HomeMy WebLinkAbout09-26-07 (2)
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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
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\}lk
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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
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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>
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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
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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.
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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
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By
Die
/ J 1~ X / J' /2 )( 0-,6
,
cll;l.>(/O X 0-6
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(~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
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Re: Estate of Laura E. Long
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Dear Madam:
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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
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Enclosures
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