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Home My WebLink About03-0078ALLAN W. LUGG ROBERT H. LUGG LUGG AND LUGG ATTORNEYS AT LAW LOCK HAVEN, PENNSYLVANIA 17745 :350 EAST WATER STREET POST OFFICE BOX 905 January 23, 2003 PHONE (570) 748-2481 FAX (570) 748-7368 E-MAIL: lugglc~v@cub.kcnet.org Mary C. Lewis, Reg. of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013-3387 Dear Ms. Lewis: Enclosed herewith for filing for decedent, Roy R. Frank, who died November 16, 2002, are two (2) executed copies of REV-1500, Inheritance Tax Return Resident Decedent, reporting jointly held assets. Also enclosed are original death certificate for Mr. Frank, check in the amount of $15.00 for the filing fee, and check in the amount of $1,830.59 for the tax due. If you require anything further, please advise. AWL:ms Enclosures - 5 Respectfully, Allan W. Lugg REV.' I'5' DEPARTMENT OF REVENUE DEPT. 280601 INHERITANCE TAX RETURN "'SBURG, PA17128 601 RESIDENT DECEDENT -- DECEDENTS NAME (LAST. FIRST. AND MIDDLE iNITIAL) FRANK, ROY R. SOCIAL SECURITY NUMBER 177-10 -6807 DATE OF DEATH (MM.OD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPUCATE WITH THE November 16, 2002 April 13, 1912 REGISTEROFWILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST. AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER ~"~1. Odginal Return F-'~ 4. Umited Estate E~6. Decedent Died Testate []9. LiUgation Pro~ds R~ived E~2. Supplemental Return E~4a. Future Interest Compromise (da~ o~ dea~ alt~ 12.12.82) E~7. Decedent Maintained a Uving Trust E]10. Spousal Poverty Credit (dm ~ d,~ ~e~ ~2-3~.~ are ~.~.g$) E~3. Remainder Return (da, d~ ;~r m 12-13-821 [~5. Federal Fmtata Tax Retum Required 0 8. Total Numba' of Safe Deposit Boxes [11.Election to tax under Sec. 9113(A) (^,am s= o) THIS SECTION MU, ST BE COMPI.=, ,-u. ALL CORRESPONDENCE, AND, ,CONF!DENTIAL.TAX INFORMATION SHOULD SE DIRECTED TO: i I coMPu-: A,L,N i bRE S ............. Allan W. Luqq, Esq. ~ 350 E. Water Street FIRM NAME(,~) I Lock Haven, PA 17745 Luqq and Luqq I TELEPHONE NUMBER 570-748-2481 1. Real Estate (S~edule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Rec~wable (Schedule D) (4) 5. Cash, B~k Deposits & Miscellaneous Personal Property (Schedule E) 8. JolntJy Owned Property (Schedule F) L.a Separate Billing Requested 7. Inter. V~vos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. 9. 10. 11. 12. 13. 14. (6) Total Gross A~eta (total Unes 1-7) Funeral Expenses & Admini~a~ Costa (Schedule H) (9) Debts of Decedent, Mortgage Uabililles, & liens (Schedule I) (10) Total Deduction~ (total lines 9 & 10) Net Value of Eetat~ (Line 8 minus Line !1) Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) Net Value Subject to Tax (Une 12 minus Une 13) $54,206.69 (8) $ 8,030.00 3,355.70 (11) (12) (13) (14) OFFICIAL USE ONLY SEE INSTRUCTIONS ON REVERSE SIDE FOR APPMCABLE RATES 15. Amount of Une 14 taxable at the spousal lax rate, or transfers under Sec. 9116 (a)(1.2) x .0 (15) 16. Amount of Une14 taxeqle at lineal rate $42,820.99 x .o45 (18) 17. Amount of Line 14 taxable at sibling rata x .12 (17) 18. Amount of Line 14 taxable at collatand rat~ x .15 (18) 19. Tax Due (19) $54,206.69 11,385.70 $42,820.99 --0-- $42~820.99 1,926.94 1,926.94 > · BE SURE TO ANSWER ALL QUEStiONS ON ki-VERSE SIDE AND RECHF..CK MATH < < Decedent's. Complete Address: STRE~DRE$$ Messiah Village, 100 Mt. Allen Drive cl~ Mechanicsburg, Cumberland County Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Creqits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount $96.35 STATE PA (1) $1,926.94 Total Creqits (A+ B +. C ) 3. Interest/Penalty if applicable O. Interest E. Penalty Total Interest/Penalty ( D + E ) 4. If Une 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page I Une 20 to request a refund 5. If Une 1 + Une 3 is greater than Une 2, enter the difference. This is the TAX DUF_ A. Enter the interest on the tax due. B. Enter the total of Une 5 + SA. This is the BALANCE DUE. Make Check Payable to: REOiSTER OF WILLS, AOENT (2) 96.35 (3) -0- (4) (~ $ 1,830.59 (~) - o - (SB) $ 1,830.59 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 usa or income of the property transferred; .................... ~. ................................................................... [] [] b. retain the right to designate who shall use the properly transferred or its income; ............................................ [] [] c. retain a reversionary interest; or. ....................................................................................................................... [] [] d. receive the promise for life of either payments, benefits or care? .................................................................. [] [] 2. If death occurmcl after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ........................................................................................................... [] [] 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 beneficiary designation? ........................................................................................................................ [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ncler pe~a ~es of pequty, declare b'~at I have exa~ ~m return, mctuding acting sct~ules anti sta~, ancl to the best of ~ ~ ~ ~, ~ m U, ~ a~ ~. ~,,~.~E OF PERSON RESPONSIBI~E FOR FILING RETURN ESS ' . / 313. Elcjin Circler Mechanicsburc~, S,GNATU, OF,A .*R OT, F. eT RF. SF."TAT E 350 E. Water St., Lock Haven, PA PA 17055 17745 DATE JanuaryS/ ~ 2003 ~2, 20 03 January 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 usa of Ihe sun,lying spouse is 3% F2 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 sun4ving spouse is 0% [72 RS. §9116 (a) (1.1) (ii)]. The statute does not exemo~ a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum are slill applicable even if the sundving 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 usa 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 dececlent'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 ES. §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. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ROY R. FRANK SCHEDULE F JOINTLY-OWNED PROPERTY Pa~e 1 of 2 Pa~es RLE NUMBER If an asset was made ~int within one year of the decedent's dam of death, it must be reported on Sr, bedUle G. SURVIVING JOINT TENANT(S) NAME ADDRESS A. Robert A. Frank B. Janice A. Orndorf 587 Cheshire Rd., Sunbury, OH 43074 311 Elgin Circle, Mechanicsburg, PA 17055 RELATIONSHIP TO DECEDENT Son Daughter JOINTLY-OWNED PROPERTY: ~11 ~ DATE DES~IPTION OF PR~=Ki Y % OF DATE OF D~TH ~M FA JOlT MADE I~ude name d financial insbtulion anti ~ ac~muN numl:~ = ~milar idem~i~ numDer. Attac~ ~ OF D~ OE~'S V~UE OF NUMBER TENANT JOl~ deed ~ ~n~y~ ma ~l~te. VALUE OF ASS~ INTEREST ~C~ENT~ IN~RES 1. A. 1999 CD#3300528233 at Sun Bank, Lock Haven, PA originally issued 10-5-99 thru Mellon Bank which was acquired by Sun Bank 6-1-01, last renewed 6-8-02 @3.70% $10,003.93 50% $ 5,001.97 Accrued interest 8.11 50% 4.05 2. Following CD~s issued with Jersey Shore State Bank, Lock Haven, PA: A 1999 (a) #324-892-505 issued 3-15-99, last renewed at 4.80% 5,000.00 50% 2,500.00 Accrued interest .66 50% .33 A 1999 (b) #311-895-938 issued 12-1-99, last renewed at 4.20% 5,000.00 50% 2,500.00 Accrued interest 8.63 50% 4.31 A 2000 (c) #310-936-677 issued 7-24-00, last renewed at 2.20% 5,000.00 50% 2,500.00 Accrued interest 6.93 50% 3.47 3. Following CD's issued with M&T Bank, Lock Haven, PA: A 1999 (a) #31003910497542 originally issued 10-22-99 thru Keystone Financial which was acquired by M&T 10-6-2000, last renewed at 3.44% 5,000.00 50% 2,500.00 Accrued interest 40.70 50% 20.35 A 1999 (b) #31003910546323 originally issued 11-15-99 thru Keystone Financial which was acuquired by M&T 10-6-2000, last renewed at 3.34% 10,000.00 50% 5,000.00 Accrued interest 56.97 50% 28.49 4. A 1964- Various US Gov't Series E Bonds - see 1975 attached listin8 with values "Ek~IBIT A" 7;278.35 50% 3,639.17 TOTAL(Alsoent~online6, Reca~tula~) $ (CONTINUED) (If more space ~s neeaea. ~nsert aclditional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA INHERR'ANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ROY R. FRANK CONTINUATION OF SCHEDULE F JOINTLY-OWNED PROPERTY Page 2 of 2,,Pages FILE NUMBER JOINTLY-OWNED PROPERTY: I LETT~ I DATE b~CA]PTION OF PR~ % OF DATE OF D~TH ]~M FOR JOINT] MADE I~e na~e of financial ~l~tulmn an~ I~,~K account numm~ ~ simi~ m~f/mg nutone', miata ~ OF D~ DECD'S V~UE OF NUMBER ~NANT JOINT ~eed ~r l~n~v~el~ ma ~late. V~UE OF ASS~ INTEREST DECEDENTS INgRES- S. A 9-97- 5 $1,000. U. S. Government Series H Bonds - 5-01 4 issued Sept., 1997 and one issued May, 2001 $ 5,000.00 50% $ 2,500.00 6. Following CD's issued with Sovereign Bank, Lock Haven, PA: B 2001 (a) #0005940745 originally issued 5-21-01, last renewed at 3.68% 5,000.00 50% 2,500.00 Accrued interest 28.36 50% 14.18 B 2001 (b) #3685023719 originally issued 9-13-01, last renewed at 2.71% 7,500.00 50% 3,750.00 Accrued interest 35.76 50% 17.88 B 2000 (c) #3685018438 originally issued 4-13-00, last renewed at 3.73% 10,000.00 50% 5,000.00 Accrued interest 3.07 50% 1.53 7. B 1962- Various US Gov't Series E Bonds - see 1975 attached listing with values "EXHIBIT B" 6,533.66 50% 3,266.83 8. B 9-97- 5 $1,000. U. S. Government Series H Bonds - 5-01 4 issued Sept., 1997 and one issued May, 2001 5,000.00 50% 2,500.00 9. Following accounts at Sun Bank, Lock Haven,, PA: B 1997 (a) Savings Account #352060166 6,646.69 50% 3,323.34 Accrued interest 10.83 50% 5.42 B 1997 (b) Checking Account #8698 with balance of $20,755.15, less following checks writt~m and mailed before death: #1163 to Messiah Village $5,344.08 for Oct. chges; #1164 to Messiah Village $25.00 for Xmas fund, #1165 to PharMerica $131.68 for Oct. '. pharmacy; & #1166 to Leukemia & Lymphona Society $10; leaving balance subject to tax of 15,244.39 50% 7,622.20 Accrued interest 6.35 50% 3.17 TOTAL (Also enter on line 6, Recapitulation) S 5 4,2 0 6.6 9 df more space is neeaea, mserl aactmonal sheets of me same size) · SCHEDULE H ~~H o~'~v~ ' I FUNERAL EXPENSES & ~r~r,~c~ t~x ~ AD ESTATE OF . ROY R. FRANK FILENUMBER D~ of decedent mum be repon~l on $~ule L NUMBER .' _nESCRIP710N A. FUNERAL E~'~.','$_~$: 1. Walker Funeral Home - funeral expenses 2. Cutting date on marker AMOUNT $5,065.00 75.00 Bo Z 5. 6. 7. ADMINISTRATIVE COSTS: Pmmal Reamsema~e's Commmims Name of Pem31m aemsmaem (s) Y~s) C~ P~ ~F~- ~u99 ~d ~u99 F~ ~:(Ifd~s ~ ~ W~e ~ W~ ~) T~R~Pm~sF~ - S~e;e TOTAL (Also enter on line 9, Recapi~m) $ (If mom space m neecle(I, insert addilional shems of the same size) 2,650.00 15.00 225.00 8,030.00 REV. I512 EX*~I-~) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT E~¥ATE OF ROY R. FRANK SCHEDULE ! DEBTS OF DECEDENT, MORTGAGE LIABII:ITIES? & LIENS . FILE NUMBER Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION Messiah Village - November charges. PharMerica - November pharmacy Center for Neurobehaviorial Health - co-pay due for 9-27, 10-4 and 10-25 service dates United States Treasury - fourth quarter tax payment AMOUNT $2,582.25 91.48 101.97 580.00 TOTAL (Also enter on line 10, RecaDitulation) $ 3,3 5 5.7 0 (If more s~ace is nee~ea, inser~ additional sheets of the same sizei COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT D;C.;nENT F.,~TATE OF NUMBER I. II. ROY R. FRANK SCHEDULE J BENEFICIARIES NAME'AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions) Robert A. Frank, 587 Cheshire Road, Sunbury, OH 43074 Janice A. Orndorf, 311 Elgin Circle, Mechanicsburg, PA 17055 RLE NUMBER RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not i1~ Tm__~,(__,~) OF ESTATE Son Daughter Jointly Held Jointly Held ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON UNES 15 THROUGH 17, AS APPROPRIATE 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 II . ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET ON REV 1500 COVER SHEET (If mo~e space ~s neeaeO, insert a~iditional sheets of the same size) EXHIBIT A U.S. GOV. SERIES E BONDS N/O Roy R. Frank or Robert A. Frank Up date Help Savinc Series iE Bonds ~ # Bonds Total Price 31 S1,012.50 Denomination $i5o Serial Number Issue Date Total Interest $6,265.85 Issue Serial Number Issue Date Series Dehorn Price L2225539437E 12/1975 ~× E $50 $37.50 L2225539436E 11/1975./ E 50 37.50 L2225539435E 10/1975 ./ E 50 37.50 L2225539434E 09/1975~' E 50 37.50 L2225539433E 09/1975'/ E 50 37.50 L2225539432E 12/1974,/ E 50 37.50 L2225539431E 11/1974,/ E 50 37.50 L2225539430E 10/1974 / E 50 37.50 L2225539429E 08/1974 v' E 50 37.50 L2225539428E 07/1974 / E 50 37.50 L2225539427E 12/1973 '/ E 50 37.50 L2225539426E 11/1973~" E 50 37.50 L2225539425E 09/1973 ,/ E 50 37.50 L2225539424E 08/1973'/ E 50 37.50 L2225539423E 12/1972`/. E 50 37.50 L2225539422E 10/1972 / E 50 37.50 L2225539421E 09/1972 / E 50 37.50 L2225539420E 07/1972" E 50 37.50 L2225539419E 12/19717 E 50 37.50 L2225539418E 11/197W E 50 37.50 L2225539417E 10/1971v,' E 50 37.50 L2225539416E 08/1971t/ E 50 37.50 L2225539415E 07/1971../ E 50 37.50 Q6418607027E 11/1965-/ E 25 18.75 Q6418607026E 09/1965 '/ E 25 18.75 Q6418607025E 11/1964,/ E 25 18.75 Q6418607024E 09/1964,/ E 25 18.75 Q6418607023E 07/1964 ,/ E 25 18.75 Q6418607022E 12/1963,- E 25 18.75 Q6418607021E 10/1963 ~/E 25 18.75 Q6418607020E 12/1962 ,--'E 25 18.75 Total Value YTD $7.278.35 $215. Interest Next Final Interest Value Rate Accrual Maturit3 $197.12 $234.62 4.00% 12/2002 12/2005 201.28 238.78 4.00% 05/2003 11/2005 198.96 236.46 4.00% 04/2003 10/2005 198.96 236.46 4.00% 03/2003 09/2005 198.96 236.46 4.00% 03/2003 09/2005 200.88 238.38 4.00% 12/2002 12/2004 205.04 242.54 4.00% 05/2003 11/2004 202.74 240.24 4.00% 04/2003 10/2004 202.74 240.24 4.00% 02/2003 08/2004 202.74 240.24 4.00% 01/2003 07/2004 204.64 242.14 4.00% 12/2002 12/2003 214.12 251.62 4.00% 03/2003 11/2003 214.12 251.62 4.00% 01/2003 09/2003 214.08 251.58 4.00% 12/2002 08/2003 217.48 254.98 4.00% 12/2002 12/2002 218.60 256.10 10/2002 218.60 256.10 09/2002 218.04 255.54 07/2002 215.82 253.33 12/2001 215.22 252.72 11/2001 215.22 252.72 10/2001 215.22 252.72 08/2001 214.62 252.12 07/2001 147.23 165.98 4.01% 02/2003 11/2005 147.23 165.98 4.01% 12/2002 09/2005 194.03 212.78 4.00% 02/2003 11/2004 194.03 212.78 4.00% 12/2002 09/2004 195.18 213.93 4.00% 04/2003 07/2004 194.96 213.71 4.00% 03/2003' 12/2003 193.64 212.39 4.00% 01/2003 10/2003 194.35 213.10 4.00% 12/2002 12/2002 http://wwws.publicdebt, treas.gov/BC/SBCPrice 11/30/2002 EXHIBIT B U. S. GOV. SERIES E BONDS N/O Roy R. Frank or Janice A. Orndorf $avinc [11/2002 Update', Help !~ Series Denomination Serial Number Issue Date )E '_t $iso -{ I I # Bonds Total Price 28 $881.25 Serial Number Issue Date Series Denom L2225539408E 07/1975 E L2225539407E 06/1975 E~ L2225539406E 05/1975 E L2225539405E .03/1975 E L2225539404E 02/1975 E L2225539403E 05/1974 E× L2225539402E 04/1974 E- L2225539401E 03/1974 E L2225539400E 01/1974 L2225539399E 06/1973 E~' L2225539398E 05/1973 E--' L2225539397E 04/1973 E.~ L2225539396E 02/1973 E L2225539395E 01/1973 E~- L2225539394E 06/1972 E- L2225539393E 05/1972 E L2225539392E 03/1972 L2225539391E 02/1972 E-~ L2225539390E 06/1971 E/ Q6418607013E 06/1965 E~ Q6418607012E 04/1965 E.~ Q6418607011E 02/1965 E Q6418607010E 05/1964 E~' Q6418607009E 02/1964 E Q6418607008E 07/1963 Q6418607007E 05/1963 Q6418607006E 03/1963 E~ Q6418607005E 10/1962 E-~ Total Interest Total Value YTD In~ $5,6~2.41 $6,533.66 $223.'7,0.- Issue Interest Next Final Price Interest Value Rate Accrual Maturit3 $198.96 $236.46 4.00% 01/2003 07/2005 198.96 236.46 4.00% 12/2002 06/2005 203.12 240.62 4.00% 05/2003 05/2005 200.82 238.32 4.00% 03/2003 03/2005 200.82 238.32 4.00% 02/2003 02/2005 206.96 244.46 4.00% 05/2003 05/2004 204.64 242.14 4.00% 00/2003 04/2004 204.64 242.14 4.00% 03/2003 03/2004 204.64 242.14 4.00% 01/2003 01/200~ 216.10 253.60 4.00% 00/2003 06/2003 215.50 253.00 4.00% 03/2003 05/2003 215.50 253.00 4.00% 02/2003 04/2003 215.50 253.00 4.00% 12/2002 02/2003 219.92 257.42 4.00% 01/2003 01/2003 $50 $37.50 50 37.50 50 37.50 50 37.50 50 37.50 50 37.50 50 37.50 50 37.50 50 37.50 50 37.50 50 37.50 50 37.50 50 37.50 50 37.50 50 37.50 50 37.50 50 37.50 50 37.50 50 37.50 25 18.75 25 18.75 25 18.75 25 18.75 25 18.75 25 18.75 25 18.75 25 18.75 25 18.75 215.58 253.08 214.88 252.38 214.88 252.38 214.84 252.34 216.40 253.90 06/200~g 05/200~/~ 03/200~/'0g 02/200~/r/g 06/2001~N 151.74 170.49 4.01% 03/2003 06/2005 172.87 191.62 6.00% 01/2003 04/2005 177.68 196.43 4.00% 05/2003 02/2005 193.77 212.52 4.00% 02/2003 05/2004 197.01 215.76 4.00% 05/2003 02/2004 194.77 213.52 4.00% 04/2003 07/2003 193.15 211.90 4.00% 02~2003 05/2003 193.18 211.93 4.00% 12/2002 03/2003 195.58 214.33 10/200~~ http://wwws.publicdebt.treas.gov/BC/SBCPrice 11~0/2002 ~ FIRST CLASS MAIL AWL hUGG AND [UGG 350 EAST WATER STREET POST OFFICE BOX 905 LOCK HAVEN PA 17745 TO: MARY C LEWIS REG OF WILLS CUMBERLAND COUNTY COURTHOUSE ONE COURTHOUSE SQUARE CARLISLE PA 17013-3387 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 002093 LUGG ALLAN W. ESQUIRE LUGG AND LUGG 350 E WATER STREET, P O BOX 905 LOCK HAVEN, PA 17745 ........ fold ESTATE INFORMATION: SSN: 177-10-6807 FILE NUMBER: 21 03-0078 DECEDENT NAME: FRANK ROY R DATE OF PAYMENT: 01/27/2003 POSTMARK DATE: 01/23/2003 COUNTY: CUM BERLAN D DATE OF DEATH: 11/16/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $1,830.59 TOTAL AMOUNT PAID' $1,830.59 REMARKS: JANICE ANN ORNDORF C/O ALLAN W LUGG ESQUIRE SEAL CHECK# 1175 INITIALS' CW RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 28060I HARRISBURG, PA I7128-0&0! COMMONWEALTH OF PENNSYLVANZA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REY~1547 EX AFP ALLAN W LUGG ESQ LUGG & LUGG $50 E WATER ST LOCK HAVEN PA [7745 DATE 03-24-2005 ESTATE OF FRANK DATE OF DEATH 11-16-2002 FILE NUMBER 21 05-0078 COUNTY CUHBERLAND ACN 101 Amount Remitted ROY R MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF N[LLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONg THIS LINE ~ RETAIN LONER PORT[ON FOR YOUR RECORDS ~ REV-1547 EX AFP C01-053 NOT[CE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR D[SALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF FRANK ROY R FILE NO. 21 05-0078 ACN 101 DATE 05-24-2005 TAX RETURN NAS: C X} ACCEPTED AS FILED C ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate CSchedule A) 2. Stocks and Bonds CSchedule B} C2) $. Closely Held Stock/Partnership Interest CSchedule C) CS) 4. Mortgages/Notes Receivable CSchedule D) C4) 5. Cash/Bank Deposits/Misc. Personal Property CSchedule E) (5) 6. Jointly Owned Property (Schedule F) C6) 7. Transfers CSchedule G) C7) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTTONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) CIO) 11. Total Deductions 12. Net Value of Tax Return .00 O0 O0 O0 O0 O0 C8) 8,050.00 NOTE: To insure proper credit to your account, submit the upper portion of this form w/th your tax payment. 14. NOTE: 54,206.69 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate C15) 16. Amount of Line 14 taxable at Lineal/Class A rate C16) 17. Amount of Line 14 at Sibling rate C17) 18. Amount of Line 14 taxable at Collateral/Class B rate C18) 19. Pr/nc/pal Tax Due TAX CREDTTS: PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID 01-25-2005 CD002095 96.55 · O0 X O0 = . O0 42,820.99 X 045= 1,926.94 · O0 X 12 = . O0 · O0 x 15 = . O0 (19)= 1,926.94 AMOUNT PAID 1,850.59 Char/table/Governmental Bequests; Non-elected 9115 Trusts CSchedule J) C15) . O0 Net Value of Estate Subject to Tax (143 42,820.99 [f an assessment was Issued previously, lines 14, 15 and/or 16, 17, 18 and 19 w111 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 1,926.94 .00 .00 .00 ( IF TOTAL DUE IS LESS THAN 81, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) reflect figures that Include the total of ALL returns assessed to date. 5~555.70 Cll) 11.~8B.70 c12) 42,820.99 RESERVATION= Estates of decedents dying on or before December 12, 1982 -- 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 Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Ciass B (coiiaterai) rate on any such future interest. PURPOSE OF NOT[CE: PAYMENT: REFUND CCR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS= DISCOUNT= PENALTY: INTEREST= To fulfill the requirements of Section 21~0 of the Inheritance and Estate Tax Act, Act 25 of 2000. C72 P.S. Section 91~0). Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side. --Make check or money order payable to: REGISTER OF NXLLS, AGENT A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" CREV-I$1$). Applications are available at the Office of the Register of Nills, any of the 25 Revenue District Offices, or by calling the special 24-hour answering service for forms ordering: 1-800-$62-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-~7-$020 CTT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as sho~n on this Notice must object within sixty (&O) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 28102I, Harrisburg, PA I7128-102I, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone C717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three C$) calendar months after the decedent's death, a five percent CSX) discount of the tax paid is allowed. The 15X 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 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 C9) months and one (1) day from the date of death, to the date of payment. Taxes ~hich became delinquent before January 1, 1982 bear interest at the rate of six C&X) percent per annum calculated at a daily rate of .00016~. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate uhich will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2003 are: Interest Daily Interest Daily Interest Daily Factor Year Rate Factor Year Rate Factor Yea.~r Rate 1982 20X .000548 1987 9X .0002~7 1999 7X .000192 1983 I&X .000~38 1988-1991 llX .000301 2000 8X .000219 198~ 11~ .000301 1992 9~ .0002~7 2001 9X .0002~7 1985 ISX .000556 1993-199~ 7X .000192 2002 6X .00016~ 1986 10X .00027~ 1995-1998 9~ .0002~7 2003 5X .000157 --Interest ts calculated as follows: XNTEREST = BALANCE OF TAX UNPAXD X NUNBER OF DAYS DELXNIIUENT X DATLY XNTEREST 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 sho~n on the Notice, additional interest must be calculated.