HomeMy WebLinkAbout03-0437COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
I C)FFiC AL USE ONLY
FILE NUMBER
21 q~}'~
COUNTY CODE 0 3
YEAR NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
STACHE, EARNEST H. 202-20-6710
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
04/04/2003 08/30/1925 REGISTER OF WILLS
IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
[] 1. Original Return [] 2. Supplemental Return [] 3. Remainder Return (date of death prior to 12-13-82)
uJ
z
] 4. Limited Estate [] 4a. Future Interest Compromise (date of death after
12-12-82) [] 5. Federal Estate Tax Return Required
[] 6. Decedent Died Testate (Attach copy [] 7. Decedent Maintained a Living Trust (Attach 0 8. Total Number of Safe Deposit Boxes
of Will) copy of Trust) --
[] 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (date of death between [] 11.Election to tax under Sec. 9113(A) (Attach Sch O)
12-31-91 and 1-1-95}
COMPLETE MAILING ADDRESS
NAME
Edward L. Schorpp, Esquire
FIRM NAME (If applicable)
Martson Deardorff Williams & Otto
TELEPHONE NUMBER
717/243-3341
Ten East High Street
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)
Noffe
None
388.0~:
Non~:!
38,147.44
7,978.00
Carlisle, PA 17013
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)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(8)
38,535.44
7,978.00
30,557.44
30,557.44
(11)
(12)
(13)
(14)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15.Amount of Line 14 taxable at the spousal tax rate, x .00
or transfers under Sec. 9116(a)(1.2)
16.Amount of Line 14 taxable at lineal rate x .045
17.Amount of Line 14 taxable at sibling rate x .12
18. Amount of Line 14 taxable at collateral rate x .15
19. Tax Due
20.
30,557.44
(15)
(16)
(17)
(18)
(19)
3,666.89
3,666.89
Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00)
Dece'dent's Complete Address:
ISTREET ADDRESS 301 Franklin Street
CITY Carlisle
STATE PA
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
InterestJPenalty if applicable
D. Interest
E. Penalty
183.34
ZIP 17013
(1)
Total Credits (A + B + C) (2)
Total InterestJPenalty (D + E) (3)
4. 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
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
3,666.89
Make Check Payable to: REGISTER OF WILLS, AGENT
183.34
0.00
3,483.55
3,483.55
(4)
(5)
(5A)
(5B)
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 property within one year of death without
receiving adequate consideration? ....................................................................................................................... [] []
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ......... [] []
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ...................................................................................................................... [] []
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
preparer other than the personal representative is based on all information of which preparer has any knowledge,
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS
Pa~ricia R. Mohler
SI~N~'I~E'~O~'P~R"S'~)N REShO'NSIBLE'FOR I~I~ING'-RETURN ADDRESS
DATE
301 Franklin Street
Carlisle, PA 17013
DATE
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
ADDRESS
DATE
Edward L. Schorpp, Esqui~
Ten East High Street
Carlisle, PA 17013
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 Dn or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. {}9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure
of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. {}9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. {}9116
1.2) [72 P.S. {}9116 (a) (1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. {}9116 (a) (1.3)]. A sibling is defined,
under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
COMMONWEALTH OF PENNSYLVANIA
INHERiTANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
STACHE, EARNEST H.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
21 - 03 -
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on schedule F.
ITEM
NUMBER
DESCRIPTION
Social Security payment, March 2003
TOTAL (Also enter on Line 5, Recapitulation)
VALUE AT DATE OF
DEATH
388.00
388.00
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
STACHE, EARNEST H.
FILE NUMBER
21 - 03 -
This schedule must be completed and filed if the answer to any of uestions 1 throu
ITEM DESCRIPTION OF PROPERTY
Include the name of the transferee their relationship to decedent and the date of transfer. DATE OF DEATH % OF
NUMBER ,
Attach a copy of the deed for real estate. VALUE OF ASSET DECD'S EXCLUSION TAXABLE VALUE
INTEREST 0F APPLICABLE)
1 Jefferson Pilot Fixed Annuity Contract No. JP5179574; 38,147.4,~ 100% 38,147.44
Patricia R. Mohler (sister), beneficiary.
TOTAL (Also enter on line 7, Recapitulation) 38,147.44
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSE~ &
.N3MIN~TNE COSTS
ESTATE OF
STACHE, EA~EST H. FILE NUMBER
21 - 03 -
Debt of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
1
FUNERAL EXPENSES:
Ewing Brothers Funeral Home
Georges' Flowers
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address
City State Zip
Year(s) Commission paid
Attorney's Fees Martson Deardorff Williams & Otto (estimated)
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
C~ty
Relationship of Claimant to Decedent
Probate Fees
State ~ Zip
Accountant's Fees
Tax Retum Preparer's Fees
Other Administrative Costs
Register of Wills, filing fee, Inheritance Tax Return
TOTAL (Also enter on line 9, Recapitulation)
6,857.00
106.00
1,000.00
15.00
7,978.00
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
STACHE, EARNEST H.
SCHEDULE J
BENEFICIARIES
FILE NUMBER
21 - 03 -
RELATIONSHIP TO AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT OF ESTATE
Do Nat List Trustee/si
Io TAXABLE DISTRIBUTIONS (include outright spousal distributions)
1 Patricia R. Mohler Sister Entire residue
301 Franklin Street
Carlisle, PA 17013
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
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 002621
SCHORPP EDWARD L ESQUIRE
10 EAST HIGH STREET
CARLISLE, PA 17013
........ fold
ESTATE INFORMATION: SSN: 202-20-6710
FILE NUMBER: 2103-0437
DECEDENT NAME: STACHE EARNEST H
DATE OF PAYMENT: 05/28/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 04/04/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $3,483.55
TOTAL AMOUNT PAID:
$3,483.55
REMARKS' PATRICIA R MOHLER
C/O EDWARD L SCHORPP ESQUIRE
SEAL
CHECK# 1 OO3
INITIALS: JA
RECEIVED BY.'
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
I /0-
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
COMMONNEALTH OF PENNSYLVANZA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAZSENENT, ALLO#ANCE OR DZSALLO#ANCE
OF DEDUCTIONS AND ASSESSNENT OF TAX
REV-16~7 EX AFP C02-OS)
~:~ DATE 07-14-Z005
i~ ESTATE OF STACHE
DATE OF DEATH 04-04-200:3
FILE NUNBER ZZ 0:3-04:37
'03 JUL 21 ~gqlJNTY CUHBERLAND
EDNARD L SCHORPP ACN 101
MARTSON ETAL
I Amoun~ Reei~ed
10 E flZGH ST
CARLISLE PA 1701:3 ~UI~ ,
EARNEST H
MAKE CHECK PAYABLE AND REMZT PAYMENT TO:
REGI'STER OF NI'LLS
CUMI~ERLAND CO COURT HOUSE
CARLTSLE, PA 1701:3
CUT ALONG THIS LINE I~ RETAIN LONER PORTION FOR YOUR RECORDS ~
REV-Z547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRA]:SEMENT, ALLONANCE OR
DZSALLONANCE OF DEDUCTIONS AND ASSESSNENT OF TAX
ESTATE OF STACHE EARNEST H FILE NO. 21 0:3-04:37 ACN 101 DATE 07-14-200:3
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)
3. Closely Held Stock/Partnership Interest (Schedule C) (3)
4. Nortgagas/Notas Receivable (Schedule D) (4)
E. Cash/Bank Daposlts/Niso. Personal Property (Schedule E) (5)
6. Jo/ntZy O~nad Property (Schedule F) (6)
7. Transfers (SchaduZe G) (7)
8. Total Assets
APPROVED DEDUCTIONS AND EXEHPTZONS:
9. Funeral Expansas/Adm. Costs/N/sc. Expenses (Schedule H) (9)
10. Dabts/Hortgege Liabilities/Liens (Schedule I) (10)
11. Tote1 Deductions
12. Net Value of Tax Return
13.
14.
Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
Net Value of Estate Subject to Tax
.00
.00
.00
.00
:388.00
.00
38~147.44
7,978.00
.O0
NOTE: To /nsure proper
crad/t to your account,
sube/t the upper port/on
of th~s for~ w~th your
tax payment.
NOTE:
38,5:35.44
(1.;) .00 X O0 : .00
(16) .00 X Oq5= .00
(17) $0,557.44 X 12 = :3,666.89
(18) .00 x 15 = .00
(19)= $,666.89
ANOUNT PAZD
3,483.55
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
ASSESSHENT OF TAX:
15. Amount of L/ne 14 at Spousal rate
16. Amount of LLne 1~ taxable et LLneal/Class A rate
17. Aaount of Line lq et Sibl/ng rate
18. Amount of L/nm 14 taxable at Collateral/Class B rate
19. Princ/pal Tax Due
TAX CREDTTS:
PAYMENT RECETpT DT$COUNT (+J
DATE NUHBER INTEREST/PEN PATD (-)
05-28-200:3 CD002621 18:3. :54
ZF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDZTZONAL ZNTEREST.
:5,666.89
.00
.00
.00
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS RE~UZRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDZT' (CR), YOU NAY BE DUE
A REFUND. SEE REVERSE s'rDE OF THZS FORN FOR ZNSTRUCTZONS.)
Zf an assessment was /ssued previously, 1/nas 14, 15 and/or 16, 17, 18 and 19 will
reflect fLgures that include the total of ALL returns assessed to date.
(11) 7. 978. fid
(12) :30,557 .qq
(13) . O0
(14) 30,557.44~
RESERVATION:
Estates of decedents dying on or befor~ December 1Z, 19BI -- if any future interest in the astate is transferred
in possession ar enjoyment to Class B (collataral) beneficiaries of tho decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such futura interest.
PURPOSE OF
NOTICE:
PAYNENT:
REFUND (CR):
OBJECTZONS:
ADNZN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST=
To ~ulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act Z$ of 2000. (TI P.S.
Section 9140).
Detach the top portion of this Notice and submit with your payment to the Register of Hills printed an the reverse side.
--Make chock or money order payable to: REGISTER OF NILES, AGENT
A refund of a tax credit, which was not requested on the Tax Return, amy be requested by completing an "Application
for Rafund of Pennsylvania Inheritance and Estate Tax" (REV-iS15). Applications are available at the Office
of tha Register of Hills, any of the ZS Revenue District Offices, or by calling tha special Z4-hour
answering service for foras ordering: 1-800-562-2050; services for taxpayers with special hearing and ! or
speaking needs: 1-800-447-50Z0 (TT only).
Any party in interest not satisfied with the appraisement, allooance, or disallowanca of deductions, or assass~ant
of tax (including discount or interest) as shown on this Notice must object aithin sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revanue, Board of Appeals, Dept. ZSlOZ1, Harrisburg, PA 17128-1021, 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 assessaent should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dapt. Z80601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. See page S of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
If any tax due is paid aithin three (5) calendar months after the decedent's death, a five percent (SI) discount of
the tax paid is allowed.
The 1SI 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 appealabla in the saaa mannar and in the the same tiaa 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 nina (9) aonths and one (1) day froa the date of
death, to the date of payment. Taxes ahich became delinquent before January 1, 1982 bear interest at the rate of
six (6Z) percent par annum calculated at a dally rate of .000164. All taxes which became delinquent on and after
January 1, 1982 mill bear interest at a rate which will vary froa calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2003 ara:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rata Factor Year Rate Factor
1982 lOX .000548 1987 9Z .000247 1999 7Z .O0019Z
1985 16Z .000458 1988-1991 IIX .000301 ZOO0 BX .000219
1984 llZ .000301 199Z 9X .000247 ZOOT 9Z .000247
1985 13Z .000356 1993-1994 7Z .O0019Z ZOOT 6Z .000164
1986 lOX .000Z74 1995-1998 9Z .000Z47 ZOO3 5Z .000137
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINgIUENT X DALLY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fiftean (1S) 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.
Estate of EARNEST H. ST ACHE
also known as
PETITION FOR PROBATE and GRANT OF LETTERS
-
Social Security No. 202-20-6710
Deceased.
No. J..\.. ~ -~ .. ~ ~ '1
To: Register of Wills for the
County of Cumberland in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner is 18 years of age or older. The named Executrix, Patricia R. Mohler died
on January 6, 2004, and no successor executor was appointed under the Last Will and Testament of Earnest
H. Stache dated April 7, 1987. The residuary heirs living at the time of the decedent's death, to wit: John
L. Stache, Jr., a resident of Illinois, and Richard A. Stache, a resident of Florida, have both renounced their
right to serve as personal representatives as evidenced by their Renunciations attached hereto. In their
respective Renunciations, both parties entitled to serve as personal representatives have requested the
appointment of the decedent's brother-in-law, John W. Mohler. Probate was not necessary at the time of
the decedent's death, but has since become necessary in order to claim property of the decedent held as
"unclaimed" by the Commonwealth of Pennsylvania Treasury Department.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or
principal residence at 301 Franklin Street, Carlisle, Cumberland County, Pennsylvania.
Decedent, then 77 years of age, died April 4, 2003, at Carlisle Regional Medical Center,
Carlisle, Pennsylvania.
Except as follows, decedent did not marry, was not divorced and did not have a child born or
adopted after execution of the will offered for probate; was not the victim of a killing and was never
adjudicated incompetent:
Decedent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania [none]
situated as follows:
$ unestimated
$--
$--
$--
WHEREFORE, petitioner respectfully requests the probate of the last will and codicil( s) presented
herewith and the grant of letters administration c.t.a. th on.
W. Mohler
30 Franklin Street
rlisle, PA 17013
(717) 249-6655
============= -==================================
OA TH OF PERSONAL REPRESENTATIVE
COMMONWEAL TH OF PENNSYL VANIA )
: SS.
COUNTY OF CUMBERLAND )
Sworn to or affinneilnd subscribed
before me this ~ day of
\l\'t..~~\\ , J..f:::i~<.c .
~~~~ "'S.~,
~ ~ '~~~'\ ')...'-'l\) ~egister
The petitioner above-named swears or affirms that the statements in the foregoing petition are true and
correct to the best of the knowledge and belief of petitioner and that as personal representative of the above
decedent, petitioner will well and truly administer the estate according to law.
J'i/" LA.! tn <:<Lev", ?
J . Mohler
No. ~"\ - ~ -2:, - '-\ 3"\
Estate of Earnest H. Stache, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW,
"'~'" ~~ \" . "').., ~~ \0
.
, 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 April 7, 1987, described therein be admitted to probate and
filed ofrecord as the last will of Eamest H. Stache and Letters of Administration c.t.a. are hereby granted
to John W. Mohler.
FEES
Probate, Letters, Etc.
Short Certificates( "\ )
Renunciation l L. \
~ \ u...
~,~~ ~"'~~ TOT.~
"' ~,~L
Filed ~_~ _ ~ ~
$ ~~.
$ 1.\.
$ '\~ .
$ \S
$ \.S
~\.\ .\:'l~
c:~ ,,""""'^ ~'&~ ~
jJ.'. Register.... of Wills G\<... .'( --:.'" '\:.....l\,~~
llfJ2L/cU--- O. !)JJJJ'L) \ ~-1
illary A. Dea{/. t92878)
ATIORNEY (Sup. Ct. J.D. No.)
MARTSON DEARDORFF WILLIAMS & OTTO
10 East High Street
Carlisle, P A 17013
(717) 243-3341
Will Book #
Page
F:\FILESIDAT AFlLEIEST A TES\I0415.1.petitionltr
-
").. \ - 'J ~- "'\ ~ \,
RENUNCIATION
In Re Estate of Earnest H. Stache, deceased.
To the Register of Wills of Cumberland County, Pennsylvania.
The undersigned John L. Stache, Jr., brother of the above decedent, hereby renounces the
right to administer the estate and respectfully asks that Letters of Administration be issued to John
W. Mohler, brother-in-law of the decedent.
WITNESS my hand this
1./
daYOf~ (
~c-V ~
'-'
John L. Stache, Jr.
634 Wintergreen Drive
O'Fallon, IL 62268
rJ,~,f,
Affirmed and subscribed before me this
.:z \ oS lr- day of J 0...", '^ 4. r ~ , 2006
~~\(.~
Notary Public
. OFFICIAL SEAL.
Bonnie K. Schad
Notary Public, State of Illinois
My Commission Exp. 09/19/09 .
--
~ \ ~ \:J ~ - i...~ :),
RENUNCIATION
In Re Estate ofEamest H. Stache, deceased.
To the Register of Wills of Cumberland County, Pennsylvania.
The undersigned Richard A. Stache, brother of the above decedent, hereby renounces the
right to administer the estate and respectfully asks that Letters of Administration be issued to John
W. Mohler, brother-in-law of the decedent.
WITNESS my hand this 83 day of ~AJVf/12.V
,~.
r?P /~ -/A~,
Rich~
4731 SW 47th Terrace
Davie, FL 33314
Affirmed and subscribed before me this
,2006
[~i~~~f,> MY CO:M~S:'~~~O~263661
~.")"....J!it",: EXPIRES November lJ. 2007
":!'~<~:i~...." Bonded Thru Western SJrety Company
P,\FILES\DA r AFILEIESr A rES\1 0415. J .oath.kfldln
Created: 02/09/9904:31:03 PM
Revised, 02/24/06 04 18 58 PM
REGISTER OF WILLS OF CUMBERLAND COUNTY
OATH OF SUBSCRIBING WITNESS
J... '\ - (J -:s - \..\ ~ '\
Karen E. Faircloth, a subscribing witness to the Will presented herewith, being duly qualified
according to law, deposes and says that she was present and saw Earnest H. Stache, the testator, sign
the same, and that she signed as a witness at the request of the testator in his presence.
Sworn to or affinn~ and subscribed
be:ti me this r-.J7 day of
,2006
r:
)f~~"~~-4
Karen E. Faircloth
b
Notary Public
NOTARIAL SEAL
VICTORIA l. OTTO, NOTARY PUBLIC
CARLISLE BORO:l CUMBERLAND COUNTY
MY COMMISSION EXPIRES DEC. 2 2006
::::-.-)
, ,
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---
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F:IFILES\DA T AFlLEIESTA TES\I 0415.1.oath.nonsubscribing
REGISTER OF WILLS OF CUMBERLAND COUNTY
OATH OF NON-SUBSCRIBING WITNESS
").. '\ - c::; ~ - L{ ~'\
John W. Mohler, a subscriber hereto, being duly qualified according to law, deposes and says
that he is familiar with the signature of Earnest H. Stache, Testator of the Will presented herewi th,
and he believes the signature on the Will is in the handwriting of Earnest H. Stache to the best of his
knowledge and belief
Sworn to or affirmed and subscribed
before me this ~ ~""~lY~f 2006
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'NAFlNING: It is iIIe!iJal to duplicate this copy by photostat or photograph.
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9190802
No.
D;lre
H105.:4..3 Ae-v 2187
!=tINT
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
'lENT
IH~
N....ME OF DECEDENT (F"st. MlOdIe. !..asr)
,. Eamest H.
Stache
STATE ':1lE: ~UMBER
SOClA,l SECURIT"t' NUiI,48ER
AGEllasrBlI1tIdav)
SEX
UNDE"R 1 YEAA
Months Days
DAlE OF DEAT...~. o.~, '-J
.. 41412M3
UNDER 1 DAY
Hour. I Minttt..
.. M '.202 - 20
BIRTHPLACE 'C., ,.., PLAcE OF ""AT" IC"-c' ""'Y """ .... 'n",uc."", on _, ...,
Stale 01 Fcre.gn COlJntry) HOSPITAL;
Carlisle PA lnpalienr~ E~l_nc G
7. , ...
FACn.rrr N....ME (l11'lOf IflSNullOn. QIY& SIre.! and ntJmtle"
77
v...
..
COuNTY OF DeATH
~I ..... Cumberland
DECEDENTS USUAL OCCUPA1/ON
(~~,:O%'-=,~:;r
KitChen Worker
~)O
RACE. AMencan 1ndiM, ~. Wht.. etc.
,......,)
,..White
SUA\I1vlNQ SPouSE
I"..... grw ma.oen nwne.
301 Franklin Str.
,..Carlisle, PA 17013
FRHER'S NAME (Fits!, M~. last)
,.. John L. Stache, Sr.
INFOAMANT's NAIo4'E (T YP&'Prinf1
.... Patricia R. Mohler
METHQ() OF Of$POSITION
...... 5{) c,....,"" 0 "-.... St.,. 0
""* 1Sooo"YL...
MARITAL STATUS. M~
N.......Mvried. ~.
--. ""-"
".Never Married
...
"""-"
......
17b.c.... = Cumberland -"'''1 "d.(X:.;~..= Carlisle
MOTHER'S NAME IF".. MIdOIe. MiI.aetl Surname)
II. Minnie E. Stei lanan
INFORMANT'S ......1l1NG ....DDRess (Slreet. ~fbwn. SlaM. Zip Cooe)
_.301 Franklin Street; Carlisle, PA 17013
PLACE OF OISPOsrr"",. N......, "-,.,,,. C.."''''''''' LOCATION. C'""""'", SI",.. r,,"-
orou.PloICe
17c.O""'~lN.cfin
lICENSE NUUSER
22.. FD 012633 L
21.Mt.
PA 17065
PA 17013
DATE PAONOU'L(r~~r:OCJ:3
>t.
IA.pprg.t;,.".r.
'ine.,....~
1 DnMt at1c1 clhth
:
-~~. ...........
~lng in the undMying cau.. c;w... in PART I.
c-J
~lty"* CGnditiont b
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'-..In; In dedt) LAsT
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WERE AUTOPsy FIHOtNGS -----,-wANNER OF DEATH
AWiULA8LE PRIOR TO I Y
co...ptETION OF CAUSE
OF DEATH? ....1II'aI
o
o
CUE miCA AS "'ONsEOUENCE "'>
~TE OF INJURY
(MClnfh.IAy, .......,
TIME OF INJURY
Homic:icM
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a.. 2Ib.
CblTIFlER fChecll: ~ Clnwj
"C€IITIFY'NG PHYSIC'AN '''''- '""""",, """" oJ .,.,,, "'en .nOl'~ """"'..n '" "'O<>our<oo "'''''no ,...."..eo "....23'
T. ......1.. "'y 'now_, ..... oce............ ... ..u....,."" ""no,.. ...,... .... . . . .
INJURY .('( WORK?
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o PlACE OF INJURy. AI home. f.":':;~I, 'actory, oII'lc. AI,
~ Me. fSpeclfy)
'do.
NoJf
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oeSCRIBE HOw INJURY OCcuRAE:D.
Pencfinglnveat;g.lIon
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Could I'IOf be del~.necJ
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"PAONouNCING ANO CEATlFY'NG PHYSIC'AN ''''''''''..n ""'" "",n""",,",, O,,,,.nO eM'""",,.. ".u,. .''''''''
To......... "'y 'nowl...., O""h DCCU'........ _. ........, P'''., 'no duo I. 'ho <<u..,.,..., ""nn.,.. ...,.... . . ..
.MEDICAl EXAMINER/CORONER
On 'h. bo./..r '..m/n.lIon .ndlM In.""g"lon, 'n "'y .p'nlon, d"'h DCcU"'d "Ih. ""'., d.,., .nd Pl.ce, and due '0 'he c,u"")'nd
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31..
REGISTRAR'S SIGNATURE ....ND N
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D....TE FilED (MOI'llh. Dav, ""at,
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34.
me as
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wills by me at any time heretofore made.
and for my last will and testament, hereby revoking and making void all former
of sound mind, memory and understanding, do make, Publish and declare this as
I, EARNEST E. STACHE, of Carlisle, Cumberland County, Pennsylvania, being
LAST WILL AND TESTAMENT
1.\ -'<::;J~ - i.., ":5,
inheritance taxes that may be assessed against my estate, be fully paid and
FIRST. I direct all my just debts and funeral expenses, including all
satisfied out of my estate by my personal representative hereinafter named as
soon as conveniently may be done after my decease.
has placed the same, to my father, John L. Stache, if living; otherwise, to
whatsoever, wherever situate and in whatever form my personal representative
SECOND. I give, devise and bequeath all of my estate, real and personal,
my sister, Patricia R. Mohler, if living; otherwise, in equal shares, share
and share alike, to my brothers, John Stache, Lester Stache and Richard Stache,
or the brothers or brother living at the time of my death.
THIRD. I direct that 1!!ly personal repreSentative hereinafter named in her
discretion may convert all or any part of my estate, real andpersonal, whatsoever
and wherever situate, into cash at either public or private sale or sales at the
in cash or partly in kind and partly in cash in her discretion.
best price or Prices obtainable in her discretion and make distribution in kind,
Executrix, of this my Last Will and Testament. My personal representative shall
LASny, I nominate, constitute and appoint my Sister, Patricia R. Mohler,
serve in this or any other jurisdiction without giving any bond whatsoever.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~!t' day of
.. .
'--.c/", 'L J__",
, A.D., 1987.
[ h it IV t 0' f-I !;)- \ ::r 4/ (SEAL)
Signed, sealed, published and declared by the ahove named Testator, larnest
H. Stacne, as and Nihis last will and testament, in the presence of us, who, at
hi s req ties t and. i"h~is pre se nee and in th e pre sence 0 f each 0 t her, have hor eun to
subscribed Our names as witnesses thereto.
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Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 3/06/2006
DEAN HILLARY ANN
TEN E. HIGH STREET
CARLISLE, PA 17013
RE: Estate ofSTACHE EARNEST H
File Number: 2003-00437
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6.12 is due on the below listed
date.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103
SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after
July I, 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:
4/04/2006
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
~~~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Personal Representative(s)
v}
Cumberland County - Register Of Wills
· One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 3/06/2006
MOHLER JOHN W
301 FRANKLIN STREET
CARLISLE, PA 17013
RE: Estate of STACHE EARNEST H
File Number: 2003-00437
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6.12 is due on the below listed
date.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103
SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after
July I, 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:
4/04/2006
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
~~.~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
V}
REGISTER OF WILLS OF CUMBERLAND COUNTY
STATUS REPORT UNDER RULE 6.12
(For Resident Decedents Dying After July 1, 1992)
Name of Decedent:
Earnest Stache
Date of Death:
April 4, 2003
File No. :
21-03-0437
Social Security No. :
202-20-6710
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 X
2. If the answer is No, state when the personal representative reasonably believes that the
administration will be complete: Within six months
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 No
d.
Copies of receipts, releases, joinders and approvals of formal or informal accounts
may be filed wit~ th~ Clerk~Ofthe Orphans' Court and may be attached to this report.
Signature: j-kQY / aft)
Name: Hillary . Dean, EIre
Address: MARTSON DEARDORFF WILLIAMS & OTIO
Ten East High Street
Carlisle, PA 17013
(717) 243 3341 ,-.:"',:t.-.".
-. ............. . .,'1\ \;")
Counsel far} RYt.~q~a~; 1e.w~$tUtative
,::,1. '\\j'.._" ".
Date:
March 8, 2006
F:\FILES\DA T AFILE\EST A TES\1 0415. l.srep. 1
L. f". . .,
t,'V
fl
Name of Decedent:
Date of Death:
File No.:
Social Security No. :
REGISTER OF WILLS OF CUMBERLAND COUNTY
STATUS REPORT UNDER RULE 6.12
(For Resident Decedents Dying After July 1, 1992)
Earnest Stache
April 4, 2003
21-03-0437
202-20-6710
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 X
2. If the answer is No, state when the personal representative reasonably believes that the
administration will be complete: Within six months
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. (ifany)for the personal
representative's account is:
c. Did the personal representative state an account informally to the parties in
interest?
Yes No
d.
Date:
LrJ
tJ~)
April 7, 2006
::"""0,_
,
t:;.:::~
F \FILES\l>A T AFILE\EsI~~~~\ 10415. l.srep. 1
::.<::. (. .':
".. .'....,:
Copies of receipts, releases, joinders and approvals of formal or informal accounts
may be filed with the Clerk of the Orphans' Court and may be attached to this report.
Signature: M J 1(J,1!J (} . j)efJJ? /
Name: "'--,/ Hillary A. D , Esquire
Address: MARTSON DEARDORFF WILLIAMS & OTTO
Ten East High Street
Carlisle, P A 17013
(717) 243-3341
Counsel for personal representative
g
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717)240-6345
Date: 05/18/2006
DEAN HILLARY ANN
TEN E. HIGH STREET
CARLISLE, PA 17013
RE: Estate of STACHE EARNEST H
File Number: 2003-00437
Dear Sir/Madam:
This notice is to serve as a reminder that the Certificate of
Notice under Rule 5.6(a) is due on the below listed date.
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 I, 1992, the personal representative or his
councel, within ten (10) days after giving proper notice to the
beneficiaries and intestate heirs as required by subdivision
(a) of Rule 5.7, shall file with the Register of Wills or Clerk
of the Orphans' Court his/her Certification of Notice.
This filing is due by:
06/16/2006
Please feel free to contact this office with any questions you
may have. If you have already filed your certificate, please
disregard this notice.
sr~~
u
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Personal Representative(s)
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717)240-6345
Date: 05/18/2006
MOHLER JOHN W
301 FRANKLIN STREET
CARLISLE, PA 17013
RE: Estate of STACHE EARNEST H
File Number: 2003-00437
Dear Sir/Madam:
This notice is to serve as a reminder that the Certificate of
Notice under Rule 5.6(a) is due on the below listed date.
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 I, 1992, the personal representative or his
councel, within ten (10) days after giving proper notice to the
beneficiaries and intestate heirs as required by subdivision
(a) of Rule 5.71 shall file with the Register of Wills or Clerk
of the Orphans' Court his/her Certification of Notice.
This filing is due by:
06/16/2006
Please feel free to contact this office with any questions you
may have. If you have already filed your certificatel please
disregard this notice.
Sincerely 1
Gl~~~
Clerk of the Orphans' Court
cc: File
Counsel
IN RE: ESTATE OF
ST ACHE EARNEST H
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
NO. 21- 2003-00437
NOTICE OF FAILURE TO FILE CERTIFICATION
Personal Representative: MOHLER JOHN W
Counsel for Personal Representative: DEAN HILLARY ANN
Date of Grant of Original Letters: 3/6/2006
The Orphans' Court record indicates that neither the above named personal representative
nor the above named counsel for the personal representative have filed with the Register ofWiUs
or Clerk of the Orphans' Court his, her or its certification required by Rule 5.6(e), Supreme
Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 5.6(e), Supreme Court
Orphans' Court Rules, is hereby given that you have ten (10) days to file the Certification
Report. If the required 5.6 form is not filed in accordance with Rule 5.6(e) the Court will be
notified of such delinquency and the undersign will request that a Court conduct a hearing to
determine whether sanctions should be imposed upon the delinquent personal representative or
counsel for the delinquent personal representative.
Date: 7/11/2006
~~~
Glenda Farner Strasbaugh ' .
Clerk of the Orphans' Court
Distribution:
Personal Representative
Counsel for Personal Representative
Estate File
IN RE: ESTATE OF
ST ACHE EARNEST H
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
NO. 21- 2003-00437
NOTICE OF FAILURE TO FILE CERTIFICATION
Personal Representative: MOHLER JOHN W
Counsel for Personal Representative: DEAN HILLARY ANN
Date of Grant of Original Letters: 3/6/2006
The Orphans' Court record indicates that neither the above named personal representative
nor the above named counsel for the personal representative have filed with the Register of Wills
or Clerk of the Orphans' Court his, her or its certification required by Rule 5.6(e), Supreme
Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 5.6(e), Supreme Court
Orphans' Court Rules, is hereby given that you have ten (10) days to file the Certification
Report. If the required 5.6 form is not filed in accordance with Rule 5.6(e) the Court will be
notified of such delinquency and the undersign will request that a Court conduct a hearing to
determine whether sanctions should be imposed upon the delinquent personal representative or
counsel for the delinquent personal representative.
~v~~
Date: 7/11/2006
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
Distribution:
Personal Representative
Counsel for Personal Representative
Estate File
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CERTIFIED MAILTM RECEIPT' , ,
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l-UIVI'MONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT 280601
Hriflr,ISG:.Jr,c, F'~ 17; 23-uu0 I
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
MOHLER JOHN W
301 FRANKLIN STREET
CARLISLE, PA 17013
_u__u_ fold
ESTATE INFORMATION: SSN: 202-20-6710
FILE NUMBER: 2103-0437
DECEDENT NAME: ST ACHE EARNEST H
-
DA TE OF PAYMENT: 07/12/2006
POSTMARK DATE: 07/12/2006
COUNTY: CUMBERLAND
DA TE OF DEATH: 04/04/2003
NO. CD 006959
ACN
ASSESSMENT
CONTROL
NUMBER
AMOU NT
101 I $7.57
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$7.57
REMARKS: JOHN W MOHLER
CHECI(# 2595
SEAL
INITIALS: CM
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REV. 1500 EX + (6..00)
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
~ 2. Supplemental Return
o 4a. Future Interest Compromise (date 01 death after
12-12-82)
o 7. Decedent Maintained a Living Trust (Attach
copy 01 Trust)
o 10. Spousal Poverty Credit (date 01 death between
.JH1-91 L__
. ll-lI.~ SECTIO!,!_ MU~T BE ~Q.f!1PLE:rED. ALL CORRESPON CONFIDENTIAL TAX INFORMATION SHOULD r:iE DI~.E.(;TED T.o:
NAME COMPLETE MAILING ADDRESS
Hillary A. Dean, Esquire
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG. PA 17128-0601
DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAL)
STACHE, Earnest H.
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DATE OF DEATH (MM-DD-YEAR)
DATE OF BIRTH (MM-DD-YEAR)
04/04/2003
08/30/1925
(IF APPLICABLE) SURVIVING SPOUSE'S NAME ( lAST. FIRST AND MIDDLE INITIAL)
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6. Decedent Died Testate (Attach copy
01 Will)
9. Litigation Proceeds Received
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FIRM NAME (II applicable)
Malison Deardorff Williams & Otto
TELEPHONE NUMBER
717/243-3341
1. Real Estate (Schedule A)
2, Stocks and Bonds (Schedule B)
3. Closely Held Corporation. Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
FILE NUMBER
21 03
COUNTY CODE YEAR
SOCIAL SECURITY NUMBER
0437
NUMBER
202-20-6710
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 3. Remainder Return (date 01 death pnor to 12-13-82)
o 5. Federal Estate Tax Return Required
8. Total Nurnber of Sale Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
10 East High Street
Carlisle, PA 17013
(1 ) None
(2) None
(3) None
(4) None
(5) 597.24
(6) None
(7) None
(8) 597.24
(9) 429.00
(10)
(11 )
429.00
(12)
168.24
(13)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(14)
168.24
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax rate, x .00 (15)
or transfers under Sec. 9116(a)(1.2)
z 168.24 .045 (16)
0 16. Amount of Line 14 taxable at lineal rate x
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<(
I-
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ll. 17 Amount of Line 14 taxable at sibling rate x .12
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0
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x 18. Amount of Line 14 taxable at collateral rate (18)
<( x .15
I-
19. Tax Due (19)
7.57
7.57
20. 0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
>> BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH <<
Copyright 2000 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00)
l/
Decedent's Complete Address:
STREET ADDRESS
301 Franklin Street
CITY
STATE PA
ZIP 17013
Carlisle
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
Total Credits (A + B + C)
(2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
7.57
0.00
Total Interest/Penalty (0 + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is thEDVERPAYMENT.
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 theTAX DUE.
A. Enter the interest on the tax due.
B Enter the total of Line 5 + 5A. This is theBALANCE DUE
(3) 0.00
(4)
(5) 7.57
(5A)
(5B) 7.57
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
a. retain the use or income of the property transferred;...........................................................-................. 0
~: ~:~::~ ~h~e~;~:i:~~~s:~~;~s~~~. ~~~~I. .~.~~. ~~~. :.~~:.~~~. .t~~.~.~~~~~~.~. .~~ .i~~. i.n.~~.~~~..............................~~::::::::::: ~~.'.'. 8
d. receive the promise for life of either payments, benefits or care?........................................................... 0
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?............................ .............................. ...................................................... 0
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... 0
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?............................. ..............................................................-.................... 0
No
~
~
~
~
~
~
~
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury. I declare that I have examined this return. including accompanying schedules and statements, and to the best of my knowledge and belief. It is true, correct and complete. Declaratlor
pre parer other than the personal representative is based on all informalion of which prepare~l1as anykl1()v;ledl1e,-__
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS
John W. ~ohler .
, t/: u..O / 1 J ")f,/ {c' (),tJ.", ~_
StGN T - E bf-p'ERSON RtsPONSIBLE FO~ I'T~
'J -0
Sl AT RE OF PREPA~~ER TH'
illary A. Dean, ES~H
301 Franklin Street
Carlisle, PA 17013
- .-..-
ADDRESS
ADDRESS
10 East High Street
Carlisle, PA 17013
DATE
'7-//-IJ/,
DATE
1-1/-D4?
DATE
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. 99116 (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. 99116 (a) (1.1) (ii)]. The statutedoes not exemota 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. 99116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P .S. 99116
1.2) [72 P.S. 99116 (a) (1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 99116 (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.
SCHEDULE H
FUNERAL EXPENSES &
ADIVIINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
STACHE, Earnest H.
FILE NUMBER
21-03-0437
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A. FUNERAL EXPENSES:
DESCRIPTION
AMOUNT
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
B.
Social Security Number(s) I EIN Number of Personal Representative(s):
Street Address
City State Zip
Year(s) Commission paid
Attorney's Fees Martson Deardorff Williams & Otto (estimated)
2.
350.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
State
Zip
4.
Probate Fees
Cumberland County Register of Wills
64.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7
Other Administrative Costs
Register of Wills, filing fee, supplemental Inheritance Tax return
15.00
TOTAL (Also enter on line 9, Recapitulation)
429.00
REV.1513 EX+ (9-00)
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
ST ACHE, Earnest H.
FILE NUMBER
21-03-0437
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
RELATIONSHIP TO
DECEDENT
D_o_NotLlst Trustee(s)
AMOUNT OR SHARE
OF ESTATE
I. TAXABLE DISTRIBUTIONS (include outright spousal distributions)
Patncla R. Mohler Estate
301 Franklin Street
Carlisle, P A 17013
Sister
All of estate residue
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
B CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
.. .
.
· Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
· Print your name and address on the reverse
so that we can return the card to you.
. Attach this card to the back of the mail piece,
or on the front if space permits.
1. Article Addressed to:
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S Form 3811, February 2004
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COMPLETE THIS SECTION ON DELIVERY
3. Service Type I
pi Certified Mall
o Registered
o Insured Mail
. Re nCt
[J'~'MIn~"
o Return Receipt for Merchandise
[J C.O.D.
DYes
SENDER: COMPLETE THIS SECTION
"1::~'O ~ 1%~~HM!~~~~5 4052
Domestic Return Receipt
. Complete items 1, 2, and 3. Also ~mplete
item 4 if Restricted Delivery is deSired.
. Print your name and address on the reverse
so that we can return the card to you.
. Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
:b'0'C\ \Y\o~ \-e,
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2. Article Number
(Tntnsfer from service label)
PS Form 3811, February 2004
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102595-Q2-M-1540
COMPLETE THIS SECTION ON DELIVERY
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B.
D. Is delivery 8d<j~ different ~ item!? ,..... es
If YES, enter delivery addressJ>elow:,;';.@I:flo
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4. Restricted Delivery? (Extnt Fee)
3. Service Type .'.
JSlI Certifled.MalI
Jo-
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DYes
7005 1820 0002 4615 4069
Domestic Return Receipt
102595-02.M-1540 i
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FHLESIDA T AFlLEIEST A TESI 10415. l.notice.cert
CERTIFICATION OF NOTICE UNDER RULE 5.6(,U
Name of Decedent:
Earnest H. Stache
Date of Death:
April 4, 2003
File No.
2003-0437
To the Register:
I certify that Notice of 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 or about
July 12,2006.
Estate of Patricia R. Mohler
301 Franklin Street
Carlisle, P A 17013
N/A
Date: July 12, 2006
Signature
Name
-
(",J
)
2006 OCT 13 AM II: 09
COMMONWEALTH OF PENNSYLVANIA
DEP~T~EN;r OF REVENUE
r'c:r('Y::C'~['" ('\c..:...L ' i"
1""-0',,-, u~ )N~mcE-6F 'INHERITANCE TAX
iJ1XfPAA(SE1MENT:A~L6\(VANCE OR DISALLOWANCE
'Ie OF DEDUCTIONS AND ASSESSMENT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FILE NO.
COUNTY
ACN
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG, PA 17128..0601
REV-1541 EX 106-05) PC
Appeal Date: 12-08-2006
(See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
Register of Wills
Cumberland County Courthouse
Carlisle, PA 17013
CUT ALONG THIS LINE q RETAIN LOWER PORTION FOR YOUR RECORDS ~
"REv~154i E}n()6-0"S)""PC .. - - - - - - - - - - - - -Notic-E-O-F-fNj:fERff A-NCE-TA;( AP-PRAis-EME-Nt-,- A-CLow;.:t:.fCE-OR.... - - - - - - - - - - - - - -, - - - - - - - - - - - - - --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
STACHE EARNEST H FILE NO. 21 03-0437 ACN 501
TAX RETURN WAS: (~) ACCEPTED AS FILED ( D ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: LITIGATION RETURN
HILLARY A DEAN ESQ
MARTSON ET AL
10 E HIGH ST
CARLISLE PA 17013
CI rr'j 1"-
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ORpll "J'^' n'-\' IrJT
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10-09-2006
STACHE
04-04-2006
21 03-0437
Cumberland
501
EARNEST
H
ESTATE OF
DATE 10-09-2006
1. Real Estate (Schedule A)
2, Stocks and Bonds (Schedule B)
3, Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5, Cash/Bank Deposits/ Misc, Personal Property (Schedule E)
6, Jointly Owned Property (Schedule F)
7, Transfers (Schedule G)
8, Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9, Funeral Expenses/Adm, Costs/Misc, Expenses (Schedule H) (9) 429,00
1 A, Debts/Mortgage Liabilities/Liens (Schedule I) (10) 0.00
11, Total Deductions (11)
12, Net Value of Tax Return (12)
13, Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13)
14, Net Value of Estate Subject to Tax (14)
NOTE: If an assessment was issued previously, lines 14,15 and/or 16,17 and 18 will reflect figures
that include the total of ALL returns assessed to date.
(1 )
(2)
(3)
(4)
(5)
(6)
(7)
0,00
0,00
0,00
0,00
597.24
0,00
0.00
(8)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
597,24
429,,00
168.24
0,00
168.24
ASSESSMENT OF TAX:
15, Amount of Line 14 at Spousal rate
16, Amount of Line 14 taxable at Lineal/Class A rate
17, Amount of Line 14 taxable at Sibling rate
18. Amount of Line 14 taxable at Collateral/Class B rate
19, Principal Tax Due
TAX CREDITS:
(15)
(16)
(17)
(18)
0,00 X .00
168,24 X ,045
0,00 X ,12
0,00 X .15
(19)
0.00
7,57
0,00
0.00
7.57
PAYMENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
07 -12-2006 CD006959 0,00 7,57
TOTAL TAX CREDIT 7,57
BALANCE OF TAX DUE 0,00
INTEREST 0,00
TOTAL DUE 0,00
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
(IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A CREDIT (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
~
REGISTER OF WILLS OF CUMBERLAND COUNTY
STATUS REPORT UNDER RULE 6.12
(For Resident Decedents Dying After July 1,1992)
Name of Decedent:
Earnest Stache
Date of Death:
April 4, 2003
File No.:
21-03-0437
Social Security No. :
202-20-6710
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 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 X
b. The separate Orphans' Court No. (if any) for the personal
representative's account is:
c. Did the personal representative state an account informally to the parties in
interest?
Yes No X
Date:
Copies of receipts, releases, joinders and approvals offormal or informal accounts
may be filed with the Clerk ?fthe Orphans /furt and may be attached to this report.
December 27, 2006 Signature: ~~ U :/J1lfl-/
Name: Hillary A. an, Esq . e
Address: / MARTSON DEARDORFF WILLIAMS & OTTO
Ten East High Street
Carlisle, P A 17013
(717) 243-3341
Counsel for personal representative
d.
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