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HomeMy WebLinkAbout03-0569PETITION FOR PROBATE and GRANT OF LETTERS also known as l~'Tl~ C-. 'PbcCo:;J¥. To: Deceased. Social Security No. c[~-IO-I g! I Register of Wills for the County of C0 Pti tS~.R~AID Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or old,er an the execug7 in the last wilt of the above.decedent, dated ~'-0 _ and codicil(s) dated in the named (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in ~ O~b~tO../~O0 County, Pennsylvania, with h l $ la§t family, or prinlc~)l residence at 7_ c,~. p ~t/cc ?~ ti (list street, number and muncipality) Decendent, then ~ yea. rs of age, died at_ ~c~;.T ~pf-clrrC7¥ I'bS~t7'~ ~ ~csx7' 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.) Person.al.property in County Value of real estate in P~onnsylvanill,a,#a~ _ - situated as follows: ." '- ~_ ~ p ~ce: It/t~ WHEREFORE, petitioner(s) respectfully request(s) the.probate of the last will and codicil(s) presented herewith and the grant of letters t~/b~t~,qt~ ~4./-~ t c,~ ~n~¢ O'/O,~ at ~hrE o~ ~ ~x.~ (testamentary; administration c.t.a.; administration d.b.u.c.t.a.) theron. ~'F'U/tZ.qTT.O o~ '~ 70 6 z. OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PE ~NNS~LVANIA COUNTY OF C__,oo~,x'-~_~ . ~ ss The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affi/~e~and subscribed ~~~ ~ befor~ _3. oo~ Xl~dayOf { · ~ ~e~ter No. ~1-. ~ Estate Of BERTRAM C HILl A.K.A. RFRTRAM C. ~111 ,1R , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW dilLY 15: 7003 the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated_ dUNE 13~ 200'3 described therein be admitted to probate and filed of record as the last will of BERTRAM C HILL A.K.A. BERTRAM £ HILl and Letters TESTAMENTARY are hereby granted to RANDALL M HILt , in consideration of the petition on FEES Probate, Letters, Etc .......... $_~. Short Certificates( ) .......... $ ..30--¢ $ lO · oo TOTAL ~ $~.o~_~ Filed ..~-1 .-. I.~,..C>.~ ..................... -1-~ - 03 ATTORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE LAST WILL AND TESTAMENT OF BERTRAM C. HILL I, BERTRAM C. HILL, having my legal residence at 2806 Fairview Road, Camp Hill, Cumberland County, Pennsylvania, hereby declare this to be my Last Will and Testament, revoking all other Wills and Codicils heretofore made by me. ARTICLE ONE I declare that I am currently married to but separated from MAMIE A. HILL. I have intentionally, with full knowledge, chosen to exclude MAMIE A. HILL and her descendants from any benefit under the terms of this Will. ARTICLE TWO I have three children bom to me whose names and birth dates are as follows: NAMES BERTRAM C. HILL III HOLLACE ZEDAKER RANDALL M. HILL BIRTH DATES July 20, 1947 June 19, 1950 November 30, 1952 I have intentionally and with full knowledge chosen to exclude the following children from any distributions under this Will, not for any lack of affection but because I feel they are otherwise well provided for: BERTRAM C. HILL III HOLLACE ZEDAKER ARTICLE THREE I direct the payment from my estate of the expenses of my last illness and funeral as soon after my death as conveniently may be done. ARTICLE FOUR I intend to leave a memorandum which will direct the distribution of certain items of tangible personal property, and I request that my wishes as set forth in said memorandum be followed. To the extent that my tangible personal property is not disposed of by memorandum, I give all of the tangible personal property that I own at my death, including any household furniture and furnishings, automobiles, books, pictures, jewelry, art objects, hobby equipment and collections, wearing apparel, and other articles of personal and household use, equipment and ornament, and all insurance thereon to my son, RANDALL M. HILL, provided he survives me by thirty (30) days. If RANDALL M. HILL fails to survive me by thirty (30) days, such items shall be sold and the proceeds distributed with the residue of my estate. ARTICLE FIVE I give the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate to my son, RANDALL M. HILL, provided he survives me by thirty (30) days. ARTICLE SIX If any such descendant of mine has not reached legal age under the law of the jurisdiction in which that descendant is domiciled at the time of distribution under this Will, then distribution of his or her share shall be made instead to the custodian for that descendant under the Pennsylvania Uniform Transfer to Minors Act, and all provisions of that Act as they exist at the time of this my Last Will and Testament shall apply to the distribution. If necessary for legal transfer to that custodian, my Executor shall convert the assets in that descendant's share to cash or securities. ARTICLE SEVEN No beneficiary or remainderman under this Will or any codicil hereto shall have any right to alienate, encumber or hypothecate his or her interest in this Will in any manner, nor shall any interest of any beneficiary or remainderman be subject to claims of his or her creditors or liable to attachment, execution or other process of law. ARTICLE EIGHT Should the payment of expenses, claims and taxes from any Qualified Retirement Plan or Individual Retirement Account ("IRA") assets which comprise my estate cause my estate to be disqualified as a "Qualified Beneficiary," it is my intent, and I hereby direct that, to the extent practicable, no expenses, claims and taxes shall be paid from such Qualified Retirement Plan or IRA assets. ARTICLE NINE I appoint my son, RANDALL M. HILL, as Executor of my Will. I give to my Executor, in addition to and not in limitation of the powers given by law or by other provisions of this Will, the following powers with respect to settlement of my estate to be exercised from time to time in the discretion of my Executor, without further order or license of the Register of Wills or of any court: 1. To retain any property, pending distribution hereunder, to invest in or purchase any property without restriction to legal investments for fiduciaries, to distribute property in kind, to compromise claims, and to sell any property at public or private sale; 2. To borrow money from any person including any fiduciary acting hereunder, and to mortgage or pledge any real or personal property; 3. To engage in litigation and compromise, arbitrate or abandon claims; 4. To make distributions in cash, or in kind at current values, or partly in each, allocating specific assets to particular distributees on a non-prorata basis, and for such purposes to make reasonable determinations of current values; 5. To make elections, decisions, concessions and settlements in connection with all income, estate, inheritance, gift or other tax returns and the payment of such taxes, without obligation to adjust the distributive share of income or principal of any person affected thereby; 6. To invest and reinvest in every kind of property and investment which persons of prudence, discretion and intelligence acquire for their own accounts; To manage, control, repair and improve all real property; To procure and carry at the expense of the estate insurance of the kinds, fonrts and deemed advisable by the Executor to protect the Executor and the estate against any amounts hazard; 9. To pay all taxes, assessments, fees of the Executor and all other expenses incurred in the collection, care, administration and protection of the estate; 10. To exercise such powers, herein conferred, after the termination of the trust estate until final distribution of the estate assets; and 11. To do all the acts, to take all the proceedings, and to exercise all the rights, powers and privileges which an absolute owner of the property would have, subject always to the discharge of their fiduciary obligations; the enumeration of certain powers in this Will shall not limit the general or implied powers of the Executor; the Executor shall have all additional powers that may now or hereafter be conferred on them by law or that may be necessary to enable the Executor to administer the estate in accordance with the provisions of this Will, subject to any limitations specified in this Will. No bond shall be required of any fiduciary hereunder in any jurisdiction. No fiduciary hereunder shall have any liability for any mistake or error of judgment made in good faith. My Executor shall receive reasonable compensation for services performed as determined by the court in which this Will is admitted to probate. ARTICLE TEN I realize that Executors are given discretion by law to make various elections which affect the income and estate taxes payable by estates and beneficiaries, as well as the relative shares of beneficiaries, such as taking administration expenses as deductions for either estate or income tax purposes, selecting options for the payment of employee death benefits, electing to take a qualified terminable interest as part of the marital deduction, selecting alternate valuation dates, postponing the payment of taxes, filing joint income tax or gift tax returns and redeeming corporate stock. The decisions made by my fiduciaries in any of these matters shall be binding upon, and not subject to question by, any affected persons. I rely upon my fiduciaries to take into consideration the total income and estate taxes payable by reason of their decisions including those payable by my survivors, and they are authorized in their discretion, but not required, to make adjustments between income and principal as a result thereof. ARTICLE ELEVEN I direct that all estate, inheritance and other taxes in the nature thereof, together with any interest and penalties thereon, becoming payable because of my death with respect to the property constituting my gross estate for death tax purposes, whether or not such property passes under this Will, shall be paid from the principal of my residuary estate, and no person receiving or having a beneficial interest in any such property, whether under this Will or otherwise, shall at any time be required to contribute to or refund any part thereof; PROVIDED, however, that this direction shall not apply to the taxes on any property included in my estate solely because of a power of appointment thereover which I possess but have not exercised or on any qualified terminable interest or to any generation-skipping transfer taxes. (6~ pages. WITNESS WHEREOF, I have at Hershey, Pennsylvania, this /~day of ,2003, set my hand and seal to this my Last Will and Testament, consisting of six BERTRAM C. HILL SIGNED, SEALED, PUBLISHED and DECLARED by BERTRAM C. HILL, the above named Testator, as and for his Last Will and Testament, in the presence of us, who, at his request and in his presence, and in the presence of each other, have hereunto subscribed our names as witnesses. ' ~' Residence ~xC4//~Z~ /~)/~ //~ ~/ Residence ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA · COUNTY OF DAUPHIN ' SS: We, BERTRAM C. HILL, ,~:x$&w /Y] ~_../O~i~O]C and Testator and witnesses, respectively, whose names are signed to the attached and foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his last will and that he had signed willingly, and that he executed it as his free and voluntary act for the purpose therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as witnesses and that to the best of his/her knowledge the Testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. TESTATOR WITNESS- Subscribed and swom to and acknowledged before me by BERTRAM C. HILL, the Testator, and subscribed and sworn to before me by ~_.,tJ~_m /TI. ~/O.x~ t9,~/~-.- and witnesses, on this [ Notarial Seal ~ I IJnda L. Fetterh_off, ~h~in~lc I Oerry Twp., D c,uumy I Mv comm~sg~on ~.~ro~ Nov. e, am ~ MEMORANDUM TO THE LAST WILL AND TESTAMENT OF BERTRAM C. HILL It is my desire that the items listed below be distributed in-kind to the individuals whose name or names appear opposite the items listed: DATE BERTRAM C. HILL LAW OmCE JAMES SMITH DIETFERI~ & CONNELLY LLP EO. BOX 650 HERSIdL~, PENNSYLVANIA 170334Yo50 Name of Decedent: CERTIFICATION OF NOTICE UNDER RULE 5.6(a) ) Date of Death: Admin. No. Pti/' To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of thg Orghans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on ! ! /~/o 3 : Name Address Notice has now been given ,to all persons entitled thereto under Rule 5.6(a) except Date: Signature Name Address i Trgq5 y,O .Cl~?/~,v/o~ ce/i/ Telephone ( ) ~ (j~ -- Capacity: ~)( ' Personal Representative 0.~ q 7092 Counsel for personal representative Cumberland County - Register Of wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 5/18/2005 HILL RANDALL M 17995 SW CHEYENNE WAY TUALATIN, OR 97062 RE: Estate of HILL BERTRAM C File Number: 2003-00569 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: 6/27/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, Ani~W/~ GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Counsel Judge cd. RECEIVED Jut 152005.1 Estate of HILL BERTRAM C Late of CAMP HILL BOROUGH ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA Estate No.: 21-03-00569 Date: 7/18/2005 NO.: 21-03-00569 HILL RANDALL M 17995 SW CHEYENNE WAY TUALATIN OR 97062 NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 6. 12, SUPREME COURT ORPHANS' COURT RULE Personal Representative: HILL RANDALL M Personal Representative Counsel: ** NO INFORMATION FOUND ** Date of Decedent's Death: 6/27/2003 Date of Delinquency Notice: 6/27/2005 The undersigned, Glenda Farner Strasbaugh, Clerk of Orhans' Court, in accordance with rule 6.12, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor their counsel, have filed with the Register of Wills or Clerk of Orphans' Court, his/her Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule, and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orhans' Court Rules, was given by the Clerk of Orphans' Court on 5/15/2005 and that the ten (10) day notice to file the status report has expired. Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or their counsel. cc: File Personal Representative Counsel ..~~~ Glenda Farner Strasbaugh Clerk of Orhans' Court A hearing is scheduled for August 19, 2005 at 9:30 AM in Courtroom No. 03. If the Status Report is filed prior to the hearing date, the hearing will automatically be cancelled. - / .... Geat9 ,no . --, p 1 vA Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 4/25/2006 HILL RANDALL M 17995 SW CHEYENNE WAY TUALATIN, OR 97062 RE: Estate of HILL BERTRAM C File Number: 2003-00569 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: 6/27/2006 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. Si~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File l'nlln RP 1 In Re: Estate of HILL BERTRAM C ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 2003-00569 NOTICE OF FAILURE TO FILE STATUS REPORT Personal Representative: HILL RANDALL M Counsel for Personal Representative: Date of Decedent's Death: 6/27/2003 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 ofthe Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, is hereby given by that the you have ten (10) day to file the Status Report. If the required 6.12 form is not filed in accordance with Rule 6.12 the Court will be notified of such delinquency and the undersigned will requests 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: 7/10/2006 ~~~ u.s. Postal ServiceTM CERTIFIED MAILTM RECEIPT . (Domestic Mail Only; No Insurance Coverage ProVIded) Glenda Farner Strasbaugh Clerk of the Orphans' Court 3'" 3'" iru l...n II II :5 " ru 'r'- ,resentative Postage $ (p-t?- l 0 lim~'vY Here b~-5 (001 7(11 IT1 Certified Fee CJ CJ Return Reciept Fee CJ (Endorsement Required) CJ Restricted Delivery Fee Ul (Endorsement Required) rn r=l Total Postage & Fees $ 3'" CJ CJ r'- .- II See Reverse for Instructions , ~ >< o ..0 t.f) \:.c ~...... i.~ !.;~ + 0.. N "0 C CO rJl t.f) (I) .... 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(jj ~~ l? ~ ~ ~ ~ = ~ (1) ~ ~ iil ! o ~ en 000 O:Il[!1 baB . c: I 0'" . :J ~~ ~ ~ -s Q' t-31-':I: C::::-..J-l ~ \0 L"l_~ L"l \0 ~ :t:' ~ J"'-1 H ::.:cJ f-~ en ~ 2;:8,-< tJ on>, ~~li t:rjL"l >-< \Ot::l3;: -..JZ 02; 0ltr:J l\.) :8 >' K; ~ ~ (1) o ::r l>> :J a. 00. (1) . . O~CIl""Cit() ;~E.f~5.3~ ,~ g. ~ ~ ~"Q. st_;g~~ 2: CD;:r.<..,:oCD Cil ~C/lCD~CD;:+ en OOOIll!!iCD en a~~3~.3 ~ ~a...,CD$l.C/l !=f CIl o~~~.:-'" -g st 3 a. o.!'J ~CDst~~~ -cgCDQ-(iia. ~oom-<(,,) 3 " ~ CIl -.):. itaa.O~iil . sto;:mo CD '< ~ _. 0 30CDCil~ !!!.!= Cil p.-c ~ (ii ![ CD iil CD _~ CD ~ r- Register of Wills of Cumberland County Name of Decedent: STATIJS REPORT UNDER RULE 6.12 OtrA:{OLAr;J\ ll-h Cc J fL Date of Death: ~ (1. 7 ( 'Ze)D -:::) Estate No.: L()C/3 ~ 005GQ Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the admilJistration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes JAl No 0 2. If the answer is No, state ,,,hen the persona.J.xepresentative reasonably believes that the administration will be complete: /' 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes 0 No~ b. The separate Or;I?hans' Court No. (if any) for the personal representative's account is: f'J 0 IJrL c. Did the personal representative state an account informally to the parties in interest? Yes f2l No 0 In 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. - I{r<tr /14.. II / Date: C{ n(of; r::z;;J/!/i! ~Iu Signature ~ (tTJP~L /V1 (h tG Name C~ .... -- to -. ()C{'15 St:J CffbVMN~ rJfJ:! Address lVth...fh7N a{ 910 {;Z 50 '3 -- G''f Z -- r11 Z Telephone No. ("''': <:- -: c:.:: c'-; c)- (--' Capacity: fi(1 Personal Representative o Counsel for personal representative c J 15056051058 REV-1500 EX (os-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN ' PO Box 280601 21 ! 03 0569 Harrisburg, PA 1712&0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATH)N BELOW Social Security Number Date of Death Date of Birth 462-10-1881 06/27/2003 08/12/1917 Decedent's Last Name Suffix Decedent's First Name MI Hill Jr. !Bertram C (If Applicable) Enter Surviving Spouse's Information Selow Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST 13E FILED IN DUPLICATE WITH TWE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ~:*. 1. Original Retum ;~;::'" 2. Supplemental Return ;:~ ~'~ 3. Remainder Retum (date of death prarto 12-13-82) ,.. 4. Limited Estate 4a. Future Interest Compromise (date of %":~r 5. Federal Estate Tax Retum Required death after 12-12-82) ~:" ~ 6. Decedent Died Testate ; . 7. Decedent Maintained a Living Trust _...._ _ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received r, ~'~:? 10. Spousal Poverty Credit (date of death .::~ 11. Election to lax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT - THIS SECTN)N MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTUIL TAX INFORMATIONS LQ BE DIRECI~TO: Name Daytime Telephone~~ ~ r rr ~ Randall M. Hill _. _ - D "~1I (503) 577-7694 ~ ~ _ _ r~I r Firm Name (If Applicable) _ _ ~ f'rt ~ REGISTER OF~ ~E ONt~ r~-y ~i"1 C.7 C`1 Q 1 -p ~ -n ~; ' T ;a_ First line of address ~ { ~ ~ ~ '~ C"> ",.'' " ' 17995 SW Cheyene Way - N ' ~ ~ ~ E t r 1 ~,:, ~ Second line of address W ~D __ ~ 4 --s s 4 City Or POSt Office State ZIP Code ~ DATE FILED j ._ .. Tualatin OR 97062 Correspondent's e-mail address: Under penalties of perjury, I declare that I have examined this return, including aocomparrying schedules and statements, and to the beat of my knowledge and beflef, ft is true, correct and complete. DeGaration of preparer other than the personal representative is based on all informetlon of which preparer ties arty knwwledge. SIGNATURE OF PERSON ~S~P~SIBLE FOR FILING RETURN D~T~ '~,I,,.,LLtL~t ~~~~.u' -E C c~~ F _ ~ / J~ C /~ t ~'~ t 2161 D~' ADDRESS ~ ~`,~^^ ~~ V ' "~ `-'~i ~Gp'~ / 17995 SW Cha a ay, ualatin, OR 97062 ,~bt°~ __ SIGNATURE Of PREPARE THER THAN REPRESENTATIVE DATE - /' ~ lra; ~4` ~ ~ ~I ,~/t~c:C _% c° . 12/05/08 ADDRESS L 10477 SW Beaverton-Hillsdale Hwy, Beaverton, OR 97005 PLEASE USE ORIOINIAL FORM ONLY Side 1 15056051058 15056051058 J ~ 15056052059 REV-1500 EX Decedent's SociaO Security Number __ _ - -_ Bertram C Hill ' 462-10-1881 Decedents Name: ~._.u.~..._~ e._._ e_ .... __._..,_ ...__ _ . .._ .___ .... _ . __~ _ _ _... . ..~._r. _... .__ _ __~._ u_, _w. . RECAPITULATION _._ 1. Real estate (Schedule A) ............................................. 1. 172,000.00 2. Stocks and Bonds (Schedule B) ....................................... 2. ; E 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages 8 Notes Receivable (Schedule D) ............................. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ........ 5. 119.00 6. Jointly Owned Property (Schedule F) c::;:~"~ Separate Billing Requested ....... 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~`-~"=' Separate Billing Requested........ 7. 1 8. Total Gross Assets (total Lines 1-7) .................................... 8. ` 172,119.00 9. Funeral Expenses & Administrative Costs (Schedule H) ..................... 9. ! 1,305.00 10. Debts of Decedent, Mortgage Liabilities, 8 Liens (Schedule I) ................ 10. '; 218,118.00 11. Total Deductions (total Lines 9 8 10) ................................... 11. ' 219,423.00 12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. 0.00 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which . .. _. an election to tax has not been made (Schedule J) ........................ 13. 'i 14. Net Value Subject to Tax (Line 12 minus Line 13) ........................ 14. 0.00 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES ~~ ~~ ~~ --.~.~..~..~,..._.~-,...~,~...,.._Rm_.a .~~.m. 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 _ _ _ __ _ _ _ _ _ (ax1.2) X .0_ 15. 16. Amount of line 14 taxable at lineal rate X .0 _ 16. 17. Amount of Line 14 taxable at sibling rate X .12 ' _ 17. _. 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. TAX DUE ......................................................... 19.: 0.00 20. FILL IHt THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT C~ ,°~ 15056052059 Side 2 15056052059 REV-150 EX Page 3 Decedent's Complete Address: ~._..._ Fltt Nrrntia+er _. 21 03 ;0569 DECEDENT'S NAME DECEDENT'S SOCIAL SECURITY NUMBER Bertram C Hill 462-10-1881 STREET ADDRESS _ - -- -- -- - -_ _ - - _- _ -- 2806 Fairview Road -- CITY i STATE 'ZIP Camp Hill ! PA ~ 17011 - - --- --- -- ---..._.L_-. Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. CreditslPayments A. Spousal Poverty Credit _ _- _- _ _ __ B. Prior Payments - - - _ __ __ C. Discount (1) o.oo Total Credits (A + B + C) (2) 3. InteresUPenalty if applicable D. Interest E. Penalty _ _ _. - _ _ _ Total InteresUPenalty (D + E ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, 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) (4) (5) 0.00 (5A) (5B) 0.00 Make Check Payable to: REGISTER OF W1LLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did dece~nl 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. ff 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 arx:a~nt or security at his or her death? .............. ^ 4. Did decedent own an Individual Retirement Account, annuity, or other ran-probate property which contains a benefiaary designaGon? ........................................................................................................................ ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ~ - For dates of death on or after Juty 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 three (3) percent (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 zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)J. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disdosure of assets and filing a tax return are still applicable even if the surviving spouse is the only benefidary. 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-0ne 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 zero (0) percent (72 P.S. §9116(a)(1.2)J. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5~) percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)J. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(8)(1.3)J. Asibling isdefined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. FFi,'-].502 ET: f- (11-OS) -~ Pennsylvania ~ DEPARTMENT OF REVENUE INHERRANCE TAX RETURN RESIDENT DKEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Bertram C. Hill, Jr. 0569 All real proptrty owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knpwledge of the relevant facts. Real property that is jointlywwned with right of survivorship must be disclosed on Schedule ~. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1' Primary residence at 2806 Fairview Road, Camp Hill, PA 17011 172 000.00 TOTAL (Also enter on Line 1, Recapitulation.) If more space is needed, insert additional sheets of the same size. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 172,000.00 REV.1508 EX+ {6-~81 ' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, ~ MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Bertram C. Hill, Jr. 0569 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of aurvfvorshio must be disclosed on Schedule F ~.. •••-•~ ~r~w ~~ ~~aww, meson avunrenei sneers or [ne same s¢e) REV-1511 EX+ (12-99) • COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCNEp11LE H FUNERAL EXPENSES 8~ ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Bertram C. Hiil, Jr. 0569 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRlPT10N AMOUNT A. FUNERAL EXPENSES: 1 ~ Parthemore FH and CS, Inc., PO Box 431, New Cumberland, PA 17070 1.240.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)IEIN Number of Personal RepresentaGve(s) _ Street Address City .State Zip Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address Ciry State Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Zip TOTAL (Also enter on line 9, Recapitulation) I S (It more space is needed, insert additanal sheets of the same size) 0.00 65.00 1,305.00 REV 1512 EX+ (12-03) scNEOU~E ~ . ' COMMONWEALTH of PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE 7AX RETURN MORTGAGE UABIUTIES, & UENS RESIDENT DECEDENT ESTATE OF FILE NUMBER Bertram C. Hill, Jr. 0569 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unnimbursed medical expenses. (i( more space is needed, insert additional sheets of the same size) a ~~~ ~~ °' p ~ a r N +~ ° O LL ~ r = ,~ a o ~~ ~ ~ ttN~~~~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ~` NOTICE AF...LN~jERITANCE TAX BUREAU OF INDIVIDUAL TAXES AppRA'ISEMEN.T,`ALCOWANCf OR DISALLOWANCE INHERITANCE TAX DIVISION OF pEDUCTT,ON$ AND ASSESSMENT OF TAX PO BOX 280601 HARRISBURG PA 17128-0601 ~' `"' REV-1547 EX AFP CO1-09) 2~09JUPdC6 P~! ~'E'SgATE OF HILL2-2009 BERTRAM C DATE OF DEATH 06-30-2003 pCLERK C~ FILE NUMBER 21 03-0569 OIlPHA+`~f ~J C©~JRT COUNTY CUMBERLAND RANDALL M HILL CUMF~~':°-:",~I~ rrl pp4CN 101 17995 SW CHEYENE WAY ~ APPEAL DATE: 08-21-2009 TUALATIN OR 97062 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ -------------- ----------------------------------------------------------------------------- REV-1547 EX AFP CO1-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF HILL BERTRAM C FILE N0. 21 03-0569 ACN 101 DATE 06-22-2009 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 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 (1) 172, 000.00 (2) .00 (3) .00 (4) .00 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. (5) 119.00 (6) .00 cn .00 ($) 172, 119.00 APPROVED DEDUCTIONS AND EXEMPTIONS: 1,305 .00 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 218.118 .0 0 11. Total Deductions C11) 2 7 9.423.00 12. Net Value of Tax Return (1Y) 47,304.00- 13. Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedu le J) C13) .00 14. Net Value of Estate Subject to Tax (14) 47,304.00- NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate C15) •00 X 00 _ .00 16. Amount of Line 14 taxable at Lineal/Class A rate C16) .00 X 04 5 = .00 17. Amount of Line 14 at Sibling rate (17) .00 X 12 = .00 18. Amount of Line 14 taxable at Collateral/Class B rate C18) •00 X 15 _ .00 19. Principal Tax Due (19). .00 TAY f_RFi1TTC PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID (-) AMOUNT PAID ~ IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 IF TOTAL DUE IS LESS THAN 81, 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 FDR INSTRUCTIONS.)