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Home My WebLink About02-0927 Estate of CATHARINE M. SLASEMAN also known as PETITION FOR PROBATE and GRANT OF LETTERS ;2/-0.:l-ct.;t'1- No. To: Register of Wills for the , Deceased. County of CUMBERLAND in the Social Security No. 204-01-5005 Commonwealth of Pennsylvania The petition of the nndersigned respectfully represents that: Yourpetitioner(s), who islare 18 years of age or older an the executor named in the last will of the above decedent, dated 12/26/00 and codicil(s) dated NONE (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decedent was domiciled at death in CUMBERLAND Connty, Pennsylvania, with h er last family or principal residence at 4905 Trindle Road. Mechanlcsbura. HamDden Town.hID. pennsvlvanla (list street, number and municipality) Decedent, then 93 years of age, died 3/13/02 at Holy SDlrlt HosDltal. CamD Hili. PA Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never ajudicated incompetent: NONE Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ 90.000.00 (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ 0.00 situated as follows: None WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters Testamentary thereon. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) ~~~Jk. t;;J Kenneth E. Ylng r ' 603 Gap Road Lewisberrv PA 17339 ~ ~ u ~ ~* .,,~ . . . ." -;;;-"P -~ e.... a 0 . &, i;j OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA } ss COUNTY OF.~!!.II!!!!,RLAND The petitioner(sJ wove-n.med swear(s) or affirm(s) that the statements in the foregoing petition are true and correct io the best of the knowledge and belief of petitioner( s) and that as personal represen- tative(s) of the ahove decedent petitioner(s) will well and ly administer the estate according to law. Sworn to or affmned and subscribed ~:o, :~Egi~ '" 0;;' ~ ~ " ~ ~ { \ 1- ..qfA to No. ~I- O~ - q~.,. Estate of CATHARINE M. SLASEMAN , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW OCTOBER 1 'i. :;>00:;> ,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 12/26/00 described therein be admitted to probate and filed of record as the last will of Catharine M. Slaseman and Letters Testamentarv are hereby granted to Kenneth E. Yinger FEES Murrel R. Walters, III 24849 Probate, Letters, Etc.. . . . . . . . $ 200 - 00 Short Certificates ( )...... $ 9.00 ~~HMWR.extra'pages $ 6.00 j~r $ 5 00 TOTAL_ $ 220.00 Filed. 10-15-2002 717-697-4650 'put Tn' atty' pr6th 'box ''-0-15-2002 ATTORNEY (Sup. Ct. !.D. No.) 54 East Main Street Mechanlcsbura PA 17055 ADDRESS PHONE HIOS.80S REV 9/86 I This is to certify that the infotmation hete given is correctly copied ftom an original certificate of death duly filed wit~ Local RegIstrar. The ongmal ceruficate wIll be forwarded to the State Vital Recotds Office for permanem filing. I WARNING: It is illegal to duplicate this copy by photostat or photograph. I e as Fee for this certificate, $2.00 No. 1"IIJ1fl11'#"",~""" ","''i..,,\.1" OF Pfj;"" ....~~~.,. ~.r."" i''"'''.'.o --c. --_ ~\ il~ij -.. .... .-.~~ ~~ -,~,,'" 13;'::: 1:;., . oi" ! ~ ~ * - "'. .~/ *$ \. a.. . '.:'. ~__ ~...'. ~. ........ t ~ ("'A>~' ~ '., ~"V" "'.:. .. ~~\' ;.,[f,prl,( rt-\';.... "..... fNT~ '1'" ""'#1111/111' ~/?(~ Local Registrar P 8031911 MAR 1 5 2002- Date .JFI....2J87 COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH NAME Of' DECEOENT Ih.. ModdIlrI.l_1 t. Catharine AGE (lMl BomIoIy) UNDER 1 Y€AA - - M. ~ .., 2. female STA1lf'L1E~1\ $CCIAL Sl.CUAlTr ",UMlI(R .. 204 - 01 93 VIS. COOItTYOFOEAtH UNDER 1 OM ,..,...! un- OAl'EClF8lRTt-I ,Monlh.aa.,.....' May 25, . 1908 8IRTHPLACEIC~~_ PUoCiOFOERHIC.-..c.OI>ly~__ _'....~""_"""" s...OIfO"IllgIlCcta-llrYl HOSPITAL Steelton. PA I~ ER/OulpaI-.O 00-.0 ,. .. Il/AAlEjMnc>tonsMulloo'>.o-SIrINlan<lno..rnt*. .......WhiI.... Cff'I. 8OflO. 1WP OF DeATH Cumberland E. Pennsboro Twp k KINO OF 8USIHESSIfNOUSTAY I e OECEtlf:NT.S USUAL OCCUMJlOH ~"'=::~-=-':::2.:r Dress Mfg. na. Dressmaker 1.... DECEOEN1"'SMAll.lNGAOORt:SS(Slr-.c~.~.~CodI) 4905 Trind1e Road 1" Mechanicsbur . PA 17055 FRHEIt'S NAME jF." Miodlt. l&lll) 11. Frank Prowell INFOf'fr.WlrSfWIiE(T~ Kenneth E. Yin er .......,'" ,.. ~ - _.. Cumberland -.-p1 tr..o ~"'==~d UOTHER.S NAME ,f.-I. MiOI;IIr. "'->So..-IIMIOI) Maude Yetter WNVTAi. swus.__ ............-.~ .......- '4. widowed 11L~ -'-.......1lrrNd ~.....\lMI - DECIEOENT.S ""..... ........,. - ~-- trLStMe am .. en Tw . 2002 'L 1NF000000T'S.......-.aAOOAEsalSlr_~.s...q,~ .... 603 Ga Road Lewisberr , PA 17339 Pl.ACIEOF~-"""'OI~o......, lOCRlON.CllyIbott.sa-.ZipCGde ."""- Cross Roads Cemetery 2tc. NAYEAHDAOOAIESSOFI'o\CaJTY Part D2.0. Box 431 New lICENSE NIAlBEIl. Fairview "L 7339 ........ ... I\:OS'Q.,..,"... 8.NRTI: iElUflhe--.irliuritSOI~.-hidlCpHd""""lh.l)Q__Ihe_oI~ing.Wd\lISl;aldiaC"'~aIOfy."IIJI.Ihol:/IOIhuI1fa"" ....onJt_~llllM<;A1illII .... ... Wl'SCASlERlEFERAEOTOIoIEOICM.ElCAt.I~ "",0 0431 FD 012 848 L . WA DUlElDlOFI...sACClNSEOlIENCEO"l: ... ,- I......'*-' l-...- . i PARTIf: 0lIW........~ _-*il'9in_......... .-... in"","l. ! : WAHNEIIClFOUJH ORI:Of'IHJURY (Uonft.o..,........, TIto1EOf'IJUUR'l' mJlJAY RWOAK1 OESCIUlIEHClWINJlJRY D. --........ ........ ...... '" COWlETlOH OF CAuSE '" OERH' - -- IlQ o o - o o o PlACEClFlNJUAY.A1".,..,........",-.lacllloy.ofIIgo Y. Ilu-.g._.~, - ... 0 "",0 -- "",0 ~O ~ CoukI....tNo...."""*' .. "'"7..~:::.7-{?"~~.-.p- _____ 1.:I,/,.,l.,/1 .- 0". lQ:~~ o 31C. fVlD 4 NAME AND AOOAESS OF PERSON -Vi znrYNorPfint /0& ,-e;rOl/YA-- 6 o ../JU!A"OV+ ORE FILEOIMonll.Oa-,......l _ :J4.~ /f:L~tJ.!'..!:-~ 1J - - CERT.... tCNdo cRy ""-I .Cl:llTWYWtQPHYSlClANIPl'lylOCl8n~~d-__..-.cIh.pl\yIlC""'_~_a.-.oc~lIfIm23l ro....."'...,---,.,diI___.........cau.e(.)..._____ . '" '''-0 C.~ANOCERTIFYINQl'H'tlSlQAfl~_;><~"'9_,j(ldCOlflllylroQlOcau..oI_...\ ro..._ofMYknDwIMilJe.llfealhoec..........._.....M.....qpIK........."''''-c.......,.ndal."......_...... .... .MlDtCAL lXAMlNlRICOROMER OntheMtlsDl.~kMlandfOl"lft.....lgatkMl.lIlftlyopiniotl.dIt..hOCWl\".a..I...tIIM.d.I..andpl-.:.,andd....to thecau"l_)and -.."....,....................------...,..........................................,........,................ 3". , ~SEClFOE"" o~ LAST WILL AND TESTAMENT 2..\ -02 -9 7.. .. BE IT REMEMBERED THAT .. I, CATHARINE M. SLASEMAN, a resident of Cumberland County, pennSYlvanial being of sou~d and disposing mind, memory and understanding, do make, publish ani. declare this to be my LAST WILL AND TESTAMENT, hereby revoking any and all Willf I and Codicils previously made by me. i I ! that I have no children. II , I I declare that I am not married, my beloved husband, having predeceased me, an~ II I 1 I II I direct that all my just debts and funeral expenses shall be paid from my residua estate as soon as practicable after my decease. I direct that all taxes that may be ass:::ed in consequence of my death, of whatev~J n.ture ~d by wba""'" j""",,oonn Im_ "".. be pilld from my",",,_ ""''' .. ~ 'I i i part of the expense of the administration of my estate. i I I\T I I I give, devise and bequeath all my property, whether real or personal, wherever situa~ including any property over which I may have a power of appointment to my nephen KENNETH E. YINGER, per stirpes. i I I nnmi..". oo"",tu" ~d .ppnin: my ..pb~. KENNEfH E. YINGER. ~ 1 Executor of this LAST WILL, to serve without bond. i I IN WITNESS WHEREOF, I, CATHARINE M. SLASEMAN, have set my hand to LAST WILL this1- 0day of .$ ~c , 2000. C 9~. CATHARINE M. SLASEMAN Signed, sealed, published and declared by the above-named CATHARI:!JE M. SLASEMAN, as and for her Last Will and Testament, in the presence of us, wh , at her ~It 2 ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA ss. COUNTY OF CUMBERLAND I, CATHARINE M. SLASEMAN, Testatrix, whose name is signed to the attached of foregoing instrument, having been duly qualified according to law, do hereby acknowledg that I signed and executed the instrument as my LAST WILL; that I signed it as my free an voluntary act for the purposes therein expressed. (!a:t/ia/1 ~ (jjJ'ef~~' CATHARINE M. SLASEMAN Sworn or affirmed to and acknowle.!!8..ed before me by CATHARINE M. SLASEMAN, Testatrix, this c:x. '/1- dayof Quunw ,2000. o~ fYI. ~ Notary Public Notarial Se8I .. I Diane M. Smith. NotarY PublIC Mechanlcsbul1l Boro. Cumberland My Commission Explles June 22. AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ss. COUNTY OF CUMBERLAND : weltet2L.L (1. vJ I1tTll/ G'uand .-4'1::R L.<...)4'~--r:;, the witnesses whose names are signed to We attachld~r~foregoing instrumeIii,being du qualified according to law, do depose and say that we were present and saw Testatrix si and execute the instrument as her LAST WILL, that CATHARINE M. SLASEMAN sign willingly and that she executed it as her free and voluntary act for the purposes ;there expressed; that each of us in the hearing and sight of e Testatrix signed e Will witnesses; and that to the best of our knowledge, the 1 trix wa~;fue tim 8 years ~o, more, mwoodnliod "d =d" 00 oonrnmot fr1J4 ' , Sworn or affirmed to and acknowledged before me .Ji ..2 6 'f1... day of 7;u.u.mw ,2000."1 , I, ! I II .~ I 2 Notarial Se8I Diane M. Smith. N~}~~lc Mechanicsbu'll Boro. CUn__~ CountY My CommiSSIon Expires June 22. 2004 ~ CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: CATIffiRINE M. SLASEMAN Date of Death: March 13, 2002 Will No. 2002-00927 Admin. No. 21-02-0927 To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' COlut Rules was served on or mailed to the following beneficiaries of the above-captioned estate on October 17,2002. Name Address Kenneth E. Yinger 603 Gap Road Lewisberry, PA 17339 Notice has now been given to all persons entitled thereto llllder R None Date: October 17, 2002 Murre! R Walters, III, Esquire 54 East Main Street Mechanicsburg, PA 17055 (717) 697-4650 Capacity: _ Personal Representative _X _ Connse! for personal representative ,=:' 1 II COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INOIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTAT OFFICIAL RECEIPT JORDON VERA 260 EDGEWOOD ROAD YORK, PA 17402-3008 ____h__ fold ESTATE INFORMATION: SSN: 204-01-5005 FILE NUMBER: 2102-0927 DECEDENT NAME: SlASEMAN CATHARINE M DATE OF PAYMENT: 03/04/2003 POSTMARK DATE: 02/21/2003 COUNTY: CUMBERLAND DATE OF DEATH: 03/13/2002 TOTAL AMOUNT REMARKS: VERA JORDON CHECK# 1528 SEAL INITIALS: AC RECEIVED BY: REGISTER OF WILLS ., , REV_1162EXlll-r i E TAX NO. CD 00224 ACN ASSESSMENT AMOUNT CONTROL NUMBER - H--- 03100918 I $443.72 I I I , , I I I I I PAID: $443.72 DONNA M. OTTO DEPUTY REGISTER OF WillS COMMONWEALTH OF PEterlSVLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG~ PA 17128-0601 *' XNFORMATXON NOTXCE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21 02- 031009 01-23- REY-1545U....P UI9-IO) '{J TYPE OF EST. OF CATHERINE M SLASEMAN 5.5. NO. 204-01-5005 DATE OF DEATH 03-13-2002 C~YNTY CUMBERLAND REHIT PAYMENT AND FORNS T : REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 SANDRA L BUTTS 260 EDGEWOOD RD YORK PA 17402 PNC BANK has provided the Oeparblent with the infanlation listed below which has bHn used in calculating the pot....tial tax due. Their records indicate that at the death of the above dlilc::edent~ YOU were a joint owner/benefic this accDlmt. If you feel this infonlation is incorrlilc::t~ please obtain written correction froll th8 fin.,cial institut1on~ attach to this fanl and return it to the above address. This account is taxable in accordance with the Inh.ri tBI'ICe Tax Laws of th8 C of ~enn~ylv.nia. Q~astiDns gay b. answerad by calling (717J 787.83Z7. COMPLETE PART 1 BELOW . Account No. 31800163594 . . SEE REVERSE SIDE FOR o.t. 08-30-1999 Est.bU_d FILING AND PAYMENT INSTRUCTIONS To insure proper credit to your BCCQunt~ t (2l copies of this notice IILIst accDllplllny y ~ pay.....t to the Register of Wills. Make ch Ij. payable to: "Register of Wills~ Agent". Account Balance Percent Taxable Anount Subject to Tax Tax Rate Potential Tax Due x x NOTE: If tax paYllenb are lIade within thr (3) IIDnths of the decedent.s date of death YOU IIl!IIY deduct II SiC discount of the tax du I Any inheritance tax due will becou dellnq ~t nine (9) 80nths after the date of death. [CHECK ] ONE BLOCK ONLY A. 0 The above infonlation and tax due is carrBct. 1. You.ay choose to rllldt paYllent to the Ragister of Wills with two copies of this notice to obta a discount or avoid int8rest~ or yOU lIay check box "A" and return this notice to the Register a Wills and an official assess.ant will ba issued by the PA Department of Revenue. B. [] Tha above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax re m to be filed by the decedent.s representative. c. D Thill abava inforllation is incorrect and/or debts and deductions were paid by you. You .ust co.plate PART [!] and/or PART ~ below. If you indicate a different tax rate~ please state your relationship to decedent: PART ~ TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Oat. Est.b11~ 1 2. Account Balance 2 3. Percent Taxable 3 X 4. AltOunt Subject to Tax 4 5. Debts and Deductions 5 6. AlIOUnt Taxable 6 7. Tax Rate 7 X 8. Tax Due 8 PART I!l DATE PAID PAYEE DESCRIPTION AMOUNT TOTAL (Ente... on line 5 of Tax Co.putation) $ Under penalties of q; compl.t~ to the bast of ~.;f TAXPAYER SIGNATURE per jury ~ I declare that the Ill! know1edllll _ beU.f. B~ facts I have reported above are true~ correct -.c:I HOME ( > WORK (7. '55>:L'l 15 TElEPHON! NUMBER Ii 27 3 OUNT SAVINGS CHECKING TRUST CERTIF. !j . Df ... ..lth _D~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUReAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1'128-0601 PENNSYLVANIA INHERITANCE AND ESTAT OFFICIAL RECEIPT RECEIVED FROM: WALTERS MURREL R III 54 E MAIN STREET MECHANICSBURG, PA 17055 nnn.. fold ESTATE INFORMATION: SSN: 204-01-5005 FILE NUMBER: 2102-0927 DECEDENT NAME: SLASEMAN CATHARINE M DATE OF PAYMENT: 07/03/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 03/13/2002 TOTAL AMOUNT P REMARKS: RECEIVED:KENNETH E YINGER C/O MURREL R WALTERS III. ESQ. CHECK# 1006 SEAL INITIALS: SK RECEIVED BY: REGISTER OF WillS REV-1162 EX(11 I E TAX NO. CD 00276 ACN SSESSMENT AMOUNT CONTROL NUMBER I -- ~~n 101 I $7,425.75 I I I I I I I, I I AID: $7,425.75 I I DONNA M. OTTO DEPUTY REGISTER OF WILLS , A REV-1501 :X+(D-OO) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 I- Z W C W U W C DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SLASEMAN CATHERINE M DATE OF DEATH (MM-OO-Year) n-Cit~-l\) REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT eft j- OFFICIAL USE ONLY FILE NUMBER 21 -0 2 0927 ""'CciUNTYC'Ci6€ ---Voo- - - iluMBER-- SOCIAL SECURITY NUMBER DA1E OF B1R1H (MM-DO-Year) 2 0 4 - 0 1 - 5 0 0 5 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS 03/13/2002 OS/2511908 (IF APPLlCABLEI SURVIVING SPOUSE'S NAME (LAST. FIRST, AND MIDDLE INITIAL) w !;;: ,,-'" 0"''' w..o ,,00 0"'.... ..'" .. < t&J 1. Original Return o 4. Limited Estate o 6. Decedent Died Testate (AIlac:hC09yofWiIl) o 9. litigation Proceeds Received SOCIAL SECURITY NUMBER o 2. Supplemental Return o 4a. Future Interest Compromise (date of death after 12.12-82) o 7. Decedent Maintained a Living Trust (AllachcopyofTlUSt\ o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1.1-95) 03. Remainder Return (dale of dealh prior to 12.13-82) o 5. Federal Estate Tax Return Required _ 6. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) 1''''''","0) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS MURREL R. WALTERS III ESQ FIRM NAME Ilf __0) I- Z W o z o .. '" w '" '" o o z o 5 ::l l- ii: <( u w II:: z o ~ ~ ::l 0.. :!! o U ~ I- 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable {Schedule D) 5. Cash, Bank Deposits & Miscellaneous PefSOnal Property (Schedule E) 6. Jointly Owned Property (Schedufe F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent. Mortgage Liebilities, & Lien, (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (line 8 minus line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) TELEPHONE NUMBER 717/697-4650 54 EAST MAIN STREET MECHANICSBURG PA 17055 OFF . I.A~ USE ONLY ~~ (1) (2) (3) (4) (5) ~ :_~ IN '. '- c ,. ~ -.J ~-- 16,543.42 [:0 (6) P 0' 43,178.78 (7) (8) 59,722.20 (9) (10) 2,600.00 7,617.17 (11) (12) (13) 10,217.17 49,505.03 14. NetVa\ue Subject to Tax (Une 12 minus Une 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (14) 49,505.03 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. AmountofUne 14 taxableatnnea\ rate 17. Amount of Une 14 taxable at sibling rate 18. Amount of Une 14 taxable at collateral rate 19. Tax Due X _(15) X _(16) X .12 (17) 49,505.03 X .15 (18) 7,425.75 (19) 7 ,425. 75 20 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < .. C f:!ecedent's omplete Address: STREET ADDRESS COUNTRY MEADOWS 4905 TRINDLE ROAD CITY I STATE -rZIP MECHANICSBURG PA 17050 Tax Payments and Credits: 1. Tax Due (Page Hine 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) 7,425.75 Total Credits ( A + 8 + C ) (2) 3. InteresUPenalty il applicable D. Interest E. Penalty TotallnteresUPenalty ( 0 + E ) (3) 4. If Line 21s greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to requesl a refund (4) 5. If Line 1 + Line 3 is greaterthan Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE, (58) Make Check Payable to: REGISTER OF WILLS, AGENT 7,425.75 7,425,75 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; ........................................................................... 0 ~ b. retain the right to designale who shall use the property transferred or its income; ........................................ 0 ~ c. retain a reversionary interest; or ...................................................................................................... 0 ~ d. receive the promise for life of either payments, benefits or care? ............................................................. 0 ~ 2. If death occurred after December 12, 1982, did decedent Iransfer property within one year of dealh without receiving adequate consideration?.............................................................................................. 0 ~ 3. Did decedent own an 'in truslfo~ or payable upon dealh bank account or security at his or her death? ................. 0 ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... 0 ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. UMar penalties of perjury, I dac\are lhat I have examined this relum, including accompanying schedules and statements, and 10 the best of my knowledge and belief, it is lrue, correct and complete. Declaration of preparer other than the personal representative is based on all Information of which preparer has any knowledge. SIGNATURE OF PERSON ESPONSI F FI G RETURN DATE ( -1- (<- 'OJ AODRESS PA 17339 DATE f':Z -~3 ADDRESS PA 17055 For dates of death on or after Juiy 1, 1994 and before January 1,1995, the tax rate imposed on the net vaiue 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) (iill. The stalute does not exemet a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are stii! applicable even if the surviving spouse is the oniy beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased chiid twenty-one years of age or younger al death to or for lhe use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. ~9116(a)(1.2)J. The tax rate imposed on the net value oftranslers to or for the use ofthe 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 orforthe 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. ."""'''''''''"'0* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT OECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF SLASEMAN CATHERINE M FILE NUMBER 21 02 0927 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 NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 16,543.42 PNC BANK CHECKING ACCOUNT # 5140302943 TOTAL (Also enteron line 5. Recapitulation) $ (If more space IS needed. Insert additional sheets of the same size) 16.543A2 """''''''''0. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTL Y.OWNED PROPERTY ESTATE OF SLASEMAN CATHERINE M FILE NUMBER 21 02 0927 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. KENNETH E. YINGER 603 GAP ROAD LEWISBERRY, PA 17339 NEPHEW B ROBERT E. UPDEGRAFF DECEASED FEBRUARY 13, 2001 NEPHEW c JOINTLY -OWNED PROPERTY: l.ETlER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEA1H ITEM FOR !OINT MADE Include name 01 financial institution and bank account number or similar iden~fying number. Attach DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT deed for joinUy-held real estate. VALUE OF ASSET INTEREST DECEDENr5INTEREST 1. A. 12/27/00 FULTON BANK 4,282.33 50. 2,141.17 CHECKING # 0101.01748 2 A 12/27100 FULTON BANK 46,624.54 50. 23,312.27 CD # 000-01232344 3 A 11/17/00 FULTON BANK 10,045.79 50. 5,022.90 CD # 000-0132691 4 A 11/17/00 FULTON BANK 5,022.89 50. 2,511.45 CD # 000-000-0132692 5 B 51411995 PNC BANK 10,190.99 100. 10,190.99 CD # 21001022119 TOTAL (Also enter on line 6, Recapitulation) $ 43.178.78 (If more space is needed, insert additional sheets of the same size) .. ~EV-151tEX+(1.9n . . . COMMONWEALTH OF PENNSYLVANiA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF SLASEMAN. CATHERINE M FILE NUMBER 21 02 0927 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) KENNETH E. YINGER RENOUNCED Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City Stata Zip Year(s) Commission Paid; 2. Attorney Fees MURREL R. WALTERS III 2,325.00 3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) Claimant Slreet Address City Stata Zip Relationship of Claimant to Decedent 4. Probate Fees REGISTER OF WILLS CUMBERLAND COUNTY 275.00 5. Accountanfs Fees 6. Tax Return Preparer's Fees 7. TOTAL (Also enter on line 9, Recapitulation) $ 2.600.00 (If more space Is needed, insert additional sheets of the same size) "'''''':.'''n* COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF SLASEMAN CATHERINE M FilE NUMBER 21 02 0927 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1. COUNTRY MEADOWS RESIDENTIAL CARE 2 PHARMOR MEDICINE 3 COMCAST CABLE TV 4 VERIZON TELEPHONE 5 CHARLENE ARNOLD PERSONAL CARE 6 SUSAN YINGER PERSONAL CARE 7 LISA YINGER PERSONAL CARE 8 WILLIAM WESSEL PERSONAL PROPERTY STORAGE 9 HAMPDEN TOWNSHIP AMBULANCE MEDICAL 10 WEST SHORE EMS MEDICAL 11 QUANTUM IMAGING MEDICAL 12 MOFFIT HEART AND VASCULAR MEDICAL 13 KILMORE EYE ASSOCIATES MEDICAL 14 ATT TELEPHONE 1,877.70 236.47 31.10 93.69 1,740.22 1,458.62 925.75 381.60 270.00 422.87 36.00 21.58 107.02 14.55 TOTAL (Also enler on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 7617.17 ~EV.15"EX+('. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SI ASFMAN ~~. INF M NUMBER 1. SCHEDULE J BENEFICIARIES NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS linclude oulright spousal dislributions, and transfers under Sec. 9116 (a) (1.2)] 1. KENNETH E. YINGER 603 GAP ROAD LEWISBERRRY, PA 17339 FILE NUMBER 21 02 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) NEPHEW 0!l27 AMOUNT OR SHARE OF ESTATE 100% 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 T f\X IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAl DISTRIBUTIONS 1. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) / 1-tJ'^I- /0 \, BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIYISION DEPT. 280601 HARRISBURG~ PA 17128-0601 MURREL R WALTERS III ESQ03 DATE ESTATE OF DATE OF DEATH FILE NUMBER I',! i :~ 9 COUNTY ACN 08-25-2003 SLASEMAN 03-13-2002 21 02-0927 CUMBERLAND 101 M COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX SEP - 2 54 E MAIN ST I AlIOunt R...itted I MECHANICSBURG PA 17~_5!! Ct L'. MAKE CHECK PAYABLE AND REMIT PAYMENT I "0: REGISTER OF WILLS , i CUMBERLAND CO COURT HOUSE I CARLISLE, PA 17013 I CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ~----- RE'i=isiirEx-Aj:jo-foFci3Y-Niii'"icE--oF-YliHERifANciE-YAini"PPRAiSEifENy-,--ALD)'iiANCnili---------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SLASEMAN CATHERINE M FILE NO. 21 02-0927 ACN 101 DATE 08-2 ,2003 TAX RETURN liAS: I X I ACCEPTED AS FILED I I CHANGED ! RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Reel Estate (Schedule A) III .00 NOTE: To in~r ~ pro... 2. Stocks lIl'ld Bonds ISchedu1. BI 121 .00 credit to yol/I iaccoun 3. Closely Held stock/Partnership Interest I Schedu1. C I 131 .00 subIIlt th. .. ~r port 4. MOrtgages/Notes Receivable (Schedule DJ 141 .00 of this for. lthyou S. Cash/Bank Deposits/Hisc. Person81 Property [Schedule E) (51 16.543.42 tax pay_nt. I 6. Jointly Owned Property (Schedule f) 161 43 .178. 78 , 7. Transfers (Schedule G) 171 .00 8. Total Assets 181 59,7 '.20 APPROVED DEDUCTIONS AND EXEMPTIONS: 2,600.00 9. Funeral Expenses/A~. Costs/"lsc. Expenses [Schedule H) (91 1n J 10. Debts/Mortgage Liabilities/Liens (Schedule I) llOI 7.617.17 11. Total Deduetions 1111 17 12. Net Value of Tax Return ll21 49,5b~.03 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 1131 Iii .00 14. N.t Value of Est.te Subject to Tax ll41 49,5015.03 , NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and I will reflect ~igures that include the total af ~ returns assessed to date. ASSESSMENT OF TAX: .00 00 IS. Amount of Line 14 at Spousal rate 1151 X = .00 16. A.uunt of Line 14 taxable at Lineal/Class A rate ll61 .00 X 045 = .00 17. Amount of LinB 14 .t Sibling rBt. ll71 .00 X 12 = .00 18. A.ount of Line 14 taxable at Collateral/Class Brat. 1181 49,505.03 X 15 = 7,4 ~ 19. Principal Tax Due ll91= 7,' ~ TAX C IT'" r ,OJ AIlIlUNT PAID DATE NUIIIlER INTEREST/PEN PAID (-I 07-03-2003 CD002764 .00 7,425.75 BALANCE OF UNPAID INTEREST/PENALTY AS OF 07-04-2003 TOTAL TAX CREDIT 7,42 .'75 BALANCE OF TAX DUE ;00 INTEREST AND PEN. 20 Jll TOTAL DUE 20 al r t, ion r . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRlO. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YDU 114Y BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.I BUREAU OF INDIVIDUAL TAXES XNHERTTANCE TAX DT¥ZSXON DEPT. 280601 HARRISBURG, PA 17128-G601 EARL SLASEMAN 530 PENN AYR RD CAMP HILL PA 17011 COMMON#EALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHER/TANCE TAX APPRAISEMENT. ALLO#ANCE OR DISALLO#ANCE OF DEDUCTXON~, AND ASSESSMENT OF TAX ON JOXNTL¥ HELD OR TRUST ASSETS DATE 12-29-2003 ESTATE OF SLASEMAN DATE OF DEATH 03-13-2002 FILE NUMBER 21 02-0927 COUNTY CUMBERLAND SSN/DC 204-01-5005 ACN 03100917 Amoun~ RemZ~md CATHERINE M MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF HILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LO#ER PORTION FOR YOUR RECORDS ~ REV-1548 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DZSALLONANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON dOZNTLY HELD OR TRUST ASSETS DATE 12-29-2003 ESTATE OF SLASEMAN CATHERINE M DATE OF DEATH 03-13-2002 COUNTY CUMBERLAND FILE NO. 21 02-0927 S.S/D.C. NO. 204-01-5005 ACN 03100917 TAX RETURN NAS: (X) ACCEPTED AS FILED ¢ ) CHANGED dOXNT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. 21001022067 TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST (~ TIME CERTIFICATE DATE ESTABLISHED 05-04-1990 Account Balance 6,349.45 Percent Taxable X 0.500 Amount Subject to Tax 3,174.73 Debts and DeductAons - .00 Taxable Amount 3,174.73 Tax Rate X .15 Tax Due 476.21 TAX CREDITS: NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE HITH YOUR TAX PAYMENT TO THE REGISTER OF HILLS AT THE ABOVE ADDRESS. HAKE CHECK OR HONEY ORDER PAYABLE TO: "REGISTER OF HILLS, AGENT." PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID INTEREST IS CHARGED THROUGH 01-06-2004 TOTAL TAX CREDIT ] AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE I REVERSE SIDE OF THIS FORM INTEREST AND PEN. TOTAL DUE ~ IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~ ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REI~UIRED. IF TOTAL DUE 'rs REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) .00 476.21 25.53 501.74 BUREAU OF TNDTVTDUAL TAXES INHERITANCE TAX DTV/SZON DEPT, 280601 HARRISBURG, PA 17128-0601 SANDRA L BUTTS 260 EDGEWOOD RD YORK PA 17q02 COHNONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF /NHER/TANCE TAX APPRAISEMENT. ALLONANCE OR D/SALLONANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 12-29-2003 ESTATE OF SLASEHAN DATE OF DEATH 05-13-2002 FILE NUHBER 21 02-0927 COUNTY CUHBERLAND SSN/DC 20q-01-5005 ACN 05100918 Amoun~ CATHERINE M I HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA I7013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTXON FOR YOUR RECORDS ~ REV-1548 EX AFP (01-03) NOTXCE OF INHERITANCE TAX APPRAXSENENT, ALLOWANCE OR DXSALLOWANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 12-29-2003 ESTATE OF SLASEHAN CATHERINE H DATE OF DEATH 03-13-2002 COUNTY CUMBERLAND FILE NO. 21 02-0927 S.S/D.C. NO. 20~-01-5005 ACN 03100918 TAX RETURN WAS: IX) ACCEPTED AS FILED ( ) CHANGED dOXNT OR TRUST ASSET XNFORNATION FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. 3180016359~ TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST (~ TIME CERTIFICATE DATE ESTABLISHED 08-30-1999 Account Balance 5,916.26 Percent Taxable X 0.500 Amount Subject to Tax 2,958.13 Debts and Deductions .00 TaxabZe Amount 2,958.13 Tax Rate X .15 Tax Due TAX CREDITS: NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: '*REGISTER OF WILLS, AGENT.** PAYHENT DATE 02-21-2005 RECEIPT NUMBER CDOOZZq5 DISCOUNT (+) INTEREST/PEN PAID C-) .00 AMOUNT PAID qq3.7Z BALANCE OF UNPAID INTEREST/PENALTY AS OF 02-22-2003 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE TF pATD AFTER THTS DATE, SEE REVERSE FOR CALCULATTON OF ADDTTTONAL TNTEREST. TF TOTAL DUE TS LESS THAN $1, NO PAYMENT TS REQUTRED. IF TOTAL DUE TS REFLECTED AS A "CREDTT" ( CR}, YOU MAY BE DUE A REFUND. SEE REVERSE STDE OF THTS FORM FOR TNSTRUCTTONS. qq3.7Z .00 q.q7 q.q7 BUREAU OF INDIVIDUAL TAXES ZNHERTTANCE TAX DZVZSTON DEPT. Z80601 HARRISBURG, PA 171Z8-0601 EARL SLASEMAN 530 PENN AYR RD CAHP HILL PA 17011 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT. ALLO#ANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 12-29-2003 ESTATE OF SLASEHAN DATE OF DEATH 03-13-ZOOZ FILE NUMBER 21 02-0927 COUNTY CUMBERLAND SSN/DC Z04-01-5005 ACN 03100916 Amoun~ RBmi~d MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CATHERINE M CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS REV-1548 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 1Z-29-ZO03 ESTATE OF SLASEHAN CATHERINE M DATE OF DEATH 03-13-2002 COUNTY CUMBERLAND FILE NO. Z1 02-0927 S.S/D.C. NO. 204-01-5005 ACN 03100916 TAX RETURN WAS: eX) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PHC BANK ACCOUNT NO. 2100102Z062 TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST (~ TIME CERTIFICATE DATE ESTABLISHED 10-07-1989 Account Balance 5,004.39 Percent Taxable X 0.500 Amount Subject to Tax 2,502.20 Debts and Deductions .00 Taxable Amount Z,5OZ.20 Tax Rate X .15 Tax Due 375.33 TAX CREDITS: NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID INTEREST IS CHARGED THROUGH 01-06-2004 TOTAL TAX CREDIT AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUEl REVERSE SIDE OF THIS FORM INTEREST AND PEN. TOTAL DUE ~ TF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT TS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) .00 375.33 20.12 395.45 BUREAU OF INDIVIDUAL TAXES ZHHERTTANCE TAX DTVISION DEPT. Z80601 HARRTSBURG, PA 171Z8-0601 DORIS FINK 6 N 2ND ST WORMLEYSBURG PA 17045 COHMONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF ZNHER/TANCE TAX APPRAISENENT, ALLONANCE OR DISALLONANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 12-29-2005 ESTATE OF SLASEMAN DATE OF DEATH 05-15-2002 FILE NUMBER 21 02-0927 COUNTY CUMBERLAND - SSN/DC 204-01-5005 ACM 05100915 Amoun'~ Remi'l:ted REV-l$48 EX AFP (gl-OS) CATHERINE M MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS REV-1548 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSHENT OF TAX ON dOZNTLY HELD OR TRUST ASSETS DATE 12-29-2003 ESTATE OF SLASEHAN CATHERINE M DATE OF DEATH 05-15-2002 COUNTY CUMBERLAND FILE NO. 21 02-0927 S.S/D.C. NO. 204-01-5005 ACN 05100915 TAX RETURN WAS: IX) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PNC BANK ACCOUNT NO. 21001022120 TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST (~ TIME CERTIFICATE DATE ESTABLISHED 05-04-1995 Account Balance 10,191.00 Percent Taxable X 0.500 Amount Subject to Tax 5,095.50 Debts and Deductions - .00 Taxable Amount 5,095.50 Tax Rate X .15 Tax Due 764.33 TAX CREDITS: NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYHENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. HAKE CHECK OR HONEY ORDER PAYABLE TO: °~REGISTER OF WILLS, AGENT." PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID INTEREST IS CHARGED THROUGH 01-06-2004 TOTAL TAX CREDIT ] AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE I REVERSE SIDE OF THIS FORM INTEREST AND PEN. TOTAL DUE a ZF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~ ( IF TOTAL DUE ZS LESS THAN $1, NO PAYMENT IS RE{~UZRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) .00 764.33 40.98 805.31 BUREAU OF INDIVIDUAL TAXES ZNHERTTANCE TAX DXVTSTON DEPT. 280601 HARRXSBURG, PA 17128-0601 DORIS FINK 6 N ZND ST NORHLEYSBURG PA 170q5 CONNON#EALTH OF PENNSYLVANZA DEPARTMENT OF REVENUE NOTXCE OF XNHERXTANCE TAX APPRAXSEMENT, ALLONANCE OR DXSALLO#ANCE OF DEDUCTXONS, AND ASSESSMENT OF TAX ON JOXNTL¥ HELD OR TRUST ASSETS DATE 12-29-2005 ESTATE OF SLASEMAN DATE OF DEATH 05-15-2002 FILE NUMBER 21 02-0927 COUNTY CUMBERLAND SSN/DC 20q-01-5005 ACN 0510091~ Amoun~ MAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF HILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CATHERINE H CUT ALONG THXS LXNE ~ RETAIN LO#ER PORTXON FOR YOUR RECORDS REV-XSq8 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLO#ANCE OR DXSALLO#ANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON dOZNTLY HELD OR TRUST ASSETS DATE 12-29-2005 ESTATE OF SLASEMAN CATHERINE H DATE OF DEATH 05-15-2002 COUNTY CUMBERLAND FILE NO. 21 02-0927 S.S/D.C. NO. 20~-01-5005 ACN 0510091R TAX RETURN NAS: eX) ACCEPTED AS FILED ¢ ) CHANGED dOXNT OR TRUST ASSET ZNFORHATZON FINANCIAL INSTITUTION: PHC BANK ACCOUNT NO. 51500155221 TYPE OF ACCOUNT: ( ) SAVINGS ¢ ) CHECKING ( ) TRUST (~ TIME CERTIFICATE DATE ESTABLISHED 05-07-1999 Accoun~ Balance 19,875.78 Percen~ Taxable X 0.500 Amoun~ Sub~ec~ ~o Tax 9,956.89 Debts and Deductions - .00 Taxable Amoun~ 9,936.89 Tax Ra~e ~ .15 Tax Due 1,~90.55 NOTE: TAX CRED'rTS: PAYHENT RECEIPT DISCOUNT (+) DATE NUHBER INTEREST/PEN PAID (-) AHOUNT PAID TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE NITH YOUR TAX PAYMENT TO THE REGISTER OF HILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF HILLS, AGENT." INTEREST IS CHARGED THROUGH 01-06-200q TOTAL TAX CREDIT AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUEl REVERSE SIDE OF THIS FORM TNTEREST AND PEN. TOTAL DUE a XF PA/D AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( [F TOTAL DUE TS LESS THAN $1, NO PAYMENT ZS RE{~UZRED. IF TOTAL DUE 1S REFLECTED AS A 'CREDIT" ~ CR), YOU MAY BE DUE A REFUND. SEE REVERSE S~DE OF THIS FORM FOR INSTRUCTIONS. } .00 1,q90.53 79.92 1,570.q5 BUREAU Of INDIVIDUAL TAXES IMHERIT~KCE T~X DlVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX DUNNING NOTICE ATTN: POST ASSESSMENT REVIEW UNIT PHONE (717) 787-&505 TDD# 1-800-447-3020 (SERVICE FOR TA AYERS WITH SPECIAL HEARING AND SPEAKING NE SJ. NOTICE DATE 11-07-2 05 MURREL R WALTERS III ESQ 54 E MAIN ST MECHANICSBURG PA 17055 ESTATE OF SLASEMAN CATHERINE FILE NO/SSN 21 02-092 COUNTY CUMBERLAND I DATE OF ASSESSMENT 08-18-2~05 ACN 101 I \ OUR RECORDS INDICATE A DELINQUENT INHERITANCE TAX LIABILITY FOR THE ABOVE ESTATE. OUTLINED BELOW IS A SUMMARY OF OUR RECORDS. ADDITIONAL INTEREST IS CALCULATED AND INCLUDED IN THE BALANCE TO FIFTEEN (15) DAYS FROM THE DATE OF THIS NOTICE. TAX INTEREST CREDIT BALANCE 7,425.75 209.11 7,425.75 209.11 TO AVOID ADDITIONAL COSTS AND INTEREST, THE ABOVE AMOUNT DUE MUST BE PAID WITHIN 15 DAYS FROM THE DATE OF THIS NOTICE. PLEASE DETACH AND RETURN THE LOWER PORTION WITH YOUR PAYMENT TO THE REGISTER OF WILLS OF THE COUNTY INDICATED. MAKE CHECK OR MONEY ORDER PAYABLE TO 'REGISTER OF WILLS, AGENT'. IF THE ABOVE BALANCE DUE HAS BEEN PAID RECENTLY, PLEASE DISREGARD THIS NOTICE. - - - - - - - - - - - - - - - - - - - - - - - PLEASE RETURN THIS PORTION WITH YOUR PAYMENT TO THE REGISTER OF WILLS LISTED BELOW ESTATE OF SLASEMAN CATHERINE M FILE NO/SSN 21 02-0927 COUNTY CUMBERLAND DATE OF ASSESSMENT 08-18-2003 ACN 101 REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INOlVIDUAl TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTAT OFFICIAL RECEIPT DUPLlCA WALTERS MURREL R III 54 E MAIN STREET MECHANICSBURG, PA 17055 un..._ fold ESTATE INFORMATION: SSN: 204-01-5005 FILE NUMBER: 2102-0927 DECEDENT NAME: SLASEMAN CATHARINE M DATE OF PAYMENT: 01/30/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 03/13/2002 TOTAL AMOUNT P REMARKS: CHECK# 1112 ,- INITIALS: JA RECEIVED BY: SEAL REGISTER OF WILLS REV.1162EX{1 - b, ! ETAX , i NO. CD 0035 TE ACN SSESSMENT AMOUNT CONTROl NUMBER . ~--- 101 I $212.00 I I I I I I i I I I I I I I I , I I I I AID: $212.00 GLENDA FARNER STRASBAUGH REGISTER OF WILLS I: I A \ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z806Dl HARRISBURG~ PA 171Z8-D6Dl COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT Rec;:o'c"> Rp,',c ~.~,D~TE ,.."'TATE OF DATE OF DEATH FILE NUMBER P1~IfI"Y 03-08-2004 SLASEMAN 03-13-2002 21 02-0927 CUMBERLAND 101 MURREL R WALTERS 54 E MAIN ST MECHANICS BURG III ESQ '04 MAR 12 AlIOunt R..itt.d PA 17055 ,",! C"~...' ",",,<;1._. Gun..., RE'I-ln1EXAFP CATHER ~ M MAKE CHECK PAYABLE AND REMIT PAYMENT ~: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this for. with your tax pa t. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .... RE-y=ii.ifj-EiC":i:'jo-foFii:n-------...--itiiiERITANcE-TiliCsTAfiMENT-il-"-ilircouiif--;;.ii-------------- ESTATE OF SLASEMAN CATHERINE M FILE NO. 21 02-0927 ACN 101 DATE 03-08 004 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE MAHEO ESTATE. SHOWN BE IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABL A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-25-2003 PRINCIPAL TAX DUE: ".,."''''''''''.,.,.,.___..._ PAYMENTS (TAX CREDITS): PAYMENT DATE 07-03-2003 01-30-2004 RECEIPT NUMBER CD002764 CD003508 DISCOUNT (+) INTEREST/PEN PAID (-) .00 209.11- 7,425.75 212.00 AMOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE . IF PAID AFTER THIS DATE, SEE REVERSE 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" ICRJ, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J 7 4 75 7,428 Ii 2 ~CR ~ 2 ~CR , BUREAU OF 'rNDZVZDUAL TAXES TNHERZTANCE TAX D~'¥TSTON DEPT. 28D601 HARRTSBURG, PA 1712&-0601 MURREL R WALTERS TTI_ESQJt¥'Od It 5q E HATN ST MECHANTCSBURG P~: ~t7055 COHMONWEALTH OF PENNSYLVANZA DEPARTMENT OF REVENUE ZNHERZTANCE TAX STATEMENT OF ACCOUNT P3:03 DATE 0q-12-200~ ESTATE OF SLASEMAN DATE OF DEATH 03-15-2002 FZLE NUMBER 21 02-0927 COUNTY CUMBERLAND ACM 101 Amoun't Remi't'ted REV-l[07 EX AFP [01-05) CATHERINE M MAKE CHECK PAYABLE AND REMZT PAYMENT TO: REGISTER OF WZLLS CUMBERLAND CO COURT HOUSE CARLTSLE, PA 17013 NOTE: To insure proper credl~: ~o your account:, submit: ~he upper portion of ~his fore wi~h your 4:ax payment:. CUT ALONG THZS LZNE ~ RETA]:N LOWER PORT'rON FOR YOUR RECORDS ~ REV-1607 EX AFP (01-03) ##a ZNHERZTANCE TAX STATEMENT OF ACCOUNT ESTATE OF SLASEMAN CATHER'rNE M FZLE NO. 21 02-0927 ACM 101 DATE Oq-lZ-ZOOq TH/S STATEMENT TS PROVZDED TO ADV/SE OF THE CURRENT STATUS OF THE STATED ACM TN THE NAMED ESTATE. SHONN BELON TS A SUMMARY OF THE PR'rNC/PAL TAX DUE., APpLI'CAT/ON OF ALL PAYMENTS, THE CURRENT BALANCE., AND,, ZF APPLZCABLE., A PROJECTED TNTEREST F'rOURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-25-2003 PR[NC[PAL TAX DUE: ........................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): 7,q25.75 PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID .00 07-03-2003 01-30-2004 03-29-200q CDOOZ76q CD005508 REFUND 209.11- .00 7,q25.75 212.00 2.89- ZF PAZD AFTER THZS DATE, SEE REVERSE SZDE FOR CALCULATZON OF ADDZTZONAL ZNTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUZRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDZT' (CR), TOTAL TAX CREDZT 7,q25.75 ~ALANCE OF TAX DUE .00 ZNTEREST AND PEN. .00 TOTAL DUE .00 YOU MAY BE DUE A REFUND. SEE REVERSE SZDE OF TH*rS FORM FOR *rNSTRUCTZONS. ) PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OFFS/ THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY UNTIL COMPLETION STATUS REPORT UNDER RULE 6.12 Name of Decedent: CATHERINE M. SLASEMAN Date of Death: MARCH 13, 2002 Estate No.: 21-02-0927 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 If the answer is No, state when the personal representative reasonably believes that the administration will be complete (date) If the answer to No. 1 is yes, state the following: A. Did the personal representative file a final account with the court? Yes No X Bo The separate Orphans' Court No. (if any) for the personal representative's account is: (Not Applicable in Dauphin County) Date: May 5, 2004 Do Did the personal representative state an account informally to the parties in interest: Yes .X No ///~ Copies of receipts, releases, joinders and approvals of formalj;}f~nformal accounts may be filed with the Clerk of the Orphans' CourCa/.r~may be attached to this report. ~ '~~~~',~ i MURREL .~. WALTERS, III, ESQUIRE 54 East Main Street Mechanicsburg, PA 17055 717-697-4650 Capacity: Personal Representative X.__ Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 FEG 29 Pt112: CO DORIS FINK 6 N 2ND ST WORMLEYSBURG r.o ~_,- L.. ~ Or''''-)! :.. ~ , "r' I"" /"1 t !/~': '''I ,/ \.J\Ji PA 17043 CUT ALONG THIS LINE REV-1604 EX AFP (03-05) DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 02-14-2008 SLASEMAN 03-13-2002 21 02-0927 CUMBERLAND 204-01-5005 03100914 CATHERINE M Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 --+ RETAIN LOWER PORTION FOR YOUR RECORDS +- --------------------------------...----------------------...-----------------------------------------..-------------------------------------------.--------------- REV-1604 EX AFP (03-05) -- INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __ DATE 02-14-2008 ESTATE OF SLASEMAN CATHERINE M DATE OF DEATH 03-13-2002 CUMBERLAND FILE NO. 21 02-0927 COUNTY ADJUSTMENT BASED ON: S.S/D.C. NO. 204-01-5005 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PNC BANK ACN 03100914 ACCOUNT NO. 31300155221 TYPE OF ACCOUNT: () SAVINGS () CHECKING () TRUST (X) TIME CERTIFICATE DATE ESTABLISHED 05-07-1999 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 19,873.78 0.500 9,936.89 .00 9,936.89 .15 1,490.53 TAX CREDITS: PAYMENT DATE 02-08-2008 RECEIPT NUMBER WRITEOFF DISCOUNT (+) INTEREST/PEN PAID (-) .00 AMOUNT PAID 1,938.77 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." 1,490.53 .00 .00 "CREDIT" (CR), ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRIS8URG PA 17128-0601 , ",' 0, F"'- ,i'~ U ';; 0 1-::": I')' ,'" '- ..J L: t' ~ . \'1 ., ~ t...-' "'" DORIS FINK 6 N 2ND ST WORMLEYSBURG ('i J, PA 17043 CUT ALONG THIS LINE REV-1604 EX AFP (03-05) DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 02-14-2008 SLASEMAN 03-13-2002 21 02-0927 CUMBERLAND 204-01-5005 03100915 CATHERINE M Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 --+ RETAIN LOWER PORTION FOR YOUR RECORDS ~ -----------------------------------------------------.------------------------------------------------------------------------------------------------------------ REV-1604 EX AFP (03-05) .. INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS .. DATE 02-14-2008 ESTATE OF SLASEMAN CATHERINE M DATE OF DEATH 03-13-2002 CUMBERLAND FILE NO. 21 02- 0927 ADJUSTMENT BASED ON: COUNTY S.S/D.C. NO. 204-01-5005 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PNC BANK ACN 03100915 ACCOUNT NO. 21001022120 TYPE OF ACCOUNT: () SAVINGS () CHECKING () TRUST (X) TIME CERTIFICATE DATE ESTABLISHED 05-04-1995 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE * IF PAID AFTER THIS DATE. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN *1. NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 10,191.00 0.500 5,095.50 .00 5,095.50 .15 764.33 TAX CREDITS: PAYMENT DATE 02-08-2008 RECEIPT NUMBER WRITEOFF DISCOUNT (+) INTEREST/PEN PAID (-) .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE TO: "RESISTER OF WILLS, AGENT." AMOUNT PAID 994.18 764.33 .00 .00 "CREDIT" {CRl. ~ REV-1470'EX (6-88) '* INHERITANCE TAX EXPLANATION OF CHANGES COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARRISBURG PA 17128-0601 DECEDENT'S NAME Catherine M. Slaseman FILE NUMBER Steven James ACN 21 02-0927 03100914,03100915 REVIEWED BY ITEM SCHEDULE NO. EXPLANATION OF CHANGES The Department has waived the balance due on the above referenced estate as not collectible. The Department, however, reserves the right to collect the tax, penalty and interest at a later date. ROW Paqe 1