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Home My WebLink About01-0509 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY - PENNSYLVANIA Estate of Ray E. Boyd PETITION FOR GRANT OF LETTERS No. rJ.. /- (/ / - ~7:J7 also known as , Deceased Social Security No. 164304815 Tonia D. Fischer Petitioner(s), who is/are 18 years of age or older, apply)ies) for: (COMPLETE "A" OR "B" BELOW:) o A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut Decedent, dated and codicil(s) dated named in the Last Will of the State relevant circumstances, e.g., renunciation, death of executor, etc Except as follows, Decedent did not marry, was not divorced and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: KI B. Grant of Letters of Administration (c.t.a., d.b.n.c.t.a.: pendente lite, durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence . {71'1 S' G<<.I..p l?aS5 County, Pennsylvania, with his/her last family or principal Decedent, then 66 years of age, died March 27 Decedent at death owned property with estimated values as follows: (if domiciled in PA All personal property......................................... $ /1.// 000 . 00 (if not domiciled in PA Personal property in Pennsylvania .................... $ (if not domiciled in PA Personal property in County.............................. $ Value of real estate in Pennsylvania ........................................................................................ $ T atal ..................................................................................................................... $ I <-/, 0 0 0 . 6 0 Real Estate situated as follows: Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: Typed or printed name and residence 1525 Santa Rosalia Drive North Las Ve as NV 89031 RW-1 /-~ -;) 3~...1 'i 21-01-509 Oath of Personal Representative Commonwealth of Pennsylvania County of CUMBERLAND The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of ~e~~~2rer(s). and. that, as pe.rsonal representative(s) of the Decedent, Petitioner(s) will well and truly administer th~~inJtJa"Fi& ~ Sworn to and affirmed and subscribed -'-- before me this /c:J a day of Aoril. 2001 ~t~~;:w. (l.1l.~~~ TOn"Q D. h'~e_j712~ Estate of Rav E. Bovd DECREE OF REGISTER Deceased No. 21-01-509 also known as Date of Death: 3/27/01 Social Security No: 164304815 AND NOW, MAY 29, 2001 reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters 0 Testamentary !XI of Administration , in consideration of the Petition on the are hereby granted to Tonia D. Fischer ((c.t.a., d.b.n.c.t.; pendente~;:OOrante a~ntia; duranteminoriate) ~_. '. l..-. in the above estate and that the instrument(s), if any, dated None described in the Petition be admitted to probate and filed of record as the Last Will of Decedent. FEES Letters.. o.f.. .ADMlNISTMT.l.ON $ 50.00 Short Certificates( s) ....... .~...... Renunciation.................. J..... Extra Pages ( ) ............... I.T.R....................................... JCP Fee ................................. Inventory............................... . Other............. ~.~~................ mlJr! te~.M>. {l.tl. ~.I7,U)I, OoO/Jf ' Register of Wills / , $ 12.00 $ $ $ $ $ $ $ 5.00 Signature 5.00 Attorney: H. Anthony Adams, Esquire 1.0. No: 25502 Address: 128 E. KinQ Street ShippensburQ Telephone: (717)-532-3270 PA 17257 15.00 TOTAL .............................$ 87.00 MAILED LETTERS TO ATTORNEY DATE FILED: MAY 29, 2001 MAY 29. 2001 T---.J'f\':::"C'(\:::; "':'~\' (\10(. 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. Fee for this certificate, $2.00 p 7249263 Akc.42 ~ 2L?L>/ Date v 1/9\ COMMONWEALTH OF PENNSYLVANIA' D!PAATMENT OF HEALTH' VITAL RECORDS CERTIFICATE OF DEATH (Coroner) .,..,ILE _II ITY NUMBER g:~'Iy,D White SURVIVING SPOUSE (U wlln, gll,/(O l1\dl(t.~" IlllfTlIl) - /bolO MD __ 24-21_blClIlIllIIIIIdbr ----. NoD MfIT II: 0IIw Ilgnlftc.... condItIoM CO_In1l'O _h, Ilul nac _Ing In ,''' ~1n1l ceuoe given In ""AT I -.CAWI(FlnoI _OI~ 'fl1U4hng",-)- ~..- w...,. -.gill.......... _.E_~ CAUII ~0I1rVY "'81__ '''''''ngln_1UllT b. DIJE TO (OR AS" CONSEQUENCE 01'): DUE TO (OR AS" CONSEOUENCE 01'): MSAN" PERFORMED? d Y FlNDINOS MIl.AIIl.E PRIOR TO COMPlETION OF CAUSE OF DERK? MANNER OF DE _ 0 No~ _0 No!>> Nil"'" - ~ o o - HI. ... CEJnJNRlO**cny one) 'CEJnI'YIIIQ 1lH'fIICIAN(Phyoicion certIIyW1g ca.-0I dMlh __ phyolcilln.... pranwnced _ and~ '- 23) To.._"............. ___ID..___,----..................................................... ~ ft. NndInO -.-n Could nac bI_ .,..,..... NIIJ CIIITI'YlIIG IlH'fIICIAN (PhyoIciIn boIh poonounclnO _ _ CIIIlfyIng to _ 01 dIIlh) __......."..,........... _ _ II "lInII. .... _....... ....... to... 0MIII(ll).... ___ II...... . . . . . . . . . . . . . . . . . . . . . . . . '1mJlCAL~ 011........."............... end/Or~, In my apInIOn. C1M1t1___Il....llIlIe. .... IIId ....1IId _ to.... .....) IIId --................ . ....... ........... . .............. .............. ....... ..................... ............ 31.. REGlSTlWl'S SIO I~/ I~II ~ ANDNV_ II. M. IN THE COURT OF COMMON PLEAS OF THE 39TH JUDICIAL DISTRICT OF PENNSYLVANIA - FRANKLIN COUNTY BRANCH RENUNCIATION Estate of Ray E. Boyd No. 21-01-509 also known as , Deceased The undersigned, Terri R. Peck, daughter, and Kenneth E. Boyd, son, (Relationship) (Capacity) of the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that Letters Administration be issued to Tonia D. Fischer Witness our hand this 10t"h day of April 2001 ~i (? pj,.flK (Signature) 205 Three SpinQs Estates, Three spr~ ~ &A#~JfLE . . n~~ PA 17264 HCR 83, Box 891, Shade Gap, (Address) PA 17255 C' ,.... -~," (Signature) (Address) Sworn to or affirmed and subscribed before me this day of Notary Public My Commission Expires: (Signature and seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's commission.) NOTE: Renunciations executed outside the Office of Register of Wills are required in some counties to be notarized. RW-3 21-01-509 - BOND REGISTER OF WILLS OF CUMBERlAND COUNTY BOND AND SURETY FOR PERSONAL REPRESENTATIVE KNOW ALL BY THESE PRESENTS, That Tonia D. Fischer as principal(s) and Pennsylvania National Insurance Co. POBox 2361 Harrisburg, Pa. 17105-2361 as surety (sureties) are held and firmly bound unto the Commonwealth of Pennsylvania in the sum of Twenty Thousand dollars ($ 20,OOO.CAo be paid to the Commonwealth, for which payment we do bind ourselves, jointly and severally, our heirs, executors, administrators and successors, the condition of this obligation being that if Tonia D. Fischer as (state fiduciary capacity) Administratrix of the estate of RRY F. _ Royd , deceased, or any of them, shall well and truly administer the estate according to law, then this obligation shall be void as to the personal representative or representatives who shall so administer the estate and his or their surety or sureties; but otherwise it shall remain in full force. Signed and sealed this I i+~ day of May , 19 2001 , each intending to be legally bound hereby. (Seal) (Seal) (Seal) (Seal) ? (Seal) PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY Harrisburg, Pennsylvania POWER OF ATTORNEY Know All Mcn By thesc Prcsents, That PENNSYL VANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY, a corporation of the Commonwealth of Pennsylvania, does hereby make, constitute and appoint JEFFREY P. FOGEL SANGER AND FRED E. CLAPSADDLE JR., BOTH OF SHIPPENSBURG, PENNSYLVANIA (EACH) its true and lawful Attorney(s)-in-Fact to make, execute, seal and deliver for and on its behalf as surety as its act and deed: ANY AND ALL BONDS AND UNDERTAKINGS PROVIDED THE AMOUNT OF NO ONE BOND OR UNDERTAKING EXCEEDS THE SUM OF TWO HUNDRED FIFTY THOUSAND DOLLARS ($250,000.00)----------------- ---------------------------------------------------------_._------------------------- ALL POWER AND AUTHORITY HEREBY CONFERRED SHALL HEREBY EXPIRE AND TERMINATE WITHOUT NOTICE AT MIDNIGHT OF THE 31ST DAY OF AUGUST 2002, AS' RESPECTS EXECUTION SUBSEQUENT THERETO. and the execution of such bonds in pursuance of these presents shall be as binding upon said Company as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the Company at its office in Harrisburg Pennsylvania, in their own proper persons. This appointment is made by and under the authorization of a resolution adopted by the Board of Directors of the Company on October 24, 1973 at Harrisburg, Pennsylvania, which resolution is shown on the reverse side hereof and is now in full force and effect. In Witncss Whc.'cof: PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY has caused these presents to be signed and its corporate seal to be affixed on AUGUST 14, 2000 \{~:~~~~:~;~:~, \. '.r ....~., f \ :~.., .~,,>; J ":'~;".<".~\~ .'/ PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY By t;;"Y1/d r? JJ{.::tP ~ "Kenneth R. Shutts-Secretary Commonwealth of Pennsylvania, County of Dauphin - ss: 0~'~_if' (\ ~~(:_t?~ Public NOTARIAL SEAL CHRIST'NA ENCK, Notary Public Harnsburg, Dauphin County My Commission Expires Jan, 27, 2003 I, Thomas L. Vehar, Vice President, Surety of the PENNSYLVANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY, a corporation of the Commonwealth of Pennsylvania, do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney, executed by the said Company, which is still in full force and effect. On AUGUST 14, 2000 , before me appeared Kenneth R. Shutts to me personally known, who being by me duly sworn, did say that he resides in the Commonwealth of Pennsylvania, that he is Secretary of PENNSYL VANIA NATIONAL MUTUAL CASUALTY INSURANCE COMPANY, that he is the individual described in and who executed the preceding instrument, and tl13t the seal affixed on said instrument is the corporate seal of said Company, and that said instrument was signed and sealed on behalf of said Company by authority and direction of said Company, and the said officer acknowledged said instrument to be the free act and deed of said Company. ....;\;:~.irJ~.. ;>" .:/..A.:i~{;~;;:;,..,~~Z~:':. iF \~~t?~:~~::::>/ Conmlol1wealth of Pennsylvania, County of Dauphin - ss: In Witncss Whercof, I have hereunto set my hand and affixed the corporate seal of said Company on Vice President, Surety IMPORTANT NOTICE: This border must be RED in color. If it is not RED, this is not a certified copy. Telephone us at Area Code 717-255-6870. ~ 78-19O{Rev 1/99) E --- CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) Name of Decedent: Ray E. Boyd Date of Death: March 27, 2001 Will No: 2001-00509 To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphan's Court Rules were served on or mailed to the following beneficiaries of the above captioned estate on: September 7, 2001 Name Address Terri R. Peck 205 Three Springs Estates Three Springs, PA 17264 Kenneth E. Boyd HCR 83, Box 891 Shade Gap, Pa. 17255 Tonia D. Fischer 1525 Santa Rosalia Drive North Las Vegas, NV 89031 Notice has now been given to all persons entitled thereto under Rule 5.6 (a) except: None. Date: 9/7/01 ~~~ H. Anthony Adams, Esquire - 128 E. King Street Shippensburg, PA 17257 Telephone: (717)-532-3270 Counsel for Personal Representatives 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 ADAMS H ANTHONY 128 EKING ST SHIPPENSBURG, PA 17257 -------- fold ESTATE INFORMATION: SSN: 1 64-30-481 5 FILE NUMBER: 2101-0509 DECEDENT NAME: BOYD RAY E DA TE OF PAYMENT: 04/10/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 03/27/2001 NO. CD 001047 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $7/715.83 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: TONIA FISCHER C/O H ANTHONY ADAMS ESQUIRE CHECK#108 SEAL INITIALS: VZ RECEIVED BY: REGISTER OF WILLS $7/715.83 MARY C. LEWIS REGISTER OF WILLS ex: c-- ~ d. '-- ~.-...." " ~\~, -~ ~ ~?: .~O- -- a-"I ,If · ~.' ';. i"-'. ~, - .... . ..1, -j~ -----.\ '" V, .. ,~ ... .l -"'~ '~ . .... fa ---- \ilL ~. \18 ...... 0.. ~1:' '. ~. .. \\ (f' .. "~'.:.'.. ':, .~. }....J-. _~\ 'J \~ .) _In ';! -~ ./ .. \~ )... j:, :,J. - - ,. .i ~ _.~ c. ua -1 ua \ , , ~ r;.'3 0.0 .ta Ul \ Q _'~i ,\1.. ,,,,,~".l .. '~ ').~..:\ ;:'\ .,~. -. \ _:~~ a It ."l ~ -, ,~ .:~ \~ 0"\ '>& ... ~.l\ ;', a:: t\ I', ,. .-- () \ ?1> \~. ~ fa 'X rv' ~~ ~.~ ~ _'~ .c::C. ..\li '\J" .~ ..~ 0\ t: ~ .. \ \;\ 1-- *-.. .. ~.v ,. -(;-'1 .~. J,~\ i6 . .. J~: ~'" ~ ~ C)).\ tt. ' ~ ,/:7, (/. if.\ .. ) l!- t!. ....'-' .. ;;, tal - .. '31 ~ 6:" ~~... l;. " ./ ~" "-<!\ ,-.- ,\'\ ~. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT 280601 HARRISBURG. PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT 10':L~03Y~ -It-f v oo60g COUNTYCQiiE -YEA~ - - NUM6ER- - FILE NUMBER ~ 1-0 I- Z W C W CJ w C DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) DATE OF BIRTH (MM.DD-Year) SOCIAL SECURITY NUMBER 64-30-4815 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER W I- ~~(/) ,,"'''' w"'-" ,,00 ,,"'-' "'-'" "'- <: 03/27/2001 09/20/1934 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) L&J 1. Original Return o 4. limited Estate o 6. Decedent Died Testate (AlIachcopyofWill) D 9. litigation Proceeds Received D 2. Supplemental Return o 4a. Future Interest Compromise (date of death alter 12.12.82) D 7. Decedent Maintained a Living Trust (Attach copy clTlust) D 10. Spousal Poverty Credit (dale of death lletween 12-31-91 and 1-1-95) 03. Remainder Return (date of death pnor to 12-13-82) o 5. Federal Estate Tax Return Required Q.. 8. Total Number of Safe Deposit Boxes o 11, Election to tax under Sec. 9113(A) (Attach Sch 0) THI$SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS H_ Anthon Adams 49 West Orange Street FIRM NAME (If Applicable) I- Z W C Z o "'- Ul W '" '" o o TELEPHONE NUMBER 717 -532-3270 Suite 3 Shi (1) (2) (3) (4) (5) (6) (7) PA 17257 z o I- <( ....I ::J l- ii: <( CJ w Q;: z o ~ I- ::J D.. :!! o CJ ~ I- 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) OFFICIAL USE ONLY d i-J 3. Closely Held Corporation, Partnership or Sole-Proprietorship ........". ,-_.I', ' 4. Mortgages & Notes Receivable (Schedule 0) 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) 15,64298' .J 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 7.99110 10, Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total 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) 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 spousai tax rate, or transfers under Sec. 9116 (a)(1.2) 19. Tax Due x (15) 171,462.88 X .045 (16) X 12 (17) X .15 (18) (19) i: G\ 163,811.00 (8) 179,453.98 (11) (12) (13) 7,991.10 171,462.88 16. Amount of Line 14 taxable at lineal rate (14) 171,462.88 17. Amount of Line 14 taxable atsiblin9 rate 7,715.83 7,71583 20. D CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 18. Amount of Line 14 taxable at collateral rate De!:edent~s Complete Address: STREET ADDRESS 4 North washinoton Street CITY I STATE I ZIP Shippensburg Pa 17257 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C Discount (1) 7,715.83 Total Credits (A + B +C) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty T otallnterest/Penaily ( 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) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This Is the TAX DUE. (5) A. Enter the interesl on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 7,715.83 7,715.83 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred; .................. ..... b. retain the right to designate who shall use the property transferred or its income: . c. retain a reversionary interest; or ... ... .................. d. receive the promise for life of either payments, benefits or care? . 2 If death occurred after December 12, 1982, did decedenl transfer property within one year of death without receiving adequate consideration? ................ 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? .. Yes o o o o No IKJ IKJ IKJ IKJ o o IKJ IKJ IKJ o IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEOULE G AND FILE IT AS PART OF THE RETURN. DATE 7J57 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 us [72 P.S. 99116 (a) (1.1) (ill. 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) (iil] The statute does not exemDt 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 slepparenl of the child is 0% [72 P.S. 99116(a)(1.2)] The lax rale imposed on the net value of transfers to orlor the use of the decedent's lineal beneficiaries is 45%, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)]. The lax rale imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 PS. 99116(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 c".,~"""."". COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Rav E. Bovd 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. FILE NUMBER ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 784.00 U.S. Treasury Tax Refund 2. Allstate refund of Insurance 240.30 3. Checking account Orrstown Bank 14,618.68 TOTAL IAlso enter on line 5, Recapitulation) $ IIf more space is needed, insert additional sheets of the same size) 15,642.98 ""'~""."'O". COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER.VIVOS TRANSFERS & MISC, NON-PROBATE PROPERTY ESTATE OF Rav E. Bovd FILE NUMBER This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes DESCRIPTION OF PROPERTY %OF ITEM INCLUDE THE NAME OFTHE TRANSFEREE,THEIR RELATIONSHIP TO DECEDEN TANDTHEDATEOFIRANSFER DATE OF DEATH DECO'S EXCLUSION TAXABLE VALUE NUMBER ATTACH ACOPYOf THE DEED FOR REAL ESTATE VALUE OF ASSET INTEREST iIFAPPlICABLE;. 1 Scudder Trust Funds (IRA ACCOUNT) 163,81100 100. 163,81100 #9226549-7 TOTAL (Also enter on line 7, Recapitulalion) $ 163,811.00 (If more space is needed, insert additional sheets of the same size) REV.1511EX~ll;97)._~_ .' ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Rav E. Bovd FILE NUMBER Debts of decedent must be reported on Schedule!. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Fogelsanger Bricker Funeral Home 4.31410 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Tonia Fischer 2.00000 Social Security Number(s) I EIN Number of Personal Representative(s) Street Address 1525 Santa Rosalia Drive City North Las Ve!<as State NV Zip 89031 Year(s) Commission Paid: 2002 2. Attorney Fees H. Anthony Adams 1,500.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees Register of Wills 102.00 5. Accountant's Fees 6. Tax Return Prepare~s Fees 7. Bond for Administrator J. Paul Fogelsanger 75.00 TOTAL (Also enter on line 9, Recapitulation) $ 7991.10 (If more space is needed, insert additional sheets of the same size) REV'1513E~+11:971__~_ . ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER R~" E. B ,,,rl RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1. Tonia D. Fischer child 1/3 1525 Santa Rosalia Drive North Las Vegas, NV 89031 2. Terri R Peck child 1/3 205 Three Springs Estates Three Springs, Pa. 17264 3. Kenneth E. Boyd child 1/3 HeR 83, BOx 891 Shade Gap, Pa. 17255 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 1. 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) V /tl,-~E~-/-Y BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX H ANTHONY ADAMS ESQ STE 3 49 W ORANGE ST SHIPPENSBURG .02 DATE ESTATE OF DATE OF DEATH FILE NUMBER :r99UNTY ACN 05-20-2002 BOYD 03-27-2001 21 01-0509 CUMBERLAND 101 jijAY 24 '* REY-1547 EX AFP UI-02) RAY E c:,~. PA 1725~,~tTr/ 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 .. REY=is'4-j-ix--AFP-foi-:ozl--NOy-iCi--oF-INHiifiTAifcE-YAX-A-PPRA-isiiiENT~--Ai:l-owANcE-'ifR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BOYD RAY E FILE NO. 21 01-0509 ACN 101 DATE 05-20-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED 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 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: r'","cnl I'(C~C~"I {+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 04-10-2002 CDOOI047 .00 7,715.83 BALANCE OF UNPAID INTEREST/PENALTY AS OF 04-11-2002 TOTAL TAX CREDIT 7,715.83 BALANCE OF TAX DUE .00 INTEREST AND PEN. 134.16 TOTAL DUE 134.16 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 15,642.98 .00 163,811.00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ad.. 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 (9) (10) 7,,991.10 .00 (11) (12) (13) (14) NOTE: .00 X 00 = 171,462.88 X 045 = .00 X 12 = .00 X 15 = · IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 179,453.98 7.991 10 171,462.88 .00 171,462.88 (19)= .00 7,715.83 .00 .00 7,715.83 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.) 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 H ANTHONY ADAMS ESQUIRE 1 28 E KING STREET SHIPPENSBURG, PA 17257 -------- fold ESTATE INFORMATION: SSN: 164-30-481 5 FILE NUMBER: 2101-0509 DECEDENT NAME: BOYD RAY E DA TE OF PAYMENT: 06/13/2002 POSTMARK DATE: 06/12/2002 COUNTY: CUMBERLAND DATE OF DEATH: 03/27/2001 NO. CD 001288 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $134.16 I I I I I I I I TOTAL AMOUNT PAID: $134.16 REMARKS: TONIA 0 FISCHER C/O H ANTHONY ADAMS ESQUIRE CHECK# 111 SEAL INITIALS: DO RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS BUREAU'OF INDIVIDUAL TAXES INHERITA~E TAX DIVISION DEPT. 280601 HARRISBURG~ PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, AllOWANCE OR DISAllOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX H ANTHONY ADAMS ESQ STE 3 49 W ORANGE ST SHIPPENSBURG PA 17257 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 05-20-2002 BOYD 03-27-2001 21 01-0509 CUMBERLAND 101 *' REV-1547 EX iFP 101-02) RAY E 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 ~ R'E-y=isit-j-ix--AFP--foi-:02:f-Noi'-ici--OF-.rtiHEifiTANCE-i'-AjrjrpPRA-isEirENT~--ALi-oWAiicE-OR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BOYD RAY E FILE NO. 21 01-0509 ACN 101 DATE 05-20-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. Allount of line 14 at Spousal rate (15) 16. A.ount 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: RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Hortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 15~642.98 .00 163~811.oo (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 7,991.10 .00 (11) (12) (13) (14) NOTE: .00 X 00 = 171,,462.88 X 045 = .00 X 12 = .00 X 15 = NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 179,453.98 7.991 10 171,462.88 .00 171,462.88 (19)= .00 7,715.83 .00 .00 7,715.83 " .." ......." ",..~...." . II {+J AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 04-10-2002 CDooIo47 .00 7,715.83 BALANCE OF UNPAID INTEREST/PENALTY AS OF 04-11-2002 TOTAL TAX CREDIT 7,715.83 BALANCE OF TAX DUE .00 INTEREST AND PEN. 134.16 TOTAL DUE 134.16 · IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. 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(t ,. lU 7.0 /6-~e2- /'l ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 11128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT * REV-1n7 EX AFP (01-02) '02 H ANTHONY ADAMS ESQ STE 3 49 W ORANGE ST SHIPPENSBURG J'IU" 1 C) L _J E: >14 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 07-08-2002 BOYD 03-27-2001 21 01-0509 CUMBERLAND 101 Allount Rellitted RAY E \", P~';17257 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-V: i6o-j-ix--AFP--fol-:ozl-------...--INHEiIi"-ANc'E-fAx--sTA-fEME-tif-oF'-Accou'Nf--...--------------- - ----- ESTATE OF BOYD RAY E FILE NO. 21 01-0509 ACN 101 DATE 07-08-2002 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-20-2002 P R I NC I PAL TAX DU E : ........................................................................................................................................................................................................................... 7,715.83 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 04-10-2002 CDOOI047 .00 7,715.83 06-12-2002 CDOO1288 134.16- 134.16 TOTAL TAX CREDIT 7,715.83 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) - / ~j/ o~ -. Date of Death: ~C'\ \.t 2 ~ \ 3/;;;'7/0 ) ( I STATUS REPORT UNDER RULE 6.12 60,-\ cO \ Name of Decedent: Will No.: Admin. No.: d:n (- 0650? 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~ether administration of the estate is complete: Yes ~ No 0 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 0 b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the persona~resentative state an account informally to the parties in interest? Y es ~ No 0 Date:1jJ3/03 c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. L~-~ Signature \ bl . ~ ~ ~"'" ~ i'{1 'MS Name \(q u..::>. ~~e ~~ S\.)~~ ..3 ,~'^ ~ ~ ~\\;> \1...) '" \0 W'6 \ ~ 6.. /7 'a -.; 7 Address ~/) - S~d ~ 3d-7U Telephone No. Capacity: Wersonal Representative ~ Counsel for personal representative Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (71 7) 240 - 6345 Date: 2/07/2003 FISCHER TONIA D 1525 SANTA ROSALIA DRIVE NORTH LAS VEGAS, NV 89031 RE: Estate of BOYD RAY E File Number: 2001-00509 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. I, for decedents dying on or after July I, 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: 3/27/2003 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, DONNA M. OTTO DEPUTY REGISTER OF WILLS cc: ,J File Counsel Judge