HomeMy WebLinkAbout04-0877PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Estate of Ralph W. Bretzman
Also known as
To:
No..21 -Oq-g77
, Deceased. Register of Wills for the
Social Security No. 199-14-0547 County of Cumberland
CommonwealS_ ~ Penns. ylvania
ig tfully
The Petition of the unders ned respec represents that: :~-~ ::
Your petitioner(s) who is/are 18 years of age or older, applies for ~tters of~
Administration on the estate of the above decedent.
Decedent was domiciled at death in Cumberland County Pennsylvania, .~ his iffst
family or principal residence at 540 Pine Road, Carlisle, PA (Dickinson ~'oWnshi~).
Decedent then 80 years of age, died September 16, 2004, at Carlisle Regional Medical
Center.
Decedent 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:
$5O,O00.OO
$
Petitioner after a proper search had ascertained that decedent left no will and was
survived by the following spouse (if any) and heirs:
Name
Hilda M. Bretzman
Phyllis B. Henneman
Charles E. Bretzman
Relationship
Wife
Daughter
Son
Residence
540 Pine Road, Carlisle, PA
111 Fairway Drive, Carlisle, PA
THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the
~p~~rm tfithe u~d.ersigned.
Hilda M. Bretzman 'r~
540 Pine Road
Carlisle, PA 17013
Page 1 of 2
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
)
)
)
SS
The petitioner(s) above named swear(s) or affirm(s)
that the statements in the foregoing petition are true and
correct to the best of the knowledge and belief of
petitioner(s) and that as personal 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 24t~ day of
._~Z2~ ~ (_Hilda M. Bretzman
~ ~--.(~egister (J- (
Estate of Ralph W. Bretzman, Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW, September, 2004, in consideration of the petition on the reverse side hereof,
satisfactory proof having been presented before me,
IT IS DECREED that Hilda M. Bretzman is entitled to Letters of Administration, and in
accord with such finding, Letters of Administration are hereby granted to Hilda M. Bretzman in
the estate of Ralph W. Bretzman.
FEES
Letters of Administration ........ $ ~0.
Short Certificate(s) ............... $
.3e.O IO.c~
Renunciation ...................... $
TOTAL $
Filed....q.,&.q .................. }00~.c
glster of Wills' _v'"
Robert G. Frey, 46397
5 South Hanover Street,
Carlisle, PA17013
(717)243-5838
Page 2 of 2
his is 1o 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 10590315
No.
Local Registrar '-
S£P 1 8 200~
Date
CERTIFICATE OF DEATH -~
M 199 --j:~4 -- 0547
White
FD 012633 L
Hilda M. Brethren
..540 Pine Road; Carlisle, PA 17013
M~m. Gardens ;,. Carlisle, PA 17013
Brothers F~neral Hc~e, Inc., Carlisle, PA
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
Ralph W. Bretzman
Date of Death:
September 16, 2004
Will No. Admin. No. 21-04-0877
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: September 28, 2004.
Name
Hilda M. Bretzman
Phyllis B. Henneman
Charles E. Bretzman
Address
540 Pine Road, Carlisle, PA 17013
111 Fairway Drive, Carlisle, PA 17013
18031 North Sixth St., Phoenix, AZ 85022
Notice has now been given to all persons entitled thereto under Rule 5.6)a) except
NO EXCEPTIONS
Date: 9/28/04
Name:
Address:
Capacity:
Robert G. Frey
5 South Hanover Street
Carlisle. Pennsylvania 17013
Personal Representative
X Counsel for Personal Representative
217
REV-1500 EX (6-00)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
....
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Ral h W Bretzman
DATE OF DEATH (MM-DD-YEAR)
DATE OF BIRTH (MM-DD-YEAR)
9/16/2004 4/21/1924
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Hilda M Bretzman
[Kj 1. Original Return
o 4. Limited Estate
o 6. Decedent Died Testate (Attach copy of Will)
09. Litigation Proceeds Received
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o 2. Supplemental Retum
04a. Future Interest Compromise (date of death after 12-12-82)
o 7. Decedent Maintained a Living Trust (Attach copy of Trust)
010. Spousal Poverty Credn (date of death between 12.31-91 and 1-1-95)
....
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WI....Cl)Nfr~;.~_.
NAME
Robert G. Fre
FIRM NAME (If Applicable)
COMPLETE MAILING ADDRESS
5 South Hanover Street
Carlisle, PA 17013
717-243-5838
1. Real Estate (Schedule A)
(1) NONE
(2) NONE
(3) NONE
(4) NONE
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Reeeivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
(5)
(6)
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:J
....
a::
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6. Jointly Owned Property (Schedule F)
Dseparate Billing Requested
7. Inter-Vivos Transfer & Miscellaneous Non-Probate Property
(Schedule G or L)
(7)
8. TOTAl GROSS ASSETS (total Lines 1-7)
(8)
9. Funeral Expenses & Administrative Costs (Schedule H)
(9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) :10) NONE
11. TOTAl DEDUCTIONS (total Lines 9 & 10)
(11)
(12)
12. NET VALUE OF ESTATE (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not
been made (Schedule J)
(13)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(14)
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) 164,207 X .0 (15)
Z
0
i= 16. Amount of line 14 taxable at lineal rate X .0 (16)
~
:J
Q.
:Ii! 17. Amount of line 14 taxable at sibling rate X .12 (17)
0
0
S 18. Amount of Line 14 taxable at collateral rate X .15 (18)
19. Tax Due (19)
20.0
OFFICIAL USE ONLY
FILE NUMBER
21-04-877
CoUNTY COOE
YEAR
NUMBER
SOCIAL SECURITY NUMBER
199-14-0547
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
204-01-9974
o 3. Remainder Return (date of death prior to 12-13-82)
o 5. Federal Estate Tax Retum Required
8. Total Number of Safe DepOSit Boxes
011. Election to tax under Sec. 9113(A) (Allach Sch 0)
.'_II,b\t.i)~E) TO:
OFFIClAL:USE ONLY
52,066
114,216
C-'""'i
9,304
175,586
11,379
11,379
164,207
164,207
217
,
C
Ralph W Bretzman
199-14-0547
Decedent's ampl e e ress:
STREET ADDRESS
540 Pine Road
CITY I~TATE IZIP
Carlisle PA 17013
I t Add
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19) (1)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Total Credits ( A + B + C ) (2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
TotallnterestlPenalty ( 0 + E ) (3)
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 (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 OF AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1.
Did decedent make a transfer and:
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?
If death occurred after December 12, 1982,did decedent transfer property within one year of death
without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . .
Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?
Yes
o
o
o
o
o
o
No
o
o
o
o
o
o
2.
3.
4.
Did decedent own an Individual Retirement Account, annuity or other non-probate property which
contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . .
....... 0 0
IF THE ANSWER TO ANY Of THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
DATE
~cL- ls'"": <- 00 5
DATE
t-rch I~ Z 01::/'5>
ADDRESS
5 South Hanover Street Carlisle
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. Section 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. Section 9116 (a)(l.l)(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 retum 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. Section 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. Section 9116(1.2) [72 P.S. Section 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. Section 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.
AT
REV.1508 EX + (1-97) (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Ralph W Bretzman
FILE NUMBER
21-04-877
Includ.the proceeds of IKlgation and the dat.the proceeds were received by the estato. ALL PROPERTY JOINTL Y-OWNEO WITH THE RIGHT OF SURVIVORSHIP MUST BE OISCLOSED ON SCHEDULE F.
ITEM
NUMBER
1.
2.
3.
4.
DESCRIPTION
Waypoint Bank Account No. 9600037072
M & T Bank Account No. 374925445
2003 Chevrolet S-1 0 pickup truck
1996 Dodge Caravan minivan
VALUE AT DATE
OF DEATH
20,034
18,632
9,855
3,545
TOTAL (Also enter on line 5 Recapitulation $
(If more space is needed, insert additional sheets ofthe same size)
52 066
217
REV-1509 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTL V-OWNED PROPERTY
ESTATE OF
Ralph W Bretzman
FILE NUMBER
21-04-877
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A. Hilda M. Bretzman
540 Pine Road
Carlisle, PA 17013
Surviving Spouse
B.
C.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF
TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
NUMBER
1. A. 11/19/03 Waypoint Acct 100685114 50 50.00% 25
2. A 9/4/01 Waypoint Acct 7100011938 10,011 50.00% 5,006
3. A 4/8/02 Waypoint Acct 7100027486 10,021 50.00% 5,011
4. A 2/19/00 Waypoint Acct 8000053512 15,022 50.00% 7,511
5. A 2/19/04 Waypoint Acct 9600025320 15,022 50.00% 7,511
6. A 4/29/99 M & T Bank Acct 035004200221650 9,304 50.00% 4,652
7. A Real Estate, 540 Pine Road, Carlisle, PA 50.00%
TOTAL (Also enter on line 6 Recapitulation $ 29716
(If more space is needed, insert additional sheets of the same size)
217
REV-1510 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
Ralph W Bretzman
FILE NUMBER
21-04-877
DESCRIPTION OF PROPERTY
ITEM INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE
NUMBER TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPliCABLE) VALUE
1. M&T Bank IRA, Acct. No. 035004200221650 9,304 100.00% 9,304
TOTAL (Also enter on line 7 Recapitulation) $ 9304
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.
(If more space is needed, insert additional sheets of the same size)
217
REV-1511 EX + (12-99)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Ralph W Bretzman
FILE NUMBER
21-04-877
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Ewing Brothers Funeral Home 9,689
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees 1,000
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 102
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Ambulance 588
TOTAL (Also enter on line 9, Recapitulation $ 11 379
Debts of decedent must be reported on Schedule J.
(If more space is needed, insert additional sheets of the same size)
217
REV-1513 EX + (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
FILE NUMBER
Raloh W Bretzman
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and
transfers under Sec. 9116 (a) (1.2)]
1.
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 AS APPROPRIATE ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1. Hilda M. Bretzman
540 Pine Road
Carlisle, PA 17013 Wife
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART \I - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
. !!J!!!-..!~
Save ~~~~u:7.,~:':~~ds~jl7~ lID blue nile
USED CARS
REVIEWS & RATINGS ADVICE FINANCING & INSURANCE
I) Fnle Dealer Pl1ce QuolAl I) SMn:ll u..d Car Usllngs 0 list Your Car fell; Sao1lI
BLUE BOOK PRIVATE PARTY REPORT
Pennsylvania. September 29, 2004
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2003 Chevrolet S10 Pickup Short Bed
Engine: 4-Cyl. 2.2 Liter
Trans: 5 Speed Manual
Drive: 2 Wheel Drive
Mileage: 10,000
Equipment
Air Conditioning
Power Steering
AM/FM Stereo
BJmIZlir
VIINICL. NISTClIW R.PORTS
carfax.com
Dual Front Air Bags
ABS (4-Wheel)
Consumer Rated Condition: Excellent
"Excellent" condition means that the vehicle looks great, IS In
excellent mechanical condition and needs no reconditioning. It should
pass a smog inspection. The engine compartment should be clean,
with no fluid leaks. The paint is glossy and the body and interior are
free of any wear or visible defects. There is no rust. The tires are the
proper size and match and are new or nearly new. A clean title
history is assumed. This is an exceptional vehicle.
Private Party Value Search Local Listings for This Car $9,855
Private Party value represents what you might expect to pay for a used car
when purchasing from a private party. It may also represent the value you
might expect to receive when selling your own used car to another private
party.
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BLUE BOOK VALUE
FEEDBACK
Copyright @ 2004 by Kelley Blue Book Co., All Rights Reserved. Sep-Oct 2004 Edition. The
specific information required to determine the value for this particular vehicle was supplied by
the person generating this report. Vehicle valuations are opinions and may vary from vehicle to
vehicle. Actual valuations will vary based upon market conditions, specifications, vehicle condition
or other particular circumstances pertinent to this particular vehicle or the transaction or the
parties to the transaction. This report Is Intended for the Individual use of the person generating
this report only and shall not be sold or transmitted to another party. Kelley Blue Book assumes
no responsibility for errors or omisslons.(v.04093)
.~!!~RE50~
uaeD CARl
REVIEWS & RATINGS ADVICE FINANCING & IHSURAlICE
f) Fr&& Dealer Pl1ce QuolAl I) $ean::II URd Car Li$lings 0 UstYour Cllr klr &lie
BLUE BOOK PRIVATE PARTY REPORT
Pennsylvania · September 29, 2004
---- ,'- AdVE! rtlsement
1996 Dodge Caravan SE Minivan
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Engine: V6 3.0 Liter
Trans: Automatic
Drive: Front Wheel Drive
Mileage: 90,000
Equipment
7 Passenger
Air Conditioning
Power Steering
Tilt Wheel
Cruise Control
AM/FM Stereo
Cassette
Dual Front Air Bags
ABS (4-Wheel)
Consumer Rated Condition: Excellent
"Excellent" condition means that the vehicle looks great, Is in
excellent mechanical condition and needs no reconditioning. It should
pass a smog inspection. The engine compartment should be clean,
with no fluid leaks. The paint is glossy and the body and interior are
free of any wear or visible defects. There is no rust. The tires are the
proper size and match and are new or nearly new. A clean title
history is assumed. This is an exceptional vehicle.
Private Party Value Search Local Listings for This Car $3,545
Private Party value represents what you might expect to pay for a used car
when purchasing from a private party. It may also represent the value you
might expect to receive when selling your own used car to another private
party.
Get a Used Car Trade- In Value
Get Invoice & MSRP on New Cars
Get a Person to Person Auto Loan
Bl.UE IIOOK VAI.UE
. FEEDBACK
Copyright @ 2004 by Kelley Blue Book Co., All Rights Reserved. Sep-Oct 2004 Edition. The
speCific information required to determine the value for this particular vehicle was supplied by
the person generating this report. Vehicle valuations are opinions and may vary from vehicle to
vehicle. Actual valuations will vary based upon market conditions, specifications, vehicle condition
or other particular circumstances pertinent to this particular vehicle or the transaction or the
parties to the transaction. This report Is intended for the individual use of the person generating
this report only and shall not be sold or transmitted to another party. Kelley Blue Book assumes
no responsibility for errors or omissfons.(v.04093)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
y-_-,c~, ~'T,,,~JCE DF INHERITANCE TAX
_ G'-, 'u:-;A~IIENT, ALLDIIANCE DR DISALLDlIANCE
'OF, IIllQUl:TIDNS AND ASSESSHENT OF TAX
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
05-30-2005
BRETZMAN
09-16-2004
21 04-0877
CUMBERLAND
101
0"5
j'IH.
= Y 27 rH12: 35
ROBERT G FREY
FREY & TILEY
5 S HANOVER ST
CARLISLE
t",J rQV C:~
GLtl;,\ ,
Cr-,,,,+\~,.-C' (V"! lOT
lhr-'i .."",i\! U \J\...!\.)i I
.- ""','~'
PA 17013
ESTATE OF
BRETZMAN
TAX RETURN liAS:
I ACCEPTED AS FILED
SEE
DATE 05-30-2005
ATTACHED NOTICE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..l Est.t. ISchedul. AI
2. Stocks ..... Bonds I SchllClul. B I
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule DJ
S. Cashl8ank Deposits/Hisco Personal Property (Schedule E)
6. Jointly Owned Property (Schedule f)
7. Transfers (Schedule G)
8. Total Assets
*'
REY-1547 EX AFP (03-05)
RALPH
W
Allount 1..1 tted
I X I CHANGED
III
121
131
141
151
161
171
.00
.00
.00
.00
52.066.00
.00
9,304.00
181
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
IUV-"M.r:"Yf.m.m~~'.mtm.!II!'.!MMIlWIM!'t.m.II'11\fJtllmrd'R1'~.ycr.WIM!'t.IlW'.............. ...
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
RALPH W FILE NO. 21 04-0877 ACN 101
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expens.s/A~. Costs/Hisc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule Il
11. Total Deductions
12. Net Value of Tex Return
13. Charitabla/Sovern.-nt.l Bequests; Non-elected 9113 Trusts (Schedule ~l
14. Net Value of Estate Subject to Tax
191
1101
11,379.00
NOTE: To insure proper
credl t to your acCOW'lt J
sub.lt the upper portion
of this fo~ with your
tax pe~nt.
61,370.00
11.37Q nn
49,991. 00
.00
49,991.00
T6Y r~Hlli ,+, AMOUNT PAID
DATE NUIIBER INTEREST/PEN PAID I-I
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
~
.00
1111
1121
1131
1141
1151 49,991. 00 X 00 =
1161 .00 X 045 =
1171 .00 X 12 =
1181 .00 X 15 =
1191=
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS RElIUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE DF THIS FDRM FOR INSTRUCTIONS.I
REV-1470 E): (6-88)
*'
INHERITANCE TAX
EXPLANATION
OF CHANGES
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDMDUAL TAXES
PO Box 280601
HARRISBURG PA 17128-0601
DECEDENTS NAME
Ralph W. Bretzman
FILE NUMBER
REVIEWED BY
Destiny S.R.Brown
ACN
2104-0877
101
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
F 7 The value of the account and real estate subject to tax has been adjusted to zero since
jointly held assets are not reportable when husband and wife hold properties as
entireties.
ROW
Page 1
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Ralph W. Bretzman
Date of Death:
September 16. 2004
Will No.
Admin. No. 21-04-0877
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 ( X ) 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 f'mal account with the Court?
Yes () No ( X)
(b) The separate Orphans' Court no. (if any) for the personal
representative's account is:
(c) Did the personal representative state an account informally to the parties
in interest? Yes ( X) No ( )
(d) Copies of receipts, releases, joinders and approvals of formal or informal
accounts may be filed with the Clerk of the Orphans' Court and may be attached to
this report.
Date: February 13.2006
\~
Robert G. Frey
5 South Hanover Street
Carlisle. Pa 17013
(717) 243-5838
- Capacity: ((':) Personal Representative
( X) Counsel for Personal Representative
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