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HomeMy WebLinkAbout03-0208PETITION FOR GRANT OF LETTERS OF ADMINISTRATION also known as To.' Register of Wills for thc t Deceased. County of Ca ,,,~_~er ~qv~ C} in the Social Security No. ~ ~ ~ -' t ~ ~' ~/ O / Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older, appl for letters of administration on the estate of (d.b.n.; pendente lite; durante absentia; durante minoritate) the above decedent. Decenden l"?{f)t7 , . f t was domiciled at death in [~--{a /~ ~ ~-~2 JO,C, ~'~3 , · .' - ~unty,~Pennsylvania, with h ! ~ last family or principal residence atl ~_ / (~ ~ ~; ~ .C. ~{'j )') L)~ 0 (list street, numl~er and municipality) Decendent, then ~ years of age, died ~m~ ~'l at ' Decendent at death owned property with estimated values as folllows: (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: Petitioner after a proper search ha 6 ascertained that decedent left no will and was survived by the following spouse (if any) and heirs: Name, Relationship Residence~ / THEREFORE, appropriate form to the undersigned. petitioner(s) respectfully request(s) the grant of letters of administration in the OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF ~r~r~ SS 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. Sworn to or affirmed and subscribed before me this ~x_~__ __ day of No. ~/-tg,-q- ~tg~q~ Estate of ~ j~ ~ ~ CO~. ~(.;_/o. ~ , Deceased GRANT OF LETTERS OF ADMINISTRATION AND NOW ~~-~J ~ ~ ,~z~, in consideration of the petition on the revers~ side hereof, ~dsfactory proof having been presented before me, IT IS DECREED that (..J~,~ J~q~#/~ fl/ /o~_., is/are enticed to Letter~5~ Administration, and in a~cord with such finding, Letters of Administration are hereby granted to ~.~'~_ )~' ff.t.~D_~.t in the estate of ~/0-/~ ('0~ ~j_ ~ ~ FEES Letters of Administration ..... $ Short Certificates( ) .......... ation ................ $ TOTAL __ Filed ,~, ~ .......... A.D. ATTORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Clifton E. Wiley Date of Death: January 31, 2003 Will No. Admin. No. 2003-00208 To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on June 20, 2003. Jessie E. Wiley 126 16~ Street New Cumberland, PA 17070 Shari Tamanini, 126 16~ Street New Cumberland, PA 17070 Gregg Wiley 2322 Hoffer St. Harrisburg, PA 17103 Lynne Richards 1504 Red Hill Rd. Dauphin, PA 17018 Dennis Wiley 5380 Oak Lawn Blvd. C/O Comfort Inn Prince George, VA 23875 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None Date: 6/20/2003 ~~ /David FQ TamAnini P.O.Box 6206 Harrisburg, PA 17112 Attorney ID# 75557 Phone: (717) 541-1805 Capacity: X Personal Representative Counsel for Personal Representative PLEASE FII.E THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STA ESTATE IS NOT COMPLETED, FILE a 6,12 FORM YEARLY UNTIL COMPLETION STATUS REPORT UNDER RULE 6.12 Name of Decedent: Clifton E. Wiley Date of Death: January 31, 2003 Estate No.' 2003-00208 Purs~nt 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 the administration of the estate is complete: Yes X No 2.ffthe answer is NO, state when the personal representative reasonably believes that the administration will be complete. 3. ff the answer to No. 1 is yes, state the following: P~ Did the personal representative file a final account with the court? Yes No X B. The separate Orphans' Court No. (if any) for the personal representative's account is: none C. Did the personal representative state an account informally to the parties in interest? Yes X No D. 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. (/Je~si~e E. Wil~, 126 16~ St. New Cumberland, PA 17070 Capacity: X__ Personal Representative Counsel for Personal Representative l~W. - 55 STATUS REPORT UNDER RULE 6.12 Name of Decedent: Clifton E. Wiley Date of Death: January 31, 2003 Will No.: N/A Admin. No.: 2003-00208 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes No X 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: October 31, 2003. 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 No b. The separate Orphans' Court No. (if any) for the personal representative's account is: Did the personal representative state an account informally to the parties in interest? Yes No c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: 6/20/2003 ~~ P.O.Box 6206 Harrisburg, PA 17112 Attorney ID# 75557 Phone: (717) 541-1805 X Personal Representative Counsel for Personal Representative. DEPARTMENT OF REVENUE ~'~~~ DEPT. 280601 INHERITANCE TAX RETURNI 20 _ 03 00208 *' RISBURG, PA17128-0601 RESIDENT DECEDENT i -- DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER I-- Wiley, Cleon, E. 188-12-5101 Z ~ DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE LI.I 01/31/03 03/31/19 REGISTER OF WILLS UJ (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER ¢3 Wiley, Jessie, E. I- Z Z r~l. Original Return D4. Limited Estate r-'"] 6. Decedent Died Testate (Attain copy or Will) DB. Litigation Proceeds Received F'12. Supplemental Retum D4a. Future Intamst Compromise (da~e of death amir 12-12-82) E~7. Decedent Maintained a Living Trust (^~am c~py of Trust) F--] 10. Spousal Poverty Credit (date of math t)e~veen 12-31-91 and 1-1-95) ---]3. Remainder Return (date of death p~a'to 12-13q~2) '-'-]5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes F-~ 11. Election to tax under Sac. 9113(A) (Attach NAME David F. Tamanini FIRM NAME (If Applicable) Law Office of David F. Tamanini TELEPHONE NUMBER (717) 541-1805 COMPLETE MAILING ADDRESS P.O. Box 6206 harrisburg, PA 17112 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) [~ Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Pmbata Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)(10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. 14. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) Net Value Subject to Tax (Line 12 minus Line 13) 0.00 0.00 0.00 0.00 22,839.17 0.00 0.00 (8) 9,675.21 0.00 (11) (12) (13) 22,839.17 9,675.21 13,163.96 0.00 13,163.96 (14) 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 colleteml rate 19. Tax Due 13,163.96 x .0 0 (15) x .0 (16) x .12 (17) x .15 (18) (19) 0.00 ' Deced~nt's Complete Address: STREET ADDRESS 126 16th Street c~TY New Cumberland STATEpA 7070 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 0.00 0.00 0.00 0.00 0.00 0.00 Total Credits ( A + B + C ) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interesl/Penalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (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. (5Al B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; .......................................................................................... [] [] b. retain the right to designate who shall use the property transferred or its income; ............................................ [] [] c. retain a reversionary interest; or .......................................................................................................................... [] [] d. receive the promise for life of either payments, benefits or care? ...................................................................... [] [] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. [] [] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of pe~J~y, I declare that I hav~ examined this tatum, inducting accorrq3ar~qg schedules md statements, ~ to ~e best of my knowledge and belief, it is tree, correct md complete. Oedaraf~n of preparer oQler t~afl lhe personal mpresenta~ve is ba~d on aU ~orma~on of wfich preparer has any kno~edge. 12_ ._... Street, New Cumberland, PA / DATE / SI~URE OF._P~._~~AN I~EPRESE. NTATIVE - P.O. Box 6206, Harrisburg, PA 17112 For dates of death on or after July I, 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)(il]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (al (1.1) (ii)l. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and firing 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 tale 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 stepparenl of the child is 0% [72 RS. §9116(a)(1.2)]. The tax rate imposed on the nel value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 P,S. §9116(a)(1)]. The tax rale imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 RS. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has al least one parent in common with the decedent, whelher by blood or adoption. RE'~-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF' Wiley, Clifton, E. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 200300208 Include the proceeds of litigation and the data the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 2. 3 4 Members 1st Federal Credit Union acct. # 46 Certificate of Deposit 1973 Dodge Truck 1991 Plymouth Grand Voyager Assorted coins and silver collectibles, clothing, hunting gun and cabinet, and assorted personal items 20788.82 100. 1930 Unknown TOTAL (Atso enter on Fine 5, Recapitulation) $ 22,839.17 (If mom space is needed, insert additional sheets of the same size) REV-1510 EX+ (6-98) ~, COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ~iley, ClRon E. SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 2003-00208 This schedule must be completed and filed if the answer to any o~ questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY ITEM ~NCtU~'~E~U~EOF'mE~,~L~TO~Da~T~ND DATE OF DEATH %OFDECD'S EXCLUSION TAXABLE NUMBER '~-E DATE OF 'IRANSFER. A~, A COPY 0F THE DEED FOR RE.N. ESTATE VALUE OF ASSET INTEREST I]F ~=~LIC.,m~ VALUE l. United States Office of Personnel Management Retirement $1945. 100 100% Survivor annuity Lump sum to spouse Jessie E. Wiley 2. United States Office of Personnel Management Retirement 0.00 0 100% Survivor annuity monthly annuity to spouse Jessie E. Wiley of $846.07 per month 3. Washington National Insurance Co. Contract No. 000 No. 000138849, Lump Sum to spouse $10,810.79 100 100% Jessie E. Wiley 4. Washington National Insurance Co. Contract No. 000 No. 000155459, Lump Sum to spouse 944.64 100 100% Jessie E. Wiley TOTAL (Also enter on line 7 Recapitulation) $ 0.C (If more space is needed, insert additional sheets of the same size) RE',~-1511 EX+ (12-99)~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Wiley Clifton E. SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 2003-00208 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT 5. 6. 7. 8. FUNERAL EXPENSES: HetrickFunemlHome, lnc 3125WalnutStree! Hardsbu~,PA17109 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representalive(s) NO COMMISSION CLAIMED Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Jessie E. Wiley StrnetAddress 126 161~ St. C~y New Cumberland state PA Zip 17070 RelaUonship of Claimant to Decedent Spouse Probate Fees Accountant's Fees Tax Return Pmparer's Fees fees for Petition for Letters of Adminislmtion, Short Certificates, JCP fees, filing spousal inheritance return disclaimer of intestate interests Fees for publishing legal notices in the Carlisle Sentinel and Cumberland Law Journal $4881.52 0.00 1,008.00 3,500.00 112.00 173.69 TOTAL (Also enter on tine 9, Recapitulation) $ 9,675.21 (If mom space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RE'fURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Clifton E. Wiley 2003-00208 RB..4'TION~ TO DECEDENT kMOt~ OR ~ NUMI~ER NAME N~ID ADORF~ OF PI~,SON($) RECEMN~ PROPER'ff I~ !~ L.~ tl'lml~l~ OF ESTATE 3. 4. 5. ~ 9116 (~) (1.2)1 Jessie E.W'~j, spouse, under intestate law 20.Pa.C.S. 2100 et.seq, entilled to 100 pement in absence of childrefl Intestate Rights by the four children of decedent and his surviving spouse. The Disclaimers giving up all rights to any share in the estate which the disctaimants would have had under 20 P.C.S. 2102 Shari Tamanini, see attached Disclaimer Lynne Richards, see attached Disclaimer Dennis W'dey, see attached Disclaimer Gregg Wiley, see attached Disclaimer 100% ENTER D(ILI. AR AMOUNTS FOR DISTRIBUTIONS SHOWN/~ ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET A. SPOUSAL ~ UNDER SECTION g113 FOR WHICH N~I ELECTION TO TAX IS NOT BEING MADE E CHARITAIN.E NdO GOVERNMENTAL DISTRIBUTIONS I~TAI. OF PA~I' II - EN'rl~ TOT~. NON-T~.E DISTRI~mONS ON LII~ 13 OF EEV-I~ ~ ~ $ 0.00 IN RE THE ESTATE OF CLIFFON WILEY File No. 2003-2080 PA File No. 21-08-2003 Date of Death 1/31/2003 Social Security No. 188-12-5101 DISCLAIMER OF PROPERTY RIGHTS BY INTESTATE 1.Clifton E. Wiley died intestate on January 31, 2003. 2.His estate was probated on March 6, 2003 with letters of Admini~ration being granted to his surviving wife, Jessie E. Wiley who is also the natural mother of decedent's issue. 3.The only issue of the decedent and only issue of Jessie E. Wiley are: a. Shari Tamanini of 12~r 16~ Street, New Cumberland, PA 17070 b. Gregg Wiley of 2322 Hoffer St., Harrisburg, PA 17103 c. Lynne Richards of 1504 Red Hill Rd., Dauphin~ PA 17018 d. Denni.~ Wiley of 5380 Oaldawn Blvd., Prince George, VA 23875 4.The first complete advertisement of the grant of Letters of Adi~liii~xation to Jessie E. Wiley appeared on June 26, 2003, July 3~ and 10th, 2003, and June 27, 2003, July 4a and 11~, 2003. 5. All known debts of Clifton E. Wiley have been paid. 6. Under the Pennsylvania Estates and Fiduciaries code, 20 Pa.C.S 2102, ffthere are surviving issue of the decedent all of whom are issue of the surviving spouse ..., the first $30,000 plus one-half of the balance of the intestate estate.", goes to the spouse. The remaining one-half of the balance of the estate, shall be given as follows: '°Fhe share of the estate, if any, to which the surviving spouse is not entitled, ..., shall pass in the following order: 1. Issue.-To the issue of the decedent .... "(Section 2103) 7. The issue of the decedent, all and unanimously hereby each disclaim all rights to take from the intestate estate of the decedent, and agree that all of the estate left by their father shall therefore pass to their mother, Jessie E. Wiley as though she were the only heir under law according to 20 Pa.C.S. 2102 (1). 8. Each of the issue named above in paragraph 3 hereby executes a separate DISCLAIMER OF PROPERTY RIGHTS BY INTESTATE HEIRS for the purpose above stated. IN WITNESS WHEREOF, the disclain~h~g issue of the decedent hereto, intending to be legally bound, has hereunto set hirJher hand and seal the day and year hereaRer written. Date Shad L. Tamanini COMMONWEALTH OF PENNSYLV~,IIA · On this, the ~ ~ day of ~ ~Y~,~ 2003, before me, a Notary Public, in and for said Coran~onwealth and County, the (undersigned officer, personally appeared Shari L. Tamanini known to me (or satisfactor~y proven) to be the person whose name is subscr~ed to the within instrument and acknowledged that she executed the same for purposes therein IN WITNESS WHEREOF, I hereunto set my hand and official seal My Coninii.e. sion Expires: NOTARIAL SEAL l K. HOOV/N, NOTARY RUBLIC J BOROUGH, COUNTY OF CUMIERLAND J J IN RE THE ESTATE OF CLIFTON WILEY File No. 2003-2080 PA File No. 21-08-2003 Date of Death 1/31/2003 Social Security No. 188-12-5101 DISCLAIMER OF PROPERTY RIGHTS BY INTESTATE HE~ 1.Cli~on E. Wiley died intestate on January 31, 2003. 2.His estate was probated on March 6, 2003 with letters of Administration being granted to his survixfing wife, Jessie E. Wiley who is also the natural mother of decedent's issue. 3.The only issue of the decedent and only issue of Jessie E. Wiley are: a. Shari Tamanlni of 124-16~' Street, New Cumberland, PA 17070 b. Gregg Wiley of 2322 Hoffer St., Harrisburg, PA 17103 c. Lynne Richards of 1504 Red Hill Rd., Dauphin, PA 17018 d. Dennia Wiley of 5380 Oaklawn Blvd., Prince George, VA 23875 4.The first complete advertisement of the grant of Letters of Admini.~tration to Jessie E. Wiley appeared on June 26, 2003, July 34 and 10th, 2003, and June 27, 2003, July 4a and 11a, 2003. 5. All known debts of Clifton E. Wiley have been paid. 6. Under the Pennsylvania Estates and Fiduciaries code, 20 Pa.C.S 2102, If there are surviving issue of the decedent all of whom are issue of the surviving spouse ..., the first $30,000 plus one-half of the balance of the intestate estate.", goes to the spouse. The remaining one-half of the balance of the estate, shall be given as follows: "The share of the estate, if any, to which the surviving spouse is not entitled, ..., shall pass in the following order: 1. Issue.-To the issue of the decedent .... "(Section 2103) 7. The issue of the decedent, all and unanimously hereby each disclaim aH fights to take from the intestate estate of the decedent, and agree that all of the estate lef~ by their father shall therefore pass to their mother, Jessie E. Wiley as though she were the only heir under law according to 20 Pa.C.S. 2102 (1). 8. Each of the issue named above in paragraph 3 hereby executes a separate DISCLAIMER OF PROPERTY RIGHTS BY INTESTATE HEIRS for the purpose above stated. IN WITNESS WHEREOF, the disclaiming issue of the decedent hereto, intending to be legally bound, has hereunto set hi.~ner hand and seal the day and year hereaf~r written. Date Gregg Wiley (SEAL) COMMONWEALTH OF PENNSYLVANIA : On this, the ~ day of September, 2003, before me, a Notary Public, in and for said Commonwealth and County, the undersigned officer, personally appeared a)C-regg Wiley known to me (or satisfactorily proven) to be the person whose name is subsc~ed to the within instrument and acknowledged that he executed the same for purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Notary Public My Commi.~ion Expires: NOTARIAL SEAL PHILLIP FARABELLI, Notary Public Lemoyne Bom, Cumberland County My Commission Expires Feb. 6, 2006 IN RE THE ESTATE OF CLIFTON WILEY File No. 2003-2080 ;~ © ~ Date of Death 1/31/2003 Social Security No. 188-12-5101 DISCLAIMER OF PROPERTY RIGHTS BY INTESTATE HE1R,~ 1.CliRon E. Wiley died intestate on January 31, 2003. 2.His estate was probated on March 6, 2003 with letters of Admlni.~tration being granted to his surviving wife, Jessie E. Wiley who is also the natural mother of decedent's issue. 3.The only issue of the decedent and only issue of Jessie E. Wiley are: a. Shari Tamanini of 12q~ 16~' SWeet, New Cumberland, PA 17070 b. Gregg Wiley of 2322 Hoffer St,, ~urg, PA 17103 c. Lynne Richards of 1504 Red Hill Rd., Dauphin~ PA 17018 d. Denni.~ Wiley of 5380 Oaklawn Blvd., Prince George, VA 23875 4.The first complete advertisement of the grant of Letters of Administration to Jessie E. Wiley appeared on June 26, 2003, July 3~d and 10th, 2003, and June 27, 2003, July 4* and 11', 2003. 5. AH known debts of CILfton E. Wiley have been paid. 6. Under the Pennsylvania Estates and Fiduciaries code, 20 Pa.C.S 2102, If there are surviving issue of the decedent all of whom are issue of the surviving spouse ..., the first $30,000 plus one=half of the balance of the intestate estate.", goes to the spouse. The remaining one-half of the balance of the estate, shall be given as follows: "The share of the estate, if any, to which the surviving spouse is not entitled, ..., shall pass in the following order: 1. Issue..To the issue ofthe decedent .... "(Section 2103) 7. The issue of the decedent, all and unanimously hereby each disclaim all rights to take from the intestat~ ~tate of the decedent, and agree that all of the estate let~ by their father shall therefore pass to their mother, ~essie E. Wiley as though she were the only heir under law according to 2O Pa.C.S. 2102 (1). 8. Each of the issue named above in paragraph 3 hereby executes a separate DISCLAIMER OF PROPERTY RIGHTS BY INTESTATE HEIRS for the purpose above stated. IN WITNESS WHEREOF, the disclaiming issue of the decedent hereto, intending to be legally bound, has hereunto set his/her hand and seal the day and year hereafter written. Date Lynne Richards COMMONWEALTH OF PENNSYLVANIA COUNTY OF On this, the~-t/~, day of ~ ,2003, before me, a Notary Public, in and for said Commonwealth and County, the ufl/iersigned officer, personally appeared Lyune Richards known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that she executed the same for purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. My Commission Expires: M~yC NOTARIAL SEAL CYNTHIA T. LENTZ, Notary Publk~ Harrisburg, D,a, uphln County ~,m_~!?io~n E;,pires July 15, 2004 IN RE THE ESTATE OF C~IFTON WILEY File No. 2003--2080- Date of Death 1/31/2003 Social Securky No. 188-12-5101 DISCLAIMER OF PROPERTY RIGHTS BY INTESTATE HF. IRg 1.ClLffon E. Wiley died intestate on January 31, 2003. 2.His estate was probated on March 6, 2003 with letters of Admini~tration being granted to his survh~g wife, Jessie E. Wiley who is also the natural mother of decedent's issue. 3.The only issue of the decedent and only issue of Jessie E. Wiley are: a. Shari Tamanini of 124-16~ Street, New Cumberland, PA 17070 b. Gregg Wiley of 2322 Hoffer St., Harrisburg, PA 17103 c. Lynne Richards of 1504 Red Hill Rd., Dauphin. PA 17018 &Dennig Wiley of 5380 Oaklawn BlvcL, Prince George, VA 23875 4.The first complete advertisement of the grant of Letters of A~ation to Jessie E. Wiley appeared on June 26, 2003, July 3~a and 10th, 2003, and June 27, 2003, July 4a and 11~, 2003. 5. AH known debts of Clifton E. Wiley have been paid. 6. Under the Pennsylvania Estates and Fiduciaries code, 20 Pa.C.S 2102, 6& If there are surviving issue of the decedent aH of whom are issue of the surviving spouse ..., the first $30,000 plus one-half of the balance of the intestate estate.", goes to the spouse. The remaining one-half of the balance of the estate, shall be given as follows: '°lrhe share of the estate, if any, to which the surviving spouse is not entitled,..., shall pass in the following order: 1. Issue.-To the issue of the decedent .... "(Section 2103) 7. The issue of the decedent, all and unanimously hereby each disclaim all rights to take from the intestate estate of the decedent, and agree that all of the estate left by their father shall therefore pass to their mother, Jessie E. Wiley as though she were the only heir under law according to 20 Pa.C.S. 2102 (1). 8. Each of the issue named above in paragraph 3 hereby executes a separate DISCLAIMER OF PROPERTY RIGHTS BY INTESTATE HEIRS for the purpose above stated. IN WITNESS WHEREOF, the disclaimh~g issue of the decedent hereto, intending to be legally bound, has hereunto set hi~Jher hand and seal the day and year hereafter written~ Date Denni~ Wiley (SEAL) COMMONWEALTH OF t~'h~S~_Vb2,~L~. : C~-~4 : ss. or : On this, the ~Q'~ day of ~0,~7- ,2003, before me, a Notary Public, in and for said Commonwealth and County, the undersigned officer, personally appeared a)Dennlu Wiley tmown to me (or satisfactorily proven) to be the person whose name is subscr~ed to the within insmunmt and acknowledged that he executed the same for purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Notary Public My Commi.~ion Expires: BUREAU OF INDZVZDUAL TAXES ZNHERTTANCE TAX DTVZSZON DEPT. 280601 HARRISBURG, PA 1711&-0601 DAVID F TAHANINI D F TAMANINI LAW OFC PO BOX 6206 HB$ PA 1711Ii. COMHONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCT/ONS AND ASSESSHENT OF TAX REV-154? EX AFP COl-D3) DATE 11-10-2005 ESTATE OF WILEY DATE OF DEATH 01-$1-2005 FILE NUMBER 21 05-0208 ' ~OOUNTY CUHBERLAND ACN 101 d Amoun~ Rsmi~sd CLIFTON HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 1701:5 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01'03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR DISALLOWANCE OF BEDUCT/ONS AND ASSESSMENT OF TAX ESTATE OF WILEY CLIFTON E FILE NO. 21 0:5-0208 ACN 101 DATE 11-10-200:5 TAX RETURN HAS: (~) ACCEPTED AS FXLED ( ) CHANlaED SEE ATTACHED NOTICE RESERVATZON CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es~a~s (Schedule A) (1) 2. S~ocks and Bonds (Schedule B) (2) :3. Closely HeZd S~ock/Par~nsrship Zn~erss~ (Schedule C) (:3) 4. Nor~:geges/No~as Receivable (Schedule D) (4) 5. Cash/Bank Daposi~s/Hisc. Personal Propsr~y (Schedule E) (5) 6. Jointly Offned Propar~y (Schedule F) (6) 7. Transfers (Schedule la) (7) 8. To,al Asse~s APPROVED DEDUCT:ZONS AND EXEHPTTONS: 9. Funeral Expanses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Deb*s/Her*gage Liabilities/Liens (Schedule Z) (10) 11. To,al Deduc~/ons 12. Na~ Value of Tax Re~urn 1:3. 14. Charitable/Governmental Bequests; Non-elsc~ad 911:3 Trusts (Schedule J) Na~ Value of Es~a~e Subjec~ ~o Tax 22~8:59.17 .00 .00 NOTE: To insure proper .00 credi~ ~o your account, .00 subai~ ~he upper por~ion .00 of ~hls form w1~h your ~ax payman*. .00 (8) 9,675.21 22,8:59.17 NOTE: O0 (11) 9.675.2~ (1~) 1:5,16:5.96 (15) . O0 (14) 1:5,16:5.96 Z~ an assessment ~as lssued prev/ously, lines 14, 15 and/or 16, 17, reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amoun~ of Line 14 a~ Spousal ra~a 16. Amoun~ of Line 14 ~axabls a~ L/neal/Class A ra~e 17. Amoun~ of Line 14 a~ Sibling re~a 18. Amoun~ of Line 14 ~axebla a~ Collateral/Class B ra~e 19. Principal Tax Due TAX CREDITS: PAYNEN1 RECEIPT UZ~cuUNT DATE NUNBER INTEREST/PEN PAZD (-) 18 and 19 will .00 .00 .00 .00 ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS RE{)UTRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDZT' (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR ZNSTRUCTZONS.) TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE AHOUNT PAID IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. (1~) 1:5,16:5.96 X O0 = .00 (16) .00 x Oq5= .00 (17) .00 x 12 = .00 (2a) .00 x 15 = .00 (19)= . O0 RESERVATION: Estates of decedents dying on or before December 1Z, 19BI -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMZN- ZSTRATZVE CORRECTZONS: DZSCOUNT: PENALTY: iNTEREST: To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act 23 of ZOO0. (72 P.S. Section 91qg). Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side. --Hake check ar money order payable to: REGISTER OF HILLS, AGENT A refund of a tax credit, ahich ems not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-Z315). Applications ere available at the Office of the Register of Nills, any of the Z3 Revenue District Offices, or by calling the special Z4-hour answering service for forms ordering: 1-800-56Z-ZOSO; services for taxpayers eith special hearing and / or speaking needs: 1-800-447-30Z0 (TT only). Any party in interest not satisfied aith the appraisement, alloeenca, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --erittan protest to the PA Department of Revenue, Board of Appeals, Dapt. Z810Z1, Harrisburg, PA 171ZS-10Z1, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80681, Harrisburg, PA 171ZD-0601 Phone (717) 787-6505. See page S of the booklet "Instructions for inheritance Tax Return for e Resident Decadent" (REV-IS01) for an explanation of administratively correctable errors. If any tax due is paid within three (5) calendar months after the dacedent's death, a five percent CSX) discount of the tax paid is alloaad. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6g) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which a111 vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through 2003 are: /nterest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 ZOZ .000548 1987 9Z .000247 1999 7Z .O00zgz 1983 162 .00043D 1988-1991 112 .000501 ZOO0 8Z .000Z19 1984 llZ .000501 199Z 92 .000Z47 2001 9Z .000247 1985 15Z .000356 1995-1994 7Z .00019Z ZOOZ 6Z .000164 1986 lOX .000274 1995-1998 9g .000247 ZOO5 5Z ,000137 --Tnterast is calculated as follows: ZNTEREST= BALANCE OF TAX UNPAID X NUI~BER OF DAYS DELZNQUENT X DALLY ZNTEREST FACTOR --Any Notice issued after the tax becomes delinquent uill reflect an interest calculation to fifteen (15] days beyond the date of the assessment. Tf payment is made after the interest computation date sheen on the Notice, additional interest must bo calculated.