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HomeMy WebLinkAbout02-0537PETITION FOR PROBATE and GRANT OF LETTERS Esrare of KAtln leea L . I..,tal~ l i fe,lr No. _~_~_-Q 2-' S~'~ _ also known as To: Deceased. Social.SectrrilvNo. e2,72.'1`(•Z929' Register of Wills (or the County of t^/pH~ in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is,~are IR years of age or older an the executsly- named in the last will o(the above decedent, dated A~p{^i l ~.! , lyg,~ and codicil(s) dated OV~I'c.l'Na1 ErP.-user cQieeP -7uk,o ~4,J2S~y (sialc relevant circumnances, c. g. renunciation, Jeath of eaecumr, eleJ Decendent was domiciled at death in CuKf~eetr(wsd County, Pennsylvania, with h ev- last family or principal residence at .klassinln Yallav aL ioo ,uT A!(etA Dt~ws (list street, number and muncipality) Decendent, then . $ ~ years of age, died _ d0A ~ 1 `~ , yg ,Zoo 7i at __ 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: _ Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ ~/ba~4GO •= (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: ~~a.d~. WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the gran[ of letters _ pestamcntary; admfnistralfon e.t.a.; adminisiralion d. b. n.c i.a.t theron. -~ ~~ - - _ '_ :~ 3GN1 CGtes'f'nuT ST crtNttOl,~;lf PR of s OATH OF PERSONAL REPRESENTATIVE COMMONW'F:ALTH OF PENNSYLVANIA 1 COUNTY OF' L°tlVU bevy( 1Arncl _ ~ S3 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 represen- tative(s) of the above decedent petitioner(s) will well and ruly admini ter the estate according to law. Sworn to or affirmed and subscribed ti before me this ___ 5t1'1 .day of 3 N11Y _2002 }~{~q,~ ( _ a 1i.~1 .r7ta,srio per. ~~Il(7~S-/ ; fARY f,EWIS Regls[er ~~'~L>~-Jt' No. ~ 1-02-53"' Estate of KATHLEDN L LICHLITER ,Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOw MAY 6. 2002 19 , in consideration of [he petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated 4- 1-1993 described therein be admitted to probate and tiled of record as the last will of KATHLEEN L LICHLITER 2nd Letters TESTAMENTARY are hereby granted ro ROBFA2T r r rr~t rmFR FEES Probate, Letters, Etc.......... g 340.00 Shoff Certificates( ).......... 5 IS•00 ll~x~tiatxx..extra .pages . S 9 . nn jcp 3 5.00 TOTAL _ g 372.00 Filed 6 6-02 _ called exec 6-62002~~~~~~~~~~~~~~ ~ ~ _~ Y LEWIS Registtt of Wills AT['ORNEY (Sup. Cc. I.D. No.) ADDRESS PHONE 11 'F 9 i ._ _ - Dirt[' ~U. '.. v Ka ~s ; '~ cc ~'.' ralr 1 Te information ilerc r:;iven is correcrh' copied fl-om an original certificate of death duly filed with me as 1oL-il R:giYI u. [6c of „final cerrlficare will be foriroarded ro the tirarc Viral Records Of}ice for permamenr filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Ins hv- Lhin cernl scare. $2.0(1 ~/fr .~ J'7 (i?'G-,ate Local Regu[rar ' __ P_8207576 No. r~aY z 1 zoa~ Ualc M.. v5> COMMONWEALTN OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH NAMF OF OFLEOEM IFm. MiIXya, Lyl sTRE RIF aUM9Fp ] ~~.~~ (~1~ / ~ ~~//_ 1C e~ 6E% SOCIAL 9ELVR iYNUM$ER _ ORF Of DEAiN rMCrM.0.v-TVs - AcE0.aReo-inmyl uMDEYg1vrEAR ll'~ L ~ a. /- ] t _ /< c UNDEp IpAy / DATEOFBIpfH pLALE Of DEATNKnevh $IgTHPLApE LCgram -r~7~~ a 1. AS !rS`-<~qU ~.i 88 ~"°• r Dan HnM, 1 MYrul,a IMmrn. wr Y•aq sMNarn.yncm,vrrl «w nr• :•• a..,mnm,r°,I NOSPITR OTNEp: rm. ~ July 23, Glen Jean,WVA Irrpnmm^ Ewomp,um,^ ~~ Nw,aq - ' couNTV OPOEATN 1913 x. D°^^ Nnm. C7~ R.KYryw^: °~',u ^ cm.SOgO. iV/P Op DEATN FACRm NAMENrVn maMUlon. DiveanMaMrumarr Cumberland wASDECEDENr oFNlswNC OglDwx RACe.Am.rr<,rrlMiy.51KY,vma...m. M,. 4pper AllenTwp, aMessiah Village "° ~•^nYn..P•<rn apan. IsPrml white DECECEM'9 USUALOCCUPRION KINp CF pUSINE58lINOUSiRY MW~.Pumle RY n. Kc Carve WWdwyv 4ymyrug rrq VM90ECEDEM FVEfl IN DECEDEM'S EDUCATION E IO. IwwLirr94N. yrmluurNV«.1 U.S. AgMEO FOgLESx M/rq?AL SiRVS. MarrrM SIIpVIVING $pOVSE ~^ ~® EN cµn I Mvn MmrW. WipywvG. UI wJe. BrKmaken names ' ++. hool Teacher ve, Education m.~zi'vv0•ry 0o14pi w•r<a lsm<rpl DECEDENT'S MMLINO ApppE8851rM.CN own, vM•. rpcma DECEDENT'S aP' ». 12 a+ors.w 1 widowed 100 Mt. Allen Drive "cmR Tx.. sm. PennsVlVania 1p' peslDENCE Da ,m.® w.. a.<'.n.<nlMtlM Upper Allen Twn Mechanicsburg, PA 17055 's°°~,°"; "°°° °i<e°•" mP u. l cal lN.m• FRNEfl's NAME1FirR. MrmN, LaaR Iry. Cumberland °w"'"^x "°. n.<wralMe l na^ wgan,MOMIOn%,m IE. Robert Lewis MoTNEp's NAME IF.aI. MrmM. M,rp„, s,r,ramn <nvmm° INFOgMANT'SNAME QypMRiml ,,. Kate Robinson Robert L. Lichliter INFORMANT'$MAILINO ADOgE%ISUrI Ctylbwn, yalL ZipCmel ME.NOOOC dsposnoN O.UE OF DISposrtloN zee. 3641 Chestnut Street, Camp Hill, PA 17011 $uml~ Cmmugn^ gorrr°vW lr°m Sab^ IM°nlp,fAK 1Nr1 Pam PO ~DVSPOSITIDN-N,rm °ICSm•Iary, Q,m,bry LOCATIgV.CMIi n.sbM. ZpCWa Rnnon^ ON•r 15Cac%L ^ °r '•~ z1 May 23,2001 Rolling Green Mem. Park 6NilUTUp oFF EML E Ic EoR PERSONACnINi AS SUCH zT<. :Ia.DPPer Allen Twp., Cumb. Co LICENSE NUMSEq NAME ANDAOppES50F FACILItt . ].nmm. 3.<mlywRM.y m irN r uE. FD013-340-L 33c Parthemore FH d CS, Inc Pny«ciyM .LIMNrr +ce.mlp rl.e•n°ImyYn°,.MaB..°.,mo«Wrae.I llr.Irm.. eel. am Pl.c. al.l.e. l7mn wrvryuyFa°IUUIq ISp^.luvan°inlm UCEN N MDER DRESIGNEO Mam, Y4]B mra1W<o: pMlaJ py ]]a. fMnM. wY nyl pnprlwMPmrarm<a Mnn, TIME OFOERH WTE PRONOUNCED pEADIMwm.OnY. Yeen ]7D, ih. / ~ (/ ~ VMS CASE REFERRED iO MEpICAL F%AMINEWCORONEPo n. PApT I: Em•rlM eiw.w•.~Iwi.,o-mmwrmliom.m<n<+ww m. c.mn.m ~ re. as. _.'.`t IB -Z~z w.^ ,a® Lnl Only Orr•Grua eaUIIM. an rlnamWF°I pyirq,,uCMacvnr•c°r raspiral°ry arrKl.sMCY °rnuarl larlur0 M Pmp.anM• PART n: an•r.ipnincm%mrraewrsmrmiwr°9m ann.pw IMYEDU]e Cluse lFrna 'inl•~"u O,Mnn emnvpr°In•wNarM-ry<awprvan rn PApTI awKo-cmwnon mrpyyr °"r KManBmwaml-.v . V r° OUE TOICq ASp CQV5E0UENLE C~. ~(~~] „U I, 5•pMmMM1Y YRmM1oM ~ Op. - , I ~, °r• W'~~I°""^•D•1j OUElO1Cq A5ALON5E0UENCE OFI; i Emar UXOEpLYINO r DAl1EE lOwM,wu+avy ~~•0•µM° DUE TOICggSACCN5E0UENCE ON: H I IJ a._ i __ yMS AN AUICPSY WEgE AUTCPSYFINDINGS MANNER OFDEATN __ PERFOgMEDx µyLA9LE Pppp ip ORE OFINJURY TIME OFINJURY COMPLETH)NCf CAUSE ® IMmm. pay. Yevl INJUNYRNORKx DESCgIRE NIXVINIURY DLCUpgED. Of CEATNi Na1wY HpnK,tlP ^ 'ktM•M ^ P•nNnplmaarlyalnn ^ Yea ^ NO^ m. ^ No® m ^ Na ($ swLw ^ cmmmr <.nnmmr,r,tl ^ w.. PIACEDF INIURY~pI Mrn•, Iarm~slrKl.IxY M ]0C~ ]C' I••• ]FO. ]9. WrM4ny. vlc.ISpecuvl orY.OXkr LCCRION5Oax. C.ryrtaxn.5ryv1 :ERTIFIERICM<k wvY wl ]p•. 'CEgTIPYINO PHY51C1.V11FnYarwncentlVx O<aum.n neanwnen aro net pn ]m' TOIM pK1 OImY Mr°w4OPa tl•am OO[yrp tluab lM Cau• ~ W rrO 2"I $IGNATVRE DiITIEOF CERTIFIER NgmMm aw .. .. .. ^ '~. ~ '~> ` 'PRONDUNCIND ANDCERTIFYINO PXY9ICIAN IPM1,n¢an Wl'ya µirc 9 m O' d ~~~~~~ ~~~~~~~ ]+0. ~. • i /~ `~`~ iO 1M Ma1mml YnOw1•tl9•~tl•am omurr•tl,l m•rlma O,m aM ~ LICENS UMDER DRE SIDNED Mµrm, Dav. MSrl P.<.,.ne an.mum. ~ Ml.m m.n,,:r-.. w ._..... ^ , )U L1 .:1 •il» z _.. _. ma. 5 ~ 1->I "L 'MEOILAL E%AMINEII/LOgONEfl N/,ME ANDACpgE550F PERSON WXOCOMPLETEO CMl$F pF DEATN On IN•pa•bol aaamirMllan mp/or lnvea119alron, inm Illem DI TYMOr Pnnl _ mannnnKa•tl........... ,... YOpini°q tlOMlr oceunM•tlM llma, tlalo, anC Pl•o,anO tlua+Olpa e,uae(.I,ntl la .. _......... 7~7.a J.'~L REGI R'S $IDNRUflE AND NVMBEp ~~~ ]] ~a ' ~' ,y. ~~ ) lY~ M J. +~ t I "~"T/ ~/ l``~' ~ oREFILEDIMOrrIn. Day. YMn l l~A.7 .rY ..... ]<. ~~ LAST WILL AND TESTAMENT OF KATHLEEN L. LICNLITER e2l-oa-537 I, KATHLEEN L. LICNLITER of Upper Allen Township, Cumberland County, Pennsylvania, declare this to be my Last Will and Testa- ment, hereby revoking any will previously made by me. I - I direct the payment of all my just debts and funeral expenses out of my estate as soon as may be practical after my death. II - I bequeath my Tanzanite ring unto my granddaugh- ter, Susan Kathleen Salmore. III - I bequeath my ruby and diamond ring to my grand- daughter, Sherri Jean Castelnuovo. IV - I bequeath my two-stone; Tiffany setting ring to SAIDIS, GUIDO & MASLAND 2109 Marke[ Street Camp Hill, PA my grandson, Steven R. Lichliter. V - I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate unto my husband, Heil H. Lichliter, providing he survives me by sixty (60) days. i ~"_ ~ v Page 1 VI - Should my said husband fail to be living on the sixty-first (61st) day following my death, then I devise and bequeath the residue of my estate of whatever nature and wherever situate as follows: A. I bequeath 100 shares of AMP stock and 5€ cf the residue of my estate to each of my grandchildren. B. All the rest, residue and remainder of my estate I devise and bequeath unto my son, Robert L. Lichliter. Should he be deceased, then I devise and bequeath one-half of the residue unto his wife, Marlene A. Lichliter, and the other one- half unto my grandchildren, in equal shares, the share of a deceased grandchild to be paid to his or her issue per stirpes. VII - I appoint my husband, Heil H. Lichliter, Executor SAIDIS, GUIDO & MASLAND 2109 Market S[reet Camp Hill, PA of this, my Last Will and Testament. Should my said husband fail to qualify or cease to act as such, then I appoint my son, Robert L. Lichliter, to act in this capacity. Should he fail to qualify or cease to act as such, then I appoint John E. Slike, Esquire, to act in this capacity. None of my personal represen- tatives shall be required to post bond in this or any jurisdic- tion. Page 2 IN WITNESS WHEREOF, I have hereunto set my hand and seal on this, the ;~/ ~ day of i 1993. ~F~~~~h~~nFi(SEAL) Kathleen L. L chi liter Signed, sealed, published and declared by KATHLEEN L. LICHLITER, Testatrix therein named, on this and two (2) other sheets of paper as and for her Last Will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. l ~ ~.wr tL ~~ / ~ Address Fnl i c, /~A I7 S Address SAIDIS, GUIDO & MASLAND 2109 Marke[ Street Camp Hill, PA Page 3 Name COMMONWEALTH OF PENNSYLVANIA) COUNTY OF SS. CUMBERLAND) WE, the undersigned, the testatrix and the witnesses, respectively, whose names are signed to the foregoing instru- ment, being first duly sworn, do hereby declare to the under- signed authority that the testatrix signed and executed the instrument as her Last Will and Testament and that she signed willingly (or willingly directed another to sign for her), and that she executed it as her free will and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatrix signed the will as witnesses and that to the best of their knowledge the testatrix was at that time eighteen years of age or older, of sound mind, and under no constraint or undue influence. Subscribed, sworn to and acknowledged before me by the testatrix, and subscribed and .worn to before me by both wit- nesses, this I/''~ da of ~~~~. tiA1DIS, GUIDO y - 1993. & MASLAND ~ 2109 Market Street ~~ Camp Hill, PA 1\ ~/ otary Public iHELMA S. M CAUSLIN Notary Pubfic Camp Hill, Cumberland County My Commission Expires July 3,1996 /~~ Testat ix CERTIFICATION OF NOTICE NDFR RULE 5 6tal Name of Decedent: Date of Death: iL1 /aV L `~ , ~O O wiu No. a ~ - o z - 5 37 To the Register: Admin. No, eZpmy _ oo ,--~.~j I certify that notice of (beneficial interest) estate admini tration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed [o [he following beneficiaries of the above-captioned estate on O(o~7.0/~©Q~ Name Address `J L/ r7Y Notice has now been given to all persons entitled [hereto under Rule 5.6(a) Date: 0620 ~~00 ~~ t~ Signature ~,~J~ ~~ Name ~~f~O Me~' ~. {,' /'t i Address ~?~~I ~ efl'F`N~ 5't~ ~°Hu~/~ l~l U~ l~/~- I O t ! Telephone ( ) '7/'T _ ~ 3O . cY 3 Z 9 Capacity: X Personal Representative . -Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE REV-1162 EXI11-961 BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, Pq 1) t 28-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 001368 LICHLITER ROBERT L 3641 CHESTNUT ST CAMP HILL, PA 17011 ACN ASSESSMENT AMOUNT CONTROL NUMBER told ESTATE INFORMATION: ssN: zaz-la-2szs FILE NUMBER: 2102-0537 DECEDENT NAME: LICHLITER KATHLEEN L DATE OF PAYMENT: 07/02/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 05/18/2002 REMARKS: ROBERT L LICHLITER CHECK#1004 SEAL 101 ~ $21,178.00 TOTAL AMOUNT PAID: INITIALS: AC RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS $21,178.00 ~OOEXIIJ.-OO) , . REV-1500 w "' ~:g;(I) ,,0:'" wo." ,,00 ,,0:-' 0. III 0. <( COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT 280601 HARRISBURG, PA 17128-0601 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) I- Z W o W o W o L.. DATE OF BIRTH (MM-DD-YEAR) OFFICIAL USE ONLY /?- 6R- '>6-- FILE NUMBER ;e I - 0 .1!'- -- -- _o~U_ NUMBER ffi'1. Original Return o 4. Limited Estate ~. Decedent Died Testate (AltEth copy 01 Will) o 9. Litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (aat6 of cleatll after 12-12-82) o 7. Decedent Maintained a Living Trust (Attac~ copy ofTrust) o 10. Spousal Poverty Credit {date of death between 12.31.\11 and 1-1.95) COUNTY CODE YEAR SOCIAL SECURITY NUMBER 0l.3~ - I ..z92'1 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. Remainder Return (dale of death prior to 12-13-62) o 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes o 11. Election to tax underSec, 9113(A) (AlIachSch0) "' z w c z o 0. "' w 0: 0: o " FIRM NAME (If Applicable) COMPLETE MAILING ADDRESS 3CRl.{1 dfe-SrnvIS;r. CAIM/,./i/II PIl r~ol{ TELEPHONE NUMBER 7r - "l~o -'15;:c?:Cf OFFICIAL USE ONLY l , I 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 ~ ::::l l- ii: cs: o w 0:: 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 (Schedule GorL) 8. Total Gross Atisets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) (10) /0 S'1':<.o3' o f'"j I N (8) G'oCo :(:'~.5. S-:lJ to. Debts of Decedent, Mortgage Uabj)jtjes, &Uens (Schedule I) 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 lax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o !ci I- ::::l Q,. :iii o o >< ~ 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) '.0_ (15) (11) (12) (13) I 0 q;~ "Z .0"5 'fQ.5 39/ .50 16. Amount of Line 14 taxable at lineal rate '.0_ (16) , .12 (17) (14) q "f 5 3 "r I. &'0 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate x .15 (18) (19) 19. Tax Due 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Decedent's Complete Address: STREET ADDRESS .M k V~ ( 114 {I CITY Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) Total Credits (A + B + C) (2) 3. InteresUPenalty if applicable D. Interest E. Penally TotallnteresUPenalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) , ZIP 17os,-b- 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SA) (SB) Make Check Payable 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? ..... 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? . No o o o o o o .....0 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Yes .....0 .....0 o .....0 .....0 o RETURN Under penalties of perjury, I declare that I have ex.am(~ed this retl.lrt1, if\c\l.Idill9 accompanying schedules and statements, and 10 the best of my knowledge arid belief, it is true, correct and complete. Declaration of prep r therthan the personal representative is based on all information of which preparer hesany knowledge. DATE ADDRESS ? 61{ I C4dtE''7 j "'"..;- St/-:-- SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE e IQ<Q. ~ /.J dl. I / f"/l- 1'70(1 (jp ADDRESS DATE 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. 99116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ji)]. The statute does not exemol 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 atter 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. 99116(a)(1.2)]. The tax rate imposed on the net value oftranslers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. S9116(1.2) [72 P.S. s9116(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. 99116(a)(I.3)]. A sibling is defined, under Seclion 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. , ' "".'~''''''.971. COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF f<' ,4TI1I P- e.Vl l-... h. i c-l. I,'t:i>..v- FilE NUMBER All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. A1pt'hI:lVl t- )...eu,;I<i> SeC-c.llA','t-te.s Ad..#: !iw<(,-I.{S"""T z'iS- / ;U{/, I ~.;-, 7 'I "if::? I "I::<..L{ . err;. ;z. VPVI"ll/lAv-d Fuuci ;lei Acl# 9~ 3 {,/ ::?,SCf.,<:V TOTAL (Also enter on line 2, Recapitulation) $"3 ~ 3, 5~O. 7,5 (If more space is needed, insert additional sheets of the same size) """?".,"". COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF f( A-fl1leelA 1-..1--;e-h/;t-el/- FILE NUMBER Include the proceeds of litigation and the date the proceeds were received by the estate. All property joinUy-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. AI/F','v-sr ~Awk- CO 1i?oa ~ /01/0 ~~t{1 ;?;;< It:. z., . 'i3 FI(,.Sr UlIlio/1 BA<1K Ar;;.Ttt" {OOOG?I 3ZI.{Z9f/ tS'l.z"5.'-(1!:> FiV'sT VVlioVl T5V1<1k p.c-T#- 3o/<-l/5z33'1o"t"l -;2..;? '1 ~ Lf . z:. '( FI'v-siUl,ftt>1/I ~lA>t K - C 0 ~ L'f '7'1 r ;[0<70"1/ ZZZt-{ to o~1 .9:/ f N c. Bt4/1lk (c'$C{~/lIoT) 50 _ 0000 _ /"63/ C Y:t) = '-("1 'I<tt-( . Cfl.( t?,,,,'1 - TAV/'ZAvrii-e- Z,?oo . <!)<!::> RlW1 - Two '7+cC1 e. 01, 'j4tM..ud /,zeo 00 R,r,tq Ruhy AUcI. oI,,.,,,(,fJu"'/ !Joe . 00 TOTAL (Also enteron lineS, Recapitulation) $ 1:0:.:<: "'(pip. "1(;0 (if more space is needed, insert additional sheets of the same size) REV"51OEX~(1-97)~ ,.~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER.VIVOS TRANSFERS & MISC. NON.PROBATE PROPERTY ESTATE OF FILE NUMBER /C A+t! leell1 l. h.ieL. I;tell' This schedule must be completed and filed if the answer to any of questions 1 through <1 on the reverse side 01 the REV.1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY %OF ITEM lOCliJOE .HE- N,o,!.\E Of W,e TRM1SttREE,1KEIR RB..ATICNSHl'i' 10 DECECEW,I\ND1HE DAlE Of TRANSFER DATE OF DEATH DECO'S EXCLUSION TAXABLE VALUE ATTACH A COPY OF THE DEED FOR REAl ESTATE. VAWE OF ASSET INTEREST IFAPPLICABLEI NUMBER 1. 5"UIII ~\1.7ev;CA An"~+y P~1"'r C(S-~H 51 '1"5) tfOI . "{If 'fS'iOI . crt{ ;? j..;vtc"lvr r;e.v,~Fi t- J.:'I~~ AII/l'lui-ly ISj"'3.Z'jf F 00710 '5'1 , S' 51 '5 . z 3. "M}lM v/,'I"" ~ P<?lic,-/ I f'ev;o.A C<eVTA,'vJ "fl{~."5''' <:tV/). c((, ;t: !i'/~~-'lII(-o.{ C:",d';'r ",/2/Cv 1.(. MOrllY IIF~ Pt?(,'CI/ .# 51;'1-10 - J!:J~ ~~'i'''' !7cr 000 5. AMP Iryc..e> t-;Fe- tI~I"ey ;::?<?(JtJ.~ OrJ 0 TOTAL (Also enter on line 7, Recapitulation) $ !f<'t I "6 <.7 S-. '1 <{ . .. c;( (If more space IS needed, Insert additional sheets of the same size) flEV-15,11 .'i:X+ (12-99) " ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF kA+l1 I ee.n L. L ic.h h+e.v- Debts of decedent must be reported on Schedule I. FILE NUMBER ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. 'P"'I'"'tlccz IMD.-e--- F""~rA I S"et"VIc..e:.s "(Sf '1Z. 6'1 B. ADMINISTRATIVE COSTS: 1. 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. Attorney Fees 3. 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 4. Probate Fees Fit.;"<j Fee of- c~t";~>:> "'F 5H,.",rc-erlo"r,c14res :;YfL{.aa F"hl ,'eI4+.~., fG>e - C'v..,( t..fiI....l.."d J..A..r j,;......... t 'r !>. <> co 5. AeS81:11Elr1t't l7el!S P..ft,fICA+...... F~~ - 'PA1,.,",rl-- "veu>'iii 1 5'f" ~ 6. Tall Reh:Jm PF8~aro U"<7~ ... ;?? ";t.t:). <>0 .L W"",je ""/ Me~&il4 It V. f/1Itf.e-) MAy 01-1<6 7. CAf'T; I Rec.,ver $ell'(/ic~ { M<?dkAL.J { {~. 00 7hlOlNMeV-lcA (J"'V1~ ;07 d 'Z.- ~1Il +--eV'l'Il'7+:;' ..~ c....". fV'1f1 PA ,,, . lS TOTAL (Also enter on line 9, Recapitulation) $ 10, ~"fZ. 03 - (If more space IS needed, Insert additional sheets of the same size) REV.1513EX+(1-97),~ .,~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF - C/h I. rev NUMBER L NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions) l<oJ.,evl~' ~(.'cW Ii reV' 3~4l Cke~+tAv+ st' CfMMt /J:((j ~A 1'101l S"'J~l<1 fCA't"1r le.ee( >pl"'#W'.e- 17'IfPr, !?PI"'" C4-1J",tf- Mt'JOV't14V'F::) CR "f~;%t 5~~'1 V-eA41 C14~"'e1I1I/t:>"~ l~oO( r:r~'FeV' "3~. M IAc1':'~lIf /Ulr f;3?oif CVtw e'" 1l~ f.ev+- l-icLt lireV' A "6l 73 6.-'f r', 0I"..e-- ~ tJ I/" y-- ()V'M~~cf f?e~/ Pi- 52,1?1 1. FILE NUMBER I - tP Z. - D-'" RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do NotUstTrustee(s) OF ESTATE :JoN (;?.....,.bl... V1 to rev' " .. ",..dd~v'f "reI/' G-V'~.....ol9t9vt ttoo/ ""Cf, ~I:J~ ;Z3'lZ'-{.I~ , ~3'L{ zrt .13 I ^"'t7.'l-I~ ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II. 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) . , ,_.... P.A. Taxable Estate of Kathleen L. Lichliter All figures are date of death. 05/18/2002 Stocks and Mutual Funds: Nathan & Lewis Securities, Acct. # 5W8-459245 Vanguard Fund 21, Acct. # 9936125982 Annuities: Sun America, Policy # P3798533351 . Beneficiary, Robert Lichliter Lincoln Benefit Life, Policy # F0071037. Beneficiary, Robert Lichliter Manulife, Policy # 5-175-714-4, Beneficiary, Robert Lichliter Period certain, Ending 08/02/02 Bank deposits: Allfirst C.D. Acct. # 87008101103341 First Union, Checking Acct. # 1000613242911 First Union, Growth Acct. # 3014152334099 First Union, C.D. Acct. # 247412050912224 PNC, Joint Checking Acct. # 50-0000-1831. K.L./ R. L. Lichliter (Account value $ 94989.88 x Y:.) = Taxable value Personal Property: Ring, Tanzanite Ring, Two stone Diamond Ring, Diamond and Ruby Sub-Total Taxable Estate Assets Deductible Fees and Expenses: Filing fee and copies of Short Certificates Publication fee, Cumberland Law Journal Publication fee, Patriot News Invoice, Messiah Village, May 0 I - 18 Parthemore Funeral Services Capitol Recovery Service Pharmerica, Drugs Internists of Central Pennsylvania Total Deductible Fees and Expenses Total Taxable Estate Assets = C$ 506.283.53 C-) $ 10.892.03) Total P.A. Inheritance Tax Due @.4.5%(Lineal Heirs) Less 5% Discount ($ 1114.63) for Pavment in < 90 Days $241,135.77 $ 82,424.96 $ 43401.84 $ 15,513.28 $ 940.86 $ 22,162.43 $ 15,723.40 $ 22,994.24 $ 10,091.81 $ 47,494.94 $ 2700.00 $ 1200.00 $ 500.00 $ 506.283.53 $ 384.00 $ 75.00 $ 154.12 $ 2720.00 $ 7372.64 $ 118.00 $ 50.12 $ 18.15 $ 10.892.03 $ 495.391.50 $ 22.292.62 Total Due = $ 21177.99 I do hereby affirm that the information contained in this document is true and accurate, based on the' ati n fu ishe b t e individual entities and / or to my knowledge. Date 0 '7/01/ DZot5J -:z....- 1 I G STATUS REPORT UNDER RULE 6.12 Name of Decedent: KR+y ~eeb ~ , ~ ~~~ ~ •.F.P Date of Death: 85~~~zoo Z Will No. ~6~iZ. - Ob 539 Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes ~/ 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 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 / No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be at~t[,a~c-h/ed to tlhis report. Date : 7 ~ o Z -<~~~~r~~ d~k~s~- Signature Name (Please type or print) ;,.~ i Address--Cr ebf' v S'l=: Lpw ~it/ PR l9otl -- Tel. No. -- Capacity: ___~personal Representative Counsel for personal representative (MAH:rmf/AM3) '/ BI~REAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION ~ DEPT. 280681 HARRISBURG. pA 17128-8681 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX EEV-154> FE EFP cYl-On ROBERT L LICHLITER _-; 3641 CHESTNUT ST CAMP HILL PA 17011 CUT ALONG THIS L DATE 08-19-2002 ESTATE OF LICHLITER KATHLEEN L DATE OF DEATH OS-18-2002 FILE NUMBER 21 02-0537 COUNTY CUMBERLAND ACN 101 Amount Repitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 DN FOR YOUR RECeRns -~.+..~E.4,nnn4.c Ur uCDUCTIDNS AND ASSESSMENT OF TAX ESTATE OF LICHLITER KATHLEEN L FILE N0. 21 02-0537 ACN 101 DATE 08-19-2002 TAX RETURN NAS: ( )ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE RERFDVeTTnu nnun~...._.._ _.._..__ __ N1iCD 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) B. total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9 F uneral Expenses/Adm. Costs/Misc. Expenses (Schedule N) (g) 10,892 .03 30. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions (1B) .00 12. Net Value of Tax Return (11) 10.89 0~ 13. Charitable/Governmental Bequests; Non-elected 9113 Trus t (S 495,391: 14. Nat Value of Estate Subject to Tax s chedule J) (13) 00 NOTE: if an assessment was issued previously, lines r fl 14 15 f14) 495,391.50 e ect figures that inciude the total of ALL , andior returns 16, 17, 18 and 19 will ASSESSMENT OF TAX: assess ed to da te. 15. Amount of Line 14 at Spousal rate f15) 00 00 16. Anount of Lina 14 taxable at Lineal/Class A rate (16) ~~ 495,391 50 _ X 045 OD 2 . 17. Amount of Line 14 at Sibling rate . = X 2 292 62 ~~ 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 00 15 ~_ 19. Principal Tax Due . X = 00 -~~ ~XPa~t~E ~ITS• (19)= 2_2,292.62 AMOUNT PAID 21,178.0 TAX CREDIT E OF TAX DUE .ST AND PEN. ?AL DUE • IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 22,292.63 .O1CR .00 .O1CR ( IF TOTAL DUE IS LESS THAN 51, 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.) [1) .DO NOTE: To insure proper (2) 323 .560 73 credit to your account, (31 .00 submit the upper portion (4) .00 of this Porn with your (5) 122. 866 82 tax payment. (6) .00 (7T 59. 855 98 (B) 506,283.53 REV-t O0 FJt(&!E) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDMDUAL TAXES Kathleen L Lichliter Deborah Washington SCHEDULE I INO. INHERITANCE TAX EXPLANATION OF CHANGES EXPLANATION OF CHANGES 2102-0537 101 The value of the estate has been adjusted as the result of the correction of an error in arithmetic. ROW Page 1