HomeMy WebLinkAbout03-0092PETITION FOR PROBATE and GRANT OF LETTERS
Estate of HELEN C. LUTZ No.
also known as To:
, Deceased.
Social Security No. 170.05.6870
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the executora
in the last will of the above decedent, dated Janua~ 26~ 1979
and codicil(s) dated NONE
Register of Wills for the
County of CUMnERL~ND
Commonwealth of Pennsylvania
in the
named
(state relevant cimumstances, e.g. renunciation, death of executor, etc.)
Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, with
h er last family or principal residence at 711 ALLENVIEW DRIVE~ MECHANICSBURG~
UPPER ALLEN TOWNSHIP1 PENNSYLVANIA 17055
(list street, number and municipality)
Decedent, then 89 years of age, died 1/13/03
at HOLY SPIRIT HOSPITAL~ CAMP HILL~ PA
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 ajudicated
incompetent:
Decedent 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
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
30~000.00
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters TESTAMENTARY
thereon. -~ x //~,~f~l . (testamentap/; administration c.t.a.; administration d.b.n.c.t.a.)
~ ~--del~tt~- r'''-~' ~ "~'~'~e PA 17055
918 Loring Lane
MechanicsburR
I South Seasons Drive
Dillsbur~l
PA 17019
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA '[
SS
COUNTY OF CUMBERLAND
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and conect to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and trul~dminister the estate according to law.
Sworn to or affirmed nd subscribed .,~_
befqre~nethis ~J~ dayof F ~'7~
Estate of HELEN ¢. LUTZ , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW ~.a~4,~~ ?.V ,. ,~t..K.}~ , in consideration of the petition on
the reverse side hereof, satisfac~ry proof having been presented before me,
IT IS DECREED that the instrument(s) dated 1/28t79
described therein be admitted to probate and filed of record as the last will of HELEN ¢. LUTZ
,;
and Letters TETAMENTARY
are hereby granted to
BARRY L. LUTZ
HELEN J. GARRETT
~' Register of Wills' -
FEES MURREL R. WALTERS, III
Probate, Letters, Etc ......... $ (.oO. C;~ 24849
Short Certificates ( ~_~ ) ...... $ ~. O{D ATTORNEY (Sup. Ct. I.D. No.)
R-entlt,a~t~ .x~e~_.~..._ .~ .... $ ,~. Oc) 54 EAST MAIN STREET
.~.~0~;~ $ ~3.~X.~ MECHANICSBURG PA 17055
ADDRESS
TOTAL ~ $ -Iq.oD
Filed J- ~C~- .~.c:~._,~ ............ 717-697-465o
........ PHONE
REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
OATH OF NON-SUBSCRIBING WITNESS
BARRY L. LUTZ and HELEN J. GARRETT
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that they are
familiar with the signature of HELEN C. LUTZ , testat rix of (one of the
codicil
subscribing witnesses to) the will presented herewith and that they believes the signature on the
codicil
will is in the handwriting of HELEN C. LUTZ to the b~ll~'of their knowledge and belief.
Sworn to or affirmed and sub-
/ J/' ' (-/ -~/ (Name)
scribed before me this 29th day of ,18 L{O/RJNO LANE ~/
MEC}IANICSBURG PA 17055
JANUARY~ 2003 ~A~ddress)
~ For the Register 1 SOUTH SEASONS DRIVE (Name)
(~ ~ DILLSBURO PA 17019
(Address)
This is to certi~' that the information here given is correctly copied fi:om an otiginal ccrtificatc el' death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office f~)l' pcrmataent h~hng.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00 ,~,,~,,,.,;, ~,~.~t~'U~ -..~
mos ;,~3 He, ~'a7 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
.~.c.,.. HelenC. Lu~ I*' Female ~ 170- 05-- 6870I
Mar 9, 1914 Harrisburg, Pa t~ 0 ~0 ~
,. 88'~ ~ i ,- ,.
. Cumberland .. East Pennsboro Twp...~/* ~,/,,,~- ' ' ~ ~/ I~'~''a ,n.,~. '~'
m~m.rs.~m ~ ~, ~.z.c~. ~lmc~"rs ~u~ ,,.. ~.,. Pennsylvania~. ,,..~, ~ Upper Allen
711 Allenview Drive /m-~
,t Mechamcsburo, Pennsylvama 170/~.~ ,~-~ Cumberland ~* ,~.~ ~
~oss ~obed ~lack Janot Fmeland
Bar~ L. Lu~ 918 Loring Lane Mechanicsburg, Pa. 17055
~ ~-~- ~ ~ ..... o ~.~,
~ ~<~ O Rolling Green Memorial Park 17011
,,,. Jan 16 2003 ,,~ Camp Hill, Pennsylvania
FD-014318-L Myers Funeral Home, Inc, 37 East Main Street Mechanicsburg, Pa 1705~
~. ~ i~. ~. t . .
LAST WILL AND TESTAMENT OF HELEN C. LUTZ
I, HELEN C. LUTZ, of the Township of Upper Allen, County of
Cumberland and State of Pennsylvania, being of sound and dis-
posing mind, memory and understanding, do make, publish and de-
clare this my Last Will and Testament, hereby revoking and making
void any and all prior Wills by me at any time heretofore made.
I direct the payment of all my just debts and funeral expenses
as soon after my decease as the same can conveniently be done.
Ail the rest, residue and remainder of my estate, real,
personal and mixed, of whatsoever nature and wheresoever situate,
I give, devise and bequeath to my husband, Edgar W. Lutz,
absolutely and in fee simple.
In the event my husband should predecease me or should die
within thirty (30) days from the date of my death, I give, devise
and bequeath my entire estate in equal shares to my children.
I nominate, constitute and appoint my husband, Edgar W. Lutz,
Executor of this my Last Will and Testament, and in the event
he should predecease me or for any reason be unwilling or unable
to act as such, I nominate, constitute and appoint my son, Barry
L. Lutz, and my daughter, Helen J. Garrett, Co-Executors of this
my Last Will and Testament in his place and stead.
IN WITNESS WHEREOF, I have hereunto set
-1-
my hand and seal this ~'~~"-~ dam of January, 1979.
Helen C. L~tz ~
Signed, sealed, published and declared by the above named
Helen C. Lutz, as and for her Last Will and Testament, in the
presence of us who have subscribed our names hereto as witnesses,
at the request of said testatrix, in her presence and in the
presence of each other.
-2-
LAST WILL AND TESTAMENT
OF
HELEN C. LUTZ
JOHN M. EAKIN
A'I-rORN£Y AT LAW
MARKET SCIUAE£ BUILDING
MEP-HANIP-SBURG, PA. 1'7055
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: HELEN C. LUTZ
Date of Death: January 13, 2003
Will No. 2003-00092 Admin. No. 21-03-0092
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the
Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned
estate on January 31, 2003.
Name Address
Barry L. Lutz 918 Loring Lane, Mechanicsburg, PA 17~055
Helen J. Garrett 1 South Seasons Drive, Dillsburg, PA 17019
/
Notice has now been given to all persons entitled thereto under Rule }/-/-6/(a) except:
one
Date: January31, 2003
vlurrel 1~. Walters, III, ~'~quire
54 East Main Street
Mechanicsburg, PA 17055
(717) 697-4650
Capacity: __ Personal Representative
X Counsel for personal representative
REV-1500 E~,X + (6-00)
COMMONWEALTH OF REV-1 OFFIC,AL USE ONLY
PENNSYLVANIA 500
OEPARTMENT OF REVENUE INHERITANCE TAX RETURN ,,LENU.BER
DEPT. 260601
HARR,SBURG, P^ 17128-0601 RESIDENT DECEDENT
COUNTY COOE YEN~ NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAl SOCIAL SECURITY NUMBER
Z LUTZ HELEN C.
LU I 7 0 - 0 5 - 6 8 7 0
t'~ DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
(D 01/13/2003 0310911914 REGISTER OF WILLS
UJ (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
t'~ SOCIAL SECURITY NUMBER
~_'" [] 1. Original Return [~ 2. Supplemental Return [~] 3. Remainder Return (date of death prior 1o 12~13-82)
'.-' "~'~' ~' "' E~] 4. Limited Estate [] 4a. Future Interest Compromise (date of death after 12.12-82) ['~ 5. Federal Estate Tax Return Required
,-, ~,,., r~ 6. Decedent Died Testate (Affach copy of Will) E~ 7. Decedent Maintained a Living Trust (Attach copy. of Trust) ~ 8. Total Number of Safe Deposit Boxes
< [~] 9. Litigation Proceeds Received r'-] 10. Spousal Poverty Credit (date of death between t2-31-91 a~ 1-~-95) [] 11. Election to tax under Sec. 9113(A)(Attac~ Sch O)
THIS SECTION MUST BE COMPL""~ I:O. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
MURREL R, WALTERS II1~ ESQ.
FIRM NAME (If Applicable)
54 EAST MAIN STREET
TELEPHONE NUMBER
717-697-4650 MECHANICSBURG PA 17055
1. Real Estate (Schedule A) (1) OFFICIAL USE ONLY
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 & Miscellaneous Personal Property (5) 1~i! c~
(Schedule E)
6. Jointly Owned Property (Schedule F) (6) 5'~'~9'67 ~ ii::
E~ Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7) (8) 107;709.67
9. Funeral Expenses & Administrative Costs (Schedule H) (9) 9~255.0o
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 29~783.60
11. Total Deductions (total Lines 9 & 10) (11) 39,038.60
12. Net Value of Estate (Line 8 minus Line 11) (12) 68,671.07'
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13)
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 68~671.07
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) X (15)
16. Amountof Line 14 taxable at lineal rate 68~671.07 X .04S (16) 3,090.20
17. Amount of Line 14 taxable at sibling rate X .12 (17)
18. Amount of Line 14 taxable at collateral rate X .15 (18)
19. Tax Due (19) 3~090.20
20. E~] ' ' ' ' 'si ,- - ~1 ,~ , ' I~l
> · BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
.Decedent's Complete Address:
STREET ADDRESS
7'11 ALLENVlEW DRIVE
CITY
MECHANICSBURG I STATE ZiP
PA 17055
Tax Payments and Credits:
1. Tax Due(Page 1 Line 19)
2. Credits/Payments (1) 3,090.20
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Total Credits ( A + B + C ) (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) 3,090.20
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
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 in'come of the property transferred; ........................................................................... [] []
b. retain the dght 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? ............................................................. [] []
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate cons deration?
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 des gnat on?
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penatbes of perjury I declare that I have examined this return, including accompanying schedules and statem~ts, and to the best of my knowledge and belief, it is true, correct and complete.
Declaration of preparer other than the personal representative is besed on all information of which preparer hes,~a~/l(nowtedge..._..
SIGNATURE .OF PERSON RESPONSII~.E FOR FILING RETURN /J /- ~-~-) DATE
ADDR "A..¥ '. ¢055
HELEI~J. GA, I~IJiOiiiTT, IO,,,,RIAYFIELD ROAD, I~I~CHAf~II~"SBURG ///' PA 17055
SIGNATURE OF ~/ ~,,-
P~I~/~,//.~/~_/~,/~ jP ER QTJ,'J~T,J,)¢~ RF~ESENTATIVE DATE
ADDRESS i{,IUi~R~L~'R.W~LTER i~..[.U.c~SQ. '~' ~ ' ~ ~
54 EAST MAIN STREET; MECHANICSBURG PA 17055
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 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 exembt 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 transfers 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.
REV-tS09 E;~ * (1-97)
SCHEDULE F
COMMONWEA'TH Or PENNSY V^N,A JOINTLY'OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
LUTZ HELEN ¢. 21 03
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A. BARRY L. LUTZ 918 LORING LANE SON
MECHANICSBURG, PA 17055
B HELEN J. GARRETT 10 MAYFIELD ROAD DAUGHTER
MECHANICSBURG, PA 17055
C
JOINTLY-OWNED PROPERTY:
L~- ~ ~ ER DATE DESCRIPTION OF PROP~-~ ~ ~' % OF DATE OF DEATH
ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar idenfifTing number. Attach DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT deed for joinUy-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTERE~
1. A & B. 8/4/88 MEMBERS 1ST F.C.U. 18,656.98 16.667 3,109.5~
O5
2 A & B 8/16/88 MEMBERS 1ST F.C.U. 2,164.21 16.667: 360.71
11
3 A & B 12/18188 MEMBERS 1ST F.C.U. 13,436.13 16.667 2,239.40
41
TOTAL (Also enter on line 6, Recapitulation) $
,,~ ................. S~709.6 ~'
(if more space is needed, insert additional sheets of the same s~ze)
REV-~510 ~; + (1.97)
~ SCHEDULE G
INTER-VIVOS TRANSFERS &
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN MISC, NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
LUTZ HELEN ¢, 21 03 0092
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is "es.
DESCRIPTION OF PROPERTY % OF
ITEM INCLUDE THE NAME OF'FHE TRAN~EREE, THEIR RELATIONSHIP TO DECEDENT ANO THE DATE OF TR.~NS~ER~ DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
NUMBER A'rrAcH A COPY OF THE DEED FOR REAL ESTATE.
VALUE OF ASSET INTEREST (IF APPUCABLE)
1. REAL ESTATE SITUATE AT 711 ALLENVlEW DRIVE~ 105,000.00 100. 3,000.00 102,000.0(
UPPER ALLEN TOWNSHIP~ CUMBERLAND COUNTY,
MECHANICSBURG~ PA
TRANSFERRED TO BARRY L. LUTZ & HELEN J. GARRETT
AUG 8, 2002
SOLD TO THIRD PARTY OCT 10, 2003
TOTAL (Also enter on line 7, Recapitulation) $ '102~000.0,,
(If more space Js needed, insert additional sheets of the same s~ze)
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN
RESIDENT DECEDENT ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
LUTZ HELEN (;. :~1 03 0092
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. MYERS FUNERAL HOME, INC.
6,660.00
2. JAMES R. GINGRICH MEMORIALS
145.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s) BARRY L, LUTZ & HELEN J,GARRETT RENOUNCED
Social Secudty Number(s) / LIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees MURREL R. WALTERS III, ESQUIRE 2,250.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
CIaimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees REGISTER OF WILLS CUMBERLAND COUNTY 200,00
5. Accountant's Fees
6. Tax Return Preparer's Fees
TOTAL (Also enter on line 9, Recapitulation) $
9,255.0(]
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX + (1-97)
SCHEDULE I
COMMONWEALTH OF PENNSYLVANIA DEBTS OFDECEDENT,
INHERITANCE TAX RETURN
RESIOENTDECEDENT MORTGAGE LIABILITIES, & LIENS
ESTATE OF FILE NUMBER
LUTZ HELEN ¢. ~1 03 0092
Include unreimbursed medical expenses,
ITEM
NUMBER DESCRIPTION AMOUNT
1. UNITED WATER
WATER SERVICE 44.06
2. PP&L
ELECTRIC SERVICE 470.49
3. BOSSERMAN'S 118.72
CARPET CLEANING
4. UPPER ALLEN TOWNSHIP AUTHORITY 300.00
SEWER
5 NATIONAL CITY MORTGAGE
MORTGAGE PAYMENTS 2,385.25
6 REAL ESTATE TAXES 1,323.13
7 NATIONAL CITY MORTGAGE
PAYOFF 23,768.95
8 REAL ESTATE SALE SETTLEMENT CHARGES 1,373.00
TOTAL (Also enter on line 10, Recapitulation) $
29,783.6~
(if more space is needed, insert additional sheets of the same size)
REV-1517. EX + (g-nm
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
LUTZ HE LEN (;. 21 0:~ 0092
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
[. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a)(1.2)]
1. BARRY L. LUI'Z SON 50%
918 LORING LANE
MECHANICSBURG~ PA 17055
2. HELEN J. GARRETT DAUGHTER 50%
10 MAYFIELD ROAD
MECHANICSBURG, PA 17055
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE ON REV-1500 COVER SHEET
ir]'. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - 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)
COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIOUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 003598
WALTERS, MURREL R. III
54 EAST MAIN STREET
MECHANICSBURG, PA 17055
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
........ fold ..........
101 93,090.20
ESTATE INFORMATION: SSN: 170-05-6870
FILE NUMBER: 2103- 0092
DECEDENT NAME: LUTZ HELEN C
DATE OF PAYMENT: 02/25/2004
POSTMARK DATE: 00/00/0000
COUNTY: CUM BERLAN D
DATE OF DEATH: 01 / 13/2003
...... TOTAL AMOUNT PAID: $3,090.20
REMARKS: MURREL RWALTERS III, ESQ
: ' CHECK#336
INITIALS: AC
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
' REGISTER OF WILLS
REGISTER OF WILLS
CONNONNEALTH OF PENNSYLVANIA
BUREAU OF ZNDZVTDUAL TAXES DEPARTHENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT. Z&0601 INHERITANCE TAX
HARRISBURG, PA 171Z8-0601 STATEHENT OF ACCOUNT
RE¥-I~O7 EX AFP (01-03)
Rec-~-~-~ i~ :~ ofDATE o3-o1-2oo~
ESTATE
OF
KERLZNG
HARGARET
DATE OF DEATH 11-21-2002
FILE NUHBER 21 0~-0085
LZNDA L YOUNG '~ HAR -5 P3 :~UNTY CUHBERLAND
ACN 05~0~22
~ NAPLE AVE I Amoun~
CANP HZLL PA ~70~- ~ :
i
NAKE CHECK PAYABLE AND RENZT PAYN[NT TO:
REGZSTER OF NZLLS
CUN~ERLAND CO COURT HOUSE
CARLZSLE, PA ~70~
NOTE: To ~nsure proper credJ~ ~o ~our accoun~ submJ~ ~he upper por~Jo~ of ~h~s form wJ~h
CUT ALONG THZS LZNE ~ RETAZN LONER PORTZON FOR YOUR RECORDS
ESTATE OF KERLING HARGARET FILE NO. 21 0q-0085 ACN 05105522 DATE 05-01-200~
THIS STATEHENT ZS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN TN THE NAHED ESTATE. SHO#N BELOW/
ZSA SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, ZF APPLTCABLE.,
A PROJECTED INTEREST FTOURE.
DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT: 01-1Z-ZO0~
PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... $9.15
PAYHENTS (TAX CREDITS):
PAYHENT RECEIPT DISCOUNT (+) AHOUNT PAID
DATE NUHBER INTEREST/PEN PAID
01-27-200~ CD005~86 .00 39.15
TOTAL TAX CREDIT 39.13
BALANCE OF TAX DUE . O0
INTEREST AND PENo .82
TF pATD AFTER THTS DATE, SEE REVERSE TOTAL DUE .82
STDE FOR CALCULATTON OF ADDTTTONAL TNTEREST.
TF TOTAL DUE TS LESS THAN $1,
NO PAYNENT TS REI~UTRED.
TF TOTAL DUE TS REFLECTED AS A "CREDTT" (CR),
YOU HAY BE DUE A REFUND. SEE REVERSE STDE OF THTS FORN FOR TNSTRUCTTONS. )
BUREAU OF INDIVIDUAL TAXES
TNHERTTANCE TAX DTV/$TON
DEPT. 280601
HARRTSBURG, PA 17128-0601
BARRY L LUTZ
918 LORING LN
MECHANICSBURG
COMHONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENTj ALLONANCE OR DISALLORANCE
OF DEDUCTIONS, AND ASSESSHENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
FILE NUMBER
COUNTY
'04 MAR -5 P3:43SSN/DC
ACN
DATE 03-08-2004
ESTATE OF LUTZ
DATE OF DEATH 01-13-2003
21 03-0092
CUMBERLAND
170-05-6870
05114489
Amoun~ Reml~ed
RE¥-15~8 EX AFP (01-05)
HELEN
HAKE CHECK PAYABLE AND REMIT PAYHENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1548 EX AFP {01-03}
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 03-08-Z004
ESTATE OF LUTZ HELEN
C DATE OF DEATH 01-13-2003 COUNTY CUMBERLAND
FILE NO. 21 03-0092 S.S/D.C. NO. 170-05-6870 ACN
TAX RETURN WAS: (X) ACCEPTED AS FILED ¢ ) CHANGED
03114489
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 48598-41
TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST (~ TIME CERTIFICATE
DATE ESTABLISHED 12-18-1998
Accoun~ Balance
Percen~ Taxable ~ 0.166
Amoun~ Subjec~ ~o Tax 2,239.40
Debts and Deduc~/ons - .00
Taxable Amoun~ 2,239.40
Tax Ra~e X .45
Tax Due 100.77
TAX CREDITS:
13,436.15 NOTE:
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT ¢+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
INTEREST IS CHARGED THROUGH 03-16-2004
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX CREDIT
BALANCE OF TAX DUEI
INTEREST AND PEN.
TOTAL DUE
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" { CR}, YOU HAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. )
.00
100.77
I .93
102.70
COHHONWEALTH OF PENNSYLVANIA
BUREAU OF INDIVIDUAL TAXES DEPARTHENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA Z71ZS-0601 NOTICE OF INHERITANCE TAX
APPRAZSEHENT, ALLOWANCE OR DISALLONANCE
OF DEDUCTIONS AND ASSESSNENT OF TAX R~V-~S47EXAF,[O~-OS~
~'~!~ ~ DATE 0~-12-2004
~': ESTATE OF LUTZ HELEN C
DATE OF DEATH 01-15-2005
FILE NUNgER 21 05-0092
'04 I\P~ 1~ ~'~ ? l~ ~COUNTY CUMBERLAND
HURREL R WALTERS III ESQ ACN 101
5~ E HAIN ST Amoun~ RemA~ed
HECHANICSBURG PA 170~5
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS
REV-l$47 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF LUTZ HELEN CFILE NO. Z! 03-0092 ACN 101 DATE 0~-1Z-200~
TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN ~ASED ON: ORIGINAL RETURN
1. Real Es~a~e (Schedule A) (1) O0 NOTE: To insure proper
2. S~ocks and Bonds (Schedule B) (2) O0 credi* ~o your account,
$. Closely Held S*ock/Par~nership In~aras~ (Schedule C) ($) O0 submi~ ~he upper por~1on
~. Nor~gagas/No~as Receivable (Schedule D) (~) O0 of ~his form ~i~h your
5. Cash/Bank Deposi~s/Nisc. Personal Proper~y (Schedule E) (5) O0 ~ax payment.
6. Jointly O~ned Proper*y (Schedule F) (6) 5~709 67
7. Transfers (Schedule G) (7) 102;000.00
8. To'al AssaYs (8) 107,709.67
APPROVED DEDUCTIONS AND EXEHPTZONS: 9,255.00
9 Funeral Expenses/Adm. Cos~s/N~sc. Expanses (ScheduZe H) (9)
10 Deb~s/Hor~gage Liabili~les/L~ens (Schedule I) (10) Z9,78~.60
11 To,al Deductions (11)
12 Na~ Value of Tax Re*urn (12) 68,671.07
1~ Char1~abla/Govarnmen~al Bequests; Non-elec*ad 9115 Trusts (Schedule J) (15} .00
1~ Ne~ Value of Es~a~e Sub~ec~ *o Tax (lq) 68,671.07
NOT;: If an assessment #as issued previously, lines 1~, 15 and/or 16, 17, 18 and 19 ~ill
re~lect ~igures that include the total o~ ALL returns assessed to date.
ASSESSHENT OF TAX:
15. Amoun~ of L/ne 1~ a~ Spousal ra~e (15) .00 X O0 = .00
16. Amoun~ of Line 1~ *axable a~ Lineal/Class A ra~e (16) 68,671.07 x 0~5 = ~,090.20
17. Amoun~ of Line lq a~ Slbllng ra~a (17) .00 X 12 = .00
18. Amoun~ of Line 1~ ~axable a~ Collateral/Class B ra~a (18) .00 X 15 = .00
19. Prlnc/pel Tax Due (19)= 5,090.20
TAX CREDITS:
PAYHENT RECEIPT DISCOUNT (+) ANOUNT PAID
DATE NUNBER INTEREST/PEN PAID (-)
02-25-200~ CD005598 .00 3,090.20
BALANCE OF UNPAID INTEREST/PENALTY AS OF OZ-Z6-ZO0~ TOTAL TAX CREDIT J $,090.Z0
BALANCE OF TAX DUEJ .00
INTEREST AND PEN. 5Z.48
TOTAL DUE 5Z. 48
~ ZF PAID AFTER DATE INDICATED, SEE REVERSE ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUIRED.
FOR CALCULATION OF ADDTTZONAL INTEREST. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.)
PAYMENT: Detach the top portion of this Notice and submit eith your payment made payable to the name and address
printed on the reverse side.
-- If RESIDENT DECEDENT make check or money order payable to: REGXSTER OF NILLS, AGENT.
-- If NON-RESIDENT DECEDENT make check or money order payable to: COMMONWEALTH OF PENNSYLVANIA.
REFUND (CR): A refund of a tax credit, ahich 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 Z3 Revenue District Offices or from the Department's gq-hour
answering service for fores ordering: 1-800-36Z-Z050; services for taxpayers with special hearing and / or
speaking needs: 1-800-6`q7-30Z0 (TT only).
REPLY TO: guestions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau
of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 28060l, Harrisburg, PA I7118-0601, phone
(7173 787-6505.
DISCOUNT: If any tax due is paid within throe (33 calendar months after the decedsnt's death, a five percent (51) discount
of the tax paid is allowed.
PENALTY: The 1Si tax amnesty non-participation penalty is computed on the tote! of the tax and interest assessed, and not
paid before January 18, i996, the first day after the end of the tax amnesty period.
INTEREST: Interest is charged beginning with first day of delinquency, or nine [93 months and one (l) day from the data of
death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate ;F
six (61) percent per annum caZculated at a daily rate of .000166`. Al1 taxes which became delinquent on and after
January 1, 1982 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 1981 through 2003 ara:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1982: 207. . OOOSq8 1987 97. .00026,7 1999 71 .000192
1983 161 .0006`38 1988-1991 llZ .000301 ZOO0 81 .000119
1986` 117. .000301 199Z 91 .00016`7 ZOO1 97. .00026`7
1985 131 .000356 1993-1996` 71 .000191 ZOOZ 61 .000166`
1986 107. .000276` 1995-1998 91 .00016`7 2003 57. .000137
--Interest is calculated as follows:
TNTEREST = BALANCE OF TAX UNPATD X NUI~BER OF DAYS DELTNQUENT X DATLY TNTEREST 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.
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRXSBURG, PA 17118-0601
CONHONNEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOTICE OF INHERXTANCE TAX
APPRAXSENENT, ALLONANCE OR DXSALLONANCE
OF DEDUCTXONS, AND ASSESSHENT OF TAX ON
JOXNTL¥ HELD OR TRUST ASSETS
REV-ISiS8 EX AFP
HELEN j GARRET~C)4 MAR-5 P3~3
I s SEASONS DR
DILLSBURG
~019 .... ~i
DATE 05-08-2004
ESTATE OF LUTZ HELEN
DATE OF DEATH 01-15-2005
FILE NUHBER 11 05-0091
COUNTY CUHBER LAND
SSN/DC 170-05-6870
ACN 05114488
Amoun~c Re, mi ~:'l:ed
HAKE CHECK PAYABLE AND REH'rT PAYNENT TO:
REGISTER OF NILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~
REV-1548 EX AFP (01-03)
NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLONANCE OR DZSALLONANCE OF
DEDUCT/ONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 05-08-2004
ESTATE OF LUTZ HELEN C DATE OF DEATH 01-15-2005 COUNTY CUHBERLAND
FILE NO. 21 05-0092 S.S/D.C. NO. 170-05-6870 ACN 05114488
TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET XNFORHATXON
FINANCIAL INSTITUTION: HEHBERS 1ST FCU ACCOUNT NO. 48598-41
TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST (~ TIHE CERTIFICATE
DATE ESTABLISHED 12-18-1998
Account BaZance
Percent Taxable X 0.166
Amount Subject to Tax 2,259.40
Debts and Deductions .00
Taxable Amount 2,259.40
Tax Rate X .45
Tax Due 100.77
TAX CRED'rTS:
15,456.13 NOTE:
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBHIT THE
UPPER PORTION OF THIS NOTICE
NITH YOUR TAX PAYHENT TO THE
REGISTER OF NILLS AT THE
ABOVE ADDRESS. HAKE CHECK
OR HONEY ORDER PAYABLE TO:
"REGISTER OF NILLS, AGENT."
PAYHENT RECEIPT DISCOUNT (+)
DATE NUHBER INTEREST/PEN PAID (-) AHOUNT PAID
INTEREST IS CHARGED THROUGH 05-16-2004 TOTAL TAX CRED'rT
AT THE RATES APPLICABLE AS OUTLINED ON THE ~ALANCE OF TAX DUE
REVERSE SIDE OF THIS FORH INTEREST AND PEN.
TOTAL DUE
~ IF pAID AFTER THIS DATE, SEE REVERSE FOR CALCULATZON OF ADDITTONAL ZNTEREST. ~
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REI~UZRED.
ZF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND.
SEE REVERSE SIDE OF THZS FORN FOR INSTRUCTIONS. )
.00
100.77
1.95
102.70
BUREAU OF TNDTVTDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
HELEN J GARRETT
I S SEASONS DR
DILLSBURG
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRATSEHENT. ALLONANCE OR DISALLONANCE
OF DEDUCTIONS, AND ASSESSHENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
Rc,r..;:or~_~:. :;).~DATE O$-08-ZOOq
R~;~' ';;!~- ESTATE OF LUTZ
DATE OF DEATH 01-15-2005
FILE NUMBER ZZ 05-0092
· aCpUNTY
'0~ MAR-5 P3.,~SSN/DC
ACN
CUMBERLAND
170-05-6870
0511qq90
Amount Remi'l:~:ed
REV-1;~8 EX &FP COl-OS)
HELEN C
PA 1701t~t5:i~-: .,: ~
HAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~'- RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1548 EX AFP (01-03)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 05-08-200q
ESTATE OF LUTZ HELEN C DATE OF DEATH 01-15-2003 COUNTY CUMBERLAND
FILE NO. 21 05-0092 S.S/D.C. NO. 170-05-6870 ACN 0511~90
TAX RETURN WAS: iX) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. ~8598-05
TYPE OF ACCOUNT: (~ SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 08-0~-1988
Account Balance
Percent Taxable X 0.166
Amount Subject to Tax 5,109.56
Debts and Deductions - .00
Taxable Amount 5,109.56
Tax Rate X .q5
Tax Due 159.95
TAX CRED'rTS:
18,656.98 NOTE:
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF gILLS, AGENT."
PAYMENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
INTEREST IS CHARGED THROUGH 05-16-200q TOTAL TAX CREDIT I
I
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE
REVERSE SIDE OF THIS FORH INTEREST AND PEN.
TOTAL DUE
~ IF PAID AFTER THTS DATE, SEE REVERSE FOR CALCULATION OF ADDTTZONAL INTEREST. ~
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REI~UZRED.
ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT" (CR), YOU NAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. )
.00
159.95
2.68
lqZ.61
BUREAU OF TNDIVTDUAL TAXES
TNHERITANCE TAX DIVTSZON
DEPT. 280601
HARRTSBURG, PA 171Z8-0601
BARRY L LUTZ
918 LORING LN
HECHANICSBURG
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS, AND ASSESSHENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
...... ~ATE O$-08-ZOOq
R~.~i ~-~ i '~iESTATE OF LUTZ
DATE OF DEATH 01-13-Z005
FILE NUH~ER Z1 03-0092
D~¢~NTY
'04 MAR -D
ACN
PA 17055 Cie;~,
CUHBERLAND
170-05-6870
0311qq91
Amoun'l: Rem J.'~'~ed
HELEN C
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS
REV-1548 EX AFP
NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 03-08-ZOOq
ESTATE OF LUTZ HELEN C DATE OF DEATH 01-13-Z003 COUNTY CUMBERLAND
FILE NO. 21 03-0092 S.S/D.C. NO. 170-05-6870 ACN 0311~91
TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. ~8598-05
TYPE OF ACCOUNT: ¢~ SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 08-0~-1988
Accoun~ Balance
Percen~ Taxable X 0.166
Amoun~ Sub~ec~ ~o Tax 3,109.56
Debts and Deductions - .00
Taxable Amoun~ 3,109.56
Tax Ra~e X .q5
Tax Due 139.93
TAX CREDITS:
18,656.98 NOTE:
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT ¢+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
INTEREST IS CHARGED THROUGH 03-16-Z00~ TOTAL TAX CREDIT
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE
REVERSE SIDE OF THIS FORM TNTEREST AND PEN.
TOTAL DUE
~ ZF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. a
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
TF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND.
SEE REVERSE S/DE OF THIS FORM FOR INSTRUCTIONS. )
.00
139.93
2.68
1qZ.61
BUREAU OF ZNDTVTDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. ZSOGD1
HARRISBURG, PA 171Z6-0601
BARRY L LUTZ
918 LORING LN
MECHANICSBURG
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAZSEHENT. ALLOHANCE OR DZSALLOHANCE
OF DEDUCTIONS, AND ASSEBSHENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
~GOr~ ~ DATE 05-08-2004
Re,? ~, ~ ESTATE OF LUTZ
,-~ "~ DATE OF DEATH 01-15-2003
FILE NUMBER Z1 03-0092
COUNTY CUMBERLAND
'04 MAR -5 P3:4 SN/nC tTO-O5- 8;O
ACN 0~11~q9~
Amoun~ Rmmi~ed
HELEN
I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
C
CUT ALONG THIS LINE ~'- RETAIN LOWER PORTION FOR YOUR RECORDS "~
- - f ...................................................................................
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON dOZNTLY HELD OR TRUST ASSETS
DATE 03-08-Z004
ESTATE OF LUTZ HELEN
C DATE OF DEATH 01-13-Z003 COUNTY CUMBERLAND
FILE NO. 21 03-0092 S.S/D.C. NO. 170-05-6870 ACN 0311~493
TAX RETURN WAS: ex) ACCEPTED AS FILED ( ) CHANGED
dOXNT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 48598-1!
TYPE OF ACCOUNT: ( ) SAVINGS C~ CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 08-16-1988
Account Balance
Percen~ Taxable X 0.166
Amoun~ Sub~ec~ to Tax $60.71
Debts and Deductions - .00
Taxable Amoun~ 360.71
Tax Ra~e
Tax Due 16.25
TAX CREDITS:
2,164.21 NOTE:
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF HILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT.**
PAYMENT
DATE
RECEIPT
NUMBER
DISCOUNT (+)
INTEREST/PEN PAID (-)
AMOUNT PAID
INTEREST IS CHARGED THROUGH 03-16-ZOOq TOTAL TAX CREDIT
AT THE RATES APPLICABLE AS OUTLINED ON THE !BALANCE OF TAX DUE
REVERSE SIDE OF THIS FORM ZNTEREST AND PEN.
TOTAL DUE
~ ZF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. )
.00
16.25
.31
16.54
BUREAU OF TNDZVZDUAL TAXES
TNHERZTANCE TAX D'rv'rsToN
DEPT. 280601
HARR'rSBURG, PA 171:~8-0601
HELEN J GARRETT
i S SEASONS DR
DILLSBURG
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAZSENENT. ALLORANCE OR DZSALLO#ANCE
OF DEDUCTIONS, AND ASSESSHENT OF TAX OR
JOINTLY HELD OR TRUST ASSETS
'~ MAR-5 P3:43
DATE 05-08-2004
ESTATE OF LUTZ HELEN
DATE OF DEATH 01-15-2005
FILE NUMBER Z1 05-009Z
COUNTY CUMBERLAND
SSN/DC 170-05-6870
ACN 05114492
Amoun~ Remi~ed I
HAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~" RETAIN LOWER PORTION FOR YOUR RECORDS ""~
REV-1548 EX AFP (01-03)
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DZSALLO#ANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 05-08-2004
ESTATE OF LUTZ
HELEN C DATE OF DEATH 01-15-2005 COUNTY CUMBERLAND
FILE NO. 21 05-0092 S.S/D.C. NO. 170-05-6870 ACN 05114492
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. 48598-11
TYPE OF ACCOUNT: ( ) SAVINGS (~ CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 08-16-1988
Accoun~ Balance 2,164.21
Percent Taxable X 0.166
Amoun~ Sub~ec~ ~o Tax 560.71
Debts and Deduc~/ons - .00
Ta×able Amoun~ 560.71
Tax Ra~e X .45
Tax Due 16.25
TAX CREDITS:
NOTE:
TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO:
"REGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
REVERSE SIDE OF THIS FORM
INTEREST IS CHARGED THROUGH 05-16-Z004 TOTAL TAX CREDIT
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
ZF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORH FOR ZNSTRUCTTONS. )
.00
16.25
.$1
16.54
COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
O '~'~ T. 280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 003821
WALTERS, MURREL R. III
54 EAST MAIN STREET
MECHANICSBURG, PA 17055
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
........ fold ..........
101 $52.48
ESTATE INFORMATION: SSN: 170-05-6870
FILE NUMBER: 21 03-0092
DECEDENT NAME: LUTZ HELEN C
DATE OF PAYMENT: 04/15/2004
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 01 / 13/2003
' TOTAL AMOUNT PAID' $52.48
REMARKS:
CHECK# 10563
INITIALS: JA
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
CONMONNEALTH OF PENNSYLVANIA
BUREAU OF INDTVZDUAL TAXES DEPARTMENT OF REVENUE
XNHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLONANCE OR DISALLONANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
REV-15~? EX AFP
/~ ' DATE Oq-12-ZOOq
* ~ ESTATE OF LUTZ HELEN C
DATE OF DEATH 01-15-2005
FILE NUMBER 21 03-009Z
15 CUMBERLAND
MURREL R NALTERS III ESQ ACN lO!
5q E MAIN ST
MECHANICSBUR6 PA 170~5 L: L~ Aeoun( Ree~((ed
/
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF MILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS
REV-1547 EX AFP (01-03} NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF LUTZ HELEN CFZLE NO. 21 03-009Z ACM 101 DATE Oq-lZ-ZOOq
TAX RETURN NAS: (X) ACCEPTED AS FTLED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) .00 HOTE: To insure proper
2. Stocks and Bonds (Schedule B) (2) . O0 credit to your account,
$. Closely Held Stock/Partnership Interest (Schedule C) ($) . O0 subeit the upper portion
q. Hortgeges/Notes Receivable (Schedule D) (q) .00 of this fore with your
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) ($) .00 tax payeent.
6. Jointly O~ned Property (Schedule F) (6) 5; 709.67
7. Transfers (Schedule G) (7) ~OZIO00.O0
8. Total Assets (8) 107,709.67
APPROVED DEDUCTIONS AND EXEMPTIONS:
9,Z55.00
9. Funeral Expenses/Ad,. Costs/His¢. Expenses (Schedule H) (9)
10. Debts/Mortgage Liabilities/Liens (Schedule T) (10) Z9 · 78~. 60
11. Total Deductions (11)
12. Net Velum of Tax Return (12) 68,671.07
15. Cheritable/Governeentel Bequests; Non-elected 9115 Trusts (Schedule J) (15) .00
lq. Net Value of Estate Sub,eot to Tax (lq) 68,671.07
NOTE: Z~ an assessment was issued previously, lines 1~, 15 and/or 16, 17, 18 and 19 w~11
re~lect flgures that lnclude the totaZ of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line lq et Spouse1 rate (15) .00 X O0 = .00
16. Amount of Line lq taxable at Lineal/Class A rate (16) 68,671.07 X Oq5 = 3,090.20
17. Amount of Line lq at Sibling rate (17) .00 X 1Z = .00
18. Amount of Line lq taxable at Co~laterel/Cless B rate (18) . O0 X 15 = .00
19. Principal Tax Due (19)= ~,090.ZO
FAX CREDITS:
PAYMENT RECEIPT D[SCOUNT (+)
DATE NUMBER TNTEREST/PEN PATD (-) AHOUNT PAID
OZ-ZS-ZOOq CD003598 .00 $,090.Z0
BALANCE OF UNPAID TNTEREST/PENALTY AS OF OZ-Z6-ZOOq TOTAL TAX CREDZT I 3,090.Z0
BALANCE OF TAX DUEI .00
INTEREST AND PEN. 5Z.q8
TOTAL DUE 5Z. q8
~ ZF pAID AFTER DATE ZNDTCATED~ SEE REVERSE ( TF TOTAL DUE TS LESS THAN $1, NO PAYMENT IS REi)UZRED.
FOR CALCULATTON OF ADDTTTONAL TNTEREST. TF TOTAL DUE IS REFLECTED AS A 'CREDTT' (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR TNSTRUCTTONS.)
RESERVATION: Estates of decedents dying on or before December 1Z, I98Z -- if any future interest in the estate is transferred
in possess[on or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawfut Class B (collateral) rate an any such future interest.
PURPOSE OF
NOTICE: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (72 P.S.
Section 9140).
PAYHENT: 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 NILLS, AGENT
REFUND (CR): 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-131$). Applications are available at the Office
of the Register of Nills, any of the 23 Revenue District Offices) or by calling the special Z4-hour
answering service for fores ordering: 1-800-36Z-lOS0; services for taxpayers with special hearing and / or
speaking needs: 1-800-447-3020 (TT only).
OBJECTIONS: 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 eithin sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-10Z1, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
ADNIN-
ISTRATIVE
CORRECTIONS: 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, Dept. Z80601, Harrisburg, PA 171Z8-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-IS01) for an explanation of administratively correctable errors.
DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (SI) discount of
the tax paid is allowed.
PENALTY: The 151 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. 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: 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, 1982 bear interest at the rate of
six (OZ) 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 wilI vary from calendar year to calendar year with that rate
announced by the PA Deparbaent of Revenue. The applicable interest rates for 198Z through ZOO4 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1982 20X .000548 ~)'~'8-1991 11Z .000501 ~"~ 9Z .000247
1983 16Z .000438 199Z 92 .000247 ZOOZ 6Z .000164
1984 112 .000301 1993-1994 72 .O00lgz 2003 5Z .000137
1985 132 .000356 1995-1998 9Z .000Z47 2004 42 .000110
1986 lOZ .000274 1999 72 .00019Z
1987 IOZ .000274 ZOO0 7Z .000192
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY 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.
COMMONNEALTH OF PENNSYLVANTA
BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE
TNHERTTANCE TAX DTVZSTON
DEPT. 280601 '
HARRISBURG, PA 17128-0601 INHERITANCE TAX
RECORD ADJUSTHENT
JOINTLY HELD OR TRUST ASSETS
R~2¢:,,:~ ~DATE 04-08-200~
~ -ESTATE OF LUTZ HELEN C
DATE OF DEATH 01-15-2005
FILE NUMBER 21 05-0092
COUNTY CUMBERLAND
BARRY L LUTZ '04 J~R 2(}. i',~] ~q/DC 170-05-6870
918 LORING LN ACN 0:511~.489
MECHANICSBURG PA 17055~./ ~ Amount: Remi'l:'ted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF gILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS
REV-1604 EX AFP (01-03)
~ INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS
DATE 04-08-200~
ESTATE OF LUTZ HELEN C DATE OF DEATH 01-15-2005 COUNTY CUMBERLAND
FILE NO. 21 05-0092 S.S/D.C. NO. 170-05-6870 ACN 0~11~89
ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION
dOZNT OR TRUST ASSET ZNFORNATZON
FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT NO. ~8598-41
TYPE OF ACCOUNT: ¢ ) SAVINGS ( ) CHECKING ¢ ) TRUST (X) TIME CERTIFICATE
DATE ESTABLISHED 12-18-1998
Account Balance .00 NOTE: TO INSURE PROPER CREDIT TO YOUR
Percen~ Taxable X O. 166 ACCOUNT, SUBMTT THE UPPER PORTION
Amoun~ Sub~ec'c 'co Tax .00 OF THIS NOTICE NZTH YOUR TAX
Deb'cs and Deduc'cions - .00 PAYNENT TO THE REGISTER OF NZLLS
Taxable Amoun'c .00 AT THE ADDRESS SHONN ABOVE.
Tax Ra'ce X .~5 HAKE CHECK OR HONEY ORDER PAYABLE
Tax Due .00 TO: 'REGISTER OF NZLLS, AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUEI
.00
INTEREST AND PEN.
TOTAL DUE / .00
IF PAID AFTER THIS DATE~ SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .0§
ZF TOTAL DUE ZS LESS THAN $1~ NO PAYHENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT' (CR}~
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
PAYNENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address
printed on the reverse side.
-- Hake check or money order payable to: REGXSTER OF HILLS, AGENT.
REFUND (CR): A refund of m 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 ars available at
the Office of the Register of #ills, any of the 25 Revenue District Offices or from the Department's iq-hour
answering service for forms ordering: 1-DO0-36Z-ZO50; services for taxpayers Nith special hearing
and / or speaking needs: 1-800-q~7-3010 (TT only).
REPLY TO: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau
of Individual Taxes, ATTN: Past Assessment Review Unit, Dept. 180601, Harrisburg, PA 17118-0601, Phone
(717) 787-6505.
DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (51) discount
of the tax paid is allowed.
PENALTY: The 151 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 and 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 1, 1981 bear interest at the rate of
six (61) percent par annum calculated at a daily rate of .D0016~. A11 taxes which became deIinqusnt on and after
January 1, 1982 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 1982 through Z003 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1982 202 .0005q8 1987 91 .0002~,7 1999 72 .00019;'
1983 162 .000q.38 1988-1991 llZ .000301 2000 82 .000219
198~ 112 . O003OX 1992 92 .0002~7 ZOOX 91 . O00Zq7
1985 132 .000356 1993-1994 72 .000192 2001 62 .O0016q
1986 lOX .O00Z7q 1995-1998 92 .000247 2003 52 .000137
--Xntarest is calculated as follows:
TNTEREST = BALANCE OF TAX UNPATD X NUHBBR OF DAYS DELTN{IUENT X DAILY 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 bm calculated.
COHNONNEALTH OF PENNSYLVANIA
BUREAU OF INDIVIDUAL TAXES DEPARTHENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT. ZB060I *
HARRXSBURG, PA X?XZB-OGOX INHERITANCE TAX
RECORD ADdUSTNENT
dOZNTLY HELD OR TRUST ASSETS
DATE 0~-08-200~
:',~:~, ESTATE OF LUTZ HELEN C
DATE OF DEATH 01-15-2005
FILE NUNBER Z! 05-0092
'04 tCR 20 ~}i :~ COUNTY CUNBERLAND
BARRY L LUTZ SSN/DC 170-05-6870
918 LORING LN ACN 0511~9Z
NECHANICSBURG PA 1~,~.,~5, Amoun~ Remi~ed
I
HAKE CHECK PAYABLE AND RENZT PAYHENT TO:
REGISTER OF NILLS
CUNBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LOHER PORTION FOR YOUR RECORDS ~
REV-160~ EX AFP (01-03)
~# INHERITANCE TAX RECORD ADJUSTNENT JOINTLY HELD OR TRUST ASSETS ~#
DATE 0~-08-200~
ESTATE OF LUTZ HELEN C DATE OF DEATH 0Z-15-200S COUNTY CUNBERLAND
FILE NO. 21 05-0092 S.S/D.C. NO. 170-05-6870 ACN 0511~q91
ADJUSTNENT BASED ON: ADNINISTRATIVE CORRECTION
dOZNT OR TRUST ASSET ZNFORNATZON
FINANCIAL INSTITUTION: NENBERS 1ST FCU ACCOUNT NO. ~8598-05
TYPE OF ACCOUNT: (X) SAVINGS ( ) CHECKING ( ) TRUST ( ) TINE CERTIFICATE
DATE ESTABLISHED 08-0q-1988
Account Balance .00 NOTE: TO INSURE PROPER CREDIT TO YOUR
Percent Taxable X 0.166 ACCOUNT, SUBNZT THE UPPER PORTION
Amount Sub~ect to Tax .00 OF THIS NOTICE gZTH YOUR TAX
Debts and Deduct/ohs - .00 PAYNENT TO THE REGISTER OF #ILLS
Taxable Amount . O0 AT THE ADDRESS SHO~/N ABOVE.
Tax Rate X. .c~5 HAKE CHECK OR HONEY ORDER PAYABLE
Tax Due .00 TO: 'REGISTER OF ~/ZLLS, AGENT."
TAX CREDITS:
PAYHENT RECEIPT DISCOUNT (+)
DATE NUNBER INTEREST/PEN PAID (-) ANOUNT PAID
TOTAL TAX C.EDZTI .00
BALANCE OF TAX DUEI
I
.00
INTEREST AND PEN. J
.00
TOTAL DUE
ZF PAID AFTER THIS DATE~ SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .00
ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REgUZRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT" (CR),
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to tho name and address
printed on the reverse side.
-- Make check or money order payable to: REGISTER OF WILLS, AGENT.
REFUND (CR): A refund of a tax credit, ahich 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 tho Register of Wills, any of the Z3 Revenue District Offices or fram the Department's Z~-hour
answering service for forms ordering: 1-800-56Z-ZOSO; services for taxpayers with special hearing
and / or speaking needs: 1-800-qqT-3OZO iTT only).
REPLY TO: Ouastions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau
of individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z&0601, Harrisburg, PA 171ZB-060l, Phone
I717) 787-6S05.
DISCDUNT: If any tax due is paid aithin three (3) caZandar months after the dacedont's death, a five percent (SI) discount
of the tax paid is allowed.
PENALTY: The leg tax amnesty non-participation penalty is computed on tho total of the tax and interest assessed, and not
paid before January 18, 1996, tho first day after the end of the tax amnesty period.
INTEREST: Interest is charged beginning with first day of delinquency or nine I93 months and one ill day from tho date of
death to the date of payment. Taxes ahich became delinquent before January l, 198Z bear interest at tho rate of
six (SI) percent par annum calculated et a daily rate of .O0016q. All taxes which became delinquent on and after
January 1, 1982 will bear interest at a rate which will vary from calendar year to caZendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 198Z through Z003 are:
Interest Dally Interest Dally Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
198Z 20Z .0005q8 1987 9Z . O00gq7 1999 7Z .000192
1983 167. .000~8 1988-1991 117. .000301 ZOO0 87. .000219
198q llT- .000301 199Z 97- . O00Zq7 ZOO1 97- . O00Zq7
1985 137- .000356 1993-199q 77. .O0019Z ZOOZ 67. .000164
1986 107. .O00Z7q 1995-1996 97. .O00Zq7 ZOO3 57. .000137
--Interest is calculated as follows:
/NTEREST = BALANCE OF TAX UNPA/D X NUIqBER OF DAYS DEL/NQUENT X DA/LY /NTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen i15) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must bm calculated.
COHHONHEALTH OF PENNSYLVANZA
BUREAU OF ZNDZVZDUAL TAXES DEPARTHENT OF REVENUE
ZNHERZTANCE TAX DZV/SZON
DEPT. 280601 ~
HARRZSBURG, PA 17128-0601 ZNHERZTANCE TAX
RECORD ADdUSTHENT
JOZNTLY HELD OR TRUST ASSETS
r~:~_~ i DATE 0~-08-200~
i: .... : ESTATE OF LUTZ HELEN C
DATE OF DEATH 01-13-2005
FZLE NUNBER 21 03-0092
COUNTY CUHSERLAND
· ~ SSN/DC 170-05-6870
BARRY L LUTZ '0~, APR 20 Ail' ~
918 LORZNG LN ACN 03114493
NECHANZCSBUR$ pA~..7055 Amoun~ Remi~ed
HAKE CHECK PAYABLE AND REHXT PAYHENT TO:
REGISTER OF N~LLS
CUH~ERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THZS LZNE ~ RETAZN LOgER PORTZON FOR YOUR RECORDS ~
REV-160~ EX AFP (01-03)
#~ ZNHERZTANCE TAX RECORD ADJUSTHENT JOZNTLY HELD OR TRUST ASSETS ~
DATE 04-08-2004
ESTATE OF LUTZ HELEN C DATE OF DEATH 01-13-2003 COUNTY CUHBERLAND
FZLE NO. 21 03-0092 S.S/D.C. NO. 170-05-6870 ACN 03114493
ADJUSTHENT BASED ON: ADNZNZSTRATZVE CORRECT,ON
dOZNT OR TRUST ASSET ZNFORNATZON
FZNANC~AL INSTZTUTION: NEHBERS 1ST FCU ACCOUNT NO. 48598-11
TYPE OF ACCOUNT: ( ) SAVZNGS (X) CHECKZNG ( ) TRUST ¢ ) TZNE CERTIFZCATE
DATE ESTABLISHED 08-16-1988
Accoun~ lialance .00 NOTE: TO TNSURE PROPER CREDZT TO YOUR
Percent Taxable X. O. 166 ACCOUNT~ SUBHZT THE UPPER PORT]:ON
Amoun'c Sub.~ect ~o Tax .00 OF THTS NOTZCE ~/TTH YOUR TAX
Debts and Deduc~cions - .00 PAYHENT TO THE REG]:STER OF NZLLS
Taxable Amoun~ .00 AT THE ADDRESS SHONN ABOVE.
Tax Rate X .45 HAKE CHECK OR HONEY ORDER PAYABLE
Tax Due .00 TO: "REGZSTER OF N'rLLS, AGENT."
TAX CREDZTS:
PAYHENT RECETPT DTSCOUNT (+)
DATE NUNSER TNTEREST/PEN PATD (-) ANOUNT PAZD
TOTAL TAX CREDZT I .00 )
BALANC[ OF TAX DUEI
~NTEREST AND PEN. J .00
TOTAL DUE J .00
~F PAZD AFTER TH~S DATE] SEE REVERSE FOR CALCULATZON OF ADDZTZONAL ZNTEREST. ,00
~F TOTAL DUE ~S LESS THAN $1) NO PAYHENT 1S REQUIRED. IF TOTAL DUE ZS REFLECTED AS A "CREDZT" (CR))
YOU HAY BE DUE A REFUND. SEE REVERSE S/DE OF TH~S FORN FOR INSTRUCTZONS.~ ~
REV-1470 EX (6-88)
INHERITANCE TAX
COMMONWEALTH OF PENNSYLVANIA EXPLANATION
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES OF CHANGES
DEPT. 280601
HARRISBURG PA 17128-0601
DECEDENT'S NAME
REVIEWED BY Helen Lutz ~
Emerson Luciano ~~
L-~~ I See Below
SCHEDU . EXPLANATION OF CHANGES
The above referenced ACH has been reduced to zero, as this account
was reported on the probate return.
ACH # 03114489, 03114491 and 03114493
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.
-- Make check or money order payable to: REGISTER OF #ILLS, AGENT.
REFUND (CR): A refund of a tax credit) which was not requested on the Tax Return, may be requested by completing an
"Application for Refund cf PannsyZvania Inheritance and Estate Tax" [REV-13133. AppZications ara available at
the Office of the Register of Wills, any of the Z3 Revenue District Offices or from the Department's gq-hour
answering service for fores ordering: I-BgO-36Z-Z050; services for taxpayers with special hearing
and / or speaking needs: 1-BOO-qq7-3OZO (TT only).
REPLY TO: guestions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau
of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. ZB0601, Harrisburg, PA 171g8-0601) Phone
(7173 787-6505.
DISCOUNT: If any tax due is paid within three (3] calendar months after the decedent's death, a five percent (5Z] discount
of the tax paid is allowed.
PENALTY: The lex 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 (1) day from the date of
death to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of
six (GZ) percent per annum calculated at a daily rate of .000164. Al1 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 rata
announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOO3 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1982 ZOZ . OOOSq8 1987 92 .0002~,7 1999 72 .000192
1983 16Z .O00q3& 1988-1991 llZ .000301 gO00 8Z .000Z19
198~, 11Z .000301 1992 9Z . O00Zq7 ZOO1 9Z . O00Zq7
1985 132 .000356 1993-199q 72 .00019Z ZOOZ 62 . O0016q
1986 log .O00Z7~, 1995-1998 9Z .000247 ZOO3 57. .000137
--Tnterest is calculated as follows:
XNTEREST = BALANCE OF TAX UNPAID X NUHBBR OF DAYS DELXNQUENT X DAILY TNTEREST 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.
COMMONWEALTH OF PENNSYLVANIA ~L_
BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT. Z80601 INHERITANCE TAX
HARRISBURg, PA 171Z8-060!
STATEHENT OF ACCOUNT
REV-i~O? EX AFP (01-03)
DATE 05-2~-2004
ESTATE OF LUTZ HELEN C
DATE OF DEATH 01-15-2005
FILE NUMBER Z1 05-0092
'04 d~i~ -7 ~ ~ :*~OUNTY CUMBERLAND
MURREL R WALTERS III ESQ ACN 101
54 E MAIN ST Amoun~ Rem/~ed
MECHANICSBURG PA 17055 =
HAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
NOTE: To insure proper credi~ ~o your account, submi~ ~he upper por~ion of ~his fore wi~h your ~ax payment.
CUT ALONG THIS LZNE ~' RETAIN LOWER PORTION FOR YOUR RECORDS -~
REV-1607 EX AFP (01-03) ### INHERITANCE TAX STATEMENT OF ACCOUNT xxx
ESTATE OF LUTZ HELEN C FILE NO. 21 05-009Z ACN 101 DATE 05-Z4-Z004
TH'rS STATEHENT TS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN TN THE NAHED ESTATE. SHO#N BELO#
TS A SUHHARY OF THE PR'fMC/PAL TAX DUE., APPL/CATZON OF ALL PAYMENTS, THE CURRENT BALANCE, AND, TF APPL'rCABLE,
A PROJECTED TNTEREST FTGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 04-12-2004
PRINCIPAL TAX DUE= ........................................................................................................................................................................................................................... $,090.20
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
02-25-2004 CD003598 .00 3,090.Z0
0~-15-2004 CD003821 52.48- 52.~8
TOTAL TAX CREDIT 3,090.20
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
ZF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE . O0
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
ZF TOTAL DUE Z$ LESS THAN $1,
NO PAYHENT ZS RE{)UZRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR),
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. )
PAYHENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address
printed on the reverse side.
-- If RESIDENT DECEDENT make check or money order payable to: REG/STER OF #ILLS, AGENT.
-- If NON-RESIDENT DECEDENT make check or money order payable to: CONNON#EALTH OF PENNSYLVANIA.
REFUND (CR): A refund of · 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 Wills, any of the 23 Revenue District Offices or from the Department's Z~-hour
answering service for forms ordering: 1-800-362-Z050; services for taxpayers with special hearing and / or
speaking needs: 1-800-q~7-3020 (TT only).
REPLY TO: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau
of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601) Harrisburg, PA 17128-0601, phone
(717) 787-6505.
DISCOUNT: If any tax due is paid within three (3) calendar months after the decedant's death, a five percent (SZ) discount
of the tax paid is aIlowed.
PENALTY: The 15Z 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.
TNTEREST: 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 daIinquent before January 1, 1982 bear interest at the rate of
six (62) percent par 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 from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2004 are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1982 202 .000548 1988-1991 llZ .000301 2001 92 .000Z47
1983 16X .000~38 1992 92 .000247 ZOOZ 62 .00016~
1984 llZ .000301 1993-1994 72 . O0019Z 2003 52 .000137
1985 13Z .000356 1995-1998 92 .000Z~7 Z004 ~Z .000110
1986 lOZ .000274 1999 72 .000192
1987 92 . OOOZ~7 2000 82 .000219
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DA/LY 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
Notlca, additlonal interest must bo calculated.
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 12/01/2004
WALTERS, MURREL R. III
54 EAST MAIN STREET
MECHANICSBURG, PA 17055
RE: Estate of LUTZ HELEN C
File Number: 2003-00092
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of complete~ or uncompleted administration.
This filing will become delinquent on: 1/13/2005
Your prompt attention to this matter wilt be appreciated.
Thank You.
Sincerely,
GLENDA FARNER STRAS~GH
REGISTER OF WILLS
cc: File
Personal Representative(s)
Judge
PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF
THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY
UNTIL COMPLETION
STATUS REPORT UNDER RULE 6.12
Name of Decedent: HELEN C. LUTZ
Date of Death: January 13, 2003
Estate No.: 2003-00092
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 administration of the estate is complete:
Yes ~/' No
2. If the answer is No, state when the personal representative reasonably believes that the
administration will be complete
(date)
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 Orphans' Court No. (if any) for the personal representative's
account is: (Not Applicable in Dauphin County)
C. Did the personal representative state an account infbrmally to the parties
in
interest: Yes __X__ No
D. Copies of receipts, releases, joinders and approvals of formaFbr informal
accounts may be filed with the Clerk of the Orphans' Co~a~'~ and may be
attached to this report. , /' ,/~::~
,! /./ ~/;
DaR Dece~er 3, 20~4
~ ~: ~ ~ MURREL R. WALTERS, III, ESQUIRE
t~:: ~ ~= ~ ~, 54 East Main S~eet
~ ...... ~-~: ~ ~ xc ~ Mechanicsburg, PA 17055
~z~, ~ ~ ~; 717-697-4650
c~ ~ ~~ Capacity: Personal Representative
X Counsel for Personal Representative
Name of Decedent:
STATUS REPORT UNDER RULE 6.12
fl,.etJ ~ \.,JlL-
f - t 'S> - 2..Q:?>
Date of Death:
Will No.: ~ - 60070
Adnlln. No.:
Pursuant to Rule 6.12 of the Supreme Court Orpha.'1s' Court Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
1. State whether administration ofthe estate is complete:
Yes ~ No 0
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete:
3. lithe answer to No. I is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes 1- No 0
b. The separate Orphans' Court No. (if any) for the personal representative's
account is: ~
c. Did the personal representative state an account informally to the parties
in interest? Yes 0 No 001
c. Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the Orphans' Court
and may be attached to this report.
Date: --dJ105
Sign
Name
I,.,n
?r'6 (gLJIJP L.--..
Address
if1( - friO
Telephone No.
r0~tf.~ (~
C" '
Capacity: [jfPersonal Representative
o Counsel for personal representatIve
~
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES HTC)RDED GrFICE INHERITANCE TAX
INHERITANCE TAX DIVISION T(":n;:i STATEMENT OF ACCOUNT
PO lOX 210601 11[',.)1 J: c..i,
HARRISIURG PA 17121-0601
*
REV-1607 EX AFP (03-05)
2001 JUN 29 PM I: 24
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
06-18-2007
LUTZ
01-13-2003
21 03-0092
CUMBERLAND
03114492
HELEN
C
HELEN J
1 S SEASONS
DILLSBURG
CLERK OF
ORPHAN'S COURT
CLLltr:>~:r;1 ,\ ('fI P^,
GARIt~T ',,',', "- " I"'
DR
Amount Remitted
PA 17019
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 payment.
CUT ALONG THIS LINE
~
RETAIN LOWER PORTION FOR YOUR RECORDS
+-
REV-1607 EX AFP (03-05)
*** INHERITANCE TAX STATEMENT OF ACCOUNT ...
ESTATE OF LUTZ
HELEN
C FILE NO. 21 03-0092
ACN 03114492 DATE 06-18-2007
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY 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: 03-01-2004
PRINCIPAL TAX DUE: 16.23
PAYMENTS (TAX CREDITS):
INT
AT
REV
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
EREST IS CHARGED THROUGH 07-03-2007 TOTAL TAX CREDIT .00
THE RATES APPLICABLE AS OUTLINED ON THE
ERSE SIDE OF THIS FORM.. BALANCE OF TAX DUE 16.23
INTEREST AND PEN. 3.43
IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE 19.66
II
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" (CR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
~
BUREAU ,PF-.INDIVIDUAL TAXES
INHERitANCE TAx DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
RECORD ADJUSTMENT
JOINTLY HELD OR TRUST ASSETS
REV-160~ EX AFP (03-05)
V1
..., I' 7
,li
D'j !"'),
I II fL'
r) '~'j
....: .J
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
03-07-2008
LUTZ
01-13-2003
21 03-0092
CUMBERLAND
170-05-6870
03114490
HELEN
C
()P~
HELEN J GARRETT r',-' '
,~,
1 S SEASONS DR
DILLSBURG PA 17019
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE
--+ RETAIN LOWER PORTION FOR YOUR RECORDS
+-
-------------------------------------------------------------------------------------.--------------------------------------------------------------------.------
REV-1604 EX AFP (03-05)
__ INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS --
DATE 03-07-2008
ESTATE OF LUTZ
HELEN
C DATE OF DEATH 01-13-2003
COUNTY
CUMBERLAND
FILE NO. 21 03-0092
ADJUSTMENT BASED ON:
S.S/D.C. NO. 170-05-6870
ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
ACN
03114490
FINANCIAL INSTITUTION: MEMBERS 1ST FCU
ACCOUNT NO.
48598-05
TYPE OF ACCOUNT: (X) SAVINGS () CHECKING () TRUST () TIME CERTIFICATE
DATE ESTABLISHED 08-04-1988
Account Balance .00 NOTE: TO INSURE PROPER CREDIT TO YOUR
Percent Taxable X 1. 000 ACCOUNT, SUBMIT THE UPPER PORTION
Amount Subject to Tax .00 OF THIS NOTICE WITH YOUR TAX
Debts and Deductions .00 PAYMENT TO THE REGISTER OF WILLS
Taxable Amount .00 AT THE ADDRESS SHOWN ABOVE.
Tax Rate X .45 MAKE CHECK OR MONEY ORDER PAYABLE
Tax Due .00 TO: "REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED, IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), ~U
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
REV-1470 EX (6-88)
'* INHERITANCE TAX
. -
EXPLANATION
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
PO Box. 280601
HARRISBURG PA 17128-0601
DECEDENT'S NAME FILE NUMBER
Helen Lutz 2103-0092
REVIEWED BY ACN
Eunice Baker 03114490
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
The above account has been adjusted to zero. The account was reported on the probate
retu rn.
ROW
Paqe 1
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
RECORD ADJUSTMENT
JOINTLY HELD OR TRUST ASSETS
'*
f"",
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
'.",:' 17
, "
:j \:1:
.~: ../
,-'" r-'
r::r"
HELEN J GARREJ,T~' ,
1 S SEASONS DR
DILLSBURG PA 17019
REV-1604 EX AFP (03-05)
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
03-06-2008
LUTZ
01-13-2003
21 03-0092
CUMBERLAND
170-05-6870
03114488
HELEN
C
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE
--+ RETAIN LOWER PORTION FOR YOUR RECORDS
~
--------------------------------------------------.--------------------....-------...--------...--------..........................................................
REV-1604 EX AFP (03-05)
__ INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS --
DATE 03-06-2008
ESTATE OF LUTZ
HELEN
C DATE OF DEATH 01-13-2003
COUNTY
CUMBERLAND
ACN
03114488
ADJUSTMENT BASED ON:
S.S/D.C. NO. 170-05-6870
ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
FILE NO.
21 03-0092
FINANCIAL INSTITUTION: MEMBERS 1ST FCU
ACCOUNT NO.
48598-41
TYPE OF ACCOUNT: () SAVINGS () CHECKING () TRUST (X) TIME CERTIFICATE
DATE ESTABLISHED 12-18-1998
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
.00
1. 000
.00
.00
.00
.45
.00
TAX CREDITS:
NOTE: TO INSURE PROPER CREDIT TO YOUR
ACCOUNT, SUBMIT THE UPPER PORTION
OF THIS NOTICE WITH YOUR TAX
PAYMENT TO THE REGISTER OF WILLS
AT THE ADDRESS SHOWN ABOVE.
MAKE CHECK OR MONEY ORDER PAYABLE
TO: "REGISTER OF WILLS, AGENT."
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE ,DO
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
"-.--1)
REV.1470 EX (3-88, , .
INHERITANCE TAX
EXPLANATION
OF CHANGES
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
PO Box. 280601
HARRISBURG PA 17128-0601
DECEDENT'S NAME
FILE NUMBER
REVIEWED BY
ACN
2103-0092
03114488
Helen Lutz
Eunice Baker
ITEM
SCHEDULE NO.
EXPLANATION OF CHANGES
The above account has been adjusted to zero. The account was reported on the probate
return.
ROW
Paqe 1
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRIS8URG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
RECORD ADJUSTMENT
JOINTLY HELD OR TRUST ASSETS
REV-1604 EX AFP (03-05)
HELEN J GARRETT
1 S SEASONS DR
DILLSBURG PA 17019
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
03-10-2008
LUTZ
01-13-2003
21 03-0092
CUMBERLAND
170-05-6870
03114492
Amount Remitted =:]
HELEN
C
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE
--+ RETAIN LOWER PORTION FOR YOUR RECORDS
+-
----------------------------------------------------------------------------------------------------------------------------------------------------------.-------
REV-1604 EX AFP (03-05)
** INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS **
DATE 03-10-2008
ESTATE OF LUTZ
HELEN
C DATE OF DEATH 01-13-2003
COUNTY
CUMBERLAND
FILE NO.
21 03-0092
S.S/D.C. NO. 170-05-6870
ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
ACN
03114492
ADJUSTMENT BASED ON:
FINANCIAL I NST I TUT I ON: MEMBERS 1ST FCU
ACCOUNT NO.
~18598-11
TYPE OF ACCOUNT: () SAVINGS (X) CHECKING () TRUST () TIME CERTIFICATE
DATE ESTABLISHED 08-16-1988
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
.00
1.000
.00
.00
.00
.45
.00
NOTE: TO INSURE PROPER CREDIT TO YOUR
ACCOUNT, SUBMIT THE UPPER PORTION
OF THIS NOTICE WITH YOUR TAX
PAYMENT TO THE REGISTER OF WILLS
AT THE ADDRESS SHOWN ABOVE.
MAKE CHECK OR MONEY ORDER PAYABLE
TO: "REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT
DATE
RECEIPT
NUMBER
DISCOUNT (+)
INTEREST/PEN PAID (-)
AMOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
~oo
.00
.00
4
* IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ,
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
REV-1470 EX (6-88)
INHERITANCE TAX
EXPLANATION
OF CHANGES
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
PO Box. 280601
HARRISBURG PA 17128-0601
DECEDENT'S NAME
Helen Lutz
FILE NUMBER
Eunice Baker
ACN
2103-0092
03114492
REVIEWED BY
ITEM
SCHEDULE NO.
EXPLANATION OF CHANGES
The above account has been adjusted to zero. The account was reported on the probate
return.
ROW
Paqe 1