HomeMy WebLinkAbout03-0236Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of Martha C. Blanchard
a~o known as
John E. Geschwindt , Deceased
Petitioner(s), who is/are 18 years of age or older, apply(les) for:
Social Security No. 183 - 09- 9224
(COMPLETE 'A' or 'B' BELOW:)
A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut or
the Decedent, dated 02/12/97 and codicil(s) dated None
~named in the last Will of
State relevant circumstances, e.g., renunciation, death of executor, etc.
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents
offered for probate; was not the victim of a killing and was never adjudicated incompetent:
I" ] B. Grant of Letters of Administration
(c.t.a.; d.b.n.c.ta; pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and
heirs:
Name
Relationshi ~
Residence
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Cumberland
Decedent was domiciled at death in
or principal residence at 210 Big
Decedent, then 87
Spring Rd.,
County, Pennsylvania with his/her last family
West Pennsboro Twp.
(list street, number, and municipality)
yearsofage, died....02/28 , 0...~.3,at Green Ridge Village, PA
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
(Location)
100,000.00
situated as follows:
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant
letters in the a ro riate forrnto the undersi ned: of
~ Signature ~ ~ ~ ~ ~ ~ ~ _
.----.----~me and residence
~___~?~--~ -~ ~-v~ 24 Corvair Drive, Dillsburg, PA 17019
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, Inc.
Form RW-1 (1991)
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumb er 1 and
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 Decedent, Petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed ~~
before me this 18t[r~::lay of
March ~gx_2D03
/~"' - For the ~egi~te ~ ~.~3.~'4~/
Donn~ ~. Otto,lst Deputy ~
No.
Estate of Martha C. Blanchard
Social Security No: 183- 09- 9224
AND NOW, March 18_~J~_
21-2003-236
Date of Death: 02/28/03
'of the Petition on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters
Deceased
20___0 ~ consideration
[]Testamentary [~ Of Administration
(c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate)
are hereby granted to
John E. Geschwindt
in the above estate and that the instrument(s) dated 0...~___~..~97
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
~M. Otto,lst D~6ut
$ 2O0. O0
Letters ...........
Short Certificate(s). · 1. q . $ 30.00
Renunciation ........ $
Affidavits ( ) .... $
Extra Pages ( 3 ) .... $ 9 · O0
Codicil ........... $
JCPFee .......... $ 10.00
I.D. No:
29078 '
The Wiley Group
One S. Baltimore St.
Address:
Telephone: 717/432-9666
$
Inventory ..........
Other ........... $ MAILED LEI~fER_S O~N 3-18-2003.
249.00 TO A~fORNEY -
TOTAL ......... $
Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software onl-~P~ystems, Inc.
Form RW-1 (1991)
21-2003-236
MARTHA C. BLANCHARD
BE IT REMEMBERED, that I, MARTHA C. BLANCHARD of 120 Green Ridge
Lane, Newville, West Pennsboro Township, Cumberland County, Pennsylvania, being of
sound mind, memory and understanding, do make, publish and declare this as and for my
Last Will and Testament, hereby revoking and making null and void any and all Wills and
Testaments and writings in the nature thereof by me at any time heretofore made.
ITEM 1: I direct that my hereinafter named Executor pay all my just debts, my
funeral expenses, and the expenses of the administration of my estate. With this direction,
I authorize and empower my Executor to expend for my funeral expenses and interment
such amounts as he may consider necessary and proper, without regard to any limit that
may be prescribed by a court of law.
ITEM 2: I direct my Executor to pay all inheritance, estate, succession, and legacy
taxes of whatsoever nature and kind, to which my estate, or the transfer of any property
passing hereunder or otherwise passing by reason of my demise, may be subject, and to
charge such taxes against my residuary estate, it being my intention that none of the
aforesaid taxes, either federal or state, on any property required to be included in my gross
estate, under the provisions of any state or federal law now in force or hereafter enacted,
shall be prorated among the persons interested in my estate to whom such property is or
may be transferred or to whom any benefit accrues.
.ITEM 3: All the rest, residue and remainder of my estate, of whatsoever nature and
wheresoever situate, whether it be real, personal or mixed, including property over which
I have a power of appointment, I give, de,Ase and bequeath unto my spouse, LEO C.
BLANCHARD, provided he survives me for a period of thirty (30) days.
ITEM 4: In the event that my beloved spouse fails to survive me for a period of
thirty days, I give, devise, and bequeath the rest, residue and remainder of my estate, of
whatsoever nature, and wheresoever situate, whether it be real, personal, or mixed,
including property over which I may have a power of appointment, unto my daughters, in
equal shares, per stirpes.
ITEM 5: In the event that either of my daughters predecease me, leaving issue
surviving, I give, devise and bequeath the share of such deceased daughter to her children
in equal shares.
ITEM 6: I nominate, constitute and appoint my son-in-law, JOHN E.
GESCHWINDT, as Executor of this my Last Will and Testament. In the event my son-in-
law, JOHN E. GESCHWINDT, should predecease me, fail to qualify, cease to act, or
renounce probate, I appoint my daughter, EMILY ANNE GESCHWINDT, as alternate
Executrix of this my Last Will and Testament.
ITEM 7: I direct that my hereinbefore named Executor shall not be required to give
bond for the faithful performance of his duties in this or any jurisdiction.
IN ~ESS WHEREOF, I have hereunto set my hand and seal this ..//~ day
of. ~_ TCA~~). , 1997.
The preceding instrument, consisting of this and two (2) other typewritten pages, was
on the day and date thereof signed, sealed, published, and declared by the Testatrix herein
named, as and for her Last Will and Testament, in the presence of us, who, at her request,
in her presence and in the presence of each other, have subscribed our names as witnesses
hereto.
3
SWORN TO AND SUBSCRIBED
COMMONWEALTH OF PENNSYLVANIA :
COUNTY OF YORK :
.~M~- T~/A~C' BLANCHARD' '~' X/~'~~ and
"~////" aZ~/~ , the Testatrix and the witnesses, respectively, whose
names are signed to the attached or foregoing instrument, being first duly sworn, do hereby
declare to the undersigned authority that the Testatrix signed and executed the instrument
as her Last Will and Testament, and that she signed willingly, and that she executed it as
her free and voluntary act for the purposes therein expressed, and that each of the
witnesses, in the presence and hearing of the Testatrix signed the Will as witnesses, and
that to the best of their knowledge, the Testatrix was at the time eighteen (18) years of age
or older, of sound mind, and under no constraint or undue influence.
BEFORE ME THIS/,~ ~ DAY
:--'.~L"/.~,~/~_, 1997.
I'!o~ariai Seal
Janet S. Gore, Notar p .,
DiIlsbur Y ubl~c
...... -~.,9don of Notaries
MARTHA C. BLANCHARD
WM. D. SCHRACK, III, ESQUIRE
124 West Harrisburg Street
Post Office Box 310
Dillsburg, Pennsylvania
17019
CERTIFICATION OF NOTICE UNDER RULE 5.6 (a)
Name of Decedent: Martha C. Blanchard
Date of Death: February 28, 2003
Estate Number:
To the Register:
I certify that notice of beneficial interest 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
March ~D .,2003:
Name Address
Dr. Cyntia Blanchard-Kittle 184 D4 Mountain Club Drive, Vilas, NC 28692
Emily B. Geschwindt 24 Corvair Drive, Dillsburg, PA 17019
Notice has now been given to all persons entitled thereto under Rule 5.6 (a) except N/A.
Date: March ~.0 , 2003
Signatur~ [ ~( ~
Name: David J. Lenox, Esquire
Address: One S. Baltimore St.
Dillsburg, PA 17019
Telephone: (717) 432-9666
Capacity: Counsel for personal Rep.
· ~' ';OMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280801
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OF'- CIA~. ~S= O;,L.Y
i FILE NUMBER
21 03 00236
COUNTY CODE YEAR NUMBER
.... ~£:-2-2 2-TV:~TT: ............................ -~TZ_~_22L "' . ................................................................................. , ...............................................
i DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
i Blanchard, Martha C,
i DATE OF DEATH (MM-DD-YEAR) r DATE OF BIRTH (MM-DD-YEAR)
;02/28/2003 I 05/25/1915
i (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL)
183-09-9224
~HIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
12-31-91 and 1-%95)
~IAME
i_?ZJ__?n°x''_ ............................................
~'IRM NAME (If applicable)
The Wiley Group
[] 1. Original Return [] 2. Supplemental Return [] 3. Remainder Retum (date of death pnor to ~2-13-82)
[] 4. Limited Estate [] 4a. Future Interest Compromise (dateof death after [] 5. Federal Estate Tax Return Required
12-12-82)
[] 6. Decedent Died Testate (Attach copy [] 7. Decedent Maintained a Living Trust (Attach 1 8. Total Number of Safe Deposit Boxes
of Will) copy of Trust) --
[] 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (date of death between [] 11. Election to tax under Sec. 9113(A) (Attach Sch O)
COMPLETE MAILING ADDRESS
717~432-9666
1 S. Baltimore Street
Dillsburg, PA 17019
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Hetd Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
[] Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
None
None
None
None
None
75,116.47
None
8,981.31
(8) 75,116.47
(11) 8,981.31
13.Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 66, ] 3 5. ] 6
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15.Amount of Line 14 taxable at the spousal tax rate, x .00 (15)
or transfers under Sec. 9116(a)(1.2)
(12) 66,135.16
(13)
18. Amount of Line 14 taxable at collateral rate x .'~ 5 (18)
19. Tax Due (19) 2,976.08
20. []
-"~,,-'~.~ x;~.. ~.,:~.~ ~'~ ~' " ~'; ..... ~' ~ ...... "~' :,~'~._.~.~~::
Gopyright 2000 form so.are only The Lackner Group, Inc. Fo~ REV-~S00 EX (Rev. 6-00)
17.Amount of Line 14 taxable at sibling rate
x .12 (17)
16, Amount of Line 14 taxable at lineal rate
66,135.16 x .045 (16) 2,976.08
Decedent's Complete Address:
ISTREETADDRESS
...... '.'.i ............ 20 SgRod __1_ Big ?rin_____a- .............................
CITY Newville
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
148.80
STATE
PA
ZIP 17241
(1) 2,976.08
Total Credits (A + B + C)
(2) 148.80
(4)
(5) 2,827.28
3. Interest/Penalty if applicable
D. Interest
E. Penalty ............................
Total Interest/Penalty (D + E)
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
5. If Line I + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
(5A) ............................
(5B) 2,827.28
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.
preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS
John,'~. Geschwindt .. ~ .....
//-~ c---- ,.2,_ . za ~.orvalr Lrave
7~.-,_~'_ _-~'_~---~-'-~~ Dillsburg, Pa 17019
OFPERSON RESPONSIBLE FOR FILING RETURN ......... ~E~S~
DATE
DATE
Dav/j~nox,~q~'~) / ] S. Baltimore Street / /
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure
of assets and filing a tax return are still applicable even 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-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) (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. §9116
1.2) [72 P.S. §9116 (a) (1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 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.
COMMONWI~AI'TH1NNJ~L~ITANC~DEPARTMENT0EPT, 2~000, OF 3'AX OF PE..sY,~*N,A ,EvE.U~ ~'~'"0" SAFE I N DEPOS YE N ToITRyBOX ..
HARRISBURG, PA 17128-0601
Please Print or.Type
MUST BE COMPLETED BY REPRESENTATIVE OF FINANCIAL INSTITUTION WHERE SAFE DEPOSIT BOX IS LOCATED AND RETURNED TO ABOVE ADDRESS
I~ COUNTY CODE ~,.~ FILE NUMBER ~jJ.~ SOCIAL SECURITY OR DEATH C,RTIFICATE NU'MBER
~ DECEDENT'5 NAME {LAST, FIRST, MIDDLE) ~ DATE OF DEATH
ADDRESS OF DECEDENT (STREET) {CITY) (STATE) (ZIP CODE}
re NAME AND ADDRESS OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOX
(NAME)
{STATE) (ZIP CODE)
{STREET ADDRESS) (CITY)
NAME, ADDRESS AND RELATIONSHIP JIF ANY) TO DECEDENT, OF PERSONIS) PRESENT AT THE BOX OPENING
a. INAME) (RELATIONSHIP)
(STREET'ADDRESS) (CITY) (STATE) (ZiP CODE)
~ur Co~ut~P.. D~ue 'Ditls'bu~ PA
b. (NAME) IRELATIONSHIP)
(STREET ADDRESS) (CITY) (STATE) (ZIP CODE)
,-. (NAME) (RELATIONSHIP)
(STREET ADDRESS( JCITY) ISTATE) (ZiP CODEI
N~AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED
(NAMEJ.
y /,J nc,
(STREET ADDRESS) (CITY) (STATE} (ZiP CODE~
J Lu. j~i~, ~PP~iN~ AV~ A/E~vv'~'IIC. ~gA lq2'el
jJlJ NAME OF PERSON MAKING LAST ENTRY
JOH~J · G~ScH~~ ~T
DATE OF CONTRACT TO RENT BOX J~J NUMBER OF BOX
NAME AND ADDRESS OF PERSONJS).HAVING ACCESS TO BOX
J~ DATE AND TIME OF LAST ENTRY
i~,,TITLE UNDER WHICH BOX IS REGISTERED
a. (NAME) b. (NAME}
STREET A .DDRESS)
{STREET ADDRESS)
"(CITY) ;,.. ' ' (STATE) (ZIP CODE} (CITY)
~ .ILd~ME~.~.ND TITLE OF EMPLQY.E TAKING THE INVENTORY '":"' ,'... '
J~'WAs A WiLL IN THE BOX? [:3YES ~NO If yes, a. Date of will:
· "?."W b. Name a~l addres~ of persona) representative, If named in fhe will
(NAMEI
(STATE)
(ZiP CODE}
· (STREET ADDRESS). {CITYJ (STATEJ (ZIP CODEI
?:;-~ ~ . .. :~ ,- .
,),.~ :..~ :~. "Name '~nd addreJs of a'florn~y, If any
,. iNAME) ............. .
. r'; : '.~'~,':~! .~.::,;~;.::_.:., ...... . .
,..;~ .,' -.'.':'.Z;;,:[ -.'-'. ......... =.:.,: .!:'~ .......
j~. f...: (STI~E~T: .A. DDR,E$S) {CITY} {STATE) (ZIP CODE)
Page
SAFE DEPOSIT BOX .INVENTORY
, ' INSTRUCTIONS . _
: (1) Cash: Report total only.
(2) Stocks: List in detail every common or preferred certificate, warrant or ath6r rights found in' box, Stocks are
to be designated by name of company, certificate number, date of certificate, name in which stock is regMered~
and number of shares and cla..ss of stock.
(3) Obllgatlons.of U. S. Government: Number of.item~, date of issue, face value, names in Which registered
and type of ownership, i.e., jointly held, payable on death, etc.
(4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds)
(5) Bank and Savings and Loan Passbooks: State name of depositor, number of book, last date appearing in
'book, name of bank and branch, and balance.
(6) Jewelry, Coins, Stamps, Manuscripts, etc: List and describe as fully as .possible,
(7) Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: List and describe as
fully as possible.
(8) All other contents.
ITEM
NO. ITEM DESCRIPTION.
CERTIFY UNDER PENALTY OF ~RJURY THAT THE ABOVE RECORD IS ' J PERSON RECEIVING COPY OF ·
:ORRE~ND C~PL~TO ~ BElt OF MY KNOWLEDGE AND BELIEF.~ SAFE~EPOSIT BOX INVENTORYt
PRINT TITLE
~ '~ C~AP~OPRIATE BOX: ' '
~L~ ~~ ~[x,cutorJtrlxJ ~Aamini,trotor(trJx)
' ~ Eslate Representative
No'rE: Attach additional 8t/~'' x 1 1" sheet (s) if.necessarY or use duplicatesaf this Page of form.
- ~' SCHEDULE F
COMI~ONWEALT. OF PENNSYLVANIA JOINTLY'OWNED PROPERTY
INHERITANCE TAX RETURN
.............. _.R.._E. SIDENT DECE~DEN~T ............................................................................................ [ ....................................
ESTATE OF FILE NUMBER
Blanchard, Marthn C, 21 - 03 - 00236
If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A John E. Geschwindt 24 Corvair Drive son-in-law
Dillsburg, PA 17019
B Emily Geschwindt 24 Corvair Drive Daughter
Dillsburg, PA 17019
JOINTLY OWNED PROPERTY:
i I DESCR PT ON OF PROPERTY
~ LETTER , DATE .....
ITEM i ......... ~ ..... Ilnclude name of fmancml institution and bank account number
NUMBER Ir'~,~°~?I ~v~ for similar identifying number. Attach deed for jointly-held real
.............', "-'"~"' ·"" ~___ _____.~__ __'-'" __ estate. _
1 A 05/06/1999 Adams County National Bank CD #3990569:
2
3
4
5
A
A
A
A
B
A
A
A
A
09/23/1999
11/05/1998
07/30/1998
04/18/1996
07/24/1998
12/16/1996
09/23/1997
01/13/1998
01/13/1998
Adams County National Bank CD #3990685:
Adams County National Bank CD #3990396:
Adams County National Bank CD #3990285:
Adams County National Bank Checking Account
#223557:
Orrstown Bank CD# 60061436:
Orrstown Bank CD# 5060056437:
Orrstown Bank CD# 5060058942:
Orrstown Bank CD#5060060037:
Orrstown Bank CD #5060060038:
% OF I DATE OF DEATH
DATE OF DEATH DECD'S i VALUE OF
11,016.58 5,508.29
10,038.55 5,019.28
10,755.01 5,377.51
21,263.48 10,631.74
12,677.321 6,338.66
9,782.83
9,027.3?
22,005.27
14,651.58
29,014.912
6
7
8
9
10
50%
50%
50%I
50%[
50%
50%
5o%i
50%
50%i
4,891.42
4,513.69
11,002.64
7,325.79
TOTAL (Also enter on line 6, Recapitulation)
50%
14,507.45
75,116.47
(;OMMON1NEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Blanchard, Martha C.
I FILE NUMBER
21 - 03 - 00236
Debts of decedent must be reported on Schedule I.
NUMBER DESCRIPTION
A. FUNERAL EXPENSES:
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address
City State Zip
Year(s) Commission paid
2. Attorney's Fees Wiley, Lenox, Colgan, & Marzzacco, P.C. 7,500.00
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 (probate): [ 249.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
1 Cumberland Law Journal (advertise): 75.00
2 The Sentinel (advertise): 98.69
Total of Continuation Schedule(s) 1,058.62
TOIAL (Also enter on line 9, Recapitulation) , 8,981.31
AMOUNT
COMMONWEALTH OF PENNSYLVANIA'
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Schedule H
ESTATE OF I FILE NUMBER
Blanchard, Martha C. 21 - 03 - 00236
3 Register of Wills (filing fee)
PA Dept. of Revenue (income tax 2002):
Social Security Administration (repayment):
Presbyterian Homes:
Continuing Care RX (last illness):
15.00
105.00
764.00
52.00
122.62
Page 2 of Schedule H
NATIONAL BANK
March 25, 2003
The Wiley Group
Attorneys at Law
1 South Baltimore Street
Dillsburg, PA 17019
Re: Estate ofMartha C. Blanchard
Dear Mr. Lenox:
The following information is being provided as per your request:
Acct. Type Acct. Acct. Acc. Int.
Number Principal to D.O.D.
On D.O.D.
CD. 3990569 $11,000.00 $16.58
C.D. 3990685 $ ! 0,000.00 $38.55
C.D. 3990396 $10,679.30 $75.71
C.D. 3990285 $21,000.00 $263.48
Checking 223557 $12,677.32 $00.00
Ownership Date
Joint
Inquiries concerning ACNB Corporation stock information should be directed to the
Registrar and Transfer Company at 1-800-368-5948. If you need any additional
information, please feel free to contact me.
Sincerely,
Lois A. Kime
Deposit Services
ORRSTO VN BANK
TO: The Wiley Group
Attorneys at Law
1 South Baltimore Street
Dillsburg, PA 17019
FROM: ORRSTOWN BANK
P.O. BOX 250
SHIPPENSBURG PA 17257-0250
RE: ESTATE OF Martha C Blanchard DECEASED
DATE OF DEATH: February 28, 2003
IT IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT HAD, ON THE ABOVE DATE, THE
FOLLOWING ACCOUNTS WITH ORRSTOWN BANK:
(1)
CHECKING ACCOUNTS
ACCOUNT NO. TITLE OF ACCOUNT
DATE OPENED
DATE OF DEATH
PRINCIPLE & ACCRUED INTEREST
(2)
SAVINGS ACCOUNT
ACCOUNT NO. TITLE OF ACCOUNT
DATE OPENED
DATE OF DEATH
PRINCIPLE & ACCRUED INTEREST
(3)
CERTIFICATES OF DEPOSIT
ACCOUNT NO.
TITLE OF ACCOUNT
DATE OPENED
DATE OF DEATH
PRINCIPLE & ACCRUEDINTEREST
60061436 Martha C Blanchard 7/24/98 9,781.23 1 °60
Emily Geschwindt
5060056437 Martha C Blanchard 12/16/96 9,000.00 27.37
John Geschwindt
5060058942 Martha C Blanchard 9/23/97 22,000.00 5.27
John Geschwindt
5060060037 Martha C Blanchard 1/13/98 14,628.54 23.04
John Geschwindt
5060060038 Martha C Blanchard 1/13/98 29,000.00 14.90
John Geschwindt
Date: 3/26/03 By: Timothea Customer'Service Operator
P.O. BOX 250 ¢ SHIPPENSBURG? PA 17257 o TEL (7!7) 532-6114
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 00262O
LENOX DAVID J ESQ
305 ROBIN HOOD RD
DILLSBURG, PA 17019
........ fold
ESTATE INFORMATION: SSN: 183-09-9224
FILE NUMBER: 2103-0236
DECEDENT NAME: BLANCHARD MARTHA C
DATE OF PAYMENT: 05/28/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 02/28/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $2,827.28
REMARKS:
TOTAL AMOUNT PAID:
DAVID J LENOX ESQUIRE
$2,827.28
SEAL
CHECK# 1142
INITIALS: VZ
RECEIVED BY.'
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Date of Death:
Will No. ,~l
Admin. No.
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with
respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes ,--"" No
2. If the answer is No, state when the personal representative reasonably believes that the
administration will be complete:
If the answer to No. I is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes No ;J
b. The separate Orphans' Court No. (if any) for the personal representative's account is:
c. Did the personal representative state an account informally to the parties in
interest? Yes v'" No
d. Copies of receipts, releases, joinders and approvals of formal or informal accounts
may be filed with the Clerk of the Orphans' Court and may be attached to this report.
m :' ~- Name (Please type or print)
Z. 60. t ma- . 5+.
Address
~,-~' Tel. No.
::., ..~
~ ¢.~ Capacity: Personal Representative
~ Counsel for personal
representative
Date:
BUREAU OF TNDIV/DUAL TAXES
ZNHERTTANCE TAX DZV[S~ON
DEPT. ZB0601
HARRTSBURG, PA 17118-0601
DAVID J LENOX ESQ
WILEY GROUP
I S BALTIMORE ST
DILLSBURG
R~:~','::. COMMONNEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF ZNHERITANCE TAX
APPRAZSEMEI~IT, AU~O#ANCE OR DISALLONANCE
'0~ ,i~ BE-~UC~I~ ~,ND ASSESSMENT OF TAX
PA 17019
DATE 07-07-2003
ESTATE OF BLANCHARD
DATE OF DEATH OZ-Z8-ZO0$
FZLE NUMBER 21 05-0156
COUNTY CUMBERLAND
ACN 101
Amount Rem/fred
REV-ISgi7 EX AFP (01-05)
~ :,., MARTHA C
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BLANCHARD MARTHA C FILE NO. 21 05-0256 ACN 101 DATE 07-07-2003
TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERN]:NG FUTURE INTEREST - SEE REVERSE
APPRAZSED VALUE OF RETURN BASED ON:
1. Reel Estate (Schedule A)
2.
$.
5.
6.
7.
8.
ORIGINAL RETURN
(1)
Stocks and Bonds (Schedule B) (2)
Closely Held Stock~Partnership Interest (Schedule C) ($)
Mortgages/Notes Receivable (Schedule D) (fi)
Cash/Bank Deposlts/Misc. Personal Property (Schedule E) (5)
Jointly Owned Property (Schedule F) (6) 75;116
Transfers (Schedule G) (7)
Tote1 Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adc. Costs~Misc. Expanses (Schedule H)
10. Debts/Mortgage Liabilities~Liens (Schedule 1)
11. Total Deduct ions
12. Nat Value of Tax Return
1:5.
lq.
(9)
(10)
Charitable/governmental Bequests; Non-elected 911:5 Trusts (Schedule J)
Nat Value of Estate Subject to Tax
O0 NOTE: To insure proper
O0 credit to your account,
O0 submit the upper portion
O0 of this fore with your
O0 tax payment.
.q7
O0
(8)
8,981.31
.00
NOTE:
75,116.q7
(11) 8.98!
(12) 66,135.16
(1:5) . O0
(1~) 66,1:55.16
Zf an assessment ~as issued previously, lines 14, 15 and/or 16, 17,
re~lect ~igures that include the total o~ ALL returns assessed to date.
18 and 19 wlll
(15) .00 X O0 = .00
(16) 66,135.16 X Oq5= 2,976.08
(17) .00 x ZZ = .00
(18) .00 x 15 = .00
(19)= 2,976.08
ASSESSMENT OF TAX:
15. Amount of L/ne lq at Spouse1 rata
16. Amount of Line lq taxable at Lineal/Class A rata
17. Amount of Line lq at Sibling rata
18. Amount of Line lq taxable at Collateral/Class B rata
19. Principal Tax Due
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT
DATE NUMBER INTEREST/PEN PAID (-)
05-28-2005 CD002620 lq8.80
ZF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDZTZONAL INTEREST.
AMOUNT PAID
2,827.28
TOTAL TAX CREDZT 2,976.08
BALANCE OF TAX DUEI .00
INTEREST AND PEN. .00
TOTAL DUE .00
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS RE~UZRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SZDE OF THIS FORM FOR INSTRUCTIONS.)
RESERVATION:
Estates of decedents dying on or before December 1Z, 198Z -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collataral) beneficiaries of the decedent after tho expiration of any estate for
life or for years, the Commonaaalth 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:
To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act 25 of ZOO0. (TI P.S.
Section 9140).
PAYMENT:
REFUND [CR):
OBJECTIONS:
ADNZN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
Detach the top portion of this Notice and submit aJth your payment to tho Register of Nills printed on tho reverse side.
--Hake check or money order payable to: REGISTER OF NILES, AGENT
A refund of a tax credit, ahich ams not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" [REV-ISIS). Applications are available at the Office
of the Register of Nills, any of the ZS Revenue District Offices, or by calling the special Z4-hour
anseering service for fores ordering: z-eoo-s6Z-205O~ services for taxpayers with special hearing and / or
speaking needs: l-BOO-447-SOZO (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax [including discount or interest) as sheen on this Notice oust object mithin sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. ZBlOZ1j Harrisburg, PA 171lB-lOll, 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 Taxesj ATTN: Post Assessment Review Unit~ Dept. Z80601, Harrisburg, PA 171Z8-0601
Phone (717) 787-6505. Sea page 5 of tho booklet "Instructions for Inheritance Tax Return far a Resident
Decedent" (REV-IS01) for an explanation of administratively correctable errors.
If any tax due is paid within three (S) calendar months after the decadent's death~ a five percent (SI} discount of
the tax paid is allowed.
Tho 15Z tax aanast~ 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 end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in tho the same tiaa period as you would appeal tho tax and interest
that has been assessed as indicated on this notice.
INTEREST:
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day free the data of
death, to the date of payment. Taxes which became delinquent before January l, 198Z bear interest at tho rate of
six (6Z) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January 1, 198Z will bear interest at a rate which wilt vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2003 ara:
Interest Daily Interest Deity Interest Daily
Year Rate Factor Year Rate Factor Year Rata Factor
1982 ZOZ .O005q8 1987 9Z .000Z47 1999 7Z .OOO19Z
1983 16Z .0004S8 1988-1991 llZ .O00S01 logo ex .000219
1984 llZ .000301 199g 9Z .000247 2001 9Z .000247
1985 1SI .000356 1993-1994 7Z .00019Z ZOOZ 6Z .000164
1986 IOZ .000Z74 1995-1998 9Z .000Z47 ZOOS 52 .O00lS7
--Interest is calculated as follous:
INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent mill reflect an interest calculation to fifteen [153 days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.