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Home My WebLink About06-30-1015056051058 ~'~ ~~ ~ (~) o~nr~r~c, tam oaMtY,_, w- of t~weaae ~ tbde 11ber Fie Nte~bsr t~e~uoflndMdliiiTioes ~ TAX RETt1RN pow ~~ oaE~~ ~ 0 C~ 0 ~~~ ------ ~~ 1sg-o~-~7s o~rolr~~s Deasderrt`s t.sst Name SuMix R9TZ (~ ~-qj ~' ~ t3~oetse*a. In~orntaUon Below Spouse's last Name Std~c Spouse's Sodat Y i~rrtbsr Flu. ~ ~oi~eurTig t~-~l.s e~iv ~~ 091C~9V1922 Deoederd's First lame MI LILLIAN B Spouse's First Name MI nMS aeruaM wsr ae nis wIouPUG-~ wmi n~ REGISTER OF W~.LS ~ ~ 1.Oriyinal Rslurrt 2 StyppkmeMai Raiiart 3. Remainder tieWrlt (dale d dseM~ prior b 12-t3~2) 4. l.irrtited Fatale 4a. Ftdtse kpereet Cattppntes (dais of 5. Federal Fatale Tact t~sttxrt R,egtrir+ed death strier 12-12-82) 6. Ueoederrt Died Testate T. Cleoederrt ~Aaktlaited a t.itrirte Trust 8. Tout Number of Sale Deposit ( ~y d M!r) (Attach Copy of Tn~st) 9. Propefls Received 10. Prywriy Credit (dills Of death 11. Elediort b tarn tinder Sea 9113(A) batweert 121-tit and 1-1-85) (Ati~dt 9ch. D) 7118 tilECTgII t ~ A!L 1~ iWme TA~If lMl~tlI1NQ'h'lON tillillNB tiE ~' Ppxrttwer SALLY J. WINDER Fiml Marne ( AppGcabMa __ _-- _. REti1Si'ER OF IIIIILts tISE ONLY First line of C~3 C r~ '~' a 221 DC)U~.ING G~-P RD ~ ~... Second line al`address ~ ~~ ~ ~ ~.x ~ ~~ c~~'"` P.O. BOX 341 ~~ ~,.. ` ; City or Podt 4itioe Stale Z~ Cods _ ~~ -~~' - ~ i 9 ^"'~'» ~ "'` NEWVILLE PA 17241 `~ ~ ~ r ~-' C7 ^,~ Coneeponderrt'fs a~ddpeN. ,. i ^ t~ ~ t~ l ~irlawle stli~rW~ad riN wturrt, inr~r~0soooa+p~tn~ saltedttieiear+~l ... eM b Ot! bevt d~l'I~Mtpwirf~e arMd beNeir, ~: motet p~enraawrtlten ~ persoretl ra+p~aeeeillve k basalt OR ell It le . eorA w R of wt+iih pulperK has antr lmr`awhdye. ~ y ~ I V ~~ ~~ II ~~ t 7 ~ ~ f gIONA ATNE QATE ~~ ~~ ~~ ~~~~ ~ ~ ~ ~~~~I Shia 1 15056051058 15056051058 J 25056052059 RE1f-1:00 EX DeosdenYs Sold 3ea~ljr HNnnber LILLIAN B ROTZ 199-07-567'9 ,~,~ t~ RECAPITt'JL11TiON 1. Red ee~e(Schedule A) ............................................. 1. 2. Sboicks and i~orrds (Stie B) . . ..................................... 2. 3. Closely Held Corporafjdn. Partriership or Sole-~4 (ScheduMa C) ..... 3. 4. Mortgages b Noiss`Reoehrable (Sc~~edule D) .... - • - - - • . . . ................ 4. 5. Cash, Bank Dsposifs b MisoeNaneous Personal Property (Sdtsdule E) ........ 5. 1,500.00 8. Jointly Owned Property tSchsdufe ~ S~eparale BifMMnQ Requested ....... 8. 4,550.55 T. tuber-Vfirvs Tea b Misosremeous Non-Probate Properly (Sct~edtaie G) 8~ ........ 7. 8. Tio~td tir+oeei Assets Lines 1 n ......................... . .......... 8. 6,460,85 9. Furrerai Expenses b Adrrard~ad-re Costs (Schsdute H) ..................... 9. 10,064.61 10. Debts d [~cederrt, MortDage 1., b Liens (Schedde I) . . .............. 10. 911.36 11. Total Deductions (~ Lines 9 b 10) ....... . . . ........ . . . .............. 11. 14,575.8'T 12. Nst Vdus o[ Este (Line 8 minus Line 11) . . ............................ 12_ -4,925.42 13. C2sa~bis and Gotiemmenlal BeKF~/Sec 9113 Tn~sts for wtriCFt an eledbn b tax tree not been trade (Schedule J) .................. . ..... 13. 14. Net Vlslus 3ubjsct b Tax (Line 12 minus LNte 13) ........................ 14. TAX ©OMPI)TATiON - iiirE t11~7'RUCTIONS FOR APPLICABLE RATES 15. Amourrt of Lie 14 ta~oebie at the spousat tau nws, or tra~as under Sec. 9116 16_ Amount cif ibis 14 teucable at lineal rate X .0 _ 18. 1T. Arrwurtt of Line 14 taxetife at aidiirg race X .12 1T. 18. Amount df Line 14 taxable at ooMeterat tabs X .15 18. 19. TAX DUE ......................................................... 19. 20. F9.L MI TtlE OVAL ~ YOU ARE REtZUEBTiNti A R OF AN OVERP9AYMENT 0.00 15056052059 S[ds 2 15056052059 RE1~1~00 EX l+rpp 3 /tom'! ~~AI ' ' I==: ~ 1~lsMn6rr 0'PS 80CIAt MUIi11i~R ULLIAN B ROTZ 199-07-6679 101 hK3RTH PRINCE STREET APT 208 t~rv SHlPPElVSBURG stA~E PA zr~ 17257 Tax Paylmetr~#s a~+d Cired#t~s: 1. Tax Due (Page 2 Lins 1~ 2 Cr~edfislPsyrrrerrts A Spousal PbMeiiy Cne~ B. Prior Payments C. ois'oourtt 3. 1rIPelrahy if appfirwble D. hrberest E, P~lty (3) (4) (~ (~y (~) (i) Total Gedlls (A + B + C) (2) _ Tail IMerssi+PeucaMy (D + E ) 4. if L'me 7 is 9 than Lhe 1 + tine S, enter ilre ~ This is the OVERRAYiIENT. RN b o~tl on Pape 2, idea 20 b a refund. 5. ff tine 1 + tine 3 is greyer Ursn Line 7, enMr fhe dii(ierenoe. This is the TAX DUE. A Enfer the interest on fhe fax due. B. Enter fire total of Line 5 + 5A. This is the BAtANC;E DUE if8 Check Payer it,: i~ECl'fi~t OF iA~.Sy A~iE1VT 0.00 0.~ 0.00. PLEABE A-N~~MMER THE FC~LI.OMANG QUESTIO~N8 BY PL.A~GN`t!G Aw "X" IN T'!~ APPROPRIATE Bt.4CKS 1. Did deoederd nraioe a irarwibr and: lfae No a r~ fhe use a ixorrre of fhe properly ~ ...................................................................................... ^ b. t+eflein gte- rigtrE fa deeigrreie who shall use fhe property tramerred a tts income :........................................... ^ d. receive ~ or .......................................................................................................................... ^ prteriiee for ie of Pte. bene~ or car+eT ...................................................................... ^ 2. 9 deeeb occurred aibr Deoerrlberr 12.1987, did decederd transfer property w8hin erne yeex t~f dew ~d~? .............................................................................................................. ^ 3. Did deoederrt aw<r +en "h frost tor• or payable upon death bank acoaurt ar se~axily at his or'her death? .............. ^ 4. Did decedent own an Idtrel ~ Ar~oocmt, anr~y, or other non-pKObeie property which c~orerins a beneficiary designadon? ........................................................................................................................ ^ ~ TFiE ANNMMER??0 ANY OF T~ ~ QU °' ~ YES, YpU Ct1~ETE N~'~tA.E G AND Fr.E R A~ ' OF Tt = RETURN. For dates of death an or aver July 1, t994 and before Jar 1,1995, the tax role imposed on the net valriie of trar~ers b or for be use of the surviving spouse is ttrree (3) Percent (72 P.~. §OttB (aj (1.1 j {i)]. For dales of death on or after 1,1995, the tax foie irrrposed an the net value of transfers b or for be use of the surviving spouse is ~ (O) Peroerrt [72 P.S. §®116 (a) (1.1) ~. 'flrs sttirirtie y~,p~,pp~ a ttanstier b a g spouse from tax, and'the rsquinemerrts for one of assets and fi'8ng a Ync r~eiurn are s~N apple eMen rt'the w spcxrse ~ the oNy a For ds~ of dea6r on or aAer July 1, ZOQO: The talc rate irrrposed on be net value of fiarwfers from a deceased child tw~erd,--one Years of age or Yaeger ai deatl~ b or for the use of a ~fi~rai panarrt, ~r perer~ or a sleppanerd of Ere chid ~ aeru (0) perroent [12 P.S. §9116(a}(1.2)]. The boc race arrpoeed on the net vahre of trar~ers b a for the use of be decedent's latest berne6aartes is four and one-Imf!' (4.5) Peroent, except as nobdi in 72 P.S. §9t16(t.2) [12 P.S. ~i1t6(ax1)]. The tax rye Wrtpossd on Ute net value of b orb the use of the decedent's sibfings is twt~itae (12) t j72 P.S. §9116(ax1.3)j. Awing is defined, under Sediort 9102, ~ an irtdtEidtrai wtq has at l~ one petard in oon>tttort wi6t fire decedettl; whether bi- bbod or adoption. _~.-.~ ~~ ~-, c1 2~ ~,,"~+ ~~+' ~~ ~~ ~ ~ ~• ~-r- p'0'~'~ 0~ ~ l Vpst, ~'tZ4"C~ ~~~ V+'~` ~ ~ 1~ 1,5A{~•~ ~~ ~~ RE1~1308 DCt x.06) ~oNwrce~N.~t+oF nwuw- ~~ ,~LY' ~~ E>aT11YE OF -- - FN.E Mu~s~ LILL~AN B. RflTZ ~~ 1f as ~eeetrMS wM~,~nt r~ ane yeercf Ur M ~ of ~~, It be wpoeMd e• Q SURVIYNrG JONiiT TENANT(~8j MANE I~Dt~ESS ii€U-T101~IBI~P TO OEC.I~tT A. GLORUI J. GAS3iDY 100fa0 MCCRF.~IDY RL~, PP11 T257 ~ DV+UGHT~R B. C. .IE~Mt1LY•I PROPERTY: (if +eone N~ N neu~ed, UaMt addi~onrt eh~ of the eime) PENNSYLVANIA INHERITANCE TAX INFORMATION NOTICE BUREAU OF INDIYIDUA~ TAXES AND F I L E NO. 21 0 9- 0 6 4 2 Po soot zaosol TAXPAYER RESPONSE ACN 09163768 NARRISBUR6 PA 17128-9601 DATE 10-07-2009 REV-)Sf3 EX AFP (O1-N) GLORIA J CASSIDY 10050 MCCREADY RD SWIPPENSBURG PA 17257 EST. OF LILLIAN B ROTZ SSN 199-07-5679 DATE OF DEATH o7-of-2ao9 COUNTY CUMBERLAND REMIT PAYMENT AND FORMS T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 TYPE OF ACCQUNT SAVINGS ® CHECKING TRUST CERTIF. ORRSTOWN BANK provided the Departaent with the infonatien below. which has been used fn calculating tM potential tax due. Records indicate that at the death of .the above-naRasd dpeadent, you were a ioint owneNbenafieiary of this account. If You feel the intonation is incorrect: please obtain written correction fraR the financial institution. attach a copy to this ton and return it to the above address. This account is taxable in accordance with the Inheritance Tax laws of the Coaaonwealth of Pennsylvania. Please call (T1T) 7BT-8327 with questions. COMPLETE PART 1 BELOW * SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 634!!40 Account Balance Percent Taxable Aaount Subject to Tax Tax Rate Potential Tax Du• Date 01-30-2001 Established ~ 9,100.91 X 5a.ooo ~ 4,550..46 X .15 ~ 682.57 To ensure prayer credit to the account, two' copies of this notice oust accoapsr~ payMant to the. Resister of Wills. Make check peo-sble to "Rapistar of Wills, Asant". NOrtE) If tax payaents are ^ede within three aoelths of the deesdant's date of death, deduct a 5 percent discount on the tax due. Any Inharitanc~ Tax due will bacoao delinquent nine aonths of#ar the date of death. P©T TA7CI'/l1,'~` ~ KC~1""~~1~ii '" A. ~ The above intonation and tax due is correct. Re~Rit payaant to the Resistor of Wills with two copies of this notice to obtain CHECK a discount or avoid interest, or check box "A" and return this notice to the Repistar of Wills and an official assessaent will be issued by the PA Departaant of Revenw. ONE BLOCK B. The above asset has boon or will ba reported and tax paid with the Pennsylvania Inheritance Tax return ONL Y to be filed by the estate representative. C. ~ Tha above info ion is incorre t and/or debts and deducti~s ware paid. Coaplate PART '2 and/or PART 3~ below. PART If indicating a different tax rate, please state a relationship to decedent: TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Aaount Subject to Tax 5. Debts and Deductions 6. Aaount Taxable 7. Tax Rate S. Tax Due PART DATE PAID PAYEE DESCRIPTION AMOUNT PAID OF TAX ON JOINT/TRUST ACCOUNTS 1 2 ~ 3 X 4 5 - 6 $ 7 X 8 DEBTS AND DEDUCTIONS Under penalties of perjury, I declare that the facts I have reported above aro true, correct and cotapleto to the best of ey knowledge and belief. HOME C ) C ~ WOitK C ] TeYPevER SIGNAT T L PW N R - A TDTAL CEnter on Lin• 5 of Tax Cowputation) FIE1F-1511 d(+ (12-~ QVL~ M co~~~n~ of eew~nwwu- SAL EX1~IS & AD~AIINVfST1~ATNE t~051'S GO'i~fi. V~' tJL.L.LA-N B. ROTZ 21-09-0642 OMile of deoede~t wwt De np~d en S~ciiedii L __ ~ RM~ERAL ~tP@1~18ES: 1' F06ELSlt'~l0~t 8R FUNERAL HONE, FUNERAL. ACCOl1NT MONCUL CEMEIERIf, t~RAVE OPEI~NNG GRACE UNfTED CHURCH OF t~iRIST, F~I~P FOLlOYMING FUNE~'AL B. ADMNNB'FRATNE C06T5: !. Pe~reonet Rs~e~eaiwwe's CoaNninfo~r i~leMM d Prnomt Rspwse~iw(s} Soot SsarAgt Nunber(s~1 NunDer d Pe~saMi iieprssei~s) 9lreetAd~i+eee . StMe llfee~(e} Qonpieibn Paid: 2. 1ldoms~- Fees 3. fa~'rf- E~ae~nplion: (if deoed~iElt sdbas is not the came as ddmar5's, aii~oh ear~NNafas} Cieinrrk SiYsN Addnees ~ . Stile Re~iomidp d E~einsnt b Oecade<t 4. PmAab Fees 8. AoooendnNs Fees 6. Ax i~De4rn Pnepe~s Fees 7. ~P _2!P TOt'A1. (ANo ear an Nr~s 9, Rece~Nul~lion) ~ ; rn mope epaee is needed, irrafc addNiotrl en.Na d in. aama eiee} 8,800.8a 450,00' 126.80 800.00 87.E ao,o64.6a REV-1512 pC+ (12-08) ' Hof D~~i ~~wnr~en~w MOR"~ LIAl~itTtl~i ~ t,i STATE t~ ~`' ULLIAN B. ROTZ 21-~0~~2 . . ~t iMNe Mair~~f•Mr frig Ir iIMM tlrt tai ~rM aR tM ili! ~ r~ - ---------- 1• P~1F~.EC, t1Tll.ilY A('.000NT 52.66 ' " x.00 2 rE PRELIM , MdSURl1t~ AE 3. P~1 N~ITt01+lA1 INSURANCE. CAR INSUtiIINt.E 50.00 4. COiACA~'1', CASE SERVKrE ACCOUNT 21.22 5. EPISCOPAL SQUARE APARtl-6:NTS, RENT DUE 447.00 6. ADYANTA RX, PATION INDICATION ACOOIMiT 22.20 7. PENELEC, F'9lAi. 6~.L 26.26 8. EtrBARQ, PHONE ACCOUI~IT DUE 36.22 9. ~ WEST SHORE EMS, AINULANCE Oll't~TANDN+lt3 ACCOUNT , 180.78 'T+0-fAt (IY~o ~ on Liih~ i0, Rrecaplluwtion) ~; 911.E If more ~psoe is need, Inert ~ of u+e eamr Vie.