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Home My WebLink About01-0370 PETITION FOR GRANT OF LETTERS OF ADMINISTRATION No. To: ~/- C) 1- 370 Estate of Betty L. Sumpter also known as Deceased. Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania Social Security No. 203-22-4522 The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older, applies for letters of administration on the estate of (d.b.n.; pendente lite; durante aosentia; durante rninorilate) the above decedent. Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal residence at 95 Foxcroft Driv~, Camp Hill, PA. 17011 (list street, number. Twp. or Boro.) Decedent, then 68 years of age, died October 18 at Holy Spirit Hospital, 503 N. 21st Street, Camp HilJ.J._P'A , 1999 17011 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 situated as follows: $ 2,200.00 $ $ $ Petitioncr__ after a proper search ha~ ascertained that decedent left no will and was survived by the following spouse (if any) and heirs: Name Relationship Residence Husband Dau hter Son Dau hter 95 Foxcroft Drive, 3905 7 Hi 6168 PA THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the appropriate form to the undersigned. '" V' u c:: \J ~3 \J ... <<\J c:: ,,0 c'':; ell'':; 'V)~ u<- ~ 0 CiS c:: 00 Vi r!fto~ Cleo Smith 6168 Spring Knoll Drive Harrisburg, PA 17111 /&., .- ;)23-6- OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND } 88 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 above decedent petitioner(s) will well and truly administer the estate according to law. I'~t!/M~ I l -;;- 'i)' ... =' ~ Q en N 21-01-370 o. Estate of BETTY L. SUMPTER , Deceased GRANT OF LETTERS OF ADMINISTRATION AND NOW APRIL 1 0 ~ 2001, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that CLEO _SMIXllI A/KI A CLEO A. SMITH is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration are hereby granted to CLEO SMITH A/K/ A CLEO A. SMITH i~he estate oj ~ETTYL.-SUMPT~----- mOhh~ :t,ux.h ,oL.. ~.l.L 'JI!::;;j;- A.J C';;t/ Di1~ ' , , Register of Wills FEES Letters of Administration $ 25.00 Short Certificates(2 ) . . . . . . . . .. $ 6.00 Renunciation ................ $ 15.00 JCP $ 5.00 TOTAL _ $ 51.00 Filed ... ~.~~~..I.q .. .. .... A.D. ~ 2001 ELIZABETH P. ~ruLLAUGH, ESQUIRE 76397 A lTORNEY (Sup. Ct. 1.0. No.) 100 PINE STREET, HARRISBURG, PA 17101 ADDRESS 717) 232-8000 PHONE MAILED LETTERS TO ATTORNEY APRIL 11, 2001 H105.905M REV. 4/96 This is to certify that this is a true cop.f the record which is on file in the pennsylvw' Division of Vital Records in accordance with Act 66, P.L. 304, approved by the eral Assembly, June 29, 1953. WARNING: It is illegal to duplicate this copy by photostat or photograph. No. ~II~ Charles Hardester S tate Registrar 0538423 OCT 2 61999 Date Hl05.144 Rev 1/91 COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH (Coroner) SEX STATE FilE NUMBlR SOCIAL SECURITY NUMBER L 2. Female 3.2 22 DATE OF BIRTH BIR~r-;~LACE (CIty and PLACE OF DEATH (Check only one see Instructions on ather side) (Month, Day Year) Slate ':r Foreign Country) HOSPITAL 7.Pittsburgh PA ~:tient 0 FACILITY NAME (II nJ! mslllullon. give street and number) Holy Spirit Hospital 1999 UNDER 1 YEAR Days UNDER 1 DAY Minutes ~~~dy)D ), RACE. American Indian, Black, White, etc (Specity) BLACK SURVIVING SPOUSE (I! wile. give maiden Ilame) SUMPTER DKl decedent live ina township? 17d.D ~~h~n~:~7~i~~~ of MOTHER'S N"'ME IF;", M'ddle. Ma,den surnameBESSIE SMITH ". INFOgr~Tif Ms~MereN8n C;'fil'lft.Z'PftnR.ISBURG. P A 17011 2 PLACE OF DISPOSITION. Name of Cemetery, Crematory lOCATION. CityfTown, State, lip Code or DlMr Place lwp city/bora ~ ::> (j') .. ~ 21C.ALLEGHENY CEMETERY 21d.PITrSBURGH. PA 15201 INAME ANG ADDRESS OF FACILITY 22C.White Mem Chpl 7204 Thomas Blvd Pgh. PA 15208 LICENSE NUMBER DATE SIGNED (Month Oa'l" Year 230. TIME OF DEATH 11:14 A. DATE PRONOUNCED DEAD (MOfllh, Day, Year) 25 October 18, 1999 23b. 23c. WAS CASE REFERRED TO MED~AL EXAMINER/CORONER? Yo.~ NoD 26. 27. PART 1: EnttH the dIseases, Injuries Of comptications whICh causttd the death, Do not enter 'he mode 01 dying, !.:uch as cardiac or respiratory arrest, shock or nsan faIlure '_:3; v;-;;) C'ne cause f)n each line : Approximate I Inlerval between i onset and dBath PART II: Other significant conditions contrlbuttng 10 death, bul om resulting In 1M underlying caUSF.l given in PART I Hypertensive Cardiovascular Disease DUE TO (OR ASA CONSEOuENCE OF( . DUE m (OR AS A CONSEQuENCE OF) DUE TO (OR AS A CONSEQUENCE OF) d WERE AUTOPSY FINDINGS AVAILABLE PRIOR TO COMPLETION OF CAUSE OF DEATH? Natural ~ o D Homicide D o "0 31b. LICE E NUMBER /~ 031<. 31d.Oct.20,1999 N"'ME AND "'DDRESS OF PERSON WHO COMPLETED CAUSE OF DEATH l"em27)TypeorPrint Michael L. Norris, Coroner ~ 6375 Basehore Road, Suite 1 R Mechanicsburg, PA 17055 DATE FILED (Month, Day. Year) Coroner MANNER OF DEATH DATE OF INJURY (Month. Day, Year) Yo. 0 NO~ Yo. 0 No 0 Accident Pending InvestiGation 2... 28b. CERTIFIER (Check only one) .CERTIFYING PHYSICIAN (PhYSICian certllYlng cause 01 death when another physiCian has pronounced death ar"J completed ltem 23) To the best ot my knowledge. de.th oecurred due to the caUM{s) and manner a. .t.t~ ... _ ............................ Suicide 29. Could not be delermil.ed ~ :il ~ o u. o ~ .. Z -PRONOUNCING AND CERTIFYING PHYSICIAN (PhYSICian both pronounCing death and certifYing to cause 01 cealh) To the beat of my knowledge, death occurred at the time, dat., and pile.. and due to the cau"(I) and mllnner.. Itllted 'MEDICAl EXAMINER/CORONER On the b.sla of examination India v..Ug.tlon, In my opinion, de.th occu mlnner.l.tated........... .... J'.. REGISTRAR'S SIGNATURE "'ND NU lItho limo, do 0, ond pilei, Ind dUlto Ihl CIU"(O) Ind ,)2037 34. OCT 261999 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: ESTATE OF BETTY L. SUMPTER, NO. 21-01-370 Deceased ) RENUNCIA TION The undersigned, Christopher Sumpter, son of the above-named Decedent, hereby renounces the right to administer the estate and respectfully requests that Letters of Administration be issued to Cleo A. Smith, daughter of the Decedent. Witness his hand this - day of November, 2000. ....,/l (!//; ... ~ ~if nv 61/ ~f1fA, Christop r Sumpter Sworn to or affirmed and subscribed before me this t:) day of No v Glllber, 2000. J)<2C- .Actd! Notary Public My Commission Expires: STUART B. GALKlN NOTARY PUBLIC OF NEW JERSEY My Commission Expires Jan. 28, 2001 ID #2084147 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA ORPHANS~ COURT DIVISION IN RE: ESTATE OF BETTY L. SUMPTER, NO. 21-01-370 Deceased RENUNCIATION The undersigned, Columbus Sumpter, husband of the above-named Decedent, hereby renounces the right to administer the estate and respectfully requests that Letters of Administration be issued to Cleo A. Smith, daughter of the Decedent. Witness his hand this ~ day of November, 2000. Q ((;~/y(k~'!' Columbus Sumpter Sworn to or affirmed and subscribed before me this 'leg. day of November, 2000. ir5JiJn~lfA Not Ii' Pui1lic Notarial Sc\al Cathy L. Youngblood. Notary Publfe M C .. . Camp HID Boro, Cumberland County y ommISSIon ExpIres My Commission Expires June 22,2802 Member, Pennsylvania Association of Notaries _J IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: ESTATE OF BETTY L. SUMPTER, NO. 21-01-370 Deceased RENUNCIATION The undersigned, Gwendol Fletcher, daughter of the above-named Decedent, hereby renounces the right to administer the estate and respectfully requests that Letters of Administration be issued to Cleo A. Smith, daughter of the Decedent. Witness her hand this _ day of November 2000. Sworn to or affirmed and subscribed before me this 'L-C? f'--- day of November, 2000. tCkL; II Notary Public My Commission Expires: Notal1al Seal David M. Konnen, Notary Public Pittsburgh, Allegheny County My Corflmi~hJtl Expires D.c. 31, 2001 Ml?mhl>r. pcltlt'ilylvam.. AllocllitlOn Of NMAI'l" ~ CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Betty L. Sumpter Date of Death: October 18, 1999 Will No. Admin. No. 2001-0370 To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on October 1, 2001 Name Address Columbus Sumpter Gwendol Fletcher Christopher Sumpter Cleo Smith 95 Foxcroft Drive, Camp Hill, P A 17022 3905 B1ackridge Drive, Pittsburgh, P A 7 Highgate Road, Cherry Hill, NJ 6168 Spring Knoll Drive, Harrisburg, P A Notice has now been given to all persons entitled thereto under Rule 5.6(a) except N/A Date: /6~/or / ~ Address McNEES WALLACE & NURICK LLC 100 Pine Street, 3rd Floor P.O. Box 1166 Harrisburg, P A 1 71 08-1166 Telephone (717) 237-5243 ~~ Capacity: _ Personal Representative ~ Counsel for personal representative {A274183:} . , JRD/June 30, 1992117858 AUG 0 1 2001 to Estate No.: 21-01-370 ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA In Re: Estate of Betty L. Sumpter Late of East Pennsboro Township NO. 21-01-370 NOTICE OF FAILURE TO FILE CERTIFICATION AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 5.6(e), SUPREME COURT ORPHANS' COURT RULE Personal Representative: Cleo Smith Counsel for Personal Representative: Elizabeth P. Mullaugh Date of Grant of Original Letters: April 10, 2001 Date of Delinquency Notice: July 20, 2001 The undersigned, Mary C. Lewis, Register of Wills, in accordance with Rule 5.6, 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 certification required by Rule 5.6(e), Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 5.6(e), Supreme Court Orphans' Court Rules, was given by the Register of Wills on July 16" 2001, and that the ten (10) day notice to file the certification has expired. Accordingly, in accordance with Rule 5 ,6( e) 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. Date: July 31, 2001 Distribution: Personal Representative Counsel for Personal Representative Estate File A hearing is scheduled for ~b.LL, ..j";~/ at 9,' 3p'.4.4n Courtroom No.3. If the Certification of Notice is filed prior to the hearing date, the hearing will automatically be cancelled. George . OK ~ 'D a-d ~e-~-D\ (. STATUS REPORT UNDER RULE 6.12 Name of Decedent : Betty L. Sumpter Date of Death : October 18, 1999 Estate Number: 2001-0370 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. lfthe answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. lfthe answer to No.1 is Yes, state the following: A. Did the personal representative file a formal final account with the court? Yes No ')( B. Did the personal representative state an account informally to the parties in interest? Yes Y No C. Did the personal representative file approvals of the account, receipts, joinders and releases with the Clerk of Orphans' Court? Yes No)( D. Did the pers~)l~al representative complete final distribution? Yes X No Date : l b \ \ \ 6> ( I , ~- ~ ~ ~a--. ~~~ Name: Elizabeth P. Mullaugh McNees Wallace & Nurick LLC P.O. Box 1166 Harrisburg, PAl 71 08-1166 (717) 237-5243 Capacity: Personal Representative Z Counsel for personal representative {A291994:} A ly'fti McNees Wallace & Nurick LLC attorneys at law ELIZABETH P. MULLAUGH DIRECT DIAL: (717) 237-5243 E-MAIL ADDRESS:EMULLAUGH@MWN.COM February 7, 2003 VIA CERTIFIED MAIL Cumberland County Register of Wills 3 South Hanover Street Carlisle, PA 17013 RE: Estate of Betty L. Sumpter 21-01-0370 Dear Register: Enclosed for filing on behalf of the above-referenced estate are two (2) originals and one copy of an inheritance tax return showing no tax due. A filing fee of $20 is also enclosed. Kindly date-stamp the extra copy and return it to us in the envelope provided. Thanks you for your assistance. If you have any questions, please do not hesitate to contact me. Very truly yours, McNEES WALLACE & NURICK LLC Enclosure {A291934:} 100 PINE STREET. PO Box 1166 · HARRISBURG, PA 17108-1166 · TEL: 717.232.8000 · FAX: 717.237.5300. WWW.MWN.COM COLUMBUS, OH · HAZLETON, PA. STATE COLLEGE, PA. WASHINGTON, DC "(J ~ ~\ .~ .~ \ ~ ,^" ~ b, - ~ - a -- ?fi ~ Vi - ~ \J'1 t"- 'Go ~~ ~ Ui ~ ~ 0 :J' Vi - ~ - i ~ ::> i rn ~ o -' .J ~ o i : ':) ~ %ti8 ~..tE ~\Illi;'t '~o tv. ~ ~.,!I(~. . i ';(.. ..1'. ,OJ ..J .J 8' L' .c- - ~ i .c. '" ~ III III % u - .- te ~ en en te - o .... en '- .- u.. _.:~ b ~ iA t-' (/) ....... o ~ ~ >- ~ t-' t-' ~ (/)~ o ~.-. o iAO U >r- o 0'-' z ~i -< ~ ~ ,...:l ,..,...iA ~ ';:t.~ ~(/)s~ '$,...:loo::. o~(/)-< u~~u ~ r ~---.... c...j ~ ~) / b - ~~ $ .,.~s-' .. ~ BUREAU OF INDIVIDUA~ T~ES INHERITANCE 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 COUNTY ACN 03-31-2003 SUMPTER 10-18-1999 21 01-0370 CUMBERLAND 101 ELIZABETH P MULLAUGH MCNEES ETAL PO BOX 1166 HBG PA 17108 '* REV-1547 EX AFP (01-051 BETTY 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 ~ RE-Y-=is4-j-ix-AFP--foi-:031--Ncffici--oF-'fNHiifiTANCE-TAi-jrpPRA-isiirENT~--Ar.i-oWAifCE-(fR--------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SUMPTER BETTY L FILE NO. 21 01-0370 ACN 101 DATE 03-31-20l TAX RETURN WAS: ) ACCEPTED AS FILED SEE ATTACHED NOTICE ( X) CHANGED APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 . 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} lB. Amount of Line 14 taxable at Collateral/Class B rate {lB} 19. Principal Tax Due TAX CREDITS: 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) B. Total Assets (1) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 2,209.00 .00 .00 (B) NOTE: To insure pr credit to your ace submit the upper p of this form with tax payment. 2,209.0r (1l) (12) (13) (14) 2.820 01 611.C . ( 611./ (9) nO) 2,820.00 .00 t"Aynl:NI KI:\;I:.Lt"1 (+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 x 00 = .00 X 06 .00 x 00 = .00 X 15 n9)= . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRI IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU I A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUI REV-1470 EX (6-88) ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT 280601 HARRISBURG PA 17128-0601 DECEDENTS NAME INHERITANCE TAX EXPLANATION OF CHANGES Betty L. Sumpter FILE NUMBER John Kuchinski ACN 2101-0370 101 REVIEWED BY ITEM SCHEDULE NO. EXPLANATION OF CHANGES H B3 Reduced to $2,208.98. Family exemption can only be claimed against assets subject to will or intestacy. ROW Page 1 REV-1500EX(6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 i f.p - " aD - j~ REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT ~. OFFICIAL USE ONLY FILE NUMBER Z.L - 6L COOOY CODE YEAR ~~3:~_ M..M8ER w r, :::,,;::$U} 0"'>: wa.o rOO 0"'-' a.al !l: STfPA42021F.1 I- Z W C W o W C DECCDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SUMPTER, BETTY L. DATE OF DEATH (MM-DD- YEAR) DATE OF BIRTH (MM-DD- YEAR) October 18, 1999 December 30, 1930 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLIE INITIAL) Columbus H. Sumpter 1ZI 1. Onginal Return o 4. Limited Estate o 6. Decedent Died Testate (Attach copy ofV<II o 9. Lrtigation Proceeds Received i o l Supplemental Return D/4a. Future Interest Compromise (date of death aller 12-12-82) D' 7. Decedent Maintained a Living Trust {Attach copy ofTrustj o 10. Spousal Poverty Credit (date of death between 12.31.91 and 1-1-95) f-- Z W o Z o a. '" w '" '" o o SOCl'\L SECURITY NUMBER 203-22-4522 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCl'\L SECURITY NUMBER o 3. Remainder Return (date of death prklr to 12-13-82) o 5. Federal Estate Tax Return Required _ 8. Total Number of Sale Deposrt Bcxes o 11. Election to tax under Sec. 9113(A) (Attach Sch 0) tijjlli!lI!C'l'!!ilIl,!f,I!i!$\'1HIiII!II\1ll!I\l., NAME Elizabeth P. Mu11au h FIRM NAME Qf AppIcabo) McNees Wallace & Nurick LLC TELEPHONE NUMBER 717.237.5243 ~il~'Il!illil\l!Il!:llil!\l!!II$$Il:!I8l;!ll\ll~I'I'!il: COMPLETE MAILING ADDRESS 100 Pine Street P.O. Box 1166 Harrisburg, PA 17108-1166 I. Real Estale (Schedule A) Z. Stocks anti BontIs (Schedule B) (I) (Z) (3) (4) (5) z o !<c ...J ::::l I- ~ <( o w a:: 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposns & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate BiIHng Requested 7 . Inter. Vivos Transfers & Miscellaneous Non-Probale Property (Schedule G '" L) (7) (6) 8. Total Gross Assets (total Lines 1 - 7) 9. Funeral Expenses & Admmistrative Costs (Schedule H) 10. Debts of Decedenl, Mortgage Liabilrties, & Liens (Schedule I) 11. Total Deduction. (Iotal 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 (Schedule J) (9) (10) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS FOR APPLICABLE RATES z o !(( I- ::::l Q. :!: o o ~ 15. Amount of line 14 taxable at the spousal tax rate, "'Iransl",. und", Sec. 9116 (a)(I.2) o X 0---2. (15) o xO 45 (16) X .IZ (17) X .15 (18) (19) 16. Amount of Line 14 taxable at lineal rate 17. Amount of line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due OFFICIAL USE ONLY 2,209 (8) 4,111 2,209 (II) (IZ) (13) 4,111 (1,902) (14) (1,902) o o o ZOo 0 fYC.Il. ...... !llKl'''......i[. i~"'i'.iliRJ"",,"ii' Sl!1-',l!i:,"""''''''I",",::~~:",'''~''',Iil'E~ I !i . ",_.f'. _!i."""",I'I.."._~"II""",,,,.,,~,,,,,,,,,~..l1W '.J'i'!ii~JIiII!.Y.li!liIlmiItOl:~' . F~'Sl!.!I\!!\!$:OII\I\. l'!!I.E".,.!!IlI,m;clIl!. .' 'l\'I'~'Ir!lI,,#,i!(:: Decedent's Complete Address: STREET ADDRESS 9 5 Foxcroft Drive CITY Camn Hill I STATE PA I ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) o o o o Total Credits (A + B + C) (2) o 3. interesUPenalty if applicable D. Interest E. Penalty o o A. Enter the Interest on the tax due. (5A) o o o o o Total interesUPenalty (0 + 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) 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 PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a retain the use or income of the property transferred; ................. . 0 [Z] b. retain the right to designate who shall use the property transferred or its income; . . . . . . . . . . . . 0 [Z] c. retain a reversionary interesl; or . .. .. .. .. .. .. .. . . .. ... 0 [Z] d. receive the promise for life of either payments, benelits or care? . . . . . . . .. . 0 [Z] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . 0 3. Did decedent own an "in trust fo( or payable upon death bank account or security at his or her death? . 0 4. Did decedent own an Individuai Retirement Account, annuity, or other non-probate property which contains a beneliciary designation? ................. . . . . . . . . . . 0 l.2I 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 penaHies of perjury, I dee/we that I have examined this return, including accompanying schedules and statements, and to111e best 01' my knCM'ledge and belief, .~ is true, COITect and complete. Declaration of preparer other than the pe(sooal representative is based on aU information of wnich preparer has any koo.vIedge. SIGNj OF PERSct,~SP~NS ~~G RETURN DDR 95 Foxcroft SIGNA TYllli [Z] IX! I'U.-Jl RESS 17011 , PA 17108 1166 For dates of death on or after July 1, 1994 and use of the surviving spouse is 3% [72 PS. S9116 (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. S9116 (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 liIing a tax retum are still appiicable even if the surviving spouse Is the only beneliciary. 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. s9118(a)(1.2)]. The lax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneliciaries is 4.5%, except as noted in 72 P.S. S9116(1.2) [72 P.S. s9116(a)(I)]. The tax rate imposed on the net value at transfers to or for the use of the decedent's siblings Is 12% [72 P.S. s9116(a)(1.3)). A sibling is de1ined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. STFPA42021F.2 REV.1S0S EX + (1-97) (I) COMMONVVEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENl SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Betty L. Sumpter FILE NUMBER 21-01-370 Include the proceeds of litigatiOl1 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 VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 1/7 share of residuary Estate of Freeman M. Thomas 2,208.98 STFPA42021F.9 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 2,209 REV-1511 EX + (1-97) (I) COMMONW'EALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESlDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Betty L. Sumpter FILE NUMBER 21-01-370 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees 559.70 3. Family Exemption: (~decedent's address is not the same as claimant's, attach explanation) CI~man\ Columbus H. Sumpter Street Address 9 5 Foxcroft Drive City Camp Hill State PA Zip 17011 Relationship of Claimant to Decedent H US ban d 3,500.00 4. Probate Fees 51. 00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. TOTAL (Also enter on line 9, Recapitulation) $ 4 III (If more space IS needed, IOSert additional sheets of the same size) STFPA42021F.12 ,~ IN THE COURT OF COMMON PLEAS OF ALLEGHENY COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: ESTATE OF FREEMAN M. THOMAS, a/k/ a FREEMAN MACK THOMAS, a/k/a FREEMAN THOMAS, a/k/a F. M. THOMAS, DECEASED ) ) ) ) ) ) ) NO. 7952 OF 1999 DECREE AND NOW, to-wit, DEC~ER ,~ , 2000, the account in this case having been filed and confirmed nisi and having been examined and audited by the Court, upon consideration thereof it is decreed that the account be confirmed absolutely and that all personalty in the hands of the accountant, to-wit, $43,997.55, be distributed in accordance with the schedule hereto attached and marked Schedule A, and that the unconverted real estate in the hands of the accountant, at the valuation of $1.00, be distributed in accordance with the schedule hereto attached and marked Schedule B, unless exceptions are filed within ten days. / SCHEDULES OF DISTRIBU SCHEDULE A Balance per First and Final Account $44,589.55 Deduct per Petition for Distribution 592.00 To: Lowell J. Thomas Payment of 'Claim Distributive share (1/7) $20,608.94 2.208.98 To: Abernethy, Auld & Young, p.e. Payment of Claim To: Michael D. Simon, Esquire payment of Claim To: Robert B. Marcus, Esquire Payment of Claim To: Frank IV. Jones, Esquire Balance of Fees $22,817.92 4,783.63 842.12 1,500.00 800.00 $43,997.55 ,~. To: Freeman L. Thomas (1/7) 2,208.98 To: Martha Naylor (1/7) 2,208.98 To: Rose Marie Long (1/7) 2,208.98 To: Estate of Betty sumpter, Deceased (1/7) 2,208.98 To: Shirlee Jamison (1/7) 2,208.98 To: Joanne L. Thomas (1/7) 2.208.98 $43,997.55 FORM 218 O.C. REV. 10-80 SCHEDULE B All unconverted real estate in the hands of the accountant, FRANK W. JONES, , Administrator , in the estate of FREEMAN M. THOMAS, a/k/a FREEMAN MACK \fY1i~~~mi'a'Y~/I'mEMAN THOMAS, a/k/a F. M. THOMAS, DECEASED , viz: FREEMAN 1. THOMAS, MARTHA NAYLOR, ROSE MARIE LONG, BETTY SUMPTER, To LOWELL J. THOMAS. SHTRT,EE TAMTSON ANn TOANNF. T, 'T'HnMA~ All that certain lot or parcel of ground situate in the City of Pittsburgh, Allegheny County, Pennsylvania, known as 6551 Shetland Avenue. Block and Lot No. 125-B-23. $ 1.00