HomeMy WebLinkAbout04-0754 PETITION FOR PROBATE and GRANT OF LETTERS
also known as To:
Register of Wills for the
- . ~12.eceased. County of in the
Social Securily No. ~ ! ~1 ~. 6a -1 ~t~ Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age ar.o~e,r an the execute- i X/ named
in the last wil} of the above decedent, dated ~i~[~ ["Z. O0'2,. , 19__
and codicil(s) dated
~ · (list slreet, number and muncipality)
Dec,eg~e~g,t,,l, hen ~ ye, a~_of age~ ,died. ~X~ ~ ,19 2~
Except as follows, dec~nt did not ~arr3, was~ot divorced &nd did not have a child bbrn [; a~o~ted
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 $ ~t O~O
(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:
WHEREFORE, petitioner(s) respectfully r. eq.uesg(.s)5~_e pr~obate of the ~-h~s~c will and codicil(s)
presented herewith and the grant of letters ~'L~'~5'/'~t:L,L4'/I- , t-4
(testamentary; admin~tion . ~ ' '~ ~
c.t.a; admm~stratmn d.b.n.c.t~a.)
theron.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF (-..LLt ]'~. B f-~t~D J~
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 represen-
tative(s) of the above decedent petitioner(s) will well a~ruly admirer th~st~t~ according to law.
Sworn to or affirmed and subscribed ~~ ~' !~
before me this i~ dgy.~f~ ~ ~
Estate0f l~qL-~)~k/~) ]). M~/~c7'~ ,Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
, m consideration of ;he petition on
the ~everse side hereof, satisfactory proof having been presented before me,
IT ~S DECREED tha; ;he nstrument(s) da;ed__ ,~ .;)~ [' :~
described therein be admitted ;~robate and filed of record as the las; will of
and Letters ~A I¥1~~T~ Ik /
are hereby granted to ~[~ (!.
Probate, Letters, Etc .........
Short Certificates(5) $~ ATTORNEY (Sup. Ct. I,D, No)
.%1o,-.
TOTAL
Filed ...................................
PHONE
LAST WILL AND TESTAMENT
OF
HILDRED P. BARTON
I, HILDRED P. BARTON, of Cun~berland County, Pennsylvania, declare this to be my Last
Will and Testament. I revoke all other Wills and Codicils that I may have previously made.
Article I
My just debts and expenses of my last illness, funeral, and administration of my estate shall
be paid by my Executor from the principal of my residuary estate as soon as practicable after my
death.
Article II
All inheritance, estate, and succession taxes (including interest and penalties thereon, but not
including any generation skipping tax) payable by reason of my death shall be paid out of and be
charged generally against the principal of my residuary estate without reimbursement from any
person. This provision is not a waiver of any right which my Executor has to claim reimbursement
for any such taxes which become payable as the result of any property over which [ have the power
of appointment.
Article 1II
I give, devise and bequeath in accordance with any memorandum which ! have either
handwritten or signed, located with my Will or with my valuable papers and found within 30 days of
the probate of my Will. Gifts may only be to persons who survive me or to organizations which
exist at my death, and if there is a conflict, the memorandum having the latest date shall govern.
Article IV
All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever
situate, I give, devise and bequeath to my niece, JANE C. ALLEN, of Cumberland County,
Pennsylvania. In the event that JANE C. ALLEN predeceases me or fails to survive me by thirty
(30) days, I give, devise and bequeath the remainder of my estate, of whatsoever nature and
wheresoever situate to THE ENDOWMENT FUND OF ST. MARK'S EPISCOPAL CHURCIt,
or its successors, of South Main Street, Lewisto~vn, Pennsylvania.
Article V
I nominate, constitute, and appoint my niece, JANE C. ALLEN, Executrix of my Last Will
and Testament. In the event of the renunciation, death, or inability to act, for any reason whatsoever
of my Executrix, I nominate, constitute and appoint OMEGA BANK, or its successor, of
Le~vistown, Pennsylvania, successor Executor of my Last Will and Testament. I direct that my
Executrix or successor Executor be permitted to serve without bond and in addition to those powers
granted by law, I grant them power to distribute in cash or in kind in like or in unlike shares and to
-2-
file any qualified disclaimer I could have filed if living. My Executrix and successor Executor shall
receive reasonable compensation for services rendered to my estate.
Article VI
In addition to the powers conferred by law, I authorize my Executrix and successor Executor,
in his/her absolute discretion:
(a) to retain in the form received and to sell either at public or private sale, any real estate
or personal property except that which I specifically bequeath herein,
(b) to manage real estatc,
(c) to invest and reinvest in all forms of property without being confined to legal
investments, and without regard to the principal of diversification,
(d) to exercise any option or right arising from the ownership of investments,
(e) to compromise claims without court approval and without consent of any beneficiary,
(f) to file any federal income tax return for any year for which 1 have not filed such
return prior to my death,
(g) to make distributions in cash or in kind, or in both, and to determine the value of any
such property,
(h) to employ any attorney, investment advisor, or other agent deemed necessary by my
Executor; and to pay from my estate reasonable compensation for ail their services,
(i) to conduct alone or with others, any business in which I am engaged in, or have an
interest in at time of my death, and
-3-
(j) to receive reasonable compensation in accordance with their standard schedule of fees
in effect while their services are performed.
IN WITNESS WHEREOF, I, HILDRED P. BARTON, hereby set my hand to this my Last
Will and Testament, on /V/d,-.,~.,~ ' ,2002, at Harrisburg, Pennsylvania.
HILDRED P. BARTON
In our presence, the above-named HILDRED P. BARTON signed this and declared this to
be her Last Will and Testament, and now at her request, in her presence, and in the presence of each
other, we sign as witnesses.
Name Address
-4-
I, HILDRED P. BARTON, Testatrix, who signed the foregoing instrument, having been
duly qualified according to law, acknowledge that I signed and executed this instrument as my Will,
and that ! signed it willingly as my free and voluntary act for the purposes therein expressed.
Sworn to or affirmed and
acknowledged before me by
HILDRED P. BARTON, the Testatrix,
on .3 . :~- ,2002.
Public HILDRED P. BARTON
We, the undersigned witnesses who signed the foregoing instrument, being duly qualified
according to law, depose and say that we were present and saw the Testatrix sign and execute this
instrument as her Will that she signed and executed it willingly as her free and voluntary act for the
purposes therein expressed; that each of us in her sight and hearing signed the Will as witnesses, and
that to the best of our knowledge, that she was at that time eighteen (18) years or more of age, of
sound mind, and under no constraint or undue influence.
Sworn to or affirmed and
subscribed to before me
and~.fe' hS,r'c~_ 'X-J, /~//~)T)/' Witn4ss - - ~ ~ --
,vitnesses, on :5- '~ ,2002. -~;C~Jx~((6~-' ~[' ///;/:q --/~/~ ~/
~ Public' - 3
COMMONWEALTH OF PENNSYLVANIA REV-1162 EX( 11 90)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT 280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 004542
ALLEN JANE C
210 GARRETT LANE
CAMP HILL, PA 17011
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
........ fold ..................
101 I $12,000.00
ESTATE INFORMATION: SSN: 177-10-2674 I
FILE NUMBER: 2104-0754
DECEDENT NAME: BARTON HILDRED P
DATE OF PAYMENT: 10/25/2004
POSTMARK DATE: 10/25/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 08/02/2004
TOTAL AMOUNT PAID: $12,000.00
REMARKS:
CHECK//103
INITIALS: JA
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717)240-6345
Date: 11/01/2004
ALLEN JANE C
210 GARRETT LANE
CAMP HILL, PA 17011
RE: Estate of BARTON HILDRED p
File Number: 2004-00754
Dear Sir/Madam:
It has come to my attention that you have not filed the
Certification of Notice Under Rule 5.7 (a) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS, COURT RULES,
NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on
or after July 1, 1992, the personal representative or his
counsel, within ten (10) days after giving proper notice to the
beneficiaries and intestate heirs as required by subdivision
(a) of Rule 5.7, shall file with the Register of Wills or Clerk
of the Orphans' Court his/her Certification of Notice.
This filing will become delinquent on 11/23/2004
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
GLENDA FARNER STRASBAUGH
Clerk of the Orphans' Court
cc: File
Counsel
Judge
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: /~'///~-/~ &
Date of Death: ~/,~/~t~ ¢
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of th~Qrpha~s'~/// Coun,,~Rules was
served ot~ or mailed to the following beneficiaries of the aboYe-captioned estate on ¢/,~/Z~/cf-
Name Address
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Signature
Teleph°ne 757,
Capacity: /Personal Representative
Counsel for personal representative
Glenda Farner Strasbaugh
Register of Wills
and
Cierk of Orphans' Court
Marjorie A. Wevodau
First Deputy
Kirk S. Sohonage, Esq
Solicitor
Register of Wills and Clerk of the Orphans' Court
County of Cumberland
One Courthouse Square
Carlisle, PA 17013
(717) 240-6345
FAX (717)240-7797
INVOICE
Bill To:
InvoiceNo:
Invoice Date:
Estate of:
Estate No:
358
5/12/2005
HILDRED P. BARTON
21-04-0754
JANE ALLEN
210 GARRETT LANE
JA
CAMP HILL, PA 17011
130.00
Total
$130.00
Qty
1
Fee Description
Additional Probate
Fee
Total:
$130.00
Olecks should be made payable to the Register of Wills. Terms: Net 30.
Please rerum one copy of this invoice with your payment. Thank you.
.fV.15DOEx(6.00J
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAL)
H,IJNJ -p D"'I"'-'O,.J
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
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(IF APPliCABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST. AND MIDDLE INITIAL)
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gJ 1. Original Return
o 4. Limited Estate
D 6. Decedent DIed Testate (Mach copy of Will)
o 9. litigation Proceo<Js Received
'tfUS1
NAME
o 2. Supplemental Return
o 4a. Future Interest Compromise ,dale of death alter 12-12-82)
o 7. Decedent Maintained a Living Trust (AlI&dl eopyolTrusl)
o 10. Spousal Poverty Credit\da\eolde&\l1~12-:)1'@121)(\1-'.95)
OfFICiAl- USE O\'~L"{
FILE NUMBER
2-~-.!l~
COUNTY CODE YEAR
.E2~3_
NUMBER
SOCIAL SECURITY NUMBER
177 - 10 - 2(,74
THIS RETURN MUST BE FilED IN DUPUCATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 3. Remainder Return (dale 01 death prior to 12.1:J.a2\
o 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
o 11. Election !o !"" under Se~ 911J(A) IA""',," 0)
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COMPLETE MAiliNG ADDRESS
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c.~p 1-1 ,-II 1"174 ("70 I I
FIRM NAME (II ApplicabIa)
TELEPHONE NUMBER
7/7-73'7 - /lrO I
(I)
(2)
(3)
(4)
(5)
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1. Real Estate (Schedule A)
2. Slocks and Bonds (Schedule B)
3. ClOsely Held Corporation, partnership or Sole-Proprietorship
4. Mortyages & Notes Recar..b\e (Schedule D)
5. Cash, Bani< Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly cmned Property (Schedule F)
o Separate Billing Requested
7, Inter-VIVOS Transfers & Miscellaneous Non-Probate Property
(Sche<Ju1e G or l)
8. Total Gross Assets (Iotal Uoes 1-7)
9, Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Oeceden, Mortgage Uabillties, & Uens (Schedule I)
11. Totallleduc:tions (Iolal Unas 9 & 10)
12. Net Value of Estate (Une 8 minus line 11)
13. Charitable and GovemmentalBequestslSec 9113 Trusts for which an election to tax has nol been
made (Schedule J)
(8)
'is/107
9//7'17
(6)
(7)
(9)
(10)
14. Net Value SUbject to Tax (line 12 minus Lina 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPUCABLE RATES
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15. Amount of line 14 taxable at the spousal tax
rale, or lransfe!s under Sec. 9116 (a)(1.2)
x .0_ (15)
X.O_ (16)
16. Amount of Une 14 taxable at lineal rate
17, Amount of Une 14 taxable at sibling rate
x .12 (17)
'83/(..90
x .15 (18)
18. Amount of Una 14 taxable at collateral rate
19. Tax Due
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CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
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OFFICIAL USE ONLY
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(12)
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(19)
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Decedent's Complete Address:
STREET ADDRESS...., /"
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C/h'>1 P .J/,- / j
Tax Payments and Credits:
1. Tax Due (Page 1 una 19)
2. CreditslPayments
A. Spousal Poverty'Credi\
B. Prior Payments
C. Discount
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I ZIP / 7a I f
Cln'
(1)
/2,000
/4Zg
Total Credits (A+ B + C) (2)
/2, c.z.8"
3. InteresUPenalty ~ applicable
D. Interest
E. Penalty
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TotallnteresVPenalty ( 0 + 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 10 request a refund (4)
/Z,5$'-I
5. If Line 1 + Line 31s greater than Line 2, enler the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
(5)
(SA)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
~..,,~~~I~.ilif...J\.'!;k_,g:~,~~;~!,~~~1!!;',~~;\lf1~T~i~~i!f.ii'Z~~.L1L il..__:- m~;ll1i~",,;:,t.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN .X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes
a. retain the use or income of the property transferred;.......................................................................................... 0
b. retain the ri9ht to designate wh'o shall use the property transferred or its income; ............................................ 0
c. retain a reversionary interest; or...........................,.............................................................................................. 0
d. receive the promise for life of either payments, benefits or care? ...................................................................... 0
2. If death occurred after Deoernber 12, 1982, did decedent transfer property .,;thin one year of death
without receiving adequate consideration? .............................................................................................................. 0
3. Did daredent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0
4. Did deeedent own an Individual Retirement Accoun~ annuity, or other non.probate property which
contains a beneficiary designation? ........................................................................................................................ 0
No
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18'1
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 ~of pel}Isty, 'dedafe thall hcwe exam'rned ttris rEIUIm, irlduding 9CCOIJlpanying scfledtjes Md stal8m9nts, and to the basi of my knowledge end belief, it is true, COllect and
complete.
Dedaration of other than !he personal . is ba!6ll on all information 01 which preparer has eny knowkldge.
P SON fl,ESPON }L1NG RETURN
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~N<E
SENTATIVE
<:04-n."Z..crr
OF PREPARER OTHER THAN
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ADDRESS
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170z..5
/701/
DATE
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ifii~~~~1?,tlN~~~~~Sii~!f~!fr,a~'1i~~i~t1f~~~~~~~Z"*Ji,.~~~~~;~i,~::
For dates of death on or after July 1, 1994 and before January I, 1995, the tax rele 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)J.
For dales of death on or after January 1,1995, the tax rate imposed on the net value of ~ansfers to or for the use of the sUMvin O't --, ,I - - --"-" ,. .. .."
The statule does not exemot a transfer to a surviving spouse from lax, and the statutory requiremenls for disclosure of assets ane -, CS "1 \30 r-l- Co r--
the surviving spouse is the only beneficiary.
For datesot dealh on or after July 1, 2000: ~"- :leo.60
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 th, 'Pc'. ,""'.........
or a stepparent of the child is 0% [72 P.S. ~9116(aX1.2)]. ..., ..........
The tax rate imposed on the net value of transfers to or for the use of the decedenfs lineal beneficiaries is 4.5%, except as ooled in 7 'A ()r) \ ::'0. 00
The tax rate imposed on the nel value of transfers to or for the use of the decedenfs siblings is 12% [72 P.S. ~9116(a)(1.3)]. A-=#:.35 <;)
individual who hes at least one parent in common with the deoedent, whether bv blood or adoption. <} .:r ~
REV-t5DlIEX4(1.e7j
*'
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONMAl.TH OF PENNSYLVANIA
INHEflITANC€ TAX RETURN
RESIDENT DECEDENT
ESTATE OF
#/d"eJ 7. D.q..-..rorJ
FILE HUMBER 2 . / 5
fO.,..-07 '7
Include the proceeds of litigation and the dale the proceeds.... received by the -.e. All p~ joIntIy-owned wlIh the right oI8UrvI1Io,.hIp mat be _sed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. CJ/Yl~64 t54NJ\ -# 23,'-/.%/
2..
3.
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5,
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4r-r>e"'C4r-J t;.x('""ss- /ft-<<-rrfO, .34S8'S~O.;l.-Oz.,
VV4'1pOj~"-- &.-. '"
C-A-$/-I "i?E~"',-.Jt;) - L3",d'1<'.5 c;.J OGNr Cr'ee "'-
G I/:::'r€ D -ro ~€. 4/1,6"'/
/1/11><:" 4,S1-I -R.E~"'r-JD'>
"1, 7- '3 2..
"-10'1
~S99
.5'1/62.0
So
TOTAl (Also enter on line 5, Recapitulation) $ '71 , 7 9 '7
REV"1511 EX+ (12-99) .
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
/-Ir i J N J 7. /34-L,--0--J
FILE NUMBER
.;;2 /"'4 - 07:5<-1
Debts 01 decedent must be reported on Schedule J.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
;-Ioe", 5h~~ h..-Jp/"4--t- h6"",,,,-- -If 7,1/ :5
B. ADMINISTRATIVE COSTS:
1. PefSOM! Representat\ve's ~kms
Nams 01 Personal Represantative(s)
Social Security Numbe~s)IEIN Number of Persona' Representative(s)
Street Address
City State _Zip
Year(s) Commission Paid:
2. Attomey Fees
3. Family Exemption: (If decedenfs address is not the same as claimant's, attach explanation)
Claimant
Stree\. Address
City State _ Zip
Relationship of Claimant to Decedent
4. Probate Fees /a...,
5. Accountant's Fees ( r= 1',..., ~ C I ~ to- r:;.zLv I ;.oa...) ~oo
6. Tax Return Preparer's Fees 2.50
rn (5~e.I/-1-'eou > .-
7. C:xl'~-- ~" 5
~ 6_1/trJIA. ?'-eA-v't: ~ Zc:r
/11 EO f ~4-Z.-- ?'<Af'~/,p~ &<1
/I'?/.}-r..ro.- U 42-
",-,c
TOTAL (Also enter on line 9, Recapitulation) $ ;j, / 0 7
tlf ..........0 eon.......,.... ...."""""' ;.......... ..A~~........l _~nf" ...1 fk... ~.._... ..;_~l
REV'1513 EX+ (9-00.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF ,/_
rfr/dreJ -;::" D__/r"J
SCHEDULE J
BENEFICIARIES
FILE NUMBER
NUMBER
I
RELATIONSHIP TO DECEDENT
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not UsI T,uslee(s)
TAXABLE D1STRIBUTIOrlS [include outrighl spousal distributions, and transfers under
Sec. 9116 (a) (1.2)J
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;V /6:c.6
CA-n--.r ;/; (/ ,74
Iro/f
2/o<-r'-075'Lf
AMOUNT OR SHARE
OF ESTATE
/06 "70
ENTER DOlLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES t5 THROUGH 16, AS APPROPRIATE, ON REV.1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART n - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON UNE 13 OF REY-1500 COYER SHEET $
,I{............... ~ \.... ........"'_ .......... ....I.allol.......1 __....... _I ""... ___" ..:~...\
We have retained a
copy for processing
This copy is for your
records
Jon Brenneman
Pa Dept Revenue
Inheritance Tax
Document Processing
(717) 787-3942
I
.fV.lfi(Kltx~
COMMONWEAlTH OF
PENNSYLVANIA
D'EPIIRTMENT OF REVENUE
DEPT,280601
HAR~\SBURG, PA 17128-0601
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REV-1--500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAl)
H,IJr..J JP.~A~rO~
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
?/2.-/o-l /O/I~/I:3
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
l8J 1. Original Return
o 4.l.imited Estate
o 6. DecedemDiedTestate (AlIachCOPYolWilll
o 9. Litigation Proceeds Received
o 2. Supplemenlal Retum
o 4a. Future Interest Compromise (dale of daathaller 12-12-82)
o 7. Decedent Maintained a Living Trust (Alladl copyofTrusl)
o 10. Spousal Poverty Credit (dale of death bl!\weefl12+31-91 and 1.1-95\
~
OFFICIAL USE ONLV
_.__.__._._,.~.__e'_.__'_'__'_~+
FILE NUMBER
2.. .!... -..!2 '--I
COUNTY CODE YEAR
07'5'-/
- NUMBER- - --
SOCIAL SECURITY NUMBER
177 - /a
'2-<:'74-
THIS RETURN MUST BE ALED IN DUPLIGATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 3. Remainder Return (data of lIea1h prl?t 10 12-1].82)
o 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9\I~A) \All>d>'""O)
'"'
z
l!l
z
o
..
.,
w
'"
'"
o
u
NAME
411~"/
FIRM NAME or....._1
TELEPHONE NUMBER
7/7-73'7 - /lrO'
z
o
~
:;)
...
ii:
c(
o
w
a:
14. Net Value Subject to Tax (Line 12 minus Line 13)
COMPLETE MAIUNG ADDRESS
-:2. 'e G4rt.n."'rr L4Ni:
CA-.->-> (> 1--1 ,-,I I ---;::> A 1"7'" I
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(9)
\101
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPUCABLE RATES
1. Real Estate (Schedule A)
2. Slecks and Bonds (Schedule B)
3. C1ose~ Held Corporation, Partnership or Sole~Proprielorship
4. Mo<tgages & Notes Receivable (SdIeduIe D)
5. Cas/l, Bank Deposi~ & Miscellaneoos Personal Property
(Schedule E)
6. Jointly Owned Properly (Schedule F)
o Separete Billing Requested
7. Intar-VIVOS Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Deb\s of Oecede.~ Mot\9aae Liabilities, & liens (Schedule I)
11. Totel Deductions (Iolal Lines 9 & 10)
12. Net Value of Estate tUne 8 minus line 11)
13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to lax has nol been
mede (Schedule J)
z
o
!cc
I-'
:;)
Do
:E
o
o
~
15. Amount of line 14 taxable at the spousal tax
rete, or transfers under Sec. 9116 (a)(1.2)
16. Amount of line 14 taxable at lioeal rate
17. Amount of Una 14 taxable at sibling rate
18. Amount of Line 14 taxable al collateral rate
19. Tax Due
g 3, L90
9/, 7 q 7
(8)
'8',107
,,0_ (15)
'.0_ (16)
x .12 (17)
, .15 (18)
(19)
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
2O(gl
:i:i~:~~f:}kJ~ih;tf'~" ;i!i
OFFICIAL USE ONLY
51'!/,/'
l
9/,7Q7
(11)
(12)
(13)
'8,107
83,(.,90
(14)
8'3,(.,'70
12,5S,--/
I ?,SS'-I
." :i!
Decedent's Complete Address:
STREET ADDRESS..., /'
...../0 w~err
/ .JkAj €
CITY
I STATE 7,4-
I ZIP /70 J f
~p 11/1/
Tax Payments and Credits:
1. Tax Due (Page 1 Une 19)
2. Crll<ItslPayments
A. Spousal Poverty'Credit
B. PMor Payments
C. Discount
(1)
/2,000
f.,Z8
Total Credits ( A + B + C ) (2)
12, c::.z.8"
3. InterosVPenalty n applicable
D. Interest
E. Penalty
TotallnteresVPenalty ( 0 + E ) (3)
4. If Line 2 is 9reater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Une 20 to request. rafund (4)
;z.,55"-1
'7'-{
5. If Une 1 + Line 3 is grealer than Une 2, enter the difference. This is the TAX DUE.
(5)
(SA)
(58)
A. Enter the inlerest on the tax due.
B. Enter the lotal of Line 5 + SA. This Is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
~~""''''''' -..-. !illJ.~~~!,~~Jlill',gj'.~1M~,1!jj!'i~~~1\~~! r!li'11~~,Jkt1j"',..,
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN .X. IN THE APPROPRIATE BLOCKS
1. Did decedent make a lnlnsfer and: Ves
a. retain tlte use or income 01 the property lnlnsferred;.......................................................................................... 0
b. retain the right to designate wh'o shall use the propertY transferred or its income; ............................................ 0
c. retain a reversionary interes~ or.......................................................................................................................... 0
d. receive the promise for Ine 01 either payments, benefits (l( care? ...................................................................... 0
2. If death occurred alIer December 12. 1982, did decedent lnlnSfer propertY ..thin one year of death
without receiving adequate consideration? .............................................................................................................. 0
3. Did decedent own an "In trust for" or payable upon death bank account or secuMty at his or her death?.............. 0
4. Did decedent own an Individual Retirement Aocount annuity, or other non.probale propertY which
contains a beneficiary designation? ........................................................................................................................ 0
No
IKJ
~
~
81
IBI
jgj
~
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
x D~~_
04n'2..Crr
SIGNAnJ F PREPARER OTHER THAN RE
C+-. p /I, 01/
,
--;;z;> .4-
ADDRESS
-rJO CI4 ---0/",,-
.... ( r '7
q,'3o ;V crJO LA --;l>a.-II/6:
170Z.!!>
0"-"'.-
170//
DATE
'-f Z-?/Q:)
N~~~ltIIi$!WIffiOOi;~-.&__.t~_st_~r~~~&\~~J~~~::il~.i:tt:;~{:~':.:";
F(l(datesof death on or after July 1,1994 and before January 1, 1995, the tax rale imposed on the net value of transfers 10 or for the use 01 the surviving spouse is 3%
[72 P.S. ~9116 (a) (1.1) (I)].
For dates of doalh 00 or after January 1, 1995. Ihe tax rate imposed on Ihe net value of transfers to or for the use of !he surviving spouse is 0% 172 P.S. ~9116 fa) (1.1) (ii)
The statute does nol exemol a transfer kl a surviving spouse tram tax, and Ihe staMory relluirements for disclosure of assets and filing a tax retum are still applicable even
the surviving spouse is the only beneficiary.
for dates 01 dealh on (l( after July 1, 2000:
The tax rate imposed on the net value of tranSfers from a deceased chiid twenty-one years of age or younger at dealh to or for the use of a natural parent, an adoptive paren
or a stepparent ollhe chiid is 0% [72 P.S. ~9116(aX1.2)1.
The tax rate imposed on the net value of lnlnslers kl or for the use of the decedenrslineal heneflciaMes is 4.5%,eXC<ll1t as noled in 72 P.S. ~9116(t2) (72 P.S. fi9116(a)(I)].
The tax rale imposed on the nel value of transfers to or for the use of the deeedenrs siblings Is 12% [72 P.S. ~9116(a)(t3)). A sibling Is defined, under Section 9102, as al
Individuai who has alleast one oarenl in common wilh the decedenl. whelher by blood or adoption.
""...".,..".
COMMONWEAl.TH OF PENNSYLVANIA
INHERiTANCE TAX llETURN .
llESID NT DE OENT
EST ATE OF
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
~/dreJ 7. D-qn.ro""
Fl.E ItUM8ER
2 ((Ji.{.-07S,-/
Indude the proceeds of 11Iig"1ion aod the date the proceeds _ RlCeived by the eslale. All pRlIIOI\y joIntIy-owned with the rlght of IUlYlvorshlp must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
O~~64 ?3A.-.J 1\
#> 23,4%'7
2.
3.
4-.
s,
("
/}-rnerlC4r-' t;.xf"'l>SS - /k.-"-r r/o, .345 K5>r-o;;J.-oz-/
v/4'1POJ:""'''''' &..-s.::.
C.kS/-I "i?t:~",,...,1) - 6", 1;J'7~.5 <2.. 3~r C/'Re":;
G (Pre D -?O ::;74,v<=. AI/E,"';
/t1 I>C ~t+ -K.E1=..,"'P5
CJI -z.. 3 2...
40'1
~ S9 '7
.5'1/02..0
50
TOTAL (Also enter on line 5, Recapitulation) $ '11 . 7 9,
RE\f!'1511 EX+ (12.99) )'
.9,,~~
~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
~iJreJ 7, 64-<-ro,J
FILE NUMBER
,;2 /.t! <I - c)''7':s '-I
Deblll 01 decedent must be reported on Schedule).
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
#0,..", 5-h~~ ;=:u-./p ~ 4-<-. .J-,6.-.-.",-- 4 7,1/5
B. ADMINISTRATIVE COSTS:
1. Pen.<mal Repmsenta\Ne's Cornm\ss\ons
Name of Personal Representative(s)
Social Security Number(s}IEIN Number of Personal Representative{s)
Street Address
City State _Zip
Year(s) Commission Paid:
2. Attomey Fees
3. Family Exemption: (If decedenfs address is not the same as claimant's, attach explanation)
Claimant
Street: Address
City Slale _ Zip
Relationship of Claimant to Decedent
4. Probate Fees /Ci 7
5. Accoun1ant'sFees ( r,l,..J4--'Vcl~'- 4-ztV/~Oa..-) sac>
6. Tax Return Preparer's Fees 2.50
/YII S <-,,-/14-' ",:w > '"
7. C:xl'~~" " $,
~6_/~~ :{e/t./~~ 2.9
/I? eo r C:4-z.-- 5"';';1/'<>"> &<1
/I?~o.~ ~"(.b 412-
TOTAL (Also enter on line 9, Recapitulation) $ y,107
IIf .....".... co""'...... ,... ...""..".... i........... ..;l...IiI;.......1 ...h......... ^' I~... ....._... ..:.....\
REV'1513 ex. (9"00.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT OECEDENT
ESTATE OF j I -
rttlclred 7. L3.+> j."J
NUMBER
I
SCHEDULE J
BENEFICIARIES
FILE NUMBER
1.
RELATIONSHIP TO DECEDENT
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not L18t T'U8te0(8)
TAXABLE DISTRIBUTIONS {include outright spouse! distributions, and transfers under
Sse. 9116 (e) (1.2)J
::::r;q N '" /1/1 e ,./
"2 10 04-rl-o't-iE'r-r ~,.v.E
2/c><!_ 07:'04
AMOUNT OR SHARE
OF ESTATE
I 0 0 "70
ENTER DOLlAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV.1500 COVER SHEET
II NON. TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MAOE
/'I 1~C:e=
~r ;lil/ ,74
170/1
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART n - ENTER TOTAL NON.TAXABLE DISTRIBUTIONS ON UNE 13 OF REV.1500 COVER SHEET $
(" __ ......^'" l.. ......._.... ;......~ ........,........... -s........ ..' H... ......__ ~_..\
REV-1513 EX+ 19-D0*,
COMMONWEAlT,H OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
NUMBER
I
,.
NAME AND ADDRESS OF PERSONIS) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (e) (1.2)]
'~'e-o.,\C:.-tL q Z::. \f\A.bN-Ul'S
~q e. s~nV\C}\J\\:\~\. A-VL
c..bV\.S\AO U.OC--~ v'\ ~o..' \,C\4t)'i(
FILE NUMBER
RELATIONSHIP TO DECEDENT
00 Not LlstTrustee(s)
Wld6u) ,
AMOUNT OR SHARE
OF ESTATE
t\ tCCD., 60
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II NON.TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
,.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
,.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
Glenda Farner Strasbaugh
Register of Wills
and
Clerk of Orphans' Court
Marjorie A. Wevodau
First Deputy
Kirk S. Sohonage, Esq
Solicitor
Register of Wills and Clerk of the Orphans' Court
County of Cumberland
One Courthouse Square
Carlisle, PA 17013
(717) 240-6345
FAX (717)240-7797
INVOICE
Bill To:
InvoiceNo:
Invoice Date:
Estate of:
Estate No:
358
5/12/2005
HILDRED p, BARTON
21-04-0754
JANE ALLEN
210 GARRETT LANE
JA
CAMP HILL, PA 17011
130,00
Total
$130,00
Qty
1
Fee Description
Additional Probate
Fee
Total:
$130,00
pj
V /crlo
-
"
.
vj
C1Iecks should be made payable to the Register of Wills. Terms: Net 30.
Please return one copy of this invoice with your payment. Thank you.
07-25-2005
BARTON
08-02-2004
21 04-0754
CUMBERLAND
101
APPEAL DATE: 09-23-2005
( See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE _ RETAIN LOWER PORTION FOR YOUR RECORDS +-
iEv:is47-Ei-AFP-co3:osi-NOTICE-OF-INHEiITANCE-TAi-APpiAISEMENT:-ALLowANCE-oi---------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
HILDRED P FILE NO. 21 04-0754 ACN 101
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
n-f'f'nf'f'" r,rr,-" ,-," NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES',':j-:,"C' ",';"-iPPRAISEHENT, ALLOWANCE OR DISALLOIIANCE
INtERITANCE TAX DIVISION -- .. ,-,^ ,- -,- - '. 'I . Of DEDUCTIONS AND ASSEsst1ENT OF TAX
PD BOX 280601
HARRISBURG PA 11128-0601
'"'(\,,;-
[1 ':J
'!_ 22
I', ,c. "'-,
- ~'~. ,-:...
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
JANE ALLEN
210 GARRETT LN
CAMP HILL
PA 17011
ESTATE OF
BARTON
*'
REV-1547 EX AFP (06-05)
HILDRED
P
TAX RETURN liAS: I X) ACCEPTED AS FILED
) CHANGED
DATE 07-25-2005
I~ an assess.ent was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect ~igures that include the total ~ ~ returns assessed to date.
ASSESSMENT OF TAX:
IS. AItount of Line 14 at Spousal rate US)
16. Amount of Line 14 taxable .t Lin..l/Class A rat. (16)
17. AIIount of Line 14 at Sibling r8t. (17)
18. Amount of Line 14 taxable at Collateral/Class Brat. (18)
19. Principal Tax Due
TS:
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule 8)
3. Closely Held stock/Partnership Interest (Schedule C)
4. Mortgages/Notes ReceIvable (Schedule D)
5. Cash/Bank DepositslHisc. Personal Property (Schedule E)
6. Jointly Owned Property ISchedule F)
7. Transfers (Schedule G)
8. Total Assets
11)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
91. 797 . 00
.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expens.s/A~. CostslHisc. Expenses (Schedule H)
10. DebtslHortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. N.t Value of Tax R.turn
13. Charltab1e/GoYer~ental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Est.te Subject to Tax
(9)
110)
8,107.00
DO
Ill)
112)
113)
114)
NOTE:
.00 X
.00 X
.00 X
83,690.00 X
00 =
045 =
12 =
15 =
TA
AHllUNT PAID
12,000.00
73.70-
+
DATE
10-25-2004
07-18-2005
NlIHBER
CD004542
REFUND
INTEREST/PEN PAID 1-)
627.70
.00
~
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
NOTE: To insure proper
credit to your account,
sub.it the upper portIon
of this for. with your
tax payllent.
91,797.00
8.107 00
83,690.00
.00
83,690.00
119)=
.00
.00
.00
12,554.00
12,554.00
12,554.00
.00
.00
.00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
prl'()Q~[J) f'\CC!I'E I'C
BUREAU OF INOIVIO&II'-1Yl - ,,, I 'v V
INHERITANCE TAX DIYISIQtC('-~~-.~.--:, ;,.! . ;....
PO BOX 280601 --',~,-;
HARRISBURG PA 171Z8-06Dl
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
'*
REY-16D7 EX AFP (03-05)
2005 WG 12 Pii I: 10
,^
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
08-01-2005
BARTON
08-02-2004
21 04-0754
CUMBERLAND
101
AIIO...,t R...l tt.d
HILDRED
P
CtE::~::<
f"ISC'!_' .-"
\...)1'.:
JANE AUEN
210 GARRETT LN
CAMP HILL
'-~T
PA 17011
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, sub.it the upper portion of this forn with your tax pay.ant.
CUT ALONG THIS LINE
--+ RETAIN LOWER PORTION FOR YOUR RECORDS
-
---------------------------------------------------------------------------
REV-1607 EX AFP (03-05)
~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ...
ESTATE OF BARTON HILDRED P FILE NO. 21 04-0754 ACN 101 DATE 08-01-2005
THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 07-18-2005
PRINCIPAL TAX DUE: 12,554.00
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
10-25-2004 """ CD004542 627.70 12,000.00
07-18-2005 REFUND .00 73.70-
TOTAL TAX CREDIT 12,554.00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
.
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
I IF TOTAL DUE IS LESS THAN $1,
NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRJ,
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. J
_ ,,-
(C'^'::>
,,-
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 7/05/2006
ALLEN JANE C
210 GARRETT LANE
CN~P HILLI PA 17011
RE: Estate of BARTON HILDRED P
File Number: 2004-00754
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6.12 is due on the below listed
date.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES I NO. 103
SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after
July 11 19921 the personal representative or his counsel, within two
(2) years of the decedent's deathl shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by:
8/02/2006
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
SincerelYI
~" ~., i J;"
. "~.4 /
c__:c Y;;y~.tJ tij~~'7' .
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
\>'
Register of Wills of Cumberland County
STATUS REPORT UNDER RULE 6.12
Name ofDecedent: 1-1/ lei ~ed &ritJn
Date of Death: ;f:/Z-tJt) ~
Estate No.: . 4-007~c.;
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 0
2. If the an.swer is No, state ",hen 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 0 No fi(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 00 No M-
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
Date: 'lfi<fP;;;hed lo this report. ~AlL,{j)IA~..-J
s~
:JfWC AilGN
Name 0 6~// ~
?hm.P fflU- I!IJ- 17t;/1
Address
'711.137. J g-oL
Telephone No.
,"7 ,.., 11.
..... )
~J "::"',
L i ~d
L
./'",
Capacity: ~ Personal Representative
o Counsel for personal representative
c