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. 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 +~
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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