HomeMy WebLinkAbout03-0312PETITION FOR PROBATE and GRANT OF LE'FrERS
Estate of ALMA K- HARTMAN
also known as
, Deceased
Social Security No.
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are I 8 years of age or older an the execut of
in the last will of the above decedent, dated Auqust §, 1981
and codicil(s) dated
To:
Register of Wills for the
Coumy of CUMBERLAND
Commonwealth of Per~nsylvania
in the
named
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decedent was domiciled at death in Cumberland County, Pennsylvania, with
her last family or principal residence at 40 ~rf~q0 R0a0, Camo Hilt. PA 17011
Decedent, then 81
(list street, number and municipality)
years of age, died 1/3/2003
Except as follows, decedent did not marry, was not divorced and did not have a child bom or adopted
after execution of the will offered for probate; was not the victim ofa ~'Iling and was never ajudicated
incompetent:
Decedent at death owned property with estimated values as follows:
(If domiciled in Pa.) AH personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(lfnot domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith axed the gram of letters ~;t;i~m~P/
thereon. (testamentary; administration c.t.a.; administration d.b.n.c.t.m)
Richard K. Hartman
1919 N. Front Street
Harrisburq PA 17102
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF CUMBERLAND
The petitioner(s) above-named swear(s) or afl-mn(s) that the statements in the foregoing petition are
true and correct to the best &the knowledge and belief of petitioner(s) and that as persona[ represen-
tative(s) of the above decedent petitioner(s) wffi well and tmly administer the estate accmdh~g to law.
Sworn to or affirmed and subscribed
befoxe me this ~ ~rh day of
\ ,
Estate of ALMA K. HARTMAN , ~ea~
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW APRIl q, 2flfl':l , in consi~ ofthe petition on
the reverse side hereof, satisfactory proof baying been pi-esented before me,
IT tS DECREED that the instnnnent(s) dated 0/~11001
described therein be admitted to probate and filed of record as the last will of Alma K. Hartman
~ Lettem T~tamenlav/
are hereby granted to
Richard K. Haan
FEES
Probate, Letters, Etc ......... $ 25. O0
Short Certificates (2 ) ...... $ 6 00
R__~._~ktti~x .extra .pages . $ 9 00
jcp $10.00
TOTAL ~ $ 50_ 00
Flied. 4-9-2003
mailed to arty 4-9-2~003
~. Reg~sterof~Vi[ls t ~ '/- '
Mafielle F. Hazen
60883
ATTORNEY (Su¢ Ct. I.D. No.)
2000 Linglestown Road, Suite 303
Harriaburq PA 17110
ADDRESS
{717) 540-4332
PHONE
LAST WILL AND TESTAMENT
OF
ALMA K. HAR?MAN
County, Pennsylvania, being of sound and disposing mind, do
hereby make and declare this to be my Last Will and Testament,
and I do hereby revoke and make null and void all prior Wills
and Codicils made by me at any time heretofore.
ITEM I: I direct that all my legally valid debts, funeral
and administration expenses, and inheritance and estate taxes
incurred on account of my death shall be paid by my personal
representative out of my residuary estate as soon after my death
as practicable.
ITEM II: It is my desire to be interred in the New
Columbia Cemetery located in New Columbia, Columbia County,
Pennsylvania, as near to the grave of my late husband, Henry
Kimber Hartman, as is possible.
ITEM III:
(a) I hereby give my son, Richard K. Hartman,
the option, exercisable within ninety (90) days of my death,
to purchase my interest in the real estate at 2260 Adrian Street,
Harrisburg, Pennsylvania. The purchase price of the real estate
shall be four-fifth (4/5ths) of the fair market value of the
real estate as of my death, or such fraction of the fair market
value as represents the number of my children other than Richard K.
Hartman who survive me over the total number of my children who
survive me. Said proceeds shall then be divided equally among my
surviving children other than Richard K. Hartman.
(b) The purchase price shall be adjusted downward
based upon any credits to which my son, Richard K. Hartman,
is entitled resulting from improvements made by him to my home
at Adrian Street. Credits shall be allowed only if there exists
at my death a dated receipt signed by me indicating the value
of an improvement for which he is entitled to credit.
(c) Should my son be unable or unwilling to execute
said option or to come up with necessary funds to purchase the
above real estate, the house shall be sold by my executor and
the net proceeds shall become part of the residue of my estate.
ITEM IV: I give, devise and bequeath all of the residue
of my estate of every nature and wherever situate equally to
such of my children, Richard K. Hartman, Jesse K. Hartman,
Ruby J. Hartman, Charles C. Hartman and William E. Hartman, as
may be living at the time of my death. The shares of any of the
foregoing who shall predecease me shall be paid to the other
legatees entitled hereunder in proportion to their respective
interest in the residue.
ITEM V: I appoint my son, Richard K. Hartman, of Harris-
burg, as Executor of this my Last Will and Testament. In the
event of the refusal or inability of my said son to serve or con-
tinue to serve as my Executor, I nominate and appoint Jesse H.
Hartman as my Successor Executor.
ITEM VI: I direct that my Executor and my Successor Executor
shall not be required to give bond or post any other security for
the faithful performance of their duties in any jurisdiction.
- 2 -
ITEM VII: My Executor and Successor Executor shall have the
following powers in addition to those invested in them by law
and by other provisions of my Will applicable to all property,
whether principal or income, exercisable without Court approval,
and effective until actual distribution of all property:
(a)
(b)
(c)
To retain any or all of the assets of
my estate, real or personal, in their
sole discretion.
To sell at public or private sale, to
exchange or lease, for any period of
time, any real or personal property,
and to give options for sales, exchanges,
or leases, for such prices and upon such
terms as they deem proper.
To make distribution in cash or in kind,
or partly in cash and partly in kind,
and in such manner as they may determine
and at valuations finally to be fixed by
them.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to
this my Last Will and Testament, consisting of three (3) typewritten
pages, this .~ day of ~u%u~ ' , 1981.
Alma K. Hart~an
(SEAL)
We, the undersigned, hereby certify that the foregoing Will
was signed, sealed, published and declared by the above named
Testatrix, Alma K. Hartman, as and for her Last Will and Testa-
ment, in the presence of us, who at her request and in her presence
and in the presence of each other, have hereunto set our hands
and seals the day and year above written, and we certify that at
the time of the execution thereof, the said Testatrix was of sound
and disposing mind and memory.
residing at y~~~ ~c~.
- 3 -
COMMONWEALTH OF PENNSYLVANIA,
CO TY 0F
We, Alma K. Hartman, Testatrix, and
and ~~70X~c~ , the witnesses, respectively, whose
names are signed to the foregoing instrument, being first duly sworn,
do hereby declare to the undersigned authority that the Testatrix
signed and executed the instrument as her LaSt Will and Testament
and that she had signed willingly, and that she executed it as her
free and voluntary act for the purposes therein expressed, and that
each of the witnesses, in the presence and hearing of the Testatrix,
signed the will as witness and that to the best of her knowledge
the Testatrix was at that time eighteen years of age or older,
of sound mind and under no constraint or undue influence.
Testatrix
Witness
Witness
Subscribed, sworn to and acknowledged before me by Alma K.
Hartman, Testatrix, and subscribed and sworn to before me by
this
--~ day of
and ~J--/V~ C"~, .o42,,~,_ witnesses,
.... , 1981.
~-~' Notary Publ~ '
My commission expires
Jlll
oF
ALMA K. HARTMAN
LAW OFFICI~J $
GOLDBERO, EVANS & I~ATZMAN
HARRISBURO, PENNSYLVANIA 1710~
REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
ORIGINA
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Alma K, Hartman
Date of Death: 1/3/2oo;~
Will No. 2003-00312
Admin. No. 21-03-0312
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphan's Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on 8/6/2003 -
Name Address
Jesse H. Hartman 4921 Earl Drive
Harrisbura PA 1711;:
Ruby J. (Hartman) Porr 2095 Market Street Ext.
Middletgwrl p/~ 17057
Chades C. Hartman 4913 Earl Ddve
Hardsburo PA 1711;:
William E. Hartrnan 257 Cherry Street
HiqhsDim PA 17034
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except:
Date:
Capacity:
Signature Madelle F. Hazen
Name: Madelle F. Hazen. Eso.
Address: 2000 Linolestown Road. Suite 303
Harrisburo PA
17110
Telephone(717) - 5404332
Personal Representative
Counsel for Personal
Representative
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 002989
HAZEN MARIELLE F ESQUIRE
845 SIR THOMAS COURT
HARRISBURG, PA 17109
........ fold
ESTATE INFORMATION: SSN: 287-20-8783
FILE NUMBER: 2103-031 2
DECEDENT NAME: HARTMAN ALMA K
DATE OF PAYMENT: 09/09/2003
POSTMARK DATE: 09/08/2003
COUNTY: CUMBERLAND
DATE OF DEATH: 01/03/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $25.58
TOTAL AMOUNT PAID:
$25.58
REMARKS: RICHARD K HARTMAN C/O
MARIELLE F HAZEN ESQUIRE
SEAL
CHECK# 117
INITIALS: VZ
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
Z
I.U
UJ
Z
0
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL
Hartman, Alma K.
DATE OF DEATH (MM-DD-Year)
01/03~2003
INHERITANCE TAX RETURN
RESIDENT DECEDENT
IDATE OF BIRTH (MM-DD-Year)
07/27/1921
(IF APPUCABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
OFFICIAL USE ONLY
FILE NUMBER
2 I -0 3 0 3 1 2
COUNTY CODE YEAR ~ ~ NUMBER
SOCIAL SECURITY NUMBER
2 8 7-2 0-8 7
8 3
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
[] 1. Original Retum
O4. Limited Estate
O6. Decedent Died Testate (A~ach ~y~W~)
[--1 9. Lrdgalieo Proceeds Received
2. Supplemental Retum
['~ 4a. Futura Interest Compromise (da~ of deah alta' 12-12-82)
[---~ 7. Decedent Maintained a Living Trust (~ach copy of Tr~s~)
10. Spousal Poverty Credit (~ of deah be~e, 12-31-91 aad 1-1-95)
D3. RemainderRetum (da~ofdeahp~orto12*13-82)
D5. Federal Estate Tax Retum Required
m 8. Total Number of Safe Deposit Boxes
F"111. Election to lax under Sec. 9113(A) (At~ach Sch O)
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Madelle F. Hazen, Esquire
FIRM NAME (If Apl~icable)
Law Office of Marielle F. Hazen
TELEPHONE NUMBER
717-540-4332
COMF LETE MAILING ADDRESS
2000 Linglestown Road
Suite 303
Harrisburg
PA 17110
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Pa~emhip or Sole-Proprietemhip (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposils & Miscellaneous Pemonal Pmpert7 (5)
(Schedule E)
6. JoinW Owned Proper (Schedule F) (6)
r-'] Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Properly (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & AdminislmlJve Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductiens (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Govemmental Bequests/sec 9113 Trusts for which an election to lax has not bnen
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
1,101.07
512.35
OFFICIAL-usE ONLY
(8)
1,045.00
(11)
(12)
(13)
(14)
1,61 3.42
1,045.00
568.42
568.42
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rote, or transfem under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Arno~nt of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20.
X ~ (15)
568.42 X .045 (16)
X .12 (17)
X .15 (18)
(19)
25.58
25.58
Decedent's Complete Address:
STREET ADt~RESS
46 Erford Road
Camp Hill
ISTATE PA
ZIP
17011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Interest/Penalty if applicable
D. Interest
E. Penalty
(1)
Total Credits ( A + B + C ) (2)
Total Interest/Penalty ( D + E )
(3)
If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page I Line 20 to request a refund (4)
If Line 1 + Une 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 + SA. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
25.58
25.58
25.58
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN 'X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a l]'ansfer and: Yes No
a. retain the use or income of the property transferred; ........................................................................... [] []
b. retain the dght 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 secudty 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 QUESTION8 IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
~ penal~s, of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete.
Declaration ot pmpa'ef other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RET~,.~ ~,,
ADDRESS 1919 North Front Street, 3rd Floor
Harrisburq
PA
DATE {
17102
SIGNATURE OF PREP~AR~EA OTHER T~I~ R~PR~ESEI~TATIVE
ADDRESS '2"00~ Lmglest~'~'n F~ad, Suite 303
Harrisburg, PA
PA 17110
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%
F2 P.S. {}9116 (a) (1.1) (i)].
For dates o~ dealh on (w ~er January 1, 1995, Ihe tax rate imposed oa lhe ne~ value o~ ~ to or for the use d the stm~ving spouse b 0% r/2 p.s. ~9116 (a) (1.1) (k~
er a steppae~ ~ Ihe child is 0% [72 P.S. {9116(a)(1.2)].
Thetax tale ~ m ll~e net value ei~ to ~tor II~ use ot Ihe decede~s liaeal ~ is 4.5%, ~ as nd~li~ 72 P.S. ~YI16(12) [72 P.S, ~9116(aX1~.
RE~'-1508 EX + (1~37) ~
CO~IdONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Hartman, ^lm~ K. Z1 03 0312
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly.owned with the ~ght of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. 1,101.07
Nursing Home refund
Camp Hill Care Center
46 Erford Road, Camp Hill, PA 17011
TOTAL (Also enter on line 5, Recapitulation)
1,101.07
REV-1509 EX + (1-97) ~
COMM(~WEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF FILE NUMBER
Hartman. Alma K. 21
If an asset was made joint wifltin one year of the decedent's date of death, it must be repmted on Schedule G.
03 0312
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A. Richard K. Hartman Son
C
1919 North Front Street
3rd Floor
Hanisburg, PA 17102
JOINTLY-OWNED PROPERTY:
LE'I-FER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
iTEM FOR JOINT MADE Include name o( ~ancial inslitulJon and bank account number or similar identifying number. Attach DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTERES
1. A. 1993 Checking Account 1,024.70 50. 512.35
Commerce Bank
Account No. 0513033316
TOTAL (Also enter on line 6, Recapitulation) $
512.35
REY-I§HEX + {1~: ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Hartman. Alma K.
Debts of decedent must be reposed on Schedule I.
FILE NUMBER
ITEM
NUMBER DESCRIPTION AMOUNT
FUNERAL EXPENSES:
Headstone
Hayhurst Memorials (inscription for headstone)
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s) / EIN Number of Personal Representative(s)
Street Address
c~ state
Year(s) Commission Paid:
Altemey Fees Law Office of Marielle F. Hazen
Family Exemption: (If decedent's address is not the same as daima~s, attach explanation)
Claimant
Zip
Street Address
c~/ state Zip
Relationship of Claimant to Decedent
Probate Fees Cumberland County Register of Wills
Accountant's Fees
Tax Return PrepareCs Fees
Register of Wills Tax Return Filing Fee
TOTAL (Also enter on line 9, Recapitulation) $
125.00
105.00
750.00
50.00
15.00
lr045.00
RE¥-1513 EX + (.c~nn~
C~NWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
Hartman Alma K.
NUMBER
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [mdude outfight spousal dislributions, and transfers under
Sec. 9116 (a)(1.2)]
Richard K. Hartman
1919 North Front St., 3rd Floor
Harrisburg, PA 17102
FILE NUMBER
21 03
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Son
0312
AMOUNT ORSHARE
OF ESTATE
lDO
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If mnm ~n~c~ is n~=~rl~=~cl in~rf ndditinn~l ~h~:~t~ nf th~ ~m~ ~i?~
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
Estate of Hartman, Alma K.
also known as
Register of Wills
Dauphin County, Pennsylvania
INVENTORY
, Deceased
No. 21 03 0312
Date of Death 1/3/2003
Social Security No. 287208783
Personal Representative(s) of the above Estate, deceased, vedfy that the items appearing in the following inventory include all of the
personal assets wherever situate and ail of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation
placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no
real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We
verify that the statements made in this inventory are true and correct. I/VVe understand that false statements herein made are subject to the
penalties of 18 Pa. C.S. Section 4904 relating to unswom falsification to authorities.
Name of
Attorney:
I.D. No.:
Marielle F. Hazen, Esquire
68003
Personal Representative:
Richard K. Hartman
Address: 2000 Linglestown Road Dated 9/8/03
Harrisburg PA 17110
Telephone: 717-540-4332
Description
Cash, Bank Deposits, & Misc. Personal Properly
Nursing Home refund
Camp Hill Care Center
46 Erford Road, Camp Hill, PA 17011
(Attach Additional Sheets if necessary)
Total
Value
1,101.07
1,101.07
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
RW-4
TO:
Law Office of Marielle F. Hazen
2000 Linglestown Road
Suite 303
Harrisburg, PA 17110
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
REAU OF ZNDZVIOUAL TAXES
XNHERZTANCE TAX DZV[SXDN
DEPT. 280601
HARRISBURG., PA ].7128-0601
CONHOHNEALTH OF PENNSYLVANXA
DEPARTNENT OF REVENUE
NOTZCE OF ZNHERZTANCE TAX
APPRAZSENENT) ALLONANCE OR DZSALLONANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
HARIELLE F HAZEN ESQ
H F HAZEN LAN OFFICE
2000 LINOLESTONN RDL.
HOG PA~'~7110
DATE 10-21-2005
ESTATE OF HARTHAN
DATE OF DEATH 01-05-Z005
FXLE NUHBER 21 05-0512
COUNTY CUNBERLAND
ACN 101
Amount Remitted
ALNA K
HAKE CHECK PAYABLE AND REHZT PAYNENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLZSLE, PA 17015
CUT ALONG THZS LZNE ~ RETAZN LONER PORTZON FOR YOUR RECORDS ~
DZSALLONANCE OF DEDUCTXONS AND ASSESSHENT OF TAX
ESTATE OF HARTNAN ALHA K FZLE NO. 21 05-0512 ACN 101 DATE 10-21-2005
TAX RETURN NAS: (X) ACCEPTED AS FTLED ( ) CHANGED
RESERVATXON CONCERNZNG FUTURE ZNTEREST - SEE REVERSE
APPRAZSED VALUE OF RETURN BASED ON: ORXGINAL RETURN
1. Real Estate (Schedule A} (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Stock/Partnership Interest (Schedule C) (3)
4. Hortgagas/Notas Receivable (Schedule D} (4)
S. Cash/Bank Deposits/Nisc. Personal Property (Schedule E) (5)
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7}
8. Total Assets
APPROVED DEDUCTZONS AND EXENPTZONS:
9. Funeral Expenses/Adm. Costs/Nisc. Expanses (Schedule H) (9)
10. Debts/Hortgaga Liabillties/Lians (Schedule 1) (10)
11. Total Deductions
12. Net Value of Tax Return
15.
14.
Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J)
Nat Value of Estate Subject to Tax
1~101.07
512.55
.00 NOTE: To insure proper
.00 credit to your account,
.00 submlt the upper portion
.00 of this form with your
tax payment.
.00
(8)
1,0~5.00
.0O
1,615.~2
(11) 1.0q. 5. oo
(12) 568.q2
(15) . O0
(14) 568. ~2
NOTE:
Zf an assessment ~as issued previously, lines 1~, 15 and/er 16, 17, 18 and 19 w111
reflect figures that include the total of ALL returns assessed to date.
ASSESSNENT OF TAX:
15. Amount of Line 14 at Spousal rate
16. Amount of Line lq taxabXe at L1neal/CXass A rata
17. Amount of Line 14 mt SibXing rate
18. Amount of Line 14 taxabXe at CoXXateraX/Class B rata
19. Principal Tax Due
TAX CREDXTS:
PAYMENT RECETpT DISCOUNT (+J
DATE NUHBER /NTEREST/PEN PAZD (-)
09-08-2005 CD002989 .00
(15) .00 X O0 = .00
(16) 568.R2 X OR5 = 25.58
(17) .00 X 12 = .00
(18) .00 x 15 = .00
(19)= 25.58
ANOUNT PAZD
25.58
ZF PAZD AFTER DATE ZNDZCATED) SEE REVERSE
FOR CALCULATZON OF ADDIT/ONAL /NTEREST.
TOTAL TAX CREDZT
BALANCE OF TAX DUE
ZNTEREST AND PEN.
TOTAL DUE
25.58
.00
.00
.00
( ZF TOTAL DUE 1S LESS THAN $1, NO PAYNENT ZS RE~UZRED.
ZF TOTAL DUE ZS REFLECTED AS A 'CREDZT' (CR), YOU NAY BE DUE
A REFUND. SEE REVERSE SZDE OF THZS FORH FOR ZNSTRUCTZONS.)
RESERVATION:
PURPOSE OF
NOTICE:
PAYMENT:
REFUND (CR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December 1Z, 198Z -- if any futura interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class 8 (collateral) rate an any such future interest.
To ~ulfill the requirements of Section Il40 of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (7Z P.S.
Section 9140).
Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side.
--Make check or money order payable to: REGISTER OF HILLS, AGENT
A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISiS). Applications arm available at tho Office
of the Register of Nills, any of the Z$ Revenue District Offices, or by calling the special Z4-hour
answering service for forms ordering: 1-800-$6Z-ZOSO~ services for taxpayers with special hearing end / or
speaking needs: 1-800-q47-30ZO (TT only).
Any party in interest~ not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 171ze-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 be addressed in ~riting to: PA Dapartaent of Ravenumj
Bureau of Individual Taxes, ATTN: Post Assessment Review Unitj Dept. Z80601, HarrJsburg~ PA 171Z8-0601
Phone (717) 787-6505. Sam page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
If any tax due is paid within three (5) calendar months after the decedent's death, e five percent (SZ) discount of
the tax paid is allowed.
The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you ~ould appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning ~ith first day of delinquency, or nine (9) months and one (1) day from the date of
dmath~ to the data of payment. Taxes which became detinquent before January 1, 198Z bear interest at the rate of
six (6Z) percent par annum calculated at a daily rate of .000164. All taxes ~hJch became delinquent on end after
January 1, 1982 will bear interest at a rate Nhich ,il1 vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2005 are:
Interest Daily Interest Daily Interest Daily
Rate Factor Year Rate Factor Year Rate Factor
198Z ZOZ .000348 1987 9Z .000Z47 1999 7Z .00019Z
1985 16Z .000438 1988-1991 llZ .000301 ZOO0 8Z .000219
1984 llZ .000301 199Z 9Z .000247 ZOO1 9Z .000Z47
1985 13X ,000356 1993-1994 7Z .00019Z ZOOZ 6Z .000164
1986 lOZ .000Z74 1995-1998 9Z .000Z47 2005 5Z .000137
--Interest ts calculated
INTEREST = BALANCE OF
as follows:
TAX UNPATD X NUNBER OF DAYS DELINQUENT X DAILY TNTEREST FACTOR
--Any Notice lssued after the tax becomes delinquent wiX1 refXect an interest calcuXatlon to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice~ additional interest must be calculated.
STATUS REPORT UNDER RULE 6.12
6RiGINA
Name of Decedent: ALMA K. HARTMAN
Date of Death' 1/3/2oo3
Will No. 2o03-oo31g
Admin. No. 21.03-0312
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:
ao
account with the Court ?
Did the personal representative file a final
Yes ~ No X
b. The separate Orphans' Court No. ( if any ) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest ? Yes No X
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.
Marielle F. Hazen. Eso.
Name (Please type or print )
2000 Linglestown Road, Suite 303
Harrisbura PA
Address
17110
(717) 5404332
Tel. No.
Capacity
Personal Representative
Counsel for personal
representative
X