agreement.
11. Was the decedent's partnership interest sold? DYes 0 No
If yes, provide a copy of the agreement of sale, etc.
12. Was the partnership dissolved or liquidated affer the decedent's death?
DYes
DNo
DYes
DNo
If yes, provide a breakdown of distributions received by the estate, including dates and amounts received.
13. Was the decedent related to any o!the partners?
DYes
DNo
If yes, explain
14. Did the partnership have an interest in other corporations or partnerships? 0 Yes 0 No
If yes, report the necessary information on a separate sheet, including a Schedule C-l or C-2 for each interest.
THE FOLLOWING INFORMATION MUST BE SUBMITTED WITH THIS SCHEDULE
A. Detailed calculations used in the valuation of the decedent's partnership interest.
B. Complete copies of financial statements or Federal Partnership Income Tax retums (Form 1065) for the year of death and 4 preceding years.
C. If the partnership owned real estate, submit a list showing the complete address/es and estimated fair market value/s. If real estate appraisals have been
secured, attach copies.
D. Any other information relating to the valuation of the decedent's partnership interest.
STFPA42021F,7
RE\)'-1507 EX + (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE D
MORTGAGES & NOTES
RECEIVABLE
ESTATE OF
Mary E. Hubley
FILE NUMBER
2002.00859
All property jointly<<med with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER OESCRIPTION
VALUE AT DATE
OF DEATH
1. None
TOTAL (Also enter on line 4, Recapitulation) $
(If more space IS needed, insert additIOnal sheets of the same size)
STFPA42021F8
REIJ'-1508 EX + (1-97) (I)
COMMONWEALTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Mary E. Hubley
FILE NUMBER
2002.00859
Include the proceeds of I~igation ood 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
PNC Bank NA 51.4003.0829
VALUE AT DATE
OF DEATH
38,309
TOTAL (Also enter on line 5, Recapitulation) $
(It more space IS needed, Insert additional sheets of the same size)
38,309.00
STF PA42021F.9
RE"'~'509 EX + (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY.OWNED PROPERTY
ESTATE OF
Mary E. Hubley
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
FILE NUMBER
2002.00859
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A. None
B.
c.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE IrcllKIe name of finaooal institution all! batt accOl.nl runberor similar idenlifyirg runber. DATE OF DEATH DECO'S VALUE OF
NUMBER TENANT JOINT Allachdeedfor'pinl~-heldrealestate VAlUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A.
TOTAL (Also enter on line 6, Recapitulation) $
(It more space is needed, insert additional sheets of the same size)
STFPA42021F.10
REt-1510 EX + {1-97} {I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER.VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
Mary E. Hubley
FILE NUMBER
2002.00859
This schedule must be completed and filed if the answer to any of questioos 1 through 4 on the reverse side of the REV.1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY %OF
ITEM Il'CLlIlE Tl-E Nll.ME OF Tl-E TRAfIllFEREE, Tl-EIR RELATlOI'liHP TO [ECEC€NT AN) Tl-E DATE DATE OF DEATH DECO'S EXCLUSION TAXABLE VALUE
NUMBER OF TRAASFER. ATTACH A COPY OF Tl-E [EED FOR REAl ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE}
1. None
TOTAL (Also enter on line 7, Recapitulation) $
..
(If more space IS needed, Insert additional sheets of the same sIZe)
STFPA42021F.11
R~-1511 EX + (1-97) (1)
CC>jMONMALTH OF PENNSYLVAN~
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Mary E. Hubley
FILE NUMBER
2002.00859
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Musselman's Funeral Home, Lemoyne, PA 600
2 . PNC Bank NA 600.
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative( s) Lawrence J. Vuxta
Social Security Number(s) I EIN Number of Personal Representalive(s)
Street Address 8 02 Mountian View Road
City Harrisburg, StalePA Zip 17112
Year(s) Commission Paid: 2002 1,915
2. Attorney Fees
3. Family Exemption: (If decedent's address is not the same as c1aimoofs, attach explanation)
ClaimCl1t
Street Address
City Stale Zip
Relationship of Claimant tQ.Decedent
4. Probate Fees 84
5. Accountoot's Fees 757
6. Tax Return Preparer's Fees 185
7. Ketrin Varner - Thank Yous 175
8 . Cumberland Cty Law Journal 75
9. Patriot News 154.
TOTAL (Also enter on line 9, Recapitulation) $ 4 545.00
(If more space IS needed, Insert additIOnal sheets of the same size)
STFPA42021F.12
RE~-15'2 EX + (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF
Mary E. Hubley
FILE NUMBER
2002.00859
Include unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
AMOUNT
1. None
TOTAL (Also enter on line 10, Recapitulation) $
(II more space IS needed, Insert addlllonal sheets of Ihe same size)
STFPA42021F.13
RSV-1513 EX + (9-00)
COMMONINEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
Marv E Hublev
FilE NUMBER
2002 00859
RELATIONSHIP TO DECEDENT
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Nollisl Trusleels)
I. TAXABLE DISTRIBUTIONS [include outlight spousal distlibutions, and transfers
under Sec. 9116 (a) (1.2)]
Lawrence J Vuxta
1. 802 Mountian View Road
Harrisburg, PA 17112 Nephew
2. Patricia A. Davis
302 Debora
Georgetown, TX Neice
AMOUNT OR SHARE
OF ESTATE
50%
50%
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 $
(It more space IS needed, Insert additional sheets of the same size)
STFPA42021F.14
R6lV-1514 EX + (1-97) (I)
COMMONWEALTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE K
LIFE ESTATE, ANNUITY
& TERM CERTAIN
(Check Box 4 on Rev-1500 Cover Sheet)
ESTATE OF FILE NUMBER
Mary E. Hubley 2002.00859
This schedule is to be used for all single life, joint or successive life estate and term certain calculations. For dates of death
prior to 5-1-89, actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit.
Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death on or after 5-1-89.
Indicate the type of instrument which created the future interest below and attach a copy to the tax return.
DWiII Dlntervivos Deed of Trust DOther
LIFE ESTATE INTEREST CALCULATION
NAME(S) OF NEAREST AGE AT TERM OF YEARS LIFE ESTATE IS
LIFE TENANT(S) DATE OF BIRTH DATE OF DEATH PAYABLE
None OUle or OTenn 01 Years
o ute or OTenn 01 Years
OUle or OTenn of Years
OUle or OTenn 01 Years
1. Value of fund from which life estate is payable
2. Actuarial factor per appropriate table
Interest table rate- 031/2% 06% 010%
3. Value of life estate (Line 1 mUltiplied by Line 2)
ANNUITY INTEREST CALCULATION
$
o Variable Rate
%
$
NAME(S) OF NEAREST AGE AT TERM OF YEARS
ANNUITANT(S) DATE OF BIRTH DATE OF DEATH ANNUITY IS PAYABLE
OUle or OTenn 01 Years
o Ute or OTenn of Years
o Ute or OTenn olYears
o Ute or OTenn 01 Years
1. Value of fund from which annuity is payable $
2. Check appropriate block below and enter corresponding (number)
Frequency of payout - OWeekly (52) 0 Bi-weekly (26) 0 Monthly (12)
o Quarterly (4) 0 Semi-annually (2) o Annually (1) o Other ( )
3. Amount of payout per period $
4. Aggregate annual payment, Line 2 multiplied by Line 3
5. Annuity Factor (see instructions)
Interest table rate 03 1/2% 06% 010% 0 Variable Rate %
6. Adjustment Factor (see instructions)
7. Value of annuity - If using 3 1/2%, 6%, 10%, or if variable rate and period payout is at end of period,
calculation is: Line 4 x Line 5 x Line 6 $
If using variable rate and period payout is at beginning of period, calculation is:
(Line 4 x Line 5 x Line 6) + Line 3 $
NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on
Schedules A through G of this tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13,
15,16 and 17.
(II more space is needed. insert additional sheets 01 the same size)
SlFPA42021F.15
Rfi.V-1647 EX + (9-00)
. .
SCHEDULE M
FUTURE INTEREST COMPROMISE
COMMONVVEAlTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(Check Box 4a on Rev-1500 Cover Sheet)
ESTATE OF FILE NUMBER
Mary E. Hubley 2002.00859
This schedule is appropriate only for estates of decedents dying after December 12,1982.
This schedule is to be used for all future interests where the rate of tax which will be applicable when the future interest vests in possession and enjoyment
cannot be established with certainty.
Indicate below the type of instrument which created the future interest and attach a copy to the tax retum.
o Will o Trust o Other
I. Beneficiaries
NAME OF BENEFICIARY RELATIONSHIP DATE OF BIRTH AGE TO
NEAREST BIRTHDAY
1. None
2.
3.
4.
5.
11 For decedents dying on or after July 1, 1994, ~ a sur1living spouse exercised or intends to exercise a right of withdrawal within 9 months
of the decedent's death, check the appropriate block and attach a copy of the document in which the sur1living spouse exercises such
withdrawal right.
0 Unlimited right of withdrawal 0 Limited right of withdrawal
ilL Explanation of Compromise Offer:
Iv. Summary of Compromise Offer:
1. Amount of Future Interest. .............. .......... ................. ........ .................. $
2. Value of Line 1 exempt from tax as amount passing to charities, etc.
(also include as part of total shown on Line 13 of Cover Sheet) ........... $
3. Value of Line 1 passing to spouse at appropriate tax rate
Check One 06%, 03%, 00% ...... ............ .. $
(also include as part of total shown on Line 15 of Cover Sheet)
4. Value of Line 1 taxable at lineal rate
Check One 06%, 04.5%......... .............. .......... $
(also include as part of total shown on Line 16 of Cover Sheet)
5. Value of Line 1 Taxable at sibling rate (12%)
(also include as part of total shown on Line 17 of Cover Sheet) ........... $
6. Value of Line 1 Taxable at collateral rate (15%)
(also include as part of total shown on Line 18 of Cover Sheet) ... ........ $
7. Total value of Future Interest (sum of Lines 2 thru 6 must equal Line 1) ..... .... $
SlFPA42021F.16
(If more space is needed, insert additional sheets of the same size)
~~
c:5~
s
~iS
~~
ct~
'"
,.
f'
-
----
ca..
:E~
(l)n
(1)_
cal>>
-en
Oen
-;)3:
"I>>
-- --
1.1._
r'I
LS1
m
l"-
n-
..0
o
LS1
rt.I
o
o
~
f3 g
~ "tg
:::'Ii ~~
ffi :::is(
tI) lJ)a;
SLiSW~
~~~~
~!l:!IiI!Il
U:::r:~~
~~lE~
~~~~
. 0
tJ r-
C_O
-~r-
u) $ ~
~.S <l:
.- en 0-
2: _ _
Ql-U
en$C
-....ro
ro__
Ti en lii
CQl.o
ro C1l E
cU:J
u:: .C 0
>,CO ~
=oQl
QlOZ
~"=t
I
I
!
I
i
r
I
i
i
,
i
i UJ
I en
.:.... ::l
g 0
~ ~UJ
--= ::l0 ~
I~ ~:3\O
I; f-~8
,- enzUJC')
1= -l ::l en ~
II:: :;g::lR
= > O~
-= u..Q:C<l:
i:enOZI-O-
'= - <l:~
1 = ~~-l::lUJ
, :: UJUJ~O~
I'-=-ll-UJ,,_
= enCO'-'-l
=>--:2UJ~
I - ~~::lZ<l:
! :::2~000
1-
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT DF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 17128-0601
PENNSYLVANI
ECEIVED FROM: INHERITANCE AND EST
OFFICIAL RECEIP
VUXTA lAWRENCE J
802 MOUNTAIN VIEW
HARRISBURG, PA 17112
nun fold __~~nn__
ESTATE INFORMATION: SSN: 204-03-6002
FILE NUMBER: 2102- 859
DECEDENT NAME: HUBlE V MARY E
DATE OF PAYMENT: 12/23 2002
POSTMARK DATE: 12/20/ ~002
COUNTY: CUMB RlAND
DATE OF DEATH: 09/20 2002
TOTAL AMOUNT
REMARKS: lAWRENCE J \) UXTA
CHECK# 1635
INITIALS: CW
SEAL RECEIVED BY:
TAXPAYER
R
REV-1162 EX(11-961
A
ATE TAX
T
NO. 0 001985
ACN
SSESSMENT AMOUNT
CONTROL
NUMBER
____n~_
101 I $4,811.60
I I
I !
I !
!
I !
I
I I
I
I !
I
I i
I !
A
PAID:
$4,811.60
DONNA M. OTTO I
DEPUTY REGISTER !oF WillS
\../?
- ?'CJ- y COMMONWEALTH OF PENNSYLVANIA
BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE *
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX leW-l!il(7EX AFP Ul-U.n
DATE 02-10-200;$
ESTATE OF HUBLEY , MARY
I E
DATE OF DEATH 09-20-200!
FILE NUMBER 21 02-085
, COUNTY CUMBER LAN
FRANK H KELLY EA ACN 101 ,
I
KELLY FINANCIAL SER ICE Anount R..itt.d
400 BRIDGE ST STE 4
NEW CUMBERLAND PA 17070 I
. MAKE CHECK PAYABLE AND R~MIT PAYMENT TO:
REGISTER OF WILLS I
CUMBERLAND CO COURTIHOUSE
CARLISLE, PA 17013 !
~.!'_"!._~~~_t!l!_!_'!!!__I;.!~!:,______~ ~iCE~~~~{~H~*~~~~~~t~~~A~~~Y~~~E~~~E.~~~OjjA~-OR-----------------
REV-1547 EX AFP (01-03) ~i
DI ALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF"TAX
ESTATE OF HUBLEY MARY E FILE NO. 21 02-0859 ACN 101 DATE 02-10-2003
TAX RETURN WAS: I X I ACCEPTED AS FILED I I CHANGED
,
RESERVATION CONCERNING FU URE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Est.t. (Sch.dul. A III .00 NOTE: To insure prop
2. Stocks ond Bonds I Ie BI 121 .00 credit to your aceD
3. Closely Held Stock/P8rt .rship Interest ISchedule CI 131 .00 sublli t the upper port
4. Hortgages/Notes R.c.i~ 1. (Schedule DJ 141 .00 of this form with yo
5. Cash/Bank Deposits/Mise Personal Property ISchedule EI 151 38.309.00 tax pay_nt.
6. Jointly Owned Property Schedule Fl 161 .00
7. Transfers (Schedule G) 171 .00
8. Total Assets 181 38,309.00
APPROVED DEDUCTIONS AND E, EMPTIONS:
9. Funeral Expensesl AdII. Cc sts/Hisc. Expenses (Schedule HI 191 4,545.00 I
I
10. Debts/Hortgage Liabilit es/Liens (Schedule I) 1101 .00 j
11. Total Deductions III 4.1;41; nn
12. Net Value of Tax Ret rn 112 33,764.00
13. Charitable/Governmen al Bequests; Non-elected 9113 Trusts (Schedule ~) 113 .00
14. Net Value of Estate ~ject to Tax 114 33,764.00
NOTE: I., an aSSBssllent I as issued previously, lines 14, 15 and/or 16't 17, 18 and 19 will
reflect figures t at include the total of abb returns assessed D date.
ASSESSMENT OF TAX: .00 0
1S. Amount of Line 14 at ~ usal rate 1151 X = .00
16. Anount of Line 14 tax'" e .t LineallClass A rat. 1161 .00 X 0 5= .00
17. ABOUnt of Line 14 at SI ling .,t. 1171 .00 X 1 = .00
18. A.ount of Line 14 taxab e at Collateral/Class B rate 1181 33,764.00 X 1 = 5,064.60
19. Principal Tax Due I 91= 5,064.60
TAX CREDITS:
cnm.", ,+, AMOUNT PAID
DATE IU1BER INTEREST/PEN PAID I-I
12-20-2002 CDOO1985 253.23 4,811.60
I
I
I
I
TOTAL TAX CREDIT 5,064.83
BALANCE OF TAX DUE .23CR
INTEREST AND PEN. .00
TOTAL DUE , .23CR
er
unt,
ion
ur
. IF PAID AFTER DATE INDICATED,I SEE REVERSE
FOR CALCULATION OF ADDITIONA~ INTEREST.
I IF TOTAL DUE IS LESS THAN $1, NO PAY"ENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDjr- ICRI, YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.I
I
\..
,-.t'- 9 COMMONWEALTH OF PENNSYLVANIA
8UREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE *
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX , REV-1547EXlfPU1-ISl
DATE 02-10-200$
ESTATE OF LINKS ALAIN
DATE OF DEATH 06-06-200;
FILE NUMBER 21 01-085
'[) If.; COUNTY CUMBER LAN
GEORGE B FALLER ,
ACN 101 I
MARTSON ETAL I Anount R_ittid I
TEN EAST HIGH Sl
CARLISLE 'PA 17013-4802
MAKE CHECK PAYABLE AND ~EMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURTIHOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE . YiCE~-~~~{~H~*~~~~~~t~~~~~~Y~~~E~~~E.~~~-OjjA~E-OR-----------------
REV:is4j-EX-A~"P-(OFii3.n~
DI ALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF LINKS ALAIN FILE NO. 21 01-0859 ACN 101 I DATE 02-10-2003
TA) RETURN WAS: I X I ACCEPTED AS FILED I I CHANGED
RESERVATION CONCERNING FU URE INTEREST - SEE REVERSE I
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Est.t. (Schedule A III .00 NOTE: To insure prop.
2. Stocks .nd Bonds ISched 1_ BJ 121 .00 credit to your accoun
3. Closely Held Stock/Pert ership Interest (Schedule C) 131 .00 ~it the upper port
4. Mortgages/Notes R.c.ly~ 1. (Schedule D) 141 .00 of this form with you
S. Cash/Bank Oeposits/Hlsc Personal Property ISchedule EI 151 28.000.00 tax pey.."t.
6. Jointly Owned Property Schedul. Fl 161 .00
7. Transfers (Schedule G) 171 .00 r
8. Total Assets 18 28,000.00
APPROVED DEDUCTIONS AND E EMPTIONS: .00
9. Funeral Expenses/Ad.. C sts/Hisc. Expenses (Schedule H) 191 i
,
10. Debts/Hortgage Liabilit es/Llens (Schedule I) 1101 .00
11. Total Deductions III nn
12. N.t Value of Tax Ret rn 112 28,000.00
13. Charitable/Govern..n al BequestSj Non-elected 9113 Trusts (Schedule J) 1131 .00
14. N.t Value of Estate ubject 'to Tax 1141 28,000.00
NOTE: I~ an assess.ent as issued previausly, lines 14, 15 and/ar 16, 17, 18 and 19 Ifill
reflect ~igures t at include the tatal a~ ALL returns assessed-' a date.
ASSESSMENT OF TAX: 28,000.00 00 =
15. Aeount of Line 14 .t SP )Usal rate 1151 X .00
16. AItount of Line 14 texab . at Lineal/Class A rate 1161 .00 X 0~5 = .00
17. Amount of Line 14 at 51 ling Mlt. 1171 .00 X 12 = .00
18. Anount of Line 14 taxab . at Collateral/Class Brat. 1181 .00 X 15 = .00
19. Principal Tax Due IL91= .00
rAlC CREDITS:
ft.~.u. "J AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID I-I
I
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE I .00
r
t,
ion
r
. IF PAID AFTER DATE INDICATED] SEE REVERSE
FOR CALCULATION OF ADDITIONA~ INTEREST.
I IF TOTAL DUE IS LESS THAN $1, NO PA~NENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREdIT" ICRI, YDU NAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. I
Date: 8/03/2004
VUXTA LAWRENCE J
802 MOUNTAIN VIEW
HARRISBURG, PA 171 2
Cu erland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717) 240-6345
RE: Estate of HUBLE MARY E
File Number: 20 2-00859
Dear Sir/Madam:
It has come t
Report by Personal
estate.
As per the AM
103 SUPREME COURT
July 1, 1992, the
(2) years of the d
Wills a Status Rep
my attention that you have not filed ~he Status
Representative (Rule 6.12) in the abov~ captioned
NDMENTS TO SUPREME COURT ORPHANS' COURt RULES, NO.
ULES DOCKET NO.1, for decedents dyingion or after
ersonal representative or his counsel, 'within two
cedent's death, shall file with the Register of
rt of completed or uncompleted administration.
,
This filing w 11 become delinquent on: 9/20/2004
,
Your prompt a tent ion to this matter will be appreci~ted.
Thank You.
cc: File
Counsel
Judge
Sincerely,
~~~
GLENDA FARNER ST~SBAUGH
REGISTER OF WILL~
JRDlJune 30, 1992117858
OCT 0 6 2004 If
In Re: Estate of Mary . Hubley
Late of Camp Hill Bor ugh
ORPHANS' COURT DIVISION
,
COURT OF COMMON ItLEAS OF
CUMBERLAND COUNty
PENNSYLVANIA
Estate No.: 21-02-0859
NOTICE OF FAlLU
HEARING PURSU
NO. 21-21-02-0859
TO FILE STATUS REPORT AND REQUEST TO CONDUCT A
T TO RULE 6.12, SUPREME COURT ORPHANS' CPURT RULE
Personal Representative Lawreuce J. Vuxta
Counsel for Personal Re resentative: None
Date of Decedent's Dea : 09/20/2002
Date of Delinquency No ice: 10/08/2004
The undersigned Glenda Farner-Strasbaugh, Clerk of Orphans' Court, in a~cordance
with Rule 6.12, Suprem Court Orphans' Court Rules, hereby notifies the Orphans!' Court
Division, Court of Co on Pleas of Cumberland County, that neither the above njuned personal
representative nor the ab ve named counsel for the personal representative have filed with the
Register of Wills or Cle of the Orphans' Court his, her or its Status Report requi~ed by Rille
6.12, Supreme Court 0 hans' Court Rule and that the requisite notice, pursuant td Rule 6.12,
Supreme Court Orphans Court Rules, was given by the Clerk of the Orphans' Co~ on April 30,
2004, and that the ten (1 ) day notice to file the Status Report has expired. Accordlingly, in
accordance with Rule 6. 2 the Court is hereby notified of such delinquency and th~ undersigned
,
requests that a Court con uct a hearing to determine whether sanctions should be iJlnposed upon
the delinquent personal r resentative or counsel for the delinquent personal repre~entative.
Date: 10/08/2004
.~~~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
Distribution: Persona Representative
Estate F Ie
I /i':l./1cc>"t q: 30 f\t'\ !
A hearing is scheduled fi r at in Courtroom No.3. If the Status Report is filed prior to
the hearing date, the he ng will automatically be cancelled. ~,
/<i;Y}f!:/1 /1ft/'~\i
Geo,~e i/Iiofteri.J( I .d....
~- ,!;.l~' j
STATUS REPORT UNDER RULE 6.12
Pursuant to ule 6.12 of the Supreme Court Orphans' Court Rules, I re~ort the
following with respe t to completion of the administration of the above-captiOIied estate:
~
~ \\,'" ~\--\:l~...!::l~~<\Ad:min. No.: ~\-+~~~~
Name of Decedent:
Date of Death:
1.
er administration of the estate is complete:
NoD
2.
er is No, state when the personal representative reasonably believes
. . stration will be complete:
3.
er to No.1 is Yes, state the following:
a. Did t e personal representative file a final account with the Cou.jt?
Yes No 0' '
b. arate Orphans' Court No. (if any) for the personal repre~entative's
tis:
c. Did e personal ~esentative state an account informally to the parties
in int rest? Yes ~ No D ,
c. C pies of receipts, releases, joinders and approval of formali or
ormal accounts may be filed with the Clerk of the Orpharls' Court
D're~~ d=Yb''-''~~~~
\ ~ o~\ ,. :0
\..--O.~"~""<:"L ~~-$'~e. ~~
0- ' i y~ r-
Name (\)' ."~. '"
- ~ Cle"
~.; p:; ::IT (l
~~~ ~~\}~ ~~~, ~ ~\~.'
Address ~~. ~'"., '" ~: :;'
,,--\. :1:ll::~ ~ . tr) 0
"\ \t ,~~:-I.Et~ p '-'
Telephone No.
Capacity:
2f Personal Representative
D Counsel for personal representatite
.<;:,'....~:
.,,:'~ \
t.~~':"'_'~
:,1