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Home My WebLink About04-0115STATUS REPORT UNDER RULE 6.12 Name of Decedent: Date of Death: File No.: Inza B. Foster January6,2004 2104-0115 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether the administration is complete: Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: Not applicable. 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No X b. The separate Orphan's Court No. (If any) for the personal representative's account is: Not applicable. c. Did the personal representative state an account informally to the parties in interest? Yes X No Date: November '2~- 20.04 d. Copies of receipts, releases, j oinders and approvals)of formal or informal accounts may be filed with the Clerk of the Orphans'.Eourt and may be attached to this report. /. - · Signature ~ Barbara Sumple-Sullivan, Es .~i~'re Name 549 Bridge Street - ~ Address :_z New Cumberland, PA 17070 <: (717) 774-1445, Supreme Ct #32317 Telephone No. Capacity: X Personal Representative Counsel for Personal Representative Deceased. Social Security No..196-14-5519 ' The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut. in the last will of the above decedent, dated arid. codicil(s) dated PETITION FOR PROBATE and GRANT OF LETTERS Estate of Inza Beatrice Foster No. ~ also known as To: Register of Wills for the County of Cumberland Commonwealth of Pennsylvania in the named ,19 (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Oamb~rlm-~ County, Pennsylvania, with h er last family or principal residence at 826 Linwood St., New O,mher]and PA 1707~ (list street, number and muncipality) Decendent, then - 81 years of age, died January 6, ~ 9-004 at Holy Spirit Hospifa], Camp Bi ] ], PA 17001 ' ' Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not' the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (}f not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: $ 76,000.00 WHEREFORE, presented herewith and the grant of letters theron. petitioner(s) respectfully request(s) the probate of the last will and codicil(s) (testamentary; administrmion c.t.a.; administration d.b.n.c.t.a.) OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ COUNTY OF . aamh~_r]~ y $S The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the Dest of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly admini~er the~(~,~ ,~K,ding to law. Sworn to or affixed and subscribed ~ ~~-~~ ~fore me this ~/ day of [ ~ COMMONVVEALTH OF PENNSLYVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-I$O0 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITrAL) Foster, Inza B. DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) January 6, 2004 March 8, 1922 (IF APPLICAELE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Not applicable 1. Original Return 4. Limited Estate 6. Decedent Died Testate (Attach copy of Will) b_J9. Litigation Proceeds Received SOCIAL SECURITY NUMBER 196-1 ~5519 THIS RETURN MUST BE FII..I~) IN DUPLICATE WiTH ~"IE REGISTER OF WILLS SOCIAL SECURITY NUMBER 2. Supplemental Return U 3. Remainder Rntum H4a. Future Interest Comprise (~t. d ~a~th a~t~ 12-12-62) ~ 5. Federal Estate Tax Rntum Required 7. Decedent Maintained a Living Trust (~t.=h. =~py d Tn~) 8. Total Number of Safe Deposit Boxes ~--~ 10. Spousal Poverty Credit (d~t. of .eath b. Nn 12-31-~1 and 1-1-.) ~ !~;Election to tax under Sec. 9113(A) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME Barbara Sumple-Sul~ivan, Esquire FIRM NAME (If Applicable) TELEPHONE NUMBER (717) 774-1445 1. Real Estate (Bohedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) I~] Seporata Bi~ling Requested 7. Inter-Vivos Transfers & Misc. Non-Probata Proporly (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 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) 12. Net Value of Estate (Line 8 minus Line 11) COMPLETE MAILING ADDRESS 549 Bridge Street New Cumberland, PA 17070 13. Chantable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES L USE ONLY $ 0.00 (8) $12,793.46 $ 0.00 (11) (12) (13) (14) $70,492.88 $12,793.46 $58,155.40 $ 0.00 $58,155.40 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x (15) 16. Amount of Line 14 taxable at lineal rate $58,155.40 x 4.5 (16) 17. Amount of Line 14 taxable at sibling rate x .12 (17) 18. Amount of Line 14 taxable at colraterar rate x .15 (18) 19. Tax__Due (19) 20. r x i CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT $ 0.00 $2,616,99 $ 0.00 $2,616.99 > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < Decedent's Comp ete Address STREET ADDRESS 826 Linw~od Street ziP 17070 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount $125.00 Total Credits (A + B + C) (1) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) (3) 4. If line 2 is greater than line 1 + line 3, enter the difference. This is the OVERPAYMENT Check box on Page 1 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) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE (5B) Make Check Payable to: REGISTER OF WILLS, AGENT $2,616.99 $2,625.00 $ 0.00 -$8.01 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred; ~ b. retain the right to designate who shall use the property transferred or its income; c. retain a revisionary 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 on year of death without receiving adequate consideration? 3. Did decedent own an In trust for" or payable upon death bank account o¢ sec~ st his or her death? 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which No contains a beneficiary designation? ~ ~'~ IF THE ANSWER TO ANY OF 'l't~ ABOVE QUES'noNs IS YES, YOU MUST COMPLE-~ SCHEDiJLE G N~iD Fit. E iT AS PART OF THE RErURN. A~DDR~;S 826 Li~ RE P S ESPONSIBLE FOR FILING RETURN ~.~~ Mark K. Foster, Executor tr umberland, PA 17070 ~THAN REPRESENTATIVE Barbara Sumple-Sullivan, Esquire 549 Bridge Street, New Cumberland, PA 17070 Fo~ 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 3% [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 0% [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 parent, an adoptive parent, or a stepparent of the child is 0% [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 4.5%, 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 trensfere to or for the use of the decedent's siblings is 12% [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. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Inza B. Foster SCHEDULE B STOCKS & BONDS FILE NUMBER 200~-00115 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. $21,372.00 Bond Redemption (Series EE Bonds) M42997840EE X01833820EE M42997835EE M42997834EE M42997833EE M42997838EE M42997831 EE M42997839EE M42997837EE M42997832EE M42997836EE Bonds had previously been held with her Mother who predeceased her in death. TOTAL IAIso enter on line 2, RecapitulationI $21,372.0~) (If more space is needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF Inza B. Foster FILE NUMBER 2004-00115 If an asset was made joint within one ?ear of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Mark K. Foster Son 826 Linwood Street New Cumberland, PA 17070 JOINTLY-OWNED PROPERTY: 5. A. i Jointly Titled EE Bonds with son: $0.oc X02080872EE V02373505EE V02373504EE TOTAL (Also enter on line 6, Recapitulation $49,576.86 (If more space is needed, insert additional sheets of the same size) Bank ACCOUNT NO. I ACCOUNT TYPE 33830(452 RELATZONSHZP CHECKZNG NTTH ZNTEREST O0 STATEMENT PERXOD , pAGE 'DEC.18-JAN.16,200q *"1 I OF 0 0611511 NN 017 272~ INZA B FOSTER OR HARK K FOSTER 826 LINNOOD ST NEN CUMBERLAND PA 17070-1qq2 ZNTEREST PAZD YEAR TO DATE 0.1(4 H/G11LAND PARK BEG/NH/NC · BALANCE ACCOUNT SUMMARY DEPOS/TS & OTHER ~ INTEREST PD NO. ANOUNT NO. A11OUNT NO. AMOUNT I 3 ~25.00I II 1,097.10I 0I 0.00 0.1~, ACCOUNT ACTIVITY DATE TRANSA~¥zoN iOE~CRZPTZON ! i & OTHER ADDXTZONS SUBTRACTZO~IS i!i i: BALANCE i;ill 1093 01-09-0q 1,097.10 ANNUAL PERCENTAGE YZELD EARNED = 0.10 MARK FOSTER 826 LINNOOD ST NEN CUMBERLAND PA 17070 ZNFORHATZON NOTICE AND TAXPAYER RESPONSE FILE NO. Z1 OR-Oil5 ACN 0q109805 DATE 03-15-200q TYPE OF ACCOUNT EST. OF INZA B FOSTER [] SAVTNSS S.S. HO. 196-1~-5519 [] CHECKZNO DATE OF DEATH 01-06-200~ [] TRUST COUHT~ CUMBERLAND [] CERTIF. REHZT PAYHENT AND FORHS TO: REGISTER OF gILLS CUMEERLAHD CO COURT HOUSE CARLISLE, PA 17015 COMPLETE PART I BELON ~ ~ ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS A~ount No. 01961~5519 Date 03-08-].983 Established Accoun'~ Balance 2? , 660. ~2 Percent Taxable X 50. 000 bou~t Sub.iect to Tax '11,330 . 21 Tax Rate X . 0~5 Potential Tax Du~ 509.86 PART TAXPAYER RESPONSE ] ~ ........ !--F:,',,=;;''' "~' ',":"=_~irTM' '~ ................ ~"' =~ .~r .~' "i. "~=. ' 'ii~ ' '"~ ..... . *'i== You must complete PART ~ ~d/or PART--131 below. PART ] relationship to decedent: TAX RETURN ' COHPUTATZON OF TAX ON JOINT/TRUST ACCOUNTS 8. Tax Due 8. PART DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) Under penalties of perjury~ Z d~clare thai the facts ! have reported above are tr'ue~ correct and colp1ete to the best of my knowledge and beltef. HOME ( ) ~ORK ( ) TAXPAYER SIGNATURE TELEPHONE NUMBER DATE HARK FOSTER 826 LZNWOOD ST NEW CUMDERLAND PA 17070 ZNFORNATZON NOTICE AND TAXPAYER RESPONSE FILE NO. Z1 0q-011S ACN 0q10980~ DATE 05-15-Z00~ EST. OF INZA B FOSTER S.S. NO. 196-1~-5519 DATE OF DEATH 01-06-Z00~ COUNT~ CUMBERLAND TYPE OF ACCOUNT [] SAVINGS [] CHECKTNG [] CERTTF. RENTT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 COHPLETE PART 1 BELON ~ ~ ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 01961q5519 Date 03-08-1983 Established Account Balance 25,709.56 Percen* Tmxmble X 50,000 Amotmt Subject to Tax 1Z,856~. 78 Tax Rate X .15 Potential Tax Due :~,928.22 PART TAXPAYER RESPONSE ONE ] relationship to decadent: TAX RETURN" CONPUTATION OF 8, Tax Due O. PART DATE PAID TAX ON JOINT/TRUST ACCOUNTS DE~TS AND DESUCTZONS CLAZHED PAYEE DESCRIPTION AMOUNT PAID J TOTAL (Enter on Line 5 of Tax Co.putet~on) Under penalties of perJury~ Z deolare that the facts I have reported above are ~rum, correct and co~pllte ~o the bast of my kno#ledga and beLief, HOME ( ~ORK ( TAXPAYER SIGNATURE TELEPHONE NUMBER DATE February 4, 2004 American Express Financial Advisors inc. 70100 AXP Financial Center Minneapolis, MN 55474 Hr. Hark K. Foster Hrs. Inza B. Foster 826 Linwood Street Hew Cumberlnd PA 17070-1442 Client ID Number 1590 8199 1 001 1769 8790 7 001 Dear Mr. Foster and Hrs. Foster: Thank you for your business with American Express Financial Advisors Inc. I am writing in response to your request for account value information. As you requested, we are providing the following account information. This information is current as of January 6, 2004. Total yalue Shares Net Asset Value Account Number / Descrlntion $5,545.97 243.672 $22.760 $28,244.22 5,806.221 $4.860 $14,884.19 3,048.455 $4.880 0000 0010 6785 8366 6 002 AXP New Dimensions Fund, Class B 0000 0011 2785 8366 8 002 AXP Diversified Bond Fund Class B 0000 0012 4785 8366 4 002 AXP Short Dur U.S. Government Fund Class B If you have questions or further service needs, please contact John Grove, your financial advisor, at (717) 761-3600, or our office at the telephone number below. SinCerely, / inne Hutdal Fund ahd Certlfic~te Service and Transactions (800) 862-7919, Option O, Ext. 68588 00846 81306 0612 66584 Insurance end annuities ara issued by IDS Life Insurance Company, an Americae Express company. American Express Brokerage is provided by American Express Financial Advisors Inc. American Express Financial Advisors Inc. Member NASD. American Express Company is separate from Americae Express Financial Advisors Inc. and is not a braker-deale¢. OMMONVVEN. TH OF PENNSYLVANIA INHERITANCETAXREi'URN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Inza B. Foster FILE NUMBER 2004- 00115 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRrPTION AMOUNT 5. 6. 7. FUNERAL EXPENSES: Parthemore Funeral Home & Cremation Services, Inc. Rolling Green Cemetery ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Mark K. Foster Social Security Number(s) / EIN Number of Personal Representative(a) Street Address 826 Linwood Street 166-46-3549 City New Cumberland State PA Zip 17070 Year(s) Commission Paid: Attorney Fees 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 Probate Fees Open Estate; Advertising in Patroit News and Cumberland County Law Journal Accountant's Fees Tax Return Preparer's Fees $8,125.29 $870.00 $2,500.00 548.17 $750.00 TOTAL (Also enter on line 9, I~ eC~r'2i{:ulation)i $12,793.46 (If more space is needed, insert additional sheets of the same size) PARTHEMORE Funeral Home & Cremation Services, Inc. The Estate ofInza B. Foster c/o Mr. M~rk IC Foster I/6/2004 826 Linwoud Sm~et New Cumberland, PA 17070 1303 Bridge Street We sincerely appreciate the confidcoce you have placed in us mad will eoutinue to assist you m every way we ca~ Please feel free to contact us if you have any questions in regard to this statemcot. The following P.O. Box 431 is an itemized statement of the services, facilities, automotive equipment and merchandise that you selected New Cumberland. PA 17070 when making the funeral arnmgemco~s. (717) 774-7721 (Fax) 774-5546 Torres Duo Dato ] ~,eeount # www. parthemore.com Net 30 2/5/2004 2004003.0 __ Doseription .Amount Traditional Funeral Service 4,959.00 Stainless Steel Brushed 'Hyacinth" Casket 2,575.00 Total Services cod Merchandise 7,534.00 Death Notice, Hacrisbusg Patriot 185.28 Death Notice, Altooou Mirror 208.01 Certified Copies of Dcoth Cextificates 30.00 Hairdresser 35.00 Clergy Honorarium 125.00 Additional Certified Copies of Dcoth Cmifieetas 8.00 Total Cash Advances 591.29 Total $~,lZS.2o Paym~ntslCmdits $o.oo Ba[al~¢o Dtio $~,1~s.2~ Gilbert W. Parthemore, Founder Gilbert J. Parthemore. Supervisor Stephen K. Parthemore. CFSP Bruce R. Parthemore, Pre-Need Coordinator. CPC Professional Memberships: NFDA · PFDA DCFDA · CCFDA ROttlNO CE ET£nY Nc. $126 7 THIS AG~EMENT PROVIDES FOR ENDOWMENT CA~ CEMETERY INTE~ENT ~GHTS, MERCHANDISE AND SERVICES PURCHASE/SECU~TY AG~EMENT The undersigned, referred to as "Purchaser", hereby agrees to purchase the Interment Rights, Merchandise and Services described herein, subject to acceptance and a~rova of the,above named cemetery, hereinafter referred to as "Seller~. NameofOeceased Description of Interment Rights: Issue Certificate of Interment Rights to: Address INTERMENT RIGHTS~ MERCHANDISE AND SERVICES Interment Rights (including Endowment Care of $. .) ................................................................... $ '~ Interment Fees ..................................................................................................................... ~.~. Memorlalization -- Type ........................... Size Design .......................... r Memorial Base Type ~ . ............................. Size Color .. .......................... -- Memorial Epdowment Care of .................................................................................................................................. Memorial In~/thllation~lnspecflon Fee ........................................................................................................................ -- Outer Burial Container ~ Material ........................... Model Supplier .......................... Cremation Charge ........................................................................................................................................................ Urn -- Type Size -- Flower Vase--Type ............................ Nameplate ..................................................................................................................................................................... Lettering ....................................................................................................................................................................... ~-~ Other ........................... Other SalesTax ..................................................................................................................................................................... TOTAL CASH PRICE ............................................................................................................................ 7o, O0 RECEIPT FOR PAYMENT Cumberland County - Register Of Wills Hanover and Hiqh Street Carlisle, PA I7013 Receipt Date 2/06/2004 Receipt Time 10:55:20 Receipt No. 1035505 FOSTER INZA B File Number Remarks 2004-00115 MARK K FOSTER AC ........................ Distribution Of Receipt Transaction Description Payment Amount PETITION FOR PROBA 200.00 EXTP~A PAGES 12.00 SHORT CERTIFICATE 15.00 JCP FEE 10.00 Payee Name CUMBERLAND COUNTY GENERAL FUN CUMBERLAiqD COUNTY GENERAL FUN CUMBERLAND COUNTY GENEP~AL FUN BUREAU OF RECEIPTS & CNTR M.D Check# 1094 $237.00 Total Received ......... $237.00 TI E PATRIOT WS THESUNDAY PATRIOT NEWS Proof of Publication UnderAct No. 587, Approved May18, 1929 Commonwealth of Pennsylvania, County of Dauphin} ss Joseph A. Dennison, being duly sworn according to law, deposes and says: That he is the Asst. Controller of The Patriot News Co., a corporation organized and existing under the laws of the Commonwealth of Pennsylvania, with its principal office and place of business at 812 to 818 Market Street, in the City of Harrisburg, County of Dauphin, State of Pennsylvania, owner and publisher of The Patriot-News and The Sunday Patriot-News newspapers of general cimulation, printed and published at 812 to 818 Market Street, in the City, County and State aforesaid; that The Patriot-News and The Sunday Patriot-News were established Mamh 4th, 1854, and September 18th, 1949, respectively, and all have been continuously published ever since; That the printed notice or publication which is securely attached hereto is exactly as printed and published in their regular daily and/or Sunday/ Metro editions which appeared on the 16th and 23rd day(s) of February and the 1st day(s) of Mamh 2004. That neither he nor said Company is interested in the subject matter of said printed notice or advertising, and that all of the allegations of this statement as to the time, place and character of publication are true; and That he has personal knowledge of the facts aforesaid and is duly authorized and empowered to verify this statement on behalf of The Patriot-News Co. aforesaid by virtue and pursuant to a resolution unanimously passed and adopted severally by the stockholders and board of directors of the said Company and subsequently duly recorded in the office for the Recording of Deeds in and for said County of Dauphin in Miscellaneous Book "M", Volume 14, Page 317. ~~ PUBLICATION ........................... C O P Y Sworn to and ~"h -e~rlh_t~/_ LC:.I~;'; ,~... ~%is 4th day~t~ Maroh~04 A D City . . . 62006 l ' ,-J N O~ARY My c~on E~res June PUBLIC Member ~r~ Assoca~ (~ .No~.' . . . . My corniness on exp res June 6, 2006 BARBARA SUMPLE-SULLIVAN 549 BRIDGE STREET NEW CUMBERLAND, PA. 17070 Statement of Advertising Costs To THE PATRIOT-NEWS CO., Dr, For publishing the notice or publication attached hereto on the above stated dates Total $ 236.17 Publisher's Receipt for Advertising Cost The Patriot News Co., publisher of The Patriot-News and Th un Patri -News, newspapers of general circulation, hereby acknowledge receipt of the aforesaid notice and publication costs and certifies that the same have been duly paid. CUMBERLAND LAW JOURNAL 32 SOUTH BEDFORD STREET CARLISLE, PA 17013 March 5, 2004 Cumberland Law Journal is published every Friday by the Cumberland County Bar Association and is designated by the Court of Common Pleas as the official legal publication for Cumberland County and the legal newspaper for publication of legal notices. TO: Barbara Sumple - Sullivan, ESQUIRE Inza Beatrice Foster,ESTATE Legal advertisements must be received by Friday NoOn. All legal advertising must be paid in advance. Make all checks payable to: Cumberland Law Journal. Advertisement inserted on following dates: FEBRUARY 20, 27,MARCH 5, 2004 Advertising Cost Proof of Publication Second Proof Request Payment Received Total Amount Due Payment received FEBRUARY 18, 2004 by Becky H. Morgenthal/Executive Director $ 75.00 $ 0.00 $ 0.00 $ 75.00 $ 0.00 PROOF OF PUBLICATION OF NOTICE IN CUMBERLAND LAW JOURNAL (Under Act No. 587, approved May 16, 1929), P. L. 1784 STATE OF PENNSYLVANIA : : COUNTY OF CUMBERLAND : SS. Lisa Marie Coyne, Esquire, Editor of the Cumberland Law Journal, of the County and State aforesaid, being duly sworn, according to law, deposes and says that thc Cumberland Law Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid, was established January 2, 1952, and designated by the local courts as the official legal periodical for the publication of all legal notices, and has, since January 2, 1952, been regnlarly issued weekly in the said County, and that the printed notice or publication attached hereto is exactly the same as was printed in the regular editions and issues of the said Cumberland Law Journal on the following dates, viz: FEBRUARY 20, 27, MARCH 5, 2004 Affiant further deposes that he is authorized to verify this statement by the Cumberland Law Journal, a legal periodical of general circulation, and that he is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statements as to time, place and character of publication are true. Foster, Inza Beatrice, dec'd. Late of 826 Llnwood Street, New Cumberland. Executo~ Mark Ii. Foster, 826 Lin- wood Street, New Cumberland, PA ! 7070. Attorneys: Barbaxa Sumple-Sulli- van, Esquire, 549 Bridge Street, New Cumberland, PA 17070, (717) 774-1445. /isa Marie Coyne/Editor SWORN TO AND SUBSCRIBED before me this 5 .day of MARCH 2004 NOTAPi~AL SEAL t7 LOIS E, SNYDER, Notary Public Carlisle Boro, Cumberland County My Commission Expires March 5, 2005 o . REV-151.3 EX+ COMMONWEALTH OFPENNEYLVANIA INHERITANCE TAX RETURN RESlDENT DECEDENT ESTATE OF Inza B. Foster SCHEDULE J BENEFICIARIES FILE NUMBER 2004-00115 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] RELATIONSHIP TO DECEDENT .,wo~rrc~ Do Not List Trustee(s) S-~RE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET 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 ~[. 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) OLOL LVcI aNOHd ~L-~LL(LLL) LL£E£ ~:II :O' S uo uo.tl.v.~d oql 3o uo!l~a~p!suoo u! _2$,/1 _/,~_/~ --o~4 ll)5 8()~ RFV 9/86 This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 9 8 13 3 4 9 JAN 0 8 t004 No. Date H105A43 Rev. 2/87 RINT NAME OF DECEDENT (Fi'et. Middle. Last) Inza Beatrice COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH SEX SOO^L SECUR,TY NUMBER Foster z. female 3. 196-- 14 -- 5~19 DATE OF DEATH (Mo~th, Day, Year) 4. January 6° 2004 AGE (Last BiIlhday) 81 Yrs. COUNTY OF DEATH Cumberland DECEDENT'S USUAL OCCUPATION 826 Linwood Street FATHER'S NAME (Ft~l, Middle. Last) E. Grace CATE OF BIRTH BIRTHPLACE (City and State or Foreign Co~z~try) ~ MOTHER'S NAME (First, Mid~le. Mak~en Surname) I~g. Elsie O. Donelson ~ INFORMANT'S MAILING ADDRESS (Street, Cily F~mvn. Slate, Z~p Code) ~ter Izm. 826 Ltnwood Street~ New C~,mberland, PA 17070 ~DATE OF ~S~,T,O. I~%~S"OS'T,O.-N.* ~ O...te~, C--et~ I?CAT,O.-C'ty.--, S,et., Z,p Bi,,,.January 8, 2004 I~plling Green Memorial Parkl~wer Allen Twp., PA 17011 PERSON ACTING AS SUCH UCENSENUMBER INAMEANDADDRESSOFFAClLITYParthemore EH & CS, Inc. 22~.FD 012 848 L I2zc, P.O. Box 431= New Cumberland~ PA 17070-04:~1 [ the time, date and place stated LICENSE NUMBER ~DATE SIGNED Phy~anisnol available et time ofdeathto (Signature arid Title) I , 1. ~ ~ ~ ~) --__g~ . I(Monlh, Day, Year) DATE PRONOUNCED DEAD (Month. Day, Year) I WAS CASE REFERRED TO A MEDICAL EXAMINER ICOROI~ER? I -4, -o~ I-. Y.,O * ~ter~el bet,veer ~ resulting in the underlythg cause given ir~ PART I. : onset am;I death ~. ~I::-T'R~CT~JE L_UN ~ ~t~¢gg~- : re~ultlag o~ death ) LAST ', I°FDEAT"' I. en, O P*., ln.e.,get I I Y.,O .col ",D '*'BI Y"D"°B Isui..~ [] ~.,dr~,..e,e..i.. D'~l~~ J~ & ,..- - 3.. -. I.. I i ~c/.£.q=2~Y_ At home,, .... ~'eet. ,ac~-/, office ]LOCATION (Street, City/Town~ ' --, , a~,~ee ...................... , .......................................... I I ~lb. ~ ' ~"'- ' Saxton, PA ~.. [] E.~,.., I"] ~o^ I-I .~.D .-.--'-~'---.D o,. [] CITY. BORO, TWP OF DEATH FACILITY NAME (If not [qstitu~orl, give slmet and numder) NAS DECEDENT OF HISPANIC ORIGIN? ~RACE - Ameilcae Indian, Black, V~ite, et~ If yes, specify Cul3arl, ~ (Spe<:tfy) Pennsboro Twp Select Specialty Hospital "et~' [~p. white ~NO OF SUS,NESS nNDUST,¥ DECEDEm'S EDUCATED, MAR,Tg ST^~US- M~I SURV~NG S~OUSE Federal Government YesD No~ (~t2) (,~5.) DIvorced(Spe~) ~z ~.12 widowed I ~' DECEDENT'S ACTUAL ~?a. Slala Pennsylvania DId ~?~. [] ¥,.d~.~nt"~m ~p RESIDENCE decedent (See ~n~tmctio~s live in & o~ other side) 17b. County CumDe r land township? 17d. [~ Ne, decedent lived witch amuaHthas of [~e~ Cumberland re~-~g in death) LICENSE NUMBER -- --~ ~..IDATESIGNED(~I~Ih Day Yeaq / NAME AND A~RESS OF PERSON ~O COMPLETED ~US~ oF D~TH ~ (Item 2~ Ty~ or P~ j'P ~ ~ ~1 ~ ~ ~ 4 OF I~.A B. FOSTER I, Inza B. Foster, residing at 517 Boston Court, Mechanicsburg, Cumberland County, Pennsylvania, being of a sound and disposing mind, over the age of eighteen (18) years, and under no legal disability, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking all other Wills and Codicils heretofore made by me at any other time. Article I: I direct that my Executor, hereinafter named, pay all my just debts and funeral expenses as soon after my death as practicable, including all property, state and federal death taxes assessed against me, my estate, or my beneficiaries, without proration among my beneficiaries. However, all property bequeathed or devised hereunder, either outright or in trust, is bequeathed or devised subject to existing mortgages, liens or encumbrances thereon. Article II: I give and grant unto my Executor appointed herein and his successors all the powers given under the common and statutory law of Pennsylvania at the time of my death, to be exercised in his absolute discretion, unless otherwise restricted herein, in any capacity to which such powers may be applicable. ~ Inza B. Foster Douglas H. Gent Attorney At Law 11~7 Eichelberger Street Hanover, PA 17331 In addition to such powers, he shall have the following powers: A. To accept in kind and retain any property which I may own at my death, without regard to any principal of diversification, and to invest and reinvest in any form of property without restriction to legal investments for fiduciaries. B. To purchase investments at a premium and, at his discretion, to charge such premium and the premium on any investments owned by me at my death either to principal or income. C. To give proxies and to Join in any merger, reorganization, voting trust plan, or other concerted action of security holders affecting investments, delegating powers with respect thereto. D. To sell at public or private sale, exchange or lease for any period of time any real or personal property, and to give options for sales or leases. £. To borrow money and to mortgage or pledge any real or personal property. F. To register property in the name of a nominee or to hold property unregistered. G. To compromise claims. B. Foster H. To allocate any property received or charge incurred to principal or income or partly to each, without being obliged to apply the usual rules of trust accounting. I. In investing, reinvesting, purchasing, acquiring, exchanging, and selling property for the benefit of my estate or any trust created hereunder, they shall exercise the Judgment and care, under the circumstances then prevailing, that men of prudence, discretion, and intelligence exercise in the management of their own affairs, not in regard to speculation, but in regard to the permanent disposition of their funds, considering the probable income as well as the probable safety of their capital. Article III: I hereby nominate and appoint my son, Hark K. Foster, as Executor of this my Last Will and Testament. In the event he predeceases me or is unable to serve as Executor, then I nominate my sister, Audrey L. Hamilton, as Executrix of this my Last Will and Testament. In the event she predeceases me or is unable to serve as Executrix, then I nominate my brother, ~erald L. Grace, as Executor. My individual Executors or Executrix shall not be required to furnish bond or surety. Article IV: I give, devise and bequeath all the rest and residue of my estate of whatever kind and description wherever situate, to my son, Hark K. Foster. ~Inza B. Foster In the event that my son predeceases me then this gift to him shall be divested and I then give, devise and bequeath the rest, residue and remainder of my estate, whether real, personal or mixed and wheresoever situate unto my sister, Audrey L. Hamilton, of Hollidaysburg, Pennsylvania. In the event that my sister predeceases me then this gift to her shall be divested and I then give, devise and bequeath the rest. residue and remainder of my estate whether real or personal or mixed and wheresoever situate unto my brother, Gerald L. ~race, of Audubon, New Jersey. of I have hereunto set my hand and seal this ,_~ day Inza B. Foster (SEAL} Signed, sealed, published and declared by the foregoing Testatrix as and for her Last Will and Testament, consisting of four pages, in the presence of us, who at her request, and in her presence, and in the presence of each other, have hereunto set our hands as witnesses thereto. COI'Ii"IONI~E:fM..TH OF @ENNSYLV~qNX~I COUNTY OF CUiIBERUIND I, Inza B. Fostee, Testateix, whose name is signed to the attached o~ foeegoing insteument, being duly qualified accoeding to law, do heeeby acknowledge that I signed and executed the insteument as my Last Will and Testament; that I signed it willingly; and that I signed it as my f~ee and voluntary act foe the pueposes theeein expressed. Swo'rn to o'r~a~sfi'rmed and~now~d befo're me by Inza B. FosteT, the Testat'rix, this . .~day of . ~_~.~, 1997. Inza ~.~ F~ste'r CO~TY OF ~RL~D ~he Ni~nesses Nhose n~mes ~*re signed ~o ~he ~ached o*/ fo*reDoing being duly qualified ~cco?ding ~o 1~ do depose and and s~N Tes~*~ix sign ~nd execute ~he ins~*rumen~ as he'c f*ree ~nd volun~*ry ac~ fo'~ ~he pu*epose~ ~he*cein exp*~essed; ~ha~ each of us in sigh~ of ~he Tes~*cix ~s ~ ~he ~ime 18 o'r mo*re ye,'rs of ~ge~ of sound mind ~nd unde'r no con;~'cain~ o*~ undue influence. Swo'rn to o'r affi'rmed and subsc'ribed befo're me by '~*/~ '___~)q~ ~day~t//~"F~of ~ ~nd1997,~ ~/?z ~ ~ ~ __, witnesses, this ~ ' 5 LAW OFFICEs BARBARA SUMPLE. SULLIVAN NEW CJUMBERLAND, PENNSYLVANIA 17070-1931 PHONE (717) 774-1445 FAX (717) 774-7059 April 2, 2004 Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 Re: Estate of Inza B. Foster No. 2004-00115 / Cumberland Count Dear Sir/Madam: Enclosed please fred a check in the amount of TWO ~D?L. LARS ($2,500.00) for pre-payment of th° T--~.A--'~ TH~OUS.AN.D FIVE HUNDRED estate. ,, -m~mance lax ~n the above-captioned BSS/ld Enclosure Should you have any questions please contact my office. Thank you. t/Barbara Sumple-Sullivan cc: Mr. Mark K. Foster, Executor BARBARA SUMPLE- SULLIVAN A..rTOi, CN~'¥ A"r LAw NEW CUMBERLAND, P£NNSYLVANIA 17070-1~,31 Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 i 7o t 3 .a..'3~"?zh,,lth,,llh,,,,,th,lh,,Ih,,Ihhh,,,hlhh,hh,,,Ihi COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU QF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: SUMPLE-SULLIVAN BARBARA 549 BRIDGE STREET NEW CUMBERLAND, PA 17070 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003770 ........ fold ACN ASSESSMENT CONTROL NUMBER AMOUNT ESTATE INFORMATION: SSN.. 196-14-5519 FILE NUMBER: 2104- 0115 DECEDENT NAME: FOSTER INZA B DATE OF PAYMENT: 04/06/2004 POSTMARK DATE: 04/03/2004 COUNTY: CUMBERLAND DATE OF DEATH: 01/06/2004 101 I $2,500.00 REMARKS: SEAL CHECK//1022 TOTAL AMOUNT PAID: $2,500.00 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS CERTIFICATION OF NOTICE UNDER RULE 5.6(a) BEFORE THE REGISTER OF WILLS, CUMBERLAND COUNTY, PENNSYLVANIA Name of decedent: Inza B. Foster Date of death: January 6, 2004 No. 2004 - 00115 To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate as follows: Name: Address: Dated Mailed Mark K. Foster February l0,2004 826 Linwood Street New Cumberland, PA 17070 Notice has now been given to all persons entitled thereto under le 5.6-(a) iexcept~zN/A Date: April 8, 2004 ' ~.Ba~ ~umple-Sullivan, Esquire 549 Bridge Street New Cumberland, PA 17070 (717) 774-1445 Supreme CT. ID # 32317 Capacity: __ X Personal Representative Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENTOFREVENUE BUREAU OFINDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128 0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV 1162 EX(11-96) NO. CD 004471 SUMPLE-SULLIVAN BARBARA 549 BRIDGE STREET NEW CUMBERLAND, PA 17070 ESTATE INFORMATION: SSN: 196~14-5519 FILE NUMBER: 2104-0115 DECEDENT NAME: FOSTER INZA B DATE OF PAYMENT: 10/06/2004 POSTMARK DATE: 1 0/05/2004 COUNTY: CUMBERLAND DATE OF DEATH: 01/06/2004 REMARKS: CHECK//1131 SEAL TOTAL AMOUNT PAID: INITIALS: JA RECEIVED BY: ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 9439.65 9439,65 GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS LAW OFFICES BARBARA SUMPLE- SULLIVAN October 5, 2004 Register of Wills Cumberland County Courthouse I Courthouse Square Carlisle, PA 17013 Re: Estate oflnza B. Foster No. 21-04-0115 / Cumberland County Dear Sir/Madam: Pursuant to your Notice of Inheritance Tax dated September 27, 2004, enclosed please find Check No. 1131 in the amount of $439.65 for payment of the additional tax due on the above referenced Estate. Should you have any questions please contact my office. ~ Barbara Sumple-Sullivan BSS/ld Enclosures cc: Mr. Mark K. Foster, Executor BUREAU OF ZNDZVZDUAL TAXES COHHONNEALTH OF PENNSYLVANZA DEPARTHENT OF REVENUE NOTZCE OF ZNHERZTANCE TAX APPRAISEMENT, ALLOHANCE OR DZSALLOHANCE OF DEDUCTZONS AND ASSESSMENT OF TAX BARBARA SUHPLE SULLIVAN E 549 BRIDGE ST NEN CUMBERLAND PA 17070 DATE 09-27-2004 ESTATE OF FOSTER DATE OF DEATH 01-06-2004 FXLE NUMBER 21 04-0115 COUNTY CUMBERLAND ACN 101 Amoun~ Rmt~ed INZA B HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF MILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 1701S CUT ALONG THIS LINE ~'~ RETAZN LONER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTZCE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLONANCE OR DZSALLONANCE OF DEDUCTZONS AND ASSESSMENT OF TAX ESTATE OF FOSTER INZA B FZLE NO. 21 04-0115 ACH 101 DATE 09-27-200q TAX RETURN NAS: ( ) ACCEPTED AS FELED (X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE ZNTEREST- SEE REVEre; APPRAZu,.-u VALUE OF RETURN BASED ON: 0RZGTNAL RETURN 1. Reel Es~m~e (Schedule A) APPROVED DEBUCTZONS AND EXEHPTZONS: (Z) .00 NOTE: To insure proper (2) 11 $7Z.00 credit ~o your account, ($) .00 sub. i~ ~he upper pore/on (q) .00 of ~his form wi~h your (E} .00 ~ax payment. (~) 59 656.86 (7) .00 (G} 81,028.86 (9) 12,795.46 NOTE: z.~ an assessment was issued previously, lines 1~,, 15 end/eP :16, 17, ASSESSNENT OF TAX: 15. AJnoun~ of L/ne lq 16. Amoun~ of Line Zq ~exable a~ Lineal/Class A ra*e (16) reflect ~igures that include the total ~ ALL returns assessed to date. TAX CREDZTS: DATE 04-05-200q NUMBER INTEREST/PEN PAID (-) CD005770 1S1.58 INTE~ST IS CHARGED THROUGH 10-19-2004 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM 68,255.40 .00 68,235.40 :18 and 19 wi11 .00 x O0 = .00 68,2~5.40 x 045= 5,070.60 .00 x 12 = .00 .00 X 15 ~ .00 (19)= 5,070.60 AHOUNT PAID 2,631.58 459.02 459.65 2,500.00 TOTAL TAX CREDIT BALANCE OF TAX DUE ZNTEAgS¥ AND PEN. TOTAL DUE A REFUND. SEE REVERSE SIDE OF THT$ FORM FOR TNSTIrdCTTONS. } COMMONWEALTH OF PENNSYLVANIA EXPLANATION DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17t28~601 DECEDENT'S NAME FILE NUMBER Foster, Inza B. 2104-0115 REVIEWED BY ~CN Daniel Heck 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES F 5 % value of these savings bonds $10,080.00 has been placed on this schedule. These savings bonds are ½ taxable. ~J BARBARA SUMPLE- SULLIVAN Regi~ ~f Wills Cumberland County Courthouse I Courthouse Square Carlisle, PA 17013 BUREAU OF ZNDTVZDUAL TAXES INHERITANCE TAX DTVTSTON EjrF.'i: 280601 H~qRTSBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOT/CE OF INHERITANCE TAX APPRAISEMENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE 09-Z7-ZOOR r--- ESTATE OF FOSTER { DATE OF DEATH 01-06-200~ c_~ FZLE NUMBER 21 0~-0115 ' COUNTY CUMBERLAND BARBARA SUJ~PLE SUkLIVAN E ACM 101 NEW CUMBERLAND ~PA 17070 Amoun~ Remi'~ted REV-IgC7 EX AFP (01-05) INZA B MAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LXNE ~ RETAIN LOWER PORTXON FOR YOUR RECORDS ~ REV-15&7 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF FOSTER INZA B FILE NO. 21 0~-0115 ACM 101 DATE 09-27-200~ TAX RETURN WAS: ( ) ACCEPTED AS FTLED (X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 4. Nortgages/Notes Receivable (Schedule D) (4) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jo/ntly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXEHPTZONS: 9. Funeral Expenses/Adm. Costs/N/sc. Expenses (Schedule H) (9) 10. Debts/Nortgage Liabilities/L/aris (Schedule Z) (10) 11. Total Deductions Nat Value of Tax Return 15. 14. Charitable/governmental Bequests; Non-elected 9115 Trusts (Schedule J) Net Value of Estate Subject to Tax .00 21t372.00 .00 .00 .00 59~656.86 .00 (8) 1Z,793.q6 .O0 (11) (12) (13) (14) NOTE: Zf an assessment was lssued previously, 11nes 14, 15 and/er 16, 17, reflect flgures that include the total of ALL returns assessed to date. ASSESSHENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 *axeble at Lineal/Class A rata 17. Amount of Line 14 e~ S/bl/ng rate 18. Amount of L/ne 14 taxable at Collateral/Class B re~a 19. Pr/nc/pal Tax Due TAX CREDTTS: PAYMENT RECEIPT DATE NUHBER NOTE: To insure proper crad/t to your account, subEit the upper por~/on of this form with your tax payment. O~,-O$-ZO0~ CD003770 DISCOUNT INTEREST/PEN PAID (-) INTEREST IS CHARGED THROUGH 10-19-200q AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM 131.58 81,028.86 12.793.66 68,Z$5.~0 .00 68,255.~0 18 and 19 will (1.;) .00 X O0 = .00 (16) 68,255.fi0 x 0~5= :5,070.60 (17) . O0 x 12 = . O0 (18) .00 x 15 : .00 (19)= :5,070.60 AMOUNT PAID 2,500.00 TOTAL TAX CREDIT BALANCE OF TAX DUEI INTEREST AND PEN. TOTAL DUE 2,631.58 ~$9.0Z .65 q$9.65 IF TOTAL DUE ~S REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.) IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT ZS REgUZRED. FOR CALCULATION OF ADDITIONAL INTEREST. RESERVATION: PURPOSE OF NOTICE: PAYHENT: REFUND (CA): OBJECTIONS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class 8 (collatmral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the laaful Class B (collateral) rate on any such future interest. To fulfill the requirements of Section ZlqO of the inheritance and Estate Tax Act, Act 13 of ZOO0. (72 P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. --Make check or money order payable to: REGISTER OF NZLLS, AGENT A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1515). Applications ara available at the Office of the Register of Nills, any of the Z3 Revenue District Offices, or by calling the special Z4-hour answering service for forms ordering: 1-800-$61-1050~ services for taxpayers eith special hearing and / or speaking needs: 1-800-447-30Z0 iTT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. ZBiOZ1, Harrisburg, PA 17118-1011, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Depart~ent of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17118-0601 Phone (717) 787-6S05. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5Z3 discount of the tax paid is allowed. The 1SI tax amnesty non-participation penalty is computed on tho total of tho tax and interest assessed, and not paid before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1981 bear interest at the rate of six (61) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary free calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through Z004 ars: Interest Daily Interest Daily Year Rata Factor Year Rate Factor Year 1982 lOX .000548 ~1~'8-1991 117. .000301 ~-~ 1983 167. . 000438 1991 97. . 000247 2002 1984 117. ,000301 1993-1994 77. .00019Z 2003 1985 137. .000356 1995-1998 97, .000147 Z004 1986 107. .000274 1999 77. .000192 1987 107. .000274 ZOO0 77. .000191 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUI~BER OF DAYS DELINQUENT X DALLY INTEREST FACTOR Xntarest Daily Rate Factor 9X .000147 6Z .000164 57. .000157 47. .000110 --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. REV-1470 EX (~88) ' ~ INHERITANCE TAX EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT, 280601 HARRISBURG, PA 17128-0601 DECEDENTS NAME FILE NUMBER Foster, Inza B, 2104-0115 REVIEWED BY ACN Daniel Heck 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES ½ value of these savings bonds $10,080.00 has been placed on this schedule. These F 5 savings bonds are ½ taxable. Row Page I BUREAU OF ZNDZVZDUAL TAXES I'NHERTTANCE TAX DI'VTSI'ON PO BOX Z80601 HARRTSBURG, PA 17128-0601 BARBARA SUMPLE SULLIVAN'~ 5q9 BRIDGE ST NEW CUMBERLAND PA 17070 COMMONHEALTH OF PENNSYLVAN'rA DEPARTMENT OF REVENUE ZNHERZTANCE TAX STATEMENT OF ACCOUNT REV-I~07 EX AFP (09-Oq) DATE 11-15-200fi ESTATE OF FOSTER INZA DATE OF DEATH 01-06-200q FZLE NUMBER 21 0q-0115 COUNTY CUMBERLAND ''.' ACN 101 Amoun~ Remi~ed HAKE CHECK PAYABLE AND REMZT PAYMENT TO: REGISTER OF HILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper credi~ ~o your account, submi~ ~he upper portion of ~his fore wi~h your ~ax payment. CUT ALONG THZS LZNE ~ RETAZN LOHER PORTZON FOR YOUR RECORDS ~11 RE~r:f&~'EY '~' '~OT'-'~]~ ...... ';;~' ~FIr~f ~ YAM ~' 'fR~ '~?XYI~ R~q~Tf ' ~Y 'R~'¢~0Fff ' ' E~'~ ..................... ESTATE OF FOSTER INZA B FZLE NO. 21 0q-0115 ACN 101 DATE 11-15-200q THZS STATEMENT ZS PROVZDED TO ADVZSE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAMED ESTATE. SHONN BELO# TS A SUMMARY OF THE PRZNCZPAL TAX DUE~ APPLZCATZON OF ALL PAYMENTS,, THE CURRENT BALANCE., AND,, ZF APPLZCABLE,, A PROdECTED ZNTEREST F/GURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 09-Z7-ZOOq PRINCIPAL TAX DUE: ............................................................................................ PAYMENTS (TAX CREDITS): ~,070.60 PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 151.58 Oq-O$-2OOq lO-05-ZOOq CD005770 CDOOqq7! .O0 2,500.00 q$9.65 TOTAL TAX CREDZT $,071.25 BALANCE OF TAX DUE .65CR ZNTEREST AND PEN. .00 TOTAL DUE .65CR IF PAZD AFTER THZS DATE~ SEE REVERSE S~DE FOR CALCULATION OF ADDZTZONAL ZNTEREST. ( ZF TOTAL DUE ZS LESS THAN $1~ NO PAYMENT 1S REgU/RED. ZF TOTAL DUE IS REFLECTED AS A 'CREDZT' (CR)~ YOU MAY BE DUE A REFUND. SEE REVERSE SZDE OF THIS FORM FOR ZNSTRUCTZONS. PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- Zf RESIDENT DECEDENT make check or money order payable to: REGISTER OF NILLS, AGENT. -- If NON-RESIDENT DECEDENT make check or money order payable to: CONNONNEALTH OF PENNSYLVANIA. REFUND (CA): A refund of a tax credit, which was not requested on the Tax Return, may ba requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" [REV-l~13). Applications ara available online at www.rsvenue.state.oa.us~ any Register of Nills or Revenue District Office, or from the Department's Iq-hour answering service for forms orders: 1-800-361-2050~ services for taxpayers with special hearing and/or speaking needs: 1-800-~7-~010 (TT only). REPLY TO: DISCOUNT: PENALTY: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit) P.O. Box Z80601, Harrisburg, PA 171Z8-0601, phone (717) 787-6S05. If any tax due is paid within three (5) calendar months after the decedent's death, a five percent (51) discount of the tax paid is allowed. The 1SI tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (l) day from the date of death, to the date of payment. Taxes which became delinquent before January l, 1981 bear interest at the rate of six (SX) percent par annum calculated at a daily rate of .00016q. All taxes which became delinquent on and after January 1, 1981 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZO0~ ara: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 198Z ZOZ .OOOSqB 1988-1991 11Z .O00~O1 ZOOi 9Z .O00Z~7 198~ 16Z .000~8 199Z 9Z .O00Z~7 ZOOZ 62 .00016~ 19Bq 11X .000501 1993-199q 72 .OOOl9Z ZO0~ SZ .000137 1985 l$Z .000556 1995-1998 92 .O00Zq7 ZO0~ qZ .000110 1986 IOZ .OOOZTq 1999 72 .00019Z 1987 9Z .O00Zq7 ZOO0 8Z .000219 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINI;~UENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (153 days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated.