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Home My WebLink About08-08-0815D56D41147 REV-150 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue ~ County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX.280601 /~ c~ , f Harrisburg, PA 17128-060 RESIDENT DECEDENT 2 1 0 8 L1 0~`'t ENTF_R DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 03 13 2008 01 26 1917 Decedent's Last Name Suffix Decedent's First Name MI CI~ULL MARGUERITE S (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 (J~~ 2. Supplemental Return j -j 3. Remainder Retum (date of death prior to 12-13-82) 4. Limited Estate `~ 48. Future Interest Compromise r . ~, 5. Federal Estate Tax Return Required (date of death after 72-12-82) { X ~~ 6 Decedent Died Testate _ ~ Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes `~ (Attach Copy of Will) ~--.~ (Attach Copy of Trusq 9. Litigation Proceeds Received C- ~ 10 Spousal Poverty Credit (date of death 11. E{ection to tax under Sec. 9113(A) 'between 12-31-91 and 1-1-95) (Attach SCh. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL 7AX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number JAi3 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 Corretspondent's a-mail address: State ZIP Code PA 17019 r., REGISTER QF' AF~I L5 USE~OJJLY =: ~ ~, ' . ; r r- c -'`~ t - - - ~ C; -.-. r` , {--. , 9',) D.~E FILED G 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. SIGNAIfURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE Barbara J. Gilbert $"' ~ ~ d ADDRESS 1400 Bent Creek Road, Mechanicsburg, PA 17050 ~ ~~~~~-~..-_~ ~ ~~,; IGNATURE OF PREPARER OTHER THAN REPRESENTATIVE // D TE ~/ ti r~~ ~ \~,J~-~ Jan M Wiley _ - - _ V ~ ~o W. Church Street, Dillsburg, PA 17019 Side 1 15056041147 15D56D41147 J 15Q56D42148 REV-1500 EX Decedent's Social Security Number oecedenrs Name: M8P9Uerlte S. CrU~~ ~ __ __ __ _- F2ECAPITULATION 1. Real Estate (Schedule A)_.._.......__......._ ......................._. _ ...._ _......_... ...._..... t 2. __...._...... Stocks and Bonds (Schedule B) ............................................. _.......__ 2. 2 5 5 3 2 0 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) ... ............. 5. 3 7 7 0 8 8 6. Jointly Owned Property (Schedule F) ~ ~ Separate Billing Requested ............. 6. 7. on,Probate Property Inter-Vivos Transfers & Miscellaneous N Separate Billing Requested (Schedule G) ............. 7. 8. Total Gross Assets (total Lines 1-7) .......................................................... ............. 8. 6 3 2 4 0 8 9. Funeral Expenses & Administrative Costs (Schedule H)......... g. 2 5 9 7 9 6 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .................. ............. . 10. 11. Total Deductions (total Lines 9& 10) ........................................................ ............. . 11. 2 5 9 7 9 6 12. Net Value of Estate (Line 8 minus Line 11) ............................................... ............. . 12. 3 7 2 6 1 2 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. 3 , 7 2 6 1 2 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 0 0 0 15. 0 0 0 (a)(1.2) X .00 1~6. Amount of Line 14 taxable 7 2 6 3 1 2 16. 1 6 7. 6 8 . , at lineal rate X .045 17. Amount of Line 14 taxable 0 0 0 17~ 0 0 0 at sibling rate X .12 18. Amount of line 14 taxable 0 0 0 1 g. 0 0 0 at collateral rate X .15 19• ....................................................................... Tax Due ................................ ............. 19. . 1 6 7 6 8 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 1505604214$ 15056042148 REV-1500 EX Page 3 File Number 21-08- Decedent's Complete Address: DECEDE_NT'S NAME Marguerite S. Crull STREET ADDRESS 1000 Claremont Road CITY STATE ZIP PA 17013 Carlisle Tax Patrments and Credits: 1. Tax Due (Page 1 Line 19) 2 Credits/Payments A. Spousal Poverty Credit g, Prior Payments C. Discount 0.00 3. InteresVPenalty if applicable ID. Interest E. Penalty Total InteresVPenalty (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. ,q, Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (1) 167.68 (2) 0.00 Total Credits (A + B + C) (3) (4) (5) 167.68 (5A) (5B> 16 7.6 8 Make Check Payable to: REGfSTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes N _~ a. retain the use or income of the property transferred :.................................................................................. ~ c. retain ahrevers ovary irate est; oo shall use the property transferred or its income :.:...............:...:...........::. d. receive the promise for life of either payments, benefits or care? .............................................................. ~ _~ 't~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................................................... ~1 I 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 ..... ......................................................................_._............ RT ;- IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PA~ J OF T E RETURN. :' - -- ,.] t .:. ~ , ~. ~ _, 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 par~snt, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116 (a) (1.2)]. The tax rates 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 rioted 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 dE>,fined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. L.CA-L REGISTRAR'S CERTIFIC~-TIOIV ®~ ®E~4TH WARNING: ft is iftegal to duplicate this copy Icy photostat or photograph. f~~?r this certit~cate. `i;6.0(, - x ~ ~ -~ ~ `~~~, { ..~.. "~ ~... l ~,~ Certification Number This is to certsf~ that the infon~ation here given ~ •orrectly copied from an original Certificate of Dea[ lul_y filed with me as Local Registrar. The origin certificate will be forwarded to the State Vita Zecord~s-~+Office for permanent filing. ~• `C'esw.~•t.~.~~M~` 1 ~ 200 ~ocal Registrar Date Issued R5~5aaREVnrmoa COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS PERMPNEMW CERTIFICATE OF DEATH iN~crclNx (See instructions and exam lee on reverse P ~ STATE FILE NUMBER i t. Name d Decema ffast ndtlma. msl, sudx) 2 Sea 3. Saclel Seamy Number A. Date of orm lMalb, ay. Yaer) Marguerite S. Crull Female 160 - 18 - 7236 March 13, 2008 s. Aae ILeu Bir9der! unmr 1 e ummr 1 mr s Dale a eian (Mash. my, yea) r. (clry em sate a laelgn rwaail ea Pies d Deem coati arl rwww wn ww. iu.ws - YMg8a1: olrc 9i rre January 2'8,1917 Mi3lbrook NJ mpened ^ER/oapetlea ^D0A ^Nwary Hwr ^Resimrce pother-SpedlY gb. cowry of Deem ~. Cdy, Roro, Twp. d Deem ea. FaciRy Name in rot Iroaueorr, ghre street orb nsMa) 9. was Dandent d N~k Orl~n1 ^iwo ^ vas 10. Race: Americerl m6an, Bode. While, ate N rr. wado-, Der. l ~ Cumberland S. Middleton Twp ite Carlisle Regional Medical Center ~) 11. Deadeae I/eud 13ua d was done m most d de. Ix rld smm rem 72 Was DeradaY war in ma 13.OeceaeN's ECuair lSpedry Qtly highest 9rem ~Vet•di 10. Mead `Jams Married Never Married. 15 SurvWip Spouse (a wile. gve maben name! " lam a won lam a errerese / irdrtrY yl LLS. Armed Forcas7 wdared. DNorcad (Spea Emmantary / n io-tz) canaaa ltd « 5~I ^Y•r ®Na 12 Widowed 18. Deadrl's Meirrg Adtlress (Beset. c8Y / mwn, amm, xip wm) Uacaaal's Db Daadaa Aarei flesbare va smm PA are ~ e 17c ^ rr, Ileadenl lived n Twp. 1000 Claremont Road ToT ,Ta[~NO,DeaarluWawanm Middlese ,m c l C b l d Carlisle PA 17013 oa Y x an um er Arnwudmw ciy/sera 1& Fatlrfr Name (Fiat radme, IeN, aumxl 59. A1otlrYa roans !Feat mld0e, nreHrl swlmro) Irvin Smith L die Kimble zDa bmrmmas Name Rme I Pmj 2m. inlarronrs IAerngAmress ISIre.L dry /bwrt sum,>ip am! Barbara Gilbert 1400 Bent Creek Blvd., Mechanicsburg PA 17050 Apt. 208 21a Melhad a otsprlum ^pemeion ^ Doneion 210. Dab d D'spoNiea (MpiN• mY. YeaA 25c. Pma d Dky«IIM (Nsrro d emarY, aarrarY a ana place) 214 Irutlon (CBy / bem, amm, ap mm~ [}e,rla ^ Remanlhora wra.rwwn«Dm.natAumaWd ~ March 17 200$ Zion Cemeter Mt Churchtown PA ^ pyym . ;•,~. bKMadkd Eiaminerl CaorwR ^ Yes ^ No . y .' zz. ra+saaaam! 2a.UCareNweGr zxrmmewAdnearaFadmy Hoffman-Roth Funeral Home & Crematory . ~ 138504 219 N. Hanover St. Carlisle PA 17013 tlrre 23es ai/ who plyddanYaa weiode.l tlmed b 23a. To Bw a , drm aaaaree a<lM tlme. (Sg»we em iMa) ~ ' 23b. Uanr Ndeea 'In ~~- ~" ~~ 23e Dam $Iprntl (Homo. ear. Year) /~1~Ci-f 13 2ddg arey rare cl m.m ~IitcL ~i~ ~ ! l1 - m~ ba mmPMed MPrwn i ~ 24. Tone • ~ ~ 25. Dale Drd (Mo~a n./mY, yary 0 ~ 28. was caw Reirrea b Medlml Ereminer / Corona rot a Rrcon Otllar mr Gremeaon ar DarBOnT wn M r pmr M. /i ~ 3 1 ~ p C3'r t 3 2 ^Yr No CAUSE OF DEATH (err fnetructlvxls end eaampNa) r Apprmerem mlarvd: Par! m Edr oma 2B. Did Tabamo Ur CmdWm b Deamt Item 22. Pr I: Filer tlr dmu d wrh-d'reases, fnpdes. a cprpN®mr - mel erectly raraM tM dra. DO tKlr xaa lemwrl evaras uch r carrtac anmL prat b Drm da np ~dlerp m ma uMerlYlnp muse pvr N Pan I. ^ Yea ^ Probady rrPeab'V attar a ranialer fdMatbn wihM shoMrra tlr aBdogY. lid ad/ aw aeaw a rdr ins. ^ No ^ llnNrwn IN ~ ~AflU~~ Fitd a+eme a n e. ~e.m) --~ f"~ l!4lMOn '~ ~ //~~ ~~a~Jrr~s /.tc/%i~.s y9. II Frrb: ^ na Due m (a r a mreRaara d): ~ Na w npaa,Yaar Ira ^ Preprrrl r tine d mom Se~r~6rW rl tardiars i b. 1 ~ ia e. 4ay~b6r xbr ieled al6 Due b (« as a arrequsnca Dry: ^ Nd PrgrM1 but WaBw^~n92 mys FrIBr Ar UtNEflLYV10 CAUSE - Imere«~~I{rymaliemmame c. ~ dmem evrm R dkAiWtli j YI drm) LRSL L+~.'a rA {« SS a exeerHerla Dry: 1 ^ Na geyw4 ba ge~rriSS dayab Sy681 Habra deem d. r ^ Uaaiwm r prepnra wlWn ma Pad Year 3qa Wes r NAaPaY 3ab. Was AdOpq FMlgs 35. Murm d 32a 11am d mAaY lMmm, mA Y•TMI 32L. Iamb How i9rY Occwud 32c. Plea d Yr}ay: Honr. Farm. S4aa. FsIaY. OlYea 9d6q. Ne. (Speary') Pedamea7 AveBeNe Prfab Caution dCrred D w mi ^ Flarridm ~ ~,/ ^ ra ~ "' r ~ ~~ ^ ~ Lt^" ^ 'ABM ^ ParWrp Imrtlpatlon 32d Time d InIaY 32a. bM•Y et WoM 321. M Trenglala8r agaY BPacBY) 32Q Imria d L~xY (Strat. dIY / tow4 sum) Y ^ s,utiae ^ Cqud Nd be Damrmmetl M ^ Yr ^ No ^ pP'al DPeaa ^ Peaerr~r ^Pednemn Ww-SpecYy 33a Certlfia IctrrA ady one) eleO nem za) arm d caa a 39 . SigwrMe ~a CeaBet ~ an den lus D • crmYmu I> f araTyup ear d drm wlrn caner DnY N drtll axured me m tae quads) rd mrrer r Wled _ _ _ _"_ _ _ _"_ _ _"_"' _ _' _ _ _ _' _ _ _ To tlvt hsY a my mlawl•a9r A/, . • Warxxardn9 vd txrtltybg pYryekmn IPAYSeir rah gaaridig tlral and aulilying b reuse d drm! ^ 3Y. Leam Number 33d Dam ~ lMarm, .rear) To tlar hrM Of my lmowlrge,acdtlawnedNme mne, ester ra place, and dwmtne auea(e)ad manrrrramted__________________ yHl~ -oHjgq/-G 3 /3 O 3 • imdelE:.rnlrw/caerr On IM beam of uamarlbn am I a inwetlyaw, m my opirdm, mom aaarea m ar time, dam, erd place, em dr to are easels) rd mrrr. r smmd_ ^ 3a. Nara entlA\d Pala Wbo ~nprp~e_r-/'` d DB/Bm (Hem 27J Type / I ' : ~ I' , s ~ ;R :. Nre em u~y ~ ~ Z ~ ~ ~ ~ ~ ~ ~ I ~ ~ ' Dam Wee (Harm. ml: Year! T /Os I "W r r~W "S~r ~ ~~sK ~ GtP1r ~1 ~ ~~ o o T r `~^~• ~ l pslbai0on Perrref No. O { I -J l LAST WILL AND TESTAMENT OF MARGUERITE P. CRULL I, MARGUERITE P. CRULL, of R. D. #6, Carlisle, Monroe Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory, and understanding, do hereby make, publish, and declare this my Last Will and Testament, hereby expressly revoking all other writings in nature testamentary by me at any time heretofore made. ]FIRST: I direct that all my debts and funeral expenses be paid as soon after my decease as may be practicable. SECOND: I hereby give, bequeath, and devise all the rest and residue of my estate and property, real, personal and mixed, of what- soever nature and wheresoever situated, of which I may die seized or possessed or to which I may be__entitled or of which I may have the right to dispose at the time of my death, absolutely and in fee simple to my husband, Lewis R. Cruz-1., if he is living at the time of my death. 'PHIRD: In the event that my husband is not living.at the time of my death, or in the event that he and I shall die simultaneously, then I give, bequeath and devise all of my property to my two children, Barbara J. Gilbert and Judith L. Brown, in equal shares. FOURTH: I hereby appoint my husband, Lewis R. Crull, as Executor of this my Last Will and Testament, but in the event that he is unable or unwilling to serve, I then appoint my daughter, Barbara J. Gilbert of Mounted Route, Enola, Pennsylvania, as Executrix, of this, my (SEAL) RITE P. CRULL PAGE ONE OF TWO bast Will and Testament, and I direct that they shall not be required to gi~~e bond or other security in any jurisdiction wherein proceedings may bey held in connection with my estate. I:N WITNESS WHEREOF, I have hereunto set my hand and seal this 7th day of January, 1974. ~~ _. ~ 1 (SEAL) MAR RITE P. CRULL PAGE TWO OF TWO Rev-1503 E;K+ (6-96) SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHER3TANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Crull, Marguerite S. 21-08- All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 Series EE Savings Bond M27957638EE issued 1,341.20 02/1989: 2 Series EE Savings Bond M76452000EE issued 606.00 ~ ~~~nn~- 3 Series EE Savings Bond M76452001 EE issued 606.00 12/2002: TOTAL (Also enter on Line 2, Recapitulation) 2,553.20 (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) Calculated Value of Your Paper Savines Bond(sl ~alCUlated e/aiue of Your Paper ~a~rings bond(s) Callculator Results for Redemption Date 07/2008 Page I o±~ I Total Price Total Value Total Interest YTD Interest $1,500.00 $2,553.20 $1,053.20 $52 40 Boinds: 1-3 of 3 Seria! ~ S eries Denom Issue Next Final Issue Interest Interest Value Notc ~ Date Accrual Maturity Price Rate INA' EE $1,000 12/2002 08/2008. 12/2032: $500.00: $106.00 2.74%; $606.00 NA EE $1,000 12/2002. 08/2008 12/2032 $500.00 $106.00 2.74% - --- - $606.00 IVA! EE $1,000 02/1989 08/2008 _02/2019 $500.00 $841.20 4.00% - _ _ ___. $1,341.20 T..i... ~.. i 7 ~.....J ~ d.~ ~A~ /~^ ky ~J3~LU ~ ~.. Notes NI :Not Issued NE: Not eligible for payment __ P5 Includes 3 month interest. penalty MA Matured and not earnin interest n , WIGS R GRULL -~~: ~~~ - ~~ ~6a5'~,B A~LLEN~DALE "R[TAD'' ~ - ~- - - ~~IANIGS BURG ~ PA 1~7~055-4464 [IIIf~I/If t111111'li'(1t7~1i ~1~~111(YP11-I F~1 ' I " 111 III II MARGUERITE ` ~ {, CRUL L - ~r~~~ ~, ~~~z 231372387- OOOkO Q63'2I47 '122402- 102-- _ F-~ ~ # 1 ' -~ ~x e ~~ v ~ ~t~~ \ ~~- ` . t ~ i --- ~~ ~~090.00 7~°-° 6.00 '~ 6 ~,'~ 20.0 ~ ~f - - =_; -Lewis R. Crull 1065B ~`,llendale Road ~lechariicsbur •rssa~~=x~~,4 _ g, Pa. 17055~~ _: tt- --- --- ~ ~~. ~; _ - - - - - ~Y - ~~ ==- d`"'~ x:00009000 ?~:O 7 ~~~ Rev-1508 E7:+ (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TA% RETURN RESIDENT DECEDENT ESTATE OF 1F1LE NUMBER Crull, Marguerite S. 21-08- lnclutle the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 MST Bank Checking Account: 3,005.75 2 ~ Sovereign Bank Savings Account: 765.13 TOTAL (Also enter on Line 5, Recapitulation) ~ 3,770.88 (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) Sovereign Bank ES7"ATF, OF Marguerite S Crull SOCIAL SECURITY #: 160-18-7236 DATE OF DEATH: March 13, 2008 Account #: 1684002957 Type Savings Open date In the name of: Marguerite S Crull (Barbara J Gilbert POA) Date of Death Balance: $764.22 Int.(YTD) from 1/1/2008 to 3/13/2008 Accrued interest to date of death: $0.91 Otherlnfo: 3/S/ 1996 $0.00 Page 1 of 1 ® M8T ~~~nk 4 99 Mitchell Street, Millsboro, DE 19966 May 15, 2008 The Wiley Group Attorneys at Law 130 W. Church Street Suite 101 Dillsburg, PA 17019 RE: Estate of Marguerite Crull Date of Death: March 13, 2008 Social Security Number: 160-18-7236 Dear Ms. Wiley: In response to your request, please be advised that at the time of death, the above- named decedent had on deposit with this bank the following accounts. Account Type ........................... Checking Account Account Number ....................... 9841943500 Ownership (Names of J .............. Marguerite Crull Opening Date ...........................06/28/06 Balance on Date of Death.........$3,005.69 Accrued Interest $ 0.06 Total ......................................$3,005.75 The above named decedent did not have a safe deposit box. * If upon reviewing the information above, you believe there are additional accounts not referenced, please provide us with an account number and/or the name of any possible joint account holder. For any additional information on the-above accounts, including ownership and any changes, closures and/or reimbursement of funds, please contact our Carlisle Pike branch at 6560 Carlisle Pike Suite 500, Mechanicsburg, PA 17050, or # 717-795-1710- Sincerely, // ~~ ~' Charlene Warrington, Records Management 1-888-502-4349 REV•1151 EX+~12-99) COMMONWEALTH OF PENNSYLVANIA fNF+ERITANCE TAX RETURN RESIDENT DECEDENT SCHEQULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE: OF FILE NUMBER Crull, Marguerite S. 21-08- Debts of decedent must be reported on Schedule {. ITEM DESCRIPTION AMOUNT NUMBER q, FUNERAL EXPENSES: See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission paid 2. Attorney's Fees The Wiley Group, PC 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 1,067.96 1,500.00 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 30.00 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 2,597.96 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 OP PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE: OF (FILE NUMBER Crull, Marguerite S. 21-08- ITEM NUMBEf2 DESCRIPTION AMOUNT Gingrich Memorial: 2 ~ HoffmanRoth Funeral Home: Subtotal 130.00 937.96 1,067.96 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule N-A (Rev. 6-98) Rev-1502 E1{+ (8-98) SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA continued INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Crull, Marguerite S. 21-0$- ITEM NUMBER DESCRIPTION AMOUNT 1 Filing Fee -inheritance tax return: 15.00 2 Filing Fee -Petition for Settlement of Small Estate: 15.00 Subtotal 30.00 Copyright (c) 2002 form software only The Lackner Group, lnc. Form PA-1500 Schedule H-B7 (Rev. 6-98) REV-1513 EX~r (gA0) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE: OF FILE NUMBER Crull, Marguerite S. 21-08- NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBIER PERSON(S) RECEIVING PROPERTY DECEDENT {Words} ($$$) Do Not List Trustee(s) I TAXABLE DISTRIBUTIONS [include outright spousal . distributions, and transfers under Sec. 9116(a)(1.2)j Barbara J. Gilbert Daughter 3,726.12 1400 Bent Creek Blvd. Apt. 208 Mechanicsburg, PA 17050 Total 3,726.12 Enter dollar amounts for distributions shown above on lines 1 5 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 TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS UN uNt 13 Vr rcty-~ 5uu ccwtrt Stitt r ~ v.uu Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-~ 500 Schedule J (Rev. 6-98)