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HomeMy WebLinkAbout04-1049 PETITION FOR PROBATE and GRANT OF LETTERS also known as To: Register of Wills for the Deceased. County of C~be-~-[~nd~ in the Social Security No. ~o~ - 3 2_-0q0~ CommonwealthofPennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut O~ named in the last will of the above decedent, dated ~ a~t4~/- ~ , ~, z_oe ~ and codicil(s) dated Decendent was domiciled at death in ~)~ ,,/i 5 County, ~, with h ~r" last family or principal residence at ~t/~ ~o~fft~ ~:~o ~sr ~, ~ (list street, number and muncipality) Decend~nt, the~ 61 years of age, died g~be~ ] 7i , ~ 2a0~ ExcePt as follows, decedent did not mariy,~as no/ t ~vor~ed 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 person~ prope~y $ ~ ,0 ~ (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Person~ property in County $ V~ue of real estate in Pennsylv~ia $ ~, ~, ~ WHEREFO~, petitioner(s) res~ctfully request(s) the probate of the last will ~d codicil(s) presented herewith ~d the grant of l~ters, theron. (testamentary; administration c.t.a,; administration d.b.n.c.t.a.) OATH OF PERSONAL REPRESENTATIVE ' CO ONWEALTH OF PENNSYLVANIA 3 COUNTY OF 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 ~ personal represen- Sworn to or affirmed and subscribed ~ ~~~ ~ before me this ']~k' day of / ~ / /~ ~' Estate 0f'--~,o-v,.e._ X-X'M~.,. k"NrXa~ ]'TIo-qub';, Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW ~tSX/ , ~."~ 2(5~ ~ , in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT tS DECREED that thc instrument(s) dated described therein be admitted to probate and filed of record as the last will of ~d Letters ~', are hereby granted to Register of ~ill~ ~, ~-~ ~ Probate, Letters, Etc .......... $(-~)' ~ ~2-p~/,~,,/~ e ~ ~3 ?0 ~ Shon Cenificates(~) .......... $ q .~ A~ORNaY (Sap. Ct. L2. No.) FU~d /~- ~2 :. ~.~ ............... ~ ff~o~ BEAN & SMEDLEY I NOV - § 200 David E. Bean (0253) L SECOND Attorney for Petitioner DISTHICT COUHT 190 South Fort Lane, #2 La,on, Utah 84041 Telephone: (801) 544-4221 Fax: (801) 547-1316 1N THE SECOND JUDICIAL DISTRICT COURT OF DAVIS COUNTY STATE OF UTAH Ln the Matter of the LETTERS TESTAMENTARY Estate of DIANE MARIE MATHIAS MUTH, Deceased. Probate No. 0 q~ 7 019~-3¢q MORGAN T. MUTH was duly appointed and qualified as general Personal representative of the estate of the above named decedent on the I.~ day of~, 2004, by the Court, with all authority pertaining thereto. Administration of the estate is unsupervised. These Letters are issued to evidence the appointment, qualification, and authority of the said personal representative. WITNESS, my signature and the Seal of this Court, this S~X _ day of AL¥SON E. BROWN STATE 0F UZ?.q Clerk or Registrar of the Court COUNW O~ OA'¢,S } I H~TSY CERTIP¢ TH;4 TH!S S A TRUE COPY OF THE~ ~,~, OF (~~ ...... S I A I E OF UTAH - DEPARTMEN f OF HEALTH ................. CERTIFICATE OF DEATH ....... to¢~ ~LE"UM"E" 29-- 1127--04 Diane Marie Mathias MUTH I FemalelSeptember 17,2004I 1200 August 23, 1943 61 / E"~'/"°'/ ...... ~ Harrisburg, PA , 206-32-0903 ~ ~E~.,~, []3~ ~.~. ~ Ogden Regional Hospital Ogden ~ Weber ~ None ' ~., X~"* ~.~ ~ Elementary Teacher Education 545 s. 85o E. _ ....... m Laytonm Davis ) Utah ~ ~ .o,; 84041 )~ ~ ~ ,~(s~) White ) -16- ~ , ~ Lester Benjamin Mathias Jr. i Frances Margaret Jane Beck ~ Morgan Thomas Muth/son/ Box 65 Carlisle, PA 17013 ~ ~=~ X!.~. ,]],c~],~.,iSep. 24. 2004 mGardens Cemetery Harrisburg, PA ~,2~ E~, ~""~m~'"~'--~'~"'o"~L ~" 1867 NO. Fairfield Rd. Layton, Utah 84041 Sep 17.~ 2004 _ _lM~ .. ~0 o~v Adhish Aga~all M.D., 425 E, 5350 So. ~3200gden, Utah 84405 ~ SIP ~0~ ~004 I This is to certify that this is a true copy of the certificate on file in this office. This certified copy is issued under a~hority of ~tion 26-2-22 of the Utah Code Annotated, 1953 As Amended. SEP 2 0 2~4 ~ Barry ~. DIRECTOR OF vITAL RECORDS Registrar mi Imm Il Imm mi mi il Il 11 *01120609* LAST WILL AND TESTAMENT DIANE M. MATHIAS-MUTH I, Diane M. Mathias-Muth, of Cumberland County, Pennsylvanial being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking all other wills and codicils heretofore made by me. FIRST I direct the payment of my debts and the expenses of my last illness and funeral from my estate as soon after my death as conveniently may be done. SECOND I may identify in a subsequent writing the disposition of certain items of personal property and it is my direction to my Executors to follow those instructions. If my son Morgan does not wish to keep a family heirloom of mine, I direct that he offer it for sale to members of my family at the fair market value, or less as he solely may determine. THIRD All the rest, residue and remainder of my estate, real, personal or mixed wherever situate, I give, devise and bequeath to my son, Morgan Thomas Muth, per stirpes. Should my son predecease me and leave no surviving issue, I give my entire estate to my nieces and nephews living at the time of my death. FOURTH I nominate, constitute and appoint Morgan Thomas Muth as Executor of this my Last Will and Testament. In the event Morgan Thomas Muth is unable to serve as my executor, I appoint my sister, Clare Elizabeth Mathias as my alternate Executrix. I relieve my personal representative from the necessity of posting security in connection with his duties as such in any jurisdiction in which he may be called upon to act insofar as I am able by law to do so. FIFTH In addition to the powers conferred by law, I authorize my Executor in his/her absolute discretion: A. To retain in the form received, and to sell either at public or private sale any real or personal property. B. To manage real estate. C. To invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification. D. To exercise any option or rights arising from ownership of investments. E. To compromise claims without court approval, and without the consent of any beneficiary. SIXTH This Will shall be interpreted pursuant to the laws of the Commonwealth of Pennsylvania where it was prepared and executed. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, consisting of two (2) typewritten pages, the first page which bears my signature in the margin for the purpose of identification, this the (?day of/~, 2003. Diane M. Mathias-Muth Signed, sealed, published and declared by the above named testatrix Diane M. Mathias-Muth, as and for her Last Will and Testament, in the presence of us, who, at her request, in her sight and presence, and in the sight and presence of each other, have hereunto subscribed our names as witnesses. "~'~~ ADDRESS ~r~, ~"'~'~' COMMONVVEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND We, Diane M. aathias~Uuth, ~l.i~t~ff..IO~E-~'u~{~-~a~l- 'l'~';t~¢~, 6. the testatrix and the witnesses, respectively, whose names are signed to the a~ached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument of her Last Will, and that she signed willingly and that she executed as her free and volunta~ act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the ~11 as witnesses, and that to the best of their knowledge, the testatrix was at the time eighteen (18) years of age or older, of sOund mind and under no constraint or undue influence. Sworn to and subscribed before me this ~ day of~ , 2003. ~ ~ KEITH VAN ME~EREN State of Uta~ CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Diane Marie Mathias Muth, deceased Date of Death: September 17, 2004 Admin. No.: 2004-01049 PA No. 21-04-1049 To the Register: i certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed the following beneficiaries of the above-captioned estate: Name Address Date Morgan Thomas Muth 1506 Terrace Avenue 11/18/04 Carlisle, PA 17013 Notice has now been given to all persons entitled thereto under Signature Name Gregory R. Reed Address 3120 Parkview Lane Harrisburg, PA 17112 Telephone (717) 238-0434 ~ X Counsel for personal ~ representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE REV-1162 EX(11 96) BUREAU OF ~NDIVIDUA~. TAXES DEFT 280601 HARRISBURG, PA 17128 0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 004725 MUTH MORGAN THOMAS BOX 65 1506 TERRACE AVE CARLISLE, PA 17013 ACN ASSESSMENT AMOUNT CONTROL NUMBER .... fold 101 $1,713.17 I ESTATE INFORMATION: SSN: 206-320903 FILE NUMBER: 2104- 1 049 DECEDENT NAME: MUTH DIANE MARIE MATHIA: DATE OF PAYMENT: 1 2/1 3/2004 POSTMARK DATE: 1 2/1 3/2004 COUNTY: CUMBERLAND DATE OF DEATH: 09/1 7/2004 TOTAL AMOUNT PAID: $1,713.17 REMARKS: CHECK//110 INITIALS: JA SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS Gregory R. Reed Attorney At Law 3120 Parkview Lane Harrisburg, Pennsylvania 17111 Phone: (717) 238-0434 * Fax: (717) 238-8469 e-mail: lawo ftice(L~epix.net January 3, 2005 Glenda F. Strausbaug Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, IDA 17013-3387 Re: Diane Marie Mathias Muth, deceased File No. 04-1049 Dear Ms. Strausbaug: Enclosed find check no. 8577 in the amount of $18.00. The check is for $15.00 for the filing fee for the NonResident Decedent inheritance tax return and $3.00 for the NonResident Decedent Affidavit of Domicile for the above referred to estate. Very truly yours, Gregory R. Reed Enclosure ' --- ~.~ REV-1;'37-A EX (9-00)  FILE ;,HIS RETURN WITH: COMMONWEALTH OF REV- 1 7 3 7-A PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RETURN F,LE NUMBER DEPT. 280601 ¢ 2-- 04 1049 HARRISBURG, PA 17128-0601NONRESIDENT DECEDENT COUNTYOODE YEAR NUMBER DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Z Muth Mathias Diane Marie 206-32-0903 LU DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) LU 09/17/2004 08/23/1943 LU (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER w F~i. Original Return [] 2. Supplemental Return [] 3. Remainder Return (dale o, death prior ~o 12-13-S2) ~ -~ [] 4. Limited Estate [] 4a. Future interest Compromise Idata o, death after 12-12-82) [] 5. Federal Estate Tax Return Required ~ ~ [] 6. Decedent Died Testate (Attach copy of Will) [] 7. Decedent Maintained a Living Trust (Attach copy of Trust) 8. Total Number of Safe Deposit Boxes n < [] 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (date ofdeath bet .... 12-31-91 and 1-1-95) [] 11. Election to tax under Sec. 9113(A)(Attach Sch O) ~_ THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Z ,,, NAME COMPLETE MAILING ADDRESS z Gregory R. Reed, Esquire o 3120 Parkview Lane '" FIRM NAME (IfApplicable) ,,,~ Harrisburg, PA 17111 TELEPHONE NUMBER 0 (717) 238-0434 REFER TO METHOD OF COMPUTATION IN THE NONRESIDENT DECEDENT INSTRUCTION BOOKLET (REV-1736) METHOE Check One: [] Flat Rate [] Proportionate (Complete Worksheet on Reverse Side) 1. Real Estate (Schedule A) (1) 42,495.00 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) (Schedule C) 4. Modgages & Notes Receivable (Schedule D) (4) !.~ =~; r'-- ~ . (2;;) " 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) Z (Schedule E) ,':.~ 0 '-" '~-'~ ~ -0 --~ '-'r~  6. Jointly Owned Property (Schedule F) (6) '-._TZ_ '-' r'l~ ..~-~ ~-~ .,,.,J [] Separate Billing Requested ~) 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) I'"' (Schedule G or L) '<~ 8. Total Gross Assets (total Lines 1-7) (8) 42,495.00 LL~ 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 2,420.99 11. Total Deductions (total Lines 9 & 10) (11) 2,420.99 12. Net Value of Estate (Line 8 minus Line 11) (12) 40,074.01 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) 0.00 made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 40,074.01 LO ' tY Z SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES ~..~. O 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 40,074.01 1,803.33 X (16) ~ ~ 17. Amount of Line 14 taxable at sibling rate x .12 (17) f~(.~ 18, Amount of Line 14 taxable at collateral rate x .15 (18) ¢1' 19 Tax Due- Make check payable to Commonwealth of PA (19) 1,803.33 .c~ 20, [] > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < SCHEDULE "A" REAL ESTATE ESTATE OF: FILE NO. 2004-01049 DIANE MARIE MATHIAS MUTH ITEM DESCRIPTION VALUE AT DEATH NUMBER 1. 1506 Terrace Avenue, Carlisle, PA $ 42,495.00* ALL THAT CERTAIN lot or piece of ground situate in the 3rd Ward of the Borough of Carlisle, Cumberland County, Pennsylvania, bounded and described in accordance with a survey made by Gerrit J. Betz, R.S., dated June 11, 1975, as follows, to wit: BEGINNING at a point on the southerly side of Terrace Avenue, said point being located 286.88 feet West of the southwest corner of Terrace Avenue and the proposed Valley Street Exit; thence along the remainder of Lot No. 75 on the hereinafter mentioned plan of lots, lands now or late of Lee E. Berry, South 25 degrees 30 minutes East, a distance of 117 feet to a point; thence along lands now or late of Israel G. Royer, South 63 degrees 49 minutes West, a distance of 94.50 feet to a point; thence along the remainder of Lot NO. 76 on the hereinafter mentioned plan of lots, land belonging now or late of Ronald L. Curry, North 25 degrees 30 seconds West, a distance of 118 feet to a point on the southerly side of Terrace Avenue; thence along the same North 64 degrees 30 minutes East, a distance of 94.50 feet to a point, the place of Beginning. Having thereon erected a frame ranch dwelling, known and numbered as 1506 Terrace Avenue, Carlisle, Pennsylvania. Also being the western 36 feet of Lot No. 75 and the eastern 58.50 feet of Lot No. 76 on Plan of Valley Meadows, recorded in right of way Plan Book 1, page 81, Cumberland County Records. (See attached tax assessment from Cumberland County Tax Assessment Office, marked Exhibit "1" and incorporated herein by reference.) *Total value $84,900.00. Decedent owned a one-half (1/2) interest as a tenant in common with Albert H. Muth, her former husband, from who she was divorced. SCHEDULE 'T' DEBTS OF DECEDENT, MORTGAGE LIABILITIES AND LIENS ESTATE OF: FILE NO. 2004-01049 DIANE MARIE MATHIAS MUTH ITEM VALUE OF DATE NUMBER DESCRIPTION OF DEATH 1. Satisfaction of Chase Home Finance - Loan #2014339295 $ 2,420.99 (See copy of Statement for Loan #2014339295 attached hereto marked Exhibit "2" and incorporated herein by reference). SCHEDULE "J" BENEFICIARIES ESTATE OF: FILE NO. 2004-01049 DIANE MARIE MATHIAS MUTH ITEM NAME AND ADDRESS AMOUNT OR NUMBER OF BENEFICIARY RELATIONSHIP SHARE OF ESTATE A. Taxable Bequests: 1. Morgan Thomas Muth Son Residue of 1506 Terrace Avenue Estate Carlisle, PA 17013 B. Charitable and Governmental Bequests: None ~ FacetWin.Screen Print for assess01, from "CAMA_Login" 12/10/2004 10:44:50 AM CUMBERLAND COUNTY ASSESSMENT OFFICE NEIGHBORHOOD: 724 CONTROL # 50000219 DISTRICT: 50 - CARLISLE 3RD WARD AMX SD: 3 PARCEL: 50-21-0326-135. ~ SPEC ID: LOT: L-0075 + ~--] Tback: Short Name : MUTH, ALBERT H & DIANE M ~ LAST NAME : MUTH : I I PROPERTY TYPE: R FIRST NAME : ALBERT H & DIANE M ! C/O NAME : [ SALES ADDRESS1 : 1506 TERRACE AVENUE I DEED BK/PG ..... 0027M-00572 ADDRESS2 : I DATE OF SALE...10/31/1977 POST OFFICE: CARLISLE I SELLING PRICE: 34000 STATE & ZIP: PA 17013 ] Situs: 1506 TERRACE AVENUE I .CURRENT VALUES Prop Descrip.: J Assessed Fair Market LAND DESC: WESTERN 36 FT OF LT 75 & 58.50 FMV - 84990 L - 20350 LAND USE TYPE: 101 C&G - B - 64640 DEEDED ACRES: .25 approved? -> T - 84990 Screen 1 Enter Selection > Record: 86405 Number -Switch Screens, X -Exit, J -Jump Mode, F -Forms, I -Image Down Arrow -Next Entry, Up Arrow -Previous Entry, ? -Screens, B -Browse EXHIBIT ":1" THE RIGHT RELATIONSHIP IS EVERYTHING.® Loan Number: 2014339295 Customer Care Phone: 1-800-848-9!36 Statement Date: 09/30/04 Please send payments ONLY to: PO BOX 830016 Payment Due Date: 10/01/04 ~Ud.~MORE MO :2~.28~-oo~.~ Property Address: Hearing Impaired (TDD): 1-800-582-O5a,2 1506 Terrace Ave, Carlisle PA 17013 e41oo! 2oas CHR~eOXP. ET200S ~ORACH 39,l&8 Loan Information: Balances: #BWNJCCL Principal Balance on 09/30/04 $2,420.99 #9992014339295091# 39,168 AO CC 0 Escrow Balance on 09/30/04 $219.23 Payment Factors: Interest Rate 8.50000% ALBERT H MUTH Principal & Interest $234.55 DIANE M MUTH Escrow Payment $147.97 1506 TERRACE AVE Optional Products $33.94 CARUSLE, PA 17013-9369 Past Due Payment $0.00 Unpaid Late Charges $O.00 I,,,lll,,,lll,,,,,,ll,,ll,l,h,,,ll,,Ih,hl.ll,,,,ll,,,I,l,I Miscellaneous Fees $0.00 Total Payment $616.~6 Year-to-Date: Interest $221.87 Taxes $1,511.87 Principal $1,889.08 Chase Presents The Fo[lowing Opportunities To You Please detach and return the bottom portion of this statement with your payment using the enclosed envelope. EXHIBIT "2" REV-1737-1 EX + (9-00) NONRESIDENT DECEDENT COMMONWEALTH OF PENNSYLVANIA DE~AR~-MENTOr REVENUE AFFIDAVIT OF DOMICILE DEPT. 280601 HARRISBURG, PA 17128~0601 This affidavit must be completed and sworn to by a person having personal knowledge of these facts, preferably by a surviving spouse or member of the decedent's family. Name of Decedent Date of Death Diane Marie Mathias Muth 09/17/2004 Legal Address at Time of Death: Street Address City/Borough State Zip Code 545 S. 850 E. Layton UT 84041 The following information is submitted in support of the statement that the above individual was not domiciled in the Commonwealth of Pennsylvania at the date of death. 1. Names and addresses of the decedenrs surviving spouse and members of his/her immediate family: Name and relationship to decedent Morgan T. Muth (son) Street Address City/Borough State Zip Code 1506 Terrace Avenue Carlisle PA 17013 Name and relationship to decedent Street Address City/Borough State Zip Code Name and relationship to decedent Street Address City/Borough State Zip Code 2. Did the decedent ever live in Pennsylvania? ,1~ Yes I-] No If yes, during what periods? 3. Did the decedent spend time in Pennsylvania during the five years preceding death ? ~ Yes [] No If yes, during what periods and at what address? Decedent resided at 1506 Terrace Avenue, Carlisle, PA until June of 2003 when she was divorced from her husband. After moving to Utah in June of 2003 until her death she did not return to Pennsylvania. 4. What was the nature of decedent's places of residence during the five years immediately preceding death? Indicate whether decedent resided in a house or apartment and whether it was rented or owned by the decedent, and/or whether decedent resided in hotel or the home of relatives or friends. She resided at 1506 Terrace Ave., Carlisle, PA with her husband until June of 2003. She resided from June of 2003 her death on September 17, 2004 at 545 S. 850 E., Layton, Utah with her father, sister and brother., 5. Was the decedent employed during the five years preceding death? [] Yes ~ No ;~ If yes, list the name and address of employer(s). ' ~-' Decedent retired in 1998 from the Steelton-Highspire School District where she was a teacher. .~- =:. rn ~ 6. Did the decedent leave a will? ~ Yes ~ No If yes, s~te the ~ud which admi~ed the will to probate, the date admi~ed, and attach a copy, including all codicils, and~'~fi~te of ~ance~ le~ers testamenta~. --, 2nd District - Farmington CouP, Davis County Utah; Case ~043700344EI, October 21, 2004 7. If the decedent did not leave a will, has an administrator of his estate been appointed? ~ Yes ~ No If yes, state the coud which appointed the adminisEator, the date of ap~intment, and a~ach a ce~ificate of the issuance of letters of administration. Not Applicable 8. At any time during the last five years did the decedent execute a will, a codicil, trust indenture, deed, mortgage, lease or any other document in which the decedent was described as a resident of Pennsylvania? [] Yes ,~] No If yes, describe such document. NONRESIDENT DECEDENT AFFIDAVIT OF DOMICILE (continued) Page2 9. Had the decedent paid a tax on income or on intangible property to any state, county, or municipality during the last five years? If yes, where and when was it paid? ~ Yes [] No Pennsylvania Income Tax for 2003. 10. To what regional office of the Internal Revenue Service did the decedent forward his Federal Income Tax returns during the last five years preceding death? Philadelphia, Pennsylvania 11. At the time of death, did the decedent own, individually or jointly, any interest in real property, including lease-holds or tangible personal property located in Pennsylvania? ~ Yes [] No If yes, describe the property in detail. 1506 Terrace Avenue, Carlisle, PA. Decedent owned a one-half (1/2) interest as a tenant in common with Albert H. Muth, her former husband, from who she was divorced. 12. In what business activities was the decedent engaged during the last five years preceding death? Indicate whether decedent was employed or otherwise engaged in business, and state the names and the addresses of the persons, firms or corporations with which the decedent had such business affiliations. ( Except for employer listed in #5 ) None of Pennsylvania? $42,495.00 (1/2 interest in real estate) 14. At the time of death, did the decedent own or operate an automobile? ~ Yes [] No If yes, in which state was it re~listered? Utah 15. At the time of death, was the decedent a member of a church or any other organization ? ~ Yes [] No If yes, provide the name and address of the church or any other organization. Kaysville Bible Church, Kaysville, Utah 16. State the purpose or reason the decedent owned real property in Pennsylvania. See answer to question 10 which is incorporated herein by reference. 17. Include any other information you wish to submit in support of the contention that the individual was not domiciled in Pennsylvania at the time of death. If more space is needed, insert additional sheets of same size. Decedent did borrow $25,000 from Bonnie Mathias. The Promissory Note shows her address as 545 S. 850 E., Layton, Utah and a UCC-1 was recorded with the Utah Department of Commerce to NO. 251438200437 on August 20, 2004, see a copy of Promissory Note and Acknowledgment of filing attached hereto and incorporated herein by reference. Name of person completing affidavit Relationship to decedent Morgan T. Muth Son Street Address City State Zip Code Carlisle Carlisle PA 17013 Under penalties of perjury, I declare that based on my personal knowledge of the decedent, the information provided on this form is true, correct and complete. Signa~ compS, .~ Date 2nd Districn - Farmington COURT 5TAz~ OF UTAH DAVIS COUNTY, iN THE .MATTER OF THE ESTATE : NOTICE OF APPLICATION W~LT OF DIANE MARIE MATHIAS MUTH : FOR INFORMAL PROBATE OF = = : AND : INFORMAL APPOINTMENT OF : PERSONAL REPRESENTATIVE : DECEDENT : Case: 043700344 EI Notice is hereby given that on October 14, 2004 MUTH, MORGB~ T filed with the registrar of this court an application for informal probate of the decedent's will dated August 06, 2003 and for informal appointment of MORGAN T MUTH as personal representative of the decedent, to act without bond. A copy of the application is on file with the clerk of the court and may be reviewed upon request. Afner nhe elapse of ten days from the date of this notice, if the application is found to be complete and in compliance with the Utah Uniform Probate Code, it will be granted. Failure to object to the application will not affect the right of an interested person to petition the court to set aside the informal probate or appointment. Reviewed by the registrar for approval on November 01, 2004. Dated: October 21, 2004 Page 1 Case No: 043700344 Date: Oct 21, 2004 DAVID E BEAN 190 S FORT LN STE 2 LAYTON, UT 84041 (An5orney) In compliance with the Americans with Disabilities Act, individuals needing special accommodations (including auxiliary communicative aids and services) during this proceeding should call Ali Holmes at 801-447-3818 at least three working days prior to the proceeding. The general information phone number is 801-447-3800. CERTIFICATE OF NOTiFICATiON i certify that a copy of the attached document was sent to the following people for case 043700344 by the method and on the date specified. METHOD NAME Mail CLARE E MATHIAS OTHER PARTY 545 SOUTH 850 EAST LAYTON, UT 84041 Mail LESTER B III MATHIAS OTHER PARTY 545 SOUTH 850 EAST LAYTON UT 84041 Mail LESTER B JR MATHIAS OTHER PARTY 545 SOUTH 850 EAST LAYTON UT 84041 MailMORGAN T MUTH PETITIONER 1506 TERP~ACE AVE CARLISLE PA 17013 Mail DAVID E BEAN ATTOP~EY PET 190 S FORT LN STE 2 _YTON UT Dated this ,~/ day of Page 2 Case No: 043700344 Date: Oct 21, 2004 Page 3 (last) Glenda Farner Strasbaugh Register of Wills and Clerk of Orphans' Court Marjorie A. Wevodau First Deputy Ki~S.Sohonage, Esq Solicitor Register of Wills and Clerk of the Orphans' Court County of Cumberland One Courthouse Square Carlisle, PA 17013 (717) 240-6345 FAX (717)240-7797 INVOICE Bill To: InvoiceNo: Invoice Date: Estate of: Estate No: GREGORY R. REED 3120 PARKVIEW LANE HARRISBURG, PA 17111 Qty 1 Fee Description Additional Probate Fee 20.00 166 01/12/2005 Diane Marie Mathias Muth 21-04-1049 cop Total $20.00 $20.00 Total: Checks should be made payable to the Register of Wills. Terms: Net 30. Please return one copy of this invoice with your payment. Thank you. BUREAU OF INDlYIDUi\L TAXES P.O. BOX 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYL VANIA DEPARTMENT OF REVENUE February 16, 2005 IN YOUR REPLY PLEASE "REFER TO: J (717) 783-3836 GLENDA FARNER REGISTER OF WILLS CUMBERLAND CNTY COURTHOUSE ONE COURTHOUSE SQ CARLISLE PA 17013 ~: t, j '1'1 ~,_. v,", Dear Ms. Farner: Re: Estate of Diane M. Muth File No.: 21-04-1049 County: Cumberland Date of Death: September 17, 2004 The subject decedent at death legally resided outside the state of Pennsylvania; accordingly, you are authorized to close your records for inheritance tax purposes. All other inheritance tax documents filed under your resident inheritance tax number for the subject decedent (if any) should be forwarded to this office at the address shown above. Included should be photocopies of all receipts for collection of inheritance tax in the subject estate which have been issued by your office. It is not necessary to return Departmental documents forwarded to your office under the nonresident file number as we maintain a file of all documents forwarded for the estates. All matters concerning this estate will be maintained under the Pennsylvania Nonresident File Number 99-05-0048. Thank you for your cooperation in this matter. Sincerely I John Murphy, Chief Inheritance Tax Division S-IT: INH13 02:pm:023 0'. '1~ "'. , '; "-;.1" " 1'''1111''''''111'1''''1'1'11'''1/'''1/''1/''''''1/1'''111'''\ '';;ij,';~J\~ H ~'~(' :' \ ,,) 6~OI- r o-Ie f:; r~, / "'.co". ,\., -'t. . ',~ ~ ' ~, >." - ,.1:;. .1' i ".~ ,. . , ' . '. -, ~ . j ,R .,,~ t.;; ':n'''' ~d :)i{':TIJ~ \f.r.'-: ::.: 1: l:lL \. s\..n.~i'::i.:J~)l::1 ",r C~':'ln4. /) ',; PLEASE FILE lHIS REPORT WTIlIIN 1W YEARS OF DATE OF DEAllI RFX;ARDLESS OF mE SI'AWS OF 1lIE FSrATE. IF FSrATE IS NOT <nfPI.El'ED, FTI..E A 6.12 FORM YFARLY UNITL <n1PIEITON. STATUS REPORT UNDER RULE 6.12 Name of Decedent: [) I'a n~ (Y) ar i e. fJ1 a fh i as fYJ Ii. fh Date of Death: Se.pte m b~(" / Z 200'-1 Will No. 2..004. () 10 4 q Admin. No. PA. No. 2/-0'1./049 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: J. 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 X b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representativ~ state an account informally to the parties in interest? Yes No J( d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this~,report. Date. 3)s-/d:> ~ . Sigfiature 'D C--) c...J Greff('~ 'R. Ree.d I Esquke. Name Ie se type or print) 312D ~V"~vje.UJ Lane, ~a(,l'i~burj, PA 17/11 Address I I ( ,11 23~-()43lf Tel. No. Capacity: Personal Representative ~ .Counsel for personal representative ( MAH: r'ntl / AM3 ) RW-27 '~ iN I' ~. ~.. , '- 'i, 3: (,j ~ I-' r:l ,... 0 ...j H ia 0 C/l l:" t-;l ,... t%J ~ (,j 0 't:J c:: :t" C/l t%J I-' -J C/l 0 iO I-' W - - - - - - - r i, "1. ,....;- p:: l'Of p. H h ," e> '- " , ;'::J !-'- -..., , (") ;), () ,... ~ ::0 :s: t%J C/l G:l tl:J H G:l t%J C/l l:" ~ ::0 t-;l t%J 1': ~ t%J ~ r ::0 ""tl <.:0 0 ~ "l ~ .... r.' r:l :a 0 :=;: ~ '" H ;';;:' r:l l:" t%J a f',' ~ l:" ::0 z ~. j Z C/l C> nT, -.' t-;l ~ ~~ ~ g i'RfSfqHF,--. C/l ~rRST ::LA~S t%J F~ ,\>~\ J: l',~,. :!: ,,-....,>'8: ~ "J "' " ., ~ .... " no '" = ~:;) r--J -...J 100 Jt.....'""~..!. (') .. ~ '" '" " DATE: SUBJECT: TO: FROM: COMMONWEALTH OF PENNSYLVANIA DOCKETING NONRESIDENT DECEDENT FILE INFORMATION V\s. C, \"''''<\" \=o.,'rMr . c:::..u'<'o,\'~v\""""'~ COUNTY REGISTER OF WILLS John Riedman Specialty TaxlNonresident Unit Inheritance Tax Division Bureau of Individual Taxes DepananentofRevenue ,j Attached is nonresident decedent file information concerning taxable property located in your county. Please docket and file the attached information so it may be available for future reference. Thank you. Attachment 04-04-2005 MUTH 09-17-2004 99 05-0048 NON-RESIDENT Vi 101 A.IIOunt Re..itt.d COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 NOTICE or NONRESIDENT INHERITANCE TAX APPRAISE~NT, ALLOMANCE OR DISALLOMANCE.OF DEDUCTIONS, AND ASSESSMENT OF TAX DATE : i!$lATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 1 ~; , GREGORY R REED 3120 PARKVIEW LN HBG '*' REV-537EXAFP1l2-D4l DIANE M PA 17111 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: PA DEPARTMENT OF REVENUE P.O. Box 280601 HARRISBURG, PA 17128-0601 CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV=S!"i-EX-A'FiQ-oi:-03'j"-N'OTi-crW-NifN'RESYiiENTiNHERITANCE-TAX-APPRAYSEH'E-N'i';-A'Ci:.ifwANC-€-O'R--- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF MUTH DIANE M FILE NO. 99 05-0048 ACN 101 TAX COMPUTATION METHOD ELECTED: (X) FLAT RATE () PROPORTIONATE TAX RETURN WAS: ( X) ACCEPTED AS FILED () CMANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule AJ 2. stocks and Bonds (Schedule J!,J 3. Closely Held stock/Partnership Interest (Schedule CJ 4. Hortgages/Notes Receivable (Schedule DJ 5. Cash/Bank Deposits/Misc. Personal Property (Schedule EJ 6. ~olntly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets ll) (2) (3) (4) (5) (6) {7J 42,495.00 .00 .00 .00 .00 .00 .00 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ad... Costs/Misc. Expenses (Schedule H) (9) 10. nebts/Hortgage Liabilities/Liens (Schedule X) (10) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests (Schedule J) 14. Net Value of Estate Subject to Tax .00 2.420.99 DATE 04-04-2005 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax paYllent. (8) 42,495.00 Ill) (12) (13) (14) 2.420.99 40.074.01 .00 40.074.01 NOTE: I~ an assessment was 1ssued prev1Dusly, lines 14, 15 and/Dr 16, 17, 18 and 19 will reflect ~1gures that include the total D~ abh returns assessed to date. ASSESSKENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. A.ount of Line 14 taxable at Lineal/Class A rat. (16) 17. Amount of Line 14 at Sibling rate (17) 18. AMount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due D : .00 X 00 = 40,074.01 X 045 = .00 X 12 = .00 X 15 = (19) AMOUNT PAID INTEREST/PEN PAID (-) 90.17 NUNBER CD004725 DATE 12-13-2004 1,713.17 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 1,803.33 .00 .00 1,803.33 1.803.34 .0ICR .00 .0ICR . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQVIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION; Estates of decedents dying on or before December lZ~ 1982 -- If any future interest in the estate is transferred in possession or enjoy~ent to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or fo~ years~ the ComaDnwealth ~rebY expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE; OBJECTIONS; ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: REFUND (CR): PENAL TV: INTEREST: TO REMIT PAYMENT: To fulfill the requirellents of Section Zl40 of the Inharitance and Estate Tax Act~ Act Z3 of ZOOO. (7Z P.S. Section 9140). Any party in interest not satisfied with the appraismant~ allowance or disallowance of deductions or assess.ent of tax (Including discount or interest) as shown on this Notice lIay object within 60 days of the date of receipt of this notice by filing one of the following: A) Protest to the PA Departllent of Revenue~ Board of Appeal$. You may object by filing a protest online at www.boardafappaals.state.pa.u$ on or before the expiration of the sixty-day appeal periOd. In order for an e~ec~ronlC pro~es~ ~o De valid~ you must receive a confirmation nUMber and processed date froll the Board of Appeals website. You .ay also send a written protest to PA Depart.ent of R8venue~ Board of Appeals P.O. Box Z810ZI~ H8rrisbur9~ PA 17]28-]021. Petitions may not be faxed. B) Election to have the lIatter deter.ined at the audit of the account of the personal representative. C) Apl'eal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Depart.ent of Revenue~ Bureau of Individual Taxes~ ATTN~ Post Assessment Review Unlt~ P.O. Box 280601~ Harrisburg~PA 17128-0601 Phone (717) 787-6505. See page 3 of the book18t "Instructions for Inheritance Tax Return for a Nonresident Decedent" (REV-1736) Jor an explanation of administratively correctable errors. If any tax due is paid within three (3) .onths aJter the decedent's death~ a discount of five percent (S;() of the tax paid is allowed. A refund of B tax credit~ which was not requested on the Tax Return~ may be requested by co.pleting an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available online at www.revenue.state.DB us~ any Register of Wills or Revenue District Dffice~ or fro. the Deparfwent.s 24-hour answering service for forms orders: 1-800-36Z-Z0S0j services for taxpayers with special hearing and/or speaking needs: 1-800-447-30Z<< (T1 only). The 15% tax B~sty non-participation penalty is co.puted on the total of the tax and interest assessed~ and not paid before Jl!lnuary 18~ 1996~ the first day after the end of the tax a.nesty periOd. This non-parUcipation penalty is appealable in the same .anner and in the the sue the periOd as you would l!lppeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency or nine (9) lIonths and one (1) day fr~ the date of death to the date of pay.ent. Taxes which became delinquent befora January l~ 1982 baar interest at the rate of six (6%) percent per annu. calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1~ 1982 will bear interest at a rate which will vary from calendar year to Cl!llendar year with that rate announced by the PA Department of Revenue. The l!lpplicable interest rates for 1982 through 2005 ara: Interest Daily Interest Dally Interest ~ f!2!2!:- Year ....B!!!..... ~ Year -B!!L.. ZOX .000548 m8-1991 UX .000301 ZOii 9X 16X .000438 1992 9;( .000247 2002 6iC UX .000301 1993-1994 7X .OOOlIJ2 2003 5X 13X .000356 1995-1998 9;( .000247 2004 4iC lOX .000274 1999 n .000192 2005 5X 9;( .000247 2000 8iC .000219 Year i9ii ]983 1984 1985 1986 1987 Daily Factor .iiffi47 .000164 .000137 .000110 .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAK UNPAID K NUKBER OF DAYS DELINQUENT K DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assess.ent. If pay.ent is .ade after the interest computation date shown on the Notice~ additional interest must be calculated. Detach the top portion of this Notice and sub.it with your payment to PA Department of Revenue~ at the address shown on the reverse side. -Make check or .oney order l'ayable to: PA Department of' REVENUE ~ C',r :_' (';' SCHEDULE"M REAL ESTATE ESTATE OF: FILE NO. 2004-01049 DIANE MARIE MATHIAS MUTH ITEM DEATH NUMBER DESCRIPTION VALUE AT 1. 1506 Terrace Avenue, Carlisle, PA $ 42,495.00* ALL THAT CERTAIN lot or piece of ground situate in the 3m Ward of the Borough of Carlisle, Cumberland County, Pennsylvania, bounded and described in accordance with a survey made by Gerrit J. Betz, R.S., dated June II, 1975, as follows, to wit: BEGINNING at a point on the southerly side of Terrace A venue, said point being located 286.88 feet West of the southwest corner of Terrace Avenue and the proposed Valley Street Exit; thence along the remainder of Lot No. 75 on the hereinafter mentioned plan oflots, lands now or late of Lee E. Berry, South 25 degrees 30 minutes East, a distance of 117 feet to a point: thence along lands now or late of Israel G. Royer. South 63 degrees 49 minutes West, a distance of 94.50 feet to a point; thence along the remainder of Lot NO. 76 on the hereinafter mentioned plan of lots, land belonging now or late of Ronald L. Curry, North 25 degrees 30 seconds West, a distance of 118 feet to a point on the southerly side of Terrace Avenue; thence along the same North 64 degrees 30 minutes East, a distance of 94.50 feet to a point, the place of Beginning. Having thereon erected a frame ranch dwelling, known and numbered as 1506 Terrace Avenue, Carlisle, Pennsylvania. Also being the western 36 feet of Lot No. 75 and the eastern 58.50 feet of Lot No. 76 on Plan of Valley Meadows, recorded in right of way Plan Book I, page 81, Cumberland County Records. (See attached tax assessment from Cumberland County Tax Assessment Office, marked Exhibit "I" and incorporated herein by reference.) *Total value $84,900.00. Decedent owned a one-half (112) interest as a tenant III common with Albert H. Muth, her former husband, from who she was divorced. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE aUREAU OF II\.. "'J,VIOUAL fAXES DEP1. 280601 HARR.ISBURG,?A 17128-0601 AEV-1l62 EX(11.96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFiCIAL RECEiPT MUTH MORGAN THOMAS BOX 65 1506 TERRACE AVE CARLISLE, PA 17013 -..c---. fold EST A TE INFORMATION: SSN: 206-32-0903 FILE NUMBER; . .2104 1549-. "le; -oS -()<,,\( ~ DECEDENT NAME: MUTH DIANE MARIE MATHIAS DATE OF PAYMENT: 12/13/2004 POSTMARK DATE: 12/13/2004 COUNTY: CUMBERhAND.... ~0(\'I":.,,: d Cm DATE OF DEATH: 09/17/2004 i :; NO. CD 004725 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $1,713.17 I I I I I [ I I $1,713.17 TOTAL AMOUNT PAID: REMARKS: CHECK# 110 SEAL INITIALS: JA RECEIVED BY: DEPARTMENT OF REVENUE , GLENDA FARNER STRASBAUGH REGISTER OF WILLS