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HomeMy WebLinkAbout02-0147REV-1500 ~[X + (6-00)  COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INtTIAt REIDER, LEAH B. Z LU 0 o~.., REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DATE OF DEATH (MM-DD-Year) 11/11/2001 DATE OF BIRTH (MM-DD-Year) 05/24/1 91 9 (IF: APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) OFFICIAL USE ONLY 17- 1'-I FILE NUMBER COUN'~Ty O'~DE YEAR SOCIAL SECURITY NUMBER 2 0 6- 1 0-8 6 3 8 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER r-~l. Odginal Return [~4. Limited Estate [~]6. Decedent Died Testate (AttachcopyofW~lt) ~._..~ 9. Litigation Proceeds Received n"~ 2. Supplemental Return r-~ 4a, Future Interest Compromise (date of death after 12-12-82) E~7. Decedent Maintained a Living Trust (Attach copy of Trust) E~ 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) r~3. Remainder Return (da~ of death prior to 12-13-82) r~5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes [] 11. Election to tax under Sec. 9113(A) (Attach Sch O) I-.- Z LU Z O (/3 tU n~ O JONATHAN M. CRIST, ESQ. FIRM NAME (If Applicable) LATSHA, DAVIS & YOHE, P.C. TELEPHONE NUMBER 717-761-1880 COMPLETE MAILING ADDRESS P.O. BOX 825 HARRISBURG PA 17108 Z Z X I- 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) E] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 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) OFFICIAL USE ONLY 77~:63 (8) -~ 9,641.37 g~'909.66 (11) 77,497.63 19,551.03 57,946.60 57,946.60 (12) (13) (14) 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 x ~ (15) 57,946.60 x .045 (16) 2,607.60 2,607.60 17, Amount of Line 14 taxable at sibling rate X .12 (17) 18. Amount of Line 14 taxable at collateral rate X .15 (18) 19. Tax Due (19) 20, ~'~ Dece~lent's Complete Address: STREET ADDRESS CITY CARLISLE, 770 SOUTH HANOVER STREET ISTATE PA I 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 130.38 (1) Total Credits ( A + B + C ) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. {SA) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (SB) Make Check Payable to: REGISTER OF WILLS, AGENT 2,607.60 130.38 2,477.22 2,477.22 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 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. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of the personal representative is based on all information of which preparer has any knowledge. SIGNATURE ADDRESS PA 17065 825 ',RISBURG PA 17108 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 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 inQNidual 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 F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER REIDER, LEAH B. 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. SAUNDRA W. JENKINS DAUGHTER 19 INDEPENDENCE DRIVE V1T HOLLY SPRINGS, PA. 17065 JOINTLyiOWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and 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 INTEREST 1. A. 10/98 ALLFIRST FINANCIAL SERVICES 33,829.69 50. 16,914.85 CERTIF OF DEPOSIT # 87008141267345 2. A. 12/96 ~,LLFIRST FINANCIAL SERVICES 9,613.99 50. 4,807.00 CHECKING ACCOUNT #0071003568 3. A. 12/96 RESIDENCE - 10 KENNSINGTON DRIVE 108,500.00 50. 54,250.00 CAMP HILL, PA. 17011 SEE SETTLEMENT SHEET ATTACHED AGREEMENT OF SALE EXECUTED PRIOR TO DEATH & CLOSING OCCURED AFTER DEATH 4. A. 10/73 SERIES E US SAVINGS BOND W/INTEREST 241.86 50. 120.93 # L2226338113E 5. A. 03~74 SERIES E US SAVINGS BOND W/INTEREST 116.37 50. 58.19 # Q6419430698E 6. A. 05~74 SERIES E US SAVINGS BOND W/INTEREST 117.49 50. 58.75 # Q6419430697E 7. A. 01/74 SERIES E US SAVINGS BOND W/INTEREST 232.74 50. 116.37 # L2226338115E 8. A. 01/74 SERIES E US SAVINGS BOND W/INTEREST 232.74 50. 116.37 # L2226338114E 9. A. 03~74 SERIES E US SAVINGS BOND W/INTEREST 232.74 50. 116.37 # L2226338117E TOTAL (Also enter on line 6, Recapitulation) $ 77,497.6,~ (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent REIDER, LEAH B. P a cLe_ 1 Schedule F-2 -Jointly-Owned Property ! LETTER ITEM i FORJOINT NUMBERI TENAN~T 15. [A. DATE MADE JOINT 03~74 05~74 05~74 '05/74 ; 05/74 !05/74 06/74 06/74 DESCRIPTION OF PROPERTY i include name of financial institution and bank account number or similar identifying number- Attach deed for jointly-held real estate. [SERIES E US SAVINGS BOND W/INTEREST I# L2226338116E i, SERIES E US SAVINGS BOND W/INTEREST [# L2226338112E I SERIES E US SAVINGS BOND W/INTEREST i# L2226338111E SERIES E US SAVINGS BOND W/INTEREST !# L2226338110E SERIES E US SAVINGS BOND W/INTEREST i# L2226338109E ;ERIES E US SAVINGS BOND W/INTEREST # L2226338108E SERIES E US SAVINGS BOND W/INTEREST # L2226338107E SERIES E US SAVINGS BOND W/INTEREST # L2226338113E % OF DATE OF DEATH DECD'S VALUE OF ASSET INTEREST 232.74 50. 234.98 234.98 234.98 234.98 234.98 234.98 234.98 50. 50. 50. 50. 50. 50. 50. DATE OF DEATH VALUE OF DECEDENT'S INTEREST 116.37 117.49 117.49 117.49 117.49 117.49 117.49 117.49 SUBTOTALSCHEDULEF-2 938.80 GRANDTOTALSCHEDULEF-2 $ 77,497.63 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF REIDER, LEAH B. SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS :ILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER A. 5. 6. 7. DESCRIPTION FUNERAL EXPENSES: MUSSELEMAN FUNERAL HOME - LEMOYNE PA ZION LUTHERAN CHURCH - GRAVE OPENING HARDINGSIKARNSIBONANZA- FOOD FOR FUNERAL ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address Oty State Year(s) Commission Paid: Attorney Fees LATSHA, DAVIS & YOHE, P.C. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Zip Street Address city Relationship of Claimant to Decedent Probate Fees State Zip Accountant's Fees Tax Return Preparer's Fees REGISTER OF WILLS - FEE TO FILE INHERITANCE TAX RETURN TOTAL (Also enter on line 9, Recapitulation) AMOUNT 7,459.76 475.00 691.61 1,000.00 15.00 $ 9,641.37 (If more space is needed, insert additional sheets of the same size) REV-1512EX+(1-97) ~ COMMONWEALTH OF pENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER ESTATE OF REIDER~ LEAH B. Include unreimbursed medical expenses. iTEM i AMOUNT NUMBER DESCRIPTION 8.05 1. 10. 11. I PHARMERICA- BALANCE DUE MEDICATION SERVICE !CHAPEL POINTE AT CARLISLE - FINAL INVOICES PP&L - 1/2 OF ELECTRIC BILLS ON JOINTLY OWNED RESIDENCE UNITED CHURCH OF CHRIST HOME - THORNWALD HOME FINAL INVOICES IALLFIRST MASTERCARD UGI -1/2 OF GAS BILLS ON JOINTLY OWNED RESIDENCE PA AMER WATER CO - 1/2 OF WATER BILLS ON JOINTLY OWNED RESIDENCE PINACLE HEALTH HOSPITALS - FINAL INVOICES MEDICAL SERVICES PRIOR TO DEATH APRIA HEALTHCARE RENTAL OF MEDICAL EQUIPMENT MOBIL X-RAY IMAGING 1/2 OF SETTLEMENT COSTS FOR SALE OF 10 KENSINGTON DRIVE, CAMP HILL PA 204.09 9.33 5,687.55 26.20 47.38 7.05 31.61 9.18 29.22 3,850.00 TOTAL (Also enter on line 10, Recapitulation) $ 9,909.66 (If more space is needed, insert additional sheets of the same size) U,S. DEPARTMENT OF HOUSING AND URBAN OEVELOPMENT SETTLEMENT STATEMENT Affiliated Settlement Services Group, LLP 3912 Market Street Camp Hill, PA 17011 (717) 975-7839 Form Approved OMB No. 2502-0265 B. -- T'~'PE-OF-E0~,-N- ~--[=q FHA 2. ~ FMHA 3. ~Jc0~v.-(JNINS. 4 ~q VA 5.~J CONV. INS. . 6'.-ES~-R0~'FI~E-I~0MBER-: ........... 7 ~OAN NUMBER: 00001986-001 NJT 618671014 ~ MORTGAGEINSURANCE CASE NUMBER: FINAL C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(P. O, C.) " were paid outside the closing; they are shown here for informational purposes and are not included_, in the totals. DT-N~I~E-~F~-I~0~)~'R~- -peT(J~l-D~-G-~e-e~-~-d-J-6~-~i~'n H. Tress ADDRESS OF BORROWER: 5078 Pajabon Drive #T-1 Harrisburg, PA 17111 NAME OF SELLER: E. ' ................ S~sFa--wT. :J~ kin s ADDRESS OF SELLER: 10 Kensington Drive Camp Hill, PA 17011 F. ...................... NAME OF LENDER: ;A-SN"~MR'O-~-rtgage Group, Inc. ADDRESS OF LENDER: 2600 W. Big Beaver Road Troy, Michigan 48084 . -G~-PROPERTY LOCATION: '1-0 Kensington Drive Camp Hill, PA 17011 Cumberland County 13-25-0022-060 Lot(s) 28, Block "C", of Country and Town Homes, Inc., Plan Book 7, H~-'-SETTC. EblE-N-'r-A-Gi~glT.~-----~iliated Settlement Services Group, LLP PLACE OF SETTLEMENT: 3912 Market Street, Camp Hill, PA 17011 ... I. SETTLEMENT DATE: 1:1-/;I-~F2~01 PRORATION DATE: 11/16/2001 J SUMMARY OF BORROWER'S TRANSACTION t K. SUMMARY oF'SE~I-ER'sTR~,NSACTION ' ~ ~ ~-"'~-~'~' "'"'~'"""'"'~ .... ~'~ ' ~ ~ 108,500,00 101. Contract Sales Price 108,500.00 ~01. Contract Sales Price 102..~e~ ---8_-~ Personal Property i ......... 103. ~) Borrower (line 1400) ~,-E"r27.~ } .......... 7 ..... 104.10.5. -- .............. -~ ............. _l,,u--~ ;-7,~ '1 -" ADJUSTMENTS FOR iTEMS PAID BY SELLER IN ADVANCE: ADJUSTMENTS FOR ITEMS PAID BY SELLER IN ADvANcEi' 406. City/Town Taxes 1 ' l'(~6.'(;it¢~own Taxes . 107. County Taxes 11/16/01 to 12/31/01 47.54 407. County Taxes ...... 1-1~1-~]01---i~---12/-3-'U-01 "'I -47.54 108. Assessments 408. Assessments I 113. 114. 115, 120. GROSS AMOUNT DUE FROM BORROWER: 201. Deposit or earnest money 202. Principal amount of new loan(s) 203. Existing loan(s) taken subject to 204. -205. '206. -- -207. 208. 209. 113,096.57 103;000~0- 413. 414. t _. 501. Excess deposit (see instructions) I 502. Settlement charges to Seller(line 1400) ! ......... 7;700100 503. Existing loan(s) taken subject to 504. Payoff of first mortgage loan iL-i~_i _ ii_.. -- -,~5~ Payoff of second modgage loan I ADJUSTMENTS FOR ITEMS UNPAID BY SELLER: ADJUSTMENTS FOR ITEMS UNPAID BY SELLER: ......... 210. City/Town Taxes 1 510. City/Town Taxes ~ . 211. County Taxes ............. 1 511. County Taxes 2i2. Asse-s~r~'e~ .................................... ~_~ '~ 2:- .,~s-~-~ r~is ......................... !' ............... [-~-37- ............................. " 213. 214. j E~-4. 216. 516. J ......... 21z I517. ............. . - 219. ............... ~ J_~.?:. .......................................... l - - -2~-o~---r~)--TXL+p-~D-B~'7¢~{~O-RRoWE'i~--:---'~-(~,-~.o~T520. TOTAL REDUCTIONS IN AM?UNT DU.E SELLER: '.. 7,700.~0 301. Gross amount due from Borrower ( line 120) 113,096.57 601. Gross amount due to Seller (line 420) ! 109,223.69 302. Less amount paid by/for Borrower ( line 220) 105,000.00 602. Less reduction in amount due Seller (line 520) 303. CASN(~FROM) ( L3 TO)BORROWER: 8,096.57 603. CASN(L~FROM) ( [~ TO)SELLER | 101,523.69 ~L S_..~_._T~_~EME NT CHARGES _ ,,E~~ ~i.. BASED ON PRICES 108,500.00 @ 6.000%= $6,510.00 PAID FROM DIVISION OF COMMISSION {LINE 700) AS FOLLOWS: BORROWER'S FUNDS AT .70:1. $ 3.280.00 to Jack Gaughen ERA SETTLEMENT 702] $ ........... 3~230~00]o--]John G sei' nc]Realtor] .................................................. 703. Commission paid at settlement 704. 801, Loan Origination Fee % 802. Loan Discount Fee % ............................................ 27'5;00 803. Appraisal Fee to: to Cody Financial Services ~04. Credit Report to: to Cody Financial Services 50.00 805._ L e ~ d_e_ r _s _1 _n s_p e_c.t_i o_n_F_e, e_ 806. Mortgage Insurance Application Fee to: 807. Assumption Fee 808, Administrative Fee to ABN AMRO Mortgage Group, Inc. 809. Flood Certification Fee to Cody Financial Services 810, 811. 902. Mortgage Insurance Premium for Month(s) to 903. Hazard Insurance Premium for I Years{s} to Erie Insurance Group ($188.00 P.O.C. 904. Deferred Prem Pd by ABN AMRO to Cody Financial Services ($2,575.00 P.O.C. 905. ~001. Hazard Insurance 15.67 )er month 1002. Mortgage Insurance months @ $ )er month 1003. City Property Taxes months @ $ )er month 1004. County Property Taxes 10' months @ $ 31.02 )er month 1005. Annual Assessments months @ $ )er month 1006. School Taxes ~' months @ $ 84.32 )er month 10~7. months @ $ )er month 1008. Aggregate Acct. Adj. months @ $ )er month 1101. Settlement or closing fee 1102. Abstract or title search 1103. Title examination 1104, Title insurance binder 1105. Document preparation 1106. Notary fees 1o Settlement Officer 1107. Attorney's Fees (includes above items numbers: 1108. Title Insurance to Affiliated Settlement Services Group,LLP (includes above items numbers: 1109. Lenders coverage: $ 103,000.00 11-10. Owner's coverage $ 108,500.00 1111. Endorsements 100-300-8.1 to Affiliated Settlement Services Group,LLP 1112. Overnight Delivery Fee to Affiliated Settlement Services Group,LLP 1113. 1201. Recording Fees: Deed $ 27.50 Mortgage $ 49.50 Release $ 1202. City/County tax/stamps Deed $ 1,085.00 Mortgage $ 1203. State tax/stamps Deed $ 1,085.00 Mortgage $ 1204. 1205. 1301. Survey 1-302T"P~{-I~p~tlb-n- ..... 16-Biechler & Tillery, Inc. 1303. Whole House Inspection --t~-~i~chler & Ti,ery. Inc. 1304]-Tr~,-n-sactl~r~-Fee to John Glise, lnc. Realtor '1-3~)5. Transaction Fee---- to Jack Gaughen ERA 375.00 21.50 6-001 NJT ~, PAID FROM SELLER'S FUNDS AT SETTLEMENT ........ 6151o~0 ~'~0:2o] ......... .......... ]265.18' 1 ) ) 77.00 ,- ....... ~ :085.oo ......... ~_:.°_~_~-°_~..t 2o.oo 5.oo 786.38 155.00 ,-- ........ 15.00 ($3-5]ob-P~O?(~ ................ l- ....... ($250.00 P.-O:C. '12,~:00't]]:~--~ ......... '1306. I 100.00 1307. **See attached for breakdown -t 3 ~218-8 ....... 7-700[00 1400. TOTAL SETTLEMENT CHARGES (Enter on line 103,Section J - and - line 502, Section K) , . ~-~ ....... : _ . I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief, it is a true and accurate statement of all receipts and Disbursements made ~n~y account or by me in thi~transaction. I further certify that I have received a copy of the HUD-1 Seffiement Statement. PercellD. Gree, ~ ,/]~ D 9'/// Sauri;UraW. Jenkins ~ Jocelyn h~T-r~ss /? . /~ Th ettl St~temem which/I Borrowers Sellers .have prepared is a true and accurate account of this transaction. I have caused or will cause the funds to be di,.~-~d ~'.~ ccp rd a n ce(.~/J~//~)/~,/~///~////:/with t t'~'s ,~{e~n t. _ /,///~/2~/----~////~.~//~/~// Afffliatbd Seitlemep~'Servic,~s Group, LLP ' WARNING: It is a crime to knowingly make false statements to the United States on this or any similar form. Penalties upon conviction can include a fine and imprisonment. For details see: Title 18 U.S. Code Section 1001 and Section 1010. 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 000840 CRIST JONATHAN M ESQUIRE LATSHA DAVIS & YOHE PC PO BOX 825 HARRISBURG, PA 17108 ........ fold ESTATE INFORMATION: SSN: 206-10-8638 FILE NUMBER: 2102-01 47 DECEDENT NAME: REIDER LEAH B DATE OF PAYMENT: 02/08/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 11/11/2001 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $2,477.22 TOTAL AMOUNT PAID: $2,477.22 REMARKS: SAUNDRAWJENKINS C/O JONATHAN M CRIST ESQUIRE SEAL CHECK//271 2 INITIALS: SK RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS BUIEAU OF INDIVIDUAL TAXES INHERItaNCE TAX DIVISION DEPl. ~80601 eHARRISBURG, PA 17128-0~01 JONATHAN M CRIST PO BOX 825 L~,~i~', HBG p~t ~.¥~.~.08 - 0825 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX DATE 04- 08-2002 ESTATE OF REIDER DATE OF DEATH Ii-II-2001 ~'iPR 12 ?i :!~4 FILE NUMBER COUNTY ACM 21 02-0147 CUMBERLAND lOI Amount Remitted REV*1547 EX AFP (01-02) LEAH 8 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-1547 EX AFP C01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF REIDER LEAH B FILE NO. 21 02-0147 ACN 101 DATE 04-08-2002 TAX RETURN WAS: C } ACCEPTED AS FILED C X} CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) C1) 2. Stocks and Bonds (Schedule B} C2} $. Closely Held Stock/Partnership Interest (Schedule C} CS} ~. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) &. Jointly Owned Property CSchedule F} C6) 7. Transfers (Schedule G) C7} 8. Tota! Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H} C9) lO. Debts/Mortgage Liabilities/Liens (Schedule 11. Total Deductions 12. Net Value of Tax Return .00 .00 .00 .00 .00 77~497.65 .00 C8) 9,641.57 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 15. 14. NOTE: ASSESSMENT OF TAX: 15. Amount of L/ne 14 at Spousal rate 16. Amount of Line ~ taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate 18. Amount of L/ne 14 taxable at Collateral/CZass B rate 77,497.65 6~059.66 Cll) l~.7fll.fl~ c~2) 61,796.60 .00 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. DISCOUNT C+} AMOUNT PAID INTEREST/PEN PAID C-) 1.%0 .~8 2,477.22 PAYMENT MUST BE MADE BY 08-11-2002~. TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 2,607.60 175.25 .00 175.25 ( IF TOTAL DUE IS LESS THAN 91, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A 'CREDTT" CCR}, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.} 19. Princt3al Tax Due TAX CREDITS PAYMENT RECEIPT DATE NUMBER 02-08-2002 CDOOO840 cz5} .00 x O0 = .00 Cl~> 61,796.60 x 045= 2,780.85 c~7) . OO x 12 = . O0 cia) .00 x 15 = .OO cl~)= 2,780.85 Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) C15) Net Value of Estate Subject to Tax C14> 61,796.60 If an assessment was issued previously, 11nes 14, 15 and/or 16, 17, 18 and 19 wi11 reflect figures that Include the total of ALL returns assessed to date. RESERVATION: PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTZONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class 8 (coIIateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawfu! Class B (collateralI rate on any such future interest. To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of 2000. (72 P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side. -*Hake check or money order payable to: REGISTER OF NXLLS, 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-ISIS). Applications are available at the Office of the Register of W/l/s, any of the 25 Revenue District Offices, or by calling the special 24-hour answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-$020 (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 sho~n on this Notice must object withln sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. OR Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, 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 within three (5) calendar months after the decedent's death, a five percent (SI) discount of the tax paid is allo~ed. The I5~ tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before Januar~ 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6X) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after Janua~J 1, 1982 will bear interest at a rate which will var~ from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2002 are: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor m 1982 20Y, .000548 1992 9~ .000247 1985 16Y. .000458 1995-1994 7Y. .000192 1984 1 lY. .000501 1995-1998 9Y. .000247 1985 15Y, .000556 1999 7Y. .000192 1986 10Y, .000274 2000 8~. .000219 1987 9Y. .000247 2001 9Y. .000247 1988-1991 1]Y, .000501 2002 ~}', .000164 --Interest is calculated as follows,* INTEREST = BALANCE OF TAX UNPATD X NUNBER OF DAYS DELXN{IUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. REV-1470 F~ ~ INHERITANCE TAX EXPLANATION COMMO.W~,~-N OF PE.NS¥,V^N~ DEP^m'ME.T OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL T.a0(ES DEPT. 280601 I-'I^RRISBURG, PA 17128-0601 DECEDEN'FS NAME FILE NUMBER Reider, Leah B. 2102-0147 REVIEWED BY ACN Daniel Heck 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES Reduced to $00. Selling expenses are not allowable deductions when the real estate, was I jointly owned by right of su~ivorship. ROW Page 1 EAT SHA DAVIS & YOHE, EC. ~ A'I-FORNEYS AT LAW PLEASE REPLY TO: Harrisburg WRITER'S E- MAIL: jcrist~ldylaw.com Mary C. Lewis, Register of Wills Cumberland County Courthouse Hanover & High Street Carlisle, PA 17013 April 16, 2002 RE: Estate of Leah B. Reider, Deceased Our File No.: 807-01 Kimber L. Latsha Douglas C. Yohe** Glenn R. Davis Kevin M. McKenna*** Jonathan M. Crist Barbara G. Graybill Timothy W. Garvey* David C. Marshall Steven M. Montresor* Christine L. Sudlow* Chadwick O. Bogar Duane P. Stone Julianna G. Van Duyne Also admitted *NJ **NC, MD ***NJ, DC Dear Ms. Lewis: Enclosed please find a check in the amount of $173.25 to cover the additional tax on the above-referenced Estate as indicated in the attached bill from the Commonwealth of Pennsylvania Department of Revenue. Thank you for your attention to this matter. If you have any questions or concerns, please do not hesitate to contact us. JMC/jeb Enclosure /yours, 74151 Post Office Box 825 · Harrisburg, PA 17108-0825 4720 Old Gettysburg Road, Suite 101 · Mechanicsburg, PA 17055 ° (717) 761-1880 ° FAX (717) 761-2286 7 Great Valley Parkway, Suite 221 · Malvern, PA 19355 ° (610) 251-6985 · FAX (610) 407-9265 3000 Atrium Way, Suite 251 · Mt. Laurel, NJ 08054 · (856) 231-5351 · FAX (856) 231-5341 Maryland Telephone: (410) 727-2810 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 001080 CRIST JONATHAN M ESQUIRE LATSHA DAVIS & YOHE PC PO BOX 825 HARRISBURG, PA 17108 ........ fold ESTATE INFORMATION: SSN: 206-10-8638 FILE NUMBER: 2102-0147 DECEDENT NAME: REIDER LEAH B DATE OF PAYMENT: 04/17/2002 POSTMARK DATE: 04/1 6/2002 COUNTY: CUMBERLAND DATE OF DEATH: 11/11/2001 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $173.25 TOTAL AMOUNT PAID: $173.25 REMARKS: JONATHAN M CRISTESQUIRE SEAL CHECK# 2752 INITIALS: AC RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DTVTSTOH DEPT. 280601 HARRISBURG., PA 17128-0601 CONHONNEALTH OF PENNSYLVANIA DEPARTNENT OF REVENUE INHERITANCE TAX STATEHENT OF ACCOUNT REV-i&D7 EX AFP JONATHAN H CRIST PO BOX 825 ': DATE 05-28-2002 ~ ESTATE OF REIDER LEAH DATE OF DEATH 11-11-2001 F'rLE NUH*tER 21 02-0147 '0:~ i'i!~¥ 31 ?i:~.~3 COUNTY CUH]~ERLAND ACN 101 PA l'~.,t O~ 8- 0825 Amoun~ Remi~c'l:md HAKE CHECK PAYABLE AND RENZT PAYNENT TO: REGISTER OF WILLS CUH]}ERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To /nsure proper credi~ ~o your account, submit: ~he upper portion of ~:his fore wi~:h your ~ax payment. CUT ALONG TH'rS LINE ~ RETA'rN LONER PORT'rON FOR YOUR RECORDS REV-1607 EX AFP (01-02) ~ ZNHERZTANCE TAX STATEHENT OF ACCOUNT ESTATE OF REIDER LEAH ]} F'rLE NO. 21 02-0147 ACN 101 DATE 05-28-2002 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAHED ESTATE. SHO#N BELO# ZSA SUHHARY OF THE PRINCIPAL TAX DUE.. APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE.. AND, ZF APPLICABLE, A PROdECTED INTEREST FIGURE. DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT: 04-08-2002 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYHENTS (TAX CREDITS): 2,780.85 PAYHENT RECEIPT DISCOUNT (+) ANOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 130.38 02-08-2002 04-16-2002 CD000840 CDO01080 .00 2,477.22 173.25 IF PAID AFTER TH/S DATE, SEE REVERSE S/DE FOR CALCULATION OF ADDITIONAL INTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT 1S REQUIRED. ZF TOTAL DUE IS REFLECTED AS A 'CREDIT" (CR), TOTAL TAX CRED'rT 2,780.85 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR *rNSTRUCTTONS. ) PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF NILLS, AGENT. -- If NON-RESIDENT DECEDENT make check or money order payable to: COMMONNEALTH OF PENNSYLVANIA. REFUND (CA): A refund of a tax credit, ahich ams not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISIS). Applications ara available at the Office of the Register of Wills, any of the 25 Revenue District Offices or frei the Department's Z4-hour answering service for fores ordering: 1-800-362-Z050; services for taxpayers with special hearing and / or speaking needs: 1-BOO-4q7-30ZO (TT only). REPLY TO: Questions regarding errors contained on this notice should bm addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. ZO0601j Harrisburg, PA 17128-0601, phone (717) 787-6SOS. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (SI) discount of the tax paid is allowed. PENALTY: The 1SI tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January lB, 1996, the first day after the end of the tax amnesty period. INTEREST: Interest is charged beginning mith 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 l, 1982 bear interest at the rate of six (62) percent per annum calculated at a daily rate of .000164. All taxes ahich became delinquent on and after January 1, 1982 will bear interest at a rate which miZZ vary from calendar year tn calendar year mith that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through ZOOZ ars: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor 1982 ZOZ .0003q8 1992 9X .0002q7 1983 16Z .000438 X993-1994 72 .000192 1984 X1Z .000301 199S-X998 92 .0002q7 1983 13Z .000356 1999 7Z .000292 1986 IOZ .000274 2000 8Z .000219 1987 9Z .000247 2001 9Z .0002q7 1988-1991 11~ .000301 2002 6~ .000164 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent ~ill 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.