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Home My WebLink About02-0264Estate of also known as Register of Wills of Dauphin County, Pennsylvania PETITION FOR GRANT OF LETTERS Petitionel(s), who is/ate 18 yeals of alia or older, applyties) 1o1: (COMPLETE "A" OR "B" BELOW:) , Deceased A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut Decedent, dated and codicil(s) dated Social Security No. named in the Last Will of the State lelev~t circumstances, e.g.. renunciation, death of executoL 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: B. Grant of Letters of Administration (cA,a., d.b,n.c [,a.: pendente lite; dtsfante absentia; dulartte mi~ofitate) 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 Residence (COMPLETE IN ALL CASES:) Attach additional '~oq heats if necessary. ,~lDecedent was domiciled at death in residence at I ?_~)0 t~,-~-¥ ~Decedent, then ~ years of age, died _ County, Pennsylvania, with his/her last family or principal (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 .............................................................. $ Real Estate 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: Signature Typed or printed name and residence Oath of Personal Representative Commonwealth of Pennsylvania County of Dauphin 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 that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to lav~. Sworn to and affirmed and subscribed before me this ,/-~7'- day of ~.~-,~._ 20o~ Estate of also known as DECREE OF REGISTER PRISCILLA ANN ALLISON Deceased No. Social Security No: 209-22-7378 Date of Death: 10-06-2001 AND NOW, MARCH 14, 2002 , 20 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters ~ Testamentary [] of Administration are hereby granted to BONNIE C WILLIMAS in the above estate and that the instrument(s), if any, dated described in the Petition be admitted to probate and filed of record a~ las~Will Q~ecedent. FEES Letters ........................... $ 115.00 6.00 Short Certificate(s) .......... $ Renunciation .................. $ !0.00 Affidavit ( ) ................. $ Extra Pages ( ) ............ Codicil .......................... $ JCP Fee ........................ $ 5.00 Inventory & Tax Forms... $ Other ............................ $ Attorney: I.D. No: Address: TOTAL ................ $ ~.2f.99 mai,led to exec on 2-14-02 Telephone: DATE FILED: MARCH 13, 2002 Register of Wills of Dauphin County, Pennsylvania Page 1 of 2 Subj: Renunciation Form - Please, print, execute, notarize & mail. Thanks Date: 3/1/2002 10:39:31 AM US Mountain Standard Time From: awil!ia~s@generaleco!0gy,co_m To: sun ny boy? a@aol: com Sent from the Internet (Details) Register of Wills of Dauphin County, Pennsylvania RENUNCIATION Estate of Priscilla A. Allison also known as , Deceased I I I The undersigned, Ken Allison, child and intestate heir of the above Decedent, hereby renounces the right to administer the estate and respectfully requests that Letters of Administration be issued to Bonnie C. Williams, child and intestate heir of the above Decedent. Witness my hand this ~ ~2 day of ~*d~c"/ ,2002. Ken Allison 18024 N. 55th Street Scottsdale, AZ 85254 Sworn to or affirmed and subscribed Before me this ~;:).r,d day of /~ ,2002. Notary Public ~-/t~/~/~ My Commission Expires: (Signature and seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary, commission) MARIA IPPOI.~I~( Notary Public - Arizona Maricopa County My Commission Expires v v~ v vJune t3, 2005v ~ Saturday, March 02, 2002 America Online: SUNNYBOY7A Register of Wills of Dauphin County, Pennsylvania Page 1 of 2 Richard Allison From: Andrea Williams [awilliams@generalecology.com] Sent: Friday, March 01,2002 11:34 AM To: Richard Allison Subject: Renunciation, please print, execute, notarize, mail, thanks Register of Wills of Dauphin County, RENUNCIATION Pennsylvania Estate of Priscilla A. Allison also known as , Deceased The undersigned, Richard Allison, child and intestate heir of the above Decedent, hereby renounces the right to administer the estate and respectfully requests that Letters of Administration be issued to Bonnie C. Williams, child and intestate heir of the above Decedent, Witness my hand this .Zig ¢¢~ day of ~ ~ , 2002. 7167 Pindell School Road Fulton, MD 20759 Sworn to or affirmed and subscribed Before me this z,/.~ day of ~ ~[~..~..j ,2002. Notary Public My Commission Expires: OA[E A. H;XON NOTARY ~!JP~LtC 5i;~ff:: OF MA~'¢~ ).;'.~7~ (Signature and seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary, commission) 3/1/02 "CERTIFICATION OF NOTICE -UNDER RULE S.6(a)' Name of Decedent: Date of Death: Will No. Adm. To the Register: I certify that notice of 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 · Name Address ~,\.. 5~'~' Notice has now been given to all persons entitled thereto under Rule 5.6a) except: (Signature) Address: Telephone (~o) Capacity: ~Personal Representative Counsel for Personal Representative AUGUST 1, 2002 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPARTMENT 280601 HARRISBURG, PA 17128-0601 Telephone 717 787-3930 Dear Register of Wills: Re: Estate of PRISCILLA A. ALLISON File Number: 2102-0264 County: CUMBERLAND Date of Death: 10/06/2001 The subject decedent legally resided in CUMBERLAND County as of the date of death. Accordingly, you are authorized to cancel file number 2202-0712. All matters concerning this estate should be maintained under CUMBERLAND County File Number2102-0264. All original Inheritance Tax documents for the subject decedent should be forwarded to the CUMBERLAND County Register of Wills; however, you may wish to retain a copy, including photocopies of all receipts for the collection of Inheritance Taxes in the subject estate which have been issued by your office. Please contact me at the telephone number above if you have any questions. Sincerely, Document Processing Unit Inheritance Tax Division AUGUST 1, 2002 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPARTMENT 280601 HARRISBURG, PA 17128-0601 Telephone 717 787-3930 Dear Register of Wills: Re: Estate of PRISCILLA A. ALLISON File Number: 2102-0264 County: CUMBERLAND Date of Death: 10/06/2001 The subject decedent legally resided in CUMBERLAND County as of the date of death. Accordingly, you are authorized to cancel file number 2202-0712. All matters concerning this estate should be maintained under CUMBERLAND County File Number2102-0264. All original Inheritance Tax documents for the subject decedent should be forwarded to the CUMBERLAND County Register of Wills; however, you may wish to retain a copy, including photocopies of all receipts for the collection of Inheritance Taxes in the subject estate which have been issued by your office. Please contact me at the telephone number above if you have any questions. Sincerely, J(~e'~~ey~ush, Su per visor Document Processing Unit Inheritance Tax Division COMMONWEALTH OF PENNSYLVANIA L')EPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT .oAA 557615 RECEIVED FROM: PAUL A. 1500 IL ~i'I~t A~ , SU[~ 202 PAOLI, PA. 19301 --- FOLD HERE ESTATE INFORMATION: I FILE NUMBER 22--02-0712 NAME OF DECEDENT (LAST) (FIRST) (MI) DATE OF PAYMENT POSTMARK DATE COUNTY DATE O~O~2001 REMARKS SS # 209-22-7378 dEAL ACN ASSESSMENT CONTROL NUMBER 101 TOTAL AMOUNT PAID RECEIVED BY REGISTER OF WILLS AMOUNT 2,992.00 FOLD HERE 2,992.00 REV-'I500 EX (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128~601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 0?'2 _ o& COUNTY CODE YEAR NUMBER I- Z LU w LU LU 0 DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) ALLISON, PRISCILLA ANN DATE OF BEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) 10/06/2001 I 10/25/1910 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) N/A SOCIAL SECURITY NUMBER 209-22 -7378 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER [] 1, Original Return [] 4. Limited Estate [] 6. Decedent Died Testate (Attach copy of Wil) [] 9. Litigation Proceeds Received [] 2. Supplemental Retum [] 4a. Future Interest Compromise (date d death ~a- 12. U.~) [] 7. Decedent Maintained a Uving Trust (Attach copy of Trust) [] 10. Spousal Poverty Credit (date of dea{h be{ween12-31-91and 1.1-95) ] 3. Remainder Return (dae d dea{h prior to 12-13-82) [] 5. Federal Estate Tax Return Required O 8. Total Number of Safe Deposit Boxes [] 11. Election to tax under Sec. 9113(A)(~achSc~O) NAME PAUL A. SIANA FIRMNAME(IfAppli~bb) SIANA CARR & O'CONNOR, LLP TE~E NUMBER 610-296-4200 rC~PLETE ~LING ~DRESS SIANA CARR & O'CONNOR, LLP 1500 E. LANCASTER AVENUE SUITE 202 PAOLI, PA 19301 9. 10. 11. 12. 13. 14. 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) [] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) Total Gross Assets (total Lines 1- 7) Funeral Expenses & Administrative Costs (Schedule H) (9) Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) Total Deductions (total Unes 9 & 10) Net Value of Estate (Une 8 minus Une 11) Charitable and Govemmentat Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) Net Value Subject to Tax (Line 12 minus Une 13) 70,621 7,932 (8) 9,593 2,463 (11) (12) (t3) (14) OFFICIAL USE ONLY PILED JUL ' RE~I~T~ 78,553 12,056 66,497 66,497 SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount d Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. 0 X ,0, (15) 66,497 x .o 45 (16) X .12 (17) X .15 (18) (19) [] IcHECK HERE IFYOUARE REQUESTING AREFUN~OFAN OVERpAyMENTI 2,992 2,992 > >BE SURE TO ANSWERALLQUESTIONSONREVERSE SIDE ANDRECHECKiMATH < < STFPA42021F.1 Decedent's Complete Address: ISTREE'[, AI~DRESS ]. 7 0 0 c~Y CAMPHILL MARKET STREET JSTATE PA ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Interest/Penalty if applicable D. Interest E. Penalty If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. Total Credits (A + B + C) (2) (1) 2,992 (3) (4) Total Interest/Penalty (D + E) (5) (5A) (5B) 0 2,992 2,992 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 properly transferred; ........................................ [] [] b. retain the right to designate who shall use the properly transferred or its income; ................... [] [] c. retain a reversionary interest; or ....................................................... [] [] d. receive the promise for life of either payments, benefits or care? ............................... [] [] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .................................................. [] [] 3. Did decedent own an "in trust for" or payable upon death bank account or secudty at his or her death? ..... [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE, CF PERSON RESPONSIBLE FOR FILING RETURN DATE ADDRESS SIGNATURE OF PREPA.I~9OTHE_R(I~IAN REPRESENTATIVE DATE 1500 E. LANCASTER AVE. SUITE 202, PAOLI, PA 19301 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 statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum 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 RS. §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 decedent, whether by blood or adoption. STF PA42021F.2 REV-1503 EX + (1-97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF PRISCILLA ANN ALLISON SCHEDULE B STOCKS & BONDS FILE NUMBER 21-02-0264 NUMBER VALUE AT DATE OF DEATH 63,346 All pm~ jointly~wn~ with the right of su~ivomhip mu~ ~ disclos~ on Sch~ule E ITEM DESCRIPTION 1. ALLFIRST TRUST COMPANY 213 MARKET ST., HARRISBURG, PA ACCT. # 1250487994 6,353.638 SH, ARK FDS US GOVT BD INS MONEY MARKET 17101 (040711475) TOTAL (Also enter on line 2, Recapitulation) 7,275 $ 70,621 STF PA42021F.4 (If more space is needed, insed additional sheets of the same size) REV-1508 EX + (1-97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF PRISCILLA ANN ALLISON SCHEDULE E CASH, BANK DEPOSITS,& MISC. PERSONALPROPERTY I FILE NUMBER 21-02 -0264 Include 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 DESCRIPTION IRREVOCABLE BURIAL RESERVE FUND WETZEL FUNERAL HOME C/O M. HAMMON P.O. BOX 2961 001-02-05 HARRISBURG, PA 17105-2961 TOTAL (Also enter on line 5, Recapitulation) VALUE AT DATE OF DEATH 7,932 $ 7,932 STF PA42021F.9 (If more space is needed, insert additional sheets of the same size) REV-1511 EX + (1-97)(I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF PRISCILLA ANN ALLISON SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-02 -0264 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION A. 1. 5. 6. 7. FUNERAL EXPENSES: WETZEL FUNERAL HOME, INC. 548 CARLISLE ST., HANOVER, (SEE ATTACHED SCHEDULE FOR PA 17331 BREAKDOWN OF EXPENSES) ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Persona~ Representative(s) Social Secudty Number(s) / EIN Number of Personal Representative(s) Street Address City State Year(s) Commission Paid: Attomey Fees Family Exemption: (If decedent's address is not the same as claimant's, a~ach explanation) Claimant Zip Street Address City Relationship of Claimant to Decedent Pmbate Fees Accountant's Fees Tax Retum Pmparer's Fees State Zip. TOTAL (Aisc enter on line 9, Recapitulation) AMOUNT 7,932 161 1,500 $ 9,593 (If more space is needed insert additional sheets of the same size) STF PA42021 F.12 ' 7176324123 WETZEL FNRL HOME T,T_li.e..:,~,~$!_{~.eia.l,~Se~-~..ic¢ for Pris¢illa.~nn 'K'II~h;'n :. '." , 285 PO:I. JUL 82 '02 14:47 Oi 12.'L THE' F.O£1;,OWINO IS AN IT~:iMIZED S1i4,TI~MI~4T OF'DIE SERVICES, FACILITIES. AIH'OMOTIVll EQUIPMliNT. ~ND'MERCHANDJSE THAT ~'ER{¢' SEI~J~'D ~I-{EN MAKING THE FUNERAL ARRANGEMI~'I'S. ...... · ..... :. · ................. $2689.00 S~omf ~cr~n on removal $4,s.00 · Flowe&t~d/Clec~lUtili~ ~r $95.{X1 ........... C~i '~84C Berks ............................ $750.00 "~di~'dr~s ~d tmdercloth~ I;H (25}" ........................ $;45.~ " $ AT THI5 '['IMB ~NERAL ARRANOEM.EN~ WERe] MADE, WE ADVANCED CERTAIN I'AYMRN~ TO (YD-IERS AS AN ACCOMMODATION. 'lite FOt,LdWlNG IS AN ACCOUNTING FOR TI. lOSE Gl tAI(GES. ............................ $400.00 ~ertitldd. Copies $12.00 0t5~ ltonor~ium ............................ 2fi0.00 :Marker Foun<h~tion .......................... M~gmin~{ ~mplcte ........................... ~ofund'lo fi~mily ............................ $12.29 AddMonal ~nse for script I~t~in~ COh~O ~RICE ......................... 27931.59 _~6~C~ m~ ........................... ... t0/10~001 Burial Re~c A~unt ....................... $-79.t 1.59 PAYM.Ei. N~$.. Priscilla Ann Allison REV-1512 EX + (1-97) (I) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF PRISCILLA ANN ALLISON SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21-02-0264 Include unmimbursed medical expenses. ITEM NUMBER DESCRIPTION MEDICAL BILLS MANOR CARE WEST 1700 MARKET STREET CAMP HILL, PA 17011 NEIGHBOR CARE PHARMACY P.O. BOX 20347 LEHIGH VALLEY, PA 18002 QUANTAM IMAGING & THERAPUETIC ASSOC. INC. 2527 CPJuNBERRY HIGHWAY WAREHAM, MA 02571-5000 ALLFIRST TRUST BANK 213 MARKERT STREET HARRISBURG, PA 17101 (REPAYMENT OF OVERDRAFT ON GUARDIANSHIP ACCOUNT) TOTAL (Also enter on line 10, Recapitulation) AMOUNT 1,369 97 995 2,463 (If more space is needed, insed additional sheets of the same size) STF PA42021F. 13 REV-1513 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF PRISCILLA ~ ALLISON SCHEDULE J BENEFICIARIES FILE NUMBER 21-02 -0264 NUMBER I. o II. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outdght spousal distributions, and transfers under Sec. 9116 (a) (1.2)] BONNIE C. WILLIAMS 100 GREENRIDGE RD., P.O. BOX 39 UWCHLAND, PA 19480 KEN ALLISON 18024 N. 55TH STREET SCOTTSDALE, ARIZONA 85254 RICHARD ALLISON 7167 PINDELL SCHOOL FULTON, MD 20759 RELATIONSHIP TO DECEDENT Do Not List DAUGHTER SON ROAD SON ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE AMOUNT OR SHARE OF ESTATE 22,165 22,166 22,166 ON REV-1500 COVER SHEET B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART [! - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) STF PA42021F. 14 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPARTMENT 280601 HARRISBURG, PA 17128-0601 Telephone AUGUST 1, 2002 ~,; _ ~ _ ; ;`_t 717 787-3930 Dear Register of Wills: Re: Estate of PRISCILLA A. ALLISON File Number: 2102-0264 County: CUMBERLAND Date of Death:10/06/2001 The subject decedent legally resided in CUMBERLAND County as of the date of death. Accordingly, you are authorized to cancel file number 2202-0712. All matters concerning this estate should be maintained under CUMBERLAND County File Number2102-0264. All original Inheritance Tax documents for the subject decedent should be forwarded to the CUMBERLAND County Register of Wills; however, you may wish to retain a copy, including photocopies of all receipts for the collection of Inheritance Taxes in the subject estate which have been issued by your office. Please contact me at the telephone number above if you have any questions. Sincerely, ~ ,~' , e `~ ~;'" ,> :Jefffiry Q. Hollenbush, Supervisor Document Processing Unit Inheritance Tax Division Jane D. Ma~o P~g~ter ~ W~ls and c~rk qf t~e Orphans' court Of Dauphin Coun~ Harffsburg, Pennsylvan~ 17101 CUMBERI~ COUN~ COURTHOUSE REGISTER OF WILLS 1 'COURTHOUSE SQUARE CARLISLE, PA. 17013 i7013+~2 ~2 BUREAU OF INDIVIDUAL TAXES TNHERTTANCE TAX DZVZ$/ON DEPT. 280601 HARRTSBURG, PA 17118-06nl COHHONHEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLONANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX RE¥-1~7 EX AFP (Ol-02) 4¸; PAUL A SIANA 1500 E LANCASTER AVENUE SUITE ?02 ,. PAOLI ~I~,A 19501 DATE ESTATE OF DATE OF DEATH FILE NUHBER COUNTY ACN 08-19-2002 ALLISON 10-06-2001 21 02-0264 CUHBERLAND 101 Amount Remitted PRISCILLA A HAKE CHECK PAYABLE AND REN'rT PAYNENT TO: REGISTER OF gILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE I~> RETAIN LOHER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-01) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLONANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF ALLISON PRISCILLA AFZLE NO. 21 02-0264 ACN 101 DATE 08-19-2002 TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1} 2. Stocks end Bonds (Schedule B) (2) 3. Closely Hold Stock/Partnership Interest (Schedule C) (3) ~. Nortgagos/Notas Receivable (Schedule D) (q) $. Cash/Bank Daposits/Hisc. Personal Property (SchoduZa E) 6. JointZy Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Tote1 Assots APPROVED DEDUCTIONS AND EXEHPTZONS: 9 Funeral Expenses/Adm. Costs/Hisc. Expanses (Schedule H) (9) 10 Debts/Nortgago Liabilities/Liens (Schedule Z) 11 Tote/ Deductions 12 Net Value of Tax Return .00 70/621.00 .00 .0O 7/951. O0 .0O .0O (8) 9,59~.00 (10) Z~465.00 (11) (12) 15 NOTE: Charitable/Governmental Bequests; Non-elected 911:5 Trusts (Schedulo J) (15) Net Value of Estate Sub,oct to Tax (1~) Zf an assess.ant ~as Sssued previousZy, lSnes 1~, 15 and/or 16, 17, reflect f$gures that Snclude the total of ALL returns assessed to date. NOTE: To insure proper credlt to your account, submit the upper portion of this form ~ith your tax payment. 78,553.00 66,497.00 .00 66,497.00 ASSESSNENT OF TAX: 16. Amount of Line 14 et Spousal rate 16. Amount of Line 1~ taxable et Lineal/Class A rate 17. Amount of Line lq et Sibling rate 18. Amount of Line lq taxable et Collateral/Class B rate 19. Principal Tax Due TAX CREDITS PAYMENT REC~.xP I DISCOUNT DATE NUHBER :]:NTEREST/PEN PA:]:D (-) 07-08-2002 AA557615 . O0 1F PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 18 and 19 will ( ZF TOTAL DUE ZS LESS THAN $1~ NO PAYNENT ZS RE~UZRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT' (CR)~ YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 2,991.00 ANOUNT PAID 2,992.00 .00 .98 .98 (15) .00 X O0 = .00 (16) 66,497.00 X 045= 2,992.00 (17) . O0 x 12 = .00 (18) .00 x 15 = .00 (19)= 2,992. O0 Name of Decedent: STATUS REPORT UNDER RULE 6.12 Date of Death: Will No.: 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 w._~tMer 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: o 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 r~ep,~ntative state an account informally to the parties in interest? Yes IDd' No [Z] c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Signature Capacity: Address '010- '--tS8 - 5;:;1'-t Telephone No. [~l~rsonal Representative [-] Counsel for personal representative Receipt & Release Estate of Priscilla A. Allison The undersigned, Ken Allison, child and intestate heir of the above Decedent, hereby renounces in the interest of economy the formal administration of the Decedent's estate and the filing of the estate for formal audit and confirmation by the Court. The undersigned is fully aware of all receipts and disbursements that have occurred in the Decedent's estate and hereby agrees to the proposed method of distribution. The undersigned hereby further discharges and releases Bonnie C. Williams, child and intestate heir of the above Decedent, from duties as administrator and representative of the estate and hereby releases and indemnifies Bonnie C. Williams from all liability which may adse from her service as fiduciary and in the administration of Decedent's estate. Wrtness my hand this day of ,2002. Ken Allison 18024 N. 55m Street Scottsdale, AZ 85254 Swom to or affirmed and subscribed Before me this ~/~/ day of My Commission Expires:~,'~ (Signature and seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary, commission) Receipt & Release Estate of Priscilla A. Allison The undersigned, Richard Allison, child and intestate heir of the above Decedent, hereby renounces in the interest of economy the formal administration of the Decedent's estate and the filing of the estate for formal audit and confirmation by the Court. The undersigned is fully aware of all receipts and disbursements that have occurred in the Decedent's estate and hereby agrees to the proposed method of distribution. The undersigned hereby further discharges and releases Bonnie C. Williams, child and intestate heir of the above Decedent, from duties as administrator and representative of the estate and hereby releases and indemnifies Bonnie C. Williams from all liability which may arise from her service as fiduciary and in the administration of Decedent's estate. Witness my hand this day of ~ ,2002. Richard Allison 7167 Pindell School Road Fulton, MD 20759 Sworn to or affirmed and subscribed Before me this ~ day of ~_..f -v..~,~,~._~,,t ./' ,2002. Notary Public My Commission Expires: ... ~'.'..d~.~....~,... TONEY VOGEL , -. NOTARY PUBLIC ......... My Comrn~ion F..xr~e~ Ju¥ 1.2oo~ (Signature and seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary, commission)