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HomeMy WebLinkAbout04-0919 PETITION FOR I'ROBATE and GRANT OF LETTERS E,~tate of_.Irene L. Hirsch No.&~' 0q'q Iq also known as To: Register of Wills for Ihe Social Security No. 162-07-0785 ~' Deceased. County of ~ in the Commonwealth of Pennsylvania Tile petition of the uuderslgned respectfully represents that: Your petitioner(s), Ilo ~s/are 18 years of age or older att the executOrs named iu the last will of tile above decedent, dated September 23 ,19 97 aud codicil(s) dated __Nmn~ (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death Ju Cumberland County, Pennsylvania, with ILer last family or priuclpal residence at. 1 Devonshire Square, Mechanicsbur~ (Hampden~ Township) (list street, number and muncipallty) D~.ce~de~Lt, the.n 88 years of aae, died October 7 , Jg. 2004 at. noa. y opxrxt Hospital, Camp ~Hll, ~EAst Pennsboro Township) ' Except as follows, decedent did not marry, was not divorced and did not have a child born or adopte~ .after execution of thc will offered for probate; was not tile victim of a kilting and was never adjudicated nlCOUlpeteut: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property . $ 289,000.00 (If no( domiciled in Pa.) Personal property In Peunsylvanla $ (If not domiciled in Pa.) Personal property in Couuty $ Value of real estate ill Pennsylvauia . ' $ t ct'4: nn~. ~n situated as follows: ~ D~xrc,~h4~c~ R~,,~-~ M,a,.~!~a~,4~,~EbU~~ WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) pre,eh(ed herewith aud tile grant of letters therou. (testamentary; administration cA.a.; administration d.b.n.c.t.a.) OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANI~ COUNTY OF ~-~'-~'~,~r- x,c~c~ ~ ~s t The ~etitioner(s) ~boye-named sw?r(s) or affirm(s) th~the s~atemen~ In the foregoing petition are rue auo correct to the vest of the ?owledge and be i~f/o~ velitmner~s~nd that as penonal represen- tative(s) of the abo~ decedent petitioner(s) will well ~r~l~ a~n}~ the es~t~rding to law. Sworn to or a[f,~, aud subscribed ~ ~~[]~ ~J !/~ ~ b~oremethis l~~ dayof I -~Wll ~l /t/ 'vt~ ~' No..~-~- oq-ql~ Estate of ,.~~_ ~~,~c.k. , ~ Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW (~)C--"¥'OS~,.._ ~ -~ ~c~o~ ~ , In consideration of the petition on the reverse side hereof, satisfactory proof baying been presented before me. IT IS DECREED that the instrument(s) dated C~. d ° ' escrlbed thereto be admitted to probate and filed of record as the last will of aad Letters _ · '::~:-L~0:Z2:, ,,~.~ ~ ~, ; % - FEES ' ~J '~ Probate, Letters, Etc .......... $ ~/"~, 6~ Short Certificates( ) .......... ~ ATTOrNEy (Sup. Ct. I.D. No.) TOTAL _ $ ~'~g. o ~ ADDRESS Filed ..... J.~.. 7. ~ .'~.'7...~..~ ............. PitlONE 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 tbr this certificate, $2.00 ~ 2,t,~.~z_~ P 10867570 : Date COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH 88 LAST WILL AND TESTAMENT OF IRENE L. HIRSCH I, IRENE L. HIRSCH, of the Township of Hampden, County of Cumberland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Lsst Will and Testament, hereby revoking and making void any and all prior Wills by me at any time heretofore made. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can be conveniently done, and in this respect, I further direct that all estate, inheritance and succession taxes that may be assessed in consequence of my death, of whatever nature and by whatever Jurisdiction imposed, shall be paid out of the principal of my general estate to the same effect as if said taxes were expenses o£ administration mud all property includable in my taxable estate whether or not passing under this Will shall be free and clear thereof. 2. I give and bequeath my diamond and ruby ring and my antique amethyst dishes to my good friend, JANET TYSON, if she slL~vives me, -1- I give, devise and bequeath all the rest, residue and remainder of my estate, real, personal and mixed, whatsoever and wheresoever the same may be situate, to my good friend, RAT A. YOUNG, absolutely and unconditionally. LASTLY, I nominate, constitute and appoint my good friend, RAT A. ¥0UNG and J. ROBERT STAUFFER, Co-Executors of this my Last Will and Testament, and direct that they be excused from posting bond or other security for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this __~L~_ day of September, A. D., 1997. Irene L. Hirsch -2- Signed, sealed, published and declared by the above named, IRENE L. HIRSCH, as and for her Last Will and Testament, in the presence of us, who have subscribed ou~ names hereto as witnesses, at the request of said testatrix, in her Presence and in the presence of each other. COMMONWEALTH OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) I, IRE~,TE L. ~IRSCH , the testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and volun- tary act and deed, for the purposes therein contained. Sworn and affirmed to and acknowledged before m.~ I~_~ L. }!!~SC!{ , the testatrix , this day of Septembe~ , A. D., 1997. ~' - Irene L. Hirsch ~ Notary Public · ' SS. COUNTY OF CUMBERLAND ) ~ We, the undersigned, J. ROBERT STAUFFER and SUSAN A. McCOY , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the testatrix , IRENE L. HIRSCH , sign and exe- cute the instrument as ~her Last Will and Testament; that the said testatrJ_~ , IREt~E L, HIRSC}t , executed it as ]~/her free and voluntary act for the purposes therein expressed; that each of us, in the bearing and sight of the testatrix , signed the Will as witnesses; and that to the best of our knowledge, the testatrix was, at the time, eighteen (18) or more years of age, of sound mind, and under no constraint, duress or undue influence. Sworn and s~bscribed to before ~~~~~~'~J~'% me~ thi. s ,'~O'~r2~'~ day of oep~ember , 1997 -4- CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Irene L. Hirsch Date of Death: October 7, 200/4 Will No. 21-04-0919 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 oil or mailed to the following beneficiaries of the above-captioned estate on aotvbe,- t a, 200/4 : Name Address Janet Tyson 673 South Middlesex Road Carlisle. PA 17019 Nolice has now been given to all persons entitled thereto under Rule 5.6(a) except None Name John lq. Eak±n Address Market Square Building ~ Mechanicsburg~ PA 17055 Telephone (713 766-3172 ca~ ¢ Capacity: __ Personal Representative X L~i~ , .:! Z. Counsel for personal representative PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 004728 YOUNG RAY A 1 DEVONSHIRE SQUARE MECHANICSBURG, PA 17050 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 $56,779.27 ESTATE INFORMATION: SSN: 162070785 FILE NUMBER: 2104-0919 DECEDENT NAME: HIRSCH IRENE L DATE OF PAYMENT: 12/13/2004 POSTMARK DATE: 12/13/2004 COUNTY: CUMBERLAND DATE OF DEATH: 10/07/2004 TOTAL AMOUNT PAID: $56,779.27 REMARKS: R YOUNG CHECK# 100 INITIALS: VZ SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS '" REV-1500 ~ COMMONWEALTH OF ~_ '-~'_ ~ PENNSYLVANIA ~,"~.~¢~ DEPT 280601 INHERITANCE TAX RETURN 2 1 0 4 0 9 ! 9 -'q%~'.~ HARRISBURG, PA17128-0601 RESIDENT DECEDENT C,91AT¥COD~ YEAR NUUBER DECEDENTS NAME iLAST FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Z Hirsch, Irene, L. 162 07 - 0785 UJ t""~ DATE OF DEATH (N1M-DD-YEAR) DATE OF BIRTH IMM DD YEAR, THIS RETURN MUST BE FILED IN DUPLICATE WITH THE LU fO 7 October 04 I 12 February 1916 REGISTER OFWILLS LU )IF APPLICABLE) SURV!ViNG SPOUSE S NAME !LAST FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER ~ [~ 3 Remainder Return ,date c'death rcr to 2 3 8 , [ 4 Limited Estate ~ 5. Federal Estate Tax Return Requi~ed =oo ~ 6 DecedentUied Testate,Axe -c:p c~,', [] 7 Decedent Maintaned a Living Trust ;*tta ncsp of Tr~st, 1 8 TotalNumberofSafe DeposdBoxes ~' btigation !~ !1 Election to tax unde~Sec 9113(A ~,tt~ ,-s ,,c, < ~ 9 Proceeds Received ~ THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: z ~ NAME COMPLETE MAILING ADDRESS z John M. Eakin O m~ FIRM NAblE,FApoha~ Market Square Building ~ Mechanicsburg, PA 17055 ~ TELEPHONE NUMBER o o (717) 766-3172 1 Rea! Estate (ScheduleA) ii1 2. Stocks aqd Bonds (Schedule B) (2) 127,285 17 4 Modgages & Notes Receivable (Schedule D) (4) 5 Cash, Bank Deposits &Miscelianeous Personal Property (5) 15,942 · 04 (Schedule E/ X~ ~ 6 Jointly Owned Proper~y (Schedule F) (6) 12 1,886. O0 ~ [] Separate Billing Requested ~ 147,136.08 ~ (Schedule O or L} ,~ 8 Total Gross Assets (total Lines 1-7) (8) 412,249 · 29 O 10,936.43 [,BI 9 Funeral Expenses & Administrative Costs (Schedule H) (9) 10 Debts of Decedent. Modgage Liabilities, & bens (Schedule I) (10) 2 ~ 86 1 · 85 11 Total Deductions (total Lines 9 & 10) (1111 13 ~, 798 · 28 12 Net Value of Estate (Line 8 minus Line 11) (12) 398,451.01 made ISchedule J) 14 Net Value Subject to Tax (Line 12 minus Lie 13/ (14) 398,45 1.0 1 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES ~ rate or transfers under Sec 9116re)/ 2) x 0 (15) ~ 16 Amount of Line 14 taxable at lineal rate x 0 __ (!6) I~. 17 Amount of Line 14 taxable at sibling rate x 12 O 18 Amount of Line 14 taxable at co)lateral rate 398,451,0] 59,767,65 (~ x 15 (181 X 19 Tax Due 191 59,767.65 > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < Decedent's Complete Address: STREET ADDRESS i Devonshire Square STATE PA I ZIP 17055 CiTY Mechanicsburg '1 , Tax Payments and Credits: 1 Tax Due (Page 1 Line 19) {1) 59,767.65 2 Credits/Payments A Spousal Poverty Credit B Prior Payments C Discount 2,988.38 Total Credits (A + B + C ) (2) 56,779.27 3 Interest/Penalty if applicable D Interest E Penalty Total Interest/Penalty ( 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) 56,779.27 A. Enter the interest on the tax due (5A) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B) 56,779.27 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1 Did decedent make a transfer and: Yes No a retain the use or income of the property transferred: b retain the right to designate who shall use the property transferred or its ~ncome; c retain a reversionary interest; or __ d receive the promise for life of either payments, benefits or care? LJ 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 Retiremen Account, annuity, or other non-probate properly 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, Ur'de Dena les cf peri Jr/ I eec!are tria! I ha',e examined this return iF, clodlng accompany'nc scnedUes and sta(ements an¢ to tl~e best of m~ knowledge and Dehef it is [rae correct acd complete ~ persop8' representatse is based on ah ir formation of ~',hich 3reparo'hss a"y xno¢cledge DATE >. TATIVE DATE For dates of death on or after July 1 1994 and before January 1, 1995, the tax rats imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 PS §9116 (a){1,1) 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 PS §9116 (a) (1,1) (ii)l The statute doe. 8 not exempt a transfer to a surv~wng spouse from tax, and the statutory requoements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneflciaq/ 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 naturat parent an adoptive parent, or a stepparent of the child is 0% [72 P.S, §9116(a)(1 2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beoeficiaries is 4.5%, except as noted in 72 PS §9116(1.2) I72 PS. §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 PS. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent m common with the decedent, whether by blood or adoption ~'~"' ~' ~ SCHEDULE B :~O,~O~^,~A~,~-'~N~,,^~,~ STOCKS & BONDS INHERITANCE TAX RETURN ESTATE OF FILE NUMBER Irene L. Hirsch 21-04-0919 All property jointly-owned with right of sun/ivorship must be disclosed on Schedule F ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 1646.456 Shares PP&L Common @ 48.15 $ 79,276.86 2 665.958 Shares CSX Common @ 35.29 $ 23,501.67 3 396.8044 Shares PPG Common @ 61.76 $ 24,506.64 TOTAL (Also enter on line 2. Recapitulation) $ 127,285.17 (If more space is needed, insert additional sheets of the same size) ~~ SCHEDULE E COMMONWEALTHOFPENNSYLVANIA CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Irene L. Hirsch 21-04-0919 include the }roceeds of litigation and the date the proceeds were received by the estate All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Waypolnt BAnk Acct. # 1800002073 $ 4,812.15 2 Waypoint Bank Acct. # 1800010760 $ 10,269.69 3 A~nerican Express, Refund of Long Term Care Policy $ 628.20 4 AAA Refund $ 232.00 TOTAL (Also enter on line 5, Recapitulation) $ 15,942.04 (If more space is needed inseri additional sheets of the same size) 10-13-2004 Checking Account Inquiry Next display: 05 20-0700-4 11:20:04 Current Statement for: 1800002073 DSPBR01817 IRENE L HIRSCH Bal as of 9-20-04 277.39 1 DEVONSHIRE SQ +Dep/CR: 2 11,000.00 MECHANICSBURG PA 17050 6876 -Chks/DR: 4 6,465.24 -Service charge: .00 +Interest paid: .00 Current balance: 4,812.15 Pst Dt Serial Number TC Description Amount Balance X Eff Dt Str/Run/Bat/Seq# 092204 016 ATM/WEB CREDIT 1000.00 1277.39 092704 010 DEPOSIT 10000.00 11277.39 092804 1979 081 CHECK 1000.00- 10277.39 093004 1980 081 CHECK 1244.00- 9033.39 100404 1982 081 CHECK 3653.82- 5379.57 100504 1981 081 CHECK 567.42- 4812.15 Bottom F3=Exit F8=Recent trans F16=Print research stmt Fll=Fold/unfold F13=Inquiry window F15=Restart F24=More keys 10-13-2004 Savings Account Inquiry Next display: 05 20-0700-4 11:19:37 Current Statement for: 1800010760 DSPBR01817 IRENE L F!RSCH~. Bal as of 9-20-04 1,200 69 1 DEVONSHIRE SQ +Dep/CR: 5 10,068 70 MECHANICSBURG PA 17050 6876 -Chks/DR: 1 1,000 00 -Service charge: 00 +Interest paid: 30 Current balance: 10,269 69 Pst Dt Serial Number TC Description Amount Balance X Eff Dt Str/Run/Bat/Seq# 092204 053 WEB FR SAV TO D 1000.00- 200.69 092404 018 IDS ~d~EX MPLS M 300.00 500.69 092404 018 IDS AMEX MPLS M 200.00 700.69 092704 011 DEPOSIT 8193.28 8893.97 093004 997 INTEREST PAYMEN .30 8894.27 100104 018 US TREASURY 303 729.00 9623.27 100404 011 DEPOSIT 646.42 10269~69 Bottom F3=Exit F8=Recent trans F16=Print research stmt Fll=Fold/unfold F13=Inquiry window F15=Restart F24=More keys SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER Irene L. Hirsch 21-04-0919 Joint tenant(s): NAME ADDRESS RELATIONSHIP TO DECEDENT A. Ray A. Young 1 Devonshire Square None Mechanicsburg, PA 17055 B. Jointly-owned property: LETTER DATE ITEM FOR NUMBER JOINT J MADE DESCRIPTION Of: PROPERTY TOTAL VALUE DECD'S DOLLAR VALUE C TENANT JOINT OF ASSET % INT. DECEDENT'S INTERI ST 1. A 6/30/04 Real Estate - 1 Devonshire Square, Mechanicsburg, PA (Hampden Township) Assessed Value $217,812 Common level ratio 1.]I 217,812 X 1.11 $241,771.00 50 $120,886.00 2. A 5/26/91 1992 Pontiac Bonneville $ 2,000.00 50 $ 1,000.00 , I TOTAL (Also enter on line 6, RecapitulationI S 121,886.00 (if more space is needed insert additional sheets of same size) ~. ,5~,.~×.,~.g,, ~,~ SCHEDULE G INTER-VIVOS TRANSFERS & COMMONWEALTH OF PENNSYLVANIA iNHERITANCE TAX RETURN MISC, NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Irene L. Hirsch 21-04-0919 This sciledule must be completed ~qd fleo ~f the ans.,er to any of qdes~i ~ns i ~ o~ch 4 on t~e rever~e sde of the REV 1500 COVER SHEET is yes DESCRIPTION OF PROPERTY ......... ¥,0 t.¢~ i ...... 1 ~e=~ca~ gxpress, see at~ac~ed 147,~36.08 tO0 [t47,t36.08 TOTAL (Also enter on line 7, Recapi[ulation) $ 147,136,08 (If more space is needed, insert additional sheets of the same s~ze) Daniel V Lowe 11/22/2004 02:25 PM To: David X Kidd/Field/WH/AEFA@AMEX cc: Subject: iRENE HIRSCH (DEC) CID 11073026 4 001 - DATE OF DEATH VALUES AS REQUESTED IDS LIFE INSURANCE COMPANY AMERICAN EXPRESS FUNDS AMERICAN EXPRESS CERTIFICATE COMPANY AMERICAN EXPRESS BROKERAGE 70100 AXP Financial Center Minneapolis, MN 55474 November 22, 2004 DAVID W KIDD STE 302 1200 CA~MP HILL BY-PASS CAMP HILL, PA 17011-3700 Dear DAVID W KIDD: Thank you for your recent h~quiry regarding IRENE L HIRSCH's accounts. These are the values of the accounts as of 10/07/2004. Annuities - Post 1985 Account Number Total Value 93001874142 9 004 $32132.00 93001970710 6 004 $57629.75 93001970712 2 004 $25701.07 93002058455 I 004 $31673.23 LTC Premium Return Account Number Total Value 91002542975 4 004 $628.20 The date of death values provided are for estate tax purposes and are not a value to be paid. Accounts may be subject to market fluctuation as governed by each product. Please note that the values indicated for any Life Insurance product(s) reflect the gross death benefit at date of death, not the cash value. We appreciate the opporlunity to be of service to you. Please contact us if you have any questions. Sincerely, Dan Lowe for MC Death Settlements Processing Team REV 1511 EX+ (12-99) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Irene L. Hirsch 21-04-0919 Debts of decedent must be reported on Schedule [, ITEM NUMBER DESCRIPTION AMOUNT A FUNERAL EXPENSES: t Malpezzl Funeral Home $ 2,045.00 B ADMINISTRATIVE COSTS: 1 Personal Representative's Commissions $ 4, 125. O0 J. Robert Stauffer Name of Personal Representative(s) Social Security Nurnber(s)/EIN Number of Personal Representative(s) Street Address 119 E. Coover Street City Mechanlcsburg State PA Zip 17055 Year(s) Commission Paid: 2005 2. Attorney Fees $ 4, 125.00 3 Family Exemption: (If decedents address is not the same as claimant's attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4 Probate Fees Letters Testamentary $ 383.00 5 Accountants Fees 6. Tax Return Preparer's Fees Cumberland Law Journal, Estate Notice $ 75.00 8 Sentinel, Estate Notice $ 118.43 9 Filing Fee $ 15.00 10 Reserved for account, short certificate, notary $ 50.00 TOTAL (Also enter on line 9. Recapitulation) S 10,936.43 (If more space is needed, insert additional sheets of the same size) E$IAIE OF rILE IIUMBER Irene L. H±rsch 21-04-0919 IIFM f JUM[IEI~ [ H: ~( fur' I I~ )Il AMOUI If I Ess±s & Sons, ~mp=ovemen~: contract; made pr±o= l:o death $ 2,643.00 2 Bankcard, mastercard account $ 218.85 101 AL (Also e.te¢ on fine t0, Rec..pilulallon) $ 2.861.85 REV-1513 EX+ (9-00) ~ SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FIlE NUMBER Irene L. Hirsch 21-04-0919 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 transCers under Sec. 9116 (a)(1.2)] 1. Ray A. Young None Entire Estate 1 Devonshire Square Mechanicsburg, PA 17055 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET 11 NON-TAXABLE DISTRIBUTIONS: A, SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 1! - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space ~s needed, insert additional sheets of the same size) LAST WILL AI'[D TESTA~ENT OF IREIIE L. ttIRSCH I, IJIE1]E L. IIIRSCtI, of tho Town, ship of Itampden, County of C~m~berland and State of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Lest Will and Testament, hereby revoking making voi,l any ampi a3! prier Wills by me at any time heretofore mad~. 1. I direct the pavement of all mi just debts and f~eral expenses as soon after my decease as the same can be conveniently done, and in this respect, I further direct that all estate, inheritance and succession taxes t[lat may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid out of the principal of my general estate to the same effect as if said t~es were expenses of administration and all property includable in my b~able estate whether or not passing ~der this Will shall be free and clear thereof. 2. I give and bequeath my diamond and ruby ring and my antique amethyst dishes to my good friend, JANET TYSON, -1- I give, devise and bequeath all the rest, residue and remainder of my estate~ real, personal and mixed, whatsoever and ~,~heresoever the same may be situate, to my good friend, RAY k. YOUNG, absolutely and v~nconditionally. LASTLY, I nomf~nate, constitute and appoint my good friend, RAY A. YOUNG and J. ROBERT STAUFFER, Co-Executors of this my Last Will and Testament, and direct that they be excused from posting bond or other security for the faithful performance of their duties in any jurisdiction. IN WITNESS Wt~EOF, I have heretu~to set my hand and seal this ~'~ . day of September, A. D., 1997. _ ~ ~m f , ' Irene L. Htrsch -2- Signed, sealed, published and declared by the above named, IRE~E L. tIIRSCIt, as and for her Dast ~Jill and Testament, in the presence of us, ~,~ho haYe subscribed our names hereto as witnesses, at the request o~' said testatrix, in her presence and in the presence of each ether. , COMMONWEALTH OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) IR!~!E L. HI~SC]I , the testatrix whose name is signed to tbs attached or foregoing iustrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed tile iustrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and volun- tary act and deed, for tbe purposes therein contained- Sworn and affirmed to and acknowledged before , the testat_~ix ., this day of Irsns L. Public COMR4ONWEALTH OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) We, the undersigned, J, ROBERT STAUFFER and SUSAN A. ~o00Y , the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the IRENE L. tIIRSCt{ , sign and exe- testat rix , cute tt-~-e in~tru-~nent as iit~Y~her Last Will and Testament; that the , executed it as said testatr~ , IREI~E_ L,. H%_RSCtI__ ]~/her free and 'vo~unt~ry act for the purposes therein expressed; that each of us, in the bearing and sight of the testatl~tx ,.' signed tile will as witnesses; and that to the best of our knowl-~dge, the testatl~ix was, at the time, eighteen (18) or more years of age, of soun--~ mi~d, and under no constraint, duress or undue influence- COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX Z806Dl HARRISBURG PA 171Z8-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX JOHN MEAKIN MARKET SQUARE BLDG MECH~NICSBURG PA 17055 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-07-2005 HIRSCH 10-07-2004 21 04-0919 CUMBERLAND 101 '* REV-15~7 Ell AFP 112-D~) IRENE L Allount Rellitted ~,." ,; MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 cUr ALONG:tHIS ~ ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ 11V =IAW:Ic--AFP--C5T:o!"-NOT-icl-oF-l'N'HlitiflN-cE-"-AX-A-PPIA-fsli"€N'~-Ai:lowANCE-OR------._----- - --. DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX IRENE L FILE NO. 21 04-0919 ACN 101 ESTATE OF HIRSCH TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED DATE 03-07-2005 NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will r~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. AIIount of Line 14 at Spousal rate (15) 16. AIIount of Line 14 taxable at Lineal/Class A rate (16) 17. AIIount of Line 14 at Sibling rate (17) 18. AIIount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due .00 X 00 = .00 .00 X 045 = .00 .00 X 12 = .00 398,451. 01 X 15 = 59,767.65 Cl9)= 59,767.65 RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets Cl) (2) (3) (4) (5) (6) (7) .00 127.285.17 .00 .00 15.942.04 121.886.00 147.136.08 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) ClO) 10,936.43 2.861.85 Cll) Cl2) Cl3) Cl4) NOTE: To insure proper credit to your account, sub.it the upper portion of this forll with your tax paYllent. 412,249.29 13.798 28 398,451.01 .00 398,451.01 TAX C DITS: rA' IT .----. l+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 12-13-2004 CD004728 2,988.38 56,779.27 TOTAL TAX CREDIT 59,767.65 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ~ . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT"" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ! LI - (-~) t-.;_ u_ : ._ C) C) c.:J /..1.' C. n~ { '\ (" I-L-., t : STATUS REPORT UNDER RULE 6.12 Name of Decedent: Irene L. Hirsch Date of Death: 10/7/2004 Will No. 21-04-0919 Admin. No. 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. account with the Court? Did the personal representative file a fmal Yes No X b . The separate Orphans I Court No. (if any) for the personal representative I 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 I Court and may be attached to this report. Date: 9/18/2006 Sign~ rn ' ~ John M. Eakin Name (Please type or print) Market Square Building Mechanicsbura Address N o PA 17055 ~~.( f-CL: 0:-; ~C. LLQC: o c..) 0 fr ~ ~~~ ::1<ctC o&~ 0::::> (.) :c 0... ( 717 ) 7663172 Tel. No . o N 0- W (/) ....0 <:;:;:) = C'J Capacity : Personal Representative x Counsel for personal representative J Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 9/14/2006 EAKIN JOHN M MARKET SQUARE BUILDING MECHANICSBURG, PA 17055 RE: Estate of HIRSCH IRENE L File Number: 2004-00919 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, 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: 10/07/2006 please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) ~ cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 9/14/2006 YOUNG RAY A 1 DEVONSHIRE SQUARE MECHANICSBURG, PA 17050 RE: Estate of HIRSCH IRENE L File Number: 2004-00919 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, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 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: 10/07/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, G~=~ Clerk of the Orphans' Court cc: File Counsel ~ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 9/14/2006 STAUFFER J ROBERT MARKET SQUARE BUILDING MECHANICSBURG, PA 17055 RE: Estate of HIRSCH IRENE L File Number: 2004-00919 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, 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: 10/07/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~~ , l Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel ~ . Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 NameofDecedent: ri!Gtlr:;: C-, Itrrf S~ IJ Date of Death: /b!J p-d () tj Estate No.: ~Obr--069/'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 .v.ether 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 ~personal representative file a final account with the Court? Yes lti No 0 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 0 No 0 c. Copies of receipts, releases, joind s and approval of formal or informal accounts may be filed with the C k of e Orphans' Court and y be Date: *~hed to this report u__ <.::) c.- Lu .-' C..::> IT.. LL I c.) c5 C)cr ?:5 i:':~! 6~5 C_) II j Ll.1 r .c CL N IJ") ..,..-0- f-.. 6.:: cc ~ . -'j( at;-- ~~<? l..Lf :;;:~ UI (L, 0:: ~--:-: o=:.::; (::5 am t1J.A/I1Ar:/t/fk1fr;' lf40iJ)IJ I 'fIt - ~~/(/J 11tf)1 Thleplione No. Capacity: .tr Personal Representative o Counsel for personal representative x: 0- C) t-- (.,.) o '-'0 <::::> c::> C"-J ~