HomeMy WebLinkAbout03-0450PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Estate of Melissa A. Conrad No.
also known as To:
8, -o3
Social Securit.v No. 188-62-9697
Register of Wills for the
Deceased. County of Cumberland in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitionertX), who is/$~X 18 years of age or older, applies
for letters of administration
on the estate of
(d.b.n,; pendeme lile; durante ab~entia; durante minorilate)
the above decedent.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with
h er last family or principal residence at 31 East Main Street: P]ainfio_ld; PA
West Permsboro Township (list street, number, Twp. or Boro.)
Decedent, then 26 years of age, died April 14:2003 ,~ ,
at 21 w~_~ ~in Stree_t, Plainfield, PA 17081
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 $
situated as follows: nono
1 t 000.00
0.00
0.00
0.00
Petitioner after a proper search haS
the following spouse (if any) and heirs:
Name
Michael Cx~nrad :
Kayla M. Conrad
Christopher M. Reed
ascertained that decedent left no'will and was survived by
Relationship
f~ther
daughter (minor
son (minor)
Residence
, 31 E_ Main ~qf-vPlainfiold, PA
31 E_ Main SI-.: Plainfi-~ld, PA
Mary J. Kantz mother 31 E. Main St., Plainfield, PA
THEREFORE, petitioner(s) respectfully request(s):the grant of letters of administration in the
appropriate form to the undersigned.
31 Ea.~ t~in ~q~r~
Plainfield: PA 17081
OATH OF PERSONAL REPRF~ENTATIVE
COMMONWEALTH OF PENNSYLVANIA ~ ss
COUNTY OF CU~B~rA~D
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
representative(s) of the above decedent petitioner(s) will well and
truly administer the estate according to law.
Sworn to or affirmed and subscribed
bffft~e me this 2nd day of
M. 6ttg, ist PerCY
No. 21-2003-450
Estate of IvlF~',TggA A: m~,'~An
, Dec~
GRANT OF LETTERS OF ADMINISTRATION
AND NOW May dune 2nd Xl~ 2003, in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that IVOry
is/are entitled to Letters of Administration, and in accord with such f'mding, Letters of Adrnini.~tration
are hereby granted to M~r,;,..7_ ~_~,~-~,
in the estate of Melissa A. Conrad
FEES "-'
Letters of Administration ..... $18.00
Short Certificates(.3) .......... $ 9.00
Renunciation . .(.1.! ........... $ 5.00 /--~)~ [IV
JCP $10.00
TOTAL
Filed . ~ . J..un...e.. 20.d.,.. 2 P.O 3
Donna M.Otto, 1st Deputy
~ r. -.~ ~!._?!i~:~qU. lp,0
Br~Ol~y r,_ ~r~ff4e, ~,4~e ~34~49
~QR~Y (Su~. ~. I.D. No.)
~--~ N~ ~ov~ S~t
C~r]~]~; PA !70!3
ADD~
AD ~x~[~ ~ ~ ..... ~7~ 243-5551
PHONE
Put Letters in Attorney's box in Proth.
_
RENUNCIATION
21-2003-450
In Re Estate of Melissa A. Conrad
deceased.
To the Register of Wills of
County, Pennsylvania.
The undersigned Michael Conradt Sr. of
the above decedent, hereby renounce(s) the fight to administer the estate and respectfully ask(s) that Letters
of Administrationg~b~.
Mary J. Kantz
be issued to
WITNESS my hand this c-~f~Oday of f~l c~ ,IQ[ 2003.
(Signature)
MICHAEL CONRAD, SR.
~ Doe Road
Enolag PA 17025
(Address)
(Address)
(Signature)
(Address)
21-2003-450
LO: ~LV ~- NnP CO.
CERTIFICATE OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Melissa A. Conrad
Date of Death: April 14, 2003
Will No. 2003-0450
Admin. No. 21-03-0450
TO THE REGISTER:
I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules
was mailed to the following beneficiaries of the above-captioned estate on September 29, 2003.
NAME ADDRESS
Kayla M. Conrad
c/o Mary J. Kantz
31 East Main Street
Plainfield, PA 17081
Christopher M. Reed
c/o Mary J. Kantz
31 East Main Street
Plainfield, PA 17081
Notice has now been given to all personal entitled thereto under Rule 5.6(a) except: NONE
~~nsel for Personal~Repreesentative
GRIFFIE & ASSOCIATES
200 North Hanover Street
Carlisle, PA 17013
(717) 243-5551
(800) 347-5552
.~-" COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV- §O0
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
CS,~.TM CODE YEAF' NUMBER
DECEDENTS NAME (LAST. FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
Z Conrac]., Mellssa A, 188 - 62 - 969'7
f"l DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
I,,U 04/14/2003 0'7/20/1976 REGISTER OF WILLS
Iii IF APPLICABLE) SURVIVING SPOUSES NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
none - -
Z
u.I
Z
0
Q..
0
LU
n,
X
~1. Original Return ~-~ 2. Supplemental Return
-~ 4. Limited Estate F-'-} 4a. Future Interest Compromise I~a~e .;i :oath aftor '242-82)
__~6. Decedent Died Testate (A~tach copy of wi,; ~. 7 Decedent Maintained a Living Trust ~tUcn cooy of Trust)
--'-] 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date ofdeam ...... 72-31-91 and 1-,--35]
NAME
Bradley L. Griffie, Esquire
(5) $2,500.00
(9) $4,664.00
3. Remainder Return Idale of death ,?,nor
j~l5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
,i'~ 11. Election to tax under Sec. 91131A) ,A:tacn
COMPLETE MAILING ADDRESS
200 North Hanover Street
Carlisle, PA 17013
(8) $2,500.00
FIRM NAME (If Appli~ble)
GRIFFIE & ASSOCIATES
(11) $9,120.02
TELEPHONE NUMBER
71 7-243-5551
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 B) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
E~ Separate Billing Requested
7. Intar-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines t-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Uens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Chantable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
!4. Net Value Subject to Tax (Line 12 minus Line 13)
(12) -$6,620.02
(13)
(lO) $4,456.02
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) x .0 __
16. Amount of Line 14 taxable at lineal rate x .0 __
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
114) 0
(15) 0
(16) 0
(17) 0
(16) O
(19) 0
OFFICIAL USE ONLY
Decedent's Complete Address:
STREET ADDRESS
31 East Main Street
tzIP
CITY
Plainfield..
STATE PA
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Pdor Payments
C. Discount
(1)
Total Credits ( A + B + C ) (2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total InterestJPenaity ( 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 (4)
5. 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)
17081
0
0
0
0
0
0
0
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; .......................................................................................... [] []
b. retain the dght to designate who shall use the property transferred or its income; ............................................ [] ! []
c. retain a reversionary interest; or .......................................................................................................................... E~' []
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 prope~ which
contains a beneficiary designation? []
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT
AS PART OF THE RETURN.
Under penalties o[ perjury, 1 c~lare that I have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete.
Declaration of preparer other :nan the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESBONSIBLE FOR FILING RETURN
ADDRESS i Ea~st Main) Street, Plainfield
31 ,
SIGN~N REPRESENTATIVE
A~orth Hanover Street, Carlisle,
PA 17081
DATE
/o!.
PA 17013 (Griffie
D~E
/bi,/ 3
& Assoc.)
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 stilt applicable even if
the surviving spouse is :he 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 45%, 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
INHEPJTANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Melissa A. Conrad 21-03-0450
Include the pmcs~s of I~:Ja~don and the date t~e procaeds were received by the esl~. Ail pmpert7 joinfly-o~med ~h ~he right of survivorship must be casclosed on Sc~3eduJe F.
ITEM
NUMBER
e
DESCRIPTION
1989 Chevrolet Beretta
Accidental Death Insurance payment
VALUEAT DATE
OF D~&TH
;500.00
;2,500.00
TOTAL (Also enter on line 5, Recapitulation) ,¢ · 5 0 0 _ r~
COMMCNWEALTH OF PENNSYLVANIA
iNHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Melissa A.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
Conrac] 21 -03-0450
Debts of decedent must be reported on Schedule 1.
iTEM
NUMBER DESCRIPTION AMOUNT
A.
1.
5.
6.
7.
FUNERAL EXPENSES:
Ewing Brothers Funeral Home
ADMINISTRATIVE COSTS:
Pemonal Representative's Comm~ions
Name of Personal Represena~ve (si
Social Security Number(s) 1 EIN Number of Personal Representa~ve(s)
Street Address
S~le
Year(s) Comm~sion Paid:
At~meyFees Griffie & Associates
Family Exemption: (If decedenfs address ~ not ~he same as claimanfs, attach explanation)
Claimant
Street Address
c~
Reta~onship of Ciaimant ~ Decedent
Probate Fees
Accountanl~s Fees
Tax Return Preparers Fees
TOTAL (Also enter on line 9, Recapitulation
(If more space is needed, insert additional sheets of the same size)
$4,387.00
$220.00
$57.00
$ 4,664.00
REV-1.Sl2 5X~- Jl-~3J ~
COMMON~VF_ALTH OF P~NNS~VANJA
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES AND LIENS
Please Print or Type
ESTATE OF FILE NUMBER
Melissa A. Conrad 21-03-0450
ITEM
NUMBER DESCRIPTION AA4.OU NT
1.
PPL Utilities Electric Bill
Andorra Radiology Assocaites, PC
Carlisle Regional Medical Center
T-Mobile Corporation
Sprint
Sprint
1,315.60
67.00
~930.49
$1,550.38
$242.16
$350,39
TOTAL (Also enter on line 10, Recapitulation) S4,456.02
(If more space is needed, insert additional sheet~ oF same size.)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
Melissa A. Conrad
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (include outright spousal distributions)
Kayla M. Conrad
31 East Main Street
Plainfield, PA 17081
Christopher M. Reed
31 East Ma~n Street
plainfield, PA 17081
FILENUMBER
21-03-0450
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
Do Not List Trustee(s) OF ESTATE
minor child
minor child
50%
50%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, 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 ]~ - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET
IN THE ESTATE OF:
MELISSA A. CONRAD
Deceased
NOV
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
: ORPHANS' COURT DIVISION
: NO. 2003-00450
: Pa. NO. 21-03-0450
PETITION UNDER SECTION 3102 OF THE PROBATE~
ESTATES AND FIDUCIARIES CODE FOR
SETTLEMENT OF SMALL ESTATE
AND NOW, this ]__~i~day of ~ ,2003, upon motion of Mary J. Kantz
and upon consideration of the within Petition, it appearing that the estate is an insolvent estate,
the Court hereby confirms the account and approves the distributions made thereunder.
1 2 2003
By the Court,
IN THE ESTATE OF:
MELISSA A. CONRAD
Deceased
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
: ORPHANS' COURT DIVISION
: NO. 2003-00450
: Pa. NO. 21-03-0450
PETITION UNDER SECTION 3102 OF THE PROBATE~
ESTATES AND FIDUCIARIES CODE FOR
SETTLEMENT OF SMALL ESTATE
TO THE HONORABLE JUDGES OF SAID COURT:
AND NOW, comes Petitioner, Mary J. Kantz, by and through her attorney of record,
Bradley L. Griffie, Esquire, and petitions the Court as follows:
1. Your Petitioner is Mary J. Kantz, an adult individual currently residing at 31 East
Main Street, Plainfield, Cumberland County, Pennsylvania, being the natural mother
of the above-named Decedent.
2. The Decedent, Melissa A. Conrad, died on April 14, 2003, at 31 East Main Street,
Plainfield, Cumberland County, Pennsylvania and as a resident of Cumberland
County, Pennsylvania, a copy of the death certificate for the Decedent being attached
hereto and incorporated herein by reference as Exhibit "A."
3. Decedent died intestate and your Petitioner was appointed as Administrator of the
estate by Grant of Letters of Administration on June 2, 2003.
4. Next of kin to the Decedent are Kayla M. Conrad, Decedent's daughter, and
Christopher M. Reed, Decedent's son, both of whom are minors, being the ages of
eight (8) and four (4), respectively.
5. The only assets of the Decedent known to exist at the time of her death were as
follows:
o
o
a.)
a.)
c.)
d.)
a.)
b.)
c.)
1989 Chevrolet Beretta
Homeowner's Accidental Death
disbursement from Nationwide Insurance
TOTAL ASSETS:
$ 500.00
$2,000.00
$2,500.00
A Pennsylvania Inheritance Tax Return has been filed evidencing the fact that there
are no proceeds for distribution and, therefore, no Inheritance Tax is due.
Petitioner has inquired into all of the debts of the Decedent and found the following
debts to be in existence at the time of Decedent's death:
Delinquent PPL utilities electric bill $1,315.60
Delinquent medical bill from Andorra
Radiology Associates, PC $ 67.00
Carlisle Regional Medical Center
medical bill $ 930.49
T-Mobile Corporation cell phone bill $1,550.38
Sprint telephone bill $ 242.16
Sprint telephone bill $ 350.39
TOTAL DEBTS
AT TIME OF DEATH: $4,456.02
The following debts have been incurred as a result of or since Decedent's death:
Funeral bill (Ewing Brothers Funeral
Home)
Attorney's fees to Griffie & Associates
(ongoing)
Probate cost to Register of Wills
TOTAL DEBTS
AS A RESULT OF DEATH:
$4,387.00
$ 220.00
$ 57.00
$4,664.00
9. Petitioner has exhausted the estate assets to the payment of administrative costs and
funeral expenses in accordance with 20 Pa.C.S. {}3392.
10. Petitioner has provided all of the funds over and above those listed as assets in this
Petition for purposes of paying the debts that were created by the Decedent's death.
11. The estate is insolvent and, therefore, unable to pay the claims set forth in paragraph
6 above, which are debts that existed at the time of the Decedent's death.
12. Petitioner has provided a copy of this Petition to the creditors named in paragraph 6
and has advised said creditors of Petitioner's intention to file the within Petition on or
about November 1, 2003.
13. There are no other funds or assets of any nature whatsoever in existence to
Petitioner's knowledge that could be used to contribute to the costs associated with
Decedent's death which Petitioner has otherwise paid, nor to provide funds to the
creditors named in paragraph 6.
14. Petitioner and the creditors named in paragraph 6 are the only parties known to have
any interest in the within Petition.
WHEREFORE, Petitioner requests your Honorable Court to confirm the account for the
estate and approve the distributions made as identified above.
Date
Respectfully submitted,
At~jl~~itione/
GRIFFIE & ASSOCIATES
200 North Hanover Street
Carlisle, PA 17013
(717) 243-5551
(800) 347-5552
VERIFICATION
I verify that the statements made in the foregoing document are true and correct. I
understand that false statements herein are made subject to the penalties of 18 Pa.C.S. Section
4904, relating to unswom falsifications to authorities.
BUREAU OF INDIVIDUAL TAXES
TNHERTTANCE TAX DZVTSTON
DEPT. 280601
HARRTSBURG, PA 17128-060!
COMMONNEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLONANCE OR DZSALLONANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
RE¥-15~i7 EX AFP C01-D3)
BRADLEY L GRIFFIE ESQ
GRIFFIE & ASSOCS
200 N HANOVER ST
CARLXSLE PA 17015
CUT ALONG THIS LZNE ~
DATE 11-17-2003
ESTATE OF CONRAD
DATE OF DEATH 04-14-2005
FILE NUMBER 2! 05-0450
COUNTY CUMBERLAND
ACN 101
Amount
NELISSA
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF NXLLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
RETAIN LONER PORTION FOR YOUR RECORDS ~
DZSALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF CONRAD MELISSA AFZLE NO. 21 05-0450 ACN 101 DATE 11-17-2005
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 and Bonds (Schedule B) (2)
$. Closely Held Stock~Partnership Interest (Schedule C) (3)
~. Mortgages/Notes Receivable (Schedule D) (~)
$. Cash/Bank Deposits~Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule 8) (7)
8. Tote1 Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9 Funeral Expenses/Adm. Costs/N/sc. Expenses (Schedule H) (9)
10 Debts/Hortgege L/eb/litias/L/ans (Schedule I)
11 Tote1 Deductions
12 Nat Value of Tax Return
2/500.00
O0 NOTE: To /nsure proper
O0 cred/t to your account,
O0 sube/t the upper port/on
O0 of th/s form w/th your
tax payment.
O0
O0
(10)
(8)
4,664.00
13
NOTE:
ASSESSMENT OF TAX:
15. Amount of L/ne 1~ at Spousal rata
16. Aeoun'1' of L/ne 1~ taxable at LineaX/CXess A rata
17. Amount of L/ne Xq at S/bX/ng rmte
18. Aeoun~ of Line lq ~axable a~ Collateral/CZass B ra~e
19. Princt ~al Tax Due
TAX CREDITS:
PAYMENT RECE[PT DISCOUNT [+J
DATE NUMBER INTEREST/PEN PAID (-)
2,500.00
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
(16) .00 x O0 = .00
(16) .00 X 045= .00
(17) . O0 X 12 = .00
(18) .00 x 15 = .00
(19)= . O0
AMOUNT PAID
reflect figures that include the total of ALL returns assessed to date.
TOTAL TAX CREDIT I
I
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
.00
.00
.00
.00
( ZF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
Char/tebXe/Governmantal Bequests; Non-eXacted 9113 Trusts (Schedule J) (13) . O0
Nat VeXue of Estate Subject to Tax (lq) 6,6ZO.OZ-
If an assessment was issued previously, lines 1~, 15 and/or 16, 17, 18 and 19 w~11
456.02
(11) Q. ]20.02
(12) 6,620.02-
RESERVATION:
PURPOSE OF
NOTICE:
PAYHENT:
REFUND (CR):
OBJECTIONS:
ADHIN-
ZSTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decadents dying on or before December II, 1981 -- ]f any future interest in the estate ]s transferred
in possession or enjoyment to Class B CcoZlateral) beneficiaries of the decedent after the expiration of any estate for
1]fo or for years, the Coemonaealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class D (collateral) rate on any such future interest.
To fulfill the requirements of Section 21q0 of the Inheritance and Estate Tax Act, Act 13 of ZOO0. (71 P.S.
Section 9140).
Detach the top port]on of this Not]ce and submit a]th your payment to the Register of #]11s printed on the reverse side.
--Hake check or money order payable to: REGISTER OF HILLS, AGENT
A refund of a tax credit, #hJch wes not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" {REV-Z313}. Applicat]ons are available at the Office
of the Register of N]lls, any of the 13 Revenue Distr]ct Off]cas, or by calling the spec]al Z4-hour
answering service for fores ordering: 1-800-361-Z050; services for taxpayers with special hearing and / or
speaking needs: 1-800-qq7-3020 (TT only).
Any party ]n interest not satisfied aith the appraisement, allowance, or disallowance of deductions, or assessment
of tax (]nclud]ng discount or interest) as shown on this Not]ce oust object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. ZSIOZ1, 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 be addressed tn writing to: PA Department of Revenue,
Bureau of IndivJdua! Taxes, ATTN: Post Assessment Review Unit, Dept. lB0601, Harr]sburg~ PA 17118-060!
Phone (717) 787-6503. Sea 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 ]s paid a]thJn three (3) calendar months after the dacedent's death, a five percent (51) discount of
the tax paid ]s elloaed.
The 151 tax amnesty non-par]lc]pat]on penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period~ This non-participation
penaZt¥ is appealable in the same manner and ]n the the same t]ee per]od as you would appeal the tax and ]nterest
that has been assessed as indicated on th]s notice.
Interest is charged beginning with first day of del]nquancy, 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, 1981 bear interest at the rate of
slx (61) percent per annum calculated et a dally rate of .OOO16q. All taxes which became delinquent on and after
January 1, 1982 will bear interest at a rate which w]11 vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable Interest rates for 1981 through 2003 are:
Interest Dally Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1981 2OZ . O005a,8 1987 9Z . OOO Z¢7 1999 71 .000192
1983 161 . OOO~,38 1988-1991 117. .OOOSOl ZOO0 81 .000Z19
198a, llZ , OOOSO1 1992 9Z . OOOZ~,7 Z001 91 . O00Zq7
1985 131 .000356 1993-199a, 7Z .000192 ZOOZ 61 . OOOl6q
1986 IOZ .O00Z7q 1995-1998 97. .O00Zq7 1003 51 .000137
--Interest is calculated as follows:
ZNTEREST= BALANCE OF TAX UNPAZD X NUNBER OF DAYS DELZNQUENT X DAZLY ZNTEREST FACTOR
--Any Notice issued after the 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 an the
Not]ce, additional ]nterest must be calculated.
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 3/03/2005
GRIFFIE BRADLEY L
200 N HANOVER STREET
CARLISLE, PA 17013
RE: Estate of CONRAD MELISSA A
File Number: 2003-00450
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:
4/14/2005
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
~ElID~~':tuGH
REGISTER OF WILLS
cc: File
Personal Representative(s)
Judge
ufi
Register of Wills of Cumberland County
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Melissa A. Conrad
Date of Death: April 14. 2003
Estate No.: 21-03-0450
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following
with respect to completion ofthe administration of the above-captioned estate:
1. State whether administration of the estate is complete:
. Yes IXl No 0
2. lfthe answer is No, state when the personal representative reasonably believes that
the administration will be complete:
3. lfthe answer to No.1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes 0 No KJ
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?YeslXl No 0 Petition under Section 3102 of
the P.E.F. Code filed and approved by Order of Court dated
c. Copies of receipts, releases, joinders and approval of formal or informal Nov. 1 7, 2003,
accounts may be filed with the Clerk of the Orphans' Court and may be of record.
attached to this report.
Date: J(~l (0)
Name
200 North Hanover Street
Carlisle, PA 17013
Address
717-243-5551
Telephone No.
C~~a2ity: 0 Personal Representative
[N Counsel for personal representative
9 t"l :~;
uA