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HomeMy WebLinkAbout07-27-07 (2) ~ 15056051047 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 Date of Birth Decedent's Last Name Suffix Decedent's First Name MI (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW _ 1. Original Return c:::> 4. Limited Estate c:::> 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required c:::> 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 Da ime Telephone Number 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received 8. Total Number of Safe Deposit Boxes - ~3~ c.= =cJ --I --0 P -0 ___"1'" --". .r:- c:> U1 Correspondent's e-mail address: DATE 11--27--0 ~/2-LISL61 ~1l / 7'-01 ~ ?y, #G~ S:?: J $'p ,~~ C49/2-L/sLt3} PLEASE USE ORIGINAL FORM ONLY ~'" DATE -2.~ -0 Side 1 L 15056051047 15056051047 .....J ....J 15056052048 REV-1500 EX Decedent's Name: ~4 fve/vf) k 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) ~ Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~ 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 Subjectto 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_ 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 ~~~~ ~ ~! ~~,P:-'~ /cf~ ~ ~CCr L--. 15056052048 Side 2 Decedent's Social Security Number 15. 16. 17. 18. c:=>> 15056052048 ....J REV-1500 EX Page 3 File Number D~cedent's Complete Address: DECEDENTS NAME tv E /Y D V K K--f?~ /V STREETADDRESS ---20- 0:=+-.. ~ ~,q K--:;;jVE------- . ._---~ --?-'----------------------- CITY C R~/SLc -~-rTATElP~----Tz'P/-90/~ Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) // ~7 7-, ~.3 "#' / ,300.-ocr =~=_____.. &, ~~=-77I. Total Credits ( A + B + C ) (2) /; :3 c;, 8, ~2- , 3. Interest/Penalty if applicable D. Interest E. Penally ---~--------- Total Interest/Penally ( D + E ) (3) 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. (4) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5) (5A) (5B) I'O?~ 0 I 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. 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 EJ 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 III 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 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 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. SCHEDULE A REAL ESTATE 1. VALUE AT DATE OF DEATH , /21; g~G,OO I . TOTAL (Also enter on line 1, Recapitulation (I more space IS needed, insert additional sheets 01 the same size) ) $/.2 II Bt C, c:7c7 ~;9 L-~? I,~~ FacetWin Screen Print for public04, from "CAMA_Login" 11/17/2006 4:22:13 PM I 'It 7- NEIGHBORHOOD: 4000 CUMBERLAND COUNTY ASSESSMENT OFFICE 2004 BASEYEAR CONTROL # 40004218 DISTRICT: 40 - SOUTH MIDDLETON TWP I I IShort Name I LAST NAME IFIRST NAME Ic/o NAME IADDRESS1 IADDRESS2 IpOST OFFICE: ISTATE & ZIP: I KAPLAN, WENDY K KAPLAN WENDY K SD: 8 PARCEL: 40-25-0060-033. I SPEC ID: LOT: L-0010 ~ Tback: 40-10-0636-008. I I I I PROPERTY TYPE: R I I I I SALES DEED BK/PG.....00109-00549 DATE OF SALE...08/01/1994 SELLING PRICE: 14000 20 OAK PARK AVENUE CARLISLE PA 17015 Situs: 20 OAK PARK AVENUE Prop Descrip.: FAIR OAKS LAND DESC: LOT 10 PB 17 PG 21 LAND USE TYPE: 101 DEEDED ACRES: .83 I CURRENT VALUES I J Assessed Fair Market ~ FMV - 106900 L - 28200 I C&G - B - 78700 I approved? -> T - 106900 I Screen 1 Enter Selection > Number -Switch Screens, X -Exit, J -Jump Mode, Down Arrow -Next Entry, Up Arrow -Previous Entry, Record: 18891 F -Forms, I -Image ? -Screens, B -Browse V <:I' V 10 M a ri 0 Z .. ~ s:: ..c: Q) Q) U tn 0 Q) ~ ro u ~ ro 0 ~ Jl!l t!) Q) Pl ro P: ~ t!) ~ F:( '0 l>oi Q) H t! s:: tnen H ro I s:: 0 ........ Jl!l Q) -,-i r-i ~ III r-i H ell E-i F:( > U E 0 U -,-i s:: en P: Hril ell III --- l>oi ~ 0 ~ 0 0 0 0 u Q) 0 0 0 0 .. Q) .. ..I<: N r-- 0'1 0'1 ~ tn >< ~ ~ 00 00 10 10 ~ ro ~ ro N r-- 0 0 ~ P. :E: ri ri en ro p. ell t!) ro P: ~ Jl!l -,-i I '0 ~ ~ ro Q) s:: en r... 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III ri t:lo ........ 00 o 0'1 Gl <:I' ml1') III 0 III 0 ........ , ~O'I o 0 o ri IQ 0 o Gl Gl :.:: ,j,J s:: ~ ~ f@ CI ril :3: ~ Pl ~ -,~~.,," .- COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ~ /.} /'1 Ir' ~ /1/ ~ K FILE NUMBER Include the proceeds of litigation and the date the proceeds were received b th ta . . ,;;? / t:::' ~ - C71- 6' 0 ITEM Y e es te. All properfy JOmtly-owned with the right of survivorship must be disclosed 0 Sch d NUMBER n e ule F. DESCRIPTION VALUE AT DATE 1. /;2J /1/ {;, / 6 ic- 7 E/LS"c? /V ~ L l-? ~c;::/6' ~t. ..r OF DEATH (' ,8r ?7/p-4 '11~/V7/=r/ sC-E If'~ c"ye~ C .::? :;, Cl(J ESTATE OF :? W4C/(C'Y/4 Y;f ff / c::1 / cJ I /tJ' 0?c:J9 r :;8 / f6-: ~/ 3, If e-r=<<A/J) I al?W'A/~r-~' j;E eJCRr:;q) ~(/~ . . TOTAL (Also enter on line 5, Recapitulation) $ 1:1 Q ~, ~,k, (If more space IS needed, Insert additional sheets of the same size) APPRAISAL Personal Property of WE i./ d Y 1<.-, k. A f L-1/J cs T.-1 ~ Appraised by Chuck E. Bricker AU094-L Date 9 - 8' - 0 ITEM VALUE ITEM VALUE ~ .00 OD J 6/) IJD 3D Pc. . .~4!!!:i .. At Work Regular Checking 01 1010110809478 752 30 0 17 122,594 WACBOVIA 00035441 ............... SNGlP I.. .11I.. .llIn '11.11.1.1.1.1.. ..1.1.11'11.1.1111.111. 11.1.1.1 WENDY KAPLAN 20 OAk. PARk. AVE CARLISLE PA 17013 PI - At Work Regular Checking 7/28/2006 thru 8/25/2006 Account number: Account owner(s): 1010110809478 WENDY KAPLAN Account Summary Opening balance 7/28 Deposits and other credits Checks Other withdrawals and service fees Closing balance 8/25 $259.15 260.00 + 313.61 - 60.33 - 5145.21 Deposits and Other Credits DI!tfe Amount Description 7/31 26D~OO DEPOSIT Total _11).00 ;> :1 . '" t- ~ Checks Number Amount Datil . Number 0101 5.00 8/11 1117.- 0305- 50.00 8/11 Total Amount 258.61 $313.61 Date Number Amount Date r. I,( ~ -. 8/02 ~- ~ '" ;c. TotSl ..3i Ii: i:! z -< z z z z ~ z z z z z z ! - Indicates a break in check number sequence Otller Witlldrawals and Service Fees Date 8/08 Amount Description 60.33 AUTOMATED DEmT CITI-CLlCK2 PAY PAYMENT CO. 10. 9936153162080808 wee MISC M*Y@S74LQ5*4CTP WACHOVIA BANK, N.A., CAMP HILL page 1 of 2 REV-1511 EX+ (12-99) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF /(' /f ;; L 1;Y / ITEM NUMBER A. frc/VcOr K~ Debts of decedent must be reported on Schedule I. FILE NUMBER ,,'? /00 -c:J? 80 DESCRIPTION 1. FUNERAL EXPENSES: ~-:-CV/,yC ~~r/lC:Y0 r~NC/e/;?( //6')?)C 1. B. ADMINISTRATIVE COSTS: Personal Representative's Commissions /~ 2. 3. 4. 5. 6. 7. 8, 9, /(/', //, I.AI Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State _ Zip Year(s) Commission Paid: Attorney Fees ~# /?Jt!3?2-- tK ;2)"p/V/et:.. s Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant A' /.-9- Street Address City State _ Zip Relationship of Claimant to Decedent Probate Fees /2 ~ /..>??:1'2... Y C; ,7' If- /\eeetmtll"!',, f",,~ /.?c-C/S'ri!??Z.. ~ c:;"Yft; .s>/cr7CC!,;z Ti';C/0'/.h5 Tal( RetwrR ~rI1Farllr'i' J:iie /1:) ~ r" ~ t9;,vK C kc.k. cA /1/2, "c:.? '> / fclrl7/f?N /1L jJ/<O~/fj-rG I PC/S7c/Z ~ 0,/0- Ct:-fh")61C:-rLL~t1) L~(;,v :;o/~A-A-c. I ~h Lc/T't?;e.J' 17-1~ r'e"V )f",//y e L - ?eC;9 ~ ,t;2c! 1", L-E 7/ C /!. r;-- ) /2G5'e?e-Ve rr:-' o~r//;c Cf;.)r/97~ ~/>6j1- -r/~' Yk I r~7 /~r~r -L ~~<S"J I~~/HV~ / ' TOTAL (Also enter on line 9, Recapitulation) $ (If more space IS needed, Insert additional sheets of the same size) AMOUNT Ir ~ 3f/a Co -0- 6/ /~o. co _ 0- J?;7, CO /~/CO /&!, 2.s- ;2 ~o; C7V' :;' S; c::t7 ;;;..251 00 cZJ ..GC:J J)oo, r3c:> .- ~o. / /,J~81.2.J:, REV-1512 EX+ (12-03) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF ,/0-;0 L4/C1 } IrE/V ,D,Y /<': FILE NUMBER -::z. '/1' ?/OC - C? / 8'u Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER 1. ~, -3 4, s, &, 7. c9 11 lO. I/, ) 2., / 'j, /t /~, I~, /'1. /8, /9, ~, DESCRIPTION 0/1-;0/1"-"'9 L c::,:;}/l/~ I' /;)?4..>-rcF'Z- C/'?/ZO C4f/1' -T/?-L- C?N<.-) )//.$4 ;;t'" 3/7rf -C:;5/t?- 92//-3~"3 Pl'fC'::"V'l!'r j=/N.. S'lrc.s. .# ~(?/I-,t:?27-7t?/~-r.2t3 IJ AlL.O / < (3CCKR~ (C~'?/) -'.It '"'"2) .1.92(,- ~~~- C,t)I5"'Cl::7v.er ~,H -;/ZT - ~712~ c- -'?1 ~,f ~ <f2 I 7.-/ 5'rC J UC-I,v7"'/Z-j h, -~ Ac~~ ~ 7b f) C-9 "";pU( hn- & /.' v1fJ- ( S'u::=1 .; A> <J 7 / f fAl-X') - de - cc-(j- / // ""' / ' I 0 -L. Qu.. cis; vC f' O/JI'Z-Llf1- K.I.-;T/~hA/ .#?.t. de~/1' j r~, / . ,f/Lb?;{ s;.~ #t?~ S- -dc_ /-! t?a....r /-/Cj /?U.~ c;p'/ Ce/v re /-"L.. -. cia _ if N D ovz-/Lfi9 ;2-/1. t) (o! V7 J _ cla- -de - O/j/ZC-I5"~ ~'ll';q(. .-~ - a,;9/t<..l'f~ OhCC~ c?:77 ~ C2/L~7 ;tJ-"J~L5 ~5"'..r~ /7""'~ .-------...... . S t..c....b,ror. TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH vP ij<7'31'2b ~ ~~" '":1-7- ~/ B~C/, ~(/ ;; !?!:> -s; S-7' ~S-,crS S5" !;-c,5~ C~ / /, / ;('~, Jd ~?s'.s8 // ? 3 ~ 00 I f'38" C 3 It 02. 9'1' <18 80,~O /'1,0(/ 57: 87 3 9, 50 'l- 39, Sf 3C7; 9~ ~ & 7, s-s- 3 ?2, v(? 4- 5C/. VC/ ?8//:J/, 9S , REV.1512 EX. (1.97) SCHEDULEI~I DEBTS OF DECED~ MORTGAGE LIABILITIES & LIENS . bB/</2) Y /~ <- COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF /...,./ \-~L-4-# ~ r FILE NUMBER ;</0' - O:?-cBo Include unreimbursed medical expenses. ITEM NUMBER A1. J-.;J., . .2-3 , ~'l, ..25: u, ~r. 28, DESCRIPTION ;?/o ~>~/ T ~e~/< r Le#/c/../ ~;I"[,csT,yC-S /4 (])~, 8c~/( . , 'D,e. j/ #/t- 'fP C'JA!) /.2~r ~N.PO/Z./e~ ~4i:J/C7L 0,/ ;; 7E i- <- ~ ,t!.~ec c//(!-:s ;--/9 -?7' '1 ;O~ t/cc- h'J/ SC't C=-;X I'CNS'C CO in c'1'sr C~"7 /3 L.-C:;; ') S e.-~ j.e.f. AMOUNT .;f? G" 3, ?3 58,. c:7c7 / S I c:::t1' /!2S $",~ /(7 3" ~~ I ,A CP I 0(7 ~ II00SI 3 tt 8, 99 TOTAL (Also enleron line 10, Recapitulation) $ ~ r?t:J~ ~) (If more space is needed, insert additional sheets of the same size) REV.I509 EX' (1.97) SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNS\ cVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Y /. J /) 1;Oi-/lAJ/ uJE/YlJY If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. ~ FILE NUMBER ,7../0' - 07-80 SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. d-1S0N k; 1<,,",1'- ~.. CJ1-k C/'?/Z L/5"ZC/ /,pfl ~o~ 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 number or similar identifying number. Attach DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT deed for jointly-held real eslale. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. Ii/~ /J1 ot T /344K. :3 ?6: <89 .IlJ I ~2., <15 /to :z~ ""7/0/ ~o.3 9' ~ , ~ ,4-. r1' J;OVE/2UCA B,(//( I< ;? 03, L L( ,,:;(J JoI" t& ./fr: ~-~ //3 ~ 0 2-,.S- TOTAL (Also enter on line 6, Recapitulation) $ ~~~I 1'+- - 2 (If more space is needed, insert additional sheets of the same size) 03-19-'07 07:35 FROM- rlNI\l\JL1I\L., I $1ItemtlltCytit: cuswmer ~VI~"~~ 1 TRuST . , L:.~' from S.IV_ Chlrgt:. ~t ~ '( ._ _ (Ruson! TY'~ OF ACCOUNT \""'''aI) . o In4I~.... '( Jgjlll''''~ :\ c.J I.. T'Wt For ~ lW_ T,,,,,,.,. 10 MiPIW 'R'N ,,. "GOUNT 181nl""" ~ sa. "..pllel\llSft1, ';J PlIIIoel1Np 1Y,e 0' ,"'v\C!! a o..cWlI8 Q N.O.W.. !:I Nonoy Mar~.1 Agc;ounl '=I ,..... g SujNf"O.W. D 01"'-.__._ iM ~ ~... .....1fU '-PHil ....._ ....~. ..".... 11M..... o.~ w.1IIlIIIt1\ Opoflod ~ ~~ Ollie. r L'" '1A. Inilill Otposil $ . _ ConIi8ling ClI a Cash ':t CheI:ks Idtll1irlCalion Ellfli~ Oale . s..._ Dr ~ PtlViouS SIrlk "'ltliOll"'ip PIMtfIt At:icllJ1I1111i Olher Than FTC o JlmI."O Sl.M4nlIlp o OINt tI 00lp0j01l\ll\. "'Cllll Q UnInoIHparalGd '-"llCioticln tI e.potMn. Nell tor p,onl Q Olftor.~_.,_ ~llIjllIIytf No. I !11Ip/o," No, a R__~V11 01 f,iond To CollI",: ___ T_hunt TelephOlll (II ""- . .f: T"~ (~I." T.phone 0'-, ..Mets: A'M ._ Telepholw ",...," Cli,", OopoJil__._ AAlIom,'c T'4Iltle, __ A1Icomellc PeYlUf11 OOItMAr.r "CCOU.tl VEl A Ice will lie CftCtted II tile,. I. IIG ICIiYll; in lilt lICCOUlIl 10' _ ClllIAOU~\It "'11, and ";11 lie wrgelll lOr Itdt _ c1tr 9trW ""', 110 aCIMty aa:~15 on Iht _Ill. Wll'HOl'AWAlS a TIlAHSF(II' ._~ dlY. pliof wriIIl" .111". ""V bll ,eqli,od 111 .,IIClUtI. en)' w1lhd..w.l" No mOr1l IheII p"IDul/lorlZld 11_"15 oMI .. .aOWDd "., '""" No mor,'heII ___ ahllCllrt "",..1Io q"iwn.CIIlln..ICeQUIII. , . SPiCl~\. WSr!UCrlollS N \:;. HGdl(\t, .~ _,. NAill hi .~7 . NO,1 Y\lt..:\d"'_K .~: ~ NAMI~r ' , JoIn' Ai:;c;ounl ~~",:\ ~. D4T, MIIIlllNG "\ BUS. AOOAISll _ PHONE CITY. $'~Te, (' HOM5 ""5\/ 1 &lIP cooe rl.r \1 ~ ,~ PA, ':l.!Ci. PtlONE,. g .. ~lIIIo_'___"IM_"'_" IN1tRI.J U .- - -. _.11I. """ . "'"I ._,'. '0"" ~~'!lO'~~). \() . , D - ~O L 0 ..... '- -.:1...... II M ~~,~ ., OM ......., it - __ U ~= :: ~_ ==",! ;"~:. w.:"~,--:: CHfCK1I. 011I,,"$, ANO WITHDRAWALS TO 86 ,ell..,. LI:'!!~' - - WI.,.. MIll "'II .t....EO ev, -~ -....ell-I(_IIi........ =:-- ~1.:::.::-~cw::.::.:'_--= 0 AfYi_o/ /h, slone';', f'l...-.-,..... ,......... "_........~. .. "'" illoI I (-, .,. .... ...... ''''ill! It ....., ............. Ie n..I~...... N ........ d ::.~. - - ....IlfW...~... IllS Nl .....uti"I..... v g..... ., \In_' _.n _:\. ow to:::;: ~ ...,.... '- =--= =- ...~ '=....... a~ I, -...: ..r ~Unl'"lgn.d bv Numb.r ~,~--_, '..t '0 267[0IltO)9 "/~..J, '.,e. ~\,~.2.~~ II; ~i L' if. ~9 >' tillfi I ~~ ~fi ,. . T-152 P003/0~3 F-663 / 03-16-'07 11:30 FROM- ~ - T-150 P002!002 F-653 JESSICA R 'e's '. Re': 'rQd'~'bate'ofb8ath 'Re' uest .......... .... '.. .' Pa e 1: l41;J~ ~!~~~f;....,..;....JL. ........,. "...." ...~ ..........}L.. ......--~.".._..... ...' '. ~ ?/]d... '...........,....,. ..n."'.... ...,9 . I From: To: Date: Subject: DATE OF DEATH REQUESTS REESE, JESSICA 3116/200710:30:09 AM Re; prod. Oat. of Death Request l~/&~ To: Jessica. 3/16/2007 Please find the date of death balance you had requested on the below account for decedent Name of decedent: Wandy K Kaplan Social Security # 210-40-3060 For the Date of Death: 08125/2008 Records Management J DOD Unit M&T Bank. "Undemanding what'. important." >>> <JLREeSE@mandtbank.com>03l14/07 2:12 PM >>> Account Information Date of death: 08l2t5/2006 Account Number: 2671014039 Product Type: Deposit Account Have a great day! Records Management / 000 Unit M&T Bank- "Understanding what's important." Additional Information Wendy K. Kaplan is the deceased. She has been removed. Request Details Deliver to: ReQue5tor Delivery Options: E-mail Delivery Details: ilreesetalmandtbank.com ::n- ? I ? j/~/L r7~, 0r,- 11" / )~ t, . "I ,1 f 1 ~,l)ll~ ;r ',f.1' Ifr" J Amount Reference # = - $50.00 617404240 === - 2 Check(s) Posted = $165.51 An asterisk (*) indicates a skip in sequential check numbers which may be caused by one of the following: . A check not yet received == . A check that was converted to an electronic transaction, which will be listed in the "Electronic Checks Posted" ~ section below. If no checks were electronically converted, this section will not appear. == - Account Activity === Date Description Additions Subtractions Balance 08-15 Beginning Balance 1-877-S0V-BANK (1-877-768-2265) www.sovereignbank.com Statement Period 08/16/06 TO 09/14/06 TOTALLY FREE PREMIER CHECKING TOTALLY FREE PREMIER CHECKING Statemellt Period 0,3 15 O() - 09 1406 JASON A KAPLAN Account # 571134025 Balances Deposits/Credits + $626.64 Average Daily Balance $270.68 Checks Posted Check # Date Paid Amount Reference # Check # Date Paid 841 09105 08/17 $115.51 611040880 9003* page 3 of4 571134025 - - - - - - - - - - - - - - - - - REV-1513 EX+ (9-00*, COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES weN i) K 0=1--80 ESTATE OF / /.. /l/1; N1 NUMBER I NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 0~S~ /I. K11L1~/ c?o 0//1< P/?/L/~ /!y,t. o /;/2 1../ f / C) r;PI? 1::;'0 I S- 1. FILE NUMBER ~C/C RELATIONSHIP TO DECEDENT Do Not List Trustee( s) SON AMOUNT OR SHARE OF ESTATE /f-LL- ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 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)