HomeMy WebLinkAbout03-0811PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Estate of S g f~ U ~, ~ ~ A ~"~ } d
also known as
Social Security No.
No. ~-~- o~//
To:
Re~gister of Wills for the
County of
Commonwealth of Pennsylvania
in the
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older, app[
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 CU Ut ~ '0~(I.[AO~ County Penns- Iv- '
.... j, y ama, WI[fl_
h I ~' last family or principal residence at ~'2. fg0,~o/c ")~fl ~tJi~' , C/4~kl.~ k~', {)~
(list street, '~umb~r a~nd municipality) ? '
Decendent, then ~ 2_ years of, a_ge, died ~£ (o.~- ~ / o t-9- '.~ o
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 follows:
~ 00c~, oo
Petitioner after a proper search ha -~'
the following spouse (if any) and heirs:
Name
ascertained that decedent left no will and was survived by
Relationship Residence
THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the
appropriate form to the undersigned.
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ~ ss
COUNTY OF 0~r~l~g
The petitioner(s) above-named swear(s) or affirm(s)that the
statements in the foregoing petition are true and correct to the best
of the knowledge and belief of petitioner(s) and that as personal
representative(s) of the above decedent petitioner(s) will well and
truly administer the estate according to law.
Sworn to or affirmed and subscribed
before me this r~'7-H day of
No.
Estate of .~~/ g~q_~.-~ ~ , Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW ~c'Tr~ ~& e-- ~) .,~_Oc~, in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that ~r~.,.-or~ Y~_~,~-~r~
is/are entitled to Letters of Ad~nistration, and in accord with such finding, Letters of Administration
are hereby granted to
in the estate of .~rr~,o.[ IY~m-f~n
FEES
Letters of Administration ..... $
Short Certificates( ) .......... $
tion ................ $
$
TOTAL ~
Filed (~..-..,:~.~..-A.D. 19
ATTORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
Name of Decedent:
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Date of Death:
Will No.
Admin. No.
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 :
Address
Name
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
Signature
Name
Address
Telephone( )
Capacity: __
Personal Representative
Counsel for personal representative
Cumberland County - Register Of wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 8/15/2005
MARTIN ANNA
52 BROOK DRIVE
CARLISLE, PA 17013
RE: Estate of MARTIN SAMUEL
File Number: 2003-00811
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:
9/10/2005
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
~t~~
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Counsel
Judge
rA
Register of Wills of Cumberland County
Name of Decedent:
STATUS REPORT UNDER RULE 6.12
51\ t-\ v ~L M/\ (L'T l tJ
Date of Death: 5"~ fT 10 -< 0 0 3
)
Estate No.: :z 00 J - 0 cJ F 1/
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 ~1;ether administration of the estate is complete:
Yes GJ No 0
2. If the answer is No, state when the personal representative reasonably believes that
the administration will be complete:
J. 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
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal represent~e state an account informally to the parties in
interest? Yes 0 No t1
c. Copies of receipts, releases, joinders and approval of fonnal or infonnal
accounts may be filed with the Clerk of the Orphans' Court and may be
attached to this report.
Date:
9/~/())
v0C/JUy / J/kf}~ :n~
Signature
0--.
Lf"J
Name
ANNA
MA(lTfN
c
5':L rJ3>{CooL V(l. 1 C4.(/J (JAr) PA 11\\ J J
Address
.f{ 1-22f ~ - ~lL)J
Telephone No.
CJ\
I
L-'~_:"
{.-~
eM'';'
,--..!
(~."
Capacity: B'Personal Representative
o Counsel for personal representative
ep
15056051058
REV-150 0 EX (06-05)
PA Department of Revenue OFFICIAL USE ONLY
Bureau of Individual Taxes
Po Box 2eosol County Code Year File Number
INHERITANCE TAX RETURN
Hamsburg, PA 17128-0601
E ~ 0 ~ 0 ~ ~ I
RESIDENT DECEDENT
NTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
159-24-8968 09!10/2003 11 /12/1930
Decedent's Last Name Suffix Decedent's First Name
MARTIN MI
SAMUEL
_
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name
MARTIN MI
ANNA
Spouse's Social Security Number
094-56-2352 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
'. ~ 1. 1. Original Return 2. Supplemental Return
3. Remainder Return (date of death
4. Limited Estate prior to 12-13-82)
4a. Future Interest Compromise (date of 5. Federal Estate Tax Retum Required
death after 12-12-82)
.,... 6. Decedent Died Testate
(Attach Copy of Will) °' !, 7. Decedent Maintained a Livin Trust
9 -.-.. 8. Total Number of Safe Deposit Boxes
(Attach Copy of Trust)
.. ,, 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death 11. Election to tax under Sec
9113(A)
b
.
etween 12-31-91 and 1-1-95) (Attach Sch. O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHO
N
ame ULD BE DIRECTED TO:
Daytime Telephone Number
ABRAHAM R. MARTIN
(717) 243-522 o
Firm Name (If Applicable) CQ ,~ J
x, ; ,
REGISTER
g
USE OI~ ~ ~ j
[
~
_;~~ f`' 2 C 3 7
First line of address m - - .•
f ~ '
`
52 BROOK DRIVE : t
=: ~7
~
~
Second line of address ~O ~ r- {_~
3 +i
'J
~
--4 «--~-
~~
D
c;7 ~)
Ciry or Post Office
CARLISLE
State ZIP Code
PA 17015
W ~i
DATE FILED
Correspondent's a-mail address: db2WIn~801.C0f11
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belies,
It is true, correct and complete. Declaration of preparer other than the personal representative is based on all Information of which preparer has any knowledge.
SIGNATURE OF PE~ ESPONSG~ FILING RETURN
DATE
ADDRESS 01 /13/10
52 BROOK DRIVE, CARLISLE, PA 17015
__ ___
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE - -- -
__.
DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
1 505605 1 058 Side 1
15056051058
J
._
15056052059
REV-1500 EX
Decedent's Social Security Number
oecedentsName SAMUEL - MARTIN
_ 159-24-8968
RECAPITULATION
~ ~ " ~ -~~ ~- • ~ -
1. Real estate (Schedule A) .........
................................ ....
1. 0.00
2. Stocks and Bands (Schedule B) .......
............................ ....
2, 0.00
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) .. ... 3. 0.00
4. Mortgages & Notes Receivable (Schedule D)
..... . .............. . . ..
4, 0.00
5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ..... ... 5 150.00
6. Jointly Owned Property (Schedule F) ;Separate Billing Requested .... ... 6. 0
00
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property .
(Schedule G) Separate Billing Requested..... ... 7. 0.00
8. Total Gross Assets (total Lines 1-7).
..... .
.. ............
... 8.
150.00
9. Funeral Expenses & Administrative Costs (Schedule H) ..
........... .
......
... s.
980.00
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 1
............ ...
0,
0.00
11. Total Deductions (total Lines 9 & 10) ..
.............................. ... 11.
980.00
12. Net Value of Estate (Line 8 minus Line 11) ..
.
......... ...... .
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
... 1z.
-830.00
an election to tax has not been made (Schedule J)
............ . ......... .. 13.
0.00
14. Net Value Subjeet to Tax (Erne 12 minus Ltne 13)
. _ .__. _.
..
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 1a. 830.00
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(t2) x .o- 0.00 1s. 0
00
16. Amount of Line 14 taxable .
at lineal rate X .0 _ 0.00 16. 0
00
17. Amount of Line 14 taxable .
at sibling rate X .12 0.00 17 0
00
18. Amount of Line 14 taxable .
at collateral rate X .15 0.00 18 0.00
19. TAX DUE ................................ ...................... ..19. 0.00
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
L_. 15056052059 Side 2
15056052059
REV-1500 EX Page 3
Decedent's Complete Address: F~~e Number
DECEDENT'S NAME
SAMUEL MARTIN DECEDENT'S SOCIAL SECURITY NUMBER
STREET ADDRESS - 159-24-8968
52 BROOK DRIVE
__
cfrr - -
CARLISLE ,STATE _ _ - zIP- ---- -
PA 17015
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments (1) 0.00
A. Spousal Poverty Credit 0.00
B. Prior Payments 0.00
C. Discount
0.00
3. InterestlPenalty if applicable Total Credits (A + B + C) (2) 0.00
D. Interest 0.00
E. Penalty
0.00
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENTotal InteresUPenalty (D + E) (3) 0.00
Fill in oval on Page 2, Line 20 to request a refund.
(4)
0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE
.
(5)
0.00
A. Enter the interest on the tax due.
(SA) 0.00
B. Enter the total of Line 5 + SA. This is the BALANCE DUE.
(SB) 0.00
Make Check Payable to: REGISTER OF WILLS, AGENT
a,
PLEAS E ANSWER THEaFOLa OWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLO
CKS
a. retain the use or income of the property transferred :............................................................................ Yes No
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 ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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 three (3) percent [72 P.S. §9116 (a) (1.1) (i)].
Far 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)]. The statute does not ex -mnr 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 zero (0) percent [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 four and one-half (4.5) percent, 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 twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
k_~V-r SG2 EX+ r 1-Jg~
s
r ~~' pennsylvania SCHEDULE A
oErnarHeNT Dr utvrNUE
rNHERrTANCE rnx REruRN REAL ESTATE
RESIDENT DECEDENT
ESTATE OF
SAMUEL MARTIN FILE NUMBER
All real property owned solely or as a tenant in common must be reported at fair market value. Fair rnarket 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, bath having reasonable knowledge of the relevant facts.
_ Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F.
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.
NUMBER VALUE AT DATE
DESCRIPTION OF DEATH
1' NO PROPERTY OWNED AT TIME Of DEATH. (DECECEASED LIVED WITH SON) 0.00
TOTAL (Also enter on Line 1, Recapitulation.) I $ 0.00
If more space is needed, insert additional sheets of the same size.
REV-1503 EX+ (6-96)
SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SAMUEL MARTIN
FILE NUMBER
All .a.....r.. :_:_a~ .. ...... ... ..
REV-1508 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
w in~c Vr
SAMUEL MARTIN FILE
Include the proceeds of litigation and the date the proceeds were received by the estala
All nrnncMv ~ninllu a...~_J .....~. _~ ..
~`°" pennsytvania
nI PA RI MENT pr NFUENUf'
1NHER[TANCF TAx RFit1RN
RESIDENT OECEDEIJT
ESTATE OF
A• ~ FUNERAL EXPENSES;
1' CREAMATION
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
Decedent's debts must be reported on Schedule I.
FILE NUMBER
980.00
B. ADMINISTRATIVE COSTS:
1 Personal Representative Commissions:
Name(s) of Personal Representatwe(s) 0.00
Street Address
City
State Z1P
Year(sl Commission Paid:
Z• Attorney Fees:
0.00
3• Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.)
0.00
Claimant
Street Address
City
State ZIP
Relationship of Claimant to Decedent
q. Probate fees:
0.00
5• Accountant fees:
0.00
6• Tax Return Preparer Fees:
~ 0.00
__ _ TOTAL (Also enter on line 9, Recapitulation) I $ 980.00
If more space is needed, use additional shee[s of paper of the same size.
NOTICE OF INHERITANCE TAX pennsy van~a ~
BUREAU OF INDIVIDUAL TAXES '= A~PR~AI6~~~itl~~ ,~LLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION OF...~~EDUC~TY'O~I~$ AND ASSESSMENT OF TAX REV-1547 EX AFP (12-09)
PO BOX 280601 ;~, -i
HARRISBURG PA 17128-0601 `"~"~~ '
~~~~ ~t~Y ~~ ~ ~; ~ ~ DATE 05-24-2010
ESTATE OF MARTIN SAMUEL
DATE OF DEATH 09-10-2003
Ci~.ER~ ~~~ FILE NUMBER 21 03-0811
(?RPH~N'~ ~Q~~RT COUNTY CUMBERLAND
ABRAHAM R MARTIN CUI~~FR~ ~,~~~ (`,~~ F~ ACN 101
52 BROOK DR APPEAL DATE: 07-23-2010
C A R L I S L E P A 17 015 (See reverse side under Objections )
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
--------------------------------------------------------------------------
REV-1547 EX AFP C12-09~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: MARTIN SAMUEL FILE N0.:21 03-0811 ACN: 101
-----------------
OR
DATE: 05-24-2010
TAX RETURN WAS: C X ) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) C1) •0 0 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) (2) .0 0 credit to your account,
0 0 submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) C3) . of this form with your
4. Mortgages/Notes Receivable (Schedule D) C4) •0 0 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) 15 0.0 0
6. Jointly Owned Property (Schedule F) (6) .0 0
7. Transfers (Schedule G) (7) .0 0
8. Total Assets C8) 150.00
APPROV ED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (y) 98 0.0 0
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) .0 0
11. Total Deductions C11) 980.00
12. Net Value of Tax Return C12) 830.00-
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .0 0
14. Net Value of Estate Subject to Tax C14) 830.00-
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) .0 0 X 0 0 - .0 0
16. Amount of Line 14 taxable at Lineal/Class A rate C16) .0 0 x 0 4 5 = .0 0
17. Amount of Line 14 at Sibling rate C17) .0 0 X 12 - .0 0
18. Amount of Line 14 taxable at Collateral/Class B rate (18) .0 0 X 15 = .0 0
19. Principal Tax Due (19 )= .0 0
TAX CREDITS:
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-)
AMOUNT PAID
TOTAL TAX PAYMENT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
* IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ,!~,yf,