HomeMy WebLinkAbout02-0562
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COMPLETE MAILING ADDRESS
1704 Kathryn Street
New Cumberland, PA 17070
COMMONWEAlTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 28060 1
HARRISBURG, PA 1712ll-(J601
REV -1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL.)
Mildred C. Saer
DAT5. OF DEATH (MM-DD-YEAR)
FILE NUMBER
:<IP:2 - !l S?;2
COUNTY COOE YEAR NUMB R
SOCIAL SECURITY NUMBER
176-34-8385
T1-llS AETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
03
Os
Rem~irnjerRetum(daleoldealllPri<.>rto11_13_82)
Federal Estate Tax Return Required
DATE OF BIRTH (MM-DD-YEAR)
312812002 9/6/1912
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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D 4. UmitedEstate
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NAME
8. Total Number of Saf4 D4posltBoxes
011. Election 10 tax under Sec. 9113(A) (Attach SchO)
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OFFICIAL USE ONt.. Y
2,742
807 ,228
6,778
800,450
800,450
36,020
36,020
D 2. Supplemental Return
D4a. Futur1!llnt1!llbtCompl"OTni$e(da\emaeatnal'mr12-12-82)
o 7. Decedent Maintained a living Trust (Attach copy of Trust)
010. S90usaIPo'o'ertyCredit(da~ClfdeathbetwMn 12-31-91 ancl1-1.95)
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Decedent Died Testate (Attach copy of Will)
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John M. Saer
FIRM NAME (If Applicable)
TELEPHONE NUMBER
1. Real Estate (Schedule A)
(1)
(2)
(3) NONE
(4) NONE
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Note$ Recei\lable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
(5)
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6. Jointly Owned Property (Schedule F) (6)
o Separate Billing Requested
7. Inter-VIVOS Tr.ansfer & Miscellaneous Non-Probate Property
(Schedule G or l) (7)
8. TOTAL GROSS ASSETS (total lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Oebtsof Decedent, Mortgage Uabilities, & Liens (Schedule I) 10)
11. TOTAL DEDUCTIONS (total lines 9 & 10)
12. NET VALUE OF ESTATE (Line 8 minus Line 11)
'\3. ~-fJ-~;g.."'.'lITWI<;'--"''''''''''
--(~r;j)
14. Net Value Subj8Ctto Tax (Line 12 mrnU& Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
217
Mildred C. Saer
d C
176-34-8385
Dece ents omplete Address:
STREET ADDRESS
1704 Kathrvn Street
CITY I~TATE IZIP
New Cumberland PA 17070
Tax Payments and Credits:
,.
2.
Tax Due (Page 1 Line 19)
Credits/Payments
A. SplXJsal Poverty Credit
B. Prior Payments
C. Discount
34,200
1,800
(1)
Total Credits ( A+B + C) (2)
36,020
36.000
3. Interest/Penalty' it applicable
D. Interest
E. Penalty
4.
T otallnterestlPenalty ( D -+ E )
If Line 2 is greaterttlan Une 1 + line 3. enter the difference. This istt\e OVERPAYMENT
Check box on Page 1 line 20 to request a refund
(4)
(5)
(SA)
(56)
20
(3)
5.
If Une 1 + line 3 (s greater than line 2, enter 'the difference. This is the T IV< QUE.
A Enter the ioM-est on the tax due,
e, Enter the total of Una 5 + SA This is the BALANCE DUE.
20
OF
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
No
8]
8]
8]
8]
o
8]
o 8]
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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Did d9C8dent make a transfer and:
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a. retain the lJ$G or income of the property tran-afen'ed;
b. retain the right to designate who shall use the property transferred or its income;
c. retain a reversionary interest; or
2.
d. receive the promise for life of either payments, benefits or care?
If death occurred after December 12,1 9B2,did decedent transfer property within OIle year of death
without receMng adequate consideration?
o
o
3.
Did decedent own an "in trust for" or payable upOn death banI< account or security at his or her death?
4.
Did decedent own an Individual Retirement Account, annuity or other non4probate property which
contains a beneficiary designation?
UndIM penaltie$ of perjury, 1 declare lhatl have examined Itlis retum, including accompanying schedulessnd stal'9ments, and to tt1e best afmy knowledge and belief, it is true,
andcom . Declaratianot rerattlerthanthe nalre esantativeisbasedanallinformationotwhich r rerhasen knowlod a.
SIG U E P SON RESPONSIBLE FOR FlUNG RETURN
1
DATE
1- 7 -() )
d PA 17070
PRESENTATIVE DATE
/ 3
4999 Louise Drive, Suite 101, Mechanicsbul'll. PA 17055
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Fordatas of death on or after July 1, 1994 and before January 1,1995, Ihatax rate imposed on the net value otlransfers 10 or for tt1e usa of the surviving Spouse is 3%
[72 P.S. Section 9116 {a)(1.1)(1)I.
For dates of death on or after January 1. 1995, the lax rate imposed on the net value oftral15fers to or fot the usa orthe surviving spouse is 0% [72 P.S. Section 9116 (a)(1.1)(il)J
Thtt statute does Mt exempt a tnmsfer to a $UNNir!g spouse frnm taX, and 'ItIe statutory requiram8flts for disclosure of assets and filing a taX retufl'l are still applicable eV8l"l
if
the surviving spouSlt is the only beneficiary.
FOf'datu of death on or after July 1, 2000:
ThEl tax m. imposed on thtt net value of transfers from a dEleeased child tv.'enty-one years of age or)'Qunger atdealh to or fOf' the use ofa natural parent, an adoptive parent,
01" a!oteppa/ent oftl1e child is 0%[72 P.S. Section 9116(a)(1.2)].
The tax rate imposed on the net value oftTansfers to or for the usa ()fthe decedent's Uneal beneficia\1e$ is 4.5%, e'ltceptas noted \rI n P.S. Secti0l19116(1.2) [72 P.S. Section 9116(a)(1)).
The tax rat. imposed on ItMt n&tvalue o'transfers to or for the usa of the dececlenrs siblings is 12% [72 P.S. Secllon 9116(a)(1.3)IA sibling is defined, under Section 9102, as an
indiVIdual who has at least one parttnt in common with the decedent, whether by blood or adoption.
AT
REV.15C8 EX -+- (1-97) (I)
C~N\NEAl TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Mildred C. Baer
FILE NUMBER
2102-0562
Include I:tle proceeds olllbgaticm and 1M date ttle proceed. we... receiVed t>y I:tle estlle, AlL PAOPERrf JOINTl Y-QWNED WITH THE RIGHT OF SURVIVORSHIP MUST BE DISCLOSED ON SCHEDULE
F
ITEM
NUMBER
1.
2.
3.
4.
DESCRIPTION
Commonwealth of Pennsylvania Retirement payment for March, 2002
Commonwealth of Pennsylvania Retirement payment for March, 2002
Commonwealth of Pennsylvania refund of personal income tax for 2001.
United States Treasury refund of individual income tax for 2001.
VALUE AT DATE
OF DEATH
649
556
36
1,499
TOTAL IAlso enter on line 5 Recanitulation\ $
(If more space is needed, insert additional sheets of the same size)
2742
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SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
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ESTATE OF
Mildred C. Baer
FILE NUMBER
2102-0562
This schedule must be completed and filed ifltle answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPER1Y % OF DECO'S
ITEM 1000UJOETlIE_EOFTliETRNlIlFERei.tHI;:IRRELJIoTIONSI;IPTODeCeOENTAIlll~OA.rEOFTl\ANSFER DATE OF DEATH INTEREST EXCLUSION TAXABLE VALUE
NUMBER AT'TAeHACOP"rOFn.EOEEDFOlI:REAL.E.sTAUi VALUE OF ASSET !F..p"\Jr-"',,~
1. Alliance Muni Income Fund II: PA, Class A, 19,531.25 shares@
$10.18/share. 198,828 100.00% 198,828
2. Alvanon Ltd, Common, 1,000 shares @ $2.425/share 2,425 100.00% 2,425
3. Armstrong Holdings, Inc., Common, 80 shares@$3.155/share 252 100.00% 252
4. AT&T CorporaUon, Common, 177 shares@ $15.61Ishare 2,763 100.00% 2,763
5. Bryn Mawr Bank Corp, Common, 768 shares @ $32.00/share 24,576 100.00% 24,576
6. Chevrontexaco Corp, Common, 77 shares @ $90.595/share 6,976 100.00% 6,976
7. Comsmos Resources, Inc. Common, 4 share @ $O.OO/share, 100.00%
(Company not located)
8. Dole Food Comany Inc, Common, 116 share@ $31.035Ishare 3,600 100.00% 3,600
9. E. I. du Pont de Numours and Comapny, Common, 100 shares
@ $47.99Ishare 4,799 100.00% 4,799
10. Fedex Corporation, Common, 530 shares @ $58.225/share 30,859 100.00% 30,859
11. Gannett Company, Inc., Common, 180 share @ $76.09Ishare 13,696 100.00% 13,696
12. Hershey Foods Corporation, Common,
200 shares @ $68.90/share 13,780 100.00% 13,780
13. ING GNMA Fund, Class A, 14534.884 shares @ $8.53/share 123,983 100.00% 123,983
14. Lucent Technologies Inc, Common, 152 shares@$4.585/share 697 100.00% 697
15. McGraw Hill Companies, Inc., Common,
480 shares @ $67.90/share 32,592 100.00% 32,592
16. PNC Financial Services Group, Inc., Common,
600 shares @ $61.525/share 36,915 100.00% 36,915
17. Pharmacia Corporation, Common, 172 shares@ $45.2145/share 7,777 100.00% 7,777
18. PIMCO Funds, Long Term US Government Fund, institutional
Class, 9852.217 shares@ $9.98/ share 98,128 100.00% 98,128
19. PPL Corporation, Common, 136 shares@ $39.45/share 5,365 100.00% 5,365
20. Red Hat, Inc., Common, 1000 shares@ $5.695/share 5,695 100.00% 5,695
21. Roadway Corporation, Common, 166 share @ $37.29/share 6,190 100.00% 6,190
22. Service Corporation International, Common,
300 shares @ $5.25/share 1,575 100.00% 1,575
23. Trust Company of New Jersey, Common,
240 shares @ $23.65/share 5,676 100.00% 5,676
24. Tyee International, Ltd, Common, 200 shares @ $32.675/share 6,536 100.00% 6,536
25. Venzon Communication, Common, 616 shares @ $ 46.045Ishare 28,364 100.00% 28,364
26. Wilshire Oil Company of Texas, Common,
174 shares @ $3.585Ishare 624 100.00% 624
27. LPL Money Fund, @ $1.00/share 62,440 100.00% 62,440
28. Accrued dividends on preceding items through date of death 606 100.00% 606
Above were in a joint account created on Sept. 12,2001
with John M. Baer as joint owner, account was previously
a joint account of John H. Baer and Mildred C. Baer.
John H. Baer died on July 26,2001.
29. Scudder GNMA-AARP Fund, 5261.821 shares @ $14.97/share 78,769 100.00% 78,769
Above item were in a joint account with John M. Saer that was
created about July, 2001, after the death of John H. Baer.
TOTAL (Also enteron line 7 Recapitulation\ $ 804 486
(If more space is needed, insert additional sheets of the same size)
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ESTATE OF
Mildred C. Baer
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
2102-0562
Debts of decedent must be reoorted on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A FUNERAL EXPENSES:
1. Cremalion Society 240
2. Expressly Yours (Bereavement luncheon) 400
3. Church honorariums 300
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (5)
Social Security Number(s.) ( EIN Number of Personal Representabve(s)
Street Address
City Slate Zip
Year(s) Commission Paid:
2. Attomey Fees
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State lip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees 1,000
6. Tax Return Preparer's Fees 530
7.
TOTAL {Aiso enler on line 9, Recaoilulalion $ 2470
(If more space is needed, insert addiliona' sheets of the same size)
AT
REV.1~12 EX + (1-97) <I>
COMMON\NEAl TH OF P~NNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DEC(:DENT
ESTATE OF
Mildred C. Baer
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
2102-0562
Include unreimbursed medical exnenses.
ITEM
NUMBER
1.
2.
3.
DESCRIPTION
Year of death tax liability-Federal income tax liability for 2002.
Year of death tax liability-Pennsylvania income tax liability for 2002.
Outlook Point-Room and board for March 2002.
AMOUNT
1,500
300
2,508
TOTAL IAlso enter on line 10 Recaoituiation $
(If more space is needed, insert additional sheets of the same size)
4308
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ESTATE OF
Mildred C Saer
SCHEDULE J
BENEFICIARIES
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSONIS\ RECEIVING PROPERTY Do Not List Trustee/s' OF ESTATE
I. TAXABLE DISTRIBUTIONS finclude outright spousal distributions, and
Iransfers under Sec. 9116 (a) (1.2)]
1. John M. Saer
1704 Kathryn Street
New Cumberland, PA 17070 Son 100.00%
ENTER DOllAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV.1500 COVER SHEET
II. NON.TAXA8lE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBunONS
1.
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
FILE NUMBER
2102-0562
(If more space is needed, insert additional sheets of the same size)
CCMI~10~)WEALTH OF PENNSYLVANIA
DEPARTr,1[:NT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT,230601
HARRISBURG, PA 171 2S,0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYL VANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
DUANE E HERMAN ESQUIRE
4999 LOUISE DRIVE
SUITE 101
MECHANICSBURG, PA 17055
-------- fold
EST A TE INFORMATION: SSN: 176-34-8385
FILE NUMBER: 2102-0562
DECEDENT NAME: BAER MILDRED C
DATE OF PAYMENT: 06/13/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 03/28/2002
NO. CD 001293
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $34,200.00
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TOTAL AMOUNT PAID:
REMARKS: JOHN M BAER
C/O DUANE HERMAN ESQUIRE
CHECK#1002
SEAL
INITIALS: VZ
RECEIVED BY:
T AXPA YER
$34,200.00
MARY C. LEWIS
REGISTER OF WILLS
/~-69-~~
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
JOHN M BAER
1704 KATHRYN ST
NEW CUMBERLAND PA 17070
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
REY-1547 EX ~FP (O1-AS)
DATE 03-10-2003
ESTATE OF BAER MILDRED C
DATE OF DEATH 03-28-2002
FILE NUMBER 21 02-0562
COUNTY.' CUMBERLAND
ACN 101
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HDUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS -~
----------------------------------------------------------------------------------------------------------------
REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BAER MILDRED C FILE N0. 21 02-0562 ACN 101 DATE 03-10-2003
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 Bl
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
[1) .00
(2) .00
t3) .00
(4) . 00
(5) 2,742.00
(6) .00
(7) 804,486.00
[8)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this fore with your
tax payment.
807,228.00
APPROVED DEDUCTIONS AND EXEMPTIONS: 2,,470.00
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9)
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 4,308.00
11. Total Deductions (11) 6 .778 _ 00
12. Net Value of Tax Return (12) 800,450.00
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (131 .00
t to Tax
bj
t
t
S
f E
t (14) 800,450.00
14. u
ec
a
e
Value o
s
Ne
NOTE: If an assessment was issued previously, lines 14, 15 andior 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
00
00
.00
15. Amount of Line 14 at Spousal rate (15) •
=
X
16. Amount of Line 14 taxable at Lineal/Class A rate (16) 800,450.00 X 045. 36,020.00
17. Amount of Line 14 at Sibling rate (17) • 00 X 12 . 00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) •00 X 15 .00
19 al Tax Due
Princi (19)= 36,020.00
. p
DATE
NUMBER +
INTEREST/PEN PAID (-) AMOUNT PAID
06-13-2002 CD001293 1,800.00 34,200.00
INTEREST IS CHARGED THROUGH 03-25-2003
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX CREDIT 36,000.00
BALANCE OF TAX DUE 20.00
INTEREST AND PEN. .24
TOTAL DUE 20.24
* IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED.
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
BUREAU OF INDIVIDUAL TAXES
I-~HERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
JOHN M BAER
1704 KATHRYN ST
NEW CUMBERLAND
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
REY-1547 EX RFP [R1-33)
DATE 03-10-2003
ESTATE OF BAER MILDRED C
DATE OF DEATH 03-28-2002
FILE NUMBER 21 02-0562
'~ COUNTY CUMBERLAND
J: ,, ..
ACN 101
Amount Remitted
PA 1.70.70 ,
a1.
,,:,
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~
----------------------------------------------------------------------------------------------------------------
REV-154? EX AFP (01-03] NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BAER MILDRED C FILE N0. 21 02-0562 ACN 101 DATE 03-10-2003
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) (1) .00 NOTE: To insure proper
2. Stocks and Bonds (Schedule B) (2) .00 credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion
4. Mortgages/Notes Receivable (Schedule D) (4) .00 of this fora with your
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 2,742.00 tax payment.
6. Jointly Owned Property (Schedule F) (b) .00
7. Transfers (Schedule G) (7) 804,486.00
8. Total Assets [g) 807,228.00
APPROVED DEDUCTIONS AND EXEMPTIONS: 2,470.00
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9)
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 4.308.00
(11) 6 .778. DO
11. Total Deductions 800,450.00
12. Net Value of Tax Return (12) 00
13 Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) [13) .
. T
t t (14) 800,450.00
14. o
ax
Net Value of Estate Subjec
NOTE: If an assess~(ent Figs issued Prev"ic~(s1y, lines 14, 35 an(~ior lb, 17, 18 and 14 i~(i3i
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
00
00
.00
15. Awount of Line 14 at Spousal rate (15) •
X
=
16. Amount of Line 14 taxable at Lineal/Class A rate (16) 800,450.00 X 045. 36,020.00
17. Amount of Line 14 at Sibling rate (17) .00 X 12 .00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) •00 X 15 .00
l T
D (19)= 36, 020.00
19. ue
ax
Principa
1 A A V - Y i, V
DATE
NUMBER
INTEREST/PEN PAID (-)
AMOUNT PAID
06-13-2002 CD001293 1,800.00 34,200.00
INTEREST IS CHARGED THROUGH 03-25-2003
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX CREDIT 36,000.00
BALANCE OF TAX DUE 20.00
INTEREST AND PEN. .24
TOTAL DUE 20.24
* IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN Sl, NO PAYMENT IS REQUIRED.
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" [CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 002294
BAER JOHN M
1704 KATHRYN STREET
NEW CUMBERLAND, PA 17070
fold
ESTATE INFORMATION: ssrv: ~ ~s-34-8385
FILE NUMBER: 2102-0562
DECEDENT NAME: BAER MILDRED C
DATE OF PAYMENT: 03/17/2003
POSTMARK DATE: 03/15/2003
COUNTY: CUMBERLAND
DATE OF DEATH: 03/28/2002
REMARKS: JOHN M BEAR
CHECK#5286
SEAL
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
101 ~ 520.24
TOTAL AMOUNT PAID:
INITIALS: CW
RECEIVED BY: DONNA M. OTTO
REV-1162 EX111-96)
520.24
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
~~-6p- ~~
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
JOHN M BAER
1704 KATHRYN ST
NEW CUMBERLAND
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
REtl-1607 E% 1FP (O1-OS)
~}C~~-;. ~_ D~ITE 04-14-2003
~~ ~ ~ , ' ~ <<18STATE OF BAER MI LDRED C
DATE OF DEATH 03-28-2002
FILE NUMBER 21 02-0562
O3 aPR 2$ P ~O~TY CUMBERLAND
ACN 101
PA 17070 t Amount Remitted
~.rs~~Ca 4. ~~...`~ s
Gt~mb~~..`. t~ ~., r A
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this fore with your tax payment.
CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS -~
----------------------------------------------------------------------------------------------------------------
REV-1607 EX AFP (01-03) **~ INHERITANCE TAX STATEMENT OF ACCOUNT ~*~(
ESTATE OF BAER
MILDRED C FILE N0. 21 02-0562 ACN 101 DATE 04-14-2003
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: 03-10-2003
PRINCIPAL TAX DUE:
PAYMENTS (TAX CREDITS):
36,020.00
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT (+)
INTEREST/PEN PAID (-) AMOUNT PAID
06-13-2002 CD001293 1,800.00 34,200.00
03-15-2003 CD002294 .21- 20.24
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
^ IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN S1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
36,020.03
.03CR
.00
.03CR