HomeMy WebLinkAbout04-0803
PETITION FOR GRANT OF LETTERS
Estate of ANGELA PASKEY No. OU '-' 0 If -<6'03
also known as
ANGELA PASKEY
, Deceased
Social Security No. 181.03.1658
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE "A" OR "B" BELOW:)
n A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut
UU Decedent, dated 10/23/1976 and cOdicil(s) dated
WALTER J. PASKEY PREDECEASED THE DECEDENT. THE ALTERNATE EXECUTRIXES MARY ANN EMANUELLI
AND CHRISTINE XISTRIS BOTH RESIDE OUTSIDE OF THE COMMONWEALTH OF PENNSYLVANIA AND HAVE
REQUESTED THAT WALTER PASKEY, JR SERVE AS ADMINISTRATOR C.TA
State relevant circumstances, e.g., renunciation, death of executor. ate
Except as follows, Decedent did not marry, was not divorced and did not have a child bom or adopted after execution of the documents offered
for probate; was not the victim of a killing and was never adjudicated incapacitated:
named in the Last Will of the
o
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
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(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in CUMBERLAND
residence at 1 LONGSDORF WAY, CARLISLE, PA
o
County, pennSYIVania,~!thhiS/heJl,st fam~ Iii principal
:1,\,",.. ,..)
)"'" -.';.....lo ,;..,....
(list street, number and municipality) W
2004 at CUMBERLAND CROSSING RET. COM
, - , (Location)
Decedent, then 88
years of age, died JUNE 19
Decedent at death owned property with estimated values as follows:
(if domiciled!~ PAl All personal property ......................................... $
(if not domiciled in PA) Personal property in Pennsylvania .................... $
(If not domiciled in PAl Personal property in County .............................. $
Value of real estate in Pennsylvania ........................................................................................ $
Total...................................,........,.......................,.........,.................,..........,......... $
40,000.00
40,000.00
Real Estate situated as follows:
I
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 fonn to the undersigned:
Signature
Typed or printed name and residence
I
-,.=- ,L:>A
, \l
\,...
WALTER J. PASKEY JR
112 FOURTH STREET
BOILING SPRINGS PA 17007
RW-7
Oath of Personal Representative
Commonwealth of Pennsylvania
County of CUMBERLAND
The Petitioner(s) above-named swear(s) and affirm(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
\ cJ- "'--
day of
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DECREE OF REGISTER
Estate of ANGELA PASKEY
Deceased
No. ,:).1- 0'-/ - 8' ~
also known as
Social Security No: 181-03-1658 Date of Death: 6/19/2004
AND NOW, ~\ '-XY'~ 0, -, ,~ ,in consideration of the Petition
on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters 0 Testamentary IXI of Administration c.t.a.
(c.t.a.. d.b.n.c.t.; pendente lite; durante absentia; durante minoritate)
are hereby granted to WALTER J. PASKEY, JR.
in the above estate and that the instrument(s), if any, dated 10/23/1976
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters ....................................
Short Certificate(s) ...............
Renunciation ..........................
Affidavit ( ) .......................
Extra Pages ( 3 )..............
Codicil .................................
JCP Fee .................................
Inventory & Tax Forms.............
Other......................................
$.=:JD .61'\
$ 3.0 . O\:l
$ \5.00
$
$ qoo
$
$ In .00
$
$~
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~.^~-h,obor~ >
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Attorney
Attorney: MARK A. MATEYA, ESQUIRE
I.D. No: 78931
Address: P.O. BOX 127
CARLISLE
Telephone: (717) 241-6500
DATE FILED: Rl1. lM4 Cj - .., b2 rot{
PA 17007
TOTAL .............................$ /40 . l.lD
RW-7A
CUMBERLAND COUNTY
RENUNCIATION
Estate of ANGELA PASKEY
No. 21
2004
<iD3
also known as
ANGELA PASKEY
, Deceased
The undersigned, ARLENE JEVELLE, DAUGHTER
(Relationship)
(Capacity)
of
the above Decedent, hereby renounce(s} the right to administer the estate and respectfully request(s) that
Letters OF ADMINISTRATION C.TA be issued to WALTER PASKEY
hand this ~ f <U-. day of ,1" 1"J- ,->--'" y..
Wt~,-- hl~
20 NOD BROOK ROA
WALLINGFORD
Witness
CT 06492
(Address)
r/Ub e,~/:~
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(Address)
(Signature)
(Address)
Sworn to or affirmed and subscribed
on
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before me this 2/cr. day of
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Notary Public
My Commission bpires: '1/ jo- oLj
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(Signature and sAal of Notary or other
official qualified to administer oaths. Show
dale 01 expiration of Notary's commission,)
NOTF: RRnunci;:Jtions executed outside the Office of Register of WilLe:: ;:Ire
required in some counties to be notarized.
RW-3
CUMBERLANI.J .;OUNTY
RENUNCIATION
Estate of ANGELA PASKEY
No. 21
2004
~03
also known as
ANGELA PASKEY
, Deceased
The undersigned, CHRISTINE XISTRIS, DAUGHTER
(Relationship)
(Capacity)
of
the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that
Letters OF ADMINISTRATION C.T.A. be issued to WALTER PASKEY
Witness
hand this
.2 7-11I day of !A~ . ' ow,!
~~X~
(Signature)
9 FARM DRIVE
FARMINGTON
CT 06032
(Address)
(Signature)
(Address)
(Signature)
(Address)
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Sworn to or affirmed and subscribed
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before me thls__.____ day of
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(Signature a.ld tieal of Notary or oilier
official qL'a,ified l) ;~o'rr.ini::,tt"'r cat'JS. Show
dale of expiration of Notary's commis~ion.)
NOTE: Renunciations executed outside the Office of Register of Wills are
required in some counties to be notarized.
RW-3
CUMBERLAND COUNTY
RENUNCIATION
Estate of ANGELA PASKEY
No. 21
2004
9"0 :J
also known as
ANGELA PASKEY
, Deceased
The undersigned, MARY AN
DAUGHTER
(Relallonship) (Capacity)
of
the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that
Letters OF ADMINISTRATION C.TA be issued to WALTER PASKEY
Witness hand this :: day of ~
V~a t-.~-
(Signature)
6 COLON I L ROAD
WHITE PLAINS
;>".0+
u.:....
NY
10605
(Address)
(Signature)
(Address)
(Signature)
(Address)
Sworn to or affirmed and subscribed
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My Commission Expires:
MICHELE ROMANO
Notary Public, State of New VCIIlc
No. 01 R06045280
eon:::ed In Putnam County /_
on Explr. July 24, 200 .It''
DC:
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(Signature and seal of Notary or other
official Qualified to administer oaths. Show
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NOTE: Renunciations executed outside the O~~:bf Regi9.ter of Willg~ti.
required in some counties to be notarized. W
RW-3
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3l\.egil>ttr of Wills of Q[:umberlllnb Q[:ountp
OATH OF SUBSCRIBING WITNESS
Estate of
Angela Paskey
No. ~/-(j./-'iOJ
Also known as
Anqela Paskey
,Deceased 9 Cj
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Albert J. Emanuelli
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(each) a subscribing witness to the will/codicil presented herewith, (each) bejiOg,duly ~lified"
according to law, depose(s) and say(s) he was present and saw
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Anqela Paskey
, the testa~ix , sign the same and
that J1esigned as a witness at the request of the testatri y in his- presence
and (in the presence of each other) (in the presence of the other subscribing witness(es),
Sworn to or affirmed and subscribed
Before me this /5171- day' of
M/FtIs r , 20~
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(Name)Uf:-~ ?
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(Adcfress) t1~ ~ 7Ji /00 OJ''
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t!Dt/u"l ,tr lJ~mlt!'.5fY1-
(Name)
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(Address)
For the Register
DAVID M. WHEELER
Notary Public, State of New YOdI
. Westchester Counll '" -U-tJ '"
.., Commission Expires- ,
No. 01 WH f7]1~7' _,,~
_. l\egister of Wills of QJ:umberlanll QJ:ountp
OATH OF SUBSCRIBING WITNESS
Estate of
Angela Paskey
No. ~, ffI- ?~3
Also Imown as
Anqela Paskey
, Deceased
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Victor Xistris
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(each) a subscribing witness to the will/codlcil presented herewith, (each) h<:i4g duly~alifieffi.
according to law, depose(s) and say(s)hp w" " present and saw c... W
Anqela Paskey , the testat..'l!. , sign the same and
that
he
signed as a witness at the request of the testat rix. in h~ presence
and (in the presence of each other) (in the presence of the other subscribing witness(es).
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(Name) /
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(Address) _,~_
Sworn to or affirmed and subscribed
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FUll' ,e Regislei'.
8tlAVON IWlTIN '
1lOo..... PI,IIIUC, STATE OF NEWWIIIIr
NO.01MA5077125
CC~~C:1:r&
(Name)
(Address)
U'r'_<_~I'~ ",f'V n/\h
This is to certify that the infonnation here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent tiling.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
No.
/U>lLo If;. J( ~
,
Local Registrar
p
10553663
JUt~ 2 8 2004
Date
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'PRONOUNCING AND CERTIFYING PHYSICIAN (Physlcian bOlh pwno,,"l"'ng d~all1 and c~f1jtyiny 10 cause of dealh)
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REGJS1RAR~NATUREANDNU~DER / .
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I, ANGELA PASKEY, also known as ANGELA PASKEWICZ,
residing in the County of Schuykill, Commonwealth of
Pennsylvania, do publish and declare the following to be my
last will and testament, hereby revoking all prior wills.
FIRST: I devise and bequeath to my husband, VIALTER
J. PASKBY, if he survives me, any real estate used by me as a
residence at the time of my death, and all of my tangible
personal property. If my husband does not survive U~, I
bequeath all of my tangible personal property to my children
who survive me, to be divided among them by my executors in
as nearly equal proportions as may be practicable, having due
regard to the personal preferences of my children. Devises
and bequests of raal and personal property under this Article
shall carry with them any policies of insurance relating to
said property. I direct that the expenses of distributing my
tangible personal property and of maintaining it prior to
distribution shall be a charge upon my general estate.
SECOND: If my husband survives me, I bequeath any
insurance policies on his life of which I am the owner to my
issue who survive me, in equal shares, per stirpes.
THIRD: I devise and bequeath all the rest of my
property (hereinafter known as my "residuary estate") to my
said husband, if he survives me, or if my said husband does not
survive me, to such of my issue who survive me, in equal shares,
per stirpes.
FOURTH:
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If I am not survived by my husband n~
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by ~i~ ~'2"
issue, I devise and bequeath all of my property to-the ~rsaria
co
to whom and in the proportions in which the same wpiI1d Itave
-
been distributed under the laws of the Commonwealth of W
'0
Pennsylvania if I had died intestate a resident of the
Commonwealth of Pennsylvania.
FIFTH: If any part of the principal or income of my
estate shall vest in absolute ownership in a person under the
age of twenty-one (21) years (hereinafter referred to as a
"minor", such person's actual legal status to the contrary
'I
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notwithstanding), my executor may, in his discretion, hold and
administer, sell, invest and reinvest such part for the uenefit
of the minor during minority. My executor may pay to or apply
to the use of the minor such sums, out of income or principal,
as he shall, in his discretion, deem proper for the minorIs
support, maintenance and education, and shall add to principal
any income not so paid or applied. Payment of income or
principal to the minor may be made direct to the minor, to the
guardian of the property of the minor, or to the custodian of
the minorIs property under a Gifts to Minors Act. Application
of income or principal to the use of the minor may be made by
payment to a parent of the Ininor, to the guardian of the person
of the minor, or to any other person with whom the minor shall
reside, as well as by expenditures for the benefit of the minor.
The receipt of the minor, guardian, custodian, parent or person
for any payment or application so made shall be a full disCharge
of my executor and he shall have no further duty in respect
thereto. All property shall be paid over to the minor upon the
minorIs attaining the age of twenty-one (21) years, but if the
minor shall die before attaining the age of twenty-one (21)
years such property shall thereupon be paid over to the estate
of the minor. My executor shall have the same powers,
authorities, discretions and immunities with respect to the
property held hereunder and the investment thereof as are
conferred upon him with respect to my estate, and shall be
entitled to the same compensation as would a testamentary
trustee of the property held hereunder.
SIXTH: In addition to the powers conferred by law,
I give to my executor and any successors, full power and
authority from time to time-in their absolute discretion, to
retain as part of my estate any securities which I may own at
the time of my death; to invest the funds of my estate without
diversification, in stocks, cornmon, preferred or of any other
class, in bonds, secured or unsecured and in other securities,
in commodities, equities, mortgages, real estate, business
enterprises, investments in the nature of loans, or other
properties of any kind, whether or not such stocks, bonds, or
other securities and properties are of the nature approved for
fiduciaries by the present or future laws or statutes applicable
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- 2 -
thereto; to hold a part or all of my estate in cash for a
reasonable period of timei to purchase and hold for periods of
time non-income producing securities and other property upon
such terms and conditions as they may determinei to sell,
exchange, lease, n~rtgage, grant options upon, abandon, demolish,
alter, repair in an ordinary or extraordinary manner, or otherwise
deal with any real or personal property in such manner, for such
periods of time and upon such terms and conditions as they
shall deem proper, and to make, execute and deliver all proper
instruments for said purposesi to borrow money from anyone,
including themselves, and to continue any existing loans; to
renew or modify any existing contracts or agreements entered into
by me during my life and to continue any business in which I was
a stockholder, partner or proprietor at the time of my death;
to compromise any and all claims, debts, accounts and causes of
action in favor of or against me or my estate; to employ agentsi
to delegate authority; to participate in reorganizations; to
exercise rights; to register securities in the names of nominees,
insofar as permitted by law; to join in or consent to income and
gift tax returns filed by my surviving spouse and to pay any
part or all of the income tax or gift tax due upon such tax
returns; to enter into pooling arrangements and voting trust
agreements; to create reserves for depreciation and obsolescence,
or for wasting assets; to amortize or not amortize premiums; to
make distribution of my estate Wholly or partly in kind, and
for that purpose to determine the values of any property so
distributed insofar as permitted by law and by other provisions
of this will.
SEVENTH: All transfer, estate, inheritance or other
death taxes of every description (including any interest and
penalties thereon) which may be lawfUlly imposed upon any
property passing under this will shall be paid out of my
r~siduary estate without apportionment.
EIGHTH: I appoint my husband, HALTER, executor of
this my will. If he shall predecease me or shall thereafter
die, resign, fail to qualify or become incapable of acting, I
appoint ray daughters, MARYANN PASKEY and CHRISTINE XISTRIS, as
'1
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executors, to act jointly or singly in place and stead of my
- 3 -
said husband.
The word "executor" as used herein shall be deemed
to refer to any successors, and shall include the masculine,
feminine or neuter and the singular or plural, as the context
or circumstances shall require. The word Ilestate" as used
herein shall be deemed to refer to any trust estate created
herein as well as to my general estate.
No bond or otller security shall be required of any
executor, trustee or guardian n~ned above for the faithful
performance of his or her duties hereunder.
IN WITNESS WHEREOF, I have hereunto set my hand and
affixed my seal this
. " ."
",j
day of ,J<.;,..r:13:.3-i{ , 19 7~
?!j",L,c..
ANGELA PASKEY
~:;..---
If
(L.S. )
SIGNBD, SEALED, PUBLISHED and DECLARED
by ANGELA PASKEY, the testatrix above
named, as and for her last will and
testament, in our presence, and we
thereupon, at her request, and in her
presence and in the presence of each
other, have hereunto subscribed our
names as witnesses this ;?.3 day of
(}.c{;,~ ,191?
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residing at
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residing at
residing at
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
PASKEY WALTER J
112 FOURTH STREET
BOILING SPRINGS, PA 17007
___n___ fold
ESTATE INFORMATION: SSN: 181.03.1658
FILE NUMBER: 2104-0803
DECEDENT NAME: PASKEY ANGELA
DATE OF PAYMENT: 09/09/2004
POSTMARK DATE: 09/09/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 06/19/2004
NO. CD 004358
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $1,600.00
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TOTAL AMOUNT PAID:
$1,600.00
REMARKS: PASKEY ANGELA
CHECK# 1111
. SEAL
INITIALS: CCP
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
CERTIFICATION OF NOTICE UNDER RULE 5.61al
Name of Decedent: ANGELA PASKEY
Date of Death: 6/19/2004
Will No.
Admin. No. 21-04-0803
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphan's Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on 9/9/2004
Name Address
WALTER PASKEY 112 FOURTH STREET
BOILING SPRINGS PA 17007
CHRISTINE XISTRIS 9 FARM DRIVE
FARMINGTON CT 06032
MARY ANNE EMANUELLI 6 COLONIAL ROAD
WHITE PLAINS NY 10605
ARLENE JEVELLE 20 NOD BROOK ROAD
WALLINGFORD CT 06492
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except:
Date:
qlD/Ot.f
.
,~~~
Name: MARK A. MATEYA ESQUIRE
Address: P.O. BOX 127
BOILING SPRINGS
PA 17007
. ,., "qclIn:.)
.",q,:)
Telephone(717) -241-650
LZ: l d n d3S 170.
Capacity:
X
Personal Representative
Counsel for Personal
Representative
,
f:~jH
\f
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG~ PA 17128-0601
*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21 ()4 ~Q:3
ACN 04134881
DATE 09-17-2004
REV-1S4SUAFPC09.00l
TYPE OF
ACCOUNT
o SAVINGS
o CHECKING
o TRUST
IX] CERTIF .
.04 OCT 13
""EST. OF ANGELA PASKEY
S.S. NO. 181-03-1658
DATE OF DEATH 06-19-2004
COUNTY CUMBERLAND
P 3 :58
REHIT PAYHENT AND FORHS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
WALTER
112 4TH
BOILING
PASKEY
ST
SPGS PA
1700,/(;'"
Clin"iLc.
, ,~i.1
,
[';"\
FIRST FEDERAL BANK hl!ls provided the Depart..ent with thllll infonlation listed below which has been used in
calculating the potential tax due. Their rllllcords indicate that at the death of the above decedent~ YOU were a joint owner/beneficiary of
this account. If you fael this infor.ation is incorrect~ please obtain written correction frail the financial institution~ attach a copy
to this for. and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the C~.onwealth
of Pennsylvania. Questions .ay be answered by calling (717) 787-8327.
COMPLETE PART 1 BELOW
Account No. 0327015743
J( J( J( SEE
Date
Established
REVERSE SIDE FOR
03-30-1989
FILING AND PAYMENT INSTRUCTIONS
Account Balance
Percent Taxable
Amount Subiect to Tax
Tax Rate
Potential Tax Due
x
601. 46
50.000
300.73
.045
13.53
To insure proper credit to your I!Iccount~ two
(2) copies of this notIce .ust accompany your
pl!lYllent to the Register of Wills. Make check
payable to: "Register of Wills~ Agent...
x
NOTE: If tax pay.ants are made within three
(3) months of the decedent"s date of daath~
you may deduct I!I 52 discount of tha tax due.
Any inheritl!lnce tI!Ix due will beco.e delinquent
nine (9) months after the date of death.
PART TAXPAYER RESPONSE
[!]1!1!1~~'~~_i!!i.i!~_..ii!I*~~!!!i!l_~!!!!!~I!!!!~!i!!.~~~~!iii!~Hi!ii!_~~!!!!Ip!i!i.~!!ii~~I!!!.~J~!!i!il
'.'.'.....'.'.'.'.'.'.'.'...'.....'.'...'...'.'.'.'.'.,...,.,.~,.,.,~,.,.~,.,.,.,.,.,.,."..,.,.,.~,.,.,.,.,.'.'.'.'.'.'.'.'.'.'.'.,.'.'...-.'.'.,.-.'.'.-.....,.........-...-......................................,.....,.,.,...,.,.....,...,.,...,.,,..,',...,.,.,.,.,.,',',.,',""',"'".,.,.,.,~.,.,.,.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.-..~.'.-.-...'.'.-.-.-.-...........-...................,.......................
........................_...................-.....-..................................................................................,.......,.,.,.....,.,.,.,.,.,.,.,.,.,.,.,.,.'".... .,.,...,.,...,. ,. ..,., . ...... ..~... ... ... ..... ... ............................................................,...................,.,.,.....,.....,.,.""P""""" .,.,.... .,.,. .,.
[CHECK ]
ONE
BLOCK
ONLY
A. 0 The above infor.ation and tl!lX due is correct.
1. You .ay choose to ramit payment to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest~ or you !ll!Iy check box "A" and return this notIce to the RegIster of
Wills and I!In official assess.ant will be Issued by the PA Depl!lrt.ent of Revenue.
B. IXI The above asset has been or will be reported and tax paid with the Pennsylvanil!l Inheri tanca Tax return
to be filed by the decedent's representative.
C. 0 The above infor.Btion is incorrect and/or debts and deductions were paid by you.
You must complete PART 0 and/or PART @] below.
TAX ON JOINT/TRUST ACCOUNTS
If you indicate a different tax rate, please state your
relationship to decedent:
PART
~
TAX RETURN - COMPUTATION
LINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
S. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
OF
1
2
3
4
5
6
7
8
x
x
PART
~
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Line S of Tax Computation)
I
$
Under penalties of
co~lete to the best of
"-.) ~
TAXPAYER SIGNATURE
periury, I declare that the
my knowledge and belief.
Q~
facts I
have reported above are true, correct and
HOME (VI ) 1iK'~~3 ~
WORK (7vi) c..ar-~ )...-jl--t'
TELEPHONE NUMBER DATE
v-
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based on infarllstian
subllitted by the financial Institution.
2. Inheritance tax b.C~BS delinquent nine lIanths after the decedent's date of death.
3. A joint account is taxable Bven though the decedent"s nall8 was added as a !latter of convenience.
4. Accounts (including those held between husband and wife) which the decedent put in joint nSlles within ana year prior to
death are fully taxable as transfers.
5. Accounts established jointlY between husband and wife .ore than one year prior to death are not taxable.
6. Accounts held by a decadent "in trust forn another or athBrs are taxable fully.
REPORTING INSTRUCTIONS - PART
1
TAXPAYER RESPONSE
1. BLOCK A _ If the lnforllation and co.putation in the notice are correct and deductions are not being claimed, place an "X"
in block "A" of Part 1 of the "Taxpayer Response" section. Sign two copies and submit them with your check for the amount of
tax to the Register of wills of the county indicated. The PA Department of Revenue will issue an official assessment
(Form REV-1548 EX) upon receipt of the return from the Register of Wills.
2. BLOCK B _ If the asset specified an this notice has been or will be reported and tax paid with the Pennsylvania Inheritance
Tax Return filed by the decedent's representative, place an "X" in black nB" of Part 1 of the "Taxpayer Response" section. Sign one
COpy and return to the PA Department of Revenue, Bureau of Individual Taxes, Dept 280601, Harrisburg, PA 17128-0601 in the
envelope provided.
3. BLOCK C _ If the notice infor.ation is incorrect and/or deductions are being ClaiMed, check black nc" and complete Parts 2 and 3
according to the instructions below. Sign two copies and sub. it theM with your check for the ~ount of tax payable to the Register
of Wills of the county indicated. The PA Depart.ent of Revenue will issue an official assessment (For. REV-1548 EX) upon receipt
of the return fro. the Register of Wills.
TAX RETURN - PART
2
- TAX COMPUTATION
LINE
I. Enter
NOTE:
the date the account originallY was established or titled in the manner existing at date of death.
For a decedent dying after 12/12/82: Accounts which the decedent put in joint names within one (I) year of death are
taxable fully as transfers. However, there is an exclusion not to exceed $3,000 per transferee regardless of the value of
the account or the nueber of accounts held.
If a double asterisk (MM) appears before your first na.e in the address portion of this notice, the $3,000 exclusion
already has been deducted from the account balance as reported by the financial institution.
2. Enter the total balance of the account including interest accrued to the date of death.
3. The percent of the account that is taxable for each survivor is determined as follows:
A. The percent taxable for joint assets establ~shed more than one year prior to the decedent's death:
I DIVIDED BY TOTAL NUMBER OF
JOINT OWNERS
ExaMple: A joint asset registered
DIVIDED BY TOTAL NUMBER OF X 100 PERCENT TAXABLE
SURVIVING JOINT OWNERS
in the na.e of the decedent and two ather persons.
I DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) . .167 X 100
16.7~ (TAXABLE FOR EACH SURVIVOR)
B. The percent taxable for assets created within one year of the decedent.s death or accounts owned by the decedent but held
in trust for another individual(s) (trust beneficiaries):
I DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT
OWNERS OR TRUST BENEFICIARIES
X 100
PERCENT TAXABLE
Exa.ple: Joint account registered
the decedent.
I DIVIDED BY 2 (SURVIVORS) ; .50
in the name of the decedent and two other parsons and established within one year of daath by
X 100
50~ (TAXABLE FOR EACH SURVIVOR)
4. The a.ount subject to tax (line 4) is determined by mUltiplying the account balance (lina 2) by the parcent taxabla (line 3).
5. Enter the total of the debts and deductions listed in Part 3.
6. The aeount taxable (line 6) is deter.ined by subtracting the debts and daductIons Uina 5) from tha a.ount sUbjact to tax (Une 4).
7. Enter the appropriate tax rate (line 7) as determined below.
death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is oX.
The lineal class of heirs includes grandparents, parents, children, and lineal descendents. nChildren" includes natural children
whether or not they have been adopted by others, adopted children and step children. "lineal descendents" includes all children of the
natural parsnts and their descendents, whether or not they have been adapted by others, adopted descendents and their descendants
and step-descendants. nSiblingsn are defined as individuals who have at least one parent in co..on with the decedent, wheth.r by blood
or adoption. The nCallateral" class of heirs includes all other beneficiaries.
Date of Death Spouse Line.l Sibling Collateral
07/01/94 to 12/31/94 37. 67. 157. 157.
01/01/95 to 06/30/00 07. 67. 157. 157.
07/01/00 to present 07. 4.5X- 127. 157.
_The tax rate imposed an the not value Df transfers fro. a deceased child twenty-one years of age Dr Y
ounger at
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allowabls debts and deductions are deter.ined as follows:
A. You legallY are responsible for payment, or the estate Subject to administration by a personal representative is insufficiant
to pay the deductible ite.s.
B. You actually paid the debts after death of the decedent and can furnish proof of pay..nt.
C. Debts being clai.ed aust be itemized fully in Part 3. If additional space is needed, use plain paper 8 l/Zn x Iln. Proof of
payment may be requested by the PA Depart.ent of Revenue.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG~ PA 17128-0601
'*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO.210t..\- '803
04134882
09-17-2004
REV-15UEXAFP U9-DDJ
'04 OCT 13
EST. OF ANGELA PASKEY
S.S. NO. 181-03-1658
DATE OF DEATH 06-19-2004
COUNTY CUMBERLAND
TYPE OF ACCOUNT
o SAVINGS
o CHECKING
o TRUST
IX] CERTIF,
P3 :58
REHIT PAYHENT AND FDRHS TD:
REGISTER DF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
WALTER
112 4TH
BOILING
PASKEY
ST
SPGS PA
1 ~~~,;,
[--.i
FIRST FEDERAL BANK has provided the Depart.ent with the infor.ation listed below which has been uSBd in
calculating the potential tax due. Their records indicate that at the death of the above decedent~ you were e joint owner/beneficiary of
this account. If you feel this information is incorrect~ please obtain writtBn correction fr~ the financial institution~ attach a COpy
to this for. and rsturn it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Co..onwealth
of Pennsylvania. QUBstions may be answered by calling (717) 787-8327.
Date
Est.blished
REVERSE SIDE FOR
06-30-1989
FILING AND PAYMENT INSTRUCTIONS
COMPLETE PART 1 BELOW
Account No. 727004174
1I! 1I! 1I! SEE
Account B.l.nce 501 . 56
Percent Taxable X 50.000
Allouni Subjeci to T.x 250.78
Tax Rate X .045
Potential Tax D\;e 11.29
PART TAXPAYER RESPONSE
[!]~i.~!!~!.:!.;~.::.'~.:~.:,';,_,:,:,:,:',:,:,:;,!i,:I,.,:,;:,:,:',:i,m.,',!'_,~iir!::I!::~i~1;:m~.I:IJI~::,:;:~~:i!;i'~I:i~I,:I:'i!:i!:i.I:I:i:i:IJi~i!.I:I:I::;1~!~DI:!!'!!:i!!~g!!!!~I:I'~,,:::,:,"""':::,:::,:::,:~",:,"":,:,:.i.:;,i!~!_,:I:i:,:;:I:1:1!,!i!~!l!i.~~~I!..Bi!I!~1
t '''~..+-.'Jiij'..''.''.'''''''''' .....~.~.." !.,.,.,...,.,., ,.,.,...:;,~.,.il,.i~~~,.....,.,.,....:~..,.~...._.........:.;.:.:.;.:.;,;.:.:.;.:.:.;.:.:...:.:.:.i........._.~.........i...:.;..:.................._...:)lmmm1!~mm1!nll~....-..... .:... .L.:. ...... .-..................... ~... W.! !.. ... ~.... ';
To insure proper credit to your account~ two
(2) capias of this notice .ust acco.pany your
peyment to the Register of Wills. Make check
pllyabh to: "Register of Wi1ls~ Agent...
NOTE: If tax pay.ents are made within three
(3) months of the decedent's date of death~
you may deduct a 5~ discount of the tax due.
Any inheritance tax due will bscome delinquent
nine (9) months after the date of death.
[CHECK ]
ONE
BLOCK
ONLY
A. D The above infor.aUon and tax dUB is correct.
1. You .ey choose to remit pay.ent to the Register of Wills with two copies of this notice to obtain
a discount or avoid intsrBst~ or you may check box "A" end return this notice to the Register of
Wills and an official assess.ent will be issued by the PA Depart.ent of Revenue.
B. IXI The above asset has been or will be reported and tax paid with thB Psnnsylvania Inheritance Tax return
to be filed by the decedent's representative.
C. D The above infor.ation is incorrect and/or debts and deductions were paid by you.
You must complete PART ~ and/or PART ~ balow.
x
If you indicate a differeni tax rate, please staie your
relationship to decedeni:
PART
~
TAX RETURN - COMPUTATION
LINE 1. Daie Esiabllshed
2. Account Balance
3. Percent Taxable
4. A~unt Subjeci io Tax
S. Debts and Deducilons
6. A.ount Taxable
7. Tax Rat.
8. Tax Due
OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3
4
5
6
7
8
x
PART
[!]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Line S of Tax COllpuiationJ
I
$
Under penalties of perjury, I declare ihat the facts I have reporied above are true, correci and
CO.Plet~ th~ 0(;> ~ end belief. ~~=~ ~ ~
TAXPAYER SIGNATURE TELEPHONE NUMBER DATE
-::J-
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicab18 interest based on inforlllation
sub.ltted by the financial InstitutIon.
z. Inheritance tax beeo.as delinquent nine Banths after the decedent.s date of death.
3. A joint account Is taxable Bven though the decedent's naBe was added as a .atte; of convenience.
4. Accounts (inCluding thOSB held between husband and wife) which tha decedent put in joint "a.es within one yesr prior to
death are fully taxable as transfers.
5. AccDunts established jointly between husband and wife .ore than DnB year prior to death are not tBxBble.
6. Accounts held by B decadent "In trust for" another or others arB taxab18 fully.
REPORTING INSTRUCTIONS - PART
1
TAXPAYER RESPONSE
1. BLOCK A _ If the inforllation and co.putation In the notice are correct and deductions are not being chimed" place an "X"
in block "A" of Part 1 of the "Taxpayer Response" section. Sign tNO copies and submit the. with your chlilck for thlil a.aunt of
tax to the Register of Wills of the county indicated. The PA Dlilpart.ent of Revenue wUl issue an official assess.ent
(For. REV-1548 EX) upon receipt of the return fro. the Register of Wills.
Z. BLOCK B - If the asslilt spscifllild on this notice has blilen or will bs rlilported and tax paid with the PennsYlvania Inheritance
Tax Return fiied by the decedent"s representative" place an "X" in block "B" of Part 1 of the "Taxpayer Rasponse" saction. Sign one
COpy and return to the PA Department of Revenue" Bureau of Individual Taxlils" Dept 280601" Harrisburg" PA 17128-0601 in the
envelope provided.
3. BLOCK C _ If the notice infor.ation Is incorrect and/or deductions are being clai.ed" check block nc" and co.plete Parts 2 and 3
according to the instructions below. Sign two copies and sub. it the. with your check for the a.aunt of t1!Ix payable to the Register
of Wills of the county indicated. The PA Depart.ent of Revenue will issue an official assesSlilent (ForN REV-I548 EX) upon receipt
of the return froN the Register of Wills.
TAX RETURN - PART
2
- TAX COMPUTATION
LINE
1. Enter
NOTE:
the data the account originallY was established or titled in the .anner existing at date of death.
For a decedent dying after 12/12/82: Accounts which the decedent put in joint na.es within one (1) year of death are
taxable fully as transfers. However" there is an exclusion not to exceed $3,,000 per transferee regardless of the value of
the account or the nuBber of accounts held.
If a double asterisk (MM) appears before your first na.. in the address portion of this notice" the $3,,000 exclusion
already has been deducted fro. the account balance as reported by the financial institution.
2. Enter the tot1!ll balance of the account including interest accrued to the date of death.
3. The percent of the account that is t1!Ixable for each survivor is deter_Ined as follows:
A. The percent taxable for joint assets estab1ist'1'Jd .ore than one year prior to the decedent's death:
I DIVIDED BY TOTAL NUMBER OF
JO INT OWNERS
Exa.ple: A joint asset registered
DIVIDED BY TOTAL NUMBER OF X 100 PERCENT TAXABLE
SURVIVING JOINT OWNERS
in the nalile of the decedent and two other persons.
1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) - .167 X 100
16.7X (TAXABLE FOR EACH SURVIVOR)
B. The percent taxable for assets created within one year of the decedent's death or accounts owned by the decedent but held
in trust for another indlvldual(s) (trust beneficiaries):
1 DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT
OWNERS DR TRUST BENEFICIARIES
X 100
PERCENT TAXABLE
Example: Joint account registered
the decedent.
1 DIVIDED BY 2 (SURVIVORS) - .50
in the naae of the decedent and two other persons and established within one year of death by
X 100
sox (TAXABLE FOR EACH SURVIVOR)
4. The aaaunt subject to tax (line 4) is deter.ined by aultiplylng the account balance (line 2) by the percent taxable (line 3).
5. Enter the total of the debts and deductions listed in Part 3.
6. The a.ount taxable (line 6) is deter.ined by subtracting the debts and deductions (line 5) from the Haunt subjlilct to tax (lina 4).
7. Enter the appropriate tax rate (line 7) as deter.ined below.
death to or for the use of a natural parent" an adoptive parent" or a stepparent of the child is OX.
The lineal class of heirs includes grandparents" parents" childrliln" and lineal descendents. "Children" includes natural children
wh.ther or not they have been adopted by othsrs" adopted children and step children. "Lineal dsscendsnts" includes all children of the
natural parents and their descendents" whether or not they have been adopted by others" adopted descendents and their descendants
and step-descendants. "Siblings" are defined as individuals who have at least one parent in co_..on with the decedent" whether by blood
or adoption. The "Collateral" class of heirs includes all other beneficiaries.
Dat. of Death Spouse Lineal Sibling Collat.ral
07101/94 to 12/31/94 3X 6X 15X 15X
01101195 to 06/30/00 OX 6X 15X 15X
07101/00 to pr.sent OX 4.57.- 12X 15X
"The tax rate illposed on the not va us of transfers frail a deceased child twenty-one years of age or Y
ounger at
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allowable debts and deductions are deterllined as follows:
A. You legally are responsible for pay_ent" or the estate subject to ad_inistration by a personal representative is insufficient
to pay the deductible ite_s.
B. You actually paid the debts after death of the decedent and can furnish proof of payment.
C. Debts being claiMed .ust be it..ized fully in Part 3. If additional space is needed" use plain paper 8 1/2" x II". Proof of
payment lIay be r.quested by the PA Departlilent of Revenue.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21 04 802,
ACN 04134883
DATE 09-17-2004
IH-154SEX AFP CO'-DDl
'.-
:.c
EST. OF ANGELA PASKEY
S.S. NO. 181-03-1658
D 3 .~TE OF DEATH 06-19-2004
OC1 13 I '{:'OUNTY CUMBERLAND
TYPE OF ACCOUNT
D SAVINGS
D CHECKING
D TRUST
IX] CERTIF.
'04
ST
SPGS
t.,,~"_: i
PA 17007GUIY1(;''''''
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUM8ERLAND CO COURT HOUSE
CARLISLE, PA 17013
WALTER
112 4TH
BOIL ING
PASKEY
FIRST FEDERAL BANK has provided the Department with the inforllation listed below which has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent, YOU were a joint owner/beneficiary of
this account. If yOU feel this inforllation is incorrect, please obtain written correction froll the financial institution, attach a copy
to this for. and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth
of Pennsylvania. Questions may be answered by calling (717) 787-83Z7.
COMPLETE PART 1 BELOW
Account No. 332011568
.. .. .. SEE
Date
Established
REVERSE SIDE FOR
09-30-1985
FILING AND PAYMENT INSTRUCTIONS
Account Balance
Percent Taxable
A.ount Subject to Tax
Tax Rate
Potential Tax Due
x
2,651. 70
50.000
1,325.85
.045
59.66
To insure proper credit to your account, two
(Z> copies of this notice IIUst accompany your
payment to the RegIster of Wills. Maka chack
payable to: "Register of Wills, Agent...
x
NOTE: If tax payments are made within three
(3) months of the decedent.s date of death,
you may deduct a 5X discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) 1I0nths after the date of death.
PART TAXPAYER RESPONSE
[!]llil!~~t~~.~!!.~i"l~il~~llili_~I~il~II!I!.!i!I.~!l1~g!1111~.ill!_.~I!I.".II!!.III!Ii~I!~I.~.I~111
A. D The above information and tax due is correct.
1. You may choose to rellit paYllent to tha Register of Wills with two copies of this notica to obtain
a discount or evoid interest, or you may check box "A" and raturn this notice to the Register of
Wills and an official assessment will be issued by the PA Department of Revenue.
[CHECK ]
ONE
BLOCK
ONLY
B. IJ'The above asset has bean or will be reported and tax paid with the Pannsylvania Inheritance Tax return
to be filed by the decedent"s representative.
C. D The above inforllaUon is incorrect and/or debts and deductions were paid by you.
You .ust cOllplete PART 0 and/or PART @] below.
PART
~
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
If you indicate a different tax rate, please state your
relationship to decedent:
PART
@]
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Date Established I
2. Account Balance 2
3. Percent Taxable 3 x
4. A.ount Subject to Tax 4
5. Debts and Deductions 5
6. Allount Taxable 6
7. Tax Rate 7 x
8. Tax Due 8
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Line 5 of Tax COllputation)
I
$
Under penalties of perjury, I declare that the facts I
cOllplete to the best of IIY knowledge and belief.
"-J ~ G>~
TAXPAYER SIGNATURE
have reported above are tru., correct and
HOME (71') )p-~~ -\ti)V:>
WORK (7' ') ) c;, '" :> b ;1.. r I
TELEPHONE NUMBER DATE
'^
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based on inforllation
sub.lttad by the financial institution.
Z. Inharitance tax becomes delinquent nine .onths after the decedent"s date of death.
3. A joint account is taxable even though the decedent"s name was added 8S a .atter of conveniancB.
4. Accounts (including those held between husband and wife) which the decadent put in joint nBlles within one year prior to
death ara fully taxable as transfers.
5. Accounts Bstablishad jointly between husband and wIfa .are than one year prior to death are not taxabls.
6. Accounts held by a decedent "in trust for" another or others are taxable fully.
REPORTING INSTRUCTIONS
PART
1
TAXPAYER RESPONSE
1. BLOCK A - If the infor~tion and computation in the notice are correct and deductions are not being claimed, place an "X"
in block dA" of Part 1 of the "Taxpayer Response" section. Sign two copies and sub.it the. with your check for the ..aunt of
tax to the Register of Wills of the county indicated. The PA Department of Revenue will issue an official assess.ent
(Form REV-1548 EX) upon raceipt of the return from the Register of Wills.
2. BLOCK B - If the asset specified on this notice has been or will be reported and tax paid with the Pennsylvania Inheritance
Tax Return filed by the decedent's representative, place an "X" in block nBn of Part 1 of the nTaxpayer Responsen section. Sign one
copy and return to the PA Departeent of Revenue, Bureau of Individual Taxes, Dept 280601, HarriSburg, PA 17128-0601 in the
envelope provided.
3. BLOCK C _ If the notice infor.ation is incorrect andlor deductions are being clai.ed, check block "C" and complete Parts 2 and 3
according to the instructions below. Sign two copies and sub. it the. with your check for the allount of tax payable to the Register
of Wills of the county indicated. The PA Depart.ent of Revenue will issue an official assess.ent (For. REV-1548 EX) upon receipt
of the return frail the Register of Wills.
TAX RETURN - PART
2
- TAX COMPUTATION
LINE
1. Enter
NOTE:
the data the account originally was astablished or titled in the .anner existing at data of death.
For a decedent dying after 12/12/82: Accounts which tha decedent put in joint nalles within one (1) year of death are
taxable fully as transfars. However, there is an exclusion not to exceed $3,000 per transferea regardless of the value of
the account or the number of accounts held.
If a double asterisk (..) appears before your first na.e in the address portion of this notice, the $3,000 BXclusion
already has been deducted fro. the account balance as reported by the financial institution.
2. Enter the total balance of the account inclUding interest accrued to the date of death.
3. The percant of the account that is taxable for each survivor is detereined as follows:
A. The percent taxable for joint assets established .ore than one year prior to the decedent.s daath:
I DIVIDED BY TOTAL NUMBER OF
JOINT OWNERS
Exa.ple: A joint assat registered
DIVIDED BY TOTAL NUMBER OF X 100 PERCENT TAXABLE
SURVIVING JOINT OWNERS
in the na.e of the decedent and two other persons.
1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) - .167 X 100
16.7% (TAXABLE FOR EACH SURVIVOR)
B. The percent taxeble for assets created within Dna year of the decedent's death or accounts owned by the decedent but held
in trust for another individual(s) (trust beneficiaries):
I DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT
OWNERS OR TRUST BENEFICIARIES
X 100
PERCENT TAXABLE
Example: Joint account registered
the decedent.
1 DIVIDED BY 2 (SURVIVORS) = .50
in the naBe of the decedent and two other persons and established within one yeer of death by
X 100
50% (TAXABLE FOR EACH SURVIVOR)
4. The a.ount subject to tax (line 4) is deterllinad by multiplying the account balElnce Uine 2) by the percent taxable (line 3).
5. Enter the total of the debts end deductions listed in Part 3.
6. The allount taxable (line 6) is deter.ined by sUbtracting the debts and daductions (line 5) fro. the ellount SUbject to tax (line 4).
7. Enter the appropriate tax rate (line 7) as deter.ined below.
death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0%.
The lineal class of heirs includes grandparents, parents, children, and lineal dBsc.ndents. nChlldr.n" includes natural children
whether or not th.y have b.en adopted by others, adopted childran and step children. "Lineal d.scandentsn includBs all children of the
natural parents and their descendents, whether or not they have been adopted by others, adopted descendents and their descendants
and st.p-descendants. "Siblings" are defined as individuals who have at least one par.nt in co.eon with the decedent, whether by blood
or adoption. The nCollateral" class of heirs includes all other beneficiaries.
D.te of Death Spouse Lineal Sibling Collateral
07/01/94 to 12131/94 3Y. 6Y. lSY. lSY.
01/01/9S to 06130/00 OY. 6Y. lSY. lSY.
07/01100 to present OY. 4.5X- 12Y. lSY.
_The tax rate l.posed on the not value of transfers frOB a deceased chIld twenty-one years of age or .
ounger at
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allowable debts and daductions are deter.ined as follows:
A. You legally are responsible for pay.ent, or tha estate subject to ad.inistration by a personal representative is insufficiBnt
to pay the deductible ite.s.
B. You actually paid the debts after death of the decedent and can furnish proof of paYBent.
C. Debts being claimed .ust be ite.ized fully in Part 3. If additional space is needed, use plain paper 8 1/2n x 11n. Proof of
paYBent Bay be requested by the PA Departllent of R.venue.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG~ PA 17128-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21 Of %03
ACN 04134884
DATE 09-17-2004
REV.154S UAFP en-DOl
TYPE OF
ACCOUNT
D SAVINGS
D CHECKIHG
D TRUST
[Xl CERTIF.
'04
EST. OF ANGELA PASKEY
S.S. NO. 181-03-1658
DATE OF DEATH 06-19-2004
COUNTY CUMBERLAND
P3 :59
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
OCT 13
WALTER
112 4TH
BOILING
PASKEY
ST
SPGS PA
170&~" b,
\'IYli-
.1. "J"
FIRST FEDERAL BANK has provided the DepBrt.Bnt with the infor_ation listed below which has been used in
calculating the potential tax due. Their records indicetB thet at the death of the above decedent, you werB a joint ownBr/beneficiary of
this account. If you feel this infor_ation is incorrect, please obtain writtBn correction fro_ the financial institution, attach a copy
to this far. and return it to the above address. This account is taxable in accordancB with the Inheritance Tax Laws of the Co..onweslth
of Pennsylvania. Questions _ay be answered by calling (717) 787-8327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 331012632 Data 06-27-1986
Established
Account Balance
Percent Taxable
Amount Subiect to
Tax Rate
Potential Tax Due
x
669.96
50.000
334.98
.045
15.07
To insure proper credit to your account~ two
(2) copies of this notice must accompany your
pay.ant to the Register of Wills. Make check
payable to: "Register of Wills~ Agent".
x
NOTE: If tBx paYIlBnts arB .ads within three
(3) _onths of the decedent"s date of death~
you _ay deduct e 5% discount of the tax due.
Any inheritance tax due will beco_e delinquent
nIne (9) _onths after the date of death.
Tax
PART TAXPAYER RESPONSE
[!]lm~ili~~.!i!I.!i!_.i!!!~~~~!~!~.~I!III~1111l.illl.~ll~~~m~.!~!~_IIII_I!I.lill.~~!lil~~~~!!I!!I
,.,.,.,.,.,.,...,.,...,.,.,.,.,.,.....,....".,',....."~.',.",','.'.'.',,~.'.',,,'.'~.'.'.'.','.'.'.'.'.'.,.,.,.,.,...,.,.,.,.,.,.-.,.,.,.,...,.-.,...............................................................,.,.,.,.,'..,.,.,..,.",',.,.,'.",,'.'.'.'.'!'.'.'...'.....'.'.'.'.'.-.-.-.'.'.-...'............................................,.,.,.,.,...,.,.,.,.,.,.,.,.,.,.,.,.,...,.,...,.",'....,..'.'...'.'...'
[CHECK ]
ONE
BLOCK
ONLY
A. D The above infor_etion and tax dUB is correct.
I. You .ay choose to re.it pay_ent to the Register of Wills with two copies of this notice to obtain
8 discount or avoid interest, or you .ay chBck box "An and return this notice to thB Register of
Wills and an offIcial assessment will be issued by thB PA Department of Revenue.
B. 51 ThB above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax rBturn
to be filed by the decedent"s representative.
c. D The above infor.ation is incorrect and/or debts and deductions were paid by you.
You must complete PART 0 and/or PART @] below.
PART
~
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
If you indicate a different tax rate, please state your
relationship to decedent:
PART
~
TAX RETURN - COMPUTATION
LINE 1. Dete Established
2. Account Balance
3. Percent Tax.ble
4. A~unt Subiect to Tex
S. Debts end Deductions
6. A.ount Taxable
7. T.x R.te
8. T.x Due
OF
1
2
3
4
S
6
7
8
x
TAX ON JOINT/TRUST ACCOUNTS
x
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Line 5 of Tex Computation)
I
$
Under penalties of periury, I declare th.t the facts I have reported above are true, correct and
CDllPlata~ha ~:,t ~ _kn;Wl/"a and baliaf. HOME ( )
c.-><...JL>- "-C~ WORK ( )
TAXPAYER SIGNATURE TELEPHONE NUMBER DATE
\}-
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicablB intef"nt based an inforlllation
sub.ltted by the financial institution.
Z. Inheritance tax becomes delinquent nine months after the decedent's date of death.
3. A joint account is taxable eVBn though the decedent's na.e was added as a matter of convenience.
4. Accounts (including those held between husband and wife) which the dBCBdBnt put in joint nSBes within one yaBr prior to
dlilsth ara fully taxable as transfers.
5. Accounts establishsd jointly between husband and wife .ore than one YBsr prior to death are not taxable.
6. Accounts held by a decedent "in trust forn another or others are taxable fully,
REPORTING INSTRUCTIONS - PART
1
TAXPAVER RESPONSE
1. BLOCK A - If tha infor.ation and cDIIPutatlon in the notice are correct and deductions are not being clabed~ place an "X"
in block "A" of Part 1 of the "Taxpayer Response" section. Sign two copies and su~it the. with your check for the a.ount of
tax to the Register of Wills of the county indicated. The PA Depart.ent of Revenue will issue an official assess.ent
(For. REV-1548 EX) upon receipt of the return fro. the Register of Wills.
Z. BLOCK B - If the asset specified on this notice has been or will ba raported and tax paid with the Pennsylvania Inharitanca
Tax Return filed by the decedent's representativB~ place an "X" in block "Bn of Part 1 of the "Taxpayer Responsa" section. Sign ona
copy and raturn to the PA Department of Revenue~ Bureau of Individual Taxes~ Dept Z80601~ Harrisburg~ PA 171Z8-0601 in the
envelope provided.
3. BLOCK C _ If the notice information is incorract andlor deductions are being clai.ed~ check block "C" and co~lete Parts Z and 3
according to the instructions below. Sign two copies and sub.it the. with your check for the a.ount of tax payable to the Register
of Wills of the county indicated. The PA Depart.ent of Revenue will issue an official assess.ent (Form REY-1548 EX) upon receipt
of tha return frog the Register of Wills.
TAX RETURN - PART
z
- TAX COMPUTATION
LINE
1. Enter
NOTE:
the date the account originallY was established or titled in the .anner existing at date of death.
For a decedent dying after lZ/IZ/8Z: Accounts which the decedent put in joint na.es within one (1) year of death are
taxable fully as transfers. However~ there is an exclusion not to axceed $3~OOO per transferee regardless of the value of
the account or the nu.ber of accounts held.
If a double asterisk (MM) appears before your first n~a in the addrass portion of this notice~ the $3~OOO sxclusion
already has been daducted frOB the account balance as raported by the financial institution.
Z. Enter the total balanca of the account including interest accrued to the date of death.
3. The percent of the account that is taxable for each survivor is detanBined as fallows:
A. The percent taxable for joint assets established gora ":han ona year prior to the decedent.s death:
1 DIVIDED BY TOTAL NUMBER OF
JOINT OWNERS
EXBBple: A joint asset registared
DIYIDED BY TOTAL NUMBER OF X 100 PERCENT TAXABLE
SURVIVING JOINT OWNERS
in the nage of the decedent and two other persons.
1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY Z (SURVIVORS) = .167 X 100
16.7% (TAXABLE FOR EACH SURVIVOR)
B. The percent taxable for assets created within one year of the decedent.s daath or accounts owned by the decedent but held
in trust for another individual(s} (trust beneficiaries):
1 DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT
OWNERS DR TRUST BENEFICIARIES
X 100
PERCENT TAXABLE
Exa.pls: Joint account registered
the decadent.
1 DIVIDED BY Z (SURVIVORS) = .50
in the nalle of the decedant and two other persons and established within one yaar of death by
X 100
50% (TAXABLE FOR EACH SURVIVOR)
4. The amount subject to tax (line 4) 15 deter.ined by .ultiplying the account balance (lins Z) by the percent taxable (line 3).
5. Enter the totel of the debts and deductions listed in Pert 3.
6. Tha a.ount taxable (line 6) is deterllined by Subtracting the debts and deductions (line 5) frOB the a.ount subject to tax (line 4).
7. Enter tha appropriate tax rete (line 7) as deter.ined below.
death to or for the use of a natural parent~ an adoptive parent~ or II stepparent of ths child is 0%.
The lineal class of heirs includas grandparents~ parents~ childrsn~ and lineal descendents. "Childrsn" includes natural children
whather or not they have bean edopted by others~ adoptad childran and stsp children. "Linsal descendents" includBs all children of the
natural parents end their descendents~ whether or not thay have been adoptad by others~ adopted dascendents and their descsndants
and step-descendants. "Siblings" are dafined as individuals who have at least one parent in COBRon with the decadent~ whether by blood
or adoption. Tha "Collateral" class of heirs includes all other beneficiaries.
Dat. of De.th Spouse Lineal Sibling Collate,..l
07/01/94 to 12/31/94 3r. 6r. 15r. 15r.
01/01/95 to 06/30/00 Or. 6r. 15r. 15r.
07/01/00 to p,.esent Or. 4.5X- 12r. 15r.
MThe tax rate l.posad on the n.' valua of transfers fro. a deceased child tWBf1ty-one years of age or y
ounger at
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allowabls debts and deductions are deter.inad as follows:
A. You legally ara responsible for pay.ent~ or the estate subject to administration by a pBrsonal representative is insufficient
to pay the deductible ite.s.
B. You actually paid the dabts after daath of the decadent and can furnish proof of paymant.
C. Debts being clailled .ust be iteeized fully in Part 3. If additional space is n8eded~ use plain paper 8 lIZn x 11". Proof of
pay.ant .ay be requested by the PA Deperbent of Revenue.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG~ PA 17128-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21 04 'tS"C'3
ACN 04134885
DATE 09-17-2004
REV-1545EX'fPU9-QO)
TYPE OF
ACCOUNT
o SAVINGS
o CHECKING
o TRUST
IX] CERTIF .
TO:
rk;~
'04
. . .,1
EST. OF ANGELA PASKEY
S.S. NO.' 181-03-1658
DATE OF DEATH 06-19-2004
ocfOf~T7 3 :59 CUMBERLAND
REHIT PAYHENT ANO FORHS
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
WALTER
112 4TH
BOILING
PASKEY
ST
SPGS PA 17007
Cc.f;
(~HmLic
.I.i.,
" ;,'
FIRST FEDERAL BANK has provided the Departllent with the infoMlation listed below which has been used in
calculating the potential tax due. Their records indicate that at the death of tha above decedent~ YOU were a joint owner/beneficiary of
this account. If you feel this inforllation is Incorrect~ please obtain written correction from the financial institution~ attach a COpy
to this for. and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the CO.llonwealth
of Pennsylvania. Questions .ay be answersd by calling (717) 787-8327.
COMPLETE PART 1 BELOW
Account No. 0327017903
Il Il Il SEE
Date
Established
REVERSE SIDE FOR
10-02-1990
FILING AND PAYMENT INSTRUCTIONS
Account Balance
Percent Taxable
Amount Subject to Tax
Tax Rate
Potential Tax Due
x
667.60
50.000
333.80
.045
15.02
To insure proper credit to your account~ two
(2) copies of this notice .ust acco.pany your
pay.ent to the Register of Wills. Make check
payable to: "Register of Wills~ Agent".
x
NOTE: If tax pay.ents are .ade within three
(3) months of the decedent's date of death~
YOU may deduct a 5% discount of the tax due.
Any inheritance tax due will become delinquent
nine (9) .onths after the date of death.
PART TAXPAYER RESPONSE
[!]1!~ilgl~.I!~_i!'!._i!i!I~~~!I!!.~!!!!!~11!1!~I!!!l.*!~g!!I!~~~~J!Jj.._!I~_!iJ.111!.~!i!IJ.~~!i
.'.'~.'.'.'.. -.-...............,.,. .,.,. ,~.'.'.'.'.'.'.-... ............,.,.,.,.,. ,~,~'.'.~'.'.'.'.'._.. ....-........,.,.,. '," ..'.'.'.'.'.'.'.'.,................,.,.,..." .",'.'.'.'.'.'.'.,................. .,. ."ll;:"""'''''.-.'.''' .....,.,.,.,.,.,..',..'.'.'.'.'................,.. .,..'.~'.'.'.'.-...'..........,.,.,.,.,.,..'...'.'.'.'.'.'.-.-..............,.,.. ...,'.'.'.'.'.'.-.-
A. c=J The above infor.ation and tax due is correct.
1. You .ay choose to remit pay.ent to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest~ or yoU .ay check box "A" and return this notice to the Register of
Wills and an official asses~ent will be issued by the PA Department of Revenue.
B. IKI The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return
to be filed by the decedant's representative.
[CHECK ]
ONE
BLOCK
ONLY
c. c=J The above information is incorrect and/or debts and deductions were paid by you.
You .ust co.plete PART 0 and/or PART @J below.
If you indicate iii different tax rate I please state your
relationship to decedent:
PART
[!]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PART
~
TAX RETURN - COMPUTATION
LINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. A.ount Taxable
7. Tax Rate
8. Tax Due
OF
1
2
3
4
5
6
7
8
x
TAX ON JOINT/TRUST ACCOUNTS
x
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Line 5 of Tax Computation)
I
$
Under penalties of perjury I I declare that the facts I
complete to the best of my knowledge and belief.
TAXPAYER~A~ 9 ~
have reported above are truel correct
HOME ( ') n ) )... {" r - I{ J 't ?
WORK ('1n ) c:. <:> )- - G").. f" (
TELEPHONE NUMBER
and
v-
DATE
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with appl1cabla intarest basad on inforllation
sub..! ttBd by the financial Institution.
2. Inheritance taK becoIIBs delinquent nIne ..onths after the d8csdent's data of death.
3. A joint account is taxable Bven though the dacedent.s nBlIe was added as a .atter of convenlancB.
4. Accounts (Including those held betweBn husband Bnd wife) which thB decedent put in joint names within one year prior to
death arB fully taxable as transfers.
5. Accounts established jointlY between husband and wife .ore than one yaar prior to death are not taKable.
6. Accounts held by a decedent "in trust for" another Dr others are taxable fully.
REPORTING INSTRUCTIONS - PART
1
- TAXPAYER RESPONSE
1. BLOCK A - If the Infor.atIan and computation in the notice are correct and deductions are not being clai.ed, place an "X"
in block "Aft of Part 1 of the ftTa~payer Response" section. Sign two copies and su~it the. with your check for the a.ount of
taM to the Register of wills of the county indicated. The PA Depart.ent of Revenue will issue an official assesSllent
(For. REV-1548 EX) upon receipt of the return froe the Register of Wills.
2. BLOCK B - If the asset specified on this notice has been or will be reported and taM paid with the Pennsylvania Inheritance
TaM Return filed by the decedent's representative, place an ftX" in block "Bft of Part 1 of the "TaMpayer Response" section. Sign one
copy and return to the PA Department of Revenue, Bureau of Individual TaMes, Dept 280601, HarriSburg, PA 17128-0601 in the
envelope provided.
3. BLOCK C _ If the notice information is incorrect and/or deductions are being claimed, check block "C" and complete Parts 2 and 3
according to the instructions below. Sign two copies and sub.it the. with your check for the allount of taM payable to the Register
of Wills of the county indicated. The PA Depart.ent of Revenue will issue an official assessment (For. REV-1548 EX) upon receipt
of the return fro. the Register of Wills.
TAX RETURN - PART
2
- TAX COMPUTATION
LINE
1. Entar
NOTE:
the date the account originallY was established or titled in the IIBnner eMisting at date of death.
For a decedent dying after 12/12182: Accounts which the decedent put in joint nBlles within one (1) year of death are
taKable fully as transfers. However, there is an eMclusion not to eMceed $3,000 per transferee regardless of the value of
the account or the number of accounts held.
If a double asterisk (NN) appears before your first nBlle in the address portion of this notice, the $3,000 eKclusion
already has been deductad froll the account balance as reportad by the financial institution.
z. Enter the total balanca of the account including interest accrued to the date of death.
3. The percent of the account that is taKable for each survivor is deter.ined as follows:
A. The percent taKable for joint assets established 1I0re tha'l one year prior to the decedent's death:
1 DIVIDED BY TOTAL NUMBER OF
JOINT OWNERS
EKaeple: A joint asset registered
DIVIDED BY TOTAL NUMBER OF X 100 PERCENT TAXABLE
SURVIVING JOINT OWNERS
in the name of the decedent and two other persons.
1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY Z (SURVIVORS) - .167 X 100
16.7~ (TAXABLE FOR EACH SURVIVOR)
B. The percent taMable for assets created within one year of the decedent's death or accounts owned by the decedent but held
in trust for another individuaHs) (trust beneficiaries):
1 DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT
OWNERS OR TRUST BENEFICIARIES
X 100
PERCENT TAXABLE
Example: Joint account registered
the decedent.
1 DIVIDED BY 2 (SURVIVORS) = .50
in the nalle of the decedent and two other persons and established within one year of death by
X 100
SOZ (TAXABLE FOR EACH SURVIVOR)
4. The allount Subject to tax (line 4) Is detereined by .ultiplying the account balance (line 2) by the percent taxable (line 3).
5. Enter the total of the debts and deductions listed in Part 3.
6. The a.ount taxable (line 6) is deter.ined by subtracting the debts and deductions (line 5) fro. the a.ount Subject to tax (line ~).
7. Enter the appropriate tax rata (line 7) as detereined balow.
death to or for the use of a natural parant, an adoptiva parant, or a stepparant of the child is OZ.
The lIneal class of hairs includes grandparents, parents, children, and lineal dascendents. "Children" includes natural children
whether or not they have bean adopted by othars, adopt.d children and stap children. "Lineal descendents" includes all children of tha
natural parents and their descendents, whether or not they have been adoptad by others, adopted descendents and their descendants
and step-descendants. "Siblings" are defined as individuals who have at least one parent in co..on with the dec.dent, whethar by blood
or adoption. The "Collateral" class of hairs includes all other beneficiarias.
Oat. of Death Spouse Lineal Sibling Coll.teral
07l01/9~ to 12/31/9~ 37- 67- 157- 157-
01/01/95 to 06/30/00 07- 67- 157- 157-
07101/00 to present 07- q..SY.- 127- 157-
NThe tax rate i.posed on the not value of transfers froll a decaased cnlld twenty-ana years of age or y
ounger at
CLAIMED DEDUCTIONS
PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allowable debts and deductions are detar.ined as follows:
A. You legally are responsible for payeent, or the estate subject to administration by a parsonal rapresantative is insufficient
to pay the deductible !tails.
B. You actually paid the debts after death of the decedent and can furnish proof of pay.ent.
C. Debts being clalead lIust be itellized fully in Part 3. If additional spaca is needed, use plain papar 8 1/2" x 11ft. ProDf of
payment may be requestad by the PA Department of Revenue.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. Z8D6DI
HARRISBURG~ PA 171Z8-D6DI
*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
NO.21 oLl. 8-03
04134886
09-17-2004
IEW-1S43 EX AFI' [D9-DDl
J
EST. OF ANGELA PASKEY
S.S. NO. 181-03-1658
DATE OF DEATH 06-19-2004
COUNTY CUMBERLAND
TYPE OF ACCOUNT
D SAVINGS
D CHECKING
D TRUST
IX] CERTIF.
'04 OCT 13
P 3 :59
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
WALTER
112 4TH
BOILING
PASKEY
ST
SPGS PA
~~"~l;,
"""
FIRST FEDERAL BANK has provided the Departllent with the infor.atien listed below which has been used in
calculating the potential tax due. Their records indicate that at the death of the above decedent~ you we~e a joint owne~/beneficiary of
this account. If you feel this infor.ation is ince~rect~ please obtain written cerrection frail the financial institution~ attach a copy
to this fOr. and return it to the above address. This account is taxable in accerdance with the Inheritance Tax Laws of the Ce..onwealth
of Pennsylvania. Quast ions IIBY be answered by calling (717) 787-83Z7.
COMPLETE PART 1 BELOW
Account No. 327016263
.. .. .. SEE
Dat.
Established
REVERSE SIDE FOR
07-05-1989
FILING AND PAYMENT INSTRUCTIONS
Account Balance
P....c.nt Taxable
AMount Subject to Tax
Tax Rate
Potential Tax Due
x
3,073.67
50.000
1,536.84
.045
69.16
To insure proper credit to your acceunt~ two
CZl copies of this notice .ust acco.pany your
payment to the Register of Wills. Mak. check
payable to: "Register of Wills~ Agent".
x
NOTE: If tax paYllents are mada within three
(3) .onths of the dacadent's date of death~
you .ay deduct a 5% discount of the tax due.
Any inharitance tax due will beco.e delinquant
nine (9l 1I0nths after the data of death.
PART TAXPAYER RESPONSE
[!]lil!l.~.!I!!.!i!i"'ill~~i:!iiil.~!i!i!~lll.li!.~;~.!i111~gii!I__I!l.~!i~'IIII.~llil.I}.
A. c=J The above infor.atien and tax due is corract.
I. You .ay choose to re.it pay.ent to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest~ er YOU .ay check box "A" and return this notice to the Register of
Wills and an official assessment will be issued by the PA Department of Revenue.
B. IXI The above asset has been or will be reported and tax paid with the Pennsylvania Inh.ri tance Tax raturn
to be filed by the decedent's representative.
C. c=J The above information is incorrect and/or debts and deductions wer8 paid by you.
You .ust co.plete PART 0 and/or PART @J below.
[CHECK ]
ONE
BLOCK
ONLY
PART
@]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
If you indicate a diff.....nt tax rat., please state you...
relationship to decedent:
PART
~
TAX RETURN - COMPUTATION
lINE 1. Date Established
2. Account Balance
3. Percent Taxable
4. A.ount Subject to Tax
S. Debts and Deductions
6. Amount Taxabl.
7. Tax Rat.
8. Tax Due
OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3
4
5
6
7
8
x
x
PAYEE
DESCR I PH ON
AMOUNT PAID
I
TOTAL lEnt.r on line S of Tax COMPutation)
I
$
Und.... penalties of pe...ju...y, I d.ela...e that the
cOMpl.t. to the b.st of BY ~~ef.
TAXPAYE~AT~ Q;:.... ....:......e-
facts I have report.d above are tru.~ corr.ct and
v"
HOME (
WORK (
TELEPHONE
)
)
NUMBER
DATE
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based on infor.ation
subgItted by the financial institution.
Z. InharitancB tax becomes delinquent nlna months aftar the decedent's date af death.
3. A joint account Is taxable even though the decedent.s name was added as a Batter of convenience.
4. Accounts (includIng those held betWBen husband Bnd wife) which the decedent put in joint nsaas within one year prior to
death are fully taxable 8S transfers.
5. Accounts established jointlY between husband and wIfe Bore than one year prior to death are not taxable.
6. Accounts held by a decedant "in trust for" another or others are taxable fully.
REPORTING INSTRUCTIONS
PART
1
- TAXPAYER RESPONSE
1. BLOCK A _ If the infor.ation and co.putation in the notice are correct and deductions are not being claimed, place an "X"
in block "A" of Part 1 of the "Taxpayer Response" section. Sign two copies and subtlit them with your chack for tha Mount of
tax to the Register of wills of the county indicated. The PA Depart.ant of Revenue will issue an official assas$lent
(For. REV-1548 EX) upon receipt of tha return fro. tha Registar of wills.
2. BLOCK B _ If the asset spacified on this notice has been or will be reportad and tax paid with the Pennsylvania Inheritance
Tax Return filad by the decedent's representat1vB, place an "X" in block "B" of Part 1 of the "Taxpayer Response" section. Sign one
copy and return to the PA Department of Revenue, Bureau of Individual Taxss, Dept 280601, Harrisburg, PA 17128-0601 in the
envelope provided.
3. BLOCK C _ If the notice information is incorrsct and/or deductions are being clai.ed, chsck block "C" and co.plets Parts 2 and 3
Bccording to the instructions below. Sign two copies and subait the. with your check for the a.aunt of tax payable to the RegIstar
of Wills of the county indicated. The PA Depart.ent of Revenue will issue an official assessment (Form REV-1548 EX) upon receipt
of ths return from the Register of Wills.
TAX RETURN - PART
2
- TAX COMPUTATION
LINE
1. Enter
NOTE:
ths date the account originallY was established or titled in the Banner existing at date of death.
For a decedent dying after 12/12/82: Accounts which ths decedent put in joint na.es within one (1) year of deBth are
taxable fully as transfers. However, there is an exclusion not to excssd $3,000 per transferee regardless of the value of
the account or the nu.ber of accounts held.
If a doubls asterisk (MM) appears before your first n~e in the address portion of this notice, the $3,000 exclusion
alraady has been daducted fro. the acCOlmt balance as reportsd by the financial institution.
2. Enter tha total balance of the account including interest accrued to tha date of death.
3. The percent of the account that is taxable for each survivor is deter.inad as follows:
A. The percent taxable for joint assets established more than one year prior to the decadent's death:
1 DIVIDED BY TOTAL NUMBER OF
JOINT OWNERS
Example: A joint asset registered
DIVIDED BY TOTAL NUMBER OF X 100 PERCENT TAXABLE
SURVIVING JOINT OWNERS
in the name of the decedant and two other persons.
1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) s .167 X 100
16.7X (TAXABLE FOR EACH SURVIVOR)
B. The percent taxable for assets created within ona year of the decedent's death or accounts owned by the decedent but held
in trust for another individUBl(s) (trust beneficiBries):
1 DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT
OWNERS OR TRUST BENEFICIARIES
X 100
PERCENT TAXABLE
Example: Joint account registered
the decedent.
1 DIVIDED BY 2 (SURVIVORS) = .50
in the na.e of the dacedant and two other psrsons and established within one year of death by
X 100
soX (TAXABLE FOR EACH SURVIVOR)
4. The a.ount subject to tax (line 4) is detsr.ined by IIUIt1plying the account balance (lina 2) by the parcent taxable (line 3l.
5. Enter the total of the debts and deductions listed in Part 3.
6. The amount taxable (line 6) is deter.ined by subtracting the debts and deductions (line 5) fro. the a.aunt subject to tax (line 4).
1. Enter the appropriate tax rate (Une 7l as deter.ined balow.
death to or for the usa of a natural parent, an adoptive parent, or a stBpparent of the child is OX.
The lineal class of heirs includes grandparents, parents, children, and lineal descendents. "Children" includes natural children
whether or not they have baen adopted by others, adopted children and step children. "Lineal descandents" includes all children of the
natural parents and their descendents, whether or not they have been adopted by others, adopted descendents and their dascendants
and step-descendants. "Siblings" are defined as individuals who hava at least one parent in co~.on with the decedent, whether by blood
or adoption. The "Collateral" class of heirs includes all other beneficiaries.
Date of Death Spouse Lineal Sibling Collateral
07/01/94 to 12/31/94 37. 67. 157. 157.
01/01/95 to 06/30/00 07. 67. 157. 157.
07/01/00 to present 07. IIt.5r.- 127. 157.
MThe 'tax rate l.posea on the not value of 'transfers from a deceased chlld twenty-one yaars of age Dr y
ounger at
CLAIMED DEDUCTIONS
PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allowable debts and daductlons are determinad as follows:
A. You legallY ere rBsponslble for pay.ent, or the astate subject to ad.inistration by a personal represBntativa is insufficient
to pay the deductible items.
B. You actually paid the debts after daath of the dBcedent and can furnish proof of pay.ent.
C. Debts being claiBed !lust be itemized fullY in Part 3. If additional space is needed, usa plain paper 8 112" x 11". Proof of
payment may be requested by the PA DepartBent of Revenue.
COMMONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21 CI+ 'g()3,
ACN 04134293
DATE 09-17-2004
REV-15UEXAFP <09-001
TYPE OF
ACCOUNT
o SAVINGS
lXJ CHECKING
o TRUST
o CERTIF.
FORMS TO:
'04 OCT 13
eST. OF ANGELA PASKEY
~.S. NO. 181-03-1658
DATE OF DEATH 06-19-2004
CO>>NTY CUMBERLAND
P3 :');1
REMIT PAYMENT AND
REGISTER OF WILLS
CUMBERLAND CO COURT
CARLISLE, PA 17013
HOUSE
WALTER
112 4TH
BOILING
J PASKEY JR
ST
SPRING PA 17007
I ',~ "
V.:;'ll
CUlnbc.
i.
THE LEGACY BANK has providad the Departllent with the infor.ation listed below which has bean used in
calculating the potential tax due. Thair records indicate that at the death of the above decedent, YOU were a joint owner/beneficiary of
this account. If you feel this infor.ation is incorrect, please obtain written correction fro. the financial institution, attach a copy
to this for. and return it to the above address. This account is taxabla in accordance with tha Inheritance Tax laws of the COIIMonwealth
of Pennsylvania. Questions ~ay ba answerad by callJng (717) 787-8327.
COMPLETE PART 1 BELOW
Account No. 541012269
II II II SEE
Date
Established
REVERSE SIDE FOR
04-20-2001
FILING AND PAYMENT INSTRUCTIONS
Account Balance 6 , 07 0 , 73
Percent Taxable X 50.000
AIIount Subject to Tax 3,035.37
Tex Rete X .045
Potential Tax Due 136.59
PART TAXPAYER RESPONSE
[!]filJiS~~.I:!~.,:,!;:,:::I!~I.fti!I!I~~,~~!!:_I:I:I:.~1!1!1~!!I!i.!!!!.~~!:;:,!~.!I!I!!I~I~!.I:i:'!::,;I!!!~.I:,;,;'!!I!~i,';:;':;:::;:,,;,,:;;!!!.I::!I!I!.~~!I!I!.~.I:I:'!!m!1
=....~..~. .~ ~.~.....- ............";'...'.'.'.'.'..... ,.,.......... ... ..........';.;..'.'...'.'...'.' 1"'.... .... .-.. ..............,...,.,., '...r!.... ... ...;!-:.;~),.,.,., '.'.'.1'......... .-...;.;.;.;.;..,.,.,.,.,.,.....L.. ...... ..............,.,.,.,.,.... ....,....... .-.. .-. -..........-;-.'.'.'.'.
To insure propsr credit to your account, two
(2) copIss of this notics must acco.pany your
payment to ths Register of Wills. Make check
payable to: "Register of Wills, Agent".
NOTE: If tax payments ars lIade within three
(3) months of the decedent"s date of death,
you aay dsduct a 5% discount of the tax due.
Any inheritBncs tax due will beco.e dalinquent
nine (9) .onths after ths date of death.
[CHECK ]
ONE
BLOCK
ONLY
A. W lhe above information and tax due is correct.
1. You may choose to re.it pay.ent to the Register of Wills with two copies of this notice to obtain
a discount or avoid interest, or you may chsck box "A" and rsturn this notica to the Register of
WIlls and an official assessment will be issued by the PA Departmsnt of Revenue.
B. ~ The above asset has been or will be reported and tax paid with the Pennsylvania Inheritancs Tax return
to be filed by the dscedent's representative.
C. D The above infor.ation is incorrect and/or debts and deductions wera paId by you.
You must complete PART ~ and/or PART ~ beloN.
PART
[!]
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
If you indicate a different tax rate, please state your
relationship to decedent:
PART
~
TAX RETURN - COMPUTATION
LINE 1. Date Established
2, Account B.lance
3. Percent Taxable
4. Amount Subject to Tax
5. Debts and Deductions
6. Amount Taxable
7. Tax Rate
8. Tax Due
OF
1
2
3
4
5
6
7
8
x
TAX ON JOINT/TRUST ACCOUNTS
x
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Enter on Line 5 of Tax Co~ut.tion)
I
$
Under penalties of perjury, I declare that tha facts I have reported above ..e true, correct and
cOlIIPlete to the best of my knowledge and belief. HOME ("/V)) 'l..:r?-jt:J 't'")
0 '""-l ~ }9~ 1"-. WORK ( IV) ) (" "oS -- Co :>- ~t'
TAXPAYER SIGNATURE TELEPHONE NUMBER DATE
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable internt bassd en inforllatian
sub.ittBd by the financial institution.
Z. Inharltance tax becolles delinquent nine .onths after the decadent"s data of death.
3. A joint account Is taxable even though the decedent's n~a was added 8S <II .atter of convenience.
4. Accounts (including those held between husband and wife) which the decadent put in joint nBIlSS within one year prior to
death are fully taxable 85 transfers.
5. Accounts established jointly betwBen husband and wife .ore than Dna year prior to death are not taxable.
6. Accounts held by <II decadent "in trust forn another or others ara taxable fully,
REPORTING INSTRUCTIONS - PART
1
TAXPAYER RESPONSE
1. BLOCK A - If the inforllation and cOllputation in the notice are correct and deductions are not being clai.ed, place an "X"
in block "A" of Part 1 of tha "Taxpayer Response" section. Sign two copies and sub_it the. with your check for the a.ount of
tax to tha Register of Wills of the county indicated. The PA DepartMent of Revenue will issue an official assessment
(Fo~. REV-1548 EX) upon ~ecaipt of the ~aturn f~oN the Regista~ of Wills.
Z. BLOCK B - If the asset specified on this notice has been o~ will ba ~epo~ted and tax paid with the Pennsylvania Inhe~itance
Tax Return filad by the decadent's rep~esantatlva, place an "X" in block "Bn of Part 1 of the "Taxpayar Response" section. Sign one
copy and ~etu~n to the PA Department of Revenue, Bureau of Individual Taxes, Dept 280601, HBr~isbu~g, PA 11128-0601 in the
envelope provided.
3. BLOCK C - If the notice info~ation is inco~~act and/or deductions are being claimad, check block "C" and co.plete Pa~ts 2 and 3
according to the instructions below. Sign two copies and submit the. with your check for the aMount of tax payablB to the Register
of Wills of the county Indicated. The PA Department of Revenue will issue an official asses~ant (Forll REV-1548 EX) upon receipt
of the raturn frail the Register of Wills.
TAX RETURN - PART
2
- TAX COMPUTATION
LINE
I. Enter
NOTE:
tha date the account originallY was established o~ titled in the lIannar existing at date of death.
For a decedent dying after 12/12/82: Accounts which the decadent put in joint names within one (1) year of death are
taxable fully as transfers. However, there is an axclusion not to exceed $3,000 par transferee regardless of the value of
the account or the number of accounts held.
If a double asterisk (..) appears before your first nalle in the address po~tion of this notice, the $3,000 exclusion
already has been deducted from the account balance as ~epo~ted by the financial institution.
2. Enter the total balance of the account including interest accrued to the date of death.
3. The percent of the account that Is taxable fo~ each survivor is dater.ined as follows:
A. The percent taxable for joint assets established 1I0re than one year prior to the decedent's death:
I DIVIDED BY TOTAL NUMBER OF
JOINT OWNERS
EX8llple: A joint asset registered
DIVIDED BY TOTAL NUMBER OF X litO PERCENT TAXABLE
SURVIVING JOINT OWNERS
In the nalle of the decedent and two other pe~sons.
1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) . .167 X 10D
16.1~ (TAXABLE FOR EACH SURVIVOR)
B. The percent taxable for assets created within one year of the decedent"s death or accounts owned by the decedant but held
In trust for another individual(s) (trust beneficiaries):
1 DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT
OWNERS OR TRUST BENEFICIARIES
X 10D
PERCENT TAXABLE
ExaMple: Joint account ~agistered
the decedant.
I DIVIDED BY 2 (SURVIVORS) = .50
in the nama of the dacedent and two other pe~sons and establishad wi thin ena yaar of death by
X IDD
5D~ (TAXABLE FOR EACH SURVIVOR)
4. The a.ount subject to tax (line 4) Is dete~ined by lIultiplying tha account balanca (line 2) by the percent taxable (line 3).
5. Enter the total of tha debts and deductions listed In Part 3.
6. The allount taxable (I1ne 6) is deterlllned by SUbtracting the debts and deductions Uine 5) froll the a.ount subject to tax (I1ne 4).
7. Enter the appropriate tax rate (line 7) as deterllined below.
Date of Death Spouse Lineal Sibling Coll.te,..el
07/01/94 to 12/31/94 3X 6X 15X 15X
01/01/95 to 06/30/00 OX 6X 15X 15X
07/01/00 to present OX 4.5%- 127. 15X
_The tax rate lllposed on the not value Df transfers fro. a deceased Ch11d twenty-one years of age D' Y
ounger at
death to or for the use of a netural parent, an adoptive parant~ or a stepparent of the child is O~.
The lineal class of heirs includes grandparents~ parents~ children, and lineal descendants. "Children" includes natural chlldran
Nhethe~ o~ not thlilY havs been adopted by others~ adopted children and step chi1d~Bn. "Lineal descendents" includes all children of the
natural parents and their descandents, whether or not they have been adopted by others~ adopted dascendents and their descandants
and step-descendants. "Siblings" are defined as individuals who havs at least ona parent in co..on with the decedent~ wh8the~ by blood
o~ adoption. The "Collateral" class of heirs Includes all othar beneficiaries.
CLAIMED DEDUCTIONS
PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allowable debts and deductions are deterllinad as follows:
A. You legally are responsible for payment~ or the estate subject to ad.inistration by a pe~sonal repreSBntative is insufficient
to pay the deductible itells.
B. You actually paid the debts after death of the decedent and can fu~nish proof of pay.ant.
C. Debts baing claimed Must be ite.ized fully in Part 3. If additional space is needed, use plain paper 8 1/2" x 11". Proof of
payment lIay be ~equested by the PA Department of Revenue.
COMMC",W LTH OF P:'\~SYLVANIA
DEPARHlE N OF REVE".:JE
BJ;:EAlj OF I DI'v'IDL.;AL TAXES
=l':D~ 2806
i-IA_"RISBI~R PA . 7118-0601
PENNSYLVANI
ECEIVED FF OM: INHERITANCE AND EST
OFFICIAL RECEIP
MATE :- MARK A
PO BO 127
BOlLIN G SPRINGS, PA 17007
to""
ESTATE I~ FORMATION: SSN: 181-03-1658
FILE NUM ER: 2104-0803
DECEDEN, NAME: PASKEY ANGELA
DATE OF AYMENT: 11/23/2004
POSTMAR K DATE: 11/23/2004
COUNTY: CUMBERLAND
DATE OF EATH: 06/19/2004
TOT AL AMOUN
REMAR~ S: W J PASKEY
HECK#106
INITIALS: VZ
SEAL RECEIVED BY:
REGISTER OF WILLS
R
REV-1162 tX(11-96)
A
ATE TAX
T
NO. CD 004660
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $543.19
I
I
I
I
I
I
I
I
T PAID:
$543.19
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
INVENTORY
Estate of PASKEY, ANGELA No.21 04 0803
also knOl n as Date of Death 6/19/2004
ANGELA PASKEY , Deceased Social Security No. 181031658
WALTER PASKEY JR.
Personal R presentative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the
personal as ets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation
placed oPP ite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no
real estate utside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We
verify that t statements made in this inventory are true and correct. I/We understand that false statements herein made are subject to the
penalties of 8 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Personal Representative:
Name of ~ .c.%-.. G>~ ~.
Attorney: MARK A MATEYA ESQUIRE
I.D. No.: 8931
Address: P.O. BOX 127 Dated
30lLlNG SPRINGS PA 17007
Telephone: 717) 241-6500
Description Value
US SAVI~ GS BOND $500.00 DENOMINATION - 1,306.80
ISSUE DA TE 2/1980
SERIAL N ~MBER D848927EE ,
US SAVI~ GS BOND $500.00 DENOMINATION 1 ,3~0.00
ISSUE Dj E 5/1980
SERIAL N JMBER D2201629EE I
i
US SAVI~ GS BOND $500.00 DENOMINATION 1,294.00
ISSUE Dt TE 7/1980
SERIAL N JMBER D2201632EE
US SAVIN f;S BOND $1,000.00 DENOMINATION 2,588,00
ISSUE DA irE 8/1980
SERIAL r--j liMBER M1030934EE
US SAViN f;S BOND $1,000.00 DENOMINATION 2,098,00
ISSUE DA irE 7/1982
SERIAL N MBER M368/1959EE
US SAVIN 3S BOND $500.00 DENOMINATION 1,049,00
iSSUE DA rE 9/1982
SERIAL N MBER D2243393EE
Total
64,879.12
(Attach Addi nal Sheets if necessary)
NOTE: The ~morandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the v lue of each item, but such figures should not be extended into the total of the Inventory.
RW-4
Continuation of Inventory
PASKEY, ANG LA
21
04
0803
Paqe 1
Description of Inventory
Description Value
US SAViNGS ~ OND $1,000.00 DENOMINATION
ISSUE DATE 9 1982
SERIAL NUMB R M3927117EE
US SAVINGS E OND $50000 DENOMINATION
ISSUE DATE 1 /1982
SERIAL NUMB R D2243399EE
US SAVINGS e OND $500.00 DENOMINATiON
ISSUE DATE 21983
SERIAL NUMB R D2707077EE
US SAVINGS e OND $500.00 DENOMINATiON
ISSUE DATE 3 1983
SERIAL NUMB R D2707091 EE
US SAVINGS e PND $1,00000 DENOMINATION
ISSUE DATE 3 984
SERIAL NUMB R M6249307EE
US SAVINGS apND $500.00 DENOMINATION
ISSUE DATE 4 985
SERIAL NUMB R D7600411 EE
US SAVINGS a::>ND $200.00 DENOMINATION
ISSUE DATE 51 986
SERIAL NUMB R R028783199EE
US SAVINGS B::>ND $20000 DENOMINATION
ISSUE DATE 31 987
SERIAL NUMB R R37278964EE
US SAVINGS B::>ND $500.00 DENOMINATION
ISSUE DATE 51 987
SERIAL NUMB R D15573435EE
US SAVINGS BDND $100.00 DENOMINATION
ISSUE DATE 11 1975
SERIAL NUMB R C2009413902E
US SAVINGS BpND $100.00
ISSUE DATE 111975
SERIAL NUMB. R C2009413903E
US SAVINGS B )ND $100.00 DENOMINATION
ISSUE DATE 3A 976
SERIAL NUMBl R C2013171821 E
US SAVINGS B ND $100.00 DENOMiNATION
ISSUE DATE 9A 976
SERIAL NUMB~ R C2013171820E
US SAVINGS B' ND $500.00 DENOMiNATION
ISSUE DATE 1C 1975
SERIAL NUMB~ R D105332741E
2,098.00
1,001.00
981 .40
895.80
1,624.80
746.00
286.80
248.24
619.60
506.80
506.80
498.00
498.00
2,509.40
Subtotal $
13,020.64
Continuation of Inventory
PASKEY, ANCl LA
21
04
0803
Pane 2
Description of Inventory
Description
US SAVINGS OND $500.00 DENOMINATION
iSSUE DATE 21976
SERIAL NUMB=R D200281350E
US SAVINGS OND $500.00 DENOMINATION
ISSUE DATE:3 1976
SERIAL NUME!=R D201723041 E
US SAVINGS OND $500.00 DENOMINATION
ISSUE DATE 81976
SERIAL NUMBER D202534729E
US SAVINGS OND $500.00 DENOMINATION
ISSUE DATE 6 1977
SERIAL NUMBER D204270730E
US SAVINGS OND $500.00 DENOMINATION
ISSUE DATE $ 1978
SERIAL NUMBER D206299788E
US SAVINGS OND $500.00 DENOMINATION
ISSUE DATE 11 1978
SERIAL NUMa=R D206299787E
US SAVINGS j OND $500.00 DENOMINATION
ISSUE DATE 9 1979
SERIAL NUMEl~R D208641561 E
US SAVINGS l OND $500.00 DENOMINATION
ISSUE DATE 1 /1979
SERIAL NUM~ER D208641573E
US SAVINGS OND $500.00 DENOMINATION
ISSUE DATE 1 /1979
SERIAL NUMa~R D208641582E
US SAVINGS OND $500.00 DENOMINATION
ISSUE DATE 1 /1979
SERIAL NUMaER D208641591 E
LEGACY BAN - WILLlAMSPORT, PA
CERTIFICATE bF DEPOSIT - OPENED ON 4/29/04
ACCOUNT NO 430000489
LEGACY BAN - WILLlAMSPORT, PA
CERTIFICATEibF DEPOSIT - OPENED 9/21/96
ACCOUNT NO 430001222
LEGACY BANI - WiLLlAMSPORT, PA
CERTIFICATE!bF DEPOSIT -OPENED 12/29/96
ACCOUNT NO 430001966
LEGACY BANI - WILLlAMSPORT, PA
CERTIFICATE: bF DEPOSIT - OPENED 4/16/97
ACCOUNT NO 430003228
Value
2,490.00
2,490.00
2,469.40
2,481.001
1,821.00
1,821.00
1,762.80
1,762.80:
1,779.40
1,779.401
1,479.52
1,015.97
1,009.71
1,012.19
Subtotal $
25,174.19
Continuation of Inventory
PASKEY, ANG LA
21
04
0803
Paqe 3
Description 0 Inventory
Description
LEGACY BAN - WILLIAMS PORT, PA
CERTIFICAT8 OF DEPOSIT - OPENED 4/22/98
ACCOUNT NO 430007476
LEGACY BAN - WILLlAMSPORT, PA
CERTIFICATE! OF DEPOSIT - OPENED 5/6/82
ACCOUNT Nd 430018408
LEGACY BAN. - WILLIAMSPORT, PA
CERTIFICAT8 OF DEPOSIT - OPENED 5/20/82
ACCOUNT NO 430018416
LEGACY BAN - WILLlAMSPORT, PA
CERTIFICATE OF DEPOSIT - OPENED 10/15/82
ACCOUNT NO 430018879
LEGACY BAN - WILLlAMSPORT, PA
CERTIFICAT~ OF DEPOSIT - OPENED 3/25/91
ACCOUNT NO 430024265
,
LEGACY BAN. - WILLlAMSPORT, PA
CERTIFICAT~ OF DEPOSIT - OPENED 2/7/2000
ACCOUNT NO 431002856
LEGACY BAN - WILLlAMSPORT, PA
CERTIFICATE! OF DEPOSIT - OPENED 5/10/2000
ACCOUNTNq 431011394
PENN-NATIO~ AL ABSTRACT SERVICES, INC.
REFUND OF Ii ATER BILL
Value
1,007.53
2,031.8(i
1,015.94
2,035.00
505.46
2,017.32
1,016.70
37.54
POTTSVILLE EPUBLlCAN, INC.
NEWSPAPER' ,UBSCRIPTION REFUND
52.89
ROYAL & SUNlll,LLlANCE
HOMEOWNEH S INSURANCE REFUND
189.91'
LEGACY BAN CHECKING ACCOUNT
ACCOUNT NC 541012269
JOINTLY OW~ ED (6070.73)
FIRST FEDE~ ,L BANK
CERTIFICAT~ OF DEPOSIT NO. 727004174
JOINTLY OW~ ED (501.56)
FIRST FEDE~ ,L BANK
CERTIFICAT~ OF DEPOSIT NO. 0327015743
JOINTLY OW~ ED (601.46
FIRST FEDE~ ,L BANK
CERTIFICATE! OF DEPOSIT NO. 332011568
JOINTLY owri ED (2651.70)
3,035.37
250.78
300.73
1,325.85
Subtotal $
14,822.87
Continuation of Inventory
PASKEY,ANG =LA 21 04 0803
Paae 4
Description 0 Inventory
Description Value
FIRST FEDEI1 L BANK 334.98
CERTIFICATe OF DEPOSIT NO. 331012632
JOINTL Y OW~ ED (669.96)
FIRST FEDE~ .L BANK 333.80
CERTIFICATE! OF DEPOSIT NO. 0327017903
JOINTL Y OW~ ED (667.60)
FIRST FEDE~ .L BANK 1,536.84
CERTIFICATE OF DEPOSIT NO. 327016263
JOINTL Y OW~ ED (3073.67)
Subtotal $ 2,205.612
Grand Total $ 64,879.12
REV-1500EX+(6-00)
'*
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV -1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
21-040803
""'CO'UNTV"'COOE ----yEA~ - - NUMBER- -
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
~
Z
W
C
W
()
W
C
PASKEY ANGELA
DATE OF DEATH (MM-DD-Year)
DATE OF BIRTH (MM-DD-Year)
SOCIAL SECURITY NUMBER
181-03-1658
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
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Oll.al
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06/19/2004 11/22/1915
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
D 3. Remainder Return (dale of death prior to 12.13-82)
o 5. Federal Estate Tax Return Required
_ 8. Total Number of Safe Deposit Boxes
D 11. Election to tax under See, 9113(A) (Attach Sch 0)
N/A
[R] 1. Original Return
o 4. Limited Estate
[Xl 6. Decedent Died Testate (Attach copy 01 Will)
o g, Litigation Proceeds Received
o 2. Supplernental Return
o 4a. Future Interest Compromise [date o/death after 12-12-82)
o 7. Decedent Maintained a Living Trust (Attach copy oITrust)
o 10. Spousal Poverty Credit (date 01 death between 12-31-91 and 1-1-95)
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
MARK A. MATEYA ESQUIRE P.O. BOX 127
FIRM NAME (II Applicable)
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
(1)
(2)
(3)
(4)
(5)
....
Z
W
C
Z
C
"-
'"
W
'"
'"
o
o
TELEPHONE NUMBER
717 241-6500
BOILING SPRINGS
PA 17007
OFFICIAL USE ONLY
3. Closely Held Corporation. Partnership or Sole-Proprietorship
43,333.24
4. Mortgages & Notes Receivable (Schedule D)
I
,
14,427.53 .
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5. Cash. Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
D Separate Billing Requested
7,118.35
(8)
64,879.12
0.00 X _(15) 0.00
49,497.70 X .045 (16) 2,22740
0.00 X 12 (17) 000
0.00 X .15 (18) 000
(19) 2,22740
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/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subjectto Tax (Line 12 minus line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FDR APPLICABLE RATES
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~
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
11,66146
3,719.96
(11)
(12)
(13)
15,38142
49,497.70
16. Amount of Line 14 taxable at lineal rate
(14)
49,497.70
17. Amount of line 14 taxable at sibling rate
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
18. Amount of line 14 taxable at collateral rate
19, Tax Due
Decedent's Complete Address:
STREET ADDRESS
1 LONGSDORF WAY
CITY I STATE I ZIP
CARLISLE PA 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A Spousal Poverty Credit
B. Prior Payments
C Discount
(1)
2,22740
1,600.00
84.21
Total Credits (A + B + C)
(2)
1,684.21
3. InteresUPenalty if applicable
D. Interest
E. Penalty
T otallnteresUPenalty ( 0 + E ) (3)
4. It Line 2 is 9reater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. ThIS is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A This is the BALANCE DUE, (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
0.00
0.00
543.19
543.19
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, ..................... ................ ..................... .............. D IKI
b. retain the righlto designate who shalt use the property transferred or its income; ... ..................... .............. D IKI
c. retain a reversionary interest; or n' ....................................................... ...................... ................... D lXJ
d. receive the promise for life of either payments, benefits or care? ................. ................ ................... D IKI
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?........ ..................................... ................. 0 [K]
3, Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ........ 0 [Z]
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ......................................................... ................... ...... 0 00
IF THE ANSWER TO ANY DF THE ABOVE QUESTIONS IS YES, YDU MUST COMPLETE SCHEDULE G AND FILE IT AS PART DF THE RETURN.
Under penalties of perJLlry, I declare that I have examined this retLlm, inclLlding accompanying schedLlles and statements, and to the best of my knowledge and belief, it is trLle, correct and complete,
Declarahon of pre parer other than the personal representative is based on all information of which preparer has any knowledge
SIGNATURE OF PERSONR,:S~~NS~~G RETU
AOORESS 112 FOURTH STREET
BOILING SPRINGS
SIGNATURE OF PRE ARER OTHER T N R PRESENTATIVE
t..t. Ct -
DATE
lit >-->-/0 (
PA
17007
DATE
h 2) ()I('
ADDRESS
PA 17007
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. 99116 (a) (1.1) (i)l.
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to orfor the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (iI)l.
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 applicable even if
the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent,
or a stepparent of the child is 0% [72 P.S. 99116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)1
The tax rate imposed on the net vaiue of transfers to or for the use of the decedent's siblings is 12% [72 PS. 99116(a)(1.3)]. A Slbiing 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)
'*
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
21 04
0803
ESTATE OF
PASKEY ANGELA
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
2.
3.
4.
5.
6.
7
8.
9.
10.
11
12.
13.
14.
15.
16.
VALUE AT DATE
OF DEATH
1,30680
DESCRIPTION
US SAVINGS BOND $500.00 DENOMINATION
ISSUE DATE 2/1980
SERIAL NUMBER D848927EE
US SAVINGS BOND $500.00 DENOMINATION
ISSUE DATE 5/1980
SERIAL NUMBER D2201629EE
US SAVINGS BOND $500.00 DENOMINATION
ISSUE DATE 7/1980
SERIAL NUMBER D2201632EE
US SAVINGS BOND $1,000.00 DENOMINATION
ISSUE DATE 8/1980
SERIAL NUMBER M1030934EE
US SAVINGS BOND $1,000.00 DENOMINATION
ISSUE DATE 7/1982
SERIAL NUMBER M368/1959EE
US SAVINGS BOND $500.00 DENOMINATION
ISSUE DATE 9/1982
SERIAL NUMBER D2243393EE
US SAVINGS BOND $1,00000 DENOMINATION
ISSUE DATE 9/1982
SERIAL NUMBER M3927117EE
US SAVINGS BOND $500.00 DENOMINATION
ISSUE DATE 11/1982
SERIAL NUMBER D2243399EE
US SAVINGS BOND $500.00 DENOMINATION
ISSUE DATE 2/1983
SERIAL NUMBER D2707077EE
US SAVINGS BOND $500.00 DENOMINATION
ISSUE DATE 3/1983
SERIAL NUMBER D2707091EE
US SAVINGS BOND $1,000.00 DENOMINATION
ISSUE DATE 3/1984
SERIAL NUMBER M6249307EE
US SAVINGS BOND $500.00 DENOMINATION
ISSUE DATE 4/1985
SERIAL NUMBER D7600411 EE
US SAVINGS BOND $200.00 DENOMINATION
ISSUE DATE 5/1986
SERIAL NUMBER R028783199EE
US SAVINGS BOND $200.00 DENOMINATION
ISSUE DATE 3/1987
SERIAL NUMBER R37278964EE
US SAVINGS BOND $500.00 DENOMINATION
ISSUE DATE 5/1987
SERIAL NUMBER D15573435EE
US SAVINGS BOND $100.00 DENOMINATION
ISSUE DATE 11/1975
SERIAL NUMBER C2009413902E
1,320.00
1,294.00
2,588.00
2,098.00
1,049.00
2,098.00
1,001.00
981.40
895.80
1,624.80
746.00
286.80
248.24
619.60
506.80
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
43 333.24
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
PASKEY, ANGELA
Decedent's Name
Page 1
21 04 0803
File Number
Schedule B - Stocks & Bonds
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
17. US SAVINGS BOND $100.00 506.80
ISSUE DATE 11/1975
SERIAL NUMBER C2009413903E
18. US SAVINGS BOND $100.00 DENOMINATION 498.00
ISSUE DATE 3/1976
SERIAL NUMBER C2013171821E
19. US SAVINGS BOND $10000 DENOMINATION 498.00
ISSUE DATE 9/1976
SERIAL NUMBER C2013171820E
20. US SAVINGS BOND $500.00 DENOMINATION 2,509.40
ISSUE DATE 10/1975
SERIAL NUMBER D105332741E
21. US SAVINGS BOND $500.00 DENOMINATION 2,49000
ISSUE DATE 2/1976
SERIAL NUMBER D200281350E
22. US SAVINGS BOND $500.00 DENOMINATION 2,490.00
ISSUE DATE 3/1976
SERIAL NUMBER D201723041E
23. US SAVINGS BOND $500.00 DENOMINATION 2,469.40
ISSUE DATE 8/1976
SERIAL NUMBER D202534729E
24. US SAVINGS BOND $500.00 DENOMINATION 2,48100
ISSUE DATE 6/1977
SERIAL NUMBER D204270730E
25. US SAVINGS BOND $500.00 DENOMINATION 1,821.00
ISSUE DATE 5/1978
SERIAL NUMBER D206299788E
26. US SAVINGS BOND $50000 DENOMINATION 1,821.00
ISSUE DATE 5/1978
SERIAL NUMBER D206299787E
27. US SAVINGS BOND $500.00 DENOMINATION 1,762.80
ISSUE DATE 9/1979
SERIAL NUMBER D208641561 E
28. US SAVINGS BOND $500.00 DENOMINATION 1,762.80
ISSUE DATE 10/1979
SERIAL NUMBER D208641573E
29. US SAVINGS BOND $500.00 DENOMINATION 1,779.40
ISSUE DATE 11/1979
SERIAL NUMBER D208641582E
30. US SAVINGS BOND $500.00 DENOMINATION 1,779.40
ISSUE DATE 12/1979
SERIAL NUMBER D208641591E
SUBTOTAL SCHEDULE B 24,669.00
GRAND TOTAL SCHEDULE B $ 43,333.24
REV-15G8 EX + (6-98)
*'
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
21 04
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
0803
ESTATE OF
PASKEY ANGELA
ITEM
NUMBER
1.
DESCRIPTION
LEGACY BANK - WILLlAMSPORT, PA
CERTIFICATE OF DEPOSIT - OPENED ON 4/29/04
ACCOUNT NO. 430000489
LEGACY BANK - WILLlAMSPORT, PA
CERTIFICATE OF DEPOSIT - OPENED 9/21/96
ACCOUNT NO. 430001222
LEGACY BANK - WILLlAMSPORT, PA
CERTIFICATE OF DEPOSIT -OPENED 12/29/96
ACCOUNT NO. 430001966
LEGACY BANK - WILLlAMSPORT, PA
CERTIFICATE OF DEPOSIT - OPENED 4/16/97
ACCOUNT NO. 430003228
LEGACY BANK - WILLlAMSPORT, PA
CERTIFICATE OF DEPOSIT - OPENED 4/22/98
ACCOUNT NO. 430007476
LEGACY BANK - WILLlAMSPORT, PA
CERTIFICATE OF DEPOSIT - OPENED 5/6/82
ACCOUNT NO. 430018408
LEGACY BANK - WILLlAMSPORT, PA
CERTIFICATE OF DEPOSIT - OPENED 5/20/82
ACCOUNT NO. 430018416
LEGACY BANK - WILLlAMSPORT, PA
CERTIFICATE OF DEPOSIT - OPENED 10/15/82
ACCOUNT NO. 430018879
LEGACY BANK - WILLlAMSPORT, PA
CERTIFICATE OF DEPOSIT - OPENED 3/25/91
ACCOUNT NO. 430024265
LEGACY BANK - WILLlAMSPORT, PA
CERTIFICATE OF DEPOSIT - OPENED 2/7/2000
ACCOUNT NO. 431002856
LEGACY BANK - WILLIAMS PORT, PA
CERTIFICATE OF DEPOSIT - OPENED 5/10/2000
ACCOUNT NO. 431011394
PENN-NATIONAL ABSTRACT SERVICES, INC.
REFUND OF WATER BILL
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
POTTSVILLE REPUBLICAN, INC.
NEWSPAPER SUBSCRIPTION REFUND
14.
ROYAL & SUNALLlANCE
HOMEOWNERS INSURANCE REFUND
VALUE AT DATE
OF DEATH
1,4 79.52
1,015.97
1,009.71
1,012.19
1,007.53
2,031.85 -
1,015.94
2,035.00
505.46
2,017 .32
1,016.70
37.54
52.89
189.91
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
1442753
REV -1509 EX + (6-98)
'*
SCHEDULE F
JOINTLY-OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF
PASKEY ANGELA
21
04
0803
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT{S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A. WALTER PASKEY, JR
112 FOURTH STREET
BOILING SPRINGS, PA 17007
SON
B
c
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECO'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER ATTACH DEED FOR JOINTLY.HELD REAL ESTATE VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A 4/20/01 LEGACY BANK 6,070.73 50. 3,035.37
CHECKING ACCOUNT NO. 541012269
2. B. 6/30/89 FIRST FEDERAL BANK 501.56 50. 250.78
CERTIFICATE OF DEPOSIT
ACCOUNT NO. 727004174
3. C. 3/30/89 FIRST FEDERAL BANK 601.46 50. 300.73
CERTIFICATE OF DEPOSIT
ACCOUNT NO. 0327015743
4. D 9/30/85 FIRST FEDERAL BANK 2,651.70 50. 1,325.85
CERTIFICATE OF DEPOSIT
ACCOUNT NO. 332011568
5. E 6/27/86 FIRST FEDERAL BANK 669.96 50. 334.98
CERTIFICATE OF DEPOSIT
ACCOUNT NO. 331012632
6. F 10/2/90 FIRST FEDERAL BANK 667.60 50. 333.80
CERTIFICATE OF DEPOSIT
ACCOUNT NO. 0327017903
7. G 7/05/89 FIRST FEDERAL BANK 3,073.67 50. 1,536.84
CERTIFICATE OF DEPOSIT
ACCOUNT NO. 327016263
TOTAL (Also enter on line 6, Recapitulation) $ 7118.35
(If more space is needed, insert additional sheets of the same size)
R:::V-1511 EX + (12-99)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
PASKEY ANGELA
FILE NUMBER
21
04
0803
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. ORAVITZ HOME FOR FUNERALS, INC. 6,045.00
2. E.T. EVERETT & SONS - INSCRIPTION ON MEMORIAL MARKER 65.98
3. TINA'S FLOWER SHOP - FLOWERS FOR FUNERAL SERVICE 254.40
4. VERNALlS RESTAURANT - AFTER FUNERAL LUNCHEON 581 .45
5. CASH ADVANCE FOR CLERGY SERVICES FOR FUNERAL 200.00
B AOMINISTRA TIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. AtlomeyFees MARKA. MATEYA, ESQUIRE 4,100.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4 Probate Fees CUMBERLAND COUNTY REGISTER OF WILLS 140.00
CARLISLE, PA
5. Accountant's Fees
6. Tax Return Prepare~s Fees
7 CUMBERLAND COUNTY LAW JOURNAL - ADVERTISEMENT OF ESTATE 75.00
8. THE PATRIOT NEWS - ADVERTISEMENT OF ESTATE 199.63
TOTAL (Also enter on line 9, Recapitulation) $ 11661.46
Debts of decedent must be reported on Schedule l.
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX + (6-98)
'*
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
PASKEY ANGELA
21
04
0803
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1. CUMBERLAND CROSSING
ASSISTED LIVING FINAL BILL
ACCOUNT NO. SC000039
2. CONTINUING CARE RX, INC
PRESCRIPTION MEDICATIONS - FINAL BILL
ACCOUNT NO. 100020452
VALUE AT DATE
OF DEATH
3,514.94
20502
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
3719.96
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 lal 11.2)]
1. WALTER PASKEY Lineal
112 FOURTH STREET 25% of residual
BOILING SPRINGS, PA 17007
2. CHRISTINE XISTRIS Lineal
9 FARM DRIVE 25% of residual
FARMINGTON, CT 06032
3. MARY ANNE EMANUELLI Lineal
6 COLONIAL ROAD 25% of residual
WHITE PLAINS, NY 10605
4. ARLENE JEVELLE Lineal
20 NOD BROOK ROAD 25% of residual
WALLINGFORD, CT 06492
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II _ ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
REV-1513EX<',*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
PASKEY ANGELA
SCHEDULE J
BENEFICIARIES
(If more space is needed, insert additional sheets at the same size)
FILE NUMBER
21 04
0803
REV-1500 Discount, Interest and Penalty Worksheet
Discount Calculation
Total Amount Paid within three calendar months of the decedent's date of death:
1,60000
Discount:
84.21
Interest Table
Year
, Days Delinquent I
I this time period
Balance Due
this year
Interest
this period
Before 1981
1982
1983
1984
,1985
1986
1987
1988 through 1991
1992
1993 through 1994
1995 through 1998
1999
2000
2001
2002
2003
,
f-
TOTALS
Penalty Calculation
If the decedent's date of death was on or before March 31, 1993, insert the applicable amount:
Total Balance Due on January 17,1996:
Penalty:
I I ANGELA PASI<EY, also knmm as ANGELA P.i\SKEwICZ,
residing in the county of Schuykill, Conunonwealth of
Pennsylvania, do publish and declare the following to be my
last will and testament, hereby revoking all prior wills.
FIRST: I devise and bequeat..1. to my husband, T''lAL'l'ER
J. PASKEY, if he survives me, any real estate used by me as a
residence at the time of my death, and all of my tangible
personal property. If my husband does not survive me, I
bequeath all of my tangible personal property to my children
who survive me, to be divided among them by my executors in
as nearly equal proportions as may be practicable, having due
regard to the personal preferences of my children. Devises
and bequests of real and personal property under this Article
shall carry with them any policies of insurance relating to
said property. I direct that the expenses of distributing my
tangible personal property and of maintaining it prior to
distribution shall be a charge upon my general estate.
SECOND: If my husband survives me, I bequeath any
insurance policies on his life of which I am the owner to my
issue who survive me, in equal shares, per stirpes.
THIRD: I devise and bequeath all the rest of my
property (hereinafter known as my "residuary estate") to my
said husband, if he survives me, or if my said husband does not
survive me, to such of my issue who survive me, in equal shares,
per stirpes.
()('::
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cr ~ .
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by i~~ '~~.
FOURTH:
If I am not survived by my husb~n~ n~
issue, I devise and bequeath all of my property to~the persons
""'"
to whom and in the proportions in which the same Wpuld have
- -
been distributed under the laws of the corrunonwealth of W
Pennsylvania if I had died intestate a resident of the
Commonwealth of Pennsylvania.
FIFTH: If any part of the principal or income of my
estate shall vest in absolute ownership in a person under the
age of twenty-one (21) years (hereinafter referred to as a
"minor", such person's actual legal status to the contrary
/")
, ,
.)J
notwithstanding), my executor may, in his discretion, hold and
administar, sell, invest and reinvest such part for the uen0fit
of the minor during minority. :1-1y e~cecutor may pay to or apply
to the use of the minor such sums, out of income or principal,
as he shall, in his discretion, deem proper for the minor's
support, maintanance and education, and shall add to principal
any income not so paid or applied. Payment of income or
principal to the minor may be made direct to the minor, to the
guardian of the property of the minor I or to the custodian of
Ule minor's property under a Gifts to Minors Act. Application
of incorn..:: or principal to the use of the minor may be made by
payment to a par€:nt of the lninor, to the guardian of the person
of the minor, or to any o~ler person with whom the minor shall
reside, as well as by expenditures for the benefit of the minor.
The receipt of the minor, guardian, custodian, parent or person
for any payment or application so made shall be a full discharge
of my executor and he shall have no further duty in respect
thereto. All property shall be paid over to the minor upon the
minor's attaining the age of twenty-one (21) years, but if the
minor shall die before attaining the age of twenty-one (21)
years such property shall thereupon be paid over to the estate
of the minor. My executor shall have the same powers,
authorities, discretions and immunities with respect to the
property held hereunder and the investment thereof as are
conferred upon him with respect to my estate, and shall be
entitled to the same compensation as would a testamentary
trustee of the property held hereunder.
SIXTH: In addition to the powers conferred by law,
I give to my executor and any successors, full power and
authority from time to time-in their absolute discretion, to
retain as part of my estate any securities which I may own at
the time of my death; to invest the funds of my estate without
diversification, in stocks, common, preferred or of any other
class, in bonds, secured or unsecured and in other securities,
in commodities, equities, mortgages, real estate, business
enterprises, investments in the nature of loans, or other
properties of a!1Y kind, whether or not such stocks, bonds, or
other securities and properties are of the nature approved for
fiduciaries by the pres6nt or future laws or statutes applicable
- 2 -
,",
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thereto; to hold a part or all of my estate in cash for a
reasonable period of time; to purchase and hold for periods of
time non-income producing securities and other property upon
such terms and conditions as they may determine; to sell,
exchange, lease, nlortgage, grant options upon, abandon, demolish,
alter, repair in an ordinary or extraordinary manner, or otherwise
deal with any real or personal property in such manner, for such
periods of time and upon such terms and conditions as they
shall deem proper, and to make, execute and deliver all proper
instruments for said purposes; to borrow money from anyone,
including themselves, and to continue any existing loans; to
renew or modify any existing contracts or agreements entered into
by me during my life and to continue any businsss in which I was
a stockholder, partner or proprietor at the time of my deatlli
to compromise any and all claims, debts, accounts and causes of
action in favor of or against me or my estate; to employ agents;
to delegate authority; to participate in reorganizations; to
exercise rights; to register securities in the names of nominees,
insofar as permitted by law; to join in or consent to income and
gift tax returns filed by my surviving spouse and to pay any
part or all of the income tax or gift tax due upon such tax
returns; to ent9r into pooling arrangements and voting trust
agreementsi to create reserves for depreciation and obsolescence,
or for wasting assetsi to amortize or not amortize premiums; to
make distribution of my esta te ~"holly or partly in kind, and
for that purpose to determine the values of any property so
distributed insofar as permitted by law and by other provisions
of this will.
SEVEN'fll: All transfer, estate, inheritance or other
death taxes of every description (including any interest and
penalties thereon) which may be lawfully imposed upon any
property passing under this will shall be paid out of my
residuary estate without apportionment.
EIGH'fII: I appoint my husband, ~'/ALTER, executor of
this my will. If he shall predecease me or shall thereafter
die, resign, fail to qualify or become incapable of acting, I
appoint my daughtsrs, tffiRYAN1J PASKEY and CHRISTINE XISTRIS, as
executors, to act jointly or singly in place and stead of my
/)
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(l.
- 3 -
said husband.
The word "executor" as used herein shall be deemed
to refer to any successors, and shall include the masculine,
feminine or neuter and the singular or plural, as the context
or circumstances shall require. The word "estate" as used
herein shall De deemed to refer to any trust estate created
herein as well as to my general estate.
No bond or other security shall be required of any
executor, trustee or guardian nmned above for the faithful
performance of his or her duties hereunder.
IN WITNESS ~n{EREOF, I have hereunto set my hand and
affi:cad my seal this ;: 3 day of ..,"'1 e;,.:J ,3 i3- FZ , 19 7 r:.
tl.-'"'-f"'J'>-
.I
ANGELA PASKEY
p~:v-
1/
(L.S. )
SIGN~D, SEALED, PUBLISHED and DECLARED
by ANGELA PASlmy, the testatrix above
named, as and for her last will and
testament, in our presence, and we
thereupon, at her request, and in her
presence and in the presence of each
other, have hereunto subscribed our
names as witnesses this ;1.; day of
r)-<J;~~ , 191(.,.
,dc~"c:{]~~
~.~94ut'iet,
~ J.-e--.~
residing at
2JLo~p'z" 51-"",-1'-
~"e../l /,,-.Y. . c, .-",
~, r:./&..fT:i" (I u
!;~"-'-& /t",/ tl.c" /CUe:;
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,::,..7 D )~...-,,~ /d-t-~ tC...(~
residing at
residing at
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OFINllI\lIDUALT,AXES'-
INHERITANCE TAX,DIVISION
PO BO)( 280601
HARRISBURG PA 11128-0601
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
:22
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
MARK A MATEYA
PO BOX 127
BOILING SPGS
02-14-2005
PASKEY
06-19-2004
21 04-0803
CUMBERLAND
101
*'
REV-1547 EX 'FP (12-0~)
ANGELA
PA 17007
Allount Rallitied
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .....
REv:r!4"-EX"AFi>"m.':6'!Y-N6T-fcE'iiF'j;NHI~YfAN-CE'i"AX'A'PPRA'fsUilNi'~-'Ar.'LiiwANCE'OR""------------'
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF PASKEY ANGELA FILE NO. 21 04-0803 ACN 101 DATE 02-14-2005
TAX RETURN WAS: I X} ACCEPTED AS FILED
} CMANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Raceivable {Schedule DJ
S. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. ~olntly Owned Property (Schedule f)
7. Transfers (Schedule G)
8. Total Assets
ll}
12}
[3}
[~}
IS}
16}
17}
.00
43.333.24
.00
.00
14.427. 53
7.118.35
.00
IB}
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Ad... Costs/Misc. Expenses (Schedule H)
10. Debts/Hortgage Liabilities/Liens (Schedule I)
11. Tot.l Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequestsj Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subiect to Tax
[9}
IlO}
11,661. 46
3.719.96
Ill}
112}
113}
ll~}
NOTE: To insure proper
credit to your account~
submit the upper portion
of this form with your
tax payment.
64,879.12
}~.38} 4?
49,497.70
.00
49,497.70
14, IS and/or 16, 17, 18 and 19 will
returns assessed to date.
NOTE: I~ an assessment was issued previoUSly, lines
re~lect ~igures that include the total o~ ALL
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15)
16. Amount of Line 14 taxable at Lineal/Class A rate (16J
17. Amount of Line 14 at Sibling rate (17)
18. Amount of Line 14 taxable at Coll.teral/Class B rate (18)
19. Principal Tax Due
TAX C
+
INTEREST/PEN PAID I-)
84.21
.00
DATE
09-09-2004
11-23-2004
NUMBER
CD004358
CD004660
.OOXOO=
49,497. 7 0 X 0.45 =
.00 X 12 =
.00 X 15 =
119}=
AMOUNT PAID
1,600.00
543.19
~
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
.00
2,227.40
.00
.00
2,227.40
2,227.40
.00
.00
.00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
[ IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR}, YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.}
REV'~500 EX t (~)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT,280601
HARRISBURG, PA 17128~601
I-
Z
W
C
W
o
W
C
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
PASKEY ANGELA
DATE OF DEATH (MM-DD-Year)
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
ALEN~-(Q)f-Y
21 -0 4 0803
"'OOUrffi''''C05E--Y~--NUii8E~-
SOCIAL SECURITY NUMBER
DATE OF BIRTH (MM-DD-Year}
181-03-1658
THIS RETURN tAUST BE FILED lH DllPLlCATE WITH THE
REGISTER OF WILLS
06/19/2004 11/22/1915
(IF APPLICABLE) SURViVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAl)
"'
....
~~~
0"0
WOO
"'0:....
0....
~
N/A
o 1, Original Return
o 4, Limited Eslate
06. Decedent Died Testate (Altach copy of Will)
o 9. litigation Proceeds Received
SOCIAL SECURITY NUMBER
00 2. Supplemenlal Re\um
o 4a. Future Interest Compromise lllateofdealhafler 12-12.82)
o 7. Decedent Maintained a living Trust (Attach copy of Trust)
o 10. Spousal Poverty Credit (date ofdelllh be\Ween 12-31-91 an1l1-1.95)
o 3. Remainder Retum (lIate ofdelllh prior to 12.t3.82)
o 5. Federal Estate Tax Return Required
_ 8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) 1-' Soh OJ
THIS SECTlON MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAXJNFORMATION SHOULD BE. DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
MARKA. MATEYA ESQUIRE P,O. BOX 127
FIRM NAME (If Ap~icabl.)
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7) (8)
9. Funera) Expenses & Administrative Costs (Schedule H) (9)
10. Debts ot Decedent, Mortgage Liabili\ies, & Liens (Solledule I) (10)
!Z
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z
o
..
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l:!
0:
8
z
o
5
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ii:
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w
~
1. Real Eslate (Schedule A)
2, Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partne<Ship or Sole-Proprieiorship
4, Mortgages & Notes Receivabie (Schedule 0)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
o Separate Billing Requested
TELEPHONE NUMBER
717 241-6500
BOILING SPRINGS
r-->
= PA 17 7
O~FICIAL liS €l/iIIlY
c:: r:;"'C:J
r c'::.;;~~g
T ' ~ I'-n
U1 ::'C""J
(1)
(2)
(3)
(4)
(5)
-u
::r.
-~. C)
i --,-j
--n
(~
,'I
14,427.5_~ ~
16,180.85
r"
D
'.'/)
73,941.62
11,661,46
3,719.96
11. Total Deductions (10101 Lines 9 & 1D)
12, NelValue 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)
(11)
(12)
(13)
15,381.42
58,560.20
14. NelValue Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
(14)
58,560,20
z
o
~
I-
~
1I.
::i
o
o
><
c(
I-
15. Amount of line 14 taxable at the spousal tax
rale, or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14laxable at lineal rate
17, Amount of Line 14 Iaxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
0.00 X _(15) 0.00
58,560,20 X .045 (16) 2,635,21
0,00 X .12 (17) 0.00
0.00 X .15 (18) 0.00
(19) 2,635.21
20. 0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
,.,. BE.SURE TO ANSWER ALL ClUESTIONS C>N REVERSE SIDE AND RECHECK MATH < <
L
,
RFWAY
"'" .
CITY
CARLISLE
STATE
PA
ZIP
17013
Tax Payments and Credits:
1. Tax Due (Page 1 Une 19)
2. Credits/Payments
A. Spousal Poverty Credit
8, Prior Payments
C, Discount
(1)
2,635,21
2143.19
84.21
Total Credits (A + 8 +C)
(2)
2,227.40
3, InteresVPenalty if applicable
D. Interest
E. Penalty
4.
T otallnteresVPenalty ( D + E )
If Line 21s greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund
If Line 1 + Line 3 is greater than Line 2, enter the difference, This is the TAX OUE.
(3)
0.00
A, Enter the interest on the tax due.
(4)
(5)
(5A)
8, Enter the total of Line 5 + 5A, This is the 8ALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
0.00
407,81
5,
407,81
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a lransferand: Yes No
a, retain the use or income of the property transferred; ........................................................................... 0 IXI
b, retain the right to designate who shall use the property transferred or its income; ........................................ 0 IXI
c. retain a reversionary interest; or ...................................................................................................... 0 00
d. receive the promise for life of either payments, benefits or care? ............................................................. 0 IXI
2, If death occurred after December 12,1982, did decedent transfer property within one year of death
without receiving adequate consideration?.......,...............,............................"",.........".......,.".....",......" 0 IXI
3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ................. 0 IXI
4, Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ...",......"",........,.,.""""""""""""....."",........""............."".....""" 0 IXI
IF THE ANSWER TO ANY DF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under ~nalties of pe~ury, I declare that I have examined ~is ~lum, jncludj~ accompanying ~chedules and statements, and 10 the best of my knowledge and belief, it is true, correct and complete.
Declaration of preparerother than the personal representative IS based on all mfonnation of which preparer has any knowledge.
SIGNATURE OF PERSON RESPQN~L~OR F~ RETURN OATE
-0 ~ ~> 7/13/0.;)......
ADDRESS 112 FOURTH STREET
B ILlNG SPRINGS
SIGNATURE OF PR PAR OT R TH REPRESENTATIVE
ADDRESS
PA 17007
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to orfor the use of the surviving spouse 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 transfers to or for the use ofthe surviving spouse is 0% [72 P,S. ~9116 (a) (1,1) (Ii)),
The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if
the surviving spouse is the only beneficiary,
For dates of death on or after July 1, 2000:
The lax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a naturai 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 ofthe 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 vaiue of transfers to or for the use of the decedent's siblings is 12% [72 P,S, ~9116(a)(l,3)l, 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-1509 EX.+ (6-96)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTL Y.OWNED PROPERTY
ESTATE OF
PASKEY ANGELA
FILE NUMBER
21 04
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
0803
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A. WALTER PASKEY, JR
112 FOURTH STREET
BOILING SPRINGS, PA 17007
SON
B
c
JOINTL Y.OWNED PROPERTY:
LEDER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMIlAR DATE OF DEATH DECO'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER. ADACH DEED FOR JOINTLY .HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENrSINTERE$T
1. A, 4/20/01 LEGACY BANK 6,070.73 50. 3,035.37
CHECKING ACCOUNT NO. 541012269
2. B, 6/30/89 FIRST FEDERAL BANK 501,56 50_ 250,78
CERTIFICATE OF DEPOSIT
ACCOUNT NO. 727004174
3. C. 3/30/89 FIRST FEDERAL BANK 601.46 50. 300,73
CERTIFICATE OF DEPOSIT
ACCOUNT NO. 0327015743
4. D 9/30/85 FIRST FEDERAL BANK 2,651,70 50. 1,325.85
CERTIFICATE OF DEPOSIT
ACCOUNT NO. 332011568
5. E 6/27/86 FIRST FEDERAL BANK 669.96 50. 334.98
CERTIFICATE OF DEPOSIT
ACCOUNT NO, 331012632
6. F 10/2/90 FIRST FEDERAL BANK 667.60 50. 333,80
CERTIFICATE OF DEPOSIT
ACCOUNT NO, 0327017903
7. G 7/05/89 FIRST FEDERAL BANK 3,073.67 50. 1,536.84
CERTIFICATE OF DEPOSIT
ACCOUNT NO, 327016263
8. H. 4/08/85 KEYSTONE NAZARETH BANK & TRUST 10,101.88 50. 5,050,94
CERTIFICATE OF DEPOSIT
ACCOUNT NO, 334010551
9, I. 6/30/89 KEYSTONE NAZARETH BANK & TRUST 501.77 50. 250.89
CERTIFICATE OF DEPOSIT
ACCOUNT NO 727004174
10. J. 122480 LIBERTY US GOV MONEY MARKET FUND 898.67 50. 449.34
FEDERATED ACCOUNT NO. 2/11253701
898.60 SHARES INCLUDES UNPAID DIVIDEND .07
TOTAL (Also enter on line 6, Recapitulation) $ 16 180.85
(If more space is needed, insert additional sheets of the same size)
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
PASKEY, ANGELA
Decedent's Name
Page 2
21 04 0803
File Number
Schedule F-2 . Jointly-Owned Property
LETTER OATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOiNT MADE INCLUDE NAME OF FINANCIAL INSTITUTION ANO BANK ACCOUNT NUMBER OR SIMILAR OATE OF OEATH DECO'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTERES
11, K. 4/8/85 TAX FREE INSTRUMENTS TRUST SHARES 2,191.02 50. 1,095.51
FEDERATED ACCOUNT NO. 342/11253701
2190.65 SHARES INCLUDES UPAID DIVIDEND .37
12, L. 7/03/85 FEDERATED MUNICIPAL SECURITIES FUNDS 4,431,63 50. 2,215.82
ACCOUNT NO. 358/11253701 423,539 SHARES
DECLARED BUT UNPAID DIVIDEND OF 9,88
SUBTOTAL SCHEDULE F.2 3,311.33
GRAND TOTAL SCHEDULE F.2 $ 16,180.85
T
4
.. ,
SUPPLEI1ENTAL
INVENTORY
ANGELA PASKEY
WALTER PASKEY, JR.
, Deceased
NO,21 04 0803
Date of Death 6/19/2004
Social Security No. 181-03-1658
Estate of ANGELA PASKEY
also known as
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation
placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no
real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We
verify that the statements made in this inventory are true and correct. I/We understand that false statements herein made are subject to the
penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Name of
Attorney: MARK A. MATEYA, ESQUIRE
1.0. No.: 78931
Address: PO BOX 127
Personal Representative:
--0,~QcJ-y ~,
Dated 7/t1/oS'
BOILING SPRINGS
PA 17007
Telephone: (717) 241-6500
Description
US SAVINGS BOND $500,00 DENOMINATION
ISSUE DATE 2/1980
SERIAL NUMBER D848927EE
US SAVINGS BOND $500.00 DENOMINATION
ISSUE DATE 5/1980
SERIAL NUMBER D2201629EE
US SAVINGS BOND 500,00 DENOMINATION
ISSUE DATE 7/1980
SERIAL NUMBER D2201632EE
US SAVINGS BOND $1,000.00 DENOMINATION
ISSUE DATE 8/1980
SERIAL NUMBER M1030934EE
US SAVINGS BOND $1,000,00 DENOMINATION
ISSUE DATE 7/1982
SERIAL NUMBER M368/1959EE
US SAVINGS BOND $500.00 DENOMINATION
SERIAL NUMBER D2243393EE
ISSUE DATE 9/1982
Value
1,306,80
1,320,00
1,294,00
2,588.00
2,098.00
,'n .,.... "J-,:w"n"
~,'" \..,J,' I( . .:J~ 'Ij ..;;
ll:iilCJ::l S,NV1rl 80
~O >It!31
1,049.00
(Attach Additional Sheets if necessary)
Total
'10 :~I I~d S I 1 nCOl
73,941.62
NOTE: The Memorandum of real estate outside the Commonwealth of pe~h$y!y""l~ l11aM:~'lhll.~lection of the personal representative,
include the value of each item, but such figures should not be extendedinlp~t?~ qt;Q~~J!}\(~\Y.
.,J'J .J\;uJU ..}\JdUJ:Jti
RW-4
:}I
Continuation of Inventory
ANGELA PASKEY
21
04
0803
Page 1
Description of Inventory
Description
US SAVINGS BOND $1,000.00 DENOMINATION
ISSUE DATE 9/1982
SERIAL NUMBER M3927117EE
US SAVINGS BOND $500,00 DENOMINATION
ISSUE DATE 11/1982
SERIAL NUMBER D2243399EE
US SAVINGS BOND $500,00 DENOMINATION
ISSUE DATE 2/1983
SERIAL NUMBER D2707077EE
US SAVINGS BOND $500.00 DENOMINATION
ISSUE DATE 3/1983
SERIAL NUMBER D2707091 EE
US SAVINGS BOND $1,000.00 DENOMINATION
ISSUE DATE 3/1984
SERIAL NUMBER M6249307EE
US SAVINGS BOND $500.00 DENOMINATION
ISSUE DATE 4/1985
SERIAL NUMBER D7600411 EE
US SAVINGS BOND $200.00 DENOMINATION
ISSUE DATE 5/1986
SERIAL NUMBER R28783199EE
US SAVINGS BOND $200.00 DENOMINATION
ISSUE DATE 3/1987
SERIAL NUMB ER R37278964EE
US SAVINGS BOND $500.00 DENOMINATION
ISSUE DATE 5/1987
SERIAL NUMBER D15573435EE
US SAVINGS BOND $100.00 DENOMINATION
ISSUE DATE 11/1975
SERIAL NUMBER C2009413902E
US SAVINGS BOND $100.00 DENOMINATION
ISSUE DATE 11/1975
SERIAL NUMBER C2009413903E
US SAVINGS BOND $100.00 DENOMINATION
ISSUE DATE 3/1976
SERIAL NUMBER C2013171821E
US SAVINGS BOND $100,00 DENOMINATION
ISSUE DATE 9/1976
SERIAL NUMBER C2013171820E
US SAVINGS BOND $500,00 DENOMINATION
ISSUE DATE 10/1975
SERIAL NUMBER D105332741E
Value
2,098.00
1,001.00
981 .40
895,80
1,624.80
746.00
286,80
248.24
619.60
506.80
506,80
498.00
498.00
2,509.40
Subtotal $
13,020,64
.,
Continuation of Inventory
ANGELA PASKEY
21
04
0803
PaQe 2
Description of Inventory
Description
US SAVINGS BOND $500.00 DENOMINATION
ISSUE DATE 2/1976
SERIAL NUMBER D200281350E
US SAVINGS BOND $500,00 DENOMINATION
ISSUE DATE 3/1976
SERIAL NUMBER D201723041 E
US SAVINGS BOND $500.00 DENOMINATION
ISSUE DATE 8/1976
SERIAL NUMBER D202534729E
US SAVINGS BOND $500.00 DENOMINATION
ISSUE DATE 6/1977
SERIAL NUMBER D204270730E
US SAVINGS BOND $500,00 DENOMINATION
ISSUE DATE 5/1978
SERIAL NUMBER D206299788E
US SAVINGS BOND $500.00 DENOMINATION
ISSUE DATE 5/1978
SERIAL NUMBER D206299787E
US SAVINGS BOND $500.00 DENOMINATION
ISSUE DATE 9/1979
SERIAL NUMBER D208641561E
US SAVINGS BOND $500.00 DENOMINATION
ISSUE DATE 10/1979
SERIAL NUMBER D208641573E
US SAVINGS BOND $500,00 DENOMINATION
ISSUE DATE 11/1979
SERIAL NUMBER D208641582E
US SAVINGS BOND $500.00 DENOMINATION
ISSUE DATE 12/1979
SERIAL NUMBER D208641591E
LEGACY BANK - WILLlAMSPORT, PA
CERTIFICATE OF DEPOSIT - OPENED ON 4/29/04
ACCOUNT NO. 430000489
LEGACY BANK - WILLIAMS PORT, PA
CERTIFICATE OF DEPOSIT - OPENED ON 9/21/96
ACCOUNT NO. 430001222
LEGACY BANK - WILLlAMSPORT, PA
CERTIFICATE OF DEPOSIT - OPENED 12/29/96
ACCOUNT NO. 430001966
LEGACY BANK - WILLlAMSPORT, PA
CERTIFICATE OF DEPOSIT - OPENED 4/16/97
ACCOUNT NO. 430003228
Value
2,490,00
2,490.00
2,469.40
2,481,00
1,821.00
1,821.00
1,762.80
1,762.80
1,779.40
1,779.40
1,479.52
1,015.97
1,009,71
1,012.19
Subtot.1 $
25,174,19
.
Continuation of Inventory
ANGELA PASKEY
21
04
0803
Page 3
Description of Inventory
Description
LEGACY BANK - WILLlAMSPORT, PA
CERTIFICATE OF DEPOSIT - OPENED ON 4/22/98
ACCOUNT NO. 430007476
LEGACY BANK - WILLlAMSPORT, PA
CERTIFICATE OF DEPOSIT - OPENED ON 5/6/82
ACCOUNT NO 430018408
LEGACY BANK - WILLlAMSPORT, PA
CERTIFICATE OF DEPOSIT - OPENED ON 5/20/82
ACCOUNT NO, 430018416
LEGACY BANK - WILLlAMSPORT, P A
CERTIFICATE OF DEPOSIT - OPENED ON 10/15/82
ACCOUNT NO. 430018879
LEGACY BANK - WILLlAMSPORT, PA
CERTIFICATE OF DEPOSIT - OPENED ON 3/25/91
ACCOUNT NO. 430024265
LEGACY BANK - WILLlAMSPORT, PA
CERTIFICATE OF DEPOSIT - OPENED ON 2/7/00
ACCOUNT NO. 431002856
LEGACY BANK - WILLlAMSPORT, PA
CERTIFICATE OF DEPOSIT - OPENED ON 5/10/00
ACCOUNT NO. 431011394
PENN-NATIONAL ABSTRACT SERVICES, INC.
REFUND OF WATER BILL FROM REAL ESTATE SETTLEMENT
Value
1,007.53
2,031.85
1,015,94
2,035,00
505.46
2,017.32
1,016.70
37.54
POTTSVILLE REPUBLICAN, INC,
NEWSPAPER SUBSCRIPTION REFUND
52.89
ROYAL & SUNALLlANCE
HOMEOWNERS INSURANCE REFUND
189,91
LEGAC Y BANK CHECKING ACCOUNT
ACCOUNT NO. 541012269
JOINTLY OWNED (6070.73)
FIRST FEDERAL BANK
CERTIFICATE OF DEPOSIT NO, 727004174
JOINTLY OWNED (501,56)
FIRST FEDERAL BANK
CERTIFICATE OF DEPOSIT NO. 0327015743
JOINTLY OWNED (604.46)
FIRST FEDERAL BANK
CERTIFICATE OF DEPOSIT NO. 332011568
JOINTLY OWNED (2651.70)
3,035.37
250.78
300.73
1,325.85
Subtotal $
14,822,87
.,
Continuation of Inventory
ANGELA PASKEY
21
04
0803
Page 4
Description of Inventory
Description
Value
FIRST FEDERAL BANK
CERTIFICATE OF DEPOSIT NO. 331012632
JOINTLY OWNED (669.96)
FIRST FEDERAL BANK
CERTIFICATE OF DEPOSIT NO. 0327017903
JOINTLY OWNED (667.60)
FIRST FEDERAL BANK
CERTIFICATE OF DEPOSIT NO. 327016263
JOINTLY OWNED (3073.67)
KEYSTONE NAZARETH BANK & TRUST
CERTIFICATE OF DEPOSIT ACCT. NO. 334010551
JOINTLY OWNED (10101.88)
KEYSTONE NAZARETH BANK & TRUST
CERTIFICATE OF DEPOSIT ACCT. NO. 727004174
JOINTLY OWNED (501.77)
UBERTY US GOV MONEY MARKET FUND
FEDERATED ACCT, 2/11253701
JOINTLY OWNED (898.67)
TAX FREE INSTRUMENTS TRUST SHARES
FEDERATED ACCOUNT NO 342/11253701
2190 SHARES JOINTLY OWNED (2191.02)
FEDERATED MUNICIPAL SECCURITIES FUND
ACCOUNT NO. 358/11253701
423.539 SHARES JOINTLY OWNED (4431,63)
334.98
333,80
1,536,84
5,050,94
250.89
449.34
1,095.51
2,215.82
Subtotal
$
11,268,12
73,941.62
Grand Total $
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT,280601
HARRISBURG. PA 17128-0601
REV-1162 EX111-961
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
MA TEY A MARK A
PO BOX 127
BOILING SPRINGS, PA 17007
_____u_ fold
ESTATE INFORMATION: SSN: 181-03-1658
FILE NUMBER: 2104-0803
DECEDENT NAME: PASKEY ANGELA
DATE OF PAYMENT: 07/15/2005
POSTMARK DATE: 07/1 5/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 06/19/2004
NO. CD 005580
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $407.81
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: MARK A MATEYA
CHECK# 114
SEAL
INITIALS: SK
RECEIVED BY:
REGISTER OF WILLS
$407.81
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRIS8URG, PA 17128-0601
REV-1162 EX(1'-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 005800
MA TEY A MARK A
PO BOX 127
BOILING SPRINGS, PA 17007
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
-------- fold ---------- --------
101 I $6.59
ESTATE INFORMATION: SSN: 181-03-1658 I
FILE NUMBER: 2104-0803 I
DECEDENT NAME: PASKEY ANGELA I
DATE OF PAYMENT: 09/16/2005 I
POSTMARK DATE: 09/16/2005 I
COUNTY: CUMBERLAND I
DATE OF DEATH: 06/19/2004 I
I
TOTAL AMOUNT PAID: $6.59
REMARKS:
MARK MATEY A
CHECK# 115
INITIALS: RSK
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WillS
REGISTER OF WILLS
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.
BUREAU OF INDIVIDUAL TAXES-,,' (,~,CCrc
INHERITANCE TAX DIVISION' " ,I
PO BOX 280601 ' "
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
,....-A'PP-RA'fSEI1ENT, ALLOWANCE OR DISALLOWANCE
"'OF:,.pEDUCTIONS AND ASSESSI1ENT OF TAX
REV.1547 EX AFP (06-05)
09-19-2005
PASKEY
06-19-2004
21 04-0803
CUMBERLAND
101
APPEAL DATE: 11-18-2005
( See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
~Y!_~~~~~_!~!~-~!~~------~---~~!~!~-~~~~~-~g~!!g~-~g~-yg~~_~~~g~~~__~____________________
REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ANGELA FILE NO. 21 04-0803 ACN 101 DATE 09-19-2005
TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE
I..'
f" ( '~', ! ~-:
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
ANGELA
MARK A MATEYA
PO BOX 127
BOILING SPGS
',"
~SQ
PA 17007
ESTATE OF
PASKEY
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN
1. Real Estete (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Stock/Partnership Interest (Schedule C) (3)
4. 110rtgages/Notes Receivable (Schedule D) (4)
5. Cash/Bank Deposits/l1isc. Personal Property (Schedule E) (5)
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
NO. 01
.00
.00
.00
.00
.00
9,062.50
.00
(8)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax pay..ent.
9,062.50
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Ad... Costs/l1isc. Expenses (Schedule H) (9)
10. Debts/l1ortgage Liabilities/Liens (Schedule I) (10)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Govern..ental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
.00
.00
(11)
(12)
(13)
(14)
no
9,062.50
.00
58,560.20
NOTE: IT an assessment was issued previously. lines 14. 15 and/or 16. 17. 18 and 19 will
reTlect Tigures that include the total oT ALL returns assessed to date.
ASSESSMENT OF TAX:
15. A..ount of Line 14 at Spousal rate (15)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
17. A..ount of Line 14 at Sibling rate (17)
18. A..ount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
.00 X 00 = .00
58,560.20 X 045 = 2,635.21
.00 X 12 = .00
.00 X 15 = .00
(19)= 2,635.21
TAX CR!;:DITS:
n....."". "".."..r, {+J AI10UNT PAID
DATE NUI1BER INTEREST/PEN PAID (-)
09 09 2004 CD004358 84.21 1,600.00
11-23-2004 CD004660 .00 543.19
07-15-2005 CD005580 .00 407.81
BALANCE OF UNPAID INTEREST/PENALTY AS OF 07-16-2005 TOTAL TAX CREDIT 2,635.21
BALANCE OF TAX DUE .00
INTEREST AND PEN. 6.59
TOTAL DUE 6.59
· IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYI1ENT IS REQUIRED. nJ'
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU I1AY BE DU~<\I'oo
A REFUND. SEE REVERSE SIDE OF THIS FORI1 FOR INSTRUCTIONS.)
REV-1470 EX (6-88)
.
INHERITANCE TAX
EXPLANATION
OF CHANGES
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
PO Box 280601
HARRISBURG PA 17128-0601
DECEDENTS NAME
ANGELA PASKEY
REVIEWED BY
John Kealy
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
F 8 - 12 Accepted additional assets.
ROW
FILE NUMBER
ACN
2104-0803
101
Page 1
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 171~-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
c. .-~_, '_.,_I!"\~ '"'_:-"
. <STA'TEMENT OF ACCOUNT
;"-" ....'..-'.".-', 1"""':
REV-1607 EX AFP (03-05)
r~, , , 9
,. !
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
09-26-2005
PASKEY
06-19-2004
21 04-0803
CUMBERLAND
101
ANGELA
MARK A MATEYA ESQ
PO BOX 127
BOILING SPGS PA 17007
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE
--to
RETAIN LOWER PORTION FOR YOUR RECORDS
+-
---------------------------------------------------------------------------
REV-1607 EX AFP (03-05)
*** INHERITANCE TAX STATEMENT OF ACCOUNT ...
ESTATE OF PASKEY ANGELA FILE NO.21 04-0803 ACN 101 DATE 09-26-2005
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 09-19-2005
PRINCIPAL TAX DUE: 2,635.21
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
09-09-2004 CD004358 84.21 1,600.00
11-23-2004 CD004660 .00 543.19
07-15-2005 CDOO5580 .00 407.81
09-16-2005 CDOO5800 6.59- 6.59
TOTAL TAX CREDIT 2,635.21
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
. IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
elf^-
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 4/25/2006
MATEYA MARK A
PO BOX 127
BOILING SPRINGS, PA 17007
RE: Estate of PASKEY ANGELA
File Number: 2004-00803
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6.12 is due on the below listed
date.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103
SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
rhis filing is due by:
6/19/2006
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
~~~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
:::c: File
Personal Representative(s)
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 4/25/2006
PASKEY WALTER J
112 FOURTH STREET
BOILING SPRINGS, PA 17007
RE: Estate of PASKEY ANGELA
File Number: 2004-00803
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6.12 is due on the below listed
date.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103
SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after
July I, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by:
6/19/2006
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
~~~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
STATUS REPORT UNDER RULE 6.12
Name of Decedent: ANGELA PASKEY
Date of Death: 6/19/2004
Will No .
Admin. No. 21-04-0803
Pursuant to Rule 6. 12 of the Supreme Court Orphans I
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 No X
2 . If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3 . If the answer to No. I is Yes, state the following:
a.
account with the Court?
Did the personal representative file a final
Yes No
b . The separate Orphans I Court No. (if any) for
the personal representative I s account is :
c . Did the personal representative state an
account informally to the parties in interest? Yes No
d . Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Clerk of the Orphans I Court and may be attached to this report. .--.--
I ,---
V~~ W~
.......-
Signature n
Date: 5/23/2006
MARK A. MATEYA. ESQUIRE
Name (Please type or print)
P.O. BOX 127
BOILING SPRINGS PA 17007
Address
(717) 2416500
Tel. No .
Capacity :
Personal Representative
X
Counsel for personal
representative
. .
/~ 'f ._
I.,. ~..
'~:.... .
',-
'~
~\~j
Cumberland County - .Kegls"Cer V.L VV..lJ..J..o
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 6/08/2007
PASKEY WALTER J
112 FOURTH STREET
BOILING SPRINGS, PA 17007
c
r'-L,,_--.
RE: Estate of PASKEY ANGELA
File Number: 2004-00803
"'::
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6.12 is due on the below listed
date.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103
SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after
July I, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by:
6/19/2007
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
I~, V .~.b- .(/
!~~~) ./..
. (
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
Cumberland County - Reglster ur Wl~~b
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 6/08/2007
Q
~,
""..1.
MATEYA MARK A
PO BOX 127
l '..."
BOILING SPRINGS, PA 17007
\,."!~
RE: Estate of PASKEY ANGELA
File Number: 2004-00803
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6.12 is due on the below listed
date.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103
SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
wills a Status Report of completed or uncompleted administration.
This filing is due by:
6/19/2007
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
.I . . . /J
~~J~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Personal Representative(s)
Pa. O.t. Rule 6.12 STATUS REPORT
REGISTER OF WILLS OF c: ~V"\13~({ l^-~O
COUNTY, PENNSYLVANIA
Name of Decedent:
~ '" L-T~tt.
(5~s/C-c-Y
Date of Death:
1,\ ~ \J,.J'-<- ~~ Y
File Number:
~ o~V - 00'(01
pursuant to Pa. O.C. Rule 6.12, 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: . . . . . . . . . . . . . . . . . . ., ~s DNo
2. If the answel-is No, state when the personal representative
reasonably believes that the adririnistration will be complete:
3. If the answer to No.1 is YES, state the following:
a. Did the personal representative file a finaf account wi1l1 the Court? . . . . . .. rn-fes DNa
b. The separate Orphans' Court No. (if any) for the personal
representative's account is:
c. ~~ the lPlersonhal repr~se~ta~ve sta~e an account , -:-,' ,/ res D.i No
ll1.1.0ID1a y to t e pames mmterest! ..............,................ ffie~
d. 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 attached to this repOlt.
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Form R IV.! 0 rev j 013.06
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STATUS REPORT UNDER RULE 6.12
Name of Decedent: ANGELA PASKEY'
Date of Death: 6/19/2004
Will No.
Admin. No. 2004-00803
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
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3 . If the answer to No. I is Yes, state the following:
a.
account with the Court?
Did the personal representative file a final
Yes No X
b . The separate Orphans' Court No. (if any) for
the personal representative's account is:
c . Did the personal representative state an
account informally to the parties in interest? Yes X No
t d... 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 at1acbed to\tbio\~ .
Date: 6/1912007 1~.& (,~
Signature . J
MARK A. MATEYA. ESQUIRE
Name (Please type or print)
PO BOX 127
BOILING SPRINGS PA 17007
Address
(717 ) 241-6500
Tel. No .
Capacity :
Personal Representative
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Counsel for personal
representative
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