HomeMy WebLinkAbout03-0678 PETITION FOR PROBATE and GRANT OF LETTERS
also known as To:
Register of Wills for the
County of Cumberland
Commonwealth of Pennsylvania
, Deceased.
Social Security No. ,/~.5'---/_~ _ ? ~.6g~/
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut~]c.~3
in the last will of the above decedent, dated O~7"; /~ ,).~.fl---"
and codicil(s) dated
in the
named
, 19.__
(state relevant circnmstances, e.g. renunciation, death of executor, etc.)
_D, ecendent was domiciled at death in C q..,,,t~o-*~ LM-..~.~ County, Penn~vlvania with
h; ~: last family or principal residence at ,~,~ ~' F~'o',~ --~-~-r~.~_r ~ ~
(list street, number and muncipality)
Decepdeny, then ~r~ ,,~ years of age, died ~' '"'-2 , ~-~_d_~_~.,
ExcePt as ~llows,-deced~nt did ~ot marryl ~hs not divorced and did not have a child born or adopteci
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent: /t~/.~.
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 ~'-c'e'~.~--,~-,,~_ ~- .~,_y-7~.-~._ ¥'
theron. (testamentary; administratial~c.t.a.; administrati0h d.b.n.c.t.a.)
"/ ..c' ?
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA '!
COUNTY OF Oumb~r'l and
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..~ , zthe estate according to law.
Sworn to or affirmed ..and subscribed c .X'~~ C, ,~.~~
before mer.th, i,s 1 zI I:n day of
NO. 21-2003-678
Estate Of JOSEPH A. LAWLER , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
August 15th, I~X
AND NOW
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated October 10th,
described therein be admitted to probate and filed of record as the last will of
JO~qEPH A- ¥.AWLF. R
and Letters TEKTAMENTARY
are hereby grantedto JOSEPH A. LAWLER JR AND MARY C,
20_,0i~ consideration of the petition on
1995
BOSTDORF
FEES
Probate, Letters, Etc .......... $ 1 i__~_5_,_Q/I
Short Certificates(3) .......... $ 9.0 0
~i${~i~x...x..-?.a. 9.e..s.. ( 9 ~ -o- -
10.00
JCP $
TOTAL .
Filed .. Au.guat..15.th..2 0.0 3 ..........
Mailed letters to Joseph A. Lawler on
8/15/2003.
DONNA M.' OTTO, 1st DEPUTY '~7~'~
ATTORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
REGISTER OF WILLS ~ COUNTY
OATH OF SUBSCR~.~ITNESS
each as ~c~dl~__.. ~~ '
( ) ubscribing witness to the wnl pres~gl~a herewith, (each) being duly ~ording to
law, d ose(s) and say(s) that ~ presen d saw
presen~
the testat ~gn the same and that ~_ signed as a witness at t~
request of testat _~~ presence and (in thc presence ~ other) (in the presence of the
witn s,
Sworn to or affirmed and ~bscribe~ore ~
me this _ day~ (Name) ~
R~t~ ~
21-2003-678
REGISTER OF WILLS OF CUMBERLAND COUNTY
OATH OF NON-SUBSCRIBING WITNESS
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
They ~re familiar with the signature of Joseph A. La~er
codicil
testator of (one of the subscribing witnesses to) the
presented
herewith
and
codicil
that " W~ believes~the signature on the ~is in the handwriting of
Joseph A. T.swler
to the best of our knowledge and belief.
Sworn to or affirmed and subscribed before
/
me this 14 ? h day of // (N~e)
.~uqu~t& l~X 2003
Donna M. Otto,lst De;~ty~, ~
(Address)
105.805 REV 9/86
This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
P 95055 8
No.
21-2003-678
Local Registrar
AUG 0 7 2003
Date
5 143 Rev 2/87
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
I N*"E oF DECEDENT {Firs,, Midd,e. L.s. IBEX e sOC,AL DATE OF D T.,Month Da
~E([.stBi,~.y) I U,DERIYAR ' Joseph A. i~l~, R. 12 Male ]3 195 - 16- 2846 4~ ,--~ '--Y' )
m . E J UNDg~ 1 DAy DATE OF BIRTH I S RTHP~CE (Ci,~ and IP~ACE
[ M~S ~ Days J Houm /Minutes ~ (~.Day, Ye~) I Slate~F~e~nC~unt~)mHOSPiT~,r~c~m~[bnecK°nlvOne'seemslmcti°nBonOt~rside~
~ Y~. OTHER:
COUN~ OF DEATH Cl~ I' J' J aa.
~.~ Cumb~land J- E~t Pen~boro r,,,l ~ I O , ,. II , . JNo~ Y.s~lfyes, s~d~Cuban, I(S~ci~) '
~,, DEC EDEN.S USUAL OCCUPATiON KIND OF BUS NESS / INDUSTRY ~AS DEC~DENT ~ER N n~o------ ~ ~ N 19.. Ilo. w, ~t
~DECEDENVSmILINGADDRESS(S~eeLCi~n°~'Smm'ZipO~e)IOEOEDENVS 11~" s,.,. - ?".. '= I
j 205 Fo~ Se~o~ Lane J~i~NC~ · YR,n~y~ua,~a ~en 11c.~ Yes, de~enllived~ E~t Pen~boro
E~ (~ee ins~uct~n, live h a
~, o~a, PA 17025 J~o,be,~.) ,~. co..~ Cumb ~d , .... h~ ~ ~ "~ ~, ,.
~ FATHER'S ~ME {First. Middle. Last)MOTHER'S N~E (Fkst Middle MaVen S~na~}
J INFOR~NPS N~E (Typ~Print)
LICENSE NUMBER
WAS AN AUTOPSY J WERE AUTOPSy FINDINGS I
PERFORMED? J AVAILABLE PRIOR TO J
J COMPLETION OF CAUSE J
Yes ~J No J"--J YesJ~ No[:]
hep,
live in a
Cumbe_atand township? ~7d. C] No. decsdenl INed
wilhin actual limits of
'19,
INFORMANT'S MAILI/~G ADpR~,SS [Street, .City/TDwn, State, ~ip J;:q~ie)
12Ob. 5 Rounc~ H,~£{ Road, Camp ~l~, PA 17011
PLACE OF DI,~3DSITION~Neo~e of ~eo3e err_ Czemator,,t ~ LOCATION - Ci y/Town State Zip Code
I°rotherP~acgJA[ma~T*0tz bOC~.[,~y of~ ~ '
I~- PA Crematory/ J~tdHarag~bu,~_g, PA 17109
N~EANDAODRESSOFF^C~LI~U~.em~3.,~X. On 5oo_ie~y of gA
e time, dale and place staled.
EAD (Month, Day, Year)
LICENSE NUMBER
(Month, Day, Year)
WAS CASE REFERRED TO A MEDICAL EXAM NER/CORONER?
vD• IK'I JL No r')~
Approximate
onsel ami death
PART I1: Other significant conditions comributing to death, but
not resulting in the underlying cause given in PART I.
CERTIFIER (Check only one)
*CERTiFYINGPHYSicIAN(Physiciancerlityingcauseoldealhwhenanotherphysiclanhas ronounced death a,qd compleled item 23 )
To the belt of my knewledge, death occurred due to the causea(s) and manner as sta~d ................................................................. []
*PRONOUNCING AND CERTIFYING PHYSICIAN (Physician both pron<~Jncing death and celliyng o cause of death)
To the belt of my knowledge, death occurred at the time, date, and p ace, and due to the CaUlei{$) and manner ii stated ...................... []
"MEDICAL EXAMINER/CORONER
Off the basil of examination and/or Invaetlgatlon, In my opinion, death occurred at the time, data and place and due to the causes(s and
31amrunner am stated ............................. '~l ............... 3 ........... .z .................. .. .. []
MANNER OF DEATH J DATE OF INJURY J TIME OF INJURY J lN]URY AT WORK? J DESCRIBE HOW lNJURY OCCURRED,
Acciden, [] Pending, ..... I Ye.• .oE]l
30e. '
LOCATION (St~eel, City/Town, Stale)
3Of.
SIGNAT~.~ AND TITLE OF CERTIFIE~/
LICENSE N~BER DATE SIGNED (M~, Day, Year)
N~E AND ADDRESS OF PER~ON WHO COMPLETED CAUSE OF D~TH
(Item 27) Type or
DATE FILED (Momh. Day, Year)
I, Joseph A. Lawler, of 205 Four Seasons Lane, Enola, PA
Last Will.
21-2003-678
17025, declare this to be my
I give my financial assets, i.e. my checking account at Dauphin Deposit and funds
remaining at PA State Retirement Service to my son, Joseph A. Lawler, Jr.
I give my automobile, 1 1988 white Ford Tempo LX, to my companion, Mary C.
Bostdorf. She is also to receive first choice of any furniture, appliances, jewelry or
clothing in my apartment in Enola.
I have arranged with the Cremation Society of PA to dispose of my body and to deliver
my ashes to my companion, Mary C. Bostdorf, for disposition or burial.
4. I hereby appoint my son and my companion to be co-executors of my estate.
day of
IN WITNESS WHEREOF, I have hereunto set my hand this
19..
Signed, published and declared
have affixed our names as witnesses.
?
//
Name
Address
Address
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 003292
LAWLER JR JOSEPH A
5 ROUND HILL ROAD
CAMP HILL, PA 17011
........ fold
ESTATE INFORMATION: SSN: 195-16-2846
FILE NUMBER: 21 03-0678
DECEDENT NAME: LAWLER JOSEPH A
DATE OF PAYMENT: 12/01/2003
POSTMARK DATE: 11/26/2003
COUNTY: CUMBERLAND
DATE OF DEATH: 08/03/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $2,966.70
TOTAL AMOUNT PAID:
$2,966.70
REMARKS: JOSEPH A LAWLERJR
SEAL
CHECK# 3196
INITIALS' AC
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
Name of Decedent:
Date of Death:
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
!
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on ~ --.~ ~ :
Na!Tle
Address
!
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
Si re
Name ,~q gV-/OH t~'
Address ~ ~ q~ ~f~
Telephone ( ) ~/~ _ ~ ff~
Capacity: ~Personal Representative
~.Counsel for personal representative
Name of Decedent:
Date of Death:
Will No.
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
3.,
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on /gTL -- / ---' tO ~ :
Nalne
Address
I 7011
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except.
Date:
Signature
Name "~~ ~_._./~~,~
Address / ~{~'~.~.~=.~g~ ~~
Capacity: __ Personal Representative
~.Counsel for personal representative
:1EV-1500 EX (6-00) J
~ COMMONWEALTH OFI REV-1500
~ PENNSYLVANIA
.e~::~~~ DEPARTMENT OF REVENUE
r~;~:~-~ DEPT. 280601 INHERITANCE TAX RETURN
~HARRISBURG, PA17128-0601 RESIDENT BECEDENT
I,--
Z
LL,I
U.I
LU
;oo
I--
Z
Z
O
LLI
n,
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
I'.awler, Joseph A. Sr.
DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR)
08-03-2003 I 10-17-1917
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
OFFICIAL USE ONLY
FILE NUMBER
COUNTY CODE YEAR
NUMBER
SOCIAL SECURITY NUMBER
195 - 16 - 2846
THiS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
E~I. Original Return
E~4. Limited Estate
r'~6. Decedent Died Testate (A~ch copy of Will)
--']9. Litigation Proceeds Received
~]2. Supplemental Return
~--"] 4a. Future Interest Compromise (date of death after 12-12-82)
[~7. Decedent Maintained a Living Trust (Attach copy of'rn~st)
['--J 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
r-~3. Remainder Return (date of death pdor to 12-13-82)
~"-] 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
~-] 11. Election to tax under Sec. 9113(A) (Attach
]HmRM~ON SHOU[~D !BE DIRECTEI~ TQ~,~i
NA~ME . I COMPLETE MAILING ADDRESS
Joseph A. ~.awler, Jr. I
FIRM NAME(If*pp~imue) I 5 Round Hill Road
I
TELEPHONE NUMBER ~ Camp Hill, PA 17011
717-737-2457
I
14.
1. Real Estate (Schedule A) (1) 0
2. Stocks and Bonds (Schedule B) (2) 0
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 0
4. Mortgages & Notes Receivable (Schedule D) (4) 0
5. Cash, Bank Deposits & Miscellaneous Personal Property (5) $ 6 8,7 7 7 · 6 9
(Schedule E)
o
6. Jointly Owned Property (Schedule F) (6)
[~ Separate Billing Requested
o
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9) $ 2,85 1,03
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 0
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line 13)
(8) $68,777.69
OFFICIAL USE ONLY
(11) $2,851.03
(12) $65,926.66
(13) O
(14) $65,926.66
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)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
$65,926.66
x.O
o
x .12
o
x .15
(15)
45
(16)
(17)
(18)
(19)
$2966.70
0
0
$2966.70
Decedent's Complete Address:
S
Seasons Lane
I Cl~
I Enola
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Interest/Pena~ E applicable N/A
D. Interest
E. Penalty N/A
ISTATE PA
I Z1~7025
(1) $2966.70
Total Credits ( A + B + C ) (2)
Total Interest/Penalty ( D + E ) (3) N/A
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page I 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.
0
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(4)
(5) $2966.70
(5A) 0
$2966.70
(5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
PL~SE ANSWER THE FOLLOWING QUESTIONS BY P~CING AN "X" IN THE APPROPRIATE BLOCKS
1. Did de.dent make a ~ansfer and: Yes No
a. m~in ~e use or in.me of the pm~ transfe~ed; .......................................................................................... ~ ~
b. retain the dght to designate who shall use the pm~ tmnsfe~ed ~ ~s in,me; ............................................ ~ ~
c. m~in a revemiona~ interest; or .......................................................................................................................... ~ ~
d. r~ive the promise for life of either payment, beneffis or ~m? ...................................................................... ~ ~
2. If dea~ occu~ed a~er De~mber 12, 1982, did de.dent transfer pm~ wi~in one year of dea~
wi~out m~iving adequate ~nsideration? .............................................................................................................. ~ ~
3. Did de.dent own an "in trust fo~ or payable upon death bank ac~unt or secu~ at his or her death? .............. ~ ~
4. Did de.dent o~ an Individual Re~rement Account, annulS, or o~er non-probate p~pe~ ~ich
con,ins a beneficia~ designa~on? ........................................................................................................................ ~ ~
IF THE ANSER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under ~naEies of ~u~, I declare ~ I ~ve exami~d this m~m, including a~m~n~ng s~ules and ~tamen~, and · ~ ~st M my kn~dge and ~1~, ~ is t~, ~e~ and ~m~eta.
DATE
/
Declaration of preparer other than the personal representative is based on all information of which pmparar has any knowledge.
SIGNATURE PERSON RESPO LE R I ETU
AD ~5 Rc~nd Hill Road, Camp H~i, PA 17011
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.1) (ii)
The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even
the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive paren
or a stepparent of the child is 0% [72 RS. §9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as a
individual who has at least one parent in common with the decedent, whether by blood or adoption.
OOMMONV~TH OF PENNSYLVANIA
INHERITANDE TAX RETURN
RESIDENT DECEDENT
ESTATEOF Joseph A. Lawler,
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
Sr. FILE NUMBER
Include ~he proceeds of litigation and lhe dale the proceeds were received by the estate. All property jointly.owned with the right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. $62,165.46
Personal Bank Account - CheckinRAccount.'/# 16982290
M&T Bank, Summerdale Plaza, 423~North Enola Road
Enola, PA 17025
Deposit held by Ecumenical Retirement Community
Michael J. Shalonis Funeral Home - Pre-paid funeral
expenses
$5,293.00
$!,319.23
68,777.69
TOTAL ('Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
REV-1510 EX+ (6-98~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
FILE NUMBER
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY
ITEM INCLUDETHENAblEOFTHETRANSFEREE, THEIRRELATIONSHIPTODECEDENTAND DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER. ATTACHACOPYOFTHEDEEDFORREALESTATE. :VALUE OFASSET INTEREST (IFAPPLICABLE) VALUE
1,
Pennsylvania State Employee's Retirement
Service Pension: $135.00 $135.00 0
Joseph A. Lawler, Jr. - Son
Catharine M. Borda - Daughter
Mary Abruzzese - Daughter
Transferred in equal shares October 15, 200f
TOTAL (Also enter on line 7 Recapitulation) $ 0
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+ (12-99)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Joseph A. Lawler, Sr.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION
5.
6.
7.
FUNERALEXPENSES:
Michael J. Shalonis Funeral Home:
Memorial Mass and Burial
Cremation Urn
Grass Marker and Install
Opening Grave
Newspaper/Obituary
Clergy/Mass Offering
Family Flowers
Organist
Luncheon Donation
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name ~ Pemonal Representative(s)
Headstone
AMOUNT
$295.00
$60.00
$500.00
$55o.oo
$96.00
$50.00
$80.00
$75.00
$468.03
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State
Year(s) Commission Paid:
Attorney Fees
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Zip
Street Address
City State
Relationship of Claimant to Decedent
Probate Fees
Accountant's Fees
Tax Return Preparer's Fees
Michael J. Shalonis Funeral Home (cont.);
Discount Allowed
Cremation Society:~6f Pennsylvania:
Cremation, Disposition and Container
Death Certificate and Coroner Fee
TOTAL (Also enter on line 9, Recapitulation
$100.00)
;740.00
;37.00
$2,851.03
(If more space is needed, insert additional sheets of the same size)
I, Joseph A. Lawler, of 205 Four Seasons Lane, Enola, PA 17025, declare this to be my
Last Will.
I give my financial assets, i.e. my checking account at Dauphin Deposit and funds
remaining at PA State Retirement Service to my son, Joseph A. Lawler, Jr.
I give my automobile, 1 1988 white Ford Tempo LX, to my companion, Mary C.
Bostdorf. She is also to receive first choice of any furniture, appliances, jewelry or
clothing in my apartmem in Enola.
I have arranged with the Cremation Society of PA to dispose of my body and to deliver
my ashes to my companion, Mary C. Bostdorf, for disposition or burial.
I hereby appoint my son and my companion to be co-executors of my estate.
day of
IN WITNESS WHEREOF, I have hereunto set my hand this
~'~¢_.-~ , 1995.
Signed, published and declared t~ t~ee TeCt/ator ~ his"[~t
have affixed our names as witnesses.
Name
Address
Address
Michael J. Shalonis Funeral Home '
206 Maple Avenue
Marysville, Pennsylvania 17053
Fax (717)-957-2077 Michael J. Shalonis, Owner Phone (717) 957-3451
STATEMENT OF FUNERAL GOODS AND SERVICES SELECTED
Charges are only for those items that you selected or that are required. If we are required by law or by a cemetery or crematory to use any items, we will
explmn in writing below. If you selected a funeral that may require embalming, such as a funeral with viewing, you may have to pay for embalming. You
do not have to pay for embalming you did not approve if you selected arrangements such as direct cremation or immediate burial. If we charge you for an
embalming, we will explain why below.
For Services of ..... J_q_seph A. Lawler, Sr. Date of Death August 3, 2003 . Date of Contract August 4, 2003
Charge to Mary C. Bostdorf I Dickens Drive Marysville, PA -- --i'}053
-- Nfi~c- ............... Address ~ Sthtc- ........... Zip
A. CHARGE FOR SERVICES SELECTED:
I. PROFESSIONAL SERVICES
Services of Funeral Director and Staff $
Embalming $
Casketing, dressing, cosmetology $
Other Preparation of body ................... $ ......
Hairdresser / Barber $
$
SUB-TOTAL PROFESSIONAL SERVICES Al $
2. USE OF FACILITIES AND SERVICES
For visitation / wake service.- ............. $____
For funeral ceremony $
For memorial service ......................
Equipment & servic-ei;~or ~-vve~i~ s~-ce .... $-- .......
Memorial Mass & Burial $ 295.0_~
§bi~:Y-oY$,L-g~,C]iii¥IES--AKd~-Q~iffM-z3~y- AZ $ 295.00
3. AUTOMOTIVE EQUIPMENT
Vehicle to transfer remains to Funeral Home $
Hearse (Casket Coach) .......... --- - $
Flower Car / Floral Distribution $
Family Car
Lead Car / Clergy Car ................. $
Utility Car $
Out °f t°wn transp°rtati0n ~
$
SUB-TOTAL AUTOMOTIVE EQUIPMENT A3 $
TOTAL SERVICES, FACILITIES, AUTOMOBILE A $ 295.00
B. CHARGES FOR MERCHANDISE SELECTED
Casket $
Other ReceptaCle .......... $
Outer Burial Container ........... $
Acknowledgment Cards $ included
Register Book $ included
Memorial Folders 150 $ included
Prayer Cards $
Temporary Grave Marl~er_s ............ $ included
Burial Clothing ................ $
Other Clothing $
Cremation urn Marbie Urn ..... $--'_--~0.0~0
12x24 Bronze G~ass Mar~r ............. $ 300.00
$
TOTAL MERCHANDISE SELECTED B $ 360.00
C. SPECIAL CHARGES
Forwarding Remains to other Funeral Home $
Receiving Remains form other Funeral Home $
Immediate Burial
Direct Cremation ................. $
$
SUB-TOTAL OF SPECIAL CHARGES C $
D. CASH ADVANCED
Opening Grave/Crypt $ 550.00
Newspaper Patriot News $- ....... 96~.-2~
Newspaper $
Clergy / Mass Offering ..............
Certified Copies of Death Certificate $
Family Flower_s_ .............. Z---_.-_~i'-~_ $ .-_-~ 3~_~0_
Organist $ 75.00
Luncheo~n_D__onati_0n_ ....................... $ _ 4_6g_-_03
-F_amily. F_lp_w_ e_r_s_ ..................... $ 45_.00
SUB-TOTAL OF CASH ADVANCED D $ 1,319.23
We charge you for our services in obtaining the following:
SUMMARY OF CHARGES
TOTAL ABOVE ITEMS (A,B.C:D_) ....... $_.. 1,974.23
Sales Tax (ifApp) _~_ .... 0_ _ °_A $ .... 0-00
TOTAL OF ALL SECTIONS .......... $ !~974.23
LESS: Payment Made Burial Trust $
LESS: Credits Pending_ ................
LESS: Credits granted__ D~is_c_ou_nt.al_l_owed ..... $ ' 100.00
BALANCE DUE by .............. Sep__3, 2_0_0_3 . . $ .!,874.23
A late charge of 1.5% per month on the outslanding balance (annual rate of 18%)
will be added to the balance.
REASON FOR REQUIRED SERVICES OR MERCHANDISE
DISCLAIMER OF WARRANTIES
Our funeral home makes no representations or warranties regarding caskets
or outer burial containers. The only warranties, expressed or implied, granted
in connection with goods sold with the funeral service are the express written
warranties, if any, extended by the manufacturer thereof. No other warranties
including the implied warranties of merchantability or fitness for particular
purpose are extended by the seller.
I agree that I have examined the items of goods and services selected above and found them to be correct and according to the arrangements I have
requested. I acknowledge receipt of a copy of this Statement of Funeral Goods and Services Selected. I represent that I have sufficient funds available for
payment of the cash price for the goods and services selected aolso agree to maok, e payment of $ 1874.23 within 30 days. I agree to be jointly and severally
liable with anyone else who signs below. A LATE CHARGE of 1.5 % per month (18 ~per annum) w~ed to the unpaid balance be mnin 30 da s after
t..h.e date o.f this co. ntr. ac.t. I ..will also. pay the Funeral Director. all reasonable costs Da dbv the Funeral Director to collec~ nmnun~
· noSebe reflectedC°StS onma~e~nmu°efinal billa .ttorney tees and court costs . Any ~tems requested after {he da{e of th~s' agreement will' be cD~'s[(ie['~l" '~)~rt~---of thls-'-'i'~a reeme~t ......... and w, ll' ""'
(Seal)
(Seal)
Purchaser
g-ti~ch~T .......
....................A~us4_u~__t__? 3093 Contract Date
CREMATION SOCIETY OF PENNSYLVANIA
Statement of Goods and Services Selected
Charges are only for items that you selected or are required. If we are required by law or by a cemetery or
crematory to use any items you have not selected, we will explain the reasons in writing below. If you have
selected services that may require embalming, you may have to pay for embalminl~ You do not have to pay
for embalmiqg that you did not approve. Embalmtrtg is not required for direct cremation or immediate
burial Embalmir~g is not required by law, except in certain special cases. If we charged for embalming, we
will explain why below.
For the Service of ~o~e~h ~ ~aw!¢r~ $~.
PROFESSIONAL CRF~FIATION SERVICES Direct cremation
Medical documents / courier fee
Nationwide G~rantee Progr~ (non-re~ndable)
Worldwide Travel Protection Program (non-re~ndable)
Private f~ily identification and/or witnessing cremation
DNA Prese~ation
~ DISPOS~ON
Packaging and fomarding cremated remains (registered mail)
Express mail
Personal delive~ of cremated remains
Delive~ and coordination of cremated remains
co a national cemete~ for burial
Scattering of cremated remains over land or sea
~R C~ISE
Register book
Memorial folders/prayer cards
Thank you cards
Memorial ~e~ice Pa~age
Urn~ Cardboard Container
Urn outer burial container
Other Cremation Container
CertiGed copies of the death certificate
County coroner cremation approval fee
Flowers
Other O t h e r
Newspaper placement fee
Newspaper charges:
$695.00
$45.00
$12.00
$25.~
Date 8-5-2003
23~851
Ifa cremation container, urn, outer bfirial container or
embalmin~ is required this is wily: ~ >:~
SALE PRICE
DOWN PAYMENT
UNPAID BALANCE
*Purchaser understands they desire services we do not render However, a list of service providers can be made available at purchaser's request.
FOl' at-need serlri _o~s only: I hereby agree that I have examined the above stated items and found them to be correct and according to the arrangements requested and
I hereby acknowledge receipt of a copy of this statement. I hereby represent that I have sufficient assets legally available for payment of the cash price and hereby agree and
covenfint jointly and severally to make payments of $ within days. A late charge of I ~ f ~ month amounting to '~ R.~V~ per year is
applied to the unpaid balance beginning ~ days from the date of this agreement. Any additional services or merchandise ordered or requested al~e~ ~t~e date of
this/ag.r'e~¥ntl will be//,considered_: P~tT; ' of this agreement4 and thff~costr thereof will be reflected on the final statement.
/ / ~t~thovized Representative. ~ ." f i' m J ..
/' /: Crerr~/o~,,/Socie~y of Pennayl~a.ic(iI ,?V /' Purcb ....'
Manufacturers and Traders Trust Company
BUFFALO, N.Y. 14240
OFFICIAL CHECK
..,,o,o 288459071--
Issued by Integrated Payment Systems Inc., Englewood, Colorado
Bank One, NA, Denver, Colorado
DRAWER: M & T BANK
/' ~ AUTHORI~ED~E~IGNATUR'E --
PAY
TO THE
ORDER OF
· DATE
08/18/05
JOSEPH ~ t.~I, tLEI~ ,,JR ~62165. ¢6
AUTHORIZED SIGNATURE
NOTICE TO CUSTOMER: The purchase of an Indemnity Bond may be required before this check will be replaced or refunded in the event it is lost, misplaced or stolen.
CO,rvI~vlONWEA'~-~H OF PENNE, YLVANIA
STD--4OP. ! 9--8!
NO/~INATION OF BENEFICIARY(lES)
State Employes' Retirement System
204 Labor & Industry Building
Harrisburg, PA 17120
THIS FORM WILL NOT BE VALID UNTIL FILED IN PROPER FORM!
Your copy will be acknowledged and returned to you by the State Employes' Retirement System.
PRINT IN INK OR TYPE ALL DATA. THIS IS ALEGAL DOCUMENT. NO ERASURES ARE PERMITTED. IF YOU MAKE AMISTAKE,
REQUEST A NEW FORM.
L
,A,.: [--'] A. ACT,VE I--1 A YESTEE .ET,.EO
1
A. PRINCIPAL BENEFICIARY(lES)
In the event of my death, the full amount of my retirement account, including any outstanding amounts payable to me, shall be paid to the
Principal Beneficiary(ies) designated below. If two principal beneficiaries are listed then they shall share equally. Should one principal
beneficiary predecease me, then the surviving beneficiary will receive the entire amount.
NAME DATE OF BIRTH ADDRESS
~ ' ~'" ' ~ ·L.'~i~ - '"~ (.STREETI~. CITY. STATE:,, Z P CODE)
4 B. CONTINGENT (SECOND) BENEFICIARY(lES) '
In the event of my death, and there are no surviving principal beneficiaries, the full amount of my retirement account, including any outstand-
ing amounts payable to me, shall be paid as designated below. If more than one contingent beneficiary is listed, then they shall share
equally. Should one contingent benefJciary(ies) predecease the other(s), then the surviving beneficiary(les) will receive the entire amount.
'":': CD ~r '"'1
C. GUARDIAN
(To be listed if any beneficiary named above is under 18 years of age.)
ADDRESS
(STREET, CITY, STATE, ZIP CODE)
D. COMPLETE ALL BLOCKS BELOW
Two witnesses are required to your signature. (A benefici
STATE EMPLOYEE'S
D-L"'TI D ~'1./~1~ IMT. ~VqT~lgJ
REVIEWER
WITNESS ABOUndS (ST~E;'~ITY,~T~TE. ZIP' ~ODE) WIT E' STATE, ZIP CODE)
a i
IF THIS FORM DOES NOT MEET YOUR_ SP_E_C!.F_IC_N_EED_S_, _SEE._T_H.E_.R_E.V..E.R_S_E SIDE FOR AN EXPLANATION OF ALTERNA-
DESIGNATED SURVIVOR S NAME
ADDreSS
SOCIAL SECUritY nUMbER
DATE Of biRTH (AttAC~ DOCUMeNTAT ON--SEE INSTRUCTIONS)
MONTH DaY
lMALE ~"~ FEMALE
I elect another form of payment plan specified in the attached letter. Complete details, including beneficiary or designated survivor information and
method of di,Str buti6h are listed, (Since payments under this plan must be certified to be of equivalent value, arrangements with the Retirement System
should be made in advance. Some of the restrictions under this plan are: (a) The monthly annuity shall be payable Without reduction during the member's
lifetime (except members with Joint Coverage), and (b) The sum of all annuities payable to any designated survivor annuitants may not exceed one and
one-half times the amount of the annuity paid to the member.)
SIGNATURE
"~. FiR.ST) . . (MI~OD[~E) '/*? LAST)
APPLICANT INFORMATION ~ ~
SOCIAL SECURITY NUMSER
/
/7
YEAR
DATE Of BIRTH (ATTACH D(~UMENTATJON--SEE iNSTRUCTIONS)
t 7
MONTH DAY
SEX
LAST EMPLOYING AGENCY/DEPARTMENT
DATE OV TERMiNATiOn
MONTH DAY YEAR
TELEPHONE NUMBER
(CITY) (STATE) (ZIP CODE)
CERTIFICATION
HaVing read and understood all of the preceding provisions, I acknowledge that my selectiOn of a retirement payment plan
(option) is final and binding. I certify that all statements made on this application are true and correct to the best of my
knowledge and belief. I understand that any willful falsification or failure to provide the information required may result in
the forfeiture of my rights to future benefits based on such information and such other penalties as provided by law.
V Two witnesses are required to your signature. A beneficiary or designated survivor may not be a witness.
-/ WITNESS SIGNATURE
MEMBER'S COPY
CO,v~R~ON, WEALY~-~ OF PENNSYLVANIA
RS'6
3-82
CATION FOR RETIREMENT ALLOWANCE
PAYMENT PLAN SELECTIONS
STa~E EMPLOYES' RETIREMENT SYSTEM
204 LASOR & INDUSTRY BUILDING
HARRISSURG. PENNSYLVANIA 17120
You may elect to rec'6ive a portion of your benefits in a lump sum payment and the remainder in a reduced monthly allowance under one of the monthly
payment plans liste~l beloW. Only one lump sum payment is permitted and only at the time of retirement. The lump sum payment may not, exceed your
accumulated dedu~ctions (your contributions plus earned interest). You may, however, elect to receive less. The amount of reduction to your monthly
benefits depend,~ on how much you elect to receive in a lump sum payment.
IF YOU DO NOT WANT A LUMP SUM PAYMENT, LEAVE THIS SECTION BLANK
I elect a lump sum payment from~my accumulated deductions as follows:
~] AIl contributions and earned interest
(Check one.) [] All contributions but n~o interest
E~$ of ac mulateddeductions
The remainder of my benefits are to be paid under the monthly payment plan sp~cified below.
SIGNA~MRE .
MONTHLY PAYMENT pLANS
(Complete only the plan you want--leave others blank.)
I understand that under this plan I will receive the maximum amount each month for as long as I live. If I die before receiving in payments an amount equal
to my own accumulated deductions (my contributions plus earned interest) as they were at the time of my retirement, the balance will be paid to my
beneficiary(les). I may name one or more beneficiaries and may change beneficiaries at any time. I have completed and attached a Nomination of
Beneficiary(les) form.
I understand that under this plan I Will receive a reduced retirement allowance. In addition to monthly payments to me for as long as I live. a value is
placed on my retirement allowance called the "present value". This includes the State's contribution as well as my own accumulated deductions. All
payments to me are subtracted from the present value. Any balance remaining at my death will be paid to my beneficiary(les). I may name one or more
beneficiaries and may change beneficiaries at any time. I have completed and attached a Nomination of Beneficiary(les) form.
DATE
x:
I understand that under this plan I will receive a reduced retirement allowance for life. The amount of reduction is based on the age and sex of myself and
the person I name as my "Designated Survivor". Only one person may be named as my Designated Survivor. At my death, that person will continue to
receive for life the same monthly amount as was paid to me, in addition to any outstanding amounts payable to me. I have indicated my Designated
Survivor in the space below on this form.
SIGNATUre
I undel ~ this plan I will receive a reduced retirement allowance for life. The amount of reduction is based on the~*age and sex of myself and
the name asrmy "Des gnated Survivor". Only one person may be named as my Designated Survivor. At my death, that~person will receive, for life,
one-half (1/2)~ ~ monthly amount that was paid to me, in addition to any outstanding amounts paYable to me. I have indicated, my Designated Survivor in
the space below on this form
IDATE
~' DESIGNATED SURVIVOR II~ORMATION (FOR OPTION 2 OR 3 ONLY) ~,
Complete the following information for your Designated Survivo[.(D~LY if you elected a monthly payment plan under Option 2 or 3. If you selected Full
Retirement or Option 1, leave this section blank; nominate your beneficiary(les) on a beneficiary form and attach it to this application.
H~A:~I:~Bt.~G PA 1.7.~N(~ 26 2003
BUREAU OF ZNDZVZDUAL TAXES
IHHERZTANCE TAX DZVTSTON
DEPT. 280601
HARRZSBURG, PA 17128-0601
COHHON#EALTH OF PENNSYLVANZA
DEPARTNENT OF REVENUE
NOTZCE OF ZNHERZTANCE TAX
APPRAZSENENT, ALLO#ANCE OR DZSALLO#ANCE
OF DEDUCTZONS AND ASSESSNENT OF TAX
JOSEPH A LANLER JR
5 ROUND HILL RD
CAHP HILL
'04 FEB 13 73:29
REV-15~? EX &FP
DATE 02-16-2006
ESTATE OF LANLER JOSEPH A
DATE OF DEATH 08-05-2005
FZLE NUHBER 21 03-0678
COUNTY CUHBERLAND
ACN 101
Aeoun~ Reei~ed
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGISTER OF WILLS
CUNBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THTS LINE ~ RETAZN LOWER PORTZON FOR YOUR RECORDS ~
REV-1567 EX AFP (01-03) NOTZCE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTZONS AND ASSESSHENT OF TAX
ESTATE OF LAWLER JOSEPH AFZLE NO. 21 05-0678 ACN 101 DATE 02-16-2006
TAX RETURN NAS: (X) ACCEPTED AS F/LED ( ) CHANGED
RESERVATZON CONCERNZNG FUTURE ZNTEREST - SEE REVERSE
APPRAZSED VALUE OF RETURN BASED ON: ORZGTNAL RETURN
1. Real Es~:a~e (Schedule A) (1) . O0
2. S*ocks and Bonds (Schedule B) (2) . O0
3. Closely Held S~:ock/Per~:nershlp Zn~eres~ (Schedule C) ($) .00
c~. Nor:kgages/No~ces Receivable (Schedule D) (fi) .00
5. Cash/Bank Deposits/Misc. Personal Proper~y (Schedule E) ($) 68;777.69
6. Jointly Owned Proper~y (Schedule F) (6) .00
7. Transfers (Schedule 6) (7) .00
8. To,al Asse~s (8)
APPROVED DEDUCTZONS AND EXEHPTIONS:
9. Funeral Expenses/Adm. Cos~:s/Nisc. Expenses (Schedule H) (9) 2,851.03
10. Deb*s/Nor*gage Liablll:t:ies/Liens (Schedule Z) (10) .00
11. To,al Deductions (11)
12. Ne* Value of Tax Re*urn (12)
15.
1~. (1:5)
(1~)
Chari*able/Governmen~al Beques*s; Non-elected 9115 Trusts (Schedule J)
Ne~ Value of Es~e~e Sub~ec~ ~o Tax
NOTE: To insure proper
credi~ ~o your account,
submi~ ~he upper portion
of ~his fore wi~h your
~ax payment.
68,777.69
2.851.03
65,926.66
.00
65,926.66
NOTE:
If an assessment was issued previously, lines 16, 15 and/or 16, 17, 18 and 19 will
reflect figures that lnclude the total of ALL returns assessed to date.
ASSESSHENT OF TAX:
15. Amoun~ of L/ne 1~ a'E Spousal re*e (1E) . O0 X O0 = . O0
16. Aeoun~ of Line 1~ ~exable e~ Lineal/Class A ra~e (16) 65,926.66 X 065 = 2,966.70
17. Amount: of Line 1~ e* Sibling ra*e (17) .00 X 12 = .00
18. Amoun~ of Line 1~ ~exable a~ Collateral/Class B re*e (18) .00 X 15 = . O0
19. Princ/pal Tax Due (19)= 2,966.70
TAX CREDTTS:
PAYMENT
DATE
11-26-2003
DZSCOUNT (+)
~NTEREST/PEN PAZD (-)
.00
RECE.[PT
NUNBER
CD003292
ANOUNT PAZD
2,966.70
ZF PAZD AFTER DATE ZNDICATED, SEE REVERSE
FOR CALCULAT[ON OF ADDZTZONAL ZNTEREST.
TOTAL TAX CREDIT I 2,966.70
BALANCE OF TAX DUEI .00
ZNTEREST AND PEN. I .00
TOTAL DUE I .00
ZF TOTAL DUE TS LESS THAN $1, NO PAYNENT TS RE~UTRED.
ZF TOTAL DUE TS REFLECTED AS A "CREDZT" (CR), YOU NAY DE DUE~_</~
REFUND. SEE REVERSE STDE OF THTS FORH FOR [NSTRUCTTONS.)'~5)~
RESERVATION:
Estates of decedents dying on or before December 1Z, 1982 -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Coaaoneealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at tho lawful Class B (collateral) rate on any such futura interest.
PURPOSE OF
NOTICE:
PAYHENT:
REFUND (CR):
OBJECTIONS:
ADNIN-
ISTRATZVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST=
To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of ZOOO. (72 P.S.
Section 9140).
Detach tho top portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side.
--Hake check or money order payable to: REGISTER OF #ILLS, AGENT
A refund of a tax credit, which Nas not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1515). Applications ara available at the Office
of the Register of Nills, any of the 23 Revenue District Offices, or by calling tho special Z4-hour
answering service for forms ordering: 1-800-362-2050~ services for taxpayers aith special hearing and / or
speaking needs: 1-800-4~7-5010 (TT only).
Any party in interest not satisfied with the appraisement, a11oaanca, or disallowance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 181021, Harrisburg, PA 17128-1011, 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 in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. Sea page 5 of tho booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
If any tax duo is paid within three ($) calendar months after tho decodent's death, a five percent {5Z) discount of
tho tax paid is allowed.
The 1SI tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in tho the same tiaa period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January l, 1981 bear interest at the rate of
six (61) percent par annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January 1, 1981 will bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by tho PA Department of Revenue. Tho applicable interest rates for 1981 through 2003 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Yea.~r Rate Factor Yea.~r Rate Factor
1982 2OZ .000548 1987 91 .000247 1999 7X .000192
1983 161 .000¢38 1988-1991 111 .000S01 ZOO0 81 .000119
1984 111 .000301 1991 91 .000247 2001 91 .000247
1985 13Z .000356 1993-1994 71 .000192 ZOOZ 61 .00016~
1986 101 .000Z74 1995-1998 9Z .000Z47 2003 51 .000137
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DATLY INTEREST FACTOR
--Any Notice issued after tho tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond tho date of the assessment. If payment is made after tho interest computation date shown on the
Notice, additional interest must be calculated.
STATUS REPORT UNDER RULE 6.12
Name of Decedent: ::JtJsc=r>H A~ l-A-t;Vl--t;'7(
Date of Death:
~\~
Wtll No.:
(J 8" -tJJ - ;Zr1a..5
2tJtJ3-tJlJG //)
Achw!. Nu..
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes~ No 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 _ No ~
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal~resentative s. tate an account informally to the parties
in interest? Yes Jbl No 0
r-
lO
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. pd4 d J
D,"e '7 ;?-tJ.r l... ~Xrd L ·
~nire ?7'-
'J/J6 {;f'}f A-. fA- wk-'N... .r/L
. ,
Name ~
S- /t~q.vb Hd-t> /<.."A- D
CAfiff )Tltb... I',A-. / /c/J/
Address
(71')) >3 /-~ 'rf/
Telephone N;. r
~.::~
(.>
C'....J
..... '~..l
l.":~
~:-,
C..:,,:;I
C-'
Capacity: ~Personal Renresel1tative
o Counsel for .personal representative
cI
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 7/13/2005
BOSTDORF MARY C
1 DICKEN DRIVE
MARYSVILLE, PA 17053
RE: Estate of LAWLER JOSEPH A
File Number: 2003-00678
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 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:
8/03/2005
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
~~::::~
REGISTER OF WILLS
cc: File
Counsel
Judge
uuf