The URL can be used to link to this page

Home My WebLink About04-25-14 REV-1500 EXue2-ib( 1) di 1505613105 � OFFICIAL USE ONLY PA Department of Revenue peon,sylvania Bureau of Individual Taxes "T County Code Year File Number PO BOX 28o6at INHERITANCE TAX RETURN Harrisburg PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDOYYYY 03/03/2013 03/31/1957 Decedent's Last Name Suffix Decedent's First Name MI Dailey MS Karen L (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW M 1.Original Return Q Z Supplemental Return CI 3. Remainder Return(Date of Death Prior to 12-13-82) 1-5 4,Limited Estate iC 49.Future Interest Compromise(date of C) E Federal Estate Tax Return Required death after 12-12-82) C) 6. Decedent Died Testate O 7.Decedent Maintained a Living Trust S. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust.) C) 9.Litigation Proceeds Received O 10.Spousal Poverty Credit(Date of Death O IT Election to Tax under Sec.9113(A) Between 12-31-91 and 1-1-95) (Attach Schedule O) a CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTF.Q,30: r " Name Daytime Teleriti Number s m Jack A. Knaub Jr (303) 514-2f52o ho REGISTE f :�WiL4rUSE O SLY -I d r T ITT ' fr7 tJ-t C7 First Line of Address c7 'L7 -T 'rT 120 Wisp Creek Drive e, c) --n n C Cy c:) Second Line of Address - 'O f. r M _U V C:) C..3 Ti City or Past Office State ZIP Code. DATE FILED Bailey CO 80421 Correspondent's e-mail address:jacknaub @hotmai(.Com Under penalties of r)ury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true,correct a complete.Declaration of preparer other than the pers al representative is based on all information of which preparer has any knowledge. SIGNATURE OF E SON NSIBLE FOR '11-100 BETURN DATE Q � ADDRESS 124 wis tree drive, bailey, co 80421 SIGNATUR OF P -PARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 1505610105 1505613105 J 1505610205 REV-1500 EX(Fl) Decedent's Social Security Number Decedent's Name: Karen L. Dailey RECAPITULATION 1. Real Estate(Schedule A). . . .. . ... . .. . .. . . .. . . .. .... .. . ... . ... . ... . .. . 1. 2. Stocks and Bonds(Schedule B) .. . . .. . .. . . .. . ... .. . . .. . ... . .. . ... . ... . 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . . . .. 3. 4. Mortgages and Notes Receivable(Schedule D) . .. ... . .. . ... . .. . ... . ... . .. 4. 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E).. . . .. . 5. 6. Jointly Owned Property(Schedule F) O Separate Billing Requested ... .. . . 6. 11,693.65 7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property _ (Schedule G) O Separate Billing Requested.... . ... 7. 10,718.02 8. Total Gross Assets(total Lines 1 through 7).. . .. . . .. . .. . . .. . . .. .... . ... . 8. 22,411.67 9. Funeral Expenses and Administrative Costs(Schedule H). _. _.. .. .. .. . ... . 9. 3,446.63 10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule I). . ... . .. . . ... . . 10. 11. Total Deductions(total Lines 9 and 10).. . .. . . .. . . .. . ... . .. . . .. . . .. .. .. . 11. 3,446.63 12. Net Value of Estate(Line 8 minus Line 11) . ... . .. . . .. . . .. . ... . .. . . .. . ... 12. 18,965.04 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J) .. .. .. . . .. . . .. . ... . .. . . . 13. 14. Net Value Subject to Tax(Line 12 minus Line 13) . . .. . . .. . . .. .... . ... .... 14. 18,965.04 TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 (a)(1.2)X.0_ 15. 16. Amount of Line 14 taxable at lineal rate X.0 45 18,965.04 16, 853.43 17. Amount of Line 14 taxable at sibling rate X.12 17. 18. Amount of Line 14 taxable at collateral rate X.15 18. 19. TAX DUE ... . . ... . . .... . . ... . .. . . .. . . .. . . .. . . .. . . . .... .... ... . ._ 19. 853.43 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 1505610205 1505610205 J REV-1500 EX(FI) Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME Karen L Dailey STREETADDRESS 423 Herman Avenue — —� —� ZIP -_ Lemoyne PA 17043 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 853.43 2. Credits/Payments A.Prior Payments -- 0.00 B.Discount 0.00 Total Credits(A+B) (2) 3. Interest (3) 8.25 4. If Line 2 is greater than Line 1+Line 3,enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2,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) 861.68 Make check payable to: REGISTER OF WILLS,AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS 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.................................._-....._........................._..........-..... ❑ N b. retain the right to designate who shall use the property transferred or its income ..................................._...... ❑ 0 c. retain a reversionary interest ...................................................................................-..........,............................- ❑ S d. receive the promise for life of either payments,benefits or care?.._..-..........-........................................,......... ❑ N 2. If death occurred after Dec.12,1982,did decedent transfer property within one year of death without receiving adequate consideration?. ..................................,_,......... .............__._...._.._..._........ ❑ 3. Did decedent own an"in trust 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 beneficiary designation? ,-................._...........................................................................-.................... 0 ❑ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1,1994,and before Jan.1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent[72 P.S.§9116(a)(1.1)(1)]. For dates of death on or after Jan, 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent 172 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 return 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 21 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 percent f72 P.S.§9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in f72 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 percent[72 P.S. §9116(a)(1.3)],A sibling is defined, under Section 9162,as an individual who has at least one parent in common with the decedent,whether by blood or adoption. r REV-1509 EX+(01-10) �'.�. pennsylvania SCHEDULE F DEPARTMENT OF REVENUE INHERITANCE TAX RETURN .JOINTLY-OWNED PROPERTY RESIDENT DECEDENT ESTATE OF: FILE NUMBER: Karen L. Dailey It an asset became jointly owned within one year of the decedent's date of death,it must be reported on Schedule G. SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT A.Jack A. Knaub Jr 120 Wisp Creek Drive Son Bailey, CO 80421 B. C. JOINTLY OWNED PROPERTY: LETTER DATE DESCRIPrION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER.ATTACH DEED FOR JOINTLY HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST 1, A. 06105196 New Cumberland Federal Credit Union--Acct-9614 23,387.29 50 11,693,65 TOTAL(Also enter on Line 6, Recapitulation) $ 11,693.65 If more space is needed,use additional Sheets of paper of the Same size. p � II I�4 M r 4GCbtl11T NUMBER: STATEMENT PERtOB: xlaxxxx614 Mar 1,2'013-Mar 31,2013 Page 2 of 2 Trans Eff Dale Transaction Deposit WFtttdrawal Balance The Annual Percentage Yield Earned Is 0.15. Now Balance 567 36 : i , i Trans Eff Date Transaction Deposit Withdraws! bajunce,' Previous Balance 0.00 Mar 15 Transfer From S 3 From Share 3................. ,..... 956.95 956,95 .............. -956.95 0.00 Mari Virtual Ln Pmt..................................... . New Balance 0.00 ;. - Roth r r ° Trans Eff Date Transaction Deposit Withdrawal Balance Previous Balance 5.32029 =` Mar 29 Mar 31 Certificate Earnings 11.97............................ ............................... 11.97 5,332.26 The Annual Percentage Yield Earned Is 2.69. New Balance 5,352.26 r! Your Current Member Rewards Level is Plat Plus Which Entities You To A 0-35 increase Over And Above Our Base Rate On Future Cd Purchases, Certificate Rate:2.650% G5 - . ° • r r ; Trans Eff Date Transaction Deposit rawal Balance Previous Balance 10,135.27 Mar 29 Mar31 Certificate Earnings5.60................... .. 5.60 10,140.87 The Annual Percentage Yield Earned Is 0.66. Now Balance 10,140.87 SL�� Your Current Member Rewards Level is Plat Plus Which Entitles You To A 0.35 Increase Over And Above Our Base Rate On Future Cd Purchases. Certificate Rate:0.650% Roth ' + Date.- r r L ff Date Transac n eposit Withdrawal Balance S' Previous Balance . . ....•................................ 12.15 5,397.73 Mar 31 Certificate Earnings 12.15.................. . .....The Annual Percentage Yield Eamed Is 2.69, Now Balance 5,409.81:Your Current Member Rewards Level Is Plat Pius Which Entities You To A 0.35 Increase Over And Above Our Base Rate On Future Cd Purchases, Certificate Rate:2.6WV6 Other Year-to-Date Amounts RothlCoverdetl ESA Earnings Year-to-Date:69.88 Prior Year-to-Date Dividends;219.43 Prior Year4o-Data Roth Dividends:279.55 TOTAL.DIVIDEND YEAR-TO-DATE 21.44 TOTAL FINANCE CHARGE YEAR-TO-DATE for all loans. 0100 VISA vales as low as 6.9W.,, and Frcc Balance Trallsf�r _APPINA'Odayl I n h i m 11 1 @w P.o.6Dx.ssa ACCOUNT NUMBER: S�ATEINENT PERIOD: NEW CUMBERLAND,PA 17070 X)OCX=614 Mar 1, 013-Mar 31, 2013 TowCommunit?'C'reddt 4lriron 800-7"CCCU l 717-774.5731 ADDRESS St;RYfCE REQULe3730 4vWWAOFCUONLINE.ORG SUMMARY AT A GLANCE Total Shares: 11,831.56 Total Loans: 0.00 Total Certificates: 20,883.01 Karen t,Dailey -° . 423 Herman Ave Lemoyne as 17049.1843 NewiUsed Car Rates t t j 5 YEARS IWkNW/tENJE i9KiptliROR1110 Page 1 of 2. Joint Owners:Jack A. Knaub Jr S1 S1-Primary Shares Trans Eff Date ransaction Deposit Withdrawal 4alance Previous Balance 829".03 �d Mar 01 Automated Deposit 102 Us Treasury 3121xxciv Ser....................... 325.71 954.74 SL' ! Mar 31 Dividend........................................................................ ................. 0.12 954.86 The Annual Percentage Yield Earned Is 0.15. New Balance 854.88 S3-Money Market 4 Trans Eff Dats Transac8on Depask Withdrawal alance '^ 11 Previous Balance 6,747.17 Mar 01 Automated Deposit 102 Us Treasury 312 txxciv Ser....................... 200.00 6,947.17 Mar 15 Transfer To S80 Xfr To S80............................................................. -956.95 5,990.22 Mar 3i Divdend........................................_......,... -._......... ....._ _ _ .... 1.09 8,991.31 .......... The Annual Percentage Yield Earned is 0.20- New Balance 5.891-31 S4-Share:Drafts Trans Eff Date Transaction Deposit Withdrawai Belaince Previous Balance 3,582,80 �.— Mar 01 Automated Deposit 102 Us Treasury 3121xxciv Ser....................... 1,200.00 4,7x2.80 Mar 04 Share Draft Cleared 2141 New Cumberland F Payment-.............. -400.00 4,382.80 !.... Mar 05 Ach Withdrawal 1340438190 Westfield Group Payment........... ...- -65.16 4,317.64 Mar 31 Dividend........................................................................................... 0.37 4,318-01 The Annual Percentage Yield Gamed Is 0.10. New Balance 4,318.01 CHECKS CLEARED AT A GLANCE 'indicates a break in sequence Date Draft Number Amount Date Draft Number Amount Date Draft Number Amount Mar ❑ 2141 -400.00 t 3 Trans Eff Date Transaction Deposit Withdrawal Balance '. Previous Balance 467.31 t i Mar 01 Automated Deposit 102 Us Treasury 312/xxciv Ser...- 100.0D 567.31 L Mar 31 Dividend........ ........................____....................................... 0.07 567.38 VISA rates as lo-�v as 6.90% and Free Balance Tnuisficr ...APPIN T px�_' F «.n. ni ipw BF61V lJlll'xaJ 3 ON i ) a! S / ) i � � � I � ' ii \ ' [ ° I • . m ! # / y!&!r . � . . . E ky®; REV-1510 Ex+(08-09) pennsytvania SCHEDULE G DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND INHERITANCE TAX RETURN MISC. NON—PROBATE PROPERTY RESIDENT DECEDENT - ESTATE OF FILE NUMBER Karen L. Dailey This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH ^/o OF DEWS EXCLUSION TAXABLE IBCWOETHE OF tlr THE,ATEACEPEECTHE10. THE DEC) ESTATE.AND NUMBER THE GATE Or TaqusrEP.AnACHamm or THE OEO FOR REAL ESTATE. VALUE OF ASSET INTEREST iP avvucnau) VALUE 1, Jack A.Knaub Jr,Son of decedent,transferred upon death-03/0312013 10,718.02 100 1Q71B.D2 Roth IRA's TOTAL(Also enter on Line 7, Recapitulation) $ 10,718.02 If more space is needed,use additional sheets of paper of the same size. 1 ACCOUNT NUMBER: STATEMENT PERIOD: x614 Mar 1,2013-Mar 31 >.cwooc , 2413 I I Page 2 of 2 tied Trans Etf Date Transaction Deposit Withdrawal Balance The Annu I Percentage Yield Earned Is 0.115. New Balanc 567.38 Trans EffDOW Transaotiol I Deposit Withorawal Balance:' Previous B ilance 0.00 Mar 15 Transfer Ft om S 3 From Share 3...... . ......................... 956.95 956.95 .-: ;,.. Mar 15 Virtual Ln I Tot................ 1 .... -956.95 0:00 New BatarI4 e 0.00 >. Roth r r * Trans Eff Date Transatioo Deposit ithdrawal Balance Previous B lance 5,320.29 Mar 29 Mar3l Certificate amings 11.97..................... ....... 5..,........ ................... 11.97 5.332.26 The Annu (Percentage Yield Eamad 15 2.69. _ ' New Balan a 5,33226 �7 Your Current Mem r Rewards Level Is Plat Plus Which Entities You To A 0.35 Increase O r And Above Our Base Rate Dili Future',Cd Purchases. . Certlfloate ate;2.660% Trans Date Transactio Deposit at Balance Previous Iance I I 10,135.27 Mar29 Mar31 Certificate Earnings 5.80........................`..... ..,......_........................ 5.60 t0;140.87 i`.: The Ann r Pe tentage ,; Earned Is 0,66. New Baran 10,140.87 `> U / Your Current Mem er Rewards Level Is Plat Plus hick Entities You To (� A 0.35 Increase Over And Above Our Base Rate O Future Cd Purchases. Certificate Rate.0.650% LTr,an lf Date Transatit0 Deposit Wit drawsi Batance Previous atance 5,397.73 Mar 31 Certtffcato Earnings 12.15................ . . .. .. ..... 12.t5 5,409,88The Ann at Percentage Yield Earned Is 2,169. A 0 r Curr nt e 0 erAR d Above vel Is P agate Future Cd Purchases.,` 5,409-88. Certificate Rata.2.650% Jul: e Year-t ate Amou RoitUCoverdeg SA Earnings Year-to-Date:69 88 Prior Year-to-Da a Dividends:219.63 Prior Year-to-Da s Roth Dividends:279.55 TOTAL DIVIDEND YEAR- 10-DATE 21A4 TOTAL FINANCE CHAR E YEAR-TO DATE for all loans oleo i I REMsrt Ex+ (08-13) pennsylvania SCHEU LE H pEP.pRTMEMOFREVENUE FUNERAL EXP NSES AND mN Rrtnrvc X RETURN ADMINISTRA IVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER Karen L. Dailey Decedent's debts must be eported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A, FUNERAL EXPENSES: I' DIrectCremation 1,575, 0 Combustible Cremation Container&Wood Scattering Urn 285. 0 Certified Copies of Death Certificate 90. 0 Coroners Cremation Authorization 30, 0 Flowers 63. 5 Ooituary 220. 0 B, ADMINISTRATIVE COSTS: I 1, Personal Representative Commissions: Name(5)of Personal Representative(s) _ Street Address City_ State 21P_ Years)Commission Paid: 2, ,ttorney Fees: 3. �amily Exemption: (If decedent's address is not the same as daima it's, attach explanation.) Claimant Street Address City _ State ZIP Relationship of Claimant to Decedent 4. t�robate Fees: S. accountant Fees: 1 6. Tax Return Preparer Fees: y Arline Fares to fly in to arrange funeral and cremation 711. 0 R ntal Car to drive to arrange funeral and cremation 429. 3 B�ggage Fee 25, 0 T Its 17. 5 TOTAL(Also enter on Line 9, Recapitulation) $ 3,446.63 If more space is needed,use additional sheets of paper of the same size. Paym Inn Due Date New Balance Past Due Amount Minimum Payment 063I13 $235.66 $0.00 azs.po Make your check payable to: Q Chase Cara Services. �1 Pli write amoum enclosed. New address or e-maili Print on back 042916Ex 901D rrrlll l�rl�i ll�dll I�r'IIII�IIIIrPInrl�rl�r�II�IJ�rrll�rlll�l JACK A KNAUB JR 120 WISP CREEK DR CAROMEMBER SERVICE BAILEY CO 60421-2348 PO BOX 94014 PALATINE IL 60094-4014 ILrIrllrrrrLJrrl lrrrilrrllr,lI h.IL.L. 1.111r...ILA CHASE0 Manage your account online: 0atom.r San'.. Additional contact wcheaerri itcards 1-90P945-2000 information on back AC{JOUNT SU MARY PAYMENT INF RMATION I New Balance $235.66 Previous Balance $1,480.84 Payment Due Data 0$23113 Payment,Credits -55,510.12 Minimum Payment D 525 00 Purchases +54,264.94 Late Payment Wdmi g: If we do not receive your minimum Cash!Advances 50.00 payment by the date I led above,you may have to pay a late fee of up to$35.00 and you APR's will be subject to increase to a Balance Transfers 50.00 maximum Penally AP of 2999%. Fees Charged $0.00 Minimum Payment arning:If you make only the minimum Inter st Charged $0.00 payment earn per od, ou will pay more in interest and it will take New Balance $235.66 you longer to pay off ur balance. For example. OpeniI nglClo,img Date 0212 7113-0326113 If you make no on will pay off the And you will end up additional charges alarm shown an paying an estimated Credt Access Line $22,800 using this card and this statement in total df... Available Credit $22,564 each month you about... Cash Access Line $9,120 pay"' Avail ble for Cash $9,120 Only the minimum 10 months $246 payment If you would like intorm Lion about credit counseling services,call 1-866-791. TRAVELPLUS SUMMARY Previous miles balance 44,886 Th nk you for using the credit Card that rewards +2X miles earned on travel 2,989 yo miles for all your purchases' Redeem your +Mips earned on all other purchases 2771 mil s by logging onto www.chase coin or by +Boqr�us miles on Chase Rewards Plus 0 ml ng the number on the back of your card. If =Tol$I miles available for redemption 51 yo have any questions,please don't hesitate to Cal V6. Your Lase TravelPlu$credd card allows you to earn dri miled miles. You earn 1 mile or every$1 spent on purchases,and 2 miles on airline t c eta-when Purchased directly with the airline,hotel acwmmodation -when purchased directly with the holed, and Ir rental agencies. Add authorized users,and sign up to have your monthly bdds harged to your card. ACCOUNT ACTIVITY DatI of Tran ction Merchant Name or Transaction Descriptio y $Amount ty k�eiT; ,�, a `}� { AYMENIS ANU OT 4,ER„�.REDIfSy;.oiy,.q �f�5 .ux r+.'}`sjr4esn,';. 0228 Payment Thank You-Web -1,79a 48 0321 Payment Thank You-Web�,4 dry,: _ r,` 3,.711664 Pl�`kG!{ASEB tx£:"�%" ak: .�Rr+'i'1'i .K atHi 02126 DOLLAR RAC BWI HANOVER MD 303.40 0226 ANTHONY'S PIZZA 8 DENVER CO 924 0207 KRAUSE GENTLE CONIFER CO 5.65 03103 UNITED 0162605674172800-932-2732 TX 2500 0304131 E DEN BWI 031 MCDONALO'S F13573 DENVER CO 529 03103 UNITED 0162357937098800-932-2732 TX 485.90 R1S� 0304131 H , DEN BWI. 03105 TARGET 00021865 HARRISBURG PA 2.69 n p 03104 CHICK-FIL-A #01750 SHREWSBURY PA 797 rt�C 03/05 UNITED .` 0162358188585800-932-2732 TX 225.80 0310131 T MDT CLE 2 T j CLE DEN 03105 SUBWAY 00290635 HARRISBURG PA 16.43 Itement a Page 1 of 2 ACCOUNT ACTIVITY(CONTINUED) Defeat (' o Transaction Merchant Name or Transaction Oalch On E Amount }uA CA 0407 JOHNIE NEUMYER FUNERAL HO HARRISBURG PA 2,220.57 �IUW er S D108 - CREATIONS WITH YOU IN MI 717-944-5425 PA 63.25 �,D r,��BBBBE BITLJEI I IA RRfBBCRB FM CoY (C� 031110 HERTZ RENT-A-CAR BALTIMORE MD 429'13 (;arGS 03y110 UNITED 0162605997114800-932-2732 TX 25.00 0310131 E MDT CLE 2 E CLE DEN "it JIMMY JOHN'S d 1154 AURORA CO 9'32 031/13 KING SOOPERS 00087 CONIFER CO 8206. 03/115 ABC-Anytime Fitness 800b226290 CO 46.00 ` 031116 QtfIK FLIX ENTERTAINMENT,HENDERSON CO 183 {QsJi✓1 Cdr' 1)3�18 PLATEPASS HERTZ TOLLS 877.4114300 AZ - 17.55 06%19 ODOBA MEXICAN GRILL-073 DENVER CO 701 0320 SUBWAY 00220947 DENVER CO 4.32 0322 BEST BUY 00003822 LAKEWOOD CO 201.34 0323 VUDU.COM 408492-1010 CA 5.18 0324 GYPSY DINER AND CAFE BAILEY CO 2482 y013 Totals Year,"ata 7 Total fees charged In 2013 E0.00 Total interest charged In 2013 E0.00 Year-to-dale totals reflect all charges minus a iy refunds applied to your account. INTEREST CHARGES Your Annual Percentage Rate(APR)is the annual interest rate on your account. Annual Balance Balance Percentage Subject To Interest pe Rate(APR) Interest Rate Charges urchases 990%(v) 0 0- CSRggVAyCEB ....i .-1-' t. . IL_•.' ... .. . Cash Advances 19.24%lv) .0- -0- �l�LANOF,TF)ANS�R9�,.._ .__. __ - -. _ .. . . . _ L ..'' •t. .... - dalanceTransfer 9.90%(vl -0- -0- (v)I=Variable Rate 28 Days in Billing Period Please see Information About Your Account section for the Calculation of Balance 3 bled to Interest Rate,Annual Renewal Notice. Ho to Avcld Interest on Purchases,and other important Information,as appllcabla. HARRISBURG,PA 17128-0501 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD O 18918 DUPLICATE KNAUB JACK A JR 120 WISP CREEK DR BAILEY, CO 80421 ACN ASSESSMENT AMOUNT CONTROL NUMBER -°'---- Uld 101 $861 .68 ESTATE INFORMATION: SSN: FILE NUMBER: 2114-0264 DECEDENT NAME: DAILEY KAREN L DATE OF PAYMENT: 03/24/2014 POSTMARK DATE: 03/19/2014 COUNTY: CUMBERLAND DATE OF DEATH: 03/03/2013 i TOTAL AMOUNT PAID: $861 .68 REMARKS: CHECK# 864 INITIALS: DMB SEAL RECEIVED BY: LISA M. GRAYSON, ESQ. REGISTER OF WILLS TAXPAYER RECEIPT FOR PAYMENT ------------------- ------------------- LISA M. GRAYSON, ESQ. Receipt Date: 4/25/2014 Cumberland County - Register Of Wills Receipt Time: 13 :30 : 55 One Courthouse Square Receipt No. : 1077790 Carlisle, PA 17013 DAILEY KAREN L Estate File No. : 2014-00264 Paid By Remarks : JACK A KNAUB SR DB1 ------------------------ Receipt Distribution ------- - ---------------- Fee/Tax Description Payment Amount- Payee Name INH TAX RETURN 15 . 00 ' CUMBERLAND COUNTY GENERAL FUN -------------- -- Check# 831 ls . 00 Total Received. . . . . . . . . P5 . 00 w N m N Z _a co I 0 -- H " y t2g�.f0 OD N G C ;K y y t3 a* m = o� 3 a ca m ` cn a V _ N W Lood< .2013 76WIgW m N � � N � m r r F orb G _ l w J a _ Vd ''OJ 4NJ i 13flWf1J 18nOO •SNVHdUO 30 M 313 v � '�t/J�''i gw000� L Jy , ;0 m 4 n 1)1440 1!'1(144h45-0