HomeMy WebLinkAbout02-1141
PETITION FOR PROBATE and GRANT OF LETTERS
Estate of Donald M. Smith No. ~I ~[~~ " ~ ~ ~ I
also known as To:
Register of Wills for the
Deceased. County of Cumberland in the
Social Security No. 201-18-7249 - - Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut nx named
in the last wilt of the above decedent, dated April 16, 1996 , 19
and codicil(s) dated n/a
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in Cumberland Count , Penns.yylvani ,with
1LS last family or principal residence at 105 Moore an venue, t. Holly ~prmgs, Yennsy~vanta
(list street, number and muncipality)
Decendent, then 79 ears of age, died November 20,2002 , 19 ,
at Carlisle, Cumberland County, Pennsylvania
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 $ ~ j b ~ C(9 C~
(If not domiciled in Pa.} Personal property in Pennsylvania $ r
(If not domiciled in Pa.) Personal property in County $
Value of real estate in Pennsyly~pia $ ..>S~B, J6 d
situated as follows: ' ~ 5 htoorelao~~ ~e
Vb'HEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented ht:rewith and the grant of letters testamentary
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
[heron.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA 1
COUNTY OF Cumberland ~`- ~'
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 kno~.vledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly admjnister the estate according to law.
Sworn to or affirmed and st,bscribed ~J ~
.. efore me this _ 12th _ day of Kathy a oo•
ecemb 20 9 a
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nna P7. utto, 1st ueput~' Kegister
/>- ~ y--~
No.
21-2002-111
Estate of DONALD M. SMITH ,Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW December 16th , 2002 19 , in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated April 16, 1996
described therein be admitted to probate and filed of record as the last will of
DONALD M. SMITH
and Letters testamentary '
are hereby granted to Kathy E. Hoffinan
Regis er of Wills
Donna M. Otto,~st Deputy
r
FEES
Probate, Letters, Etc..... ..... $ 375.00 Thomas E. Flower, Esquire #83993
Short Certificates( 1~..... ..... $ 30.00 ATTORNEY (Sup. Ct. I.D. No.)
l~ii~dx~ioax .(.3) ....... ..... $ 9.00
26 West High Street, Carlisle, PA 17013
Extra Pages
JCP
10.00 ADDRESS
TOTAL $
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PHONE
MAILED LETTERS TO ATTORNEY ON December 16th, 2002
LAST WILL
I, DONALD M. SMITH, of Mt. Holly Springs, Cumberland
County, Pennsylvania, declare this to be my Last Will and
revoke any wills previously made by me.
I. I devise and bequeath my estate of whatever nature
or wherever situated to my daughter, Kathy E. Hoffman. In
the event my daughter does not survive me, then I bequeath
my estate to my grandchildren in equal shares.
II. Should my daughter not survive me, I appoint Duane
E. Hoffman to be guardian of the estate of any minor
grandchildren I may have whether such property passes under
this wil_1 or in any other manner including the proceeds of
insurance on my life.
III. In addition to all other powers allowed by law,
the guardian shall apply such amounts of principal as he, in
his sole discretion, deems advisable for the care,
maintenance, support, education and general welfare of such
minor children.
IV. The guardian may retain any of the assets of my
estate which comes into his hands, and shall invest and. keep
invested the principal of the guardian estate in such manner
and in such securities or other property, real or personal,
and upon such terms and for such length of time as the
guardian shall deem advisable, it being intended hereby to
give unto the guardian full and complete authority to hold,
possess, manage, and reinvest the whole and every part of
the guardian estate according to his sole judgment and
discretion without any limit upon the power and authority so
to do by statute or otherwise.
V. I appoint my daughter, Kathy E. Hoffman, to be
executrix of this my Last Will. In the event she fails to
qualify or ceases to act then I appoint Duane E. Hoffman to
be ex_ectaor .
VI. I direct that my personal representative not be
required to file bond in this or any other jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and
seal to this my Last Will this 16th day of April, 1996.
~~~-rf l~_ ., ~ ( SEAL )
The preceding instrument consisting of two (2) page(s)
was on the date thereof signed, published and declared by
DONALD M. SMITH, the testator herein, as and for his Last
Will, in the presence of us, who at his request, in his
presence, and in the presence of each other, have subscribed
our names as witnesses hereto.
STATE OF PENNSYLVANIA ..
SS
COUNTY OF CUMBERLAND ..
We, DONALD M. SMITH, Frances H. Del Duca and Marylyn A.
Lapato, the testator and witnesses, respectively, whose
names are signed to the attached or foregoing instrument,
being first duly sworn, do hereby declare to the undersigned
authority that the testator signed and executed the
instrument as his Last Will and that he had signed
willingly, and that he executed it as his free and voluntary
act for the purposes therein expressed, and that each of the
witnesses, in the presence and hearing of the testator,
signed the will as witness and that to the best of his
knowledge the testator was at that time eighteen years of
age or older, of sound mind and under no constraint or undue
influence.
~ tel. .,-t~crZ`~
estator
SUBSCRIBED, sworn to and acknowledged before me by
the testator, and subscribed and sworn to before me by
Frances H. Del Duca and Marylyn A. Lapato, this 16th day of
April, 1996.
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Notary b is '
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NOTARIAL SEAL
SHIRLE'M' P. CLEVEN~,I~R, NOTARY PUBLIC
CaWtf Borough, ~~,moerland County
~rCgfpmlaalon Expires March 5, 2000
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REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
CERTIFICATION OF NOTICE UNDER RULE 5.6(A)
Name of Decedent: Donald M. Smith
Date of Death: November 20, 2002
Will No. 21-02-1141
To the Register:
Admin. No. 2002-01141
I c~t-tify that Notice of Estate i'-id~iiiiistrati~+ri rEquired by Rule S.r',(a) of the Orphans'
Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate
on January 7, 2003.
Name Address
Kathy E. Hoffinan 309 Idaville -York Springs Road, Gardners, PA 17324
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
none
Date: ~ ~ ~ ~ 3 ~l
Tomas E. Flower, Esquire
SAIDIS, SNUFF, FLOWER & LINDSAY
2109 Market Street
Camp Hill, PA 17011
(717) 737-3405
Capacity: -Personal Representative
X Counsel for Personal
Representative
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February 19, 2003
390 Idaville-Yk. Spgs. Rd.
Gardners, PA 17324
(717)-677-0851
Register of Wills
1 Courthouse Square
Carlisle, PA 17013
Dear Register of Wills,
Enclosed is a check for $18,000.00 for payment of estimated
Pennsylvania estate tax on the estate of Donald M. Smith, late of 105
Mooreland Ave., Mt. Holly Springs, PA 17065. The PA File number is
21-02-1141, and File number 2002-01141.
Please mail me a receipt for the payment.
Thank you.
Sincerely,
~ ~.
Kathy S. Hoffman
Estate Executrix
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX111-96)
N0. CD 002196
HOFFMAN KATHY E
390 IDAVILLE YORK SPRINGS ROAD
GARDNERS, PA 17324
-------- fold
ESTATE INFORMATION: ssN: 2oi-~B-7249
FILE NUMBER: 2102-1 141
DECEDENT NAME: SMITH DONALD M
DATE OF PAYMENT: 02/20/2003
POSTMARK DATE: 02/ 1 9/2003
COUNTY: CUMBERLAND
DATE OF DEATH: 1 1 /20/2002
REMARKS: KATHY E HOFFMAN
SEAL
CHECK# 4063
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
101 ~ S 18,000.00
TOTAL AMOUNT PAID:
INITIALS: AC
RECEIVED BY: DONNA M. OTTO
S 18, 000.00
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
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COMMONWEALTH OF PENNSYLVANIA REV-1162 EX~11-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
N0. CD 002689
FLOWER THOMAS E ESQUIRE
2109 MARKET STREET
CAMP HILL, PA 1701 1
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
__________ ________
-------- fold
ESTATE INFORMATION: ssN: 2o~-is-~z4s
FILE NUMBER: 2102-1 141
DECEDENT NAME: SMITH DONALD M
DATE OF PAYMENT: 06/17/2003
POSTMARK DATE: 06/16/2003
COUNTY: CUMBERLAND
DATE OF DEATH: 11/20/2002
101 ~ 51,334.70
TOTAL AMOUNT PAID:
REMARKS: THOMAS E FLOWER ESQUIRE
CHECK# 4
INITIALS: VZ
51,334.70
SEAL RECEIVED BY: DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
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.' COMMONWEALTH Of
. PENNSYLVANIA
, DEPARTMENT OF REVENUE
DEPl 280601
HARRISBURG, PA 17128.{)601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
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FILE NUMBER
21 02
01141
COUNTY CODE
YEAR
-----
NUt.'BER
DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
~ Smith, Donald M, I 201.18.7249
W 'DATE OF DEATH (MM.DD-YEAR) i DATE OF BIRTH (MM.DD-YEARJ-- ---t THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
~ 11/20/02 112/19/22 ,I' REGISTER OF WILLS
W (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) --tsOCIAL SECURITY NUMBER
C
~ 1. Onginal Return
o 4. Limited Estate
[!] 6. Decedent Died Testate (Attach copy ofWlI)
o 9. litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (dale of dealh afler 12-12-82)
o 7. Decedent Maintained a Living Trust (Attach copy ofTrusl)
o 10. Spousal Poverty Credit (date of death between 12-31.91 and 1-1-95)
o 3. Remainder Return (date 01 death prior 10 12.13-82)
o 5. Federal Estate Talt Return Required
8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (AlIach Sch OJ
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COMPLETE MAILING ADDRESS
2109 Market Street
Camp Hill. PA 17011
NAME
Thomas E, Flower, Esquire
FIRMNAME(lfAppl~~~-----
Said is. Shuff, Flower & Lindsay
TELEPHONE NUMBER---
(717) 737.3405
(1)
(2)
(3)
(4)
(5)
151.500.00
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages &. Notes Receivable (Schedule 0)
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
(ScheduleG orL)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Ac:Iministrative Costs (Schedule H)
10. Debts of Decedent, Mortgage liabilities, & 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 ejection to tax has not been
made (Schedule J)
5,411.65
450,712.02
0.00
93,778.31
)
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(6)
193.749,36
(7)
17,096.00
456,123.67
(9)
(10)
(8)
5.223,87
187.78
(11)
(12)
(13)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(14)
450,712.02
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. I\mount of Line 14 taxable at the spousall.ax
rate, or transfers under Sec. 9116 (a)(1.2)
0.00 x ,0 (15)
_'I?Q,71<!,.01. x .0 45. (16)
20,282.04
16. Amount of Line 14 taxable at lineal rate
0.00 x ,12
(17)
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14l.axable at collateral rate
0,00 x .15 (18)
19. Tax Due
(19)
20,0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Dec~dent's Complete Address:
STREET ADDRESS
f-. 105 Moorela[1d Avenue
I STATEpA
CITY Mt. . Holly Springs
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Cred~siPayments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
\ ZiP
17065
20,282.04
1 ~,OOO.OO_
947.34
Total Credits ( A + B + C ) (2)
18,947.34
3. Interest/Penalty if applicable
D.lnterest
E. Penalty
0.00
Total Interest/Penalty ( 0 + 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)
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.
(5A)
1,334.70
0.00
8. Enter the total of Line 5 + 5A This is the BALANCE DUE. (58) 1,334.70
Make Check Payable to: REGISTER OF WILLS, AGENT
Il!ilM ~ Hlj!IIl~IllIl!ilM-,'1 .1111 ill "" IV" III
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes
a. retain the use or income of the property transferred;.......................................................................................... D
b. retain the right to designate who shall use the property transferred or its income; .................................,.......... D
c. retain a reversionary interest; or.....................................................................,.................................................... D
d. receive the promise for life of either payments, benefits or care? ...................................................................." 0
2. If death occurred after Oecember 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ..................................................................................................."......... 0
3. Did decedent own an "in trust fo( 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? ......................................................................................"..........,..................... 0
No
[K]
[K]
[K]
[iJ
D
[K]
D
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FilE IT AS PART OF THE RETURN.
\Jncler penalties of peJjury, I dedar8 fuat I have examined lhls return, lnc1udiflQ accompanying schedules and statements, and 10 the besl of my knowledge and belief, il is true, correct
and complete.
Declaration of preparerother Ihan lhe personal representative Is based on all informatio n ofwhfch preparer has any knowledge.
SIGB P7~N 11fl=JR FI~NG RETUR~
ADD S
Kathy E. Hoffman, 390 Idaville-York Springs Road, Gardners, PA 17324
S~O:~~E?~RO~~E
ADD'ir!slUl~
Saidis, Shuff, Flower & Lindsay, 2109 Market Street, Camp Hill, PA 17011
II r-'-.. It '''''''''
For da1es 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. ~9116 (al (1.1) (i)l.
DATE h
(,,/5 p:j
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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) (1.11 (iill.
The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable el/en if
the surviving spouse is the only beneficiary.
For dales 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(a)(I)].
The tax rale imposed on Ihe nel vaiue of lransfers to or for the use of the decedent's siblings is 12% [72 P.S. ~9116(a)(1.3)1. 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.
REV-1S0' EX+ (6-'.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF
Smith, Donald M.
FILE NUMBER
21-02-1141
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property which Is Jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
,.
DESCRIPTION
VALUE AT DATE
OF DEATH
151,500.00
house and .62 acres
105 Mooreland Avenue
Mt Holly Spring, PA 17065
per attached assessment at 100% of market value
TOTAL (Aiso enter on line 1, Recapitulation) $
151,500.00
(If more space is needed, insert additional sheets of the same size)
ReV-150B EX+ (6-9B) ..
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Smith, Estate of Donald M,
FILE NUMBER
21-02-1141
Include the proceeds of litigation and the date Ihe proceeds were received by Ihe estate.
All property Jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION
1, 1991 GMC Sonoma Short Bed Pick-up Truck
16,370 miles (Blue Book report)
VALUE AT DATE
OF DEATH
2,830,00
2 1995 Dodge Caravan - sales price
4,000,00
3,217,55
25,686,60
31,008_59
17,296,69
9,325,07
3, Household furnishings and personal effects - auction proceeds
4, CUNA Mutual Life Annuity # 40010448
5, Gienbrook Life Annuity # GA809960
6, Glenbrook Life Annuity # GA 0596115
7, PNC Bank checking account # 5140191657
principal - $9,323,99
Interest - $1,08
8, PNC Bank IRA account # 6500101608
principal- $413,74
interest - $0,069
413.81
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L Jl5I,\"-" t< I><'"epc..<"-,,,,\
/)JOS a~O v J
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of Ihe same size)
93,778.31
REV-1509 EX+ i6-98*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
Smith, Donald M.
FILE NUMBER
21-02-1141
If an uset was made joint within ona 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. Kathy E. Hoffman
390 Idaville - York Springs Road
Gardners, PA 17324
daughter
B.
C.
JOINTLY-OWNEO PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUOE NAME OF FINANCIAL INSTITUTION AND aANKACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECO'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER, ATTACH DEED FOR JOINTLY-HELD REl\l ESTATE. VA\..UE OF P\SSET INTEREST DECEDENT'S INTEREST
,. A. 5-8-1991 McLaughlin, Piven, Vogel Securiities 23,778.65 50% 11,889.33
2. A. 10-12-93 PaineWebber 345,902.76 50% 172,951.38
3. A, 10-7-1996 JPMorgan Chase 4,925.60 50% 2,462.80
4. A. 8-10-1992 Members 1 sl FCU account # 50011-00 12,891.70 50% 6,445.85
TOTAL (Also enter on line 6, Recapitulation) $ 193,749.36
(If more space is needed, insert additional sheets of the same size)
REV~1510 EX+ (6~98.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
Smith, Donald M.
FILE NUMBER
21-02-1141
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
ITEM OESCRIPTION OF PROPERTY DATE OF DEATH
INCLUDE THE NAME OFTHETRANSFEREE,THEIRRELATION$HIPTOOECEOENTAND % OF DECO'S EXCLUSION TAXABLE
NUMBER THEOATEOFlRANSFER. ATTACHACOPY'OFTHE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST IIFAPPLlCABLEl VALUE
1. 40 EE U.S. Savings Bonds purchased within one year of
death in joint names of Decedent and daughter, Kathy Hoffman
(see attached inventory listing bond values) 20,096.00 50% 3,000.00 17,096.00
TOTAL (Also enter on line 7 Recapitulation) $ 17,096.00
(If more space is needed, insert additional sheets of the same size)
.
REV-1511 EX+ (12-99l.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Smith, Estate of Donald M.
FILE NUMBER
21-02-1141
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
,. $1,616.92
Gibson-Hollinger Funeral Home - pre-paid funeral policy accepted as payment in full
200.00
memorial service refreshments - Church Ladies Aid
B. ADMINISTRATIVE COSTS:
,. Personal Representative's Commissions
Name of Personal Represenlalive(s)
Social ~curit'j Number(s}IEIN Number of Personal Representa\ive(s)
SlreetAddress
City State~Zip
Year(s) Commission Paid:
2. Attorney Fees 2,500.00
3. Family Exemption: (If decedent's address is nol the same as claimant's, attach explanation)
Claimant
Street Address
City State ~Zip
Relationship of Claimant to Decedent
4. Probate Fees 424.00
5. Accountant's Fees
6. Tax Return Preparer's Fees 145.00
7. The Patriot News - estate advertising 119.95
Cumberland Law Journal - estate advertising 75.00
Met Ed electric service 12/02 - 105 Mooreland Avenue, Mt. Holly Springs, PA 143.00
TOTAL (Also enter on line 9, Recapitulation) $ 5,223.87
Debts of decedent must be reported on Schedule I.
(If more space is needed, insert additional sheets of the same size)
,
REV-1512 EXt (6-98)
..
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE UABIUTlES, & UENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIOENT DECEDENT
ESTATE OF
Smith, Donald M.
FILE NUMBER
21-02-1141
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1. Sprint - phone bill
VALUE AT DATE
DF DEATH
2. MCI - phone bill
28.53
4.04
27.80
3. Corncast - t.v. cable bill
4. Met Ed - electric bill
123.00
5. Verizon - cell phone bill
4.41
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
187.78
REV-1513 EXt (9-00)
'*
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Smith, Donald M.
FILE NUMBER
21-02-1141
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 Unclude outright spousal distributions, and transfers under
Sec. 9116 (al (1.2)]
Kathy E. Hoffman daughter 100%
390 Idaville-York Springs Road
Gardners, PA 17324
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, 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
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- 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)
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->XelIey Blue Book Used Car Values
Page lof2
..
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Blue Book Private Party Report
Pennsylvania. February 15, 2003
1991 GMC Sonoma Short Bed
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ALllo_L()iln~JrOJ!Ll-.29"{,,-_AJ>R
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Warranty Quote
Print "FOLSille."SJgn ~ Scarel
PilY-'D_e.nLCilJ~IJ.l<;LtQr
SeH YOLlLcar OUel3i'lYMotors ~ Reque
Engine: V6 4.3 Liter
Trans: 5 Speed Manual
Drive: 4 Wheel Drive
Mileage: 16,370
Equipment
AllOut kl>b SLE
Home Air Conditioning
Power Steering
Kelley Blue Book
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AM/FM Stereo
Bed Liner
Consumer Rated Condition: Fair
"Fair" condition means that the vehicle probably has some
mechanical or cosmetic defects, but is still in safe running condition.
The paint, body and/or interior need work to be performed by a
professional in order to be sold. The tires need to be replaced. There
may be some repairable rust damage. The value of cars in this
category may vary widely, A clean title histOry is assumed. Even
after significant reconditioning this vehicle may not qualify for the
Blue Book Suggested Retail value.
Private Party Value $2,830
Private Party value represents what you might expect to pay for a
used car when purchasing from a private party. It may also represent
the value you might expect to receive when selling your own used
car to another private party.
~B~
Get a Used Car Trade-In Value Get Invoice & MSRP on New Cars
Get a Person to Person Auto Loan
Copyright @ 2003 by Kelley Blue Book Co., All Rights Reserved. Jan-Feb 2003 Edition. The
specific information required to determine the value for this particular vehicle was supplied
by the person generating this report. Vehicle valuations are opinions and may vary from
http://www.kbb.com/kb/ki.dll/kw.kc.ur?kbb.PA;796706;PA041&1 70 1 3;p&723;GMC; 1991 ... 2/1 5/2003
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FIRST LIEN RELEASED
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AUTHORIZEDREPR~SENTAT.IVE
MAIUNGADDRESS
IEPARTMENT OF TRANSPORTATION
:ATE OF TITLE FOR A VEHICLE
h
95
4"493220201
DODGE
YEAR
TITLE NUM8ER
MAKE OF, VEHICLE
Ae I UNLADEN WEIGHT
5 I
PRIOR TITLE STATE
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000033
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I
6/13/95
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l'ITlEBRANDS
aDOM,PRDeD,DATE
ODOM,MILES
QOOM STATUS
ODOMETER STATUS
a ~ ACTUAL MILEAGE
1 ~ MILEABE EXCEEDS THl MECHANICAL
LIMITS
2- 1I0T THE i\CTUAlIAILEAGE
J- OOT THE ,o,CTUALMILEAGE-oOOMETER
TAMPERING VERIFIED
., ~ EXEMPT FROM OO(JME1Efl DISCLOSURE
,7065
TITLE BRANDS
A.~ ANTIGUE VEHICLE
C ~ CLASSIC VEHICLE
F" OUT or COUNTRY
G' ORIGINALLYMFGD FOR NON.U.S
DISTRI8UflQtI
H-IIGRICULTURALVEHICLE,
L" lOGGING VEHICLE I
p. FORMERLY'" POLK:E VEHIC~E
R ~ RECONSTRUCTEO
S- STREET ROD
T ~ RECOVERED THEFT VEHICLE
V ~ VEHICLE CONTAINS REISSUED VIN
W-FLOODVEHICLE
X-FORMERLY A TAXI
SECOND LIEN FAVOR OF
DATE
~
If a second IIe~holder is listed, upo~ satisfacHo~ of the first lie~. the first
lienholder must forward this Tille 10 the Bureau ot Motor Vehicles with the
appropriafe!ormar1d!ee
SECOND.UENRELEASED
ll,
DA"
"
AUTHORIZED REPRESENTATIVE
DONALD M SMITH
105 MOORLAND AVE
MT HOLLY SPGS PA 17065
.
.
.
BRADLEY L MALLORY
I certily ~s ot tloe date of issue. lhe official <Bcords o! the pennsyl,vania Department
of Transportalion ,etlect Iha1 the persol1(s)or company named here.n's the law!ulowrlBr
Secretary or Transporta/ion
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TO BE COMPLETED BY PURCHASER WHEN VEHJClE IS SO~D AND TllE
APPLICATION FOR TITLE AND LIEN INFORMATION - ~~~R~~~~bE SECTIONS oN THE REVERSE SIDE OF THIS DOCUMENT ARE
When applying tor tllte with a co.uwner. other than your spouse, check one or
thesa blocks. I! no block Is cht!<:ked, title will be issued as "Tenants In Common'
A 0 Joi~tTenanlswithR;ghtoISurVOvo<ship(ondelltholoneow""r.tilleg""s
lolhesv'vi\t,ngow",,'1
8 0 Terln"ts'nCommnnl"",je,,'hot one nWl'ler,Inte,esl of <.Jeceasedow"..r
goes to his ur I,e, "'elrs '" ,,~tlllel
LIEN
OAf I'
FIFlSTlIENHOLDER
NOTARIAL SEAL
KATIE E. KERSTETTER, Notary Public
Borough at Carlisle, Cumberland County
My Commission Expires April 26, 2004
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YINGLING'S AUCTION GALLERY
1980 BALTIMORE PIKE
GETTYSBURG PA 17325
PRONE: 17171334-1568
03/11/03
CONSIGNOR NUMBER : 1
NAME : DONALD M. SMITH ESTATE
KATHY S HOFFMAN
390 IDAVILLE-YORK SPRINGS RD.
GARDNERS, PA 17324
(717) 677-0851
. . CONSIGNOR STATEMENT - -
PAGE 23
AUCTION NUMBER : 030311
PROD ITM INV
CODE NO. ..--.. ITEM DESCRIPTION ---.... NO. QTY
UNIT
PRICE
TOTAL
PRICE
COMMISSION SELLER'S RESERVE
AMOUNT NET AMOUNT AMOUNT EIDDER ~
M___..__~__________________~____________________._____-----------------------------------~------------------.---.----.------------.
1915 TV STAND/CART LOT 1 3.00 3.0030l .90 2,10 .00 340
PLANT STAND
> 1916 AIR COMPRESSOR 1 5.00 5.00 30l 1.50 3,50 .00 44
1917 TREADMILL/WORKBBNCH/SHELVING 1 .50 .5030l .15 .35 .00 16
UNIT/WORK TABLE LOT
1918 2 MUSIC BOOKS-LOT 1 .50 .50 3D! .15 .35 .00 16
1919 WINDMILL 1 55.00 55.00 3D! IUD 38.50 .00 292
1920 SCREEN DOOR GUARD 1 .50 .50 3D! .15 .35 .00 418
1921 ROLL A WAY CART 1 .50 .50 30\ .15 .35 .00 385
1922 WORKBENCH 1 1.50 1.50 30\ .45 1.05 .00 149
1923 WORKBENCH W/VISE 1 1.00 1.0030\ .30 ,70 .00 419
1924 CORNER CLAMP 1 .50 .50 30\ .15 .35 .00 160
1925 2 MBTAL WARDROBBS - LOT 1 5.00 5.00 30\ 1.50 3.50 .00 253
1926 LIGHTED CROSS LOT 0 .00 .00 0\ .00 .00 .00 NOBID
1927 TRACTOR 1 435.00 435.00 30\ 130.50 304.50 .00 200
1928 NEW BLADE FOR TRACTOR 1 40.00 40.00 30\ 12.00 28.00 .00 J59
fl. "
". I
i
COMPLETED : / YES 'NO
TOTAL GROSS SALE AMOUNT
ACTUAL SAL8S TOTAL
LESS COMMISSION
4,596.50
4,596.50
1,378.95
/"'::c:;.~-'-,,~
r~'/ "/
C_~~:~5/../
3,217.55
1.90
/tJj /
-/;/ A1'v-7f,l~t
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/ 7-f: ~
,/// I
v'
TOTAL N8T PROCEEDS
TOTAL ITEMS: 727
TOTAL OUE TO SELLER
AVERAGE ITEM COMMISSION AMOUNT
'\
NOTE :
. , BIDDER OF THIS ITEM IS ON ACCOUNT.
080003-1064- G~
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Soc"'ilyF<a'"ro.lne'ude<f Ell Detal',onb.ok
4' CUNA MUTUAL LIFE
>-<. INSURANCE COMPANY
January 17, 2003
.
Ms Kathy Hoffman
390 Idaville York Springs Rd
Gardners PA 17324
Re: 40010448 Donald M. Smith, Deceased
Dear Ms. Hoffman:
Thank you for your recent call requesting value information for your father's policy.
The value of Donald M. Smith's variable annuity account as of November 20, 2002, was
$25,686.60.
The claim settlement was completed and benefits paid to you on December 31, 2002.
If you have further questions regarding this information, please contact me at our toll-free number
1-800-798-6600, Ex!. 2440. Our office hours are 7:30 a.m. to 5 p.m., Central time, Monday
through Friday.
Sincerely,
uk
ene White, FLMI, ALHC, ACS
Senior Claim Specialist
JWH17KHsms
2000 Heritage Way . Waverly, IA 50677 ~9202
Business: 800/798-6600 . VoicefTOD: 319/3524090 . Fax: 319/352-6132
Glenbrook Life and Annuity Company
P.O. Box 94212
Palatine,IL 60094-4212
GLENBROOK LIFE
A Member of Allstate Financial Group
January 16, 2003
Kathy Hoffman
390 ldaville York Springs Road
Gardners, Pennsylvania 17324
Re: Donald M Smith
Contract Nwnber: GA809960
Dear:
We have been requested to complete Internal Revenue Service (IRS) Form 712 with regard to the
referenced contract.
The purpose of Form 712 is to provide an estate or donor with the value ofa life insurance contract or
with its proceeds as of certain date (usually the owner's date of death or date of transfer of the contract).
The contract referenced was an annuity contract, which is not reportable on IRS form 712.
The following information is provided regarding the value of the annuity and other data as ofthe date
specified:
Date of Death: November 20, 2002
Annuity Value* as of Date of Death: $31,008.59
Cost Basis: $25,000.00
Named Beneficiary: Kathy Smith Hoffman
*The actual amount paid may differ due to Market Value Adjustments and/or any applicable Surrender
Charges.
lfyou have any questions, or need further assistance, please contact us at 1-877-499-6418.
Sincerely,
*
Life and Annuity Claims
Overnight Address: 300 North Milwaukee Avenue, Vernon Hills, lL 60061
Toll Free Fax: 1-866-635-4523
Glenhrook Life and Annuity Company
Po. Box 94212
Palatine, IL 60094-4212
GLENBROOK LIFE
A Member of Allstate Financial Group
January 30, 2003
Kathy Hoffman
390 ldaville York Springs Road
Gardners, PA 17324
Re: Donald M Smith
Contract Number: GA0596115
Dear:
We have been requested to complete Internal Revenue Service (IRS) Form 712 with regard to the
referenced contract.
The purpose of Form 712 is to provide an estate or donor with the value ofa life insurance contract or
with its proceeds as of certain date (usually the owner's date of death or date of transfer of the contract).
The contract referenced was an annuity contract, which is not reportable on IRS form 712.
The following information is provided regarding the value of the annuity and other data as of the date
specified:
Date of Death: November 20, 2002
Annuity Value* as of Date of Death: $17,296.69
"The actual amount paid may differ due to Market Value Adjustments and/or any applicable Surrender
Charges.
If you have any questions, or need further assistance, please contact us at 1-877-499-6418.
Sincerely,
Life and Annuity Claims
Overnight Address: 300 North Milwaukee Avenue, Vernon Hills, IL 60061
Toll Free Fax: 1-866-635-4523
o PNCBAN<
January 16, 2003
Kathy Hoffman
105 Mooreland Ave
Mount Holly Spring, PA 17065
scp
RE: Estate of Donald M Smith (Deceased)
SSN: 201-18-7249
DOD: 11-20-2002
Dear Ms Hoffman:
In response to your request for Date of Death balances for the customer noted above, our
records show the following:
Checking Account
Account#5140191657 Established 11-01-1994
DONALD M SMITH
DOD balance: $9,323.99 + $1.08 accrued interest
IRA Accounts
Account #6500101608 Established 04-03-1994
DONALD M SMITH
DOD balance: $413.74 + $.069 accrued interest
For Beneficiary or IRA information please call1-888-PNC-IRAS.
Please note that this office only provides date of death balances for deposit accounts
(IRAs, CDs, Checking and Savings accounts). We do not process any financial
transactions or provide statements. If you need assistance with any of these items, please
call 1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch office.
S4c~rely, j/
lYtt1'-1Z ,[~I,/()
Helen A Cozad
PNC Decedent Re rting
Firstside Center
500 First Ave, 4" FI CIF
Pittsburgh PA 15219-3128
1-800-762-1775
Member FDIC
McLAUGHLIN, PIVEN, VOGEL SECURITIES INC.
30 WALL STREET. NEW YORK. NY. 10005 . [212) 248-0750 . [800) 221-4947 . Fax [212) 363-8578
www.mpvsec.com
Re: Account 66320415
Donald Smith
Kathy Smith Hoffman, JTWROS
SSN# 200-36-1604
To whom it may concern:
On November 20,2002, the date of Mr. Donald Smith's death his account value was the
following
2,750 shares of Federated Strategic Income Class B shares: $20,680
684 Units of the Symphony High Yield Trust: 3,098.65
Total Account Value on date of Death: $23,778.65
The information contained herein is obtained from soW'Ces considered reliable, but the accuracy thereof, is not intended to, and should not be relied upon as a solicitation to
purchase any securities referred to nerem. McLaughlin. Piv~, Vogel Securities Inc. andforits individual officers andlordirectors and/or security holders and/or employees andlor
members of their families, may have a position in the securities mentioned and may make purchases andlor sales of their securities from time to time in the open market or
otherwise. All securldes including stocks. bonds, CMO's, mutual funds and unit investment trusts aresubjectto price change due to market eondltioDs. This means that
the securities could be worth the same, more, or Jess than the value at the time of purchase tfthe security is sold prior to maturity. Securlties are Dot F.D.I.C. inJured.
Past performance is DO indication of future results. Neitherthe information, nor any opinion expressed, constitutes a solicitation of the purchase or sale of any securities.
Please re.d the above carefully.
'* DBS PaineWebber
UBS Paine Webber Inc.
54 State Street
Suite 1000
Albany, NY 12207~2501
518434 5770
518 4451600 fax
800 255 3400
ubspainewebber.com
January 23, 2003
Mrs, Kathy Smith Hoffinan
390 Idaville York Springs Rd.
Gardners, P A ] 7324
Re: Date of death values
Dear Mrs. Hoffinan,
As per your request, the following are the values of the mutual funds held in your account
US3] 494 as of ] 1/2012002:
Fund Name # of shares Price per share Value
Eaton Vance Tax Mngd Growth C 2,974.90] ]5.960 $47,479.42
Evergreen Penn. Muni Bond C 461.265 ] 1.460 $5,286.10
Evergreen Tax Strategic C 1,823.327 13.760 $25,088.98
FT - Franklin Growth C 2,181.473 23.90 $52,137.20
FT - Franklin PAT IF Inc. C ]8,249.8]8 10.460 $]90,893.09
]NG Principal Protec. IV B 2,504,563 9.960 $24,945.45
Oppenheimer Penn Muni A 6.246 ] 1.6]0 $72.52
If you have any questions please feel free to contact Ted Wood or myself at (800) 255-
3400 or (518) 445-]630.
'-Since 'e1y,
The infonnation contained herein has been assembled for your assistance and convenience. It is believed to be reliable, however, its
accuracy cannot be guaranteed. All prices and yields shown are subject to change without notice.
JPMorgan Chase Bank
Unit Investment Trust
PO 80x 660083
Dallas. TX 75266-0083
~...
...., JPMorganChase
April I 0, 2003
KATHY SMITH HOFFMAN
390 IDA VILLE YORK-SPRINGS RD
GARDERNERS PA 17324
Re: Fund Prices
R!NfO: DONALD M SMITH & KATHY SMITH HOFFMAN IT TEN
Dear Ms. Hoffman:
Thank you for the recent inquiry regarding the account referenced above. We appreciate
the opportunity to be of assistance.
The following list represents the value-per-unit as of November 20, 02:
Fund Name
IS- 224-M
Units f Shares
5
~
$974.93000
Accrued Interest
$10.19000
Total Value
$4,925.60
Prices are furnished by the evaluator and are subject to change depending on market
conditions.
If you have any further questions or need additional assistance, please call our customer
service representatives at (800) 428-8890. We are available to help you Monday through
Friday from 9:00 A.M. to 6:00 P.M., Eastern Time.
Sincerely,
NOLA DEAN
Customer Service Representative
200304100356
MemberslSl
FEDERAL CREDIT UNION
INSURANCE DEPARTMENT
5000 Louise Drive
P. O. Box 40
Mechanicsburg, PA 17055
1-800-283-2328 or (717) 697-1161
REGULAR SAVINGS ACCOUNT:
Account Number/Suffix
Date Account Opened
Principal Balance at Date of Death
Accrued Interest to Date of Death
Total Principal and Accrued Interest
Name of Joint Owner
Date Joint Ownership Created
50011 -00
10/01/1974
$12,880.03
$11.67
$12,891.70
Kathy S. Hoffman
08/10/1992
~BERS 1 ST E
ALJ~4U
Denise A. Anders
Insurance Products Supervisor
REDIT UNION
January 23. 2003
Estate of: DONALD M. SMITH.
Date of Death: 11/20/2002
Social Security Number: 201-18-7249
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Inventory Report
Active Inventory
Bonds'
Print Date: 02115/2003
File Priclr:tsti:)ate..:.-..11/2QQ2
-Tillext Interesrrinal Maturity fr
~-~~~~;~I~~~m~]:~~;-
Issue -
No. Series Denom Serial Number Date Price Interest Value Rate Yield
39 EE $1,000 M79719320EE 08/2002 $500,00 $0,00 $500,00 3,96% 0,00'
40 EE 1,000 M79719319EE 08/2002 500,00 0,00 500,00 3,96% 0,00'
Totals:
:~;~~lnte~i~6"-0~~~-=~~~~_~~~~J
. CI- bond was Cashed In . EX - bond was EXchanged for an HH bond . ME - bond is Matured and Exchangeable for an HH bond
. MN - bond is Matured and Not exchangeable for an HH bond . NE - bond is Not yet Eligible for payment (it's < 6 months old) . NI - bond has Not yet beeh Issued
. P5 - bond is a Series I or EE, was issued in or after May 1997 and includes a 3-month-interest Penalty until the bond is 5 years old
. * bond is a Series I or EE, was issued in or after January 1990 and may be tax exempt if used for post-secondary education
. () bond was Cashed in or EXchanged for an HH bond, but is being priced on a date prior to the cashed or exchanged date
A:ISavings BondslSavings Bonds-DMS,sbw Page 2 of 2
~O~- s COMMONWEALTH OF PENNSYLVANIA
ENUE
BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REV
INHERITANCE TAX DIVISION
DEPT. 280681 NOTICE OF INHERITANCE TAX
HARRISBURG, PA 17128-8681
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX REY-1547 E% ~FP t01-03)
DATE 07-28-2003
ESTATE OF SMITH DONALD M
DATE OF DEATH 11-20-2002
FILE NUMBER 21 02-1141
•U~ J~;- ~;, r;~ .;CpUNTY CUMBERLAND
THOMAS E FLOWER ESQ ACN 101
SAIDIS ETAL Amount Remitted
2109 MARKET ST ~;
CAMP HILL PA 17011',~~ ~ ~;
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT H OUSE
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 ASSESSMENT OF TAX
ESTATE OF SMITH DONALD M FILE N0. 21 02-1141 ACN 101 DATE 07-28-2003
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
00
500
151
NOTE: To insure proper
.
,
1. Real Estate (Schedule A) (1)
00 credit to your account,
2. Stocks and Bonds (Schedule B) (2) .
00 submit the upper portion
Closely Held Stock/Partnership Interest (Schedule C) [3) .
3
.
Mortgages/Notes Receivable (Schedule D) (4) .00
4 of this form with your
.
Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 93,7 78.31
5 tax payment.
.
6. Jointly Owned Property (Schedule F) (6) 193,749.36
7. Transfers (Schedule G) (7) 17,096.00
123.67
456
($)
8. Total Assets ,
APPROVED DEDUCTIONS AND EXEMPTIONS: 5,223.87
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9)
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 187.78
65
(11) 5.411.
11. Total Deductions 450,712.02
12. Net Value of Tax Return (12) .00
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) 45 0,712.02
14. Net Value of Estate Subject to Tax (14)
NOTE: if an assessment was issued previously, lines 14, 15 andior 16, 17,
sed to da 18 and 19 will
te
.
reflect figures that include the total of ALL returns asses
ASSESSMENT OF TAX: .00 X 00 = .00
15. (15)
Amount of Line 14 at Spousal rate
045 =
02
712
450
20,282.04
16. Amount of Line 14 taxable at Lineal/Class A rate (16) .
,
X 00
(17) .00 X 12 = .
17. Amount of Line 14 at Sibling rate
15
(18)
t
B .00 X
=
18 e
ra
Amount of Line 14 taxable at Collateral/Class
. _
(19) 20,282.04
19. Principal Tax Due
TAX GREDiI~' +
AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
02-19-2003 CD002196 947.37
00 18,000.00
334.70
1
06-16-2003 CD002689 . ,
TOTAL TAX CREDIT 20,282.07
BALANCE OF TAX DUE .03CR
INTEREST AND PEN. .00
TOTAL DUE .03CR
* IF PAID AFTER DATE INDICATED, SEE REVERSE [ IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED.
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND.. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
RESERVATION: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or far years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class 8 (collateral) rate on any such future interest.
PURPOSE OF
NOTICE: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S.
Section 9140).
PAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side.
--Make check or money order payable to: REGISTER OF WILLS, AGENT
REFUND fCR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an ^Application
for Refund of Pennsylvania Inheritance and Estate Tax^ (REV-1313). Applications are available at the Office
of the Register of Wills, any of the 23 Revenue District Offices, or by calling the special 24-hour
answering service for farms ordering: 1-800-362-2050; services for taxpayers with special hearing and / or
speaking needs: 1-800-447-3020 (TT only).
OBJECTIONS: Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
ADMIN-
ISTRATIVE
CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. See page 5 of the booklet ^Instructions for Inheritance Tax Return for a Resident
Decedent^ (REV-15017 for an explanation of administratively correctable errors.
DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5%) discount of
the tax paid is allowed.
PENALTY: The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of
six (6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2003 are:
Interest Daily Interest Daily Interest Daily
Year Rata Factor Year Rate Factor Year Rate Factor
1982 20% .000548 1987 9% .000247 1999 7% .000192
1983 16% .000438 1988-1991 11% .000301 2000 8% .000219
1984 11% .000301 1992 9% .000247 2001 9% .000247
1985 13% .000356 1993-1994 7% .000192 2002 6% .000164
1986 10% .000274 1995-1998 9% .000247 2003 5% .000137
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen C15) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.
~a-5
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Donald M. Smith
Date of Death: November 20, 2002
Will No.: 21-02-1141
Admin. No.: 2002-01141
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 X ; 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 X
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 X ; No
d. Copies of receipts, releases, joinders and approvals of formal or informal
accounts maybe filed with the Clerk of the Orphans' Court and maybe attached to this report.
Date: ~ ' ~ 1~
Signature
Name: Thomas E. Flower, Esquire
LD. No. 83993
SAIDIS, SNUFF, FLOWER & LINDSAY
2109 Market Street
~~_ Camp Hill, PA 17011
(717) 737-3405
Capacity: Personal Representative
X Counsel for Personal Representative