Loading...
HomeMy WebLinkAbout03-0393BUREAU OF INDIVIDUAL TAXES TNHERZTANCE TAX DZVTSXOH DEPT. 280601 HARRTSBURG, PA 17128-0601 DAVID N REAGER ESQ REAGER 8 ADLER 2331HARKET ST CAHP HILL CONNONNEALTH OF PENNSYLVANIA DEPARTNENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISENENT, ALLO#ANCE OR DZSALLONANCE OF DEDUCT/ONS AND ASSESSNENT OF TAX REV-I$¢7 EX AFP (0'~-03) DATE ESTATE OF DATE OF DEATH FILE NUHBER °UNTY ACN 03-15-2004 SCHAUFERT 04-24-2003 21 03-0393 CUNBERLAND 101 ERIC H Aeoun{ Ram/{~ed I HAKE CHECK PAYABLE AND RENZT PAYHENT TO: REGISTER OF NILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE I~ RETAIN LONER PORTION FOR YOUR RECORDS -~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSENENT, ALLONANCE OR DISALLONANCE OF DEDUCTIONS AND ASSESSNENT OF TAX ESTATE OF SCHAUFERT ERIC NFZLE NO. 21 03-0393 ACN 101 DATE 03-15-2004 TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B} (2) 3. Closely Held Stock/Partnership Interest (Schedule C) ($) ~. Hortgages/Notes Receivable (Schedule D) (~) 5. Cash/Bank Deposits/Nisc. Personal Property (Schedule E} (5) 6. Jointly Owned Propar~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. To{al Assets APPROVED DEDUCTZONS AND EXEHPTZONS: 9. Funeral Expansas/Adm. Costs/Hisc. Expenses (Schedule H) (9) 10. Debts/Nortgege Liabilitlas/Liens (Schedule Z) (10) 11. Total Deductions 12. Net Value of Tax Return 15. 1~. Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) Net Value of Estate Sub~ect to Tax O0 O0 O0 783/703.26 O0 O0 9,101.65 (8) NOTE: To insure proper credit to your account, submit the upper portion of this fore with your tax payment. 1,124,107.51 .00 (11) ~). 101.65 (12) 1,115,005.86 (15) .00 (1~] 1,115,005.86 NOTE: Z~ an assessment was lssued previously, 1/nas 1~, 15 and/or 16, 17, 18 and 19 will reflect f/gures that include the total of ALL returns assessed to date. ASSESSNENT OF TAX: 15. Aaount of Line 1~ at Spousal rats (1.6) 16. Amount of Line 1~ taxable st Lineal/Class A rate (16) 17. Aaoun~ of L/ns lq at Sibling rate (17) 18. Amount of Line lq taxable et Collateral/Class B rata (18) 19. Principal Tax Due TAX CREDITS: PAYllENT DATE 1,115,005.86 X O0 = .00 · 00 X 045= .00 · 00 X 12 = .00 . O0 X 15 = . O0 (19)= . O0 RECEIPT NUHBER ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. DISCOUNT INTEREST/PEN PAID (-) AHOUNT PAID TOTAL TAX CREDIT I I BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 .00 .00 .00 ( IF TOTAL DUE IS LESS THAN $1, NO PAYNENT ~S REQUIRED. ZF TOTAL DUE IS REFLECTED AS A 'CRED/T' (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.) RESERVATION: PURPOSE OF NOTXCE: PAYMENT: REFUND (CR): OBJECTIONS: ADHZN- ISTRATIVE CORRECTIONS: D~SCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 11, 1981 -- if any futura interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the 1aclu1 Class 8 (collateral) rate on any such future interest. To fulfill the requirements of Section 21q0 of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (71 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 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-ISIS). Applications era available at the Office of the Register of Hills) any of the 23 Revenue District Offices) or by calling the special Z4-hour answering service for forms ordering: 1-800-362-ZOS0) services for taxpayers with specie1 hearing and / or speaking needs: 1-800-447-3010 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (603 days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17118-1011, 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, Oept. 280601, Harrisburg) PA 17118-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for /nheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the dacsdant's death, a five percent (51) discount of the tax paid is allowed. The 151 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed) and not paid before January 18) 1996t 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 (9) months and one (1) day fram the date of death, to the date of payment. Taxes which became delinquent before January 1, 1981 bear interest et the rate of six (61) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January it 1981 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 1981 through Z004 are: Interest Daily [nterast Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ~ EOZ .000548 ~"~J"~-1991 X1Z .000301 ~ 91 .ooogq7 1983 16Z .000438 1992 9Z .000147 2002 6Z .000164 1984 111 .000301 1993-1994 71 .000192 Z003 51 .000137 1985 13Z .000356 1995-1998 9Z .000147 2004 41 .OOOIZO 1986 101 .OOOZT~ 1999 71 .OOO192 1987 10Z .O00Z7q 2000 7Z .00019Z --Interest is calculated as fallows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest caXculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation data shown on the Notice) additional interest must be calculated. Register of Wills of Cumberland County Pennsylvania PETITION FOR GRANT OF LETTERS Estate of Eric M. Schaufert No. ,~ also known as Eric Schaufert Linda M. Schaufert Petitioner(s), who is/ara 18 years of age or older, apply(les) for: Deceased Social Security No. 202-50-5571 (COMPLETE "A" OR "B" BELOW:) A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut rix ~-~ Decedent, dated 7/26/94 and codicil(s) dated none named in the Last Will of the State relevant circumstances, e.g., renunciation, death of executor, etc Except as follows, Decedent did not marry, was not divorced and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: B. Grant of Letters of Administration (c.t.a., d.b.n.c.t.a.: pendente lite, durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal residence at 497 Crape Myrtle Drive, Boilin~l Sprin~ls, PA 17007 (list street, number and municipality) Decedent, then 43 years of age, died April 24, , .2003 , at Jame Wri~lht Farm, Perr~ County, Pennsylvania (Location) Decedent at death owned property with estimated values as follows: (if domiciled in PA) All personal property ......................................... $ (if not domiciled in PA) Personal property in Pennsylvania .................... $ (If not domiciled in PA) Personal property in County .............................. $ Value of real estate in Pennsylvania Total Real Estate situated as follows: 50,000.00 50,000.00 Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: Signature Typed or printed name and residence Linda M. Schaufert Drive PA 17007 RW-7 Oath of Personal Representative Commonwealth of Pennsylvania County o[ Cumberland The Petitioner(s) above-named swear(s) and afffirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to and affirmed and subscribed before me this ~ '+~ day of DECREE OF REGISTER Estate of Eric M. Schayf~rt Deceased No. ~. also known as Eric Schaufert Social Security No: 202-50-5,571 Date of Death: 4/24/03 AND NOW, , 200.__~__3, , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters [~ Testamentary Q of Administration (c.t.a., d.b,n.c.t.; pendente lite; durante absentia; durante minodtate) are hereby granted to.Linda M. Schaufert in the above estate and that the instrument(s), if any, dated Jul), 26, 1994 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters .................................... Shod Certificate(s) ............... $ Renunciation .......................... $ Affidavit ( ) ....................... $ Extra Pages ( ) .............. $ Codicil ................................. $, JCP Fee ................................. $ ID, Inventory & Tax Forms ............. $ Other ...................................... $ TOTAL ............................. $ / o~(:J'. (~ RW-7A Register o~ Wills ~J ! -- 0 ~ Attorney: David W. Readier I.D. No: 20868 Address: 2331 Market Street Camp Hill PA 17011 Telephone: 717-763-1383 DATE FILED: his is to certify that the information here given is correctly copied from an original certificate of death duly flied with me as I,ocal Registrar. The original certificate will be. forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 9283293 No. Local Registrar APR. 2 8 21103 Date COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH 202-- 50 -- 5571 43 ; 10~ | 497 Crape Myrtle Drive Boiling Springs, PA 17007 ~'$~ (~t M~.~ a. Schaufert ''L ~ PA 219 N. York, PA 17404 Funeral Home Llz:£,:l L-X~I tO. ,to ~--,,,~0 pamo::)ebl LAST WILL AND TESTA~E. NT - o. -39 I, ERIC M. SCHAUFERT, of Bedford County, Virginia, do hereby make, publish and declare this to be my last will and testament, hereby expressly revoking all wills and codicils heretofore made by me. ARTICLE ONE A. I bequeath all of my tangible personal property to my wife, LINDA M. SCHAUFERT, (hereinafter referred to as my "WIFE"). B. If my wife fails to survive me, I bequeath all of my tangible personal property to my step-children, BRADFORD RALPH SCOTT EXUM and JAYSON BRENT EXUM, surviving at the time of my death; if my step-children should not survive me, then I give all of my tangible personal property to their issue, Der ~tirDes; provided, however, that if any beneficiary is less than eighteen (18) years of age at the time of my death, my Executor shall deliver, without requiring bond, to such beneficiary or to the person with whom such beneficiary is residing at the time of distribution, so much of the beneficiary,s share of such tangible personal property as may be deemed appropriate, in my Executor,s sole discretion, and the receipt of the beneficiary or of such person shall be a full and final discharge of my Executor for the property so delivered, and my Executor shall sell the remainder of the beneficiary,s share of tangible personal property and add the proceeds therefrom to the share of the beneficiary in my residuary estate. I may leave a letter of intent with my Executor, or another, for the purpose of giving guidance to my Executor in the distribution of my tangible personal property among my beneficiaries and I request, but do not require, that my Executor honor my wishes therein expressed. ARTICLE TWO I devise and bequeath all of the rest and residue of my estate, real and personal, as follows: A. If my wife survives me, I give all of such rest and residue to her in fee simple absolutely. B. If my wife fails to survive me, I direct that all of such rest and residue be divided into as many equal shares as may be necessary in order to provide (i) one share for each of my step-children surviving at my death and (ii) one share for each of my step-children who has predeceased me leaving issue surviving at my death and, subject to the provisions of Article Three, I dispose of such shares as follows: (1) One of such shares shall be paid over and distributed to each of my step-children surviving at my death; and (2) One of such shares shall be paid over and distributed to the issue of each of my step-children who has predeceased me leaving issue surviving at my death. ARTICLE THREE If any beneficiary under Article Two has not reached the age of twenty-five (25) years (hereinafter referred to as the "age of distribution,,) at the time of my death, then I give the share of such beneficiary to my Trustee, hereinafter named, IN TRUST, to hold and manage for the benefit of the beneficiary. So much of the income from this trust and, if net income be at any time insufficient, so much of the principal of this trust as may be deemed necessary in the discretion of my Trustee (taking into account all other sources of income or support of the beneficiary of which my Trustee has knowledge), shall be either paid to or expended on behalf of the beneficiary (whichever in the Trustee,s discretion is determined most appropriate) in order to insure the proper support, maintenance and education (including collegiate, vocational, professional, etc.) of the beneficiary. When the beneficiary reaches the age of distribution, the principal, together with any accumulations of income, shall be paid over and distributed to the beneficiary. In the event that the beneficiary should fail to attain the age of distribution, the property being held for the beneficiary shall be paid over and distributed to the beneficiary,s heirs (excluding any such heirs who are not my kindred) pursuant to Sections 64.1-1 and 64.1-3 of the Code of Virginia as written on the date of this will; provided, however, that (i) should any such heir be the beneficiary of a trust created herein, and still in effect, the share of such beneficiary shall be added to such trust and be held, managed and distributed as a part thereof, and (ii) should any other heir be under the age of twenty-one (21) years, such beneficiary,s share shall vest absolutely and indefeasibly in the beneficiary but it may be retained in trust by my Trustee, and used on behalf of the beneficiary in accordance with the instructions contained in the first paragraph of this article, until the beneficiary reaches the age of twenty- one (21). If, at any time, the property held in trust for any beneficiary is an amount so small that, in the discretion of my Trustee, the continuation of the trust is not in the overall best interests of the beneficiary, then my Trustee may (i) convert the trust assets (including or excluding, in my Trustee's discretion, any interest in real estate) into qualifying property and pay over and deliver such property to a suitable person (who may be my Trustee) as Custodian for the beneficiary under the Virginia Uniform Gifts to Minors Act (21); or (ii) pay over, deliver and convey the property to the beneficiary; or (iii) utilize any combination of (i) and (ii), above, and so terminate the trust. .ARTICLE FOUR I nominate my wife, LINDA M. SCHAUFERT, as my Executor. If my wife should not qualify or complete the administration of my estate, I nominate my father-in-law, RALPH M. DEL DUCA, of Bedford County, Virginia, as my Successor Executor. If my father-in-law is deceased or does not qualify as my Executor, I then nominate my brother, SCOTT LIVINGSTON SCHAUFERT, of Camp Hill, Pennsylvania, to serve as my Successor Executor. I request that no surety be required on the bond of any person or representative of my estate or of any trustees of any trust created duly qualifying as such. I further request that no accounting be required on any trustee acting hereunder. ARTICLE FIVE A. Any beneficiary who fails to survive me by 120 hours shall be deemed to have predeceased me, for purposes of succession to property under this will, and the gift to such beneficiary shall be disposed of accordingly. B. A relationship by or through legal adoption shall be treated the same as a relationship by or through blood for purposes of succession to property under this will. C. When it is provided herein that the issue of a deceased beneficiary shall receive that beneficiary,s gift, share or interest, then the division among such issue shall be in accordance with Section 64.1-3 of the Code of Virginia, as written on the date of this will. D. The term "tangible personal property,, shall be construed as not including any such property that, in the determination of my Executor, is (i) held primarily for investment purposes or (ii) used in connection with any business in which I may be engaged or in which I may have any interest at the time of my death. E. Neither the corpus nor the income of any trust created herein shall be subject to the liabilities of, or to alienation by, the beneficiary(s). F. Any taxes imposed under the laws of any jurisdiction by reason of my death, by whatever name called, upon or with respect 5 to any property included in my estate for the purpose of such taxes, whether such property passes under or outside of this will, shall be paid by my Executor without apportionment. G. The expenses of my last illness, the expenses of a funeral appropriate to my station in life and custom of living (including the purchase and erection of a suitable monument or marker at my grave) and my written charitable pledges shall be paid by my Executor. H. My Executor is requested to settle my estate as soon after my death as may be practicable, and to pay or deliver every legacy or bequest to my beneficiaries without waiting any time that may be believed to be customary in probate matters. I. As used in this will, the male gender shall include the female and the neuter, the singular shall include the plural, and vice versa. J. In addition to the powers now or hereafter granted by law, every fiduciary serving hereunder shall have all of the powers listed in Section 64.1-57 of the Code of Virginia as it is written on the date of my death. K. If the terms of this will provide for the creation of a trust for any beneficiary and if, in my Executor,s discretion, the facts and circumstances existing at the time for the funding of such trust indicate that the creation of such a trust is not in the overall best interests of the beneficiary, then I authorize my Executor to not fund such trust but, instead, (1) to convert the beneficiary,s share of my estate (including or pages on the excluding, in my Executor's discretion, any interest in real estate) into qualifying property and to pay over and deliver the same to a suitable person (who may be my Executor), as Custodian for the beneficiary under the Virginia Uniform Gifts to Minors Act (21); or (ii) to pay over, deliver and convey the property to the beneficiary; or (III) to utilize any combination of (1) and (ii), above. My Executor may make such decisions in regard to any beneficiary and not make such decisions in regard to any other beneficiary. L. Any interest in any real estate devised to any beneficiary herein is hereby expressly devised to such beneficiary as his or her sole and separate equitable estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my last will and testament, written on this and -8- other 26th day of July , 1994. The foregoing will was subscribed, published and declared by the Testator as and for Testator,s last will and testament in our joint presence and we, in Testator,s presence and in the presence of each other and at Testator,s request, hereunto subscribe our names as attesting witnesses thereto. 7 STATE OF VIRGINIA) ( CITY OF LYNCHBURG( TO-WIT: Before me, the undersigned authority, on this day, personally appeared ERIC M. SCHAUFERT, JOHN J. O'FR~WFE, JR. , LISA M. TINSLEY , and GRACE H. FARMER , known to me to be the Testator and the witnesses, respectively, whose names are signed to the attached or foregoing instrument and, all of these persons being by me first duly sworn, the Testator declared to me and to the witnesses in my presence that said instrument is Testator,s last will and testament and that Testator had willingly signed and executed it in the presence of said witnesses as Testator,s free and voluntary act for the purposes therein expressed; that said witnesses stated before me that the foregoing will was executed and acknowledged by the Testator as Testator,s last will and testament in the presence of said witnesses who, in Testator,s presence and at Testator,s request, and in the presence of each other, did subscribe their names thereto as attesting witnesses on the day of the date of said will, and that the Testator, at the time of the execution of said will, was over the age of eighteen (18) years and of sound and disposing mind and memory. 8 Witness Subscribed, sworn and acknowledged before me by the Testator and the witnesses, this 26th day of July , 1994. My commission expires: 11/30/96 (SEAL) Notary Publi~ 102916.jjo LAST WILL AND TESTAMENT OF ERIC M. SCHAUFERT Bedford County, Virginia O'KeeffE & SPIES ATTORNEYS AT LAW 828 MAIN STREET, SUITE 1803 CENTRAL FIDELITY BANK BUILDING POST OFFICE BOX 1419 LYNCHBURG, VIRGINIA 24505-i4i9 CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) Name of Decedent: Date of Death: April 24, 2003 Will No. 21-03-0393 To the Register: Eric M. Schaufert Admin. No. I certify that notice of beneficial interest required by Rule 5.6 (a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on July 15, 2002: Name Address Linda B. Schaufert 497 Crape Myrtle Drive Boilin~ Svfings, PA 17007 Notice has now been given to all persons entitled thereto under Rule 5.6 (a) except N/A Date: David'W~. P~eager, Esquire Reager & Adler, PC 2331 Market Street Camp Hill, PA 17011 (717) 763-1383 Counsel for Personal Representative EV-1500 EX'~ (6-00) LU Oo COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL' SCHAUFERT, ERIC M. DATE OF DEATH (MM-DD-Year) 04/24/2003 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT IDATE OF BIRTH (MM-DD-Year) 05/10/1959 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SCHAUFERT, LINDA M. OFFICIAL USE ONLY FILE NUMBER ........ 2 1 -0 3 0 3 9 3 COUN'P(CODE YEAR NUMBER SOCIAL SECURITY NUMBER 2 0 2-5 0-5 5 7 1 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER r~l. odginal Return r--] 4. Limited Estate '-']6. Decedent Died Testate (Attach copy of Willl r--] 9. Litigation Proceeds Received r~2. Supplemental Return E~4a. Future Interest Compromise (date ofdeatJ~ after 12-12-82) r-lA Decedent Maintained a Living Trust (Attach copy of Trust) [--~ 10. Spousal Poverty Credit (date of death between t2-31-91 and 1-1-95) ~]3. Remainder Return (date ofdeath prior to 12-13-82) ~--]5. Federal Estate Tax Return Required -- 8. Total Number of Safe Deposit Boxes [--111. Election to tax under Sec. 9113(A) (Attach Sch O) NAME DAVID W. REAGER, ESQUIRE FIRM NAME (If Applicable) REAGER & ADLER, P.C. TELEPHONE NUMBER 717-763-1383 COMPLETE MAILING ADDRESS 2331 MARKET STREET CAMP HILL PA 17011 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) E~] Separate Billin9 Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 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 made (Schedule J) 14, Net Value Subject to Tax (Line 12 minus Line 13) 340,404.251 783,7O3.26 OFFICIAL USE ONLY (8) 1,124,107.51 9,101.65 (11) 9,101.65 (12) 1,115,005.86 1,115,005.86 (13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. 1,115,005.86 x 0 (15) x (16) x .12 (17) x .15 (18) (19) Decedent's ,Complete Address: STREET ADDRESS 497 CRAPE MYRTLE DRIVE CITY BOILING SPRINGS Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount STATE PA 7007 (1) 0 o 0 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 I 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) (~. O O A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SB) 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 care? ............................................................. [] [] 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 th s return, including accompanying schedules and statemenls, 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, SIGNA,7~RE OF PF-.ESON RESPONSIBLE FOR F~(LING RETURN ADDRESS-- 'LINDA M. SC'HAUFERT' ~./' DATE PA 17007 497 CRAPE MYRTLE DRIVE, BOILING SPRINGS SIGNATURE OF PRI~AI:~,R?/'.'.'~ER THAN REPRESENTATIVE DATE For dates of death on or after July 1, 1994 and before Janua~ 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the su~iving spouse is 3% [72 P.S. {9116 (a) (1.1) (i)]. For dates of death on or after Janua~ 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the su~iving spouse is 0% ~2 P.S. {9116 (a) (1,1) (ii)I. The statute does not exempt a transfer to a su~iving spouse from tax, and the statuto~ requirements for disclosure of assets and filing a tax retum are still applicable even if the suwiving spouse is the only beneficial. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a d~eased child ~enty~ne 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 decedenrs lineal beneficiaries is 4.5%, except as noted in 72 P,S, {9116(1.2) ~2 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, REV-1503 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHAUFERT. ERIC M. SCHEDULE B STOCKS & BONDS FILE NUMBER 21 03 O393 All property jointly.owned with right of survivorship must be disclosed on Schedule F. VALUE AT DATE DESCRIPTION OF DEATH Legg Mason Value Trust 13,886.77 325.217 shares @ 42.70 per share ITEM NUMBER 1. o 10. 11. 12. 13. 14. Legg Mason Special Investment Trust 498.931 shares @ 31.07 per share MBNA Amer Bk 25,000 bond + accrued interest Household Bk 25,000 bond + accrued interest Discover BK 25,000 bond + accrued interest Household Bk 25,000 bond + accrued interest MBNA Amer Bk 25,000 bond + accrued interest Discover Bk 25,000 bond + accrued interest Provident Bk 25,000 bond + accrued interest Capital One FSB 25,000 bond + accrued interest MBNA Amer Bk 25,000 bond + accrued interest Flagstar Bk 25,000 bond + accrued interest Bell South stock 740 shares @ 23.08 per share Corning, Inc. stock 5418 shares @ 5.82 per share TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 15,501.79 25,558.04 26,013.13 26,349.79 26,767.41 26,896.90 26,814.28 26,716.23 26,696.28 25,666.48 24,925.19 17,079.20 31,532.76 340,404.2~, REV-1508 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHAUFERT. ERIC tv1, ITEM NUMBER 1. SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 21 03 0393 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly.owned with right of survivomhip must be disc osed on Sched,_de F. VALUE AT DATE DESCRIPTION OF DEATH Cash held in Legg Mason Wood Walker Account #360-02-02142 683,055.64 Waypoint Bank - Money Market Motorcycle - Honda 1983 VIN JHRCO719DM122195 decedent agreed on this sales price prior to his death - transfer completed after death 2001 Nissan Pathfinder Misc. personal property TOTAL (Also enter on line 5, Recapitulation) 79,422.62 2,000.00 18,975.00 250.00 783,703.26 (If more space is needed, insed additional shee~ of the same size) REV-1510 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHAUFERT. ERIC M. SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY FILE NUMBER 21 03 039;~ This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is "es. DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE N UMBER THE DATE OF TRANSFER. AT[ACH A COPY OF THE DEED FOR REN. ESTATE VALUE OF ASSET INTEREST (IFAPPLICABLE) VALUE 1. Individual Retirement Account - Legg Mason Wood Walker 429,946.89 O. Account Number 360-71398 TOTAL (Also enter on line 7 Recapitulation) $ needed, insert additional sheets of the same size) REV-1511 EX + (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHAUFERT. ERI(~ M, ITEM NUMBER 8. 9. SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21 03 0393 DeMsofdecedentmustbempoAedonSchedulei. DESCRIPTION AMOUNT FUNERAL EXPENSES: 2,802.32 Hoffman-Roth Funeral Home 219 North Hanover Street, Carlisle, PA 17013 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Year(s) Commission Paid: Attorney Fees Reager & Adler, P.C. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Linda M. Schaufert Zip Street Address 497 Crape Myrtle Drive city Boilin~l Sprin~ls Relationship of Claimant to Decedent wife Probate Fees Cumberland County Register of Wills Accountant's Fees Tax Retum Preparer's Fees Legal Advertising - Cumberland Law Journal Legal Advertising - The Sentinel Additional Short Certificates State PA Zip 17007 TOTAL (Also enter on line 9, Recapitulation) I (If more space is needed, insert additional sheets of the same size) 2,500.00 3,500.00 129.00 75.00 71.33 24.00 9,101.6:', REV-1513 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF SCHAUFERT. ER;lC M, NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec, 9116 (a)(1.2)] Linda M. Schaufert 497 Crape Myrtle Drive Boiling Springs, PA 17007 FILE NUMBER 21 03 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) 0397 AMOUNT OR SHARE OF ESTATE 100% of the estate (If more space is needed, insert additional sheets of the same size) II. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 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 Register of Wills of CUMBERLAND County, Pennsylvania Certificate of Grant of Letters WHEREAS, on the 8th dated July 26th 1994 No. 2003-00393 ESTATE OF a/k/a Late of PA No. 21-03-0393 SCHAUFERT ERIC M SCHAUFERT ERIC SOUTH MIDDLETON TOWNSHIP CU~AI~U ~'U~'I'~, Deceased Social Security No. 202-50-5571 day of May was admitted to probate as the last will of SCHAUFERT ERIC M a/k/a SCHAUFERT ERIC 2003 an instrument late of SOUTH MIDDLETON TOWNSHIP , CUMBERLAND County, who died on the 24th day of April 2003 and, ~ WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, DONNA M. OTTO , Register of Wills in and for the County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify that I have this day granted Letters TESTAMENTARY to SCHAUFERT LINDA M who has duly qualified as EXecutor(rix) and has agreed to administer the estate according to law, all of which fully appears of record in my Office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYLVANIA. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of my Office the 8th day of May 2003. **NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE) LAST WILL AND TESTAMENT I I, ERIC M. SCHAUFERT, of Bedford County, Virginia, do hereby make, publish and declare this to be my last will and testament, hereby expressly revoking all wills and codicils heretofore made by me. .ARTICLE ONE A. I bequeath all of my tangible personal property to'my wife, LINDA M. SCHAUFERT, (hereinafter referred to as'my "WIFE"). B. If my wife fails to survive me, I bequeath all of my tangible personal property to my step-children, BRADFORD RALPH SCOTT EXUM and JAYSON BRENT EXUM, surviving at the time of my death; if my step-children should not survive me, then I give all of my tangible personal property to their issue, per ~; provided, however, that if any beneficiary is l~s than eighteen (18) years of age at the time of my death, my Executor'shall deliver, without requiring bond, to such beneficiary or to the person with whom such beneficiary is residing at the time of distribution, so much of the beneficiary,s share of such tangible personal property as may be deemed appropriate, in my Executor,s sole discretion, and the receipt of the beneficiary or of such person shall be a full and final discharge of my Executor for the property so delivered, and my Executor shall sell the remainder of the beneficiary,s share of tangible personal property and add the proceeds therefrom to the share of the beneficiary in my residuary estate. I may leave a letter of intent with my Executor, or another, for the purpose of giving guidance to my Executor in the distribution of my tangible personal property among my beneficiaries and I request, but do not require, that my Executor honor my wishes therein expressed. ARTICLE TWO I devise and bequeath all of the rest and residue of my estate, real and personal, as follows: A. If my wife survives me, I give all of such. rest and residue to her in fee simple absolutely. B. If my wife fails to survive me, I direct that all of such rest and residue be divided into as many equal shares as may be necessary in order to provide (i) one share for each of my step-children surviving at my death and (ii) one share for each of my step-children who has predeceased me leav£hg issue surviving at my death and, subject to the provisions o'f Article Three, I dispose of such shares as follows: (1) One of such shares shall be paid over and distributed to each of my step-children surviving at my death; and (2) One of such shares shall be paid over and distributed to the issue of each of my step-children who has predeceased me leaving issue surviving at my death. ARTICLE TH/LEE If any beneficiary under Article Two has not reached the age of twenty-five (25) years (hereinafter referred to as the "age of distribution") at the time of my death, then I give the share of such beneficiary to my Trustee, hereinafter named, IN TRUST, to hold and manage for the benefit of the beneficiary. So much of the income from this trust and, if net income be at any time insufficient, so much of the principal of this trust as may be deemed necessary in the discretion of my Trustee (taking into account all other sources of income or support of the beneficiary of which my Trustee has knowledge), shall be either paid to or expended on behalf of the beneficiary (whichever in the Trustee's discretion is determined most appropriate) in order to insure the proper support, maintenance and education (including collegiate, vocational, professional, etc.) of the beneficiary. When the beneficiary reaches the age of distribution, the principal, together with any accumulations Of income, shall be paid over and distributed to the beneficiary. °- In the event that the beneficiary should fail'to ~ttain the age of distribution, the property being held for the beneficiary shall be paid over and distributed to the beneficiary.s heirs (excluding any such heirs who are not my kindred) pursuant to Sections 64.1-1 and 64.1-3 of the Code of Virginia as written on the date of this will; provided, however, that (i) should any such heir be the beneficiary of a trust created herein, and still in effect, the share of such beneficiary shall be added to such trust and be held, managed and distributed as a part thereof, and (ii) should any other heir be under the age of twenty-one (21) years, such beneficiary.s share shall vest absolutely and indefeasibly in the beneficiary but it may be retained in trust by my Trustee, and used on behalf of the beneficiary in accordance with the instructions contained in the first paragraph of this article, until the beneficiary reaches the age of twenty- one (21). If, at any time, the property held in trust for any beneficiary is an amount so small that, in the discretion of my Trustee, the continuation of the trust is not in the overall best interests of the beneficiary, then my Trustee may (i) convert the trust assets (including or excluding, in my Trustee's discretion, any interest in real estate) into qualifying property and pay over and deliver such property to a suitable person (who may be my Trustee) as Custodian for the beneficiary under the Virginia Uniform Gifts to Minors Act (21); or (ii) pay over, deliver and convey the property to the beneficiary; or (iii)'-utilize any combination of (i) and (ii), above, and so terminate the trust. ARTICLE FOUR I nominate my wife, LINDA M. SCHAUFERT, as my Executor. If my wife should not qualify or complete the administration of my estate, I nominate my father-in-law, ~LPH M. DEL DUCA, of Bedford County, Virginia, as my Successor Executor. If my father-in-law is deceased or does not qualify as my Executor, I then nominate my brother, SCOTT LIVINGSTON SCHAUFERT, of Camp Hill, Pennsylvania, to serve as my Successor Executor. I request that no surety be required on the bond of any person or representative of my estate or of any trustees of any trust created duly qualifying as such. I further request that no accounting be required on any trustee acting hereunder. ARTICLE FIVE. A. Any beneficiary who fails to survive me by 120 hours shall be deemed to have predeceased me, for purposes of succession to property under this will, and the gift to such beneficiary shall be disposed of accordingly. B. A relationship by or through legal adoption shall be treated the same as a relationship by or through blood for purposes of succession to property under this will. C. When it is provided herein that the issue of a deceased beneficiary shall receive that beneficiary,s gift, share or interest, then the division among such issue shall be in accordance with Section 64.1-3 of the Code of Virginia, as written on the date of this will. - D. The term "tangible personal property,, shall ~e construed as not including any such property that, in the determination of my Executor, is (i) held primarily for investment purposes or (ii) used in connection with any business in which I may be engaged or in which I may have any interest at the time of my death. E. Neither the corpus nor the income of any trust created herein shall be subject to the liabilities of, or to alienation by, the beneficiary(s). F. Any taxes imposed under the laws of any jurisdiction by reason of my death, by whatever name called, upon or with respect to any property included in my estate for the purpose of such taxes, 'whether such property passes under or outside of this will, shall be paid by my Executor without apportionment. G. The expenses of my last illness, the expenses of a funeral appropriate to my station in life and custom of living (including the purchase and erection of a suitable monument or marker at my grave) and my written charitable pledges shall be paid by my Executor. H. My Executor is reque'sted to settle my estate as soon after my death as may be practicable, and to pay or deliver every legacy or bequest to my beneficiaries without waiting any time that may be believed to be customary in probate matters. I. As used in this will, the male gender shall include the female and the neuter, the singular shall include the plural, and vice versa. J. In addition to the powers now or hereafter granted by law, every fiduciary serving hereunder shall have all of the powers listed in Section 64.1-57 of the Code of Virginia as it is written on the date of my death. K. If the terms of this will provide for the creation of a trust for any beneficiary and if, in my Executor's discretion, the facts and circumstances existing at the time for the funding of such trust indicate that the creation of such a trust is not in the overall best interests of the beneficiary, then authorize my Executor to not fund such trust but, instead, (1) to convert the beneficiary,s share of my estate (including or excluding, in my Executor's discretion, any interest in real estate) into qualifying property and to pay over and deliver the same to a suitable person (who may be my Executor), as Custodian for the beneficiary under the Virginia Uniform Gifts to Minors Act (21); or (ii) to pay over, deliver and convey the property to the beneficiary; or (III) to utilize any combination of (1) and (ii), above. My Executor may make such decisions in regard to any beneficiary and not make such decisions in regard to any other beneficiary. L. Any interest in any real estate devised to any beneficiary herein is hereby expressly devised to such beneficiary as his or her sole and separate equitable estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my last will and testament, written on this and -8- other pages on the 26th day of July , 1994. '~ Eric ~ ~cha~t The foregoing will was subscribed, published and declared by the Testator as and for Testator,s last will and testament in our joint presence and we, in Testator,s presence and in the presence of each other and at Testator's request, hereunto subscribe our names as attesting witnesses thereto. Witness Witness STATE OF VIRGINIA) ( CITY OF LYNCHBURG( TO-WIT: Before me, the undersigned authority, on this day, personally appeared ERIC M. SCHAUFERT, JOHN J. 0'~, JR. , LISA M. TINSLEY , and GRACE H. FARMER , known to me to be the Testator and the witnesses, respectively, whose names are signed to the attached or foregoing instrument and, all of these persons being by me first duly sworn, the Testator declared to me and to the witnesses in my presence that said instrument is Testator,s last will and testament-and that Testator had willingly signed and executed it in the p~esence of said witnesses as Testator,s free and voluntary act for the purposes therein expressed; that said witnesses stated before me that the foregoing will was executed and acknowledged by the Testator as Testator's last will and testament in the presence of said witnesses who, in Testator,s presence and at Testator,s request, and in the presence of each other, did subscribe their names thereto as attesting witnesses on the day of the date of said will, and that the Testator, at the time of the execution of said will, was over the age of eighteen (18) years and of sound and disposing mind and memory. Witness Subscribed, sworn and acknowledged before me by the Testator and the witnesses, this 26th day ef July , 1994. My commission expires: 11/30/96 (SEAL) Notary P_ubli~ 102916.jjo 9 BUREAU OF INDIVIDUAL TAXES TNHERTTANCE TAX DTVZSTON DEPT. 280601 HARRTSBURG, PA 17128-0601 DAVID g REAGER ESQ REAGER & ADLER 2331 MARKET ST CAMP HILL '04 I* AR 12 PA 17b~lZ'~iC~ ~' ' COMMONgEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN ~;~i'~,,:~? ,;~; ~ DATE ESTATE OF DATE OF DEATH FILE NUMBER ?1:43 COUNTY ACM O$-15-ZO0q SCHAUFERT Oq-Z4-ZO0$ Z1 05-0395 CUMBERLAND 201 Aeoun~: Remi~ed REV-ii83 EX AFP COZ-DS) ERIC M MAKE CMECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF gILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper credi~ ~o your account, subei~ ~he upper portion of ~his fore wi~h your ~ax payeen~. CUT ALONG THIS LINE ~ RETAIN LO#ER PORTION FOR YOUR FILES ~ REV-483 EX AFP (01-03) M# NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN M~ ESTATE OF SCHAUFERT ERIC M FILE NO.Z1 05-0595 ACN 201 DATE OS-15-ZO0~ ESTATE TAX DETERHZNATZON 1. Credit For State Death Taxes as Verified .00 Z. Pennsylvania Inheritance Tax Assessed (Excluding Discount and/or Interest) .00 .00 Inheritance Tax Assessed by Other States or Territories of the United States (Excluding Discount and/or Interest) q. Total Inheritance Tax Assessed .00 .00 5. Pennsylvania Estate Tax Due TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID ~IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX CREDIT I .00 BALANCE OF TAX DUEI .00 INTEREST AND PEN. I .00 TOTAL DUE / . O0 (IF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUIRED IF TOTAL DUE IS REFLECTED AS A "CREDIT- (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) PURPOSE OF NOTICE: PAYMENT: To fulfiL1 the requirements of Section 2140 (b) of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (7Z P.S. Section 91403. Detach the top portion of this Notice and submit with your payment to the Register of Nilis printed on the reverse side. -- Make check or money order payable to: REGISTER OF #ILLS, AGENT. REFUND (CR): A refund of e tax credit may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1515). Applications are available at the Office of the Register of Hills, any of the 13 Revenue District Offices or from the Department's Iq-hour answering service for forms ordering: 1-800-361-Z050; services for taxpayers with special hearing and / or speaking needs: 1-800-q47-$010 (TT only). OBJECTIONS: Any party in interest not satisfied with the assessment of tax as shown on this notice may object within sixty (60) days of receipt of this Notice by: --written protest to the PA Oapart.ent of Revenue, Board of Appeals, Dept. ZBl02L, Harrisburg, PA 17128-1021, --electing to have the .attar determined at audit of the personal representative, OR --appeal to the Orphans' Court. ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should ba addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 180601, Harrisburg, PA 17L18-0601, Phone (717) 787-6505. See page S of tho booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. OR PENALTY: INTEREST: Department of Revenue. The 151 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 time period as you would appeal tho tax and interest that has been assessed as indicated on this notice. For dates of death on or after 10-3-91, Pennsylvania Estate Tax based on the Federal Estate Tax return becomes delinquent at tho expiration of nine (09) months from tho date of death. For dates of death prior to 10-3-91, Pennsylvania Estate Tax based on tho Federal Estate Tax return becomes delinquent at the expiration of eighteen (16) months from the date of death. Taxes which became delinquent before January 1, 1961 bear interest at tho rate of six (6Z) percent par annum calculated at a daily rate of .000164. All taxes which became delinquent on or after January 1, 1981 will bear interest at e rate which will vary from calendar year to calendar year with that rate announced by tho PA The applicable interest rates for 1981 through ZOOq are: Interest DaiLy Interest Daily Interest DaiZy Year Rate Factor Yea~ Rate Factor Yeq£ Rate Factor 198Z ZOZ .000548 1988-1991 Ill .000301 Z001 9Z .O00Zq7 1983 X6Z .000458 1991 9Z .000147 ZOO2 6Z .000164 1984 112 .000301 1993-1994 7Z .000192 2003 52 .000137 1985 132 .000356 1995-1998 92 .000Z47 2004 4Z .000110 1986 lOX .000274 1999 71 .000191 1986 IOZ .000274 ZOOO 8Z .OOOZ19 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (lS) days beyond the date of tho assessment. If payment is made after the interest computation date shown on the Notice, additional interest .ust be calculated. PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY UNTIL COMPLETION. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Eric M. Schaufert Date of Death: April 24, 2003 Will No.: 21 03-0393 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes X No If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is yes, state the following: A. Did the personal representative file a final account with the court? Yes No X The separate Orphans' Court No. (if any) for the personal representative's account is: Co Did the personal representative state an account informally to the parties in interest? Yes No X **EXECUTRIX WAS SOLE BENEFICIARY** Date: Do Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be Davi~'--W.-Re~--ger,~squire Reager & Adler, P.C. 2331 Market Street Camp Hill, PA 17011 (717) 763-1383 Counsel for Personal Representative BUREAU OF TNDTVXDUAL TAXES /NHERZTANCE TAX DTVISZON DEPT. 280601 HARRISBURG, PA 171Z8-0601 DAVID W REAGER ESQ REAGER & ADLER 2331 MARKET ST CAMP HILL PA 17011 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER DATE 08-$0-200q ESTATE OF SCHAUFERT DATE OF DEATH Oq-Z~-ZO05 FILE NUMBER Z! -~-.~0595 . COUNTY cum~LAN]~ ACN ZO~ Amount Rmmittd~ REV-7$6 EX AFP (01-02) ERIC HAKE CHECK PAYABLE` AND R.~IIT PAYMENT TO: REGISTER OF ~X. LLS ~ ~,::i. CUMBERLAND CO COURT q~OUSE CARLISLE, PA 17015 NOTE: To insure proper credit to your account~ submit ~he upper portion of this form ~ith your ~ax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR FILES ~ REV-736 EX AFP (01-0~) ~ NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER ~ ESTATE OF SCHAUFERT ERIC M FILE NO.Z1 03-0393 ACN 202 DATE 08-$0-200~ ESTATE TAX DETERHZNATZON 1. Credit For State Death Taxes as Verified .00 Z. Pennsylvania Inheritance Tax Assessed (Excluding Discount and/or Interest) Inheritance Tax Assessed by Other States or Territories of the United States (Excluding Discount and/or Interest) q. Total Inheritance Tax Assessed 5. Pennsylvania Estate Tax Due 6. Amount of Pennsylvania Estate Tax Previously Assessed Based on Federal Estate Tax Return 7. Additional Pennsylvania Estate Tax Due .00 .00 TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID .00 .00 .00 .00 TOTAL TAX CREDIT BALANCE OF TAX DUE] INTEREST AND PEN. [ TOTAL DUE aXF PAID AFTER THIS DATE, SEE REVERSE SIDE (/F TOTAL DUE ZS LESS THAN $1, NO PAYMENT 15 REQUIRED FOR CALCULATION OF ADD/T/ONAL XNTEREST. XF TOTAL DUE XS REFLECTED AS A "CREDIT** DUE A REFUND. SEE REVERSE S/DE OF THIS FORM FOR /NSTRUCTZONS.] .00 .00 .00 .00 PURPOSE OF NOTICE: PAYNENT: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (7Z 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. -- Hake check or money order payable to: REGISTER OF HILLS, AGENT. REFUND (CA): A refund of a tax credit may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Hills, any of the Z3 Revenue District Offices or from the Department's 24-hour answering service for forms ordering: 1-800-36Z-ZOSO; services for taxpayers aith special hearing and/or speaking needs: 1-800-447-30Z0 (TT only). OBJECTIONS: Any party in interest not satisfied aith the assessment of tax as shown on this notice may object mi[bin sixty (60) days of receipt of this Notice by: --eritten protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 171ZB-lOZl, --electing to have the matter determined at audit of the personal representative, OR --appeal to the Orphans' Court ADHIH- ISTRATIVE CORRECTIONS: PENALTY: INTEREST: OR Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Revise Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601, Phone (717) 787-6505. See page S of the booklet "Instructions for Inheritance Tax Return for a Res[dent Decedent" (REV-IS01) for an explanation of administratively correctable errors. The 1SI 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 time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Additional Pennsylvania Estate Tax assessed as a result of a change on the Federal Estate Tax closing letter becomes delinquent at the expiration of one (1) month from the date the final notice cf the increase in Federal Estate Tax is received. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6Z) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on or after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA The applicable interest rates for 198Z through ZOO4 are: Department of Revenue. Interest Daily Interest Daily Interest Daily Yea._~r Rate Factor Yea._~r Rate .. Factor Yea_~_r Rate . Factor 198Z ZOZ .000548 1986-1991 llZ .000301 2001 9Z .OOOZ47 1983 162 .000438 1992 9Z .000247 ZOOZ 6Z .000164 1984 llZ .000301 1993-1994 72 .000192 2003 5X .000137 1985 13Z .000356 1995-1998 92 .000Z47 2004 4Z .000110 1986 lOZ .000274 1999 7Z .00019Z 1987 9Z .000Z47 ZOO0 8Z .000219 calculated as follows: --Interest is INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DALLY INTEREST trACTOR --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 be calculated. RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17IT13 Receipt Date: Receipt Time: Receipt No.: 1/18/2005 15:03:18 1039149 SCHAUFERT ERIC M Estate File No. : Paid By Remarks: 2003-00393 LINDA SCHAUFERT FIX RCPT 1035586 2/13/04 MW ------------------------ Receipt Distribution ------------------------ Fee/Tax Description ADD PROBATE FEE Check# 841 Total Received......... Payment Amount 865.00 ---------------- $865.00 $865.00 Payee Name CUMBERLAND COUNTY GENERAL FUN t/lB\DS"' -:D.- 10 3 '558 { ~\Qce-S ~<e-w.:p+ \:::J ~LU ROW285D Cumberland County - Reglster Ot Wllls Revise Receipt Pmt Date 2/13/2004 Receipt No 1035586 Amount Paid 865.00 Remarks< LINDA M SCHAUFERT JA > Fee / Tax <Payee> Name Amount Check No 2003-00419 JOHNS EDWARD E ADD PROBATE FEE 501 CUMBERLAND COUNTY GENERAL FU 865.00 841 F12=Cance1 Total Distribution: 865.00 Payment Already Disbursed... No Changes Can Be Made. \ JI0)c:i~ C; ~~lc1 b-e. [~d1L' ~ 03 <JC[3 VOLOrl) rwc<-r-j- : r'C.ei\=LClLL'I- 7\.W