HomeMy WebLinkAbout01-0190
- OFFIC1A.1. \JSE ONLY
AEV-1500 EX + (6-00) REV-1500 I (., - ;L II - 3
INHERITANCE TAX RETURN FILE NUMBER
COMMONWEALTH OF PENNSYLVANIA 21-01-0190
DEPARTMENT of ReVENUE RESIDENT DECEDENT
DEPT. 280601 COUNTY CODE YEAR NU MoSER
HARRISBURG. PA. 17128-0601
DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
0
E Scott Flainder L. 22B-2B-6900
C OATEOF OEATH(MM-OO-YEAA) DATE OF BIRTH (MM.-DO-YEAR) THIS RETURN MUST BE ALEC IN DUPUCAYE WITH THE
E
0 10/11/1999 07/28/1912 REGISTER OF WILLS
E (IF APPL.ICABLE) SURVIVING SPOUSE'S NAME (lAST, FIRST, AND MIDDLE JNIT1AL) SOCIAL SECURITY NUMBER
N
T
.l: 1. Original Return 2. S,pp'emenl., Rel"n B~ 3. I tdateofdeath
- Rema!nd,er Return prior to 12 -13-82)
CAPB X 4. limited Estate - 4a. Future Interest Compromise (date of death aHer 12-12-82) 5. Federal Estate Tax Return Required
HpRL 6. 7. 0 8. Total Number of Safe Deposit Boxes
EP 10 Decedent DIed Testate Decedent Maintained a Living Trust
-" - -
CRAC (Attach copy of Will) (Attach ctlpy of Trust)
KOTK 09. 010. 0 11. Election to tax under Sec. 9113(A)
ES lItigatlon Proceeds Received Spousal Poverty Credit
(date of death between 12-31-91 and 1-1-95) (AttaCh Sch 0)
i~\1Jl!I$$j;.~l1!QIiI:Ml,i$l1lIilE'tQMPI.liIj;P"."m:'e(l~FlIS$!iO"PIS"C;:IS~~I':'PIS"'I"I"'~:~.u~N\"(l~M"'TI(l"$H(lU~Q!lE(lI~E4;:TED'I"6:
P NAME COMPLETE MAILING ADDRESS
C
0 0 ROller B. Irwin Esq. 60 West Pomfret Street
R N FIRM NAME (If Applicable) Profess ional
R 0 West Pomfret Bldg.
E E IRWIN McKNIGHT & HUGHES Carlisle, PA 17013
S N
T TELEPHONE NUMBER
717 /249-ry~53 . ,
r .
1. Real Estate (Schedule A) (1) 110,060.00 OFFiCIAL USEONL Y
2. Stocks and Bonds (Schedule B) (2) None
3. Closely Held Corporation, Partnership or (3) None
Sole-Proprietorship
4, Mortgages & Notes Receivable (Schedule 0) (4) None
R 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 1,332.15
E (Schedule E)
C
A 6. Joinlly Owned Properly (Schedule F) (6) None .~' ,
P 0
I Separate Billing Requested
T 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) None
U
L (Schedule G or L)
A
T S. Total Gross Assets (total Lines 1-7) (S) 111,392.15
I 9. Funeral Expenses & Administrative Costs {Schedule H) (9) 7,819.09
0
N 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 180,270.12
11. Total Deductions (Iotalllnes 9 & 10) (11) 188.089.21
12. Net Value of Estate (line B minus Line 11) (12) (76,697.06)
13. Charitable and Governmental BequestS/Sec 9113 Trusts for which an election to tax has not been (13)
made (Schedule J)
14. Net Value Subject to Tax (Une 12 minus Line 13) (14) (76,697.06)
C
0 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
M
T P 15. Amount of Line 14 taxable at the spousal tax
U
A T rate, or transfers under Sec. 9116(a)(1.2) X .0 0 (15) 0.00
X A (76,697.06) ~
T 16. Amount of Line 14 taxable at lineal rate X .0 (16) 0.00
I 17. Amount of Line 14 taxable at sibling rate X .12 (17) 0.00
0
N 18. Amount of Line 14 taxable at collateral rate X ,15 (IS) 0.00
19. Tax Due (19) 0.00
20. ~F'r rU1::Ii!l4;:K'1fll!R!l'lf"rp!l,i\REI'll:QUESTI"c;""!le!'ll~tl(l1""~!\I'PVERPA"("'J;;;iIlTlTII
e,.
,,: > >/IlE SURE TO ANSWER AL!.'QUESTIONS ON REVERSe SltlE AND TO RECHECK MATH < <
Copyright (c) 2000 form software only The Lackner Group,Im:.
Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
5210 Roval Drive
CITY I STATE I ZIP
Mechanicsburg PA 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. CreditsIPayments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
0.00
Total Credits ( A + B + C) (2)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
TotallnterestlPenalty ( D + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Cheek 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. (SA)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B)
M~ke Check. Payable to: REGISTER OF WillS, AGENT
......ptEAsE"A~gWg~:'~~~F~~ttowiN(rCmESTIONS.BY'ptAd.NG.AN!!:~:!' :\~':f~~.~~~.~~~r~rl~fg~t6cKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ~ ~~x
b. retain the right to designate who shallllse the property transferred or its income; .
c. retain a reversionary interest; or . . . . . . .
d. receive the promise for life of either payments, benefits or care?
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? . D [KI
3. Did decedent own an -in trust for" or payable upon death bank account or security at his
or her death? . . . . . . . . . . . . . . . . . D [!l
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property
which contains a beneficiary designation? . . . . . . . D [KI
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FilE IT AS PART OF THE RETURN.
0.00
0.00
0.00
0.00
0.00
Under penalties of perjury, I declare that I have examined this return, Including accompanying schedules and statements, and to the best of my knowledge and belief. it Is true,
correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATUAEO' PEASON AiNSIBLE 'c:':':TURN _ _ ~~~~_ _~;;,,:~~p_~~ YO'_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
~ ~~ Mechanicsbur ,PA 17055
AAEAOTHEATHANAEPAESENTATIVE IRWIN McKNIGHT & HUGHES
/3. ~ 60 West Pomfret Street
- - -Carl-i~i;'-,- - PA - - i Y6i'i - - - - - - - - - - - - - - - - - - - - - - - - - --
OA E
0\
For dates of deat on r 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
~o [72 P.S. 91'6 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transf~rs to or for the use of the surviving spouse is 0"10
[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"10 [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(aX1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(aX1.3)]. 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.
Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6.00)
FlEV.150Z EX + (1-97)
SCHEDULE A
COMMONWEALTH OF PENNSYLVANIA REAL ESTATE
INHEFlITANCETAX. FlETUFlN
FlESrOENT DECEDENT
EST ATE OF FILE NUMBER
Flainder L. Scott SS# 228-28-6900 10/11/1999 21-01-0190
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
knowledr'l9 of the relevant facts. Real property which is jointly-owned with riaht of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
DESCRIPTION
NUMBER OF DEATH
1 5210 Royal Drive, Windsor Park, Mechanicsburg - Lower Allen 110,060.00
Township, Cumberland County
TOTAL (Also enter on line 1, Recapitulation) SIlO, 060.00
(If more space is needed, insert additional sheets of the same size)
Copyright (cl 1996 form software only CPSystems, Inc. Form REV-1502 EX (Rev. 1-97)
, REV-1SOl\EX+(1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCETf(X RETURN
RESIDENT DECEDENT
ESTATE OF
Flainder L. Scott
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
55!! 228-28-6900
10/11/1999
FILE NUMBER
21-01-0190
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1
DESCRIPTION
Claremont Nursing & Rehabilitation Center
VALUE AT DATE
OF DEATH
732.15
2
PA Department of Revenue, tax rebates
600.00
TOTAL (Also enter on line 5. Recapitulation) $ 1,332.15
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-150B EX (Rev. 1-97)
REV~ 151 \ EX + (1-97)
COMMONWEA.LTH O~ PENNSYLVANIA
rNHERITANCETPJ( RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Flainder L. 5cott
55ft 228-28-6900
10/11/1999
FILE NUMBER
21-01-0190
Debt. of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION
A. FUNERAL EXPENSES,
1 Ronan Funeral Home
B.
AMOUNT
47.09
1.
ADMINISTRATIVE COSTS,
Personal Representative's Commissions
Name of Personal Representative(s}
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address
City
Zip
State
Year(s) Commission Paid:
2.
3.
Attorney's Fees IRWIN McKNIGIIT & HUGHES
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant Mary L. Scott
Street Address 5210 Royal Drive
City Mechanicsburg State ~ Zip 17055
Relationship of Claimant to Decedent daughter
4,000.00
3,500.00
4.
Register of Wills
246.00
Probate Fees
5. Accountant's Fees
6. Tax Return Pre parer's Fees
7.
1
Other Administrative Costs
Register of Wills - filing fee
10.00
2
Ronan Funeral Home - corrected death certificates
16.00
TOTAL (Also enter on line 9, Recapitulation) $ 7.819.09
(If more space is needed, insert additional sheets of the same si2e)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1~97)
REV-151.~ EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TW-RETURN
RESIDENT DECEDENT
ESTATE OF
Flainder L. Scott
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, AND LIENS
SS/f 228-28-6900
10/11/1999
FILE NUMBER
21-01-0190
Include unreimbursed medical expenses.
ITEM
NUMBER
1
DESCRIPTION
PA Department of Public Welfare - restitution
AMOUNT
180,270.12
TOTAL (Also enter on line 10, Recapitulation) $ 180.270.12
(If more space is needed, insert additional sheets of the same size)
CopyrIght (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97)
REV~15q EX... (9-00)
COMMONWEALTH OF peNNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Flainder L. Scott
SCHEDULE J
BENEFICIARIES
SS4ft 228-28-6900
10/11/1999
FILE NUMBER
21-01-0190
RELATIONSHIP TODEqDENT AMOlJNT OR SHARE
Do NotListTrustee(s) OF ESTATE
NUMBER NAME AND AODRESS OF PERSON(Sl RECEIVING PROPERTY
I. TAXABLE DISTRIBUTIONS [lncludeoutrlghtspousaldlstrlbutlc!'lS,and
transfers under Sec. 9116(aX1.Z)}
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS,
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET S
0.00
(If more space is needed, insert additional sheets of the same size)
CopyrIght (c) ZOOO form software only The Lackner Group, Inc.
Form REV-1S13 EX (Rev. 9-00)
. I
LAST WILL AND TESTAMENT
OF
FLAINDER LEE SCOTT
I, Flainder Lee Scott, of the Cumberland County Nursing Home,
Carlisle, Cumberland County, Pennsylvania, being of sound and
disposing mind, memory and understanding, do make, publish and
declare this to be my Last Will and Testament, hereby revoking all
wills and codicils heretofore made by me.
ITEM I. I direct that all my debts and funeral expenses,
including my cemetery lot and gravemarker and all expenses of my
last illness, shall be paid from my residuary estate as soon as
practicable after my death as part of the expense of the
administration of my estate.
ITEM II. I devise and bequeath 50 percent (50%) of my net
estate to my daughter, Mary Lee scott, 25 percent (25%) of my net
estate to my son, Ernest R. Scott, Jr., and 25 percent (25%) of my
net estate to my son, Harry Winston Scott, on the condition that
Harry Winston Scott presents himself to the Executrix within 180
days of my death, provides the Executrix with a mailing address,
and cooperates with the Executrix so that the estate may be
settled promptly. Failure of my son, Harry winston Scott, to
fulfill any of these conditions will result in the forfeiture of
his bequest on the 181st day, and that 25 percent (25%) shall then
be divided equally between Mary Lee Scott and Ernest R. Scott, Jr.
ITEM III. I direct that any and all Inheritance, Estate and
Transfer taxes imposed upon my estate passing under my Will or
otherwise, shall be paid out of the principal of my residual
,~ estate.
1
ITEM IV. I appoint my daughter, Mary Lee scott, Executr ix of
this my Last will and Testament. In the event of her renunciation,
death, resignation or inability to act for any reason whatsoever,
I appoint my son, Ernest R. scott, Jr., Executor of this my Last
will and Testament. I relieve my Executrix or Executor from the
necessity of posting security in connection with her or his duties
as such in any jurisdiction in which she or he may be called upon
to act.
IN WITNESS WHEREOF, I have hereunto set my hand to this my
Last Will and Testament, which consists of two pages, to each of
which I have aff ixed my signature this -2O'l'ctay of /t..J' t /
one thousand nine hundred and seven (1997).
.--; l '1:z.2 7:/
1/ ~-vu1 ." _ ;P,. S,,~ :t;
Flainder Lee Scott
2
'I
II
II
COMMONWEALTH OF PENNSYLVANIA
COUNT' OF ~ss . . _ .
We, Flainder Lee Scott, and '-I71~ t. f1{;.<--JfJ~- and Mary
Lee Scott, the testatrix and the wifhesses respect~vely, whose
names are signed to the attached or foregoing instrument, being
first duly sworn, do hereby declare to the undersigned authority
that the testatrix signed and executed the instrument as her Last
Will and that she had signed willingly, and that she executed it
as her free and voluntary act for the purposes therein expressed,
and that each of the witnesses, in the presence and hearing of the
testatrix, signed the Will as witness and that to the best of
their knowledge the testatrix was at that time eighteen years of
age or older, of sound mind and under no constraint or undue
influence.
7~*kf!!~
~7 ~~
wi tness '-
'?;ltA;;~~
W~tness . .
A;a/~t seAL
WENDY S. CaY, NCh:lry Public
Nl.ar"fi~tl. B~ro. Vony CrJ,'Jllly, PA
My CUr:h"1l~OO Expll's:: IIpvil 7,2001
3
MAILING DATE: July 1. 2000
District: 13 - LOWER ALLEN TOWNSHIP
School..: WEST SHORE SD
Location:
5210 ROYAL DRIVE
WINDSOR PARK
LOT 6 BLK A PL 3 PB 12 PO 23
TAXABLE
UNIT/~T ID..= Lw0006
Land Size....r .19 acres
'Property Type: R
Re6idential With Buildings
Control No: 13002493
THIS IS NOT A TAX Bill
Parcel Identifier:
13-24-0793-141.
2000 Assessed Value Old Assessed Value
Mar1<el Value (2000 Mar1<el x 100%) (1974 Mar1<et x 25%)
land 23,020 23,020 930
Buildings 87,040 87,040 6,590
TOTAL 110,060 110,060 7,520
2000 Clean and Green Values
Land NOT NOT NOT
Buildings APPLJ:CABLE . APPLJ:CABLE APPLJ:CABLE
TOTAL
Clean and Green values apply to some farm and forest land. Such values
become effective only upon application and approval. All applications must be
receivea by the Assessment Office by 4:30 p.m. on October 15, 2000. Those
previously approved for Clean and Green do not need to re-apply.
CUQDLHNT
1974 value (the .Pre-Determined Rado?; < ~~iieV(:taf Ilse Year'pdii be. "~.Ve'a;2006, With tilf?new.aSsesseiJ v8lues
becoming effective for the 2001 tax year. The Pre-De/ermined Ratio has been changed to 100%. Your new assessed ,'due
equals your Year 2000 market value. : .' /,.'.'
-'.-..,." ';..:', ".\' ,< '.'
It is very Important for you to know that when the new 2000 tax base Is determIned after this reassessmen~ all taxing
districts are requIred by law to lower the millage rate by tile same proporf/onthat the tax base .~nt up. The law
provides that in the first yearafterreassessmenl;(200tJ, the.county,and all.townships and boroughs may not Increase overall
revenue by more than five percent (5%) and school districts may not increase overall revenue by more than ten percent (10%).
The county and the other taxing bodies will make these decisions next year,and may choose not to increase overall revenue.
Of course, some individual's taxes will go up or down by fJiore than those percentages..The essential point Is that an
Increase In market values does not necessarily mean'a corresponding Increase In taxes. Individual changes In taxes
will depend upon a speCific property's change as compared to the overall change for the taxing district.
The ESTIMATED impact statement printed below is our best estimate of change, based on 2000
COUNTY tax figures. This estimate does not include any borough,township, or school district impact.
CUrrent 2000 County mills =
Adjusted 2000 County mills =
27.500
1.858
ESTIMATED COUNTY TAX J:MPACT.
$
$
207
204
2000 County Tax BEFORE Reassessment,
2000 County Tax AFTER Reassessment.
*'
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF PUBUC WELFARE
BUREAU OF FINANCIAL OPERATIONS
TPL SECTION - CASUAL. TV UNIT
PO BOX 8486
HARRISBURG PA 17105-8486
January 28, 2000
STATEMENT OF CLAIM SUMMARY
NAME
10 ~
Estate 01 SCOTT, FLAINDER
030022441
MEDICAL CLASS 3 CLASS 6 ~ TOTAL
INPATIENT .00 1,476.00 1,476.00
OUTPATIENT 1,871.22 1,157.42 3,028.64
LONG TERM CARE 16,425.41 157,618.80 174,044.21
DRUG 453.93 1,267.34 1,721.27
REIMBURSEMENT TO DPW 18,750.56 161,519.56 180,270.12
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF PUBLIC WELFARE
EIN - 23-6003113
PETITION FOR PROBATE & GRANT OF LETTERS
Estate of Flainder Lee Scott
also known as Flainder L. Scott
No.
21-01-190
To: Register of Wills for the
County of Cumberland
Commonwealth of Pennsylvania
, deceased.
Social Security No.
228-28-6900
The Petition of the undersigned respectfully represents that:
Your Petitioners, who is/are 18 years of age or older and the Executrix named in the Last Will of the
above decedent dated May 20 ,1997, and codicils dated none, 19----,- The
Executor named none died Renunciations for
none attached hereto.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or principal
residence at 5210 Royal Drive, Mechanicsburq
Decedent, then ~ years of age, died October 11 , 1999, at
Claremont Nursinq & Rehabilitation Center
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the Will offf:red for probate; was not the victim of a killing and was never adjudicated
i ncom petent:
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 PA
(If not domiciled in PA) Personal property in County
Value of real estate in Pennsylvania, situated as follows:
5210 Royal Drive, Mechanicsburq, PA 17055
$200.00
$
$
$110,000.00
WHEREFORE, Petitioners respectfully requests the probate of the Last Will and Codicil(s) presented
herewith and the grant of letters testamentary thereon.
Signature(s) and Residence(s) of Petitioner(s):
.~ Uc.iC
Ma e Scott
52'1 oval Dnve
Mechanicsburq, PA 17055
7H-766-5758
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
ss
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 of
the above decedent, petitioner{s) will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed
before me this 16th day of
February,2001.
- J7 ~. SftC
M7;jlee Scol!
. ~. f.
-L?:7lt/f/ (fl." "LLGv!.v.t.!.i.liJt/, J,i<.a-.6./
)' ./ / / RegIster I
/. .
~o. 21-01- 190
Estate of FLAI~DER LEE SCOTT a/k/a
FLAI~DER L. SCOTT , deceased.
DECREE OF PROBATE & GRA~T OF LETTERS
AND NOW, February 20th , 2001, 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 Mav 20, 1997 described therein be admitted to probate and filed of record as the
Last Will of Flainder Lee Scott a/kJa Flainder L. Scott ; and Letters
Testamentary are hereby granted to Mary Lee Scott
">>-;l2"'r (J J!j!/ I/I'~" ) ,.t!," d*nZd
Ister of Ills f
/ -. .
FEES
Probate, Letters, Etc. . . . . . . . $ 235.00
Short Certificates(none ). . . . $
Renunciation(s) . . . . . . . . . . . $
JCP . . . . . . . . . . . . . . . . . . . . $ 5.00
OthE~r Will Paqes (2) . . . . $ 6.00
TOTAL: .... $ 246.00
Filed. . . f~pJ:'.u.a.r:y .\Q! .2001. . . . . . .
60 West Pomfret St., Carlisle, PA 17013
ADDRESS
717 -249-2353
PHONE
,----""
H105.905 REV.(09/00)
This is to certify that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records In accordance
with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
~II~
(=\~5.~/~.
Robert S. <ZiuJnerman, Jr., MPH
Secretary of Health
Charles Hardester
State Registrar
1409700
MAR 0 1 2001
Date
UI
;r:,x
C:~TED ITEMS: # 17 c , d
H1DS.!43 Aev.1'~,1: FD DATE: 2/27/01 cj d COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
100925
TYPElPRINT
IH
PERMANEHT
BLACK tNK
87 v..
f-'
UNDER 1 0J(:t
~l--
sex
2. Female
STATE FILf NUMBER
SOCIAL SECURITY NUMBER
3.228
NAME OF DEceOENT (FIfSf. Middle. L.asa:)
1.r 1-- 4 flJ b E R-
AGE (last Birthday) UNDER 1 YEAR
........ [Joys
BlRTHPIJ.CE tcity ar.d PlACE OF DEATH (CI>edl only one '>4Ml,l'lSlrucbOftS on 0It'Ier SlCJet
Stale Of FCf8lgl'l Country) HOSPITAL:
Berryville Va ,__0
1. ...
FACIlITY NAME (It!"l(l( 1I"ISMul1Ofl. give streel and number!
=.." 0
s.
COUNTY OF DENH
~I
Cumberland
Middlesex Twp.
...
KINO OF BUSIHESSltHOUSTRV
...
~
~
Ii!
:rl
o
...
o
w
~
~
z
5210 Royal Drive
l~echanicsburg, Pa
FRHER'S NAME (First. Middle. L'"'I
Robert Lee
11.
INfORMANT'S NAME (T ypetPrinll
.... Mar L. Scot t
METHOD OF DtSPOSITW-
O ......H c..........O
DonMion CltMf (Spec
. 21L
SIGNATURE
,71>.
MARITAl STATUS. M8nied SURVMNG SPOUSE
Ne\.wManied, WidowMd. (I'MIe. gr..erNlderl~
--
,.. Widowed
"" '1eK] ,...__...... Lower Two.
--
tiwin.
Cumberland _, l1d.L::"'-=':::..
MOTHeR'S NAME jFut. Micldle. Malden Surname)
... Unknown Vinney
WFORMANrs MAIUNG AOOAESS (Slfeel. CityflOwn. Stale. Zip Code)
~ 5210 Ro al Drive Mechanicsbur Pa 17055
PLACE OF DISPOSITION. Name of Cemetety. Crematory lOCRlON - CitylTown. Stat.. ZIp Code
orOlhef ~
1999 22~mb. Valley Mem. Gardens
NAME AND ADDRESS OF FAClUlY
23c.Ronan Funeral Hare 255 York Rd. Carlisle, Pa 17013
LICENSE NUMBER DATE SIGNED
3 qq I L _.Doy.-'
012- 23b. IVJ - i 4J - 23c. .0 It (
W\S CASE REFERRED TO:O EXAMINERlCORONEA? No~
21.
I App'o;cimat. PART I: Othefsic)niftcantCCllldMionsconb'llutinglOdHttI. but
:=-= ~ rwultinginthe~c-.QivleftinPMTI.
I
i
.....
DECEDENT'S USUAl OCCUPAJlON
(~wcwtc~~~=~:f
11.. Housewife lib. Homemaking
DECEDENT'S MAtLING ADDRESS (StfMl. atyfl"own. Stale. Z"IpCodel DECEOENrs
ACTUAl.
RESIDENCE
(See"","""",,"
on__
17055
_.
Moten, Sr.
~
v
C/(;
-.J.
t :
d.
RENA\.... ~A\........"'E
DUE TO(OR AS A CONSEQUENCE Of):
\'\ "'~E'r\."\e.J$1 0..1
DUE 10 (OR AS A CONSEOUENCE Of):
DUE 10(00 AS A CONSEOUf:NCE Of):
WERE AUlOPSY FlNOINGS MANNER OF DEATH
AWlASLE PRIOfII TO
COMPLEllON OF CAUSE ........ 13 -- 0
OF OERH?
- 0 Pending irwMtiglltion 0
YooO NoKl Suicido 0 Could not be deJermioed 0
DATE OF INJURY
[MOI1!1"t. Oey. ..)
TIME OF INJURY
INJURY /Iil WORK? OESCRtBE HOW INJURY OCCURRED.
,.. 0 NoD
3CM. 3Gb. M.
PlACE OF INJURY. AI home. farm, street factofy. offic.e
building.ek:'.(Specotv}
2eI. 2... 21. 3Oe.
CERTiFIER (Ct1ec:k ClrIiy ooeI
.~~=,:;:=::::~ C:C~f~ca=:, :,a~-=.:=::--n:'= =:~rad death ana Ccwnpteled nem 231 0
'PRONOUNCING AND CERTIFYING PHVStClAN (PtlySICraf'l both pt:lflcuoc:ng cealh and Cer1l1Vlr'19 10 cause 01 deatt-l
To the ~ ot my knowledge. death OCC.....," ilt the 1m.., dilte. and place, and due 10 the cawM(s) ilnd ,.,.nner as stilled.
[gj
33.
DAlE FILED (Month Day_ ~all
I 701- :>
.UEDlCAl EXAMINEAiCORONER
On the be... of examination and/or Investigation, in my opinion, death occurred al the time, date, and place, and due 10 Ihe C8Use(S) and
manner a. stilted.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
31&.
33. REGISTRAR'SSIGNATUREAN~~ "'. ~...... t\4-- \ ....~
~ M '"'\........c.X\.~'"^'~ IdJ 11d.1\ 10i
o
30.
'&6',
\3, I \ q 99
21-01-190
LAST WILL AND TESTAMENT
OF
FLAINDER LEE SCOTT
I, Flainder Lee Scott, of the Cumberland County Nursing Home,
Carlisle, Cumberland County, Pennsylvania, being of sound and
disposing mind, memory and understanding, do make, publish and
declare this to be my Last Will and Testament, hereby revoking all
Wills and codicils heretofore made by me.
ITEM I. I direct that all my debts and funeral expenses,
including my cemetery lot and gravemarker and all expenses of my
last illness, shall be paid from my residuary estate as soon as
practicable after my death as part of the expense of the
administration of my estate.
ITEM II. I devise and bequeath 50 percent (50%) of my net
estate to my daughter, Mary Lee Scott, 25 percent (25%) of my net
estate to my son, Ernest R. Scott, Jr., and 25 percent (25%) of my
net estate to my son, Harry Winston Scott, on the condition that
Harry Winston Scott presents himself to the Executrix within 180
days of my death, provides the Executrix with a mailing address,
and cooperates with the Executrix so that the estate may be
settled promptly. Failure of my son, Harry Winston Scott, to
fulfill any of these conditions will result in the forfeiture of
his bequest on the 181st day, and that 25 percent (25%) shall then
be divided equally between Mary Lee Scott and Ernest R. Scott, Jr.
ITEM III. I direct that any and all Inheritance, Estate and
Transfer taxes imposed upon my estate passing under my Will or
otherwise, shall be paid out of the principal of my residual
. "'. estate.
1
ITEM IV. I appoint my daughter, Mary Lee Scott, Executrix of
this my Last will and Testament. In the event of her renunciation,
death, resignation or inability to act for any reason whatsoever,
I appoint my son, Ernest R. Scott, Jr., Executor of this my Last
Will and Testament. I relieve my Executrix or Executor from the
necessity of posting security in connection with her or his duties
as such in any jurisdiction in which she or he may be called upon
to act.
IN WITNESS WHEREOF, I have hereunto set my hand to this my
Last will and Testament, which consists of two pages, to each of
which I have affixed my signature this -2()~ay of A.~ ;'
one thousand nine hundred and seven (1997). JV
,/'7/ ., ~ ~
/ / A--(/VLd-_f"~. n . l Y.. ,'7 X-~.
Flainder Lee Scott
2
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF
ss
~. '.'"
We, Flainder Lee Scott, and c(}laiJ, (; [li..~~ and Mary
Lee Scott, the testatrix and the wi esses respectively, whose
names are signed to the attached or foregoing instrument, being
first duly sworn, do hereby declare to the undersigned authority
that the testatrix signed and executed the instrument as her Last
Will and that she had signed willingly, and that she executed it
as her free and voluntary act for the purposes therein expressed,
and that each of the witnesses, in the presence and hearing of the
testatrix, signed the will as witness and that to the best of
their knowledge the testatrix was at that time eighteen years of
age or older, of sound mind and under no constraint or undue
influence.
rJLH/f~kCj 5~
37)(7 Itu-. s,Co-cc
witness _ ~
'--7/tVl?~ ~-
Wltness .~
r-
JA~y
~ N .,~.:;.:t,L SEAl
'-"'END'j S. L~Y, Nero.),.,. Public
. Mory>vil\.e Bora. P;'lf!)' C./Jrllnfy, PA
. My Ccr:w"f!.zkl" b..f:.,i!s~ 1\1'111 7, 2001
:-......-"""'.
3
E
-
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
FLAINDER L. SCOTT
Date of Death:
October 1 L 1999
Estate No.:
21-01-0190
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 March 14,2001
.Name
Address
. Mary Lee Scott
Ernest R. Scott Jr.
5210 Royal Drive, Mechanicsburg, P A 17055
5210 Royal Drive, Mechancisburg, P A 17055
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Harry W.
Scott (whereabouts unknown).
Date:
03/14/01
OJ
,/{,/LU\ /?). ~ <
Signature ~.)
IRWIN, McKNIGHT & HUGHES
Name Roger B. Irwin, Esquire
Address 60 West Pomfret Street
Carlisle. PA 17013
Telephone (717) 249-2353
Capacity:
Personal Representative
~ ,..-:1
x
Counsel for Personal Representative
",." '-..-"
~
STATUS REPORT UNDER RULE 6.12
\-.-"'.
Name of Decedent:
FLAINDER L. SCOTT
Date of Death:
OCTOBER 11. 1999
No. 21-01-0190
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: -L 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 ---L- No
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties
in interest? x Yes No
d. Copies of receipts, releases, joinders and approvals of formal or informal
accounts may be filed with the Clerk of Orphan's Court and may be
attached to this report.
Date:
9/12/02
/"~-J4 /) ~
Signature '(:j .
IRWIN, McKNIGHT & HUGHES
Roger B. Irwin. Esquire
Name (please type or print)
60 West Pomfret Street
Address
Carlisle. P A 17013
City, State, Zip
(717) 249-2353
Telephone Number
x
Personal Representative
Counsel for Personal Representative
Capacity:
Cumberland County - Register Of Wills
Hanover and High Street
Carlislel PA 17013
Phone: (717) 240-6345
Date: 9/04/2002
IRWIN ROGER B ESQ
60 W POMFRET ST
CARLISLE I PA 17013
RE: Estate of SCOTT FLAINDER LEE
File Number: 2001-00190
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 I NO.
103 SUPREME COURT RULES DOCKET NO. 11 for decedents dying on or after
July 11 19921 the personal representative or his counsell within two
(2) years of the decedent's deathl shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing will become delinquent on: 10/11/2002
Your prompt attention to this matter will be appreciated.
Thank You.
SincerelYI
&~ m.fJtbr/df)~ IW
MARY C. LEWIS ~l?~
REGISTER OF WILLS
cc: File
Jpersonal Representative(s)
Judge
'\, /6 -C::;/I- 3
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
ROGER B IRWIN ESQ
IRWIN ETAL
60 W POMFRET ST
CARLISLE
~~.: "-'
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
06-05-2001
SCOTT
10-11-1999
21 01-0190
CUMBERLAND
101
~~*
REY-1547 EX IFP 1l2-DDI
FLAINDER
L
Allount Rellitted
PA\17013
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=is47-EX-AFP-n'2:iioY-NOTicE--OF-YNHEiiiTANCE-TAX-APPRAYSEifENT~--AiroiANCE-'ifR-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF SCOTT FLAINDER L FILE NO. 21 01-0190 ACN 101 DATE 06-05-2001
TAX RETURN WAS: (X) ACCEPTED AS FILED
) CHANGED
14, 15 and/or 16, 17, 18 and 19 will
returns assessed to date.
.00 X 00 = .00
.00 X 06 = .00
.00 X 00 = .00
.00 X 15 = .00
(9)= .00
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. Hortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
U)
(2)
(3)
(4)
(5)
(6)
(7)
110,060.00
.00
.00
.00
1, 332 .15
.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H)
10. Debts/Hortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
UO)
7,819.09
180.270.12
(1)
(2)
(3)
(4)
NOTE: If an assessment was issued previously, lines
reflect figures that include the total of ALL
ASSESSMENT OF TAX:
15. Allount of Line 14 at Spousal rate (15)
16. Allount 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: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
111,392.15
188.089 ?l
76,697.06-
.00
76,697.06-
PAYHENT RECEIPT DISCOUNT (+) AHOUNT PAID
DATE NUHBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .00
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 PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A Rl=l=lINn ~I=I= RI=VI=R~1= ~Tnl= nl= THT~ I=nRM I=nR TN~TRIlr:TTnN~_l