HomeMy WebLinkAbout01-0958
PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Estate of Nl\NCY JUNE DOUGHERTY
also known as
No.
To:
21-01-958
Social Security No.
Deceased.
210-28-3383
Register of Wills for the
County of CUMBERLAND in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older, appl
ies
for letters of administration
on the estate of
(d.b.n.; pendente lite; durante absentia; durante minoritate)
the above dect:dent.
Decendent was domiciled at death in Cumberland County, Pennsylvania, with
h er last family or principal residence at 2940 Beverly Road, Borough of Camp Hil~
(list street, number and municipality)
Decendent, then 65 years of age, died
~ Holy spirit Hospital
May 25,
2001
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:
850.00
$
$
$
$
-0-
Petitionec_ after a proper search h~ ascertained that decedent left no will and was survived by
the following spouse (if any) and heirs:
Name Relationship Residence
James J. Dougherty
on
2940 Beverl
Camp Hill, PA 17011
J. Robert Dou
THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the
appropriate form to the undersigned.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
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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
before me this 15th day of
OCTOBER 2001
J i411fo{~~~0f.irty
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Register
No. 21-01-958
Estate of
NANCY JUNE DOUGHERTY
, Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW OCTOBER 16, 2001, in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that J. Robert Dougherty
is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration
are hereby granted to
J. Robert Dougherty
in the estate of
NANCY JUNE DOUGHERTY
FEES
Letters of Administration $ 18.00
Short Certificates( ).......... $ 3 . 00
Renunciation ................ $
JCP $ 5.00
TOTAL _ $ 26.00
/Filed ...~9:-.1.~-;?P.qL..... A.D. Ji91L-
Register of Wills
~~
MiCha~~. Cassidy (82164)
JOhns~ u Duffie, Stewart & Weidner
ATTORNEY (Sup. Ct. I.D. No.)
301 Market st., P. O. Box 109
T.PmnynP, PA 17043-0109
ADDRESS
(717) 761-4540
PHONE
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REV"1500 EX (6-00) "'l
,
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
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REV-1500
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
DOUGHERTY, NANCY JUNE
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
May 25, 2001 April 27, 1936
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
J. Robert Dougherty
FILE NUMBER
21_01
COUNTY CODE YEAR
SOCIAL SECURITY NUMBER
210 28
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00958
NUMBER
3383
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
!KJ 1. Original Return
o 4. Limited Estate
o 6. Decedent Died Testate (Attach copy 01 Will)
o 9. Litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (date of death after 12-12-82)
o 7. Decedent Maintained a Living Trust (Attach copy ofTrust)
o 10. Spousal Poverty Credit (dale 01 death between 12-31.91 and 1.1-95)
204
- 26
8251
o 3. Remainder Return (dale of dealh prior 10 12-13-82)
o 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
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Michael J. Cassidy, Esq.
FIRM NAME (If Applicable)
Johnson, Duffie, stewart & Weidner
TELEPHONE NUMBER
(717) 761-4540
COMPLETE MAILING ADDRESS
301 Market st.
P. O. Box 109
Lemoyne, PA 17043-0109
NAME
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
(1)
(2)
(3)
(4)
(5)
876.80
iOFFICIAL USE ONLY
876.80
(11)
(12)
(13)
4,731.00
(.1,854.20)
-0-
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
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5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
(7)
(6)
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)
(9)
(10)
(8)
4,731.00
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
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
x .0 -.0... (15)
16. Amount of Line 14 taxable at lineal rate
x .0_ (16)
x .12 (17)
x .15 (18)
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
(14)
-0-
-0-
(19)
-0-
RFV-1503 Ex + (i-97)
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ESTATE OF
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DOUGHERTY, NANCY JUNE
FILE NUMBER
21-01-00958
ITEM
NUMBER
1.
All property jointly-owned with right of sUNivorship must be disclosed on Schedule F.
I
DESCRIPTION
$1,000.00 - Series EE Bond
Dated September, 1991.
Date of death value
VALUE AT DATE
OF DEATH
876.80
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
876.80
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
FILE NUMBER
21-01-00958
DOUGHERTY, NANCY JUNE
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
FUNERAL EXPENSES:
1.
Cremation Society of Pennsylvania
B.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Person.al Representatlve (s)
Social Secunty Numbef(s) I EIN Number of Personal Representative(s)
Street Address
1.
City
State
Zip
Year(s) Commission Paid:
2.
3.
Attomey Fees
Family Exemption: (If decedenfs address is not the same as ctalmanfs, attach explanation)
Claimant J. Robert Dougherty
Street Address 2940 Beverly Road
Camp Hill
Zip
17011
City
Relationship of Claimant to Decedent
State
PA
Husband
4.
Probate Fees
- Register of Wills, Cumberland County
5.
Accountanfs Fees
6.
Tax Retum Preparer's Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
AMOUNT
1,205.00
3,500.00
26.00
4,731.00
REV.1S13 C:X + (1.~
ESTATE OF
NUMBER
1.
SCHEDULE J
BENEFICIARIES
FILE NUMBER
21-01-00958
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
AMOUNT OR SHARE
OF ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DOUGHERTY, NANCY JUNE
1.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (include outright spousal distributions)
J. Robert Dougherty
2940 Beverly Road
Camp Hill, PA 17011
Spouse
PEF Code
Section 2102 (3)
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 TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART n. 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)
.-
-Inventory of the real and personal estate of
NANCY JUNE DOUGHERTY
1. $l~OOO.OO - Series EE Bond
dated September, 1991.
Date of death value
TOTAL
deceased
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876
80
876
80
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
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J. Robert Dougherty
being duly sworn according to law, deposes and says that he is Administrator
of the Estate of Nancy June Dougherty
late of _--- CaI})12-!:!!.!J....!?grough . ,Cumberland County, Pa., deceased and that the
'th" . t d b J. Robert Dougherty th 'd Administrator
WI In IS an Inven ory ma e y , e sa.
of the entire estate of said decedent, consisting of all the personal proJ3~rty 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. .
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NOTARIAL SEAL
DIANNE LENIG. Notary Public
Lemoyne Borough Cumberland Co.
My Commission Expires Dec. 21, 2001
25th
2001
cutor . ministrlltor .
Robert Dougherty, Administrator
Beverly Road
Sworn to
and subscribed before me,
Camp Hill, PA 17011
Address
Day
May
Month
2001
Date of Death
Yur
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.
(V)
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CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: NANCY JUNE DOUGHERTY
Date of Death: May 25, 2001
Will No.: 20101-00958
Admin. No.:
To the Register:
, certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court
Rules was sE!rved on or mailed to the following beneficiaries of the above-captioned estate on
October 16, 2001.
Name Address
J. Robert Dougherty, Spouse & Administrator 2940 Beverly Road, Camp Hill, PA 17011
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except none.
Date: /I/Jl/v/
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Signatur~
Name MI ael J. CassIdy, Esq.
Johnson, Duffie, Stewart & Weidner
Address 301 Market St.
P. O. Box 109
Lemoyne, PA 17043-0109
Telephone (717) 761-4540
Capacity:
Personal Representative
X Counsel for personal representative
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
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i'J-/'I- /iI *' ':>i
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
Reco;c
Req:'
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
12-31-2001
DOUGHERTY
05-25-2001
21 01-0958
CUMBERLAND
101
MICHAEl J CASSIDY E'P~
JOHNSON ET,Al
PO BOX 109
lEMOYNE
JAN -4
P12 :32
REV-1541 EX AFP <12-00)
NANCY
J
Allount Rellitted
C:elk
F0l1~,
FA
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 :i.5"4-j-Ex--AFP--fI2-:ooY-NoYicE--oF-'rNHEififAifcE-TA)C-jrpPRA-isEi"-€NT~--ALl-owAifcE-oR-------------- _ __
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF DOUGHEIHY NANCY J FILE NO. 21 01-0958 ACN 101 DATE 12-31-2001
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/Notos Receivable (Schedule D)
5. Cash/Bank DepClsits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Asse1:s
Cl)
(2)
(3)
(4)
(5)
(6)
(7)
.00
876.80
.00
.00
.00
.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Chari table/IGovernllental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
ClO)
4,731.00
.00
NOTE: I~ an assessment was issued previously, lines
re~lect ~igures that include the total o~ ~
ASSESSMENT OF TAX:
15. Allount of Line 14 at Spousal rate (15)
16. Allount of Line 14 taxable at Lineal/Class A rate (16)
17. Allount of Line 14 at Sibling rate (17)
18. Allount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax I:lue
TAX CREDITS'
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
876.80
(11)
Cl2)
Cl3)
Cl4)
4.131 on
3,854.20-
.00
3,854.20-
14, 15 and/or 16, 17, 18 and 19 will
returns assessed to date.
.
PAYMENT IlECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
.00 X 00 =
.00 X 045 =
.00 X 12 =
.00 X 15 =
Cl9)=
· IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
.00
.00
.00
.00
.00
IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
RESERVATION: Estates of decedents dying on or before December lZ, 198Z -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of anY estate for
life or for years, the Commonwealth 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:
PAYMENT:
REFUND (CR):
08JECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act Z3 of ZOOO. (7Z P.S.
Section 9140).
Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side.
--Make check or money order payable to: REGISTER OF WILLS J AGENT
A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-13l3). Applications are available at the Office
of the Register of WillS, any of the Z3 Revenue District Offices, or by calling the special Z4-hour
answering service for forms ordering: l-800-36Z-Z0S0; services for taxpayers with special hearing and I or
speaking needs: l-800-447-30Z0 (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. Z8l0Zl, Harrisburg, PA l7lZ8-l0Zl, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z8060l, Harrisburg, PA l7lZ8-060l
Phone (717) 787-6S0S. See page S of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-lSOl) for an explanation of administrativelY correctable errors.
If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (SZ) discount of
the tax paid is allowed.
The lSZ tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of
six (6Z) percent per annum calculated at a dailY rate of .000164. All taxes which became delinquent on and after
January 1, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOOZ are:
Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor
198Z ZOZ .000S48 199Z 9Z .000Z47
1983 l6Z .000438 1993-1994 7Z .00019Z
1984 llZ .000301 1995-l998 9Z .000Z47
1985 l3Z .0003S6 1999 7Z .00019Z
1986 10Z .000Z74 ZOOO 8Z .000Z19
1987 9Z .000Z47 ZOOl 9Z .000Z47
1988-1991 llZ .000301 ZOOZ 6Z .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 becomes delinquent will reflect an interest calculation to fifteen (IS) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculeted.
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PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF
THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM
YEARLY UNTIL COMPLETION.
STATUS REPORT UNDER RULE 6.12
Name of Decedent: NANCY JUNE DOUGHERTY
Date of Death: May 25.2001
Will No.: 2001-00958
Admin No.:
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes X No
2. If the answer is No, state when the personal representative reasonably
believes that the administration will be complete:.
3. If the answer to No. 1 is yes, state the following:
A. Did the personal representative file a final account with the Court?
Yes No X
B. The separate Orphans' Court No. (if any) for the personal
representative's account is:.
C. Did the personal representative state an account informally to the
parties in interest? Yes No X
The administrator is the surviving spouse and sole
beneficiary .
D.
Copies of receipts, releases, joinders and approvals of formal or
informal accounts may be filed with the Clerk of the Orphans'
Court and may be attached to this report.
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SignaEi
Michael J. Cassidy
Johnson, Duffie, Stewart & Weidner
301 Market Street, P.O. Box 109
Lemoyne. PA 17043-0109
.Date:
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(717) 761-4540
Telephone No.
Capacity: Personal Representative
X Counsel for Personal Representative