The URL can be used to link to this page

Home My WebLink About04-0924PETITION FOR PROBATE and GRANT O^YLE ,. 5TA,,, No. ~z,fsz; Xz/aw/r r,,~' To: 3'o,--:Z,/ocer,#/'/ft./Vo, 204-01-4223 fhe petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut ors in the last will of the above decedent, dated OCTODER 15~ 190:! and codicil(s) dated NONE Register of Wills for the County of CUMBERLAND Commonwealth of Pennsylvania in the named (state relevant circumstances, e g renunciatkm, death ofexecutnr, etc ) Decedent was domiciled at death in CUMBERL&ND County, Pennsylvania, with h er last family or principal residence at 831 NORTH WALNUT STREET~ MECHANICSBURG~ MECHANICSBURG BOROUGHI PA 17055 (list street, number and municipality) Decedent, then 85 years of age, died 9125104 at SELECT SPECIALTY CARE AT HOLY SPIRIT HOSPITAL~ 503 N. 218T STREET~ CAMP HILL~ PA Except as follows, decedent did not marry, was not divorced and did not have a child bom or adopted alter execution of the will offered for probate; was not the victim of a killing and was never ajudicated incompetent: 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: $ 1241000.00 $ $ $ 75~000.00 831 NORTH WALNUT STREET, MECHANICSBURG, PA 17055 WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters TE$1AMENTARY thereon. _ .-. / (testamentary; administration c t a; administration d b n c.t.a.) -' ' (, : '~/ / J 1035 HIGHFIELD COURT ~ ~'"'~.F~/ ?~' ~ ~ ('/~L~!~/'~'~'''' MECHANICSBURG PA 17055 ~ ' LOIS ~S.-EC~ KERT ¢, ~ ~ ELIZA/BEV" G. 5PAHR / 33 W'"~ LOCUST 5TREE'------'--~ ~ '= MECHANICSBURG PA 17055 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF~UMBERLANDf 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 ~e knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to laxv. ~ ,' -cd ~/ /. Sworn to or affirmed and subscribed before me this jz~ da~y6f ! IOIS S. ECKERT OCT Estate of OAYLE ,. STANa , Deceased DECREE OF PROBATE AND GRANT OF LETTERS ^ D OW OCT', t q, , in consideration ofthe petition on the reverse side hereof; satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated 101¶5193 described therein be admitted to probate and filed of record as the last will of 6AYLE I. aTANR and Letters TESTAMENTARY are hereby granted to LOIS S. ECKERT ELIZABETH G. 5PAHR FEES Probate, Letters, Etc ......... Short Certificates ( .~ } ...... TOT*~ Filed ........................ MURREL R. WALTERS Iii, ESQ. 24849 ATTORNEY (Sup Ct. ID No) 54 EAST MAIN STREET MECHANICSBURG PA 17055 ADDRESS PHONE COMMONWEALTH OF PENNSYLVANIA ° DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH Cumberland East Pennsboro ~r LAST WILL AND TESTAMENT BE IT REMEMBERED THAT I, GAYLE I. STARR, a resident of Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this to be my LAST WILL and TESTAMENT, hereby previously made by me. revoking any and all Wills and Codicils I I declare that I am not married, my beloved husband, MAURICE E. STARR, having predeceased me, and that I have nine children, LOIS S. ECKERT, ELIZABETH G. SPAHR, DOROTHY A. VESLICH, NANCY L. WELLS, JEANETTE L. ZIEMER, RICHARD M. STARR, CAROL L. BARRICK, VICKI K. KNEPP, and TERRY J. BLAND. paid from decease. II I direct that all my just debts and funeral expenses shall be my residuary estate as soon as practicable after my III I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. IV I give, devise and bequeath all my property, whether real or personal, wherever situate, including any property over which I may have a power of appointment to my children, LOIS, DOROTHY, NANCY, JEANETTE, equal shares, per capita. RICHARD, CAROL, VICKI, V My children have given me jewelry and personal wish to have returned to them if they so desire. children have borrowed money from me. If there remaining at my death, and TERRY, in items which I Some of my is a balance it should be offset against any inheritance. VI I nominate, constitute and appoint my daughters, LOIS and ELIZABETH, as Co-Executrixes of this LAST WILL, to serve without bond. If either is unable or unwilling to act in that capacity, then I nominate, constitute and appoint my daughter, DOROTHY, as Executrix of this LAST WILL, to serve without bond. IN WITNESS WHEREOF, I, GAYLE I. STARR, have set my hand to ? this L~ST WILL this ~ ~ day of ~'~ ,~? , 1993. GAYLE I. STARR Signed, sealed, published and declared by the above-named GAYLE I. STARR, as and for her Last Will and Testament, in the presence of us, who, at her request and in her presence, and ink,the p~esence of each other, have hereunto subscribed our na~e~ as witnesses, f / ~ / ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA : ss. COUNTY OF CUMBERLAND : I, GAYLE I. STARR, 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; that I signed it as my free and voluntary act for the purposes therein expressed. GAYLE I. STARR Sworn or affirmed to and acknowledged before me by GAYLE I. STAR, Testatrix, this ....: F,~ day of , . ij.,)t~ , 1993. Nora/ry' PUblic I No afi~ Sea{ Mary Lou Mechal C'~Ot:~rO [3ct°, C umberl~r,d County AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA : ss. COUNTY OF CUMBERLAND : the witnesses whose names are signed to the attached or foregoing instrument being duly qualified according to law, do depose and say that we were present and saw Testatrix sign and execute the instrument as her LAST WILL; that GAYLE I. STARR signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing an~ sight of the Testatrix signed the Will as witnesses; and that/~o the best of our knowledge, the Testatrix was at the time 18 y~ars of age or more, of sound mind and under/no constraint or ~ndue influence. / / // /~ Sworn or affirmed to and acknowledged before me this :-- day of ~'~2%~.~ , 1993 Notary 1 . ,. CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: GAYLE I. STARR Date of Death: 9/25/04 Will No. 2004-00924 To the Register: Admin. No. 21-04-0924 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 October 18, 2004 Name Lois S. Eckert Elizabeth G. Spahr Dorothy A. Veselich Nancy L. Wells Jeanette S. Ziemer Richard M. Spahr Carol L. Barrick Vicki K. Knepp Terry J. Bland Address~ 1035 Highfield Court, Mechanicsburg, PA 17055 33 W. Locust Street, Mechanicsburg, PA 27055 4293 Patterson Road, Butler, PA 16002 7121 Caprock Circle, Las Vegas, NV 89129 502 Hilltop Place, Joshua, TX 76058 MTR, 5th Floor, Johnson VAMC, 1 Medical Center Drive, Clarksburg, WV 26301 Box 109, Barrick Hilll Road, Shermansdale, PA 17090 1622 Centerville Road, New~ille, PA 17241 17943 Highlands Ranch Place, Poway, CA ~ 92064 Notice has now been given to all persons entitled theret nder R t: NONE 2004 Murrel R. Waiters, III, Esquire 54 East Main Street Mechanicsburg, PA 17055 (717) 697-4650 Capacity: . Personal Representative __X_ Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENTOFREVENUE BUREAU OFINDIVIDUAL TAXES DEPT 280601 HARRISBURG, PA 37128 O601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV 1162 EX{11-96) NO. CD 004764 WALTERS MURREL R III 54 E MAIN STREET MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN: 204-01-4223 FILE NUMBER: 21 04- 0924 DECEDENT NAME: STARR GAYLE I DATE OF PAYMENT: 12/27/2004 POSTMARK DATE: 1 2/24/2004 COUNTY: CUMBERLAND DATE OF DEATH: 09/25/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $7,500.23 REMARKS: TOTAL AMOUNT PAID: $7,500.23 SEAL CHECK//104 INITIALS; JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INiTIAl' STARR GAYLE DATE OF DEATH (Mt~DD-Year) 09/25/2004 (fF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST. AND MIDDLE INITIAL) REV-1500 INHERITANCE TAX EETUEN RESIDENT DECEDENT DATE OF BIRTH (MM-DD-Year) 08108/t 918 OFFICIAL USE ONLY 2 I -0 4 0 9 2 4 SOCIAL SECURITY NUMBER 2 0 4 - 0 I - 4 2 2 3 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER ["~'] 1. Original Return n-]4. Limited Estate ~-16. Decedent Died Testate [] 9. Lil~aiton Proceeds Received F12. Supplemental Return ]4a. Futom Interest Compromise H~ o~h a~ 12-12-82) --']7. Decedent Maintained a Living T~Jst (At,ch coty of Trust) ] 10. SpDUsal Poverty Crodit (date of dea~ between 12-3~-91 and 1.1.§$) NAME MURREL R. WALTERS III, ESQUIRE FIRM NAME (If Aopl~cable) TELEPHONE NUMBER 7'17-697-4650 ICOMPLETE MAIUNG ADDRESS 54 EAST MAIN STREET MECHAN~_$~RG J'~3. Remainder Return Nateofde~pr~to 12-13-82) [~5. Federal Estate Tax Return Required __ 8. Total Number of Safe Depesit Boxes [] 11. Election to tax under Sec. 9113(A) (Atac~ Sch O) PA '17055 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held CorportaJon, Pamemhip or Sole-Pmppetomhip {3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Pe~onal Prope~/ (5) (Schedule E) 6. Join~ Owned Property (Schedule F) (6) ] Separate Billing Requested 7. Inter-Vivos Traesfem & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Adrninistm~ve Costs (Scheduta H) (9) 10. Debts of Decedent, Mo~age Liabil~es, & Liens (Schedule I) (10) 11. Total Beducttans (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) (8) '199,362.02 (11) 23~368.48 549.54 (12) 23,9'18.02 '175,444.00 13. Charitable and Governmental Bequesta/Seo 9113 Trusts for which an eleciJon to tax has not been (13) made (Schedule J) 14. Net Value Subject ~ Tax (Line 12 minus Line 13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the s~usal tax rate, or transfers under Sec. 9116 Ia)(1.2) 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 cellateml rate 19. Tax Due X (15) '175,444.00 X .045 (16) 7,894.98 X .12 (17) X .15 (18) (19) 7,894.98 Oecedent's Complete Address: STREET ADDRESS 831NORTHWALNUT STREET CITY MECHANICSBURG STATE PA Tax Payments and Credits: 1. Tax Due {Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 394.75 3. Interest/Penalty if applicable D. Interest E. Penalty Total Credits ( A * B + C ) (2) Total Interest/Penalty ( D + E } (3) if Line 2 is greater than Line I + Une 3, enter the difference. This is the OVERPAYMENT. Check box on Page I Line 20 to request a refund (4) If Une I + Une 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 Une 5 + 5A. This is the BALANCE DUE. (SB) Make Check Payable to: REGISTER OF WILLS, AGENT IZ~P t7055 7,894.98 394,78 7,500,23 7;500.23 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a trensfer and: Yes No a. retain the use or income of the property transferred; ........................................................................... [] [] b. retain the dght to designate who shall use the property transferred or its income; ........................................ [] [] c, retain a reversionary interest; or ...................................................................................................... [] [] d. receive the promise for life of either payments, benefits or care? ............................................................. [] [] 2. If death occurred after December 12, 1982, did decedent transfer preper~y within one year of desth without receiving adequate consideration?. .............................................................................................. [] [] 3. Did decedent own an 'in trust for" or payable upon death bank account or secudty at his or her death? ................. [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non.prepete 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. ~ ~p ef pa~ur~, i dec~a? ~at I have examined this refum intsudin~ accompany ng schedu es and statements, and to the best of my knowledge and belief it is true, corTect ~ comp e e redarer omer than me personal representative is based on all mformaiion of which p~eparer has any Imowledge. SIGNATU RF...q)F PER~ RF~q~ON~IBLE F~)R FILING RETURN DATE LOIS $. ECK~I~T 103~H~"~H~I~-LD COURT ELIZAB~'r~ G. $.~R~ 3~/~OCUST ST. MECHAH!r~$_~RG PA 17055 SIGNATURE OF PREPAF~/~E,~. ~,.~,.,TH R HCfl/I~pR,,E~EJ~"ATIVE ADDRESS MURREL R. ;I~ALTER$ ,! EEQ. MECHANICSBURG 54 EAST MAIN STREET PA ¶ 7055 For dates of death on or after JuJy 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 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, §9116 (a) (1.1) (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 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 dec, eased 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 PS. §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. §9116(1.2) [72 PS, §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedeat's siblings is 12% [72 P.S, §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. REV-1502 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER STARR GAYLE I, ;{1 04 0924 All real ~,,,,~t~, owned solely or as a tenant in common must be repo~ted at fair market value. Fair market value is defined as the pdce at which property wouh:i be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevaot facts Real prepert'/which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION 831 N. WALNUT STREET MECHANICSBURG, PA t 7055 NET 5ALE PRICE VALUE AT DATE OF DEATH 102,188.72 TOTAL (Also enter on line 1, Recapitulation) $ '102,188.7., (It more space is needed, insert additional sheets of the same size) REV-15~)8 EX ~- (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF STARR GAYLI~ FILE NUMBER I, ;~1 04 Include the proceeds of litigation and the date the proceeds were received by the estate, All property jointly.owned with right of sun~ivorship must be dis~!,,-o,~ on Scbedure F. 0924 ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 2. 3, 4 5 CITIZENS BANK CHECKING CITIZENS BANK CHECKING 1997 BUICK CENTURY NET SALE PRICE FURNITURE AND HOUSEHOLU ITEMS NET SALE PRICE MEDICAL INSURANCE REFUND 73,511.90 16,904.26 5,200.00 1~054.30 502.84 TOTAL (Also enter on line 5, Recapitulation $ 97,t7~3q (If more space is needed, insert additional sheets of the same size) EV-15~I1 EX + (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER STARR GAYLE I, 21 04 DeMs of decedent must be reported on Schedule 1, 0924 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. MYERS FUNERAL HOME 8,56'1.00 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Pemonal Representative (s) LOIS S, ECKERT Social Secudb/Number(s)/EIN Number of Pemonal Representative(s) S'~etAddress t035 HIGHFIELD CT. 195-28-2485 C~ MECHANICSBURG State PA Year(s) Commission Paid: 2005 AttomeyFees MURREL R. WALTERS II1~ ESQUIRE Family Exemption: (If decedent's address is not the same as ctaimeafs, attach explana~on) Claimant Zip 17055 Sheet Address Relationship of Claimant to Decedent Proba'~ Fees REGISTER OF WILLS Aocountant's Fees Tax Retum Preparer's Fees HOUSE APPRAISAL ESTATE CHECK FEE State Zip CUMBERLAND COUNTY WILLIAM L. DERRICK 4,487.00 5,180.00 325.00 300.00 28.48 TOTAL (Also enter on line 9, Recapitulation) $ {If more space is needed, insert additional sheets of the same size) TARR Decedent's Name Continuation of REV-1500 Inheritance Tax Return Resident Decedent GAYLE I. 21 Page 1 04 0924 File Number Schedule H - Funeral Expenses & Administrative Costs - B1 ITEM NUMBER 2 DESCRIPTION ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) ELIZABETH G. SPAHR Social Secudty Number(s)/ElN Number of Pemonal Representative(s) StmetAddress 33 WEST LOCUST ST 171305843 CJI7 MECHANICSBURG Year(s) Commission Paid: 2005 S~ PA Zip 17055 AMOUNT 4,487.00 SUBTOTAL SCHEDULE H-BI 4,487.00 · REV-1512 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES~ & LIENS ESTATE OF FILE NUMBER STARR GAYLE I, ;~1 04 0924 Include unreimbumed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH t/ERIZON TELEPHONE !JNITED WATER e,l-r TELEPHONE PPL ELECTRIC WATER HEATER REPAIR BOROUGH OF MECHANICSBURG 8EWER AND REFUSE 25.33 28.17 48.49 106.t7 235.36 106.02 TOTAL (A~so enter on line 10, Recapitulation) (If more space is needed, inser~ additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA iNHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF STARR NUMBER ]E, 1. 2. 3. 4. 5. 6. 7. GAYLE I, NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include oulfight spousal distributions, and transfers under Sec. 9116 (a) (1.2)] LOIS S. ECKERT t035 HIGHFIELD COURT MECHANICSBURG, PA .17055 ELIZABETH G. SPAHR 33 W. LOCUST STREET MECHANICSBURG, PA '17055 DOROTHY A. VESELICH 4'193 PA'I'rERSON ROAD BUTLER, PA '16002 NANCY L. WELLS 7t2"1 CAPROCK CIRCLE LAS VEGAS, NV 89'129 JEANEI-rE S. ZIMMER 502 HILLTOP PLACE JOSHUA, TX 76058 RICHARD M. STARR 294 GRAND AVE., ROOM ~ KITTANING, PA ¶ 620t CAROL L. BARRICK BOX t09, BARRICK HILL ROAD SHERMANSDALE, PA .17090 FILE NUMBER 21 04 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) DAUGHTER DAUGHTER DAUGHTER DAUGHTER DAUGHTER SON DAUGHTER 0924 AMOUNTORSHARE OF ESTATE t/9 RESIDUE t/9 RESIDUE 't/9 RESIDUE '1/9 RESIDUE .1/9 RESIDUE t/9 RESIDUE t/9 RESIDUE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET 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 II - 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) Continuation of REV-1500 Inheritance Tax Return Resident Decedent STARR GAYLE I. 21 04 0924 Decedent's Name Page 2 File Number Schedule J - Beneficiaries - 1 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE ! TAXABLE DISTRIBUTIONS (include outright spousal distributions) 8. VICKI $. KNEPP DAUGHTER 1/9 RESIDUE 622 CENTERVILLE ROAD NEWVILLE, PA 17241 9. TERRY J. BLAND DAUGHTER t/9 RESIDUE 17943 HIGHLANDS RANCH PLACE POWAY, CA 92064 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX MURREL R WALTERS III ESQ 54 E MAIN ST MECHANICSBURG PA 17055 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-07-2005 STARR 09-25-2004 21 04-0924 CUMBERLAND 101 '* REV-1541 EX AFP 112-041 GAYLE I Allount Rellitted ~:::; MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 CUT ALONG.THIS~LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ iEv:rJl"f.t!('.AFP'~l1r:6!'r.NO".icE.OF.l'N'HEi.I.fANCE.TAX.A.PPiA.fsEJiEN'~..A[LoQANCE.OR.............. ... ....-.... ;;...-.. DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX GAYLE I FILE NO. 21 04-0924 ACN 101 ESTATE OF ;iCSTARR e1::. .-..., ~.:: ' () TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED NOTE: I~ an assessment was issued previausly, lines 14, IS and/ar 16, 17, 18 and 19 will re~lect ~igures that include the tatal a~ !bb returns assessed ta date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due .00 X 00 = .00 175.444.00 X 045 = 7.894.98 .00 X 12 = .00 .00 X 15 = .00 ll9)= 7.894.98 v 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 ll) (2) (3) (4) (5) (6) (7) 102.188.72 .00 .00 .00 97.173.30 .00 .00 (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/Governmental Bequestsj Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 23.368.48 549.54 (11) ll2) ll3) ll4) DATE 03-07-2005 NOTE: To insure proper credit to your account. subIIit the upper portion of this forll with your tax paYllent. 199.362.02 23.918 02 175.444.00 .00 175.444.00 TAX CREDIT~: I+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 12-24-2004 CD004764 394.75 7.500.23 TOTAL TAX CREDIT 7.894.98 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.) PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY UNTIL COMPLETION STATUS REPORT UNDER RULE 6.12 Name of Decedent: Date of Death: GAYLE 1. STARR 9/25/04 Estate No.: 21-04-0924 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 (date) 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 No_X_ B. The separate Orphans' Court No. (if any) for the personal representative's account is: (Not Applicable in Dauphin County) C. in interest: Did the personal representative state an account informally to the parties 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' Couvtand may be attached to this report. / I III . /1i/II/v/ / ./ ____ r- D~1~~September 7, 2005 ?r' _ c~ '.-: ~. -. .::"_~- (- ': -- co j MURREL R. WALTERS, III, ESQUIRE 54 East Main Street Mechanicsburg, P A 17055 717-697-4650 ,~ L.'""J c,/) L~ C:;'~:'.\ -e::":;;.:.:i ('-.; Capacity: Personal Representative _X_ Counsel for Personal Representative e~