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HomeMy WebLinkAbout01-0649 PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Estate of /VJt:::tYj t::ur~ C E. l.eva,rfo also known as No. 21-01-649 To: Register of ~lls fqr the j County of LVrv? bcr la rlCl in the Commonwealth of Pennsylvania Deceased. Social Security No. 159- 2 '1- is 7/ The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older, appl for letters of administration on the estate of (d.b.n.; pendente lite; durante absentia; durante minoritate) the above decedent. Decendent was domiciled at death in Cu m be" Ie- "d COJ!!1ty, Pennsylvani~, with hel' last family or principalresidence at 417 S!b 5"+./ New L",,v! 6erl4-l'1o( . (list street, number and municipality) Decendent, then '7 Cj'. yea,rs of age) diyd at /-'o/y SpIrt'/- /.../05jJlrr::.f M~y (e, -1'tT 200 I , , Decendent at death owned property with estimated values as folllows: (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: $ II; 77'1,00 $ $ $ Petitioner_ after a proper search haL ascertained that decedent left no will and was survived by the following spouse (if any) and heirs: pN at:. 1/ t::J C- 0 eV?.r-fo 5 Relationship 011 oYl 4/7 5"tf- !;sidlV~:" G~berla.Y1c1 /~~ S, I'/vle:.. ,. ~#'lO Ie:... THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the appropriate form to the undersigned. i ~i?~ :9,;;, on '-' ~ ~ {"'-CAr /e..s P. &v~~1-o 19 I..{I 7 5'~ Sf. 3~ N~w CVI'V\.bt!.yl",-rd Pit- ..,..... - BO os = OIl Vi /~ -""11''''' - /6 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND } ss The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal representative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. /J~-- Sworn to or affirmed and subscribed J (!R~ k ' I before me this 6 th day of JULY ~2001 '>y>>'Yt2~~I,_ILL/~;~j l ,..... '" '-' Cl) ... ::s ...... tIS c:: OIl iZi No. 21-01-649 Estate of MARGARET E LEVARTO , Deceased GRANT OF LETTERS OF ADMINISTRATION AND NOW JULY '0 ~2001 , in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, lT IS DECREED that CHARLES P LEVARTO is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration are hereby granted to CHARLES P LEVARTO in the estate of MARGARET E LEVARTO '7p'rC?~,(,~,d;~.IA.~<'y egIster 0 Wills FEES Letters of Administration $ 50.00 Short Certificates( ).......... $ 6.00 Renunciation ................ $ 5.00 JCP $ 5.00 TOTAL _ $ 66.00 Filed .... .;rP.~~ . ~. . . . . . . . .. A.D. Jt9Jillll ATTORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE , , Hl0';.80'; REV 91B6 This is to certify that the information here given is correctly copied fro~ an original certificate of death dul~ filed with Local Registrar. The original certificate will be forwarded to the State Vltal Records Office for permanent fillOg. me as WARNING: It is illegal to duplicate this copy by photostat or photograph, P 7297932 ",,,,,''''''''''''",'''',, \",,"~~\.1\\ OF PEl----___ l'#~..... '. .... . ~~\. i 5::).", '. ~~ ~ ~ ~... I'?>' ~~/c <400 'I~~ ~ c:::l\-' _tr--#:.~: i;~ ~C-', -'f';ji, I ~ ~*~ '.' 'h." :_._;/*~ ~....~., .' !"""~ \~ . ~~.i" /.~...\" "'"~ ~\\' ---.,."J1AfENT \)\ 't.;",'" """""#NI/l1111"" ~/ rz~~T Local Registrar Fee for this certificate, $2.00 No. ITEM # II' SHOULD READ AS FOLLOWS; ~~ tZ'A(/ .:h( ~A-:~ iJ MAY 0 7 2001 Date 21-01-649 ; 43 Rev. 2187 COMMONWEALTH OF PENNSYLVANIA. OEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH . Cumberland k.E. DECEDENT'S USUAl 0CClJAI0'l0H (~..:::.:.::.. "::: ::~:f .. Binder ..It. Printing DECEDENT'S MAJt.1HG ADOAESS(Sl,.... c_. _. Z,,~l DECEDENT'S 417 5th Street ~~ New Cumberland, PA 17070 ~~ SEX 2.female STAlE FILE NUMBER SOCIAL SECURITY NUMBER NAME OF DECEDENT (First. Middle. last 1. Margaret E. Levarto AGE (Las! BitIh<laVl UNDER 1 YEAR UNDER t 011II Mor1R'lI: o.Y8 tfouts i wtnut.. s. 79 Y... . COUNTYOFDERH 159- 24 8571 BIRTHPlACE (c....""" :s..e or fctllql Counby) Middletown, g::-oIyl 0 RACe. American IndIln. 8IKk. WhfI.. fI&:. (~) 1.. White 171t. DOl - Iiwina Cumberland -..oip? 11..00 ::..."=".::'.. IolOlkER'S NAME If............. _s..""""'l Unknown IolNUTAL SlAruS-"""'" N.~ Man_. Widowed, ~(SpocIy) 1.. Divorced "c.O ....__.. SURVlVlNG SPOuSE ,,, -.. QMI tnalOIIn name) 11.. SIaIe ..... New ClImherland C1Iy- Unknown Godshall ... lNFORlAANl'S ___ ADDRESS \so..... CiIyIIi>wn. Sloto. Z" ~l 417 5th Street, New Cumberland, PA 17070 PlACE OF DISPOSITION. _..~..." C'-IIOfy LOCRtON.~, _. ZIIl~ oIOlhIt _ __Sl".O 2001 21c. Con-O-Lite Crematory Z1~chaefferstown, PA NAMEANDAllDRESSOFFN:lUTY Parthemore FH & CS, Ine., 22c. 17088 FD 013-340-L 2311. Uc. ......sCASE REfERRED lO:Dir." EXAMlNERiCORONER? Ji:f 21. ~ t Approximale PART It: aigniAcan1 ~ conIfibutIng 10 dtalh. buI : interval beCWMn noc.'"'*ing in UW undrIftytn;C&UMl gMtft '" PART ~. lonMI and deeOl ~ lb. c. d. WERE AUTOPSY FINDINGS -.uwu: PftIOA 10 COMPLETlOH Of' CAUSE OF llERH1 DUE 10 (OR AS ACONSEOUENCE 00: ......NER Of' DEArH DATE OF INJURY (M"""'. Day. _I TIME OF INJURY INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED. _II ~ o D Homicide _n1 PenGng Invnligalion D o o ~CE OF INJURY. AI home. f.,m. $I;.... factory, office M. building. ~. tSp&c"v) _. VIII 0 NoD No~ VIIID NoD -... Could not be determtn8d 3.m~ '?'. t:1t/O / u.. 21b. CSl'T1F1EIl1C.oc:J< ""'" enol -CERTIFYING PHYSICIAN (Phv$IC.at' Ceflllytng cause ~ death when anotf'1e.- ph\lSICoan has pronounced death ana cample\ed Ilem 23) To'" beet of my Iil;nowhtdge. death OCCUlTed due ID IhlI cau.eca) and manner.. .tate4. . . . . . . . . 211. "PfIONOUNClNG AND ClRTlfYINQ PHYSICIAN IPhysaan bolh ;.>IOnoufIClfIg oealh and cf/f16lYIflQ 10 CCluSB 01 cSeClth) To"" Met o' my knowf4tdge, death occurred a........... d.IIl., and place, and due to the nu..,e).net m_nner..a ali11ed 'MEDICAL EXAMIHER/CORONER On ttw be... of .....",tn.tkM\ andIOf "'lve.ligatlon, in my opinion. d..th oc:curred .t the Ume. da.e, and place. and due to the '.UH(.) and ....n........ I'.ted.. . . . . . . . . . . . ' . . . . . . . . ... . . .. . . . . . . . . . . . . . . .... .. .. '" .. ............................ 31.. REGI~R'S SIGNATURE AND NUMBER ~-.L.{J 33 ~~~,A~,,~~-- 21-01-649 RENUNCIATION In Re Estate of /'( ffl<&-J.\f<€- -,- i=. Lie.. \fAR 10 deceased. To the Register of Wills of CUMBEI?U4NO County. Pennsylvania. The undersigned /HONIl\S E. LEV/-\RT01 50n of the above decedent. hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters WITNESS CHAf<-LES P. LEV/4.RlO, SOn /1 -r- jilt" , . 28'K. V~--<-I '--. t. () .-- on --- hand this - day of \.) . C/cAI &- 2. tNOLFO/?Jj J 1/ ^' e:.. ~:2.00 ( '-' be issued to ~b~ C;:~ (Signature) 1ft s, l~(}k 0 t. t/l()~ Ii I~ (Address) ~ (Signature) (Address) (Signature) (Address) E" CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Margaret E. Levarto Date of Death: 6 May 2001 Will No. nla Ad . N 2001-00649 PA NO 21-01-0649 mtn. o. To the Register: I certify that notice of (beneficial interest) estate administration 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 3 Au g u s t 2001 ~ame Address Thomas E. Levarto, 148 S. Enola Drive, Enola, PA Charles P. Levarto, 417 N. 5th Street, New Cumberland, PA Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: 3 August 2001 Signature Name ~I!.~~ 415 N. 5th Street Address New Cumberland, PA 17070 Telephone (71"7) 774-0322 Capacity: ~ Personal Representative _Counsel for personal 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 LEV ARTO CHARLES P 417 5TH STREET NEW CUMBERLAND, PA 17070 __nun fold ESTATE INFORMATION: SSN: 159-24-8571 FILE NUMBER: 2101-0649 DECEDENT NAME: LEV ARTO MARGARET E DATE OF PAYMENT: 02/22/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 05/06/2001 NO. CD 000882 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $388.4 7 I I I I I I I I TOTAL AMOUNT PAID: $388.4 7 REMARKS: CHARLES P LEV ARTO CHECK# 1621 SEAL INITIALS: VZ RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS C// 1 STATUS REPORT UNDER RULE 6.12 Name of Decedent: /J1 Cd}! ?tIe -t E. Le i/ar-f D Date of Death: t, fYIay 260 I Will No. Admin. No. 2.001- OO(,Lf q 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: IVI Ac- 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 X 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 approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. :-fi8QUII1:J ).lJI3:~) e)~a~;;tu- Signature C/frM.lA'::-~ ?r ~vJ4f2-Jo Name (Please type or print) tf/ 7 51i~ s-f, NIlW an1lllZ1LlFw p( PA ' Address Date: 2/12/02- ell? ) 71 l[... 0 ~ Z. '2 Tel. No. Capacity: ~ Personal Representative LZ: Z d ZZ 811 ZOo Counsel for personal representative (MAH:rmf/AM3) RfY-I!IOOEJlit.OOl " COMMONWE.~LTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 OF:=ICIAL USE Oi'ILY I (p- ~Lf2 - (0 FILE NUMBER 2 I -~-L COlJNt'YCOOE YEAR c., I- Z W Cl W U W Cl w !< "'-'" <..>"" wa.<..> ",00 <..>"~ a." a. .: >- Z W o Z o a. '" w " " o <..> z o ~ ...J ::l !:: a. <l: u w 0:: INHERITANCE TAX RETURN RESIDENT DECEDENT .f2..='-r:L__ NUM8ER DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) LEVAf<.TO MARGARE:..! E. I SOCIAL SECURITI NUMBER 159 - 24 ~57 t I THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITI NUMBER NIP< - DATE OF DEATH (MM.DD,YE,R) DATE OF BIRTH (MM.DD.YEAR) DCa "" Pr'l 200 I 02 MP>.R,CH (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST. AND MIDDLE INITIAL) NIp., 19'22- ~ 1. Original ".etum o 4. limited Estate o 6. Decedent Died Testate (ArtadlCllP'folWtll) o 9. litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (dale of death ~ltef 12.1Z.aZ) o 7. Decedent Maintained a Uving Trust {AllachCOll'folTI\ISt} o 10. Spousal Poverty Credit (dale oldealh between 12.31.91 and 1,'.95\ o 3. Remainder Retum Id~te ofdealh pnor to lZ-13.aZ) o 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes o 11. Election to lax under Sec. 9113(A) (Mach Sell 0) :'l'HIS.SECr.i.ON,MtisT BE'COM!'LETED;',o.Ll.::,CORRESPONDENCE AND'CONFIDENTIALTAX INFORMATION SHOULD BE DIRECTED TO: i NAME CHARLES U;VARTO COMPLETE MAILING ADDRESS Lj 17 N, t:; 1]:1 'S T: NE..W CUM15G~LAI\JD PI\ FIRM NAME (If"""",) N I A 17070 TELEPHONENUMBERJlIl_174_ 0-:; 12 1. Real Estate (Schedule A) (1) 0 OFFICIAL USE ONLY , (2) 0 ;:....1..... d :lJ - f!"' :~~ N (') 0 " (3) 0 -~'"1 (4) "., CD (5) \2,0110. '\2- "-, '-..J (6) D -'~] >\) ~-.,'l (7) 0 ~ (8) 12JOlb.97- (9) 10'1'6.00 (10) 2'2.'isb:~:2. 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule OJ 5. Cash, Bank Deposits & Misce!laneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Misce!laneous 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, & Uens (Schedule I) 11. Total Deductions (total Unes 9 & 10) 12. Net Value of Estate (Une 8 minus Line 11) , 3. Charitable and Governmental Bequests/See 9113 Tl1Jsts for which an election to tax has not been made (Schedule J) (11) ;J?:.'is~.'2.7- (12) 'is 10:' 2.70 , (13) 0 (14) ~I 10 ~2.10 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPUCABLE RATES z o ~ I- ::l a. ::iE o u X ~ 15. Amount of Une 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x,o_ (15) x.0~(16) 3'6%.lf7 16. Amount of Une 14 taxable at lineal rate ~(p32.10 17. Amount of Une 14 taxable at sibling rate xl2 (17) 1 a. Amount of Une 14 taxable at collateral rare x 15 (18) 19. Tax Due (19) 3g'a'.'f7 20.0 .-> > BE SURE TO ANSWER AU QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < Decedent's Complete Address: , STREET ADDRESS t...jll N '5~ s+. CITY Ne.w CUM berlcc.V\cA. I STATE PA- I ZIP 17070 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) Total Credits (A + 8 + C) (2) 3. InteresUPenalty if applicable D. Interest . E. Penalty TolallnleresUPenalty ( 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 interest on the tax due. (SA) 8. Enter the lotal of Line 5 + SA. This is the 8ALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT ~~';::;"';~:-7!~~!';:i,'~~3i't"~'S1~':;'~~~f,::,r::;::Er~-*,""?>':;:'~3'~~~~~"'>;~~~~':;','4?'.hrt,/~:io;:;~.~_~i..~~-"'~d'k1?~~~~~~~t:.,.~~~ 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;.. ......... ............................................................................. D ~ b. retait:1 the right to designate who shall use the property transferred or its income;. ................. ........................ D [L9 c. retain a reversionary interest; or... ..................... ................. .... ................... .............. ....... . ........ D l:&I 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 receiving adequate consideration? ....... ............................... ........................ ............................................. D ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ............. D iXI 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ............................................................... .......n.............................. ....... D IXl 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 thai I have examined this relt.lm, induding accompanying schedules and statements, and to the cesl of my knowledge and celief, it is true. correct and complete. Declaration 01 preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE 0 FILING RETURN ADDRESS 411 N. ~ St., NQ..w ('.AJM-bulane!. PI\- SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE 17070 DATE ADDRESS ;;.~""';;:~~&...~-'&~~i'l.:::'~=i.~~-r-::-g?1'~'E~k-'Si'~jr~.i:~~~.L:.s:;:-""'J'J"~'t.\i..<;..:a""""';.~~~~~~"'"..,~~;,;:;.rl\.;:~ 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 PS. 99116 (a) (1.1) (i)l. For dates of death on or after January 1, 1995. the lax rale imposed on the net value of transfers to or for the use of the survIVing spouse is 0% [72 PS. 99116 (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 beneficiarj. For dales of death on or after July 1. 2000: The tax rate imposed an the net value of Tansfers from a ceceased chtld twenty-one years of age or younger at death to or far the use of a natural parent, an adoptive parent. or a stepparent of the child IS 0% [72 PS. 99116(aI(1.2)]. The tax rate imposed an the net value of J'ansfers to cr for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116ia}(I)]. The tax rate imposed an the net '/alue at transfers to or for the use of the decedent's siblings is 12% [72 P,S. 99116ia)(1.3J]. A sibling is defined, under Section 9102, as an individual who has at least one parent In ccmmon with :he decedent. whether by blood or adoption. 1l.~.':::lE)l. .ll.?ll '* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PEJINSYL V ~N1A INHERITANCE TAX RETURN RESlOENT OEC~IJENT ESTATE OF fill ARG-AR.E-T E. tJ;VAR TO FILE NUMBER ::2/-01- foYCf Inc~ude the proceeds of litigation anc:."'le dale the ~rcc...~ds 'Nere received by the es<ale. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATe OF DEMH 19~2 F"ORD fAIR-MONTI VIN-1f I FAE,P21 B)<CK.Il,0'1'iS3) .. "lin~# 3Lj2'&2'2.77 102 L~ lSot..D "(127101) 200 .00 2. C.~RTIt=IC~TE OF 1)~-PDSIT 5"h,-/(,.25 3. C.rlE.c...l(IN& Aox>uNT " 110.107 12,01 b."l2.. TOTAL (;:'l~a e!1ler sn line:. F,ec:Cltuiaricn) I s ~.ISIIE;(.ll.'Tl *' COMMONWEALTH OF PENNSYL'IA..l.llA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATiVE COSTS FILE NUMBER 2 I -0 I - ~'i'1 ESTATE OF M A i((,rA RE-r EO. LEV A rz. TO Debts of decedent must be reported on Schedule L ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES, 1. PARTHi:. MOR~ HOME: FVNG-R~L. 1,0 ~2-.oo B. ADMINISTRATIVE COSTS: 1. Personal Repre~entative's Commissions Name of Personal Representative (s) Soc:al SecurITy Numbe~s) I EIN Number of Persona! Representative(s) Str~t A,ddress City State Z'p Year(s) Commission ?aid: 2. Attorney Fees 3. Family Exemption: {If der....edenrs address is not tile some as eairnanfs, attach explanation) Ctaimant Street Address City Slate Zip Relationship of Claimant to Decedent 4. Probate Fees CD '-. 00 5. Accounlanrs Feo...5 6. Tax Ret:Jm Prepare(s Fees 7. - l,oq<5. 00 TOTAL U.iso enler em line 9, Rec:milulalicn) S (If mare Sp8C2 ~s nEeded, :nsert addlhonal sheets or the same sIze) HV.\jI1 fX..ll.QJl 'i!l ~~ SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES AND LIENS COMMONWEAlTH Of PENNSYWANIA INHERIT..NCE lAX ~UU~N ~ESIOENT OECEOENT ESTATE OF MAR&-A1<IE.T E:.. LEVA/<. TO Please Print or Type I FILE NUMBER I 21-ol-b'1Q ITEM I NUMBER DESCRIPTION AMOUNT 1. HOL.'{ SPIILIT HOSPITAL, Ac.c-l::.II"U74'1b 2. CPO 2- BILLING- CE..NTER, Acct.OOQtj-004 325100c:003-MP 3. rWTE-RNATIoNAL THERAPeUTIC SVS., P,cd.OOIO-OO47G.!91- 047410-MP 4. 11-\OMA5. 'P. KUNKLE D.O. S. WEST ~HoR€ €MER<:,E:NC'I I'^E.DICA-L SIIs.,P-cd:. [,,'\s'l'iib Iq~7.21 (pL/.35 l'-lO.5b Lj I.IS"' -12. qS- TOTAL (Also ~nter on tine 10, Recapitulation) \ S 2,2.'isG..2.1- (If more space i~ needed, insert additional ~heef!: of ~oml:! ~jze.) \, /6 -.;21/.;)- 10 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 CHARLES LEVARTO'02 417 N 5TH ST NEW CUMBERLANl\;_PA Curl' iVil\Y 1 () DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 05-06-2002 LEVARTO 05-06-2001 21 01-0649 CUMBERLAND 101 :L4 '* REV-1547 EX AFP eGl-Of) MARGARET E Allount Relli tted 17070 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=is'4-j-E3f-AFP-foY=02Y-NOYicE--OF-YNHERifANCE-YAX-A-PPRAisEHENT-,--ALLOWANCE-O"R-------------- --- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF LEVARTO MARGARET E FILE NO. 21 01-0649 ACN 101 DATE 05-06-2002 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. 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 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 U) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 12.016.92 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequestsj Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) UO) 1,098.00 2.286.22 U1> (2) (3) (4) NOTE: .00 X 8.632.70 X .00 X .00 X NOTE: To insure proper credit to your account. submit the upper portion of this form with your tax payment. 12,016.92 3.384.22 8,632.70 .00 8.632.70 00 = 045 = 12 = 15 = .00 388.47 .00 .00 388.47 (9)= TAX CREDITS: ". " .n..."'.... . \+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 02-22-2002 CDOO0882 .00 388.47 BALANCE OF UNPAID INTEREST/PENALTY AS OF 02-23-2002 TOTAL TAX CREDIT 388.47 BALANCE OF TAX DUE .00 INTEREST AND PEN. 1. 02 TOTAL DUE 1.02 . 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.) 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 LEV ARTO CHARLES P 417 5TH STREET NEW CUMBERLAND, PA 17070 ------~- fold ESTATE INFORMATION: SSN: 159-24-8571 FILE NUMBER: 2101-0649 DECEDENT NAME: LEV ARTO MARGARET E DATE OF PAYMENT: 05/15/2002 POSTMARK DATE: 05/14/2002 COUNTY: CUMBERLAND DATE OF DEATH: 05/06/2001 NO. CD 001176 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $1.02 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHARLES LEV ARTO CHECK# 1670 SEAL INITIALS: CW RECEIVED BY: REGISTER OF WILLS $1.02 MARY C. LEWIS REGISTER OF WILLS ~ " \~ ~ ~ ~ Q ~ ~ ~ ~ \ \ \~ \~~ \~ \~ \ \~ \\ \~ \-0 \~ ~ \ A r:. \"" \C\ \~ ~ ~ ',0(\ (') <J:. ~ tC! ~ ~~~ 9- .L ~~;...l.-o a ~~~~ ~ ~~ 0 ~ ~ ~Oo(\ ~ ~ -o("'!~\C\ ~ ,.,O~~ ~ ~~~'tt _\. '" 0 ~ ~"'o ~~ ~ ~~~ ~ ~ -0 ((\ ~ ~ ~ "" o .' .s:-~ ~~~ .,;. ~ ~ ("'! l,{I ~~(' ~~~ ~~~ ~ ~ ~ \, , -0 ,., ~ ~ o ~~ \\\~ ~.~~ ~~~o \~~"'" ~ ~""'q -0 '!i. 't) ". Q~ ~ ~~ ~ 'j,~ "'~ ~~ ~ "" .... "Y ~ \II ~ ~ ~ ~'\. d~ c:!~~ ~\, ~~~ ~~ ~tc.\~ .~~ ~';.~ ~A '9.~ 0 ~ .,:. '\ .1iI"(-"'" ~a ~ 1": '0. "i 0 "C\ ~"So~ ""-0 '0;.. l;.~ ~ "~~~ ~\ij\~~) \. ;Ga~ ~ ~ ~ ~ \~~ (t\~ a:- ~ ~ \C\ 0 '" ~~ ~ ~'t"" ~ ""\ ~ ~ li-~ ~~ \'C\ .,:. "':'-- . 0-' ~c: :;;. -- ~ - ~ ~~~-: ... - >-: ~ \ ~ ~ ~ t<' Vb-~.y'c:2-- /0 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRIS8URG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REV-1U7 EX AFP (01-021 '02 DATE ESTATE OF DATE OF DEATH FILE NUMBER .I, E :O~UNTY ACN 06-10-2002 LEVARTO 05-06-2001 21 01-0649 CUMBERLAND 101 MARGARET E CHARLES LEVARTO 417 N 5TH ST NEW CUMBERLAND JuU 1 7 Allount Rellitted PA 1707Q, Ct 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=i60-j-E"i-AFP-("OY:02Y------...-iNHERiTANCE-Tr;i-STATEMENT-O-F'-ACfcouiff--j(..------------------ --- ESTATE OF LEVARTO MARGARET E FILE NO. 21 01-0649 ACN 101 DATE 06-10-2002 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE. APPLICATION OF ALL PAYMENTS. THE CURRENT BALANCE. AND. IF APPLICABLE. A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-06-2002 PR I NCI PAL TAX DUE: ........................................................................................................................................................................................................................... 388.47 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 02-22-2002 CDOO0882 .00 388.47 05-14-2002 CDOO1l76 1. 02- 1. 02 TOTAL TAX CREDIT 388.47 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 If PAID AFTER THIS DATE. SEE REVERSE TOTAL DUE .00 IE SIDE 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). 01_00 ~H' Dr nile A D""IJND _ SEE REVERSE SIDE OF THIS fORM FOR INSTRUCTIONS. )