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Home My WebLink About04-0568COMMONWEALTH 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 004057 ROGERS ELYSE E 415 FALLOWFIELD ROAD SUITE 102 CAMP HILL, PA 17011-4906 ........ fold ESTATE INFORMATION: SSN: 086-26-1255 FILE NUMBER: 2104-0568 DECEDENT NAME: PIRK STEPHEN DATE OF PAYMENT: 06/1 6/2004 POSTMARK DATE: 06/1 0/2004 COUNTY: CUMBERLAND DATE OF DEATH: 04/04/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $1,102.43 TOTAL AMOUNT PAID: $1,102.43 REMARKS: SPDODD SEAL CHECK# 3345 INITIALS: VZ RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS REV~1500 EX i~-00) J' COMMONWEALTH OF PENNSYLVAN IA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 OFFICIAL USE ONLY REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT _z£ _ 0 d COUI~('Y C0~[IE YEAR NUMBER DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECL.RIITY%,IUMBER I Pirk, Stephen DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DO-YEAR) T~E FILED IN DUPLICATE WITH THE 04/04/200z~ 04/28/1914 IP,~_~ TER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) sociAL SE(~ t,~UMBER Pirk, Aida J. 10dginalRetum [~] 2. SupplementelRetum ~ 3 Re "~ai~d~r Return date of death nor to1213-82 ~ . , ( P ' . ) ~O ~ I L-J 4. Umited Estate ~'---~ 4a. Future Interest Compromise (date of death after 12-12-82)~ 5. F,cerra EE~tate Tax Return Required ~IL~ 6. DecedentDiedTestate(AttachcopyofWill)E~ 7. Decedent MaintainedaLivingTrust(AttachcopyofTrust) · 8. Toltal tl~utmberofSafeDeposit Boxes ~-~ 9. Litigation Proceeds Received [~ 10. Spousal Poverty Credit (dateof cieathb ...... 12-31-9t and1-1-95) [~ 11. E'~,m to tax under Sec. 9113(A)(^uachScho) Z O O X THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SI-IC~'I~'~J'~DIRECTED TO: NAME COMPLETE MAILING ADDRESS Elyse E. Rogers, Esquire FIRM NAME (IfApplicable) 415 Fallowfield Road~ ,~n~e 301 Keefer Wood Allen & Rahal, LLP Camp Hill, PA 17011 TELEPHONE NUMBER 717-612-5801 t. Real Estate (Schedule A) (1) 0. ~-.~ 2. Stocks and Bonds (Schedule B) (2) 6 7 . 55 i Closely Held Corporation, Partnership or Sole-Proprietorship (3) 0. 00 Mortgages & Notes Receivable (Schedule D) (4) (~ · 0 0 Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 0. 0 0 6. Jointly Owned Property (Schedule F) (6) 2 3,7 4 ~;. 10 [~ Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) 2,0 4 $. 6 3 (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) (8) ' 9. Funeral Expenses & Administrative Costs (Schedule H) (9) ~ · (} 0 10. Debts of Decedent, Mortgage Liabilities, & Liens (Sohedule I) (10) D . (} 0 1 1. Total Deductions (total Lines 9 & 10) ( 11 ) 12. Net Value of Estate (Line 8 minus Line 11) ('12) t 3. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) (13) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) , OFRCIAL USE O;'~-Y 25,859.25 0.00 25,859.25 0.00 25,859.25 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) 0.0 0 x .00 __ (15) 16. Amount of Line 14 taxable at lineal rate 25,859.25 x.045 (16) 17. Amount of Line14 taxable at sibling rate ' 0.00 x .12 (17) 18. Amount of Line 14 taxable at collateral rate 0.0 0 x .15 (18) 19. Tax Due (19) 0.00 1,16,3.67 0.00 0.00 1,163.67 · > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK ,~"-J,~'H ~< < 2W4645 100o Decedent's Complete Address: STREET ADDR.ESS 355 Beverly Road CITY Camp Hill STATE ZIP 17011-2814 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Interest/Penalty if applicable D. Interest E. Penalty 0.00 0.00 61.24 0.00 0.00 (1) Total Credits (A + B + C) (2) Total Interest/Penalty(D + E) (3) 1,163.67 61.24 0.00 1,102.43 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Pa OF WILLS, AGENT (5B) 1,102.43 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? ................. E~] ~ 2. if death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ............................ E~ ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? E~ ~ 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. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PER, SON RESPONSIBLEfF, OR FILING RE IURN ADDRESS 355 Bevez'q_.7' Road DATE Camp Hill, PA 17011-2814 SIGNATURE O/P~REPARER,.OTHF~ THAN REPRESENTATIVE 5 ~-llOwfi~d~oad Suite 301 DATE 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.§ 9916 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. § 9116 (a) (1.1) (ii)] The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. § 9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. § 9116(1.2) [72 P.S. §9116(a)(1 )]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% (72 P.S. § 9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. 2W4646 1.000 REV-1503, EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER Pirk, Stephen -- All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. $100 Series EE Savings Bond issued 09/97 POD Kathy A. Pirk 67.52 (n/k/a Ethan Pirk) TOTAL (Also enter on line 2, RecapJtulation) $ 67.52 2w4696 3.000 (If more space is needed, insert additional sheets of the same size) REV-1509 EX + (1-97) (~OMMOI~,~VVEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER Pirk, Stephen __ If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Pirk-n/k/a Ethan, Kathy A. Child B. Needham, Catherine C. Dodd, Mary 5112 45th St NW Washington, DC 20016 4009 Summer Hollow Court #163F Chantilly, VA 20151 4803 Wilwyn Way Rockville, MD 20852 Granddaughter Granddaughter JOINTLY-OWNED PROPERTY: ~ ~K DATE DESCRIPTION OF PROPER~ % ~ DA~ OF DEA~ ITU FORJOI~ MADE include name of financ~l institution and bank account number or DA~ OF DEATH DECD~ VALUE OF NUMBER TE~ JOINT ~imilar identifying number. A~ach de~ for jointly-held r~l estate. VALUE OF ASSET INTE~ST ~CEDENTS IN.REST 1. A 11/01/1997 :850 Series EE US Savings 33.08 50.00 16.54 Bond issued 11/97 joint with decedent's child, Kathy Pirk (n/k/a Ethan Pirk) 2 A .02/01/1999 $75 Series EE US Savings 46.74 50.00 23.37 Bond issued 2/99 joint with decedent's child, Kathy Pirk (n/k/a Ethan Pirk) 3 A 05/15/2002 Citizens Bank Checking 37,177.27 50.00 18,588.63 Account #6106422684 joint with decedent's child, Kathy Pirk (n/k/a Ethan Pirk) 4 B 03/21/2003 Citizens Bank CD 5,117.56 50.00 2,558.78 #6241084424 joint with decedent's granddaughter, Catherine Needham 5 c 03/21/2003 Citizens Bank CD 5,117.56 50.00 2,558.78 #6241084432 joint with decedent's granddaughter, Mary Dodd TOTAL(Alsoenteronline6, Reca@itulation) $ 23,746.10 2W46AE 2.000 (If more space is needed, insert additional sheets of same size) CITIZENS BANK Account Number 6100706451 Account Title STEPHEN PIRK OR AIDA JEAN PIRK Date Opened Account Type Principal Balance as of DOD Interest from Last Posting to DOD 6/6/66 Checking $8560.02 Account Balance as of DOD $8560.02 YTD Interest to DOD $ .00 CITIZENS BANK Account Number 6101191730 Account Title STEPHEN PIRK OR AIDA JEAN PIRK Date Opened 2/13/02 Account Type Principal Balance as of DOD Interest from Last Posting to DOD Accoum Balance as of DOD YI'D Interest to DOD Checking $122109.50 $122109.50 $599.07 Savings Bond Calculator Page 1 of 1 i04/2004 t:,?~p~me j Series Denomination # Bonds Total Price 3 $112.50 SerialNumber Issue Date Series Denom K103841968EE 02/1999 EE $75 C620159592EE 09/1997 EE 100 L562362507EE 11/1997 EE 50 Serial Number Total Interest $34.84 Issue Price $37.50 50.00 25.00 Interest $9.24 17.52 8.08 Value $46.74 67.52 33.08 Issue Date Total Value YTD In~ $147.34 $1.6 Interest Next Final Rate Accrual Maturity 2.61% 05/2004 02/2029 2.61% 05/2004 09/2027 2.61% 05/2004 11/2027 Note Description NI Not Issued NE Not Eligible for Payment P5 Includes 3-month interest penalty ME Matured (Exchangeable for HH) MN Matured (Not Exchangeable for HH) Please rate this service. (Please print and/or save this page before submitting your survey) Service Excellent Good Fair Poor Savings Bond Calculator C' C C: C http://wwws.publicdebt.treas.gov/BC/SBCPrice 5/5/2004 -086 2. IL2.55 :IL1 3.99:7 . STEPHEN ~PTRK ' .--~-;--. :~55 BEVERL y RD : : :::i': : ,, ,':'1:.~.~,~:~7", il CAMP H I:LL t~A.. ,,' .t ',, .~- I.,JIh,,llh,,,,.Ih,,~:~.,,Ihi,d~l,:~,hl:, : ,, f, ~..~: ?,~'' ' L' ~ ~ ~ :~ ~ i~: :~ '~,..:B~'~ n ' . · O:OOO.gOO0 ?'~.O ~ :: :BO :: ..... ~- --- '~ r- '--- T ~:~. ~, 7~ STEPHEN PIRK -' t ' _- ..... ~' S55 BEVERLY RD - ' ~ .... ,' :. 'SHIREMANSTOWN PA 17~0[1-28:16 ~ ~:::,' ~ .......... ~ 1,,,llh,,lll,,,,,,ll,,,l!~l,lh~l,,,,ll,h,'l~!~,~.~:L,,i,i ~..~ :~-~.~ :-~.. ,, ,,, POD KATHY A pIRK :]' .: :;' ~ . :' ': :.]:: .?:~::]:{::.~. "',.. ..." . PR 520385 OOOO 972510560 717737~9:~92,..':~:;'?':.' .~g-20~5959Z ,:oooo.ooo?,:° ;o; 086 26 1255 STEPHEN PIRK 555 BEVERLY RD · CAMP HILL P~ i7§II-'28i~ " OR KATHY A PR 520383 0000 991):55000~, 7177-376690-111098 02 1999 ' 02-0 9-99 "-ol n~l 9~;8 CITIZENS BANK Account Number Account Title Date Opened Account Type Principal Balance as of DOD Interest from Last Posting to DOD 6106422684 STEPHEN PIRK OR KATHY PIRK 5/15/02 Checking $37177.27 Account Balance as of DOD $37177.27 YTD Interest to DOD $134.70 CITIZENS BANK Account Number Account Title Date Opened Account Type Principal Balance as of DOD Interest from Last Posting to DOD Account Balance as of DOD YI'D Interest to DOD 6241084424 STEPHEN PIRK OR CATHERINE NEEDHAM 3/21/03 Time Deposits $5112.89 $4.67 $5117.56 $28.25 CITIZENS BANK Account Number 6241084432 Account Title STEPHEN PIRK OR MARY DODD Date Opened Account Type Principal Balance as of DOD Interest from Last Posting to DOD 3/21/03 Time Deposits $5112.89 $4.67 Account Balance as of DOD $5117.56 YTD Interest to DOD $28.25 REV-151~EX + (1-97) 'COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER Pirk, Stephen __ This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY % OF ITEM INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DATE OF DEATH DECD'S EXCLUSION DECEDENTAND THE DATE OF TRANSFER. A'FI'ACH A COPY OF THE TAXABLE VALUE NUMBER DEED FOR RE~L ESTATE. VALUE OF ASSET INTEREST (IF APF~CABLE} 1. Citizens Bank Checking Account 5,045.63 100.00 3,000.00 2,045.63 #6203980270 made joint with decedent' s grandson, Michael Dodd on 04/15/03 TOTAL (Also enter on line 7, Recapitulation) $ 2,045.63 (If more space is needed, insert additional sheets of same size.) 2W46AF 2.000 CITIZENS BANK Account Number 6203980270 Account Title STEPHEN PIRK OR MICHAF, I, DODD Date Opened 4/15/03 Account Type Principal Balance as of DOD Interest from Last Posting to DOD Account Balance as of DOD Checking $5045.63 $5045.63 YID Interest to DOD $12.53 REV-1~13 EX+ (9~0) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER Pirk, Stephen -- RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLEDISTRIBUTIONS[includeoutrights~usaldistributions, andtmnsfers underSec. 9116(a)(l.2)] Pirk-n/k/a Ethan, Kathy A. 5112 45th St NW Washington, DC 20016 Dodd, Michael 410 Candler Park Dr NE Apt G12 Atlanta, GA 30307 Needhaun, Catherine 4009 Summer Hollow Court #163F Chanti11y, VA 20151 Dodd, Mar~ 4803 Wilwyn Way Rockville, MD 20852 Child Grandson Granddaughter Granddaughter 18,696.06 2,045.63 2,558.78 2,558.78 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET I1. NON-TAXABLE Di$¥~,iBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 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 o 0 0 W46AI 1.000 (If more space is needed, insert additional sheets of the same size) OF STEPHEN PIRK I, STEPHEN PIRK, of the Borough of Camp Hill, Cumberland County, Pennsylvania, do make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils by me heretofore made. ITEM I: Family Information. I am married to AIDA JEAN PIRK and all references to my wife in this Will are to her. I have two children: KATHY A. PIRK and SHARON PIRK DODD. These and any other children born to or adopted by my ~vife and me are described in this Will as "my children," or as "a child of mine." Any person born to or adopted by issue of mine is to be included as issue of mine. Provided, however, no adopted person shall benefit under this Will unless the order or decree of adoption is entered before the adopted person attains the age of t~venty-one (21)years. ITEM II: Death Taxes. I direct that all inheritance and estate taxes becoming due by reason of my death, whether payable by my estate or by any recipient of any property, shall be paid by the Executor out of the residue of my estate, as an expense and cost of adxninistration of my estate, except that no taxes shall be charged against any gift qualifying for the marital or charitable deduction in my estate. The Executor shall have no duty or obligation to obtain reimbursement for any such tax so paid, even though on proceeds of insurance or otb. er property not passing under this Will. Page i ITEM III: Debts and Final Expenses. I direct the Executor to pay the expenses of my last illness and funeral expenses from the residue of my estate as an expense and cost of admiuistration of my estate. ITEM IV: Tangible Personal Property. If I die before my wife, AIDA JEAN PIRK, I give to her all my tangible personal property, including but not limited to, all of my household furniture and furnishings, books, pictures, jewelry, silverware, automobiles, wearing apparel and all other articles of household or personal use or adornment and all policies of insurance thereon. If I do not die before my wife, I may leave a written list in my safe deposit box or elsewhere disposing of certain items of my tangible personal property. The Executor shall dispose of items of my personal property as specified in the written list. If no written list is found in my safe deposit box or elsewhere and properly identified by the Executor within thirty (30) days after the probate of my Will, it shall be presumed that there is no other statement or list. Any subsequently discovered list shall be ignored. If I survive my wife, I give any property of the type described in this Item and not set forth in a written list to my children, to be divided between them as they shall agree. ITEM V: Residue. I give the residue of my estate, not disposed of in the preceding portions of this Will, to my wife, AIDA JEAN PiRK, if she survives me. If she does not survive me, I give the residue to my children, in equal shares. If either of my children is not living at my death, the share of my deceased child shall be paid to her then living issue, per stirpes. ITEM VI: Administrative Powers.In addition to the powers granted, at law, the Executor shall possess the following powers, each of which shall be construed broadly and may be exercised without court approval, but in a fiduciary capacity only: Page 2 (a) To retain any investments I have at my death, including specifically those consisting of stock of any bank even ii' I have named that bank as the Executor. (b) To vary investments and to invest in bonds, stocks, notes, real estate mortgages or other securities or in other property, real or personal, without being restricted to so-called "legal investments", and without being limited by any statute or rule of law regarding investments by fiduciaries. (c) In order to divide the principal of my estate or make distributions, the Executor is authorized to distribute personal property and real property partly or wholly in kind, and to allocate specific assets among beneficiaries so long as the total market value of each share is not affected by the division, distribution or allocation in kind. The Executor is authorized to make, join in and consummate partitions of lands, voluntarily or involuntarily, including giving of mutual deeds, or other obligations, with as ~vide powers as an individual owner in fee rumple. (d) To sell either at public or private sale any or all real or personal property severally or in conjunction with other persons, and to consummate sale(s) by deed(s) or other instrument(s) to the purchaser(s), conveying a fee simple title. No purchaser shall be obligated to see to the application of the purchase money or to make inquiry into the validity of any sale. The Executor is authorized to make, execute, acknowledge and deliver deeds, assignments, options or other writings as necessary or convenient to carry out the powers conferred upon the Executor. Page 3 (e) To mortgage real estate, and to make leases of real estate. (f) To borrow money fronl any person, including the Executor, to pay indebtedness of mine or of my estate, expenses of administration or inheritance, legacy, estate and other taxes, and to assign and pledge assets of my estate. (g) To pay all costs, taxes, expenses and charges in connection ~vith the administration of my estate. (h) To make distributions of income and of principal to the proper beneficiaries, during the administration of my estate, with or without court order, in such manner and in such amounts as my Executor deems prudent and appropriate. (i) To exercise voting rights with respect to securities which form a part of my estate, and to exercise all the powers incident to the ownership of securities. (j) To unite with other owners of property similar to property in my estate to carry out any plans for the reorganization of any company whose securities fortn a part of my estate. (k) To disclaim any interest in property which would devolve to me or my estate by whatever means, including but not limited to the following means: as beneficiary under a will, as an appointee under the exercise of a power of appointment, as a person entitled to take'by intestacy, as a donee of an inter vivos transfer, and as a donee ur/der a third-party beneficiary contract. Page 4 (1) To prepare, execute and file tax returns of any type required by applicable law, and to make all tax elections authorized by law. (m) To allocate administrative expenses to income or to principal, as the Executor deems appropriate. However, no allocation to income shall be made if the effect of the allocation is to cause a reduction in the amount of any estate tax marital deduction or estate tax charitable deduction. (n) To employ custodians of property, investment or business advisors, accountants and a[torneys as the Executor deems appropriate, and to compensate these persons fi'om assets of my estate, without affecting the compensation to which the Executor is entitled. (o) To make any adjustment to basis authorized by law, including, but not limited to increasing the basis of any property included in my estate, whether or not passing under this Will, by allocating any amount by which the bases of assets may be increased. The Executor shall be under no duty and shall not be required to allocate basis increase exclusively, primarily, or at all to assets which pass as part of my probate estate as opposed to other property for which a basis adjustment is allowable. The Executor shall allocate basis increase equitably among those beneficiaries receiving property as a result of my death, but shall not be liable to any person, nor subject to removal or surcharge, for any reasonable allocation of basis increase. (p) To compromise claims. Page 5 (q) To do all other acts in the Executor's judgment deemed necessary or desirable for the proper and advantageous management., investment and distribution of the estate. ITEM VII: Beneficiary Under Age 25. If a beneficiary under the age of twenty-five (25) years is entitled to receive assets under this Will, the person who served as Executor of my estate shall retain those assets as Custodian for the beneficiary under the Pennsylvania Uniform Transfers to Minors Act. The Custodian may receive and administer all assets authorized by law, and shall have full authority as provided in the Pennsylvania Uniform Transfers to Minors Act to use assets in the manner the Custodian deems advisable for the best interests of the beneficiary. I also designate the person who served as Executor of my estate as successor Custodian of any property for which I am custodian under any Uniform Gifts to Minors Act or Uniform Transfers to Minors Act. ITEM VIII: Survival. Any person who has died within thirty (30) days of my death, or under such circumstances that the order of our deaths cannot be established by proof, shall be deemed to have predeceased me. ITEM IX: with respect to Executors: Executors. I make the following provisions (a) I appoint my wife, AIDA JEAN PIRK, to be the Executor. (b) In the event that my wife is unable or refuses to serve as Executor, my daughters, KATHY A. PIRK and SHARON PIRK DODD, shall serve as Co-Executors. Page 6 (c) The Executor shall have the right to receive reasonable compensation for services rendered and reimbursement fro' reasonable expenses. (d) No Executor shall be liable or accountable for any loss that may result from the good faith exercise of the authority granted in this Will. (e) The Executor is specifically relieved from the duty of filing bond or entering security. IN WETNESS WHEREOF, I have set my hand and seal to this, my Last Will and Testament, consisting of this and the preceding six (6) pages, at the end of each page of which I have als,o set my initials for greater security and better identification this /~/~ day of 20 . STEPHEN PIRK (SEAL) We, the undersigned, hereby certify that the foregoing Will was signed, sealed, published and declared by the above-named Testator as and for his Last Will and Testament, in the presence of us, who, at his request and in his presence and in the presence of each other, have hereunto set our hands and seals the day and year first above written, and we certify that at the time of the execution thereof, the said Testator was of sound and disposing mind and memory. ~! ~~.~~~ -~(SEAL) Residing at Residing at ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA ) ) SS: COUNTY OF ) I, STEPHEN PIRK, Testator, whose name is signed to the attached or ibregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. STEPHEN PIRK (SEAL) Sworn to and subscribed before me this day of ,20 Notary Public My Commission Expires: (SEAL) AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) ) SS: COUNTY OF ) We, and the Witnesses whose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testator, STEPHEN PIRK, sign and execute the instrument as his Last Will and Testament; that Testator signed willingly and that he executed said Will as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the Will as Witnesses; and that to the best of our knowledge the Testator was at that time eighteen (18) or more years of age, of sound mind and under no constraint or undue influence. Witness Witness Sworn to and subscribed before me this day of ,20 Notary Public My Commission Expires: (SEAL) HEATH L. ALLEN N. DAVID RAHAL CHARLES W, RUBENDALL 3T ROBERT I. WELDON EUGENE E. PEPINSKY, JR. JOHN H. ENOS 3Tr GARY E. FRENCH DONNA S. WELDON BRADFORD DORRANCE JEFFREY S. STOKES ROBERT R. CHURCH STEPHEN L. GROSE R. SCOTT SHEARER ELYSE E. ROGERS CRAIG A. LONGYEAR DONALD M. LEWIS T~T BRIDGET M. WHITLEY JOHN A. FEICHTEL ELIZABETH J. GOLDSTEIN BARBARA A. GALL STEPHANIE KLEINFELTER KeEfeR WOOD ALLEN & RahaL, ATTORNEYS At LAW 415 FAILOWFIELD ROAD, SUITE 301 CAMP HILL. PA I70II-4906 PHONE 717- 612-5800 FAX 717-612-5805 EIN No. 23-0716135 www. keefe~vood.com June 10,2004 LLP ESTABLISHED IN 1878 OF COUNSEL: SAMUEL C. HARRY HARRISBURG OFFICE: :~10 WALNUT STREET HARRISBURG, PA 17101 PHONE 717-255-8000 717-612-5808 cswindler~keeferwood.com Cumberland County Register of Wills Cumberland County Courthouse I Courthouse Square Carlisle, PA 17013 Re: Estate of Stephen Pirk File No. 21-04-0568 Dear Sir/Madam: of additional Enclosed herewith is a check in the amount of $3.22 in payment tax due for the above estate. Thank you for your assistance. /cds 90963 Enclosure Sincerel.~.o~, Legal Assistant to Elyse E. Rogers DUREAU OF INDZVZDUAL TAXES INHERITANCE TAX DTVISTDN DEPT. Z8060! HARRISBURg, PA 171ZS-O6nz ELYSE E ROGERS ESQ KEEFER ETAL q15 FALLONFIELD RD 30 CAMP HILL PA 1701! COMNONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLO#ANCE OR DISALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FZLE NUNDER COUNTY ACN 08-02-200q PIRK O~-O~-ZO0~ 21 0~-0568 CUMBERLAND 101 REV-I;Ii7 EX &FP C01-05) STEPHEN Amount REGISTER OF W~LLS CUHBERLAND CQ7COURT ~USE CUT ALONG THZS LZNE ~. RFAAA ~p~ER PORTZON FOR YOUR R=COR~S ~ZSALLOHANCE OF DEDUCTZOHS AND ASSESSHENT ~TAX ESTATE OF P2RK STEPHEN FZLE NO. 21 0~-05~8 ACH~' ;i01 ~DATE 08-02-200~ TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSF APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks end Bonds (Schedule B) (2). $. Closely Held Stock/Partnership Interest (Schedule C) (3) q. Mortgages/Notes Receivable (Schedule D) E. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXENPTZONS: 9. Funeral Expanses/Adm. Costs/Hisc. Expenses (Schedule H) (9).. 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 11. Total Deductions 67.52 .00 NOTE: To insure proper credit to your account, .00 submit the upper portion .00 of this form wi~h your .00 tax payment. Z3/7q6.10 2~0~5.63 .00 .0O 12. 15. lq. NOTE= Net Value of Tax Return (12) Charitable/governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) Net Value of Estate Sub~ect to Tax (lq) Z~. an assessment was issued previous!y, 11nas 1~, 15 and/or 16, 17, 25,859.25 (11) .0(] 25,859.25 reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line lq et Spousal rate (15) 16. Amount of L/ne lq taxable et Lineal/Class A rate (16) 17. Amount of Line lq et Sibling rate (17) 18. Amount of Line lq taxable at Collateral/Class B rate 19. Principal Tax Due DISCOUNT (+) INTEREST/PEN PAID (-) .00 25,859.25 AMOUNT PAID 1,102.q3 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. PAYMENT MUST BE MADE BY 01-Oq-ZO05~. TOTAL TAX CREDZT BALANCE OF TAX DUEI 3.22 ZNTEREST AND PEN. I .00 TOTAL DUE I ~.22 IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE REFUND· SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RECE]-IaT NUMBER CD00q057 · 00 x O0 = . O0 25,859.Z5 x Oq5= 1,16~.67 · O0 x 12 = . O0 · O0 x 15 = . O0 (19)= 1,163.67 TAX CREDZTS PAY~NT DATE 06-10-200~ 58.02 18 and 19 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-O601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 004287 DODD SHARON PIRK 355 BEVERLY ROAD CAMP HILL, PA 17011-2814 ........ fold ESTATE INFORMATION: SSN: 086-26-1255 FILE NUMBER: 2104-0568 DECEDENT NAME: PIRK STEPHEN DATE OF PAYMENT: 08/18/2004 POSTMARK DATE: 08/1 8/2004 COUNTY: CUMBERLAND DATE OF DEATH: 04/04/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $3.22 REMARKS: TOTAL AMOUNT PAID: $3.22 SEAL CHECK// 3375 INITIALS: CP RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS KEEFER WOOD ALLEN & RAHAL, LLP 415 FALLOWFIELD ROAD, SUITE 301 CAMP HILL, PA 17011-4906 Recorc~ ' .~ of 4H 15206 i95 $0.370 08/1 / / ~004 Mai!ed From i7011 uJ Cumberland County Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 i 70 i 3+330 i O2 i,,,lti,,,llh,,,,,ll,,ll,,,ll,,,ll,lh,,,,,lli,h,i,l,,,,Ihl COMMONWF~LTH OF PENNSYLVANIA DEPARTMENT OF REVENUE KATHY PIRK 355 BEVERLY RD CAMP HILL ZNFORNATZON NOTZCE AND TAXPAYER RESPONSE EST. OF STEPHEN PIRK S.S. NO. 086-26- 1255 DEATH 04-04-2004 CUHBERLAND r FILE NO. 0q 5(o8' ACH 04127599 DATE 07-08-2004 TYPE OF ACCOUNT --']SAVINGS REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 COMPLETE PART 1 BELOW ~ · * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 6106~22684 Date 05- 15-2002 Established Account Balance $7,177.27 Percent Taxable X 50.000 Amount Subject to Tax ~8,58B.6Ei Tax Rate X . '15 Potent/al Tax Due 2,788.$0 PART TAXPAYER RESPONSE / Wills and an official assessaent will be issued by the PA Deoartment of Revenue. ONE You must complete PART [] and/or PART [] below. TAX RETURN - COHPUTATION OF TAX 0N JOZNT/TRUS~ ACCOUNTS PART DATE PAID DEBTS AND DEDUCTIONS CLAZM;D PAYEE DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation} comple be f my kno.ledge and belief. HOME C ~' }~(~-~c/~7' TAXPAYER SIGNATURE TELEPHONE NUMBER DATE GENERAL INFORMATION REPORTING INSTRUCTIONS - PART i - TAXPAYER RESPONSE TAX RETURN - PART 2 - TAX COMPUTATION CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED COMMONWEALTH OF PENNSYLVANIA DEPARTMENTOFREVENUE BUREAU OFINDIVIDUAL TAXES DEPT 280601 HARRISBURG, PA 17128 0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV 1162 EX(11 96) NO. CD 004486 fold ROGERS ELYSE E 415 FALLOWFIELD ROAD SUITE 102 CAMP HILL, PA 17011-4906 ESTATE INFORMATION: SSN: 086-26-1255 FILE NUMBER: 2104-0568 DECEDENT NAME: PIRK STEPHEN DATE OF PAYMENT: 10/12/2004 POSTMARK DATE: 1 0/07/2004 COUNTY: CUMBERLAND DATE OF DEATH: 04/04/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 04127399 I $836.49 REMARKS: TOTAL AMOUNT PAID: ,')836.49 SEAL CHECK# 196 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES TNHERTTANCE TAX DTVTSTOH DEPT. 180601 HARRTSBURG, PA 17118-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLONANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ~D~]i~ :~r,_, :~ :~ !~/iiin ESTATE OF DATE OF DEATH FILE NUMBER '04 JUL 30 A]'t ;31~OUNTY ELYSE E ROGERS ESQ ACN KEEFER ETAL qZ5 FALLONFZELO ...... ~ ~,~. ~ ~ CAMP HILL PA 1701~{lBb~:'~:}cJ Cc-., ~A 08-02-2004 PIRK 0q-04-2004 21 04-0568 CUMBERLAND 101 Aaoun'l: Rami'c'ced REV-lSq7 EX AFP C01-05) STEPHEN MAKE CHECK PAYABLE AND REMZT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 1701:5 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF PTRK STEPHEN FILE NO. 21 0q-0568 ACN 101 DATE 08-02-2004 TAX RETURN HAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATZON CONCERNING FUTURE INTEREST - SEE REVERSE APPRAZSED VALUE OF RETURN BASED ON: 1. Real Es'ca~e (Schedule A) 2. $. q. 5. 6. 7. 8. ORIGINAL RETURN (1) S'cocks and Bonds (Schedule B) (2) Closely Held S'cock/Par'cnarship Zn'cares'c (Schedule C) ($) Mortgages/No'cas Receivable (Schedule D) (q) Cash/Bank Deposi'cs/Misc. Personal Proper'cy (Schedule E) Join'cly Owned Propar'cy (Schedule F) (6) Transfers (Schedule G) (7) APPROVED DEDUCTZONS AND EXEMPTIONS: 9. Funeral Expansas/Adm. Cos'cs/Misc. Expanses (Schedule H} 10. Dab'cs/Mor'cgaga Liabili'cias/Lians {Schedule 11. To'ca1 Dadu¢'cions 12. Na'C Value of Tax 15. Iq. (9) (10) Chari'cabla/Govarnaan'cal Baques'cs; Non-alac'cad 9115 Trus'cs (Schedule J) Ne'C Value of Esha'ca Subjec~ 'co Tax O0 67 52 O0 O0 O0 25/746 10 2/045.65 (8) .0O .00 (11) (12) (13) NOTE: NOTE: To insure proper cradi~ 'co your accoun'c, submi'c 'cha upper por'cion of ~h/s form w/'ch your 'cax payment. 25,859.15 .00 25,859.25 .00 25,859.25 I~ an assess.ent was issued previously, lines 14, 15 and/er 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. (15) .00 x O0 = .00 (16) 25,859.25 x 045= 1,165.67 (17) .00 x 12 = .00 (18) .00 x 15 = .00 (19)= 1,165.67 AHOUNT PAID ASSESSMENT OF TAX: 15. Aaoun'c of L/ne lq a'c Spousal re'ca 16. Aaoun~ of L/ne lq 'caxabla a'c Lineal/Class A re'ca 17. Aaoun'c of L/ne lq a'c Sibl/ng re'ca 18. Amoun'c of L/ne lq 'caxable a'c Colla'caral/Class B ra~e 19. Pr/nc/paZ Tax Due TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+J DATE NUMBER INTEREST/PEN PAID (-) 06-10-2004 CD004057 58.02 PAYMENT MUST BE MADE BY Ol-Oq-ZO05~. IF PAID AFTER DATE INDZCATED~ SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 1,102.45 TOTAL TAX CREDIT BALANCE OF TAX DUEI INTEREST AND PEN. TOTAL DUE 1,160.q5 5.22 .00 5.22 ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT ZS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: Estates of decedents dying on or before December 1Z, 198Z -- if any futura interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after tho expiration of any estate for life ar for years, the Commonaealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate an any such future interest. PURPOSE OF NOTICE: PAYNENT: REFUND (CR): OBJECTIONS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (7Z P.S. Section 9140). Detach the top portion of this Notice and submit aith your payment to the Register of Hills printed on the reverse side. --Hake check or money order payable to: REGISTER OF #ILLS, AGENT A refund of a tax credit, ahich was not requested on the Tax Return, may ba 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 23 Revenue District Offices, or by calling the special Z4-hour answering service for forms ordering: 1-800-~BZ-ZOSO~ services for taxpayers aith special hearing and / or speaking needs: 1-800-447-50Z0 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. ZBiOZ1, Harrisburg, PA 171lB-lOll, OR --election to have the matter determined at audit of the 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: Pest Assessment Review Unit, Dept. ZB060l, 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 within three (3) calendar months after the dacedent's death, a five percent (SI) discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January IBj 1996j the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency~ or nine (9) months and one (1) day from the date of dsath~ to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (BI) percent par annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1~ 198Z ail1 bear interest at a rate which will vary from calendar year to calendar year aith that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOO4 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ~'~ lOX .000548 ~'~-1991 IIX .OOO~O1 ~ 9Z .000247 1983 16Z .000438 1992 9Z .000Z47 ZOOZ 62 .000164 1984 llZ .000301 1993-1994 7Z .00019Z ZOO3 5Z .000137 1965 1SI .000356 1995-1998 9Z .000Z47 ZOO4 ~Z .000110 1986 XOZ .000Z74 1999 72 .OOOXgZ 1987 IOZ .O00Z7~ ZOOO 7Z .00019Z --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent 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 D/VTSTOH DEPT. 280601 HARRISBURG:, PA 171Z8-0601 COHMONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ZNHERZTANCE TAX STATEMENT OF ACCOUNT REV-IG57 EX AFP (01-05) ELYSE E ROGERS ESQ KEEFER ETAL R15 FALLONFIELD RD 30 CAMP HILL PA 17011 DATE 09-27-200~ ESTATE OF PIRK DATE OF DEATH O~-O~-ZO0~ FILE NUHBER 21 0~-0568 COUNTY CUHBERLAND ACN 101 Aeoun~ STEPHEN HAKE CHECK PAYABLE AND REMZT PAYHENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credi~ ~co your accoun~c, subei~ ~he upper por~ion of ~his fore wi~h your ~cax peyeen~. CUT ALONG THIS L~rNE ~ RETAIN LONER PORTION FOR YOUR RECORDS -~ REV-1607 EX AFP (01-03) ~ ZNHERZTANCE TAX STATEMENT OF ACCOUNT ~ ESTATE OF PTRK STEPHEN FILE NO. 21 0q-0568 ACN 101 DATE 09-27-200~ THIS STATEMENT 'rs PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAHED ESTATE. SHO#N BELO# ZSA SUHNARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT DALANCE, AND, ZF APPL.rCABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTHENT: 08-OZ-Z00~ PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYHENTS CTAX CREDITS): 1,165.67 PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-10-200~ 08-18-200~ CD00~057 CD00~287 58.02 .00 ZF PAZD AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADD.rT.rONAL INTEREST. ( ZF TOTAL DUE 'rS LESS THAN $1, NO PAYHENT ZS REQUIRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' TOTAL TAX CREDIT 1,165.67 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 YOU HAY BE DUE A REFUND. SEE REVERSE S'rDE OF THIS FORH FOR INSTRUCTIONS. } COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '* BUREAU OF INOIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX Z80601 HARRISBURG PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOHANCE OR DISALLOHANCE OF DEDUCTION~, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-1548 EX AfP (12-04) _" ~r:: CO DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 02-21-2005 PIRK 04-04-2004 21 04-0568 CUMBERLAND 086-26-1255 04127399 Allount Rellitted STEPHEN KATHY " PIRK 5112 45TH ST NW WASHINGTON DC 20016 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ___ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-y:islii-Eif-AFP--roi-:031------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 02-21-2005 ESTATE OF PIRK STEPHEN DATE OF DEATH 04-04-2004 COUNTY CUMBERLAND FILE NO. 21 04-0568 TAX RETURN WAS: S.S/D.C. NO. 086-26-1255 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 04127399 FINANCIAL INSTITUTION: CITIZENS BANK OF PA ACCOUNT NO. 6106422684 TYPE OF ACCOUNT: DATE ESTABLISHED ( ) SAVINGS (Xl CHECKING ( ) TRUST ( ) TIME CERTIFICATE 05-15-2002 x .00 0.500 .00 .00 .00 .45 .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due x TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 10-07-2004 CD004486 .00 "---", 836.49 TOTAL TAX CREDIT 836.49 BALANCE OF TAX DUE 836.49CR INTEREST AND PEN. .00 TOTAL DUE 836.49CR . IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. . ( IF TOTAL DUE IS LESS THAN $1, ND PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRI, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I <,,,So '?- BUREAU OF INDIVIDlI~LrJ,AXE$ INHERITANCE TAX DIVISro.(' PO BOX 280601 ,.' HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT '* REV-1607 EX AFP (03-05) l!:33 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-21-2005 PIRK 04-04-2004 21 04-0568 CUMBERLAND 04127399 Allount Re.itted STEPHEN KATHYnc PIRK 5112 4S'l'H ST NW WASHINGTON DC 20016 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE~ PA 17013 NOTE: To insure proper credit to your account~ subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ "1t!-Wll,.Yf.m.m!'U!'......V.I.TlfMYfftWr."U.",IWAm.W.~~WOIW'..lrJl'.................. ... ESTATE OF PIRK STEPHEN FILE NO. 21 04-0568 ACN 04127399 DATE 03-21-2005 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE~ APPLICATION OF ALL PAYHENTS~ THE CURRENT BALANCE~ AND~ IF APPLICABLE~ A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT DR RECORD ADJUSTMENT: 02-14-2005 PRINCIPAL TAX DUE:, .00 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 10-07-2004 CDo04486 .00 836.49 03-03-2005 ~ REFUND .00 836.49- TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 IF PAID AFTER THIS DATE~ SEE REVERSE TOTAL DUE .00 lIE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $l~ NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A ..CREDIT" (CR) ~ YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) <":::;\l..... Q...