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Home My WebLink About03-29-06 Register of Wills of Cumberland County l STATUS REPORT UNDER RULE 6.12 Sara V. Hair Name of Decedent: Date of Death: July 16, 2005 Estate No.: 21-05-0666 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 0 No 1Xk 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: Approxima tely 6 months 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 0 No 0 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 0 No 0 c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Cle the Orphans' Court and may be attached to this report. Date: 3/28/06 Sign tu: Richard C. Snelbaker Sneluaker & Brenneman, P.C. Name 44 West Main Street Mechanicsburg, PA 17055 Address ( 7 17) 6 97- 8528 Telephone No. or 0\...1 Capacity: 0 Personal Representative ~ Counsel for personal representative ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT HAIR EDWARD P 8 MILL ROAD CARLISLE, PA 17013 __n_n_ fold ESTATE INFORMATION: SSN: 196-54-8747 FILE NUMBER: 2105-0666 DECEDENT NAME: HAl R SARA V DATE OF PAYMENT: 03/29/2006 POSTMARK DATE: 03/29/2006 COUNTY: CUMBERLAND DATE OF DEATH: 07/16/2005 NO. CD 006492 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $744.13 I I I I I I I I TOTAL AMOUNT PAID: $744.13 REMARKS: CHECK#1012 SEAL INITIALS: MG RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS REV-1500 EX (6-,",0) OFFICIAL USE 0 NL Y COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ~L COUNTY CODE -9~ 0666 ___ YEAR NUMBER I- Z W C W () W C DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Hair Sara DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 7/16/2005 11/22/1918 (IF APPLJCABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) v SOCIAL SECURITY NUMBER 196-54-8747 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER ~ [X] 1. Original Retum ~ ~(/) D u ~~ 4. Limited Estate w a..u ::I: 00 r;;-lX u~...J LaJ 6. Decedent Died Testate (Attach copy of Will) a..D'.l ~ D 9. Litigation Proceeds Received D 2. Supplemental Retum D 3. Remainder Retum (date of death prior to 12-13-82) D 4a. Future Interest Compromise (date of death after 12-12-82) D 5. Federal Estate Tax Return Required D 7. Decedent Maintained a Living Trust (Attach copy of Trust) L 8. Total Number of Safe Deposit Boxes D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) D 11. Election to tax under Sec. 9113(A) (Attach Sch 0) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE ANDCONFIDENTIALTAXINFORMATIONSHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS .- Z W C Z o D- C/) W It: It: o U Richard C. Snelbaker FI RM NAME (If Applicable) Snelbaker & Brenneman, P.C. TELEPHONE NUMBER 44 West Main Street Mechanicsburg, PA 17055 717-697-8528 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) Z 6. Jointly Owned Property (Schedule F) (6) 0 D Separate Billing Requested i= :5 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) :::) (Schedule G or L) l- ii: 8. Total Gross Assets (total Lines 1-7) <( () W 9. Funeral Expenses & Administrative 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) 0.00 0.00 0.00 0.00 172,966.44 0.00 "',. ., 1. Real Estate (Schedule A) (1 ) OFFICIAL USE ONLY I 2. Stocks and Bonds (Schedule B) (2) : ') 1...-' 0.00 (8) 4,268.56 494.93 172,966.44 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) ( 13) 4,763.49 168,202.95 0.00 (11 ) ( 12) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (14 ) 168,202.95 15. Amount of Line 14 taxable at the spousal tax 0.00 ~ (15) z rate, or transfers under Sec. 9116 (a)(1.2) x .0 0 j::: 16. Amount of Line 14 taxable at lineal rate 168,202.95 x .0 45 (16) <( I- :;:) 0.00 D.. 17. Amount of Line 14 taxable at sibling rate x .12 ( 17) :E 0 0.00 U 18. Amount of Line 14 taxable at collateral rate x.15 ( 18) >< <( T ax Due I- 19. ( 19) 0.00 7,569.13 0.00 0.00 7,569.13 20. ~ CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SlOE AND RECHECK MATH << 3W4645 1.000 (J Decedent's Complete Address: Sl'REET ADDRESS 801 North Hanover Street, Church of God Home North Middleton Twp , Cumberland County CITY 1 STATE I ZJP Carlisle PA 17013- Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1 ) 7,569.13 0.00 6,500.00 325.00 Total Credits (A + 8 + C) (2) 6,825.00 3. Interest/Penalty if applicable D. Interest E. Penalty 0.00 0.00 TotallnterestlPenalty (0 + E) (3) 0.00 4. 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) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 744.13 A. Enter the interest on the tax due. (5A) 0.00 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable (58) 744.13 AGENT 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;. . . . . . . . . . . . . . . . D []j b. retain the right to designate who shall use the property transferred or its income; . D [Jg c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . . D ~ d. receive the promise for life of either payments, benefits or care? . . . . . . . . . D ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . .. D ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? D [Jg 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. D ~ IF THE ANSWER TO ANY OF TH~ ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PER~ RESPONSIBLE FOR FILI~G RETURN C~U/ I? 4.uu (EXEC.J ADDRESS / DATE 'mtJl}~l )..~ Zoot, 8 ~ll Road, Carlisle,PA 17013 DATE 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. 89916 (a) (1.1) (i)]. For dates of death on or after Jan uary 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. S 9116 (a) (1.1) (ii)] The statute does not exempt 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. S 9116(1.2) [72 P.S. S 9116(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. S 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. 3W4646 1.000 , . R EV-1508 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Sara V. Hair FILE NUMBER 21 05 0666 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 DESCRIPTION VALUE AT DATE OF DEATH 1 Blue Cross, refund unused medical premium 294.61 2 Church of God Home refund on resident care 47.01 3 Commonwealth of Pennsylvania refund on 2005 Final Individual Income Tax Return 60.00 4 Edward Jones Investment account #377-08785-1-4 125,573.75 5 M&T Bank Checking account #416398 997.52 6 M&T Bank Savings account #015004204213083 20,687.18 7 M&T Bank Certificate of Deposit #031003913463095 25,306.37 3W46AD 1.000 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 172,966.44 REV-1511 EX+ (12-99) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Sara V. Hair ITEM NUMBER A. B. 2 3W46AG 1.000 Debts of decedent must be reported on Schedule I. DESCRIPTION FUNERAL EXPENSES: 1. Carlisle Memorial Services, Inc. monument Total from continuation schedules 1. ADMINISTRATIVE COSTS: 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. Snelbaker & Brenneman} P.G. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Cumberland Law Journal Advertising Executor's notice Edward Hair reimburse for postage expense Total from continuation schedules FILE NUMBER 21 05 0666 TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) $ AMOUNT 160.00 1,074.09 1,500.00 311.00 75.00 22.20 1,126.27 4 268.56 Estate of: Sara V. Hair Item No. 2 3 4 5 196-54-8747 Schedule H Part 1 (Page 2) Description Amount Edward Hair reimburse for food for funeral luncheon 57.76 Hoffman-Roth Funeral Home, Inc. funeral services 866.33 ~ddlesex United Methodist Church funeral expense, use of social hall 75.00 ~ddlesex United Methodist Women funeral luncheon 75.00 Total (Carry forward to main schedule) 1,074.09 Estate of: Sara V. Hair 196-54-8747 Schedule H Part 7 (Page 2) 3 Patriot News Advertising Executor's notice 126.27 4 Reserve for filing fees, accounting fees and other costs associated with the administration of Decedent's estate 1,000.00 Total (Carry forward to main schedule) 1,126.27 REV-1512 EX': (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Sara V. Hair SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21 05 0666 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 . Church of God Home final resident care 253.13 2 Church of God Home therapy services 89.97 3 Continuing Care RX prescription costs 12.19 4 West Shore EMS ambulance service 139.64 3W46AH 2.000 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 494.93 REV-1513 E~+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Sara V. Hair FILE NUMBER 21 05 0666 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1 Edward P. Hair 8 Mill Road Carlisle, PA 17013 33.333333 of Residue: 56,067.65 Son 56,067.65 2 Fred E. Hair 693 Barnstable Road Carlisle, PA 17013 33.333333 of Residue: 56,067.65 Son 56,067.65 3 Nancy A. Walters 2 Mill Road Carlisle, PA 17013 33.333333 of Residue: 56,067.65 Daughter 56,067.65 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 3W46AI 1.000 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET (If more space is needed, insert additional sheets of the same size) $ 0.00 LAST WILL AND TESTAMENT I, SARA V. HAIR, of the Township of Middlesex, County of Cumberland and Commonwealth of Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this as and for my Last will and Testament, hereby t revoking and making void all former wills and.codicils by me at any time heretofore made. FIRST. I order and direct that all my just debts and ....... - funeral expenses be paid by my Executors, hereinafter named, as ~ soon as conveniently may be done after my decease. ~ "'........... SECOND. I give, devise and bequeath all the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situated, in equal shares unto my three (3) children, namely, EDWARD P. HAIR, FRED E. HAIR and NANCY A. WALTERS, share and share alike, absolutely and in fee simple. If any of my said children should predecease me, I order and direct that the foregoing share of my residuary estate attributable to a deceased beneficiary shall be distributed unto such deceased beneficiary's issue per stirpes by representation and not per capita. LASTLY. I nominate, constitute and appoint my three (3) children, namely, EDWARD P. HAIR, FRED E. HAIR and NANCY A. WALTERS, to be the Executors of this My last will and Testament, LAW OFFICES SNELBAKER. BRENNEMAN & SPARE . \ LAW OFFICES SNELBAKER. BRENNEMAN & SPARE each and all to serve without bond or other security as a condition of qualifications hereunder. IN WITNESS WHEREOF, I, SARA V. HAIR, have hereunto set my hand and seal to this, my Last will and Testament which consists of two (2) typewritten pages to each of which I have affixed my signature this ~~ ~day of April A.D., One Thousand ine Hundred Ninety-nine (1999). /'~. ('...... L.~r Ct/lrO-/ !J, l ~ (/...{ .1-(.' Sara V. Hair ( SEAL) The preceding instrument, consisting of this and one (1) other typewritten page, each identified by the signature of the estatrix, was on the date thereof signed, sealed, published and eclared by SARA V. HAIR, the Testatrix therein named, as and for er Last Will and Testament, in the presence of us, who, at her equest, in her presence, and in the presence of each other, have subscribed our names as Witness~to. ..~~ ~g.~ -2- I . 0 . t . . . ~ LAW OFFICES SNELBAKER. BRENNEMAN 8c SPARE COMMONWEALTH OF PENNSYLVANIA SSe COUNTY CUMBERLAND OF We, SARA V. HAIR, RICHARD C. SNELBAKER and JANE J. COONEY, the ~estatrix 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 ar Testament and that she had signed willingly, 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 a witness and that to the best of his or her knowledge the Testatrix was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. v · .J aJGOU 7f' },/ r~ Llt/ ....~~ witness ~ (1 . ~~-,~ U witrless Subscribed, sworn to and acknowledged before me by SARA V. HAIR, the Testatrix, and subscribed and sworn to before me by RICHARD C. SNELBAKER and JANE J. COONEY witnesses, this day of April, 1999. ~~ fYl. .Lu~ ~ -. .. .......u.uN6Eary..-PublIc .mn__ NoIBMI sea, Chn8tine M, White ,'Notafy Pubffc Meohamcsburg Boro, Cumbetfand CountY My Commission Expires Sept. 17 200i Member. Pennsylvania Association of Notar~le1;