HomeMy WebLinkAbout02-0541PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
EStale O,J~ CAARi.F.S T. GOTSAATT No. ~t-n~ - St-II
also known as To:
Deceased.
Social Security No. 186-28-7478
Register of Wills for the
County of CAE r in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are IS years of age or older, applies for letters of administration
(d.b.n.; pendente lire; duranie absentia; duran[e minori[ate)
the above decedent.
on the estate of
Decendent was domiciled at death in Cumberland County, Pennsylvania, with
h is last family or principal residence at 5 I 0 an ap Roa' No h ntt a A 1 a r m ..
(list street, rumbet and municipality)
Decendent, then -57 years of age, died May 1 6 - , $Q 9009
at Reed Township Dauuhin Countv PA
Decendent at death owned property with estimated values as folllows:
(If domiciled in Pa.) All personal property $9,500.00
(lf not domiciled in Pa.) Personal property in Pennsylvania $
(If not domiciled in Pal Personal property in County $
Value of real estate in Pennsylvania g
situated as follows:
Petitioner- after a proper search has ascertained that decedent left no will and was survived by
the following spouse (if any) and heirs:
i~ame Kelationship Residence
Esther R. Bloser sister 510 Cranes Ga Road
Carlisle PA 17013
THEREFORE, petitioner(;) respectfully request(s) the grant of letters of administration in the
appropriate form to the undersigned.
J ~~'~~/
ESTHER R. BLOSER
0 510 CRANES GAP ROAD
°=
.~ CARLISLE PA 17013
"0' 717-243-1357
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA 1 ss
COUNTY OF cHrIBERLANn J
The petitioner(s) above-named sweaz(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 c
representative(s) of the above decedent petitioner(s) will well and
truly administer the estate according to law. i
Sworn to or affirmed an subscribed e,o ~ ~ ~ =~,
before me this ~th___- day of
$j 2002 ESTHER R. BLOSER '
~ ° ~ e°o
N' C 5 Register l °'
No. zl-oz- 5H1
Estate of CHARLES L. GOTSHALL ,Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW JUNE ~ 1Rj 2002 , in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that FCmwRR R RT.fLSFR
is/are entitled to Letters of Administration, and in accord with such finding, Letters of Admtntstra[ton
are hereby granted to FCTRRR R Ai OSFR
In [he estate Of MART FC T Crrmeue7T
FEES
Letters of Administration ..... $ 40.00
Short Certificates(3) .......... $ 9.00
---
Renunciation ~ • • ~ • "' JCP 5.00
7~OTAL _ $ 54.00
Filed .. ,6-7. 2002........ A.D. $9 20
called atty 6-7-02
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H1ARY--~ egist«r of Wills
IRW_ McRNIGHT fi HUGHES
~2--~~~TT 3. c~~--
ROGER.B.IIRWLN, ESQ. 06282)
// //ORNEY (Sup. CL LD. NoJ
60 G POMFRET ST reRiTStF. FA 17013
ADDRESS
717-249-2353
PHONE
~ ~ ~ ^ ~ `:~: c -1rm ~ lon ;acre Given is correcr'v copied from an original certificate of death dilly filed with me as
Io it R°gisl~.u the o hu 11 rsrnfcare will be forwarded [~~ nc~ tiutc Vilal Records Office for permanent filing,
NIARNING: It is illegal to duplicate this copy by photostat or photograph.
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Local Re„iscrar
MAY 1 92002
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NIM.IN RN.Igf
COMMON WEALTH OF PENNSYLVANIA • DEPAgTMENT OF HEALTH • VITAL RECOgOS
xmmxr CERTIFICATE OF DEATH
Axexr (Coroner)
:K IXN NNAEOi pECEDENi IFIrW Nb,le
~'harYes L. Gutshall ]EK '^q'%
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ranes Gap Road -'
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Asst. Chief Deputy Coroner
h St., Harrisburg, PA 17111
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CERTIFICATION OF NOTICE UNDER RULE 5 6(al
Name of Decedent: CHARLES L. GUTSHALL
Date of Death: MAY 16 2002
Estate No.: 21-02-0541
To the Register:
I certify that notice of the beneficial interest required by Rule 5.6(a) of the Orphan's
Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate
on _June 26, 2002 .
Name
Address
Esther Bloser 510 Cranes Ga Road Carlisle PA 17013
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except none .
Date: 06/26/02
r
~.~.~
Signature
IRWIN, McKNIGHT & HUGHES
Name Roeer B Irwin Esquire
Address 60 West Pomfret Street
Carlisle PA 17013
Telephone [717) 249-2353
Capacity: Personal Representative
X Counsel for Personal Representative
~ ~ ~f~.
COMMONWEALTH OF PENNSYLVANIA ~
COUNTY OF CUMBERLAND J u'
Esther Bloser
being duly sworn _ _ according to law, deposes and says that she _ _
is the Administratrix _
-------- -_____ of the Estate of Charles L. Gutshall
late of _ __North Middleton Township _ _. ____ _. _ _ Cumberland County, Pa., deceased and that the
within is an inventory made by _ _Esther Bloser __ __ - ___ the said Administratrix
of the en}ire estate of said decedent, consisting of all+he personal proparty and real estate, except real estate outside
the Commonwealth of Pennsylvania, and that the figures opposite each i}em of the Inventory represent it's fair value
as of the date of decedent's death,
Sworn
and subscribed before me,
16th day of !}}tgty~t,
2002
Esther Bloser, Administratix
510 Cranes Gap Road
(/ Notarial Seal ~/ Carlisle, PA 17013
Jacqueline L. Dmwbaugh Notary Public J --
Carlisle Boro, Cumberland County - Addrars
My Commission Expires Aug. 14, 2003
tAember, PerxtsylvarNaAasac~llotl o}NOlaties
Date of Death ____ _ 16 _ _ OS __ 2002
Day Mon}h ~-
Ysar
INSTRUCTIONS
I. An inventory must be filed within three months of}er appointment of personal representative.
2. A supplement inventory must be filed within thir}y days of discovery of additional assets.
3. Additional sheets may be attached as to personalty or realty
4. See Artiele IV, Fiduciaries Ac+ o{ 1940
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Inventory of the real and personal estate of
CHARLES L. GUTSHALL
deceased
1. Bank of Landisburg - Savings Account.
2. 1975 Pontiac; 1985 Buick; 1987 Buick - Very high mileage. .
3. 1999 Trailer (Flatbed) - Sold 06/28/02. .
4. Miscellaneous Personal Property .
5. Southwind Motor Home - Sold
5,624 16
600 00
1,000 00
200 00
1,000 00
TOTAL. - - II 8,424 16
e~~ EX .(6-00)
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REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
0v
1-61 -y
FILE NUMBER
Copyright (c) 2000 form software only The Lackner Group, Inc.
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COMMONWEALTH OF PENNSYLVI\NIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENT'S NAME (LAST, FIRST, AND MICDLE INITIAL)
Gutshall Charles L.
DATE OF DEATH (MM-DD~YEAR)
CQUNTYCODE YEAR
SOCIAL SECURITY NUMBER
186-28-7478
THIS RETURN MUST BE FILED IN DUPUCATEWlTH THE
DATE OF BIRTH (MM-OO-YEAA)
21-02-0541
NUMBEl=l
REGISTER OF WILLS
SIAL S CURl Y HUM ER
05 16 2002 10/13 1934
IFAPPLlCA LE SU V1VINGS 0 SE'SNAME lAST,FIRST,ANDMJODL INITIAL
X 1. Original Return
4. limited Estate
6. Oecedent DIed Testate
2. Supplemental Return
4a. Future Interest CompromIse (date of death after 12-12-82)
7. Decedent Maintained a Living Trust
3 date of death
. R$malnder Return prior to 12~ 13-82)
5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
(Attach copy of Will) (Attach copy of Trust)
09. lltlgatlonPrOCeedsAeceiVed 010. SpousalPovertyCrl!dlt 0 11.ErecUontotaxunderS~.9113(A)
(date of death between 12~31-91 and 1-1-95) (Attach Sc:h 0)
::ii'tii!i$:$~N]U1rl&;~<lMP!;lliEp;rr~ieQ~.~~~,&'i~~4!.1tftiftl':~j!jg'$~I!i!I:01~Ie;rg:~\,?:m
NAME COMPLETE MAILING ADDRESS
Ro er B. Irwin Es .
FIRM NAME (If Applicable)
IRWIN McKNIGHT & HUGHES
TELEPHONE NUMBER
60 West Pomfret Street
West Pomfret Professional Bldg.
Carlisle, PA 17013
R
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4 -23
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 & AdministTative Costs {Schedule H) (9)
10. Debts of Decedent, Mortgage Liabll.Ies, & Liens (Schedule I) (10)
11, Total Deductions (total lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Ga'lernmental Bequests/Sec 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)
OFFICIAL USE.ONL Y
(8) 8,424.16
(11) 2.122.07
(12) 6,302.09
(13)
(14) 6,302.09
(15)
(16)
(17)
(18)
(19)
0.00
0.00
756.25
0.00
756.25
(1)
(2)
(3)
None-
None
None
(4)
(5)
None
8,424.16
(6)
None
None
2,047.07
75.00
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
1S. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(aX1.2)
16. Amount of Line 14 taxable at [ineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20.
0.00
6,302.09
x
X
X
X
.0 0
.045
.12
.15
FormREV-I500 EX (Rev. 6-00)
Decedent's Complete Address:
,
STREET ADDRESS
510 Cranes Gan Road
CITY I STATE I ZIP
Carlisle PA 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. CredltslPayments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
756.25
37.81
Total Credits ( A + 8 + C) (2)
37.81
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Totallnterest/Penalty ( D + E) (3)
4. If Line 2 is greater than Line 1 + line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 2D to request a rolund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
0.00
0.00
718.44
0.00
718.44
. .... .... ". _ ,',' .... .... .... ,'._,.', ,"._,.,..,.,..,.",.,., """,_",,",.,, ,.._.., ,._.,....,..,", ,......:. ',.;':" l::~::::;:::::!!!:~:\:m!!!!\l :![i::l:::i:::::'.::::', ,"".,
..,.,.".,.".,., :':":':::::!::!::'ii::.i!!!!:!!!!i!!!i!!;!!::i.'.,:'::::'::::;!:::::,,::;::i:i!!!!;);:!:, ,!!::!i! }!!!!!!::,!j!I:!!!!::i::::::':::::::,::':::::::,:.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X'; IN THE APPROPFUATE BI.OCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; . . ~ ~ix
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? . D [ID
3. Did decedent own an "in trust for" or payable upon death bank account or'security at his
or her death? . D [!]
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property
which contains a beneficiary designation? . . . . . . . D []J
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that I have examined this return, Including accompanying schedules and statements, and to the best of my knowledge and belief, it Is true,
correct and complete. Declaration of preparer other than the personal representative Is based on all Information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
Esther Blaser
_ _ _S.~9_ _~:r:~!'_,,~_ 9_~1' _ ~_<!: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - - - - --
Carlisle, PA 17013
IRWIN McKNIGHT & HUGHES
60 West Pomfret Street
- - -carl"i~i;'- - - PA - - i'i6i:i- - - - - - - - - n - - - - - - - - - - - - - - --
DATE
~4~-.. ./
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
l dL.
:(t.1v l-
DATE
For dates of death 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"!o [72 P.S. 9116 (a)(1.1) (il].
For dates of death on or after January 1. 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. 9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets
and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2)j.
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(aXll].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(a)(1.3)]. A sibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Copyrlght(c) 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6vOO)
REV-,sa8-'EX + (1-97)
COMMONWeAl. TH OF PENNSYLVANIA.
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Charles L. Gutshall 55# 186-28-7478 05/16/2002 21-02-0541
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.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ITEM
NUMBER
1 Bank of Landisburg
DESCRIPTION
savings
VALUE AT DATE
OF DEATH
5,624.16
2
1975 Pontiac, 1985 Buick, 1987 Buick, very high mileage
600.00
3
1999 Trailer (flatbed) - sold 06/28/02
1,000.00
4
Miscellaneous personal property
200.00
5
Southwind motorhome, sold
1,000.00
TOTAL (Also enter on line 5, Recapitulation) S
(If mole space IS needed, Insert additIonal sheets at the same size)
Copyright (c) 1996 form software only CPSystems, lnc.
8,424
Form REV-1508 EX (RI
Rf4-1511 'Ex + (1~97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX AETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAl EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Charles L. Gutshall
SSf! 186-28-7478
FILE NUMBER
21-02-0541
05/16/2002
Debts of decedent must be reported on Schedule l-
ITEM
NUMBER
A.
ADMINISTRATIVE COSTS,
1. Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address
City State Zip
B.
2.
3.
4.
DESCRIPTION
AMOUNT
1
FUNERAL EXPENSES,
Ewing Brothers Funeral Home
1,037.00
Year(s) Commission Paid:
Attorney's Fees IRWIN McKNIGHT & HUGHES
Family Exemption: (It decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
750.00
City
Relationship of Claimant to Decedent
State
Zip
5. Accountant's Fees
Probate Fees
Register of Wills
54.00
6. Tax Return Preparer's Fees
7.
1
Other Administrative Costs
Cumberland Law Journal - estate notice publication
75.00
2
Register of Wills - short certificates/filing fees
34.00
3
The Sentinel - Legal - estate notice publication
97.07
TOTAL (Also enter on line 9. Recapitulation) S 2,047.07
(If 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)
RE.V~1512.1!X -l' (1-97)
COMMONWEALTH OF PENNSYLVANIA
IN.HERITANCETAX RETURN
RESIOENT DECEOENT
ESTATE OF
Charles L. Cutshall
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, AND LIENS
55f! 186-28-7478
05/16/2002
FILE NUMBER
21-02-0541
Include unreimbursed medical expenses.
ITEM
NUMBER
1
DESCRIPTION
Dick Yohn Auto Body - towing fee
AMOUNT
75.00
TOTAL (Also enter on line 10, Recapitulation) $ 75.00
(If more space is needed. insert additional sheets of the same s\ze)
Copyright (c) 1996 form software only CPSystems, loc. Form REV..1512 EX (Rev. 1-97)
R~-15BEX+(9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
Charles L. Gutshall
SSfj 186-28-7478
05/16/2002
FILE NUMBER
21-02-0541
RELATIONSHIP TO DECEq~NT AMOUNT OR ~!lARE
Do Not List Trustee(s) OF ESTATE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I. TAXABLE DISTRIBUTIONS [Include outright spousal dIstributions, and
transfers under Sec. 9116(aXl2)]
1 Esther B10ser
510 Cranes Gap Road
Carlisle, PA 17013
Sister remainder
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 S
0.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 2000 form software only The Lackner Group, Inc.
Form REV-1513 EX (Rev. 9-00)
The Ban~of Landisbur~ ESTABLISHED 1903
P,O, BOX 179 . LANDISBURG, PA 17040
June 6-2002
~~~~UW[~
dUN 07 2002
Irwin McKnight & Hughes
60 West Pomfret Street
Carlisle, Pa. 17013
IRWIN, McKNIGHT 8. HUGHES
Re: Estate of CharLes--L--;'Gillshall
Dear Sir:
Regarding the Estate of Charles L . Gutshall , the information
you requested, is as follows:
Statement Savings Account No. 366923295, opened 4/11/2000,
Charles L. Gutshall, sole owner, balance as of date of death-
$5607.29, accrued interest-$16.87(date of death), interest rate-
2.25%.
If additional information is needed, please feel free to
contact us at 717-582-8511.
Sincer..elY ~
Qn-~ ~YLf!lao../
J~ Smoker, Customer Service
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE REV-1162 EXI11-961
' gJREAU OF INDIVIDUAL TA%ES
DEPT. 280601
HARRISBURG, Pq 1126-Ofi01
RECEIVED FROM: PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
N0. CD 001548
IRWIN ROGER B ESQUIRE
60 W POMFRET STREET
CARLISLE, PA 17013
ACN
ASSESSMENT AMOUNT
CONTROL
,o„ NUMBER
TOTAL AMOUNT PAID: 5718.44
REMARKS: ROGER B IRWIN ESQUIRE
CHECK#18835
INITIALS: SK
SEAL RECEIVED BY: MARY C. LEWIS
REGISTER OF WILLS
REGISTER OF WILLS
This receipt replaces CD 1535
BUREAU OF INDIVIDUAL TAXES COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX DIVISION DEPARTMENT OF REVENUE
DEPT. 2806U1
HARRISBURG. PA 17128-0601 NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLONANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSNENi OF TAX
PEY-15q E% ,FP Ip]-pb
DATE 09-30-2002
ESTATE OF GUTSHALL CHARLES L
DATE OF DEATH OS-16-2002
FILE NUMBER 21 02-0541
ROGER B IRWIN ESQ ~' COUNTY CUMBERLAND
IRWIN ETAL ACN 101
60 W POMFRET ST Amount Remitted
CARLISLE PA 17013',`,
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CUT ALONG THIS LINE
E
- CARLISLE, PA 17013
- RETAIN LOWER PORTION FOR
R
V
1547 EX AFP (01-021 _
YOUR RECORDS ~
NOTICE OF I
I
NHER
TANCE TAX APPRAISEMENT, ALLOWANCE OR
-----------------------
DISALLOWANCE OF
ESTATE OF GUTSHALL DEDUCTIONS AND ASSESSMENT OF TAX
CHARLES L FILE
2
NO.
1 02-0541
ACN 101 DATE 09-30-2002
TAX RETURN WAS: f X) ACCEPTED AS FILED
( ) CHANGED
xa~tD VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A]
2 . Stocks and Bonds [Sehetlule B) (1) .00 NOTE: To insure proper
3 . Closely Held Stock/Partnership Interest (Schedule C) .00 credit to your account,
4. Mortgages/Notes Receivable (Schedule D) (3) •00 submit the upper portion
5. Gash/Bank Deposits/Misc. Personal Property (Schedule E) this torn with your
b. Jointly Owned Property (Schedule F) (5) 8.424 16 tax
Payment.
7. Transfers (Schedule G) (6) .00
8. Total Assets (7) ~y00
APPROV ED DEDUCTIONS AND EXEMPTIONS: (B) 8,424.16
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (g) 2,047.07
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. total Deductions (30) 75 00
12. Net Value of Tax Return (11] ~ 1 ~ 07
13. Charitable/Govarnnental Bequests) Non-elected 9113 6,302
14.
Net Value of Estate Subject to Tax Trus ts (Sc hedule J) (13) :00
NOTE: if an assessment was issued previously, lines
reflect figures that i 14, 15 andior 16
417
nciude the total of
ASSESSMENT OF TAX:
ALL ,
returns assessed to , 18 and 19 wsli
date.
15. Amount of Line 14 at Spousal rata
16. Amount of Line 14 taxable at Lineal/Glass A rate (15) -~ X 00 _ 00
17. Amount of Line 14 at Sibling rate (16) ~ -~00 X 045 -~
18.
Anount of Lina 14 taxable at Collateral/Cl
B an 6,302.09 12
X ~-
~ ?5
19. ass
rats
Principal Tax Due (18) X 15 =0U
C~tE
~)f~l)E DITS•
~ I ~F(Fipr ~ _ a9) ~756.25
_) ~ ANOUNi PAID
"^`°•' ~ 756.25
w IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
OF TAX DUE .00
~ AND PEN. .00
1L DUE .00
( IF TOTAL DUE IS LESS THAN 51, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A ••CREDIi•• (CR), YOU MAY BE DUE
A REFUND SEE REVE
• RSE SIDE OF THIS FORM FOR INSTRUCTIONS.]
STATUS REPORT UNDER RULE 6.12
Name of Decedent: CHARLES L. GUTSHALL
Date of Death: MAY 16 2002
No. 21-02-0541
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: X 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 X 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? X Yes No
d. Copies of receipts, releases, joinders and approvals of formal or informal
accounts may be filed with the Clerk of Orphan's Court and may be
attached to this report.
Date: 1/15/03
Capacity:
o ~. ~~
Signature
IRWIN, McKNIGHT & HUGHES
Roger B. Irwin Esouire
Name (please type or prm[)
60 West Pomfret Street
Address
Carlisle PA 17013
City, Slate, Zip
X7171 249-2353
Telephone Number
Personal Representative
X Counsel for Personal Representative
~~
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