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Home My WebLink About95-0338This is to certify that the certificate hereunto attached is a true and accurate copy of the original death record on file with the Division of Vital Records, and that Frank Yeropoli, whose name is subscribed thereto, was at the time of subscribing the same and now is Director, Division of Vital Records of the Department of Health, for the Commonwealth of Pennsylvania, duly appointed and commissioned as directed by Act 66 of the General Assembly, approved 29 June 1953, P.L. 304. AUG 16 2001 Date N705.1~3 Rav. 2f87 TYPF.?IE11T E, rEmuwmrr xaac rrc 21, i; • ;,• OI 0 w W O 7 Fran eropoli, ' ect Division of Vital Records P.O. Box 1528 New Castle, PA 16103 COMMONWEALTH OF pENlISYL1MNIA • DEPARTMENT OF HEALTH • VfGL RECORDS CERTIFICATE OF DEATH 06~ ios SDCULL SECUIIT'NUMEER ORE OFOERNddw,O. Da,.'Mq NAMEaFOESEOENrrt*,~Mlaa.u.o Voi t H gh SE„ ,. Male ,. 368 -09 -8958 ~/4/ .ZG 9`rl aary ,. Lawrence ADE1LY Bir,idN) uNDEI„rEM uuDEww, M' ORE OF EE,M Ewn,/~ACE1tM+•d ,~~ IMm/,. O•G wrl srbasar.gncaaar» Neu. , D. p,ACEOF DERN1~aA mry.••-,w Yrioarmaww.dM NOSpIL,L~ Ouur ^ ° ' t MoAI b N arnegie A ^ a.w»»^ av.~v~ EpygdplMaG ou+^ w ; ,,y.,,,~ S7 n. 9/13/1906 VNS OECEODR OfNIS/MNIC ORIDIN, MCE-AmMb,bdln,.BYOI.,NMM. a,c. COUN,YOF DERV CT:EO„O.,,MOf OERN NAME(Mnq Yrl~an.pM,trM aM rvneari Tw S b / MMCaAp,Iwb1ECMMC ,~llhlte /~~ i~~ oro ~ J p. as /7~/ Cunberland ~E. Peans ~~~-~, aENlruDarousE EaN A~ocarw,oN IaNDarwuwESSnNDUS,m ,w w ua r DECEDn,rsEwcr M.M~N.s.vado..a n~.+..w.m»aanrAy u DECEDE„ a dnq u.a AaMEDwncES, dam' Iii NK*eem~'lu»ri•d~'1 'M^ Ns L"] py~d~+,q 1lidowed ~01~ ~'' *~ Vernment ~ ~ Arahiteot ~~ ~ „ „ wer en ,.asap,r~aap..i,~,rro,,.~,sw.,zy,eoei ~n~ PeIIAeylV8IIi8 ~ „~,[]w.,e,»eN.awe• a».d.a 824 Lisburn Road "~O ~,a a"~'0ij Cumberlan ~"" N40MMnaMM d '°""""'°' „aDwMm.aw Camp Hill, PA 17011 ,n. , Middla rR„Eas NAME~»I Ia,q 6.,I. MidOr. Maidanaur+»1 Dieterich mina M ~h 3 . . Harry C. Voight . . iso,ww,raNAME(r,yovd~q srAEx«3ADDIF85paM4cryrtoaM.s,r..2lpCadal 504 Cocklin Street, Yeohanicsburg, PA 17055 Donna Sprowls DREar DleROartaM w,cc of DgpoE,„oN•NaabMCMbMrMClaaa,MY ~GCR,oN•CMWbaw s,Mw mcod. wE,NOOasae.~gp °u"~ y 26 1994 rL^I c,«»w.^ R.~,b~..bs,.b^ ~o Ong Green Memorial Park Lower Allen Trrp. ^ . , s. N ^ GE ° L ~ a , wk DMa~., , ~,. a,orwuREaFSUNERAI UCEimEEORPE11aONACTINfiASSUCN NuweE., 012662-L r.. NAMEANDAODR[SSac a~ E. Main St., Mechanicsburg, PA 17055 c - ~~~~,,,~ M,,,~, ~ MOMOtm,~•dE•-d»MaxaradrlM 6na. dalaaM paea aabd. uCENSE NUMBER D~EE S,DNED IMdR dxlYarl bnal.rarMa•, tllb •I daaMb aM TM crraa.r. nas,NwwmnpwwM ovce~uN arcEPnaNOUNCEOOEAOO~.~•v.w•n rwacASEREFERREOmMEacaexAMwEncaRDNEm `M ^ No^ 2,. Ml,f! gW„I~M,badtiwr»a0lWpbd,MO,OM EMUMM aIwa O M D.RMT F. ENarM Arr».i7WM•a~WpbwNeL ernad Mdaad,. DO nM arMMmoda o,dYO~G rardae orNag , a O rab7 ana . iYba»aaa nolrariYq ladbuAONyYgarwya»bpARTl UMard/abcMranaare E». ..~~~~ l~ ~ 1 h ~ ~anM and daaw ' ~ ~ .~. Orraarov~ilon , .. c~~ rani0iq in dad,)-- IXlEW10R A$AC016EOlIENCE Oi}. D DUE W(GRASACONSEDUENCE OFk iaNA l»bgbwwnaau EMw11WE11LrMD ~ GAYEE IDa'n'arinj~ry OUE,O(p1 ASACONSEGUENCE OFk bilal,d a~wir ~ n,vlYpbdalollAST IISr FlNDN,GS MMINER OF DERV ORE OFpWRY TIME aF N,JI1Rr gilURr RWORI(T OESCRISE NOW EUlN1Y000IMiREO. YNS AN AUR,PSr WEREAUR PERFORIdED, /IMA6LE P1110R 1D Q'" ~~'O'Y''a~) OF CAUSE Naeaal ~~ FlamdOa ^ ^ No ^ •a OF AcabaM ^ pan6gONM4d•^ ^ a M, ry w ^ No LrJ ~a. ^ No ^ s~+cia ^ coule naaewwm:.e ^ RIACE OCUwm-albm.. aim. m.w.,mv.•~• ~ocRaNlat.M.cM~.sw ~ a+,arq, aw. as. aoa. we. lso• rl aa. ANDnnE Ern Mp ,i11fENE11ICMtlrmM•nal 'CORIFVMD p11YSICIAN 1~Y~~eMMq w»d daaM Man anoa.sr M,at~an naapmwnc.d daaE. s.b canpxad Mm 231 bw.v~q..a m.+,.r»w.,w .......... ...... e a .... ,w w AMrwamrlme•aew.~a«„m. LICENSE NUMBEA ORE SKWED nA~.O.v. - 2i - `( S 3 L ~ •rnoNOwrcnaANOCeaTlFrws-Nrs~aANlvn,~ane~a«~,n~wrna,w~«w~nub~•da»eo a,a ,4 d 'l l Te MOMam,YA••bdll•. chap oawad a,Mwr.dw.andp»a, anddwb Mea,+alNWm.mar»pstW ...... .................... NAME AND M011ESS aF VER50N W110 GOWLETEO CAUSE OF OF/1N .. Qtem 27) T ar PAM ' ~^ D ~ ~ ~ ~ • Mpnp.Oy~M es~MMnO,or Nw.sNyMbn. in my oplNw,. M010 oeewrM al M Drrr. dNq arW pace. arW du »tl»Kp dWd. . to tM ewr(a and ^ ........ ..... .. ~{ • ~~..I() t N 2, ( U a'•• DRE vaEO tMOnn. Gar. wul REG TRAR'S SIGNRURE AND NUM R -~ - . - ~~.- 1(6~ -- a.. J~ 1 i __ ~, , FOR DATES OF DEATH AFTER 12/31/91 CHECK HERE REV - 1500 EX + (7-94) INHERITANCE TAX RETURN IF A SPOUSAL POV RTY C EDIT IS CLAIMED RESIDENT DECEDENT FILE NUMBER COMM pNyyEA~TH Of P YLyANIA DEPARTMENT fr~1UE {TO BE FILED IN DUPLICATE ~ l ~95- 0338 HARRISBURG, PA17~28-0601 WITH REGISTER OF WILLS COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) DECEDENT'S COMPLETE ADDRESS E VOIGHT, LAWRENCE H. -" 824 Lisburn Road C SOCIAL SECURITY NUMBER DATE OF DEATH DATE OF BIRTH Camp Hill , PA 17011 0 368-09-8958 07/20/ 09/13/06 N County Cumberland T (IF APPLICABLE)SURVIVINGSPOUS NAME(LAST,fIRSTANDMIDDLEINITIAL) SOCIAL SECURITY NUMBER AMOUNT RECEIVED(SEEINSTRUCTIONS) A B 1. Original Return 2. Supplemental Return 3. Remainder Return ~ P L 4. Limited Estate 4a. Future Interest Compromise (for dates of death prior to 12-13-82 : P O R C (for dates of death after 12-12-82) ~ 5. Federal Estate Tax Return Required F S ~ 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes (Attach co y of Will) (Attach a copy of Trust) C p ALL CORRESPONDENCE AND CONFIDENTI TAX INFORMATION SHOULD BE DIRECTED TO: R N NAME COMPLETE MAILING ADDRESS E E John E. Slike, Es uire Saidis, Guido, Shuff &Masland S N TELEPHONE NUMBER 2109 rket Street - T 717 737-3405 Hill PA 17011 r. meat eswre Wcneawe q/ l ,~ ~`".:.. 2. Stocks and Bonds (Schedule B) " r 3S , UUU . UU 368 .63 3. Closely Held Stock/Partnership Interest (Schedule C) .~"'~~ (3) 4. Mortgages and Notes Receivable (Schedule D) (4) R Personal Property (Sch. E) )„_ " "' e l S9 , 850.75 C A ~6 6. Join ly Owned Property S chedule F) ) p 7. Transfers (Schedule G) (Schedule L) (7) - ~~°'~?j T 8. Total Gross Assets (total Lines 1-7} ~ (8) ~3 ; 219.38 ~ 9. Funeral Expenses, Administrative Costs, Miscellaneous r~ 16 , 909.18 , , F / e ~- +* A Expenses (Schedule H) ~ 10. Debts, Mortgage Liabilities, Liens (Schedule I) ~}-°""'~ 14 , 094.76 N ~ 11. Total Deductions (total Lines 9 & 10) (11) 31, 003.94 12. Net Value of Estate (Line 8 minus Line 11) J x ~ ~'~` ~a4 c ~ (12) 62 215 44 ~ . 13. Charitable and Governmental Bequests (Schedule J) (13) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 62 , 215.44 15. Spousal Transfers (for dates of death after 6-30-94) See Instructions for Applicable Percentage on page 2. (15) 0.. 00 X = ~ 0.00 (Include values from Schedule K or Schedule M.) t ~ . _ : '` / +1~~ ~ (~ -~ ~ % : ~+ 16. Amount of Line 14 taxable at 6% rate (16) 62 , 215.44 X .t~~ ' 3 , 732.93 (Include values from Schedule K or Schedule M.) ~ T A 17. Amount of Line 14 taxable at 15% rate (17) 0 . 00 X .15 = 0.00 X (Include values from Schedule K or Schedule M.} O 18. Principal tax due (Add tax from Line 15, 16 and 17.) (18) 3 , 732.93 M 19. Credits/Sp Poverty Prior Payments Discount Interest ~ 4,000.00 + - 244.34 (19) 3,755.66 A 20. If Line 19 is greater than Line 18, enter the difference on Line 20. This is the OVERPAYMENT. (ZO) 22 , 73 T ~ ® Check here if you are r uestfn a: refund of our ove: a msnt 0.00 I 0 21. If Line 18 is greater than Line 19, enter the difference on Line 21. This is the TAX DUE. (21) 0.00 N A. Enter the interest on the balance due on Line 21 A. (21A) 0.00 B. Enter the total of Line 21 and 21A on Line 218. This is the BALANCE DUE. (21B) 0.00 Make Check Pa able to: R aster of Wills, A ent - - BE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND TO RECHECK MATH ~ ~ Under penalties of perjury, I declare that I have examin this return, Inc uding accompanylrtg sc edules and statements, and to the best of my knowledge and belief, it Is true, correct and complete. I declare that all real estate has been reported at true market value. Declaration of preparer other than the personal representative Is based on all Information of which preparer has any knowledge. SIGNAT RE OF PERSON RESPONSIBLE FOR FILING RETURN John E. Slake, Esquire ' ~ 2109 Market Street Cam Hill PA 17011 SIGN EOFPREPAREROTHERTHANREPRESENTATIVE Saidis, Guido, Shuff &Masland 2109 Market Street ----------------------------------------------------- Camp Hill, PA 17011 Cogvnght (c1 1994 form software onto CPSVStems, Ina DATE c ~ 6 DATE Form 1 0~(Rev. 7-94) (~~ Y ~ Act #48 of 1994 provides for the reduction of the tax rates imposed on the net value of transfers to or for the use of the spouse. The rates as prescribed by the statute will be: •3% (.03) will be applicable for estates of decedents dying on or after 7/1/94 and before 1/1/96 •2% (.02) will be applicable for estates of decedents dying on or after 1/1/96 and before 1/1197 •1% (.01) will be applicable for estates of decedents dying on or after 111/97 and before 1/1/98 •Spousal transfers occurring on or after 111/98 will be exempt from inheritance tax. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A MARK ()C) IN THE APPROPRIATE BLOCKS. YES NO 1. Did decedent make a transfer and: a. retain the use or income of the property transferred, . ... ~{ b. retain the right to designate who shall use the property transferred or its income, g c. retain a reversionary interest; or . ~{ d. receive the promise for Irfe of either payments, benefits or care?. .. X 2. If death occurred on or before December 12, 1982, did decedent within two years preceding death transfer property without receiving adequate consideration? If death occurred after December 12, 1982, did decedent transfer property wthin one year of death without receiving adequate consideration? X 3. Did decedent own an 'in trust for' bank account at his or her death? X IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Coovriaht (cl 1994 form software oniv CPSvstems_ Ina c,,..,, ~~ ~Qe ,~ cei REV - 1502 EX + (12-85) COM,NO~~WF~ANOT FNt~uRLN ANIA I SCHEDULE A ~I EIJ E 6JNT REAL ESTATE ----....--~----..._..........,...~ .,~ .,a~~ti ~~«.~ Copyright(c11994formsoftwareonNCPSvstams.Inc. F~rm1S000rhr.riuloOlRsai t~_aai ESTATE vF FILE NUMBER LAWRENCE H. VOIGHT SS~~ 368-09-8958 07/20/94 1995 00338 (Property ~omtly owned with Right of Survivorship must be disclosed on Schedule F) All real estate should be reported at fair market value which is defined as the price at which property would be exchanged between a willing buyer and a willing seller. neither being cen,snu~ .., REV - 7503 EX + (4-86) COMMONWEEALT OFP NSYLVANIA I SCHEDULE B INFj~SIIANN~T~]'UgN STOCKS AND B01 OF LAWRENCE H. VOIGHT SS~~ 368-09-8958 07/20/94 FILE NUMBER 1995-00338 e.,,... 1~A/1 c..tisa„~e R io..., w oe~ ~.~ ~~..,.~~ J~.IaM6 is naeueu~ wiser[ aaamonai sneers OT SBme slZe.) n...,.,.i„tirr~iioaer,,....~„Fr,.,~,e....i..(`DC..c/s.nc ~... REV - 1508 EX + (2-87) COMINRES~AENHDFP N NT MANIA TE OF E 'D {{f~ SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS Print or 1995-00338 LAWRENCE H. VOIGHT SS~~ 368-09-8958 07/20/94 ~~....~.~~ uuunwna~ v vc x I I sneers R more space is heeded.) !`nnvrinhflrl tggd inrm cni~..rorn ....L, roc....te..,.. b,,. r_-._ 1CAA n_. _~..~_ C .,-,_.. .. ..~~ r REV - 1510 EX + (2-87) COM tNO~ERF,t4ANNT~O_ pE NgyLN ANIA SCHEDULE G _ _ Print or . tSTATE vF FILE NUMBER LAWRENCE H. VOIGHT SS~~ 368-09-8958 07/20/94 1995-00338 THIS SCHEDULE MUST BE COMPLETED AND FILED IF THE ANSWER TO ANY OF THE QUESTIONS ON PAGE 2 IS YES. ITEM DESCRIPTION OF PROPERTY TOTAL VALUE DECD'S DOLLAR VALUE OF NUMBER tndude ^anb of the transferee, their EXCLUSION relationshi todeeedent date oftransfar.. OF ASSET % INT. DECEDENT INTEREST 1 Checking account ~~112-932-5104 at Mellon Bank transferred to joint nam_es.. wi,~~~, daugk~ter , Honna`~prowles, between ......_ March 11 acid March~~13 ;"1994 , having a balance of $58,780.51. __ _ This transfer is being contested in court and if the estate prevails, a supplemental return will be filed. ~'J 'y`~` ^ ~(~(l ~^'y J ~~ ~ y ~ ~/ `~ ~~ ~'~ a~ ~!~ ~} 6 ylk ~«~ TOTAL {Also enter on line 7, Reca itulation) (If more space is needed, insert additional sheets of same size.) f :nnvrin ht !r1 1QOd inrm enFfu,arn nnh. !`PC..clnn.a. I n.. Y f~ 0.00 I-_.._. ~Gffl~ .. ~ ~ ~ n ~.. .. --. ' REV - 1511 EX + ~-88> SCHEDULE H FUNERAL EXPENSES, COMMO WEALTH FP N SYLVANIA ADMINISTRATIVE COSTS AND INI~F~s~b,~l"~~~~'~,~N MISCELLANEOUS EXPENSES ESTATE OF LAWRENCE H. VOIGHT SS~~ 368-09-8958 07 20 94 ITEM NUMBER DESCRIPTION A. Funeral Expenses: 1 Boyd Myers Funeral Home 2 Rolling Green Cemetery - grave marker 3 Trinity Lutheran Church - funeral services and luncheon B. Administrative Costs: 1. Personal Representative Commissions Social Security Number of Personal Representative: Year Commissions paid 2. Attorney Fees Saidis, Guido, Shuff & Masland 3. ~ Family Exemption Claimant Address of Claimant at decedent's death Street Address City 4. Probate Fees Register. of Wills State Zip Code 302.00 C. Miscetlansous Expenses: 1 Register of Wills - short certificates 2 Register of Wills - filing fees for petition 3 Register of Wills - filing fees for inheritance tax, return and county inventory 4' Reserved for future litigation expenses TOTAL (Also enter on line err more space rs neeeed, insert additional sheets of same size.) enr..,r~nhf a~ ioen Fnrm ~n++,,.,ro nnw rac..~r>m~ i„~ 5,171.00. 1,640.18 255.00 4,500.00 Relationship 4,500.00 AMOUNT 6.00 10.00 25.00 `500.00 Please Print or Type FILE NUMBER 1995-00338 S' ~~ 16, 909.18 r"` Fnrm tSnt) Cr`hnr~ule H rao„ 7_AAl REV - 1512 EX + (1-93) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, iTATE OF LAWRENCE H. VOIGHT SS~~ 368-09-8958 07/20/94 of Type ILE NU 1995-00338 ITEM NUMBER DESCRIPTION AMOUNT 1 Costs of sale of house 2,126.71 2 Mark S. Ulsh - trimming of shrubbery and yard clean up 399.48 3 Tax Claim Bureau - 1994 school taxes 767.39 4 Philip B. Wollmer - structural engineering services 320.00 5 Cowley Associates - copies of medical records 25.00 6 Fairview Professional Pharmacy 76.82 7 Holy Spirit Hospital 44.00 8 Cowley Medical Associates - balance due 13.71 9 PAWC 59.28 10 UGI 484.31 11 PP&L 141.38 12 Health Force - balance due for medical care 8,581.3b 13 PP&L 6.32 14 Accrued state and federal income taxes on deferred annuity income of $8,693 1,049.00 TOTAL (Also enter on line 10, Recapitulation) S ~ 14 , 094.76 (If more space is needed, insert additional sheets of same size.) Copyright (c) 1994 form software only CPSystems, Inc. Form 1500 Schedule I (Rav. 1-93) ~ a REV - 1513 EX + (2-87) COM I N RESENT DTECEDEN7 N ANIA SCHEDULE) S I ATE OF LAWRENCE H. VOIGHT SS~~ 368-09-8958 07 20 9~ ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY A. Taxable Bequests: 1 Richter L. Voight 45 Windsor Way Camp Hill, PA 17011 2 Donna V. Sprowls 504 Cocklin Street Mechanicsburg, PA 17055 FILE NUMBER 1995-00338 RELATIONSHIP AMOUNT OR SHARE OF ESTATE Son 50Y of residue Daughter ~50Y of residue - ~ - - --- •- a+~uvi im anae[s OT SaRle S12@. ) Copyright (c) 1994 form software only CPSystems, Inc. Form 1$00 Schedule ~ (Rev.2-87) , N 3 ~7~' ~` FOR DATES OF DEATH AFTER 12/31/91 CHECK HERE REV - 1500 EX . p-sa> INHERITANCE TAX RETURN pOVERTYCREDIT IS CLAIMED RESIDENT DECEDENT FILE NUMBER COM~IQ~I R M oFPg~NSYL~ANIA uuttr NT REVENU A E 2~p U G (TO BE FILED IN DUPLICATE 21-~95-0338 HARRIS ,PA17128-oeot WITH REGISTER OF WILLS COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) DECEDENT'S COMPLETE ADDRESS E Voi ht, Lawrence H. 824 Lisburn Road C SOCIAL SECURITY NUMBER DATE OF DEATH DATE OF BIRTH Camp Hill p 368-09-8958 07/20/1994 09/13/1906 E N County Cumberland T (IF APPLICABLE) SURVIVING SPOUSE'S NAME(LAST,FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER AMOUNT RECEIVED (SEE INSTRUCTIONS) 0.00 A B 1. Original Return X 2. Supplemental Return 3. Remainder Return E P LO 4. Limited Estate 4a. Future Interest Compromise (for dates of death prior to 12-13-82 R C (for dates of death after 12-12-82) ~ 5. Federal Estate Tax Return Required (P S QX 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes {Attach copy of Will) (Attach a cop of Trust) C p ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: R N NAME COMPLETE MAILINGAODRESS E E Saidis, Shuff & Masland S N TELEPHONE NUMBER 2109 Market St. T 717 737-3405 Cam Hill PA 17011 .. 116Q1 ~„a.~ \Jl:lICUUn; Nf lU None 2. Stocks and Bonds (Schedule B) (2) Notes"~ _ 3. Closely Held Stock/Partnership Interest (Schedule C) (3) None 4. Mortgages and Notes Receivable (Schedule D) (4) None E 5. Cash, Bank Deposits & Miscellaneous Personal Property (Sch. E) (5) None C A 6. Jointly Owned Property (Schedule F) (6) None p 7. Transfers (Schedule G) (Schedule L) (7) None _, T 8. Total Gross Assets (total Lines 1-7) (8) 0.00 ~ 9. Funeral Expenses, Administrative Costs, Miscellaneous (9) None A Expenses (Schedule H) T 10. Debts, Mortgage Liabilities, Liens (Schedule I) (10) 3 , 898.80 N 11. Total Deductions (total Lines 9 & 10) (11) 3 , 898.80 12. Net Value of Estate (Line 8 minus Line 11) (12) (3 , 898.80 ) 13. Charitable and Governmental Bequests (Schedule J) (13) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) (3 , 898.80 ) 15. Spousal Transfers (for dates of death after 6-30-94) See Instructions for Applicable Percentage on page 2. (15) 0.00 X = 0.00 _ (Include values from Schedule K or Schedule M.) 16. Amount of Line 14 taxable at b% rate (16) 0.00 X .06 = 0.00 (Include values from Schedule K or Schedule M.) X 17. Amount of Line 14 taxable at 15% rate (17) 0.00 X .15 = 0.00 (Include values from Schedule K or Schedule M.) C 18. Principal tax due (Add tax from Line 15, 16 and 17.) (18) 0 00 O M 19. CrediWSp Poverty Prior Payments Discount Interest . ~ + * - (19) 0.00 A 20. If Line 19 is greater than Line 18, enter the difference on Line 20. This is the OVERPAYMENT. (20) 0 00 T AO. ® CheckE~ere:iE you ai+erequestln a tef~inc#oiyowr ovi~~taytAei>it . 0.00 OI 21. If Line 18 is greater than Line 19, enter the difference on Line 21. This is the TAX DUE. (21) 0.00 N A. Enter the interest on the balance due on Line 21A. (21A) 0.00 8. Enter the total of Line 21 and 21A on Line 218. This is the BALANCE DUE. (21B) 0.00 Make Check Pa able to: R Inter of Wills, A ent - - BE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND TO RECHECK MATH ~ ~ Under penalties of perjury, I declare that I have examin th s return, Inc uding accomparrying se edu es and statements, and to the best of my knowledge and belief It is t rue , , correct and complete. l declare that all real estate has been reported at true market value. Oeclaratlon of preparer other than the personal representative Is based on all Information of which preparer has any knowledge. DATE / `1 GATE /~/~ ~ SIGMA URE OF PERSON RESPONSIBLE FOR FILING RETURN John I/ . S1 ike 2109 Market Street ---- ---------------------------------------- Cam Hill, PA 17011 SIGN URA OF PREPARER OTHER THAN REPRESENTATIVE f & Mas 1 and ~/ ~~ l_iN1a'rk_~~~t . i I' /~t,,_ ~ ~~,~r("„ Camp Hill, PA 17011 Y Act #48 of 1994 provides for the reduction of the tax rates imposed on the net value of transfers to or for the use of the spouse. The rates as prescribed by the statute will be: •3% (.03) will be applicable for estates of decedents dying on or after 7/1/94 and before 1/1196 •2% (.02) will be appiicable for estates of decedents dying on or after 1/1/96 and before 1/1/97 • 19~ (.01) will be applicable for estates of decedents dying on or after 1/1/97 and before 1/1/98 •Spousal transfers occurring on or after 1/1/98 will be exempt from inheritance tax. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A MARK (X) IN THE APPROPRIATE BLOCKS. YES NO 1. Did decedent make a transfer and: a. retain the use or income of the property transferred, . g b. retain the right to designate who shall use the property transferred or its income, g c. retain a reversionary interest; or g d. receive the promise for I'rfe of either payments, benefits or care? . ~{ 2. If death occurred on or before December 12, 1982, did decedent within two years preceding death transfer property without receiving adequate consideration? If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ~{ 3. Did decedent own an 'in trust for' bank account at his or her death? ~{ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,. YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. r REV - 1512 EX + (1-93) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, SAGE LIABILITIES AND LIENS STATE OF Lawrence H. Voight SS~~ 368-09-8958 07/20/1994 e FILE NUMBER 21095-0338 ~•• ••••••o ~ra..Q w ~ivcueu, u~seri aaamo~a~ meets of 5a(t1e sl2e.) METZGER, WICKERSHAM, KNAUSS & ERB, P.C. P. O. BOX 5300 HARRISBURG, PA 17110-0300 717/238-8187 Tax I.D. 23-2871395 May 30, 1997 Bill number 000020-00051- REY John E. Slike, Esquire Administrator of the Estate of Lawrence Voight Saidis, Guido, Shuff & Masland 2109 Market Street Camp Hill, PA 17011 VOIGHT ESTATE, LAWRENCE (Final Bill) FOR PROFESSIONAL SERVICES RENDERED 02/05/91 REY Study of file. Letter to District Justice Clements. 30 hrs 02/08/91 REY Letter from District Justice. Letter . 02/12/91 REY to Mrs. Sprowls. Telecon Mrs. Sprowls. .20 hrs 03/06/91 JAA Call from Donna Sprowls. Conference .10 hrs with JLH. Call to. D. J. Clements; correspondence to D. J. Clements. Call to Donna Sprowls. Note to file. (Paralegal) 04/09/91 REY Conference at office. Preparation .40 hrs for hearing. 04/11/91 REY Prepare for hearing. Attend hearing. .70 2 20 hrs hrs 04/15/91 REY Letter from District Justice Clements. . 04/22/91 REY Letter to Mrs. Sprowls. Letter to Accountant Richert .30 hrs 11/20/91 REY . Conference Mrs. Sprowls. Drafting of .20 hrs 12/03/91 REY Will. Letter to Mrs. Sprowls. Telecon Mrs. Sprowls. .80 hrs 07/10/92 REY Telecon Mrs. Sprowls. .20 hrs 08/06/92 REY Telecon Mrs. Sprowls on estate planning .20 20 hrs hrs 08/10/92 REY . Telecon Mrs. Sprowls. . 20 hrs 08/13/92 REY Telecon Mrs. Sprowls. Conference with . Mr. Voight. 08/24/92 REY Telecon Mrs. Sprowls. .50 hrs 08/25/92 REY Telecon Mrs. Sprowls. Study of petition. .20 .60 hrs hrs r Voight Estate, Lawrence Page 2 08/27/92 REY Legal research. Telecon Attorney Campbell. 1.20 hrs 09/04/92 REY Telecon Donna Sprowls. .20 hrs 09/09/92 REY Conference Attorney Reed. Telecon Mrs. Sprowls. .40 hrs 09/09/92 RPR Office conference, review file, and telephone call to client. 1.00 hrs 09/11/92 RPR Review file, travel, attendance at deposition. 1.70 hrs 09/19/92 REY Study of transcript of deposition. .50 hrs 09/22/92 REY Telecon Richard Oare. .20 hrs 09/23/92 REY Telecons Mrs. Sprowls. .60 hrs 09/24/92 JLH Attorney conference. .20 hrs 10/01/92 REY Telecon Donna Sprowls. .20 hrs 11/03/92 REY Letter from Attorney Campbell. Review Medicare inventory assets. Telecon Mrs. Sprowls. Letter to Mrs. Sprowls. .80 hrs 11/06/92 REY Telecon Attorney Campbell. Letter to Attorney Campbell. .30 hrs 11/13/92 REY Letter from Attorney Campbell. Letter to Attorney Campbell. Letter to Mrs. Sprowls. .60 hrs 11/17/92 REY Telecon Mrs. Sprowls. .20 hrs 11/19/92 REY Telecon Attorney Campbell. Telecon Mrs. Sprowls. .30 hrs 11/20/92 REY Conference with Mrs. Sprowls. Legal research. .80 hrs 11/22/92 REY Preparation for hearing. .50 hrs 11/23/92 REY Attendance at pre-hearing conference on Medicaid appeal. 2.00 hrs 12/10/92 REY letter from Attorney Campbell. Letter to Mrs. Sprowls. .20 hrs 12/14/92 REY Telecon Mrs. Sprowls on account. .20 hrs 12/18/92 REY Letter from Mrs. Sprowls forwarding 12/22/92 REY account. Telecon Mrs. Sprowls. Letter to .20 hrs Attorney Campbell. .40 hrs 12/23/92 REY Telecons Mrs. Sprowls. 30 hrs 01/11/93 REY Study of letter from Richter. . 20 hrs 01/14/93 REY Telecon Mrs. Sprowls. . 20 hrs 02/05/93 REY. Telecon Mrs. Sprowls. . 20 hrs 02/08/93 REY Letter to Richter. . 20 hrs 02/12/93 REY Study of letter from Richter. . 20 hrs 02/26/93 REY Telecon Attorney Campbell. . 20 hrs 03/15/93 REY Telecon Mrs. Sprowls. . 20 hrs 03/16/93 RPR Review file and preparation for hearing. . .40 hrs Voight Estate, Lawrence Page 3 03/18/93 RPR Travel, conference, attendance at conference with Cumberland County 06/09/93 REY Assistance, correspondence. Telecon Mrs. Sprowls. 2.60 hrs 08/03/93 RPR Telephone call from Donna Sprowls. .20 20 hrs hrs 08/09/93 REY Study of Will. . 08/11/93 REY Legal research. Telecon Mrs. Sprowls. .20 40 hrs hrs 08/12/93 REY Preparation of Will. Letter to Mr. . Voight. 08/13/93 REY Letter to Attorney Campbell. .60 20 hrs hr 08/23/93 REY Telecon Mrs. Sprowls. . s 08/25/93 REY Letter from Attorney Campbell. Letter .20 hrs 09/02/93 REY to Attorney Campbell. Letter from Mr. Richter. Telecon Mrs. .20 hrs Sprowls. 09/07/93 REY Telecon Mrs. Sprowls. Study of file. .40 20 hrs hr 09/08/93 REY Telecons Mrs. Sprowls. Revision of . s Will. 09/09/93 REY Telecon Mrs. Sprowls on Will. .40 hrs 09/09/93 PAK Conference Mr. Voight on Will. Voight Will conference. (Paralegal) 1.10 1 5 hrs 09/28/93 REY Telecon Attorney Campbell . 0 hrs 10/12/93 REY . Study of account for May I. Voight. .20 hrs 10/28/93 REY Letter to Mrs. Sprowls.. Letter from Mrs. Sprowls. .30 hrs 11/01/93 REY Telecon Mrs. Sprowls. .20 hrs 11/02/93 REY Letter to Attorney Campbell .20 hrs 11/05/93 REY . Attendance at probate of Will of May .20 hrs Voight. 11/30/93 REY Telecon Mrs. Sprowls. 2.00 hrs 12/07/93 REY Telecon Mrs. Sprowls. .20 hrs 01/24/94 REY Letter from Attorney Campbell. .20 hrs 02/07/94 REY Letter to Mrs. Sprowls. Study of letter. .30 hrs 02/15/94 REY Telecon Mrs. Sprowls. Letter to .30 hrs Attorney Campbell. 04/22/94 REY Letter from Attorney Campbell. Telecons .20 hrs Mrs. Sprowls. 04/25/94 REY . Letter to Attorney Campbell. Letter .30 hrs from Mrs. Sprowls. 05/10/94 REY Telecon Mrs. Sprowls. .30 hrs 06/13/94 REY Letter on Power of Attorne y, stocks .30 hrs 06/29/94 REY , bonds, insurance, and bank account. Telecon Mrs. Sprowls. .60 hrs .20 hrs r Voight Estate, Lawrence Total fees for this matter DISBURSEMENTS 09/21/92 Hughes, Albright, transcript Total disbursements for this matter BILLING SUMMARY '- JO ANN ALLEMAN PETER A. KOSIBA JERED L. HOCK • ROBERT P. REED ROBERT E. YETTER t ' . (JAA) .40 hrs (PAK) 1.50 hrs (JLH) .20 hrs (RPR) 5.90 hrs (REY) 28.50 hrs Page 4 $3,882.00 16.80 $ 16.80 16.00 60.00 22.00 649.00 3,135.00 TOTAL FEES 36.50 hrs $ 3,882.00 TOTAL DISBURSEMENTS 16.80 TOTAL CHARGES FOR THIS BILL $ 3,898.80 r REV-1547 EX AFP (12-951 ' COMNONMEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX ACN 101 BUREAU OF INDIVIDUAL raxES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPT. 280601 HARRISBURG, PA 17128-0601 OF DEDUCTIONS AND ASSESSMENT OF TAX DATE 08-19-96 FCTeTe ne un r_uT LMwR CI\~.C n FILE N0. 21 95-0338 DATE OF DEATH 07-20-94 COUNTY CUMBERLAND NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS FORM WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS. MAKE CHECK PAYABLE TO "REGISTER OF WILLS, AGENT" • REMIT PAYMENT TO: JOHN E SLIKE ESQ SAIDIS ETAL 2109 MARKET ST CAMP HILL PA 17011 REGISTER OF WILLS CUMBERLAND CO COURT HO-USE CARLISLE, PA 17013 Amount Remitted UT ALONG THIS LINE - RETAIN LOWER POR_TION_ FOR YOUR RECORDS ~ -------------------------------------------------------- ________________ REV-1547 EX AFP (12-95) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF VOIGHT LAWRENCE H FILE N0. 21 95-0338 ACN 101 DATE 08-19-96 TAX RETURN WAS: ( 7 ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE 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 Cl 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets ' APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expanses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests (Schedule J) 14. Net Value of Estate Subject to Tax NOTE: If an assessment was issued previously, lines 14, 15 andior 16, 17 and 18 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 taxable at Collateral/Class 8 rats 18. Principal Tax Due TAX CREDITS: PAYM6NT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST (-) 01-11-96 AA082494 465.15- INTEREST IS CHARGED FROM 01-12-96 TO OS-27-96 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM (15) . DO X . 03_ . 00 (16) 117,995.95 X .06. 7,079.76 (17) .,00 X .15. .00 (18) 7,079.76 AMOUNT PAID 4, TOTAL TAX CREDIT 3,534.85 BALANCE OF TAX DUE 3,544.91 INTEREST AND PEN. 200.51 TOTAL DUE 3,745.42 (1) 33.000.00 (2) 368.63 (3) .00 (4) .00 (5)_ 59.850.75 (6) .00 (7)_ 55.780.51 (8) 148,999.89 (9) 16,909.18 (lo) 14.094.76 (11) ~1 .00.94 (121 117,995.95 (13) . 00 (14) 117,995.95 * IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A '•CREDIT•• (CR), YOU MAY BE DUE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT Of REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 2 8-060 1 DECEDENT'S NAME INHERITANCE TAX EXPLANATION OF CHANGES FILE NUMBER <' 1 ~, _; ACN ).3 i SCHEDULE ITEM NO. EXPLANATION OF CHANGES ~, 1 s~:. ~,,._,~;., c~xc. `~S.lOt1 ~:a;; u~~.; _.. .; ttic F t ~ ,- .- l 1 t i ~ ,l (c)(~j t,s ~ ~~ ;,y t~~;al ~c.t }:r~~i ~t~ ~i,;.' a tr ~n~~~l. :iarr t i,., _c, . a 1 F _ ~ ~i;r r;f Cl;t_ ue~t~~i GS i.t1~ t.:itl.~1.:IJl" is Sc_:;~r~rt tG l?~, va?1y` ~ tii. t - \~- * tz:~`~ 1~1.e vvyl~tt~ b:i, t~.~i tr~rt;>f c> ~~c~; ~s,> ,C7t ~.;.~>_ i ;- u~_ - v ~L~t~`~t z_. L,. ! r ., _. _. . ~fi oL~r~ YU~:3~' :Jil 1.iRttGlnr tr7 , ( ~ C c, 6 h . i<it ~ • :)11.11~i1:: <1.:t2Cc t0 G i~~~~__]$C..I , ,.tu.tC. :.it1S~ 1C1~ r,.~ t 11:~ ) - _.a ,~.~ . L „ U~?C :)Et. TAX EXAMINER: '«rr t~.tu: 3'ci~; PAGE COMMONWEALTH OF PENNSYLVANIA BUREAU OF INDIVIDUAL TAxES DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION I N H E R I TA N C E TA X DEPT. 280601 HARRISBURG, PA 17128-0601 STATEMENT O F A C C O U N T REY-1i 07 ER iFi f05-97) DATE 03-16-98 ESTATE OF VOIGHT LAWRENCE H DATE OF DEATH 07-20-94 FILE NUMBER 21 95-0338 DONNA V SPROWLS COUNTY CUMBERLAND 504 COCKLIN ST. ACN 98000084 MECHANICSBURG PA 17055 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 __-____ RE_TAIN LOWER P_ORTI_ON FOR YOUR RECORDS ~ REV-1607 EX AFP ( 03-971 ~~~ INHERITANCE TAX - - -'- --------------------- STATEMENT OF ACCOUNT x~~ ESTATE OF VOIGHT LAWRENCE H FILE NO. 21 95-0338 ACN 98000084 DATE 03-16-98 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: 02-02-98 PRINCIPAL TAX DUE : ............... ................................................................................................... PAYMENTS CTAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID 01-29-98 AA269707 .03- 3,346.86 BALANCE OF UNPAID INTEREST/PENALTY AS OF 01-30-98 TOTAL TAX CREDIT BALANCE OF TAX DUE * IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE I5 LESS THAN S1, 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. ) INTEREST AND PEN. TOTAL DUE 3,346.83 3,346.83 .00 839.04 839.04 BilREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 DONNA V SPROWLS 504 COCKLIN ST. MECHANICSBURG PA 17055 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT REY-1607 EX ~Fi (OS-97) DATE 05-18-98 ESTATE OF VOIGHT LAWRENCE H DATE OF DEATH 07-20-94 FILE NUMBER 21 95-0338 COUNTY CUMBERLAND ACN 98000084 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: 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 --__ RETAIN LOWER PORTION FOR YOUR RECORDS __~ ----------------------------- ____ REV-1607 EX AFP ( 03-971 *** ------------------------------------------ INHERITANCE TAX STATEMENT OF ACCOUNT ~** ------------- ESTATE OF VOIGHT LAWRENCE H FILE N0. 21 95-0338 ACN 98000084 DATE 05-18-98 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: 05-04-98 PRINCIPAL TAX DUE: .................................................................................................................................. ..................................................................................... PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 01-29-98 AA269707 .03- 3,346.86 02-26-98 AA269799 456.18- 456.18 BALANCE OF UNPAID INTEREST/PENALTY AS OF 02-27-98 I TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. * IF PAID AFTER THIS DATE, SEE REVERSE ~ TOTAL DUE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" '(CR), VOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) 3,346.83 3,346.83 .00 382.86 382.86 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION INHERITANCE TAX DEPT. 280601 STATEMENT OF ACCOUNT HARRISBURG, PA 17128-0601 REY-1C0] ER ~F- (OS-97) DATE 05-26-98 ESTATE OF VOIGHT LAWRENCE H DATE OF DEATH 07-20-94 FILE NUMBER 21 95-0338 SAIDIS ETAL COUNTY CUMBERLAND 2109 MARKET ST ACN 101 CAMP HILL PA 17011 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the uppor portion of this form with your tax payment. CUT ALONG_ THIS LINE __-___ RE_TAIN LOWER P_ORTI_ON FOR YOUR RECORDS ~ REV-1607 EX AFP (03-97) *~(~ INFIERITANCE TAX STATEMENT OF "- " "'""'""""""'""" ACCOUNT ~~(* ESTATE OF VOIGHT LAWRENCE H FILE N0. 21 95-0338 ACN 101 DATE 05-26-98 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: 05-18-98 PRINCIPAL TAX DUE: PAYMENTS (TAX CREDITS): 3,499.01 PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID 01-11-96 AA082494 229.89- 4,000.00 * IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN fl, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A ^CREDIT^ (CR), TOTAL TAX CREDIT 3,770.11 BALANCE OF TAX DUE 271.1OCR INTEREST AND PEN. .00 TOTAL DUE 271.1OCR CUT ALONG THIS LINE - RETA_IN LOWER POR_TION_ FOR YOUR RECORDS ~ ------------------------------------ REV-1547 EX AFP (09-97) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR --------------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF VOIGHT LAWRENCE H FILE NO. 21 95-0338 ACN 101 DATE 05-25-98 TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE e COMMONWEALTH OF PENNSYLVANIA BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE INHERITANCE Tax DIVISION DEPT. 280601 NOTICE OF INHERITANCE TAX HARRISBURG, PA 17128-0601 APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 E% AF? <09-917 DATE 05-25-98 ESTATE OF VOIGHT LAWRENCE H DATE OF DEATH 07-20-94 FILE NUMBER 21 95-0338 SAIDIS ETAL COUNTY CUMBERLAND 2109 MARKET ST ACN 101 CAMP HILL PA 17011 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 APPRAISED VALUE OF RETURN BASED ON: 2 SUPPLEMENTAL 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule 8l 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule Dl 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) .00 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10l_ 3.898.8 0 11. Total Deductions 12. Net Value of Tax Return (11l 3.898 80 13 Ch t . ari able/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) ( 00 14. Net Value of Estate Subject to Tax 13) . (14) 58,316.6 4 NOTE: if an assessment was issued previously, lines reflect figures that incl d 14, 15 andior 16, 17 and 18 will u e the total of ALL ASSESSMENT OF TAX: returns assessed to date. 15. Amount of Line 14 at Spousal rate (15l • 00 X . 03_ . 00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 58, 316 .64 X . 06. 3, 499 O1 17. Amount of Line 14 taxable at Collateral/Class B rat' (17l .00 X .15. . 00 18. Principal Tax Due . TAX CRE (lg) 3,499.01 DITS: PAYMENT DATE RECEIPT DISCOUNT (+) NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 01-11-96 AA082494 229.89- 4,000.00 TOTAL TAX CREDIT 3,770.11 BALANCE OF TAX DUE 271.1OCR INTEREST AND PEN. .00 TOTAL DUE 271.1OCR RETURNS O1 AND 02 (1) .0 0 NOTE: To insure proper (2) .00 credit to your account, (3) .0 0 submit the upper portion (4) .00 of this form with your (5) .00 tax payment. (6) .00 (7) .00 (B) .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN 51, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE STOF nF TNrC FnWM cna TNCTg11rTTnwG ~ r REV-1470 EX (6-88) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 BY SCHEDULE I 1 °ry NO. Lawrence H. Voight Angelique Foica INHERITANCE TAX EXPLANATION OF CHANGES EXPLANATION OF CHANGES Accepted additional deductions. FILE 21 95-0338 101 Page 1 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE REV-1595 EX /F7 (09-97) INHERITANCE TAX RECORD ADJUSTMENT JOHN E SLIKE ESQ SAIDIS ETAL 2109 MARKET ST CAMP HILL PA 17011 DATE 01-28-98 ESTATE OF UOIGHT LAWRENCE H DATE OF DEATH 07-20-94 FILE NUMBER 21 95-0338 COUNTY CUMBERLAND ACN 101 Am fitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: 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 __-___ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ----------------------------- REV-1593 EX AFP ( 09-971 ** -----"'"-"-----"-" INHERITANCE TAX RECORD ADJUSTMENT *~ ESTATE OF VOIGHT LAWRENCE H FILE N0. 21 95-0338 ACN 101 DATE 01-28-98 ADJUSTMENT BASED ON: C URT D T MIN T ON VALUE OF ESTATE: 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) (11 33,000.00 3. Closely Held Stock/Partnership Interest (Schedule C) (2) 368.63 (3) 4. Mortgages/Notes Receivable (Schedule D) .00 5. Cash/Sank Deposits/Misc. Personal Property (Schedule (4) . 00 El (5) 85 0 75 59 6. Jointly Owned Property (Schedule F) , . 7. Transfers (Schedule G) (6) .00 8. Total Assets (71 .00 DEDUCTIONS AND EXEMPTIONS: (8) 93,219.38 9. Funeral Expenses/Administrative Costs/ Miscellaneous Expenses (Schedule H) (9) 16,909 18 10. Debts/Mortgage Liabilities/Liens (Schedule I) . (10) 14,094 76 11. Total Deductions . 12. Net Value of Tax Return (11) 31,003 94 13. Charitable/Governmental Bequests; Non-el.eted 9113 Trusts (Schedule J) 62'215 44 14. Net Value of Estate Subject to Tax (131 .00 TAX: (14) 62, 215 44 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rat (15) •00 X.03 = .00 e 17. Amount of Line 14 taxable at Coll t (161 6 2'215 44 X.06 = 3,732 93 a eral/Class B rate 18. Principal Tax Due (i71 . 00 X.15 = . 00 TAX CREDITS: (18) 3.732 93 PAYMENT RECEIPT DATE DISCOUNT (+) NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 01-11-96 AA082494 245 26- . 4,000.00 TOTAL TAX CREDIT 3,754 74 BALANCE OF TAX DUE . 21.81CR INTEREST AND PEN. .00 TOTAL DUE 21.81CR * IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED FOR CALCULATION OF ADDITIONAL INTEREST . IF TOTAL DUE IS REFLECTED AS A •'CREDIT•• (C . R), A DC CIIWR CCC DCIIC DCC CTRL nC TuTC CnDU CnD VOU MAY BE DUE TuCTD11,~TTn.IC ~ REV~1470 E% ~6-8BI `~` ~~~~~~ INHERITANCE TAX COMMONWEALTH OF PENNSYLVANIA EXPLANATION BUREAU OF INDIVIDUAL TAXES OF CHANGES DEPT. 280601 HARRISBURG, PA 17 ~8-0601 DECEDENT'S NAME . ~ ~ , r , ,t ,' FILE NUM~fyR,~ ~,_ ~ i I /~ ~_____~ SCHEDULE ITEM NO. ~ EXPLANATION OF CHANGES -~ r t r ~`r/, ~ i~~`s~ ~~~GJ~~:, ~~ / Ott v ~ //'~J// G/ / ~`~k ~yl: ~ J;'~/ l/ f ~ r a y ~~ r~~ I~ I ,,; ~ I ~ - ~- ,, _ ' ~~ ~` TAX EXAMINER`` ~ ~ ~ %_ ~ ' / ` PAGE