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Home My WebLink About03-0620PETITION FOR PROBATE and GRANT OF LETTERS Estate of' K ~ ~f' ~-I ~_ IL) Ioi I t th t~ No. also known as f~) [' {~ ...... To: Deceased. Social Security No. [. ~ ,~ " ~ 7- - l..! t...~ ~ 7' The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years o f age or older a,,~,h~e~,~ut in the last wilt of the above.decedent, dated i ~/ and codicil(s) dated ~xJ 0 /~J ~' Register of Wills for the County of Q 0 04 l~ff-~-~/Aff4~i_ 'n the Commonwealth of Pennsylvania named Decendent was dom~i[j~TZ~cti7 ~~u h ~' ~ last family or principal residence at Z~ Z: O' t ~ ~ ~$3L ~. . (list street, number and muncipality) at 0 ~ ~T~ t ' n~ divorce~ and ~id not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiCiled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: c~' l J-- bt~l~ ~ f:~/~ I/1) ~- 'TO ~/A/~ WHEREFORE, petitioner(s) respectfully presented herewith and the grant of letters theron. ~ O request(s) the 12lobate of the last will and codicil(s) (testamentary; administration c~.t.a.; administration d.b.n.c.t.a.) OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA } ss COUNTY OF Q The petitioner(s) above-named swe~(s) or affirm(s) that the statements in the foregoing petition are true and correct 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 truly administer the estate according to law. Sworn to or affirmed ,and subscribed ~ ~~~'~~~' .m ~~~/ before; t~- --3Ot~ day of / ~" --~~'~' ~[/~' l~ ~ 2003 / ~ ~ ~~~//~~,,~_~~ ~'~,,~ ~ ~,-~)~ RegisterS, ~ No. 21-2003-620 Estate Of ~u~ i. NAILOR , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW July 30th xi:9 2003.., in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated January_ ] 7t-h: 90131 described therein be admitted to probate and filed of record as the last will of Ruth I. Nail]or ; and Letters Test/~nentary are hereby granted to Reba Nailor McDonald and Nevin i'.. NM ] o,- FEES Probate, Letters, Etc .......... $ 235.00 Short Certificates(3) .......... $ 9.00 ~. o{ .,-. Pages..(.2)$ 6.00 JCP $ 10.00 TOTAL __ $ 260.00 Filed .... JUly. 30 th,. 2003 ............. Mailed Letters to Attornev on 7/30/03 Donna m. Otto,lst Deputy rD ~^{[~O~¥ (sup. ct. ~.D. ADDRESS PHONE W '""xlaw' depose(s) and say(s) that '",,,~ x.x,,,,x ~present arr~aw the t~__, sign the same and that~ '""'x_signed asa witness at the request o~.stat . in h presence and'~he presence of each other~the presence of the i~~~i~ s~iiab f~i)b s c r i bed ~:~°~ ~ (Name) x~~ · ~9 - ~ ddress · (Address) 21-2003-620 REGISTER OF WILLS OF C~ L) Vt4, ~t.~t'~COUNTY OATH OF NON-SUBSCRIBING WITNESS (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that ~-~ LJ a~e familiar with the signature of testat ~}~.,of (iglazm~fx:~ -- ' he will presented herewith and that ~ (-~/~. ~/ believe~tthe signature on the will is in the handwriting of /' Ruth I. Na±lor to the best of o~r knowledge and belief. Sworn to or affirmed and subscribed before me this 30~h day of ~ ~ i o .- rName) ~ 'July ~nna M. Otto, lst'~ut~ (Name) his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as l.ocal Registrar.' The original certificate will be forwarded to the State Vital Records Office for permanent ~ling. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee ~br this certificate, $2.00 Local Registrar 21-2003-620 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH (Coroner) Ruth W. Nailor I" I" ' ........ I" July 18~ 2~3 93 Feb 26, 1910 Pennsylvama ~,~ ~,~ ~ ~Q ~ ~ m a~ J~. I~ u .~ ~ ~,. Dau~in ~y ~. Hershey M~i~l ~ter ~ ~,~ j(s~,,~ ~ite ~;~"'~ Textile ~ ~ ,o ~ I ~ea~Iress ~~ p~) j j ~m~.~,.~ ~. --I 14. OIIVel Opllll~ /wp. 36 Cumberland Ddve ~s,~E ~ Mechanicsburg, Pa. 17050 (~ Cumberland ~, ~.~ ~.~.,s.~..~,~ John H. Wagner I~THER'SN~,~.~) Ivy Green ,~m~'~a,~r,;4 R~ba N McDonald ~~~sbur~, Pa ~ 7050 ~ ~ 3u122, 2003 ~ kon~do~ Comste~ ~ew Km~stown, ,~. ~ 7072 FD-0~ 2~2-[ ~. ~v~r, [un~r~l ~m~, Inc. ~7 fia*t ~am StroeI ~echamc~bur~, ~a 17055 p.m. I Y ........ ~,~)~ . ~li~tions o~ short pr~edure skin graft ~SA s.,.~,~-- ,. Bu~s over 17% of ~y caught in fire 'ME~ BAMIN~ [1~ T~ M P~ '"' - ....................................................................................................... ~ ..1271 S. 28th St., ~rris~rg~ PA 17111 OF RUTH _I. NAILOR I, RUTH I. NAILOR, of Silver Spring Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all prior wills by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can be conveniently done. 2. I direct that there shall be paid out of my residuary estate all estate, inheritance and like taxes together with any interest or penalty thereon imposed by the Government of the United States, or any state or territory thereof, or by any foreign government or political subdivision thereof, in respect to all property required to be included in my gross estate for estate, inheritance or like tax purposes by any of such governments, whether the property passes under this will or otherwise. -1- I give and bequeath the sum of One Thousand ($1,000.00) Dollars apiece, to each of my following named grandchildren and great-grandchildren, if they survive me, to wit: my grandson, NEVlN L. NAILOR, JR.; my granddaughter, SHARON L. McDONALD; my great-grandson, EVAN M. KAISER; my granddaughter, BARBARA A. DELGADO; my granddaughter, KATHLEEN M. McDONALD; my great-granddaughter, KELLY A. McDONALD; my great-granddaughter, KERRI E. McDONALD; my granddaughter, NANCY A. GONZALEZ; my great-granddaughter, JOSE R. GONZALEZ; and my great-granddaughter, ANNA M. GONZALEZ. o All the rest, residue and remainder of my estate, real, personal and mixed, I give, devise and bequeath in equal shares to my two children, REBA NAILOR McDONALD and NEVIN L. NAILOR. In the event REBA NAILOR McDONALD predeceases me, her share shall not lapse, but pass instead as follows: A.) To her husband, JASPER R. McDONALD, the sum of Two Thousand ($2,000.00) Dollars; B.) The balance of her undivided one-half interest shall pass to her children in equal shares, per stirpes. -2- In the event NEVIN L. NAILOR should predecease me, his share shall lapse and pass instead as follows: A.) To his wife, SALLIE JO NAILOR, the stun of Two Thousand ($2,000.00) Dollars; B.) The balance of his undivided one-half interest shall pass to his son, NEVIN L. NAILOR, JR. 5. Lastly, I nominate, constitute and appoint my children, REBA NAILOR McDONALD and NEVIN L. NAILOR, to be Executors of this my Last Will and Testament. In the event either cannot act as such, the other shall serve as the sole Executor and I further direct that no bond or other security be required of my personal representative to guarantee faithful performance of her or his duties. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ? ~ ~7( day of January, 2001. · '~ Ruth I. Nailor (SEAL) Signed, sealed, published and declared by the above named RUTH I. NAILOR as and for her Last Will and Testament, in the presence of us who have subscribed our names hereto as witnesses, at her request, in her presence and~._~e presence of each other. -~- LAST NILL AND TESTAMENT OF RUTH I. NAILOR J. ROBERT STAUFFER ATTOIINI~¥ AT LAW M~ S~u~ Bu~.~'~a MECHANICSBIJRG, PA. 17055 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: RUTH I. NAILOR Date of Death: July 18, 2003 Will No.: 21-03-0620 To the Register: I certify that notice of beneficial interest 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 August 14, 2003: Nevin L. Nailor 474 Sample Bridge Road Enola, PA 17025 Kathleen M. McDonald 141 Wolf's Bridge Road Carlisle, PA 17013-8905 Mrs. Reba N. McDonald 221 Ridge Hill Road Mechanicsburg, PA 17055 Kelly A. McDonald 141 Wolf's Bridge Road Carlisle, PA 17013-8905 Nevin L. Nailor, Jr. 1670 Holtz Drive Enola, PA 17025 Kerri E. McDonald 141 Wolf's Bridge Rd. Carlisle, PA 17013-8905 Sharon L. McDonald 1871 Powells Valley Road Halifax, PA 17032 Nancy A. Gonzalez 334 Pine Grove Road. Gardners, PA 17324-8947 Evan M. Kaiser 1871 Powells Valley Road Halifax, PA 17032 Jose R. Gonzalez 2900 W. Baker Road, Apt. 1605 Baytown, TX 77521 Barbara A. Delgado P.O. Box 34 Idaville, PA 17337 Anna M. Gonzalez 2715 Emmitsburg Road Gettysburg, PA 17325 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None Date: COYNE & COYNE, P.C. ~ ~ /'3 Lisa Marie C02~ne, Esquire 3901 Market ~Street Camp Hill, PA 170114227 (717) 737-0464 Pa. Supreme Ct. No. 53788 Counsel for Personal Representative COYNE & COYNE A PROFESSIONAL CORPORATION ATTORNEYS AT LAW Henry F. Coyne Lisa Marie Coyne Austin F. Grogan 3901 Market Street Camp Hill, Pennsylvania 17011-4227 October 16, 2003 Via Certified Mail No. 7002 2410 0007 8508 9980 Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 717-737o0464 Fax: 717-737-5161 Re: Estate of Ruth W. Nailor, Deceased No. 21-03-0620 Dear Madam: We represent the Estate of the Late Ruth W. Nailor. Enclosed please find estate check no. 125 in the amount of $6,500.00 which represents payment on account of the inheritance tax due in this matter. Kindly record the payment and issue a receipt for this payment made during the discount period for the estate. Thank you for your assistance. If you have any questions, please contact me. Very truly yours, COYNE & COYNE, P.C. J~Marie Coyne ~/~-- LMC/cmc Enclosure Mr. Nevin L. Nailor, Exec., w/encl. Mrs. Reba N. McDonald, Exec., w/encl. COYNE & COYNE, KC. AI-I'ORNEYS AT LAW 3901 MARKET STREET CAMP HILL, PA 17011-4227 2'410 0007 8508 9980 .~"~' .... ~ ..... oOOO ~70~3 Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 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 003131 COYNE LISA MARIE 3901 MARKET ST CAMP HILL, PA 17011 ........ fold ESTATE INFORMATION: SSN: 188-12-4467 FILE NUMBER: 21 03-0620 DECEDENT NAME: NAILOR RUTH I DATE OF PAYMENT: 1 O/16/2003 POSTMARK DATE: 10/15/2003 COUNTY: CUMBERLAND DATE OF DEATH: 07/18/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $6,500.00 TOTAL AMOUNT PAID' $6,500.00 REMARKS: NEVIN L NAILOR & REBA N MCDONALD-C/O COYNE & COYNE SEAL CHECK# 125 INITIALS: SK RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS C OYNE & C OYNE A PROFESSIONAL CORPORATION ATTORNEYS AT LAW Henry F. Coyne Lisa Marie Coyne Austin F. Grogan 3901 Market Street Camp Hill, Pennsylvania 17011-4227 717-737-0464 Fax: 717-737-5161 December 1, 2003 Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 Re: Estate of Ruth ~ Nailor, Deceased No. 21-03-0620 Dear Madam: We represent the Estate of the Late Ruth W. Nailor. Enclosed please find Taxpayers' Responses for various joint holdings of the Decedent. Kindly docket the originals and remm to me "clocked-in" copies with the enclosed envelope. Thank you for your assistance. If you have any questions, please contact me. Very truly yours, LMC/cmc Enclosure COYNE & COYNE, P.C. cc: Mr. Nevin L. Nailor, Exec. Mrs. Reba N. McDonald, Exec. COMHONMEALTH OF PENNSYLVAN/A DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. Z80601 HARRISBURG, PA 17128-0601,, R£V-ISd5 EX AFP (09-00) NEVIN L NAILOR,-* q7q SAMPLE BRIDGE RD ENOLA PA 17025 ZNFORHATZON NOTICE AND TAXPAYER RESPONSE FILE NO. 21 03-0620 ACN 03137529 DATE 10-21-2005 TYPE OF ACCOUNT EST. OF RUTH W NAILOR [] SAVINGS S.S. NO. 188-1Z-q~67 [] CHECKING DATE OF DEATH 07-18-2005 [] TRUST COUNTY CUMBERLAND {~']CERTZF. REMIT PAYHENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 NAYPOINT DANK has provided the Department wlth the information 11stad bale..hich has bean used in calculating the potential tax duo. Their records indicate that at the death af the above decedent, you Hera a joint o.nar/benaficiary of this account. Tf you faa1 this information is incorrect, please obtain written correction from the financial institution, attach a copy to this fora and return it to the above address. This account is taxable in accordance with the Tnharitance Tax Laos of the Comaon.aalth of Pennsylvania. Questions may ba ans.arad by calling (717) 7B7-B3ZT. COMPLETE PART 1 BELOW # x x SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 5200006619 Date 02-0q-1998 To insure proper credit to your account, two Establ/shed (2) capias of this notice must accompany your payment to the Register of Nills. Make check Account Balance S, 572.08 payable to: "Register of Mills, Agent". Percent Taxable X 50. 000 NOTE: Tf tax payments ara made within three Amount Subject to Tax 2,686. O~ (3) months of the dacedant's data of death, Tax Rate X .15 you may deduct a 5Z discount of the tax due. Any inheritance tax due .ill become delinquent Potent/e/ Tax Due qOZ. 91 nine (9) months after tho date of death. PART TAXPAYER RESPONSE PART TAX LINE A. []The above information and tax due is correct. 1. You may choose to remit payment to the Register of Mills .ith tho copies of this notice to obtain ~CHECK~ ~T adiscountoravoidint.rest, oryou.aycheckbox-A-andr, turnthisnotic, toth. R.gist.rof ONE Nills and an official assessment Hill bo issued by the PA Department af Revenue. BLOCK B. ha above asset has been or .il1 ba reported and tax paid .ith the Pennsylvania Inheritance Tax return ONLY ~ to ba filed by the dacadant's representative. C. []The above information is incorrect and/or debts and deductions .ara paid by you. You must complete PART []and/or PART [] bale.. Zf you indicate a different tax rate, please state your relationship to decedent: RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS 1. Data Establishea 1 2. Account Balance 2 $. Percent Taxable $ ~ q. Amount Subject to Tax ~ $. Debts and Deductions $ - 6. Amount Taxable 6 7. Tax Rate 7 ~ 8. Tax Due 8 PART DATE PAID DEBTS AND DEDUCTIONS CLAIMEn PAYEE DESCRIPTION AMOUNT PATD TOTAL (Enter on Line $ of Tax Computation) Under penalties of perjury, Z declare that the facts I have reported above era true, correct end complete to the best of my knowledge and belief. >C '-~ ~ ~:._ ~. WORK ( ) TAXPAYER SIGNATURE TELEPHONE NUMBER ~ GENERAL ZNFORHATION 1. FA/LURE TO RESPOND NZLL RESULT ZN AN OFF/C/AL TAX ASSESSNENT with applicable interest based on information submitted by the financial institution, Z. Inheritance tax becomes delinquent nine months after the dacadent's data 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 are 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. REPORT[NO ZNSTRUCTZONS - PART 1 - TAXPAYER RESPONSE 1. BLOCK A - [f the information and computation in the notice ara correct and deductions ara not being claimed, place an in block "A" of Part 1 of the "Taxpayer Response" section. Sign two copies and submit them with your check for the amount of tax to the Register of Rills of the county indicated. The PA Department of Revenue w111 issue an official assessment (Fore REV-lSq8 EX} upon receipt of the return from the Register of Rills. Z. BLOCK B - Tf the asset specified on this notice has been or will be reported and tax paid with the Pennsylvania Tnheritanca 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 end return to the PA Department of Revenue, Bureau of [ndividual Taxes, Dept ZOO60[, Harrisburg, PA 171Z8-0601 in the envoi ope provided. 5. BLOCK C - [f the notice information is incorrect and/or deductions ara being claimed, check block "C" and according to the instructions beloa. Sign two copies and submit them with your check for the amount of tax payable to the Register of #ills of the county indicated. The PA Department of Revenue will issue an official assessment (Fora RE¥-iSq8 EX) upon receipt of the return from the Register of Rills. TAX RETURN - PART Z - TAX COMPUTATTON 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 IZ/[Z/BZ: Accounts which the decedent put in joint names within one (l) year of death are taxable fully 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. [f a double asterisk (w~) appears before your first name in the address portion of this notice, the $5,000 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. 5. The percent of the account that is taxable for each surv[vor is determined as follows: A. The percent taxable for joint assets established more th~n one year prior to the decadent's death: ! DTyTDED BY TOTAL NUNBER OF DTVXDED BY TOTAL NUNBER DF X 100 = PERCENT TAXABLE JOTNT ONNERS SURVTVTNO JOTNT OWNERS Example: A joint asset registered in the name of the decedent and two other persons. 1 DXVTDED BY 5 (JOTNT OWNERS) OTVTDED BY Z (SURVTVORS) = .167 X 100 = 16.7Z (TAXABLE FOR EACH SURVTVOR) B.The percent taxable for assets created within Dna year of the dacedent's death or accounts owned by the decadent but held in trust for another individual(s) (trust beneficiaries): 1 DTVTDED BY TOTAL NUNBER OF SURVTVTNB JOINT X 100 = PERCENT TAXABLE OWNERS OR TRUST BENEFTC[ARTES Example: Joint account registered in the name of the decedent and two other persons and established within one year of death by the decadent. 1 DXVTDED BY Z (SURVZVORS) = .50 X lO0 = 5aZ (TAXABLE FOR EACH SURVZVOR) 4. The amount subject to tax (line fi) is determined by multiplying the account balance (line Z) by the percent taxable (line 53. 5. Enter the totat 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) fram the amount subject to tax (line 4). 7. Enter the appropriate tax rate (line 73 as eterained below. De~e of Death Spouse I LAnce1 Sibllng Collateral 07/01/9q *o 12/51/9q SX 6X 16X 01/01/95 't:o 06/30/00 OX 6Z 16X 16X 07/01/00 ~o presen~ OX q.SZ~ 12Z 15X wTha tax rate imposed on ti nat yE rea younger at death to or for the usa of a natural parent, an adoptive parent, or a stepparent of the child is OX. 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 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 defined as individuals who have at least one parent in common with the decedent, whether by blood ar adoption. The "Collateral" class of heirs includes all other beneficiaries. CLAIMED DEDUCTIONS - PART 5 - DE~TS AND DEDUCTZONS CLAZMED Allowable debts and deductions ara 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 ~teeized fully in Part 5. [f additional space is needed, use plain paper B l/Z" x 11". Proof of payment may be requested by the PA Oeparteant of Revenue. COMMON#EALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. Z80601 HARRISBURG, PA 17128-0601 REV-1GIi3 EX AFP (09-00) INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. 21 05-0620 ACN 05157528 DATE 10-21-2003 EST. OF RUTH W NAILOR S.S. NO. 188-12-qq67 DATE OF DEATH 07-18-2003 COUNTY CUMBERLAND REBA N MCDONALD 221 RIDGE HILL RD MECHANICSBURG PA 17050 TYPE OF ACCOUNT [] SAVINGS [] CHECKING [] TRUST [] CERTZF. REMTT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE· PA 17013 #AYPOINT BANK has provlded the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you ware a joint owner/beneficiary of this account. Zf you feel this information is incorrect, please obtain written correction free the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the ~nhmritenca Tax Laws of the Commonwealth of Penflsylvenia~ QuestJon~ amy be answered by caTling (7[73 787-&$ZT. COMPLETE PART ! BELOW # x # SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. q6622399Z Data 11- 09-1992 To insure proper credit to your account, two Established (2) copies of this notice must accompany your Account Balance 15,023.75 payment to the Register of Hills. Make check payable to: "Register of Hills, Agent". Percent Taxable X 5 0.0 0 0 NOTE: Tf tax payments are made within three Amount Subject to Tax 7 · 511.88 ($) months of the decedant's date of death, Tax Rata X . [5 you amy deduct e 5Z discount of the tax due. Any inheritance tax due wi]l become delinquent Potential Tax Due I ·126.78 nine (9) months after the date of death. PART TAXPAYER RESPONSE PART TAX LINE A. []The above information and tax duo is correct. [. You amy choose to remit payment to the Register of RilZs with 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 ONE Hills and an official assessment will be issued by the PA Department of Revenue. BLOCK ~ B.%~*The above asset has been or wi[! be reported and tax paid with the Pennsylvania inheritance Tax return ONLY rte be filed by the decadent's representative. C. D The above information is incorrect and/or debts and deductions were paid by you. You must coapteta PART ~ and/or PART ~below. If you indicate a different tax rata, please state your raZationship to decedent: RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS 1. Data Established I 2. Account Balance 2 $. Percent Taxable S ~ q. Amount Subject to Tax q $. Debts and Deductions $ - 6. Amount Taxable 6 7. Tax Rata 7 ~ 8. Tax Due 8 PART DATE PAID DE]ITS AND DEDUCTIONS CLAZME~ PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line $ of Tax C_n_-.~utation) $ Under penalties of perjury, I declare that the facts ! have reported above ara true, correct and ~gale~ to the best of ay knowledge and beltaf. HOME ( ) TAXPAYER S[GNATURE' TELEPHONE NUMBER DAT[ GENERAL ZNFORHATZON 1. FAILURE TO RESPOND NXLL RESULT ZN AN OFFXCZAL TAX ASSESSHENT with applicable interest based on information submitted by the financial institution. 2. Inheritance tax becomes delinquent nine months after the decadent's date of death. 5. A joint account is taxable even though the decadent's name Nas added as a .attar of convenience. ~. Accounts (including those hold betaeen husband and aifm) ahich the decedent put in joint names ,ithin one year prior to death ara fully taxable as transfers. 5. Accounts established jointly between husband and eifa 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 end computation in the notice are correct and deductions are not being claimed, place an in block "A" of Part I of tho "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 ail1 issue an official assessment (Form REV-15~,B EX) upon receipt of the return from the Register of Wills. Z. BLOCK B - If the asset specified on this notice hms been or mill be reported and tax paid with the Pennsylvania Inheritance Tax Return filed by the decedent's representative, place an "X" in block "S" of Part 1 of the "Taxpayer Response" section. Sign one copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Dept ZOO601, Harrisburg, PA 171ZB-0601 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 the instructions below. Sign tad copies end submit them with your check for the amount of tax payable to the Register of Wills of the county indicated. The PA Department of Revenue ail1 issue an official assessment (Fora REV-15~8 EX) upon receipt of the return from the Rag[star of Nills. TAX RETURN - PART Z - TAX CONPUTATION L[NE 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/IZ/BZ: Accounts ahich the decedent put in joint names within one (13 year of death are taxable fully as transfers. Hoaever, there is an exclusion not to exceed $$,000 per transferee regardless of the value of the account or the number of accounts held. If a double asterisk (mx) appears before your first name in the address portion of this not[ce, the $5,000 exclusion already has been deducted from the account balance as reported by the financial institution. Z. Enter the tatar 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 folloas: A. The percent taxable for joint assets established more than one year prior to the decedent's death: I DIVIDED BY TOTAL NUNBER OF DIVIDED BY TOTAL NUMBER OF X 100 = PERCENT TAXABLE JOINT OWNERS SURVIVING JOINT DNNERS Example.' A joint asset registered in the name of the decedent and too other persons. I DIVIDED BY 5 (JOINT OWNERS) DIVIDED BY Z (SURVIVORS) = .167 X 160 = 16.77. (TAXABLE FOR EACH SURVIVOR) 6. The percent taxable for assets created within one year of the decadent's death or accounts oaned by the decedent but held in trust for another individual(s) (trust beneficiaries): 1 DIVIDED BY TOTAL NUNBER OF SURVIVTNG JOINT X 100 = PERCENT TAXABLE OWNERS OR TRUST BENEFICIARIES Example: Joint account registered in the name of the decedent and too other persons and established aithin one year of death by the decedent. I DIVIDED BY Z (SURVIVORS) = .50 X 100 = 5OZ (TAXABLE FOR EACH SURVIVOR) The amount subject to tax (line 4) is determined by multiplying the account balance (line Z) by the percent texablm (1ina 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 4). 7. Enter the appropriate tax rate (Line 7) as letarmined beloa. Da~e of Death Spouse I Lineal ] Sibling I Collateral 07/01/9q *~o 12/$1/9q SX 6X 15X 15X 01/01/95 ~:o 06/$0/00 OX 6X 07/01/00 ~o presen~ OX aThe tax rate imposed on ti : n of tral 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 grandparents, parents, children, and lineal descendents. "Children" includes natural children ahether or not they have been adopted by others, adopted children and step children. "Lineal descendents" includes all children of the natural parents and their descendents, ahether or not they have been adopted by others, adopted descendents and their descendants and step-descendants. "Siblings" are defined as individuals abe have at least one parent in common eith the decedent, ehether by blood or adoption. The "Collateral" class of heirs includes all other beneficiaries. CLAIMED DEDUCTIONS - PART 3 - DEBTS AND DEDUCTIONS CLAIMED Alloaabla debts and deductions are determined as fallows: A. You legally ore responsible for payment, or the estate subject to administration by · personal representative is insufficient to pay the deductible items. B. You actually paid the debts after death of the decedent and can RJrnish proof of payment. C. Debts being claimed must be itemized fully in Part 5. If additional space is needed, use plain paper B l/Z" x 11". Proof of payment may be requested by the PA Department of Revenue. CONHONSEALTH OF PENNSYLVANIA DEPARTNENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. Z80601 HARRISBURG, PA 1712B-0601 REV-1545 EX AFP COg-O0) NEVIN .b NAILOR qTq SAHPLE BRIDGE-RD ENOLA PA 17025 ZNFORNATZON NOTZCE AND TAXPAYER RESPONSE FILE NO, 21 03-0620 ACN 03137530 DATE 10-21-2003 TYPE OF ACCOUNT EST. OF RUTH W NAILOR []SAVINGS S.S. NO. 188-12-qq67 []CHECKING DATE OF DEATH 07-18-2003 [~]TRUST COUNTY CUMBERLAND []CERTZF. REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 HAYPOZNT BANK has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of tho above decedent, you were a joint caner/beneficiary of this account. Tf you faa1 this information is incorrect, please obtain written correction from the financial institution, attach a copy to this fore and return it to the above address. This account is taxable in accordance with the Inheritance Tax Lams of tho Commanaealth o~c Pennsylvania. Questions may be answered by calling ¢717) 7&7-8527. COMPLETE PART I BELOW ~ # # SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS No. 3265Z98q36 Date 06-27-! 997 To insure proper credit to your account, two Established (2) copies of this notice must accompany your Account Balance 11 · 0(~ 86 payment to the Register of Nills. Hake check · payable to: "Register of Sills, Agent". Percent Taxable X 5 0.0 0 0 Amount Subject to Tax 5 · 522. ~3 NOTE: If tax payments are made within three ES) months of the decedent's date of death, Tax Rata X . 15 you may deduct a 5Z discount of the tax due. Any inheritance tax dum will became delinquent Potential Tax Due 828.36 nine (9) months after the date of death. PART TAXPAYER RESPONSE PART TAX LINE ........................................... ~ ~;~;~, ........ "::::::::~,~ i~i~ ~!~!~i~ii ~ ~ ~ ~ ~ !~!:::!:!:i;i;~;i~!~i~i~i::'':~:~:' ~i !~ A. ~ The above information and tax due is correct. 1. You may choose to remit payment to tho Register of Sills aith t~o copies of this notice to obtain ~- CHECK -~ ~l~r_~/. a disc°unt °r ay°id interest, or you may check box "A" and return this notice to the Register of ONE Sills and an official assessment wiII be issued by the PA Department of Revenue. BLOCK B.~J ~he above asset has been or ail1 be reported and tax paid ~ith the Pennsylvania Inheritance Tax return ONLY /-~-to be filed by the decedent's representative. C. [] The above information is incorrect and/or debts and deductions aero paid by you. You must complete PART [~and/or PART I-~-Jbaloa. Zf you indicate a differen~ ~ax ra~e~ please s~a~e your relationship ~o decedent: RETURN - COMPUTATZON OF TAX ON JOZNT/TRUST ACCOUNTS 2. Account Balance 2 $. Percent Taxable $ ~ q. Amount Subject to Tax q $. Debts and Deductions $ - 6. Amount Taxable 6 7. Tax Rate 7 ~ 8. Tax Due 8 PART DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTTON TOTAL (Enter on Line S of Tax C~tation) complete to the best of my knowledge and bel:ief. TAXPAYER SIGNATURE AMOUNT PAID Under penalt/as of perjury, Z decZare that the facts Z have reported above are true, correct and HOME ¢ 7/?) Z (? WORK ( TELEPHONE NUMBER GENERAL ~NFORHAT~ON 1. FAILURE TO RESPOND NILL RESULT ZN AN OFF/C/AL TAX ASSESSNENT with applicable interest based on information submitted by the financial institution. 2. Inheritance tax becomes delinquent nine months after the decadant's date of death. $. A joint account is taxable even though the dacadant's name ems added as a matter of convenience. q. Accounts (including those held between husband and mile) which the decedent put in joint names within one year prior to death are fully taxable as transfers. 5. Accounts established jointty between husband and Nifo more than one year prior to death ara not taxable. 6. Accounts held by a decedent "in trust for" another or others ara taxable fully. REPORT[NC INSTRUCTIONS - PART 1 TAXPAYER RESPONSE 1. BLOCK A - [f the information and computation 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 two copies and submit them with your check for the amount of tax to the Register of Nills of the county indicated. The PA Department of Revenue Hill issue an official assessment (Form REV-15~B EX} upon receipt of the return from the Register of Z. BLOCK B - If the asset specified on this notice has been or Hill ba reported end tax paid eith the Pennsylvania Tnharitanca Tax Return filed by the dacedant'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 Z80601, Harrisburg, PA 17128-0601 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 sublit them with your check for the amount of tax payable to the Register of Wills of the county indicated. The PA Department of Revenue will issue an cffJcia! assessment (Fore REV-lSd,8 EX) upon receipt of the return from the Register of WiLls. TAX RETURN - PART Z TAX COIdPUTATTON LINE 1. Enter the data the account originally was established ar titled in the manner existing at date of death. NOTE: For a decedent dying after lZ/lZ/BZ: 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 $5,000 per transferee regardless of the value of the account or the number of accounts held. If a double asterisk (aw) appears before your first name in the address portion of this notice, the $$,000 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. 5. The percent of the account that is taxable for each survivor is determined as ~oZlows: A. The percent taxable for joint assets established mare than one year prior to the dacadent's death: I DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF X log = PERCENT TAXABLE JOINT OWNERS SURVIVING JOINT OWNERS Example: A joint asset registered in the name of tho decedent and two other persons. I DIVIDED BY $ (JOINT OWNERS) 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 decadent's death or accounts owned by the decedent but held in trust for another individual(s) (trust beneficiaries): I DIVIDED BY TOTAL NUMBER OF SURVTVING JOINT X 100 = PERCENT TAXABLE OWNERS OR TRUST BENEFICIARIES Example: Joint account registered in the name of the decadent and two other parsons 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 to tax (line ~) is determined by multiplying the account balance (line 2) by the percent taxable (line 5. Enter the total of the debts and deductions Listed in Part 3. 6. The amount taxable (1ina 6) is determined by subtracting the debts and deductions (line 5) fram the amount subject to tax (line q). 7. Enter the appropriate tax rate (line 7) as determined below. Da~e of Death Spouse Lineal Sibling Collateral 07/01/9q ~¢o 12/$1/9q 01/01/95 ~:o 06/:30/00 OX 6Z 1.~X 07/01/00 ~o presen~ OX wThe tax rate lmposmd on th~ net value of transfers ~roa a acmes, younger at death to or for the usa of e natural parent, an adopt[va parent, or a stapparent of the child is OZ. The lineal class of heirs includes grandparents, parents, children, and 1inca! descendents. "Children" includes natural children whether or nat they have been adopted by others, adopted children and step children. "Lineal descendents" includes ell 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" ara defined as individuals eho have at toast one parent in common aith the decadent, whether by blood or adoption. The "Collateral" class of heirs includes ell other beneficiaries. CLAIMED DEDUCTIONS - PART $ - DEBTS AND DEDUCTIONS CLA/MED Allowable debts and deductions ara determined as follows: A. You legally ara 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 bm itemized fully in Part 3. [f additional space is needed, use plain paper 8 1/2" x 1L". Proof of payment may be requested by the PA Oaparteant cf Revenue. COHNONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. Ia0601 HARRISBURG, PA 171Z8-0601 REV-i;~S EX RFP (Dg-O0) ZNFORHATZON NOTICE AND TAXPAYER RESPONSE FILE NO. 21 03-0620 ACN 03137526 DATE 10-Zl-2003 REBA N MCDONALD 221 RIDGE HI~LL RD MECHANICSBURG PA. 17050-17q7 TYPE OF ACCOUNT EST. OF RUTH N NATLOR []SAVINGS S.S. NO. 188-1Z-q~67 [] CHECKING DATE OF DEATH 07-18-2003 [] TRUST COUNTY CUMBERLAND [] CERTZF. REHZT PAYHENT AND FORMS TO: REGISTER OF MILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NAYPOZNT BANK has provided the Department aith the information listed below which has bean used in calculating the potential tax due. Their records indicate that at the death of the above decadent, you aarea joint oanar/banaficiary of this account. If you feel this information is incorrect, please obtain Nrittsn correction from the financial institution, attach a copy to this form end return it to the above address. This account is taxable in accordance aith the Inheritance Tax Lams of the Commonwealth of Pennsylvania. Questions may be answered by calling (717) 787-8327. COMPLETE PART I BELO#! # ! SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. ~66Z~3ZSq Date 08-09-1993 Established Account BaXance 6,601.75 Percent Taxable X 50.000 Amount Subject to Tax 3,300.88 Tax Rate X .15 Potentia! Tax Due q95.13 To insure proper credit to your eccount, tho (Z) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". NOTE: If tax payments are made within three (3) months of the decadent's data of death, you may deduct a 5Z discount of the tax due. Any inheritance tax due mill become delinquent nine (9) aonths after the data of death. PART TAXPAYER RESPONSE CHECK ONE BLOCK ONLY PART L/NE A. O The above information and tax due is correct. 1. You say choose to remit payment to the Register of Wills with 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 mill be issued by the PA Department of Revenue. B.~The above asset has been or ail1 be reported and tax paid ~ith the Pennsylvania Inheritance Tax return to be filed by the dacadant's representative. C. I ~Tha above information is incorrect and/or debts and deductions aero paid by you. You must complete PART ~ and/or PART ~beloa. Zf yOU indicate a diffe:ent tax rate, please state your relatlonship to decedent: RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS 1. Date Estabi~shad i 2. Account Balance 2 $. Percent Taxable $ X ~. Amount Subject to Tax q E. Debts and Deductions 5 - 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 Cem~utation) Under penalties of perSury, ! declare ~hat the facts ! have reported above ara ~rua, correct and .y.l tO the best of my knowledge and belief. y .c, __. ___ TS[~ATURE - ~ TELEPHONE NUHBER DATE GENERAL ZNFORHATZON 1. FAILURE TO RESPOND MILL RESULT IN AN OFFICIAL TAX ASSESSMENT aith applicable interest based an information submitted by the financial institution. Z. Inheritance tax becomes delinquent nine months after the dmcadent's date of death. 3. A joint account is taxable even though the decedent's name Nas added as a matter of convenience. q. Accounts (including those held bet#men husband and mile) #hich the decedent put in joint names aithin one year prior to death arm fully taxable as transfers. 5. Accounts established jointly bat#man husband and #ifc more than Dna 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 - Tf the information and computation in the notice ara correct and deductions ara not being claimed, place an 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 to the Register of Mills of the county indicated. The PA Department of Revenue will issue an official assessment (Form REV-1SqB EX) upon receipt of the return from the Register of Ilills. Z. 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, Dmpt 260601, Harrisburg, PA 17128-0601 in the anveZope provided. 5. BLOCK C - If the notice information is incorrect and/or deductions ara being claimed, check block "C" and complete Parts Z and according to the instructions below. Sign two copies and submit them with your check ~or the amount of tax payable to the Register of Mills of the county indicated. The PA Department of Revenue will issue an official assessment (Fora REV-la48 EX) upon receipt of the return from the Register of Hills. TAX RETURN - PART Z - TAX COHPUTATTON LINE 1. Enter the date tho account originally was established or titled in the manner existing at date of death. NOTE: For a decedent dying after 1Z/12:/BZ: Accounts which the decedent put in joint names within one (1) year of death are taxable fully as transfers. However, there is an exclusion not to exceed $$,000 par transferee regardless of the value of the account or the number of accounts held. If a double asterisk (ax) appears before your first name in the address portion of this notice, the $5,000 exclusion already has been deducted from the account balance as reported by tho financial institution. Z. Enter the total balance of the account including interest accrued to the date of death. $. The percent of the account that Js taxable for each survivor is determined as follows: A. The percent taxable for joint assets established more than one year prior to the decedmnt's death: I DIVTDEO BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF X 100 = PERCENT TAXABLE JOINT ONNERS SURVIVING JOINT OHNERS Example: A joint asset registered in the name of tho decedent and two other persons. 1 DIVIDED BY 5 (JOINT ONNERS) DIVIDED DY Z (SURVIVORS) = .167 X lO0 = 16.7Z (TAXABLE FOR EACH SURVIVOR) B.The percent taxable for assets created within one year of the decedmnt's death or accounts owned by the decedent but held in trust for another individual(s) (trust beneficiaries): I OIVTDEO BY TOTAL NUMBER OF SURVIVING JOINT X 100 PERCENT TAXABLE O#NERS OR TRUST DENEFTCTARIES Example: Joint account registered in the name of the decedent and twa other persons and established within one year of death by the decedent. 1 OIV1[DED BY Z (SURVIVORS) = .50 X ln0 = SOX (TAXABLE FOR EACH SURVTVOR) The amount subject to tax (line 4) is determined by multiplying the account balance (line 23 by the percent taxable (1ina 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 bmiow. Da~e of Death Spouse Lineal Sibling Collateral 07/01/9q ~o 12/31/9q 3X 6X 01/01/95 ~o 06/$0/00 OX 6X 07/01/00 ~o proson~ OX q.$Xx aThm tax rate imposed on the net value of transfers frae a dace twenty one years age younger at death to or for the use of a natural parent, an adoptive parent, or a stapparent of the child is OZ. The lineal class of hairs 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 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 defined as individuals who have at [east one parent in common with the decedent, whether by blood or adoption. The "Collateral" class of hairs includes all other beneficiaries. CLATMED DEOUCT]:ONS - PART :5 - DEBTS AND DEDUCTTONS CLATMED 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 tho deductible items. B. You actually paid the debts after death of the decedent and can furnish proof of payment. C. Debts being claimed must bm itemized fully in Part 5. If additional space is needed, use plain paper B 1/2" x 11". Proof of payment may bm requested by the PA Department of Revenue. COHNONHEALTH OF PENNSYLVANIA DEPARTNENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARR/SBURG, PA 17128-0601, REBA N NCDONALD 221 RIDGE HILL RD NECHANICSBURG REV-i$,I5 EX AFP ZNFORHATZON NOTZCE AND TAXPAYER RESPONSE FILE NO. 21 03-0620 ACN 03157527 DATE 10-21-2003 PA 17050-1747 TYPE OF ACCOUNT EST. OF RUTH N NAILOR [] SAVINGS S.S. NO. 188-12-4467 [] CHECKING DATE OF DEATH 07-18-2003 [] TRUST COUNTY CUNBERLAND [] CERTIF. RENIT PAYNENT AND FORNS TO: REGISTER OF HILLS CUNBERLAND CO COURT HOUSE CARLISLE, PA 17013 NAYPOZNT BANK has provided the Department aith the information listed belom Hhich has been used in calculating the potential tax duo. Their records indicate that at the death of the above decedent, you Hera a joint oHner/bensficiary of this account. If you feel this information is incorrect, please obtain Hrittan correction from the financial institution, attach a copy to this fore and return it to the above address. This account is taxable in accordance Hith the Inheritance Tax LaHs of the CommonHealth of Pennsylvania. Questions may be ansHarod by calling (717) 787-8327. CONPLETE PART 1 BELO# x # x SEE REVERSE SIDE FOR FILING AND PAYNENT INSTRUCTIONS Account No. 8000057040 Date 07-25-2000 To insure proper credit to your account, tao EstabLished (z) cop[as of this notice must accompany your Account Balance [ 1 · 017. 16 paylent to the Register of Hills. Hake check payable to: '"Register of Hills, Agent". Percent Taxable X 50.0 0 0 NOTE: If tax payments are made Hith]n three Aeount Subject to Tax 5 · 508.58 (3} months of the decedent's date of death, Tax Rate X .15 you may deduct a 52 discount of the tax due. Any inheritance tax due mill become delinquent Po~en~ial Tax Due 8~. ~ nine (9) months a~ter the date of death. PART TAXPAYER RESPONSE A. [] The above information and tax due is correct. 1. You may choose to remit payment to the Register of Hills Hith tho copies of this notice to obtain CHECK ONE BLOCK ONLY '~ ~he a discount or avoid interest, or you may check box "A" and return this notice to the Register of Hills and an official assessment Hill be issued by tho PA Department of Revenue. B.'~ above asset has been or ail1 be reported and tax paid aith the Pennsylvania Inheritance Tax return f tb be filed by the decedont's representative. C. [] The above information is incorrect and/or debts end deductions Hera paid by you. You must complete PART [] and/or PART [] baloH. PART If you indicate a different tax rate, please state your relationship to decedent: TAX RETURN - CONPUTATZON OF TAX ON JOZNT/TRUST ACCOUNTS LINE 1. Date Established I 2. Account Balance 2 $. Percent TaxabLe $ X 4. Amount Subject to Tax 4 S. Debts and Deduct/ons 5 - 6. Amount Taxable 6 7. Tax Rate 7 X 8. Tax Due 8 DEBTS AND DEDUCTIONS CLAZNEn PART DATE PAID PAYEE DESCRIPTION TOTAL (Enter on L/ne $ of Tax Computer/on) ANOUNT PAID Under penalties of perjury, I declare that the facts Z have reported above ara true, correct and to the be;4: of my knowledge and bel/ef. HONE ( TAXPAYER S~GNATURE ' TELEPHONE NUHBER GENERAL INFORMATION 1. FAZLURE TO RESPOND NZLL RESULT ZN AN OFFZCZAL TAX ASSESSNENTmith applicable interest based on information submitted by the financJa! institution. Z. Inheritance tax becomes delinquent nine months after the decedent's date of death. 5. A joint account ]s taxable even though tho dacadent's name was added as a matter of convenience. 4. Accounts (incZuding those held bataaan husband and wife) which the decedent put in joint names within one year prior to death ere fully taxable as transfers. 5. Accounts established jointly bateaan 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 1 - TAXPAYER RESPONSE 1. BLOCK A - If tho information and computation in the notice ara correct and deductions ara not being claimed, place an "X" in bIock "A" of Part 1 of tho "Taxpayer Response" section. Sign two copies and submit thee with your check for the amount of tax to the Register of RiIIs of the county indicated. The PA Department of Revenue aiII issue an officiaI assessment (Form REV-154B EX) upon receipt of the return from the Register of Nills. Z. 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 tho dacedant'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, Oapt 280601, Harrisburg, PA 17128-0601 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 according to the instructions beloe. Sign two copies and submit thee with your check for the amount of tax payable to the Register of Hi[Is of the county indicated. The PA Department of Revenue will issue an official assessment (Form 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 or titled in the manner existing at date of death. NOTE: For a decedent dying after 1~/1Z/82: 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 (~w) appears before your first name in the address portion of this notice, the $5,000 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 taxabIe for joint assets established more than one year prior to the dacedent's death: ! DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF X 100 = PERCENT TAXABLE JOINT ONNERS SURVIVING JOINT ORNERS Example: A joint asset registered tn the naaa of the decedent and two other persons. 1 DIVIDED BY 5 (JOINT ONNERS) 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 dacadant's death or accounts owned by the decedent but held in trust for another individual(s) (trust beneficiaries): 1 DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE ONNERS OR TRUST BENEFICIARIES Example: Joint account registered in the name of tho decedent and two other persons and established eithin one year of death by the decedent. 1 DIVIDED BY Z (SURVIVORS) = ,50 X 100 = 507. (TAXABLE FOR EACH SURVIVOR) 4. The amount subject to tax (1ina 4) is determined by multiplying the account balance (line 2) by the percent taxable (line 5. Enter tho total of the debts and deductions listed in Part $. 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. Da~m of Death Spouse Lineal Sibling Collateral 07/01/9q ~o 12/$1/9q 01/01/95 ~o 06/50/00 OX 6X 15X 15X 07/01/00 ~o prmsen~ OX younger at xTha tax rata imposed on the nat value trane;ers : death to or for the usa of a natural parent, an adoptive stent, or a stapparant of the child is 07.. The lineal class of hairs includes grandparents, parents, children, and linaa! 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 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 a11 other beneficiaries. CLAIMED DEDUCTIONS - PART $ - DEBTS AND DEDUCTIONS CLAIMED Allowable debts and deductions are determined as follows: A. You legally ara 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 bo itemized fully in Part 3. If additional space is needed, usa plain paper 8 1/Z" x 11". Proof of payment may bm requested by the PA Department of Revenue. COMMONNEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE BUREAU OF INDIVIDUAL TAXES BEPT. 280601 HARRISBURg, PA I?IZB-060I*, REV-I$11S EX IrlFP (09-00) 5 ZNFORHATZON NOTICE AND TAXPAYER RESPONSE FILE NO. 21 03-0620 ACN 05137524 DATE 10-21-2003 REBA N MCDONALD 221 RIDGE HILL RD MECHANICSBURG PA 17050-1747 TYPE OF ACCOUNT EST. OF RUTH N NAILOR []SAVINGS S.S. NO. 188-12-4467 [] CHECKING DATE OF DEATH 07-18-2005 [] TRUST COUNTY CUMBERLAND [] CERT/F. REH/T PAYHENT AND FORHS TO: REGISTER OF MILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 #AYPOZNT BANK has provided the Department with the information listed baloa ehich has been used in calculating the potential tax due. Their records indicate that at the death of the above decadent, you Nero a joint oNnar/baneficiary of this account. If you feel this information is incorrect, please obtain wrltten correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance eith the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions amy be answered by calling (717) 787-8327. COMPLETE PART 1 BELON x x ~ SEE REVERSE SIDE FOR FILING AND PAYHENT INSTRUCTIONS Account No. 1861291787 Date 12-02-1996 Established Account Balance 13 · 433.20 Percent Taxable X 5 0.0 0 0 Amount SubSect to Tax 6,716.60 Tax Rate X .15 Potential Tax Due 1 · 007.49 To insure proper credit to your account, tee (2) copies of this notice must accompany your payment to the Register of Hills. Make check payable to: "Register of Hills, Agent". NOTE: If tax payments are made within three (5) months of the decedant's date of death, you may deduct a 52 discount of the tax due. Any inheritance tax due mill become delinquent nine (9) months after the date of death. PART TAXPAYER RESPONSE A. [] The abava information and tax due is correct. 1. You Bay choose to remit payment to the Register of Mills Nith two copies of thls notice to obtain ~ CHECK ~ .~T. a discount er ay°id intarest' °r You may check b°x "A" and return this notice to the Register of ONE Hills and an official assessment ail1 be issued by the PA Department of Revenue. BLOCK s. ha above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return ONLY / -~a be filed by the decadent's representative. C. [] The above information is incorrect and/or debts and deductions mere paid by you. You must complete PART [] and/or PART [] belam. PART If you indicate a different tax rate~ please state your [] relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS L/NE i. Date Established i 2. Account Balance 2 3. Percent Taxable 3 X ~. Amount SubSect to Tax ~ $. Debts end Deductions $ - 6. Amount Taxable 6 7. Tax Rate 7 X 8. Tax Due 8 PART DATE PAID DEBTS AND DEDUCTIONS CLAZMEn PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line $ of Tax Computation) Under penaZties of perjury, T declare that the facts T have reported above are true, correct and complete to the bast of my knowledge and belief. HOME ( ) TAXPAYER SIGNATURE TELEPHONE NUMBER DATE GENERAL INFORMATION 1. FAILURE TO RESPOND HILL RESULT ZN AN OFF/CZAL TAX ASSESSHENT 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. $. 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 jain[ names within one year prior to death are fully taxable as transfers. S. Accounts established jointly between husband and wife more than one year prlor to death are not taxable. 6. Accounts held by a decedent "in trust for" another or others ara taxable fully. REPORTING INSTRUCTIONS - PART I - TAXPAYER RESPONSE 1. BLOCK A - If the information and computation in the natlce are correct and deductions are not being claimed, place an "X" in block "A" of Part ! of the "Taxpayer Response" section. Sign two copies and submit them with 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-15~8 EX) upon receipt of the return from the Register of Hills. Z. 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, Dept Z80601, Harrisburg, PA 171Z8-060! in the envelope provided. $. BLOCK C - If the notice information is incorrect and/or deductions ara being claimed, check black "C" and coapletm Parts Z and 5 according to tho instructions below. Sign two copies and submit them with your check for the amount of tax payable to the Register of Hills of the county indicated. The PA Department of Revenue w111 issue an official assessment (Form REV-15~8 EX) upon receipt of the return from the Register of Hills. TAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Enter tho 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 arm taxable fully as transfers. However, there is an exclusion not to exceed $3,000 per transferee regardless of the value of the account or the number of accounts held. If a double asterisk (xa) 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. 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 decedent's death: I DIVIDED BY TOTAL NUHBER OF DIVIDED BY TOTAL NUMBER OF X 100 = PERCENT TAXABLE JOINT OWNERS SURVIVING JOINT ONNERS Example: A joint asset registered in the name of the decedent and two other persons. I DIVIDED BY 5 (JOINT OWNERS) DIVIDED BY Z (SURVTVORS) = .167 X 100 = 16.7X (TAXABLE FOR EACH SURVIVOR) B.Tho percent taxable for assets created within one year of the decadent's death or accounts owned by tho decedent but held in trust for another individual(s) (trust beneficiaries): I DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE OWNERS OR TRUST BENEFICIARIES Example: Joint account registered in tho name of the decedent and two other parsons and established within one year of death by the decedent. I DIVIDED BY Z (SURVIVORS) = .SO X 100 SOX (TAXABLE FOR EACH SURVIVOR) The amount subject to tax (line ~) is determined by multiplying the account baIance (line Z) by the percent taxable (line 5). 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 below. De~e of Death Spouse I Lineal Sibling Collateral 07/01/94 ~o 12/$1/94 01/01/95 ~o 06/30/00 OX 6X 07/01/00 ~o presen~ OX eThe tax rate imposed on th; net value -ansfers a younger at death to or for tho usa of a natural parent, an adoptive parent, or a stepparant of the child is OZ. The lineal class of heirs includes grandparents, parents, children, and lineaI descendents. "ChjIdrmn" incIudas natural children whether or not they have been adopted by others, adopted children and stap children. "Lineal descendents" includes all children of the natural parents and their descendants, whether or not they have been adopted by others, adopted descendents and their descendants and step-descendants. "Siblings" era defined as individuals who have at least one parent in common with the decedent, whether by bIood or adoption. The "Collateral# class of heirs incIudes all other beneficiaries. CLAIMED ~E])UCTIONS - PART $ - DEISTS AND DEDUCTIONS CLAIMED Allowable debts and deductions are determined as follows: A. You Iaga[Iy ara responsible for payment, or the estate subject to administration by a personal representative is insufficient to pay the deductible items. S. You actually paid the debts after death of the decedent and can RJrnJsh proof of payment. C. Debts being claimed oust be itemized fulIy in Part 5. If additionaI space is needed, use plain paper 8 I/Z" x Il". Proof of payment may be requested by tho PA Department of Revenue. . COHHONHEALTH OF PENNSYLVANIA DEPARTNENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA l?lZB-060}i REV-10~S EX AFP (09-00) REBA N NCDONALD 221 RIDGE HILL RD HECHANICSBURG PA 17050-1747 ZNFORNATZON NOTZCE AND TAXPAYER RESPONSE FILE NO. 21 03-0620 ACN 03137525 DATE 10-21-2003 TYPE OF ACCOUNT EST. OF RUTH N NAILOR []SAVINGS S.S. NO. 188-12-4467 E~CHECKZNG DATE OF DEATH 07-18-2003 E~TRUST COUNTY CUHBERLAND ~-~CERTZF. REHZT PAYNENT AND FORHS TO: REGISTER OF NZLLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 NAYPOZNT BANK has provided the Department with the information listed below which has been used in calculating the potential tax due. Their records indicate that at the death of the above decedent, you ware a joint owner/beneficiary of this account, zf you feel this information is incorrect, please obtain arittan correction from the financial institution, attach a copy to this fora and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions may be ansaarad by callJn.q (717) 787-83Z7. CONPLETE PART 1 BELON ~ # ~ SEE REVERSE SIDE FOR PILING AND PAYNENT INSTRUCTIONS Account No. 5500029661 Date 08-30-2002 Established Account Balance .00 Percent Taxable X 100.00 Amount Subject to Tax .00 Tax Rate X .15 Potential Tax Due .00 To insure proper credit to your account, two (2) copies of this notice must accompany your payment to the Register of gills. Hake check payable to: "Register of Nills, Agent". NOTE: If tax payments ara made within three (3) months of the decadant's date of death, you amy deduct a 5Z discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. PART TAXPAYER RESPONSE A. [] The above information and tax due is correct. 1. You may choose to remit payment to the Register of Hills with two copies of this notice to obtain ~ CHECK ~ ~T a disc°unt °r av°]d interest' °r Y°u may check box "A" and return this notice to the Register of ONE Hills and an official assessment will be issued by the PA Dapartaent of Revenue. BLOCK s. he above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return ONLY /-~ta ba filed by the dacodent's representative. C. [] The above inforaatJon is incorrect and/or debts and deductions aero paid by you. You must complete PART [] and/or PART ~ PART Zf you indicate a different ~ax ra~e, please s~ate your relationship ~o decedent: TAX RETURN - COHPUTATZON OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Da~e Es~abllshed 2. Account Balance 2 3. Percent Taxable 3 ~ ~. Amount Subject to Tax ~ $. Debts and Deductions $ - 6. Amount Taxable 6 7. Tax Rate 7 X 8. Tax Due 8 PART DATE PAID DEBTS AND DEDUCTIONS CLAINE]~ PAYEE DESCRIPTION AHOUNT PAID YU[AL (Enter on Line S of Tax Computation) Under penalties of perjury, T declare that the facts T have reported above are true, correct and co_mplete to the best of my knowledge and belief. HOHE ( ) TAXPAYER SIGNATURE TELEPHONE NUNBER DATE GENERAL INFORHATION 1. FAILURE TO RESPOND N/LL RESULT ZN AN OFFICIAL TAX ASSESSHENT with applicable interest based on information submitted by the financial institution. Z. Inheritance tax becomes delinquent nine months after the dacedent's date of death. $. A joint account is taxable even though the decedent's name was added as a matter of convenience. 4. Accounts (including those held between husband and wife) which the decedent put in joint names within one year prior to death are fully taxable as transfers. 5. Accounts established jointly between husband and ~ife more than one year prior to death arm not taxable. 6. Accounts held by a decadent "in trust for" another or others are taxable fully. REPORTIN$ INSTRUCTIONS - PART I - TAXPAYER RESPONSE 1. BLOCK A - If the information and computation in the notice ara correct and deductions are not being claimed, place an "X" in block "A" of Part I of the "Taxpayer Response" section. Sign two copies end submit thai with your check for the amount of tax to the Register of Hills of the county indicated. The PA Department of Revenue Hill issue an official assessment (Form REV-1548 EX) upon receipt of the return from the Register of Wills. 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 decedmnt'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 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 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 of the county indicated. The PA Department of Revenue will issue an official assessment (Fora REV-1548 EX) upon receipt of the return from the Register of gills. TAX RETURN - PART 2 - TAX COMPUTATION 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 II/II/BI: Accounts which the decedent put in joint names within one (I) 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 (xx) appears before your first name in the address portion of this notice, the $3,000 exclusion already has been deducted from the account balance as reported by the financial institution. Enter the total balance of the account including interest accrued to the date of death. The percent of the account that is taxable for each survivor is determined as follo~s: A. The percent taxable for joint assets established more than one year prior to the decedent's death: I DIVIDED BY TOTAL NUNBER OF DIVIDED BY TOTAL NUNBER OF X 100 = PERCENT TAXABLE JOINT OHNERS SURVTVING JOINT OWNERS Example: A joint asset registered in the name of the decadent and two other persons. I DIVIDED BY 3 (JOINT ONNERS) DIVIDED BY 2 (SURVIVORS) = .167 X 100 = 16.7Z (TAXABLE FOR EACH SURVIVOR) B.The percent taxable for assets created mithin one year of the decmdent's death or accounts o~ned by the decedent but held in trust for another individual(s) (trust beneficiaries): 1 DIVIDED BY TOTAL NUNBER OF SURVIVING JOINT X 100 = PERCENT TAXABLE ONNERS OR TRUST BENEFICIARIES Example: Joint account registered in the name of the decedmnt and two other persons and established within one year of death by the decedent. ! DIVIDED BY Z (SURVIVORS) = .50 X 100 50Z (TAXABLE FOR EACH SURVIVOR) 4. The amount subject to tax (line 4) is determined by multiplying the account balance (line Z) by the percent taxable (line 3). S. Enter the total of the debts and deductions listed in Part 3. 6. The amount taxable (line 6) is determined by subtracting the debts and deductions (line 5) from the amount subject to tax (line 7. Enter the appropriate tax rate (line 7) as determined belom. Da~e of Death Spouse Lineal Sibling I Collateral 07/01/9q ~o 12/31/9~ 3Z 6Z 01/01/95 ~o 06/30/00 OZ 6Z 07/01/00 ~o presen~ OX ~,$X~ 12Z xThe tax rate imposed on the net value rea; younger at death to or ~or the use of a naturaL parent, an adoptive Brant, or a stepparent of the child is OZ. The linmaI class of heirs incl~es grandparents, parents, children, and linea! descendents. "Children" includes nature! 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 others, adopted descendents end their descendants and step-descendants. "Siblings" are defined es individuals Nba have at least one parent ~n common ,Jth ~e decedent, whether by blood or adoption. The "Co[lateral" class o~ heirs [nc(odes BiZ other beneficiaries. CLAZNED DEDUCTIONS - PART 3 - DEBTS AND DEDUCTIONS CLAZNED A][owab[e debts and deductions are determined as A. You [egaZ]y are responsible ~or payaent~ or the estate subject to administration by a personal representative Js insufficient to pay the deductible items. B. You actua~Z~ paid ~e debts a~t.~ death o~ the decedent and can ~urn~sh proo~ o~ payaent. C. Debts being c~aJaed .ust be ~taa~zad ~u~ payment may be requested by ~e PA Departaent of Revenue. COYNE & COYNE, P.C. A'rrORNEYS AT LAW 3901 MARKET STREET CAMP HILL, PA 17011-4227 Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT, 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 21 2003 620 COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER NAILOR, RUTH I. 188-12-4467 DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE 07/18/2003 02/26/1910 REGISTER OF WILLS IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER < [] 12-31-91 and 1-1-95) qAME Lisa M. Coyne, Esquire 1. OdginalReturn [] 2. SupplementalRetum [] 3. Remainder Retum (date of death pdor to12-13-82) 4. Limited Estate [] 4a. Future Interest Compromise (date of death after [] 5. Federal Estate Tax Return Required 12-12-82) 6. Decedent Died Testate (Attach copy [] 7. Decedent Maintained a Living Trust (Attach 8. Total Number of Safe Deposit Boxes of W~II) copy of Trust) -- 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (date of death between [] 11. Election to tax under Sec. 9113(A) (Attach Sch O) COMPLETE MAILING ADDRESS :IRM NAME (If applicable) Coyne & Coy-ne, P.C. FELEPHONE NUMBER 717/737-0464 3901 Market Street Camp Hill, PA 17011-4227 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & 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. 13. 14. 107,000.00 420.00 None None 12,010.00 50,711.73 None 26,356.25 1,022.50 Net Value of Estate (Line 8 minus Line 11 ) 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) OFFICIAL USE ONLY (8) 170,141.73 27,378.75 142,762.98 142,762.98 (11) (12) (13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, x .00 or transfers under Sec. 9116(a)(1.2) 16.Amount of Line 14 taxable at lineal rate x .045 17.Amount of Line 14 taxable at sibling rate x .12 18. Amount of Line 14 taxable at collateral rate x .15 19. Tax Due 142,762.98 20. [] (15) (16) (17) (18) (19) 6,424.00 6,424.00 Copyright 2000 form software only The Lackner Group, Inc. Form REV-'I500 EX (Rev. 6-00) Decedent's Complete Address: ISTREET ADDRESS 36 Cumberland Drive CITY Mehanicsburg STATE PA ZIP 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 2. Credits/Payments A. Spousal Poverty Credit B. Pdor Payments 6,500.00 C. Discount 32].00 6,424.00 Interest/Penalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) Total Interest/Penalty (D + E) (3) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page I Line 20 to request a refund If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. 6,821.00 0.00 397.00 0.00 (4) (5) (5A) (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 income of the property transferred; ................................................................................ -- [] [] b. retain the dght to designate who shall use the property transferred or its income; .................................... I I 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 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 G 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, correct and complete. Declaration preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Reba~N~Mc~onald ~ SlGNA'fURE OF PERSON RESPONSIBLE FOR FILING-RETURN Nevin L. Nailor SIGNATURE"OFPRE~'-AR~R ~-HER THAN REPR~ESENT.E. TIVE Lisa M. Coyne, Esquire ADDRESS DATE ADDRESS Mechamcsburg, PA 17055 [~' ADDRESS 474 Sample Brid~e Road Enola, PA 1702ff 3901 Market Street Camp Hill, PA 17011-4227 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 exempt] 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. SCHEDULE A REAL ESTATE COMMONVVEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER NAILOR, RUTH I. 21 - 2003 - 620 All real property owned solely or as a tenant in common must be rel~orted at fair market value. Fair market value is defined as the price at which propert~ would be exchanged between a willing buyer and a wiring seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION 36 Cumberland Road, Mechanicsburg, Cumberland County, Pennsylvania (Sold at Public Auction) TOTAL (Also enter on Line 1, Recapitulation) VALUE AT DATE OF DEATH 107,000.00 107,000.00 ~le~ent Statement u.s. Department of Housing and Urban Development ~ of Loan~ OMB No 2502-0265 REV, HUD-I (3/86) 1 ~F'H^ 2. ~FmHA 3. OConv. Unins. I 6. FileNumber I 7. LoanNumber 8. ModgagelnsuranceCas;Number 4, [~VA 5. rlConv, lns. I ST2003-169RCS ! ' I conviction can include a fine and imJxisonmenL For details see; Title 1S U. S Code Section 1~(]1 and Sec, lion 1010. I Printed 11/18/2003 at 13:54 RLM D. NAME OF BORROWER: Kelly A. McDonald ADDRESS: E, NAME OF SELLER: The Estate of Ruth W. Nailor ADDRESS: F, NAME OF LENDER: AmeriCholce Federal Credit Union ADDRESS: G. PROPERTY ADDRESS: H. SETTLEMENT AGENT: PLACE OF SETTLEMENT: 26 West High Straet~ Carlisle, PA 17013 SETTLEMENT DATE: 1111gl2003 J, SUMMARY OF BORROWER'S TRANSACTION: 20 Sporting Green Ddve, Mechanicsburg, PA 17055 36 Cumberland Drive, Mechanicsburg, PA 17050 Silver Spring Township Saidis, Shuff, Flower & Lindsay, Telephone: 717-243-6222 Fax: 7'17-243-6486 100. GROSS AMOUNT DUE FROM BORROWER 400. 101. 102. 103. Contract sales price 107~000 00 401. Personal Propedy 402. Settlement charqes to borrower (line 1400) 104, 105. Adiustments for items paid by seller in advance 107. Counly taxes t1119103t012131103 108. School Taxes 111t9103to06130104 109. 110. 111. 112. 120. GROSS AMOUNT DUE FROM BORROWER 200. AMOUNTS PAID BY OR ON BEHALF OF BORROWER 201. Deposit or earnest money 202. Principal amount of new loans 203. Existin.q oan(s) taken subiect 204. 205. 206. 207. 208, 209. Adjustments for items unpaid by seller 213. 214. 215. 216. 217. 218, 219. 220, TOTAL PAID BY/FOR BORROWER 300. CASH AT SETTLEMENT FROM ORTO BORROWER 301. Gross amount due from borrower (line 120) 2~941.75 403. 404. 405. 31.17 407. 534.24 4O8. 409. 410. 411. 412. 110~507.11 420. 500. t0,000.00 501. 101,650.0{ 502. 503. 504. 505, 506. 507. 508. 509. 513. 302. Less amounts paid by/for borrower (line 220) 303. CASH TO BORROWER K. SUMMARY OF SELLER'S TRANSACTION: GROSS AMOUNT DUE TO .~F~ ! ER Contract sales price Personal Property 107,000.00 Adjustr,.=i~{= for items paid by seller in advance Counly taxes 11119103to12131103 3t.t7 School Taxes 11/t 9103 to 06130104 534.24 GROSS AMOUNT BUR TO SELLER 107,565.41 REDUCTIONS IN AMOUNT DUE TO SELLER Excess Deposit (see instructions) Settlement charqes lo seller (line 1400) Existin,q loan(s) taken subject to Payoff of Fimt Modqa,qe Ldan 10,000.00 t,136.50 Adjustments for items unpaid by seller 514. 515. 516. 517. 518. 519. 520. TOTAL REDUCTION AMOUNT DUE SELLER 111,650.00 110,507.16 111,650.00 1,142.84 600. CASH AT SETTLEMENT TO OR FROM Sl::l I I::R 601. Gross amount due to seller (line 420) 602. Less reduction amount due seller (line 520) 603. CASH TO SELLER 11,136.5, 107,565.4t tt~136.50 96~428.91 SELLER(S) NEW MAIUNG ADDRESS: 1005. School Taxes . 1009~.Adiustment 1100. TITLE CHARGES ' 1101. Settlemenl or closin(3 fee ~11~2. Abstract or title seamh 1103. Title examination 1104. Title insurance binder 1105. Doc_ument Preparation -- ~1107. At!or--es __ (includes above items No: 1108. Titl~ Insurance __/includes above items No: 1109. Lender's Polic 1110. Owner's Polic Ill 1. End 100 End 300 End 900 1112. ~1113, Closin§ S_erviceLelter Division of commission (line 700) as follows: _~01. $ to 702. $ to _ 703. Comm~aJd at'Se tement 800; ITEMS PAYABLE IN CONNECTION WITH LOAN 80~1~ Loan Orif:linaton Fee % 8~02. Loan Dis~count % ~ ~Fee_~__~ to ArneriChoice Federal Credit Union (P.O.C.) 27 804. Credi~t Repo~____ to AmeriChoice Federa Credit Union 8~05. Lende~ection Fee 37.5( 80§~__~.' Mort,qag~Appllcation Fee -- ~on Fee b -- 808.~Proces~ee to AmeriChoi~ce Federal Credit Union 550.00- 809~ Wire Transf~er Fee to Ame_.___riChoice Federal Credit Union - - 810~ Flood C~eerl Fee 1o ArneriChoic@ Federal Credit Union ~ 30.00 811. Ovemi hlUaiiin s __ to AmeriChoice Federal'Credit Union ~ 25.00 900. ITEMS REQUIRED BY LENDER TO BE PAI~'~-~ IN ADVANCE-- 37.50 90~1~ Interes__~_t From to ~,~ /d~ 902. Mod a elnsurance Pren~!um for to -- 903. Hazard Insurance premi~um for __ to 904. 905. 1000. RESERVES DEPOSIT. ED WITH LENDER FOR 1001, Hazard Insurance mo. ~.. $ /mo 1~2. Mortgage nsuranc~ee __ mo. ~. /mo 1003, Cit Pro~ mo ~,,$ /mo 1004. Cou~ly Pro e~_~ Tax . mo. ¢,, $ _ 22,05./mo .mo. ~. $ ~ 72.22/mo ;£PARTMENT OF HOUSING AND URBAN DEVELOPMENT File Number: ST2003-169 ,YTLEMENT STATEMENT REV. HUD-1 (3/,R~) PAGE 2 'TTLEMF.:NT CHARGES Ti[leExpress Sefllemenf SyslE~ ~d,1~1/~1~8~.0.03 at I3:54 RLM TOTAL sALEs/BROKER'S COMMISSION based on price $107,000.00 I~, 0.000 = ~ -~ ° ~.~.~ v...V ~ ~':5I SELLER'S ~ .,..r~..~_!._ j FUNDSAT ~_~ O1:::11L;-MI-NF SETI'LEMEN~ 1301. Ovem~~ 1302, Tax Ced 1303. FinalSewer Readin~ 1304. 1305. 1306, 1307. to S~ff= Flower & Lindsay L.o .~.CCP, Inc. 10t~650.00 - ~00 - 893.75 to ACCP~ Inc. 1200, GOVERNMENT RECORDING AN~D TRANSFER CHARGES 12~01, Recording_Fees Deed $ 38.50 _L~Modcla~..~ $ 40.50 ; Relea~ese $ 120___2. City~.!ax/slamps Deed 1~00 ; Morl ag.~.q~$ 1203~ Slale~Tax/slam_~p~_ Deed $1 070.00 ; Modf:la~e_.$_ 1205. 1300, ADDITIONAL SETTLEMENT CHARGES !o Saidis, Shuff~ F~ to Debra B~sehore Wiest !o Silv~ownship 14.00 ~.~93.7_5 150.0C 35.0~0 The Estate of Ruth W. Nailer WARNING: IT IS A CRIME TO KNOWINGLY ~'"~""~-"~ · O 1OO1 AND SECTION 1010. 10; 1400. TOTAL SETTLEMENT.CHARGES ~103, Section J a~nnd 502, Se~jgn K) 2,941.75 1 1~-36 50 HUD CERTIFICATION OF BUYERAND SELLER ~ -- ~ .' I haye cars~u y revieWed Ihe HUD-1 SeSlemenl Statement and o he best efm knowledge and beliei il is a ~ and accurate s~alement of all fecal ts and dtsbursemenls made on ec~3 ! in this transaction. I further certify thai [ have received a COpy of Ihe HUD-1 Set~jVemenl ela~emant, 'Pmy un er by me ~ 63.5~ I - 1,o70.ooI - SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER NAILOR, RUTH I. 21 - 2003 - 620 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE OF NUMBER DESCRIPTION UNIT VALUE DEATH 1 5 PP&L Corp Preferred Shares (4.40%) 84 420.00 TOTAL (Also enter on line 2, Recapitulation) 420.00 Historical Pricing Inquiry Historical PHcing Inquiry 59E38 - PPL ELEC UTILS CORP Cusip: 69351U202 Date Hilth Price Low Pdce Close Price Volume a 7/[ 8/2003 84,0013 84.000 84.000 20 The information has been obtained from sources we believe to be reliable but we do not guarantee its accuracy. Past performance is not indicative of future performance, Z Z -0 l> SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER NAILOR, RUTH I. 21 - 2003 - 620 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 DESCRIPTION VALUE AT DATE OF NUMBER DEATH 1 Misc. Personalty and Automobile Sold at Auction 12,010.00 TOTAL (Also enter on Line 5, Recapitulation) 12,010.00 BRICKERS AUCTION Buy & Sell on Commission - Complete Sale ServiGe 93 Texaco Rd., Mechanicsburg, PA 17055 766-5785 Personal P~operty of Address ~)ld At Publio Sale ~-~ ~, 5 Lr~, ~ 20 ~) .~ ~(/~/(~ Out.tamding Total Sale Total Checks Total Cash Cash After Payout /Ar Expenses Auctioneer & ClaH;s Adv, Cost Property Fee hie Setup or Help Total Expenses Thank You For Selecting Chuck Brlcker, Auctfoneer & SYaff NOIIDF~ S t{B>OI~ ~9§T99~_I/_ I8 Ng~d 60:9I £00EII~/0I COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER NAILOR, RUTH I. 21 - 2003 - 620 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 Reba N. McDonald Mechanicsburg, PA 17055 Daughter B Nevin L. Nailor Mehanicsburg, PA 17055 Son JOINTLY OWNED PROPERTY: DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM LETTER DATE Include name of financial institution and bank account number DATE OF DEATH DECD'S VALUE OF NUMBER FORTENANTJOINT JOINTMADE ~=state.3r similar identifying number. Attach deed for jointly-held real VALUE OF ASSET INTEREST DECEDENT'S INTERES'I 1 A 12/02/1996 Waypoint Bank 13,433.21~ 50% 6,716.60 Cert. of Deposit #186129787 2 B 02/04/1998 Waypoint Bank 5,372.08 50% 2,686.04 Cert. of Deposit #3200006619 3 B 06/27/1997 Waypoint Bank 11,044.86 50% 5,522.43 Cert. of Deposit #3265298435 4 A 11/09/1992 Wayoint Bank 15,023.75 50% 7,511.88 Cert. of Deposit #466223992 5 A 08/09/1993 Waypoint Bank 6,601.75 50% 3,300.88 Cert. of Deposit ~466243254 6 A 07/25/2000 Waypoint Bank 11,017.16 50°A 5,508.58 Cert. of Deposit #8000057040 7 A 08/03/2002 Waypoint Bank 2,266.07 50°A 1,133.04 Savings Acct. #5500029661 8 B 09/24/2002 AmeriChoice FCU 25.21 50% 12.61 i Savings Acct. #34392-01 9 B 09/24/2002 AmeriChoice FCU 13,914.74 50% 6,957.37 Cert. of Deposit #34392-60 10 A 06/25/20021 Members Ist FCU 12,017.38 50% 6,008.69 Cert. of Deposit #84984-40 ! i Total of Continuation Schedule(s) 5,353.61 TOTAL (Also enter on line 6, Recapitulation) 50,711.73 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY continued ESTATE OF FILE NUMBER NAILOR, RUTH I. 21 - 2003 - 620 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. JOINTLY OWNED PROPERTY DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM LETTER DATE Include name of financial institution and bank account number DATE OF DEATH DECD'S VALUE OF NUMBER FOR JOINT MADE 3r similar identifying number. Attach deed for jointly-held real VALUE OF ASSET I iNTEREST _ TENANT JOINT ~state. DECEDENT'S INTERES'I 11 A 08/01/1979 M&T Bank 3,198.3C 50% 1,599.15 ~ r Checking Acct. No. 575372 12 A 08/05/1999 M&T Bank 7,508.91 50% 3,754.46 Cert. of Deposit #31003910356433 Page 2 of Schedule F 3/19/2003 COYNE & COYNE 3901 MARKET ST CAMP HILL PA 17011-4227 LOOK FOR US. WE'LL GET YOU THERE. The information which you requested on the account(s) of RUTH W NAILOR (Social Security Number 188-12-4467) is/are as follows: Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name of Joint Owner, if any Date Ownership Was Established Account Number Class of Account Date Opened Principal Balance~ Accrued Interest Balance at Date of Death Account Ownership Name of Joint Owner, if any Date Ownership Was Established 1861291787 3200006619 3265298435 466223992 CERTIFICATE CERTIFICATE CERTIFICATE CERTIFICATE 120296 020498 062797 110992 13401.81 5360.00 11009.59 15000.00 31.39 12.08 35.27 23.75 13433.20 5372.08 11044.86 15023.75 JTO REBAN MCDONALD 120296 8000057040 CERTIFICATE 072500 11000.00 17.16 11017.16 JTO JTO JTO NEVIN L NEVIN L REBA N NAILOR NAILOR MCDONALD 020498 062797 110992 JTO REBA I MCDONALD 072500 466243254 5500029661 CERTIFICATE SAVINGS 080993 083002 6600.00 2265.65 1.75 .42 6601.75 2266.07 JTO JTO REBA N REBAN MCDONALD MCDONALD 080993 083002 Additional Information Requested SENIOR SERVICES REP. P.O. Box 171 I. HARRISBURG, PENNSYLVANIA 17105-1711 Toll FrEE 1-866-WAYPOINT (I-866-9;~9-7646) · IN YORK ARr=A 717/815-4500 · www. wagpointbank.com Checking Accounts Number: Date Opened: Balance at Date of Death: Name of Joint Owner, if any: Savings Accounts: Number: Date Opened: Balance at Date of Death: Name of Joint Owner, if any: Certificates of Deposit: Number: 34392-01 34392-60 Date Opened: Name of Joint Owner, if any: Balance at Date of Death: Maturity Date: Interest Rate: 4,5'3 Interest Paid Quarterly, Semi-Annual, etc. Debts: HOME EQUITY LOAN CAR LOAN Estate of: Ruth W. Nailor, Name of Bank: AmeriChoice Federal Credit Union Date of Death: July 18, 2003 Signature of Ban~ or ~a-v/ngs Assoc. Official Primary Owner: st MEMBERS 1st FEDERAL CREDIT UNION Reba N. McDonald CERTIFICATE OF DEPOSIT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Created 84984 -40 06/25/2003 $12,000.00 $17.38 $12,017.38 Ruth W. Nailor 06/25/2003 ~Wolfe Insurance Supervisor October 15, 2003 Estate of: RUTH W. NAILOR Date of Death: 07/18/2003 Social Security Number: 188-12-4467 5000 Louise Drive · P.O. Box 40 ° Mechanicsburg, Pennsylvania 17055 · (717) 697-1161 · www. memberslst, org 03 11; 338 CIS . 13(]2~34,2136 I0. 1 Mil~boro, Oe[avv~ 19966 (302) 9342722 Fax TO; ~ Coyne' From: Fax= (717) 737-5161' Pho~ (717) 737-0464 II.tm 12/30/03 ~ RutJ1 Nailor- Date of D~ 07/1~03 · Co~ Please find ~e date of dear balances [of' ~ al)ore named decede~ you had mquesled. ~f you have any ~Eg-~O-O~ TUE 9:25' A~ 43679i312~9~3~' ~^X N0. 717737516~ ?. 5 Number: 5753Y2 Da-- Op~r,d: .~//']c/ of l~h: ..... Balanc,~ at of Dca~: Dat~ o£Dcath: Stfl7 15, Name o£Ba~k M~TBa.nk/l~ermerlv Kev,stone F~n~nci.l Cor~.) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL~& ,N3M~'iRATIVE COSTS ESTATE OF FILE NUMBER NAILOR, RUTH I. 21 - 2003 - 620 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT 1. 2. 3. 2 FUNERAL EXPENSES: Myers Funeral Home, Inc. Reception Headstone and Engraving ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid Attorney's Fees CO.NE & CO~E, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent Probate Fees Register o£ Wills State Zip Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs Postage Auctioneer's Fee- Bricker's Auction 8,915.00 200.00 500.00 8,900.00 260.00 74.00 2,900.00 Total of Continuation Schedule(s) 4,608.00 TOTAL (Also enter on line 9, Recapitulation) 26,356.25 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER NAILOR, RUTH I. 21 - 2003 - 620 3 Merrill Lynch- Broker's Commission 175.00 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 Lititz Mutual Insurance-- Car Insurance Lititz Mutual Insuamce-- Home Owners Reserves 2003 Income Taxes Settlement Closing Costs Silver Spring Sewer & Trash Mileage for Executors ~ $.32/mile Patriot News-- Legal Advertisement Cumberland Law Journal-- Legal Advertisement Carey & Associates-- Tax Returns Preparation Cleaning Supplies for Sale and Auction Lawn care and cutting Filing Fee-- Inheritance Tax Return Estate Checks D&D Rentals-- Portable Toilet for Auction Central Penn Appraisals 234.00 240.00 1,000.00 300.00 1,137.00 81.00 176.00 100.00 75.00 200.00 200.00 300.00 15.00 25.00 75.00 275.00 Page 2 of Schedule H COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER NAILOR, RUTH I. 21 - 2003 - 620 Include unreimbursed medical expenses. ITEM DESCRIPTION AMOUNT NUMBER Verizon PP&L Lifestar Response of Maryland 80.00 85.00 858.00 TOTAL (Also enter on Line 10, Recapitulation) 1,023.00 REV-1513 EX+ (9-00) · SCHEDULE J COMMONW~L~, OF PENNS¥'VANI^ BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER NAILOR, RUTH I. 21 - 2003 - 620 RELATIONSHIP TO AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT OF ESTATE Do Not List Trustee(si [o TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1 Nevin L Nailor, Jr. Grandson 1,000.00 1670 Holtz, Dr., Enola, PA 2 Sharon L. McDonald Granddaughter 1,000.00 1871 Powells Valley Rd., Halifax, PA 3 Evan M. Kaiser Great-Grandson 1,000.00 1871 Powells Valley Rd., Halifax, PA 4 Barbara A. Delgado Granddaugher 1,000.00 P.O. Box 34, Idaville, PA 5 Kathleen M. McDonald Granddaughter 1,000.00 141 Wolf's Bridge Road, Carlisle, PA 6 Kelly A. McDonald Great- 1,000.00 141 Wolf' s Bridge Road, Carlise, PA Granddaughter See Continuation Schedule(s) attached Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS I TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES continued BSTATE OF FILE NUMBER NAILOR, RUTH I. 21 - 2003 - 620 RELATIONSHIP TO NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT AMOUNT OR SHARE Do Not Mst Trustee(s) OF ESTATE 10 11 12 TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] Kerri E. McDonald 141 Wolf's Bridge Road, Carlise, PA Nancy A. Gonzalez 334 Pine Grove Road, Gardners, PA Jose R. Gonzalez 2900 W. Baker Rd., Baytown, TX Anna M. Gonzalez 271 Emmitsburg Rd., Gettysburg, PA Nevin L. Nailor 474 Sample Bridge Road, Enola, PA Reba N. McDonald 221 Ridge Hill Rd., Mechanicsburg, PA Great- Granddaughter Granddaughter Great- Grandson Great- Granddaughter Son Daughter 1,000.00 1,000.00 1,000.00 1,000.00 1/2 of Residual 1/2 of Residual Page 2 of Schedule J COHHONWEALTH OF PENNSYLVANIA '.-: DEPARTHENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DE~T. ZBO60Z HARRISBURG, PA 171ZB-0601 .... RE¥-]$~15 EX AFP (09-00} ~NFORNATZON NOTICE AND TAXPAYER RESPONSE FTLE NO. 21 03-0620 ACN 03157529 DATE 10-21-2005 :-, TYPE OF ACCOUNT ~::! EST. OF RUTH W NAILOR [~SAVZNeS $.$ NO. i88-1Z-qq67 [] CHECKTNG ~~' ~ - ":-{- ~ DATE OF DEATH 07-i8-2005 ~TRUST ~"-" ' ~'" ' '~ COUNTY CUMBERLAND ~ CERTIF. NEVIN L NAILOR ~ - ~ 9F~;~ ..... REGISTERREHZT oFPAYHENTwILLsAND FOR~S TO: qTq SAMPLE BRIDGE RD ' -~ CUMBERLAND CO COURT HOUSE ENOLA PA 17025 ?' CARLISLE, PA 17015 NAYPOINT BANK has provided the Department with the information listed below 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 written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions cay be anseered bv calling (717) ?BT-85ZT. COMPLETE PART I BELOW x x x SEE REVERSE SZ~E FOR FILING AND PAYMENT INSTRUCTIONS Accoun~ No. 3200006619 Da~a 02-0fi-1998 Established Accoun~ Balance 5, ~72.08 Percan~ Taxable X 5 0.0 0 0 Aeoun~ SubSec~ ~o Tax 2,686.~0fi Tax Ra~ce X . i 5 Po{an*iai Tax Due qOZ.91 To insure proper credit to your account, two (Z) copies of this notice must accompany your payment to the Register of Wiils. Hake check payabIa to: "Register of Wills, Agent". NOTE: If tax payments are made within three (5) months of the decedent's date of death, you may deduct a SZ discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death.' PART TAXPAYER RESPONSE CHECK ONE BLOCK ONLY PART TAX LZNE A. ~ The above information and tax due is correct. 1. You may choose to remit payment to the Register of Wills with 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 '~T Wi~s and an officiaI assessment wilI be issued by the PA Department of Revenue. B. ha above asset has been or will bm reported and tax paid with the Pennsylvania Inheritance Tax return /-~ta be filed by the decedent's representative. C. ~ The above information is incorrect and/or debts and deductions were paid by you. You must compiata PART ~ and/ar PART ~ below. If you indicate a dif~eren~ ~ax ra~e, please s~a~a your relationship ~o decaden~: RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS l. Da~e Established' ~ 2. Accoun~ Balance 2 ~. Parcen* Taxable $ ~ ~. Amoun~ SubSec~ *o Tax ~ S. Debts and Deductions ~ - 6. Aeoun~ Taxable 6 7. Tax Ra*e 7 ~ 8. Tax Due 8 PART DATE PAID DEBTS AND DEDUCTZONS CLAZMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line $ of Tax Computation) $ Under penalties of perjury, T declare ~ha~ the fac~s T have reported above are ~rue, correc* and complo*e {o the bes~ of .~ kno.iedga and belief. HOME ¢ 7/:7) ~ ~ 2 ~/~ ~ ~ ~.r~,.--,.~. ~"'~'?~ ,_ ~..~¥,.~_~ WORK ( ) TAXPAYER SIGNATURE TELEPHONE NUMBER DATE CONHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE BUREAU OF INDIVIDUAL TAXES D~PT. 280601 HARRISBURG, PA 17128-0601 RE¥-ZG~iS EX &FP ¢09-00) INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. 21 05-0620 ACN 05157530 DATE 10-21-2005 NEVI N L "NA! LOR, ,-: fiTfi SAMPLE BRIDGE-RD' ENOLA PA 17025 EST. OF RUTH W NAILOR S.S. NO. 188-12-qfi67 DATE OF DEATH 07-18-2005 COUNTY CUMBERLAND TYPE OF ACCOUNT [] SAVTNOS [] CHECKING [] TRUST [] CERTIF. REHZT PAYHENT AND FORHS TO: ..... ~' REGISTER OF WILLS CUMBERLAND CO COURT HOUSE ................ CARLISLE, PA 17015 #AYPOINT BANK has provided the Department with the information listed below which has been used in calculating t~e potential tax due. Their records indicate that at the death of the above decedent, you were a jolnt owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions may be answered by ca]ling (717) 7&7-8327. CONPLETE PART 1 BELOW x x ~ SEE REVERSE SIDE FOR FILING AND PAYNENT INSTRUCTIONS Account No. 3265298q56 Date 06-27-1997 Established Account Balance 11,0q~.86 Percent Taxable X 50.000 Amount Subject to Tax 5,522.q~ Tax Rate X .15 Potential Tax Due 628.56 To insure proper credit to your account~ (2) copies of this notice must accompany your payment to the Register of Nills. Nake check payable to: "Register of Wills, Agent". NOTE: If tax payments are made within three (~) months of the decedent's date of death, you may deduct a 52 discount of the ~ax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. PART TAXPAYER RESPONSE CHECK ONE BLOCK ONLY PART TAX LINE A. F--] The above in+ormation and tax due is correct. 1. You may choose to remit payment to the Register cf N[lls with two copies of this notice to obtain a discount or avoid interest~ or you may check box "A" and return thls notice to the Register of B.~ Nills and an official assessment will be issued by the PA Department of Revenue. he above asset has been ar will be reported and tax paid ~ith the Pennsylvania Inheritance Tax return o be filed by the decedent's representative. C. [] The above inforeatien is incorrect and/or debts and deductions were paid by you. You must complete PART [] and/or PART [] below. If you indicate a different ~ax ra~e, please state your relationship to decedent: RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS 1. Da~e Established 2. Account Balance 2 $. Percent Taxable $ ~ q. Amount SubSact to Tax q $. Debts and Deductions S - 6. Amoun* 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) Under penalt/es of perjury, I declare that the facts I have reported above are true, correct( and complete to the bas* of my knowledge and belief. HOME (7/?) ~//7 ?~,' ~ ~ ~ ~ ~X~ WORK ( ) ' - ' T~XPAYER SISNATURE TELEPHONE NUMBER ~ATE COMMONWEALTH OF PENNSYLVANZA DEPARTMENT OF REVENUE BUREAU OF INDTVZDUAL TAXES DEPT. ZBOSDI HARRISBURG, PA 171lB-DB01 ZNFORMATION NOTICE AND TAXPAYER RESPONSE FZLE NO. 21 05-0620 ACN 05157526 DATE 10-21-2005 REBA N MCDONALD 221 RIDGE HILL RD MECHANICSBURG PA 17050-17q7 EST. OF RUTH W NAILOR S.S. NO. 188-12-qq67 DATE. OF DEATH 07-18-2003 COUNTY CUMBERLAND TYPE OF ACCOUNT [$AVZNGS []CHECKING []TRUST []CERTIF. REHZT PAYHENT AND FORHS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 WAYpOTNT BANK has provided the Department with the information listed below which has been used in calcuIating the potential tax due. Their records indicate that at the death of the above decadent, you were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institutionj attach a copy to this form and return it to the above address. This account is tax~ble in accordance with the Inheritance Tax Laws of the Commonwealth of PannsyIvan[a. Questions may be answered by calling (717) 767-552_7. COMPLETE PART ! BELOW ~ ~ ~ SEE REVERSE SZDE FOR FXLZNG AND PAYMENT XNSTRUCTIONS A¢¢oun~ No. q66Z~SZSq Da*e 08-09-1993 Es~abl 1shed A¢coun~ Balance 6,601.7 5 Percan~ Taxable X 50 . 000 Aeoun~ SubSec~ ~o Tax ~00.88 Tax RB~e X . 15 Po~en~ia/ Tax Due q95.1~ To insure proper credit to your account, two (Z) copies of this notice must accompany your payment to the Register of Hills. Make check payable to: "Register of WiIisj Agent". NOTE: If tax payments arm made within three (~) months of the decedent's date of death, you may deduct a SZ discount of the tax due. Any inheritance tax due wil! become delinquent nine (9) months after the date Of death. PART TAXPAYER RESPONSE CHECK ONE BLOCK ONLY A. ~ The above information and tax due ts correct. 1. You may choose to remit payment to the Register of WilIs with 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 Wills and an official assessment will be issued by the PA Department of Revenue., B.~The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return t° be filed by the decedent's representative. C. I ~ The above information is incorrect and/or debts and deductions were paid by you. You must comp[ate PART ~ and/or PART ~ beIow. PART TAX LTNE If you indicate a differen~ ~ax ra~e, please $~a~a your rela~ionsh[p ~o decedent: RETURN COMPUTATZON OF TAX ON JOTNT/TRUST ACCOUNTS 1. Da~e Established I 2. Accoun~ Balance 2. 3. Percan~ Taxable $ ~ q. Amoun~ Subjec~ ~o Tax q S. Debts and Deductions 5. - 6. Aaoun~ Taxable 6 7. Tax Ra~e 7 ~ B. Tax Due 8 PART DATE PAID DEBTS AND DEDUCTZONS CLAZMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Coepu(a(ion) $ Under penalties of perjury, I declare ~ha~ ~he fac~cs Z have reported above are ~rue, correc~ and ee~o ~he bes~ of my knowledge and belief. HOME C ) TAXPAYER SIGNATURE ' ~ TELEPHONE NUMBER DATE COHHDNNEALTH OF PENNSYLVANIA OEPARTHENT DF REVENUE BUREAU OF INDZVTDUAL TAXES DEPT. IS0601 HARRTSBURG, PA I?IZe-DBOl ZNFORHATZON NOTICE AND TAXPAYER RESPONSE FILE NO. 21 05-0620 ACN 05157527 DATE 10-21-2005 REBA N'~RCDONALD 221 RIDGE HILL MECHANICSBURG PA 17050-17fi7 TYPE OF ACCOUNT EST. OF RUTH W NAILOR [] SAVINGS S .S. NO. 188-12-qq67 [] CHECKING 'DATE OF DEATH 07-18-2003 [] TRUST COUNTy CUMBERLAND [] CERTIF. "EHIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE ................... CARLISLE, PA 17013 NAYPOINT BANK has provided the Department with the information listed below whlch has bean 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 written correction from the financial institution, attach a copy to this form and return it to the above address. This account is to×able in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. ~uastion~ Hay be answered by calling(.7[~ COMPLETE PART 1 BELOW x x x SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 80000570q0 Data 07-25-2000 Established Account Balance 11,017.16 Percent Taxable X 50.000 Amount Sub,act to Tax 5,508.58 Tax Rate X .15 Potential Tax Due 826.29 To insure proper credit to your account, two (Z) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of ~ills~ Agent". NOTE: If tax payments are made within three C5) months of the decadent's date of death, you may deduct a 52 discount of the tax due. Any inheritance tax due will become delinquent nine C9) months after the date o~ death. PART TAXPAYER RESPONSE F~. CHECK ONE BLOCK ONLY A. ~ The above information and tax due is correct. 1. You may choose to remit payment to the Raglster cf Wills with 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 ~il! be issued by the PA Department of Revenue. ~he B. above asset has been or will ba reported and tax paid with the Pennsylvania Inheritance Tax return f t~ be filed by the decedant's representative. C. I I The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~and/or PART ~below. PART If you indicate a different tax rate, please stats your relationship to decedent: TAX RETURN - COMPUTATTON OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Data Established. 1 2. Account Balance 5. Percent Taxable q. Amount SubSact to Tax $. Debts and Deductions 6. Amount Taxable 7. Tax Rata 8. Tax Due PART DATE PAID DEBTS AND DEDUCTTONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line $ of Tax Computation) Under penalties of perjury, I declare that the facts I have reported above are true, correct and / .~]_~.e~plete to the best of my knowledge and belief. HOME C ) TAXPAYER SIGNATURE' ~ TELEPHONE NUMBER DATE CDNMONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DF-~PT. ZSD6DZ HARRISBURG, PA 171Z8-0601 REV-1E4S EX AFP INFORMATION NOTZCE AND TAXPAYER RESPONSE FILE NO. 21 03-0620 ACN 0513752q DATE 10-21-2003 ,c, TYPE OF ACCOUNT '*' £ST. OF RUTH W NAILOR [] SAVINGS ---~* S.S. NO. 188-12-qq67 [] CHECKING DATE OF DEATH 07-18-2003 [] TRUST ; COUNTY CUMBERLAND [] CERTTF. :_~ L!L~.L' .-. ~. _ . REMIT PAYMENT AND FORMS TO: REBA N:MCDONALD REGISTER OF WILLS 221 RIDGE HILL RD CUMBERLAND CO COURT HOUSE HECHANICSBURG PA 17050-17q7 -~ CARLISLE, PA 17015 HAYPOINT BANK has provided the Department with the information listed below 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 written correction fram the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance eith the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions ~ay be answered by ceiling (717) 7&7-8327. COMPLETE PART I ~ELOW x x x SEE REVERSE S~DE FOR FILING AND PAYMENT INSTRUCTIONS Accoun~ No. 1861291787 Data 12-02-1996 Established Accoun~ Balance 1~ · q3~ . 20 Percen~ Taxable X 5 O . 0 0 0 Amount: SubSec~: ~:o Tax 6,716.6 0 Tax Ra~a X .15 Po~en~iai Tax Due I ~ 007. q9 To insure proper credit to your account, two CZ) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills, Agent". NOTE: If tax payments are made within three C$) months cf the decedent's date of death~ you may deduct a SZ discount of the tax due. Any inheritance tax due will became delinquent nine (9) months after the date of death· PART TAXPAYER RESPONSE CHECK ONE BLOCK ONLY A. ~ The above information and tax due is correct. ' 1. You may choose to remit payment to the Register of Wills with 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 Wills and an official assessment mill be issued by the PA Department of Revenue. B. ~T~e~ above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return be filed by the decedent's representative. C. ~ The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~below. PART TAX LINE If you indicate a differan~ ~ax ra~e, please s~a~a your relationship ~co decedent: RETURN - COMPUTATION OF' TAX ON JOINT/TRUST ACCOUNTS 1. Da~e Established 2. Accoun* Balance 2. ~. Patten* Taxable ~ ~ q. Amoun~ Sub~ec~ ~o Tax fi 5. Debts and Deductions 5 - 6. Amoun~ Taxable 6 7. Tax Ra*a 7 ~ 8. Tax Due 8 PART DATE PAID DE~TS AND DEDUCTIONS CLAZMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line S of Tax Computation) Under penalties of perjury· I declare ~ha~ ~he fac~s I have repor~ced above are ~rue, correc~C and complete ~o ~he bes~ of my knowledge and belief. HOME C ) 7l, .aRK ) TAXPAYER SIGNATURE TELEPHONE NUMBER DATE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 INFORMATION NOTICE AND TAXPAYER RESPONSE FZLE NO. 21 05-0620 ACN 05157525 DATE 10-21-2005 REBA N M~DONALD 221 RIDGE HIE[ RD MECHANICSBURG-: PA 17050-17q7 [~G - 8 EST. OF RUTH W NAILOR S.S. NO. 188-12-qq67 DATE OF DEATH 07-18-2005 COUNTY CUMBERLAND TYPE OF ACCOUNT ~ SAVINGS [] CHECKING [] TRUST [] CERTIF. REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 WAYPOINT BANK has provided the Department with the information listed below 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 written correction from the financial institution, attach a copy to this ~ors and return it ta the above address. This account is t~xable in uccerdance with the Inheritance Tax La~s of the CommonweaZth of Pennsylvania. Questions ma~ be answered by calling C717) 787-8~27. COMPLETE PART i ~ELOW ~ ~ ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Accoun~ No. 5500029661 Date 08-50-2002 Established Accoun~ Balance .00 Parcan~ Taxable X l00.00 Amoun~ Sub~ec~ ~o Tax .00 Tax Ra~e X .i5 Po~en~ia! Tax Due .00 To insure proper credit to your account, two CZ) copies of this notice must accompany your payment to the Register of Wills. Make check payable to: "Register of Wills~ Agent". NOTE: If tax payments are made within three [~) months of the decedent's date of death, you nay deduct a 52 discount of the tax due. Any inheritance tax due will become delinquent nine C9) months after the date of death. PART TAXPAYER RESPONSE CHECK BLOCK ONLY A. [] The above information and tax due is correct. 1. You may choose to remit payment to the Register of Wills with tad copies of this notice to obtain a discount or avoid intarest~ or you may ch~ck box "A" and return this notice to the Register of Nills and an official assessment will be issued by the PA Department of Revenue. B.~The above asset has been or will be reported and tax paid with the Pennsylvania [nherltance Tax return /~--~to be filed by the decedent's representative. C. ~ The above information is incorrect and/or debts and deductions ~ere paid by you. You must complete PART [] and/er PART [] below. If you indicate a differan~ ~ax ra~e, please s~a~e your relationship ~o decedent: RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS 1. Oa~e EstabliShed I PART TAX LINE 2. Accoun~ Balance 2 5. Percen~ Taxabie $ ~ q. Aeoun~ SubSec~ ~o Tax q S. Dab~s and Deductions ~ 6. Amoun~ Taxable 6 7. Tax Ra~e 7 ~ 8. Tax Due 8 PART DATE PAID DESTS AND DEDUCTIONS CLAZMED PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line S of Tax Computation) Under penalties of perjury, I declare {ha{ ~he fac~cs I have reported above are ~crue, correc~ and co_mpie~e ~o ~he bes~ of my know[edge and belief. HOME C ) TAXPAYER SIGNATURE - TELFPHflNF NIIMRF~ nATF COHMONHEALTH OF PEHHSYLVAHIA DEPARTHEMT OF REVEHUE BUREAU OF INDIVIDUAL TAXES DEPT. Z80601 HARRISBURG, PA 171Z6-0601 ZNFORHATZON NOTZCE AND TAXPAYER RESPONSE REBA N MCDoNAL~'' 221 RIDGE HILL RD HECHANICSBURG PA 17050 FZLE NO. 21 03-0620 ACN 05157528 DATE 10-21-2005 EST. OF RUTH W NAILOR S.S. NO. 188-12-4q67 DATE OF DEATH 07-18-2005 COUNTY CUMBERLAND REHIT PAYHENT AND FORHS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 TYPE OF ACCOUNT []SAVINGS [] CHECKING []TRUST [] CERTTF. NAYPOINT BANK hms provided the Department with the information listed below which has been used in calculating the potantial tax due. Their records indicate that at the death of the above decedent, you ware a joint o~ner/beneficiary cf this account. [~ you feel this information is incorrect~ please obtain ~rltten correction from the financial institutlon~ attach a copy to this form and return it to the above address. Th~s account is ~xable in acccrdance w~th ~he Inheritance Tax Laws o~ the Commonwealth of Pennsylvania~ Question~ m'~y be an~ueredby belling (717) 767-S3~7. COMPLETE PART ! BELON x x x SEE REVERSE SIDE FOR FILING AND PAYMENT ~NSTRUCTZONS Accoun~ No. q6622599Z Dance 11-09-1992 Established Accoun~ Balance 15,025.75 Percen* Taxable X 5 0.0 00 Amoun~ Subjec~ ~o Tax 7,511.88 Tax Ra~e X . 15 Po~en~ial Tax Due 1 , 12~. 78 To insure proper credit to your account~ two CZ) copies of this notice must accompany your payment to the Register of Wills. Make check payabIe to: "Register of NilIs, Agent". NOTE: If tax payments are made within three C3) months o~ the decedent's date of death, you may deduct a 5Z discount o~ the tax due. Any inheritance tax due will become delinquent nine (9) months a~ter the date of death. PART TAXPAYER RESPONSE CHECK ONE BLOCK ONLY PART TAX LTNE A. ~ The above information and tax due is correct. ' . [. You may choose to remit payment to the Register of Hills with 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 cf Revenue. B. The above asset has been or ~ili be reported and tax paid ~ith the Pennsylvania Inheritance Tax return rte be filed by the decedent's representative. C. ~ The above information is incorrect and/or debts end deductions were paid by you. You must complete PART ~ and/or PART ~ below. If you indicate a d[fferen~ ~ax ra~e, please sta~e your relationship ~o decedent: RETURN - COMPUTATION OF TAX ON dOZNT/TRUST ACCOUNTS [.oate Established 1' 2. Accoun~ Balance 2 $. Percen~ Taxable $ X q. Amount Subject to Tax q ~. Debts and Deductions S - 6. Amoun~ Taxable 6 7. Tax Ra~e 7 ~ 8. Tax Due 8 PART DATE PAID DEBTS AND DEDUCTIONS CLA'rMED PAYEE DESCRIPTION AMOUNT PAID I TOTAL (Enter on Line S of Tax Computation) Under penalt/es of perjury, T declare that the facts T have reported above ara true, correct and p. le~e ~co ~che bes~ of my knowledge and belief. TELEPHONE NUMBER DATE 'JUL 3 I 2003 Register of Wills of CUMBERLAND County, Pennsylvania Certificate of Grant of Letters No. 2003-00620 PA No. 21-03-0620 ESTATE OF NAILOR RUTH I (~S'l', ~'~S'r, m~uu~) WHEREAS, on the 30th ~ated January 17th 2001 Late of SILVER SPRING TOWNSHIP Deceased Social Security No. 188-12-4467 day of July ~as admitted to probate as the last will of NAILOR RUTH I (~S'r, ~'±~'r, 2003 an instrument late of SILVER SPRING TOWNSHIP , CUMBERLAND County, who died on the t8th day of July 2003 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, DONNA M. OTTO , Register of Wills in and for ;he County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify ;hat I have this day granted Letters TESTAMENTARY ;o NAILOR NEVIN L and MC DONALD REBA NAILOR ~ho have duly qualified as Executor(rix) ~nd have agreed to administer the estate according to law, all of which fully ~ppears of record in my Office at CUMBERLAND COUNTY COURT HOUSE, _~ARLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal )f my Office the 30th day of July 2003. ~egls~er Or **NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE) OF RUTH L NAILOR I, RUTH I. NAILOR, of Silver Spring Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this my Last Will and Testamem, hereby revoking and making void any and all prior wills by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can be conveniently done. 2. I direct that there shall be paid out of my residuary estate all estate, inheritance and like taxes together with any interest or penalty thereon imposed by the Government of the United States, or any state or territory thereof, or by any foreign governmem or political subdivision thereof, in respect to all property required to be included in my gross estate for estate, inheritance or like tax purposes by any of such governmems, whether the property passes under this will or otherwise. -1- I give and bequeath the sum of One Thousand ($1,000.00) Dollars apiece, to each of my following named grandchildren and great-grandchildren, if they survive me, to wit: my grandson,.NEVIN L. NAIl,OR, JR.; my granddaughter, SHARON L. McDONALD; my great-grandson, EVAN M. KAISER; my granddaughter, BARBARA A. DELGADO; my granddaughter, KATHLEEN M. McDONALD; my great-granddaughter, KELLY A. McDONALD; my great-granddaughter, KERRI E. McDONALD; my granddaughter, NANCY A. GONZALEZ; my great-granddaughter, JOSE IL GONZALEZ; and my great-granddaughter, ANNA M. GONZALEZ. All the rest, residue and remainder of my estate, real, personal ,and mixed, I give, devise and bequeath in equal shares to my two children, REBA NAILOR McDONALD and NEVIN L. NAILOR. In the event REBA NAII,OR McDONALD predeceases me, her share shall not lapse, but pass instead as follows: A.) To her husband, JASPER R. McDONALD, the sum of Two Thousand ($2,000.00) Dollars; B.) .The balance of her undivided one-half interest shall pass to her children in equal shares, per stirpes. -2- In the event NEVIN L. NAILOR should predecease me, his share shall lapse and pass instead as follows: A.) To his wife, SALLIE JO NAILOR, the sum of Two Thousand ($2,000.00) Dollars; B.) The balance of his undivided one-half interest shall pass to his son, NEVIN L. NAILOR, JR. Lastly, I nominate, constitute and appoint my children, REBA NAILOR McDONALD and NEVIN L. NAILOR, to be Executors of this my Last Will and Testament. In the event either cannot act as such, the other shall serve as the sole Executor and I further direct that no bond or other security be required of my personal representative to guarantee faithful performance of her or his duties. IN WITNESS W-FIEREOF, I have hereunto set my hand and seal this/~ 'gz~ day of January, 2001. Ruth I. ZNailor (SEAL) Signed, sealed, published and declared by the above named RUTH I. NAILOR as and for her Last Will and Testament, in the presence of us who have subscribed our names hereto as wimesses, at her request, in her presence and_~_.the presence of each other. BUREAU OF INDIVIDUAL TAXES ZNHERTTANCE TAX D'rVTSZON DEPT. 28n601 HARRISBURG, PA 17128-0601 LISA H COYNE ESQ COYNE & COYNE $901 MARKET ST CAMP HILL COHHONgEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTZCE OF INHERITANCE TAX APPRAZSEHENT, ALLO#ANCE OR DZSALLOHANCE OF DEDUCTIONS AND ASSESSHENT OF TAX REV-16~i7 EX AFP (01-05) DATE -- .: . ~,.:. O~-STATE= OF : .i vVills DATE OF DEATH FILE NUNBER 02-24-2004 NAZLOR 07-18-200:5 21 0:5-0620 CUHBERLAND 101 Amount Remitted RUTH HAKE CHECK PAYABLE AND REMIT PAYHENT TO: REGTSTER OF gILLS CUMBERLAND CO COURT HOUSE CARLTSLE, PA 1701:5 CUT ALONG THZS LZNE ~ RETAIN LONER PORTZON FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTZCE OF ZNHERZTANCE TAX APPRA]:SEHENT, ALLOgANCE OR DZSALLOgANCE OF DEDUCTZONS AND ASSESSHENT OF TAX ESTATE OF NATLOR RUTH I FZLE NO. 21 0:5-0620 ACN 101 DATE OZ-Z4-ZO04 TAX RETURN #AS: (X) ACCEPTED AS FZLED ( ) CHANGED RESERVATZON CONCERNING FUTURE INTEREST - SEE REVERSE APPRAZSED VALUE OF RETURN BASED ON: ORZ6INAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (~) 3. Closely Held Stock/Partnership Interest (Schedule C) ($) ~. Hortgegas/Notas Receivable (Schedule D) (~) 5. Cash/Bank Daposlts/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Tote1 Assets APPROVED DEDUCTZONS AND EXENPTZONS: 9. Funera! Expenses/Ada. Costs/Hisc. Expenses (Schedule H) (9) 10. Dabts/Hortgaga L~abilities/Liens (Schedule Z) (10) 11. Total Daductions 12. Nat Value of Tax Return 107~000.00 420.00 .0O .O0 12/010.00 50~711.7:5 .00 (8) 26,:556.25 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 15. NOTE: 170,141 1,022.50 (11) 27.~78.7S (la) 142,762.98 Charitable~governmental Bequests; Non-elected 9113 Trusts (Schedule J) (1:3) Net Value of Estate Subject to Tax (lq) Zf an assessment .as issued previously, lines 14, 15 and/or 16, 17, reflect f/gures that include the total of ALL returns assessed to date. .00 142,762.98 18 and 19 ~ill ASSESSHENT OF TAX: 1.6. Amount of Line 1~ at Spouse1 rate 16. Amount of Line 1~ taxable at Lineal/Class A rata 17. Amount of Line 1~, at Sibling rate 18. Amount of Line 1~, taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDTTS: PAYNENT RECE/PT DISCOUNT DATE NUNBER :]:NTEREST/PEN PA]:D (- 10-15-200:5 CD005151 :521.20 ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 6,821 .ZO :597.20CR .00 :597.20CR ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS REg~UTRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT" (CR), YOU NAY BE D~ A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. ) '~)! TOTAL TAX CREDIT BALANCE OF TAX DUEI INTEREST AND PEN. TOTAL DUE 6,500.00 ANOUNT PAI*D (15), .00 X O0 : .00 (16). 142,762.98 X 045= 6,424.00 (17), .00 x 12 = .00 (18), .00 X 15 = .00 (19)= 6,424. O0 RESERVATION: Estates of decedents dying on or before December 1Z, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Coamonaealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: PAYHENT: REFUND (CR): OBJECTIONS: ADHIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (72 P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. --Hake check or money order payable to: REGZSTER OF NZLLS, AGENT A refund of a tax credit, which wes not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications ara available at the Office of the Register of Hills, any of the 23 Revenue District Offices, or by calling the special Z4-hour ansaering service for forms ordering: 1-800-362-Z050~ services for taxpayers with special hearing and / or speaking needs: 1-800-447-3020 (TT only). Any party in interest not satisfied eith the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as sheen on this Notice must object within sixty (60) days of receipt of this Notice by: --#ritten protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 1712B-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 be addressed in ariting to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. Sea page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax duo is paid aithin three (3) calendar months after the decedent's death, a five percent (SX) discount of the tax paid is allowed. The 15X tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January lB, 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 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 (6X) percent par annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 mill bear interest at a rate which ail1 vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through ZO0~ ara: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Yea__r Rate Factor 1982 AOX .000548 1987 9Z .000247 1999 72 .000192 1983 16Z .000458 1988-1991 11Z .000301 2000 8Z .000219 1984 112 .000301 1992 9Z .000247 2001 9Z .000247 1985 13Z .000S56 1995-1994 72 .O0019Z ZOOZ 62 .000164 1986 lOX .000274 1995-1998 9Z .000247 Z003 5Z .000137 --Interest is calculated as follows: TNTEREST = BALANCE OF TAX UNPAZD X NUNBER OF DAYS DELZNQUENT X DAZLY ZNTEREST FACTOR --Any Notice issued after the tax becalms 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 sheen on the Notice, additional interest oust be calculated. BUREAU OF INDIVIDUAL TAXES /NHERTTANCE TAX DTV/SZDN DEPT. 280601 HARRISBURG., PA 17128-0601 '04 itFC LISA H COYNE ESQ COYNE & COYNE $901 HARKET ST CAHP HILL ':'PA 17011 COHHONNEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE 'rNHERZTANCE TAX STATEHENT OF ACCOUNT DATE ESTATE OF DATE OF DEATH FILE NUHBER COUNTY ACN RE¥-1607 EX AFP (01-05) 0:5-15-2004 NAILOR RUTH Z 07-18-200:5 21 0:5-0620 CUNBERLAND 101 Amoun~ Remi~ed HAKE CHECK PAYABLE AND REHIT PAYNENT TO: REGISTER OF NILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 1701:5 NOTE: To insure proper credit: ~o your account, submi~ ~he upper por~ion of ~his form wi~h your ~ex payment. CUT ALONG THIS LINE ~ RETA'rN LONER PORTION FOR YOUR RECORDS REV-1607 EX AFP (01-03} """ 'rNHERZTANCE TAX STATEHENT OF ACCOUNT ESTATE OF NAILOR RUTH I FILE N0.21 05-0620 ACN 101 DATE 0:5-15-Z004 THIS STATENENT 1S PROVIDED TO ADV/SE OF THE CURRENT STATUS OF THE STATED ACN IN THE NANED ESTATE. SHO#N BELON 1S A SUHNARY OF THE PR/NC/PAL TAX DUE, APPLZCAT/ON OF ALL PAYHENTS, THE CURRENT BALANCE, AND, ZF APPLICABLE, A PROJECTED /NTEREST FIGURE. DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT: 02-24-2004 PRINCIPAL TAX DUE: PAYHENTS (TAX CREDITS): 6,424.00 PAYHENT RECEIPT DISCOUNT DATE NUNBER INTEREST/PEN PAID ¢-) AHOUNT PAID 10-15-200:5 :521.20 02-27-2004 REFUND .00 6,500.00 :597.Z0- ZF PAID AFTER THIS DATE, SEE REVERSE SIDE 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), TOTAL TAX CREDIT 6,424.00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF TH/S FORH FOR TNSTRUCTTONS. ) 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. -- If RES[BENT DECEDENT make check or money order payable to: REGISTER OF #ILLS, AGENT. -- If NON-RES[DENT DECEDENT make check or money order payable to: COMMONHEALTN OF PENNSYLVANIA. REFUND REPLY TO: DISCOUNT: PENALTY: 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-1313). Applications are available at the Office of the Register of Hills, any of the Z3 Revenue District Offices or from the Department's Iq-hour answering service for forms ordering: 1-800-36Z-ZO50~ services for taxpayers with special hearing and / or speaking needs: 1-BOO-q47-SOZO (TT only). Ouestions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxas~ ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA l?lZS-0601, phone (717) 787-6S05. 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. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, [996, 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, 198Z bear interest at the rate of six (SI) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 19SI 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 gOg .00054B' 1988-1991 llg .00030£ gOOl 9Z .000247 1983 16Z .000438 199Z 9Z .000Z47 ZOOZ 6X .000164 198q llX .000301 1993-1994 71 .O0019Z ZOO3 5X .000137 1985 132 .000356 1995-1998 9X .000247 ZOO4 4X .000110 1986 lOZ .000274 1999 72 .00019Z 1987 9Z .000Z47 ZOOO BZ .ODOZZ9 --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 (1S) days beyond the date of the assessment. Xf payment is made after the interest computation date shown on the Notice, additional interest must be calculated. STATUS REPORT UNDER RULE 6.12 Name of Decedent: RUTH I. NAILOR Date of Death: _July 18, 2003 Will No. 21-03-0620 Admin. No. 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: State whether administration of the estate is complete: Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: 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: interest? Did the personal representative state an account informally to the parties in Yes X No d. Copies of receipts releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Dated: COYNE & COYNE, P.C. oyne, Esqt~re Ct. No. 53r/88 Street Camp Hill, PA 17011-4227 (717) 737-0464 Counsel for Estate