HomeMy WebLinkAbout03-0996Register of Wills of Dauphin County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of
also known as
, Deceased
Social Security No. ~::2~Oq qO~-,~ ~,~
(COMPLETE "A" OR "B" BELOW:)
[~ and aver that Petitioner(s) is/are the execut
A.
Probate
and
Grant
of
Letters
Decedent, dated and codicil(s) dated
named in the Last Will of the
State ~eva~t cJrcurnsta~ues, e.g, ~enunciation, death of executor, etc.
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered
for probate; was not the victim of a killing and was never adjudicated incompetent:
B. Grant of Letters of Administration
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse
(if any) and heirs:
Name
Relationship
(COMPLETE IN ALL CASES:) Attach additional :heets if necessary.
Decedent. then /~ ~earsof age, died ~. 15
Decedent at death owned property with estimated values as follows:
Residence
County, Penns.~ania, with his/her last family or principal
i-
(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
Total
Real Estate situated as fol;o'v~;: .......................................................... $
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the
appropriate form to the undersigned:
J Signature Typed or printed name and res;dance I
I
Mo. bcl J,
0 R.-~ /7-/?0- ?
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Dauphin
The Petitioner(s) above-named swear(s) and 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 Decedent,
Petitioner(s) will well and truly administer the estate according to law.
Sworn ,o and affirmed and subscribed
before me this 2nc] day of
2003
Estate of
also known as
DECREE OF REGISTER
Brian Peter Koser
Deceased No.
21-2003-996
Social Security No: 204-70-2422 Date of Death: May 15, 2002
AND NOW, December 2nd , 2003 , in consideration of the Petition
on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters [] Testamentary E~ of Administration
are hereby granted to M~h~l J. Ko~o_r
in the above estate and that the instrument(s), if any, dated
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters ........................... $
40.00
Short Certificate(s)...2~ ..... $ 6.00
Renunciation....1. ............. $ 5.00
Affidavit ( ) ................. $
Extra Pages ( ) ............ $
Codicil ..........................
JCP Fee ........................ $ lO.On
inventory & Tax Forms...
Other ............................ $
I.D. No:
Address:
Telephone:
DATE FILED: December 2nd, 2003
TOTAL ................ $ 61 _Orl
E~rixwill pick up letters on
Wednesday 12/03/2003
Register of Wills of ~ County, Pennsylvania
RENUNCIATION
Estate of j~)~l/t~ ~E1-EtL_ ~o-(E/~.
also known as
No. 21-2003-996
, Deceased
The undersigned, _.~-/~.,~ ~---, ~--O_(F...J~.
(Relationship~ (Capacity)
the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that
Letters OF Ab~v~ildl~,TIZ4~llO/k/ be issued to ~VJ,14~gt:
of
Witness
hand this / day of
(S'g ature)
(Address)
(Signature)
(Address)
(Signature)
(Address)
rntO or affirmed and subscribed
e this ___j day of
Notary Public
My Commission Ex }~res:
NOTARIAL SEAL
pANIELA A. SWITALSKI. Notary Public
~hlppensburg, Cumberland County
My Commission Expires F?. 9.. ~00~4
RN-13 (Rvsd 9/92)
NOTE:
Renunciations executed outside the Office of Register of
Wills are required in some counties to be notarized.
21-2003-996
CERTIFICATION OF NOTICE
UNDER RULE 5.6(a)
Name of Decedent:
Date of Death:
VY LL/. l.'~'~J,
To the Register:
Admin No:
21-2003-996
I certify that notice of 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 .
Sallie
Ad&ess
Notice has now been given to all persons entitles thereto under Rule 5.6(a) except:
Date:
Personal Representative
Counsel for Personal
Representative
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPARTMENT 280601
HARRISBURG, PA 17128-0601
Telephone
12/15/2003
717-783-0972
Joseph F Murphy, Esquire
Marshall et al
4200 Crums Mill Road, Suite B
Harrisburg, PA 17112
Re:
Estate of Brian P Koser
File Number: 2103-0996
Date of Death: May 15, 2002
Court Number: Cumberland
Dear Mr. Murphy:
The Department of Revenue received the Petition for Approval of Settlement Claim to be filed on
behalf of the above-referenced Estate in regard to a wrongful death and survival action. It was forwarded
to this Bureau for the Commonwealth's approval of the allocation of the proceeds paid to settle the
actions.
Pursuant to the Petition, the 12-year-old-decedent died as a result of motor vehicle accident. The
heirs to the decedent's estate are his parents. Therefore, any proceeds paid to settle the survival action
would pass to decedent's parents and would be subject to a zero percent inheritance tax rate. 72 P.S.
§9116(a)(1.2). Accordingly, regardless of the allocation of the subject proceeds, there would be no
inheritance tax consequences.
Please be advised that based upon these facts and for inheritance tax purposes only, this
Department has no objection to the proposed allocation of the gross proceeds of this action, $ 90,000.00
to the wrongful death claim and $10,000.00 to the survival claim. Proceeds of a survival action are an
asset included in the decedent's estate and, although subject to the imposition of a zero percent
inheritance tax rate in this instance, they must be reported on decedent's Pennsylvania inheritance tax
return. 42 Pa.C.S.A. §8302; 72 P.S. §§9106, 9107. Costs and fees must be deducted in the same
percentages as the proceeds are allocated. In re Estate of Merrvman, 669 A.2d 1059 (Pa. Cmxvlth. 1995).
I trust that this letter is a sufficient representation of the Department's position on this matter. As
the Department has no objections to the Petition, an attorney from the Department of Revenue will not be
attending the hearing regarding it. Please contact me if you or the Court has any questions or requires
anything additional from this Bureau. Finally, the approval of this allocation is limited to this estate and
does not reflect the position that the Department may take in any other proposed distribution of proceeds
of a wrongful death / survival action.
cc:
Cumberland County Clerk of Orphans Courtso/
Sincerely ~
(I J Paul Dibert
\g Business & Trust Valuation Manager
Inheritance Tax Division
Bureau of Individual Taxes
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REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
iNTYLOE -0 YEA~ - 0 ~R9- ftL
SOCIAL SECURITY NUMBER
2 04- 7 0 - 2 422
THIS RETURN MUST BE FILED IN !lUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 3. Remainder Return (date Ofdeathpnorto 12-13-82l
o 5. Federal Estate Tax Re1um Required
_ 8. Total Number of Safe Deposit Boxes
o 11, Electiontota, under See, 9113(A) I_hSth01
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THIS SECTION MUST BE COMPLETED, ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
Neuharth Aaron John
FIRM NAME (If Applicable)
Law Offices of La ezNeuharth LLP PO Box 359
TELEPHONE NUMBER
717-264-2939 Chambersbur PA 17201
~ . \ ~ \00 x .lL- (15) 0,00
x 6,0 (16) 0,00
0.00 X .12 (17) 0.00
0.00 X .15 (18) 0.00
(19) 0.00
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10,000.00,
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG. PA 17128-0601
OFFI~ USE
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DECEDENrs NAME (LAST, FIRST. AND MIDDLE INITIAL)
Koser Brian Peter
DATE OF DEATH {MM-DD-Yearj
DATE OF BIRTH (MM-DD-Year)
(8)
10,000,00
05/15/2002 \ \. q
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
[RJ 1. Dnginal Relllm
o 4. Limited Estate
o 6. Decedent Died Testate (AUach copy of Will)
o 9. Utigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (dateofdealh after i2-12-82)
o 7. Decedent Maintained a Living Trust (AtIlr;h copyafTrust)
o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
6,819.00
(11)
(12)
(13)
6,819,00
3,181.00
0.00
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1. Real Estate (Schedule A)
2, Stocks and Bonds (Schedule B)
3, Closely He~ Corporation, Partnership or SOIe-Proprtetorship
4, Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6, Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (tolal Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent. Mortgage Liabilities, & Liens (Schedule i)
11. Total Deductions (lntal Lines 9 & 10)
12. Net Value of Estate (Line 8 minus line 11)
13. Charitable and GovemmentalBequestsJSec 9113 Trusts for which an election to tax has not been
made (Schedule J)
(14)
3,181.00
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(9)
(10)
14, Net Value Subject!o Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15, Amount of Line 14 taxable at the spousal tax
late, or tJanstelS under Sec, 9116 (a)(l ,2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20. 0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
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ecedent's omplete Address:
STREET ADDRESS
1482 Three SQuare Hollow
CITY I STATE I ZIP
Newberg PA 17240
.
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
3. InteresVPenalty if appiicabie
D. Interest
E. Penalty
TDtal Credits (A +B +C)
(2)
0.00
T atallnteresVPenalty ( D + 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. (SA)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B)
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 ND
a. retain the use or income of the property transferred; ........................................................................... 0 !XI
b. retain the nght to designate who shall use the property transferred Dr its income; ........................................ 0 00
c. retain a reversiDnary interest; or ...................................................................................................... 0 !XI
d. receive the promise for life of either payments, benefits or care? ............................................................. 0 !XI
2. If death occurred after December 12, 1982, did decadent lransfer property within one year of death
without receiving adequate consideration?.. ....... ......... ............. ............................................................... 0 !XI
3. Did decedent own an 'in trust for' or payabie upon death bank aCCDunt orsecunty at his or her death? ................. 0 !XI
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
cDntains a beneficiary designation? ....................................................................................................... 0 !XI
0.00
0.00
0.00
0.00
IF THE ANSWER TO ANY OF THE ABOVE QUESTiONS is YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN,
/
T\~Q.e<z SQlA~
THAN REPRESENTATIVE
Ir-\OLJ. c-\ ""'-l , r0e. ..........'081..-. , 9A
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\( o.'-\S:::>
DATE
31-2005
ADDRESS
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FDr 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 dales afdealh 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 (al (1.1) (ii)].
The statute does not exemot 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 fransfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an edaptive palent,
or a stepparent of the child is 0% [72 P.S. ~9116(al(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 siblinge is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an
individuai who has at least one parent in common with the decedent, whether by blood or adoption.
REV.1511 EX + (12-99)
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
FILE NUMBER
Koser Brian Peter
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Funeral Bill 5,069.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s) MabelKoser
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address 1482 three Square Hollow
City NewbUHl State PA Zip 17240
Year{s) Commission Paid:
2. Attorney Fees 1,750.00
3. Family Exemption: (If decedenfs address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountanfs Fees
6. Tax Return Prepare(s Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $ 6819.00
(If more space is needed, insert additional sheets of the same size)
. . REV_1513."X<I*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
Koser. Bri"n p~t,,,
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Truste.(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS [indude outright spousal distnbutions, and transfers under
Sec. 9116 lal 11.2)]
1. Mabel and 3' AiVl6'!' Ko::.<:.-cl.... Lineal 10,000.00
for Proceeds of Wrongful Death Action ($90,000.00)(~~)
and Survival Action ($10,000.00) I.:.~ Itt 0,%)
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.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00
(If more space Is needed, insert additional sheets of the same size)
Rev.34lJ EX (S-92) ~
PA DEPARTMENT OF REVENUE ~
ESTATE INFORMATION SHEET
FOR REGISTER'S OFFICE USE ONLY
County Code Year
OIl 03
File Number
qqLo
DECEDENT INFORMATION: Enter data as it will appear on all documents submitted to the department.
Name (Last) (First) (Middle)
Koser Brian Peter
Decedent's Social Security Number Date of Death Date of Birth
2 0 4 I 7 0 12 4 2 2 5/15/2002 10/ 'S/ ,,,,g<1
TYPE FILING: Enter check (,f) mark to indicate the nature of the return to be filed with the department.
!XI Probate Return
D Joint Assets Only
o Estate Tax Only
o Litigation Purposes (No Other Assets)
LETTERS GRANTED:
Enter check (,r) mark to indicate the nature of the proceedings at the Register of Wills
Office. (Attach additional sheets if explanation is necessary.)
o Testamentary
D Administration
IX! No Letters
o Other (Please Explain)
ATTORNEY/CORRESPONDENT
INFORMATION:
Enter all data concerning the attorney or other individual to receive all
tax information and correspondence.
Name (Last) (First) (Middle) Supreme Court I.D. #
Neuharth Aaron John 88625
Street Address
PO BOX 359
City State Zip Code Telephone Number
Chambersburo PA 17201 717 264-2939
PERSONAL REPRESENTATIVE
INFORMATION:
Executor/Administrator
Enter all data concerning the personal representative(s) of the estate
authorized by the Register of Wills
Name (Last) (First) (Middle) Social Security Number
Koser Mabel 11~ I 100 , 2002-
Street Address
1482 Three Sauare Hollow
City State Zip Code Telephone Number
Newbera PA 17240 717 423-5127
Co-Executor/Administrator
Name (Last) (First) (Middle) Social Security Number
, ,
Street Address
City State Zip Code Telephone Number
Co-Executor/Administrator
Name (Last) (First) (Middle) Social Security Number
I ,
Street Address
City State Zip Code Telephone Number
Prepared By
Aaron J. Neuharth Es
Date
1/25/2005
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
phone: (717) 240-6345
Date: 4/07/2005
KOSER MABEL J
1482 THREE SQUARE HOLLOW ROAD
NEWBURG, PA 17240
RE: Estate of KOSER BRIAN PETER
File Number: 2003-00996
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:
5/15/2005
Your prompt attention to this matter will be appreciated.
Thank You.
~~~
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Counsel
Judge
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Register of Wills of Cumberland County
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
\<..0>01--, ~-,~
8...-(/<--
~- \ ....
Date of Death: c:;- ) I <':;J .,A oad..,
Estate No.: t4oA0~ J ! - () 3 - 0 9~fa
Pursuant to Ru1e 6.12 of the Supreme Court Orphans' Court Rules, I report the following
with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes ~ No 0
2. If the answer is No, state when the personal representative reasonably believes that
the administration will be complete:
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes 0 No D5l
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? Y es ~ 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.
Date: S-/q/ dO:...)'::;;
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Name
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Address
Capacity:
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Telephone No.
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o Personal Representative
Iti Counsel for personal representative
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