HomeMy WebLinkAbout01-0074
REV.1500 EX + (8-00)
/b -~- t6.-'
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT,280601
HARRISBURG, PA 17128.0001
(LAST, FIRST, AND MiDDlE INITIAL)
I-
Z
W
C
W
o
W
C
KIRK MARK E,
DATE Of DEATH (MM-OO-VearJ
DATE OF BIRTH (MM-DOVearJ
01/03/2001 07/0211965
(IF APPUCABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDlE INITIAL)
I!!
,,~Ul
u"'''
w~g
:r"'....
u....
~
[Xl 1. Ol9inal Return
o 4,LimiledEstate
o B, lJecedent Died Testate __..,oIWI!
o 9, Litigation Proceeds Received
o 2, Supplemental Return
o 4a.FuturelnterestCompromise(datloldultl.12.-12-82) .
o 7, Decedent Maintained a Living TlUst ___ oITMl)
o 10,SpousaIPovertyCredttC'..oI__l2,,,,,'''''-'-95j
OFFICIAl USE ONLy
FilE HUMBER
21-010074
CCltINIYOOlir -_ - - _--
SOCIAL SECURITY NUMBER
168-54-6814
TIllS RElURH II\lSl BE FUD IlIlUP\JCt.lE WITM TIlE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 3. Remainder Retum l_oldealhprior~12.1H2)
o 5, federal Estate Tax Return Required
Q.. 8, TolalNumberofSafeDepo5ttBoxes
o 11. Election to tax underSec, 9113(A)__Sd>01
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLET MAILING ADDRESS
Scott W. Morrison Es PO Box 232
FIRM NAME (~I\W;cab.j
..
z
w
Q
Z
o
..
Ul
W
'"
'"
o
u
New Bloomfield. PA 17068
TELEPHONE NUMBER
717 582-2306
z
o
;:::
:5
::;)
l-
ii:
c(
o
W
II::
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
1, Real Estate (SoIledule A)
2, Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership:or Sole-Proprietorship
4, Mortgages & Notes Receivable (SoIledule D)
5. Cash, Bank Depostts & Miscellaneous Personal Property
(Schedule E) .
6, Jointly o..ned Property (Boheduie F)
o Separate Billing Requested
7. Inter-VIVos Transfers & Miscellaneous Non-Probate Property
(SoIleduie G or L)
8, Total Gross Assets (total Lines 1.7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10, Debts of Decedent, Mortgage Liabilroes, & Liens (Schedule I)
11. Total DeductloM (lotalLines 9 & 10)
12, Net Value of Estate (Line B minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Velue Sublect to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
z
o
S
::;)
Q.
:E
o
o
~
15. Amount of Line 14 taxable at the spousal tax
rate, or lransfe" under Sec. 9116(aXl.2)
X _(15)
23.884.62 X .045 (16)
X ,12 (17)
X ,15 (18)
(19)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20, 0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYi,lEriT
> > BE SURE TO ANSWER ALL QUESTIO' ONEVERSE SIDE AND RECHECK MATH < <
OFFICIAL USE ONLY
37.028.69
L________~__ --
37,028.69
6,363.00
6.781.07
(n)
(12)
(13)
13,144.07
23.884,62
(14)
23,884,62
1.074,81
1,074,81
Decedent's ComDlete Address:
STREET AIlIlRESS
121 Rolo Court
CITY I STATE 1 ZIP
Mechanicsbura PA 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Une 19)
2. CreditslPayments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1}
1,074.81
Total Credits (A +8 +C) (2)
3. InterestlPenalty if applicable
D. Interest
E.Penalty
T otallnterestlPenalty ( 0 + E ) (3)
4. ~ Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to requelt a refund (4)
5. If Une 1 + Line 3 is greater than Line 2, enterthe difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (SA)
8. Enter the tolal of Line 5 + SA. This is the BALANCE DUE. (58)
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; ........................................................................... 0 00
b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 00
c. retain a reversionary interest; or ...................................................................................................... 0 00
d. receive the promise for I~e of either payments, benefits oreare? ............................................................. 0 00
2. ~ death occurred.flfter December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?............... ............................................................................... 0 00
3. Did decedent own an 'in trust fo~ or payabie upon death bank account or security at his or her death? ................. 0 00
4. Did decedent own an Individual Retirement Acoount, annuity, or other non-probate property which
contains a beneficiary designation? ................. ............................ ..................................................... ..... 0 00
1,074.81
1,074.81
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
:5~rM.o(0
ADDRESS
3(}- Ne~'D~&
70 b &"
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate Imposed on the net vaiue of transfers to or for the use of the surviving spouse is 3%
[72 P.S. ~9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net vaiue 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 exemol a transfer to a surviving spouse from tax, and the statutory requirements tor disclosure of assets and fiiing a tax retum 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-llne 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)].
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)(1)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. ~gl16(a)(1.3)J. 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.
",,'\OJIEX"'~ '*
COMMONWEAlTH OF PENNSYLVANIA
INItERITANCC TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
KIRK. MARK E.
FILE NUMBER
21 01
0074
Include the proceeds of fl1igalion end the date the proceeds were received by \he estlte. AH property jolnlly-owned wIlh the right ohurvlvo..hlp must be dllcloud on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
Members 1st Federal Credit Union-savings account #175011-00
VALUEA T DATE
OF DEATH
1,966.92
2.
Members 1st Federal Credit Union-savings account #175011-05
18,955.81
3.
Members 1st Federal Credit Union-checking account #175011-11
812.33
4.
Final paychecks-Intelistaf Health ServiceslLeupoldstadt, Inc
68D.63
5.
1984 Titan Mobile Home--sold to John E. Shipe on 05110101
10,500.00
6.
1995 Geo Prizm automobile--soJd to Sherri Shiffer
3,800.00
7.
FederaVState Income Tax Refunds
313.00
.
TOTAL (Also enteron line 5, Recapitulation) $
(If more space is needed, insert ad<lilional sheets of the same size)
37 028.69
""''''''''01,''',.
~THOFPENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT oeCEIlEMT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE Of
KIRK MARK E
FILE NUMBER
21 01
0074
Deb.. of dKedent must be ..ported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A, FUNERAL EXPENSES:
1, Ronald C.L Smith Funeral Home 4,793,00
.
"
B. ADMINISTRATIVE COSTS:
1- Personal Representative's Commissions
Name of Personal Represenlalive (s)
Social Security Number(s) I EIN Number of Personal Representalive(s)
Street Address
City Slate Zip
Yea~s) Comm~ion Paid:
2, Altome, Fees Scott W. Morrison 1,480.00
.
3. Faml~ Exemption: (If decedents address Is not the same as claimants, attach explanation)
Claimant
Street AddnlSS
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees Mary C. Lewis, Register of Wills 90.00
5. Accountanfs Fees
6, Tax Return Preparer's Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $ 6363.00
..
(If more space IS needed, Insert additIOnal sheets of the same size)
REV.""",....n' '*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RfT\lRN
RESIDENT oeceoeNT
ESTATE OF
KIRK. MARK E
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
FILE NUMBER
21 01
0074
Include unrelmburHd medical expenses.
ITEM
NUMBER
DESCRIPTION
1.
Members 1st Federal Credit Union--Loan Account #175011-01
2.
Rent payments to Rolo Mobile Home Court
3.
Sentinel-estate advertising
4.
PP&L-electric bill
5.
Cumberland County Law Journal--estate advertising
6.
Capital Area Tax Collection Bureau--Iocal income tax
7.
Sentinel--advertisements for sale of mobile home
.
8.
Rice Memorial Works-Gravestone
9.
Real Estate Taxes--Marlin Yohn, tax collector
10.
Inspection/repairs for Geo Prizm
11.
Progressive-car insurance
12.
Verizon-phone bill
13.
Comcast-cable bill
14.
EKG Associates-medical account
15.
CCS Financial Systems-ambulance and emergency room visit
AMOUNT
2,411.01
1,080.00
97.07
139.50
75.00
7.32
55.30
2,012.00
25.83
55.72
68.88
67.97
39.60
35.00
610.87
TOTAL (Also enter on line 10, Recapitulation) S
(If more space is needed, insert additional sheets of the same size)
6781.07
REV.'513EX+(*
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
KIRK MARK F
SCHEDULE J
BENEFICIARIES
NUMBER
I.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS pnclude outright spousal d~bibutions. and llansfe". under
Sec. 9116 (aJ (1.2))
James L. Kirk, Sr
71 Rambo Hill Road
Shermans Dale, PA 17090
Linda L. Kirk
71 Rambo Hill Road
Shermans Dale, PA 17090
1.
2.
.
FILE NUMBER
21 01
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
0074
AMOUNT DR SHARE
OF ESTATE
1/2
1/2
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18. AS APPROPRIATE, ON REV-l500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-l500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
..
COMMOJrfMW.. TN OF PENNSYlVANIA
DEPAA1MENT OF PUBUC N!:LFARE
BUREAU OF FINANCIAl. OPERATIONS
ESTATE RECOVERY PROGRAM
PO BOX 8488
HARRISBURG, PA 17105-8486
February 09, 2001
SCOTT W MORRISON ESQUIRE
CENTER SQUARE
POBOX 232
NEW BLOOMFIELD PA 17068
Re: MARK KIRK
SSN: 168-54-6814
Dear Attorney Morrison:
Pursuant to your letter dated January 22, 2001, the Department of Public
Welfare (DPW), Estate Recovery Program, has reviewed the information you
provided regarding the above-referenced individual.
It has been determined that DPW will only pursue the recovery of PROBATE
ESTATE claims when the individual was fifty-five years of age or older at the
time that assistance was received.
Therefore, according to the information you provided, the Department's
Estate Recovery P~ograrn will not seek any recovery from this estate.
If you have any questions, please feel free to contact me.
.
Sincerely,
~ ',\&Q
Ronald D. Hill, Manager
TPL - Casualty Unit
(717) 772-6604
(717)772-6553 FAX
PETITION FOR GRANT OF LETTERS
Estate of Mark E. Kirk
No.
21-01-74
also known as
, Deceased
Social Security No. 168-54-6814
Petitioner(s), who isfare 18 years of age or older, apply)ies) for:
(COMPLETE "A" OR liB" BELOW:)
o
A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut
Decedent, dated and codicil(s) dates
named in the Last Will of the
State relevant circumstances, e.g., renunciation, death of executor, etc
Except as follows, Decedent did not marry, was not divorced and did not have a child born or adopted after execution of the documents offered
for probate; was not the victim of a killing and was never adjudicated incapacitated:
GJ
B. Grant of Letters of Administration
(c.t.a., d.b.n.c.t.a.: pendente lite, durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse
(if any) and heirs:
I Name Relationship Residence I
Linda L. Kirk mother 71 Rambo Hill Road, Shermans Dale, P A
James L. Kirk, Sr. father 71 Rambo Hill Road, Shermans Dale, PA
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in ~umberland. CO~f)ty, Pennsywania, with his/her last family or principal
residence at 121 Rolo Court, Mechanlcsburg, PA 17055 KP p~ ~ -rW fJ .
(list street, number and municipality)
Decedent, then 35 years of age, died' Jan. 3 ~, at Ridge Road - Cumberland County
(Location)
Decedent at death owned property with estimated values as follows:
(if domiciled in PA All personal property......................................... $ 33,000.00
(if not domiciled in PA Personal property in Pennsylvania .................... $
(if not domiciled in PA Personal property in County .............................. $
Value of real estate in Pennsylvania ........................................................................................ $
Total ...... ................................................... ................. ..................... ...................... $ 33,000.00
Real Estate situated as follows:
Wherefor, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in
the appropriate form to the undersigned:
Signature
Typed or printed name and residence
Linda L. Kirk of 71 Rambo Hill Road, Shermans Dale, P A 17090
James L. Kirk, Sr. of71 Rambo Hill Road, Shermans Dale, PA
17090
RW-1
/h -c203 -~
Oath of Personal Representative
Commonwealth of Pennsylvania
County of
The Petitioner(s) above-named swear(s) and 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 representative( s) of the
Decedent, Petitioner(s) will well and truly administer t estate accord~ng to law~),{ 0
Sworn to and affirmed and subscribed ~ LJ2,IJ- X /; 'j/ vl.-.f}t/l.
;t?:l.c:h~ ;t 5t:;;/
before me this 17th day of
JANUARY ~:g 2001
'z;;J2uy(Jr(4Rf/2H/J-I2~ / l~u~
Estate of Mark E. Kirk
DECREE OF REGISTER
Deceased
No. 21-01-74
also known as
Social Security No: 168-54-6814 Date of Death: 1/3/2001
AND NOW, JANUARY 17 ~ , in consideration of the Petition on the
r~verse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters 0 Testamentary lID of Administration
are hereby granted to Linda L. Kirk and James L. Kirk, Sr.
((c.t.a., d.b.n.c.t.; pendente lite; durante absentia; durante minoriate)
in the above estate and that the instrument(s), if any, dated
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters................................... .
Short Certificates(s) ...............
Renunciation ..........................
Extra Pages (
) ...............
I.T.R. ......................................
JCP Fee .................................
Inventory .,. .... ......... ................
Other ......................................
TOTAL .... ................. ........$
$
70.00
I . \
0/-///1' e ~<C-f/&b!;l(jj:~//'l
' . Reg(ster of Ills
~ ."-
$
$
$
$
$
$
$
$
15.00
5.00
Attorney: Scott W. Morrison, Esquire
1.0. No: 83943
Address: P.O. Box 232
New Bloomfield
PA 17068
90.00
Telephone: 717 582-2300
DATE FILED:
WARNING: IT IS IllEGAL TO ALTER THIS COpy OR
TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF HEALTH VITAL RECORDS
LOCAL REGISTRAR'S CERTIFICATION OF DEAlt
CERT. NO. T 4 7 3 2 316
~_ (;; i',--ii;i;71/-1:~ 7.~; :,--,~
/l~tl~ t.~ '\ \\ . Of p c i;'~)..
.'11' _ ~ \.t'//. ---/:/f l' ~'\
;;,\ ~....' ,/ '" ~" --::~
'~~/ ~~\<;;.\
d ~ ~:oi . \~\,
", . ..', [>' i'.' ':t:a. :::1
\~."; .~. ~.;';;"c._,> ;*pl
,-::. ~. ..(:);:..",
\'\.1t '. .... ...~'\\'
'~~:,;./!,h'iE-" (\\ ~'iii\':?'
-.<r,/" N I \l /IIII!--/
~~!.!t.!!.!:.':~.!.f.!!.!--/ ~,
1-;;,S-61
Date of Issue of ThiS Certification
Date of BIrth
fL1!1f21!l___..._____ ..~ ~ ____ _._~____!.1!.f?_/~____ --
\A't1dip
Sccla! Security No,_L_&__~ - 5"4 - It-liL-------- Date of Death __.l~}_~_:._QJ__.,__.___________
tJ -~_- Lo...6'____ _ BirthPlace____C ftR-ll SL.~ _____________~__...___._______________________,..______'_..----
~I QC-, 1 j2.~.-.----- tu Iv1 h f.eL,ArJ J1-------.h1 ~,tM'iu J_ __.E.enn~l'i\l.aI1la
_ >, :'1) ~<.1'1I' {...AJU!'IV' ~!j.'v' DO(Cl:ij!: T,_'....'TISt~'p
Race 10 I-\I[ t. . Occupation C't t I"~l ~ D \J'JiVVl /J (,,~l'__ Armed Forces? (Yes -: No) .- -- --.- -.-- -..-----
II Decedent's () C . ,r 11 J -0
Mantal Status ~~~~_~f!..\Q--- Mailing Address __I;) I~~_~ ~1..L~__ IVfrcU8_!J'(~f~tl~L-L_~__l_'Jo6.? _________h___
NUi':,hl:::'f ~)trf:'~\ I..-,.j.\, .:-' fc~_-\r) '~I~'itc-~'
Informan1 ..:\A-M ~L4~_~7.11~r>flrJ.:t~- Funeral Director ~y..tM-f) ~-~~----._~ ..--.-
~~:~afrk~t;~~~~~~e~'tt't_....~~ ~lll{tC->!LSt_.. .~ (&tJ NON .J.._f.~_.....-i-;~;er~!~~et;~~- ..-
Pan I: Irnmt"'-:dktle C;aus,=; Onset and Death
la) _ ._Q ~ P2t.~.BajJil1.,~_f~S6 ~.0l~__----~ .--.----~---.---...--..- .
Name of Oecedt.:nt
Sex _________rYL.._
Place of Death
(b';
_~_.___. .__~______.____.~___._..._.___~___~.___"__________~_________________..,_.___~_t""~-~------------.-.-.--.-.----- _,,__u_________.____'._
Ie)
___~__________---1-_____._ - ....-.------ ----. -- .--
Part II:
( d) ._._____._____.___._____________________.___..________.______________________._-----,-____________.___.__.n_____________
Other Significant ConditIons
._._ .____.....__.____._____..___________._______________._________.1-...._.....____ ----.., ..---..---..---.--.-
Natural Hom!cicie
Describe how injury occurred:
--'I:JbhM..h --' rlJ-tJtt It V'-- ft~f&J/tMt-
Manner of D(lath
Accident
Pending Investigation
------------_.~-_._-----_._----~.__._.__._-----------------,-------~._---.._-_._-,--
Suicide
,--/
Could not be Detern1ined
Name and lltle of Certficr ______..._________,_1\~_~~1 ~-!:-- L.. Nf) ([Jt.d~______~__..___________________._________________
~ ~ 1 C; (2~_'t~Q~~<<-.k- .~]~L fl--t ~ tu IHA{~j;>ul~ftt _'1 O?~~M .D~_D~~_.,_~==er~~~~
Address
ThiS is to certify that the Information here given is correctly copied from an original certificate
of death duly filed with me as Local Registrar. The original certificate will be forwarded to the
State Vital Rec(,(d~ Office for permanent filing. n ~-{)~~jrut:J--$o.d..~!:- _
~rl tiel 0' 'Itl! He-., j~ let "Jc
J -- ~ --'0 I (1jJ, UA.-4___________.
-;i;-'~~-'7;~'~, :0;----.~G'rr;.~-~--
(>tv
~
----
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Mark E. Kirk
Date of Death: January 3,2001
Will No.
Admin No. 2001-00074
To the Register:
I certify that notice of 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
November I, 2000:
Name
Address
Administrators are sole beneficiaries.
Notice has now been given to all persons entitled thereto under
Rule5.6(a)except
Date: January 23,2001
~~.~~,
Signature
Name Scott W. Morrison, Esquire
Address Center Square
New Bloomfield, PAl 7068
Telephone (717)582-2300
Capacity_Personal Representative
X Counsel for personal
Representative
~"--
E
_:::::-
AMENDED CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Mark E. Kirk
Date of Death: January 3" 2001
Will No.
Admin No. 2001-00074
To the Register:
I certify that notice of 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 ahove-captioned estate on
January 23" 2001
Name
Address
Administrators are sole beneficiaries.
Notice has now been given to all persons entitled thereto under
RuleS .6( a )except
Date: January 26" 2001
~tAJ4J tt~vV-~
Signature
Name Scott W. Morrison" Esquire
Address Center Square
New Bloomfield" FA 17068
Telephone (717)582-2300
Capacity_Personal Representative
X Coun~~l..for personal
Represenfative ::::.:
<j'J!
c
STATUS REPORT UNDER RULE 6.12
BEFORE THE REGISTER OF WillS, COUNTY OF CUMBERLAND , PENNSYLVANIA
Name of Decedent: Mark E-,-Kirk_ ____ --~-~-----------------------~ -~- -------------
Date of Death:
01/03/2001
File No.
2001-00074: PA NO.21-01-0074
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect
to the 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 "Noll, state when the personal representative reasonably believes that the
administration will be complete: ---- ------- ------------------
3 If the answer to No.1 is "Yes", state the following:
a. Did the personal representative file a final account with the Court?
YES ___ NO_~
b. The separate Orphan's Court No. (if any) for the personal representative's account is:
c. Did the personal representative state an account informally to the parties in interest?
YES~ NO__
d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may
be filed with the Clerk of the Orphans' Court and may be attached to this report.
0'\
R
,,; "~ "....';
.;.) C'
1U0:
a:
~
",';
;::-g
~~~ 5
Uw
*~Jt,~ ~ ~-.
Signature
Scott W. Morrison ____ ____________~_
Name (Please type or print)
p_O Box 23~___
Address
i~
Date: 01/07/2002'
~
co
I
I.:.'
Z
.::::t::
J
t~te_~~IQQmneJg_ _
__P8_J 706_L___
(717) 582-2300
Tel. No.
Capacity: _____ Personal Representative
__L Counsel for personal representative
/6-~-0-
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG1 PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
SCOTT W MORRISON ESQ
PO BOX 232
NEW BLOOMFIELD PA 17068
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
09-11-2001
KIRK
01-03-2001
21 01-0074
CUMBERLAND
101
REY-1647 EX AFP el2-00)
MARK
E
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REY=is4,-ix--AFP-ci2"':ool--N(ffiCi--oF-YNHEifiTANCE-YAX-APPRAISEi'-ENT~--At.l-oWANCE-oii-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF KIRK MARK E FILE NO. 21 01-0074 ACN 101 DATE 09-11-2001
TAX RETURN WAS: (X) ACCEPTED AS FILED
) CHANGED
NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 1&, 17, 18 and 19 will
re~lect ~igures that include the total o~ ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
17. Amount of Line 14 at Sibling rate (17)
18. Amount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CREDITS:
.00 X 00 = .00
23,884.62 X 045 = 1,074.81
.00 X 12 = .00
.00 X 15 = .00
(19)= 1,074.81
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. ~ointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
(1)
(2)
(3)
(4)
(5)
(6)
(])
.00
.00
.00
.00
37,028.69
.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
(10)
6,363.00
6.781.07
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
37,028.69
(11)
(12)
(13)
(14)
13.144 07
23,884.62
.00
23,884.62
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
07-23-2001 CDOOO074 .00 1,074.81
TOTAL TAX CREDIT 1,074.81
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
~ IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, 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.)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX( 11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
MORRISON SCOTT W ESQ
POBOX 232
NEW BLOOMFIELD, PA 17068
_u_____ fold
ESTATE INFORMATION: SSN: 1 68-54-6814
FILE NUMBER: 21-2001- 0074
DECEDENT NAME: KIRK MARK E
DATE OF PAYMENT: 07/23/2001
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 01/03/2001
NO. CD 000074
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $1,074.81
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$1,074.81
REMARKS: SCOTT W MORRISON ESQUIRE
CHECK# 3
SEAL
INITIALS: AC
RECEIVED BY:
REGISTER OF WILLS
MARY C. LEWIS
REGISTER OF WILLS
/__----------- _____-~-C--------c===-
",. ,-~ . ---.....
" ,/\ . ~""
Wi
~,..
~~~.., ~
.. ,
.t ...,' '-....,
~ ,~)~/<I)
-j'~
<5 if)
919
:'-*
)~
~O
,t'l
r:"'~
~'.. \
,
, i
j
J
---------- -
t::x4
U1
P
o
t:O
~
p
o
u
~_::>
("I")
~U1~
8HO
';ZHr-
pH~
0';3:
U
~~
pOP-\
~(:t.~
t;jt::x4H
~8U1
t::x4 vI) H
c:QHH
~~~
P ~. ~
U~U
r r--.
(-) ~
~.. t~
~ \"
~\ ~
~r
\ \'~