HomeMy WebLinkAbout01-0870
PETITION FOR PROBATE and GRANT OF LETTERS
Estate or' H-rrn t'e 1.0, He"i/i No. ~\.- 0 1- ~1 0
also kn;;wn as . if' To:
Register of Wills fpr tht},
/ D"f-eased. County of r..;w11 be.. /fi-t7cL in the
Social Security No. ;?~tf it? f.O.9'/~ Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut
in the last will of the above decedent, dated ~B ;,t" ~
and codicil(s) dated ~ \pr;Jf.l? f9' 7f- I
named /9'11
,,~ 1 :If?t~t9'
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in ~ I (1)611[J I(]J 7J d County, Pennsylvania, with
h last family or principal residence at ~'1 t=,OdJ /e/ ,,1"7 /-flt? L:-
/J7et-l"'r2TJ,'c...fbuf:' Pti - ,/~JO~- t'~./ }ll(;.>y/ ~;y/jj:?
(list str et, ~umber and muncipality)
Decendent. then (!,.6 y~s o!:.ue. died ~?,,/k-I .19 ;~ r,
at ;(tf {~rtP Ie/' ~ {reel J7~ h!..-~ '~5 jJUJt:;:b ~ 17L/~ .
Except as follows, decedent did not marry, was not divorced and did n t have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
V. alue of real estate in pennsllrJ
sItuated as follows: ~
$ ,?.l /{)C) D .00
$ ~.
$
$
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters '"r e, T ~ tfJe TJ T~ fI r
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
theron.
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13 'C];hn ,5 !t'reJ
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OATH OF-PERSONAL REPRESENTATIVE
COMMONWE~TH OF ~NNSYLVANIA 1- sa
COUNTY OF '//)6e~ ~rL . J
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well ruly a inis the estate according to law.
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No. 21 - 01 - 870
Estate of
ANNIE L HEIGES
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW SEPTEMBER 2+, xt~, in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated SEPTEMBER 26'1 1979
described therein be admitted to probate and filed of record as the last will of
ANNIE L HEIGES
TESTAMENTARY
JOHN S HEIGES
and Letters
are hereby granted to
~(}.~~~&,~.
MARY CLEWIS
FEES
Probate, Letters, Etc. ......... $ 70.00
Short Certificates( 3) . . . . . . . . " $ 9.00
Re.:wtlciation ................ $
X'-PAl:it~ $ 9.00
JCP 5.00
TOTAL _ $ 93.00
Filed .... .~~P.lJ~~~R .21 II. .<QOJ... .. ....
A TIORNEY (Sup. Ct. LD. No.)
ADDRESS
PHONE
Mailed letters to Executor on 9-24-01.
105.805 REV 9/86
This is to certify that the information here given is correctly copied fro~ an original certificate of death dul~ filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent fiUng.
WARNING: It is illegal to duplicate this copy bv...p'hotostat or phot~graph.
Fee for this certificate, $2.00
p
7691042
No.
iC",~~Ji.'-k ~
Local Registrar
. J't~~~ 18, d.c>CJ(
Date
HIQ) 11ll3R." 21fH
COMMONWEALTH OF PENNSYlVANIA. OEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
7YPEJPRlNT
IN
-'ERMANENT
BLACK INK
a.
STAtE F'lt "UMllER
NAME OfDECEDiNTif.;~~--"-'----- ---------------------.--- sex--- SOCIAL SECURIl'f NUMBER
6979 ..
September 16,2001
,.
AGE (l... BorlNlIlvl UNDER' YEAR
__ llAp
8lRTHI'LAcE le.lv v.d
Slale Of f CfInQl1 Cwnuyt
-- OI.TEOFOWH,Mc;;;;;:o..--;:'_~-'
Female 3.
204-
30-
PlACE OF DEATH /Ci>ecl< ""'Y""'" _ ,n5l"o<'.or...". 0II>et 'lOOeI
HOSPllAI.:
,,,,,,,,_Ox E~..", 0
86v"
COUNl'f OF DENH
York Countr,
and notntler I
Cumberland
DECEDENT'S USUAL OCCUPATlOH
,Give tundI oI.WOIk done duftng mc:8
01 """k"'Q lole, do A04 _......, I
. II.. Homemaker nIL
DECEDENT'S MAIlING ADORESS (SIt... ColyIIOwn. SIaIa. Z~ COlleI
III.
...
="'00
RACE. -..._. Black. _....,.
tSpacot,1
,..
White
DECEDENT'S
ACTUAl
RESIDENCE
See onsIrucoona
"-I
MARITAl STATUS. _.- SUflVlVING SPOUSE
Na_......_. w_, ,__. ~_namal
Iliwrcad (Spec"vl
,.. Widowed
Pennsylvania::- I7c.DX-'dec__.. Ilpper Aller:}
....
Cumberland -"""1 17t1.D :;...'*-="='"
MOTHER'S NAME ,F.... Moddle. _ Sulnarnal
Own Home
17.._
29 Kower Drive
Mechanicsburg, Pennsylvania 170
...
FAJHER'S NAME \h.1. _ l.5I)
'710.
...
INfORMANT'S N.U.lf: (T ypelPrinrl
John Harry Smyser
John Heiges
fil
CfJJpJJAC~~EOF)'
l :
DUE 10 (OR AS A CONSEOUENCE OF)'
DUE 10 lOR AS A CONSEOUE NCE OF)'
WERE AUlOPSY FINOINGS
~E PRIOR 10
COMPlETION OF CAUSE
OF DENH1
......"" R Of' D€ATH
DATE OF INJURY
(Mon". O.y. """'I
g
o
o
....
cllyAloro
Camp Hill, Pennsylvania 17011
ICENSE NUMBER
DATE SIGNED
(MonIIl. Day. ""'I
2:'. nc.
Wo\S CASE REF EARED TO ME~ EllAMlNERlCOROHER1
v..~
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. .~..NMI.
· inIefvaI behwMn
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PART .: ou... sOgnjIk:anl __ conulllutinV III .,..,11. buI
A04 ..lUlling in.... ~ CAtM ...... in PART I
I
I
--............
I
I
,
TIME OF INJUAY
INJURY AT WORK? OESCRlBE HOW INJURY OCCURRED
Accident
Pending, "'~'Krn
o
o
o PlACE OF INJURY. AI home, farm. ..,.... t.~.
1>uoIdinQ. au: ,Spacofv\
JOa.
_ 0 ",,0
Ha'ura!
Homocide
v.. 0
NoD
5uocId<o
Coutd noI be ...e'mu\8d
aea. 211l.
ClRTIFIER .neck .,...,. one)
.CERTIfYING PHYSICIAN (Phys.f:..ul c~WyI09 cauw oIdealtl wilen .lf1Od1ttf IlhwSIC,an hdS pronounceo dealh dtlO Compteled Item 23)
TD....be..O'...,~~....OCCWNd.....to..cauUCI).ndmanne'.....ted..... .
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8
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"PROHOUMONG AND CEATaFYING PHVSICIAN (Pttys.clilO bolI'1 ~QllOlJOCIIl9 Oedlh dfld CeflllYlng 10 cause 01 cleat"')
Ta the best o. mv knowNdgft. death ociC,,"red a. "'IIme, dil.e, Mtd P'K., and due 101M clluM(a) and man"., .. ....led
.MEDICAl EXAMINER/CORONER
On the b..i. 0' ..aminat.on and/or inv..Ugalton. in my opinion. d.ath occurred a. 'he tlm.. d.... .and p'ace. and due 10 'he c.use(a).nd
.anne, .. ".'ed. . . . . . . . . _ . _ _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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34. r
3Ect5t Jltill ctub Qrt5tctttttnt
OF
ANNIE L. HEIGES
I, ANNIE L. HEIGES, of Upper Allen Township, Cumberland County,
Pennsylvania, declare this to be my Last Will and revoke any Will
previously made by me.
I.
I direct that all my just debts and funeral expenses, including
my gravemarker and all expenses of my last illness, shall be paid
from my residuary estate as a part of the expense of the administra-
tion of my estate.
II.
I devise and bequeath all of my estate of every nature and
wherever situate, in equal shares, to my children, DOROTHY M.
BECKER, BETTY R. WEAVER, JOHN S. HEIGES, CHARLOTTE E. HESS, SARA
J. CUNNINGHAM, GLORIA E. SPANGLER and BEVERLY A. SHEETZ, provided
that the share of any child that predeceases me or dies on or before
the thirtieth (30th) day following my death shall be distributed to
his or her issue, per stirpes, living on the thirty-first (31st) day
following my death and in default of any such then-living issue,
such share shall be added to the shares of my other children.
III.
I appoint THE FIRST BANK AND TRUST COMPANY, of Mechanicsburg,
Pennsylvania, guardian of any property which passes, either under
this Will or otherwise, to a minor and with respect to which I am
authorized to appoint a guardian and have not otherwise specifically
done so, provided that this appointment of a guardian shall not
apply to property distributable to a minor for whom I have otherwise
made special provision, and provided further that this appointment
of a guardian shall not supersede the right of any fiduciary in its
discretion to distribute a share where possible to the minor or to
another for the minor's benefit. Such guardian shall have the power
to use principal as well as income from time to time for the minor's
support and education (including college education, both graduate
and undergraduate and trade school) without regard to his or her
parent's ability to provide for such support and education or to
make payment for these purposes without further responsibility to
the minor or to the minor's parent or to any person taking care of
the minor.
IV.
I appoint my son, JOHN S. HEIGES, Executor of this, my Last
Will. Should my son, JOHN S. HEIGES, fail to qualify or cease to
act as Executor, I appoint my daughter, BETTY R. WEAVER, Executrix
of this, my Last Will.
v.
I direct that my Executor or his successors shall not be re-
quired to post bond for the faithful performance of their duties
in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
this ~, day of
s, ,t, f'Ir'" 'I'
, 1979.
a.v:~- -f:. H~.
Annie L. He ges
(SEAL)
Signed, sealed, published and declared by the above-named
Testatrix, as and for her Last Will and Testament, in the presence
of us, who, at her request, in her presence and in the presence
of each other, have hereunto subscribed our names as witnesses.
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
ss:
COUNTY OF CUMBERLAND
I, ANNIE L. HEIGES, Testatrix, whose name is signed to the
foregoing instrument, having been duly qualified according to law,
do hereby acknowledge that I signed and executed the instrument as
my Last Will and Testament; that I signed it willingly; and that I
signed it as my free and voluntary act for the purposes therein
expressed.
~:IJ. ~fi.~~~"
Annie L. iges
Sworn or affirmed to and acknowledged before me, by ANNIE L.
HEIGES, the Testatrix, this .2 (L. Ul day of ~l~~~f\....,
, 1979.
~, ~
-~ .~
Notary ~ l.C ~
NOTARY PUmJC
My Commitsloa izpir.. Dec. 21,1981
i.emoJU, Po.. Cumbetlasad ~
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
SS:
COUNTY OF CUMBERLAND
We, -%. ~. ~..W. and ~ (; , ~ ! l.-.-->
the witnesses whose names are signed to the forego1ng instrument,
being duly qualified according to law, do depose and say that we
were present and saw the Testatrix sign and execute the foregoing
instrument as her Last Will and Testament; that she signed willingly
and that she executed it as her free and voluntary act for the pur-
poses therein expressed; that each of us in the hearing and sight of
the Testatrix signed the Will as witnesses; and that to the best of
our knowledge, the Testatrix was at that time 18 or more years of
age, of sound mind and under no constraint or undue influence.
ltk t. c2f;twJ
Sworn or affirmed to and subscribed to before me by
(y' 13. ~ =-and ~
witnesses, this.2~ illday of ~
~.
.~.. I f -T-
, 1979.
~_ D ~ ~
Notary P~c' tS
NOTARY PUBLIC
My eo..1lS1oe hplrel Dec. 21, 1981
.i.ealO'1U., PQ. Cumbclud CoDA11
.~
-~
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
Annie I
HpilJPC::
Date of Death:
Seotember 16. 2001
Will No.
2001-00870
Admin. No.
21 01 0870
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 5 e p t 2 0 t 2 0 0 1
Name
Address
Betty H. Weav~r; 3 Walnut Lane; Mechanicsburgt Pa. - 17050 (Daughter)
Cnarlotte H. Hess; 339 W. Meadow Drive; Mechanicsburgt Pa - 17050 (Daughte
Sara J. Cunningham; 2484 Cope Drive; Mechanicsburg, Pa - 17055 (Daughter)
Gloria SpanQler; 515 Mt. Airy Road: Lewisberrv. Pa - 17339 (DalllJhtpr)
Beverly A. Sheetz; 29 Kower Drive; Mechanicsburg, Pa - 17055 (Daughter)
John s. Heiges; 6026 Hummingbird Drive; Mechanicsburgt Pa 17050 (Son)
Linda Artz; 3 N Baltimore St; Apt A; Dillsburg, Pa - 17019 (Neice)
Gail Shirley; 1047 York Road; DillsburQ, Pa - 17019 (Neice)
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
January 3. 2002
S;grl! c5/~~
Na J 0 h n 5. _ He i Q e 5
Address
6026 HumminQbird Drive
co
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CO
o:::.t:
lYIer.hflnir.c::hllrg, PfI
17050
r"I
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c:::c
....,
Telephone ~ 1 7)
691 - 6823
,'/1
Capacity: ~ Personal Representative
I:,;: l~"
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_Counsel for personal representative
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-961
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
HEIGES JOHN S
6026 HUMMINGBIRD DRIVE
MECHANICSBURG, PA 17050
-------- fold
ESTATE INFORMATION: SSN: 204-30-6979
FILE NUMBER: 21-2001- 0870
DECEDENT NAME: HEIGES ANNIE L
DA TE OF PAYMENT: 10/04/2001
POSTMARK DATE: 1 % 3/2001
COUNTY: CUMBERLAND
DATE OF DEATH: 09/16/2001
NO. CD 000344
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $1,165.35
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: JOHN S HEIGES
CHECK# 2
SEAL
INITIALS: SK
RECEIVED BY:
REGISTER OF WILLS
$1,165.35
MARY C. LEWIS
REGISTER OF WILLS
/J- 9~ Y
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-IU7 EX iFP U2-DD)
RecorOi;. -,
Repj~~t :=;
of DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
P 1 :44cOUNTY
ACN
12-31-2001
HEIGES
09-16-2001
21 01-0870
CUMBERLAND
101
ANNIE
L
JOHN S HEIGES
6026 HUMMINGBIRD DR
MECHANICSBURG PA 17D€~rh-
CUfnbcnc', :
.02
FEB -1
Allount Rellitted
(Ji't
P"t-.
J--\
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 paYIIBnt.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REY=i6Cfj-EY-AFP-ri"2-:ooi-------...--iNifiiiTANC'E--TA)r-sTiffiM'E-tiT-ifF-ACCOuN"f--...---------------------
ESTATE OF HEIGES ANNIE L FILE NO.21 01-0870 ACN 101 DATE 12-31-2001
THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 11-12-2001
P R I NC I PAL TAX DUE: ...............................................................-...........................................................................................................................................................
1,169.35
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
10-03-2001 CDOO0344 58.47 1,165.35
12-17-2001 REFUND .00 54.47-
TOTAL TAX CREDIT 1,169.35
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
. IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A ..CREDIT.. (CR),
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. )
I?- 9-Y
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
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
Recon>:::<J of
Reg 1 ~;u: r Vv!Os
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
NOV 16 All :51 COUNTY
ACN
11-12-2001
HEIGES
09-16-2001
21 01-0870
CUMBERLAND
101
.01
JOHN S HEIGES
6026 HUMMINGBIRD DR Clerk-
MECHANICSBURG PA 171KD..-bt-~r'-1nd
'1.iIllJ" ~ feu-tv
. PA
*'
REY-1547 EX AFP n2-00)
ANNIE L
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=isl.'-EX-AFP--riZ-:ooj--NOTicE--OF-'rNHEifiTANCi-YAi-AppRAiSEMENy-;-iil-oWANci-oli-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HEIGES ANNIE l FILE NO. 21 01-0870 ACN 101 DATE 11-12-2001
TAX RETURN WAS: (X) ACCEPTED AS FILED
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 FJ
7. Transfers (Schedule G)
8. Total Assets
) CHANGED
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
34..193.59
.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H)
10. Debts/Hortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subiect to Tax
(9)
(10)
8,208.00
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
34,193.59
8.'08 00
25,985.59
.00
25,985.59
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
16. Allount of Line 14 taxable at Lineal/Class A rate
17. Allount of Line 14 at Sibling rate
18. AlIOunt of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
.00
(11)
(12)
(13)
(14)
ns) .00 X 00 = .00
(16) 25,985.59 X 045 = 1,169.35
(17) .00 X 12 = .00
(18) .00 X 15 = .00
(19)= 1,169.35
TAX CREDITS:
PAYHENT RECEIPT DISCOUNT (+) AHOUNT PAID
DATE NUHBER INTEREST/PEN PAID (-)
10-03-2001 CDOO0344 58.47 1,165.35
TOTAL TAX CREDIT 1,223.82
BALANCE OF TAX DUE 54.47CR
INTEREST AND PEN. .00
TOTAL DUE 54.47CR
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REfLECTED AS A "CREDIT.. (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
..
.
)
s~
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Annie Laura Heiges
Date of Death:
September 16, 2001
Will No.:
2001-00870
/
PaN o. 21 - 01 - 8 7fJ 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 w~her administration of the estate is complete:
Yes ~V"j No 0
2. lfthe answer is No, state when the personal representative reasonably believes
that the administration will be complete:
3. lfthe answer to No.1 is Yes, state the following:
a. Did thp~rsonal representative file a final account with the Court?
Yes Z/:'-- No 0
b. The separate Orphans' Court No. (if any) for the personal representative's
accountis:______
c. Did the personal ~entative state an account informally to the parties
in interest? Yes ~"'~\.No 0
c. Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the Orphans' Court
and may be attached to this re ort
Date:~tri: cJoo)
N
N John S. Heiges
Name
,-r,
~t
6026 Hummingbird Drive
IhaniCSburg, Pa. 17050
Address
(71') -691-6823
Telep-hon~'Nt.. -----
Capacity: ~sonal Representative
o Counsel for personal representative
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REV-1500 EX {6-001
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
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FILE NUMBER
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
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NUMBER
e.S
DATE OF BIRTH (MM-DD-YEAR)
M 0 -{.'3 -" ~6
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
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THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
~ 1. Original Return
D 4. Limited Estate
o 6. Decedent Died Testate (Attach ccpy of Will)
D 9. Litigation Proceeds Received
D 2. Supplemental Return
D 4a. Future Interest Compromise (date of death after 12-12-82)
D 7. Decedent Maintained a Living Trust (Attach copy of Trust)
D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
D 3. Remainder Return (date of death prior to 12-13-82)
D 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
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13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
20.0
REV-1511 EX+ (12-99) .
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
FILE NUMBER
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
FUNERAL EXPENSES:
1//-< Il-O
(
1.
B. ADMINISTRATIVE COSTS:
Name of Personal Representative(s)
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1.
Personal Representative's Commissions
Street Address
2. Attorney Fees
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
State _ Zip
Relationship of Claimant to Decedent
Probate Fees #q,3 ,cro
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4.
5.
Accountant's Fees
6.
Tax Return Preparer's Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $ i
(If more space is needed, insert additional sheets of the same size)
CJO
REV.l508 EX. (1.97)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
AN)DJ6 '-
FILE NUMBER
1-/ E'I G €S
Include the proceeds of litigation and the date the proceeds were received by the estate, All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
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VALUE AT DATE
OF DEATH
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ITEM
NUMBER
1.
DESCRIPTION
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TOTAL (Also enter on line 5, Recapitulation) $ 54-, J 9 s . -s<J
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX+ (9-00*,
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
,t:}JJIJIE L.. HclG E5>
FILE NUMBER
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee( s) OF ESTATE
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
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ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
n NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
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