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HomeMy WebLinkAbout01-0100 ~,~ ~7 - I . / REV-1500EX(6<JO; i (0 ~ ~ C 4- - 1+ REV-1500 .' COMMONWEALTH OF PENNSYLVANIA . . DEPARTMENT OF REVENUE DEPT 280601 HARRISBURG, PA 17128-0601 w "' ::.:;::!:(I) u"'''' w"u ",00 u"'-' ..'" .. " INHERITANCE TAX RETURN RESIDENT DECEDENT I- Z W o W U W o DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) McLEOD, RICHARD A DATE OF DEATH (MM.DD.YEAR) 11/22/00 I DATE OF BIRTH (MM-DD.YEAR) I 08/05/36 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) ~ I.Origina\Re\\lTn o 4. LimiledEslate o 6. Decedent Died Testate (Allach copy of Will) o g. Litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (date of death after 12-12-82] o 7. DecedenlMaintained a Living Trus!(Altacl1oopyofTrusl) o 10. Spousal Poverty Credit (date of death belwoon 12-31-91 and H-95) OFFICIAL USE ONLY FILE NUMBER 21 01 0100 COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER f 397~32-0958 .__ _ THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. Remainder Return (dale of death prior to 12-13-82) o 5, Federal Estate Tax Return Required -1.. 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113(A) (Attach Sch 0) "' Z W C Z o .. '" w '" '" o u TillS $i!C1"IO!'IMIlST._eC!!lMpI..ETEIil;"L.LCClFlRESI'OMOI$MC'E' Al!P'COI'II'IPEN:rIAi\..Tt~illW~l'lON . Qlll!"PIRECTI$Oil'l1i, NAME COMPLETE MAILING ADDRESS ROGER M. MORGENTHAL, ESQUIRE 2450 E. BAYBERRY DRIVE FIRM NAME (IfAppli~b"l HARRISBURG, PA 17112-6015 TELEPHONE NUMBER (717) 671-8754 z o ~ ..J ~ l- ii: <l: u w a: 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) o. Jointly Owned Property (Schedule F) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G orL) 8. Total Gross Assets (total Lines 1-7) (I) (2) (3) (4) (5) (6) (7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) (10) '\0. Debts of Decedent, Mortgage liabilities, &. Liens (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 election to tax has not been made (ScheduleJ) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o ~ I-' ~ D. :E o t) >< ~ 15. Amount of line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x .0 16. Amount of Line 14 taxable at lineal rate 5,000.00 x.o 45 43,278.49 x 12 123,375.00 x .15 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at conateral rate 20 113,000.00 OFFICIAL USE ONLY 83,920.26 (8) 14,148.75 11,093.02 (11) {12} (13) 196,920.26 25,241.77 171,678.49 1 ,000.00 (14) 170,678.49 (15) (16) 225.00 (17) 5,193.42 (18) 18,506.25 (19) 23,924.67 > > liE SUItE 1"0 AMSWER ALL QUESl"IONS ON REVERSE SIDE AIIIO REiOHEOl( MA1"f1 <' < Decedent's Complete Address: STREET ADDRESS 1 06 EA~LQBt\NGE STREET CITY SHIPPENSBURG Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount STATE PA ZIP 17257 (1) 23,924.67 24,000.00 750.00 3. InteresWenatty if applicable a.lnterest E. Penalty Total Credits (A + B + C) (2) 24,750.00 TotallnteresUPenalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) A. Enter the interest on the tax due. (5A) 825.33 0.00 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 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; ........................................................... ............................. D [K] b. retain the right to designate who shall use the property transferred or its income; ................... .............. 0 [i] c. retain a reversionary interest; or. ..................................................................................... ......................... ........ D [i] d. receive the promise for life of either payments, benefits or care? .............................. ...................................... 0 [K] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .................................................................................. ............... 0 [i] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ............. D [K] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ..................................................... ................................. ................................ 0 [iJ 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. Declaralionofpreparerotherthanthepersonalrepresenlativeisbased on all informalion of which preparer has any knowledge. SIGNATU~~~:S~N RESPONSIBLE FO'YILlNG RETURN ..,... /' ......L-4- ADDRESS 3952 SOUTH THIRD STREET, MilWAUKEE, WI 53207 SIGN~J~~R~~~RESENTATIVE ADDRJs[ v... 2450 EAST BAYBERRY DRIVE, HARRISBURG, PA 17112-6015 DATE 08/22103 DATE 08/22/02 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 99116 (,) (1.1) (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. ~9116 (a) (1.1) (ii)]. 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 even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 99116(')(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 )]. The lax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 PS. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. 1lLast Ilfill aub QTtstamtul OF RICHARD A. McLEOD I, RICHARD A. McLEOD of 101> East Orange Street. Shippenshurg. Cumherland County, Pennsylvania, declare this instrul11ent to he Illy Last Will and Testament, in manner and form following: FIRST: I herehy expressly revoke all Wills ;Ind Codicils heretofore made hy me. SECOND: I herehy direct my Executrix to pay all my just dehts, funeral and administrative expenses out of my e-'tate, as soon as practicahle after my death. THIRD: I direct that all taxes which may he assessed in consequence of my death of whatever nature and hy whatever jurisdiction imposed shall he paid out of my estate as a part of the administration of my estate. FOURTH: I give and hequeath to Illy friend. CHARLES LOUCKS. the sum of Five Hundr~d ($.'\00.00) Doll;lrs. provided he survivcs my dcath. FIFTH: I give :Ind hcquc:llh 10 1111' fricnd. JOHN I{OGERS. the sum of Five Hundred ($.'\()().OO) Dollars. pwvided he survivc.s Illy ddlh. I I I I I ! I , I I I I I I I c:\Wp.'i] \Wills\McL~"d, KA SIXTH: I give, devise and hequeath to illY dOlllestic p.lrtner, RENEE TANTALA, my residence real estate ;It J()!J East Orange Street, Shippenshurg, Cumherland County, Pennsylvania 17257, together with :111 of its contents. Should RENEE TANTALA fail to survive my death, I direct that my said real estate, and its contents should he sold and the proceeds thereof distributed as a portion of the remainder of illY estate. SEVENTH: I give and hequ~ath to my daughter, Ai\IALlA HESS, the sum of Five Thousand ($5,()()().()()) Dollars, provided she survives my death. Should illY daughter, AMALIA HESS, fail to survive 1m' death. I direct that this SUIll be given to her son, MICHAEL, in Full. EIGHTH: give and bequeath to illY friend and former spouse, NANCY LONGENBACH, the SUIll of Five Thousand ($5,()tlll.llll) Dollars, provided she survives my death. NINTH: r give, devise and hequ~:lth to the SHII'I'ENSBUI~G VNIVERSITI' FOUNDATION/GIFTED MINORITY SCHOLARSHIP FUI'\D. the SUIll of One Thousand ($1,000.00) Dollars. TENTH: I give and hequ~ath to mv st~ps"n. KEITH KOCHERT, the sum "I' One Thousand ($I,()()().()(I) Dollars provided he survives illY death. ELEVENTH: I give and bequeath to LYDIA I'\ABlRYE, daughter of RENEE TANTALA, the slim "I' One TlwlIsand ($I,()()().()()) Dol!:lrs provided she survives my death. 'lWELFTH: I give and bequeath to.IOHANN KISAAi\1E, son of RENEE TANTALA, tlaughter of RENEE TANTALA. the sum of One Tlwusallll ($ I.tlllll.()()) Dollars provided she survives my death. (\ye -"' illlliah c:\wp51 \Will~\McL~oJ.RA THIRTEENTH: I give. devise and bequeath. all the res!. residue and remainder of my estate, real, personal and mixed. whatsoever :tnd wheresoever situate. to my sister, JANET GILES, of Seattle. WashinglOn. Should my siSler. .JAI'IET GILES. fail to survive my death, I then give, devise and bequeath the remainder of my estate 10 my domestic partner, RENEE TANTALA. Should RENEE TANTALA also fail to survive my death, then I give and bequeath the remainder of my estate to her then-living issue in equal shares, share and share alike. FOURTEENTH: I nominate. constitute and appoint the ORRSTOWN BANK, of Shippensburg, Pennsylvania. Tn!slee of the share of any bendiciary who may be a minor. The income and/or principal of said Trust may be accumulated or expended for the maintenance, education and support of such bendiciary as my Trustee in its sole discretion may determine; and my Trustee. in the expenditure of inwme and/or principal for such purposes, may, at its discretion. apply the same direc(/y without the intervention of a guardian or pay the same to any person having the care or wntrol of said beneficiary, or with whom the heneficiary resides. without duty on the part of the Trustee to supervise or inquire into the application of the funds by any person 10 whom any payment is so made. The balance of such income and/or principal shall be paid to such beneficiary upon reaching the age of twenty-two (22) years. or 10 such beneficiary"s estate, in the event of death prior therelo. FIFTEENTH: I nominate. constitute and appoint my domestic partner. RENEE TANTALA, as Executrix of this my Last Will and T eS!ament: but if she should fail to qualify or cease to serve in that c:!pacity. Illominate. constitute ami :'ppoint as substitute Executors, :; It ;YI( iniliaJ\ c:\wp51 \Wilb\r.kLt"OlI, RA In order of preference. first. my friend. JOHN ROGERS. of Newville. Pennsylvania. and second, ORRSTOWN BANK, of Shippenshurg. Pennsylvania. SIXTEENTH: I direct that l11y person;1I representative :ll1d Trustee. as well as their successors. shall not he required to file bond or security in any jurisdiction. SEVENTEENTH: In addition to the powers conferred by case law, by statute and by other provisions of this Last Will and Testament, my person:d represenwtive. and any successors in that capacity shall have the following discretionary powers applicable to all real and personal property held by them. which powers sball be effective without Order of any Court and which .,b;1I1 exist ;11HI ClJntinue until the time of actual distribution: A. To retain any properly of ;lny nature received by them for whatever period it shall be deemed advisahle; B. To invest ami reinvest all or any part of tbe assets of my Estate without regard to statutes limiting the property which a fiduciary m:ty purchase: C. To sell. transfer. exchange or otherwise dispose of. any part of the assets of my Estate, for cash or on terms. puhlicly or privately. or to lease. without liability on the purchasers to see to the appliGltion of the proceeds, and to give options for these purchases without the obligation to repudiate them in favor of a higher offer; D. To execute and deliver any deeds. leases. assignments or other instruments as may be necessary to carry out the provisions of this Will; 4 )1);)'1 :(. It'- ! 'illili:'l~ c: \wf151 \ WiJJs\'\kL('(I<I. /{J\ E. To horrow money. if necessary to facilitate the administration and closing of my Estate. including the right to horrow money from any hank. including ORRSTOWN BANK. of Shipp<:nshurg. I'enmylvania, and to mortgage or pledge any asset of the estate as security; F. To loan to, and to purchase assets from, my Estate. even if it is also acting as Executor thereof. G. To assume continuance of the status of any beneficiary with regard to death. marriage. divorce. illness. incapacity and similar incidents or matters in the ahsence of information deemed reliable without liahility for disbursements m<lde Oil such a""lImplioll; H. To make any distrihution her<:under either in kind or in money. or partially in kind <lnd p<lrti<llly in uHlney. considering of course the reason<lhle wishes of the hendiciary. Distrihution in kind shall he m<lde at the appraised value of the property distrihuted. as it is set forth in the Inheritance Tax Return filed in my Estate; I. To exercise any suhscription right in connection with any security held hereunder. to consent to or participate in <lny recapit:i1ization, reorganization. consolidation or merger of any corporation, company or association. the securities of which may he held hereunder: ami to delegate authority with respect thereto, to deposit invesllnents under agreements. to pay assessments, and generally to exercise all rights of investors; :; ;? {11 ( inili:ll~ . ,c:\wp5I\Will~\McLn.....U{^ J. To continue in any partnership, joint venture, joint ownership or other husine.ls enterprise of which I am a part at the time of my death; K. To compromise claims; L. To continue for whatever period of time my personal representative shall deem necessary any ownership as a tenant in common or as a partner. in real estate or other property and to act a.1 I would have done had I been living; M. To do all other acts in his/her/their judgment necessary or desirahle for the proper managemenr. investment and distrihution of the assets of my Estate; N. I direct that my Exemtrix, RENEE TANTALA, shall he compensated for the services it renders to my Estate in accordance with its prevailing schedule of fees in effect during the time when said services are rendered. O. Should any changes occur in the Internal Revenue Code or Pennsylvania Statutes after the date of the execution of this Will which affect the tax liahility of my estate. then III the extent possihle and as may he permitted by law, my personal representative shall have the power and discretion to interpret this Will and to admini.\!er my Estate in a manner which results in the lowest tax liahility possihle. P. Should the principal of ,lny Trust herein provided for he or become too small. in the TRUSTEE\ discretjon, so as to make estahlishment h ,J Jrf inili:II.' . c.:\wr_~I\Wilh\McL,.('ltLf<A or continuance of the trust inadvisable. my TRUSTEE or my Executor may make immediate distribution of the then remaining principal am! any accumulated or undistributed income outright to the person or persons and in the proportions they are then entitled to income. If any such person is under the age of twenty.one (21) years. distribution may be made to the Trust established under Paragraph Fifteenth above. Upon such termination. the rights of all persons who might otherwise have an interest as succeeding income beneficiary or in remainder shall cease. EIGHTEENTH: The interests of thc bcneficiaries hereunder shall not be subject to anticipation or to voluiHary or involuntary alienation. IN WITNESS WHEREOF. I hercunto sct my hand and seal this ~""'''''v-l.. , V I'" ., day of ,1'!%, /) r@' ',' L- ) , .p~j /1 111< '-:{,., .,.1 --;' tC/liim '1.' 1/1 f(:X1V , RICHARD A. McLEOD SIGNED, SEALED, PUBLISHED ;lnd DECLARED in the presence of: $' :;) ;/1 f't ':J' I'-.i(../ .L..t. r . -' I ......-. !I ( I \ .i..' I I " I /: " ! ,,I I. ,/ " ~ I{ i ' , t' I ' , ",/"-Y"t/t' .," f '.J I" " 'l 7 '1 . c:\wp51 \Will~\McLo:{XI.RA COMMONWEALTH OF PENNSYLVANIA : SS. COUNTY OF CUMBERLAND I, RICHARD A McLEOD. Testalor. whose name is signed to the attached or foregoing instrument. having been duly qu:i!ified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or aff~rmed to and aCkn()\Vledge~e me, by RICHARD A McLEOD, Testator, this / 7 ~ day of Ji ' ]lJ%. ~ a~'~ ,,'. I I . . c . "J //... ~ 'ttM7z.' 1J! le:a RICHARD A McLEOD, Testator ~ Notarv Public NOTARIAL SEAL SUSAN M. RAMSEY, NaIaJy PuIlic CI/IIIt, ClmleItII1lf Counly, PI. !kf CocMliaaIan EllpirII September 8, 1999 .,.,,,,- x . . c.:\wp51\Wjlb\McLc:od.RA COMMONWEALTH OF PENNSYLVANIA : ss. COUNTY OF CUMBERLAND We, Roqer M. r.'..orgenthal and Deborah J. Sirrondi the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and S.IY that we were present and saw Testator, RICHARD A. McLEOD, sign and execute the instrument as his Last Will; that he signed wiIlingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the sight of the Testator signed the Will as witnesses; and that to the best of our knowledge the Test:ltor was at that time IX or more years of age, of sound mind and under no constraint or undue influence. Sworn or affirmed to and suhscrihed to hefore me hy Reger M. Morgenthal and Deborah J. Sim:>ndi , witnesses. this 17th day of June . 19%. ~Il I'll! (/1 r"-~ .c Witness \ \. tl)l()!c.!i Witnes c.:.' ~tdtUl NOTAIlW.IIEAL SUSAN U. RAMSEY, NoIaty PIbIic ~ ClInberIand Ccu1Iy, Pa. My CotrmSIlon Exp/rII SeIlIllilober 8, 1999 <) REV-1502 EX. 16-9* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF McLEOD, RICHARD A. FILE NUMBER 21-01-0100 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 al which properly 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 facls. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION REAL ESTATE AT 106 EAST ORANGE STREET, SHIPPENSBURG, CUMBERLAND COUNTY, PENNSYLVANIA 17257, VALUED IN ACCORDANCE WITH THE SALE PRICE OBTAINED BY SPECIFIC DEVISEE WITHIN ONE YEAR OF DEATH VALUE AT DATE OF DEATH 113,000.00 TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 113,000.00 REV-1508 EX+ (6-98) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF McLEOD, RICHARD A. FILE NUMBER 21-01-0100 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION 1. CASH ON HAND 2. CHECKING ACCOUNT #000688959, ORRSTOWN BANK, SHIPPENSBURG, PA, INCLUDING INTEREST ACCRUED TO DATE OF DEATH 3. SAVINGS ACCOUNT #000755087, ORRSTOWN BANK, SHIPPENSBURG, PA, INCLUDING INTEREST ACCRUED TO DATE OF DEATH 4. SAVINGS ACCOUNT #000755088, ORRSTOWN BANK, SHIPPENSBURG, PA, INCLUDING INTEREST ACCRUED TO DATE OF DEATH 5. CERTIFICATE OF DEPOSIT #5030058189, ORRSTOWN BANK, SHIPPENSBURG, PA, INCLUDING INTEREST TO DATE OF DEATH 6. DODGE CARAVAN, CONVERTED FOR HANDICAPPED USE, SOLD AFTER DECEDENT'S DEATH HOUSEHOLD GOODS, FURNITURE AND FURNISHINGS (NONE-ALL HAD BEEN 7. DISPOSED OF WHEN DECEDENT MOVED TO A PERSONAL CARE HOME IN 1997 DUE TO HIS ILLNESS AND HOUSE WAS RENTED TO TENANT) B FEDERAL INCOME TAX REFUND DUE FOR TAX YEAR 1999 9. FEDERAL TAX REFUND DUE FOR TAX YEAR 2000 10. FEDERAL ONE-TIME TAX REBATE PAID IN YEAR 2000 11. PROPERTY TAX REFUND DUE TO OVERPAYMENT TO STATE FARM INSURANCE COMPANY FOR 106 EAST ORANGE STREET, SHIPPENSBURG PA 12. MAGAZINE SUBSCRIPTION REFUND FROM KALMBACH PUBLISHING 13. REMAINING BALANCE IN GREEN RIDGE NURSING HOME ACCOUNT 14. REFUND FROM OVERPAYMENT TO HERSHEY MEDICAL CENTER VALUE AT DATE OF DEATH 5.00 8394.77 415.97 858.36 35,846.61 20,000.00 0.00 8278.00 9325.38 300.00 293.00 23.30 46.16 133.71 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 83,920.26 @~ ORRSTOWN BANK TO Roger M. Morgenthal Attorney at Law 2450 East Bayberry Drive Harrisburg, PA 17112-6015 Fax 717-671-8755 FROM ORRSTOWN BANK POBOX 250 SHIPPENSBURG PA 17257-0250 RE ESTATE OF Richard A McLeod DECEASED DATE OF DEATH November 22,2000 IT IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT HAD, ON THE ABOVE DATE. THE FOLLOWING ACCOUNTS WITH ORRSTOWN BANK (1) CHECKING ACCOUNTS DATE OF DEATH ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPLE & ACCRUED INTEREST (2) SAVINGS ACCOUNTS DATE OF DEATH ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPLE & ACCRUED INTEREST (3) CERTIFICATES OF DEPOSIT DATE OF DEATH ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPLE & ACCRUED INTEREST 5030058152 Richard A McLeod 06-17-97 $35,846.61 Addition to the report provided to your office on 02-12-01 Date 09-11-02 By: Jennifer K. Coffey POBOX 250 SHIPPENSBURG, PA 17257 TEL. (717) 532-6114 REV-1511 EX' (12-99). COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF McLEOD, RICHARD A. FILE NUMBER 21-01-0100 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: ,. EGGER FUNERAL HOME, NEWVILLE, PA 17241 975.00 B. ADMINISTRATIVE COSTS: ,. Personal Representative's Commissions 5,000.00 Name of Personal Representaive(s) RENEE TANTALA Social Security Number(s)/EIN Number of Personal Representalive(s) SlreelAddress 3952 SOUTH THIRD STREET Cily MILWAUKEE Stale~Zip 53207 Year(s) Commission Paid: 2001, 2002 2. Attorney Fees 5,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Slate_Zip RelalionshipofClaimantto Decedent 4. Probate Fees 273.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. CUMBERLAND LAW JOURNAL, ADVERTISING LETTERS 75.00 8. REGISTER OF WILLS, ADDITIONAL SHORT CERTIFICATES 9.00 9. THE SENTINEL, ADVERTISING LETTERS 90.59 10. GEORGE L. EBENER & ASSOCIATES, REALTORS, REAL ESTATE APPRAISAL 250.00 11. NECESSARY TRAVEL EXPENSE FOR EXECUTRIX, BASED ON MILEAGE AT $0.345 PER MILE 2,045.16 FROM WISCONSIN TO PENNSYLVANIA TOTAL (Also enter on line 9, Recapitulation) $ O~~ts of decedent must be reported on Schedule 1. (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (12-99IW COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF McLEOD, RICHARD A. FILE NUMBER 21-01-0100 Debts of decedent must be reporte-d or. Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A FUNERAL EXPENSES: ,. CONTINUATION SHEET FOR SCHEDULE H. B. ADMINISTRATIVE COSTS: ,. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Represenlative(s) SlreetAddress City Slate_Zip Year{s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Acldress City Stale_Zip Relationship of Claimant 10 Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 12. REGISTER OF WILLS, FILING INHERITANCE TAX RETURN 15.00 13. ORRSTOWN BANK, PURCHASE CHECKS FOR ESTATE ACCOUNT 16.00 14. REGISTER OF WILLS, RESERVE FOR FILING ACCOUNTING 300.00 15. EXECUTRIX, RESERVE FIR MISCELLANEOUS CLOSING EXPENSES 100.00 TOTAL (Also enter on line 9, Recapitulation) $ 14,178.75 (If more space is needed, insert additional sheets of the same size) """",:."",. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF McLEOD RICHARD A. FILE NUMBER 21 01 0100 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1.410.33 Continuing Care RX, prescription costs 2. Final Bill, Presbyterian Homes 6,56998 3. PPL Utilities. statement for gas service 1 ,786.29 4 State Farm Insurance, insurance coverage for handicapped van 340.75 5. GPU Energy, statement for electric service 248.30 6 Lisa Helm, Tax Collector, past due real estate taxes 467.53 7 Borough of Shippensburg, Water and Sewer bill 254.84 8. Orrstown Bank, reimbursement for lost safe deposit box key (lost during decedent's lifetime) 15.00 TOTAL (Also enter on line 10, Recapitulation) $ (If more space IS needed, Insert additional sheets of the same Size) 11 093.02 . R.EV1SDE'.'w SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ..~, """ Rlc-"'~" A NUMBER I. FRIEND $500.00 DAUGHTER $5,000.00 FRIEND $5,000.00 (FORMER SPOUSE) FRIEND $1,000.00 FRIEND $1,00000 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (al (1.2)J FILE NUMBER ?1 01 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) 2 RENEE TANTALA 3952 S THIRD STREET MILWAUKEE, WI 53207 CHARLES LOUCKS 111 N. EARL STREET SHIPPENSBURG, PA 17257 JOHN ROGERS 325 MEADOWS ROAD NEWVILLE, PA 17257 AMALIA McLEOD HESS 709 CEDAR HILL DRIVE ALLENTOWN, PA 18109 NANCY LONGENBACH 824 CENTER STREET BETHLEHEM, PA 18018 KEITH KOCHERT 250 S. ST CLAIR STREET PITTSBURGH, PA 15206 LYDIA NABIRYE 2561 S. 44TH STREET, APT. 2 MILWAUKEE, WI 53219 FRIEND FRIEND AND DOMESTIC PARTNER 3. 4 5 6 7 0100 AMOUNT OR SHARE OF ESTATE REAL ESTATE SET FORTH ON SCHED. A $500.00 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500COVER SHEET NON-TAXABLE DISTRIBUTIONS: A SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE \RIT ABLE AND GOVERNMENTAL DISTRIBUTIONS 'ENSBURG UNIVERSITY FOUNDATION, GIFTED MINORITY STUDENT .ARSHIP FUND .0 MAIN DR, SHIPPENSBURG, PA 17257 {\ - 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) 1.00000 $ 1 000.00 ~ I. rOr~, ""OFP4Rr, I - Continuation of REV-1500 Inheritance Tax Return Resident Decedent McLEOD, RICHARD A 21 01 0100 PaQe 1 Schedule J - Beneficiaries - 1 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) 8 JOHANN KISAAME FRIEND $1,000.00 7200 MERION TERRACE, APT. D109 UPPER DARBY, PA 19082 9 JANET GILES SISTER REMAINDER OF 7030 38TH AVE, NE. ESTATE SEATTLE, WA98115 Shippensburg University Foundation 1871 Old Main Drive Shippensburg, Pennsylvania 17257 Telephone 1717) 477-1377 Fox (717) 477-1471 January 8, 2002 Estate of Richard A. McLeod Mr. Roger M. Morgenthal, Esq. Salzmann, DePaulis, Fishman & Morgenthal, P.C. 455 Phoenix Drive, Suite A Chambersburg, PAl 7201 Dear Mr. Morgenthal, Thank you for the recent contribution of$I,OOO from the Estate of Richard A. McLeod designated for the Gifted Minority Student Scholarship Fund administered by the Shippensburg University Foundation. We are always saddened by the loss of a member of the "Shippensburg Family" and sincerely appreciate him providing for this contribution thrQugh his estate plan. John E. Clinton Executive Vice President In accordance with IRS regulations, this letter will serve as a receipt for federal income tax deduction purposes. and the SU Foundation affirms that neither goods nor services were promised in return for your contribution. Register of Wills of CUMBERLAND County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of also known as RICHARD A McLEOD No. r2/ -01-/ ()() , Deceased Social Security No. 397 - 32 - 0958 RENEE TANTALA Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW:) [X] A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut r ix named in the last Will of the Decedent, dated 06/17/1996 and codicil(s) dated None NONE 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 incompetent: NONE D 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 that Decedent left no Will and was survived by the following spouse (if any) and heirs: r Name Relationship Residence I (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in CUMBERLAND County, Pennsylvania with his/her last family or principal residence at 210 BIG SPRING ROAD, WEST PENNSBORO TOWNSHIP (list street, number, and municipality) Decedent, then ~years of age, died 11/22/2000 at GREEN RIDGE VILLAGE, PA (Location) Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property (If not domiciled in PA) Personal property in Pennsylvania (If not domiciled in PA) Personal property in County Value of real estate in Pennsylvania 50,000.00 $ $ $ $ 100,000.00 106 E. ORANGE STREET, SHIPPENSBURG, CUMBERLAND CO., PA situated as follows: Wherefore, 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 a riate form to the undersi ned: Si RENEE TANTALA 3862 SOUTH WHITNALL AVENUE, MILWAUKEE, WI 53207 /6 --2o/f- /r Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form RW-1 (1991) Oath of Personal Representative Commonwealth of Pennsylvania 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 knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. ~~L RENEE TANTALA Sworn to or affirmed and subscribed ~;C-<' " -"- before me this 1 7 tlQay of ~:... J <HJ11ary ::;? /.L~ For the Register J // Lewis ~~ "A' No. 21-01-100 Estate of RICHARD A McLEOD Deceased Social Security No: 397 - 32 - 0958 Date of Death: 11/22/2000 AND NOW, Januarv 23rd. 2 0 0 1 ' in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters [KJ Testamentary D Of Administration (c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate) are hereby granted to RENEE TANTALA in the above estate and that the instrument(s) dated 06/17/1996 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. Short Certificate(s). .3. $ 235.00 9.00 <./}?t A /l .I / /l (A</~ L . / ~.~~~1;- Register of Wills Mary C.Lewls ? FEES Letters. . . $ Renunciation. $ Affidavits ( $ Extra Pages ( 8 ) . $ Codicil. $ JCP Fee. $ Inventory. $ Other $ Attorney: ROGER M. MORGENTHAL, ESQUIRE 24.00 1.0. No: 17143 FISHMAN & MORGENTHAL Address: 95 ALEXANDER SPRING ROAD SUITE 3 CARLISLE, PA 17013 5.00 Telephone: 717/249-6333 TOTAL. . . . . . . . . Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. $ 273.00 Form RW-1 (1991) H lOS.l30S REV lJIg6 This is to certify that the information here given is correctly copied from an original certificate of death dul~ filed with me as Local Reg~strar. The original certihcate will 6e forwarded to the State Vital Records Office for permanent filmg. WARNING: It is illegal to duplicate this copy by photostat or photograph. No. ~~. ~b-\-~~ Local Registrar Fee for this certificate, $2.00 p 6959898 NOV 2 9 2000 Date 21-2001-100 Hl05.:43 Rev. 2187 COMMONWEALTH OF PENNSYLVANIA' OEPARTMENT OF HEALTH' VITAL RECOROS CERTIFICATE OF DEATH ., J, \ Cumberland .... SEX ..Male 'S"R(~I\.E~~ SOC.....L SECURIT'Y NUMBER 3. 397 _ 32 ~""() ., IK NAME OF DECEOENT (I~:"St. M;;"e. i.as, L Richard A. .-OE (Lata Bwthda'rl UNOER' YEAR uNDER 1 DAY 6 4 MonIht Da.,. Iiol.n:: ..lout.. v". .. COUNTY OF DERH PLACE OF CJeRH ICt>edl 0f\Iy QI"Ie iee ,nSllUCloOnS on ~ '!I081 HOSPI'lAL: - 1~lienfO 1. ... FACtLlr'I" N.-ME (II rl()I M'l$l'fUIIOl'\. 9Ye SIr", and numberl 8IRTI'4PL.ACf ;Coty ~ Se!!t't"l11'\!" C'tm' ="",0 oeCEOENl'S USU....L OCCUPRIOH (G<velund a1....ork oonc dur~ CO~~~~~TT~SO fT.. 111t. DECEDENT'S MAttING AOOAESS (SIr.... C~. s.a.. Z~ Code) 106 East Orange St Shippensburg PA 17257 SUAVIYING SPOuSE (n 'Mfe. QNe m--. namel Education oeCEDENT'S -.<:tUAL RESIDENCE ISH .-....ona on 0Ihet SlOe) 11..&.._ ,,,,. ... - Min. . Cumberland _7 '7d.~:::"'""=,,.:::'.. Shlppensburg MOTHER~ S't'We'M It"''s"CTiE! n ... 'Nf~~'2'..~'WtH"'f:m<:f>''r'"'~~'m.llwaukee .n 53207 .... tt. f"RliEA'S NAME IFitsl. MiO<H. Last) ~ J, Blair McLeod 1Nf00MANT'S NA~ ~ 1ie'EW Tan tal a - METHOD OF 0I5PQS1TION IlurioI 0 c,....."" QIl _....$1...0 ou...._ _. PlACE OF OtSPOSmON. Name otc.rn.t~. CIWftatOry cwOttMtrFttalce East 21c. L Spring Ave '-~~ f~ PART II: Other stgnil\canl condIIioN contributing 10 dIt.I". but notrMUftinQinttle~~9iWnW\~ , DUE TO (()A AS ACONSEQUENCE Of): lb. c. d. DUE 10 (OR AS A CONSEQUENCE 0Fl: '-- OUE '10 (OR AS A CONSEOIJENCE OF), WERE AU10PSY FINDINGS MANNER Of DEATH _lA8l.E PRIOR 10 ~ CQMP\.El1OH CIF CAUSE 0 OF DEArH? ........ HomiCida ~~ - 0 Pen6nrg ln~.d9.tlon 0 ...."'" 0 Could not ~ determined 0 DATE Of INJURY (Monlh. Day. 'fUrl TlUE OF INJURY INJURY 1fI WORK? DESCRIBE HOt\' INJURY OCCURflEO. _ 0 ~O *. 300. M. PLACE Of: INJURV . At home, taffft. slr",.l~. O1flte buitcIng. ..c. ($pee"") 2ft. 21. 3CM. CElnlFIf;A(Ct-<<:k(ll'liy~ .~~s:.o::.:;==;:.c::~e:::':::~.~';.=:'~=::::~~~~~~.C~~~~~I':':' 23) 0 'MEDICAL exAMINEIlICOAONER On the ba.is 01 ...mln8tlon .nd/or Inv..tlgation,ln my opinion, death occurred at the U",., da'a, and pl.ce, and due 10 the causa(.) and mann.....st.ted............. .... ...... ....... -. ......... ... .................... ............ .... .-.. .... 31.. REOI$TR....,q.S SIGNATURE .-NO o .P\JIONOVHCING AND CEATI"INQ PHYSICIAH IF"hysloan boltl l)f:yo()uncltlQ OHIt! and certJfyorlg lO cause 01 deathl 6lJ To.....1Mst of my kno....'-dQfI. death oecur~ 8' the time, dale, "nd p'*=e. anet due to the eauM(.)and m...n~, .. .'ated b;:>.1\I~tIOI >>. :.:I'E HI.EO(Month. 0111\:'." _ Nv\J ~~ I ~(){SD /111 , ~ -- CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: RICHARD L. McLEOD Date of Death: NOVEMBER 22. 2000 Estate No.: 21-01-0100 To the Register: I certify that notice of the beneficial interest required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on April 2. 2001. Name Address See attached list of beneficiaries Notice has now been given to all persons entitled thereto under Rule 5.6(a) except NONE Date: April 2. 2001 ~ U1,ft4~ Signature FISHMAN & MORGENTHAL Name Roaer M. Moraenthal . Esauire . #17143 Address 95 Alexander Sprina Road. Suite 3 Carlisle. PA 17013 Telephone (717) 249-6333 Capacity: _ Personal Representative -L Counsel for Personal Representative Estate of Richard McLeod: List of Beneficiaries Charles Loucks 126-28-9335 111 North Earl St. Shippensburg, PA 17257 >00. ~ 717-532-6335 John Rogers 191-34-4464 325 Meadows Road J";~" -"" Newvillw, PA 17241 717-776-7057 Renee Tantala 394-54-6375 3862 S. Whitnall Ave. Milwaukee, WI 53207 414-486-1398 Amalia McLeod Hess 186-64-4000 709 Cedar Hill Dr. >fJ()(). ", Allentown, PA 18109 Alternate address: send c/o Nancy Langenbach 610-231-3459 Michael Joseph McLeod 198-70-8751 fIDOO,- 709 Cedar Hill Dr. Allentown, PA 18109 Brandon Christopher Hess 182-74-0226 709 Cedar Hill Dr. I 0 00 .. ,,- Allentown, PA 18109 Continues on back II. lIAR 0 6 200f Nancy Longenbach 320-34-9799 824 Center Street Bethlehem, PA 18018 [l%b · ../ 610-865-9994 Keith Kochert 186-54-4103 250 S. St. Clair St. Pittsburgh, PA 15206 , t) 0 '(), ,.- 661-6797 Lydia Nabirye 176-70-9140 2561 S. 44th St., Apt. 2 Milwaukee, WI 53219 l 't) b 0......- 414-546-3384 Johann Kisaame 396-80-6317 7200 Merion Terrace, Apt 0109 . Upper Darby, PA 19082 {D 00, - 610-453-9061 Janet Giles 396-30-1243 7030 38th Ave. NE Seattle, WA 98115 ~ ~.c26</-/Y ",6 OF INDIVIDUAL TAXES ~ .ITANCE TAX DIVISION DEPT. 280601 HARRISBURG~ PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER COtJ.NTY ACN ROGER M MORGENTHAL ESQ 2450 E BAYBERRY DR HBG PA 17112 \ 10-27-2003 MCLEOD 11-22-2000 21 01-0100 CUMBERLAND 101 '* REV-1541 EX AFP (01-03) RICHARD A Amount Rellitted (1) (2) (3) (4) (5) (6) (7) 113,000.00 .00 .00 .00 83,920.26 .00 .00 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 ~ REv=is'4-j-Ex-AFP--coi-:031--Nti,.-icE--oF-'rNHEifiTANcE-T-Ai-APPRAIsi:irENT~--ALi-owANcE-ifR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF MCLEOD RICHARD A FILE NO. 21 01-0100 ACN 101 DATE 10-27-2003 TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE 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) S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. 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 I~ an assessment was issued previOUSly, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total D~ ALL returns assessed to date. ASSESSMENT OF TAX: IS. Allount of Line 14 at Spousal rate (IS) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: NOTE: 14,148.75 11,093.02 (11) (12) (13) (14) (9) (10) .00 X 00 = 6,000.00 X 045= 43,678.49 X 12 = 121,000.00 X 15 = (8) (19)= NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 196,920.26 25.241 77 171,678.49 1,000.00 170,678.49 .00 270.00 5,241.42 18,150.00 23,661.42 r>....~n. K~(;~~t'1 (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 02-22-2001 AA478062 789.47 15,000.00 08-26-2002 CDOO1566 561.97- 9,000.00 TOTAL TAX CREDIT 24,227.50 BALANCE OF TAX DUE 566.08CR INTEREST AND PEN. .00 TOTAL DUE 566.08CR . 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 IIICREDITIII (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) .... REV-1-470 EX (6-88) INHERITANCE TAX EXPLANA TION OF CHANGES COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENrS NAME FILE NUMBER RICHARD A MCLEOD REVIEWED BY ACN 2101-0100 101 John Kealy ITEM SCHEDULE NO. EXPLANATION OF CHANGES J Increased the amount subject to tax at 4.5% to $6,000, a stepson is a lineal heir. ROW Page 1 / 6 -c2O </- /j/ ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG I PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REY-1n7 EX AFP (01-03) ROGER M MORGENTHAL ESQ 2450 E BAYBERRY DR HBG PA 17112 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 11-17-2003 MCLEOD 11-22-2000 21 01-0100 CUMBERLAND 101 RICHARD A Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-Y=i6o-j-Ex--AFP--fol---o3i-------...--iNirERITANc'E-TAi--STATEMENT-ifF'-ACCouirf--.-..--------------------- ESTATE OF MCLEOD RICHARD A FILE NO.21 01-0100 ACN 101 DATE 11-17-2003 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 10-20-2003 P R I NC I PAL T AX DUE: ........................................................................................................................................................................................................................... 23,661.42 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 02-22-2001 AA478062 789.47 15,000.00 08-26-2002 CDOO1566 561.97- 9,000.00 10-27-2003 REFUND .00 566.08- TOTAL TAX CREDIT 23,661.42 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 IE SIDE 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. ) l ~ ROGER M. MORGENTHAL ArrORNEY AT LAW 2450 EAST BAYBERRY DRIVE HARRISBURG, PENNSYLVANIA 171 12-6015 E-MAIL: rogerm2450@earthlink.net (71 7) 671 ~8754 FAX (717) 671-8755 August 26, 2002 Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, P A 17013 RE: ESTATE OF RICHARD A. McLEOD NO. 21-01-0100 Ladies and Gentlemen: Enclosed is a check to be applied to the Inheritance Tax on the above-referenced estate. Please note my new address and telephone number for any future correspondence regarding this or any other Estate that I may be representing. Thank you for your attention to this matter. Very truly yours, -put JIJ?~ . Roger M. Morgenthal, Esquire Enc: Check ~:, COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 2.80601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT MORGENTHAL ROGER M 2450 EAST BAYBERRY DRIVE HARRISBURG, PA 17112-6015 ____n__ fold ESTATE INFORMATION: SSN: 397-32-0958 FILE NUMBER: 2101-0100 DECEDENT NAME: MCLEOD RICHARD A DATE OF PAYMENT: 08/27/2002 POSTMARK DATE: 08/26/2002 COUNTY: CUMBERLAND DATE OF DEATH: 11/22/2000 NO. CD 001566 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $9,000.00 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: ROGER M MOGENTHAL ESQUIRE CHECK#145 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS $9,000.00 MARY C. LEWIS REGISTER OF WILLS ROGER M. MORGENTHAL ATTORNEY AT LAW 2450 EAST BAYBERRY DRIVE HARRISBURG, PENNSYLVANIA 17112-6015 E-MAIL: rogerm2450@comcast.net (71 7) 671-8754 FAX (717) 671-8755 January 9, 2003 Register of Wills Attn: Sue Cumberland County Courthouse One Courthouse Square Carlisle PA 17013 Ladies and Gentlemen: ~/~ ~ f\ \. .\~\N~Q ~~ \J'U ~~ ~~1 ~~ /02 I A4 e-..;j ~ (/-v1 l'~(;~ ;2;- CJ 1- /CJO This will confirm that I have withdrawn from representation of the followipg estates, which are now being represented by Salzmann, DePaulis & Fishman, PC: Estate of Arthur Herr .F Estate of Anne E. Olmstead Estate of Ida G. Skelly Thank you for your attention to this matter. ~~~..~ ~ . i / .t/0 bu t().;LI)J, t.~ v l.^- '; II U .€~~~ ~~~ Very truly yours, ~MtAr-J-- Roger M. Morgenthal, Esquire ~J( (L/[Zhvt l/) ~?J1~ Ci~ f v- I oU"-()/~t( 3 6 ,- 02/- 01 ~ 101'1-- .;JI-(}/-/tJfi3 S~/ t.1&1..b. td-z-..:(?~ e-eJ-Y~ (\ ff" , v/' STATUS REPORT UNDER RULE 6.12 Name of Decedent: RICHARD A. McLEOD Date of Death: 11/22/2000 No. 21-01-0100 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: XX 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 XX No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? XX Yes _ No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphan's Court and may be attached to this report. Date: Qctober23.2003 Signature . ~\ -", I '{'/~11{ /l/J'/~1..J-.---- Name (please type or print) Rdger M. Morgenttla, squire, #17143 2450 East Bavberrv Drive Address HaniSbU~A 17112-6015 City, State, p (7~671-8754 Tel ne Number Capacity: _ Personal Representative -A. Counsel for Personal Representative (~ 0 i( ~ ..../ V STATUS REPORT UNDER RULE 6.12 Name of Decedent: RICHARD A. McLEOD Date of Death: 11/22/2000 No. 21-01-0100 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 XX No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 6/30/2003 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 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 d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphan's Court and may be attached to this report. Date: 1/9/03 Signature V ~l~ . ~\\)." V ~~C ~J44~ Name (please type or print) Roger M. Morgenthal, EsqUIre, #17143 2450 East Bavberry Drive Address Harrisbur~PA 17112-6015 City, State, Ip (717~ 671-8754 Telep one Number Capacity: _ Personal Representative ~ Counsel for Personal Representative JRD/June 30, 1992/17858 DEG 1 2 2002 ~ .. .. ... In Re: Estate of Richard A. McLeod Late of West Pennsboro Township ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA Estate No.: 21-2001-0100 NO. 21-2001-0100 NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE Personal Representative: Counsel for Personal Representative: Roger M. Morgenthal, Esquire Date of Decedent's Death: 11-22-2001 Date of Delinquency Notice: 10-08-2002 The undersigned, Mary C. Lewis, Register of Wills, in accordance with Rule 6.12, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, was given by the Register of Wills on 10-08, 2002, and that the ten (10) day notice to file the Status Report has expired. Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Distribution: Personal Representative Counsel for Personal Representative Estate File Date: 12-09-2002 0!-I(/tJ3 9~'3oA,IJ1,. A hearing is scheduled for at in Courtroom No.3. prior to the hearing date, the hearing will automatically be canc .. Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (71 7) 240 - 6345 .. Date: 10/08/2002 RENEE TANTALA 3862 SOUTH WHITNALL AVENUE MILWAUKEE, WI 53207 RE: Estate of MCLEOD RICHARD A File Number: 2001-00100 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 11/22/2002 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, MARY C. LEW S REGISTER OF WILLS ~,)yl !)t:bJ I A:I- cc: v'File Counsel Judge JRDlJune 30, 1992/17858 DEG 1 2 200Zr .. J1I In Re: Estate of Richard A. McLeod Late of West Pennsboro Township ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA Estate No.: 21-2001-0100 NO. 21-2001-0100 NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE Personal Representative: Counsel for Personal Representative: Roger M. Morgenthal, Esquire Date of Decedent's Death: 11-22-2001 Date of Delinquency Notice: 10-08-2002 The undersigned, Mary C. Lewis, Register of Wills, in accordance with Rule 6.12, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, was given by the Register of Wills on 10-08, 2002, and that the ten (10) day notice to file the Status Report has expired. Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Distribution: Personal Representative Counsel for Personal Representative Estate File Date: 12-09-2002 0/-1 t/ tJ 3; C;)~ .3 iJA ,IJ1, A hearing is scheduled for at in Courtroom No.3. prior to the hearing date, the hearing will automatically be canc \\~} ~JY ~~ Georg / STATUS REPORT UNDER RULE 6.12 Name of Decedent: Date of Death: Will No. 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 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 d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. Date: Signature Name (Please type or print) Address ( ) Tel. 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"'1!"""'~. ;. :,;,s.... ~ ~ "/C ~ ~ -' ~ ~. - ..-:. .,.. - - - -:: - - ... ... ~ ~ -=;. ... - - - ... .:=:: ,'t.\ '11) ',:".1 ~~. j','\ ~.i ......1 ~ .t c-l ... ~ t' .;l Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 Date: 10/08/2002 RENEE TANTALA 3862 SOUTH WHITNALL AVENUE MILWAUKEE, WI 53207 RE: Estate of MCLEOD RICHARD A File Number: 2001-00100 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 11/22/2002 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, MARY C. LEW S REGISTER OF WILLS ~,iJ1. ~ {d- cc: J File Counsel Judge JRD/June 30, 1992/17858 DEe 1 2 2002 ( Estate No.: 21-2001-0100 ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA In Re: Estate of Richard A. McLeod Late of West Pennsboro Township NO. 21-2001-0100 NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE Personal Representative: Counsel for Personal Representative: Roger M. Morgenthal, Esquire Date of Decedent's Death: 11-22-2001 Date of Delinquency Notice: 10-08-2002 The undersigned, Mary C. Lewis, Register of Wills, in accordance with Rule 6.12, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, was given by the Register of Wills on 10-08, 2002, and that the ten (10) day notice to file the Status Report has expired. Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Distribution: Personal Representative Counsel for Personal Representative Estate File Date: 12-09-2002 o1-/f./tJ3 9,304.1J1, A hearing is scheduled for at in Courtroom No.3. I the Statu Report is filed prior to the hearing date, the hearing will automatically be canc / Georg STATUS REPORT UNDER RULE 6.12 Name of Decedent: Date of Death: Will No. 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 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 d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. Date: Signacure Name (Please type or print) Address ( ) Tel. No. Capacity: Personal Representative Counsel for personal representative (MAH:rmf/AM3)