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Home My WebLink About03-0763PETITION FOR GRANT OF LETTERS OF ADMINISTRATION also known as To: Deceased. Social Security Register of Wills for the County of ~'a~[e~-ln~ in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/a~ 18 years of age or older, appl ~, ~a for letters of administration on the estate of (d.b.n.; pendente lite; durante absentia; durante minoritate) the above decedent. Decendent was domiciled at death in ~ ~'?~ ~'r~ ,{~ ,_l~_ _. C.o, unty, Pennsylvania, with h ~ e- last family or principal residence at ~ (..[~e-t,mo~,tT' ~/~ ~ (list street, number and municipality) Decendent, then qL y~s of ~~ ~ ] ~ ~ Decendent at death owned property with estimated values as folllows: (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 followa;_ ~-te~ _.51"1~'" /'~' '~'~, Petitioner after a proper search ha~ the following spouse (if any) and heirs: Name ascertained that decedent left no will and was survived by .,~aRelationship Residence THEREFORE, appropriate form to the undersigned. petitioner(s) respectfully request(s) the grant of letters of administration in the OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~- ss COUNTY OF ("_,~¥cr- !~ ~. The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal representative(s, of the above decedent petitioner(s, will well truly administer the estate according to law. Sworn to or affirmed and subscribed c- ~ before me this 16th day of ! ~ Donna M. Ot:~:o, lgt l~a~al~3r l(egis~~ / No. 21-2003-763 Estate of ~'a~,c~ ~. ~/ ,Deceased GRANT OF LETTERS OF ADMINISTRATION AND NOW ~~,- 17t-h 1~ ~flOa in consideration of the petition on the reverse side hereof, satisfactory proof having been presented beforeme, IT IS DECREED that Gary 1~1. l~_-Jffer, is/a~ entitled to Letters of Administration, and in accord with such finding, Letters of Administration are hereby granted to ~f ~' fi~-iffov-: Jr. in the estate of .q~_~h E_C~ FEES Letters of Administration ..... $ 60.00 Short Certificates(~) .......... $ 3.00 Renunciation ........ .{.1.1 .... $ 5.00 _ 3CP $ lO.OO TOTAL ~ $ 78.00 Filed .~,p~:e~l~r' 17'o'2003 A.D. ~ ATTORNEY (Sup. Ct. I.D. No.) ADDRESS 7~7- 21-2003-763 REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA RENUNCIATION In Re Estate of SARAH E. CAPP, deceased. The undersigned son, CHARLES N. CAPP, of the above decedent hereby renounces the right to administer the estate and respectfully asks that Letters of Administration be issued to GARY M. PEIFFER, JR., a nephew of Sarah E. Capp. Witness my hand this day of /~//~ , 2003. Sworn to and subscribed before me this ~ day of /=fwj ~- , 2003. Not~ ~ublic ' - 21-2003-763 1500 EX i6-00 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 I-- Z u.I LU LU REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT X FILE NUMBER 21 _ 03 COUNTY CODE YEAR DECEDENT'S NAME (LAST, FIRST. AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER SARAH E. CAPP i 174-20-0174 DEAT~rvI~:DD-Y~AR) ' ! DATE OF BIRTH (MM-DB-YEAR) 02/12/03 04/01/11 (I~PPLICABLE) SuRvIVING sPOUSE's NAME (LAST, FIRST, A~D MIDDLE iNiTIAL} 0763 NUMBER THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS ~OCIAL sECURITY NUMBER- J"~ 1. Original Return r--14. Limited Estate r--~6 Decedent Died Testate (Attach copy of Will) F-'J 9. Litigation Proceeds Received ---1 Supplemental Return [~] 4a. Future Interest Compromise (date of death after 12-12-82) r'--j 7. Decedent Maintained a Living Trust (Attach copy of Trust) I'~10. Spousal Poverty Credit (date el death between 12-31-91 and 1-1-95) ]3, Remainder Return (date of death prior to 12-13-82) '--1 Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes ['~ 11. Election to tax under Sec. 9113(A) (A~ach Sch O) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME GREGORY R. REED, ESQUIRE FIRM NAME (if Applicable) ?EEEPHONE NUMBER (717) 238-0434 COMPLETE MAILING ADDRESS 3120 Parkview Lane Harrisburg, PA 17111 -. - 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Properly (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) ~] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate ProperLy (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)(10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line tl) 13. 14. 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) 30,000.00 (8) 1,010.18 203,301.60 (11) (12) (13) (14) 30,000.00 204,311.78 0.O0 0.00 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x .0 (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) 20. [] 0.00 > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < Decedent's Complete Address: tSTREET ADDRESS Cla_r_e~mont Nursing & Rahab Center 375 Claremont Drive clTYCarlisle ~ STATEpA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 0.00 (2) 0.00 (3) (4) (5) 0.00 (5A) (5B) 0.00 Total Credits ( A + B + C ) 3. Interest/Penalty if applicable D. Interest E Penalty Total Interest/Penalty ( D + E ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; .......................................................................................... [] [] b. retain the right to designate who shall use the property transferred or its income; ............................................ [] [] c. retain a reversionary interest; or .......................................................................................................................... [] [] d. receive the promise for life of either payments, benefits or care? ...................................................................... [] [] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. [] [] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ [] IF THE ANSWER TO ANY OF THE , tur QUJ~nm "r"~i ABOVE !STIONS IS YES, YOU MUST COMPLETE SCHEDULE 6 AND FILE IT AS PART OF THE RETURN. Under penalties of per~,l~ I declare that I have examine~Lt~i~, t.ur~,t~d~, dig aa~pany,ng schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of prepa~j,~ther than the~ive isj~j~ on all i~l/l~aUon of which preparer has any knowledge. SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE BATE 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 if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 RS. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. SCHEDULE "A" REAL ESTATE ESTATE OF: SARAH E. CAPP FILE NO. 21-03-0763 ITEM NUMBER DESCRIPTION 3 acres in Middle Paxton Township, Dauphin, County, Pennsylvania ALL THAT CERTAIN three (3) acres of land along Mountain Road in Middle Paxton Township, Dauphin County, Pennsylvania, and described as follows from a survey by William B. Whittock, Professional Engineer, dated October 16, 1966: BEGINNING at a point in the center of L.R. 22026, said point being located and referenced westwardly a distance of 1,230 feet, more or less, from the center line of T-300; thence along the center line of L.R. 22026 South 76 degrees 23 minutes 30 seconds west, a distance of 100.0 feet to a point; thence due North a distance of 745.0 feet to a point; thence North 89 degrees 53 minutes 22 seconds east, a distance of 259.13 feet to a point; thence along Parcel #40 on Tax Map No. 43 - 9, South 6 degrees 02 minutes 30 seconds west, a distance of 365.0 feet to a point; thence along Parcel #8 on Tax Map No. 43 - 9, South 73 degrees 58 minutes 50 seconds west, a distance of 97.98 feet to a point; thence along the same South 5 degrees 02 minutes 02 seconds west, a distance of 333.24 feet to a point, the place of Beginning. (See attached Settlement Sheet, marked Exhibit "1" and incorporated herein by reference.) VALUE AT DEATH $ 30,000.00 TOTAL $ 30,000.00 SCHEDULE "H" FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES ESTATE OF: SARAH E. CAPP FILE NO. 21-03-00763 ITEM NUMBER mo DESCRIPTION Funeral Expenses: VALUE AT DATE OF DEATH Administrative Costs: Filing fees - Register of Wills Expenses in selling real estate in Middle Paxton Township, Dauphin County, PA See a copy of HUD-1 Settlement Sheet attached hereto, marked Exhibit "1" and incorporated herein by reference. 78.00 932.18 TOTAL $ 1,010.18 SCHEDULE "I" DEBTS OF DECEDENT, MORTGAGE LIABILITIES AND LIENS ESTATE OF: SARAH E CAPP ITEM NUMBER DESCRIPTION Commonwealth of Pennsylvania Department of Public Welfare See a copy of letter from Robert E. Lester, Claims Investigation Agent, Department of Welfare, dated September 22, 2003 attached hereto, marked Exhibit "2" and incorporated herein by reference. FILE NO. 21-03-0763 VALUE AT DATE OF DEATH $ 203,301.60 Total: $ 203,301.60 SCHEDULE "J" BENEFICIARIES ESTATE OF: BETTY J. RIFE ITEM NAME AND ADDRESS NUMBER OF BENEFICIARY A. Taxable Bequests: 1. Charles N. Capp 3075 Pecan Circle Fairfield, CA 94533 RELATIONSHIP Son FILE NO. 21-03-0763 AMOUNT OR SHARE OF ESTATE Residue B. Charitable and Governmental Bequests: None Name of Decedent: Date of Death: Will No. To the Register: CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Sarah E. f".~pp: ~.~.~] February 12, 2003 2flfV~-O(176q Admin. No. 2]-0~-0762 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 NoveMber 6, 2003 : Name Address Charles Capp 2290 Diamond Blvd., Suite 100, Concord, CA 94520 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: Signature Name Gregory R. Reed, Esquire Address 3120 Parkview Lane Harrisburg, PA 17111 Telephone (717) 238-0434 Capacity: ~ Personal Representative × Counsel for personal representative BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA ]7128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX &FP (01-03) GREGORY R REED ESQ 5120 PARKVIEW LN HBG PA 17111 DATE 12-22-2005 ESTATE OF CAPP SARAH DATE OF DEATH 02-12-2005 FILE NUMBER 21 05-0765 CbUNTY CUHBERLAND ACM 101 I Amount Remitted I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~'* RETAIN LONER PORTION FOR YOUR RECORDS *.~ REV-1547 EX AFP C01-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF CAPP SARAH E FILE NO. 21 05-0765 ACN 101 DATE 12-22-2005 TAX RETURN WAS: C X) ACCEPTED AS FILED C } CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON.- ORIGINAL RETURN 1. Real Estate CSchedule A} 2. Stocks and Bonds CSchedule ]~) 3. Closely Held Stock/Partnership Interest CSchedule 4. Hortgages/Notes Receivable CSchedule D) 5. Cash/Bank Deposits/Misc. Personal Property CSchedule E) C5) 6. Jointly Owned Property CSchedule F) (6) 7. Transfers CSchedule G) C7) 8. Total Assets APPROVED DEDUCTIONS AND EXEHPTIONS: 9. Funeral Expenses/Adm. Costs/M/sc. Expenses CSchedule H) 10. Debts/Mortgage Liabilities/Liens CSchedule I) (10) 11. Total Deductions 12. Net Value of Tax Return ~OrO00.O0 .00 .00 .00 .O0 .00 .00 C8) 1,010.18 NOTE: To insure proper credit to your account, submit the upper port/on of this form w/th your tax payment. 13. 14. NOTE: 50,000.00 ASSESSHENT OF TAX: 15. Amount of L/ne 14 at Spousal rate ClS) 16. Amount of L/ne 14 taxable at Lineal/Class A rate C16) 17. Amount of L/ne 14 at Sibling rate C17> 18. Amount of L/ne 14 taxable at Collateral/Class B rate C18} 19. Principal Tax Due · O0 x 00 = . O0 · 00 x 045 = .00 · O0 x 12 = . O0 · O0 x 15 = .00 c19>= .00 TAX CREDITS: PAYMENT DATE IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. RECEIPT NUMBER DISCOUNT C+> INTEREST/PEN PAID C-) AMOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE -°°r .00 .00 .00 C IF TOTAL DUE IS LESS THAN 81, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CA), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) Char/table/Governmental Bequests; Non-elected 9113 Trusts CSchedule J) C13) .00 Net Value of Estate Subject to Tax C14) 174,511.78- Zf an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 wi1! reflect figures that include the total of ALL returns assessed to date. 205~501.60 c11) 2o4.31 1.78 ¢12) 174,511.78- RESERVATION= Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enSoyment to Class 8 (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonuealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawfu! Class 8 (collateral) rate on any such future interest. PURPOSE OF NOT[CE= PAYMENT: REFUND OBJECTIONS: ADMIN- ISTRATIVE CORRECT[ONS= DISCOUNT= PENALTY= INTEREST= To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of 2000. (72 P.S. Section 91401. Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. --Make check or money order payable to: RF, OZS~,"~ OF NZLLS) AGENT A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISIS). Applications are available at the Office of the Register of Wills, any of the 25 Revenue District Offices, or by calling the special 24-hour answering service for forms ordering= 1-800-562-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-$020 (TT only). AnY party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as sho~n on this Notice must obSect within sixty (60) days of receipt of this Not~ce by= --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans° Court. Factual errors discovered on this assessment should be addressed in writing to= PA Department of Revenue, Bureau of Individual Taxes, ATTM= Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (7171 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (51 calendar months after the decedent's death, a five percent (SX) discount of the tax paid is allo~ed. The 15~ 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 the the same time 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 (11 day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (SX) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced bY the PA Department of Revenue. The applicable interest rates for 1982 through 2005 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Yea.~r Rate Factor 1982 20~ .000548 1987 9~ .000247 1999 7~ .000192 1983 16~ .000438 1988-1991 11X .000301 2000 8~ .000219 1984 11~ .000301 1992 9~ .000247 2001 9~ .000247 1985 13~ .000556 1993-1994 7~ .000192 2002 6~ .000164 1986 10~ .000274 1995-1998 9~ .000247 2003 5~ .000157 --Interest is calculated as follows: /NTEREST = BALANCE OF TAX UNPATD X NUNBER OF DAYS DELI'NqUENT X DAXLY XNTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date sho~n on the Notice, additional interest must be calculated. Name of Decedent: Date of Death: STATUS REPORT UNDER RULE 6.12 WillNo.: "~'t/','~-- Admin. No.: ~2C~ ~3 '- '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[-] 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: ~ Date: c. Did the personal r_.~resentative state an account informally to the parties in interest? Yes ~] No ['"] ' c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the. flmhans' C~urt and may be attached to this repoi. ,~..,.~_A,;~~L.~'~/'/..Q~ ,m,~J'~P~ Signature Name / 7 17 -- 2. 3f'--- Telephone No. Capacity: [-] Pe.f.$onal Representative [__h~ounsel for personal representative GREGORY R REED ESQUIRE 3120 PARKVIEW LN HARRISBURG PA 17111 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE BUREAU OF FINANCIAL OPERATIONS DIVISION OF THIRD PARTY LIABILITY ESTATE RECOVERY PROGRAM PO BOX 8486 HARRISBURG, PA 17105-8486 November 5, 2003 Re: SARA CAPP CIS #: 550126048 SSN: 174-20-0174 Date of Death: 02/12/2003 Dear Attorney Reed: This is to acknowledge receipt of payment in the amount of $27,807.51 regarding the above-referenced estate. This reflects payment up to the value of the estate. If any additional funds become available, please contact me. Your cooperation in resolving this matter is appreciated. Sincerely, Robert E. Lester Claims Investigation Agent 717-772-6611 717-705-8150 FAX