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HomeMy WebLinkAbout08-01-13 � 15D561Q�43 REV-1 g00 �"°��"''� OFFICW.U$E ONLY PA Department of Revenue p�rmN cw�y coee va,r Fib N�mMf Bureau of Indhridual Taxes °�"""M°^a'� Po soxzsoso� INHERITANCE TAX RETURN 21 12 1232 Harrisburg,PA 17728-�801 RESiDENT DEGEDENT @NTER DECEUENT INFOftIMATON BEIOW Sociai Security Number Date of Death Date of Birth li O1 2012 O6 15 1929 Decedant's Last Name Suffix DacedenCS First Name MI �+T� PAULINE v (M MPllcabk)EM�r SurvWing Spqup's In(ormatlon BNow Spouse's Last Name . Suffuc Spause's Firsf Name MI Spouse's Sacial Security Number THIS RETURN MUST BE FItED IN DUPUGATL iMtTt!TNE RE(iISTER QF WlLLS FILL IN APpROPRIATE OVALS BELOW O 1. Originei Retum � 2. SupplemeMal Retum � 3. Remaiader RMUm(Oate of�eeth Prior to t2-13-A� 4. Lim(ted Eatate 40.F'�°��K°���q�qp�� 5. Fetlerei Esiete Tax Ratum R uired � (E6te d Melh Mar 12•12A2) ❑ � � g' {D�ea9e�MCQPYi�W�elj Ie � 7. De�nl�fr��}a Living Trust � B. TINe!NtsnDat ot Sefe Dtlpoelt 86z88 {nrixn c � 9. Li�patlottPmceetl6R8ceWed � 10.�°n?��a�1,�Da�abastlr � 11.E�I�SeMd�kO)Sac.8113(A) CORRESPON�NT-TMl6 DECTiON MUST�d6MPI27EO.lU.I CORRESP9NC�NCE AMD CONFIDENML T1UC NiWRMATN?!I SNOULD 8E DIIlECTED TO: Nwna Otytlm�T�MpAons t,�mMr JOHN R T9POMBLY JR ESQ (6]$} 925 �50� � � ° f'� n REti1ST�t i�YYi�3 USFi6RW � p, r- --a r� Flnt Une oiAddress � � � w � a . ;,c 224 EAST STREET RI? ° � �, � � �i <� ra �x � _ -n Jeeana Uns at AdBews ° ��-.' �-+ �"` e�a svzm� i � `' � � o �-- DATE A4ED � Cily o►Pwt IJfflcs 8�a 7dP�oda �rmrETT sQv� pa 19348 Corr�P�'s rmdi Wdr�a: rt is�hue���s a�rW�nv�ro r�an�h o�f O�P���om�er Men Uro�Panaial��Pe��.n0 acheaules ena elatemenb.an0 m the beat W my knwnedCe arW balief. leproeentehva fa bdM!ml eN intumletlon�whiGt pnpanr t�f e�y kttowistlpe. SIGNATURE ER ON RES LE F LING R URN ATE Donna J. (iosik 11 noo�ss 3 Buck Run Thomton PA 18375 SIGNATURE OF PREPMER OTHER iHAN REPRESENTATNE QATE John R.Twamby Jr.,Esq. AOORESS 224 East Strest Rd.,Suite 1,Kennat!Square, PA 19348 S(de 1 � 150561D143 1SD5610143 J , . ( ZSOS610243 �.1 REV-7500 EX Decedant's Sociat Security Number �+�'•� Baten, PaullneY. r�cnwruu►noN �i`--- - -�_ �. rtea�sstate�scnea�reA>....................................................................................... i. 150,OOO.qO 2. Siocks and Bonds(SCheduie B}............................................................................. 2. 3. Closey Held Caryoretion,PeRnership or Sole-PropriMorship(SchedWe C)......... 3. 4. Mortga9es&Notes Receivable(Schedule D)................................_..,................... 4 5. Cash,Bank Deposits&Miscellaneous Personal Property{Schedule E)............... 5. 29 j�$4 .$3.. 6. Jointly Owned Proparty(Schedule F? ❑ Separate Billing Requested............ 5. 2�$48 , QO 7. Inter-Vivos Tranxfers 8 Miscallaneaus t�aq-Probate Property {Scheduls G) �� separate eiUins Recueated.._......_ T. 285� 7$6, 91 8. ToW CirusArfets(total�ines 1 through 7)...................................................._., 8. 38H,489. 32 ` ..� .�. _._.� _ 4. Funeral E�ryenses and Admioistrative Costs(Schedule H}.................................... 9. 21�141. 14 14. CIeMs af Qecsdeat,Mortgage liabiNties and Liens(Scheduk i}............................� 10. 150. 00 1 t. TMai DiMueflorro(total Lines 9 and 10)................................................................ t 1. 21 r 2 91.14 �2. tMtYaiuuoff�hbiline6minustinett}.......................................................... t2. 367r19$. 18 19. Charilable and Govemmenlal Bequesis/Sec 9113 Trusts for which an eiection to.tax has not been made(Scheduie J)............................................... 13. � T4. NM Wlw Eubjaet to Tax(Line 72 minus Line 13)_..._........_.............................. 14. 367 �198. 1$ TAX CCSMPUTATION-8EE INSTRUC7'ION8 FOR APPLICABLE RATES � i 15. Amount of Line 14 ta�cabb - at the spousai ta�c rate,or tronsfers under Sec.911 B �5 O .OO {ay(1.2}X.d6 i6. AmouniofLine 14taxable 3g7� 198 . 18 is. 16. 528 • $2 at Iineai rate X .045 17. Amount of Line 14 Gaxeble d 0� �7 0 . 00 at sibling rate X.12 16. Amnunt of Line 14 taxable Q . 00 78. �• Q 0 at coliateral rate X.15 19. TAX DUE.._..._..._................_.......................,......_................................................ 19. 16,523. 92 20. FILL IN THE DVAL IF YOU ARE REQUESTIN6 A REFUND 4F AN QYERPAYMENT. � S&!e 2 �,�,�, 15Q561Q243 1505610243 J REV•150Q EX Page 3 FIN Numbsr 21-12-1232 Qswdsnt's Compteb Addrws: DECEDENT'S NAME Baten,Paullne V. STREETADDRESS ��i B Ra�daii Dreve arv —— -- �— srn� zia Enola PA 17025 T8X Ptyfrietrt6 AAtI CMdltf: 1. Taac Due(Page 2.Lim3 t9} (tj _ 16.825.92 2. Credits/PaymeMs A. Prior Payments 15,OOQ.00 B. Discount T8$.47 Total CrodRs(A +B) t2) 15,789A7 3. IMerest �3� _--- — 4. If Line 2 is greater than Line 1�Line 3,enter Ne diHerver�ce. This fs tAe 4YERPAYMENT. (4} Ch�ck box on Pap�2,Lln�2Q to rpuaY a rdund '�� 5. It Line 1 +Line 3 is greater tban Line 2,enter khe difference. This is the 7AX DUE. {5} 731�.A� Make Check Pa able#o: REGFSTER OF WILLS AGEN7. PI.EASE/UiSWER THE FOCtONflNti QUESTtONS BY PLACINC3 AN"X" IN THE APPROPRUTE BLOCK$ I 1. 6id decedent make a trensfer and: Y� � a. rotein tAe use or income of the proparty transhsrted:.................................................................._......._.. � � b. retain the right to desgnate wh4 shall use the property transterred w its income:.................................. c. retain a reverofonary intarest:or......................................................._..,_..............................._.._............ d. receive the promise for life of either paryments,benefits w care?......._................................................... 2. If death axurred after Dec. 12, 4992, ditl dacedent Vansfer propeAy within w�e year of death without � receiving adequate consideretion7..............._..............._............._........................................._........................ ❑ � 3. Did decedent own an"io iruat for' or payabk upon desM bank acco�M or sacurity at his or her death?....,.. OO ❑ 4. Did tlecedeM arm an individusi retiremaM account,annuity,or ather nomprobate propety which cantainsa beneficiary designaticn?.................................................................................................................. 0 ❑ IF THE XNSWER TO ANY OF TNE ABQVE OUEETION5 i3 YES,YOU MUST COMPLETE SCHEDULE 6 AND FILE IT AS PART OF THE RETURN. For dates of death on or aftar July 7,1894 and before Jart.1,t995,the tan rate impaseG on the rret value of transFers to or for Me use of ine surviving spouse is 3 percent[72 P.S,§9716(a){t.1?(�J7• For dales M death on cr after JanUary t,1495,the t�rate impased on the net value of ttansfers to w for the use ot tne surviving spause ia 0 pereeM (72 P.S.§9116(a){4.1)(ii)J. The statute duea not euampt a tranater ta a survh+ing Spbuse ftam tax,and the statutory requiraments for disGosura of � assets antl filing a tau retum are sti!!sppticab�even iT the surviving apouse is the oniy Oeneflciary. For dates of death on ar after Jnty'i,2000: � •The tau rate imposed on the net value af tranefers irom a daceased chiW 21 yeara of age or younger at death to or far the use of a naWra4 parent,eq adoptive pereM,or a stepperent of the chiW is 0 peteent[72 P.S.§911&(a}(12)j. .�The tau rake imposed on the net vaiue pf trensfen to or for the use of the decedent's line�l beneficiaries is 4.5 percent,except as noted in �'2 P.S.g4116(a)i�}j. .The tax rate imposed on the net vaiue M treneters to or for the use of the decedenPS siblings ia 12 percent[72 P.S.§9118{a)(1.3)]. A stblirn�is defirred under Seetion 9102,as an ind'mdusi wha has at least ane pareM in common with the decedent,whether by bioai or adoption. ibwtl02@Xs(N-16) scH�ou�.E a � ������ REAL ESTATE pEPARTMENT�F REVF.NUE INHERITANCE TA%RETURN RES�EMTOECEOENT ESTATE OF FILE NUMBER BtNn,Pauilna V. 21-12.7232 AMnYW9V�7�MdiWIMywls�IwwMMaamnonmistArnpor4tlM/tlrmrkMrWM.FeirmyrkatvelueisCelnadestlu�xicaetvfilrl� op�r�yxoWdbe axrl�angeCbet�vam�awiBkfG�+Y�a�tic �e111er.nNNarlreinO�rtpMedtot�Aarseli�bWtM�inqruwneWeb+oMeGBeottherabvent�luae. RW pnVrtf tlW M wNh�qIM of aYHvorWp mNt W dMePo�W on`ehwluM F. A1hU1 y WpY0111Ni�WU11�M NI�KMiM ptOpMt��1MbM)�OIa YKJ�W a eopr aa�a.w aww�na aeMlxtrs InarNl xewmd r bYwrtm eamwn. ITEM VAt�UE AT DATE NUMBER DESCRIPTfON OFDEATH 1 Dsc�derN s psrsonal residence locptrd rt 8 Randall Drive,Enola,PA-value ba�W on 150.O�.IXi apprahai by Robert K.Bsnzhoff of Centrat Penn Apprpisob,Shiremanatown,Pp {pe atkaehed appratsat) TQTAL{q�p���line 1.RacapFp�Iattoni 1$O.IXIO.W (nmare s{+ace is neeaeii�atlduorre�pagas ot Hre seme size} Cupyright{c)2p10 Wrtn soflware only The Lackner Group,lr�c. Form PA-1500 Scheduie A(Rav.87-10) _ �in� x`v-,aae ex.{,,.,er SCNEDULE E pennsylvanla CASH, BANK DEPOSITS, & MISC. OEPAR7MENTOFREVENUE INHERITANCE TAX RETURN PERSONAL PROPERTY REBIDENT DECEpENT EBTATE OF FILE NUMBER Babn,Paaltne V. 27-12-1232 �fIC�1M81�1B Of�� 8��18t�Gf81r8. FfOClBt�fAlflflu'9�Ylf�by{�WK19�6. Nlpapod���ofMwNVa�hlpmu,Ih�tlNda�MOnWwdY�F. ITEM VAIUE AT DATE NUMBER DESCRIPTION oF DEA7H 1 Mhnbars 1st Bank-chaetdng accouM no.278t314804 9.847.48 2 Sow�rolyn&�nk-checldng accau�no.921749T22 2.509•17 S Soversign Bank-ahecking acccurrt na.921710825 8828T 4 Savereign Bank-wvings account na 8249041ST 1�1.43 5 Mernbers 1st Bank-swings aaaount rto.8 181480 9.468.71 6 2008 Toyot�P�iw-vatue based on Keliay Blue Book 12,�.00 7 7a�ylbls ps�sonal propa+t�+locabad 1n the dacedenYs pano�nf residanee at 6 RarW�H Driw, 75p.00 Enola,PA TOTAL(NSO erMsr on Une b.Recapltulatlon) 29.854.41 (n more w��neeaea.aaa�aw,ea paoes w me same siu} Copyright(c)2410 form software only The Lackner Group,7na Fortn PA-1606 ScheduM E(Rev. 11-1 q) — �,-,.�.�.�,.,�, pannsylvania SCHEDULE F DEPAft7MENT Of REVENUE JpiNTLY-UYYNED RRORERTY MHERITANCE TAX RETURN RESIDEM DECEpENT ESTA'PE OF FILE NUMBER B�tsn,PauiMa V. 21-12-12SZ p�wNwea m�w 1dntMMM�omY+r MIM d�aar�M�a�b MtlrW4 kmwt 6���paW onadrdW 0. SURVIVING JOINT TENANT(S}NAME ADDRESS REtATiONSHIP TO DECEDENT A. Susan J.Bronnan �00$Vat►ord Cir. Daughker Lacwt Cirove,YA 2280$ B. C. J0INTLY OWNED PRBPERTY: DESCRIPTION OF PRQPER7Y UqTE OF pEA7X ITEM FOR,JOIN MADE 'N�MgER OR 91MILAR iDECHTiFY1NG NUMbER.ATTP.C�H OEEDGFOq DAT€OF DEATH DECG�S DECEDENPS INIEREST NUMBER TENANT JOINT �riv-Newrc�uesrare. ALUEOFASSE iNTEREST 1 A 0lMM79Y8 GE Capifai Utvest Dl�sct-OE Int�nst Plw 8.896.00 3Q. 7,848.00 Notss 1%,InvptrneM No.8Sbd8242098684 � TOTAL(Aiw er�#sr on Lins B,Rscapitulatlonl 2,648.00 (M mws Wece is neeGetf.adtlltian0l Pe9es af tlta same size} . Cnpyright(c}2Q70 farn soflware unly Fhe lacknar Group,lac. Parm PM154D Sehedule F(Rev.07-10) NvdliQ67t.(6b�0�Y scHEOU�E c� pennsylvania lNTER VlYt)S TRANSFERS AND DEPAftTMENT OF RkVENUB INHERR'ANCETAXRETURN MISC. NON-PROBATE PROPERIY RES�DENT 6ECEpEM ESTATE dF FILE NUMBER Babn,PauiMs V. 21-12-1232 ri„:scnaaWa�,m ee mmWmaa ana n�ea an»e�swar�o am�waua,a+mrwmn<o�p��r�oru»aevnsoo�s ras. ��M DESCRIPTIpN OF PROPERTY QATE OF DEATH xoF oecos �ccwsioN TAXABLE NUMBER �o���ns�.Sa�EH�orvE�'�tt+E�o�oF�a�t.EESr�n�. VALUEOFASSEF �"TEn�sT ��^�,�,E> VALUE 1 Waiis Farya Adviwra-IRA no.138M�fl90. The 54.307.00 84.301.00 bensficiari�are the Decaderrt's ffiras ehiidren: $wan J.Bnrnn�n,Mlchasi L.B�bn end Donna J. Gasik (see atFached coMinwtioo schadule� 2 WelUr Far'�o Advlwrs-tramfar at d�Yh brokerage 151,486.41 757,48b.81 aCCOUnt rw.1364-7888. TM transfens�ara the DecedeM's three ahlidren: Sw�n J,8nnnan,Mlchasi L Sa�n and Uonrui J.tiwik {see aitached caMinwBon sehedWej TOTAL tAtsa anbr on Lirro 7,RacapitulaHoni 2G3,788.81 {x mara spnce is naeaat� p�as ot me same siu3 Copyright(c)2009 Twm software onty The Wdarer Group,inc. form PM1600 Schadule G(Rev.OB-09� SCHEDULE G INTER-VIYOS TRAN8FER3& MfSC. NOt�I-PR08ATE PROPERTY cantinuerf ESTATE QF FN.E NUNlBER Babn,Psullns 2t-12-1232 iTEM DESCRIPTIdN dF PROPERN QUANTITY PRICE DATE OF NUMBER DEATH VALUE Ameriwn Century Mutuat Funds Growfh Fund- 1 {cottt} �nstitutbna� $3.48 $ 28.0600 $ 2,622.3$ Arrrerican Century Investment Trust Diversitied Bazd Fund Institutional Class 242.69 $ 11.2$OQ $ 2,737.53 Cohen 8 Steers ReaHy Shares�nc. 15.39 $ 87.5004 $ 1,439.1Q Dodge s Cox Stodc Fund 22.42 $179.S7QQ $ 2,686.89 DreyNs Appreciation Fund loc. 71.58 $ 44.6200 $ 3,183.72 Europac'fiic GrrnMh Fund Glass F-1 41.11 $ 38.$904 $ 1,$39.88 Goklman Sachs Trust Financial Squara Treasury instruments Pund�nsikutiona�qass 568.01 $ 1.0000 $ 56$.G1 Artio Gbbai investment Funds Tatat Retum 8ond Fund ciass i 274.03 $ 14.0200 $ 3,841.86 Mainstay Fund H�h YieW Corporate Born!Ft�nd Class t 289.79 $ 6.0900 $ 1,642.53 Managers Fu�es Bomt Fund 79.66 $ 27.9100 $ 2,223.73 �iFS Ser Trust X Emergiog t+�artcats pebt Fund Ciass I 170.44 $ 18.1400 $ 2,750.84 PAertropotitan Wast Funds Totat ReWm 8ond Fund Ciass I 34$.55 $ 11.0700 $ 3,858.40 � .IPMorgan Truat t intrepid Vawe Fund Seiect Ct 1d4.83 $ 25.930d $ 2,718.11 Heartland Value Pius Fund Ctass Institutionai 5229 $ 30.0500 $ 1,571.34 Oppeaheimer Irnamatianat eond Fum!c�ass Y 417.$9 $ 6.5500 $ 2,737.21 virtus Emaryiny Maricets opponunities Fund C�ass� 337.3� $ 9.9300 $ 3,350.10 Aiger Smaikap and Midcap Grow Ctass I 90.72 $ 17.2400 $ 1,564.06 Pimco Funds FAC InvestmeM Manag�neM Series Total Return Fund Instkutional Class 426.28 $ 11.590Q $ 4,9A0.61 Pimco Furids PAC Investmen!Management Seriea Commodiry Real Retum Strat Fund Instkutiona�Cless 151.09 $ 6.890Q $ 1,041.01 Pioneer Series Trust i Pioneer Oak Ridge Smaii Cap Growtn Funa ciass v 34.35 $ 30.6904 $ 1,054.08 RS irnestment TrvSt Vatue Fuad CIaSS Y 63.16 $ 26.050Q $ 1,64524 Thamburg Investment 7rusts invt income Buikier Furid ciassi 172.89 $ 19.itOt? $ 3,343.59 Wells Fargo Funds Tmst Advantage Endeavor Select Fund ciess� 142,25 $ 11.0400 $ 1,570.4Q Totai $ 54,301.00 SCHEDULE G INTER YIYOS TRANBFERS � MiSC. NdN-P'ROBATE PROPERTY continued ESTATE O� FN.E NUMSER Bst��.P*uNM 2t-12-1232 ITEM DESCRIPTION OF PROPERTY QUANTlTY PRlCE dATE OF NUMBER DEATH VALUE 2 (cont.) Arar 380A0 $ 34.9200 $ 13,269.60 Boardwalk Pipeline Parinero LP 335.00 $ 28.7454 $ 8,946.7$ Heatth Care Ren�na 22QAQ $ 5$.3600 $ 13,Q59.24 lehares 8arclays MBS Bond Fund ETF 45.04 $108.590Q $ 4,886.55 Ishares Barclays 7-10 yr.Treasury 6ond Fund ETF 45.QQ $1 Q7.540Q $ 4,838.34 Ishares Barclays Intgrmediate Cradit Bond Fund ETF 68.OQ $119.7054 $ 7,595.94 Ishares Barolays t-3 yr.Credit 9ond Fund ETF 7Q.00 $1 Q5.71Qd $ 7,399.70 Isharas Barclays&7 yc Treasury Bond Fund ETF 3Q.QQ $123.1540 $ 3,694.82 Ishares Core S8P Midcap ETF 34.OQ $ 99.Q250 $ 3,36fi.85 Ishares Core S&P Smalkap ETP 38.00 $ 76.9654 $ 2,$86.87 Ishares Ibo�oc$Yisk!Corporate Bonct Fund ETfi 25.00 $ 92.3450 $ 2,3d8.63 Ishares Ibo�a Investment Grade Corporete Bond Fund E'rF 44.00 $122.5800 $ 5,393.52 ishares JP Morgan Emerging Markets 8pnd Fund ETF 19.00 $121.2450 $ 2,3U3.6fi Ishares TR-Russell 1000 Value Index Fund 103.0� $ 72.2650 $ 7,443.30 Ishares TR-Russell 1000 Growth Index Fund 102.00 $ 65.3400 $ 6,664.68 Powershares Emerging Markets Sovereign qebt Portfolio E'r� 89Ad $ 31.'1050 $ 2,768.35 Powershares E�har�ge Traded Fund Trust II Buiid nmerica Bond Portfolio E7F 815.04 $ 34.1304 $ 9,490.95 PPLCorporation $53.38 $ 29.54Q0 $ 25,208.96 SPDR earclays High Yield Bond ETF 126.00 $ 40.190Q $ 5,063.94 SPDR Barclays I�temadonal Treasu[y eond ETF 77.� $ 61.1140 $ 4,705.78 Vanguard MSCI EAFE ETF 180.04 $ $3.5050 $ 5,360.80 Vanguarsl Total Bond Market ETF 57.00 � 84.7t 50 S 4,828.76 Total $ 151,4$5.91 rtev-tanT mc.jic�y � pennsyhrania SCNEDULE H °EPARiA�T��"� FUNERAi. EXPENSES AND ft SE6EM EC EMTORN ppMINISTRATIVE COSTS EBTATE OF FiLE MUMBER B�bn,Paullns V. 21-12-1232 DecedanYs dN�s mwt be roported on 8ctroduie I. fTEM DESCRIPTION AMpUNT p, FUNERAL EXPENSE3: Ses eo�tinw�tlan sch�duk(s}attaeh�d v0,tso.00 8. ADMINISTRATIVE C08T8: t. Personal Representativa's Commiseione Neme of Peraonai ROpresentetive(s) Street Address City State 2io Year{s}Commissian Paid z. nnornev's Fess Law OMICp of John R.Twcntl6iy,Jr. 8.044.QQ 3. Family F�cemption: (If decedenYs address is nat the same as Ga&nant's,attach e�rylanakion} Claimant Streat Address City State Zro Retationshio of GlaimaM ta pecedent 4. Probate Fees Mp,gp 5. AccountanFs Fees 6. Tau Ratum Preparera Fees 7. QtherAdminiatrativeCosts 4,520.84 Sss coe�tMuatbn achsdnN(sj attaehed TOTAL{Nw q�r on line 8.Rscapituiation) 27,147.14 CopyrigM(c)2W9 fortn soNware ony The Lackraer Group,lrac. Fartn pJ1-1500 Scheriuie H(Rev. 10.09} SCHEDULE H FUNERAL EXPEN8ES AND ADMtNISTRATNE COSTS aontinued E87ATE OF FILE NUMSER Batsn Pauiina V. 21-12•1232 ITEM NUMBER QESCRIPTtON AMpUN7 ��[il.F.iCRiO�lt t Suiiivan Funeni Hame,Enoia,PA-iunerai servicero am!merehandhe 8.424.OQ 2 Roqing f3reen Cematary-burla!plot 1.78Q.00 H-A 10.180.00 3 Re�palrs made at DacoMenCs panonal resldence after DacedeM'�dea�tlt 3.OW.df1 4 Cart of u#Ilitles at the Dacadsnt's psnarurl residence 1,0�.00 5 PaMot News.Harril�burg.FA-oblkuarY fee 266.10 6 Cwnbertand Law Joumal-faa for adverB�ing gr�rrt of IeiMrs 75.00 7 The Serntrrel,CaMNte,PA-fea tor adwrtlsing grerrt of latb�s 189.54 H-B7 4.b20.&t I Capyrighk{c}2�2 iartn sofiware any The Ladcner Group,inc. form PM160d Schedule N(Rev.6-98) Rlv�t8ltEXr{tt-0!) scN�ou�E � ������ DEBTS OF DECEDENT QEPARTMENT�F REVF.NUE � INHERITANCETAXRENRN MORTGAGE LIABILITIES AND LIENS RES�NT�CE6EllT E�T�T�� FILE NUNIBER Bnbet,PauiMa V. 21-12-12a2 rt.�wn a.w i�un.e nr u»a.s.a.n anor m a.nr u,w n�r�.n�.pa r a.aa ae ara.tnwana�■+pne�...a R.aic.�.,�.n... ITEM VAtUE AT DATE NUMBER DESCRIPTION DF pEATH 1 Holy SpiMt Nospital,Camp FIIII,PA-msdlcal enparnas 150.00 T4TA1.{Alsa entat on line 10,I2eeapHuNtlon} 1�6d.00 {re rt�e apaca is n.eaea.saauooai papec ame same sue} Copyright{c)20�8 form software only Tha Lackner Group,l�c. Form PJr�1b00 5ohatlule I(Rev.12-08} REY-td13E7tty01.id) pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHER(�ANCETAICRETURN BENEFIClARlES . REBiDENTDECEDEHT ESTATE OF FILE NUMBER Babn Psuilns V. 21-12•1232 RELATIOMSHIP T4 NAME AND ADDRESS OF SHARE OF ESTATE AMOUN7 OF ES7ATE NUMBER PERS4N(S1 REGEIVtNG PROAERTY OECEDENT (yyoMsj ($E$) � TAXAOLE DISI'RIBUTIQNS (include outright apouaai dntr�butrons,and transfers Unde(Sac.$11 a t Z 1 Jefiroy B�ttn Grandson t10,00d spacMic 1QOOO.OQ 118 i.auM�. bequest Enoia,PA 17025 2 Mletwel L Baten Son ona-fhlyd shara 148,066.� 118 Lauroi Dr. of the resldw Enoia,PA 7�025 3 SussnJ.Bronnan DauyhMr orro-tltirdsMra 1t$�d68,06 �t00 8tratfoM Clr. ot tM retid�re Locust Grova,VA 22508 4 Donna J.C�osik Daughtsr on�thl►d share 179.088.08 s s�rtw� ot n�.r..raw Thwnton,PA t8S73 � Tota) 387,188.18 Errter doliar amau�ts tor d�hibutians shcxm aCOVe on Nnes 15 Mro h 1 S on Rev 1500 cover sheet as riate. NON-TAXABLE 6ISTRiBtFi'IdNS: � � II. A.SPOUSAL OtSTRkBUTtONS UNDER SECTi6N 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN i B.CHARfTABLE AND GOVERNMENTAL dISTRiBUTIONS TOTAL QF PART 8-ENTER TOTAI NON-TAXABtE DIS7RiBUT14NS ON IiNE'13 OF REV-1506 CAVER SHEE CopyrigM jc}2410 far+n software onry The tackoer Group,Uc. 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RECEIPT FOR PAYMENT GLENDA FARNER STRASBAUGH Receipt Date : 8/O1 2013 Cumberland County - Register Of Wills Receipt Time : 12 : 3 : 37 One Courthouse Square Receipt No. : 1075083 Carlisle, PA 17Q13 BATEN PAULINE V Estate File No . : 2012-01232 Paid By Remarks : DBiN TWOMBLY JR ------------------------ Receipt Distribution ------------------'-'--- Fee/Tax Description Payment Amount Payee Name INH TAX RETURN 15 . 00 CUMBERLAND COUNTY GENERAL FUN ---------------- Check# 4694 $15 . 00 Total Received. . . . . . . . . $15 . 00 __ _ _ _ _