HomeMy WebLinkAbout03-03-08 (2)
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15056041125
REV -1500 EX (06-05)
PA Department of Revenue '*
~~~~~~~~~~~uaITaxes INHERITANCE TAX RETURN
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
OFFICIAL USE ONLY
County Code Year
021 Of
File Number
0935
Date of Birth
16430 072 1
o 1 122 0 0 8
042 7 1 9 1 6
Decedent's Last Name
Suffix
Decedent's First Name
LIMBERT
THELMA
MI
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
[ZJ 1. Original Return
o 4. Limited Estate
o
o
o 2. Supplemental Return
o 4a. Future Interest Compromise (date of
death after 12-12-82)
o 7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
o 10. Spousal Poverty Credit (date of death 0 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. 0)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
o
o
3. Remainder Retum (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
8. Total Number of Safe Deposit Boxes
JAN
L
BROWN
71754 1 555 0
Finn Name (If Applicable)
845
SIR
THOMAS
C T
S T E
1 2
I "GIS~~ "" WILLS use -ONt: y- . .
I I
W
I~TE'FILED 22 : . ,
l_._._~~____4_____,.
:.D
--i
J A N
L
BROWN
&
ASSOC
First line of address
SE~cond line of address
City or Post Office
State
ZIP Code
H A R R I S BUR G
PA
17109
N
o
C',
Correspondent's a-mail address: brendajlb@verizon.net
Under penalties of pe~U1Y, I declare that I have examined this retum, 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.
SIGNATUR OF ERSON R P NSIB OR FILING RETURN DATE
2/29/2008
Drive
Mechanicsburg
PA 17050
DATE
2/29/2008
PA 17109
EPRESENTATIVE
ADORE
845 Sir Thomas Ct Ste 12 Harrisburg
PLEASE USE ORIGINAL FORM ONLY
Side 1
L
15056041125
15056041125
....J
.-J
15056042126
REV-1500 EX
Decedent's Social Security Number
164300721
Decedent's Name: THELMA E. LIMBERT
RECA.PITULA TION
1. Fleal 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. Gash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 5. 5 5 7 7 3 5
...... .
6. ,Jointly Owned Property (Schedule F) D Separate Billing Requested . . . . . . . 6. 5 2 7 1 3 . 2 3
7. Inter-Vivos Transfers & Miscellaneous NErrobate Property
(Schedule G) Separate Billing Requested . . . . . . . 7. 2 4 8 9. 0 0
8. Total Gross Assets (total Lines 1-7) .......................... . 8. 6 0 7 7 9 . 5 8
9. Funeral Expenses & Administrative Costs (Schedule H) 9. 8 9 9 3. 6 2
............... .
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . 10. 2 5 5 2. 6 6
11. Total Deductions (total Lines 9 & 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 1 1 5 4 6 . 2 8
12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . 12. 4 9 2 3 3 3 0
13. Charitable and Governmental Bequests/See 9113 Trusts for which
an election to tax has not been made (Schedule J) ...... . . . . . . . . . . ..13.
14. Net Value Subject to Tax (Line 12 minus Line 13) ........ . . . . . ..... 14. 4 9 2 3 3 . 3 0
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.O _ o . 0 0 15. O. 0 0
16. Amount of Line 14 taxable 9
at lineal rate X .O~ 4 2 3 3 . 3 0 16. 2 2 1 5 . 5 0
17. Amount of Line 14 taxable o . 0 0
at sibling rate X .12 17. o . 0 0
18. Amount of Line 14 taxable o . 0 0 O.
at collateral rate X .15 18. 0 0
19.. Tax Due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 2 2 1 5 . 5 0
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
o
Side 2
L
15056042126
15056042126
.-J
REV-1500 EX Page ,I
Decedent's Complete Address:
DECEDENT'S NAME
THELMA E. LIMBERT
STREEfADDRESS -----~--
Goliten 1d....lD9~~ent~: W~st St)ore _
File Number
o 0
I!Q_P~2Iar 9~ilJ!~hB~ClfL______
CITY
Camp Hill
STATE
PA
ZIP
17011
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1) 2,215.50
110.77
Total Credits (A + 8 + C)
(2)
110.77
3.
(3)
(4)
(5)
(5A)
(58)
0.00
0.00
2,104.73
4.
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.
2,104.73
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; ...................................................................... 0 00
b. retain the right to designate who shall use the property transferred or its income; ............................... 0 00
c. retain a reversionary interest; or ................................................................................................ 0 00
d. receive the promise for life of either payments, benefits or care? ....................................................... 0 00
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... 00 0
3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ......... 0 00
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .................................................................................................. 0 lXI
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.
REV-150B EX + (6-9:6)
'*
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
THELMA E. LIMBERT
FILE NUMBER
o 0
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
5,577 .35
PNC Bank; Savings 50-0521-3366
(Account proceeds paid directly to Wayne P Urbine Funeral Home Inc)
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
5 577.35
REV-1509 EX + (6-98)
*'
SCHEDULE F
JOINTLY-OWNED PROPERTY
,
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
THELMA E. LIMBERT
FILE NUMBER
o 0
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A. Shirley Ann Reiff
519 Seventh Street
New Cumberland PA 17020
daughter
B Patricia E Jones
220 South Lovelady Road
Cookeville TN 38506
daughter
c Melanie E Reiff Eshleman
2 Hillcrest Drive
Mechanicsburg PA 17050
granddaughter
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 DATE OF DEATH DECO'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. 2001 PNC Bank; Checking 50-0350-4856 99,321.02 50. 49,660.51
2 A 1976-77 US Savings Bonds, Series E, Qty 4 2,194.88 50. 1,097.44
Inventory is attached.
3 B 1976-77 US Savings Bonds, Series E, Qty 7 2,965.58 50. 1,482.79
Inventory is attached.
4 C 1975-76 US Savings Bonds, Series E, Qty 3 944.98 50. 472.49
Inventory is attached.
TOTAL (Also enter on line 6, Recapitulation) $ 52.713.23
..
(If more space is needed. insert additional sheets of the same size)
REV-1510 EX + (6-98)
.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
THELMA E. LIMBERT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
FILE NUMBER
o 0
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY
ITEM INCLUDE THE NAME OF THE TRN>ISFEREE, THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRN>ISFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST VALUE
(IF APPLICABlE)
1. Transfers/Gifts to Melanie E Eshleman, granddaughter 5,489.00 100. 3,000.00 2,489.00
$499 x 11; Feb 2007 - Jan 2008
TOTAL (Also enter on line 7 Recapitulation) $ 2489.00
III more space is needed. insert additional sheets of the same size)
REV-1511 EX + (12-99)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
THELMA E. LIMBERT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
o 0
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Wayne P Urbine Funeral Home Inc 8,288.62
2 Funeral luncheon 170.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attomey Fees Jan L Brown & Associates 500.00
3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountanfs Fees
6. Tax Retum Prepare!'s Fees
7. Additional death certificate 20.00
8 Register of Wills, Cumberland County; filing fee Inheritance Tax Return 15.00
TOTAL (Also enter on line 9, Recapitulation) $ 8 993.62
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX + (12-03)
'*
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
THELMA E. LIMBERT
FILE NUMBER
o 0
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1. Ck 196 payable to Blue Cross of Northeastern Pennsylvania
Written 12/27/07; cashed postdeath
VALUE AT DATE
OF DEATH
14.34
2 Golden LivingCenter - West Shore
2,538.32
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
2 552.66
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
1. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. Shirley A Reiff, daughter Lineal
51~l Seventh St, New Cumberland, PA 17020 Sch F
2 Patricia E Jones, daughter Lineal
220 S Lovelady Rd, Cookeville, TN 38506 Sch F
3 Melanie E Eshleman, granddaughter Lineal
2 Hillcrest Dr, Mechanicsburg, PA 17050 Sch F & G
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 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
R"-""'" ".
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
THELMA E. LIMBERT
SCHEDULE J
BENEFICIARIES
FILE NUMBER
o 0
(If more space is needed, insert additional sheets of the same size)
Caleulated Value of Your Paper Savings Bond(s)
Page 1 of I
Thelma E Limbert or Shirley Ann Reiff
Calculated Value of Your Paper Savings Bond(s)
Calculator Results for Redemption Date 01/2008
[Total Price
300.00
Total Value
2 194.88
Total Interest
1 894.88
Bonds: 1-4 of 4
Serial #
Issue Next Final
Series Denom
Date Accrual Maturity
E $100 01/1977 01/2007
E $100 01/1977 01/2007
E $100 09/1976 09/2006
E $100 07/1976 07/2006
Totals for 4 Bonds
C20i15118522E
C2015118521E
C2015118498E
c2015118493e
~ Notes
HI Not Issued
HE Not eligible for payment
P5 Includes 3 month interest penalty
MA Matured and not eamin interest
YTD Interest
0.00
I t t Interest
n eres Rate
$477.16
$477.16
$470.28
$470.28
1 894.88
Value
$552.16
$552.16
$545.28
$545.28
2 194.88
Note
MA
MA
MA
MA
ISSUE~DATE ".
WHICIlISJ~T D...v or, .'
~ '. ":m~~i:%&~.
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~, w W :.., _- . w: _- _-
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AT THt ORIGINAL MATURITY MERKO" WILL PAY
_ug!m8M>DJ!n~
fdMrS. Thelma E. Limbert, J'64-3D-0721
'. lIt, Point Breeze
.i~:.Renovo~ Pa. 17764
Mrs. Shirley Ann R~iff
,-"'-~~;;~ERlES:E...
~ .,....MttO..lSMlIlO.....~M
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- AT THE OR.OtNAL MATURITY HERIEO,. WILL PAY
_~~~_Dtm81
164-30-0721
r~
.{Q~:~6. Thelma E. Limbert:
'117 Point. Breeze Ave.
2" '.RenOVO, Penna. 17764
Shirley Ann Re:l,tt
'. ;It
_::.~ -:-~~~ .
>-~~~~;e;ERIE$.E .. .
.....eottD.....'*""~O'-~' 'ACT. ...MICIIDID,..........
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.~1RI1DD~a~
AT THIE O"IGfNAL MATURITY HltltCOP" WILL PAY
-~~~~~
70.
Mr-s. Thelma E. Limbert
117 Point Breeze
RenoV'o, Fa. 17764
164-30-0721
Shirley Ann Reif
. .",,:.., -- . ":_--.
_-:l~"
.,....::_4__.; .. :......._.'
...~_-u-u_-;.~~~.~
-:- ..-- - AT THE ORIGINAL MATURtTY HEREOF WILL ,.AY
~!!Dg!!~~~
2;/
..'.- Mrs. Thelma E. Limbert
~::-117. Point Breeze
-ii<Renovo, Fa. 17764
164- 30-0721
Shirley Ann Reif
.~
Calculated Value of Your Paper Savings Bond(s)
Page I of I
Thelma E Limbert or Patricia Eileen Jones
Calculated Value of Your Paper Savings Bond(s)
Calculator Results for Redemption Date 01/2008
[Total Price
412.50
Bonds: 1-7 of 7
Serial #
C2055174227E
Q6222281501E
Q6222281500E
C2015118524E
C2015118523E
C2015118501E
C2015118500E
Total Value
2 965.58
Total Interest
2 553.08
YTD Interest
0.00
Issue Next Final
Series Denom
Date Accrual Maturity
E $100 12/1977 12/2007
E $25 12/1977 12/2007
E $25 12/1977 12/2007
E $100 01/1977 01/2007
E $100 01/1977 01/2007
E $100 09/1976 09/2006
E $100 09/1976 09/2006
Totals for 7 Bonds
~ Notes
NI Not Issued
NE Not eligible for payment
P5 Includes 3 month interest penalty
MA Matured and not earnin interest
Issue Interest Interest Value Note
Price Rate
$75.00 $438.80 $513.80 MA
$18.75 $109.70 $128.45 MA
$18.75 $109.70 $128.45 MA
$75.00 $477.16 $552.16 MA
$75.00 $477.16 $552.16 MA
$75.00 $470.28 $545.28 MA
$75.00 $470.28 $545.28 MA
12.50 2 553.08 2 965.58
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f 117 l\)int Breeze Isa. ~
!~1... !lenovo, Penna. 17764 '~"'''.tm "",~. .j.~
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Calculated Value of Your Paper Savings Bond(s)
Page 1 ofl
Thelma E Limbert or Melanie Eileen Reiff Eshleman
Calculated Value of Your Paper Savings Bond(s)
Calculator Results for Redemption Date 01/2008
[Total Price
131.25
Total Value
944.98
Total Interest
813.73
Bonds: 1-3 of 3
Serial #
Issue Next Final
Series Denom
Date Accrual Maturity
E $50 06/1976 06/2006
E $100 11/1975 11/2005
E $25 11/1975 11/2005
Totals for 3 Bonds
L2026139586E
C1031480595E
Q2S76417488E
Notes
HI Not Issued
NE Not eligible for payment
P5 Includes 3 month interest penalty
MA Matured and not earnina interest
YTD Interest
0.00
Interest
Interest Rate Value Note
$235.18 $272.68 MA
$462.84 $537.84 MA
$115.71 $134.46 MA
813.73 944.98
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AT THE OR'G'~A'" MATURt"'Y HC-REOF WILL "AY
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TflMrs. Thelma E. Limbert 16Lr-30-0721
117 Fbint Breeze
Renovo, Fa. 17764
or
M1ss Me1enie Eileen Reiff
.
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Plya ftAII. AND Tl:N MONTH. PltOM THE .SSUE DAT. HlEltlEOP' WILl.. PO.Y
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Thelma Limbert 164-30-0721
117 Point Breeze
Renovo, Pa.
or ..
Melanie Eileen Reif"f
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AT THE ORIGINAL MATURITY HERCOP'WILL PAY
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Thelma Limbert 164- 30-0721
117 Point Breeze
Renovo, Fa.
or
Melanie Eileen Reiff"
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1031480595E
JAN L. BF:oWN, ESQUIRE'
JACQUELINE A. KELLY, ESQUIRE
. ADMITTED IN PA AND DISTRICT OF COLUMBIA
JAN L. BROWN & ASSOCIATES
ATTORNEYS AND COUNSELORS AT LAW
aLOE ENGLISH GAP
845 SIR THOMAS COURT
SUITE 12
HARRISBURG, PA 17109
EMAIL jlbassoc@verizon.net
1/'oNIIN. janbrownlaw. com
TELEPHONE (717) 541-5550
FACSIMILE (717) 541-9223
BRENDA F. KEPHART. LEGAL ASSISTANT
PAULA K. WHITE. LEGAL ASSISTANT
JUDITH A. EBERSOLE, ADMINISTRATIVE ASSISTANT
February 29, 2008
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, P A 17013
J::tlIo
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Re:
Thelma E. Limbert, deceased
Social Security No. 164-30-0721
N
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Gentlemen or Ladies:
Enclosed please find the following items for filing with the Register of Wills:
1. An Estate Information Sheet
2. Inheritance Tax Return in duplicate.
3. A check payable to Register of Wills, Agent in the amount of$2,104.73 to cover the
Inheritance Tax liability.
4. A check payable to the Register of Wills in the amount of $15 to cover the filing fee for
the non-probate Inheritance Tax Return.
Please time stamp and return our file copy. A return envelope is provided.
If you have any questions, feel free to contact this office.
Sincerely,
~dcL f ~aAf;
Brenda F. Kephart
Legal Assistant
bfk
Enclosure
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