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Home My WebLink About04-0439· REV - 1~ EX + (~oo) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER21 04 q3q COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER KECK, DONALD E. 186-34-498 l ~; DATE OF DEATH (MM-DD--YEAR) DATE OF BIRTH (MM-DD-YEAR) uJ THIS RETURN MUST BE FILED IN DUPLICATE WITH THE ,y, 08/08/2003 08/18/1946 REGISTER OF WILLS uJ IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) KECK, CYNTHIA A. [] 1. Original Return [] 2. Supplemental Return [] 4. Limited Estate [] 4a. Future Interest Compromise (date of death after [] 12-12-82) [] 6. Decedent Died Testate (Attach copy [] 7. Decedent Maintained a Living Trust (Attach 0 of Will) copy of Trust) [] 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-I-95) SOCIAL SECURITY i~ of death pdor 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) ',lAME Edward L. Schorpp, Esquire :IRM NAME (If applicable) Martson Deardorff Williams & Otto FELEPHONENUMBER 717/243-3341 COMPLETE MAILING ADDRESS Ten East High Street Carlisle, PA 17013 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) None None None 32,173.95 None 2,500.00 36,329.21 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) 34,673.95 36,329.21 insolvent (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 20. [] (15) (16) (17) (18) (19) Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: ISTREET ADDRESS CITY 245 West Middlesex Road Carlisle STATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount InterestJPenalty if applicable D. Interest E. Penalty (1) Total Credits (A + B + C) (2) Total InterestJPenalty (D + E) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund If Line I + 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. (3) (4) (5) (5A) (5B) 0.00 0.00 0.00 0.00 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; .................................................................................. ~ i b. retain the right to designate who shall use the property transferred or its income; .................................... c. retain a reversionary interest; or .................................................................................................................. d. receive the promise for life of either payments, benefits or care? .............................................................. 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. preparer other than the personal representative is based on all information of which preparer has any knowledge, SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS C~thia A. Keck ~,/ SI~URE'OF PERSON RESPONSIBLE ~)R FILING RETURN ADDRESS 245 West Middlesex Road Carlisle, PA 17013 DATE DATE SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ADDRESS DATE Edwar horpp, Esquir . Ten .East High Street ~ 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 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 Df 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 KECK, DONALD E. 21 - 04 - 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 Sole proprietorship known as North End Shoe Repair (see attached) 32,173.95 TOTAL (Also enter on Line 5, Recapitulation) 32,173.95 Estate of Donald E. Keck Schedule E, Item 1: North End Shoe Repair: Cash on Hand Liquidated Inventory Inventory in kind Shoe Repair Equipment Total Assets: $ 792.00 22,238.95 8,143.00 1,000.00 32,173.95 Exhibit to Schedule E COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF KECK, DONALD E. FILE NUMBER 21 - 04 - This schedule must be completed and filed if the answer to any of questions 1 throug~ 4 on page 2 is yes. DESCRIPTION OF PROPERTY % OF ITEM Include the name of the transferee, their relationship to decedent and the date of transfer. DATE OF DEATH EXCLUSION DECD'S TAXABLE VALUE NUMBER Attach a copy of the deed for real estate. VALUE OF ASSET INTEREST 0F APPLICABLE) 1 IRA with State Farm Mutual; beneficiary: Cynthia A. Keck, 2,500.00 100% 2,500.00 spouse TOTAL (Also enter on line 7, Recapitulation) 2,500.00 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER KECK, DONALD E. 21 - 04 - Include unreimbursed medical expenses. ITEM DESCRIPTION AMOUNT NUMBER North End Shoe Repair, ongoing expenses of business Weinbrenner Shoe Co., account payable TOTAL (Also enter on Line 10, Recapitulation) 30,463.21 5,866.00 36,329.21 · REV-1513 EX+ (9-00) ~ SCHEDULE J COMMONWEA'T. Or ~ENNS~LVAN,A BEN EFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER "~'~"rxr:,.~t._, DONALD E. 21 - 04 - RELATIONSHIP TO AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT OF ESTATE ~'. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1 Cynthia A. Keck Spouse $2,500-IRA 245 West Middlesex Road Carlisle, PA 17013 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 TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I, DONALD EUG1~IE KECK, a legal resident of Middlesex Township, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my last Will and Testament, hereby revoking all other wills and codicils heretofore made by me. FIRST: I direct that all my just debts and funeral expenses, including my grave marker, shall be paid from the assets of my estate as soon as practicable after my decease. S~C[~D: I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. ~]I~D: I devise and bequeath the residue of my estate, of every nature and wherever situate, to my Wife, CYNTHIA A. KECK, providing she shall survive me by thirty (30) days. ~: Should my Wife, CYNTHIA A. KECK, predecease me or die on or before the thirtieth day following my death, I devise and bequeath my businesses known as "K Street Video" and "North End Shoe Repair" (both businesses being operated under the same federal employer identification number) to my Daughter, LISA M. KECK. Should both my Wife, ~ A. KECK and my Daughter, LISA M. KECK, predecease me or die on or before the thirtieth (30th) day following my death, I devise and bequeath said businesses to my Daughter, NICOLE R. KECK. In the event that she is a minor at the time of my death, I request that my trustees hereinafter named operate said businesses for her benefit as part of the trust hereinafter est~_blished. It is my desire that said businesses, to the extent possible, be preserved intact as part of the assets of said trust and that full ownership of the businesses be turned over as a going concern to my Daughter, NIOOLE R. KECK at the time she attains the age of 21. In the event that my wife and both daughters aforesaid predecease me or die on or before the thirtieth (30th) da~v following my death, th~n I devise and bequeath said businesses to MR. and MRS. GIENNWOOD BICK~A, or the survivor. FIF/~: Should my Wife, CYNTHIA A. KECK, predecease me or die on or before the thirtieth day following my death, I devise and bequeath the residue of my estate, of every nature and wherever situate, to my children, equally, provided that the share of any child who predeceases me or dies on or before the thirtieth day following my death shall be distributed to his or her issue, per stirpes, living on the thirty-first day following my death, and in default of any such then-living issue, such share shall be added to the share or shares for my other children. SIXI~: I direct that the share of any beneficiary under the age of 21 years shall be held, IN TRUST, however, by MR. and MRS. GLENNWOOD BICKTA, as Co-Trustees, or the survivor, to hold said share for the benefit of each said beneficiary under the age of 21, upon the following terms and conditions: A. To pay the'income and so much of the principal as may, i~ the. sole discretion of my Trustee, be necessary for the maintenance, support, medical expenses and education of each beneficiary. B. The amount to be paid for the benefit of any of said beneficiaries shall be determined frc~ time to time by the n~ of each of said beneficiaries, and the amounts and times of said payments shall be determined by such need. The said payments may be made by my Trustee directly to each of the said beneficiaries, or to such of them as may be, in the sole opinion of my Trustee, of such age and ability to handle properly the funds so paid to such beneficiary, or may be made by my said Trustee directly to the person having the custody and care of any of the said beneficiaries, or may be made by my said Trustee directly to any institution entitled to such payment by reason of services rendered or to be rendered to any of the said beneficiaries. C. To pay the accumulated ~ and principal then remaining in their hands to the said beneficiaries, upon each beneficiary's attaining the age of 21 years. D. Any and all payment or payments of any sum or sums, whether in cash or in kind, and whether for principal or income, payable to said beneficiaries, shall be made upon the sole receipt of the respective beneficiary to whom the payment is made, and free f-,-cm-~ anticipation, alienation, assignment, attachment and pledge, and free from control by the creditors of any such beneficiary. All shares of principal and income herein given shall be free from anticipation, assignment, pledge or obligation of any beneficiary, and shall not be subject to any execution or attachment. E. In the event of the renunciation, death, resignation or inability to act for any reason whatsoever of the said MR. and MRS. GTFNNWOOD BICK~A, I nominate, constitute and appoint MR. and MRS. ARTHUR S. KECK as Co-Trustees, or the survivor, under the terms and conditions of this Paragraph Fourth. SEV~q~: Should my Wife, CYNTH/A A. KECK predecease me or die on or before the thirtieth day following my death, I nominate, constitute and appoint MR. and MRS. GLENNWOOD BIC~A, or the survivor, ~p,a~dians of the person of my Daughter, NIODLE R. KECK. In the event of the renunciation, death, resignation or inability to act for any reason whatsoever of the said MR. and MRS. GTRNNWOOD BICKTA, I nominate, constitute and appoint MR. and MRS. ARTHUR S. KECK, or the survivor, as guardians as aforesaid. EIGHTH: I nominate, constitute and appoint my Wife, CYNTHIA A. KECK, Executrix of this, my Last Will and Testament. In the event of the renunciation, death, resignation or ir~hility to act for any reason whatsoever of the said CYNTHIA A. KECK, I nominate, constitute and appoint MRS. GLENNWOOD BIC~TA, Executrix of this, my Last Will and Testament. I hereby relieve my Executrix or her successor frc{n the necessity of posting security in connection with their duties as such in any jurisdiction in which they may be called upon to act, insofar as I am able by law so to do. Last Will and Testament, consisting o.f/~.. (3) tvDewritten pages, each of which bears my signature, this ~---~-~ day of ~~/ , 1989. Signed, sealed, published and declared by the above-named Testator, IXINALD EUGENE KECK, as and for his Iast Will and Testament, in the presence of us, who, at his request, in his sight and presence, and in the sight and presence of each other, have hereunto subscribed our names as witnesses. C0~O~~ OF PENNSYLVANIA ) : COUNTY OF CUM~EP//~D ) SSe I, DONALD EUGENE KECK, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; t_hat I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Sworn or affirmed to and acknowledged before me by DONALD EUGENE KECK, the Testator, this ~? day of--~~~ , 1989. CO~0NWEALTH OF PENNSYLVANIA ) : COUNTY OF ~ ) SS. We, Edward L. Schorpp and Robert R. Black, the witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testator sign and execute the instrument as his Iast Will; that DONALD EUGENE KECK signed willingly and that he executed it as his free and voluntary act for the purpose therein expressed; that each of us in the hearing and sight of the Testator signed the Will as witnesses; and that to the best of our knowledge the Testator was at that time eighteen or more years of age, of sound mind and under no constraint or undue influence. Wit_ness RDbe~t R. Black NOTARIAL SEAL i KELLY A. NICKEL. NOTARY PUBLIC CARLISLE BORO.. CUMBERLANi) COUNTY, PA MY COMMISSION EXPIRES JULY 1:3, 19g~ Sluan Allan & Associates, Inc. October 7th, 2004 Cumberland County Courthouse Register of Wills i Courthouse Square Carlisle, Pa. 17013 Attn Sue '04 OOT 12 H2:51 Re: Estate number Our Client: Lease No: Account No: Amount Due: 2:~04439 Donald E Keck 420 E. North St. Carlisle· Pa. 17013 Marlin Leasing Corp. 001-0152696-001 1414;L04-17 $2~027.55 (Tn US Dollars) Dear Sue, As per our conversation Stuart Allan & Associates acting as authorized agents on behalf of Marlin Leasing Corp. Request the attached claim be included against the estate of Donald E Keck . ! have enclosed our return self addressed envelope along with the check for the claim fee of $5.00. Please return our timed stamped claim receipt in order for us to maintain proper records of this transaction. Cordially, STUART ALLAN & ASSOCIATES CC: Edward L Schorpp Esq. J]: kg THE STUART ALLAN BUILDING * 5447 East Fifth Street, Suite 110 * Tucson, Arizona 85711-2345 520 88! 5900 * Facsimile 520 318 6799 * Toll Free 800 880 5400 This is an attempt to collect a debt. Any information obtained will be used for that purpose. This communication is from a professional debt collector. This debt is not subject to provisions of the Federal Fair Debt Collection Practices Act (FDCPA). See Bloom v. I.C. S stem · 1067 (9~ Cir. 1992). y s 972 F2D MARLIN LEASING. ...your business equipment leasing partners. Octob~ 4, 2004 Statement o£Account Re: Marlin Leasing Corp. vs. Carlisle Pedorthlc Center Marlin Lease #: 001-0152696-001 Agency File - Stuart Allan & Associates ~F-~Jc]o$¢d ]$ tlJ¢ abov'e-l~otcd colIectio~ znatte~ we would Jike to r~£er to you. ICindly contuct uS zr your e~r~iest convenience if you zre unable to ~ccept t~]$ c~$e £or any reason, Arldzess: Telephone: Gua£arlto~: Social Security #: Address'. Carlisle Pedo~nkic Cenm~: 420 East North Street, C~[isle, PA 17015 ~17) 258-5931 Doaald Keck (DECEASED) 186-54-4981 245 West Middlesex Drive, C~tlisle, PA 17013 Paid To: 08/15/04 Payments Made: 23.0 Payment Term: 36 Months Payment Amoun= $134.21 Total Amount Paid to Date: $3,086.83 Base Balance: $1,744.73 Residual: $1.00 ' Sales Tax ( %): $ UPFRONT Late Fees: $281.82 Sub Total: $2,027.55 Secutky Deposit: $0,00 TOTAL FOR COI.!.leCTION: $2,027.55 Summary - Equipment lease is for I Step CD Burner aud not cost effective to repossess. Guarantor deccascd, please pursue estate. 9NIS~Bq NIq~W Office ot ~he General Coun~t 124 GaiSaer Drive, Suite 170 Mount Laurel, NJ 000~4 888.479.911 I, Fax: 856.813.1325 ~'ww. modinleo&lng.¢om SE :60 ~00E-~O-IDO £0'~ S~£T£T89S8 9NISUB~ NI~W S~:60 ~00~-~0-i30 BUREAU OF INDTVZDUAL TAXES INHERITANCE TAX DIVISTON DEPT. 180601 HARRISBURG, PA 171Z8-060! EDWARD L SCHORPP ESQ HARTSON ETAL 10 E HIGH ST CARLISLE CONHONWEALTH OF PENNSYLVANTA DEPARTHENT OF REVENUE NOT/CE OF ZNHERZTANCE TAX APPRATSEMENT, ALLONANCE OR DZSALLO#ANCE OF DEDUCTZONS AND ASSESSMENT OF TAX ~v:? ...... ESTATE OF DATE OF DEATH ~E NUHBER '04 JUL30 /~]I~ONTY ACN 08-02-200q KECK 08-08-2003 21 0q-0~$9 CUHBERLAND 101 Amount Remltted RE¥-15~i7 EX AFP (DI-O~r) DONALD E HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLTSLE, PA 17013 CUT ALONG THZS LZNE ~ RETAZN LOWER PORTZON FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTZCE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLONANCE OR DZSALLOWANCE OF DEDUCTZONS AND ASSESSHENT OF TAX ESTATE OF KECK DONALD E FZLE NO. 21 Oq-Oq$9 ACN 101 DATE 08-02-200q TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERS[aC APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) fi. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/MAsc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Tote1 Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/MAsc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule [) (10) 11. Total Deductions 12. Net Value of Tax Return .00 NOTE: To insure proper .00 credit to your account, .00 submit the upper portion 32,173.95 .00 .00 of this form with your tax pay;ant. 2~500.00 (8) 3q,673.95 .00 13. NOTE: 36~$29.21 (11) 36.329.21 (12) 1,655.26- Charitable/governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13} . O0 Net Value of Estate Subject to Tax (lq) 1,655.26- :if an assess, ent was issued previously, 1Shes la, 15 and/or 16, 17, 18 and 19 w$11 reflect f$gures that Snclude the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of LAne lq at Spousal rate 16. Amount of Llne lfi taxable at Lineal/Class A rate 17. Amount of LAne lfi at Sibling rate 18. A.ount of LAne lq taxable at Collateral/Class B rate 19. Principal Tax Due TAX CRED:iTS: PAYMENT RECEZP1 DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) (15) .00 x 00 = .00 (15) .00 x 0q5 = .00 (17) .00 x 12 = .00 (18) .00 x 15 = .00 (19)= .00 IF PAZD AFTER DATE ZNDZCATED, SEE REVERSE FOR CALCULATZON OF ADDZTZONAL ZNTEREST. AMOUNT PAZD TOTAL TAX CRED:iT .00 I BALANCE OF TAX DUEI .00 ZNTEREST AND PEN. I .00 TOTAL DUE I .O0 ;~j~ , ( TF TOTAL DUE ]:S LESS THAN $1, NO PAYMENT TS REQU:]:RED. ]:F TOTAL DUE TS REFLECTED AS A "CRED:]:T" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE STDE OF THIS FORM FOR ]:NSTRUCT:]:ONS.) RESERVATION: Estates of decadents dying on or before December 1Z, 19DZ -- if any futura interest in the estate is transferred in possession er enjoyment to Class D (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Coaaonmaalth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class D (collateral) rate on any such future interest. PURPOSE OF NOTICE: PAYHENT: REFUND (CR): OBJECTIONS: ADNZN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S. Section 9140). Detach the top portion of this Notice and submit aith your payment to the Register of Rills printed on the reverse side, --Hake check or money order payable to: RBG/STER OF NZLLS, AGENT 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-I$13). Applications ara available at the Office of the Register of Rills, any of the 23 Revenue District Offices, or by calling the special 24-haur ansaering service for forms ordering: 1-800-36Z-Z050~ services for taxpayers with special hearing and / or speaking needs: 1-800-447-30Z0 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must ob[act within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 171ZB-IOZZ, OR --election to have the matter determined at audit aT tho account of the personal representative, OR --appeal to the Orphans' Court. Factual errars discovered on this assessment should ba addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page S of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IDOl) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after tho dacedent's death, a five percent (DX) discount of the tax paid is allowed. The 152 tax amnesty non-participation penalty is computed an tho total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (62) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rata 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 Z004 are: Interest Daily Interest Daily Interest Daily Year Rata Factor Year Rata Factor Year Rate Factor ~ ZOZ .000548 '~'~"~8-1991 111 .000301 ~ 9Z .000147 1983 I6Z .000438 1992 91 .000247 ZOOZ 62 .000164 1984 Ill .000301 1993-1994 72 .000192 2003 52 .000137 1985 132 .000356 1995-1998 92 .000247 2004 qZ .000110 1986 iOZ .000174 1999 7Z .000192 1987 101 .000174 ZOO0 71 .000191 --Interest is calculated as follows: ZNTEREST= BALANCE OF TAX UNPAZD X NUNBER OF DAYS DELZNQUENT X DAZL¥ ZNTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. - ~. -:. - -;. -:. ~ -::. -::::. -:::. ~ .' ?:;' ~ o Q __ <l>, .~ 'b .s:. 9- ~~ ~ '% ~ ~ ;?,U~~ '-" ?:;' ~ .... '"'0 ~ '6- ~ rfJ::g.t/);,.-< ~Q~.et ' ~. ~ '7 ~ ~ < 4-'0 ~ .s ~ ~ \.-\ rfJ ""' <l> ~ ,;::. ~..c20~ '~t\~U U V"~.... ~u ~ -;:;;. ~ ~ - -:::. - - -::. - - -;. - .t'~' "', \.~-:\ t,", ,', \ \.'} .~....\ ''', I." '('" .~..l ~ % ~ ',:< ~ \ ~ ?>. .;: J. V, ?~ 'b ~,.J. ~ ~~ ~ ~~ \\ ~% %~ fA~ ~1$ ~<1.. KERWIN & KERWIN ATTORNEYS AT LAW 4245 ROUfE 209 ELIZABETHVILLE, PA 17023 (717) 362-3215 (717) 896-9089 FAJ{(717) 362-4459 E-mail: kkl@epix.net GOVERNORS' ROW 27 NORTH FRONT STREET HARRISBURG, PA 17101 PATRICK E. KERWIN (1913-1987) (717) 238-4765 FAJ{(717) 238-8455 GREGORYM. KERWIN - GMK@Kerwinlawfirm.com TERRENCE J. KERWIN - KK@Kerwinlawfirm.com JOSEPH D. KERWIN - JDK@Kerwinlawfirm.com HOLLY McCLURE KERWIN - KK@Kerwinlawfirm.com please Reply To: Cl ELIZABETHVILLE OFFICE Cl HARRISBURG OFFICE July 6, 2005 Register of Wills of Cumberland County Cumberland County Courthouse 1 Courthouse Square Carlisle, P A 17013-3387 RE: The Estate of Dorothy A. Devers Date of Death - Apri115, 2005 Estate #2005-00439 P A #21-05-0439 Dear Sir or Madam : Please find enclosed herewith a check in the amount of $15,000.00 payable to Cumberland County Register of Wills as payment on the Pennsylvania inheritance tax with respect to the above estate. Would you kindly mail a receipt to me in the enclosed stamped, self-addressed envelope? Thank you for your help. Very truly yours, 11 ~. ~ , ~~ORY~N GMK:mlb Enclosure cc: Ms. Lois Butler Ms. Deborah Butler Richard L. Placey, Esquire COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX( 11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 005535 4245 ROUTE 209 ELlZABETHVILLE, PA 17023 ACN ASSESSMENT AMOUNT CONTROL NUMBER __n_n_ fold ---------- -------- 101 I $15,000.00 ESTATE INFORMATION: SSN: 186-05-4922 I FILE NUMBER: 2105-0439 I DECEDENT NAME: DEVERS DOROTHY A I DATE OF PAYMENT: 07/07/2005 I POSTMARK DATE: 07/06/2005 I COUNTY: CUMBERLAND I DATE OF DEATH: 04/15/2005 I I TOT AL AMOUNT PAID: $15,000.00 REMARKS: CHECK# 1199 INITIALS: JA SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS KERWIN GREGORY M BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT REV-1607 EX AFP (03-05) GREGORY M KERWIN KERWIN & KERWIN 4245 RTE 209 E LIZABETHVIL LE DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 05-01-2006 DEVERS 04-15-2005 21 05-0439 CUMBERLAND 101 DOROTHY A Amount Remitted PA 17023 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +- REV-1607 EX AFP (03-05) --------------------------------------------------------------------------- *** INHERITANCE TAX STATEMENT OF ACCOUNT *** ESTATE OF DEVERS DOROTHY A FILE NO. 21 05-0439 ACN 101 DATE 05- 01-2006 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 03-27-2006 PRINCIPAL TAX DUE: 16,806.68 PAYMENTS (TAX CREDITS): PAYME DATE NT ! RECEIPT DISCOUNT (+) AMOUNT PAID I NUMBER INTEREST/PEN PAID (-) 2005 CD005535 789.47 15,000.00 005 CD005548 50.86 2,400.00 2006 REFUND .00 L 433.65- TOTAL TAX CREDIT 16,806. BALANCE OF TAX DUE INTEREST AND PEN. i -- ! 10 AFTER THIS DATE, SEE REVERSE TOTAL DUE I 6-;1 I -----j 00 i -j 00 ! ~ ~ 07-06- 07-11-2 04-13- L lE IF PA SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J