HomeMy WebLinkAbout02-0266PETITION FOR PROBATE and GRANT OF LETTERS
Estate of. Elizabeth L. Stark No. 21-02-266
also known as. _ To:
Deceased.
Social Security No. .. 178~-05-6434 '
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut or
in the last will of the above decedent, dated September 6
and codicil(s) dated
Register of Wills for the
County of Cumberland in the
Commonwealth of Pennsylvania
named
,1996
(state relevant circumstances, ~.g. renunciation,'death 0feXecutor, etc.).
'Decendent was domiciled at death in c..,.~or]~.a County; Pennsylvania, with
h ,~- last family or principal residence at 14 Randi Road ~ Enola, PA
(Ea'~t ?ennsboro Township)
(list street, number and muncipality)
Decendent, then 83' years of age, died March 7 , ]f~ 2002
at Manorcare Nurs~n_~ Home_. Camp H~I_. PA '
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
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 domiciledJm 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 last will and codicil(s)
presented herewith andthe grant of letters tez~ammn~:ary
theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
Robert S. Hippman
14 Randi Road
.Enola~ PA 17025
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA 3
COUNTY OF . C~ ~,e~ ~,~ ~> f 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 affirmed and subscribed ~'~n~o~.~- ~ ~.~ .'. ' ¥
before me this 14th day of [ ..... ~-~ .v--.~-~_~--~- ~
~... March_, ~ ~2002 .~ -
No. 21-02-266
Estate of E~,ZzASET~ L. STAR~ ., Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
· AND NOW March 15, 2002 ~tg~ _, in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated September 6, 1996-
described therein be admitted to probate and fded of record as the last will of Elizabeth L. Stark
;
e s t ament ary
and Letters
are hereby granted to Robert S. Hi man
Filed
FEES
Probate, Letters, Etc .......... $ 235.00
6.00
Short Certificates( )'. ......... $ 9.00
RXe-P a g.e .s.
nunmauon ................ $
JCP $ 5.00
TOTAL . $ 255.00.
.. MARC:B..kS,. ZQ02 ................
David H. Radcliff, Es~
~254_~3
ATTORNEY (S_up. Ct. I=.D. No.)
624 North Front Street
Wormleysburg, PA 17043
ADDRESS
(717) 236-9318
PHONE
21-02-266
I, ELIZABETH L. STARK, of the City of Shamokin, County of
Northumberland and Commonwealth of Pennsylvania, declare this to be my Last Will
and revoke any wills previously made by me.
ITEM I
I direct that all my just debts and funeral expenses 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 expense of the administration of my estate.
ITEM II
I give, devise, and bequeath one-half (1/2) of my estate whatsoever the same may
be and wheresoever the same may be unto my brother, ROBERT S. ItIPPMAN, of
Enola, Pennsylvania and one-half (1/2) to my sister, DOROTItY D. CLARK, of Stowe,
Pennsylvania, providing they shall survive me by hhirty (3 0) days.
Eli~li~eth L. Stark
ITEM III
In the event that either of my beneficiaries hereunder should predecease me or die
on or before thirty (30) days, I give, devise, and bequeath their share unto my nephews,
ROBERT E. HIPPMAN, of New Buffalo, Pennsylvania and BRIAN P. ItIPPMAN, of
York, Pennsylvania, or the survivor of them, in equal shares.
ITEM IV
I appoint my brother, ROBERT S. HIPPMAN, as Executor of this, my Last
Will. In the event my brother, ROBERT S. HIPPMAN, can not perform the duties of
Executor, I then appoint my sister, DOROTHY D. CLARK, as Alternate Executrix, of
this my Last Will.
ITEM VI
I direct that my personal representative or guardian shall not be required to give
bond for the faithful performance of his or her duties in this or any other jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand this 6th day of
September, 1996.
The preceding instrument consisting of this and two (2) other typewritten pages
identified by the signature of the Testatrix, ELIZABETH L. STARK, was on the date
thereof signed, published and declared by ELIZABETIt L. STARK, the Testatrix
therein 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.
ACKNOWLEDGMENT AND AFFIDAVIT
I, ELIZABETH L. STARK, the Testatrix, sign my name to this instrument this
6th day of September, 1996, and being first duly sworn, do hereby declare to the
undersigned authority that I sign and execute this instrument as my Last Will, that I sign
it willingly, that I execute it as my free and voluntary act for the purposes therein
expressed, and that I am eighteen years of age or older, of sound mind, and under no
constraint or undue influence.
E~lizab~eth L. Stark
We, Ann Targonski and Edward O'Donnell, the wimesses, sign our names to this
instrument, being first duly sworn, and do hereby declare to the undersigned authority
that the Testatrix signs and executes this instrument as her Last Will and that she signs it
willingly, and that each of us, in the presence or hearing of the Testatrix, hereby signs
this Will as wimess to the Testatrix signing and that to the best of our knowledge the
Testatrix is eighteen years or older, of sound mind, and under no constraint or undue
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF NORTHUMBERLAND
SS:
Subscribed, sworn to and acknowledged before me by ELIZABETH L. STARK,
the Testatrix, and subscribed and sworn before me by ANN TARGONSKI, and
EDWARD O'DONNELL, wimesses, this 6th day of September, 1996.
MY COMMISSION EXPIRES:
NOTARIAL SEAL
TRACEY M WtTM[R NOI'ARY PUBLIC
Sh'AMOKIN NORTItUMI3ERLAND COUNTY
MY COMMISSION EXPIRES MAY 10, 1999
4
CERTIFICATION OF NOTICE UNDER RULE 5. 6(a)
Name of Decedent:
Date of Death:
Will No.
To the Register:
ELIZABETH L. STARK
March 7, 2002
2002-0266 Admin No.
I certify that the Notice of Estate Administration required by Rule 5.6(a) of the Orphans'
Court Rules was served or mailed to the following beneficim-ies of the above-captioned estate on
April 8, 2002.
NAME
ROBERT S. HIPPMAN
DOROTHY D. CLARK
ADDRESS
14 Randi Road
Enola, PA 17025
7777 46t~ Avenue
Lot 27
St. Petersburg, FL 33709
Date:
CHEREWKA & RADCLIFF, LLP
DAVID H. RADCLIFF,
624 North Front Street
Wormleysburg, PA 17043
(717) 232-4701
'Capacity: Personal Representative
X Counsel for Personal Representative
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-O601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 001269
RADCLIFF DAVID H
624 NORTH FRONST STREET
WORMLEYSBURG, PA 17043
........ fold
ESTATE INFORMATION: SSN: 178-05-6434
FILE NUMBER: 2102-0266
DECEDENT NAME: STARK ELIZABETH L
DATE OF PAYMENT: 06/07/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 03/07/2002
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $17,000.00
REMARKS:
TOTAL AMOUNT PAID'
C/O ROBERT S HIPPMAN
7,000.00
SEAL
CHECK# 110
INITIALS: CW
RECEIVED BY:
MARY C. LEWIS
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 171 2840601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 00191 2
RADCLIFF DAVID H ESQUIRE
624 NORTH FRONT STREET
WORMLEYSBURG, PA 17043
........ fold
ESTATE INFORMATION: SSN: 178-05-6434
FILE NUMBER: 2102- 0266
DECEDENT NAME: STARK ELIZABETH L
DATE OF PAYMENT: 12/04/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 03/07/2002
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $1,083.57
TOTAL AMOUNT PAID:
$1,083.57
REMARKS: DAVID H RADCLIFF ESQUIRE
SEAL
CHECK//116
INITIALS: JA
RECEIVED BY'
MARY C. LEWIS
REGISTER OF WILLS
REGISTER OF WILLS
~EV-~S00 EX !6-00)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
OFFICIAL USE ONLY
FILE NUMBER
I.-
z
uJ
z
O
fl
u.I
O
0
X
E~I. Original Return
~---~ 4. Limited Estate
[~--] 6. Decedent Died Testate {Attach copy of Will)
I----I 9. Litigation Proceeds Received
-'-]2. Supplemental Return
r--i 4a. Future Interest Compromise (date of dealh alter 12-12-82)
r'--~ 7. Decedent Maintained a Living Trust (Atach copy of Trust)
---I 10. Spousal Poverty Credit (date DJ'death between 12-31-91 and 1-1-95)
NAME
David H. Radcliff, Esquire
FI.ElM I~AIVI.,E
xa~c±l[[Law Office, P.C.
TELEPHONE NUMBER
(717) 236-9318
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)
L__J Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage LiabiMies, & Liens (Schedule I) (10)
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)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(8)
8,423.15
2,172.99
(11)
(12)
(13)
(14)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of 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
t7. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20.
158,152.60
x .0_ (15)
x .0_ (16)
x .12 (17)
x .15 (18)
(19)
L'--i 3. Remainder Return (date of death prior to 12-1382)
r--i 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
~--'-I 11. Election to tax under Sec. 9113(A) (A,ach Sch O)
COMPLETE MAILING ADDRESS
20 Erford Road, Suite 300A
Lemoyne, PA 17043
154,312.80
14,435.94
OFFICIAL USE ONLY
168,748.74
10,596.14
158,152.60
0.00
158,152.60
18,978.31
1R=q7R.R1
L~
fl.
2 1 - 0 2 0 0 2 6 6
RES I D E N T D E C E D E N T cou. cooE YE^R
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
Z STARK, ELIZABETH L 178 --05 -- 6434
~ DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
(.) 03/07/2002 09/01/1918 REGISTER OF WILLS
LU (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
Decedent's Complete Address:
STREET ADDRESS
14 Randi Road
CITY Enola ISTATE PA I ZiP 17025
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
17~000.00
894.74
Total Credits (A + B + C ) (2)
Total Interest/Penalty ( D + E )
4. if Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page I 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.
(3)
(4)
(5)
(5A)
(5B)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
(1) 18,978.31
17,894.74
0.00
1,083.57
0.00
1,083.57
IF THE ANSWER
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; ............................................ [] []
c. retain a reversionary interest; or .......................................................................................................................... [] []
d. receive the promise for life of either payments, benefits or care? ...................................................................... [] []
If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. [] []
Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ..............[] []
Did decedent own an Individual Retirement Account; annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ [] []
TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjurT, 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. ~ !
SIC_~I'~UR~OF PERSON RESPQNSIBLI:I F(~R FILING RETUEN
ADDRESS '~ t
14 Randi Road, Enola, PA 17025
SIGN~SIUE,.F, OF PREPARER OSHER TI-JAN REPRESEblTA?IVE
ADDRESS 03~I~A ~
20 Erford Road~ Suite Lemoyne
PA 17043
DATE/
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 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 benefidades 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 decedent, whether by blood or adoption.
REV-15O8 EX + (1-97)
SCHEDULE E
COMMONWEALTHOFPENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
INHERITANCE TAX RETURN
RESIDENT DECEDENT PERSONAL PROPERTY
ESTATE OF ELIZABETH L. STARK
FILE NUMBER 2 1 - 0 2 - 0 2 6 6
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship
must be disclosed on Schedule F.
ITEM
NUMBER
4
DESCRIPTION
Allfirst
Cert. of Deposit
#80000002220094
Allfirst
Cert. of Deposit
#80000002220131
Allfirst
Cert. of Deposit
#80000002220195
Allfirst Bank
Checking Acct #0056772459
TOTAL (Also enter on line 5, Recapitulation)
VALUE AT DATE
Of DEATH
80,148.97
43, 102 . 10
10,025.01
21,036.72
154,312.80
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1997 form software only CPSystems, Inc. Form REV-1508 EX (Rev. 1-97)
REV-1509 EX + (1-97)
SCHEDULE F
JOINTLY-OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF ELIZABETH L. STARK FILE NUMBER 21- 02- 0266
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. Robert S. Hippman Brother
14 Randi Road
Enola, PA 17025
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
ITEM FOR JOIN'r MADE Include name of financial institution and bank DATE OF DEATH DECD'S VALUE OF
account number or similar identifying number.
NUMBER TENANT JOINT Attach deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1 A 09/03/97Allfirst Bank
Cert Deposit 87008140926140 17,015.88 50 8,507.9,
2 A 11/01/96U.S. EE Savings Bonds
(See attached listing) 11,856.00 50 5,928.0(
TOTAL (Also enter on line 6~ Recapitulation)
(If more space is needed insert additional sheets of the same size)
Copyright (c) 1997 form software only CPSystems, Inc.
$ 14,435.94
Form REV-1509 EX (Rev. 1-97)
ESTATE OF ELIZABETH L. STARK
S.S.N. 178-05-6434
Date of Death: March 7, 2002
Attachment to Schedule F - Jointly Owned Property
Item Number 2, Joint Tenant "A"
Date
Made Joint
Description of Property_
Date of Death
Asset Value
% of
Decedent's
Date of Death
Value of
Decedent's Interest
11/96 $5OO U.S.
11/96 $500 U.S.
11/96 $500 U.S.
11/96 $500 U.S.
11/96 $500 U.S.
11/96 $500 U.S.
11/96 $500 U.S.
11/96 $500 U.S.
11/96 $500 U.S.
11/96 $500 U.S.
11/96 $500 U.S.
11/96 $500 U.S.
12/96 $500 U.S.
12/96 $500 U.S.
12/96 $500 U.S.
12/96 $500 U.S.
12/96 $500 U.S.
12/96 $500 U.S.
12/96 $500 U.S.
12/96 $500 U.S.
12/96 $500 U.S.
12/96 $500 U.S.
12/96 $500 U.S.
12/96 $500 U.S.
12/96 $500 U.S.
Savings Bond D48582782EE
Savings Bond D4858278 lEE
Savings Bond D48582780EE
Savings Bond D48582779EE
Savings Bond D48582778EE
Savings Bond D48582777EE
Savings Bond D48582776EE
Savings Bond D48582775EE
Savings Bond D48582774EE
Savings Bond D48582773EE
Savings Bond D48582772EE
Savings Bond D4858277 lEE
Savings Bond D48625960EE
Savings Bond D48625959EE
Savings Bond D48625958EE
Savings Bond D48625957EE
Savings Bond D48625956EE
Savings Bond D48625955EE
Savings Bond D48625954EE
Savings Bond D48625953EE
Savings Bond D48625952EE
Savings Bond D4862595 lEE
Savings Bond D48625950EE
Savings Bond D48625949EE
Savings Bond D48625948EE
$ 312.00
$ 312.00
$ 312.00
$ 312.00
$ 312.00
$ 312.00
$ 312.00
$ 312.00
$ 312.00
$ 312.00
$ 312.00
$ 312.00
$ 312.00
$ 312.00
$ 312.00
$ 312.00
$ 312.00
$ 312.00
$ 312.00
$ 312.00
$ 312.00
$ 312.00
$ 312.00
$ 312.00
$ 312.00
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
156.00
156.00
156.00
156.00
156.00
156.00
156.00
156.00
156.00
156.00
156.00
156.00
156.00
156.00
156.00
156.00
156.00
156.00
156.00
156.00
156.00
156.00
156.00
156.00
156.00
12/96
12/96
12/96
12/96
12/96
11/96
11/96
11/96
11/96
11/96
11/96
11/96
11/96
I 1/96
11/96
11/96
11/96
11/96
11/96
I 1/96
I 1/96
11/96
11/96
I 1/96
11/96
$500 U.S.
$500 U.S.
$500 U.S.
$500 U.S.
$500 U.S.
$200 U.S.
$200 U.S.
$200 U.S.
$200 U.S.
$200 U.S.
$200 U.S.
$200 U.S.
$200 U.S.
$200 U.S.
$200 U.S.
$200 U.S.
$200 U.S.
$200 U.S.
$200 U.S.
$200 U.S.
$200 U.S.
$200 U.S.
$200 U.S.
$200 U.S.
$200 U.S.
Savings Bond D48625947EE
Savings Bond D48625946EE
Savings Bond D48625945EE
Savings Bond D48625944EE
Savings Bond D48625943EE
Savings Bond R137651786EE
Savings Bond R137651787EE
Savings Bond R137651788EE
Savings Bond R137651789EE
Savings Bond R137651790EE
Savings Bond R13765179lEE
Savings Bond R137651792EE
Savings Bond R137651793EE
Savings Bond R137651785EE
Savings Bond R137651784EE
Savings Bond R137651783EE
Savings Bond R137651782EE
Savings Bond R13765178 lEE
Savings Bond R137651780EE
Savings Bond R137651779EE
Savings Bond R137651778EE
Savings Bond R137651777EE
Savings Bond R137651776EE
Savings Bond R137651775EE
Savings Bond R137651774EE
$ 312.00
$ 312.00
$ 312.00
$ 312.00
$ 312.00
$ 124.80
$ 124.80
$ 124.80
$ 124.80
$ 124.80
$ 124.80
$ 124.80
$ 124.80
$ 124.80
$ 124.80
$ 124.80
$ 124.80
$ 124.80
$ 124.80
$ 124.80
$ 124.80
$ 124.80
$ 124.80
$ 124.80
$ 124.80
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
$ 156.00
$ 156.00
$ 156.00
$ 156.00
$ 156.00
$ 62.4O
$ 62.40
$ 62.40
$ 62.40
$ 62.40
$ 62.40
$ 62.40
$ 62.40
$ 62.40
$ 62.40
$ 62.40
$ 62.40
$ 62.40
$ 62.40
$ 62.40
$ 62.40
$ 62.40
$ 62.40
$ 62.40
$. 62.40
Totals $11856.00 $5,928.00
REV-1511 EX+(1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF ELIZABETH L. STARK
FILE NUMBER
21-02-0266
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION
5.
6.
7.
10.
FUNERAL EXPENSES:
Stephen Chowka
Stephen Chowka
Grave Marker
FuneTal Home
Funeral Home
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) / EIN Number of Personal Representative(s)
Street Address
City. State
Year(s) Commission Paid:
Attorney Fees
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State __ Zip
Relationship of Claimant to Deceder~t
Probate Fees
Accountant's Fees
Tax Return Preparer's Fees
Register of Wills
Filing fees Inventory and PA
Inheritance Tax Return
Register of Wills
Additinal short certificate
Cumberland County
Legal advertising
The Sentinel
Legal Advertising
Law Journal
Total miscellaneous expenses from continuation page(s)
Copyright (c) 1997 form software only CPSystems, Inc.
AMOUNT
5,505.00
455.00
0.00
2,000.00
N/A
255.00
0.00
0.00
25.00
6.00
75.00
87.35
TOTAL (Also enter on line 9, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
Form REV-1511 EX (Rev. 1-97)
14.80
$ 8,423.15
ESTATE OF: ELIZABETH L. STARK
ITEM
NO
11.
DESCRIPTION
PA State Bank
Check Charge
SCHEDULE H
MISCELLANEOUS EXPENSES
continued)
FILE NUMBER: 21-02-0266
~O~T
14.80
Total. (Carry forward to main schedule)
$ 14.80
REV-1512 EX+ (1-97)
SCHEDULE I
COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT,
INHERITANCE TAX RETURN
RESIDENT DECEDENT MORTGAGE LIABILITIES, AND LIENS
ESTATE OF ELIZABETH L. STARK
FILE NUMBER 21 - 0 2 - 0 2 6 6
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION AMOUNT
1
2
3
4
5
6
7
Holy Spirit Hospital
HCR - Manor Care
Conner-Rich
Internists Central PA
Quantum Imaging
Camp Hill Fire Co (ambulance)
PA Department Revenue
Balance 2001 personal income
tax
TOTAL (Also enter on line 10, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1997 form software only CPSystems, Inc.
835.68
964.00
77.83
106.50
88.55
35.70
64.73
2,172 . 99
Form REV-1512 EX (Rev. 1-97)
REV-1513 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF ELIZABETH L. STARK
FILE NUMBER
21-02-0266
NUMBER
I1.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (include out~ight spousal disa'ibutions)
Robert S. Hippman
14 Randi Road
Enola, PA 17025
Dorothy D. Clark
7777 46th Avenue
Lot 27
St. Petersburg, FL 33709
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Brother
Sister
AMOUNT OR SHARE
OF ESTATE
$86,294.27
$71,858.33
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN, 15 THRU 17~ AS APPROPRIATE~ ON REV 1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A, SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B, CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
None
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
0.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) lgg7 form software only CPSystems, Inc. Form REV-1513 EX (Rev. 1-97)
I, ELIZABETH L. STARK, of the City of Shamokin, County of
Northumberland and Commonwealth of Pennsylvania, declare this to be my Last Will
and revoke any wills previously made by me.
iTEM
I direct that all my just debts and funeral expenses and all expenses of my last
illness, shall be paid fxom my residuary estate as soon as practicable after my decease as
a part of the expense of the administration of my estate.
I give, devise, and bequeath one-half (1/2) of my estate Whatsoever the same may
be and wheresoever the same may be unto my brother, ROBERT S. HIPPMAN, of
Enola, Pennsylvania and one-half (1/2) to my sister, DOROTHY D. CLARK, of Stowe,
Pennsylvania, providing they shalt surviVe:me by thirty (30) days.
Eli~eth L. Stark
on or before thirty (30) days, I give, devise, and bequeath their share unto my nephews,
ROBERT E. HIPPMAN, of New Buffalo, Pennsylvania and BRIAN P. HIPPMAN, of
York, Pennsylvania, or the survivor of them, in equal shares.
ITEM IV
I appoint my brother, ROBERT S. I:[IPPMAN, as Exe%tor of this, my Last
Will. In the event my brother, ROBERT S. HIPPMAN, can not perform the duties of
EXeeutor, I then appoint my sister, DOROTHY D. CLARK, as Alternate 'Executrix, o£
this my Last Will.
ITEM VI
I direct that my personal representative or guardian shall not be required to give
bond for the faithful performance of his or her duties in this or any tother jurisdiction.
IN WITNESS WllEREOF, I have hereunto set my hand this 6th day of
September, 1996.
Eliza~'eth L. Stark
2
The preceding instrument consisting of this and two (2) other typewritten pages
identified by the signature of the Testatrix, ELIZABETH L. STARK, was on the date
thereof signed, published and declared by ELIZABETH L. STARK, the Testatrix
therein 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
"-' -~Edward ~'D{Jnne~ ~ ~" ~ T~g~tsl~i 0 ~"
ACKNOWLEDGMENT AND AFFIDAVIT
I, ELIZABETH L. STARK, the Testatrix, sign my name to this instrument this
6th day of September, 1996, and being first duly sworn, do hereby declare to the
undersigned authority that I sign and execute this instrument as my Last Will, that I sign
it willingly, that I execute it as my f~ee and voluntary act for the purposes thereto
expressed, and that I am eighteen years of age or older, of sound mind, and under no
constra/nt or undue influence.
3
We, Ann Targonsld and Edward O'Donnell, the wimesses, sign our names to this
instrument, being first duly sworn, and do hereby declare to the undersigned authority
that the Testatrix signs and executes this instrument as her Last Will and that she signs it
willingly, and that each of us, in the presence or hearing of the Testatrix, hereby signs
this Will as wimess to the Testatrix signing and that to the best of our knowledge the
Testatrix is eighteen years or older, of sound mind, and under no constraint or undue
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF NORTHUMBERLAND ·
·
--~ ,E~dwarfftO,iSohn'~ell -.
SS:
Subscribed, sworn t° and acknowledged before me by ELIZABETH L. STARK,
the Testatrix, and subscribed and sworn before me by ANN TARGONSKI, and
EDWARD O'DONNELL, wimesses, this 6th day of September, 1996.
MY COMMISSION EXPIRES:
NOTARIAL SEAL
?RACEY M. WITMER, NOTARY PUBLIC
S~,,~MOKIN, NORTHUMBERLAND COUNT
-
BUREAU OF ZNDZVTDUAL TAXES
TNHERTTANCE TAX DTyTSTON
DEPT. Z80601
HARRISBURG, PA '1712:8-0601
CONNONHEALTH OF PENNSYLVANIA
DEPARTNENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAZSEHENT, ALLO#ANCE OR DZSALLO#ANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
REV-15¢7 EX AFP (01-05)
DAVID H RADCLIFF ESQ
RADCLZFF LAN OFFICE
ZO ERFORD RD STE $OOA
LEHOYNE PA ZTQ~
DATE 01-28-2005
ESTATE OF STARK
DATE OF DEATH 05-07-2001
FILE NUHBER 21 02-0266
COUNTY CUMBERLAND
ACN 101
Amount Remitted
HAKE CHECK PAYABLE AND RENZT PAYHENT TO.'
REGISTER OF gILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 1701:5
ELIZABETH L
CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~
DZSALLONANCE OF DEDUCTIONS AND ASSESSNENT OF TAX
ESTATE OF STARK ELIZABETH L FILE NO. 21 02-0266 ACN 101 DATE 01-28-2003
TAX RETURN HAS: (X) ACCEPTED AS FZLED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Hsld Stock/Partnership Interest (Schedule C}
4. Hortgages/Notas Receivable (Schedule D)
5. Cash/Bank Daposits/Nisc. Personal Property (Schedule E) (5)
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
APPROVED DEDUCTZONS AND EXEHPTIONS:
9. Funeral Expenses/Adm. Costs/Hisc. Expanses (Schedule H) (9)
10. Debts/Hortgago Liabil/ties/Liens (Schedule Z) (10)
11. Total Deduct/ons
12. Net Value of Tax Return
15~z312.80
1~z~35.9~
O0
O0 NOTE: To insure proper
O0 credit to your account,
O0 sub./t the upper port/on
O0 of this form with your
tax payment.
(8)
8,~23.15
Z.172.99
(12)
168,7~8.7~
10.596.16
158,152.60
Char/table/governmental Bequests; Non-slectod 911:5 Trusts (Schedule J) (13)
Nat Value of Estate Sub~sct to Tax (14)
:]:f an assessment ~as issued previously, lines 1~, 15 and/or 16, 17,
re~lect ~igures that include the total o~ ALL returns assessed to date.
ASSESSNENT OF TAX:
15. Amount of L/ne 14 at Spousal rata (15) . O0 X O0 =
16. Amount of L/ne 14 taxable at Lineal/Class A rate (16) . O0 X 0~5 =
17. Amount of L/ne 14 at S/bLing rate (17) 158,152.60 x 12 =
18. Amount of L/ne 14 ~:axeble at Collateral/Class B rata (18) . O0 X 15 =
19. Pr/nc/pal Tax Due (19)=
TAX CREDZTS:
PAYNENT RECEIPT DISCOUNT (+)
DATE NUHBER INTEREST/PEN PA/D (-)
06-07-2002 CD001269 89~.7~
12-0~-2002 CD001912 .00
13.
14.
NOTE:
ZF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
ANOUNT PAZD
17,000.00
1,083.57
.00
158,152.60
18 and 19 ~111
.00
.00
18,978.31
.00
18,978.31
TOTAL TAX CREDIT I
I
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
18,978.31
.00
.00
.00
( ZF TOTAL DUE IS LESS THAN $1, NO PAYNENT ZS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORN FOR ZNSTRUCTZONS.)
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: ELIZABETH L. STARK
Date of Death: March 7, 2002
Will No.: 2002-00266
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:
State whether administration of the estate is complete:
Yes x No
If the answer is No, state when the personal representative reasonably believes
that the administration will be complete:
(MAH:rmt/AM3)
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 X
The separate Orphans' Court No. (if any) for the personal representative's account
is:
Did the personal representative state an account informally to the parties in
interest? Yes X No
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.
Day-id H. Radcl±ff, Esq.
Name (Please type or print)
20 Erford Road, Suite 300A
Lemoyne, PA 17043
Address
(717) 236-9318
Telephone No.
Capacity:
Personal Representative
X
Counsel for Personal Representative
R.W. - 27