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HomeMy WebLinkAbout11-15-07 (3) -.J 15056041147 DI=\I.4I;OO EX (06-05) "A~a~enrom'evenue 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 RESIDENT DECEDENT 2 1 0 6 FIle Number 1034 Date of Birth 184124544 08212006 02041922 Decedent's Last Name Suffix Decedent's First Name MI PHILLIPS IVAH C (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 1. Original Return o 2. Supplemental Return o 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 6. Decedent Died Testate (Attach Copy of Will) o [!] 4a. Future Interest Compromise (date of death after 12-12-82) 4. Limited Estate rXi '---' 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 1 8. Total Number of Safe Deposit Boxes 9. Litigation Proceeds Received n 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) [J 11.Election to tax under Sec. 9113(A) (Attach Sch. 0) ijORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: ame Daytime Telephone Number GARY L. JAMES ESQ. 7175333280 HUMMELSTOWN State PA ZIP Code 17036 ~ REGISTER~ ~LLS USEitNL Y;:.~ 2; ~:6 %....!- C) ~ '"'0 C) Y-; _ .n frliO ..:: v d ;;g- hi - rot i"h ';;E:; -::Q (J1 ::') CJ zCl>/" _ 0 o_~a -0 -1:::r1~ g. -n :s -;0 _ -("It ~;;;..t .. t - c> DA FILED N ""'1 Firm Name (If Applicable) JAMES, SMITH, DIETTERICK & First line of address 134 SIPE AVENUE Second line of address City or Post Office 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. SIG73U;;;;;RSOliiA'llNm~ILlNG RETURN Bruce Linn Phillips / t' ~~~ ~(J "1 ADDRESS ~ 1029 Schoolhouse Road, Annville, PA 17003 Gary L. James Esq. DATE 1(- '7 - i&c( melstown, PA 17036 Side 1 L 15056041147 15056041147 -.J ri --.J 15056042148 REV-1500 EX Decedent's Name Ivah C. Ph i II i ps RECAPITULATION 1. Real Estate (Schedule A).......................................................................................... 1. 2. Stocks and Bonds (Schedule B)............................................................................... 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............. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) 0 Separate Billing Requested............. Decedent's Social Security Number 184124544 2. 20,342.39 5. 11,849.03 6. 7. 320,536.91 8. Total Gross Assets (total Lines 1-7)....................................................................... 8. 352 , 72 8 . 33 . -----_._~-.__.__.-.~---_._~._-------~_._-------~~--,---~~--_. 9. Funeral Expenses & Administrative Costs (Schedule H)......................................... 9. 4 4 , 111 . 7 2 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)................................ 11. Total Deductions (total Lines 9 & 10)...................................................................... 12. Net Value of Estate (Line 8 minus Line 11)............................................................. 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J)................................................. 14. Net Value Subject to Tax (Line 12 minus Line 13)................................................. 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 .00 16. Amount of Line 14 taxable at lineal rate X .045 17. Amount of Line 1"41aXable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 o . 0 0 259,715.59 0.00 0.00 19. Tax Du8..................................................................................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 L 15056042148 10. 20,043.74 11. 64,155.46 12. 288,572.87 13. 28,857.28 14. 259,715.59 15. 0.00 16. 11,687.20 17. 0.00 18. 0.00 11,687.20 D 15056042148 --.J REV-1500 EX Page 3 Decedent's Complete Address: ;:, l'IAMt: Ivah C. Phillips STREET-ADDRESS ------------------------ 702 Fifteenth Street File Number 21-06-1034 CITY I STATE PA TZ'P-------- I 17070 New Cumberland Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 11,000.00 578.95 11,687.20 3. Interest/Penalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) 11,578.95 Total Interest/Penalty (D + E) 4. If Line 2 is greater than Line 1 + line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 2 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) (5A) (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 108.25 108.25 PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred;...............................on................................................ 0 b. retain the right to designate who shall use the property transferred or its income;.................................... 0 c. retain a reversionary interest; or.................................................................................................................. 0 d. receive the promise for life of either payments, benefits or care? .............................................................. 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?....................................................................................................................... 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?........ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?...................................................................................................................... 0 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. No I '-- [J o o [J o iX L- o 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 (O) percent [72 P.S. 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 or for the use of the decedent's siblings is twelve (12) percent [72 P.S. 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-1503 EX:> (6-98) '. SCHEDULE B STOCKS & BONDS COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Phillips, Ivah C. FILE NUMBER 21-06-1034 ESTATE OF All property jointfy-owned with right of survivorship must be disclosed on Schedule F. ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH 1 $20,000 Central Pennsylvania Conference Committee 100 20,000.00 The United Methodist Church demand note 5.5% - valued per letter dated 02/22/07 Accrued income on Item 1 through date of death 342.39 TOTAL (Also enter on Line 2, Recapitulation) 20,342.39 (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 B (Rev. 6-98) Rev-1508 EX+ (6-98) .*, SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Phillips, Ivah C. FILE NUMBER 21-06-1034 Include the proceeds of litigation and the date the proceeds were received by the estate. All property JoInlly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION 1 PA Central Federal Credit Union share savings account # 13073-015 - valued per letter dated 03/12/2007 VALUE AT DATE OF DEATH 5,012.24 2 Sovereign Bank checking account # 0771100582 - valued per letter dated 02/15/2007 1,836.67 Accrued income on Item 2 through date of death 0.12 3 1997 Toyota Camry - valued per sales price 5,000.00 TOTAL (Also enter on Line 5, Recapitulation) 11,849.03 (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) Rev-1510 EX.+ (6-98) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE T AA RETURN RESIDENT DECEDENT ESTATE OF Phillips, Ivah C. FILE NUMBER 21-06-1034 This schedule must be completed and filed if the answerto any of questions 1 tI1rough 4 on the reverse side of the REV-l500 COVER SHEET is yes. ITEM ' IIVI'! vr t'Kvt'cK I Y DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE NUMBER INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE THE DATE OF TRANSFER- ATTACH A COPY OF THE DEED FOR REAL ESTATE. 1 AIG SunAmerica Annuity account # 83,992.42 83,992.42 P37A0011502 - titled in the name of Harry J and Ivah C Phillips Living Trust dated September 27, 1997 valued per letter dated 02121/07- beneficiaries are Bruce Phillips and Kathy Phillips Finley 2 252.323 units of American Funds Capitallnc 14,518.67 14,518.67 Builder Fund CI A - held in the Edward Jones Brokerage account No. 957-08689-1-0 - titled in the name of Harry J and Ivah C Phillips Living Trust dated September 27,1997 valued per statement and public listing 3 152.856 units of American Funds Smallcap World 5,797.83 5,797.83 A - held in the Edward Jones Brokerage account No. 957-08689-1-0 - titled in the name of Harry J and Ivah C Phillips Living Trust dated September 27,1997 valued per statement and public listing 4 300.074 units of American Funds Washington 9,866.43 9,866.43 Mutual Investors Fund CL A - held in the Edward Jones Brokerage account No. 957-08689-1-0- titled in the name of Harry J and Ivah C Phillips Living Trust dated September 27,1997 valued per statement and public listing 5 Real estate located at 702 Fifteenth Street, 175,000.00 175,000.00 Cumberland County, PA - titled in the Harry J. Phillips and Ivah C. Phillips Living Trust dated September 27,1997 valued per sales price Total of Continuation Schedule ee attached page TOTAL (Also enter on Line 7, Recapitulation) 320,536.91 (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 G (Rev. 6-98) Rev-1510 EX+ (6-98) .w SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY continued COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Phillips, Ivah C. IIFILE NUMBER I 21-06-1034 ITEM 'IIUN Uf ""'" " y DATE OF DEATH % OF OECD'S EXCLUSION TAXABLE NUMBER INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND VALUE OF ASSET INTEREST (IF APPliCABLE) VALUE THE DATE OF TRANSFER. ATTACH A COpy OF THE DEED FOR REAL ESTATE. 6 Sovereign Bank savings account # 0774042758- 4,298.56 4,298.56 titled in the Harry J and Ivah C Philips Living Trust dated September 27, 1997 - valued per letter dated 02115/2007 Accrued interest on Item 6 through date of death 4.51 4.51 7 1,158.529 units of Van Kampen Equity and 10,241.40 10,241.40 Income Fund CL A - held in the Edward Jones Brokerage account No. 957-08689-1-0 - titled in the name of Harry J and Ivah C Phillips Living Trust dated September 27,1997 valued per statement and public listing 8 1,519.159 units of Van Kampen HighYield 16,817.09 16,817.09 Municipal Fund CL A - held in the Edward Jones Brokerage account No. 957-08689-1-0 - titled in the name of Harry J and Ivah C Phillips Living Trust dated September 27,1997 valued per statement and public listing TOTAL (Also enter on Line 7, Recapitulation) 320,536.91 Copyright (c) 2002 form software only The Lackner GrouP. Inc. Form PA.1500 Schedule G (Rev. 6-98) REV-1151 EX+ (12-99) ,*' SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Phillips, Ivah C. Debts of decedent must be reported on Schedule I. FILE NUMBER 21-06-1034 ITEM NUMBER A. FUNERAL EXPENSES: DESCRIPTION AMOUNT See continuation schedule(s} attached 5,499.89 B. 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City Year(s) Commission paid State Zip 2. Attorney's Fees James, Smith, Dietterick & Connelly, LLP 11,000.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent State Zip 4. Probate Fees 132.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs See continuation schedule(s) attached 27,479.83 TOTAL (Also enter on line 9, Recapitulation) 44,111.72 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 PENNSYl VANIA INHER1TANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Phillips, Ivah C. FILE NUMBER 21.06-1034 ITEM NUMBER 1 DESCRIPTION Coakley's Restaurant & Pub. funeral lunch AMOUNT 446.89 2 Stone & Murray Funeral Home. funeral services 5,053.00 Subtotal 5,499.89 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98) Rev-1502 EX.+ (6-98) ESTATE OF SCHEDULE H-87 OTHER ADMINISTRATIVE COSTS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Phillips, Ivah C. FILE NUMBER 21-06-1034 ITEM NUMBER AMOUNT 1 DESCRIPTION Advance Auto Parts - service on 1997 Toyota Camry 99.33 2 AT&T 158.28 3 AT&T 42.87 4 AT&T 30.39 5 Borough of New Cumberland - sewer/trash for residence 64.80 6 Borough of New Cumberland - sewer/trash for residence 64.80 7 Bruce Phillips - miscellaneous items for house 13.98 8 Castle Clean 127.20 9 CB Homesale Services Goup, Inc - broker's commission on real estate sale 5,067.50 10 Comcast Cable 47.68 11 Com cast Cable 47.68 12 Comcast Cable 47.68 13 Comcast Cable 48.00 14 Comcast Cable 146.14 15 Comcast Cable 199.00 16 Cumberland County Recorder of Deeds - transfer tax 1,750.00 17 CVS Pharmacy - miscellaneous items for house 17.67 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev.1502 EX+ (6-98) ,* SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS continued COMMONWEAL TH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Phillips, Ivah C. FILE NUMBER 21-06-1034 ITEM NUMBER DESCRIPTION AMOUNT 18 CVS Pharmacy - miscellaneous items for house 9.96 19 Edward Jones - overnight delivery charge 8.00 20 Gunn-Mowery LLC - insurance on residence - vacant dwelling 432.76 21 Gunn-Mowery LLC - insurance on residence - vacant dwelling 317.76 22 Hepfers Ace Homecenter - miscellaneous items for house 35.75 23 Hepfers Ace Homecenter - miscellaneous items for house 13.94 24 Hepfers Ace Homecenter - miscellaneous items for house 4.01 25 Hepfers Ace Homecenter - miscellaneous items for house 15.35 26 Hepfers Ace Homecenter - miscellaneous items for house 6.87 27 Hepfers Ace Homecenter - miscellaneous items for house 4.54 28 Hepfers Ace Homecenter - miscellaneous items for house 31.62 29 Hepfers Ace Homecenter - miscellaneous items for house 19.05 30 Hepfers Ace Homecenter - miscellaneous items for house 9.70 31 Hepfers Ace Homecenter - miscellaneous items for house 10.58 32 Hepfers Ace Homecenter - miscellaneous items for house 28.60 33 Hepfers Ace Homecenter - miscellaneous items for house 35.87 34 Hepfers Ace Homecenter - miscellaneous items for house 6.34 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev.1502 EX+ (6-98) .* SCHEDULE H-87 OTHER ADMINISTRATIVE COSTS continued COMMONWEAl TH OF PENNSYLVANIA INHERiTANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Phillips, Ivah C. FILE NUMBER 21-06-1034 ITEM NUMBER AMOUNT DESCRIPTION 35 Hepfers Ace Homecenter - miscellaneous items for house 11.65 36 Hepfers Ace Homecenter - miscellaneous items for house 32.30 37 Hepfers Ace Homecenter - miscellaneous items for house 12.69 38 Hepfers Ace Homecenter - miscellaneous items for house 51.98 39 Highmark Blue Shield 410.55 40 Homestead Group Realtor Inc - broker's commission on real estate sale 5,117.50 41 Homestead Group Realtor Inc - transaction fee 100.00 42 James C. Lutz, Landscaping - lawn service 76.00 43 James, Smith, Dietterick, & Connelly LLP - reserve for estate administartion closing costs 250.00 44 John R. Zimmerman - messenger service 38.00 45 K Mart - kitchen curtains 21.18 46 K Mart - miscellaneous items for house 4.72 47 Keystone Oil 277.64 48 Keystone Oil 249.90 49 Keystone Oil 256.65 50 Keystone Oil 374.85 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev.1502 EJC+ (6-98) ESTATE OF SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX R.ETURN RESIDENT DECEDENT Phillips, Ivah C. FILE NUMBER 21-06-1034 ITEM NUMBER AMOUNT DESCRIPTION 51 Kleinfelter Chevrolet 177.55 52 Lentha Zinsky - paint for kitchen 28.00 53 Linens 'N Things - miscellaneous items for house 27.54 54 Lowe's - miscellaneous items for house 49.70 less items returned to store 31.78 17.92 55 Lowe's - miscellaneous items for house 63.98 56 Lowe's - miscellaneous items for house 6.08 57 Lowe's - miscellaneous items for house 35.04 58 Lowe's - miscellaneous items for house 5.81 59 Lowe's - miscellaneous items for house 48.39 60 Lowe's - miscellaneous items for house 25.40 61 Lowe's - miscellaneous items for house 32.04 62 Lowe's - miscellaneous items for house 21.05 63 Lowe's - miscellaneous items for house 43.19 64 Lowe's - miscellaneous items for house 32.12 65 Lowe's - compact electric stove 207.76 66 Lowe's - miscellaneous items for house 7.38 67 Lowe's - miscellaneous items for house 110.56 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA.1500 Schedule H-B7 (Rev. 6-98) Rev-1502 EX+ (6-98) .tti SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Phillips, Ivah C. FILE NUMBER 21-06-1034 ITEM NUMBER DESCRIPTION AMOUNT 68 Lowe's - miscellaneous items for house 32.63 69 Lowe's - miscellaneous items for house 46.38 70 Lowe's - miscellaneous items for house 27.86 71 Lowe's - miscellaneous items for house 60.36 72 Lowe's - miscellaneous items for house 35.78 73 Lowe's - miscellaneous items for house 34.34 74 Lowe's - miscellaneous items for house 72.30 75 Lowe's - miscellaneous items for house 106.00 76 Lowe's - miscellaneous items for house 32.71 77 Lowe's - miscellaneous items for house 63.18 78 Lowe's - miscellaneous items for house 21.30 79 Lowe's - miscellaneous items for house 37.06 80 Lowe's - miscellaneous items for house 28.26 81 Lowe's - miscellaneous items for house 0.56 82 Lowe's - miscellaneous items for house 27.95 83 Lowe's - miscellaneous items for house 16.55 84 Lowe's - miscellaneous items for house 259.07 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev-1502 EX+ (6-98) ESTATE OF SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS continued COMMONWEAlTH OF PENNSYLVANIA ~HERITANCETAXRETURN RESIDENT DECEDENT Phillips, Ivah C. FILE NUMBER 21-06-1034 ITEM NUMBER AMOUNT DESCRIPTION 100 85 Lowe's - miscellaneous items for house 77.87 86 New Cumberland Borough - sewerl trash service for residence 64.80 87 New Cumberland Borough - sewer April - June 26.20 88 New Cumberland Borough - trash July - September $38.60 less adjustment for item paid by sell in advance per HUD 1 settlement sheet $29.18 9.42 89 New Cumberland Borough - sewer July - September 6.60 90 Nicole L. Vanorder - seller assistance for real estate located at 70215th Street, New Cumberland per HUD 1 settlement sheet 5,250.00 91 Ollie's Bargain Outlet - miscellaneous items for house 269.14 92 Ollie's Bargain Outlet - miscellaneous items for house 5.29 93 Ollie's Bargain Outlet - miscellaneous items for house 5.28 94 Ollie's Bargain Outlet - miscellaneous items for house 5.80 95 Outdoor World - 2007 annual dues 169.00 96 PA Central Federal Credit Union - Visa credit card payment 15.00 97 PA Central Federal Credit Union - Visa credit card payment 286.00 98 Penn National Insurance - home owners insurance 71.00 99 Penn National Insurance - home owners insurance 176.00 Pennsylvania American Water Company 17.23 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev-1502 EX.. (6-98) SCHEDULE H-87 OTHER ADMINISTRATIVE COSTS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Phillips, Ivah C. FILE NUMBER 21-06-1034 ITEM NUMBER DESCRIPTION AMOUNT 101 Pennsylvania American Water Company 13.22 102 Pennsylvania American Water Company 17.62 103 Pennsylvania American Water Company 17.62 104 Pennsylvania American Water Company 17.03 105 Pennsylvania American Water Company 17.62 106 Pennsylvania American Water Company 18.22 107 Pennsylvania American Water Company 17.03 108 Pennsylvania American Water Company 16.83 109 Pennsylvania American Water Company 17.03 110 Pennsylvania American Water Company 19.42 111 Pennsylvania American Water Company 17.62 112 PPL - service for residence 66.64 113 PPL - service for residence 67.53 114 PPL - service for residence 30.69 115 PPL - service for residence 29.04 116 PPL - service for residence 35.62 117 PPL - service for residence 34.54 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev-1502 EX + (6-98) ESTATE OF SCHEDULE H-87 OTHER ADMINISTRATIVE COSTS continued COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Phillips, Ivah C. FILE NUMBER 21-06-1034 ITEM NUMBER AMOUNT DESCRIPTION 118 37.43 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 PPL - service for residence PPL - service for residence 41.20 PPL - service for residence 45.87 PPL - service for residence 28.04 PPL - service for residence 24.94 PPL - service for residence 47.35 PPL - final service for residence 35.44 SECCO Home Services - repairs for air conditioning 1,354.68 Sovereign Bank savings account # 0774042758 - service fee 0.90 The Home Depot - miscellaneous items for house 34.83 The Home Depot - miscellaneous items for house 30.91 The Home Depot - miscellaneous items for house 23.65 The Home Depot - miscellaneous items for house 40.37 The Home Depot - miscellaneous items for house 20.10 The Home Depot - miscellaneous items for house 20.93 The Patriot News - ad for electric piano 29.25 The Patriot News - ad for Toshiba TV 24.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev-1502 EX+ (6-98) .. SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS continued COMMONWEAL TH OF PENNSYLVANIA INHERITANCE TM RETURN RESIDENT DECEDENT Phillips, Ivah C. FILE NUMBER 21-06-1034 ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 135 The Patriot News - ad for sleeper sofa 24.00 136 The Patriot News - ad for dining set 27.50 137 The Patriot News - ad for dryer & washer 31.00 138 UGI 16.43 139 UGI 16.35 140 UGI 14.80 141 UGI 16.06 142 UGI 15.74 143 UGI 14.32 144 UGI 14.32 145 UGI 15.89 146 UGI 14.32 147 UGI 17.20 148 UGI 13.21 149 United Rentals - deposit 150.00 150 UPS - overnight delivery charges 9.31 151 Verizon 26.03 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev-1502 EX+ (6-98) SCHEDULE H-87 OTHER ADMINISTRATIVE COSTS continued COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Phillips, Ivah C. FILE NUMBER 21-06-1034 ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 152 Verizon 26.90 153 Verizon 26.30 154 Verizon 55.43 155 Verizon 26.17 156 Wal Mart - miscellaneous items for house 44.03 157 Wal-Mart - miscellaneous items for house 75.27 Subtotal 27,479.83 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 lNHERITANCE TM RETURN RESIDENT DECEDENT ESTATE OF Phillips, Ivah C. FILE NUMBER 21-06-1034 Include unrelmbursed medical expenses. ITEM NUMBER DESCRIPTION 1 AT & T VALUE AT DATE OF DEATH 47.12 2 Central Pennsylvania OB-GYN - annual exam 102.00 3 Hepfers Ace Homecenter - miscellaneous items for house purchased prior to date of death 13.77 4 Kathy Finley - loan to Ivah 10,800.00 5 Lowe's - miscellaneous items for house purchased prior to date of death 36.02 6 Lowe's - miscellaneous items for house purchased prior to date of death 102.48 7 PA Central Federal Credit Union auto loan # 13073-025 - valued per letter dated 03/12/2007 8,507.12 8 PA Department of Revenue - 2006 personal income tax 65.00 9 Pennsylvania American Water Company 14.26 10 U.S. Treasury - 2006 personal income tax 310.00 11 UGI 14.94 12 Verizon 31.03 TOTAL (Also enter on Line 10, Recapitulation) 20,043.74 (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) ,* SCHEDULE .. BENEFICIARIES COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF NUMBER Phillips, Ivah C. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY ITIUN:S l~nCluoe outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] FILE NUMBER 21-06-1034 -T. RELATIONSHIP TU DECEDENT Do Not List Trustee(s) SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) 1 Bruce Linn Phillips 1029 Schoolhouse Road Annville, PA 17003 Son 45% of residue 129,857.79 2 Kathy Eileen Phillips Finley 45 Winding River Trail Chagrin Falls, OH 44022 Daughter 45% residue 129,857.79 Total 259,715.58 Enter dollar amounts for distributions shown above on lines 5 through 18, as appropnate, 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 See continuation schedule(s) attached 28,857.28 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 7R,K~ r .;lts Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) Rev.1502 EX+ (6-98) SCHEDULE .I-liB CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE lAX. RETURN RESIDENT DECEDENT ESTATE OF Phillips, Ivah C. FILE NUMBER 21-06-1034 ITEM NUMBER 1 DESCRIPTION Central Pennsylvania Conference of the United Methodist Church 303 Mulberry Drive P.O. Box 2053 Mechanicsburg, PA 17055 AMOUNT 28,857.28 Subtotal 28,857.28 Copyright (c) 2002 form software only The Lackner GrouP. Inc. Form PA-1500 Schedule J-IIS (Rev. 6-98) ~ ~ ~ ~.t_. \(""") ~ \1"'(2 9~, ~ W).~ ~ .;:;:\ ro ~" ~ _ '-'$:) \...'-:) '~ (J\ -,. I'J ~.~ 1...:>..,.".:"f1.-. (jJ. - \ -'f"\ n ..-0 % 1"') ~~ -$ 'f'-"" 1"f" <p~ -:: \':'... 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