The URL can be used to link to this page

Home My WebLink About02-07-07 .-J 15056051047 -;; ~i ~ REV-1500 EX (06-05) PA Department of Revenue '* Bureau of Individual Taxes _ PO BOX 280601 Harrisbu ,PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death INHERITANCE TAX RETURN RESIDENT DECEDENT MI Suffix MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW _ 1. Original Return c:::) 2. Supplemental Return c:::> 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required c:::) c:::) 4a. Future Interest Compromise (date of death after 12-12-82) c:::) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) c:::) 10. Spousal Poverty Credit (date of death c:::) 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT... THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Da ime Telephone Number 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received o 8. Total Number of Safe Deposit Boxes 4. Limited Estate c:::) c:::) c:::> c"')(') ~:, 0 -Ti ')e.-=: - :l.J ::u --I J>- -0 ::i: r;.? Correspondent's -e-mail address: be meres ,. x. lief Under penalties of perjury, I declare that I have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, ration of preparer other than the personal representative is based on all information of which preparer has any knowledge. RESPONSI R FILING RETURN ADDRESS T&>l>]) 7/ (J~ Err, _;:J..03S NAIl/leST 2>R.;f'1..~t!.NA)vI(!,~8 t//(&'3 PA n(),~~ SIGNATUR RE 'AKe."R-~ nr=.'~ - NTATIY- ADDRESS N "'rltES E: SNIEZDS ~ i!:.$4J. , t!l.O/tSE~ ~... ME{!HAAI~4uRt$.l I'AI7DSr PLEASE USE ORIGINAL FORM ONLY DATE z/i /d Side 1 L 15056051047 15056051047 .....J -.l 15056052048 REV-1500 EX Decedent's Name: RECAPITULATION 1. Real estate (Schedule A). . . . . . . . . .. ... . . ; . . . ; . . . . . ... . . . . . ; . :.. . . '. . .. . . 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . .. . '.; . . . . . . . . . . . . . . . . 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . . . 4. Mortgages'& Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . , 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . . . 6. Jointly Owned Property (Schedule F) c:::::> Separate Billing Requested . . . . . . . 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) c:::::> Separate Billing Requested. . . . . . . . 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . , . . . . . . . . . . . . . . . 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . . . . . 10. 11. Total Deductions (total Lines 9 & 10). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .. 11. 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election. to tax has nC?t been made (Schedule J) . . . . . . . . . . ., . . . . . . . . . . . . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) .. . . . . . . . . . . . . . . . . . . . . . . 14. TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .O~ 16. Amount of Line 14 taxable at lineal rate X.O ~ 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. , . . : ... .'. . . . . ....... .; . . . . . .19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15056052048 Decedent's Social Security Number 1. 2. 3. 4. 5. 6. 7. 8. t" 9. 15. 16. 17. 18': <::) 15056052048 ---I REV~1500 EX Page 3 Decedent's Complete Address: File Number ;JI-()(. - 'If' DECEDENTS NAME }(A-7IIR.YN X. ttPPE TT STREET ADDRESS 1:/3 E. MAIN sr. CITY :5H/~M~S ,/JwN 1 STATE PII I ZIP 17DII Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) ~,t.f. 71/ 3. InterestlPenalty if applicable D. Interest E. Penalty o o o ? ;3 ~,Y'l o Total Credits ( A + B + C ) (2) () TotallnterestJPenalty ( D + E ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (3) (4) (5) (5A) (5B) 11 ..3'f, II'! ~ ~ ~''f.:l3 D ,. 2'?-,7..1 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, 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 ~ b. retain the right to designate who shall use the property transferred or its income; ............................................ D ~ 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 ~ 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 THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 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 three (3) percent [72 P.S. ~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 zero (0) percent [72 P.S. ~9116 (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 zero (0) percent [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 four and one-half (4.5) percent, except as noted in 72 P.S. ~9116(1.2) [72 P.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 twelve (12) percent [72 P.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. ,', ~ ; . \ \ \, \ \ ' \ ~ ' \\\ /J Q -r- +-;, , ~ .."v. ~ \\ \ ~ '2,uqJi ~ooS f!.4.e'" 000 ';,I"~ 1> ,ac..Lf. '11/ t.. OOOI~'l ,; 1"6.0af 'f.. 3t.\q::: 4- r~ ,qC", t\ \ l "'1'- 5 J ,?-DOlP .. · 60/2 I ct . ~ II~~ f ~lpLf.1'f 'to .000 tqJ.'" $0.05..,c ,3Co5" ~ 12. do. 5 , \ \ \ , \ 11 \ ~111()1- ~ '1 01 :; 3l? d ----- \;\,~ J \ ~ \ 4 ..lip\}' 'lLt ~ .ooo~ (}& 001 1<1~ .. '* O.Dh 'f. 3lf';:: t;2. ~ .----------- -------- '- -;. \ \ \ -- -------------------------/--------- :'. /----------------~----------- \. \ ---- -------------------------- ~~~----------~-------- ~ ., .--- -- -------- -----------~~--:::::.-- -------------------. ~ \ \ \-\\ ~&O~.l~ '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF TI PPE T1; SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY I< Ar/f/lY/V 1. FILE NUMBER ~/-Ob - 9~6, Indude the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. :J. DESCRIPTION I+ewas tA pv{,ono. Ity ta.-J<tIt -b Er~c.ker$ A"tc;Hf)t1 ,f /VlechAi\ ~ c. 5 b\Ar j C ~e.t, 8 r,' c ker s &tcdtMent 4.Jh,. c.h e. d) A dJ,' -h',na I :r.teMs ()f. pe,r.Sonalry 7b 13r,'c.cerl (~t 8rlc.KtJ.S ~MtrY1fAt CttfacJauJ ) VALUE AT DATE OF DEATH ~ ;Z, 1'17,00 ITEM NUMBER 1. '3 s-l SO TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) $ r2 So f.btJ , . REV.1509 EX + (1.971 '* SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNS) LVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF 71 PfJE r 1; KA 7N~)'N I. FILE NUMBER ,A l-piJ - 9tffD 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 RELATIONSHIP TO DECEDENT ADDRESS A. RDIIA-Lb E. l,pfJE-rr B. c. 3100 G-oif".e/IJ ])rive /YIec.hAnic:sb""3 I f'A /7DSb S6h JOINTLY -OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT deed for joinUy-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 1/3D//)1 Cifi Z<<J.S BAnIL of PI&- I C ..,..f;f. , ,; Aed: 1/6. '~'I-() -9'1 '1'11/3 IS} '182. to Sat ~ 9'11. '10 t1. A. 'b' I"~ C;t;zU16 1!,alllt () f PA- J eht.c:.k.'na ~ 89/. 'II Sbt ., J/'IS; '9 A-ed.. N6. "00- 7/S 3.7J. (Set eJf;cJJ informah'fJl( oil e: c./s !,v,M Pl.. Pqt. "f AeftJJut a f/ao,e.J) TOTAL.(Also enter on line 6, Recapitulation) $ K, I.J 37.97 IIf mnrp e;:n~p Ie;: nAArlPI'I in<lprf ~r1r1itinn~1 <lhAAte;: nf thp e;:~mp <li7P' a../~!Dp CHARLES E. SHIELDS, III ATTORNEY-AT-LA W /~-- 6 CWUSER ROAD Corner ofTrindle and Clouser Roads MECH~CSBURG.PA17055 GEORGE M. HOUCK (1912-1991) TELEPHONE (717) 766-0209 FAX (717) 795-7473 February 20, 2006 Commonwealth of Pennsylvania Department of Revenue Bureau of Individual Taxes Dept. 280601 Harrisburg, P A 17128-0601 RE: ESTATE OF Kathryn I. Tippettt SSN: 172-01-3988 DOD: 4/16/04 ACN: 06104295 and 06104296 Dear Sir / Madam: Please find enclosed signed assessment sheets for two (2) separate accounts at Citizens Bank that were evidently held in the joint names of Kathryn I. Tippett and Ronald E. Tippett, her son, to wit: Account No.: 6240-994443 Account No.: 6100715272 As stated on your assessment sheets, Kathryn I Tippett died on April 16, 2004. Unfortunately, her son, Ronald E. Tippett has recently died on November 19, 2005. He had a lingering illness and both his mother's estate matters and his own affairs were in considerable disarray. I am now involved in both estates and hope to get them settled in some reasonably sensible and timely fashion with the expected cooperation of the heirs. Thank you for your kindness and cooperation in these matters. Very truly yours, ~~?-----. Charles E. Shields, III Attorney-At-Law CES/mjj Enclosure COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. Z8D6Dl HARRISBURG, PA 171Z8-D6Dl '*' INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. 22 ACN 06104295 DATE 02-07-2006 REY-1S43 EX AFP lD9- III RONALD E TIPPETT 254 LINCOLN AVE HBG PA 17111 TYPE OF ACCOUNT EST. OF KATHRYN I TIPPETT 0 SAVINGS 5.5. NO. 172-01-3988 0 CHECKING DATE OF DEATH 04-16-2004 0 TRUST COUNTY DAUPHIN IX] CERTIF. REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS DAUPHIN CO COURT HOUSE HARRISBURG, PA 17101 CITIZENS BANK OF PA has provided the Department with the inforution listed below which has been used in calculating the potential tax due. Their records indIcate that at the death of the above decedent, yoU were a joint owner/benefIciary of this account. If YOU feel this inforntion is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. ThIs account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvmnia. Questions..y be answerad by calling (717) 787-83Z7. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 6240-994443 Date 07-30-2002 Established Account Balance Percent Taxable Mount Subject to Tax Rate Potential Tax Due x 15,982.80 50.000 7,991.40 .045 359.61 TAXPAYER RESPONSE To insure proper credit to your account, two (l) copies of this notice .ust accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". x NOTE: If tax payments are made within three (3) months of the decedent's date of death, yoU ny deduct a 57. discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. Tax PART m A. [ CHECK ] ONE BLOCK B. ONLY c. [] The above infor.ation and tax due is correct. 1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or yoU may check box "A" and return this netice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance rax return to be filed by the decedent.s representative. [] The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. PART [!J DATE PAID DEBTS AND DEDUCTIONS CLAIMED If you indicate a different tax rate, please state your relationship to decedent: PART @] TAX RETURN - COMPUTATION OF TAX LINE 1. Date Established 1 2. Account aalance 2 3. Percent Taxable 3 X 4. Aaount Subject to Tax 4 5. Debts and Deductions 5 6. Aaount Taxable 6 7. Tax Rate 7 X 8. Tax Due 8 ON JOINT/TRUST ACCOUNTS PAYEE DESCRIPTION AMOUNT PAID I TOTAL (Enter on Line 5 of Tax Conputation) I $ Under penalties of perjury, I declare that the facts I have reported above are true, correct and cOIIPlete to the ~ of my knowledge and belief. HOME ( ) &A'h..v i'. ~~ ~ h~ L AA.z .t;" "'"Pit', -7,"7 , "7/..L -n 7"'0 '" /A . /~ ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 *' INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. 22 ACN 06104296 DATE 02-07-2006 IEY-lS43 IX AFP (09-001 RONALD E TIPPETT 254 LINCOLN AVE HBS PA 17111 TYPE OF ACCOUNT EST. OF KATHRYN I TIPPETT D SAVINGS S.S. NO. 172-01-3988 IX] CHECKING DATE OF DEATH 04-16-2004 D TRUST COUNTY DAUPHIN 0 CERTIF. REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS DAUPHIN CO COURT HOUSE HARRISBURG, PA 17101 CITIZENS BANK OF PA has prDvided the DepartBent with the infDrmatiDn listed belDw which has been used in calculating tha potential tax due. Their records indicate th8t at the de8th of the above decedent, YOU were a joint owner/beneficiary of this account. If you feel this infor..tion is incDrrect, ple8se obtain written correction froll the fin8ncial institution, attach a copy to this for. and raturn it to the above address. This account is taxable in accord8nce with the Inheritance Tax Laws of the COBmonwealth of PennsylllBnia. Guestions..y be answered by calling (717) 787-8327. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 6100715272 Dete 01-13-1981 Established Account Balance Percent Taxable Mol.8\t Subject to Tex Rate Potential Tax Due x 891. 98 50.000 445.99 .045 20.07 TAXPAYER RESPONSE To insure proper credit to your accDunt, two (2) cDpies of this notice .ust accompany YOur p8ymant to the Register of Wills. Make check payable to: "Register of Wills, Agent". x NOTE: If tllX payments are lIade within three (3) Bonths of the decedent's date of death, you may deduct a 5Z discount of the tax due. Any inheritance tax due will becoBe delinquent nine (9) Bonths after the date of death. Tax PART [!] A. [ CHECK ] ONE BLOCK B. ONLY c. [] The abDve infor-.tion and tax due is correct. 1. You may choose tD remit payment to the Register of Wills with two copies of this notice to obtain a discount Dr aVDid interest, Dr YDU lIay check box "A" and return this notice tD the Register of Wills and an Dfficial assessment will be issued by the PA Department of Revenue. ~ The abDve asset has been Dr will be repDrted and tax paid with the Pennsylvania Inheritance Tax return tD be filed by the decedent's representative. [] The above infor-.tiDn is incDrrect and/or debts and deductions were paid by you. You IIUst complete PART ~ and/Dr PART ~ belDw. PART ~ TAX RETURN - COMPUTATION OF TAX LINE 1. Date Established 1 2. Account Balance 2 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 5. Debts and Deductions 5 6. Amount Taxable 6 7. Tax Rate 7 X 8. Tax Due 8 ON JOINT/TRUST ACCOUNTS If you indicate a different tax rate, please state your relationship to decedent: PART [!] DATE PAID PAYEE DESCRIPTION AMOUNT PAID I TOTAL (Enter on Line 5 of Tax Computation) I $ Under p8nalties of perjury, I declare that the facts I have reported above are true, correct and c;.,~lete to the b.w of IIY knowledge and belief. HOME ( ) a~~h",,t' ~~"b~ ..,;r- ,~ R' I! Z /: IoInDV' -7/7 , -7/ / -/J ) _.... ~ /... _ /n/ REV-ISIO EX. (i-97) *' SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATEOF T P IP E II, KAT}f~Yjl) :c. FILE NUMBER ;1,1- tJ" - 1IJ" This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY 0/0 OF ITEM INClUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE ATTACH A COP'!' OF THE DEED FOR REAL ESTATE. NUMBER VALUE OF ASSET INTEREST /IF APPUCABlE \ 1. /i,: 1)~"2r ~ V, Louretle. /:JowtrrJ Gif1~ fhadt with; " t)"e. (,) YeAr of at-Ath : '1 ( ch;ld's fea sd J/s./JO ~ o<<J,()/) neX~ TOTAL (Also enter on line 7, Recapitulation) $ , [) 0 (If more space is needed, insert additional sheets of the same size) REV-15011 EX+ (12-99) . * SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER .;J/-b6> -lIl(, ESTATE OF -r I tPPE /7; KA7lfJf?YA) I. ITEM NUMBER A. Debts of decedent must be reported on Schedule I. DESCRIPTION 1. FUNERAL EXPENSES: m u. SSft,*1I11MJ FIIAlE/lM. HDME (pte/a;' ,it filII) B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) -r; eI,J i/pJ1e It Social Security Number(s)/EIN Number of Personal Representative(s) ;}O()-, 1./ - 703(, Street Address Ol 0 :l S #1/ Il..v (;~ b /IN € city-.!flIFCHAAlICSBul2,6- StateM-Zip _/'70S'S 1/. 1:1.. 2. Year(s) Commission Paid: l t:'L' I J .-J~ ItDte -jI.;s, figure hU$ bee.l1 eapp::;d AttorneY,Fees CH4re.s E; <.;Ulle.tr.tS 1lJ. ~~ 9(:f in V;et.cI ~ I)a.ht.~ ofe.}.i R~f1mJiJl ac,frA-..( -hme q~'uI J.f/,./I well lt1<~e~tI -M,'$ 1i91l1fe). Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant lI/oA/E 3. Street Address City State _ Zip Relationship of Claimant to Decedent 4. Probate Fee' uvI IPriaih.J issue. of short cuf,' f,'c.Jes Accountant's Fees 1 j tLnd' BJ11GKb: II Hi-/{ B J IU;.f(. of mea. Tax ReturnPreparer's Fees ic.sb",.-a PA(;~tll)ltleS e.>tlen~;vi (e,l;..) l . 1.1 ' re.Ct>n~~lAc.nll'" t1I u..ni.'l&.d r-e,,1l(ton.s Renu.nc;tJionS fu -It> -'Rea-i&ter "f wif{s A-dllt.rti.s i~ ~ C~~'CAMd L...w =r"lArm.,1 A~"uf;5.:na h. CfLrlisle Sentinel AI'; ~""a I prDbrU-e f~ e- n 1- Allch CI, u r;k 8r ic.l<er c.,.6IHM;SS;IU'I .,., If" 'DI1e.er .. F,'l ; n :::r" ht.r~ -ht.t\CL -r ~ Re./-rLr (15 t=t.e. 10 R eIi' of . fIJ; lis see. '" it TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) 5. 6. 7. 8. ,. /0, AMOUNT -0- Sat>. DO , :3J 000. ()f) A/PIIIE . /.17.00 1$ 45'0./)0 ~()Jbb *I 7~ D() 1- 1 0 7. " It), ()O ~ 7/7. eJeJ ~. J S. ,,() $ 5", 0 S1- '1-'1 i SCJI Eo]). HI Cl-d'd. _ __~______ __M~Ji:~_t:__PE___T!~f!f!:T,_Kl17l1~!/l!_~_:______ ________________j~. i _._(;-'UI;~~~~__fR___a_U.cb:~tle~!"___QI1M~J5.~,_/~__~_~?!!,joS_!t:.._ _ ~_~__gl.:~j,_~L&L~____._ ~ /7, P 000 o 1 1 BRICKERS AUCTI9N Complete Auction SerVice '1IP/crr CST; Auction - Wednesday Evenings 766-5785 Chuck Bricker, Auctioneer TOTAL SALE o c C * o G ~~ O~-',"7, :: q ~;c , .! I > ~ " '. ~, . ;:; '" 0 0 5 3 0 S 0 27"5-0 + 1Li6"OO .:~' '? 9 I.~: [~ fJ )-1<.00 26"00 ;;Oi"SO .~. 151"50 59 4t 1] 0 "'1 " 'I, JJ7 .' n n ;j: e;c.. .~. fp t' ',j ... COMM. CLEAR. / ~ 60 7/ 1'!3{).()u BRICKERS AUCTION Complete Auction Service Auction - Wednesday Evenings 766-5785 Chuck Bricker, Auctioneer TOTAL SALE 000 0" :>j: 38"00 8" 00 -r 1151>00 + loaD 46"00 99" SO 006 357"~;O * COMM. CLEAR. 17/J~CTr '3:5-'~ s~ I / 7/slJ ~fLo, d tf REV.1512 EX. (1.97) '* SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS k If TN 1f!.j' AI I. FILE NUMBER ClI-/)~-~i' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF - /1-LJr ,_ Ilrrc: '.~ Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1. TJlG;eE" /JJIf.Y lET ~ UAlKIII~1U1f) I'E1<SO/ll,lf(.. 1~~A1t lA-X L. I AIi/ L I rll:: S IcJIII ~II /l)~,fie&" ttAl/kSL~ ~ A-5 CG /l,rA-/ IV ,If r 77Y'IS 7/4/ E: TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) . .. REV-I513 EX+ (9-00. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATEOF TJPPE 11) KII7}f~YN I. FILE NUMBER ~/- 0(; -If''~ RELATIONSHIP TO DECEDENT NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. V. L~urene J3ower& d..+tt.r C/o I?4f01/J/'JtI 1I,l3lJlVel'S 0/0 .:14ne A-/exlln~r; 1:56. Il{l ,JlJuH, /Jalr{m/)~ .st fl p /!,o1C '12/ Di/l.:sbUI"'!, I'A /7/)1'1 j. Ron';" E. 7i,pet!- SOh ~o .7ii/ v/r'eff "I_II I" , II - '103~ ff~ 1>n -,r0.;77 -." _ ,-, ,~. ~ . /1:JA?'it;;J;Hrt~ ~f /1/11 Yl4..u~.11r .- - 11~% 3. )."~"4 STho/er dttuqhft;r 3'11 s. 1J4/I/~f J~ () /J,rt:l$6oro I;!A 19SIJ" ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET AMOUNT OR SHARE OF ESTATE Y3 J3 Ya 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 $ (If more space is needed, insert additional sheets of the same size) CHARLES E. SHIELDS, m ATTORNEY-AT-LAW 6 CLOUSER ROAD Corner ofTrindle and Clouser Roads MECHANICSBURG, PA 17055 GEORGE M. HOUCK (1912-1991) TELEPHONE (717) 766-0209 FAX (717) 795-7473 February 6, 2007 Register of Wills Cumberland County Court House 1 Court Square Carlisle, P A 17013 Re: Estate of Kathryn I. Tippett No. 21-06-0486 Dear Register of Wills: . . Please find enclosed 2 copies of the Inheritance Tax Return along with Check No. 314, in the amount of $299.23 for Inheritance Tax due, Check No. 312, in the amount of$10.00 for the additional probate fee due and Check No. 313, in the amount of$15.00, for the filing fee for the above-captioned Estate. I have also enclosed an additional copy to be date-stamped for our records. Thank you for your kind attention to this matter. Very truly yours, ~ CMdwf~JJ- Charles E. Shields, III Attorney-At-Law CES/mjj Enclosures (') S~ ..c:~C") .:f~~ (---'r) _:Q-h ~n :;~? :::::; r--...) c:::;. c:> -...J " fTl co I -.J -0 ::f: N