HomeMy WebLinkAbout03-0283 PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
also known as To:
Register of~Wills for the ~
SocialSecurityNo. I(~l'L~'~5~700 Deceased. County o([/_. _~'f/tTUE;[.~ in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older, appl i~ for letters of administration
on the estate of
(d.b.n.; pendente lite; durante absentia; durante minoritate)
the above decedent.
Decendent was domiciled at death in~l~i~ ~r~/~ ~ ~ County, Pennsy, l,vgnia, with
h last family or principal residence at ifS ~. ~r~C~ x.~. IJ0~/TI~L/O~Z~/~/~L-- ~
-' (list street, number a~l muni~ality)
D,e~c~en/:i. eqt, .~ .~'f)3(}3J _ .~age, ,
att Jl/tl(]lr~f? t~ ~le~ars died ~a ~d'h g~ , '¥ ~3
Decendent at death owned property with estimated values as folllows:
(If domiciled in Pa.) All personal property $ /~)!
(If not domiciled in Pa.) Personal property in Pennsylvania $
(If not dOmiciled in Pa.) Personal property in County $
Value of real estate in Pennsylvania $
situated as follows:
Petitioner.__ after a proper search ha ascertained that decedent left no will and was survived by
the following spouse (if any) and heirs:
Name,L~t cn~nL.t~L/r~I}~e~'~i~pship . Re' enc
THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the
appropriate form to the undersigned.
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ~ ss
COUNTY OF ~ ~m~o~lo~ng
The petitioner(s) above-named swear(s) or affirm(s) that the
statements in the foregoing petition are true and correct to the best
of the knowledge and belief of petitioner(s) and that as personal
representative(s) of the above decedent petitioner(s) will well and
truly administer the estate according to law.
Sworn to or affirmed and subscribed
before me this tx~/~ day of
No.
Estate of I ~-~--~m ns Q~ _~-rtgp.~ , Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW ~C~iTc...14 ~ ! Xj~_, in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that
is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration
are hereby granted to ~Ohn [~) ~'t-z~g ]...
in the estate of
.-~'~ ~te~
of Wills
FEES
Letters of Administration ..... $ ~/<9,Z2D
Short Certificates( ) .......... $ ,:~t~t~)c} t'- . . ATTORNEY (Sup. Ct. I.D. No.)
Renunciation ................ $--~-~--~.~" ' ~ ' : ~'
TOTAL __ $ '~d~..eOO ADDRESS
Filed . .f0g.~e,.J3....~/ ........ A.D. ,3~_,O_cg~
PHONE
This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
~ Local Registrar
No. '~ Dare
5 144 R~v. 1/gl COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
(Coroner)
Thomas C Butler z Male a. 191-4f-8550 ,. ~rch 22, 2003
~ ]~ ~0~ ~CO~ ~ RESIDENCE
John Bu~ l". Ne~c {Unknown)
Th~esa BuYer Wetzel }~ 19 Ed~glga Drive, Ch~s~g, PA 17201
~,(s~ ~ M~eh 25, 2005 ~,~. Pen~qlvania Crgm~ory ~,,~. H~r~b~ PA 17109
4:35 p. ~. [~. ~arch 2~, 2003 ~,.
C~PL~N~CAUSE I I( ~ ,~Y,Y~0 [ Aprx. I On-tutor failed to
: ........ I~. '' "
'MEG~MI~N~ (,~27)T~mP,nl Michael L. Norris, Coroner
.................................................................................................. ,,.~echanicsburg, Pa. 17050
RENUNCIATION
To the Register of Wills of C~/'~ be}" [ ~Q b~ County, Pennsylvania.
The undersigned'~[~6~- '~'}~- ~ '~~ ~~[ of
the above d~edent, hereby renounces) the ri~t to ad~Mster the estate and res~tfully ~k(s) that Letters
be issued to 7~ ~n WC¢~d/
WITNESS hand this __ day of , 19 .
(Signature)
(Address)
(Xddress) ' ~
(Signature)
(Address)
STATE OF FILE NO:
PENNSYLVANIA STATEMENT AND PROOF
PROBATE COURT OF CLAIM #21-03-283
CUMBERLAND
COUNTY
Estate of THOMAS C. BUTLER
I, Howard A. Enders, Esq. on behalf of CHASE MANHATTEN BANK located at 7800
TESORO DRIVE, 4TM FLOOR, SAN ANTONIO, TX 78217 submit the following claim
against the estate for the sum set forth.
DECSRIPTION VALUE
CHASE MANHATTEN BANK ACCT# 5184450003717323
AMOUNT DUE $ 4,038.64
There is now due on the claim, above all legal set-offs, the sum of' $ 4,038.64
[---] Notice to interested persons: This is a claim by a personal representative. This claim
will be allowed unless notice of an objection by an interested person is delivered or
mailed to the personal representative not later than
I declare that this claim has been examined by me and that its contents are true to the best
of my information, knowledge, and belief.
Auihorized signature' ff)~'
Howard A. Enders, Esq., General Counsel ~ .
Name (type or print)
The Creditor's Rights & Bankruptcy Group
A Division of Phillips & Cohen Associates, Ltd.
695 Rancocas Road
Address
Westampton, NJ 08060 609-518-9000
City, State, Zip Telephone
IPROOF OF SERVICE OF CLAIM~
I served upon JOHN GLACE, ESQ.
Name
fiduciary, a copy of this claim on MARCH 12, 2004 by REGULAR MAIL
Date State manner and address of service
132-134 WALNUT ST; HARRISBURG,PA 17101
I declare that this proof of service has been examined by me and that its contents are tree
to the best of my information, knowledge, and belief.
Date Signature ~'- / ~./
~CCEPTANCE OF SERVICE]
Service of the attached claim is accepted.
Date Signature
To whom it may concern,
Due to the voluminous nature of the documentation supporting this claim,
the following account summary is provided:
SUMMARY OF ACCOUNT
1 ACCOUNT NUMBER: 5184450003717323
2 NAME IN WHICH CARD ISSUED: BUTLER, THOMAS C
3 PRIMARY CARD HOLDER(S) : THOMAS C BUTLER
4 OPEN DATE: 2/24/04
5 CREDIT LIMIT: $2720.00
6 FINAL BALANCE: $4038.64
7 PRIMARY USE OF CARD: Purchases
CERTIFICATION OF NOTICE UNDER RULE
Name of Decedent: 7~ 0/~ t~ 5 0.~. 3/~'~ [~/~'
Date of Death: //~ ~t'~ '~/ 7~
Will No. Admin. No. Z / ~
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of tl~e Orohans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on ~' 1{9 ~ ~O'~ :
/ '
Name Address
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
~a~e: ~~~' /t.
] Signature
Name _ t~ bC~t
Address 137,-15 ~
Capacity: ~ Personal Representative
unsel for personal representative
Memorandum
DATE: September 13, 2003
TO: Registe~pf Wills, Cumberland County
FROM: John E.~I, Administrator
RE: Tax paymeht on the anticipated net worth of the
estate of Thomas C. Butler
Enclosed in a payment for the taxes on the anticipated net worth of The Estate of Thomas C.
Butler.
We estimate the net worth of the estate to be $30,000.00 and the enclosed payment of the taxes
at 6% of that to be $1,800.00.
Should you need to contact me, I can be reached at the following:
John E. Wetzel
Daytime phone: 717-264-9513
Home phone: 717-709-0412
Cell phone: 717-860-3522
My wife is ordinarily at home all day, and you may feel free to discuss any concerns with her. Her
name is Theresa Wetzel, and she is the decedent's daughter.
Thank-you.
7003 1680 0000 4137 [!516 .o~ ...... ~
0000
I ~.,~},.~ .iF _ ~!,,\ ,.. ~ ~_ ..... _.:' )/'~ ~----~ 17013
RETURN RECBPT .... ,'t
REQUESTED ~ ~;' ~'- ~ ~'~ '~ "':' ~ ~
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE REV-1162 EX(11-96)
BUREAU OF iNDIViDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 003015
WETZEL JOHN EDWARD
19 EDGELEA DRIVE
CHAMBERSBURG, PA 17201
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
........ fold
101 $1,800.00
ESTATE INFORMATION: SSN: 191-42-8550
FILE NUMBER: 2103-0283
DECEDENT NAME: BUTLER THOMAS C
DATE OF PAYMENT: 09/15/2003
POSTMARK DATE: 09/13/2003
COUNTY: CUMBERLAND
DATE OF DEATH: 03/22/2003
TOTAL AMOUNT PAID: $1,800.00
REMARKS: JOHN EDWARD WETZEL
CHECK//109
INITIALS: DO
SEAL RECEIVED BY: DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
· Complete items 1, 2, and 3. Also complete A. '
·Print your name and address on the revere
so that we can return the card to you.
m A~ach this card to the back of the mailpiece,
or on the front if space pe~its.
1. ~icle Addressed to: · '
If YES, en~e
I ~ Ce~ifi~ Mail ~ ~P~ M~I
~ ~ Insured Mail ~ C.O.D.
2. ~icle Numar
~mnsfer f~m se~ice label)
~ PS Form 3811, August 2001 Domestic Return R~eipt 1~9~1~
1992/17858 AU[ 2 7 2003
JRD/June
30,
In Re: Estate of THOMAS C BUTLER · ORPHANS' COURT DIVISION
Late of WORMLEYSBURG BOROUGH · COURT OF COMMON PLEAS OF
· CUMBERLAND COUNTY
Estate No.: 21-03-283 · PENNSYLVANIA
NO. 21-2003-283
NOTICE OF FAILURE TO FILE CERTIFICATION AND REQUEST TO CONDUCT A
HEARING PURSUANT TO RULE 5.6(e), SUPREME COURT
ORPHANS' COURT RULE
Personal Representative: JOHN WETZEL
Counsel for Personal Representative: JOHN M GLACE, ESQ.
Date of Grant of Original Letters: 03-31-2003
Date of Delinquency Notice: 07-11-2003
The undersigned, Mary C. Lewis, Register of Wills, in accordance with Rule 5.6,
Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of
Common Pleas of Cumberland County, that neither the above named personal representative nor
the above named counsel for the personal representative have filed with the Register of Wills or
Clerk of the Orphans' Court his, her or its certification required by Rule 5.6(e), Supreme Court
Orphans' Court Rule and that the requisite notice, pursuant to Rule 5.6(e), Supreme Court
Orphans' Court Rules, was given by the Register of Wills on JULY 11, 2003, and that the ten
(10) day notice to file the certification has expired. Accordingly, in accordance with Rule 5.6(e)
the Court is hereby notified of such delinquency and the undersigned requests that a Court
conduct a hearing to determine whether sanctions should be imposed upon the delinquent
personal representative or counsel for the delinquent personal representative.
08-26-2003 ~ Register of X/q~l[s 0 ~
Distribution: Personal Representative
Counsel for Personal Representative
Estate File
A hearing is scheduled for ~~_~ ~7; ~ ,)~,/,~,In Courtroom No. 3. If the
Certification of Notice is filed prior to the hearing date, the heating will automatically be
cancelled. George ~
OFFICIAL USE ONLY
(6~0)
~-~ COMMONWEALTH OF
~j~ ~_.~,,~,~ ~ PENNSYLVANIA
~~~ ~E.~R~ME~ O, REVENUE
r~~~ DEPT.~0~0~INHERITANCE TAX RETURN ~'~
PA
17128-0601
RESIDENT
DECEDENT
YEAR NUMBER
DECEDENTS NAME~AST, FIRST, AND MIDDLE IN~ SOCIAL SECURITY NUMBER
/ / J / 5 /
(IF APPLIC BLE)SURVIVING SPOUSe'S N~ME (~ST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
~1. Origins, ~eturn ~ 2. Supplemental Return ~ 3. Remainder Return (date o~death prior to 12-13-82)
~ 4. Limited Es ate ~ 4a. Future Interest Compromise (date o~ death after 12-12-82) ~ 5. Federal Estate Tax Return Required
~ 6. Decedent Died Testate (AUach ~py of Will) ~ 7. Decedent Maintained a Living Trust (A~ach copy of Trust) __ 8. Total Number of Safe Deposit Boxes
~ 9. Litigation Proceeds Received ~ 10. Spousal Povedy Credit (date of death be~een 12-31-91 and 1-1-95) ~ 11. Election to tax under Sec. 9113(A) (At~ch S~ O)
COMPLETE MAILING ADDRESS
NAME g'loce .
TELEPHONE NU
1.
Real
Estate
(Schedule
A)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Padnership or Sole-Proprietomhip (3)
4. Mo~gages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Prope~ (5) ~// ~ ~ ~ ' /
(Schedule E)
6. Jointly Owned Prope~y (Schedule F) (6)
~ Separate Billing Requested . ,
7. Inter-Vivos Transfers & Mis~llaneous Non-Probate Prope~ (7)
(Schedule G or L)
8. Total Gross Asse~ (total Lines 1-7) (8)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mo~gage Liabilities, & Liens (Schedule l) (10) ~] / '~ ~' ~
11. Total Deductions (total Lines 9 & 10, (11)
12. Net Value of Estate (Line 8 minus Une11) (12) /El 'e z /
13, Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13)
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14) J
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE ~TES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2) x .0 ~ (15)
16. Amount of Line 14 taxable at lineal rate /~/ ~'~[ x.0~ (16)
17. Amount of Line 14 taxable at sibling rate x .12 (17)
18. Amount of Line 14 taxable at collateral rate x .15 (18)
19. Tax Due (19)
Decedent's Complete Address:
Tax Payments and Credits.
1. Tax Due (Page1Line19) (1) /1~ 85~-.-~2..
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments /~ tq 1¢)t¢) O.~O
C. Discount
Total Credits (A + B + C ) (2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + E ) (3)
4. If Line 2 is greater than Une 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SB)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; .......................................................................................... [] [~
b. retain the right to designate who shall use the property transferred or its income; ............................................ []
c. retain a reversionary interest; or .......................................................................................................................... []
d. receive the promise for life of either payments, benefits or care? ...................................................................... []
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. []
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. []
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ ~ []
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that ~ave examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and cCplete.
Declaration of preparer other than the p_.~f~onal representative is based on all information of which preparer has any knowledge. / /
SIGNATURE OF PEFJ,qQN I:~E~$~)NStBLE FOR FILING RETURN ~ i
/vt.. ce, 5 I/
ADDRESS / I / I , / ,/ , /
( JU wat t ¢¢ t4 w 'sb /0,4
SIGNATURE OF PRBP. C~ER OTHER THAN REPRESENTATIVE -- 7 DATE
ADDRESS
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 decedenrs 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.
REV-1502 EX+ (6-98,~
SCHEDULE A
COMMONWEALT' OF ,EN.SY'VAN,A REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
t I FILENUMBER
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be
exchanged between a wilHng buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
TOTAL (Also enter on line 1, Recapitulation) $
(if more space is needed, insert additional sheets of the same size)
~ SCHEDULE E
coM,~o.W~.T.~O~ PE..S¥~V^.~^ CASH, BANK DEPOSITS, & MISC.
,..E.rr~c~ T~X ~TUR. PERSONAL PROPER~
RESIDENT ~CEDE~
RLE NU~bEk
I~ude ~e p~s ~ I~a~ a~ ~ da~ ~e ~s w~ ~ by ~ ~. All ~o~ ~i~ ~ ~e ~ht of suwb~hip mu~ ~ dbc~ on ~ub
ITEM VALUE AT DATE
;UMBER DESCRIPTION ~ D~TH
Insurance Reimbu~ement (total destm~ion of
2002 THumph Moto~ycle)
~. Chang A~~mm~e ~nk ac~
/~
Auto Insurance R~nd (Nation.de Policy
Sale ~ Trailer for Moto~ycle (FabHque VIN~
GA~NBV t 356 )
~. Sale ~ Remainder ~ ~~1 p~~
T Cash [
Sale of 1992 ~ Cab~olet
~IN~ ~CB 5t 53NK~8~ ~)
Sale of 198t Honda
(VIN # JH2SCOt08BM00t'It0) ~" O~ ,C~
1 01.°°
2003 Federal Tax Refund
TOTAL (Also enter on line 5, Recapitulation) $ ~/, ~ ~2' lz~
R~-,S,OEX*,~*9~ ~ SCHEDULE G
-~-
INTER-VIVOS TRANSFERS &
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN MISC, NON-PROBATE PROPERTY
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF
· 'z(- 07 -~o2 ~5
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is ,es.
DESCRIPTION OF PROPERTY % OF
ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
ATTACH A COPY OFTHE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST {IFAPPLICABLE)
NUMBER
4~
TOTAL (Also enter on line 7, Recapitulation) $ ~ '
(If more space is needed, insert additional sheets of the same s~ze)
REV-1511 EX+ (12-99)
SCHEDULE H
FUNERAL EXPENSES &
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
Debls o! decedent must be reported on Schedule I.
iTEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions I
Name of Personal Representative(s) '"'~0 ~ ~ W cf _,,~e,~ ,/~
Social Security Number(s)/EIN Number of Personal R, epresentative(s)
Street Address ~ q
City C k '~/~ ~ ~ ~-,~ 'J~ ~4 I~ State~ Zip17201
Year(s) Commission Paid:
2. Attorney Fees ,500 '00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Street Address
City State __ Zip
Relationship of Claimant to Decedent
4. Probate Fees 7q .'00
5. Accountant's Fees
6. Tax Return Preparer's Fees /~o ,45
7
TOTAL (Aisc enter on line 9, Recapitulation) /2.z
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX+ (9-00)
~'~ SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
7[ 0'5 oo7 5
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
PA t l zo '
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
Il NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
~x.,,..., .~~ SCHEDULE I
COMMO.WE^LT' OF PE..SY'V^"'^DEBTS OF DECEDENT.
,N.E.,T^.CE T^x .~u.. MORTGAGE LIABILITIES, & LIENS
~s.~.~ ~c~.~
Include unreimbumed medical expenses.
EM
~BER DESCRIPTION AMOUNT
Capitol One C~it Ca~ (.c~
~. U.G.I. hlance 2 ( 2 ~
~. ~ ~rough ~ Wo~leysbu~ t~ Bill (ac~ · ~770)
~. ~ Bu~au ~ ~st~ (UGI Balanc~ a~ · ~t 7)
~. PowelI,R~e~, & S~a~ C~it Bu~au (acct
~. NCO Fina.cial ( ac~
~. Capitol One C~ (ac~ · 5~-~ 5~ 7~2~ ~) ~ ~ ~'
~. PA ~ed.n Water ~mp. ( ac~
q. PA Ame.~n wat~ ~mp. (Balance)
~0 Mo~nge Pny ~ Am~quest
TOTAL (Also enter on line 10, Recapitulation)
flf more snace is need~rt in.~Rrt ;:,.ddifinn~l ~hp.~t~ nf the ~m~
REV-I,508 EX + (1-97)
,~it:j~t'/L~t~ SCHEDULE E
COMMONWEALTH~OF PENNSYLVANIACASH, BANK DEPOSITS, & MISC.
~N,ER,TANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule
iTEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Insurance Reimbursement (total destruction of
2002 Triumph Motorcycle)
Checking Acct(Commerce Bank acct # 05t 2t 09513)
Auto Insurance Refund (Nationwide Policy
,3,
#5837D435445)
4~ Personal Property (Yard sale)
7,
Sale of Trailer for Motorcycle (Fabrique VIN#
GAWR/PNBV 1356 }
~, Sale of Remainder of personal property
7' Cash / ~'/!
Sale of 1992 VW Cabriolet
(VIN# WVWCB 5t 53NKOG8135)
Sale of 198t Honda
(VIN # JH2SCOlO8BMO01110)
O0
2003 Federal Tax Refund
TOTAL (Also enter on line 5, Recapitulation) $ '~ / / O ~2' /~
(If more space is needed, insert additional sheets of the same size)
,~v.,~,2~x..~,.9,, ~ SCHEDULE I
COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES, & LIENS
RESIDENT DECEDENT
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION AMOUNT
1.
Capitol One Credit Card (,cct # 4388 6420 6056)
2. U.G.I. Balance
1'2 -
.3' Borough of Wormleysburg trash Bill (acct # 040770)
Credit Bureau of Lancaster (UG! Balance: acct # 34817)
PowelI,Rogers, & Speaks Credit Bureau (acct # t t 34817)
~. NCO Financial ( acct # 80VWt 6)
'~ Capitol One Credit (acct # 529t-t5t7-5426-0t54) ~'//~j'
g. PA American Water Comp. ( acct # 22t 606 2927-63)
C~. PA American water Comp. (Balance)
I0 Mortgage Pay Off: Ameriquest (Loan # 0042310946)
I I Settlement Charges, Sale of Residence
TOTAL (Also enter on line l0, Recapitu[ation) $ ~ {/-7 0"7 '10
(If more space is needed, insert additional sheets of the same size)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INO~AAf[X-~~E(~FF'ICE OF
INHERITANCE TAX 0 r~n(,,-- - (" - '." "~'I !
PO BOX 280601 I,,":', ,',,:
HARRISBURG PA 17128'-0'6D1 ,. -
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
zeus Jf',i'l 14 Pi', 3: 14
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
01-17-2005
BUTLER
03-22-2003
21 03-0283
CUMBERLAND
101
C'r-',
.\ "1'1,
I-L I
OPpel'}'\";
,). I .. ....
JOHN (!\.I~LACEi E'$Q'
J M GLACE LAW OFFICE
132-134 WALNUT ST
HBG PA 17101
*
RfV-15~7 EX AFP 112-0~l
THOMAS
C
Allount RSllift.d
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 ~
RE.V:r~~.EX..AFi>--rllr:6!')".NOT.I.CE.OF.i:Nil!flTl'AiicE.TAX"A.PPRAYnM.€NT:..ALLo~Ai(C€.OR-------_......._-
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BUTLER THOMAS C FILE NO. 21 03-0283 ACN 101 DATE 01-17-2005
TAX RETURN WAS, (X I ACCEPTED AS FILED
I CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held stock/Partnership Interest (Schedule C)
4. Hortgages/Notes Receivable (Schedule DJ
S. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule fJ
7. Transfers (Schedule G)
8. Total Assets
III
121
131
141
[51
[61
(7)
62.800.00
.00
.00
.00
21. 082.14
.00
.00
IBI
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule HJ
10. Debts/Mortgage Liabilities/Liens {Schedule II
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts {Schedule JJ
14. Net Value of Estate Subject to rax
191
IlOI
3,227.53
61. 707.40
(111
1121
1131
1141
NOTE: If an assessment was issued previously, lines
reflect figures that include the total of ALL
ASSESSMENT OF TAX:
15. Amount of line 14 at Spousal rate (15)
16. Amount of Line 14 taxable at Lineal/Class A rat. (16)
17. Amount of line 14 at Sibling rat. (17)
18. Amount of Line 14 taxable at Collateral/Cless B rate (18)
19. Principal Tax Due
TAX DITS:
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax paYllent.
83,882.14
64.9~4 9~
18,947.21
.00
18,947.21
14, lS and/or 16, 17, 18 and 19 will
returns assessed to date.
.00 X 00 =
18,947.21 X 045 =
.00x12=
.00x15=
1191=
.
INTEREST/PEN PAID I-I
.00
AMOUNT PAID
1,800.00
DATE
09-13-2003
NUMBER
CD003015
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
.00
852.62
.00
.00
852.62
1,800.00
947.38CR
.00
947.38CR
IF TDTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT'" (CRl) YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I ~ "> \<:...
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:
178
01/25/2005
Thomas C. Buder
21-03-0283
John M. Glace
132-134 Walnut Street
Harrisburg, PA 171011612
"p
Qty
1
o
Fee Description
Additional Probate
Fee
Total
SECOND NOTICE
160.00
0.00
$160.00
$0.00
Total:
$160.00
Checks should be made payable to the Register of Wills. Terms: Net 30.
Please return one copy of this invoice with your payment. Thank you.
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 2/02/2005
GLACE JOHN M ESQ
132 134 WALNUT ST
HARRISBURG, PA 17101
RE: Estate of BUTLER THOMAS C
File Number: 2003-00283
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) 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 two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing will become delinquent on: 3/22/2005
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
.~ t~PA) ~/k:~
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Personal Representative(s)
Judge
J
IN THE COURT of COMMON PLEAS,
CUMBERLAND COUNTY, PENNSYL VANIA,
ORPHANS COURT DIVISION
No. 21-03-0283
'Y)
THE ESTATE ofmOMASC. BUTLER
LATE of THE BOROUGH ofWORMLEYSBURG,
CUMBERLAND COUNTY, PENNSYLVANIA
e,
( I
,
FAMILY AGREEMENT, WAIVER of ACCOUNTING and
FINAL RELEASE
.. . ~
, This Agreement entered into this I ~ day of Hlotttryv1r ,2005, by
and between JOHN WETZEL, son-in-law of decedent and AdIhinistrator fthe Estate,
and THERESA WETZEL, TAIRA BUTLER and THOMAS BUTLER, the natural
children of the decedent and his only lawful heirs under the Estate filed at the Register
of Wills Office of Cumberland County to the above docket on Wills on March 3 I, 2003
with Letters of Administration issued to the above Docket, being the residuary legatees of
this Estate. For purposes of this Agreement, the term "Administrator" is used when
JOHN WETZEL is referred to in his fiduciary capacity and the term" Legatees" or the
individual legatee's first name shall be used otherwise.
Backf!round
I. Thomas C. Butler ( hereinafter "Decedent"), died intestate March 22, 2003, a
resident of Wormleysburg, Cumberland County, Pennsylvania..
2. Decedent's Estate was filed of record on March 3 I, 2003 with John Wetzel
named without objection as Administrator and Letters of Administration were issued
thereafter. .
3. Decedent's three (3) children THERESA WETZEL, TAIRA BUTLER and
THOMAS BUTLER were identified as the only lawful legatees and notified, pursuant to
Rule 5.6(a), of their beneficial interest in their father's estate
4. The Administrator advertised the grant of Letters of Administration
Testamentary, prepared and filed a Pennsylvania Inheritance Tax Return and federal and
state income tax returns.
;;--
5. The Administrator has paid all the taxes and has received a tax clearance
statement from the Pennsylvania Department of Revenue, Inheritance Tax Division. To
Administrator's and Legatees' knowledge and belief, no further unpaid claims exist
against the Estate, absolute or contingent, upon which any action may be asserted
6. The Administrator has completed his administration of the Estate, including
distribution of assets to all Legatees.
7. The Estate Inventory, filed August 26,1999, at the Office of the Register of
Wills of Dauphin County, is attached hereto which accurately reflects the value of all
Estate assets at the date of Decedent' s demise.
8. All Legatees, being closely related, desire that this Family Agreement make
unnecessary the filing of an Accounting in Orphan's Court.
9. Legatees, Theresa, Taira and Thomas, have been given full opportunity to
review the books and records of the Administrator, and, based upon such examination,
they have determined that they have sufficient information to make an informed decision
to waive their right to an Accounting and to release Administrator.
Aweement
IN CONSIDERATION of the willingness of the Administrator to distribute and
terminate the Estate in accordance with the laws of the Commonwealth of Pennsylvania
relative to intestate descent with the protection afforded him by formal adjudication of an
Administrator's account, Theresa, Taira and Thomas, the undersigned sole beneficiaries,
individually and respect to their heirs, personal representatives, successors and assigns,
do hereby:
1. Acknowledge that we have read this Agreement and represent that the facts set
forth above are true and correct to the best of our knowledge, information and belief. We
further acknowledge that we are familiar with the assets of the estate and rules governing
interstate distribution;
2. Waive the filing of a formal account of the administration of this Estate, with
respect to income and principal thereof, in any Court which may have jurisdiction, and, in
particular, the Court of Common Pleas, Orphan's Division, Cumberland County,
Pennsylvania;
3. Declare that we have examined all accounts and statements relative to the
assets of this Estate, and find them true and correct in all particulars; understand that all
administration costs and attorney fees have been paid; accept and approve these
distributions and payments as if it had been prepared, submitted and fully audited,
adjudicated and confIrmed absolutely by such court which may have jurisdiction over this
Estate; and as if, the balance of principal and income had been awarded by said Court in
accordance with this Agreement and the Inventory;
4. Warrant that we know of no outstanding and unpaid claims against the Estate
and approve the distribution of the balance of principal and income;
5 Absolutely and irrevocably release and discharge John Wetzel, Administrator
of the Estate, his personal representatives, heirs, successors and assigns, from any and all
actions, liabilities, claims, and demands, including specifIcally, but not limited to,
liability arising in connection with any mistake of fact or law, or negligent or careless act
or omission, in connection with the administration of the Estate and distribution of assets
, without a formal court hearing and adjudication;
6. Agree to refw1d to the Administrator such part or all of the distributive share
which has been distributed to us which may at any time be determined to have been an
erroneous distribution to us regardless of the cause of such error, even if attributable to
negligence;
7. Agree that any period of Limitation of actions for the collection of any
erroneous distribution to any or all of us shall commence only at such time as
Administrator has obtained actual knowledge of such erroneous distribution and that, in
no event, shall the obligation to collect any erroneous distribution start earlier than the
actual discovery thereof by Administrator;
8. With respect to any distributions of income or principal, which we have
received, or will receive upon execution of this Agreement, agree to indemnify and hold
harmless the Administrator, his personal representatives, heirs, successors and assigns,
from any liability, loss or expense ( including, but not limited to, attorney's fees), arising
from any cause whatsoever, which may be incurred by the Administrator as a result of the
administration of these Estate or distribution in accordance to this Agreement including,
but not limited to, any liability for federal estate tax, Pennsylvania Inheritance tax, or
other estate taxes and any federal or state income taxes, together with any interest or costs
incidental thereto, relating in way to the Estate and also including, but not limited to, any
assets, received or payments or distributions made by reason of any negligence or mistake
off act or law;
9. Understand that this Agreement is signed in counterpart originals, all of which
together shall be deemed to constitute one original; and
10. Agree that this Agreement shall be governed by the laws of the
Commonwealth of Pennsylvania.
I
Release
KNOW ALL MEN BY THESE PRESENTS that Theresa Wetzel, daughter
of Thomas C. Butler, Deceased does hereby acknowledge that she has been advised by
John M. Glace, Esquire on behalf of John Wetzel of Chambers burg , P A, Executor of
the Estate of Thomas C. Buder ,Deceased, late of the Borough ofWonnleysburg,
Cumberland County, Pennsylvania, that final distribution of in the sum of $ S. /06. /2
,
full satisfaction and payment of all such sum or sums of money due, owing and distributable
to him/her from the Estate of Thomas C. Buder, Deceased, will be paid immediately upon
receipt of this executed Release.
AND THEREFORE, the said Theresa Wetzel, does by these presents, remise,
release, quitclaim and forever, discharge the Estate of Thomas C. Buder, his heirs and
Executor, of and from any liability of whatsoever nature with respect to the aforementioned
final distribution and from all actions, suits, payments, accounts, reckonings, claims and
demands whatsoever for or by reason thereof, or any other act, matter, cause or thing
whatsoever.
AND FURTHER, the said Theresa Wetzel, in consideration for receipt of the
aforementioned final distribution, does agree to indemnify and hold harmless the Estate of
Thomas C. Buder to the extent of the aforesaid final distribution, for all claims and demands
whatsoever made against such Estate for which the assets of such Estate, after deducting
therefrom the aforementioned final distribution, are in adequate to satisfy.
. IN WITNESS WI;I..EREOF I hereunto set my hand and seal this M- day of
~,20o..:L.
\~i1!;;lIA~~
Wi ess
(]fww/1Jfctf/ ~
Theresa Wetzel
Social Security Number ~O q 51 Qf!7(p
*~""_A~
m$ L ~ ~j'M~
COMMONWEAlTH OF PENNSYlVANIA
NOTARIAL SEAL
LINDA E. HERMAN, Notary Public
Lemoyne Borough, Cumber1and Co.
My Commission Expltes Aug. 26. 2008
Release
KNOW ALL MEN BY THESE PRESENTS that Thomas Charles Butler,
son of Thomas C Butler, Deceased does hereby acknowledge that he has been advised by
John M. Glace, Esquire on behalf of John Wetzel of Chambersburg , PA, Executor of
the Estate of Thomas C. Butler, Deceased, late of the Borough ofWormleysburg, J2
Cumberland County, Pennsylvania, that final distribution of in the sum of $ I.J J / OJ; -
f
full satisfaction and payment of all such sum or sums of money due, owing and distributable
to him/her from the Estate of Thomas C. Butler, Deceased, will be paid immediately upon
receipt of this executed Release.
AND THEREFORE, the said Thomas Charles Butler, does by these presents,
remise, release, quitclaim and forever, discharge the Estate of Thomas C. Butler, his heirs
and Executor, of and from any liability of whatsoever nature with respect to the
aforementioned final distribution and from all actions, suits, payments, accounts, reckonings,
claims and demands whatsoever for or by reason thereof, or any other act, matter, cause or
thing whatsoever.
AND FURTHER, the said Thomas Charles Butler, in consideration for receipt of
the aforementioned final distribution, does agree to indemnify and hold harmless the Estate
of Thomas C. Butler to the extent of the aforesaid final distribution, for all claims and
demands whatsoever made against such Estate for which the assets of such Estate, after
deducting therefrom the aforementioned final distribution, are in adequate to satisfy.
IN WITNESS WHEREOF I
]",,-,, ,. "r j , 200 5-.
~~~/
hereunto set my hand and seal this ~ day of
Witness
~ c:J-k dk)I...
Thomas Charles Butler
Social Security Number 1<\5.6,0-5'150
COMMoNWEALlH OF PENNSYlVANI4
LINDA t~r~~L ~EAL
Lemayne Borough Cu~b11c
My Commission Elq)ires Aug, 26, gooOa
Release
KNOW ALL MEN BY THESE PRESENTS that Taira Buder, daughter of
Thomas C. Buder, Deceased does hereby acknowledge that she has been advised by
John M. Glace, Esquire on behalf of John Wetzel of Chambersburg , P A, Executor of
the Estate of Thomas C. Butler ,Deceased, late of the Borough ofWormleysburg,
Cumberland County, Pennsylvania, that final distribution of in the sum of $1) /o!i /}
/
full satisfaction and payment of all such sum or sums of money due, owing and distributable
to hUn/her from the Estate of Thomas C. Butler, Deceased, will be paid immediately upon
receipt of this executed Release.
AND THEREFORE, the said Taira Butler, does by these presents, remise, release,
quitclaim and forever, discharge the Estate of Thomas C. Butler, his heirs and Executor, of
and from any liability of whatsoever nature with respect to the aforementioned final
distribution and from all actions, suits, payments, accounts, reckonings, claims and demands
whatsoever for or by reason thereof, or any other act, matter, cause or thing whatsoever.
AND FURTHER, the said Taira Butler, in consideration for receipt of the
aforementioned final distribution, does agree to indemnify and hold harmless the Estate of
ThOtrulS C. Butler to the extent of the aforesaid final distribution, for all claims and demands
whatsoever trulde against such Estate for which the assets of such Estate, after deducting
therefrom the aforementioned final distribution, are in adequate to satisfy.
~ IN WITNESS WHEREOF I
J M Va- rlf-- ' 200 ;2.
~O~
hereunto set my hand and seal this JL day of
H.(O SUBSC:'<'" ..---
DAye.',..:!::!}*' ...., " :,
'/1d~
l\;;t I ",' .
COMMONWEAlTH Of PENNSYlVANIA
NOTARIAL SEAL
I LINDA E. HERMAN. Notary Public
Lemayne Borough. Cumberland Co.
Mt Coffimlsslon Expires Aug. 26. 2008
;Qdl~~
Taira Butler .
Social Security Number 15 q - & 4 - 7770
Respectfully submitted
The Law Office of John M. Glace
ut Street
17101-1612
Supreme Ct. ill: 23933
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
~ J
BUREAU OF ItmIVIDUAL TAXES
INHERiTANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
.,*
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
1EY-15"'EXAFPU2-M)
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
01-17-2005
BUTLER
03~22-2003
21 03-0283
CUMBERLAND
101
_t R_ittBd
C
JOHN M GLACE ESQ
J M GLACE LAW OFFICE
132-134 WALNUT ST
HBG PA 17101
THOMAS
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 ~
1't!\i:fAiil.~l".Af'P..r&1:.:6J'..Nili~~.cl.W.l1illl.j,.rA'Ni!E.-m.XiJ'IIRmNmT';-"lttlIUa-tilf---------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BUTLER THOMAS C FILE NO. 21 03-0283 ACN 101 DATE 01-17-2005
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/A.. Costs/tlisc. Expenses (Schedule H) (9)
10. Oebts/llort_ Liabiliti8s/Liens 1_18 II I10J 61.707.40
11. Total DBductions 1111 64 9:0;4 9:0;
12. Hat Value of Tax Raturn (12) 18,947.21
13. Charitabla/SoYBrnaental 8aquests; Non-alectad 9113 Trusts 1_1. J) (13) .00
14. Hat Value of Estata Subjact to Tax (14) 18,947.21
N01~: 11' an asseS_en1: was :l.ssued prev:l.ouslY, lines 14, l!rand'Dr 16,-17, 18 and 19-w111
ref'leC't 1'1gures 'that include 'the 'tD1:al D1' ALL re1:urns assessed 'tD date.
ASSESSMENT OF TAX:
lS. "-<rIt of Una 14 at Spousal rat. Ill)
16. ~t of Line 14 taxable .t Lineal/Class A rat. (16)
17. _t of Una 14 at Sibling rat. (17)
18. AIIount of Line 14 taxable at Collateral/Class Brat. (18)
19. Principal Tax Due
XC TS:
TAX RETURN liAS: (X) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..1 Estate (Schedule A)
2. stocks w.c:I Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. I1ortgages/Notes Receivable (Schedule DJ
5. Cash/Bank Deposits/Hisc. Personal Property (S~l. E)
6. Jointly _ P.......rty (Schedula F)
7. Transfers (Schedule S)
8. Total Assets
+
DATE
09-13-2003
NUllBER
CD003015
INTEREST/PEN PAm 1-)
.00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
I ) CHANGED
(1)
(2)
(3)
(4)
(S)
(6)
I])
62.800.00
.00
.00
.00
21. 082 .14
.00
.00
(8)
NOTE: To insure proper
credit to your account~
_it the _r portion
of this fo~ with your
tax ...._t.
83,882.14
3,227.53
.00 X
18,947.21 X
.00 X
.00 X
00 =
045 =
12 =
15 =
.00
852.62
.00
.00
852.62
(19)=
AHOUNT PAm
1,800.00
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
1,800.00
947.38CR
.00
947.38CR
IF TOTAL DUE IS LESS THAN $1, NO PAYltENT IS RElIUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU MAY 8E DUE
A REFUND. SEE REVERSE SmE OF THIS FDRN FOR INSTRUCTIONS.)
CERTIFICATE OF SERVICE
I HEREBY CERTIFY that this day of February, 2005 I have served a true
and correct copy of the foregoing Family Agreement, Waiver of Accounting and Final
Release, by first class mail, postage pre-paid, upon:
Theresa Wetzel
19 Edgelea Drive
Chambersburg, PA 17201
Thomas C. Butler
425 7th Street
New Cumberland, P A 17070
Taira Butler
425 7th Street
New Cumberland, P A 17070
LAW OFFICES of JOHN M. GLACE
, Esquire
Counsel for Administrator
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX Z80601
HARRISBURG PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
'*
REY-1U7 EX AFP 112-04)
r:
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
02-22-2005
BUTLER
03-22-2003
21 03-0283
CUMBERLAND
101
THOMAS
C
JOHN M GLACE ESQ
J M GLACE LAW OFFICE
132-134 WALNUT ST
HBG PA 17101
Allount Rellitted
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, subllit the upper portion of this forll with your tax paYllent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
~~:r&~~.!5r.A'~..rn1~.~!'...........irA~!~e1r~l1r.~'1~A1nlf.b,r.l~1!~O~...ii......................
ESTATE OF BUTLER THOMAS C FILE NO.21 03-0283 ACN 101 DATE 02-22-2005
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 01-10-2005
PRINCIPAL TAX DUE:.
852.62
PAYMENTS (TAX CREDITS):
~
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
09-13-2003 CD003015 .00 1,800.00
01-31-2005 REFUND .00 947.38-
TOTAL TAX CREDIT 852.62
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.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A ..CREDI..... (CR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
Estate of BUTLER THOMAS C
Late of WORMLEYSBURG BOROUGH
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
Estate No.: 21-03-00283
Date:
4/08/2005
NO.: 21-03-00283
GLACE JOHN M ESQ
132 134 WALNUT ST
HARRISBURG PA 17101
NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A
HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS I COURT RULE
Personal Representative: WETZEL JOHN
Personal Representative Counsel: GLACE JOHN M ESQ
Date of Decedent's Death: 3/01/2001
Date of Delinquency Notice: 3/22/2005
The undersigned, Glenda Farner Strasbaugh, Clerk of Orhans'
Court, in accordance with rule 6.12, Supreme Court Orphans' Court
Rules, hereby notifies the Orphans' Court Division, Court of Common
Pleas of Cumberland County, that neither the above named personal
representative nor their counsel, have filed with the Register of
wills or Clerk of Orphans' Court, his/her Status Report required by
Rule 6.12, Supreme Court Orphans' Court Rule, and that the
requisite notice, pursuant to Rule 6.12, Supreme Court Orhans'
Court Rules, was given by the Clerk of Orphans' Court on 3/03/2005
and that the ten (10) day notice to file the status report has
expired. Accordingly, in accordance with Rule 6.12 the Court is
hereby notified of such delinquency and the undersigned requests
that a Court conduct a hearing to determine whether sanctions
should be imposed upon the delinquent personal representative or
their counsel. .
cc: File
Personal Representative
Counsel
~~~
Glenda Farner Strasbaugh
Clerk of Orhans' Court
A hearing is scheduled for June 03, 2005 at 9:30 AM in
Courtroom No. 03. If the Status Report is filed prior to the
hearing date, the hearing will automatically be cancelled.
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Register of Wills of Cumberland County
Date of Death:
STATUS REPORT UNDER RULE 6.12
,1!t-7a-<7 c. ~t(~
~f - 03 -1}fJ 1., 8'"!J
Name of Decedent:
Estate 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. StatCl\.w,le'ther administration of the estate is complete:
Yes ~ No 0
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 perso~sentative file a final account with the Court?
Yes 0 No X!
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the persoWepresentative state an account informally to the parties in
interest? Yes Ptl No 0
c. Copies of receipts, releases,joinders and appr al offormal or informal
accounts may be filed with the Clerk of the ' Court and may be
attached to this report.
Date:
Signature
J hit lute. E~1
Name
--1;~-'!J{ tv ~ st.
Address
_lIfb'lt/t; hl1~ PA l1tVl-161z"
Telephone No. I t
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Capacity: ~rsonal Representative
~ Counsel for personal representative
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Register of Wills of Cumberland County
STATUS REPORT UNDER RULE 6.12
Name of Decedent: -.J110tY1aS t. BLtl-ler
Date of Death: ~ 03
EstateNo.:1j I 03. OO~f?3
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 ~l)ether administration of the estate is complete:
Yes W No 0
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 0 No QI'"
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the perso~7epresentative state an account informally to the parties in
interest? Yes LJ No 0
c. Copies of receipts, releases, joinders and approval of formal or informal
accounts may be filed with the Clerk of the Orphans' Court and may be
attached to this report. ~ -------n;-0
Date:~~::7 ~ ~
I ""'----Signature
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ddln. e (;Jefct:{
Name
L1-
/q Ed~Q fr. (hm~ PA J7f}D1
Addre
(1 n) J.{P4-~711
Telephone No.
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Capacity: 0 Personal Representative
o Counsel for personal representative
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