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HomeMy WebLinkAbout05-27-09J 1505607121 REV-1500 Ex (06-05) OFFICWL USE ONLY PA DepaMlent of Revenue County Code Year File Number Bureau of Individual Taws INHERITANCE TAX RETURN Po Sox z6asot 2 1 0 8 1 0 1 2 Hardsbum, PA 17128.0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 9 2 3 2 0 0 8 1 2 2 4 1 9 1 7 Decedent's Last Name Suffix Decedent's First Name MI S P A H R J A N E E (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS ^X 1. Original Retum ~ 2. Supplemental Return ~ 3. Remainder Retum (date of death prior to 12-13.82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Retum Required death after 12-12-82) ® 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe DeposA Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Seh. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTUIL TAx INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number S U S A N H C O N F A I R rya 7 1 7 ~~ 3 ~3 8 3z, Finn Name (If Applicable) ' , a~ ~~ i-j REGIS NIl1LS U9~pNLY C ~~ O R E A G E R & A D L E R , P C ~'"'-m +~ First line of address n> _~_~ - ~ 7[ v r- - -~ ~J~.ti _ n r"'::7 ' _ 2 3 3 1 M A R K E T S T R E E T i,_~ ~ ;mac ~,~ - -U "n Second line of address i N .-~ - ~ 2> J` L^ c-J i CJ '~ Dlty Or POSt OfBCe C A M P H I L L State ZIP Code ~ DATE FILED P A 1 7 0 1 1 Correspondent'se-mail address:SCONFAIRaREAGERADLERPC•COM Jnder penal8es of perjury, I declare that I have examined this slum. indudino armmoanvfne schMulea and efalaawnfn aM n, Ma h-r nr,~„ h PERSON rile personal representa8ve is based on all Infomla8on of whkh preperer 51r ~lCb KlUbt AND tlLVD• MECHANICSBURG PA SIGNATURE OF PR A),2ER O;HER THAN REPRESENTATNE ADDRESS Li/ ~~~' ~ ~ I _/ / L9 CI 2331 MARKET STREET CAMP HILL PA 17011 - PLEASE USE ORIGINAL FORM ONLY Side 1 L 1505607121 1505607121 J ~~ ~_ c~ 'f>s~ }, c~,~ `~~ 1505607221 REV-1500 EX Decedent's Social Seeudty Number Decetlent's Name: JANE E• SPAHR RECAPITULATION 1. Real estate sdnedule A 1. 1 4 2 0 0 0. 0 0 2. Stocks and Bonds (Schedule B) ................................ .. 2. 3. Closely Held Corporation, Partnership or SolaProprietorship (Schedule C) ... .. 3. 4. Mortgages & Notes Receivable (Schedule D) ...................... .. 4. 5. Cash, Bank Deposits 8 Miscellaneous Personal Property (Schedule E) ..... .. 5. {a 1 7 6 6 . 9 4 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ..... .. 6. ~ • ~ 0 7. Inter-Vivos Transfers 8 Miscellaneous N -Probate Property (Schedule G) ~ Separate Billing Requested ..... .. 7. 8. Total Gross Assets (total Lines 1-7) ......................... .. 8. 2 0 3 7 6 6. 9 4 9. Funeral Ex nses & Administrative Costs Schedule H Pe ( ) .............. 9. .. 2 ~ 8 8 1 • 6 6 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .......... .. 10. 1 7 6 2 , 0 8 11. Total Deduetlons (total Lines 9 8 10) ......................... .. 11. 2 2 6 4 3. 7 4 12. Net Value of Estate (Line B minus Line 11) ....................... .. 12. 1 8 1 1 2 3 . 2 0 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ................ .. 13. 14. Net Value Subjsd to Tax (Line 12 minus Line 13) ................ .. 14. 1 8 1 1 2 3 • 2 0 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(t.2)x.o _ 0. 0 0 ts. 0. 0 0 16. Amount of Lina 14 taxable at lineal rate x .o4s 1 8 1 1 2 3. 2 0 16, 8 1 5 0. 5 4 17. Amount of Line 14 taxable at sibling rate X .12 0 ~ 0 17. 0. 0 0 18. Amount of Line 14 taxable at collateral rate X .15 0 D O 1 g 0• 0 0 19. Tax Due .............................................. .. 19. 8 1 5 0. 5 4 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 1505607221 1505607221 J REV-1500 EX Page 3 Decedent's Complete Address: File Number z1 Da 1D1z DECEDENTS NAME JANE E• SPAHR STREET ADDRESS 586 E STREET CITY CARLISLE STATE PA ZIP 17013 Tax Payments and Credits: t. Tax Due (Page 2 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Pdor Payments C. Disaunt 3. InterestlPenalty H appliceWe D. Interest E. Penalty 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (1) 8,150.54 TotalCredits(A+g+C) (2) 0.00 Total InteresUPenalty (D + E) (3) D . 0 0 (4) 0 . D 0 (5) 8,150.54 (5A) (5B) 8 ,150.5 4 Make Check Payable fo: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property trensfemed : ................................................................ ...... ^ ^X b. retain the dght 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? ................................................................................. ...... ^ Q 3. Did decedent own an 'in trust for• or payable upon death bank account or secudty at his or her death? .. ^ X^ . 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate properly which ...... contains a beneficiary designation? ............................................................................................. ..... ^ Q IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN REV-1502 EX + (6-98) SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF JANE E• SPAHR 21 08 1012 All real property owrrod aokdy or ae a tenant in common must W roported at fair markN value. Fair market value h defuaaf as the price at which property would !» ezcharged beNreen a wlNirg buyer and a wNling sager, neidler being compelled to buy ar sell, lath havkg reasonable knowledge of the relevant (ads. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 1586 E Street, Carlisle, PA - Sold 3/26/09 - Settlement Sheet 142,000.00 Attached TOTAL (Also enter on line t (I(more space Is needed, insert additional sheets of the same size) REV-1508 EX+ (8-98) SCHEDULE E p CASH BANK DEPOSITS Cl MSC COMMO NWEALTH OF PENNSYLVANIA , , . IN E NTRN PERSONAL PROPERTY RES DENT DECED ESTATE OF FILE NUMBER JANE E• SPAHR 21 08 1012 Indude the proceeds of litigation and the date tlm proceeds were receNed by the estate. All property joirltlyowned with right of survNOmhip must be discbsed on Sehedub F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 1995 Mercury Sable 2,200.00 2• Checking Account - M 8 T Bank •80788858 16,348.99 3• Certificate of Deposit - M 8 T Bank •31003914602626 4,637.21 4 Certificate of Deposit - M 8 T Bank •31003914568935 3,282.22 5• Certificate of Deposit - M 8 T Bank •31003913948039 5,880.76 6• Refund Homeowners - Erie Insurance Exchange 436.00 7• Refund - Comcast 8.29 8• Refund - JCPenney 354.00 9• . Savings Account - Members 1st Federal Credit Union 66.03 ft165948 10. Certificate of Deposit - Members 1st Federal Credit Union 7,810.60 «165948-44 11• Certificate of Deposit - Members 1st Federal Credit Union 1,434.65 •165948-45 12• Certificate of Deposit - Members 1st Federal Credit Union 5,387.62 ><165948-46 13• Certificate of Deposit - Members 1st Federal Credit Union 13.043.27 -165948-49 14. Return 24 OD 15• Refund - PA.Net 11.00 16• Refund - Federal Tax 342.30 TOTAL (Also enter on line 5 Recapitulation) I S 61 766 94 (If mom space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent JANE E.SPAHR 21 08 1012 Decedent's Name Paget File Number Schedule E -Cash, Bank Deposits, & Misc. Personal Property ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 17• Personal Property 500•DO SUBTOTALSCHEDULE E 500.00 GRANDTOTALSCHEDULEE S 61,766.94 REV-1509 EX + (6-9e) SCHEDULEF COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN JANE E. SPAHR 21 08 1012 Nan assts was made joint wNhin one year of the daeedenCs data of death, N must be reported on Sehedub G. SURVNING JOINT TENANT(S) NAME I ADDRESS (RELATIONSHIP TO DECEDENT A. Edward Spahr 3925 Ridgelane Blvd• Mechanicsburg, PA 17050 B C JOINTLY-OWNED PROPERTY: Son ITEM NUMBER LETTER FGR JOINT TENANT DATE MADE JDINT DESCRIPTION OF PRDPERTY INCLUDE NAME OF FINANCIAL INSTITlTNON AND BANK ACCOUNT NUMBER OR SIMILAR IDENTIFYING NUMBER ATTACH DEED FDR JDINTLY-HELD REAL ESTATE. DATE OF DEATH VALUE OF ASSET % OF DECDS INTEREST DATE OF DEATH VALUE OF DECEDENTS INTERESI 1. A. 2005 Members 1st Federal Credit Union 3,571.33 0.00 Certificate of Deposit -165948-47 (Paid to Revenue- Receipt Attached) 2• B• 2005 Members 1st Federal Credit Union 2,520.50 0.00 Certificate of Deposit - 165948-48 (Paid to Revenue - Receipt Attached) TOTAL (Also enter on line 6, Recapitulation) space's needed, insed additbnal sheer of the same size) S ~ REV-1571 ~C+(70-d6) COMMONWEALTH OF PENNSYLVANIA INHERRANCE TAX RETURN SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER JANE E• SPAHR 21 08 1012 Debts of decedent must a Aported on Schedule t. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Ewing Brothers Funeral Home, Inc• 7,924.92 2• Monument Engraving - Carlisle Memorial Service, Inc• 215.00 B. I ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Pemonal Representative (s) Street Address City Srafe Zip Year(s) Commission PaW: y, Attorney Fees Reager & Adler, PC 3. Family Exemption: pf decedenCs address is not the same as daimaM's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4• Pro6ateFees Cumberland County Register of Wills 6 Accountam's Fees 6. Tax Retum Pmparers Fees 7. Advertisement - The Sentinel 8• Advertisement - The Patriot-News Co• 9• Advertisement - The Cumberland Law Journal 10• Seller Cost on Sale of Real Estate 11• 2009 County/Township Taxes Prorated 12• 2008/2009 School Tax es Prorated 1,300.00 298.00 118.72 102.59 75.00 9,616.31 152.47 1,078.65 (If more space b needed. TOTAL (Also enter on line 9, Recapitulation) I S I sheets of the same sae) REV-1512 EX ~ (12-03) COMMONWEALTH OF PENNSYLVANIA INHERRANCETAX RETURN SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8r LIENS JANE E• SPAHR __ 21 08 1012 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimburaed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. IVerizon ~~~ 4.71 2• PPL 117.59 3• UGI 610.74 4• Embarq 10.50 5• Eyecare - Hartzell Eye NDS 20.00 6• Water and Sewer - Carlisle Borough 124.50 7• Plumbing Repair for resale - Steve Cornwan 75.00 8• Chimney Repair for resale - Country Lane Construction 799.04 TOTAL (Also enter on line 10, Recapitulation) I S (If more space's needed, insert additional sheets of the same sae) REV-1513 EX+(9-pp) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN :STATE OF SCHEDULE) BENEFICIARIES ennc c• ~rnnn 21 08 1 D12 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Llst Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS ~ndude ht spousal distributions, and transfers under Sec. 9116 (a (1.pj , 1. Edward H• Spahr Lineal 181,123.20 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 T HROUGH 1B, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: 1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 5 pi more space Is neeaea, Insert atldmonal sheets of the same size) eURFAU OF INDIYIDOAL TAXES PD sox zua7 xAaRlStuxc PA ITIZS-1601 ILLY-iMa 6 r11 erYNe EDWARD H SPAHR 3925 RIDGEIAND BLVD MECHANICSBURG PA 17050 INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ND. 21 ACN 08149330 BATE 10-21'2008 EST. OF JANE E SPAHR S~ 189-09-4773 DATE OF DEATR 09'23-2008 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 TYPE OF ACCOUNT SAYINGS CXEGCTNG TRUST ® CERTIF. MENDERS 1ST FCU arsvyd.d tM pawrtaaM Ylth SM Snferwtym b•iw. which M. Nm v.•d in eaywl.lyM SM veGrrtlal te: due. Reprda indicate tMt at tM death of SM aMw-Mead denedmt. Yw ran • So1nt wMribaMflcfary of thla aeeswt. and nturnl ithta tMr boron addr•sa~~Thia account M/s•ts:abl•t1n a eeN ne. rillai tM IM•mrit ne•nTae:t laranef tM Cerae~al tht sfa fora PeMfylrmla. Plww call (T)T) 7e7-aezT wltn w.stima. COMPLETE PART 1 BELOW ^ SEE REVERSE SIDE FOR FILItN. AND PAYMENT INSTRUCTIONS Aeeeunt No. 165948-47 Data 03-10-1997 Te ensure erawr eradlt to tM account. Mo ewfu of thfs Mtlea wet seeaaoera• Established vsvaant to tM RgLter o} Mills. Neka eMeh 3 r 571.33 oe/sbU to •Reaiatar of py3L. AMn!"• Account Halane• l g X 50.000 1gTEe If tax pyaeeL an eaN wlthfn Mraa e Pe roant Taxab 785.67 1 l a M~w t s n Apeunt Sub7eet to Tex t . dw. tax urt m th wrM t • 5 due M J( .045 uy t~ryy~a Tex cue rtu beeeM dalinew^t Tax Rete 80.36 niM smMs dbr the Bete of death. pebntya3 Tex Dua j A. (Q TM above lnferYtym aM to dw 1s eerract. xi Resit versant to !ha Rgfatar of Mills rlth tre uv3es of this netfea b aMain a dlaeowt er amid Snbnat, er eMet box 4" and return Shia nK1ee to tM 41labr of CNECK ~ Mills and M offyeial waeaavmt rill M Issued by tM PA pgartwnt of Ramnw. ONE _ BLOCK a' ~ tsaha filstlsMttMSwtaN (YerapntetSV~~ad ma leer wyd Y1M SM Pame•IvmL iMrarytmu Tax ra urn ONLY C ^ CeMivl~tmPART ~S~ar PA~RTr~ a ~r debts and Mdwtians rsra w1d. PART if Sndfest ine a dlffarent tax rate, please scsca reLtienahlp to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LSRfi 1. • • sta oho ~ _-T 2. Account ;alanea ~ X ;. Pe reent Taxable S 4. Meunt Sublaet to Tax 4 S. Debts and Oeduetlero 5 i. Apount Tuable d X 7. Tax RaL• T !. Tax Oue R 8 PART DATE PAID PAYEE DESCRIPTION AMOUNT PAID Under panaltiea of pe ryurY. I declare that the facts I hwe reported above sre true, eer~et and cape7yt• to the beat of pY norledya and belief. NOME C~ ~ ) 7 3 x L \ n ~/ ~ n . Q . WORK c ) /t/ !o ~ S ~B COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE aUREAU OF INDIVIDUAL TAXES NOTICE OF INNERZTANCE TAX INHERITANCE TA% DIVISION APPRAISEMEN7, ALLOWANCE OR DISALLOMANCE PD W1I 2e66a1 OF DEDUCTIONS, AND ASSESSMENT OF TAX ON INRRISNR6 PA 17125-0601 JOINTLY HELD OR TRUST ASSETS REV-154R EX AFP (06-05) - DATE 12-15-2008 ESTATE OF SPAHR JANE E DATE OF DEATH 09-23-2008 FILE NUMBER 21 OB-1012 COUNTY CUMBERLAND EDWARD H SPAHR SSN/DC 189-09-4773 3925 RIDGELAND BLVD ACN 08149330 APPEAL DATE: 02-13-2009 MECHANICSBURG PA 17050 (SeererersesldeuuJerObjeedows) Auount RaRitted ~--~ MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONC THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ --------- --- ------------------------------------------------------------------- REV-1548 EX AFP C03=05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS. AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS ESTATE OF SPAHR JANE E DATE OF DEATH 09-23-2008 COUNTY CUMBERLAND FILE N0. 21 08-1012 S.S/D.C. N0. 189-09-4773 ACN 08149330 TAX RETURN WAS: CX) ACCEPTED AS FILED C ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT N0. 165948-47 TYPE OF ACCOUNT: C )SAVINGS C ) CHECKING ( )TRUST 4()TIME CERTIFICATE DATE ESTABLISHED 03-10-1997 Account Balane• Percent Tazabl• Aaount Sub3ect t.o Tax Debts and Deductions Taxable Awount Tax Rata Tax Duo TAX. CR',€DITS: 3,571.33 X 0.500 1,785.67 - .00 __.. __ _1~Z85-b7. x .45 80.36 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE ..-.. _.......RiGISIiR-DF-~aILJ.S-+42--73lE.._.. ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT C*) INTEREST/PEN PAID C-) AMOUNT PAID PAVYGYT YIICT ee Y~l,r nv wi ... ~~~-_ TOTAL TAX CREDIT .00 .BALANCE O;F TAX DUE 80.36 INTEREST AND PEN. .00 TOTAL DUE 80.36 PENNSYLVANIA INHERITANCE TAX ' INFORMATION NOTICE suRE1w DF INDtvlbwl TAxES AND FILE NO. 21 Po Dox zsa•u TAXPAYER RESPONSE ACN 08149331 NaRx3ssuRS PA I7us-un DATE 10-21-2008 avuas a rr na-w. EDWARD H SPAHR 3925 RID6ELAND BLVD MECHANICSBUR6 PA 17050 EST. OF JANE E SPAHR SSN 189-09-4773 DATE OF DEATH 09-23-2008 COONTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 TYPE OF ACCOUNT SAVIMRS CNECEI NO TRUa7 ® CERTIF. MENDERS 1!T FCU prwiNd tM Dsp•rt•ant wfth tM inforptfon bdw, wblch Ms b•p eea•tl in ealeulst3p tM oetantial taw dw. be•rda indieab tM! N tM death of tM absp•M••d dpedentr Yw waN • 3•Snt orMNWn•fie3arY N tMS aepunt. If you foal the inferaat ion Sa inc•revet. Pl•asa obtain written eernetlen fro tM financial lnstitutlen. ettaM • caw to thla fay antl r•tum it to tM above address. Tbfs account Ss taxMla in aecerdanu with tM IMaribnea Tae[ Irs of tM Ce~enr••lth of Wemavlgnla. Plur e•ii 0:7I 707 •i127 rilh su•ai3wes. COMPLETE PART 1 ^ELOM R SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 165948-48 Aeoount Dslanes P•re•nt Tsxabl• Apount Dub~•et to TRx Tax R•t• Potsntlal Tax Du• 50 To ansuev prover ersdit is tM secsuM, two epi•a of thfa notice east aeewpw •sle••ee4 t• tM Rp1sNr of Mille. Naka de.eb •ayMla t• 'Reel star at WSlls. ApM•. NOTE. If face p•d•anls an •W rfthin three wntM of M• MpNnt's ate of dptn. datluet • 5 wre•nt Oiacswt p tM taz dw. Aey InMritanc• Taw due rill Meap d•lingwnt nine •enMS eftar tM deb •f Meth. A. ~ Tha ab•as 1nf•r••t3p end t•z dw is correct. Rp1t aaY••nt to the b•fat•r of Wflls rfth be goias of th3a notice to obtain CHECK • discover sr arsld interest, ar Mode bar •A" and return this Mtfq to fM Rp1st•r of r MSlls .red m eff!<Ll •sapoant rill M fssuW Ov SM PA DaPVtMeet of R•ramea. ONE ~ L BLOCK R. ~ TM Mere ap•t Ms bpn or rill M rsPertstl and tar pitl r3th tM Psnnaylrania IMeritonas Ta: return ONLY to ba Hlad by tM astab rapr•apt•tfr•. C. ~ The aber• 1nf lore 1a inro et and/or Mbta and d•duetips were paid. C l L PARTw t N PART h l ap • an er a ve. PART ii ln•leatina a •3 tr•r•nt tax rate. please afore ralatienahip to d•a•d•nt: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. Oats EatablisAad -T-- ~-" --- t. Aeoount Dalano• 2 i S. P•re•nt Taxable b X 4. Asount Sub!•et to Tax 4 g E. Debts and D•duetipna 6 6. AReunt Tdxbbl• 6 ; 7. Tsx Rpto 7 X R. Tax Dus • ~ PART DEBTS AND DEDUCTIONS CLAIMED DATE PAID PAYEE DESCRIPTION AMOUNT PAID DRts 02-13-1997 Establiah•a Untl•r psnaitio of p•riury, I dselara Lhat tM }rots I hew repo rt•d aboY• are trw. eorrwt an0 eoe~ete tb tree boat of Ry Rnowl•dp Rnd holler' HOME C '~/'2 )~~1~-"70 ~~ ~ ,~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES ~ T~~APPRAISEMENTE ALLOWANCETORCDI SALLOWAXCE INHERITANCE TAX DIVISION PO e®( 2e0601 ~ OF DEDUCTIONS. AND ASSESSMENT OF TAX ON IMRRISBURC PA 17128-06e1 JOINTLY HELD OR TRUST ASSETS ~~~ v ~~ . ~ ~`~- EDWARD H SPAHR 3925 RIDGELAND BLVD MECHANICSBURG PA 17 ~ ^ REV-1547 EX AFP (06-057 DATE 12-15-2008 ESTATE OF SPAHR JANE E DATE OF DEATH 09-23-2008 FILE NUMBER 21 08-1012 COUNTY CUMBERLAND SSN/DC 189-09-4773 ACN 08149331 APPEAL DATE: 02-13-2009 (See reverse side u7rder Objec6oNS) A~DUnt Ra~ittsd MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE "'~ RETAIN LOWER PORTION FOR YOUR RECORDS ~"' REV-1848 EX AFP COS-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 12-15-2008 ESTATE OF SPAHR JANE E DATE OF DEATH 09-23-2008 COUNTY CUMBERLAND FILE N0. 21 08-1012 S.S/D.C. N0. 189-09-4773 ACN 08149331 TAX RETURN WAS: CX) ACCEPTED .AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: MEMBERS 1ST FCU ACCOUNT N0. 165946-48 TYPE OF ACCOUNT: ( )SAVINGS C ) CHECKING C )TRUST 0()TIME CERTIFICATE DATE ESTABLISHED 02-13-1997 Account Balane• Percent Taxable Aaount Subjaet to Tax Debts and Deductions -i-arabla A~our)t- - Tax Rata Tax Due TAX CREDITS: 2.520.50 x 0.500 1x260.25 .00 1.26015 X .45 56.71 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE ~- ~ R~6ESTER -0F-~L4ILbS~-/4T-TAC~-_.._. _ ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID C-) AMOUNT PAID rwrncn: nUSi at nwI/C aT 06-14-"LOOV7F. TOTAL TAX CREDIT .00 BALANCE OF TAX DUE 56.71 INTEREST ANq PEN. .00 TOTAL DUE 56.71 • COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX INIIERITIWCE TAX DIVISION STATEMENT OF ACCOUNT ro zmc zsccu INRRISBURC PA vlzs-cszi REV-16e7 EX AFP uz-oe> DATE 12-22-2008 ESTATE OF SPAHR JANE E DATE OF DEATH 09-23-2008 FILE NUMBER 21 08-1012 COUNTY CUMBERLAND EDWARD H SPAHR ACN 08149331 3925 RIDGELAND BLVD Mount Rwwitrid MECHANICSBURG PA 17050 MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure prover crw dit to your aeeeunL, suDwit the upPOr pa rt Son of this }era with your tax paywont. CUT ALONG...TH1.5 LINE ~-, RETAIN LOWER PORTION FOR YOUR RECORDS (~ REV-1607 EX AFP C12-08) ^~* INHERITANCE TAX STATEMENT OF ACCOUNT 7EB^ ESTATE OF SPAHR JANE E FILE N0. 21 08-1012 ACN 08149331 DATE 12-22-2008 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHONN SELON IS A SUMMARY OF THE -RINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE. AND. IF APPLICADIE, A_PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENTS 12-08-2006 PRINCIPAL TAX DUE: 56.71 PAYMENTS CTAX CREDITS): PAYMENT DATE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID C-) AMOUNT PAID 10-29-2008 CD010474 2.62 49.85 12-19-2008 SBADJUST .00 4.24 TOTAL TAX CREDIT • IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULIIT ION OF ADDITIONAL INTEREST. 56.71 (BALANCE OF TAX DUET .00 I ~ INTEREST AND PEN. ~ .00 ~ ~ TOTAL DUE ~ .00 U C IF TOTAL DUE IS LESS THAN •1, NO PAYMENT IS REQUIRED. GLMMONWFALTN OF PENNSYLVANIA DEPARTMENT OF eEVENUE BUBEAU OF INOIVIpUAI TAXES DEPT. 280801 HARRIBBURG, PA 1"1128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT SPAHR EDWARD H 3925 RIDGELAND BLVD MECHANICSBURG, PA 17050 REV~7162 EXlt t-98) NO. CD 010474 ACN ASSESSMENT AMOUNT CONTROL NUMBER NM ESTATE INFORMATION: sSN: tes-09-an3 FILE NUMBER: 2108-1012 DECEDENT NAME: SPAHR JANE E DATE OF PAYMENT: 10/30/2008 POSTMARK DATE: 10/29/2008 COUNTY: CUMBERLAND DATE OF DEATH: 09/23/2008 REMARKS: EDWARD SPAHR SEAL CHECK# 6767 08149330 ~ 580.36 08149331 ~ 549.85 TOTAL AMOUNT PAID: INITIALS: WZ RECEIVED BY: 5130.21 GLENDA EARNER STRASBAUGH REGISTER OF WILLS TAXPAYER P 102-WIII, 4-7A JVLIVB BLVMBENO. INC.. .PV BU6REN. NYC 10013 ~~~# t~~ ~n~ ~~~t~nt~en~ ~, ~;~~~~ rz.. ~ ,;~,/~~~.-~vL-' ~ of the ,;~ Il ~` ? of C~~~~.w,~E.:. in the County of ~u- •. °~- -a' s a and State of } :~ ~~--~,~i~ +'~~~r=--u--~-~{- being o f sound mind and memory, do make, publish and declare this my last milt ttg1 ~esfumrni, in manner following that is to s¢y: 3Airet. I direct th¢E all of my just debts ¢nd funeral expenses be paid as soon of ter my death as may be practicable. (.-'L.~:1--C^'T„U ~~~]-, rf. ~-,~t~i.: ...ti!j/~.-'.4/~'v,c,~~;T/n Q=~-6-+.t a'~S. 'J.+ ,/ 1// l ~J ~~ c ~~t.~L~ • i ~c~l.,e.iwlC,s.~.-~ Y~. ~ ~"l.-4! ..:../!,.1%..*~_e..«r `ig..c-.r~-i.-~' ~• G £ l,L~-'Lr...'l..~r- .~~ f ~r ~-- e +_ti~ ~1"t.< L, d. ~'G. t'1 b~Ki / ~~ :r .~ 2A. lP~ ,~I %1~h 1...uC. -,. 3=1~,~i~~,~ I hereby appoint ~.~4-e,~,~-u.^t~~ Fj. ,<L~a.t~.~~ifv execut~~n- of this, my last Will and Testament, with full power and authority to sell and convey, lease or mortgage real estate, hereby revoking all f ormer wills by me made. ~~ t~n~~~ ~P~.l'i~~ I have hereunto subscribed my name the /at#~ day of hzct.-cc,ih, in the year Nineteen Hundred and `~~ l Ct "vr...k. ~, r~x~ v •~ L.S. i We, whose names are hereunto subscribed, ~It ~PrtifJ that on the day of ._f/d>>~; , ,- 19, the testateu,y.. ¢bove named, subscribed ~-t'2~ name to this instrument in our pres- ence and in the presence of each oFF))f us, and at the same time, in our presence and hearing, declared the same to be ~t.A.~ last mill ttnA u.e,~fttmrnf, and requested us, and each of us, to sign our names thereto as witnesses to the execz~tion thereof, which we hereby do in the presence of the testatz,~.¢ and of each other, on the day of the _ date of the said Will, and z~ri opposite our names our respective places of residence. _~, , % -~~ ~_ re.ridin8 a[ ~'-~ ~ u ~',V I G F ~ ~~ 1/' ~ ~-7 1 f~ CY ~ ` f e~ j ~ i , rasidin8 at~:~ lrli~~/, / 1/L ~. ~: %' i -. p. / ,r /~ e~ .^~~ // r ~, '..., .. / E reeidin8 at / ~~ T .#i7r~F !)- f }Y~ ../ %/) `J 'Every eM~te re~uira at ]wE twa witnesses. Some repuire three. ~~ ~~ ~.v (.. i ~1' `." ~~ " 1