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HomeMy WebLinkAbout02-0372Estate of also known as /~umber lan~] . Register of Wills or . ~.,oun~y, Pennsylvania PETITION FOR GRANT OF LETTERS James C. Westhafer /9/~/~ ~//, Deceased Social Security No. 185-07-5375 (COMPLETE "A" OR "B" BELOW:) A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut Decedent, dated September 23, 1 999 and codicil(s) dated __ named in the Last Will of the Except as follows, Decedent did not marry,- was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incompetent: B. Grant of Letters of Administration Petitioner(s) after a prol~er search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence (COMPLETE IN ALL CASES:) Attach additional heetsif necessary. Decedent was domiciled at death in cUmberland County, Pennsylvania, with his/her last family or pr,nc~pal residence at 19 W_ Beale Avenue: Enola Pennsylvania (East Pennsboro Twp) Decedent, then 87 years of age, died March 25 2002 , ~ , at Holy Spirit Hospital Camp ~{'~'~l PA 1 7011 Decedent at death owned property with estimated values as follows: (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 ............................................... $ 50_. 000 · 00 To,al .............................................................. $ 50,000.00 Real Estate situated as follows:l 9 W Beale Avenue. Enola PA Where[ore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: Signature Typed or printed name and residence Tammy A. Enders 70 Bunker Lane, Etters PA 17319 Oath of Personal Representative Commonwealth of Pennsylvania County of The Petitioner(s) above-named swear(s) and 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 Decedent, ding to law. w,, we,, ,ru, Sworn to and affirmed and subscribed ] 0/~J/~f~l ~ ~.' . before me this 10th day of APRIL ~2 , DECREE OF REGISTER Estate of James C. Westhafer Deceased No. also known as Social Security No: 185-07-5375 Date of Death: March 25r 2002 AND NOW, APRIL 11, 2002 , ~ , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters J~ Testamentary [] of Administration are hereby granted to Tamm¥ A. Enders in the above estate and that the instrument(s), if any, dated (~-23-1999 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters ........................... $ 80.00 Short Certificate(s) .......... $ 15.00 Renunciation .................. Affidavit ( ) ................. $ Extra Pages ( ) ............ $ 6.00 Codicil .......................... $ JCP Fee ........................ $ 5.00 Inventory & Tax Forms... $ Other ............................ $ 1.50 TOTAL ................ $ 107.50 mailed to attny on 4-] ]-02 Fleg~ster Wdls~ ~'~ , ..,~ i 7-5 I.D. No:/~5~og ' ' AddresP~68 Old York Road Etters PA 1 731 9 Telephone: 717 938-3396 DATE FILED: 4-11-2002 a~-7a his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00~ P 8 2 0 4 5 3 2 No. ~ Date LOCal ~,eglstrar HAR '7 200Z , ;~3R~, ~.7 COMMONWEALTH OF PENNSYLVANIA o DEPARTMENT OF HEALTH ,, VITAL RECORDS CERTIFICATE OF DEATH I NAME OF OECEOENT iF it~, M ~%qe. L~) ST~E F~E ~MBER ~ Cumberland p .... ~',u,u~u~ · ~nsboro ,.~0/~,~,~ ~0~,/~/ ,~'~. ~ ~ .... ' White ~.T'S u~ ~ ~r~. C~. ~. ZC C~) I". 113. ~u~ ,~..~. Pennsylvania ~ ,7..~.~ East Pennsboro 19 W. Beale Ave ,~ Enola, Pa 17025 I~' ,,.~ Cumberland ,,. Wi 1 b u r We s t h a f e r I~T~R's ~ (~,.. u~. u~ ~) ~.s~,~ ,,- Helen ? ~ Denise Mescia I~ 327 S. Enola Dr.. Enola Pa ~ ~ ~*~ I~E ~ m~T~ IKE ~ --~ c--,D ~--,.O Dl,,,Sarch 29, 2002 .ndiantown Gap Nat'l C ~,.Lebanon, Pa ~-~U~ ~U~ SER~E L~E~E ~ ~ ~1~ ~ ~H iL~EN~ NUM~R ~ ~ tvvk~~ ~ D 011 · ~~. p~ ~ J J - I~. I I~'~''~' ~ ~ ~ ~ ~"s~? ~ ' ~ ~ OE~H m~E P~O ~ ,~ - ~--. I~' lin- ....... ~~ J ~ . ~ J a4) -- ~- ...uay. '~1 I~SC~REFER~D~ME~E~NE~R? LA $ T WILL A ND TE$TA MENT I, ,JAMES C~. WESTHAFER, of 19 West Beale Avenue, Enola, Cumberland County, Pennsylvania, 17025, do hereby make, publish and declare this to be my last will and testament, hereby revoking all wills heretofore made by me. 1. I direct my personal representative to pay all of my debts, funeral and administrative expenses as soon as convenient after my decease. I direct that all inheritance taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property, whether or not such property passes under this Will, shall be paid by my personal representative out of my estate. 2. I authorize and empower my personal representative to sell any realty and/or personalty owned by me at my death and not specifically devised or bequeathed herein, at public or private sale or sales and to give good and sufficient deeds and/or bills of sale therefor, in fee simple, as I could do if living. My representative is authorized and empowered to engage in any business in which I may be engaged at my death, for such period of time after my death as seems expedient to said representative. 3. I give, devise and bequeath all of my estate of whatever nature and wherever situate as follows: Ao 30% to Tammy A. Enders, 30% to Denise A. Mescia, 25%To Junanne Polend, and D. 15% to James L. Westhafer. E. If any of the foregoing beneficiaries predeceases me, then I give, devise and bequeath the share given to any deceased beneficiary to his or her children, share and share alike. 4. I nominate and appoint Tammy A. Enders to be the personal representative of my estate, to serve without bond. If Tammy A. Enders cannot or does not serve, then I appoint Denise A. Mescia to be the substitute personal representative, also without bond. 5. I suggest that my personal representative retain the services of Harold S. Irwin, III, Carlisle, Pennsylvania in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this,~O'"a~y of September, 1999. '_~ ,--~ L~~ (SEAL) JArl~S C. WESTHAFER ~ Signed, sealed, published and declared by the above-named person as and for a last will and testament, in our presence, who at said person's request, in said person's presence and in the presence of each other have hereunto set our names as subscribing witnesses. "~...-~ A CKNO WL ED I;4f EN T AND AFFIDAVIT WE, JAMES C. WESTHAFER, CAROL S. RUSS and HEATHER A. BARBOUR, the testator and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument as his last will and that he had signed willingly, and that he executed it as his free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testator, signed the will as a witness and that to the best of their knowledge the testator was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. JA~ES C. WESTHAFER CAROL S. RUSS HEATHE~R A. BARBOUR COMMONWEALTH OF PENNSYLVANIA : :SS-' COUNTY OF CUMBERLAND : Subscribed, sworn to and acknowledged before me by JAMES C. WESTHAFER, the testator herein, and subscribed and sworn to before me by CAROL S. RUSS and HEATHER A. BARBOUR, witnesses, this~ of September, 1999. Notary Publ~~~' CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: James C. Westhafer Date of Death: March 25, 2002 Will No. 7._ ~ ~ Z - ~ 0 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 April ]t~, 2002. Name Address Junanne Polend James L. Westhafer Tammy A. Enders Denise A. Mescia 2613 Alvey Drive, Haymarket VA 20169 P. O. Box 305, Bealton VA 22712 70 Bunker Lane, Etters PA 17319 327 S. Enola Drive, Enola PA 17025 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: No Exceptions Date: ist, ?.-668 Old York Road Etters PA 17319 (717) 938-3396 Supreme Court ID #15609 Capacity: _ Personal Representative _~X Counsel for Personal Representative 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. CD REV-1162 EX(11-96) 002552 SECHRIST JOEL O 568 OLD YORK ROAD ETTERS, PA 17319 ........ fold ESTATE INFORMATION: SSN: 185-07-5375 FILE NUMBER: 2102-0372 DECEDENT NAME: WESTHAFER JAMES DATE OF PAYMENT: 05/1 2/2003 POSTMARK DATE: 05~09~2003 COUNTY: CUMBERLAND DATE OF DEATH: 03/25/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $2,091.26 REMARKS- TOTAL AMOUNT PAID' C/O TAMMY A ENDERS $2,091.26 SEAL CHECK//118 INITIALS: CW RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS May 9,2003 Joel O. Sechrist Attorney at Law 568 Old York Road Etters PA 17319 Telephone 717 938-3396 Facsimile 717 938-9613 Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle PA 17013 RE: Estate of James Westhafer To Whom It May Concern: Enclosed are two copies of the Inheritance Tax Return, a check made payable to Register of Wills, Agent in the amount of $2,091.26 representing the inheritance tax, and a check in the amount of $50.00 representing $35.00 additional probate fee and the $15.00 filing fee. Thank you very much for your assistance in this matter. JOS:lm Enclosures Very truly yours ..... J RE~'-1500 EX (6-0~) I,-- Z U.I UJ .cPo o ~.~ Z z COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 Rev-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Westhafer, James C. DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) 03-25-2002 107-21-1914 IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Original Return Limited Estate Decedent Died Testate (Attach copy of Will) Litigation Proceeds Received OFFICIAL USE ONLY FILE NUMBER 21 02 0372 County Code Year Number SOCIAL SECURITY NUMBER 185-07-5375 THIS RETURN MUST BE FILED IN DUPLICATE WITH REGISTER OF WILLS SOCIAL SECURITY NUMBER  2. Supplemental Return ~3. Remainder Return (date of death pdor to 12- 4a. Future Interest Compdse (date of death after 12-12-82) L~J5. Federal Estate Tax Return Required 7. Decedent Maintained a Living Trust (Attach a copy of Trust) 8. Total Number of Safe Deposit Boxes 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) [~ 11. Election to tax under Sec. 9113(A) THIS SECTION MUST BE COMPLETED. NAME Tammy A. Enders FIRM NAME (If Applicable) TELEPHONE NUMBER 717 938-3396 ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: ICOMPLETE MAILING ADDRESS c/o Joel O. Sechrist, Esquire 568 Old York Road Etters PA 17319 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 (Schedule D) (4) 5. Cash, Bank Deposits & Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) ~] Separate Billing Requested 7. Inter-Vivos Transfers & Misc. 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. 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) $5~431.13 ~ $o.oo $0.00 (8) $12,054.09 $5,449.02 $63,087.65 (11) $17.503.11 (12) $45,584.54 (13) $0.00 (14) $45,584.54 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) 16. Amount of line 14 taxable at lineal rate 17. Amount of line 14 taxable at sibling rate 18. Amount of line 14 taxable at collateral rate 19. Tax Due 20. r'~ $45,584.54 x (15) $0.00 x .045 (16) $2,051.30 x .12 (17) $0.00 x .15 (18) $0.00 (19) $2,051.30 > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < DieCede~t's Complete Address: ISTREET ADDRESS 19 W. Beale Avenue ICITY IEnola STATE PA ZIP 17025 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) $2,051.30 Total Credits (A + B + C) (2) 3. Interest/Penalty if applicable D. Interest $39.96 E. Penalty Total Interest/Penalty (D + E) (3) 4. If line 2 is greater than line 1 + line 3, enter the difference. This is the OVERPAYMENT. Check box on Page I Line 20 to request a refund (4) 5. If line 1 + line 3 is greater than line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT $0.00 $39.96 $2,091.26 $2,091.26 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN X IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: 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 revisionary interest; or d. receive the promise for life of either payments, benefits or care? 2. If death occurred after December 12, 1982, did decedent transfer property within on 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 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? Yes No IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer other than the personal representative is based on all the information of which preparer has any knowledge. O~F PERSON RE~ONSIBL ,E.~_ FILING. RETURN ADDRESS ' _ J j ld ~ ork Road, Effem PA 173~9 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)]. o 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. LAST WILL AND TESTAMENT ,21-0;2..- I, JAMES C. WESTHAFER, of 19 West Beale Avenue, Enola, Cumberland County, Pennsylvania, 17025, do hereby make, publish and declare this to be my last will and testament, hereby revoking all wills heretofore made by me. 1. I direct my personal representative to pay all of my debts, funeral and administrative expenses as soon as convenient after my decease. I direct that all inheritance taxes imposed or payable by reason of my death and interest and penalties thereon with respect to all property, whether or not such property passes under this Will, shall be paid by my personal representative out of my estate. 2. I authorize and empower my personal representative to sell any realty and/or personalty owned by me at my death and not specifically devised or bequeathed herein, at public or private sale or sales and to give good and sufficient deeds and/or bills of sale therefor, in fee simple, as I could do if living. My representative is authorized and empowered to engage in any business in which I may be engaged at my death, for such period of time after my death 'as seems expedient to said representative. 3. I give, devise and bequeath all of my estate of whatever nature and wherever situate as follows: 30% to Tammy A. Enders, 30% to Denise A. Mescia, 25%To Junanne Polend, and D. 15% to James L. Westhafer. E. If any of the foregoing beneficiaries predeceases me, then I give, devise and bequeath the share given to any deceased beneficiary to his or her children, share and share alike. 4. I nominate and appoint Tammy A. ,Enders to be the personal representative of my estate, to serve without bond. If Tammy A. Enders cannot or does not serve, then I appoint Denise A. Mescia to be the substitute personal representative, also without bond. 5. I suggest that my personal representative retain the services of Harold S. Irwin, III, Carlisle, Pennsylvania in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this,~'~.~'%'~y of September, 1999. ~CAa~---~o~- t~~~ (SEAL) jAr-I~IES C. WESTHAFER ~' subscribing witnesses. Signed, sealed, published and declared by the above-named person as and for a last will and testament, in our presence, who at said person's request, in said person's presence and in the presence of each other have hereunto set our names as ._ . A CKNOWLEDGMENT_a. ND _a. FFiD_a. VIT WE, JAMES C. WESTHAFER, CAROL S. RUSS and HEATHER A. BARBOUR, the testator and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument as his last will and that he had signed willingly, and that he executed it as his ~=ree and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testator, signed the will as a witness and that to the best of their knowledge the testator was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. JA~ES C. WESTHAFER CAROL S. RUSS HEATHER A. BARBOUR COMMONWEALTH OF PENNSYLVANIA : COUNTY OF CUMBERLAND :SS: Subscribed, sworn to and acknowledged before me by JAMES C. WESTHAFER, the testator herein, and subscribed and sworn to before me by CAROL S. RUSS and HEATHER A. BARBOUR, witnesses, this~ Not~rial L-', e ~ I t -' Harotd S. ~in il!, h!oii~,~¢ Pb~iic Carlisle Boro, Cumber!and County MyComrtlissio~ ~x~i,~ S¢~t 2:% :00~ Nota~ Public .~9~O~r P~*~t'~v: ' ~: , L~ ;O~ 0', RE~/-lS(~2EX = (1 -~7) (Ii COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF Westhafer, James C. FILE NUMBER 21-02-0372 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 property 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 VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 19 W. Beale Avenue, Enola PA $55,000.00 TOTAL (Also enter on line 1, Recapitulation) $55,000.00 (If more space is needed, insert additional sheets of the same size) REV-1503EX = (1-'[,7) ([) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Westhafer, James C. FILE NUMBER All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH Prudential Stock - 44 Shares at 31.30 per share MetLife Stock - 42 Shares at 30.46 per share $1,377.20 $1,279.32 TOTAL (Also enter on line 2, Recapitulation) $2,656.52 (If more space is needed, insert additional sheets of the same size) RE~/-1508 EX + (1~97)(~) COMMONWEALTH OF PENNSYLVANIA INHERITANCETAXRETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Westhafer, James C. FILE NUMBER 21-02-0372 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 PNC Checking Account Proration of Real Estate Taxes on sale of house $5,182.22 $248.91 TOTAL (Also enter on line 5, Recapitulation) $5,431.13 (If more space is needed, insert additional sheets of the same size) REy-lSl,1 EX + (¥97)(1,) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Westhafer, James C. FILE NUMBER 21-02-0372 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. 8. 9. FUNERAL EXPENSES: Sullivan Funeral Home ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Tammy A. Enders Social Security Number(s) / EIN Number of Personal Representative(s) Street Address 70 Bunker Lane City Etters State PA Zip 17319 Year(s) Commission Paid: 2003 Attorney Fees 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 Register of Wills - file return Patriot News - Ad Cumberland Law Journal - Ad L.G. Conner Appraisers Clerk of Orphans' Court - Releases Register of Wills - Additional Fee $4,084.00 $3,154.00 $4,104.00 $107.50 $15.00 $188.59 $75.00 $275.00 $16.00 $35.00 TOTAL (Also enter on line 9, Recapitulation) $12,054.09 (If more space is needed, insert additional sheets of the same size) RE~V-151,2 EX + (3-97)('~) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES~ & LIENS ESTATE OF Westhafer, James C. FILE NUMBER Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. Verizon Willow Mill Vet Hospital - due at death Animal Emergency Medical Center - due at death Verizon PharAmerica - due after insurance East Pennsboro Sewer/Trash Alicia Stone, Tax Collector - Real Estate Taxes East Pennsboro Sewer/Trash F. M. Oppel- Furnace Maintenance East Pennsboro Sewer/Trash Beverly Healthcare Recorder of Deeds - record quitclaim deed to clear title John J. Karfsig, Jr. Attorney fee regarding clear title to real estate Credit Plus - Payment of West Shore EMS bill Beverly Healthcare National Mutual Insurance for hazzard insurance Settlement charges on sale of house TOTAL (Also enter on line 10, Recapitulation) $72.62 $267.68 $103.00 $27.45 $280.16 $87.75 $710.98 $96.53 $134.00 $96.00 $1,511.74 $41.50 $150.00 $44.25 $1,319.50 $472.O0 $33.86 $5,449.02 (If more space is needed, insert additional sheets of the same size) R~V-1513 EX · (9-00)) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Westhafer, James C. FILE NUMBER 21-02-0372 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY oo Not List Trustee(s) OF ESTATE I. I1. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Junanne Polend 2613 Alvey Ddve, Haymarket VA 20169 James L Westhafer P. O. Box 305, Bealton VA 22712 Tammy A. Enders 70 Bunker Lane, Etters PA 17319 Denise A. Mescia 327 S. Enola Drive, Enola PA 17025 daugh~r son daughter daugh~r ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 25% 15% 30% 30% $0.00 (If more space is needed, insert additional sheets of the same size) · Andrews & Johnson A. 'SETTLEMENT SHEET 78 W. Pom_fret St., Carlisle, Pa. 17013 HUD-1 RESPA HB 4305-2 B. Type of Loan C. This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agents are shown. Items marked "(p.o.c.)" were paid outside the closing: They are shown for informational purposes and are not included in the totals. D. Name and Address of Borrower E.Name and Address of Seller F. Name and Address of Lender Pasquale Mescia and Estate of James C. Westhafer Wachovia Bank, its successors Denise Mescia and/or assigns G. Property Location H.Settlement Agent 19 West Beale Avenue Ronald E. Johnson, Esquire Place of Settlement I. Settlement Date Enola,PA 1 7025 78 West Pomfret Street April 28, 2003 Car se, PA 17013 J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION 100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER: t01. Contract sales price $55,000.00 401. Contract sales price $55,000.00 102. Personal Property 402. Personal property 103. Settlement charges to borrower(line1400) $1,725.25 403. 104. 404. 105. 405. Adjustments for items paid by seller in advance: Adjustments for items paid by seller in advance: 106. City, own taxes to $0.00 406. City/town taxes to $0.00 107. County taxes 4/28/03 to 12/31/03 $126.19 407. County taxes 4/28/03 to 12/31/03 $126.19 108. Assessments to 408. Assessments to 109. Maintenance to 409. Maintenance to 110. School taxes 4/28/03 to 6/30/03 $122.72 410. School taxes 4/28/03 to 6/30/03 $122.72 111. to 411. Commitment fee to 112. to 412. to 120, GROSS AMOUNT DUE FROM BORROWER: $56,974.16 420. GROSS AMOUNT DUE TO SELLER: $55,248.91 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. Deposit or earnest money 501. Excess deposit (see instructions) 202. Principal amount of new loan(s) $50,000.00 502. Settlement charges to seller (line 1400) $4.00 203. Existing loan(s) taken subject to 1503. Existing loan(s) taken subject to 204. Commitment Fee 504. Payoff of first mortgage 205. 505. 206. 506. Payoff of second mortgage loan 207. 507. 208. 508. 209. 509. Adjustments for items unpaid by seller: Adjustments for items unpaid by seller: 210. City/town taxes to $0.00 510. City/town taxes to $0.00 211. County taxes to $0.00 511. County taxes to $0.00 212. Assessments to 512. Assessments to 213. School taxes to $0.00 513. Maintenance to 214. to 514. School/taxes to $0.00 215. Water/Sewer 4/1/03 to 4/28/03 $29.86 515. Water/Sewer 4/1/03 to 4/28/03~ $29.86 216. to 516. to 217. to 517. to 218. to 518. to 2I 9. to 519. to 220. TOTAL PAID BY/FOR BORROWER $50,029.86 520. TOTAL REDUCTION AMOUNT DUE SELLER: $33.86 300. CASH AT SETTLEMENT FROM/TO BORROWER 600. CASH AT SETTLEMENT TO/FROM SELLER: 301. Gross amount due from borrower (line 120): $56,974.16 601. Gross amount due to seller (line 420) $55,248.91 302. Less amounts paid by/for borrower (line 220) $50,029.86 602. Less total reductions in amount due seller $33.86 303.CASH ([ X ] FROM) ([ ] TO) BORROWER: $6,944.30 603. CASH (IX ] TO) ([ ] FROM) SELLER: $55,215.05 Exhibit for Schedules A and I · i L. ,51::TTLEMENT CHARGES Paid From Borrower's Paid From Seller's 700. TOTAL SALES/BROKER'S COMMISSION Based on price ~ funds at Settlement funds at Settlement ~3ivisic;n of commission (line 700) as follows: $0.00 701. to 702. $0.00 to 703. Commission paid at settlement 800. ITEMS PAYABLE IN CONNECTION WITH LOAN. B01. Loan origination fee to Wachovia $750.00 802. Loan discount to 803. Appraisal Report to 804~ Credit Repod to 805. Final inspection fee to 806. Application fee to 807. Assumption Fee to 808. Flood Cert Fee to Wachovia $9.50 809. FNMA Processing Fee to 810. 811. 812. 813. 900. ITEMS REQUIRED TO BE PAID IN ADVANCE. 901. Interest from to @ per day 902. Mortgage insurance premium for mo. to 903. Hazard insurance premium for yrs. to 904. Flood insurance yrs. to 905. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard insurance mo. @ per mo. $0.00 1002. Mortgage ~nsurance mo. @ per mo. $0.00 1003. City property taxes mo. @ per mo. $0.00 1004. County properly taxes mo.@ per mo. $0.00 mo. ,o.0o 1005. Annual assessments (Maint.) 1006. School Properly Taxes mo.@ per mo. $0.00 lOO7. water D~st. Prop. Tax mo. @ per mo. $0.00 1008. Agg ragate Escrow Adjustment 1009. 1100. TITLE CHARGES: 1101. Settlement or closing fee to 1102. Abstract or title search to 1103. Title examination to 1104. Title insurance binder to 1105. Document preparation to to 1106. Notary fees to cash $10.00 $4,00 1107, Attorney fees to Joel O. Sechdst, Esquire POC Attorney fees to 1108. Title insurance to Ronald E, Johnson, Agent $588,75 (includes above items ,o.: 109 Lender's coverage $50,000.00 10. Owner's coverage $55,000.00 1 11. Title Insurance Endorsements $150.00 1112. Restrictions 1113. Messenger service to Andrews & Johnson 1114. Wire fee to Andrews & Johnson 1115.Closing Protection Letter fee to Commonwealth Land Title $35.00 1200 GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording fees: Deed $39.50 Mortgage $46.50 Releases $86.00 1202. City/county tax stamps: Deed $550.00 Mortgage 1203. State tax/stamps: Deed $550.00 Mortgage 1204. Tax Certificates 1205. 1300 ADDITIONAL SETTLEMENT CHARGES 1301. Survey 1302. Pest inspection 1303. East Pennsboro Township $96.00 1304. 1305. 1400. TOTAL SETTLEMENT CHARGES (entered on lines 103, Section J and 502, Section K) $1,725.25 $4.00 File Number CERTIFICATION I direct and authorize the Company to make the distributions indicated for my account on the attached HUD-1 Settlement Statement, approving the tax prorations indicated therein, and understand that prorations were based on figures for the preceding year, or estimates for the current year, and in the event of any change for the current year, all necessary adjustments must be made between Seller and Borrower direct; likewise and DEFICIT in delinquent taxes will be reimbursed to Title Company by the Seller. I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief it is a true and accurate statement of all receipts and disbursements made on my account or by me in this transaction. I further certify that I have received a copy of the HUD-1 Sett ement Statement. Borrowers Deni'se Mescia Tammy A. EnddCrs, Executrix for th~/ ' Estate of James C.Westhafer Sellers To the best of my knowledge, the HUD-1 Settlement Statement which I have prepared is a true and accurate account of the funds which were received and have been or will be d sbursed by the undersigned as part of the settlement of this transaction. lement Agent yon~ld'E.'Jo%nson Date Historical Quote http://netscape5.marketwatch.com/tools/quotes/historical.asp?date=... tls MarketWatch q Home A Amerisave MARKET OVERVIEW Historical Quote Enter symbol(s): IPRU INe~ ~ Find symbol Keyword search FREE! 4 issues of The Deal Enter Date: ~arch 25, 2002 Prudential Finl Inc (NYSE) PRU 32.38 UNCH Hisbrical Quote For: PRU Monday, March 25, 2002 Closing Price: 31.2t open: 31.20 High: 31.45 Low: 31.14 Volume: 930,200 Investor Tools ~~ Quick Tour Change Symbol: I~ D Chart Financial Analyst Insider Msg News Option SEC 0,00% vw: n/a 4:02pm 05/02/03 PRU Da i I ~,. -- 4/24/02 33. § 30.0 Apr No Splits News & Commentary I Personal Finance I Research & Tools IMarketWatch TV & Radio CBS MarketWatch Mobile I Featured Products I NewsFinder I Search News I Feedback Newsroom I Company Info I Investor Relations I Jobs I Advertising Media KitI Licensin,q MarketWatch.com is traded on the Nasdaq stock exchange under the symbol MKTW. 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Help - Site Map - Advertise with Us - Add Site - What's New&Cool © 2003 Netscape. All rights reserved. Terms of Use I Privacy Policy Exhibit for Schedule B 1 of 1 5/5/03 9:40 AM 3458 PNCBAN< April23,2002 Joel O. Secl~st 568 Old York Road Ettem, PA 17319 Estate of James C. W~tha£er, deceased $SN: 185-07-5375 DOD: 3/25/2002 Dear Mr. Seehrist: In response to your request for Date of Death balances for the customer noted above, our records show the following: Ci~eklag Account Account #5140068368 JAMES C WESTEAFER DOD balance: $5,181.41 + $0.81 accrued interest Interest Paid 1/1/2002 - 3/25/2002. $2.16 Established 03/t6/1989 For Brokerage information, you may call 1-800-762-6111. INV #86803g§g. Please note that this office only provides date of death balances for deposit aceom2ts (1R~, CDs, Checking and Savings accounts). We do not process any financhI trsmactioas or provide statements. If you need assistance with any of these Rems, please call I-8$8-PNC-BANK (1-888-762-2265) or stop by your lo~al PNC Bank branch Sincerely, Raehelle Wells 1-800-762-1775 PT-PFSC-04-F 500 first Ave. Piflsburgh PA 15219 Member FDIC Exhibit for Schedule E TOTAL P.O1 LL c) LU t'j3.-. c:> C::l l.LJ Ei} ;' o (,..) H.! STATUS REPORT UNDER RULE 6.12 James c. Westhafer Name of Decedent: March 25, 2002 Date of Death: Will No. 2002-00372 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: 1. State whether administration of the estate is complete: Yes x No 2. representative complete: If the answer is No, state when the personal reasonably believes that the administration will be 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No x b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes x No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. ~~ I ! / Signa r Joel o. Sechrist, Esquire Name (Please type or print) 568 old York Road Etters PA 17319 Address Date: i -"',~ ....:J... ~,.:~ -'') t.~ ~:"':l c::::; <..., Of l/) -:t 0.; f.--. ,~y- 2:: ms) 0:-:. Li. U::~ Ci Personal Representative Counsel for personal nR representative \/' co ( 717) 938-3396 Tel. No. Capacity: x (MAH:rmf/AM3) IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: Estate of James C. Westhafer No.2002-00372 C> ~'~~1 =-'~p\ ,..., co ~ c:...1 L.. Late of East Pennsboro Township, Cumberland County, Pennsylvania .....,... ::n jn ::--"') ~:j t ~:J ["Tl (',-:J r<l <Jl RELEASE ~ ~~ KNOW ALL MEN BY THESE PRESENTS, that I, James L. Westhafer, dotiereby en acknowledge that I have this date received from Tammy A. Enders, Executrix of the Estate of James C. Westhafer, the sum of$9,012.80 in full satisfaction of my share of the Estale of James C. Westhafer. (=:> --n I therefore release and forever discharge the said Tammy A. Enders, individually and as Exectrix of the Estate of James C. Westhafer, her heirs, Executors, and administrators, of and from all actions, duties, claims and demands whatsoever from the beginning of the world to the date of these presents. And I hereby consent and agree that the Orphans' Court of Cumberland County, Pennsylvania, may discharge the said Executrix upon application and without further notice to me. AND the undersigned, in consideration of said payment and transfer, does hereby agree, upon written request of the Executrix to refund to the said Estate pro-rata whatever assets, in kind or in cash, that may be necessary in the future to discharge any liabilities of the Estate. IN WITNESS WHEREOF, I have hereunto set my hand this ~ ,2003. day of ~ ~ t.A.M ~ WITNESS: J.L~ <s J arite "i-, '~'1~1 "'.; ;', ?:; ~ ':i SSN: ~07 ~ "3 If - '7;1., 5: 0 ;;';'i.;-J!I: :.( ;r IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL VANIA ORPHANS' COURT DIVISION IN RE: Estate of James C. Westhafer No.2002-00372 Late of East Pennsboro Township, Cumberland County, Pennsylvania RELEASE KNOW ALL MEN BY THESE PRESENTS, that I, Denise A. Mescia, do hereby acknowledge that I have this date received from Tammy A. Enders, Executrix of the Estate of James C. Westhafer, the sum of$18,025.61 in full satisfaction of my share of the Estate of James C. Westhafer. I therefore release and forever discharge the said Tammy A. Enders, individually and as Exectrix of the Estate of James C. Westhafer, her heirs, Executors, and administrators, of and from all actions, duties, claims and demands whatsoever from the beginning of the world to the date of these presents. And I hereby consent and agree that the Orphans' Court of Cumberland County, Pennsylvania, may discharge the said Executrix upon application and without further notice to me. AND the undersigned, in consideration of said payment and transfer, does hereby agree, upon written request of the Executrix to refund to the said Estate pro-rata whatever assets, in kind or in cash, that may be necessary in the future to discharge any liabilities of the Estate. IN WITNESS WHEREOF, I have hereunto set my hand this) 0 day of N<>lIf/lt,J,el' ,2003. WITNESS: O~'q.~' Denise A. Mescia SSN: Iy r- t('Y -f(P 7(/ IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: Estate of James C. Westhafer No.2002-00372 Late of East Pennsboro Township, Cumberland County, Pennsylvania RELEASE KNOW ALL MEN BY THESE PRESENTS, that I, Junanne Polend, do hereby acknowledge that I have this date received from Tammy A. Enders, Executrix of the Estate of James C. Westhafer, the sum of$15,021.34 in full satisfaction of my share of the Estate ofJames C. Westhafer. I therefore release and forever discharge the said Tammy A. Enders, individually and as Exectrix of the Estate of James C. Westhafer, her heirs, Executors, and administrators, of and from all actions, duties, claims and demands whatsoever from the beginning of the world to the date of these presents. And I hereby consent and agree that the Orphans' Court of Cumberland County, Pennsylvania, may discharge the said Executrix upon application and without further notice to me. AND the undersigned, in consideration of said payment and transfer, does hereby agree, upon written request ofthe Executrix to refund to the said Estate pro-rata whatever assets, in kind or in cash, that may be necessary in the future to discharge any liabilities of the Estate. IN WITNESS WHEREOF, I have hereunto set my hand this c). ~ day of ;J Ov. ,2003. WITNESS: j/ // 1';1 <'1 / // / A~~ ,1 tt~. -eX '1- ( n II j/ ft21:L. " , / SSN: ,9 31 .:T&- 0 t/ f..eo IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL VANIA ORPHANS' COURT DIVISION IN RE: Estate of James C. Westhafer No.2002-00372 Late of East Pennsboro Township, Cumberland County, Pennsylvania RELEASE KNOW ALL MEN BY THESE PRESENTS, that I, Tammy A. Enders, do hereby acknowledge that I have this date received from Tammy A. Enders, Executrix of the Estate of James C. Westhafer, the sum of$18,025.61 in full satisfaction of my share ofthe Estate of James C. Westhafer. I therefore release and forever discharge the said Tammy A. Enders, individually and as Exectrix ofthe Estate of James C. Westhafer, her heirs, Executors, and administrators, of and from all actions, duties, claims and demands whatsoever from the beginning of the world to the date ofthese presents. And I hereby consent and agree that the Orphans' Court of Cumberland County, Pennsylvania, may discharge the said Executrix upon application and without further notice to me. AND the undersigned, in consideration of said payment and transfer, does hereby agree, upon written request ofthe Executrix to refund to the said Estate pro-rata whatever assets, in kind or in cash, that may be necessary in the future to discharge any liabilities of the Estate. :i'TN IN WITNESS WHEREOF, I have hereunto set my hand this ( -- day of tI~ Ve""'EG r-- ,2003. WITNESS: ---( fJJvwvvur a ~ ~ Tanimy A. Endg!; SSN: l qg - 5~ -q'lQf '03 H~,Y 12 FI2:18 TO: Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle PA 17013 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280401 HARR[SI~URG, PA' I7128-0~0! COMHONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX TAMMY A ENDERS C/O JOEL 0 SECHRIST ESQ 568 OLD YORK ROAD [],L:i. ETTERS PA 17319[~tilY/~ "~: ~:~' :-:ESTATE OF NESTHAFER DATE OF DEATH 05-25-2002 FILE NUMBER 21 02-0572 '03 Jl;i'~ 20 :',i ~NTY CUHBERLAND ACM 101 Amount Remitted JAHES C MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF MILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~* RETAIN LONER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP C01-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF WESTHAFER JAHES C FILE NO. 21 02-0572 ACN 101 DATE 06-16-2005 TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATTON 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) $. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) (4) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXEHPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 55t000.00 2t656.52 .00 .00 .00 .00 C8) 12,054.09 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 15. 14. NOTE: ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 16. Amount of Line 14 taxable at Lineal/Class A rate C16) 17. Amount of Line 14 at Sibling rate C17} 18. Amount of Line 14 taxable at Collateral/Class B rate 19. Princi=al Tax Due TAX CREDITS PAYMENT RECEIPT DISCOUNT DATE NUHBER INTEREST/PEN PAID 05- 09 -2005 CD002552 58.27- 65,087.65 AMOUNT PAID 2,091.26 TOTAL TAX CREDIT I BALANCE OF TAX DUE] INTEREST AND PEN. TOTAL DUE reflect figures that include the total of ALL returns assessed to date. · O0 x O0 = 45,584.54 x 045= .00 x 12 = .00 x 15 = (19)= .00 .00 2,051.50 .00 .00 2,051.50 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 2,052.99 1.69CR .00 1.69CR ( IF TOTAL DUE IS LESS THAN ~1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF TH[S FORM FOR INSTRUCT[ONS.) Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) Net Value of Estate SubSect to Tax (14) 45,~8~.5~ If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 w111 (11) 17.~fl~.ll (~2) 45,584.54