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HomeMy WebLinkAbout01-0660 PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Estate of frv'>/"\c:....'" ~. ('{\1~,es also known as No. e:t/~ ~ 1- " '0 To: Register of Wills for the County of ~1'n1o...~IQ."J. in the Commonwealth of Pennsylvania Deceased. Social Security No. ,'7 ? ~ I ~ - I a~o The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older, apph,,s, 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 (lJ..lIV'\b eA.lJ:> ^ h I So. last family or principal residence at C (~fU""'O lY1"cJdl(~ (list stre 7T>-,n.1O Decendent, then 7; years of age, died _X "'e 2.3 at 5 C ~ r +-f OS,f.'J..1> I, 'I-L,o~R,.s.b~ I ,.oA 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: AlA County, Pennsylvania, with .Q/"'o 3 75 CtP(U'.,..oJO~. 1"20; 3 . number and municipality) ,l;8c:206/ , $ ::</ CJ(;(), c;52- $ $ $ Petitioner_ after a proper search h~ ascertained that decedent left no will and was survived by the following spouse (if any) and heirs: Name yY1. Fe THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the appropriate form to the undersigned. ~ l>~~~iL tf-'"dI2~ '" ';)' u ~ '" ~3 '" .... r::<:'" ~ -00 ~.;; C'3.~ ~'" ~a.. "''- ;;;0 ~ ~ 00 en I /P - d l-l.?r ~ 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. Sworn to or affirmed and subscribed f ~ ~J- before me~s //(;ll. day of ~_ ~(J ~~r&;.-~r{'a .:42+~~~~1 ~ (J Register (f l ...... en '-' CI) .... :::l ..... tU s:: 00 Ci3 N 21-01-0660 o. Estate of FRANCIS E. MYERS , Deceased :-.;) GRANT OF LETTERS OF ADMINISTRATION AND NOW JULY 11th H 2001, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that LINDA MINNICK AND NANCY PRECHTL is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration are hereby granted to LINDA MINNICK AND NANCY PRECHTL in the estate of FRANCIS E. MYERS Ylp.Jryfl. ~'UA'~ b#A ~o. ~zi~ ()/Jnuh. , /~ Register of Wills FEES Letters of Administration $ 25.00 Short Certificates(2 ) . . . . . . . . .. $ 6.00 Renunciation ................ $ JCP $ 5. 00 TOTAL _ $ 36.00 Filed .J:llJ;.y..q............ A.D. U 2001 ATTORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE MAILED LETTERS AND ORDERS TO ADMINISTRIX JULY 11, 2001 H 105.805 REV 9/86 This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Rt;gistrar. 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. Ivu~.K~~ Local Registrar ~~ Fee for this certificate, $2.00 p 7387143 9~ dl S; ,;L <00 ( Date H105. ;43 Ra.... 2187 COMMONWEALTH OF PENNSYLVANIA. OEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH TYPE.tPAINT IN PERMANENT BLACK INK UHOER 1 DNlt ~!~ SEX Male STAlE fiLE NUMBER SOCIAL SECURITY NUMBER 177 _ 16_ NAME OF DECEDENT If ltSl. MIdale. L_I .. AGE tlaSl81fthOayl UNOER 1 YEAR ........ 00,. .. 3. 79,.,. BlRTHPLACE ;C.lyand PlACE: OF DE.4lJ"HICt-edtOf"llyllf'4 -- -jft,nslluct.ofoionOlt>eI 5M1et State 01 fCf8M)O COUAI'yl HOSPiTAl Middletown, ,_..... OX """"-,..nl 0 7. ... FACILITY NAME (II FW)IIOSI'lUbOr\, gIVe slIHt and numberl :;",,10 COUNTY Of DERH Dauphin White .... ... OECEOENl'S USUAL OCCuPRtON {Gv.1und afWOl'k dOne duf:':1 ~ oI_~~~m'Specialist "e. 11". OECEDENT'S MAtllNG ADOReSS (SI,.... CfyITawn. sa.. Zip Codel 1916 Carlisle Road Camp Hill, Pennsylvania 17011 SURVIVING SPOuSE (It wile. ~ rn..oen fWf'ofIl ... fRHER'S NAME (filS:!. MdGte.lattl 'lb. Coun l>d - ...... Cumberland _7 17..0 ::==.. MOTHER'S NAME IF"st. Middle. M8Iden Surname) wp. lWp Qf:CEOENT'S ACTUAl.. AESlllENCE Is.. -...clooN onottlerStde) c..._ It. tNfOAMANT'S NAME (T vp*prinr) James Myers Linda S. Minnick to. Virginia Adams INFORMANm'~:2f7~~rrerlX~,;rec"~l:sburg, Pa. 17050 ,.... PlACE OF D1SPOSlTKJN. N..... at Cemetery, Crematory lOCRMJN - CityIlOwn. SUle, Z-", Code Of OhM PlM:e Indiantown Gap National Annville, Pennsylvania 17003 ~ ~ :il o ~ o ~ < z Jun 27, 2001 21e. 21d. UCENSE NUM8ER FD-012662-L NAME AND 22c. TV Myers Funeral Home, Inc. 37 East Main Street Mechanicsburg, Pa 1705 LICENSE NUMBER 01 M 21. PART I: Enter (he diMases, inluries Of compk:a.1OM wtMth caused (he death 00 nol enter Ihlt mode of dying, such as ca,diac or fesplfalory aff851, shoe. 0' heart tailore. l.... only one cause on each N no. !ME Of DEATH 24. G 1.;2 'to NoD . ~~~CN.al"~ .~~4 ~!iW~ t -.:::> OUE~~SAC;'CN E V. I . -, A c--+--~ ~__Jl!:H~~ talO l"'AUCN"NCEOfl' . & ~ Btf..f >l- I ApprollftMlla :=:.: 1 l PART II: Odw sigI1iftclUll c:ondIIioM contnbuIing 10 ..ath. buC noI~inttw~cauMgMninPART I 'lJOtj",D ~Ih".s.ce"_ - _ QJJt, 14-/ ~ WERE AUTOPSY FIHDtNGS MANNER Of DEATH A\WlABlE PRIOR 10 COMPLETION OF CAUSE Jl9...... [] OF DEATH? ....w.. Hom~'" Acc.denl 0 PenQH'lg lnve$ltg,jllion [] V.. 0 No 0 Suoc'" 0 Coukt not ~ 4elermtned 0 DATE OF INJURY (Month O,Jy. Yearl TIME OF INJURY INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED. ..... 0 NoD "YE.OICAl EXAMINER/CORONER On the b..is 01 ....min.llon and/or InyesUgahon, in mY' opinion. death occurred al the lima, dala. and place. and due 10 the cauM(s) and manner .. sCaCed.. . . . . . . . . . , . . . . . . . . . . )'Ia REGISTJI.I'R S SIGNATURE ANO NUMBEV J3 1-/ tl--b?.-...,. "-~""- 0iJi.'Y -<!tlR_k<L;i;- "/ J'-" j;( I , '-'-1 , p:L1 2". 21.. CERTWIER ICNlck ani., <.JOe) "CERTIf'YUiIG PHYSICIAN lP"rSlCoall cer"'Y"'Ig cause ul tk'alh >/I't1er> ,Jnoltll:lf phvs.<:oan has Plonourl(.e(f de;llh dl'<J CQrnplt!lt!d Ilt!rn 2Jl To h bul 01 my know.... dlIath occurred due IlO dwI cau~.) and manne,.. s.ated. ,.. - _. PlACE OF INJURY. AI home. f.,m, SIr"', taclOfy, offic. buildinQ..u;,ISpecilv) _. 'PRONOUNCING AND CERTIFYING PttYSiClAN IPhy~""" b(,lIt1 PfOroOUil(;,ng oe..1h and\:et"lolylf'lgIOCalJStt 01 tlealhl ToiM bnl 01 my kno...~, de.'" occurred.' UWt lime. dat..,Jnd plac., and d.... to tIM t:auM(a) and manner "'. .Iiill~.. 34 ,J UN e. :J. S ,(~;CJ I , ~ --- CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Francis E. Myers Date of Death: June 23, 2001 Administration No.: 21-01-0660 To the Register: I certify that notice of estate administration required by Rule 5.6(a) of the Orphans' Court Rules was given to the following beneficiaries set forth on the attached list on October 4, 2001. Notice has now been given to all persons entitled thereto under Rule 5.6(a). //...... iCP ; / / - 1"/ . . I /( (/" C__..__ 7 (, Richard L. PlaceI'; ~uire ~ Attorney for the Estate - 3631 North Front Street Harrisburg, PA 17110 (717)236-9577 Date: October 4,2001 NOTICE GIVEN TO: ESTATE OF FRANCIS E. MYERS Linda Minnick 5217 Deerfield Avenue Mechanicsburg, P A 17050 Nancy Prechtl 940 Willc1iffDrive Mechanicsburg, P A 17050 'lE\L'I5lIl!EX!P-OO) COMMONWEALTH OF PENNSYlVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 1712~1 I- Z W o W o W o DECEDENTS NAME (lAST, FIRST, AND MiDDlE INITIAl) MYERS, Francis E. DATE OF DEATH (MM-DD- YEAR) 06/23/2001 )l.o-aL.(3-~ REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT t.. OFFICIAL USE ONLY FILE NUMBER 21 -01 0660 COOHT'ttca: -YEAR- - Nl.lf.HR- - - SOCIAl SECURITY NUMBER 171- 16 1880 DATE OF BIRTH (MM-DD-YEAR) 02/15/1922 THIS RETURN MUST BE ALED IN DUPLICATE WITIl TIlE REGISTER OF WILLS SOCIAL SECURITY NUMBER {IF APPlICABLE) SURVMNG SPOUSFS NAME (lAST, FIRST, AND MIDDlE INITIAL) n/a w ..., iS~:! ,,"0 ,,00 r.>"'''' .... .. .. KJ I,Ongina/Retum o 4. Limi\ed Eslale o 6. Decedent Died Testate (Attach aJfIY c1 Will) o B. Li\i9'tion Proceeds Received o 2. Supplemenlal Relum o 4a. Future Interest Compromise {date c1 deaItt aft8r 12--1l-82} o 7. Oecedem Maint3ined a lMngTIllsl:'(AItadlropyolTMl) o 10, Spousal Poverty Credit (dale tJf dllelh bBfween 1l-3f-9f an:! H-9:5) o 3.Remainde1Refum{daleofd8atl~1012-13-82) o 5. Federal EsIaIe Tax Return Required 8. TotaI_ of Safe Deposil BoXes o 11. EIecIicn \0 lax under See. 9113(A) "",,,,,,,,,,>) I- Z W o z o .. ~ o o NAMI' R~chard L. Placey, Esquire FIRt,l NAMEt'_ Place & Wri ht TELEPHONE NUMBER (717)236-9571 1. ReIliESlatO(S<:he<luIeA) 2. Stocf<s.nd Bonds (Schedule B) 3. CIosel1 Held Corporation, Partnership or SoIM'ruprielorship 4. MorI!JaiJeS & Nrites Receivable (Scheduto D) 5. Cash, Bank Deposils & _neous Personal Properly (S<:he<luIeE) 6. JoiI1lly OWned Properly (S<:he<luIe F) o separale Billing Requested 7. Inter-VIVOS TlllIlSfers & Miscellaneous _ Properly (Scheduto G or L) 8. Total Gross Assets (total Lines 1.7) 9. Funeral 8cpenses & Adminlslrafive Costs (S<:he<luIe Ii) 10. Debls of Decedent Mort9>geU.bililies, & Liens (Schedule Q 11. ToIal DedUClions (total Lines 9 & 10) t2. NelV.lue oIEs1ll1e (Linll 8 minus Line 11) 13. Charitabto and _1aI1leques\sISec 9113 Tmsls for whidl.n election to lax has not been made (Schedule J) z o ~ ::::I t: Q. ~ o w It 14. Net Value Subject to Tax tUne 12 minus line 13) COMPLETE MAILING ADDRESS 3631 North Front Street Harrisburg, PA 17110-1533 (1) .00 O~FICIAL U~ ONLY .00 o :!J<tJ (2) - (I) (') {C' C .00 c::> .--\ (3) I{" (', ;.; n (,., (4) .00 _. 4,000.00 --J (5) . . ",::l ::sl 1 ,099.80 (; N (6) ~'G ( 0i () " ;.':": -- (Xl (7) .00 (8) 5,099.80 (9) (10) 54,406.57 .00 (11) 54,406.57 (12) .00 (13) .00 (14) .00 x.O_ (15) .00 1..0_ (16) .00 1. .12 (17) .00 x -15 (18) .00 (19) .00 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 _ at the spousal tax rafe, or lransfers under Sec. 9116 ('XI2) z o ~ t- :;) a. :E o :..> ~ 16. Amount of line 14 taxable at lineal rate 17. Amount of line 14 taxabfe at sibling rate 18. Amount of line 14 taxable at coRateral rate 19. Tax Due CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 20.0 Decedent's Complete Address' STREET ADDRESS 1916 Carlisle Road ellY Camp Hill I STATE PA I ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/PayIiIen A. Spousal Plrier1y CrildiI B. Prior Paymenls C. Disrount (1) .00 Total Credits (Ai' B + C ) (2) 3. InterestlPenally J applicable D.1nteresI E. PenOIIy . TotaIlnlerestlPenally {O + E ) (3) 4. J Line 2 is greater than lile 1 + Uno 3, enler the ditfe<ence. This is the OVERPAYMENT. Check box on Page 1 line 2G to request a refund (4) 5. U Line 1 + Uno 3 is greater than Uno 2, enter the dilterence. This is the TAX DUE. A. Enter the interest on the lax due. (5) . (SA) .00 B. Enter the total of Line 5 + SA. This is the BAlANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT .00 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN ")(" IN THE APPROPRIATE BLOCKS ,. Did decedenl make a transfer and: Yes a retain the use or inrorne of the property transferred;............................,.......................................:..................... 0 b. retain the righllo designate who shan use the property transferred or its income; ............................................ 0 d. refain a reversionaly interest, Of......................................................................................................................_0 d. receive the promise lor life of either payments, benefits or care? ...................................................................... 0 . . 2. U death """"rred after December 12, 1982, did decedenl transfer properly within one year of death wi1houI receiving adequate consideration? .............................................................................................................. 0 3. Old decedent own an "in trust for" Of payable upon death bank account or security al his or her death? .............. 0 4. DId decedent own an Individual Retirement Aa:oun~ annuity, or other noo-probate property which . . contains a benefidary designation? ........................................................................................,............................... o. IXJ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. No iO IiU ~ ~ Under~atpetjury.I_tha<I_ _at..-..__lhe_ SIGNATURE OF PERSON RE ~ anal' schedules and slatemen!s. and 10 !he best d my Mowkldge and belief. it is true, c:orrecl and complete. at__...."'Y-..".. Ip- Harrisburg, PA 17110-1533 ADDRESS , c/o Placey & wright, 3631 N. Front Street, For dates of death on or after Juty I, 1994 and before January I, 1995, the lax rate imposed on the net value of transfers 10 or lor the use of the surviving spouse is 3% [72 P.S. ~9116 (a) (1.1) (i)]. For dates of death on or afler January I, 1995, the tax rate imposed on the net value of transfers 10 or for the use oi the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (iI)t The sIaIuIe does not exemDI a transfer 10 a surviving spouse from tax, and the s!aMery requiremenls for disclosure of assels and fiRng a tax retum are still applicable even W the surviving spouse is the only beneficiary. For dates of death on or after July I, 2000: The lax rate Imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death 10 or for the use of a naturat parent, an adoptive parent or a stepparent of the child is 0% (72 P.S. ~116(a)(1.2)J. The tax rale imposed on the nel value 01 transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noled in 72 P.S. ~9116(12) [72 P.S. ~9116(a)(1)]. The tax rate imposed on the net value of transfers 10 or for the use of the decedent's siblings is 12% [72 P.S"~9116(a)(1.3)t A Slbflll!J is defined, under Section 91Q2, as an individual who has at least one parent in common with the decedent. whether by blood or adoption. """"""';"W COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESI NT DE EDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FRANCIS E. MYERS FILE NUMBER 21-01-0660 Include the proceeds of litigation and the dale the proceeds W8lll received by the -. AI "",petty jolnlly-ownod wfIIIllIe right 01 ourviYotshlp must be dlscloud on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Funds held for decedent by Linda Minnick $ 4,000.00 NO VALUE 2. Miscellaneous Personal Effects TOTAL (Also enteron Une 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 4,000.00 REV-l509 EX.. (1-97) *' SCHEDULE F JOINTL Y.OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ESIDENT DECEDENT EST ATE OF FRANCIS E. MYERS FILE NUMBER 21-01-0660 Wan asoe! was made joint _In one yea, of the decedenfs date of death, " must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RElATIONSHIP TO DECEDENT . A Nancy A. Prechtl 940 Willcliff Drive Mechanicsburg, PA 17040 Daughter B. c. JOINTLY-OWNED PROPERTY: LElTER DATE DESCRIPTION Of PROPERTY "Of DATE OF DEATH ITEM FOR JOINT MADE Include nane of financial institution aid bMk account numbel' Of similll" identifying number. Attach DATE OF DEATH DECO'S VAlUE OF NUMBER TENANT JOINT _lor jOinl!y-heldreaI_. VAlUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A 10/69 Allfirst Checking 0062621645 2,199.59 50% 1,099.80 TOT AL,lAISO enter on nne 6, Recapitulation) $ 1,099.80 (If more space Is needed, insert add~ional sheets of the same size) II allfirst Allrrrst Financial Center N.A. P.O. Box 900 Millsboro, DE 19966 October 15,2001 Placey & Wright Attorneys At Law 3631 North Front Street Harrisburg, PA 17110-1533 RE: Estate of Francis E. Myers D',te crp~ath: .1un.., 23, 20f;l1 Social Security Number: 1'17-16-1880 Dear Mr. Placey: In response to your request, please be advised that at the time of death, the above- named decedent had on deposit with this bank the following accounts. 1. Account Type........................... Checking Accotmt Account Number....................... 0062621645 Ownership (Names oj).............. Francis E. Myers or Nancy A,'Prechtl Opening Date.. ......... ................10/28/69 Balance on Date of Death........ ..$2, 199.59 Accrued Interest $ 0.00 Total..................................... ..$2, 199.59 These accounts were converted from Ute acquisiti<m of another financial institution. Unfortunately, \\'e are unable to access any information pertaining to the date the account was made joint TIus letter does not include any accounts in wl1i~h tL.e deceased may have beeb listed as power of attorney. custodian ofllniform transfers, representative pay~, or trustee under a written trust agreement. . Page 2 October15,2001 For any additional information on these accounts, please contact our branch at: 5528 Carlisle Pike Mechanicsburg, PA 17055 Phone: (717) 255-2293 Sincerely, [~U~ Charlene Warrington, Associate I (302) 934-2722 ""0>''''''''''''. COM\4ONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FRANCIS E. MYERS FILE NUMBER 21-01-0660 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Myers Funeral Home, Inc. 7,440.00 2. Burial clothing 107.42 3. Church honorarium 250.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative s Commisskms Name of Personal Representative (s) Social Security Number(s) I EIN Number of P9/SO!lal Represenlalive(s) Street Address .00 City Slate Zip Yea~s) Commission Paid: 2. Atlorney Fees Placey & Wright 1,500.00 3. .FamIIy Exemplion: (If decedent s address is not the same as claimant s. attach explanation) Claimant .00 Street Address City Slate Zip Relationship of Clalmall\ \0 Decedent 4. Probate Fees Cumberland County Register of Wills 36.00 5. ACQ)untant s Fees 6. Tax Return Preparers Fees 7. Community Lifeteam - debt of decedent 118.00 8. Allied Behavior Clinicians - debt of decedent 70.92 9. Department of Public Welfare - estate recovery 52,024.23 TOTAL (Also enter 00 line 9, Recapnulation) $ 61,546.57 (ff more space is needed. insert additional shee1s of the same size) """"!''''.(..~''. CO!M.!ONWEAlTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIIlENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FRANCIS E. MYERS FILE NUMBER 21-01-0660 ESTATE OF Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Burial clothing 107.42 2. Church honorarium 250.00 B. ADMINISTRATIVE COSTS: 1. Personal Represenla1ive . Commissions Name of PelSOl1af RepIeSOI1Illfive (s) Social security Numbe<(s) (fiN Number of PllISOlla' Represenlalive(s) Street Address .00 City Slate Zip Year(s) Commission Paid: 2. A\Iomey Fees Placey & Wright 1,500.00 3. Family Exemption: Of decedent s addless Is not I!le same as claimant s, aUach oxpIanation) Claimant Street Address .00 City Slaw Zip Relationship of Claimant to Deoedent 4. Pmbate Fee. Cumberland County Register of Wills 36.00 5. Accountant s Fees 6. Tax Return Preparers Fees 7. Community Lifeteam - debt of decedent 118.00 8. Allied Behavior Clinicians - debt of decedent 70.92 9. Cumberland-Goodwill Fire/Rescue EMS - debt of deceden 300.00 10. Department of Public Welfare - estate recovery 52,024.23 TOTAL (Also enter on fme 9, Recapitulation) $ 54,406.57 (ff more space is needed, insert additional sheets of I!le same size) REV.1513EX~\1.91l '* SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECED NT FRANCIS E. MYERS ESTATE OF NUMBER L NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions} 1. Linda Minnick 5217 Deerfield Avenue Mechanicsburg, PA 17050 2. Nancy Prechtl 940 Willcliff Drive Mechanicsburg, PA 17050 FILE NUMBER 21-01-0660 RELATIONSHIP TO DECEDENT Do Not List Trustee{s) Daughter Daughter AMOUNT OR SHARE OF ESTATE One-Half Residue One-Half Residue 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 TAXIS 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 $ (ff more space is needed. insert adOJtional sheets 01 the same size) -0- Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 Date: 5/07/2003 PRECHTL NANCY 940 WILLCLIFF DRIVE MECHANICSBURG, PA 17050 RE: Estate of MYERS FRANCIS E File Number: 2001-00660 Dear Sir/Madam: It has corne 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.1, for decedents dying on or after July 1, 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: 6/23/2003 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, DONNA M. OTTO DEPUTY REGISTER OF WILLS cc: J File Counsel Judge 0~~ STATUS REPORT UNDER RULE 6.12 Name of Decedent: Francis E. Myers June 23, 2001 Date of Death: Will No.: 2001-00660 Admin. No.: Pursuant to Rule 6.12 ofthe Supreme Court Orphans' Court Rules, I report the following with respect to completion ofthe administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes IKl No 0 2. Ifthe answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. Ifthe 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 [Xl No 0 c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the .perk of the Orphans' Court and may be attached to this report./.?//)~/ Datb~21 /03 /; ) / . ~ o a: N N ~ ::c PA 17110-1533 ':p . ....-0 ;:: s:: ,j) ::::: Ij6 ~ p Address (717)236-9577 Telephone No. Capacity: 0 Personal Representative !Xl Counsel for personal representative \~ /6-o2YS -5 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG. PA 171Z8-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX Re:_,'" Re: DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 02-18-2002 MYERS 06-23-2001 21 01-0660 CUMBERLAND 101 RICHARD L PLACEY PLACEY & WRIGHT 3631 N FRONT ST HBG '02 FEB 25 ESQ 1\11 :57 '* REY-1547 EX AFP 112-DDl FRANCIS E C;8rh p A C"n~~l"ki i 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 ~ REV:is4-j-i3f-AFP-ci'2:0(i;--Norici--ciF-YtiHiifiTANci-rAx-APPRA-isiMiNi'~--ALrOWAirci-crR-------------- --- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF MYERS FRANCIS E FILE NO. 21 01-0660 ACN 101 DATE 02-18-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets ll) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 4.000.00 1.099.80 .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) llO) 54,406.57 .00 (11) ll2) ll3} ll4) NOTE: I~ an assessment was issued previOUSly, lines re~lect ~igures that include the total o~ Abh ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (lS) 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 (lS) 19. Principal Tax Due NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 5,099.80 54.406 57 49,306.77- .00 49,306.77- 14, 15 and/or 16, 17, 18 and 19 will returns assessed to date. .00 X 00 = .00 X 045 = .00 X 12 = .00x15= ll9)= .00 .00 .00 .00 .00 TAX CR~DITS' PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE ... Dl:l:lINn ~"'''' R"'U~RS~ S:rDE OF THIS FORM FOR INSTRUCTIONS.)