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HomeMy WebLinkAbout03-0249 PETITION FOR PROBATE and GRANT Estate of Ruth A, Pc;Pr.? No. also known as To: Deceased. Social Security No. OF LETTERS Register of Wills for the County of Cumberland Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut in the last will of the above decedent, dated h~ovember '14, and codicil(s) dated in the named ,19 c)l (state relevant circnmstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with h er last famdy or pnnc~pal residence at Mos s a_ah V~ 2] age .. ] 00 ~,t. A ] ] an Drive, Mechanicsburg, PA 170~ (Upper Allen To~qnah~p) (list street, number and muncipality) Decendent, then 8g years of age, died March 6, 2003 , l~. ., at Messiah Village, Hechaniosbur~.. PA 170~_~ Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent 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 Pennsylxania $ situated as follows: r~one 7~000.00 WHEREFORE, petitioner(s) respectfully request(s) the probate of~d codicil(s) presented herewith and the grant of letters of administration~a. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. Patricia Per~'y 2630 North Rosegarden Blvd. Mechanicsbur~, PA 170~g OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA 3 COUNTY OF CUI~93~LAND f 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/qf petitioner(s) a~nd that as personal represen- tative(s) of the above decedent petitioner(s)will Tell/~ruly adm~ the estate according to law. Sworn to or affirmed and subscribed r before me this ~-~0 ~v~ day of March ~ ~ 200~ No. ~1- 0~- 2MQ. Estate of RUTH A. PERRY , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW March ~ I the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated November 14s 1991 described therein be admitted to probate and filed of record as the last will of Ruth A. Perry c~j~_~' and Letters Of administration ~~..d.T.A. are hereby granted to Patricia Perry :1~003, in consideration of the petition on FEES Probate, Letters, Etc .......... $ !!,~_ ,O,~ Short Certificates( ) .......... $ ~. tgO Renunciation ................ $ ~, o O L~.oo TOTAL __ $ J~. O~ Filed ...~7.~ t 7..~.~ ................ _ _ ' Register of wills ~.~-. ~ ~~ J. Robert Stauffer-No. 06356 ATTORNEY (Sup. Ct. I.D. No.) Market Square Bldg. Mechanicsburg~. PA 1705g ADDRESS 717 -766-9673 PHONE RENUNCIATION In Re Estate of RUTH A. PERRY deceased. To the Register of Wills of Cumberland County, Pennsylvania. The undersigned m~m~d as Exe. c~t~qw of the Last ?fill and Testament of the above decedent, hereby~n~)~e(s) the right to administer the estate and respectfully ask(s) that Letters be issued to PATRIC~A PERRY WITNESS m~T hand this f~_ day of March ,~1~ 2003.. (Signature) Linda Ann Aulds 7b~l~ ~'~ountain Oak San Antonio, Texas 78233 (Address) (Signature) (Address) (Signature) (Address) LAST WILL AND TESTAMENT OF RUTH A. PERRY I, RUTH A. PERRY, of the Township of Hampden, County of Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all prior Wills by me at any time heretofore made~ I direct the payment of all my Just debts and funeral expenses as soon after my decease as the same can be conveniently done, and in this respect, I further direct that all estate, inheritance and succession taxes that may be assessed in consequence of my death, of whatever nature and by whatever Jurisdiction imposed, shall be paid out of the principal of my general estate to the same effect as if said taxes were expenses of administration and all property includable in my taxable estate whether or not passing under this Will shall be free and clear thereof. I give, devise and bequeath all the rest, residue and remainder of my estate, real, personal and mixed, whatsoever and wheresoever the same may be situate, to my daughter, LINDA ANN AULDS, and to my daughter-in-law, PATRICIA PERRY, share and share alike, per stirpes. -1- LASTLY, I nominate, constitute and appoint my daughter, LINDA ANN AULDS, Executrix of this my Last Will and Testament, and direct that she be excused from posting bond or other security, in this Jurisdiction or any other Jurisdiction, for the faithful performance of her duties. IN WITNESS WHEREOF, I have hereunto set my hand and seal this /~//~day of November, A. D., 1991. Ruth A. Perry (SEAL) Signed, sealed, published and declared by the above named, RUTH A. PERRY, as and for her Last Will and Testament, in the presence of us, who have subscribed our names hereto as witnesses, at the request of said testatrix, in her presence and in the presence of each other. -2- CO~ONWEALTH OF PENNSYLVANIA ) COUNTY OF CUMBERLAND ) SS. I, RUTH A. PERRY , the testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according Co,.law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and volun- tary act and deed, for the purposes therein contained. Sworn and affirmed to and acknowledged before ~UTH A. PERRY , the testatrix , this day of November , a. D., 1991. COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND We, the undersigned, J. ROBERT STAUFFER and RUTH ANN ~JLWID~ , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the testat rix , RUTH A. PERRY , sign and exe- cute the instrument as~/her Last Will and Testament; that the said testat rix , RUTH A~ P}~RR¥ , executed it as ~/her free and voluntary act,.for the purposes ~herein expressed; that each of us, in the hearing and sight of the testa~Pix , signed the Will as witnesses; and that to the best of our knowledge, the testat~ was, at the time, eighteen (18) or more years of age, of sound mind, and under no coJstraint, duress or undue influence. me ~his /¢~,~ day of ' Novembe~ , 1991 · LAST WILL AND TESTAMENT OF RUTH A. PERRY j. ROBERT STAUFFER ATTOBNEY AT LAW MARKET S~uAP~ BUILDr~I'~ MECHANICSBURG, PA. 17055 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 002495 STAUFFER J ROBERT ESQUIRE MARKET SQUAR BUILDING MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN: 179-12-3540 FILE NUMBER: 2103-0249 DECEDENT NAME: PERRY RUTH A DATE OF PAYMENT: 04/25/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUM BERLAN D DATE OF DEATH: 03/06/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $2,500.00 TOTAL AMOUNT PAID' $2,500.00 REMARKS: PATRICIA PERRY C/O J ROBERT STAUFFER ESQUIRE SEAL CHECK# 1002 INITIALS: SK RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS Name of Decedent: CERTIFICATION OF NOTICE UNDER RULE 5.6(a) ~UT_H A. P~,~RY Date of Death: March 6, 2003 Will No. 2003-00249 Admin. No. 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 Name Address Linda Ann Aulds-71~l~ Mountain Oak, San Antonio, Texas April 1, 2003 : 78233 Patricia Perry-2630 North Rose~zarden Blvd.~ Mechanicsburg~ PlY 170~5 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Nolle Date: April 2, 2003 Signature Name J · Robert Stauffer Address Market Square BldE. Mechan~csburg, PA 17055 Telephone ~'l ?)-- 766 -9673 Capacity: Personal Representative X .Counsel for personal representative 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 002814 STAUFFER J ROBERT ESQUIRE MARKET SQUARE BUILDING MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN: 179-12-3540 FILE NUMBER: 2103-0249 DECEDENT NAME: PERRY RUTH A DATE OF PAYMENT: 07/17/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 03/06/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $337.68 TOTAL AMOUNT PAID: $337.68 REMARKS' PATRICIA A PERRY C/O J ROBERT STAUFFER ESQUIRE SEAL CHECK//1007 INITIALS: SK RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS GOMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT, 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 2 1_ 03 DO 24 9 COUNTY CODE YEAR NUMBER I-- Z LU UJ I- Z U.I ,-1 Z O IAI m, O W r~ DECEDENFS NAME (LAST, FIRST, AND MIDDLE INITIAL) PERRY, Ruth A. DATE OF DEATH (MM'-DD-YEAR) March 6, 2003 DATE OF BIRTH (MM-DO-YEAR) October 26, 1917 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER N/A - - []2. Supplemental Return []4a. Future Interest Co~npromise (dale o1 dealh alter 12-12-821 []7. Decedent Maintained a Living Trust (Atlach copy of Trust) ] 10. Spousal Povedy Oedit (dale o! dealh between 12-31-9t and 1-1-951 ~]1. Original Return []4. Limited Estate []6. Decedent Died Testate (Atlach copy o1Will) ~]9. Litigation Proceeds Received SOCIAL SECURITY NUMBER 179- 12 - 3540 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS ] 3. Remainder Return (date of death priorlo 12-13-821 [~5. Federal Estate Tax Return Required O 8. Total Number of Safe Deposit Boxes [~11. Election to tax under Sec. 91131A) (Attach Sch O) :ii'HiS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CoNFIDENtlAL-~,rjlo( IN~INIJL~N ~i~lff;FF.BE~eiD~A~ COMPLETE MAILING ADDRESS Market Square Bldg. Mechanicsburg, PA 170~ NAME O x .0 J. Robert Stauffer FIRM NAME (l~plicable) TELEPHONE NUMBER 717 -766 -9673 Char. liable 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 131 1, Real Estate (Schedule A) 111 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) lEI 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 & Adminislrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 1101 11. Total Deductions (tolal Lines 9 & 101 12. Net Value of Estate (Line 8 minus Line 111 13, 14. SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES Amounl of Line 14 taxable al the spousal tax 15. 65,037.25 x.0__ O x .12 rate, or transfers under Sec. 9116 (a)11.21 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due r-.7 0;00 oi:oo 74,201.79 0, O0 0.00 OFFICIAL USE ONLY ¢) 74,201.79 2,54 . 5 ~.817.69 1111 8,364.54 1121 65,837.25 1131 0. O0 1141 65,837.2.5 O x .15 1151 0. O0 1161 2,962.68 1171 0. O0 1181 0 ,, O0 1191 2,962.68 Decedent's Complete Address: tSIREETADDRESS Messiah Villag~e 100 Mt. Allen Drive CIIY r.%echanicsburg ISTATE PA zip Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 0.00 2,500.00 125.00 InterestJPenalty if applicable D. Interest 0.0 0 E. Penalty 0. O0 (1) Total Credits ( A + B + C ) (2) Total InterestJPenalty ( D + E ) 4, If Line 2 is greater than Line 1 + Line 3, enter tile difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to reques! a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. TI]is is the TAX DUE. (3) (4) (5) (5A) (5B) 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 2,962.68 2,625.00 0.00 0.00 337.68 0.00 337.68 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 properly transferred; .......................................................................................... [] [] b. retain the right to designate who shall use the properly transferred or its income; ............................................ [] [] b. 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 perjury, I declare that I have examined this return, including accompanying schedules and slatemenls, and to the best of my knowledge and belief, it is true. correct and complete. Declaration of pre,~r other than the personal r~sentative is based on all information of which preparer has any knowledge. $1GN~ATUR~/~/PER~ON RESPON~B~E FOR FILING RETURN ADDRESS ~ / 2630 North Rosegarden Boulevard, Mechanicsburg, SIG ~'~ E EP RE TH __ IHAN REPRESENTATIVE AD S' ' ~/ Market Sq~re Bldg.~ Mechanicsburg~ DATE PA~17055 DATE 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 RS. §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 RS. §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; 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 paren~ 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 ~o 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 a' individual who has at least one parent in common with the decedent, whether by blood or adoption. all rst' Division of M&T Bank Alll'irst Financial (]enter N.A. I~(). ]),()x ~)00 Iklillsb~)ro. I)F; April 23, 2003 J. Robert Stauffer Attorney-At-Law Market Square Building 1 West Main Street Mechanicsburg, PA 17055 RE: Estate of Ruth A. Perry Date of Death: March 6, 2003 Social Security Number: 179-12-3540 Dear Mr. Stauffer: In response to your request, please be advised of the following accounts the above- named decedent had with this bank and the balances on the date of death. Account Type ........................... Relationship Checking w/Int. Account Account Number ....................... 0080140122 Ownership (Names of) ............... Ruth A. Perry Opening Date ............................ 09/26/97 Balance on Date of Death ........... $ 212.66 Accrued Interest ....................... 0.06 Total ...................................... $ 212.72 Account Type ........................... Money Fund Alt. Account Account Number ....................... 0098120247 Ownership (Names of) ............... Ruth A. Perry Opening Date ............................ 03/25/97 Balance on Date of Death ........... $ 73,418.34 Accrued Interest ....................... 46.39 Total ...................................... $ 73,464.73 ® Page 2 April 23, 2003 This response does not apply to any assets held with Allfirst Brokerage, where Allfirst Bank is serving as a trustee, nor to any credit cards owned by Bank of Amerfca bea~ng Allfirst Bank's name. For further account information, closures and/or reimbursement of funds refer to below branch. 1200 Market Street, Lemoyne, PA 17043, telephone 717-255-2271. Sincerely, Mary Anne Macielag Associate I/CIS (302) 934-2240 ESI'AlE OF SCI IEIJULE E CASI I, DANK DEI'OSI IS, & MISC. PERSONAL IIFM r,.F_ NUM~En 21_03_0249 ...... .............................. F 0_o_3_-. o_o_~_4 9_ I )1 ;;t :RII'Ill)II .,SLL.PIRST ]3A]'~, Checking Account No. 00~01~1.0~22. ALLFZR8T DA~ Mone~ ~u. nG Albe~r]~ive Accoun~ No. 0098120247 , Interest accrued to March 6, 2003. Cash on hand. IOI^L (Also euler o. line 5, Recapilulalion) VALUE Al DAlE OF DEATII 212.72 73,4~8.34 ll-6.39 5a4.34 $ 74,201.79 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER 21- 0.3- 0249 RUTH A. PERRY 2005_00211.9 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. 10. 11. FUNERAL EXPENSES: DESCRIPflON Pre pa id. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: AflomeyFees J. Robert Stauffer, Esq.,~ attorney fee. Family Exemption: (If decedenrs address is not the same as claimant's, attach explanation) Claimant Street Address City State __ Zip Relationship of Claimant to Decedent Probate Fees Register of Wills of Cumberland County, Penn- sylvania, letters Testamentary. Accountant's Fees 3'ax Return Preparer's Fees Cumberland Law Journal, Estate Notice. The Sentinel, Estate Notice. Gingrich Memorials, lettering cemetery monument. Register of Wills, filing Inventory and Pennsylvania Inheritance Tax Return. Register of ~z]..ls, filing Account. TOTAL (Also enter on line 9, Recapitulation) AMOUNT 2,000.00 145.oo 75. oo 91.85 100. O0 25.00 11o.oo $ 2,546.85 (If more space is needed, insed additional sheets of the same size) MESSIAH VILLAGE 100 Mt. Allen Drive P.O. Box 2015 Hechanicsburg, PA 170552015 (717) 697-4666 Resident: Date RUTH A PERRY PATRICK ARTER, JR. I HUNTER LANE CAMP HILL, PA 17011 STATEMENT Resident Number Date 000109607 03/31/2003 Page Amount Due 1 5,658.00 Discharge Date 03/06/2003 Description Charges ] Credits ] Total 03/01/2003 Beginning Balance ROOM & BOARD - SEMI-PVT 5 DAYS AT 171.00 PER DAY 855.00 4,803.00 5,658.00 Current Past 31-60 Days 61-90 Days 91-120 Days Over 120 Total Due fi Due 855. O0 4,803. O0 O. O0 O. O0 5,658. O0 1% FINAl,lANCE CHARGE A ~ ~-R APRIL 30. 2003 Statement End Date: 03/31/2003 SCHEDUI_E I DEL]TS OF DECEDENT, MOR1GAGE LIAI31LIlIES,. & LIENS JllcltJcJe tllilolfllhlllsml melli(:,~l I1 F._M NUMBER I)E?,CI]II'I I()11 ?aul D. ])alt)y, DJ?M, Doctor charges. Internists, medical bill. Phar America, pharmacy charges. Messiah Village, February and March 2003 care. Mobile X-ray Imaging, Inc., X-rays. 'TOl AL (Also enter on line 10, Rec;apit.lation) ........................ (~[-[l~;-e~-~.'l~-i~ i~,'],m], i[~.~ed addiliolml sheets of tim same size) AMOUtlT $ 32.00 8.23 103.47 5,658.oo Z5.99 5,817.69 REV-1513 EX * (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ~UTtT A. SCHEDULE J BENEFICIARIES FILENUMBER 21-03-0249 PER R¥ 2003 - 00249 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS (include outright spousal distributions) NUMBER e II. 1. LINDA ANN AULDS 7l~15 Mountain Oak San Antonio, Texas 78233 PATRICIA PERRY 2630 North Rosegarden Boulevard Mechanicsburg, PA Daughter. Unr emarr i e d daughter-in-law. One-half of total estate. 0ne-half of total estate. ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART l!- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insed additional sheets of the same size) I.ventory of the real a.d pe~so.al estate of RUTH A. P.~RRY deceased (1) ALI,FIRST BANK, Checking Account No. 00801~0122. (2) ALI~IRST BANK, Money Fund Alternative Account No. 0098120247. Interest accr~.~ed to I~arch 6, 200~. (3) Cash on hand. Total ........... ~ I 212172 7~, 4181 ~4 ~ 524/34 74, ~ol 179 COMMONWEALTli OF PENNSYLVANIA COUNTY OF CUMBERLAND SS: Patr.~cia Perry being duly ....... _~wo.r_n ..... eccord[ncj to law, deposes and says fhafShe is the Executrix late of .... Upper Allen Township , Cumberland County, Pa., deceased and that the within is an inventory mnde ~y ]~b~io[~ ~e~r~ .... the said ~_~_g]~_~ of the entire estate of said decedent, consisih~q of all fha personal property and real estate, except real estate outside fha Commonwealth of Pennsylvania, end thai the figures opposite each ilem of fha Inventory represent it's fair value as of the date of decedenl's death. Sworn and subscribed before me, . -~~-'~~ ................ 2630 North Rosegarden Boulevard I',Iqoh~ag~=o_s__b_._u__r_g,_, PA 17055 Address Date of Death ...... 6th March Day 2003 INSTRUCTIONS I. An inventory must be filed within three months after appointment of personal represenfatlve. 2. A supplement inventory must be filed withln thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personally or realty 4. See Article IV, Fiduciaries Act of 1949. , O UREAU OF INDIVIDUAL TAXES TNHERTTANCE TAX DIVISION DEPT. 280601 HARRTSBUR(~, PA 171Z8-0601 J ROBERT STAUFFER MARKET SQ BLDG MECHANICSBURG CONNONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-16,~7 EX AFP (01-05) ,:PA 17055 DATE 08-25-2005 ESTATE OF PERRY RUTH DATE OF DEATH 0:3-06-2005 FILE NUNBER 21 0:3-0249 COUNTY CUMBERLAND ACN 101 Aaoun~ Rami~ed MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF MILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 1701:3 A CUT ALONG THIS LINE ~ RETAIN LONER PORT]:ON FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLO#ANCE OR DISALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF PERRY RUTH AFILE NO. 21 03-0249 ACN 101 DATE 08-25-2003 TAX RETURN NAS: (X) ACCEPTED AS F/LED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es~a~o (Schadulo A) (1) 2. S~ocks and Bonds (Schedule B) (2) 3. Closely Held S~ock/Par~norship Zn~ores~ (Schedule C) ($) 4. Hor~gagos/No~os Roco/vabla (Schedule D) (4) E. Cash/Bank Deposits/Misc. Personal Propor~y (Schedule E) (5) 6. Jointly Owned Propar~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To,al Assa~s APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expanses/Ada. Cos~s/Hisc. Expenses (Schedule H) (9) 10. Deb~s/Nor~gaga Liabilities/Liens (Schedule 1) (10) 11. To,al Daduc~/ons 12. No~ Value of Tax Ra~urn .00 .00 .00 .00 74~201.79 .00 .00 (8) 2,546.85 NOTE: To insure proper credi~ ~o your account, submi~ ~he upper portion of ~his fora wi~h your ~ax payaan~. 13. 14. NOTE: ASSESSMENT OF TAX: 15. Aeoun'l' of Line 14 a~ Spousal ra~e 16. Amoun'l: of Line 14 ~axable a~ L/noel/Class A ra~e 17. Amount of LAne 1~ a~ Sibllng ra~e 18. A.oun~ of Line 1~ ~axable a~ Collateral/Class B ra~e )al Tax Due 19. Princi TAX CREDITS PAYIIFNT DATE 04-25-200:3 07-17-200:3 74,201.79 (la), .00 X O0 = .00 (16) 65,8:37.25 x 045 = 2,962.68 (17) . O0 X 12 = . O0 (lS), .00 X 15 = .00 (19)= 2,962.68 KECEZPT NUHBER CD002495 CD002814 ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. DISCOUNT INTEREST/PEN PA/D (-) 1:31.58 .00 AMOUNT PAID 2,500.00 :337.68 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 2,969.26 6.58CR .00 6.58CR ( 1F TOTAL DUE 1S LESS THAN $1, NO PAYHENT 1S REQUIRED. ZF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SZDE OF THIS FORM FOR /NSTRUCTIONS.) Chari~abla/Governaen~al Bequests; Non-elec~ad 9113 Trusts (Schedule J) (1:3) . O0 Ne~ Value of Es~a~:e SubSec~ ~o Tax (14) 65,857.25 Z~ an assessment was issued previously, lines 14, 15 and/er 16, 17, 18 and 19 ~ill re~lect ~lgures that include the total of ALL returns assessed to date. 5,817.69 (11) 8.36q.;~ (lZ) 65,8:37.25 RESERVATION: Estates of decadents dying on or before December 1Z, 1981 -- if any future interest in the estate is transferred in possession or enjoyment to Class S (collataral) 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 S (collatmral) rate on any such future intmrast. PURPOSE OF NOTZCE: PAYHENT: REFUND (CR): OBJECTIONS: ADNZH- ISTRATIVE CORRECT/OHS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of ZOO0. (71 P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of #ills printed on the reverse side. --Hake check or money order payable to: REGISTER OF MILLS, AGENT A refund of a tax credit, which ems not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-IS15). Applications era available at the Office of tho Register of Rills, any of the 15 Revenue District Offices, or by calling tho special Z4-hour answering service for forms ordering: 1-800-561-ZOS0; services for taxpayers with special hearing end / or speaking needs: 1-BOO-4q7-50ZO (TT only)o Any party in interest not satisfied with the appraisement, allowance, 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: --written protest to the PA Department of Revenue, Board of Appeals, Dept. ZBIOZ1, Harrisburg, PA 17118-1011, 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 assesslent should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. Sea page 5 of the booklet "[nstructions for Inheritance Tax Return for a Resident Decedent" (REV-lBO1) for an explanation of administratively correctable errors. [f any tax due is paid within three (5) calendar months after the dscadant's death, a five percent (51) discount of the tax paid is allowed. 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 tiaa period as you would appeal the tax and interest that has been assessed as indicated on this notice. [ntarast 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, 1981 bear interest at the rate of six (61) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1981 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1981 through Z005 ara: interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 198Z ZOZ .000S48 1987 91 .000147 1999 71 .000191 1983 16Z .000¢$B 1988-1991 llZ .000501 ZOO0 8Z .000Z19 1984 11Z .000501 1992 91 .000247 ZOO1 91 ,000247 1985 13Z .0005S6 1993-1994 71 .000191 ZOOZ 6Z .000164 1986 /OX .000274 1995-1998 91 .000247 2003 SZ .000137 --Interest is calculated as follows: TNTEREST = BALANCE OF TAX UNPATD X NUNBER OF DAYS DELTNQUENT X DATLy TNTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation data shown on the Notice, additional interest must ba calculated. FIRST A~r]) ];'II'~A.L ACCOI]I.~!i? OF PAq.'ITICIA PEtit{Y, ADHI_~.~ISTRATRIX C.T.A. f,)t;' ']'YE ESTATE OF RI?.['H A. PF,]';t:t¥, LATE OF T',I'E TO!rNS]!iP OF UPPER ALI,E;~!~ COU1T~.['Y ()F CUfH3EI:ILAITD A~'~D STATE O? PENNSYI.,VAI{IA~ DECEASED. I)ate of Death: I'.?arch 6, 2003. Dates of Adverbisement of I,etters of Administration. In the Cumberland Law Journal: April Il., 11 and 18, 2003. ]in The Sentinel: March 27 and April 3 and 10, 2003. ?] ~ I I,ICTI; PA L A C C OU fit Debits Accountant charges herself with the following receipts and assets of decedent's estate, consisting entirely of personalty as follows, bo wit: qo3_ 3/6 Allfirst Bank, Checking Account No. 0080140122. $ 3/6 Allfirst Bank, Money Fund Alternative Account No. 0098120247. Interest accrued to March 6, 2003. Cash on Hand. 3/6 GROSS ~2!UCIPAL ASSETS A%U) RECEIPTS ...................... $ 212.72 73,4~8.34 46.39 524.34 74,2Ol.79 PRINCIPAL ACCOUNT Credits Accountant asks Credit for the following items paid out of Principal in the Settlement and Administration of decedents estate, to wit: 200~ 3/21 3/21 3/21 4/lO 4/i8 1r/22 Register of Wills, Letters Testamentary. Cumberland Law Journal, Estate Notice. Paul D. Dalby, DPM, Doctor charges. Internests, medical bill. Messiah Village, February and March 2003 care. Phar America, pharmacy charges. i45.oo 75.oo 32.00 8.23 5,658.00 103.47 -1- ifc t' PA Ii, A C C OUN T Credits 2oo_.! 4/29 ~/2 6/3 7/~7 7/17 '.l.U:~e Semti. nel, Estate ITot~.ce. Register of lfi!ls, Agert, pa~uent o~ accouter of Pennsy].va~ia I~heri. t~nce Tax, Gingrich ~iemor:~_als, Letterim~cemetery monument. Hobile X-ray Imaging, Inc., X-rays. I.,inda Ann A~.~lds, advance on legacy. Patr~cia Perry, adva~'~ce o~ ].egac~. Register of Wills, fi]_~i, ng Inventory and Pemnsy!va~].a I.nheri. tance Tax Pet~rn. Register of Wi. lis, Agent, pa~nnant o~ accoun6 of Pe~usylvania Inheritance Tax. J. Robert Stauffer, Esquire, attorney fee. Cash, reserved to preparation of final fiduciary tax return amd comtingeucies. Register of Wills, filing account. TOTAL PRINCI PAL EXPENDITURES ............................ $ 2,500.00 100. O0 15.99 20,000.00 20,000.00 2S. oo 337.68 2,000.00 500.00 110.00 ,~1. 702.22 RECAPITULATION GROSS PRINCIPAL ASSETS A~.~) RECIEPTS. LESS: PRINCI PAL EXPENDITURES. BALANCE IN HANDS 0F ACCOUNIAN5 I0R DISTRIBU'ffION ........ . 74,201 79 51,702[22 22 -2- SCtIEI)UI..~C OF PRO POSED DISTRIBUTION Sugi!;est~_on is ~lade tt'~at the balance in hands of Accountant for Distribution, to wit, the sum of $22,].~99.~7, be made in Cash to decedent's daughter, LINDA ANN AULDS and to her daughter- in-law, PATi'~ICIA PEIi].~?f, in two (2) equal shares in accordance with item "2." of her LAST WILL AND TESTAI'IENT, an therefore Distribution is proposed as follows: Cash, to LINDA AIfN AULDS, decedent's daughter. Cash, to PATRICIA PERRY, decedent's daughter- in-law. $ 11,249.785 11,2[~9. 785 22,4 9.5..7 -3- COUNTY 0]? CUI,~BI'.]]~I.,AND ) Personally appeared before me, the und. ersigned officer, a Notary Public, in and for said Commonwealth and County, ?ATt~ZCIA ?EI'{RY, Administratrix, C.T.A. of the Estate of ~II!I'U A. P~R¥, ].ate of the Township of Upper Allen, County of C~lml0erland and State of Pennsylvania, deceased, ~,~ho being duly sworn accordi..ng to law, deposes and states, that she is 'the Accountant in tl~o annexes Account and. that said Account is true and correct to the best of her knowledge, information and be].ief, and t?~at there are t~o unpaid creditors to be notified of this Account and the day of proposed decree of confirmation has been given to ali. parties who have an interest in the estate as beneficiaries and deponent further avers that the foregoing Schedule of Proposed Distribution of the net assets of the estate of ]]UTtI A PERRY, deceased, is true and correct and is made in accordance ~.ri. th the provisions of said. decedent's Last I'[ill and Testament and the laws of the Commonwealth of Penns.y].vania, apulicable t~ereto. Patric~a P~ry Sworn and subscribed before me this ~ day of September, A. D., 2003. Notary Public COMMONWEALTH OF PENNSI. VAN!A .. LAST WILL AND TESTAMENT OF R~rTIt A. PERR~ I, RUTH A. PERRY, of the Township of Hampden], County of Cumberland and State of Pennsylvs. n[a, being of sound a~d disposing mind, memory and understanding, do m~ke, publish and declare this my Last Will and Test~men't, hereby making void any and all prior Wills b2 me ~,~ a~y time hereto.~ore made. I direct the payment of all my Just debts and funeral expenses as soon after my decease as the same cs.n be conveniently done, and in this respect, I fur~her direct that all estate, inheritance and succession taxes that may be assessed in consequence of my death, of whatever nature and b~ whatever jurisdiction imposed, shall be paid out of the principal of my general estate to the same effect as if said taxes were expenses of adm~.nistratioD and all property includable in my taxable estate whether or not passing under this Will shall be free and clear thereof. e I give, devise and bequeath all the rest, residue and remainder of my estate, real, personal a~t]d mixed, whatsoever and wheresoever the same may be situate, to ~.7 daughter, LI~tDA AULDS, and to my daughter-in-law, FATMICIA PERRY, sh~.re ~.nd share alike, per stirpes. -1- LASTLY, I nominate, constitute and appoint my daughter, LINDA ANN AULDS, Executrix of this my Last Will and Testament, and direct that she be excused from posting bond or other security, in this Jurisdiction or any other Jurisdiction, for the faithful performance of her duties. IN WITNESS WHEREOF, I have hereunto set my hand and seal this /Z~/~/day of November, A. D., 1991. Ruth A. Perry ( SEAL ) Signed, sealed, published and declared by the above named, RUTH A. PERRY, as and for her Last Will and Testament, in the presence of us, who have subscribed our names hereto as witnesses, at the request of said testatrix, in her presence and in the presence of each other. COMMONWgALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS, I, RUTH A. p~RRy , the testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to.law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and volun- tary act and deed, for the purposes therein contained. Sworn and affirmed to and acknowledged before RUTH A. PERRY , the res[at rix , this day of November , A. D., 1991. COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF CUMBERLAND ) SS. Member, Pennsylvania A%odc;ion o[ ~ We, the undersigned, J. ROBERT STAUFFER and RUTH ANN FULWIDER _, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the testat rix , RUTIt A, PERRY , sign and exe- cute the instrument as~/her Last Will and Testament; that the said testat rix , RUTH A~ PERRY , executed it as ~b~/her free and voluntary act,,for the purposes therein expressed; that each of us, in the hearing and sight of the testatrix , signed the Will as witnesses; and that to the best of our knowledge, the testat.~ was, at the time, eighteen (18) or more years of age, of sound mind, and under no co~straint, duress or undue influence. Sworn and subs¢;lbed to before me this .. /~;'~ day of · Novembe1~ ' 1991. Mombc~; Pci]ns:,'lvania AssccialJoa of Notariee It0. 2003-00249 IhT RE: F_I_RST A'iTD FESTAL ACCOUNT OF PATRICZA PERRY, ADMI~TISTRATRIX C.T.A. OF THE ESTAT.E ~OF RUTH A LATE OF TItE TOUNSHIP OF UPP]~. ALLEN, COUNTY OF CU~ERLA~D A~ STATE 0t? FZRST AND F][IfAL ACCOL', P AND ~C~,.~.~.DUI ...... OF PROPOo~D I hereby certify that written noth~ of the filing of this Account, and of the date, time and place II heir or..l~t of J,l,l,l,l,l,l,l,l,~n. /' II j.ROBERT STAUFFER II ~,~ro~ .~ ~w Il Ma.arm'r absolutely and dlltrlbutlon decreod In ~iccordance with proposed sched- ule of d. tat. ributlon herewith. By the STATUS REPORT UNDER RULE 6.12 Name of Decedent: RUTH A. P~RY Date of Death: March 6, 2003 Will No. 2003-002~9 Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, ! report the following with respect to completion of the administration of the above-captioned estate: State whether administration of the estate is complete: Yes x No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes x No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes No Date: NOV, 17, 2003 d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be/a~tached to this report. ~gna~ure ' _ ~/ J. Robert Stauffer Name (Please type or print) Market Square Bldg. Mechanicsburg, PA 170~ Address (717) 766-9673 Tel. No. Capacity: __Personal Representative x __Counsel for personal representative (MAH:rmf/AM3)