The URL can be used to link to this page

Home My WebLink About04-1185 NON-PROBATE RETURN , REV-1500 COMMONWEALTHOFPENNSYLVANIA INHERITANCE TAX RETURN DEPARTMENT OF r~EVENUE DEPT 280601 RESIDENT DECEDENT DECEDENT'S NAME (LAST. FIRST. AND MIDDLE iNITIAL) ~ Paxton, Gregoo~ C uJ DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) ~ 01/19/1988 ~ 06/08/1966 (IF APPUCASLE) SURVIVING SPOUSE'S NAME ( LAST. FIRST AND MIDDLE JNITIAL) [] 1. Original Return [] 2. SupprementarReturn ~ [] 4. Limited Estate [] 4a Fumrelmeres Comprornise(0ateofdeathafter u~ [] 6. Decedent Died Testate (Attach copy [] 7. DecedentUalntainedaLtvingTrust(Attac, 21 2004 s- COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 196-48-3861 THIS RETURN MUST BE FILED iN DUPLICATE WITH THE REGISTER OF WILLS ] 3. Remainder Return (dateof death prior to 12-13-82) ] 5. Federal Estate Tax Return Requlred 0 8. Total Number of Safe Deposit BOXES [] 9. Litigation Proceeds Received [] 10. SpousalPovertyCredit(dateofdeathbe~ween [] 11.Electiontotaxundersac. 9113(A)(AttachSchO) Dale F Shughart, Jr. Esquire COMPLETE MAILING ADDRESS 35 E. High Street, Suite 203 TELEPHONE NUMBER 717/241-4311 1. Real Estate (Schedule Carlisle. PA 17013 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Sank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) [] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (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) (1) None (2) None (3) None (4) None (5) None (6) 7,300.00 (7) None (9) 4,272.00 (to) x .06 x .06 x .12 x .15 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) 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 (8) 7,300.00 (11) 4,272.00 (12) 3,028.00 (13) 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 3,028.00 (18) 454.20 19. Tax Due 20. [] · , ,. · , ,- ,, . , .., (19) 454.20 Copyright 2000 form software only The Lackner Group, Inc. - ................ :----=-'-"' Form REV-1500 EX (Rev. 6-00) (14) 3,028.00 (15) (16) (17) Decedent's Complete Address: IST~.EET ADDRESS 22 Appalachian Trail Drive CITY Gardners STATE PA ZIP 17324 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 454.20 Total Credits (A +B+C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page I 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) 454.20 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (SB) 454.20 ..... Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUES'nONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred .................................................................... b.retain the right to designate who shall use the properly transferred or ts ncome; ................................... retain a reversionary interest; or ................................................. receive the promise for life of either meets benef ts or pay , care ......................... 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ........ . ................................................................. [] 3. Did decedent own an "in tr " ust for or payable upon death bank account or security at his or her death? ......... [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneflc arv desianat on? IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS Davi , Krulac DATE Z~s ou~a ~.., _~.~..' P.O. Box I064 / /~)t7/ s~ p Mechanicsburg, PA 17055 ES ONSIBLE FOF~ FILING RETURN ADDRESS Diane E. Krulac DATE ~ ~x-~:~.,x_. P.O. Box 1064 Mechanicsburg, PAI 17055 SIGNATURE OF PREPARER OTHER T N REPRESENTATIVE ADDRESS DATE ,~v Shug.~hart, Jr~;~'~~EPF 35 E. High Street, Suite 203 . ~ ~/~ Carlisle PA 17013 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 surv~vlng spouse is 3% [72 P.S. §9116 (a) (1.1) For dates of death on er after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exemDt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are sti~l applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. §9116 (a) (1.2)]. T~2~ tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116 [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% I72 P.S. §9116 (a) (1.3)1. A sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. COMMONWEALTH OF PENNSYLVANIA ~NHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE F JOINTLY-OWNED PROPERTY Paxton, Gregory C FILE NUMBER 21 - 2004 - If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A Jeffrey L. Paxton 1546 Shughart Road Brother Crarlisle, PA 17013 JOINTLY OWNED PROPERTY: ITEM LE'I-I'ER NUMBER FOR JOINT TENANT A DATE OESCR,.T,ON Or.ROPERW Include name of financ a nstitut on and bank account number DATE OF DEATH n°~/°~O~. DATE OF DEATH MADE or similar identifying number. Attach deed for jointly-he~ real VALUE OF ASSET IN-'i"E~T VALUE OF JOINT estate, DECEDENT'S INTEREST 05/30/1985 SEE ATTACHED EXPLANATION. 14,600.00 50% 7,300.00 TOTAL (Also enter on line 6, Recapitulation) SCHEDULE "F" ATTACHMENT 1. A 5/30/1995 On May 30, 1985 Jeffrey L. Paxton and Gregory C. Paxton, brothers, purchased property at 22 Appalachian Trail Drive, Gardners (South Middleton Township), Cumberland County, Pennsylvania, Tax Parcel #40-37- 2545-019, for 17,900. Deed reference: Deed Book "N", Vol. 31, Page 883. They owned the property as joint tenants with right of survivorship. Gregory C. Paxton died January 19, 1988. Obituary attached. Jeffrey L. Paxton was unaware and was never advised he owed inheritance on the one-half ownership interest passing to him from his brother. The property has subsequently been conveyed by the Cumberland County Tax Claim Bureau for $19,000 to David A. and Diane E. Krulac, by deed reference: Deed Book 260, page 2939 and Jeffrey L. Paxton subsequently delivered a Quitclaim Deed to the Krulacs. Deed Book 266, Page 1012. At Gregory Paxton's death the Cumberland County assessed value of the property was $1,460. The common level ratio was 10.0. Therefore the fair market value was 14,600. Taxes are being paid on the fair market value based upon the common level ratio. It is requested that the Department of Revenue waive the interest and penalties. Copies of the relevant deeds are attached. 14,600 50% 7,300 COMMONWEALTH OF PENNSYLVANIA iNHERITANCE TAX RETURN ESTATE OF Paxton, Gregory C SCHi~ULE H RJNEP~L~& · ~I~MSTRATIVE CO~FS Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION A. FUNERAL EXPENSES: I Hoffman-Roth Funeral Home, funeral bill FILE NUMBER 21 - 2004 - AMOUNT 4,007.00 ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip Year(s) Commission paid Attorney's Fees Dale F. Shughart, Jr., preparing inheritance tax return Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address C~ty Relationship of Claimant to Decedent 4. Probate Fees State _,, Zip 250.00 5. Accountant's Fees 6. Tax Return Preparer's Fees Other Administrative Costs Register of Wills, filing inheritance tax return 15.00 TOTAL (Also enter on line 9, Recapitulation) 4,272.00 Md, ' Artie,R. KIIne Augustus M, Keller Miriam A. G~use Virginia M. Butler Rret Maverick 7,1egler Stephen Connors. 3, helps clean up at his grandfather'shomainMechanlcsbu,rg. was for older' Of ~.0. BoX 7~0 01d Croton Road, ~lemin~on, New Jersey 08822 ALL ~h~ oe==~m ~r~c~ oS land situate fol~ows~ 19, Pa~e ~50), now or formerly of Herbert ~tller ILl ~igmr~. ~t, zai~ =nb ~eWoe~r~ ~OBERT P. ZIECt.. · UjI'SET PRIC~ SALE r.r. CORDE[{ OF DEEDS e ._Js ............... day o~ ....................................... 20 ....... GRANTOR, and Da~ ~ K~lae ~ Diane E. ~, tha~ in consideration of $,...,,~?.~:.~?~... in hand paid, r~elpt whereof is hereby acknowled~d, the said Grantor ~oes hereby ~nt and convey unto the ~id Grantee, ...~ .... Cumberland County, Pennsylvania, aa follows: 22 Ap~hMa T~ll * S~ Ap~adlx A for ~1 22 Ap~Mchbn Troll ~d the same h=vln; been sold by the Tax Claim Bateau to the sai~ ~antee, on the ......... of ....... ~q~?F, ............................. Anne Dom n two thousand an~ ........... q~ ................. under and by virtue el the Act oF ]947 PL 1368 (Real Estate Tax Sale Law), ~rl ~[litnes$ ~[[llereaf, said Grantor has hereunto caused this Deed to be executed by its Director the da). and year first above written. Signed, Sealed and Delivered the presence of: ~NNSYLVANIA TAX CLAIM BUREAU OF CUMBER~-I~B~OUNTY, PENNSYLVANIA ' of the County of Cumber]and, the ,nderslgned ol~cer, personally appeared Director of the Ta.x Claim Bureau of the County o[ Cumberland. Commonwealth of Pennsylvania, know~ to me to be the person described in the foregoin~ instrument and acknowledged that he ex~uted the same in the capacity therein stated and for the pur- poses therein contained, ~ have hereunto set my hand and o~cial sell. · --~~o~1 "="'~ Appendix ~A" Tax Parcel No 40-37-2545-019 L~gal D*scrlption AIL ?I-L~_T CERT.4,1N tract or parcel of land situate in the Township South Middieton, Cumberland County, Pennsylvania, being more particularly bounded and described as follows: BRGINI~ING at a point in the center of a public road known as Appalachian Trail Road and at the Southwest corner of land now or formerly of Jefferson L. Ghrist, Sr.; thence from said point along said land of Jefferson L. Ohrist, Sr. in an Eastward direction a distance of 232 feet more or less, to a point in the Western line of a private lane; thence in a Southern direction along the Western line of said private lane, a distance of 75 feet to a point in line of land now or formerly of Terry L. Wenfle; thence along said land in a Western direction a distance of 232 feet more or less, to a point in the center line of the aforementioned public road; thence along the center line of said public road in a Northern direction a distance of 75 feet to a point and place of BRGINI~I~G. CON'I'~INII~G 75 feet in front along the center line of Appaiaehian Trail Road and d' extending Eastwardly therefrom at an even width a lstance of 232 feet, more or less, to a 10 foot wide private driveway. TO~R'I'I-IER with the right of free and uninterrupted ingress, egress and regress to the tract of land herein described over a strip of land 10 feet wide adjoining the within described tract of land on the East and South. BEING the same property which Harry E. Brelsford and Julia Brelsford, husband and wife, by their deed dated May 30, 1985 and recorded in the Office of the Recorder of D~eds in and for Cumberland County in Deed Book 31, Volume H, Page 883, granted and conveyed unto Jeffrey L. Paxton and Gregory C. Paxton. Gregory C. Paxton 429 Potato Road C D 17013 tRoad Mechanicsburg, 17055 South Middleton Township 40-37-2545.019 0.00 ~ ro. o0 1.05 $19,000.00 $39,385.50 nd agint (Attach (if ~ndemnoflun or In ,Ith, ~e United Stq~- - w po~ ~Mm~ I ' ,,lu o~ ~d~fj~ ~'"', aha I~um.~. ~ -"'" g got ~ a ~Jder ~ a m n'l '"~n~Jon or I~ J;~ ' ~ ~tat~ ~ ~ ' -' ~plete ~py of the arl.. ~ ~. ~ · Pa~ Number~ ~ Othm -,,~n, merger or d~Mion. ;A,a~ mg ~Pl~e explain eX~p~on dalton, E ~r 260 P 2940 i 29 t~x ~arcel No-40-37-25{5.019 QUIT-CLAIM DEED THIS INDENTURE, made the Z/~Z- day of ~/~/~ year of our Lord Two Thousand Four (2~04~ BETWEEN JEFFREY L. PAXTON, South Middleton Township, County, Pennsylvania, Grantor DAVID A. KRULAc and DIANE E. KRULAc, husband and wife, Mechanicsburg, Cumberland County, Pennsylvania, in the Cumberland of Grantees. WITNESSETH, that the said party of the first part, for and in consideration of the sum of Five H~ndred ($509.00) Dollars lawful money of the United States of Amerzca., unto him well and truly paid by the sai~ parties of the Second part, at pr before the sealing and dellvery of these presents, the recelpt whereof is hereby acknowledged, have remised, released and quit-claimed, and by these presents do remise, release and forever quit-claim Unto the said parties of the second part, as tenants by the entirety, their heirs and assigns, the following, to wit: ~LLL that certain piece or parcel Of land, situate in the Township of South Middleton, Cumberland County, Pennsylvania, being more particularly bounded and described as follows: BEGINNING at a point in the center of a public road known as Appalachian Trail Road and at the Southwest Corner of land now or formerly, of Jefferson L. Ghrist .: ~ ~zd l~d of Jefferson L.'G~th~ce.fr°m said point =~t~un.a ~Stance.of 232 feet m~r°~s~? ~ ~7~din the Western lzne of a przvate lane; thence in a Southern direction along the Western line of said private lane, a distance of 75 feet to a point in line of land now or formerly of Terry L. Wentle; thence along said land in a Western direction a distance of 232 feet more or less, to a point in the center line of the aforementioned public road; thence along the Center line of said public road in a Northern direction a distance of 75 feet to a point and place of BEGINNING. CONTAINING 75 feet in front along the ~enter line of Appalachian Trail Road and extending Eastwardly therefrom at an even width a distance of 232 feet, more or less, to a 10 foot wide private driveway. TOGETHER with the right of free and uninterrupted ingress, egress and regress to the tract of land herein described Over a strip of land 10 feet wide adjoining the within described tract of land on the East and South. BEING the same property which Harry E. Brelsford and Julia Brelsford, husband and wife, by their deed dated May 30, 1985 and recorded in the Office of the Recorder of Deeds in and for Curaberland County in Deed Book 31, Volume H, Page 883, granted and conveyed unto Jeffrey L. Paxton and Gregory C. Paxton. The said Gregory C. Paxton died January 19, 1988, vesting fee simple title in Jeffrey L. Paxton. The Tax Claim Bureau of Cumberland County granted and conveyed the premises to David A. Krulac and Diane E. Krulac, husband and wife, by Deed dated December 1, 2003 and recorded in Cumberland County Deed Book 260, Page 2938, and Corrective deed dated October 19, 2004 and recorded in Cumberland County Deed Book 265, Page 3984, vesting title in fee simple in the Grantees. The Grantor having no remaining equity in the premises, the sole purpose of this Quitclaim Deed is to remove any cloud on the title of the Grantees herein. The Grantees herein have filed an action in quiet title against the Grantor in the Court of Common Pleas of Cumberland County, Pennsylvania to Civil Term No. 04- 4229, which will be settled and discontinued upon recording of this Deed. TOGETHER with all and singular the tenements, hereditaments and appurtenances to the same belonging, or in anywise appertaining, and the reversion and reversions, remainder and remainders, rents, issues and profits thereof; and also, all the estate, right, title, interest, property, claim and demand whatsoever, both in law and equity, of the said party of the first part, of, in, to or out of the said premises, and every part or parcel thereof. TO HAVE AND TO HOLD the said premises, with all and singular the appurtenances, unto the said parties of the second part, their heirs and assigns, to and for the only proper and behoof of the said parties of the second part, their heirs and assigns forever. IN WITNESS WHEREOF, the said party of the first part has caused this Indenture to be duly executed the day and year first above written. [SEAL] Received the day of the date of the above Quitclaim Deed of the above named David A. Krulac and Diane E. Krulac, husband and wife, the sum of Five Hundred ($500.00) Dollar, lawful money of the United States, being the consideration money above mentioned in full. COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND On this, th // ~-- undersigned ^~_ ;/ day of November, 2004, before me, the ~ ~r, personally appeared Jeffrey L. Paxton, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have~ m h~a~nd a official se?2~ ] I Certify this to be recor ' In Cumberland County Z do hereby Certify that the complete pos~e the within named parties of the Second part (Grantee) is P. O. Box 1064, Mechanicsbur~, PA 17055. ~Orney f~ ~ J,OO COMMONWEALTH Of PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVlOUAL TAXES DEPT 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD O04772 SHUGHART DALE F JR 35 EAST HIGH STREET SUITE 203 CARLISLE, PA 17013 ESTATE INFORMATION: SSN: 196-48-3861 FILE NUMBER: 2104- 1185 DECEDENT NAME: PAXTON GREGORY C DATE OF PAYMENT: 12/28/2004 POSTMARK DATE: 12/28/2004 COUNTY: CUMBERLAND DATE OF DEATH: 01 / 19/1988 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $454.00 REMARKS: TOTAL AMOUNT PAID: ~454.00 SEAL CHECK//1089 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '* BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISE"ENT. ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESS"ENT OF TAX REV-1547 EX AFP C12-041 DALE F SHUGHART STE 203 35 E HIGH ST CARLISLE JR ESQ DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-07-2005 PAXTON 01-19-1988 21 04-1185 CUMBERLAND 101 GREGORY C Allount Rellitted PA 17013 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 ~.-~ CUT ALONG THI$: L%NE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RlV.:'f!~"~..A~.rar.:'6'~l..Na".I.C!.OF.iNH!jtffANCE.TAX.A.PPRAisEMYNT~..ALtOWANCE.OR......_.........- ......... DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF.; PAxrO.tI GREGORY C FILE NO. 21 04-1185 ACN 101 ,.....__ -'0 j, _, ():""'::"", ':>J ("="') DATE 03-07-2005 c..) TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED ~ RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/"isc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 .00 7.300.00 .00 (8) NOTE: To insure proper credit to your account. submit the upper portion of this forll with your tax paYllent. 7.300.00 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/"isc. Expenses (Schedule H) 10. Debts/"ortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 4.272.00 .00 (11) (12) (13) (14) 4.272 00 3.028.00 .00 3.028.00 19 will I~ an assessment was issued previously, lines 14, IS and/or 16, 17, 18 and re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. ABOUnt of Line 14 at Spousal rate (15) 16. Amount 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 NOTE: .00 .00 .00 3,028.00 X 00 = X 06 = X 00 = X 15 = (19)= .00 .00 .00 454.20 454.20 ~ TAX CREDITS. n~_~.' l+J ~OUNT PAID DATE ~BER INTEREST/PEN PAID (-) 01-18-1996 AMNP PEN 114.24 .00 NOTE: AMNESTY N 12-28-2004 CD004772 .00 454.00 PENALTY ASSESSE INTEREST IS CHARGED THROUGH 03-22-2005 TOTAL TAX CREDIT 454.00 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE .20 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 719.77 TOTAL DUE 719.97 P D . IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1. NO PAY"ENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A ..CREDIT" (CR). YOU "AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTTnN~ 1 .,r.c-f.l.cr"T\ "'Tier "'\[: BUREAU OF DI)lVIDU~:-:__~J[lj I...T'.; C \.): ENHEAITANCE TAX DIVISION PO BOX 210601 HARRISBURG Pl 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE I:NHERI:TANCE TAX STATEMENT OF ACCOUNT *' REY-l~D7 EX AFP (03-05) DALE F SHU~MARt JR ESQ STE 203 35 E HIGH ST CARLISLE PA 17013 I: , MAKE CHECK PAYABLE AND REMIT PA~MENT TO: 04-18-2005 PAXTON 01-19-1988 21 04-1185 CUMBERLAND 101 -..t _ltted GREGORY I C 20n5 ""'q L, PH ',r,'. 09 .i"; '[," DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN e: REGISTER DF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 NOTE: To Insu~ proper credit to your 8CCount, s~it th8 upper portion of this fo~ with your t.x ~t. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ... ................................................................................................................ REV-1607 EX AFP (03-05) ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF PAXTON GREGORY C FILE NO.21 04-1185 ACN 101 DATE '04-18-2005 THIS STATEHENT IS PROVIDED TD ADVISE OF THE CURRENT STATUS OF THE STATED ACH IN THE NAKED ESTATE. S~ BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APfLICABLE, A PROJECTEO INTEREST FIBURE. . DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 03-07-2005 PRINCIPAL TAX DUE: 454.20 PAYMENTS (TAX CREDITS): AMN PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 01-18-1996 AMNP PEN 114.24 .00 i 12-28-2004 CD004772 .00 454.00 03-16-2005 CD005068 719.77- 719.97 I i , I I I TOTAL TAX CREDIT I 454.20 , BALANCE OF TAX DUE .00 , ESTY NON-PARTICIPATION PENALTY HAS BEEN ASSESSED INTEREST AND PEN. .00 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 . , SIDE FOR CALCULATION OF ADDITI_L INTEREST. I IF TOTAL DUE IS LESS THAN 11, IlO PAYHENT IS REIlUIRED. IF TOTAL DUE IS REFLECTED AS A nCREOITn ICRI, YDU MY BE DUE A REFIHI. SEE REVERSE SlOE OF THIS FORII FOR INSTRUCTIONS. I ~