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HomeMy WebLinkAbout03-0369PETITION FOR PROBATE and GRANT OF LETTERS Estate of ?ORi'c~ J' BEITZET= No. also known as To: Deceased. Social Security No. 2'00 - 2 8 - ! 07~ c) Register of Wills for the County of Cumberland Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age ~r older,an the~e~ecutOr s in the last will of the above decedent, dated ~.: o vemD e ~ and codicil(s) dated in the named ,19 99 (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in C~mb~ ~ 1 a r~.d County, Pennsylvania, with her last family o~ principal~residence at 200 Ualnut St.. Boilin~ Sprin~s Pennsylvania-South 1.~idd!eton Township- ' - (list street, number and muncipality) Decendent, then 66 years of age, died A.I~V±I 1~ 2©0~ ,JI , at South Hiddleton Township 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: -None- 60,000.00 WHEREFORE, petitioner(s) respectfully presented herewith and the grant of letters theron. request(s) the probate of the last will and codicil(s) Tes taraentary (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ] COUNTY OF CUt~3ERLAI~.U)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 and truly administer the estate according to law. Sworn to or affirmed and subscribed ~- ~' b~efore me this ?Sth day of 2o03 -- u Estate of ~0R~'~ J. BEITZEL , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW April E8 ~003, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated l',lovember 1~, 1999 described therein be admitted to probate and filed of record as the last will of Norm~ J. Beitzel ; and Letters To s tame nt ary are hereby granted to Lori Jo Jamieson and Timoth7 Ray Beitzel FEES Probate, Letters, Etc .......... $. 115.00 Short Certificates( ) .......... $. 9.00 l~~fo~X...e.x.t~.a.p.a.§.e.s. $ 6.00 jcp$ 10.00 TOTAL __ $ 140.00 Filed ....... .raP.3. ................. mailed tO atty 4-28-2003 ' _--U-~~~ ~i, tx, ~,,.. ~ o ~- (1 ko Register of W~il]s 0' tJ J. Robert Stauffer (No, 06356) ATTORNEY (Sup. Ct. I.D. No.) Market Square Bldg. Mechanicsburg, PA 170~ ADDRESS 717-766-9673 PHONE 105.g05 REV 9/86 This is tO certi~ that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar.,. The original certificate will be forwarded to the State Vital Records Office for permanent fJling. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 ~ · ~1~'~ '/ l.ocal Registrar P 9154127 No. '~ ~ 5)ate mos ;,u ..v z'87 COMMONWEALTH OF PENNSYLVANIA · OEPARTMENT OF HEALTH * VITAL RECORDS CERTIFICATE OF DEATH ,. Norma Jean Bettzel . '~,,.~, u~,,~ ~, ~__~ .... F~le ,. 200 -- 28 -- 1959 ,. Aprzl 1, 2003 66 : : : o,~.: ~ ....... ,. *" : { June 4 1936 .... Activity Dir~ .... Adult me b,. 200 Walnut S~t I~ ,,..m. Pe~ylvania ~ ,,..B,.~,. ~uth ~iddleton Diling Springs PA 17007 I~ ~ams~Tm '~ 1~.1019 High S~t ~o~n~n, PA 17020 '"- ~ ~,,~ April 5, 2003 f,. Mt. Zion C~t~ ,,a.~ ~. PA 17007 ~-~ .... a-~,~'o,~"~ ~T~~ ................. LAST WILL AND TESTAMENT OF NORMA J. BEITZEL I, NORMA J. BEITZEL, of the Township of South Middleton, County of Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all prior Wills by me at any time heretofore made. me I direct the payment of all my Just debts and funeral expenses as soon after my decease as the same can be conveniently done ~ e I give, devise and bequeath all the rest, residue and remainder of my estate, real, personal and mixed, whatsoever and wheresoever the same may be situate, to my two (2) children, to wit, my daughter, LORI JO JAMIESON and my son, TIMOTHY RAY BEITZEL, share and share alike, per stirpes. LASTLY, I nominate, constitute and appoint my two (2) children, the aforementioned, LORI JO JAMIESON and TIMOTHY RAY BEITZEL, Co-Executors of this my Last Will and Testament, -1- and direct that they be excused from posting bond or other security for the faithful performance of their duties in any jurisdiction. IN WITNESS ~HEREOF, I have hereunto set my hand and seal this _/~ day of November, A. D., 1999 J. ~'e ~t zel (SEAL) Signed, sealed, published and declared by the above named testatrix, as and for her Last Will and Testament, in the presence of us, who have subscribed our names hereto as witnesses, at the request of said testatrix, in her presence and in the presence of each other. -2- COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS. I, NORMA J. BEITZEL , the testatl"iX whose name is signed to the attached or foregoing instrument, ~--aaving been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and volun- tary act and deed, for tile purposes therein contained. Sworn and affirmed to and acknowledged before me NORMA J. BEITZEL , the tes[atrtX , this day of Novembe~ , A. P., 1999. ' Nor~a~. -Bo'itz~l -- Notary Public COMMONWEALTH OF PENNSYLVANIA ) : COUNTY OF CUMBERLAND ) SS. We, the undersigned, J. ROBERT STAUFFER and SUSAN A. McCOY , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the testatrix , NOR~iA J. BEITZEL , sign and exe- cute the instrument as J~XX/her Last Will and Testament; that the said testatl~ix , NORMA J. BEITZEL , executed it as ~%~her free and voluntary act for tile purposes therein expressed; that each of us, in the hearing and sight of the testatrix , signed the Will as witnesses; and that to the best of our knowledge, the testatrix was, at the time, eighteen (18) or more years of age, of sound mind, and under no constraint, duress or undue influence. Sworn and subscribed to before . , ~ me this / ~-~day of f November , 1999. , ~ ~. W.'illiarns, Notary Public Ml~Eh;~cs~u'~ Boro, Cumberland 'Ceunty My Corhmission Expires Nov. 6, 2001 · .~r, ~r~Vh/anfa A~so~Jath~n ~f N~l~des LAST WILL A~rD TEST~,'~MENT OF NOR~,~ J. J. ROBERT STAUFFER ATTOHNI~y AT LAW M,~RKET SQU.~RE BUILDING MECHANICSBURG, PA. 17055 Name of Decedent: CERTIFICATION OF NOTICE UNDER RULE 5.6(a) NORHA J. BEITZEL Date of Death: April 1, 2003 Will No. 2003-00369 Admin. No. 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 Ihe above-captioned estate on ?.a?£ 2 s 2003 : Name Address Lori Jo Jamieson-109 Warwick Road, i-~addonfield, I.~,. J., 08033 Timothy Ra'~, Beitzel-1019 High St., Duncannon, PA 17020 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except ])~orle Date: MaX 5, 2003 Name J. Robert Stauffer Address Market Square Bldg. Hechautcsburg, PA 17055 Telephone (71~-766-9673 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 002990 STAUFFER J ROBERT ESQUIRE MARKET SQUARE BLDG 1 WEST MAIN STREET MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN: 200-28-1959 FILE NUMBER: 2103-0369 DECEDENT NAME: BEITZEL NORMA J DATE OF PAYMENT: 09/09/2003 POSTMARK DATE: 09/09/2003 COUNTY: CUMBERLAND DATE OF DEATH: 04/01/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $2,599.97 REMARKS: TOTAL AMOUNT PAID: TIMOTHY RAY BEITZEL C/O J ROBERT STAUFFER ESQUIRE CHECK# 107 INITIALS: SK SEAL RECEIVED BY: $2,599.97 DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS REVdSO0 EX (6-00) ~-~,. COMMONWEALTH OF ~.._-,~'?J~ ~ PENNSYLVANIA ,,e~~~ DEPARTMENT OF REVENUE ,r ~,~j~,/~",~ '~ DEPT. 280601 ~"~ HARRISBURG, PA 17128-0601 / REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 - 03 OO 36 9 COUNTY CODE YEAR NUMBER DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Z BEITZEL, ~Iorma J. 200- 28 -1957 t"t DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE LU Apr:L1 1, 2003 Jtme )I, '1936 REGISTER OF WILLS (..) LEI (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER _ _ ,';I,o.o 0. I-- Z U.I C~ Z o 0. o x [~] 1. Original Return ~ 2. Supplemental Relurn ~]4. Limited Estate [] 4a. Future Interest Compromise (dale of dealh after 12-12-82) ~]6. Decedent Died Testate (Attach copy of Will) ~J 7. Decedent Maintained a Living Trust (Attach copy of Trust) E~9. Litigation Proceeds Received L] 10. Spousal Povedy Credit (date or death between 12-31-91 and 1-t-95) HIS 8,,u ~iON MUST BE COMPLE'YeO: ALL CORRESPONDEH~:E ~ NAME J'. ]lobert Stauffer FIRM NAME (If Applicable) TELEPHONE NUMBER 717-76(,-9673 E~3. Remainder Return (date of death pdor to 12-13-82) [~5. Federal Estate Tax Return Required O 8. Total Number of Safe Deposit Boxes [~11. Election to tax under Sec. 9113(A) (Attach Sch O) COMPLETE MAILING ADDRESS Harket Square Bldg. 1 West Main St. Mechanicsburg, PA 170~5 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Modgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Properly (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) E~] 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 & 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. 14. Charitable and Governmental 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) 0.00 0.00 0.00 62,437.63 O. O0 7,134. o8 (8) 11,794.6o 0.00 (11) (12) (13) OFFICIAL USE ONLY 69,571.71 11,794.60 57,777.11 0.00 (14) 57.777.11 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) O, OO 16. Amourtt of Line 14 taxable at lineal rate ~; 7,7 7 7.11 17. Amount of Line 14 taxable at sibling rate O, OO 18. Amounl of Line 14 taxable at collateral rate 19. Tax Due 0.00 x .12 x .15 (15) (16) (17) O.OO 2,599.97 0.oo 0.0o 2,599.97 (18) (19) > > BE SURE TO ANSWER ALL QUE~ION~ Decedent's Complete Address: STREET ADDRESS 200 !,',[~l'l~l.lt S~I~O~ CiTY Doiling Springs I STATE I~A ZIP 17007 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 0.00 0.00 0.00 Interest/Penalty if applicable 0. f)0 D. Interest E. Penalty 0 · O 0 (1) Total Credits ( A + B + C ) (2) Total Interest/Penalty ( D + E ) If Line 2 is greater titan Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (3) (4) (5) (5A) (5B) A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT 2,599.97 0 · O0 0·0o 0.00 2,599.97 0.00 2,599.97 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; ............................................ [] [] (~. 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 pena t es of perjury declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge af/ei~ef, it is true, correct and complete. Declaration of preparer other than the personal representative igbased on all information of which preparer has any knowledge. TU ~ DATE SIGNATURE OF PERSON RESPONSIBLE. FOR~,~ING RET RN, ADDRESS 109 Warwic~ Ro-gd ~/ ~/ 1019 High St. tIa~d~onfield, N. J. 08033 D~ncannon, PA 17020 SIGNATURE Op'P'REF/ARFm~r~TI-I~ER THAN REliHAESENTATIV~ DATE ADDRESS x/'~/ ! c ' ' ~ ~/ /~arket Square Bldg,, 1 t.'!est ?..~ai~ St., Mechanicsburg, PA 17055 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 i 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 paren~ 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 decedenl's lineal beneficiaries is 4.5%, except as noted in 72 P.S. {}9116(12) [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 a~ individual who has at least one parent in common with the decedent, whether by blood or adoption. / PERSONAL I'IIOPERI'Y J ....................................... -- ................ ..... _ ................. e003-oo369 dad lira pu.'eod; win- m~ ~,iw,,I Iw t1., ~'~lah, All i.olm~l~ J.l.lly .w.~d wllll lh~ II,hi ol ~l~lVDot~hlp I1.~1 b. ~ll~elo~ll on 8c11.~1~ I ~1 ,';! ,I]11'1 II Members 1st F'edera]. Credit lJn;[otl, Sari. rigs Account ]'.~o. 2811~-00. Nembers ls~ ].;'edernl Crodit 'Ut~-[ot], Checking Account I'.~o. 2811~-!1. ~embers 1st Federal Credit U~ion, Znvestme~t Savings Account No. 2811~-0~. 1998 Ford Contour automobile. Household Furnishings as appraise~ by Yvonne Laukemann of Spring House Antiques. Comcast, refund. Capital Blue Cross, refund. Renterts Insurance, refuud. VALUE AI DA'I'E OF DEA]'tt $ 1,162.04 1,092. r52 50,$23.27 6,000.00 3,100.00 ~4.64 197.16 48.00 ]OIAL (^1.o e,,le, o,, II.e §, Recapilulalion) $ 62, li-37 · 63 COMMONWEAL'~H OF PENNSYLVANIA INHERITANCE TAX REiURN RESIDEN I DECEDENT ESTATE OF IOR,'IA J B EiI.'TZ.t!jL SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON*PROBATE PROPERTY FILE NUMBER 21-03-0369 20o3-oo367 ITEM NUMBER This schedule must be compieted and filed if the answe' to any of questions 1 lhr(mgh 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY Members 1st Federal Credit Un IRA Account No. 2811~-.].~, her grandchildren, Alexande Beitzel a~d Sarah E. P. Bei as beneficiaries. % OF I[?^NSFER DATE OF DEATH DECD'S EXCLUSION TAXABLE VALI VALUE OF ASSET INTEREST IIF APPtJCABLE i_o~ ~it~g ? C. :zel 7,134.08 loo;'~ 0.0o $ 7,134 TOTAL (Also enler on line 7, Recapitulation) $ 7 ~ ]-.3~t. ~ .I..Of' (If more space is needed, insert additional sheets of the same size) COMMONWEAl. iH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER 21-03-00.369 ]~fORI~A J. BE_ITZEL 2003_00,369 Debts of decedent must be reported on Schedule I, ITEM NUMBER DESCRIPTION AMOUNT A. 1. 11. 12. 13. 16. FUNERAL EXPENSES: Malpezzi Funeral !lomo, Funeral Lxpenses. Mechanicsburg, PA, 17055, ADMINISTRATIVE COSTS: Personal Representative's Commissions ~r O n e Name of Personal Representative (s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: AttomeyFees g. Robert Stauffer, Attorney fee. Family Exemption'. (If decedent's address is not the same as claimant's, attach explanation) Claimant N/A Street Address City State Zip Relationship of Claimant to Decedent Probate Fees Register Pennsylvania, Accountant's Fees of Wills of Cumberland County, Letters Testamentary. Tax Return Preparer's Fees Cumberland Law Journal, Estate Notice. Sprint, April telephone. MCI, April telephone. Shepherdstown Evangelical United Brethren Church, Funeral Luncheon. James R. Gingrtch Memorials, Inc., lettering monument The Sentinel, Estate Notice. MCI, May Telephone. Erie Insurance Co., Automobile Insurance premium. MCI, final bill. Register of Wills, filing Inventory and Pennsylvania Inheritance Tax Return. TOTAL (Also enter on line 9, Recapitulation) $ 8,8o5.5. 0.00 1,700.00 140.o0 75.00 37.08 20.50 300.00 lO0.OO 8 .Ol 37.58 466. oo 2.88 25 · O0 $ 11,794.60 (If more space is needed, insert additional sheets of the same size) SCHEDULE J BENEFICIARIES REV-1513 EX + 0-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NORJ'fA J. BEITZEL FILENUMBER RELATIONSHIP TO DECEDENT NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) TAXABLE DISTRIBUTIONS (include outright spousal distributions) NUMBER II. 1. LORI JO JAMIESON 109 Warwick Road Haddonfield, N. J. 080.33 TII',IOTIIY. RAY L~_,I!PZJ:~L 1019 IIigh St. Dunoannon, PA 17020 Daughter Son ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE 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 ]!. 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) 21-o3-o369 2003-00369 AMOUNT OR SHARE OF ESTATE One-half of Estate. One-half of Estate. ON REV 1500 COVER SHEET COMMONWEALTII OF PENNSYLVANIA COUNTY OF CUMBERLAND ...... Timothy Ray Beitzel being duly ....... S330.~ ........ ~c¢ordh, g to law, d~poses a,,d says fhaf he ZS the Executor ................................ of the Estate of Norraa J. Beitz~l I.~. oF South Middleton Township ....... Cum~erl~.8 Cou.ly, Pa., witl, ln is an htvento,'y .,nde by Timothy Ra~ Beitzel ......... the the Commonwealth of Perln, syJvsn;a, and fl, el' JJle figures opposite each Jlem of the Inventory re~esenf if s fair value as of the da~e of decede,t s death. 1019 Hlgh St. _ . ~U_o~nnon, SA ~7020 Addres~ Date of Death .... 1st April Day Mo.U, 2o03 Year INSTRUCTIONS I. An inventory must be filed wlfhin three months after nppolnfmenf of personal repr. e_~s~nfal;ve. 2. A supplemef, f inventory must be filed wif4in fhlrly days of discovery of addlflonal~ssefs. 3. Additional sheets may be attached as to personally or really 4. See Article IV, Fiduciaries Act of 1949. ~ r~ I o h~ve~,tory of the ,eal and personal estate of NOR?h~ J. BEITZEL deceased (1) Members 1st Federal Credit Union, Savings Account No. 2811~-00.[ (2) Merabers 1st Federal Credit Union, Checking Account No. 2811~-11 (3) Members 1st Federal Credit Union, Investment Savings Account No. aSll -0 . (1.~) 1998 Ford "Contour" automobile. (~) Household Furnishings as appraised by Yvonne Laukemann, of Spring House Antiques. (6) Comcast, refund. (7) Capital Blue Cross, refund. (8) Renter's Insurance, refund. Total................,I 1,162 04 ~0, 27 6, 00 O0 64 19' 16 00 BUREAU OF INDIVIDUAL TAXES ZNHERTTANCE TAX DIVTS/OH DEPT. 180601 HARRISBURG, PA 17118-0601 COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCTZONS AND ASSESSHENT OF TAX J ROBERT STAUFFER HARKET SQUARE BLDG I W HAIN ST NECHANICSBURG PA *iii?055 REV-154? EX AFP DATE 10-21-2005 ESTATE OF BEITZEL NORHA J DATE OF DEATH 04-01-Z005 FILE NUHBER 21 05-0569 COUNTY CUHBERLAND ACN 101 Amount RaeL*~ad I HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE I~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR DZSALLOWANCE OF DEDUCTZONS AND ASSESSHENT OF TAX ESTATE OF BEITZEL NORHA J FILE NO. 21 03-0569 ACN 101 DATE 10-21-2005 TAX RETURN WAS: (X) ACCEPTED AS FZLED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSF APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Raal Estata (Schadula A} (1) 2. Stocks and Bonds (Schedule B) (2) $. Closely Held Stock/Partnersh/p Zntarast (Schedule C) ($) q. Hortgagas/Notas Raca/vable (Schadula D) (4) $. Cash/Bank Dapos/ts/H/sc. Personal Proparty (Schedule E) 6. Jo/ntly Owned Property (Schadule F) (6) 7. Transfars (Schedule G) (7) 8. Total Assats APPROVED DEDUCTZONS AND EXEHPTZONS: 9. Funeral Expanses/Ada. Costs/N/sc. Expanses (Schadula H) (9) 10. Dabts/Hortgaga L/ab/Z/ties/Liens (Schadula Z) (10) 11. Total Deduct/ohs 62/457.65 .00 .00 NOTE: To /nsura proper .00 crod/t to your account, .00 suba/t fha upper port/on .00 of th/s fore w/th your tax payment. 7z154.08 (8) 69,571.71 11,794.60 12. 1:3. 14. NOTE: ASSESSHENT OF TAX: 15. Amount of L/ne 14 at Spousal rate 16. Amount of L/ne 14 taxable at Lineal/Class A ra~e 17. Amount of L/ne lq at S/bling ra~e 18. Amount of L/ne 14 taxable at CollataraZ/C1ass B rata 19. Pr/nc/pal Tax Due TAX CREDZTS: PAYflENT RECEXP1 DISCOUNT (+J DATE NUHBER ZNTEREST/PEN PA/D (-) .o0 (11) 11.794.t~D 57,777.11 (15) .00 x 00 = .00 (16) 57,777.11 x 045= 2,599.97 (17) . O0 X 12 = . O0 (18) .00 x 15 = .00 (19)= 2,599.97 AHOUNT PAID ] .00 2,599.97 TOTAL TAX CREDIT I 2,599.97 BALANCE OF TAX DUEI .00 INTEREST AND PEN. I .00 TOTAL DUE / .00 ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUZRED. TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE REFUND. SEE REVERSE SIDE OF TH/S FORH FOR INSTRUCTIONS.) ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 09-09-2005 / CDOOZ990 Nat Valua of Tax Return (12) Charitabla/Govarneental Baquasts; Non-elected 9115 Trusts (Schedule J) (1:3) .00 Net Valua of Estata Subject to Tax (14) 57,777.11 Zf an assessment ~as lssued previously, lines 1~, 15 and/er 16, 17, 18 and 19 ~ill reflect figures that include the total of ALL returns assessed to date. RESERVATION: Estates of decedents dying an or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ZSTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (72 P.S. Section 91qO). Detach the top portion of this Notice and submit eith your payment to the Register of Mills printed on the reverse side. --Make check or money order payable to: REGISTER OF HILLS, AGENT A refund of s tax credit, ehich mas not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications ara available at the Office of the Register of Nills, any of the Z$ Revenue District Offices, or by calling the special gq-hour answering service for forms ordering: 1-800-362-Z050; services for taxpayers with special hearing and / or speaking needs: 1-800-qq7-3020 (TT only). Any party in interest not satisfied eith the appraisement, alloeance, or disalloeance 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. 281021, Harrisburg, PA 171za-iozI, 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 mriting to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. g80601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 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 aithin three (5) calendar months after the decedant's death, a five percent (5Z) discount of the tax paid is alloead. The 152 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January lB, 1996, the first day after the end of the tax amnesty parted. This non-participation penalty is appealable in the same manner and in the the same tiaa parted as you would appeal the tax and interest that has been assessed as indicated on this notice. Tnterest is charged beginning aith first day of delinquency, or nine (9) months and one (1) day free the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (62) percent per annum calculated at a daily rate of .00016q. 211 taxes mhich became delinquent on and after January 1, 1982 ail1 bear interest at a rate which mill vary from calendar year to calendar year eith that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through g003 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Yaa__._r Rate Factor Yea__._r Rate Factor 1982 207. . O OOSq8 1987 9Z . O00Zq7 1999 7Z .00019g 1985 167. ,O00q3D 1988-1991 IlZ .000301 ZOO0 DZ .000219 198q 112 .000301 1992 92 .0002q7 gO01 92 .O00Zq7 1985 132 .000356 1993-199q 77. .000192 2002 62 . OOOl6q 1986 102 . OOO 27q 1995-1998 97. . O002q7 2005 57. .000157 --Interest is calculated as folloes: INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent mill reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date sheen on the Notice, additional interest must ba calculated. STATUS REPORT UNDER RULE 6.12 Name of Decedent: NOR},~ J. BEITZEL Date of Death: April 1~ 2003 Will No. 2003-00369 Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 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: a. Did the personal representative file a final account with the Court? Yes__ 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 x No Personal representatives are sole beneficiaries of Estate. d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be~ttached to this report. Date: Nov. 17, 2003 ~/~~(--~ /~gnat~ure ~ J. Robert Stauffer ~ Name (Please type or print) -. Market Square Bldg. Mechanicsburg, PA 170~ Address (717) 766-9673 Tel. No. (MAH:rmf/AM3) Capacity: x __Personal Representative __Counsel for personal representative