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Home My WebLink About01-0540 Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of also known as Niles Hartman No. ~f -01 ~<lo , Deceased Social Security No. l 8 7 - :3 0 - 0 ( ..3 'f Herbert L. Hartman and Marlin N. Hartman Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW:) [!] A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut ors named in the last Will of the Decedent, dated 03/30/66 and codicil(s) dated None 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 incompetent: D B. Grant of Letters of Administration (c.I.a.; d.b.n.c.t.a; pendente lite; durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: l Name Relationship Residence I .. (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with his/her last family or principal residence at Church of God Home, Carlisle Borough (list street, number, and municipality) Decedent,then~yearsofage,died 05/19 ,~OOl,at Church of God Home, Carlisle, PA (Location) Decedent at death owned property with estimated values as follows: (If domiciled in PAl All personal property (If not domiciled in PAl Personal property in Pennsylvania (If not domiciled in PAl Personal property in County Value of real estate in Pennsylvania $ $ $ $ 54,000.00 situated as follows: Wherefore, Petitioner(s) respectfully requestCs) the probate of the last Will and Codici~s) presented with this Petition and the grant of letters in the a riate form to the undersi ned: Si nature T ed or rinted name and residence Herbert L. Hartman 13 Gilbert Rd., Dillsbur , PA 17019 Marlin N. Hartman 21 Locust Lane, Di1lsbur , PA 17019 /fo --':<35 ,-3 Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form RW-1 (1991) Oath of Personal Representative Commonwealth of Pennsylvania County of Cwnberland 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 Decedent, Petitioner(s) will well and truly administer the estate according to law. JUNE ~2illJ 1 9&~~ 9/Cu/~ Herbert L. ~artman ~/ ~.. ~A'1/~ Ma li:: . Hartman Sworn to or affirmed and subscribed before me this~ay of 'Vfj ~ fi~~ No. ?l-nl-t;L1.Q Estate of Niles Hartman Deceased Social Security No: 187-30-0134 Date of Death: 05/19/01 AND NOW, iune 7 2001 , ~ _' in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters IJ9 Testamentary 0 Of Administration (c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate) I'- I are hereby granted to Herbert L. Hartman and Marlin N. Hartman in the above estate and that the instrument(s) dated 03/30/66 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. Short Certificate(s). $ 11S . 00 12.00 ~.~ FEES Letters. . . . . . . $ Renunciation. $ Attorney: Extra Pages ( ) . $ Address: 06298 The Wiley Group One S. Baltimore St. Affidavits ( $ 1.0. No: 3.00 Codicil. $ JCP Fee. $ Inventory. $ Other $ Dillsburg, PA 17019 5.00 Telephone: 717/432 - 9666 TOTAL. . . . . . . ., $ 135.00 FILED: June 7 I 2000 Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form soft~~e.?nIY cpsyste;;s~'. 1~~Do~' ~'-''1-QI Form RW-1 (1991) WARNING: IT IS ILLEGAL TO ALTER THIS COpy OR TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH. E;1 i F '~F~C' r . f DEA 21-01-5,40 T 4867849 Hay 23 L~200L. S',.lt' '-ljrhi. C'-"',ili'_:,I:iOf"1 Niles Hartman Male j' 187 - 30 - 0134 Dale of DeaHi MCly) J,. 200J.. November 27. 1903f3! Monaghan Township. York COUTlty. PeTln~ylVlmta.w..._.. Church of God Home Cumberland County Car.lisle Bor()ugh . E e.tlJl.?1'.' v alll? White Farmer '~'lt;O 1=0((;(':3) \(8::=. (:"r No c,nV)1 Wj.dowed ~'.,'-1 ;~, (! 1 !"j '>~~ Church of God Home Carlisle PA Mr. Herbert L. Hartman Scott D. Brenneman, FD Cocklin Fune:ralllome.lnc..30 N. Chestnut StreE!.t.l I).illsb1.l.r.,g!1>t\..~E()19~____._... !nterval Between Onset and Death Sepsis days Ischemic Ulcers months Atherosclerosis years ]()W uccurred xxx Dr. Daniels, MD D. DO Coroner, M.E.) 303 N. Baltimore Ave. Mt. Holly Springs, PA ) t, ,: r, f r () : Jl; r t i ~ ! (: ,i':~ J' ncrtillcate Ci~(jecj to the 6..16.0a.__ .. ;'." May 23, 2001 153 I~~gfllj:.R4...DiH.sbu.rg..PA 170L9.. .- "' IDastllill ann IDpstamput OF NILES HARTMAN BE IT REMEMBERED, that I, Niles Hartman, of Monaghan Township, Dillsburg R. D. #3, York County, Pennsylvania, being of sound mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making null and void any and all wills and testaments and writings in the nature thereof by me at any time heretofore made. ITEM 1: I direct that all my just debts and funeral expenses be paid as soon after my demise as may be convenient. ITEM 2: All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situated, whether it be real, personal or mixed, including property over which I have a power of appointment, I give, devise and bequeath unto my wife, Margaret A. Hartman, absolutely, providing that she survives me for a period of thirty (30) days. ITEM 3: In the event that my said wife should predecease me or fail to survive me for a period of thirty (30) days, I then give, devise and bequeath my entire residuary estate unto my children, namely, Mary L. Fertenbaugh, Herbert L. Hartman, Marlin N. Hartman and Ray C. Hartman, in equal shares, per stirpes. ITEM 4: In the event that any child or children succeed to an interest in my residuary estate and said child or children are under the age of twenty-one (21) years at the time of my demise, I then nominate, constitute and appoint the First Bank and Trust w~ess: \(;~Y\ vn (Ai A . ~ .' ( / . - j ... u Iv 'IJ Li~t 'h:~..!t.J d/t?Lt;z~ (Niles Hartman) - 1 - .. ," I I, I I I I I I I (SE~ ) I ! j I i ! I - I I I ~ ," , . . I Company of Mechanicsburg, Pennsylvania, Trustee, until such minor child or children shall respectively attain the age of twenty-one (21) years, at which time my Trustee is directed to pay to said minor its undivided interest in the trust res. I invest my Trustee with power, in its uncontrolled discretion, to anticipate the principal of the trust res for the health, education and maintenance of said minor child or children. LASTLY, I nominate, constitute and appoint my sons, Herbert L. Hartman and Marlin N. Hartman, to be the Executors of this my Last Will and Testament. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 3c-f-L, da y 0 f Iv\. CJ.. v '- " , 1966. Q;t' ~~. . 1./ .y; " . /t- ~-dJ/j/2> (Niles Hartman) (SEAL The preceding instrument, consisting of this and one (1) other typewritten page, was on the day and date hereof signed, sealed, published and declared by NILES HARTMAN, the testator herein named, as and for his Last Will and Testament, in the presence of us, who, at his request, in his presence, and in the presence of each other, have subscribed our names as witnesses hereto. ~ \ ~I (__~ VY) W~, (jUJ0.J.~I/// of Cj ~ vJ~ (/~c J 7 ~ ~ It ;/~-L~~ /"::J Ie.... of - 2 - 21-01-540 Register of Wills of Cumberland County, Pennsylvania OATH OF SUBSCRIBING WITNESS Estate of Niles Hartman No. 21-01-540 also known as , Deceased Jan M. Wiley Joan W. Wiley (each) a subscribing witness to the 0 codiciKs) [ID wilKs) presented herewith, (each) being duly qualified according to law depose(s) and say{s) that she/ he/ they was/ were present and saw the above Testator(rix) sign the same and that she/he/they signed as a witness at the request of Testator(rix) in his/her/their presence and [!] in the presence of each other 0 in the presence of the other subscribing witness(es). (Signature) One S. Baltimore St. 17019 / (Address) .~ (Signature) Kensington Square Mechanicsbur , PA 17055 (Address) Sworn to or affirmed and subscribed b ~ JIIJ4 n U; JI-e j before me this 5~ day Notarial Seal Kenneth L Schlegel, Notary Public Hampden Twp., Cumberland County My Commission Expires Apr. 4, 2005 Member, Pennsylvania Association of Notaries NOTE: To be taken by officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization. ry Public )l Commission Expires: (Signature and seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's commission.) Prepared by the Pennsylvania Bar Assoclallon Copyright (c) 1996 form software only CPSystems, Inc. Form ii\lRW-2 (1991) 21-01-540 Register of Wills of Cumberland County, Pennsylvania OATH OF SUBSCRIBING WITNESS Estate of Niles Hartman No. 21-01-540 also known as , Deceased Jan M. Wiley Joan W. Wiley (each) a subscribing witness to the D codicil(s) [!J will(s) presented herewith, (each) being duly qualified according to law depose(s) and say(s) that she! he! they was! were present and saw the above Testator(rix) sign the same and that shelhelthey signed as a witness at the request of Testator(rix) in hislher!their presence and [!J in the presence of each other D in the presence of the other subscribing witness(es). ,,~ lA- ~ t-J (Signature) Baltimore St. PA 17019 (Address) (Signature) 15 Kensington Square Mechanicsburg, PA 17055 (Address) Sworn to or affirmed and subscribed before me this ~()~ '.. 2..00 I day of ~ s[JfJ ~ Notary Public My Commission Expires: (Signature and seal of Notary or other official qualified to admlnlster oaths. Show date of lIXplratlon of Notary's commission.) ~ Notarial Seal S. Dawn Gladfelter, Notary Public Dillsburg Bora, York County My Commission Expires May 17, 2005 Member, Pennsylvania Association of Notaries NOTE: To be taken by officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization. Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form 'RW-2 (1991) - 1- ,- - CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) Name of Decedent: Niles Hartman Date of Death: May 19, 2001 Estate Number: Oi-I-OJ -o5LJ 0 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 L,-\Y-DJ ~ Herbert L. Hartman Marlin N. Hartman Ray C. Hartman Mary L. Fertenbaugh Address 13 Gilbert Rd., Dillsburg, PA 17019 21 Locust Lane, Dillsburg, P A 17019 44 Boulevard De-La Marne, 94130 Nogent-Sur-Marne France 20 Saw Mill Rd., Dillsburg, P A 17019 Notice has now been given to all persons entitled there 0 under Rule 5.6 (a) except N/A. Date: (0 -\ ~ -tJ I Name: Ian M. Wiley, Esquire Address: One S. Baltimore St. Dillsburg, PA 17019 Telephone: (717) 432-9666 Capacity: Counsel for personal Rep. l ,1 ~ l , I j . THE WILEY GROUP August 13, 2001 Attorl1L"}'s at Lavv Wiley · Lenox · Colgan · Marzzacco · P.c. Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, P A 17013 In Re: Estate of Niles Hartman Number 21-01-0540 Dear Register: Enclosed please find a check from the Estate of Niles Hartman in the amount of$1,824.00 for prepayment of inheritance tax. This payment is being made on an estimated estate as follows: $40,000.00 @ 4.5% for a total tax of$1,920.00 less the 5% discount of$96.00 equals the payment of $$1,824.00. Please return a receipt to my office in the envelope provided. Thank you for your assistance. Sincerely, ! ~1t"n 7 {c /J..{Ly /s~Lg-- / tJ v JAN M. WILEY, ESQUIRE JMW/sdg encl. jan M. Wiley · David j. Lenox · Timothy j. Colgan · Christopher J. Marzzacco · Christine J. Taylor 1 South Baltimore Street · Dillsburg, PA 17019 · Phone: (717) 432-9666 · (800) 682-4250 · Fax: (717) 432-0426 Offices in Harrisburg · York · Carbondale 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 WI LEY JAN M 1 S BALTIMORE STREET DILLSBURG, PA 17019 ______n fold ESTATE INFORMATION: SSN: 187-30-0134 FILE NUMBER: 21-2001- 0540 DECEDENT NAME: HARTMAN NILES DATE OF PAYMENT: 08/20/2001 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 05/19/2001 NO. CD 000174 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $1,824.00 I I I I I I I I TOTAL AMOUNT PAID: $1,824.00 REMARKS: HERBERT L HARTMAN & MAriLIN N HARTMAN C/O CHECK# 3 INITIALS: SK RECEIVED BY: SEAL REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS .. -" ----.........----------- ---==--~--------------.--- : ~..~~.....' .~~.' :J ~ltI ~ , Q) '" . en '"... a:: ~ ~ ..... III 1.: .. , III '- 'III "III ,- .. w-t " ('t) ...... -'III z ...'" , <( ........ ..... -:"') ~.... .- ...... .- ~.. L.J.J u.. '," "' ..., J5 N ~...' >= ~ "(5 '.. ... ... ,- ...... 'II" ,- -- ... ~ ... ... .. .. N o o N -- .. . ~ "- 'II . - f_ - Q~ i att , il; :till ~ , ~ .. ... .--. '" ....... ... <( -- 0.. <.9 ... 0::: :J .. C[; (j, -. :r .. a: ,j d' 'ljl. -.. - .. .... , , , I ~ REV-1500 EX + (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG. PA 17126-0601 DECE- DENT CHECK APPRO- PRIATE BLOCKS CDR- RE- SPON DENT RECA- PITULA- TION TAX COMPU- TATION ;;;:;:;:;:;:;:;;~#mw:::;:;::;;;::: :'::~ o PA1S001 c:.. OFFICIAL USE ONLY REV-1500 / {; - e>1dO:- 0 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 COUNTYCQOE 01 YEAR 0540 NUMBER DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Hartman Niles DATE OF DEATH (MM-DD-YEAR) 05 19 01 11 17 1903 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLIE INITlAL) 187-30-0134 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILlLS SOCIAL SECURITY NUMBER ~ 1. Oliginal Return 4. Umited Estate 6. Decedent Died Testate (Attach copy of Will) . 9. litigation Proceeds Received ~ 2. Supplemental Return 4a. Future \r.t&fut Compromise (date of death after 12-12-82) 7. O,clldent Maintained a Living Trust (Attach acopyof TrustJ 10. Spousal Poverty Credlt(date of death between 12-31-9111nd 1-1-95) 3. Remainder Return o (date of death plior to 12-13-82) o 5. Federal Estate Tax Return Required o 8. Total Number of Safe Deposit Boxes O 11, Election to tax under Sec. 9113(A) (Attach Sch 0) Mffllj~fo!'Pll.... ;lllii$ll~tllllll ...\jt~'*..... . NAME Jan M. Wile e FIRM NAME (If AppHcable) 'Ihe Wile Gr TELEPHONE NUMBER 717-432-9666 ... ..........,.~ .'ttM!l_lll'fAfW\ilt$1l!l~i$!l'~llit!lW COMPLETE MAILING ADDRESS One S. BaltilOOre st. Dillsb..1rg, PA 17019 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) (1) (2) None 11 267. NoI1i '. Nor:@- :; c OFFICIAL USE ONLY 53,268.65 F3 :0 ell ('7 -,-, rr1 co I ~ v ~ ~,,:l Q:l 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schadule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 6. Jointiy Owned Property (Schedule F) o Separate Billing Requested (6) None 7. Inter-Vi'Jos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) (7) None' (8) 13,829.97 None (11) (12) (13) 64,535.81 8. Total Gross Assets (total Unes 1-7) 9. Funeral Expenses & AdministratIve Costs (Schedule H)(9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule II (10) 11. Total Deductlona (total Unes 9 & 10) 12. Net Value of Estate (Une 8 minus Une 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 Une 12 minus Une 13) 13,829.97 50,705.84 None 14) 50 705.84 SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0 (15) 16. AmountofUne14taxa.bleatllnltalra'te 50,705.84 X.O 45 (16) 17. AmountofLlne14taxableatsiblingrate 0.00 X .12 (17) 18. Amount 01 Une 14 taxable at collateral rate 0.00 X .15 (18) 19. Tax Due (19) 20. 0 ~tQ&;jji$j~iijj'i*Q\iit;Mil.jl'$Q!l~~1Bl!Illij'>>M!l~imm;d 2,281.76 0.00 0.00 2,281. 76 .......,.....,.....:. ;~:::;:;~:;:::~::: Wi'ii,i}f'@ilillii$l)jjl!itQM,~'.iilminmjM\$,m;I'i~ltliM;~!le~@sjjjjWMAWli~g}W" ~fNWN :;::~~m:::: :.:.;.:':.:.'.'.:....... >..,',..,;.. NTF 29755 Cop'Irlgl\t ZOOO GrlHlt\andfNelco Ll" - Forms SoHware Only Estate of: Niles Hartman 21-01-0540 SUMMARY OF ALLOCATIONS 'IO BENEFICIARIES Taxable at lineal rate Herbert L. Hartman Marlin N. Hartrran Ray c. Hartman Mary L. Fertenbaugh 12,676.46 12,676.46 12,676.46 12,676.46 50,705.84 PA REV-1500 EX (6-00) Dedt'C I Page 2 ec en s OmDlete ress: STREET ADDRESS Church of God Home CITY TSTATE IZIP Carlisle FA 17013 Add Tax Payments and Credits: 1. Tax Due (Page 1 Une 19) 2. Credi1s/Payments A. Spousal Poverty credit B. Prior Payments C. Discount (1) 2,281. 76 1,824.00 96.00 Total Credits (A + 6 + C) (2) 1,920.00 3. interest/Penalty it applicable D. Interest E. Penalty 0.00 0.00 TotallnteresVPen.lty (0 + E) If Una 2 is greater than Una 1 + Una 3, enter the dIfference. This is the OVERPAYMENT. Check box on Page 1 Une 20 to request a refund If Una 1 + Una 3ls greater than Una 2, enter the difference. This Is the TAX DUE. A. Enter the interest on the tax due. 6. Enter the total of Une 5 + 5A. This Is the BAlANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS Yes No ~ I B ~ (3) 0.00 4. 5. (4) (5) (5A) (56) 361. 76 0.00 361. 76 1. Did decedent make a transfer and: a. retain the use or Income of the property transferred; .....,.........,..,......,............. b. retain the r\ght 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 decedent 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'? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . .. 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 perjul)I, I declare that I have examined this return Including accoll)panying schedules and statements, and to the best of my knowledge and benef, it is trUe, correct and complete. Declaration of preparer other ttlan the personal representative Is based on information of which oreparer has anv knowledaa. SIGNAT R OF PERSON RESPONSIB~E FOR FILING RETURN . DATE ijg Ao"- /-3 -0;;< ADDRESS Schedule attached SIGNATURE OF PREPARER THE THAN REPRESENTATIVE vY\ _ DATE Baltimore st. , oillsburg, FA 17019 \\'. .::::::::::::~::::::':\~B{~;[(ttmt ???!~~,;",:,:t~\:':~'. ,::~<::<. ::!, ;?:e:,!. :.:.:~. ::::::::??';':::=!:!'. :::.:::::::=!::::=::!::::::~~:!:::::. .':':::':':;t':. !::':::":??:?:::. U:,??tt :';0::':':': . :';::::?:::::~:~~':::::':'. :.: :.: :':':::':';~:', ,,!nl!:. >::::~::::::. .<.?:~ ,'.~. ?::~ :::::::::r. :'!W. ~~ .~ ' ~mtK .'.W,','. For datu of death on or after July 1, 1994 and before January " 1995, the tax rate imposed on the net value of transfers to or forthe use of the survlvlngslloustl is 3"10 {np.5.19115te.}(1.1)ti)). For datu of death on or after January 1, 1995, the tax rate is imposed on the net value of transfers to or forthe use of th. surviving spouse is 0% [72 P.S. 19116 (a) (1.1)(11)]. The statute tin...' .."1 A....mpt a transfer to asurvivingspouse from tax, and the statutory r9~ulrement$ for disclosure of IIossets and flIing a tax return are stili applicable liven If the surviving spouse is the only beneficiary. For dates at dllath on or after JUly 1. 2000: The tax rate imposed on the net value of transfers from a dllceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stllpparent of the child is 0% [72 P.S.89116(aX1.2)]. The tax rate imposed on the net value of transfers to or for thl!l US8 of the decedent's lineal beneficiaries \s 4.5%, except as noted in 72.P.S.' 9116(1.2) [72 P.S.li 9116(a)(1)). The tax rate Imposed on tnlll net value of transfers to or for the use of the decedent's sibllng$ 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. o PA1S002 NTF 29756 Copyright 2000 Greatland/Nelco LP- Forms Soitware Only Fstate of: Niles Hartman 21-01-0540 The following person(s) are signing the return as representative(s) of the estate: Herbert L. Hartman 13 Gilbert Rd. DillsWrg, FA 17019 Marlin N. HartnIan 21 lDCUst lane DillsWrg, FA 17019 lliasllIill ann m-egbt1tu~nt OF NILES HARTMAN BE IT :REMEMBERED, that I, Niles Hartman, of Monaghan Township, Dillsburg R. D. #3, York County, Pennsylvania, being of sound mind, memory and under~tanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making null and void any and all wills and testaments and writings -. in the nature thereof by me at any time heretofore made. ITEM 1: I direct that all my just debts and funeral expenses be paid as soon after my demise as may be convenient. ITEM 2: All the rest, .residue and remainder of my estate, of whatsoever nature and wheresoever situated, whetherrit be real, personal or mixed, including property over which I have a power of appointment, I give, devise and bequeath unto my wife, Margaret A. Hartman, absolutely, providing that she survives me for a period of thirty (30) days. ITEM 3: In the event that my said wife should predecease me or fail to su~vive me for a period of thirty (30) days, I then give, devi~e and bequeath my entire residuary estate unto my .,- children, namely, MaryL.. Fertenbaugh, Herbert L.. Hartman, Marlin N.. Hartman and Ray C. Hartman, in equal shares, per stirpes.. ITEM 4: In the event that any ~hild or children succeed to an interest in my residuary estate and said child or children are under the age of twenty-one (21) years at the time of my demise, I then nominate, constitute and appoint the First Bank and Trust W~f' (t~ vn r./ .y> ~Jfn. ~l ;/4i' C);;;L ~/1/;;;~ (Niles Hartman) (SE - ], - Company of Mechanicsburg, Pennsylvania, Trustee, until such minor child or children shall respectively attain the age of twenty-one (21) years, at which time my Trustee is directed to pay to said minor its undivided interest in the trust res. I invest my Trustee with power, in its uncontrolled discretion, to anticipate the principal of the trust res for the health, education and maintenance of said minor child or children. LAS:~Y, I nominate, constitute and appoint my sons, Herbert L. Hartman and Marlin N. Hartman, to be the Executors of this my Last Will and Testament. IN WITNESS WHEREOF. I have hereunto set my hand and seal this 3c+1., day of Mo."-~'" , 1966. ()/;!j~ eJlcui;::.~, (Niles Har.tman) (SEAL The preceding instrument, consisting of this and one (I) other typewritten page, was on the day and date hereof signed, sealed, publi~hed and declared by NILES HARTMAN, the testator herein name4, as and for his Last Will and Testament, in 'the presence "of us, who, at his request, in his presence, and in the presence of each other, have subscribed our names as witnesses hereto. ~ vn W~, ~A<l0J.01/ly of .8.J-L, 'I ~ /(Jf/hLh~ 4 of - 2 - REV-1503 Ex. (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Niles Hartman SCHEDULE B STOCKS & BONDS FILE NUMBER 21-01-0540 All property Jolntiy-owned with right of survivorship must be disclosed on Schedule F. ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH 1 cumberland valley Cooperation Assn. (stock) 2 ~'" from sale of First Energy stodk from First Union: 10.00 11,257.16 TOTAL/Also enter on fine 2, Recspitulationl $ (If more space Is needed, Insert addltlonaJ sheets of the same size) 11.267.16 7 CPA31 NTF 10905 Copyright Forms Softwarl!l Only, 1997 Nelco, Inc. 1)/>.'([: 07/31/01 055110 BERLAND VALl.EY COOPERArlVE ASSN, T ....w__.........""- .",_",":.cA"'~',,,,,;,_,,,,__,,,,,,,",,,,,,,,,,,"-~~;,,,.,,,,,,,,,,'C,,,,,,_,,"_,-"""'''''''''''''''='''-"''_''_",,,,,,,,,,=,..>=~.,,,,,,,~,....<-~-,~,-,,~...,,.,.-.... ~EFERENCE DATE DESCRIPTION VOUCHER. AMOUNT ) 07/27/01 STOCK PURCHASE 043640 .10.00 -t ? ~ ' 'I 1 I: HARTMAN ESTATE, NILES -"'.....,. 10.00 " ---''''"'''''''''-- -""",,,,,,,,,,,,,"' ~ CUI\IIBERI.AfllD V,c...ll$'YCPOPiEfiAnVE ASSN. '~Q8 NiT, HOCK ROAD' . 1',0, SOX 3.,,0 g5j4IPF'EN$BUflP. 'I'A 17.,,7 'PH: 117',3Z;z19" OllllsroWjI!9AIIlK 'Ms,' KINGS,RSn OFFICE t:-;~JIP.PEN$f.l(NiHj.~ -PA .17:~[5~1 60-150~~..:l',l:3 NQ,055110 )i"';. ,: "'i-r.., ""'"":<!"'~,,___~ <r ..... '" ,.-- "T~'_", . '1 li NILES ,~~E~~ATE ,ATTN :J'A1r '.~.W~r.:)!:y, .~$PU:rRE + .SOUTH :!W.T.:r~.~El'l!,l1REET DILI$BURG 'P:l\. 17019 :ii. I , I 055110 07/31/01 *****;*~10. 00* :; . '-'---~---' ."._._~-~--~-_.~.~._-----~,-_.."",--.--~~._._..J!l ~ 11 ,~ ~ ., ~~/~~i.' ~~.~ I --~~~5~ "_. Qljr~~~'~--"'---.c-.,.- ) - --. - '''''"''. '1'B.N AMI:) "0/100 11'055. .011' ':0 j B .50 H,': .0 Cj2b bll' F~N. ..ourlfl.. Post Office Box 4284 Glen Allen, Virginia 23058-4284 NO. 333-16671 ACCOUNT NUMBER DESCRIPTION AMOUNT 4110-55 12- 1 12/24/01 033316671 ESTATE pF NILES HARTMAN HECK ISSUED 11,257.16 OTAL 11,257.16 . 0000 544314 (2501pkg Rev 06) Accounts carried by First Clearing Corporation, Member NYSE and SIPC PLEASE DETACH BEFORE DEPOSITING II' 3 3 3 H'b 7 ~II' I: 2 5bO 7 2 70 ~I: 20 7'1'1200 ~ ~bb ~II' REV-15OB EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Niles Hartman SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21-01-0540 Include proceeds of litigation & date procBeds were received by the estate, All DrOD. lolnUv-owned with rlaht of survlvorshlc must be disclosed on Sch. F. ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH 1 PNC Bank, N.A. Checking #5140196263: 2 PNC Bank Savings Account #5003269534: 3,919.83 49,348.82 7 CPA81 NTF 10908 Copyright Forms Software Only. 1997 NelcQ, Inc. TOTAL (Also enter on line 5. Recanltulation\ $ (If more space is needed, Insert additional sheets of the same size) 53.268.65 JUL-25-2001 08:51 PNCBANK CIF DEPRRTMENT . QPNCBAN< Decedent Reporting Firstside Center P7-PFSC-04-F 500 First Avenue Pittsbwgh, PA 15219.3128 June 27,2001 Mr Herbert L Hartman 13 Gilbert Rd Dil1sburg, PA 17019 RE: Estate of Niles Hartman Deceased SSN: 187-30-0134 DOD: 05-19-2001 Dear Mr Hartman: Please find the date of death balances you have requested listed below. CHECKING ACCOUNT #5140196263 NILES HARTMAN MARGARET HARTMAN DOD Balance: $3,917.84 + $1.99 accrued interest Interest earned 01-01-2001 thru 05.19-2001 $7.25 YTD SAVINGS ACCOUNT #5003269534 NILES HARTMAN MARGARET HARTMAN 000 Balance: $49,203.20 + $145.62 accrued interest Interest earned 01-01-2001 thn1 05-19-2001 $1,074.52 YTD I Page 1 of2 A m.mb.. DfThe PNC Finaneia' Services Group On. PNC PI.za 249 Fifth Avon.o Pitt,burgh f'<<,nsy!vani. 15222 2707 412 705 0057 P.02/03 SCP Established 06-01-1967 Established 11-30-2000 JUL-25-2001 08:52 PNCBANK CIF DEPARTMENT 412705 0057 P.03/03 QPNCBAN< Our oflJce only provides date of death balances for IRA's, CD'., Checking and Savings accounts. We do NO Flnanelal Transactions or Statement Orders. Fol'" Further informatioD please caIIl-800-4-BANKER or your local PNC Brauch and ask to speak with a Financial Serviees Representative. Sincerely, ~Z~ Erica L. Schlegel 1-800-762-1775 Page 2 of2 A member of The PNC Anandal s.r.iees Group One PNC PI.,. 249 Fifth Avenue Pittsburgh ""n",vlvania 15222 2701 TOTAL P.03 REV-1511EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Niles Hartman SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-01-0540 Debts of decedent must ~ reDOrted on Schedule I. ITEM NO. DESCRIPTION A. FUNERAL EXPENSES: AMOUNT 1 Cocklin Funeral Home: 6,843.28 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN No. of Personal Representatlve(s) Street Address City State 3,250.00 Zip Yaar(s} Commission Paid: 2. 3. Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Oaimant Street Address City State Zip Relationship of Claimant to Decadent 3,250.00 0.00 4. Probate Fees 0.00 5. Accountant's Fees 0.00 6. Tax Return Preparets Fees 0.00 See Schedule attached Total from continuation page(s} 486.69 TOTAL (Also enter on line 9, Recaoltulationl $ (If more space Is needed, insert additional sheets 01 the same size) 13 829.97 7 CPA11 NTF 10911 Copyright Forms Software Only, 1997 Nelco, Inc. Estate of: Niles Hartman SCHEDULE H, PARI' B - Administrative Costs Item No. Description 7 Register of Wills (probate): 8 Cumberlarrl law Journal (advertise): 9 '!he Sentinel (advertise): 10 Joan Wiley (witness fee): 11 Notary: 12 Filing Fee: 13 Lincoln Financial Group: 14 First Union securities (re.in1bursement for overpayment) TOl'AL. (Carry forward to main schedule) . . . . . . Page 2 21-01-0540 Amount 135.00 75.00 110.03 20.00 10.00 25.00 57.16 54.50 486.69 REV-1513 EX + (1-97) COMMONWEA~TH OF PENNSY~VANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FI~ NUMBER Niles Hartman 21-01-0540 RE~TIONSHIP TO DECEDENT AMOUNT OR No. NAME AND ADDRESS OF PERSON(S} RECEIVING PROPERTY Do Not Ust Tru81ee(s) SHARE OF ESTATE I. TAXAB~E DISTRIBUTIONS (include outright spousal dlstrlbutions) 1 Herbert L. Hartn>an son 12,676.46 13 Gilbert Rd. OillsbJrg, PA 17019 2 Marlin N. Hartman son 12,676.46 21 lDcust Lane oillsbJrg, PA 17019 3 Ray C. Hartman son 12,676.46 44 Boulevard De-Ia Marne 94130 Nogent-sur-Marne, FR 4 MarY L. Fertenbaugh daughter 12,676.46 20 Saw Mill Rd. Dillsburg, PA 17019 ENTER DO~~R AMTS. FOR DISTRIBS. 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 None B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS None TOTAL OF PART 11-- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00 7 CPA13 NTF 10913 (If more space is needed, insert adcfltional sheets of the same size) Copyrignt Forms Software Only, 1997 NeloD, Inc. ",.,....,........,,-,...,'-,..............,......""',., i I ; I ! ! January 3 1, 2002 THE WILEY GROUP Attorneys at La'\V Wiley · Lenox · Colgan · Marzzacco . P.c. Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, P A 17013 In Re: Estate of Niles Hartman, deceased File Number 21-01-0540 Dear Register: Enclosed for filing please find an Inventory, the inheritance tax return in duplicate, and the status report with regard to the above captioned estate. Also enclosed is a check in the amount of $361.76 representing the tax due, and a checks totaling $25.00 representing the filing fee. Please return the recording receipts to my attention in the enclosed envelope. Thank you for your cooperation. fjelY, Daw~felter/ Assis /dg encl. Jan M. Wiley · David J. Lenox · Timothy J. Colgan · Christopher ). Marzzacco . Christine ). Taylor 1 South Baltimore Street · Dillsburg, PA 17019 · Phone: (717) 432-9666 . (800) 682-4250 . Fax: (717) 432-0426 Offices in Harrisburg · York. Carbondale COMMONWEALTH OF PENNSYLVANIA COUNTY OF ~~~_ York l J 55: Herber~ L. Hartman and Marlin N. Hartman being duly 'SWOPl according to law, deposes and says thatt he y are tJ,~ F.Y.~(""l1t-nr!=: of the Estate of Niles Hartman late of ---Ca.r---l-is-l.e--BoroulJh , Cumberland County, Pa., deceased and that the within is an inventory made by Hprbpr~ L - Hi'lrtman & -Ma-rJ.,i.~., the said Co-Executors of the entire estate of said decedent, consisting of all the personal propt!Rf~rr81Feral estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedent's death. -lI.R4---t,l ~ Qh-,;:t;;;;:::;.~ Sworn to and subscribed before me, Herbert ~. Hartman -1. /I{~4 -J/ ~~ ,,'-- . Executor - Administrator Marlin N. Hartman ~dJ1.JIA~ .~. I - . U " ") Notarial Sea S Dawn Gladfeher. No . DiIIsburg Boro, .York C My Commission Expires Ma Member, pennsylvanlaAssOCiati notNotaries Addr.ss Date of Death 19 Day 05 Month 2001 Y.ar INSTRUCTIONS I. An inventory must be filed within three months after appointment of personal representative. 2. A supplement inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. (J ~ ~ -d :r >- c- o I- W --t lit \'1] >- a:: l- 'll W -< GI ~ O! Q. I- u 0 0 en ~ Q) I W a:: w ~. C ',,- t- :r:: Q. LL )) Z I- -oJ 011 LL -oJ -< 0 ! Q. ---- W 0 -< w I >. > Z a:: Vi .... z 0 c c --3J ~ 0 en Z 0 a:: 0 Z w -< '-.- - Q. -a ~ c Oll , - -;: 0 Q) .Q ." 0 E .... .! Oll ~ -oJ 0 LL Inventory of the real and personal estate of Niles Hartman deceased 1. Cumberland Valley Cooperation Assn. (stock): 2. First Energy stock: 3. PNC Bank, N.A. Checking #5140196262: 4. PNC Bank Savings #5003269534: 10. 00 11,257. 1 6 3,919. 83 49,348. 82 TOTAL: 64,535. 81 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRIS8URG, PA 17128.0601 REV.1162 EX(11.96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT WILEY JAN M 1 S BALTIMORE STREET DILLSBURG, PA 17019 ______n fold ESTATE INFORMATION: SSN: 187-30-0134 FILE NUMBER: 2101-0540 DECEDENT NAME: HARTMAN NILES DATE OF PAYMENT: 02/01/2002 POSTMARK DATE: 01/31/2002 COUNTY: CUMBERLAND DATE OF DEATH: 05/19/2001 NO. CD 000820 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $361.76 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: JAN M WILEY ESQUIRE CHECK# 4943 SEAL INITIALS: AC RECEIVED BY: REGISTER OF WILLS $361.76 MARY C. LEWIS REGISTER OF WILLS ~ I j , -Sh STATUS REPORT UNDER RULE 6.12 Name of Decedent: IV/I (: <) /-/11 r +rYl a..n Date of Death: tJS/lq/oJ I I Will No. ~/.. 6/ - 05'-/6 Admin. 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 estate: 1. State whether administration of the estate is complete: Yes / No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No~. b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes ~ No ~ d. Copies of receipts, releases, joinders and apPEoval~~of f9rmal or informal accounts may be filed with the Cerk. of ~e Orphans' Court and may be attached to this report. ~~ VL-<. WJ--, g a ture z.~ (C1~r.~"{~e f{'fllj/!tr- (JOe. S. BtLJl-iliore. s-I. Address ])i I/s U1-91 ,011 /70/9 (1/7) '-/3d -q(II/~~ Tel. No. Date: /~11 ~{).~ L..l... ;1'; cr ~ ';'f.: ~~ ~ >- (j) :::: -.., ,-J ...",.... ......",,'~ Capacity: Personal Representative ~sel for personal representative (MAH:rmf/AM3) \, //. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ->2 :::-,"~ L'~---::.. ~) "'--' -./ - - BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX F{c DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-11-2002 HARTMAN 05-19-2001 21 01-0540 CUMBERLAND 101 JAN M WILEY ESQ THE WILEY GROUP 1 S BALTIMORE ST DILLSBURG '02 IvltHl 1 co p 'J '-1 6- 1111\ {) I L .! '* REY-1547 EX AFP IDl-D2J NILES l~,~l Allount Rellitted PA ItllnBu83 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV =gi'-i-E3f-AFP--foY--02Y-NOYicE--OF-YNHEifiTAifcE-YAX-A-PPRA-isEHENT~--AL:rOWANCE-C'-R------------ ----- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF HARTMAN NILES FILE NO. 21 01-0540 ACN 101 DATE 03-11-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED NOTE: 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. 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. .00 X 00 = .00 50,705.84 X 045 = 2,281.76 .00 X 12 = .00 .00 X 15 = .00 (9)= 2,281.76 RE~ERVATION 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 11.267.16 .00 .00 53,268.65 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 13,829.97 .00 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 64,535.81 Ul) (12) (13) (14) 13.829 97 50,705.84 .00 50,705.84 . KEl::E.LPT l+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 08-20-2001 CDOOO174 .00 1,824.00 01-31-2002 CDOO0820 .00 361.76 INTEREST IS CHARGED THROUGH 03-26-2002 TOTAL TAX CREDIT 2,185.76 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 96.00 REVERSE SIDE OF THIS FORM INTEREST AND PEN. .55 TOTAL DUE 96.55 · 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.) RESERVATION: Estates Df decedents dying Dn Dr befDre December lZ, 198Z -- if any future interest in the estate is transferred in pDssessiDn Dr enjDyment tD Class B (cDllateral) beneficiaries Df the decedent after the expiratiDn Df any estate fDr life Dr fDr years, the CDmmDnwealth hereby expressly reserves the right tD appraise and assess transfer Inheritance Taxes at the lawful Class B (cDllateral) rate Dn any such future interest. PURPOSE OF NOTICE: TD fulfill the requirements Df SectiDn Zl40 Df the Inheritance and Estate Tax Act, Act Z3 Df ZOOO. (7Z P.S. SectiDn 9140). PAYMENT: Detach the tDP pDrtiDn Df this NDtice and submit with YDur payment tD the Register Df Wills printed Dn the reverse side. --Make check Dr IIDney Drder payable tD: REGISTER OF MILLS, AGENT REFUND (CR): A refund Df a tax credit, which was nDt requested Dn the Tax Return, lIay be requested by cDllpleting an "ApplicatiDn fDr Refund Df Pennsylvania Inheritance and Estate Tax" (REV-1313). ApplicatiDns are available at the Office Df the Register Df Wills, any Df the Z3 Revenue District Offices, Dr by calling the special Z4-hDur answering service fDr fDrlls Drdering: 1-800-36Z-Z050; services fDr taxpayers with special hearing and I Dr speaking needs: 1-800-447-30Z0 (TT Dnly). OBJECTIONS: Any party in interest nDt satisfied with the appraisement, allDwance, Dr disallDwance Df deductiDns, Dr assessment Df tax (including discDunt Dr interest) as shDwn Dn this NDtice must Dbject within sixty (60) days Df receipt Df this NDtice by: --written prDtest tD the PA Department Df Revenue, BDard Df Appeals, Dept. Z810Z1, Harrisburg, PA~ --electiDn tD have the matter determined at audit Df the accDunt Df the persDnal representative, --appeal tD the Orphans' CDurt. 171Z8-10Z1, OR OR ADMIN- ISTRATIVE CORRECTIONS: Factual errDrs discDvered Dn this assessment shDuld be addressed in writing tD: PA Department Df Revenue, Bureau Df Individual Taxes, ATTN: PDSt Assessment Review Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601 PhDne (717) 787-6505. See page 5 Df the bDDklet "InstructiDns fDr Inheritance Tax Return fDr a Resident Decedent" (REV-1501) fDr an explanatiDn Df adllinistratively cDrrectable errDrs. DISCOUNT: If any tax due is paid within three (3) calendar mDnths after the decedent's death, a five percent (5Z) discDunt Df the tax paid is allDwed. PENALTY: The 15Z tax amnesty nDn-participatiDn penalty is cDllputed Dn the tDtal Df the tax and interest assessed, and nDt paid befDre January 18, 1996, the first day after the end Df the tax amnesty periDd. This nDn-participatiDn penalty is appealable in the same lIanner and in the the same time periDd as YDU wDuld appeal the tax and interest that has been assessed as indicated Dn this nDtice. INTEREST: Interest is charged beginning with first day Df delinquency, Dr nine (9) mDnths and Dne (1) day frDII the date Df death, tD the date Df paYllent. Taxes which became delinquent befDre January 1, 198Z bear interest at the rate Df six (6Z) percent per annum calculated at a daily rate Df .000164. All taxes which became delinquent Dn and after January 1, 198Z will bear interest at a rate which will vary frDm calendar year tD calendar year with that rate annDunced by the PA Department Df Revenue. The applicable interest rates fDr 198Z thrDugh ZOOZ are: Year Interest Rate Daily Interest FactDr Year Interest Rate Daily Interest FactDr 198Z ZOZ .000548 199Z 9Z .000Z47 1983 16Z .000438 1993-1994 n .00019Z 1984 llZ .000301 1995-1998 9Z .000Z47 1985 13Z .000356 1999 n .00019Z 1986 10Z .000Z74 ZOOO 8Z .000Z19 1987 9Z .000Z47 ZOOI 9Z .000Z47 1988-1991 117- .000301 ZOOZ 6Z .000164 --Interest is calculated as fDllDws: INTEREST = BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any NDtice issued after the tax beCDlles delinquent will reflect an interest calculatiDn tD fifteen (15) days beYDnd the date Df the assessllent. If payment is made after the interest cDllputatiDn date shDwn Dn the NDtice, additiDnal interest must be calculated. \ / b - cQ.:5 ~-;- -~)/ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT '* REV-1607 EX AFP 101-021 JAN M WILEY ESQ THE WILEY GROUP 1 S BALTIMORE ST DILLSBURG '02 APH-1 '2 :L\7 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-25-2002 HARTMAN 05-19-2001 21 01-0540 CUMBERLAND 101 NILES Allount Rellitted ~<>< P 4~llmCl.l9 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 ~ REY=i'6o-j-i3f-AFP-foY=o2Y------...--fNirERITANCE-YA3f-STA-fEMENY-OF"-AC-couiff--i'i.------------------ --- ESTATE OF HARTMAN NILES FILE NO.21 01-0540 ACN 101 DATE 03-25-2002 THIS STATE"ENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NA"ED ESTATE. SHOWN BELOW IS A SU""ARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAY"ENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 03-04-2002 P R I N C I PAL TAX DUE: uu<u<uuuuuu<u<u<uu<uuuuuuuuuu<muuuuuuu<u<u<u<umuumu<um<mu<muuu<mmuummu<umuu<mu<u<u<uuu<umuuuuuuuu<u<UUU.mUU.mUUU'UU 2,281.76 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 08-17-2001 CDOOO174 96.00 1,824.00 01-31-2002 CDOO0820 .00 361. 76 TOTAL TAX CREDIT 2,281.76 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 PAY"ENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU "AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. ) PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to tha name and address printed on the reverse side. If RESIDENT DECEDENT make check or money order payable to: REGISTER OF WILLS, AGENT. If NON-RESIDENT DECEDENT make check or money order payable to: COMMONWEALTH OF PENNSYLVANIA, REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Wills, any of the Z3 Revenue District Offices or from the Department's Z4-hour answering service for forms ordering: 1-800-36Z-Z050; services for taxpayers with special hearing and I or speaking needs: 1-800-447-30Z0 (TT only). REPLY TO: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601, phone (717) 787-6505. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5Z) discount of the tax paid is allowed. PENALTY: The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOOZ are: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor 198Z ZOZ .000548 199Z 9Z .000Z47 1983 16Z .000438 1993-1994 n .00019Z 1984 HZ .000301 1995-1998 9Z .000Z47 1985 13Z .000356 1999 n .00019Z 1986 10Z .000Z74 ZOOO 8Z .000Z19 1987 9Z .000Z47 ZOOl 9Z .000Z47 1988-1991 HZ .000301 ZOOZ 6Z .000164 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated.