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Home My WebLink About06-30-0815056041125 REV-1500 Ex (D6-D5> PA Department of Revenue Bureau of Individual Taxes County Code Year File Number POBOx28oso1 INHERITANCE TAX RETURN 2 1 0 7 1 0 8 8 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 1 6 8 0 7 0 4 4 5 0 8 1 3 2 0 0 7 0 9 1 1 1 9 1 3 Decedent's Last Name Suffix Decedent's First Name MI S n u f f e r E l e a n o r L (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI N / A 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 Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) QX 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COM PLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number rv J o h n D E n c k E s q u i r e rya 7 1 7 ~ ~~ 3 '~~6 2-i~=~ Firm Name (If Applicable) S p i t i e r K i l g o r e & E n c k First line of address P O B o x 1 1 8 8 Second line of address 5 2 2 S o u t h 8 t h S t r e e t City or Post Office State ZIP Code DATE FILED _. -T l __.~ -:-f ==s ~~ ~~'~ _..r ~ L e b a n o n P A 1 7 0 4 2 Correspondent's a-mail address: jdenck@skelawfirm.COm Under penalties of perjury, I deGare that I have examined this return, including acx:ompanying 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. GNATURE OF PE~2$ON F~SPON$A~l.~ FOR I~ REJfURN r1AtiF ~ '3419 Canb Street V Harrisbur PA 17109 SIG U O~PfjtEP ROT R THAN REPRESENTATIVE E AD SS (,`f P. Box 1188, 522 South 8th Street Lebanon PA 17042 PLEASE USE ORIGINAL FORM ONLY Side 1 15056041125 15056041125 15056042126 REV-1500 EX Decedent's Social Security Number Decedent's Name: Eleanor L. Snuffer 1 6 8 0 7 0 4 4 5 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 De osits & Miscellaneous Personal Pro e , • • • . • • p p rty (Schedule E) 5. 4 6 3 9 • 5 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) ........................... 8. 4 6 3 9 • 5 9 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 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. 0. 0 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.0 _ 0 0 0 15. 16. Amount of Line 14 taxable at lineal rate X .0 _ 0 0 0 16 17. Amount of Line 14 taxable 0 0 0 at sibling rate X .12 . 17. 18. Amount of Line 14 taxable 0 0 0 at collateral rate X .15 . 18 19. Tax Due ................................................19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 15056042126 15056042126 3 1 5 4, 3 2 2 9 5 2 1. 4 2 3 2 6 7 5. 7 4 0, 0 0 0. 0 0 0. 0 0 0. 0 0 0. 0 0 0. 0 0 REV-1500 EX Page 3 File Number Decedent's Complete Address: 21 07 loss DECEDENTS NAME Eleanor L. Snuffer __ STREET ADDRESS Messiah Village 100 Mt. Allen Drive CITY _ STATE 'ZIP Mechanicsburg PA ~ 17055 Tax Payments and Credits: ~ • Tax Due (Page 2 Line 19) (1) 0.00 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 A. Enter the interest on the tax due. (5A) B. Enter the total of line 5 + 5A. This is the BALANCE DUE. (5B) 0.00 Make Check Payable fo: 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; ............................... ^ X^ c. retain a reversionary interest; or ................................................................................................ ^ 0 d. receive the promise for life of either payments, benefits or care? ....................................................... ^ ^X 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 "intrust 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 property which contains a beneficiary designation? .................................................................................................. ^ X^ 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 childtwenty-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)]. Asibling 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 Fill of Eleanor Snuffer of 409 Belevedere Road, Hamsburg, Pa. 17109 I Eleanor Snuffer being of Sound mind due declare this to be my last will and supersedes any previous documents. My assets and real property are to be equally divided between my two children Mr. David F. Snuffer of Pittsburgh, Pa. and Jane L. Snuffer Peyton of Harrisburg, Pa. In the event that my children precede me in death than their share is to be distributed as followed: In the event David Snuffer precede me his share will go to his son David Fleming LeSeur Snuffer, with Mary Lee Snuffer to serve as trustee until David reaches the age of 21. In the event that Mary Lee Snuffer is not living than Jane L. Peyton shall be the trustee. In the event that my daughter, Jane L. Snuffer Peyton precede me her share will be equally divided between her son Eliott Scott Peyton and her daughter Adriane Mahe Peyton, with the trustee to be David F. Snuffer until the children turn 21 years of age. In the event that David F. Snuffer, Jane L. Snuffer Peyton or Mary Lee Snuffer is not living at the time of this reading than James Harley of Pittsburgh, Pa shall be the trustee until the children reach the age of 21. At such time an accounting shall be rendered and the funds be made available. In the event that David F. Snuffer and David. Fleming Lacer Snuffer are deceased than Jane L. Snuffer Peyton if alive shall inherit my entire estate; or if deceased than her children shall inherit my entire estate. In the event that Jane 1. Snuffer Peyton and her children, Eliott Scott Peyton and Adriane Marie Peyton are deceased than David F. Snuffer shall inherit my estate and if alive or if deceased than David Fleming Le Seur Snuffer shall inherit my entire estate. In the event that David F. Snuffer, David Le Seur Snuffer, Jane L. Snuffer Peyton, Eliott Scott Peyton and Adriane Marre Peyton are all deceased than my estate shall be equally divided among the following Sara Harley of Washington, Pa. (Sister-in-law) Russell Harley of Pittsburgh, Pa. (Brother) Reginald Harley of Pittsburgh, Pa. (Brother) Albert Mc Call of Pittsburgh. (Cousin) Signed this 1 STh day of July,1996 Eleanor Lowse Snuffer Witness ; - Witness-----~~~ - ----- ---- REV-1508 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Eleanor L. Snuffer 21 07 1088 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointlyowned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Wachovia Bank, N.A., P.O. Box 40028, Roanoke, VA 24022-7313 4,225.01 Checking Account 1000922575845 -see attached 2. Wachovia Bank, N.A. 0.15 Interest accrued to date of death on Checking Account 1000922575845 -see attached 3. Commonwealth of PA, State Employees' Retirement System, 30 North Third Street, 217.43 Suite 150, Harrisburg, PA 17101-1716 -decedent's final retirement payment -see attached 4. I Internal Revenue Service, Department of the Treasury I 197.00 2007 Income tax refund -see attached TOTAL (Also enter on line 5, Recapitulation) 13 4,639.59 (If more space is needed, insert additional sheets of the same size) ,Fax Transmission. 12/21/2007 1:49 PM PAGE 2/003 Fax Server ~H[~YIA Wachovia Bznk N.A. Balance Confirmation Services P O Boy 40023 Roanoke, VA 24022-7313 December 21. 2007 SPITLER I:II.GORE & ENCK LAW OFFICES ATTN: JOHN D ENCl: X22 SOUTH EIGHTH STREET P O BOX 1188 LEBAtiON, PA 17042 Reference ID: 2274Li7 SUBJECT: Verification / Confirmation of Account and Balance Infomoation provided for: Customer: ELEANOR L SNUFFER (SSN# X_tiX ~\.l'-0445) Date of Death: August 13, ?007 Deuosit Account Information Account Account Date of Death Average Date Maturity Interest Accrued STD Date T}pe Number Balance Balance• Opened Date Rate Interest Interest Paid Closed CHECKING YY3CXYY~CYX5845 $4,225.01 $0.15 52.43 11/30/2007 LEGAL TITLE: ELEANOR L SNUFFER JANE L PEYTON - POA CLOSING BALANCE: $2590.58 OPEN DATE UNAVAII.ABLE CHECKING YYYX.~{XYYX1637 1!2012004 1/161?007 LEGAL TITLE: ELEANOR L SNUFFER JANE L PEYION - POA CLOSING BALANCE: $7769.02 _~ Fax Transmission r~'!Li r~I~l'$ No Safe Deposit Boy: found for customer. Date of death balance does not include accrued interest. Reference ID: 2274137 If date of death occiu•rs ~m a weekend or a holiday, date of death balance does not include any transactions that were made during that time period. aryr.,d,~.;u Amy Graybill Servicenter Associate Phone:(~40)SF3-7323 ll~ ag 12/21/2007 1:49 PM PAGE 3/003 Fax Server _~ COMMONWEALTH OF PENNSYLVANIA STATE EMPLOYEES' RETIREMENT SYSTEM 30 NORTH THIRD ST STE 150 HARRISBURG, PA 17101-1716 1-800-633-5461 www.sers.state.pa. us March 17, 2008 JANE L SNUFFER PEYTON EXECUTRIX Member SSN: ELEANOR SNUFFER ESTATE Beneficiary SSN/EIN C/O JOHN D ENCK ESQ 522 S 8TH ST LEBANON PA 17042 Dear Beneficiary: SE XXX-XX-0445 26-6124999 A check in amount of $217.43 will be mailed to you within two (2) weeks from the date of this letter. The amount of $0.00 was withheld for Federal Withholding Taxes. If you have elected to rollover then the taxable portion of $0.00 has been transferred to your qualified plans. This payment represents your designated share of 100.00% in the Final settlement of the Account of ELEANOR L SNUFFER with this retirement system. If the individual listed above was a member of the Retirement system before January 1, 1982, their contributions prior to that date were taxed as part of their gross income at that time. Therefore, no taxes are being withheld on that portion of their contributions. The difference between the amount of your payment and your share of the deceased member's non-taxable contributions, if any, is taxable for federal income tax purposes. This payment has been reported to the Internal Revenue Service. If a 1099R form is not enclosed with this letter, you will receive one prior to January 31 of next year, with the necessary tax information regarding this payment. Under current law there are no Pennsylvania state or local taxes on any benefits paid from this system. This letter and the 1099R form that you receive should be kept in a safe place, as you will need the information when filing your Federal Income Tax Return. This is the only notice you will receive. There is a $5.00 charge for each request of duplicate information. Sincerely, ~C./. / ~f Debra G. Murphy, Director Benefit Determination Division BEN3IFSL '4 1r'' y r ~`, y t t 2 "~ ' ~.. ~d~ ~R.~~Li ~ ~ !~'~'* " 's,. ;,..; i ~r't3 ,~~'' r .n E! ~`%~. ~_ ;1NI~F4T~~O.:EIGt!#T E~~,~ 11~/C,~ ,~ t, • ~ ~. .: :. - ~ !a ix^ e~ ~ tit e.. ~ ~ ~ .~ 3 f±r.{ .,iii a . ,. 00000 061 070 031808 77010261 852761 *++**4999 ~Q4ZJ ~i~4"~ ~-~ ~'''~ ~'~'~~ ~7V7~~~ ~ ~, ~ CDC FUND DEPT PREP DATE VOUCHER WARRANT ID 1c ~ *~ 'c s ;.~ 1 _..~. ~~ '' ~ ~" v 9'i " ~ iF =_.~s~i C ~ ; 4 t; 3 +' ~ ~ s GH~~C~NCjM'B{FR ' ~ ~~' ~> ULTQI~~BANIC , ,~~ Ewa •~f e' ~eq,y`! ~ ` ` / .j 5 . ~ ,:~ TER PA x ~ r5 r ~ Y I ~°' 's~.~"~ ,,:,~ ,. ~Q3f25/2008 ~ s~ .. r s ;DATE o VERIF1CA7lON AVAILABLE •PO$ITIVE'PAY" PROTECTEb ~- .,. ~ ~ ~~~ ,} ~ .. _ ~ ~~..., ~.~ _. • _, w ,_ ~~~ ,~ ... C TO THE OF.^"^ ^~ VOID AFTER 180 DAYS o ' ~ JANE l SNUFFER PEYTON EXECUTRIX ...,, ;. ~ ELEANOR SNUFFER ESTATE ~ C/O JOHN D ENCK ESQ N A ~ 522 S 8TH ST ~ LEBANON PA 17042. • " _ » ' _ PE _ ' ; w ~ i. ; i l w y,,r Z' FTAEASURER F ! 1V _. .... .+ N,SY(,VANIi- 11.5674665011• x:03 i30 L4 2 2~: i 2 i9 5384711' .. .. - ~ ..~; . .. . .: ~. _ - EV-1511 EX + (12-99) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Eleanor L. Snuffer 21 07 1088 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Funeral Prepaid 0.00 2. The Evergreen Cemetery Company -grave opening (see attached) 550.00 3. Sarah Davis -food, paper products and catering charge for funeral luncheon 450.00 (see attached) 4. Harold's Flower Shop -funeral flowers (see attached) 207.05 5. Staples -printing funeral service flyer (see attached) 67.27 6. Freemont Monument -gravestone inscription 146.00 7. Reverend Dr. J. VanAlfred Winsett -funeral service 100.00 8. Deborah Moncrief -organist at funeral service 50.00 B. ADMINISTRATIVE COSTS: ~, Personal Representative's Commissions Name of Personal Representative (s) Jane L. Peyton 369.00 Social Security Number(s)IEIN Number of Personal Representative(s) 193-36-0635 street Address 3419 Canby Street city Harrisburg State PA zip 17109 Year(s) Commission Paid: 2008 2, AttomeyFees Spitler, Kilgore &Enck, PC, P.O. Box 1188, Lebanon, PA 17042 1,000.00 3, Family Exemption: (If decedents address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate l=ees Letters Testamentary, Renunciation, Short Certificate, JCP Fee, and 103.00 Automation Fee -see attached 5 Accountant's Fees 6. Tax Retum Preparer's Fees 7. Division of Vital Records, 101 South Mercer Street, P.O. Box 1528, New Castle, 18.00 PA 16101 -two death certificates for Flemming Snuffer 8. Register of Wills of Cumberland County for short certificate -see attached 4.00 9. Register of VVlls of Cumberland County to file inheritance tax return and inventory 30.00 10. Spitler, Kilgore &Enck, PC -reimburse for copying and postage expenses 40.00 11. Bank service fees: $20.00 on 03/26/08; $20.00 on 04/25/08 20.00 TOTAL (Also enter on line 9, Recapitulation) S 3.154.32 (If more space is needed, insert additional sheets of the same size) ~Q ~~ ~vergreer~ niter ~p~~: Certifies That ~''~`~',,7 , ,~, ~:~,~'~ ~ ~:~ ~ .~ 2 ,r.L f:/ . ~, ~, 1 ~- ha~ paid. Jl.~ ~~-~= ~~~~:-zit G~..c~~ -:~,s~tt ~r c--~"-"'~.`°.~-°-...`.~--e-,..-.~°.~._....~.;-~-.~c~iars ~c~r Lc~t of I~~-lnci in the Cemetery- of raid Cor~oratitrn, ca1?ecl THE E~T}7GRFF; ~E~=IETERY C(~1VlP~'~~~, situated... ire Gilpin tosrn~li~, ~rr~lstrcrn~ c~trnty~, an~i Cc~n~rr:on~+~ealth oz Penns~~lvania, u'11iG~1 I.~t ~.L delineated and laid do~.~:~n an the ~1a~ car Plan ~f the :said C;enaetery Cn'mpany in the pcissessitrn of the s<3id ~r~rporation, and ._.:. .~=._ _ therein designated bti7 the number __ / l~, in Section ccrl~taning ~~'' ~;~~ sta~irfic,ial Beet, subject to the cc~ncltior_s anti inlitatiorl:, end :~.~ith the ~?riti-i':e~ges specified in the rubs. anal regulations or' said'. Cemetery company. I\ TESTI~IQtiY ~~'HEF:EUF, .the said Et-ergreen Ct~rnetery Compan;~ lia cnuseci this- instr~urrent tc~ l;~e s.igrerf by its President.. and. its Cor~~rr~orz Seal to b',e hereto at}~:~etl,* the ~,l ~,~~, (:~ dad trf in .the year o our Lord, ore thc~~~tsanti nine hundred and ,,, '~ ~,v ., l - ~ ,~~ .-~ ._. Y3t~L}'£Yf6d o-ne """ 292@ s,~~c-we'r xr. n~rrr M.-~+y ~ wwaw.x~~ na .~1~t~[l1~ZC+O`1yY~[~~' a _ CQ ~icanii ~ E~ ~vicsasza ~'~'*.v. t:C3iDg05D3f;iD14i129C3+~9~~' 2g2_~~~~ rccr~t~51u2SZY40 PAIB 8/21 550.OQ r _.~ _, r-~" - ~ - -_ ~ ~ - ... -^7 4 ~ _ s~ _ ~. _ ('PI . - tom ~~ y ~» ` ' ~ K a"' AfR .-~.. a .' i...J K~ ?°~ - ~°'- nr «. 1 c t t ~ i y v ,m t~ ~T9f 'y. _ .row. ` ~ ;~ ~ ~, ~ L ~, ~ ~ n ~' ~ a Y ' ~ . ' 1C' ~ R1 ~~ 5.,. ..~ ~ ~~'3 ~ ~ .,~ t ~ ~ `r ~ ~ h~+ ~ _,_ G1.~ a '. _ - ..: % ~ r (' y t t; „~.! l..S i Q ;t. ~ ~ x ~~~ C a ~ a W t~J ,L. _ _ .. . . - - . ~, . , T r - _ ~. ~.- - ~ ~~ ~:~ t • ~~ ~ ~' ~ ~t~. _ . xr ~ ~ ~ ~~ o ~ ~4 ~; O ~.~ ~ ~ -.- S.i ~~ kx 4' ~ - - "" ~ e ~~ ~~ ~. ~-' r~ j tf .: 0-' .. ry T2i m ,y :~ 4„- _. "s 7L ' ~ ~ Li-~ . '~ Li-~ ~ ~ ~ * ~ ~ t ~ _~ f_p II ~ --77 ~ t.l ... i ^ _ ~ A-' _ ~ L~ 3 c _v~ ~, ~~~~~_~~ ~~~d ~. _ _ ~_. _ ..:. p E ~ F RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Cumberland County - Register Of Wills One Courthouse Sqquuare Carlisle, PA 17Q13 SNUFFER ELEANOR Estate File No.: 2007-01088 Paid By Remarks: SPITLER KILGORE & ENCK PC AJW Receipt Distribution Receipt Date: 11/29/2007 Receipt Time: 14:33:15 Receipt No.: 1050760 Fee/Tax Description Payment Amount Payee Name PETITION LTRS TEST 60.00 CUMBERLAND COUNTY GENERAL FUN WILL 15.00 CUMBERLAND COUNTY GENERAL FUN RENUNCIATION 5.00 CUMBERLAND COUNTY GENERAL FUN SHORT CERTIFICATE 8.00 CUMBERLAND COUNTY GENERAL FUN JCP FEE 10.00 BUREAU OF RECEIPTS & CNTR M.D AUTOMATION FEE 5.00 CUMBERLAND COUNTY GENERAL FUN Check# 8815 ---------------- $103.00 Total Received......... $103.00 RECEIPT FOR PAYMENT GLENDA FARNER STRASBAUGH Cumberland County - Register Of Wills One Courthouse S uare Carlisle, PA 1713 SNUFFER ELEANOR Estate File No.: 2007-01088 Paid By Remarks: JANE PEYTON JA Receipt Distribution Receipt Date: 3/07/2008 Receipt Time: 12:49:25 Receipt No.: 1051864 Fee/Tax Description Payment Amount Payee Name SHORT CERTIFICATE 4.00 CUMBERLAND COUNTY GENERAL FUN ---------------- Check#1002 $4.00 Total Received......... $4.00 REV-1512 EX + (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8~ LIENS ESTATE OF FILE NUMBER Eleanor L. Snuffer 21 07 1088 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Commonwealth of Pennsylvania, Department of Public Welfare 21,509.15 Estate Recovery Program P.O. Box 8486 Harrisburg, PA 17105-8486 Claim for restitution for medical assistance granted. See attached. 2. Messiah Village 100 Mount Allen Drive Mechanicsburg, PA 17055 Nursing Home Care. See attached TOTAL (Also enter on line 10, Recapitulation) (If more space is needed, insert additional sheets of the same size) 5 8,012.27 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE BUREAU OF FINANCIAL OPERATIONS DMSION OF THIRD PARTY LIABILITY ESTATE RECOVERY PROGRAM PO BOX 8486 HARRISBURG, PA 17105-8486 December 28, 2007 SPITLER KILGORE & ENCK PC JOHN D ENCK ESQUIRE 522 S 8TH ST PO BOX 1188 LEBANON PA 17042 Re: ELEANOR SNUFFER CIS #: 740185434 SSN: 168-07-0445 Date of Death: 08/13/2007 Dear Mr. Enck: Please be advised that the Department of Public Welfare maintains a claim in the amount of $21,509.15 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 August 15, 1994, as amended by Act 20-95, effective June 30, 1995. Enclosed is the Department's itemized statement of claim. A portion of this medical expense, namely $13,352.49, was incurred during the last six months of the decedent's life; therefore, it is a Class 3 claim pursuant to Section 3392 of the Decedents, Estates, and Fiduciaries Code, 20 Pa. C.S.A. 3392(3). The balance of the cle~m, namely $8,156.66, 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, ~x~ Nathan L. Snyder TPL Program Investigator 717-772-6266 717-772-6553 FAX Enclosure ~sslah v~ ~~A~~ 100 MOUNT ALLEN DRIVE, MECHANICSBURG, PA 17055 JANE PEYTON 3419 CANBY ST. HARRISBURG, PA 17109 Forth PB-01 QUESTIONS? CALL 717 697-4666 RESIDENT # UNIT '' STMT. DATE 20203 009 D 08/31/2007 R SIDENT S Mrs. ELEANOR L. SNUFFER TOTAL AMOUNT DUE $8,012.27 DATE DUE 09/30/2007 DATE DESCRIRTIOt+I RATE Units CHARGES CREDITS EA'~.ANCE Balance Forward 8,012.27 RESIDENT # 20203 CURRENT 0.00 OVER 30 1,261.36 OVER 60 0.00 OVER 90 0.00 OVER 120 6,750.91 TOTAL AMOUNT DUE $8,012.27 RESIDENT NAME Mrs. ELEANOR L. SNUFFER FortnPB-Ot MA A 1% finance charge may be assessed on accounts for which payment has not been received by the due date. Thank you! If you have any questions or concerns about your bill, please address them directly to Fiscal Services at 790-8220. Thank You! REy-1513 EX + (gA0) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER FlPannr I Sniiffar 21 07 1088 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include outrightsppousaldistributions, and transfers under Sec. 9116 (a) (1.2)] 1. Jane L. Peyton, 3419 Canby Street, Harrisburg, Lineal 50.00 PA 17109 2. David F. Snuffer,837 North Highland Avenue, Pittsburgh, Lineal 50.00 PA 15206 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS; 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) Law Offices SPITLER, KILGORE &ENCK, PC 522 South Eighth Street P.O. Box 1188 KEITH L. KILGORE LEBANON, PENNSYLVANIA 17042 CALVIN D. SPITLER PAUL W. KILGORE (1943 - 2003) JOHN D. ENCK (717) 273-7621(VOICE) (717) 273-1693 (FAX) THOMAS A. EHRGOOD ske(a),skelawfirm.com (1952 - 2006) ~~, June 27, 2008 "° c~ , -o ~ _tr, ~ ~-- , T c ~ :~ =; Glenda Farner Strasbaugh ~ ~ ~ _' ' '=~ Register of Wills _ r''' {" ' ~ "' ~,- , -~ 1 Courthouse Square `-=' "`~' =~ -_~ Carlisle, PA 17013 - ~ ~ t`.' :!, w _ cs~ RE: ESTATE OF ELEANOR L. SNUFFER, DECEASED CUMBERLAND COUNTY NO.: 2007-01088 Dear Register Strasbaugh: With respect to the above estate we are enclosing the following: A. Four originally signed Pennsylvania Inheritance Tax Returns, one for your office, one for the Department of Revenue, and two to be returned to us after being time stamped in the enclosed, stamped, addressed, envelope; B. Original Inventory and two copies to be time stamped and returned to us in the enclosed, stamped, addressed, envelope; and C. Estate check payable to your office in the amount of $30.00 to cover the filing of the Inheritance Tax Return and the Inventory. Thank you for your kind attention to these matters. Very truly yours, d~t~~ Jo n D. Enck JDE/aag Enclosures cc: Jane L. Peyton ~ C' y7 r~"a - ,. w it .., ,. ,~~ 4~ T .l ~~e~aj7 ..J i a ~... i..'T e'`7 r1- C~.4 ~ , ~:~t,~- M ~J~r_ r.} ~ ~, ~ v. C~ ~.~ ... 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