HomeMy WebLinkAbout04-0784 PETITION FOR PROBATE and GRANT OF LETTERS
Estateof'-[[~f-Lt~t~ {{[~'t~ C~e2t~({ No. ~,l-O4 - "~'4
also known as
To:
Social Security No. 1~ ~ '2 $- 7 ~ gl~eceased.
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut ~', ~
in the last will of the above decedent, dated Pec , *-. ~ '/f. ~
and codicil(s) dated
Register of W~ills fox.lthe
County of c,~/4 ~ a.L.~ ~ O in the
Commonwealth of Pennsylvania
named
,19___
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in ~/7 ~ '~' ~ ~ 41. t. ~q .at O ~County, Pennsylvania, with
h¢ 1~ last family or principal residence at '770 ~ /d~tvo~,t:~ .~-~ . cy~f(~IYt~E~
~
(list street, number and muncipality)
Decendent, then ~ c~ years of age, died ~ ~; t ~L. , 1 9 ~ ~' o ~,
at -']~,~ 5' ~7~,/~0¥~-a ¢5-t-; ~.&l-I~ L~[('tet.
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent: ,-
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property '
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters "i' C-5~'~ ~ {E,t~ 'T & i~, ~,
{testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
theron.
OATH OF' PERSONAL REPRESENTATIVE
COMMONWEAJ~TH OF PENNSI(LVANIA ~. ss
COUNTY OF L~,o,~,rx'<~.~\c~6 ,
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 affirme~ and subscribed c-~r~ .q~.za~m'''~
before me this ~:.~.% : . day of ~ I) ~
No. ;11- 4-- s4
Estate 0f'-T~e.\~ T_~z~.~_ 0.~_~ , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW
the reverse side hereof, ~tisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated ~t.e~w~-~, ~, .~
described therein be admitted to probate and filed of record as the last will of
and Letters
, in consideration of the petition on
are hereby granted
FEES
Probate, Letters, Etc .......... $1.~)
Short Certificates(~) .......... $ lo
~,~,,~g~,u~.~~ s q.oo
TOTAL
Filed . .~.-. ~ 7.~..o.c?..~. ..................
AYrORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Loc~tl Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent, filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this cer[ificate, $2.00
P 10545607
No,
Local Registrar
Dater
t- o4-'w 8,/
COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
Thelma Irene Crozier Fercale 168- 26 - 7369
August '13, 2004 --
~,. E<] .......... [71 ........ L~
770 South Hanover Street
Carlisle, Pennsylvania 17013
Theodore b Moore
Dorothea J. Coulson
Anna Basehore
17070
Aug 17, 2004 Prospect Hill Cemetery I =~. Harrisburg, Pa.
LAST WILL AND TESTAMENT OF THELMA IRENE CROZIER
I, THELMA IRENE CROZIER of 509 16th Street, New Cumberland, Cumberland
County, Pennsylvania, being of sound and disposing mind, memory and under-
standing, do hereby make, publish and declare this as and for my Last Will
and Testament, hereby revoking all other Wills and CodJ~ her~tofore%~
made by me.
FIRST
I direct the payment of my debts and expenses of m~ iAst
funeral from my estate as soon after my death as conveniently m~ be d~e.
I direct that my body be interred in the cemetery lot owned by me in the
Prospect Hill Cemetery, Harrisburg, Pennsylvania.
SECOND
I give and bequeath unto my grandson, William Russell Coulson of
524 16th Street, New Cumberland, all my tools, hardware and lumber supplies.
THIRD
Ail the rest, residue and remainder of my estate of whatever nature
and wherever situated, I give, devise and bequeath unto my husband, W.
Barton Crozier, provided my said husband shall survive me by thirty (30)
days.
FOURTH
Should my said husband, W. Barton Crozier, predecease me or fail to
survive me by thirty (30) days, I direct that the rest, residue and
remainder of my estate, of whatever nature and wherever situated shall be
divided equally between my two daughters, Dorothea Jane Coulson of 524
16th Street, New Cumberland, Pennsylvania, and Marjorie Ann Walters Hobart
of 1723 Sherwood Road, New Cumberland, Pennsylvania, provided they survive
me by thirty (30) days.
In the event Dorothea Jane Coulson predecease me or fails to survive
me by thirty (30) days leaving issue to survive, said issue shall take the
share of their deceased parent by representation.
In the event Marjorie Ann Walters Hobart predecease me or fails to
survive me by thirty (30) days, said share of their deceased parent shall
be divided equally among her three children as follows: Amy Sue Walters
and Thomas Robert Walters of 1723 Sherwood Road, New Cumberland, Pennsyl-
vania and Beverly Ann Linebaugh of 1002 Bridge Street, New Cumberland
Pennsylvania.
I direct that my grandson, William Barton Walters be specifically
excluded from my Will.
I also direct that ~rjorie Ann Walters Hobart's step children shall
be specifically excluded from my Will.
FIFTH
I hereby nominate, constitute and appoint my daughter, Dorothea Jane
Coulson as Executrix of this my Last Will and Testament but should she
predecease me or fail to qualify, then I nominate, constitute and appoint
my daughter, M~rjorie Ann Walters Hobart as Executrix of this my Last
Will and Testament. I direct that no bond shall be required of either
Executrix named in this Will.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
day of ~ , 1980.
Thelma Irene Crozier
Signed, sealed, published and declared by THELMA IP. ENE CROZIER,
Testatrix, above named, as and for her Last Will and Testament, written
on three sheets of paper, in our presence, who, in her presence, at
her request and in the presence of each other, have hereunto subscribed
our names as attesting witnesses.
STATE OF PENNSYLVANIA
COUNTY OF CUMBERLAND
We, THELMA IRENE CROZIER,
SS.
and
.z , the Testatrix witnesses,
and
respectively,
- Uv
whose names are sigend to the attached or foregoing instrument, being first
duly sworn, do hereby declare to the undersigned authority, that the
Testatrix signed and executed the instrument as her Last Will and that she
signed willingly, and that she executed it as her free and voluntary act
for the purposes therein expressed, and that each of the witnesses in the
presence and hearing of the Testatrix, signed the Will as a witness and
that to the best of their knowledge, the Testatrix was at that time
eighteen years of age or older, of sound mind and under no constraints
or undue influence.
'~o~-~ ~'~-~ ~'z~c~c~ (SEAL)
Testatrix ~
Witness
~tness~ ~ pV
Subscribed, sworn to and acknowledged before me by THELMA IRENE
CROZIER, the Testatrix and subscribed and sworn to before me by~
1980.
Notary Public
My commission expires:
Name of Decedent:
Date of Death:
To the Register:
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
t~ f 7 ~ tl Admin. No.
I certify that notice of (beneficial interest) ~&[t~[olt required by Rule 5.6(a) of the Orpjaans~ Court
served on or mailed to the following beneficiaries Of the above-captioned estate on
Nme Address
Rules was
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Signatu~~~
Name
Telephone ( )
Capacity: __ Personal Representative
X Counsel for personal representative
COMMONWEALTHO R E V' 1 5 0 0
PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
Z
DEO-DcNTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
Crozier, Thema 1.
DATE OF DEATH (MM-OD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
8/13/04 12/12/14
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL{
1~1. Original Return
Norman M. Yoffe, Esquire
r--12. Supplemental Return
SOCIALSECURITYNUMBER
168 -- 26 - 7369
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
[] 4, Limited Estate [] 4a. Futura Interest Compromise (dat~ c~ ~a~.~,~2.~2~2) [] 5* Federal Estate Tax Return Reqtared
[~] 6 Decedenl Dieq Testate (At~ cop~ ol w~l)[] 7, Deceqent Maintained a Living Trust i~a~ ropy d Trysil ~ 8. To~al Number of Sate Depot Sexes
~ 9, Lit~ati~ Pr~s Re~[ved ~ 10. Spou~l Pove~ Cr~il [~al, d ~ ~t~*, 12.31a~ and 1-1-95) ~ 11. El~n ~ ~x under ~c. 9113{A) (~ ~ o)
THIS BECKON MU~ BE COMPLETED. A~ CORRESPONDENCE AND CONFIDEN~L T~ INFOR~TION SHOULD BE DIRE~D TO:
Yoffe & Yoffe, P.C.
TELEPHONENUMBER
(717) 975-1838
1. Real Estata (Schedule A) (1)
2. Stocks and Bo~ds (Schedule B) (2)
3. Closely Held Corporation, Parinership or Sota-Proprietarship {3)
4. Mortgages & Noles Receivable (Schedule D) (4}
5. Cash, Bank Deposits & Misceltanecus Personal Property (5)
{Bsheduta E)
6. Jointly Owned Property (Schedule F) (6)
--r Seqarata Billing Requestad
7. Inter-Vivos Transfers & Misceilaneous Non-Probate prope~ (7)
(Sd~edule G o~ L)
8. Total Gross Assets (tatal Lines I-7)
9. Funeral Expenses &Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Modgage Liabilities, S Uens (Schedule I) (I0)
11. Total Deducaons (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 1 t)
$0.00
COMPLETE MAILING ADDRESS
214 Senate Avenue, Suite 203
Camp Hill, PA 17011
$0.00
$0.00
$0.00
$2~23.27
$0.00
$0.00
(6)
$7,618.00
$2,506.76
(11)
{12)
$10,124.76
-$7,801.49
O
13. Cheqtabie and Governmental Bequests/Sec 9113 Truste for which an elecJion to tax has not been (13}
made (Sd~eduta J)
14, Net Value Subject to Tax (Ltae 12 minus Line 13) (14)
$0.00
$0.00
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15, Amount of Line 14 taxable al the spousal tax $0.00
rate, or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rate
.. x .0 (15)
x .0 (16}
17. Amount of Line 14 taxabta at sibling rata x .12 (17)
16, Amount of Line 14 taxaMe at collateral rata x .15 (18)
19. Tax Due (19)
$0.00
$0.00
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
Decedent's Complete Address:
S?REET ADDRESS
770 South Hanover Street
CiTY Carlisle
I STATE PA
17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
S. Prior Payments
C. Discount
$0.00
$0.00
$0.00
$0.00
Interest/Penalty if applicable Total Credits (A + B + C )
D. Interest $0.00
E Penalty $0.00
Total Interesl/Pesalty { D + E ) (3)
ft Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page '1 Line 20 to request a refund (4)
If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the inieresl on the lax due. (SA)
S. Enter the to,al of Line 5 + SA. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
(2) $0.00
$0.00
$0.00
$0.00
$0.00
$0.00
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
I. Did decedent make a lransfer 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 reversi~aly interest; or .......................................................................................................................... [] []
d. receive the premise for life of either payments, benefits or care? ...................................................................... [] []
2. If death occurred after December 12, 1982, did decedent transfer prppefly within one year of death
without receiving adequate considereUon? .............................................................................................................. [] []
3. Did decedent own an "in trust for" ~' payable upon death bank account or secudty at his or her death? .............. [] []
4, Did decedent own an Individual Retirement Account, annuity, or other non-prehete property which
contsins a beneficiar,/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.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETtJ. RN DATE
~DDRESS (~ / .
524 16th ~treet, New Cumb_.~..~nd, PA 17070
P.C ,._,
214 Senat~Avenue, Suite 203, Camp ~ill, P~ 17011
F~ da~ of dea~ on or a~er July ~, 19~ and ~fom Janua~ ~, ~995, ~e ~x rate impo~d on ~ net value of ~nsfers th or for the usa of the su~ving s~u~ is 3%
F2 P.S. ~6 (a) 0.~) (i)].
For dates of d~ on ~ a~er danua~ 1, 1995, ~e ~x rate ~m~sad co t~ net value of ~nsfe~ to or for the use of the su~iving spouse ~ 0% ~72
~e su~Mng s~u~ is ~o only
For dates of dea~ ~ or aRer July ~, 20~:
~ ~x m~ im~ ~ ~e net value of tranafe~ ~m a d~a~d ~ild ~en¥one yea~ of age er younger at death th or for ~e u~ of a natural parent, sa adoptive parent,
or a stepparent of ~e ~ig is 0% ~2 P.S, ~91~6(a)(~.2)].
The ~x rate imbed on ~e net value of ~ansfe~ to or for ~e usa of ~e den~e~t's lineal benefic~fies is 4.5%, ex.pt as nol~ id 72 P.S. ~9~6(L2)
The ~x ra~ im~sad on ~e net value of ~a~s~ ~ ~ ~r ~e use of the de.dent's siblings is 12% ~2 ~S. ~91~6(a)(1.3)]. A sibling is define, under Se~on 9102, as an
iddMdual ~o has at least ~e parent in ~mon ~ ~e d~ent, whet~r by b~d or adoption.
REV-1508 EX+ (6-98)
COMMOI~NVEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Thelma I. Crozier
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
2004-00784
thclude the Ixoceeds of lillg ation and fl~e date the proceeds were received by the estate.
All property Jointly-owned with dght of survivorship must be disc osed on ~.haa.,I. F.
ITEM
VALUE AT DATE
NUMEER DESCRIPTION OF DEATH
1.
Citizens Bank account #6100771199
Refund from Decedent's personal account at Chapel Point Nursing Home
$2,306.26
$17.01
TOTAL (Also enter on line 5, Recapitulation) $ $2,323.27
(~f more specs is needed, insert additiorml sheets of the same size)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Thelma I. Crozier
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
2004-00784
Debts of decedent must be reported on Schedule L
ITEM
NUMBER
6.
DESCRIPTION
FUNERAL EXPENSES:
Myers Funeral Home, 37 E. Main St., Mechanicsburg, PA 17055
Gingrich Memorials
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s}/EIN Number of Personal Representative(s)
Street Address
City
State __ Zip
Year(s) Commission Paid:
Adomey Fees Yoffe & Yoffe, P.C.
Family Exemptis~: (If ddcedenrs address is not ~e same as claimant's, aUach explanaUon)
Claimant
City State Zip
Relationship of Claimant to Decedent
Probate Fees Cumberland County Register of Wills
Accountant's Fees
Tax Return Preparer's Fees
AMOUNT
$7,033.00
$145.00
$350.00
$90.00
TOTAL (Nso enter on line g, Recapitulation) $ $7,618.00
(If more space is needed, insert additional sheets of I~e same size)
REV-1512 EX+ (12~)3)
ESTATE OF Thelma I. Crozier
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE UAB LINES, &UENS
FILE NUMBER
2004-00784
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, Including unrelmbursed medical expenses.
iTEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
Chapel Point Nursing Home, 770 South Hanover Street, Carlisle, PA 17013 for final
bill
Millenium Pharmacy Systems, Inc. for final bill
$2,315.00
$191.76
TOTAL (Nso enter ~ Pine 10, Recapitulation) $ $2,506.76
{If more space is needed, insert addi~onal sheets of the same size)
REV-IS13 EX+ (9-00)
SCHEDULE
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Thelma I. Crozier
FILE NUMBER
2004-00784
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
TAXABLE DISTRIBUTIONS [include outright Mx~sal dist~butions, and Iransfers under
Sec. gliB (a) (1.2)1
Dorothea Jane Coulson
Marjorie Ann Walters Hobart
William Russell Coulson
daughter
daughter
grandson
50%
50%
items of personal
property; non-
existent
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSALDISTRIBUT[ONSUNDERSECTIONg113FORWHICHANELECTIONTOTAXISNOTBEINGMADE
8. CHARITABLE AND GOVERNMENTAL OISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
(If mom space is needsd, insert additional ~heets of I~e same size)
BUREAU OF INDIVIDUAL TAXES
ZNHER/TANCE TAX DZVTSTON
PO BOX 280601
HARR/$BURG, PA 17118-0601
CONNONWEALTH OF PENNSYLVANIA
DEPARTNENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAZSENENT, ALLOHANCE OR DZSALLOHANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
NORHAN H YOFFE
STE 205
214 SENATE AVE
CAHPHILL
PA 17011
DATE
ESTATE OF
DATE OF DEATH
FILE NUHBER
COUNTY
ACN
11-15-2004
CROZIER
08-15-2004
21 04-0784
CUNBERLAND
101
Amount Ree.J.~:ted
THELHA I
HAKE CHECK PAYABLE AND RENZT PAYNENT TO:
REGTSTER OF WTLLS
CUHBERLAND CO COURT HOUSE
CARLTSLE, PA 1701:5
CUT ALONG THZS LZNE Im~ RETAZN LOWER PORTION FOR YOUR RECORDS ~
REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTZONS AND ASSESSNENT OF TAX
ESTATE OF CROZIER THELNA ! FILE NO. 21 04-0784 ACH 101 DATE 11-15-2004
TAX RETURN HAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: 0RZGZNAL RETURN
1. Real Estate (Schmdule A) (1)
2. Stocks and Bonds (Schedule B) (2)
$. Closely Held Stock/Partnership Interest (Schedule C) (3)
q. Nortgages/No~as Receivable (Schedule D) (q)
5. Cash/Bank Daposits/Nisc. Personal Property (Schedule E) (5)
6. Jointly Owned Proper~y (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Asse~s
APPROVED DEDUCTIONS AND EXEHPTZONS:
9. Funeral Expanses/Ada. Costs/Hisc. Expenses (Schedule H) (9)
10. Debts/Hortgaga Liabilities/Liens (Schedule I) (10)
11. Total Deductions
12. Nat Value of Tax Return
2~:52:5.27
.00
.00 NOTE: To insure proper
.00 credit to your account,
.00 subeit ~ha upper portion
.00 of this fore with your
tax payeen~.
.0O
(8)
7,618.00
13.
lq.
NOTE:
2,:525.27
2,506.76
(11) 10.124.76
(12) 7,801.49-
Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) .00
Nat Value of Es~e~e Subject ~o Tax (lq) 7,801.49-
If an assess;ant ~as issued previously, lines 14, 15 and/or 16, 17, 18 and 19 ~ill
reflect figures that include the total of ALL returns assessed to date.
(1.;) .00 X O0 = ,00
(16) .00 X 045= .00
(17) .00 X 11 = .00
(18) .00 x 15 = .00
(19)= . O0
AHOUNT PAID
ASSESSNENT OF TAX:
1s. Amount of Line lq e~ Spousal rata
16. Amount of Line lq taxable at Lineal/Class A rata
17. Aaount of Line lq at Sibling rata
18. Aaount of Line lq taxable at Collateral/Class B rata
19. Principal Tax Due
TAX CREDITS:
PAYH~NT ~-- RECEIPT
DATE ~i~ NUHBER
D/SCOUNT
INTEREST/PEN PAZD (-)
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATZON OF ADDITIONAL INTEREST.
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
.00
.00
.00
.00
( XF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS RE~UZRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SZDE OF THIS FORH FOR ZNSTRUCTZONS.)
RESERVATION: Estates of decedents dying on or before December 1Z, 198Z -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commoneealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
PURPOSE OF
NOTICE: To fulfill the requirements of Section Z140 of tho Inheritance and Estate Tax Act, Act Z$ of ZOO0. (TI P.S.
Section 9140).
PAYHENT: Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side.
--Hake check or money order payable to: REGISTER OF HILLS, AGENT
REFUND (CR): A refund of a tax credit, which ams not requested on the Tax Return, may be requested by completing an
"Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-X513). Applications ara available
online at www.revenue.state.pa.us, any Register of Wills or Revenue District Office, or fram the Department's
Z4-hour enamoring service for forms orders: 1-800-56Z-Z050; services for taxpayers with special hearing and/or
speaking needs: 1-600-447-5020 (TT only).
OBJECTIONS: Any party in interest not satisfied with the appraismant, allowance or disallowance of deductions or assessment of tax
(including discount or interest) as shown on this Notice may object within 60 days of the date of receipt of this notice
by filing one of the following:
A) Protest to the PA Department of Revenue, Soard of Appeals. You may object by filing a protest online at
www.boardofappaals.stata.pa.us on or before the expiration of the sixty-day appeal period, in order for
an eIsctronic protest to be valid, you must race[va a confirmation number and processed data from the
Board of Appeals website. You may also send a written protest to PA Department of Revenue, Board of Appeals
P.O. Box 281021, Harrisburg, PA 17128-1021. Petitions may not be foxed.
B) Election to have the matter determined at the audit of the account of the personal representative.
C) Appeal to the Orphans' Court.
ADNIN-
ISTRATIVE
CORRECTIONS: Factual errors discovered on this assessment should ba addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, P.O. Box ZB060I~ Harrisburg, PA 171Z8-0601
Phone (717) 787-6SOSo See page S of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-IS01) for an explanation of administratively correctable errors.
DISCOUNT: If any tax due is paid within three (5) calendar months after the decmdent's death, a five percent (SI) discount of
the tax paid is allowed.
PENALTY: The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and nat
paid before January 18, 1996, the first day after the end of the tax amnesty par[od. This non-participation
penalty is appealable in the same Banner and in the the same tiao period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of
six (6Z) percent per annum calculated at a daily rate of .000164. AL1 taxes which became delinquent on and after
January l, 19Bi wit! bear interest at a rata which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 198Z through 2004 are:
Interest Daily Interest Daily Interest
Year Rate Factor Year Rate Factor
~ lOX ,00054g 1988-1991 XXZ .000501
1983 16Z .000458 1992 9Z ,000247
1984 llZ .000501 1993-1994 7Z .00019Z
1985 15Z .000356 1995-1998 92 .000247
1986 IOZ .000274 1999 7Z .O00lgZ
1987 lOZ .000Z74 ZOO0 7Z ,O0019Z
--Interest is calculated as follows:
INTEREST =BALANCB OF TAX UNPAID
Daily
Year Rate Factor
ZOO[ 9X .000Z47
ZOOZ 6Z .000164
2005 5Z .O00X~7
2004 4Z .000110
X NUHBER OF DAYS DELINQUENT X DALLY TNTEREST FACTOR
--Any Notice issued after the tax becomes delinquent wi11 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 be calculated.
LUffiDer~and County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (71 7) 240 - 6345
Date: 7/05/2006
COULSON DOROTHEA J
524 16TH ST
NEW CUMBERL.~D, PA 17070
RE: Estate of CROZIER THELMA IRENE
File Number: 2004-00784
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.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:
8/13/2006
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,
fJ
"-'lv
!
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
~
I...-U[llVerl.ana county - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 7/05/2006
YOFFE NORMAN M
YOFFE & YOFFE PC
214 SENATE AVE STE 203
CAMP HILL, PA 17011
RE: Estate of CROZIER THELMA IRENE
File Number: 2004-00784
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:
8/13/2006
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,
(' b-' P
(21'l,,~.?/~jJtOZ/~
(,
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Personal Representative(s)
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,
.
Register of Wills of Cumberland County
STATUS REPORT UNDER RULE 6.12
Name of Decedent: T tt ~ L..tV1 A
Date of Death: ~ II '] { 0 "'I
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Estate No.: 2- 1- u 1..' _ _ 7 'g "I:
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 IE No 0
2. If the answer is No, state when the personal representative reasonably believes that
the administration will be complete:
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes 0 No rn
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 00 No 0
c. Copies of receipts, releases, joinders and approval of formal or informal
accounts may be filed with the Clerk of the Orphans' Court and may be
attached to this report.
Date: ..::z..lz..l...
e.. fT" t 'Y " F \ A. h ~ (. 'I f" ",-n-
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IN THE MATTER OF THE ESTATE OF
THELMA IRENE CROZIER, DECEASED
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 2004-784
INFORMAL ACCOUNT IN THE NATURE OF A FAMILY SETTLEMENT
AS STATED TO LEGATEES BY EXECUTRIX, PERTAINING TO
ESTATE OF THELMA IRENE CROZIER WHO DIED AUGUST 13, 2004
A. Receipts
1. Proceeds of Citizens Bank checking account... .$2,306.26
2. Protective Life proceeds........ ........ ...... .8,188.69
3. Proceeds from Pershing Mutual Funds Pro
E qu i tie s , In c. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 , 4 07 . 1 4
At Decedent's death, she owned none of the assets
described in Paragraph of Will
TOTAL RECEI PTS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $11, 902.09
B. Disbursements
1. Mayers Funeral Home, for funeral............. .$7,033.00
2. Millenium Pharmacy for bill of Decedent......... .191.76
3. Chapel Point Nursing Home for last bill of
Decedent. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1,293.19
4. Gingrich Memorials for grave marker.......... ... .145.00
5. Attorney fees to Yoffe & Yoffe, P.C......... .... .400.00
6. Fees payable to Cumberland County Register
of Wills........................................ .165.00
7. Notary fees and miscellaneous........... ......... .45.00
TOTAL DISBURSEMENTS. ............................. .$9,272.95
C. Balance for Distribution
Balance for distribution......................................... .$2,629.14
One-half of above to Dorothea Coulson............ .$1,314.57
One-half of above to Marjorie Ann Walters Hobart..$1,314.57 $2,629.14
ESTATE OF THELMA IRENE CROZIER
Dated: I~)I .Io,+-
'.'" tv
By: ~;"~~A'"'- :0t~uu~s~';;, EXECUTRIX
The undersigned hereby acknowledges receipt of a copy of the foregoing and a
receipt of checks in the amounts of their distribution shares as above indicated.
~ _ - -~, ~, "'J. \
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DOROTHE J. c(o LSON
M ~Q",;/ ~ W d1uu/ ~,yf
MARJ IE ANN WALTERS HOBART
,r) n r /~ ^
-~-~~
RUSSELL COULSON
c8ulson\account