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HomeMy WebLinkAbout05-21-07 -.J lSDSbD41147 REV.1500 EX (06-05) PA Department of Revenue *' Bureau of Individual Taxes PO BOX.280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death " OFFICIAL USE ONLY County Code v_ INHERITANCE TAX RETURN RESIDENT DECEDENT 2 1 0 6 FIe Number 0762 Date of Birth 067567807 08152006 09081913 WILLIAMS LILLIAN MI B Decedent's Last Name SuffIX Decedent's First Name (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WillS FILL IN APPROPRIATE OVALS BELOW [!] 1. Original Retum 0 2. Supplemental Retum 0 3. Remainder Retum (date of death prior to 12-13-82) 0 4. Limited Estate 0 4a. Future Interest Compnlll1lse 0 5. Federal Estate Tax Retum Required (dete of death after 12-12-82) [KJ 8. Decedent DIed Testate 0 7 Dac:adent MalntaIned a UvIng TN.t 0 8. Total Number of Safe Deposit Boxes (Attach Copy 01 WiI) . (Attach Copy 01 TNst) 0 9. Litigation Proceeds Received 0 1 0 Spouaal p~ CredII ~date of death 0 11. Election to tax under Sec. 9113(A) . between 12-31- 1 and -1-95) (Attach Sch. 0) ~ORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: ame Daytime Telephone Number JOSEPH CAFARO, JR. ESQ. 4122819696 Firm Name (If Applicable) COOPER OWEN & RENNER, P.C. :-<l REGISTER OFyilLLS USE ~L Y -. - --.I ...., -r'"1 f-n : .'i ,~~ ; .c~.:; First line of address 223 FOURTH AVENUE, SUITE 1600 r-) Second line of address ~7"" City or Post OffIce PITTSBURGH State PA ZIP Code 15222 n" DATE FIlED _...,-~ u ondent's e-mail addl.8S8:jcafaro@corlaw.com naltlea of P.8ljury, I declal8that I have examined this retum, Including accompa!lY1ng schedules and statements, and to the beat of my ~ and belief, , correct pIete. Declaration of preparer other than the personal representative is beaed on all information of which preparer haS any knoWledge. RE R ONSIBlE FOR FILING RETURN I DATE Paul Johnson 5" It... - b Joseph Cafaro, Jr. Esq. 0, Pittsburgh, PA 15222 Side 1 L lSDSbD41:L47 :LSDSbD4:L:L47 -.J ~ .-J 15056042148 REV-1500 EX Oeoedent's Name: L 1111 a n B. Willi a m 8 RECAPITULATION 1. Real Estate (Schedule A).......................................................................................... 1. 2. Stocks and Bonds (Schedule B)............................................................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3. 4. Mortgages & Notes Receivable (Schedule D).......................................................... 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E)................ 5. 6. Jointly Owned Property (Schedule F) D Separate Billing Requested............. 6. 7. Inter-VIVos Transfers & Miscellaneous Non-Probate Property (Schedule G) D Separate Billing Requested............. 7. 8. Total Gross Assets (total Lines 1-7)....................................................................... 8. 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)...................................................................... 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 not 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, of transfers under Sec. 9116 (a)(1.2) X ~ 16. Amount of Line 14 taxable at lineal rate X .045 17. Amount of Line 14'taX8ble at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 0.00 15. 0.00 16. 54,382.39 17. 0.00 18. 19. Tax Due.................................... .................. ................ .................. .......... ................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 L 15056042148 Decedent's Social Security Number 067567807 70,599.18 2,746.23 73,345.41 15,915.84 3,047.18 18,963.02 54,382.39 54,382.39 0.00 0.00 6,525.89 0.00 6,525.89 D 15056042148 .-J . REV-1500 EX Page 3 Decadent'. Complete Address: DECEDENrs NAME Lillian B. WIlliams STREET ADDRESS 1 Alliance Drive, Apt. #301 File Number 21-06-0762 Carlisle I STATE PA IZIP I 17013 CITY Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditslPayments A. Spousal Poverty Credit 6. Prior Payments C. Discount (1) 6,525.89 5,200.00 273.68 3. InterestlPenalty if applicable D. Interest E. Penalty Total Credits (A + 6 + C) (2) 5,473.68 0.69 TotallnterestlPenalty (0 + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 Line 20 to request a I'8fund 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. 6. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) 0.69 (4) (5) 1,052.90 (5A) (56) 1,052.90 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: a. retain the use or income of the property transferred;.................................................................................. b. retain the right to designate who shall use the property transferred or its income;.................................... c. retain a reversionary interest; or.................................................................................................................. d. receive the promise for life of either payments, benefits or care?............................................................. 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 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. Ve. No ~ ~ [!] [!] 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 exemDt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum 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 decedenfs 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. Rev.1108 EX+ (....) *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COIoHONWEAL TH OF PENNSYLVANIA INHERITANCE TAX AE1\JRN RE8IlENT DECEDENT ESTATE OF Williams, Lillian B. FILE NUMBER 21-06-0762 Include the proceedI of IIlIgalIon 8Ild the dm the proceedIwwe I1IClIiYed by the ..... All property joInlIy-.-l with the 1I1I1Il of...mvorahlp muet be dIecIOHd on echeduIe F. ITEM NUMBER DESCRIPTION 1 100 Capital One Bank VA US Rate 04.05%, Matures 5/12/08 - Fixed rate CD VALUE AT DATE OF DEATH 9.746.10 2 200 Flagstar BK FSB MI US Rate .03.1000%, Matures 517/07 - Fixed rate CD 19.667.05 3 GMAC Automoblve BK US Rate 03.2500%, matures 12/8/06 - Fixed rate CD 9.933.35 4 200 Lehman Brothers BK DE US Rate 03.45%, Matures 5/5/08 - Fixed rate CD 19.304.95 5 UBS Financial Services Money Market 11.947.73 TOTAL (Also enter on Line 5, Recapitulation) 70.599.18 (If more SplICe Is needed, addltlonal pages of the same size) Copyright (c) 2002 fOnT! software only The Lackner Group, Inc. FOnT! PA-1500 Schedule E (Rev. 6-98) Rev-iSoe EX+ (~I . COMMONWEALTH OF PENNlIYlVANA INHERITANCE TAX RElIJRN RE8lDENT DECEDENT SCHEDULE F JOINTL V-OWNED PROPERTY ESTATE OF ILE NUMBER WIlliams, LIllian B. 21-06-0762 If en .... _ IlllIde joint wtthln _ yew of the dececIenl'e dete of dealh, It mwt be reportM on HIIeduIe G. SURVIVING JOINT TENANT(S) NAME A. Patricia Johnson ADDRESS RELATIONSHIP TO DECEDENT Niece B. C. JOINTLY OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT NUMBER OR SIMILAR IDENTIFYING NUMBER. ATTACH DEED FOR VALUE OF ASSEl INTEREST DECEDENT'S INTEREST JOINTL Y-HELD REAL ESTATE. 1 A 1/1/2005 M& T Bank Checking Account No. 5.492.45 50.000% 2.746.23 2672031248 TOTAL (Also enter on Line 6, Recapitulation) 2.746.23 (If more apace is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) REV.11.1 EX+ (12"" . SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Williams, lillian B. Debts of decedent must be reported on Schedule I. FILE NUMBER 21-06-0762 ESTATE OF ITEM NUMBER A. FUNERAL EXPENSES: DESCRIPTION AMOUNT See continuation schedule(s) attached 7,072.59 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Paul Johnson Social Security Number(s) I EIN Number of Personal Representative(s): 173-42-2738 Street Address 1042 Old Gate Road City Pittsburgh Year(s) Commission paid 2007 State PA Zip 15235 4,071.00 2. Attomey's Fees Cooper Owen & Renner, P.C. 4,327.00 3. Family Exemption: (If decedent's address is not the same as c1aimanfs, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent State Zip 4. Probate Fees 70.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs See continuation schedule(s) attached 375.25 TOTAL (Also enter on line 9, Recapitulation) 15,915.84 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA.1500 Schedule H (Rev. 6-98) Rey.1102 EX+ (...., . SCHEDULE H.A FUNERAL EXPENSES continued COMMONWEALTH OF _nvANIA INHEIlITANCI! TAX RE1\JRN RE8IOENT DECEDENT Williams, LIllian B. FILE NUMBER 21-08-0762 ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 Flowers 117.70 2 Jaycox-Jaworskl Funeral Home 6,584.95 3 Nelson Rock of Ages - engraving 135.00 4 Palmieri's Restaurant 234.94 Subtotal 7,072.59 Copyright (c) 2002 form software only The Lackner Group. Inc. Form PA-1500 Schedule H-A (Rev. 6-98) Rev.1102 EX+ (...., *' SCHEDULE H-87 OTHER ADMINISTRATIVE COSTS continued COMMONWEALTH OF PENNllYLV_ INHERITANCE TAX RElURN RE8IDEHT DECEDENT ESTATE OF WIlliams, Lillian B. FILE NUMBER 21-06-0762 ITEM NUMBER DESCRIPTION AMOUNT 1 Cumberland Law Journal - Advertising 75.00 2 Register of Wills - Family Agreement flUng fee 20.00 3 Register of Wills - Inheritance Tax Return Fee 15.00 4 Register of Wills - Inventory flUng fee 130.00 5 Register of Wills of Allegheny County - Fee to transfer Probate Petition to 20.00 Cumberland County Register of Wills 6 The Sentinel - Advertising 115.25 Subtotal 375.25 Copyright (c) 2002 fonn software only The Lackner Group, Inc. Fonn PA-1500 Schedule H-B7 (Rev. 6-98) Rey.1512 EX+ (5.tI' *' COMMONWI!AI. TH OF PENN8VlVANA _ANCE TA,X ReTURN R1!8IlI!NT DECEDENT ESTATE OF WIlliams, Lillian B. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS Include un....mbuned medlcale~. ITEM NUMBER DESCRIPTION 1 Chapel Point at Carlisle 2 Millennium Pharmacy FILE NUMBER 21-06-0762 TOTAL (Also enter on Line 10, Recapitulation) (If more space Is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. I VALUE AT DATE OF DEATH 2.859.25 187.93 3,047.18 Form PA-1500 Schedule I (Rev. 6-98) REV.1513 EX+ ('-'0' . SCHEDULE .. BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NUMBER Williams, Lillian B. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal Clistributions and transfers under Sec. ih 16(a)(1.2)J RELATIONSHIP TO DECEDENT Do Not u. ,..-., FILE NUMBER 21-06-0762 SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) I. Elsie Johnson c/o Paul Johnson 1042 Old Gate Road Pittsburgh, PA 15235 Sister Sole heir Total Enter dollar amounts for distributions shown above on lines 5 throuah 18, as approp ate, 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 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-15oo COVER SHEET 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA.1500 Schedule J (Rev. 6-98) , WILL OF LILLIAB B. WILLIAMS I, LILLIAN B. WILLIAMS, of Allegheny County, Pennsylvania, do make this my Will, hereby revoking any and all Wills at any time heretofore made by me. FIRST: I direct that the expenses of my last illness and funeral be paid out of my estate as soon as may be convenient after my death. SECOND: I give my entire estate, both real and personal, to my husband, KENNETH E. WILLIAMS, if he survives me by a period of thirty (30) days. If my husband fails to so survive me, I give my entire estate to my sister, ELSIE JOHNSON, presently of McKeesport, Pennsylvania, if she survives me by a periOd of thirty (30) days. THIRD: In the event my said sister fails to survive me by a period of thirty (30) days, I give my entire estate in equal shares to such of the following as shall survive me by a period of thirty (30) days: 1 A. My niece, MARY JANE MARTIN B. My nephew, CHARLES McCUTCHEON C. My niece, ELSIE RUBENSTEIN D. My niece, LILLIAN RAYER E. My niece, JACQUELINE KING F. My nephew, WILLIAM JOHNSON G. My nephew, PAUL JOHNSON If none of my above named nieces and nephews survive me by a period of thirty (30) days, I give my entire estate to CHILDREN'S HOSPITAL of Buffalo, New York. FOURTH: I appoint my nephew, PAUL JOHNSON, Executor of my will. In the event he is unable or unwilling to so serve for any reason, I appoint my sister, ELSIE JOHNSON, as Executrix. No bond shall be required of any fiduciary serving hereunder in any jurisdiction. FIFTH: In the exercise of responsibilities, my fiduciaries shall have, in addition to and not in liaitation of any authority given by law, and without the necessity of obtaining the consent of any court, the following powers: to accept and to retain investments and property which are a part of my estate; to invest and reinvest the principal of my estate in any kind of property without being restricted to investments which are authorized for 2 ~iduciaries; to sell, give options to sell, pledge, exchange, lease for any term or mortgage any real or personal property; to borrow money; to compromise claims; to vote the stock of any firm or corporation in which the estate may have an interest on any issue affecting said firm or corporation; to carry securities in the name of a nominee; to allocate and apportion items of receipt between income and principal; and to distribute the estate either in cash or in kind. SIXTH: I direct that all estate, inheritance and other taxes in the nature thereof together with any interest and penalties thereon becoming payable because of my death with respect to the property constituting my gross estate for death tax purposes, whether or not such property passes under this Will, shall be paid from the principal of my residuary estate and no person receiving or having a beneficial interest in any such property whether under this Will or otherwise shall at any time be required to contribute to or refund any part thereof; provided, however, that this direction shall not apply to taxes on any property included in my estate solely because of a power of appointment thereover which I possess, but have not exercised, or any qualified terminable interest or to any generation-skipping transfer taxes. 3 IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~3ri) day of A ~j~ ~I , 1994. ~' .' ~~.:c (SEAL) ILL IAN B. WILLIAMS ~ SIGNED, SEALED, PUBLISHED and DECLARED by the above _ named Testatrix, as and for her Will, and we, at her request, in her presence and in the presence of each other, have hereunto subscribed our names as witnesses, certifying that this act is of her own free will and accord, executed with full testamentary capacity. IUJtJ~~ Address tilt ~<. C-..{ f)A. liP>), t?~ J '>"'-"1 S' .t?~ -_\. \. ~- J'l Addr,es --- I.)};. l I hl~ I ~(\~ " \ -"') J \, \ '::> \:)..'" \.\ \. _ r \\ \ S 1- \ (, !J4-f /l ~ Addressl'l/:J2- w/1~~ ~~ M ~17/11dd') ~/9. /Jtyz, 4 .r- We, LILLIAN B. WILLIAMS, sQ we s>..<Q <?. ~ ~fh and the Testatrix and the witnesses ) ) ) .-' ./' ~c.,:>(~.<-\ \.J !-\c.:+( 'j.~ C 3:: C{'~"'" I~ .^;..xl~. \ respectively, whose names , ,CO~ONWEALTH OF PENNSYLVANIA .COUNTY OF ALLEGHENY SS: are signed to the foregoing Will, being first duly sworn according to law, do depose and say that the Testatrix signed and executed the foregoing instrument as her Will, that she signed willingly, that she executed it as her free and voluntary act for the purpose therein expressed, that each of the witnesses, in the presence and hearing of the Testatrix signed the will as. witnesses and that to the best knowledge of each of them the Testatrix was at the time eighteen years of age or older, of sound mind and under no constraint or undue influence. o{j! ~~..Jf.44..a :'.-,pESTATlUX) , LILLIAN B. WILLIAMS (WITNESS) (WITN.ESS) ~ (WI'ftfESS) SUbscribed, sworn to and acknowledged before me by LTT~.TAN B. WILLIAMS, the Testatrix and subscribed and sworn to before me by ~obe..r+ 'W. A5o.i~ -:J e ~ e 'I ~. 0 '--Ue.n of A l"3V ~-t. , Ed 1.Jw~ d 'R. ~de. , witnesses, this a ~' d , 1994. ~_R~ Notary Publl.c and day ~SeaI Dawn R. 0wlIn. NoIluy N:lIc 5 My~l:::-#~~ ; INVENTORY . r REGISTER OF WillS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA } SS COUNTY OF Cumberland } Paul Johnson Personal Representative(s) of the Estate of LIllian B. Williams File Number 21-06-0762 deceased! depose(s) and say(s) that the items appearing in "fOlloWing inventol)' include aU of the personal assets wherever situate and aU of the real estate in tlie Commonwealth of PennsyJva of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the deced s dela nd that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears i rnem n um t the end of this entory. I verify that the statements made in this InVen-} ~_ tory are true and correct. I understand that false state- ments herein are made subject to the penalties of Paul Johnso . 18 Pa.C.S. ~ 4904 relating to unsworn falsification to } authorities. Attorney - (Name) (Firm) (Address) (Te/aphone) Joseph Cafaro, Jr. Esq. Cooper Owen & Renner, P.C. 223 Fourth Avenue, Suite 1600, Pittsburgh, PA 15222 412-281-9696 (Supreme Court I.D. No.) DATE OF DEATH 08/15/2006 LAST RESIDENCE 1 Alliance Drive, Apt. #301 Carll.le, PA 17013 FIGURES MUST BE TOTALED DECEDENT'S SOC. SEC. NO. 067-56-7807 Personal ProD8rtv Cash...................................... ....... ...... ............................................ 70,599.18 Personal Property...................................... ................................... Stocks/LI.ted................................................................................. Stocks/C losely Held...................................................................... f'.,) = ~ -J :x ~ -< N (") S;o . ,;;p, -~o 'd; F;=; -' ~~~:) f~ -~ c3 ~~ J:lto - Bonds............................................................................................. Partnerships and Sole Proprietorships ..................................... Mortgages and Notes Receivable............................................... All Other Property.................................... ..................................... :0 ~--o I j.> 70,5af18 Total Personal Property......................................... Total Real Property............................. ................... Total Personal and Real Property......................... NOTE: The Memoranc:lum of reel estate outside the Commonwealth of Pennsylvania may, at the election of the personal rapresenlative Include the value of each item, but such figures should not be extended into the total of the Inventory. (See 20 Pa. C.S. S 3301 (b)) Form RW-D9 Rev. 1()'13-2006 73719 .. ~~ ) . INVENTORY ,- REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENN5YLVANIA } 55 COUNTY OF Cumberland } File Number 21-06-0762 DATE OF DEATH 08/15/2006 LAST RESIDENCE 1 Alliance Drive, Apt. #301 Carlisle, PA 17013 DECEDENl'S soc. SEC. NO. 067-56-7807 Cash 100.0000 Capital One Bank VA US Rate 04.05%, Matures 5/12108 - Fixed rate CD 9.746.10 200.0000 Flagstar BK FSB MI US Rate .03.1000%, Matures 5"/07 - Fixed rate CD 19.667.05 100.0000 GMAC Automoblve BK US Rate 03.2500%, matures 1218/06 - Fixed rate CD 9.933.35 200.0000 Lehman Brothers BK DE US Rate 03.45%, Matures 5/5/08 - Fixed rate CD 19.304.95 UBS Financial Services Money Market 11.947.73 Total Cash 70.599.18 (Attach additional sheets if necessary) Total Personal Property and Real Estate 70.599.18 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 JOHNSON PAUL 1042 OLD GATE ROAD PITTSBURGH, PA 15235 __nn__ fold ESTATE INFORMATION: SSN: 067-56-7807 FILE NUMBER: 2106-0762 DECEDENT NAME: WILLIAMS LILLIAN B DA TE OF PAYMENT: OS/21/2007 POSTMARK DATE: 05/17/2007 COUNTY: CUMBERLAND DATE OF DEATH: 08/15/2006 NO. CD 008191 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $1,052.90 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: RECEIPT TO A TTY CHECK# 110 SEAL INITIALS: DM RECEIVED BY: REGISTER OF WILLS $1,052.90 GLENDA FARNER STRASBAUGH REGISTER OF WILLS I--.'-'~ '>," '.r':~\!- :~"j :"~"'C c\("' 1= COOPER OWEN & RENN:~lt!~::8 C!~", ATTORNEYS AT LAW !""I, 1600 BENEDUM TREES BUlWING. 223 FOURTH AVENUE, PITTSBURGH, PENNSYLVANIA 1522l\mOOPfi~ (4Ati Ui-i~ · FAX (412) 281-9680 P. Ronald Cooper Jeffrey R. Owen S. Todd Renner Joseph Cafaro, Jr. re" ....., CLcril\ Ui' QRPH I,!, 1'(' ('(1\ IRT -;\ fL...,!,,~ () \.)\j,_, , CLIH" " pA, 1,1.,' Of Counsel: William E. Goehring Gary H. McQuone Merle \lv. Powell, Jr. May 17,2007 Register of Wills 1 Courthouse Square Carlisle, P A 17013 Re: Estate of Lillian B. Williams, Deceased No. 21-06-0762 Dear Sir or Madam: Enclosed please find an original Inventory and extra cover sheet in reference to the above estate along with a check in the amount of$130.00 which includes $115.00 additional probate fee plus $15.00 filing fee. Kindly process this document in your usual manner, time-stamp the extra cover sheet and return to me along with your receipt using the self-addressed stamped envelope enclosed. Also enclosed for filing is an original, a copy and extra first page of the Inheritance Tax Return along with a check in the amount of $15.00 for your filing fee and another check in the amount of $1,052.90 representing the balance due on the inheritance tax. Kindly process this document in your usual manner, time-stamp the extra first page and return to me in the enclosed envelope. If you require any further information, please do not hesitate to contact me. Very truly yours, 4::t.Jr.~ ~ JCJ :ja Enclosures - I . ...... ..... u ..... ~ 0.; ~ :I!' ... ~ Lf') <:,- ~ C. ] .. f--- ~ - G::, z~ :.:) .;.. LL_ C-) ,.- ! oq: (~C~:' Z<( ~.::: (/) ~....l ex: - . ~f-< N LU-::: --1 ::;" <( ! ~C"'l >- C) r;'. <( 0:: ;:: ~~ to al..-l JC 0=; ..-l g.g r-- U Z~ ..-l ~:') .... 'I"l CJ)..-l C~7) ..... C""-J ..... ~ ~~ ; ~~ c:5 ~ 4-l ~g 0 ::I .. 0 ~ t-l,.d Q,l O~ Q,loU..-l ~ oU t-l to .,' to ::I 'I"l ~ 'I"lO..-l bOt) t-l ~ i Q,l al Pot ~..-lt) 0 0 a:l .. U I~ g - .'.'1 " ,.' I ~:I E'" ....i :"\i:, i ~"!b,,1 'l;~' . .:........ .'". ".~ i _I n-'=_. 'I I