HomeMy WebLinkAbout06-22-07
....J
15056051047
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 Number Date of Death
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Date of Birth
/
Decedent's Last Name
Suffix
Decedent's First Name
MI
1,
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's First Name
MI
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW..
~ 1. Original Return c:>
c:>
4. Limited Estate
c:>
3. Remainder Retum (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
2. Supplemental Return
c:>
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 Daytime Telephone Number
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
8. Total Number of Safe Deposit Boxes
c:>
I
City or Post Office
State
ZIP Code
1 /i7 1i1...Z..i5iOb q
""0
REGISTE~~ILLS US~LY
---:0 '-
g~-o(") ~
C- >r--
~o)S3 ~
CJ ^
82~
~ ::0
:o-f
J1:)ATE FILED
:::J>
:3:
~
)rq
rlC)
{..O
tJ t~~
~c)O
. 4 ~'1'-'1
::!f
".. -. (~)
(0. rTl
(" C')
_:_;1
First line of address
Second line of address
riA
I
Correspondent's e-mail address:
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.
I E FOR FILING RETURN DATE
Side 1
L
15056051047
15056051047
....J
~
~
15056052048
REV-1500 EX
Decedent's Name:
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) c:::> Separate Billing Requested . . . . . .. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) c:::> 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, 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 -----r----: 18.
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
Number
I · f 8
c:::>
15056052048
~
REV-1500 EX Page 3
File Number
Decedent's Complete Address:
DECEDENT'S NAME
~/iz ttbeJ.h t.b Vi (5 e
If) - IS+f1 ~-free-r
ie W/.s
EhrhtlY'
STREET ADDRESS
CITY
Nuu (!UIYl bttunA
STAn
~,4,
ZIP
111l7(}-151
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
/~/I, /&
Total Credits ( A + 8 + C ) (2)
.--"
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( 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) I~ II, IS
(5A) ~
(58) /),11, f<g
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 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROP~IA TE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;.......................................................................................... D ~
~: ~::::~ :h~e~;~i~~:~sii~t:~::;:~..~.~.~~~.~~~. ~~~.~~~~~.~.~.~.~~.~.~.~~.~~~ .~~.~~~. ~~~.~.~.;.: :::: ::: :::: :::::::: ::::::::::::::::::: ::::: B ~
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 O.nJ-)
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. 99116 (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. 99116 (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 zero (0) percent [72 PS. 99116(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. 99116(1.2) [72 P.S. 99116(a)(1)].
The tax rate imposed on the net value of transfers to orfor the use of the decedent's siblings is twelve (12) percent [72 PS. 99116(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-1508 EX+ (6-98) '*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
ESTATE OF
RI/ZlLbe+h jOtLt":je J...etd/~ E h,hdr-t
Include the proceeds of litigation and the date the proceeds were received by the estate"
All property jolntly-owned with right of survivorship must be disclosed on Schedule F"
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
-:I {
-*;Z
""".Z1
:ttk
-:tJ:.::s
-:Jitp
..Jt:1
1P
150,00
~50. tJO
;100, 0-0
~;;~(7tLl App~~. /(!{ath,nq
-(win &J
!-I H (! h{L~k
:D(e~~d~ (~)
J e t-Je-I (Lj
0ood7 - b~o~, ~Yn/~h~~ - la-(#)r~
Au-ilJ mO bl'Lu- - I qq (p - ""jjJui.~/C liegiiL 4- ttoot'
, 0 0 , d-()
2{)O.tr~
226.tnJ
:2..J (p 5 . ~
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
f] if-{) q 0
0.00
REV-15D9 EX+ (6-98.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
FILE NUMBER
tl/ztl:i';eff, AOu(~e /..l'li/;~ ~hrhd/t-
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. /..,'ndll ~. Ht'l~ef")plu.g
B. jttndrtt -/{. I()bl&.~
C.
40 ():3 (! ht/c.y I J)-r, Ye
II a ,n' ~ b U'~c.t)t fir, 11/0 q - 1-/-/-I-cJ..
'/15 - 15-1!> ,;jlreet 0
N~uJ~beJc.Ld:Atei,-l(;(, 111i?(}-15I~
~ hTM..
~,,~-frM-
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND 8ANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECO'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY.HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST
1. A. 1- /1-If7 t!..i!i ~~ n::, a~ /tz.. '~, ()~O, ~+
trl(!~ v/I/-O '71f4 ~ 51lk uS 16,/7
~ A 3..~ .3-18 t-:f1-un'4 :BUlK. ftf ~/<j{ '-Id-.,q(, .!:J-,z /+~/, t.fg
rtr!! ItJ J /)0 581 q Il,
~. 13 q-11- 1~ ~;-H1Pn'" J!u.nK .fA, l J/.jj'
Ir/e- -it /0/1)0 1 ~ B E ~ ~
.4-, E>, Ir 'Z-8lJ J,""-h'j bLi& ve& e~ fJu" -Jr~
( beL,t<J
nDtkb'H)
~~ ])en~ ; tern-:J NDT I " ?~ti
1'(\ +n,:, ~.~ ~ -#.uJ uJer~
P(~V;~ ~ t"ernit:f.qJ... t't.~ ~
Il:i:l.tt.(l h.d e(iJ etA.. m€ nr,dJ .
TOTAL (Also enter on line 6, Recapitulation) $ '7 q 3&, ,,~
(If more space is needed, insert additional sheets of the same size)
REV-1510 EX+ (6-98*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF t:
!:-I i ~(LheJh
FILE NUMBER
J...f)ai~e J..eu)i~
t: h Y'ht'if-t
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.
ITEM DESCRIPTION OF PROPERTY
INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST f1F APPLICABLE) VALUE
1. lhl!frtJ p'1>,,'t Itn L/ fe Ir0u Y dIJ (!e t!Nn{ld ny he J I tI!.
:iR.. it ~ ~ n -tr A.-(i 1:.. -1:L '7 qz - /-f{)Z- 005 A B ~filtelu l,.. J,~ 5./}'/-.
TOTAL (Also enter on line 7 Recapitulation) $ 13/5'74-.4-& 0.00
4-~
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+ (12-99)_
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
FILE NUMBER
EI/ za~ hOlli~ LelJJi;j Eh yhtU~t-
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
Not lln~d tn.4i'\i~. ~"'Li.nq ~ jtem~
/AJd(! p (e V, lM,L~Ly (e mrtt~& tl..6 ~
td:l:t<<Lheel }..o eu m~-tInt
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:
3.
AttorneyFees tv1tlri~1e- f. Ha..un 0-.6Ck <2./~ ~~I d~/ p~~vi~\
I LJ' r--@rT)'1t'i!'t:\.. I ~ pA.t-"- /
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant .::5 tl ~(ll 4<. I() vi Ct.d
Street Address If A ~ 1. tt (\ ~
City fA'" ~ (JJL~
~
I 8{o, ()~
-3500, IJ--()
2.
State
Zip
Relationship of Claimant to Decedent
tiL.o_j kt-lk
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $ !J It! 2{ (p, (JJ(JO
(If more space is needed, insert additional sheets of the same size)
.~
LAST WILL AND TEST AMENT
r'II C.' ..;;1')
l....../ Ci,V ,
./ i
OF
LOUISE L. EHRHART
I, LOUISE L. EHRHART, now domiciled in Cumberland County, Pennsylvania, declare
this to be my Last Will and Testament. I revoke all other wills and codicils that I may have
previously made.
Article I
My just debts and expenses of my last illness, funeral, and administration of my estate shall
be paid by my Executor from the principal of my residuary estate as soon as practicable after my
death.
Article II
All inheritance, estate, and succession taxes (including interest and penalties thereon, but not
including any generation skipping tax) payable by reason of my death shall be paid out of and be
charged generally against the principal of my residuary estate without reimbursement from any
person. This provision is not a waiver of any right which my Executor has to claim reimbursement
for any such taxes which become payable as the result of any property over which I have the power
of appointment.
Article III
I give, devise and bequeath in accordance with any memorandum which I have either
handwritten or signed, located with my will or with my valuable papers and found within 30 days of
the probate of my will. Gifts may only be to persons who survive me or to organizations which exist
at my death, and if there is a conflict, the memorandum having the latest date shall govern.
Article IV
All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever
situate, I give, devise and bequeath IN TWO (2) EQUAL SHARES to my daughters: FRAN
WINTERS, of Aston, Pennsylvania, and LINDA HASSENPLUG, of Harrisburg, Pennsylvania.
If any of my beneficiaries predecease me or fail to survive me by thirty (30) days, I give,
devise and bequeath his or her share to his or her issue who survive me, per stirpes, or ifhe or she
have no issue, the share(s) are to be added equally to the other shares.
Article V
I nominate, constitute, and appoint my daughters, FRAN WINTERS and LINDA
HASSENPLUG as Co-Executors of my Last Will and Testament. I direct that my Co-Executors be
permitted to serve without bond and in addition to those powers granted by law, I grant them power
to distribute in cash or in kind in like or in unlike shares and to file any qualified disclaimer I could
have filed ifliving. My Executors shall receive reasonable compensation for services rendered to my
estate.
Article VI
In addition to the powers conferred by law, I authorize my Executors, in his/her absolute
discretion:
(a) to retain in the form received and to sell either at public or private sale, any real estate or
personal property except that which I specifically bequeath herein,
(b) to manage real estate,
(c) to invest and reinvest in all forms of property without being confined to legal
investments, and without regard to the principal of diversification,
(d) to exercise any option or right arising from the ownership of investments,
(e) to compromise claims without court approval and without consent of any beneficiary,
(f) to file any federal income tax return for any year for which I have not filed such return
prior to my death,
(g) to make distributions in cash or in kind, or in both, and to determine the value of any
such property,
(h) to employ any attorney, investment advisor, or other agent deemed necessary by my
Executors; and to pay from my estate reasonable compensation for all their services,
(i) to conduct alone or with others, any business in which I am engaged in, or have an
interest in at time of my death, and
- 3 -
CD to receive reasonable compensation in accordance with their standard schedule offees in
effect while their services are performed.
IN WITNESS WHEREOF, I, LOUISE L. EHRHART, hereby set my hand to this my Last
Will and Testament, on ~ ,'S; i1PO d ~ 2002, at Harrisburg, Pennsylvania.
)<0 _ y:.,/ ;::' /!
/'::::/; ,:':-L~ Cd, ~MJlA,d
LOUISE L. EHRHART
In our presence, the above-named LOUISE L. EHRHART signed this and declared this to
be her Last Will and Testament and now at her request, in her presence, and in the presence of each
other, we sign as witnesses.
Name
Address
6'~f~ Sir '-rhC)(ftQS (if Ifb3 fA 17/09
PJi8((~(Th:xna6 (~.)P^l \71~'
"-"-'
r {
~'Ft,J~ .C~lcn
- 4-
I, LOUISE L. EHRHART, Testatrix, who signed the foregoing instrument, having been
duly qualified according to law, acknowledge that I signed and executed this instrument as my Will,
and that I signed it willingly as my free and voluntary act for the purposes therein expressed.
Sworn to or affirmed and
acknowledged before me by
LOUISE L. EHRHART, the Testatrix
on ~ - ,-5' 2002.
L ~
~ / . ~'d:/(].L
,/ . ~-a. /A~;;;;
LOUISE L. EHRHART
NOTARIAL SEAL
JESSICA A. HOLLAND, NOTARY PUBLIC
CITY or HARRISBURG, DAUPHIN COUNTY
MY COMMISSION EXPIRES MARCH 4 2006
We, the undersigned witnesses who signed the foregoing instrument, being duly qualified
according to law, depose and say that we were present and saw the Testatrix sign and execute this
instrument as her Will; that she signed and executed it willingly as her free and voluntary act for the
purposes therein expressed; that each of us in her sight and hearing signed the Will as witnesses, and
that to the best of our knowledge, that she was at that time eighteen (18) years or more of age, of
sound mind, and under no constraint or undue influence.
Sworn to or affirmed and
subscribed to before me
byr~nd<u<;K~~
and \F'I ~1. ("'. . , ,
witnesses, on :;;; . ~-
,2002.
MuriediJJ ~ ~~
Witness v
~~nocr.~~()
WIt ess
- 5 -
NOTARIAL SEAL
JESSICA A. HOLLAND. NOTARY PUBLIC
CITY OF HARRISBURG, DAUPHIN COUNTY
MY COMMISSION EXPIRES MARCH 4 2006
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 06157561
DATE 11-22-2006
REY-1545 EX AFP lit-OBI
EST. OF LOUISE EHRHART
5.5. NO. 182-16-6858
DATE OF DEATH 09-26-2006
COUNTY DAUPHIN
TYPE OF ACCOUNT
o SAVINGS
!XJ CHECKING
o TRUST
o CERTIF.
LINDA S HASSENPLUG
4003 CHERYL DR
HBG PA 17109
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
~"iY\~~~AtJPIlIN CO COURT HOUSE
~.RRI8B~RG. nA lil;l
l C 0 u..~ \-tOU-se
Q s. "'\\ ~\e \ ~'tt-
~~'-f
it D \ 3
CITIZENS BANK OF PA has provided the Departaent with the inforaation 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 inforaation is incorrect, please obtain written correction froa the financial institution, attach a copy
to this fora and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Coaaonwealth
of Pennsylvania. Questions..y be answsred by ceUing (717) 737-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 6100587916 Date 02-03-1998
Established
Account Balance
Percent Taxable
A.ount Subject to
Tax Rate
Potential Tax Due
x
2,842.96
50.000
1,421. 48
.045
63.97
TAXPAYER RESPONSE
To insure proper credit to your account, two
(2) copies of this notice BUst accoapany your
payaent to the Register of Wills. Make check
payable to: "Registsr of Wills, Agent".
x
NOTE: If tax payaents ars aade within thrBB
(3) aonths of the decedsnt's date of death,
yOU aay deduct a SiC discount of the tax due.
Any inheritance tax due will becoae delinquent
nins (9) aonths after the date of death.
Tax
PART
ill
A. D The above inforaation and tax due is correct.
I. You aey choose to reait payaent to ths Registsr of Wills with two copies of this notice to obtain
a discount or evoid interest, or you aay check box "A" and return this notice to the Register of
~ills and en official assessaent will be issued by the PA Oepartaent of Ravenue.
B. --~ above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
~~=ebe filed by the decedent's representative.
[CHECK ]
ONE
BLOCK
ONLY
c. D The above inforaation is incorrect and/or debts and deductions ware paid by you.
You aust coaplate PART ~ and/or PART ~ below.
PART
~
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 ON JOINT/TRUST ACCOUNTS
lINE 1. Date Established 1
2. Account Balance 2
3. Percent Taxable 3 X
4. A.ount Subject to Tax 4
5. Debts and Deductions 5
6. A.aunt Taxable 6
7. Tax Rate 7 X
8. Tax Due 8
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on line 5 of Tax C~utation)
facts I
I
$
HOME (
WORK (
TELEPHO
- CrD 7
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
'*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 22
ACN 06157562
DATE 11-22-2006
REY-1545 EX AFP (0'-001
LINDA S HASSENPLUG
4003 CHERYL DR
HBG PA 17109
TYPE OF ACCOUNT
EST. OF LOUISE EHRHART 0 SAVINGS
S.S. NO. 182-16-6858 0 CHECKING
DATE OF DEATH 09-26-2006 0 TRUST
COUNTY DAUPHIN [Xl CERTIF.
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
C wa. '\M<)~~ rllm CO COURT HOUSE
IIARRISBlIRS. PA 1718t
\ eeu.~\- \-\b.\l~Q.. SCf>\N\."~
C ~" \ 'oS \(') ~ '\\ \1 0 13
CITIZENS BANK OF PA hes p...ovided the D.pa...t..nt Ilith the info....ation listed below which hes be.n used in
celculeting the potential tax due. Thei... ...eco...ds indicate that at the deeth of the above deced.nt, yoU we.... e joint own..../beneficia...y of
this account. If you feel this info....ation is inco......ect, pl.as. obtain w...itten co......ection f...oe the financial institution, attach a copy
to this fo.... and ...etu...n it to the above add...ess. This account is taxable in acco...dance with the Inh....itance Tax Laws of the Co..onwealth
of Pennsylvania. Questions eay be answe...ed by calling (717) 787-83Z7.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 6140716446 Date 07-17-1997
Established
Account Balance
Percent Taxable
A.ount Subject to
Tax Rate
Potential Tax Due
x
13.030.34
50.000
6.515.17
.045
293.18
TAXPAYER RESPONSE
To insu...e p...ope... c....dit to you... account. two
(Z) copies of this notice .ust acco.pany you...
pay.ent to the Registe... of Wills. Make check
payable to: "Registe... of Wills, Ag.nt".
x
NOTE: If tax pay.ents a...e .ade within th...ee
(3) .onths of the decedent's date of d.ath,
yoU eay d.duct a 5X discount of the tax due.
Any inh....itance tax due will becoe. delinquent
nine (9) .onths afte... the date of death.
Tax
PART
II]
A. D The above info....etion and tax due is co......ect.
1. You .ay choose to .....it pay.ent to the Registe... of Wills with two copies of this notice to obtain
a discount 0'" avoid inte...est, 0... you .ay check box "A" and ...etu...n this notice to the Registe... of
~WillS and an official assesseent will be issued by the PA Depa...teent of R.venue.
B. The above asset has been 0... will be ...epo...ted and tax paid with the Pennsylvania Inhe...itance Tax ...etu...n
to be filed by the decedent's ...ep...esentative.
C. D The above info....ation is inco......ect and/o... debts and deductions we...e paid by you.
You .ust co.plete PART ~ and/o... PART ~ below.
[CHECK ]
ONE
BLOCK
ONLY
PART
[!]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
If you indicate a different tax rate. please state your
relationship to decedent:
PART
~
TAX RETURN - COMPUTATION OF
LINE 1. Date Established 1
2. Account Balance 2
3. Percent Taxable 3
4. A.ount Subject to Tax 4
S. Debts and Deductions 5
6. A.ount Taxable 6
7. Tax Rate 7
8. Tax Due 8
TAX ON JOINT/TRUST ACCOUNTS
x
x
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Line 5 of Tax COBPUtation)
facts I
I
$
Metropolitan Life Insurance Company
MetLife
ESTATE OF ELOUISE EHRHART
C/O SANDRA TOBIAS
715 15TH ST
NEW CUMBERLAND PA 17070
RE METROPOLITAN LIFE INSURANCE COMPANY
INDIVIDUAL RETIREMENT ANNUITY
CONTRACT 792 402 005AB
Dear Ms Tobias
I am writing to provide you with important information regarding the above contract.
The Internal Revenue Service requires we furnish the date of death value for
Individual Retirement Annuities (IRAs) on which a death claim has been filed in case
this value is needed for income tax purposes. In most cases, the
executor/administrator of the decedent's estate will not need the date of death fair
market value for income tax purposes. The date of death valuation will only be
necessary for income tax purposes if one or more of the decedent's IRAs contain
nondeductible contributions and, in addition, the decedent received an IRA
distribution in the year of death.
This is to inform you that the value of the IRA contract as of the date of death,
September 26, 2006, was $18,574.48.
If you have any questions, please contact your representative or call our toll-free
number at 1-800-638-7732. One of our Customer Service Consultants will be happy
to assist you.
Sincerely
Theresa Hornsby
Theresa Hornsby, Manager
Annuity Death Claim Unit
Annuity Operations-Tulsa
November 24, 2006
.~
l-()~ -
-=+~
December 23, 2006
To: Register of Wills, Cumberland Co.
From: Sandra Tobias
Re: Inheritance Taxes on Estate of E. Louise Ehrhart
Please find enclosed a check in the amount of $2,823.30 to pay for the estimated
Inheritance taxes on my proceeds from my late mother's estate. The REV 1500
will be flied by my sisters (Linda Hassenplug, Frances Winters) as they are
executors of the estate. I am sending this now to take advantage of the 5%
discount If the taxes are paid within 3 calendar months of my mothers death
(September 26, 2006).
Documentation Is enclosed to back up this estimate including a copy of the deed
which lists my husband and me as entitled to the house as joint tenants and right
of survivorship. An assessment of the property from Cumberland County, as well
as documents from Citizens Bank regarding a joint checking account held with
my mother are also enclosed stating bills paid on her behalf.
Value of house = $136,090 x..5 = $68,045.00
Amount Taxable from joint bank account = ($2,002.89)
$68,045.00
2,002.89
$66,042.11
X .045 taxable rate as a child of decedent
$ 2,971.89
X .05 discount if paid within 3 calendar months of death
$ 2,823.30
If you have any questions regarding this matter please feel free to contact me.
Sandra Tobias
715 Fifteenth Street
New Cumberland, PA 17070
717-774-4706
Sandra Tobias
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
TOBIAS SANDRA
71 5 15TH ST
NEW CUMBERLAND, PA 17070-1512
NO. CD 007611
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
--_.;'_lc!
ESTATE INFORMATION: SSN: 182-16-6858
FILE NUMBER: 2106-1149
DECEDENT NAME: EHRHART E LOUISE
DA TE OF PAYMENT: 12/27/2006
POSTMARK DATE: 12/26/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 09/26/2006
06157560 I $2,823.30
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS:
CHECK#10006
SEAL
INITIALS: JA
RECEIVED BY:
TAXPAYER
$2,823.30
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
~~~HT OF REVENUE
~U_~F INDIVIDUAL TAXES
DEPT. Z8D6Dl
~RG' PA l7lZ8-D6Dl
..
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 22
ACN 06157560
DATE 11-22-2006
REY-1545 EX AFP <19-001
EST. OF LOUISE EHRHART
S.S. NO. 182-16-6858
DATE OF DEATH 09-26-2006
COUNTY DAUPHIN
TYPE OF ACCOUNT
D SAVINGS
[X] CHECKING
D TRUST
D CERTIF.
SANDRA TOBIAS
715 15TH ST
NEW CUMBERLAND PA 17070-1512
REHIT PAYHENT AND FORHS TO:
REGISTER OF WILLS
C>"~"25>' lr"v"J.11 8U COURT HOUSE
,H'-RRI3BtJRe, PA -l-7-l-81:
~,\.~~) \'~
CITIZENS BANK OF PA has provided the Department with the information listed below which has been used in
calculeting the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiery of
this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach e copy
to this form and'return it to the above address. This account is taxable in eccordance with the Inheritance Tax Lews of tha Cu.lIOnwealth
of .Per,-"sylvaniz:...__~Que::tiDn=-_a:ay"-.b8 answerad-.by-cal-l-ing...('717) 737-8327.,
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 6100768562 Date. 09-17-1975
,
Established
x
6,058.64
50.000
3,029.32
.045
136.32
TAXPAYER RESPONSE
To insure proper credit to your account, two
(Z) copies of this notice must accollpeny your
paYlIBnt to the Register of Wills. Hake check
payable to: "Register of Wills, Agent".
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
x
NOTE: If tax payments are made within three
(3) months of the decedent's date of death,
you ..ay deduct a 5" discount of the tax due.
Any inheritanca tax due will becDlle delinquent
nine (9) months after the date of death.
PART
[!I
A.
[ CHECK ]
ONE
BLOCK B.
ONLY
c.
[] The above inforllBtion 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" end return this notice 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 Pennsylvenia Inheritance Tax return
to be filed by the decedent's representative.
~ The above information is incorract and/or debts and deductions were paid by you.
You lIust complete PART ~ end/or PART ~ below.
PART
~
TAX RETURN - COMPUTATION
LINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. Allount Subject to Tax
5. Debts and Deductions
6, Allount Taxable
7. Tax Rate
8. Tax Due
OF
1
2
3
4
5
6
7
8
TAX ON JOINT/TRUST ACCOUNTS
D~ \ \"i\ \,\,,\$
, D ...-<'- - L 1
c.o) ~ b. ~,
X ~.~
~ ~c.... 3~
- o~~
/___(;ro","-: ~ '- ~
~()4
If you indicate a different tax rate, please state your
relationship to decedent:
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
AMOUNT PAID
I.JL..--
$
Under penalties of perjury, I 'declare that the
~colIPlete to the best of IIY koawledge and belief.
~~~\.h Xrul ~~~':"
facts I have reported above are true, correct and
HOME ("'1\"\) '\-tY:-~~?c
WORK (IS\. ) '1"1 '-l. -'1,t Y. ~)~ l~G \ () <c
FacetWln ~cr~~1I n IIIL ...,. .-"'-.-
PARCEL: 26-24-0809-050. TYPE: R
Municipality: 26 - NEW CUMBERLAND 2ND WD
owner's Name: EHRHART, E LOUIS ET AL
year Group sty Grade Int. Land NBHD LFI
1952. 2 1 B S. 239 2617
Residential value ...( 1628.. 110729
( . % complete, Index: 92.%)
out Buildings (screen 4)......
other Residentials (no. )..
commercial Bldgs...(no. )..
Total Building value............ 111090
current prev FMV cost Fair Market
Land ...... 25000 25000 25000.
Improvments 111090 60110 111090
Total..... 136090 85110 136090
Assessed... 136090 85110 136090
SALES VALIDATION
/OV steb: Ratio:
Analysis: Ratio:
val i d : -
schl: 9 value override:
Nbhd: EVergreen/simpson/oak/Brt
LAF(code)
. ( .)
DwlTyp Ext Walls
DETACH Brick
special-comments
360
I- REVIEW:
L..-- Part Interest:
Ag usePre-Reval
18500
101880
120380
120380
.of .-
Fctr Impact
Land 18 %
1.13
3%
FMVL/AC: /OV FMV/AC:
Acres code:
Deeded. Acres:
.17
sales Date: 06/02/1986
sell price: 10
Adjusted SP:
screen 8 Enter selection>
Index Mode
o -Delete H -Hardcopy U -update x -Exit
Record:
85758
F -print Form B -Browse
F.eetWin screen print for fogels.n, from "CAMA....Login" 10/3/2006 12:12:09 PM
CHANGE NOTICE ARCHIVE CUMBTHVX
PARCEL: 26 26-24-0809-050. OWNER: EHRHART, E LOUIS ET AL
PROPOSED ASSESSED VALUES (same as most recent notice if mailed) Total c&G
Land Bldg Total Land Bldg
05/10/2004 25000 111090 136090 I
HISTORY OF ASSESSMENT CHANGE NOTICES MAILED
MAIL DATE Why FAV LAND FAV BLDG TOTAL I CG LAND CG BLDG TOTAL
05/10/2004 05 25000 111090 136090 I
05/09/2004 18500 101880 120380 I
07/01/2000 05 18500 101880 120380 I
06/30/2000 640 7510 8150 I
screen 9 Enter selection> Record: 85758
Index Mode -Hardcopy U -update X -Exit F -print Form B -Browse
o -Delete H
'\.~\\ L/~/
~"'~~
~ ~:::--
-~hJ~
PARTHEMORE Funeral Home & Cremation Services, Inc.
A Family Tradition Of Caring
Mrs. Sandra K. Tobias
715 Fifteenth Street
New Cumberland, P A 17070
9/27/2006
For the services ofE. Louise Ehrhart
1303 Bridge Street
P.O. Box 431
\Jew Cumberland, PA 17070
:717) 774-7721
:Fax) 774-5546
www.parthemore.com
We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way
we can. Please feel free to contact us if you have any questions in regard to this statement. The following
is an itemized statement of the services, facilities, automotive equipment and merchandise that you selected
when making the funeral arrangements.
Terms
Net 30
Due Date
I 0/27/2006
Account #
2006077.3
Description
Amount
SERVICES & MERCHANDISE
Cremation with Memorial Service
3,275.00
Total Services and Merchandise
3,275.00
Gilbert W. Parthemore,
Founder
Stephen K. Parthemore,
CFSP
CASH ADVANCE ITEMS
, Death Notice, Han'isburg Patriot
120 Certified Copies of Death Certificates
(2) Clergy Honoraria-
Organist Honorarium
Flowers, Fireside Basket
Dauphin County Coroner Fee, Cremation Authorization
325.00
120.00
3UO.00
100.00
96.00
25.00
Gilbert J. Parthemore,
Supervisor
Total Cash Advances
966.00
Bruce R. Parthemore,
Pre-Need Coordinator, CPC
Immediate Pay Discount - Thank you!
-65.50
Professional Memberships:
NFDA . PFDA
DC FDA . CCFDA
G~
The Rille YOII KilO"',
The People YOll Trllst
~~
U L~::::j 2.~
__L _HZJaE'
~~m~1
.~
-~ II~S
o,-)<r\,-\ \
Total
Payments/Credits
Balance Due
$4,175.50
$0.00
$4,175.50
! 0 N
0 In
Q N 0 0 r... . CO
{ '- to to en M~
1 N "... (!)
al"'- en en (Y) to -. z:
+' CJ in 0 M H
co - In =>
{ ~ &::) c::
co :E UJ
~ CL. en
c::
In 0 UJ UJ
~ r.9 c(l 0 => c::
al o' I' c:: :::l
~ E- UJ en
~ ~ z: .- (Y) I en a:
- a: ~ .. UJ
c:: ..J~ :::l c:: -'
':J :::l .. :::l CL.
a: +' al ro o:tn 0 CJ
~ C :><:0 +' >- c:: :::l
/, .- en ~ .. 0 f-tO >- :::l0
UJ al ~ >- 0>-
~ e::: ::J en 1 -' X 0 a::
e~ ro .D >.. a: a: CL. en
:n +' ::J ... ~~ I- ~ a::
fI) :> .. en Cl UJ 3:
>- al 0- ::J ~ en Z ~ en
UJ c:: c..J l- "tJ +' UJ a:: ~
~~ -' en 0 ro CD -' ~ 0: C. UJ H
3 :><: UJ t- o .. :::l a: -'
a: .D co :::l UJ u.. (!) en VI U :I 0: CL. ::=l
:=> ro (!) u.. 0
q u ~ u.. LU I- >-
:::l
\~ () en CD 'T" :.L
->< t.O CJ :z:
() - a::
alCO :J::
.r::-r 51 ~
WMENT NO.
1
PAYMENT NO.
1
COVERAGE PERIOD
09/01/06 TO 09/30/06
DUE DATE
10/01/06
PREMIUM AMOUNT
$16.94
OVERAGE
10/ SEP
fit 20Q6,
\~ \\\ 'iJ~'
lATE PAID
\~.~N1
'MOUNT PAID
\,.,)..\1\
CHECK NO.
YOUR
CANCELLED
CHECK IS YOUR
RECEIPT.
401712742 001 0000001694 09012006 &3&29 6
MEMBER NAME:
E L EHRHART
PLEASE WRITE YOUR ACCOUNT NUMBER
ON YOUR CHECK. 401712742-001
PLEASE MAKE YOUR PAYMENT TO:
HUMANA INSURANCE CO
P.O. BOX 21091
NEW YORK NY 10286-2091
1111111111111111111111111111111111111111111111111111
RETURN THIS~_ON WITH Yi'tUR P1\l'NLE!>JI
AMOUNT PAID
$
CHECK NO.
H
HUMANA.
. I
\ '1!/t(l/ll("('whcnyounwditmo5t
.L
__11:. 11
~~...""~
LOUISE L. EHRHART
SANDRA EHRHART TOBIAS
715 15TH ST.
NEW CUMBERLND, PA 17070-1512
1417
:;
3-76Ili/3&O '!
zso
Date~
Pay to the ~ \.,......,...... I,
Order of ~l\.~\'D-.... ..-l-D$\J..:("'Q)C\CC: -' ~" I $ ( ~ ~9 'i
S\"'i-- ~e"€..<"'\ m"~ ~.._~, 'I
~ ~ Dollars lD ~~. i'
a Citizens Bank ',I
Pennsylvania 1'1
~.~~-~~~~ .;
~(1.1J'/I.1:1p,KYi,u'r .... Ii!!! ~=----- ~~~~
GUAADWmSAFElV GRi::Ii'" WQN
-
-
-
-
-
-
-
-
-
-
-
-
-
~
-
!!!!!!!!!!
-
-
-
-
~
~
!!!!!!!!!!
---
==
~
-
~
-
-
-
-
~
===
-
-
~
-,
Go to WWW._I.lICtIrd.com
Write to U6.at PO'Box 6822 The Lakes.:NV 88901-6822
LOUISE L EHRHART
Account Number: 51210717 61026784
Page 1 ,012
1 0/16/06
Vour.AccountSummary
Billing Cycle ,Closing mate
AmountOver Credit Line
Amount PastDue
Current Minimum. Due
Total' Minimum Due
09122106
$0.00
$0;00
$2!95
$2.95
$2.95
$2.95
$2.95
$0.00
$0.00
$2.95
'Manage.youraccount,online-lt's.FREE
Pay your bill. . .trackpurohases. ..set emallalerts...
even requests creditlineincrease-do it all online at
SearsCard:coril.lt's a great way tostey on top of your
account.
[[ ~__at-=n.
, It'sfree',and you.won't believe how
much time you can save. See for
(tEg~g~~ yourself at SearsCard.com.
---- ._---
Amount
Activity
Deecription
-2.95
2.95
LOUISE L. EHRHART
SANDRA EHRHART TOBIAS
715 15TH ST.
NEW CUMBERLND, PA 17070-1512
c~o\'-~ C.c;."d
Pay to the .-... ." ,
Order of ~ e.c::,s-~
=-r~ ~ 0.$'-&
a Citizens Bank
Pennsylvania
09/1 0106 09/10106
09/18/06 09/18/06
PAYMENT-THANK YOU
5484029016079
ALLSTATE UFE IC AO&O
CALL TOLL-FREE 1-800-736-2242
'T':1 ~ ...
Average Cornspcmding Periodic Rete Periodic
Daily ANNUAL D=Dey FINANCE
S..nee Be.nee PERCENTAGE RATE M=Month CHARGE
$2.95 $0.00 19.83%* .0544%(0)* $0.00
$0.00 $0.00 19.83%* .0544%(0)* $0.00
SEARS
REGULAR
EXTERNAL
REGULAR
CASH ACCESS
REGULAR $0.00 $0.00 19.05%* .0522%(0)* $0.00
Days in Billing Period: 29 EffectiVe ANNUAL PERCENTAGE RAlE: 19.83% Minimum FINANCE CHARGE: $0.00
111111..011111111111111111111111111111
Payment Total
Account 8aIanca Due Date Minimum Due
._~~~~~;;m.,.!,!!!!!,~~,:,;g;; 'A_~;~~~~~~~A...;;t"f"~ ------:--
Previous Balance
Payments & Credits
Activity
Other Charges
FINANCE CHARGES
Account Balance
Your Credit Summary
Total Credit Line
Available Crec::lit Line
Cash Access Line
Available Cash
$15,000.00
$14,997.00
$3,000.00
$3,000.00
t'
I
I
SIIle Date Poet Date
Rates "Rate Varies
Sears Gold MasterCard"
Account Number: 5121 07176102 6784
6...""'...... c__._..........
~
1418
Date
itll h \C~
I
I ling, I want to
I l \s. Bill the fee
3-7616/360
290
tl
'doq$"'
tn
1$
----~
( Cr.::. Do Hars
I .11.1..1
~....::.>'t'1
~'*"
~N~"~~~4~--"... ~
Register of Wills Cumberland County
June 17, 2007
Re: Elizabeth Louise Lewis Ehrhart, File #21061149
To Whom It May Concern,
Enclosed please find the Inheritance Tax Return for our mother, Elizabeth Louise Lewis
Ehrhart.
A separate remittance for filing fee in the amount of $15.00 is also enclosed as well as
remittance for the balance of inheritance tax due in the amount of$1211.18.
I have also included, for reference, copies of documents previously submitted by my
sister, Sandra Tobias, on December 23,2006, to take advantage ofthe .05% discount for
monies paid within 3 months of the date of death. She did not utilize the $3500.00 family
exemption permitted by law but it has been included on the enclosed Inheritance Tax
Return.
Please feel free to contact me if you have any questions.
~ ~.cU
Linda S. Hassenplug
o
<;;0
cD :0
m=Po
::r.:J~r
S;~93
~(/)7'
o.'go
o -n
OC
~ :0
:0--;
)>
,....,.,
c:;;->
c:=>
--'
c-
c:
z
::0
-,.-, fl
Fie; c-)
~J~~
r---, r-,
:J::lCJ
C)c::>
~~. r, "'~n
..- ...,"'
:~: (''5
t"= rn
0?C>
"'1
N
N
:r>
::x
N
..
g~ ~~
.~~
~~<t:
~ i
~~
~'--
-...-
~_.-..-~
~.-
"""'''-'''"":"":~~--==------=--
_'::E:2.-_~
"':..
..
-
-
'-
-'
~
-
'.......
.-
:.......
..
. .....
........
--~
~
,:<.';
~.
-=.....
.,.::;;,
'..:
-
=-
....:
.~
=-
==
~
.=:-
"~
~; ,....
......
~
--=
,-
l"-
Ll')
Ir
rn
::r
LI')
LI')
Ir
c:J
c:J
c:J
c:J
c:J
r-'I
r-'I
rn
LI')
c:J
c:J
I"-