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Home My WebLink About06-21-07 (2) -.J 15056051058 REV-1500 EX (()6.{)5) PA DepertmenI d R8veooe .. Bureau d IndivIdu8l T8ll8S PO BOX 2D01 HanlsbIIg, PA 17128-0601 I ENTER DECEDENT INFORMATION BELOW SoclaI Security Number Date of Death INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY Ccu1Iy Code VB 21 07 fie NIInber 00035 Date of Bir1h 174-20-9687 12127fOO6 0510811912 Decedent's Last Name SufIIx Decedent's First Name MI Ramer . (If App!IClIble) Em. Surviving Spouse'. I~ Below SPOUll8's Last Name I SufIIx I John A Spouse's First Name MI Spouse's SocIal Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS flU IN APPROPRIATE OVALS BELOW i.tJ 1. OrIginal Retum C::J . Supplemental Retum c.") 3. RemaIncler Rell.m (date of death prior to 12-13-82) 5. Federal Eslate Tax Return RequIred CORRESPONDENT - THIS SECTION MUST BE COM Name . FUlunllntenlst CompromIae (date of C) death after 12-12-82) . Oecaclent MaIntained a living Trust (Attach Copy of Trust) 1 . Spousal Poverty CrecIt (date of death C..:> 11. Election to tax lA'1der See. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) TED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORIIATION SHOULD BE DIRECTED TO: Daytime Telephone Number 8. TolaI Number of Safe DeposIt Boxes C::l 4. limited Estate c:::J C:J 6. Decedent DIed Teslate c::::;, (Attach Copy of Win) c:::) 9. Utlgatlon Proceeds ReceIYed c.:) Albert W. Ramer Firm Name (If Applicable) (717) 567-3491 City or Post 0IIice Newport State ZIP Code 17074 ~ ~ REGISTER ~ USE ON~ ~~i. ~ ~cn ." o ()~... .., ~l o ".. ~> DATE~~" o:! eN -0 -1""> {ri rl'l C) (~-) (.::> (";') ::0 :'--1 1:::::;/ c:::},-n _-,-) c:J ("") C) "-,'. "'\-, _...., ;;; ('"') .-~., n, t:";} (":) "To Fat Ine at addr8ss 181 Creekview Drive Second Hne of address PA , inc:tudIng 8CllOIIlplII1ylllCheclules and ....11I8I..., 1nI to the bat d my knowledge and belief. the plII'IlIll8I ~lll1IlI".1s I.-d m" ilfoullolllo.il d which pnIp8nIl' h8a 8If'/ knowledge. RN DATE 06120/07 ADDRESS 181 Creekview Drive, Newport, PA 17074 SIGNATURE OF PREPARER OTHER THAN REPRESENT. DATE ADDRESS USE ORIGINAL POWM ONLY L 15056051058 Side 1 15056051058 -.J .-J 15056052059 REV-1500 EX Decedent's Name: RECAPITULATION John A Ramer 1. Real eslate (Schedule A). ............................................ 1. 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2. 3. Closely Held Corporation. Partnership or 5oIe-Proprietorip (Schedule C) . . . .. 3. 4. MortgageS & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4. 5. Cash. Bank Deposits & MiscellaneoUs Personal Property (Schedule E) . . . . . . .. 5. 6. JoinUy Owned Property (Schedule F) Separate Billing Requested. . . . . .' 6. 7. Inter-VIVOS Transfers & MiscellaneoUs Non-Probate Property (Schedule G) Separate 8iIIing Requested.. . . . . .. 7. 8. Total Gross Assets (total Unes 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 Unes 9 & 10). . . . . . . . . ... .. .. . .. . . .. . .. . .. .. .. .. 11. 12. Net Value of Estate (Une 8 minus Une 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been made (Schedule J) ... . . . . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subject to Tax (Une 12 minus Una 13) . .. .' . ., .. .. . . ... . . . . . . . 14. TAX COMPUTATION. SEE INSTRUCTIONS FOR APPUCABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_ 15. 16. Amount of Line 14 taxable at lineal rate X.O _ 16. 17. Amount of Line 14 taxable at sibling rate X .12 17. 18. Amount of Line 14 taxable at collateral rate X. 15 18. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 15056052059 Side 2 L 174-20-9687 Decedent's Social Security Number 0.00 93,500.08 0.00 0.00 895.00 25.699.26 0.00 120,094.34 5.507.19 3,231.37 8,738.56 111,355.78 0.00 111,355.78 5,011.01 . 15056052059 .-J . REV-1500 Ex Page 3 Decedent's Complete Address. Fl" Nv..... 00035 . , DECEDENTS NAME DECEDENrS SOCIAL SEaJRnY NUI&R John A Ramer 174-20-9687 smEET ADDRESS Thomwald Home, 442 Walnut Bottom Road crrv I STATE I ZP17013 Cariisle PA . . Tax Payments and Credits. 1. Tax Due (Page 2 Une 19) 2. CreditslPayments A. Spousal Poverty Credn B. Prior Payments C. Discount (1) 5,011.01 6,793.86 233.25 3. Interest/Penalty if applicable D. Interest E. Penally Total Credns ( A + B + C ) (2) 7,027.11 TotaIlnterestlPenalty ( 0 + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. is is the OVERPA YIIENT. RIlIn oval on PIge 2, Une 20 to request . nd. (4) i 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. ~is is the TAX DUE. I A. Enter the interest on the tax due. ! 2,016.10 B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5) (SA) (58) Make Check Pa able to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING ESTIONS BY PLACING AN .X" IN THE APPROPRIATE BLOCKS 1. Did decedent maIre a transfer and: Yes No a. I8tain the use or income of the property ;.......................................................................................... 0 [i] b. I8fain the r9Jl i) designate who shal use property transferred or its income; ............................................ 0 [i] c. retain a reversionary interest; or................. ........................................................................................................ 0 [i{] d. receive the promise b' life of either benefits or cate? ...................................................................... 0 iii 2. If death occurred after December 12, 1982, d' decedent transfer property within one year of death without receiving adequate consideration? ..... ........................................................................................................ 0 iii 3. Did decedent CMIl an "in trust for" or payable death bank account or security at his or her death? .............. 0 [iJ 4. Did decedent own an Individual Retirement nt, annuity, or other non-probate property which contains a beneficiary designation? ............... ........................................................................................................ 0 [iJ IF THE ANSWER TO ANY OF THE ABOVE QUE5nONS YES, YOU MUST COMPLETE SCHEDULE G AND ALE IT AS PART OF THE RETURN. For dales of death on or after July 1, 1994 and before January ,1995, the tax rate imposed on the net value of transfers to or for the use of the sllViving spouse is three (3) percent [72 P.S. ~116 (a) (1.1) (i)). For dales of death on or after January 1, 1995, the tax rate i 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 exel1l)t a 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 adoptive parent, or a stepparent of the child is zero (0) percent The tax rate imposed on the net value of transfers to or for 72 P.S. ~116(1.2) [72 P.S. ~116(a)(1)). The tax rate imposed on the net value of transfers to or for the Section 9102, as an individual who has at least one parent in child twenty-one years of age or younger at death to or for the use of a natural parent, an 2 P.S. ~116(a)(1.2)). use of the decedent's lineal beneficiaries is fou' and one-half (4.5) percent, except as noted in of the decedent's siblings is twelve (12) percent [72 P.S. ~9116(a)(1.3)). A sibling is defined, under man with the decedent, whether by blood or adoption. r REV-1503 EX+ (6-98. SCHEDULE . COMMONWEAlTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF RLENUMBER John A. Ramer 210700035 All property joInt1y_ lid with right of lurvlvonhlp IIIlIIt be dllc:loNcl on Sc:hecIule F. ITEM VALUE AT ~TE NUMBER DESCRPTION OF DEATH ,. John A. Ramer. FIe No.21 07-0035. ~ eN 07500069. AIJert W. Ramer 46.750.04 2. John A. Ramer. FIe No.21 07-0035, ~ CN 0750070. Bonnie A. Casebeer 46.750.04 (See aIIached oopies) (Forms sent to ~ oIIioes on 03I22J07 AIIn: Judy Walls) TOTAL (Also enter on ine 2, RecapiIuIation) $ 93.500.08 (If more &paCl is needed, insert additional sheets of the same size) REV-1508 EX+ (6-98) *' SCHEDUU E ~, BANK DEPOSITS, & MISC. COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN ' PERSONAL PROPERlY RESIDENT DECEDENT ESTATE OF FILE NUMBER John A. Ramer 210700035 Include the proceeds of litigation and the dale the proceeds were received by !he estate. All property jolntly-ownl tel with right of lurvlYorshlp mull be dllClolId on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEAllf 1. CIoIhing, hearing aides, glasses donalBd o charily. No oIher personal property. 0.00 2. Cremation Servas. Inc. - prepaid 895.00 lUI'AL (Also enIer on line 5, RecapiluIation) $ 895.00 (If more spacl is needed, insert additional sheets of the same size) REV-1509 EX+ <. SCHEDULE F COMMONWEAlTH OF PENNSYLVANIA "OINTLY-owNED PROPERlY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER John A. Ramer 210700035 If an aaaet was made Joint within 01 . year of the cltctdtnt's data of dtath, It must be reported on Schtdult G. SURVMNG JOINTTENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Albert W. Ramer 181 Creekview Drive, Newport, PA 17074 son B. Bonnie A. Casebeer 20 Drive, Hershey, PA 17033 daughter C. JOINTlY-owNED PROPERTY: LETTER DME DE OF PROPERTY ~OF lIo\1E OF DEATH ITEM FOR JOINT IWlE IICllIlE MAlE OF FIlWICW. NID IWI(ACCOtMr IUIIIER OR SMUR lIo\1E OF DEATH DECD'S VALUE OF IUIlER TBMNT JOINT IIlENTFYIIG IUlllER.Ii IrAcH DEED FOR JOIIllY-HEUl REAl. ESTATE. VALUE OF ASSET INTEREST llECEDENT'S INTEREST 1. A. OlII27AJ4 FranIcIn CoII1ly Teachers Cl ~ Union, AccotI1t, 7311 55,799.13 33 18,599.71 B. OlII27AJ4 FranIdin CcuIly Teachers a [edit Union, AccotI1t, 7311 2. A. 08127AJ4 MlT 8ri, Account, ~ 1&17 21,298.66 33 7,099.55 B. 08127AJ4 MlT 8ri, Account, ~ 1&17 1UfAL (Also enter on line 6, RecapitUation) $ 25,699.26 (If more spac is needed, insert additional sheets of the same size) I __ Franklin CountyT..chers' . Union 1156 Kennebec 0riv8. p'Oo Bole Ch8mbenibUrg, A\ 17201-0505 _.Idcu.Ofg D'::iECT rNOU1?=S TO: Phone: n7..ztl4.1l106 Tal FIw: ........7828 - - - - JOHN A R.AMBR ALBERT W R.UlBR 181 CRBBJtVJ:D DR NEWPORT PA 17074- 00 you want up-to-date information about your ace access. It is safe and secure, and best of all, i SUPF.Cl: 01 BASB SImItB ACC!T STATBMBNT PERIOD 01/01/07 - 01/31/07 BBGINNING BALANCE 55,799.13 DEPOSITS 1 970.30 WITHDRAWALS 2 56,76...3 ENDING BALANCE 5.00 DIVIDEND YBAR-TO-DATB DIVIDEND THIS PBRJ:OD AVERAGE DAILY BALANCE DAYS DIVIDEND BARNBD .00 .00 .00 o st7FPJ:X 01 BASB SRARB ACC!T HISTORY DATE 1/02/07 DBSCRIPTION DFAS-CLBVBLAND 1/02/07 CBBClt tfXTBDRIUfAL RBCLAMATN 1/2/07 TRANSACTION 970.30 DFAS-CLBVBLAND 55,7'4.13 970.30 1/18/07 1/25/07 .. ~~ Notic.: _ rc9lIC8. side for isportant iDfol:aU_ regacd1"11 v-r rigbt. to dispat. errors _ your sUt_c. ACCOUJIIT RUMBBR. 7311 TrD CD RBCJaVBD: .00 PASB JnDIBBR: 1 of 1 20 _ 1_ ..... you 801' l::be..1I: ou~ our 10www 1CNIID araa_ .~ www.'IaHu..ol:'g' a:Iad f!iJacl ....t: It"" 1"" you "all go I nts? Then signup for the Playground FCTCU's 34-hour Internet account is available when it is convenient for you. Y 01' YOUR ACCOUNTS ACCOUNT BALANCE 56,769.43 RBT NET 975.30 5.00 DEBITS DATE CREDITS I ACCOl NT NUMBER I 5.00 2/27/07 329971 I CHECK NUMBER TRANSACTION DESCRIPTION CHECK AMOUNT DISBURSED CHECK WITHDRAWAL JOHN A. RAMER NAME' 5.00 SEE WHAT'S NEW AT FCTCU ON OUR WEBSITE WWW . FCTCU . ORG ACCOUNT NUMBER I ACCOUNT BALANCE I ADDITIONAL INFORMATION 7311-01 TELLER-07/TRANSACTION CODE-14 FRANKLIN COUNTY TEACHERS' CREDIT UNION Chambersburg, loA 17201 04/24/2007 TUE 16:18 FAX 7172641441 A Icranklln County Turhet$. Credit Union WnrldR/: r"~(t"I(:r ,,, M""e ,lfe (;rtttle April 24, 2007 ," ,,' Albert W. Ramer 18 I Creekview Drive Newport, PA 17074-7659 .. ,.,. .......... ............ . .... Re: John A. Ramer Account Number: 7311 :,.:.. ........ I~ .:~:':.~~~ ", Dear Mr. Ram.er. 19l UUZlUUJ 1156 Kennebec Drive P.O. Box 505 Chambersburg. PA 17201 Phone: 717-264-6506 T~IFree: 888-~7828 Fax: 717.264.1441 .,ww.fctC:lI. "'r: The account of John A. Ramer a joint Share Savings account, with survivorsbip~ held between John A. Ramer, Albert illiam Ramer. and Bonnie Anne Casebeer. I have attached a copy of the most t account signature card for your reference. If you have any further questions please feel &ee to contact mc. -ML ", 04/24/2007 TUE 16:18 FAX 7172641441 I i I ~ I I ~ I ! .li I I ! i li.J j ... ::: ~ a. .!l! 'ii j .~ Jl - i1J I tl !~5 ' I I i I I IJ ,s l! 1m I ' I j I I I ! I f ; If 1 /lia:8 o 0 OJ ~ ::t 9 1: I r~: i~l ~'k ~ II & ~ . 'S I' I .... a. ~ ... <: ..~ ~ v ,~ ... .. .tl 3 2 ~~ ~ ~ .g U <: 1!! ~ ,2 ::> a: kl ~ III' 1? 4( tt) 0: .. ... - ~ ~ :s I..., 8 - ..' ~ ~ 0 n '0 ,- .:!l c: ~ .:- -.c ~ I !J i ! I I.ft ! a Q; lil iiiS '" ,.., .)< .... en l5 I I 'i I... ~.~ · f J j ~. ,~~ ~ - ~: i; ,; 2 t .!-8;I~fJI!~ w'VJ c)j :I w ~ 0 6 ~.'::?~OOOOO o , ,. :;:::0 ~ i i i ~':."'-: '. , & 000 ?~:. . Th ~ 1!.2~ ;~~;/ . :..",., ~ :i ! r..... . it a n c~ ~:t ,'...:.: t 000 .::.:.~ f~::~ Q t;':;O r.~ fD I .fft Mi ~~~! ,: . 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I I~ ' . ~ liE z~iI...! -.o~g. ~~SlI'f rno~Q.w J :5 o :; !l o 1 {"Iii "ll..J!Ci : Jr- ~ I -6i " ~i .si!ft~ 13 -u"'S! :il~;: .' 1iI,,- ... t .', !!... J .!1 ~ - :lijou~ Ii -- ~ - "E~f"J ~J~;o:; 5~5J.1 ." ..,i!S....~~ ...... r.: u!lOW .. , -':~~vl z' 'ic!eli o ij,oij' i 'M'!:'Ii i' N f~- .!!'ti - ~~J. ~ ~ . ~ .~ I X' 1!!v i~ s !lI~.s,lit: .c: a#_... , t-i'I"'w ... g- f~ .... li!t~:s "v": o!"- . . ..... i'li 9 ~ ;; i .1 '" s ,- gQ..sr~i '~if'" i . .. \ " '51 :I ~ 'l' '.. .J =- :a ~ 1iI 'So -11"'li .' : fl '0 :: ~ i- ll!! .:s :.' &01 .. ._ . lI' . .. .. 'ti -i -l!I ~ ...,: ~ 8 j i III 3'~'/ ~:::'-Q' : . . .' ,S! i. ....i! . ,;:" "" . !II " :.m 'II 'ii'," . o.c ...t; ill' :.' C . I .11).)' :~i'j:: :l~~ ~<<::: :.lr:~-z: ... V5 ::J'$::~ .' .' :-:PSJ'.; I E'j~f/ .:': I ~ ,'of. ....: . u,. "'':'ll! ~ l:: 'ft::'" :j:< ~ N"'. -..; .",.cr: ; ~ j:~..,~..o.:: : ~I :~.i'~"li.'. '" ~ '!~""'PD . ...., ~ ' !.,. ~v .0 ..':." ..' ~.. ~. ;:....: ~ fl. '::::;-:'. I~""" '~'~';~!.~~>'" ::. iJI ' .., ..' .. ~.. ~.~.... :11';;::':"8.. '. ~:.a:~, " z}li~~: .:!i!":. i~ !: .:~':. ..... ~... . .' /'" . I ~ 't::~ ~(}O'.. i cr~'-'''''', IS :":~'::::'"":'''''~ >< x ~j~~?rp;:, i""J; tE't il!l ..f, I . Bit iJ )8 .:6 j: . Ii f' ~ I '- "! i~1 6J.. Ii -'" ~ eta !_.i! 1"!- I jl Ij . i J if ~ .. .s) .a .. ~llr - !! ' .e , ~,II u.. s..cl ~il ,!>S ~ ~, o j ;c i '. . .'~ .--... .' r- :; t:r:~: ... -..: ~ ~ "''''6 CL .... -- .:: a. - - C\ '.. N!~: '" !Q *' ! i!! l.8' ~li5~ 8 -Q.1t iffi ;; 'a!~l!!i~ isz.j'" ~ C5-,..,a . -- ~ L' ~ en .... % :;... 05 0 ,;: Q . ........ "'r'o ....,.- ..............-.........,...... ..-.............. . . IgJ UU3/UU3 J m M8EfBank 7~~....< ::\<:~(.OUMi:TYP:E' >::', 25732617 RELATIGNSIIIP CHECltDC WITH ImTEREST .a JOHN A RAMER ALBERT W RAMER BONNIE A CASEBEER 181 CREEKVIEW DR NEW PORT PA 17074 INTEREST PAID YEAR TO DATE 1.90 o '''1'" lit 017 18793 ACCOUNT SUMMARY 11). 21,298.17 . MIDUIIT II) .... . MIDUIIT 11). I .... 1 I '::'bAT .::: ":. .: '.:c. '" ..::::. . ::::. :." ACCOUNT ACTIVITY .. : :iIri.h::" 01-06-01 1ISIN11I118 IALAllCE 01-11-11 INTEREST PAYIISI'T 01-11-01 CLOSEOUT EllDDC BALANCE I.......... .................. ..., .::.:::::$tl.tiNHt~'PQD::::::.. .:~. .. ... ,;;...~~~;,,:~; .~~; ... ..... PHILADELPHIA AVENUE MIUII' Zl.,ZW.66 1.29 ....:....-:.. :::~ ,;;<~."':~~::::: 0.29 21,298.66 ANNUAL P~RCENTA8E YIELD EA_ED. t." 1. A t1,... FOR YOUR TIIOU8IfTS? VISIT All tIlT IMK BIWICH BETWEBI .IMlMRY 16 AND FEBRUARY 16 TO IECEM AN DIIl'ITATICIN TO PAltnCIPATE III OUR CUSTOIER SERVICE SATISFACTICIN SUIVEY. CGlR.E1E THE SUIIVEY F'oIt A CHANCE TO VIII A GRAND PRIZE OF $1,800. NO PURCHASE OR TRANSACTION IfW .IIAIeT8ANICSURVEY .aIII. RY. FOR COItPLETE SWEEPSTAKES IU..ES VISIT: ..,,:]..::: IOFI if:" E'':",: .... .21,298.37 .... ..... r REV-1511 EX+ (12-99. SCHIDULI H COMMONWEAlTH OF PENNSYLVANIA RlNERAL EXPENSES & INHERITANCE TAX RETlJRN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF F1LE NUMBER John A. Ramer 210700035 DebII of cIececIenI mUlt be reported on Schedule L ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Cremation Services, Inc. Pnlpaid by 895.00 2. AJJItI Memorial HomeICremaIion - , Inc. (lI11, aemaby chg, coroner chg., DeaIh Cert., obil) 1,053.19 3. New BIoomfiekt Cemelary 125.00 4. Chun:h service, United MeIhodist CIud pasO, organist, ctuch use, meal 350.00 5. Flowers 73.00 6. Boyer Funeral Service 500.00 7. Rice MernoriaI Works 165.00 B. ADMINISTRATIVE COSTS: 1. P8nIonaI R8pnIIeIItlIti,.'s CclnIIisIiolIS 2,000.00 Name of P8nIonaI R8pnllel1I8lIAl(s) A bert W. Ramer - Executor Social SecuIIy NlInber(s)/EIN NlInIIer ( · P8nIonaI R81n-lWha(s) Slreet Address 181 Creekview [ rive cay Newport Staae PA ~ 17074 Yt&(s) CommlsIion Paid: 2007 2. Albney Fees 0.00 3. FlIIIiIy ~: (If decedent's acldreIs Is not lie SlIIIlI as can.t's, aIIIIc:h expta......,) 0.00 CIaiIrBlt Slreet Address cay Staae -~ ReIaIioIlIlIlip of CIIIinwlt 10 Oeclldent 4. PnlbaIe Fees 256.00 5. Aa:ountlI1t's Fees 6. Tax ReUn Pnlplnr's Fees 90.00 7. TOrAL (Also enler on Hne 9, RecapituIaIion) $ 5,507.19 (If more space is needed, insert additional sheets of the same size) REV-1512 EX+ (12-03) . sca....u I DEllS OF DECEDENT, AGE lIA8I.I1IES, & lIENS COMMONWEALlH OF PENNSYLVNM NlERl1MCE TAX RETUlH RESIlENT DECEDENT mATE OF John A. Ramer RIport ..... Incwnd .., 11II -.....c prior to 2. 3. FI.E .-eR 210700035 ..... .......... URpIId . 0111II dill 01..... ....... ........_ .... ........... VALUE AT DATE OF DEATH ITEM NUMBER 1. Providence Place, Chanlbenllug, Pa - living charge - 0eceI... 548.93 405.75 10.00 4. VIIaI Records charge - n&riage &sense to State Employee Retirement . name change for Bonnie A. (Ramer) Casebeer 157.26 5. 6. Morrow Tax ServiaIs - tax pnIp8I'8tion for FederalInoome Tax. 2006 PA State Inoome Tax, 2006 85.43 90.00 7. 8. 1,713.00 221.00 TOTAL (AIlIo.... on Ine 10,~) $ (If more splIC8 needed, in8ert 8dcIIIon8I sheeIs of.. SlIllI sIz8) 3,231.37 R~1513 EX+ (9-00) . SCHEDULE J BENEFICIARIES COMMONWEAl.lll OF PENNSYLVANIA INHERITANCE TAX REnJlN RESI)ENT DECEDENT ESTATE OF John A. Ramer NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIIUTIONS rl1dude MWd. ~ cIIIIIIJuIons........lIlder See. 9116 (a) (1.2)) Allert W. Ramer. 181 CnMIItview Drive, PA 17074 FILE NUMBER 210700035 RELATIONSttF TO DECEDENT AMOUNT OR SHARE Do NcIt lilt TNIIII(s) OF ESTATE son 55230.39 2. Bonnie A. Casebeer. 20 Cambridge Drive. fiershey. PA 17033 daughter 55230.39 ENTER DOllAR AMOUNTS FOR DISTRI8UTIONS SHOWN ABOVE ON LIES 151HROUGH 18, AS~TE. ON REV-1500 COVER SHEET n NON-TAXABLE DISTRIIUTIONS: A. SPOUSAL DISTRIIUTIONS lNlER SECTION ~113 FOR WHICH AN B.ECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL TOTAL OF PART . - ENTER TOTAL NON-TAX~ DISTRIBUTIONS ON UNE 13 OF RE\L1500 COVER SHEET $ (If more spec is needed, insert addllional sheets of the same size) REV-1313 EX (3.Q4) *' A PLICATION FOR REFUND OF PENNSYLVANIA INHERITANCElESTATE TAX Official Use Only COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF NWlDUAL TAXES DEPT. 280801 HARRISBURG. PA 17128-0801 TO: PA Department of Revenu Bureau of Individual Taxes Dept. 280601 Harrisburg, PA 17128-060 OffIcial Representative Decedent Data FROM: Name Albert W. Ramer Address 181 Creekview Drive Newport, PA 17074 Name of Decedent John A. Ramer File Number 210700035 Date of Death 12/2712006 Social Security Number 174-20-9687 Phone Number (717) 567-3491 e-mail Address ramenn@pa.net The undersigned requests a refund in the amount of $ referenced decedenfs estate. 2,016.10 for the above REFUND REQUESTED ON: o Original or Supplemental 0 Joi t1Trust Assets III Remainder Return 0 Estate Tax Probate Return EXPLANATION OF OVERPAYMENT ,..., ~ c:::::> ~!.:~J -1 The total original tax due was $5011.01. C its and payments were made in the amount of $70 6793a; in t8 ~3 payments during the 90 day period immediat y following death and $233.25 in discount). This I _ ve~meIi[9€3 $2016.10. ~CJ5~ - 9.:] 23 o~~ (~. c> >>- -n -n (") ::II: ..- --n o _ :0::: 0 : ~ <<;? ~:: rn ::;t 0 (,'j Cio,) ~~~ Signature O~~VD/' P..... .lIow four six weeks for the procealng of your refund request.