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HomeMy WebLinkAbout02-0618BUREAU OF ZNDTVZDUAL TAXES INHERITANCE TAN DTVT~'~ON DEPT. ZSO.~. 01 ~ARRISBURG, PA 171~'8-0601 HATTHEW A SINKOVITZ $8 BIG SPRING AVE NEWVILLE COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE INHERITANCE TAX RECORD ADJUSTHENT JOINTLY HELD OR TRUST ASSETS *04 FILE NUHBER COUNTY FEB 27 ACN DATE 02-25-2004 ESTATE OF NEARING DATE OF DEATH 07-02-2002 21 02-0618 CUMBERLAND 115-14-7945 02152724 Amoun~ Remi~ed REV-1604 EX AFP (0].-03) EDWIN D HAKE CHECK PAYABLE AND REHZT PAYMENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS REV-1604 EX AFP (01-03} N# INHERITANCE TAX RECORD ADJUSTHENT JOINTLY HELD OR TRUST ASSETS DATE 02-25-2004 ESTATE OF NEARING EDWIN D DATE OF DEATH 07-02-2002 COUNTY CUMBERLAND FILE NO. 21 02-0618 S.S/D.C. NO. 115-14-7945 ACN 02152724 ADJUSTHENT BASED ON: ADHINISTRATIVE CORRECTION JOINT OR TRUST ASSET ZNFORHATZON FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICES ACCOUNT NO. 87008Z01112286 TYPE OF ACCOUNT: ¢ ) SAVINGS ( ) CHECKING C ) TRUST (X) TIME CERTIFICATE DATE ESTABLISHED 04-19-1996 Account Balance Percent TaxabZe ~ Amount Subject to Tax Debts and Deductions - Taxable Amount Tax Rate X Tax Due TAX CREDTTS: 6,760.16 0.500 5,580.08 .00 3,380.08 152.11 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT~ SUBHZT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYHENT TO THE REGISTER OF WILLS AT THE ADDRESS SHOWN ABOVE. HAKE CHECK OR HONEY ORDER PAYABLE TO: 'REGISTER OF WZLLS~ AGENT." PAYMENT RECEIPT DISCOUNT ¢+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID INTEREST IS CHARGED THROUGH 05-09-2004 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM TOTAL TAX CREDZT J BALANCE OF TAX DUE ZNTEREST AND PEN. TOTAL DUE IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ZF TOTAL DUE 'rs LESS THAN $1, NO PAYHENT IS REQU/RED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE S'rDE OF THIS FORH FOR INSTRUCTIONS.) .00 152.11 6.84 158.95 PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- Make check or money order payable to: REGTSTER OF HILLS, AGENT. REFUND (CR): A refund of a tax credit, which mas not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Hills, any of the Z3 Revenue District Offices or from the Department's Z4-hour answering service for forms ordering: 1-800-36Z-ZOSO; services for taxpayers with special hearing and / or speaking needs: 1-BOO-447-$OZO (TT only). REPLY TO: guestions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Revie~ Unitj Dept. lB0601, Harrisburg, PA 17IlS-g601, Phone (717) 787-6505. DISCOUNT: If any tax due is paid within three ($) calendar months after the decedent's death, a five percent (SI) discount of the tax paid is allowed. PENALTY: The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 1Bi 1996, the first day after the end of the tax amnesty period. INTEREST: Interest is charged beginning aith first day of delinquency or nine (g) months and one (1) day frae the date of death to the date of payment. Taxes which became delinquent before January 1, 19BI bear interest at the rate of six (6X) percent par annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January l, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 19BI through ZOO3 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Yea_~r Rate Factor Yaa._._r Rate Factor 1982 20X .000548 1987 92 .000247 1999 72 .O0019Z 1985 162 .O004~B 1988-1991 112 .000301 ZOO0 8Z .O00Z19 1984 112 .000301 199Z 92 .000Z47 2001 92 .000Z47 1985 X$2 .000356 1993-1994 72 .O00XgZ ZOOZ 62 .000164 1986 102 .000274 1995-1998 92 .000Z47 ZOO3 5Z .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINtIUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. REV-1470 EX (6-88) COMMONWEALTH OF PENNSYLVANIA EXPLANATION DEPARTMENT OF REVENUE aUR~U OF ~NO~V~DU^, TAXES OF CHANGES DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME EDWIN D NEARING FILE NUMBER REVIEWED BY 2102-0618 Karen Appleby ACE 02152724 ITEM SCHEDULE NO. EXPLANATION OF CHANGES Above-referenced ACH has been adjusted to the correct tax rate of 4.5%. ROW Page 1 Nam e of Decedent: STATUS RBPOP~TUR~Ei~'RULE 6.12. Date of Death: Will No.: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State w_~hether administration of the estate is complete: Yes No [-1 2. I/the answer is No, state when the personal representative reasonably believes that the administration will be complete: If the answer tO No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes'IX No [] b. The separate.Orphans' Court No. (if any) for the personal representata e s account is: c. Did the personal repleesentafive state an account informally to the p.arties in interest? Yes [~ No [-] c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the. Orphans' Court and may be attached to th/s report. Name capacity: Address Telephone No. cceorSOnal Representative unsel for personal representative Estate of Edwin D. Nearing also known as PETITION FOR PROBATE and GRANT OF LETTERS No. JI-O~-(pI8 To: Register of Wills for the 4 S Deceased. County of Cumberland in the Social Security No. llj-l -1':J4 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the executors in the last will of the above decedent, dated February 14 and codicil(s) dated named , 19...9..Z..-- (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County. pennsylvania, with h -I ~ last family or principal residence at 102 CME, Newville, Lower niffl~n Township Cumberland County, Pennsylvania 17241 (list street, number and mundpality) Decendent, thefc )j) fl "'~Ei!t:H)f a~, ~~ July 2 at Carlisle H ,;J;'H~ , Car1:l:s1e ,e1':A 17013 Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for orobatet' was. not the..Yictim of a killing and was never adjudicated incompetent: UeceClent w~s marr~eCl 0 t;Cl~tti LNear~ng. She died on July 29. 1996 ,Xf9 2002 Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: $ 100,000.00 $ $ $ WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters tes tamentarv theron. (testamentary; administration c.t.a.; administration d.b.D.c.t.a.) " " u " " :'S!~ "- "" a:" " -g.g Newlille, P-.'. 17241 ~.- r?~?</t~"s::j~/ Marcia Jean Sinkovitz JS lUg SpriRg .1"8=8 Timothy Jon Nearing 7192 Ferestburg Drive ~rlifl~tofl, Texas 76001 -~r fko OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA "I 58 COUNTY OF Cumberland J The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well an dminister t e estate according to law. '" ;;;. '" " - " ;;: ~ \\-1'-\- \ No. JI-Oa-LPI'it Estate of Edwin D. Nearing , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW JULY 9. 2002 H 7007 in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated February 14, 1997 described therein be admitted to probate and filed of record as the last will of EDWIN D NEARING and Letters Tp..~t,qment,qry are hereby granted to Marcia Jean Sinkovitz and Timothy Jon Nearing .Iio~ FEES Probate, Letters, Etc. ......... $ Short Certificates( ).......... $ ~,.,.;",,;.."X. x.tL'a. pages. .. $ jcp $ TOTAL _ $ Filed ......? ;-9::0?.. .. .. .. . .. .. .. .. . .. . . called atty 7-9-02 200.00 15~00 9.00 5.00 229.00 Richard L. Webber, Jr. Esquire #49634 ATTORNEY (Sup. Ct. J.D. No.) 126 East King Street, Shippensburg, PA 17257 ADDRESS (717) 532-7388 PHONE .11:.) ., ,'i 1-1- ?'[J, H:n~..','(I' ;,fT '.'iW, This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to rhe Srare Viral Records Office for perrnanenr filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. P 8470388 No. ~ /,\II~~\1H OF Pfi"'~.~__ "'~~~ ~ ~ '. . ~- l~_.~ ~\ ,,,,,,I. ... 'z, '001, " 1-- ~~\" .-f~T. /:l:a.1 ':. * ~ . . "',. '/ *::: >a~ /.",,' '\.~ . /~",,' ""o-t,pr!,ff~'<-!"" ;;........ EN! ~ JII,II ~"~~~H##IIJI :.y,fi.. k~ ~~ " Fee for rhjs cenificate, $2.00 Local Registrar J!1LJl.1laII2 Date R....2f8T COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH ,~ VNOERIPltJ' l-bn ll,l........ ,n ,. SWI'l\.fNIJlafA SOCIAl.SECWlJJYNUIolMR. O...lEOfCERH,"""""-O""......' "IAME()I:OfCEDENT1'_..~,I.Hl 81 NEARING Vf'IOERIYE.Ul ..... "" J. 113 - 14 7945 .. JULY 2 2002 1. EDWIN D. AOE(l....~ ~Ic..,-_ ,....'" Fcr--onC':U'U~1 ,. WHITE """""""0'''' (1_._-- CQUNJYOf'ou;J"l1 BINGHAm'ON.I IV. Y. ,. FAClI.lJYtu.IIlIE(lInQI~,g"""'INl__, ~OFOERl4lC""".""y"", _",."loCl<<Ioton__ """''''' t.-_ Kl :="0 .. CUMBERLAND DE:CEOENT'S usu...~ OCCUI'Jl7JOol ~.=.:'~~'::~:'l" II EW ER 111>. POLICE OECEOENT'SIoIAlLIJ,jQAllORESS(SorMl,C~,~,Z"'IlCocllI k. CARLISLE KlNO~auSlNf:S&III<<lUSTI'IV Jr.ARLISLE REGIONAL MEDICAL CENTER vm.~~~':I:ll':1~r DECEOENT'S lD\JC.'olTON' .....0 NIII19 ,. IoIMITAtST'CWS.~ i'l_......"O.--.. ......- WIDOWED 102 OME NEWVILLE. PA 17241 OECI!Of:NT'S '0"'" ...""''''' - -- 17..&.., PF.NN~YTVANTA .. F.UH(1'I'SN.wEt""'_, I..-Q II. JOHN B. .NEARINC lHfClRlAANT'SNAME(lypolF'tirwlI 2IIL TIMOTHY NEARING METl1OOO#DlSI'OlllTlCJN ......1[] er_,ionO .....- ,~. CUMBERLAND .. - ....in. -.opt 11ll.[j :;"''''':'.:"':::01 NEWVILLE ~OTHER'SNoUolElI'irlll._.M-.s.,,_1 ,t. EVELYN PEAKE 1Nf000000'SMAILJNQ~sslSlr...Qy/TIlwn._.ZopC""-l . 7102 RESTBURG DRIVE ARL Pt.CCEOF0I5'OSfrIOH.~a1~Ct~ ......- 17c.O......"""-nl.....lI,. _. X lON.CIty/boft, $I"'. ZIoCoM " HALSEY CEMETERY IW.IE~OAOOAaSOI'fjl,QUJY WILB 1. LONG EDDY NEW YORK LICENSE NUM8E1'I p,(l'ESlGHEO - ... ......:..ae_Ilt~KlCy ---...--... OOE.o.D IJ.!"""'. 0.-,."""1 .... L..- ,.. P JI. 27."","1; E..........diH...s."'i<K"K<lI<o""""'~.....whd>eausKllllto_"'.O"_.n'..lMmcrSlGI LiII~....._""UCl\_ Rl!OlOIoIEOlIC:A4.EXA/oIINEM: ...0 "~ lng.sucnHoarlli'loor,.spirtlOfy,",,__.._nlalu" ,ApptO.-. '""'-lII_n J..-at>d_1II , i P-'l'lTII: 0lM/.9><1Ioant"""'*""-...............".1IolI _........w.gin"""IIIldMyInQ_...lIlPNttL ~TECAUU(FinM _cr~ ''''''''''"'_1_ I<~- AS"cora: HC.E ~-- '_-.glD.........~ _,EIIl.-IJIIClMU'IIIIO CAUHlo.-OI"""", .....-- '_"'_IUollT L OUElOlOAASAC ENCEOf'l: OUElO(OI'IAS"'CONSEOUENCEOf)' ......s~AUlOF'SY PEI'IFOFIllIE07 WERE AUlOI"$YflNOlNGS ~8~EPRIOIl1lJ COtolPlETlONOf'CAUSE 0#llEA1t<7 UJiNNEROFou.rH OATEOfIH.JURY (Mooolll_[)ay......1 llIolE~IHJUAY lNJURYRWORI<? DESCRIBE ION INJ\JRY OCCIJRNO. ~.. 0-- o o Hon,i<;1Olo o o o PI.JlCEO#IHJURV."'_.t.noo.Slf..'.'~Of'/;O~ ~. b~"'"Spoc"'" ,~. .... 0 ,.,0 -- P."dinlI~ _ 0 ~ '" 0 ~ [j}-" ~~ eo....nocllt.......,.",.., tOCATlON~....ColyiTo..<>,SIaaI ~. ,..,. CU'TlF'EII,CJ-.:k....,....., .CIEIlTIFYII<<<J""SIC.A,.I"")1I<_o....l""'9C':O"...<I__~.phYIlC_...sllf~""..n_o"""".'~1I....2J' To__.o'...W_Ie4'i",cIoI."'OO-C""...,d...lOlIwuu.....I__.a....IK................................. N. ... o T'TlEOfCfRTlFlER , /~ UCI"N$.E 1JMft"R. o ~lc. OJ.~~J?IIO.c ld.;L d< NAAlEANO"'OOR'ESSOFPERSONwliO OI.IP~ET~OCAUSEOFOE .. (1I....21lTl'J)eotP'ifllJ.l'fO...v ))(..-, lop $.1-1 ,,,--I /VI vv V. LI...c: t4/<J 17'2 ..,ItONOUNClHGAHOCfIlTIHIHG PHYSICI...NII'h....""'bOIt>;><<>nOutICong'doI""'ar>cloeo1dY""l"'''-oI_, TolM_oI...Wkno......;......."'''"ou"... "_'_.d.'.. .ndplM.,.....d...lolh<lu"..(.I.....m.........sl.l... '''EDICM. EXAM1NEFIICORONEI'I On II... bul. 0' na...lnallon an414, invuli\l.llon. i" my <>91";.".. d..lh occ:.."..d.1 ,". Ii...... da.., and pl......n<l d"..10 II.. o.....I.I.ood J,."'.n"........lod..... ....... .... . ......................................,..,.....,...............,........... o IIEGI$TRAR'SSlG"JJUR~ ANONVl,!6EA ,---- 1'\'8, ~ L.. 6J ". CMl'"ll:fIlLO/M""",Doy,_1 " ". -o:=J 2...00-'_ LAST WiLL :.\.1\0 TESTAMENT OF "".rp1iY'l\j 'P ,:'......_ t. I... .,'i, "'E \l.{' >~..~ '.... ~',. ,. :,: 1 , _'" ,::I. ~ -\, l!;' .21-02.- <DIg .LJ BDW!}:; D~ N]~A:~ING;" (:,C Itl:: '~'.:()n()d()'?'.;JnE,t 0~0bil~:. ?:8t-,,~t.c:::3! NE',.: :'~:L.i.e, Cl..~~r.lb~::rland C(Yi,',ntY'j Penll~:yl'\)~'_.~~L...-:}( ,t,;::::.LL9 .:,~f sound lrL-;.n(~. m~~"/ ~\,'Y a:iil:;' ai::::;:,cs:i.t.ion, do he:;::eby r(,t:\k(:~t .~:",~x:-:';.Llsh i~:Yl.d decIare t}:is my Lu ;;: 1.: t'11.1 J~ 3nd 'Testament { he.reby rr:voki._nq ta16. nakii19 \roid any 0:"1':5 al<L ~LL1).n. Codicils, <:1" wr-iti::l~j:; in tLe n;.,.ti.l::e th,=X'e,'.)f, 1,)-" m{~ ,~~~: :;ny t.:i.':"':'"t:"':~ l-::.eT.f~t.ci()r.e T!lade ~ FIRqJ': ",,'[HENT OF EXPENSES. :: direct that a-Ll my Just debts and funeral expenses, i:1cl~,ld:L!j,g iR:l ~::j'1~av.:;.tr:;::~:i..'kw:,;'c and f.l.ll. 2:xpe.nG,::..~s of rr,v l.ast il~n0ss, shall be pa-Ld. frcm ;ny :~':.H;iduL.ll'j~ ~--'-state as S(Jcrl as pract.l sa.ble aft.er uy j,ecc:;'.'::e as a p<.r~~"7' GL t:i-:r::' a,dmtnist"t'3.tion ()f my esLat ':. R.fCOND 1 m~SIDUE OF ESTATE- I give. ::levlse <1;,(1 bc~queath all j:~le rest, rf;Sidue and remainder of my eS'::cte, be it real, personal, or mixed, of whatsoever kind 2nd wheresoever situate, unto my children, MARCIA JEP.N SINKOVITZ and TIMOTHY .JON NEARING. However, if ::t crJild does not surVlVf:: me and lc:.avas ch.ildren who so S'.jrV.:L.V\~. me, sti.ch chila.cen shdli .cece.i.vc, pE::~C stirpes, ~\-."':I ........1.:.. .31:..a1.-;:: n~y chi 1.,j would have neceived had he or she G".l s';c.',vE'.d me. THIRD: CO-EXECUTORS - I appoi~1L '~iY Cllild,,-en, MARCIA JEAi.'l SINKOVITZ and T,U10TiIY JON NEAi~INGl C'o-'Bxecutors of my Wi_II. Neithe.~ my Co... Executors nor any successor sha:l be reqcd red to give bond .Ear the performance of their duties. I grant to my Co-Executors the power to compromise claims without court approval and without the consent of any beneficiary. FOURTH: PROTECTIVE PROVISION - To the greatest extent permitted by law, before actual payment to a beneficiary or to his or her account, no interest in income or principal shall be assignable by a beneficiary or available to anyone having a claim against a beneficiary. IN WITNESS WHEREOF, I hereunto have signed my name to this, my Last Will and Testament, the text of which consists of twO (2) " I t'~ typewritten pages, this _~ day of k brlAa r'-{ , 1997. (SEAL) In our presence, the above-named Testator signed this and declared it to be his Will, and now, at his request and in his presence and in the presence of each other, we sign as witnesses: ~~ 9 (}~~Jv (iJikuJhn (1 ) I: yY[~~jU2~ _/~ PAGE 2 STATE OF PENNSYLVANIA : SS COUNTY OF CUMBERLAND : I, EDWIN D. NEARING, having been duly qualified according to law, acknowledge that I signed the foregoing instrument as my Will and that I signed it as my free and voluntary act for the purposes therein expressed. tor We, having been duly qualified according to law, depose and say that we were present and saw EDWIN D. NEARING sign the foregoing instrument as his Will; that he signed it as his free and voluntary act for the purposes therein expressed; that each of us in his sight and hearing and at his request signed the will as witnesses; and that to the best of our knowledge he was at the time 18 or morro years of age, of sound mind and under no constraint or undue influence. 'Gtn.~~ ~. CJu ~ 1: ()ht/''tJ:tu~ ~.J C. 7nL~jD1-[.J!..~ PAGE 3 Subscribed, sworn to or affirmed, and acknowledged before roe by the above-named Testator and by the witnesses wtlose names appear opposite on this F<-Ix~,.. 7 /(, /4 day of , 1997. .~.?1A.~;JJl ~ -~~~;;;--~k--..--_._. ~;i] PAGE 4 t CERTIFICATION OF NOTICE UNDER RULE S.6(a) Name of Decedent: Edwin D. Nearing Date of Death: July 2, 2002 WiIINo. 7002-00618 Admin. No. To the Register: 1 certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on July 9. 2002 Name Address Marcia Jean Sinkovitz 38 Big Spring Avenue, Newville, PA 17241 Timothy Jon Nearing 7102 Forestburg Drive, Arlington, TX 76001 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except N/ A Date: October 17, 2002 /0~~ML1 Signature Name Richard L. Webber, Jr. Address 126 East King Street Shippensburg, PA 17257 Telephone (717) 532-7388 Capacity: _ Personal Representative ~Counsel for personal representative IN RE:ESTATE OF EDWARD D. NEARING, LATE OF LOWER MIFFLIN TOWNSHIP, CUMBERLAND COUNTY, PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 2002-618 PRAECIPE TO WITHDRAW To the Register of Wills: Please withdraw my appearance in the above-captioned matter. WEIGLE & ASSOCIATES, P.C. Dated: f/2 'if o? By: /" . ) /7 '~<('-- / Richard L. Webber, Jr., Esquire Attorney ID #49634 126 East King Street Shippensburg, PA 17257 Telephone 717-532-7388 WEIGLE & ASSOCIATES, RC. - ATTORNEYS AT LAW - 126 EAST KING STREET - SHIPPENSBURG, PA 17257-1397 1'7- '77'-1 ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '* NOTICE OF INHERITANCE TAX APPRAISEKENTL ALLOHANCE OR DISALLOHANCE OF DEDUCTIONs, ANO ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS REV-lSol8 EX An' (Ol_O~) MATTHEW A SINKOVITZ 38 BIG SPRING AVE NEWVILLE PA 17241 ;/ DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 11-17-2003 NEARING 07-02-2002 21 02-0618 CUMBERLAND 113-14-7945 02152724 EDWIN D Amount Remitted 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-i=i5"4-i-Ej(-AFP--coi-=03j------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 11-17-2003 ESTATE OF NEARING EDWIN D DATE OF DEATH 07-02-2002 COUNTY CUMBERLAND FILE NO. 21 02-0618 TAX RETURN WAS: S.S/D.C. NO. 113-14-7945 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 02152724 FINANCIAL INSTITUTION: ALLFIRST FINANCIAL SERVICES ACCOUNT NO. 87008101112286 TYPE OF ACCOUNT: DATE ESTABLISHED ( ) SAVINGS ( ) CHECKING ( ) TRUST (Xl TIME CERTIFICATE 04-19-1996 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Ra te Tax Due x 6,760.16 0.500 3,380.08 .00 3,380.08 .15 507.01 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." X TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) INTEREST IS CHARGED THROUGH 11-25-2003 TOTAL TAX CREDIT .00 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 507.01 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 16.46 TOTAL DUE 523.47 ~ IF PArn AFTER THIS DATE. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. * ( IF TOTAL DUE IS LESS THAN tl. NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) PURPOSE OF NOTICE: PAYHEHT I REFUND (CR) I OBJECTIONS: ADMIN- ISTRA nVE CORRECTIONS: DISCOUNTl PENALTY: INTERESTl To fulfill the require~ents of Section 2140 of the Inheritance and Estate Tax Act. Act 23 of 2000. (72 P.S. Section 9140). Detach the toP portion reverse side. ~ - Make check or Money of this Notice and sub~it with your paYMent to the Register of Wills printed on the order payable to; REGISTER OF WIllS. AGENT. A refund of a tax credit. which was not requested on the tax return. ~aY be requested by cOllpleting an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-13l3). Applications are available at the Office of the Resister of Wills. anv of the 2~ Revenue District Offices or bv calling the special 24~hour answering service for forMS ordering: l-800~362-20S0; services for taxpayers with special hearing and or speaking ne~dsl l-800~447-3020 (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 lIIay object within sixty (60) days of receipt of this Notice by: --'oIritten protest to the PA Departl'lent of Revenue. Board of AppealS. Dept. 281021. Harrisburg. PA 17128-1021. OR --electing to have the Matter deterMined at the 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 Departlllent of Revenue. 8ureau of Individual Taxes. ATTNl Post AsseSSMent Review Unit. DEPT. 280601. Harrisburg. PA 17128~060l Phone (717) 187-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV~150l) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar 1II0nths after the decedent's death. a five percent (SY.) discount of the tax paid is allowed. The 15% tax alllnesty non-participation penalty is co~putod on the total of the tax and interest assessed. and not paid before JanuarY 18. 1996. the first day after the end of the tax ~nesty period. This non-participation penalty is appealable in the same manner and in the the sa~e tillle 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) ~onths and one (1) day from the date of death. to the date of payment. Taxes which became delinquent before January 1. 1982 bear interest at the rate of six (6Y.) percent per annum calculated at a dailY rate of .00016~. All taxes which becaMe delinQuent on or after January 1. 1982 will bear interest at a rate which will vaf"Y calendar vear to calendar vear with that rate announced bv the PA Department of Revenue. The applicable interest rates for 1982 through 2003 are: Interest Dailv Rate Factor - - fr~ Year Year Interest Rate Dailv ~ Interest Rate DailY Factor Year 1982 20X .0005li8 1987 .. .0002ti7 1999 7Yo .000192 1983 16Y. .ODOli38 1988-1991 11Y. .000301 2000 ax .1100219 1984 11Y. .000301 1992 .. .0002ti7 2001 9X .0002li7 1985 f3Yo .000356 1993~199li 7Yo .000192 2002 OX .00016li 1986 10Y. .00027li 1995~1998 9X .0002li7 21103 5% .000137 -~Interest is calculated as follows~ INTEREST = BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR ~.Any Notice issued after the tax beCOMes delinquent will reflect an interest calculation to fifteen (15) days bevond the date of the asseSSMent. If pay~ent is made aftor the interest computation date shown on the Notice. additional interest must be calculated. COMMONWEALTH OF PENNSYLVANIA DfPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96l RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT SINKOVITZ MARCIA JEAN 38 BIG SPRING AVENUE NEWVillE, PA 17241 u_n~_. fold ESTATE INFORMATION: SSN: 113-14-7945 FILE NUMBER: 2102-0618 DECEDENT NAME: NEARING EDWIN D DATE OF PAYMENT: 03/02/2004 POSTMARK DATE: 03/01/2004 COUNTY: CUMBERLAND DATE OF DEATH: 07/02/2002 NO. CD 003626 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $158.95 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK# 3460 ,- INITIALS: JA RECEIVED BY: SEAL REGISTER OF WILLS $158.95 GLENDA FARNER STRASBAUGH REGISTER OF WillS y :II: ..~ '" nn", " :t>c:m "'%<1> ::E: r-....... '" ....mlll " Ill"'.... .. r-r-m 'D m:t>'" - z :I> '" Cl -< ." .." :t> :t>n III Cl :IE: r- .... m .... n r- :I> '" Cl r- C) c: III Z .... '" '" "" .... '" :r m Cl z c: .. III -I IT1 : -< z m z -I -I 0 .. z "" 3: m 0> :t> :E .... < "" .... .... .... :r r- <1> IT1 r- :IE: m III ." '" .... )> Z <1> III .... :t> Z < "" m Cl ." < :t> .... .... .... rJh '" N E; ;;';"~ ""' :::1- ~ """""b'" (;; ;;p ,-'" S "<:l ~ i!J .:...: - :l>1I)"'1\",m", "11)0..:1>11):1> zzcr--I-I-I 'ZJllJII)>", "'-I -I "-<zo'" C'1\ i5",~ mm ;111:1> -I : ,. I! S CH""'MN=ZO .. N"""C::~-....ImN ~""'c:N3' 1J>\ ..... U1 I =QO:::'tl'N :::v Nl-'mNN,...,,,,,, . -....IJ:Io:::O I . Z I . N I r-QNO)N too. "".......>0-. = Cl :: ...oZI-'Q C) . +'t:lOON .0- Il. '" IT1 ~ '" . :IE: . .... . z $ , '" ::tJ ::tJ([) (!) 6 & .. .!5 r-", -<m.. _"z -0: '''i,~'~ :a III ","'''' .. 0>-1 ","'> ...Z -IC" ;llllI)m -I CZ-I II)m> -Iz>< :1>-1 II) II) m -I <II n~! ~:S~.. 1-1' :lI;Im !S:~~ ~g~Q " <:I"''''' ~ " ...... : ~! " 0", :;:; <:5 ! Eg ~ ~ i!: .... ,. x m 1Il " o z "'z mo 'DZ >c "'m -I> zr- m-l Z% -I o 0'1\ '1\ 'D "'m mz <z mil) z-< cr- m< > z .. > 'i!. . '" ~ ~ \ t ~ i II ~ . "\ ~ \ i % 'i " s ~ ~ ... >; '5 ~ Ii> ~ 'Ii ~ . ~\ \ . ~ 1 . .~ i .- ~ . : " ~ ~ 't ~ %. " e t t ~ ~ l 1 ~ ~ " $, " $ . ~ ~ II ~ " l\ " o \ " o \ . 1 'i 'i ~ ~ ?: -. :== :::-. =-. _. _. ,..:. ....1 c:' ,..':. f I '>... /:i f>- ~ ,'d I:.:J (..1 _. ::=::: "- --J ~ "- ""' g=:: .0 ?: ::== ::= ~ o o"i >0 }o -', -" ,. C/ m 9- ~~ o - IIIn ~~a:: >l cc"' .. -.'" e;'" '" J'~~ :g.~' 11000 :;>!;. ",..I<- ;!:~ ; of REV-1500 tX (6-00) . . w .., l/:::!1Il Ull:l/:: Wa.U :rOO Ull:..J a.m a. <I: COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 OFFICIAL USE ONLY FILE NUMBER d- L -1)~ COUNTY CODE YEAR INHERITANCE TAX RETURN RESIDENT DECEDENT 6Q&LL NUMBER SOCIAL SECURITY NUMBER '/ I- Z W C W o W C ~E~EDENT'S NA~E (LAST, FIRST, AND MIDD~E INITIAL) 1\\ , {\ . \ Y'\ b DATE OF DEATH (MM- DATE OF BIRTH (MM-DD-YEAR) o O;}-o 0 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) 91/6 ~. Original Return o 4. Limited Estate o 6. Decedent Died Testate (Attach copy of Will) o 9. Litigation Proceeds Received THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 2. Supplemental Return o 4a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a Living Trust (Attach copy olTrust) o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) o 3. Remainder Return (date of death prior to 12-13-82) o 5. Federal Estate Tax Return Required fl 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch 0) I- Z W o Z o a. 1Il W ll: ll: o U TElEP/HONE NUMBER 7- 77 30:S;;" 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) J 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) j 6. Jointly Owned Property (Schedule F) o Separate Billing Requested r 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or l) 8. Total Gross Assets (total Lines 1-7) /9. Funeral Expenses & Administrative Costs (Schedule H) Ao. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 113. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) z o ~ ::) t:: D.. II( o w 0:: 14. Net Value Subject to Tax (Line 12 minus Line 13) (1) (2) (3) (4) (5) COMPLETE MAILING ADDRESS /) (:. ~ ()J.~; J ~ p r- 'j t' ~ U. lJ l' , Me ~.h/' , 'e' a I 7Jt..f/ o D o o L~ ft, /13. o o w w OFFICIAL USE ONLY "'.. = c:::::> --' <- T..;iJlIo -- n C;O ~'C_:, ;:Q ~-; ~~ ~_d ,-,:; rll ~~ ~':rJ ,'" -"../" I .;:- (6) -'= :'; -Oil ,J (7) (9) I~~r (8) &u/7<.), (10) (11) (12) (13) ~();fo7. mI~ t,. - !i1~~ SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (14) z o ~ ~ ::) D.. ::iE o o ~ 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20.0 x .0_ (15) g<1-j-.ID___ _ x.O 13 (16) /":/1) x .12 (17) x .15 (18) CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT (19) ~pV Decedent's Complete Address: STREET ADDRESS lO 0- CITY ZIP I 7 if-'f. e... Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) - '1 '-/. p-o 3. Interest/Penalty if applicable D. Interest E. Penalty o Total Credits (A + B + C ) (2) Total Interest/Penalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A.This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT o PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS u:v IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred;.......................................................................................... D b. retain the right to designate who shall use the property transferred or its income; ............................................ D c. retain a reversionary interest; or.......................................................................................................................... D d. receive the promise for life of either payments, benefits or care? ...................................................................... D 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. D 3. Did decedent own an "in trust fo~' or payable upon death bank account or security at his or her death? .............. D 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ D No ~ ~ [Y [J;}- ~ V 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 infonmation of which preparer has any knowledge. DATE DATE ADDRESS For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. ~9116 (a) (1.1) (i)). For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exemot 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. V For dates of death on or after July 1, 2000: l' 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. REV-1502EX. (1-97) SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE Of:::. , '" ~ \ FILE NUMBER r:- C1 w ~ (\ ~ - 1,\ €....Ck." \ V'\ if / - 0 All real property owned solely or as a tenant in common must be r rted 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 knowledge of the relevant facts. Real property which is jointly-owned with right of survivorshin must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) \fl. 'flUt'C ~JJCI\"ll;;;'" '~J rr~___...._.._.~",. LIIV ""'-II...... .......v/ REV-1504 EXt (1-97) , SCHEDULE C CLOSELY-HELD CORPORATION, PARTNERSHIP OR SOLE-PROPRIETORSHIP COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE Q.F ( j:.~W'1 ea... r \ Schedule C-1 or C-2 (including all supporting informa . must be attached for each closely-held corporation/partnership interest of the decedent, other than a sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships. FILE NUMBER J/- 0 ITEM NUMBER NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH TOTAL (Also enter on line 3, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) ~_."'" .. SCHEDULE C.1 COMMONWEALTH OF PENNSYLVANIA CLOSEL Y -HELD CORPORATE INH~:~i~~Z~;~E:~~RN STOCK INFORMATION REPORT ESTATE OF J=.clw",\^ D. }\eo.- (" i ^j 1. Name of Corporation Address City 2. Federal Employer I.D. Number 3. Type of Business FILE NUMBER J/-oJ .,(/,/t Zip Code State of Incorporation Date of Incorporation Total Number of Shareholders Business Reporting Year State Product/Service 4. TYPE TOTAL NUMBER OF NUMBER OF SHARES VALUE OF THE STOCK Voting / Non-Voting SHARES OUTSTANDING PAR VALUE OWNED BY THE DECEDENT DECEDENT'S STOCK Common $ Preferred $ Provide all rights and restrictions pertaining to each class of stock. 5. Was the decedent employed by the Corporation? 0 Yes o No If yes, Position Annual Salary $ Time Devoted to Business 6. Was the Corporation indebted to the decedent? 0 Yes o No If yes, provide amount of indebtedness $ 7. Was there life insurance payable to the corporation upon the death of the decedent? 0 Yes 0 No If yes, Cash Surrender Value $ Net proceeds payable $ Owner of the policy 8. Did the decedent sell or transfer stock of this company within one year prior to death or within two years if the date of death was prior to 12-31-82? DYes 0 No If yes, 0 Transfer 0 Sale Number of Shares Transferee or Purchaser Attach a separate sheet for additional transfers and/or sales. Consideration $ Date 9. Was there a written shareholder's agreement in effect at the time of the decedent's death? If yes, provide a copy of the agreement. DYes 0 No 10. Was the decedent's stock sold? DYes 0 No If yes, provide a copy of the agreement of sale, etc. 11. Was the corporation dissolved or liquidated after the decedent's death? 0 Yes 0 No If yes, provide a breakdown of distributions received by the estate, including dates and amounts received. 12. Did the corporation have an interest in other corporations or partnerships? 0 Yes 0 No If yes, report the necessary information on a separate sheet, including a Schedule C-1 or C-2 for each interest. A. Detailed calculations used in the valuation of the decedent's stock. B. Complete copies of financial statements or Federal Corporate Income Tax returns (Form 1120) for the year of death and 4 preceding years. C. If the corporation owned real estate, submit a list showing the complete address/es and estimated fair market value/s. If real estate appraisals have been secured, attach copies. D. List of principal stockholders at the date of death, number of shares held and their relationship to the decedent. E. List of officers, their salaries, bonuses and any other benefits received from the corporation. F. Statement of dividends paid each year. List those declared and unpaid. G. Any other information relating to the valuation of the decedent's stock. RCV-t506EX. (1.97) w.." . . - , , SCHEDULE C.2 PARTNERSHIP INFORMATION REPORT COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RE IDENT DECEDENT ESTATE OF l . fC"0\-" ~. 'N. of- Q If" ',,^ j FILE NUMBER ~/-OJ - ~t/I 2. 3. 4. 1. Name of Partnership Address City Federal Employer 1.0. Number Type of Business Decedent was a 0 General 0 Date Business Commenced Business Reporting Year State Zip Code Product/Service Umited partner. If decedent was a limited partner, provide initial investment $ 5. PERCENT OF PERCENT OF BALANCE OF PARTNER NAME INCOME OWNERSHIP CAPITAL ACCOUNT A. B. C. D. 6. Value of the decedent's interest $ 7. Was the Partnership indebted to the decedent? If yes, provide amount of indebtedness $ 8. Was there life insurance payable to the partnership upon the death of the decedent? 0 Yes 0 No If yes, Cash Surrender Value $ Net proceeds payable $ Owner of the policy DYes 0 No 9. Did the decedent sell or transfer an interest in this partnership within one year prior to death or within two years if the date of death was prior to 12-31-82? o Yes 0 No If yes, 0 Transfer 0 Sale Percentage transferred/sold Transferee or Purchaser Consideration $ Date Attach a separate sheet for additional transfers and/or sales. 10. Was there a written partnership agreement in effect at the time of the decedenfs death? If yes, provide a copy of the agreement. DYes 0 No 10. Was the decedent's partnership interest sold? If yes, provide a copy of the agreement of sale, etc. 11. Was the partnership dissolved or liquidated after the decedent's death? 0 Yes 0 No If yes, provide a breakdown of distributions received by the estate, including dates and amounts received. o Yes 0 No 12 Was the decedent related to any of the partners? DYes 0 No If yes, explain 13. Did the partnership have an interest in other corporations or partnerships? 0 Yes 0 No If yes, report the necessary information on a separate sheet, including a Schedule C-1 or C-2 for each interest A. Detailed calculations used in the valuation of the decedent's partnership interest. B. Complete copies of financial statements or Federal Partnership Income Tax returns (Form 1065) for the year of death and 4 preceding years. C. If the partnership owned real estate, submit a list showing the complete address/es and estimated fair market value/so If real estate appraisals have been secured, attach copies. D. Any other information relating to the valuation of the decedenrs partnership interest. R.EV-150~E~+(1-97) '*' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE D MORTGAGES & NOTES RECEIVABLE ESTATE OF \ Lc\ V0\,^ FILE NUMBER e~<~~ ~~OJ-al All property jointly-owned wit . ht of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. TOTAL (Also enter on line 4, Recapitulation) $ (II more space is needed, insert additional sheets 01 the same size) ~:~".,~' '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATEOF - J. ITEM NUMBER 1. 3 6 SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY C 1/ ...:7 ived by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. VALUE AT DATE DESCRIPTION OF DEATH ;... . OvYJe.. /9?t,S~;'-r1e) /qqj1 -lu;C( ~ IV ie r~ C04f d-.) chect; 1"\0. cue+ 0-.+ ttl\i.<J (V\oW 1'h,j11o,,~ ~ -B- ~ 75 Ol{p (, q I Ch r \ ; <:ole {),c( MCMe~~V\.J. A \-t. 0..--\ Al~~v'~ t ( Y10W VV'-4 --r ~V\.lC;) ~O()'1~/-<63~~"'J.. e..cv\;~\e ~A cJyecLI "'3 Qc ct. <1.-+ :l~ yY\ ~Q ~lc.. . -:JF63-02iQ;,3 N-ewu\ ~Ie ?~ ~ .us ()X). -, .J . oJ 000 . f J " / K'9.)~ 10 / Sr.9 70"dj ~%.~o TOTAL (Also enter on line 5, Recapitulation) $ Ct 1 13.IS (If more space is needed, insert additional sheets of the same size) REV-l509,EX. (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF duJ i r} .:D. If an asset was made joint within one year of the d 's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME RELATIONSHIP TO DECEDENT ADDRESS A. B. c. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. TOTAL (Also enter on line 6, Recapitulation) $ (If more space IS needed, insert additional sheets of the same size) REV-1510 EX. (1-97) SCHEDULE G /- INTER.VIVOS TRANSFERS & MISC. NON.PROBA TE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE 01 d {Jj ,n b. Nea r j r1j 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. FILE NUMBER ~I ~Od - obi t DESCRIPTION OF PROPERTY %OF ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE\ NUMBER 1. TOTAL (Also enter on line 7, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) ~EV-1511 F,X+ (12-99) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ~ .i-d w;n ..u ~ ITEM NUMBER A. B. 1. 2. 3. 4. 5. 6. 7. FILE NUMBER ~ I-O~ -r%1. ebts of decedent must be reported on Schedule 1. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: ~evJer Son ~ 6re deLa.tf ~~ V1C o( k.. )j '/ l-e r~~.. p~l VV11ChC/lC (C o . . ~oh ^ 6e!J. ~J Ie.. . J-t so.~ '1lora.jS"hoft e I N~wu,/!ePI1 ya.o e \ C '1-fe V1s.es C VVleals., LcJ s\ \"\ q') ADMINISTRATIVE COSTS: ft I fL Tvt Le J Personal Representative's Commissions ,If 1.13 ~.oo . ()O ~OO;OD ~1~, -13 . H; /v7JD,Dv o 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 Fees We; S Ie'" ~ "'!;6 0 (' 0 .., p. c. . 5/~ G 7 o Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State _ Zip Relationship of Claimant to Decedent Probate Fees () o Accountant's Fees Tax Return Preparer's Fees o TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) ~ 53 ~ SCHEDULE I COMMONWE~LTH OF PENNSYLVANIA DEBTS OF DECEDENT, INH~:~i~~~i6:2E~~~~RN MORTGAGE LIABILITIES, & LIENS ESTATE OF Ic/Wi/l~. tlea;;nj Include unreimbursed medical expenses. ITEM NUMBER 1. REV-'512 EX . {1-971 J- .3 1 - .::J {J 7 <6 ~ ,0 { 1 10- 13 I~ (5 If.o 11. IY /CJ DESCRIPTION 0(" V\ wo.. \ e SUPV' ? ;Jy V.( (3r...,bj t-(f i"-,, Iio"",p~ tV . ~ ho'le E yYl-'s 1JeY\ Y"\.=Keho..-b Qo... l ~~le t Vv\~J ~ ~ '(Y\O-~lQ~ LlbSbC. Q.o. . \; .j E' '0; 'ys-l : u e 1) i -,>eQ. sea S~D C - .. ,< .. . , , It.( e Vv\+n. a V1o..dhe~;L 1-\ ~bJ~ Dtr ~a.-to 10 JJ t:>e to:e.d e r-e VV1 e cL C tr\ t r C€"troJ VVleJ - ~ro(.'l C Q.,v- v. ~, e l YV\ A-J ~ "'j La. V'C CLd-~ (" (~vY\ {) ~ f f'\V' t C.ME lee vA') (<{ f'hOS~ hell'j 1- W -,..... ter ,Il< '( C DII ecto c (Y\~~A Adr5 ~Ieci;:.. c FILE NUMBER d /-0 J- - ot/( TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) AMOUNT 501, ftJ 567.60 6,)0,9.3 13', "7 It.67 50. 9~ V J,tL/6 C)&. i./5 c?~"1 I 10(". S1 II. ~i /5c1i' f 3~ I~ :So ,/7 <{S,al I ~~t{c *' "1 ~O,IO IOU, of ,:/eJ, S~ . (Jt) .rJO ~- C;'Ch~JVv/-e 7. - ~ . . Esta:te 1J J::dw\'nb.~\eQr'nj' d 1- OcJ - oc, / t d-I. EULCOV\ \ r7-~.J A-I~f T <:9-5. f)-etA(for l-e~ r/ I ~1~61J . 0 aD tI, c!) 700 ' 0-0 REV-1513 EX + (1-97) , SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF . ~ w If') ..0 . FILE NUMBER a-I-o RELATIONSHIP TO DECEDENT Do Not List Trustee(s) I AMOUNT OR SHARE OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) ;J.. Mcu. (; 0..- -::r ,2;', <\ k 011 ; t L J().(...~h +.. r S~ W . 8~ ~ ~ fn-; (\3 A ~)4t'w J'dle PO r}J 1 . Y\A- () 1 k j-:r. N e...Cl.< \ '^ j :':. t> '" l'O~ ~\'"eS1:bl.l r~ ~'C · ~\~ I\~to V'\ I ~ ,ip 0 17 -I )s ()1JD, 1. #" ;.~ (}7J1) . ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) -':"..,,'" . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Ed WI" b . Hea- This schedule is to be used for all si life, joint or. successive life estate and term certain calculations. For dates of death prior to 5-1-89, actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit. Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death on or after 5 -1-89. Indicate the type of instrument which created the future interest below and attach a copy to the tax retum. D Will D Intervivos Deed of Trust D Other I..IFEiESTITEfN:tERESTOALCOt.ATIQN' SCHEDULE K LIFE ESTATE, ANNUITY & TERM CERTAIN Check Box 4 on Rev.1500 Cover Sheet FILE NUMBER d-/- NAME(S) OF NEAREST AGE AT TERM OF YEARS LIFE ESTATE IS LIFE TENANTlS) DATE OF BIRTH DATE OF DEATH PAYABLE o Life or 0 Term of Years_ o Life or 0 Term of Years _ o Life or 0 Term of Years _ o Life or 0 Term of Years _ 1. Value of fund from which life estate is payable 2. Actuarial factor per appropriate table Interest table rate - D 3 1/2% D 6% D 10% D Variable Rate 3. Value of life estate (Line 1 multiplied by Line 2) $ % $ ........ ,....."...'i.".i'. ;t ...., ." .... ." ..... ..... . ...,.{ ...... ,.' NAME(S) OF NEAREST AGE AT TERM OF YEARS ANNUITANTlS) DATE OF BIRTH DATE OF DEATH ANNUITY IS PAYABLE o Life or 0 Term of Years _ o Life or 0 Term of Years _ o Life or 0 Term of Years _ o Life or 0 Term of Years _ 1. Value of fund from which annuity is payable $ 2. Check appropriate block below and enter corresponding (number) Frequency of payout - D Weekly (52) D Bi-weekly (26) D Monthly (12) D Quarterly (4) D Semi-annually (2) D Annually (1) D Other ( ) 3. Amount of payout per period $ 4. Aggregate annual payment, Line 2 multiplied by Line 3 5. Annuity Factor (see instructions) Interest table rate D 31/2% D 6% D 10% D Variable Rate % 6. Adjustment Factor (see instructions) 7. Value of annuity -If using 3 1/2%,6%, 10%, or if variable rate and period payout is at end of period, calculation is : Line 4 x Line 5 x Line 6 $ If using variable rate and period payout is at beginning of period, calculation is : (Line 4 x Line 5 x Line 6) + Line 3 $ NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on Schedules A through G of this tax return. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on Lines 13, 15, 16 and 17. (If more space is needed, insert additional sheets of the same size) . REV-16.4.4 EX + (3.8.4) INHERITANCE TAX SCHEDULE ilL" REMAINDER PREPAYMENT OR INVASION OF TRUST PRINCIPAL FILE NUMBER COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT I. Estate of II. (Last Name) (First Name) (Middle Initial) This schedule is appropriate only for estates of decedents dying on or before December 12, 1982. This schedule is to be used for all remainder returns when an election to prepay has been filed under the provisions of Section 714 of the Inheritance and Estate Tax Act of 1961 or to report the invasion of trust principal. Remainder Prepayment: A. Election to prepay filed with the Register of Wills on (attach copy of election) B. Name(s) of Life T enant(s) Date of Birth or Annuitant(s) (Date) Age on date of election Term of years income or annuity is payable C. Assets: Complete Schedule L- 1 1. Real Estate 2. Stocks and Bonds 3. Closely Held Stock/Partnership 4. Mortgages and Notes 5. Cash/Misc. Personal Property 6. Total from Schedule L- 1 D. Credits: Complete Schedule L-2 1. Unpaid liabilities 2. Unpaid Bequests 3. Value of Unincludable Assets 4. Total from Schedule L-2 $ $ $ $ $ $ $ $ $ III. E. Total value of trust assets (line C-6 minus line 0-4) F. Remainder factor (see Table I or Table II in Instruction Booklet) G. Taxable Remainder value (line E x line F) (Also enter on line 7, Reca itulation) Invasion of Corpus: A. Invasion of corpus $ $ s (Month, Day, Year) B. Name(s) of life Tenant(s) or Annuitant(s) Date of Birth Age on date corpus consumed Term of years income or annuity is payable C. Corpus consumed D. Remainder factor (see Table I or Table II in Instruction Booklet) E. Taxable value of corpus consumed (line C x line D) (Also enter on line 7, Recapitulation) $ S S REV-1.64!> EX+ (7-a. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT INHERITANCE TAX SCHEDULE L-l REMAINDER PREPAYMENT ELECTION -ASSETS- FILE NUMBER I. Estate of (Last Name) (First Name) II. Item No. Description A. Real Estate (please describe) Total value of real estate $ (include on Section II, Line C- 1 on Schedule L) B. Stocks and Bonds (please list) Total value of stocks and bonds $ (include on Section II, Line C-2 on Schedule l) C. Closely Held Stock/Partnership (attach Schedule C-1 and/or C-2) (please list) Total value of Closely Held/Partnership $ (include on Section II, Line C-3 on Schedule L) D. Mortgages and Notes (please list) Total value of Mortgages and Notes $ (include on Section II, Line C-4 on Schedule L) E. Cash and Miscellaneous Personal Property (please list) Total value of Cash/Misc. Pers. Property $ (include on Section II, Line C-5 on Schedule L) III. TOTAL (Also enter on Section II, Line C-6 on Schedule L) (If more space is needed, attach additional 8Y2 x 11 sheets.) (Middle Initial) Value s RfV-1646 EX'+ (3.84) . INHERITANCE TAX SCHEDULE L-2 REMAINDER PREPAYMENT ELECTION -CREDITS- COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT I. Estate of II. Item No. III. FILE NUMBER (Last Name) (First Name) Description A. Unpaid Liabilities Claimed against Original Estate, and payable from assets reported on Schedule L- 1 (please list) Total unpaid liabilities $ (include on Section II, Line 0-1 on Schedule L) B. Unpaid Bequests payable from assets reported on Schedule L-1 (please list) Total unpaid bequests $ (include on Section II, Line 0-2 on Schedule L) C. Value of assets reported on Schedule L-1 (other than unpaid bequests listed under "B" above) that are not included for tax purposes or that do not form a part of the trust. Computation as follows: Total unincludable assets $ (include on Section II, Line 0-3 on Schedule L) TOTAL (Also enter on Section II, Line 0-4 on Schedule L) (If more space is needed, attach additional 8Y2 x 11 sheets.) (Middle Initial) Amount $ -:"'''."., '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE M FUTURE INTEREST COMPROMISE ESTATE OF Check Box 4a on Rev.1500 Cover Sheet FILE NUMBER This schedule is appropriate only for estates of decedents dying after December 12,1982. This schedule is to be used for all future interests where the rate of tax which will be applicable when the future interest vests in possession and enjoyment cannot be established with certainty. Indicate below the type of instrument which created the future interest and attach a copy to the tax return. o Will 0 Trust 0 Other I. Beneficiaries NAME OF AGE TO BENEFICIARY RELATIONSHIP DATE OF BIRTH NEAREST BIRTHDAY 1. 2. 3. 4. 5. II. For decedents dying on or after July 1, 1994, if a surviving spouse exercised or intends to exercise a right of withdrawal within 9 months of the decedent's death, check the appropriate block and attach a copy of the document in which the surviving spouse exercises such withdrawal right. o Unlimited right of withdrawal o Limited right of withdrawal III. Explanation of Compromise Offer: IV. Summary of Compromise Offer: 1. Amount of Future Interest $ 2. Value of Line 1 exempt from tax as amount passing to charities, etc. (also include as part of total shown on Line 13 of Cover Sheet) $ 3. Value of Line 1 passing to spouse at appropriate tax rate Check One 06%, 03%, 00% (also include as part of total shown on Line 15 of Cover Sheet) $ 4. Value of Line 1 Taxable at 6% Rate (also include as part of total shown on Line 16 of Cover Sheet) $ 5. Value of Line 1 Taxable at 15% Rate (also include as part of total shown on Line 17 of Cover Sheet) $ 6. Total value of Future Interest (sum of Lines 2 thru 5 must equal Line1) $ (If more space is needed, insert additional sheets of the same size) REV.1648 {X (1.921. . . .. . '"' 'I: COMMONWEALTH OF PENNSYLANIA INHERITANCE TAX DIVISION ESTATE OF SCHEDULE N SPOUSAL POVERTY CREDIT AVAILABLE FOR DECEDENTS DYING AFTER 12/31/91) PART I - CALCULATION OF GROSS ESTATE I FILE NUMBER This schedule must be completed and filed if you checked the spousal poverty credit box on the cover sheet. 1. Taxable Assets total from line 8 (cover sheet) .................................................................... 1. 2. Insurance Proceeds on life of Decedent ............................................................................ 2. 3. Retirement Benefits..... ...... ....... ............ ......................... ..... ....................... ............ .......... 3. 4. Joint Assets with Spouse................................................................................................. 4. 5. PA Lollery Winnings..................... .......... ..................... ........... ....... .............. ......... ......... 5. 6d. 6a. Other Nontaxable Assets: list (Allach schedule if necessary).. 6a. 6b. 6c. 6. SUBTOTAL (lines 6a, b, c, d) ......................................................................................... 6. 7. Total Gross Assets (Add lines 1 thru 6) ............................................................................. 7. 8. Total Actual liabilities .................................................................................................... 8. 9. Net Value of Estate (Subtract line 8 from line 7)................................................................ 9. If line 9 is greater than $200,000 - STOP. The estate;s not eligible to claim the credit. If not, continue to Part II. PART II - CALCULATION OF JOINT EXEMPTION INCOME - (Attach copies of Federal Individual Income Tax Returns for decedent and spouse. ) Income: 1. T AX YEAR: 19 2. TAX YEAR: 19 3. T AX YEAR: 19 a. Spouse..................... . 10. 2a. 30. b. Decedent ................... lb. 2b. 3b. c. Joint.......................... Ie. 2e. 3c. d. Tax Exempt Income..... ld. 2d. 3d. e. Other Income not listed above ........... Ie. 2e. 3e. f. Total. ......................... If. 2f. 3f. 4. Average Joint Exemption Income Calculation 4a. Add Joint Exemption Income from above: (If) + (2f) + (3f) = (T 3) 4b. Average Joint Exemption Income ..................................................................................... = If line 4(b) is greater than $40,000 - STOP. The estate is not eligible to claim the credit. If not, continue to Part III. PART III - CALCULATION OF SPOUSAL POVERTY CREDIT FOR RESIDENT AND NONRESIDENT ESTATES 1. Insert amount of taxable transfers to spouse or S 100,000, whichever is less.......................... 1. 2. Multiply by credit percentage (see instructions) .................................................................. 2. 3. This is the amount of the Resident Spousal Poverty Credit. Include this figure in the calculation of total credits on line 18 of the cover sheet. ............................................ 3. 4. For Nonresidents, enter the ratio of the decedent's gross estate in PA to the value of the decedent's gross estate....................................................... ........................................... 4. 5. Multiply line 3 by line 4 and enter the total here. This is the amount of the Nonresident Spousal Poverty Credit. Include this figure in the calculation of total credits on line 18 of the cover sheet. 5. -....... REV.1649 Ej<';t-97) . \ SCHEDULE 0 ELECTION UNDER SEC. 9113(A) SPOUSAL DISTRIBUTIONS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Do not complete this schedule unless the estate is making the election to tax assets under Section 9113(A) of the Inheritance & Estate Tax Act. If the election applies to more than one trust or similar arrangement, a separate form must be filed for each trust. This election applies to the Trust (marital, residual A, B, By-pass, Unified Credit, etc.). If a trust or similar arrangement meets the requirements of Section 9113(A), and: a. The trust or similar arrangement is listed on Schedule 0, and b. The value of the trust or similar arrangement is entered in whole or in part as an asset on Schedule 0, then the transferor's personal representative may specifically identify the trust (all or a fractional portion or percentage) to be included in the election to have such trust or similar property treated as a taxable transfer in this estate. If less than the entire value of the trust or similar property is included as a taxable transfer on Schedule 0, the personal representative shall be considered to have made the election only as to a fraction of the trust or similar arrangement. The numerator of this fraction is equal to the amount of the trust or similar arrangement included as a taxable asset on Schedule O. The denominator is equal to the total value of the trust or similar arrangement. PART A: Enter the description and value of all interests, both taxable and non-taxable, regardless of location, which pass to the decedent's survivin souse under a Section 9113 A trust or similar arran ement. DESCRIPTION VALUE Part A Total $ PART B: Enter the descri tion and value of all interests included in Part A for which the Section 9113 A election to tax is bein made. DESCRIPTION VALUE Part B Total (If more space is needed, insert additional sheets of the same size) REV-1503 Ex. (1-97) SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER eJl-lJd. - Obit ESTATE QJ ..E: c\ <.-v" '" ~, )-\ e. a.. " \ ~ All property jointly-owned with right of survivorship m~ disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) w CJ a: a: r- f-- a.. Cl (/) --. I-- Claw,", -z D-1--i......JNM::J a:-.Jf'-oa .a...I--I- ~ (/) > za: . ~ a: ::J w -, Z (') co r-th c::JIR .Ln C'-Ig; 'tR;; M <:> 1'- Q::lt1 . ....S; ~~ Q '" ~~ ~'" ,,~ c c c c ::::::....r-. VJ ~ ~- '::>0 tv) (V) \ r::: ~ r N ~ ~ .~ ~ ~ ~ o ~ _ ) ~ . .~ gfp:; ~ r/) . t:: . :::E~~ e ~ 01);;::: IC . c:l ~ .~ 00 d) ~MZ , , if_*l J~.l VJ - ~ ~ ~ BUREAU OF INDIVIDUAL INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE 03-19-2007 ESTATE OF NEARING EDWIN D DATE OF DEATH 07-02-2002 FILE NUMBER 21 02- 0618 COUNTY CUMBERLAND ACN 101 APPEAL DATE: 05-18-2007 ( See reverse side under Objections) Amount Remittedl I 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 +-- ------------------------------------------------------------------------.------------------ REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF NEARING EDWIN D FILE NO. 21 02-0618 ACN 101 DATE 03-19-2007 2DG71'\!'8 t G II: 32 ORFl!;", MARCIA J Slt'N'KOVITZ 28 W BIG SPRING AVE NEWVILLE PA 17241 . REV-1547 EX AFP (06-05) T AX RETURN WAS: (X) ACCEPTED AS F I LED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. 10. 11. 12. 13. 14. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) Debts/Mortgage Liabilities/Liens (Schedule I) Total Deductions Net Value of Tax Return 0) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 66,173.00 .00 .00 (8) (9) (0) 12,388.00 7.879.00 (1) (2) (3) (4) Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) Net Value of Estate Subject to Tax NOTE: To insure proper credit to your account. submit the upper portion of this form with your tax payment. 66,173.00 20.~l>7 no 45,906.00 46,000.00 94.00- NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate OS) .00 X 00 .00 16. Amount of Line 14 taxable at Lineal/Class A rate (6) .00 X 045 = .00 17. Amount of Line 14 at Sibling rate (7) .00 X 12 = .00 18. Amount of Line 14 taxable at Collateral/Class B rate (8) .00 X 15 = .00 19. Principal Tax Due (9)= .00 TAX CREDITS: PAyMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 03-01-2004 CD003626 .00 158.95 TOTAL TAX CREDIT 158.95 BALANCE OF TAX DUE 158.95CR INTEREST AND PEN. .00 TOTAL DUE 158.95CR * IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS tHAN $1, NO PAYMENT IS REQUIRED. J IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR). YOU MAY BE DU A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ..., -_..--\ ,- CO.MMONWEAL TN OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 ,. " ^!, - V - 7 ..'1 t I"J' , I . . =~ :'.~ REV-1607 EX AFP (03-05) (' DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 04-23-2007 NEARING 07-02-2002 21 02-0618 CUMBERLAND 101 EDWIN D j"",' :' I " MARCIA J SINKOVITZ 28 W BIG SPRING AVE NEWVILLE PA 17241 Amount Remitted 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, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE ..... RETAIN LOWER PORTION FOR YOUR RECORDS ~ --------------------------------------------------------------------------- REV-1607 EX AFP (03-05) *** INHERITANCE TAX STATEMENT OF ACCOUNT *** ESTATE OF NEARING EDWIN D FILE NO. 21 02- 0618 ACN 101 DATE 04-23-2007 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 PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 03-12-2007 PRINCIPAL TAX DUE: .00 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 II IF PAID AFTER THIS DATE. SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT 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. ) ~~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280&01 HARRISBURG PA 17128-0&01 COMMONWEALtH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REV-l&07 EX AFP (03-05) I:: : , , DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 04-23-2007 NEARING 07-02-2002 21 02-0618 CUMBERLAND 02152724 EDWIN D MATTHEW A SINKOvITZ 38 BIG SPRING AVE NEWVILLE PA 17241 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insu~e p~ope~ c~edit to you~ account, submit the uppe~ po~tion of this fo~m with you~ tax payment. CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR RECORDS +- --------------------------------------------------------------------------- REV-1607 EX AFP (03-05) *** INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF NEARING EDWIN D FILE NO. 21 02-0618 ACN 02152724 DATE 04 -23-2007 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 PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 02-20-2004 PRINCIPAL TAX DUE: 152.11 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 03-01-2004 CD003626 6.71- 158.95 TOTAL TAX CREDIT 152.24 BALANCE OF TAX DUE .13CR INTEREST AND PEN. .00 TOTAL DUE .13CR l! IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT 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. ) \}J1