HomeMy WebLinkAbout03-0313 PETITION FOR PROBATE and
also known as ~--~- - ,~u-- D,-~ To:
Deceased.
Social Security No. _ I
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut
in the last wilt of lhe above decedent, dated
and codicil(s) dated
GRANT OF LETTERS
Register of Wills for the .
County of ~' c.,'r~'? .0~///t;'n~n the
Commonwealth of Pennsylvania
named
(stale relevanl circumstances, e.g. renunciation, death of executor, elc.)
Decendent was domiciled at death in ('~--"/O
h last f/tmily or principal residence at I! '7- tRe'e, t, 1~ /--~/I [~'
(Iisi street, number and muncipality)
Decendent, then ~ / _ years of age, died
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows: //~
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters '~'-T'~sq-~'o'~: o-F~tu
ttestamentary; a md"~mislralion c.l.a.; administration d.b.n.c.t.a.)
theron.
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF _Q.~_~(~,_,,,}_ ss
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the ~nowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administe~r the e~tate according to law.
Sworn to or affirmed and subscribed ,-
be,f.,ore me this __ OtTo4 day of ~
No. ~/-
Estate Of /~zgc_~ ~.
DECREE OF PROBATE AND GRANT OF LETTERS
, Deceased
AND NOW
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated
described therein be admitted to probate and filed of record as the last will of
and Letters -/-,~-_.~-.~,~,-,~/~;,z~ u '
are hereby granted to ,~4~e_~
/XI~~ in consideration of the petition on
FEES
Probate, Letters, Etc .......... $
Shorl Certificates( ) ...' .......$
~enunmauon ................ $
TOTAL
Filed . .~......~'/..~.,...~4:~,-~' .............
ATTORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
EG-1s r~ew Jersey uepartrnent et Hem• ana ~emor ~erv~ces
^UG 99 CERTIFICATE
...... ~,~n, ,r,~ , ~ vt- u~ ~ n STATE USE ONLY
1. NAME OF DECEASED {First) (Middle) (Last)
Alice D. Rowand
Items 1 and 2 to be Wpad
by Funeral Director ~ 2 DATE OF DEATH 3. SEX 4. DATE OF BIRTH Ea. AGE - Last Bi~'th* 5b. UNDER 1 YEAR 5c. UNDER 1 DAY
03/24/03 F 03/29/41day~r~) Months D&y~' H .... Mi .....
6. SOCIAL SEC. NO. 7a. PLACE OF DEATH
HOSPITAL: OTHER: Daughter ' s
residence
To be prln~ed by
Physi .... ~, 155-32-8278 r~ INPATIENT E] ER/OUTPATIENT []DOA [] NURSING HOME []RESIDENCE ]{~3TH ER (Specify)
7b. FACILITY NAME (If not institution, give street and no.) 7c. CITY/TOWN OR LOCATION 7d. COUNTY
Washing ton G louce s
~ 246 Greentree Road Twp. ter
'~ Bo. RESIDENCE - Be. INSIDE CITY LIMITS?
Bb. COUNTY 8c. CITY OR TOWN Sd. STREET AND NUMBER Bf. ZIP CODE
(Si.re) Cumber 117 Peach 17013
~'~ PA land Carlisle Lane ~YES nNO
~ "~ 9. BIRTHPLACE (C;ty & State, or Foreign Country) lOa. DECEDENT EVER IN U.S. ARMED 10b. IF YES WAR: I. MARITAL STATUS
c3 * FORCES? DATE'(From/To); [] NEVER MARRIED X~[WIDOWED
~ ~ M~ Camden. N~ []-]YES ~]NO []MARRIED ~ DIVORCED
~ ~ 12. SURVIVING SPOUSE Wife, Maiden
III
Name)
13. USUAL OCCUPATION {Kind of work done most of life, e ~en if retired) 14. KIND OF BUSINESS OR INDUSTRY
.... Controller Shipping
{~; 15. NAME AND ADDRESS OF LAST EMPLOYER
~ ~. Bookspan Mechanicsburg, PA.
~6. RACE 3n AMER. INDIAN 17. OF HISPANICORIOIN? 1 [] MEXICAN 2r~ PUERTO RICAN 18. DECEDENT'S EDUCATION
~ ~' 1 ~ WHITE 4[-10TH ER (Specify): []'FyEsYES' SPEC,FY:](~;N O H ghei%ade Comp,ete~
3[] CUBAN 4[] CENT./SO. AMERICA
~ 2 [] BLACK 5[] OTHER (Specify):
~Y~ 19. NAME OF FATHER (First) (Middle) (Last) (Last)
20. MALDEN NAME OF MOTHER (First) (Middle)
Earl DeHart Mary E. Kauffman
21a. NAME OF INFORMANT 21b. RELATIONSHIP 22a. OISPOSITION
[] BURIAL ~REMATION
Ear 1 DeHar t, Jr. brother [] OTHER (Specify): [] ENTOMBMENT
22b. NAME OF CEMETERY OR CREMATORY 22c. CITY OR TOWN 22d. STATE
Harleigh Crematory Camden NJ
23a. NAME AND ADDRESS OF FUNERAL HOME
~ Gardner Funeral Home 126 S. Black Horse-,'P~.~ P.O. Bo~LRt~nnemede,~ .. NJ 08078
~ ~.~/~ ~~3b. ION TU OFFUN RAL ECT~4~'i.~ ~XL 23c. N.J.~i(~blCENSE N . ~24a SIGNATU~~iTE OF LOCAL RE TRAR:~ 24b. DATE~.:~3ECEIVE
. 'MEOFDEAT.( ' ? .D^TEAND.OURPRO.OU.CEDOEAD '
A~~ Complete Ifems 25c-donlywhen certifyingphysi- 125c. TO THE BEST OF MY KNOWLEDGE, DEATH OCCURRED AT TIME, DATE, AND PLACE INDICATED. 25d. DATE SIGNED
-'~~ ,-, clan is not available at time of death to certify SIGNATURE OF PRONOUNCER J ] - ' , , t . ! ~ ~ ~JL _~ ,~'~.'t /
26. PART I: IMMEDIATE CAUSE (Enter the diseases, injuries or complications that caused the death. Do not enter the mode ~.~ying, such as cardiac ~r INTERVAL BETWEEN ON-
respiratory ~ shock, or hear~a~ure. List on~ one cause on each line.) ~-,' SET AND DEATH
~' IMMEDIATE CAUSE (Final a. ~1~ / ~ ~ ~
D disease or condition result- DUE TO OR AS A CONSEQUENCE OF:
'~ lng in death). Sequentially
~ list conditions, if a ny, lead- b.
~ _ lng to immediate cause. DUETOORASACONSEQUENCEOF:
~.':~ ~ Enter UNDERLYING CAUSE
~ ~ (Disease or injury that in- c.
~j ~. ~ itiated events resulting in DUETDORASACONSEOUENCEOF:
.~ ~ death) LAST.
G d.
~-i~ PART I1: Other significant conditions - contributing to death but not related to underlying cause in PART i.
STATE USE ONLY 27.1F FEMALE, WASSHE PREGNANTATDEATH. OR ANY TIME gO DAYS PRIOR TODEATH?/ 28. WASAUTDPSY PERFORMED?
~ND/OCC [] YES ~O [] YES
29.~A~U RALDEAT DUE TO: [] PENDING IN- 30a. DATE OF INJURY3Ob. TIME OF iNJURY U 30c. INJURY[] YEsAT WORK?[] NO 3Od. DESCRIBE HOW iNJURY OCCURRED
CAUSE [] ACCIDENT VESTIGATION 3De. PLACE [] HOME [] FARM
[] SUICIDE [] COULD NOT BE [] STREET [] OFFICE BUILDING [] FACTORY
[] HOMICIDE DETERMINED [] OTHER (Specify):
PLACE OF ACC.
3Of. LOCATION OF INJURY (Number end Street) 3Og. CITY AND COUNTY 3Oh. STATE
CROSSCLASS 31a. NAMEANDADDRESSOFCERTIFIER /7 ~ /~'~' F¢~'"''/¢""" ~l~"' I[~ERTIFYINGPHYSICIAN
'"""I [] MED,CAL E M,NER
[] PRONOUNCER AND CERTIFIER
3 lb. TO THE BEST OF MY KNOWLEDGE, TH OCCURRED DUE TO CAUSES LIS~D ABOVE.
31c. DATE SIGNED
OF CERTIFIER
BOROUGH OF RUNNEMEDE COUNTY OF CAMDEN
A
THIS IS TO CERTIFY THAT THE FOLLOWING IS A TRUE COPY OF A RECORD IN MY OFFICE. WARNING: DO
NOT ACCEPT THIS COPY UNLESS THE RAISED SEAL OF THE BOROUGH OF RILINNEMEDETD~N~'~F
HEALTH IS AFFIXED HEREON. .
"R~G, . .S~AR OF VITAL STATISTICS
LAW OFFICES
SNELBaKEr.
BRENNEMAN
& SPAre
LAST WILL AND TESTAMENT
OF
ALICE D. ROWAND
I, ALICE D. ROWAND, of the Middlesex Township, Cumberland County, Pennsylvania,
being of sound and disposing mind, memory and understanding, do hereby make, publish and
declare this as and for my Last Will and Testament, hereby revoking and making void any and all
wills by me at any time heretofore made.
1. I direct that all my debts and funeral expenses be paid as soon as practical after my
death by my Executor hereinafter named.
I direct that all taxes that may be assessed as a consequence of my death shall be paid
from my residuary estate as part of the expenses of the administration of my estate.
2. All the rest, residue and remainder of my estate, real, personal and mixed, and
wheresoever the same may be situate, I give, devise and bequeath in equal shares to my daughter,
DEBRA L. NIESSNER, and my grandchildren, JENNIFER L. NIESSNER and RYAN C.
NIESSNER.
If my daughter or either of my grandchildren should predecease me, I direct that the share
such deceased child or grandchild would have received hereunder shall be given to the surviving
beneficiaries above named or surviving beneficiary, whichever the case may be.
3. If my daughter, DEBRA L. NIESSNER, and my grandchildren, JENNIFER L.
NIESSNER and RYAN C. NIESSNER, should all predecease me, or be involved in a common
accident or disaster which causes their deaths, I direct that all the rest, residue and remainder of
my estate, real, personal and mixed and wheresoever the same may be situate, be given in equal
shares to MARK BURNS, EARL E. DEHART, JR. and JAMES DEHART, or the survivors or
survivor of them.
4. I hereby nominate, constitute and appoint EARL E. DEHART, JR. as Executor of this
my Last Will and Testament. I further direct that my Executor shall not be required to post any
LAW OFFICES
SNELBAKER.
BRENNEMAN
& SPARE
bond to secure the faithful performance of his duties in the Commonwealth of Pennsylvania or in
any other jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and
Testament written on Two (2) pages this 8th day of October, 2002.
~lice D. Rowand
Signed, sealed, published and declared by ALICE D. ROWAND, 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 hereunto subscribed our names as attesting witnesses.
.(SEAL)
(SEAL)
-2-
LAW OFFICES
SNElBAkER.
BRENNEMAN
& SPARE
COMMONWEALTH OF PENNSYLVANIA)
COUNTY OF CUMBERLAND )
SS.
We, ALICE D. ROWAND, KEITH O. BRENNEMAN, ESQUIRE and JANE J.
COONEY, the Testatrix and the witnesses, respectively, whose names are signed to the attached
or 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 his or 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
& q
Subscribed, sworn to and acknowledged before me by ALICE D. ROWAND, Testatrix, and
subscribed and sworn to before me by KEITH O. BRENNEMAN, ESQUIRE and JANE J.
COONEY, witnesses, this 8th day of October, 2002.
~L.Z~ch, Notary ~. Cou. I
ALICE D. ROWAND
MECHANICSBUR.G, PENNSYLVANIA 17055
P. O. BOX 318
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Date of Death: _27~ ~_ ..4~'~'~d ~.~
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on ./.t} ./~/_,~_.t,...,,/~:'.J' :
Name Address
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
Signature
^ddress
Telephone (~,t~)
Capacity: '~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 003375
PRIETO STACEY PASS
PO BOX 910
WILLOW GROVE, PA 19090
........ fold
ESTATE INFORMATION: SSN: 1 55-32-8278
FILE NUMBER: 2103-0313
DECEDENT NAME: ROWAND ALICE D
DATE OF PAYMENT: 12/26/2003
POSTMARK DATE: 12/22/2003
COUNTY: CUMBERLAND
DATE OF DEATH: 03/24/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $6,935.35
REMARKS:
STACEY PASS PRIETO
TOTAL AMOUNT PAID'
$6,935.35
SEAL
CHECK# 148
INITIALS: AC
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
7003 2260 0001 3900 4986
RETURN RECEU~j'
REQUESTED
Register of Wills
Cumberland Courthouse
1 Courthouse Square
Carlisle, PA 17103-3~
500 EX
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESlBENT BECEBENT
OFFIC~'AL USI~ ONLY
FILE NUMBER
DECEDENT'S NAME (LAST, FIRST, ANO MIDDLE INITIAL) SOCIAL SECURITY NUMBER
ROWAND, ALICE D 155-32-8278
3:OO
DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR)
03-24-03 103-29-41
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
N/A
THIS RETURN MUST BE RI.ED IN DUPUCATE WITH THE
REGISTER OF VVILLS
SOCIAL SECURrrY NUMBER
[] 1. OriginalRetum [] 2. SupplementalRetum [] 3. Remaind~Return(~eofde~hpriorto~2-~3-~
[] 4. UmitedEstate [] 4a. FuturelnterestCompromise(dat, ofd~ma~t~12-12.~ [] 5. Federal Estate Tax Retum Required
[] 6. DecedentDiedTestate(Ntac~copyofWfl) [] 7. DecedentMalntainedaLivingTrusf(Attachc~wofmrust) __8. Total Number of Safe Deposit Boxes
[] 9. Litigation Proceeds Received [] 10. Sp0usalPovertyCredit(daeof~thbaw~12-31-gland1-l*~ [] 11. Eleotion to tax under Sec. 9113(A)(Attac~sc~o)
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME ICOIVPI-ETE~ILING~DRE~
STACEY PASS PRIETO ]2300 COMPUTER AVENUE - BLDG B
p~PO BOX 910
WILLOW GROVE, PA 19090
FIRM~ME(IfA~)
SCHWARTZ, KARSIF, KALOS, LIU & CO,
TELEPHONE NUMBER
215-830-0300
1. Real Estate (Schedule A) (1) O. 0 0
2. Stocks and Bonds (Schedule B) (2) 2 5, 612.4 0
3. Closely Held Corporation, Palnership or Sde-Propdatorship (3) 0.0 0
4. Mortgages & Notes Receivable (Schedule D) (4) 0.0 0
5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 5 3, 6 2 9.3 9
(Schedule E)
6. Jointly Owned Property (Sd~dule F) (6)
[] Separate Billing Requested
7. Inter-Vivos Transfers & t~sc~laneous Non-Probate Property (7) 5 7, 9 5 2 . 4 3
(Schedule G or L)
8. Total Gross ~ (total L~es 1 - 7) (8)
9. Funeral Expenses & Administrative Costs (Schedule H) (9) 6, 1 5 2.0 0
10. Debts of Decedant, MortgageUabilities,&Uens(Schedulel) (10) 23, 063.42
11. Total Beductio~s (total Unes9& 10) (11)
12. Net Valueof Estate(UneBminus Une 11) (12)
13. Charitable and Governme~ Bequests/Sec 9113 Trusts for which an dection to tax has not been (13)
made (Schedule J)
14. Net Value Subject to Tax (Une 12 minus Une 13) (14)
OFFICIAL USE ONLY
137,194.22
29,215.42
107,978.80
107,978.80
SEE INSTRUCRONS FOR APPUCABLE RATES
15. Amount of Iine 14taxable atthespousaJtax
rate, or transfers under Sec. 9116 (a)(1.2) x .0 (15)
16. ,N'nountof Une 14 taxable at lineal rate 80,294. 80 X .0 45 (16)
17. Amount of Line14 taxable at sibling rate 27, 684. 00 X .12 (17)
18. Amount of Une 14 taxable at collateral rate × .15 (18)
19. Tax Bue (19)
20. [] I CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT]
3,613.27
3,322.08
6~935.35
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
STF PA42021F.1
Decedent's 'Complete Address:
STREET ADDRESS
117 PEACH LANE
CUY
CARLISLE
ISTATE
PA
IzIP 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Pdor Payments
C. Discount
Total Credits (A + B + C)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (D + E)
4. If Line 2 is greater than Line 1 + Une 3, enter the difference. This is the OVERPAYMENT.
Check box on Page t Line 20 to request a refund
5. If Line 1 + Une 3 is greater than Une 2, enter the difference. This is the TAX DUE.
A. 'Enter the interest on the tax due.
(1) 6,935.35
(2)
(3)
(4) 0.00
(5) 6,935.35
(5A)
(5B) 6,935.35
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
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 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 security at his or her death? ..... [] []
4. Did decedent own an IndMdual 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 pefjuq, I declare that I have examined this re{urn, including acc~npanying schedules and statements, and to the best of my knowledge 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.
SIGNATURF..~F PERSON RESPONSIBLE FOR FILING RETURN
ADDRESS" ..... ~ J - ' -
246 GREENTREE ROAD TRUNERSVILLE,
DATE
NJ 08012
SIGN/~URE OF PR~ OT~N REPgESENTATIVE
AI~DRESS (J
2300 COMPUTER AVE BUILDING B PO BOX
DATE
910 WILLOW GROVE, PA 19090
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate im posed on the net value of transfers to or for the use of the suwiving 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 sun/lying spouse is 0% [72 P.S. {}9116 la) (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 apphcable 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 RS. §9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal benefidades is 4.5%, except as noted in 72 RS. ,{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 decedenrs siblings is 12% [72 RS. ,{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.
STF PA42021F.2
REV-1502 EX + (1-97) (I)
SCHEDULE A
REAL ESTATE
COMMON--TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ALICE D. ROWAND 21-03-00313
All real property owned solely or as a tenant in common must be reported at fair marleet value. Fair market value is defined as the price at which pmp~ty would be exchanged belwee~ a
willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge dthe relevant facts. Real property which is jointly-owned with right of sun/ivo~shJp
must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. NONE 0.00
TOTAL (Also enter on line 1, Recapitulation)$ 0.0 0
(If more space is needed, insert additional sheets of the same size)
STF PA42021F.3
REV-1503 EX + (1-97~ (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
ALICE D. ROWAND
SCHEDULE B
STOCKS & BONDS
1
FILE NUMBER
21-03-003'13
All propert7 jointly-owned with the right of su~vomhip must be disd __nsed_ _ on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
644.013SHS LEGG MASON VALUE TRUST @$39.77 PER SHARE
25,612.40
TOTAL (Also enter on line 2, Recapitulation) $ 2 5, 612.4 0
(If more space is needed, insert additional sheets of the same size)
STF PA42021F.4
REV-1504 EX + (1-97)~(I)
COMMONWF. ALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
ALICE D. ROWAND
SCHEDULE C
CLOSELY-HELD CORPORATION,
PARTNERSHIP or SOLE-PROPRIETORSHIP
FILE NUMBER
21-03-003'13
Scbedule C-1 or C-2 (Including all supporting infa'mation) must be attached for each closoly-hetd corporation/partnership interest of the decedent, other than a sole-proprietorship.
See instructions for the supl:~rling information to be submitted for sole-proprietorships,
ITEM
NUMBER
DESCRIPTION
NONE
VALUE AT DATE
OF DEATH
0.00
TOTAL (Also enter on line 3, Recapitulation) $ 0.0 0
(If more space is needed, insert additional sheets of the same size)
STF PA42021F.5
REV-1505 EX + (1-97') (I)
COMMONWF_AI.TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE O F
ALICE D. ROWAND
SCHEDULE C-1
CLOSELY-HELD CORPORATE
STOCK INFORMATION REPORT
FILE NUMBER
21-03-00313
Name of Corporation N/A
Address
C~ty
2. Federal Employer I.D. Number
3. Type of Business
State Zip Code
Product/Se~ce
State of Incorporation
Date of Incorporation
Total Number of Shareholders
Business Reporting Year
TYPE TOTAL NUMBER OF NUMBER OF SHARES VALUE OF THE
STOCK Voting / Non-Voting SHARES OUTSTANDING PAR VALUE OWNED BY THE DECEDENT DECEDENT'S STOCK
Common $
Preferred $
Provide all dghts and restrictions pertaining to each dass of stock.
5. Was the decedent employed by the Corporation? [] Yes [] No
If yes, Position Annual Salay $
6. Was the Corporation indebted to the decedent? [] Yes [] No
If yes, provide amount of indebtedness $
nme Devoted to Business
7. Was there life insurance payable to the corporation upon the death of the decedent? [] Yes [] No
If yes, Cash Surrender Value $ Net proceeds payable $
Owner of the policy
8. Did the decedent sell or transfer stock of this company within one year pdor to death or within two years if the date of death was prior to 12-31-827
[]Yes []No Ifyes, ~--~Transfer []Sale Number of Shares
Transferee or Purchaser Consideration $ Date
Attach a separate sheet for additional transfa's and/or sales.
9. Was there a wdtten shareholder's agreement in effect at the time of the decedent's death?[] Yes [] No
If yes, provide a copy of the agreement.
10. Was the decedent's stock sold? [] Yes [] No
If yes, provide a copy of the agreement of sale, etc.
11. Was the corporation dissolved or liquidated after the decedenrs death? [] Yes [] No
If yes, provide a breakdown of distributions received by the estate, including dates and amounts received.
12. Did the corporation have an interest in other corporations or partnerships? [] Yes [] No
If yes, report the necessary information on a separate sheet, including a Schedule C-1 or C-2 for each interest.
THE FOllOWING INFORMATION MUST BE SUBMI'I'rED WITH THIS SCHEDULE
A. Detailed calculations used in the valuation of the decedent's stock.
B. Complete copies of financial statements or Federal Corporate Income Tax retums (Form 1120) for the year of death and 4 preceding years.
C. If the corporation owned real estate, submit a list showing the complete address/es and estimated fair market value/s. If real estate appraisals have been
secured, attach copies.
D. List of principal stockholders at the date of death, number of shares held and their relationship to the decedent.
E. List of officers, their salaries, bonuses and any other benefits received from the corporation.
F. Statement of dividends paid each year. List those declared and unpaid.
G. Any other information relating to the valuation of the decedent's stock.
S'FFPA42021F.6
REV-1506 EX + (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
ALICE D. ROWAND
SCHEDULE C-2
PARTNERSHIP
INFORMATION REPORT
RLE NUMBER
2;].-03-003'13
Name of Partnership N/A
Address
Qty
2. Federal Employer I.D. Number
3. Type of Business
4. Decedent was a [] General
State Zip Code
Date Business Commenced
Business Reporting Year
Product/Sen~ice
[] Limited partner. If decedent was a limited partner, provide initial investment $
PERCENT OF PERCENT OF BALANCE OF
PARTNER NAME INCOME OWNERSHIP CAPITAL ACCOUNT
A.
B,
C.
D.
6. Value of the decedent's interest $
7. Was the Partnership indebted to the decedent? [] Yes [] No
If yes, provide amount of indebtedness $
8. Was there life insurance payable to the partnership upon the death of the decedent? [] Yes
If yes, Cash Surrender Value $ Net proceeds payable $
Owner of the policy
[] No
9. Did the decedent sell or transfer an interest in this partnership within one year pdor to death or within two years if the date of death was prior to 12-31-827
[]Yes [] No If yes, []Transfer [] Sale Percentage transferred/sold
Transferee or Purchaser Consideration $ Date
Attach a separate sheet for additJmal transfers and/or sales.
10. Was there a written partnership agreement in effect at the time of the decedenrs death? [] Yes [] No
If yes, provide a copy of the agreement.
11. Was the decedenrs partnership interest sold? [] Yes [] No
If yes, provide a copy of the agreement of sale, etc.
12. Was the partnership dissolved or liquidated after the decedenrs death? [] Yes [] No
If yes, provide a breakdown of distributions received by the estate, including dates and amounts received.
13. Was the decedent related to any of the partners? [] Yes [] No If yes, explain
14. Did the partnership have an interest in other corporations or partnerships? [] Yes [] No -
If yes, report the necessary information on a separate sheet, including a Schedule C-1 orC-2 for each interest.
THE FOLLOWING INFORMATION MUST BE SUBMITFED WITH THIS SCHEDULE
A. Detailed calculations used in the valuation of the decedenrs partnership interest.
B. Complete copies of finandal statements or Federal Partnership Income Tax returns (Form 1065) for the year of death and 4 preceding years.
C. If the partnership owned real estate, submit a list showing the complete address/es and estimated fair market value/s. If real estate appraisals have been
secured, attach copies.
D. Any other information relating to the valuation of the decedenrs partnership interest.
STFPA42021F.7
REV-1507 EX + (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
ALICE D. ROWAND
SCHEDULE D
MORTGAGES & NOTES
RECEIVABLE
I
FILE NUMBER
21-03-00313
All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. NONE 0.0 0
TOTAL (Also enter on line 4, Recapitulation) $ 0.0 0
(If more space is needed, insat additional sheets of the same size)
STF PA42021
REV-1508,EX + (1-97~ (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATEOF
ALICE D. ROWAND
SCHEDULE E
CASH, BANK BEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
21-03-00313
Include the proceeds of litigation and the date the proceeds were received by the estate. Ail propaty jointly.~wned with the right of survivomhip must be disclosed on Schedule R
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
2.
3.
4.
5.
MEMBERS IST FEDERAL CREDIT UNION ACCT#122262-05
MEMBERS 1ST FEDERAL CREDIT UNION ACCT#122262-11
MEMBERS 1ST FEDERAL CREDIT UNION ACCT#122262-00
MOBILE HOME AND CONTENTS
AT&T UNIVERSAL CREDIT CARD
22,243.74
998.57
386.54
30,000.00
.54
TOTAL (Also enter on line 5, Recapitulation) $ 5 3, 6 2 9. 3 9
(If more space is needed, insert additional sheets of the same size)
STF PA42021F.9
REV-1505 EX + (1-97,) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERrFANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
ALICE D. ROWAND
SCHEDULE F
JOINTLY-OWNED PROPERTY
FILE NUMBER
2'1 -03-00313
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. NONE
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
rrEM FOR JOINT MADE Include name of finamJal instit~Jon and bark accost rut',her or similar idenlifcng nu'c~ber. DATE OF DEATH DECD'S VN_UE OF
NUMBER TENANT JOINT Attad~ deed forjoin~y-held real estate. VALUE OF ASSET INTEREST DECEDENTS INTEREST
1. A.
TOTAL (Also enter on line 6, Recapitulation) $
(If more space ~s needed, insert additional sheets of the same size)
STF PA42021 F. IO
REV-1510'EX + (1-g7)~ (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
ALICE D. ROWAND
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PRO~TE PROPERTY
FILE NUMBER
21-03-00313
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 yes.
DESCRIPTION OF PROPERTY % OF
['rEM INCLLDE Tt'E NNvlE OF TI-E TRANSFEREE, 1TEIR RELATIONSH P TO DE~ N~D DE DATE DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
NUMBER OF 'PRANSFE~ ATTACH A COPY OF DE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPU~E)
1. LEGG MASON IRA ROLLOVER AC#365-72591 33,343.73 100% 33,343.72
DEBRA NIESSNER BENEFICIARY-DAUGHTER
2. BOOKSPAN 401(K)- DEBRA NIESSNER BEN 24,608.70 100% 24,608.7£
TOTAL (Also enter on line 7, Recapitulation) $ 5 7, 9 5 2.4 3
(If more space is needed, insert additional sheets of the same size)
STF PA42021F.11
REV-1511 EX + (1-97),(I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
ALICE D. ROWAND
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21-03-00313
Oebts of decedent must be repoda] on Schedule I.
ITEM
NUMBER DESCRIPTION
5.
6.
7.
FUNERAL EXPENSES:
GARDNER FTJ-NE~L HOME
ADMINISTRATIVE COSTS:
Personal Represontatk, e's Commissions
Name of Personal Representative(s)
Sodal Security Number(s) / EIN Number of Personal Representative(s)
Streel Address
City State
Yeer(s) Commission Paid:
Attorney Fees
Family Exemption: (If decede~t's address is not the same as claimant's, attach explanation)
Claimant DEBRA L. NIESSNER
StreetAddress 246 GREENTREE ROAD
c~ TURNERSVILLE
Relationship of Claimar~ to Decedent DAUGHTER
Probate Fees
Accounmr~s F~es
Tax Return Preparer's Fees
State NJ
Zip 08012
TOTAL (Also enter on line 9, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
STF PA42021 F.12
AMOUNT
1,560.00
3,500.00
92.00
1,000.00
$ 6,152.00
REV-1512 EX + (1-97){I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE 0 F
ALICE D. ROWAND
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE UABILITIES, & LIENS
FILE NUMBER
2[-03-00313
Include unreimlxa~ed medical expenses.
ITEM
NUMBER DESCRIPTION AMOUNT
2
3
4
5
6
7
8
9
10
11
12
13
PNC BANK NA MOBILE HOME LOAN (DECEDENT EXPENSE)
COUNTY MANOR WEST LOT RENTAL (DECEDENT EXPENSE)
ALLSTATE INSURANCE (DECEDENT EXPENSE)
AT&T(DECEDENT EXPENSE)
PINNACLE HEALTH HOSPITAL(DECEDENT EXPENSE)
PPL(DECEDENT EXPENSE)
UGI UTILITIES (DECEDENT EXPENSE)
MBNA MASTERCARD (DECEDENT EXPENSE)
QUANTUM IMAGING (DECEDENT EXPENSE)
MRS. NANCY SHEIBLEY-SCHOOL RE TAX (DECEDENT EXPENSE)
AT&T WIRELESS(DECEDENTS EXPENSE)
MISCELLANEOUS EXPENSES (DECEDENT EXPENSE)
TITLE FEES FOR SALE OF MOBILE HOME
13,317 11
2,383 50
294 00
6 03
75 00
228 64
242 10
5,622 92
36 00
322 26
13 36
50O 00
22 50
TOTAL (Also enter on line 10, Recapitulation) $ 2 3, 0 6 3.4 2
(If more space is needed, insert additional sheets of the same size)
STF PA42021F.13
REV-1513,EX + (9-00)
COMMOI~L~ OF PENNSYLVANIA
INHERrFANCE TAX RETURN
RESIDENT DECEDENT
ESTATEOF
ALICE D. ROWAND
SCHEDULE J
BENEFIClAF ES
FILE NUMBER
21-03-00313
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
1.
o
o
o
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers
under Sec. 9116 (a)(1.2)]
DP, R]~A NT F:,S SNER
246 GREENTREE ROAD
TURNERSVILLE, NJ 08012
MARK BURNS
100 WEST ATLANTIC AVENUE
LAUREL SPRINGS, NJ 08021
EARL DEHART
195 BERGAN AVENUE
THOROFARE, NJ 08086
JAMES DEHART
169 BUCKOR DITCH ROAD
GREENFIELD, TN 38230
DAUGHTER
SON
BROTHER
BROTHER
BAL OF ESTATE
3,000.00
21,684.00
3,000.00
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 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)
STF PA42021F. 14
REV-1514,EX + (1-97,) (I)
COMMON1NEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
ALICE D. ROWAND
SCHEDULE K
UFE ESTATE, ANNUITY
& TERM CERTAIN
(Check Box 4 on Rev-tS00 Cover Sheet)
FILE NUMBER
21-03-00313
This schedule is to be used for all single life, joint or successive life estate and term certain calculations. For dates of death
prior to 5-1-89, actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit.
Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death on or after 5-1-89.
Indicate the type of instrument which created the future interest below and attach a copy to the tax return.
r-]Will J-qln~ivos Deed of Trust J'--JOther
UFE ESTATE INTEREST CALCULATION
NAME(S) OF NEAREST AGE AT TERM OF YEARS LIFE ESTATE IS
LIFE TENANT(S) DATE OF BIRTH DATE OF DEATH PAYABLE
[] Life or [] Term of Years __
[] Life or [] Term of Years ~
[] Life or [] Term of Years__
[] Life or [] Term of Years__
1. Value of fund from which life estate is payable
2. Actuarial factor per appropriate table
Interest table rate- J--J31/2% [-16%
3. Value of life estate (Line 1 multiplied by Line 2)
[] 10%' [] Vadable Rate %
ANNUITY INTEREST CALCULATION
NAME(S) OF NEAREST AGE AT TERM OF YEARS
ANNUITANT(S) DATE OF BIRTH DATE OF DEATH ANNUITY IS PAYABLE
[] Life or [] Term of Years
[] Life or [] Term of Years__
[] Life or [] Term of Years__
[] Life or [] Term of Years__
1. Value of fund from which annuity is payable
2. Check appropriate block below and enter corresponding (number)
Frequency of payout - [] Weekly (52) [] Bi-weekly (26)
[] Quarterly (4) [] Semi-annually (2) []Annually (1)
3. Amount of payout per pedod
4. Aggregate annual payment, Line 2 multiplied by Line 3
5. Annuity Factor (see instructions)
Interest table rate [] 31/2% [] 6% [] 10%
Adjustment Factor (see instructions)
[] Monthly (12)
[] Other ( )
[] Variable Rate %
Value of annuity - If using 3 1/2%, 6%, 10%, or if vadable rate and period payout is at end of period,
calculation is: Line 4 x Line $ x Une 6 $
If using variable rate and period payout is at beginning of period, calculation is:
(Line4 x Une$ x Line6) + Une3 $
NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on
Schedules A through G of this tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13,
15, 16 and 17.
(If more space is needed, insert additional sheets of the same size)
STF PA42021 F. 15
REV-164? EX + (9-GO)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE M
FUTURE INTEREST COMPROMISE
(Check Box 4a on Rev-l$00 Cover Sheet)
ESTATE OF FILE NUMBER
ALICE D. ROWAND 21-03-00313
This schedule is appropriate only for estates of decedents dying after December 12, 1982.
This schedule is to be used for all future interests where the rate of tax which will be applicable when the future interest vests in possession and enjoyment
cannot be established with certainty.
Indicate below the type of instrument which created the future interest and attach a copy to the tax return.
[] Will [] Trust [] Other
Beneficiaries
AGE TO
NAME OF BENEFICIARY RELATIONSHIP DATE OF BIRTH NEAREST BIRTHDAY
t.
z
3.
4.
5.
For decedents dying on or after July 1, 1994, if a sun~ng spouse exercised or intends to exercise a right of withdrawal within 9 months
of the decedent's death, check the appropriate block and attach a copy of the document in which the surviving spouse exercises such
withdrawal right.
[] Unlimited right of withdrawal [] Limited right of withdrawal
Explanation of Compromise Offer:.
Summary of Compromise Offer:
1. Amount of Future Interest .................................................................... $
2. Value of Line 1 exempt from tax as amount passing to charities, etc.
(also include as part of total shown on Line 13 of Cover Sheet) ........... $
3. Value of Line 1 passing to spouse at appropriate tax rate
CheckOne [-16%, r-13%, [-i0% .......................... $
(also include as part of total shown on Line 15 of Cover Sheet)
4. Value of Line 1 taxable at lineal rate
Check One L--16%, []4.5% ................................. $
(also include as part of total shown on Line 16 of Cover Sheet)
5. Value of Line 1 Taxable at sibling rate (12%)
(also include as part of total shown on Line 17 of Cover Sheet) ........... $
6. Value of Line 1 Taxable at collateral rate (15%)
(also include as part of total shown on Line 18 of Cover Sheet) ........... $
7. Total value of Future Interest (sum of Lines 2 thru 6 must equal Line 1) ................................ $
(If more space is needed, insert additional sheets of the same size)
STF PA42021 F.16
REV-1649~ EX + (1-97) (I)
SCHEDULE O
ELECTION UNDER SEC. 9'1'13(A)
(SPOUSAL DISTRIBUTIONS)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ALICE D. ROWAND 21-03-00313
Do not complete this schedule unless the estate is making the election to tax aseels under Section 9113 (A) of the Inheritance & Estate Tax Act.
If the election applies to moro than one trust or similar arrangement, a separate form must be filed for each trust.
This election applies to the Trust (marital, residual A, B, By-pass, Unified Credit, etc.).
If a trust or similar arrangement meets the requirements of Section 9113 (A), and:
a. The trust or similar arrangement is listed on Schedule O, and
b. The value of the trust or similar arrangement is entered in whole or in part as an asset on Schedule O,
then the transferor's personal representative may specifically identify the trust (all or a fradJonal portion or percentage) to be included in the election to have such trust
or similar property treated as a taxable transfer in this estate. If less than the entiro value of the trust or similar property is included as a taxable transfer on Schedule
O, the personal ropresentative shall be considered to have made the election only as to a faction of the trust or similar arrangement. The numerator of this fraction is
equal to the amount of the trust or similar arrangement included as a taxable asset on Schedule O. The denominator is equal to the total value of the trust or similar
arrangement.
PART A: Enter the description and value of all interests, both taxable and non-taxable, regardless of location, which pass to the decedent's
surviving spouse under a Section 9113 (A) trust or similar arrangement.
I~SC.,EIP'IION
VALm
Part A Total $
PART B: Enter the description and value of all interests included in Part A for which the Section 9113 (A) election to tax is being made.
DESCRIPllON
Part B Total $
(If more space is needed, insert additional sheets of the same size)
STF PA42021 F. 17
VN,.~
BUREAU OF ZNDZVZDUAL TAXES
ZNHERTTANCE TAX DTV/STON
DEPT. 280601
HARRISBURG, PA 17128-0601
CONHONWEALTH OF PENNSYLVANZA
DEPARTNENT OF REVENUE
NOTZCE OF ZNHERZTANCE TAX
APPRAZSENENT, ALLO#ANCE OR DZSALLONANCE
OF DEDUCTZONS AND ASSESSNENT OF TAX
REV-lGll7 EX AFP (D1-03)
'04 FEB 20 11:22
STACEY PASS ?RIETO
SCHWARTZ ETAL
PO BOX 910
WILLOW GROVE , t, ~,~9090U0., PA
DATE
ESTATE OF
DATE OF DEATH
FZLE NUNBER
COUNTY
ACN
02-2~-200~
ROWAND
05-2q-2003
21 03-0513
CUNBERLAND
101
Amoun~ Rem/'l'~ed
ALICE D
HAKE CHECK PAYABLE AND RENZT PAYHENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THZS LZNE ~ RETAZN LOWER PORT/ON FOR YOUR RECORDS ~
REV-1547 EX AFP (01-03) NOTZCE OF ZNHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DZSALLO#ANCE OF DEDUCTZONS AND ASSESSHENT OF TAX
ESTATE OF ROWAND ALICE D FZLE NO. 21 05-0513 ACN 101 DATE 02-2~-200~
TAX RETURN HAS: ( ) ACCEPTED AS F/LED ( X} CHANGED SEE ATTACHED NOTICE
RESERVATION CONCERNZNG FUTURE ZNTEREST - SEE REVERSE
APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Es*a~e (Schedule A) (1)
2. S4:ocks and Bonds (Schedule B) (2)
$. Closely Held S~ock/Par~nership /n~ares~ (Schedule C) ($)
~. Hor~cgeges/No'ces Receivable (Schedule D) (~')
5. Cash/Bank Deposi'cs/Hisc. Personal Froper~y (Schedule E) (E)
6. Jo/n~ly Owned Proper~y (Schedule F) (6)
7. Transfers (Schedule G} (7)
8. To,al Asse~s
APPROVED DEDUCTZONS AND EXENPTZONS:
9. Funeral Expenses/Adm. Cos~s/H/sc. Expenses (Schedule H) (9)
10. Debts/Hot,gage L/abili~c/es/L/ens (Schedule 1) (10)
11. To,al Deduc~/ons
12. Ne* Value of Tax Re*urn
25/612.~0
.00
55/629.59
.00
.00 NOTE: To insure proper
cradi~ ~o your account,
submi~ ~he upper por~ion
.00 of ~h/s form w/~h your
~ax payment.
572952.q5
(a) 157,19q.22
2,652.00
15.
lr~.
NOTE:
25aO65.fiZ
(11) 25.715.42
(12) 111,fi78.80
.o0
111,~78.80
18 and 19 will
Charitable/governmental Bequests; Non-elected 9115 Trus*s (Schedule J) (15)
Ne* Value of Es~a~e Subjec~ *o Tax (lq)
zf an assesseent ~as lssued previously, lines 14, 15 and/or 16, 17,
reflect figures that include the total of ALL returns assessed to date.
(1~) .00 x O0 = .00
(16) 86,79~.80 X 0~5 = 5,905.76
(17) 2~,68~.00 x 12 = 2,962.08
(18) .00 x 15 = .00
(19)= 6,867.8~.
AHOUNT PAZD
6,935.35
ASSESSNENT OF TAX:
15. Amouni: of L/ne 1~ e~ Spousal ra~e
16. Amoun* of Line lfi ~axable a~ L/heal/Class A ra~e
17. Amoun* of L/no 1~ a~ S/bl/ng ra*e
18. Amoun~ of L/ne 1~ ~axabla a~ Collateral/Class B re*e
19. Pr/nc/pal Tax Duo
TAX CREDZTS:
PAYHENT RECEIPT DISCOUNT (+}
DATE NUHBER TNTEREST/PEN PATD (-)
12-22-2005 CD005575 .00
IF PAID AFTER DATE ZNDZCATED, SEE REVERSE
FOR CALCULATZON OF ADDZT~ONAL ZNTEREST.
TOTAL TAX CREDZT 6,935. $5
BALANCE OF TAX DUEI 67.51CR
ZNTEREST AND PEN. I .00
, TOTAL DUE I 67.5 CR
( IF TOTAL DUE TS LESS THAN $1, NO PAYNENT TS REI)UZRED.
TF TOTAL DUE TS REFLECTED AS A "CREDTT' (CR), YOU HAY BE DUI~
A REFUND. SEE REVERSE STDE OF THZS FORH FOR ZNSTRUCTTONS.)~-~:)~
RESERVATION:
PURPOSE OF
NOTICE:
PAYMENT:
REFUND (CR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December 12, 1982 -- if any future 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 Zaefut Class B (collateral) rate on any such future interest.
To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of ZOO0. (72 P.S.
Section 9140).
Detach the top portion of this Notice and submit with your payment to tho Register of Rills printed on the reverse side.
--Make check or money order payable to: REGISTER OF NILES, AGENT
A refund of a tax credit, which ems not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office
of the Register of Nills, any of the 23 Revenue District Offices, or by calling the special gq-hour
answering service for forms ordering: 1-800-362-Z050; services for taxpayers eith special hearing and / or
speaking needs: 1-800-447-3020 (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest) ms 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. 281021, Harrisburg, PA 17128-1021,
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
OR
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. See page S of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-IS01) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (SI) discount of
the tax paid is alloeed.
The 152 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, tho first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the 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 (l) day from the date of
death, ts the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of
six (623 percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January 1, 1962 will bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2003 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1982 202 . O 00S0`8 1987 92 . 00020`7 1999 72 . 000192
1983 X6Z .0000`38 1988-1991 117. . 000301 ZOO0 87. .000219
1984 112 .000301 1992 92 .00020`7 2001 92 .00020`7
1985 132 .000356 1993-1990, 77. .000192 ZOOZ 62 .000160`
1986 IOZ . O 00270` 1995-1998 92 .000247 Z003 57. .000157
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELIN{IUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent eilX refXect an interest caXcuXation 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 calcuZated.
REV-1470 EX (6-88)
INHERITANCE TAX
EXPLANATION
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
DEPT, 280601
HARRISBURG, PA 17128-0601
DECEDENT'S NAME FILE NUMBER
ALICE D. ROWAND 2103-0313
REVIEVVED BY ACN
CHARLES WRIGHT 101
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
H B-3 The claim for the family exemption has been disallowed. The claimant must be a spouse
or if no spouse, a parent or child living in the same household as the decedent as of the
date of death.
ROW Page 1
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 2/02/2005
DEHART JR EARL E
195 BERGEN AVENUE
THORO FARE , NJ 08086
RE: Estate of ROWAND ALICE D
File Number: 2003-00313
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: 3/24/2005
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
~~;$~
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Counsel
Judge
erR
Register of Wills of Cumberland County
STATUS REPORT UNDER RULE 6.12
Name of Decedent: If#/t/AA./d ,~/<:,f'
Date of Death: t'/ 3 /.;(~ '5
p
,
Estate No.:
,d(#P.:J-,t?// ?/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 whether administration of the estate is complete:
. Yes ad No 0
2. lfthe answer is No, state when the personal representative reasonably believes that
the administration will be complete:
3. lfthe answer to No. I is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes 0 No m
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 Il1 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.
. J;Px;?$'/
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Date:
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o Counsel for personal representative
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