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HomeMy WebLinkAbout04-0984Estate of Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Deceased Social Security No. 201-18-62§2 Petitioner(s), who is/are 18 years of age or older, apply(les) for: (COMPLETE "A" OR "B" BELOW:) A. Probate and Grant of Letters and aver that Petitioner is the executrix named in the Last Will of the Decedent, dated January 30, 1986 and codicil(s) dated State relevant c rcumstances, 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 to victim of a killing and was never adjudicated incompetent: B. Grant of Letters of Administration (d.b.n.c.t.a.: pendente 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: Name Relationship ~bsidence COMPLETE IN ALL CASES:) Attach additional sheets if necessary. F" Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or principal residence at 631 Walton Street, Borough of Lemoyne (List street, number and municipality) Decedent, then 80 years of age, died October 26, 2004 at 631 Walton Street, Lemoyne (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 ...................................................................................................................... $ Total ......................................................................................................... $ 35,000.00 120,000.00 155,000.00 Real Estate situated as follows: 631 Walton Street, Borou.qh of Lemoyne, Cumberland County, PA Wherefore, Petitioners respectfully request the probate of the last Will presented with this Petition and the grant of letters in the appropriate form to the undersigned: .,, /7 I //Sign~,,/,/l'.d // Il / Typed or printed name and residence Bradley P. Smith 260 Westover Drive, New Cumberland, PA 17070 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF · The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and th,at, a,s~ersonal representative(s) of the Decedent, Petitioner(s)will well and truly adminis~..~ esta~e~co~g t~w~_ Sworn to and affirmed and subscribed //'--~~~'/'~'~ ,¢~ O~(~ / BRAD~/EY P. SMITH Before me this _~]_' ' day of ::~ ¥~ ~: NO. Estate of BETTY L. FOUST Social Security No: 201-18-6282 Date of Death: , Deceased. October 26, 2004 AND NOW, ,2004, in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters Testamentary d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate are hereby granted to BRADLEY P. SMITH in the above estate and that the instrument(s) dated January 30, 1986 described in the Petition be admitted to probate and filed of record as the last Will of the Decedent. FEES Letters ........................... $ Short Certificate(s) $. Renunciation .............. $. Affidavit ( ) .................. $. Extra Pages ( ) .......$ Codicil ............................ $ JCP Fee ....................... $ Inventory ...................... $ Other .............................. $ TOTAL .........$ Register of Wil,~; ~ C~-l- Attorney: Richard W. Stewart I.D. No: 18039 Address: Johnson, Duffie, Stewart & Weidner, 301 Market Street, P.O. Box 109, Lemoyne, PA 17043- Telephone: 717-761-4540 ! in, is. ~o ccrlify' thal the information here given is correctly copied from an original certificate of death duly filed with me as I.,,c,d 14egistrar. The original certificale will be forwarded to the State Vital Records Office /bt permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate. $2.00 P i©G8GSOG No. rr .M # /,:,. --/--'7 SHOULD READ AS FOLLOWS: ~ z,a? L/ OMMONWEALTH OF PENNSYLVANIA · DEPARTMENir OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH NAME OF OECEDENT (F,r~-~,~e. L~-~-- ....................................................... STALE SeE " ~tty L. Foust _ (~le '201 --18 --6282 t.26~2004 .. ~:rl~ ~. ~. ~De , 631 Walton S~t ],~ ..... ~.. . [,o~ite {G,~ ~ ~k ~ ~1~ ~ ~ U S. ~MED F~CES? [ {S~ay o~v h~ ~ c~I ~mL S~US- ~,~ S~IV~ *c,u,~ ,,.. m~. Pe~sylv~ia 631 Walton S~t "ES,~E ~ ,,~.~ ,~e, PA 17043 -~.,~ ~ Bradley P. ~ '~o"~rs~~..c~.~.z~c~ ~mS~T~ IoaE~aS~aT~ ~.0 Westover Dr. ,~w ~ri~,PA 17070 ~ ~s~ ~t.29,2004 Rolling Gr~ ~te~ l~r~l~ ~.,PA . ~se~ ~&C8~324 H~I Ave.~e~PA1 / / ~ ~ ~EFILEO(Mo~ Oay ~a~J STONE, SAJER & STE~/A RT Attorney:s at Law 414 Brid!;e Street New Cumberland, Pa. 17070 LAST WILL AND TESTAMENT OF BETTY L. FOUST I, BETTY L. FOUST, of the Borough of New Cumberland, County of Cumberland and Commonwealth of Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I: I bequeath the sum of Five Thousand ($5,000.00) Dollars to my grandson, STEVEN SMITH, if he survives me. ITEM II: I bequeath the sum of Five Thousand ($5,000.00) Dollars to my grandson, MITCHELL SMITH, if he survives me. ITEM III: I devise and bequeath the residue of my estate of every nature and wherever situate to my son, BRADLEY P. SMITH, if he survives me. If my son, BRADLEY P. SMITH, fails to survive me, I devise and bequeath the residue of my estate of every nature and wherever situate to the issue of my son, BRADLEY P. SMITH, per stirpes, who survive me. ITEM IV: Should any of my grandchildren entitled to a share of my estate not have attained the age of twenty-five (25) years at the time of distribution to him or her, I devise and bequeath the share of each such bene- ficiary to CCNB BANK, N.A., of New Cumberland, Cumberland County, Pennsylvania, IN SEPARATE TRUST, to hold, manage, invest and reinvest the share so received, and the accumulation of income thereon, to use and apply the income and principal, or so much thereof as, in the Trustee's discretion, may be necessary or appropriate to such beneficiary's support, education and medical care after taking into consideration the beneficiary's other readily Page 1 of 4 pages Attorneys at Law 414 Bridge Street New Cumherlland, Pa. 17O70 available assets and sources of income. Any principal or income not so applied shall be distributed to the beneficiary absolutely when he or she attains the age of twenty-five (25) years. If the beneficiary dies before attaining age twenty-five (25) years, the trust shall terminate and such share shall be distributed to the beneficiary's personal representative. ITEM V: 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. ITEM VI: I appoint my son, BRADLEY P. SMITH, Executor of this my last Will. Should my son, BRADLEY P. SMITH, fail to qualify or cease to act as Executor, I appoint CCNB BANK, N.A., of New Cumberland, Cumberland County, Pennsylvania, Executor of this my last Will. ITEM VII: I direct that my Executor and Trustee, or their successors shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I~ L. FOUST, have hereunto set my hand and seal this ~f~ day of ~ ~.c~ , 1986. BETTY L. gUST (SEAL) Page 2 of 4 pages SIGNED, SEALED, PUBLISHED and DECLARED by BETTY L. FOUST, the testatrix above named, as and for her Last Will and Testament, and in the pre- sence of us, who at her request, in her presence and in the presence of each other, have subscribed our names as witnesses. Witness Witness Address / Attorneys at Law 414 Bridge Street New Cumberland, Pa. 17070 COMMONWEALTH OF PENNSYLVANIA: :SS: COUNTY OF CUMBERLAND : I, BETTY L. FOUST, 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 this instrument as my last will; that I signed it willingly and that I signed it as my free and voluntary act for the purposes therein contained. ' :TTY f FOUST Sworn to or affirmed to and acknowledged before me by BETTY L. FOUST, the Testatrix, this ~ ~day of ~ , 1986. Notary Public ~£TH ANN HECKMAN, Notary Publlo ~w Cumberland, Cumberland CO., Pa 'I~' Commi,~m bqai~# l:eb, 8~ 1~ Page 3 of 4 pages STONE, S;AJ E R & STEWART Attorneys ,at Law 414 Bridge Street New Cumberland, Pa. 17070 COMMONWEALTH OF PENNSYLVANIA : :SS: COUNTY OF CUMBE~L~D : 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 Testatrix sign and execute the instrument as her last will; that Testatrix 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 and sight of the Testatrix signed the will as witnesses; that to the best of our knowledge, the Testatrix was at that time eighteen or more years of age, of sound mind and under no constraint or undue influence. Witness Sworn to or affirmed to and acknowledged before me by ~.../~ ~. and ~~ ~z~ ~_~ , witnesses, Notary Public :ETH ANN HECKMAN, Notary Public .?v,' Cumberland, Cumberland Co., PM Commission Expires Feb. 8, 1988 Page 4 of 4 pages CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: BETTY L. FOUST Date of Death: October 26, 2004 Will No.: 21-04-00984 Admin. No.: To the Register: I certify that the Notice of Beneficial Interest 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 December ~;;.7~ , 2004 Name Address Bradley P. Smith 260 Westover Dr., New Cumberland, PA 17070 Steven Smith 1035 Main St., Oberlin, PA 17113 Mitchell Smith 620 Hummel Ave., Lemoyne, PA 17043 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None. Date: December ,2004 Signature Name: Richard W. Stewart, Attorney Johnson, Duffle, Stewart & Weidner Address 301 Market St. P. O. Box 109 Lemoyne, PA 17043-0109 Telephone: (717) 761-4540 Capacity: Personal Representative X Counsel for personal representative I REV-1500 COMMONWEALTH OF PENNSYLVANIA I INHERITANCE T~ RETURN FILENUMBER DEPARTMENT OF REVENUE =~., ~o, RESIDENT DECEDENT 2] 04 00984 HARRISBURG, pA 1712~0~1 ~ 7 COUN~ CODE YEAR NUMBER DECEDENTS NAME (~ST, FIRST, AND MIDDLE iNITIAL) SOCIAL SECURI~ NUMBER FOUST, BETTY L. : 201-18-6282 DATE OF DEATH (MM-DD-YEAR) DATE OF B~RTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE 10/26/2004 I 02/27/1924 REGISTER OF WILLS (IF APPLICABL~) ~uRVIViNG ~POUSE'S NAME ( LAST, FIRST AND ~IDDLE I N I~I,M. ) SOCIAL SECURITY NUMBER ~ 1 DdginalReturn E] ~ Supplemental Reiur~ [~] ~erna,nder Return (date of ~eath pnor to ~2-13-82) [] 4 Limited Estate 12-12-82) [] 5 Federal EstateTax Return Required [] 6. of Decedentwill) Died Testate (Attach copy J~ 7 copyDeCedentof Trust)Maintained a Living Trust (Attach 8 Total Number of Safe Deposit Boxes [] 9. Litigation Proceeds Received [] 10 Spousal Povedy Credit (date of death between [] 11.Election to tax under Sec 9113(A) (Attach Sch O) NAME RICHARD W. STEWART COMPLETE MAILING ADDRESS FIRM NAME (If appliCable) JOHNSON, DUFFIE, STEWART & WEIDNER 301 Market St. TELEPHONENUMBE~ I Lemoyne, PA 17043-0109 717/761-4540 1, Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Propdetorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) [] Separate Billing Requested 7. (Schedulelnter-Viv°s GTransferSor L) &' Miscellaneous Non-Probate Property 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 20,043.41 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 770.69 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11 ) 13.Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 147,500.00 (2) 38,919.76 (3) None (4) None (5) 1,931.00 (6) 1,071.45 (7) 1,690.94 (8) 191,113.15 (11) 20,814.10 (12) 170,299.05 (13) 14. Net Value Subject to Tax(Line 12 minus Line 13) (14) 170,299.05 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) 16. Amount of Line 14 taxable at lineal rate 170,299.05 x .045 (16) 7,663.46 17.Amount of Line 14 taxable at sibling rate x .12 (17) 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) 7,663.46 Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Gomplete Address: 631 WALTON STREET IzIP 17043 Tax Payments and Credits: I. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applicable D. Interest E. Penalty 7,280.29 383.17 Total Credits (A + B + C) Total Interest/Penalty (D + E) If Line 2 is greater than Line I + Line 3, enter the difference. This is theOVERPAYMENT Check box on Page 1 Line 20 to request a refund If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is theBALANCE DUE (1) 7,663.46 (2) 7,663.46 {3) 0.00 (4) (5) 0.00 (5A) (5B) 0.00 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; ............................................................................. I~ r~ b, retain the right 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, benef ts or care? ........................................................... 2. If death occurred after December 12, 1982, did decedent transfer properly within one year of death without receiving adequate sons dera on? 3. Did decedent own an "in trust for" or payable upon death bank account or security a h s or her death?... [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probata property which contains a benefic aw des gnat on? IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have exam ned h s return, inc Ud ng accompanying schedu es and stai~mentsl and to the best ~fmy knowledge and belief, it is true, correct and complete, Declaration preparer other than the personal representative is based on all information of which preparer has any knowledge SIGNATURE O~ PERSON RESP0 SISLE ~ FILING RETURN ADDR~ES~ DATE RESSNT ,VE RICHARD W. STEWART ADDRESS 301 Market St. Lemoyne, PA 17043-0109 For ~tes of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surv~wng 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 statutedoes 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 deceased 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 P.S. §9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedenrs lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's 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 decadent, whether by blood or adoption. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE VALUE AT DATE OF DEATH ESTATE OF FOUST, BETTY L. I FILE NUMBER I 2] - 04 - 00984 All real property owned solelv or as a tenant in common must be reported at fair market valu~air market value is defined as the price at which property, would be exchanged between a willing buyer and a wifling seller, neither beinn compelled to buy or sell, both having reasonable knowledge of the relevant facts.Real property which is jointly-owned with right ~ survivorsh p must be disclosed on schedule F. ITEM 1 NUMBER DESCRIPTION 1 Real Estate - No. 631 Walton Street, Borough of Lemoyne, Cumberland 147,500.00 County, PA. Deed Book J, Volume 32, Page 246. Sale Price - (Copy of Settlement Statement attached). TOTAL (Also enter on Line 1, Recapitulation) 147,500.00 REV-1500 INHERITANCE TAX RETURN COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE O..T 28®o~ RESIDENT DECEDENT HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL} FOUST, BETTY L. DATE OF DEATH (MM-DO-YEAR} DATE OF BIRTH (MM-DO-YEAR} 10/26/2004 i 02/27/1924 (IF APPLICABLE} SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL} 21 04 00984 201-18-6282 REGISTER OF WILLS 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) [] 1. OdginalRetum [] 2 SupplementalReturn r-'] ~ Remamd~iReiurn(dateofdeathpdorto12-13-82) [] 4 Limited Estate [] 4a Futurelnterest Compromise (date of death after [] 5. Federal Estate Tax Return Required 12-12-82) [] 6 Decedent Died Testate (Attach copy [] 7 Decedent Maintained a Living Trust (Attach 8. Total Number of Safe Deposit Boxes of Will) copy of Trust) [] 9 Litigation Proceeds Received [] 10 Spousal Poverty Credit (date of death between [] 11.Election to tax under Sec 9113(A) (Attach Sch O} 12-31-91 and %1-95 NAME COMPLETE MAILING ADDRESS RICHARD W. STEWART ~ ~ ~IRM NAME (If applicablel JOHNSON, DUFFIE, STEWART & WEIDNER. 301 Market St. TELEPHONE NUMBER Lemoyne, PA 17043-0109 717/761-4540 (1) 147,500.00 c=,.~. ~ r~ (2) 38,919.76 C:D rn (3) None ro ~-~ ~:;r~ (4) N o ne ~ ~ co ;~ C) C) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6, Jointly Owned Property (Schedule F) [] Separate Billing Requested 7. Inter-Vivos Transfers &.Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) (5) 1,931.00 (6) 1,071.45 (7) 1,690.94 (9) 20,043.41 (10) 770.69 (8) 191,113.15 (11) 20,814.10 12. Net Value of Estate (Line 8 minus Line 11 ) (12) 170,299.05 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has Rot been made (Schedule J) 14. Net Value Subject to Tax(Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, x ,00 or transfers under Sec. 9116(a)(1.2) 16.Amount of Line 14 taxable at lineal rate 170,299.05 x .045 17.Amount of Line 14 taxable at sibling rate x .12 18. Amount of Line 14 taxable at collateral rate 19. Tax Due x .15 20. [] (13) (14) 170,299.05 (15) (16) 7,663.46 (17) (18) (19) 7,663.46 Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Gomplete Address: ISI'REET ADDRESS CITY 631 WALTON STREET LEMOYNE Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C, Discount 3. Interest/Penalty if applicable D. Interest E. Penalty ,STATE PA ' ZIP 17043 (1) 7,663.46 (2) 7,663.46 (3) 0.00 7,280.29 383.17 Total Credits (A + B + C) Total interest/Penalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMEN'[ (4) Check box on Page '1 Line 20 to request a refund 5. If Line I + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE (5) 0.00 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + SA. This is theBALANCE DUE (5B) 0.0 0 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 income; ................................ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death2 ....... [] [] contains a beneficiary designation'~ ............................................................................................................... [] [] i~ L~:, M, 260 WESTOVER DRIVE' ~/Z/,]~/~,,,K SIGNA~t4PAR~RESENTATIV~ RICHARD W. STEWART DATE ADDRESS 301 Market St. Lemoyne, PA 17043-0109 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (i)], For 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 statutedoes 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 deceased 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 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 beneficiaries is 4.5%, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116 (a) (1.3)]. A sihling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. COMMONWEALTH OF PENNSYLVANIA ~NHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE VALUE AT DATE OF DEATH ESTATE OF FILE NUMBER FOUST, BETTY L. i 21 ~ 04 - 00984 All real property owned solely or as a tenant n common must be reported at fair market valu~air market value is defined as the price at which property would be exchanged between a w ng buyer and a willing seller, neither being compelled to buy or sell both having reasonable knowledge of the relevant facts.Real property which is jointly-owned with right o~ survivorship must be disclosed on schedule F. ITEM DESCRIPTION NUMBER 1 Real Estate - No. 631 Walton Street, Borough of Lemoyne, Cumberland 147,500.00 Connty, PA. Deed Book J, Volume 32, Page 246. Sale Price - (Copy of Settlement Statement attached). TOTAL (Also enter on Line 1, Recapitulation) 147,$00.00 34.43 205. 206. 147,500.00 108. 209. Assist 7,590.00 3OZ. 1~' ,~,~ ~d~ ~y/f~r ~orrower(lb~e ~20) 157,090.00 157,090.00 412 7,590.00 17,905.60) 1t0.320.98 6, 2004 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS& BONDS ESTATE OF FILE NUMBER FOUST, BETTY L. 21-04-00984 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 75~ ~hare~ - PNc Financial Common ¢) $52.11 per share DESCRIPTION UNIT VALUE IVALUE AT DATE OF DEATH 38,919.76 TOTAL (Also enter on line 2, Recapitulation) 38,919.76 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FOUST, BETTY L. FILE NUMBER 21 - 04 - 00984 Include the proceeds of litigation and the date the proceeds were received by the estateO, II property jointly-owned with the right of survivomhip must be disclosed on schedule F, . ITEM NUMBER 1 2 Household Goods - appraised value Credit for real estate taxes paid. DESCRIPTION VALUE AT DATE OF DEATH 1,230.00 701.00 TOTAL (Also enter on Line 5, Recapitulation) 1,931.00 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FOUST, BETTY L. SCHEDULE F JOINTLY-OWNED PROPERTY FILE NUMBER 21 - 04 - 00984 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A Bradley P. Smith 260 Westover Drive New Cumberland, PA 17070 Sou JOINTLY OWNED PROPERTY: - DEScRiPTION OF PROPERTY ~ OF ATE F DEATH LETTER DATE Yo O D 0 ITEM =r~c> m~,~,T ~A^n: Include name of financial institution and bank account number DATE OF DEATH NUMBER "r"~"~'~'~' ~'~-~'~- or similar identifying number. Attach deed for jointly-held real VALUE OF ASSET ~krt~"~'~'t -~"~"- "~"'- estate. ""-~"~' 1 A 01/01/1978 PNC Bank - Checking Account 2,142.891 50% 1,071.45 No. 5140021332 TOTAL (Also enter on line 6, Recapitulation) I 1,071.45 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FOUST, BETTY L. SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ' FILE NUMBER , 21-O4- 0O984 ITEM NUMBER This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. DESCRIPTION OF PROPERTY I DATE F D I % OF ' Include ~he name of the transferee, their relationship to decedent end he da e o rahs e O EATH EXCLUSION Attach a copy of the deed for real estate VALUE OF ASSET DECD'S iNTEREST ](IF APPLICABLE)] PNC Bank- Savings Account No. ~6~6599481 4,690.94 3,000.00, : Joint with Bradley P. Smith, Son as of 7/20/2004 Date of death balance, plus accmed interest TAXABLE VALUE 1,690.94 TOTAL (Also enter on line 7, Recapitulation)I 1,690.94 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FOUST, BETTY L. Debts of decedent must be reported on Schedule I. iTEM NUMBER DESCRIPTION SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COOTS FILE NUMBER 21 - 04 - 00984 FUNERAL EXPENSES: Musselman Funeral Home AMOUNT 5,720.48 2 Rolling Green Cemetery - interment charges 895.00 3 Bricker House/Pete's Cafe - funeral luncheon 463.46 ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid Attorney's Fees JOHNSON, DUFFIE, STEWART & WEIDNER -- Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Relationship of Claimant to Decedent Probate Fees Register of Wills - Cumberland County Zip 3,000.00 266.00 5. Accountant's Fees 6. Tax Return Preparer's Fees Other Administrative Costs Cumberland Law Journal - advertise letters The Patriot-News - advertise letters 75.00 109.30 Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) 9,514.17 20,043.41 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FOUST, BET1W L. Adminisl~'~ve Cosls c(~'~ed FILE NUMBER 2I - 04- 00984 Chuck Bricker - household goods appraisal 75.00 4 Register of Wills - file Inventory & Inheritance Tax Return 5 ERA/Straub - commission - sale of real estate 6 Recorder of Deeds - 1% Transfer Tax 7 Bower's Pest Control - Pest Inspection 8 Borough of Lemoyne - 4th quarter sewer fee for 2003 9 Borough of Lemoyne - sewer charges due at settlement 10 Borough of Lemoyne - refuse charges due at settlement I 1 Settlement or closing fee 12 Capital Area Carpet Cleaners - carpets cleaned to prepare house for sale. 13 Kreamer Brothers Glass - repair porch window glass due to high winds. 14 Comcast Cable 15 PP&L - electric service 16 PA Water Co. - water service 17 UGI - gas service 18 Verizon - telephone service 19 Karen Hill - lawn maintenance 28.00 6,519.00 1,475.00 53.00 60.00 103.75 58.75 20.00 128.79 79.47 84.46 98.30 60.21 435.00 44.64 I90.80 Page 2 of Schedule H COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FOUST, BETTY L. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21 - 04 - 00984 Include unreimbursed medical expenses. ITEM NUMBER 1 2 3 4 5 6 7 8 9 10 11 12 DESCRIPTION Joyce Karash - Caregiver Tammy L. Brown, Caregiver Medco Health - Dr. Little - balance not covered by insurance Smith Radiology - balance not covered by insurance Arnesto Eye Associates - balance due on decedant's account. Holy Spirit Hospital - balance not covered by insurance. Andrews & Patel - balance not covered by insurance. CVS Pharmacy - medical supplies Quantum Imaging - balance not covered by insurance. Dr. Burick Azizkhan - balance not covered by insurance Family Physicians - balance not covered by insurance AMOUNT 440.00 72.00 30.00 4.04 5.91 2.43 178.93 5.09 16.98 7.28 5.17 2.86 TOTAL (Also enter on Line 10, Recapitulation) 770.69 REV-1513 EX+ (9-00) · ~ SCHEDULE J COMMONW~LT, OF PENNSYLVANIA BEN EFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT I ESTATE OF FILE NUMBER FOUST, BETTY g. I 21 - 04 - 00984 I RELATIONSHIP TO i NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT J.. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1 ! Bradley P. Smith Son 260 Westover Dr., New Cumberland, PA 17070 Steven Smith 1035 Main St., Oberlin, PA 17113 Mitchell Smith 620 Hummel Ave., Lemoyne, PA 17043 Grandson Grandson AMOUNT OR SHARE OF ESTATE Residue $5,000.00 cash bequest. $5,000.00 cash bequest. II. ; Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover she~ NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OE ~NDIVIDUAL TAXES DEPT 280601 HARRISBURG, PA 17 ? 28-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV 1162 EX(11-96) NO. CD 004753 STEWART RICHARD W 3RD & MARKET STREETS P. O. BOX 109 LEMOYNE, PA 17043 ..... fold ESTATE INFORMATION: SSN: 201-18 6282 FILE NUMBER: 2104-0984 DECEDENT NAME: FOUST BETTY L DATE OF PAYMENT: 12/20/2004 POSTMARK DATE: 12/17/2004 COUNTY: CUMBERLAND DATE OF DEATH: 10/26/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $7,280.29 REMARKS: TOTAL AMOUNT PAID: $7,280.29 SEAL CHECK//260-7 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of FOUST, BETTY L. also known as , Deceased No. 21 - 04- 00984 Date of Death 10/26/2004 Social Security No. 201-18-6282 BRADLEY P. SMITH The Personal Representative(s) of the above Estate, deceased, verify that the items appeadn9 in tho following Inventory include all of tho personal assets wherever situate and all of the real estate located in tho Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that tho Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. I/We verify that the statements made in this Inventory are true and correct. INVo understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to authorities. Personal Represent~e //~// BRADLFcY P. SMITH I.D. No.: 18039 Signature: Signature: Address: 301 Market St. Lemoyne, PA 17043-0109 Telephone: 717/761-4540 Personal Property 752 Shares - PNC Financial Corranon (~ $52.11 per share Household Goods - appraised value Credit for real estate taxes paid. Address: 260 WESTOVERDRIVE' NEW CUMBERLAND, PA 17070 Telephone: (717) 774-5447 Dated: ~701.00 Total Personal Property $40,850.76 (Attach additional sheets if necessary) Total Personal Property and Real Estate $188,350.76 Register of Wills of Cumberland County, Pennsylvania Estate of FOUST, BETTY L. also known as INVENTORY continued , Deceased No. 21 - 04- 00984 Date of Death 10/26/2004 Social Security No. 201-18-6282 Real Estate Real Estate - No. 631 Walton Street, Borough of Lemoyne, Cumberland County, PA. Deed Book J, Volume 32, Page 246. Sale Price - (Copy of Settlement Statement attached). 147,500.00 Total Real Estate $147,500.00 2 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 NOTICE OF INHtktTANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX RICHARD W STEWART 301 MARKET ST LEMOYNE PA 17043 . ",D~'fI': . "'EmTE OF DATE OF DEATH FILE NUMBER . \:OUNTY AIlN 02-07-2005 FOUST 10-26-2004 21 04-0984 CUMBERLAND 101 r. *' REY-1541EXAfPC12-04) BETTY L 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 ~ Ri:v:r~\"-!X".AFp..CIl1":6~n--i1I1YY'cE.oF.i:NHER.i'i'ANc~-YAx.A.pilRA.i'sEH.Eilt~..A[towANC~-OR..........._- - --- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF FOUST BETTY L FILE NO. 21 04-0984 ACN 101 DATE 02-07-2005 TAX RETURN WAS: I X I ACCEPTED AS FILED I CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule AJ 2. Stocks and Bonds (Schedule B) 3. Closely Held stock/Partnership Interest (Schedule CJ 4. Hortgages/Notes Receivable (Schedule OJ 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule fJ 7. Transfers (Schedule G) 8. Total Assets III (21 (31 (41 (51 (61 (7) 147.500.00 38.919.76 .00 .00 1.931.00 1.071.45 1.690.94 (81 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ad... Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule ~) 14. Net Value of Estate Subject to Tax (91 1101 20,043.41 770.69 (111 1121 1131 1141 NOTE: I~ an assessment was issued previoUSly, lines re~lect ~igures that include the total o~ ALL ASSESSMENT OF TAX: lS. Amount of line 14 at Spousal rate (15) 16. Amount of line 14 taxable at lineal/Class A rate (16) 17. Amount of line 14 at Sibling rat. (17) 18. Amount of line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX S: NOTE: To insure proper credit to your account~ submit the upper portion of this form with your tax payment. 191,113.15 :>0.814 10 170,299.05 .00 170,299.05 14, IS and/or 16, 17, 18 and 19 will returns assessed to date. .00 X 00 = 170,299.05 X 045 = .00X12= .00x15= 1191= DATE 12-17-2004 + INTEREST/PEN PAID I-I 383 . 17 AHDUNT PAID 7,280.29 NUHBER CD004753 ~? TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .00 7,663.46 .00 .00 7,663.46 7,663.46 .00 .00 .00 IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. J IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU HAY BE DUEOI\ A REFUND. SEE REVERSE SIDE OF THIS FDRH FOR INSTRUCTIONS. I sJ\ 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: BETTY L. FOUST Date of Death: OCTOBER 26.2004 Will No.: 21-04-00984 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 ~ 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. Did the personal representative file a final account with the Court? Yes No ~ 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 No ~ Executor was the sole beneficiary of the residue. D. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date Y/vj2?'i'S" (1)"") -?A~h- Signature Richard W. Stewart, Attorney Johnson, Duffie, Stewart & Weidner 301 Market Street, P.O. Box 109 Lemoyne, PA 17043-0109 Address r.""") "-."- (717) 761-4540 Telephone No. Capacity: Personal Representative ~ Counsel for Personal Representative cJ