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HomeMy WebLinkAbout03-0359 PETITION also known as FOR PROBATE and GRANT OF LETTERS .~ ~ L Deceased. Soci.l Se,'uri;~' No. / c/b- Lq,- ?~ ! D The petition of the undersigned respectfully represents that: Your petitioner(s), ~xho is/are 18 years of age or older an the execut in the last wilt of the above decedent, dated ,~ff) / / and codicil(s) dated To: Register of Wills for the County of ~--~//.O//rq.W.4"/.z~'~q in the Commonwealth of Pennsylvania named (state relevant circumstances, e.g. renunciation, d2h of executor, crc.) .Decendent was domiciled at death in ~St'ft'v~e/'/6")--/Q tr.* County Pennsvivania with h/~ last family or principal residence at [ g .~ t/~.. ~ '::;/9/'O9~ ~/, ' - - . .hq.. E c' h ~, .,p.. ; (' ~ O u f'a P,4 / ¢z2,¢,0 ' -~ r ' a .' (7- 5list street, number and muncipality) Decend t, then 7 ~ years of age, died at / ',~f !_,~7 '.~ ~-7~ ' " 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: ct 3 /c3, o00, oo WHEREFORE, petitioner(s) respectfully request(s) the prpbate of the last will and codicil(s) presented herewith and the grant of letters (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF ~ ~.,p_.~,~,~ f 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 knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s)will well ~/trulY adm~he~~law. Sworn to or affirmed and subscribed ,- befo¥,e me this _. a~"7',riZ) da5'' of ~ ""' _ ,, /'"x ,, ~, o~' 19-/,60 -~ Estate Of DECREE OF PROBATE AND GRANT OF LETTERS , Deceased ~i0,~L, in consideration of the petition on AND NOW the reverse side hereof, satisfactory proof havin~.been p. resented before me, IT IS DECREED that the instrument(s) dated ---F-lPg[ described therein be admitted to probate and filed of record as the last will of and Letters -~l-~-w v, r~x ~ ~'-r~,,~ t, are hereby granted to ~9A~¢~-, ~-~?r~ ~x3n[el~..~ FEES Probate, Letters, Etc ..........  o~r~_Certificates( ) .......... nuncaauon ................ TOTAL Filed~.¢ ~,J...&'q .... .~..~. ?.& ........... ATTORNEY (Sup. Ct. i.D. No.) ADDRESS PHONE This is to certify that the information here given is correctly copied from an original certificate of death dully filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 Local Registrar ,. Stanley B. Szczypta ... stc:~l mrker COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF OEATH "male '- 195-- 12 --gill0 110 31 1924 I~ant ~, / / .~- ~, .... 8i1~ S~ing D 13 Silver Sprin- R~d la~ ~n, fact=*ngl,,. ,. wi~ ,,. John SzczvD~a ~.Sharon Walden e.r..Eil c,,...,-- [] m,,,o~s,.,.[] ,white 13 Sil~ Spring Rd. I~cs~g, PA 17050 '~) ,m.c~ ~1~ ~? ''L~ ~r~ l,,.Victor~a ~ 3 Sil~ Sprt~ Rd. t M~nics~g, PA 17050 ~ .... ~=~ ' ~ ~ h- 0116~' - ~ ...... ~ ~ket Plaza- Way Io% IR.-, I&l LAST WILL AND TESTAMENT BE IT REMEMBERED THAT I, STANLEY B. SZCZYPTA, a resident of Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this to be my LAST WILL AND TESTAMENT, hereby revoking any and ail Wills and Codicils previously made by me. I I declare that I am not married, my beloved wife having predeceased me. I have two (2) children, SHARON ANN WALDEN and MICHAEL S. SZCZYPTA. II I direct that ail my just debts and funerai expenses shail be paid from my residuary estate as soon as practicable after my decease. III I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shail be paid from my residuary estate as a part of the expense of the administration of my estate. IV I give, devise and bequeath my home aiong with its furniture and the entire contents of the garage to my daughter, SHARON, per stirpes. V All the rest, residue and remainder of my property, whether reai or personai, wherever situate, including any property over which I may have a power of appointment, and specifically including all investments including checking and savings accounts, I give, devise and bequeath to my son, MICHAEL, per stirpes. VI I nominate, constitute and appoint my daughter, SHARON ANN WALDEN, and my son, MICHAEL S. SZCZYPTA, as Co-Executors of this LAST WILL, to serve without bond. If either is unable or unwilling to so act, the other may continue aione as Executor. IN WITNESS WHEREOF, I, STANLEY B. SZCZYPTA, have set my hand to this LAST WILL this/'- day of ',~t~,~!f , 2002. Signed, sealed, published and declared by the above-named STANLEY B. SZCZYPTA, as and for his Last Will and Testament, in the presence of us,-who, at his request and in his presence, and in the presence of each other, ha/ve~hereunto subscribed our names as witnesses. / ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA · SS. COUNTY OF CUMBERLAND · I, STANLEY B. SZCZYPTA, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my LAST WILL; that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me by STANLEY B. SZCZYPTA, Testator, this /57- day of /~/D/J' / ,2002. Notary Public Notarial Seal ] Diane M. Smith, Notary Public | Mechanicsburl] Boro, Cumberland County! My Commission Expires June 22, 2004~ AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA · SS. COUNTY OF CUMBERLAND · the ~tnesses whose nines ~e si~ed to the attdched or forego~g instrument, being duly quEffied according to law, do depose ~d say that we were present ~d saw Testator si~ ~d execute the instrument as his LAST WILL, that STANLEY B. SZCZY~A si~ed ~llingly ~d that he executed it as hisffree ~d volunt~ act for the pu~oses therein expressed; that each of us in ~e he~ng ~d sight of the Testator si~ed the Will as ~tnesses; ~d that to t~est of our ~owledge, the Testator was at the time 18 ye~s of age or more~ ~sound mind ~d under no constrant or undue influence. Sworn or affirmed to a~d acknowledged before me this ]5~' day of /-}~r,'/ ,2002. Notary Public 3 I Notarial Seal ] Diane M. Smith, Notary Public · Mechanicsbur9 Boro, Cumberland County[ My C~mmiss~on Expires June 22, 2004[ 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 002680 WALDEN SHARON ANN 13 SILVER SPRING ROAD MECHANICSBURG, PA 17050 ........ fold ESTATE INFORMATION: SSN: 195-12-9610 FILE NUMBER: 2103-0359 DECEDENT NAME: SZCZYPTA STANLEY B DATE OF PAYMENT: 06/13/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 04/04/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 .')9,937.51 TOTAL AMOUNT PAID: $9,937.51 REMARKS: SHARON ANN WALDEN SEAL CHECK# 00006865 INITIALS: JA RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 I- Z iii Z O UJ r~ REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 _ 03 0359 COUNTY CODE lC=AR N~BER SOCIAL SECURITY NUMBER 195-12-9610 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Szczypta, Stanley B 04/04/03 10/31/24 DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DO-YEAN) {IFAPPLICABLE) SURVIVING SPOUSE'S NAME {LAST, FIRST, AND MIDDLE INITIAL) [-~3. Remainder Return (date of death prio~ to 12-13~2) ~]5. Federal Estate Tax Return Required 8, Total Number of Safe Deposit Boxes r'--] 11, Election to tax under Sec. 9113(A) (Attadl Sch O) r~l. Original Return [~4. Limited Estate [~6. Decedent Died Testate (Atted~ c~y ~ wa) [~9. Litigation Proceeds Received NAME Sharon Ann Walden FIRM NAME ilf,N~le) E~]2. Supplemental Retum [-'""~ 4a, Future Interest Compromise Idate of deetfl aria' 12-12~2) [~]7. Decedent Maintained a Living Trust (Attad~ copy CTrust) [~t0. Spousal Poverty Credit (date of death belv~:~e~ 12-31-91 and 1-1-95) TELEPHONE NUMBER (717) 795-1115 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 (5) (Schedule E) 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) 13. Charitable and Govemmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) Net Value Subject to Tax (Line 12 minus Line 13) COMPLETE MAILING ADDRESS 13 Silver Spring Road Mechanicsburg, PA 17050 L 244,832.08 12,392.12 232,439.96 0.00 151,000.~1~)C:' 0.~ 0.® 93,832.0~ 0.00 (8) 12,281.64 110.48 (11) (12) (13) 232,439.96 14. 232,439.96 (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19, Tax Due 0.00 10,459.80 0.00 0.00 10,459.80 x ,0_ (15) x .0 4~5 (16) x .12 (17) x .15 (18) (19) 20. [] ~II:~III~I:~:II~I~i~:~:~I:I:~I'~[e/-`~:~]I:1~v~I~I~Y~''4q~I Decedent's Complete Address: STREET ADDRESS 13 Silver Spring Road CITY .... MecnanlcsDurg I STATEpA IziP 17050 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 0.00 B. Pdor Payments O.00 C. Discounl 522.29 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 1 Line 20 to request a refund (4) 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 + SA. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 10,459.80 522.29 0.00 0.00 9,937.51 0.00 9,937.51 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; .......................................................................................... [] [] b. retain the right to designate who shall use the property transferred or its income; ............................................ [] [] c. retain a reversionary interest; or .......................................................................................................................... [] [] d. receive the promise for life of either payments, benefits or care? ...................................................................... [] [] 2. If death occurred after December 12, 1982, did decedent transfer properly 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 ~enalties of perjury, I declare that I have examined this return, including accornpaDY~g schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of praparar Other than the personal representative is based on all inforrnati~,,~which preparer has an,y.,knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ,~,/f~ ~'~ .,~/,~ ~',/~~_-~¢~ DATE _ r',--,~ ,,~..,.,,.-,, ,',~ u.J.l~_.-,..,,~.,,,~,.~,.~/ $1GNATURE OF PREPARER OTHER THAN REPRESENTATIVE ~,c,,'~--'/ ,"v'v,v~l DATE ADDRESS For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. ,{,9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. {}9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. {}9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal benefidaries 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 decedenrs siblings is 12% [72 P.S. {}9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX',' (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Stanley B Szczypta 21-03-0359 All real prope~ owned solely ar as a tenant in eommen must be repar~d at f~ir market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disaloead on Sahedule F ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 151,000.00 Real Estate located at 13 Silver Spring Road, Mechanicsburg, PA 17050 Qualified Fair Market Appraisal attatched TOTAL (Also enter on line 1, Recapitulation) $ 151,000.00 (if more space is needed, insert additional sheets of the same size) REV-1506 EX+ (6-96) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Stanley B Szczypta 21-03-0359 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Sohedule F ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH Members 1st Federal Credit Union Household Goods are all old and of little or not value 1986 Chevrolet Cavilier car is in poor condition 1993 Chevrolet Caprice car has mechanical problems and is in need of repair before attempting to drive $93,432.08 $400.00 0.00 0.00 TOTAL (Also enter on line 5, Recapitulation) $ 93,832.08 (If more space is needed, insert addi~onal sheets of the same s~ze) REV-1511 EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Stanley B Szczypta FILE NUMBER 21-03-0359 Debts of decedent m~st be reported on S~hedule 1. ITEM NUMBER DESCRIPTION 2. 3. 4. 5. 6. 7. 8o FUNERAL EXPENSES: Opening of Grave Gate of Heaven Cemeta~j Ck 1579 Sharon Walden Funeral Malpezzi Funeral Home Reception following funeral (Food & Drinks) Suit for Decedent ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State_____ Zip Year(s) Commission Paid: Attorney Fees Family Exemption: (if decedenrs address is not the same as claimant's, attach explanation) Claimant Sharon Ann Walden Street Address 13 Silver Spdng Road city Mechanicsburg Relationship of Claimant to Decedent Probate Fees Accountanrs Fees Tax Return Preparer's Fees Qualified Assement of Real Estate Paid to Leon D, Gerlach, Appraiser Ck 1629 Sharon Walden Deed Praperation and Recording Paid to Murrell R Walters III Ck 1633 Daughter State PA Zip 17050 AMOUNT $675.00 $6,786.14 $310.00 $279.00 3,500.00 263.00 0.00 50.00 300.00 118.50 TOTAL (Also enter on line 9, Recapitulation) $ 12,281.64 (If more space is needed, insert additional sheets of the same size) REV-1512 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER Stanley B Szczypta 21-03-0359 Include unralmbureed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Andrews and Patel Uncologist Paid Ck 1576 Sharon Walden Verizon Phone Bill Paid Cks 1577 & 1625 Sharon Walden PA Gl Consultants PC Gastro Doctor Paid Ck 1624 Sharon Walden Neurology Center, P.C. Paid Ck 1630 Sharon Walden $16.56 $20.86 $31.54 $41.52 TOTAL (Also enter on line 10, Recapitulation) $ 110.48 (If more space is needed, insert additional sheets of the same size) REV*1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Stanley B Szczypta 21-03-0359 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s} OF ESTATE ! TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Sharon Ann Walden 13 Silver Spring Road Mechanicsburg, PA 17050 Michael S Szczypta 1209 Minnich Road Mechanicsburg, PA 17055 Daughter Son Real Estate with Furniture and contents of garage Cheking and Savings accounts and two automobiles 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 $ 0.00 (If more space is needed, insert additional sheets of the same size) IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE. Whether you will receive any money or property will be deter- mined wholly or partly by the decedent's will. If the decedent died without a will, whether you will receive any money or prop- erty will be determined by the intestacy laws of Pennsylvania. BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, CARLISLE, PA In re Estate of ,.~7-/~-)~'C/ .~ ~,/~C/q~ I~t ,f-)T'/~ ,deceased, Estate No. '~ ~-'~(~ '-~ (Name and Address) 1 Please take notice of the death of decedent and the grant of letters to the personal representative(s) named below. The Decedent ,~'7/~p'-')/-- ~ L// ~ :~d-~- VP :/4 , died on the /-//7~/P) day of /d~tO~[L~ ,~) .~ at ~L~~/L)/:) County, Pennsylvania. The Decedent died testate (with a Will); or The Decedent died intestate (without a Will). The personal representative of the Decedent is (name, address and telephone number). Zc3: £ cl[ t Nfl[' CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: '5 T/5~ A-}/-~ ~-/? ~ S ~ ,J~ ¥ to ?'~ Date of Death: A P/~ / ~ ~)/-/! o~ ~} 0 ~ WillNo. ~3~ (-f~'3~Jq Admin. mo. 2/' 0~.~ ' 03~'-q 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 : Name Address Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: Signature Name Address /..¢ ..... ~, · ~. ...... : ::n-,,-~, apac~ty: Personal Representative __.Counsel for personal representative /203-0 If the Decedent died testate, the will has been filed with the Office of the Register of Wills of Cumberland County, 1 Courthouse Square, Carlisle, Pa. 17013. Phone No. 717-240-6345 If the Decedent died intestate, a Petition for the Grant of Letters of Administration was filed with the Office of the Register of Wills of Cumberland County, 1 Courthouse Square, Carlisle, Pa. 17013. Phone No. 717-240-6345 A copy of the Will or Petition may be obtained by contacting the Register of WiJJ~, and paying the charges for duplication. Date: Signature: ~qT~ ~ '/d~ · Name (print) Telephone (~/ Capacity: Personal Representative Counsel for personal representative ZG:~d fit NFl? ,CO. BUREAU OF INDIVIDUAL TAXES TNHERZTANCE TAX DZVTSTON DEPT. 280601 HARRTSBURG, PA 17118-0601 COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRA/SEHENT, ALLO#ANCE OR DISALLO#ANCE OF DEDUCTIONS AND ASSESSNENT OF TAX SHARON ANN WALDEN 15 SILVER SPRING RD HECHANICSBUR$ F!~c~ ~ DATE 07-28-2005 ?ii. ESTATE OF SZCZYPTA DATE OF DEATH 04-04-2005 FILE NUHBER 21 03-0359 JUL 28 COUNTY CUNBERLAND ACN 101 PA 17 Q..50 Amoun'l: Remitted REV-I~7 EX AFP (01-05) STANLEY HAKE CHECK PAYABLE AND RENIT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISENENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF SZCZYPTA STANLEY B FILE NO. 21 05-0559 ACN 101 DATE 07-28-2003 TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks end Bonds (Schedule B) (2) ~. ClosaZy Held S~ock/Partnership Interest (Schedule C) ($) q. Nortgages/Notes Receivable (Schedule D) (q) 5. Cash/Bank Daposlts/Hisc. Personal Property (Schedule E) (5) 6. Jointly O~ned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXEHPTIONS: 9. Funeral Expenses/Ada. Cos~s/Nisc. Expenses (Schedule H) (9) 10. Dabts/Nortgaga Liabilities/Liens (SchaduZe I) (10) 11. TotaZ Deductions 12. Net Value of Tax Return 151~000.00 .00 .00 .00 93~,852.08 .00 .00 (8) 12,281.64 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 1S. NOTE: ASSESSHENT OF TAX: 16. Amount of L/ne 1~ et Spousal rate 16. Amount of LAne 1~ taxable et LineaL/Class A rata 17. Aaount of Line 1~ at Sibling rata 18. Amount of Line 1~ ~axable et Colla~caral/Class B rate 19. Principal Tax Due 244,832.08 TAX CREDITS: PAYHENT DATE 110.48 (11) (12) 252,459.96 06-15-2005 Char/table/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) Nat Value of Estate Subject to Tax (1~) If an assessment ~as issued previously, 11nes 1~, 15 and/or 16, 17, reflect figures that include the total of ALL returns assessed to date. INTEREST/PEN PAID (-) .00 252,459.96 18 and 19 will IF PA/D AFTER DATE INDICATED, SEE REVERSE FOR CALCULAT/ON OF ADDITIONAL /NTEREST. 9,957.51 CD00E-,?$G TOTAL TAX CREDIT 10,460.50 BALANCE OF TAX DUEI .7OCR INTEREST AND PEN. I .00 TOTAL DUE I .7OCR ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYNENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE S/DE OF THIS FORN FOR INSTRUCT/ONS.) RECE/PT' NUNBER 522.99 ANOUNT PAID (~) .00 x O0 = .00 (16) 252,459.96 x 045= 10,459.80 (17) .00 X 12 = .00 (18) .00 x 15 : .00 (19)= 10,459.80 RESERVATION: Estates of decedents dying on or before December 12, 1981 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: PAYHENT: REFUND (CR): OBJECTIONS: ADHIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section Il40 of the Inheritance and Estate Tax Act, Act Z$ of 2000. (71 P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of #111s printed on the reverse side. --Hake check or money order payable to: REGISTER OF RILLS, AGENT A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for ReRmd of Pennsylvania Inheritance and Estate Tax" (REV-IS1:5). Applications are available at the Office of the Register of Rills, any of the Z:5 Revenue District Offices, or by calling the special Z4-hour answering service for fores ordering: 1-800-:561-2050; services for taxpayers aith special hearing and ! or speaking needs: 1-800-447-:5020 (TT only). Any party in interest not satisfied eith the appraiseeent, allowance, ar 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. ZBIO21, Harrisburg, PA 17118-1011, 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 ba addressed in ariting to: PA Department of Revenue, Bureau of Individual Taxas~ ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17118-0601 Phone (717) 787-6505. Sea page S of the booklet "Instructions far Inheritance Tax Return far a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (:5) calendar months after tho decedent's death, a five percent (57.) discount of the tax paid is allowed. The 151 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 sase 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 (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1981 bear interest at the rate of six (6X) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and 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. The applicable interest rates for 1981 through Z003 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Yea.~r Rate Factor Yea.~r Rate Factor 1981 ZOZ .000548 1987 97. . O00247 1999 71 . O00IgZ 198:5 161 .000438 1988-1991 111 .000:501 2000 81 .OOOZ19 1984 117. . O00:501 1991 91 .000147 2001 97. .000247 1985 13Z .000:556 199:5-1994 72 .O00lgZ ZOO2 6Z .000164 1986 101 .000274 1995-1998 91 .000247 Z00:5 5Z .0001:57 --Interest is calculated as follows: ZNTEREST= BALANCE OF TAX UNPAID X NUNBER OF DAYS DEL/NI~UENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the data cf the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must ba calculated. BUREAU OF INDIVTDUAL TAXES /NHER/TANCE TAX D/VISION DEPT. 280601 HARRISBURG., PA 17128-0601 SHARON ANN WALDEN 15 SILVER SPRING RD HECHANICSBURG PA 17050 COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE ZNHERZTANCE TAX STATEHENT OF ACCOUNT DATE ESTATE OF DATE OF DEATH FILE NUHBER REV-'E&07 EX AFP 09-22-2005 SZCZYPTA STANLEY B 04-0~-2005 21 03-0359 COUNTY CUHBERLAND ACN 101 Amoun~ Remi~ed I HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUNBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper credi~ ~o your account, submi~ ~he upper pore/on of ~:his for. wi~:h your ~ex paymen~:. CUT ALONG THIS LINE ~* RETAIN LOWER PORTION FOR YOUR RECORDS *~ REV-1607 EX AFP (01-03) #~ INHERITANCE TAX STATEHENT OF ACCOUNT ~ ESTATE OF SZCZYPTA STANLEY B FILE NO. 21 05-0559 ACN 101 DATE 09-Z2-Z005 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHO#N BELO# IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSNENT OR RECORD ADJUSTHENT: 07-28-2005 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYHENTS (TAX CREDITS): 10,~59.80 PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER /NTEREST/PEN PAID (-) AMOUNT PAID 06-13-Z005 CDOOZ680 522.99 9,937.51 IF PAID AFTER TH/S DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYNENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), TOTAL TAX CREDIT 10,~60.50 .7OCR YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) BALANCE OF TAX DUE INTEREST AND PEN. .00 TOTAL DUE .7OCR PAYNENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF WILLS, AGENT. -- If NON-RES/DENT DECEDENT make check or money order payable to: COHHONWEALTH OF PENNSYLVANIA. REFUND (CR): 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-1513). Applications ara available at tho Office of the Register of Hills, any of tho Z3 Revenue District Offices or from the Department's Z4-hour answering service for fores ordering: 1-800-36Z-Z050; services for taxpayers aith special hearing and / or speaking needs: 1-800-447-30Z0 (TT only). REPLY TO: guastions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Past Assessment Review Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601, phone (717) 787-6505. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedant's death, a five percent (SX) discount of the tax paid is allowed. PENALTY: The ISZ tax amnesty non-participation penalty is computed on the total of tho tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. INTEREST: 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 l, 1982 bear interest at the rate of six (SI) percent per annum calculated at a daily rate of .000164. Al1 taxes which became delinquent on and after January 1, 198Z will bear interest at a rate ahich 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 ZOO3 ara: Interest Daily Interest Daily Interest Year Rate Factor Year Rate Factor Year~ Rate Daily Factor 198Z ZOZ .00054B 1987 9Z .000Z47 1999 7Z .00019Z 1983 16Z .O00q38 1988-1991 11Z .O00SOZ ZOO0 8X .OOOZ19 1984 llZ .000301 X99Z 9X .OOOZ47 ZOOX 9Z .000Z47 1985 132 .000356 1993-1994 7Z .00019Z ZOOZ 62 .000164 1986 lOX .000274 1995-1998 9Z .000Z47 2003 5Z .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAZEY INTEREST FACTOR --Any Notice issued after tho tax becomes delinquent will reflect an interest calculation 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. Cumberland County - Register Of wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 3/03/2005 WALDEN SHARON ANN 13 SILVER SPRING ROAD MECHANICSBURG, PA 17050 RE: Estate of SZCZYPTA STANLEY B File Number: 2003-00359 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 is due by: 4/04/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ~~~~ REGISTER OF WILLS cc: File Counsel Judge u^ Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedent: <::.., -r fI N U:- Y B 5 ;z.c.:z. Y PT A Date of Death: I1PRI\- If, "2..003 Estate No.: 2.00~ _003'5'1 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: . Yes .~ No 0 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes 0 No ~ 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 0 No ~ 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. Date: l.f- 1- 2.00"5 ~~kf/ ~ Signature J ~ M \ c...l-\ f1, t.L S $-z.C;z.'1"PTA Name ('.~") \'2..0 q JV\ INN\C..t/ f?.D 'ff\tolA"-ll0.13VtU--?fJ no 5 5 I Address (I, (pcn~'Z-o,st Telephone No. Capacity: I&i Personal Representative o Counsel for personal representative (J