HomeMy WebLinkAbout01-0393
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Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of
also known as
Florence H. Heffner
No.
2(-0\ - 3<1 ~
, Deceased
Social Security No. 438 - 62 - 8908
Sharon M. Heffner
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
rn A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut r ix named in the last Will of
the Decedent, dated 11/22/1999 and codicil(s) dated
- None -
State relevant circumstances, e.g., renunciation, death of executor, etc.
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:
- No exceptions -
D B. Grant of Letters of Administration
(c.t.a.; d.b.n.c.t.a; pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and
heirs:
r
Name
Relationship
Residence
I
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland
County, Pennsylvania with his/her last family
or principal residence at 35 Abbey Court, South Middleton Township
(list street, number, and municipality)
Decedent, then ~years of age, died 01/19/2001 at Carlisle Hospi tl, Carlisle, PA
(Location)
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
$
$
$
$
situated as follows:
- No real estate -
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of
letters' the a riate form to the undersi ned:
T
Sharon M. Heffner
8 Strawberr Lane, Carlisle, PA 17013
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, Inc.
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Form RW-1 (1991)
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Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true
and correct to the best of the knowledge and belief of Petitioner. s) and that, as personal representative(s) of
the Decedent, Petitione~s) will well and truly administer the e 1 te accordinvo law. ,
Sworn 10 or affirrned and subscribed V\i\ &~
Sharon M. Heffner
before me this--.f1IcHty of
AUGUST , 2001
. ~.~{J.*~.
For t e Register ~
MA Y CLEWIS
21 - 01 0 393
No.
Estate of Florence H. Heffner
Deceased
Social Security No: 438-62-8908 Date of Death: 01/19/2001
AND NOW,
AUGUST 29,
, 2001 , in consideration
of the Petition on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters [!] Testamentary D Of Administration
(c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate)
are hereby granted to
Sharon M. Heffner
in the above estate and that the instrument(s) dated
11/22/1999
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
Short Certificate(s).
$
3.00
ltfAn (d. rJ,1U~ ~U- Om~ ~
I Register of Wills
MARY CLEWIS
FEES
Letters. . .
$
18.00
Renunciation.
$
Attorney:
Donna M. Mullin, Esq.
Affidavits (
$
1.0. No:
30392
James, Smith, Durkin & Connelly
134 Sipe Avenue
Extra Pages (
) .
$
18.00
Address:
Codicil. .
$
Hummelstown, PA
17036
JCP Fee.
$
5.00
Telephone:
717/533-3280
Inventory.
$
Other
$
TOTAL. . . . . . . .. $ 44.00
Prepared by the Pennsylvania Bar Association COEyright (c) 1996 form software only CPSystems, Inc.
Mailed to attorney on 8-JO-01
Form RW-1 (1991)
H105.905 REV.(09/00l
This is to certifY that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records in accordance
with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
~~s,~/cr.
Robert S.6m!nerman, Jr., MPH
Secretary of Health
No.
~II~
Charles Hardester
State Registrar
1454021
MAR 2 9 2001
Date
o
,
CO~~CTED ITEMS:3 PE-~:FD DATE:3-27-01bas
Hl05. '43 Aev. 2/87 COR.~CTED ITEMS: 3 COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
PER.:FD DATE:3-8-01bas CERTIFICATE OF DEATH
002519
TYPE/PAINT
IN
PERMANENT
Ill.ACK INK
AGE (Las -vi
UNllER 1 YEAR
MonIho Days
STATE FilE NUMBER
SEX SOCIAL SECUAITY NUMBEA
DATE OF OEJ\TH .""'""'. 08). ._1
NAME OF DECEDENT IflrSt". Middle. Las)
8 0 Y...
2. Female J. 438 - 62
8IRTHPVoCE IC"", orod ~ OF DEATH /Ct>edo only """ "'" '''''rue''''''' on _ ""'"
SlaJe or f Cfeq1 COUtlIlyl HOSPITAl.;
1""",_ DI ER/OuIpet_ 0
7 ...
FACrllTV NAME (It not ff'l!l1'hAI()(l. giVE' street and number.
19 2001
....
~IO
RACE ."-_.-.Wl\ite.eIC.
(Spoay)
White
10.
5-
COUNTY OF DEATH
d\
...
Cumberland
DECEDENT'S USUAl OCCUPATION
(~...=:.::':.. ~ ~:J,:'i'
. llL Food Service Worker 11" Hospital
DECEDENT'S MAK.IHG AIlOflESS (SI..... c~. SlaIo. Zop coo"l
. 35 Abbey Court
Carlisle, Pa 17013
,..
FRHER'S NAME (fin!. MoOdIe. Lastl
~ Hugh Hattr1ck
lNF~i~!.?:H~ f fne r
201.
METHOD OF DISPOSITION
_ 0 C._ f9 __SIat.D
0IIler lSpecoIyI
171>.
MARITAL STATUS._
N_lotIniecl, WicIowed.
~~
Widowed
Oicl Sonth
-
we.".
Cumberland -..ship? 17d.o :;"'~-'=aI
MOTHER'S NAME iF..1. _. Maoden Su<namel
,t. Lillian Browne
-T"STtSr~~SSt.;'ri~,c~{i~~, Pal 7013
2Gb.
~ OF DISPOSITION. _ 01 ~...,. Crerna\ofy LOCATION . C~, SIal., Zip CaW
Of 0IIler PIK.
SURVMNG SPOUSE
I.......__nome,
hip.
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2001
21C.Yorktowne Crematory 21d. York, Pa
NAME ANO AOORESSOF FACI\.IlY
_.Ronan Ftmeral Hc.nE 255 York Road Carlisle, Pa 17013
LICENSE NUMBER DATE SIGNED
(Mono!\. 0.-,.:-1
01
PERSON ACTING AS SUCH
ILrJ
Lv/ll~ d '-Ms~
28.
I Apprcuumat.
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~. DUETO(OAASAC~OUENCE 01'): ..f
W;(,tYVIC U~V~YLJ.
DUE TO (OR ASA CONSEOUENCE 01'):
If)
DUE 10 (OR AS A CONSEOUE NCE 01')
PAAlII: Olher 'ignJlcont condilions conlribuIing 10 d..",. bul
noc resuttil\g in the undertytng cause gMtn in PART I
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WERE AUTOPSY F'NDtNGS
AVAILABLE PRIOR 10
COMPLETION OF CAUSE
OF DEATH?
Homl(;ide
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[]
[] NoD
v...D NoD
:::AOfD€~
-'" []
Suocide []
DATE OF INJURY'
fMonm. Day. lean
TIME Of INJUAY
INJURY AT WORK? DESCRIBE HOW IN.JURY OCCURRED
Pendtng Inveshgabon
Cowd nor be determined
[]
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2k. 21b. 29.
CERTtFlER fCt'eck 001)' one)
.CERTIFYING PHYSICIAN fPhys.c1dfl Cf>flltyu",C] c..ause 01 death wner .lnOl"'er Pt1vSIC'dfl has pronounced deal'" ana COfTlpleled Item 23)
To lite 0..1 0' my knowa.doe, cte.th occurred due to the c:ause($).nd m.nner.. st.ted. .
u...
-PAONOUNCING AND CERTIFYING PHYSICIAN (Ph'('iK:idn bolt; J'~noIJ(lClng rJE'dlh dnd Ceft"Vlfl<) lQCause uf oealh\ .
To ttM be.t 'Of my know'e>dg~. de.lh occurred.at lhe time. dale. oind pface. and due to Ihe c.u:S~($) and mann~r as slated
'MEDICAL EXAMINER/COAONEA
~~~:fb::i:t::::.~mil1.tion and/O~ ~nveS"9ation. in my o~inlOn. death oCcurred at the "me. date, and place. a~d due to th~ cause(s) and
31. . . .. .. ... .. -.. . . . - . . - '. - . . . . . . . . ... ." - ..................
REGISTRAR'S SIGNATURE -'NO M
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Last Will
of
FLORENCE H. HEFFNER
I, FLORENCE H. HEFFNER, a resident of Cumberland County, Pennsylvania, declare that this is
my last will. I hereby revoke all my previous wills and codicils.
Article One
Introductory Provisions
Section 1. Marital Status
I am not currently married.
Section 2. Children
a. The names and birth dates of my children are:
Name Birth Date
DOROTHYJ.MCCAULEY
ROBERT G. LOWN
SHARON M. HEFFNER
1
January 25, 1943
November 09, 1948
September 30, 1961
Article Two
Appointment of My Personal Representatives
Section 1. Nomination of My Personal Representatives
I appoint the following to be my Personal Representative(s) in the order of priority in which
their names appear:
SHARON M. HEFFNER; THEN
ROBERT G. LOWN; THEN
DOROTHYJ.MCCAULEY
If, for any reason, the Personal Representative(s) named above are unable or unwilling to serve,
the next successor Personal Representative(s) shall serve in the order of priority listed until the
list has been exhausted. Unless otherwise specified, if Co-Personal Representatives are serving,
the next named successor Personal Representative shall serve only after all of the Co-Personal
Representatives cease to act as Personal Representatives.
Section 2. Waiver of Bond
No bond or undertaking shall be required of any Personal Representative nominated in this will.
Section 3. General Powers
My Personal Representative shall have full authority to administer my estate under the laws of
the Commonwealth of Pennsylvania relating to the powers of fiduciaries. My Personal
Representative shall have the power to administer my estate under the Pennsylvania Probate,
Estates and Fiduciaries Code.
2
Article Three
Disposition of My Property
Section 1. Estate Planning Letter or Memorandum
To the extent permitted by state law and not necessary to fully utilize my Unused Unified Credit
Equivalent, my Personal Representative shall distribute such of my personal or household items
to such persons as I may direct by a written instrument signed by me and delivered to my
Personal Representative.
Section 2. Distribution to My Revocable Living Trust
I give all the rest, residue and remainder of my property of whatever nature and kind and
wherever located to the then acting Trustee(s) of my revocable living trust of which I am a
Trustor known as the:
FLORENCE H. HEFFNER LIVING TRUST dated NOV 2 2 1999
amendments thereto.
and any
I executed said trust prior to the execution of this will.
Section 3. Alternate Disposition
If my revocable living trust is not in effect for any reason, I give all of my property to my
Personal Representative under this will as Trustee who shall hold, administer and distribute my
property as a testamentary trust the provisions of which are identical to those of my revocable
living trust on the date of execution of this will, or as thereafter amended.
3
Article Four
Death Taxes
Section 1. Definition of Death Taxes
The term "death taxes," as used in this will, shall mean all inheritance, estate, succession, and
other similar taxes that are payable by any person on account of that person's interest in the
estate of the decedent or by reason of the decedent's death, including penalties and interest, but
excluding the following:
a. Any addition to the federal estate tax for any "excess retirement
accumulation" under Internal Revenue Code Section 4980A.
b. Any additional tax that may be assessed under Internal Revenue Code
Section 203 2A.
c. Any federal or state tax imposed on a generation-skipping transfer, as
that term is defined in the federal tax laws, unless the applicable tax
statutes provide that the generation-skipping transfer tax is payable
directly out of the assets of my gross estate.
Section 2. Payment of Death Taxes
Pursuant to the terms of my revocable living trust, all death taxes whether or not attributable to
property inventoried in my probate estate shall be paid by the Trustee from my trust. However,
if my trust does not exist at the time of my death or if the assets of my trust are insufficient to
pay the death taxes in full, I direct my personal representative to pay any death taxes that cannot
be paid by my trustee from the assets of my probate estate by equitably prorating and
apportioning those taxes among the beneficiaries of this will.
Unless specifically provided otherwise in nlY trust, all death taxes incurred by reason of assets
being transferred outside of my trust or probate estate shall be assessed against those persons
recei ving such property.
4
Article Five
General Provisions
Section 1. No Contest Clause
If any person or entity other than me singularly or in conjunction with any other person or
entity, directly or indirectly, contests in any court the validity of this will including any codicils
thereto, then the right of that person or entity to take any interest in my estate shall cease and
that person (and his or her descendants) or entity shall be deemed to have predeceased me.
Section 2. Captions
The captions of Articles, Sections and Paragraphs used in this will are for convenience of
reference only and shall have no significance in the construction or interpretation of this will.
Section 3. Severability
Should any of the provisions of this will be for any reason declared invalid, such invalidity shall
not affect any of the other provisions of this will and all invalid provisions shall be wholly
disregarded in interpreting this will.
Section 4. Governing Law
This will shall be construed, regulated and governed by and in accordance with the laws of the
Commonwealth of Pennsylvania.
I signed this, my last will, on NOV 2 2 1999
Q- jI Yf
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< )/.~-t!u --/, ~
FLORENCE H. HEFFNER .
5
ATTESTATION CLAUSE
The foregoing last will was, on the day and year written above, published and declared by
FLORENCE H. HEFFNER to be her Last Will and Testament.
We, in her presence and at her request, and in the presence of each other, also signed our names
as attesting witnesses.
We further state that each of us believes, according to our best knowledge and belief, that at the
time FLORENCE H. HEFFNER executed the foregoing last will, she was of sound mind and
memory, of lawful age, and did so execute it as her own free act and deed and not under the
unlawful influence of any person.
~70~_L ",f Jltl./l/L-i't1d./tl)
WITNESS'
Residing at
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COMMONWEALTH OF PENNSYLVANIA
: ss:
COUNTY OF DAUPHIN
W e, FLORENCE H. HEFFNER, Ie r IJI/a Yi"? I'L and fi I.[~ 11 [' 1'\')\'1'\ tI k, ,
the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing
instrument, being first duly sworn, do hereby declare to the undersigned authority that the
Testatrix signed and executed the foregoing instrument as the Testatrix's last will, that the
Testatrix signed it willingly, or directed another to sign it for the Testatrix, that it was executed
as a free and voluntary act for the purposes therein expressed, and that each of the witnesses, in
the presence and hearing of the Testatrix, signed the last will as witnesses, and that to the best
of their knowledge and belief, the Testatrix was at the time of sound mind and memory, of lawful
age, and under no constraint or undue influence.
j ~/~
~.JJ,
FLORENCE H. HEFFNE
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Subscribed, sworn to and acknowledged before me by FLORENCE H. HEFFNER, the Testatrix, and
subscribed ~d. sworn to before me by to rJ S' Hcu~'7 ~tl /l and
Filth I ( I ('llIle 1/(/ , witnesses, this NOV 2 2 999 .
I I
N
(SEAL )
Notarial Seal
Linda L. Fetterhoff, Nota,v Public
Derry Twp., Dauphin C"'!lnty
My Commission Expires f\,l< ;~ 2003
7
- - - - - -- - -- -- - - - - - - -- - - - ---,. ~ ~ -......- - - - - -..--.. - -..... - - - - - ~ - - ---- - -- -.--- --..... -- ---,.---..
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT.280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
'*
No.AA 478288 REV-1162 EX (11-96)
RECEIVED FROM:
I
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
DONNA M MULLIN ESQUIRE
JAMES SMITH DURKIN & CONNELLY
134 SIPE AVENUe:
HUMMELSTOWN, PA 1703b
101
$14.000.00
FOlD HERE
FOLD HERE -
ESTATE INFORMATION:
FILE NUMBER
21-2001-0393
SSN 43B-b2-8909
NAME OF DECEDENT (LAST) (FIRST)
HEFFNER FLORENCE H
(MI)
DATE OF PAYMENT
4/18/2001
POSTMARK DATE
0/00/0000
COUNTY
CUMBERLAND
$14,000.00
TOTAL AMOUNT PAID
5K
CHECK" ~02
SEAL
RECEIVED BY
MARY C. ~LE
REGISTER
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REGISTER OF WILLS
-----------~----,----------
'-. ~ ----.--------------------------
}AMEs SMITH DURKIN & CONNELLY LLP
Elizabeth S. Eck
Paralegal
ese@jsdlega1.com
April 12, 2001
Mary C. Lewis, Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, P A 17013
~J-DI- 3tJ3
Re: Trust Estate of Florence H. Heffner
Dear Ms. Lewis:
Our office represents the Trust Estate of Florence H. Heffner, deceased, who died on
January 19,2001, a resident of the Borough of Carlisle, Cumberland County, Pennsylvania.
Enclosed please find a check in the amount of $14,000.00 payable to the Register of Wills,
Agent, as a prepayment of Pennsylvania inheritance tax due the Commonwealth. This
payment is being made within 90 days of the decedent's death and thus qualifies for a 5%
discount.
Also enclosed is an original Estate Information Sheet to be forwarded to the Department of
Revenue. There is no estate file on record with the Cumberland County Court at this time
because there are no probate assets.
Please send me a receipt for the tax payment in the envelope that I have provided as well as
a clocked-in copy of the Estate Information Sheet.
Should you have any questions, or need any additional information, please do not hesitate
to contact me, or Donna M. Mullin, Esq., Counsel to the Trust Estate.
Very truly yours,
C-\
J
/ i' L' 'j"
Ul )'coLtt '-0
Elizabeth S. Eck
Paralegal
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lese
Enclosures
cc: Sharon M. Heffner
F: \HO ME\ESE\Heffner\Hetlner25 .doc
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J.~.).(
GARY L. JAMES
MAX. J. SMITH, JR.
KAREN DURKIN
JOHN J. CONNELLY, JR.
STUART J. MAGDULE
STEVEN A. STINE
JOHN J. McNALLY, III
SCOTT A. DIETTERICK
GREGORY K. RICHARDS
RICHARD L. DAHLEN
SUSAN M. KADEL
JARAD W. HANDELMAN
DONNA M. MULLIN
EDWARD P. SEEBER
E
CERTIFICATION OF NOTICE UNDER RlJLE 5.6(A)
Name of Decedent: Florence H. Heffner
Date of Death: January 19,2001
Will No.: Admin. No.: 2001-00393
TO THE REGISTER OF WILLS OF CUMBERLAND COUNTY:
I certify that Notice of 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 September 12~ 2001 :
Name
Address
Sharon M. Heffner, individually 8 Strawberry Lane, Carlisle, PA 17013
and as Trustee of the Florence H.
Heffner Living Trust dated 11/22/99,
and any amendments thereto
Dorothy 1. McCauley
245 S. Church Street, WaYllesboro, P A 17268
Robert G. Lown
964 Savannah Circle, Naperville, IL 60564
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except:
- no exceptions -
Date: 11/;2/0/
I ,
Signature: ~ //1, 7J,-J2f!.~
Telephone:
Donna M. Mullin, Esq.
James, Smith, Durkin & Connelly LLP
134 Sipe Avenue
Hummelstown, P A 17036
(717) 533-3280
Name:
Address:
Capacity:
Personal Representative
~ Counsel for Personal
Representative
F :\HOME\ESE\Heffuer\Heffner4 7 .doc
,.
Register of Wills of
County, Pennsylvania
INVENTORY
Estate of Florence H. Heffner
No. 21-01-0393
also known as
Date of Death 01/19/2001
, Deceased Social Security No. 438 - 62 - 8909
Sharon M. Heffner,
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation
placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned
no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this
Inventory. I /We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein
are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Name of Donna M. Mullin Esq.
Attorney:
1.0. No.: 30392
Address: 134 Sipe Avenue
Hummelstown, PA 17036
Telephone: 717/533-3280
Personal Represen4i~e , . ? .' '.
Signalure .~""" ~.~~ _ ~a:",~
Sharon M. Heffner
Signature:
Address:
8 Strawberry Lane
Carlisle, PA 17013
Telephone: 717/249 - 0848
Dated: , D -1lJ; - u I
Description Value
(See continuation page(s) attached)
(Attach additional sheets if necessary)
Total:
5,109.06
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, Inc.
Form#RW-7 (1992)
~
Estate of:
Date of Death:
County:
INVENTORY
Florence H. Heffner
01/19/2001
CASH:
Commerce Bank, N.A. - Time
deposit account #23099
titled in decedent's name
alone, valued per CIF
associate letter.
233.63
Commerce Bank, N.A. - Accrued
interest earned on time
deposit account #23099,
referenced above.
0.43
234.06
PERSONAL PROPERTY:
Decedent's vehicle - 1987
Plymouth Horizon, 4-door
hatchback, with
approximately 60,000 miles,
valued per actual sale.
500.00
Personal property - Furniture
and furnishings in
decedent's residence, valued
per executrix opinion.
1,000.00
1,500.00
-1-
#'
STOCKS/LISTED:
108.00 shares MetLife, Inc. - Traded
on the NYSE, common
3,375.00
3,375.00
TOTAL RECEIPTS OF PRINCIPAL...............
5,109.06
-2-
J\\II~~\IIIII[)IR..I.&((1..I."111. I \\\ Ollie 1\ J'~')'(
October 15,2001
Mary C. Lewis, Register of Wills
Cumberland County Courthouse
1 Courthouse Square
Carlisle, P A 17013-3387
Re: Trust Estate of Florence H. Heffner, deceased
Department of Revenue File #21-01-0393
Dear Ms. Lewis:
Enclosed please find an original Pennsylvania Inheritance Tax Return with attachments
and two (2) copies with no attachments for the referenced Estate. Please forward the
original to the Department of Revenue and keep one copy for your files. Kindly time-
stamp and return the extra copy to me along with your receipt for our check in the
amount of$15.00 payable to the Cumberland County Register of Wills for filing fees.
Also enclosed is an original and one copy of an Inventory. Please time-stamp and return
the copy to me.
Finally, also enclosed is our check in the amount of $40.00 payable to the Cumberland
County Register of Wills for additional fees for the grant of Letters Testamentary.
Please return your receipt to me.
Should you have any questions, or need any additional information, please do not
hesitate to contact me, or Donna M. Mullin, Esq., Counsel to the Estate.
Very truly yours,
I
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\--iLU:fJxJ-A
Elizabeth S. Eck
Paralegal
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Enclosures
cc: Sharon M. Heffner
Sent via certified mail
Article #7001 114000028633 2132
F: \HO M E\ES E\He ffner\Heffner57 .doc
ESTATE
SECURITY
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Elizabeth S. Eck
Paralegal
ese@jsdlegal.com
134 SIPE AVENUE
HUMMELSTOWN, PA 17036
MAILING ADDRESS
PO. BOX 650
HERSHEY. PA 17033
TOLL FREE 1800942.3660
TEL. 717533.3280
FAX 717.5337771
www.jamesestateplan.com
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REV-1500 EX + (6~OO)
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REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENT'S NAME(LAST, FIRST. AND MIDDLE INITIAL}
Heffner Florence H.
DATE OF DEATH (MM-DD-YEAR)
FILE NUMBER
I ~ -d.~'-/-13
OFFICIAL USE ONLY
21-01-0393
COUNTY CODE YEAR
SOCIAL SECURITY NUMBER
438-62-8909
THIS RETURN MUST BE FILED IN DUPUCATEWlTH THE
NUMBER
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
D
COMPLETE MAILING ADDRESS
3. date of death
. Remainder Return prior to 12- 13-82)
5. Federal Estate Tax Return RequIred
8. Total Number of Safe Deposit Boxes
~;i;
q
11. Election to tax under Sec. 9113(A)
(Attach Sch 0)
Donna M. Mullin Es .
FIRM NAME (If Applicable)
JAMES, SMITH, DURKIN & CONNELLY, LLP
TELEPHONE NUMBER
134 Sipe Avenue
Humme1stown, PA 17036
33 - 3 80
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or
Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o 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. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Une 12 minus Line 13)
(1)
(2)
(3)
01 19/2001 01 16/1921
IF APPLICABLE SURVIVING SPOUSE'S NAME LAST, FIRST, AND MIDDLE INITIAL)
X 1. OrIginal Return
4. Limited Estate
X 6. Decedent Died Testate
(Attach copy of W!1I)
o 9. Litigation Proceeds Received
2. Supplemental Return
4a. Future Interest Compromise (date of death after 12-12-82)
X 7. Decedent MaIntained a Living Trust
(Attach copy of Trust)
010. Spousal Poverty Credit
(date of death between 12-31-91 and 1- 1-95)
None
3,375.00
None
None
1,734.06
3,180.10
335,362.63
22,486.06
776.74
X
X
X
X
.0 0
.0 45
.12
.15
OFFICIAL USE ONLY
(B) 343,651.79
(11) 23,262.80
(12) 320,388.99
(13)
(14) 320,388.99
(15)
(16)
(17)
(IB)
(19)
0.00
14,417.50
0.00
0.00
14,417.50
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(4)
(5)
(6)
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 Une 14 taxable at lineal rate 320,388.99
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20. X H~Il!li;l
Copyright (c) 2000 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address'
STREET ADDRESS
CITY I STATE 1 ZIP
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
14,417.50
0.00
14,000.00
720.88
Total Credits ( A + B + C) (2)
14,720.88
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Totallnterest/Penahy ( D + E) (3)
4. If Une 2. is greater than Line 1 + Line 3, enter the difference. This is the OVERPA.YMENT.
Check box on Page 1 Line 20 to request a refund (4)
S. \f 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. (SA)
B. Enter the total of Line 5 + 5A. This is the 8A~ANCE DUE. (58)
Make Check Payable to: REGISTER OF WillS, AGENT
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:::i:;::: __ ;''',. __ .. ,,'::;>;:I:li:':':!< iL "I" " ?!!!::i:!:::i:i~i:)!;]:;::!:::!<<i:
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
8. retain the use or income of the property transferred; ~i ~
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 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
wh'lch contains a beneficiary des'lgnatian?
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
0.00
303.38
0.00
0.00
0.00
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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 lstrue,
d complete. Declaration of preparer other than the personal representative Is based on all Information of which preparer has any knowledge.
RE OF PERSON RESPONSIBLE FOR FlUNG RETURN Sharon M. Heffner
_ _ _~ _ ~:t_r:~~?_"r:"LIo~,l"_... _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Carlisle, PA 17013
JAMES, SMITH, DURKIN & CONNELLY, LLP
Avenue
DATE
10' (Lv- OJ
AN REPRESENTATIVE
~
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 tile
surviving spouse is 3% [72 P.S. 9116 (al( 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 forthe use at the surViving spouse is 0%
[72 P.S. 9116 (a) (1.1) 0i)J 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)
172 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)J. A sibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Copyright (c) 2000 form software only The Lackner Group, Inc, Form REV-1500 EX (Rev. 6-00)
REV-1S03 EX +(1-97)
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX. RETURN
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF
Florence H. Heffner
SSfl 438-62-8909
01/19/2001
21-01-0393
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM DESCRIPTION VALUE AT DATE
UNIT VALUE
NUMBER OF DEATH
1 108 shares MetLife, Inc. - Traded on the NYSE, common 31. 25 3,375.00
TOTAL (Also enter on line 2, Recapitulation) 3,375.00
(It more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc.
Form REV-1503 EX (Rev. 1-97)
REV-1508 EX t (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCETAA RETURN
RESIDENT DECEDENT
ESTATE OF
Florence H. Heffner
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
SSII 438-62-8909
01/19/2001
FILE NUMBER
21-01-0393
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
NUMBER
1
DESCRIPTION
Commerce Bank, N.A. - Time deposit account 1123099 titled in
decedent's name alone, valued per elF associate letter.
VALUE AT DATE
OF DEATH
233.63
2
Commerce Bank, N.A. - Accrued interest earned on time deposit
account 1123099, referenced above.
0.43
3
Decedent's vehicle - 1987 Plymouth Horizon, 4-door hatchback,
with approximately 60,000 miles, valued per actual sale.
500.00
4
Personal property - Furniture and furnishings in decedent's
residence, valued per executrix opinion.
1,000.00
TOTAL (Also enter on line 5, Recapitulation) $ 1,734.06
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-150a EX (Rev. 1-97)
REV~1509 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Florence H. Heffner
SCHEDULE F
JOINTLY-OWNED PROPERTY
SSfJ 438-62-8909
01/19/2001
FILE NUMBER
21-01-0393
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
A.
SURVIVING JOINT TENANT(S) NAME
Sharon M. Heffner
ADDRESS
RELATIONSHIP TO DECEDENT
Daughter
8 Strawberry Lane
Carlisle, PA 17013
B,
c.
JOINTLY-OWNED PROPERTY
LETTER DATE DESCRIPTION OF PROPERTY "10 OF DATE OF DEATH
ITEM FOR JOINT MADE Include name of financial Institution and bank DATE OF DEATH DECO'S VALUE OF
account number or similar Identffylng number.
NUMBER TENANT JOINT Attach deed for Jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTERES
1 A 01/01/98 Muriel Siebert & Co. , Inc. 6,360.19 50.00% 3,180.10
- Brokerage account
l1CXT-166316 titled jointly
wi th daughter, Sharon M.
Heffner, valued per
administrative manager
letter.
TOTAL (Also enter on line 6, Recapitulation) $ 3,180.10
T
(If more space is needed insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc.
Form REV-1509 EX (Rev. 1-97)
REV-1510 EX +(1-97)
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE T p.:x RETURN
RESlDENT DECEDENT
ESTATE OF
Florence H. Heffner
5511 438-62-8909
01/19/2001
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes.
ITEM
NUMBER
1
DESCRIPTION OF PROPERTY
RELA W8hM~,~ t~b~~~B~~lt:'t~J~~~~Al-'tEJF t~~~RSFER.
ATTACH A COPYOF THE DEED FOR REAL ESTATE.
Prudential Insurance
Company of America -
Annuity contract
#R05885621, owned by
decedent; beneficiaries are
decedent's three children
in equal shares.
DATE OF DEATH
VALUE OF ASSET
26,935.97
2
American Express -
Strategic Portfolio Service
Advantage account
#47365077, titled in the
name of the Florence H.
Heffner Living Trust dated
11/22/1999, valued per
senior financial advisor
letter.
115,421.17
3
Commerce Bank, N.A. - Time
deposit account #25130
titled in the name of the
Florence H. Heffner Living
Trust dated 11/19/1999,
valued per ClF associate
letter.
10,524.22
4
Commerce Bank, N.A. -
Accrued interest earned on
time deposit account
#25130, referenced above.
13.29
5
Commerce Bank, N.A. -
Non-interest bearing
checking account #513040873
titled in the name of the
Florence H. Heffner Living
Trust dated 11/22/1999,
valued per ClF associate.
961.56
6
Commerce Bank, N.A. -
Savings checking account
#616084563 titled in the
name of the Florence H.
Heffner Living Trust dated
11/22/1999, valued per ClF
associate.
21,240.82
Total of Continuation 5chedu1e(s)
% OF
DECO'S
INTEREST
100.00%
EXCLUSION
(IF APPLICABLE)
0.00
100.00%
100.00%
100.00%
100.00%
100.00%
TOTAL (Also enter on line 7, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
Copyright (e) 1996 form software only CPSystems, Inc.
0.00
0.00
0.00
0.00
0.00
FILE NUMBER
21-01-0393
TAXABLE VALUE
26,935.97
115,421.17
10,524.22
13.29
961.56
21,240.82
160,265.60
335,362.63
Form REV-1510 EX (Rev. 1-97)
Estate of: Florence H. Heffner
Sac Sec #: 438-62-8909
Date of Death: 01/19/2001
Continuation of Schedule G
(Inter-Vivos Transfers & Misc. Non-Probate Property)
Item Description of Property
#
Date of Death % Decd Exclusion Taxable Value
Value of Asset Intrst
7
Commerce Bank, N.A. -
Accrued interest earned on
savings checking account
#616084563, referenced
above.
36.66 100.00%
0.00
36.66
8
Decedent's residence -
House and lot situate at 35
Abbey Court, South
Middleton Township,
Cumberland County, PA,
titled in the name of the
Florence H. Heffer Living
Trust dated 11/22/1999;
valued per actual sale.
120,000.00 100.00%
0.00
120,000.00
9
1,258.5995 shares Lucent
Technologies Inc, CUSIP
#549463107 - Traded on the
NYSE, common shares titled
in the name of the Florence
H. Heffner Liiving Trust
dated 11/22/99 and held in
shareholder investment plan
account #0031585599.
25,250.65 100.00%
0.00
25,250.65
10
Manufacturers and Traders
Trust Company -
Non-interest bearing
checking account
#0000113811 titled in the
name of the Florence H.
Heffner Living Trust dated
11/22/1999, valued per bank
letter.
1,802.45 100.00%
0.00
1,802.45
11
Pennsylvania State
Employees Credit Union
Interest bearing Regular
Shares Account 81, titled
in the name of the Florence
H. Heffner Living Trust
dated 11/22/1999, valued
per finance support unit
11,698.42 100.00%
0.00
11,698.42
Estate of: Florence H. Heffner
Sac Sec #: 438-62-8909
Date of Death: 01/19/2001
Continuation of Schedule G
(Inter-Vivos Transfers & Misc. Non-Probate Property)
Item Description of Property
1f
Date of Death % Decd Exclusion Taxable Value
Value of Asset Intrst
letter.
12
Pennsylvania State
Employees Credit Union
Accrued interest earned on
Regular Shares Account Sl,
referenced above.
17.85 100.00%
0.00
17.85
13
Pennsylvania State
Employees Credit Union
Interest bearing Checking
Shares Account 34, titled
in the name of the Florence
H. Heffner Living Trust
dated 11/22/1999, valued
per finance support unit
letter.
1,458.13 100.00%
0.00
1,458.13
14
Pennsylvania State
Employees Credit Union
Accrued interest earned on
Checking Shares Account 34,
referenced above.
1. 44 100.00%
0.00
1.44
160,265.60
REV-1511 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Florence H. Heffner
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
B.
7.
1
SSlt 438-62-8909
FILE NUMBER
21-01-0393
01/19/2001
DESCRIPTION
AMOUNT
1
FUNERAL EXPENSES,
Carlisle VFW - Post-funeral luncheon for family and friends
345.00
2
George's Flowers - Funeral flowers
265.00
3
Ronan Funeral Home - Funeral goods and services
2,280.00
1.
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:
2.
3.
Attorney's Fees JAMES, SMITH, DURKIN & CONNELLY, LLP
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
6,000.00
4.
Register of Wills
91.00
Probate Fees
5.
Accountant's Fees
300.00
6. Tax Return Preparer's Fees
Other Administrative Costs
Beckholts & Son - Carpet cleaning services prior to listing house
for sale
159.95
2
Cumberland County Register of Wills - Filing fee for inheritance
tax return and inventory
15.00
3
Dept. of Vital Records - Cost of corrected death certificates
15.00
4
GPU Energy - Utility bill after death
81.84
5
James, Smith, Durkin & Connelly, LLP - Reserved for closing costs
250.00
Total of Continuation Schedule(s)
12,683.27
TOTAL (Also enter on line 9, Recapitulation) $ 22,486.06
(It more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97)
Estate of: Florence H. Heffner
Soc See #: 438-62-8909
Date of Death: 01/19/2001
Continuation of Schedule H-B2
(Attorney's Fees)
Item
il
Description
Amount
1
James, Smith, Durkin & Connelly, LLP - Attorney fees
6,000.00
6,000.00
Estate of: Florence H. Heffner
Sac Sec #: 438-62-8909
Date of Death: 01/19/2001
Continuation of Schedule H-B4
(Probate Fees)
Item
i/
Description
Amount
1
Cumberland County Register of Wills
Probate fees
51. 00
2
Cumberland County Register of Wills
Testamentary
Additional fee for Letters
40.00
91. 00
Estate of: Florence H. Heffner
Sac Sec #: 438-62-8909
Date of Death: 01/19/101
Continuation of Schedule H-B5
(Accountant's Fees)
Item
1/
Description
Amount
1
Miller & Associates - Accountant's fee for preparation of
decedent's 2000 income tax return.
200.00
2
Miller & Associates - Estimated accountant's fee for preparation
of decedent's 2001 income tax return.
100.00
300.00
Estate of: Florence H. Heffner
Soc See #: 438-62-8909
Date of Death: 01/19/2001
Continuation of Schedule H-B7
(Other Administrative Costs)
Item
11
Description
Amount
6
Real estate settlement - Net deductions from sale of decedent's
residence
8,505.77
7
Robert G. Lawn - Fee paid to decedent's son to manage household
affairs from date of death until date of sale of residence.
2,800.00
8
Robert G. Lawn - Reimbursement to decedent's son for truck
rental.
1,000.00
9
South Middleton Township - Sewer and water bills after death
66.00
10
The Villas Homeowners Association - Homeowners association dues
210.00
11
United Parcel Service - Overnight delivery charges
11.50
12
Waste Management - Trash bills for 3 months after death
90.00
12,683.27
REV-1512 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Florence H. Heffner
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, AND LIENS
SS1! 438-62-8909
01/19/2001
FILE NUMBER
21-01-0393
Include unreimbursed medical expenses.
ITEM
NUMBER
1
DESCRIPTION
Arthur Christopher - Repairs made to roof of residence prior to
death
AMOUNT
250.00
2
GPU Energy - Decedent's final utility bill
81.84
3
Jean Salinger - House-cleaning services
70.00
4
PACE - Prescription bill not covered by insurance
311. 90
5
South Middleton Township - Final sewer and water bill
33.00
6
Waste Management - Final trash bill
30.00
TOTAL (Also enter on line 10, Recapitulation) $ 776.74
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97)
REV- 1513 EX + (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
Florence H. Heffner
01/19/2001
SSfl 438 - 62 - 8909
NUMBER
I.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [Include outright spousai distributions, and
transfers under Sec. 9116(a)(1.2)]
Sharon M. Heffner
8 Strawberry Lane
Carlisle, PA 17013
1
2
Amy K. Lown
1176 Village
Atlanta, GA
Court SE
30316
3
Jeffrey Lown
964 Savannah Circle
Naperville, IL 60564
4
Robert G. Lown
964 Savannah Circle
Naperville, IL 60564
5
Ryan G. Lown
964 Savannah Circle
RELA IIONSHIP TO DECEDENT
Do Not List Trustee(s)
Daughter
Gr anddaughter
Grandson
Son
Grandson
FILE NUMBER
21-01-0393
AMOUNT OR SHARE
OF ESTATE
One-third
(1/3) of
residue
10,000.00
10,000.00
One-third
(1/3) residue
10,000.00
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18. AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS,
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 2000 form software only The Lackner Group, Inc.
0.00
Form REV-1513 EX (Rev. 9-00)
.
Estate of: Florence H. Heffner
Soc See #: 438-62-8909
Date of Death: 01/19/2001
Item
il
Continuation of Schedule J, Part I
(Taxable Bequests)
Name and Address of Beneficiary
Relationship
Amount or
Share of Estate
Naperville, IL 60564
6
Dorothy J. McCauley
245 South Church Street
Waynesboro, PA 17268
Daughter
One-third
(1/3) residue
7
Great
Grandson
5,000.00
John Travis Schoenberger
514 Cumberland Avenue
Chambersburg, PA 17201
8
Great
Granddaughter
5,000.00
Stephanie Schoenberger
514 Cumberland Avenue
Chambersburg, PA 17201
9
Great
Granddaughter
5,000.00
Amelia Wetzel
2195-A Sowell Court
Schofield Barracks
Wahiawa, HI 96786
10
Great
Granddaughter
5,000.00
Ashley Wetzel
2195-A Sowell Court
Schofield Barracks
Wahiawa, HI 96786
11
George R. Wetzel, Jr.
2195-A Sowell Court
Schofield Barracks
Wahiawa, HI 96786
Grandson
10,000.00
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STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Florence H. Heffuer
Date of Death:
January 15.2001
Will No.
Admin. No. 2001-00393
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 administration of the estate is complete:
Yes X No
2. If the answer is No, state when the personal representative
reasonably believes that the administration will be complete:
3. If the answer to No. I is Yes, state the following:
a. Did the personal representative file a final account
with the Court? Yes No X
b. The separate Orphan's Court No. (if any) for the
personal representative's account is:
c. Did the personal representative state an account
informally to the parties in interest? Yes No --L
d.
Copies of receipts, releases, joinders and approvals of
formal or informal accounts may be filed with the Clerk of the
Orphans' Court and may be attached to this report.
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Signature
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Donna M. Mullin. ESQ.
JAMES. SMITH. DIETTERlCK & CONNELLY
134 Sipe Avenue
Hurnmelstown. P A 17036
(717) 533-3280
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Capacity:
Personal representative
X Counsel for personal representative
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG. PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT 1 ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
ReCorCH3G of
Rec:~1;~~t'\;d!s
.01
ole 27 A10 :11
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
DONNA M MULLIN ESQ
JAMES ETAL
134 SIPE AVE
HUMMELSTOWN
Cierk-
Curnbbi
PA 17036
12-17-2001
HEFFNER
01-19-2001
21 01-0393
CUMBERLAND
101
*'
REY-1547 EX AFP llZ-DDl
FLORENCE H
,::::1- h~f
P/\
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE1 PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV=is4j-E3f-AFP--fi';f=offf-NO'T-icE--OF-'rNHEifiTANCi-'T-Ax-A-PPRAisEMENT~--A[rowANCi-(rR------------ -----
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HEFFNER FLORENCE H FILE NO. 21 01-0393 ACN 101 DATE 12-17-2001
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)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
ll)
(2)
(3)
(4)
(5)
(6)
(7)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
llO)
.00
3.375.00
.00
.00
1,734.06
3,180.10
335,362.63
(8)
221486.06
776.74
lllJ
ll2)
ll3)
ll4)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
3431651.79
23.26? 80
3201388.99
.00
3201388.99
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate
16. Amount of Line 14 taxable at Lineal/Class A rate
17. Amount of Line 14 at Sibling rate
18. Amount of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS:
ll5) .00 X 00 = .00
ll6) 3201388.99 X 045 = 14/417.50
ll7) .00 X 12 = .00
ll8) .00 X 15 = .00
ll9)= 14/417.50
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
04-18-2001 AA478288 720.88 14/000.00
TOTAL TAX CREDIT 14/720.88
BALANCE OF TAX DUE 303.38CR
INTEREST AND PEN. .00
TOTAL DUE 303.38CR
. IF PAID AFTER DATE INDICATED 1 SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1/ NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR)1 YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
" / b '- .2 c2 'l - /-_-q
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
*
REY-1607 EX AFP (12-00)
Ree(;r; ; .
He:""
DONNA M MULLIN Es~02
JAMES ETAL
134 SIPE AVE
HUMMELSTOWN
FEB -1
P 1 :44
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
12-31-2001
HEFFNER
01-19-2001
21 01-0393
CUMBERLAND
101
FLORENCE
H
Cit;nc;
CMntlO ;56
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLEI PA 17013
NOTE: To insure proper credit to your accountl submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~
RE-V =i6'ifj-ix--AFP--fi"2-:offr------...--fNifERI,.-ANCE--TAX--STA-fEME-tiT-CrF"-AC-Couiff--.-..--------------- - -- - --
ESTATE OF HEFFNER
FLORENCE H FILE NO.21 01-0393
ACN 1 01
DATE 12-31-2001
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUEl APPLICATION OF ALL PAYMENTS I THE CURRENT BALANCEI ANDI IF APPLICABLE I
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 12-17-2001
P R I NC I PAL TAX DU E : ...........................................................................................................................................................................................................................
141417.50
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
04-18-2001 AA478288 720.88 141000.00
12-12-2001 REFUND .00 303.38-
TOTAL TAX CREDIT 141417.50
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
. IF PAID AFTER THIS DATEI SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $11
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRll
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. l
~V'
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STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Florence H. Heffner
Date of Death:
January 15,2001
Will No.
Admin. No. 2001-00393
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:
y~ ~ X
2. If the answer is No, state when the personal representative
reasonably believes that the administration will be complete:
Unknown - dependent on resolution of litigation matter
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final account
with the Court? Yes No
b. The separate Orphan's Court No. (if any) for the
personal representative's account is:
c. Did the personal representative state an account
informally to the parties in interest? Yes No
d. Copies of receipts, releases, joinders and approvals of
formal or informal accounts may be filed with the Clerk of the
Orphans' Court and may be attached to this report.
Date: P-j(1/o~
~?J1. ~-
Signature
Donna M. Mullin, Esq.
JAMES, SMITH, DURKIN & CONNELLY
134 Sipe Avenue
Hummelstown, P A 17036
(717) 533-3280
Capacity:
Personal representative
X Counsel for personal representative
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (71 7) 240 - 6345
Date: 12/06/2002
HEFFNER SHARON M
8 STRAWBERRY LANE
CARLISLE, PA 17013
RE: Estate of HEFFNER FLORENCE H
File Number: 2001-00393
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing will become delinquent on: 1/19/2003
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
MARY C. LEWIS
REGISTER OF WILLS
cc:
/File
Counsel
Judge
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STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Florence H. Heffner
Date of Death:
January 15. 2001
Will No.
Admin. No. 2001-00393
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. If the answer is No, state when the personal representative
reasonably believes that the administration will be complete:
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final account
with the Court? Yes No X
b. The separate Orphan's Court No. (if any) for the
personal representative's account is:
c. Did the personal representative state an account
informally to the parties in interest? Yes No X
d.
Copies of receipts, releases, joinders and approvals of
formal or informal accounts may be filed with the Clerk of the
Orphans' Court and may be attached to this report.
(Y)
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Donna M. Mullin. ESQ.
JAMES. SMITH. DIETTERICK & CONNELLY
134 Sipe Avenue
Hummelstown. P A 17036
(717) 533-3280
c~~
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Capacity:
Personal representative
X Counsel for personal representative