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Home My WebLink About04-1066 Estate of . U IJ-ft J3. ~~ also known as 17-rz..'j e. '""~..",., PETITION FOR PROBATE and GRANT OF LETTERS I;) I ~(J Lf- / 0 ltJ ~I . No. To': Register of Wills for the County of in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older aQ the execut in the last will of the above decedent, dated 0 C'- + 0 ~lt2- and codicil(s) dated Qc..i:oi>ei'l- I <:> . I q ,,"}8 , $LJbn-tJ C~ J..L'''''''-J G~6 {Ho"'~~c-n named , 19'& , Deceased. Social Security No. Q. 0 Lf- 03 - (o<Jq S- (state relevant circnmstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in /11 h (/12- last family or principal residence at C (list street, number and muncipality) De,cendent; then R L" years of age, died ~ DYe Tn.b e \- I ~ , ,W, ;> 0 D '-/ at C flv<<.-I'\ '"" -f- 6ci:::) ~'f'II.J:>. (' .A-. a LsL.D:'. ,?"". . Except as follows, decedent did not ma~ry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: $ $ $ $. f [;~ D~ Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: 3' tj, t:>c>C> ~ WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) ~ ~ '" -.r ~~ ~~t.,.~ "'~ <l) ... ~~ -g.g cu'';: 3&: <l) '- 50 tU l: bIl en ~ U"11 LJ. f -i"""r~~ ".. -.. .... ::-..1 l . CJ f' CJ ~-: OATH OF'PERSONAL REPRESENTATIVE COMMONWEl\.LTH ~J;NNSY~VANIA 1- ss COUNTY OF ~"'<'i\ ~ \a v\c . J \.0 The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and corrc;ct to the best of 'the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above; decedent petitioner(s) will well and truly administer the estate according to law. and subscribed {~.~~' day of ' I . ~?y. .U ~a-<:<. L <J 'L t.-' C;:r,. l' eg;ster I.. 1~r2t~1?t ~ .;Q' ::! l::l .... ::: ~ ~ No. OJ /~ cQoOC/- / ore & Estate of /Y)llr4 E ThCft1(J5 0 Il ~ Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW J Cf 1c-h L lh/i(j . 'd' "h . . 1~, In conSl eratIOn 01 t e petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated J 0 /1 D 119-7 B . described therein be admitted to robate and filed of record as the last will of ~{)lJ and Letters () are hereby granted to . ;'11 <; an t . , 6etry W./hoMf15til FEES ~' Probate, Letters, Etc. ......... $ 00 ()..) . (, 00 Short Certificates( ).......... $ c;. Renunciation ........ {;;;. PtlA I:. $ -: 0 . . It: t-J J $ % fr 0 TOTAL _ $ 3;):5. v b Filed ....... .0./(91 p. y. . . . . . . . . . . . . . . . . '~0LL AITORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE "2 I - 0 L{- f D~)y, \l ':"":';11" RY\' l)iSh This is to certify that the information here given is correctly copied fron~ an original ce~~ific~te of death du~!. fikd with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent fIlIng. WARNING: It is illegal to duplicate this copy by photostat or photograph. Pee for this certificate, $2.00 No. t2 7.,y) ~ ~ ?2/~ / I'~z., "M.A" Loc~ Registrar G p 10687857 N QV Ja~ 2004 ,.'~ ,~." , J ~ '-' ,J::::~ \.0 ; 43 Ae"V. 2187 COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH . '-' 1.fT\ AGE (Last BIf1 E. /ho.h UNDER 1 YEAR MonI~ Daya SEX ..Fe f>\ STATE FilE NUMBfR SOCIAL SECUAIT'V NUMBER DATE OF DEATH tMcrntl. Da~. leal) NAME at: DECEDENT IFI~sl. Middle. L.uo:) 5. Sb Yrs COUNTY OF OEATH BIRTHPLACE Ie" ,,!rod PlACE OF OEATH IO'K" Qfll'1l)(le ->ee InslfU(;IIOf'~ OOOlt>el SIOeI Stale Of FcrelQfl COUflllYI HOSPITAL H....rr. '.....-l. rfl In"'''....O ERlO......'.n' 0 DOAO ,. ... FACILITY NAME (II nOllfll.Nullon, \jIve slleet and number I '.20'1 -0.1 -b8cr,'!>- .. "e...J.J er ;~ ZOo lb. RACE. Amellcan Indian, BlaCk. Wtlit.. ttc: (S""",,,,) 1.. W~. (,e MARITAL STATUS. M."jed SURviVING SPOUse N..,., Marrtred, Widow.d, ltt "...,.. 0;,"" malOen nNnlill OMl<CO<l (Spec...,) 1.. LJ. Ju...H'd 11. 17c.Ciil ,""._liYodin ~0."Lh ,'Y\..!..lI.d.....,,J ~IO Iwp """-.0 ). 00'-/ A {. ,,,.<Ct." 1',> n. A'( ,;:,'1, i.. , , ( DUE TO lOR AS A CONSEOUENCE Of)" ... I ApploaUnaI. : intetVal between I onset and death I : No8l' M. 25. 27. PART I: Ent.,. the diseases, inlu,ies Of compacalionl which caused lhe dliIalh 00 nol 8nlel lhe mode ot d...ing, such as cal~ac 01 resptrafory all8sl. shock o. heart ladur. lJll only one cause on each line PART II: Other stgliiftcant COIldiIionI contributing to dea'h. buI not relUllirli in the undIItytng c-... given in PART I. [1",'<.1/-""t,,'v,0("'L,..... (LL;~"( DUE 10 (OR AS A CONSEauENCE OF)' 11. I, i;,. 1/7.J (.// J~,."..,~ DUE TO (OR AS A CONSEOUENCE Of)" I: .b....., . WERE A.lJTOP$Y FINDINGS AVAILABLE PRtQR 10 COMPLETION OF CAUSE OF DEATH? MANNER OF DEATH NO~ v.. 0 NoD Nalural 0' Acetde"l 0 SuiCide 0 DATE OF INJURY (Month. Da.... Year) TIME OF INJURY INJURY AT WOAK? OESCRtOE HOW INJURY OCCURRED HomICide o [J o PLACe OF INJURY. AI home, larm.':;eet. factory, office M. building. ele. ISpecllv) 300. Y.. 0 NoD Pendtng lnveSlag;UlOn Could notobe delemuned lOCATION (Slreet. CtlylTown. SIaI81 2... 2ab. CERTifiER lCheck OOy one) .CERTIFYING PHVSICIAN (PhVSlC.ancerlll...109 cause at dealh wh.l" <1nOlllet Dh....s.c.'an has Pfonouoced dedlh ana completed Item 231 To the beaI of my know'-dge, de.lh occurred due to the cau..(.. and manne,.. Itated. . 't. .PRONOUNCIHG AND CERTifYING PHYSICIAN tPhtSiClan (JOIn ;JIOflOI.UI(:oflg l1edU1.md 1.:t'ftlIYIOg 10 LdU~ 01 (ledlh\ To Ihe belli ot my knowledg., dealh occurred allhellme, date, and place, and due 10 the cause(l) and mann.,.. I'aled.. u '". DATE FILED (Monlh Day, 1ean ~ 'MEDICAL EXAMINER/CORONER On theb.ail ot examination and/or inyestigalion, in my opinion, dealh occurred illlhe lime, dat., and place, .md due 10 the cause(a) and manner as stated., . . . . , . , . . . . . , , , . . . . . , . . . . . . . . . .. . , . . ". REGISTRAR'S SIGNATURE AND NU" ""'11 0~ ~ /( ;/...~-<2a.v~ 4'T- [] I~ I o? II' ( I ]4. LAST WILL AND TESTAl.ffiNT . o ..!~ OF MARY E. THOMPSON \..C I, MARY E. THOr~SON, of the City of Harrisbur~ Dauphin County, Pennsylvania, do declare this to be my Last Will and Testament and revoke any Wills previously made by me. ITEM I. I direct that all of my just debts and funeral expenses, including the cost of my gravemarker, if any, shall be paid from my residuary estate as soon as practicable after my decease as a part of the administrative expenses of my estate. ITEM II. I give and devise all of my estate of every nature and wherever situate to my husband, MILLARD W. THOMPSON, providing he survives me by thirty (30) days. ITEM III. Should my husband, MILLARD W. THOMPSON, pre- decease me or die on or before the thirtieth day following my death, then I give and devise all of my estate of every nature and wherever situate in equal shares to my children, SUSAN E. GALLION and GARY W. THOMPSON, or their issue per stirpes. Should either of them predecease me without issue, then I give the share of such child to the then surviving of those two children, or issue. ITEM IV. I appoint my husband, MILLARD W. THOr~SON, as Executor of this my Last Will and Testament. Should he fail to qualify or cease to act as such, I appoint my children, SUSAN E. GALLION and GARY W. THOMPSON, as Co-Executors of this my Last Will and Testament. No bond shall be required by my personal repre- sentatives in any jurisdiction. ITEM V. In addition to the powers given to my Executor and Co-Executors by operation of law, the following powers are herein given to them to be exercised by them at their sole discretion: A. To retain property received by them and to invest in all forms of property without restriction as to investments; ?n7 cf 'tIfan~ B. To operate any business, corporation, partnership, or enter into any recapitalization, merger, reorganization or voting trust plan and to delegate authority with respect thereto and to deposit investments under agreements and pay assessments and to exercise all rights of an investor; C. To hold investments in the name of a nominee or to compromise controversies with respect to any assets held by them; D. To exchange or sell for cash, property or credit, publicly or privately, or to lease for any term without liability to see to the application of the consideration and to give options for such purposes without obligation to repudiate them in the favor of a higher offer and to mortgage any assets held by them; E. To make distributions in cash or kind or partly in each at the valuations fixed by each and the right to borrow money, including the right to borrow from themselves as Executor and Co-Executors; and F. To exercise and dispose of warrants and to loan to and buy property from my estate. IN WITNESS WHEREOF, 'I have hereunto set my hand and seal thiS~()~ day of C5~1-d 6-.br) , 1978. mlT~ e. 'flfrlZ~ l~ ry E. omps The preceding instrument, consisting of this and one (1) other typewritten page, identified by the signature of the testator, was on the day and date thereof signed, published and declared by Mary E. Thompson, the testator therein named, as and for her last Will in the presence of us, who at her request, in her prese~ e and~' the presence of each other have subscribed our names s w'Bnes es hereto. , ') /... r ,} d3~ N :2,,-cfJ L~ LV d/YJ~/ j c-\ 17/()r '""'I;): V1 1,:'/1::1 ?I -I-l Il/l/ . '~7' ~ f'/ (71 off <'" 'LX. I / ,A ,y[., / ",..4'.. u "".(i (f.',L t..r \ ~ 1 > c?:le> AJd-.{-t:rf!-Wv ~ J?J>~ ", ''-.:/' " I,,?" IJ I \ J) [J--r VA.l ,: ?.../ ( A;,j}/<.<)A.P ,7I.A) ~0 ~~d' _&4/ _ '-./ ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA: SS: COUNTY OF DAUPHIN : I, MARY E. THOHPSON , testatrix whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my last Will, that I signed it willingly, and that I signed it as my free and voluntary act for the purposes therein expressed. J1?A1i; "<ho'{;{,,~4M1--' Sworn or affirmed to and acknowledged before me, by MARY E. THOMPSON , testatrix, this . f,_J ii, day of 1-0c~-...J , 1978 . ~~l-()-f 0. ~^~ Notary Publ' My Commission Expires: NOTARY PUBLIC My (om:nis,'un Expires InlCmbi:/ b. 1980 Harrisburg, PA Dauphin (eun1v AFFIDAVIT COMMONWEALTH OF. PENNSYLVANIA: SS: COUNTY OF DAUPHIN t) '}We l 'if;;/", {PM U A_ -U.~.A/tfl (0:;) L.~tt>.J' ~fi-4\J' J tVk-1--./ Lt..1....d2JIA"J.o(..../,. \ u :./~ l , the witnesses whose names are signed to the atta ed or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw testatrix sign and execute the instrument as her last Will; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatrix signed the will as her witnesses;. and that to the best of our knowledge the testatrix was at that time 18 or more years of age, f sound m.~' . and under no constraint or undue influence. / /,- '- /Jh'. . \ L.!. (.}I~..A...cL - I ;;:"; J ; ~G ,:/~,jj .ib,,:; ~ ~/ / C,.J-~ day ~ /' ..' .//~__7 ~ L.-/ Sworn to and subscribed be~ore me this ()c,Jclat)j ,19 78 . of (lc~.J {i. ...J/.v~~ ~;JA ~ Notc:r:j' I'ut{. 'lC !-1y Com...'Tlission ::-.Y1i!-es: rnTARY PUBUC My . (om:n;':."" hp,res December 6. 1980 Harr;sburo. PA D I . ~ aup lE'j {1lWJt1tV ~~" _ ~'S.K.. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '* NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP 101-05) DAVID H MARTINEAU METZGER WICKERSHAM PO BOX 5300 HBG PA 17110 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 09-20-2004 CULLEN 12-17-2003 21 03-1066 CUMBERLAND 101 DONNA M Allount Rellitted 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 =i5'4-j-E3f-AFP--foY:oiY-No,.-icE--oF-YNHErfiTANcE-,.-A'x-A-PPRA-isEi"-ENT~--~~.-. -Ai.fc~OR---_~-::r------- --- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENTi~;'TAX .c:,. ;;': "~k.' ESTATE OF CULLEN DONNA M FILE NO. 21 03-1066 ACj" 101 DATE 0"9-20-2004 ~<' TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANG~D Cd RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 4. Mortgages/Notes Receivable (Schedule D) (4) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets -.j 133.500.00 ,: .00 .00 .00 1, 666 .56 42.921.54 .00 (8) 178,088.10 ::::::./ I'.JNOTE :Io .,insure proper wcredit tli;.,your account, 1.0subllit the upper portion of this forll with your tax paYllent. APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequestsj Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 31,609.72 79.883.42 (11) (12) (13) (14) 111.493 14 66,594.96 .00 66,594.96 NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ~ returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: .00 66,594.96 .00 .00 X 00 = X 045 = X 12 = X 15 = (19)= .00 2,996.77 .00 .00 2,996.77 ""'.."'....-. l+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 03-17-2004 CD003700 149.84 3,000.00 TOTAL TAX CREDIT 3,149.84 BALANCE OF TAX DUE 153.07CR INTEREST AND PEN. .00 TOTAL DUE 153.07CR · 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" (CR), YOU MAY BE DUE '1/ '\. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to eppraise and assess transfer Inheritance Texes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: PAVMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENAL TV: INTEREST: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side. --Make check or money order payable to: REGISTER OF HILLS. AGENT A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of t~e Register of Wills, any of the 23 Revenue District Offices, or by calling the special 24-hour answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and I or speaking needs: 1-800-447-3020 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administrativelY correctable errors. If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (570) discount of the tax paid is allowed. The 1570 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (670) percent per annum calculated at a dailY rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2004 are: Interest Daily Interest Daily Interest Rate Factor Vear Rate Factor Vear Rate ZJi7."'""'"" -:D"il"fim ~-1991 ~:1iDD!'OI" m1 ~ 1670 .000438 1992 970 .000247 2002 670 1170 .000301 1993-1994 770 .000192 2003 570 1370 .000356 1995-1998 970 .000247 2004 470 lOX .000274 1999 77. .000192 lOX .000274 2000 77. .000192 Vear rID 1983 1984 1985 1986 1987 Daily Factor .~ .000164 .000137 .000110 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717)240-6345 Date: 02/28/2005 GALLION SUSAN E 1769 NORMANDIE DRIVE YORK, PA 17404 RE: Estate of THOMPSON MARY E File Number: 2004-01066 Dear Sir/Madam: It has come to my attention that you have not filed the Certification of Notice Under Rule 5.6 (a) in the above captioned estate. 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 ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing is due by: 03/01/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, GL6R~~ Clerk of the Orphans' Court cc: File Counsel Judge Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717)240-6345 Date: 02/28/2005 THOMPSON GARY W 64 WESTWOOD CRT ENOLA, PA 17025 RE: Estate of THOMPSON MARY E File Number: 2004-01066 Dear Sir/Madam: It has come to my attention that you have not filed the Certification of Notice Under Rule 5.6 (a) in the above captioned estate. 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 ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing is due by: 03/01/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, GL~~~ Clerk of the Orphans' Court cc: File Counsel Judge Name of Decedent: CERTIFICATION OF NOTICE UNDER RULE 5.61al 1/1 -- {'-"I IIIl-J '{:;. - 1 HO/1\P~a,...J f ;J D ve rl'\- (3 e rz.-. (3 I d6<::>Y dl bY -I l'Jb C. Date of Death: Will No. rl. Do L{ - Dldt, " Admin. No. To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) ;jthe Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on Ol/-tEmlbea- I '1 ~..o'/. I Name Address C::4~ J H-6(h~O'n toLl We<;:{ w<>.;() Cp:r; e lvol4., ~)}.....5' < St{5~10 r:;ALLf~ J7t'1 ~ DR. Mt4IJf> ~ ~ j) /l. . 'lOp-/:. .pt(. 17'16" J Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: YJ1 ~ '-I I ./ .JbO!> -AzjI4<~ Sigf:j ------ Name G ft 0-'1 11-1 t> fh1!:o^, Address C, if pJ es. -r W""r;;. C p-;-, E fJ 0 L .4, p.,. .-- r1~2,..) Telephone 0., ) 13,;) - I D 3 $?" Capacity: ~~ersonal Representative ~ ." ,; _Counsel for personal representative o CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: ~\a $''<1 \=- \ \ -- \~~ Will No. WC)4- - 0 \ 0 ~ ~ Date of Death: '\ "^ 0 <N\ ~ <;, c""\ \f\ (~ 4-- Admin. No. '2~ \ - Dt - \ 0 \. <l (\,) To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on Name Address S$"C.;d'{\ E _ ()d. \\\<'\\\ Ga{''i .~ ,\\\(~'M~'S,(~V\ nl9~ \\16{' M~Y\~\ ~~"~tl~~ ~ ~ l,A \;k -,; \ CD ~ C-A \'/1<J1-- -E '{\C)\~ I \S (i02.:s Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: '?:, - c;:" -as Signature ~-0'\''i_.~~~) NameC::J"C~;?I.\(\ _ t"_ Ga\(\c~n Address \7L,c~ Nc>~ I\i\.dl/\l\~ ~('\ "<o~v. ~ A. \ \7404--qD.2~ Telephone (')\? ----'lJp7 - '7 '? 04--. Capacity: ~ Personal Representative C.:" _Counsel for personal representative i>- COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE *' BUREAU OF INDIVIDUALTIollES' INHERITANCE TAX DIVISION PO BDX 280601 HARRISBURG PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEI1ENT, ALLOWANCE OR DISALLOWANCE Of DEDUCTIONS, AND ASSESSMENT OF TAXON .JOINTLY HELD DR TRUST ASSETS REV-1548 EX AFP (03-05) , ~: 35 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 06-27-2005 THOMPSON 11-13-2004 21 04-1066 CUMBERLAND 204-03-6895 05110101 AIIo...t RNitted MARY E (- MILLARD WTHOMPSON 64 WESTWOODCT ENOLA PA 17025 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ... A"'-~'1r"J:~J.1rG~~1.................................................................................... NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLONANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 06-27-2005 ESTATE OF THOMPSON MARY E DATE Of DEATH 11-13-2004 COUNTY CUMBERLAND fILE NO. 21 04-1066 TAX RETURN WAS: S.S/D.C. NO. 204-03-6895 (X) ACCEPTED AS fILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 05110101 fINANCIAL INSTITUTION: WACHOVIA BANK NA ACCOUNT NO. 1000653976687 TYPE OF ACCOUNT: () SAVINGS (XI CHECKING ( ) TRUST ( ) TIME CERTIfICATE DATE ESTABLISHED 06-25-1981 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 0.500 .00 .00 .00 .15 .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION Of THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER Of WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER Of WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. . IF TOTAL DUE IS LESS THAN $1, NO PAYNENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. ) ~",,"- I , I ~ (.' {~r,n-'- ~ !\rr-.'~0..r-.., ~~.' '-"i:~:i~.\~.!-'-__,' i) t./;-'I'-;\,,it L '\ .. ,"-- \. i" -~ . '. "I . rj~.J- of' 2C' r" ~ '('Fi_' ,j~~t ~ \, \'f:-' -- 1 . \ ~~.....\v ~~ ~ ~ f) .......;) " j \j ~ ~\ ~i' r" >, .'.---., ,J ~~__. ~~" '. I ~., :/ '- ',' ,,,1\'.., ~-:I,:~ ~ --J ~ ~ ~ l ~ f\) ~ ~ $ Vl ~ -:- 1- \S0..; \Y --.) .,J GvU(J ~ ':J) ~ . V\ ...... ~ ~ - I J <:) - - - - - :::::: - - .- - - - - - 1".1 1)'1 1") 1'.) '. ". I') "", "', I... I'" .r" COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. Z80601 HARRISBURG, PA 171Z8-0601 *' INFORMATION NOTICE TAXPAYE~~~~~~~!CE REV-154! EX AFP [09-001 FILE -,~CN 'DATE NO. 21 04-1066 05107296 03-02-2005 TYPE OF ACCOUNT o SAVINGS [Xl CHECKING o TRUST o CERTIF. FORHS TO: ** GARY W THOMPSON 64 WESTWOOD ST ENOLA PA 17025 E5TZDifFf\i~~~5E rr;"O"P$)t) 5.5. NO. 204-03-6895 DATE OF qE~r-tt:. (1)-13-2004 COUNT~>F,i ';-'~..tJMB.Ell~-AND 01 REHITPAYHENT AND " REGISTER 'OF WILLS CUMBERLAND CO COURT CARLISLE, PA 17013 HOUSE WACHOVIA BANK NA has provided the Department with the information 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 information is incorrect, please obtain written correction frail the financial institution, attach a copy to this forll and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions lIay be answered by calling (717) 787-83Z7. COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 1010084283599 Date 02-09-2004 Established x 74,691.72 50.000 37,345.86 .15 i,f;91.88 To insure proper credit to your account, two (Z) copies of this notice must accompany your paYllent to the Register of Wills. Make check payable to: "Register of Wills, Agent". Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x Tax ;.j ~ < 1~ , NOTE: If tax payments 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 become delinquent nine (9) lIonths after the date of death. f" PART [!] A. [ CHECK ] ONE BLOCK B. ONLY c. TAXPAYER RESPONSE [] The above information and tax due is correct. 1. You may choose to remit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you may 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. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent.s representative. [] The above inforllation is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. PART @] DATE PAID DEBTS AND DEDUCTIONS CLAIMED PART [3] TAX RETURN - COMPUTATION If you indicate a different tax rate, please state your relationship to decedent: LINE 1. Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF TAX ON JOINT/TRUST ACCOUNTS I 2 3 X 4 5 6 7 X 8 PAYEE DESCRIPTION AMOUNT PAID I TOTAL (Enter on Line 5 of Tax Computation) of perjury, I declare that the facts I of my knowledge and belief. HOME I $ correct and (> ~-II"'-c~- DATE GENERAL INFORMATION 1. fAILURE TO RESPOND WILL RESULT IN AN OffICIAL TAX ASSESSMENT with applicable interest based on information submitted by the financial institution. Z. Inheritance tax becomes delinquent nine months after the decedent's date of death. 3. A joint account is taxable even though the decedent's name was added as a matter of convenience. 4. Accounts (inCluding those held between husband and wife) which the decedent put in joint names within one year prior to death are fullY taxable as transfers. 5. Accounts established jointly between husband and wife more than one year prior to death are not taxable. 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 information and computation in the notice are correct and deductions are not being claimed, place an "X" in block "A" of Part I 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. Z. 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 "B" of Part 1 of the "Taxpayer Response" section. Sign one COpy and return to the PA Department of Revenue, Bureau of Individual Taxes, Dept Z80601, Harrisburg, PA l7lZ8-o6ol in the envelope provided. 3. BLOCK C - If the notice information is incorrect andlor deductions are being claimed, check block "C" and complete Parts Z and 3 according to the instructions below. Sign two copies and submit them with your check for the amount of tax payable 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. TAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Enter NOTE: the date the account originally was established or titled in the manner existing at date of death. For a decedent dying after lZ/lZ/8Z: Accounts which the decedent put in joint names 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 number of accounts held. If a double asterisk (MM) appears before your first name 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. Z. 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 established more than one year prior to the decedent's death: DIVIDED BY TOTAL NUMBER OF DIVIDED BY TOTAL NUMBER OF X 100 PERCENT TAXABLE JOINT OWNERS SURVIVING JOINT OWNERS Example: A joint asset registered in the name of the decedent and two other persons. 1 DIVIDED BY 3 (JOINT OWNERS) OIVIDED 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 death 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 OR TRUST BENEFICIARIES X 100 PERCENT TAXABLE Example: Joint account registered in the name of the decedent and two other persons and established within one year of death by the decedent. 1 DIVIDED BY Z (SURVIVORS) = .50 X 100 50% (TAXABLE FOR EACH SURVIVOR) 4. The amount subject to tax (line 4) is determined by multiplying the account balance (line Z) by the percent taxable (line 3). 5. Enter the total of the debts and deductions listed in Part 3. 6. The amount taxable (line 6) is determined by subtracting the debts and deductions (line 5) from the amount SUbject to tax (line 4). 7. Enter the appropriate tax rate (line 7) as determined below. Date of Death Spouse Lineal Sibling Collateral 07101/94 to 12/31/94 3% 6Y. 15% 157- 01/01/95 to 06/30/00 0% 6% 15% 157- 07101/00 to present 0% 4.5%. 12% 15% MThe tax rate .mposed on the net value of transfers from a deceased ch.ld 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%. The lineal class of heirs includes grandparents, parents, children, and lineal descendents. "Children" 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 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 common with the decedent, whether by blood or adoption. The "Collateral" class of heirs includes all other beneficiaries. CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowable debts and deductions are determined as follows: A. You legally are responsible for payment, or the estate subject to administration by a personal representative is insufficient to pay the deductible items. B. You actually paid the debts after death of the decedent and can furnish proof of payment. C. Debts being claimed must be itemized fully in Part 3. If additional space is needed, use plain paper 8 l/Z" x II". Proof of payment may be requested by the PA Department of Revenue. 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 THOMPSON GARY W 64 WESTWOOD CRT ENOLA, PA 17025 n__n__ fold ESTATE INFORMATION: SSN: 204-03-6845 FILE NUMBER: 2104-1066 DECEDENT NAME: THOMPSON MARY E DA TE OF PAYMENT: 08/25/2005 POSTMARK DATE: 08/24/2005 COUNTY: CUMBERLAND DATE OF DEATH: 11/13/2004 NO. CD 005725 ACN ASSESSMENT CONTROL NUMBER AMOUNT 05107296 I $100.00 I I I I I I I I TOTAL AMOUNT PAID: $100.00 REMARKS: CHECK# 549 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS r' .... , i ;, ,":" u.,,; . '-'.. -:'-2C~~j :"L ,..-.,' \ J 'ij ,"1,.0 !.') :-~, i:_ ! Iii I I 't"I ...of C'j '2 C'j ~ ....... rn >. 0) 0 rn ><: 2 0) C'j \0 0) ;:l f- '9 " s::....... co - 0) C'j N '-+-< ~;:l ....... 00)"'0 f"-. ...t:: ~ 's:.............. I ..::::<+-.i.....-l 0 ~ C'jO"'O\O'-'., ~........soo.. .,.s:: COb[) s::~15NI-< 0;::;< ,"",;:l d~;:l""..o ;::;< C'j 0 rn S 0) co ,- ofr~o~ UOCOo..:I: DEX55 (9-931 '* .., '" " r. 0 : ': ~. jj tit "-.-' ~ - ~ - - - - - - ~ ~ "r I,. -s. 8 ! ; r;>o, ,l. [ j. \._' wCl) =w z><z wi!o >....- weCl) a:=> Ll.QQ 0- ....>>< zQi! if wZ :e-W"'CJ .... oLl. () C) a: a: ZeD= !C=i!im A;e-C'iCl) Ww a:,..: a: Qa:!I!o.a: if~a;~~ ,.. C) eD :i C'i ,.. .... ,.. Q. l'l ! ~ ~ c o ~ ~ c COMMONWEALTH OF PENNSYLVANIA BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE Dear Register of Wills:~ Enclosed you will find: Mcheck(s) Ddoc;um.nt;(s) which were received by the Department of Revenue in error. These may be processed according to no~maT procedures. REMINDER: The POST MARK DATE on envelope a"ached to any checks enclosed must appear on your Official Receipt. O~ : I . C-:. _.] S:E Thank you. rLl U) ::> o ::r:: E-i U)~ ~~o .-i rLl....:lU% ~~oU)~ ~ UrLl lidi.. CJ) ~ ~o~::>~ ~~ grLl ZrLl E-i~ rLlE-i~~U) ~U)IJ;:l::>H OHj:QO~ CJ)g~u~ ~~U.-iU M ( I -' ,_ - I' C}.J::JO:J3d \ ~ ~. ' ';:. ;'\i . :'......... ===== .' '~:\.~.. C~., _ , f"; ",':j =~~ ~~._! ,L "y ~,~.i ~ - (I) T-! C)j c= r'M L') ..... I/! II a.:.. , ...l -:1 H I ~ : w Sincerely, John Murphy, Chief Inheritance Tax Division (717) 787-6201 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 11 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 '* INFORMATION NOTICE " ,",,-.r" , -'I'''~ "".AND .::). i-\.U...,rf..(jC~Y.ER RESPONSE REV-1543 EX AFP 1I~-a.o1_ :1 FILE ACN DATE NO. 21 051 03- 4-1066 7295 2-2005 ~~ SUSAN E GALLION 1769 NORMANDIE DR YORK PA 17404 TYPE F ACCOUNT Ii:' '. -9 r; iEst.3 raF MARY E THOMPSON 0 SAVINGS S. S. NO. 204-03-6895 [Xl CHECKING DATE OF DEATH 11-13-2004 0 TRUST COUNTY CUMBERLAND 0 CERTIF. REHIT PAYHENT AND FOR S TO: REGISTER OF WILLS CUMBERLAND CO COURT H USE CARLISLE, PA 17013 WACHOVIA BANK NA has provided the Department with the information listed below which has been used ili1 calculating the potential tax due. Their records indicate that at the death of the above decedent, you were a joint owner/be~eficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form 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) 787-8327. ! COMPLETE PART 1 BELOW ~ . . SEE REVERSE SIDE FOR FILING AND PAYMENT .lN5TROCn Account No. 1010084283599 Date 02-09-2004 Established Account Balance Percent Taxable Amount Subject to Tax Rate Potential Tax Due x 74,691.72 50.000 37,345.86 .15 5,601.88 TAXPAYER RESPONSE To insure proper credit to your acco nt, two (2) copies of this notice must acco.. any your payment to the Register of Wills. H ke check payable to: "Register of Wills, Agen ". x NOTE: If tax payments are made with n three (3) months of the decedent's date of death, you ..ay deduct a 5% discount of the ax due. Any inheritance tax due will become elinquent nine (9) months after the date of de tho Tax PART [!] LINE l. Dah. Fo::tabli!li:hed 1 2. Account Balance 2 3. Percent Taxable 3 4. Amount Subject to Tax 4 5. Debts and Deductions 5 6. Amount Taxable 6 7. Tax Rate 7 8. Tax Due 8 PART @] DATE PAID PAYEE above information and tax due is correct. You may choose to remit payment to the Register of Wills with two copies of this notice obtain a discount or avoid interest, or you may 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. [CHECK ] ONE BLOCK ONLY B. [] The above asset has been or will be reported and tax paid with the Pennsylvania Inheritance to be filed by the decedent's representative. C. [] The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. PART If you indicate a differe~x rate,~~se s~te your @] relationship to decedent: ~t ~ ~ ---!!E!. ~ TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST x x4,s \\C~\k~~ DEBTS AND DESCRIPTION TOTAL (Enter on Line 5 of Tax Computation) $ perjury, I declare that the facts I knowledge and belief. A have reported above HOME ('7 , WORK ('7 \ TELEPHONE correc and ~-C\S GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with applicable interest based on information submitted by the financial institution. Z. Inheritance tax becomes delinquent nine months after the decedent's date of death. 3. A joint account is taxable even though the decedent's name was added as a matter of convenience. 4. Accounts (including those held between husband and wife) which the decedent put in joint names within one year prior to death are fully taxable as transfers. 5. Accounts established jointly between husband and wife more than one year prior to death are not taxable. 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 information and computation 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 Oepartment of Revenue will issue an official assessment (Form REV-1548 EX) upon receipt of the return from the Register of Wills. Z. 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 "8ft of Part 1 of the "Taxpayer Response" sBction~ Sign one COpy and return to the PA Department of Revenue, Bureau of Individual Taxes, Dept Z8060l, Harrisburg, PA l7lZ8-060l in the envelope provided. 3. BLOCK C - If the notice information is incorrect andlor deductions are being claimed, check block "C" and complete Parts Z and 3 according to the instructions below. Sign two copies and submit them with your check for the amount of tax payable 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. TAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Enter NOTE: the date the account originally was established or titled in the manner existing at date of death. For a decedent dying after lZ/lZ/8Z: Accounts which the decedent put in joint names 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 number of accounts held. If a double asterisk (WW) appears before your first name 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. Z. 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 established more than one year prior to the decedent's death: 1 DIVIOEO BY TOTAL NUMBER OF DIVIDEO BY TOTAL NUMBER OF X 100 PERCENT TAXABLE JOINT OWNERS SURVIVING JOINT OWNERS Example: A joint asset registered in the name of the decedent and two other persons. 1 OIVIDEO BY 3 (JOINT OWNERS) OIVIOEO 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 death 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 OR TRUST BENEFICIARIES X 100 PERCENT TAXABLE Example: Joint account registered in the name of the decedent and two other persons and established within one year of death by the decedent. 1 DIVIOED BY Z (SURVIVORS) = .50 X 100 50% (TAXABLE FOR EACH SURVIVOR) 4. The amount subject to tax (line 4) is determined by multiplying the account balance (line Z) by the percent taxable (line 3). 5. Enter the total of the debts and deductions listed in Part 3. 6. The amount taxable (line 6) is determined by subtracting the debts and deductions (line 5) from the amount subject to tax (line 4). 7. Enter the appropriate tax rate (line 7) as determined below. WThe tax rate lmposed on the net value of transfers from a deceased Chlld 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%. The lineal class of heirs includes grandparents, parents, children, and lineal descendents. "Children" 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 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 common with the decedent, whether by blood or adoption. The "Collateral" class of heirs includes all other beneficiaries. Date of Death Spouse Lineal Sibling Collateral 07/01/9ct to 12/31/94 3% 6% 15% 15% 01/01/95 to 06/30/00 0% 6% ' 15% 15% 07/01/00 to present 0% 4.5%. 12% 15% CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowable debts and deductions are determined as follows: A. You legally are responsible for payment, or the estate subject to administration by a personal representative is insufficient to pay the deductible items. B. You actually paid the debts after death of the decedent and can furnish proof of payment. C. Debts being claimed must be itemized fully in Part 3. If additional space is needed, use plain paper 8 l/Z" x II". Proof of payment may be requested by the PA Oepartment of Revenue. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA INHERITANCE AND ESTAT OFFICIAL RECEIPT RECEIVED FROM: GALLION SUSAN E 1769 NORMANDIE DRIVE YORK, PA 17404 ___n_h fold ESTATE INFORMATION: SSN: 204-03-6845 FILE NUMBER: 2104-1066 DECEDENT NAME: THOMPSON MARY E DA TE OF PAYMENT: 11/09/2005 POSTMARK DATE: 10/31/2005 COUNTY: CUMBERLAND DATE OF DEATH: 11/13/2004 TOTAL AMOUNT P REMARKS: CHECK#1529 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS REV-1162 X(11-96) E TAX NO. CD 005 985 ACN SSESSM ENT AMOU~ T CONTROL NUMBER -------- 05107295 I $1,681. )0 I I I I I I I I AID: $1,681. PO GLENDA FARNER STRASBAL GH REGISTER OF WillS A REv-1500 EX (6-00)- OFFICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 . HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ")..L-~~ COUNTY CODE YEAR. -"-~~~~ NUMBER SOCIAL SECURITY NUMBER ~DLJ - 03 - 0~~ to- Z W Q W (J W Q E (LAST, FIRST, AND MIDDLE INITIAL D P$b,.) r. DATE OF EATH (MM-DD-YEAR) 11- 13 -;) &c:::::. '+ D 5 - ~ '-{ - I ~ (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) tU Dt0e' I lI( (J w II:: z o ~ ~ :;) Q. :IE o (J ~ THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISjrER OF WILLS SOCIAL SECURITY NU BER o 2. Supplemental Retum o 4a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a Living Trust (Attach copy of Trust) o 10. Spousal Poverty Credit (dale ofdealf1 between 12-31.91 and 1-1-95) o 3. Remainder Retum (dale of dealf1 poor to 12-13-82) o 5. Federal ES'!3te Tax Retum Required 8. Total Number of Safe Deposit Boxes o 11. Election to: tax under Sec. 9113(A) (Attach Sch 0) I FIRM NAME (If Applicable) TELEPHONE NUMBER 73.",;;)..- l t::>3g"" 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. JoinUy Owned Property (Schedule F) o Separate Billing Requested 14. Net Value Subject to Tax (Line 12 minus Line 13) COMPLETE MAILING ADDRESS , \ ' h Y {,)J<?STW~cSD C~ i? /.J D L rt t PC('. l J 02-5" (1) (2) (3) (4) (5) OFFICIAL USE ONLY r--> = = CJ"\ X o cC N W o. c:;O ::t~5 -,j ~-~ g .....::,,~~. ::TJ .~ (}) 7::' :-~\;3 ~~ 'j:a . --i :E~ N ::0 r1l C') o ::"l.:J CJ rTl CJ c> "'11 -t-\ e5 rn c..:::> ....... 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. TotI! Gross AI.- (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent. Mortgage Liabilities, & Liens (Schedule I) 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) 3 7, 3l.j.~ '~, ,:.- -!'?' - - - (6) (7) (9) (10) d ,/<5:3 I (8) 37 J "3 'f: ~.?1 Co. (11) ~ (~-S. CO (12) 3 s-' I ,-,.. ~ b I (13) (14) 3 S b;>. 8" ~ SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due ~<- .:3~ JbCj.. ) x .0_ (15) x .0 ...45 (16) x .12 (17) x .15 (18) (19) CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 20.0 Decedent's Complete Address: STREET ADDRESS b rJ AlOUE (2 ~ <. CITY -e- ~ Tax Payments and Credits: 1. Tax DUe '(Page 1 line 19) " 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) .' Total Credits (A + B + C ) (2) 3. InteresVPenalty it applicable D. Interest E. Penalty TotallnteresVPenalty ( D + E ) (3) 4. If line 2 is greater 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 + SA. This is the BALANCE DUE. (5B) Make 'Check Payable to: REGISTER OF WILLS, AG~NT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. ~.idr:~~d;:t~::~ ~n:;~:f ~~::property tranSferred;............................:....:........................................................ r:L- ~ t ::;~ ~h~e:~:i~~:~s;~~::t~:~..~.~.~~~.~~.~~.~~.~.~~.~~~.~.~~.~~.~~~~.~.;.:::::::::::::::::::::::::::::::::::::::::::: 0 ~ d. receive the promise for lite of eittler payments, t>enefitsot c:are? ...................................................................... W 0 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ..............................................................................................................0 ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D W 4. ~~~::e::~~:~ I::::~o~~ti~~~~~~.~~~.~~'..~~~~i.~:.~~..~.~.~~.~~~~~~~~~~.:.~~.~..~~~~~......,............... 0 ~ IF THE ANSWER yo ANY ()F THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN, Under penalties of perjury, 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 personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE ADDRESS SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS 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. ~9116 (a) (1.1) (i)l. For dates of death on or after January 1, 1995, the tax rate imposed on the net valueoftraosfers to or .for' t1ie use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum 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 paren~ 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 of the decedenfs 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 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 '). ,J{1dividual who has at least one parent in common with the decedent, whether by blood or adoption. .;", ' \ ';""'<"'.l.'"..',",'l'~" i:'ll!"lt3L,..JWJIIIR:i.'IImIii~~lJ!1fl~11l/,~'" ._-""".",. . --~.,..". COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER If an asset was made joint within one year of the decedenfs date of death, It must be reported on Schedule G. , SURVIVING JOINT TENANT(S) NAME ADDRESS ! RELATIONSHIP TO DECEDENT , A. G f\{~, 1 Hotv' fSl'".J ~L/ ~~S'Ttu~u:b C~ SD~ f? 10 D 1- A. {? ell . " ~ )... ,>"- \ B. , I C. JOINTLY -OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE Include nlll1e of financial institution and balk account number or similll' identifying number. AlIach DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT deed for joinUy-heId real estate. VALUE OF ASSET INTEREST DECEDENTS INTEREST 1. A. WAChbV'~~ ~~cl::- S 'I ~'f5: 8'~ , ~ I I . TOTAL (Also enter on line 6, RecaPitulati4n) $ .. I (If more space IS needed, Insert additional sheets of the same size) REVtil511 EX+ (12-99) . '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM I NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: C + ' ! ~ f.(~ 1. 1( Q Iv\.t"r 1 ~ /J4 .s::. '-e Y>-t....-h.L l..+ .;t. ~ "8' S- -f /OtJ 1- J-Dw~r s ~ . I Y) n e c,- $d~ B. ADMINISTRATIVE 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. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant - Street Address I City State _ Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. TOTAL (Also enter on line 9, Recapitulation) $ ,2J / 'if 3- (If more space is needed, insert additional sheets of the same size) I . . REV!IlS13 EX+ (9-00. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF tJ1tl 'O,.J FILE NUMBER a RELATIONSHIP TO DECEDENT Do Not Lilt TrUstee(I) ()bl. AMOUNT OR SHARE OF ESTATE 1. NAME AND ADDRESS OF PERSON(S) RECEIVING P OPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under G Sec. 9116 (a) (1.2)) &:'J~s~:;:c~- ;z- '" j) L II- ) (j> c;. n" 2/5 S~t--J 37 '3 yt:,~" ~L J ;). I I~?;r ~ NUMBER I J . f 3,S I ~~. ~ ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV.1500 COVE~ SHEET n 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. I TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET i$ (If more space is needed, insert additional sheets of the same size) 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 GALLION SUSAN E 1769 NORMANDIE DRIVE YORK, PA 17404 ____un fold ESTATE INFORMATION: SSN: 204-03-6845 FILE NUMBER: 2104-1066 DECEDENT NAME: THOMPSON MARY E DATE OF PAYMENT: 02/03/2006 POSTMARK DATE: 02/02/2006 COUNTY: CUMBERLAND DATE OF DEATH: 11/13/2004 NO. CD 006279 ACN ASSESSM ENT CONTROL NUMBER AMOUNT 101 I $17.75 I I I I I I I I TOTAL AMOUNT PAID: $17.75 REMARKS: GALLION DONALD R GALLION SUSAN E CHECK# 1664 SEAL INITIALS: CM RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS . ~ ..... 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" ;.. ~c> $ 0;.0' ... c: ... 0 s .~ ... u :;~ '5 'tA~ ~~ &~ ~ to (j r to ~ I' ~ ~ I' - ~ ... , r c :IE. \~ \"( Ie. ,r. - 'i ~ ~ 0- ... l .. ~ ,"" Ice ~,c " ~ I p. ,~ ,c: ,~ ~C/l , , \\ I , I I , I I I , I , I I , I \ \ \ ----- BUREAU OF INDIVIQI1A['il'AKE~;- INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT REV-1607 EX AFP (03-05) ...);", , ; , ~ I "~i ~ ~.;.i , " :~: :~ 7 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 01-23-2006 THOMPSON 11-13-2004 21 04-1066 CUMBERLAND 05107296 MARY E (",\.r-., GARY."" W THOMPSON 64 WESTWOOD ST ENOLA PA 17025 Anount Renitted 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, subnit the upper portion of this forn with your tax paynent. CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR RECORDS +- --------------------------------------------------------------------------- REV-1607 EX AFP (03-05) *** INHERITANCE TAX STATEMENT OF ACCOUNT KKK ESTATE OF THOMPSON MARY E FILE NO.21 04-1066 ACN 05107296 DATE 01-23-2006 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: 10-10-2005 PRINCIPAL TAX DUE: 1,680.56 PAYMENTS (TAX CREDITS): INT AT REV PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) EREST IS CHARGED THROUGH 02-07-2006 TOTAL TAX CREDIT .00 THE RATES APPLICABLE AS OUTLINED ON THE ERSE SIDE OF THIS FORM.* BALANCE OF TAX DUE 1,680.56 INTEREST AND PEN. 44.49 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE 1,725.05 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" (CRl, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) pJ( BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE , ; NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NO. COUNTY ACN REV.1S47 EX (06.oSl PC 02-13-2006 THOMPSON 11-13-2004 2104-1066 Cumberland 101 MARY E GARY THOMPSON 64 WESTWOOD CT- ENOLA PA 17025 Appeal Date: 04-14-2006 (See reverse side under Objections) Amount Remitted I I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: Register of Wills Cumberland County Courthouse Carlisle, PA 17013 CUT ALONG THIS LINE c:> RETAIN LOWER PORTION FOR YOUR RECORDS ~ - R-eV:154Y EX-(Cf6-0Sfpc - -- - - - - - - - - - - -Notjc-e- b-F -fN~fERiiA-NCE- TAX APPRAjs-eMe-Nt-,- A-CLOWAtfCE-OR- -- - - - - - - - - - - - - - - - - - - - - - - - - - - - -- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX THOMPSON MARY E FILE NO. 2104-1066 ACN 101 TAX RETURN WAS: ([8l) ACCEPTED AS FILED (D) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN ESTATE OF DATE 02-13-2006 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 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 Expenses/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; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax NOTE: If an assessment was issued previously, lines 14, 15 and/or 16,17 and 18 will that include the total of ALL returns assessed to date. (1 ) (2) (3) (4) (5) (6) (7) 0.00 000 0.00 0.00 35,345.86 0.00 0.00 (8) NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 35,345.86 (9) (10) 2,183.00 0.00 (11) 2,183.00 (12) 33,162.86 (13) 0.00 (14) 33,162.86 reflect figures 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 Sibling rate 18. Amount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDITS: (15) 0.00 X .00 0.00 (16) 35,162.86 X .045 1,582.33 (17) 0.00 X .12 0.00 (18) 0.00 X .15 0.00 (19) 1 ,582.33 PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 08-24-2005 CD005725 0.00 100.00 TOTAL TAX CREDIT 100.00 BALANCE OF TAX DUE 1,482.33 INTEREST 45.37 TOT AL DUE 1,527.70 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 (CR), YOU MAY BE DUE A REFUND. SEE REVERSE S'DE OF THIS FORM FOR INSTRUCTIONS.) (!J BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT REV-1607 EX AFP (03-05) GARY THOMPSON 64 WESTWOOD CT ENOLA DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 02-13-2006 THOMPSON 11-13-2004 21 04-1066 CUMBERLAND 101 MARY E PA 17025 Anount Renitted 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, subnit the upper portion of this forn with your tax paynent. CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR RECORDS +- --------------------------------------------------------------------------- REV-1607 EX AFP (03-05) *** INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF THOMPSON MARY E FILE NO.21 04-1066 ACN 1 01 DATE 02-13-2006 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: 02-13-2006 PRINCIPAL TAX DUE: 1,582.33 PAYMENTS (TAX CREDITS): PAYMENT DATE 08-24-2005 RECEIPT NUMBER CD005725 DISCOUNT (+) INTEREST/PEN PAID (-) .00 AMOUNT PAID 100.00 INTEREST IS CHARGED THROUGH 02-28-2006 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM.* TOTAL TAX CREDIT 100.00 BALANCE OF TAX DUE 1,482.33 INTEREST AND PEN. 45.37 . IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. TOTAL DUE 1,527.70 IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J () BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX Z80601 HARRISBURG PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE P OJ INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS REV-1604 EX AFP (03-05) GARY W THOMPSON 64 WESTWOOD ST ENOLA PA 17025 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSNI'DC ACN 02-16-2006 THOMPSON 11-13-2004 21 04-1066 CUMBERLAND 204-03-6895 05107296 Anount Renitted MARY E 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-1604 EX AFP (03-05) -- INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS __ DATE 02-16-2006 ESTATE OF THOMPSON MARY E DATE OF DEATH 11-13-2004 COUNTY CUMBERLAND FILE NO. 21 04-1066 ADJUSTMENT BASED ON: S.S/D.C. NO. 204-03-6895 ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 05107296 FINANCIAL INSTITUTION: WACHOVIA BANK NA ACCOUNT NO. 1010084283599 TYPE OF ACCOUNT: () SAVINGS (X) CHECKING () TRUST () TIME CERTIFICATE DATE ESTABLISHED 02-09-2004 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due .00 0.500 .00 .00 .00 .45 .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER.OF WILLS AT THE ADDRESS SHO~N ABOVE. MAKE CHECK OR MONEY ORD~R'PAYABLE: TO: "REGISTER OF WILLS, AGENT." , , TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE · IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. nJl ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), 1<.1' YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) REV-1470 EX (6-88) I' . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARRISBURG PA 17128-0601 DECEDENT'S NAME INHERITANCE TAX EXPLANATION OF CHANGES FILE NUMBER Joan Peters ACN 2104-1066 05107296 REVIEWED BY ITEM SCHEDULE NO. EXPLANATION OF CHANGES The above referenced Account Control Number has been adjusted to zero since the joint bank account was reported on the Inheritance Tax Return. ROW Paqe 1 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT REV-1607 EX AFP (03-05) ~ j ,. \..,.i DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 02-21-2006 THOMPSON 11-13-2004 21 04-1066 CUMBERLAND 101 MARY E GARY THOMPSON 64 WESTWOOD CT ENOLA Allount Rellitted PA 17025 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, subllit the upper portion of this forll with your tax payment. CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS 4-- --------------------------------------------------------------------------- REV-1607 EX AFP (03-05) *** INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF THOMPSON MARY E FILE NO. 21 04-1066 ACN 101 DATE 02-21-2006 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: 02-06-2006 PRINCIPAL TAX DUE: 1,582.33 PAYMENTS (TAX CREDITS): INT AT REV PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 08-24-2005 CD005725 .00 100.00 EREST IS CHARGED THROUGH 03-08-2006 TOTAL TAX CREDIT 100.00 THE RATES APPLICABLE AS OUTLINED ON THE ERSE SIDE OF THIS FORM.* BALANCE OF TAX DUE 1,482.33 INTEREST AND PEN. 47.65 :IE IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE 1,529.98 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 HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION . PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT REV-1607 EX AFP (03-05) ; ; "~ J DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 02-21-2006 THOMPSON 11-13-2004 21 04-1066 CUMBERLAND 05107295 MARY E SUSAN E GALLION 1769 NORMANDIE DR YORK PA 17404 Allount Rellitted 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, subnit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE --. RETAIN LOWER PORTION FOR YOUR RECORDS +- REV-1607 EX AFP (03-05) **~ INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF THOMPSON MARY E FILE NO.21 04-1066 ACN 05107295 DATE 02-21-2006 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: 01-17-2006 PRINCIPAL TAX DUE: 1,680.56 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 10-31-2005 CD005985 .44- 1,681.00 02-02-2006 CD006279 17.75- 17.75 TOTAL TAX CREDIT 1,680.56 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 :IE 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. ) ~&JP 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 THOMPSON GARY W 64 WESTWOOD CRT ENOLA, PA 1 7025 -------- fold EST ATE INFORMATION: SSN: 204-03-6845 FILE NUMBER: 2104-1066 DECEDENT NAME: THOMPSON MARY E DATE OF PAYMENT: 03/20/2006 POSTMARK DATE: 03/1 8/2006 COUNTY: CUMBERLAND DATE OF DEATH: 11/13/2004 NO. CD 006447 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $ 7 5.00 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK#1366 SEAL INITIALS: MG RECEIVED BY: REGISTER OF WILLS $75.00 GLENDA FARNER STRASBAUGH REGISTER OF WILLS rnCJ'(i) %.,r:..~ o ::0 - r- c.--<r !~ ~,~: !; 9 -t::e ~o 03 O"'tJ d W- o n~ -t '" ) ~. =' '" c ., CD "0 ., % CD ., n ., CD Q. ... ,... ,... 0 \( 0 c ., III n n 0 c :J ,... .. 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CJ' Q. 3 ]:lJ ::0 -< ~ I "'" Q'I Cl -.,j rn )C ~ "0 rn ,... o VI I o ~ {.,l. I . ", I () i..:. (,) .... (,.I (t:i f.J.! 1<' t ,. - -.. " f"\. ~ :::: \ ) \-..J ~ V -... ~ ~. ro -.. ) ~ ~ ~~: ~ t ~ =:~~ ~. ~ ~ ==: ~ ~ ~~ ~ ~ !\D ::. ~'~ .s: .-... 3 ~ ~. t -...... -", ',9. "\ ~~) if ~~ If, :t \/".3 ;-~ -,1\ ,......,- . '). ~~ ..J::.. '"Po , ,~" jo..<<. 1~ OJ 7.! .1; ~;~ ~ ~~ /..; .~'J r~J . c:: o 7.J 8 -G1 ~ ;..:....::-. ~'tf:- ._ ~ ~ ~~~ 9 ~:~! t ,\, ~:-; COMMONWEALTH OF PENNSYLVANIA ~ ~O:CE O~ DEPARTMENT OF REVENUE RECORDtD VI r-l i. r BUREAU OF INDIVIDUAL TAXES. E("""~">:rl 0;;' \tl't L(; INHERITANCE TAX INHERITANCE TAX DIVISION R_\J'~.!UI "f ,d.uSTATEMENT OF ACCOUNT PO BOX 280601 HARRISBURG PA 17128-0601 '* REV-1607 EX AFP (03-05) 2006 APR 24 PM 4: 24 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 04-17-2006 THOMPSON 11-13-2004 21 04-1066 CUMBERLAND 101 Allount Rellitted MARY E CLERK OF ORPHANtS COURT CUM8[Plj~ND CO. PA GARY THOMPSON 64 WESTWOOD CT ENOLA PA 17025 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, subllit the upper portion of this forll with your tax paynent. CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +-- REV-1607 EX AFP (03-05) *** INHERITANCE TAX STATEMENT OF ACCOUNT KKK ESTATE OF THOMPSON MARY E FILE NO.21 04-1066 ACN 101 DATE 04-17-2006 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE~ A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 02-13-2006 PRINCIPAL TAX DUE: 1,582.33 PAYMENTS (TAX CREDITS): INT AT REV PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 08-24-2005 CD005725 .00 100.00 03-18-2006 CD006447 .00 75.00 EREST IS CHARGED THROUGH 05-02-2006 TOTAL TAX CREDIT 175.00 THE RATES APPLICABLE AS OUTLINED ON THE ERSE SIDE OF THIS FORM.* BALANCE OF TAX DUE 1,407.33 INTEREST AND PEN. 62.65 . IF PAID AFTER THIS DATE~ SEE REVERSE TOTAL DUE 1,469.98 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $l~ NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT"" (CR) ~ YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) c r-~-'-"----~- BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE :~':($:.g;~~FCEACT:O~NT REV-1607 EX AFP (03-05) "f1:':' i' 'I ') L ,; ...J ~ -'.j DATE Pi; r~): iSTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 06-12-2006 THOMPSON 11-13-2004 21 04-1066 CUMBERLAND 101 MARY E GARY THOMPSON 64 WESTWOOD CT ENOLA PA 17025 I~ I S"'OIl ~ 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 tu.m with your tax payment. CUT ALONG THIS LINE --+ RETAIN lOWER PORTION FOR YOUR RECORDS ...... ~~~~;;~::RI~B~RG :A- 171 yY) ~t. ~.;. I ~ ..s?-JlJL 2006 PM '3 l - J:-,: c.:~) U.:: t .i i CI~: ! C~ C) i. " , ci~ ~.."'=-:'! A')II~_ . ~~ ~,.. RG \~t7- c-{' C,J ILLs. "~u~ho~~() (0. COl.{(Z< HOuSQ C I"-~L.l; lc I ?".. /7. DI3 ( . r-..~' , " r...:.....::l = C"-.i .: -:::....:.:: "'":- ."~.-:..-..: 4 : '_'.!. '.'" ,.....1.:1. 111111I111111111111111111,,, 1I1111l11l111111HlII, ,1,IIIIIH II COMMONWEAL TH 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 GALLION SUSAN E 1769 NORMANDIE DRIVE YORK, PA 17404 __nn__ fold ESTATE INFORMATION: SSN: 204-03-6845 FILE NUMBER: 2104-1066 DECEDENT NAME: THOMPSON MARY E DA TE OF PAYMENT: 07/03/2006 POSTMARK DATE: 07/01/2006 COUNTY: CUMBERLAND DA TE OF DEATH: 11/13/2004 NO. CD 006913 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $150.00 I I I I I I I I TOTAL AMOUNT PAID: $150.00 REMARKS: ANGELA C THOMPSON CHECK# 592 SEAL INITIALS: WZ RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 REV-1162 EX(11-961 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT THOMPSON GARY W 432 STONEHEDGE lANE MECHANICSBURG, PA 17055 ___~_n_ fold ESTATE INFORMATION: SSN: 204-03-6845 FILE NUMBER: 2104-1066 DECEDENT NAME: THOMPSON MARY E DA TE OF PAYMENT: 05/18/2006 POSTMARK DATE: 05/17/2006 COUNTY: CUMBERLAND DATE OF DEATH: 11/13/2004 NO. CD 006715 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $25.00 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK# 1421 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS $25.00 GLENDA FARNER STRASBAUGH REGISTER OF WillS ( . .() (\) .. -+' 0 i. ""' Ii ,.. ~ III 0. ~ ~ ~ -+' I- Go uJ ~ ""' f/'l ,.. ... '::) ~ ~ 0 ~ ... ~ 3: I-tn Ii ~ Q::r-4 I- f/'l'::)C) 0 ,..lOr- '+' ,..IUr-4 III ul 1-1 ... ..J ~B<t ~ ~ u.. 0- '+' ~ oP 0 Z "' Go Q::<tuJ C uJ,..I,..I 0 ... ~ I-Q::f/'l -+' f/'luJl-I I- ~ I-I~,..I 0 (!)~Q:: 0. (.) uJ'::)<t I- Q::UU Ql ul 0. ~ ~ Ql ~ ~ -+' ... Ii ~ III "' -+' 5 0 I) I) III I- ~ ,.. 0 -+' -+' ... 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I.' f') '. 1") .,..J ;~~) I" ":'0: ~h .;F PEI,I"SYLVAr"IA CE~ARTMErJT REVENUE E:,UF:EAU UF T.AXES S~[::T i-''::''r~RIS6UR3, 1.28-0601 REV-1162 EX(11-96) FiECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT THOMPSON GARY W 432 STONEHEDGE lANE MECHANICSBURG, PA 17055 ESTATE INFORMATION: SSN: 204-03-6845 I FILE NUMBER: 2104-1066 DECEDENT NAME: THOMPSON MARY E IDA TE OF PAYMENT: 06/16/2006 I POSTMARK DATE: 06/1 5/2006 COUNTY: CUMBERLAND DATE OF DEATH: 11/13/2004 NO. CD 006843 ACN ASSESSMENT CONTROL NUMBER AMOUNT .... ... 101 I $60.00 I I I I I I I I .... TOTAL AMOUNT PAID: REMARKS: CHECI(# 1444 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS $60.00 ..... -'-<"" .......-. GLENDA FARNER STRASBAUGH REGISTER OF WillS .... COMMONWEAL TH CF PENNSYLVANIA DEPARTMENT 0" 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 THOMPSON GARY W 432 STONEHEDGE LANE MECHANICSBURG, PA 17055 u______ fold ESTATE INFORMATION: SSN: 204-03-6845 FILE NUMBER: 2104-1066 DECEDENT NAME: THOMPSON MARY E DA TE OF PAYMENT: 08/07/2006 POSTMARK DATE: 08/04/2006 COUNTY: CUMBERLAND DA TE OF DEATH: 11/13/2004 NO. CD 007062 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $150.00 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: GARY W THOMPSON CHECK#1484 SEAL INITIALS: WZ RECEIVED BY: REGISTER OF WILLS $150.00 ... .. -..... .. GLENDA FARNER STRASBAUGH REGISTER OF WILLS ... ... -.....I. -...... --" - ---.~ ',.'~ -- ~?> d-- t(I eel ? a. I ~ HF-\RRJSBURG PA 1.71 / l 7 D~"5 f>1, /\t}<~~\ ;;~{)(j(~Sf-'~~"1 ,{t t Ol/O ~ ~ / I u .-::-r' ( ~~ 1, W~ ~ G.G,;r~ C ~ cPa. nOr) L~ --'/ LLl -.\ , - , C" i 7::; i ::::~{2:26 ! /'J'J II i J'I' iI' i' ...,.\ ,... . . Ill! 11:lIW!li I!I l!if!l!!ld"iddl!ll:i,ldl!!!i!!il BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX Z80601 HARRISBURG PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE 'INHERITANCE TAX STATEMENT OF ACCOUNT REV-1607 EX A; GARY THOMPSON ,.l;4 "'EHW60D C'f. [HaL'" /)AA-i10d /' fVl~<:..~. l l..... ~- (I C:S~ tf3:J SivA-e h~ DATE ESTATE OF DATE OF DEATH FILE NUMBER L COUNTY ~ACN 07-10-2006 THOMPSON 11-13-2004 21 04-1066 CUMBERLAND 101 MARY Allount Rellitted J50.::-~ MAKE CHECK PAYABLE AND REMIT PAYMENT REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax pa CUT AI'" 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 NO. CD 007151 THOMPSON GARY W 432 STONEHEDGE LANE MECHANICSBURG, PA 17055 ACN ASSESSMENT CONTROL NUMBER AMOUNT ____nu fold 101 $150.00 ESTATE INFORMATION: SSN: 204-03-6845 FILE NUMBER: 2104-1066 DECEDENT NAME: THOMPSON MARY E DATE OF PAYMENT: 08/28/2006 POSTMARK DATE: 07/01/2006 COUNTY: CUMBERLAND DATE OF DEATH: 11/13/2004 TOTAL AMOUNT PAID: $150.00 REMARKS: REPLACES RECEIPT 6913 WRONG RECEIVED FROM NAME CHECK# 592 INITIALS: MW SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS ~12Q lo~ 0pJCl V'/l ~c-~f ~ (,+:11"3 ~'OJ REGISTER OF WILLS 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 THOMPSON GARY W 432 STONEHEDGE LANE MECHANICSBURG, PA 17055 _n_n__ fold ESTATE INFORMATION: SSN: 204-03-6845 FILE NUMBER: 2104-1066 DECEDENT NAME: THOMPSON MARY E DATE OF PAYMENT: 10/27/2006 POSTMARK DATE: 10/27/2006 COUNTY: CUMBERLAND DA TE OF DEATH: 11/13/2004 NO. CD 007356 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $150.00 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: GARY W THOMPSON CHECK# 1518 SEAL INITIALS: CM RECEIVED BY: REGISTER OF WILLS $150.00 GLENDA FARNER STRASBAUGH REGISTER OF WILLS ~;:~h~~r~ .~. mt?cL I p.;. t~:> $~~ :/I(,~;. eN:::"r ;;::lftrt){j, P'U'''!l 3 'f L) t, )./';:. C,::1 F>/\ .J ''';',1 .L _,I" .t. - '~--.~r~.,-..~. L"______ fiJlftfijlr"fHlIJII.Hl\IHh~f"''.,.'>'' .0J'~;..~!{il:?Jlttl~H1m).Hl.11f!,tt\H "'-' _ Ii f1llltllii::::::Hiil\lhIJ":<j;~:,:::;;~t!'ii( "';'"liUWij,h.I ~ \ ~ C' \..:'1 ~' 4 ul~ ~~ Co, ,CtJUd~ ~ I P"",. t7.ot~ . },KfUi IIl/lf III III II ! ! I L!lIl! II n ,1/1111/ i "lll,,; It 111/ "1 i \.~\ Gr}, 1......- / L}-~ >;~~. t..-/ --- \ i (i:; i ~:../:=::::~~~:a' \~r~ .~:_~~: ....- I , (,.......J ,- BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT . REV-1607 EX AF: o W""') DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 09-05-2006 THOMPSON 11-13-2004 21 04-1066 CUMBERLAND 101 MARY i' ~v THOMPSON 'f';).. ~1Y?1r k 64 'WE3r~66D &r ~eLA PA-118~ .-~, ( :; yll e d \ I P ~. t" t> ~Y 1.-. .! Allount Rellitted I !Sty? MAKE CHECK PAYABLE AND REMIT PAYMENT 1 REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account. submit the upper portion of this forll with your tax pay. Cumberland County - Register Of wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 10/30/2006 GALLION SUSAN E 1769 NORMANDIE DRIVE YORK, PA 17404 RE: Estate of THOMPSON MARY E File Number: 2004-01066 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Ruleo6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS I 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 lS due by: 11/13/2006 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, ~ L~W J1fZ#J/;ff /.' / Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel \ G\ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 10/30/2006 THOMPSON GARY W 432 STONEHEDGE LANE MECHANICSBURG, PA 17055 RE: Estate of THOMPSON MARY E File Number: 2004-01066 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: 11/13/2006 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, I~J C.,.P' ,P- I!.. n _ jJ I~ L~UAj)aMLutr~v Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel ~ Register of Wills of Cumberland County Narne of Decedent: STATUS REPORT UNDER RULE 6.12 tv1 t4t'-y A- I t/omP.s:~ ill/3/oLI J d. D04"/ 0 t b L L Date of Death: Estate No.: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration ofthe above-captioned estate: 1. State whetk6"administration of the estate is complete: Yes ~ No 0 ') !fthe answer is No, state when the personal representative reasonahly believes that the administration will be complete: 3. If the answer to No. I is Yes, state the following: a. Did the p~nal representative file a final account with the Court? Yes .[J/" No 0 b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the person~ r~sentative state an account informally to the parties in interest? Yes 12r" No 0 c. Copies of receipts, releases, joinders and approval of formal or infom1al accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: Il-- ;)..-0. I. Capacity: Name '-i.3~ Sklt,A..~~ latA f/l&ti.J R(1&)~ Address ~ l (7/7) S-C)'.- ~ 30, ~lephone No. ~rsonal Representative o Counsel for personal representative CV" I' : I (I.' J ;~..: Qj Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedent ~ 1 -E.. '\,\q:::, IN\, \ ""s, 0 \f) Date of Death: \ \ - \"'3 - ~:tL~O+-' Estate No.: ~4 --. 0 \ OC(J (r) Pursuant to Rule 6.12 ofthe Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration ofthe above-captioned estate: 1. l~hether administration of the estate is complete: Yes ~ No 0 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. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes 0 No 0 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 0 No 0 c. Copies of receipts, releases, joinders and approval of fomlal or infomlal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. h~~b~ ~.U~ Signature Date: IJ.oQ-Q6 S \.) cs. .... \1\ "C... <3- ~ \ \' \ C) (\ Name r ",""0,[ _ , ,.1=Gfin::; ,SJ~,rH&10 /jj <J \ 7Cc~ 'NC)'{'"~",6\~ Uf'_ Address '-(o("'~\. t>f\ \l40~ r-z lo'1 - '7 '/04- Telephone No. 2(' '7i r I I (' I ,,'1 (,c',,, ( !1~~Jn"'lZ .. " :, ,.; ,.;.. \.,.i rt ;;Uu Capacity: 0 Personal Representative o Counsel for personal representative ~ PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT COMMONWEALTH OF PENNSYLVANIA DE"'ARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 2B0601 HARRISBURG. PA 17128-0601 RECEIVED FROM: GALLION SUSAN E 1769 NORMANDIE DRIVE YORK, PA 17404 ------.- fold ESTATE INFORMATION: SSN: 204-03-6845 FILE NUMBER: 2104-1066 DECEDENT NAME: THOMPSON MARY E DA TE OF PAYMENT: 11/09/2005 POSTMARK DATE: 10/31/2005 COUNTY: CUMBERLAND DATE OF DEATH: 11/13/2004 REV- 1162 EX( 11 -96) NO. CD 005985 ACN ASSESSMENT CONTROL NUMBER AMOUNT 05107295 I $1,681.00 I I I I I I I I TOTAL AMOUNT PAID: $1,681.00 REMARKS: CHECK# 1529 SEAL INITIALS: JA RECEIVED BY: TAXPAYER GLENDA FARNER STRASBAUGH REGISTER OF WILLS PENNSYLVANIA INHERIT ANCE AND ESTATE TAX OFFICIAL RECEIPT COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 RECEIVED FROM: GALLION SUSAN E 1769 NORMANDIE DRIVE YORK, PA 17404 'n~nn fold ESTATE INFORMATION: SSN: 204-03-6845 FILE NUMBER: 2104-1066 DECEDENT NAME: THOMPSON MARY E DATE OF PAYMENT: 02/03/2006 POSTMARK DATE: 02/02/2006 COUNTY: CUMBERLAND DATE OF DEATH: 11/13/2004 REV-1162 EX(11-96) NO. CD 006279 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $17.75 I I I I I I I I TOTAL AMOUNT PAID: $17.75 REMARKS: GALLION DONALD R GALLION SUSAN E CHECK# 1664 SEAL INITIALS: CM RECEIVED BY: TAXPAYER GLENDA FARNER STRASBAUGH REGISTER OF WILLS t'age t of I ~ DONA~~GA~-~N. ~85' :f ~ ~7~~R~~I~~~~ r YORK PA 17404 Date \ a. ~~ ..oS , TELE:717-767.n04 . :::.,~OS'" ~~.\... ~ \.J'oo.I~.~ I $ \\o'<s\~..o 'h..~-",~ ~,,,,,," . ~DOl\'" lil =::: t W (I . B k Citizens CIrcle Account " M tlzens an , ,- PennsylVilnia 0 <: ~ ",," :r Fo~~='2\C:~HOflD ~t~~ . ,: ~""<'- C> S \ C:l' :lC\ 5 . - - -- --, ,---- :~ I:O~bO?b ,501: b 200 2b~BbBII' ~S 2q ."0000.(;8,00.1' , ...--_.1:0 ~..."'... ...."'" ........ ~ .. ~ 1529 3-76\ !ilJ6Q 318 ,,< -- Posting Date 2005 Nov 10 Posting Seq No 91942640 Account Number 6200264R68 Check Number 1529 Amount $1.681,00 hUn:1 Iwi ismab0003 5008/inqu i ry Ipage/i tcmpri nt.jsp? B EA NN AM E= Archive I tcm Listdetai Is... 6/27/2006 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES.,_ .'''I'J-cr,; (WFe: INHERITANCE TAX IIIIERITAHCE TAX DIVISION ~,{ I,)J.) ':C ,STATEMENT OF ACCOUNT PO BOX 2110601 " :. HARRISBURG PA 171211-0601 \_'\ *" REV-1607 EX AFP (03-05) \1 ~V~\\~31 l~\1b JUL GARY THOMPSON 64 WESTWOOD CT ENOLA ",--'-!I/ {"~C r.l\...,.l'''''~ \ J\ \J ,:',;;, ;:::".\ \Q\ n'! \rl"', ....... \ ,I, )\.....d \\ OO\"-,l...,;", \ '....' \,,,J~, '"1 r"~ \ ' \,': , - +~'-. "." , -' i..l, C\J\'.:' 1'-- DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 07-10-2006 THOMPSON 11-13-2004 21 04-1066 CUMBERLAND 101 AIIount R_i tteel MARY E PA 17025 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your eccount, s~it the upper portion of this fo~ with your tax peywent. CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +-- REV-1607 EX AFP (03-05) ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF THOMPSON MARY E FILE NO. 21 04-1066 ACN 101 DATE 07-10-2006 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUHKARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIeuRE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 02-13-2006 PRINCIPAL TAX DUE: 1,582.33 PAYMENTS (TAX CREDITS): INT AT REV PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 08-24-2005 CD005725 .00 100.00 03-18-2006 CD006447 .00 75.00 05-17-2006 CD006715 .00 25.00 06-15-2006 CD006843 .00 60.00 EREST IS CHARGED THROUGH 07-25-2006 TOTAL TAX CREDIT 260.00 THE RATES APPLICABLE AS OUTLINED ON THE ERSE SIDE OF THIS FORM.~ BALANCE OF TAX DUE 1,322.33 INTEREST AND PEN. 84.56 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE 1,406.89 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 210601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ,~-r",",r'i,;:r\ (",C~:Ct.IlijHERITANCE TAX \';i,:I,_,\)\\U,_u ~:-Sl~T~MENT OF ACCOUNT I -: ,-,'; l -.__.>~ '* REV-1607 EX AFP (03-05) ')""nl' LUUb .- " ,~. 0 3 \ '., I)';, 'J" e ill '" DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 09-05-2006 THOMPSON 11-13-2004 21 04-1066 CUMBERLAND 101 AlIOUI'lt R_l tted MARY E GARY THOMPSON 64 WESTWOOD CT ENOLA PA 17025 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 NOTE: To Insure proper credit to your ~count. subIIlt the upper portion of this fore with your t.x p~t. CUT ALONG THIS LINE REV-1607 EX AFP (03-05) --------------------------------------------------------------------------- --+ RETAIN LOWER PORTION FOR YOUR RECORDS +-- ... INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF THOMPSON MARY E FILE NO. 21 04-1066 ACN 101 DATE 09-05-2006 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUlttlARY 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: 02-13-2006 PRINCIPAL TAX DUE: 1.582.33 PAYMENTS (TAX CREDITS): INT AT REV PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) ... SUMMARY OF ALL 006 PAYMENTS ... 08-04-2006 .00 560.00 EREST IS CHARGED THROUGH 09-20-2006 TOTAL TAX CREDIT 560.00 THE RATES APPLICABLE AS OUTLINED ON THE ERSE SIDE OF THIS FORM.. BALANCE OF TAX DUE 1.022.33 INTEREST AND PEN. 95.34 . IF PAID AFTER THIS DATE. SEE REVERSE TOTAL DUE 1.117.67 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $I. NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIP' (CR). YOU KAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX za0601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE r\i(\r'"',r~,rr'\ "",.-~,~r-..,;;; 1<,i:~\}J'-iU[U U;-wNth;KITANCE TAX ~::r:]CTr-!~~ATEM~NT OF ACCOUNT '-_ -.,.' ".,' , l_l: ..,,'.. .' f" _, '.' '* REY-1607 EX AFP (03-05) "0",....(' Jf.. '.,'.1 ? 7 P' ~ L " 'lk'j' '/.' 00'" ,!J () <. !"" 'j '- L.. DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 06-12-2006 THOMPSON 11-13-2004 21 04-1066 CUMBERLAND 101 Allount Re.i tted MARY E GARY THOMPSON 64 WESTWOOD CT ENOLA PA 17025 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your eccount, submit the upper portion of this form with your tax pay..nt. CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS ... --------------------------------------------------------------------------- REV-1607 EX AFP (03-05) *** INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF THOMPSON MARY E FILE NO.21 04-1066 ACN 101 DATE 06-12-2006 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: 02-13-2006 PRINCIPAL TAX DUE: 1,582.33 PAYMENTS (TAX CREDITS): INT AT REV PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 08-24-2005 CD005725 .00 100.00 03-18-2006 CD006447 .00 75.00 05-17-2006 CD006715 .00 25.00 EREST IS CHARGED THROUGH 06-27-2006 TOTAL TAX CREDIT 200.00 THE RATES APPLICABLE AS OUTLINED ON THE ERSE'SIDE OF THIS FORM.* BALANCE OF TAX DUE 1,382.33 INTEREST AND PEN. 77.58 II IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE 1..459.91 SIPE 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. ) ~ BUREAU OF INDIVlDU~.- ~.'=\-'. llIERITANCE TAX DIVISI.;I'/dl' ,. .J. PO lOX Z80601 . . HARRISBURG PA 11128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REV-1607 EX AFP (03-05) 2nnh 1,10Ui ~ 21 Pi'1 3~ 32 11lhJ ,< DATE ESTATE OF DA TE OF DEATH FILE NUMBER COUNTY ACN 11-13-2006 THOMPSON 11-13-2004 21 04-1066 CUMBERLAND 101 Allount R_I UM MARY E CI ~HK OF WQ.PHI::"\'~ r,nup.T GARY THOMP ',~[i~:;" u ,~,("O, Pl\ 64 WESTWO 'CT'" , ENOLA PA 17025 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLEI PA 17013 NOTE: To Insure proper crMlt to your eccountl ~It the upper portion of this fore with your tax p~t. CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS +-- --------------------------------------------------------------------------- REV-1607 EX AFP (03-05) .** INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF THOMPSON MARY E FILE NO.21 04-1066 ACN 101 DATE 11-13-2006 THIS STATEMENT IS PROVIDED TO ADVISE Of THE CURRENT STATUS Of THE STATED ACH IN THE NAIlED ESTATE. SHOWN BELOW IS A SlIIIAIY Of THE PRINCIPAL TAX DUEl APPLICATION OF ALL PAYtlENTSI THE CURRENT BALANCEI ANDI If APPLICABLE I A PROJECTED INTEREST FI8URE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 06-02-2006 PRINCIPAL TAX DUE: 11582.33 PAYMENTS (TAX CREDITS): INT AT REV PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) ... SUMMARY OF !ALL 007 PAYMENTS ... 10-27-2006 .00 710.00 EREST IS CHARGED THROUGH 11-28-2006 TOTAL TAX CREDIT 710.00. THE RATES APPLICABLE AS OUTLINED ON THE ERSE SIDE OF THIS FORM.. BALANCE OF TAX DUE 872.33 INTEREST AND PEN. 107.96 . IF PAID AFTER THIS DATEI SEE REVERSE TOTAL DUE 980.29 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( If TOTAL DUE IS LESS THAN .11 NO PAYtlENT IS REIlUIRED. IF TOTAL DUE IS REfLECTED AS A "CREDI,..' (CR) I YOU HAY BE DUE A REFUND. SEE REVERSE SIDE Of THIS FORM FOR INSTRUCTIONS. ) 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 THOMPSON GARY W 432 STONEHEDGE LANE MECHANICSBURG, PA 17055 _n_____ fold ESTATE INFORMATION: SSN: 204-03-6845 FILE NUMBER: 2104-1066 DECEDENT NAME: THOMPSON MARY E DATE OF PAYMENT: 03/23/2007 POSTMARK DATE: 03/22/2007 COUNTY: CUMBERLAND DATE OF DEATH: 11/13/2004 NO. CD 007937 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $250.00 I I I I I I I I TOTAL AMOUNT PAID: $250.00 REMARKS: CHECK#1573 SEAL INITIALS: CJ RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS r :s ~ ~~ ~~ ~~ ~~ ~o =~ ~z ~~ ~~ o~ ~~ ~ o u ~ ~ 0 ~ ~ u l!!l ~oe~ sU>~~ O;ZO. ;~~; ~e~~ I I I ~ ~ f1J1R 23 M'lIO: 52 .... ~ CI CF! 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I .Ji.JUV .J\.J BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 2B0601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT * REV-1607 EX AFP (03-05) ~ i. ; ,., \,. t) it ,"..\' I . 1 . LoU . ('~t ....J :.' I DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 04-16-2007 THOMPSON 11-13-2004 21 04-1066 CUMBERLAND 101 MARY E GARY THOMPSONr'i 64 WESTWOOD e'r ENOLA Amount Remitted PA 17025 MAKE CHECK PAYABLE AND REMIT PAY~ENT 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 -+ RETAIN LOWER PORTION FOR YOUR RECORDS of- --------------------------------------------------------------------------- REV-1607 EX AFP (03-05) *** INHERITANCE TAX STATEMENT OF ACCOUNT *** ESTATE OF THOMPSON MARY E FILE NO. 21 04-1066 ACN 101 DATE 04-16-2007 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: 06-02-2006 PRINCIPAL TAX DUE: 1,582.33 PAYMENTS (TAX CREDITS): INT AT REV PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) *** SUMMARY OF II,LL 008 PAYMENTS *** 03-22-2007 .00 960.00 EREST IS CHARGED THROUGH 05-01-2007 TOTAL TAX CREDIT 960.00 THE RATES APPLICABLE AS OUTLINED ON THE ERSE SIDE OF THIS FORM.* BALANCE OF TAX DUE 622.33 INTEREST AND PEN. 134.41 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE 756.74 l! 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), YDU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) qv - --- 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 THOMPSON GARY W 432 STONEHEDGE LANE MECHANICSBURG, PA 17055 n______ fold ESTATE INFORMATION: SSN: 204-03-6845 FILE NUMBER: 2104-1066 DECEDENT NAME: THOMPSON MARY E DATE OF PAYMENT: OS/21/2007 POSTMARK DATE: 05/18/2007 COUNTY: CUMBERLAND DATE OF DEATH: 11/13/2004 NO. CD 008192 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $250.00 I I I I I I . I I TOTAL AMOUNT PAID: $250.00 REMARKS: GARY THOMPSON CHECK#1588 SEAL INITIALS: WZ RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS <<7 .. ~3: m ~nt~ ~ 4 .------;-~ I -U-61n(f S ~ MLf: .df d / oV-/ ~~~ ~. , Co ;p D ~ PL -J ~ ~ ~~ -- ~,~ ; -: ~F. ; t,) ~+. "\ ' (:t ,) ~ '61 8 ,~ ....., ." '" " :t J: l' 01 ,pi; ....".;J j1 'jIoL COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX ~~H~~T~=~~oIAX DIVISION ~:CORm:D OFFH~E~ATEMENT OF ACCOUNT HARRISBURG PA 17128-0601 /"" , " *' REV-1607 EX AFP <03-05) ~' DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 06-18-2007 THOMPSON 11-13-2004 21 04-1066 CUMBERLAND 101 MARY E 2007 JUN 29 PM I: 16 CLERK OF GARY THOMPSON ORPHAN'S COURT 64 WESTWOOD clCU\;'f-:;r:-' 'V-', , P4 ENOLA PA 17025 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insu~e prope~ credit to your account, submit the upper po~tion of this fo~m with you~ tax payment. CUT ALONG THIS LINE --------------------------------------------------------------------------- ...... RETAIN LOWER PORTION FOR YOUR RECORDS +- REV-1607 EX AFP (03-05) *** INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF THOMPSON MARY E FILE NO. 21 04-1066 ACN 101 DATE 06-18-2007 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: 06-02-2006 PRINCIPAL TAX DUE: 1,582.33 PAYMENTS (TAX CREDITS): PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID 05-18-2007 *** SUMMARY OF ~LL 009 PAYMENTS *** .00 1,210.00 INTEREST IS CHARGED THROUGH 07-03-2007 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM.* TOTAL TAX CREDIT 1,210.00 BALANCE OF TAX DUE 372.33 INTEREST AND PEN. 140.48 TOTAL DUE 512.81 * IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" <CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) Lp ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.