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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 ~~ M ~1'~n~° 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 ~'~ v f `i 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. F'c_ fbr this cerririe+[r, ~LpU ____e _8 31 9 5 7 6 nl>. iem~ ~V~~ Ceal~~ ~CCCI~ ~s~UA~t~ I Q1~ 5-14-pa~~' Local Re„iscrar MAY 1 92002 i~:,~e 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'% '~ $OCI/,LSECURIiYN 67 .M. YpFpEgN Dauphin ranes Gap Road -' sle ,E~p~leYMn~~ na. 1~01j '.IFtl. MO Gl8 W-~~~~I ~P General m,` Esther R Bloser mMlan^ an.rs~Imcr.rMrenf~, wm•.xrMm Mm^ s ^ tie ®I vm ^ xa ^ a.m. L male UMBER DAEOFOFRNIMmm. p•y+yrl $Igyi`MPIACE ~' 186-28-y4y8 P3{ln ~m 1 PIACECFDERXICYiwJi mMwN-M•vglrlwli?vpnwMrpyl q. ~y 16, ZOOZ Lu Q NOBPIgL a 1 • E InpIMM ^ E PoA OiNER: enn M grOUlp•Ibnl ^ ^ X Grp ^ Rpeenw ^ pMr ~S IAMEIIIMiiyi91u4m, plrF nrpleryy nynMr) 18CBCNI L] ing lot of C18rks Fe wqs cspENroPNlswNnpgrolN+ ~~~ .MNIIV3p, x•cE.W S~ buck w F~ .N ^ II,.., NNmDI,Mn. Q M .PNrmRk•n.•k. white $DECEOENi EVER IN DECEDEM'B EOVG.VpN '~ 8.1RMED P011CE$i q Mgg11gL8]IPUB-MVrMp "' Vw mW~ ry^ ENmPMVyrt•tur~ry Ly N•Nr M•rrlp, ygdnrN SURVIVING $ppUBE %+R 6 Mw D ~ nr..N. oNem.lanwm.l D'w].1 Neverw}~iarrie „,Pennsylvania • - ~~-Dp "°~~*•'ew.MMmelti North Mi dd] + Cumberland IM :" Ir _-__ m..l.ea* rn.eNN.m II.N ne.^ mnnM.dm gmrod MO]XEP'$NAMEIFMI M M•q•nyrr +.. ~arY "°3~usan Long INFMgMP{~gxN~K~nne ,yV VlQ~~OOE~'L~ar'liele,penneylvanial~ ION PLACEOFOIBPo IiIgV-Wm•a1Gmry Cr• wpMr%•w m•IwY LOCgICN.CIry/+wm, BrnP,Zp CN• ,2002 East Harr aburg 1$EN~M$Eq ]+ Cremator Harrisburg,pennsylva -- - N.MF.nn.~„e...----- . ~']~ Numkb p ^ PNdrq MrNM•Mq ^ ^ uMe MIMeMnmx.] ^ 9R0•IpUMCMpnxDCEgiIF11NO FxY$IOxxIPoYYYn GMnwPVUV •.••.••.•••. •••.•••••••.••.•••.•••••• ^ ]u T•u•L•nalmYMeNNp•,epMOrounNtrun llm•~ey~•rbpNe~ugputp~~ MI.riV low••d U•elnj LICENSE UMBEq epwdl•Nm•nrwp•bIN ............. ..,. ^ ]10. 'MEOILgLEXGMINENCpgONEq ~~~~~~~~~ H1MEµ-pygPFppgEB Onq,RUl•R]•nminNbn,M/wlm•MIPMIm.Mmy•Plnpn~e••tNMeume•ItN•Ilm,. e•t•~pe PIN•, ugyu•IeIMGUpE pe ~mt.~I~, eRL mnmr n FItlN ................... N ..... ..................... ( 1 gE018iMq'$810NRURE MEEq ~~ 1Z71 S. (~ b. A. P.. wLLT \ _ r DttE FILEpIMOME ~.L7 +.. ^ N• ^ Asst. Chief Deputy Coroner h St., Harrisburg, PA 17111 V ]•. F 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 O 1 N 0 I N 0 z O t~ Z W Z u, o_ ~ W O N d. W H ~ J LL O Q w O Z ~ ~ D '^ Z w a a a U' u O d N J v v d 0 U c A .n E U v w ~ x •~+ c~ I ~ x of W .a lT T ~ ^ ~ F C x .~ H 3 ~ H Q ~ U ~ ~ ~ N ~ z N H Pi H ~ ~ ar o .= O LL m 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) CAPB HpRL EplO CRAC KOTK ES C P o 0 R N R D E E S N T C o M T P A Y X A T I o N 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. D E C E D E N T 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 E C A P I T U L A T I o N 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 C(Jffk~ LANDISBURG - 717-789-3213 . BLAIN - 536-3118 . SHERMANS DALE - 582-8511 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 ~~ ~,,