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HomeMy WebLinkAbout03-0287PETITION FOR PROBATE and GRANT OF LETTERS Estate of HARPER, EMILIE G., Deceased. No. To: Social Security No. 190-26-6601 The Petition of the undersigned respectfully represents that: Register of Wills for Cumberland County, Pennsylvania Your Petitioners, who are 18 years of age or older and the Executors named in the Last Will and Testament of the above decedent, dated February 28, 1979. Decedent was domiciled at death in Cumberland County, Pennsylvania, with her principal residence at 408 Allendale Way Camp Hill, Cumberland County, Pennsylvania. Decedent, then 96 years of age, died March 17, 2003, at Bethany Village, Lower Allen Township, Cumberland County, Pennsylvania. 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: N/A. Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: $ 100.00 herewi, kh and the grant of letters TESTAMENTARY thereon. John W. Harper, Jr. ~ 408 Allendale Way Camp Hill, Pennsylvania 17011 WHEREFORE, Petitioners respectfully request the probate of the Last Will and Testament presented 408 Allendale Way Camp Hill, Pennsylvania 17011 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ) : SS COUNTY OF CUMBERLAND ) The Petitioners above-named swear or affirm that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of Petitioners and that as personal representatives of the above decedent Petitioners will well and truly administer the estaJq according I;o law. Sworn to or affirmed and subscribed (~E~__ ~c3 ~ ~L~,_., ~'~ before me this 1 day of Jol:m W. Harper, Jr. ' Donna Iq. Otto, 1st De..Duty Re~,tster / ',~~~ El~z~(15ath H. Harper '-- - ' # 17-1 o7 _/ NO. 21-2003-287 Estate of Emilie G. Harper DECREE OF PROBATE AND GRANT OF LETTERS AND NOW April 2nd ,2003, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated February 28, 1979 described therein be admitted to probate and filed of record as the last will of EMILIE G. HARPER; and Letters Testamentary are hereby granted to John W. Harper, Jr. and Elizabeth H. Harper. FEES Probate, Letters, Etc ............$18.00 Short Certificate(s) .....5. ....... $15.00 Renunciation ....................... $ x-Pages (1) $ 3.00 Ta~afL St~.o0 Filed... bp.r. }.1....2..n..d..,..2..0..0..3. .......... .$....4..6....0..O....Tgtal Register of Wills ,' ' / /f/! - - ,r),,] .g.. Donna ~I. lotto, 1st l~¢uty ~' ~ M~ch~el~ff~ff- /'~/ ' 6/ · J. Hanft, Es~ire Attorney I.D. No. 57976 19 Brookwood Avenue, Suite 106 Carlisle, Pennsylvania 17103-9142 (717) 249-5373 F:\User Folder~Firm Docs~EstatesX3100- lpet.ltrs,wpd Put Letters in Attorney's file in Prothonotary on 4/2/03 21-2003-287 REGISTER OF WILL OF CUMBERLAND COUNTY OATH OF NON-SUBSCRIBING WITNESS John W. Harper, Jr. and Elizabeth H. Harper, each a subscriber hereto, being duly qualified according to law, depose and say that they are familiar with the signature of Emilie G. Harper, Testatrix, and believe to the best of their knowledge and belief that the signature on the Will dated February 28, 1979 is in the handwriting ofEmilie G. Harper, Testatrix. Sworn to or affirmed and subscribed before meAhis lstday of April 2003. Register Donna M. Ot~:t~,l'st ffer~uty ~ John W. Harper, Jr. ~ '"-~' 408 Allendale Way Camp Hill, Pennsylvania 17011 408 Allendale Way Camp Hill, Pennsylvaina 17011 F:\User Folder~Firm Docs~EstatesL3100-1 oath.non sub. witness.wpd 21-2003-287 LAST WILL AND TESTAMENT OF EMILIE G. HARPER I, EMILIE G. HARPER, of Lower Allen Township, Dauphin County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, utter and publish this my last will and testament, hereby revoking all former wills by me heretofore made. 1. I order and direct that all my just debts and funeral expenses, including inheritance taxes, be fully paid and satisfied by my Executors, hereinafter named, as soon as may be convenient after my death. 2. I give, devise and bequeath all the rest, residue and remainder of my estate, real, personal and mixed, whatsoever nature and whmresoever situate, of which I shall die seized and possessed, or to which I shall be entitled at the time of my death, to my son, John W. Harper, Jr., and Elizabeth H. Harper, his wife, or their survivor, of Lower Paxton Township, Dauphin County, Pennsylvania. In the event that both my son, John W. Harper, Jr., and Elizabeth H. Harper, his wife, should predecease me, I give, devise and bequeath, all the rest, residue and remainder of my estate, real, personal and mixed, whatsoever nature and wheresoever situate, or to which I shall die seized and possessed, or to which I shall be entitled at the time of my death, to my Grandson, John W. Harper, III, of Lower Paxton Township, Dauphin County, Pennsylvania, per stirpes. 3. I nominate, constitute and appoint John W' Harper, Jr., and Elizabeth H. Harper, his wife, or their survivor, aforesaid, Co-Executors of this my last will and testament, to serve without bond of any type whatsoever. In the event that both my said son, John W. Harper, Jr., and Elizabeth H. Harper, his wife, should predecease me, or be unable to serve for any reason whatsoever, I nOminate, constitute and appoint my Grandson, John W. Harper, III, aforesaid, Executor of this my last will and testament, to serve without bond of any type whatsoever. 4. I direct that my Executor(s) shall serve as Guardian of the estates of any minor beneficiaries, without bond of any type whatsoever. IN WITNESS WHEREOF, I have to this my last will and testament, set my hand and seal at the end hereof, this ~ ~ day of l~ ...... , 1979. Signed, sealed, published and declared by Emilie G. Harper, the testatrix above named, as and for her last will and testament, in our presence, who, in her presence, at her request, andin the presence of each other, have subscribed ) our names as attesting witnesses. Emilie G. : p ( SEAL ) LAST WILL AND TESTAMENT OF EMILIE G. HARPER I~fIDDLETON, ROE AND ]~TZWEILER ATTORI~EY$ AT LAW 101 NORTH FRONT STREET H~I~RISBURG. PENNSYLVAlqIA 17101 Name of Decedent: Date of Death: Will No. To the Register: F:\User Folder\Firm Docs\EstatesL3100- I cert.wpd CERTIFICATION OF NOTICE UNDER RULE 5.6(a) EMILIE G. HARPER March 17, 2003 2003-00287 I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on April 11, 2003. Name Address John W. Harper, Jr. Elizabeth H. Harper John W. Harper, IH 408 Allendale Way, Camp Hill, Pennsylvania 17011 408 Allendale Way, Camp Hill, Pennsylvania 17011 1220 Riverview Road, Dauphin, Pennsylvania 17018-9723 Notice has not been given to all persons entitled thereto under Rule 5.6(a) except: N/A Date: April ! ~J, 2003 HANFT & KNIGHT, P.C. Mlc - ~~ · ~'mre Attorney I.D. No. 57976 19 Brookwood Avenue, Suite 106 Carlisle, Pennsylvania 17013-9142 Telephone (717) 249-5373 Capacity: Counsel forpersonalrepresentatives REV-I~OEX+{6~O) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT, 280601 HARRISBURG. PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 03 00287 COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Harper, Emilie O. DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 03/17/2003 08/18/1906 IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 190-26-6601 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 1. Original Return [] 2. Supplemental Return [] 3. Remainder Return (date of death pdor to 12-13-82) ~: ~ ~ [] 4. Limited Estate zOO ,,, ~ [] 6. Decedent Died Testate (Attach copy 0 ~. m of Will) < [] 9. Litigation Proceeds Received ] 4a. Future Interest Compromise (date of death after 12-12-82) [] 5. Federal Estate Tax Return Required [] 7. Decedent Maintained a Living Trust (Attach 8. Total Number of Safe Deposit Boxes copy of Trust) -- [] 10. Spousal Povedy Credit (date of death between [] 11~ Election to tax under Sec. 9113(A) (Attach Sch O) Michael J. Hanft, Esquire fIRM NAME (If applicable) Hanft & Knight, P.C. UMBER 717/249-5373 COMPLETE MAILING ADDRESS 19 Brookwood Avenue, Suite 106 Carlisle, PA 17013 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) [] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) None~ None~ .¢? None None 1,476.71 683.70 None 7,256.95 12,126.83 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) ~)FFiCIAL [.]SE f-.- I -0 (8) 2,160.41 19,383.78 (11) (12) (13) insolvent (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, x or transfers under Sec. 9116(a)(1.2) 16.Amount of Line 14 taxable at lineal rate x .045 17. Amount of Line 14 taxable at sibling rate x .12 18. Amount of Line 14 taxable at collateral rate x .15 19. Tax Due 20. [] (15) (16) (17) (18) (19) Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: ISTREET ADDRESS CJTY Camp Hill STATE PA ZIP 17011 408 Allendale Way Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) Interest/Penalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) 0.00 0.00 0.00 0.00 Total Interest/Penalty (D + E) (3) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Check box on Page I Line 20 to request a refund 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. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; .................................................................................. [] ~ b. retain the right to designate who shall use the property transferred or its income .............................. ~ c. retain a reversionary interest; or ..................................................................................................... d. receive the promise for life of either oavments beneftsorc r ? r J , ae .......................... [] 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 statements, and to the best of my knowredge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE iOF P.,~E~ON RESPONSIBLE FOR FILING RETURN :,'----- ERSON RESPONSIBLE FO"~ FILING RE~RN ADDRESS ADDRESS DATE 408 Allendale Way Camp Hill, PA 17011 Elizabeth H. Harper _ __ DATE "~' : J,. / [ /I. L ~_ ~ 408AllendaleWav SIGNATURE /~. /~..4c,'~.//.,~./ Cam ' - I~O~~ER THAN REPRE ..... p Hill, PA l~011 SENTA.,v ADDRE Michael J. Fl~C, t4ftCEsquire ~ ~ ',~F ./ SS DATE //./~.~" J/-fl ('~ ~~2.~ 1C9arl~[yff. p~p~O¢7A0venue, Suite 106 '"" / For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. §9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116 (a) (1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Harper, Emilie G. SCHEDULE E CASH, BANK DEPOSITS,& MISC. PERSONAL PROPERTY FILE NUMBER 21-03-00287 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 F. ITEM NUMBER DESCRIPTION PNC Bank Checking Account No. 5002317937 Blue Shield - rebate on health insurance Highmark Blue Cross/Blue Shield - refund Pharmacy Rebate Refund from Funeral Home TOTAL (Also enter on Line 5, Recapitulation) VALUE AT DATE OF DEATH 0.00 117.14 462.57 532.91 364.09 1,476.71 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF Harper, EmJlie G. FILE NUMBER 21 - 03- 00287 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A John W. Harper, Jr. 408 Allendale Way son Camp Hill, PA 17011 JOINTLY OWNED PROPERT' ~: LETTER DESCRIPTION OF PROPERTY - DATE Include name of financial institution and bank account number DATE OF DEATH I % OF DATE OF DEATH ITEM FOR JOINT MADE or similar identifying number. Attach deed for jointly-held real VALUE OF ASSET INTEREST DECEDENT'S INTERES DECD'S VALUE OF NUMBER TENANT JOINT estate. 1 A 05/01/1960 PNC Bank Checking Account No. 5140026715 1,367.40 50% 683.7( , TOTAL (Also enter on line 6, Recapitulation) 683.70 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMIN~TNE COSTS ESTATE OF Harper, Ernilie G. FILE NUMBER 21 - 03 - 00287 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: Myers Hamer Funeral Home Country Oven - funeral meal &DMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid Attorney's Fees to Hanft & Knight, P.O. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent Probate Fees State Zip Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs Cumberland Law Journal - advertising letters The Sentinel ~ advertising letters Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) 6,334.00 193.48 500.00 75.00 129.47 25.00 7,256.95 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Harper, Emilie G. 3 Income Tax Preparation Schedule H Fune,-~ Expemes & Admin~ Costs continL_~l FILE NUMBER 21 - 03 - 00287 25.00 Page 2 of Schedule H COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Harper, Emilie G. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21 - 03 ~00287 Include unreimbursed medical expenses. ITEM NUMBER 1 2 Department of Public Welfare Claim DESCRIPTION Conner Rich Associates Family Practice TOTAL (Also enter on Line 10, Recapitulation) AMOUNT 12,116.95 9.88 12,126.83 REV-1513 EX+ {9-00) ~ SCHEDULE J CO~ON~E^,T~ O~ ~NNS~,V^N,^ INHER'TANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF Harper, Emi]ie G. FILE NUMBER RELATIONSHIP TO AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT Do Net List Trustt~.{S) OF ESTATE Id TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1 John W. Harper, Jr. 408 Allendale Way son 50% residue of estate Camp Hill, PA 17011 2 Elizabeth H. Harper daughter-in-law 50% residue of estate 408 Allendale Way Camp Hill, PA 17011 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 - ENTFR TOTAl NI('~KI_'I'~,VAC)I ~: r~*c, ....................... DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET LAST WILL AND TESTAMENT OF EMILIE G. HARPER I, EMILIE G. HARPER, of Lower Allen Township, Dauphin County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, utter and publish this my last will and testament, hereby revoking all former wills by me heretofore made. 1. I order and direct that all my just debts and funeral expenses, including inheritance taxes, be fully paid and satisfied by my Executors, hereinafter named, as soon as may be convenient after my death. 2. I give, devise and bequeath all the rest, residue and remainder of my estate, real, personal and mixed, whatsoever nature and wheresoever situate, of which I shall die seized and possessed, or to which I shall be entitled at the time of my death, to my son, John W. Harper, Jr., and Elizabeth H. Harper, his wife, or their survivor, of Lower Paxton Township, Dauphin County, Pennsylvania. In the event that both my son, John W. Harper, Jr., and Elizabeth H. Harper, his wife, should predecease me, I give, devise and bequeath, all the rest, residue and - remainder of my estate, real, personal and mixed, whatsoever nature and wheresoever situate, or to which I shall die seized and possessed, or to which I shall be entitled at the time of my death, to my Grandson, John W. Harper, III, of Lower Paxton Township, Dauphin County, Pennsylvania, per stirpes. 3. I nominate, constitute and appoint John W. Harper, Jr., and Elizabeth H. Harper, his wife, or their survivor, aforesaid, Co-Executors of this my last will and testament, to serve without bond of any type whatsoever. In the event that both my said son, John W. Harper, Jr., and Elizabeth H. Harper, his wife, should predecease me, or be unable to serve for any reason whatsoever, I n6minate, constitute and appoint my Grandson, John W. Harper, ~II, aforesaid, Executor of this my last will and testament, to serve without bond of any type whatsoever. 4. I direct that my Executor(s) shall serve as Guardian of the estates of any minor beneficiaries, without bond of any type whatsoever. IN WITNESS WHEREOF,.I .have to this my last will and testament, set my hand and seal at the end hereof, this ~ ~ day of ~-~f~.~ ~ , 1979. Signed, sealed, published and declared by Emilie G. Harper, the testatrix above named, as and for her last will and testament, ~in our presence, who, in her presence, at her request, and.in the presence of each other, have subscribed our names as attesting witnesses. ) Emilie ~. Harper/ ( SEAI BUREAU OF TNDZVZDUAL TAXES INHERITANCE TAX DIVISION DEPT. 180601 HARRISBURG, PA 1711&-0601 COHMONNEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOHANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX MICHAEL J HANFT ESQ HANFT & KNIGHT 19 BROOKNOOD AVE 106 CARLISLE PA 17015 DATE 08-11-2005 ESTATE OF HARPER DATE OF DEATH 05-17-2005 FILE NUNDER 21 03-0287 ~I~NTY CUNSERLAND ACN 101 Amount Remitted REV-1;~I7 EX AFP (01-05) EMILIE G HAKE CHECK PAYABLE AND RENZT PAYMENT TO: REGISTER OF NZLLS CUHBERLAND CO COURT HOUSE CARLISLE. PA 17015 CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS -~ REV-Z547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR ESTATE OF HARPER DZSALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX EHILIE GFZLE NO. 21 05-0287 ACN 101 DATE 08-11-200,~ TAX RETURN NAS: { X) ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE ( ) CHANGED APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks end Bonds (SchaduZe B) (2) 3. CloseZy Held Stock/Partnership Zntermst (Schedule C) q. Mortgages/Norms Receivable (Schedule D) (q) S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) ($) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9, FuneraZ Expansas/Adm. Costs/HLsc. Expenses (Schedule H) (9) 10. Dabts/Hortgago Liabilities/Liens (Schedule Z) (10) 11. Total Deductions 12. Net Value of Tax Return lzq76.71 685.70 .00 .00 NOTE: To insure proper .00 credit to your account, . O0 submit the upper portion .00 of this form with your tax payment. (8) 7,256.95 12,126.85 (11) 2,160.ql 17,223.37- ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. DISCOUNT (+) INTEREST/PEN PAID (-) AHOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) .00 .00 .00 .00 15. Amount of Line lq et Spousal rate 16. Amount of Line 1~ taxable at Lineal/Class A rate 17. Amount of Line lq et Sibling rate 18. Amount of Line lq taxable et Collatoral/Class B rate 19. Principal Tax Due TAX CREDITS: NUMBER (15) .00 X O0 = .00 (16) .00 X Oq5= .00 (17) . O0 X 12 = . O0 (18), .00 x 15 = .00 (19)= . O0 (12) 13. Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (13) .00 lq. Net Value of Estate Sub~act to Tax (lq) 17,22~.$7- NOTE: Z~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: RESERVATION: PURPOSE OF NOTICE: PAYHENT: REFUND (CR): OBJECTIONS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 1Z, 198Z -- if any futura interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Coeeonaselth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the laaful Class B (collateral) rate on a~y such future interest. To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (7Z P.S. Section 9140). Detach tho top portion of this Notice and submit with your payment to the Register of gills printed on the reverse side. --Make check or money order payable to: REG/STER OF NZLLS~ AGENT A refund of a tax credit, ahich ams not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-131$). Applications ara available at the Office of the Register of Hills, any of tho Z3 Revenue District Offices, or by calling the special Z4-hour ansaaring service for forms ordering: 1-SOO-36Z-Z050; services for taxpayers aith special hearing and / or speaking needs: 1-800-447-30Z0 (TT Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) es shown on this Notice must object aithin sixty (60) days of receipt of this Notice by: --written protest to tbs PA Department of Revenue, Board of Appeals, Dept. Z81021, Harrisburg, PA 171ZS-lOZ1, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should bo addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Raviaa Unit, Bapt. Z80601, Harrisburg, PA 171Z8-0601 Phone (7173 787-650S. Sea page 5 of the booklet "Tnstructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. If any tax duo is paid within three (5) calendar months after the dacsdent's death, a five percent (SX) discount of the tax paid is allowed. The 15;: tax amnesty non-participation penalty is computed on the totml 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 tho tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, IgBz bear interest at tho rate of six (6Z) percent per annum calculated at a daily rate of .000164. All taxes ahich became delinquent on end after January 1, 1982 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. Tho applicable interest rates for 198Z through ZOO5 ara: Interest Daily Interest Daily Interest Daily Year Rate Factor Yaa.~.r Rate Factor Year Rate Factor 198Z 207. .000548 1987 97. .000247 1999 7Z .00019Z 1983 16Z .000456 1988-1991 117. .000301 ZOO0 aX .000Z19 1984 117. .000501 199Z 97. .000Z47 ZOO1 9Z .000Z47 1985 157. .000556 1993-1994 72 . Og 0192 ZOOZ 6Z .000164 1986 107. . OO OZTq 1995-1998 97. .000Z47 ZOO3 5Z .000157 --Interest is calculated as folloas: /NTEREST = BALANCE OF TAX UNPA/D X NUNBER OF DAYS DELTNQUENT X DA/L¥ INTEREST FACTOR --Any Notica issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of tho assessment. If payment is made after the interest computation date shown on the Notice, additional interest must bo calculated. ORPHANS' COURT DIVISION OF THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA STATUS REPORT UNDER RULE 6.12 Name of Decedent: EMILIE G. HARPER Date of Death: March 17, 2003 Admin. No. 21 03-0287 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: 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: is: Yes ao Did the personal representative file a final account with the Court? Yes No X The separate Orphans' Court No. (if any) for the personal representative's-account c. Did the personal representative state an account informally to the parties in interest? X No ' d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: August 18, 2003 Respectfully submitted, HANFT & KNIGHT, P.C. M(ichael J. Hanft, Attorney ID No. 57976 19 Brookwood Avenue, Suite 106 Carlisle, Pennsylvania 17013-9142 (717) 249-5373 Counsel for personal representatives