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HomeMy WebLinkAbout02-0149 pET.ITIO~N~F~R PROB, ATE and GRANT OF LETTERS also Rnown as To: Register of Wills for the ~,_ Deceased. County of Social Security No. ~ ~ ~' ~ 0 ~ ~ Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut~ in the last will of the above decedent, dated / ~ ~ and codicil(s) dated p ~ ~ ~ in the named (~tate relevant circumstances,~/.g...re, n;n~ciati~n, d~t~h of executor, etc.) Decendent was domiciled at death in ' . _ County., P_~nsylvania, with h ~ las~ fa.mily or princil~l residence at gtc '~' ~ 4a~~- _ (Pa.; / 7a~ x'" / (list street, number and muncipality) at De~n~ ~/~f age,c~.~ ~, '~t:~ ~.;/'~ ~'''! '~' .t~ , Except as follows, decedent did not rn~rry,-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 adjudicated incompetent: Decendent at death owned property with estimated values as follows: ..~/ (If domiciled in Pa.) All personal property $ (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows~~~e~.~ WHEREFORE, petitioner(s) respectfully r.equest(s) the probate of the last will and codicil(s) presented herewith and the grant of letters, testamentary (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. OATH OF PERSONAL REPRESENTATIVE COMMONWEALnTH OF~ PEnNSYlVANIA COUNTY OF ~.~,,xA,..~z-~-~.X J The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed before me this 8th dav of FEBRUARY , -- NO. 21-02-149 Estate of ~ ,~. ~ , Deceased DECREE OF PROBATE AND GRANT OF LETTERS FEBRUARY 8 AND NOW the reverse side hereof, satisfactory proof having been present.ed before me, IT IS DECREED that the instrument(s) dated /'~ '~"~,~ ~' ~ O / described therein be admitted to probate .and filed o,~recor, d ~ the last will of and Letters 7: ~t~~T~ ~ are hereby granted to x19 2002, in consideration of the petition on FEES Probate, Letters, Etc .......... $ 115.00 Short Certificates( ) .......... $ 18.00 ~-pag~s. 12.00 enunciation ................ $ JCP $ 5.00 TOTAL __ $ 150.00 Filed ....F.E.B.R..U.A.R.Y...8 ,..2. 0. 9.2 ............. // ~RPgi~ter of Wills I his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 8029375 ~ FEB 0 6 200Z Local Registrar No. Date ! 43 Rev. 2/87 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH Carlisle, PA 17013 FATHER'S NAME (Felt. M~dl®. Lasl! ,,~ Homemaker Home O~t~ [R=NT'$ M~-ING ADDR~ $$ (St reel. C~f/Tow~. Slate. Z'~ Co,et ID~CEDENT'SACTUAL 375 Claremont Drive ,ESI~ ,.Elizabeth G. Bair ,.Female ,.207 -- 09 -- 0359 5, 2002 , 87 '-.I , I : I~r2 [e~ ~est Falrvlew I,~-~ ,~.~ ~ I~ ~ m Cumberland~c~.sus~u,~ [~lddlesex,,,o~aus,~s~,,ou~,vTwp. g~aremont Nursing & Rehab. Ctr. '~~' 11,. White (~k~*~ ~ U.S.~MEDF~ES? I ~~c~l S~VI~ I1 I ~ 'FzZ 0 *~S+) "~. ~ ,. p~. ,. ~dO~e~ ~s. MOTHER'S NAME (F~sL M~c~e. Maven Surname) ,,. Bertha Troup [INFORMANT'S MAU. ING ADDRES~ (~,~. City/Term, ~ta~e. Zip Co(~) 1~2865 S.W. Hwy. 17, Lot 115, Arcadia, FL 5426 i:~c..~.~,~.-.=...,.,c,.,,.,. I=~'~"'--','~' 9 ],,~.olling Green Mem. Park [,,~.amp Hill, PA 17011 ,,. Charles Shuler ~NFOFIMANT'$ NAME (Type/Prinl! ~ Judy A. Dreisbach ~,,,.~, , o~(~ /~[,~ebruary 8, 2002 ~l;one&MurrayrH408 3rd St Ne~ Cumberla~a?~li ~ ' I,,. qq0A-m .. I,,. g~h ~A 200Z ~C~"EFERRED=.~E~MINE~O~R, leading Io wnmediate DUE TO (OR AS A CONSEQUENCE 0~: ~. Enl~r UNDERLYING 120- INJURY AT WORK? ID~SCRlaE HOW INJURY OCCURRED. LTATION (Street C4~/i*ow.. Sate) mannm~' ms stated ........... ' · , . ( ) d [] :,lem~?}r¥~p,~! Michael Gawlas,MD ~830 Good Hope Road ,,. Eno]a. PA 17025 )ATE FILED {Month 'Oay. ~a. 2002-149 THE LAW OFFICE of: JAMES M. BACH Attorney-At-Law 352 S. Sporting Hill Road Mechanicsburg, PA 17050 737-2033 LAST WILL AND TESTAMENT FOR ELIZABETH G. BAIR Last Will And Testament Of ELIZABETH G. BAIR I, ELIZABETH G. BAIR, of the TOWNSHIP OF EAST PENNSBORO, COUNTY OF CUMBERLAND, COMMONWEALTH of PENNSYLVANIA, being in good bodily health and of sound and disposing mind and memory, and not acting under duress, menace, fraud, or undue influence of any person whomsoever, merely calling to mind the frailty of human life, and being desirous of disposing my worldly goods while I have the strength and capacity so to do, I do make, publish and declare this my LAST WILL AND TESTAMENT. I hereby revoke, cancel and annul all my former Wills and Testaments, including codicils thereto, by me at any time made, and declare this alone to be my LAST WILL AND TESTAMENT. AS TO SUCH ESTATE IT HAS PLEASED GOD TO ENTRUST ME WITH IN THIS LIFETIME, I DISPOSE OF THE SAME AS FOLLOWS, VIZ: ITEM 1. I direct that my Executor hereinafter named, pay and discharge all of my just debts, funeral and testamentary expenses. ITEM 2. I order and direct that I be buried in the lot which I own, situate at the ROLLING GREEN CEMETERY, CAMP HILL, PA, Cumberland County, Pennsylvania. ITEM 3. I give, devise, and bequeath my real estate known and numbered as 438 THIRD STREET, ENOLA, PA 17025, together with, all contents to my dearly beloved daughter JUDY ANN DREISBACH, per stirpes. ITEM 4. All the rest, residue and remainder of my entire estate, wheresoever situate, and whatsoever it may consist of, I give, devise, and bequeath, absolutely, and in fee, to my dearly beloved daughter, ITEM 5. ITEM 6. ITEM 7. I nominate and appoint JUDY ANN DREISBACH as executrix of this, my Last Will and Testament. In the event that she fails to quality or cannot act, then I nominate and appoint TERRY W. DREISBACH as executor in her stead. I hereby direct that all my personal representatives, as well as their successors, shall not be required to give bond for the faithful performance of their duties in any jurisdiction. I order and direct that my Personal Representative(s) named herein Use the legal services of JAMES M. BACH, as Attorney for my Estate. ITEM 8. ITEM 9. I direct that all estate, succession, legacy, inheritance or other transfer taxes, however designated, that shall become payable by reason of my death in respect of all property comprising my gross estate for tax purposes, whether or not such property passes under this LAST WILL, shall be paid by my Executrix out of my residuary estate. I grant to my personal representatives herein named, in addition to, but not in limitation of those powers vested by law, to be exercised without prior application to or approval of any court, the power and authority to retain indefinitely any property, to invest and reinvest any assets or the proceeds derived from the sale of assets, although said investments may not be of the character prescribed by law, to sell, convey, assign, transfer and encumber any property, to pay, settle or compromise all claims, to make distribution or divisions in right, and to execute and deliver any and all instruments and to do all' acts, which may be deemed necessary and proper. /' ~" ELIZABETH G. BAIR ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA ) ) COUNTY OF CUMBERLAND ) SS I, ELIZABETH G. BAIR, the TESTATRIX, 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; that I signed it willingly; and that I signed it as my free and voluntary act for the purpose therein expressed. Sworn to or af~j~ned and/~tcknowledged before me, by: the TESTATRIX this /'/O~-<f day of ~_/LW/,-~fde?x,...~, 2001. t ELIZABETH G. BAIR NOTARY PUBLIC The preceding instrument consisrl-o ~~~~pe~vritten pages, identified by the signature of the TESTA~I~-9~, ~i~-y~l~~~ed, published and declared by ELIZ~E~ G. B~R, the TESTAT~X therein named as md for her LAST ~LL AND TESTAMENT. Witn~e~s~S(gdnature ~itn~ss Signature -- I AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) ) COUNTY OF CUMBERLAND ) SS witnesses whose names~re'sign'ed' to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the TESTATRIX sign and execute the instrument as her LAST WILL; that the TESTATRIX signed it willingly and that he executed it as her free and voluntary act for the purpose therein expressed; that each witness in the hearing and sight of the TESTATRIX signed the WILL as witnesses; and that, to the best of our knowledge, the TESTATRIX was, at the time, 18 or more years of age, of sound mind and under no constraint or undue influence. 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 001042 DREISBACH JUDY ANN 12865 S WEST HIGHWAY 17 #115 ARCADIA, FL 34269 fold ESTATE INFORMATION: SSN: 207-09-0359 FILE NUMBER: 2102-0149 DECEDENT NAME: BAIR ELIZABETH G DATE OF PAYMENT: 04/08/2002 POSTMARK DATE: 04/03/2002 COUNTY: CUMBERLAND DATE OF DEATH: 02/05/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 02112703 $106.94 TOTAL AMOUNT PAID: $106.94 REMARKS: JUDYADREISBACH SEAL CHECK# 106 INITIALS: CW RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS CONNONWEALTH OF PENNSYLVANIA D~ARTNENT OF REVENUE BUREAU OF /NDIVIDUAL TAXES DEPT. Z80601 HARRISBURg, PA 171Z8-0601 REV-1S43 EX AFP '02 APR-8 JUDY A DREI$,BACH LOT 115 t.,. :~:. q~98 ARCADIA - ZNFORHATZON NOTICE AND TAXPAYER RESPONSE I FILE NO. 21 0Z-01~9 ACN OZ112705 DATE O$-ZO-ZOOZ TYPE OF ACCOUNT EST. OF ELIZABETH G BAIR [] SAVINGS S.S. NO. 207-09-0559 [] CHECKING DATE 01: DEATH 02-05-2002 [] TRUST COUNTY CUHBERLAND [] CERTZF. REHZT PAYNENT AND FORHS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 ALLFIRST FINANC/AL SERVICES has provided the Department Nith the information listed bales ehich has been used in calculating the potantial tax due. Their records ]nd]cata that at the death of the above dscedent, you mere a joint owner/beneficiary of this account. If you feel this information is incorrect, pleasm obtain written correct]on free the financial institution, attach e copy to this fora and return it to the obeys address. This account is taxable in accordancs with the Inh~erltance Tax Lass of the Commonwealth of Pennsylvania. Questions may be anseered by calling (717) 787-85Z7. COHPLETE PART 1 BELOW ~ # # SEE REVERSE SIDE FOR FILING AND PAYHENT INSTRUCTIONS Accoun~ No. 870081~0026550 Date 09-01-1995 Established 5,003.16 Accoun~ Balance Percan~ Taxable Aeoun~ Subject ~o Tax Tax Ra~e Po~an~ial Tax Due X X 50.000 To insure propsr credit to your account, two (Z) copies of this notics must accompany your payment to the Register of Wills. Hake check payable to: "Register of gills~ Agent". NOTE: If tax payments are sade within thrse (3) months of the decsdent's date of death, you say dsduct e 5~ discount of the tax due. Any inheritance tax due will heroes dslinquent nine (9) months after the data cf dsath. PART TAXPAYER RESPONSE A. O The above information and tax due ls correct. 1. You may choose to reeit payment to the Register of Wills with tee copies of this notice to obtain a discount or avoid intarest, or you say check box "A" and return this notice to the Reglstar of CHECK -~ gills and an official assessment will be issued by the PA Department of Revenue. ONE BLOCK s. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return ONLY to be filed by the dacsdent's representative. C. ~The above information is incorrect end/or dsbts and deductions sere paid by you. You must cosplete PART ~ and/or PART ~below. LINE 1. Dais Established 2. Account Balance 2 3. Percent Taxable 3 ~ q. Amount Sub,act to Tax i E. Debts and Deductions S - 6. Aeoun~ Taxable 6 7. Tax Rata 7 ~ 8. Tax Due 8 PART DATE PAID DEBTS AND DEDUCTIONS CLAZNED PAYEE DESCRIPTION ANOUNT PAID TOTAL (Enter on Line 5 of Tax Co.putation) Under penalties of perjury, Z declare ~ha~ ~he fac~s I have reported above ara true, corrac~ and comple'l:a '~o the bas'l: o.,'~.y kn~wl/~dge and b. li.f. HOHE (~A) ~¢--7© 7 ~ ~AXPA~R S[GNATURE TELEPHONE NUHBER '~A~ GENERAL ZNFORHATZON Z. FAZLURE TO RESPOND #ZLL RESULT XN AN OFFZCXAL TAX ASSESSHENT .ith applicable interest based on information submitted by the financial institution. Z. Inheritance tax becomes delinquent nine months after the decedent's date of death. 5. A joint account is taxable even though the decedent's name mas added as a matter of convenience. 4. Accounts (including those held between husband and mile) which the decedent put in joint names within one year prior to death are fully taxable as transfers. 5. Accounts established jointly bataeen husband and wife more than one year priar to death ara not taxable. 6. Accounts held by a decedent "in trust for" another or others arm taxable fully. REPORTTNG TNSTRUCTZONS - PART I TAXPAYER RESPONSE 1. BLOCK A - If the information and computation in the notice are correct and deductions are not being claimed, place an "X" in block "Aw of Part I of the "Taxpayer Response" section. Sign tuo copies and submit them with your check far the amount of tax to the Register of Hills of the county indicated. The PA Department of Revenue will issue an official assessment (Fora REV-LS48 EX) upon receipt of the return from the Register of Hills. Z. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid with the Pennsylvania Inheritance Tax Return filed by the decadent's representative, place an "X" in block "B" of Part 1 of the "Taxpayer Response" section. Sign eno copy and return to the PA Department of Revenue, Bureau of Individual Taxes, Dept Z80601, Harrisburg, PA 171Z8-0601 in the envelope provided. $. BLOCK C - Zf the notice information is incorrect and/or deductions are being claieed, check block "C" and coapleta Parts Z and $ according to the instructions below. Sign two copies and submit them with your check for the amount of tax payable to the Register of Nills of the county indicated. The PA Department of Revenue will issue an official assessment (Fora REV-1548 EX) upon receipt of the return from the Register of Hills. TAX RETURN - PART 2 - TAX CONPUTATZON LZNE 1. Enter the date the account originally was established or titled in the manner existing at date of death. NOTE: For a decedent dying after 1Z/1Z/BZ: Accounts which the decedent put in joint names within one (1) year of death are taxable fully as transfers. However, there is an exclusion not to exceed $3,000 per transferee regardless of the value of the account or the number of accounts held. Ifa double asterisk (mw) appears before your first name in the address portion of this notice, the $3,000 exclusion already has been deducted from the account balance as reported by the financial institution. Z. Enter the total balance of the account including interest accrued to the date of death. 3. The percent of the account that is taxable for each survivor is determined as fallows: A. The percent taxable for joint assets established more than one year prior to the decedent's death: ! DIVZDED BY TOTAL NUNDER OF DIVIDED BY TOTAL NUNBER OF X 100 = PERCENT TAXABLE JOINT ONNERS SURVZVZNG JOINT ONNERS Example: A joint asset registered in the name of the decedent and tuo other persons. I DIVIDED BY 3 (JOINT ONNERS) DIVIDED BY Z (SURVIVORS) = .167 X L00 = 16.?Z (TAXABLE FOR EACH SURVZVOR) B.The percent taxable for assets created within cna year of the decedent's death ar accounts o~nad by the decedent but held in trust for another individual(s) (trust beneficiaries): I DIVIDED BY TOTAL NUNBER OF SURVIVZNG JOINT X 100 = PERCENT TAXABLE ONNERS OR TRUST BENEFZCIARIES Example: Joint account registered in the name of the decedent and twa other persons and established within cna year of death by the decedent. I DIVIDED BY Z (SURVIVORS) = .SO X lO0 = 50Z (TAXABLE FOR EACH SURVIVOR) The amount subject to tax (line 4) is determined by multiplying the account balance (line Z) by the percent taxable (line 3). 5. Enter the total of the debts and deductions listed in Part 3. 6. The amount taxable (line 6) is datareined by subtracting the debts and deductions (1ina 5) from the amount subject to tax (line 4). 7. Enter the appropriate tax rate (line 7) as determined below. Da~e of Death ~ Spouse Lineal 07/01/9~ *o 12/31/9~ SZ 6X 01/01/9S ~o 06/30/00 0Z 6Z 07/01/00 *o preson~ OZ ~Tha tax rata imposed on the net value of transfers from a deceased child tuenty-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 OZ. The lineal class of heirs includes grandparents, parents, children, and Lineal descendents. "Children" includes natural children whether or net they have been adopted by others, adopted children and step children. "Lineal descendents" includes all children of the natural parents end theLr descendents, whether or not they have been adopted by others, adopted descendents end their descendants end step-descendants. "Siblings" ere defined es individuals who have et [east one parent in common with the decedent, whether by blood or adoption. The "Collateral" class of hairs includes all other beneficiaries. CLATNED DEDUCTTONS - PART $ - DEBTS AND DEDUCTTONS CLA[NED Allo~able debts and deductions are determined as follows: A. You legally are responsible for payment, or the estate subject to administration by a persona[ representative Js insufficient to pay the deductible items. B. You actually paid the debts after death of the decedent and cmn ~urnish proof of payment. C. Debts being claimed must be itemized fully in Part 3. If additional space is needed, usa plain paper 8 l/Z" x Il". Proof of payment may be requested by the PA Department of Revenue. Cumb~ A ¼' NOTICE UNDER RULE 5.6(a) Admin. No. stration required by Rule 5.6(a) of the Orphans' Court Rules was above-captioned estate on : Address 12865 S. West Highway 17 - Lot ~115 Ar~n~n~ wl ~426q ier Rule 5.6(a) except Signature Name James M. Bach, Esquire Address 352 South Sporting Hill Road Mechanicsburg, PA 17055 i Telephone (717) 737-2033 Personal Representative X Counsel for personal representative 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 001214 BACH JAMES M 352 S SPORTING HILL ROAD MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN: 207-09-0359 FILE NUMBER: 2102-0149 DECEDENT NAME: BAIR ELIZABETH G DATE OF PAYMENT: 05/24/2002 POSTMARK DATE: 05/23/2002 COUNTY: CUMBERLAND DATE OF DEATH: 02/05/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $2,436.83 REMARKS: TOTAL AMOUNT PAID- JUDY A DRIESBACH C/O JAMES M BACH ESQUIRE $2,436.83 SEAL CHECK//110 INITIALS: CW RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN OF:FICIAL USE ONLY FILE NUMBER {'-~ 1. Original Return [~4. Limited Estate [~6. Decedent Died Testate (Attach copy o[Wifl) ~----] 9. Litigation Proceeds Received [~2. Supplemental Return E~] 4a. Future Interest Compromise (date of death after 12-12-82) E~7. Decedent Maintained a Living Trust (Attach copy of T~ust) E~]10. Spousal Poverty Credit (dale of death be~een 12-31-91 and 1-1-95) NAME James M. Bach, Attorney at Law FIRM NAME (ffApl~icable) TELEPHONE NUMBER (717) 737-2033 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) [~ Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) · (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) -O- $15,354.93 --0-- 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) $71,883.19 (11) $15,354.93 (12) $56,528.26 (13) -0- (14) $56,528.26 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 $ 5 6, 5 2 8. 2 6 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due x .0_ (15) -O- x .0~' 5%(16) $ 2,543.77 x .12 (17) -O- x .15 (18) -O- (19) $ 2,543.77 --]3. Remainder Retum (date of death prior to 12-13-82) E~5. Federal Estate Tax Return Required __ 8. Total Number of Safe Deposit Boxes L--]11. Election to tax under Sec. 9113(A)(Attach Sch O) COMPLETE MAILING ADDRESS 352 S. Sporting Hill Road ?Mechanicsburg, PA 17050 $35,000.00 -0- $36,883.19 --0-- OFFICIAL USE ONLY UJ ~-oo O. 21-02 0 1 49 R E S I D E N T D E C E D E N T couN cooE DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Z Bair, Elizabeth G. 207 - 09 -0359 ~'t DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE U.I 02-05-02 04-02- 14 REGISTER OF WILLS III (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Decede'nt's Complete Address: STREET ADDRESS 438 Third Street CITY West Fairview I STATE PA I JZIP 17025 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments (1) A. Spousal Poverty Credit - O- B. Prior Payments $1 0 6.9 4 C. Discount - 0- 3. Interest/Penalty if applicable Total Credits ( A + B + C ) (2) D. Interest - 0 - E, Penalty - 0 - 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 I 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. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT $2,543.77 $ 106.94 --0-- --0-- $2,436.83 --0-- $2,436.83 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 secudty 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 ~ have exam ned this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIG NATU RE ~ES, p,~ S IBL~tE/J).,R ~FI,L.~_G.,I~_ TU R N ~, Jt~d-'"'-- -'"~ ,,-',.<,' ~ p' ann(/43relsDacr~ --- --,..~ ADDRESS DATE Hay 15, 2002 12865 South West Highway 17, Lot ~115, Arcadia, FL 34269 SIGNATURE ~PAEE.~R~T~_HER T~RESENT~ DATE Jam~s\M. Bach, A~torne¥ at Law May 15 2002 ADDRESS ~ ' 352 S. Sporting Hill Road, Mechanicsburg, PA 17050 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 decedenrs 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 decedenrs siblings is 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. SCHEDULE A REAL ESTATE ..... E1 i zabe t.h.....G ._ B.a..~ r ............................................ 21-02-0149 . All real P,~;pe~y owned solely or as a tenm~t in c r , ' ' ' .............. :. -- ,_,~,,~-)~,?, .;.. ,. ,',tc~c..qe o1' tho relov;mt facts. Real nronor~v ~,.;t',f;.'~('(,; ~2~';t,;{,:'?.n..g_s,e"e.h n,ei~,/1.er @hind compelled to bu~ ~c~euu~o r. ,' ~ -- .......... ~ ...... ~-uw~]ea wl[n rlgn[ Of survivorship must C~F ,., f.':.A 35,000 IT E M NUI',IBE.q DESCRIPTION 438 Third Street, West Fairview, Pennsylvania 17025 (See Exhibit A) TOTAL 35,000 COMMONWEALTH OF PENNSYLVANIA INHERITANCE~X RETURN RESIDENT DECEDENT ESTATE OF Elizabeth G. Bair SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21-02-0149 Include the ITEM NUMBER )roceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorshi = must be disclosed on Schedule F. DESCRIPTION Ail First Bank, Summerdale, Checking Account Ail First Bank, Summerdale, Certificate of Deposit Pennsylvania Pennsylvania TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) VALUEAT DATE OF DEATH 31,883.19 5,000.00 r~ $36'883'19 ~-v-~s~. (?7) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Elizabeth G. Bair SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-02-0149 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. FUNERAL EXPENSES: 1. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. DESCRIPTION 34269 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Jud~ Ann Dreisbach Social Security Number(s) / EIN Number of Personal Representative(s) 164- 30- 3251 SffeetAddress 12865 South West Hiqhwa¥ 17, Lot ~115 Ci~ Arcadia State FL Zip Year(s) Commission Paid: 2002 A~0meyFees - James H. Bach, Attorney at Law Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address Zip City State Relationship of Claimant to Decedent PmbateFees-~- Register of Wills Cumberland County Accountant's Fees Tax Return Preparer's Fees Terry W. Dreisbach (Snow Removal from Home prior to Sale) PAWC (Water Bill) PPH (Electric Bill for Home) : Claremont Nursing Home (Final Bill) Yellow Breeches EMS Ambulance Service Century 21 Real Estate Commission James A. Milled (Settlement Cost) Century 21 Real Estate Transfer Fee Recorder of Deeds (Real Estate Transfer Tax) Recorder of Deeds (Recording Cost) Alicia Stine (2002 County Taxes) Carlisle Regional Medical Center TOTAL (Also enter on line 9, Recapitulation) 3,594.00 4,313.00 $ 165.00 100.00 $ 35.15 $ 21.74 $ 3,167.28 $ 144.30 $ 3,000.00 $ 45.00 125.00 350.00 25.00 169.46 100.00 $!~5,354.93 (If more space is needed, insert additional sheets of the same size) AMOUNT COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Elizabeth G. Bair NUMBER 11. SCHEDULE J BENEFICIARIES NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outdghI spousal distributions) Judy Ann Dreisbach 12865 South West Highway 17 Lot ~115 Arcadia, FL 34269 FILENUMBER 21-02-0149 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Daughter ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINE~ NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE AMOUNT OR SHARE OF ESTATE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET (If m~e space is needed, inseFt additional sheets of the same size) 10o% 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET JAMES M. BACH Attorney At Law 352 S. Sporting Hill Rd., Mechanicsburg, PA 17050, Tel: (717) 737-2033 May 23, 2002 Register of Wills Cumberland County Courthouse Hanover & High Streets Carlisle, PA 17013 Re: Estate of Elizabeth G. Bait File NO. 2002-00149 Dear Register of Wills, Enclosed herewith please fred an original and a one copy of Pennsylvania Inheritance tax return. I also enclose a check in the amount of $2,436.83 for inheritance and $15.00 for the fding costs. Please process in your normal fashion. Lastly, kindly send to me at your convience the official Commonwealth of Pennsylvania receipt. JMB/ljs Respectfully~ UAttornqy-at-Law Enclosure 2 Pa Inheritance Tax Returns (2) Check No. 109 from the estate of Elizabeth G. Bait ($15.00) Check No. 110 from the estate of Elizabeth G. Bair ($2,436.83) cc: Judy A. Dreisbach (Letter only) 0 OF PENNSYLVANIA r OF REVENUE INHERITANCE T&X )NANCE OR DISALLOHANCE ) ASSESSHENT OF TAX ON ,0 OR TRUST ASSETS ~DATE 06-10-2002 ESTATE OF BAIR DATE OF DEATH 02-05-2002 FILE NUMBER 21 02-01q9 COUNTY CUMBERLAND SSN/DC 207-09-0359 ACN 02112703 Amoun~ Remitted REV-1548 EX AFP (01-02) ELIZABETH G MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF HILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 (TION FOR YOUR RECORDS ALLOHANCE OR DZSALLONANCE OF ~NTLY HELD OR TRUST ASSETS DATE 06-10-2002 : DEATH 02-05-2002 COUNTY CUMBERLAND 19-0359 ACN .ED ( ) CHANGED 02112703 · ASSET INFORMATION ;ICES ACCOUNT NO. 870081q0026530 ) TRUST ¢~ TIME CERTIFICATE 16 O0 58 O0 58 q5 57 ~') I ,ID (-) 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. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF HILLS, AGENT." 63 AMOUNT PAID 106.9q TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE ZF pATD AFTER THTS DATE,, SEE REVERSE FOR CALCULATTON OF ADDZTTONAL INTEREST. ! ( IF TOTAL DUE IS LESS THAN $1:, NO PAYMENT IS REQU/RED. IF TOTAL DUE IS REFLECTED AS A "CRED'rT" ( CR)., YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THI'S FORM FOR 'rNSTRUCT'rONS. ) 112.57 .00 .00 .00 PURPOSE OF NOTICE: To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act) Act Z3 of ZOO0. (TZ P.S. Section 9140). PAYHENT: Detach the top portion of this Notice and submit ai~h your payment to the Register of Nills printed on the reverse side. -- Hake check ar money order payable to: REGISTER OF RILLS, AGENT. REFUND (CR): OBJECTIONS: ADHIN- ISTRATZVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: A refund of a tax credit, which was net requested on tho tax return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications ara available at the Office of the Register of Rills, any of the 23 Revenue District Offices or by calling the special Z4-hour ansmaring service for forms ordering: 1-BO0-36Z-ZO50; services for taxpayers with special hearing and or speaking needs: 1-8oo-447-3ozo (TT only). Any party in interest not satisfied aith the appraisement, allomance, or disallowance of deductions or assessment of tax (including discount or interest) as shomn on this Notice may object aithin sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 181021, Harrisburg, PA 17128-1011, OR --electing to have the matter detarained at the audit of the account of the personal representer/va, OR --appeal to the Orphans' Court Factual errors discovered on this assessment should be addressed in ariting to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, DEPT. 180601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. Sea page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (51) discount of the tax paid is allowed. The 151 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the 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, 19BI bear interest at the rate of six (61) percent per annum calculated at a daily rate of .000164. Ali taxes which became delinquent on or after January 1, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1981 through 2002 are: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor 1982 ZOZ .000548 1992 9Z .000247 1983 162 .000~38 1993-1994 72 .00019Z 1964 111 .000301 1995-1998 92 .0002~7 1985 13Z .000556 1999 7Z .000192 1986 XOZ .000174 ZOO0 81 .000119 1987 92 .000Z47 ZOOl 92 .000Z47 1988-1991 112 .000301 ZOOZ 62 .000164 --Interest is calculated as follows: ZNTEREST= BALANCE OF TAX UNPAZD X NUI{BBR OF DAYS DELZNQUENT X DAZLY 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 an the Notice, additional interest must bo calculated. dREAU OF INDIVIDUAL TAXES ZNHERTTAHCE TAX DI¥ZSTON DEPT. 280601 HARRISBURG, PA 17128-0601 'O2 JAMES H BACH ATTY $52 S SPORTING HILL RD MECHANICSBURG PA.:17050 CONMONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX BATE 06-24-2002 ESTATE OF BAIR BATE OF BEATH 02-05-Z002 FILE NUMBER 21 02-0149 COUNTY CUMBERLAND ACM 101 Aaoun'l: Raa/'l;~:ad REV-1;¢? EX ~'FP ca1-12) ELIZABETH G MAKE CHECK PAYABLE AND REHIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETATN LONER PORTZON FOR YOUR RECORDS ~ REV-1547 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR BZSALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BAIR ELIZABETH GFZLE NO. 21 02-0149 ACN 101 DATE 06-24-2002 TAX RETURN HAS: (X) ACCEPTED AS FTLED ( ) CHANGED RESERVATTON CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es~a~e (Schedule A) (1) 2. S~ocks and Bonds (Schedule B) (2) 3. Closely HeZd S~ock/Par~narship /n~aras~ (Schedule C) (3) q. Hor~gagas/No~as Receivable (Schedule D) (~) 5. Cash/Bank Daposi~s/HLsc. Personal Propar~y (Schedule E) (5) 6. Jointly Owned Propar~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To,aZ Assa~s APPROVEB DEDUCTIONS ANB EXEMPTIONS: 9. Funeral Expanses/Ada. Cos~s/HLsc. Expanses (Schedule H) (9) 10. Deb~s/Hor~gega Liabil1*1as/Liens (Schedule Z) (10) 11. To,al Deductions 12. Na~ Value of Tax Re~urn $5~000.00 .00 .00 .0O 885.19 .00 .00 (8) 15,354.93 .00 NOTE: To insure proper cradL~ ~o your account, subet~ ~he upper por~ion of ~his form w~h your ~ax payment. 13. NOTE: 71,885.19 . O0 X O0 = . O0 56,528.26 x 045= 2,545.77 . O0 x 12 = . O0 · O0 X 15 = . O0 (19)= 2,545.77 ASSESSMENT OF TAX: 16. Aeoun* of Line lq a* Spouse1 ra~e (15) 16. Aaoun~ of Line lq *axab~a a~ Lineal/Class A ra~e (16). 17. Aeoun~ of Line lq a~ SLbling ra~a (17). 18. Aaoun~ of Line lfi ~exable e~ Colla~araZ/Class B re~a (18) 19. Princlpal Tax Due TAX CREBZTS: PAYMENT DATE 05-25-2002 RECE/PT I D/SCOUNT NUHBER J TNTEREST/PEN PAID (-) CDO01214 . O0 PAYHENT MUST BE HADE BY 11-05-Z002~. 1F PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. AHOUNT PAID 2,436.83 TOTAL TAX CREDIT BALANCE OF TAX BUE INTEREST AND PEN. TOTAL DUE 2,436.83 106.94 .00 106.94 ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR /NSTRUCT/ONS.) Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) . O0 Na~: Value of Es*a~e Sub.~ac~ '~o Tax (1~) 56,528.26 ~ an assessment ~as issued previously, 11nas 14, 15 and/er 16, 17, 18 and 19 ~ill re~lect ~igures that lnclude the total o~ ALL returns assessed to date. (11) 15.354.03 (12) 56,528.26 RESERVATION: Estates of decedents dying on or before December 1Z) 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collataral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonmealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such futura interest. PURPOSE OF NOTICE: PAYHENT: REFUND (CR): OBJECTIONS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of ZOO0. (72 P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. --Hake check or money order payable to: REGXSTER OF NXLLS, AGENT A refund of a tax credit, which was nat requested on tho Tax Return, may be requested by compXeting an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Nills, any of the 23 Revenue District Offices, or by calling the special 24-hour ans#ering service for forms ordering: 1-B00-362-20S0; services for taxpayers with special hearing and / or speaking needs: 1-800-447-3020 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disalloeance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --#ritten protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --election to have tho .attar determined et audit of tho account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Reviee 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-IS01) for an explanation of administratively correctable errors. If any tax due is paid mithin three (5) calendar months after the dacadent's death, a five percent (SI) discount of the tax paid is allowed. The 152 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you .ould appeal the tax and interest that has been assessed es 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, lgaZ bear interest at the rate of six (62) percent per annum calculated at a daily rate of .000164. All taxes ehich became delinquent on and after January 1, 1982 will bear interest at a rate which mill vary from calendar year to calendar year mith that rata announced by the PA Department of Revenue. Tho applicable interest rates for 198Z through 2002 ara: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor 1982 202 .000548 1992 92 .000247 1983 162 .000438 1993-1994 7X .000192 1984 llZ .000301 1995-199B 92 .000247 1985 132 .000356 1999 72 .000192 1986 IOZ .000274 2000 82 .000219 1987 92 .000247 2001 92 .000247 1988-1991 Ill .000301 2002 62 .000164 --Interest is calculated as folloes: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINI~UENT 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 sheen on the Notice, additional interest must be calculated. BUREAU OF INDIVIDUAL TAXES TNHERZTANCE TAX DTV/SZON DEPT. Z80601 HARR'rSBURG, PA 171Z8-0601 JANES H BACH ATTY $52 S SPORTING HILL RD MECHANICSBURG PA !7050 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEHENT OF ACCOUNT DATE 07-08-2002 ESTATE OF BAIR DATE OF DEATH 02-05-2002 FILE NUMBER Z10Z-Olq9 COUNTY CUMBERLAND ACM 101 REV-16n7 EX AFP cn1-~2) ELIZABETH G Amoun~ Remi'l:~ed I HAKE CHECK PAYABLE AND REHZT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credi~ ~o your account, submi~ ~he upper portion of ~his form wi~h your ~ax payment. CUT ALONG THIS LINE Im,,.* RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1607 EX AFP (01-02} ~ INHERITANCE TAX STATEMENT OF ACCOUNT ~ ESTATE OF BAIR ELIZABETH G FILE ND. Z1 OZ-Olq9 ACN lO1 DATE 07-08-2002 THIS STATEMENT ZS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHO#N BELON ZSA SUMMARY OF THE PRINCIPAL TAX DUE, APPLZCATZON OF ALL PAYMENTS, THE CURRENT BALANCE, AND, ZF APPLZCABLE, A PROJECTED ZNTEREST FZGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 06-Z~-ZOOZ PRINCIPAL TAX DUE= PAYHENTS (TAX CREDITS): 2,5~3.77 PAYHENT DATE OR-O$-ZOOZ 05-Z$-ZOOZ RECEIPT NUMBER CDOOIOq2 CDOOZZZq DISCOUNT C+) INTEREST/PEN PAID ¢-) 5.63 .00 AMOUNT PAID 106.9q 2,q36.83 IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. ZF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 2,sqg.qo 5.65CR .00 5.63CR YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) PAYNENT: 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 HILLS, AGENT. -- If NON-RES/DENT DECEDENT make check or money order payable to: CONNONNEALTN OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, which was not requested an the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications are available at the Office of the Register of Hills, any of the g5 Revenue District Offices or from the Department's Z~-hour answering service for forms ordering: 1-800-56Z-Z050; services for taxpayers with special hearing and / or speaking needs: 1-800-qqT-30ZO (TT only). REPLY TO: guestions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes) ATTN: Post Assessment Review Unit) Dept. Z80601, Harrisburg) PA 171Z8-060i, phone (717) 787-6505. DISCOUNT: If any tax due is paid aithin three (5) calendar months after the decedent's death, a five percent (5Z) discount of the tax paid is allowed. PENALTY: The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. INTEREST: Interest is charged beginning aith first day of delinquency, or nine (9) months and one fi} day free the date of death, to the date of payment. Taxes which became delinquent before January l, i98Z bear interest at the rata of six (SZ) percent par annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through ZOOZ are: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor 1982 20Z .000548 199Z 9g .000247 1995-1994 7Z .00019Z 1983 16Z .000458 1984 11~ .000501 1995-1998 9~ .000Z47 1985 13Z .000356 1999 7Z .O0019Z 1986 lOX .00027q 2000 8Z .000219 1987 9Z .000Z47 2001 9Z .000Z47 1988-1991 llZ .000301 ZOOZ 6Z .000164 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPA/D X NUI{BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation ta 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. BUREAU OF TNDTVZDUAL TAXES INHERITANCE TAX D'rVZSTON DEPT. 280601 HARRISBURG, PA 17128-0601 ,JUDY ,~OZD R ~/~CH ?'~ :~ LOT 115 12865 S I,~ HIGHNAY 17 ARCADIA I'i,~. !::: FL :SqZ69,qq98 COMMONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ZNHER'rTANCE TAX STATEMENT OF ACCOUNT DATE 07-08-2002 ESTATE OF BAIR DATE OF DEATH 02-05-2002 FILE NUMBER 21 02-01q9 COUNTY CUMBERLAND ACM 02112705 Amoun*l: REV-Il;07 EX AFP (01-02) ELIZABETH MAKE CHECK PAYABLE AND REN'rT PAYMENT TO: REGISTER OF NZLLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper credJ~ ~o your account, subeJ~ ~he upper port,on of ~h~s for. wJ~h your ~ax Payment. CUT ALONG THZS LINE ~'* RETAIN LONER PORTION FOR YOUR RECORDS ~ REV-1607 EX AFP (01-02) ~ ZNHERZTANCE TAX STATEMENT OF ACCOUNT ~ ESTATE OF BAIR ELIZABETH 13 F]:LE NO. 21 02-01~9 ACN 02112705 DATE 07-08-2002 TH*rS STATEMENT *rS PROV'rDED TO ADV*rSE OF THE CURRENT STATUS OF THE STATED ACM TN THE NAMED ESTATE. SHOI./N BELO# 1S A SUMMARY OF THE PRZNC*rPAL TAX DUE, APPLZCAT/ON OF ALL PAYMENTS, THE CURRENT BALANCE, AND, ZF APPL[CABLE, A PROJECTED *rNTEREST F/GURE. DATE OF LAST ASSESSMENT OR RECORD AD,JUSTMENT: 07-02-2002 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID ZF PA*rD AFTER THIS DATE, SEE REVERSE S~DE FOR CALCULAT*rON OF ADDITIONAL *rNTEREST. ( ZF TOTAL DUE 1S LESS THAN $1, NO PAYMENT 1S REgU*rRED. *rF TOTAL DUE *rS REFLECTED AS A "CRED/T" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF TH*rS FORM FOR ~NSTRUCT*rONS. ) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 .00 TOTAL DUE .00 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: REGTSTER OF #TLLS, AGENT. -- If NON-RESIDENT DECEDENT make check or money order payable to: COMMONNEALTH OF PENNSYLVANTA. REFUND iCA): 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-L313). Applications ara available at tho Office of the Register of Nills, any of the 23 Revenue District Offices or from the Department's Lq-hour answering service for forms ordering: L-800-$6Z-2050~ services for taxpayers with special hearing and / or speaking needs: L-BOg-4q7-3020 [TT only). REPLY TO: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 28060L, Harrisburg, PA L7IZS-O6OL, phone (7L7) 787-6505. DZSCOUNT: If any tax due is paid ~ithin three (5) calendar months after the dacadant's death, a five percent (52) discount of the tax paid is allowed. PENALTY: The LSX tax amnesty non-participation penalty is computed on the totml of the tax and interest assessed, and not paid before January 18, 1996, the first day after the and of tho tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes Nhich became delinquent before January i, L982 bear interest at the rate of six (62) percent per annum calcuZated et a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which ail! vary from calendar year to calendar year ~ith that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2002 ara: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor 1962 20Z .000548 1992 92 .000247 1983 162 .000438 1993-199q 72 .000192 1995-1996 92 ,000247 1964 112 .000301 1985 132 .O003S& 1999 72 .000192 1986 10Z .000274 2000 82 .000219 1987 9Z .000247 2001 92 .000247 1988-1991 112 .000301 2002 6Z .00016q --Interest is calculated as follows: TNTEREST = BALANCE OF TAX UNPAXD X NUHBER OF DAYS DELTNI~UENT X DAXLY TNTERBST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of tho assessment. Xf payment is made after the interest computation date sho~n on the Notice, additional interest must bm calculated. BUREAU OF TNDIVZDUAL TAXES TNHERITANCE TAX DIV/STON DEPT. 280601 HARRISBURG,, PA 17128-0601 COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT R£V-I~O? EX AFP C01-oZ) JAHES H BACH A $52 S SPORTING HILL RD HECHANICSBURG . PA 17050 DATE 08-05-2002 ESTATE OF BAIR DATE OF DEATH 02-05-2002 FILE NUHDER 21 02-01~9 COUNTY CUHBERLAND ACN 101 Aeoun'~ Rem i'l:'l:ed ELIZABETH G HAKE CHECK PAYABLE AND REHIT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit: ~o your account, submi~ ~hm upper por~ion of ~his fore wi~:h your ~:ex payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS *~ REV-1607 EX AFP (01-02) #~# INHERITANCE TAX STATEHENT OF ACCOUNT ~ ESTATE OF BAIR ELIZABETH G FILE NO. Z1 02-01~9 ACN 101 DATE 08-05-2002 THIS STATEHENT ZS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAHED ESTATE. SHO#N BELO# ZSA SUNHARY OF THE PRINCIPAL TAX DUE~, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, ZF APPLICABLE, A PROJECTED TNTEREST FZSURE. DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT: 06-17-2002 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYHENTS (TAX CREDITS): 2,5~$.77 PAYHENT RECEIPT DISCOUNT (+) DATE NUHBER INTEREST/PEN PAID (-) AHOUNT PAID 0R-05-2002 05-Z$-ZOOZ 07-22-Z002 CDO010~Z CDO01ZI~ REFUND 5.63 .00 .0O 106.9R 2,~$6.85 5.65- IF PAID AFTER THIS DATE, SEE REVERSE S~DE FOR CALCULATION OF ADDITIONAL INTEREST. { IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. ZF TOTAL DUE 1S REFLECTED AS A "CREDIT" {CR), TOTAL TAX CREDIT 2,5~$.77 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. ) PAYMENT: Detach the top portion of this Notice end submit aith 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 NZLLS~ AGENT. -- If NON-RESIDENT DECEDENT make check or money order payable to: COMMONNEALTH OF PENNSYLVANTA. REFUND (CR): 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-131~). Applications ara available at the Office of the Register of Hills, any of the Z$ Revenue District Offices or from the Department's Z4-hour anseering service for forms ordering: 1-eOO-36Z-ZO50; services for taxpayers eith special hearing and / or speaking needs: 1-eo0-q47-30ZO (TT only). REPLY TD: guestions regarding errors contained on this notice should be addressed to: PA Department af Revenue, Bureau of individual Taxes, ATTN: Post Assas~ent Review Unit, Dept. ZegBgl, Harrisburg, PA [TIZe-O6gl, phone (717) 787-6505. 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 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. INTEREST: Interest is charged beginning with first day af delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .O0016q. All taxes ahich became delinquent on and after January 1, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOOZ are: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor 1982 lOX ,000548 1992 92 ,O00Zq7 1983 16Z .000438 199~-199~ 72 .O00Igz 1964 112 .000301 1995-1998 92 .000247 1985 13Z .000356 1999 7Z .00019Z 1986 IOZ .000Z74 ZOO0 eX .O00Z19 1987 9Z .000Z47 ZOOl 9Z .000247 1988-1991 11Z .000501 ZOOZ 6Z .00016~ --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUI~BER OF DAYS DELINQUENT X DALLY 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 shaNn on the Notice, additional interest must be calculated.