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HomeMy WebLinkAbout09-26-07 (2) ....J 15056041147 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 Year INHERITANCE TAX RETURN J}/"',rI1 RESIDENT DECEDENT 2 1 ()l.LA..Jo I FHe Number orrd-'f:; Date of Birth 201164383 07152007 08031902 Decedent's Last Name Suffix Decedent's First Name MI LONG LAURA E (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 o 1. Original Retum o 4. Limited Estate 9. litigation Proceeds Received o o o o 4a. Future Interest Compromise (date of death after 12-12-82) o o 3. Remainder Retum (date of death prior to 12-13-82) 5. Federal Estate Tax Retum Required 2. Supplemental Retum 00 o 6. Decedent Died Testate (Attach Copy of Will) 7 Decedent Maintained a Living Trust . (Attach Copy of Trust) 8. Total Number of Safe Deposit Boxes 10 Spousal Poverty Cred~ (date of death . between 12-31-91 and 1-1-95) o 11. Election to tax under Sec. 9113(A) (Attach Sch. 0) CORRESPONDENT _ THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number EARL RICHARD ETZWEILER 7172345600 Firm Name (If Applicable) ETZWEILER AND ASSOCIATES First line of address REGISTER Of WILLS USE .o~L Y (. ) r.:-> ~:;O ~ .:F> ~~! (/) pOoJ 0"'0 105 NORTH FRONT STREET f'.,) 0'\ Second line of address City or Post Office HARRISBU State PA ZIP Code 17101 DAt~ILED ~:J\ -~:;. N .c:- REtzweiler@Comcast.net of pe~ury, I declare that I have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief an Ie aration of preparer other than the personal representative is based on all information of which preparer has any knoWledge. ' S RE LE FOR FILING RETURN DATE Karen L. Long Earl Richard Etzweiler 105 North Front Street, H Side 1 L 15056041147 15056041147 ....J \}lk ---I 15056042148 REV-1500 EX Decedenl'sName: Laura E. Long 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)................ 6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested............. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) 0 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 Govemmental 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 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 15. 9,819.23 16. 0.00 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 201164383 5. 19,516.51 19,516.51 7,753.28 1,944.00 9,697.28 9,819.23 9,819.23 0.00 441.87 0.00 0.00 441.87 D 15056042148 ---I REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-- DECEDENTS NAME Laura E. Long STREET ADDRESS 10 Bellmore Road CITY I STATE IZIP Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 441.87 419.78 22.09 3. InterestlPenalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) 441.87 TotallnteresUPenalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 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. (3) (4) (5) 0.00 (5A) (5B) 0.00 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS No o ~ o ~ o ~ o ~ o ~ 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?...................................................................................................................... 0 ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 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?..... ................... ........ ....... ................. .... ....... .................. ................ ... .............. Yes For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. ~9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. ~9116 (a) (1.1) (ii)). The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. ~9116 (a) (1.2)). The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. ~9116 1.2) [72 P.S. ~9116 (a) (1)]. The tax rate imposed on the net value oftransfers to or for the use ofthe 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. LAST WILL AND TESTAMENT OF LAURA E. LONG I, Laura E. Long, a resident of Lower Allen Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this instrument to be my Last Will and Testament, hereby revoking any and all wills by me at any time heretofore made. ITEM I: I direct my hereinafter named Executrix to pay all my just debts, funeral expenses, administration expenses and inheritance, estate, succession or excise taxes, which I owe or may become due on account of my death, as soon as may be convenient after my decease. ITEM II: All the rest, residue and remainder of my estate, be it real, personal or mixed, of whatever nature and wheresoever situate which I may own or have the right to dispose of at the time of my decease I give, devise and bequeath to be equally divided among my following six (6) named children, provided they survive me: 1. Irene L. Runkle, of Box 685, 1532 W. Maple Street, Valley View, PA 17983 2. Blanche I. Wiest, of901 Buttonwood Drive, Harrisburg, PA 3.Clair A. Long, of341 Tarry Hall Road, Millersburg, PA 17061 ~ ~</U U. t ~'-Jil(SEAL) Laura E. Long 4. Martha M. Shade, of P.O. Box 308, Elizabethville, PA 17023 5. Karen L. Long, of 10 Bellmore Road, Camp Hill, PA 17011 6. Mark V. Long, of P.O. Box 84, Gratz, PA 17030 A. If any of the above named children shall predecease me or die simultaneously with me, then said share shall lapse, and the residue of my estate shall be divided equally among my children who do survive me. ITEM In: I hereby nominate, constitute and appoint my daughter, Karen L. Long, Executrix, of this my Last Will and Testament, with full power in her discretion to do any and all things necessary for the complete administration of my estate, without being required to file bond for the performance of her duties, with full power to sell at public or private sale and without order of court any real or personal property belonging to my estate, and to compound, compromise or otherwise settle or adjust any and all claims, charges, debts and demands whatsoever against or in favor of my estate as fully as I could if living. A. If my said daughter should predecease me, die simultaneously with me, or be unable or unavailable to serve or complete his duties, then I nominate, constitute and appoint my daughter, Martha M. Shade, Executrix, with the same power and authority as given my said daughter. <fb0~ _ (SEAL) Laura - if56~ 'fi ""7--~ IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament this / ~ay of June, 2004. . ..., /--' " -.".r... ...._#........-1 , ..~~. . (SEAL) ~~~('Y TL> --y. /1, t~~ Signed, sealed, published and declared by the above-named Laura E. Long as and for her Last Will and Testament, in the presence of us, who at her request, in her presence and in the presence of each other, we believing her to be of sound and disposing mind, memory and understanding, have hereunto subscribed our names as witnesses this I r ~ day of June, 2004. ~~ cZ;-k~...p~ f)'lA-f"U4-' ~.{t~~ Rev-1508 EX+ (6-98) . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Long, Laura E. IFILE NUMBER 21-- ESTATE OF Include the proceeds of litigation and the date the proceeds were received by the estate. All property jolntly-owned with the right of survtvorshlp must be disclosed on schedule F. ITEM NUMBER DESCRIPTION 1 Register of Wills of Cumberland County, refund of probate costs VALUE AT DATE OF DEATH 26.00 2 Gratz National Bank Checking Account 31121605 - Date of Death Value $4,361.20 4.361.20 3 Gratz National Bank Savings Account 32008954 - Date of Death Value - $14,997.31 14.997.31 4 Unite Here Fund Administration - pension check from Amalgamated 132.00 TOTAL (Also enter on Line 5, Recapitulation) 19.516.51 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA.1500 Schedule E (Rev. 6-98) 07/30/07 13:16 FAX 7173653902 GRATZ NATL BANK ~ul 30.2007 IDI43A" ETZWEILER LRW 7172345GI0 raJ 02 p.... 1M lteUM iI!MUII._iII QQriII', Pwirir,&(_ ETZWEILER AND ASSOCIATES ATTORNBY!-A,-tA \V 105 140ltm PllONT sTd!.T HAIUUSBUl\</,;Ph n~Ql.l'l~~ ~ ~ MM.-hL l:tJea....JMf- (711) 234-~600 125~ SItNt MilIa'IburL r A. 110tl (71'7) 692-2'19 4bIm~ I'M_wilt '".".-ItINJ..... sa 1.:011.....11:...... HALJ1.U r.nm (T17) a,o-J1J7 Fa lJDc; (717) 234-5610 [U1I.\.r~! ~".._..... 2 W.. MaIn Slroet Effabcdivlltcr. PA 11O:S (1l7) 3db1391 ii.6I" ifilliil' n.,.. 1M ~""':OI #J& GRATZ NATIONAL BANIC P.O. Bfm 159 Grata, PI. mtJO Thill offioo .."..... the En.te of Laur.t 1i. Lea, MID d1Jed OD July ]5. 2007, .1CSidcm of Lowu An. TOWDAIdp. Cwnberl.llld Comlty. 'Pe~YaDia, au! whose Social Security Number 1. 20J-I6-43'3. July 19. %007 Would. you plc:aae COUl'plotc dIll' bottom portioD of thi& lDttllr for III MCO..... III wlaieJt the decedellt bad all bltel'e&t ta .. .r the d.te 0' d_tJt .b~ tile baluac. 1m ..ut aceoUd(.) at .. of II_till and have the __ Ilpcd 'by the appropriate oftlcer OC' empl~ of your rUWJOial inltitutloo. SiDcerely yoUl'l. BU:k1p ~11\5llrt _tiler I , do' LDD5 ~DD~ 5L\- JTlTI ~ Du.Opeacl ~ ~ Amud I..... ~.td e.l..dar # I q'1 Jt ''10 I ~ , ~ru,t.clateol...... V, :J ~ll ~ ~=:Deatb $lJ3531~ ~ AccNed I'nt.en:1t :~~r $.<<1>4- MaturftyD.rc ~ AccoUDt C>wunbip l.o.w\A.. ~ ~~ NatYofJchJtOwur ~ Date Joint OwDetUip _ \ wu F.atablliihed ~o......., A~t NlIIDDer(ll) ~J.b~ --.. ~.~3 Ln"':r~ mt: Ma... If . joint accoWlt it dated within ODCI year of the dItI of cbth. of dececlam. could that account be tnced to a piar joint account in cx.l.c.eDCle OYer one year prigr to the death of d.cedecrt. ~~~ f\\~ ~ .. --'-~~..,.."....--..-------- -.'- REV-1151 EX+ (12-99) . SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Long, Laura E. Debts of decedent must be reported on Schedule I. I FILE NUMBER 21- ESTATE OF ITEM NUMBER A. FUNERAL EXPENSES: DESCRIPTION AMOUNT See continuation schedule(s) attached 2,177.42 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions B. Karen L. Long Social Security Number(s) I EIN Number of Personal Representative(s): 162-36-7536 Street Address 10 Bellmore Road City Camp Hill State P A Zip 17011 Year(s) Commission paid 967.93 2. Attorney's Fees Earl Richard Etzweiler 967.93 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Karen L. Long Street Address 10 Bellmore Road City Camp Hill Relationship of Claimant to Decedent 3,500.00 State Daughter PA Zip 17011 4. Probate Fees 120.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs See continuation schedule(s) attached 20.00 TOTAL (Also enter on line 9, Recapitulation) 7,753.28 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev.1502 EX+ (6-98) *' SCHEDULE H.A FUNERAL EXPENSES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Long, Laura E. IFILE NUMBER 21- ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 Buffington-Reed Funeral Home - funeral bill 211.82 2 Evans Cemetary Memorials - granite memorial stone 925.00 3 James Shade - Maple Grove Burial plot 500.00 4 Kathy Fisher - Garden Path Flowers - funeral expense 540.60 Subtotal 2.177.42 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98) Buffington-Reed Funeral Home P.O. Box 123,200 West Main St. Valley View P A 17983 Ph 570-682-3070 Cell 570-682-3707 www.buffingtonreed.com James A. Reed, Jr., F.D. Monday, July 23, 2007 Mrs. Karen L Long 10 Bellmore Road Camp Hill, PA 17011 Dear Karen, Thank you for selecting our funeral home to provide service to you during your breavement. I hope that you found our services to be of the highest standards. If you were not totally satisfied with our services please contact me at the above listed number. The following is a summary of the charges for: LAURA EDNA LONG PROFESSIONAL SERVICES, FACILITIES & AUTOMOTIVE EQUIPMENT Basic service of funeral director, staff and basic overhead charges, Embalming, Dressing, casketing, cosmetics, details. Use of Facilities & Staff for Funeral Ceremony,. Removal Vehicle, Hearse / Funeral Coach, Flower / Lead Car. TOTAL SERVICE CHARGES $2,975.00 MERCHANDISE Casket: Clark Solid Ash $1,995.00 Outer Burial Container Con-O-Lite $1,175.00 Acknowledgement Cards 25 $ 10.00 Register Booklet $ 25.00 Memorial Folders 50 $ 25.00 Video Tribute $ 125.00 CASH ADVANCES Opening Grave Paid Newspaper Notice Harrisburg Patriot Paid Newspaper Notice Pottsville Republican Clergy Honorarium Certified Copies of Death Certificate Card of Thanks Citizen Standard Funeral Meal at Reed's Inn $3,355.00 $ 600.00 $ 226.80 $ 115.00 $ 125.00 $ 36.00 $ 7.00 $ 1236.20 $2,346.00 $lS,b7b.UU 8,464.18 $211.82 TOTAL OF SERVICES LESS: Payments Made BALANCE DUE If there are any questions or concerns that remain unanswered, please call me. Sincerely, y1-C)/ James A. Reed, Jr. BILL OF SALE Maple Grove Cemetary Elizabethville, P A Lot No. 28 Grave Site No. 53 No. 53 $500 James D. Shade I/)' WOIK: 237-o<lJ.1.f YSuanJ ?i3e?nele;;y ~WjfiatJ 39 Porter Road - Tower City, PA 17980 Phone: 117-641-2014 Artz Memorials - 510-682-9101 Minersvillel Pottsville Memorials - 570-544-0460 Millersburg Memorials. 717-692-0214 Date fC27/il7 No. ~a ree .. arliilf1l(" 0";: ) 11 1//2 e F. /o~r,. (Zt7 /~9.e(;-:A/ L.o ~ -./ reet / CJ (3 ~ II "'7 /7 Ie -e FE? ()A!..) >~' . / '/'0// c~_linJ n J-/; / / State /~ I Phone // 73 -7 "7' O-Vy Please enter my order for a memorial, with lettering as specified herein, for which I agree to pay you the sum of >7 c? s: 00 .Dollars in the manner s -' ed herei.9aft~r, to be erected on l,o.t No. in In/}/) /~ C:? I? (; IJ/::Cemetery I /) b )G/? / ~ /.....jf subject to the rules , ( City and State) and Regulations of said Cemetery. Materials, design, dimensions, finish and lettering of the memorial are to be substantantially as follows: S~ll '1 $h nJ e 3/g;)- qrg-l .Yee ApP(()\leJ VRAWINj No LITho Rose 6 (::t'l\ d b ( R St- Whd-e L li--hD N d cn e 5 ~. \, VI\ te s !' h The said memorial is guaranteed by you against any defect in wor1<manship. The said memorial, with title thereto and right of possesion thereof, shall remain your personal property until I have paid for it in full. In default of any payment hereunder I license you yo reposses and remove the said memorial without guilt of trespass or other wrong and authorized and empower you, in my name and on my behalf, to apply to the management of said Cemetery or other premises for a permit for its removal and to take any other steps you may deem necessary or expedient and further agree to save you harmless from and under any entry, repossession and removal, you may then retain said memorial or dispose of it at your own discretion without being answerable to me for it or any proceeds therefrom. Sale does not include any future service (death dates). Only the lettering herein specified is included in the agreed price. This order is subject to any delay cused by any strike, lockout, fire or other conditions beyond our control. I will inform you forthwith of any change in my address prior to final payment hereuncler. There is no other agreement regarding this order other than contained herein. Any part of this agreement contrary to the laws of any State shall not invalidate any other part thereof. Agreement of Payments: $ cash herewith: $ In or within ten days after erection of said memorial . *Excluding memorials placed in any cemetery that does not have the foundation in place when thenlemorial is in our possesion, require payment in fullupon notification to the customer of completed !'fIe-morial, not necessarily erection of memorial. This orde~,not su~j~et to cancellation after acceptance. /1 t't ' l'::: I /," . III ! , SIgned v---.... I .. , f /. ' / / i I "" ' By Die / J 1~ X / J' /2 )( 0-,6 , cll;l.>(/O X 0-6 ..J . ..-;) I (~eek ~//lcl/ Base Color f~..!J h I /J f u Date Ordered Cost Accepted Date "Y / cP 7 I 07 //~7/07 /, T~e I If not oaid within 30 Davs. 1.5% int&rest will bf! charged or 18% per year will be charged. Any other collection fees will be added to your account balance. Rev-1502 EX+ (6-98) *' SCHEDULE H-87 OTHER ADMINISTRATIVE COSTS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Long, Laura E. IFILE NUMBER 21-- ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 Register of Wills of Dauphin County - take Oath of Executor 20.00 Subtotal 20.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev-1512 EX+ (6-98) *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Long, Laura E. IFILE NUMBER 21-- ESTATE OF Include unrelmbursed medical expenses. ITEM NUMBER DESCRIPTION 1 Blanche Wiest - in-home care bill VALUE AT DATE OF DEATH 300.00 2 Merri Dorman - in-home care bill 750.00 3 Norma Allen - in-home care bill 594.00 4 Sally Shade - in-home care bill 300.00 TOTAL (Also enter on Line 10, Recapitulation) 1,944.00 (If more space is needed, additional pages of the same size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98) REV-1513 EX+ (9-00) ESTATE OF NUMBER I. *' SCHEDULE .. BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Long, Laura E. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] FILE NUMBER 21-- SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) RELATIONSHIP TO DECEDENT Do Not Ust Trusteels) 1 Clair A. Long 347 Tarry Hall Road Millersburg, PA 17061 1/6 of Residue Son 2 Karen L. Long 10 Bellmore Road Camp Hill, PA 17011 1/6 of Residue Daughter 3 Mark V. Long P.O. Box 84 Gratz, PA 17030 1/6 of Residue Son 4 Irene L. Runkle Box 685,1532 W. Maple Street Valley View, PA 17983 Martha M. Shade P.O. Box 308 Elizabethville, PA 17023 1/6 of Residue Daughter 1/6 of Residue Daughter 5 See continuation schedule attached Continuation Total Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) SCHEDULE .. BENEFICIARIES (Part I, Taxable Distributions) ESTATE OF: Laura E. Long 201-16-4383 07/15/2007 Item Name and Address of Person(s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($$$) 6 Blanche I. Wiest 901 Buttonwood Drive Harrisburg, PA 17109 Daughter 1/6 of Residue Total 1 ETZWEILER AND ASSOCIATES ATTORNEYS-AT-LAW 105 NORTH FRONT STREET HARRISBURG, PA 17101-1436 Office hours: Mon.-Fri. 8:00 a.m.-5:00 p.m. (717) 234-5600 Earl Richard Etzweiler, Esquire Christian S. Daghir, Esquire HALIFAX LINE (717) 896-3737 Fax Line: (717) 234-5610 Email Address:retzweiler(W.comcast.net 2 West Main Street Elizabethville, PA 17023 (717) 362-8395 Office hours: Thurs. 7:00 p.m.-9:00 p.m. 225 Market Street Millersburg, P A 17061 (717) 692-2519 Office hours: Tues. and Fri. 4:00 p.m.-8:00 p.m. Sat. 10:00 a.m.-12:00 noon September 25,2007 Register of Wills Office Cumberland County Courthouse 1 Courthouse Square Carlisle, P A 17013 (") -:J "" '-...':.:) --' en 1-'\ .'0 Re: Estate of Laura E. Long f'.) CY' Dear Madam: l"" r- Please find enclosed the original and three copies of the Inheritance Tax Return together with a check in the amount of $30.00 to file the same in regard the above estate. Please time-stamp the two copies and return them to our office in the enclosed self- addressed postage prepaid envelope. I am also enclosing the original and two copies of the Inventory. Please time-stamp two copies and return in the same envelope. Please contact my office if you have any questions regarding this matter. Sincerely yours, ~~ Earl Richard Etzweiler ERE:klp Enclosures H:IEST A TE-DIRIEST A TEILong-Lauralletters.wpd -"""~l ~ - ." .- " co -. , ; ... ) -4 :E en ~ ~ L "'c;,.-~-.c<..;;., ~ tn II 0 -' "i 2: tn - .... co Q) ...0 N 0 - en 0 en .... 3: tn '- Q) .- u. -. - ..:r N ~ """- <<:J: 1-- a:: --., ~~p ""-....... 1.._,) In N c... 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