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Home My WebLink About01-0437 PETITION FOR PROBATE and GRANT OF LETTERS Estate of e/A~( h~ L ,NI C::Cv If Ot:: ~ No. ~/- 0 I J.f..3? also known as To: 8IA"~"t!' r= Il1f:ClJ 110''"' . Deceased. Social Security No. 20' - lb. YS'2 5 Register of Wills for the County of C """"" be,.( A...d in the 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 executo'" in the last will of the above decedent, dated '3AI'\rJA'1 8, l '\'\R and codicil(s) dated named ,19_ (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in CVM heJo/A...d h (l r last family or principal residence at )..-51 County, Pennsylvania, with w,'Ic:J....,uod LA^e1 A/cwvl'Jle;,o1l I,l.'1J (list street, number and muncipality) Decendent, then 75 years of age, died A1A~cH SO , 19 2.00 I , at G ".tft (l.-d.,. V,.itA'll!. J W(3T P~",.,~J.o"o -r""f.: ~~...,.b~I"'~d COoJ",4'j . 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: $ $ $ $ o WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters +~S';A_#AI-A"Y (testamentary; administration C.La.; administration d.b.n.c.La.) theron. t (Iiwen lIa-r;,- j'VJc ClhcJ) ~'E' 3?rJ ;/'1> ,JkitIlrf"/J~)I A/I. "O.~ ^Jf..JJ;lit .t?:t Jld..~1 c~ . ro '= 3~ <l.>...... :;0 ~ s:: Ol) Vi (t1''Ii'1lL~IU(' JJ1,ll.tecr."- OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF. PENNSYLVANIA 1- ss COUNTY OF CUMBERLAND 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 we and truly administer the estate according to law. Sworn to or affirmed and before me this 2nd 'fYJo .... c... .~~<- 1 (c -;l.,"- ~ ~ &- .B. 'Jr'\. subscribed { day of ~ Register ~ QQ' ~ l:::l ..... ~ ~ ~ ~o. 21-01-437 Estate of MCC~H BLANCHE L. MCCIJLI.(n1 a/k/a/ BLANCHE E; Deceased DECREE OF PROBATE AND GRA~T OF LETTERS AND NOW lTIme 7 ~~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 JANUARY 8,1998 described therein be admitted to probate and filed of record as the last will of BLANCHE L. MCC~H a/k/a BLANCHE E. MCC~H and Letters TESTAMENTARY are hereby granted to 0iJEN HARPER MCC~H 'Y-n(h~J C f.,,~ O&-.f./; S)'f.:t-\ \ . Re~ister of W<lls FEES $ 18 .00 $ 9.00 $ 21.00 $ 5 gg TOTAL _ $ 53.00 Filed . .J:lJl)~. .7. . . . ,20P.l. . . . . . . . . . . . . . . . . . Probate, Letters, Etc. ......... Short Certificates( 3) . . . . . . . . . . Renunciation ................ x-pages JCP ATTORNEY (Sup. Ct. 1.0. No.) ADDRESS PHONE !h i IS to certify that the information here given is correctly copied from an original certificate of death duly filed with me as l~),:.1 Registrar. The original certificate will be forwarded to the State Vital Records OHice for permanent tiling. WARNING: It is illegal to duplicate this copy by photostat or photograph. 21-01-437 No. 2:1.._~. ~~~~~ Local Registrar Fee for rhis certificate. $2.00 p 7248029 APR : . 1 200; Date \('\'; ".1,) t1~v 2'87 COMMONWEALTH Of PENNSYLVANIA. OEPAR' MEtH OF HEALlIl . 'II fAL RECORDS CERTIFICATE OF DEATH S TAU fll! :'-lUMBER tl....E OF OfCEOENT ,,~;-M,dc,~ --- _..__._.._~- --------...-------.-.- -. -..- ----.. __._u__ SE*--------.--rOCiAlSEcliniN ;;U\CBE~---- --.T~T(orl~(MH -,M-;-n;l f'\.~, :":;:f- Blanche E~J::1QCJJ.l O-ClL.----.--1- .___..____.__.___ J'f.~r'!al~_ ~_:Z.O_l _-=-lL-=4525-__h.-r.~mQ.;\~ 32-l~p01 .GEfL.1~~"'!hC;1V' VNOER1YEAR __ UNOE~_ OAfeOF 81nnt . B,nrllrv.CE'C:'y.r.d Pi.J"C~O~~~II_'r:!~.d.~"'_'~':::' ,...~n~'~",'~~'~~.'~"'":"'I ...__. __ ___._ . Months Oa,... ,toufs: Minot" ,Mflll'" (J.ly ~ll" ;lttlftnrfc::rr'oQf'l.rM"''''tl H PtfAL OH~iER' -7 7 5 v~ . A P r i 1 2 2 'M . 11 In~I..n' [J EfVOuq>.,,,on, : j ~::'''''I 111 R..""'n<.41 ;J :?;'c':'fvl U s. · e. 925 .,~ ewv 1 e ".1 ~NrY~:~ ~. C:.:: :::e:H -C:lG~~V::ff":~0'\ \ Q K'NO()l"RUSINESSIINOUSfJW --IASO[CEOENTF.VEJ11N ~ CEOENI.S.CA1IO.N ...ARl1AlSTATIIS...."'...d --- - - lJ ~ ^';"JorolGis1 .Ei~~~~~TI'."'~f~g;tl N.'~::~~~j,~~od .0.. Ob. hno.L.__ tJ .vo' No U. (01:11 J 4 (t.",~.. M DECEDENT'S ......IlING...OORESS{Sl'Pel.c.....'.,..". SloW. EopC~1 ~~~~~Nl's ".. S,.'O P n [);d Irc.U _. __"'INed;n N. N eWlvt nn RESIDENCE _O<l.... ~ InSf1'VChOn5 lYe '" . onOlt1@r~) 17b.COUnty ~llmh ~5hip1 17d.O :h:-C':'~~oI MOTkeR'S N......e ,F.... "'odele. ....,d.." Sotn.",.,!" white ~I SURVIVING sPOusr- I" ..Ifl Jt"'" "',\",1f'1\ /\;lI".'1 ". FAl~R.S NAlolE 'f.......oddIe lO'" 251 Wildwood Ln. Newville, Pa. 17241 <","lOOn:> fI, John T. Lebo INfOR...ANT'S N......E (lypelPro"'l ~. Jay W. McCulloch UElllOO OF lJISroSITION lluNllKl C,.motion 0 n""""'al ~om SIal. 0 01.... (5"""oIyl I'. Bertha F. Bau INF ......Nl's ......IlING AoonESS ,5/...... C..,fTown. Slate. lop Codel J~ 251 Wildwood Ln M.A E or DI~J'OSITION. No"'" 01 Com.,ory. Clom.'ory or 01"'" J'I.co 21Newville Cern JT..Nelvville, pa 17241 ----~UE...NoAOOJ1eSSoH...cI1I1Y 15 Big Spring--A~-V-e _Jfi~L~<:.!:__Funeral ._Home, Inc T . Le~. _._____ LICENSE NUMBEn DAlE SIGNED (Mon4h. o.y. '\!ar, o...Te J'J10NOUNCED DEAD ,..."""'. D.y. ""a'l J5. \'{\o..'\.c.~ 30 l.eJO\ NoD CVP'- DUE TO (OR AS A CONSEQUENCE (1): ) Je. I ApproKima.. ; inlerval belWeen I onset Ind del'" I l PART n: Other $igrlinclnt eoncMions conutbuling to c)ell,.,. Duf noI ,"uftln9 in !he unclorty;ng aI.... _ in PAAlI DUE TO (OR AS A CONSEQUeNCE (1): {) ( A e r;,l-5" JV y r [~1f-"..J$ I ~ to DUE TO (OR AS'" CONSEQUENCE (1). lolANNER Of orATII DATE OF INJURY ("''''U''. Day. ""ar, TI"'E Of IN.JURY INJURV AT WORK? DESCRIBE HOW INJURY OCCURREO _no D SuiOOo D D Pending Inve~uqaHon 0 Could not tHI dp-termtne(J 0 _ D HoD . fl'ROftOUHCtHO AND CEAlfF'YINO PHYS'CIAN IPhySCg(t tlOttl P'on<:l\IflClOQ tlt"a'" dnd C!'f'hlY.OQ 10 (:;\l'~ nl f1eatf\' To the rMet Of "'y knowtedOft. de.'" OC'curred.e the time. da.e, and prace, and due 10 the cau,e(l) and manner.s ttatH.. 3'. na. JIb. 29. CERTIFIER ICNICt< onil one. .conlFYtNG PHYSICIA" (Ph~lr3f\Cf!fllf"ttng cauw d dt'8tt't 'Nhero al'\Ot~er phySIC ,an has pl'()n()l.,nced dealt'! ano compleled lIefn lJl To..... beet of "'Y IlItoWIedge, deettt occurred due to Ihe cause(sJ and ma,."", .1 I..ted. . 'IIEOreAl exAMINER/CORONER On the ba.l. 0' ,,"mln"llon Indlo< Inyuligltion.ln my opinion. dulh occurred II lhellme. dlle. and place. Ind due 10 the Cluse(.) and 31..mannft al .t.tl'd.................,...........',................................, ....................,.... ........ R€GISTR...R.S SIGNATURE AND NUMBER ~ C'" 33.~: '~&..~-t>...~ I~\ 1d1-\ ~I F:\FILES\DA T AFlLE\ WILLS\8998- W ,WIL , r LAST WILL AND TESTAMENT I, BLANCHE L. McCULLOCH, of North Newton Township, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any and all former Wills or Codicils by me made. ITEM ONE I direct that all my just debts, funeral expenses, testamentary expenses and all inheritance taxes shall be paid to the extent possible from those assets held or passing under ITEM FOUR hereof as soon as practicable after my decease and as part of the administration of my estate. ITEM TWO I give all of my personal and household effects, automobiles, boats and collections, if any, and any insurance policies thereon, unto my husband, JAY W. McCULLOCH, ifmy husband survives me by thirty (30) days, otherwise to my children who so survive me to be divided equally among them as they agree. My Executor shall sell any property as to which there is no such agreement within sixty (60) days after the admission of this Last Will and Testament to probate and shall add the proceeds to the residue of my estate. ITEM THREE lfmy said husband, JAY W. McCULLOCH, survives me, in order to obtain the portion of the marital deduction allowed in my estate by the Federal tax laws that will eliminate all Federal estate taxes payable as a result of my death, my Executor shall divide my residuary estate into two portions known as the "Marital Fund" and the "Credit Trust." The Marital Fund, which shall not be reduced by any taxes payable by reason of my death, shall be that fractional proportion of the entire residuary estate determined as follows: The numerator of such fractional proportion of my residuary estate shall be the smallest amount which, if allowed as a marital deduction, would result in the least possible Federal estate tax being payable as a result of my death, after allowing for the unified credit against Federal estate tax and all available credits and deductions claimed. The numerator shall be reduced by the value of any other property which passes to my said husband, JAY W. McCULLOCH, which qualifies for the marital 75:tW, B.L.M. Page 1 of 8 Pages , I . I deduction and reduced by that amount, if any, which, when added to my taxable estate, will result in Federal estate tax no larger than the credit for State death taxes allowed in my estate without increasing any State death taxes payable as a result of my death. The denominator of this fraction shall be the value of the entire residuary estate. Values assigned to the property for the purposes of this computation shall be those values finally determined for Federal estate tax purposes. The Marital Fund shall be distributed outright to my husband, JAY W. McCULLOCH, as soon as practicable after my death. The Credit Trust shall be held and managed by my Trustee in accordance with ITEM FOUR of this my Last Will and Testament. My Executrix shall have the power to distribute assets in cash or in kind to the Marital Fund and to the Credit Trust and to select specific property to be distributed to the Marital Fund or the Credit Trust without regard to the income tax basis on such property. In making these allocations, my Executor shall use the value of the assets as of the date or dates of distribution so that each distribution shares proportionately in the appreciation or depreciation of assets between the date of my death and the date or dates for distribution. However, no allocation of assets shall be made to the Marital Fund which does not qualify for the marital deduction. To the extent that other assets which qualify for the marital deduction are available, there shall not be allocated to the Marital Fund (a) assets with respect to which an estate tax credit for foreign taxes paid is allowable or (b) any payments under an employees trust or retirement annuity contract of the type described in Section 2039(c) of the Internal Revenue Code or subsequent provisions of similar import or (c) United States Treasury Bonds that are eligible for redemption at par value in payment of the Federal estate tax. In computing the marital deduction all generation-skipping transfers for which I am the "deemed transferor" shall be disregarded. If I am not survived by my husband, JAY W. McCULLOCH, I give, devise and bequeath all of the rest, residue and remainder of my estate, both real and personal property, unto my Trustee to be held or distributed by such Trustee under ITEM FOUR hereof. Ifmy said husband, JAY W. McCULLOCH, survives me and disclaims any portion of the Marital Fund, such portion shall be added to the Credit Trust. ~ B.L.M. Page 2 of 8 Pages If my said husband, JAY W. McCULLOCH, and I die simultaneously, or under circumstances which render it difficult to determine who died first, my said husband shall be deemed to have survived me for all purposes of this my Last Will and Testament. ITEM FOUR CREDIT TRUST My Trustee shall hold the assets received under ITEM THREE hereof, if any, for the following purposes: A. To pay the net income, at least quarter-annually, to my husband, JAY W. McCULLOCH, for life. In addition, my Trustee, in my Trustee's sole discretion, may invade the principal of the trust to provide for the proper and adequate support of my said husband, JAY W. McCULLOCH. B. The Trustee shall pay to my husband, JAY W. McCULLOCH, annually, such sum from the principal of the trust as my husband may request in writing, provided, however, that said sum may not exceed the greater of Five Thousand Dollars ($5,000.00) or five percent (50/0) of the aggregate value, at the time of said request, of the principal of the trust hereunder. C. Upon the death of my husband, JAY W. McCULLOCH, my Trustee shall distribute the principal of the trust in the following manner: 1. Five Thousand Dollars ($5,000.00) to FIRST UNITED PRESBYTERIAN CHURCH, Newville, Pennsylvania; 2. One Thousand Dollars ($1,000.00) to each of my grandchildren living at the death of my husband; 3. Forty-five percent (45%) of the residue to my son, OWEN HARPER McCULLOCH; 4. Twenty-five percent (250/0) of the residue to my son, HALE ALAN McCULLOCH; 5. Fifteen percent (150/0) of the residue to my son, NEAL ARNOLD McCULLOCH; and 6. Fifteen percent (15%) of the residue to my daughter, RUTH ANN ROLAR. D. In the event that any of my said children shall fail to survive my husband and me, but 13 t "? B.L.M. Page 3 of 8 Pages shall leave issue surviving, then such deceased child's share shall be held by my Trustee and the net income therefrom shall be used for the support, maintenance and education of the issue of such deceased child. My Trustee shall use as much of the principal as it shall deem desirable for said purposes. My Trustee shall distribute absolutely the principal of such share of such deceased child to the issue of such deceased child per stirpes as each shall attain the age of twenty-one (21) years. In the event that any of my children shall fail to survive my husband and me and not leave issue surviving, then such deceased child's share shall be added to the shares of my other children as if originally a part thereof. E. Notwithstanding any other provisions to the contrary, in no event shall any share be distributed to any beneficiary later than twenty (20) years after the later of the death of my husband or me. ITEM FIVE POWERS OF EXECUTOR AND TRUSTEE In addition to the powers conferred by case law, by statute, and by other provisions hereof, my Executor and Trustee and their successors, shall have the following discretionary powers applicable to all property held by them which powers shall be effective without order of any court and shall exist until final distribution: A. To retain any property of any nature received by them for whatever period they shall deem advisable; B. To invest and reinvest all or any part of said property in such stocks, bonds, common trust funds, securities, accounts, certificates of deposit (including, but not limited to, stocks, bonds, common trust funds, securities, accounts or certificates of deposit of the Trustee) or other property, real or personal, as in their discretion they shall deem proper, without regard to statutes limiting the property which a fiduciary may purchase; C. To sell, transfer, exchange or otherwise dispose of, any part of said property, for cash or on terms, publicly or privately, or to lease, even for a term exceeding five (5) years or the duration of any trust herein, without liability on the purchasers or lessees to see to the application of the proceeds, and to give options for these purchases without the obligation to repudiate them in favor of a higher offer; '8-tz;) B.L.M. Page 4 of 8 Pages D. To execute and deliver any deeds, leases, assignments or other instruments as may be necessary to carry out the provisions of any trust hereunder; E. To borrow money, including the right to borrow money from any bank and to mortgage or pledge any asset of the estate as security; F. To assume continuance of the status of any beneficiary with regard to death, marriage, divorce, illness, incapacity and the like in the absence of information deemed reliable without liability for disbursements made on such assumption; G. To pay from the trust, or the income therefrom, all debts or claims against my estate, or any taxes or similar charges on my estate; H. To make any distribution hereunder either in kind or in money, or partially in kind and partially in money. Distribution in kind shall be made at the market value of the property distributed, and my Trustee, in my Trustee's absolute discretion, may cause the share distributed to any distributee to be composed of property similar to or different from that distributed to any other distributee; 1. To exercise any subscription right in connection with any security held hereunder, to consent to or participate in any recapitalization, reorganization, consolidation or merger of any corporation, company or association, the securities of which may be held hereunder, to delegate authority with respect thereto, to deposit investments under agreements, to pay assessments, and generally to exercise all rights of investors; J. To invest in endowment, insurance or annuity policies on the lives of beneficiaries of any trust hereunder; K. To continue in any partnership, joint venture, joint ownership or other business enterprise of which I am a part at the time of my death; L. To compromise claims; M. To continue for whatever period of time as they shall deem necessary any ownership as a tenant in common or as a partner, in real estate or other property and to act as I could have done had I been living; N. To lend money to my estate or to any trust created hereunder or to purchase from the estate or from any trust created hereunder, at the market value thereof at the time of purchase, any t3'L..'lJ') B.L.M. Page 5 of 8 Pages securities or other property tendered to them by my estate or any trust created hereunder at any time and from time to time within a period of nine (9) months after my death; O. In the event that any amounts are payable hereunder or under any trust created hereunder to a minor, or to a person otherwise under legal disability, or to a person not adjudicated incapacitated, but who, by reason of illness or mental or physical disability is, in the opinion of fiduciary(ies) hereunder, unable to properly administer such amounts, such amounts may be paid by the fiduciary(ies) hereunder in his, her or their sole discretion in any of the following ways as he, she or they may deem best: 1. Directly to such beneficiary; 2. To a legally appointed guardian of such beneficiary for the benefit of such beneficiary; 3. To a person having custody of such beneficiary for the benefit of such beneficiary; 4. By the fiduciary(ies) hereunder using such amounts directly to the benefit of such beneficiary. P. To employ agents, attorneys and proxies and to delegate to them such power as my personal representative and Trustee considers desirable and to pay reasonable compensation for such services as may be rendered by such agents, attorneys and proxies; Q. To conduct an inventory of any safe deposit box necessary to the administration of my estate. R. To do all other acts in their judgment necessary or desirable for the proper management, investment and distribution of my Estate. ITEM SIX PROTECTIVE PROVISIONS All income or principal held for the use and benefit of the beneficiaries of any trust hereunder shall not be in any way or manner subject to anticipation, assignment, pledge, sale or transfer, nor shall any such interest, while in the possession of my Trustee, be liable for or subject to the debts, contracts, obligations, liabilities or torts of any beneficiary, or to attachments, executions or sequestrations under process of law. 73~t!J B.L.M. Page 6 of 8 Pages ITEM SEVEN APPOINTMENT OF EXECUTOR AND TRUSTEE I nominate, constitute and appoint my husband, JAY W. McCULLOCH, as Executor of my estate. In the event that my said husband shall predecease me or fail to act as Executor, then my son, OWEN HARPER McCULLOCH, shall serve as Executor of my estate. I nominate, constitute and appoint my husband, JAY W. McCULLOCH, as Trustee of any trust created hereunder. In the event that my said husband shall fail or be unwilling to continue to act as Trustee, then I appoint my son, OWEN HARPER McCULLOCH, to act as Trustee of any trust created hereunder. ITEM EIGHT WAIVER OF jBOND I direct that neither my Executor nor my Trustee shall be required to file any bond in any jurisdiction to secure the faithful performance of their duties, nor shall they be required to obtain any order or approval of any court for the exercise of any power or discretion set forth in this Will. IN WITNESS WHEREOF I have hereunto set my hand and seal this ZJ.h day of J~~, 1998 73~ ~. ":7 c.r.J.4.fv Blanche L. McCulloch (SEAL) SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testatrix, as and for her Last Will and Testament, in the presence of us,. who at her request, have hereunto subscribed our names as witnesses thereto, in the presence of the said Testatrix and of each other. ~ 9 /#;t ~~. / . /.~~ --- Page 7 of 8 Pages . , COMMONWEALTH OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) I, Blanche L. McCulloch, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. ~:t~~G~ Blanche L. McCulloch .I.J~wom or affirmed to and acknowledged before me by Blanche L. McCulloch, the Testatrix, thisg'7"\. dayof \.l~ ,199K , ~~~A~ No ary Public Notarial Seat Corrine L. Myers, Notary Public Carlisle Boro, Cumberland County My Commission Expires May 27, 1999 COMMONWEALTH OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) We, yY) Iu-.~ -T H-~f a...td .s-fcf.~ J.... IY /) tf>V\, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Blanche L. McCulloch, the Testatrix, sign and execute the instrument as her Last Will; that the Testatrix signed willingly and that the Testatrix executed it as her free and voluntary act for the purposes therein expressed; that each of us, in the hearing and sight of the Testatrix, signed the Will as witnesses; and that to the best of our knowledge the Testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. Ad~~I~{1:AsJ th~ ~~ < ~~~~A- (7D13 ~~~ ~ Address ~ J) I~', S-f j I j I. S(:~:~. (__ ~_._ /, ':./, II II" i I I L' I 'S Sworn or affirmed to and subscribed before me this ~ day of J~ ,199(5 &~~ Notary Public . Notarial Seal Corrine L. Myers, Notary Public . Carlisle Boro, Cumberland County . My Commission Expires May 27, 1999 Page 8 of 8 Pages RENUNCIATION 21-01-437 In Re Estate of B /''1/1 C;, t!. C. ;nt:cvl/oc.h deceased. To the Register of Wills of C V't)) ber/AI1 cl County, Pennsylvania. The undersigned ::r ~ -{ w. Me. (v\\o<:.~ of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters ~ 4. I . · ~ I . I. T W ,.,, n (:5 rifT t" T\T4 ef~' \ I~v,-, , be issued to OWeA \-\AtLPe~ fr\ (C ",II 0,- h 'I WITNEss~tl.e 11. 11 f'{JdtJ hand this / 10 ""'- day of /!1. a.; 1/ v ,Jc9Z00/ . o d:Z~ .~ 5-/ t",,),' jd 1.,:-' Cf)"...l, Lev-. ~ Ne_w~l, lie fA 17 J. tj} I (Address) (Signature) (Address) (Signature) (Address) E ---- CERTIFCATION OF NOT1Cf: UNDER RULE 5.6(A) Name of Decedent: Blanche L. McCulloch ak~ Blanche E. McCulloch I Date of Death: March 30, 2001 Admin No.: 21-01-0437 Will No.: 2001-00437 To the Register: County of Cumberland I certify that notice of (beneficial interest) estate administration required by Rule 5 .6~ ~ of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on 9/2001 : Name Address Jay w. McCulloch 251 Wildwood Lane Newville, PA 17241 Owen H. McCulloch 321 Wildwood Lane Newvttlle, PA 17241 Neal A. McCulloch 243 Wildwood Lane Newville, B PA 17241 Hale A. McCulloch 233 Wildwood Lane Ne~ille, PA 17241 Ruth A. Rmlar RR7 Box 144A Manchestet, KY 40962 Notice has now been given to all persons entitled thereto I under Rule 5.6(a) except Date: 8/9/2001 71 f( Signature Thomas J. Ahrens, Esq. Name 5521 Carlisle Pike Mechanicsburg, PA 17050 Address (717) 69}-1800 Telephone Capacity: 0 Personal Representative ~ Counsel for~ersonal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT AHRENS THOMAS J 5521 CARLISLE PIKE MECHANICSBURG, PA 17050 -------- fold ESTATE INFORMATION: SSN: 201-16-4525 FILE NUMBER: 21-2001- 0437 DECEDENT NAME: MCCULLOCH BLANCHE L DATE OF PAYMENT: 11/15/2001 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 03/30/2001 NO. CD 000529 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $574.12 I I I I I I I I TOTAL AMOUNT PAID: $574.12 REMARKS: LYNETTE M MCCULLOCH C/O THOMAS J AHRENS CHECK# 495 SEAL INITIALS: SK RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT AHRENS THOMAS J 5521 CARLISLE PIKE MECHANICSBURG, PA 17050 n______ fold ESTATE INFORMATION: SSN: 201-16-4525 FILE NUMBER: 2101-0437 DECEDENT NAME: MCCULLOCH BLANCHE L DATE OF PAYMENT: 09/26/2002 ; POSTMARK DATE: 00/00/0000 , CUMBERLAND ; COUNTY: 03/30/2001 I DATE OF DEATH: NO. CD 001655 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $184.20 I I I I I I I I TOTAL AMOUNif PAID: REMARKS: LYNETTE M MCCULLOCH C/O JUDD AHRENS ESQUIRE CHECK# 102 SEAL INITIALS: SK RECEIVED BY: REGISTER OF WILLS $184.20 MARY C. LEWIS REGISTER OF WILLS CO' q> - --r---- I I X LlJ C\j CD ~ LlJ cr () o fJ .....-.-:. <X ...' . - '>;II' J I, . "..... (~ '; I o , #, - . .... (, :.:t ' , . --OJ... .# ..- C\J Q:) f'.- <.0 (:') ~ <( <( d z I- 2 ~ o ~ <:( lLJ 0:: lLJ ::r: :3 o u. "4l"-'-'-"".:;l >< ~I- ~E:: c:t ~ LLJ Z C/) (J ~ ~ crLLJ ~z C/) c:t ...J Zw c:( Z U __ WZ (J a.~ __ -lL. LtlL. ~O Z - I- 2 I.J.J-Jcr :z~OI.J.J OC!)fEco <:{C!)2~ l.J.Jo~ 202 <:( c i, · f- '5'\"" o ~ c:( ...J ~ E S 2 ~ s! en en ILl 21J.Ji>( 2:::>;! g 1L12-1 0 Q.lLlo:( r:h 1.1..>.;:) C\J o a:1LI Q ;: ::r - I-I.I..~ q:: q!~~ Q ~~;:Z....(~j 2~O&3 Ol-';:)~cn ~a:o:(C\JC/) ~~IU....:(( OIJ.J!fhcr OCmc1 (f) -J -J ~ L.L.. o cr: ~ (f) tB cr: ::.. i-_ ,.. L., !.... ~ o cr I.L. o ILl > iLi u l.LJ crL ('0.. .~~ .~- ~l: . -~ I..J l.LJ r tJ ...J ~ en \ /6- ~c:LR-,--~~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 11128-0601 I COMMONWEALI~~. _ DEPARTMENT OF REVENu~ I I ~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REY-1547 EX AFP 101-02> '02 IlPi:: -1 DATE ESTATE OF DATE OF DEATH FILE NUMBER :( -.ZCOUNTY ACN 03-18-2002 MCCULLOCH 03-30-2001 21 01-0437 CUMBERLAND 101 BLANCHE L THOMAS J AHRENS ESQ AHRENS LAW OFFICE - ;. 5521 CARLISLE PIKE \.;.': MECHANICSBURG PA 17GBOlii' 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 ~ RE-,,=is4-j-Ex--AFP--foi-:o21--NoTICE-OF-'rN"HERITANci-TAX-A-PPRA-isEHENT~--AL:rOWAN-ci-cfR-------------- --- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF MCCULLOCH BLANCHE L FILE NO. 21 01-0437 ACN 101 DATE 03-18-2002 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 (1) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 3,435.12 .00 595,291.29 (8) NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 598,726.41 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 Bequestsj Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 13,073.24 .00 (11) (12) (13) (14) ]3.073 24 585,653.17 .00 585,653.17 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. Allount of Line 14 at Spousal 16. Allount of Line 14 taxable at 17. Allount of Line 14 at Sibling 18. Allount of Line 14 taxable at 19. Principal Tax Due TAX CREDITS: rate (15) 11,491.29 X 00 = .00 Lineal/Class A rate (16) 574,161.88 X 045 = 25,837.28 rate (17) .00 X 12 = .00 Collateral/Class B rate (18) .00 X 15 = .00 (19)= 25,837.28 '... I........ 1'(1:\..I:.1r. (+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-29-2001 AA496782 1,263.16 24,000.00 11-15-2001 CDOO0529 .00 574.12 TOTAL TAX CREDIT 25,837.28 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 $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) \. /6-~?-0' BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG. PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '* NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP (01-02) DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN THOMAS J AHRENS ESQ AHRENS LAW OFFICE 5521 CARLISLE PIKE MECHANICSBURG PA 17050 10-22-2002 MCCULLOCH 03-30-2001 21 01-0437 CUMBERLAND 101 L BLANCHE Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-V = iS47-ix--AFP--fol-:021--Ncffici--oF--fNHiifiiAifcE-''-AX-A-PPRA-isiifENT~--A[i-oWAifCE-(fR----------- - - - - -- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF MCCULLOCH BLANCHE L FILE NO. 21 01-0437 ACN 101 DATE 10-22-2002 TAX RETURN WAS: (X) ACCEPTED A$ FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REV~ APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAl RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 4. Mortgages/Notes Receivable (Schedule D) (4) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets CHANGED NO. 01 .00 .00 .00 .00 .00 3J919.50 .00 (8) NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 3,919.50 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 911~ Trusts (Schedule J) 14. Net Value of Estate Subject to Tax I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and re~lect ~igures that include the total of ALL returns assessed to date. 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: .00 .00 (11) (12) (13) (14) nn 3,919.50 .00 589,572.67 19 will 11,491.29 X 578,081.38 X .00 X .00 X 00 = 045 = 12 = 15 = .00 26,013.66 .00 .00 26,013.66 (19)= r"Tn~nl 1'(~\;~.1rl (+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-29-2001 AA496782 1,263.16 24,000.00 11-15-2001 CDOO0529 .00 574.12 09-26-2002 CDOO1655 7.82- 184.20 TOTAL TAX CREDIT 26,013.66 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 REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) 7~ v 5521 CARLISLE PIKE MECHANICSBURG, PA 17050 TELEPHONE (717) 697-1800 FAX (717) 697-1866 AHRENS LAw OFFICES, P.C. November 14,2001 Commonwealth of Pennsylvania Department of Revenue Dept. 280601 Harrisburg, P A 17128-0601 RE: Blanche L. McCulloch S.S. # 201-16-4525 Date of Death: March 30, 2001 Dear Sir or Madam: Enclosed please find Form REV -1500 (Inheritance Tax Return for Resident Decedent) to be filed in your office in reference to the above decedent. We are sending the Tax Return and all attachments directly to the Department of Revenue for confidentiality purposes. Weare filing only the first two pages and Schedule E (Cash, Bank Deposits) of Form (REV-1500 EX) with the local Register of Wills in Cumberland County along with a copy of this letter so that the local office is aware of the reason for only receiving the first two (2) pages and Schedule E of the Return. With kindest regards, 4/ L---. Thomas J. Ahrens, J.D. Enclosure cc: Cumberland County Register of Wills Owen H. McCulloch, Executor Jay W. McCulloch, Trustee WWW.AHRENSGROUP COM o V PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY UNTIL COMPLETION STATUS REPORT UNDER RULE 6.12 Name of Decedent: 6l-.flN~1I E L. /111,(_, CULL oct, Date of Death: mAl( ( J..l '3 L7 j 20 CJ I 2oo/.Jo (?O'l~ 7 Estate No.: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned ~state: 1. State whether administration of the e~tate is complete: Yes v No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: (dale) 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 ~ The separate Orphans' Court No. (if any) for the personal representative's account is: (Not Applicable in Dauphin County) Did the personal representative state an account informally to the parties in interest? Yes t/ No Copies of receipts, releases, joinders and approvals of fonnal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. B. C. D. Date: g -0- 02- -;,J I-~ Signature -rH () lVlI1 S J. H H Ie ~/1J .J' Name (Please type or print) 55 2, I elf ;e L I J L f PI f f,= Address /'Vf tf:' ( 1-1 Ii rJ I C, SitU/( {;/ P /I ; 10 5D J ! rl7J (017 ~ / fj IJD Telephone No. Capacity: Personal Representative / Counsel for Personal Representati ve REV.1500.rXII..(IQ) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 ;' C,-,:,';, ,? - -3 OFFICIAL USE ONLY ~;/( C I- Z W C W U W C w I- ",:5" ,,"'''' w"g J:~...l "..., .. " FILE NUMBER 21 - 01 COUNTY CODE YEAR INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENfS NAME (LAST, FIRST, AND MIDDLE INITIAL) McCulloch, Blanche L. DATE OF OEATH (MM-OO-YEAR) OATE OF BIRTH (MM-OO-YEAR) 03/30/01 04/22/1925 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, ANO MIDDLE INITIAL) McCulloch, Jay W. [iJ 1. Original Return D 4. Limited Estate (!] 6. Decedent Died Testate (Attach a:lPY 01 W~ll D 9. Litigation Proceeds Received 437 --- NUMBER SOCIAL SECURITY NUMBER 201 - 16 ~ 4525 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER D 2. Supplemental Return D 4a. Future Interest Compromise Idale of death after 12.12.62) [X] 7. Decedent Maintained a Living Trust (Attach copy 01 TnJst) D 10. Spousal Poverty Credit (dltt olliealh tlelwMn 12.31.91 and 1.1.95) o 3, Remainder Return {date of deat~ poor 10 12.D-B2: o 5, Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec, 9113(A) IAMCIl Scr 0', I- Z W C Z o .. " w '" '" o " NAME COMPLETE MAILING ADDRESS Thomas J. Ahrens Es FIRM NAME ('_..\.. Ahrens aw Offices TELEPHONE NUMBER (717) 697-1800 5521 Carlisle Pike Mechanicsburg, PA 17050 None None None OFFICIAL USE ONLY 1. Reel Estate (Schedule A) 2. Stocks and Bonds (Schedute B) (1) (2) (3) (4) (5) None 3,435.12 None 595,291.29 (8) 598,726.41 3. Closely Held Corporation, Partnership or Sole-Proprietorship z o ~ ::l l- ii: < u w a: 4. Mortgages & Noles Receivable (Schedule OJ 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. JoinUy Owned Property (Schedule F) o 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 & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Tot,l Deduction. (Iotal Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental BequestsJSec 9113 Trusts for which an election to tax has not been m,de (Schedule J) (11) (12) (13) (14) 00 (15) x.O_ x .045- (16) x .12 (17) x .15 (18) (19) 13,073,24 585,653,17 (6) (7) 13,073.24 (9) (10) None None 585,653.17 0.00 25,837.28 0.00 0.00 19. Tax Due CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 25.837.28 z o ~ I-' ::l a.. :E o U ~ 20.0 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 11,491.29 - - . ~ '. ~ :; ~,~.,:;.~ --;;-:,.::;.~ 16. Amount of Line 14 taxable at lineal rate 574.161.88 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate Decedent's Complete Address: STREET ADDRESS 251 Wildwood Lane CITY Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B.Priorpayments C. Discount (1) 25,837.28 0.00 74.000'uU 1.263.16 Total Credits (A+ B + C) (2) 25,263.16 3. InterestlPenalty ~ 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) 0.00 5. ~ 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 + SA. This is the BALANCE DUE. (SA) (5B) 574.12 0.00 A. Enter the interest on the tax due. 574.12 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 01 the property transferred;.................................................. ....................................... 0 IX] b. retain the right to designate who shall use the property transferred or its income; ....................... ................ 0 IX] c. retain a reversionary interest; or.............................................................. ............................ .................... 0 IX] d. receive the promise for life of either payments, benefits or care? .................. ........................................ 0 IX] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .................................................................... .................... .................... 0 [l1] 3. Did decedent own an "in trust for" or payable upon death bank acoount or security at his or her death? ..... 0 Qg 4. Did decedent own an Individual Retirement Acoount, annuity, or other non-probate property which contains a beneficiary designation? ............................................................................ .......................... ..... [] 0 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 lhall haV9 examined this return, including accompanying schedules and statements, and to the best of my kr'lOWledge and belief, it is true, correct arid complete Dedar1tion of preperer other than the parsonall1lpresentativlt is based on ,II information of which preparer has any knowledge. S N RE OF ~RJON RESPON~L; FO)l,FILlNG RETURN ~t 'flv~ Owen Harper McCulloch ADDRESS ~ DATE 321 Wildwood Lane, Newville, PA 17241 REPRESENTATIVE DATE Ahrens Law Offices 5521 Carlisle Pike, Mechanicsburg, PA 17050 For dates of death on Of 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. 99116 (a) (1.1) (ii)] The staMe does not examot a transfer to a surviving spouse from tax, and the staMory 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 stepperent of the child is 0% [72 P.S. ~9116(a)(1.2)1. 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(alllll The tax rate imposed on the net value 01 transfers to or for the use of the decedenfs sibnngs is 12% [72 P.S. ~9116(a)(1.3)J. 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. ~1!QO'I'_'1j '* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEAlTH OF PENNSYLVANIA INHERiTANCE T IJ. RETURN I liT liT ESTATE OF Blanche L. McCulloch SSN: 201-16-4525 FILE NUMBER 21-01-437 1nc:tu6e !he proc:eeds of litigation and the date the proceeds were recetYed by the estate. All property jolntly-owntd wtth the right of lurvivo"hip must be disclosed on s.chedu~ ; ITEf.! NUf.!BER DESCRIPTION VALUE AiDA 7:: OF OEA;- Burial Reserve CD at Farmers National Bank, Statement of Values Attached. 3,435.12 T/"'IT~! '^ I" "'_ , '1 I, I r:; ,,, REV.'_EX+(i-llOl *' _1 REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT COMMONWEALTH Of PENNSYLVANIA DEPARTMENT OF REVENUE DEPT,280601 HARRISBURG. PA 17128-0601 ~ [m'._ d&3 i 3 i __"'":::...._""""_==,,,,,,,,,,,1 11.0 FILE NUMBER 21 01 0437 COUNTY .CO~E;__ Y!"ti~.__ --=r _i~~:~~;R; :UM8ER[..:=[::[.._-- I THIS RETURN MUST BE FILED IN DUPLICATE WITH THE -1- SOCIAL SEC~;~I~~~~ OF WILLS ! ~ z w o w u w o DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) McCulloch, Blanche L J\~.UM.B_ER + McCulloch, Jay W ---- i U1-:-0riglna'l Return- ~ 2. supplemen1al-R;t~~~' w , ~ "I 0 lI: ~ :! D 4. Limited Estate 4a. Future Interest Compromise (date of death after ottg 12-12-82) ~ ~ al D 6 Decedent Died Testate (Attach copy D 7. Decedent Maintained a Living Trust {Attach of Will) copy of Trust) ~ 0 0 0 I 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of dealh between 11.Election to tax under Sec. 9113(A) (Attach 8ch 0) '"..... _. ....., '," ....... '.' ..~____~~.~2~31-91a~;d1-1-9~l,.;; "';""'~~_'-'-~__~""""""". . .'~_.... . . . ...~__ . .. -~~f$iicnON"MUST1iacOMPiiTED' .ALL. CORRESPONDENCE.ANDCONf!P~::~~~~1~~N~~~~~~~~.S!lQ~LDElEI?I~ECTED TO:___. . I- 'Thomas J. Ahrens "'z Ww ~o ~i!i u~ DATE OF DEATH (MM-DD-YEAR) -----DATE OF BIRfl.r(MM~15o--YEAR) 03/30/2001 04/22/1925 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL) FIRM NAME (If applicable) i Ahrens Law Offices, P.C. ELEPHONE NUMBER 717/697-1800 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule 0) z o ~ ~ ~ ~ < u w ~ 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o 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 & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 161,34-0730 D 3. Remainder Relum (dale of death prior to 12-13-82) o 5. Federal Estate Tax Return Required 8 Total Number of Safe Deposit Boxes 5521 Carlisle Pike Mechanicsburg, PA 17055 (1) (2) (3) (4) (5) (6) (7) 'lULl' None None None None None 3,919.50 None (8) 3,919.50 (9) (10) (11) (12) 3,919.50 13. Charitable and Governmental Bequests/Sec 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) (13) (14) 3,919.50 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) z 3,919.50 .045 (16) 0 16.Amount of line 14 taxable at lineal rate x ~ ---- ~ ~ 17.Amount of line 14 taxable at sibling rate x .12 (17) ~ 0 u ~ 18. Amount of line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) 120. 0 176.38 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 176.38 >> BE SURE !() ANSWER ~LL Q~esllQNSON REVERSe sllle AN" ~l\CHECK MATIi<~ Copyright 2000 form software only The Lackner Group. Inc. Form REV-1500 EX (Rev. 6-00) .' Decedent's Complete Address: STREET ADDRESS CITY Newville STATE , PA I ZIP Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 176.38 Total Credits (A + B + C) (2) 0.00 3. lnteresUPenalty if applicable D. Interest E. Penalty 7.82 A. Enter the interest on the tax due. B. Enter the total of Une 5 + SA. This is the BALANCE DUE. (3) 7.82 (4) (5) 184.20 (SA) (58) 184.20 TotallnteresVPenalty (D + E) 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 5. If Line 1 + Line 3 is greater than line 2, enter the difference. This is the TAX DUE. 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; B ~ b. retain the right to designate who shall use the property transferred or its income;.. 101 c. retain a reversionary interest; or.. . .................. D ~ 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 D receiving adequate consideration?. .. .......................... D ~ ~ ~ D 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?.. 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?. 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 pe~ury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief. il is true, correct and complete. Declaration of preparer other th~nJ~~_PlOl_rsonal represent~li\le.ls_ ~~~~~I inforr:!!ation of w~i0y~e...a_rer_has any kno.Vo'~~~~: __ _ _ ________ ________ SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN AODRESS o Harper McCulloch SI : REOF E~~~ -rk_ d SIGNATURE OPPRE-PARER OTHER THAN REPRESENTATIVE Thomas J. Ahrens DATE 321 Wildwood Lane Newville, PA 17241 9/~Dfio:;, ADDRESS 9- 27 4'z... ADDRESS DATE 5521 Carlisle Pike Mechanicsburg, PA 17055 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 twentyMone 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) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116 1.2) [72 P.S. ~9116 <a) (1)]. The 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 (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. '* SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT I FILE NUMBER 21-01-0437 ------------- ESTATE OF McCulloch, Blanche L If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A Owen H. McCulloch 321 Wildwood Lane Newville, PA 17241 Son B Neal A. McCulloch 243 Wildwood Lane Newville, PA 17241 Son C Hale A. McCulloch 233 Wildwood Lane Newville, PA 17241 Son see continuation JOINTLY OWNED PROPERTY: u---r --- ITEM LETTER NUMBER FOR JOINT TENANT -, DESCRIPTION OF PROPERTY Include name of financial institution and bank account number or similar identifying number. Attach deed for jointly-held real estate. DATE OF DEATH % OF DATE OF DEATH DECO'S VALUE OF VALUE OF ASSET [INTEREST DECEDENT'S INTEREST DATE MADE JOINT -- ------.-......--..-- A 04/01/1988 US EE Bond 2 A 09/01/1987 US EE Bond 3 B 02/0111988 US EE Bond 4 B 05/01/1988 US EE Bond 5 C ' 02/0 I /1988 US EE Bond 6 C 02/0111989 US EE Bond , , 7 D :02/01/1988 [US EE Bond 8 D 06/0111988 US EE Bond 1,036.80 50% 518.40 539.40 I 269.70 50%, 1,057.60 50% 528.80 1,036.80 50% 518.40 1,057.60 50% 528.80 1,016.40 50% 508.20 1,057.60 50% 528.80 1,036.80 50% 518.40 TOTAL (Also enter on line 6, Recapitulation) 3,919.50 ,. *' SCHEDULE F JOINT OWNERS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF McCulloch, Blanche L FILE NUMBER 21-01-0437 SURVIVING JOINT TENANT(S) NAME D Ruth A. Rolar ADDRESS RELATIONSHIP TO DECEDENT 40 Dogwood Manchester, KY 40962 Daughter