HomeMy WebLinkAbout08-25-15 IN THE COURT OF COMMON PLEAS OF THE NINTH JUDICIAL DISTRICT
CUMBERLAND COUNTY, PENNSYLVANIA
IN RE: ESTATE OF ORPHANS' COURT DIVISION
ORVILLE CARVER, �
DECEASED
DOCKET NO. 21-15-0935
REGISTER'S CERTIFICATION OF TAX RECORD
FOR SMALL ESTATE
I, Lisa M. Grayson, Esq., do hereby certify the following information in regard to the Estate of
Orville Carver, date of death March 27, 2005:
REVENUE BALANCE
FlLING DATE AMOUNTPAID NOTICERECENED DEBT/1CREDIT
Inh. Tax Retum 8/19/15 0 Not yet Received ---
See attached copies of Department of Revenue documents for more detail. This certification is
made in accordance with the provisions of Local Rule, 611-2 (j)(4).
In wimess whereof I have hereunto set my hand and seal of
office, at Carlisle, Pennsylvania this 25th of August, 2015.
� M
`- "' Register of Wills and Clerk of Orp s' Court
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BureeuWlntllmtluai'ems CwnlyCotle Vae� FileNumber
vo eox xeosm INHERITANCE TAJ( RETURN
namseum. vnniae-oeo� RESIDENTDECEDENT � ( I� U���
ENTER DEGEDENT INFORMATION BELOW
Soclal Securlry Number oa�e of oealh mmoovvvv Oete of WrtM1 MMoorrrr
723-14-0981 �3272�15 12141927
�ecetlenCs Last Name Su(fix Decetlenl's Firsl Name M I
CARVER ORVILLE
p(Applicable� Enter Surviving Spouse's I�rformation Belaw
Spovses Last Name SuOix Spouse s First Name MI
CARVER LEAH W
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FIIL IN APPftOPRIATE OVALS BELOW
� �. OriglnalReWrn � 2. SupplementalReWm � 3. RemainaerRetum(tlateoftleath
� pnor lo�2-13-827
4. Agricul�ure Exemplion(dale of � 5. FUNre Inlerest Compmmise(tlate of C' fi. Fetleral Esla�e Tax ReWm Reqwred
�ea�� on o�afle�]4�2012) tl¢a(h eflEr 12-1282)
❑ l. �ecetlen�oietl Testate � B. Decetlent Main�alnetl a Living Tms� � 9. To�al Number of Safe Deposil0oxes
(AVecM1 ropy of wAIJ (Attach copy o(imsL)
_�'i 10. Litigation Proceetls Receivetl � 11. Non-Probate Transferee ReWm � 12. Oeferral/Election of Spousal Tmsts
(Scheaule F and G Assets Only)
_ 13 Buslnass Assets � ia. Spousa Is Sole Benaficiery
(No�rusilnwivatl)
CORRESPONOENT� THIS SECTIIXI MUST BE COMPLETE�.ALL CORFESFON�ENCE ANO CONFIDENTIAL TA%INFORMATION SHOOLO BE�IRELTEO TO:
Name Daylime Telephone Numbe�
CRAIG A � HATCH, ES4 • 717-731-9600
First line of Atltlress
2109 MARKET STREET
Secontl Line of Atltlress
Ci�y or Posl Office Stale ZIP Cotle
CAMP HILL PA 17011
eo..espo�ae�r:em:�i aae.ea.: C •H A T C H a H H G L L P . C 0 M
NEGISTEROF WILLS USE ONLY
REGISTER OF W ILLS USE ONLY �
DATE FILE�MM�DYYYY I
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PLEASE USE ORIGINNL FORM ONLV ��� -'O --.�
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L 1505618627 1505618627n TJ �
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P.cdress 3� _.. _�_.:ecca ^rive
F.r.ecr., PA 193?--
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Rev-�sao ex�ra�
Deceeenfs Soclal5ecurity Nomber
oeoaaa�r9rvame:CARVER ORVILLE 723-14-0981
RECAPITULATION
1. Reai Estate(Sc�ecule A1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . L Q . 0 Q
z. smcksanaeonds(scneawea). . . . . . . . . . . . . . . . . . . . . . . . . z. 2, 335 • 50
3. Closely Held Corporation, Partnershlp or SOI�Pmprietorshlp(SCM1adula C). , , , , 3. 0 • 00
<. Morlgages and Notes Receivable(SCM1etlule D), , , , , , . , , , p O • Q O
5. Cash. Bank Deposi�s antl Miscellaneous Personal Pmpetly(SCM1etlule E�, , , , , , 5. Q • Q Q
6. Jointly Ownetl Pmpetly(SCM1edule F� iL J Separa�e Bllling Requestetl. . . . . 6. � • 0�
�� Inter-Vlvos Trens�e�s 8 Mlscellaneous Nan-Proba�e Pmpetly
(Scbedule G) � Separete Billing Reques�ed. . . . . ]. � • �Q
s. rotai cross nssets(mtai�'ines i mrou9n n , , , , , , , , , , , , , , , , , , e. 2 ,335 . 50
s. Funerai expenses and ntlm'inisva�ive Cosis(5cnetlWe H). . . . . . . . . . . . . 9. 50� . D O
t 0. Debts oi oecetlem, Morigage��iabiii�ies ana Liens(Scnedule p. . . . . . . . . . t o. � . 0 0
11. Total Detluctions(total Lines 9 and t0). . . . . . . . . . . . . . . . . . . . . t 1, $0 Q , Q�
iz. Neivaweores�a�el���neem���s���eii) . . . . . . . . . . . . . . . . . . . �z. y,835 • 50
t3. Charitablean4GovemmenlalBequests�Sec.9113Tmstsforwhich
an election m�ax M1as not been matle(Sc�etlule J). . . . . . . . . . . . . . . . t 3. � •��
ta. rvetvaiuesubjecttoiax�Linetzm�inus�ine�3J. . . . . t4. 1 ,835 . 50
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Hmoun� of Llne 141axable
a���e spousal[ax�a�e.or
Iransfers uryper5ec.9tt6
�a>n-z�x_o�� 1 ,835 • 50 is. 0 . 00
16. Amomt of Cine la yivable
auineal rate X A4 b 0 • 0� +s- 0 • 00
1]. Amoun� of Llne 14�axable
atslblingrateX.12 0 • 0� 1y. 0 •0�
19. Amoun� o!Line �4laxable
at collateral rale %.15 p • �Q 18. 0 • Q�
19. TAXDOE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. O . 00
20. FlL�IN THE BO% IF VOU ARE REpIlESTING F REFUND OP AN OVERPAYMENT �
pn0er penalUes o!pe�lury.I tletleratM1e�I M1ave exammea��is re�urry InCutling eccom0enying scM1etlules anJ sla�emen�s,anE�o IM1e Ees�ol my knowletlge and beliel.
i� is acl antl compla�a �ecla2�ion ol prepareroNer��an IM1e pe�son esponsibleto�lilling IM1e reWm Is basEd On alllnlolmellon ofw!IICM1 preperar has
dnyk OwIMO¢,
SIGNHTURE EP ^ RESP SI EbURFILINGRE1lIftN pqSE i
F � � '1 ;���^ ' �
AODRE55 �' " �
38 LINDENWO V EXTON , PA 19341 �
S16�OF PR E T N PERSON RESPONSIB�E FOR FlLING THE RETURN �AT
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AO�RE$$
2109 ARKET STREET CAMP HILL , PA 17�11
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1505618635 J
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Pile Numbar
DecetlenYs Complete Address:
oeceoeNrsNAmE
�ARVER ORVILLE
STREETADDRESS ��- —
R AN
GTV STATE i ZIP
MECHANICSBIJRG PA 17050
Tax Payments and Credits:
1. Tax�ue(Page 2. Lfne 1BJ (�� Q • Q 0
2. Cretllts/Payments
A. PIiO!Pdymenls Q • Q Q
B.OISCOuOt Q . Q Q
(sae���s��,�ro�s_7 lmaicrea��s(n.a) (2) 0 • 00
3. Interest �
(31 � • 0�
<. It Llne 2 Is grealer(M1an Llne 1 �Line 3.enter IM1e OiRe�ence.TM1Is is�M1e OVERPAYMENT.
Fill in oval on Page 3, l.ine 20�o requez0 a refund (4) o . o 0
6. If Llne 1 + Llne 3 is 9�eater�M1an Llne 2,antertM1e dlRerence-This Islhe TAX OUE �5) a • a o
Make check payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BV PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did aecetlent make a vansfer ana�. 1'es No
a. retain the use or'mcome oi Ine pmperty Vansferred . . . . . . . . . . . . . . . . . . . . . . . . . . . �� ��—'�
b. retain ihe rigM1l to tlesignate wM10 s�all use iM1e pmperry Vansierred or Its Income . . . . . . . . . . . . . ❑ L'
c. retain a reversionary Inlerest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ❑ ��
0. recaiva IM1e pmmise tor Ilfe o(either payments,benefl�s or cere7 . . . . . . . . . . . . . . . . . . . . . . ❑ Is].
2. If deat�occurreC atter Dec. 12. 1982.Oid decetlent Iransfer pmperty wlihin one year ot tleatM1 I�
wiUout receiving ade0uale consideration9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ❑ u
3. �itl tlecetlenl own an"in Irus�tof'or payable-upon-Oea�M1 bank acmun�or secunry al M1is or M1er tlea1M . . . . . ❑ �
a. oitl tlecetlenl own an Intlivitlual retlremenl accounl.annviry.or olher nonqrobatepmperTy.which
contalns a beneiiciarydesignation9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ❑ ❑X
IF THE ANSWER TO ANY OF THE TBOVE pUESTIONS IS YES, TOII MUST COMP�ETE SCHEOULE G ANO FILE IT AS PPRT OF THE RETORN.
Por Oa�es o�tlea1M1 on o�after July 1. 1994. antl bebre Jan. 1, 1995. �M1e tax rate ImpoSeE on IM1e nel value of Vansfers(o or for�M1e use of tM1e surviving spouse
Is 4 percent p2 P S.�9110 (e)(i_1�(I��.
Por tla�es of dea1M1 on or afte� lan. 1, 1995. [he la+ ra�e Imposed on Ne ne� valve of Uanslers to or for IM1e use ot iM1e survNing sDouse I5 0 percent
[]2 P5.§911 B (a) (ti) 01)�.The stalute doas nol ezemp� a transfer to e survivin9 spouse fmm tax, end IM1a slatutory reQulrements tor tlisclosure o(assets ane
filing a tar reW m are sNll appllcable evan I�IM1e swviving spousa is t�e only Oene�iciary.
Fa aales o!tleatn on or afler July t,2000.
• T�e�ax tate Imposetl on IM1e net value of Vansfers from a tleceasetl cM1iltl 21 Years of age o� Younger al tleatM1 [o or for the use o�a naW�al paren�. an
adop�lve parent or a s�e�pa�enl ol�be cM1lld Is 0 parcent[]2 P.5§911 fi�a�(1 2J�.
• iM1e lax ra�e Imposetl on tM1e net velue of Irens(ers�o or(or IM1e use ot�he OecedanCs llneal peneficie�ies 154.5 pement except as nMed In[]2 P.S§9118(a)�11�.
• TM1e lax rate Imposetl on IM1e net valua of Vens�xs to or for iM1e use of tM1e tlecedenfs slblinge Is 12 parceN []2 PS.§911fi(a)(19�7. A slbling Is tlefinEtl.
untler Section 9142,as an Intlivitlual who has at least one paren�In common wl�h Ihe decedenL whether by blootl or atloplion.