Loading...
HomeMy WebLinkAbout02-0600 .:'JovJ ~ G K . OFFICIAL USE ONLY REV~ 1500 EX + (6-00) REV-1500 17- 72-J[) INHERITANCE TAX RETURN FILE NUMBER CaOD COMMONWEALTH OF PENNSYLVANIA 21-02- OEPAATMENTOF REVENUE RESIDENT DECEDENT DEPT. 280601 COUNTY CODE YEAR NUMBER HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDL.E INITIAL) SOCIAL SECURITYNUMBEA 0 Gluntz Victoria 204-03-2824 E C DATE OF DEATH (MM-DD-YEAA) DATE OF BIRTH (MM-DD~YEAR) THIS RETURN MUST BE FIlED IN OUPlICATEWlTH THE E 0 03/29/2002 02/21/1920 REGISTER OF WILLS E (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST. AND MIDDLE I NlTIAW SQClAL SECURITY NUMBER N T ~ 1. Original Return 2. S"pp',m,n'.' R,'"" tJ 3 . ;1date of death - . Remamder Retl,lrn prior to 12-13-82) APB X 4. Limited Estate - 40. Future Interest Compromise (date of death after 12-12-82) 5. Federal Estate Tax Return Required HpRL 6. Decedent Died Testate 7. Decedent Maintained a Living Trust ~ 8. Total Number of Safe Deposit Boxes EplO ...:.: - CRAC (Attach copy of Will) (Attach copy of Trust) OTK o 9. litigation Proceeds Received 010. 0 11. Election to tax I,mder Sec. 9113(A) ES Spousal Poverty CredIt {da.te c1 death between rZ-3i-S1 and i~1-95) (Attach Sch 0) -ll!IS_Se:C'l'IOI'l1.I\fUS'I' ElE..COMPLliTlill. -ALLCOIlRliSPONOENCE-&COI'l1FIPENTI.AL.'I'AX -ll'IlFoIlMATION-SHOULDBEDIRe:C'I'Ell" '1'0,... P NA.ME COMPLETE MAlUNG ADDRESS C 0 0 Roger B. Irwin Esq. 60 West Pomfret Street R N FlAM NAME (If Applicable) R 0 West Pomfret Professional Bldg. E E IRWIN McKN1GHT & HUGHES Carlisle, PA 17013 S N T TELEPHONE NUMBER 717/249-23S3 1. Real Estate (Schedule A) (1) None OFFICIAL USE ONLY 2. Stocks and Bonds (Schedule e) (l) None 3. Closely Held Corporation, Partnership or (3) None c' _. Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule 0) (4) None R 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) None I E C (Schedule E) ~',.J A 6. Jointly Owned Property (Schedule F) (6) 19,947.48 P D ~ I Separate Billing Requested T 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) None U L (Schedule G or L) .. A T 8. Total Gross Assets (total Lines 1-7) (8) 19,947.48 I 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 1,165.85 0 N 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule il (10) 73 9.92 11. Total Deductions (total Lines 9 & 10) (11) 1.905.77 12. Net Value of Estate (Line 8 minus Line 11) (12) 18,041. 71 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been (13) made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 18,041. 71 C SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 0 M P 15. Amount of Une 14 taxable at the spousal tax T U A T rate, or transfers under Sec. 9116(a)(1.2) X .0 0 (15) 0.00 X A 16. Amount of Line 14 taxable at lineal rate 18,041. 71 45 (16) 811. 88 T X .0 I 17. Amoun1 of Line 14 taxable at sibling rate X .12 (17) 0.00 0 N 18. Amount of Line 14 taxable at collateral rate X .15 (18) 0.00 19. Tax Due (19) 811. 88 20. .n l;.cl-lli\\'-K~!lEill'::"'PPAllliIlE!ilVli$'I'!Nl!i4!lliF\JN~Pi"~P'l'E!lP4Y"'E"''I':H1 C ) > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SlOE AND TO RECHECK MATH < < ' Copyright (c) 2000 form software only The Lackner Group, Inc. Form R EV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 56 Sharon Road CITY I STATE I ZIP Enola PA 17025 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 811.88 40.59 Total Credits ( A + B + C ) (Z) 3. Interest/Penalty if applicable D. Interest E. Penalty 40.59 TotallnteresVPenalty ( D + E) (3) 4. Jf Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line ZQ 10 requesl a retund (4) 5. If Line 1 + line 3 is greater than line 2, enter the difference. This is the TAX DUE. (S) A. Enter the interest on the tax due. (SA) B. Enter the total of Line S + SA. This is the BALANCE DUE. (5B) Make .?~eck Payable 10: REGISTER OF WILLS, AGENT 'Pi..EASEANSWER"THEF6LL6wINGQUESTIC)NSBYPLACIN~;'~N' "x,,\~i;rf~i~!rr~~~~~~~I~fr~ri;~t8g~~ 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ~ m:x b. retain the right to designate who shall use the property transferred or its income; . c. retain a reversionary interest or . d. receive the promise for life of either payments, benefits or 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 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? IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 0.00 0.00 771. 2 9 0.00 771. 2 9 o o o []J []J []J Under penalties of perjury, I declare that t have examined this return, including accompanying schedules and statements, and to the best of my Kl'\Owledge 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 Linda Rudis i 11 ""-..- 56 Sharon Road ~,~ d.<i'- -<-<.-a-<?c. e..e- ---Enol-a:;-PA--rio2s-uh-----m-m-u-------m- SIQ ATUREOFPREPARERO HER THAN REPRESENTATIVE IRWIN McKNIGHT & HUGHES 60 West Pomfret Street - - c';'~l-isi~-; -PA-- i"i6i3- -- ------ --- - ----- - ---- -- -- DATE .' 6 -.3 t9 -"'d2- DATE I!t/O}.. For dates of dea 0 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. % !72 P.S. 9116 (a) (1.1) (i)]. . For dares of death on or 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 exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are stjJJ 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 trom 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)]. The 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( 1.2) [72 P.S. 91 16(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(aX1.3)]. 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. Copyright (c) 2000 form s.oftware only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) flEV-1509 Ex + (1-97) COMMONWEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Victoria Gluntz SCHEDULE F JOINTLY-OWNED PROPERTY SSII 204- 03 -2824 03/29/2002 FILE NUMBER 21-02- If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. A. SURVIVING JOINT TENANT(S) NAME Linda J. Rudisill ADDRESS 56 Sharon Road Enola, PA 17025 RELATIONSHIP TO DECEDENT Daughter B. c. JOINTLY -OWr,ED PROPERTY LETTER DATE DESCRIPTION OF PROPERTY %QF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank DATE OF DEATH DECD'S VALUE OF account number or similar identifying number. NUMBER TENANT JOINT Attach deed for jointly-held real estate. VALUE OF ASSET INTEREST OECEDENT'S INTERES 1 A 08/28/64 lA11first Bank, checking 11,436.07 50.00% 5,718.04 2 A 02/08/01 A1lfirst Bank, savings 12,720.67 50.00% 6,360.34 3 A 12/28/83 A11first Bank, checking 15,738.19 50.00% 7,869.10 account TOTAL (Also enter on line 6, Recapitulation) $ 19,947.48 T (If more space is needed insert additional sheets of the same size) CopyrIght (e) 1996 form software only CPSystems, Inc. Form REV-1509 EX (Rev. 1-97) ~EV-1511 EX +(1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Victoria Gluntz SS# 204-03-2824 03/29/2002 FILE NUMBER 21-02- Debts of decedent must be reported on Schedule 1- ITEM NUMBER A. DESCRIPTION AMOUNT 1 FUNERAL EXPENSES, Flowers 235.00 2 Geo's Restaurant 665.85 B. ADMINISTRATIVE COSTS, 1. Personal Representative's Commissions Name of Personal Representative(s) Social Securi~ Number(s) I EIN Number of Personal Representative(s) Street Address City State ZIp Yeans) Commission Paid: 2. 3. Attorney's Fees IRWIN McKNIGHT & HUGHES Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address 250.00 State lip City Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Other Administrative Costs Register of Wills - filing fee 15.00 TOTAL (Also enter on line 9, Recapitulation) $ 1,165.85 tlf more space is needed, insert additional sheets of the same size) Copyright (c) 1996formsoftware only CPsystems, Inc. ForM REV-1511 EX (Rev. 1-97) ~EV.1512 EX + (1-97) COMMONWEAL1'H OF PEMNSYLVA.NIA INHER1TA.NCE TAX RETURN RESIDENT DECEDENT ESTATE OF Victoria Gluntz SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS SSII 204-03-2824 03/29/2002 FILE NUMBER 21-02- Include unreimbursed medical expenses. ITEM NUMBER 1 Cardiology Assoc. DESCRIPTION AMOUNT 31.75 2 Dr. Dailey 4.00 3 Dr. Zanetti 9.86 4 Express Prescriptions 16.12 5 Holy Spirit Hospital 19.08 6 Sarah A. Todd Memorial Home 639.00 7 Spring Road Family Practice 5.22 8 West Shore EMS 14.89 TOTAL (Also enter on line 10, Recapitulation) $ 739.92 (If more space is needed, insert additional sheets of the same size) Copy tight (c) 1996 form software only CPSysterns. Inc. Form REV-1512 EX (Rev. 1-97) COMMONWEALTH OF PENNSVLVANIA DEPARTHENJ OF REVENUE ~~EAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG~ PA 17128-0601 *' INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. 21 02123470 05-16-2002 REY-l!i4SEKU'<D9-GOl TYPE OF ACCOUNT o SAVINGS !Xl CHECKING o TRUST o CERTIF. TO: EST. OF VICTORIA GLUNTZ 5.5. NO. 204-03-2824 DATE OF DEATH 03-29-2002 COUNTY CUMBERLAND LINDA J RUDISILL US BIB RBEI( DR DOVeR j1 t9 PA 17315 2131 S-4:> ~ ~e/. t~ ~ /7C~.s- .7 . REHIT PAYMENT ANO FORMS REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 ALLFIRST BANK has provided the Department with the inforlllation listed below which has been used in calculating the potential tax due. Their racords indicate that at the death of the above decedent~ YOU were a joint owner/beneficiary of this account. If you feel this infor_ation is incorrect~ please obtain written correction fro~ the financial institution~ attach a copy to this for. and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions .ay be answered by calling (717) 787-8327. COMPLETE PART 1 BELOW Account No. 0037579568 II! II! II! SEE REVERSE SIDE FOR Oat. 08-28-1964 Established FILING AND PAYMENT INSTRUCTIONS Account Balance 11 ~ 436.07 P.rcent Taxable X 50 . 000 Altount Subject to Tax 5 ~ 718 . 04 Tax Rate X .15 Potential Tax Due 857.71 PART TAXPAYER RESPONSE [!].I~~li!liiiim:ii!il."'lii!il~~~!i!i!_'!l!!il~~i~j.!!!i.~~~lili!ii1!t.i!~_.i!i!.~l!ii!l!.!ii!~I~I!ili.~~i!i!!1 To insure proper credit to your eccount~ two (2) copies of this notice must acco.pany your payment to the Register of Wills. Make check payable to: "Register of Wills~ Agent". NOTE: If tax pay.ants ara .ade within thrBe (3) months of the dacedent's data of death~ you may deduct a 52 discount of the tax due. Any inned tance tax due will becollle delinquent nine (9) 1I0nths after the date of death. [CHECK ] ONE BLOCK ONLY A. 0 The above information and tax due is correct. 1. You May choose to remit pay.ant to the Register of Wills with two copies of this notice to obtain a discount or avoid interest~ or yoU may check box nA" and return this notice to the Register of Wills and an official assessment will be issued by the PA Department of Revenue. B. c=J The above asset has been or wilt be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. C. 0 The above infor.ation is incorrect and/or debts and deductions wer-a paid by you. You must complete PART 0 and/or PART @] below. If you indicate a different tax rate~ please state your relationship to decedent: PART [!] DATE PAID DEBTS AND DEDUCTIONS CLAIMED PART ~ TAX RETURN - COMPUTATION LINE 1. Date Established 2. Account Balance 3. Percent Taxable ~. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due OF 1 2 3 4 5 6 7 e x TAX ON JOINT/TRUST ACCOUNTS x PAYEE DESCRIPTION AMOUNT PAID I TOTAL (Enter on Line 5 of Tax Computation) I $ Under penalties of perjury~ I declare that the facts I have reported above are true~ correct and complete to the best of my knowledge and belief. HOME ( WORK ( TELEPHONE ) ) NUMBER DATE TAXPAYER SIGNATURE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF. INDIVIDUAL TAXES DEPr. 280601 HARRISBURG, PA 17128-0601 * INFORMATION NOTICE AND TAXPAYER RESPONSE FILE NO. 21 ACN 02123468 DATE 05-16-2002 REV-15~S EX AFP 109-00) TYPE OF ACCOUNT [X] SAVINGS o CHECKING o TRUST o CERTIF. TO: EST. OF VICTORIA GLUNTZ 5.5. NO. 204-03-2824 DATE OF DEATH 03-29-2002 COUNTY CUMBERLAND LINDA J RUDISILL 125 BI" "n~1C nR ;!~[R~A;J;.15 ,:ff~ 4. /7CJolS 2131 REHIT PAYHENT ANO FORHS REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 ALLFIRST BANK has providsd ths Deparbsnt with the inforllation listed below which has been used in calculating the potsntial tax due. Their rscords indicats that at ths death of the above decedsnt, you wsrs a joint ownsr/beneficiary of this account. If YOU feel this information is incorrect, plsass obtain written corrsction froll the financial institution, attach a copy to this for. and return it to the above address. This account is taxable in accordance loIith the Inheritancs Tax Laws of ths Commonwealth of Pennsylvania. Questions .a> bs answered by calling (717) 787-8327. COMPLETE PART 1 BELOW Account No. 2220210 . . . SEE REVERSE SIDE FOR Oat. 02-08-2002 Established FILING AND PAYMENT INSTRUCTIONS Account Balance Percent Taxable Amount Subject to Tax Tax Raie Potential Tax Due 12,720.67 X 50.000 6,360.34 X .15 954.05 To insure proper credit to your account, two (2) copies of this notice must accompany your pay.ant to the Register of Wills. Make check payable to: "Register of Wills, Agent". NOTE: If tax paYllents are .ade within three (3) .onths of the decedent.s date of death, you IIBY deduct a 57. discount of ths tax dUe. Any inheritance tax due will becoms delinquent nine (9) months after the date of death. PART TAXPAYER RESPONSE [!) Im!~I1}i~~.~.I[!.m~.~~~~.. ,~ml~.'~.'liimj!..i~.~~.,~.~,jjj!~I![~1ii.ii.!li~. ;~~.'~....mi!ffi1l!'1I.~i.!!.jl.:$!!III". "'.:..;:.!j!!.~!j.!!*!I. m:~.~. ~$ijm~. ,:....;i~g.j!.:! ...,.,.._._........'m' ..,.....~....'.-.-.'. ......... ....,..."....,...._._..... ..._.....'m'.'..............,,','.. .'~. ...-....,.. ..,.....,.,.,....,.. ,'. ,'...............,.,.,.,.",.,.....'" . ........... ,.,_,.,",", ,'. . ..................,.,., "",'. . . . . ........,...,..,,'._. ........,...,.,"' "'. . ._. ....,.,.,.,.,.,.,'..,'_. on "..,.,.,., ,.,.,'~.'. ".', ........,.....,.,.,.~, .,. . ...............'..._. . ._ _.. . no ........... ,., ", ...... ......... ..... ......... ..................... ."..... ._.... ............... no"'. ........ no ....,.,.. ........... ...................,....... ............,.,.,.... ......~.. ................... .". on ............. ."... on ................. n. ................... ........,.. ....... no .............. ........... A. D The above infor.ation and tax due is correct. 1. You IIBY choose to relllit payment to the Register of Wills with two copi8s of this notice to obtain B discount or avoid interest, or you .ay check box "A" and return this notice to the Register of Wills and an official assesSMant will be issued by the PA Depart.snt of Ravsnue. [CHECK ] ONE BLOCK ONLY B. c=J The above asset has basn or will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filsd by the decedent.s representative. C. 0 Ths above infor.ation is incorrect and/or debts and deductions loIer'e paid by you. You must cOIlpIete PART 0 and/or PART @] bslow. If you indicate a differeni tax rate, please state your relaiionship io decedeni: PART I!J DATE PAID DEBTS AND DEDUCTIONS CLAIMED PART ~ TAX RETURN - COMPUTATION LINE 1. Dai. Established 2. Account B.lance 3. Percent Taxabl. 4. Amount Subject to Tax 5. Debis and Deductions o. Amount Taxable 7. Tax Rate 8. Tax Due OF 1 2 3 4 5 6 7 8 X TAX ON JOINT/TRUST ACCOUNTS X PAYEE DESCRIPTION AMOUNT PAID I $ I TOTAL (Enter on Line 5 of Tax ComputaiionJ Under penalties of perjury, I declare ihai the facts I have reporied above are tru., correct and complete to the besi of my knowledge and belief. HOME ( WORK ( TELEPHONE ) ) NUMBER DATE TAXPAYER SIGNATURE COMMONWEALTH OF PENNSYLVANIA DEPARTMENT". OF REVENUE B4REAUDF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 171l8-060l *' XNFORMATXON NOTXCE AND TAXPAYER RESPONSE FILE NO. 21 ACN 02123469 DATE 05-16-2002 REY~l~U EX AF' 109~OOI EST. OF VICTORIA SLUNTZ 5.S. NO. 204-03-2824 DATE OF DEATH 03-29-2002 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS IX] CHECKING o TRUST o CERTIF. LINDA J RUDISILL H~5 BIB ReCI( DR D&Yffl: , PA 17315 2131 5~ 2/~<- /11. t~/ !?t. I7IJ~S REHIT PAYHENT AND FORHS TO, REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 ALLFIRST BANK has provided the Department with tha inforlllation listed balow which has baan usad in calculating the potential tax due. Thair records indicata that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feal tt\is infnr.lItion is incorrect, plaasB obtain written correction fro. the financial institution, attach a copy to this for~ and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Co..onwealth of PannsYlvania. Questions ~ay be answared by calling (7171 787~83l7. COMPLETE PART 1 BELOW Account No. 0094227853 . . . SEE REVERSE SIDE FOR Oat. 12-28-1983 Established FILING AND PAYMENT INSTRUCTIONS Account Balance Percent Taxable Amount Subject to Tax Tax Rate Potential Tax Due 15,738.19 X 50.000 7,869.10 X .15 1,180.37 To insure proper credit to your account, two (ll copies of this notice Must accoGpany your psy\lQf\t to the Registar of 'IIills. Make check payable to: ~Register of Wills, Agent~. NOTE: If tax payments are .ade within three (3) months of the decedant's date of death, you ~ay deduct a SZ discount of the tax dUB. Any inheritance taK due will become delinquent nine (9) qonths after the date of death. PA~ TAXPAYER RESPONSE [TIE~~li~."~,!!!~';i~._I~~~.~'lm~lmm..1:~~I~t:f~jli!~--~..1!IBlmg"~.lI [CHECK ] ONE BLOCK ONLY A. 0 The above infor.ation and tax dUB is corract. 1. Vou may choose to remit payment to the Register af Wills with two copies of this notice to obtain a discount or avoid interest, or you may check bOK ~A~ and return this notica to the Register of Wills and an official assesSlRent will be issued by thlil PA Department of Revanue. B. D The above asset has been or will' be reported and tSK paid with the Pennsylvania Inheritance Tax return to be filed by the deced'iKlt's representative. C. 0 Tha above inforlllation is incorrect and/or debts and deductions were paid by you. You MUst complete PART ~ and/or PART ~ below. OF 1 2 3 4 5 6 7 8 X If you indicate a different tax rate, please state your relationship to decedent: PART [3.] TAX RETURN - COMPUTATION LINE 1. Oat. 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 TAX ON JOINT/TRUST ACCOUNTS X PART ~ DATE PAID DEBTS AND DEDUCTIONS CLAIMED PAYEE DESCRIPTION AMOUNT PAID I TOTAL (Enter on Line 5 of Tax COMPutation) I $ Under penalties of perjury, I declar. that the facts I have reported above are true, correct and cOMPlet. to the best of my knowledge and belief. HOME ( WORK ( TELEPHONE ) ) NUMBER DATE TAXPAYER SIGNATURE /~ ~`~ -/~~ COMMONWEALTH OF PENNSYLVANIA BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-D6o1 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX RFP (O1-R2) DATE 08-19-2002 ESTATE OF GLUNTZ VICTORIA DATE OF DEATH 03-29-2002 FILE NUMBER 21 02-0600 COUNTY CUMBERLAND ROGER B IRWIN ESQ -- -• ACN 101 IRWIN ETAL Amount Remitted 60 W POMFRET ST - CARLISLE PA 17013 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-1547 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF GLUNTZ VICTORIA FILE N0. 21 02-0600 ACN 101 DATE 08-19-2002 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) .0 0 submit the upper portion 4. Mortgages/Notes Receivable (Schedule D) (4) .00 of this fore with your 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) .00 tax payment. 6. Jointly Owned Property (Schedule F) (6) 19,947.48 7. Transfers (Schedule G) (7) .00 8. Total Assets (g1 19,947.48 APPROVED DEDUCTIONS AND EXEMPTIONS: 1,165.85 9. Funeral Expenses/Adn. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 7 39.92 11. Total Deductions (11) 1.905.77 12 . Net Value of Tax Return (121 18 , 0 41.71 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00 14. Net Value of Estate Subject to Tax (141 18, 041 ' 71 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: 0 0 0 0 0 0 15. Amount of Line 14 at Spousal rate (15) . = X . 16. Amount ofi Line 14 taxable at Lineal/Class A rate (16) 18, 041 • 71 X 045 . 811 .88 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. Principal Tax Due (191= 811.88 v•`~ DATE NUMBER + INTEREST/PEN PAID (-) AMOUNT PAID 06-28-2002 CD001353 40.59 771.29 TOTAL TAX CREDIT 811.88 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * 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 O 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 RECEIVED FROM: IRWIN ROGER B ESQ 60 W POMFRET ST CARLISLE, PA 17013 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ACN ASSESSMENT CONTROL NUMBER fold ESTATE INFORMATION: ssrv: 204-oa-2824 FILE NUMBER: 2102-0600 DECEDENT NAME: GLUNTZ VICTORIA DATE OF PAYMENT: 06/28/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 03/29/2002 AMOUNT 101 ~ $771.29 TOTAL AMOUNT PAID: REMARKS: ROGER B IRWIN ESQUIRE SEAL CHECK# 2550 INITIALS: VZ RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REV-1162 EX111-96) NO. CD 001353 5771.29 REGISTER OF WILLS