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Home My WebLink About05-31-0815056041147 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO 60X.280601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT 2 1 0 7 0 0 9 3 3 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 162 22 8938 09 Ol 2007 12 29 1921 Decedent's Last Name Suffix Decedent's First Narne MI COOKS HELEN A (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Names MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW X~ 1. Original Return I ! 2. Supplemental Return ' i 3. Remainder Return (date of death ' prior to 12-13-82) 4. Limited Estate i qa, Future Interest compromise ~ 5. Federal Estate Tax Return Required - - (date of death after 12-12-82) - - f~ g Decedent Died Testate ~ ~ ~ Decedent Maintained a Living Trust /`~ ~B. Total Number of Safe Deposit Boxes L^~ (Attach Copy of Will) (Attach Copy of Trust) V 9. Litigation Proceeds Received 10. spousal Poverty Credit (date of Beam '! 11. Election to tax under Sec. 9113(A) L_, !_...~ between 12-31-91 and 1-1-95) _ (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL 1'AX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number JAN M WILEY 717 432 9666 Firm Name (If Applicable) THE WILEY GROUP, PC First line of address 130 W. CHURCH STREET Second line of address City or Post Office DILLSBURG Correspondent's a-mail address: State ZIP Code PA 17019 REGISTE~F WILLS U~,,-'ONLY -- C7 ~, `^~ - ~ , -- ' .~,, _ ~ - :~~ _ - ~7tfiE FILE[J. ~ ~., C:~ 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. 30 W. Church Street, Dillsburg, PA 17019 Side 1 15056041147 15056041],47 15 W. Barrens VAlley Road, Dillsburg, PA 17019 S NATURE OF PREPARER OTHHER TH~N REPRESENTATIVE DATE ~'}'~-~Z b~Vl t- t.~J ._-~-~ Jan M Wiley 7~~~ z%~ r!-~ -J 1556042148 REV-1500 EX Decedent's Social Security Number oeceae~rs name: Helen A. Cooke 1 6 2 2 2 8 9 3 8 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 8 Notes Receivable (Schedule D) ........................................................ .. 4. 5 Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ............... . 5. 6 1 7 8 6 3 9 6. Jointly Owned Property (Schedule F) ~~ Separate Billing Requested ............ . 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ~~ Separate Billing Requested ............ . 7_ 8. Total Gross Assets (total Lines 1-7) ...................................................................... . g. 6 1 7 8 6 3 9 9. Funeral Expenses 8 Administrative Costs (Schedule H) ........................................ . 9. 4 4 7 0 7 0 1 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .............................. .. 10. 2 3 0 4 3 8 11. Total Deductions (total Lines 9& 10) .................................................................... .. 11 4 7 0 1 1 3 9 12 Net Value of Estate (Line 8 minus Line 11) ........................................................... .. 12. 1 4 7 7 5 0 0 13. Charitable and Governmental Bequests/Sec 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. 1 4 7 7 5 0 0 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 0 0 0 15. 0 0 0 16. Amount of Line 14 taxable at lineal rate X .045 1 4 7 7 5 0 0 16. 6 6 4 8 8 17. Amount of Line 14 taxable at sibling rate X .12 0 0 0 17 0 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0 0 0 18. 0 0 0 19. Tax Due ......................._............................_._..........._._............._................._. __ .. 19. 6 6 4 8 8 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 15056042148 1556042148 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-07-00933 DEC Helen A. Cooke __ __ ,STREET ADDRESS 315 W. Barrens Valley Road ----------- Dillsburg -- -- -- - -STATE i ZIP PA I 17019 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) _ _ _664.88 2. Credits/Payments A. Spousal Poverty Credit _ B. Prior Payments C. Discount 0.00 Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable p. Interest E. Penalty _____ Total Interest/Penalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2 Line 20 to request a refund 5. tf Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) _ _ 6 6 4.8.8 A. Enter the interest on the tax due. (5A) --- ------- ---- B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 6 6 4. $ 8 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 :...................................................._........................... ~ ~ x ___ _ b. retain the right to designate who shall use the property transferred or its income;......._......_..__............ ~ j ; x -, r , c. retain a reversionary interest; or ............................................__..........................._............ _........._...... , _ iu _....._...... I I_x i d. receive the promise for life of either payments, benefits or care?.._ .................._...... , r l 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without --- receiving adequate consideration? ....................................._..................._........................................................ ! x' 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... ' x 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate propert}~ which contains a beneficiarydesignation?_.... __..._ . __ ........ ........ .__...._.___.._ . _.._......__ __ _-__..._ .... x IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE tT 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 cif 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)j. 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 ~~t 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)j. 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)j. 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)j. A sibling is defned under Section 9102, as an individual who has at feast one parent in common with the decedent, whether by blood or adoption. i t c~5 ' 1 ~.~~st dill ttrc~ ~rstttmerct OF HELEN A. COOKE BE IT REMEMBERED, that I, HELEN A. COOKE, of 18 North Chestnut Street, Dillsburg Borough, York County, Pennsylvania, being of sound mind, memory and undersr_anding, do make, publ'_sh and declare this as and for my Last Wi11 and Testament, hereby revoking and making null and void any and all Wills and Testaments and writings in the nature thereof by me at any time heretofore made. ITEM 1: I direct that all my just debts and funeral expenses be paid as soon after my demise as may be convenient. ITEM 2: A11 the rest, residue and remainder of my estate, of whatso- ever nature and wheresoever situate, whether i:t be real, personal or mixed, including property over which I have a power of appointment, I give, devise and bequeath unto my husband, Wayne B. Cooke, absolutely, provided he survives me for a period of thirty (30) days. ITEM 3: Should my husband, Wayne B. Cooke, predecease me, fail to survive me for a period of thirty (30) days, or should we die simulta- neously, I then give, devise and bequeath my entire residuary estate unto my issue, i.n equal shares per stirpes. ITEM 4: I appoint The Commonwealth National Bank of Harrisburg, Pennsylvania, as guardian over any property which passes either under this Wi11 or otherwise to a minor and with respect to which I am author- ized to appoint_ a guardian and have not other~~i-se specifi-cal~y don- ;n, ;~r~>vi~ied that il:. ~ ,~ppc~inL~~~_~ut ~1 a guardi-an shat.!. r„~t su;~ ~ >:~~1' ~--- right of any Lir(:i~_;_ary in ?ts d;s~~retion to di-s'.-rl~oute a shar:~ ~.,:~crc~ posibLe to the r~inc~r ur ~c; aro~her for the minor'., hene[!r-. Such „uardian shall hr~e th-~ p;~~,~er to usc~ principal ~~ ~~,>11 as i r;r~;~i:~, ~,rn t_f_me to time for t_he minor's Support and educ~ti_on, iincluding collt~ge education, both gradua*.-e aid ~.~nd .rc raduate) , ~,i.t_ho~.~t regard Co .., _, <>> '.v1TtiE:SS: j' A- ./ 1 /~ L~ FiF;I-EN A . 000K- her parent's ability to provide for such supFrort and education, or to make payment for these purposes, without further responsibility to the minor's parent or to any person taking care of the minor. ITEM 5: I direct that my hereinafter named Executor pay all inheri- tance, estate, succession and legacy taxes of whatsoever nature and j kind, to which my Estate or t'ne transfer of any property passing hereuno~ er or otherwise passing by reason of my demise, and may be subject and to charge such taxes against my residuary estate, it being my intention that none of the aforesaid taxes, either federal or state, or any property required to be included in my gross estate, under the pro- visions of any state or federal law now in force or hereafter enacted, i shall be prorated among the persons interested in my Estate to whom I~ such property is or may 6e transferred or to whom any benefit accrues. ITEM 6: I appoint my husband, Wayne B. Cooke, as Executor of this my Last Wi11. and Testament. Should my husband predecease me, fail to qualify, cease to act or renounce probate, I then appoint my daughter, Sandra A. Vogelsong, as alternate Executrix of this my Last Wi11 and Testament. Should Sandra A. Vogelsong be unable t_o perform in this capacity, i then appoint my daughter, Susan A. Cooke, as alternate executrix of this my Last Wi11 and Testament. ITEM 7: I direct that my Executor, guard!_an or their successors shall not he required to give bond for the tai_thtul performance of their duties in any jurisdiction. IN WiI;~:SS WHEREOF, T hav: t~~rceunCO sit my },:~*id and seal ~~~., _~. day o -~.~:~ 1980. =~'__- ~ _~ u , ': E..Ei~ A. COOKS The pe~~~-edi_n~ instrument, .~onsistin~ or ti>> and one oti~er :-yl~ewrit ten page w;s on the day and d<r~e thereof si~;n,ed; sealed, publ is'r!ed and decLarea by H elen A. Cooke, ttt~~ Testatrix herein named, as and for her Last Will and Testament, i n thE~ presence of ~..; ~~.aho, at her requcs: i n her prese nc_ ;~~,d i_n the pr Knee of each other, ~r~~ivc' subscribc~,i _ «~- names 'is ~~ait~~ ~~~;ses hereto. .~ _; ;,,- ,. ' ;~ ~ _/. ; _,. - - - - - - _ T__ - - -- --- . _,-- _ _- -_ ~ ,' Rev-1568 EX+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONVJEAI.TH OF PENNSYLVANIA INHERrTANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Cooke, Helen A. 21-07-00933 InGude the proceeds of litigation and the date [he proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. pr 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) tr ~~~~. March 26, 2008 S DAWN GLADFELTER THE WILEY GROUP 130 W CHURCH ST STE 100 Dii_LSBURG PA 17019 Estate of HELEN A COOKE Date of Death: September O1, 2007 SSN: 162-22-8938 Dear Sir/Madam: 525 William Penn Place Suite 153-2618 Pittsburgh, PA 15219 In accordance with your request, the attached information sheet has been provided in the above decedent's name as of her date of death. The decedent had 1 active account at the time of her death and she had no Safe Deposit Box. For IL or LC accounts, contact our Loan Department at 1-800-708-6680. For all other inquiries, please call 1-888-999-6884 Sincerely, Phillip Lynch ~peratior,s Sei ~ ices ~~~= Account Number 6100745643 Account Title HELEN A COO]KE Date Opened _ 6/6/1966 Account Type Checking Principal Balance as of DOD $2,151.39 Interest from Last Posting to DOD $ .00 Account Balance as of DOD $2,151.39 YTD Interest to DOD $ .00 FirstEnergy September 12, 2007 Ms. Sandra Vogelsong 315 West Barrens Valley Rd Dillsburg, PA 17019 Re: Helen A. Cooke, deceased Dear Ms. Vogelsong: 2800 Pottsville Pike Po Box 1soo1 Reading, PA 19612-6001 (610)921-6407 Our records indicate that you are handling the affairs for Helen A. Cookf:, deceased. The death benefit of Helen A. Cooke's Additional Annuity account within the Met-Ed Plan for Retirement Annuities will be payable "To the Estate". The death benefit pay.ible from the plan is $59,635.00, which is taxable. A distribution of this account will be made after we receive the enclosed Federal income tax withholding election form. Please refer to the enclosed letter to recipients of non-periodic distributions regarding the taxability of distributions from the pension flan. We ask that you return the withholding election form as soon as possible. A business reply envelope is provided for your convenience. Also enclosed is a Special Tax Notice Regarding Plan Payments which we suggest you read carefully. The rules and regulations regarding the special tax treatment a:re complex and contain many conditions and exceptions that are not included in the notice. There may also be recent tax law changes, which are not detailed in this notice. Therefore, we strongly suggest that you consult with a professional tax advisor before making any final decisions regarding this diaribu.tian. Very truly yours, Jane L. Heatwolc Sr. Admin. Assistant l~;~ecutive Benefits & Capital Accumulation Enclosures REV-1151 EX+t12-99) gCHEDULE H FUNERAL EXPENSES 8c COMMONWEALTH OF PENNSYLVANIA ' IN RN E ADMINISTRATIVE COSTS RESIDENT D CEDENT ESTATE OF I FILE NUMBER Cooke, Helen A. 21-07-00933 Debts of decedent must be reported on Schedule 1. ITEM DESCRIPTION AMOUNT NUMBER A, FUNERAL EXPENSES: See continuation schedule(s) attached B. 1 ADMINISTRATIVE COSTS: Personal Representative's Commissions Sandra A. Vogelsong Social Security Number(s) / EIN Number of Personal Representative(s): Street Address 315 W. Barrens VAlley Road City Dillsburg State PA zip 17019 Year(s) Commission paid 2008 0.00 4,300.00 2 Attorney's Fees The Wiley Group, PC 4,300.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Sandra A. Vogelsong Street Address 315 W. Barrens Valley Road City Dillsburg State PA zip 17'019 Relationship of Claimant to Decedent Daughter 4 Probate Fees Register of Wills: 177.00 5 Accountant's Fees 6. Tax Return Preparer's Fees David J. Lenox, Esq. 525.00 7 Other Administrative Costs 35,405.01 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitul~ition) 44,707.01 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-B7 OTHER ADMINISTRATIVE COSTS COmvaONWEALTH OF PENNSYLVANIA continued INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Cooke, Helen A. 21-07-00933 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE BUREAU OF FINANCIAL OPERATIONS DIVISION OF THIRD PARTY LIABILITY ESTATE RECOVERY PROGRAM PO BOX Ba86 HARRISBURG, PA 17105486 October 31, 2007 THE WILEY GROUP S DAWN GLADFELTER LEGAL ASSISTANT 130 WEST CHURCH ST STE 100 DILLSBURG PA 17019 Re: HELEN COOKS CIS #: 240185135 SSN: 162-22-8938 Date of Death: 09/01/2007 Dear Attorney: Please be advised that the Department of Public Welf~.re maintains a claim in the amount of $35,133.41 against the above-mentioned estate. This claim is for restitution of medical assistance granted on behalf of the decedent for which the Probate Estate is now responsible to reimburse the Department according to Act 49, 62 P.S. 1412, effective AL~gust 15, 1994, as amended by Act 20-95, effective June 30, 1995. Enclosed i-s the Department's itemized statement of claim. A portion of this medical expense, namely $18,838.28, was incurred during the last six months of the decedent's life; therefc>re, it is a Class 3 claim pursuant to Section 3392 of the Decedents, Estates, and Fiduciaries Code, 20 Pa. C.S_A. 3392(31. The balance of the claim, namely $16,295.13, is to be entered as a priority Class 6 claim against the estate. Please acknowledge receipt of this letter and advise whether the Commonwealth's claim is admitted and when payment may be expected- If the estate accounting is complete, please provide a copy. If the estate contains real estate, please provide copies of the deed, the latest: tax assessment, and a current appraisal, if available. Sincerely, ~-- Terri M. Smith Claims Investigation Agent 717-772-6961 71.7-772-6553 FAX Enclosure Rev-1512 EX+ (6-981 SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COfrffvIONVJEALTH OF PENNSYLVANIA I INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Cooke, Helen A. 21-07-00933 Include unreim6ursed medical expenses. {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) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Cooke, Helen A. 21-07-00933 NAME AND ADDRESS OF RELATIONSHIP TO DECEDENT SHAPE OF ESTATE W d AMOUNT OF ESTATE ($$$) NUMBER PERSONS RECEIVING PROPERTY ( ) Do Not List Trustee(s) ( or s) I TAXABLE DISTRIBUTIONS jinclude outright spousal f . ers distributions, and trans under Sec. 9116(a)(1.2)] Susan A. Nell Daughter 7,387.50 5656 Linden Ct. Warrenton, VA 20187 Sandra A. Vogelsong Daughter 7,387.50 315 W. Barrens Valley Road Dillsburg, PA 17019 Total 14,775.00 Enter dollar amounts for distributions shown above on lines 15 through 18, as appropr iate, on Rev 1500 cove r sheet II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO T<\X IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF ittV-15~JU C;UVtfl SHtt i ~ v.v~ Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) INVENTORY REGISTER OF WILLS OF CUMBERLAND - ~ i; , . ,. ; COON"'~`if, PENNSYL~~NIA COMMONWEALTH OF PENNSYLVANIA ~~~-~`}~ ! ~ _ ,. , COUNTY OF Cumberland } SS File Number 21-07-•OQ~~ ' ~~'` ,.. Sandra A. Vogelsong ,,, ~ Personal Representative(s) of the Estate of Helen A. Cooke deceased, depose(s) and say(s) that the items appearing in the following inventory include all of tf•le personal assets wherever situate and alf of the real estate In the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a/m~emorandum at the end of this inventory. I verify that the statements made in this Inven- ~ ~ ,~,~~ ~[ - ~ _ ^~l ~~~j~ , f _ S~j~ G1 t')~ tory are true and correct. I understand that false state- ~`" -- ments herein are made subject to the penalties of Sandra A. Vogelso g ~ 18 Pa.C.S. § 4904 relating to unsworn falsification to } authorities. Attorney -- (Name) Jan M Wiley ___ (Fir"') The Wiley Group, PC (Address) 130 W. Church Street, Dillsburg, PA 17019 -- (Telephone) 717-432-9666 (Supreme Court I.D. No.) 06978 DATE OF DEATH LAST RESIDENCE 315 W. Barrens Valley Road DECEDENT'S SOC. SEC. NO. 09/01/2007 Dillsburg, PA 17019 162-22-8938 FIGURES MUST BE TOTALED Personal Property Cash ............................................................................................... 61,786.39 Personal Property ......................................................................... Stocks/Listed ................................................................................. Stocks/Closely Held ...................................................................... Bonds ............................................................................................. Partnerships and Sole Proprietorships ..................................... Mortgages and Notes Receivable ............................................... All Other Property ......................................................................... Total Personal Property ......................................... 61,786.39 Total Real Property ................................................ Total Personal and Real Property ......................... 61,786.39 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative include the value of each item, but such figures should not be extended into the total of the Inventory. (See 20 Pa. C.S. § 3301(b)) Form RW-a9 Rey. ~o-~3-zoos ~~~ Jan M. Wiley David 1. Lenox THE WILEY GROUP Attorneys at Law May 29, 2008 Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 In Re: Estate of Helen A. Cooke, deceased File Number 21-07-00933 Dear Register: Enclosed for filing please find an Inventory, the inheritance tax return in duplicate, and the status report with regard to the above captioned estate. Also enclosed is a check in the amount of $664.88 representing the tax due, and a check in the amount of $30.00 representing the filing fee. Please return the recording receipts to my attention in the enclosed envelope. Thank you for your cooperation. Sincerely, Dawn Gladfelter/Legal ssistant /d g ~~ encl. = c> .; ---, r- - - ,.. ~ ` ~ ~ _" _:~ C~ *C~ ~ ~ ~ . 130 W. Church Street, Suite 101 Dillsburg, PA 17019 • Phone: (717) 432-9666 (800) 682-4250 • Fax: (717) 432-0426 _ ~, ~~ .~} N i ~~ N d' Q ~ /,. C N d ~.~ fi -~ ~~. ti r~ r f t ~, ~C -,~ +~ z z o ~~ :~ ~.' ~. ~ .~~ N ~-' ~ ~ O ~ V ~ T r`n,,, ~ y O ..~ O Sri C`- `~ ~ c ~~~a ~ ti ~ _°~ ~pU v: clwvpV o v ~o xa .~ ~~ ~~ (3a u s aw ~~ ~y ~ U C~ Wo x~