HomeMy WebLinkAbout04-0251REV-1162 EX(11-96)
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.
CD OO3669
SEEBER EDWARD P
134 SIPE AVENUE
HUMMELSTOWN, PA
17036
........ fold
ESTATE INFORMATION: SSN: 184-26-4567
FILE NUMBER: 2104-0251
DECEDENT NAME: MCPHERSON JAMES R JR
DATE OF PAYMENT: 03/12/2004
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 06/14/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $3,750.00
REMARKS:
...... SEAL
CHECK#534
TOTAL AMOUNT PAID'
$3,750.00
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF ZNDZVZDUAL TAXES
][NHERTTANCE TAX DTVTSTON
DEPT. Z80601
HARR~[SBURG, PA 171Z8-0601
COHMONWEALTH OF PENNSYLVANZA
DEPARTHENT OF REVENUE
NOTZCE OF ZNHERZTANCE TAX
APPRAZSEMENT, ALLOWANCE OR DZSALLOWANCE
OF DEDUCTZONS AND ASSESSMENT OF TAX
RE¥-1547 EX AFP (nl-05)
EDWARD P SEEDER
JANES ETAL
15q SIPE AVE
HUNMELSTOWN
PA 17056
DATE
ESTATE OF
DATE OF DEATH
FZLE NUMBER
COUNTY
ACN
05-O$-ZOOq
MCPHERSON JR
06-1~-2005
21 OR-OZ5!
CUMBERLAND
101
Amoun~ Rem'i tted
JAMES R
HAKE CHECK PAYABLE AND RENZT PAYMENT TO:
REGTSTER OF WTLLS
CUMBERLAND CO COURT HOUSE
CARLTSLE, PA 1701:5
CUT ALONG THZS LZNE ~ RETAZN LOWER PORTZON FOR YOUR RECORDS ~
REV-1547 EX AFP (01-03) NOTZCE OF ZNHERZTANCE TAX APPRAZSENENT, ALLOWANCE OR
DZSALLOWANCE OF DEDUCTZONS AND ASSESSMENT OF TAX
ESTATE OF MCPHERSON JR JAMES R FZLE NO. 21 0~-0251 ACN 101 DATE 05-03-Z00~
TAX RETURN WAS: (X) ACCEPTED AS FZLED ( ) CHANGED
RESERVAT];ON CONCERNZNG FUTURE ZNTEREST - SEE REVERSE
APPRAZSED VALUE OF RETURN BASED ON: ORZGZNAL RETURN
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
$. CloseZy Held Stock/Partnership Interest (Schedule C) ($)
~. Mortgages/Notes Receivable (Schedule D) (q)
$. Cash/Bank Deposits~Misc. Personal Property (Schedule E) (5)
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
APPROVED DEDUCTZONS AND EXENPTZONS:
9. Funeral Exponsos/Adm. Costs/Misc. Expenses (Schedule H) (9)
10. Debts/Mortgage Liabilities/Lions (Schedule Z) (10)
11. Total Deductions
12. Net Valu® of Tax Return
O0
O0
O0
O0
qSz$O0.O0
O0
69Zz~Z5.96
(8) 755,7Z5.96
1Z,55Z.00
.00
NOTE: To insure proper
credit to your account,
submit tho upper port/on
of this form with your
tax payment.
(11) 1].~52.00
(12) 72~,175.96
13.
NOTE:
Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (1:5) . O0
Net Value of Estate Subject to Tax (lq) 72R,175.96
:i:f an assessment ~as lssued previ=usly, lines :1~, 15 and/or 16, 17, :18 and 19 ~ill
reflect figures that lnclude the total of ALL returns assessed to date.
ASSESSHENT OF TAX:
15. Amount of Line lq at Spousal rate
16. Amount of Line lq taxable mt Lineal/Class A rate
17. Amount of Line lq mt Sibling rate
18. Amount of Line lq taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CRED[TS:
PAYMENT RECE/PT DZ$COUNT (+}
DATE NUMBER ZNTEREST/PEN PAZD (-)
03-12-200~ CD005669 .00
(15) 699,17:5.96 x O0 = .00
-~,{~ ":~ O0
(16) X 0q,~ = ~ .:
x oo
(~8). 25,00&7700 x ~5 = -~,750.00
:5,750.00
AMOUNT PAXD
IF PAID AFTER DATE ZNDZCATED, SEE REVERSE
FOR CALCULATZON OF ADDZTZONAL /NTEREST.
3,750.00
TOTAL TAX CREDZT
BALANCE OF TAX DUE
ZNTEREST AND PEN.
TOTAL DUE
3,750.00
.00
.00
.00
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUZRED.
ZF TOTAL DUE ZS REFLECTED AS A 'CREDZT' (CR)~ YOU MAY BE DUE
A REFUND. SEE REVERSE S~DE OF THZS FORM FOR ZNSTRUCT/ONS.)
RESERVATION:
PURPOSE OF
NOTICE=
PAYNENT:
REFUND (CR):
OBJECTIONS:
ADNIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decadents dying on or before December 1Z, 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
life or for years, the Commonaealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act Z3 of 2000. (72 P.S.
Section 9140).
Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side.
--Hake check or money order payable to: REGISTER OF #ILLS, AGENT
A refund cf 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-1313). Applications are available at the Office
of the Register of Hills, any of the 23 Revenue District Offices, or by calling the special 24-hour
enamoring service for forms ordering: 1-800-36Z-ZOSO; services for taxpayers with special hearing and / or
speaking needs: 1-800-447-30Z0 (TT 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 pretest to tho PA Department of Revenue, Board of Appeals, Dept. Z81021, Harrisburg, PA 171ZB-1021, 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 bo addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Oapt. Z80601, Harrisburg, PA 171Z8-0601
Phone (717) 787-6505. Ssa 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 within three (3) calendar months after the dacedent's death, a five percent (SI) discount of
the tax paid is allowed.
The 15Z tax amnesty non-participation penalty is computed an the total of the 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 data of
death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of
six (6X) percent par annum calculated at a daily rate of .000164. AIl taxes which became delinquent on and after
January 1, 198Z 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 2004 ara:
Interest Doily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
198Z ZOZ .000548 ~'8-1991 11Z .000501 ~-~ 9Z .000247
1983 162 .000438 1992 9Z .000247 ZOO2 6Z .000164
1984 llZ .000301 1993-1994 72 .000192 2003 5Z .000137
1985 132 .000356 1995-1998 92 .000247 2004 4Z .000110
1986 102 .000274 1999 7Z .OOOlgZ
1987 lOZ .000274 2000 72 .00019Z
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID
X NUtIBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR
--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.
C~MMONgEA~TH OF PENNSYLVANIA
DEP/~TNENT OF REVENUE
BUREAU CF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1712B-0601
REV-15qS EX AFP
INFORMATION NOTTCE
AND
TAXPAYER RESPONSE
REVISED NOTICE ~ ~ ~
FILE NO. 21 OH HSI
ACH 0q001120
DATE 05-Oq-ZOOq
SHIRLEY A WHEELER
855 DELLA VISTA DR
ENOLA PA 17025
E~T. OF FRANCES ! OTT
S.S. NO. 18q-26-2809
DATE OF DEATH 02-15-200~
COUNTY CUHBERLAND
TYPE OF ACCOUNT
[] SAVZNGS
[] CHECK/NG
[] TRUST
[] CERTZF.
REHZT PAYNENT AND FORHS TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
NAYPOZNT BANK has provided the Department uith the information listed balo~ ahlch has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, you aero a joint o~ner/beneficiary of
this account. If you fall this information is incorrect, please obtain .ritten correction free the financial institution, attach a copy
to this form and return it to the above address. This account is taxable in accordance #ith the Inheritance Tax Lo~s o~ the Coemonaealth
of Pennsylvania. guastions may be answered by calling (717) 787-~Z7,
CONPLETE PART I BELOW ~ # ~ SEE REVERSE SIDE FOR FILING AND PAYNENT INSTRUCTIONS
Accoun* No. 700021886 Data 01-$1-199~
Established
Accoun~ Balance 6,761.67
Percen~ Taxable X 16. 667
Aeoun~ Subjec~ ~o Tax 1,126.97
Tax Ra~a X . Oq5
Potential Tax Due 50.71
To insure proper credit to your account, the
(Z) copies of this notice must accompany your
payment to the Register of Hills. Make check
payable to: "Register of Hills, Agent".
NOTE: I; tax payments are made ~ithin three
(5) months of the decadent's date of death,
you amy deduct a 5X discount o~ the tax due.
Any inheritance tax due ell! become delinquent
nine (9) months alter the date o{ death.
PART TAXPAYER RESPONSE
a discount or avoid interest, or you may check box "A" and return this notice to the Register of
CHECK ~ .ins and an off Joia[ assessment ~[[ be issued by the PA Oepartlent of Revenue.
ONE
BLOCK
ONLY
B. [] The above asset has been or ~ill be reported and tax paid with the Pennsylvania Inheritance Tax return
to be filed by the decedent's representative. ~_' ~'J"/k~~
C. ~Tha above information is incorrect and/or debts and deductions ~era paid by you. ~
! ~YOU lUSt complete PART [] and/or PART [] belo~.
PART Tf you ~nd[ca~e a differen~ ~ax ra~e, please s~a~e your
relationship ~o decaden~:
TAX RETURN - COHPUTATZON OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Da'l:e Es~abllshed 2. Accoun~ Balance
$. Percen~ Taxable
(~, Aloun~ Subjec~ ~o Tax
6. Amoun~ Taxable 6
7. Tax Ra~e 7
8. Tax Due 8
DEBTS AND DEDUCTIONS CLAZMED
PAYEE DESCRIPTION
PART
DATE PAID
AMOUNT PAID
TOTAL (Enter on Line $ of Tax Computation)
Under penal~i~of perjury~ Z declare ~ha~ ~he fac~s Z have reported above Rrm ~r~e, corrac~ and
COl. lete *o the be * of In kno edge and Aa, NOME ( r-~.~ ) r[~2. ~ ~ 5
TAXPAYER SIGN TELEPHONE NUMBER DATE
GENERAL INFORHATION ,
1. FAILURE TO RESPOND #ILL RESULT IN AN OFFICIAL TAX ASSESSNENT with applicable interest based on information
submitted by the financial institution.
Z. Inheritance tax becomes delinquent nine months after the decedent's date of death.
5. A joint account is taxable even though the dacedent's name was added as a matter of convenience.
4. Accounts (including those held between husband and wife) which the decedent put in joint names within one year prior to
death are fully taxable as transfers.
5. Accounts established jointly between husband and wife more than one year prior to death are not taxable.
6. Accounts held by a decedent "in trust for" another or others are taxable fully.
REPORTING INSTRUCTIONS - PART I - TAXPAYER RESPONSE
1. BLOCK A - Zf the information and computation in the notice are correct and deductions ara not being claimed, place an
in black "A" of Part I of the "Taxpayer Response" section. Sign two copies and submit them with your check for the amount of
tax to the Register of Wills of the county indicated. The PA Department of Revenue will issue an official assessment
(Form REV-lB48 EX) upon receipt of the return from the Register of Wills.
Z. BLOCK B - If the asset specified on this notice has been or will ba reported and tax paid with the Pennsylvania Inheritance
Tax Return filed by the decadent's representative, place an "X" in block "B" of Part i of the "Taxpayer Response" section. Sign one
copy and return to the PA Department of Revenue, Bureau of Individual Taxes) Dept IS0601) Harrisburg) PA 1711B-0601 in the
envelope provided.
5. BLOCK C - If the notice information is incorrect and/or deductions are being claimed) check bZock "C" and complete Parts Z and
according to the instructions below. Sign two copies and submit thee with your check for the amount of tax payable to the Register
of NilIs of the county indicated. The PA Department of Revenue wiII issue an official assessment (Form REV-IS48 EX) upon receipt
of the return from the Register of Hills.
TAX RETURN - PART Z - TAX COHPUTAT[ON
LINE
1. Enter the date the account originally was established or titled in the manner existing at date of death.
NOTE= For a decedent dying after lZ/lZ/lZ: Accounts which the decedent put in joint names within one (1) year of death are
taxable fuIIy as transfers. However) there is an exclusion not to exceed $5,000 per transferee regardless of the value of
the account or the number of accounts held.
If a double asterisk (xx) appears before your first name in the address portion af this notice, the $3)600 exclusion
already has been deducted from the account balance as reported by the financial institution.
Enter the total balance of the account including interest accrued to the date of death.
The percent af the account that is taxable for each survivor is determined as follows:
A. The percent taxable for joint assets established more than one year prior to the decadent's death:
i DIVIDED BY TOTAL NUHBER OF DIVIDED BY TOTAL NUNBER OF X 100 = PERCENT TAXABLE
JOINT OWNERS SURVIVING JOINT OWNERS
Example: A joint asset reDistared in the name of the decadent and two other persons.
1 DIVIDED BY 3 (JOINT ORNERS) DIVIDED BY 2 (SURVIVORS) = .167 X lO0 = 16.71 (TAXABLE FOR EACH SURVIVOR)
B.The percent taxable for assets created within one year of the decedant's death or accounts owned by the decedent but held
in trust for another individual(s) (trust beneficiaries):
1 DIVIDED BY TOTAL NUHBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE
OWNERS OR TRUST BENEFICIARIES
Example: Joint account registered in the name of the decedent and two other persons and established within one year of death by
the decedent.
1 DIVIDED BY 2 (SURVIVORS) = .50 X lO0 = 501 (TAXABLE FOR EACH SURVIVOR)
Tho amount subject to tax (line 4) is determined by euItiplying the account balance (line Z) by the percent taxable (line
5. Enter the total of the debts and deductions listed in Part 5.
6. The amount taxable (line 6) is determined by subtracting the debts and deductions (line 5) from the amount subject to tax (line
7. Enter the appropriate tax rate (line 7) as determined beIow.
Data of Death Spouse I Lineal Sibling Collateral
07/01/94 ~o 12/$1/94 $Z 6Z
01/01/95 ~o 06/50/00 OX 6X
07/01/00 ~o presen~ OX
I
xTha tax rate imposed on the nat value of transfers free a deceased twenty-one years age or younger at
death to or for the use of a natural parent) an adoptive parent, or a stepparent of the child is OZ.
The lineal class of heirs includes grandparants~ parents, children, and lineal descendents. "Children" includes natural children
whether or not they have been adopted by others) adopted children and step children. "Lineal descendents" includes all children of the
natural parents and their descendants, whether or not they have been adopted by othars~ adopted descendents and their descendants
and step-descendants. "Siblings" are defined as individuals who have at least one parent in common xith the decedent~ whether by blood
or adoption. The "Collateral" class of heirs includes all other beneficiaries.
CLAIHED DEDUCTIONS - PART 5 - DEBTS AND DEDUCTIONS CLAIHED
Allowable debts and deductions are determined as follows:
A. You legally are responsible for payment, or the estate subject to administration by a personal representative is insufficient
to pay the deductible items.
B. You actuatly paid the debts after death of the decedent and can ~urnish proof of payment.
C. Debts being claimed must be itemized fully in Part 3. [f additional space is needed~ use plain paper 8 1/Z" x 11". Proo~ of
payment may be requested by the PA Department of Revenue.
CONHONNEALTH OF PENNSYLVANIA
DEPA?~!~NT OF REVENUE
BUREA~ OF INDIVIDUAL TAXES
DEPT. Z80601
HARRISDURG, PA 17128-0601
REV-1545 EX AFP
I
ZNFORNATZON NOTICE I FILE NO. 21 Oq L~'t
AND
TAXPAYER RESPONSE ACN OqOO11Z1
REVISED NOTICE ~ ~ ~ DATE 05-Oq-ZOOq
EsT. OF FRANCES I OTT
S.S. NO. 18q-Z6-2809
DATE OF DEATH 02-15-200~
'04 11
ROBERT E OTT
qOq5 CHEROKEE AVE
CAHP HILL PA 17011
TYPE OF ACCOUNT
[] SAVTNGS
[] CHECKING
[] TRUST
CUI. IBERLAND [] CERT:]:F.
RENTT PAYHENT AND FORNS TO:
REGISTER OF HILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
NAYPOZNT BANK has provided the Department with the informatian listed below ehlch has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, you mere a joint oenar/bsnsficiary of
this account. If you feel this information is incorrect, please obtain Nritten correction from the financial institution, attach a copy
to this form and return it to tho above address. This account is taxable in accordance with the Inheritance Tax La#s of the Commonasalth
of Pennsylv=n[a. Questions =~-y be answered by calling (717) 787-8327-
CONPLETE PART 1BELON ~ # x SEE REVERSE SIDE FOR FILING AND PAYHENT INSTRUCTIONS
Account No. 700021886 Date 01-$1-199R
Establ/shed
Account Balance 6,761.67
Percent Taxable X 16. 667
Amount SubSect to Tax I, 126.97
Tax Rate X .
Potential Tax Due 50.71
To insure proper credit to your account, tad
(Z) copies of this notice lust accompany your
payment to the Register of #ills. Hake check
payable to: "Register of Nills, Agent".
ROTE: If tax payments ars made ~ithin three
(5) months of the dscedent's date of death,
you say deduct a SZ discount of the tax due.
Any inheritance tax due ail1 become delinquent
nine (9) months after the date of death.
PART TAXPAYER RESPONSE
CHECK
ONE
BLOCK
ONLY
A. ~Tha above information and tax due is correct.
1. You may choose to remit payment to the Register of Hills Nith two copies of this notice to obtain
a discount or avoid interest, or you may check box "A" and return this notice to the Register of
Hills and an official assessment ~ill be issued by the PA Department of Revenue.
B. ~ The above asset has been or will be reported and tax paid Nith the Pennsylvania Inheritance Tax return
e filed by the decedent's representative.
C. ~1 The above information is incorrect and/or debts and deductions were paid by you.
~--~ou must complete PART [] and/or PART [] below. &~.., ~"'~_CZ['
PART Tf you indicate a different tax rate, please state your
relat/onshlp to decedent:
TAX RETURN - CONPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
6
LZNE 1. Dato Established 2. Account Balanco
$. Porcont Taxable
4. Amount Sub5oct to Tax
$. Dobts and Deductions
6. Amount Taxablo
7. Tax Rate
8. Tax Duo
DEBTS AND DEDUCTIONS CLAINED
PAYEE DESCRIPTION
PART
DATE PAID
TOTAL (Entor on L/no $ of Tax Computation)
AHOUNT PAID
I
$ t ~'5~ O0
Under penalties of perjury, I declare that the facts T have reported above ere true, correct and
ci;~.~;i~he~est~kn°"ledge and belief' WoRKHONE ((qlc~)) q"~q' r'/~'~:~l,. ~
TAXPAYER SIGNATURE TELEPHONE NUNBER DATE
GENERAL INFORHATION
l. FAZLURE TO RESPOND #ILL RESULT ZN AN OFFICZAL TAX ASSESSHENT with applicable interest based on information
submitted by the finencie! institution.
Z. Inheritance tax becomes delinquent nine months after the decedent's data af death.
3. A joint account is taxable even though the decedent's name was added as a matter of convenience,
¢. Accounts (including those held between husband and wife) which the decedent put in joint names within one year prior to
death are fully taxable as transfers.
S. Accounts established jointly between husband and wife more than one year prior to death are not taxable.
6. Accounts held by a decedent "in trust for" another or others are taxable fully.
REPORTING INSTRUCTIONS - PART I - TAXPAYER RESPONSE
1. BLOCK A - If the information and computation in the notice are correct and deductions are not being claimed, place an "X"
in block "A" of Part I of the "Taxpayer Response" section. Sign two copies and submit them with your check for the amount of
tax te the Register of Nills of the county indicated. The PA Department of Revenue will issue an offic[al assessment
(Form REV-15¢8 EX) upon receipt of the return from the Register of Wills.
Z. BLOCK B - If the asset specified on this notice has been or will ba reported and tax paid wlth the Pennsylvania Inheritance
Tax Return filed by the dacedent's representative, place an "X" in block "B" of Part I of the "Taxpayer Response" section. Sign one
copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Bept Z80601, Harrisburg, PA 171Z8-0601 in the
envelope provided.
3. BLOCK C - If the notice information is incorrect and/or deductions ara being claimed, check block "C" and complete Parts Z and 3
according to the instructions below. Sign two copies and submit them with your check for the amount of tax payable to the Register
of Nills of the county indicated. The PA Department of Revenue will issue an official assmssment (Form REV-15fi8 EX) upon receipt
of the return from the Register of Wills.
TAX RETURN - PART Z - TAX COHPUTATION
LINE
1. Enter the date the account originally was established or titled in the manner existing at date of death.
NOTE: For a decedent dying after 1Z/II/BI= Accounts which the decedent put in joint names within one (1) year of death ara
taxable fully as transfers. However, there is an exclusion not to exceed $3,000 par transferee regardless of the value of
the account or the number of accounts held.
If a double asterisk [aa) appears before your first name in the address portion of this notice, the $3,000 exclusion
already has been deducted from the account balance as reported by the financial institution.
Z. Enter the total balance of the account including interest accrued to the date of death.
The percent of the account that is taxable for each survivor is determined as follows:
A. The percent taxable for joint assets establlshed more than one year prier to the dmcedent's death:
I DIVIDED BY TOTAL NUHBER OF DIVIDED BY TOTAL NUNBER OF X 100 = PERCENT TAXABLE
JOINT OWNERS SURVIVING JOINT D#NERS
Example: A joint asset registered in the name of the decedent and two other persons.
I DIVIDED BY 3 (JOINT ORNERS) DIVIDED BY Z (SURVIVORS) = .167 X 100 = 16.7Z (TAXABLE FOR EACH SURVIVOR)
S.The percent taxable for assets created within one year of the decedent's death or accounts owned by the decedent but held
Jn trust for another individual(s) [trust beneficiaries):
I DIVIDED BY TOTAL NUNBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE
O#NERS OR TRUST BENEFICIARIES
Example: Joint account registered in the name of the decadent and two other persons and established within one year of death by
the decedent.
i DIVIDED BY Z (SURVIVORS) = .SO X lO0 = SOX (TAXABLE FOR EACH SURVIVOR)
¢. The amount subject to tax (line ¢) is determined by multiplying the account balance (line Z) by the percent taxable (line 5].
S. Enter the totat of the debts and deductions listed in Part 3.
6. The amount taxable (line 6) is determined by subtracting the debts and deductions (line 5) from the amount subject to tax (line ¢).
7. Enter the appropriate tax rate (line 7) as determined below.
I Da!a of Dea!h Spouse ] Lineal I Sibling ] Collateral
07/01/94 ~o 12/$1/94
01/01/95 4o 06/50/00 OX 6X
07/01/00 ~o proson* OX 4.SXx 12X
aThe tax rate imposed on the nat value of transfers from a deceased child twenty-one years of age or younger at
death to or for the use of m natural parent, an adoptive parent, or a stmpparent of the child is OZ.
The lineal class of heirs includes grandparents~ parents, children, and lineal descendents. "Children" includes natural children
whether or not they have been adopted by others, adopted children and step children. "Lineal descendents" includes a11 children of the
natural parents and their descendents, whether or not they have been adopted by others, adopted descendents and their descendants
and step-descendants. "Siblings" are defined as individuals who have at least one parent in common with the decadent, whether by blood
or adoption. The "Collateral" class of heirs includes all other beneficiaries.
CLAIHED DEDUCTIONS - PART 5 - DEBTS AND DEDUCTIONS CLAZHED
A11o~able debts and deductions are determ[ned as ~ollo~s:
A. You legally are re~onsJble for payment, or the estate subject to administration by a personal representative is insufficient
to pay the deductible items.
B, You actually pa~d the debts after death of the decedent and can ~urnish proo~ o~ payment.
C. Debts being claimed must be itemized fully in Part 5. if additional space is needed~ use plain paper 8 l/Z" x 11". Proof of
payment ~ay be requested by ~e PA Depar~ent o~ Revenue.
CONHONNEALTH OF PENNSYLVANIA
DEPARTN*~NT OF REVENUE
.BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-I~5 EX AFP
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21 C~-~ HSI
ACN 0~001122
DATE 05-0~-200~
SHIRLEY A HHEELER
855 BELLA VISTA DR
ENOLA PA 17025
'04 h/~¥ 11
TYPE OF ACCOUNT
EST. OF FRANCES I OTT [] SAVINGS
S.S, NO. 18~-26-2809 [] CHECKING
DATE OF DEATN 02-15-200~ [] TRUST
COUNTY ~J~ ' '"~CERTIF.
,.07 .E<T PAY.E.T A.G rO..S TO: \
/ .E ZSTE. OF .,LLS
I CUM'ERLAHD CO COURT HOUSE ,
#AYPOZNT BANK has provided the Department .ith the information listed belom .hich has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, you .ere e joint o.ner/beneficiary of
this account. If you feel this inforaat/on ]s incorrect, please obtain arltten correction from the financial institution, attach a copy
to this ;ora and return Jt to ~e above address. Th]s account ]s ~xable in accordance ~ith the Inheritance Tax La~s o~ the Commonwealth
COHPLETE PART I BELO~ ~ ~ ~ SEE REVERSE SIDE FOR~ AN~ PAYHENT INSTRUCTIONS
Accoun~ No. 5500028758 Date 08-08-200~.________'' ~4).t [ ~o insure proper c.,d~t to your account,
Parc.n* Taxable X 16.667 ~
...... ) ~1 ~ NOTE: Xf bx peymont; ar; mad; NithJn throe
Amoun~ Subj~c~ ~o Tax 5,~bb .~1 / ( ~ (~) months of th. d.c;d.nt'; det~ o; d.eth,
Tax Ra~; X .0~5~ ~A&d ~ou ma~ deduct a 5~ discount o; th; ta~ du..
Any inhabit,nc, tax due NJ11 become dglJnquont
Tax
Due
. ~1 ~ ~' nJng (;) months 8;tot ~0 date o; death.
PART TAXPAYER RESPONSE
A. %~ The above information and tax due is correct.
1. You may choose to remit payment to the Register of Nills aith two copies of this notice to obtain
CHECK a discount or avoid interest, or you may check box "A" and return this notice to the Register of
l-- ONE q Wills and an official assess.ant .ill be issued by the PA Department of Revenue.
BLOCK J B. [--]The above asset has been or will be reported and tax paid .ith the Pennsylvania Inheritance Tax return
ONLY to be filed by the dacadent's representative.
~lThe above infer.orion ]s incorrect and/or debts and deductions
C.
paid
by
you.
You must complete PART [~and/or PART
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Date Established 1
2. Account Balance 2,
$. Percent Taxable S ~
~. Amount SubS.ct to Tax ~
5. Debts and Deductions ~
6. Amount Taxable 6
7. Tax Rate 7 ~
8. Tax Due 8
PART
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE DESCRIPTION AMOUNT PAID
TOTAL (Enter on Line $ of Tax Computation)
Undaj; penalties of perjury, Z declare that tha facts I have reported above are true~ correct and
TAXPAYER SIGNATURE TELEPHONE NUMBER DATE
GENERAL INFORMATION
1. FAILURE TO RESPOND NZLL RESULT ZN AN OFFICIAL TAX ASSESSMENT aith applicable interest based on information
submitted by the financial institution.
Z. Inheritance tax becomes delinquent nine months after the dacedant's date of death.
5. A joint account is taxable even though the decedent's name was added as a matter of convenience.
q. Accounts (including those held between husband and wife) which the decedent put in joint names within one year prior to
death ara Fully taxable as transfers.
5. Accounts established jointly between husband and wife more than one year prior to death ara not taxable.
6. Accounts held by a decedent "in trust for" another or others are taxable fully.
REPORTING INSTRUCTIONS - PART I - TAXPAYER RESPONSE
1. BLOCK A - If the information and computation in the notice are correct and deductions are not being claimed, place an
in block "A" of Part 1 of the "Taxpayer Response" sect[on. Sign two cop[es and subait thee with your check for the amount of
tax to the Register of Nills of the county indicated. The PA Department of Revenue will issue an official assessment
(Form REV-ISCB EX) upon receipt of the return from the Register of Hills.
2. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid with the Pennsylvania Inheritance
Tax Return filed by the decedent's representative, place an "X" in block "B" of Part 1 of the "Taxpayer Response" section. Sign one
copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Oapt 280601, Harrisburg, PA 17128-0601 in the
enveZope provided.
5. BLOCK C - If the notice information is incorrect and/or deductions ara being claimed, check black "C" and complete Parts
according to the instructions below. Sign two copies and submit them with your check for the amount of tax payable to the Register
of Wills cf the county indicated. The PA Department af Revenue ~ili issue an official assessment (Farm REV-1548 EX) upon receipt
of the return from the Register of Hills.
TAX RETURN - PART 2 - TAX COMPUTATION
LINE
1. Enter the date the account originally was established ar titled in the manner existing at date of death.
NOTE: For a decedent dying after 1Z/12/B2: Accounts which the decedent put in joint names within one (1) year of death ara
taxable fully as transfers. HoNorer, there is an exclusion not to exceed $5,000 per transferee regardless of the value of
the account or the number of accounts held.
If a double asterisk (am) appears before your first name tn the address portion of this notice, the $~,000 exclusion
already has bean deducted from the account balance as reported by the financial institution.
Z. Enter the total balance of the account including interest accrued to the date of death.
5. The percent of the account that is taxable for each survivor is determined as follows:
A. The percent taxable for joint assets established more than one year prior to the dacedent's death:
1 DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF X 100 = PERCENT TAXABLE
JOINT OWNERS SURVIVING JOINT ORNERS
Example: A joint asset registered in tho name of the decadent and two other persons.
I DIVIDED BY 3 (JOINT OHNERS) DIVIDED BY Z (SURVIVORS) = .167 X 100 = 16.7Z (TAXABLE FOR EACH SURVIVOR)
B.The percent taxable for assets created aithin one year of the decedent's death or accounts owned by the decedent but held
in trust for another indivldual(s) (trust benaflciaries):
1 DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT X 100 PERCENT TAXABLE
ONNERS OR TRUST BENEFICIARIES
Example: Joint account registered in the name of the decedent and two other persons and established within one year of death by
the decedent.
I DIVIDED BY 2 (SURVIVORS) = .50 X 100 = 50Z (TAXABLE FOR EACH SURVIVOR)
The amount subject ta tax (line ~) is determined by multiplying the account balance (line Z) by the percent taxable (line 3).
5. Enter the total of the debts and deductions listed in Part 3.
6. The amount taxable (line 6) is determined by subtracting the debts and deductions (line 5) from the amount subject to tax (line 4).
7. Enter the appropriate tax rate (line 7) as determined below.
Ds~e of Des~h Spouse I Lines[ I Sibling Col!e~era!
07/01/9q ~o 12/51/9q SZ 6X
01/01/95 ~o O&/$O/O0 OX 6X
07/01/00 ~o prssen~ OX
xTha tax rate imposed on the net value of transfers free a deceased child leanly-one years of age or younger at
death to or for the usa of a natural parent, an adoptive parent, or a stepparant of the child is OZ.
The lineal class of halts includes grandparents, parents, children, and lineal descendents. "Children" includes natural children
whather or not they have been adopted by others, adopted chlldren and step children. "Lineal descendents" includes all chlldren of the
natural parents and their descendents, whether or not they have been adopted by others, adopted descendents and their descendants
and step-descendants. "Siblings" are defined as individuals mhd have at least one parent in common with the decedent, whether by blood
or adoption. The "Collatera[" class of heirs includes all other beneficiaries.
CLAIMED DEDUCTIONS - PART $ - DEBTS AND DEDUCTTONS CLAIMED
Allowable debts and deductions are determined as follows:
A. You legally are responsible for payment, or the estate subject to administration by a personal representative is insufficient
to pay the deductible items.
B. You actually paid the debts after death of the decedent and can furnish proof of payment.
C. Debts being claimed must be itemized fully Jn Part 3. If additional space is needed, use plain paper n I/Z" x 11". Proof of
payment may be requested by the PA Department of Revenue.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDtVlDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 003924
WHEELER SHIRLEY A
835 BELLA VISTA DR
ENOLA, PA 17025
........ fold
ESTATE INFORMATION: SSN: 184-26-2809
FILE NUMBER: 2104-0451
DECEDENT NAME: OTT FRANCES I
DATE OF PAYMENT: 05/11/2004
POSTMARK DATE: 05/1 0/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 02/15/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
04001122 $246.54
REMARKS:
TOTAL AMOUNT PAID:
$246.54
SEAL
CHECK//2178
INITIALS: JA
RECEIVED BY'.
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
CONHONNEALTH OF PENNSYLVANIA
DE~RTV~NT OF REVENUE
~UREA~ F INDIVIDUAL TAXES
~EPT .... &01
HARRISBURG, PA 171Z8-0601
REV-15~$ EX AFP [09-DO)
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21 O~ ~i
ACN 0q001125
DATE 05-0q-200q
C~,... TYPE OF ACCOUNT
;,; EST. OF FRANCES I OTT [] SAVINGS
' - S.S. NO. 18q-26-2809 [] CHECKING
DATE OF DEATH 02-15-200q [] TRUST
COUHT¥ CUMBERLAND [] CERTIF.
'04 I'i ¥ 11 72:( 7
REHIT PAYHENT AND FORHS TO:
REGISTER OF HILLS
ROBERT E OTT
qOq5 CHEROKEE AVE~"'~iii CUMBERLAND CO COURT HOUSE
CAMP HILL PA 1701 { :~ ,. -,_. CARLISLE· PA 17015
NAYPOZNT BANK has provided the Department with the information listed bslow which has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/beneficiary of
this account. If you feel this information is incorrect, please obtain aritten correction from the financial institution, attach a copy
to this form and return it to the above address. This account is taxabta in accordance with the Inheritance Tax Lams of the Commonwealth
of Pennsylvania. Question: may be answered by calling (717) 787-8527.
COMPLETE PART ! BELOH x # # SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Accoun~ No. 5500028718 De~e 08-08-2002 To insure proper credit to your account, two
Established cz) copies of this notice must accompany your
payment to the Register of Hills. Hake check
Accoun~ Balance ~q · 600 . 18 payable to: "Register of Wills, Agent".
Percen~ Taxable X 16. 667
. . . . ~ ~ ..... NOTE: If tax payments are made within three
Aeounz Sub3ec~ 'to Tax ~ ~lbb. ~1 (53 months of ~e decedent's date o~ death,
Tax Ra~e , X /~ · 0~5 you may deduct a 5Z discount o~ ~m tax due.
..... ~ ~, / ~,/ / ~j ~(___ - Any inheritance tax due will become delinquent
I ~' ~r/ nine (9) months after the date of death.
~ T~RYER RESPONSE
You may choose to remit payment to ~e Register o~ NJlls ~ith tuo copies o~ this notice to obtain
a discount or avoid interest, or ~ou may check box ~A~ and return this notice to the Register o~
CHECK
ONE
SLOCK
ONLY
PART
TAX
L/NE
~ills and an official assessment will be issued by the PA Department of Revenue.
B. [] The above asset has been or mill be reported and tax paid eith the Pennsylvania Inheritance Tax return
to be filed by the decedsnt's representative.
C. D The above information is incorrect and/or debts and deductions were paid by you. You must complete PART [] and/or PART [] below.
If you indicate a differen~ ~ax ra~e, please s~a~e your
relationship ~o decedent:
RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
1. Da~e Established 1
2. Accoun~ Balance 2
3. Percen~ Taxable $ ~
q. Aeoun~ Subjec~ to Tax q
5. Debts and Deductions $ -
6. Amoun~ Taxable 6
7. Tax Ra~a 7 ~
8. Tax Due 8
PART
DATE PAID
DE~ITS AND DEDUCTIONS CLAIMED
PAYEE DESCRIPTION AMOUNT PAID
TOTAL (Enter on Line $ of Tax Computation) $
Under penal~/es of perjury, I declare ~ha~ ~he fac~s ! have reported above are ~rue~ correc~ and
co~ll~la~a ~o ~ha bes~ of ay knowledge end belief. HOME (~J~) ~-~
TA TELEPHONE NUH~ER DATE
GENERAL INFORHATION
1. FAILURE TO RESPOND NZLL RESULT ZN AN O~FZCZAL TAX ASSESSNENT eith applicable interest based on information
submitted by the financial institution.
Z. Inheritance tax becomes delinquent nine months after the decedent's date of death.
5. A joint account is taxable even though the decadent's name ems added as a matter of convenience.
4. Accounts (including those held batmaan husband and wife) which tho decedent put in joint names within one year prior to
death are fully taxable as transfers.
5. Accounts established jointly between husband and wife more then one year prior to death are nat taxable.
6. Accounts held by a decedent "in trust for" another or others are taxable fully,
REPORTING INSTRUCTIONS - PART ! - TAXPAYER RESPONSE
1. BLOCK A - If the information and coaputetlon in the notice are correct and deductions ara not being claimed, place an
in block "A" of Part 1 of the "Taxpayer Response" section. Sign too copies and submit them aith your check for the amount of
tax to the Register of Hills of the county indicated. The PA Department of Revenue will issue an official assessment
(Form REV-lS4B EX) upon receipt of the return from the Register of Hills.
2. BLOCK B - If the asset specified on this notice has been or will ba reported and tax paid with the Pennsylvania Inheritance
Tax Return filed by the dacadant's representative, place an "X" in block "B" of Part I of the "Taxpayer Response" section. Sign one
copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Dept ZBOB01, Harrisburg, PA 171Z8-060! in the
envelope provided.
5. BLOCK C - If the notice information is incorrect and/or deductions are being claimed, check block "C"' and complete Parts Z and
according to tho instructions below. Sign two copies and submit them with your check for the amount of tax payable to the Register
of NilIs of the county indicated. The PA Department of Revenue will issue an official assessment (Fore REV-IS48 EX) upon receipt
of the return from the Rag[star of Nills.
TAX RETURN - PART Z TAX COHPUTATION
LINE
1. Enter the date the account originally was estabIished or titled in the manner existing at date of death.
NOTE: For a decedent dying after 1Z/II/BI: Accounts which the decedent put in joint names within one (1) year of death are
taxable fully as transfers. Haaavar, there is an exclusion not to exceed $5,000 per transferee regardless of the value of
the account or the number of accounts held.
If a double asterisk (xN) appears before your first name in the address portion of this notice, the $3,000 exclusion
already has been deducted fram the account balance as reported by the financial institution.
Z. Enter the total balance of the account including interest accrued to the date of death.
5. The percent of the account that is taxable for each survivor is determined as folloes:
A. The percent taxable for joint assets established more than one year prior to the dacedant's death:
I DIVIDED BY TOTAL NUNBER OF DIVIDED BY TOTAL NUNBER OF X 100 = PERCENT TAXABLE
JOINT DNNERS SURVIVING JOINT ORNERS
Example: A joint asset registered in the name af the decedent and two other persons.
I DIVIDED BY 3 (JOINT OHNERS) DIVIDED BY Z (SURVIVORS) = .167 X 100 = 16.7Z {TAXABLE FOR EACH SURVIVOR)
B. The percent taxable for assets created within one year of the decedant's death or accounts owned by the decedent but held
in trust for another individuaL(s) (trust beneficiaries):
1 DIVIDED BY TOTAL NUNBER OF SURVIVING JOINT X 100 PERCENT TAXABLE
O#NERS OR TRUST BENEFICIARIES
Example: Joint account registered in the name of the decedent and two other persons and established within one year of death by
the decedent.
1 DIVIDED BY Z (SURVIVORS) = .50 X 100 = 30Z (TAXABLE FOR EACH SURVIVOR)
The amount subject to tax (line 4) is determined by multiplying the account balance (line Z) by the percent taxable (line 3).
5. Enter the total of the debts end deductions listed in Part 3.
6. The amount taxable (line 6) is determined by subtracting the debts and deductions (line 5) fram the amount subject to tax (line 4).
7. Enter the appropriate tax rate (line 7) as determined below.
Da{e of Dea{h Spouse I Lineal I Sibling Cella{era1
07/01/94 ~¢o 12/$1/94
01/01/95 ~o 06/30/00 OX 6X
07/01/00 ~o presen~ OX
NThe tax rate imposed on the nat ers younger at
death to or for the usa of a natural parent, an adoptive parent, or a stepparent of the child is OZ.
The 11naa1 class of heirs includes grandparents, parents, children, and lineal descendents. "Children" includes naturaI children
whether or not they have been adopted by ethers, adopted children and step children. "Lineal descendants" includes all children of the
natural parents and their descendents, whether or not they have been adopted by others, adopted descendents and their descendants
and step-descendants. "Siblings" are daf[ned as individuals who have at least one parent in common with the decadent, whether by blood
or adoption. The "Collateral" class of heirs includes a11 other beneficiaries.
CLAINED DEDUCTIONS - PART $ - DEBTS AND DEDUCTIONS CLAIHED
Allowable debts and deductions are determined as follows:
A. You legally ara responsibZe for payment, or the estate subject to administration by a personal representative is insufficient
to pay the deductible items.
B. You actually paid the debts after death of the decedent and can furnish proof of payment.
C. Debts being claimed must be itemized fully in Part 3. If additional space is needed, usa plain paper B I/Z" x 11". Proof of
payment may be requested by tho PA Department of Revenue.
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 003925
OTT ROBERT E
4045 CHEROKEE AVE
CAMP HILL, PA 17011
........ fold
ESTATE INFORMATION: SSN: 184-26-2809
FILE NUMBER: 2104-0451
DECEDENT NAME: OTT FRANCES I
DATE OF PAYMENT: 05/11/2004
POSTMARK DATE: 05/10/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 02/15/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
04001123 I $246.54
REMARKS'
TOTAL AMOUNT PAID:
$246.54
SEAL
CHECK# 2178
INITIALS' JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
I, I I ! I I I ~! I ~
,'004 I ~'
MAv ! 0
20O4
il
OOlllOlOll
March 11, 2004
Glenda Famer Strausbaugh, Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
Re.'
Trust Estate of James R. McPherson, Jr., deceased
Social Security #184-26-4567
Dear Ms. Strausbaugh:
Our office represents the Trust Estate of James R. McPherson, Jr., who died on June 14,
2003, a resident of East Pennsboro Township, Cumberland County, Pennsylvania.
Enclosed please find an original Pennsylvania Inheritance Tax Return with attachments
and two (2) copies with no attachments. Please forward the original to the Department of
Revenue along with the enclosed Estate Information Sheet.
Kindly time-stamp and return the extra copy of the Return to me in the envelope
provided along with your receipts for the following 2 checks;
1. $15.00 payable to the Register of Wills for filing fees; and
2. $3,750.00 payable to Register of Wills, Agent for inheritance tax
due the Commonwealth.
We are not filing an Inventory because there were no probate assets.
Should you have any questions, or need any additional information, please ~ot hesitate
to contact me, or Edward P. Seeber, Esq., Counsel to the Trust Estate.
Very truly yours, 7. :~
Elizabeth S. Eck
Paralegal
/ese
Enclosures
cc: Audrey J. McPherson
Sent via certified mail
Article #7002 0860 0004 2141 7464
Return Receipt Requested
t t:\HOM E\ESE\McPhcrsonUames 14.doc
THE
..ESTATE
SECURITY
Elizabeth S. Eck
Paralegal
ese@jsdc.com
134 SIPE AVENUE
HUMMELSTOWN, PA 17036
MAILING ADDRESS
RO. BOX 650
HERSHEY, PA 17033
TOLL FREE 1,800.942.3660
TEL, 717.533.3280
FAX 717.533.7771
www. jsdc,corn
REV- 1500 EX + (6-00)
OFFICIAL USE ONLY
REV-1500
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
INHERITANCE TAX RETUF
RESIDENT DECEDENT
D
E McPherson Jr. James R
C ·
E DATE OF DEATH (MM-DO-YEAR) DATE OF BIRTH (MM-DO-YEAR)
D
E 12
N
T
CAPB
HpRL
EpIO
cRAC
KoTK
ES
Co.
R
E
C
A
P
I
T
U
L
A
T
I
O
N
O
M
T
I
O
N
FILE NUMBER
COUNTYCODE YEAR NUMBER
184-26-4567
THIS RETURN MUST BE RLED IN DUPUCATE WITH THE
McPherson Audrey J.'
1. Original Return ~ ~ment~l Return
4. Limi~edEstate ~,,~4~a. F_uture_ lnterest Compromise (date of death after12_lZ_8Z)
6. Decedent Died Testate L._J 7. Decedent Maintained a Living Trust
(Attach copy of Will) (Attach copy of Trust)
Federal Estate Tax Return Required
0.~ 8. Total Number of Safe Deposit Boxes
~'] 9. Litigation Proceeds Received [] 10. Spousa~ Poverty Credit [] 11. Election to tax under Sec. 9113(A)
(date of death between 1Z-31-~3 and 1-1-95) (Attach Sch O)
NAME
COMPLETE MAILING ADDRESS
Edward P. Seeber
FIRM NAME(IfApplicable) J 134 Si/ne Avenue
~Eep~(;NESNmU~M~aEhR, Dietterick & Connelly, [~p I Hummel;town, P~036
1. Real Estate (Schedule A) ~.,,
1. Real Estate (Schedule A) (1) N~3~.
Z. Stocks and Bonds (Schedule B) ~'21 . ~'t =- ~ OFFICI~?~ ONLY
3. Closely Held Corporation, Partnership or ~-~
Sole-Propnetorship ~
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. Inter-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)
12. Net Value of Estate (Line 8 minus Line 11)
13.
14.
43,300
N on ~
692,425.96
11,552.00
Nonm
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line 13)
(8) 735,725.96
(11)_ 11,552.00
(12)' 724,173.96-
(13)_
(14)
724,173.96
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(a)(1.2)
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 collateral rate
699,173.96 X .0 0
x .0 %5
X .12
25,000o 00 X
(is) o. 00
(16)_ o. oo
(17) O. O0
~~.., .... ~ ] 3,750.00
Copyright (c) Z000 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-001
Decedent's Complete Address:
STR~-~- I ADDRESS
613 Mountain Street
CITY
Enola
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
0.00
JSTATE
?A
(1)
Total Credits ( A + B + C ) (2)
JZIP
17025-1608
3,750. O0
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 recluest 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. (SA)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (SB)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;
b. retain the right 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 care? ...................
Z. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ................................ ~-~ ~-~
3. Did decedent own an "in trust for" or payable upon death bank account or security at his
or her death?
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property
which contains a beneficiary designation? ................................ ~ [----]
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE Q AND FILE IT AS PART OF THE RETURN.
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,
0.00
0.00
0.00
3,750.00
0.00
3,750. O0
correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Audrey J. McPhers on
DATE
/~ ~ ~ ~-~. /?, /2 613 Mountain Street .~_
~u~/~....k.~., .~.,)_~'~~ -'~gk~-~%'-~V6~-figb~ ........................ ~/w/'~c/
SIGNA~F~A~,~T~ER T~AN REPRESENTATIVE j ..........
/ / ~'/'~ / [~,u;~ =m~=n, o[etterick & Connelly,
' ' ' ' ~ -- lpe avenue
~;[~v~s;~:~;~s°;/;~rxu~ ~ Igor. a~,.trfor. Janua~ 1, 19,5, the ,x rate imposed on the net val~;'~'~r~e';~'~";~'~J~"~:~';':~;";~::;~:;
For dates of death on or after Janua- 1 1995 the tax rate ' '
,~ , , Impose~ on the net value of transfers to or for the use of the surviving spouse s 0%
[72 P.S. 9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the ~atuto~ require~n~ f~r disclosure of assets
and filing a tax return are still applicable even if the surviving spouse is the only beneficial.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twen~-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. gl 16(1.2)
[72 P.S. 9~ ~ ~(~)(~)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. gl 16(aX1.3)]. A sibling is defined, under
Section g102, as an individual who has at least one parent in compri with the decedent, whether by blood or adoption.
Oopyright (c) Z000 form software on y The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00)
REV- 1508 EX + (1-97)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
INHERITANCE TAX RETURN
RESIDENT DECEDENT PERSONAL PROPERTY
ESTATE OF
FILE NUMBER
James R. McPherson Jr. SS~/ 184-26-4567 06/14/2003
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on Schedule F.
ITEM
VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Decedent's vehicle - 1997 Ford Taurus 4-door sedan with 8,000.00
approximately 18,000 miles in good condition valued per online
services
2 Decedent's vehicle 1997 Dodge 1500 pickup with approximately 13,300.00
38,000 miles in good condition valued per online services
3 Decedent' s vehicle - 1995 Ford Windstar motorhome approximately 22,000.00
45,000 miles in good condition valued per online services
TOTAL (Also enter on line 5, Recapitulation) $ 43,300.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc.
Form REV-1508 EX (Rev. 1-97)
REV-'~510 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
James R. McPherson Jr.
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
SS# 184-26-4567 06/14/2003
This schedule must be completed and filed if the answer to an)' of questions 1 through 4 on page 2 is yes.
FILE NUMBER
sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc.
Form REV-1510 EX (Rev. 1-97)
DESCRIPTION OF PROPERTY % OF
ITEM INCLUDE THE NAME OF THE TRANSFERE~ THEIR DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
RE LATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER,
NUMBER ATTACH ACOPYOF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE)
1 AmeriChoice Federal Credit 5,756°62 100.00~ 0.00 5,756.62
Union - IRA share account
#32303-1, owned by
decedent; beneficiary is
decedent's spouse; valued
per head teller letter.
2 AmeriChoice Federal Credit 31.62 100.00% 0.0C 31.62
Union - Share account
#32303-1, titled in the
name of the James R.
McPherson, a/k/a James R.
McPherson, Jr., Living
Trust dated 04/17/2001, amd
any amendments thereto,
valued per head teller
letter.
3 AmeriChoice Federal Credit 9,758.52 100.00% 0.00 9,758.52
Union - Certificate of
deposit account #32303-1,
titled in the name of the
James R. McPherson, a/k/a
James R~ McPherson, Jr.,
Living Trust dated
04/17/2001, and any
amendments thereto, valued
per head teller letter.
4 AmeriChoice Federal Credit 87,925.72 100.00% 0.00 87,925.72
Union - Certificate of
deposit account #32303-1,
titled in the name of the
James R. McPherson, a/k/a
James R. McPherson, Jr.,
Living Trust dated
O4/17/2001, and any
amendments thereto, valued
per head teller letter.
5 AmeriChoice Federal Credit 117,214.80 100.00% 0 00 117,214.80
Union - Certificate of '
deposit account #32303-1,
titled in the name of the
James R. McPherson, a/k/a
James R. McPherson, Jr.,
Total of Continuation Schedule(s) 471,738.68
TOTAL (Also emer on line 7, Recapitulation) $ 692 ~ 425.96
(If mom space i~ n~H i~ ~;~-~ -~ ..... ·.,
REV- ,"511 EX * (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
James R. McPherson Jr.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
SS# 184-26-4567 06/14/2003
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
DESCRIPTION
FUNERAL EXPENSES:
Sullivan Funeral Home - Funeral goods and services
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) / EIN Number of Personal Representative(s)
Street Address
C~ty
Year(s) Commission Paid:
State ~ Zip
Attorne¥'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
C~ty
Relationship of Claimant to Decedent
Probate Fees
Accountant's Fees
Tax Return Preparer's Fees
Other Administrative Costs
Cumberland County Register of Wills
inheritance tax return
State~ Zip
Filing fee for Penns~
FILE NUMBER
AMOUNT
4,037o00
7,500.00
15.00
TOTAL (Also enter on line 9, Recapitulation) $ 11,552.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97)
REV-~I513 EX + (9-00) I I
I SCHEDULE J [
COMMONWEALTH OF PENNSYLVANIA I BENEFICIARIES
INHERITANCE TAX RETURN /
"' '" ' ~"~"~:~:RD"E~?V A" ' ^ _ I BENEFICIARIES t
ESTATE OF
Ja~es R. Mc?herson Jr. SS~/ 184-26-4567 06 ~__~_~03 FILE NUMBER
NUMBE~ NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and ------"----- --------------
transfers under Sec. 9116(aX1.;')]
1 Survivor's Trust created under the James Ro Trust all assets on
McPherson, Jr. Living Trust dated
04/17/2001, and any amendments thereto, Schedule C
created for the benefit of spouse except
c/o Audrey J. McPherson, Trustee AmeriChoice
613 Mountain Street IRA
Enola, PA 17025-1608
2 Trust for the benefit of Nicole Lydia Friend
Howell created under the James R. 25,000.00
McPherson, 3r. Living Trust dated
04/17/2001, and any amendments thereto
3 Audrey J. McPherson Wife
613 Mountain Street AmeriChoice
Enola, PA 17025~1608 IRA and
vehicles
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
(If more space is needed, insert additional sheets of the same size)
Copyright (c) Z000 form software only The Lackner Group, Inc.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET
$ 0.00
Form REV-1513 EX (Rev. 9-00)
Estate of: James R. McPherson Jr.
Soc Sec #: 184-26-4567
Date of Death: 06/14/2003
Continuation of Schedule G
(Inter-Vivos Transfers & Misco Non-Probate Property)
Item Description of Property Date of Death % Decd Exclusion
# Value of Asset Intrst
Taxable Value
Living Trust dated
04/17/2001, and any
amendments thereto, valued
per head teller letter.
Decedent's residence -
House and lot situate at
613 Mountain Street, East
Pennsboro Township,
Cumberland County, PA,
titled in the names of
James R. McPherson, Jro and
Audrey J. McPherson,
Trustees, or their
successors in trust under
the James R. McPherson
Living Trust dated April
17, 2001, and any
amendments thereto, and
Audrey J. McPherson and
James R. McPherson, Jr.,
Trustees, or their
successors in trust under
the Audrey J. McPherson
Living Trust dated April
17, 2001, and any
amendments thereto~ as
tenants in common; valued
per county assessment
($126,440) times common
level ratio factor for
Cumberland County (1.01);
one-half (1/2) of asset's
value is reported.
The Vanguard Group
Pennsylvania Tax-Exempt
Money Market Fund account
#9948281238, titled in the
name of the James Ro
McPherson, Jr., Living
Trust dated 04/17/2001, and
any amendments thereto,
valued per registered
63,852.20
171,764.23
100.00%
100.00%
0.00
0.00
63,852.20
171,764.23
Estate of: James R. McPherson Jr.
Soc Sec #: 184-26-4567
Date of Death: 06/14/2003
Continuation of Schedule G
(Inter-Vivos Transfers & Misc. Non-Probate Property)
Item Description of Property Date of Death % Decd Exclusion
Value of Asset Intrst
Taxable Value
10
11
12
13
representative letter.
The Vanguard Group -
Accrued dividends earned on
Pennsylvania Tax-Exempt
Money Market Fund account
#9948281238, referenced
above.
Vartan National Bank -
Certificate of deposit
account #301-095-3, titled
in the name of the James R.
McPherson Living Trust
dated 04/17/2001 and any
amendments thereto;
principal balance valued
per branch manager letter.
Vartan National Bank -
Accrued interest earned on
certificate of deposit
account #301-095-3,
referenced above.
Waypoint Bank - Certificate
of deposit account
#3700015306, titled in the
name of James R. McPherson
Living Trust datd
04/17/2001, and any
amendments thereto, valued
per senior services
representative letter.
Waypoint Bank - Accrued
interest earned on
certificate of deposit
account #3700015306,
referenced above.
Waypoint Bank - Certificate
of deposit account
#7100014863, titled in the
62.33 100.00% 0.00
36,635.08 100.00% 0.00
545.06 100.00% 0.00
90,000.00 100.00% 0.00
230.79 100.00% 0.00
41,780.62 100.00% 0.00
62.33
36,635.08
545.06
90,000.00
230.79
41,780.62
Estate of: James R. McPherson Jr.
Soc Sec #: 184-26-4567
Date of Death: 06/14/2003
Continuation of Schedule G
(Inter-Vivos Transfers & Misc. Non-Probate Property)
Item Description of Property Date of Death % Deed Exclusion Taxable Value
# Value of Asset Intrst
14
15
16
17
18
19
name of the James R.
McPherson Living Trust
dated 04/17/2001, and any
amendments thereto, valued
per senior services
representative letter.
Waypoint Bank - Accrued
interest earned on
certificate of deposit
account ~7100014863,
referenced above.
Waypoint Bank - Certificate
of deposit account
#7100014866, titled in the
name of the James R.
McPherson Living Trust
dated 04/17/2001, and any
amendments thereto, valued
per senior services
representative letter.
Waypo~nt Bank - Accrued
interest earned on
certificate of deposit
account #7100014866,
referenced above°
Waypoint Bank - Checking
account #905005104, titled
in the name of the James R.
McPherson Living Trust
dated 04/17/2001, and any
amendments thereto, valued
per senior services
representative letter.
Waypoint Bank - Accrued
interest earned on checking
account #905005104,
referenced above.
782.82 100.00%
52,225.79 100.00%
978.52 100.00%
1,009.68 100.00%
0°20 100.00%
0.00
0.00
0.00
0.00
0.00
782.82
52,225.79
978.52
1,009.68
0.20
Waypoint Bank ~ Checking 2,455.12 100.00% 0.00 2,455.12
Estate of: James R. McPherson Jro
Soc Sec #: 184-26-4567
Date of Death: 06/14/2003
Continuation of Schedule G
(Inter-Vivos Transfers & Misc. Non-Probate Property)
Item Description of Property Date of Death % Deed Exclusion
Value of Asset Intrst
Taxable Value
2O
22
21
account #100007961, titled
in the name of the James R.
McPherson Living Trust
dated 04/17/2001, and any
amendments thereto, valued
per senior services
representative letter.
Waypoint Bank - Accrued
interest earned on checking
account #100007961,
referenced above.
Waypoint Bank - Checking
account #3700001591, titled
in the name of the James R.
McPherson Living Trust
dated 04/17/2001, and any
amendments thereto, valued
per senior services
representative letter.
'Waypoint Bank - Accrued
interest earned on checking
account #3700001591,
referenced above.
0.53
9,414.99
0.72
100.00%
iO0.OOZ
100.00%
0.00
0.00
0.00
0.53
9,414.99
O. 72
471,738.68
Estate of:
Soc Sec #: 184-26-4567
Date of Death: 06/14/2003
James R. McPherson Jr.
Item Description
#
Continuation of Schedule H-B2
(Attorney's Fees)
Amount
James, Smith, Dietterick & Connelly, LLP - Attorney fees
7,500.00
7,500.00
7002 0860. 0004 2141 74~!'
THE
E~E ~AME$ SMITH DIETTERICK & CONNELLY LLP
$~-~LJRITY P.O. Box 650
FORMULA,~, Hershey, PA 17033-0650
Glenda F. Strausbaugh, Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013