HomeMy WebLinkAbout04-1067PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Estate of ~/It~r' ~,t%%g~[ ~r~l'/l'~$~#
Deceased.
Social Security No. ,~gX- lip - 7[~,g~Z~
NO.
TO:
Register of Wills for the
County of ~ in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/.a~. 18 years of age or older, appl;~¢
(d.b.n.; ~enden~ ~te; durante absentla; durante m~nontate~ t
the above decedent.
for letters of administration
on the estate of
Decendent was domiciled at death in t'~-/-mda6~/a,n~/ Coun...ty, Pennsylvania, with
ht'~ lastfamilyorprincipalresidencea~ 135 ~'~t
(hst street, number an~l municipality)
Decendent, then.~ years of age, died ~.,~ X/ , ~ ,~
at b /~ _~/~e a~ c a / ~ eagl~'' i .~ . /--e~ zz~ 7'-*t,~,~..:. z" e.,g.o'~s~'~ /_/~.., ~d~ '
Decendent at death owned property with estimated values as folllows:
(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:
Petitioner after a proper search ha~
the following spouse (if any) and heirs:
Name
ascertained that decedent left no will and was survived by
Relationship
Residence
77./_)~all
;,,.,,.,.'/,,,,,,,,,.,,
rHEREFORE petitioner(s) respectfully request(s) the grant of letters ol~ administration in the
appropriate form to the undersigned, c
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ~-mk~ ~cJ
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
representative(s) of the above decedent petitioner(s) will well and
truly administer the estate according to law. · ,~
Sworn to or afflrm~c{ and subscribed c
before mc this ~ day of
No. ~-
Estate of[~bc~L~. ~,~ ~ ~..~ Qh~}.~ o_]~cyDeeeased
GR~NT OF LETTERS OF ADMINISTRATION
AND NOW ~0V°~ r~k::L~x_ c~ 09` oQOO~- 14~ , in consideration of ~e ~ition on
the reverse side hereof, safisfaao~ ~roof havi~ b~n pres~t~ before me.
ITIS DECREED that ~ ~ ~ ~ I/ah~ , ~
is/are entitled to ~ters of Adm~ffaUon, and tn. accord w~th such find~, Lett~s of Admlmsffaaon
~e hereby gr~,~ to ~'~ ~ ~ ~ ~ ~' ' , ? r
in the estate of~- ~c .... ~%~ ~
FEES
Letters of Administration ..... $ ~.
Short Certificates(.~) .......... $ ~ ~ c-rc~
Renunciation ...... ~C~' ' ' $
$
TOTAL $..~._d~
Filed ...~.~:.c~.~.~. ·O.'.~ ...... A.D.
ATTORNEY (Sup, Ct. I,D. No.)
ADD.SS
PHONE
his is to certify that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records in accordance
with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
0518542
No.
Charles Hardester
State Registrar
SEP 13
Date
CERTIFICATE OF DEATH
125 Kost Road
Carlisle, Pa 17013
Harry P~ips0n
:esturant
SEX
=. ~le
~.Berrysburg .--.[] =
VA Medical Center
¥.,ffi .oD °l~ed
'~At°sli~ce
White
,~ ~ertrude Xr~ck
"~"~"*~ 8:30 a. 21, 2004
INFORMAN1"$ ADD SS (S (T n
Mary E. Deitch
Aug 25, 2004 St. John's Cemetery ~. Camp Hill, Pa 17011
FD-012662-L Inc 37 East
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
Date of Death:
Will No.
TO THE REGISTER:
Walter Warren Philipson affda Warren Philipson
August 21, 2004
Admin. No. 21-04-1067
I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on
November 26, 2004:
Name Address
Van Philipson
c/o Ray T. Dell, 33 State Avenue, Carlisle, PA 17013
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date: November 26, 2004
CHARLES E. SHIELDS, III
6 Clouser Road
Mechanicsburg, PA 17055
Telephone: (717) 766-0209
Counsel for Personal Representative
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Walter Warren Phil ipson. alk/a Warren Philipson
Date of Death: 8/21/2004
Will No.
Admin. No.
21-04-1067
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 1{
2. If the answer is No, state when the personal
representativp reasonably believes that the administration will be
complete: 1not vet determined
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes No
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest? Yes No
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.
Da te : February 18. 2005
@/~ r/tUX>
Signature
Charles E. Shields, III, Esquire
Name (Please type or print)
6 Clouser Road, Mechanicsburg, PA 17055
Address
(717 ) 766-0209
Tel. No.
Capacity:
Personal Representative
c;~: ".'
X Counsel for personal
representative
(MAH:rmf/AM3)
J.
May 23, 2005
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
PO Box 280601
HARRISBURG, PA 17128-0601
Telephone
(717) 787-3930
FAX (717) 772-0412
CHARLES E. SHIELDS, III
ATTORNEY AT LAW
6 CLOUSER ROAD
CORNER OF TRINDLE AN CLOUSER ROADS
MECHANICSBURG, PA 17 55
Dear SIR/MADAM:
Re: Estate of WALTER W. PHILIPSON
File Number 2104-1067
This is in response to our request for an extension of time to file the Inheritance Tax Return for
the above estate.
In accordance with ection 2136 (d) of the Inheritance and Estate Tax Act of 1995, the time for
filing the return is extended or an additional period of six months. This extension will avoid the
imposition of a penalty for f i1ure to make a timely return. However, it does not prevent interest from
accruing on any tax remaini g unpaid after the delinquent date.
The return must be led with the Register of Wills on or before 11/21/05. Because Section 2136
(d) of the 1995 Act allows f r only one extra period of six (6) months, no additional extension(s) will be
granted that would exceed t e maximum time permitted.
.":)
~ > -
Sincerely, . ./
~~..)~
Claudia Maffei, supeM~
Document Processing Unit
Inheritance Tax Division
Q....~~
1\
REV.1500 EX (6.00)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
OFFiCIAL USE ONLY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
-2./ - 04
o / () (07
COUNTY COOE
YEAR
NUMBER
I-
Z
W
C
W
o
W
C
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
'P H J LJ {JSON J Wlf-L TE 1<.
DATE OF DEATH (MM-DD-YEAR)
o! - 2/- ~ (JoLt
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
N/A
I-
Z
W
Q
Z
o
Q.
1II
W
~
~
o
(,J
NAME CIIA-R.LG"S E. SlIE"LDS
#/A-
TELEPHONE NUMBER 7/7 - 7~~ - C>.:L 0 r
FIRM NAME (II Applicable)
WItRt<.EN
SOCIAL SECURITY NUMBER
.;{ 03 - /0
7.8z
DATE OF BIRTH (MM-DD-YEAR)
t!)(,-20- /9;1../
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
z
o
~
..J
::::)
!::
Q.
<(
o
w
0::
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Scheduie E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Scheduie G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
W
I-
lI::$lII
(,J~lI:
wQ.(,J
J:OO
(,J~~
Q.1O
Q.
c(
cgJ 1. Original Return
o 4. Limited Estate
o 6. Decedent Died Testate (AMacl1 copy of Will)
o 9. Litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (date of death after 12-12-82)
o 7. Decedent Maintained a Living Trust (Mach copy ofTrust)
o 10. Spousal Poverty Credit (date 01 death between 12-31-91 and 1-1.95)
o 3. Remainder Return (dale 01 death pnor to 12-13-82)
o 5. Federal Estate Tax Return Required
o 8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Macl1 Sch 0)
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
1iL
COMPLETE MAILING ADDRESS
~ CLOtlSG"/C ~D.
MECHI1;l/ICS8u /(6-.. fJ,4
/70 S5:
(1)
(2)
(3)
(4)
(5)
- 0-
~ 3.777,-'13
-0
I OFFICIAL USE ONLY
1
! -
-0
~S.~13.'?7
.
C,'~)
(6)
o -
f",,)
(7)
-0 -
N
cp,
(9)
(10)
I
~/3'1,17
/</3.23
(8)
'f 9 / ~ g .2, Lf-O
,,-
(11) 9, 2; Z . ~O
(12) (!)
(13) ~
(14) -0 -
13. Charitable and Governmental Bequests/See 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)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
Z 15. Amount of Line 14 taxable at the spousal tax
0 t) x.oL t)
~ rate, or transfers under Sec. 9116 (a)(1.2) (15)
IJ x .0 If..S.- 0
~ 16. Amount of Line 14 taxable at lineal rate (16)
::::) (JJ ~
Q. 17. Amount of Line 14 taxable at sibling rate x .12 (17)
::E iJ I)
0
0 18. Amount of Line 14 taxable at collateral rate x .15 (18)
>< (19) 0
i:!: 19. Tax Due pt.
20.0
Decedent's Complete Address:
STREET ADDRESS I~S ,kbS7 IV>.
CITY CAt'J.L.I S Le- I STATE ~A- I ZIP / 7~/.3
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
o
e:;
o
1/
Total Credits ( A + B + C ) (2)
o
3. Interest/Penalty if applicable
D. Interest
E. Penalty
o
()
Total Interest/Penalty ( D + E ) (3)
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 (4)
o
o
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.
o
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5A)
(5B)
iJ
~~
Make Check Payable to: REGISTER OF WILLS, AGENT
..."l!I"',.,.,,--.-.--..----.~ - _. U I ~f." III
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes
a. retain the use or income of the property transferred;.......................................................................................... 0
b. retain the right to designate who shall use the property transferred or its income; ............................................ 0
c. retain a reversionary interest; or.......................................................................................................................... 0
d. receive the promise for life of either payments, benefits or care? ...................................................................... 0
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. 0
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ......... ..... ........................ ...................... ...... .................. .................................... 0
No
~
~
~
~
JZ]
~
~
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true. correct and complete.
Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PER ~ ~O SIBL R ;;t,G RETURN
ADDRE~ A.1l..t.IN ;fl.. YtJHAI,JIl.
~ NICJc~If.Y UM/#, AfE'~HIIIIIIC S8'fJt.6" ,-", "7~ S$"
SIGNATU E OF PREPARER OTHER N REPRESENTATiVE
;e . 7C
ADDRESS (!. #~L e;s E: SH,c:z.DS pr
, Ct.OVSe;f( /l.P., AfE~#.l-NIC'S'8 liar" /JA- /71J5">"
;!'?t:!,~*'~~..V;t..;i;::,,":.,....y;'!.!,c.:{;:.,:t..'..;'!.:'~i.,.i.\ii:;~.I)t,}'4;~~~~.=<,_~_.~!\,~,"'-4il..~,,".JUL"c~- __"..~"Lt_~~if~~~'
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. S9116 (a) (1.1) (i)].
DATE
Iz.l~"/~J'"
DATE
12/~~ ~r
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. S9116 (a) (1.1) (Ii)].
The statute does not exemot 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. S9116(a)(1.2)].
Th6l;\8"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. S9116(1.2) [72 P.S. S9116(a)(1 )].
,j I
The t'1l~ rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. S9116(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.EV.l503 EX + 11.9.7)
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF P rJ
HIUPSo )
ttJlI-L r~ 7(
W/I-/(!?EAI
FILE NUMBER
~.J -01./ - /tJ07
All property jointly.owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
SALt: I)F rf~ c!5II/I-/Ze- dF (Y;/lM/I)Af S~C!k "r
PRUfJ!:NT/AI.. F/A/,1Ai~//f{../ Drt'. @ !J.jt.:ltJ I"~ S#/I~
(See ver/hcah'ol1 tI cfale ~1ftlckd/
;t
3; 7 tft? '13
TOTAL (Also enter on line 2, Recapitulation) $ 3,; J' 8: '13
(If more space is needed, insert additional sheets of the same size)
Proceeds From
Broker and Barter
Exchange
Transactions
Copy B
For Recipient
This is important tax
information and is being
furnished to the Internal
Revenue Service. If you
are required to file a
return, a negligence
penalty or other sanction
may be imposed on you
if this income is taxable
and the I RS determines
that it has not been
reported.
Form 1099-8
DEPARTMENT OF THE TREASURY - INTERNAL REVENUE SERVICE
OMS No. 1545-0715 1a Date of sale or 1b CUSIP No. 2 Stocks, bonds, etc. Reported to IRS )
exchange
2004 08/26/04 744320 10 2 $ 3,788.43
Form 1099.8
4 Federal Income tax withheld Account number 7 Description
~ Gross proceeds
o Gross proceeds less commissions
and option premiums
0.00
K2300
SALE OF STOCK
PRUDENTIAL
COMMON
333-0998
RECIPIENT'S name, address, city, state and ZIP code
PAYER'S name, address, city, state, ZIP code and telephone no.
WALTER W PHILIPSON
125 KOST RD
CARLISLE PA 17013-9779
EQUISERVE, INC.
PRUDENTIAL FINANCIAL, INC.
P.O. BOX 43033
PROVIDENCE, RI. 02940-3033
1-800-305-9404
RECIPIENT'S identification number
2nd TI N notification
PAYER'S jederal Tax Identification Number
203-10-7682
o
43-1912740
INSTRUCTIONS FOR RECIPIENT ON REVERSE SIDE
DETACH BEFORE CASHING CHECK
"C
I
Proceeds From
Broker and Barter
Exchange
Transactions
DEPARTMENT OF THE TREASURY. INTERNAL REVENUE SERVICE
OMS No. 1545-0715 1a Date of sale or 1b CUSIP No. 2 Stocks, bonds, etc. Reported to IRS )
exchange
2004 08/26/04 744320 10 2 $ 3,788.43
Form 1099.8
4 Federal Income tax withheld Account number 7 Description
~ Gross proceeds
D Gross proceeds less commissions
and option premiums
Copy B
For Recipient
This is important tax
information and is being
furnished to the Intemal
Revenue Service. If you
are required to file a
return, a negligence
penalty or other sanction
may be imposed on you
if this income is taxable
and the IRS determines
that it has not been
reported.
0.00
2300
333-0998
SALE OF STOCK
PRUDENTIAL
COMMON
RECIPIENT'S name, address, city, state and ZIP code
PAYER'S name, address. city. state. ZIP code and telephone no.
WALTER W PHILIPSON
125 KOST RD
CARLISLE PA 17013-9779
EQUISERVE, INC.
PRUDENTIAL FINANCIAL, INC.
P.O. BOX 43033
PROVIDENCE, RI. 02940-3033
1-800-305-9404
RECIPIENT'S identification number
2nd TIN notification
PAYER'S federal Tax Identification Number
Form 1099-8
203-10-7682
D
43-1912740
INSTRUCTIONS FOR RECIPIENT ON REVERSE SIDE
DETACH BEFORE CASHING CHECK
.REV-1508 EX + (1.97)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
INH~~~;~~~~ 6EAC~~:~~RN PERSONAL PROPERTY
ESTATE OF FILE NUMBER
PHILIPcl~A/, /I)/f-t. Te7( tIJ/!/UeE"AJ Z/-ol.f- /LJ67
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. /J11 T ./3#AlK, e8!7eKIAI~ 4eetJtlHT #' ~ tf6 I" 19 ~
s., oS 3. 7(,
? t!J.2/
:?
1/1/7: A~. ~ :p.o,j). tJ/V.7 T€/}( A/P./
(SEE: f/lf-t.tt#7i{);V L$ T~ nu/JI /J1tr E/MJK ~ T~etY'ez))
3.
AlEr SA-U: jJlZleE /9'10 eNC-y/ZOL€T (}GZEt!llIry AT
Ii /!-1-Ut15 t3 tI NG /ftI1O 4-lleI/t?A/
(JEG" /I2btJFJ Or SAiG of- /f/ET PA-YmBVT /I- 774-e/7"c;b)
~
'11-0. at)
'* /NPIJ lit) Te} Z>E(!t:])/F},J/ fI/fl> No TANGIBLE" ..%P.G127Y
t)~ Ft(It#I1lt~F 6J/l ~E UK€". #15: #~ ~/Y "f
;?Pt'~.6f 4-r 7#'E FA-/UI t!JF /H/f~y .LJareH ~/?
::b.lJ1E Y EF7f/!l~.
TOTAL (Also enter on line 5, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$ 5' if C; 3. 9 7
I
mlM&rBank
499 Mitchell Road, MilIsboro, DE 19966 Mail Code DE-MB-12
Phone (888) 502-4349
Fax (302) 934-2955
December 7, 2004
Charles E. Shields, III
Attorney At Law
6 Clouser Road
Mechanicsburg, P A 17055
Re: Estate of" Walter W Philivson
Social Securitv: 203-10-7682
Date of Death: AUf!ust 21. 2004
Dear Sir or Madam:
Per your inquiry dated November 26,2004, please be advised that at the time of death, the above-named decedent had on
deposit with this bank the following:
1.
Type of Account
Checking Account
Account Number
68616619
Ownership (Names oj)
Walter W Philipson
Opening Date
10/28/75
Balance on Date of Death
$5,053.55
Accrued Interest
$
0.21
Total
$5,053.76
Please be advised, there was no safe deposit box found for the above decedent.
For further account information, regarding ownership, closures and/or reimbursement of funds, etc., please call the
Carlisle West Office # 717-240-6717.
Sincerely,
~/~~?"~Ci CY~?M
Nancy Clagett
Records Management
~T~
O'EPOSIT/P A YMEM~4lECt!tPT
\
Bank By Phone... Call
M& T Telephone Banking Center
1-800-724- 2440
D DEPOSIT
,
" 0 CHECKING
o SAVINGS
o LOC
o LOAN
DMTG
o OTHER
D PAYMENT
~128 02 OOS-051B55 1551 072205
DDA-RTLCKDP ~837102129
'5 L
$'~4(}. \)0
~
~
'.\
i
THE DEPOSIT OR PAYMENT HAS BEEN RECEIVED ON THE DATE VALIDATED ABOVE AND IS SUBJECT TO THE TERMS AND
CONDITIONS GOVERNING YOUR ACCOUNT CHECKS AND OTHER NON-CASH ITEMS RECEIVED FOR DEPOSIT ARE SUBJECT
TO VERIFICATION AND COLLECTION BY M&T BANK. DEPOSITS MAY NOT BE AVAILABLE FOR IMMEDIATE WITHDRAWAL.
Member FDIC BR.534AF (5/03)
Vendor:
STATOD ENTERPRISES. INC.
MECHANICSBURG. PENNSYLVANIA 17055
Check Number:
Estate of Walter W. Philipson
Item to be Paid - Description
1990 Chevrolet Celebrity BSE
Check Amount:
Discount Taken
38972
Jun 3,
38972
2005
$440.00
Amount Paid
440.00
NVOICE NUMBER I REGISTRATION & TITLE WARRANTY
"'", '"': (' .:- (.,
;r :"LER (TRANSFEROR) SALE DATE ENTRY NO. TIME SOLD SOLD BY S.O.S.
; lfJVlt~,'1 ~ .I :..t, ~.{ ~ I
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; :'.'1'-'" " UF:'!- :';'1 <= .. , .....i ;' ,71''':; i '~'I ':'j' ,t:1. c.'~ .. " ; 'I'.
'!j1i.; ..:j ,
, . l"'~ i '.; . .~~ !~-;".l ,..i ;':-:': r.';:i "!.:1t;.7j15 GREEN YELLOW T RED BLUE TITLE WHiTE IF NO SALE
i - ..',''!. j WITH DRIVE AS IS ATTACHED MILEAGE
/ "
Cl;~~ :',} .0.~.' YEAR MAKE MODEL BODY TYPE
, n ~~ ,. " ~.~}t:,' .;, iH
. i.~ll':)17f ~..." ;.,.: t.::. ,-' ::~; ,t~t r'j"::, C- :'\ ,~, ! .... c. ,',j::J
rmE STATE ~ .' " t::, rl ::::;(/1;:::1 !)I..) CYL I: R I H I AT PS I AC I OTHER COLOR TRIM STOCK NUMBER
TiTlE NO. "I, .- :~
WE "?\ (-, r ~ ~il C'i ". ," 1 , i '7, ..:-~ 'I' .':~ /...
;ELLER (TRANSFEROR) VEHICLE 1.0. NUMBER UNIT 1.0.
; -,.' t .~ l jR:j 1,.,..1 j,71, .~:!. " . ! .. I i ,r::...:.J..-!'
I
'RINT NAME: " ';; '.I! !..-rCi\/f'l r 'r'~:;:.< (1) ANNOUNCED CONDITIONS (2) ANNOUNCED CONDITIONS
~!}l,nE r ::')
,IGNATURE: ,-" T :~? i",,;~:'; 'T'{,J f.::[' ON F' ! I C' (3) ANNOUNCED CONDITIONS (4) ANNOUNCED CONDITIONS
'~;
state Ihat the odometer (Of the vehicle described herein) now reads Ui}FP ;;~e- ,1 '-'Wi
D
D
D
, ODOMETER MILEAGE STATEMENT,
Federal law (and State law, if applicable) requires that you state the mileage upon transfer of ownership.
Failure to complete or providing a false statement may result in fines and/or imprisonment.
PlEASE SETI'LE WITHIN 1 HOUR OF TIME SOLD.
ii.'l H .1 ::; E,':i (no tenths)
niles and to Ihe best of my knowledge that it reflects the actual mUeage of the vehicle
lescribed herein, unless one of the following statements is checked.
(1) I hereby certrty that to the best of my knowledge the
odometer reading reflects the amount of mileage in
excess of its mechanical limits.
(2) I hereby certrty that the odometer reading is NOT
the actual mUeage, WARNING, ODOMETER DISCREPANCY.
HARR~BURGAUTOAUcnON
(3) Exempt Title Brand.
1100 S. York St., P.O. Box 368 · Mechanicsburg, PA 17055
TELEPHONE: (717) 697-2222 · FAX: (717) 697-2234
'URCHASER (TRANSFEREE)
'RINT NAME: .f t ) ~:!, J;::
SALE EACH THURSDAY AT 9:30 AM
ARBITRATION MUST BE WITHIN 1 HOUR OF PURCHASE
OFFICE USE ONLY
>IGNATURE:
'URCHASER(TRANSFEREE)
.-::::.------
SALE PRICE
, ~': ~
,-i'
BUYER'S FEE
TOTAL
THIS 'JCClMENT :\lOT VAUD r::OR.=XPIJRT
RECEIPT OF COpy ACKNOWLEDGE
SELLER C':OP'{
BLOCK CLERI
REV-1511 EX+ (12-99) .
~.' \,I~~R.~
~~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
P H/L / flSIJIl0 ft)/l-t rc:?e
ITEM
NUMBER
A.
WA-/<~E /II'
FILE NUMBER
;21-0'/- /~~7
Debts of decedent must be reported on Schedule I.
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
f)l yFlt S FtI/VE7U-l Nt/AlE of /J1Et!U/htl/CSB H;{G
G //11 r; /(f(!-I{ In ~M tl /t/ A-LS
to.sr EJF 4jult/4-L c~mES
7~ 3 ~ 'I. (}a;
~/oo.tJo
P / $VdJO
~
A.
.5.
B. ADMINISTRATIVE COSTS:
4.
5.
6.
7.
j.
7.
10.
II.
/2.
1. Personal Representative's Commissions
Name of Personal Representative(s) !J1c,..I,'" ~J", r,..
Social Security Number(s)/EIN Number of Personal Representative(s) .:z - ::I" - bSS7:)
Street Address (, H,'c!ct/l,.y l.41J~
City ./J1t21t'Lfll'c.Sh~ State 1L Zip /76~
Year(s) Commission Paid: 2,,,6
~ :2/,. ~~
2.
AltorneyFees Clcl(.r/e...s E. S/,,'e,ld.s l.!t, IR~.
~7&o.ao
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
/V()AI€
/f/i!1A/E
Street Address
City
State _ Zip
Relationship of Claimant to Decedent
Probate Fees tUC4 "r'J''na,! i SSIA.t!. (5)t ShtH.t et.tt,'f,'C4~
~ ~s.0()
Accountant's Fees 1
. ~ rA.n~t- 13"'u.J::b~ /I
Tax Return Preparer's Fees '
H+R.
aII'd< . T~ Prep.
1J ::T tJ. DO
0>5t5 of Oe.Lu.re eheek~
Adwrli5inJ Ct.c.lI4kJfMIeI La.w ,J;"rital
"f..,Ivpf,j-'A; C'4,./).r!e rbh/iel
FI':/d ,4. (!(!()f4n~
':'/;7 Z"Ia~~,f<<Ift:.~ '4tt /?ekn,
treihl61(,.~~ z: ~s..r/,,'e/C/ ,~k/"~I"'es, f1-s/a~,~.
r 23.50
T' 7 S.OO
I liS". ZS-
'fA
I Jo. Dj)
~/:,-. DD
~$,~.
TOTAL (Also enter on line 9, Recapitulation) $
'7 131. I 7
,
(If more space is needed, insert additional sheets of the same size)
REV.1512 EX. (1.97)
ESTATE OF
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
hI,1-t. Ie?( ttJ~e-.If/
FILE NUMBER
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
PHIL IPS(J~
Include unreimbursed medical expenses.
ITEM
NUMBER
1.
DESCRIPTION
t?e;",.iJu,.~ ~ /)'Iu/,'" ~J#1 pr ~MIIi -I ~J,tt'h1~c~a;'c,,1
h;//,'''fS fA,.e,' v.;f..
;1.1- al.f- /0"7
AMOUNT
If /~3.23
TOTAL (Also enter on line 10, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$ 1~3. -zj
REv-1513 EX + 11-97)
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF ? Ii ILl f3StJA!.
<<),f-L 7~ ttJ/I-/l/let/
FILE NUMBER
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I. TAXABLE DISTRIBUTIONS (include outright spousal distributions)
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
1. V J-A) PH IL 1f''sPN
o/P It 6Y -r: i>i:U.
33 S7A7'4F /l-I"k:
U/tl/S~Gi JI1#- /7f//~
~o/ll
c2/-al/-/~7
AMOUNT OR SHARE
OF ESTATE
/6>0';;
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART IT. 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)
02-20-2006
PHILIPSON
08-21-2004
21 04-1067
CUMBERLAND
101
APPEAL DATE: 04-21-2006
( See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
P~!_~~9~~_!~~~_~~~~______~___~!!~!~_~9~!~_~9~!!9~_~9~-~9~~_~!~9~~~__~--------------------
REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
WALTER W FILE NO. 21 04-1067 ACN 101
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
CHARLES E SHIELDS III
6 CLOUSER RD
MECHANICSBURG
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
PA 17055
ESTATE OF
PHILIPSON
*'
REV-1547 EX AFP (06-05)
WALTER
W
TAX RETURN WAS: (X) ACCEPTED AS FILED
DATE 02-20-2006
) CHANGED
If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15)
16. Allount of Line 14 taxable at Lineal/Class A rate (16)
11. Amount of line 14 at Sibling rate (11)
18. Amount of line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CREDITS:
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)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Recei~'able (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
(1)
(2)
(3)
(4)
(5)
(6)
(1)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
(10)
NOTE:
.00
3.788.43
.00
.00
5.493.97
.00
.00
(8)
9,139.17
143.23
(11)
(12)
(13)
(14)
.00 X 00 =
.00 X 045=
.00 X 12 =
.00 X 15 =
+
DATE
NUMBER
INTEREST/PEN PAID (-)
AMOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
9,282.40
9.282 40
.00
.00
.00
(19)=
.00
.00
.00
.00
.00
.00
.00
.00
.00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A ..CREDIT" (CRJ, YOU MAY BE DU
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 7/05/2006
YOHN MARLIN A, SR
6 HICKORY LANE
MECHANICSBURG, PA 17055
RE: Estate of PHILIPSON WALTER WARREN
File Number: 2004-01067
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6.12 is due on the below listed
date.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103
SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
wills a Status Report of completed or uncompleted administration.
This filing is due by:
8/21/2006
please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
~
cumberland County - Register Of wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 7/05/2006
SHIELDS CHARLES EDWARD III ESQ
SIX CLOUSER ROAD
MECHANICSBURG, PA 17013
RE: Estate of PHILIPSON WALTER WARREN
File Number: 2004-01067
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6.12 is due on the below listed
date.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103
SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing 1S due by:
8/21/2006
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
t.,6... ~ tJ
)17~~~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Personal Representative(s)
~
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Walter Warren Philipson
Date of Death:
August 21, 2004
Will No.
Admin. No.
21-04-1067
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 yPether administration of the estate is complete:
yes--r- No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
1.
3. If the answer to No.1 is Yes, state the following:
a. Did the personal ;xresentati ve
account with the Court? Yes No .
b. The separate Orphans' Court No.
the personal representative's account is:
file a final
(if any) for
c. Did the personal representative state an
account informally to the parties in interest? Yes~ No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
:::::Of ;~:/o~:ns' Court and may &;;;;:;z;;;ort.
I { Signa~ure / ~
Charles E. Shields, III, Esquire
Name (Please type or print)
6 Clouser Road, Mechanicsburg, PA 17055
Address
;'.../
(717 ) 766-0209
Te 1. No.
fJ fl : 11 :.IV ;~17 -',:l,"';;~' C t.:'J-P
'v Ii;: ."u[,
Capacity:
Personal Representative
x
Counsel for personal
representative
(MAH: rmf / AM3)
c/
Register of Wills of Cumberland County
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
) Iq~T~,~ \J~ Q. C2-;U'::<,,-'
Date of Death:
'\J (,,> \i', ,>1 g, I
Q. 0 0 ,-{
Estate No.: 'J.., <"'.J O'-t - j D <-c (1
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following
with respect to completion of the administration of t..'l],e above-captioned estate:
1. State~ether administration of the estate is complete:
Yes~ No 0
2. lithe answer is No, state 'when the personal representative reasonably believes that
the administration will be complete: (\1 J It-,
3. If the answer to No.1 is Yes, state the following:
a. Did t1:! personal representative file a fmal account with the Court?
Yes~ No 0
b. The separate Orphans' Court No. (if any) for the personal representative's
accountis:~ A
c. Did the personal representative state an account informally to the parties in
interest? Yes ~ No 0
c. Copies of receipts, releases, joinders and approval offormal or informal
accounts may be filed with the Clerk of the Orphans' Court and may be
attached to this report. ' //) /J)"
Date: ~(+)~ s,~Z i?/~'~
n J H..l,l, i() PI. lA 0 \'1 {~ j ,~
I
Name
C)
I,
. ",W ) () l(6Q~ Lv.),,, (~
Address V1\ {: C ' [~\ l.. (~C::o 'l:"U' ~-'f\ \ -, 0 S '7
I I, ~ C\ ~l - C[ I 0 <f
Telephone No.
Capacity: [;(Personal Representative
1:rCounsel for personal representative