HomeMy WebLinkAbout04-0804
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COMMONWEAL~ OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDEN~PS NAME (LAST, FIRST, AND MIDDLE INITIAL)
Fromme Kenneth L.
DATE OF BIRTH (MM-DD-YEAR)
12E/~l./'~D 03
DATE OF DEATH (MM-DD-YEAR)
04/08/1934
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
OFFICIAL USE ONLY
FILE NUMBER
SOCIAL SECURI'~f NUMBER
170-26-8261
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
Fromme, JoAnne
~ 1. OdginalRetum ~24~'.
4. Limited Estate .
6. Decedent Died Testate
(Attach copy of Will)
204-30-8842
Supplemental Return .~ 3. Remainder Return (pdda
~,~r~j~ Compromise (date of death after 1 z-12~ 5. Federel Estate Tax Retum
Beqededt Maintained a Living T~ust 0 2. Total Nurnber of Safe Deed
~ttl~uJ,ua~py of Trust)
Spousal Poverty Credit [] 11. Election to tax under Sec. 9
NmE
John E. Slike
FIRM NmE (If ~plicable)
Saidis, Shuff, Flower & Lfndsay
TELEPHONE NUMBER
717/737-3405
1Real Estate (Schedule A) (1)
2Stocks and Bonds (Schedule B) (2)
3Closely Held Corporation, Partnership or (3)
Sole-Proprietorship
4Mortgages & Notes Receivable (Schedule D) (4)
5Cash, Bank Deposits & Miscellaneous Persona~ Property (5)
(Schedule E)
6Jointly Owned Property (Schedule F) (6)
E~eparate Billing Requested
7inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schequle G or L)
8.'Fetal Gross Assets (total Lines 1-7)
9Funeral Expenses & Administrative Costs (Schedule H) (9)
l(~3ebts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11Total Deductions (total Lines 9 & 10}
COMPLETE MAILING ~ESS
2109 Market St.
Camp Hill, PA 17011
Ohe
12,00,0.00
Nbne
921,869:::~8
(8) 933,869.88
20,699.34
None
(11) 20,699.34
(12) 913,170.54
1;alet Value of Estate (Line 8 minus Line 11)
13Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13)
n~de (Schedule J)
1,~let Value Subject to Tax (Line 12 minus Line 13) (14) 913,170.54
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15~.m~unt of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(a)(1.2) 913,170.54 X .0 0 (15) 0.00
16Arnount of Line 14 taxable at lineal rote X .0 4.5 (16) 0.00
17Amount of Line 14 taxable at sibling rate X .12 (17) 0.00
18i~nount of Line 14 taxable at collateral rate X .15 (18) 0.00
l~l'ax Due (19) 0. O0
Decedent's Complete Address:
ADDRESS
125 Rodney Lane
;ITY
Camp ["Jill
Tax Payments and Credits:
1.Tax Due (Page 1 Line 19)
2Credits/Payments
A. Spousal Poverty Credit
B, Prior Payments
C, Discount
3Interest/Penalty if applicable
D, interest
E, Penalty
STATE IPA ZIP
(1)
0.00
Total Credits ( A + B + C ) (2)
Total Interest/Penalty ( D + E ) (3)
17011
4Jf Line 2 is greater than Line I + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Paga 1 Line 20 to request a refund (4)
SJf Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (aB)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1Did decedent make a transfer and: Yea No
a. retain the use or income of the property transferred; ......................... ~ ~
b. retain the right to designate who shall use the properly transferred or Its income; ...........
c. retain a revemieaary interest; or ....................................
d. receive the promise for life of ether payments, benefits or care? ...................
2If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ................................ [] I~
3Did decedent own an "in trust for" or payable upon death bank account or security at his
or her death? [~ ~
4Did decedent own an Individual Retirement Account, annuity, or other con-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,
0.00
0.00
0.00
0.00
0.00
0.00
O. O0
'~u (./~ ~/~ ,,'..~' ,.'/ Z a.'v~-/v,;,u_~ ............. .~. .......................
~/ ~- ~ C~p Hill, PA 17011 ............... ~ ~/~/~ T
S~NA~REO~REPARERO~ER~R~p.~TATiVE Saidis, Shuff, Flower & Lindsay / e
~ ' ~-/ ~ // ~ , 2109 Market St. . / A
F°rdatas~<'orafferJu{Y 1, l~and beforoJanua~ 1, 1~5 ~e~x rata m~onthenetvalue~transf~or~r~e~eof~e
sullying s~se is 3% [72 P.S. 9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfem to or for the use of the surviving spouse is 0%
[72 P.S. 9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets
and filing a tax return are still appficable 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 yearn 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 transfem 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 valus of transfem 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.
~{EV-1508 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE E
CASH, BANK DEPOSITS,& MISC.
PERSONAL PROPERTY
FILE NUMBER
Kenneth L. Fromme SS# 170-26-8261 12/31/2003
Include the proce~ds of litigation and the date the_proceeds were received by the estate A properly jointly-owned with the right of
survivorship must be disclosed on Schedule I'.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 12,000.00
Copyright (c) 1996 foml software only CPSystems, Inc.
1999 Honda Accord]Q(, 23,000 mi.
(value based on sale price)
TOTAL (Also enter on line 5, Re~ps,.~.~.~n) $
(If rr~re space is needed, insert additional sheets of the same size)
Eom REV-1508 EX (Rev. 1-97)
12,000.00
.EV-~S,0EX +<~-97) SCHEDULE G
INTER-VIVOS TRANSFERS &
COMMONWEALTH OF PENNSYLVANIA
iNHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF
Kenneth L. Fromme SS~/ 170-26-8261 12/31/2003
FILE NUMBER
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 Is yes,
DESCRIPTION OF PROPE~ ~ ¥ % OF
ITEM INCLUDE ME NAME OF ME ~ANS~REE ~EIR
RE~TIONSHIP TO DECEDENT KD ME DA~ O~ TR~SEER. DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
NUMBER AWAON A C~Y OF ME DEED FOR RE~ ESTATE. VALUE OF ASSET INTEREST (~P APPLICOn)
Fidelity Investments IRA
acct. ~Y99591378 containing
the following assets:
1984.6510 Fidelity Advisor,SerI 92,345.81 100.00% 92,345.81
Instl. grwth, at 46.53
1969.763 Fid. Advisor, Set VIII 30,728.30 100.00% 30,728.30
Intl Cap Appr, at 15.60
2008.015 Fid. Mt. Vernon Sir Tr 61,023.58 100.00% 61,023.58
New Millenium, at 30.39
1131.132 Fid. Puritan Tr, Low 39,567.00 39,567.00
Price Stk, at 34.98
1554.046 Fid. Security Fd, 42,425.46 100.00% 42,425.46
dividend growth, at 27.30
1705.597 Blair William Mut Fds 31,809.38 100.00~; 31,809.38
Intl Growth Fd N, at 18.65
1346.608 Harris Assoc. Invt. Tr 50,551.66 [00.00~ 50,551.66
Oakmark Fd I, at 37.54
3205.8210 Marisco Invt Fd, 47,670.56 [00.00 47,670.56
Focus Fd, at 14.87
1926.4820 Morgan Stanley Instl 36,506.83 [00.00~ 36,506.83
Fd, Intl Eqty C1B, at 18.95
2145.1440 Oppenheimer Main St 70,360.72 100.00~ 70,360.72
Fds, Opportunity A, at 32.80
2204.2760 T Rowe Price, Equity 53,167.14 100.00! 53,167.14
Income Fd, Adv, at 24.12
2158.5340 Selected Amern Shs, 71,598.57 100.00~ 71,598.57
Inc., Com, at 33.17
4127.9860 Fidelity Cap & Income 33,271.57 100.00~ 33,271.57
at 8.06
4758.9980 Spartan Invest. Grade 50,968.87 100.00% 50,968.87
Bond, at 10.71
3486.16 Pimco Fds Pac Invt Mgmt 34,059.78 34,059.78
Ser, Hi Yield Admin, at 9.77
4890.1640 Pimco Fds Pac Invt 52,373.66 100.00% 52,373.66
Mgmt Ser, total return, @ 10.71
2186.204 Pimco Fds Pac Invt Mgt 24,594.80 100.00% 24,594.80
Ser, Real retrn adat, at 11.25
4709.006 T Rowe Price, ~i Yield 33,151.40 100.00% 33,151.40
Fd, Inc., Advisor C1, at 7.04
2 Fidelity Investment IRA acct.
Number 1~7-531286, containing
the following:
78000 Con~modore Applied Tech, 1,053.00 100.00% 1,053.00
Inc., common, at .012
Total of Continuation Schedule(s) 64,641.79
.... TOTAL.(Nso emer on line 7, R~apr.~t ~1) 921,869.88
(If more space is needed, insert additional sheets of the same SiZE
C~pydght (c) 1996 form software only CPSystems, Inc. Fomt REV-~'~0 EX (Rev. 1-97)
Estate of: Kenneth L. From/ne
Soc Sec #: 170-26-8261
Date of Death: 12/31/2003
Continuation of Schedule G
(Inter-Vivos Transfers & Misc. Non-Probate Property)
Item Description of Property Date of Death % Decd Exclusion
# Value of Asset Intrst
Taxable Value
8000 Commodore Environ Svsc
Inc., common, at .0075
3000 Commodore Separation
Tech, Inc., common, at .015
500 Gene Logic, Inc.,
common, at 4.97
775 Medtmune, Inc., common
at 25.17
396 OSI Pharmaceuticals,Inc
common, at 31.92
7000 OSI Pharmaceuticals
rt contn§ val, at
29554.81 Fidelity Cash res.
*Spouse benef, of both
accounts
60.00
45.00
2,555.00
19,654.00
12,772.98
29,554.81
100.00%
60.00
45.00
2,555.00
19,654.00
12,772.98
29,554.81
64,641.79
~EV*lS. Ex+(~-9?) I SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA J FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF
Kenneth L. Fromme SS~// 170-26-8261 12/31/2003
FILE NUMBER
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A.
5.
6.
7.
:UNERALEXPENSES:
?arthemore Funeral Home
Funeral lunch and Bricker House Rentals
[DMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) / EIN Number of Pereonal Represantative(s)
Street Address
City State
Year(s) Commission Paid:
A~omey'sFees Saidis, Shuff, Flower & Lindsay
Family Exemption: (If decedent's address is not the san~ as claimant's, attach explanation)
Claimant JoAnne Fr omme
StrestAddress 125 Rodney Lane
City Camj) Hill
Relationship of Claimant to Decedent Spouse
Probate Fees
State
__Zip 17011
Accountant's Fees
Tax Return Preparer's Fees
Other Administrative Costs
Register of Wills, filing fee for tax return
Travel expenses for children from AZ
9,536.22
1,896.12
5,000.00
3,500.00
15.00
752.00
TOTAL (Also enter on line 9, R~--?u[-~) $ 20,699.34
(If more space is needed, insert additional sheets of the same size)
Fora1 REV-1511 EX (Rev. 1-97)
~EV-1513 EX + (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Kenneth L. Fromme SS~/; 170-26-8261
NUMBER
I1.
SCHEDULE J
BENEFICIARIES
12/31/2003
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [Include outright spousal dist dbatlons, and
transfem under Sec. 9116(a)(1.2)}
Joanne Fr omme
125 Rodney Lane
Camp Hill, PA 17011
RELATIONSHIP TO DECEDENT
Do Not List T~,,~--~,s)
spouse
FILE NUMBER
AMOUNT OR SHARE
OF ESTATE
entire estate
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18~ AS APPROPRIATE~ ON REV 1500 COVER SHEET
~ION-TAXABLE DISTRIBUTIONS:
t SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
I. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET
$ 0.00
(If more space is needed, insert additional sheets of the same size)
Copydght (c) 2000 form software only The Lackner Group, Inc. Fo~m REV- 1513 EX (Rev, 9-00)
Fidelity ~ Investments®
August 5, 2004
Law Offices
Saidis ShuffFlower & Lindsay PC
Attn: Shelby L. Yingling-Estate Paralegal
2109 Market St
Camp Hill PA 17011
Dear Shelby L. Yingling:
We are responding to your request for information regarding Kenneth L. Fromme's
Fidelity accounts.
Account Number: Y99-591378
Registration: Kenneth L. Fromme-Rollover IRA
Value on 12/31/2003: See attached valuation report X41156
Account Number: 147-531286
Registration: Kenneth L. Fromme-Rollover IRA
Value on 12/31/2003: See attached valuation report X41157
Ail information in the enclosed valuation report(s) is based on assets in the above-listed
Fidelity account(s) as of the date indicated on the report(s). Valuation information for
these accounts is provided through Evaluation Services Inc., a third party valuation
service provider. Fidelity does not warranty the accuracy of this information for any
particular purpose. In addition, Fidelity does not provide legal or tax advice. Consult
with an attorney or tax professional regarding any specific legal or tax situation.
We hope this information is helpful. For questions concerning account holdings or
instructions on how to transfer the ownership of the accounts, please call our Inheritor
Services Group at 800-544-0003 between 9:00 A.M. and 5:30 P.M. Eastern time Monday
through Friday or visit our website at www.fideliW.com.
Sincerely,
Fidelity Investments
Our File: W019470-30JUL04
Brokerage Services provided by Fidelity Brokerage Services LLC, Member NYSE, SIPC
Clearing, custody, and settlement services by National Financial Services LLC, Member NYSE, SIPC
lEO. Box 770001, Cincinnati, OH 45277-0034
ITEM CUSIP NO. SHABES/
PAR VALUE
1} 315805101 1,984.6510
ESTATE SECURITIES VALUATION
Name of Estate: KENNETH L FRO~
PAGE NO. I
DATE OF DEATH: Wednesday, December 31 2003
DESCRIPTION PRICE NIGH/ASK ./LOW/DID MEAN SEC~IRITY ACCRUED CO~ENTS
DATE PRICE PRICE PRICE VALUE DIV/INT
FIDELITY ADVISOR SER I 12/31 46.5300 46.53000 92,345.81 MUT FUND
INSTL GRWTH
2) 315920819 1,969.7630
3) 316200302 2,008.0150
4) 316345305 1,131.1320
5) 316389402 1,554.0460
6) 093001402 1,705.5970
7) 413838103 1,346.6080
8) 573012101 3,205.8210
FIDELITY ADVISOR SER VIII
INTL ~ APPR
FIDELITY PURITAN TR
LOW PRICE STK
FIDELITY SECS FD
DIVID GROWTH
BLAIR WTLLIA~4 MUT FDS INC
INTL GRW FD N
12/31 15.6000 15.60000 30,728.30 MUT FUND
12/31 30.3900 30.39000 61,023.58 MUT FUND
12/31 34.9800 84.98000 39,567.00 MUT FUND
12/31 27.3000 27.30000 42,425.46 MUT FUND
12/31 18.6500 18.65000 31,809.38 }f~T FUND
12/31 37.5400 37.54000 50,551.66 MUT FUND
12/31 14.8700 14.87000 47,670.56 MUT FUND
9} 61744J499 1,926.4820
10) 68380D876 2,145.1440
MORGAN STANLEY INSTL FD INC
INTL EQTY CL B
OPPENNEIMER MAIN STR FDS INC
OPPORTUNITY A
12/31 18.9500 18.95000 36,506.83 ~3T FUND
12/31 32.8000 32.80000 70,360.72 Manual
11) 779547207
12) 816221105
2,204.2760
2,158.5340
ROWE T PRICE EQUITY INCOME FD
EQ INC}~ FD ADV
SELECTED AMEP~N SHS INC
COM
12/31 24.1200 24.12000 53,167.14 MUT FUND
12/31 33.1700 33.17000 71,598.57 MET FUND
APPRAISE~MO FILE DATA
Portfolio: Date Prepared: 08/05/2004
The following data was entered by the user for this portfolio. Page I
Item(13) Accrued paid interest was in the amount of $705.19
Item(14)Accrued paid interest was in the amount of $158.00
ITEM CUSIP NO. SHARES/
PAR VALUE
1) 202630109 78,000
DATE OF DEATH: Wednesday, December 31 2003
DESCRIPTION PRICE HIGH/ASK LOW/BID MEAN SECURITY ACCRUED CO~NTS
DATE PRICE PRICE PRICE VALUE DIV/INT
CO~ODORE A~PLIED TECH INC 12/31 0.0150 0.0120 0.01350 1,053.00 NASDAQ
COM
2) 202656104 8,000
CO~40DOPd~ ENVIRON SVCS UNC 12/31 0.0075 0.00750 60.00 NASDAQ
COM
3) 202909107 3,000
4) 368689105 500
COb~4ODOP~ SEPARATION TECH INC 12/26 0.0150 0.01500 NASDAQ
COM 01/05 0.0150 0.01500
0.01500 45.00
GENE LOGIC INC 12/31 5.2500 4.9700 5.11000 2,555.00 NASDAQ
COM
5) 584699102 775
MEDI~NE INC 12/31 25.5500 25.1700 25.36000 19,654.00 NASDAQ
COM
6) 671040103 396
OSI PHARMACEUTIC~.LS INC 12/31 32.5900 31.9200 32.25500 12,772.98 NASDAQ
COM
7)*671040111 7,000
8) 316067107 29,554.8100
OSI PHARMACEUTICALS INC
RT CONTING VAL
FIDELITY CASH BESERVES 12/31
1.0000 1.00000 29,554.81 Manual
Grand Totals
Total Principal plus Accrued interest and dividends
65,694.79 0.00
65,694.79
This report was prepared using FTPAPPRAISE Ver. 7.1.0 software, an EVALUATION SERVICES, INC. product.
Visit our web site at WWW.A~P~AISENJ.COM.
ACCOUNT: X41156
ESTATE SECURITIES VALUATION
Name of Estate: KENNETH L FROMME
PASE NO. 2
DATE OF DEATH: Wednesday, December 31 2003
ITEM CUSIP NO. SHARES/ DESCRIPTION PRICE HIGH/ASK LOW/RID MEAN SECURITY ACCRUED COUNTS
PAR VALUE DATE PRICE PRICE PRICE VALUE DIV/INT
13) 316062108 4,127.9860 FIDELITY CAPITAL & INCOME 12/31 8.0600 8.06000 33,271.57 Manual
14) 316069608 4,758.9980 SPARTAN INVESTMENT GRADE BOND 12/31 I0.7100 10.71000 50,968.87 Manual
15) 693390650 3,486.1600 PIMCO FDS PAC IN~T MG~T SER 12/31 9.7700 9.77000 34,059.78 MUT FUND
HI YIELD ADMIN
16) 693390726
4,890.1640 PIMCO FDS PAC INVT MG~4T SER
TOTAL RTP~N ADM
12/31 10.7100 10.71000 52,373.66 ~T ~UND
17) 693391112 2,186.2040 PIMCO FDS PAC INVT MGMT SER 12/31 11.2500 11.25000 24,594.80 MUT FUND
P~AL RETEM ADM
18) 741481204 4,709.0060 PRICE T ROWE HIGH YIELD FD INC 12/31 7.0400 7.04000 33,151.40 MUT FUND
ADVISOR CL
Grand Totals
Total Principal plus Accrued interest and dividends
856,175.09 0.00
856,175.09
This report was prepared using FTPAPPRAISE Ver. 7.1.0 software, an EVA~UATION SERVICES, INC. product.
Visit our web site at WWW.APPRAISENJ.COM.
APERAISEMEMO FILE DATA
Portfolio: Date Erepared: 08/05/2004 Page 1
The following data was entered by the user for this portfolio.
Item(8) Accrued paid interest in the amount of $20.98.
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
Date of Death:
Will No. ')-- 0 ~'( -
Bernice A. Kline
August 22, 2004
Administration No.
To the Register:
I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court
Rules was served on or mailed to the following beneficiaries of the above captioned estate on
September 16, 2004.
Address
Name
Patricia A. George
Sandra A. Kautz
Arthur R. Kline, Jr.
1900 Valley Road, Etters, PA 17319
14 Big Spring Terrace, Newville, PA 17241
P. O. Box 4773, Pago Pago, AS 96799
Notice has now been given to ail persons entitled thereto under Rule 5.6(a) except: No
/¥64 O. Sechrist, Esquire
c~68 Old York Road
Etters PA 17319
(717) 938-3396
Supreme Court ID #15609
Capacity:
_ Personal Representative
~X Counsel for Personal
Representative
/fi:Id Ogd% t~O.
BUREAU OF INDIVIDUAL TAXES
ZNHERTTANCE TAX DTVTSZON
DEPT. 280601
HARRTSBURg, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
JOHN E SLIKE '04 dui :j
SAIDIS ETAL
2109 MARKET ST i,.':,
CAMP HILL PAr~ ?~1~ ~
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
10-25-200q
FROMME
12-31-2003
210q-OSOq
CUMBERLAND
101
Amoun~ Rem ~.'l:'l:od
KENNETH L
HAKE CHECK PAYABLE AND REMIT PAYNENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1547 EX AFP [01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF FROMME KENNETH L FILE NO. 21 Oq-O80q ACH 101 DATE 10-25-2004
TAX RETURN NAS: (X) ACCEPTED AS FILED ( ] CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Es~a~a (Schedule A} (1)
2. S~ocks and Bonds (Schedule B)
3. Closely Held S~ock/Par~nership Zn~ores~ (Schedule C) ($)
q. Mortgages~No'es Receivable (Schedule D)
$. Cash/Bank Deposits/Misc. Personal Propor~y (Schedule E) (5)
6. Jointly Owned Propor~y (Schedule F) (6]
7. Transfers (Schedule G) (7)
8. To,al Asso~s
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9)
10. Debts/Mortgage L~abil$~es/Liens (Schedule Z) (10)
11. To,al Deductions
12. Ne~ Value of Tax Ro~urn
15.
lq.
.0O
.00
.00
.00
12/000.00
.00
9211869.88
(8]
20,699.3q
Charitable/governmental Bequests; Non-elected 9113 Trusts (Schedule J)
No~ Value of Es~a~e Subjec~ ~o Tax
NOTE: To insure proper
crodi~ ~o your account,
submi~ ~he upper por~ton
of ~his fore wi~h your
~ax payment.
933,869.88
.0O
(11) 2~.&99.3~
(12) 913,170.5q
(13) . O0
(1~) 913,170.5q
NOTE:
Zf an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect flgures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Aaoun~ of L2ne 1~ a~ Spousal ra~e (1~)
16. Amoun~ of Lin® lq ~exable a~ Lineal/Class A ra~o (16)
17. Aeoun~ of L~ne 1~ a~ S2611ng ra~e (17)
18. Amoun~ of L~ne lq ~axablo a~ ColZa~eral/Class B ra~e (18)
)al Tax Duo
19. Princi
TAX CREDITS
PAYMENT
BATE
RECEIPT
NUMBER
913,170.5q x O0 = .00
· 00 x 0q5= .00
· 00 x 12 = . O0
· 00 x 15 = .00
(19)= .00
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
DISCOUNT (+)
INTEREST/PEN PAID (-)
AHOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUEI
INTEREST AND PEN.
TOTAL DUE
.00
.00
.00
,00
( ZF TOTAL DUE IS LESS THAN $1, NO PAYMENT ZS REgUZRED.
ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT" (CR), YOU NAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
RESERVATION:
PURPOSE OF
NOT[CE:
PAYMENT:
REFUND (CR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December 1Z, 198Z -- if any future interest in the estate is transferred
in possession or enjoyment to CIass B (collateral) beneficiaries of the decadent after the expiration of any estate for
1ifa or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawfut Class D (collateral) rate on any such futura interest.
To fulfill the requirements of Section ZlqO of the Inhmritanca and Estate Tax Act, Act Z$ of ZOO0. (72 P.S.
Section 91q0).
Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side.
--Make check or money order payable to: REGISTER OF NILLS, 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-1515). Applications are available at the Office
of the Register of Hills, any of the 23 Revenue District Offices, or by calling the special Iq-hour
answering service for forms ordering: 1-800-36Z-2050; services for taxpayers with special hearing and / or
speaking needs: 1-SOO-qq7-3OZO (TT onZy).
Any party Jn 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 (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-lOZ1, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. ZSgSO1, Harrisburg, PA 17128-0601
Phone (7173 787-6S05. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
if any tax due is paid within three (33 calendar months after the decedent's death, a five percent (SZ) discount of
the tax paid is allowed.
The lax tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January l, 198Z bear interest at the rata of
six (SX) percent per annum calculated at a daily rate of .00016~. All taxes which became delinquent on and after
January [, 198Z wii! 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 appIiceble interest rates for 198Z through ZO0~ arm:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
~ 20Z .OOOSqB ~)'~'8 - 1991 Ill .O0030X ~ 9X .0002q7
1983 16Z .000q38 1992 92 .O00Zq7 ZOOZ 62 · 00016~,
198q X1Z .000301 1993-199~ 7Z .O0019Z 2003 5Z .000137
1985 132 .000356 1995-1998 92 .O00Zq7 ZOOq qX .000110
1986 lOZ . OOOZTq 1999 7Z .000192
1987 102 .O00Z7~, ZOO0 72 .O0019Z
--Interest is calculated as follows:
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 calculation to fifteen (IS) 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.