HomeMy WebLinkAbout02-0274 PETITION
also known as
FOR PROBATE and GRANT OF LETTERS
, Deceased.
Social Security No..2 / / - 2 ~z-6 ~'co g,
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execu!
in the last will of the above decedent, dated 0 - ~' - ~ :2_
and codicil(s) dated
To:
Register of Wills for the
County of C',o.o~$c~t]-,.~ d
Commonwealth of Pennsylvania
in the
named
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in C,,, o ,.~ $ ~'n/'4 ,t, d County, Pennsylvania, with
high. last. family or principal resid.eonce at /~o ~;rff //~a~
(list s/reel, number and muncipality)
Decendent, then ~ ~ v~rs of age, died O ~ '~- ~ od ~ , ~ ~ ,
Except as follows, dec~dem~id ndt marry, was not divorced and did not have a child born or adopte~
after execution of the will offered for probate; was no= the victim of a killing and was never adjudicated
incompetent: ~ ~
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property $ ~.';~. ~.,~, ~/
(If not domiciled in Pa.) Personal property in Pennsylvania $
(If not domiciled in Pa.) Personal property in County $
Value of real estate in Pennsylvania
situated as follows:
!
WHEREFORE, petitioner(s) respectfully
presented herewith and the grant of letters
theron.
$ 3 o ooo
request(s) the probate of the last will and codicil(s)
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
/~'-= 5 7
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF P]ENNSYLVANIA ~
COUNTY OF ~o.~/o~:,e/~,,,,c/ 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 tim above decedent petitioner(s) will well and truly administer the estate according to law.
Sworn to OfF affirmed, and subscribed ,.-
befor_e me this I~/ll~t.h __ day of ~
, MARCH ._200.2. ~,, J
Estate Of STE!,TA J KIRBY , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW MARCH 18, 2002 XllSJXXX .... 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 ~RCH ~.5, 1982
S'i'~;L~T_A J KIRBY
described therein be admitted to probate and filed of record as the last will of
and Letters TESTb3~2qTARY
B/~I, Lr ~3EE KIRBY
are hereby granted to
FEES
25.O0
Probate, Letters, Etc .......... $
Short Certificates( ) .......... $ 6.00
Renunciation ..... ffti~ '13~6j~s $ 5.00 .
$ 3 °.8o
44.00
TOTAL __ $
Filed MARCH 14, 2002 .........
"'n~ '~b' '~c33' ~n 3-18-02
ATTORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
I, STELLA ~. KIRBY, a resident of the Township of Southampton,
County of Cumberland and Commonwealth of Pennsylvania, being of
sound mind and memory, do make, publish and declare this to be my
Last Will and Testament, hereby revoking any and all Wills by me
heretofore made._
FIRST: I hereby direct my Executors, hereinafter named, to
pay all my just debts and funeral expenses as may conveniently be done
after my decease.
SECOND: I give, devise and bequeath my entire estate, be it
real, personal or mixed, to my children, share and share alike, per stirpes.
I direct that my entire estate be converted into cash.
THIRD: I hereby nominate, constitute and appoint my son,
BASIL LEE KIRBY and/or my daughter, BETTY DELLINGER, to be the
Executors of 'this my Last Will and Testament, with full power of sale,
and I request that they shall be permitted to serve without bond or other
security and without the intervention of any court or courts, probate or
otherwise, except as required by law.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to
this my Last Will and Testament, to which I have affixed my signature,
this ~ day of March, 1982.
(SEAL)
Signed, sealed, published and declared by STELLA J. KIRBY, the above
named Testatrix, for and as her Last Will and Testament, in the presence
of us, who at her request, in her presence, and in the presence of each
other, all being present at the same time, have hereunto subscribed our
names as witnesses:
NAME
ADDRESS
COMMONWEALTH OF PENNSYLVANIA )
( SS:
COUNTY OF FRANKLIN )
I, STELLA J. KIRBY, Testatrix, whose name is signed to the foregoing
instrument, having been duly qualified according to law, do hereby
acknowledge that I signed and executed the 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 expressed.
Sworn to and acknowledged before me, by STELLA J. KIRBY, the
Testatrix, this O~ day of March, 1982.
CAROL M. HALL, NOTARY
CHAMBERSBURG BORO, FRANKLIN
MY COMMISSION EXPIRES DEC. 6, ~*~":;.
IdlmOer, Pennsylvania Association of
COMMONWEALTH OF PENNSYLVANIA )
( SS:
COUNTY OF FRANKLIN )
the witnesses whose names are signed to the foregoing instrument, being
duly qualified according to law, do depose and say that we were present
and saw testatrix sign and execute this will as her Last Will; that Stella
Kirby 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; and that 'to the best of
our knowledge the testatrix was at the 'time 18 or more years of age, of
sound mind and under no constraint or undue influence.
Sworn 'to and subscribed to before me by ~ ~,~/6y ~./~/./
/~/t//~/£ r H~/,l_~',~./~_~./'r//f' R~¥ /~/ZL.L//}J~/¢ witnesses, this
day of March, 1982. / '
//-\ ,,
CAROL M. HALL, NOI'ARY PUBLIC,,
CHAMBERSBURG BORO, FRANKLIN COUNTY
MY COMMISSION EXPIRES DEC. 6,
Member, Pm~mylf~ail Association of
RENUNCIATION
In Re Estate of
To the Register of Wills of
deceased.
County, Pennsylvania.
The undersigned
of
the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters
be issued to ~CiX a~ ~~/
WITNESS . , d this /~/ day of
(Signature) ~
(Signature)
(Address)
(Signature)
(Address)
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: ~ ,7~'L ~ ,~] ~/q ~,,V 7
Date of Death: r-~ - .2 ~-'-- ol ~3~ ~
Will No. /2/- U.TL -- ~fi" Admin. No.
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on ·
Name Address
~,zlly 15,~V da. l~19 Z,'ed~y
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
Signature '-f~~ ~e.
Name ~/4/5'~ ~ ~&
Address ~/ ~ ~ /~.~
Telephone ~/~ ~ X - d ~fl~
Capacity: ~ Personal Representative
Counsel for personal representative
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 001 668
KIRBY BASIL LEE
121 FISH HATCHERY RD
SHIPPENSBURG, PA 17257
........ fold
ESTATE INFORMATION: SSN: 211-22-6506
FILE NUMBER: 2102-0274
DECEDENT NAME: KIRBY STELLA J
DATE OF PAYMENT: 09/30/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 02/25/2002
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $6,296.19
TOTAL AMOUNT PAID:
$6,296.19
REMARKS: BASIL LEE KIRBY
SEAL
CHECK# 1004
INITIALS: SK
RECEIVED BY:
MARY C. LEWIS
REGISTER OF WILLS
REGISTER OF WILLS
REV-1500 EX (6-00) ~'~,~ ~ ~
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
.~o-o.~ 062
COUNTY CODE YEAR NUMBER
Z
ILl
U.I
Ltl
I-
Z
LU
Z
0
ILl
0
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
DATE OF DEAT~(MM-DD-YEAR)
J DATE OF BIRTH (MM-DD-YEAR)
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
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 Will)
~--~9. Litigation Proceeds Received
E~]2. Supplemental Return
~---~ 43. Future Interest Compromise (date of death after 12-12-82)
~'~7. Decedent Maintained a Living Trust (Attach copy orTrust)
J~10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
FIRM NAME (IfApplicable~..,-', /
TELEPHONE NUM,~ER \
COMPLETE MAILING ADDRESS
~]3. Remainder Return (date of death pdor tc 12-13-82)
['--~ 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
[~] 11. Election to tax under Sec. 9113(A) (Attach Sch O)
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 Properly (5)
(Schedule E)
8. Jointly Owned Property (Schedule F) (6)
~] 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 Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line tl)
13.
14.
OFFICIAL USE ONLY
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line 13)
(11)
(12) d)'~,~, ,~'~ 00,, 3 ')-'''
(13)
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) x .0 __ (15)
16. Amount of Line 14 taxable at lineal rate x .0 __ (16)
17. Amount of Line 14 taxable at sibling rate ,..~.~ ~,~C~, 3 ~ x .12 (17)
18. Amount of Line 14 taxable at collateral rate x .15 (18)
19, Tax Due (19)
Decedent's Complete Address:
STREET ADDRESS
STATE I ZIP
CITY
I
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A, Spousal Poverty Credit
B. Pdor Payments
C. Discount
Total Credits (A + B + C )
3. Interest/Penalty if applicable
D. Interest
E. Penalty
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 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. (5)
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (SB)
Make Check Payable to: REGISTER OF WILLS, AGENT
(2)
(4) ~
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? ...................................................................... []
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 security 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.
DATE
SIGNATURE OF PERSQN RESPONSIBLE FOE. FILING RETURN
SIGNATURE OF PREPARER OTHER THAN t~EPRESENTATIVE DATE
ADDRESS
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 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 decedent, whether by blood or adoption.
R~-I~2EX + (1-97) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEBULE A
REAL ESTATE
ESTATE OF FILE NUMBER
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged
between a willing 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 of
survivorship must be disclosed on Schedule F.
ITEM
NUMBER
TOTAL (Also enter on line 1, Recapitulation)
DESCRIPTION
VALUE AT DATE
OF DEATH
(If more space is needed, insert additional sheets of the same size) /
REV-1512*EX * (1-97) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT [~ECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF / /
FILE NUMBER
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION AMOUNT
1.
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
RE,V-1507 EX+ (1-97) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE D
MORTGAGES & NOTES
RECEIVABLE
ESTATE OF
FILE NUMBER
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
TOTAL (Also enter on line 4, Recapitulation
VALUE AT DATE
OF DEATH
(If more space is needed, insed additional sheets of the same size)
REV-15~8 ~ + (I-97) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF /~/~;~ ~y
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
Include the proceeds of litigation and the date the proceeds were received by the estate. All prope~'y jointly-o~med with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
TOTAL (Also enter on line 5, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
VALUE AT DATE
OF DEATH
REV-1509 EX + (1-97) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF FILE NUMBER
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,
JOINTLY-OWNED PROPERTY:
Lb ~ I ~-K DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT deed for jointly-held real estate, VALUE OF ASSET INTEREST DECEDENTS INTERES'
TOTAL (Also enter on line 6, Recapitulation)$
(If more space is needed, insert additional sheets of the same size)
REV-1510 EX* (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
FILE NUMBER
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes,
DESCRIPTION OF PROPERTY % OF
ITEM INCLUDETHE NAME OFTHE TRANSFEREE, THEIRRELATIONSHIPTODECEDENTANDTHE DATE OF TRANSFER DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
ATTACH A COPY OF THE DEED FOR REAL ESTATE,
NUMBER VALUE OF ASSET INTEREST IIFAPPLICABLE)
1.
TOTAL (Also enter on line 7, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
EV-1511 EX+ (12-99)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
~ ¢,~.z - ~o~ 74/
/
ITEM
NUMBER
5.
6.
7.
Debts of decedent must be reported on Schedule I.
DESCRIPTION
FUNERAL EXPENSES:
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s) ,~,,~ 5' I L L- k" i ,,'(2/0 y
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address /~/ /C",'.5',,~ /-g//,,,~-i~c...4/,r/:,,v ~
City ~'~, ??Z::/J,5'~ 4/~,)" State ~ Zip
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 Decedent
Probate Fees
Accountant's Fees
Tax Return Preparer's Fees
TOTAL (Also enter on line 9, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
AMOUNT
REV-1513 EX + 0-97) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
E TATEOF /rSy5
SCHEDULE J
BENEFICIARIES
FILE NUMBER
NUMBER
II.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (include outright spousal distributions)
RELATIONSHIP TO DECEDENT
DO Not List Trustee(s)
fi'o/,/
AMOUNT OR SHARE
OF ESTATE
v
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
J$
TOTAL OF PART II- 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)
BUREAU OF INDIVIDUAL TAXES
TNHERTTANCE TAX DTVTSZON
DEPT. 280601
HARRISBURG, PA 17118-0601
BASIL LEE KIRBY
111 FISH HATCHERY RD
SHIPPENSBURG PA 17157
CONNONNEALTH OF PENNSYLVANIA
DEPARTNENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISENENT, ALLOHANCE OR DZSALLOHANCE
OF DEDUCTIONS AND ASSESSNENT OF TAX
RE¥-1547 EX AFP (OI-OZ)
DATE 11-11-2002
ESTATE OF KIRBY
DATE OF DEATH 02-25-2002
FILE NUNBER 21 02-027~
--CoONT¥:~ii CUHBERLAND
ACN 101
Aaoun~ Ramified
STELLA J
HAKE CHECK PAYABLE AND RENZT PAYHENT TO:
REGISTER OF HILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~
REV-1547 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAZSENENT, ALLONANCE OR
DZSALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF KIRBY STELLA J FILE NO. 21 02-027~ ACN 101 DATE 11-11-2002
TAX RETURN HAS: ( ) ACCEPTED AS F/LED (X) CHANGED SEE ATTACHED NOTICE
RESERVATZON CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON.' ORIGINAL RETURN
I Real Es~a~e (Schedule A)
S*ocks and Bonds (Schedule B)
3 Closely Held Stock/Partnership lnterast (Schedule C)
Nor~gages/No~es Receivable (Schedule D)
5 Cash/Bank Deposits/Hisc. Personal Propar~y (Schedule E)
6 Jointly Owned Proper~y (Schedule F)
7. Transfers (Schedule G)
8. To~el Asse~s
APPROVED DEDUCTIONS AND EXENPTZONS:
9. Funeral Expenses/Adm. Cos~s/Nisc. Expanses (Schedule H)
10. Dab~s/Nor~gaga L~abili~ias/Liens (Schedule T)
11. To,al Deductions
12. Na~ Value of Tax Re~urn
15.
14.
(1) 55z569.5~
(2) .00
(3) .00
(4) .00
(5) 7z726.28
(6) .00
(?) .00
(8)
7,885.50
(9)
(10) . O0
Chari~abXe/Governmen~al Bequests; Non-eXacted 9115 Trusts (Schedule J)
Ne~ Value of Es~a~e Subject to Tax
(11)
(12)
(15)
(14)
NOTE:
If an assessment Nas issued previously, lines 14, 15 and/or 16, 17,
reflect figures that include the total of ALL returns assessed to date.
NOTE: To insure proper
credit to your account,
subeit the upper portion
of this fora with your
tax payment.
65,295.82
7.88t.50
55,~12.$2
.00
55,~12.$2
18 and 19 ~ill
ASSESSNENT OF TAX:
1E. Amoun~ of Lind 14 at Spousal rate
16. Amount of Lind 14 taxable at Lineal/Class A rata
17. Amoun~ of Lind 14 at Sibling ra~a
18. Amount of Lind 14 ~axabla a~ CoXlataral/Class B rata
19. Principal Tax Due
TAX CREDTTS:
PAYHENT RECEXPT DISCOUNT
DATE NUHBER iNTEREST/PEN pArD (-)
09-$0-2002 CD001668 .00
ZF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDIT/ONAL INTEREST.
6,296.19
$,80Z.6qCR
.00
$,802.6~CR
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
[F TOTAL DUE ZS REFLECTED AS A "CRED/T" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF TH/S FORN FOR /NSTRUCT/ONS.)
TOTAL TAX CREDIT
BALANCE OF TAX DUEI
ZNTEREST AND PEN.
TOTAL DUE
6,296.19
AHOUNT pArD
(i$) .00 x O0 = .00
(16). 55,~12.$2 x 0~5= 2,~93.55
(17), .00 x 12 = .00
(18) .00 x 15 = .00
(19)= 2,q95.55
REV-1470 EX (6-88)
COMMONVVEALTH OF PENNSYLVANIA EXPLANATION
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENTS NAME FILE NUMBER
Stella J. Kirby 2102-0274
REVIEWED BY ACN
John Kuchinski 101
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
E The total for this schedule has been recalculated and carried forward to the
recapitulation page.
H B3 The claim for the family exemption has been disallowed. The claimant must be a spouse
or if no spouse, a parent or child living in the same household as the decedent as of the
date of death.
J 1-7 Children of the decedent are lineal heirs, thus the tax rate has been change from 12% to
the lineal tax rate of 4.$%.
ROW Page 1
BUREAU OF INDIVIDUAL TAXES
]*NHER'rTANCE TAX D'I'VTS*rON
DEPT. 280601
HARRTSBURG, PA 17128-0601
COHHONNEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
INHERITANCE TAX
STATEHENT OF ACCOUNT
RE¥-1607 EX &FP (01-02)
BASIL LEE KIRBY
121 FISH HATCHERY RD
SHIPPENSBURG PA 17257
DATE 12-09-2002
ESTATE OF KIRBY
DATE OF DEATH 02-25-2002
FILE NUHDER 21 02-0274
COUNTY CUHBERLAND
ACN 101
Amount
STELLA
HAKE CHECK PAYABLE AND REHZT PAYNENT TO:
REGISTER OF HILLS
CUNBERLAND CO COURT HOUSE
CARLISLE, PA 17015
NOTE: To insurm proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG TH'rS L'rNE ~ RETAIN LONER PORT'rON FOR YOUR RECORDS *-~
REV-1607 EX AFP (01-02) ~# INHERITANCE TAX STATENENT OF ACCOUNT ~
ESTATE OF KIRBY STELLA J FILE NO. 21 02-0274 ACN 101 DATE 12-09-2002
THIS STATENENT 'rS PROVIUEU TO ADV'rSE OF THE CURRENT STATUS OF THE STATED ACH 'tN THE NANED ESTATE. SHOWN BELOW
.rS A SUNNARY OF THE PR'rNCZPAL TAX DUE, APPL.rCAT.rON OF ALL PAYNENTS, THE CURRENT BALANCE, AND, 'rF APPLICABLE,
A PROJECTED 'rNTEREST FIGURE.
DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT: 11-11-2002
PRINCIPAL TAX DUE: ...........................................................................................................................................................................................................................
PAYHENTS (TAX CREDITS):
2,495.55
PAYHENT RECEIPT DISCOUNT (+)
DATE NUHBER INTEREST/PEN PAID (-) AHOUNT PAID
09-50-2002
11-18-2002
CD001668
REFUND
.00
.00
6,296.19
5,802.64-
ZF PAID AFTER TN.rS DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( ZF TOTAL DUE ZS LESS THAN $1,
NO PAYNENT ZS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR),
TOTAL TAX CREDIT 2,495.55
BALANCE OF TAX DUE .00
XNTEREST AND PEN. .00
TOTAL DUE .00
YOU HAY BE DUE A REFUND. SEE REVERSE S'rDE OF TH'rS FORN FOR 'rNSTRUCTXONS. )
STATUS R ~.PORT UNDER RULE 6.12
Name of Decedent:
Date of Death:
Will 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 ['-I
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:
ao
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 [-'l No [-'1
Date:
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
Manic
Address
[] Personal Representative
]--] Counsel for personal representative