HomeMy WebLinkAbout02-0253REV-1500 EX + (6-00)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAL)
OFFICIAL USE ONLY
FILE NUMBER
COUNTY CODE
YEAR NUMBER
SOCIAL SECURITY NUMBER
Kotzmoyer Lester E.
DATE OF DEATH (MM-OD-YEAR) I DATE OF BIRTH (MM-DO-YEAR)
12/15/1997 08/27/1931
(IF APPLICABLE) SURV V NG SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
., Kotzmoyer, Phyllis
1. Origina] Return
4. Limited Estate
6. Decedent Died Testate
193-24-2008
THIS RETURN MUST BE FILED IN DUPLICATE M/ITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
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~247! Supplemental Return
· Future Interest Compromise (date of death after 12-12-82)
Decedent Maintained a Living Trust
(Attach copy of Will) (Attach copy of Trust)
LJ 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit
(date of death between 12 - 31-91 and 1 - 1-95)
(d.ate of death
3. Remainder Return prior to 12-13-82)
5. Federal Estate Tax Return Required
8. Total Numberof Safe Deposit Boxes
~] 11. Election to tax under Sec. 9113(A)
(Attach Sch O)
NAME
Roger B. Irwin Esq.
FIRM NAME (If Applicable)
IRWIN McKNIGHT & HUGHES
TELEPHONE NUMBER
717./269-2353
COMPLETE MAILING ADDRESS
60 West Pomfret Street
West Pomfret Professional Bldg.
Carlisle, PA 17013
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or (3)
Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
F--~ 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.
14.
5,485.00
None
None
Nose
11,357.50
None
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line 13)
(8)
(11)
(12)
(13).
(14)
OFFICIAL USE ONLY
5,485.00
11,357.50
(5,872.5O)
(5,872.50)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(aX1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
(5,872.50)
X .0 0 (15) 0.00
X .0 6 (16) 0.00
X .12 (17) 0.00
X .~5 (16) 0.00
19. Tax Due , (19) 0.00
Copyright (c) ZO00 form software only The Lackner Group, Inc. Form REV- 1500 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
1194 Newville Road
CITY
Carlisle
STATE
PA
I z1%7013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1) 0.00
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + E ) (3) 0.00
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) 0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00
A. Enter the interest on the tax due. (SA) 0.00
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SB) 0.00
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
Total Credits ( A + B + C ) (2)
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ......................... [_=.J ~
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 art "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 preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Phyllis Kotzmoyer DATE
· -~ .:? ,~ /.-..- -"'~ 1194 Newville Road ..... fA/ L
.......................
S,GNA~~PAREROT~E~hhE~SENTAT,VE IRWIN Mc~IG~ & ~GHES OATE
'~ 60 West Pomfret Street .~ / .
surviving sp~se m 3% [72 P.S. 9116 (a) (1.1) (i)].
For dates of death on or after Janua~ 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 su~iving spouse from tax, and the statuto~ requirements for disclosure of assets
and filing a ~x return are still applicable even if the surviving spouse is the only beneficial.
For dates of death on or after July 1, 2000:
The ~x rate imposed on the net value of transfers from a deceased child twen~-one years of age or younger at death m or for the use of a natural
parent, an adoptive parent, or a smpparent of the child is 0% [72 P.S. 9116 (a) (1.2)].
The tax rate imposed on the net value of transfers m 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(aXl )].
The ~x rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(a~1.3)]. A sibling is defined, under
Section 9102, as an individual who has at least one parent in common wEh the decedent, whether by blood or adoption.
Copyright (c) 2~ form software only The Lackner Group, Inc, Form REV-1500 EX (Rev. 6-00)
REV-~50Z EX + (1-97)
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Lester E. Kotzmoyer SS~/ 193-24-2008 12/15/1997 21-01-
All real property owned solely or as a tenant in common must be repo~ted at fair market value. Fair market value is defined as the price
at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable
knowled~;e of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION
OF DEATH
1 1/2 interest in mountain land in Upper Frankford Twp.
Cumberland County (copy of deed attached)
2 1/5 interest in mountain in Fayette Township Juniata County
(copy of deed attached)
TOTAL (Also enter on line 1, Recapitulation)
4,985.00
500.00
$ 5,485.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1502 EX (Rev. 1-97)
REV- ~11 EX * (1-97)
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Lester E. Kotzmoyer SS~/ 193-24-2008 12/15/1997 21-01-
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
1
2
3
4
4o
FUNERAL EXPENSES:
Eby Granite Works - marker
Eby Granite Works - inscription
Floffman-Roth Funeral Home
Westminster Cemetery - plot
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) / EIN Number of Personal Representative(s)
Street Address
City State
Zip
Year(s) Commission Paid:
Attorney's Fees IRWIN McKNIGHT & HUGHES
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant Ph~yllis Kotzmoyer
Street Address 1194 Newville Road
City Carlisle State PA Zip 17013
Relationship of Claimant to Decedent Spouse
Probate Fees
Accountant's Fees
Tax Return Preparer's Fees
Other Administrative Costs
Re§ister of Wills
filing fee
TOTAL (Also enter on line 9, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
1,100.00
75.00
5,687.50
735.00
250.00
3,500.00
10.00
$ 11,357.50
Copyright (c) 1996 form software only CPSystems, Inc. Form REV- 1511 EX (Rev. 1-97)
REV-"1513 EX + (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Lester E. Kotzmoyer SS#
NUMBER
II.
SCHEDULE J
BENEFICIARIES
193-24-2008 12/15/1997
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [incl~e outright spou~l distrlb~lo~, and
transfers under Sec. 9116(aXl.Z)]
Phyllis Kotzmoyer
1194 Newville Road
Newville, PA 17241
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Spouse
FILE NUMBER
21-01-
AMOUNT OR SHARE
OF ESTATE
remainder
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET
NON-TAXABLE DIS~HiBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) ZO00 form software only The Lackner Group, Inc. Form RE[V-1513 EX (Rev. 9-00)
ill ani lre tament
I, LESTER E. KOTZMOYER, of North Middleton Township, Cumberland
County, Pennsylvania, declare this instrument to be my last will and
testament, hereby expressly revoking all wills and codicils hereto-
fore made by me:
1. I authorize and empower my executrix to sell any realty
owned by me at my death, at either public or private sale, and to
give good and sufficient deeds therefor, in fee simple, as I could
do if living. My executrix is authorized and empowered to continue
to engage in any business in which I may be engaged at my death, for
a period of one year after my death.
2. I devise and bequeath all of my estate of every nature and
wherever situate to my wife, Phyllis L. Kotzmoyer, providing she
shall survive me by sixty days.
3. Should the gift in Paragraph No. 2 not take effect, I devise
and bequeath all of my estate of every nature and wherever situate to
my children, share and share alike, the child or children of any' de-
ceased child taking the share their parent would have taken if living
4. Should any child be under the age of twenty-one years at my
death, then all of my property given in Paragraph No. 3 shall be held
in trust by The Harrisburg National Bank and Trust Company of the
Borough of Carlisle, Pennsylvania. The trustee, as well as my execu-
trix are hereby authorized to retain unconverted, any property, real
or personal, that I may own at my death, and shall be under no duty to
convert the~me into legal investments. The trustee shall have the
power and authority to hold,manage, invest and reinvest and to pay
over the net income of the trust property to or for the use and bene-
fit of such of my children as may be under the age of twenty-one year
child in business or in a profession or for similar purposes. The
trustee shall be under no duty to distribute or use the principal equ
ally for each of my children, but may distribute or use principal un-
equally in its discretion. My primary object is the support, mainten
ance, and education of such children as may be under twenty-one years
of age. When the youngest of my ch~dren reaches the age of twenty-
one years, then whatever remains of income or principal of the trust
estate shall be distributed equally to my chi~en, share and share
alike, the child or children of any deceased child taking the share
their parent would have taken if living.
5. I nominate and appoint Phyllis L. Kotzmoyer, to be the execu
trix of this my last will and testament, she is to serve as suc~ith-
out bond. Should she die before my death, renounce or refuse to serw
for any reason, or die leaving any of my estate unadministered, my
eldest child being under the age of twenty-one years, I nominate and
appoint George Reed, as substitute executor with the same powers as
are given herein to my executrix, and also without the filing of any
bond. If, however, at my death, any child of mine is twenty-one year~
or older, such chiid or children shall be the substitute executor or
executors of this my last will and testament, also to serve as such
without bond, with the same powers as are given herein to my executri:
6. I hereby direct my executrix to retain the services of Irwin
Irwin & Irwin, as attorneys in the settlement of my estate.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
/~ day of April, 1965. ~.~.~ .~."2
...... (S~A~)
Signed, sealed, published and declared by Lester E. Kotzmoyer,
the testator above named, as and for his last will and testament, in
the presence of us, who at his request, in his presence and in the
presence of each other have subscribed our names as witnesses hereto.
Cumberland County Assessment Office
Old Courthouse, First Floor ~ ·
One Courthouse Square
Carlisle, PA 17013
(717) 240-6350
(717) 240-6354 (fax)
Board of Assessment Appeals
Lloyd V~ Bucher
R. Fred Hefelfinger.
Sarah Hughes
BONNIE M. MAHONEY
Chief Assessor
STEVEN D. T/LEY
Assistant Solicitor
KOTZMOYER, LESTER ET AL
1194 NEWVILLE ROAD
CARLISLE PA 17013
MAILING DATE: October 23, 2001
District: 43 - UPPER FRANKFORD TWP
School..: BIG SPRING SD
Location:
R ENOLA ROAD
& SR 0944
LAND APPR0X 5 ACRES
TAXABLE
CHANGE OF ASSESSMENT NOTICE - THIS IS NOT A TAX BILL
Parcel Identifier: 43-04-0389-038.
New Assessed Value indicated below will take effect for
2002 County/Library/Municipal
2002-2003 School
Land Size .... : 5.38 acres
Property Type: L3
Vacant Land
Old New Total
Assessed Value Assessed Value Change of Assessment
Land 20,450 9,970 -10,480
Buildings 0 0 0
TOTAL 20,450 9,970 ~10,480
Clean and Green Values
REASON FOR CHANGE:
INFORMATION UPDATED
Land NOT I NOT I NOT
Buildings APPLICABLE I APPLICABLE ~
TOTAL j. J. APPLICABLE
Clean and Green values become effective only upon application and approval. All
applications must be received by the Assessment Office by 4:00 p.m. on June I of each
year to take effect the following year. Those previously approved for Clean and
Green do not need to re.aPply.
RIGHT TO FORMAL APPEAL: If you feel that the appraised value of your property is more or Jess
than Fair Market Value, you may file a formal appeal with the Board of Assessment Appeals. The
appeal must be filed in writing within 40 days from the mailing date of this notice. The notice of
appeal must specifically designate the parcel number(s) in question and your address so that the
notice of the time and location of the appeal hearing may be sent to you. Appeal forms and appeal
rules and regulations may be found at the web site listed below or at the Cumberland County
Assessment Office, Old Courthouse, First Floor, One Courthouse Square, Carlisle, PA 17013.
Internet Access/Review: If you would like to review this property's assessment records, you may do so at no
cost by accessing ccpa.net.
QUESTIONS? Property owners may call an assessor at (717) 240-6350, or (717) 532-7286, or
(717) 697-0371. Calls will be taken from 8:00 a.m. to 4:00 p.m.
P-2OI-AT-I 1--Warranty Bed, Shor~ Form. A~! of l~09~rang~[ for Photo-Recording
711
ENTERED FOR: RECORD
Taxes & Fees t .~a, ~o
MADE THE 22 ~
day of April i,n the year
of o~r Lord one tho'usand nine hundred eighty-nine (1989)
/ / /
BETWEEN LAWRENCE C. ALSPAUGH, GEORGE H. REED, GORDON SMITH
and GEORGE SHANK, of Carlisle, Cumberland County, Pennsylvania,
hereinafter called
Grantors ,
and LAWRENCE C. ALSPAUGH, LESTER E. KOTZMOYER, DENNIS SHANK,
PAUL RICHIE and KEITH KOTZMOYER, of Carlisle, Cumberland
County, Pennsylvania, hereinafter called
WITNESSETH, that in consideration o[ Three Thousand and no/100---
Grrantee S ·
...... ( $3,000. O0 )- Dollars,
in hand paid, the receipt whereof is hereby acknowledged, the said grantor s do he?by grant
and convey to the said granteeS ,their heirs and assigns, as tenants zn common
ALL that certain lot of ground situate in Fayette Township,
Juniata County, Pennsylvania, bounded and described as follows,
to wit:
BEGINNING at the northeast corner of the lot hereby conveyed
at an iron pin and stones where the same corners with lands now or
formerly of Clarence N. Kauffman and lands of Joseph E. Peoples;
thence along lands of said Joseph E. Peoples, South 12 degrees East
300 feet to a point in the center of the Township Road; thence along
the center of said Township Road, South 87 1/4 degrees West 100 feet
to a point; thence along lands of Terrold Greenaway, North 12 degrees
West 300 feet to an iron pin; and thence alon~ lands now or formerly
of Clarence N. Kauffman, North 78 1/4 degrees East 100 feet to the
Place of BEGINNING. CONTAINING 30,000 square feet, more or less.
BEING the same property which John O. Frymoyer and Norma M.
Frymoyer, his wife, granted and conveyed to Lawrence C. Alspaugh,
et al, by deed dated April 27, 1968 and recorded in the Office
of the Recorder of Deeds for Juniata County in Deed Book Volume 104,
Page 486.
TOGETHER with the'water right as specified in the aforesaid deed.
IX)I~ in pay~nent of Real Estate Tr~ns[¢r TaX.
flUN~A%A cou~'f ~OOL D~
AND the said grantor s hereby covenant and agree that
will warrant general ly the property hereby conveyed.
they
IN WITNESS WHEREOF, said grantor s ha ve hereunto set their hand sand seal s
the day and year first above written.
State o/ PENNSYLVANIA [ ss.
County of CUMBERLAND t
On this, the %,i ~' day of
the undersigned ol~cer, personally appeared Law re n c e
Gordon Smith and George Shank
April ,19 89, before me,
C. Alspaugh, George H. Reed,
known to me (or satisfactorily proven) to be the persons whose names are subscribed to the
withiw i. nstrumen, t, and acknowledged that they executed same for the purposes therein
¢ontadn%d. /,. ' :
· .. "L%J:.f. ,. ';: '.
I
hereunto set my hand and officia~ seal.
..... I ~o~ a-?~-~..~em.~¥.~u¢ ..... ._~ .................................................
.... . FA~L~$.~,~E 80~?UGH, CU,~'~EERLANO COUNTY~ Title of 0t~cer.
[ ,, -uO~,9,.~IS~-~O~'4 EXP!RES ~T. 3 1~2 J
I do hereby certify that the precise residence and complete post office address
of the within named grantee s is % Z~o~,t,~ ¢'. /]~/~ ?vV ~. /t~ 5~'. ~ ~ / ~o/
April Z/_'~ 19 89
- ~ntees ~,uv~ /
Attorney tot ......................... - - ·
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COMMON~VEAL TH//~OF PENNSYLVANIA
County of ........ .___~_~~.a~.. .........................
83.
RECORDED on this ........ ..~__._7__._._~___' .... day o.f
.4. D. 19___'_~___?, in the Recorder's office of the said County,
Vol ...... ~_~_~ ..... , Page ....... 7~ ........' ":' ' "'
Given under my hand aha the seal of the sa2d o~ce, t~ ~te~O~e.'w~ttem.. ;.
o! ~,r L~d ~.~ tA~,~m~ ni,~ hum~r~ sixty-seven (1967) .
BETWF,£'N ANNA V KOTZMOYER, Widow, of the Borough of Carlisle,
Cumberland County, Pennsylvanla,
hereinafter called G~n~r
LESTER E KOTZMOYER and ROY F. KOTZMOYER, of Carlisle,
Cumberland County, Pennsylvania,
hereinafter called Grantees:
WITNE$SETII, that in con~demtbn o/ One and no/lO0 ($1.00)
-Dollars,
~ hand i~a~,~erecMptwhereo! ~herebltaebnowt~ged, thesa~ o~ntor d~es hereb~o~
and aon~ ~ t~ ta~ o~n~es, their heirs and assigns,
ALL that certain tract of mountain land situate in the Township~
of Upper Frankford, County of Cumberland and State of Pennsylvania,
and bounded and described as follows:-
BEGINNING at a stone at corner of lands formerly of John Orris
now George Miller; thence North 78~ degrees West, 10 perches to a
White Oak (fallen); thence by lands formerly of John Stine now of.
Solomon Bloser, north 32 degrees West, 56.5 perches to stones; thence
by lands belonging .to lthe Commonwealth of Pennsylvania, North 67
degrees East, 17 perches to stones; thence South 43% degrees East,
11 ~erches to point; thence b7 lands formerly of John Sgine now of
George Miller, South 19 degrees East, 51 perehea to the place of
Beginning. Containin~ five acres and sixgy perches,more or less.
BEING Tract No. 2 of those properties which Edna Bae Grlsslnger,
single woman, granted and conveyed to Earl F. Kot~moyer and ^nna ¥.
Kotzmoyer, his wife, by deed dated May 5th, 1941, and recorded in the
office of the Recorder of Deeds for Cumberland County in Deed Book
"I", Volume 12, Page 341.
The said Earl F. Kotzmoyer died February 9th, 196?,'whereupon
title became vested in fee simple in Anna V. Kotzmoyer, grantor
herein.
This conveyance is a non-taxable transfer from Mother to
Children.
she
AND t~ ~ gr~n:~yr~'Aergby w~nants~nd o47ree~that t;~eg~~o;e~ta~z ~ ~ng
~nerall~ t~e ~ h~e~ ~e~
IN WITNESS WHEREOF, said grantor ha's tt~mto set 'he r
tat day and year first above writte~
hand and seal
ANNA V. KOTZMOY~R ~
State o! PENNSYLVANIA }ss.
County of CUMBERLAND
On this, the ~7~' da~ o! 6ctober ,19 67 , before me,
theunde~rzignedo~W~er, personatlyaFpeared ANNA V. KOTZMOYER, Widow
known to me (or satiafaztoriIy proven) to be the person whose name i s rubscribed to the
within instrument, and acknowledged that s he exes. ted same for the Irurposea therein
WHEREOF, I hereunto set my hand and officio2 seal.
~4I C0,~.ILSI0X E~IR~ 0CI0~[R 3, H6~ Titk of O~er.
t ..... I -- do .hereby certify that the precise residence and complete ~ost office address
of ~ ~nsn ~ grantees ~ ~. G'~ ~. ~ //~w ~e4 ~ ~ .~.
October ~7 ~
, z~ 67. ~:~ ~ , ~~
%
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DZV/SXON
DEPT. Z80601
HARRISBURG, PA 171Z&-0601
'02 ~A¥-3
ROGER B IRWIN ESQ
IRWIN ETAL
60 W POHFRET ST
CARLISLE
CUT ALONG THIS LINE
REV-1547 EX AFP
CONHONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOTICE OF 1NHERXTANCE TAX
APPRAXSENENT, ALLOWANCE OR DISALLONANCE
OF DEDUCTIONS AND ASSESSNENT OF TAX
DATE 04-29-2002
ESTATE OF KOTZHOYER
DATE OF DEATH 12-15-1997
FILE NUHBER 21 02-0255
COUNTY CUHBERLAND
ACN 101
l , Amoun~ Remi~ed
I~EV-26~I? EX AFP C01-OZ)
LESTER E
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGISTER OF WILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
~ RETAZN LOWER PORTION FOR YOUR RECORDS ~
(01-02) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR
ESTATE OF KOTZHOYER
DZSALLO#ANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
LESTER E FILE NO. 21 02-0255 ACN 101
DATE 04-29-2002
TAX RETURN NAS: (X) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
( ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B)
$. Closely Held Stock/Partnership Interest (Schedule C) ($)
~. Hortgages/Notes Receivable (Schedule D) (~)
$. Cash/Bank Deposits/Nisc. Personal Property (Schedule E) (5)
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G} (7)
8. Total Asse*s
APPROVED DEDUCTZONS AND EXENPT~ONS:
9. Funeral Expenses/Ado. Costs/Nisc. Expenses (Schedule H) (9)
10. Debts/Hortgage Liabilities/Lions (Schedule
11. Total Deductions
12. Net Value of Tax Return
15.
5/485. O0
.00
.00
.00
.00
.00
.00
(8)
11,$57.50
Charitable/Governmental Bequests; Non-eXacted 9113 Trus*s (Schedule J)
Net Value of Estate Subject to Tax
NOTE: To insure proper
credit to your account,
submit *he upper portion
of this fore with your
tax Payment.
5,485. O0
15. Amount of Line 14 at Spousal rate
16. Amount of Line 14 ~axable at Lineal/Class A rate
17. Amount of Line 1~ m* Sibling rate
18. Amount of Line Xq ~axabZe at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS:
i PAYmeNT R~C~ZPT DISCOUNT (+J
DATE NUNBER INTEREST/PEN PAID (-)
IF PAXD AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADD~T/ONAL INTEREST.
(15) .00 X O0 = .00
(16). .00 X 06 = .00
(17) .00 X O0 = .00
(18) .00 X 15 = .00
(19)~ . O0
AHOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
.00
.00
.00
( XF TOTAL DUE IS LESS THAN $1, NO PAYHENT XS RE{~UXRED.
ZF TOTAL DUE ZS REFLECTED AS A "CRED/T" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE S/DE OF THIS FORH FOR ZNSTRUCTZONS.)
NOTE: Xf an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that /nclude the total of ALL returns assessed to date.
ASSESSNENT OF TAX:
.00
(ll) _ l] .-~7.50
(l;) 5,872.50-
(13) . O0
(1fl) 5,872.50-