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HomeMy WebLinkAbout04-0981 Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS No. 21-04- 9 <j J Estate of Mary L. Lang also known as , Deceased Social Security No. 091-26-1101 Petitioner(s), who is/are 18 years of age or older, appl(ies) for: (COMPLETE 'A' or 'B' BELOW) !Rl A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the the Decedent, dated 03-16-1989 and codicils dated Executor named in the last Will of State relevant circumstances, e.g., renunciation, death of executor, etc. Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decedent was married to Ernest G. Lang. He died on November 23,1973 o B. Grant of Letters of Administration (c.t.a; d.b.n.c.t.a; pedente lite; durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: . , . I Name Relationship Residence ._, .>::>- . 1 r-"' c-"-j --1 N CD \J 'v-J ..- "' '. ,---' (' (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with his/her family :.:;) or principal residence at 210 Big Spring Road, West Pennsboro Township, (list street, number, and mUnicipality) Decedent, then 90 years of age, died 09-10-2004 at 210 Big Spring Road, Newville, PA 17241 (Location) 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 11,600.00 $ $ $ $ situated as follows: Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: Type or printed name and residence 1154 Newville Road Newville, PA 17241 Prepared by the Pennsytvania Bar Association Copyright (e) 2004 form software only The Lackner Group, Inc. Form RW-1 (1991) Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of ::::~:O::(:"::.""""~.dm;";da'theesm~/ ~ /7 t:/ before me this r1ilIi day of {/ OfY;f~ ,c0M'I ,/IJ~fJ1A1!d. ? tbvJu>> AIwd~ p.o . F"lheReg;,~ ~~ No. :J./ - 0 4 - Cj ~ I Estate of Mary L. Lang , Deceased Social Security No: 091-26-1101 (JttM}-/A~ dR-ft Date of Death: 09-10-2004 AND NOW, , ~'I , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters !Rl Testamentary 0 of Administration (c.I.a.; d.b.n.c.l.a.; pendente lite; durante absentia; durante minoritate) are hereby granted to ~Afl0 (/o/Y1;J :.-: C -:. d ~ in the above estate and that the instrument(s) dated 3-16-1989 C':: --i ~ '-^- FEES Letters.......................................... $ ~_ em . f), 0-0 10.- Short Certificate(s).......~.......... $ Renunciation............................... $ Attorney: Richard L. Webber, Jr. Esquire Affidavits ( )...........................$ I.D.No: 49634 ~. [!! Weigle & Associates, P .C. Address: 126 East King Street Shippensburg, PA 17257 10 pO Telephone2 717-532-7388 E-Mail: weigleattywebber@earthlink.net Extra Pages (~ )......................$ Codicil.......................................... $ JCP Fee....................................... $ Inventory...................................... $ Other............................................ $ TOTAL............................ $ ,.;(. Q9 Prepared by the Pennsylvania Bar Association Copyright (cl 2004 form software only The Lackner Group, Inc. Wo;l-- ~O [U-4 Ur ~ i () /J.~/o y Form RW-1(1991) '''''<;~iQ:\is to certify that the information here given is correctly copied from an original ce~~ificate of death dulr filed with Lo~al Registrar. The original certificate will be forwarded to the State Vital Records OffIce for permanent fIlmg. WARNING: It is illegal to duplicate this copy by photostat or photograph. me as No. 2L...~. ~~,~~ Local Registrar Fee for this certificate, $2.00 P I 10590214 IEP 1 3 200~ Date ~J -0'-/, o;p/ ci .p,.. _.; c~; LJ --l N 00 H10S.14J Rh. 2117 COMMONWEALTH OF PENNSYLVANIA. OEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH -0 I....J "NT .. AGE (l.. 8irIt\c2eyt Lu Lang .... Female .. STATE ,u~ SOCIAL SECURITV NUMBE ..091 26 f.:) IEHT INK NAME OF DECEDENT (flf!ll. MidOIe.l_1 90 Mary UNDER t YEAR - .,..,. UNDER 1 OAr Hours i WInuIw 1101 v... ~l COUNTY OF OERH Cumberland ... DECEDENT'S USUAL OCCUMlON (Give tunr:I d work dOne durll'lQ ""* 1'm!r~""''''''1 KINO OF 8USlNEssnNDUSTAY Missionary tlL t~ . "''ftfS~A~f5~._z,p~ Newville, FA 17241 DECEDENT'S ACTUAL RESfOENCE - -...... ..._~ PA MAAlTALSTATUS._ ~""'iH.~. Wi~r ... t,,xx,...__.west SUfMvING SI'OUSE '"...... gn4 rnaoen nemel .o. FRHER'S NAME (Firsr, MiOdIe. Lasrl Barnett ~ Joseph W. -ORMANT'SNAME/T-jbna than G. Lang METHOO OF OISPOStTIOH O - 0 c-ion KIlC -_Sl...o ~ 00...._ . 21L SIGNR?f' f ..... '710. Cumberland 17..0 :;;..":".:::'.. MOTHI:A'S NAME (Fit.. Middle. MMien Surt\8ml) ~ Pearl Sickman INFORMrl~csr..H;>:-R"er~Z""'C!1i r 1i s 1 e, PAl 701 3 - PlACEOflllSPOSITION.N.......c-O<Y.e_ ~~.S'f>"t"1 s ~tinger Crematory PA 17065 ng -.. II. I Approxima.. I..... between : 0ftMI1ftd 0MIft I I I PART A: Other~c:ondMiorw.c:oneribuIlngtoduth. buI nat~in"~c...."'inPMTI. r: WERE AU1OPS'Y FINDINGS -...... PAlOR 10 COMI'\E71ON OF CAUSE OF llERH. ~ ,..0 "AHNER OF DEATH - ~ Homicide 0 - 0 "--.... 0 - 0 CouIdnotbedwtl~ 0 DArE OF INJURY 1........00y._1 TIME OF IKJUAV INJURY R WORK? DESCRIBE HOW INJURY OCC1.JAREo. ...rr ,.. 0 ...0 - - CEllTIf'IER lCtledI: on, onet -CEJlTWYDfG PKYSICIAN(Ph'f'SCtWI~C*lMddMlh ~~ pt!VSIC.-n has pronounced dea&to ana~ II... 231 To...........my~,_.u.oee""".....1hecauM(s..ndmann.r..Statecl.................................................... . ... PlACE OF INJURY. AI. home. III"". ....... lactOfy. omce buiIcIno._.I~ -. II. -MEDICAL EXAMINEAlCOAONEA On thelNlsia of enmi"etton end/or Investigation, 'n my opinton, de.th occurred at the lime, d.te,.nd place. .nd due to the c""(s}.nd m.."...,.. ..ated.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ...................................... 318. AEGISTRAR.S SIGNATURE ANO NUMBEA o ... DATE FILED (Monrh. o.y. -"'ONOuNc:IHG AND ClftTlJrYINQ PHVStClAH ~ bottl tJlortOI.InClI'IO oolh andceft/lylng IOcause 01 de.1tI1 To............., knowtltdgtll, ..tPlocc......... .........d.I.. andplK., and ctueto thec.UM(s..nd ",anner.s slated.. ........................ k;(111~IIIOI ,... ." "..-...... .,..- '. .'"', ~I-04 -9 VI d .;::::. IAST WILL AND TEsrAMENT c: c-:; -.; N co I, Mary L. Lang, of West Permsboro 'Ibwnship, Cumberland COUnty, w permsylvania, declare this to be my Last Will and Testairent aric:i: revoke any will or codicil previously made by Ire. ITEM I: I direct that all my just debts and funeral expenses, including my graverrarker and all expenses of my last illness, shall be paid from my residuary estate as soon as practicable after my decease as a part of the administration of my estate. ITEM II: I give, devise and bequeath all of my estate of every nature and wheresoever situate to my son, Jonathan Lang, his heirs and assigns. ITEM III: I appoint Lisa H. Lang guardian of any property which passes either under this Will or otherwise to a minor and with respect to which I am authorized to appoint a guardian and have not otherwise specifically done so, provided that this appointm:mt of a guardian shall not supersede the right of any fiduciary in its discretion to distribute a share where possible to the minor or to another for the minor's benefit. Such guardian shall have the power to use principal as well as ineate from tine to tirre for the minor I s support and education (including college education, both graduate and under- graduate) without regard to his or her parent's ability to provide for such support and education, or to make payment for these purposes, without further responsibility to the minor or to the minor I s parent or to any person taking care of the minor. ITEM IV: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction inposed, shall be paid fran my residuary estate as part of the expenses of the administration of my estate. " ITEM V: I appoint Jonathan Lang executor of this my Last Will and Testament. Should he fail to qualify or cease to act as executor, I appoint Lisa H. Lang executor of this my Last \-Jill and Testament. ITEM VI: I direct that my executor or guardian or their successors shall not be required to give bond for the faithful perfonnance of their duties in any jurisdiction. IN WI'lNESS WHEREOF, I hereunto set my hand and seal to this my Last Will and Testament, written on three sheets of paper, dated this 1(, iI, day of March, 1989. -. MaIy~ d. ~r (SEAL) The preceding instrurrent, consisting of this and two other typewritten pages, each identified by the signature of the testatrix, Mary L. Lang, was on the day and date thereof signed, published and declared by Mary L. Lang, the testatrix herein named, as and for her Last Will, in the presence of us, who, at her request, in her presence, and in the presence of each other, have subscribed our names as witnesses hereto. -&rt: M < ~R?C .1!:r residing at newvJ1R iLia. f'II . ~ /aJb residing at lsht' {p Ij ;/4 -2- .- COMM:lNWEALTH OF PENNSYLVANIA: 55 COUNTY OF CUMBERLAND We, Mary L. Lang, Joh^ /Ue t!.r47li:- and {JMAL ftt, 1J,UJ / the testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrurrent, being first duly S\IOnl, do hereby declare to the undersigned autbori ty that the testatrix signed and executed the instrurrent as her Last Will and Testament and that she signed willingly (or willingly directed another person to sign for her), and that she executed it as her free and volunta:ry act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the will as witnesses and that to the best of our knowledge, the testatrix was at that tine eighteen years or older, of sound mind and under no constraint or undue influence. ~ SUbscribed, swom to and acknowledged, by Mary L. Lang, the trestatr' x and SWOnl to be fore Ire by ~ ~~ and ~ (h. , witnesses, this day of March, 1989~-- ~~~ JyW~~ Notary Pub 1 My ccmnission expires April 16, 1990 5hippensburg Township Cumber . _c :~-.~~r~~:N~~n:f,1;th...~","f" r"!1'rp:;"'1i <::'''/.1 'j SAllY J. WINDE?. 'NO~A.;W DUBUC ~ SHIPPENSBURG lWP.. CUMl;l:KAi!') CCU:;;TV ~ MY COMMISSION EXPIR~S APRil 16 199!J j ~~!M:';:::w-~:;r~iW~ -3- IRE: MARYL.LANG,LATE OF TOWNSHIP OF WEST PENNSBORO, CUMBERLAND COUNTY, PENNSYLVANIA, DECEASED IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE NUMBER 21-04-0981 CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) Name of Decedent: Mary L. Lang Date of Death: September 10, 2004 Will No. 21-04-0981 To the Register: I certify that notice of bencficial interest requircd 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 29, 2004: Jonathan Lang 1154 Newville Road Carlisle, PA 17013 Notice has now been given to all pcrsons entitled thereto under Rule 5.6(a). Date: I - ' -~ ' Signature /' ," ,/<--~ //' / l _ ,,' .'_;, L_...,._,/ /'1 / Name: Richard L. Webber, Jr., Esquire Address: Weigle & Associates, P.c. 126 East King Street Shippensburg, P A 17257 Telephone: (717) 532-7388 Capacity: __,__Personal Representative X Counsel for Personal -- Rcprcscntati ve ,f-. WeiGLe:: & ASSOCIATES, Pc. -- .l\TTOHNEVS I-,T LAVIi - 120 I:::A~,T KINe, STREET - SHIPF'CNSUUH(.c., PA 172S7 1397 Cumberland County - l<.egls"Cer UL VU_LLC> One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 7/27/2006 LANG JONATHAN 1154 NEWVILLE ROAD NEWVILLE, PA 17241 RE: Estate of LANG MARY L File Number: 2004-00981 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 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: 9/10/2006 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. Sinc~rely, .bi (~(h7;/~NAJl. ,(ud~_ L~au.J~=--{!t'-'" Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel Cumberland County - Register Ot Wl~~S One Courthouse Square Carlisler PA 17013 phone: (717) 240-6345 Date: 7/27/2006 WEBBER JR RICHARD L WEIGLE & ASSOCIATES PC 126 E KING STREET SHIPPENSBURGr PA 17257-1397 RE: Estate of LANG MARY L File Number: 2004-00981 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 RULESr NO. 103 SUPREME COURT RULES DOCKET NO. 1r for decedents dying on or after July lr 1992r the personal representative or his counselr within two (2) years of the decedent's deathr shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 9/10/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Reportr please disregard this notice. SincerelYr If /" '^ .0 \...,P''' . ~. L fJ /~ v-f;/VtL?U'JdZ/'~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) \.. - Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedent: MARY L. LANG Date of Death: SEPTEMBER 10, 2004 Estate No.: 2104-0981 Pursuant to Rule 6.12 ofthe 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 ~ 2. lfthe answer is No, state when the personal representative reasonably believes that the administration will be complete: March I, 2007 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes 0 No 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 of formal or infonnal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. / / --,. 'Date: .\/ / / /,./ ! ~.b / ....-/ .-,....' \\' . / ,.\. 'i .----- ,../' '-'" /, Signature Name Richard L. Webber, Jr., Esquire Weigle & Associates, P.C. c. Address 126 East King Street Shippensburg, PA 17257 Telephone No. (117) 532-7388 Capacity: 0 Personal Representative [j Counsel for personal representative J t, ' c r: IN RE:EST A TE OF MARY L. LANG, LATE OF WEST PENNSBORO TOWNSHIP, CUMBERLAND COUNTY, PENNSYL VANIA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL VANIA ORPHANS' COURT DIVISION NO. 2104-0981 PRAECIPE TO WITHDRAW To the Register of Wills: Please withdraw my appearance in the above-captioned matter. WEIGLE & ASSOCIATES, P.c. , !. I ' Dated: 2(( -'/ U(~ _1-/ /( &~~ _/ Richard L. Webber, Jr., Esquire Attorney ID #49634 126 East King Street Shippensburg, P A 17257 (717)532-7388 By: :,(') \. (,:; / WEIGLE & ASSOCIATES, Pc. - ATTORNEYS AT LAW - 126 EAST KING STREET ~ SHIPPENSBURG. PA 17257-1397 J - o ',,) 'lS\ '" ~ Be ;gg ~-E ~ (lfi '0 .... .... {;.I: w ei;:) ~~ '" r"" '" t:>~ ~~ Q ,. .. ~~~. ~ '~~j ~~~ :: ~ ~ ~.e< '0 ~ 0.... o .:) ~U7r.. ::: ~ ~ c:; r=-. ,.~ b)-V .... <J ~ ;;, <J ~ r- \ ,; ~ 0 -.", ~1 r, "-.,,f "'-. 4' .i-. V tj~ ...... ;-- i ~ ~ -'- ....J -"!'''~ ~ ';;1 n ~" 0:; j.,U!""d Cn.!.L3 2'.:lJ lr WQ':C6 ~] t"" t~.. ''; tfl ',> 0 :- fJ -:;r ........ ttVi~ :: ill t-"'0;"7' t.rzz ,-... "''\. u.. .-J -; f'c" -<:~ ~ H .~< !--1 '1;. .-l ~ .q< N 0 r- ~ .-l ~ W ....:1~ ::r: ....:1~ E-i H ~ > Z 8=W 0 W....:1 f-J Z....:1 H \..') .q< > ~ Lf) 8= .-l W ....:1 .-l Z '.../' ,/I -;;~ "-- '0 ;'. ~n ~~~ ~f~ ~.t r. '..) i<J.. \t:~ ..~ ...;:: ;i/'-'C. ~...'-:' .... ~ ii''''" v ill l'i m (") (? l-.t (,f'~ 'rl 1 Ti<) i}.:~ i't'; 'J'" '::to \:"~ .- . .:~.~ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 LANG JONATHAN o (;0 . <:D :-Do . _L -~"-. (- ,--.-, :- _1 ~~ ~ = --.J ;:r::.. c::: G"J r,,) -.J Date: 8/27/2007 1154 NEWVILLE ROAD NEWVILLE, PA 17241 __ ~~'~ 0 a RE: Estate of LANG MARY L File Number: 2004-00981 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: 9/10/2007 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, fkiL.~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel In Re: Estate of LANG MARY L ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 2004-00981 NOTICE OF FAILURE TO FILE STATUS REPORT Q Personal Representative: LANG JONATHAN Counsel for Personal Representative: Date of Decedent's Death: 9/10/2004 c) co) _,1 I r0 c5 (.,) -t The Orphans' Court record indicates that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule ().12, Supreme Court Orphans' Court Rules, is hereby given by that the you have ten (10) day to file the Status Report. If the required 6.12 form is not filed in accordance with Rule 6.12 the Court will be notified of such delinquency and the undersigned will requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date: 9/21/2007 Distribution: Personal Representative Counsel for Personal Representative Estate File ~ V. ~,J,/n~Jl ~"""~ l~~(J~ Glenda Farner Strasbaugh Clerk of the Orphans' Court OCT 0 .2 2007 IN RE: ESTATE OF LANG MARY L ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 2004-00981 NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE Personal Representative: LANG JONATHAN Counsel for Personal Representative: CJ~J Date of Decedent's Death: 9/10/2004 Date of Delinquency Notice: ~'-'-. \.:) The undersigned, Glenda Farner-Strasbaugh, Clerk of Orphans' Court, in accoidanc;~ with Rule 6.12, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules was given on the above date and that the ten (10) day notice to file the Status Report has expired. Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. r- .... -.J )/;;~ ~~j ~4~b4f Date: 10/2/2007 Glenda Farner Strasbaugh Clerk ofthe Orphans' Court , Distribution: Personal Representative Counsel for Personal Representative Estate File A hearing is scheduled December 3. 2007 at llAM in Courtroom NO.2. If the Status Report is filed prior t automatically be cancelled. ~.---. , ~e heari~~,a ring wi1l \. ),,/' ) - ,,' ~ \(CA'1~ Edgar B. Bayley, J. \ NOTICE OF INHERITANCE TAX pennsyLvania BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP (12-12) PO BOX 280601 HARRISBURG PA 17128-0601 RECORDE "7 DATE 12-24-2012 REG s:. - ESTATE OF LANG MARY L DAVE OF DEATH 09-10-2004 v 2l F'jM FILE NUMBER 21 04-0981 COUNTY CUMBERLAND JONATHAN LANG CLERK ACN 101 1154 NEWVILLE APPEAL DATE: 02-22-2013 CARLISLE 3 (See reverse side under Objections) CUMEERLAN4'' ` 'L,i Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS E- REV-1547 EX AFP (12-12) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF: LANG MARY LFILE NO.:21 04-0981 ACN: 101 DATE: 12-24-2012 TAX RETURN WAS: ( ) ACCEPTED AS FILED C X) CHANGED SEE ATTACHED NOTICE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) .00 NOTE: To ensure proper 2. Stocks and Bonds (Schedule B) (2) .00 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 00 submit the upper portion of this form with your 4. Mortgages/Notes Receivable (Schedule D) (4) .00 tax payment. 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) .00 6. Jointly Owned Property (Schedule F) (6) .00 7. Transfers (Schedule G) (7) .00 8. Total Assets C8) .00 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) .0 0 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .0 0 11. Total Deductions (11) .00 12. Net Value of Tax Return (12) .0 0 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .0 0 14. Net Value of Estate Subject to Tax (14) .0 0 NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 00 X 00 = .00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) -nn X 045 = .00 17. Amount of Line 14 at Sibling rate C17) -nn X 12 = .00 18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 = .00 19. Principal Tax Due C19)= .00 TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID C-) TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DU FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ~1 REV-1470 EX (01-1C) pennsytvania INHERITANCE TAX DEPARTMENT OF REVENUE EXPLANATION BUREAU OF INDIVIDUAL TAXES OF CHANGES 091-26-1101 DOD: 09/10/2004 PO Box 280601 HARRISBURG, A 17128-0601 DECEDENT'S NAME FILE NUMBER Mary I Lang 2104-0981 REVIEWED BY ACN Amber Heimbach 101 ITEM SCHEDULE NO, EXPLANATION OF CHANGES Efforts to file an Inheritance Tax return have been exhausted in the above-referenced estate. Therefore, the filing requirements have been waived. The Department however, reserves the right to assess any assets that may be recovered at a future time. Page 1