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HomeMy WebLinkAbout04-0699 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128 0601 RECEIVED FROM: O'BRIEN ROBERT L 19 WEST SOUTH STREET CARLISLE, PA 17013 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11 961 NO. CD 0O4196 ........ fold INFORMATION: FILE NUMBER: DECEDENT NAME: DATE OF PAYMENT: POSTMARK DATE: COUNTY: DATE OF DEATH: SSN: 297-16-1808 oql -0,4- CROCKER MARGARET 07/26/2004 07/26/2004 CUMBERLAND 10/28/2003 ACN ASSESSMENT CONTROL NUMBER 101 AMOUNT $2,005.15 REMARKS: TOTAL AMOUNT PAID: $2,005.15 SEAL CHECK# 4043 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY COUNTY CODE YEAR NUMBER DECEDENTS NAME (L~S~ FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER I-- Z CRO~KER, MARGARET (NMI) 297 - 16 - 1808 LU t't DATE OF DEATH (MM-SD-YEAR) DATE OF BIRTH (MM-CD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE uJ 10/28/2003 04/04/26 REGISTER OF WILLS LU (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAS~ FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER [~1 Original Return [~4 Limited Estate [~]6 Decedent Died Testate IA~a~ copy of E~]9. Litigation Proceeds Received ~;~JL. NAME ROBERT L. FIRM NAME (Ifappli~ble) OiBRIRN. TELEPHONE NUMBER (71'7/ E~2 Supplemental Return [~4a, Future Interest Compromise {date of death after 12 124~2} [~7. Decedent Maintained a Living Trust IA'~ach copy or Tr~st) ] 10, Spousal Povedy Credit (dam of death bet~eer~ 12-31-91 ~nd 1-1-95) O'BRIENr ESQ. RART~S~R~RRR 249-6873 [~5. Federal Estate Tax Return Required __ 8. Total Number of Safe Deposit Boxes E~11. Election to tax under Sec. 9113(A) (At. ch Sob O) COMPLETE MAILING ADDRESS 19 WEST SOUTH STREET CARLISLE, PA 17013 14. 1. Real Estate (ScheduleA) (1) 47 · 845 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Padnership or Sole-Propdetorship (3) 4 Mortgages & Notes Receivable (Schedule D) (4) 889 5 Cash, Bank Deposits & Miscellaneous Personal Properly (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) [~] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) B. Total Gross Assets (total Lines 1-7) (B) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) ~. · 1 7 5 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) (11) 12 Net Value of Estate (Line 8 minus Line 11) (12) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) made (Schedule J) Net Value Subject to Tax (Line 12 minu~ Line 13) (14) OFFICIAL USE ONLY ~ 48,73~ 4,17,5 44,559 44.559 SEE INSTRUCTIONS ON REVERSI~ BIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec, 9116(a)(l.2) x ,0__ (15) 16. AmountofLine14taxableatlinealrate z~'d'o~59 x .0 ~5 (16) 17. Amount of Line 14 taxable at sibling rate x .12 (17) 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19~ Tax Due (19) 2,005.15 2,005.15 Decedent's Complete Address: STREET ADDRESS CITY 309 PINEDALE RD CARLISLE I STATE [ ZIP PA Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Pdor Payments C. Discount 3. Interest/Penalty if applicable D. interest E. Penalty Total Credits (A + B + C ) (2) Total InterestJPenalty ( D + E ) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page I Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. (t) 2., (3) (4) (5) (5A) B, Enter the total of Line 5 + SA, This is the BALANCE DUE. (SD) 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 reversionary interest; or .......................................................................................................................... [] [] d. receive the promise for life of either payments, benefits or cam? ...................................................................... [] [] 2, If death occurred 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, 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 information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE ADDRESS ADDRESS Fo-'~dates o'----~death----~)~ or after J ul¢ 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 RS. §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 exemDt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still appliceble even 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 transfem from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive paren 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 RS. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as a~ individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-'1502 EX+ (~2-85} ~r~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER MARGARET CROCKER (Property jointly-owned with Right of Survivorship must be disclosed on Schedule F) All real estate shauld be reported at fair market value which Is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy ar sell, both having reasonable knowledge of the relevant facts. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 309 PINEDALE RD, CARLISLE, PA 17013 $47,845.00 TOTAL (Also enter on line 1, Recapitulation) $ 47 f 845 · 00 (If more space is needed, insert additional sheets of same size.) COMMONWEALTH 0{: PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MARGARET CROCKER SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER This schedule must be esmpleled and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes, DESCRIPTION OF PROPERTY % OF ITEM INO-UDE THE NAUE ~ ~ TRA'u"~eEREE' ~E~R REt)'TION~IP 'r° DECE{~J~T AND ~E DATE ~ ~ DATE OF DEATH DECD'S EXCLUSION TAXABLE VALI NUMBER VALUE OF ASSET INTEREST 1. Mrs. Crocker held legal title to the ;79,044 $47,845 $31,19 $47,845 home she and her son and daughter- in-law lived in. Mr. & Mrs. Ford had aR equitable interest from 1996 due to their paying off a private mortgage on the home as well as paying the costs of repairs, taxes and insurance, all total the sum of $31,199.00. TOTAL (Also enter on line 7. Recapitulation) $ 4 7,8 4 5.0 0 (If more space is needed, insert additional sheets of the same size) ~,.,,,~,.,,.,7, ~ SCHEDULE J coM~o~W~T. DE PE,.S~LV*.,^ BENEFICIARIES 1 INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER MARGARET CROCKER NUMBER I[. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (inciude ou~ght spousal distributions) RUSSELL S. FORD AND JOANN G. FORD, HUSBAND AND WIFE RELATIONSHIP TO DECEDENT Do Net List T-,~_!~{e) SON AND DAUGHTER-IN-LAW AMOUNT ORSHARE OF ESTATE 2/3 OF REAL ESTATE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, 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 II- ENTER TOTAL NON-TAXABLE DISTRIBU!IONS ON LINE 13 OF REV 1500 COVER SHEET $ (if more space is needed, insert additional sheets d the same size) REV-1508 EX+ (6-98) I SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMMO.W~.~T~ OP ~E~NSVLV^.~^ PERSONAL PROPERTY ESTATE OF FILE NUMBER MARGARET CROCKER Include the proceeds of litigation and the date the proceeds were received by the estate. All property Jointly-owned with right of sundvorshlp must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION 1. CLOTHING AND BEDROOM FURNISHINGS CHECKING ACCOUNT VALUE AT DATE OF DEATH $300.00 $589.00 889.00 TOTAL (Nso enter on line 5, Re~'=~nit.!ation) $ (If more space is needed, insert additional sheets of the same size) SCHEDULE H co~ao.w~.~ o; ~=..s~.w.~ FUNERAL EXPENSES & ~..mT~.C~ T*X .ETU~ ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER MARGARET CROCKER Debts of decadent must be mpod~d on Schedule L ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. 5. 6. 7. ADMINISTRATIVE COSTS: pemonal Reprasentaltve's Commisatons Name o~ Pe~onal Repre~enla~ve Is) Social Secu~ty Number(s) I EIN Number of Pemonal Reflrmse~tative(s) Slmet Address C~ State Year(s) Co~miasion Paid: AtlomeyFeas O'BRIEN, BARIC & SCHERER Family Ex~np~n: (If desedenfs addmsa is not ~e same as ctei~ant's, a~ch exptena~on) Claimant 'Ru,~=l 1 $. Ford S~etAddmss 309 Pinedale Road Carlisle c~ Reb~nship of Claimant to Decedent Probate Fee~ Accountent's Fees Tax Retum Preparers Fees SoTt PA 17013 Smla Zip $375.00 $3,500.00 $300.00 TOTAL(Alsoenter~line9, Recapitulation) $ zJ, 175. O0 (If mo,'e space is needed, insert additional sheets of the same size) Parcel Number: THIS DEED MADE THE Three (2003). day of ~.~--~-w,..~- in the year of our Lord Two Thousand BETWEEN MARGARET CROCKER, single person, of Lower Frankford Township, Cumberland County, Pennsylvania, hereinafter Grantor AND MARGARET CROCKER, ( holding a two-third interest) AND RUSSELL S. AND JOANN G. FORD (holding a one-third interest), husband and wife, all as joint tenants with right of survivorship, of Lower Frankford Township, Cumberland County, Pennsylvania, hereinafter Grantees WITNESSETH, that the Grantor, for and in consideration of the sum of One and 00/100 Dollars ($1.00), lawful money of the United States of America, unto Grantor well and truly paid by the Grantees, at and before the sealing and delivery of these presents, the receipt whereof is hereby acknowledged, the Grantor has/have remised, released and quit-claimed, and by these presents does/do remise, release and forever, quit-claim unto the said Grantees, her heirs, assigns and successors: ALL that certain lot of ground with improvements thereon erected situate in Lower Frankford Township, County of Cumberland and State of Pennsylvania, bounded and described as follows: BEGINNING at a point in the center of Township Road No. 455, which point is a corner of land belonging to George A. Nace; thence along land of said George A. Nace and wife, North 4 degrees 54 minutes West 154.20 feet to a point (iron pipe); thence still along land of said George A. Nace and wife, North 46 degrees 22 minutes West 134.10 feet to a point (stake); thence along other land of the said Ida M. Myers, North 86 degrees 11 minutes East 339.67 feet to a point (spike) in the center of Township Road No. 458; thence by the center of said Township Road No. 458, South 3 degrees 49 minutes East 250 feet to a point in the center of the junction of said Township Roads Nos. 455 and 458; thence by the center of said Township Road No. 455, South 85 degrees 31 minutes West 246.52 feet to a point, the Place of BEGINNING. CONTAINING 1.537 acres in accordance with a survey by Thomas A. Neff, Registered Surveyor of the State of Pennsylvania on February 22, 1966. BEING improved with a two story house and outbuildings known as 309 Pinedale Road, Carlisle. LESS, HOWEVER, all that certain tract of land conveyed to James L. Yarlett and Vivian C. Yarlett, his wife, by Deed dated June 2, 1969 and recorded in the Office of the Recorder of Deeds for Cumberland County in Deed Book "G", Volume 23, Page 15. BEING the same premises which Francis P. Yarlett and Clara V. Yarlett, by Deed dated and recorded in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in Deed Book 138, Page 443, granted and conveyed unto Margaret Crocker, grantor herein. THIS is a tax exempt transfer of property from Mother to Son and Daughter-In-Law. TOGETHER with all and singular, the tenements, hereditaments and appurtences to the same belonging, or in anywise appertaining, and the reversion and reversions, remainder and remainders, rents, issues and profits thereof; and also, all the estate, right, title, interest, property claim and demand whatsoever, both in law and equity, of the said Grantor, of, in to or out of the said premises, and every part and parcel thereof. TO HAVE AND TO HOLD the said premises, with all and singular the appurtences, unto the said Grantees, their heirs and assigns, to and for the only proper use and behoof of the said Grantees, their heirs, assigns and successors forever. IN WITNESS WHEREOF, the said Grantor has hereunto set her hand and seal the day and year first above written. SIGNED, SEALED AND DELIVERED IN THE PRESENCE OF:  'M~M~,~z'¢-~-~ ~ (seal) A~ARET CROCKER Form View - public tax file 12-18-03.fp5 Page 1 of 1 Form View Search public tax file 12-18-03.fp5 T~able View Viewing: 1 of ! DlstrlcLNumber 14 Parcel_identifier 14-05-0421-02§ Map_Suffix_Number House_Number 309 Direction Street PINEDALE ROAD Owner_Name_t CROCKER, MARGARET & Owner..Name_2 RUSSELL $ & JOANN G FORD Land_Use_Code R Property_DeecHpUon T-455 Living_Area 2248 Current_Land_Value 30060 Currant_Improvement_Value 46760 Current_Total_Value 75820 Current_Preferred_Value Acreage .75 CleanGreen_Sfetus Taxable_or..Exempt '[ Sale_Amount Sale_Month 09 Sale_Day 05 Sale_Century 20 Sale_Year 03 Deed_Book_and_Page 00259-00638 Year_Built 1950 HF_Flle_Date HF_Approval_Statue Home I http://2~5~247~227~59:59~/FMRes/FMPr~?~db=pub~ic%2~tax%2~~~e%2~~2~~ 8~~3~fp5&-~~~ 12/30/2003 Rob, The following is a list oftbe money I spent on the house at 309 Pinedale Rd. All of this was spent before my Mom died. Mortgage: 78 months at $300.00 per month $23,400.00 Repairs Remodeling & Building: Roofing & Siding: 3,740.00 Ceiling: 1,150.00 Greenhouse: 1,782.00 Fencing: 393.43 Property Tax: 140.00 Property Insurance: 371.00 Septic service: 220.00 This is the total of money that I can prove that I put into this Property. $31,198.43 To Whom it may concern, This written statement verifies that Russell S Ford & Joann G. Ford have paid me back the sum of $23,400.00. This money was for the mortgage of the property located at: 309 Pinedale RD. Carlisle Pa 17013 Lower Fmnkford Township, Cumberland County. The mortgage was for $20,000.00. It has been repaid in full. Yours, Clyde S. Ford 24595 S. W. 124th. Ave. PrincetorvCFla. 33032 Signed this day; Name' ~~Z~)~ '~ ~a-~ff/- fj~ Date/ _ COMMONWEALTH OF PENNSYLVANIA DEPARTMENTOFREVENUE BUREAU OFINDIViDUAL TAXES DEPT, 280601 HARRISBURG, PA 17128 0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11 96) NO. CD O04472 O'BRIEN ROBERT L 19 WEST SOUTH STREET CARLISLE, PA 17013 fold ESTATE INFORMATION: SSN: 297-16-1808 FILE NUMBER: 2104-0699 DECEDENT NAME: CROCKER MARGARET DATE OF PAYMENT: 10/06/2004 POSTMARK DATE: 1 0/05/2004 COUNTY: CUMBERLAND DATE OF DEATH: 10/28/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $118.57 TOTAL AMOUNT PAID: $118.57 REMARKS: CHECK//745 ' INITIALS: JA -SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU O~ /ND/V/DUAL TAXES /N~IERZTAHCE TAX ROBERT L OBRIEN ESQ OBRIEN BARIC 8 SCHERER 19 W SOUTH ST CARLISLE COMMONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE PA 17015 NOT/CE OF /NHER/TANCE TAX APPRA/SEMENT, ALLGRANCE DR D/SALLONANCE OF DEDUCT/ONS AND ASSESSHENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY AIF~ :08 09-27-200q CROCKER 10-28-2005 21 0q-0699 CUMBERLAND 101 Amount Raett~ed MARGARET NAK~:~CHECK PAYASLE AND REMIT PAYMENT TO: REGISTER OF HILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LZNE ~ RETAIN LO~ER PORTION FOR YOUR RECORDS REV-15k7 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENTs ALLOHANCE OR DZSALLOHANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF CROCKER MARGARET FILE NO. 21 0~-0699 ACN 101 DATE 09-27-200~ TAX RETURN NAS: ( ) ACCEPTED AS F/LED (X) CHANGED SEE ATTACHED NOTICE RESERVAT/ON CONCERNING FUTURE INTEREST - SEE REVERSE APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) S. Closely Held Stock/Pertnersh:~p /nterest (Schedule C) ~. Hortgagas/Notes Receivable (Schedule D) S. Cash/Bank Deposlts/Htsc. Personal Property (Schedule E) 6. Jotntl¥ O~ed Property (Sch~lula F) 7. Transfers (Schedula G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/H1sco Expenses (Schedule H) 10. D®bts/Hortgeg~ L:~ab~lAt:Les/LAans (Schedule T) 11. Tote! D~duct Ions 12. Nat Value of Tax Re~urn (2) .00 .00 .00 .00 889.00 NOTE: To insure proper credAt to your account, submAt the upper portion of this form with your tax payment. 1,56~,.00 (9) (~0) .00 (11) ~ (za) ~7,170.00 13. 1~. NOTE: ASSESSMENT OF TAX: 15. Amount of L/ne lq at Spousal rate 16. Amount of L/ne 1~ t&xable at Lineal/Class A rata TAX CREDITS; 07-26-200q. COOOa, 196 · O0 (1S). .00 X O0 = .00 (~e). q7,170.00 x Oq5= 2,122.65 (17). .00 x 12 = .00 (~8), .00 X 15 .00 {19)= 2,122.65 INTEREST IS CHARGED-THROUGH 10-19-200q AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM /F PAID AFTER DATE ZND/CATED~ SEE REVERSE FOR CALCULATION OF ADDZT/ONAL INTEREST. Charitable/Governmental Bequests; Non-alect®d 911S Trusts (Schedule J) (15) . O0 Nat Value of Estate Sub,act to Tax (1~,) q7,170. O0 zf an assessment ~as 1ssued previously, lines lk, 15 and/or 16, 17, 18 and 19 reflect f/gures that include the total of AL__~L returns assessed to date. AMOUNT PA/D 2,005.15 TOTAL TAX CREDIT I 2,0h5.15 BALANCE OF TAX DUE] 117.50 INTEREST AND PEN. 1.07 TOTAL DUE 118.57 ( /F TOTAL DUE KS LESS THAN $1~ NO PAYMENT ZS REglU/RED. ZF TOTAL DUE TS REFLECTED AS A 'CREDTT' {CR), YOU MAY BE DUE A REFUND. SEE REVERSE STDE OF TN'rs FORH FOR 'rNSTRUCTTONS.) (6) . O0 (7) q7 ~,8q5. O0 (e) qG,75q. O0 BUREAU OF T. NDIVI~UAL TAXES INHERITANCE '£AX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLO#ANCE OR DZSALLOHANCE OF DEDUCTIONS AND ASSESSMENT OF TAX RE¥-1547 EX 4FP (gl-nS) CUT ALONG THIS LINE ~ DATE 09-27-200q ESTATE OF CROCKER DATE OF DEATH 10-28-2005 FILE NUMBER 21 0q-0699 COUNTY CUMBERLAND ACN 101 I Amount Remitted MARGARET MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 RETAIN LONER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP [01-03) NOT/CE OF INHERITANCE TAX APPRATSEMENT, ALLONANCE OR DISALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF CROCKER MARGARET FILE NO. 21 0q-0699 ACN 101 DATE 09-27-200q TAX RETURN HAS: ( ) ACCEPTED AS FILED (X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) q. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Tote1 Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expanses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 11. Total Deductions 12. Nat Value of Tax Return 889. O0 .00 NOTE: To insure proper .00 credit to your account, .00 submit the upper portion .00 of this form with your tax payment. .00 q7z8q5.00 (S) qB,7$q. O0 15. lq. NOTE: ASSESSMENT OF TAX: 15. Amount of Line Zq at Spousal rata 16. Amount of Line lq taxable at Lineal/Class A rata 17. Amount of Line lq at Sibling rata 18. Amount of L/ne lq taxable at Collateral/Class B rata 19. Principal Tax Due TAX CREDITS: PAYMENT DATE 07-26-200q 1,56q.00 .00 (11) I .56q. O0 (la) ~7,170.00 .00 q7,170.00 Charitable/governmental Bequests; Non-elected 9115 Trusts (Schedule J) (13) Nat Value of Estate Sub,act to Tax (lq) I~ an assessBent ~as issued previously, lines 14, 15 and/er 16, re~lect figures that include the total e~ ALL returns assessed to date. DISCOUNT (+) INTEREST/PEN PAID (-) RECEIP[ NUMBER .00 17, 18 and 19 ~111 (l$) .00 x O0 = .00 (16) q7,170.00 x Oq5= 2,122.65 (17) .00 x 12 : .00 (lB) .00 x 15 = . O0 (1~)= 2,122.65 AMOUNT PAID 2,005.15 117.50 1.07 118.57 CDOOq196 2,005.15 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE INTEREST IS CHARGED THROUGH 10-19-200q AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) RESERVATION: PURPOSE OF NOT[CE: PAYMENT: REFUND ICR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decadents dying on or before December 1Z, 19BZ -- if any future interest in the estate is transferred in possession or enjoyment to Class B Icollataral) beneficiaries of the decadent after the expiration of any estate for lifo or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (72 P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. --Make check or money order payable to: REGISTER OF HILLS, 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" (REV-lB13). Applications are available at the Office of the Register of Hills, any of the 23 Revenue District Offices, or by calling the special Zq-hour answering service for forms ordering: 1-BOO-56Z-ZO50~ services for taxpayers with special hearing and / or speaking needs: 1-&OO-447-50ZO (TT only). Any party in interest not satisfied ~ith the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. ZSIOZ1, Harrisburg, PA 171Z8-1021, 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 Ravie~ Unit, Dept. Z80601, Harrisburg, PA 171ZB-0601 Phone i717) 767-6505. Sea page S of the booklet "Instructions for Inheritance Tax Return for a Resident Decadent" (REV-150Z) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the dacedant's death, a five percent (SI) discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same tiaa 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 I9) months and one il) day from the date of death, to the date of payment. Taxes which became delinquent before January l, 198Z bear interest at the rate of six 16X) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 19BI 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 19BZ through 2004 are: Interest Daily Interest Daily Year Rate Factor Year Rate Factor ~ ZOZ .000548 ~'~)'~'8 - 1991 1ZZ .000301 1983 162 .000438 199Z 9Z .000247 1984 llZ .000501 1993-1994 72 .O0019Z 1985 13X .000556 1995-1998 9X .000Z47 1986 lOX .000Z74 1999 72 . O0019Z 1987 IOZ .000274 ZOO0 7Z . O00xgz --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID Interest Daily Year Rate Factor ~'~ 9Z .000Z47 ZOOZ 6Z .000164 2003 5Z .000157 ZOO4 4Z .000110 X NUI~BER OF DAYS DELINI~UENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen ilS) days beyond tho date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. ~Ev-~,70~<--~ ~ INHERITANCE TAX EXPLANATION COMMONVVEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME FILE NUMBER Crocker, Margaret 2104-0699 ACN REVIEWED BY Daniel Heck 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES The value of the real estate has been placed on schedule G as real estate that has been A transferred is a non-probate asset. H B-3 Reduced to $889.00. Family exemption can only be claimed against assets subject to will or intestacy. ROW Page 1 BUREAU OF INDIVIDUAL TAXES TNHERTTANCE TAX DTVTSTON PO BOX Z80601 HARRISBURG, PA 17128-0601 ROBERT L OBRIEN ESQ OBRIEN BARIC & SCHERER 19 W SOUTH ST CARLISLE PA 17015 COHHONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEHENT OF ACCOUNT REV-1607 EX AFP (99-01~) DATE 11-15-200~ ESTATE OF CROCKER DATE OF DEATH 10-28-2005 FILE NUHBER 21 0~-0699 iCO~y CUMBERLAND ACN 101 Amount MARGARET HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To /nsure proper cred/t to your account, submi~ the upper portion of this form with your tax payment. CUT ALONG TH'rS L/NE ~ RETAIN LONER PORT'rON FOR YOUR RECORDS ESTATE OF CROCKER HARGARET FILE NO. 21 0~-0699 ACN 101 DATE 11-15-200~ THTS STATEHENT TS PROVTDED TO ADV/SE OF THE CURRENT STATUS OF THE STATED ACM TN THE NAHED ESTATE. SHO#N BELO# TS A SUHHARY OF THE PRZNC/PAL TAX DUE, APpLTCATTON OF ALL PAYMENTS, THE CURRENT BALANCE, AND., ZF APPL/CABLE, A PROJECTED TNTEREST F/GURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 09-Z7-200~ PRINCIPAL TAX DUE: .................................................................................. PAYHENTS (TAX CREDITS): 2,122.65 PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) .00 07-26-200~ 10-05-200~ CD00~196 CD00~72 .89- 2,005.15 118.57 IF PAID AFTER THIS DATE, SEE REVERSE S/DE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CRED/T" TOTAL TAX CREDIT 2,122.85 BALANCE OF TAX DUE .18CR INTEREST AND PEN. .00 TOTAL DUE .18CR YOU HAY BE DUE A REFUND. SEE REVERSE STDE OF THTS FORM FOR TNSTRUCTTONS. PAYNERT: Detach the top portion of this Not[ce and submit with your payment made payable to the name and address printed on the reverse side. -- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF HILLS, AGENT. -- If NON-RESIDENT DECEDENT make check or money order payable to: COHHON#EALTH OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, amy be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available online at awe.revenue.state.pa.us, any Register of Hills or Revenue District Office, or from the Department's Z4-hour answering service for forms orders: 1-800-BSZ-ZO50; services for taxpayers with special hearing and/or speaking needs: 1-800-447-$0Z0 (TT only). REPLY TO: DISCOUNT: PENALTY: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, P.O. Box 280601, Harrisburg, PA 171ZB-0601, phone (717) 787-6505. If any tax due is paid within three (~) calendar months after the decedent's death, a five percent (BI) discount of the tax paid is allowed. The IBZ 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 tho end of the tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (I) day from the date of death, to the date ef payment. Taxes which became delinquent before January [, 198Z bear interest at the rate of six (SI) percent per annum calculated at a daily rate of .000164. Ali taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year ~ith that rate announced by the PA Department of Revenue. The applicable interest rates for 19BZ through 2004 are: Interest Daily Interest Daily Interest Year Rate Factor Year Rate Factor Year Rate 1982 202 .0005q8 xgs8-X99X XLZ .00030! 2001 92 1985 16Z .00043B 1992 9X .000247 200Z 62 1984 llZ .O003Ol 1995-1994 7Z .O0019Z 2003 5Z 1985 13Z .000356 1995-1998 92 ,000Z47 2004 ~Z 1986 lOZ .000274 1999 72 .O0019Z 1987 9Z .000247 2000 BZ .000Z19 Daily Factor .000247 .000X64 .000137 .O00XlO --Interest is calculated as follo~s: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent Hill reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shomn on the Notice, additional interest must be calculated.