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HomeMy WebLinkAbout04-0671MARTSON DEARDORFF WILLIAMS & OTTO TEN EAST HIGH STREET CARLISLE, PENNSYLVANIA 17013 TELEPHONE (717) 243-334I FACSIMILE (717) 243-1850 INTERNET www.mdwo.com July 16, 2004 ATTORNEYS & COUNSELLORS AT LAW WILLIAM F. MARTSON JOHN B. FOWLER III EDWARD L. SCHORPP DANIEL K. DEARDORFF THOMAS J. WILLIAMS* IVO V. OTto III GEORGE B. FALLER JR.* CARL C. RiSCH DAVID A. I~ITZSIMONS DAVID R. GALLOWAY ANTHONY W. LUCIDO CHRISTOPHER E. RICE HAND DELIVERED Office of Register of Wi lis Cumberland County Courthouse Carlisle, PA 17013 Estate of Elizabeth R. Groce SSN: 210-26-7309 Date of Death: April 23, 2004 Dear Clerk: Enclosed with this letter is check number 1279 in the amount of $1,500.00 representing payment of Pennsylvania Inheritance Tax in the above-referenced estate. Will you please issue the appropriate receipt and forward it to me at the above address. I thank you in advance for your prompt attention to this matter. Very truly yours, ~;. 7 MARTSON DEARDORFF WILLIAMS & OTTO Carl C. Risch ; ~ CCR/vlo Enclosure F \FILES~DATAFILE~ES IATES/60414 r ow iht xpayment INFORMATION ADVICE ADVOCACY sm COMMONWEALTH OF PENNSYLVANIA DEPARTMENTOFREVENUE BUREAU OFINDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17328-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11 96) NO. CD 004168 RISCH CARL C 10 EAST HIGH STREET CARLISLE, PA 17013 ........ fold ESTATE INFORMATION: SSN: 210-26-7309 FILE NUMBER: 2104-0671 DECEDENT NAME: GROCE ELIZABETH R DATE OF PAYMENT: 07/16/2004 POSTMARK DATE: 07/1 6/2004 COUNTY: CUMBERLAND DATE OF DEATH: 04/23/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $1,500.00 REMARKS: TOTAL AMOUNT PAID: 91,500.00 SEAL CHECK# 1279 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS CeMMO.WEALT. O~PENNS~LV^.,A INHERITANCE TAX RETURN F'LEND""ER DEPARTMENT OF REVENUE o~.T 2~ RESIDENT DECEDENT 21 04 00671 HARRISBURG' PA 17128'0~J1 [ COUNTY CODE YEAR NUMBER DECE-DENT'S NAME (LAST, FIRST, AND MIDDLE INmAL) ~ SOCIAL SECURITY NUMBER i GROCE, ELIZABETH R. 2 i 0-26-7309 z~ ! DATE OF DEATH (MM-DD-YEAR) i DATE OF BIRTH (MM-DD-YEAR) ~3 THIS "ETBRN MUST BE ~iLED i~ DDPMCATE WITH THE ~ 04/23/2004 I 102/15/1915 , REGISTER OF WILLS Q (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST. FIRST AND MIDDLE INITIAL) [ SOCIAL ~URI~Y NuMB~ '~ 10.ginalReturn [] 2 Supplemental Return .~,~. [] 4. Limited Estate [] 4a' FuturelntereslC°mpr°mise (date °f death affer12-12~82) o ~ m [] 6 Decedent Died Testate (Attach copy [] 7. Decedent Maintained a Living Trust (Attach e. of Will) copy of Trust) < [] 9 Litigation Proceeds Received [] 10. Spousal Poverty Credit (date of death be[ween ] 3 RemamderReturn(dateofdeathpriorto12-13-82) [] 5 Federal Estate Tax Return Required 0 8. TotalNumberofSafeDepositBoxes [] 11.Election to tax under Sec 9113(A) (Attach Sch O) Carl C. Risch, Esquire Martson Deardorff Williams & Oreo i Ten East High Street ~ELEPHONENUMBER ! Carlisle, PA 17013 717/243-3341 1. Real Estate (Schedule A) (1) None (2) (3) (4) (5) (6) (7) None None None 1,420.00 57,813.01 None (9) 13,035.92 (10) (8) 59,233.01 (11) 13,035.92 (12) 46,197.09 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) [] Separate Billing Requested 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) 10. 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) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) 46,197.09 46,197.09 16. Amount of Line 14 taxable at lineal rate x .045 (16) 2,078.87 x .12 (17) x .15 (18) (19) 2,078.87 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: Carlisle STREET ADDRESS 421 North College Street !STATE PA iZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverly Credit B. Prior Payments C. Discount 3. Interest/Penafiy if applicable D. Intemst E. Penalty 1,500.00 78.95 Total Credits (A + B + C) (1) 2,078.87 Total Intarest/Penalty (D + E) (2) 1,578.95 (3) 0.00 4. If Line 2 is greater than Line I + Line 3, enter the difference. This is theOVERPAYMEN~ (4) Check box on Page 1 Line 20 to request a refund 5. If Line I + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE (5) 4 99.92 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is theBALANCE DUE (5B) 4 9 9.9 2 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ............................................................................. [] [] b. retain the right to designate who shall use the property transferred or its income; ................................ c. retain a revemionary interest; or ........................................................................................................... d. receive the promise for life of ether payments benefits or care? ........................................................... 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without rece v ng adequate cons derat on? ................................................................................................................. [] [] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ......... [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a benefic ary des gnat on? .......................................................................................................... [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjunL 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 preparer other than the personal representative is based on all information of which preparer has any knowled_g~. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS DATE Ri rd D. Groee 214 Cockley Drive OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS bATE SIGNATURE OF PREPARER O~HER TH~N R~PRESENYATIVE ADDRESS Ten East High Street Carlisle, PA 17013 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. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfem to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.1) (ii)]. The statutedoes 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. SCHEDULE E CASH, BANK DEPOSITS, & MISC. ~O.~o.~AL.. Or .E..SyLVAN,A PERSONAL PROPERTY INHERrTANCE TAX RETURN ESTATE OF GROCE, ELIZABETH R. FILE NUMBER ~ 21 - 04- 00671 include the proceeds of litigation and the date the proceeds were received by the estato. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER ! DESCRIPTION Proceeds from sale of household goods and personal property VALUE AT DATE OF DEATH 1,420.00 TOTAL (Also enter on Line 5, Recapitulation) 1,420.00 '~ SCHEDULE F COMMORW~LTN OE PE""SVLV^.~^ ' '""E"'T^"CE m RETURN JOINTLY-OWNED PROPERTY RESIDENT DECEDENT ESTATE GROCE, ELIZABETH R. i FILE NUMBER 21 - 04- 00671 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 A Richard D. Groce B Carol A. Nigro C Joan I. Rice ADDRESS 214 Cockley Drive Mechanicsburg, PA 17055 902 Chastian Road Seffner, FL 33584 5050 Waggoners Gap Road Landisburg, PA 17040 RELATIONSHIP TO DECEDENT Son Daughter Daughter JOINTLY OWNED PROPERTY: Dr:~CRIPT ON OFP~OPERTY -- ' O ITEM LETTER DATE Inc ude name of financa institution and bank account number DATE OF DEATH Yo O,F, DATE OF DEATH NUMBER FTOERNJA~TNTi! ~Io~i~TE or similar identifying number. Attach deed for jointly-held real VALUE OF ASSET I~'D"E~C~D~'S'S'Tirq.c~l DEcEVALUEIOFERESTDENT-S NT estate. , ' 1 A B,C T06/i0/~¢927I RJ~idenc; . sim;iJ ai 421 North Coiiege Streetl 1041000 .00: ! 25°/oi 26 ,000 .00 Carlisle, Cumberland County, PA, ' ! ParcelNo.06-20-1798-164. Actual sale price, see attached Settlement Statement 2 3 4 5 6 7 8 C C C A B C C i 09/01/1967 M&T Bank checking account #415790 10/23/2001 M&T Bank savings account #I 5004198248253 07/06/2000 M&T Bank CD #31003910916518 07/06/2000 M&T Bank CD #31003910916568 107/06/2000 M&T Bank CD #31003919016592 ~ 08/16/20001 M&T Bank CD #31003910976306 03/1994 2 $1,000 Series E Saving Bonds ! (see attached savings bond calcuator) 11,595.001 50%i 5,797.50 7,001.24[ 50% 3,500.62 13,126.61 ' 50%, 6,563.31 13,126.61 50%1 6,563.31 13,126.611 5o%1 6,563.31 2,472.321 50% 1,236.16 1,588.80i 50% 794.40 B 03/1994 2 $1,000 Series E Savings Bonds see attached savings bond calcuator) 1,588.80 50%i 794.40 TOTAL (Also enter on line 6, Recapitulation) 57,813.01 ,~ SCHEDtJLE H RJNB~L~S& COMMONWEAl. TH OF PENNSYLVANIA ESTATE OF GROCE, ELIZABETH R. ! FILE NUMBER 21 - 04 - 00671 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1 Ewing Brothers Funeral Home, Carlisle, PA 2 Carol A. Nigro, travel expenses to attend funeral 9,166.50 400.00 ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Secudty Number(s) / EIN Number of Personal Representative(s): Street Address City State ~ Zip Year(s) Commission paid Attorney's Fees Martson Deardorff Williams & Otto (estimated) Family Exemption: (If decedent's address is not the same as clairsant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent Probate Fees State -- Zip 3,200.00 Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs Certified mailing, Department of Public Welfare Register of Wills, filing fee, Inheritance Tax return 4.42 15.00 Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) 250.00 13,035.92 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF GROCE, ELIZABETH R. ! ~served for misceilaneous tiling fee~and ~xpenses FILE NUMBER 21 - 04- 00671 100.00 4 Removal of trash from property at 421 No. College Street 150.00 Page 2 of Schedule H REV-l$13 EX.* (9,,00) ~ SCHEDULE J COMMDNWmTH Or PENRSYLV^.~^ BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF GROCE, ELIZABETH R. NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY ][. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1 Richard D. Groce 214 Cockley Drive Mechanicsburg, PA 17055 2 Carol A. Nigro 902 Chastian Road Sneffner, FL 33584 3 Joan I Rice 5050 Waggoners Gap Road Landisburg, PA 17040 FILE NUMBER 21 ~ 04- 00671 RELATIONSHIP TO AMOUNT OR SHARE DECEDENT oD .or km'r,'..,t,,~ OF ESTATE Son 1/3 balance of joint assets after payment of estate expenses Daughter 1/3 balance of joint assets after payment of estate expenses Daughter 1/3 balance of joint assets after payment of estate expenses II. Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet !NON-TAXABLE DISTRIBUTIONS: ~ =A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART I1- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET LAST WILL AND TESTAMENT I, ELIZABETH R. GROCE, of the Borough of Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any and all former Wills or Codicils by me made. 1. I direct that all my just debts, funeral expenses, testamentary expenses and all inheritance taxes (whether such taxes may be payable by my estate or by any recipient of any property) shall ~::~be paid from my residuary estate as soon as practicable after my decease and as part of the ~L~administration of my estate. My Executor shall have no duty or obligation to obtain ~:z::1~:z:-~.~, reimbursement for any such tax so paid, even though on proceeds of insurance or other property '~not passing under this Will. 2. I give unto each of my eight (8) grandchildren the sum of Five Hundred Dollars ($500.00). In the event any of said grandchildren shall predecease me, I direct that his or her legacy shall be divided equally among his or her siblings. 3. All the rest, residue and remainder of my estate, both real and personal property, I give, devise and bequeath in equal shares unto my three children, CAROL A. NIGRO, RICHARD D. GROCE and JOAN I. RICE, absolutely. 4. I nominate, constitute and appoint my son, RICHARD D. GROCE, as Executor of my estate. In the event he shall be unable or unwilling to so act, then I nominate and appoint JOAN I. RICE to act in his place. 5. I direct that neither my Executor nor Executrix shall be required to file a bond to secure the Page 1 of 3 E.R.G. faithful performance of their duties in any jurisdiction. 6. I authorize and empower my Executor or Executrix, in thei~ sole and absolute discretion, to purchase or otherwise acquire and retain any investments of which I die seized or any real or personal property of any nature; to sell, lease, pledge, mortgage, transfer, exchange, dispose of or grant options in regard to any or all property of any kind forming a part of my estate for such terms and such prices as they may deem advisable; to borrow money for any purposes connected with the protection and preservation of my estate; to mortgage or pledge any real or personal property forming a part of my estate or to join in or secure the partition of same; to compromise any claims or demands of my estate against others or of others against my estate; to make distribution in kind and to cause any share to be composed of cash, property or undivided fractional shares in property different in kind from any other share; and to execute and deliver such instruments as may be necessary to carry out any of these powers. IN WITNESS WHEREOF I have hereunto set my hand and seal this /O¥~ day of ,~_~, 1992. SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, who at her request, have hereunto subscribed our names as witnesses thereto, in the presence of the said Testatrix and of each other, l/~/fi~ /~//~//d~/~F 6~.' Page 2 of 3 E.R.G. COMMONWEALTH OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) I, Elizabeth R. Groce, Testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. Elizal~th R. Groce Sworn or affmned to and acknowledged before me by ]Elizabeth R. Groce, the TestaLdx, this Notary Public COM2ViONWEALTH OF PENNSYLVANIA / I~fnbe~y E. W~ser, Notmy Pubic SS. Cadisle Bom Cumberland C,?nty J My Commission Ex,res Dec. 2:~ ~ 995 COUNTY OF CUMBERLAND 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 Elizabeth R. Groce, the Testatrix, sign and execute the instrument as her Last Will; that the Testatrix signed willingly and that the Testatrix executed it as her free and voluntary act for the purposes therein expressed; that each of us, in the hearing and sight of the Testatrix, signed the Will as witnesses; and that to the best of our knowledge the Testatrix was at that time 18 or more year~ of age, of sound mind and under no constraint or undue influence. . ~ a ~, / I Sworn or affmned to and subscribed before me this ,/~:~ ¢~ay of Notary'~Public Page 3 of 3 Notarial Seal ~mbedy E. Wiser, Notary Pubic Carlisle Bore, Cumberland My Commission Exp~ Dc--c 23 995 ^. Settlement Statement u.s. Delmdment of Housfn§ and U~n ~eel~m~t B. T~ ~ ~n O~ ~. ~ R~. ~l (~) 1. ~ Z ~F~ 3. ~v.U~ ~Nu~ 7.~ ~ ~mn~Nu~ 4. OVA ~ O~.l~. I ~-B~CK / ~ ~ F. NAME OF LENDER: ADORE.SS: Bantck, Clyde W. and Banick, Phyllis J. 2660 Walnu~ _n _~__~_ m Road, Carlisle, PA 17013 Grote, Richard D. arid Rice, Joan I. Nlgm, Cm'ol A. 5050 W~loners Gap Road, Land~buq], PA 17040 N/A G. PROPERTY ADDRESS: 42t N College St, Cadisle, PA t 70t3 Cadide BorouRh H. SETTLEMENT AC4~IT: PLACE OF SET[LE~ENT: . SETTLEMENT DATE: ~ ,J. m~UUARy OF BORROWER'S TRANSACTION: Robert R. BMck 36 South Hanover Street, Carlisle, PA 17013 100. GRO~q .~-.m~. OL~I; DUE FROM BORROWER 103. e,%~t chames to bom~.~ (ane 1400) 104. 107. Ceur~ 09/23/04to12/3t~1. i I0~. SUMMARY OF SELLER'S TRANSACTION: 400. GROS~ AMOUNT DUE TO ~;I/.F..R 104,000.00 t20. GROSS AMOUNT DUE FROM BORROWER 10%479.24 260. AMOUNTS PAID BY OR ON BEHALF OF BORROWER 201. Deposit or earnest money 10,000.00 203. F_xist~ ions) ~ sub~c~ ~ 503. 206. ,~6. 206. 506. 209. ,~. Adiusmm~ ~r ~ unpaid bt 213. 513. 214. 514. ZI5. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. TOTAL PAID BY/FOR BORROWER I 10,000.00 300. CASN AT SLrl'q'rFm:kq' FROM OR TO BORROWER 301. Gross ameent due from bmo,,~ ~m 1201 ~ 106479.24 302. Less amoefits ~fld by/fix bmrower ¢line 220) I 10~000.00 303. CASH FROM BORROWER [ 96~479.24 103.hz 692.12 110. 410. t11. 411. IIZ 412, 42~. GROSS AMOUNT DUE TO 8ELLE~ 104,795.74 500. REDUCI~ONS IN AMOUNT DUE TO SELLER 501. Excess Depmit (see Inslructlons) Sel~anmnl c~ lo sdla'(~ne 14(X)) F:~tbq kmn{s) ta~m~ sublect to Pa'~ ~4 Flint kkxtaaae Loan ~i.",.-- ~ l.~ rmpald by s~ler 10,000.00 1,971.39 520. TOTAL REDUCTION AMOUNT DUE SELLER 600. CASH AT SE'n'LEMENT TO OR FROM SELLER 11,g71.39 104,795.74 11,971.39 603. CASH TO SELLER 92,824.35 SETTLEMENT CHARGES 703. com~s~ ~id a Se~an~ 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 804, Cledil Remd 1~05. ~hod T~ rm.~ ~ 1101. $elgemer,¢ ~- clo~ fee ~Land~&Black~l,O,W&O 10100 1304. 04-06 sch Tm~ ~ to Darleae MWer, Tax Collector 699.03 1305. 1400. TOTAL 8ETr LEMENT CHARGES (eni~' ~n I~ 103, Sec~io~ J a~d ~2, ~-=c~. ~ 1,6~3.60: t,g7t.39 499 Mitchell Road, Millsboro, DE 19966 Mail Code 501-120 MDW&O Attorneys At Law 10 East High Street Carlisle, PA 17013 Phone (302) 934-2909 F mx (302) 934-2955 June 2, 2004 Re: Estate of Elizabeth R Groce Social SecuritF: 210-26-7309 Date of Death: April 23,2004 Dear Sir or Madam: Per your inquiry dated May 12, 2004, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: Type of Account Account Number Ownership (Names o~) Opening Date Balance on Date of Death Accrued Interest Total Certificate of Deposit 31003910916518 Elizabeth R Groce Joan I Rice 07/06/00 $12,871.83 $ 254.78 $13,126.61 Type of Account Account Number Ownership (Names oJ) Opening Date Balance on Date of Death Accrued Interest Total Certificate of Deposit 31003910916568 Elizabeth R Grace Richard D Grace 07/06/00 $12,871.83 $ 254. 78 $13,126.61 Type of Account Account Number Ownership (Names of) Opening Date Balance on Date of Death Accrued lnterest Total Type of Account Account Number Ownership (Names of) Opening Date Balance on Date of Death Acerued Interest Total Type of Account Account Number Ownership (Names of) Opening Date Balance on Date of Death Accrued Interest Total Type of Account Account Number Ownership (Names of) Opening Date Balance on Date of Death Accrued Interest Total Certificate of Deposit 31003910916592 Elizabeth R Groce Carol A Nigro 07/06/00 $12,871.83 $ 254.78 $13,12661 Certificate of Deposit 31003910976306 Elizabeth R Groce Joan I Rice 08/16/00 $2,442.59 $ 29. 73 $2,472.32 Checking Account 415790 Elizabeth R Grace Joan 1 Rice 09/01/67 $11,591.11 $ 3.89 $11,595.00 Savings Account 15004198248253 Elizabeth R Grace Joan I Rice 10/23/01 $7,001.13 $ .Il $7,001.24 Savings Bond Calculator Page 1 of 1 Series lEE Bonds # Bonds Total Price 2 $1,000.00 Serial Number Issue Date Series M61921583EE 03/1994 EE M61921578EE 03/1994 EE Denomination $14,000 'J I Serial Number Issue Date I Total Interest Total Value $588.80 $1,588.80 Issue Interest Dehorn Price Interest Value Rate $1,000 $500.00 $294.40 $794.40 2.38% 1,000 500.00 294.40 794.40 2.38% YTD In~ $20.1 Next Final Accrual Maturit3 09/2004 03/202~ 09/2004 03/202~ 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 ~* ~ ~' V http://wwws.publicdebt.treas.gov/BC/SBCPrice 5/12/2004 Savings Bond Calculator Page 1 of 1 105/2004 Series lEE Bonds # Bonds Total Price 2 $1,000.00 Serial Number Issue Date Series M61921591EE 03/1994 EE M61921589EE 03/1994 EE Denomination Serial Number Totallnterest Total Value $588.80 $1,588.80 Issue Interest Denom Price Interest Value Rate $1,000 $500.00 $294.40 $794.40 2.38% 1,000 500.00 294.40 794.40 2.38% Issue Date YTD In, $20.1 Next Final Accrual Maturit3 09/2004 03/202L 09/2004 03/202~ 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 ;Sabmit survey , ~e~etI http://wwws.publicdebt.treas.gov/BC/SBCPrice 5/12/2004 COMMONWEALTH OF PENNSYLVANIA DEPARTMENTOFREVENUE BUREAU OF[NDIVlDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-O601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) NO. CD 004437 RISCH CARL C 10 EAST HIGH STREET CARLISLE, PA 17013 fold ESTATE INFORMATION: SSN: 210-26-7309 FILE NUMBER: 2104-0671 DECEDENT NAME: GROCE ELIZABETH R DATE OF PAYMENT: 09/29/2004 POSTMARK DATE: 09/29/2004 COUNTY: CUMBERLAND DATE OF DEATH: 04/23/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $499.92 TOTAL AMOUNT PAID: $499.92 REMARKS: CHECK# 10494 INITIALS: JA SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG, PA 17128-0601 COHHONNEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLONANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-XSd7 EX AFP CARL C RZSCH ESQ HARTSON ETAL 10 E HIGH ST CARLISLE PA 17015 DATE ESTATE OF DATE OF DEATH FILE NUHBER COUNTY ACN HAKE CHECK PAYABLE AND ,.R~NZT PAYHENT TO: REGISTER OF HILLS CUHBERLAND CO COURT*'~USE CARLISLE, PA-17015 .. CUT ALONG THIS LINE ~- RETAIN LONER PORTION FOR YOUR RECORDS REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLONANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF GROCE ELIZABETH R FILE NO. 21 0~-0671 ACN 101 DATE 11-22-200~ TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) $. Closely Held Stock/Partnership Interest (Schedule C) q. Mortgages/Notes Receivable (Schedule D) (q) 6. Cash/Bank DeposAts/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXEHPTZONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage LiabA11tAes/LAans (Schedule I) (10) 11. Total Deductions 12. Net Value of Tax Return 15. 1~. NOTE: 00 1/qZO.O0 57~815.01 O0 O0 NOTE: To insure proper O0 credit to your account, O0 sube/t the upper portion of th/s form with your tax payment. (8) 15,035.92 .00 59,235.01 Char/table/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) Net Value of Estate Sub.~ect to Tax ]:f an assessment ~as issued previously, lines 14, 15 and/or (11) 1:5.0~5.92 (12) ~6,197.09 (15) .00 (1~) ~6,197.09 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. (15) .00 x O0 = .00 (16) ~.6,197.09 x Oq5= 2,078.87 (17) . O0 x 12 = . O0 (~8) .00 x 15 = .00 (19)= 2,078.87 ASSESSMENT OF TAX: 15. Amount of L/ne 1~ at Spouse1 rate 16. Amount of L/ne lq taxable at L/noel/Class A rate 17. Amount of Line lq at Sibling rate 18. Aeount of L/ne 1~ taxable at Collateral/Class B rate 19. Pr/nc/pal Tax Due TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) 07-16-200q CDOOq168 78.95 09-29-200~ CD00R~$7 .00 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. AMOUNT PAID 1,500.00 q99.9Z TOTAL TAX CREDIT I 2,078.87 BALANCE OF TAX DUEl .00 TNTEREST AND PEN. .00 TOTAL DUE . O0 ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS RE{~UIRED. 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 12, 198Z -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years) the Comeonaealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the tawful Class B (cotIataral) rate on any such futura interest. PURPOSE OF NOTICE: PAYNENT: REFUND ODJECTIORS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section 21q0 of the Inheritance and Estate Tax Act) Act Z5 of ZOO0. (72 P.S. Section 91q0). Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. --Hake check or money order payable to: REGISTER OF RILLS, AGENT A refund of a tax credit) ehich ams nat requested on the Tax Return) may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1515). Applications ara available online at wa~.revanue.stata.oa.us, any Register of Nills or Revenue District Office, or from the Department's Iq-hour ansuering service for forms orders: 1-800-56Z-Z050~ services for taxpayers aith special hearing and/or speaking needs: 1-80O-qq7-5OgO (TT only). Any party in interest not satisfied ~ith the appraisment, alloaance or disallowance of deductions or assessment of tax (including discount or interest) as sho~n on this Notice amy object aithin 60 days of the date of receipt of this notice by filing one of the following: A) Protest to the PA Department of Revenue) Board of Appeals. You may object by filing a protest online at wwa.boardofappeals.state.pa.us on or before the expiration of the sixty-day appeal period. In order for an electronic protest to be valid, you must receive a confirmation number and processed date frei the Board of Appeals ~ebsita. You may also send a ~ritten pretest to PA Department of Revenue) Board of Appeals P.O. Box Z81OZ1) Harrisburg, PA 171lB-lOll. Petitions may not be faxad. 8) Election to have the matter determined at the audit of the account of the personal representative. C) Appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in ariting to: PA Department of Revenue) Bureau of Individual Taxes) ATTN: Post Assessment Review Unit, P.O. Box Z80601, Harrisburg, PA 17128-0601 Phone (717) 787-6S05. Sea page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" CREV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (5) calendar months after the decedent's death, a five percent (BI) discount of the tax paid is a11o~ed. The 1BI tax amnesty non-participation penalty is computed 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 amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you mould 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 Dna (1) day from the date of death) to the date of payment. Taxes which became delinquent before January 1) 198Z bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .000164. All taxes ahich became delinquent on and after January l) 198Z ail1 bear interest at a rate ahich will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOOq are: Interest Dally Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ~ lOX .O00Sq8 ~'8-1991 X1Z ~ ~ 9X .O00Z~7 1985 16Z .000¢58 199Z 9Z .O00Z~7 ZOO2 6Z .O0016q 198q llZ .000301 1995-199~ 7Z .000192 2005 5Z .000157 1985 15Z .000556 1995-1998 92 .O00Zq7 2004 CZ .000110 1986 10Z .OOOZ7q 1999 7Z .00019Z 1987 lOX .000274 ZOO0 7Z .00019Z --Interest is calculated as folloas: INTEREST = BALANCE OF TAX UNPATD X NUNBER OF DAYS DELTN~)UENT X DALLY 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 ba calculated.