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HomeMy WebLinkAbout01-0198 REV-'500EXI6-00l COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 OFFICIAL USE ONLY '7~ ( G ~LL --U~~~--- FILE NUMBER 2/-Ll/ COUNTY CSDE YEAr w "' :ll:~(I) "",,,, w"-" ",00 "",~ "-,,, "- .. INHERITANCE TAX RETURN RESIDENT DECEDENT --i---2tf':' NUMBER I- Z W C W o w c DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) hi Ii' ,,- -05 -l. E f1lfL- S~ DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 5'-.;10 - oJ-tXJo /- /.;? - /f'0& (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST. AND MIDDLE INITIAL) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER SOCIAL SECURITY NUMBER ~o~ - If? - 7,Fyo G:r1. Original Return D 4. limited Estate o 6. Decedent Died Testate (Attach copy o/Will) D 9. litigation Proceeds Received D 2. Supplemental Return D 4a. Future Interest Compromise (date of death after 12-12-82) D 7. Decedent Maintained a living Trust (Attach copy of Trust) D 10. Spousal Poverty Credit (daleo/death between 12-31-91 and 1.1.95) D 3. Remainder Return (dale of death prior to 12-13-82) D 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113(A) (Mac/1 Sc/1 OJ "' z w c z o "- '" w '" '" o " GT E, FIRM NAME (If Applicable) COMPLETE MAILING ADDRESS (I1['S MftR'fJli'E:T E W.4RII1I(&SSc'~ -:os / ,:5 f1 A./E wc;{:, .__) D,If. S'ftlf.'Ert1A-I\.JSTbt.J,tJ -;}/1 J7c>// , TELEPHONE NUMBER I 7- 7& /- .R 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (1) (2) (3) (4) (5) OFFICIAL USE ONLY 4. Mortgages & Notes Receivable (Schedule D) yyV d_!' z o 3 ~ I- 0: <( o w 0:: 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Adrninistrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (9) (10) d (,.s~ '70 (6) (7) (8) CjcjVf)3 11. Total Deductions (tolal Lines 9 & 10) (11) ;/(,.5- '10 (12) 7A 2. / J (13) - (14) 7A.f. 13 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 (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o !;( I-' ~ Il.. :::E o o ~ 15. Amount of Line 141axable at the spousal tax rate. or transfers under Sec. 9116 (a)(1 .2) x.O~ (15) x .orr (16) x .12 (17) x .15 (18) (19) .301.77 7r2/? /-3 3dl7 16. Amount of Line 14 taxable at lineal rate 17. Amounl of Line 14 taxable at sibling rale 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT STATE 'fJ/I 70S6- Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) ,~;;;. 77 Total Credits (A + B + C) (2) 3. InteresUPenalty if applicable D. Interest E. Penalty 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. (5) (5A) J~.77 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT Jdl7 , 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 ofthe property transferred;...... ............................................................. ...... D [j{] b. retain the right to designate who shall use the property transferred or its income; ........ .................................. D [l{] c. retain a reversionary interest; or ............................................... . ....................................................................... D [RI d. receive the promise for life of either payments, benefits or care? ...................................................................... D ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .......... .......................................................... ........................................ D IKI 3. Did decedent own an "in trust fo~ or payable upon death bank account or security at his or her death? .............. D CRI 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .......................................... ........................................................ . .................. D ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 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 atl information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ~t;;t. Ua~''''A,L ADDRE /J ' J /.1 I;''''''''A~) j{).,. ~..wm.~,.~-,4~ SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ' DATE 3~/y-o/ , rf] /7,.}// DATE ADDRESS 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 P.S. ~9116 (a) (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. ~9116(a)(I.2)J. The tax rate imposed on the net value of transfers to orlor 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 tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. ~9118(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. ~"~".":". COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF LI'f/f'i- S tJAR/l1k"'G" 556'- FILE NUMBER ,.;;=;- 00/ 9''? 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 If!crLIvD FRom /iseURY ."\f-RVIC:IS'" /1V<c v AFF//_jF'lTE~ 1-11-0; o(ErUJlID FjJbJIJ ';RAi)'~L~R.5 /J,::;.,JIf:i?lY C;:L5UIti-IY - .-.2-/':;~OI VALUE AT DATE OF DEATH C;;;q; ,,",'3 3d c.'() TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) '79v. 03 REV.1511 EX+ (12-99) ~: . ~.'~" , . ., SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER dCO/~ CO /fJ" EST/l.TE OF Cl'ltfL s: l!-9If'p?f(CSSC& Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1 / J/ornE fA ",T/fE rno/{'G rV'o/EtfAL J,;) t/ /0 B. ADMINISTRATIVE COSTS: 1 Personal Representative's Commissions Name 01 Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State _____ lip Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant i7A I{'CUIIf'G: r E /v'1lA'!11,yO:;SSEI- Street Address -3 ;.3 /1/lv6 VV'OG't::J ))/t' ~ State /1;2_ Zip City c,) H IIf<3fi 194/" l{)?U,,) / 70 // Relationship 01 Claimant to Decedent ;)I1UGdTG,if' - IN - L/9 n/ 4. Probate Fees ~ c; _ 00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. rEG f;,)HEI{'/ll1A/(.C - Q /~ GO FOIf FIUA/w //17< /) G 7U;f' JJ TOTAL (Also enter on line 9, Recapitulation) $ ;?&0~'1C (If more space is needed, insert additional sheets of the same size) :EV>51""::"'. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF CAlfc S' I I VVARI17/"",6.::'-S~L FILE NUMBER ='!c:t?/-OO/9'P RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not ListTrustee(s) OF ESTATE NUMBER I. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1. IYlflI'01U?ET E' Wfli\'mlr'655EL- ? 3 /} -:\ _~/, t-/IUE. /A..{)CD Ut:. 0/4 If.'Emft.u"S -, btt),tJ 1';:; / Jail j)fiJ6I'/i7:lf- /.v- LA,J lc1f /3 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II. 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) PETITION FOR PROBATE and GRANT OF LETTERS Estate of ~A,(L S. j;JfilffY}I)IZ~G'- also known as No. To: Register of Wills for the , Deceased. County of C t/ /J16~1f' '-If /V ;0 in the Social Security No. doF-/f-7r},:(:7 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the executtflJ<. in the last will of the above decedent, dated /02 -;,J ~ - 7/ and codicil(s) dated 21-01-198 named , 19--2L'- (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in C (; = L i) County, Pennsylvania, with h /.5;. last family or princi~al residence at DC /"/7, 'T/(/ Y V / L L..17 ~ C _ 3cJS- WL.~SLE Y../J1i' It;;;:cl//J,1//C-S ~fl,fG >> / 7jS S ) ) (list street, number and muncipality) ./7, 1/. ..,/ ,~+90cJO Decendent, then ~t-- years of age, died ~2.1./ u ~_ at Bb 1/1111\/ V V I LL f)6C Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: $ 9'rw. oJ $ $ $ WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters 7bSTlfm~lC/ r /9;(,'1 (testamentary; administration c.La.; administration d.b.n.c.t.a.) theron. ~ '" <1 u c <l) ~3 <l) ... ~<l) c ",,0 ='~ t:d '.0 ~<l) ",0.. <1,- ;0 O:i c OJ) Vi OATH OF PERSONAL REPRESENTATIVE COMMONWEAIJTH OF PENNSYLVANIA 1- ss COUNTY OF' CIJ/Yl15f'3IfLlUJP J 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 represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. ~ ' ~ !Jz .~ J2- I~~~il C. W7j~~T~t- ..3 /3 ~~ WOO.LJ K'. s;- H / "::- /J/tI'S IOtJ,V" //1 /70// affirmed and 8th en aQ' ::s l::l .... l:: ~ ~ /~ -_/,/ /- /) No. 21-01-1998 Estate of EARL S WARMKESSEL , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW FEBRUARY 21 ~200 1 , 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 December 24. 1991 described therein be admitted to probate and filed of record as the last will of EARL S WARMKESSEL TESTAMENTARY and Letters are hereby granted to MARGARET E WARMKESSEL ~ J~ <Y;_'~LU~j&u/jJ/ ~/ory egister 0 f Wills / FEES JCP $ 18.00 $ 3.00 $ $ 5.00 TOTAL _ $ 26.00 , . . FEB. . 8.,. .200.1 . . . . . . . . . . . . . . . . . Probate, Letters, Etc. ......... Short Certificates( ).......... Renunciation ................ ATTORNEY (Sup. Ct. I.D. No.) ADDRESS Filed ! . PHONE ~~~~ -.-- ~:) -oJ " , "- HlO).80S REV 9136 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 Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. ......'..... No. a..-~R~ Fee for this certificate, $2.00 p 6761203 AUO 2 3 2000 Date 21-01-198 ~ Aev. 2187 COMMONWEALTH OF PENNSYLVANIA. OEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH 94 UNDER 1 YEAR -- Days SEX 2. male STATE FILE NUMBER SOCtAl SECURITY NUMBER .. 208 _ 18 _ 7890 ~() NAME OF DECEDENT (Fits!. Middle. Lasll 1. Earl S. Warmkessel YNI. UNDER 1 DAY Hours ! WInul_ PL\CE OF DEArH (Ct\edl; ClflPf one i8e iflSlrucllOflS on other SlOe) HOSPI~ 1__0 OOAO g':"."0 AGE (Las! Birmday) S. COUNTY OF OERH .... Cumberland OECEDEKT'S USUAl OCCUPRION (~:o,~~=~~:r . l1i:al estate salesman llb. DECEDENT'S WAIliNG ADDRESS (SIr.... CiIy/Town. Slate. r", C_l 325 Wesley Drive ,ll.echanicsburg, PA 17055 FATHER'S NAME (First, Middle, Last) 11. Claude Warmkessel INFORMANT'S NAME (fYPWPMI) . Mar aret Warmkessel WETHOO Of DISPOSITION _ n C'......ion 0 Romovall,om St.,.O 0t/l0< <SI>o<dYl SERVICE UCENSEE OR PERSON ACTING AS SUCH DECEDENT'S ACTUAl RESIDENCE (See instrualOl1l on olhef side) Cumberland I);d - liYe in a township? 17d.O ::::-h=of MOTHER'S NAME (First. Middle. Maiden Sutname) 11. Cora A. Heckman INFORMANT'S MAOUNQ ADDRE~\SlI"',<t<v'"-'.]\plo l",C~ 313 Pinewood Drlve.~hiremanstown, PA 17011 PlACE Of DISPOSITION. N.... 01 C_otY. Cr.m.tory LOCR1ON. CIIy/bwn. Stale. Zlp ~ or Ochef Ptace Schuylkill Memorial Park Schuylkill Haven, PA 21c. MARITAL STATUS. w_ N....... Man,", 'Mdowed. DNorcod (Speedy) ... widowed 17..IXI....__.. Lower RACE. A.mencan l1'Idian, Black, White. etc. (~I 10. white SURVIVING SPOUSE tl1 WIfe. gIve maiden name) 17b. Coun city~ .. c NAIAE ANI) AOOlIESS OF fAC\llt'( rthemore FH&CS, Inc., New Cumberland PA 17070 :~e~r211;~-~~~L;( WAS CASE REFERREO 10 MEOfCAL EXAMINERICOAONeR1 ----rz...---.~ Yea 0 No~ ~. , ~zima1. :=== I I I _~d._~~_..____----o--__ o------..--~--- - -- - ....-- --- ---- MAT.: -- - -- - - - - - Other ~ condtIiorw concributlng to de.th, but not rwuking in the undertying cauM given in PART I. DUE 10 tOR AS A CONSEOUENCE OF): \ : d. WERE AUTOPSY FINDINGS ~PRlORlO COMPLETIOH OF CAUSE Of DEMH? DUE 10 (OR AS A CONSEOUENCE OF): DUE 10 (OR AS A CONSEOUENCE OF): Acctdent ~ o o DATE OF INJURY \Mooth. Qay. Year) TIME OF INJUAY INJUAY AT WORK? DESCRIBE HOW INJURY OCCURRED. WANNER Of DEATH YosO NoD Suicide Pending Invesligadon Could not ~ delermlned o o o ~CE OF INJURY. AI hom.. I.rm, str.... faciOf'!. offic. buifding. -'C. ISpeclfvl 300. Yea 0 NoD Nalural Homicide NOli' M. 30<, RAA'SSIG~~ ....,1_~J.-:Y~J'Z-.- ~/ ~I /.. /1 301. :::~ATUREAND:T~~~_. . o LICENSE NUMBEO ~ (, <f V ( l:~5K)Ne~t~l/ufl ~~~ NAME 0 AOORESS OF PERSON WHO COMPLETED CAUSE QF(le.(rH" . (Item 27) Type 0< Prinl lI'l. s.cLuvL.'1t...... o 3~. Yl( ~~':;nJf /1-1 DATE FILED (Monlh Dav. Yeal) ]Ca- _ '-fo-Z -<.:{ -f~ J 7 0 II 2111. 28b. ClRTIFIEJt (Check only one) .CeRTIFYING PHYSICIAN (PhYSICian certlf'J'lfllJ cause 01 dealh when anOUlef phvSIClan has plooouncea Clealh ana corn~led lIero 23i To the beet 0' my knowlecfge, death oct:urNd due \0 the c.auH(.) and mann.r.. a..ted.. ................ ~. -'RONOUNCING ANO CERTIFYING PHYSK:IAH (PhYSICian both pronOt..rlC1ng aealh and Cet1dylng 10 cause of deattl) Tp the beet 0' my knowledge, death occurred at the tlm., dat., and place, and due to the cause(.) and manner aa slaled.. . .MEDICAL EXAMINER/CORONER . On 'he b..'. o1examlnaUon .ndlor inve.Usalion, in my opinion, d..th occurred at the lime, dat., and ptace, and due to the uuse(a) and manner....ated....,..."......,...... .......", ..... ..'.,.,...,.. ..... ......,...... ..,..."... .............,., ... 31a. 21-01-198 REGISTER OF WILLS OF COUNTY OATH OF SUBSCRIB~G WITNESS I I ! ' "" codicil / (each) a su~~bing witness to the will prese~ed herewith, (each) being duly qualified according to "', I law, depose(s) antl,~ay(s) that / present and saw , / i the testat , sign the's~U1e and tta / signed as a witness at the request of testat_ in h""pr~s ce and (in the presence of each other) (in the presence of the other subscribing witness( es))., Sworn to or affirmed and subscrib (i before me this day of 19_ (Name) ......,{Address) Register (Name) (Address) - -' REGISl'ER OF WILLS OF COUNTY OATH OF NON-SUBSCRIBING WITNESS -.-I!1fi (' (.,. If A e /- E... tv IT A" (7J J( E ~ S e L- (each) a subscriber hereto, (each) being duly qualified according to law, depose(s~ .apd say(s) that .::r- It/)') familiar with the signature of Eft/Pt. -S tJ!!iflJ;(CSSEL., codici testatl24-- of (one of the subscribing witnesses to) the will presented herewith and ~~icil ~the signature on the evs in the handwriting of ~ f SELIC-lIE /' E. If >f L'~ u.) It f( ()11{ eSSE L that to the best of /hY knowledge and belief. Sworn to or affirmed and subscribed before me this 8th day of \ FEBRUARY / ~ 2001 >:Jh'y~("4"",;$~/ 4wo/ Register ~ ' y / J _ }.,1 ~~ Ci>. 4/t:e.on.Jo~ / (Name) '-;\ ...E/3 f},VGWOOP lJ/e. ,-)Ii//f~m/7IJ~~!~:t //7 17~J / ) (Name) (Address) 21-01-198 REGISTER OF WILLS OF CLl In ~~A-NJ) COUNTY OATH OF SUBSCRIBING WITNESS CAaJ-/e.s e. SAI ~ Ids 7L codicil (each) a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that fe wa.5 present and saw E,4-/eL S, /A)1f/(IJJ~cSScL the testat Dr , sign the same and that he signed as a witness at the request of testat 0 r in h I!". presence and (in the presence of each other) (in the presence of the other subscribing witness(es)). Swom to or afrmn~ and subscribed before me this / f day of r~~ .. 3Jn~/ t'-~~_ c:xf iJ~ ~,gi6'" NOTARIAL SEAL ~,.Qi Linda L. Willis, Notary Public Borough of Mechanicsburg, County of Cumberland My Commission Expires Sept. 11, 2003 -~~~:tJ7 (Name) . " (!/&J"~ Rd, Hlech2nlcs 6U;Q , j/A /1oSr (/ (Address) (Name) (Address) REGISTER OF WILLS OF COUNTY OATH OF NON-SUBSCRIBING WITNESS c. r-~, . (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that familiar with the signature of . codicil will presented ~erewith and codicil believes the signature on the will is in the handwriting of of (one of the subscribing witnesses to) the testat that to the best of knowledge and belief. Sworn to or affirmed and subscribed before me this day of 19 Register (Name) (Address) (Name) (Address) LAST WILL AND TESTAMENT OF EARL S. W ARMKESSEL I, EARL S. W ARMKESSEL, of Lower Allen Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all prior Wills by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can conveniently be done. 2. All the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situate, I give, devise and bequeath to my beloved daughter-in-law, Margaret E. Warmkessel. Should she predecease me, then in equal shares to my two (2) granddaughters, Karen E. Warmkessel and Lois M. Gaul, wstiqJes. 3. I nominate, constitute and appoint my daughter-in-law, Margaret E. Warmkessel, to be the Executrix of this my Last Will and Testament. In the event that she should predecease me or for any reason be unwilling or unable to act as such Executrix, I nominate, constitute and appoint my two (2) granddaughters, Karen E. Warmkessel and Lois M. Gaul, to be Co-Executrices in her place and stead. I further direct that they shall not be required to file bond or other security in the Office of the Register of Wills for the purpose of administering my Estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this e:l. <f~ day of ~ , A.D. 1991. ."~~--1/L~ (SEAL) Signed, sealed, published and declared by the above-named EARL S. W ARMKESSEL as and for his Last Will and Testament, in the presence of us, who at his request and in his presence, and in the presence of each other, have hereunto subscribed our names as witnesses. ~ E~:z;z- ~ 0( :s-~ \Ib-~//- // COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ~ * BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP el2-001 DATE ESTATE OF DATE OF DEATH FILE: NUMBER , \__1 COUNTY ACN 05-07-2001 WARMKESSEL 08-21-2000 21 01-0198 CUMBERLAND 101 S MARGARET E WARMKESSEL 313 PINEWOOD DR SHIREMANSTOWN PA 17011 EARL Allount Rellitted 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=is4-j-EX-AFP-fi1f':olff-NOTicE--OF-iNHEifiTitNCE-TA)rA-PPRA-isEifiNT~--Ai:.rowitirCE-OR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF WARMKESSEL EARL S FILE NO. 21 01-0198 ACN 101 DATE 05-07-2001 TAX RETURN WAS: (X) ACCEPTED AS FILED CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule 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. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets U) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 994.03 .00 .00 (8) NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 994.03 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/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax 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: (9) UO) 265.90 .00 Ul) (2) (3) (4) ?61i 90 728 . 13 .00 728 . 13 14, IS and/or 16, 17, 18 and 19 will returns assessed to date. .00 X 00 = 728.13 X 045 = .00 X 12 = .00 X 15 = (9)= .00 32.77 .00 .00 32.77 PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 03-20-2001 AA478186 .00 32.77 'J TOTAL TAX CREDIT 32.77 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 DI:~IINn ~c=c= DI:UI:Dc::.1: c:::.ynl: n~ TUYc::. c=nDM ~nD Tuc::.TDllrTTnwc::. \ ~ CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Earl S. Warmkessel Date of Death: AUijust 21, 2000 Will No. P. r\. 21 01-0198 Ad . N 2001-00198 mm. o. To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(aipf th~ O~Qans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on -,arCH U, 2001 : Nam~ Address Marparet E. Warmkessel 313 Pinewood Dr., Shiremanstown, FA 17011 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: Hay 25, 2001 >:rOdE J: j)a-r,..-'~ Signature Name Margaret E. Warmkessel Address 313 Pinev.'ood Dr. Shiremanstown, Fh 17011 Telephone717) 761-5278 Capacity: ~ Personal Representative _Counsel for personal representative /&-dl/-I/ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 05-07-2001 WARMKESSEL 08-21-2000 21 01-0198 CUMBERLAND 101 MARGARET E WARMKESSEL 313 PINEWOOD DR SHIREMANSTOWN PA 17011 ~ REV-lS.7 EX AFP <l2-QQl EARL S 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 -- REV::i5'4-i-Ex-AFP--[l"2---ooY-NO,.-icE--oF-INHER-iTAt.fcE-"AX-"A-PPRA-isEMENT-:--AL.rOWAtfCE-O-Ii------------ ----. DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF WARMKESSEL EARL S FILE NO. 21 01-0198 ACN 101 DATE 05-07-2001 TAX RETURN WAS: (X) ACCEPTED AS FILED CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) Z. 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. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 994~3 .00 i:'il 0 _" (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 Bequestsj Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 265.90 NOTE: To insure pro~ credit to your acco~ submit the upper por of this form with yo tax payment. 994.03 76lj qO 728.13 .00 728.13 NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of 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 = .00 728.13 X 045 = 32.77 .00 X 12 = .00 .00 X 15 = .00 (19)= 32.77 .00 ;}1l) ll2) (13) (14) . PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 03-20-2001 AA478186 .00 32.77 TOTAL TAX CREDIT 32.77 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 r:no ,......, ,...111 AT,..,."..I ,...... .I...............~..,......I.. ~......~............. IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. * IF PAID AFTER DATE INDICATED, SEE REVERSE __.... _____ ....- .. ....______.. 1__' ..,.-.. ....." *' COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE BUREAU OF FINANCIAL OPERATIONS TPL SECTION - CASUALTY UNIT PO BOX 8486 HARRISBURG, PA 17105 May 31, 2001 lVlRS MARGARET E WARMKESSEL 313 PINEWOOD DRIVE SHIREMANSTOWN PA 17011 RE: THE ESTATE OF EARL WARMKESSEL CIS #680 146 808 CO. & RECORD #21-0086757 DATE OF BIRTH: 01/12/1906 DATE OF DEATH: 08/21/2000 S.S. #208-18-7890 Dear Mrs. Warmkessel: This correspondence is in response to your letter of May 21, 2001. The Department of Public Welfare will accept your father-in-laws' estate balance of $695.36 as payment-in-full for its estate lien of $22,582.97. This is considered to be "@ to the value of the estate". Please left of the payable to: convenience. make sure that all bills are paid in full and whatever balance is $695.36 can be forwarded to our office. Your check can be made COMMONWEALTH OF PA - DPW. An envelope is provided for your Sincerely, 1(t;ll1'=':r'.~././/~ )~...~.."/ ,,7. I ' I,/'''' 'f' .. ~~.p ( /7., ~/ / /( /~;?;~/ /,/ t:c.c'~?c./~ /\\../;CZ / /~/ '~_....../ / 0' Elaine L. Andrews Claims Investigation Agent (717)-772-6608 (717)-705-8150 Fax ,JrvZ tLck: 1/7:.3 ..#;~ 9.5- J (; / v, / (y/f/() / ctv Commonwealth of Pennsylvania Department of Public Welfare Estate Recovery Program PO Box 8486 Harrisburg, PA 17105-9095 "t.\ .1 ~bllc ~_ A ~ f\~aIl':laJ O~ "&~ ~-v~~. ~uonlE.t~ ":~. ~ Qf.J JI,~~ .t~~d' 'I'll ..." ~ 1 ~ \ l '~A,( 2 2 2001 i ~ecei~e~ May 21,2001 ~ Attention: Elaine L. Andrews, Agent Re: Estate of Earl S. Wannkessel Dear Ms. Andrews: In reference to the above, my father-in-law lived as a patient under the Care Assurance Plan at Bethany Village. He had no assets. His only income was a check from social security the government sent directly to the home.. I'm enclosing a copy of the form received from the Bureau of Inlleritance Taxes. His estate balance is $695.36 Yours truly, 'fn~~ (;. iJ~ J' ~ -~ c:::I' Mrs. Margaret E. Wannkessel 313 Pinewood Dr. Shiremanstown, P A 17011 ~ "o,J tY / ;/ V STATUS REPORT UNDER RULE 6.12 Name of Decedent: E. A ~ t... S tv! A II fJ1 /1 G ss eo L- Date of Death: f} uc; .,,(' I. 01 ooCJ , Will No. PI) ~ / 01 - 0 I f I Admin. No. ,::;J 06/ - 00 / / / 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 V 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. I' "f ~ ,:;: il~->L Sig a re 0 (J!IlIt'GI9/,'EI L. ~.fiY/I(GSJ;6L. Name (Please type or print) 3/3 r?/l/i3WtJ()D Urf'.. S~/"'c /!7lt.(/SI7JtV/.)} /;-7 Addres s ' /7()/f Da te : J U... '/ ,f') ~ Od~ (7/l) )4,/- S::J }~ Tel. No. Capacity: / Personal Representative Counsel for personal representative (MAH:rmf/AM3) Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 Date: 7/03/2002 MARGARET E WARMKESSEL 313 PINEWOOD DRIVE SHIREMANSTOWN, PA 17011 RE: Estate of WARMKESSEL EARL S File Number: 2001-00198 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: 8/21/2002 Your prompt attention to this matter will be appreciated. ;\'] Thank Y~u. Sincerely, ~e.~/P<-~fJ~ MARY C. 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