The URL can be used to link to this page

Home My WebLink About03-0864COMMONWEALTH 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 0O3879 SHADE WAYNE F 53 WEST POMFRET ST CARLISLE, PA 17013 fold ESTATE INFORMATION: SSN: 186-32-5111 FILE NUMBER: 2103-0864 DECEDENT NAME: BECKWlTH KATHRYN S DATE OF PAYMENT: 04/29/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 08/22/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $747.85 REMARKS: WAYNE SHADE ESQ TOTAL AMOUNT PAID: $747.85 CHECK//2032 .... INITIALS: VZ ""'SEAL RECEIVED BY' GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS REV-1500 EX + COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 2806O1 HARRISBURG, PA 17128-0601 DECEDENTS NAME (LAST FIRST, AND MIDDLE iNITIAL I-- ' :~ ~n S. t-'t DATE OF DEATH (MM-DD-Year) REV-I$O0 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY SOCIAL S~ -,-98 H (MM-DD-Year) 08/22/2003 Lo8/30/] 905 {IF APPLICABLE) SURVIVING SPOUSE'S NAME {LAST, F RST AND MIDDLE INITIAL) J"'~ 1. Original Return E~4. Limited Estate ~]8 Decedent Died Testate (~achcopxofWd~) 1~9. Litigation Proceeds Received NAME FIRM NAME (If Appicabb) TELEPHONE NUMBER 7 ! %243-0220 aire ~"~2 Supplemental Return E~ 42. Future Interest Compromise (date of death after 12-12-82) E~7 Decedent Maintained a Living Trust (~ach co~ orrru~) E~ 13. Spousal Poverty Credit Idale of death between 12-31-91 a~d 1-1-95) 53 West Pomfret Street 1 8__.~6- 3 2 - 5 1 1 1 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER ~---] 3. Remainder Return (date of death prim-to 12-13-82) ~]5. Federal Estate Tax Return Required __ 8. Total Number of Safe Deposit Boxes --)11. Election to tax under Sec. 9113(A) ('Attach Sch O) 1~ Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3 Closely Held Corporal on, Padnership or Sole-Preprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property · (Schedule E) (5) 6. Jointly Owned Properly (Schedule F) (6) J~ Separate BlUing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Prop~ dy (Schedule G or L) (7) 8. Total Gross Asset~ (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) Carlisle 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 27!89.14 87r022.21 (8) 897211.35 890.00 527.04 (11) 1 417.04 (12) 87~794.31 (13) 1 000.00 (14) ~ 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16 Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18 Amount of Line 14 taxable at collateral rate 19 Tax Due X ~ (15) 867794.31 X .045 (16) X 12 X .15 (17) (18) _ (19) 3~905.74 REV°I$08 EX + (1_97) ~ ~ J . o.w~LT, oF PE.NS~LV^.,^ CASH. BANK DEPOSITS & Include the process of litigation and the ~te the proceeds were ~eceived by the estate All Pro~ jointly-owned wit~ ITEM NUMBER the right of su~ivomhip mu~ ~ disclo~d on Sch~ule F. DE~SCRIPTION Homes, room and boa~-d refund Department of Treasury, 2003 federal income tax refund VALUE AT DATE ~F DEATH 1,690.14 499.00 TOTAL (Also enter on line 5, Recapitulation of the same size) (If more space is needed, ' $ SCHEDULE F JOINTLY.OWNED PROPERTY 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 A. Patricia B. Orabey 19 Strawberry Drive Carlisle, PA 17013 ADDRESS JOINTLY-OWNED PROPERTY: RELATIONSHIP TO DECEDENT Daughter DESCRIPTION OF PROPERTY Incbde name of financial institution anc bank account number or similar identifying number~ Attach deed for jointly-held mai estate Waypoint Bank Certificate of Deposit No 1758246551 Waypoint Bank Certificate of Deposit No 1758319326 Waypoint Bank Certificate of Deposit No 8000057630 M&T Bank Certificate of Deposit No 31003914459829 M&T Bank Certificate of Deposit No 031003911151949 M&T Bank Checking Account No. 2678082005 M&T Bank Money Market Account No. 015004200903141 DATE OF DEATH VALUE OF ASSET 20,010.61 25,036.96 15,003.32 35,005.03 52,413.96 4,764.29 21,810.22 % OF DATE OF DEATH DECO's VALUE OF INTEREST DECEDENT'SINTEREST 50 10,005.31 50 50 50. 12,518.48 7,501.66 17,502.52 50. 26,206.98 50. 2,382.15 50. 10,905.11 TOTAL (Also enter on line 6, Recapitulatio~ (If more space is needed, insert additional sheets of the same size) · co M~:E~i~i~A SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSE INHERITANOE TAX RETURN S & ADMINISTRATIVE COSTS Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION A. FUNERAL EXPENSES: 1. AMOUNT ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (E) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City _ State _ Year(s) Commission Paid: Attorney Fees Wayne F. Shade, Esquire Family Exemption: (If decedent's address is n pt the same as claimant's attach explanation) Claimant ' Street Address City. Relationship of Claimant to Decedent Probate Fees .--.---..._ State _ Accountant's Fees Tax Return Preparer's Fees Register of Wills, filing Pennsylvania Inheritance Tax Return John P. Hassler, PC, preparation of income tax returns _ Zip __ Zip 750.00 15.00 125.00 (If more space is needed, ' TOTAL (Also enter on line 9, Recapitulation) size) 890.00 REV-1512 E~ + (1.97) ~ · / SCHEDULE I COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT INHERITANCE TAX RETURNJ ESTATE OF FILE NUM~ Include unreirnbursed medical expenses. ~ ITEM NUMBER 1. DESCRIPTION Pennsylvania State Employees'Retirement System, pension reimbursement 2. Optical, eye care West Shore EMS, ambulance services Continuing Care RX, unreimbursed pharmaceutical expense Philhaven, transportation AMOUNT 103.48 140.00 99.01 157.88 26.67 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 527.04 REV-1513 EX + OMMONWEALTH OF PENNSYLVANIA BENEFICIARIES RELATIONSHIP TO NUMI NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) [ TAXABLE DISTRIBUTIONS [include outright spousal distribut OhS and transfers under Sec. 9116 (a) (1.2)] Patricia B. Grabey 19 Strawberry Drive Carlisle, PA 17013 Daughter 100% AMOUNT SHARE OF ESTATE II. ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS Harmony Cemetary Association 1,000.00 TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET (If more space is needed, insert additional sheets of the same size) REV-1500 EX + (6-00) Z UJ UJ 0 ~-00 < I-- z uJ a z 0 uJ 0 o Z 0 X COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAl Beckwith7 Kathryn S. DATE OF DEATH (MM-DD-Year) 08/22/2003 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT IDAT~ OF BIRTH (MM-DD-Year) 08/30/1905 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) OFFICIAL USE ONLY FILE NUMBER t 2 1 -0 __ COUNTY CODE YEAR SOCIAL SECURITY NUMBER 1 8 6- 3 2- 5 1 1 1 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER r-~l. Original Return E~]4. Limited Estate r~6. Decedent Died Testate (Attach copy of Will) j'~9. Litigation Proceeds Received E~2 Supplemental Return ] 4~. Future Interest Compromlse(dateofdeatha~er12-12-82) ]7 Decedent Maintained a Living Trust (Ntach copyofTrust) ]1,,1 Spousal Poverty Credit (d~e of de~ bet'*~en 12-31-91 and 1-1-95) ---]3. Remainder Return (date of death prim'to 12-13-82) DS. Federal Estate Tax Return Required __ 8. Total Number of Safe Deposit Boxes ]11. Election to tax under Sec. 9113(A) (ARach Sch O) NAME Wayne F. Shade~ Esquire FIRM NAME (If Appicabb) TELEPHONE NUMBER 717-243-0220 COMPLETE MAILING ADDRESS 53 West Pomfret Street Carlisle 1. Real Estate (Schedule A) (I) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4 Modgages & 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 I-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10 Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11 Total Deductions (total Lines 9 & 10) 12 Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (8) (11) (12) (13) (14) 2~189.14 877022.21 890.00 527.04 PA 17013 ~ OFFICI~ ONLY C,5 897211.35 17417.04 877794.31 17000.00 867794.31 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19 Tax Due X __ (15) 867794.31 X .045 (16) X 12 (17) X .15 (18) 20¸ 37905.74 (19) 37905.74 Decedent's Complete Address: STREET ADDRESS 210 Big Spring Road CITY Newville STATE PA ZIP 17241 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3,000.00 157.89 Interest/Penalty if applicable D. Interest E. Penalty Total Credits ( A + B + C ) (2) (1) 37905.74 Total Interest/Penalty ( D + E ) 3~157.89 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 (4) If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 747.85 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 747.85 Make Check Payab/e to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ......................................................................... [] [] b. retain the right to designate who shall use the Property lmnsferred or its income; ...................................... [] [] c. retain a reversionary interest;.or .................................................................................................. [] [] d. receive the promise for life of either payments, benefits or care? .......................................................... [] [] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideratinn? .......................................................................................... [] [] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death2 ............... [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designatic~2 .................................................................................................. [] [] 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 retum, including acco npanying schedubs and statements, and to the best of my knowbdge and pelef, it is true, correct and complete. Decbration of preparer other than the personal representative is based on all information of which preparer has any knowbdge. SIGNATUR6'Qf: PERSON RESPONSIBLE FOR FILING RETURN ADDRES~ - 19 Strawberry Drive Carlisle DATE 4/27/04 PA 17013 SIGNATURE OF PREPARER OTHER THAN-EF. PRESENTATIVE ADD E 5~r West Pomfret Street DATE 4/27/04 Carlisle PA 17013 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 impcsed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of 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. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Beckwith. Kathrvn S. 21 03 Include the proceeds of litigation and the date the proceeds were received by the estate. All propert~ jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. VALUE AT DATE DESCRIPTION OF DEATH Presbyterian Homes, room and boa]'d refund 1,690.14 Department of Treasury, 2003 federal income tax refund TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) 499.00 27189.14 REV-1509 EX + (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER Beckwith. Kathrvn S. 21 03 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Patricia B. Orabey 19 Strawberry Drive Daughter Carlislc, PA 17013 c JOINTLY-OWNED PROPERTY: L',-~ H-R DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institutio~ anc bank account number or similar identifying number. Attach DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTERES 1. A. 020894 Waypoint Bank 20,010.61 50. 10,005.3] Certificate of Deposit No 1758246551 2. A 082597 Waypoint Bank 25,036.96 50. 12,518.48 Certificate of Deposit No 1758319326 3. A 060500 Waypoint Bank 15,003.32 50. 7,501.66 Certificate of Deposit No 8000057630 4. A M&T Bank 35,005.03 50. 17,502.52 Certificate of Deposit No 31003914459829 5. A M&T Bank 52,413.96 50. 26,206.98 Certificate of Deposit No 031003911151949 6. A M&T Bank 4,764.29 50 2,382.15 Checking Account No. 2d78082005 7. A M&T Bank 21,810.22 50 10,905.11 Money Market Account No. 015004200903141 TOTAL (Also enter on line 6, Recapitulation) $ ........ 87~022.21 (If more space is needed, insert additional sheets of the same size) REV-1511EYe+ (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Beckwith, Kathryn S. Debts of decedent must be reported on Schedule I. FILE NUMBER 21 03 ITEM NUMBER DESCRIPTION FUNERAL EXPENSES: ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Represenlative (.~) Sociar Security Number(s) / EIN Nulnber of Personal Representative(s) Street Address City Year(s) Commission Paid: Attorney Fees Wayne F. Shade, Esquire Family Exemption: (If decedent's address is n }t the same as claimant's, attach explanation) Claimant Street Address City State Relationship of Claimant to Deceder4 Probate Fees Accountant's Fees Tax Return Preparer's Fees Register of Wills, filing Pennsylvania Inheritance Tax Return John P. Hassler, PC, preparation of income tax returns State Zip TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) $ 890.00 AMOUNT 750.00 15.00 125.00 Zip REV-1513 EX + (,a_nn'~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER Beckwith, Kathryn S. NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] II. Patricia B. Grabey 19 Strawberry Drive Carlisle, PA 17013 21 03 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Daughter 100% AMOUNT OR SHARE OF ESTATE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS Harmony Cemetaty Association TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 1,000.00 (If more space is needed, insert additional sheets of the same size) 1~000.00 HENRY /. STUART 1-3 8. HANOVEI=I CARLISLE, PA, 17013 LAST WILL A~ TEST.~MENT I, KATHRYN S. BECKWITH, o.f South Hiddleton Township, Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do make, publish and declare this as and for my last will and testament, 'h~eby revoking and making void all former wills by me at any time heretofore made. FIRST. I direct all my just debts and funeral exoenses be fully pa~d and satisfied out of my estate by my personal reoresentative hereinafter named. as soon as conveniently may be after my decease. SECOND. I give and bequeath the sum of one thousand ($1,000.00) dollars to the Harmony Cemetery Association, Penn Run, Pennsylvania. THIRD. I give, devise and bequeath all the rest, residue and remainder of my estate, real and personal, to my daughter,~Patricia B. Grabey, if living, otherwise, as follows: A. One-third (1/3rd) thereof to my son-in-law, Joseph E. Grabey. B. One-third (1/3rd) thereof to my grandson, Kurt S. Grabey. C. One-third (1/3rd) thereof to my granddaughter, Carol Ann VUkoder~ LASTLY, I nominate, constitute and appoint my daughter, Patricia B. Grabey~ Executrix, if living, otherwise my son-in-law, Joseph E~ Grabey, Executor, of this my last will and testament. I~b~ITNESS WHEREOF, I bave _~eunto set my hand and seal this ~day .~.~_~ ..... (SEAL) Signed, sealed, published and declaPed by the above named Testatrix, Kathryn $. Beckwith, as and for her last will and testament, in the presence of us, who~ at her request and in her presence and in the presence of each other, have hereunto subscribed our na~es as witnesses thereto~ REV-1512 E~, + (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES,&LIENS ESTATE OF Beckwith. Kathryn S. Include unreimbursed medical expenses. FILE NUMBER ;~1 03 ITEM NUMBER DESCRIPTION Pennsylvania State Employees' Retirement System, pension reimbursement Optical, eye care West Shore EMS, ambulance services Continuing Care RX, unreimbursed pharmaceutical expense Philhaven, transportation TOTAL (Also enter on line 10, Recapitulation) (If more space is needed, insert additional sheets of the same size) AMOUNT 103.48 140.00 99.01 157.88 26.67 527.0/I 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 0O31 6O SHADE WAYNE F ESQUIRE 53 WEST POMFRET STREET CARLISLE, PA 17013 ........ fold ESTATE INFORMATION: SSN: 186-32-5111 FILE NUMBER: 2103-0864 DECEDENT NAME: BECKWlTH KATHRYN S DATE OF PAYMENT: 10/22/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 08/22/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $3,000.00 TOTAL AMOUNT PAID: $3,000.00 REMARKS: WAYNE FSHADE ESQUIRE SEAL CHECK# 1808 INITIALS: AC RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES ZNHERZTAHCE TAX DTVZSION DEPT. 180601 HARRTSBURG, PA 17118-0601 COHHONWEALTH OF PENNSYLVANZA DEPARTNENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1;q7 EX AFP (01-05) WAYNE F SHADE ESQ 55 W POHFRET ST CARLISLE PA 17015 DATE 06-1q-ZOOq ESTATE OF BECKWITH DATE OF DEATH 08-22-2005 FILE NUHBER 21 05-086q COUNTY CUHBER LAND ACN 101 I Amount Remitted KATHRYN S HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03} NOTICE OF ZNHER/TANCE TAX APPRAZSEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF BECKWITH KATHRYN S FILE NO. 21 05-086~ ACN 101 DATE 06-1~-200~ TAX RETURN NAS: (X) ACCEPTED AS FILED ( } CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) E. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Znterest (Schedule C) (3) q. Hortgagas/Notes Receivable (Schedule D) (q) $. Cash/Bank Depos/ts/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6} 7. Transfers (Schedule O) (7} 8. Total Assets O0 O0 O0 O0 21189 1~ 87~OZZ 21 O0 (8) NOTE: To /nsure proper cred/t to your account, subm/t the upper port/on of th/s fora w/th your tax payment. 89,211.35 APPROVED DEDUCTZONS AND EXEHPTZONS: 9. Funeral Expenses/Adm. Costs/M/sc. Expanses (Schedule H) 10. Debts/Mortgage LAabil/t/as/Lians (Schedule T) 11. 12. 15. 1~. NOTE: 890. O0 (9~ (10) 5Z7.0q Total Deduct/ohs (11) Nat Value of Tax Return (12) Char/table/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (13) Nat Value of Estate Subject to Tax (lq) ;f an assessment was issued previously, lines 14, 15 and/er 16, 17, reflect figures that include the total of ALL returns assessed to date. DISCOUNT INTEREST/PEN PAID (-) 157.89 .00 ASSESSHENT OF TAX: 15. Amount of Line lq at Spousal rata 16. Amount of Line lq taxable at L/naal/Class A rata 17. Amount of L/ne lq at S/bl/ng rata 18. Amount of L/ne lq taxable at Collateral/Class B rata 19. Princ/pal Tax Due TAX CREDZTS: PAYMENT RECE/PT 1 DATE NUMBER zo-zz-zoo~ c~o$:i6o Oq-Z9-ZOOq CD003879 (15) .00 x O0 = (16) 86,79q.$1 X Oq5= (17) .00 x 12 = (1s) .00 x 15 = (19)= AMOUNT PAID 3,000.00 7q7.85 ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 1.q17.0~ 87,79q.$1 1,000.00 86,79q.$1 18 and 19 will .00 $,905.74 .00 .00 $,905.7q TOTAL TAX CREDIT BALANCE OF TAX DUE ZNTEREST AND PEN. TOTAL DUE 5,905.7q .00 .00 .00 ( ZF TOTAL DUE TS LESS THAN $1, NO PAYMENT TS RE~U/RED. ZF TOTAL DUE IS REFLECTED AS A "CREDTT" (CR), YOU MAY BE DU~ I g A REFUHD. SEE REVERSE S DE DF TH S FORM FOR NSTRUCT ONS., RESERVATION: Estates of decedents dying on or before December 1Z, 19aZ -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Coaeonmaalth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the laefu! Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: PAYHENT: REFUND (CR): OBJECTIONS: ADmIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section 21~0 of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (72 P.S. Section 91~0). Detach the top portion of this Notice and submit with your payment to the Register of #ills printed on the reverse side. --Hake check or money order payable to: REGISTER OF NILES, AGENT A refund of a tax credit, Nhich Nas not requested on the Tax Return, amy 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 Nills, any of the Z3 Revenue District Offices, or by calling the special lq-hour ensnaring service for fores ordering: 1-800-362-2050; services for taxpayers aith special hearing and / or speaking needs: 1-800-~7-3020 (TT only). Any party in interest not satisfied Nith the appraisement, alloNance, or disalleNance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object mithin sixty (60) days of race[pt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, 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 RevieN Unit, Dept. ZBOBO1, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid Nithin three (3) calendar months after the decedent's death, a five percent (5Z) discount of the tax paid is aZloaed. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you mould appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning aith first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes ahich became delinquent before January l, 1982 bear interest at the rate of six (BZ) percent per annum calculated et a daily rate of .00016~. All taxes ahich became delinquent on and after January l, 1982 ail! bear interest at a rate which mill 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~ are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 20X .OOOSq8 ~)1'8-X991 Ill .000301 ZOO1 92 .OOOZ~? 1983 X6Z .000~38 1992 9Z .O00Z~7 ZOOZ 6Z .00016~ lgB~ llZ .000301 1993-199q 72 .000192 2003 5Z .000137 1985 13Z .000356 1995-1998 9Z .0002~7 200q ~X .000110 1986 iOZ .O0027~ 1999 7Z .O0019Z 1987 XOZ .O0027~ ZOO0 7Z .000192 --Interest is calculated as folloNs: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shoNn on the Notice, additional interest must be calculated.