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HomeMy WebLinkAbout11-02-11 (2)150561014D REV-1500 EX (01-10) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN Po Box 2sosol 2 1 1 1 0 1 1 5 Harrisburg PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYW Date of Birth MMDDYYYY 1 6 4 3 8 4 0 6 7 0 1 2 4 2 0 1 1 0 7 0 9 1 9 1 4 Decedent's Last Name Suffix Decedent's First Name MI S N A V E L Y R A C H E L C (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name Spouse's Social Security Number FILL IN APPROPRIATE OVALS BELOW THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS MI a 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Return Required death after 12-12-82) © 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number M U R R E L W A L T E R S I I I E S Q 7 1 7 6 9 7 4 6 5 0 First line of address 5 4 E A S T M A I N S T R E E T Second line of address City or Post Office M E C R A N I C S B U R G Correspondent's a-mail address: State ZIP Code REGISTER OF 1~f1}LS USE ONLSG;-? © ::~~ '"JJ -iJ -"~" r~Tf-1 c:_, _~.y ~,~ :-~r, I rJ ~ > `.~ `rt ~l t<~ _ . _~ DA FIL1fD t,:'s -~ P A 1 7 0 5 5 ~~7 ,_~..~ r ~J_J `-~`. ~~7 ~ Under penalties of pery'ury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. I TURE OF PE SON RESPONSIBLE FOR FILING RETURN DATE ~. ,/.. ~ .-~/,.:.. / ~~ ~ , ,mod// ADDRESS ' PHOEBE S TOB 14 TYLER DRIVE ELLICOTT CITY MD 2104 SIGNATU OF RE R T ER THAN REPRESENTATIVE ~ ~D `E ( / W~`I'E1Bt3" III ESQ 54 E MAIN ST MECHANICSBURG PA 17055 PLEASE USE ORIGINAL FORM ONLY Side 1 1505610140 1505610140 J 1505610240 REV-1500 EX Decedent's Social Security Number Decedent's Name: RACHEL C• S N A V E L Y 1 6 4 3 8 4 0 6 7 RECAPITULATION 1 8 6 4 1 7. 1 4 1. Real Estate (Schedule A) ........................................... 1 2. Stocks and Bonds (Schedule B) ...................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. 5. 6. 7. 8. Mortgages and Notes Receivable (Schedule D) .......................... 4. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ....... 6. Inter-Vivos Transfers & Miscellaneous N -Probate Property (Schedule G) ~ Separate Billing Requested ....... 7. Total Gross Assets (total Lines 1 through 7) ............. 8. 7 4 3 8 4 3 8 9 0 1. . 5 6 0 4 9. p ( ) ........... Funeral Ex enses and Administrative Costs Schedule H ... 9. .... 1 1 8 4 8 . 5 7 10. Debts of Decedent, Mort a e Liabilities, and Liens Schedule I 9 9 ( ) ...... ... 10. .... 8 3 9 3 . 2 4 11. Total Deductions (total Lines 9 and 10) ........................ ... .... 11. 2 0 2 4 1. 8 1 12. Net Value of Estate (Line 8 minus Line 11) ..................... ... .... 12• 9 1 4 5 6 6 . 8 3 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ............... ... .... 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) ...................... 14. 9 1 4 5 6 6 . 8 3 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x.o _ 0. 0 0 15. 0. 0 0 16. Amount of Line 14 taxable at lineal rate X .045 9 1 4 5 6 6. 8 3 1 s. 4 1 1 5 5. 5 1 17. Amount of Line 14 taxable 0 0 ~ 17 0. 0 0 at sibling rate X .12 . 18. Amount of Line 14 taxable 0. 0 0 18 0• D O at collateral rate X .15 . 19. TAX DUE ............................................... ... ....19. 4 1 1 5 5. 5 1 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^ Side 2 1505610240 1505610240 J REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 11 0115 DECEDENTS NAME RACHEL C._ SNAVELY STREET ADDRESS 89 GREENSPRING DA __-_- CITY MECHANICSBURG Tax Payments and Credits: 1. Tax Due (Page 2, Line 19) 2. CreditslPayments A. Prior Payments 30,000.00 B. Discount 1,500.00 3. Interest 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. STATE ZIP PA 17050 (1) _____ 41 15_5 Total Credits (A + B) (2) 31,500 (3) (4) ___ 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 9,655 Make check payable to: REGISTER OF WILLS, AGENT - -.:j ~y~:. ~r _;.~*r.t~,sY t+~ k =- *~'~, t"ti'' .~i tt' # t P # ! i3-' a~~ -}-st ~s +~ir0,'.,. r 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? ....................................................................................... ^ Q 3. Did decedent own an 'in trust for" orpayable-upon-death bank account or security at his or her death? ......... ^ Q 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. For dates of death on or after July 1,1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spy 3 percent p2 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [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 asset 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 21 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 percent [72 P.S. §9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1502 EX+ (01-10) pennsylvania ( SCHEDULE A DEPARTMENT OF REVENUE REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT -- -- TATE OF: FILE NUMBER: RACHEL C. SNAVELY 21 11 0115 Ail 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 facts. Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F. Attach a copy of the settlement sheet if the property has been sold. ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE NUMBER OF DEATH DESCRIPTION 1. 89 GREENSPRING DRIVE 186,417 MECHANICSBURG, PA 17050 NET SALE PRICE TOTAL (Also enter on Line 1, Recapitulation.) ~ E 18.6 417. If more space is needed, use addiBonal sheets of paper of the same size. .~`"""!N"~ ~ OMB Approval No. 2502-0265 ~ A. Settlement Statement (HUD-1) ~~~~Vl 1. ^X FHA 2. ~ RHS 3. ~ Conv. Unins. 6; f~e Number: 0321412223umber: 48~MOo798555e Insurance Case Number: 4. ^ VA 5. ~ Conv. Ins. C. Note: This forth is famished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agents are shown. Items marked "(p.o.c)" were paid outside the Dosing; they are shown here for infortnadonal purposes and aro not included in the totals. D. Name & Address of Borrower: E. Name 8 Address of Seller: F. Name 8 Address of Lender: Raymond W. Hein, Deborah S. Yazawich Estate of Rachel Snavety Wells Fargo Hone Mor~age 228 North Fairville Avenue, Hardsburg, PA 17112 89 Greenspring Drive, Mechanicsburg, PA 17050 1017 Mumma Road, Su1e 205, Wamieysburg, PA 17043 G. Property Location: H. Settlement Agent: I. SetOement Date: 06/15/2011 89 Greenspring Drive 1st Advantage Se0lemeMServices Inc. Disbursement Date: 06/15/2011 Mechanicsburg, PA 17050 6375 Mercury Drive, Suite 102, MechaMCSbtxg, PA 17050 Silver Spring Township Telephone: 717-591-7755 Fez: 717-591.7756 Place of Settlement: TItleExpress 6375 Mercury Drive, Sufte 102, MechaMrsburg, PA 17050 Printed 06!1512011 at 3:45 pm by TF 100. .Gress Amount Des from Darrotvar 400. Groh Amount Dw b SWar 101. Contract sales price 198,000.00 401. Contract sales prilx 198,000.00 102. Personal 402. Personal 103. Settlement charges tc bortovter pine 1400) 7,554.88 403. 104. 404. 105. 405. A utfmsMt for fttms old seller in advance A ustmenb for Items old taper In advance 108. CityAaxn fazes to 408. Citylbwn fazes b 107. County fazes 0611512011 to 12!3112011 309.89 407. Cotmty taxes 06!1512011 to 1213112D11 309.69 108. Scholl Taxes 0811512(111 to 0613012011 72.78 408. School Taxes 0611512011 to 0813012011 72.78 109. 409. 110. 410. 111. 411. 112. 412. 120• Gross Amount Dua hom Borrovrer 205,937.35 420. Grote Amount Due b StOer 198,312.47 200. Amounts Pald or In BehaN of Bortower 500. Raductlont In Amourd Dua to Selltr 201. DeposB a earnest money 2,000.00 501. Excess deposit (see instnlefions) 202. Princpal amount of new loan(s) 95,950.00 502. Settlement charges to seler pine 1400) 11,965.33 203. Exisfin loan s taken sub' t to 503. Exisfin loan s taken sub' to 204. 504. P of first mort ban 205. 505. PayoO of second mortgage ban 206. 506. 207. 507. 208. 508. 209. 509. A usfinenb for kerns u aid seller A usbnenb for Hemt u till seller 210. Citylbvm fazes to 510. Cityltowrt fazes to 211. Coatty farces to 511. County faxes to 212. Scholl Taxes to 512. School Taxes to 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. ~0• Tobl Pald Mor Borroarer 97,950.00 520. Total Reatetlon Amound Dus Stller 11,985.33 300. CatA at SttldsmrtM ironJto t3orrovrer 1100. Cash at StttNmtnt Itrltrsm Seller 301, Gross amount due from borrower )Yrw;120) 205,937.35 601, Gross amount due to seter pine 420) 198,382.47 302. Less amouris paid by/br bortower pine 220) 97,950.00 602. Less reduclorts in amount due seler pine 5201 11,965.33 303. Cash ^X From ~ To Bortotver rn. wtic .aen.w eua.n msm.mw,a, :wnrw uas.ww.wn.w,.. 107,917.35 in mrann ,-:..n w,.mmc m . 903. Cash ~X To ~ From Seller mu m.a.,vvm-.w oduem. wam.m...,,a-,,.,.,d,..ww 118,417.14 -tlMmM poc.u~~ om ry ,wem,ra r,v,w ,wwn,w,u.ry n-.v.a;vn a.oo.ur..r-,vnpy ,r-.-W~pP~'~..,InWb.m.REBPI,cw.M l.,YCtlon vM-an,vOOn MNtl. Previous editions are obsolete Page 1 of 4 HUD-1 700. Tohl Real Estate Broker Fees 55,940.00 Paid From Paid From Divisanotcanmission ine700 asfolbws: Borrower's Seller's 701. 55,940.00 to Re/Max 1st Advantage Funds at Funds at 702. 50.00 to Settlement Settlement 703. ComMssion pad at settlement 5,940.00 704. Comrussion to RelMazlstAdvantage 350.00 800. Rama Pa rile In Conneetion with Loan 801. Our originafon charge (Includes Origination Point 0.000%or 50.00) S (from GFE #1) 802. Your credK a charge (points) fa the specific interest rate chosen i119.94 (from GFE #2) 803. Your adjusted origination charges (from GFE A) 375.06 804. Apprasa fee to RELS Valuation 5455.00 P.O.C. • (tran GFE #3) 805. Credit report to RELS Gedit 514.84 P.O.C. ' (kom GFE #3) 14.84 806. Tax service to from GFE #3 807. Flood certification to Rom GFE #3 eoe. ~ 9D0. Rama R uhed Candor to be Peid in Advmea 901. Daily interest chxges Rom Fran ON152011 b 07101/2011 Q 510.52001day (from GFE #10) 188.32 902. Mortgage Ins. Premium for montlrs to HUD (from GFE #3) 950.00 903. Homeowner's insurance Por 1 ors to Nationwide Insurance 5447.00 P.O.C. • (~ GFE #t 1) 904. months to from GFE #11 1000. Reaerva aged with Candor 1001. IniUa deposK for your esaow account (Rom GFE #9) 1,882.91 1002. Harieowcers insurance 3 months S 37.251month 5111.75 1003. Mortgage Insurance months S O.OOImoMh S 1004. City Property Taz months f O.OOInaMh S 1005. County Property Tax 6 months S 47.10/month 528260 1006. School Taxes 14 months S 138.35/month 31,936.90 1007. Aggregate Adjustment 5-448.34 1100. TltleCh ss 1101. Title services and lender's title Insurance Ovm GFE #4 1,164.75 1102. Settlement a cbsing fee to S 1103. Owner's title insurance from GFE #5 514.00 1104. Lenders title insurance (984.75 1105. Lenders title policy limit 595,950.00 Lenders Pdicy 1106. Owners title policy Emit 5198,000.00 Owners Pdicy 1107. Agent's potion of the tots title insurance premium 51,273.94 1108. Underwriters portbn d the tots title insurance premium 5224.81 1109. 1110. Notary to Kristen D. Shine 10.00 1111. Tax CeAification Fee to 1st Advanta a Settlement Ser 10.00 1200. GovemmentReeordn endTranaferCh ea 1201. Govemnienl recording charges S (from GFE #7) 136.00 1202. Deed f62.00 Mo a 574.00 Release S 1203. Transfer taxes S (from GFE #8) 1,980.00 1204. CitylCounty taxlstamDs Deed 51,980.00 Mat e S 1205. State Taxhtamps Dead 51,980.00 e E 1,980.00 1206. Deed S Mat e S 1207. S 1300. Additlonal Settlement Ch ee 1301. Regdred services Thal you can strop for (from GFE #6) 19.00 1302. Flood Lice M Loan Fee to WF FLOOd Svcs 519.00 1303. to 1304. to 1305. m 1306. 2011 ColTwp Taxes to Debra Wrest 5565.19 P.O.C. S 1307. Fins Sewer to Saver S Town Aulhod 130.3 1308. Home Warranty to American Home Shield 395. 1309. Inheritance Taz Esaow to 1st Adv Sedlertrent Serivices 3,500.0 l 7,554.88 11,965.33 •Pad outside of cbsing by (B)orrower, (S)e0er, (L)ender, p)nvesta, Bro(K)er. ••Cred'd by lender strown on page 1. •••CredK by seller sfwwn on page 1. Previous editions are obsolete Page 2 Of 4 HUD-1 REV-1508 EX + (6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC. IN R SI DENTEDECEDENTRN PERSONAL PROPERTY - __ __ _ -- ESTATE OF FILE NUMBER RACHEL C. SNAVELY 21 11 0115 Include the proceeds of litigation and the date the proceeds were received by the estate. All property ' in -owned with ri ht of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. MERRILL LYNCH 271,816 2. ~ RAYMOND JAMES ~ 419,649 3. 11998 CHRYSLER ~ 1,500 4. 89 GREENSPRING DRIVE, MECHANICSBURG, PA 500 HOUSEHOLD CONTENTS 5. CHECKING 54,925 ___ _ _-_ TOTAL (Also enter on line 5, Recapitulation) 15 748 391. (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (10-09) pennsylvania DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER RACHEL C. SNAVELY 21 11 0115 Decedent's debts must be reported on Schedule I. ITEM NUMBER DESCRIPTION - - AMOUNT FUNERAL EXPENSES: _- 1. AUER CREMATION SERVICES 2. JAMES PARVIN, INC. -GRAVE OPENING 700 3. SILVER SPRING PRESBYTERIAN CHURCH -CATERED LUNCHEON 50 4. SUZANNE WERTZ -MEMORIAL CATERED DINNER 220 5. REVERAND DONALD STEELE -MEMORIAL SERVICE 534 6. ROLLA LEHMAN -ORGANIST 200 100 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s) of Personal Representative(s) PHOEBE S. TOBIN (RENOUNCED) Street Address 3414 TYLER DRIVE City ELLIOTT CITY State MD ZIP 21042 Year(s) Commission Paid: 2, Attorney Fees: MURREL R. WALTERS, III 3. Family Exemption: (If decedents address is not the same as claimants, attach explanation.) Claimant Street Address Cdy State ZIP Relationship of Claimant to Decedent 4• Probate Fees: CUMBERLAND COUNTY REGISTER OF WILLS 5 Accountant Fees: 6. Tax Return Preparer Fees: 7• FLOWERS, MISC. FUNERAL EXPENSES 8. ALYSA @ IBIS -APPRAISALS 9. POSTAGE -ESTATE SETTLEMENT 10. AMERICAN EXPRESS -MEAL AFTER SETTLEMENT 7,875. 692. 1,168. 180.E 47.E 79. TOTAL (Also enter on Line 9, Recapitulation) 13 _ _ ,. . If more space is needed, use addfional sheets of paper of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent RACHEL C.SNAVELY 21 11 0115 Decedent's Name Page 7 File Number Schedule H -Funeral Expenses $ Administrative Costs - B1 ITEM NUMBER DESCRIPTION AMOUNT ADMINISTRATIVE COSTS: Personal Representative Commissions: 2• Name(s) of Personal Representative(s) CHESTER C. SNAVELY. JR. (RENOUNCED) Street Address 12 OCEAN HARBOR CIRCLE City OCEAN RIDGE State FL ZIP 33435 Year(s) Commission Paid: SUBTOTAL SCHEDULE H-B1 REV-1512 EX+ (12-08) pennsylvania SCHEDULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT, INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT s - ' FILE NUMBER RACHEL C. SNAVELY 21 11 0115 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM - - NUMBER DESCRIPTION TE VA OF DEATH 1• LIVE-IN CARE OF PENNSYLVANIA CAREGIVER AGENCY 70 2. RABI BROWN CAREGIVER 1,780 3. VERiZON TELEPHONE 215 4. COMCAST TELEVISION 323, 5. SUZANNE WERTZ CLEANING LADY/SUPPLIES 75. 6. PPL ELECTRIC 1,953. 7• UNITED WATER 97. 8. HOLY SPIRIT HOSPITAL MEDICAL 37. 9. SILVER SPRING PRESBYTERIAN CHURCH PLEDGE 150.E 10. PENN WASTE REFUSE ~'' 11. BANK OF AMERICA VISA 100.._ 12. DEBRA BASEHORE WIEST COUNTY/TOWNSHIPTRXES 574.`- 13. CAMP HILL EMERGENCY PHYSICIANS MEDICAL BILL 36.1 14. LAWNSCAPES SNOW REMOVAL 227" 15. PA DEPARTMENT OF REVENUE 2011 TAXES 289.0 TOTAL (Also enter on Line 10, Recapitulation) I S 8 393.2 If more space is needed, insert adddanaf sheets of the same size. Continuation of REV-1500 Inheritance Tax Return Resident Decedent RACHEL C. SNAVELY 21 11 0115 Decedent's Name Page 2 File Number Schedule I -Debts of Decedent, Mortgage Liabilities, & Liens ITEM - NUMBER DESCRIPTION AMOUNT 16. PENN NATIONAL INSURANCE HOMEOWNERS 128 17. SILVER SPRING TOWNSHIP AUTHORITY SEWER 106 18. S.F. AND CO. TAX PREPARATION 600 19. PYRAMID CONSTRUCTION SOCS PRE-SETTLEMENT REPAIRS 1,377 20. STANLEY STEAMER -HOME CLEANING 210= SUBTOTAL SCHEDULE I 2,417.0 GRAND TOTAL SCHEDULE I S 8,393.2 REV-1513 EX+(01-10) Pennsylvania SCHEDULE J DEPARTMENT OF REVENUE BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF: FILE NUMBER: RACHEL C. SNAVELY 21 11 0115 RELATIONSHIP TO DECEDENT AMOUNT OR SHAR NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS [InGude outs' ht spousal distributions and transfers under Sec. 91 f6 (a) (1.2).] 1. CHESTER C. SNAVELY, JR. Lineal 12 OCEAN HARBOR CIRCLE OCEAN RIDGE, FL 33435 2. PHOEBE S. TOBIN lineal 3414 TYLER DRIVE ELLICOTT CITY, MD 21042 3. SUZANNE B. WERTZ Lineal 4516 E. HAMLIN DRIVE PHOENIX, AZ 85050 4. AVA G. SNAVELY Lineal 12 OCEAN HARBOR CIRCLE OCEAN RIDGE, FL 33435 5. HAROLD TOBIN Lineal 1822 CAMELOT DRIVE MADISON, WI 53705 6. RACHEL TOBIN BATRES Lineal 6646 CIMMARON CIRCLE ANCHORAGE, AK 99504 7. ELIZABETH CRABTREE HARTMAN Lineal 135317TH AVENUE SAN FRANCISCO, CA 94122 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE. II. NON-TAXABLE DISTRIBUTIONS: - - - A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET If more space is needed, use additional sheets of paper of the same size. S Continuation of REV-1500 Inheritance Tax Return Resident Decedent RACHEL C. SNAVELY Decedent's Name 21 11 0115 Page 3 File Number Schedule J -Beneficiaries - 1 NUMBER NAME AND ADDRESS OF PERSON S RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS [Include outs' ht s usal distributions and transfers under Sec. 9116 (a~1.2).] 8. LOREN CRABTREE, III 16 PAIGE TRAIL PERKASIE, PA 9. LANCE CRABTREE 2417 W. ROY ROGERS ROAD PHOENIX, AZ 85085 RELATIONSHIP TO DECEDENT Do Not List Trusteelsl AMOUNT OR SHAR OF ESTATE Lineal Lineal