HomeMy WebLinkAbout03-1045JOHN E. SLIKE
ROBERT C. SAIDIS
GEOFFREY S. SHUFF
JAMES D. FLOWER, JR.
CAROL J. LINDSAY
MATTHEW J. ESHELMAN
KIRK S. SOHONAGE
THOMAS E. FLOWER
LINDSAY GINGRICH MACLAY
JACLYN SMITH
LAW OFFICES
SAIDIS, SHUFF, FLOWER & LINDSAY
A PROFESSIONAL CORPORATION
2109 MARKET STREET
CAMP HILL, PENNSYLVANIA 17011
TELEPHONE: (717) 737-3405 - FACSIMILE: (717) 737-3407
EMAIL: attorney@ssfl-law.com
December 18, 2003
OF COUNSEL
ALBERT H. MASLAND
CARLISLE OFFICE:
26 WEST HIGH STREET
CARLISLE, PA 17013
TELEPHONE: (717)243-6222
FACSIMILE: (717)243-6486
REPLY TO CAMP HILL
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
Re-'
Mary Ann Schooley, deceased
Dear Ladies:
Enclosed please find an original and two copies of an Inheritance Tax Return for the
above decedent. An estate was not raised since we are reporting joint assets only. However, an
Estate Information Sheet is provided so that a file number may be assigned. Also enclosed are
two checks for the filing fee and the balance of tax due. Please return a time-stamped copy of
the return in the envelope provided. Thank you.
Very truly yours,
SAI/D~S, SHUF~F, FLOWER & LINDSAY
/Shelby L./Ying~/n~?~ate Paralegal
/sly
Enclosures
R~-V-1500 EX + (6-00)
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
COUNTY CODE YEAR NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Schooley Nary Ann
DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR)
0 ~/'~I~ 03 I 09/04/1906
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
201-18-5933
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
Odginal Retum 2.
Limited Estate 4a.
Decedent Died Testate 7.
(Attach copy of Will)
Litigation Proceeds Received ~ 1 0.
Supplemental Return I I 3.
~F~l~n~,~l:,~ Compromise (date of death after 12-12- 2)8~ 5.
Beqeb~dt Maintained a Living Trust 0 8.
~py ~ Trust)
Spousal Povedy Credit ~ 11.
~f death b~w~n 12-31-91 and 1-1-95)
NAME
John E. Slike
FIRM NAME (If Applicable)
Saidis, Shuff, Flower & Lindsay
TELEPHONE NUMBER
717./737- 3405
Remainder Return (pdda
Federal Estate Tax Return
Total Number of Safe Depo
i to tax under Sec
(At~a~'r{ Sch O)
COMPLETE MAILING ADDRESS
2109 Market St.
Camp Hill, PA 17011
1 Real Estate (Schedule A) (1)
2Stocks and Bonds (Schedule B) (2)
3Closely Held Corporation, Partnership or (3)
Sole-Proprietorship
4Mortgages & Notes Receivable (Schedule D) (4)
5Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6Jointly Owned Property (Schedule F) (6)
r---~eparate Billing Requested
7Jnter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8.Total Gross Assets (total Lines 1-7)
9Funeral Expenses & Administrative Costs (Schedule H) (9)
103ebts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11Total Deductions (total Lines 9 & 10)
l~let Value of Estate (Line 8 minus Line 11)
None
None
None
None
1,937.60
128,744.82
None
8,052.00
13Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
1,~let Value Subject to Tax (Line 12 minus Line 13)
858.77
OFFICIAL USE ONLY
(8) 130,682.42
(11) 8,910.77
(lZ) 121,771.65
(13)
(14) 121,771.65
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
1.~mount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(a)(1.2)
16{kmount of Line 14 taxable at lineal rate
17Amount of Line 14 taxable at sibling rate
18~.mount of Line 14 taxable at collateral rate
X .0 0 (15) 0.00
121,771.65 X .0 45 (16) 5,479.72
X .12 (17) 0.00
X .15 (18). O. O0
19rax Due (19) 5,479.72
~i ~;~:-'~ ~"'~ "~:'~; '~"'~"~'~".i~'=~= "~'~ ...... ' i~'~: '. ,: ~ ........... ' ........ ~'~ ~' ......... .,~ .... ,'.' · ""~' ................ ~-.= .~-=,..
Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-rS00 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
325 Wesley Drive
STATE IPA ZIP
Mechanicsbur~
Tax Payments and Credits:
1.Tax Due (Page I Line 19)
2Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
17055
Total Credits ( A + B + C ) (2)
5,479.72
3Jnterest/Penalty if applicable D. Interest
E. Penalty
Total Interest/Penalty ( D + E ) (3)
4Jf Line 2 is greater than Line I + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to recluest a refund (4)
5Jf Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. ($B)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING GUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1Did decedent make a transfer and: Yes No
;. retain the use or income of the property transferred; ......................... ~ ~
· retain the right to designate who shall use the property transferred or its income; ...........
c. retain a reversionary interest; or ....................................
d. receive the promise for life of either payments, benefits or care? ...................
2[f death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ................................ ~ ~
3Did decedent own an "in trust for" or payable upon death bank account or security at his
or her death? .............................................. r-'-] ~]
4Did decedent own an Individual Retirement Account, annuity, or other non-probate property
which contains a beneficiary designation? ................................ [~ ~]
IF THE ANSWER TO ANY OF THE ABOVE GUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
0.00
0.00
0.00
5,479.72
0.00
5,479.72
Under penalties of perju~/, I declare that I have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true,
correct and complete. Declaration of preparer other than the pemonal representative is based on all infon~ation of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FO~ FILING RETURN Arthur T. Schoole¥
Akron, OH 44313 ..................... /~-/~ ~0 ~
SIGN URE OF PREPARER OmER THAN REPRESENTATIVE Saidis, Shuff, Flower & Lindsay
,~.~,' ~ /' ,~ '~ 2109 Market St. / /
For dates ~eam on or after July 1, 1994 and before Janua~ 1, 1995, the ~ rate im~s~ on the net value of transfers to or for the use of'Me
suwiving ~use is 3% ~2 P.S. 9116 (a) (1.1) (i)].
For dates of death on or after Janua~ 1, 1~5, the t~ rate im~s~ on the net value of transfers to or for the use of the sullying s~use is 0%
[72 P.S. 9116 (a) (1.1} (ii)]. The s~tute do~ not exempt a transfer to a su~iving s~use from t~, and the statuto~ r~uirements for disclosure of asse~
and filing a ~ retum are still applicable even if the su~iving s~use is the only beneficial.
For dates of death on or after July 1, 2000:
The ~x rate im~s~ on the net value of transfers from a d~eased child ~en~-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. 9116 (a) (1.2)].
~e ~x rate im~s~ on ~e net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as not~ in 72 P.S. 9116(1.2)
[72 P.S. 9116(a)(1)].
The tax rate im~s~ on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(a)(1.3)]. A sibling is defined, under
Section 9102, as an individual who has at least one parent in common with the dec~ent, whether by blood or adoption.
Copyright (c) 2000 fo~ software only The Lackner Group, Inc. Fo~ REV- 1500 EX (Rev. 6-00)
· REV-1508 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mary Ann Schooley SS~/
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPER'rY
FILE NUMBER
201 - 18- 5933 09/26/2003
Include the proceeds of litigation and the date theproceeds were received by the estate. All property jointly-owned with the right of
survivorsh,p must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
Bethany Village, refund
PA State Retirement, month of Sept.
State and Federal 2003 income tax refunds expected
VALUE AT DATE
OF DEATH
945.00
858.60
134.00
TOTAL (Also enter on line
$ 1,937.60
(If more space is needed, insert additional sheets of the same size)
Copyright (C) 1996 form software only CPSystems, Inc. Form REV-1508 EX (Rev. 1-97)
RE9-1509 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mary Ann Schooley SS~/
SCHEDULE F
JOINTLY-OWNED PROPERTY
201-18-5933 09/26/2003
FILE NUMBER
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. Arthur T. Schooley son
2015 Burlington Rd.
Akron, OH 44313
JOINTLY-OWNED PROPERTY:
LE'I-rER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
ITEM FOR JOINT MADE Include name of financial institution and bani DATE OF DEATH DECD'S VALUE OF
account number or similar identifying numbe
NUMBEF TENANT JOINT Attach deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTERE~
1 A / /93 Charles Schwab Acct.
~/7900-2997 257,489.64 50.00% 128,744.82
(see attached for details
of assets contained in the
ac count )
TOTAL (Also enter on line 6, Recapitulation) $ 128,744.82
(If more space is needed insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1509 EX (Rev. 1-97)
.RE9-1511 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mary Ann Schooley SS~/
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
201-18-5933 09/26/2003
FILE NUMBER
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
Bo
5.
6.
7.
DESCRIPTION
:UNERALEXPENSES:
Funeral Myers Harner Funeral Home
Rolling Green Cemetery
~DMINISTRATIVE COSTS:
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:
A~omey's Fees Saidis, Shuff, Flower & Lindsay
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
Probate Fees
Accountant's Fees
Tax Return Preparer's Fees
Other Administrative Costs
State Zip
TOTAL (Also enter on line 9, Recapitulation)
AMOUNT
6,682.00
870.00
500.00
8,052.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97)
· REV-1512 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mary Ann Schooley
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, AND LIENS
SS# 201-18-5933 09/26/2003
FILE NUMBER
Include unreimbursed medical expenses.
ITEM
NUMBER
1
2
3
4
DESCRIPTION
Alert Pharmacy
Alert Pharmacy
Verizon Telephone
Refund of social security dep.
to Schwab acct.
TOTAL (Also enter on line 10, Recapitulation)
AMOUNT
63.73
18.30
9.74
767.00
858.77
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV- 1512 EX (Rev. 1-97)
.RE9-1513 EX + (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mary Ann Schooley SS~/
201-18-5933
SCHEDULE J
BENEFICIARIES
09/26/2003
FILE NUMBER
NUMBER
II.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
tAXABLE DISTRIBUTIONS [include outfight spousal dist~b~ions, and
tmnsfe~ under Sec, 9116~)(1.2)]
Arthur T. Schooley
2015 Burlington Rd.
Akron, OH 44313
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
s on
AMOUNT OR SHARE
OF ESTATE
jt. owner of
Chas. Schwab
acct.
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 181 AS APPROPRIATEl ON REV 1500 COVER SHEET
dON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
I, CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-00)
LAST WILL AND TESTAMENT
OF
MARY ANN SCHOOLEY
I, MARY ANN SCHOOLEY of Lower Allen Township, Cumberland
County, Pennsylvania, declare this to be my Last Will and Testa-
ment, hereby revoking any will previously made by me.
I - I direct the payment of all my just debts and
funeral expenses out of my estate as soon as may be practical
after my death.
II - I devise and bequeath all of my estate of whatever
nature and wherever situate unto my son, Arthur T. Schooley.
III - Should my said son predecease me, then I direct
that said estate shall be distributed in four equal shares among
my son's wife, Dorothy Jean Schooley, and my grandchildren, the
.share of any deceased grandchild to be distributed to his or her
issue.
~I/)IS, GUIDO,
SHUFF &
MASLAND
109 Market Street
Camp Hill, PA
IV - I appoint my son, Arthur T. Schooley, Executor of
this, my Last Will and Testament. Should my said son fail to
qualify or cease to act as such, then I appoint Dorothy Jean
Schooley to act in this capacity. Neither of my personal repre-
sentatives shall be required to post bond in this or any juris-
diction.
Page 1
COMMONWEALTH OF PENNSYLVANIA)
COUNTY OF CUMBERLAND )
SS.
WE, the undersigned, the testatrix and the witnesses,
respectively, whose names are signed to the foregoing instru-
ment, being first duly sworn, do hereby declare to the under-
signed authority that the testatrix signed and executed the
instrument as her Last Will and Testament and that she signed
willingly (or willingly directed another to sign for her), and
that she executed it as her free will and voluntary act for the
purposes therein expressed, and that each of the witnesses, in
the presence and hearing of the testatrix signed the will as
witnesses and that to the best of their knowledge the testatrix
was at that time eighteen years of age or older, of sound mind,
and under no constraint or undue influence.
Witness
itn~
kID/S, GUIDO,
SHUFF &
MASLAND
lO9 Market Street
Camp Hill, PA
Subscribed, sworn to and acknowledged before me by the
testatrix, and subscribed and sw~ to--me by both wit-
nesses, this /~A~ day of /~.~c~-~ .....
', 1994 .
otary Public
IN WITNESS WHEREOF, I have hereunto set my hand and seal on
this, the {~ day of %~~~. , 1994.
a~_~ ~ ~~~ (SEAL)
M~ry Ann Schooley
Signed, sealed, published and declared by MAR~ ANN SCHOOLE¥,
Testatrix therein named, on this and one (1) other sheet of paper
as and for her Last Will and Testament, in our presence, who, in
her presence, at her request, and in the presence of each other,
have hereunto subscribed our names as attesting witnesses.
Nam~v ~ /Address !
......
'Addres~
Name
~IDIS, GUIDO,
SHUFF &
MASLAND
!109 Market Street
Camp Hill, PA
Page 2
Charles Schwab -- Account Overview
Welcome to Charies Sc wvsb
Quotes &
Research
Advice
Nish.}ry 'TransfeFs '-* PaVments eStatements
Seamh
Page 1 of 1
Account Information
Securities Market Value
Total Cash
Total Account Value
Det~iJs
$217,697.79
$39,791.85
$257,489.64
What to do when rates rise.
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Select Account
Customize Pag~.H~lp._
Indices (Delayed)
Last Change
.S__c..h_w._a_~_J__0.0_0_ 3,202.56 -21.91
.D~_.!.od_u_~_tri~.a] 9,313.08 ~30.88
._NA._S_._D~. 1,792.07 --2517
Advance Decline
....N_Y...8_E__..A...¢_~LD_¢_c_ + 1,203 -2,019
..N.?.S~_E ..V.91_u_m.._e 1,434,893,568 shares
Account I ~r.~¢.~. I _Q...u..o..t..e.s_...&R_..e.~.e_a_r..c.b I .PJa....n...nj_ng._&_Ad__v..¢.e_ I Erpd__u_9_ts_.&__S_e._rvi_c_e_s
[ .~_etu.r.n.!q..!.gp.. ]
Account 7900-2997 MOTHER
Viewed as
https'//investing schwab com/service/?request ps&subrequest=-CustomerCenterRef& surl=%2F r o o
' ' ' ' = - P - t ading~2Fcustcenter%2F ¼3Fane... 9/27/03
Customer Service I _Sit__e.M~ I ._H__ej~.. I Log Out ~-.
Account Positions (Real-Time)
Page last updated: 09:00AM ET .~_e_fr._.e_.s-.__h.
Symbol Name Qty
._)(.0_M_ EXXON MOBIL
CORPORATION 300
GENERAL
RGM MOTORS 7.25%
........52SR NOTE DUE 400
02/15~52
GNMA PL #338858
6368134 7.50%22 DUE 45,000
11/15~22
GNMA PL #344695
6368167 7.50%23 DUE 35,000
01/15~23
GNMA PL #,358226
6280931 7%23 DUE 08/15/23
40,000
GNMA PL #392077
6281404 7.50%24 DUE
04/15~24
GNMA PL #-414809
6285342 8%25 DUE 12/15/25
25,000
Quote~ Market Value Div Reinv. Link to:
36.78 $11,034.00 NP. New_s!~hart
GNMA PL #422634
6360765 7.50%26 DUE
04115~26
GNMA PL #.440094
6286085 7.5%27 DUE
02/15~27
GNMA PL ~447398
6371465 7%27 DUE 07/15127
.T_rade.
25.10 $10,040.00 .... .._Ng.w._.>Lc_h.a_r~ _T..r.~¢._~
107.74 $1,420.46
107.68 $4,645.46
107.11 $5,562.16
107.61 $2,005.27
30,000 108.48 $1,892.46
40,000
25,000
30,000
GNMA PL #-455003
6386093 6%31 DUE 09/15/31 30,000
107.35 $2,980.21
107.09 $1,315.78
106.65 $7,497.12
104.14 $24,111.87
30,000 105.41 $5,585.19
GNMA PL #-461196
6372146 6.50%28 DUE
01115/28
106.61 $4,660. 72
6280107 GNMA PL #-478173 30,000
7%28 DUE 06/15/28
https://investing, schwab, eom/service?request=ps& subrequest=Posifion 9/27/03
GNMA PL ~492917
6374583 6%28 DUE 11115/28
GNMA PL #507111
6378562 7%29 DUE 12/15/29
GNMA PL #584065
6358392 5.50%32 DUE
10/15/32
GNMA PL# 507883
6379027 6.50%29 DUE
05/15~29
GNMA PL#407334
6284828 8%25 DUE 04115~25
30,000
30,000
3O,OO5
35,000
45,000
N...U_VNUVEEN MUN
VALUE FD INC 400
N_Q_P NUVEEN PA INVT
...... QLTY MUN 2,000
NPI NUVEEN PREM
INCM MUN FD 300
TM6 THORNBURG
MORTGAGE INC 200
VWN... VANGUARD
u~WlNDSOR FUND 879.679
VERIZON
VZ COMMUNICATIONS 322
WAYPOINT
FINANCIAL CORP
TOTAL CASH
WYPT
Totals:
934
104.36
106.59
102.68
105.39
108.48
9.16
14.65
14.21
24.80
14.21
32.59
19.69
$12,525.24
$5,690.26
$28,069.73
$4,226.65
$863.53 .....
$3,664.00 _N_o _N..e_w_ _s _/_C__h a_ r t
$29,300.00 Nm Ne~./_ch¢_rt_
$4,263.00 N~ .N_e_w__s_/Ch~ r~
$4,960.00 N_~ _News/Oh.an
$12,500.24 No2/No:~ Chart Trade
$10,493.98 No News/Chart Trade
$18,390.46
$39,791.85
$257,489.64
No News/Chart Trade
Receive Closing Summary_ & Positions Alerts
.Quotes af-.,.d r,qarket value are rea -t. me except
;i'..Mutua{ f~.,.-d db/¢:end r,sh'wesl, rr~e~t
M.y._H.o.~.',_e.. I Account I .T_r_.a..d._e. I .Q...u.9_t_~s.._.&...~es_.e_~rCh I P./_a_p_nLng.._&..___A_.¢..vj.(.;.~ I ..P..Lqd._u.q.t.s.'.__&...S_._e~ic.e__s
Balance__s_ ~ __Posi____fion____s_ J _Performance J HLs. tory. J .Transfer_s__& P_a_.yme.n.t._s
[_Se__ajc__h. ] [ Custom.e__r__Se~ice ] [ _Sj:Le__/V!_aj;~ ] [ __He_~ ]
Account 7900-2~
https://investing, schwab.com/service?request=ps&subrequest=Position 9/27103
SAIDIS
SHUFF, FLOWER
& LINDSAY
ATTORNEYS -AT-LAW
2109 Market Street
Camp Hill, PA 17011
TO:
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 003353
SLIKE JOHN E ESQUIRE
SAIDIS SHUFF FLOWER & LINDSAY
2109 MARKET STREET
CAMP HILL, PA 17011
fold
ESTATE INFORMATION: SSN: 201-18-5933
FILE NUMBER: 2103- 1045
DECEDENT NAME: SCHOOLEY MARY ANN
DATE OF PAYMENT: 12/1 9/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 09/28/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $5,205.73
TOTAL AMOUNT PAID:
$5,205.73
REMARKS:
ARTHUR T SCHOOLEY-C/O JOHN E
SLIKE-CANNOT READ POST MARK
SEAL
CHECK# 133
INITIALS: SK
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF TNDTVZDUAL TAXES
XNHERTTANCE TAX DXVTSTON
DEPT. 280601
HARRZSBURG, PA 17128-0601
COHHONNEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAZSEHENT, ALLONANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
RE¥-I~i7 EX AFP
JOHN E SLIKE
SAIDIS ETAL
2109 MARKET ST
CAMP HILL
PA 17011
FEB 27
,_~ ~,.~TATE OF
DATE OF DEATH
FILE NUHBER
Ctimb~:r.~i~d Co., PA
03-01-ZOOR
SCHOOLEY
09-28-Z003
21 05-10~5
CUHBERLAND
101
Amount Rem'a'kted
HARY A
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGISTER OF NILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LONER PORTZON FOR YOUR RECORDS ~
DZSALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF SCHOOLEY HARY AFILE NO. 21 05-10~5 ACM 101 DATE 05-01-200~
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE XNTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule D) (2)
3. Closely Held Stock/Partnership Interest (Schedule C) (3)
~. Hortgeges/Notes Receivable (Schedule D) (~)
$. Cash/Bank Deposits/HLsc. Personal Property (Schedule E) ($)
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Tote1 Assets
APPROVED DEDUCTZONS AND EXEHPTZONS:
9. Funeral Expenses/Ada. Cos~s/Hisc. Expenses (Schedule H) (9)
10. Debts/Hortgage
11. Total Deductions
12. Net Value of Tax Return
1~937.60
128~7~.82
.00
.00 NOTE: To insure proper
.00 credi~ to your account,
.00 submit the upper port/on
.00 of this form with your
tax payment.
(8)
8,052.00
858.77
13.
NOTE:
150,682.~2
(11) 8 .qlO .77
(12) 121,771.65
.00
121,771.65
Charltable/Governeentel Bequests; Non-elected 911:5 Trusts (Schedule J) (15)
Net Value of Estate Sub~ect to Tax (1~)
zf an assessment ~as issued previously, lines 1~, 15 and/or lb, 17,
reflect figures that include the total of ALL returns assessed to date.
18 and 19 will
(15) .00 x 00 = .00
(16) 121,771.65 x 0~5 = 5,~79.72
(17) .00 x 12 = .00
(].G) .00 x 15 = .00
(19)= 5,~79.72
AMOUNT PAID
5,q79.72
.00
.00
.00
5,205.73
TOTAL TAX CREDZT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
ASSESSHENT OF TAX:
15. Amount of L/ne lq at Spouse1 rate
16. Aeount of L/ne Xq texebXe at Lineal~Class A rate
17. Aeount of L1ne lq et S1btlng rate
18. Amount of L1ne lq taxable e~ CoXXeteraX/Class B rate
19. PrincipaX Tax Due
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+)
DATE NUMBER TNTEREST/PEN pATD (-
12-19-2005 CD003355 273.99
( ZF TOTAL DUE XS LESS THAN $1, NO PAYMENT TS REQUIRED.
ZF PAID AFTER DATE ZNOXCATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR), YOU NAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)