HomeMy WebLinkAbout04-0975PETITION FOR PROBATE and GRANT OF LETTERS
Estate of ~/bT-~ti~l/q~ ~, ~
also known as
Deceased.
Social Security No. [ q y.- .X ~t-
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut~-t.~
in the last will of the above decedent, dated o~'7'o
and codicil(s) dated
To:
Register of Wills for the
County of ~ in the
Commonwealth of Pennsylvania
named
(state relevant circnmstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in C- tx. ~a ,~ 6-~L/--~u~> County, Pennsylvania, with
h last family or principal residence at 35-R8 S-~.grt~nn~7~_ ~)R, Prl~r' ~ $ ~
(list street, number and muncipality)
Decendent, then ~ ~ years of age, died .. , :1~ ,
Except as follows, decedent did not marry, was not divorced and did not have a cnim t)orn or aoopt~u
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent 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:
WHEREFORE, petitioner(s) respectfully request(s) the probate of the~ will ~[nd codic~(s)
presented herewith and the grant of letters
theron.
(testamentary; administration c,t.~:; administration d.bill;c.t.a.)
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ~
COUNTY OF C'-~-,~,io.~. _ 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 represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirl~eXi ,and subscribed ,~ '~//~OMM~ ~)/j/]~L2" ~/- ~
b~re.me, this ~q~, day of ~ ~'
No.
Estate Of 0~_~r,~ ~m~_ 'Y_ ~'~.A , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated
described therein be admitted to probate and filed of record as the last will of
(~)C_zk-'OXQ. o.~ O-'-'l ~-c>Oq- Bt_____, in consideration of the petition on
FEES
Probate, Letters, Etc .......... $ '70. crO
Short Certificates( ) .......... $. q.o.9
TOTAL $ C}~. CED
Filed ..... 1.0.'. ~3.: .Q~: ..............
- .Register of Will~21t'~' ~- (~O ~
ATTORNEY (Sug}. Ct. I.D. No.)
ADDRESS
PHONE
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.
P 10529690
Fee for this certificate, $2.00
No. ~ Date
Catherine I.
COMMONWEALTH UIF PENNSYLVAN l ' DEPARTMENT OF HEALTH · VITAL RECORDS'
CERTIFICATE OF DEATH
Burkel
ct12,191 cranton, PA
Local Registrar
AUG 0 2004
Female_. .192 -- 24 -- 9794 .August 18, 2004
,e. White
Cumberland Camp Hill ~523 September Drive
,,. Homemaker ,,b. Home ~, :yldowe~
3523 September Drive ~cm^c ,7..m~,.
Camp Hill, PA 17011 ~'~'~ 'r~c~'w Cumberland ,~..,m.? ,,.ffi.~.~ Camp Hill
Cogglns
~a~ r ee n Smith
Anne Langan
407 Darla Road, Mechanicsburg, PA 17055
~tgust 24, 2004 Shoemaker Cemetery . 18414
1
FO O12342-L tone&MurrayFH408 3rd St New Cumberlan~
F Medicine Center of Camp'
4076 Market Street ~ c/?ih
LAST WILL AND TESTAMENT
CATHERINE I. BURKEL
I, Catherine I. Burkel, of the Borough of Camp Hill, Cumberl~d Correct3, Pennsylvania,
being of sound and disposing mind, memory and understanding, do ma~- e, publigl~ and d~Clare
this my Last Will and Testament. ·
I direct the payment of all my just debts and funeral expenses as soon after my decease as
the same can conveniently be done.
I direct that there shall be paid out of my residuary estate all estate, inheritance and like
taxes together with any interest or penalty thereon imposed by the Government of the United
States, or any state or territory thereof, or by any foreign government or political subdivision
thereof, in respect to all property required to be included in my gross estate for estate, inheritance
or like tax purposes by any such governments, whether the property passes under this will or
otherwise.
I give, devise and bequeath my entire estate real, personal and mixed in equal shares to
my three sisters, IRENE KOESTER, MARY WILLIAMS and ANNE HARRIS, absolutely
and in fee simple.
In the event a residuary legatee predeceases me her share shall lapse and fall into the
residue for the benefit of those residuary legatees who survive me.
5.
Lastly, I nominate, constitute and appoint my niece MAUREEN SMITH, to be
Executrix of this my Last Will and Testament and if for any reason she is unable or unwilling to
act as such, I nominate, constitute and appoint my niece PATRICIA A. LETNAUNCHYN, to
be the Executrix in her place and stead. I further direct that no bond or other security be required
of my personal representative to guarantee faithful performance of her duties.
6.
All personal property is to be distributed amongst living members of family to include
my siblings and the issue of my siblings. Any disputes shall be decided in the sole discretion of
my Executrix named herein.
IN WITENSS WHEREOF, I have hereunto set my hand and seal this 24th day of
October, 2000.
C .(SEAt,)
Catherine I. Burkel
Signed, sealed, published and declared by the above named CATHERINE I. BURKlgL
as and for her Last Will and Testament, in the presence of us who have subscribed our names
hereto as witnesses, at her request, in her presence and in the presence of each other.
Print Name
Signature
Print Name
Signature
ACKNOWLEDGMENT AND AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF :
SS:
The Testatrix and the witnesses whose names are signed and subscribed to the attached or
foregoing insmnnent, being first duly sworn and qualified according to law, do hereby acknowledge,
depose and say to the undersigned authority, that the Testatrix signed and executed the instrument as her
Last Will in the presence of the witnesses; that she signed it willingly or willingly directed another to sign it
for her; that she executed it as her fi.ce and voluntmy act for the purposes therein expressed; that each of the
witnesses were present and saw the Testatrix sign and execute the instrument as her Last Will; that each
subscribing witness in the hearing and sight of the Testatrix signed the will as witnesses; and that to the
best of their knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and
under no constraint or undue influence.
Testatrix
Witness
Witness
and witnesses,SW°mthist° oro~affi~d,daySUbscribedof l~)r~ .fft~.~o~-t°' and acknowledged, before, 2000.me by the above-named Testatrix
Notarial Seal
Racheiia R. Schreiber, Notary Pubtlc
Susquehanna Twp., Dauphin County
My Commission Expires Mar. 5, 2001
Notary Public
My Commission Expires:
u_
C~<,J'-'l
;~-5 .-
C;~'.
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C....:.;
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STATUS REPORT UNDER RULE 6.12
Name of Decedent:
CJJ1iIEf!./J./E' ..I .8a~keL
? - / g - tOO'!
Date of Death:
Will No.:
.2 (JOY - (JO q 75
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 0 No I8
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete: t.{. - 15'- oS'
3. If the answer to No. I is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes 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, joinders and approval offormal or
informal accounts may be filed with the Clerk of the Orphans' Court
and may be attached to this report.
Date: 1-18-05 /J1 b~ ~.....t4j
~ignature ./
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Name
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Address
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Telephone No.
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Capacity: ~ Personal Representative
o Counsel for personal representative
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CERTIFICATION OF NOTICE UNDER RUJ~E 5.61,,)
Name of Decedent:
CfiTHEf(/NE T .BW<I<EL
g -1';- 'J-004
Date of Death:
Will No.
;Z()()if - /)0 '175
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 on or mailed to the following beneficiaries of the above-captioned estate on I - 16- oS :
~
Address
J:",R.ENC
I< Ot:5TER..
7 5DUTHfOIIV( Oil f (YJ~CIIM/('.sjJ"u.. i PII /'7()55"
78;... It,?. :JOt...1 ET RD I J-ioaAI<f, 'IN J..f.-b3 i...f..'2
A-J.iJ.l~ HIII<R./S
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
/-18- 05
md$J?# ~~I
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Slgnature
Name mil /Jtl.{;5'N S IYI / TH
Address
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/YIt:CH.4/VICSlJdRr;, I Pi~ J'7PSS--66Si
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Telephone (71r - 7b~- III-3D
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Capacity: 1 Personal Representative
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. ZB060l
HARRISBURG, PA l71ZB-060l
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21 04-0975
ACN 05103413
DATE 02-18-2005
REY-lS45 EX AFP 109-001
MAUREEN SMITH
407 DARLA RD
MECHANICSBURG PA 17055
TYPE OF ACCOUNT
EST. OF CATHERINE BURKEL 0 SAVINGS
S. S. NO. 192-24-9794 !Xl CHECKING
DATE OF DEATH 08-18-2004 0 TRUST
COUNTY CUMBERLAND 0 CERTIF.
REHIT PAVHENT AND FORHS TO:
REGISTER OF WILLS f~.:>
CUMBERLAND CO COURT ROUSE
CARLISLE. PA ;1\7013 CJ'
-:'
PNC BANK has p..ovided the Depa..b1ent with the info...etion listed below which hub.." use.j""]n >':
calculating the potential tax due. Thei.. ..eco..ds indicate that at the death of the above decedent, you we..e a joint ~wne..ltleneficilij:;y~~f
this account. If YOU feel this info...etion is inco....ect. please obtein w..itten co....ection f..o. the financial institution. ;~~tech II (!,.,y';
to this fo... and ..etu..n it to the above add..ess. This account is taxable in acco..dance with the Inhe..itance Tax laws of th~ C~~e.ith
of Pennsylvania. Questions EY be answe..ed by celling (717) 7B7-83Z7. . cri '...,;
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUcTiONS
Account No. 5003507336 Date 01-29-2001
Established
x
2.392.48
50.000
1.196.24
.15
179.44
TAXPAYER RESPONSE
To insu..e p..ope.. c..edit to you.. account. two
(Z) copies of this notice .ust acco~eny you..
pay.ent to the Registe.. of Wills. Make check
payable to: "Registe.. of Wills. Agent".
Account Balance
Percent Taxable
AIlount Subject to
Tax Rate
Potential Tax Due
x
Tax
NOTE: If tax pa~ents e..e .ade within th..ee
(3) .onths of the decedent.s date of death.
YOU .ay deduct a 5~ discount of the tax due.
Any inhe..itance tax due will bllC~e delinquent
nine (9) .onths afte.. the date of daath.
PART
[!]
The above info...ation and tax due is co....ect.
1. You .ay choose to ..e.it pay.ent to the Registe.. of Wills with two copies of this notice to obtain
a discount 0.. avoid inte..est. 0" you .ay check box "A" and ..etu..n this notice to the Registe.. of
Wills and an official aSSlls~ent will be issued by the PA Depa..b1ent of Revenue.
[CHECK ]
ONE
BLOCK
ONLY
B. c=J The above asset has been 0.. will be ..epo..ted and tax paid with the Pennsylvania Inhe..itance Tax ..etu..n
to be filed by the decedent's ..ep..esentative.
C. E:J The above info...ation is inco....ect and/o.. debts and deductions we..e paid by you.
You .ust co.plete PART ~ and/o.. PART ~ below.
PART
~
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
If you indicate a different tax rate. please state your
relationship to decedent:
PART
[!]
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Dat. Established 1
2. Account Balence 2
3. Percent Taxable 3 X
4. AIlount Subject to Tax 4
5. Debts and Deductions 5
6. Amount Taxable 6
7. Tax Rate 7 X
8. Tax Due 8
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Line 5 of Tax Computation)
declare that the facts I
and bellef.
I
$
correct and
DATE
*
~\)J .
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. Z8060l
HARRISBURG. PA l71Z8-060l
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21 04-0975
ACN 05103412
DATE 02-18-2005
REY-lS45 EX AFP 109-001
EST. OF CATHERINE BURKEL
S.S. NO. 192-24-9794
DATE OF DEATH 08-18-2004
COUNTY CUMBERLAND
TYPE OF ACCOUNT
!Xl SAVINGS
o CHECKING
o TRUST
o CERTIF.
MAUREEN SMITH
407 DARLA RD
MECHANICSBURG PA 17055
REHIT PAVHENT AND FORHS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
, i-i
(--""-'''.
PNC BANK has p..ovided the Depa..t.ent with the info...ation listed below which has~] used;'~-;; , ' ' '
calculating the potential tax due. Thei.. ..eco..ds indicate that at the death of the above decedent. you we..e a joil1toWne"/b~r;eficii!U'Y b";
this account. If you feel this info...ation is inco....ect. please obtain written co....ection f..o. the financial instltution. attach II ClQPi..:':)
to this fo... and ..etu..n it to the above add..ess. This account is taxable in acco..dance with the Inhe..itance Tax La~s' of the';Co..onwe&L~h
of Pennsylvania. Questions .ay be answe..ed by calling (717) 787-83Z7. . - ",,'
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FlUNG AND PAYMENT INSTRUCT:EONS ,T-I
Account No. 5003648948 Date 07-23-2001 ' . >r::
To insu..e p..ope.. c..edit to you.. ac~nt. two
Established (Z) copies of this notice .ust acco.pany you..
pay.ent to the Registe.. of Wills. Make check
payable to: "Registe.. of Wills. Agent".
x
4.746.43
50.000
2.373.22
.15
355.98
TAXPAYER RESPONSE
NOTE: If tax pay.ents a..e .ade within th..ee
(3) .onths of the decedent.s date of death.
you .ay deduct a 5~ discount of the tax due.
Any inhe..itance tax due will b.c~e delinquent
nine (9) .onths afte.. the date of daath.
Account Balance
Percent Taxable
Amount Subject to
Tax Rate
Potential Tax Due
x
Tax
PART
[!]
The above info...ation and tax due is co....ect.
1. You .BY choose to ....it pay.ent to the Registe.. of Wills with two copies of this notice to obtain
a discount 0" avoid inte..est. 0" you .ay check box "A" and ..etu..n this notice to the Registe.. of
Wills and an official asses~ent will be issued by the PA Depa..taent of Revenue.
[CHECK ]
ONE
BLOCK
ONLY
B. [] The abClve asset has been 0.. will be ..epo..ted and tax paid with the Pennsylvania Inhe..itance Tax ..etu..n
to be filed by the decedent.s ..ep..esentative.
C. [] The above info...ation is inco....ect and/o.. debts and deductions we..e paid by you.
You .ust co.plete PART ~ and/o.. PART ~ below.
PART
[!]
TAX RETURN - COMPUTATION OF TAX ON
LINE 1. Dat. Estab1i$hed 1
2. Account Balance 2
3. Percent Taxable 3 X
4. A.ount Subject to Tax 4
5. Debts and Deductions 5
6. Amount Taxable 6
7. Tax Rate 7 X
8. Tax Due 8
JOINT/TRUST ACCOUNTS
If you indicate a different tax rate. please state your
relationship to decedent:
PART
~
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Line 5 of Tax Computation)
I
$
declare that the facts I
and belief.
have reported above are true. correct and
HOME ) 7 r" b -1'tl0
WORK ) 7 ~ .3 - .3 73 (p
TEL UMBER DATE
~\;
,. ,
JIEV.1500 EX (&QI)
I-
Z
W
Q
U,I
U
,;,..,.U,I
\: Q
COMMONWEAlTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
OFFICIAL USE ONLY
INHERITANCE TAX RETURN ~"lM~ER 01
RESIDENT DECEDENT CQMYCODE YEAR
-9.0315
tIllER "-.-----~,--,::y.,-~-~j!;~~
SOCIAL SECURITY NUMBER _ 979'1'
THIS RE1URN MUST BE RLED IN DUPlICATE WITH THE
REGISTER OF WILLS
SOCiAl SECURITY NUMBER
~ 0 1. Original Return
liB 0 4. Umiled Estate
u I ~ 0 6. Decedent Died Testata (AllacIl copy of Wi)
~ 0 9. Litigation Proceeds Received
o 2. SUpplemental Relum
o 4a. Future InterestCompromi&e (dale.ofdeathatler12-12.Q)
07. Decedent Maintained a Uvlng Trust (AlIachcopyofTMl)
o 10. Spousal Poverty Credit (_ of death betrIllen 12-31-91l11d 101-95)
o 3. Remainder RetUm (date of death prior fll12-13-82)
o 5. Federal Estate Tax Relum Required
8. Total Number 01 Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (AltadlSdl 0)
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation. Partnership or SoIe-Proprietorship
4. Mortgages & Notes Receivable (SchedlH D)
5. Cash. Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
tll Separate BillIng Requested
7. Inter-VIYOS Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross A$sets (total Lines 1-7)
9. Funeral Expenses & AdministlatiYe CDS\S (Schedule H)
10. Debts 01 Decedent. Mortgage LiabIlities. & LienS (Schedule I)
11. Total DeductIonS (Iolal Unes 9 & 10)
12. NIt Value of Estate (Une 8 mioos Une 11)
13. Charitable and Governmental Bequestll1Sec 9113 Trusls for which an election to tax has not been
made (SdIeduIe J)
Itee;d
FIRM NAME (If AppIicaIlIe)
TELEPHONE NUMBER / /_
7/ 'i- '7{grp- /(/30
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COMPLETE MAILING ADDRESS .a R D
t./o 7 D4131-'7 1\ . ;VA-
l)? ec JJ /iN /cS hu,cf I
, / 70~-
(1)
(2)
(3)
(4)
(5)
OFFI((lp'L USE ONl,. Y
C~,n .
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3 / / ().If I t) c:J
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(1)
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(12)
(13)
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(14)
!t3;s-eZ.afl
REVERSE SIDE FOR APPUCA8I.E RATES
\ax
x .0 _ (15)
x .0 _ (16)
93:S<l'J,37
x .12
(17)
(18)
"";:,-
x .15
Decedents Complete Address:
I ::-d::;;;J;~Jep1?m b~
l)1:.
;::;:
I.... 11tJ/I-SC(.
Tax Payments and Credits:
1. 1'all Due (PIge 1LM 19)
2. ~Cr8cIt ~&'30, 1/1
B. Pri:Jr PIymeIIlS
C. Discounl
(1)
Total CI8dIts (A" B +.C ) (2)
~t8rJ. ~f'
3. InfertsflPenally if appIIcabte
D.1merelJl
E. Penally
TOCaIlnI.8$L'P8I1a1ty ( 0 + E ) (3)
4. IfLile2 1s......LiIt 1 +l.iIe3,enIIlr....IlliIC8. 1l1IsIslleOVERPAYIIENT.
ChIctc box on "1 ... 20 to ........ ... (4)
exf a()~ LIt'
c51~3(), V~
5. If line 1 + UIe 311 greater then Lilt 2, ...Ihe dlll'e"~IIOI. This is !he TAX DUE. (5)
A. Enter the \nlerest on the tax due. (5A)
8. Enter lie.... d Lilt 5 + SA. 1lW is.. 8ALMCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOU.OWItG QUE81\OM8 BY PLACING AN -X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a lran8f8r and: Yes No
a. 1'8C8in" lilt Of Inconle d tie pRlpIIty 1I....ed;.__..............................__......_._................................ 0 ~
b. reI8In the ~ ., de8IgllII8 who shall uw the JlRlI*tY lrlnlre..fl(f Of fts income; .....................-.................... 0 ff
c. relaIn a revereionarY intetest; or.......................................................................................................................... 0 Ik1
d. teceNe the CJI'OIl1Ist b' Ife << elIher paymenrs, benefiIs or C8t8? ...................................................................... 0 u;;r
2. If death occtmld after December 12, 1982, did dec:edent ",.,. properly wilhIn one )'881' of de8lh
3. :=.~..:~.;;....;;;;.;;;..;._.;;.;;;.;;?:==:=::: 8 ~
4. ==~~~.~'.~.~.~~.~......................O ~
IFTHEMSWER TO MY OF 1HE AIlWE QUIIl'IOMItI 'tEl, YOU MUST COtIUTE SCKBU.E G All) ALE \T AI PART Of 1lE RETURN
lhlIr.....",....", dedln JIIIlI.... ~ IIIIIIIwn. bCWng 1COlllIlJllII" 1CMIWeI1IId.......... end... bell",.., llnDItIIdge........ I III 1M. CIlIl8Ct end'"
DIdIrIIlIII III JlIIlIIIIr...... ........._M It Ii 1lIIIII. III......... III "'*"........ 11ft IInllwIIdge.
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~t1'7 V;:r~Jff 7<J-- me&hr+-^/rcsb4'~ir?4. 17~S-
SlGNATlIE OF PREPARER OIlIER THAN REPRESENTATIVE DATE
i.w.-n . 7~Jj:.~..;~~"f~J;1?- ,.~~t~~~~:iji-~ -:~~;, ,4~;,t:r...: d~~~~:~:'"'1f'f"':~:Jt~;tfl~71 tK;;'~,~;.:?'i:~ i< ~f"'<'~'::~;:;~~;..~~.:~:'" J ;~:o:.~..~'"~" ~~, . 'i: =.. ,: <{l
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ADDRESS
For d8I8S rA de8lh on or BIer N!t 1, 19841nd bIb8.18nJ8ry 1, 1995, lie fIX _1mpoIed on I1e net...<<....., Of b.. ... of.. MM1g 1pl1UIe. 3'4
(12 P.S. t9f16 (a) (1.1) (I)~
For dIIIII d.... on<<".I8mBy " 1995, lie fIX...... Gn the net value of....., or b.. ""<< lie uvIWlg.... is mr. (72 P.s. 19116 (.) (1.1)
The'" ~ not....m a......., alllVMng IpOUI8 fnIm.. a1d '" *'*'Y ,........ ~ of... 8111 _ .,. RIlum .... ~ tM
lie uYhi1g IIpOtIIII is lie only b8n8IIdery.
For datil rA d8alh on or .. July " 2000:
The "_Impaled on lie net .. of.... _ 8 deceMd dIId twenty.oI1e ~ of age<< JOIIl9II' .. ~ to or for lie.. of a hIIuraI paI'fIIt, an adoplIve par
or a "'"l of lhe chid is 01 (12 P.s.18118(a)(1.2)~
The lax falelmpoeed on lie net.. rA...... tJ Of tJrl18 ... d lie dec8denI'.1Inll8I bef..... 1I...5%,IIIIllIPl-1IC*td In 72 P.s. 59116(1.2) (72 P.s. t9118(a)(1)~
The tax _ Impoeed Gn '" net ... of ..... to or far .. use of '" declId8nt's slbJings is 12'- (72 p.8- 59116(8)(1.3)). A IilIIng Is delIned. tItder Ser:lIan 9102, II
_.wo.... ....... .... <of ...... ...... ---' In ............ ..... ... ~ ........ IN Hnnct nr lldndInn.
--~.~ .
COMMONWEAI.TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
T
ESTATE OF /)
L/ tr1lz elJ' lJ 0
SCHEDULE B
STOCKS & BONDS
5 13C1 ,el:!dL
FIlE NUMBER
. :2(- 0,-/ -.- o1tS
All property joIIltIy-owned with right of suMvOl'Shlp must be dlIclosed on Schedule F.
ITEM
NUMBER
1.
eE2
us.
DESCRIPTION
~ I+V l-1'V9S 4,,<.L.L
VALUE AT DATE
OF DEATH
3/, I~ t>tJ
...ftT A I fA'............. ^" .In..? D_..nltu/o:>tinn \ C
REV.151l8 EX . (1-97)
ESTATE OF
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
.t:2 /5-' /, I-
~CI ~'::..- e..
c /f-t/? ~ /!, J /Je
:J:-
FILE NUMBER c9l _ 6 '-I - tJ f 7 S-
Indude the proceeds 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
NUMBER
1.
;( ~J<ib;7t-~U
V
DESCRIPTION
k1 ~
(J-J-r-fT . '; , ..-~
1'~;('~ L-- ~(,G~ ..;;L.<::k',,/' ",,,, -1.' ...
VALUE AT DATE
OF DEATH
/~ C; j ~
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX + (1-97)
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF /1.---r2 .~. ",' ,,"
L., 'p- //1~?/ /) 2.
~
b'? ,.,,/"", /
.""" ",~~
. ~ '<'.1".. '-" L.
FILE NUMBE~I ... tf t../ - V f ? 5
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
S~1() N e. ~ m u r:-f< yq.<{ F tI J1lj!..Yf I- jJcJ m -e
{j 6 / N 9 fa IJ )17 c> AJ U 1J1 --e /(.;-r
tJ3rt:a. 03
135 () 0
B,
1.
ADMINISTRATIVE COSTS:
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.
3.
Attomey Fees
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
State
Zip
4.
Probate Fees - tu IY1 b-e;:. /4xJd
e ou ;-1'7,/
'1 ?'/~O
5.
Accountant's Fees
6.
Tax Retum Preparer's Fees
7.
(If more space IS needed, Insert additional sheets of the same size)
TOTAL (Also enter on line 9, Recapitulation) $ '1& )? ~ '3
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 17128-0601
REV-1162 EX( 11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
SMITH MAUREEN
407 DARLA ROAD
MECHANICSBURG, PA 17055-6658
-------- fold
ESTATE INFORMATION: SSN: 192-24-9794
FILE NUMBER: 2104-0975
DECEDENT NAME: BURKEL CATHERINE I
DATE OF PAYMENT: 04/12/2005
POSTMARK DATE: 04/12/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 08/18/2004
NO. CD 005189
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
05103412 I $355.98
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$355.98
REMARKS: M SMITH
CHECK# 502
SEAL
INITIALS: VZ
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
SMITH MAUREEN
407 DARLA ROAD
MECHANICSBURG, PA 17055-6658
_uu___ fold
ESTATE INFORMATION: SSN: 192-24-9794
FILE NUMBER: 2104-0975
DECEDENT NAME: BURKEL CATHERINE I
DATE OF PAYMENT: 04/12/2005
POSTMARK DATE: 04/12/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 08/18/2004
NO. CD 005187
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $2,830.48
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$2,830.48
REMARKS: M SMITH
CHECK# 504
SEAL
INITIALS: VZ
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
SMITH MAUREEN
407 DARLA ROAD
MECHANICSBURG, PA 17055-6658
__nun fold
ESTATE INFORMATION: SSN: 192-24-9794
FILE NUMBER: 2104-0975
DECEDENT NAME: BURKEL CATHERINE I
DATE OF PAYMENT: 04/12/2005
POSTMARK DATE: 04/12/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 08/18/2004
NO. CD 005188
ACN
ASSESSM ENT
CONTROL
NUMBER
AMOUNT
05103413 I $179.44
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: M SMITH
CHECK# 501
SEAL
INITIALS: VZ
RECEIVED BY:
REGISTER OF WILLS
$179.44
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
*'
BUREAU OF INDIVIDUALTAllES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
NOTICE DF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIDNS, AND ASSESSIIENT OF TAll ON
JOINTLY HELD DR TRUST ASSETS
REV-IS4! EX AFP (03-05)
,
~F
-b Fli
~~
,Jb
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
06-07-2005
BURKEL
08-18-2004
21 04-0975
CUMBERLAND
192-24-9794
05103413
bo...t R..i ttH
CATHERINE I
ClER(
ORPi-1
MAUREEN Ci ;:;MITH
407 DARLA RD
MECHANICSBURG PA 17055
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 ...
1~-:r.!'1ri!sr~'.~G~1J.!1....................................................................................
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DISALLONANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 06-07-2005
ESTATE OF BURKEL
CATHERINE I DATE OF DEATH 08-18-2004
COUNTY
CUMBERLAND
FILE NO. 21 04-0975
TAX RETURN WAS:
S.S/D.C. NO. 192-24-9794
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
05103413
FINANCIAL INSTITUTION: PNC BANK
ACCOUNT NO.
5003507336
TYPE OF ACCOUNT: () SAVINGS (>0 CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 01-29-2001
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
2,392.48
0.500
1,196.24
.00
1,196.24
.15
179.44
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
04-12-2005 CD005188 .00 179.44
TOTAL TAX CREDIT 179.44
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
. IF PAID AFTER THIS DATE, SEE REVERSE FDR CALCULATION OF ADDITIONAL INTEREST. .
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRl, YOU HAY BE OUE A REFUND.
SEE REVERSE SIDE DF THIS FDRN FOR INSTRUCTIONS. l
C>~'+
CDMtHltWEAL TH OF PENNSYLVANIA
DEPARTtENT OF REVENUE
BUREAU OF INDIYIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
.
INFORMATION NOTICE
ANI) _ c__.c_
TAXPAYERRESPQIilSS:
FILE NO. 21 04-0975
ACN 05118281
DATE 05-31-2005
ae'-15liSEllIFPU9-IOJ
MAUREEN SMITH
407 DARLA RD
MECHANICSBURG PA 17055-6658
TYPE OF ACCOUNT
,
LEST. Ol{ CAitltRIRE] I BURKEL IXl SAVINGS
S.S. NO. 192-24-9794 o CHECKING
DATE OF DEATH 08-18-2004 0 TRUST
COUNTY CUMBERLAND 0 CERTIF.
C REMIT PAYMENT AND FOHNS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
FULTON BANK has provided the Dspartnnt wiUl the inforl!ation listed belOtt whIch has been used in
calculating the potential tax due. Their records indicate that at the dlIath of the above dec&d&nt, you were a joint owner/beneficiary of
this account. If you feal this infor.atlan is incorrect, please obtain written correction fr~ the financial institution, attach a copy
to this fori! and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the CoutOownlth
of Pennsylvania. Questlon:s Ih!l)' bII ansWtl....d by calnng (717) 187-8327.
COMPLETE PART 1 BELOW
Account No. 9904-46245
. . . SEE REVERSE SIDE FOR
o.te 08-12-2000
Est.blislwd
FILING AND PAYMENT INSTRUCTIONS
Account Balance
Percent Taxable
AItount SubjltCt to Tax
Tax Rate
Potential Tax Due
20,323.86
X 50.000
10,161.93
X .15
1,524.29
To insure proper c.....dit to your accamt, two
(2) copies of this notice .ust acco.peny your
pay.ent to the Register of WIlls. MKe check
payable to: "RegIster of WIlis, Agent".
NOTE: If tax PBYllents are .acle within three
(3) .0n'U1s of 'U1e decedent.s date of dll8'U1,
you .ay deduct a 5% discount of the tax due.
Any inherltBOC8 tax due ..Ul bec0ll8 del!nquent
nine (9) .onths after the date of death.
PART
[!] iIIllM.lllli~:~~'~' .'":
TAXPAYER RESPONSE
c_c._.]~"~'I1lJ[~....".:,,,_i~.ll!!Iw.R.!.~II.;I_.UII'.I.~,I;.EI.ll!:
[CHECK ]
ONE
BLOCK
ONLY
The above inforll8tian and tax due is correct.
1. Vou .ay choose to r_lt paynnt to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or YOU .ay check box "A" and return 'U1is notica to the Register of
WIlls and an official assesseent will be issued by the PA Depart.ent of Revenue.
B. [] The above asset has been Dr will be reported and tax paid with the Pennsylvania Inh8ritance Tax raturn
to be filed by the decadent.s representative.
C. 0 The above inforntlon is incorrect and/or debts and deductions were paid by you.
You .ust CQ~lete PART ~ and/or PART ~ below.
If you indicate a different tax rat., please state your
relationship to decedent:
PART
@J
TAX RETURN - COMPUTATION OF TAX ON JOINT,TRUST ACCOUNTS
LINE 1. Date Est.blished 1
2. Account Balance 2
3. Percent Taxable 3 x
4. Allount Subject to Tax 4
5. Debts and Deductions S
6. AiIount Taxable 6
7. Tax Ret. 7 X
8. Tax Due 8
PART
[!]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Line 5 of Tax Computation)
Under penalties of perjury, I declare that the facts I
coeplete to the best ~ knowledge and belief.
I
$
and
,"
HOME
WORK
T
(
(
to 7 -()::,-
DATE
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
SMITH MAUREEN
407 DARlA ROAD
MECHANICSBURG, PA 17055-6658
nn____ fold
ESTATE INFORMATION: SSN: 192-24-9794
FILE NUMBER: 2104-0975
DECEDENT NAME: BURKEL CATHERINE I
DATE OF PAYMENT: 06/08/2005
POSTMARK DATE: 06/07/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 08/18/2004
NO. CD 005408
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
05118281 I $1,524.29
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$1,524.29
REMARKS:
CHECK# 507
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WillS
-<:;,.'
~ - ,~.,...
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
*'
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 171Z8-0601
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR OISALLOWANCE
OF DEDUCTIONS, AND ASSESSHENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
REV-1548 EX AFP (03-05)
~j
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
07-04-2005
BURKEL
08-18-2004
21 04-0975
CUMBERLAND
192-24-9794
05118281
Amount R_i -ti.d
CATHERINE I
MAUREEN SMITH
407 DARLA RD
MECHANICSBURG PA 17055-6658
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 ~
A~-;[!'1ril!:~~.irB~1nI'....................................................................................
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 07-04-2005
ESTATE OF BURKEL
CATHERINE I DATE OF DEATH 08-18-2004
COUNTY
CUMBERLAND
FILE NO. 21 04-0975
TAX RETURN WAS:
S.S/D.C. NO. 192-24-9794
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
05118281
FINANCIAL INSTITUTION: FULTON BANK
ACCOUNT NO.
9904-46245
TYPE OF ACCOUNT: (lO SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 08-12-2000
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
20,323.86
0.500
10,161. 93
.00
10,161.93
.15
1,524.29
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
DR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
06-07-2005 CD005408 .00 1,524.29
BALANCE OF UNPAID INTEREST/PENALTY AS OF 06-08-2005 TOTAL TAX CREDIT 1,524.29
BALANCE OF TAX DUE .00
INTEREST AND PEN. 4.18
TOTAL DUE 4.18
. IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRI, YOU HAY BE DUE A REFUND.
..."".. 11""111:11..1: e:Tnl: nlC TlITlC:: J:nlllM F'nR TNSTRUCTI.ONS. )
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
OEPT, 280601
HARRISBUr~G, PA 17128-0601
REV-1 162 EXl1 1-961
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 005574
SMITH MAUREEN
407 DARLA ROAD
MECHANICSBURG, PA 17055-6658
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
_n_____ fold
05118281
$4.18
ESTATE INFORMATION:
SSN:
192-24-9794
DECEDENT NAME:
2104-0975
BURKEL CATHERINE I
FILE NUMBER:
DATE OF PAYMENT:
07/15/2005
07/14/2005
CUMBERLAND
08/18/2004
POSTMARK DATE:
COUNTY:
DATE OF DEATH:
TOTAL AMOUNT PAID:
$4.18
REMARKS:
CHECK# 510
SEAL
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
MAUREEN SMITH
407 DARLA RD
MECHANICSBURG
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
Pr:IY'IJ,"iCT' ,Ar,::lC"_=
"-V\fIlI1<IllIl W, "",,""~4fANCE TAX
APPR~'i~t~~E OR DISALLOWANCE
OF OEilliCtIoMS ;" ANlf AsSESSI1ENT OF TAX ON
~OINTLY HELO OR TRUST ASSETS
2UOS AUG -) NI/2:1IA7E
, ts'rATE OF
DATE OF DEATH
FILE NUMBER
'-,T COUNTY
.. 6SN'DC
'IICN
*'
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
REV.1548 EX AFP (06-05)
ClEI~~(
OCCl'_','
'.,' ,"',
("\1;' ,
\.....,;
08-01-2005
BURKEL
08-18-2004
21 04-0975
CUMBERLAND
192-24-9794
05103412
APPEAL DATE: 09-30-2005
(See reverse side under Objections)
AIIDun1: Rem:i.1:1:edl ,
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CATHERINE I
PA 17055
CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS _
REY=is4S-EX-AFP-C03=Osi--------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 08-01-2005
ESTATE OF BURKEL
CATHERINE I DATE OF DEATH 08-18-2004
COUNTY
CUMBERLAND
FILE NO. 21 04-0975
TAX RETURN WAS:
S.S/D.C. NO. 192-24-9794
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
05103412
FINANCIAL INSTITUTION: PNC BANK
ACCOUNT NO.
5003648948
TYPE OF ACCOUNT: 0( )SAVINGS () CHECKING (>TRUST ()TlME CERTIFICATE
DATE ESTABLISHED 07-23-2001
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
4,746.43
0.500
2,373.22
.00
2,373.22
.15
355.98
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WillS, AGENT."
TAX CREDITS:
~
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
04-12-2005 CD005189 .00 355.98
TOTAL TAX CREDIT 355.98
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
. IF PAlO AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .
( IF TOTAL DUE IS LESS THAN $1, NO PAYNENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRJ, YOU NAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORN fOR INSTRUCTIONS. J
. Def"'(\onrD (rc:'!'c (lC
BUREAU OF INDIVIDUAl!.)tA1ES. J vf. 'ut jl
INHERITANCE UK DtVISl~rJ~l(:,T:r r';~
PO BOX Z8D601 : i:~.'."~'..
HARRISBURG PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
'*
REY-16D7 EX AFP (03-05)
2005 AUG 19 PH 12: 33
CLEF, '((
OF;Pt<....',,\,j,~-~
MAUREENCU" SMITH
407 DARLA RD
MECHANICSBURG PA 17055-6658
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
08-15-2005
BURKEL
08-18-2004
21 04-0975
CUMBERLAND
05118281
Amount R..1ttBd
CATHERINE I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account~ sub.it the upper portion of this form with Your t8X payMent~
CUT ALONG THIS LINE
.....
RETAIN LOWER PORTION FOR YOUR RECORDS
-
REY-1607 EX AFP (03-05)
---------------------------------------------------------------------------
~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ...
ESTATE OF BURKEL CATHERINE I FILE NO.21 04-0975 ACN 05118281 DATE 08-15-2005
THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW
IS A S~ARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 07-04-2005
PRINCIPAL TAX DUE: 1,524.29
PAYMENTS (TAX CREDITS):
~
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
06-07-2005 CD005408 .00 1,524.29
07-14-2005 CD005574 4.18- 4.18
TOTAL TAX CREDIT 1,524.29
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
. IF PAID AFTER THIS DATE, SEE REVERSE
SIDE FDR CALCULATION OF ADOITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRl,
YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. l
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 7/05/2006
SMITH MAUREEN
407 DARLA ROAD
MECHANICSBURG, PA 17055-6658
RE: Estate of BURKEL CATHERINE I
File Number: 2004-00975
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:
8/18/2006
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~J~Jt
.' ~1
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
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