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HomeMy WebLinkAbout04-0728 OOMMO.WEALT. OF REV'1500 OFF,C.*LUSE ONLY ~ PENNSYLVANIA a~:~~ DEPARTMENT OF REVENUE ~.uu~,~.uu~FILE NUMBE~ DE T. INHERITANCE TAX RETURN HARRISBURG, PA 17128-0601 RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIBDLE INITIAL) SOCIAL SECURI~ NUMBER ~, ~ ~- 211 - 12 - 9009 DATE OF D~TH (MM-DD-Y~R) DATE OF BIRTH (MM-DD-Y~R) THIS RETURN MUST BE PILED IN DUPLICATE WITH THE REGISTER OF WILLS O5-24-1998 O7-22-1923 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (~ST, FIRSt AND MIDDLE INITIAL) SOCIAL SECURI~ NUMBER ~ 1. O~gi~al Return ~ 2. Supplemen~l Return ~ 3. Remainder Return (da~. of d.~th ~ to ~243~2) ~ 4. L~ited Estate ~ 4a. Future [Rt~rest Co~promise (date of dea~ after 12-12~2) ~ 5. Federal Es~te Tax Return Required ~ 6. Decedent Died Testate (A~ ~py ~ Wi~) ~ 7. Decedent Maintained a Living Trust (A~ch ~py of Trust) 8. TO~I Number of Safe De,sit Boxes ~ 9. Litigation Proceeds Received ~ 10. Spousal Pove~ Credit (dat. ~ d.~h ~., ~-3~-9~ a~d ~-~-95) ~ 11. Ele~ion to tax under Sec. 9113(A) (A~ ~ O) NAME COMPLETE MAILING ADDRESS HiC~el ~. Schee~e~, FIRM NAME (If~pli~ble} 5208 Libra~ Ro~ ~el P~k, PA 15102 TELEPHONE NUMBER (412) 854-0330 1. Real Estate (Schedule A) (1) OFFICIAL USE ONLY 2. Stocks a,d Bonds (Sch~ule B) (2) 3. Clo~ly ~eld Co~omtion. Pad,emhip or Sole-P~pdetomhip (3) 4. Mo~gages & Notes Revivable (Schedule D) (4) 5. Cash. Bank Deposits & Mis~llaneous Pemonal Prope~ (5) {Sch~ule E) 6. Join,y ~ned Pro~ (Sch~ule F) (6) S 4. 920.00 ~ ~rate Billing Requested 7. Inter-Vivos Transfers & Mis~llaneous No~-Pmbate P~pe~ (7) -0 - ~:~: (Schedule G or L) 8. Total 6~ss ~se~ (to~l Lines I-7) (8) S 4,920.00 9. Funeral Expenses & AdministmEve Cos~ (Schedule H) (9} ~ R: ~ ~. ~ 10. Bebts of Beeriest, MoAgage Liabilities, & Liens (Schedule I) (10) - ~ - 11. Total ~du~ions (total Li~es 9 & 10) (11) S 6,030.00 12. Net Value of Es~te (Line 8 minus Line 11) (12) - 0 - 13. Cha~table and Governmen~l Bequest/Sec 9113 Trus~ for which an election to ~x has not been (13) made (Schedule J) 14. Net Value Subje~ to T~ (Line 12 minus Line 13) (14) - 0 - SEE INSTRUCTIONS O~ REVERSE SIDE FOR APPLICABLE ~TE8 15. Amount of Line 14 ~ble at the ~x rote, br transfers under Sec. 9116 (a)(1.2) x .0 (15) 16. Amount of Line 14 taxable at lineal rote x .0 (16) ~7. Amount of Line 14 ~xable at sibling rate . x .12 (17) 18. Amount of Line 14 ~xable at collateral rote x .15 (18) 19. Tax Due (19) - 0 - Decedent's Complete Address: ' ISTREETADDRESS 4 Clemson Drive CITY STATE zip C~',',p Hi ] ] , PA i 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) - 0 - 2, Credits/Payments A. Spousal Poverty Credit B, Prior Payments C. Discount Total Credits ( A + B + C ) (2) 3. Interest/Penalty if applicable D, Interest E. Penalty Total Interest/Penalty ( D + E )(3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT, Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) - 0 - A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) - 0 - 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 properly 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 care? ...................................................................... [] [] 2. If death occurred after December 12, 1982, did decedent transfer property withiD one year of death without receiving adequate consideration? .............................................................................................................. [] [] 3. Did decadent 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 noD-prebate 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 perjurT, 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 on all information of which preparer has any knowledge. DATE Michael P. Schaefer, Esq. July 29, 2004 Park, PA 15102 DATE M. Colleen Murray JulyS, 2004 4 Clemson Drive, C~,[J PA 17011 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 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 RS. §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 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 RS. §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 RS. §9116(1.2) [72 RS. §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 an individual who has a,t least one parent in common with the decedent, whether by blood or adoption, REV-I,502 EX+ (6-9~j~ SCHEDULE A CO ' 'ONWEALTN Or PENNSYLVAN,^ REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FIL:E NUMBER Agnes T. Murray All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant fasts. Real propen'y which ia Jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE HUMBER DESCRIPTIOH OF DEATH 1, See Schedule F TOTAL (Also enter on line 1, Recapitulation $ (If more space is needed, insert additional sheets of the same size) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Agnes T. Murray All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. None TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, inset1 additional sheets of the same size) SCHEDULE C COMMONW~ALTH~OF PENNSYLVANIA CLOSELY. HELD CORPORATION, INHERITANCE TAX RETURN PARTNERSHIP or SOLE-PROPRIETORSHIP RESIDENT DECEDENT ESTATE OF FILE NUMBER Agnes T. Murray Schedule C-1 or C-2 (including all supporling informa'don) must be attached for each closely-held corporafion/pattnership interest of the decedent, other than a sole-pmpbetomhip. See ins'~mchons for the supporting information to be submitted for sole-propdetomhips. ITEM VALUE AT CATE NUMBER DESCRIPTION OF DEATH 1. None TOTAL (Also enter on line 3, Recapitulation) $ - 0 - (If more space is needed, insert additional sheets of the same size) REV-.t.07 EX+ ~-ST~ SCHEDULE D COMMONWEALTH OF PENNSYLVANIA MORTGAGES & NOTES INHERITANCE TAX RETURN RECEIVABLE RESIDENT DECEDENT ESTATE OF FILE NUMBER Agnes T. Murray Ail property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH t. None TOTAL (Also enter on line 4, Recapitulation) $ - 0 - (If more space is needed, insert additional sheets of the same size) ~ SCHEDULE E COMMONWEALTH~OF PENNSYLVANIA ----CASH, BANK DEPOSITS, & MISC. ,NNE"'TANCE T~X RETU"N PERSONAL PROPERTY RESJDENT DECEDENT ESTATE OF FILE NUMBER Agnes T. Murray include the proceeds of lifiga~n and the date the proceeds were received by the estate. All property Jotatly-ovated with the ~,ght of suP,,ivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. None TOTAL (Also enter or, line 5, Recapitulation) $ - 0 - (If more space is needed, insert additional sheets of the same size) SCHEDULE F COMMONWEALTH OE PENNSYLVANIA JOINTLY'OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF 'FILE NUMBER Agnes~ .T. Murray If an asset was made joint within one year of the decedent'e date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT{S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF eEATH ITEM FOR JOINT MADE Include ne'ce of financial institution and bank account number or similar idenlifying number, A~tach DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT deed f~r jointly-held real estate. VALUE OF ASSET INTEREST DECEDENTS INTERE ~ 1. A. 6/9/87 Real Estate generally known as 4 Cl~nson $ 9,840.00 50% $ 4,920.( Drive~ Camp Hill, Cumberland County, PA 17011; also known as tax map #13-23-0547- 472. Copy of deed attached hereto as "Exhibit A". Said property was assessed in 1998 (year of death) at a valuation of $9,840.00. Copy of 1999 real estate tax notice is attached here~as "Exhibit B". Valuation is noted thereon and highlighted. TOTAL (AIso enter on line 6, Recapitulation) $ 4, 920.00 (if more space is needed, insert additional sheets of the same size) EX+ t2-99 1. . SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Agnes T. Murray Debts of decedent must be reported on Schedule ], ITEM NUMBER DESCRIPTION AMOUNT A, FUNERAL EXPENSES: Myers-Hamer Funeral H~ne, INc. $ 2,530.00 Copy of bill attached as "Exhibit C" B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State __ Zip Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) $ 3,500. O0 Claimant M. Colleen Murray Street Address 4 ~lm~nn Driv~ City C~_ Hill State PA Zip 17011 Relationship of Claimant to Decedent Daughter 4. Probate Fees 5, Accountant's Fees 6. Tax Return Preparer's Fees TOTAL (Aisc enter on line 9. Recapitulation) $ 6,030.00 (If more space is needed, insert additional sheets of the same size) .~/~.~ SCHEDULE I COMM©NWEALTHOFPENNSYLVANIA~"~"~' DEBTS OF DECEDENT, INHERITANCE TAX RETURN R~,OEN~C~OEN~ MORTGAGE LIABILITIES, & LIENS ESTATE OF AcjT~es "~. Mu~'~c~y FILE NUMBER Include unreimbursed medical expenses, ITEM NUMBER DESCRIPTION AMOUNT 1. TOTAL (Also enter on line 10, Recapitulation) $ - 0 - (If more space is needed, insert additional sheets of the same size) SCHEDULE J CO MONW LTH Or PENNSYLVAN,A BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Agnes T. Murray RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS (include outdght spousal distributions) 1, Colleen Murray Daughter 100% 4 Clemson Drive Camp Hill, PA 17011 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 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART ]]. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additiona~ sheets of the same size) 07/28/2004 18:01 FAX * LANOA~ERICA ~005/005 ht t~t ~'t~tnc[ o~ · .*,,~ 07/28/2004 16:00 FAX + L^ND^~ERIC^ ~003/005 LEGAL FOR: 1302300 MURRAY ALLEGHENY COUNTY ALL THAT CERTAIN PIECE OR PARCEL OF LAND SITUATE IN LOW'ER ALLEN TOWNSHIP, CUMBE~ COUNTY, PENNSYLVANIA, BOUNDED AND DESCRIBED AS FOLLOWS, TO WIT: BEGINNING AT A POINT ON THE NORTHERN SIDE OF A 50 FEET WIDE ROAD KNOWN AS CLEMSON DRIVE, WHICH POINT, MEASURED ALONG THE NORTHERN SIDE OF CLEMSON DRIVE, IS 100 FEET EAST OF THE NORTHEAST CORaNER OF CLEMSON DRIVE AND STATE HIGHWAY L._R. NO. 21023 AND WHICH POINT IS ALSO AT THE SOUTHEAST CORNER OF LOT NO. 24 ON THE PLAN OF LOTS HEREINAFrER REFERRED TO; THENCE NORTHWARDLY ALONG THE EASTERN LINE OF LOT NO. 24 AFORESAID 121.69 FEET TO A POINI AT TIIE SOUTHERN LINE OF LOT NO. 25 ON SAID PLAN OF LOTS; THENCE EASTWARDLY ALONG THE SOUTHERN LINE OF LOT NO. 25 63.4 FEET TO A POrNT AT TIlE SOUTHERN LINE OF LOT NO. 21 ON SAID PLAN; THENCE EASTWARDLY ALONG THE SOUTHERN LINE OF LOT NO. 2I 38.3 FEI~T TO A POINT AT THE WESTERN LINE OF LOT NO. 22 ON SAID PLAN; THENCE SOUTHWARDLY ALONG THE WESTERN LINE OF LOT NO. 22 121,7 FEET TO A POINT AT THE NORTHERN SIDE OF CLEMSON DRIVE; THENCE ALONG THE NORTHERN SIDE ON CLEMSON DRIVE; THENCE ALONG THE NORTItERN SIDE OF CLEMSON SRIVE; THENCE ALONG TH]E NORTHERN SIDE OF CLEMSON DRIVE BY AN ARC CURVING TO THE LEFT AND HAVING A RADIUS OF 1012.45 FEET WESTWARDLY 90.06 FF.~T TO A POINT, THE PLACE OF BEGINNING. BEING LOT NO. 23, PLAN NO. 1, CEDAR CLIFF MANOR RECORDED IN PLAN BOOK 6, PAGE 33. BEING THE SAME pREMISES WHICH WILLARD F. KEISER, JR. AND ANNA M. KEISER, HIS WIFE, BY DEED DATED FEBRUARY 27, 1956 AND RECORDED IN DEED BOOK 162, PAGE 397, GRANu ED AND CONVEYED UNTO BERNARD E. MURRAY AND AGNES T, MURRAY, HIS WIFE; THE SAID BERNARD E. MURRAY DIED OCTOBER 16, 1980, WHEREBY AGNES T. MURRAY BECAM]E THE SOLE OWNER OF THE SAID PREMISES BY HER RIGHT OF SURVIVORSHIP AS A TENANT BY THE ElqTIR.ETIES. UNDER AND SUBJECT TO ALL ACTS OF ASSEMBLY, COUNTY AND TOWNSHIP ORDINANCES, RIGHTS OF PUBLIC UTILITY AND PUBLIC SERVICE COMPANIES, EXISTING RESTRICTIONS AND EASEMENTS, VISIBLE OR OF RECORD, TO THE EXIENT THAT ANY PERSONS OR ENTITIES HAVE ACQUIRED LEGAL RIGHTS THERETO. 07/29/2004 THU 06:25 FAX 7177301309 CLAIMS ANALYSIS ~004 M. COi'.I~ MURRAy ~ ** TAXPAYER COPY ** BILL DATE 3/01/1999 BILL NO 3394 1999 REAL ESTATE TAX NOTICE LA-RY ANN PRIOR, TREASURER i COUNTy OF CBMBERLAND .993 ~L AVENUE '.mr H~LL rA ~?011-~938 iTOW~SN~P OF LO~R m~Lm~ !IF T~XES ~ IN ESCRow, IT IS yOUR pa~SPONSiBILiTy TO FO~W~ TO YOUR ~ORTGAG~ AP NO 13-23-0547-472 004 CL~SON DRI~ ~ IMP~ ~I~ ~ V~UATION~ CRES .270 DE~ 32S/ 644 ~ ~uu~ 8440 ED~ CLIFF ~OR DT 23 p~ 1 PB 6 PG 33 ~ ' ,llh,,/ll,,,Ih.,,,llli,,,ll,,,II,,,ll,,,,,,lll DEn~~~.~ ' 81.18~ . COLLEEN ) ~X 522 ~ ~ ~ ~~'17.~ ' % 3/01/199 oss~ OTH~S ~. ~ ~nn ~s~s ~ ............ ONE (717) 975-7575 ~ ~ V~D aY ~m/~0/~ ~S 0?/28/2004 i4:25 7177740737 ROOKYRAD2U4 PAGE MyeFs-Harner Funeral Home, Ine- ~ H. Hm~, ~/~ A, ~ ~ i~ ~s'~ ~ c~ I_ ............................... :: 2, FACILI~S k~ Sil~C~ C. ~CI~ CH~G~S~ UK ~ ~ ~ ~ for F~i~ ~ Fe~ to ~ ~ ~ l~m~ ~-TOT~ O~ ~iAk ~ ................ ~ I ,, D. ~H ............................... s~ ~~ ~ ~ .................. ...... ~ ....... Vehicle to ~ ~ ~ P~ ~. ~ New~ N~c~ut~f-t0wfl .... - ~ ~ c~m~ ...................... ~ ~/c~ ~ ....... I_ IACILE~ ~ ~.ion) Equi~. ...................... ~. ~a~ ..................... ~) D. C~ Ad~ ................... '~ VOV~ O~ ~ [~S ........................ ~) "~ C" ~Cl ~ ................................ ~, PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 004586 SCHAEFER MICHAEL P ESQ 5208 LIBRARY ROAD BETHEL PARK, PA 15102 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 $1,500.00 ESTATE INFORMATION: SSN: 211-12 9009 FILE NUMBER: 2104-0728 DECEDENT NAME: MURRAY AGNES T DATE OF PAYMENT: 11/04/2004 POSTMARK DATE: 1 1/04/2004 COUNTY: CUMBERLAND DATE OF DEATH: 05/24/1998 TOTAL AMOUNT PAID: $1,500.00 REMARKS: CHECK// 1091 INITIALS: JA SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS MICHAEL P. SCHAEFER, ESQUIRE 5208 LIBRARY ROAD BETHEL PARK, PA 15102 2715 {412) 854-0330 Telephone (412) 854-7800 Fax No. October 26, 2004 Register of Wills Office Cumberland County Courthouse Carlisle, PA 17013 Re: Our File No. 13003L Estate File No. 21 04-0728 THE ESTATE OF AGNES T. MURRAY Property: 4 Clemson Drive, Camp Hill, PA 17011 Settlement Date: July 30, 2004 To Whom It May Concern: Enclosed please find a check made payable to the "Register of Wills Office" in the amount of $1,500.00. This check represents a partial- payment on the Pennsylvania Inheritance Tax obligation. M. Colleen Murray, the decedent's daughter, will be contacting your office in order to make the final payment arrangements. Please issue our office an appropriate receip~ for the partial-payment and return the same to my office in the enclosed envelope. Should you have any additional questions, please do not hesitate to contact me. Very truly yours, /II ~J Michael P. Schaefer~ -- MPS/cl Enclosures ~--~' COHNONNEALTH OF PENNSYLVANIA ~. BUREAU OF INDIVIDUAL TAXES DEPARTHENT OF REVENUE HARR[SBURC~ PA 17128-0601 NOT/CE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR D/SALLOWANCE OF DEDUCTTONS AND ASSESSHENT OF TAX ~EV-ZS4~£X*~P~D~-0~ DATE 09-27-2000` ESTATE OF HURRAY AGNES T DATE OF DEATH 05-20`-1998 FILE NUNBER 21 00`-0728 COUNTY CUHBERLAND HICHAEL P SCHAEFER ESQ ACN 101 5208 LIBRARY RD Amoun* Remi~ed BETHEL PARK PA 15102 HAKE CHECK PAYABLE AND REHIT PAYHENT TO: REGISTER OF NILLS CUH~ERLAND CO COURT HOUSE CARLISLE~ PA 1701~ CUT ALONG THIS LINE ~ RETAIN LO~ER PORTION FOR YOUR RECORDS *-~ - - ................. DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ESTATE OF HURRAY AGNES T FILE NO. 21 00`-0728 ACN 101 DATE 09-27-Z00fi TAX RETURN WAS: ( ) ACCEPTED AS FILED [ X) CHANSED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN ~ASED ON: ORIGINAL RETURN 1. Real Es~a~e {Schedule A} (1) .00 NOTE: To insure proper 2. S~ocks end Bonds (Schedule BJ (2} .00 credi~ ~o your accoun~ APPROVED DEDUCTIONS AND EXEHPTIONS: 2,550.00 NOTE: X~ an assessment was /ssued previously, lines 1~, 15 and/or 16, 17, 18 and 19 wil1 re~lect ~lgures that include the total o~ ALL returns assessed to date. ASSESSHENT OF TAX: 16. Amoun* of Line ifi ~axable a~ Lineal/Class A ra~e (16) 67,776.80 X 06 = 0`,066.61 TAX CREDITS: PAYHENT RECEIP1 DISCOUNT (+J INTEREST 'rS CHARGED THROUGH 10-19-2000, TOTAL TAX CREDXT .00 AT THE RATES APPL'rCA]}LE AS OUTLINED ON THE ~ALANCE OF TAX DUE c~,066.61 REVERSE SIDE OF THIS FORH INTEREST AND PEN. 'r,51Z.q7 TOTAL DUE 5,579.08 ... ~ 'rF PAZD AFTER DATE TNDTCATED~ SEE REVERSE [ ZF TOTAL DUE TS LESS THAN $1~ NO PAYHENT ZS RE~UTRED. i~' FOR CALCULATZON OF ADDZTTONAL TNTEREST. TF TOTAL DUE TS REFLECTED AS A "CREDTT" (CR)~ YOU HAY BE DUE ,, j A REFUND. SEE REVERSE STDE OF TH*rS FORH FOR ZNSTRUCTTONS.) ~NTEREST ~ BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DA~LY ~NTEREST FACTOR  INHERITANCE TAX I EXPLANATION COMMON~VEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT 28O601 HARRISBURG, PA 17128-0601 DECEDEN'FS NAME FILE NUMBER Murray, Agnes T. 2104-0728 REVIEWED BY ACN Daniel Hack 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES F I The value of the real estate is increased from $4,920.00 to $70,306.80 as the result of multiplying the assessed value of the r~al ~,..s~le $~9[~40.~,~y;tbe:common level ratio of i~mber!and Coun~ ip ~ff~,~,~;~t.h~:,d.~d~.'~{!~:'~d'~ ~f a~a'~{~f':~4~29 to .g,e_t~he fair market ~iue of the real es~te $¥~i~.6~) and dividing by 2 to get th~ decedent s % share of the real estate of $70,306.80. H B-3 The claim for family exemption cannot be made against non-probate assets as the exemption comes from Chapter 3t of the Probate, Estates and Fiduciary Code. ORIGINAL Page 1 HARRISBURG PA 17128 0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 004566 SCHAEFER MICHAEL P ESQ 5208 LIBRARY ROAD BETHEL PARK, PA 15102 ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 $4,079.08 ESTATE INFORMATION: SSN: 21112-9009 FILE NUMBER: 2104-0728 DECEDENT NAME: MURRAY AGNES T )ATE OF PAYMENT: I 1/01/2004 POSTMARK DATE: 10/30/2004- COUNTY: CUMBERLAND DATE OF DEATH: 05/24/1998 TOTAL AMOUNT PAID: $4,079.08 REMARKS: CHECK# 10667 INITIALS: JA SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS DU.EAU OF I.DIVID~p~2X~;~ TNHERZTANCE TAX PO BOX 280601 HARRTSBURG, PA COMHONWEALTH OF PENNSYLVANTA DEPARTHENT OF REVENUE INHERITANCE TAX STATEHENT OF ACCOUNT REV-i~07 EX AFP (09-0~) DEC 29 AHg:I2 CLERK OF ORPHAN'S COURT 5208 LIBRARY RD BETHEL PARK PA 15102 DATE 12-13-200~ ESTATE OF MURRAY DATE OF DEATH 05-2~-1998 FILE NUMBER 21 0~-0728 COUNTY CUHBERLAND ACN 101 L Amoun~ Remi~ed AGNES T HAKE CHECK PAYABLE AND REN/T PAYHENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper cred/* ~o your accoun~c, submi~ ~hB upper por~lon of ~hls form w1*h your ~mx paymen~c. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~RI ~y:~y 'g~" 'E~' '~1'-'~1 ......'~;~' '~r~ YAWEd' 'f~' '~?AYgR~Tf ' ~I~'~Y60gY" ~'~ ..................... ESTATE OF HURRAY AGNES T FTLE NO. 21 0~-0728 ACN 101 DATE 12-15-200~ THIS STATEMENT IS PROVIDED TO ADV/SE OF THE CURRENT STATUS OF THE STATED ACH IN THE NAMED ESTATE. SHOWN DELO# IS A SUMMARY OF THE PR/NC/PAL TAX DUE, APpLTCATTON OF ALL PAYMENTS, THE CURRENT BALANCE, AND, TF APPLICABLE, A PROJECTED INTEREST FTGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTHENT: 09-27-200~ PRINCIPAL TAX DUE: .......................................................................................... PAYHENTS (TAX CREDITS): fi,066.61 PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID C-) 10-$0-200~ 11-0~-200~ ~ CD00~566 ~ CD00~586 12.q7- 1,500.00- ~,079.08 1,500.00 BALANCE OF UNPAID INTEREST/PENALTY AS OF 11-05-200~ IF PA[D AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE ZS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" {CR), TOTAL TAX CREDIT ~,066.61 BALANCE OF TAX DUE .00 INTEREST AND PEN. ~.92 TOTAL DUE q.92 YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )