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HomeMy WebLinkAbout01-1086 PETITION FOR PROBATE and GRANT OF LETTERS Estate of CAROL M. WEBBER No. :J/ - 01 - , 0 ~, also known as To: , Deceased. Register of Wills for the County of CUMBERLAND Commonwealth of Pennsylvania in the Social Security No. 203-30-1682 The petition of the undersigned respectfully represents that: Your petitioner( s), who is/are 18 years of age or older an the execut OR in the last will of the above decedent, dated JULY 19. 1989 and codicil(s) dated RAY A. WEBBER, III WAS NAMED AS EXECUTOR IN THE WILL AND ROSEMARY BROTHERTON W AS NAMED AS ALTERNATE EXECUTOR. BOTH PEOPLE SIGNED RENUNCIA nONS. named (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, with hER last family or principal residence at 110 NOVEMBER DRIVE. CAMP HILL, P A (list street, number and municipality) Decedent, then 62 years of age, died 9/16/01 at 110 NOVEMBER DRIVE. CAMP HILL, P A Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never ajudicated incompetent: Decedent 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 Value ofreal estate in Pennsylvania situated as follows: $ $ $ $ 10.000.00 WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented he with and the grant ofletters ADMINISTRATION CTA. thereon. 1 (testamentary; administration c.I.a.; administration d.b.n.c.t.a) #13 IMBLER CINCINNATI OH 45218 V> " u <= OJ "0 'v;~ OJ V> 0::.1:"' OJ "0 <= <= 0 c;';j ';: ~.- *~ =~ '" 0 ;;! .~lJ (/l OATH OF PERSONAL REPRESENTATIVE COMMONWEAL TH OF PENNSYLVANIA} ss COUNTY OF CUMBERLAND The petitioner(s) above-milled swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to rhe' best of the knowledge and belief of if ner s) and that as p rsonal represen- tative( s) of the above decedent petitioner( s) will well and nister e s according to law. Sworn to or affirmed andSUbsc.ribed. ~. before me this 16th day of ~~);>Hy/!~~fL~3_~t//~~ /MARt c ~S Register j J '"( -c9. Y -- { r:,., ~. ~ ;;; ~ "- No. 21-01-10Rfi Estate of CAROL M. WEBBER , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW F;EBRl:}AEY. 15. 200? .~ , 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 JULY 19,1989 described therein be admitted to probate and filed of record as the last will of CAROL M. WRRRF.R and Letters TESTAMENTARY are hereby granted to RAY AlLISON WRRRF.R. IV ~ -0 'ti . vt'J"/:}/( /~. l.fu-!,67v// ),4,-) ~L/U/ M Y LEWl~>' of Wills (I FEES Probate, Letters, Etc.. . . . . . . . $ 40.00 Short Certificates ( 6 } . . . . . . $ 18.00 Renunciation. .2......... $ 10.00 x-pages $ 3 . 00 JCP TOTAL _ $ 7~:HH Filed,. .. FEBRUAI:3-Y ~ ~, .2002 mal led to attorney on i~1'~~02 BENJAMIN 1. BUTLER 81948 ATTORNEY (Sup. Ct. 1.0. No.) 500 N. THIRD STREET, 12TH FLOOR HARRISBURG P A 17101 ADDRESS (717) 236-1485 PHONE 00 '7) .,:( l'L ..- 12( '-0 ..-- h.",' l:' e; z :' '~'1 I,..~ 'l.J ..0 ::~ 011 == 0u () ',,'::,) o oj. Q.;la: a: ..- p Name of Decedent __._._~-.--.. {;. _ _ 2r~ se'_~L-_ Social Security No. ,,2 e3.__.3_Q.- f~:?:l.--..._. Date of Deat~ j ", ~O t!J I Date of Birth ~j'l,.1.iJ'i Birthplace -.-A~~~ '- , Place of Death --..,d:L~--Il.d~._- A' ",d,I,N,",,,, . . . i.,,,,~?", ,Tm,."h'" Race_________~ occupation~_~~rmed Forces? (Yes or No) J Decedent's ")1 / c;y fiJ c' Marital Status&~I'dZ~~_ Mailing Address l.La/~~ ULr. ~J.. 'I!." r Slliie! Informant .'~d_ ~ 7~. -' Funeral Director .~ JI Name and A~~7~ - II ;;-'/1. Funeral Establishment., ~J ~~o .;- J 11 r-1F ,J. WARNING: IT IS ILLEGAL TO ALTER THIS COPY OR TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH. ::>" k:J ~'V ,1 ' ,0 i iN J " II 0[',0,1 MENf ,:'o,c i VI ,l 0): ,)":/11,, E:il!;rn.M' :: Eil'lI (!I' ( IJ IIF F ,!l ; 21-01-1086 "":'1 CERT. NO. T 4 9 4 5 0 51 . , \111(,.<.. /," \, .C' I "4', ". ill'~f'~,.;l "~~ ...' \,.~~Jt.: "~,,., '/.; 11; \~;i." ._~;~./ "".' iif, N1 \j' ~, i . -;_, (_ :!_ '~'!~' ,!~:' !! I Oat of Issue Of'Th;~""'~-S-O I Pennsylvania ~--' -/~. /l Slate JU<l..LA../ J ~./, Part I Immediate Cause la)~g~~42~ (b) _ Interval Between , Onset and Death I I ___.L I I I -......--,..-..-.-. -. -- -------~---~.- ---.--.----~--..--..-----------.---.---_t_-- I I ----------L I (c) Part II (d)___.__ . _...____ Other S'~lnificant Conditions Manner of Death Natural 4?r' Homicide Accident Pencling Investigation Describe how injury occurred: D D Suicide Could not be Determined D I .-.---,-----.---- I ....J. Name and Title 01 Certfier_~L L72;:.... ~do~~~..A /J ~~.~.D/')D.~)., Coroner~ M.E.) Addcess"'-3L5_..~~ - - "7 / I ~- ~7;; t-R. This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Ilecords Office for permanent fililk!t;,_ .LJ.. 1lZo.~~~~ ~~lc~.*-2,@"L 3S:2 ?2!i:::" J , WASh:JlGTON OFFICE: 1714 LONGWORTH BLDG. WASHINGTON, DC 20515 (202) 225-5406 TOM RIDGE 21 ST DISTRICT, PENNSYLVANIA DISTRICT OFFICES: 108 FEDERAL OFFICE BLDG. ERIE, PA 16501 (8141 456-2038 COMMITTEES: BANKING, FINANCE AND URBAN AFFAIRS VETERANS' AFFAIRS POST OFFICE AND CIVIL SERVICE ~ongrt55 of tbt 11 ntttb ~tatt5 "OU~t of l\tprt~tntattbt~ .a~bingtonf m~ 20515 305 CHESTNUT STREET MEADVILLE, PA 16335 (8141724-8414 91 EAST STATE STREET SHARON, PA 16146 (412) 981-8440 LAST WILL AND TESTAMENT OF CAROL M. WEBBER I, CAROL M. WEBBER, of the Township of West Salem, Greenville, Mercer County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this to be my Last Will and Testament, hereby revoking any and all Wills by me heretofore made. ITEM I. I direct that all my just debts and funeral expenses be paid as soon after my decease as may be found convenient. ITEM II. I give, devise and bequeath my entire estate, both real and personal, and wheresoever situate to my son, RAY ALLISON WEBBER, IV. ITEM III. I hereby name, constitute and appoint RAY A. WEBBER, III to be the Executor of this, my Last Will and Testament, to serve without bond being required of him. In the event he is unable to serve in said capacity, I then name, constitute and appoint ROSEMARY BROTHERTON to act as Co-Executrix, also to serve without bond being required of her. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 19th day of July , 1989. a~<~WLk.fSEAL) This instrument, consisting of one (1) typewritten page, 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, and in her presence and in the pr ence of each other, have hereunto subscribed our names as witnesses. 67~ /?l~~' " AFFIDAVIT OF WITNESS WE, Carol M. Webber, Gina Rapovy and Sharon M. Ference the Testatrix and the witnesses respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and that she signed willingly (or willingly directed another to sign for her,)and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witnesses that to the best of our knowledge the Testatrix was at that time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. Testatrix Witness Witness Subscribed, sworn to and acknowledged before me by the Testatrix and subscribed and sworn to before me by Gina Raoovy and Sharon M. Ference , witnesses, this -1JLtbLday of July 1989. N9TAAl,q SEAL LaYERNf'HOFIUS. Notary Public Sharon. Mercer Coumy, Pa. My Commtssion Expir8$ Jun.1S. 1_ Register of Wills CUMBERLAND County, Pennsylvania Estate of Carol M. Webber also known as The undersigned, RENUNCIATION No. 21-01-1086 Letters Testamentary the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that Witness my hand this Sworn to or affirmed and subscribed ~. day of . .!)t:D I before me this (Signature and seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's commission.) RW-3 , Deceased Sister (Relationship) Rosemary Brotherton (Capacity) be issued to Ray Allisul1 Vv'ebber, IV {3 tJ} 732 Robinwood Drive Pittsburgh (Address) (Signature) (Address) (Signature) (Address) PQ :=(t:I ::s :;:\ 0"1 (\) 'Q;: Notarial Seal Dlonna J. Fomk:oIa. Notary Public Upper St. CI8Ir~..AIIegher'rf County My CommI88Ion ExpIr9s May 31. 2004 Member, PennsylYanla"ASsoctatIon of Notaries u )> PA 15220 c:i - ~ --' 0\ ~ --" (..j 00 of :0:0 ct>~ ,n 0 .....to ;:/ ' , ~.:~.,~; ,.1 ("', :::".t... NOTE: Renunciations executed outside the Office of Register of Wills are required in some counties to be notarized. Register of Wills CUMBERLAND County, Pennsylvania RENUNCIATION Estate of Carol M. Webber No. 21-01-1086 also known as , Deceased The undersigned, Husband (Relationship) Ray A. Webber, III (Capacity) of the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that Leaers Te~;tamentary be issued to Rav Allison Webber, IV Witness my hand this /3 day of October 2001 1(2 r..-lLl d J~_ /7T . \SI9h~ 661 Pe line Road, P.O. Box 82 Pierpont OR 44082 (Address) (Signature) (Address) (Signature) (Address) pO = It' 5:~ Sr! .. {i:' "., ~ ,'" :I i"A",. '.:~ es ..c: d ..... jJ::O I:!) ~, rt;;:.g~ I" r I ("' ..... 0'\ ~ JANET L MARGY, NttIry MIl Statt of Ohio My Comnission ElI,ireI Sept. 8, 2002 ;B ...... .1J ):. (..j O:l o ......'~ (Signature and seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's commission.) NOTE: Renunciations executed outside the Office of Register of Wills are required in some counties to be notarized. RW-3 ~ ... - ~~~~~~~~~~..~~" ~ ~y@ Western Surety Company Know all Persons by these Presents: Bond No. 69282002 THAT WE, Ray Allison Webber, IV and WESTERN SURETY COMPANY, a corporation duly business in the Commonwealth of Pennsylvania, firmly bound unto the Commonwealth of Pennsylvania , as Principal, licensed to do are held and in the sum of Twenty Thousand and 00/100 Dollars ($ 20,000.00 ), to be paid to the said Commonwealth, or its certain Attorney or Assigns, to which payment well and truly to be made, we bind ourselves jointly and severally, for and in the whole, our heirs, executors and administrators, firmly by these presents. Sealed With Our Seals - Dated the 23rd day of January in the year of our Lord 2002 The Condition of This Obligation Is Such, That If The Above Bounden Principal, as Administrator of all and singular the Goods, Chattels, and Credits of Carol M. Webber deceased, does make or cause to be made, a true and perfect inventory of all and singular the Goods, Chattels and Credits of the said deceased, which have come or shall come to the hands, possession or knowledge of the Principal or into the hands or possession of any other person or persons, for the said deceased and the same so made, do exhibit, or cause to be exhibited, into the Register's Office in the County of Cumberland , within thirty days from the date hereof; and the same Goods, Chattels and Credits, and all other the Goods, Chattels and Credits of the said deceased, at the time of his/her death, which at any time shall come to the hands or possession of the Principal, or into the hands and possession of any other person or persons, for the said deceased do well and truly administer according to law, and further do make or cause to be made, a just and true account of said Administration, within six months from the date hereof, or when thereunto required by the Orphans' Court, and all the rest and residue of the said Goods, Chattels and Credits which shall be found remaining upon the said Administrator's account, the same being first examined and allowed by the Orphans' Court of the county having jurisdiction, shall deliver and pay unto such person or persons at the said Orphans' Court, by their decree or sentence, pursuant to la......, shall limit and appoint, and shall well and truly ("QmpJy with the laws of this Commonwealth relating to collateral inheritances; and if it shall hereafter appear that any last will and testament was made by the deceased, and the same shall be proved according to law, if the said Principal being thereunto required, do surrender the said Letters of Admi ~ s~~on into tJ;1e Register's Office aforesaid, then this obligation to be void, otherwise to remain in full fo e. //~' / l 1 !o.'\~~\~\F'~~~~ -.(' . ~~,aM.l1~~red in the presence of I ~:. ~ .... "" 0 ~ ~~., GOl'll " ~.~ / f~./ ~T rr4A\~~ EE"5() '~:'.'P= -~:(J :_... ;:w,. .......... ~~: .~ !;(': 'i *\. ~ C A"/* i \: \r. "" ....~"l':.t ~.... 06:;.......... . '" "''''''''1. HD ##Itll" 10"" Principal Principal Form 1149-A-1-2002 WESTERN SURE TY COMPANY By ~X~ti:Vi~t ~ .. ~ ~ ," ""',,,,", .- .' . Western Surety Company POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That WESTERN SURETY COMPANY, a corporation organized and existing under the laws of the State of South Dakota, and authorized and licensed to do business in the States of Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri,Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming, and the United States of America, does hereby make, constitute and appoint ________~___StepheILT. Pate of ~___ Sioux Falls State of South Dakota , its reguiariy elected _----E-xecutive '..aoe PIPdidenL_____ as Attorn~y-ill-Fac;t, with fuil power and authority hereby conferred upon him to sign, execute, aCknowledge and deliver Tor and on its behalf as Surety and as its act and deed, all of the following classes of documents to-wit: Indemnity, Surety and Undertakings that may be desired by contract, or may be given in any action or proceeding in any court of law or equity, polic~l(i\JnMmnifying employers against loss or damage caused by the misconduct of their employees; official, bail, and surety and fidelity ~'~ in all cases where indemnity may be lawfully given; and with full power and authority to execute consents and wai\,~~ddtrie(~ or extend any bond or document executed for this Company, and to compromise and settle any and all claims or ~pds Dl'd'fr" against said Company. ...~, ~y :.q)>_\~.. ~ tii~rn Surety ~I:!.'t further certifies that the following is a true and exact copy of Section 7 of the by-laws of Western Surety ~1~ny duly adopted ~~w in force, to-wit: \ ~~ f: ~ ~ '~.$olicies, undertakings, Powers of Attorney, or other. obligations of the corporation shall be executed in the cor~~" , " "'pany by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President, or by such other office~ ~rectors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint A act or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile. In Witness Whereof, the said WESTERN SURETY COMPANY has caused these presents to be executed by Executive Vice President with the corporate seal affixed this 23rd day of January 2002 ATTEST -q.- _~-l4 ~_ __________ Assistant Secretary By~~~~~O~. Stephen T. Pate, Executive Vice President STATE OF SOUTH DAKOTA} ss COUNTY OF MINNEHAHA On this. 23rd day of January 2002, before me, a Notary Public, personally appeared Stephen T. Pate and L. Nelson who, being by me duly sworn, acknowledged that they signed the above Power of Attorney as Executive Vice President and Assistant Secretary, respectively, of the said WESTERN SURETY COMPANY, and acknowledged said instrument to be the voluntary act and deed of said Corporation. +~~~~~~~~~~~~~~~~~~~~~~~~+ ~ D. KRELL ~ ~~NOTARY PUBLIC~~ s SOUTH DAKOTA s ~ My Commission Expires 11-30-2006 ~ +~~~~~~~~~~~~~~~~~~~~~~~+ ~~Rj Notary Public Form F1975-4-2001 o Register of Wills of CUMBERLAND County, Pennsylvania 7- CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Carol M. Webber Date of Death: 9/16/01 Will No. 21-01-1086 Admin. No. To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on 6/11/02 Name Address Ray Allison Webber, IV #13 Imbler Drive Cincinnati OH 4~218 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: none Date: (,/lli02 ~ r (L---- Signature Name: Beniamin J. Butler Address: 500 N. Third Street PO. Box 1004 HalTlshuru I'A 17108-1004 , \J ') Telephone(71 7) 2 3 6148 5 x Personal Representative Counsel for Personal Representative ~,. Z l IT\f ZOo Capacity: c:. Register of Wills of CUMBERLAND County, Pennsylvania INVENTORY Estate of Carol M. Webber NO.21 01 1086 also known as Date of Death 9/16/0 I , Deceased Social Security No. 203-30-1682 Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We verify that the statements made in this inventory are true and correct. I/We understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Name of Attorney: Benjamin .I. Butler 1L I.D. No.: 81948 Ray Allison Webber, IV Address: 500 N. Third Street, PO. Box 1004 03ted &. 13 - 02. Harrisburg PA 17108-1004 .... .-1 ~. ~ d f'..; Telephone: (717) 236-1485 Description Cash, Bank Deposits, & Misc. Personal Property c.. Valiffi ~-....l PNC Bank - Checking Account No. 5080245114 $5Jd2.00 1993 Ford TaurusCiL Sedan (VIN IFACP52LJIPCi2634(5) $2.50000 Commonwealth of PA - State Treasurer's Advancement Acc!. (Reimbursement) (uncashed check) $24.95 C'lmmonwealth of Pennsylvania - State Treasury Department (uncashed check) $35.56 Bureau or Commonwealth Payroll Operations - Salary/Travel Advancements (uncashed checks) $3. 1.'i4. 'iO Total $5').782.40 (Attach Additional Sheets if necessary) NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. RW-4 .. Continuation of Inventory Carol M Webber 21 01 1086 Page 1 Description of Inventory Description Bureau of Commonwealth Payroll Operations - Salary/Travel Advancements (uncashed checks) Value 56,983.08 Bureau of Commonwealth Payroll Operations - Salary/Travel Advancements (uncashed payroll check) $37,656.98 United State Treasury - 2001 Federal Income Tax Refund (Form 1040) (uncashed check) $2,64600 United States Treasury - 2000 Federal Income Tax Refund (Form 1040) (uncashed check) 5447.33 l inlted States Treasury - 1999 Fcderallncomc Tax Refund (Form 1040) (uncashcd check) $402.00 United States Treasury - Tax Relief for America's Workers (ul1cashed check) 5300.00 Subtotal Grand Total $ $ $48,435.39 $59,782.40 COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT CD 001299 NO. BENJAMIN J BUTLER ESQUIRE 500 NORTH THIRD STREET HARRISBURG, PA 17108-1004 ACN ASSESSMENT AMOUNT CONTROL NUMBER ----~--- fold ---------- -------- 101 I $1,920.91 ESTATE INFORMATION: SSN: 203-30-1682 I FILE NUMBER: 2101-1086 I DECEDENT NAME: WEBBER CAROL M I DATE OF PAYMENT: 06/17/2002 I I POSTMARK DATE: 00/00/0000 I COUNTY: CUMBERLAND I DATE OF DEATH: 09/16/2001 I I TOTAL AMOUNT PAID: $1,920.91 REMARKS: RA Y A WEBBER C/O BENJAMIN J BUTLER ESQUIRE CHECK#1710 INITIALS: VZ SEAL RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS \. /'7-02 ~ /' BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN BENJAMIN J BUTLER BUTLER LAW FIRM PO BOX 1004 HBG "Oi: ..... -'L . C) ~''" P#\:'~~!7:108 07-29-2002 WEBBER 09-16-2001 21 01-1086 CUMBERLAND 101 Allount Rellitted '* REV-1547 EX AFP (01-02> CAROL M 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-EX-AFP--foY=02Y-NOYicE--OF-YNHER-ifiifcE-YAirjrpPRA-isEi'-ENT~--Ai:.i-owiifcE-i'-R----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF WEBBER CAROL M FILE NO. 21 01-1086 ACN 101 DATE 07-29-2002 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 F) 7. Transfers (Schedule G) 8. Total Assets ( ) CHANGED (1) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 59.782.40 .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. Charitable/Governllental Bequestsj Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax NOTE: I~ an assessment was issued previously, lines re~lect ~igures that include the total o~ ALL ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: DATE 06-17-2002 ..~-~~. NUMBER CD001299 \+J INTEREST/PEN PAID (-) .00 · IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 14,328.00 2.767.49 (11) ll2) ll3) ll4) (9) llO) NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 59,782.40 17.095 49 42,686.91 .00 42,686.91 14, 15 and/or 16, 17, 18 and 19 will returns assessed to date. .00 X 00 = 42,686.91 X 045 = .00 X 12 = .00 X 15 = (19)= AMOUNT PAID 1,920.91 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 1,920.91 .00 .00 1,920.91 1,920.91 .00 .32 .32 ( 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.) . STATUS REPORT UNDER RULE 6.12 e;~~ - Name of Decedent: Carol M. Webber Date of Death: 9/16/01 Will No. 2001-010R6 Admin. No. Pursuant to Rule 6. 12 of the Supreme Court Orphans I 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. account with the Court? Did the personal representative file a final Yes No X b. The separate Orphans I Court No. (if any) for the personal representative's account is : N/A c . Did the personal representative state an account informally to the parties in interest ? Yes X No Date: 8/7/03 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. . .~rl1.- , Signature Beniamin r Butler Name (Please type or print) 500 N. Third Street, P.O. Box 1004 Harrisburg: Address PA 1710R-l004 r,::) ,";. (717) 2361485 Tel. No . CapacIty : Personal Representative 0.-) (' q VJ ~-: X Counsel for personal representative 13 t r-:: ........' ............. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 2B0601 HARRISBURG PA 1712B-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ,I!~I:lERITANCE TAX ~TATEMENT OF ACCOUNT '* REV-1607 EX AFP (03-05) nn"'l [llU -8 Pfi2:51 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 12-26-2006 WEBBER 09-16-2001 21 01-1086 CUMBERLAND 101 CAROL M BENJAMIN J BUTLER 500 N THIRD STREET PO BOX 1004 HARRISBURG PA 17108 Amount Remitted 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, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE ..... RETAIN LOWER PORTION FOR YOUR RECORDS +- REV-1607 EX AFP (03-05) --------------------------------------------------------------------------- *** INHERITANCE TAX STATEMENT OF ACCOUNT *** ESTATE OF WEBBER CAROL M FILE NO. 21 01-1086 ACN 101 DATE 12-26-2006 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 12-26-2006 PRINCIPAL TAX DUE: 1,986.60 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-17-2002 CDoo1299 .00 1,920.91 11-01-2006 CDoo739o 15.11- 80.80 12-26-2006 SBADJUST .00 .40 TOTAL TAX CREDIT 1,986.60 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 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. > cg DATE 01-02-2007 ESTATE OF WEBBER CAROL M DATE OF DEATH 09-16-2001 FILE NUMBER 21 01-1086 COUNTY CUMBERLAND ACN 101 APPEAL DATE: 03-03-2007 ( See reverse side under Objections) Amount Remittedl I 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-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF WEBBER CAROL M FILE NO. 21 01-1086 ACN 101 DATE 01-02-2007 If an assess.ent was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of All returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate 18. Amount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due TAX CRED TS: AMENT DATE 06-17-2002 11-01-2006 12-26-2006 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE -Y, .'.CTlrNO"fICE OF INHERITANCE TAX :~p;p~AfsEMEHT, ALLOWANCE OR DISALLOWANCE 'OF DEDUCTIONS AND ASSESSMENT OF TAX 2001 Jr~;1 -8 PI1 2: 5/ CLE?:< Opr"", '1'" I Irr /,,\j', " BENJAMIN J BUTLERCU 500 N THIRD STREET PO BOX 1004 HARRISBURG PA 17108 TAX RETURN WAS: (X) ACCEPTED AS F I LED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 4. Mortgages/Notes Receivable (Schedule D) (4) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets NO. Dl .00 .OD .00 .00 2,842.12 . DO .OD APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) ClO) 1,382.29 .00 (11) Cl2) Cl3) Cl4) NOTE: (15) Cl6) Cl7) Cl8) .DO 44,146.74 .00 .00 X 00 X 045 = X 12 = X 15 = RECEIPT NUMBER CD001299 CD00739D SBADJUST DISC UNT (+) INTEREST/PEN PAID (-) .00 15.11- .00 AMOUNT PAID 1,920.91 80.80 .40 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. '* REV-1547 EX AFP (06-051 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. (8) 2,842.12 1 .38~.~9 1,459.83 .00 44,146.74 Cl9)= .00 1,986.60 .00 .00 1,986.60 1,986.60 .DO .00 .00 ( IF TOTAL DUE IS LESS THAN *1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR1, YOU MAY BE U A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ....,r ~,\"./~ 'I.-,<"_','IC":",:C,,';;;-IH''-, ',* COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128.0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT c. OF~IClALusEm<LY 7-'7.4-1 FILE NUMBER ~ I - () I I (j S (l ""77UiTT,'C3"5'f'" ---n:~~ - - ~i;- - f- Z LU Cl LU t) LU Cl :-ECE8F'\JT'::l NAME :LAST, I, !RST A~m MIDDLE INITIAL) \\\'bh":I', (';Jrul ['..I Dr,:t OF jJE.,i\.T[--1 (M\iI-DG-veari SOCIAL SECURITY NUMBl:R DATE OF BIRTH (MM.DD-Year) 2 () J - 3 () -] () II .2 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS II\) ItJ2(10] OS,.](),.']()Y) (!F:l.PPUCAB:.E) SUR'JiVI~J(; SPOUS[:, NAMF_ (lAST. FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER w >- ";", "''''''' ua.u woo J: "'~ ua.", a. " o 1. Original Return D 4 LirnitedEstate o 6, Decedent Died Testate (AttacllcopyofWilll D 9_ Litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (date ofdeatn after 12.12-82) o 7, Decedent Maintained a living Trust (Attach COpy of Trust) o 10, Spousal Poverty Credit (date of death betweer.1L.31-91 and 1-1-95) o 3 Remainder Return (J~t~ 01 I'~~tn (}I'UI : o 5, Federal Estate Tax Return Required .:!.... 8_ Total Number of Safe Deposit Boxes o 11. Election to tax underSec, 9113(A) (AUdcl'Sellf)! THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS >- z w o z o a. '" w '" '" o u Ikll:1Il1ill.l HuLk: FIRM NAME (If Applicable) Bulkr Ll\\ Finn TELEPHONE NUMBER 717) 2J()-!4X.'i Butler ]uw rirl11 sou ;-.,', TilHd .')I.rl'l'l 1'0 Hux !()()-+ Hurrisbup' z o i= <l: ...J ::::l !:: a. <l: t) LU n: 1, Real Estate (Schedule A) 1'/\ ]7 Jti:\-](jO-i (1) ! - OFFICIAL USE ONl y 2, Stocks and Bonds (Schedule B) (2) 3, Closely Held Corporation, Partnership or Sole-Proprietorship (3) 5_ Cash. Bank Deposits & Miscellaneous Personal Property {Scheduie E) 6, Jointly Owned Property (Schedule F) o Separate Billing Requested 7 InterNivos Transfers & Miscellaneous Non-Probate Property (Schedule G orL) 4 Mortgages & Notes Receivable (Schedule OJ (4) (5) , "X?" 1_.. ::1 ),1\._- U: --.i (6) (7) O,{)() L____ 8 Total Gross Assets (total Lines 1~7) 9 Funeral Expenses & Administrative Costs (Schedule H) 10, Debts of Decedent, Mortgage Liabilities, & liens (Schedu]e I) 11 Total Deductions (total Lines 9 & 10) 12, Net Value of Estate (Line 8 minus Line 11) (8) 5').7>~2_4il (9) (10) 14,J28_00 2,7(174() (11) (12) (13) 1 7.fI'J,~4q -1~_(,:'I, ' I I 13, Charitable and Governmental Bequests/See 9113 Trusts for which an election to lax 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 z o i= <l: f- ::::l a. :E o t) >< <l: f- 15, Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 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 (14) 42.();';(J 'J] X (15) 42,(l:'(()-'JI X ~ (16) X 12 (17) X 15 (18) (19) I.<I:'I!'I] I')'j"'" 20 D CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < Decedent's Complete Address. STREE: T ADDRESS 110 November Drive ---.---." CIT1 I STATE I ZIP Camp Ilill J'i\ 1701] Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit S. Prior Payments C Discount (1) ':\ I ,I)~(J.') I $0,00 ~O.()() so_oo 3 Interest/Penalty If applicable o Interest E. Penally Total Credits ( A + 8 + C ) (2) so,OO 'hOO() Totallnterest/Penalty (D + E) (3) 4 It Line 2 IS greater than Line 1 + Line 3, enter the difference. This IS the DVERPA YMENT. Check box on Page 1 Line 20 to request a refund (4) 5 If Line 1 + Line 3 IS greater than Line 2, enter the difference. This is the TAX DUE. (5) A Enter the interest on the tax due (5A) 8. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT S I >).~(II)] 'hll() S],')2iJ<lj PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS Did decedent make a transfer and' Yes No a retain the use or income of the property transferred; ..... ................ 0 IZl b retain the right to designate who shall use the property transferred or its income; .................................... D IZl c retain a reversionary interest; or ....................................... ................ ................ 0 [R] d. receive the promise for life of either payments, benefits or care? .... ................................................... 0 [R] 2 It death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? ..................................... ................ .................. 0 [R] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ....... 0 [R] 4 Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ............... ......................... ...................................... ... [K] 0 iF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND >.f.E IT AS PART OF THE RETURN. ADDRESS ,e,"l"i:;ClanOcornplete DATE t . 13 . 02 OTHER THAN R~'VE OH 4521 f{ DATE 6-IZ -02.. ADDRESS 1m.: 11)()4 J1JITisbur\..; l'i\ 1710K-I(J()4 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 PS ~9116 (a) (1.1) (i)] For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 391 ~o (8) (1,1) ill)] The statute does not exemot 8 transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable everl it the surviving spouse is the only beneficiary For dates at death on or after July 1,2000 The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent at the child IS 0% [72 P S. ~9116(a)(1.2)] The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P,S, 39116(1.2) [72 r.s. ~J116i3ji 1i) The tax rate imposed on the net vaiue of transfers to or for the use of the decedent's Siblings is 12% [72 PS ~9116(a)(1 3)]. A Sibling is defined, under Section 9102, as an IndiVidual who has at least one parent In common with the decedent, whether by blood or adoption. '* SCHEDULE A REAL ESTATE cor'.1!'..10NWEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Webber Carol M. 21 01 1086 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorshin must be disclosed on Schedule F. ITEM NUMBER 1 DESCRIPTION VALUE AT DATE OF DEATH TOTAL (Also enter on line 1, Recapltulallon) $ fit rriore space is needed, insert additional sheets of the same size) CO""". COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Webber Carol M. FILE NUMBER 21 01 1086 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 DESCRIPTION VALIJEAT DATE OF DEATH TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) '* SCHEDULE D MORTGAGES & NOTES RECEIVABLE COMMONWEALTH OF PENNSYLVANIA iNHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Webber Carol M. FILE NUMBER 21 01 1086 All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH TOTAL (Also enter on line 4. Recapitulation) $ (If more space is needed, Insert additional sheets of the same size) R''''/I'No^+i' '* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERIT Ar~CE TAX RETURN RESIDENT DECEDENT ESTATE OF Webber Carol M. FILE NUMBER 21 01 1086 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. ITEM NUMBER 1 DESCRIPTION VALUE AT DATE OF DEATH PM' 8ank - t 'heckillg Account No. 50S0245 114 ~<~.(.J21)(1 , 199J Fill"d Taunls{iL Sedan (VIi\;' IFACP52UIPCi2634(5) $2,5()O()() 1 ('\)1l1l1l11Il\\ealth of Pennsylvania - Stalc Treasurer's Advancel1lent Account (Reimhursel1lent) (ullcashed check) \2...(<)) " ("OlllIllOIl\Ve;llth o!' Pennsyhania - State TreuslIry Department (lIl1cashcd check) '<'55(l ; 8ureall olTornn1Onwcalth Payroll Operations - Salury/Travel Advancements (lIl1cashcd checks) .;;J.I_"...( ,~o " BLlreau of ('olllnltlnwealth Payrnll Operations ~ Salary/Truvcl Advancements (un cashed checks) Sh,lJX.'\()X 7. Bureau of ('ollllllonwealth Puyroll Operations - Salary/Travel Advancelllents (llncashed payroll checks) SJ7Jl5(L'}S , llnited State Trcasury - 2(101 Federal Incomc Tax Refund (FtlI"ll1 1(40) (uncashed Clll:ck) ,'i;2Jl...(ll(j(J ') lJnited Stales Treasury - 2000 Federal Income Tax Refund (Form 1(40) (uncashed check) ');-I-l."7__U 10. United States Treasury - 1991.) h:dcral lncOl111: Tux Refund (Form 1(40) (un cashed check) ,q{)~(I() " IInilcd States Treasury - Tax Relieffor America's \\/orkers (un cashed check) i;J()(J.lJ(1 TOTAL (Also enter on line 5, Recapitulation) $ (If more space IS needed, Insert additional sheets of the same size) 5'UR~,...(O "..,,',.,..'. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF Webber Carol M. FILE NUMBER 21 01 1086 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RcLATIO~ISHIP T(; lJf:::F:)EJIT A. B c JOINTL Y-OWNEO PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATEOFOEATH ITEM FOR JOINT MADE Include name offinaflcial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT deedforjointly-heldrealeslate VALUE UF ASSET I~JTEREST CECEDENT'S IfJTERiCS 1 A. TOTAL (Also enter on line 6, Recapitulation) $ (If more space is needed, Insert additional sheets of the same size) ~C',.' 'SI""Y .,"- '* SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Webber. Carol M. FILE NUMBER 21 01 1086 This schedule must be completed and filed jf the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes DESCRIPTION OF PROPERTY %OF ITEM Ir." Ul IHf' ~"'i','IE :)f' H'[ TRAI1SI-Hff'. TheiR RELATIONSHIi' m DECEDE~H A~ilIHE D~TE Cr~~A,~S"eR DATE OF DEATH DECO'S EXCLUSION TAXABLE VALUE NUMBER .~F~.'~H A. COPY OE' THe _lEeD FOR REAL ESTATE VALUE OF ASSET INTEREST .:,FAPP,ICA3LE! 1 TOTAL (Also enler on line 7, Recapitulation) $ (Iii(i (If more space IS needed, Insert additional sheets of the same size) "-\'il.<;" '* SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Webber Carol M. FILE NUMBER 21 01 1086 Debts of decedent must be reported on Schedule I, ITEM NUMBER DESCRIPTION AMOUNT A FUNERAL EXPENSES' 1. J,(llllll'l1hiSCI .lordan hlllcr<ll Htllll~ \;-:.I l!7 illl " Ikadswne S2,-II)(II)() - B. ADMINISTRATIVE COSTS 1 Personal Representative's Commissions Name of Personal Representative (sJ Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2 Attorney Fees Butkr Law hrlll S2,2:'ilj(){) 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 4 Probate Fees "i7(.JI() 5 Accountant's Fees 6 Tax Return Prepare~s Fees 7 Christi<ln-B<lker ('ol1lpan}' - Probatc Bond ,'i>llli.lJ(! , ('ul1lbcrland ('(HIIl!Y Register 01' '0/ilb - Filing Fee for Pruhate Bond <t;1:',{)(j ') Unishlppers - Ovcrnight fl.luil S~:-I,(I{) II! ('L1lllhcrland <. 'OUllt}' Rcgiskr urWil1s - Filing: Fcc for Pt:l1nsylvaniu Inhcritanee Tax Rcturn & Inventor} <\,:':'iIJ(1 II Postage SI()!,() I" (i-llaul packing supplics ,,;>I()iill(1 1_' Ruy Allisun Wchher, IV - 1':"cL'lllur I;XPL'IlSCS \1 I I ~. 1)1) TOTAL (Also enter on line 9, Recapitulation) $ I-Ll'KIlO (If more space is needed, insert additional sheets of the same size) "!'V'C' "".i' '* SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEAL TH OF PENNSYLVANIA INHERITANCt; TAX RETURN RESIDENT DECEDENT ESTATE OF Webber Carol M. FILE NUMBER 21 01 1086 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT i\purtmel1l!euse \:,:'(\-+25 ('Ulllp Ilill Schoo! Dislricl Tux <:;\)01 I_I Iii \'lTiZ(l1l .'hl):,;\) " ('ulllberland ('\lllllly Per Cupilu Tux \:';I)(J , 1\1&-1 \2;':'1 b. 1'1'&[ \ [_'i{) ')4 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 2,7(\7-I'} -"" , REI.; ",,~x.r. COMMONWEALTH OF PENN$YL VANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Webber Carol M SCHEDULE J BENEFICIARIES 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 See 9116 (a) (1.2)] 1 Ray .-\lli~()11 \Vchh\.T. 1\' SOil n:sL rc~idLll' alld IL'Il1:1indcl :t]3 Illlbkr Drive ('iIlCillllali, OIl -J52IX-112X ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER cHEET 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 II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ FILE NUMBER 21 01 1086 (If more space IS needed, Insert additional sheets of the same size) "";::;;:-:5-:;:22:::: :5:22 C;"':E:;::::;"~ DE::<>;;'T~'~'H ~12 '725 2257 p.a:/2: ~PNCBAN< March 15, 2002 /SCP Butler Law Firm 500 N orthThird Street Twelfth Floor Harrisburg PAl 71 0 1 RE: Estate of Carol M Webber, Deceased SSN: 203-30-1682 000: 09/16/2001 Dear Mr. Butler: In response to your request for Date of Death balances for the customer noted above, our records show the following. CHECKING ACCOUNT #5080245114 Established 01109/1995 CAROL M WEBBER DOD Balance: $5,632.00 + $0.00 accrued interest Please note that this ofOce only provides date of death balances for deposit accounts (IRAs, CDs, Checking lUId Savings accounts). We do not process any fmandal transactions or provide statements. If you need lIssistlUlce with any of these items, please call1-888-PNC-BA.1I\K (1-888-762.2265) or stop by your local PNC branch office. Sincerely, ft\QJJ0JY\u~ Marian Donnelly 1-800-762-1775 P7-PFSC-04-F 500 First Avenue Pittsburgh, PA 15219 A member of The PNC Financial Ser'Vices Group One PNC Phn 7if9 F:fl:h AVt"".J~ Pitl"hurgh Pf't1r1~yrvania 15222 2707 TOTAL P.01 - .., . '* COMMONWEALTH OF PENNSYLVANIA OFFICE OF THE BUDGET COMPTROLLER OPERATIONS April 2, 2002 Ray Webber 13 Imbler Drive Cincinnati, OH 45218 BUREAU OF COMMONWEALTH PAYROLL OPERATIONS P,O. BOX 8006 HARRISBURG, PA 17105-8006 (717) 772-5340 FAX: (717) 772-5333 Dear Mr. Webber: Enclosed is a check in the amount of $37,656.98 payable to your mother's estate, This check represents the total of twenty-nine checks you returned to the Pennsylvania Treasury Department. Also enclosed is an itemized list of those checks to support the $37,656.98, In addition, there were three checks (copies enclosed) issued from the State Treasurer's Advancement Account that were never cashed, Those three checks have been forwarded to two offices for follow-up action, Questions on check numbers 009099 and 009550 should be referred to Ms. Nancy Silk at (717) 787-9872 and for check number 028940, contact Ms, Jennifer Young at (717) 787-8767, If you should have any questions regarding the twenty-nine checks you returned to the Pennsylvania Treasury Department, please write to me in care of the above address or contact me at (717) 787-4793, The Bureau of Commonwealth Payroll Operations extends deepest sympathy to you in the loss of your mother, Sincerely, ~~ cd :J~~ James R. Dunkle, Manager Deduction Accounting/Reconciliation And Cost Distribution Division Enclosures (4) cc: File .~. El"IDC'U I OF COMMONWEALTH PAYROLL OPERATIONS SALARYnRAVELADVANCEMENTS P.O. BOX B007 HARRISBURG, PA 17105-B006 PAY TO THE ORDER OF: I Estate o~ Carol Webber 203301682 SAL/EXEC PNC BANK, NATIONAL ASSOCIATION PITTSBURGH, PA 8-91430 CC817 DATE I 03/28/2002 , , }/ t_ ",.' ""frr-'i'~'. II"DS'il,qSu" ':DI,30OflOQ!>i: ODD BQD"Ba~" vr.NO. 053495 00053495 CHECK AMT. $37,656.98 VOID AFTER 90 OAVS /I, <1'1 !. :I/:': 4j J t_i'._[./~... -'2/J // ~;, .) .... .~.~..,. '.''; 'd' '7 . . .j' " '/ ... r , r.. COMMONWEALTH OF PENNSYLVANIA STATE TREASURER'S ADVANCEMENT ACCOUNT : OFFICE OF ADMINISTRATION I 311 FINANCE BLDG.. HARRISBURG. PA 17120 ! PAVTO THE I: ORDER OF t " PNClRANK PNCBank,N.A. Pittsburgh, PA 00 I 030212 8-Sf 430 817 DATE April 18, 2002 Estate of Carol Webber 1i:11:"'I':::11 "'II '1::::1111::::",1'11'" ,,,,lld:Ullld"".II'llU' '111"11",, for purchase on 9121100 VOID AFTER 8 MONTHS II ~,. ,.;~,..~ b I ZI I , -=-".1 . j.kLf---,-.--- 11'0 '102 l. 211' 1:01, '1oooo"lbl: ";'<~~" ~ :;~; ~JI' . Z :III !!J . , COG I I 001 , 081 I 030502 i FUND ! DEPT PREP DATE I "7"-- ,-,,--:-:'U--T~ .""',';-__' 015542 56.369 412 28 04287364 ~ ......... 18107500 VOUCHER 432135 WARRANT ID CHECK NUMBER NATIONAL CITY BANK PITTSBURGH, PA VERIFICATION AVAILABLE- "POSITIVE PAY" ..,~,,/tI.(}IP"""s!l1. C:O......~~la/. .~';n'~"J 'J",/,a,ln,_' "<>"';" PROTECTED 03/13/2002 DATE PAYA~Ii:& ONLY'-./~crsCTS TO THE ORDER OF VOID AFTER 180 DAYS $ *************35.56 ESTATE OF CAROL WEBBER EC10705922 13 IMBLER DRIVE CINCINNATI OH 45218 1i~~~NNS~~ 11"01., 287 :'1[,1.,11" ':01., ~ 2D 38"l51: 0 ~ ~ 5bl., ~II". DO NOT ACCEPT WITHOUT HOLDING TO LIGHT TO VERIFY WATERMARKS. BUREAU OF COMMONWEALTH PAYROLL OPERATIONS SALARY/TRAVEL ADVANCEMENTS P.O. BOX B007 HARRISBURG, PA 17105-6006 PNC BANK, NATIONAl. ASSOCIATION PITTSBURGH, PA B-S/43O CC817 053255 00053255 DATE VT.NQ. CHECK AMT. PAY TO THE ORDER OF: I I 03/15/2002 $3,154.50 Estate of Carol Webber 203301682 ~ VOID AFTER 90 DAYS, (l/. ,/W I ". If~fJjn!" /.....JC _c- '" ;. J 1 ~ .r I !Ur (t' " VV', /'o'Vj' . M' SAL/EXEC 11"05325511" 1:0103000a1;t,I: 000 ~ 3"la"l2:S'1" BUREAU OF COMMONWEALTH PAYROLL OPERATIONS SALARYfTRA VEL ADVANCEMENTS P.O. BOX 8007 HARRISBURG, PA 17105-8006 PNC BANK, NATIONAL ASSOCIATION pmSBURGH, PA 8-9/430 CC817 053371 00053371 OATE VT.NO. CHECK AMT. PAY TO THE ORDER OF: I I 03/18/2002 $6,983.08 Estate of Carol Webber 203301682 VOID AFTER 90 OA YS SAL/EXEC II"0533? ~II" 1:0..30000'11;1: ....-) f l./ " ()i ,/'2 () " ,.~ ,'~, tUl V. ~l / ""in.., t,..tJ i;-., /{;~ .- OOO~ :I"lO"ai!BII" M' (JJnttrh1'tatm~'~' P 624,703,312 ",-" (~) 05 30 02 56 AUSTIN, TEXAS 00273978 130 012012831WEBB PHILA Pay to 1,1,.1,1.11111,1."111.,1'1111111111..1,11,,1,,,,11,,11,,1,,11 !be order of RAY ALLISON WEBBER IV EXEC CAROL M WEBBER DECO 13 IMBLER DR CINCINNATI OH 45218.',128 II' 2:1051:.11' - Check No. 2305 00273978 TAX REFUND203.30-1682 12/01 78 1:000000 5 ~BI: 0027:1 9 7B ~II' 01,0502 . $***2646*00 VOID AFTER ONE YEAR ~~''''!:i= 7';;P"~! .J'1'-" - ('rCt__ ~""W>>t1_Utt'I"SINt(Jfflt!'u,; IUnttlWt ~ 'Urmmtnt10-01 ~lUUUU~~~~OOO A 179.520,245 Check No. 17 AUSTIN, TEXAS 2304 01616508 TAX REFUND203-30-1682 12/99 08 $****447*33 VOID A"ER ONE YEAR 1.88 INTEREST t~)1,~ Jf:t~4""-~ ! ~---'" 1102301, Silo 1:0000005UII: oHdb508311o 01,08o~ ~ ~0Irmsnrt!1~;~1 P 328,826,405 8' 05 12 00 96 AUSTIN, TEXAS Q!68128363 130 012992823WEBBPHILA Check No. 2302 68128363 TAX REFUND203~30-1682 Pay to the order of 1...111...111......11...11.1.1.11.....11..11..11....11..11...1 CAROL M WEBBER 110 NOVEMBER DR APT 6 CAMP HILL PA 17011~5036 12/99 63 $....402.00 VOID AFTER ONE YEAR ~:u::U=S: 141 :\:I:::s:::sl:tI~ i%,~31j ~__",...:!'i 11023023110 1:0000005~81: b8~283b3b1l0 01,0500 1Initrh ~0Irmsnrt!1~1 P 530,535,722 ~ 09 14 01 73 AUSTIN, TEXAS 27628731 130 012002823WEBB PHILA Pay to II the order of I... 1...111"""11...11.1,1,11"...11,,11,,11,,,,11,,11...1 CAROL M WEBBER 110 NOVEMBER DR APT 6 CAMP HIll PA 17011-5036 Check No. 2304 27628731 TAX RElIEF203-30-1682 12/00 31 $****300*00 TAX RELIEF FOR AMERICA'S WORKERS VOID AFTER ONE YEAR ~In ~ ~ ~ =J/Jfrt.... ".~ ~;;,;;;;r.d.lI/Is/lltOfrm~ 110230.. SilO 1:0000005~81: 2?b28'i'3~"l1l0 o"o"lo~ FILE NUMBER 2 1 -0 1 1 0 8 6 CQuNi-y"'CoDE ---y~ - - 'NuMBER- - REV-1500 EX + (6-00) . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT I- Z W C W o w c DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Webber, Carol, M DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) 09/16/2001 05/19/1939 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) w ~ ~-en oO::~ w Q.o ::I:OO 00:: ...J Q.lI) Q. <( o 1. Original Return o 4. Limited Estate [Xl 6. Decedent Died Testate (Attach copy of Will) o 9. Litigation Proceeds Received [Xl 2. Supplemental Return o 4a. Future Interest Compromise (date of death after 12-12-82) D 7. Decedent Maintained a Living Trust (Attach copy ofTrust) D 10. Spousal Poverty Credit {date of death between 12-31-91 and 1-1-95} OFFICIAL USE ONLY SOCIAL SECURITY NUMBER 2 0 3 - 3 0 - 1 682 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 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) .... Z W o Z o Q. en w 0:: 0:: o o THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AN.D CONFIOENTIA4TAXJNFORMATIONSHOULO BE 01 RECTE 0 TO: NAME COMPLETE MAILING ADDRESS Ben'amin J. Butler Butler Law Firm FIRM NAME (If Applicable) Butler Law Firm 500 N. Third Street, P.O. Box 1004 TELEPHONE NUMBER 717 236-1485 Harrisbur PA 17108-1004 z o ~ ...J :J l- ii: <C o w ~ 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Adrninistrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 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 z o !;i I- ~ Q" :E o o ~ to- 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X _(15) 1,459.83 X .045 (16) X .12 (17) X .15 (18) (19) 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 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE sloe AND RECHECK MAtH < < (8) (11) (12) (13) (14) ;.,~o ..~j~ ., -r n :2~tB C0~ C)O 2842.12)O-:n , ::)~ ~~o --; ..J;.... 1,382.29 OFFICI~SE ONLY =:> ::0 c;r\ ::0 ron Z Tn C) c::> CJ) 0 -< (?.5 ::.P , r.~ ~;~ w :;:.:::;0 -0 :3: (~::) 0 - if --1'1 ~~~~ t-111 0~)O -on N c.n N 2,842.12 1,382.29 1,459.83 1,459.83 65.69 65.69 Decedent"s Complete Address: STREET ADDRESS 110 November Drive CITY I STATE I ZIP Camp Rill PA 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) 65.69 $0.00 $0.00 $0.00 Total Credits (A + 8 + C) (2) 3. InteresUPenalty if applicable D. Interest E. Penalty TotallnteresUPenalty ( D + E) (3) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT 15.11 0.00 15.11 4. 0.00 80.80 0.00 80.80 5. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ........................ ..... .................... .... ...................... 0 [R] b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 (&] c. retain a reversionary interest; or ...................................................................................................... 0 (&] d. receive the promise for life of either payments, benefits or care? ............................................................. 0 (&] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?..............................................:............................................... 0 (&] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. 0 lRl 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... 0 [X] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. DATE '() . ". 0(,' ADDRESS ATIVE OR 45218 DATE /I-/~ . J ADDRESS PA 17108-1004 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. S9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. S9116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. s9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is.4.5%, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1 )]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. s9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-15q8 EX + (6-98) . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY c"OMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Webber. Carol. M FILE NUMBER 21 01 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. 1086 ITEM NUMBER I. DESCRIPTION Commonwealth of P A, Department of Treasury, Bureau of Unclaimed Property Office of the Budget (uncashed checks) VALUE AT DATE OF DEATH 2,720.84 2. Commonwealth ofPA, Department of Treasury, Bureau of Unclaimed Property Office of the Budget (expense check) 121.28 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 2,842.12 REV.1511 EX + (12-99) .. dJMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Webber Carol. M SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER Debts of decedent must be reported on Schedule I. 21 01 1086 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees Butler Law Finn 820.00 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 4. Probate Fees Additional Probate 75.00 5. Accountanfs Fees 6. Tax Return Preparer's Fees 7. Cumberland County Register of Wills - Filing Fee 30.00 8. Pennsylvania Unclaimed Property - 15% Finder's Fee 408.13 9. Pennsylvania Unclaimed Property - 15% Finder's Fee 18.19 10. Unishippers - Overnight Mail 22.97 11. Cumberland County Register of Wills - Additional Short Certificates 8.00 TOTAL (Also enter on line 9, Recapitulation) $ 1,382.29 (If more space is needed, insert additional sheets of the same size) REV_1513.EX.'_ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Webber Carol M SCHEDULE J BENEFICIARIES FilE NUMBER 21 01 RELATIONSHIP TO DECEDENT Do ~ ot list Trustee(s) NUMBER 1. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. Ray Allison Webber, IV #13 Imbler Drive Cincinnati, OR 45218-1128 Son 10R6 AMOUNT OR SHARE OF ESTATE rest, residue and remainder ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 1! I AS APPROPRIA TE, ON REV-1500 COVER SHEET n. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS ~ OT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS I. i TOTAL OF PART II - ENTER TOT AL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1 ~O COVER SHEET (If more space is needed, insert additional sheets of the same size) $ OCT-02-2001 09:27 WPS BLDGS & GROUNDS 513 634 6997 P.03/03 . W"'5",~I;TON OFFI~(: '714 LOIilOWClIlTll Ihe>co, WASHINGTON, DC 20615 12021225.6406 TOM RIDGE 21 ST DISTRICT, PI!NNSYLIIANIA ~ongrtss of tbt Wnlttb 6tates ~OU~t of l\tprt~tntatibt~ i iIIaJb(ngton, mot 20515 DI!lT,,/C'1' OFFlCE!!' 108 FEDERAL OFFICE BLDG. ERIE, PA 16501 {81.145~2038 eQMMITTEES; BANKING, FINANCE AND URBAN AFFAIRS VETERANS' AFFAIRS POST OFFICE AND CIVIl. SERVICE 305 CHESTNUT STREET M'^PYI~~r, PA 16336 (814) 724_8414 g 1 ~An SUTE STREET SMARON. PA 1614 6 (412,981-8440 LAST WILL AND TESTAMENT OF CAROL M. WEBBER I. CAROL M. WEBBER. of the Township of West Salem~ Greenville. Mercer County, Pennsylvania, being of sound and disposing mind memory and understanding, do make, publish and declare this to be my Last Will ant Testament. hereby revoking any and all Wills by me heretotore made. I lTEM I. I direct that all my just debts tnd funeral expenses be I paid as soon after my decease as may be found convenient. ITEM II. I give, devise and bequeath my e,t1re estate. both real and personal, and wheresoever situate to my son, RAY ALLISO~ WEBBER, IV. ! I I ITEM III. I hereby' name, constitute and ap*Oint RAY A. WEBBER, III to be the Executor ot this, my Last Will and Testament, to serve without bond being required of him. In the event he is unable to serve in said capacity, I then name. constitute and appoint ROSEMARY BROTHERTON to act as CotExecutrix.o a~so to $erve I without bond be1ng required of her. I day of July IN WITNESS WHEREOF, I.have hereunto set my ~and and s~al this 19th I o I . a1%~~A' .(~/5EAL) ~ 1989. I This instrument, consisting of one (1) typ~ritten page, signed, sealed. puhlished and declared by the above named Testatrix as' and for her Last Will and Testament, in the presence of us, who at her request. . and in her presence and in the pr ence of each other, have hereunto subscribed our names as witnesses. .~~#!~~. OCT-02-2001 09:26 WPS BLDGS & GROUNDS 513 634 6997 P.02/03 AFFIDAVIT OF WITNESS WE, Carol M. Webber, Gina Rapovy and Shar TI M. Ference the Testatri~ and the ~itne55es respectiv~lY5 whose s are signed to the attached that she signed willingly (or willingly directed by decla~e to the undersigned or foregoing instru~ent, being first duly sworn, do authority that the Testatrix signed and executed trument as her Last Will and to sign fo~ h~r,)and that she exe~uted it as her free and voluntary act for the p rposes therein expressed, and that ~~ch of the witnesses, in the presence and hea ing of the Testatrix, signed the Will as witnesses that to the best of our knowledge the Testatrix was at that time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. Testat):"ix Witness Witness subscribed and sworn to before me by Subscribed, swo~~ to and acknowledged beforf me by the Testatrix and i I I Gina Ranovv and Sharon M. Ference , witnesses, ~his 19 th day of .r 1I1 Y 1989. NOTARIAl. SEAL ~VERNE'HOF/US. Notary PubRe Sharon. Merclr Cour.'iy, Pa. My CQlJllrMssiOO Expir.. June", 1. - SUPPLEMENTAL Register of Wills of CUMBERLAND County, Pennsylvania INVENTORY Estate of Carol M. Webber No.21 01 1086 also known as Date of beath 9/16/01 Social ecurity No. 203-30-1682 , Deceased Personal Representative(s) of the above Estate, deceased. verify that the items appearing in th following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvani of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the Deced nt's death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memora dum at the end of this inventory. I/We verify that the statements made in this inventory are true and correct. IfWe understand that fal e statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Name of Attorney: Benjamin J. Butler 1.0. No.: 81948 Address: 500 N. Third Street, P.O. Box 1004 Date to . 2~- o~ Harrisburg PA 17108-1004 Telephone: (717) 236-1485 Description Cash, Bank Deposits, & Misc. Personal Property Value Commonwealth ofPA, Department of Treasury, Bureau of Unclaimed Property Office of the Budget (uncashed checks) Commonwealth ofPA, Department of Treasury, Bureau of Unclaimed Property Office of the Budget (expense check) o ~O .-",,- ::0 to-o ,n :r (") :-rJ)>r- ~~?; 2; g;] :c- en X ,::; c> c')OO CJ C ..,., ~ :n '0--1 ):'> Total (Attach Additional Sheets if necessary) "-> <:::::;) ~ ~ Z o < I W -0 :x N . . Ul N 2,720.84 121.28 :n ""1:I,-n r i~J (-) f;L? (-:::) c/) ':::D i:;:=! 0 '~'." rn __u C.J (~ "n "f, o '" rn ,.-...., '-......J -n 2,842.12 ~OTE: The Memorandu~ of real estate outside the Commonwealth of Pennsylvania ay. at the election of the personal representative, Include the value of each Item. but such figures should not be extended into the total of the Inventory. RW-4 ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 I REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT BUTLER BENJAMIN J 500 NORTH FRONT STREET 12TH FLOOR HARRISBURG, PA 171081-1004 _n_____ lold ; ESTATE INFORMATION: SSN: 203-30-1682 i FILE NUMBER: 2101-1086 DECEDENT NAME: WEeBER CAROL M DATE OF PAYMENT: 11/03/2006 POSTMARK DATE: 11/01/2006 COUNTY: CUMBERLAND DATE OF DEATH: 09/16/2001 TOTAL AMOUNT P REMARKS: CHECK#1034 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS NO. cD 007390 ACN SSESSMENT AMOUNT CONTROL NUMBER -------- 101 I I $80.80 I I I I I I I I I AID: $80.80 GLENDA FAR -JE R STRASBAUGH REGISTER OF W ILLS A ! i I I I I I I Ronald D. Butler Jana Butler Toole Benjamin J. Butler I~ L; T L E R L:\ \\1 FIR l'vl 500 North Third Street Twelfth Floor Harrisburg, PA 17101 Mailing Address: Post Office Box 1004 Harrisburg, P A 171 08.1 004 November 1, 2006 Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 Re: Estate of Carol M. Webber No. 2001-01086 PA No. 21-01-1086 Dear Sir or Madam: Tel: 717.236.1485 Fax: 717.236.7777 lawyers@butlerlawfirm.com I have enclosed two originals and one copy of a Supplemental! Pennsylvania Inh ritance Tax return and an original and one copy of a Supplemental Inventory for the ab ve referenced estate. I have also enclosed a check for inheritance tax in the amoun of $80.80 and a check for filing fees in the amount of$30.00. Please cl~ck in the enclose copies and return them to me in the enclosed self-addressed stamped envelope. ~ t;:;) 0"\ Z C <: , w Your attention to this matter is appreciated. Benjamin J. Butler BJB/mot Enclosures cc: Ray Allison Webber, IV ,~:,...~ -:0-0 ;:] ..... ("") -.:Q :t; r- ',_7 fT1 ,;;: u5 ::0 ,--"1 ^ :~OO ..0..., ~C :n 0-; -u :x ~ Ul N ~n iT! C) Cl -::5 o r'O'1I C::J C> C-" ....-, -j , , --"1 ....,., ;-=:; ('T'j o~/) \~~) ~-'T.-I BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280&01 HARRISBURG PA 17128-0&01 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE -,~ (.U~ijE.RITANCE TAX ~:1\ATEHENT OF ACCOUNT , *' REV-l&07 EX AFP (03-05) BENJAMIN J BUTLER 500 N THIRD STREET PO BOX 1004 HARRISBURG 2001 JM\ -8 Pt~ 2: 51 CLE.R.< OF , 'j'r'\ (\('\ lG'T ODDU!...\,\ >'....\.)\_' II I II i ,: 'j "..' _'-"- C1 )\1' ' . l', DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 12-26-2006 WEBBER 09-16-2001 21 01-1086 CUMBERLAND 101 CAROL M Amount Remitted 1 PA 17108 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: CUT ALONG THIS LINE NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 REV-1607 EX AFP (03-05) --------------------------------------------------------------------------- -+ RETAIN LOWER PORTION FOR YOUR RECORDS +- ESTATE OF WEBBER *** INHERITANCE TAX STATEMENT OF ACCOUNT ... CAROL M FILE NO. 21 01-1086 ACN 101 DATE 12-26-2006 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 12-26-2006 PAYMENTS (TAX CREDITS): PRINCIPAL TAX DUE: 1,986.60 PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-17-2002 CDOO1299 .00 1,920.91 11-01-2006 CD007390 15.11- 80.80 12-26-2006 SBADJUST .00 .40 TOTAL TAX CREDIT 1,986.60 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 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. ) BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0&01 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE "'';''--''\'.G''rrr'\lfO'fIi:E OF INHERITANCE TAX :(1, 'v '~~lp~.Ais'EMENT, ALLOWANCE OR DISALLOWANCE 'OF jjEDU~TIONS AND ASSESSMENT OF TAX '* DATE 01-02-2007 ESTATE OF WEBBER CAROL M DATE OF DEATH 09-16-2001 FILE NUMBER 21 01-1086 COUNTY CUMBERLAND ACN 101 APPEAL DATE: 03-03-2007 ( See reverse side under Ohjections) A.ount Re.itted/ I 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-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF WEBBER CAROL M FILE NO. 21 01-1086 ACN 101 DATE 01-02-2007 2007 JAN -8 Pt1 2: 5/ REV-1547 EX AFP (0&-05) CLER!< OF ORf"'Wi\\j'(' ,r,('IIRT r'l :r\l\ '-.; \...../\..,1 '..) I BENJAMIN J BUTLERCly/r:,,~, 500 N THIRD STREET PO BOX 1004 HARRISBURG PA 17108 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 4. Mortgages/Notes Receivable (Schedule D) (4) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. JointlY Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets NO. 01 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax .00 .00 .00 .00 2,842.12 .00 .00 (8) NOTE: To insure proper credit to your account, submit the Upper portion of this form with your tax payment. 2,842.12 (9) (10) 1,382.29 NOTE: .00 (11) (12) (13) (14) 1.3B??9 1,459.83 .00 44,146.74 T If an assess.ent was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate 18. Amount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due TS: A NT DATE 06-17-2002 11- 01-2006 12-26-2006 (15) (16) (17) (18) .00 44,146.74 .00 .00 X 00 X 045 = X 12 = X 15 = (19)= .00 1,986.60 .00 .00 1,986.60 C IP NUMBER CD001299 CD007390 SBADJUST AMOUNT PAID 1,920.91 80.80 .40 * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 1,986.60 .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 U A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.