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HomeMy WebLinkAbout02-0366 PETITION also known as 1'o: FOR PROBATE and GRANT OF LETTERS 21-02-366 · Deceased. Social Securio' No. _ I-} (~o- I 0 -- 3-~ ~ _~'~ Re,islet o1' Wills for the CoUnty of (---fO gnloe,"lov~ ~_ Cc, n'mlonwealth c,f Permsylvania ]'lie petition of the undersigned respectfull.~ rcprescms that' Your petitioner(s), who is/are 18 year~ ol age o~ older an ~he cxccut~C~ in the last wilt ol the above decedent, dated ~O~C ~ k and codicil(s) dated F~r~ t~~ t'~.~O in the named , 19~ Decendem was domiciled at death in C~e~~ ~ Coumy, Pennsylvania, with h 5 ~ last family or principal residence at ~M { ~CID~ L~ g . Ili-I .tteet. number and mtmcipdhl>/ Decenden, ,,,e~ ~a ,'ears of age, died x4c, b0,5 ' '---- '_ Except hs lqllo~xZs~ decedent did not m~trrv. ,, as not tlr orccd and did not have a child born or adopted after execution of tt~e will offered for probate: ~ta~ not thc vicmn of i1 killiug and was never adjudicated incompetent: Decendent at death owned property with estimaled values as follov, s: (If domiciled in Pa.) All personal property $ (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: WHEREFORE, petitioner(s) respectfully re_queq(~) tile probate of the last will and codicil(s) presented herewith and the grant of letters' I~c,um~cnuu~ :' admmi~ralitm c.t.a.; administration d.b.n.c.l.a.) theron. OATH OF PERSONAL REPRESENTATIVE COMMONWEALTlt OF PENNSYLVANIA ~ COUNTY OF C&~kae;'l°mc--'/ f ss The petitioner(s) shine-named swear(s) or affirm(s) that file statements in the foregoing petition are true and correct to the best of the k.owledge and belief of pelitioner{s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer lhe estate according to law. Sworn to or affirmed ailS subscribed ~ ~~~ before me this 9th day of ~t.'~-J~ ~.~ o~ ~(,-~X{ ~' NO. 21-02-366 Estate Of FREDERICK T SPACICMAN , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW APRIL 10 ~t~ 2002, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated SEPTEMBER 1, 1999 and FEBRUARY 1, 2000 described therein be admitted to probate and filed of record as the last will of. FREDERICK T SPACKMAN ; and Letters TESTAMENTARY are hereby granted to TIMOTHY JOHN SPACKMAN AND FREDERICK JOSEPH SPACKMAN FEES Probate, Letters, Etc .......... $ 235.00 Short Certificates( ) .......... $ 30.00 A'rrORNEY (Sup. Ct. I.D. No.) 27. OO ~e-pag.e s. nunmaUon ................ $ JCP ~ v. 50 ADDRESS - ' CODICIL $ TOTAL __ $ 307.50 PHONE u~,~is~ o~ w~,~s o~ ~ s¢O~~ ""',~ OATH OF SUBSCRIBING W S CO //' (each) a subscribing witness to the w .ill pr~d,,~;ewith, (each) being duly qualified according to law, depose(s) and say(s) that ~'./,//~~ present and saw, the testat , sign the same and that., signed as a witness at the request of testat~ in h~ pres~ce and (in the pres ther) (in the presence of the other subscribing witness(es)). Sworn to or affirmed and subscyibed before me this .." day of ©~ / Register (Address) (Name) (Address) R~,SX~ OV Wn~,~S OV ~~,/~4 COVSX~ OATH OF NON-SUBSCRIBING WITNESS (each) a subscriber hereto, (each) being duly qualified accordinAo law, depose(s) and say(s) that .a~ e' familiar with the signature of codicil testat &)_.fl~, of (one of the subscribing witnesses to) the will presented herewith and codicil that '~,~ believes the signature on the will ig i"'--'-'~ the handwriting of to the best of /~e.'~' . knowledge and belief. Sworn to or affirmed and subscribed before me this~~ day of --V'~ '~me) ~;~/~/~;'"<~'~e~/~~. //~(,d~ess)~m '(Ad ess)' ' ~ ~ 7 Register (Na~e) (Address) t7o// CODICIL I 21-02-366 To the LAST WILL AND TESTAMENT OF FREDERICK T. SPACKMAN I, FREDERICK T. SPACKMAN, declare this the First Codicil under my Last Will and Testament, dated September 1, 1999. Under ARTICLE FIVE, I hereby appoint my son, TIMOTHY JOHN SPACKMAN, along with my son, JOSEPH FREDERICK SPACKMAN, as co-executor of my estate. ACKNOWLEDGMENT I, FREDERICK T. SPACKMAN, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Codicil I, that I signed it willingly, an&that I signed it as my free and voluntary act for the purposes therein expressed. ' FREDERIC I~..~'S PACKMAN Sworn to or affirmed to and acknowledged before me by FREDERICK T. SPACKMAN, the Testator, this 1 st day of February, 2000. Notary Public My Commission Expires: NOTARIAL SEAL ") CSRISTEI~ M. McNULI'~, NOTARY PtlBLIC ':~ ~MP HILL ~RO. CUMBER~ND CO ~ ~i ~ ~ MY ~MMI~ION'EXPIRES MAY 21, 2~01 Micfiael J. Wilson Attorney at Law LAST WILL AND TESTAMENT OF FREDERICK T. SPACKMAN I, FREDERICK T. SPACKMAN, currently residing at 3422 Walnut Street, Borough of Camp Hill, Cumberland County, Pennsylvania, do make, publish, and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils previously made by me. ARTICLE ONE IDENTITY OF TESTATOR'S FAMII,Y I declare that I am a single man and widower, with my wife having pre- deceased me. I have six natural children, now living, ROXIE ANN SHUEY, NAN LIZBETH STEVENSON, PATRICIA ELLEN LANGAN, DAVID EDWARD SPACKMAN, FREDERICK JOSEPH SPACKMAN, and TIMOTHY JOHN SPACKMAN and all references in this Will to "my child" or "my children" refer to them, unless otherwise stated or excepted. ARTICLE TWO PAYMENT OF DEBTS AND TAXES I hereby instruct my Executor/Executrix to account for and pay all debts and taxes of my Estate from the gross assets of my Estate prior to any distribution provided for herein. Page 1 of 10 Micl~ael J. Wilson Attorney at Law Debts shall include, but not be limited to, funeral expenses, attorneys fees, other professional fees and executor/executrix fees or commissions. Taxes shall include, but not be limited to, federal estate taxes, inheritance taxes, property taxes and income taxes, regardless of whether such tax liability was incurred before or after my death. The purpose for my inclusion of this instruction is to insure that no class of beneficiary hereunder is treated differently than another with respect to distributions provided for herein because of my Estate failing to have sufficient funds to satisfy the liabilities set forth herein. Nothing herein should be construed to prohibit partial distributions of my Estate pending a final distribution provided that my Executor or Executrix is absolutely certain that sufficient assets remain to satisfy all such debts and taxes which are known to or reasonably anticipated by him or her. ARTICLE THREE I direct that a funeral ceremony be accorded me upon my death which is in accordance with the doctrines and/or teachings of my Roman Catholic faith. I further direct that my remains be buried next to the remains of my wife and son, both of whom pre-deceased me ARTICLE FOUR DISPOSITION OF ESTATE Except as otherwise set forth herein below, I specifically give, bequeath, and devise all my personal and real property or mixed property, tangible or intangible, Page 2 of l0 Michael J. Wilson Attorney at Law to my children provided that they survive me by thirty (30) days. Except as otherwise set forth herein below, I give, devise, and bequeath all the rest, residue and remainder of my estate, whether real, personal or mixed, to my children provided that they survive me by thirty (30) days. In the event that any of my children should predecease me or fail to survive me by thirty (30) days, then and in that event, I direct that the respective share of my Estate shall pass to the deceased child's issue, per stirpes. Notwithstanding anything written herein, I direct that the share of my estate which shall pass to my daughter NAN LIZBETH STEVENSON be placed in trust for her sole benefit for the remainder of her natural life, with the remainder interest in any property placed in such trust passing to the natural children of such daughter upon her death or, in the event she is not survived by any natural children, passing in equal shares to all of my children who survive her. I hereby direct that my son FREDERICK JOSEPH SPACKMAN and my son-in-law, ROBERT J. LANGAN, provided he is still married to my daughter, Patricia Ellen Langan, be appointed and serve as co-trustees of the trust for the benefit of NAN LIZBETH STEVENSON which I have directed and do direct to be established upon my death. The trustees of the trust established for the benefit of NAN LIZBETH STEVENSON shall have all the powers available and proper in accordance with and pursuant to the laws of the Commonwealth of Pennsylvania, to include all discretionary powers and rights with regard to investments and re-investments of Page 3 of 10 Michael J. Wilson Attorney at Law trust principal and income and disbursements from the trust's principal or income to the beneficiary Notwithstanding anything written herein, I direct that prior to the distribution to my children, I specifically bequeath and give to my grandson, JOHN LANGAN, the car registered in my name at the time of my death. ARTICLE FIVE EXECUTOR Appointment I appoint my son, FREDERICK JOSEPH SPACKMAN, as the Executor of this Will. In the event of his death, resignation, renunciation, or inability to act in that capacity, then I direct my attorney, MICHAEL J. WILSON, whose office is situate at 816 Derby Avenue, Camp Hill, Pennsylvania, (Fairview Township, York County) to seek from my surviving children one or more designated personal representative(s) of my Estate or, alternatively, an order of court appointing another person to act as the sole Executor hereunder. My Executor or Executrix, whether original, substitute or successor, is referred to hereinafter as my "Executor". No Bond Required No bond or other security shall be required of any Executor appointed in this Will. Compensation of Executor My Executor shall be permitted to receive reasonable compensation for Page 4 of 10 Michael J. Wilson Attorney at Law services rendered to my estate. Powers My Executor shall have, in extension and not in limitation of the powers given by law or by other provisions of this Will, the following powers with respect to the settlement and administration of my estate: (1) To employ any attorney, investment advisor, accountant, broker, tax specialist, or any other agent deemed necessary by my Executor; and to pay from my estate reasonable compensation for all services performed by any of them. (2) To conduct alone or with others any business in which I am engaged or in which I have an interest at my death, with all the powers of any owner with respect thereto, including the power to delegate discretionary duties to others, to invest other property held hereunder in such business and to organize a partnership or corporation to carry on such business. (3) When paying legacies or dividing or distributing my estate, to make such payments, division, or distribution wholly or partly in kind by allotting the transferring specific securities or other personal or real properties of undivided interests therein as a part of the whole of any one or more payments or shares at current values in the manner deemed advisable by my Executor. (4) To hold and retain all or any part of my estate in the form in which the same may be at the time of my demise, as long as my Executor may deem Page 5 of 10 Mic'hael J. Wilson Attorney at Law advisable, without diversification, and whether or not the same be of the character permissible for investments by fiduciaries. (5) To invest and reinvest any funds of my estate in such securities and other property, real or personal, as he shall deem advisable, whether or not such securities or other property be of the character permissible for investments by fiduciaries. (6) To borrow money for any purpose in connection with the administration of my estate or the trust created hereunder; to execute promissory notes or other obligations for amounts so borrowed; and to secure the payment of any amounts so borrowed by mortgage or pledge of any real or personal property of which I may die seized or possessed, or which may at any time form part of my estate in such amounts and upon such terms and conditions as my Executor may deem advisable. (7) To adjust, settle, compromise, and arbitrate claims or demands in favor of or against my estate, upon such terms as my Executor may deem advisable. (8) To exercise, at such times and in such manner as my Executor shall deem appropriate, any rights of election or other rights which may from time to time be available to them under the provisions of the Internal Revenue Code or any other tax laws, including, without being limited to, the power to make such decisions as my Executor may deem appropriate in all the circumstances Page 6 of 10 Michael J. Wilson Attorney at Law (regardless of whether the decision in a particular case may be the most advantageous one from the point of view of my estate as an entity). (9) To execute and deliver any and all instruments in writing which my Executor shall deem advisable in the exercise of any of his powers, authority or discretion. No party to any such instrument signed by my Executor shall be obliged to inquire into its validity or be bound to see to the application of any money or other property paid or delivered to my Executor pursuant to the terms of any such instrument. Any of the above powers may be exercised, except as otherwise provided by law, from time to time in the discretion of my Executor without further court order or license. ARTICLE SIX WILL CONTESTS If any beneficiary or individual with a remainder interest under this Will in any manner, directly or indirectly, contests or attacks this Will or any of its provisions, any share or interest in my estate established by this Will given to that contesting individual under this Will is revoked and shall be disposed of in the same manner provided herein as if that contesting individual had predeceased me without issue. ARTICLE SEVEN GENERAL Effect of Inoperative, Invalid, or Illegal Provision If any of the provisions of this Will or of any Codicils thereto are held to Page 7 of 10 Michael J. Wilson Attorney at Law be inoperative, invalid, or illegal, it is my intention that all of the remaining provisions thereof shall continue to be fully operative and effective so far as is possible and reasonable. The headings above the various provisions of this Will have been included only in order to make it easier to locate the subject covered by each provision and are not to be used in construing this Will or in ascertaining my intentions. IN WITNESS WHEREOF, I, FREDERICK T. SPACKMAN, hereby set my hand to this my last Will and its accompanying Acknowledgment and Affidavit, consisting of ten (10) typewritten pages, on this 1st day of September, 1999. FRED ERICI4~.-SPACKMAN ******************************* PAGE IS 9 OF ************************** Page 8 of 10 Michael J. Wilson Attorney at Law ATTESTATION CLAUSE Signed, sealed, published and declared by FREDERICK T. SPACKMAN the above-named Testator, as and for his Last Will and Testament, in the presence of us, who, at his request, in his presence, and in the presence of each other, all being present at the same time have subscribed our names as witnesses. residing at: ACKNOWLEDGMENT Commonwealth of Pennsylvania County of Cumberland ) ) SS: ) I, FREDERICK T. SPACKMAN, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament, that I signed it willingly, and that I signed it as my free and voluntary act for the purposes therein expressed. FREDERICK T. SPACKMAN Sworn to or affirmed to and acknowledged before me by FREDERICK T. SPACKMAN, the Testator, this Ist day of September, 1999. Notary Public My Commission Expires: Page 9 of 10 NOTARIAL SEAL MICHAEL J. WILSON, Nola~ Public Fainflew Township York County My Com~, Ission Expires dan. 28. 2002_ MiChael J. Wilson Attorney at Law Commonwealth of Pennsylvania County of Cumberland AFFIDAVIT ) ) SS: ) ! ~/and /-'~P"~z~''-~ , the witnesses whose names are signed to the foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testator sign and execute the instrument as his Last Will and Testament; that he executed it as his free and voluntary act for the purposes therein expressed; that each of us, in the hearing and sight of the Testator, signed the Will as witnesses; and that, to the best of our knowledge, the Testator was at that timel8 or more years of age, of sound mind and under no undue constraint or influence. and Swom or affirmed to and subscribed to before me by/]4//~'~//'/'- Lffa/&/IN ~O~_A~ ~. L.A ~j~-,4-,l , witnesses, this 1st day of September, 1999. Michael J. Wilson, Notary Public NOTARIAL SEAL MlCli/~ J. WILSON, Nolary Public Faln'i~ Township York County c0mm 0n aah. Page 10 of 10 REV-1500 EX (6-00)  COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 I-- Z IJJ ILl W LIJ Z n, o REV-I$O0 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER [~1. Original Return F--] 4. Limited Estate I~'] 6. Decedent Died Testate (Attach copy of Will) [~]9. Litigation Proceeds Received I--~ 2. Supplemental Return I--'~ 4a. Future Interest Compromise (date of death after 12-12-82) ~--17. Decedent Maintained a Living Trust (Attach copy of Trust) [~10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) ---]3. Remainder Return (date of death prior to 12-13-82) [~5. Federal Estate Tax Return Required 8. Total Number of Safe Beposit Boxes r-'~ 11, Election to tax under Sec. 9113(A) (Attach Sch O) NAME ,~.__ · / k/'~--/e/,d<_ J FIRM NAME (If Applicable) TELEPHONE NUMBER [ 7J?) COMPLETE MAILING ADDRESS t-/4,a/t s Charitable and Governmental Bequests/Sec 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) (14) 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Modgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) [~] Separate Billing Requested 7, Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. /W. o 7% OFFICIAL USE ONLY //, (8) do,o/,,Z/(,,....~o (11) (12) (13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x .0 __ (15) 16. Amount of Line 14 taxable at lineal rate J ~ 7, <~- ~'z:3, x .0 ~/~16) 17. Amount of Line 14 taxable at sibling rate x .12 (17) 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) CF ^P,UCABLE/SURWWNG SPOUSE'S NAME lU~ST, mST, AND M~DDLE ~N~T~AL/ THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER I '? (~ - /o -.-? 7~,...~ Decedent's Complete Address: STREET ADDRESS STATE/,,~ ZIP Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applicable D. Interest E. Penalty 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. Total Credits (A + B + C ) (2) 4//~. ~ 4// (3) (4) (5) (5A) (5B) Total Interest/Penalty ( D + E ) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT IF THE ANSWER 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? ...................................................................... [] [~ If 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? .............. [] [Z~ Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ [] [] 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. SIGNATUREO~'PERSONRESPONSIBLEFORFILINGRETURN J f.. -F) I o')" DATE ADDRESS . v ~,,,, / f ~/' ( ADDRESS For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1503 EX + (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF All property jointly-owned with right of survivorship must be disclosed on Schedule F. FILE NUMBER J~ ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH ..~?. 3 7 TOTAL (Also enter on line 2, Recapitulation) (If more space is needed, insert additional sheets of the same size) REV-1507 EX+ (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE D MORTGAGES & NOTES RECEIVABLE ESTATE OF FILE NUMBER All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH TOTAL (Also enter on line 4, Recapitulation (If more space is needed, insert additional sheets of the same size) REV-15~ EX + (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS,& MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER ~/. ~,~ _~m~h 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. C ~ c:l : / l.~ ~ C.) ,",d ~L TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) // REV-1511 EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER 7':. D~bts of decedent must be reported on Schedule 1. ITEM NUMBER DESCRIPTION AMOUNT FUNERAL EXPI~NSES: 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__Zip Year(s) Commission Paid: Attorney Fees ./~1.'/~ ~_ ~'xP.'/~,., ~ Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State__Zip Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees TOTAL (Also enter on line 9, Recapitulation) $ more space is needed, insert additional sheets of the same size) MYERS-HARNER FUNERAL HOME, INC. 1903 MARKET STREET P.O. BOX 291 CAMP HILL, PENNSYLVANIA 17011 LOCALLY OWNED AND OPERATED ROBERT H. HARNER SUPERVISOR TELEPHONE 717-737-9961 April 19, 2002 Mr. F. Joseph Spackman 3408 Rutherford Street Harrisburg PA 17111 Services for Frederick T. Spackman April 5, 2002 Charges for Services Selected Professional Services Use of Facilities Automotive Equipment $ 3,375.00 $ 3,375.00 Charges for Merchandise Selected Casket Vault $ 3,195.00 2,180.00 $ 5,375.00 Cash Advanced Newspaper Notice/Local Mass Offering Certified Copies Flowers Organist Soloist Altar Servers Total: Less Credit for Veteran's Benefits: Total due within thirty days, please: $ 108.00 100.00 40.00 183.00 75.00 50.00 15.00 $ 571.00 $ 9,321.00 - 100.00 $ 9,221.00 REV-15~ 2 EX * (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1. TOTAL (Also enter on line 10, Recapitulation) (If more space is needed, insert additional sheets of the same size) R~-1513 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF NUMBER II. 1. FILE NUMBER 2/ RELATIONSHIP TO DECEDENT Do Not List Trustee(s) NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY AMOUNT OR SHARE OF ESTATE TAXABLE DISTRIBUTIONS (include outdght spousal distributions) g'-/I ,,~4-,.)oV),woe c.4,,,,,/, W.W ~/-- ,'?,-',,' (Zb,,..~ -...~.~,,,J ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART I[- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET . ON REV 1500 COVER SHEET (If more space is needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 001349 SPACKMAN FREDERICK JOSEPH 3408 RUTHERFORD STREET HARRISBURG, PA 17111 ........ fold ESTATE INFORMATION: SSN: 176-10-3783 FILE NUMBER: 2102-0366 DECEDENT NAME: SPACKMAN FREDERICK T DATE OF PAYMENT: 06/28/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 04/02/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $8,034.05 REMARKS: TOTAL AMOUNT PAID: FREDERICK J SPACKMAN $8,034.05 SEAL CHECK# 1015 INITIALS: CW RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: ,~"~o t ,tc~ J~ ~. Date of Death: ~,~' .'// f~ . d D0 ~ Will No. t~ /' O c~O- .~ (o ~ Admin. No. To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) .of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on 'Jo~ ~ e od ? · o/o ,~ d~ · Name Address Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Signature ~.~, .... ~" &~,'~_ f~ /~,,, Telephone (?t ? ),5'~/-~ g 3 ~ Capacity: JPersonal Representative 64~F /,'.'/~ /93, I Counsel for personal representative ~ BUREAU OF INDIVIDUAL TAXES /NHER/TANCE TAX DTVTS/ON DEPT. 280601 HARRISBURG, PA 17128-0601 CONHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE DF INHERITANCE TAX APPRAZSENENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSHENT OF TAX FREDERICK J SPACKHAN $~08 RUTHERFORD ST HARRISBURG PA 1~7111 DATE 08-12-2002 ESTATE OF SPACKNAN DATE OF DEATH O~-OZ-ZOOZ FILE NUNBER 21 02-0566 COUNTY CUNBERLAND ACN 101 I Amount Ram/ttad FREDERICK T HAKE CHECK PAYABLE AND REHZT PAYNENT TO: REGISTER OF WILLS CUNBERLAND CO COURT HOUSE CARLISLE, PA I70I$ CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-0:~) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSNENT OF TAX ESTATE OF SPACKHAH FREDERICK T FILE NO. 21 02-0366 ACN 101 DATE 08-12-2002 TAX RETURN #AS: (X) ACCEPTED AS FTLED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A] (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) ~. Nortgagas/Notas Rece/vabla (Schedule D) (~) 5. Cash/Bank Deposits/N/sc. Personal Propar~y (Schedule E) (S) 6. Jointly Owned Propar~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assa~s APPROVED DEDUCTIONS AND EXENPTZONS: 9. Funeral Expenses/Ada. Cos~s/Nisc. Expanses (Schedule H) (9) 10. Dabts/Nor~gaga L/ab/li~ies/L~ans (Schedule I) (10) 11. To,al Daduc~/ons 12. Ne~ VeZua of Tax Re~urn .00 19z795.21 .00 1~/079.86 23z0~0.82 151500.~1 .00 (8) 11,379.31 905.09 NOTE: To insure proper crad/t ~o your account, submi~ ~ha upper por~/on of ~his for. w/~h your ~ax payment, 13. 1~. NOTE: ASSESSNENT OF TAX: 16. Amoun~ of L/ne 1~ a~ Spousal ra~e 16. Amoun'~ of L/ne lq ~axabla at L/neal/Class A rate 17. Aeount of Line lq e* S/bl/ng ra*e 18. Aeoun* of Line lfi ~axable a~ Collateral/Class B ra~, 200,216.50 DATE NUNBER D/SCOUNT INTEREST/PEN PAID (-) PAYNENT NUST BE NADE BY 01-02-2005~. 19. Pr/nc/pal Tax Due TAX CREDITS: PAYHENT RECETPT (15) .00 x O0 = .00 (16) 187,930.90 x OR5= 8,q56.89 (17) .00 x 12 = .00 (18) .00 x 15 = .00 (19)= 8,~56.89 ANOUNT PAID IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADD/TZONAL /NTEREST. reflect figures that include the total of ALL returns assessed to date. TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 8,q56.89 .00 8,~56.89 ( 'rF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS REI~UZRED. ZF TDTAL DUE IS REFLECTED AS A 'CREDIT' (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (15) . O0 Nat Value of Es~e~a Subjac~ '~o Tax (IR) 187,930.90 Zf an assessment #as issued previously, lines 1~, 15 and/or 16, 17, 18 and 19 g111 (11) 12.285.~0 (12) 187,930.90 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DTVTSTON DEPT. 280601 HARRISBURG,, PA 1712:8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT RE¥-1607 EX AFP FREDERTCK J SPACKHAN $408 RUTHERFORD ST HARRISBURG PA ~7111 DATE 08-12-2002 ESTATE OF SPACKMAN DATE OF DEATH 04-02-2002 FILE NUMBER 21 02-0366 COUNTY CUMBERLAND ACN 101 I Amount Remi~ed FREDERICK T MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper cred/t to your account, submit the upper portlon of this form frith your tax payment. CUT ALONG TH'rS LINE ~.~ RETAIN LOWER PORTION FOR YOUR RECORDS *-~ REV-1607 EX AFP (01-02) #~ INHERITANCE TAX STATEMENT OF ACCOUNT N#;( ESTATE OF SPACKMAN FREDERICK T FZLE N0.21 0Z-0366 ACN 101 DATE 08-12-Z002 THIS STATEHENT ZS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAMED ESTATE. SNONN BELO# ZSA SUMMARY OF THE PRINCIPAL TAX DUE, APPLTCATZON OF ALL PAYMENTS, THE CURRENT BALANCE, AND, ZF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-12-2002 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): 8,456.89 PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 06-28-2002 CD001349 422.84 8,034.05 IF PAID AFTER TH/S DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL /NTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. ZF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), TOTAL TAX CRED'rT 8,456.89 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. Name of Decedent: STATUS REPORT UNDER RULE 6.12 Date of Death: Will No.: o~oo,~ - co 36 (-, Admin. 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: I. State whether arlministration of the estate is complete: No [2 2. If the answer is No, state when the personal representative reasonably believes that the admln~.qtration will be complete: If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final accotmt with the CoUrt? Yes _ No [~ b. The separate Orphans' Court No. (if any) for the personal representative's account is: ~ Did the personal representative state an account infonmlly to the parties in interest? Yes [--I No [~ c. Copies of receipts, releases, joindem and approval of formal or informal accounts maybe filed with the Clerk of the. Orphans' Court and may be attached to this report. Signature ~' t ~' - Name Date: Address Telephone No. / ?/// Capacity: l~] Personal Representative [-] Counsel for personal representative