Loading...
HomeMy WebLinkAbout02-0349PETITION FOR GRANT OF LETTERS OF ADMINISTRATION also known as To: Deceased. Social Security No. 2 c) q - a/ ~ -~ t9 ~ ( ~ The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older, appl5 Register of Wills for the County of (_~u/A6~t~'~3 Commonwealth of Pennsylvania in the for letters of administration on the estate of (d.b.n.; pendente lite; durante absentia; durante minoritate) the above decedent. Decendent was domiciled at death in t/It~ ~g~qLAr,,' C3 County, Pe.nnsylvania, with h i ~ last family or principal residence at I~ (list street, number/and municipality) Decendent, then ~ ~ years of age, died at /4 (., ,~te --' 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: ,4,/~ Petitioner.__ after a proper search ha__ the following spouse (if any) and heirs: Name Relationship ascertained that decedent left no will and was survived by Residence THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the appropriate form to the undersigned. 55-1 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OF 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 aff~r~ed and subscribed befor~pn~e~ this '~: day of RIL 2002 ~ ~RY C LEWIS/ Re~iste~ AND NOW No. 2t- OIZ--,Sqq JAMES W WHITCOMB , Deceased GRANT OF LETTERS OF ADMINISTRATION APRIl, 8. 2002 ~ , in consideration of the petition on the reverse side hereof, satisf~$t~y~oon~ h~_~_~g~t~ presented before me, IT IS DECREED that is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration are hereby granted to K~[-I M WHTCOV~ in the estate of JAMES W WRTq~C. OMR FEES 18.00 Letters of Administration ..... $ Short Certificates( ) .......... $ ~ 5.00 Renunciation ................ $ 5.00 jcp $ 5.00 TOTAL __ $ 43.00 Filed 4-8-2002 A.D. 19 mailed to attny on 4-8-02 ATTORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE RENUNCIATION 21 - 02.- ~4q In Re Estate of deceased. To the Register of Wills of County, Pennsylvania. The undersigned ~]G~'f ~' '~(~fr"'/"/'~.~;~-('- ~//'~'~"*~¢(-'~')~ of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters WITNESS hand this day of ,49-------'-. /.~ )~ ~_~/'~/3 (Address) ~c ~ 9'o7 (Signature) (Address) (Signature) (Address) IN RE: THE ESTATE OF JAMES W. WHITCOMB COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION No.: 2002-00349 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: Pa. File Number: JAMES W. WHITCOMB MARCH 31, 2002 21-02-0349 Administration Number: 2002-00349 To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on May 11, 2002. See copy of notices attached hereto. Name Address Kenneth M. Whitcomb, 781 Humer Street, Enola, PA 17025-2633 Melony B. Leininger, 138C Benjamin Drive, Lexington, SC 29073 Notice has now been given to all persons entitled thereto under rule 5.6(a) Date: May 17, 2002 126 Locust Street P. O. Box 11489 Harrisburg, PA 17108-1489 (717) 238-3838 Counsel for Personal Representative NOTICE OF BENEFICIAL INTEREST IN ESTATE BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERS, PENNSYLVANIA In Re Estate of JAMES W. WHITCOMB, deceased, No.2002-00349 TO: Kenneth M. Whitcomb (beneficiary) 781 Humer Street Enola. PA 17025-2623 Please take notice of the death of decedent and the grant of letters to the personal representative named below. You may have a beneficial interest in the estate as follo~v: One-half of estate. Name of Decedent: Last Known Address: Date of Death: Place of Death: JAMES W. WHITCOMB R201 Bridge Street, New Cumberland, PA 17070 March 31, 2002 R201 Bridge Street, New Cumberland, PA 17070 County of grant of original letters: Cumberland Decedent died intestate (i.e., xvithout leaving a will).. Name, address and telephone number of all personal representatives appointed: Name Address Telephone Kenneth M. Whitcomb 781 Humer Street. Enola. PA 17025-2623 732-0348 Name, address and telephone number of all counsel: Name Address Kenneth A. Wise, Esquire 126 Locust Street. Harrisburg, PA. 17101 Telephone (717) 238-3838 Additional information may be obtained from the undersigned. DalSe "'/''- '// Signature Kenneth A. Wise, Esquire 126 Locust Street, P. O. Box 11489 P. O. Box 11489 Harrisburg, PA 17108-1489 (717) 238-3838 Capacity:__Personal Representative _X_Counsel for Personal Representative NOTICE OF BENEFICIAL INTEREST IN ESTATE BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, PENNSYLVANIA In Re Estate of JAMES W. WHITCOMB, deceased, No.2002-00349 TO: _Melony B. Leinineer (beneficiary) 138C Benjamin Drive Lexin.mon. SC ~9073 Please take notice of the death of decedent and the grant of letters to the personal representative named below. You may have a beneficial interest in the estate as follow: One-half of estate. Name of Decedent: Last Known Address: Date of Death: Place of Death: JAM~S W. WHITCOMB R201 Bridge Street, New Cumberland, PA 17070 March 31, 2002 R201 Bridge Street, New Cumberland, PA 17070 County o f grant of original letters: Cumberland Decedent died intestate (i.e., without leaving a will).. Name, address and telephone number of all personal representatives appointed: Name Address Kenneth M. Whitcomb 781 Humer Street. Enola. PA 17025-2623 Name, address and telephone number of all counsel: Name Address Kenneth A. Wise Es uire 126 Locust Street Harrisbum. PA. 17101 Telephone 732-0348 Telephone (717) 238-3838 Additional information may be obtained from the undersigned. Db. te /" Kenneth A. Wise, Esquire 126 Locust Street, P. O. Box 11489 P. O. Box 11489 Harrisburg, PA 17108-1489 (717) 238-3838 Capacity:__Personal Representative __X___X Counsel for Personal Representative IN RE: THE ESTATE OF JAMES W. WHITCOMB COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION No.: 2002-00349 PRAECIPE FOR ENTRY OF APPEARANCE TO THE CLERK: Please enter my appearance as attorney for the Estate of James W. Whitcomb in the above-captioned matter. Date: .~/12 2d~02~ Respectfully, Kenneth A.eW~se, Esquire I.D. No. 16142 126 Locust Street P.O. Box 11489 Harrisburg, PA 17108-1489 (717) 238-3838 PSEC the financial linkTu NOTICE OF CLAIM OF CREDITORS In the Matter of the Estate of James Whitcomb, Deceased. State of Pennsylvania County of Cumberland The above named decedent and his/her estate are indebted to Pennsylvania State Employees Credit Union (PSECU) as hereinafter set forth. The total amount of the aforesaid claim, namely, Personal Service Loan, $4,910.02 is now owing to PSECU by the estate of the said James Whitcomb, deceased, and no part of the same has been paid. ( BY ~5~-...D~ana W~llUard, Account Advisor PENNSYLVANIA STATE EMPLOYEES CREDIT UNION Main Address: I Credit Union Place, Harrisburg, PA 17110-2990 · (717) 234-8484 - (800) 237-7328 Mailing Address: P.O. Box 67013, Harrisburg, PA 17106-7013 · (717) 777-2100 (TDD) · (800) 472-1967 (TDD) Web Address: www. psecu.com Savings federally insured up to $100,000 by the National Credit Union Administration. DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 IN H E RITANC E TAX RETURN RESIDENT DECEDENT Z ~U 0 ~oo < DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) use a blank block to separate words W H I T C J ~4 B J A M E S W. SOCIAL SECURITY NUMBER DATE OF DEATH (I~"APPLICABLE) SURVIVING 8PI~USE'8~NAME ([A8~, FIRS'~-, AND MIDDLIEIINtTI/~ ' -~:;IAt 8ECURi'rY NUI,,~ER DATE Of BIRTH l] q THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS E~l. Odginal Retum [] 4. Limited Estate [] 6. Decedent Died Testate (Attach copy of Will) [] 9. Litigation Proceeds Received [] 2. Supplemental Retum [] 4a. Future Interest Compromise (date of death after 12-12-82) [] 7. Decedent Maintained a Living Trust (Atach copy of Trust) [] 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) [] 3. Remainder RetUm(dateofdeathp~to12-13-82) [] 5. Federal Estate Tax Retum Required __ 8. Total Number of Safe Deposit Boxes [] 11. Election to tax under Sec. 9113(A) (Atach Sch O) THIS SECTION MUST BE COMPLETED; A~ CORRESPONDENCE AND CONFIDENT~L TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS FIRM NAME (If Applicable) TELEPHONE NUMBER 1 Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation,Partnership or Sole-Proprietorship (3) 4 Mortgages & Notes Receivable ISchedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 6. Jointly Owned Properly (Schedule F) (6) 7 Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) (7) 8, Total Gross Assets (total Lines 1~7) 0 '0 0 0 .0 0 0 '0 0 0 .0 0 5 8 4- 5 3 0 ,0 0 0 .0 0 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent. Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 5,9 15 8 (8) 26 -0 0 29 .3 4 (11) 12, Net Value of Estate (Line 8 minus Line 11) (12) 13, Charitable and Govemmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) made (Schedule J) 14, Net Value Subject to Tax (Line 12 minus Line 13) (14) ' 584 '5 3 21 ,7 5 5.3 4 , (2 1 ,1 7 0 .8 1 ' , 0'0 0 o o o 15. Amount of line 14 taxable at the spousal tax rate , , x .0 (15) See ins~ctions on reverse side for applicable percentage 16. Amount of line 14 taxable at6% rete , ~ x .06 (16) 17. Amount of line 14 taxable at 15% rate , ~ X .15 (17) 18. Tax Due (18) 19. > > ;BE SURE TO ANSWERALL QUESTIONS ON RE"V'ERSE SIDE AND RECHECK MATH< < 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 PERSOB, RESPONSIBLE FOR FILING RETURN ADDRESS ~/~ ~/~ ~J~__ 781 Humer Street SIGNATURE/~ ~"Y~ ~"/'~ '~///?-~-~'OF PREPARER OxTY)~E~T HA N REPRESENTATIVEIZbLo&D'DBE%S cuet DATE 3/t3/03 DATE ~!~ ~!n~ Decedent's Complete Address: STREET ADDRESS CiTY I STATE Tax Payments and Credits: 1. Tax Due(Page 1 Line 18) 2. Credits/Payments A. Spousal Poverty Credit B. Pdor Payments C. Discount Total Credits ( A + B + C ) (2) 3, Interest/Penalty if applicable D, Interest E. Penalty Total Interest/Penalty ( D + E ) 4. If line 2 is greater than line 1 + line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 19 to request a refund 5, If line 1 + line 3 is greater than line 2, enter the difference, This is the TAX DUE. A, Enter the interest on the tax due, B, Enter the total of Line 5 + SA. This is the BALANCE DUE. Make Check Pa (3) (4) (5) (5A) to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ............................................................. [] [] b. retain the right to designate who shall use the property transferred or its income; ................ [] c. retain a reversionary interest; or ............................................................................................. [] [] d. receive the promise for life of either payments, benefits or care? ......................................... [] 2. If death occurred on or before December 12, 1982, did decedent within two years preceding death transfer property without receiving adequate consideration? If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................. [] [] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ...................................................................................................................... [] 4. Did decedent own an individual retirement account, annuity, or other non-probate property? .... IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN ~2 P.S. §9116 (a) (1.1) (i) provided for the reduction of the tax rate imposed on the net value of transfers to or for the use of the surviving spouse from 6% to 3% for dates of death on or after July 1, 1994 and before January 1, 1995. 72 P.S. §9116 (a) (1.1) (ii) provided for the reduction of the rate imposed on the net value of transfers to or for the use of the surviving spouse from 3% to 0% for dates of death on or after January 1, 1995. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. FOR DATES OF DEATH ON OR AFTER JANUARY 1, t995 - Please answer the following question by placing an "x" in the appropriate space. Did the decedent create a trust or similar arrangement which is solely for the surviving spouse's benefit for his or her entire lifetime? Yes [] No [] If you answered yes to the above question, the tax on the trust or similar arrangement is postponed until the death of the second spouse, at which time it will be fully taxable at the rate(s) applicable to the remainder beneficiary(les). Enter the value of the trust on Schedule J, Part II, in order to remove it from the calculation of the tax due in this estate. You may wish to file Schedule O in order to make the election available under Section 9113. If the election is made, the trust or similar arrangement is taxed in the estate of the first decedent spouse, the portion of the trust or similar arrangement which benefits the surviving spouse is taxed at the zero tax rate, and the remainder is taxed at the rate(s) applicable to the remainder beneficiary(les). If you choose to make the election, you must attach Schedule O to a timely-filed tax return, along with Schedule(s) K and/or M in order to show the apportionment of the trust or similar arrangement between the surviving spouse and the remainder beneficiary(les). REV-I~=O'2EX + (1-97} ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which prope~ would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts, Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION None. TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH REV-1503 EX + (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER All property jointly.owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. None. -0- TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) REV-I~O7'EX + (7-88) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE D MORTGAGES AND NOTES RECEIVABLE Please Print or Type ESTATE OF FILE NUMBER (All property jointly-owned with the Right of Survivorship must be disclosed on Schedule F.) ITEM DESCRIPTION VALUE AT NUMBER DATE OF DEATH None. TOTAL (Also enter on line 4, Recapitulation) S (If more space is needed, insert additional sheets of same size.) REV-1508 EX + ~.1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER 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. Cash on Hand. Waypoint Bank and P.S.E.C.U. Pentium I. computer, TV, miscellaneous clothing, mattress, miscellaneous personal clothing 384.53 200.00 TOTAL (Also enter on line 5, Recapitulation) $ 584.53 (If more space is needed, insert additional sheets of the same size) REV-1509 EX+ (12-88) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER Joint tenant(s): NAME ADDRESS RELATIONSHIP TO DECEDENT Ao Bo Co Jointly-owned property: LETTER ITEM FOR DATE NUMBER JOINT MADE DESCRIPTION OF PROPERTY TOTAL VALUE DECD'S DOLLAR VALUE OF TENANT JOINT OF ASSET % INT. DECEDENT'S INTEREST 1. TOTAL (Also enter on line 6, Recapitulation) S (If more space is needed insert additional sheets of same size) REV-1510 EX +(1-97). ~ · COMMONWEALTH OF PENNSYLVANIA INHERIT^NCR TAX RETURN RESIDENT DECEDFNT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY % OF ITEM ~.CLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUI A~DACH A COPY OF THE DEED FOR REAL ESTATE. NUMBER VALUE OF ASSET INTEREST CFAPPUCANLE) 1. (S.E.R.S. death annuity of $102,015.78 paid to sister of decedent. See 7/19/02 L~tter to Melony Leininger from S.E.R.S. (attache~)) TOTAL (Also enter on line 7, Recapitulation) $ 0.0 0 (If more space is needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA STATE EMPLOYEES' RETIREMENT SYSTEM 30 NORTH THIRD STREET - P.O. BOX 1147 HARRISBURG, PENNSYLVANIA 17108-1147 TOLLFREE: 1-800-633-5461 www.sers.state.pa.us July 19, 2002 MELONY LEININGER 138C BENJAMIN DR LEXINGTON SC 29073 Re: JAMES WWHITCOMB SSN: 209-46-0612 Dear Beneficiary: We are writing to you regarding the above named account. The enclosed forms must be completed by you, according to the printed instructions, before we can proceed with the processing of this account for payment. Please note: The Retirement Code does not provide for the payment of interest on the principal sum of a death benefit. If you are a spouse, please read the enclosed information pertaining to the recent change in the Federal tax law. Also, please complete the Election form and the Trustee to Trustee Transfer (if applicable) and return to the system as soon as possible. If you are not a spouse, please complete the Withholding Election form along with the required forms and return to this system as soon as possible. To aid you in making an option selection, the following information is provided. Death Benefit Payable to you: Taxable Portion: Non Taxable Portion: $102,015.78 $101,544.66 $471.12 Ifyou have any questions orneed assistance, please contactthefield office nearestyou at 1-800-633-5461. Sincerely, Linda M. Miller, Director Benefits Determination Division Enclosures BEN65 I i11111 Illll IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII II!1 IIII REVo1511EX + (1-~7} ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT 5. 6. 7. FUNERAL EXPENSES: Richardson Funeral H~ne, Inc. (headstone to be pUrchased~ ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Year(s) Commission Paid: Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Zip Street Address C~ Relationship of Claimant to Decedent State Zip Probate Fees Register of Wills. Accountant's Fees Tax Return Preparer's Fees 4,968.00 900.00 58.00 TOTAL (Also enter on line 9, Recapitulation) $ 5,926.00 (If more space is needed, insert additional sheets of the same size) REV-1512 EX * (1-97) ~. ~_ ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 2. 3. 4. 5. 6. 7. 8. 9. Ton~ Kelley (Rent) Robin Gasperetti, tax collector Minim~d Dist. Corp.. (diabetes supplies) ' Holy Spirit H~spital Frederick M. Minium, D.D.S. Comcast P.S.E~.C.U. (loan) Waypoint Bank (loan) Kenneth Whitco~ (paya~_n. t of' funeral expenses¢ attorney fees) 333.00 11.00 ~9.95 25.00 9.90 11.37 4,910.02 10,480.00 TOTAL (Also enter on line 10, Recapitulation) $ !5: P2q..34 (If more space is needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS (include outright spousal distributions) H. [INSOLVENT ESTATE] ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE [INSOLVENT ESTATE] B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART I! - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheels of the same size) . BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0~0] KENNETH M WHITCOMB 781 HUMER ST ENOLA PA 17025 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX DATE OF DEATH F_[L~ NUHBER '03 ~Y 16 ACN 05-12-2005 WHITCOMB 05-51-2002 21 02-0549 CUMBERLAND 101 Amount Remitted JAMES W MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS -~ ~-: [ ~- - ~ -A ~- -~ ~i~-~ ~3- ~ 6~-~ ~- ~-~ - ~-fi ~ ~-~ - ~X~ - ~ ~ ~ ~- -~ £/~-~-~ - ~- ................. DISALLOWANCE OF DEDUCTIONS AND ASSESSNENT OF TAX ESTATE OF NHITCOMB JAMES W FILE NO. 21 02-05~9 ACN 101 DATE 05-12-200~ TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Rea1 Estate (Schedule A) 2. Stocks and Bonds (Schedule B) $. Closely Held Stock/Partnership Interest (Schedule C) ~. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misco Personal Property (Schedu/e E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. 12. 15. 1~. NOTE: ASSESSMENT OF TAX: 15. Amount of Line 1~ at SpousaZ rate 16. Amount of Line 14 taxable at Lineal/Ciass A rate 17. Amount of L/ne 1~ at Sibling rate 18. Amount of L/ne 1~ taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDITS= Total Deductions Net Value of Tax Return Char/table/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) Net Value of Estate Subject to Tax If an assessment was issued previously, lines reflect figures that include the total of ALL (15> (16) (17) (18), (1) .00 c2) .00 ($) .OO c~) .00 cs) 584.55 c6) .00 ¢7) .00 (8> 5,926.00 (9) c10) 15,829.5~ Cll) (12) (15) (14) 15 and/or 16, 17, returns assessed to date. · O0 x O0 = · O0 x 045 = · O0 x 12 = · O0 x 15 = C19)= NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 584.5:5 21,170.81- .00 21,170.81- 18 and 19 ~ill .00 .00 .00 .00 .00 PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX CREDIT I I BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 .00 .00 .00 C IF TOTAL DUE IS LESS THAN *1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CA), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) REGISTER OF WILLS OF CUMBERLAND COUNTY STATUS REPORT BY PERSONAL REPRESENTATIVE UNDER RULE 6.12 NO. 2002-00349 Name of Decedent: JAMES WILSON WHITCOMB Social Security Number: 209-46-0612 Date of Death: 3-31-02 Name of Personal Representative: Kenneth Whitcomb Capacity: Personal Administratorr Is the administration of the estate complete? Yes. Insolvent Estate If yes, how was the administration ended: Insolvency. See Inheritance Tax Return, filed in this action. Inheritance Tax Return Notice of Inheritance Tax Appraisement is attached hereto. Total amount paid to date for creditors and for funeral and administrative expenses 5,926.00 Inheritance Tax paid 0.00 Total value of distributions to date to beneficiaries 0.00 I certify under penalty of perjury that the foregoing information is correct to the best of my knowledge, information and belief. Date: Kenneth M. Whitcomb Personal Representative BUREAU OF INDIVIDUAL TAXES Im~6P. ITAN~E TAX DIVISION DE'PT. 280~01 HARRISBURG, PA I?I2B-O~O1 KENNETH M WHITCOMB 781HUMER ST ENOLA PA 17025 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE 05-12-2005 ESTATE OF WHITCOMB DATE OF DEATH 05-51-2002 FILE NUMBER 21 02-0549 COUNTY CUMBERLAND ACN IOI Amount Remitted JAMES W MAKE CHECK PAYABLE AND REMIT PAYMENT REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS -~ REV-15q7 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF WHITCOMB JAMES W FILE NO. 21 02-0549 ACN 101 DATE 05-12-2005 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) (2) 5. Closely Held Stock/Partnership Interest (Schedule C) ($) ~. Mortgages/Notes Receivable (Scheduie D) (4) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Scheduie H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (lO). lI. Total Deductions 12. Net Value of Tax Return 15. NOTE: 19. Princl TAX CREDITS O0 O0 O0 O0 584 55 O0 O0 (8) 5,926.00 15~829.5~ (Il) (12) NOTE: To insure proper credit to your account, sub.it the upper portion of this form with your tax Payment. 58q.55 21,170.81- IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. RECEIPT NUMBER PAYMENT DATE · O0 x O0 = . O0 · 00 x 045 = .00 · O0 x 12 = . O0 · O0 x 15 = . O0 (19)= .00 AMOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUEJ INTEREST AND PEN. TOTAL DUE .00 .00 .00 .00 ( IF TOTAL DUE IS LESS THAN *1, 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.) DISCOUNT (+) INTEREST/PEN PAID (-) ASSESSMENT OF TAX: 15. Amount of Line lq at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line lq at Sibling rate (17) lB. Amount of Line lq taxable at Collateral/Class B rate (18) ~al Tax Due Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) .00 Net Value of Estate Subject to Tax (lq) 21,170.81- If: an assessment was issued previously, lines 1~, lB and/or 16, 17, 18 and 19 will refiect figures that inciude the totai of ALL returns assessed to date.