HomeMy WebLinkAbout04-0839Name of Decedent:
Date of Death:
CERTIFCAT1ON OF NOTICE UNDER RULE 5.6(A)
Will No.: Admin No.:
To the Register:
1 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 :
Name
Address
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
Signatur~ ....
Name
Capacity:
Address ~ ~,~a~ / '7d~'~'-
Telephone
[~Personal Representative
[] Counsel for personal representative
PETITION FOR PROBATE and GRANT QF LETTERS
Estate of' /~e~ ~ ~x- .J, M 17:~t.U ~ct.. No. ~
also known as To:
Register of Wills for the
~ Deceased. County of in the
Social Security No. ! ~k - ~ g ~ ~ ~ t ~-/ Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut r' d )/ named
in the last will of the above decedent, dated ~'-~ P, - / ~/, t q ~ */ , 19~__
and codicil(s) dated
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in C c~ m. ~fi.,- .- f6~ yt ~ County, Pennsylvania, with
h last family or principal residence at
(list street, number and muncip~ity)
Decend~nt then ~, ~ years of age, died ~- ~ / fl , 1~ ,
Except as follows, tdecede~t did not marry, w~s not divorced and did not have a child born or ~opte~
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incomp~ent: . ~ ¢
D~endent at death owned property with estimated v~ues as follows:
(If do.died in Pa.) ~1 person~ prope~y $
(If not domiciled in Pa.) Person~ prope~y in Pennsylvania $
(If not domiciled in Pa.) Person~ property in County $
V~ue of re~ estme in Pennsylvania $,
situated as follows:
WHEREFORE, petitioner(s) respectfully request(s) the probate of the l_~tc~ill a~ codicil(~
presented herewith and the grant of letters
theron.
OATH OF' PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF
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 decedem petitioner(s) will well and truly administer the estate according to law.
Sworn to or aff~ir~a~e.e~ and subscribedt-
be(~re me this L~- day of
No.
Estate
DECREE OF PROBATE AND GRANT OF LETTERS
AND Now C .e h x_.
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated (2t- II~- Ic]~2/
described therein b.g.a~mitted to probate and filed of record as the last will of
and Letters -'~,~,'~-O-,e~fi-~e.~ (}
are hereby granted to ~x~ u. ~e~- ~QC.~tx~
13, 00-004 ~ , in consideration of the petition on
FEES
Probate, Letters, Etc ..........
Short Certificates( ) .
Filed ...................................
ATTORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
~s~teoe 4~r
Also known as
OATH OF NON-SUBSCRIBING WITNESS
,Deceased
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
x~..~es, farrdliar with the signature of ~f~ ~7~?~4v ,testator- of
(one of the subscr/bing wimesses to) the codicil/will presented herewith and that ~ believes
the signature on the codicil/will is in the handwriting of A~r~-~ ~a ~'(~ ~ ~q~
to the best of .~.~ lmowledge and belief.
(Address)
Sworn to or affirmed and subscribed
~_efore me this 18~' da~, ~f
~t"~ ~ex'~ ~ ,20~L-
Fo-
(Address)
__ ~ ~egi~t~r of 3~9iIl~ nt (~uraheri~nl~ ~untp
Also known as
OATH OF NON-SUBSCRIBING WITNESS
,Deceased
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
,,~Ja._,~._ familiar with the signature of /"~-/.z. ot~ .2jT.x',-~J~ ~testat~- of
(one of the subscribing witnesses to) the codicil/will presented herewith and that -Z7 believes
the signature on the codiciVwill is in the handwriting of ,,~f~ .j~. %~ ~. Z~
to the best of ~ ~_Imowledge and belief,
(Name)
(Address)
(Address)
his 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 10545655
No.
Local Registrar
Date
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
' ~'~i~7' Federal Government [ ",. B o~"* ~"=~ I ~ [ ......... eo~,,,,' [ , ' '
30 Wes~ S~mpson Street
' p o,..,,~ ,~ c ..... Cumberland t~ ~fd B ~%~;',~2;~0, Mecf an csbura
zo, ~__ ~ Jane M. Maxwell =.. 30 West Simpson Street Mechan csbu g, Pa 17055
~ ../ ~s~.~.~ ......... Ul~,. Aug 17,20~ Iz~' Conol~te Crematory ...... J2,. Schaefferstown, Pa 17088
0~
I, ROBERT J. MAXWELL, of the Borough of Mechaniesburq,
cumberland County, Pennsylvania, make, publish and declare this as
and for my Last Will and Testament, hereby revoking all other
Wills and Codicils heretofore made by me.
FIRST: I devise and bequeath all the rest?~sid~e and
remainder of my estate of whatever nature and wherever situate,
includinq any property over which I hold power of appointme~
M. MAXWELL, provided she survives me by sixty (60) days.
or die on or before the sixty-first (61st) day following my death,
SHULTZ, provided that should any of my step-children predecease
the aqe of twenty-one (21) years at the time for distribution to
of income and principal for the said step-child's education
(including colIege, trade school or other similar training or
education), suppor~ and welfare as my Trustee or Trustees, in
their sole discretion, deem advisable. My Trustee or Trustees may
make the palrments for the support and maintenance of my $~ep-
children directly to said step-children or to my Guardian or
Guardians, as hereinafter named, as required. Any payments ~de
by my Trustee or Trustees pursuant hereto shall be made without
further responsibility to the said step-children, my Guardian or
Guardians, or uo any person taking care of my step-children. The
Trustee or Trustees, in exercising their discretionary authority
with respec= ~o the paymenu of income or principal of the within
Trust to my step-child, shall take into consideration any income
or other resources available to my step-child from sources outside
this Trust. In addition, my hereinafter named Trustee or Trustees
shall have the right, in their sole discretion, ~o purchase and
pay for out of the principal, as well as income, such insurance
policies as will provide for the minor's medical care.
Any income or principal not so applied shall be dis-
uributed to each step-child when he or she attains the age of
uwen=y-one (21) years. In the even~ my step-child predeceases me
oz dies prior ~o the termination of this Trust, the inueresu of my
step-child in said Trust shall cease with any income and principal
being divided evenly between or among my other step-children or
the separate trusts established hereunder for their benefit. If,
however, said s~ep-child is survived by any children, my Trustee
or Trustees shall pay ne~ income of the Trust to or apply the same
foz the benefit of such children of my deceased suep-child, in
such amount os amounts as my Trustee or Trustees, ~n their sole
discretion, deem advisable for the support, welfare and main-
tenance of said children.
FOURTH: In addition to all powers granted ~o them by
law and by other provisions of this Will, I give the fiduciaries
acting hereunder the following powers, applicable to all proper-
ty,
exercisable without cour5 approval and effective until actual
distribution of all property:
(A) To sell at public or private sale, o~ to lease, for
any period of time, any real or personal property and ro give
options for sales, exchanges or leases, for such prices and upon
such terms (including credit, with or without security) or
conditions as are deemed proper. This includes the power ~o give
legally sufficient instruments for transfer of the property and to
receive the proceeds of any disposition of it.
(B) To partition, subdivide, or ~mprove real estate and
to enter into agreements concerning the partition, subdivision,
improvement, zoning or management of real estate and to impose or
extinguish restrictions on real estate.
(C) To compromise any claim or controversy and to
abandon any property which is of little or no value.
ID) To inves~ in all forms of property, including
stocks, common trus~ funds and mortgage invesr/ment funds, without
restriction to investments authorized fox Pennsylvania fiduci-
aries, as are deemed proper, without regard to any principle of
diversification, risk or productivity.
(E) TO exercise any option, right or privilege granted
in insurance policies or in other investments.
(F) To exercise any election or privilege given by the
Federal and other tax laws, including, but not necessarily being
limited to, personal income, gift and estate or inheritance tax
laws.
(G) To make dis=ributions to my herein named benefici-
aries in cash or in kind or partly in each.
(H) To borrow money from themselves or others ~n order
to pay debts, taxes, or estate or trus= administration expenses,
to protect or improve any property held under my will, and for
investment purposes.
(I) To select a mode of payment under any qualified
retirement plan (pension plan, profit sharing plan, employee stock
ownership plan, or any other type of qualified plan) to the extent
the plan or the law permits them to do so, and to exercise any
other rights which they may have under the plan, in whatever
manner they consider advisable.
(J) To make i~ediate payment for the support and
maintenance of my children or child to said children or child
directly or to his or her Guardian or Guardians as are deemed to
be in the best interest of said child or children.
FIFTH: I nominate and appoint my wife's brother, JAMES
W. DEPPEN, as Trustee of the hereinabove described trusts, who
shall serve without bond and shall receive fair and reasonable
compensation.
SIXTH: I direct that all inheritance, estate, transfer,
succession and death taxes, of any kind whatsoever, which may be
payable by reason of my death, whether or not with respect to
property passing under this Will, shall be paid out of the princi-
pal of my residuary estate.
SEVENTH: All interests hereunder, whether principal or
income, which are undistributed and in the possession of the
fiduciaries acting hereunder, even though vested or distributable,
shall not be subject to attachment, execution or sequestration for
any debt, contract, obligation or liability of any beneficiary,
and furthermore, shall not be subject to pledge, assignment,
conveyance or anticipation.
EIGHTH: I nominate and appoint my wife, JANE M.
MAXWELL, Executrix of this, my Last Will and Testament. In the
event of the death, resignation or inability to serve for any
reason whatsoever of the said Jane M. Maxwell, I nominate and
appoint JAMES W. DEPPEN, Executor of this, my Last Will and
Testament. I direc~ that my Executrix or Executor, or Trustee, as
the case may be, and their successors, shall not be required to
post security or a bond for the performance of their duties in any
jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
to this, my Last Will and Testament, this I~ day of ~'~ ,
1989.
Robert J.~ Maxw
signed, sealed, published and declared by the above-
named Testator as and for his Last Will and Testament in our
presence, who, at his reques=, in his presence and in the presence
of each other, have hereunto subscribed our Rames as attesting
witnesses.
Address
Address
CLAIM FORM
ESTATE OF
ROBERT J. MAXWELL
Notice of claim by KOHL'S DEPT. STORE
ORPHANS' COURT DIVISION 0
COURT OS coaaoN PLEAS OF
CUMBERLANDcouNTY
NO. 21-04-839
in the amount of $ 597_7] filed pursuant to section 2284, Probate, Es=aCes and
Fiduciaries Code Laws of 1972, Act No. 104 effective July 1, 1972 as amended.
TO TH~ CLERK OF THE ORP3~ANS· COURT DIVISION~
Enter the claim of KOHL'S DEPT. STORE
{Claimant and Address)
Date
9441 LBJ FREEWAY
Lock Box 30
Dallas, TX 75243
19
597.71
in the amount of $
against the above entitled Estate. The decedent
who resided at 30 W, SIMPSON ST. t MECHANICSBURG PA 1705'~ied on 8/13/04
(Address) (DaCe)
JANE M. MAXWELL
Written notice of said claim was given to
30 w. S~MPSON ST., MECHAN~CSBURS PA(PefCO%%1 Represe.~acive or Co~...~)
(Address) on
(Date)
The basis of aforesaid claim is as follows: (Itemize fully to enable personal representative
make proper investigation).
Claimant's Counsel
Acct. #0327681144
(Name)
(Address)
,~,44'~ LBJ FREEWAY
Lock Box 30
~ai~d~.75245
PROBATE COURT
Cumberland County, State of Pennsylvania
Robert J. Maxwell, Deceased
Case #21-04-839
Proof of Mailinq
I mailed the creditors claim to the fiduciary (and attorney, if applicable) as
follows:
I deposited a copy/copies of the claim with the United States Postal Service in
a sealed envelope with the postage fully pre-paid. I used first-class mail. I
am employed in the county where the mailing occurred. The envelope(s) was/were
addressed and mailed as follows:
Mrs. Jane Maxwell
30 W. Simpson St.
Mechanicsburg, PA 17055
.-~ -/ /
County of Mailing: DallaS, Texas
I declare un~nalty of perjury that the foregoing
D a t e: ///~ ~'o ~
Kohl ' s Department Store
P.O. Box 741026
Dallas, TX 75374
is true and correct.
SC8820/1 09/08/2004 KOHL'S ACCOUNT STATUS DISPLAY 09/08/2004 14:46 ID: SAG
Acqt : 0327681144 52 Cycle: 90 Bi: 08/26/2004 Due: 09/20/2004 MVC: NVIP: N
St/Lc: 90_~01 CBS - DECEASED Op: 10/08/2001 Closed: 09/08/2004 Ins: N
Namel: ~BERT J MAXWELL Home: 717 766 - 3430 Pull:
Busl: 717 580 - 9086 AScr:
Name2: Srce: I 00000001 Eh%p: NScr:
Addr : 30 W SIMPSON ST Rstr:
N C/S :
R : PA 170556324 AdChg: 10/26/2001 :
: MECHANICSBURG :
Instr: PRMENT rec d/c
pymnt H: SNLLLLLLMLMLNMLM2NLNMlqML Dun H: 110000000000100021010100
Pry Bal:
Pur/Adv:
Returns:
Fee/Iht:
Cr/Dr :
pymnts :
Cls Bal:
Last Staunt Curr Stn%nt Auths Last Reage:
594 60 597.71 Avl Credit: 877.29
· Disputes :
31.11
25.00
28.00
597.71 __6~__2.7_1_
Last Plnnnt:
Cr Lint E :
Limit Ext :
MVC Pur :
622.~! Issued Cards
449 08/04
726 10/01
28.00 07/30/2004
1500 10% 11/09/2003
165.04
Cnt Sts Issue date
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717)240-6345
Date: 12/06/2004
MAXWELL JANE M
30 W SIMPSON ST
MECHANICSBURG, PA 17055
RE: Estate of MAXWELL ROBERT J
File Number: 2004-00839
Dear Sir/Madam:
It has come to my attention that you have not filed the
Certification of Notice Under Rule 5.7 (a) 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 ten (10) days after giving proper notice to the
beneficiaries and intestate heirs as required by subdivision
(a) of Rule 5.7, shall file with the Register of Wills or Clerk
of the Orphans' Court his/her Certification of Notice.
This filing will become delinquent on 12/23/2004
Your prompt attention to this matter will be appreciated.
Thank You.
cc:
File
Counsel
Judge
GLENDA FAR_NER STRASBAUGH
Clerk of the Orphans' Court
Cumberland County - Register Of Wills
One Courthouse Square
Carlislel PA 17013
Phone: (717) 240-6345
Date: 7/05/2006
MAXWELL JANE M
30 W SIMPSON ST
MECHANICSBURGI PA 17055
RE: Estate of MAXWELL ROBERT J
File Number: 2004-00839
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 I NO. 103
SUPREME COURT RULES DOCKET NO. 11 for decedents dying on or after
July 11 19921 the personal representative or his counsell within two
(2) years of the decedentis deathl shall file with the Register of
wills a Status Report of completed or uncompleted administration.
This filing is due by:
8/13/2006
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report I please disregard
this notice.
SincerelYI
l~ /,~~ A:~'" .!l
,....L:?:" , J... ;cr." "
/--' .. /1"-
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
~
In Re: Estate of
MAXWELL ROBERT J
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
NO. 2004-00839
NOTICE OF FAILURE TO FILE STATUS REPORT
Personal Representative: MAXWELL JANE M
Counsel for Personal Representative:
Date of Decedent's Death: 8/13/2004
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 of the 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:
8/2912006
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Glenda Farner Strasbaugh
Clerk of the Orphans' Court
-esentative
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~~~~~~j~~~~;~~~~~f~tl~'~
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Register of,Vii,j u~ Cumberland County
STATUS REPORT UNDER RuLE 6,12
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~ ame 0 f Decedent:
D(lle of Death: I,{' if 3 /() if
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Estate No,: . ') (;-( L/ ~ C1 C Y.) (/
I
Pursuant to Rule 6,12 of the Supreme Court Orphans' Court Rules, I report the following
wnh respect to completion of the administration of the above-captioned estate:
Dale:
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I, State whether administration of the estate is complete:
Yes I!l No 0
2. lEthe 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 Coure
Yes 0 No ill
b. The separate Orphans' Court No. (if any) for the personal representatIve's
account is:
c. Did the personal representatiye state an account informally to the partIes in
interest? Yes 0 No 0
c. Copies of receipts, releases, joinders and approval of formal or informal
accounts may be filed with the Clerk of the Orphans' Court and may be
attached to this report.
C{ Lc '. ;. c~
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Signature!
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Name
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Address,/<JC.l-(t"z(
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7' / / - -? 4, (;;. )' L) ~(/
Telephone No.
Capacity:
o Persona] Representative
o Counsel for personal representative
J
SENDER: COMPLETE THIS SECTION
. Complete items 1, t2!~~:,f]~~t:Ul'llrJfet;;i:\
item 4 if Restricted Delivery is desired.
. Print your name an(j,\~res;:\r,o~th~~~
so that we can return the card to you: .
. Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
COMPLETE THIS SECTION ON DEL/IIFPV
F'iL\ '.lA/Slgnatur~"'u~ ~~Il'llMmn"ttukij
."""",,~y
:F)t;l.,;'~ ,
D. Is delivery address different from it
If YES. enter delivery address belo
]\1]\,XWELi.., JlillE [V]
3D W SIMPSON ST
~ECHfu~ICSBURG PA
J. ? 0_
3. Service Type
~ Certified Mall
o RegIstered
o Insured Mail
iExpress Mail
Return Receipt for Merchandise
C.O.D.
4. Restricted Delivery? (Extra Fee)
DYes
2. Article Number
..2. ::'fTr<ii!..sf!5~ service I
PS Form 3811, Februa
J,8an .n,UO;:! .<4.!...1
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199
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Domestic Return Receipt
102595-02-M-1540
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15056041046
REV-1500 EX ( 05-04)
OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes ~
Dept.28o601
Harrisburg, PA 17128-0601 ~ . County Code Year File Number
INHERITANCE TAX RETURN ll 2
RESIDENT DECEDENT ~,1 ~~ ~ ~~
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
8`~a ~~ 9 I ~ ,~ ~~c
Q3a~~~' 1~~ a~-
Decedent sLast Name l
Suffix Decedent's First Name MI
l7 ~ ~ u~~ L L, ~ d ~~,~ ?
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Nj ~ ~ ftl,~ L L ~ ,C} ~ .~ .
Spouse's Social Security Number
/ ``
~ ~
3 7 ~ ~ ~ d THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
[
- REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
~~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death
prior to 12-13-82)
O 4. Limited Estate O 4a. Future Interest Com romise date of
P ( O 5. Federal Estate Tax Return Required
death after 12-12-82)
O 6. Decedent Died Testate O
(Attach Copy of Will) 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Trust)
O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. O)
CORRESPONDENT - THIS SECTION MUST BE COM PLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
~~~ ~~?~~+~~LL `7~ `7 7~~~ ~~ v
Firm Name (IfA licable)
PP
First line of address
,~o ~~sT S~ ~l~S D~!
Second line of address
~~C~~~i~/~:~~~~L
City or Post Office
STR~~7
State ZIP Code f "'~~
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Correspondent's e-mail address: N/Jq
Under penalties of perjury, I declare that I have exa fined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
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 PF N RESPONSIBLE^O~ FILING RETUR~ DATE
r~~R~J3o uJ,~~ S
SIGNATURE OF PREPARER OTHER THAN REPRESENTATI DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
15056041046 15056041046
REGISTER OF WILLS USE ~1 LY
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15056042047
REV-1500 EX D/ecedent'tfs~ Social Security Number (]~
Decedent s Name c
RECAPITULATION
1. Real estate (Schedule A). 1 ~ C3 `~' ~ ~• r.~ U
2. Stocks and Bonds (Schedule B) 2~ ~'`y ~• ~~
A~ / ~'
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. L//.,~~J~-~• /~'v
4. Mortgages ~ Notes Receivable (Schedule D) ............................. 4. V Q ~ V'
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ........ 5. ~ ~• ~-'~
6. Jointly Owned Property (Schedule F) G Separate Billing Requested ....... 6 ~ •
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property ~
(Schedule G) O Separate Billing Requested....... 7. •
8. Total Gross Assets (total Lines 1-7) .................................... 8. ~ `~ ~~ ~' • ~ ~
~ ~
9. Funeral Expenses & Administrative Costs (Schedule H) ..................... 9. ~
~g g ( ) ............... ~ 1
10. Debts of Decedent, Mort a e Liabilities, & Liens Schedule I 10. ~ ~ ~' • ``~~
/. `l ~ ;
11. Total Deductions (total Lines 9 ~ 10) ................................... 11. h ~ CJ• U ~
12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. 1 t ,~, a Q • ~~ ~
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which G
an election to tax has not been made (Schedule J) ........................ 13. •
14. Net Value Subject to Tax (Line 12 minus Line 13) ........................ 14 ~ ~ ~ ~ ~• ~
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amoun e 14 taxable
at the ousal to ate, or
transfers under Se .9116 y•~ i ~
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. O •~
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~
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~ide 2
47
15056042047 150560420 J
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REV-1500 EX Page 3
Decedent's Complete Address: .
File Number
DECEDENT'S NAME
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STREETADDRESS
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CITY
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19) ~ a ~~ t J ~~ ~A r ~(~`r`L ~ ~ (1) ('~
2. CreditslPayments ~+T7`
A. Spousal Poverty Credit S g~t,S-~ 1.5 'D
B. Prior Payments /
C. Discount -
Total Credits (A + B + C) (2)
3. InterestlPenalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (D + E) (3) Q
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. (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5B)
Make Check Payable fo: 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 transferretl :.......................................................................................... . [~,/
b. retain the right to designate who shall use the property transferred or its income : ....................................... ~,~/
c. retain a reversionary interest; or ......................................................................................................................... C~4
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)].
For dates of death on or after Janu_ ary 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the survivin spouse i e ercent
[72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requiremen s for disclosure of assets an
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.
~ , , REV-1;y~2 EX+ (6-98)
e SCHEDULE A
COMMONWEALTH OF PENNSYLVANIA REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
V~. e fl L ~~ - ~ ~~ vs ~L L ~1 - J ~ - 0 .~ y
All real property owned solely or as a tenant in c mmon must be reported at fair market value. Fair market value is defined as the price at which pro erty would be
exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F.
(If more space is needed, insert additional sheets of the same size)
RFi~-'1511 EX+ (12-99)
~s~ SCHEDULE N
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A• FUNERAL EXPENSES:
1.
J
!~~ ~ Gf`f""~.G~f~S ~LT,~(ry ~ ~/ Yip / ~eS'"T'
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s) '~? "
Social Security Number(s)/EIN Number of Personal Representative{s~ -- (J /
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
City _ ____ State Zip
Relationship of Claimant to Decedent
4. Probate Fees ._ L~r ~'
i ~ ~'
5. Accountant's Fees
6. ~ Tax Return Preparer's Fees - 6 -
7
TOTAL (Also enter on line 9, Recapitulation) I $ ~ ~° ~s-C% , ~~
(If more space is needed, insert additional sheets of the same size)
COMMONWEALTH OF PENNSYLVANIA
HARRISBURCOISTRICTOFFICE DEPARTMENT OF REVENUE
STRAWBERRY SQ
4TH & WALNUT STS
HARRISBURG PA 17128-0101
Date:
JANE M MAXWELL
30 W SIMPSON ST
MECHANICSBURG PA 17055
Estate of:
MAXWELL
Date of Death:
File Number:
REV-S69 FO AFP (07-OS)
8/13/2008
ROBERT J
8/13/2004
21 04-0839
(Certified Mail-Return Receipt Requested)
Dear JANE M MAXWELL
CS~~~.,,;M S~sus~
Department records indicate you are responsible for the settlement of the above estate or that you
represent the responsible party. As of this date, you have failed to resolve this matter.
This is to again advise you that the estate is in delinquent status, as it remains unsettled.
The Inheritance and Estate Tax Act mandates the filing of a tax return and payrr-ent of
all outstanding liabilities by a personal representative or a transferee of an estate within nine
months of a decedent's death. Department records show that this estate remains open because:
AN INHERITANCE TAX RETURN HAS NOT BEEN FILED.
If the return was filed, please contact this office immediately. If this estate was opened for the
purpose of filing a lawsuit, please provide the term and docket number of the proceeding in writing
to this office so that we may postpone any further action.
Under Act 40 of 2005, additional collection costs, including but not limited to fees of up to
39 percent of the amount due and attorney fees incurred in securing payment, may be
imposed on any liability not paid prior to referral to a collection agency or contract counsel.
This notice shall serve as a formal demand on you or your client from the Department of
Revenue. If you fail to file the return, the Department may file a citation requiring you to
appear in court to show cause for your failure to comply with the law. A finding of contempt in
this matter could subject you to additional penalties and/or incarceration by the Orphans' Court of
Cumberland County.
RETURNS SHOULD BE FILED AND CHECKS MADE PAYABLE TO:
REGISTER OF WILLS, AGENT
Sincerely,
Crystal Caraway
Direct any questions regarding this estate to: (717) 7 8 7 - 3 8 3 7
HARRISBURG DISTRICT OFFICE cc:
STRAWBERRY SQ
4TH 8~ WALNUT STS
HARRISBURG PA 17128-0101
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
~^i ~ f tl tJOYICE DF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES ;APPRAI;6EM~NT, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION ~ , ;.• ; gF DEDldG7IONS AND ASSESSMENT OF TAX
PO 80X 280601
HARRISBURG PA 17128-0601 REV-1547 EX AFP C06-05)
~`~~~ ~~~ - ~ ~' I2~ 57 nATE 12-o8-zoos
ESTATE OF MAXWELL ROBERT J
;`~ ~,`,. ;`J~ DATE OF DEATH 08-13-2004
v~t~l ;r ~
f~;µ'~r;L~\i;~ ;;"'"k FILE NUMBER 21 04-0839
~=~T
ut~ ~~->"- >>~ `r`} C~ COUNTY CUMBERLAND
JANE MAXWELL ~ ~ ACN 101
30 W SIMPSON ST APPEAL DATE: 02-06-2009
MECHANICSBURG PA 17055 (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 Ems- ______________
-----------------------------------------------------------------------------
REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MAXWELL ROBERT J FILE N0. 21 04-0839 ACN 101 DATE 12-08-2008
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 (Schedule A) C1) 80,200.00 NOTE: To insure proper
C23 .Op credit to your account,
2. Stocks and Bonds (Schedule B) submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) C3) .00 of this form with your
4. Mortgages/Notes Receivable (Schedule D) C4) .00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) .00
6. Jointly Owned Property (Schedule F) C6) .00
7. Transfers (Schedule G] C7) .00
Cg} 80,200.00
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS: 6,800.00
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9)
10. Debts/Mortgage Liabilities/Liens (Schedule I) C10) 54.200.00
11. Total Deductions (11) 61.000.00
19,200.00
12. Net Value of Tax Return C12)
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .00
14. Net Value of Estate Sub]ect to Tax (14) 19,200.00
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 (15) 19,200.00 X 00 = .00
16. Amount of Line 14 taxable at Lineal/Class A rate C16) • 00 X 045 . . 00
17. Amount of Line 14 at Sihling rate C17) • 00 X 12 = . 00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) •00 X 15 = .00
19 al Tax Due
P
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i C19}= .00
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PAYMENT
DATE
RECEIPT
NUMBER
DISCOUNT C+)
INTEREST/PEN PAID C-)
AMOUNT PAID
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. ,00
TOTAL DUE .00
* IF PAID AFTER DATE INDICATED, SEE REVERSE C IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED.
--•• ^~ nnniTIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE D
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
__ _ __
ROW170D Cumberland County - Register Of Wills
Remarks File Maintenance
File No. 2004-00839 MAXWELL ROBERT J
Date.... 11/05/2009
Time.... 10:16
Initials MAW
Notes... ALTHOUGH THE REV1500 INDICATES THAT THE ADDITIONAL PROBATE
DUE SHOULD BE 182 RESEARCH SHOWS THAT THE REAL ESTA E WAS
JOINTLY HELD WITH THE SPOUSE THEREFORE NOT A PROBATE ASSET
NO ADDITIONAL PROBATE IS DUE. APPROVED BY GFS 11 2 09
F11=Delete F12=Cancel
.......,..,.< ......_,...,a..,.,.~....._.....~..,.__ .~..____._.._.._._..._...._.~....~......._._,.r.r._,_, ~
... ,
° COMMONWEALTH OF Pc"NNSYLVANIA
m DEPARiMENi OF P.EVENUE _
H REA:i'f ~ `
TRANifER JUl]0'It O 4 ~ 9. 0 ~ -_
sax ~
a F6..:IG2
MADE TXE ~ ~ day of ~ is tke year
of our Lord one tkouaand nine Hundred eighty-seven 987)
ItETWEEN MARK C. WALKER and LORETTA T. WALKER, iris wife, of
Mechanicsburg, Pennsylvania
Gsantor s,
and ROBERT J. MAXWELL and JANE M. MAXWELL, his wife, of
Mechanicsburg, Hennsylvania
Grantee s:
WITNESSETN, that in eonaideration uj Forty-One Thousand Nine Hundred and
No/100------------°-(591,900.00)----------------------------Dollars,:
in. haxd paid, the receipt u:hereoJ is hereby acknomtedped, the said gmntor 8 do hereby grant
and convey to tke said grantee s, their heirs and assigns:
ALL THAT CERTAIN house and lot of ground situate on the north side of
West Simpson Street, in the Borough of Mechanicsburg, Cumberland Cownty,
Pennsylvania, bounded and described as follows, to wit:
BEGINNING at the center of the partition dividing the building on the
Lot hereby conveyed from the other house, formerly owned by A. J. G~osa
and now or formerly of John M. Hall, on the building line of said WEst
Simpson Streets thence along the building line of West Simpson Strut
in a westwardly direction, twenty-five (25) feet and two (2) inches to
the property formerly of James Devinney, now or formerly of Wiliiam
Ilgenfritzt thence along the line of said Lot now or formerly of WSYliatn
Ilgenfrittt in a northwardly direction, one hundred eighteen and one+half
(118 1/2) feet, taora or lase, to an alleys thence along said allay in an
~~32 ~kce 387
10/30/2009 4:14:03 PM CUMBERLAND COUNTY Inst.# 198703688 -Page 1 of 3