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HomeMy WebLinkAbout01-0884 IN RE: The Estate of : IN THE COURT OF COMMON PLEAS OF CATHERINE B. CASEY, Deceased : CUMBERLAND COUNTY, PENNSYLVANIA : Orphans' Court Division : No. ~I- e I - e8't AND NOW, this (~~ day of~ r JNr, 2001, upon consideration of the Petition heretofore filed by Eva M. Dougherty, it is hereby Ordered and Decreed that Eva M. Dougherty be authorized to open an estate checking account; that the Checking Account numbered, 1700007678, and Savings Account numbered, 1760009605 at Waypoint Bank be closed and the proceeds from each account be placed in the estate checking account; that the other assets setforth in Exhibit "B" be placed in the estate checking account; and that the unpaid claimants set forth in Paragraph 9 in the within Petition be paid in the amounts set forth therein. PaYment and distribution are accordingly Decreed and Eva M. Dougherty, the Petitioner, is hereby authorized to receive, collect and distribute the property as herein before set forth. BY THE COURT: IN RE: The Estate of CATHERINE B. CASEY, Deceased : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA : Orphans' Court Division : No. PETTTTON FOR THE SRTTT ,RMENT OF A SMA T T, EST A TR TN ArrORDA NrR WITH 20 PAr S A SRrTTON 1102 TO THE HONORABLE, THE JUDGES OF THE SAID COURT, The Petitioner, EVA M. DOUGHERTY, by her attorney, Anthony L. DeLuc~ Esquire, respectfully represents: 1. That the Petitioner, EVA M. DOUGHERTY, is an adult individual, who resides at 1536 Longs Gap Road, Carlisle, Cumberland County, Pennsylvania. 2. That the decedent, CATHERINE B. CASEY, died on May 21,2001, and at the time of her death, was a resident of the Thornwald Home, which is situated at 442 Walnut Bottom Road, Carlisle, Cumberland County, Pennsylvania. 3. That the decedent died testate and under the First Item of her Last Will and Testament, the Petitioner, Eva M. Dougherty, was appointed the Personal Representative of the Last Will and Testament of Catherine B. Casey. A copy of the Last Will and Testament of Catherine B. Casey is attached hereto, marked as Exhibit "A", and incorporated herein. 4. That the said Catherine B. Casey left surviving her the following persons who were excluded under the Fourth Item of her Last Will and Testament from sharing in her residuary estate: A. Robert Wesley Casey RR 4, Box 300 Mifflintown, P A 17059 Relationship to decedent: Son B. Emma Dean Soule 3827 Cloverfield Road Harrisburg, Pennsylvania 17109 Relationship to decedent: Daughter None of the children mentioned herein have received or retained property by way of payment of wages, salary or vacation benefits as set forth in 20 Pa. C.S.A. Sec. 3101. 5. That no person is entitled to the Family Exemption. 6. That the gross value of the personal estate of the decedent amounts to $6,935.23. 7. That the property of the decedent and the values of the several items thereof as set forth in the attached assets of Catherine B. Casey as of Au~st 25, 2001, a copy of which is attached hereto, marked as Exhibit "B", and incorporated herein by reference. 8. That the Department of Public Welfare maintains a claim In the amount of $61,276.28 against the Estate of Catherine B. Casey. A copy of the Claim of the Department of Public Welfare is attached hereto, marked as Exhibit "C", and incorporated herein by reference. 9. That the names of all unpaid claimants of whom the Petitioner has notice or knowledge are: A. Commercial Coin Company P.O. Box 607 1611 Market Street Camp Hill, Pennsylvania 17011 Appraisal of coins $25.00 B. Bankers Trust Company P. O. Box 290039 Nashville, Tennessee 37229-0039 Return of2 months pension 40.72 from Carlisle Tire and Rubber 2 months @ $20.36 c. Cost of five (5) death certificates Eva M. Dougherty 15.00 D. Fee to Eva M. Dougherty Personal Representative 480.00 E. Fee to Anthony L. DeLuca, Esquire Attorney's fee 480.00 F. Filing Fees for Inheritance Tax Return and Inventory 25.00 G. Filing Fee for this Petition 18.00 H. Reimbursement to Department to Public Welfare ~JRlil lil $6,935.23 10. That a schedule of assets and deductions for inheritance tax purposes will be filed with the Register of Wills; inheritance tax assessed in the amount of$ -0-. 11. That the Estate of Catherine B. Casey has no value due to the claim of the Department of Public Welfare and, therefore, Petitioner avers that twenty (20) days prior written notice of the intention to file such Petition be waived. WHEREFORE, Petitioner prays that the Court direct distribution of the property of the said Catherine B. Casey in the following manner: 1. That the Petitioner, Eva M. Dougherty, be authorized to open an estate checking account; 2. That the checking account at Waypoint Bank, numbered 1700007678, be closed and the proceeds deposited into the estate checking account; 3. That the saving account at Waypoint Bank, numbered 1760009605, be closed and the proceeds deposited into the estate checking account; 4. That the coins having an appraised value of $308.10 be purchased by the Petitioner and the proceeds of $308.10 be deposited into the estate checking account by Petitioner; 5. That cash found in the wallet of the decedent in the amount of $43.00 be deposited into the estate checking account; 6. That the refund check, numbered 088523, dated July 11, 2001 from United Church of Christ Home (Thomwald) in the amount of $2,482.39 be deposited into the estate checking account; 7. That the refund check from Phannerica, numbered 682124, dated June 7, 2001 in the amount of$48.00 be deposited into the estate checking account; 8. That the refund check from AARP, numbered 18025542, dated June 20,2001 in the amount of$43.00 be deposited into the estate checking account; 9. That the Petitioner, Eva M. Dougherty, be reimbursed the sum of$25.00 for the cost of the appraisal of the coins and $15.00 for five (5) additional Death Certificates. 10. That the two pension checks to Carlisle Tire and Rubber, each in the amount of $20.36, totaling $40.72 be returned to Carlisle Tire and Rubber. 11. That the Petitioner, Eva M. Dougherty, be paid the sum of $480.00 for compensation for services rendered in this matter, which sum should be paid out of the estate checking account; 12. That Anthony L. DeLuca, Esquire be compensated in the amount of $480.00 for services rendered in this matter, which sum should be paid out of the estate checking account; 13. That the Petitioner be authorized to pay the Register of Wills the sum of $25.00, which represents the filing fee for the Inheritance Tax Return and Inventory; 14. That the Petitioner be reimbursed from the estate checking account in the amount of $18.00 which represents the filing fee advanced for this Petition; and 15. That the balance of$5,851.51 be paid to the Department of Public Welfare from the proceeds in the estate checking account. Respectfully submitted, Anthony L. De 113 Front Street P.O. Box 358 Boiling Springs, P A 17007 Telephone (717)258-6844 Attorney I.D. No. 18067 VERIFICATION I hereby verify that the facts and information set forth in the foregoing petition are true and correct to the best of my knowledge, information, and belief. I understand that any false statements contained herein are subject to the penalties of 18 Pa. c. S. Section 4904, relating to unsworn falsification to authorities. Dated: ~J?/Ol ~~~'~hf ~ .,..,.- LAST W!LL }_~ TEST~v3NT OF CATHERINE B. CASEY I, CATHERINE B. CASEY, Social Security Number 080-05-2891, of the State of Pennsylvania, declare that this is my LAST WILL &~ TESTAMENT -and I revoke all other wills and codicils previously made by me. FIRST: I appoint EVA ~i. DOUGHERTY as my Personal Representative cQncerning this Will. a. I request that my Personal Representative be permitted to serve without bond or surety thereon-and without the intervention of any court, except as required by law. I direct that my Personal Representative act in unsupervised administration so as to administer my estate with a minimum of court supervision. If it becomes necessary to have ancillary administration of my estate in any jurisdiction where ~~ Pe~sGil&l ~cp~c3cntative is ~nable er dees net desire to q~ali:y as ancillary legal representative, I appoint as such ancillary legal reDresent~tive such individual or corocraticn as my Personal xepresentative shall designate, in wrlting. c. I direct my Personal Representative to pay the expenses of my last illness, the expenses of a funeral appropriate to my station ~.l..l. life and custom of Ii v'inS. It is my desi=e that rrlY body be donated to the Commonwealth of Pennsylvania. I request that my Personal Representative first contact the Humanity Gifts Registry, 130 South Ninth Street, Philadelphia, Pennsylvania 19105, (215) 925-7469. I grant my Personal Representative the power to extend or renew any debt for such time as my Personal Representative shall deem appropriate. c. All estate, inheritance, succession and other death taxes with respect to all property passing under this my Will shall be paid from and borne by the principal of my residuary estate, without regard to reimbursement, as if such taxes were administration expenses. My Personal Representative may pay such-taxes at any time deemed advisable, whether or not then due and payable. d. My Personal Representative is requested to settle my estate as soon after my death as may be practicable, and to payor deliver every legacy or bequest to my beneficiaries without waiting any time that may be believed to be customary in probate matters. -'< EXHIBIT nAil e (J.r~~L13 (;~tf PAGE 1 OF 4 PAGES ~~ ~ ,TIP- e. I may leave a letter of intent with the executed copy of this Will for the purpose of giving guidance to my Personal Representative concerning the distribution or sale of certain items of my property. I request, but do not require, that my Personal Representative honor my wishes therein expressed. SECOND: I hereby make the following specific bequests: a. I leave the sum of THREE'THOUSAND DOLLARS ($3000) to the Veterans of the Vietnam War, Inc. Post #26, P. O. Box 921, Carlisle, - :P-e-iirisyl-vaniO:;-17 01~irr-care--of~-:Mr ;---'James Baker, Vi ce - Commander, Veterans of the Vietnam War, Inc., Carlisle, Pennsylvania. b. I leave the sum of- ONE--THOUSANDDOLLARS- ($1000) nto-the Office U~ the Aging, West High Street, Carlisle, Pennsylvania. THIRD: I give, devise and bequeath, absolutely and forever, all of the restl residue and remainder of my estate and property of which I may be seized or possessed, or to which I may be entitled, at the time of my death, wherever situated or of whatever nature, be it real, personal, or mixed, to EVA M. DOUGHERTY of 1536 Longs Gap Road, Carlislel P~nnsylvania as her sole and absolute property if she shall survive me. FOG~TH: Except as otherwise provided in this Will, I have intentionally failed to provide for any other relatives or other persons I whether claiming to be an heir of mine or not. Insofar as I have failed to provide in this Will for any of my issue now living or later born or adopted, such failure is intentional and not occasioned by accident or mistake. I specifically intend to omit my children, ROBERT WESLEY CASEY and EMMA DEAN SOULE and any of their heirs of lineal descendants. My reason for ths is due to the fact that I am very disappointed in the way they have treated me during my life. FIFTH: Any beneficiary who fails to survive until one hundred twenty (120) hours after my death shall be deemed to have predeceased me, and the gift to that beneficiary shall be disposed of accordingly. SIXTH: The term "Personal Representati ve"n as used in this Will means Executor, Executrix, Independent Executor, or any other title of like import which is used to describe such a fiduciary. /'l . --' . ,;:< /1 PAGE 2 ( , ~.J L-6..Q..t.t t OF 4 PAGES ~~ ~ ,TP -- - -.. -- - -. . -'- SEVENTH: In addition to any powers granted by the laws of the state in which this will is probated, I hereby authorize and empower the fiduciaries named in this Will, to the extent of the discretion herein granted, to sell, exchange, convey, transfer, assign, mortgage, pledge, lease or rent the whole or any part of my real or personal estate, to invest, reinvest, or retain investments of my estate, to perform all acts and to execute all documents which my fiduciaries may deem necessary or prope~ "in regard to my property. If any of my fiduciaries elect to receive compensation for services, such compensation will be that allowed by law. EIGHTH: If any part of this Will shall be invalid, illegal, or inoperative for any reason, it is my intention that the remaining parts, s9 far as possible and reasonable, shall be effective and fully operative. My Personal Representative may seek and obtain court instructions for the purpose of carrying out as nearly as may be possible the intention of this Will as shown by the terms hereof, including any terms held invalid, illegal, or inoperative. IN WITNESS WHEREOF, I have at Carlisle Barracks, Pennsylvania, this J1/b- day o'f ~ ' 19K, set my hand and seal to this my LAST WILL AND TESTAMENT, consisting of 4 typewritten pages, each page bearing my handwritten signature. This document was prepared under the authority of 10 D.S.C. section 1044, and implementing military regulations and instructions, by John T. Rothwell, who is licensed to practice law in the State of Arkansas. CtJF--q 6 (1tLD9~~ CATHE INE B. CASEY \j (SEAL) . ~ C ^~f ~ ~ MftfOF PAGE 3 4 PAGES ~ ~ ~ The foregoing instrument was, at Carlisle Barracks, Pennsylvania, this /7~ day of ~~~ ' 19~, signed, sealed, published --and declared by CATHERI B. CASEY, the testatrix, to be her LAST WILL AND TESTAL~ENT in the presence of all of us at one time, and at the same---------- time we, at her request and in her presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses, and we do so verily believe ,that the said testatrix is of sound and disposing mind and memory at the date hereof. L ;)'-/d.~iA IL(VVJ/lq;/ (&--G/ Soc.Sec.No. ~ OF &;~ / /761(1 .....: =~~_~~~~-_~'~AU I c::-:z;r .l-r 1"i ~(J Sac. See. 1'Jo . OF C~~, r f;9- / /0/3 Cd~ L1~~&:1 PAGE 4 OF 4 PAGES I _ "'. . cf~-:'~uQf1k: Sae.See.No. OF ( I'. f, , 1-' IL ( r ~Sr..2 { (I ,. )/4 '70(~ .~ ~A1 9):;;J ,-JR ')..* COMMONWEALTH OF PENNSYLVANIA CUMBERLAND COUNTY ACKNOWLEDGMENT T ..-.CATHERINE B. CASEY. testatri~ho.s_e--.name.___is_signed__t_Q__the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Willi that I signed it willingly; and that I signed it as my ~,~~:~,..:~free and voluntary act for the purposes therein expressed. H . '. ' . :;;-~.';':'~~..~ \....;.. ~ ~;:- ~~~-~_..-,... C~D~e C~~I(f CATHE NE B. CASEY ( SEAL) AFFIDAVIT We I Estel:- ~Ebe ~~ I ~xkn.<---k'. rJ',Lt..s I and \TDfhJ "7 I ~'Pr) , the witnesses, sign our names to this instrument, being duly qualified according to law, do depose and say that we were present and saw the testatrix sign and execute the instrument ~s her Last Willi that the testatrix signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testatrix signed the will as a witnesSi and that to the best of our --_m__m_-.kno_wledge_them_tes_tatrix._was_.at__.that_:....time__18. or__more .years of age, ..of.u___ sound mind and under no constraint or undue influence. Q(~~ Witness ~d-~ Witness ~o ~"'t ~ ,&I Wl ness Subscribed, sworn to and acknowledged before me by CATHERINE B. :~~'~::,-,:-_CASEY I the testatrix, and subscribed and sworn to before me by ESic~ G-EDe~c; I~~~-K. rrJ~ and " J6~: 7' P dnf7 A.) HA' , the witnesses, this , /7Jt day of ,f\ '""' II P r 'ylAdh. , 19 ttf . ,-J.-r-'/ / ~1.;{{j;~~t~ My Commission Expires: Notarial Seal Betty R. Standridge, Notary Public Carlisle ~o~o. Cumberland County.x My CommIssIon E.xpires May 14.2001 Member. Pennsylvarm AssoGiation Of Notarip.!= ,~ \ CATHERINE B. CASEY ASSETS AS OF 8/25/01 ---------------------------------------------------------------- Checking Account-Way~oint Bank #1700007678 $1,798.18 Savings Account-Way~oint Bank #1760009605 $2,020.36 m,.-.,m"1\T lVl.......l..i ~ -:: (""I";.) C ,1 ..J.:JC~-=.-''-: -------------------------------------------------------------- r"'__'- ~c..::;,u j....... :'""':'"" _J.-,_, r"'_~~ ,. r)~" r"'_'1__....~__ ~U.L.l.l Ct D.l...l....L ~U.l....LeL.L.l..UU Fa'~e \T_'.,~ va..:..u.c Pennies 1\T~ ~1,' ~_ L'I":"L.f\.J...e.::;, ""1'1 ","\ -,).L.J.UV '").1 II II -' -= . v I..J 'r"\~ ___ !...) ...L":"lLt:: ~ "'l 'J 'i ,,"\ L"') . I '.J r-'\.....__~___ ~w.c..L '_C.i..'::;' Hal ~7es /l 1111 '": . V \..) '""') :: to) L . _1'-" Della::- Ccir:s 9. :J C' Pa. ~' e :- -: -: n .-, ~.:... . '-../ '- '~::. :~~ ;-0 '"": ,,(""'l "'""'., ';;..:... '..) C . L '...J ~= -~ Ja~"J.e ~ Appraisal $302.10 -n 1""\ .~ i\ ~ 1. ',-..# 1.....-LW $416.30 ~ =- 6 . J .=. Refu::d ? =epa~.l a: .'i"'1- _ ___.._ -: -= .L .1.1. '_I ..L _.:. 1,\1 c::. ~ '''-"''- ~~,~:~.~.;:- Refund of Personal Account at Tho~::wa~d ~ - --. ..-.. ,....... ~~.'5_, P~~~1ERICA Refund for Medicatic~s ~.3 .:' .=. ~~~p Health Insurance Refund s '"': """:l "';' li,.-", ~~/.',...),...) rT1.r\rn"7\ ,. lVl.t"'....1.J 53,116.69 TOTAL $6,935.23 ITEMS YET TO BE PAID: Cost of Appraisal $25.00 Return 2 months ~CT&W Pension 2 x 20.36 =$AO. 7.2 Cost of Additional Death _C~};:li~icates--5 x$3 = $15.00 TOT;u,.:---=$80~-~'i2 - EXHIBIT IIBII *' CO~MONWEAl TH OF PENNSYL VAN/A DEPARTMENT OF PUBLIC WELFARE BUREAU OF FINANCIAL OPERATIONS ESTATE RECOVERY PROGRAM PO BOX 8486 HARRISBURG, PA 17105-8486 August 21, 2001 ANTHONY L DELUCA ATTORNEY AT LAW 113 FRONT STREET PO BOX 358 BOILING SPRINGS PA 17007 Re: CATHERINE CASEY CIS #: 380141240 Co/Rec: 21/0082881 Date of Birth: 01/28/1915 SSN: 080-05-2891 Dear Attorney DeLuca: Please be advised that the Department of Public Welfare maintains a claim in the amount of $61,276.28 against the above-mentioned estate. This claim is for restitution of medical assistance granted on behalf of the decedent for which the Probate Estate is now responsible to reimburse the Department according to Act 49, 62 P.S. 1412, effective August 15, 1994, as amended by Act 20-95, effective June 30, 1995. Enclosed is the Department's itemized statement of claim. A portion of this medical expense, namely $20,274.07, was incurred during the last six months of the decedent's life; therefore, it is a Class 3 claim pursuant to Section 3392 of the Decedents, Estates, and Fiduciaries Code, 20 Pa. C.S.A. 3392(3). The balance of the claim, namely $41,002.21, is to be entered as a priority Class 6 claim against the estate. Please acknowledge receipt of this letter and advise whether the Commonwealth's claim is admitted and when payment may be expected. If the estate accounting is complete, please provide a copy. If the estate contains real estate, please provide copies of the deed, the latest tax assessment, and a current appraisal, if available. Sincerely, ~M rvut~~ Marg:t:t Smitherman Claims Investigation Agent 717-772-6607 717-705-8150 FAX Enclosure EXHIBIT "c" /'?- b ~ - y ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT1 ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX '02 DATE ESTATE OF DATE OF DEATH FILE NUMBER i', COUNTY ACN 06-24-2002 CASEY 05-21-2001 21 01-0884 CUMBERLAND 101 ,JUL -1 ANTHONY L DELUCA ESQ 113 FRONT ST PO BOX 358 BOILING SPGS PA 17007 *' IEV-1547 EX AFP t01-021 CATHERINE B i", r" I . " \. ..t ~ -. , t Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE1 PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REY=isi;'-EX--AFP-foi-:02i--NO'ficE--OF-i-tiHEifiTAifci-Y-A)rAPPRAisEi'-ENT~--Ai:.lowANci-ifR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF CASEY CATHERINE B FILE NO. 21 01-0884 ACN 101 DATE 06-24-2002 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. Hortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule f) 7. Transfers (Schedule G) 8. Total Assets ll) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 6.903.12 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) llO) 11045.00 61.317.00 ll1) (12) ll3) ll4) ll5) .00 X 00 = ll6) .00 X 045 = ll7) .00 X 12 = ll8) .00 X 15 = (19)= NOTE: To insure proper credit to your accountl subllit the upper portion of this forll with your tax paYllent. 61903.12 62.362 00 551458.86- .00 551458.86- r","cnl KEl;EJ:f"T (+J AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER DATE INDICATED 1 SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $11 NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A ""CREDIT"" (CR) 1 YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) RESERVATION: Estates of decedents dying on or before Dece.ber 12~ 1982 -- if any future interest in the estate is transferred in possession or enjoy.ent to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years~ the Co..onwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: To fulfill the require.ants of Section 2140 of the Inheritance and Estate Tax Act~ Act 23 of 2000. (72 P.S. Section 9140). PAYMENT: Detach the top portion of this Notice and sub.it with your pay.ent to the Register of Wills printed on the reverse side. --Make check or 1I0ney order payable to: REGISTER OF HILLS.. AGENT REFUND (CR): A refund of a tax credit~ which was not requested on the Tax Return~ may be requested by co.pleting 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 23 Revenue District Offices~ or by calling the special 24-hour answering service for forlls ordering: 1-800-362-2050; services for taxpayers with special hearing and I or speaking needs: 1-800-447-3020 (TT only). OBJECTIONS: Any party in interest not satisfied with the appraise.ent~ allowance~ or disallowance of deductions~ or assessllent of tax (including discount or interest) as shown on this Notice .ust object within sixty (60) days of receipt of this Notice by: --written protest to the PA Depart.ent of Revenue~ Board of Appeals~ Dept. 281021~ Harrisburg~ PA 17128-1021~ OR --election to have the matter deter.ined at audit of the account of the personal representative~ OR --appeal to the Orphans" Court. ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this asses~ent should be addressed in writing to: PA Department of Revenue~ Bureau of Individual Taxes~ ATTN: Post Assess.ent Review Unit~ Dept. 280601~ Harrisburg~ PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of adllinistratively correctable errors. DISCOUNT: If any tax due is paid within three (3) calendar .onths after the decedent"s death~ a five percent (5%) discount of the tax paid is allowed. PENALTY: The 15% tax a.nesty non-participation penalty is co.puted 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 a.nesty period. This non-participation penalty is appealable in the salle .anner and in the the salle ti.e period as you would appeal the tax and interest that has been assessed as indicated on this notice. INTEREST: Interest is charged beginning with first day of delinquency~ or nine (9) .onths and one (1) day fro. the date of death~ to the date of pay.ent. Taxes which beca.e delinquent before January 1~ 1982 bear interest at the rate of six (6%) percent per annu. calculated at a daily rate of .000164. All taxes which beca.e delinquent on and after January 1~ 1982 will bear interest at a rate which will vary fro. calendar year to calendar year with that rats announcsd by the PA Depart.ent of Revenue. The applicable interest rates for 1982 through 2002 are: Year Interest Rate Daily Interest Factor Year Interest Rate Da ily Interest Factor 1982 20% .000548 1992 9% .000247 1983 16% .000438 1993-1994 7% .000192 1984 117- .000301 1995-1998 97- .000247 1985 137- .000356 1999 77- .000192 1986 10% .000274 2000 87- .000219 1987 97- .000247 2001 97- .000247 1988-1991 117- .000301 2002 67- .000164 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax beco.es delinquent will reflect an interest calculation to fiftesn (15) days beyond the date of the assessment. If pay.ent is .ade after the interest cOllputation date shown on the Notice~ additional interest .ust be calculated. COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND } 55: Eva M. Dougherty being duly the Executric sworn according to law. deposes and says that she is of the Estate of Catherine B. Casey late of __~2-rlif?.l~__________ . Cumberland County. Pa.. deceased and that the within is an inventory made by her of the said Executrix of the entire estate of said decedent. consisting of all the personal propdrty and real 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. (/ x~ 2002 ~-~ NOTi\R1Al SEAL MARJo.R. IE A. DeLUCA, Notary ubI' South Mldd,let?" Twp., Cumberla dCo M CommIssIon Expires Nov. 1, 2003 ' ~~%7-~~ Sworn and subscribed before me, Address Date of Death 21st May 2001 Day Month 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. ~.;; Q) I-l -rl ::s t)'1 [/J >- .,; ~ >t 0 .... W III 0::: .... Q) Ia ... ~ ~ w <( [/J CD tt:S co A. .... m u () co 0 CD CD 0 V) u 0 U' ::3 >0- J W 0::: W IV H CI) ~ J: A. U. Q) A. Q) C 0 Z .... -I . ,......, Ia ... -I < 0 ~ A. Q 0 J LL [/J :I: w 0 < W -rl .;.. <( > Z a:: Q) ,......, ... . N Z 0 s:: I-l c H 0 ::lI 0 V) Z .rl tt:S 0 >t 0::: I-l U U Z w < Q) .,. r:: 0- "'0 0 ..c: c .w ,., ..c: tt:S - &: .w 0 CI) r:: u ~ CI) E "'0 ~ ~ - ..! 0 ,., ::lI 0 ..... U u: CD ~nventory of the real and personal estate of fL. Catherine B. Casey deceased 1 . 2. 3. Checking Account, numbered 1700007678, at Waypoint Bank Savings Account, numbered 1760009695, at Waypoint Bank Personal Care account at Thornwald Nursing Home, Carlisle Pennsylvania Miscellaneous cash, coin and bill collection, refund from nursing home, Pharmerica and AARP Health Inc. 1,880.24 2 , 0 1 4. 39 99.90 4. 2,908.59 $6,903.12 :~ ........1""". ~ J' ::: ,'.,.~ -< . d N ~;. I co I,~.J ...:."- .. "'2,15008(-['$7) ~ COMMO~~SYlVAN. DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) use a blank block to sep...ale words ... Z W C W (J W C W I- ll:::$1Il Ulrll:: Wll.O J:OO Ulr...l ll.al ll. <( I- Z t.L. C Z o Q. <J) z o ~ ..J :J !:: 0.. <%: U w ex: z o i= ~~ t-'::J 0.. ::E o o d is: [rV ,. & REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT Casey, Catherine B. SOCIAL SECURITY NUMBER DATE OF DEATH OS/21/01 01/28/1915 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 080 05 - 2891 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 12. Net Value of Estate (Line 8 minus Line 11) (12) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 15. Amount of line 14 taxable at the spousal tax rate , , See instructions on reverse side for applicable percentage 16. Amount of line 14 taxable at 6% rate 17. Amount of line 14 taxable at 15% rate 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) 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) 18. Tax Due lZ~f-)~~......i.. . FlU NlIMBER ... . . r;). 01 COUllTY CODE YEAR ~/ ir 1 5a 1. Original Return D 2. Supplemental Return D 3. Remainder Return (dateoldeatl1 prior to 12.'~2) D 4. Limited Estate D 4a. Future Interest Compromise.(dale 01 deatl1 aflerI2.12.82) D 5. Federal Estate Tax Return Required 5a 6. Decedent Died Testate (Attach copy of Will) D 7. Decedent Maintained a Living Trust (Attach copyofTrust) _ 8. Total Number of Safe Deposit Boxes . D 9. Litigation Proceeds Received D 10. Spousal Poverty Credit (dale 01 death between 12.31-91 and ,.,.95) D 11. Election to tax under Sec. 9113(A) (Attach Sch 0) : THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME Anthony L. DeLuca Es FIRM NAME III ~~p,icable) Anthon L. DeLuca Es uire TELEPHONE NUMBER 717 258-6844 NUMBER DATE OF BIRTH 17007 (1) (2) (3) (4) (5) (6) (7) o f'--' I C'::Q -'~:j 6, 903.12 (9) (10) x ,0 6 2 3 6 2 0 0 <-5 5, 4 5 8 8 6> -0- <-5 5, 4 5 8 8 6> -0- -0- -0- -0- (15) x .06 (16) x ,15 (17) (18) 19. DATE L/ 1/7/" Z- DATE r//7/02 . REV.1508 EX+ 12.87} . SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY Please Print or Type FilE NUMBER COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Catherine B. Casey (All property jointly-owned with the Right of Survivorship must be disclosed on Schedule F) ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 4. Checking Account, numbered 1700007678, at Waypoint Bank. Savings Account, numbered 1760009695, at Waypoint Bank. Personal Care account at Thornwald Nursing Horne, Carlisle, Pennsylvania. Miscellaneous cash, coin and bill collection, Refund from nursing horne, Pharmerica and AARP Health Inc. 1,880.24 1 . 2. 2,014.39 3. 99.90 2,908.59 TOTAL (Also enter on line 5, Recapitulation) S 6, 903 . 1 2 (Attach additional ay," x 11" sheets if more space is needed.) REV-IS11 EX+ (7-66\' ~t~ SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES Please Print or Tvpe FILE NUMBER ESTATE OF COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Catherine B. Casey i ITEM NUMBER A. 1. B. 1. 2. 3. 4. C. 1. 2. 3. 4. 5. 6. 7. 8. DESCRIPTION AMOUNT Funeral Expenses: lAd" . C mlnJstrahve osts: I Personal Representative Commissions Social Security Number of Personal Representative: 480.00 Year Commissions paid 2001 I Attorney Fees Anthony L. DeLuca, Esquire Family Exemption 480.00 Claimant Relationship Address of Claimant at decedent's death Street Address City State Zip Code Probate Fees 20.00 Miscellaneous Expenses: Filing fees for Inventory and Inheritance Tax Return. Death Certificates and Appraisal 25.00 40.00 TOTAL (Also enter on line 9, Recapitulation) 1,045.00 $ (If more space is needed, insert additional sheets of same size.) 1EV-1512 E.X+ (9-81) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT. DECEDENT ESTATE OF SCHEDULE "1" DEBTS OF DECEDENT, MORTGAGES, AND LIENS FILE NUMBER Catherine B. Casey ITEM NUMBER DESCRIPTION AMOUNT 1. Refund of two [2] Pension Checks to Bankers Trust Co. 40.72 2. Medical Assistance Claim by Dept. of Public Welfare 61,276.28 TOTAL (Also enter on line 10, Recapitulation) $61,317.00 f more space Is needed Insert addltlonel sheets of ..me size) .~~.-- .-~ LAST WILL ~~. TEST~_~ENT OF CATHERINE B. CASEY I, CATHERINE B. CASEY, Social Security Number 080-05-2891, of the State of Pennsylvania, declare that this is my LAST WILL AND TESTAMENT and I revoke all other wills and codicils previously made by me. --- -- r L rC-, " : I aDDoint 2VA Ivi. iJOUGEERTY as my i?e:csonal Representative T~1 ~ 1 1 I ~ -'- .......;.. . conce~:-:i.:iS t.his a. I request that my Personal Representative be permitted to serve without bond or surety thereon and without the intervention of any court, except as required by law. I direct that my Personal Representative act in unsupervised administration so as to administer my estate with a minimum of court supervision. If it becomes necessary to have ancillary administration of my estate in any jurisdiction where -.... T""I_____.............l D_".....__..-._'\o"""\+-~+-.;"'I.,.O ";("""1 ",....,~~'o,......,.... ~,......o~ ,.....,,.....,... ,...:;oC'..;.......o ~r... ..-,.,,~l.;f='1r ~l.~.:t ;;;C..l-~'-'~l.u...... ...\."--~.J.,.'-o..J'-.L...I..........I....,,_.....-...J ......................,......- '....1..1.0 ..............,-"-' ....'-''- .......-"-'............- '-'-' '-'1......'-'-................1 ancillary legal representative, I appoint as such ancillary legal 1~el)reS~1-lt~ t i-v"e ~UC1-l indi -vidual or corporaticn as Tny" Personal Represencative shall designate, in writing. 3,S b. I direct my Personal Representative to pay the expenses of my last illness, the expenses of a funeral appropriate to my station ~a~ life a~d custom of living. It is my desire that my body bc dcnatsd to the Commonwealth of Pennsylvania. I request that my Personal Representative first contact the Humanity Gifts Registry, 130 South Ninth Street, Philadelphia, Pennsylvania 19105, (215) 925-7469. I grant my Personal Representative the power to extend or renew any debt for such time as my Personal Representative shall deem appropriate. c. All estate, inheritance, succession and other death taxes with respec~ to all property passing under this my Will shall be paid from and borne by the principal of my residuary estate, without regard to reimbursement, as if such taxes were administration expenses. My Personal Representative may pay such-taxes at any time deemed advisable, whether or not then due and payable. a. My Personal Representative is requested to settle my estate as soon after my death as may be practicable, and to payor deliver every legacy or bequest to my beneficiaries without waiting any time that may be believed to be customary in probate matters. G a.r~13 C ~tt PAGE 1 OF 4 PAGES ~fl ~ '-.rtP- e. I may leave a letter of intent with the executed copy of this Will for the purpose of giving guidance to my Personal Representative concerning the distribution or sale of certain items of my property. I request, but do not require, that my Personal Representative honor my wishes therein expressed. SECOND: I hereby make the following specific bequests: a. I leave the sum of THREE THOUSAND DOLLARS ($3000) to the Veterans of the Vietnam War, Inc. Post #26, P. O. Box 921, Carlisle, -~-Pennsylvanta~~7013;--in-care---of--Mr:nHJames Baker, Vice-Commander, Veterans of the Vietnam War, Inc., Carlisle, Pennsylvania. /"".;:~~__ __ .....1-_ ?\_..:.__ 1".1....._... TT";_),.... ,..,~___.... ,....,__-I~_l_ n____...l....__~_ vi..~~,-~ ......l.lC ~'':::.1~.l.j,..=', "lC~\- C.J..~.1J. ..:J....~'CC;....., "-o,.i....i..,J..;;),,l..;;::, .::::::J..l.J..~Y,.i..Va...l..J..o.. b. I leave the sum of ONE THOUSAND DOLLARS ($1000) to the THIRD: I give, devise and bequeath, absolutely and forever, all of the ~est, residue and remainder of my estate and property of which I may be seized or possessed, or to which I may be entitled, at the time of my death, wherever situated or of whatever nature, be it real, personal, or mixed, to EVA M. DOUGHERTY of 1536 Longs Gap Road, Carlisle, Pennsylvania as her sole and absolute property if she shall surVl ve ;T,e. fOURTH: Except as otherwise provided in this Will, I have inte~tio~ally failed to provide for any other relatives or otner persons, whecher claiming to be an heir of mine or not. Insofar as I have failed to provide in this Will for any of my issue now living or lutc~ b8~~ or adopted, such failure is i~tentional and n8t oc~asicned by accident or mistake. I specifically intend co omit my children, ROBERT ~lESLEY CASEY and E~MA DE&~ SOULE and any of their heirs of lineal descendants. My reason for ths is due to the fact that I am veri disappoin~ed in the way they have treated me during my life. FIFTH: Any beneficiary who fails to survive until one hundred twenty (120) hours after my death shall be deemed to have predeceased me, and the gift to that beneficiary shall be disposed of accordingly. SIXTH: The term "Personal Representative" as used in this Will means Executor, Executrix, Independent Executor, or any other title of like import which is used to describe such a fiduciary. r: ~~ C-~ OF PAGE 2 4 PAGES j?Jj Qf!L , ;/< SEVENTH: In addition to any powers granted by the laws of the state in which this will is probated, I hereby authorize and empower the fiduciaries named in this Will, to the extent of the discretion herein granted, to sell, exchange, convey, transfer, assign, mortgage, pledge, lease or rent the whole or any part of my real or personal estate, to invest, reinvest, or retain investments of my estate, to perform all acts and to execute all documents which my fiduciaries may deem necessary or prope~ in regard to my property. I: any of my fiduciaries elect to receive compensation for services, such compensation will be that allowed by law. EIGHTH: If any part of this Will shall be invalid, illegal, or inoperative for any reason, it is my intention that the remaining parts, s9 far as possible and reasonable, shall be effective and fully operative. My Personal Representative may seek and obtain court instructions for the purpose of carrying out as nearly as may be possible the intention of this Will as shown by the terms hereof, including any terms held invalid, illegal, or inoperative. IN WITNESS WHEREOF, I have at Carlisle Barracks, Pennsylvania, this J )1~ day of ;Y7~ ' 19K, set my hand and seal to this my LAST WILL fu~D TESTk~ENT, consisting of 4 typewritten pages, each page bearing my handwritten signature. This document was prepared under the authority of 10 V.S.C. section 1044, and implementing military regulations and instructions, by John 1. Rothwell, who is licensed to practice law in the State of Arkansas. C()~Q is CATHE INE B. CASEY (] d: A') 9.-1 A It '0 ( SEAL) C tJ~. 11 c......4''f'' OF PAGE 3 4 PAGES ~ ~ VV- The foregoing instrument was, at Carlisle Barracks, Pennsylvania, this /7.!!- day of !t'bA/"A , 192X-, signed, sealed, published -and declared by CATHERINE B.' CASEY, the testatrix, to be her LAST WILL AJJD TESTfu~ENT in the presence of all of us at one time, and at the same time we, at her request and in her presence and in the presence of each othert have hereunto subscribed our names as attesting witnessest and we do so verily believe ,that the said testatrix is of sound and disposing mind and memory at the date hereof. _---9 I r:;;z;r .t-, y1 ~r) L;J, /d.~i. /J~/'^-- // / t~ , I _ '" _ . ;0, . > x//..i'-{ o OJ/ r1'~" >;:/' \.1.,0 ~ " V Soe.See.No. -. -,- ......'-''-- . -.-....... . .....'-'. :;2 Z;M M / /761(:] ,,~ II. /!~ If, _ __'--L-~// \ . PH 170/3 "''' v 1:' I',. ((L ( (L.~>~ ~ '1.1 r'/+ nOr ~ C ri~ ti!!. ~1 PAGE 4 OF 4 PAGES -oH~ \.'fi<- COMMONWEALTH OF PENNSYLV&~IA CUMBERLAND COUNTY ACKNOWLEDGMENT I, CZl..THERINEB, CASE'L-~~ho.se._nameis_signed_tQ.-the__-- attached or foregoing instrument, having been duly qualified ~cccrdins to law, do hereby acknowledge that I signed and executed the instrument as my Last Willi that I signed it willinglYi and that I signed it as my __,'_''':-.-:-'H free and voluntary act for the purposes therein expressed. -- - ~ ;':~::=--:;1. t-::..:-.~~ - ...Si_"P.":"IIT:"1"'...~.'':' . C o::! ~ 0; C3 Co CATHERINE B. CASEY ( SEAL) AFFIDAVIT We, ESfEt:.- 9cc:d: G~ , I~.x G- n <- -k'. rJ " Lcs and ,TCJ.h) -;-- I ~ c;) , the witnesses, sign our names to this instr~~e~:( bei~g d~ly qualif~ed according to law, do depose a~c say chat 'Ne 'Nere present and saw the testatrix sign and execute the instrJment as her Last Willi that the testatrix signed willingly and executed it as her free and voluntary act for the purposes therein exp~essed; that eac~ subsc~ibing witness in the hea~:Dg a~d s~g~~ ~: the testatrix signed the will as a witnessi and that to the best of our ______~knowledge the testatr::..x wasatnthat_time 18 or.more years of age, of ------------ sound mind and under no constraint or undue influence. Q(~~ Witness -e,J~ Witness ~Q k4-J~ 1Rf01<< -& wi):ness Subscribed, sworn to and acknowledged before me by CATHERINE B. :-::----=~~..:_':~.:CASEY, the testatrix, and subscribed and sworn to before me by ES fEK- G2 c---O 2. G E ,~~~K. n')~ and ,J6'~ (1-^,/'. /( c!?t7 '- '::::-u , the witnesses, this , /7'd day ,-.,f' .~'- rl __. 1/ -V r VJ A.c/tJ. My Co~nission 2xplres: Nota;!;, sea;----;] Betty R. sta, ndridge. Notary PuollC , Carlisle Boro. Cumberland County~ My CommiSSion Expires May 14, 2001 I Member. PennSVI'!:Jr.!3 M$OSi,ltion 0' Nntan~"