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Home My WebLink About02-1157l~ PETITION FOR PROBATE and GRANT OF LETTERS Estate of NAOMI R. MCCLINTOCK No. ~ - Qa - ~ ~ ~j`'~ also known as To: Register of Wills for NAOMI MCCLINTOCK Cumberland County, Deceased. Pennsylvania Social Security No. 194-52-5596 The Petition of the undersigned respectfully represents that: Your Petitioners, who are 18 years of age or older and the Executors named in the Last Will and Testament of the above decedent, dated November 1, 1993. Decedent was domiciled at death in Cumberland County, Pennsylvania, with her principal residence at Church of God Home, 801 North Hanover Street, Room 410, North Middleton Township, Carlisle, Cumberland County, Pennsylvania. Decedent, then 91 years of age, died December 16, 2002, at Church of God Home, Carlisle, North Middleton Township, Cumberland County, Pennsylvania. Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: N/A. 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 $ 250,000.00 (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: WHEREFORE, Petitioners respectfullyrequest the probate ofthe Last Will and Testamentpresented herewith and the grant of letters TESTAMENTARY thereon. Q~~e-~w`~ '~ ~ ~~ Robert F. Derk 1309 White Birch Lane Carlisle, Pennsylvania 17013 ~~~. ~. ~ Jean R. Derk 1309 White Birch Lane Carlisle, Pennsylvania 17013 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ) SS COUNTY OF CUMBERLAND The Petitioners above-named swear or affirm that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of Petitioners and that as personal representatives of the above decedent Petitioners will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me this i9th day of LECEMBER , 2002 Register ~-~- ~ . C C1Z~-~,~" ~' ~-- Robert F. Derk Jean .Derk 1. ~. NO. 21-02-1157 Estate of Naomi R. McClintock, a/k/a Naomi McClintock, Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW DECMEBER 2 3 , 2002, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated November 1, 1993 described therein be admitted to probate and filed of record as the last will of NAOMI R. MCCLINTOCK A/K/A NAOMI MCCLINTOCK; and Letters Testamentary are hereby granted to Robert F. Deck and Jean R. Derk. egister of Wills FEES Probate, Letters, Etc............ $ 2 7 0. 0 0 Short Certificate(s) ............. $ 18.0 0 Michael J. Hanft Esq ' e ~~x,..extra.„pages 9.00 Attorney LD. No. 57976 - 3 cp $ ~ n . n n 19 Brookwood Avenue, Suite 106 TOTAL $ 3 0 7.0 0 Carlisle, Pennsylvania 17103-9142 Filed......J.2.-2.3.-2.0 Q.2 ............................... (717) 249-5373 called atty and put in box 11-23-2002 F: \User Folder\Firm Docs\Estates\2996- I .pet letters. wpd REGISTER OF WILL OF CUMBERLAND COUNTY OATH OF NON-SUBSCRIBING WITNESS ~l-Oa-CIS'~ Robert F. Derk and Jean R. Derk, each a subscriber hereto, being duly qualified according to law, depose and say that they are familiar with the signature of Naomi R. McClintock, Testatrix, and believe to the best of their knowledge and belief that the signature on the Will dated November 1, 1993 is in the handwriting of Naomi R. McClintock, Testatrix. Sworn to or affirmed and subscribed before me this 19 tray of December, 2002. Robert F. Derk 1309 White Birch Lane Carlisle, Pennsylvania 17013 C~„ Ot ,. Jean R. Derk 1309 White Birch Lane Carlisle, Pennsylvania 17013 F:\User Folder\Firm Dou\Fortrs\Estatesbath.non.sub.witness.wpd ~Y ~,. Last Will and Testament of _J Naomi R. McClintock ~ l- oa - 115 I, NAOMI R. McCLINTOCR, of Carroll Township, Perry County, Pennsylvania, declare this to be my Last Will and revoke any Will previously made by me. ITEM I: I direct that my Executor or alternate Co- Executors arrange for my funeral and burial. ITEM II: I direct that my funeral expenses, grave marker and the costs of the administration of my estate be paid out of my residuary estate as soon as may be convenient after my death. ITEM III: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as part of the administration thereof, to the end that no beneficiary hereunder, or any other person, shall be charged with or required to pay any part of such taxes. ITEM IV: I devise and bequeath my entire estate of every nature and wherever situate, whether real, personal or mixed, to my husband, Joseph E. McClintock, provided he shall survive me by thirty (30) days. ITEM V: Should my husband, Joseph E. McClintock, predecease me or die on or before the thirtieth (30th) day following my death, then and in that event, I devise and bequeath .! ~ w my entire estate of every nature and wherever situate, whether real, personal or mixed, to my daughter, Jean R. Derk, and my son- Ilin-law, Robert F. Derk. ITEM VI: Should my husband, Joseph E. McClintock, Ilmy daughter, Jean R. Derk, and my son-in-law, Robert F. Derk, predecease me or die on or before the thirtieth (30th) day following my death, then and in that event, I devise and bequeath my entire estate of every nature and wherever situate, whether real, personal or mixed, as follows: A. Fifty (50$) percent to my brother, Robert Myron Brown, Sr., per stirpes; and B. Fifty (50$) percent to my husband's brothers' children, in equal shares, per stirpes. ITEM VII: I authorize and empower my hereinafter _~ named Executor or alternate Co-Executors to convert any property that I may own at my death, whether real, personal or mixed, at either private or public sale, whichever in their opinion is deemed best, hereby vesting in said Executor or alternate Co-Executors full power and authority to make, execute, acknowledge and deliver good and sufficient deeds or assurances of title thereof, taking into consideration what would be best for any of my beneficiaries who may then be minors. ITEM VIII: I appoint my husband, Joseph E. McClintock, Executor of this my Last Will. Should my husband, 7oseph E. McClintock, fail to qualify or cease to act as Executor, ~' s I appoint my daughter, Jean R. Derk, and my son-in-law, Robert F. Derk, alternate Co-Executors of this my Last Will. ITEM I8: I direct that my Executor or alternate Co- Executors shall not be required to give bond for the faithful performance of their duties in this or in any other jurisdiction. IN WITNE88 WHEREOF, I have hereunto set my hand this 1st day of November, 1993. ~y,~ omi R. McClintock r' The preceding instrument, consisting of this and three other typewritten pages, each identified by the signature of the Testatrix, was on the day and date thereof signed, published and declared by Naomi R. McClintock, the Testatrix therein named, `~~ ~~ J as and for her Last Will, in the presence of us, who at her request, in her presence and in the presence of each other, have subscribed our names as witnesses hereto. ~~ ~ k.! Cl ~" '~~2r~- r~ v m Z m V ~ N 01 = p Z t~ v m D ~ ~ O ~ X ~ I ~ ~ m Q O v Yi "' °y ~ ~ Z n = ~ D Z D ° Z m N y ~ ~ r D Z ~ 0 ~ Z 7d . C7 +"1"t td ~~ ~"~~ ~"~.~ J` F:\User Folder\Firm Docs\Fstates\2990-Lcert.wpd CERTIFICATION OF NOTICE UNDER RULE 5 6(a) Name of Decedent: NAOMI R. MCCLINTOCK, A/K/A NAOMI MCCLINTOCK Date of Death: December 13, 2002 Will No. 21-02-1157 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 February jam, 2003. Name Address Robert F. Derk Jean R. Derk Robert Myron Brown, Sr. Larry A. McClintock Ramona R. Bornman Lawanna Pahler Wanita Paul 1309 White Birch Lane, Carlisle, Pennsylvania 17013 1390 White Birch Lane, Carlisle, Pennsylvania 17013 1526 Leidigh Drive, Boiling Springs, Pennsylvania 17007 910 Pisgah State Road, Shermansdale, Pennsylvania 17090 RD 1, Box 395A, New Bloomfield, Pennsylvania 17068 4503 NE 6th Place, Renton, Washington 98059 5516 Lakeshore Drive #108, Columbia, South Carolina 29206 Notice has not been given to all persons entitled thereto under Rule 5.6(a) except: N/A HANFT & KNIGHT, P.C. Date: February ~, 2003 Michael J. Hanft, Esqui~ Attorney I.D. No. 57976 19 Brookwood Avenue, Suite 106 Carlisle, Pennsylvania 17013-9142 Telephone (717) 249-5373 Capacity: Counsel forpersonal representatives HANFT ~ KNIGHT, P.C. ALTC~RNLYS ~ CC~UNSLLLOFZS AT LAW March 13, 2003 Register of Wills of Cumberland County Cumberland County Courthouse Courthouse Square Carlisle, Pennsylvania 17013 RE: Estate of Naomi R. McClintock Estate No. 2002-01157 Date of Death: December 13, 2002 My File No. 2996.1 Dear Register of Wills: Wil_unnn A. ADDnMS Ml~fintl J. tinNr-i- VRFGOIZY fi. KNICIII Enclosed with this letter is my escrow check number 1330 in the amount of $11,200.00, representing a prepayment of the inheritance tax due in the above-referenced estate. Would you please issue the appropriate receipt and forward it to me. I thank you in advance for your prompt attention to this matter. Very truly yours, HANFT & KNIGHT, P C. Michael J. Hanft MJH/dmh Enclosure cc: Robert and Jean Derk, Co-Executors (without enclosure) F.AUser FolderAFirm DocsV8states\299Glprepay-Itr.wpd 19 BR(K)KWUC)D AvrNUr Surrr 10G CnRI_itil.F. PA 17013-9142 717.249.5373 rnx 717.249.0457 www.riaNl~rLnwnRnn.conn 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 REV-1162 EXI11-96) N0. CD 002285 HANFT MICHAEL J ESQUIRE 19 BROOKWOOD AVENUE SUITE 106 CARLISLE, PA 17013 ------- told ACN ASSESSMENT AMOUNT CONTROL NUMBER ESTATE INFORMATION: SsN: i 94-52-55x6 FILE NUMBER: 2102-1 157 DECEDENT NAME: MCCLINTOCK NAOMI R DATE OF PAYMENT: 03/ 1 3/2003 POSTMARK DATE: 00/00/0000 couNTY: CUMBERLAND DATE OF DEATH: 1 2/ 1 3/2002 101 ~ S 1 1, 200.00 TOTAL AMOUNT PAID: REMARKS: MICHAEL J HANFT ESQUIRE SEAL CHECK#1330 INITIALS: SK RECEIVED BY: DONNA M. OTTO S 1 1, 200.00 DEPUTY REGISTER OF WILLS REGISTER OF WILLS REV.l'~EX'{6-'lO) /')-/IC) -.6 ,. *' REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FIL.E NUMBER 21 02 1157 COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT,280601 HARRISB':l~.r:>.,.':A 17128.0601 194-52-5596 w ~ G~l2 W~" ~OO ,,~~ ~m ~ < o 2. Supplemental Return o 4a Future Interest Compromise (date of death after 12~12-82) o 7. Decedent Maintained a Living Trust (Attach copy of Trust) o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95 THis SECTiON MUST BE COMPLETE6i"liWiliicPllR SPON6ENCEAN6;C6N~IPENTIAL TJ\XINFORliiiAT1PNS~OULD BE DIRECTEDiTO; AME COMPLETE MAILING ADDRESS Michael J. Hanft, Esquire ~ z w o w " w o 'I DECEDENT'S NAME (LAST. FIRST. AND MIDDLE INITIAL) McClintock, Naomi R. , DATE OF DEAfH~(MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) US! cr',ILY 1 I 12/13/2002 10/26/1911 THIS RETURN MUST BE FILED IN DUPL.ICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. Remainder Ret~m-(date of death prior to 121382) o 5. Federal Estate Tax Return Required 8 Total Number of Safe Deposit Boxes o 11.Election to tax under Sec, 9113(A) (Attach Sch 0) 19 Brookwood A venue, Suite 106 Carlisle, P A 17013 (1) None . - ::; (2) 1,391.26 0 gl (3) None Sc.' (4) None (5) 282,735.53 .--~ (6) None (7) None (8) (9) 12,011.63 (10) 425.47 Cli'f~CIAl USE; CM_j:) 63 :Om (1? (') ::3: =< N .... 1",/ (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST. FIRST AND MIDDLE INITIAL) 181 o 181 6. 09. 1. Original Return 4. Limited Estate Decedent Died Testate (Attach copy of Will) Litigation Proceeds Received -0 ~ 284,126.79 IRM NAME (If applicable) Hanft & Knight, P.c. ELEPHONE NUMBER 717/249-5373 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) z o ~ ~ ~ ~ < u w ~ 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (11) 12,437.10 271,689.69 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) (12) 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 (Line 12 minus Line 13) (13) (14) 271,689.69 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 12,226.04 12,226.04 Copyright 2000 form software only The Lackner Group, Inc. 'hi'; ';'''!i:!:!!!!,:;;', CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ":::;.:" 15.Amount of Line 14 taxable at the spousal tax rate. x .00 (15) or transfers under Sec. 9116(a)(1.2) z 271,689.69 .045 (16) 0 16.Amount of Line 14 taxable at lineal rate x ~ ~ ~ ~ 17.Amount of Line 14 taxable at sibling rate x .12 (17) ~ 0 " ~ 18. Amount of Line 14 taxable at collateral rate x .15 (18) ~ 19. Tax Due (19) 20. 0 >> ~\!!!'SlJRli; tPAN~W\!!!RliA~L'~UESTIPN~'\:l"IREWl'RSe'~rB\!!!Ili.NmIR~C~~CK MiA"E1II,. .....Ui,!i;i:i'.i:i; Form REV-1500 EX (Rev. 6-00) I?ecedent's Complete Address: STREET ADDRESS Church of God Horne 801 North Hanover Street CITY Carlisle Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applicable D. Interest E. Penalty (3) 0.00 (4) (5) 436.57 (SA) (58) 436.57 TotallnteresVPenalty (0 + E) 4. If Line 2 is greater than Line 1 ... Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. Make Check to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred;. ... ............ b, retain the right to designate who shall use the property transferred or its income;.. c. retain a reversionary interest; or.... ................... ................ d. receive the promise for life of either payments, benefits or care?........ ............... .................... 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?. ................. ..................... ................... ............... Yes No ~ I 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 which contains a beneficiary designation?.. .................. ................ ............................. ................ o ~ o ~ o ~ 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 pe~ury, I declare that I have examined this return, including accompanying schedules and stalements. and to lhe best of my knowledge and belief, it is true, correct and complete. Declaration of preparer olher than the personal represenlative is based on all in formation of which preparerhas anyknowiedge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS Robert F. Derk ~ v.'~~ SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Jean R. Derk DATE 1309 White Birch Lane Carlisle, PA 17013 S-iJ,. 3 ..:P.3 DATE ADDRESS 19 Brookwood Avenue, Suite 106 Carlisle, PA 17013 \,...., J I"" ,,\n \ L, 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 (al (1.1) (i)]. 1309 White Birch Lane Carlisle, PA 17013 D-~~-c::l-3 DATE SIGNATURE OF PRE RER OTHE Michael J. Hanft, Esquire ADDRESS S"- 2.3 -{);J '1; 11 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 exemDt 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. ~911B (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116 1.2)[72 P.S. ~9116 tal (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 brood or adoption. . SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF McClintock, Naomi R. I FILE NUMBER 21-02-1157 All property jolntly-owned with right of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION UNIT VALUE VALUE AT DATE OF NUMBER DEATH I PP&L Stock 33.88 847.00 2 $100.00 Series E Bond #C451555893E issued in December, 1965 512.48 3 $50.00 Series EE Bond #L563822646EE issued in December of 1997 31.78 - TOTAL (Also enter on line 2, Recapitulation) 1,391.26 . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF McClintock, Naomi R. I FILE NUMBER 21 - 02 - 1157 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 VALUE AT DATE OF DEATH 22,481.74 First National Bank of Mifflin town Certificate of Deposit No. 4035186 2 First National Bank of Mifflintown Certificate of Deposit No. 4035201 20,858.15 3 First National Bank of MIfflin town Certificate of Deposit No. 4035187 22,481.74 4 First National Bank of Mifflin town Certificate of Deposit No. 4035183 10,455.53 5 Bank of Landisburg Checking Account No. 0603945 1,311.72 6 Bank of Landisburg Money Market Checking Account No. 3618145 14,584.40 7 Bank of Landisburg Savings Account No. 366925547 13,313.25 8 Bank of Landisburg Certificate of Deposit No. 700011191 36,468.45 9 Bank of Landisburg Certificate of Deposit No. 700011192 12,156.18 10 Bank of Landisburg Certificate of Deposit No. 700011808 11,554.69 11 Bank of Landis burg Certificate of Deposit No. 700011842 21,025.31 12 Bank of Landisburg Certificate of Deposit No. 700011892 33,208.90 13 Bank of Landisburg Certificate of Deposit No. 700011963 13,086.19 14 Bank of Landis burg Certificate of Deposit No. 700012077 33,929.58 15 Refimd from Church of God Home 4,849.77 16 Refimd from Highmark Blue Cross Blue Shield 428.76 17 PPL Stock Dividend 56.26 18 Bank of Landisburg Certificate of Deposit No. 060906579 10,484.91 TOTAL (Also enter on Line 5, Recapitulation) 282,735.53 *' SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH Of f>ENNS'flVAN1A INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF McClintock, Naomi R. I FILE NUMBER 21-02-1157 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION I AMOUNT NUMBER -- A. FUNERAL EXPENSES: I 1 Hoffman-Roth Funeral Home - Funeral 7,401.50 2 Organist 50.00 3 Ladies Group - funeral dinner 250.00 I B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City State Zip - Y ear( s) Commission paid 2. Attorney's Fees to Hanft & Knight, P.C. 4,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State lip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 Postmaster - certified mail 4.42 2 The Sentinel - advertising 136.31 Total of Continuation Schedule(s) I 169.40 TOTAL (Also enter on line 9, Recapitulation) 12,011.63 *' Schedule H Funeral Expenses & Mninistrative Cos1s continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF McClintock, Naomi R. I FILE NUMBER 21 - 02 - 1157 3 Cumberland Law Journal - advertising 75.00 4 Rice Memorials - engraving on tombstone 80.00 5 Hoffinan Roth - Newspaper Obituary 14.40 Page 2 of Schedule H '* SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF McClintock, Naomi R. I FILE NUMBER I 21-02-1157 Include unreimbursed medical expenses. ITEM NUMBER 1 Brockie Pharmatech - medication DESCRIPTION AMOUNT 87.05 2 Morrow Tax Associates - income tax preparation 70.00 3 P A Department of Revenue - state taxes 264.00 4 Postmaster - postage for state taxes 4.42 TOTAL (Also enter on Line 10, Recapitulation) 425.47 REV..1513 EX+ (Q,-OO) *' SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I FilE NUMBER 21 - 02 - 1157 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE OF ESTATE McClintock, Naomi R. NUMBER I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) Robert F. Derk 1309 White Birch Lane Carlisle, Pennsylvania 17013 son-in-law 1/2 residue of estate 2 Jean R. Derk 1309 White Birch Lane Carlisle, Pennsylvania 17013 daughter 1/2 residue of estate Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet I II. 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 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET ~ ~ v ~ Q.... .~ ,~ Last Will and Testament of Naomi R. McClintock :; 1- 0;1.. - 1151 I, NAOMI R. McCLINTOCK, of Carroll Township, Perry County, Pennsylvania, declare this to be my Last will and revoke any will previously made by me. ITEM I: I direct that my Executor or alternate Co- Executors arrange for my funeral and burial. ITEM II: I direct that my funeral expenses, grave marker and the costs of the administration of my estate be paid out of my residuary estate as soon as may be convenient after my death. ITEM III: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as part of the administration thereof, to the end that no beneficiary hereunder, or any other person, shall be charged with or required to pay any part of such taxes. ITEM IV: I devise and bequeath my entire estate of every nature and wherever situate, whether real, personal or mixed, to my husband, Joseph E. McClintock, provided he shall survive me by thirty (30) days. ITEM V: Should my husband, Joseph E. McClintock, predecease me or die on or before the thirtieth (30th) day following my death, then and in that event, I devise and bequeath .......-..--. , my entJ.re estate of every nature and wherever situate, whether real, personal or mixed, to my daughter, Jean R. Derk, and my son- in-law, Robert F. Derk. ITEM VI: Should my husband, Joseph E. McClintock, my daughter, Jean R. Derk, and my son-in-law, Robert F. Derk, predecease me or die on or before the thirtieth (30th) day following my death, then and in that event, I devise and bequeath my entire estate of every nature and wherever situate, whether real, personal or mixed, as follows: A. Fifty (50%) percent to my brother, Robert Myron Brown, Sr., per stirpes; and B. Fifty (50%) percent to my husband's brothers' children, in equal shares, per stirpes. ITEM VII: I authorize and empower my hereinafter -j named Executor or alternate Co-Executors to convert any property that I may own at my death, whether real, personal or mixed, at either private or public sale, whichever in their opinion is deemed best, hereby vesting in said Executor or alternate Co-Executors full power and authority to make, execute, acknowledge and deliver ~ '-.l ~ Qc good and sufficient deeds or assurances of title thereof, taking into consideration what would be best for any of my beneficiaries ! who may then be minors. ~ ITEM VIII: I appoint my husband, Joseph E. McClintock, Executor of this my Last Will. Should my husband, Joseph E. MCClintock, fail to qualify or cease to act as Executor, ~ appo~nt my daughter, Jean R. Derk, and my son-in-law, Robert F. Derk, alternate Co-Executors of this my Last will. ITEM IX: I direct that my Executor or alternate Co- Executors shall not be required to give bond for the faithful performance of their duties in this or in any other jurisdiction. IN WITNESS WHERBOF, I have hereunto set my hand this 1st day of November, 1993. , /" ~f? JJ!c !d,;~ '{~om1 R. McClintock ~'" ", "~ , .. ',' '\;;:";,,"":;';:4.' dO,"'" .... 'i' _~,:..., ,. j '\c:. "J ~ ~ J . -..... The preceding instrument, consisting of this and three other typewritten pages, each identified by the signature of the Testatrix, was on the day and date thereof signed, published and declared by Naomi R. McClintock, the Testatrix therein named, as and for her Last Will, in the presence of us, who at her request, in her presence and in the presence of each other, have subscribed our names as .,tno;-o. hO<~~~ ~ I If- , (!XIkau (\ ~ 7f(Utv~ 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 00261 1 HANFT MICHAEL J ESQUIRE 19 BROOKWOOD AVENUE SUITE 106 CARLISLE, PA 17013 fo10 ACN ASSESSMENT AMOUNT CONTROL NUMBER TOTAL AMOUNT PAID: REV-1162 EX111-961 5436.57 REMARKS: MICHAEL J HANFT ESQUIRE CHECK# 1402 SEAL DONNA M. OTTO DEPUTY REGISTER OF WILLS INITIALS: AC RECEIVED BY: REGISTER OF WILLS i~ i~~ _ ~ \ BUREAU OF INDIVIDUAL TAXES COMMONWEALTH OF PENNSYLVANIA V INHERITANCE TAX DIVISION DEPARTMENT OF REVENUE DEPT. 28p601 HARRISBURG, PA 1712s-a6o1 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REY-1547 EX AFP (01-037 ~. '""'~ DATE 07-07-2003 ESTATE OF MCCLINTOCK NAOMI R DATE OF DEATH 12-13-2002 FILE NUMBER 21 02-1157 MICHAEL J HANFT ESQ ~~'' `'~~~- _ ~ - ~ ~ COUNTY CUMBERLAND HANFT 8 KNIGHT ACN 101 19 BROOKWOOD AVE 106 l_ Amount Remitted CARLISLE PA 17d~3 MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETA_IN LOWER PORTION FOR YOUR RECORDS ~ ------------------------------- ------------------------------ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF MCCLINTOCK NAOMI R FILE N0. 21 02-1157 ACN 101 DATE 07-07-2003 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 Gl 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 12,011.63 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 425.47 11. Total Deductions 12. Net Value of Tax Return (11) 1~.4 7 10 13 Ch t (12) 271,689.69 . ari able/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) ( 00 14. Net Value of Estate Subject to Tax 13) . (14) 271,689.69 NOTE: if an assessment was issued previously, lines reflect figures that include th 14, 15 andior 16, 17, 18 and 19 will e total of ALL ASSESSMENT OF TAX: returns assessed to date. 15. Amount of Line 14 at Spousal rate (15) 00 00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) . _ X 271 , 689.69 X 045 = .00 12 226 04 17. Amount of Line 14 at Sibling rate (17) 00 12 , . 18. Amount of Line 14 taxable at Collateral/Class B rate (18) . X - 00 15 .00 19. Principal Tax Due . X - .00 TAX CREDITS' (191= 12,226.04 DATE NUMBER 03-13-2003 CD002285 05-27-2003 CD002611 * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. PAID (-) I AMOUNT PAID .00 ++,~uu.uu 436.57 (1) .00 NOTE: To insure proper (2) 1 , 391 .26 credit to your account, (3) .00 submit the upper portion (4) .00 of this form with your (5) 282,735.53 tax payment. (6) .00 (7) .00 (s) 284,126.79 TOTAL TAX CREDIT 12,226.04 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P. . Section 9140). PAYMENT: ~eMake check orpmoneynorderhpayablec{nand REGISTER OF WILLS,snAGENThe Register of Mills printed an the reverse side. REFUND (CRI: A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an ^Application far Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices, or by calling the special 24-hour answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-3020 CTT only). OBJECTIONS: Any party in interest not satisfied with the appraisenent, allowance, ar disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60l days of receipt of this Notice by: OR --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered an this assessment should 6e addressed in writing to: PA Department of avenue, Bureau of Individual Taxes, ATTN: Past Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet ^Instructions for Inheritance Tax Return far a Resident Oecedent^ (REV-1501] for an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent [5%) discount of the tax paid is allowed. PENALTY: The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will hear interest at a rate which will vary from calendar year to calendar year with that rate announced 6y the PA Department of Revenue. The applicable interest rates for 1982 through 2Interest Daily Interest Oaily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1987 9% .000247 1999 7% .000192 1982 20% .000548 .000219 1983 16% .000438 1988-1991 11% .000301 2000 8~ ,000247 1984 11% .000301 1992 9% .000247 2001 9~ ,000lb4 1993-1994 7% .000192 2002 6% 1985 13% .000356 .000137 1986 10% .000274 1995-1998 9% .000247 2003 5% --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUlIBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15l days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. ~~/ d~ ORPHANS' COURT DIVISION OF THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA STATUS REPORT UNDER RULE 6.12 Name of Decedent: NAOMI R. MCCLINTOCK, a/k/a NAOMI MCCLINTOCK Date of Death: December 13, 2002 Admin. No. 21-02-1157 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 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 maybe filed with the Clerk of the Orphans' Court and maybe attached to this report. Date: July 14, 2003 Respectfully submitted, C! i.,~", ~~ ~, ~. . _ ; ~-' HANFT & KNIGHT, P.C. Michael J. Hanft, Esquire Attorney ID No. 57976 19 Brookwood Avenue, Suite 106 Carlisle, Pennsylvania 17013-9142 (717) 249-5373 Counsel for personal representatives F:\User Folder\Firm Docs\FSlales\2996-IsWtus.rpLwpd