HomeMy WebLinkAbout07-01-14 (2) In Re:
ESTATE OF No.2010-01224
MARY JANE SWIGERT c` t r�7
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RECEIPT, RELEASE, REFUNDING,AND INDEMNIFICAITON AGREEMENT
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The undersigned sole legatee and Executor under the Last Will of MARY JANI'"SWIGERT r'7
Deceased, does hereby:
1. Acknowledge that he has examined and approved the statement of the Pennsylvania
Department of Revenue accepting the inheritance tax return for referenced
administration of the estate of Mary Jane Swigert, deceased, a copy of which is attached
hereto;
2. Waive the filing of a formal Account and Schedule;
3. Acknowledge receipt of the entire proceeds of the said estate;
4. Release himself,the appointed personal representative and the sole beneficiary of the
estate of Mary lane Swigert, and his heirs and personal representatives,from all
liabilities, whether due to his negligence or otherwise, which may have arisen by reason
of his administration of the estate.
5. Agree to refund to the estate any portion of the distribution to which he is not properly
entitled, and to the extent of said distribution,to indemnify himself for claims made
against him as Executor,and to reimburse all expenses and casts incurred in connection
with any such claims; and
6. Declare that this instrument shall be legally binding upon himself as personal
representative and his heirs, successors and assigns.
IN WITNESS WHEREOF, I have hereunto with intent to be legally bound, set my hand and seal this
day of� 12014.
74 (SEAL)
Kurry W. Swigert
ACKNOWLEDGEMENT
COMMONWEALTH OF PENNSYLVANIA }
) ss.
COUNTY OF CUMBERLAND )
On3Zay of i� � 2014 before a Notary Public in and for said County and State,
personally appeared KUR W. SWIGERT personally known to me (or proved to me on the basis of
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satisfactory evidence) to be the person whose name is subscribed to the within instrument and
acknowledged to me that he executed the same in his authorized capacity, and that by his signature on
the instrument the person, or the entity on behalf of which the person acted, executed the instrument.
WITNESS my hand and official seal.
Commonwealth of Pennsylvania
NOTARIAL SEAL Notary Public in and for Said County and State
William S.Daniels,Notary Public
Borough of Carlisle,Cumberland County
My sommisslon expires November 13,2017
NOTICE OF INHERITANCE TAX Pennsylvania
BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE is
INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 a AFP (08-13)
PO Box 280601
HARRIS"_'OR--PA 17128-0601
DATE 05-19-2014
ESTATE OF SWIGERT MARY J
DATE OF DEATH 12-02-2010
FILE NUMBER 21 10-1224
COUNTY CUMBERLAND
DANIELS ESQ WILLIAM S
ACN 101
STE 205 APPEAL DATE: 07-18-2014
1 W HIGH ST (See reverse side under Objections)
CARLISLE PA 17013-2951 Amount Remitted- _ '1
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
I COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS LINE --f- RETAIN LOWER PORTION FOR YOUR RECORDS +-
----------------------`-------------- ---- --- --- -- -- -----------------
REV-1547 EX AFP C0B-13) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
D__I_SALLOWANCE .OF DEDUCTIONS AND-ASSESSMENT OF TAX -- - -
ESTATE OF. SWIGERT MARY JFILE NO. :21 10-1224 ACN: 101 DATE: 05-19-2014
TAX RETURN WAS: ( X) ACCEPTED AS FILED ( ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) 152,900.00 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) (2) 344,459.26 credit to your account,
DD submit the upper portion
3. Closely Held Stock/Partnership Interest (Schedule C) L31 of this farm with your
4. Mortgages/Notes Receivable (Schedule IT (4) •00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 67,987.67
6. Jointly Owned Property (Schedule F) (6) .Go
7. Transfers (Schedule G) (7) 135,848.33
S. Total Assets (8) _ 701,195.26
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule N) (9) 14.075.74
10. Debts/Mortgago Liabilities/Liens (Schedule I) (10) 8,104.18
11. Total Deductions 1113 22,179.92
12. Net Value of Tax Return f123 679,015.34
13. Charitable/Governmental Bequests, Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 679,015.34
NOTE: If an assessment was issued previously, Lines 14, 15, 16, 17, 18 and/or 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 _ U 51 .00 X 00 - 00
16. Amount of Line 14 taxable at lineal rate (16) 479.n1 F_36 x 045 30,555.69
17. Amount of Line 14 at sibling rate (17) no X 12 .00
18. Amount of Line 14 taxable at collateral rate (18) .00 X 15 .00
19. Principal Tax Due (193= 30,555.69
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT i+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
03-02-2011 CDO 40 0 1,052.63 20,0 0. 00
09-09-2011 CDO14943 .00 7,400.00
10-04-2013 CDOI8206 131.75- 2,234.81
05-12-2014 SBADJUST .00 4.07
TOTAL TAX PAYMENT 30,555.69
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
• IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A CREDIT (CR), YOU MAY BE DUE
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE FOR INSTRUCTIONS.