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HomeMy WebLinkAbout02-0962PETITION FOR PROBATE and GRANT OF LETTERS Estate of SU$atn S U~UtnIZ No 21-02-962 also known as To: Deceased. Socia! Securrfy No. ~ 7 - 6 ~ -- ~a 3 The petition of [he undersigned respectfully represents that: the Your petitioner(s), who is/are IS years of age,pr older an the execut ~/ in the last wilt of the above decedent, dated f-\u~ us~ j l 1 ZG~~ named and codicil(s) dated - l.f _ (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in L uw~ ~ /(ut,t h eY last family or principal residence at ~3p5 ~p/ dCounX, P ~ ns~lvani~~with v t' ~ (list street, number and muncipali[y) a[ l AV I S I 1-( Except as follows, e after execution of the incompetent: _~I years of aRe, died lX-1o4~ev' 1 ~ Zc~~- gem atu not marry, was not divorced and did not have a child born or adopted offered for probate; was not the victim of a killing and was never adjudicated Decendent at death owned property with estimated values as fallows: (If domiciled in Pa.) All personal property $ Z p0 Ct00 (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: _ WHEREFORE, petitioner(s) respectfully equest(s) the probate of the last will and codicil(s) presented herewith and the grant of letters ~ P~~nn^ eut ~~c v CheiOn. (testamentary; administration a[.a.; administration d. b.n.c.t.a.) v v.. ~ a ~ v ( Q ~.o - cyrb ro._ ~a v y. ~ o m c m OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA 1 COUNTY OF C U M I~ER L.A l~lJ) ~ ss The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition aze 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 truly administer the estate according to law. Sworn to or affirmed and subscribed before me this 25th day of t" OCTOBER ~g2002 - Q ,e2c.c-c%Q~J e Regrster Register of Wills for the County of C~uu1~~r~q~t~ in Commonwealth of Pennsylvania No. z>-oz-96 Estate of S u5ca ~"~ S U~ d n Z ,Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW OCTOBER 28 ~249z. in consideration of the petition on the reverse side hereof, satisfactory proof having beef} presented before me, }-1 u u s~ i t "Zcx~o IT IS DECREED that the instrument(s) date SUSait S described therein be admitted to probate and filed of record as the last will of and Letters ~ C are hereby granted to /~ /~ C°~f ~ / 1 ~ /_~zatd~_/ ~y?ec~~/ inter of Wills FEES (~ '~Inctr ~ K ~<u~ta~e Z7"768) Probate, Letters, Etc.......... S 235.00 00 9 ATTORNEY (Sup. Cc. LD. No.) Short Certificates( ) .......... - e B a . ~ ~~~ S PI ~r~. Q~ w.. hGi ~~'Nr_~~vi ul S~ x . P g Renunctatton ................ S 00 - ~2 In v , RESS {~FZ l (C'C~ j JCP S 5. AD D TOTAL $ 258.00 ~-itZ~ 2~-9- ~7~ Filed .. OCTOBER. 25,, _?002.. . , , . , " ...... pxoNE %~EJJ~~zRJ C~ ~°2~~ r. ' - ~ .I ~~xm Irion here =ive^ is correctly copied from an original certificate o(de.uh duly tiled with me as I I. I b:,~;i I Lr o _n ccrllhcae will I e Ibrw:u~ded ro the Srl[r ~%irll Records ORice for prnn;(n,enr Aline. ~j/AHIJING: It is illegal to duplicate this copy by photostat or photograph. hr. „i, rrlr. c¢a y?.UU ____~~_?37~3406 ~,(I 21-02-962 N,DE.IQ R.v. LB, NT :qT nME CF DfCEDENi if va VN AGE ILaY 9nma"YI 1 (30 Mr coDNnoF DeaN a' • c Cumberland isle, PA 17013 pC 1]e.0 Ovc•C•N Cumberland MiaN,nN'M, v. 0 C T ~ 3 2002 u.ftL I,. Liccooer 11, 2002 GIN, RACE.AmNnvnlm•n.Bb[\N,rn•. w, Is(f[M .• White ME.NDDDF psPGSlTab pw xorces xo. Carlisle, PA ~ 17013 p~ DREOF g3P051=IDx pLNCEDF p5pD5gICN.NamaNCVmvlary.Cmmabry LCCAIION ~L &nYl~l CumYion^ IMmmYFOm AYfYy (Mw[n, 0.Y.Rw1 wpMr %Yf nr/hmL 51Yf Dn,bn^ pMr6ccM IIp ENe ^ . 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IER ..., 'PROMWNCNq,NO CEMIfYIMO FMY51C1AN IpFYUCan Lq[.Ywgnc ..••.......•••.•••. •••..••.... ••.••.•..• A"y MelNmYkromlatlpn. puPacunMNMnmf.nNf aM pl•e~•M puriNi lM e.u ~ l J ~''~ •. ],0. `/ / M% NVMRER ;'E n gp,E MgNETNMo-rW MSl 0.Y n u1N•rrB m nN l•••IYM ....................... 'YEDIC1 O ~ . . ... ^ ,16 UCf ~~ ZC/O[ L fZAMINER/CORONER OnMf euluMUminYloneM,d lnr n N,MEAND,OpiE$$CipEp$LN WNOCONgE=EDC,V$EGFL(pN Inwzq Typew Pelm u gnlan, lnm mv[Inf[L alYel.......... .. Y aplnlFn~BU\FCCCUnf"al lRe Bme,Gfu. vnE Plvcf. enl EUe lO \M Ceu ............. le I , 'L J . . n(.I a .................................... REGIS=M ' nE I ~ IS J V~~ J(~1 F.j> R S 31GNALURE WGNUM ~ n „ 4p'^ G /~ (~ _•' A• •~ DREFILEDIMaryn p a y W pl MM / ~ \\ ~ \ ~ \%a~. ,~ r ~oOT COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH _'~~_~ ScNF flL(NUMBER SEF SCLIALSECURgV NUMBER VHDERIDq' DALE OF BIRTN ,. Female ,, 187 _ OS _ 6823 be i MFyln Mumn.Ory lerl BIRIMPIAG(IC.ry,M $tlMdfo•gn CdnnN PLAC~OF DERMrCN C• "M"r^e-,ef nwwlmeuunmr ynl Avg 17,1912 Shelton CT NoSP - oTNE E. , T IroflMnl^ E wam.n.m DDA ^ Nune Llry. gpgD. NJPDP DEALN F•LhI M1NANEInru nv Nnm.Om Nr[w vn a mwrr Ibm" Carlisle Carlisle Regional Medical Center y VMg DEGEDEMCG NISPANIC( "°~'°~^r•f.w«m( HIND DF BII$INESyINDU41RV VNg L(CELfM EVER IM DELFO NT'S EMICAfIpI L unn PuMpIyrL Nc U. S.AgMED FOR C E S, ^ IMRITµ 5TgU9 ~Mfmf ,fF ACt [ p M•^ WL4 ENm•mEgMSCwtl•ry Cdpg• N•vN0 ~.VMwvC. 50[GVl A. ~w..~~',/ LOCaI RC~rlti CY31 21-02-962 LAST WILL AND TESTAMENT OF SUSAN S. GLANTZ I, Susan S. Glantz, of the Borough of Carlisle, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament and revoke all Wills and Codicils previously made by me. ITEM I: I direct that all my legally enforceable debts and funeral expenses, including all expenses of my last illness, shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. ITEM II: I bequeath any automobiles or motor vehicles I may own at my death, my personal effects, my household goods, and other tangible personal property of like nature (not including cash or securities), together with any existing insurance thereon, to such of my children as are living on the date of my death, to be divided between them by my personal representative with due regard for their personal preferences in an nearly equal shares as practical. I direct that any of the foregoing articles not selected by my said children shall be sold at public or private sale by my personal representative and I further direct that the net proceeds thereof shall be administered and distributed as a part of the residue of my estate. ITEM III: I devise and bequeath the residue of my estate of every nature and wherever situate, including any property over which I shall have any power of appointment, as follows: (A) Two-thirds (2/3) thereof to my son, David M. Glantz, of Carlisle, Pennsylvania. Should my said son predecease me I devise and bequeath his share of my estate to his issue, per ~ ~ ~ stirpes, and in default of any such then living issue, such share shall be added to the share of my daughter, or her issue, as set forth in Item III (B) below. (B) One-third (1/3) thereof to my daughter, Deborah J. Hanna, of Storrs, Connecticut. Should my said daughter predecease me I devise and bequeath her share of my estate to her issue, per stirpes, and in default of any such then living issue, such share shall be added to the share of my son, or his issue, as set forth in Item III (A) above. ITEM IV: All Federal, State and other death taxes payable because of my death, with respect to the property forming my gross estate for tax purposes, whether passing under this Will or otherwise, including any interest or penalty imposed in connection with such taxes, shall be considered a part of the expense of the administration of my estate and shall be paid out of the principal of my residuary estate without apportionment or right of reimbursement. ITEM V: I appoint my son, David M. Glantz, of Carlisle, Pennsylvania, Executor of this my last Will. Should my said son fail to qualify or cease to act as Executor, I appoint my daughter, Deborah J. Hanna, of Storrs, Connecticut, Executrix of this my last Will. ITEM VI: I direct that all fiduciaries acting under this Will, whether or not named herein, shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal, this l~~'` day of August, 2000. n Q~ [SEAL] The preceding instrument, consisting of two (2) typewritten pages, each identified by the signature of the Testatrix, was on the date thereof, signed, published and declared by Susan S. Glantz, the Testatrix therein named, as and for here 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. C COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE REV-1162 EX~71-96) BUREAU OF INDI VIpUAL TAXES ^EPT. 280601 HARRISBURG, PA 1 71 2 8-0 601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 002019 BUNDLE MICHAEL R ESQUIRE SUITE 106 19 BROOKWOOD AVENUE CARLISLE, PA 17013 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------' mle ESTATE INFORMATION: ssn1: 1s~-o5-seta FILE NUMBER: 2102-0962 DECEDENT NAME: GLANTZ SUSAN DATE OF PAYMENT: 01/07/2003 POSTMARK DATE: 00/00/0000 couNTY: CUMBERLAND DATE OF DEATH: 1 0/ 1 1 / 2002 101 ~ $7,000.00 TOTAL AMOUNT PAID: REMARKS: MICHAEL R BUNDLE ESQUIRE CHECK# 8 INITIALS: JA SEAL RECEIVED BY: $7,000.00 DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS CERTIFICATION OF NOTICE UNDER RULE 5 6(al Name of Decedent: S U S a~ S G~ qyt ~ Z Date of Death: OG~ O.Ik y' ~ ~ ~ Z ~~ L Will No. ZCsIt7~ - ~QQ~p,Z Admin. No. To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a~) Qf the O hans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on IyOOHtM~w 7 2002 ame Address lar-+Z 8oS ~orb¢,~ 12d•, Carlv~le PA t"Io13 17e 6 062 Notice has now been given to all persons entitled thereto under Rale 5.6(a) except Date: ~erb ~ltav 3 top 3 ~ \ , rl Signature 'lt ~..Q..~~.ulC Name 1 Y 1,~e.~1.4E ~ K. KuNq~G. Address ~ Z ~ , ~i K l'~~ ~ L^ , ~oi lt'Ng SpvrNq~ PJ4 I'loo7 Telephone (yl"~ 2 t~Q_ 32 Capacity: _ personal Representative X Counsel for personal representative COMMONWEALTH OF PENNSV LVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 J128~0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 002387 BUNDLE MICHAEL R ESQUIRE 62 SOUTH PIN OAK DRIVE BOILING SPRINGS, PA 17007 role ESTATE INFORMATION: ssN: ts~-o5-saga FILE NUMBER: 2102-0962 DECEDENT NAME: GLANTZ SUSAN DATE OF PAYMENT: 04/03/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 1 0/ 1 1 /2002 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ $1,051.01 REV-1162 EXI11-961 TOTAL AMOUNT PAID: REMARKS: DAVID M GLANTZ C/O MICHAEL R BUNDLE ESQUIRE CHECK#102 INITIALS: DO SEAL RECEIVED BY: $1,051.01 DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS RE\;,'c00U!o^",', COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 , HARRISBURG, PA 17128.0601 l1-qlt>- IY- REV-1500 .- t... - FILE NUMBER 21 02 INHERITANCE TAX RETURN RESIDENT DECEDENT 00962 CaUNTiCODE/rAR NUMBER I- Z W Cl W U W Cl DECEDENT'S NAME (LAST FIRST, AND MIDDLE INITIAL) Glantz, Susan S SOCiAL SECURITY NUMBER 187-05-6823 DATE OF DEATH (MlvWD-YEAR) 10/11/02 DATE OF BIRTH (MM-DD-YEAR) 08/17/12 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER (iF APPliCABLE) SURVIViNG SPOUSE'S NAME (LAST FIRST, AND MIDDLE INITIAL) W :il::~CI) U"'" wo.u ",00 u"'~ 0.<0 0. " ~ 1,OriginalReturn D4_LirnitedEstate D 6_ Decedenl Died Testate iA.!ta~h fJpydWill: o 9,LitigationProceedsReceived D 3, Remainder Return {dJle of d~ath pli)( t012 ",;-:" [J 5, Federal Estate Tax Return Required o 8 Total Number of Safe Deposit Boxes o 11 Election to tax under Sec. 9113(A) u\li(1( ,S(.t;Oi D 2. Supplemental Return D 4a. Future Interest Compromise (dat~ otdeBlIl after 12-12-821 o 7. Decedent Maintained a Uving Trust iAlIach copy of Trusti D 10 Spousal Poverty Credit !rJale 01 J~ath between 12-31.91 and '-1% ... Z W o Z o 0. '" W '" '" o u THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS Michael R, Rundle, Esq, 62 South Pin Oak Drive Boiling Springs PA 17007 FIRM NAME ('fAppllCalJlel ' , TELEPHONE NUMBER (717) 249-3274 1 Real Estate (Schedule A) (1) (2) 201 ,484.23 2 Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) z o ~ ..J ::> !:: D- c:( U W IX 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) i51 1,175,00 (6) 636,37 i71 8. Total Gross Assets (total lines 1~7) 9. Funeral Expenses & Administrative Costs (Schedule H) (8) (9) 12,919.25 (10) 4,078,10 203,295,60 10 Debts of Decedent, Mortgage Uabilities, & Liens (Schedule I) 11 Total Deductions (total Lines 9 & 10) (11) (12) (13) 16,997,35 186,298,25 12 Net Value of Estate (Line 8 minus line 11) 13 Ctmrilable and GovernrnenlalBequests!Sec 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) (14) 186,298,25 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o ~ I-' ::> D- :E o u >< ~ 15 Arnountof Line 14 taxable at the spousal tax rate, or transfers underSec, 9116 (a)(12) x 0 (15) ___ 186,29_fl15 x 0 45 (16) 8,383.4~ 16_ Amount of Line 14 taxable at lineal rale x 12 17 Amounlo! Line 14 taxable at sibling rate 11Ti , 15 18. Amount of Line 14 taxable at collateral rate (18) 19. Tax Due (19) 8,383,42 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TQ ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < Decedent's Complete Address: STREET ADDRESS 805 Forbes Road CITY Carlisle I STATE I ZIP PA 17013 Tax Payments and Credits: 1. Tax Due (Page 1 line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (l( 8,383.42 7,000.00 368.41 Total Credits ( A + B + C ) (2( 7,368.41 3. Interest/Penalty if applicable D. Interest E. Penalty TotallnteresVPenalty ( D + E ) (3) 4. If line 2 is greater than Line 1 + Line 3, enler the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 1,015.01 A Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 1,015.01 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: Yes No a. retain the use or income of the property transferred: ..."..."".... .....'. .H.. ................... .. .. .......... .. .... .. .... . D [K] b retain the right to designate who shall use the property transferred or its income; 0 [K] c retain a reverSionary interest; Of.. . .. .... D [i] d receive the promise for life of either payments, benefits or care? ........................ ....... .... ....",,,,,,,, ......'.... D [iJ 2 If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.. .. .. ..,,, .... D ~ 3 Old decedent own an "in trust for" or payable upon death bank account or security at his or her death? ............. D [RJ 4 Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ......,... .. ..... ..........................., ...,.............. ,......... . ....... . ....... .."..... ,.., D [K] 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 penaRies 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 preparerother than the personal representative is based on all information of which preparer has any knowledge. SI~ ~~,jR)2~ Ry:g.N~~~R FILING RETURN ADDRESS ~ 805 Forbes Carlisle, PA 17013 SI~~ ~~~12~~AN_ Rfr~TATIVE ADDRESS 62 South Pin Oak PA 17007 DATE 0'-1; - <.."l3-c,~ DATE u<f _. 0 ?:Q:, 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 PS S9116 (a) (11( (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, 09116 (a) (U) (ill] The statute does not exemot a transfer to a surviving spouse from tax. and the statutory requirements for discioslJre of assets and filing a tax return are still apP,icable even if the surviving spouse is the oniy 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 PS, s9116(a)(1.2)]. The tax rate imposed on the net value of transfers to orfor the use of the decedent's lineal beneficiaries is 4,5%, except as noted in 72 P.S. S9116(1.2) [72 PS. 89116(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)(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 biood or adoption. REV-1503 EX+ (6-98) \': .~\,~9. ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Susan S. Glantz FILE NUMBER 21-02-0962 All property jointly-owned with right of sUlVivorship must be disclosed on Schedule F. ITEM NUMBER ,. DESCRIPTION Edward Jones Account No. 377-03886-1-3 (see attached) VALUE AT DATE OF DEATH 201484.23 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 201,484.23 2\ West High S'treet Carlisle, PA 17013 (717) 258-4688 www.edwardjones.com Art Amundsen Investment Representative November 12, 2002 Addams & Rundle Attn: Michael R. Rundle 28 S. Pitt St. Carlisle, PA 17013-3211 M,'}.e Dear Mr Rundle: Re: Susan S Glantz Accl#377-03886-1-3 Valuation as &1: ",0/11/2002 Quantity 5529.09 2700 294.786 383.049 110 13.67 24 1200 1058.554 94.352 300.68446 6000 25000 50000 3000 5000 9000 267.79 Value Per Item $1.000 $ 6.12 $ 20.16 $ 39.75 $ 23.92 $ 21.55 $ 8.76 $ 26.95 $13.46 $16.68 $ 35.14 $ 103.50 $ 99.00 $ 103.00 $ 99.00 cr".....,. (lr, 'f''''-' .vv Description Money Market Shares American Insured Mortgage Capital World Growth and Income Capital Income Builder Fund Duke Realty Corp Euro Pacific Growth Fund General Motors Corp Georgia Powers Company Income Fund of America Inc New Perspective Fund Weingarten Realty Federal Natl Mtg Assn Gtd 1993-41 CL LL Federal Home Ln Mtg Corp CL 1931 - MM Federal Nail Mtg Assn Gtd 1999-18 CL -LL Federal Natl Mtg Assn 2000-21 CL - LL US V',IAst Comm !nc Deb M8!.L\ - lBC' US West Comm Inc Deb I\ccrued Interest , $ 65.00 $1.00 EdwardJones Total Value $ 5529.09 $ 16524 $ 5942.89 $ 15226.20 $ 2631.20 $ 294.89 $ 210.24 $ 32340 $14248.14 $1573.79 $ 1 0566 $ 6210 $ 24750 $ 51500 $ 2970 $ 4850 $ 5850 $ 267.79 The values were obtained from an outside historical pricing service and while we believe that they are reliable, we do not guarantee their accuracy. Sincerely, /.':r', .~ <_<'I . /~ n" .' i r / / .:.- .'..:/ (.. , Art Amundsen Investment Representative REV-1508 EX'" (6-9H1 " ..9:..~ '...il.. ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Susan s. Glantz FILE NUMBER 21-02-0962 Include the proceeds of litigation and the dale the proceeds were received by the estate. All property jolntly.owned with right of survivorship must be disclosed on Schedule F ITEM NUMBER DESCRIPTION 1 Check, Edward Jones 2 Federal income tax refund 3 State income tax refund 4 Misceilaneous women's clothing VALUE AT DATE OF DEATH 500.00 536.00 39.00 100.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1,175.00 REV-1509 EX+ (6-98) f '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF Susan S. Glantz FILE NUMBER 21-02-0962 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. David M. Glantz 805 Forbes Road, Carlisle, PA 17013 Son B. C JOINTLY.OWNED PROPERTY: LETTER D:'TE DESCRIPTION OF PROPERTY %OF DATEmDEATH rEM EQRJOINT ~IADE !NClUDE NAME OF FINANCIAL INSTITUTiON AND BANK ACCOUNT NUMBER OR SiMV,R DATE OF DEATH DECO'S '1ALUEOF NUMBER TENANT JO'NT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE VALUE OF ASSET INTERESl DEGEDE~JT S INTEREST 1. A. 1993 Bank Of New York, checking account #008.3816694 1272.73 50% 636.37 TOTAL (Also enter on line 6, Recapitulation) $ 636.37 (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (12-99) . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Susan S. Glantz FILE NUMBER 21-02-0962 ITEM NUMBER DESCRIPTION AMOUNT A FUNERAL EXPENSES: 1. Hoffman Roth Funeral Home, Inc.- all services relative to funeral and burial 7386.25 2. Rye Monument- engraving headstone 325.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s}fEJN Number of Personal Representative(s) Street Address City State_Zip Year(s) Commission Paid. 2 Attorney Fees 1,250.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3,500.00 Claimant David M. Glantz Street Address 805 Forbes Road City Carlisle Slate~Zip 17013 Relationship of Claimant to Decedent Son 4. Probate Fees 249.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 200.00 7. Register of Wills- short certificates 9.00 . TOTAL (Also enter on line 9, Recapitulation) $ 12,919.25 Debts of decedent must be reported on Schedule I. (If more space is needed, insert additional sheets of the same size) REV.1512 EX+(6-98) '* SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Susan S. Glantz FILE NUMBER 21-02-0962 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1. Forest Park Health Center - bill 2. Pinker & Associates - bill 3. West Shore EMS - bill 4. Shermansdale Family Practice - bill 5. Belvedere Medical Corp. - bill 6. Carlisle Regional Medical Center - bill 7. Sprint - bill 8. Central Penn Medical Group - bill 9. Mary Ann Glantz- check presented for payment after death 10. Shermansdale Family Practice- check presented for payment after death 11. Port Chester Westmore News- check presented for payment after death 12. Ruth Lynn Bush Chapter NSDAR- check presented for payment after death VALUE AT DATE OF DEATH 2993.74 14.10 74.68 28.75 6.90 52.27 17.63 14.69 745.00 26.34 24.00 80.00 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 4,078.10 REV.1513 EXt (9-00) 9.,Jb~ ~ SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Susan S. Glantz FILE NUMBER 21-02-0962 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2IJ 1. David M. Glantz. 805 Forbes Road, Carlisle, PA 17013 Son Two-thirds (2/3) 2. Deborah J. Hanna, 16 Ladi Drive, Storrs, CT 06268 Daughter One -third(1/3) ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-15QO COVER SHEET " 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 REY.15QQ COYER SHEET $ (If more space is needed, insert additional sheets of the same size) BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 290601 HARRISBURG, PA I]129-9601 MICHAEL R RUNDLE 62 S PIN OAK DR BOILING SPGS COMMONWEALTH OF PENNSYLVANIA D EPARTMEN7 OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS ANO ASSESSMENT OF TAX REV-1541 IX 1Fp (01 -0 ]) R@i;rt~.;.., ,:.~ DATE 05-12-2003 !~1< ESTATE OF GLANTZ SUSAN S DATE OF DEATH 10-11-2002 FILE NUMBER 21 02-0962 ESp 03 MAY 16 ,PI~C ;~~000NTV CUMBERLAND ACN 101 PA 17 d6~T:- Amount Remittetl Cirmb~ . ... -, MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR -------------------------- ---------------- RECORDS ~ ----------------------- REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE ----------------- OR DISALLOWANCE OF DEDUCTIONS AND ASSESS MENT OF TAX ESTATE OF GLANTZ SUSAN S FILE N0. 21 02-0962 ACN 101 DATE 05-12-2003 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 A7 (1) 2. Sto<ks and Bon tls (Schedule 87 .00 NOTE: To insure proper I2)_ 201.484.23 credit to your account 3. Closely Held Stock/Partnership Interest (Sched l C , u e ) (3) 4. Mortgages/Notes Receivable (Schedule 0) .00 submit the upper portion (4) 5. Cash/Bank Deposits/MSsc. Personal Property (S<hetlule E) (5) .00 1 175 00 of this form with your t 6. Jointly Owned Prp perty (S<hetlul¢ F7 (6) . . 636.37 ax payment. 7. Transfers CSChedula G) (77 .00 s. 7otai Assess (g) 203,295.60 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Fun¢ral Expanses/Adm. Costs/Misc. Expenses (Schedule N) (q7 12+919.25 10. Debts/Mortgage Llabilitles/Liens (Schedule I) (10)_ 4.078.10 11. Total Detluctions 12. Net Value of Tax Return (11J 1[„997 ~ 186 298 25 13. Charitable/GOV¢rnmental Bequ¢sts; Non-elected 9113 Trusts (Sched (127 ule J) (13) . r .00 14. Nat Value of Estate Subject to Tax 186 29 (14) , 8.25 NOTE: If an assesseent was issued previously, lines 14. 15 f antl/or 16 17 18 re lect figures that include the total of ALL ret , , and 19 will urns ASSESSMENT O assessetl to date. F TAX: 15. Amount of Line 14 at Spousal rate (15) ,00 16. Amount of Line 14 taxabl¢ at Lineal/Class A rate (16) 186,298.25 X 17. Ampunt of Line 14 at Sibling rata (177 .00 x 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 00 x 19. Principal Tax Oue . X Twv ro rn,.rn_ PAYMENT DATE 01-07-2003 04-03-2003 RECEIPT NUMBER CD002019 CD002387 DISCOUNT (+) INTEREST/PEN PAID (-7 368.42 .00 AMOUNT PAID 7,000.00 1,051.01 * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 70 TAL TAX CREDIT 8,419.43 BALANCE OF TAX DUE 36.O1CR INTEREST AND PEN. .00 TOTAL DUE 36.O1CR ( IF TOTAL DUE IS LESS THAN bl, 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.] 00 _ .00 045_ 8,383.42 12 _ .00 15 _ .00 a 9)= 8,383.42 STATUS REPORT UNDER RULE 6.12 - /D~ Name ofDecedent: ~u~u~ S • ~T IQUl ~ 2 Date of Death: ~'`~~che~ li 2cc•2 Will No.: 2 i - c z - c~'1 ~ ~. 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 Q 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 ^ c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the. Orphans' Court and maybe attached to this (report. Date: .~ u\,~ 31 ~ 2no3 \ ~~ ~l~ ~ ~~~c~ ~ ~~ Signature ~t~'~-tnn e ~ ~. Q~a~~~ie Na/me f , f((~~J I ~ 2 C~ {~{ ~~~ 6z SCUII'~ PAN ~aK 1NiU~Q IJ D~~~L1Q ~)v~~A~S1}~ Address J 0 ~~ ~~~~~ 2~1~-31-7} Telephone No. Capacity: ^ Personal Representative ® Counsel for personal representative