The URL can be used to link to this page

Home My WebLink About09-04-08 15056041147 REV-1500 EX 06 05 ( - ) OFFICIAL USE ONLY PA Department of Revenue county code rear File Number Bureau of Individual Taxes PO BOX.280601 INHERITANCE TAX RETURN Harrisburg, PA 1~12s-osol 21 0 7 1 1 12 ~ RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 181 32 3130 12 04 2007 O1 09 1940 Decedent's Last Name Suffix Decedent's First Name MI BARER RONALD 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 X^ 1. Original Retum ~ 2. Supplemental Retum ~ 3. Remainder Retum (date of death prior to 12-13-82) 4. Limited Estate ~ qa, Future Interest Compromise ~ 5. Federal Estate Tax Retum Required (date of death after 12-12-82) a g. Decedent Died Testate ~ (Attach Copy of Will) ~ Decedent Maintained a Living Trust Q 8. Total Number of Safe Deposit Boxes (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. 0) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AWD CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number EDWARD P. 3EEBER 717 533 3280 Firm Name (If Applicable) JAMBS, SMITH, DIETTERICR & First line of address SUITE C-400, 555 GETTYSBURG Second line of address City or Post Office MECHANICSBURG State ZIP Code PA 17055 tea ea REGISTER ~~LLS US~NLY ~ ~ -;~ -a I"-1 t, ~. C-) -v _~;~.m ~ ,.,~ -; .,.-j(~-,31 -~. `3 ~ - ~` . . N .~ .. DAT~FILED N =i~1 ~~ 'J _` ~~~ c ~~`~ c.: r --r-1 urn ~~~ r'1-7 ~ ~ ~) ~;~, Correspondent's a-mail address: e p s~ j s d C. C O m 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. ADDRESS - Co .. Keith Baker O P.O. B~X~47, Walnut Bottom, PA 17266 a~vrvni~ vr/ryrte~'nKErl~(J 111tK IWIN KEYKESENTATIVE DATE ~~/`~\\\ 1 ~ Edward P. Seebelr ~ ~~~ ~ ~~ C-400, 555 Gettysburg Pike, Mechanicsburg, PA 17055 Side 1 L 15056041147 15056041147 PA Inheritance Tax Return Signature of Additional Fiduciaries ESTATE OF I 1i 07 N 1 2BER Baker, Ronald A 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. Signature #2 Name Address1 Address2 City, State, Zip Denise Mancuso Date P.O. Box 174 Walnut Bottom, PA 17266 9/a/o8' REV-1500 EX Decedents Name: R o n a I d A B a k e r RECAPITULATION Decedent's Social Security Number 181 32 3130 1. Real Estate (Schedule A) .......................................................................................... 2. Stocks and Bonds (Schedule B) ............................................................................... 3. Closely Held Corporation, Partnership orSole-Proprietorship (Schedule C).......... 4. Mortgages 8 Notes Receivable (Schedule D) .......................................................... 5• Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ................ 6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ............. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Properly (Schedule G) ~ Separate Billing Requested ............. 8. Total Gross Assets (total Lines 1-7) ....................................................................... 1 1,150,000.00 2 724,153.56 3. 4. 5 75,385.01 s. 371,505.93 7. 64,412.67 $. 2,385,457.17 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 11. Total Deductions (total Lines 9 810) ...................................................................... 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. TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, of transfers under Sec. 9116 (ax1.2) X .00 0 . 0 0 15. 16. Amount of Line 14 taxable at lineal rate X .045 2, 19 5, 2 2 2. 0 6 1s. 17. Amount of Line 14 taxable at sibling rate X .12 0 . 0 0 17. 18. Amount of Line 14 taxable at collateral rate X .15 14.5 2 5 . 5 0 18. 19. Tax Due ..................................................................................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 15056042148 15056042148 157,349.28 18,360.33 175,709.61 2,209,747.56 2,209,747.56 0.00 98,784.99 0.00 2,178.83 100,963.82 ^X 15056042148 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-07-1112 DECEDENT'S NAME Ronald A Baker STREET ADDRESS 93 East Main Street CITY Walnut Bottom STATE PA ZIP 17266 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit g. Prior Payments C. Discount 3. Interest/Penally if applicable p. Interest E. Penalty 99,000.00 5,048.19 Total Credits (A + B + C) (1) 100,963.82 Total InteresUPenalty (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. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT (2) 104,048.19 (3) (4) 3,084.37 (5) (5A) (5B) 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 :.................................... ^ c. retain a reversionary interest; or .................................................................................................................. ^ ^x 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? ....................................................................................................................... ^ ^x 3. Did decedent own an "intrust 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? ...................................................................................................................... ~ ^ 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 exemot a transfer to a surviving spouse from tax, and the statutory requirements for disGosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116 (a) (1.3)]. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Rev-1502 EX+ (8.98) SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANUI aJHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Baker, Ronald A 21-07-1112 All real property owned solely or as a tenant In common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neRher being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Rest property which Is Jointly-owned with right of survivorship must be disclosed on schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Real estate located at 11089 Hurley Drive, Southampton Township, Franklin County, 100,000.00 PA -valued per sales price 2 I Real estate located at 93 East Main Street, South Newton Township, Cumberland County, PA -valued per appraisal 3 I Real estate located on High Mountain Road, Cooke Township, Cumberland County, PA -valued per appraisal 4 I Real estate located on Horsekiller Road, South Newton Township, Cumberland County, PA -valued per appraisal 840,000.00 180,000.00 30,000.00 TOTAL (Also enter on Line 1, Recapitulation) I 1,150,000.00 (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 A (Rev. 6-98) Rev-1503 EX+ (S-g3) SCHEDULE B STOCKS 8~ BONDS COMMONWEALTH OF PENN8VLVANIA MHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Baker, Ronald A 21-07-1112 All properly Jointlyowned wtlh right of survlvorshlp must be disclosed on Schedule F. ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 1 4,000 shares of Carlisle Companies, Inc. -valued per 39.425 157,700.00 public listing 2 384 shares of Citigroup, Inc. -valued per public listing 32.535 12,493.44 3 31 shares of Cumberland Valley Co-op -valued per 10 310.00 company 4 2,375 shares of Ford Motor Co. -valued per public 7.085 16,826.88 listing 5 3,000 shares of Harsco Corp. -valued per public 57.875 173,825.00 listing 6 100 shares of Maple Press Co. -valued per public 18.25 1,825.00 listing 7 40.5 shares of MetLife Inc -valued per public listing 63.9 2,587.95 8 500 shares of Pepsico -valued per public listing 76.62 38,310.00 9 2,000 shares of The Hershey Company -valued per 39.78 79,560.00 public listing 10 4,062.5 shares of Tim Hortons -valued per public 38.395 155,979.69 listing 11 130.5 shares of Visteon Corp. -valued per public 4.015 523.96 listing Total of Continuation Schedule See attached page TOTAL (Also enter on Line 2, Recapitulation) 724,153.56 (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) Rev-1503 EX+ (8.98) SCHEDULE B STOCKS 8~ BONDS continued COMMONWEALTH OF PENNSYLVANIA WHERRANCETAX RETURN RESIDENT DECEDENT ESTATE OF (FILE NUMBER Baker, Ronald A 21-07-1112 ITEM NUMBER CUSIP NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 12 3,000 shares of Wendy's International Inc. -valued per 28.125 84,375.00 public listing 13 1 Series EE US Savings Bonds -valued per Savings 36.64 Bond Calculator TOTAL (Also enter on Line 2, Recapitulation) 724,153.56 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98) Rev-1508 EX+ (8.98) SCHEDULE E CASH, BANK DEPOSITS, 8~ MISC. PERSONAL PROPERTY COMrdONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESENT DECEDENT ESTATE OF FILE NUMBER Baker, Ronald A 21-07-1112 Include the proceeds of litigation and the date the proceeds were received by the estate. All properly Jointly-owned whh the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1 Cash in Scottrade -valued per statement 60,070.65 2 Cash in Scottrade, accrued interest 20.90 3 Commonwealth of PA -refund 42.18 4 IRS - 2005 income tax refund 2,117.03 5 M8tT Bank Checking Account No. 9845168484 -valued per bank letter dated 10.00 12/26/07 6 November Social Security Check 1,647.00 7 Shippensburg Borough -refund for Corn Fesitval held prior to death 4.00 8 1998 Dodge Ram 1500 Pickup -valued per Kelley Blue Book 2,575.00 9 2005 Ford Taurus SE Sedan -valued per Kelley Blue Book 5,600.00 10 Miscellaneous personal property -valued per auction proceeds 3,298.25 TOTAL (Also enter on Line 5, Recapitulation) I 75,385.01 (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) Rw-1509 EX+ (698) SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSnVANw INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Baker, Ronald A 21-07-1112 Han asset wos made Jo1M within ono your of the dooodak'o dab of death, k must bo nporbd on oohodulo 0. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Keith S. Baker 954 Kennedy Lane Son Elizabethtown, PA 17022 B. Denise L. Mancuso 6188 Poplar Path Daughter Elizabethtown, PA 17022 C. Lydia Baker 203 Hemlock Hall Friend Middletown, PA 17057 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 DECEDENT'S INTEREST 1 A 5/1/2007 3 Series EE US Savings Bonds -valued 152.84 100.000% 152.84 per Savings Bond Calculator 2 B 1/1/2007 3 Series EE US Savings Bonds -valued 152.44 100.000% 152.44 per Savings Bond Calculator 3 A 6/1/2006 61 Series EE US Savings Bonds -valued 4,042.52 50.000% 2,021.26 per Savings Bond Calculator 4 B 11/1/2006 61 Series EE US Savings Bonds -valued 4,022.52 50.000% 2,011.26 per Savings Bond Calculator 5 A,C 1/28/1980 MBtT Bank Checking Account No. 36,823.62 33.333% 12,274.54 97002208 -valued per letter dated 12/26/07 6 A,C 10/9/1979 M8tT Bank Savings Account No. 1,402.02 33.333% 467.34 21000001217919 -valued per letter dated 12/26/07 7 A,C 10/9/1979 M8tT Bank Savings Account No. 0.48 33.333% 0.16 21000001217919, accrued interest - valued per letter dated 12/26/07 Total of Continuation Schedules See attached a es TOTAL (Also enter on Line 6, Recapitulation) I 371,505.93 (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 F (Rev. 6-98) Rev-1509 EX+ (8.98) SCHEDULE F COMMONWEALTH OF PENNSYLVANw JOINTLY-OWNED PROPERTY INHERRANCE TA%RETURN RESIDENT DECEDENT continued ESTATE OF FILE NUMBER Baker, Ronald A 21-07-1112 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. 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 DEEP FOR JOINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST DATE OF DEATH DECEDENT'S NTEREST 8 A,B 1/30/2007 PSECU Certificate of Deposit No. 50 - 104,170.61 100.000% 104,170.61 valued per letter dated 12/21/07 9 A,B 1/30/2007 PSECU Certificate of Deposit No. 50, 42.30 100.000% 42.30 accrued interest -valued per letter dated 12/21/07 10 A,B 1/30/2007 PSECU Certificate of Deposit No. 51 - 104,170.61 100.000% 104,170.61 valued per letter dated 12/21/07 11 A,B 1/30/2007 PSECU Certificate of Deposit No. 51, 42.30 100.000% 42.30 accrued interest -valued per letter dated 12/21/07 12 A,B 1/30/2007 PSECU Certificate of Deposit No. 52 - 102,729.53 100.000% 102,729.53 valued per letter dated 12/21/07 13 A,B 1/30/2007 PSECU Certificate of Deposit No. 52, 43.32 100.000% 43.32 accrued interest -valued per letter dated 12/21/07 14 A,B 1/30/2007 PSECU Checking No. 04 -valued per 40,173.79 100.000% 40,173.79 letter dated 12/21/07 15 A,B 1/30/2007 PSECU Checking No. 04, accrued 0.83 100.000% 0.83 interest -valued per letter dated 12/21/07 16 A,B 1/30/2007 PSECU Regular Shares No. 01 -valued 3,052.49 100.000% 3,052.49 per letter dated 12/21/07 17 A,B 1/30/2007 PSECU Regular Shares No. 01, accrued 0.31 100.000% 0.31 interest -valued per letter dated 12121/07 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule F (Rev. 6-98) Rev-1570 EX+ (0.95) SCHEDULE G INTER-VIVOS TRANSFERS 8~ MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Baker, Ronald A 21-07-1112 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM NUMBER N INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECD'S INTEREST EXCLUSION (If APPLICABLE) TAXABLE VALUE 1 M8T Bank IRA No. 35004200805016 -beneficiary 7,780.17 100.000 0.00 7,780.17 is Lydia Baker, friend; valued per letter dated 12126/07 2 M8~T Bank IRA No. 35004200805016, accrued 374.31 100.000 0.00 374.31 interest -beneficiary is Lydia Baker, friend; valued per letter dated 12/26/07 3 M8~T Securities IRA No. AZR-206295 - 56,258.19 100.000 0.00 56,258.19 beneficiaries are Denise Mancuso and Keith Baker, children; valued per statement ending 12/31/07 TOTAL (Also enter on Line 7, Recapitulation) I 64,412.67 (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 G (Rev. 6-98) REY-1151 EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE H FUNERAL EXPENSES & An\Aldll@T~ATI\/C ~`ACTC ESTATE OF FILE NUMBER Baker, Ronald A 21-07-1112 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER q, FUNERAL EXPENSES: See continuation schedule(s) attached B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Keith Baker Denise Mancuso Social Security Number(s) / EIN Number of Personal Representative(s): Street Address P.O. Box 147 C;ty Walnut Bottom state PA zip 17266 Year(s) Commission paid 2008 & 2009 See continuation schedule(s) attached 2, Attorney's Fees James, Smith, Dietterick 8c Connelly, LLP 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 See continuation schedule(s) attached 5. Accountant's Fees 6. ~ Tax Return Preparer's Fees 10,715.09 80,000.00 50,000.00 1,030.00 7. Other Administrative Costs 15,604.19 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 157,349.28 Copyright (c) 2002 form software only The Lackner Group, Inc. Fonn PA-1500 Schedule H (Rev. 6-98) Rev-1502 EX+ (8.98) COMMONWEALTH OF PENNSriVANU1 INHERRANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H-A FUNERAL EXPENSES continued ESTATE OF FILE NUMBER Baker, Ronald A 21-07-1112 ITEM NUMBER DESCRIPTION AMOUNT 1 Fogelsanger-Bricker Funeral Home, Inc. -funeral services 9,792.74 2 Jim Wyrick -gravesite opening 100.00 3 Knute's Pub & Grill -funeral reception 272.35 4 Spring Hill Cemetery -gravesite services 550.00 Subtotal 10,715.09 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98) Rev-1502 EX+ (8.98) SCHEDULE N-B1 PERSONAL REPRESENTATIVE'S COMMISSIONS COMMONWEALTH OF PENNSYLVANIA continued INHERRANCE TAX RETURN RESDENT DECEDENT ESTATE OF FILE NUMBER Baker, Ronald A 21-07-1112 ITEM NUMBER DESCRIPTION AMOUNT Denise Mancuso - co-Executrix fee 2 I Keith Baker - co-Executor fee Subtotal 40,000.00 40,000.00 80,000.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B1 (Rev. 6-98) Rsv-7502 EX+ (6.98) SCHEDULE H-B4 PROBATE FEES continued COMMONWEALTH OF PENNSYLVANIA INHERRANCE TA% RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Baker, Ronald A 21-07-1112 ITEM NUMBER DESCRIPTION AMOUNT Register of Wills, Dauphin County -probate fee 2 ~ Register of Wills, Dauphin County -reservation for additional probate fee Subtotal 580.00 450.00 1,030.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-64 (Rev. 6-98) Rsv-1502 EX+ (8.98) COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESDENT DECEDENT SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Baker, Ronald A 21-07-1112 ITEM NUMBER DESCRIPTION AMOUNT 1 Chamberlin 8- Wingert Sanitary -waste removal 150.00 2 Clauser Real Estate Appraisals -real estate appraisal fees 2,250.00 3 Commonwealth of Pennsylvania -title transfer fee 58.50 4 Cumberland Law Journal -estate notice advertisement fee 75.00 5 David McBeth -electrical service 8L water pump repairs 2,311.39 6 Donnie G. Boyer 8L Co. -vehicle transfer fee 113.00 7 Embarq -telephone 8L Internet service 514.63 8 IWS -trash removal 832.00 9 James, Smith, Dietterick 8L Connelly, LLP -reservation for estate administration 500.00 closing costs 10 Penelec -electric service 98.01 11 PPL -electric service 175.28 12 Prothonotary, Cumberland County -certified copies of divorce decrees 126.00 13 R8LR Portable Storage -storage service 413.40 14 Recorder of Deeds, Cumberland County -filing fee for deeds 118.50 15 Recorder of Deeds, Franklin County -realty transfer tax 1,000.00 16 Register of Wills, Cumberland County -filing fee for Return 8 Inventory 62.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev-1502 EX+ (698) COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H-BT OTHER ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Baker, Ronald A 21-07-1112 ITEM NUMBER DESCRIPTION AMOUNT 17 Sailhamer Real Estate -real estate sales commission 6,000.00 18 The Sentinel -estate notice advertisement fee 190.54 19 Timmons Oil -oil delivery 615.94 Subtotal 15,604.19 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev-1512 EX+(8.99) SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8r. LIENS COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Baker, Ronald A 21-07-1112 Include unreimbureed medical expeneee. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Chambersburg Hospital - unreimbursed medial bill 46.16 2 Embarq -telephone 8 Internet service 78.93 3 IRS - 2006 income tax 15,539.85 4 PA Department of Revenue - 2007 income tax 1,568.00 5 Penelec -electric service 11.25 6 PPL -electric service -check issued prior to death; paid after death 94.55 7 PSECU -credit card 25.00 8 R8~R Portable Storage -storage service 964.60 9 Verizon Wireless -cellular phone service 31.99 TOTAL (Also enter on Line 10, Recapitulation) I 18,360.33 (If more space is needed, additional pages of the sanNe size) Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule 1(Rev. 6-98) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF FILE NUMBER Baker, Ronald A 21-07-1112 NAME AND ADDRESS OF RELATIONSHIP TO DECEgENT SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(S) RECEIVING PROPERTY Do Not Llst Trus s (Words) ($$$) I- TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] 1 Keith Baker Son Joint bonds 8~ 1,100,801.75 P.O. Box 147 accts; 50% of Walnut Bottom, PA 17266 IRA 8r residue 2 Lydia Baker Friend IRA & joint 14,525.50 203 Hemlock Hall accounts Middletown, PA 17057 3 Denise Mancuso Daughter Joint bonds 8r 1,094,420.31 P.O. Box 174 accts; 50% of Walnut Bottom, PA 17266 IRA 8 residue Total 2,209,747.56 Enter dollar amounts for distributions shown above on lines 1 5 through 1 , 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 ON LINE 13 OF REV-1500 COVER SHEET I U.UU Copyright (c) 2002 form software only The Lackner Group. Inc. Form PA-1500 Schedule J (Rev. 6-98) ESTATE OF RONALD A. BAKER SSN: 181-32-3130 Estate File No. 21-0?-1112 Pennsylvania Inheritance Taz Return TABLE OF EDITS Exhibit Description A Receipts of tax payments B Copy of Grant of Letters Testamentary and Last Will and Testament C Settlement Sheet for 110819 Hurley Drive, Southampton Township, Franklin County, PA D Real estate appraisal for 93 East Main Street, South Newton Township, Cumberland County, PA E Real estate appraisal for High Mountain Road, Cooke Township, Cumberland County, PA F Real estate appraisal for Horsekiller Road, South Newton Township, Cumberland County, PA G Stocks and U.S. Savings Bond valuations H M &T Bank date of death valuation letter I Jointly-held U.S. Savings Bonds valuations J PSECU date of death valuation letter K M&T Securities IRA date of death valuation September 3, 2008 T.~E Glenda Farner Strasbaugh, Register of Wills ESTATE Cumberland County Courthouse SECURITY 1 Courthouse Square Carlisle, PA 17013 F(~~~~~.~,,, Re: Estate of Ronald A. Baker File No. 21-07-1112 Cheryl L. Baker, CP Certified Paralegal clb@jsdc.com Dear Ms. Farner Strasbaugh: Enclosed are the following documents to be filed in the above-referenced Estate: 1. An original and two (2) copies of the Pennsylvania Inheritance Tax Return. 2. An original and two (2) copies of the Inventory. 3. A check for Thirty Dollars ($30.00) representing tie filing fee for both the Return and Inventory. 4. A copy of the United States Estate Tax Return to be forwarded to the Pennsylvania Department of Revenue. Please time-stamp the extra copies and return them to me with the messenger. Additionally, please update your records to reflect our office's new mailing address: Suite C-400 555 Gettysburg Pike Mechanicsburg, PA 17055 If you have any questions, please feel free to contact me. Very truly yours, dAMES~ SMITH, DIETTERICK 8i CONNELLY~ LLP ery L. Baker, CP fled Paralegal Enclosures cc: Keith Baker, Co-Executor Denise Mancuso , Co-Executrix 134 SIPE AVENUE HUMMELSTOWN, PA 17036 l Reply to: Suite C "OO MAILING, ADDRESS /-r 555 ^ettySbnrg Plke P.O. BOX 650 HERSHEY, PA 17033 Mechanicsburg, PA 17055 TOLL FREE 1.800.942.3660 Direct Dial: 717-298-2094 TEL. 717.533.3280 Direct Fax: 717-298-2095 FAX 717.533.7771 www.jsdc.com W a ~ Q ~ o N O l ~ ~ 0 ' 7 ~l / ~P a 01! ) Z ati;M ~~ o ~o ~¢W¢ ~o = Vl U W -, w ON ~ O wa o ~o e 2008 SEP -4 PM 2~ 30 G!~}ELK ~F Dirl~fYil~V~J (;T}'J~T .--. O ~~ ~ ~i ~0., " ~U ro ~ ~ ay ~, U~~ i a~ ~~oa -~ .~ a~~~ ~ ~ j U c~ U