HomeMy WebLinkAbout02-1089PET;[TION FOR GRANT OF LETTERS OF ADMINISTRATION
Estate of ~ ~-~ ~N ~ ~ ~ , /Vr' ~~ z' R S
also know~7 as
Deceased.
Social Secwrity No. ~n ~" - Lf~ - ~i~~tt
No. 2t' - 0 2 - /OBq
To:
Register of Wills for the
County of _~~'M R~ RcA,vn in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older., appl ~~ t- S for letters of administration
(d.b.n.; pendente liter durante absentia; durante minoritate) on the estate Of
the above decedent.
Decendent was domiciled at death in ~ l..' ^'~ C3 - ~ h n/-D County, Pennsylvania, with
h i 5 last family or principal residence at ~QQ~tf~r y~~? / [-" T ,~/i~ ni ~ ~ f M i,,~OL L i 4 ~/ 77~G°~
(Lst street, number and municinalitvs '
Decendent, then ~ ~ years of age, died •ti~ ~ V
at ~~'' T y M 1,1Zp L C T U N 7-ty P,
~~OQ o~
_,
Decendent nit death owned property with estimated value; as folllows:
(If domiciled in Pa.) All personal property $ ~~, ~ Od , ~ 0
(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_ ascertained that decedent left no will and was survived by
the followin€; spouse (if any) and heirs:
P 1"a"1~ _ ~ ~iZelationsh~p Residence
,M ~` 0 ~3 F T S C~
THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the
appropriate. form to the undersigned.
v ~'hv i 1-s ~ My~
.~ ~ ~
~;, V t n n~ H A R ~2 i ~' T ~'j-
xv
~o
~a
~w
~~
~~ `~~ ~1 ~
~~ ~
RclSlt~ ~,~
1-7- ~ 05-10
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ~ ss
COUNTY OF CUMBERLAND
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 3 ~irdmed and subscribed
before me this - day of
DECEMBER 2002 xx~x ~
t ~
ou
Register ~ ~
No. .?/- oa -/089
Estate of RODNEY A MYERS ,Deceased
GRANT OF LETTERS OF ADMINISTRATION
DECEMBER 4 , 2002 ~gx , in consideration of the. petition on
AND NOW
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that Pft
is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration
LETTERS OF ADMINISTRATION
are hereby granted to
in the estate of RODNEY A M -.-_--
~ (,~-~r~
Register of ~L'ills
FEES
Letters of Administration ..... $ 2 5 • 0 0
Short Certificates( ) .........: $ 15.0 0
Renunciation ............... -
~cp $ 10.00
TOTAL $50•~Q
Filed ...~2.-4'20QZ • • • • . A.D. 19
mailed to admin 12-4-2002
ATTORNEY (Sup. Ct. LD. No.)
ADDRESS
PHONE
217 (...
REV-150Q fX (6-00) COMMONWEALTH OF REV -1 500
PENNSYLVANIA
DEPARTMENT OF REVENUE INHERITANCE TAX RETURN
DEPT.2B1l601 FILE NUMBER
HARRISBURG, PA 17128-0601 RESIDENT DECEDENT ~ I - o~ lO8<f
COUNTYCOOE YEAR NUM:lER
DECEDENT'S NAME (LAST, FJRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
ffi Radnev A. Mvers 168-48-4880
DATE OF DEATH (MM-DD-YEAR) j DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE wrrH THE
fil 11/11/2002 11/4/1971 REGISTER OF WillS
frl (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
C
I'! 0 1 Original Return 02 Supplemental Return 03 RemaillderRBlum(dateofdealhprlorI012_13-82)
~~~ 04 Umiled Estate 04a Future Interest Compromise (date of death after 12-12-82) 05 Federal Estate Tax Retum Required
~&g 0 0
:r~~ 6. Decedent Died Testate {Attach copy of Will} 7. Decedent Ma'lnlalned a Living Trust (Attach copy of Trust) 8. Total Number of Safe Deposit Boxes
Ut'" -
'" 0 0,0 011. Eleclion to tax under Sec. 9113(A) (Altach Sch 0)
,. Litigation Proceeds Received SpousaIPol!ertyCredtt(dateofdeatllbe\wellnlZ.31.9.1and1_1_'d5j
.... rtffl~.~lm\'i~M!lFt,,!l9M.~p;m;g~~ffl.l~m1~g~~Ilm'l!ii~,plli!tli@tN!j~ij!:$M~fI~~T~!i9!![i;\;ij1l'P1~RiP-lqi
z NAME COMPLETE MAILING ADDRESS
w
C Phvllis H. Mvers 1003 Harriet Street
z
~ FIRM NAME (If Applicable) Carlisle, PA 17013
III
w
~ TELEPHONE NUMBER
0
'-' 717 249-3338
OFFICIAL USE ONLY
,. Real Estate (Schedule A) (1) NONE
2. Stocks and Bonds (Schedule B) (2) 2,943
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) NONE
4. Mortgages & Notes Receivable (Schedule 0) (4) NONE
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E) (5) 5,000
6. Joinlly Owned Property (Schedule F) (6) 7,064
Z D Separate Billing Requested
0
~ 7. Inter-Vivos Transfer & Miscellaneous Non-Probate Property
(Schedule G or l) (7) 0
:>
~ 8. TOTAL GROSS ASSETS (total lines 1-7) (8) - -- - 15,007
'-'
:l! 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 12,705
10. Debts of Decedent, Mortgage liabilities, & liens (Schedule I) 10) NONE - -
11. TOTAL DEDUCTIONS (total Lines 9 & 10) (11) 12,705
12. NET VALUE OF ESTATE (Une 8 minus Une 11) (12) 2,302
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not
been made (Schedule J) (13) 0
14. Net Value Subiect to Tax (Une 12 minus line 13) (14) 2,302
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Une 14 taxable at the spousal tax
rate ,or transfers under Sec.9116 (a)(1.2) X .0 (15) 0
-
t5 2,302 .0 ~ 104
~ ,. Amount of Une 14 taxable at I\neal rate X (16)
~ 17. Amount of Une 14 taxable at sibling rate X .12 (17) 0
0
'-' .15 0
~ 18. Amount of Line 14 taxable at collateral rate X (18)
....
19. Tax Due (19) 104
20.0 'JI"Iil"'TIltT'lirllll."'lliU_~..i!ll\illl'
:UI.li_lIiijjrJlk:'..:ar1lilt:::::~]~~e..:..:.: .,.: :"'.::::.:~::~,it. :~~t: ..:':...: .':: ._;;:E~~,:::... .':E:.:.:~:::.. .:.: .I;~ :'.~.~:::::r. _.. :~.:..':: '..: .:..:..: .,:.:..ia:
. .". ."~;:.:,,,-,-,,,,,.'.' :-'-'':-=:..;:;=.;~''.... .. ...c:...~....~~.~:.:.=.:.:.:.c:~.:.:.:.:c:7..,..'.. ....._.,..~' :...c:.:;ry~ . .
\ '\ - I 05- \0
.1il!Qe$Q!'ll;mQ.~RAlilliqQellmlQN$;PN~IiiR$J;\IlIIUtAI!il!:t!!;pm;!lKMj\1'H'iq!'
217
Rodney A. Myers
C
168-48-4880
Decedent's omplete Address:
STREET ADDRESS
1003 Harriet Street
CITY I:TATE IZIP
Carlisle PA 17013
Tax Payments and Credits:
1
2.
Tax Due (Page 1 Line 19)
Credits/Pa}ffTlents
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
104
15
Tolal Credits (A + B + C) (2)
15
3. Interest/Penalty if applicable
D.lnterest
E. Penalty
4.
Total Interest/Penalty (D + E )
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)
(5)
(5A)
(5B)
89
(3)
o
5.
If line 1 + line 3 is greater than line 2, enler the difference. This is the TAX DUE.
A. Enter the interest on the lax due.
B. Enter the total of Line 5 + SA This is the BALANCE DUe.
o
89
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
,.
Did decedent make a transfel' and'.
a retain the use or income of the property transferred;
b. retain the righllo designate who shall use the property transferred or its income;
c. retain a reversionary intecest; or
d. receive the promise for life of either payments, benefits or care?
It death occurred after December 12, 1982,did decedent transfer property within one year of death
without receiving adequate consideration?
Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?
Ves
o
o
o
o
o
o
2.
3.
4.
Did decedent own an Individual Retirement Account, annuity or other non-probate property which
[R]
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEOULE G AND FILE IT AS PART OF THE RETURN.
o
contains a beneficiary designation?
No
[R]
[Xl
[R]
[Xl
[Xl
[Xl
DATE
1003 Harriet Street Carlisle PA 17013
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
'--?7-7 & : &' q6? W~ ~,
~ CI
ADDRESS
/3 Gdo~,v l)~",6' C'19~4'.H.(f ~
DATE
;Jft>.Jft 3
/70/3
For dates of death or. or after July 1, 19S4 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the survMng spouse Is 3%
(72 P_S. Section 9116 (a}(1.1)(i)J.
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 lhe surviving spouse is 0% [72 P.S. Section 9116 (a){1.1)(ii)].
The statute does not exempt a transfer to a surviving spouse from tall, and the statutory requ\rement& for disclosure of assets and filing a tall return are stili applicable even if
the surviving spouse Is lheonly beneficiary.
For dales otdealh on or atter 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 stepparenl ol the child is 0%172 P,S. Section 9116(a)(1.2)J.
The lax rate imposed on the net value of transfers to or for the use of the decedent's lineal oer.eficiaries is 4.5%, except as noted in 72 P.S. Section 9116(1 .2) [72 P.S. Section 9116(a){1)J.
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. Section 9116{a}(1.3)j .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.
217
REV-1503 EX+ (6.98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
Rodney A. Myers
FILE NUMBER
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
2.
3.
4.
DESCRIPTION
VALUE AT DATE
OF DEATH
Legg Mason - 153 sh. Corning
22 sh. Corning - ComputerSare
RBC Cain Rausher - 250 sh Corning
ETrade Account
330
74
548
1,991
TOTAL (Also enter on line 2 Recanitulation' $
(If more space is needed, insert additional sheets of the same size)
2943
AT
REV-tSUB EX +" (t-g?} (I)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Rodney A. Myers
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
Include the proceeds of IlIigation and the dale the proceeds were received by the estate. ALL PRoPER.TY JO\NiLY-ONNED WITH THE RIGHT OF SURVIVORSHIP MUST 6E DISCLOSED ON SCHEDULE F
ITEM
NUMBER
1.
2.
DESCRIPTION
VALUE AT DATE
OF DEATH
Automobile - 1991 Ford Mustang
Personal Property
4,000
1,000
TOTAL tAlso enter on line 5. Recanitu/ationl $
(If more space is needed, insert additional sheets of the same size)
5,000
217
REv.1509 EX+ (6-98)
ESTATE OF
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
FILE NUMBER
Rodney A. Myers
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. Phyllis H. Myers
1003 Harriet Street Carlisle, PA 17013
Mother
B.
C.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %QF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER DR SIMILAR DATE OF DEATH DECO'S VALUE OF
JOINT IDENTIF'r1NG NUMBER. ATTACH DEED FOR JOINTL V-HELD REAl- ESTATE
NUMBER TENANT VALUE OF ASSET INTEREST DECEDENT'S INTEREST
,. A. 10/29/87 Members First Credit Union 4,469 50.00% 2,235
P.O. Box 40 0
Mechanicsburg, PA 17055 0
2. A 4/30/20 Legg Mason 0
419 Stonehedge Drive, Suite 1 0
Carlisle, PA 17013 0
2000 Household Bank CD @6.7'10 2,112 50.00% 1,056
7,000 MBNA Bank CD @6.65'10 7,354 50.00% 3,677
177 Units GNMA GRiT #84 1,865 5.00% 93
Money Market Account 6 50.00% 3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
TOTAL IAlso enter on line 6 RecaDituiationl $ 7064
(If more space is needed, insert additional sheets of the same size)
217
REV.1510 EX"" (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
FILE NUMBER
Rodney A. Myers
DESCRIPTION OF PROPERTY
ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE
NUMBER TRol.NSFER. "IT ACH A copy Of THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (lfAPI'LICA5Lt\ VALUE
1. Members 1 st Federal Credit Union 0
P.O. Box 40 0
Mechanicsburg, PA 17055 0
0
Roth IRA Account #12695 4,532 100.00% 4,532 0
Listed Beneficiary - Philip C. Myers II, Brother 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
TOTAL IAlso enter on line 7 Recanitulationl $ 0
This schedule must be comple\ed and filed if the answer to any of questions 11hrough 4 on the reverse side of the REV-1500 COVER SHEET is yes.
(if more space is needed, insert additional sheets of the same size)
-217
REV-1511 EX + (12-99)
ESTATE OF
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
Rodney A. Myers
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Hoffman Roth Funeral Home 7,013
2. Westminster Cemetery 2,030
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (5)
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address
City Stale Zip
Year{s) Commission Paid:
2. Attorney Fees
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant Phyllis H. Myers
Street Address 1003 Harriet Street
City Carlisle State PA Zip 17013
Relationship of Claimant 10 Decedent Mother 3,500
4. Probate Fees 62
5. Accountant's Fees 100
6. Tax Return Preparer's Fees
7.
TOTAL (Also enter on line 9 Recaoitulatlon $ 12705
Debts of decedent must be reported on Schedule I.
(If more space is needed, insert additional sheets of the same size)
217
R.EV-1513 EX + (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
Rodne" A. M"ers
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON'S' RECEIVING PROPERTY Do Not List Trustee/s\ OF ESTATE
I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and
lransfers under Sec. 9116 (al (1.2)]
1. Phyllis H. Myers
003 Harriet Street
Carlisle. PA 17013 Mother 100%
ENTER DOlLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 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 11- ENTER TOTAL NON-TAXABLE DiSTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0
(If more space is needed, insert additional sheets of the same size)
SeTld Intluires to".
5000 Louise Drive
PO Box 40
Mechanicsburg, PA 17055
www.members1st.org
Member's
Statement
of Account
Account Number From TO Page
12695 11-01-02 11-30-02 1 of 2
.'\ttf", f':"j t)ers 1ST
" . ..j;.~.,;u...... ..... ..!!li l.
:FEDln..\L CHEDH !:N10;"<,j
Main Switchboard:
CaU-24:
TOO,
TeleBranch:
(717) 697-1161 or (BOO) 283-2328
(717) 6-97-43.72 ()( {BGG) 283-43n
(717) 697-5312 or (800) 283-2328ext_ 5312
(717) 195-6049 or (800) 237-7288
CAUGHT IN A BLIZZARD Of
HIGH I NTEREST CREDiT CARDS?
OPEN A MEMBERS 1ST VISA
TODAY. SEE THE ENCLOSED
INSERT fOR MORE INFORMATION.
1...111...111......11..11....11.11.....11..11.11.....11..\..11 15635
RODNEY A MYERS
C/O PHYLLIS MYERS
1003 HARRIET ST
CARLISLE PA 17013-1613
TRANS
DATE
EFF. ..
DATE
TRANSACTION DESCRIPTION
AMOUNT
1105
1106
110402
110502
111502
111502
113002
SUFFIX:OO SAVINGS
TFR TO SHARES
TFR TO SHARES
SHARE WITHDRAWAL
CHECK RECEIVED
o I V I DEND
JOINT OWNERS:
12695REG-D TRANSACTION
12695REG-D TRANSACTION
-12.67
-19.02
-59.90
175 .46
6.31
BALAN.CE
.
4376.91
4364.24
4345.22
4285.32
4460.78
4467.09
PHYlLI SMYERS
Y-T-O DIVIDENDS:
TRUTH IN SAVINGS INfORMATION
ANNUAL PERCENTAGE YIELD / 1.75%
ANNUAL PERCENTAGE YIELD EARNED / 1.75%
56.48
----------------------------------------------------------------- ------------ ---
SUFFIX:11 CHECKING
BEGINNING BALANCE .00
DEPOSITS 31.69
DRAfTS 31.69 TOTAL NUMBER DRAF S CLEARED 2
DEBITS/FEES .00
MAINT/SERVICE CHGS .00 YOUR AVG DAILY BA ANCE WAS .00
END I NG BALANCE .00 YOUR LOW "'ONTH BA MICE WAS .00
1105
1105
1106
1106
110402 SHARE DRAFT # 348
110402 TfR FROM SHARES 12695-00
110502 SHARE DRAFT # 347
1 ]0502 TFR FROM SHARES - 12695-00
1104017540
1105031621
-12.67
12.67
-19.02
* *1:'~2t *
MO.
TOTAL:
-12.67
.00
-19.02
.00
* ~"c
,,: ,'t ~ * * j, * ~': *- * * * * *- * *- * * * *-
*- * * * *- * *- * * * * *
*' * j,
MO. AI\OUMT MO. /lNlUlrT MO. A"'OUNT
347 19.02 348 12.67
JOINT OWNERS: PH Illll P C MYERS
Y-T-D DIVIDENDS: .00
TRUTH IN SAVINGS INFORMATION
ANNUAL PERCENTAGE YIELD / 1.00%
AI\OUNT
31.69
SUFFIX:12 ROTH IRA SAVINGS
113002 DIVIDEND
4532.24
6.67 4538.91
-SEND ALL INQUIRES TO THE CREOIT UNION Al THE ADDRESS SHOWN ON PAGE If 1
, "t '," 1'"
~l;i/@: li'Y!l.~~t'''~
,~'v.i(:L..bers. '
'rT:In~H,A.t u.o;Url C\'JO,"\
15636
Account Number " FrOm To Page
12095 11-01-02 11-30-02 2 of 2
TRANS EFF. ',' .." TRANSACTlON'PJ:,SCRIPTION " AMOUNT BALANCE
DATE DATE ."
BENEFICIARIES: PHILLIP C MYERS II
Y-T-D DIVIDENDS: 73.70
TRUTH IN SAVINGS INfORI'tATION
ANNUAL PERCENTAGE YIELD ~ 1.80%
ANNUAL PERCENTAGE YIELD EARNED 1.81%
--- ------ ------------------------------------------------------- ------------ ---
PLA~ SUMMA RY FOR ACCOUNT: 12695
I'LI'.N NU'-" 12
12
PLA~ SUMMA ~Y FOR ACCOUNT: 12695
PLAN NUM: 0
15 16
FOR 2002
f, IRA YTD * OTHER YTD * TOTAL YTD * TOT L YTD ,~ TOT L YTD *
DIVIDENDS DIVIDENDS DIVIDENDS WITH OLDING fOR E ITURES
73.70 56.48 130.18 .00 .00
I
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. CORNING
(.omputershare
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RODNEY A MYERS
1003 HARRIET STREET
CARLISLE PA 17013
1,.,111".111",1,.11"11""11.11...,,11,.11,11,,,,.11,,1,,11
:omoutershare Trust Co.. Inc.
P.O. Box 240
Danver Colorado B0201-0240
Within the US, Canada & Puerto Rico: 8887439848
GuIS;"" tne US, Canada & Pue.!o Rico: 732491 067C
http://WWW-us.cDmputershare.com/empIDyee
I.WIIIIIIIIIIIII.WII~llti
Account Number
168484880
Statement Period
01 Jan 2002 - 31 Dee 2002
Please advise Computershare Trust Co., Inc.
Irri'mediBleJy o(an)/aiscrepancieson youfSlatement
WORLDWIDE EMPLOYEE SHARE PURCHASE PLAN - Account Summary
""$".~r"''''''.~~''
f _-'""""
~..-~~~
.-
Summary of Holdings
Security Description
Symbol
Opening Position I
(11 Jan 2IlO2 I
Closing Position I
31 Dee 2IlO2
Closing Share Price I' Closing Share Value
31 Dee 2IlO2 ~) 31 Dee 2002 ($)
CORNING INC.
GLW
22.459600
22.459600
3.310000
74.34
Summary Information
Description
This Period 01 Jan 2002 - 3t Dee 2002 ($ll
Year to Date 01 Jan 2(102 - 31 Dee 2(102 ($l
Reportable Proceeds
Reportable Dividends
0.00
0.00
0.00
Q.\)I)
Please note that yout' closing balante from last y~ar and your opening balance from this year may be different if you had any activity between 12127 and 12/31 of
last year. This Is due to any sales transactions initiated last year that had a settlement date during this year. If applicable, these sales transactions were reflected
on your prior year statement and are also Included in the "Transaction Details" of this statement.
Please be advised that these sales transactions will be reported correctly on your resulting Form 1099 or 1042-5 of the previous Tax Year and will not be included
on your Form 1099 or1042..s for the cunent TaK Year.
If you need to speak to a Participant SeMce Representative, caD weekdays between the houls of 8;ooAM and 7:00PM ET at the above is1ed number.
This statement may not reflect the investment of all funds deducted from your pay since intonnation may be receNeO 'rsy us m\er \ne s~~ oprepara\\on date.
Please retain this statement for your records. This statement should not be used io!" tax reporting purposes.
~ Please note your statement detail appears on the reverse 01 this form.
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is 131~H:I\lH EOOl
S<J3Al^i \I A3NOO<J
~
..
pR~~,~~~ED
Account Statement
Legg MascR Woo-a Wa/Hei', fm:otp01tJU3d
Membe>- New Veri: S~cJf &otc.'i:mjjf'l; f~J.\r(:.'frbm" SJPC
PAGE
A.CCOUNT,
LA,
1
360-02803
Gl.{4
SEPTE~$ER 3D, 2002
LAST STATEt1ENT
.}uN'€. )0. 2002
RODNEY A MYERS
1003 HARRIET ST
CARLISLE PA n013-1613
"!OUFc FIHA!>IC:tAL ADVISOR
GRl';G L HGtULLEN
;,;',GG H..l\SQN \~DOD ~U"U(f;R me
41.9 STONEHEDGE DRIVE
',lilT!;: 1
(;;,I',-':<:S1..F. P1I 17t'l;)-!n2fl
,7U; 2~3-<l363 (IJOO) 34[1-1'176
r\CCD\1NT VALUl::
EQ1.lITIES
244.80
IIU-',\OXIMl'.1'E VA.LUE
"l'tlIS S'lATEME.N'!
[,AST $TATEI-n;:NT
24<1.80
543.1S
'ieu \~'i H~N;:;' P'\.lRCB1\.$'ED ).fO'!1}Y\L FUNDS, A.'m\jIT:IE:S, LIM.!'tlo;l)
fAUTNERSHIPS OR OTHER INVESTMENTS WHICH ARE NOT REPORTED AS
POSITroNS ON 'flUS STATEMgt~T. If'SO. YOU WILL RECEIVE PERIOD!C
:';~TP,'H~M~N1'S DIRECrL'i F~CM THE fUND, INSURANCE COMPANY OR
PJlJ,TNERSiHP.
00RT>O~IO ~U}~~R,
SEcu~rTIES PRICBS USBD IN YOUR PORT.OLIO ~UMHARY ARE OBTAINED rROM OUTSIDE SERVICES AND TnEIR ACCURACY CANNOT as GU~TE~n.
THESE: 1fJl..l>Uf.f> AI'\E I'ROVIDED A3 A ,,E!lE.Rl:\l, GUIDE BUT INSOH'E CASES MAY NO'!, m.:rI,E:CT TJiE ACTUAL M1l.RKET PRICE_ If' A1') Er.ACT PRICE IS
NE8DED c:mrrAC1' YOl1R FlNANCH\L AD\lJSQR.
E:Qurrn:s
Q\JJINTI'ty
PRICE
MARKe'!' VALUE
-- E'.S'1'IHA'u:n --
ANNUAL CURRENT
INCmlE YIELD
W5CRJ.PTTON
')53
CORNltOG INC
~2H 80
1.60
MARKET VALUE OF EQUITIES $74~.ao
lOO.O~ of PORTFOLIO
!'.CCOUNT INSTROCTIO.."S
INVESTMENT OBJECTIVES
INVESTI~E:NT OB.1EcnVES FOR 'lOUR ACCOVN'! ARE S~~ BEl,OO. H'"tOU li]WF; MY QUESTIONS COl'JCERNING TliESE OSJECTIVES, OR WISH TO
CHANGE TflEH, PLEASE CONTACT 'lOUR F1:lJANCH\.I, ADVrSOR.
1. L.ONG T8RM GROWTH 2. :!:NcOt-1E & GROWTH 3. SIiORT T;i:RM GROW'I'H
~2LIVERY INSTRUCTIONS
SECUkITIES IN YOUR ACCOUNT WILL BB HBLD 81 LEGG MASON FO~ "tOUR BSNEFIT.
C:11~qH MUIl~cr-~S wiLl. BE. REi-\) IN YQUf'. ACCOUNT.
;,8GG t'Jl.SOl'l WOO\) WALKf.l<, INCORPORATE.D, (LMH\.~\ DIR;';'CTI., CLIENTS' ORDERS TO A NtlMBER OF MARKET CE:NTERS DEPENDING ON
11\lf;RE 1.'HOSE: S!i;ClJR1XHlS i'.RE TRADED, 1'iii: D?:<'I)Rl'\}}llTY FOR PRICE INrROVEHENT, ?liE TU1E!..J:.NESS OF EXECllTION, AND THE QUALI?X
',"W S"~RVICE. UPON ,'!RTTTE1~ REQUEST, LMWW WILL PROVIDE !NPI'/lDUAL ORDER ROU'l'lYG HISTORY f"OR THE PRtOR srx HQNTIlS, LHt-~W
STATEMENT CONTINUED ON REVERSE SIDE
SEE EMCLOSEO EROKERAGB ACCOUNT STATEMENT OISCLOSURE FOR IMPORTANT ~NrOR~~Tlrn~
JJ3
Lt1YY\i~
100 \I, I!) 2--00 1-
(! 4{"l . l(p 1 ~M.f (CII>:>i~~l
~ 330 LtC( v~
l:YV\.
~~~
\J~
---
I.., H...... - J 11 c............ur.........lr"''J -777'7/ r-r.1An.o::\rolr Ict":l-tP1'T'lpnt~ / opt rln~ Tn 0) C"t'\
1')/11/')nn'f
..
P~~~~~D
Account Statement
Lemt~Wood~ mt-OipO(at~d
J.~f.1~b~New YOf"k $hleJr ~"~. tm:J~~llfSIi"'C
PAGE
!lCCOUNT,
f.A.
,
360-02337
G~N
()C1'Onl':~ 33., ::0002
PHYLLIS tl toiYERS ..
,WDNSt A HYERS
PORS'FOLIO S:J11VJ\RY (CONTINUED)
q::wrI FTC;\'!:;:'] OF 1Jl<:POSIT
()IIANTI';'Y
DESCRIPTION
PRICE
:MARKET VALUE
n ESTIt-l1\,TED --
ANNUAL CURRe:~lT
INCOME YIEI,O
,,(lOG
\\B.~fI. i'MER ~"- 'A ~ \\'>:.,<,AAK ue'L
C/D E~DL INSD TO 100M ACli3ES
DATED DATE O~/22/99
DUE. C'l/22/2.Ga4 6.650"0 MS 22.
1.\;)-'\. 'Hi,
1,2')1.69
5465..50 6. 3~,
Jt '" Z ,c.fq
+
4-'\ t>A.q
o f- ::D"'T'i It 'i. ~ <f
~J\RKET VALVE OF CERTIFICATES OF DEPOSIT
lao.o~ OF eO~r~)LIO
$9, :!1~.. 35
$599.50
G.3~
Accou~r INSTRUCTIONS
:NVESTHENT OBJECrlVE;S
;:NVf.STh'll;:~'r 08Jf.C1'I\'ES "QR YOUR p..ccotlNT ARE S.RO'<IN 8ELOW. I. YOU HAVE ANY QUESTION.S CONCf:r-.NtNG THESE OBJF.C1'IVEt,:, OR WISH TO
Cl-iANGt.: THSH, PLEASE CONTACT YOUH FINi'l.NCI.'lJ.. ADVISOR.
1. HICOME Z. Pf<.E.SERVATION OF C1\?I.Tf\L
fSNANCY INSTRUCTIONS
JOINT T!i:NANTS InTI! RIGHTS OF SURVI\!OCtSRti'.
i)[;',LIVl;:RY INSTKUCTIm:s
SE:CUR!TIE:S IN YOUR ACCOUNT WILL BE. HE;t,O BY !.EGG Hl'.SON fOR YOUR iiEN"E:FIT.
CASH BAhl>NCE$ ~lrLI, BE HELD IN YOUR ACCOUNT.
END OF STA'i'El-relfT POP. ACCODNT 36D-[)2337
-- V A L- \A ~ T .;:O,.J 11-11-0"2---_
(-01 8.. L--
Mo""~ '( V\^A,..{.2..\l.'t-'" ::. if ",,37
H 0 I.tS n-l 0 c. j) 1!!>A.N t<-- L)) f!.(,.7o "70 .., $t .2,0 8' '3 . b l:, "
1. 000
I ~t.tflu~b z.".:> 1"" Eo ,Q.~ S ., /( 'Zfs-.b'i J
,
-(VI. BfV~ (;..b~"7o ~ 7,291.19",
7000 1'"..:>/<- .:::..1:> e.
I tJ b1...'19
A c.c:.(2..U[b 'Z:tVyf./l ~_Yl - -
/77 lA",,~r,::, ~wtA G/tl.-X1 ::ti '6"tf =- tJ I ~b4, 'i'9
.
,oTfl.t..- \,M L-Ll. t ... :t ) I} 337- 7<-}
(~iJ ~Cl.-@~-t ,,s, J'Tw RoS <So \ )7- IS 'l.50
r~~1 ot e&.~h. owY\e-r5 edo...te DC' # 5~fo g- ..2(7-
I
"-
l<ttn ./I1p:oow()rk.c:.? .7777/('.nlrln~r.k/~t~tf":mf":nt~/pf":tno(':Tn a.c:.n
17/11170m
118
P.ID?~~~ED.. .
.'\"" \,,'(
AccOeunt Statement
Legg Mason Wend-Walker, !nco1poral(!d
,~,,"';1~" ,'oN;; 'f"....\: 5~~.,.,. &dmtll1~. hl:',.!:';~~'~.t-~l" '5:'~
<'AGE
ACCOUNT,
E'.A.
360-023::0
GI-14
O"TOBER 31. 2002
LA~;T STATEMEt{1'
Sf~EMBER 3D. 20Q7
YOill<. !"lNANcrAL ADVISOH
,,"EG L W:WJI.LlW
.- F;GG ("'....SQN l--JOOD WALKER HIe
"19 S~0NEHEDGE DRIVE
:,U1Ti'; I
C)CltlL,SLE FA l'I013-')l:t~
ern; 'i.Sf:l-.t:lEi3 I[jQQ) 348-17,6
}\.CCOU:,T VAl.DE
INCOMS b RELRT~P INFbRMATI0~
C! ;j(i. BJ\LA.!'iCE
Ct;!':l;. FIC~Ti'.S OF' DE;POSl'r
1,(171.26
9, 31;,. 3~;
1''HIS HQNTH
YEAH TO DA'tT
"l',',W;GV,ATE: "Al.UI::
(>'r:H-r.~ 1.lJcCMi:.
CREDIT INTERE~~T
INTEREST
T01'J\L INc.~e
1.77
G.OD
1.TI
15.72
59!1.50
615.?:?
THIS STATEl-1E;wr
l,AST STATEMEHT
1l,2H; 61
11,2'19 81
TA.XllBLE INCONE
<_77
G':'5. :,~
YO\! l1F.Y IIAVE PI)RCHASED HUTUAL t'UNDS, .'\NNUITIES, UNlTED
PAR't'NF.RSHIPS OR OTHER INVESTMENTS WHICH ARE NOT REPoRTECi )\S
POsr'l'lot~5 ON ['Ins STATEMENT. IF SO. YOU WILL RECF.tVr: PERJOrnc
<,TN~~HEN"S DIREC't:i.Y FROH 'l'HE: .m.m. iNSURANCE COI.{PAN. O~
PAfrl'HE:RS}lIP.
':ASlI BAUH'<fO; SUNHl>.RY
OP';:IHNG [ll,V\.NCE
,-L.OSING BJI.lJ\.NCE
CASH
1.369.49
1,871.26
\$f.,<1. ~"I
...
110,"$7
JNCONE ACTIVITY
[V.TE 'rRl\NSACTION
.l()!~jl INTEREST
QUANTITY
DESCRIPTION
INTEREST ON CREDIT BAI.ANCE
AT 1.05a~ 09/28 THRU 10/30
eRICE.
PHOl.ltlT
$1. :;
l'()",-')'YQl.I 0 :;U!-!N..~,Y
Sf::r:1I1HTU;S PRICES USED :en YOUR PORTFOLIO SUMW\.o'<:Y I\RE OBTAINED F'B:OM OUTSIDE SglWrCES JUID THE!.\', l't::CI.,RAC'f CMNO't Bf,. GUARANTEED.
'iH?81', VI'IL\lF..S Ar<B I'RDV1DED AS A G~EAAL GU!i)E FlU"r INSOMF. ,.,ASES M.r>,y NOT R8FLEC't .tHE J\.C'fOAL M.,Rl<t.'f PR1CF,. U' A.N F,XACT PInel:: 15
NEE:J),,:D CoNl'AC'l' YOUR FINA-T-JCIAL ADVISOR.
C:E?T1F1CP.'rRS {)1;' DEPOSIT
Vu!>:,.;'tlYi
DE:SCRIPTION
f'R1CE
MARKET VALUE.:
-~f.S"IMATEiJ --
i'J'iNUI\L OJRREWI
INCONE YI ELD
2.000
ffO(1SEUOLD ElK FSB PROS PCT lJ:Gll.TS
JLL C/D n:DL INSD TO 100,..(
!\CT!36S
DATED DATE 08/25/99
OUR OBI2:.12004 6.100~ FA 2:'
1()'l.lil3
$2,NI3.GG
$13.'.00 6.,1':.
-- 412"8'. "tJ
+I~ 1>A~ ~
:r,NTt.fl.>. S r
STA1TJ4~ Cm1TIl<.\,lE.t1 ON i\E\/E.RS;:. SLI:%
SEE EUCLOSED BROKERAGE A.CCOUNT ST';TEt,ocUT DISCLOSURE fOR IMPOHTANT INfORHli.1'ION
II.l.D1..-
f;>OiA.G,I-li
117
lA,/':J<:;TS,
G-t-R..r:,
F-Hts I Tfl-...;::; r
'" t'1
ToTAl..-
oC-
;# I '6~'i. '('1
f
-
/,/,IE:cSE --?/ZE //VC,Lv.t;)/::"";O
/A/ ~M~ ~t;c
5 U .m/7?/9;ey
httD :lllegl!Works2: 7777/coldoacklstatementsl getDocID .asp
12111/2002
COMMONWEALTH OF PENNSYLVANIA
REV-1162 EX111-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
N0. CD 002131
MYERS PHYLLIS H
1003 HARRIET ST
CARLISLE, PA 10713
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
fold
ESTATE INFORMATION: ssrv: iss-4s-4s$o
FILE NUMBER: 2102-1089
DECEDENT NAME: MYERS RODNEY A
DATE OF PAYMENT: 02/05/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 1 1 / 1 1 /2002
REMARKS: PHYLLIS H MYERS
CHECK#841
SEAL
101 ~ $89.00
TOTAL AMOUNT PAID:
INITIALS: JA
RECEIVED BY: DONNA M. nTTn
REGISTER OF WILLS
589.00
DEPUTY REGISTER OF WILLS
CDMMDNWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE INFORMATION NOTICE
BUREAU of INDIVIDUAL TAXES FILE NO. 21 02-10$9
DEPT. 280601 AND ACN 0310$7$$
HARRISBURG, PA 171zs-o6o1 TAXPAYER RESPONSE
DATE 03-12-2003
REV-1545 E% ~FP (09-00)
TYPE OF ACCOUNT
EST. OF RODNEY A MYERS ®SAVINGS
S . S . N0. 168-48-4880 ^ CHECKING
DATE OF DEATH 11-11-2002 ^ TRUST
COUNTY CUMBERLAND ^ CERTIF.
REMIT PAYMENT AND FORMS T0:
PHYLLIS H MYERS REGISTER OF WILLS
1003 HARRIET ST CUMBERLAND CO COURT HOUSE
CARLISLE PA 17013 CARLISLE, PA 17013
MEMBERS 1ST FCU has provided the Department with the information listed below which has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of
this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy
to this fora and return it to the above address. This account is taxahle in accordance with the Inheritance Tax Laws of the Commonwealth
of Pennsylvania. Questions may be answered by calling (717) 787-8327.
COMPLETE PART 1 BELOW ~ * ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 12695-00 Date 10-29-1987 To insure proper credit to your account, two
Established (2) copies of this notice must accowpany your
Account Balance 4,347.30 Paywent to the Register of Wills. Make check
payable to: ^Register of Wills, Agent".
Percent Taxable X 50.000
2, 173.65 NOTE: If tax payments are made within three
Amount Subject to TeX C3) months of the decedent's date of death,
TeX Rate X .045 You way deduct a 5% discount of the tax due.
97.81 Any inheritance tax due will becowe delinquent
Potential Tax Due nine (9) wonths after the data of death.
PART TAXPAYER RESPONSE
€A~ `. ~~:::: ~::: .: ::~:.::::::~::::
A. ^ The above information and tax due is correct.
1. You nay choose to remit paywent to the Register of Wills with two copies of this notice to obtain
CHECK a discount or avoid interest, or you may check box "A^ and return this notice to the Register of
ONE ~,_,/ Wills and an official assesswent will be issued by the PA Departwent of Revenue.
BLOCK ~ B. M The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
ONLY P(! to be filed by the decedent's representative.
C. ^ The above information is incorrect and/or debts and deductions were paid by you.
You must complete PART 2^ and/or PART 3^ below.
PART If you indicate a different tax rate ...:::::::::.-::::-.,.;.,...
Please state Your ;'sifii~=iiii'ii;iiii~ii_iis~f
relatsonshsP to decedent. ;::~:;_::~ :::::::::::.:.::::::::::::: ,.,..~...::::;~::::::::-::~ :~~~:::::::::;-::~:::::::::: ~::::::::::::::::::.....::::~::::::::::::::
i';'.. .}. .. ...~.f. .;:;:r;
:::::::::~::::::::~::~::ss:;::s:aa::<t:[:r~~::::;:;:;:;~:;:::;:;:::~::::::~:.:.:.:.:~a
- ::::~:~::::::::~s::::::.~<~a~ ::::
[~~ s'iiiiiisisiiizl!f :.........:..:.....i.c.!.~~.aa..::##..EE.:.:€i~~:'~~iii:tt,FF:':i:t;~~:-::°.~.;.i'.i~i~~isi€iii
~;191?F:~ i:~::s:IS:l~17~~:~ si:€~::_:~;:
X RET -
URN COMPUTATION
OF °':::~::::::€~~!!~liii€
TAX ON JOINT~TRUST ACCOUNTS A~~€~- :::.:.:.:
........
..
. szii;i;i~€=€=~ii~ii€~€_€€€€~ ~~~€~:~€_?~€:€°:€_;:~;:;:=;,=;:~::~s:::::_:::
::::,:_::::::::;::;_:;:;:::;:;:;::::,;:;:;:;:;:;:;:;:;:;:::::;,;:;:::;:;:;:;:;:~;:;:;::~:~;::;:;:~:~:
LINE
1.
Da a Established
1 .
:::
;::::.:;::::
•~ ~~~~~-~•
:
:
:
:
:
:
:
:
2. Acc
Balance
2 :
~
:
::::::::::::::::::::::::::::::
;_:::::_::;:;:,.:: ~ ::::::::::::
::::~~:. :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::
::::::
:
:
:
::::::::::::::::::::~:::::::::::::
::::~:;:;:~~:;:;:;:;:;:;:;:::;:::::;:::;:;:::;:;:;:;:;:;:;:;:;:~::;~:;:::;:;:;::~:;:::;:;:~;:;:;:~€:~€:;::~:;;::.
ent Taxable 3 X • • •• •• ••• • •• • ••
nt Subject to Tax 4 ~
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5. Debts and Deductions 5 - :::::.:::::::.:: ~:_s:;:;:::;:; :;:,:;:;:~:;:;:;:i:~;:::::::~::::~::~::::_::~:~::::~::~:~:~t:t:::::::ra::,:;:;:;:;:::::
6.
Amount Taxable
6 sins:`i~i€i€i€;;i;i'i€i€i`i€i€i~i;i;i~ii€
t::;:;:~€:;::;:~ ::::::~:z:~::~:
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:::~:z::!:;~::::::::;a~ :::::::::::::::::::::::::::~:::~:::::::::_:~:::::::::::::::::::::::::::~-:::::::::::::
.....................:..: . ::::::::.:.:.:...:...:.....:.:.:.:.:.:.:.:...:.:.:.:.:.:...:.:.:.:
x Rate 7 X :.:;~=::::;:;.. _:.:;:::;:;:,; :::.::::::::::::~::;:;:;:;:;:;~:,:::;:;:;:;:;:;:;:,:;,;:;:;:::;:;:::;::~;:;:;:~::~::::~::::~:s:::::~::s::::s
Tax D
ue
g €;i`i€i€i;i€iii'i='°:€i€i; ;~ €iii€s
::::::::::::~s:::::::~ s ::::::: ~;~ ii€: ~;::~ :~ is:::;s:::;:::it:[::::€:::::€::~ ::::::::~ ~ ::::s:; ~:€:;:':::~::::;:; ~_:::::::::::~:,::
:::::.s::;:~s::~:::;::s:::s;::::::~::::
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PART
DEBTS AND DEDUCTIONS CLAIMED :
s:
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s::~::~:::~:~:::::~:~::::::::~:_:::::s::_=:;s:;s:_~:~~:_::
0
DATE P AID PAYEE DESCRIPTION AMOUNT Pain
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
c p ete to the best of my knowledge and belief . HOME C~ ~ ~ , v7 ~ ~ -3 ,3 3
J WORK C'l i-1 I o~ c-l S-~( (a'13 ,3- / ~f -03
TAXP R SIG ATURE TELEPHONE NUMBER DATE
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based on information
submitted by the financial institution.
2. Inheritance tax becomes delinquent nine months after the decedent's date of death.
3. A joint account is taxable even though the decedent's name was added as a matter of convenience.
4. Accounts (including those held between husband and wife) which the decedent put in joint names within one year prior to
death are fully taxable as transfers.
5. Accounts established jointly between husband and wife more than one year prior to death are not taxable.
6. Accounts held by a decedent "in trust for" another or others are taxable fully.
REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE
1. BLOCK A - If the information and computation in the notice are correct and deductions are not being claimed, place an ^X^
in block ^A^ of Part 1 of the "Taxpayer Response" section. Sign two copies and submit them with your check for the amount of
tax to the Register of Wills of the county indicated. The PA Department of Revenue will issue an official assessment
(Form REV-1548 EX) upon receipt of the return from the Register of Wills.
2. BLDCK B - If the asset specified on this notice has been or will be reported and tax paid with the Pennsylvania Inheritance
Tax Return filed by the decedent's representative, place an "X" in block "B" of Part 1 of the "Taxpayer Response^ section. Sign one
copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Dept 280601, Harrisburg, PA 17128-0601 in the
envelope provided.
3. BLOCK C - If the notice information is incorrect and/or deductions are being claimed, check block "C" and complete Parts 2 and 3
according to the instructions below. Sign two copies and submit them with your check for the amount of tax payable to the Register
of Wills of the county indicated. The PA Department of Revenue will issue an official assessment (Farm REV-1548 EX) upon receipt
of the return from the Register of Wills.
TAX RETURN - PART 2 - TAX COMPUTATION
LINE
1. Enter the date the account originally was established or titled in the manner existing at date of death.
NOTE: Far a decedent dying after 12/12/82: Accounts which the decedent put in joint names within one (1) year of death are
taxable fully as transfers. However, there is an exclusion net to exceed 53,D00 per transferee regardless of the value of
the account or the number of accounts held.
If a double asterisk (~*) appears before your first name in the address portion of this notice, the 53,000 exclusion
already has been deducted from the account balance as reported by the financial institution.
2. Enter the total balance of the account including interest accrued to the date of death.
3. The percent of the account that is taxable for each survivor is determined as follows:
A. The percent taxable for joint assets established more than one year prior to the decedent's death:
1 OIVIOED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF X 100 = PERCENT TAXABLE
JOINT OWNERS SURVIVING JOINT OWNERS
Example: A joint asset registered in the name of the decedent and two other persons.
1 DIVIDED BY 3 [JOINT OWNERS) DIVIDED BY 2 [SURVIVORS) _ .167 X 100 = 16.7% (TAXABLE FOR EACH SURVIVOR)
B. The percent taxable for assets created within one year of the decedent's death or accounts owned by the decedent but held
in trust far another individual(s) (trust beneficiaries):
1 DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE
DWNERS OR TRUST BENEFICIARIES
Example: Joint account registered in the name of the decedent and two other persons and established within one year of death by
the decadent.
1 DIVIDED BY 2 (SURVIVORS) _ .50 X 100 = 50% (TAXABLE FOR EACH SURVIVOR)
4. The amount subject to tax (line 47 is determined by multiplying the account balance (line 2) by the percent taxable (line 3l.
5. Enter the total of the debts and deductions listed in Part 3.
6. The amount taxable (line 6l is determined by subtracting the debts and deductions (line 5) from the amount subject to tax Cline 4).
7. Enter the appropriate tax rate Cline 7) as determined below.
Date of Death Spouse Lineal Sibling Collateral
07/01/94 to 12/31/94 3% 6% 15% 15%
01/01/95 to 06/30/00 0% 6% 15% 15%
07/01/00 to present 0% 4.5%* 12%
~..w a.......+.. _.... 15%
e ..ve.- of ar v
Hunger at
*The tax rate impasea on me nn~ moo. ~ ~~ ••~••~•o•- ••-••• - --------
death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is D%.
The lineal class of heirs includes grandparents, parents, children, and lineal descendents. ^Children^ includes natural children
whether or not they have been adopted by others, adopted children and step children. ^Lineal descendents" includes all children of the
natural parents and their descendents, whether ar net they have been adopted by others, adopted descendents and their descendants
and step-descendants. ^Siblings" are defined as individuals who have at least one parent in common with the decedent, whether by blood
or adoption. The "Collateral" class of heirs includes all other beneficiaries.
CLAIMED DEDUCTIONS - PART 3 - DEBTS AND DEDUCTIONS CLAIMED
Allowable debts and deductions are determined as follows:
A. You legally are responsible for payment, or the estate subject to administration by a personal representative is insufficient
to pay the deductible items.
B. You actually paid the debts after death of the decedent and can furnish proof of payment.
C. Debts being claimed must he iteeized fully in Part 3. If additional space is needed, use plain paper 8 1/2^ x 11". Proof of
navmant may be requested by the PA Department of Revenue.
__ _
...
CERTIFICATION OF NOTICE UNDER RULE 5.6(al
Name of Decedent: _ ~ ~~ ~ ~ ~ / " ~
Date of Death: ~ ~ '-'
Will No. Admin. No. t~ V~~ ~~ ~ ~ C
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 3 `" /~ - Q 3
Name Address
~~ i J ~~ ~~ _~ io~~3 I-4~~~'R ~ ~~ S fi
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
Signature
Name ~_-~--~,~-,
Address ~ ~ ~ 3 ~~~~~~--...)
Telephone ( )"~ I ~ ~ ~/ ~ - _~ ~ ~ c~
Capacity: Personal Representative
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COMMONWEALTH OF PENNSYLVANIA
REV-1162 EX111-961
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 002297
MYERS PHYLLIS H
1003 HARRIET ST
CARLISLE, PA 10713
fold
ESTATE INFORMATION: ssN: iss-4s-4aso
FILE NUMBER: 2102-1089
DECEDENT NAME: MYERS RODNEY A
DATE OF PAYMENT: 03/ 1 7/2003
POSTMARK DATE: 03/14/2003
COUNTY: CUMBERLAND
DATE OF DEATH: 1 1 / 1 1 /2002
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
101 ~ $10.32
TOTAL AMOUNT PAID: $10.32
REMARKS: PHYLLIS H MYERS
CHECK# 2750
INITIALS: CW
SEAL RECEIVED BY: DnNNA M nTTn
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
/~-ice - ~d
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
PHYLLIS H MYERS
1003 HARRIET ST
CAR
A.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FILE NO.
COUNTY
ACN
REV-16Q EX (12-97) PC
03-17-2003
MYERS RODNEY A
11-11-2002
21 02-1089
Cumberland
101
LISLE PA 17013 Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
Register of Wills
Cumberland County Courthouse
Carlisle, PA 17013
CUT ALONG THIS LIN_E____________ b _ RETAIN LOWER PORTION FOR YOUR RECORDS a
REV-1547 EX (06-97) PC NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR ------------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MYERS RODNEY A FILE NO. 21 02-1089 ACN 101
DATE 03-17-2003
TAX RETURN WAS: ® ACCEPTED AS FILED ^ CHANGED
RESERVATION CONCERNING FUTURE INTEREST -SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
(1)
0
0
NO
2.
Stocks and Bonds (Schedule B) .
0 TE: To insure proper
3.
Closely Held Stock/Partnership Interest (Schedule C) (2) 2,943.00 credit to your account,
4.
Mortgages/Notes Receivable (Schedule D) (3) 0.00 submittne u
peer portion
5.
Cash/Bank Deposits/ Misc. Personal Property (Schedule E) (4) 0.00 of this form with your
6.
Jointly Owned Property (Schedule F) (5) 5,000.00 tax payment.
7.
Transfers (Schedule G) (6) 7,064.00
8.
Total Assets (7) 0.00
APPRO VED DEDUCTIONS AND EXEMPTIONS: (8) 15.007.00
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10.
Debts/Mortgage Liabilities/Liens (Schedule I) (9) 12,705.00
11.
Total Deductions (10) 0.00
12. Net Value of Tax Return (11) _12,705.00
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (12) 2,302.00
14. Net Value of Estate Subject to Tax (13) 0.00
NOTE: If an assessment was issued previously, lines 14, 15 and/or
h 18, 17 a nd 18 will reflect figures 302.00
t
at include the total of ALL returns assessed to date.
ASSESSMENT OF TAX„
15. Amount of Line 14 at Spousal rate
16. Amount of Line 14 taxable at Lineal/Class A rate
17. Amount of Line 14 taxable at Sibling rate
18. Amount of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS:
(15) 0.00 X .00 0.00
(16) 2,302.00 X .045 104.00
(~ 7) 0.00 X .12 0.00
(18) 0.00 X .15 0.00
(19) 104.00
• - - • nca.c~r ~ DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID - AMOUNT PAID
02-05-2003 CD002131 4.68 89.00
PAYMENT MUST BE MADE BY 08-11-2003 *.
• IF PAID AFTER DATE INDICATED, 3E8 REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
TOTAL TAX CREDIT 93.68
BALANCE OF TAX DUE 10.32
INTEREST 0.00
~ TOTAL DUE I 1032
(IF TOTAL DU8 IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A CREDIT (CR), YOII MAY SE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
RESERVATION: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B
(collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby 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: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 21 of 1995. (72 P.S. Section 9140).
PAYMENT:
REFUND (CR):
OBJECTIONS:
Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side. Make check or money order
payable to: REGISTER OF WILLS, AGENT.
A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania
Inheritance and Estate Tax (REV-1313). Applications are available at the Office of the Register of Wills or any of the 23 Revenue District Offices, or by
calling the special 24-hour answering service numbers for forms ordering: In Pennsylvania 1-800-362-2050, outside Pennsylvania and within local
Harrisburg area (717) 787-8094, TDD# (717) 772-2252 (Hearing Impaired Only).
Any party in interest not satisfied with the appraisement, allowance or disallowance of deductions, or assessment of tax (including discount or interest) as
shown on this Notice must object within sixty (60) days of receipt of this Notice by:
--written protest to the PA Department of Revenue Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR
--election to have the matter determined at audit of the account of the personal representative OR
--appeal to the Orphans' Court.
ADMINISTRATIVE
CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: os
Assessment Review Unit, Dept. 280601 Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 3 of the booklet "Instructions for Inheritance Tax
Retum for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors.
DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death a five percent (5%) discount of the tax paid is allowed.
PENALTY: The 15% tax amnesty non-participation penalty is computed on theriod.ITh shnonX articiratont aenal Ses a nd alabpe inthe same manner and in the same
January 18,1996, the first day after the end of the tax amnesty p P P P ~' PPe
time period as you would appeal the tax and interest that has been assessed as indicated on this notice.
INTEREST: Interest is charged beginning with first days 19812 bear intere t at the rate of s zn(6 %) percent per annumacalculated at a dailyaate of .000164. Alai taxes
which became delinquent before January
which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that ra e
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2001 are:
Interest Daily Interest Daily
Interest Daily Year Rate Factor
Year Rate Factor Year Rate Factor
1982 20% .000548 1987 9% .000247 1999 7% .000192
1963 16% .000438 1988-1991 11% .000301 2000 8% .000219
9% .000247 2001 9% .000247
1984 11% .000301 1992 0 .000164
1985 13% .000356 1993-1994 7% .000192 2002 6/0
1986 10% .000274 1995-1998 9% .000247 2003 5% .000137
--Interest is calculated as follows:
INTEREST =BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X 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 assessment. If payment
is made after the interest computation date shown on the Notice, additional interest must be calculated.
l ~-, ~ ~~~: ~~ i; ~,
BUREAU OF INDIVIDUAL TAXES COMMONWEALTH OF PENNSYLVANIA
- DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 1~1za-D601 NOTICE OF INHERITANCE TAX
APPRAISEHENT ALLONANCE OR DISALLONANCE
OF DEDUCTION, AND ASSESSMENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS REV-1548 ER ~FP (81-85)
DATE 03-31-2003
ESTATE OF MYERS RODNEY A
DATE OF DEATH 11-11-2002
FILE NUMSER 21 02-1089
COUNTY CUMBERLAND
PHYLLIS H MYERS SSNiDC 168-48-4880
1003 HARRIET ST ACN 03108788
Amount Remitted
CARLISLE PA 17013
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~
----------------------------------------------------------------------------------------------------------------
REV-1548 EX AFP (01-03)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 03-31-2003
ESTATE OF MYERS RODNEY A DATE OF DEATH 11-11-2002 COUNTY CUMBERLAND
FILE N0. 21 02-1089 S.S/D.C. N0. 168-48-4880 ACN 03108788
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT N0. 12695-00
TYPE OF ACCOUNT: CX) SAVINGS ( ) CHECKING ( ) TRUST C ) TIME CERTIFICATE
DATE ESTABLISHED 10-29-1987
Account Balance
Percent Taxable
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate
Tax Due
TAX CREDITS:
.00
X 0.500
.00
.00
.00
X .45
.00
NOTE: TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE T0:
"REGISTER OF WILLS, AGENT."
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT (+)
INTEREST/PEN PAID (~-) AMOUNT PAID
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .OD
* IF PAID AFTER THIS DATE, 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" ( CR), YDU MAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
PURPOSE OF
NOTICE: To fulfill the requirenents of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2DOD. C72 P.S.
Section 9140).
PAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the
reverse side.
-- Make check or money order payable to: REGISTER OF WILLS, AGENT.
REFUND (CR): A refund of a tax credit, which was not requested on the tax return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax^ CREV-1313). Applications are available at the Office of
the Register of Wills, any of the 23 Revenue District Offices or by calling the special 24-hour answering service
for farms ordering: 1-800-362-2050; services for taxpayers with special hearing and or speaking needs:
1-800-447-3020 (TT only).
OBJECTIONS: Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions or assessment
of tax (including discount or interest) as shown on this Notice may object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Oept. 281021, Harrisburg, PA 17128-1021, OR
--electing to have the matter determined at the audit of the account of the personal representative, OR
--appeal to the Orphans' Court
ADMIN-
ISTRATIVE
CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, DEPT. 280601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-15017 for an explanation of administratively correctable errors.
DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5%)
discount of the tax paid is allowed.
PENALTY: The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
INTEREST: Interest is charged beginning with first day of delinquency, or nine C9l months and one (1) day
from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982
bear interest at the rate of six C6%) percent per annum calculated at a daily rate of .000164.
All taxes which became delinquent on or after January 1, 1982 will bear interest at a rate which will vary from
calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable
interest rates for 1982 through 2D03 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Vear Rate Factor Vear Rate Factor
1982 20% .000548 1987 9% .000247 1999 7% .000192
1983 16% .000438 1988-1991 11% .000301 2000 8% .000219
1984 11% .000301 1992 9% .000247 2001 9% .000247
1985 13% .000356 1993-1994 7% .000192 2002 6% .000164
1986 10% .OOD274 1995-1998 9% .000247 2003 5% .000137
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen C15) days
beyond the date of the assessment. If payment is made after the interest computation date shown an the
Notice, additional interest must be calculated.
/''1-/~~` ~o
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
PHYLLIS H MYERS
1003 HARRIET ST
CARLISLE
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
REV-1607 E% AFP (01-037
DATE 04-14-2003
C!"; ,- ESTATE OF MYERS RODNEY A
DATE OF DEATH 11-11-2002
FILE NUMBER 21 02-1089
~O3 APR 2$ P3 :Q~ COUNTY CUMBERLAND
ACN 101
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this fora with your tax payment.
CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~1
----------------------------------------------------------------------------------------------------------------
REV-1607 EX AFP (01-03) ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ~*~
ESTATE OF MYERS RODNEY A FILE N0. 21 02-1089 ACN 101 DATE 04-14-2003
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 03-11-2003
PRINCIPAL TAX DUE:
104.00
PAYMENTS (TAX CREDITS):
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT C+)
INTEREST/PEN PAID C-) AMOUNT PAID
02-05-2003 CD002131 4.68 89.00
03-14-2003 CD002297 .00 10.32
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
* IF PAID AFTER THIS DATE, SEE REVERSE I TOTAL DUE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN 51,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
104.00
.00
.00
.00
PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address
printed on the reverse side.
-- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF WILLS, AGENT.
-- If NON-RESIDENT DECEDENT make check or money order payable to: COMMONWEALTH OF PENNSYLVANIA.
REFUND (CR): A refund of a tax credit, which was not requested an the Tax Return, may be requested by completing an
"Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at
the Office of the Register of Wills, any of the 23 Revenue District Offices ar from the Department's 24-hour
answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and / or
speaking needs: 1-SDD-447-3020 (TT only).
REPLY TO: Wuastions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau
of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601, phone
(717) 787-6505.
DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5%) discount
of the tax paid is allowed.
PENALTY: The 15% tax amnesty non-participation penalty is computed an the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period.
INTEREST: Interest is charged beginning with first day of delinquency, ar nine (9) months and one C1) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of
six (6%) percent per annum 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 calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates far 1982 through 2003 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Y_ar Rate Factor
1982 2D% .000548 1987 9% .000247 1999 7% .000192
1983 16% .000438 1988-1991 11% .000301 2000 8% .000219
1984 11% .000301 1992 9% .000247 2001 9% .000247
1985 13% .000356 1993-1994 7% .000192 2002 6% .000164
1986 10% .000274 1995-1998 9% .000247 2003 5% .000137
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X 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 assessment. If payment is made after the interest computation date shown an the
Notice, additional interest must be calculated.
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 12/01/2004
MYERS PHYLLIS H
1003 HARRIET ST
CARLISLE, PA 10713
RE: Estate of MYERS RODNEY A
File Number: 2002-01089
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
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 will become delinquent on: 11/11/2004
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Counsel
Judge
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 10/19/2005
MYERS PHYLLIS H
1003 HARRIET ST
CARLISLE, PA 10713
RE: Estate of MYERS RODNEY A
File Number: 2002-01089
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
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: 11/11/2005
Your prompt attention to this matter will be appreciated.
Thank You.
SincerelYr
It", . (~. .. f - L. ~
)!tJ~._0~d"~~
c/
GLENDA FARNER STP~SBAUGH
REGISTER OF WILLS
cc: File
Counsel
Judge
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Register of Wills of Cumberland County
STATUS REPORT UNDER RULE 6.12
Name of Decedent: ~ t)b tJ E: Y A. fI/\ 11:;: 6<.S
Date of Death:
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Estate 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:
Ye~ No 0
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:
a. Did the persOI,~~.epresentative file a final account with the Court?
Yes 0 No~
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal represe~~state an account informally to the parties in
interest? Yes 0 No ~
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.
Date: d 0
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Signature ~~
Phy I lIs' H, M'It;:fl-5.
Name
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Address C /f- ;< LIS: L t.-
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Telephone No.
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Capacity: ~rsonal Representative
1] Counsel for personal representative
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