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Home My WebLink About04-0336April 6, 2004 JAMfiS SMITH DIETI'ERICK ~: CONNELLY LLP Elizabeth S. Eck ese@jsdc.com Olenda Famer Strausbaugh, Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013-3387 Re: Trust Estate of Franklin W. Boyd, deceased Social Security No. 194-09-2068 134 SIPE AVENUE HLJMMELSTOWN PA 17036 MAILING ADDRESS: PO BOX 650 HEqSHEY, PA 17033 T_FL. 717533 3280 WWW J S DC C 0 M Dear Ms. Strausbaugh: We represent the Trust Estate of Franklin W. Boyd, deceased, who died on January 9, 2004, a resident of East Pennsboro Township, Cumberland County, Pennsylvania. Enclosed please find a check in the amount of $20,000.00 payable to the Register of Wills, Agent, as a prepayment of Pennsylvania inheritance tax due for the Trust Estate. This payment is being made within 90 days of the decedent's death and thus qualifies for a 5% discount. Also enclosed is an Estate Information Sheet to be forwarded to the Depamnent of Revenue. The decedent's Will was not probated because all his assets are held in trust. Please send a receipt for the pre-payment to me in the envelope provided as well as a time- stamped copy of the Estate Information Sheet. Should you have any questions, or need any additional information, please do not hesitate to contact me, or Gary L. James, Esq., Counsel to the Trust Estate. Very truly yours, / Elizabeth S. Eck Paralegal GARY L. JAMES MAX J. SMITH, JR. JOHN J. CONNELLY, JR. SCO%f A. DIE%rERICK JAMES F. SPADE BRYAN S. WALK MATTHEW CHABAL, III GREGORY K. RICHARDS SUSAN M. KADEL JARAD W. HANDELMAN DONNA M. MULLIN EDWARD P. SEEDER NElL W. YAHN COURTNEY L. KISHEL KIMBERLY A. DEWITT OF COUNSEL: MANLEY DEAS & KOCHALSKI, LLC COLUMBUS, OH /ese Enclosures Sent via certified mail Article #7003 1680 0004 8041 3089 Return Receipt Requested H:'xHOME'~ESE'~Boyd~Franldinl 1.doc COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003785 JAMES GARY L, ESQ. 134 SIPE AVENUE HUMMELSTOWN, PA 17011 ........ fold ESTATE INFORMATION: SSN: 194-09-2068 FILE NUMBER: 2104-0336 DECEDENT NAME: BOYD FRANKLIN W DATE OF PAYMENT: 04/07/2004 POSTMARK DATE: 04/06/2004 COUNTY: CUMBERLAND DATE OF DEATH: 01/09/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $20,000.00 REMARKS: ..... SEAL CHECK# 106 TOTAL AMOUNT PAID: $20,000.00 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS II I II I I I I I II II · II I I I I II · I I IIII IIIII II III 7003 1680 0004 8041 3089 First Class Mail THE E~ JAMES SMITH DIETTERICK & CONNFLLY LLP~ S~13RiTY P.O. Box 650 FORMUIJ~ Hershey, PA 17033-0650 h,,llh,,llh,,,,,ll,,Ih,,Ih,,ll,l,,hh,,Ihl,,hh,l,h,I Glenda F. Strausbaugh, Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013-3387 EV- S00 REV--1500 COMMO"WE^LTHOPPB..SYLV^.,^ INHERITANCE TAX RETURN DEPARTMENT OF REVENUE DEPT. 2 Ot RESIDENT DECEDENT HARRISBURG. PA 17128-0601 D DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) E Franklin W. C OFFICIAL USE ONLY FILE NUMBER 21-04-336 'COUNTY CODE YEAR SOCIAL SECURITY NUMBER 194-09-2068 NUMBER E DATE OF DEATH (MM-DD-YEAR) D E N T [-[el en M. 1. Original Return 4. Limited Estate DATE OF BIRTH (MM- D D-YEAR) THIS RETURN MUST BE FILED IN DMPUC~,TE wrrH THE REGISTER OF WILLS SOCIAL SECURITYNUMBER 465-24-5294 (Attach copy of Trust) ~] 9. LltigatlonProceedsRecelved r~10. SpousalPovertyCredlt [] 11.ElectlontotaxunderSec. Slt3(A) NAME C RO L. James Esq. R FIRM NAME (If Applicable) E Dietterick & Conm S TELEPHONE NUMBER R E C A P I T U L A T I 0 N 0 M T I O N 1. Real F;t~t. (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or (3) Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) ] Separate Billing Requested 7. Intar-Vivos Transfers & Miscellaneous Non-Probate Property (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) ~OMPLETE MAILING ADDRESS 134 Sipe Avenu.~c. Hummels~ow~, p~ ~7036~ N~ne N~ne None 632,064.86 9,050.59 None (8) 632,064.86 (11L 9,050.59 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable 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 (12) 623,014.27 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(aX1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collataral rate' (13) (14) 623,014.27 158,572.19 X .0 0 (15) 0.00 464,442.08 X .0 45 (16) 20,899.89 x .12 (17) O. O0 x .~s (18)_ Copyright (c) Z000 form software only T he Lackner Group, I nc. Form REV- t 500 EX (Rev. Decedent's Complete Address: STREETADDRESS 527 Jo¥ce Road CITY J STATE IZIp Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 2. Credits/Payments A. Spousal Poverty Credit 0.00 B. Prior Payments 20,000.00 C. Discount 1,044.99 Total Credits ( A + B + C ) (~') 21,044.99 3. Interest/Penalty if applicable D. Interest E. Penalty Total IntaresVPenaity ( O + E ) (3) 0.00 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) 1/4-5.10 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 A. Enter the interest on the tax due. (SA) 0.00 B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SB) 0.00 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X"IN ................................................................................. !,,,,~,,,,;;,i,,!,; THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yec No a. retain the use or incoma of the property transferred; ~ ~ b. retain the right to 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 careT 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, annuify, or other non-pro, bate property which contains a benefk: a des nat on~ F THE ANSWER TO ANY OF THE ABOVE QUE$~i0N$ iS ~fE$,' ' ~ r~ YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I d~.l=,~ that r have examlr~d this return, Including &~,,,~..,,~,l, ~j schedules and statements, and to the best of my knowledge and belief, [t Is true, 20~899.89 SIGNATUREOFPERSONRESPONSIBLEFORF NGRETURN Helen Z' BoYd~ ' DATE SIGNATUREOFPREPAREROTHERTHANREPRESE~AT~E 3~ES, SMITR, D[~'I'r~ICK & CO~LY, ~p DATE ~ ~~ 13~ Sipe Avenue ............................ ................................ CJ.. ~..._.L " .~sto~, PA 17036 .............. ' ' g p us~3% [~1~6 (a) (~.1) (i)~ For dates of death on or after Janua~ 1, 1995, the ~x rate i~osed on the net value of transfem to or for the use of t~ sullying spouse is 0% [72 P.S. 9116 (a) (1.1) (ii)~ The s~tuta does not exempt a transfer to a sullying spouse from tax, and t~ ~atuto~ require~nts for disclosure of assets and fi[ing a tax return are still applicable even ~ the su~iving spouse is the on~ beneficial. For dates of death on or after Ju~ 1, 2000: 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 [72 P.S. 9116(aX1)]. of tran~ers to or for the use of the decedent's lineal benef~rMs is 4.5%, except as noted in 72 P.S. 9116(1.2) The tax rate imposed on the net value of transfem 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 o~ parent in com~n with the decedent, whether by blood or adopt~n. Co.right (c) Z~ form software only The Lack~r Gmup, l~. ' ~ Form HEV-I~00 ~ (Rev. 6_~) R£V-tS~0 EX+(t-STI SCHEDULE G I COMMONWEALTH OF PENNSYLVANJA INTER-VIVOS TRANSFERS & INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER Franklin W. Boyd SS~ 194-09-2068 01/09/2004 21-04-336 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. DESCR PT ON OF PROP~H I ¥ % OF ITEM INCLUDE THENAMEOF THE TRANSFEREE THEIR RELATIONSHIP TO DECEDENT AND THE DATE O~ TRANSFER. DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE NUMBER ATTACHACOPYOFTHEDEEDFORREALESTATE. VALUE OF ASSET INTEREST OF APPLICABL~ 1 MetLife Investors USA - 4,590.97 100.00% 0.00 4,590.97 non-qualified fixed annuity policy #C1114533; beneficiary is spouse; valued per letter dated 4/13/04 2 House and lot situate at 72,450.00 [00.00: 0.0' 72,450.00 527 Joyce Road, East Pennsboro Township, Cumberland County, PA - titled in the name of Franklin W. Boyd and Helen M. Boyd, Trustees under the Franklin W. Boyd Living Trust dated 11/20/1995, and any amendments thereto - AND - Helen M. Boyd and Franklin W. Boyd, Trustees under the Helen M. Boyd Living Trust dated 11/20/1995 and any amendments thereto; valued per county assessment ($138,000.00) times common level ratio factor for Cumberland County (1.05); one-half (1/2) of asset's value is reported 3 Merrill Lynch - Brokera§e 553,812.94 100.002 0.0t 553,812.94 account #872-46710, titled in the name of the Franklin W. Boyd Living Trust dated 11/20/1995, and any amendments thereto, valued per letter dated 3/16/04 4 Real estate located in 1,210.95 100.00% 0.00 1,210.95 Brothersavlley Township, Somerset County, PA - one-quarter of interest in property is titled in the name of Franklin W. Boyd and Helen M. Boyd, Trustees under the Franklin W. Boyd 0.00 TOTAL (Also enter on lin 7, Recapifulation) $ 632,064.86 si: d, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, lnc. Form REV-1510 EX (Rev. 1-97) Estate of: Franklin W. Boyd Soe Sec #: 194-09-2068 Date of Death: 01/09/2004 Continuation of Schedule C (Inter-Vivos Transfers & Misc. Non-Probate Property) Item Description of Property Date of Death % Decd Exclusion # Value of Asset Intrst Taxable Value Living Trust dated 11/20/1995, and any amenchnents thereto - AN1) - Helen M. Boyd and Franklin W. Boyd, Trustees under the Helen M. Boyd Living Trust dated 11/20/1995, and any amendments thereto; valued per county assessment ($4,140.00) times common level ratio factor for Somerset County (2.34); one-eighth (1/8) of asset's value is reported 0.00 REV-,S. EX+0-,?) I SCHEDULE H COMMONWEALTHOFPERNSYLV^N~A I FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF Franklin W. Boyd SS~/ 194-09-2068 01/09/2004 FILE NUMBER 21-04-336 Debts of decedent must be reporled on Schedule I, ITEM NUMBER 2 3 2 DESCRIPTION FUNERAL EXPENSES: Musselman Funeral Home and Cremation Services - funeral goods an~ services Trinity Evangelical Lutheran Church - funeral luncheon Trinity Evangelical Lutheran Church - columbarium ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: Attorney's Fees James, Smith, Dietterick & Connelly, LLP Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Relationship of Claimant to Decedent Zip. Probate Fees Tax Return Preparer's Fees OtherAdministrativeCosts Ja~es, Smith, Dietterick & Connelly, LLP - reservation for trust administration closing costs Register of Wills, Cumberland County - filing fee for PA Inheritance Tax Return TOTAL (Also enter on line 9, R-¢ep~ulation) AMOUNT 3,152.23 103.36 680.00 5,000.00 100.00 15.00 9,050.59 (If more space is needed, insert additional sheets of the same size) Copyright (c) lS96 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97) REV-1513 EX * (9-00) COMMONWEALTH OF PENNSY~ANIA INHERITANCE TAX RETURN RESIDENTDECEOENT ESTATE OF Franklin W. Boyd SS~ 194-09-2068 NUMBER I. 1 II. SCHEDULE J BENEFICIARIES 01/09/2004 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outH9ht spousal distributions, and Franklin W. Boyd Family Trust U/A dated 11/20/1995 c/o Helen M. Boyd, Trustee 527 Joyce Road Camp Hill, PA 17011 Helen M. Boyd 527 Joyce Road Camp Hill, PA 17011 RELATIONSHIP TO DECEDENT Do Not List Tr-,~f,,~/,s) Trust Spouse ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE FILE NUMBER 21-04-336 AMOUNT OR SHARE OF ESTATE Residue B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS MetLife annuity 18, AS APPROPRIATE, ON REV 1500 COVER SHEET TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET 0.00 Form REV-1513 EX (Rev. S-00) (If more space is needed, insert additional sheets of the same size) Copyright (c) Z000 form software only The Lackm~r Group, Inc. · REV-1514 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE K LIFE ESTATE, ANNUITY & TERM CERTAIN ICheck Box 4 on Rev-1500 Cover SheetI Franklin W. Boyd SS# 194-09-2068 01/09/2004 This schedule is to be used for all single life, joint or successive ~ife estate and term certain calculations. For dates of death prior to 5-1-89, actuarial factors for single lite calculations can be obtained from the Department of Revenue, Specialty Tax Unit. Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death on or after 5-1-89. Indicate the type of instrument which created the future interest below and attach a copy to the tax return. [] Will [] Intervivos Deed of Trust [] Other Copy #1 FILE NUMBER 21-04-336 NAME(S) OF NEAREST AGE AT TERM OF YEARS LIFE ESTATE IS LIFE TENANT(S) DATE OF BIRTH DATE OF DEATH PAYABLE Helen M. Boyd 05/10/22 82 ~] Lite or ~ Termof Years ~--~ Lite or ~ Term of Years i~1 Lite or i~1 Term of Years i~1 Lite or i~1 Term of Years 1. Value of fund from which life estate is payable $ 618,423.30 2. Actuarial factor per appropriate table 0. 24899 Interest table rata - [] 3 1/2% 1--16% I---]10% r~ Variable Rata 4.2% 3. Value of life estate (Line 1 multiplied by Line 2) $ 1531981.22 NAME(S) OF NEAREST AGE AT TERM OF YEARS ANNUITY IS ANNUITANT(S) DATE OF BIRTH DATE OF DEATH PAYABLE i~1 Lite or I~1 Term of Years i--'1 I'ife or i'--I Term of Years r--I Life or i'--I Term of Years '--I Lite or i'--I Term of Years 1. Value of fund from which annuity is payable 0.00 2. Check appropriate block below and enter corresponding (number) 0 Frequency of pay. ut - i~1 Weekly (52) [] Bi-weekly (26) [] Monthly (12) [] Quarterly (4) [] Semi-annually (2) I I Annually (1) L~ Other ( ) 3. Amount of pay.ut per period 0.00 4. Aggregate annual payment. Line 2 multiplied by Line 3 0.00 8. Annuity Factor (see instructions) Interest table rate - [] 3 1/2°/o [] 6°/° [] 10"/. [] Variable Rate 0.0 % 0. 0000 6. Adjustment Factor (see instructions) O. 0000 7. Value of annuity - If using 3 1/2%, 6%, 10%, or it variable rate and period pay.ut is at end of period, calculation is: Line 4 x Line $ x Line 6 0.00 If using variable rate and period pay.ut is at beginning of period, calculation is: (Line 4 x Line 8 x Line 6) + Line 3 0.00 NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through G of this tax return. The resulting life or annuity interes[~s) should be reported at the appropriate tax rate on Lines 13, 15, 16. 17 and 18. (If more space is needed, insert additional sheets of the same size) Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1814 EX (Rev, REV- 164E EX + (1/97) COMMONWEALTH OFPENNSYLVANIA INHERITANCETAXRETURN RESIDENTDECEDENT ESTATE OF SCHEDULE O ELECTION UNDER SEC. 9113(A) (SPOUSAL DISTRIBUTIONS) FILE NUMBER Franklin W. Boyd SS~ 194-09-2068 01/09/2004 21-04-336 Do not complete this schedule unless the estate Is making the election to tax assets under Section 9113(A) of the Inheritance & Estate Tax Act. If the election applies to mere than one trust or similar arrangement, a separate form must be filed for each trust. This election applies to the Frankl J.n W Boyd Fantily Trust Trust (marital, residual A, B, By-pass, Unified Credit, etc.). If a trust or similar arrangement meets the requirement of Section 9113(A), and: a. The trust or similar arrangement is listed on Schedule O, and b. The value of the trust or similar arrangement is entered in whole or in part as an asset on Schedule O, then the transferor's personal representative may specifically identify the trust (all or a fractional portion or percentage) to be included in the election to have such trust or similar property treated as a taxable transfer in this estate. If less than the entire value of the trust or similar property is included as a taxable transfer on Schedule O, the personal representative shall be considered to have mede the election only as to a fraction of the trust or similar arrangement. The numerator of this fraction is equal to the amount of the trust or similar arrangement included as a taxable asset on Schedule O. The denominator is equal to the total value of the trust or similar arran~lernent. PART A: Enter the description and value of all interests, both taxable and non-taxable, regardless of location, which pass to the decedent's surviving spouse under a Section 9113 (A) trust or similar arran~]ement. DESCRIPTION 1 House and lot situtate at 527 Joyce Raod, East Pennsboro Township, Cumberland County, PA - 1/2 value Real estate situate in Brothersvalley Township, Somerset County, PA - 1/8 value 3 Merrill Lynch Brokerage Account No. 872746710 4 Less: Expenses of administration Part A Total PART B:Entarthe description and value ofallinterestsincludedin Part Afor whichthe Section 9113(A)electionto taxis bein~mede. VALUE 72,450.00 1,210.95 553,812.94 (9,050.59) 618T423.30 DESCRIPTION VALUE 1 2 3 4 House and lot situate at 527 Joyce Road, East Pennsboro Township, Cumberland County, PA - 1/2 value Real estate situate in Brothersvalley Township, Somerset County, PA - 1/8 value Merrill Lynch Brokerage Account No. 872-456710 Less: Expenses of administration 72,450.00 1,210.95 553,812.94 (9,050.59) Part B Total 618,423.30 (If mere space is needed, insert additional sheets of the same size) Copyrlg ht (c) 1996 form software only CPSyster~, Inc. Form REV-1 ~49 EX (Rev. 1-97) BUREAU OF INDIVIDUAL TAXES /NHERTTANCE TAX DTVTSTON PO BOX Z80601 HARRTSBURG) PA 171Z8-0601 CONNONWEALTH OF PENNSYLVANZA DEPARTNENT OF REVENUE NOT/CE OF /NHER/TANCE TAX APPRAISEMENT, ALLO#ANCE OR D/SALLO#ANCE OF DEDUCT/ONS AND ASSESSMENT OF TAX RE¥-1~¢? EX &FP GARY L JAHES ESQ JANES ETAL 15q SIPE AVE HUNHELSTOWN PA 17056 DATE 11-2Z-ZOOq ESTATE OF BOYD FRANKLIN g DATE OF DEATH 01-09-Z00~ FILE NUNBER 21 0R-0556 COUNTY CUNBERLAND ACN 10L' ~ HAKE CHECK PAYABLE AND REHZT PAYNENT TO: REGISTER OF WILLS CUN~ERLAND CO COURT~;.-~LOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~*' REV-154? EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRATSENENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AN]) ASSESSNENT OF TAX ESTATE OF ~OYD FRANKLIN W FILE NO. 21 0~-0356 ACN 101 DATE 11-22-Z00~ TAX RETURN NAS: (X) ACCEPTED AS F/LED ( ) CHANGED RESERVATION CONCERN/NG FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es~a~e (Schedule A) (1) 2. S~ocks and Bonds (Schedule B) (2) $. Closely Held S~ock/Par~narship In~ares~ (Schedule C) (3) ~. Mortgages/No,es Receivable (Schedule D) (~) 5. Cash/Bank Deposits/Misc. Personal Proper~y (Schedule E) (5) 6. Jointly Owned Proper~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To,al Asse~s APPROVED DEDUCTIONS AND EXENPTZONS: 9. Funeral Expenses/Ada. Costs/Misc. Expenses (Schedule H) (9) 10. Dabts/Mortgage Liabilitias/Liens (Schedule I) (10) 11. Total Deductions 12. Ne~ Value of Tax Re~urn 13. 1~. .00 .00 .00 65Z;O6q.86 (8) 9,050.59 Char/~able/governmen~al Bequests; Non-elected 9113 Trusts (Schedule J) Ne~ Value of Es~e~e Sub~ec~ ~o Tax .00 NOTE: To insure proper .00 credi~ ~o your account, .00 subai~ ~he upper portion of ~his for~ wi~h your ~ax payment. .00 NOTE: 652,06q..86 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ASSESSNENT OF TAX: 15. Aeoun~ of L';ne 1¢ a~ Spousal ra~e 16. Amount: of Line lq. ~axable a~ Lineal/Class A ra~:e 17. Amount: of Line 1~ a~ Sibling ra~a 18. Aeoun~ of Line lq ~axable a~ Collateral/Class B ra~e 19. Principal Tax Due TAX CREDITS: PAYMENT RECEIPT OTSCOUNT DATE NUMBER INTEREST/PEN PAID (- 0~-06-200~ CD005785 1,0~.99 (is) 158,572.19 x 00 = .00 (16) q6q,qqz.08 x 0q5= 20,899.89 (17) .00 x 12 : .00 (28) .00 x 15 = .00 (].9)= 20,899.89 AMOUNT PAID 20,000.00 reflect flgures that /nclude the total of ALL returns assessed to date. TOTAL TAX CREDIT I 21,0qq.99 BALANCE OF TAX DUEl lq5.1OCR INTEREST AND PEN. .00 TOTAL DUE lq5.1OCR ( /F TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REgU/RED. IF TOTAL DUE /S REFLECTED AS A -CRED/T- (CR), YOU MAY BE DUE A REFUND. SEE REVERSE S/DE OF THIS FORM FOR /NSTRUCT/ONS.)~--~ Zf an assessment Nas issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will (11) 9. fl;fl ._;9 (12) 625,01q.27 (].~) .00 (~) 625, Olq. 27 RESERVATION: Estates of decadents dying on or before December lA, 198Z -- if any futura interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for 1ifa or for years, tho Commoneealth hereby expressly reserves the right to appralse and assess transfer Inheritance Taxes at the 1aclu1 Crass B (collateral) rate on any such futura interest. PURPOSE OF NOTICE: PAYHENT: REFUND (CR): OBJECTIONS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act Z5 of ZOO0. (7Z P.S. Section 91~0). Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. --Hake check or money order payable to: REGISTER OF HILLS, AGENT A refund of a tax credit, ehich ems not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1316). Applications are available online at ewe.revenue.state.ce.us, any Register of Hills or Revenue District Office, or frae the Department's Z4-hour enamoring service for forms orders: 1-800-36Z-ZO50; services for taxpayers with special hearing and/or speaking needs: 1-BOO-447-30ZO (TT only). Any party in interest not satisfied with the appraismant, allowance or disallowance of deductions or assessment of tax (including discount or interest) as sheen on this Notice amy object within 60 days of the date of receipt of this notice by filing one of tho folloaing: A) Protest to the PA Department of Revenue, Board ef Appeals. You may object by filing a protest online at www.boardofappeals.stata.pa.us on or before the expiration of the sixty-day appeal period. In order for an electronic protest to be valid, you must receive a confirmation number and processed date from the Board of Appeals aabsita. You say also send a written protest to PA Department of Revenue, Board of Appeals P.O. Box Z81021, Harrisburg~ PA 171ZB-IOZ1. Petitions may not be foxed. B) Election to have the matter determined at the audit of the account of the personal representative. C) Appeal to tho Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, P.O. Box 280601, Harrisburg, PA 171lB-0601 Phone (717) 767-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. If any tax due is paid aithin three (3) calendar months after the dacedant's death, a five percent (SI) discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January lB, 1996, tho first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you mould 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 (l) day from the date of death, to the date of payment. Taxes which became delinquent before January l, 198Z bear interest at the rate of six (6X) percent per annum calculated at a daily rate of .000164. AL1 taxes which became delinquent on and after January l, 1982 will bear interest at a rate ahich will vary fram calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2004 ara: Interest Daily Interest Doily Interest Daily Year Rate Factor Year Rata Factor Year Rate Factor ~ 20Z .000548 1'~Y~'8-1991 11Z .O0030X ~ 9Z .000247 1983 16Z .000438 1992 9Z .O00Z47 ZOOZ 6Z .000164 1984 llZ .000501 1995-1994 7Z .O0019Z ZOOS 5X .000157 1965 132 .000356 1995-1998 9Z .000247 2004 42 .O00110 1986 IOZ .000274 1999 7Z .OOOlgZ 1987 IOZ .000Z74 2000 7Z .000192 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (1S) days beyond the date of tho assessment. If payment is made after the interest computation date shown an the Notice, additional interest must bm calculated. BUREAU Of INDlvI~bCmliJ!S~ OTiC C:- INHERITANCE TAX Dlvlsle..r' PO BOX 280601 : ;;,'1, HARRISBURG PA 17128-0601' COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT '*' REY-16D7 EX,FP U2-U4) CLr::Y~ OF ORPil...i/',>J':S GARY L CJ,JlM\IOS ESQ JAMES ETAL 134 SIPE AVE HUMMELSTOWN PA 17036 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 12-27-2004" BOYD 01-09-2004 21 04-0336 CUMBERLAND 101 A.llouni. RBlti t:t..d FRANKLIN W 2005 JM! Il~ Pi'! 3: li 0 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account~ submit the upper portion of this form with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ IlW:1'&1J.,.~r.AW.rllr-.d'~'.......i..."fflf/W!tiMel""flr.nlYtAm.b'l!'.l~'l:6'OW...iii.................. ... ESTATE OF BOYD FRANKLIN W FILE NO.21 04-0336 ACN 101 DATE 12-27-2004 TNIS STATEMENT IS PROVIDED TO ADVISE Of THE CURRENT STATUS Of THE STATED ACN IN THE NANED ESTATE. SHOWN BELOW IS A SUHHARY Of THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT, 11-15-2004 PRINCIPAL TAX DUE:. ,.,.,.,.".,.,.,.,,,,,,,,.,,,,,,,,,,,,,,.,.,.,.,,,,,.,.,.,.,.,,.,,.,.,.,.,.",. 20,899.89 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 04-06-2004 CD003785 1,044.99 20,000.00 12-09-2004 REFUND .00 "---. 145.10- TOTAL TAX CREDIT 20,899.89 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR1, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. 1 '" \<- ~