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HomeMy WebLinkAbout12-21-11COMMONWEALTH OF PENNSYLVANIA - - -- DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL. TAXES REV-1162 EX(11-96) DEPT. 280601 HARRISBURG, PA 1712£-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 015374 COX DAVID C 509 JOYCE RD CAMP HILL, PA 1701 1 ACN ASSESSMENT AMOUNT CONTROL '----- fold NUMBER ESTATE INFORMATION: FILE NUMBER: DECEDENT NAME: DATE OF PAYMENT: POSTMARK DATE: COUNTY: DATE OF DEATH: SSN: 045-16-4423 2111-0639 COX J FREDERIC II 12/21/2011 12/20/201 1 CUMBERLAND 05/17/2011 TOTAL AMOUNT PAID: :EMARKS: RECEIPT TO ATTY CHECK# 3143 INITIALS: HEA SEAL RECEIVED BY: $180.41 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS HAZ~v ELDER Law 2000 I.invlr~~+.,,.... o__ Suite 202 Harrisburg, PA 17110 Estate Planning • Elder Law • ,s pedal Needs Planning 'rE-.: (71'~ 540-4332 rax: (717) 540-4313 ~+vww.HazenElderLaw. com December 19, 2011 CERTIFIED MAIL ,~. , ~? -M . Register of Wills ~~ ~ ~ Cwnberland County Courthouse _ ~~~? :- One Courthouse Square _:T~ ~,,, ~. ~ -.... __ Carlisle, PA 17013-3387 "~ ~~;~ Re: Estate of J Frederic Cox II ~' ~ T~ ~ ,r, ~ • a File No.: 2011-00639 n c~~ ct -;-, SSN: 045-16-4423 Inheritance Tax Ret urn To: The Register of Will s: Enclosed for filing please find the original and one copy of the above-ref Inheritance Tax Return and Invento erenced Inheritance Tax Return. Please date stamp lthe first page of the ret he f rst page of the Inventory and return them to my off ce in the enclosed self-addressed end ed a co py of the lope. Also enclosed are two checks, one for the filing fee in the amount of $30. one for the tax due in the amount of $180.41. 00 and If you have any questions or require any additional information, leas hesitate to contact me. P e do not Sincerely, ~s~..' . ~ ~~,., w~A>,e Corinne Eggers Woodhouse Paralegal Enclosures cc: David Cox INVENTORY REGISTER OF WILLS OF COMMONWEALTH OF PENNSYLVANIA } COUNTY OF Cumberland } SS David C. Cox Personal Representative(s) of the Estate of J. Frederic Attorney - (Name) (Firm) (Address) (Telephone) DATE OF DEATH 05/17/2011 PA 17110 FIGURES MUST BE TOTALED Personal Prooert f Cash .................................................................... ........................... ersonal Property ........................................................................ Stocks/Listed ............................... ................................................. Stocks/Closely Held ..................................................................... Bonds .................. ...................... .......................................... Partnershi s """"" p and Sole Proprietorships ..................................... Mortgages and Notes Receivable ............................................... All Other Property ........................................................................ Total Personal Property ........................................ Total Real Property ............................................ Total Personal and Real Property ........................ 0.96 n q~, '> 6,.tI90.00 4 O «.. .~.~ ~ ..t -} --~ ~ t~.Y> - - _; r-, ;.~ ....~,-= ~ 5 it ~ - r .. -r, 6,690.96 365, 000.00 ~371,69U.913 Marielile F Hazen, Hazen Elder Law deceased, depose(s) and say(s) 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 of the Commonwealth of Pennsylvania except that which appears in a m orandum at th end of this inventory. I verify that the statements made in this Inven- t tory are true and correct. I understand that false state- J ~ ' ments herein are made subject to the penalties of David C. Cox 18 Pa.C.S. § 4904 relating to unswom falsification to J authorities. (Supreme Courtl.D. No.) 68003 CUMBERLAND _ COUNTY, PENNSYLVANIA File Number 21-11-00639 717-5410-4332 Ha LOST RESIDENCE 610 Gale Rd DECEDENTS SOC. SEC. NO. 045-16-4423 NOTE: The Memorandum of real estate outside the Commo item, but such figures should not be extended into the~totaltof theenventoania may, at the election of the ry. (See 20 Pa. C.S. § 3301(b))~~onal representative include the value of each Form RW-09 Re~.~o-~3-zoos INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA } COUNTY OF Cumberland } SS File Number 21-11-00639 DATE OF DEATH LAST RESIDENCE 05/17/2011 610 Gale Rd DECEDENTS SOC. SEC. NO. Cam Hill PA 17011 045-16-4423 ~b Pentagon Federal CU -Reg. Acct. #876753-01-3 0.96 Total Cash --_. 0.96 ~I Pron rt • Vehicle - 2002 Buick Park Avenue -attached Kelley Blue Book valuation 6,690.00 Total Personal Property -~ 6,690.00 Real ctata Real Estate -103 Little Run Rd., Camp Hill, PA -see attached appraisal. 50,000.00 Real Estate - 610 Gale Rd. ,Camp Hill, PA -see attached appraisal. 315,000.00 Total Real Estate 365,000.00 -- • • ,.....,.~.,~ ~a~ sleets it necessary) Total Personal Property and Real Estate 371,690.96 0- y ~ .- ~ 3 O ~ ~.~ ~., ~ ~ a v~ W i ~ .- C., - . r I a ~ W V ~y ,,,,,((p 1.. d~ ;.i.' '~~y ~i.~ .~~ 1 i}t . . . f y ~ ~~ ~ O ~ O a' ~ o~^0 0 w ~ ~~ii ~] C ~i 1 ~ ~ k..'v ~ ~ ~t~i ~ i ~ J V ru t 0 sv7.~'1~ O O ~ 'J~~~ (\ (...~T i C~~PHh~,~``~ , J..i~T j''~1 ' Cl ~~~~~~ ~f t'.1 l~~~ ~ ('} ~~H .~ ul N u'1 m a 0 0 O ~ N o N a„ o- O ~ ~ '~ ~ ~ ~ ~ ~ o ~ ° a ~ ~ !-, M ,~ U ~ ,-~ --~ °" o "L? ~'M ~ ti-,~ ~~