HomeMy WebLinkAbout09-03-08 (2)15056051058
REV-1500 EX (06-05) OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes County Code Year... File Number...
Po Box 2sosol INHERITANCE TAX RETURN
Harrisburg, PA 17128-0601 RESIDENT DECEDENT , 21 08 , 0133
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
199-07-1344 ' 12/03/2007 ! 11/01/1914
Decedent's Last Name Suffix Decedent's First Name MI
Grossman James A
(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 Retum CD 2. Supplemental Retum C=? 3. Remainder Retum (date of death
C 4. Limited Estate
~ 6. Decedent Died Testate
(Attach Copy of Wili)
9. Litigation Proceeds Received
t~7 4a. Future Interest Compromise (date of
death after 12-12-82)
t-J 7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
O 10. Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95)
prior to 12-13-82)
5. Federal Estate Tax Retum Required
____ 8. Total Number of Safe Deposit Boxes
~7 11. Election to tax under Sec. 9113(A)
(Attach Sch. O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
Jeanne M. Thomas N
~ (717) 737-83 ,~^'~
_. ~
;_
Firm Name (If Applicable)
_. _ _ __ _ __
~- _ .-__ _ _ __ .. _ _ . REGISTER.. USE Y
"U ,, -;- -.
~ ~
F 7
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i ~ ; I ~. -; ~.
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__... __
First line of address _...._..... _.._. .~. __ ..._
~~~ t.J ~ T~
~~
100 Walnut Street ~~' 3 ~~ ~~
,.,_ r
line of address
Second ~J"+ ;~ ~ ;_
. , • ~~
City or Post Office State ZIP Code _ ,DATE FILED
Lemoyne PA 17043
Correspondent's a-mail address: dmthomaS@thomaSlOngIaW.COm
Under penalties of pery'ury, 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.
SIGNATURE OF PERSON RESg6-I~,$t1>1LE FOR FILING RETURN ~., ,, DATE ,
114b Walnut Street, Lemoyne PA 17043
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
ADDRESS
DATE
PLEASE USE ORIGINAL FORM ONLY
Side 1
15056051058 15056051058
,~
15056052059
REV-1500 EX
Decedent's Social Security Number
James A Grossman :199-07-1344
Decedents Name:
RECAPITULATION
1. Real estate (Schedule A) ........................................ ..... 1. ' 0.00
2. Stocks and Bonds (Schedule B) .................................. ..... 2. 14,106.43
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. ~ 0.00
4. Mort a es ~ Notes Receivable Schedule D
9 9 ( ) ........................ 4.
..... 0.00
5. Cash, Bank Deposits 8~ Miscellaneous Personal Property (Schedule E) ... ..... 5. '; 300,897.28
6. Jointly Owned Property (Schedule F) 3 Separate Billing Requested .. ..... 6. ; 24,007.10
7.
Inter-~vos Transfers & Miscellaneous Non-Probate Property ~.n.. ... __ey,._~._ m__.~ . ~ ~_ _ ~.._e.. ~ _..
(Schedule G) ~7 Separate Billing Requested... ..... 7 0.00
8. Total Gross Assets (total Lines 1-7) ............................... ..... 8. '; 339,010.81 ''
9. Funeral Expenses 8 Administrative Costs (Schedule H) ................ ..... 9. I 32,132.75
10. Debts of Decedent, Mortgage Liabilities, 13< Liens (Schedule I) ........... ..... 10. 17,982.05
11. Total Deductions (total Lines 9 i£ 10) .............................. ..... 11. ' 50,114.80
12. Net Value of Estate (Line 8 minus line 11} ......................... ..... 12. 288,896.01
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which ~~~ ~ ~~ ~ ~~~ ~ ~~~~ ~ ~~~~_ _ ~ _~
an election to tax has not been made (Schedule J) ................... ..... 13. 0.00
14. Net Value Subject to Tax (Line 12 minus Line 13) ..................... ... 14.
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
_
transfers under Sec. 9116 ~~~ ~~ ~~ _ ~~~ ~ ~'
16. Amount of Line 14 taxable
at lineal rate X .0 45 288,896.01 ,' 16.
17. Amount of Line 14 taxable ~ ~~~~ ~~~ ~ ~ ~~ ~~~~ ~ ~~®~~ m ~ ~~~~~~
at sibling rate X .12
~ 17.
18. Amount of Line 14 taxable ~ ~ ~~
at collateral rate X .15 ' 18.
19. TAX DUE .........................................................19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
15056052059 Side 2
288,896.01
13, 000.32
13,000.32
C_J
15056052059
REV-1500 EX Page 3
Decedent's Complete Address:
File Num er ~w.m~.~®~„,
21 ~ 08 0133
DECEDENTS NAME DECEDENTS SOCIAL SECURITY NUMBER
James A Grossman 199-07-1344
STREET ADDRESS
5225 Wilson Lane
Apt. 3103
CITY STATE ZIP
Mechanicsburg PA 17055
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19) (1) 13,000.32
2. CreditslPayments
A. Spousal Poverty Credit
B. Prior Payments 10,000.00
C. Discount 526.30
Total Credits (A+ B + C) (2) 10,526.30
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total InteresUPenalty (D + E) (3)
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)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 2,474.02
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (56) 2,474.02
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 :.......................................................................................... ^
b. retain the right 1o designate who shall use the property transferred or its income : ............................................ ^
c. retain a reversionary interest; or .......................................................................................................................... ^
d. receive the promise for life of either payments, benefits or care? ...................................................................... ^
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. ^
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. ^
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ ^ ^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 surriving 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 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)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)]. 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.
REV-1503 EX+ (6-98)
SCHEDULE B
COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
James A. Grossman 2008-00133
All property jointlyowned with right of survivorship must be disclosed on Schedule F.
(If more space is needed, insert additional sheets of the same size)
REV-1508 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
James A. Grossman 2008-0133
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.
(If more space is needed, insert additional sheets of the same size)
REV-1509 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF FILE NUMBER
James A. Grossman 2008-0133
If an asset was made joint within one year of the decedent's date of death, it must be repoRed on Schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A• Barbara G. Colbert 1440 9th Street, Manhattan Beach, CA 90266 .Daughter
B.
C.
JOINTLY-OWNED PROPERTY:
ITEM
NUMBER LETTER
FOR JOINT
TENANT DATE
MADE
JOINT DESCRIPTION OF PROPERTY
INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR
IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET % OF
DECD'S
INTEREST DATE OF DEATH
VALUE OF
DECEDENTS INTEREST
t' A' 02I10I06 D & E COMM INC (232860106) - 900 shares 13,230.00 50% 6,615.00
2 A. 02/10/06 DR REDDYS LABS LTD (256135703) - 500 shares 8,050.00 50% 4,025.00
3• A. 02110106 ORACLE CORPORATION (68389X105) - 500 shares 10,140.00 50% 5,070.00
4• A. 02/10106 ORIENTAL FINL GROUP INC. (68618W100) - 800 shares 10,560.00 50% 5,280.00
5• A. 02/10106 COHEN and STEERS INTL REALTY INC (19248H302) - 333.997 shares 6,112.15 50% 3,056.08
6• A. 02110106 DEBIT BALANCE -77.95 ' S0% -38.98
TOTAL (Also enter on line 6, Recapitulation), ~ 24,007.10
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+ (12-99)
SCNEDIJLE H
FUNERAL EXPENSES 8c
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN ADMINISTRATNE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
James A. Grossman 2008-00133
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1' Musselman's Funeral Home & Cremation Services, Inc. (casket, vault, published obituary, death 6,708.86
certificates, transportation and professional services)
2. Rolling Green Cemetery 1,195.00
3. Grave Marker and Maintenance 4,207.00
4. Bloom's Flowers and Julianna's Reception 2,200.00
5. Religious Services -Grace Evangelical Lutheran Church 300.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions 0.00
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. Attorney Fees 10,500.00
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
4. Probate Fees 921.89
5. Accountant's Fees
6. Tax Return Preparer's Fees
~. Bekins Mover 6,100.00
TOTAL (Also enter on line 9, Recapitulation) $ 32,132.75
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX+ (12-03)
SCHEDULE 1
DEBTS OF DECEDENT,
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN MORTGAGE LIABILITIES, & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
James A. Grossman 2008-0133
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~ Ambulance -West Shore EMS - (11106I07,11/12I07,11/23I07) 1,016.38
2. Ambulance -East Pennsboro - (11/07/07,11/09/07) 99.00
3. Ambulance -Metro Med - (11107107) 57.20
4. IRS -Late Fees on Tax Returns 77.21
5. Prism Rehab (11115/07) 3.79
6. Citi Bank Credit Card (December 2007) 2.72
7. Bethany Village Skilled Care Fees (November 2007) 3,199.00
8. Bethany Village Condo Living Fees (August through December 2007) 8,664.09
9. Camp Hill Emergency Physicians (11/12107) 11.77
10. Verizon (December 2007) 121.73
11. Pinnacle Health (10/17107 through 11/26/07) 16.28
12. Internists of Pennsylvania (10/15/07 through 11128/07) 104.68
13. Quantum Imaging (11/01/07) 1.90
14. Orthopaedic Institute of Pennsylvania (07/10107, 10/05/07) 33.30
15. Holy Spirit Hospital Emergency Room 142.76
16. Flagship Therapy (09/01/07 through 11/30/07) 102.31
17. Personal Care Assistants (09/16107 through 10105/07) 2,980.00
18. Reader's Digest (November 2007) 26.47
19. Physicians NRA Group (11127/07 through 12/03/07) 200.00
20. Health South (November 7, 2007 through November 27, 2007) 626.30
21. Health Bottom Line (December 2007) 29.95
22. Hampden Physicians (11/19/07,11/21107, 11/23/07, 11/26/07) 77.21
23. Hazen Elder Law (11/20/07) 388.00
TOTAL (Also enter on line 10, Recapitulation) ; 17,982.05
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX+ (g-00)
SCNEDI~LE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT pECEDENT
ESTATE OF FILE NUMBER
James A. Grossman 2008-0133
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 outright spousal distributions, and Vansfers under
Sec. 9116 (a) (1.2)]
1 ~ Jeanne M. Thomas Daughter 50%
2~ Barbara G. Colbert Daughter 50%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 16, 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
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET S
(If more space is needed, insert additional sheets of the same size)
LAST WILL AND TESTAMENT
OF
JAMES A. GROSSMAN
I, JAMES A. GROSSMAN, now domiciled in Cumberland County, Pennsylvania,
declare this to be my Last Will and Testament. I revoke all other wills and codicils that I may
have previously made.
Article I
My just debts and expenses of my last illness, funeral, and administration of my estate
shall be paid by my Executor from the principal of my residuary estate as soon as practicable
after my death.
Article II
All inheritance, estate, and succession taxes (including interest and penalties thereon, but
not including any generation skipping tax) payable by reason of my death shall be paid out of
and be charged generally against the principal of my residuary estate without reimbursement
from any person. This provision is not a waiver of any right which my Executor has to claim
reimbursement for any such taxes which become payable as the result of any property over
which I have the power of appointment.
Article III
I give, devise and bequeath my tangible personal property in accordance with any
memorandum which I have either handwritten or signed, located with my will or with my
valuable papers and found within 30 days of the probate of my will. Gifts may only be to
persons who survive me or to organizations which exist at my death, and if there is a conflict, the
memorandum having the latest date shall govern. To the extent no such memorandum is found,
or all of my tangible personal property is not disposed of pursuant thereto, my tangible personal
property shall be added to my residuary estate and pass under Article IV hereof.
Article IV
All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever
situate, I give, devise and bequeath IN EQUAL SHARES to my daughters: BARBARA G.
COLBERT, of Manhattan Beach, California; and JEANNE M. THOMAS, of Camp Hill,
Fennsylvania.
However, if a beneficiary does not survive me by thirty (30) days, but leaves descendants
who survive me by thirty (30) days, those descendants shall receive, per stirpes, the share the
beneficiary would have received had she survived me by thirty (30) days.
Article V
I nominate, constitute and appoint my daughter, JEANNE M. THOMAS, of Camp Hill,
Pennsylvania, as Executrix of my Last Will and Testament. In the event of the renunciation,
death, or inability to act, for any reason whatsoever of my Executrix, I nominate, constitute and
2
appoint my son-in-law, D. MARK THOMAS, of Camp Hill, Pennsylvania, as successor
Executor of my Last Will and Testament. I direct that my Executrix or successor Executor be
permitted to serve without bond and in addition to those powers granted by law, I grant them
power to distribute in cash or in kind, in like or in unlike shares, and to file any qualified
disclaimer I could have filed if living. My Executrix or successor Executor shall receive
reasonable compensation for services rendered to my estate.
Article VI
In addition to the powers conferred by law, I authorize my Executrix and successor
Executor, in his/her absolute discretion:
(a) to retain in the form received and to sell either at public or private sale, any real
estate or personal property except that which I specifically bequeath herein,
(b) to manage real estate,
(c) to invest and reinvest in all forms of property without being confined to legal
investments, and without regard to the principal of diversification,
(d) to exercise any option or right arising from the ownership of investments,
(e) to compromise claims without court approval and without consent of any
beneficiary,
(f) to file any federal income tax return for any year for which I have not filed such
return prior to my death,
(g) to make distributions in cash or in kind, or in both, and to determine the value of
any such properly,
3
(h) to employ any attorney, investment advisor, or other agent deemed necessary by
my Executor; and to pay from my estate reasonable compensation for all their services,
(i) to conduct alone or with others, any business in which I am engaged in, or have
an interest in at time of my death, and
(j) to receive reasonable compensation in accordance with their standard schedule of
fees in effect while their services are performed.
IN WITNESS WHEREOF, I, JAMES A. GROSSMAN, hereby set my hand to this my
Last Will and Testament, on :`,~,~`~Z f ~_, 2004, at Harrisburg, Pennsylvania.
1 JAMES A. GROSSMAN
In our presence, the above-named JAMES A. GROSSMAN signed this and declared this
to be his Last Will and Testament and now at his request, in his presence, and in the presence of
each other, we sign as witnesses.
Name Address
~~ ~
4
I, JAMES A. GROSSMAN, Testator, who signed the foregoing instrument, having been
duly qualified according to law, acknowledge that I signed and executed this instrument as my
Will, and that I signed it willingly as my free and voluntary act for the purposes therein
expressed.
Sworn to or affirmed and
Acknowledged before me by
JAMES A. GROSSMAN, the Testator
on ,%:., ~'1",~ L ~t~~, 2004.
i" f; ,>,
o ub ' c
AMES A. GROSSMAN
Nat.a;iai Seal
Marielle F. Hazer,, Notary Public
City of ;riarrisburg, Dauphin County
My Caraattiissian Expire; Sept. 23, 2~J+ICi
We, the undersigned witnesses who signed the foregoing instrument, being duly qualified
according to law, depose and say that we were present and saw the Testator sign and execute this
instrument as his Will; that he signed and executed it willingly as his free and voluntary act for
the purposes therein expressed; that each of us in his sight and hearing signed the Will as
witnesses, and that to the best of our knowledge, that he was at that time eighteen (18) years or
more of age, of sound mind, and under no constraint or undue influence.
Sworn to or affirmed and
Subscribed to before me
and ~~ iT 7 !"1?- ~n"7. ,/~~,
witnesses, on r~2~~~' /~_, 2004.
/ A /
~" otary Pu is
Alrrt.arial 5ea1
TV+arielle E? Pia,,., n, 1*iotar)~ Public
City of ilarrisburt;, Dauphin Cc~cniy
Rey Camn~issic.~a~ Expires Sept. 23, 2(A3ti
-~~__.s"
JEANNE M. THOMAS, ExECUTRIX
ESTATE OF JAMES A. GROSSMAN
100 Walnut Street
Lemoyne, PA 17043
September 3, 2008
~ ~
VIA HAND DELIVERY ~
~~ ~ ~ ,,
Glenda Farner Strasbaugh ~'~ ~ ~' `-~'
Register of Wills ~-r~ _ _ ; : ,rt;
Cumberland County Courthouse
~ 4' 1
.. ~ .y-= ' '~
1 Courthouse Square ~ ~„~ ~- •~
Carlisle, PA 17013-3387 '-'
In re: Estate of James A. Grossman
Late of Cumberland County
Date of Death: December 3, 2007
County File No.: 2008-00133
Pennsylvania Inheritance Tax
Dear Register of Wills:
Kindly acknowledge receipt by dating and stamping the attached copy of this letter.
Enclosed in duplicate is the Pennsylvania Inheritance Tax Return (Schedules B, E, F, H, I
and J) together with the following:
Copy of decedent's will dated March 18, 2004;
2. A check in the amount of $2,474.02 payable to the Register of Wills, Agent for the
Inheritance Taxes due;
3. There is no Federal Estate Tax Return; and
4. A check in the amount of $15.00 to cover the cost of filing the Return.
If there are any questions, please contact me.
Sincerely,
f%~
Jeanne M. Thomas, Executrix
Enclosures
JEANNE M. THOMAS, EXECUTRIX
ESTATE OF JAMES A. GROSSMAN
100 Walnut Street
Lemoyne, PA 17043
September 3, 2008
VIA HAND DELIVERY
Glenda Farner Strasbaugh
Register of Wills
Cumberland County Courthouse
1 Courthouse Square ~
Carlisle, PA 17013-3387 ~ c~ £~: `'
n
~ r*i
~ s., ->
In re: Estate of James A. Grossman ~
Late of Cumberland County i~v'
~ ~ -'' `'J
c .<< ~-~~
,
Date of Death: December 3, 2007 0C ~ '
-=
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County File No.: 2008-00133 ~
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Pennsylvania Inheritance Tax ~ ~ _
•, ° ti
f
•.i
Dear Register of Wills:
Kindly acknowledge receipt by dating and stamping the attached copy of this letter.
Enclosed in du lip cate is the Pennsylvania Inheritance Tax Return (Schedules B, E, F, H, I
and J) together with the following:
1. Copy of decedent's will dated March 18, 2004;
2. A check in the amount of $2,474.02 payable to the Register of Wills, Agent for the
Inheritance Taxes due;
There is no Federal Estate Tax Return; and
4. A check in the amount of $15.00 to cover the cost of filing the Return.
If there are any questions, please contact me.
Sincerely,
l
Jeanne M. Thomas, Executrix
Enclosures