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HomeMy WebLinkAbout09-14-14 REV-1500 EX(02-11) -1 1505610143 OFFICIAL USE ONLY PA Department of Revenue Pennsylvania Cotrmy code Yee, File Hamper Bureau of Individual Taxes pd"^`"Ee"e' PO 60x-280601 INHERITANCE TAX RETURN 21 14 0632 Harrisburg,PA 17128-0661 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW _ Social Security Number Date of Death Date of Birth 06 04 2014 07 04 1933 Decedent's Last Name Suffix Decedent's First Name MI ZIES MARJORIE E (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 a 1. Original Return ❑ 2. Supplemental Return ❑ a' prior index R Return(Date of Death ❑ 4; Umited Estate ❑ 4a.Future Interest cm ❑ S. Federal Estate Tax Return Required em (date of de after 2.12.64) ❑ 6. ApetaGe�01 Will) ❑ 7, dmo�gtsl��ia twine Ta,st 0 S. Total Number of Safe Deposit Boxes El B. Litigation Proceeds Received ❑ f0.str °senPi3l arolt{���e5lr Death ❑ 1i.Eleption to tax under Sec.9119(-0) {Attach Schedule 0} CORRESPONDENT.THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number JENNIFER 8 HIPP 717 7,47 876 REGISTEWO HILLS tiA ON(R First Line of Address yr, Z r~ ..0 m Cn 1 WEST MAIN STREET Second Line of Address ® C T Co ...c City or Post Office State ZIP Code GATE FILED Cr SHIREMANSTOWN PA 17011 Correspondent's e-mail address: ihippliftogarlaw com Under penatUes o ' ry.I declare that i have examined this return,including acccmiml ing schedules and statements,and to the best of my knowledge and belief, it is true,oo nd mplete.Declaration of preparer other than the personal representtaative is based on all Information of which preparer has any knowledge. SIGNAT OFF N RESPONSIa E FO FILING RETURN DA 11 4 Russell G.Zies Gi 3 f no REs 12 Wertzviil Road Enota PA 17025 810 P ER OTHER THAN REPRESENTATIVE DATE , Jennifer B.Hipp 01 RESa 1 We t Main Street,Shiremanstown, PA 17011 Side 1 1505610143 1505610143 ,eJ . 1505610243 REV-1500 EX Decedent's Social Security Number oeceaems name: ZieS, Marjorie E. RECAPITULATION 1. Real Estate(Schedule,A).... ..................... ............. ........................... ........... 1. 133, 181 . 00 2. Stocks and Bonds(Schedule B)..._ ........:................ ...................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C)......... 1 4, Mortgages&Notes Receivable(Schedule D)................. ...............__........... 4. 5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)............... S. 2 , 200 . 00 61 Jointly Owned Property(Schedule I F) [-] Separate Billing Requested............ 6. 8 ,214 . 65 7. Inter-Vivos Transfers&Miscellaneous Nan-Probate Property (Schedule G) LJ Separate Billing Requested............ 7. 8. Total Gross Assets(total Lines 1 through 7)._......_..,........._.........._............... 8, 143, 595. 65 9. Funeral Expenses and Administrative Costs(Schedule H)..........._...._....._....._... 9. 9, 960 . 09 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule t)......._................... 10, It- Total Deductions.(total Lines 9 and 10)..... .............. ...... 9, 960 . 09 12. Net Value of Estate(Line 8 minus Line 11)--- ............ ......-... 12- 133, 635.56 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made(Schedule J)_......_.._.......-................ 14. Net Value Subject to Tax Line 12 minus Line 13)._............................I.-.11--­--- 14. 1331635 .56 TAX COMPUTATION,SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 15. 0 . 00 (a)(1-2)X 00 16, Amount of Line 14 taxable at lineal rate X 045 133, 635. 56 16. 6, 013 . 60 17. Amount of Line 14 taxable 0 0 0 17. 0 . 00 at sibling rate X-12 18. Amount of Line 14 taxable at collateral rate X.15 0 . 00 18- 0 . 00 19. TAX DUE...................1-....... ...... ...... ....... 19, 6,013 . 60, 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND 00 AN OVERPAYMENT. Side 2 1505610243 1505610243 REV•150D EX Page 3 File Number 21-14-0632 Decedent's Complete Address: DECEDENT'S NAME Zies, Marjorie E. STREET ADDRESS 309 Wertzville Road CITY - STATE ZIP Enola PA 17025 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1} _ 6,013.60 2. Credits/Payments - A. Prior Payments B. Discount 300.66 Total Credits(A +B) (2) 300.68 3. Interest (3) 4. If Line 2 is greater than Line I +Line 3,enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2,Line 20 to request a refund 5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (5) 5,71 2.92 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:........................................................... x b. retain the right to designate who shall use the property transferred or its income:.................................. c. retain a reversionary interest:or.......................................................................................... ..................... x d. receive the promise for life of either payments,benefits or care7._........................ ............. 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?....... ❑ ❑x 4. Did decedent own an individual retirement account,annuity,or other non-probate property which contains a beneficiary designation?.................................................................................................................. ❑ n 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 January 1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(4% 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 pare nt,or a stepparent of the child Is 0 percent(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 percent,except as noted in(72 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)1. A sibling is defined, under Section 8102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption. Rev-1602 EX*(01-10) SCHEDULE A ' pennsylvania REAL ESTATE DEPARTMENT OF REVENUE - INHERITANCE TAX RETURN RESIDENT DECEDENT " ESTATE OF FILE NUMBER Zies Marjorie E. 21-14-063 All reel property ormed sOiety w es a tenant in conOnon meet ha mpomm at fair market value.Fair mencet vahre is darned as the price at which or=would be extdwnged belwreen awlllilg buyer and a willil seller,nailhef being compolled to buy or sell,both earring remoreAia knowledge of the mitmort WS. Real property that la Jolntlyro mod wRh right of Survivorship must bo disclosed on schedule F. AMCh a CORY of the sattlament shoot If the prdpctty has baen Sold Include a copy of the deed showing docadent's interest If Owned as Conant in common. ITEM - VALUE AT DATE NUMBER DESCRIPTION OF DEATH i Real Estate-All those two(2)parcels of real property collectively being known and 133,181.00 numbered as 309 Weltrville Road,Enola, Pennsylvania. These properties were acquired by Russell J.Zies and Marjorie E.Zies by Deeds dated March 28,2962 and November 19, 1963, copies of which are attached hereto and incorporated herein. These two(2)parcels of real property are collectively referred to as Tax Parcel No.09-14-0834-152. The county assessed value of this real property is$133,181.00. TOTAL(Also enter on Line 1,Recapitulation) 133,181.00 if more space is needed,additional pages of the same size) Copyright(e)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule A(Rev.01-10) 1 , � ! M1 ` ropegMapper 4 ImW42011 Jmd N 2 9ery000 mag. Y w .. �lSrts. I 1 r ti C 309 t'lFRTZVI((FROAfI £fiS1REfj PIN;914.0m 152 i ''.rr OPPdODpk;d020'o-097d3 ," t rt i ♦' .� � r' �+{ f s'4,w:ZtS,RUS•ffltlON,7RJ0RIE �` r . t. f landUsPCOdP:lD1 r �r P1PPpdYTypp: F , ,. P%I0<d r , ' Tar ad:T a�PSid' - ',•� GretnSt�, ; "' • tandASSessPGVah�= S..uodu ; 7 ` Xt,'•�C' SaI,taJ 9Axsedj,2,e.'nP t;0330p �CO RA OAIFD. IF As.,sledtahre$;13230D � 'PtkeS: Y , iF < r : t � 1 a myt \ r F 9M1 ( •. { Y ! ��� t,l{i—MmW rM�ebrt roue—M Ip1—DnIM O.e 1 non a.14 la.I.M.L Pw Meek ' MTHE 28th - day of March is the year ! o/oar Lord one thousand nine handrail sixty-two (1962) BETW&EN RUSSELL J..ZIES, of the Township of East Pennsboro, County of Cumberland and State of Pennsylvania, and Lemoyne Trust Company; Administrator of the Estate of Barbara A. Zies, deceased, Parties of the first part, ' Grantors. . had RUSSELL J. ZIES.and MARJORIE E. ZIES, his wife, of the same place, Parties of the second part, i - - Grantees: j,t., : WITHESSETH,that in eoneideration of One Dol tar (51.00) and other valuable considerations x8ttwlU) In hand Paid,the reeeiyt whereof is hereby acknowledged,the said grantors do hereby great and convey to the said grantees, ALL THAT CERTAIN lot of land situate in East Pennsboro Township, Cumberland County, Pennsylvania, bounded and described as follows: BEGINNING at a point in the center line of State Highway known as Wertzville Road, Route 944, at the easterly line of lands now'or late of Marlin Comp; thence by said Comp line and through an iron pin located twenty-three and nine-tenths (23.9) feet from said center line north five (5) degrees no . (00)m1nutes east one hundred fifty-five (155) feet to an iron-pin-at line of lands now or late of Edward F Pierce; i . thence by said Pierce lands north eighty-two (82) degrees three (3) minutes east eighty-seven and twenty-two one-hundredths (87.22) feet to a stake; thenceby land of Edwin Babcock, formerly of .Barbara Iles, south five (5) degrees no (00) minutes west, passing through a stake located fifty-six and four one-hundredths (56.04) feet from the center line of the Wertzville Road aforesaid, -a distance of two hundred and ninety-fou r one-hundredths (200.94) feet to a point in the center line of Wertzville Road; thence by said center line north sixty-seven (67) degrees forty-five (45) minutes west eighty-nine (89) feet to the Place of BEGINNING. BEING the same premises which Lemoyne Trust Company, ! _ Administrator of the.Estate of Barbara lies, Deceased, by deed dated October 27, 1961, recorded December 28, 1961 in Deed Book "K", Volume 20, Page 210, granted and conveyed unto Russell J. Iles, one of the grantors herein. - Lemoyne Trust Company joins in the execution hereof to 'correct an.error appearing in the description'wntained in the j . 'deed above recited, whereby the length of the eastern boundary of the lot was mis-stated. i Bon 1120 fAtE 103 I . . eo111120 rwe 104..- AND the said grantors .hereby covenant that they will .I WARRANT SPECIALLY the property hereby conveyed. IN WITNESS WHEREOF, said individual grantor has hereunto set his hand and seal and Lemoyne Trust Company - has caused the execution hereof by its euthorized.offieers and Sts seal to be hereto affixed, the day and year first above written. (SEAL :LEMOYNE TRUST COMPANY, Admit nistrator of Egr F 'f Zs {' � � the Est a of Brbara A. Zfes,'Decd. , RY 9 A1EOF PENNSYLVANIA) SS: . COUNTY OF CUMBERLAND On this, the31-• day of. 1962, before-me, the undersigned officer, personally appeared RUSSELL J. ZIES,' khown to me (or satisfactorily proven) to be the person whose ,.name is subseribed to the within Instrument, and acknowledged tbiijW-exeiuted seme,for the purposes therein contained. �'•�•"' IN WITNESS WHEREOF, I hereunto set my hand and •.i�MSiri+7 .fi g,. �NOTAS . PUBLIC •4f r 'STATE OF PENNSYLVANIA ). . COUNTY OF CUMBERLAND ) SSs On this, the"9 day of /s�.�.� , '1962, before me, the undersigned officer, personally appeared GEORGE F. MYERS, who acknowledged himself to be the President of Lemoyne Trust Company, a corporation, and that he es such President, being ' authorized to do so, executed the foregoing instrument for, the purposes therein eontafriad by signfng.thq name of the car poreti •by.,himself as President. 7` IN WITNESS WHEREOF, I hereunto set my hand and . � . seal. a .s- ( Im.,: . .RELIC . ♦ ht .ev �. W beniea.te+e 4^®l 4 na � •`'4�I�Qt �J` . Wamet h` A¢sslasl Oa4 I HEREBY CERTIFY THAT THE. . PRECISE RESIDENCE OF THE WITHIN c:;aooc.nc,a set NAMED GRANTEE IS ?A.e,(;.,,(a�P< svX+N wus . 14.4 di if 41 torney "I"4 A H . *XM . aoxnmtsusm aysn ' rsmsnvxu anti L o,m—Fft 1VVY—IgaVle i„¢e[ f aaary i1a11�[Ine.. InNaaa, CaR r MADE THE 1Sth day of November in the year of our Lord one thousand nine hundred and sixty-three (1963), BETWEEN EDWARD F. PIERCE and GRACE E. PIERCE, his wife, of East Pennsboro Township, Cumberland County, Pennsylvania Grantor s, and RUSSELL J. ZIES and MARJORIE E. ZIES, his wife, of the same place Grantee s 1VITNESSETH, that in consideration of the sum of Thirty-five ($35.00) Dollars, MYs?rX, in hand paid, the receipt whereof is hereby acknowledged, the said grantor s do hereby grant and convey to the said grantee s, their heirs and assigns, ALL that certain lot of land situate in the Township of East Pennsboro, Cumberland County, Pennsylvania, bounded and described as follows: BEGINNING at a point at the northwest corner of land of grantees and line of land of Marlin Comp; thence along said Comp land North 5 degrees East fifty-one and thirty-one one-hundredths (51.31) feet to an iron pin; thence along other lands of Edward F. Pierce North 82 degrees 03 minutes East one hundred thirty-three and sixty-eight one-hundredths (133.68) feet to en iron pin 'at line of lands of George*Miller; thence by the latter lands South 17 degrees 32 min- utes East fifty and seventy-one one-hundredths (50.71) feet to a stake at line of land of Edwin Babcock; thence by the latter lands and lands of the grantees South 82 degrees 03 minutes West one hundred fifty-three and sixty-two one- hundredths (153.62) feet to the place of beginning; being unimproved; BEING part of the premises which Frank Walk and Lottie A. Walk, his wife, by deed dated April 1, 1927, recorded in Deed Book 11011, Vol. 10, Page 141 Cumberland County Records, granted and conveyed to Edward F. Pierce, grantor herein. UNDER AND SUBJECT to right-of-way for sanitary sewer purposes of East Pennsboro Township Authority over the eastern portion of said lot created by prior grant of Edward F. Pierce, duly recorded. . v-tG..wCe . Fr- ,. F' I OX�21 F;icE 4.3.5. r AND the said grantor s, do hereby covenant That they will WARRANT GENERALLY" the property hereby conveyed. IN WITNESS WHEREOF, said grantors have hereunto set their hands and seal s the day and year first above written. 5igzsb, erelrb nna 39tlicrreb 4.'flzl '?. =/-! �..... __.___-------- ...____ in Or 11rrsrnrr at _ jO i, i1 i f Y ,f. � cP thin name°d C �'� Jc '-`% ounied Ro e ola Pa i licic rncy for Grante s / I i State of Pennsylvania ss. County of Cumberland - On this, the / yf� day of /��"y'^- 19 63 , before me, ±tr �'fted offzber, personally appeared EDWARD F. PIERCE and GRACE E. PIERCE, His Wife 3. f'rfttiriow`r?to ?,Batisfaetorily proven) to be the persons whose name s are subscribedto the with- ' 3yn anstru ¢YZ8 acknowledged that they executed same for the purposes therein contained. i of C4'SIN yitCSS WHEREOF, I hereunto set in a and offici seal. Officer. i State of l County of On this, the day of 19 before me, s the undersigned officer, personally appeared I i known to me (or satisfactorily Proven) to be the person whose name subscribed to the with- I in instrument, and acknowledged that executed same for the purposes therein contained. I ! IN WITNESS WHEREOF, I hereunto set my hand and opzcial seal. i _.................................... _. Title of Officer. do hereby certify that the precise residence and complete post office address of the within named grantee is 19 Attorney for .._--_---- r i v w ♦. i 3 w a ro m Q z U W vI W ¢ w w w z a R: O -w f o g H h N r O ww aH' j 6 COMMONWEALTH OF�/P�E/N/N�S�,YIL�V/./f.�1IA ' { County of._,. CS.�I.:.._�" 'v —........__ as. . RECORDED on this-----��.._____.____-..day of ....___((,'�� A.D. 29.!� in the Recorder's oftace of the said County,in Deed Book!ty Vol. __.aL.......-..., Page--- _..,,._---'---.. Given under my hand and the seal of the said office, the date above written. „ . ..3 '.:�'".:.>�-?-,v-�3'-'--_-.., Recorder. Rev-0S"EX.(N.W) SCHEDULE E pennsylvania CASH, BANK DEPOSITS, & MISC. DEPARTMENT OF REVENUE - INHERITANCETAXRETURN PERSONAL PROPERTY RESIDENT DECEDENT - - ESTATE OF FILE NUMBER Zies,Marjorie E. 21-14-0632 InGWelha stiillNgation and the date the oceads were received the estate. All property joints o ed vdlh the fight or euMvo%hlp mustbe diecloeedonechedulo F. , ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 1999 Chrysler Sebring-Value per attached appraisal. 700.00 2 Personal Property-sold at private sale 1.500.00 TOTAL(Also enter on Line 5,Recapitulation) 2.200.00 (If more space is needed,additional pages of the same size) Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev. 11-10) v'.p\ N`� 1+,iC Worley Motors, Inc. Susquehanna Avenue • Enola Road • Enola, PA 17025 • Phone (717) 732-2051 OWNER OF VEHICLE: / ARR b2(G VEHICLE IDENTIFICATION N. O. ; c 34 YEAR/MAKE/MOD$L: J9 -'ASR IMMWT VALUE AS OF (.insert date of death) . $ COMMENTS: . ABOVE INFOP6ATION PROVIDED BY: (Signature) (Title) I!all 3 VIM 1112M V..' \C ERTI FI CATE OF TITLE FOR A VEHICLE 1J, o' 4 C.3AU52N5XE11191.7 VEwtx DminRcAtxxiHwmBiR NUMBER Q cf).— : BODY TYPE DUP SEAT CAP PRIONTrTLE STATE DQM.PR060,DATE ODgA.MILES A r� DATE PA TTfLED —.--DAM OF ISSUE Omit I"rvv BRANDS oDMETEH'dex119 .LJA-•EAU .4 wvsh4c' L 4 gk 1w1' TANI�V,'.rn osufte r1, OWNPW v ZIE I1Q9 d : ' I d R Z � EN VA-Al 12's R.MCN51RUOlEp S-mmn00 T RECDVERmo THEFT� =v "S ��. AMSSI)EI)m R.0CM%Asn= X I�All A TAM Pw lo'Asni the,Tx Rs�UEN REI.EkSED "onnew Item AM Ir. IIIIVJJJJ ' DAM BY SECOND UIN RE ASED AUrIpRGED Rf2MESgFAT DAM WUNG ADDRESS BY AUfHORIZED REPHSSeNTATVE MARJORIE EDNA ZIES 309 WERTZVILLE RD ENOLA PA 17025 ..n4 As 0 the difie d Woos.Pe offidat econis 0 Me P..r.,•.ft ALLEN D BIEHLER Tmwn.bn tanecs"t InA pwsoxa)or fmRFnY ftmos naawn 6 Ine S.nns,of T.PnPudi W.—TJ J W r9l C-1 ET 9 f IT,K k 4:F.'l 19 11;V I I 19 11 If a��sr other than your spouse Is flted and you were ft Wid 10 SUBSCRIBED A�SWDRN Do IiAted as'JoInt Tenant With RIght of SuMVOrahjp'Jon des ond FO"C: /—� - j., 'I this goes RE O. �14 to sun awnqO�)�CHE9?11� �dvissudam7.n.rds Cornm4t(Onclawithol. e A -..x CN deceaeatl owner ee to _ A VFWLtEA.CHMKD MT lax (IF aRs -&-V-4 Y'v Vil/ f" .�M ER NAME -PN < 1— !TtAE ZP WN0 2ND UEN.CHECK 0 MjkIBAll Elr OF;ESFIN SEDURED)YESQ-DD o -P:. MD UEe40WER M�'Wsmuino� LA.) M UENt*XDER NAME W CRY STATE no NMI Rev-1609 EX.(01-10) Pennsylvania SCHEDULE F DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Zies Marjorie E. 21-14-0632 If an asset was made joint within one year of the decedent's date of death,it must be reported on schedule G. SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT A. Russell G.Zies 12 Wertzville Road Son Enola, PA 17025 B. C. JOINTLY OWNED PROPERTY: DESCRIPTION OF PROPERTY ova OF DATE OF DEATH ITEM LETTER DATE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECD$ DECEDENTS INTEREST VALUE OF NUMBER FOR JOINT MADE NUMBER OR SIMILAR IDENTIFYING NUMBER.ATTACH DEED FOR VALUE OF ASSE INTEREST TENANT JOINT JOINTLY-HELD REAL ESTATE. 1 A 11/03/1986 Santander-Checking Account No. 4,423.95 50.000% 2,211.98 0921705301. Principal balance at date of death$4,423.94;accrued interest$0.01. 2 A 0110211993 Santander-Savings Account No. 12,005.34 50.000% 61002.67 0924028624. Principal balance at date of death$12,005.30;accrued interest$0.04. TOTAL(Also enter on Line 6, Recapitulation) 8,214.65 (If more space is needed,additional pages of the same size) Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule F(Rev.01-10) d- Court Order Processing\Decedents- MA1-MB3-02-10 - P. O.Box 841005 Boston,MA 02284 July 23, 2014 E Jennifer B. Hipp James D. Bogar Attorney At Law E One West Main Street Shiremanstown, PA 17011 RE: Estate of Marjorie E Zies r Date of Death: 06104/2014 Dear Sir or Madam: E Per your request, enclosed please find the account information as of the date of death for the above-named decedent. For your information, accrued interest is not included in g the date of death balance. r Please feel free to contact me if I can be of any further assistance. Very truly yours, d z f S Donna M. Long Lead Specialist 617-514-5169 P C p_V 4 E Z L s 4 Santander Bank ESTATE OF Marjorie E. Zies SOCIAL SECURITY#: DATE OF DEATH: June 4, 2014 Account#: 0921705301 Type: Checking Open date: 11/3/1986 In the name of. Marjorie E. Zies or Russell G. Zies Date of Death Balance: $4,423794 Int.(YTD) from 1/1/2014 to 5/25/2014 $0.21 Accrued interest to date of death: $0.01 r Other Info: Account#: 0924028624 Type: Savings Open date: 1/2/1993 In the name of. Marjorie E. Zies or Russell G. Zies Date of Death Balance: $12,005.30 Int.(YTD) from 1/1/2014 to 6/1/2014 $1.51 Accrued interest to date of death: $0.04 Other Info: Page 1 of 1 REV-0511 EX.(W09) SCHEDULE H Pennsylvania DEPARTMFNTOF REVENUE FUNERAL EXPENSES AND iNHERITANCE DECEDENT RESIDENT DECEDENT ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Zies, Marjorie E. 21-14-0632 Decedent's debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s)attached 4,425.00 B. ADMINISTRATIVE COSTS: 1- Personal Representative's Commissions 'Name of Personal RepresentativeW Street Address City State Zip Year(s)Commission Paid 2. Attorney's Fees Boger and Hipp,Law Offices 2,520.00 3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation) Claimant Street Address City State ZiD Relationship of Claimant to Decedent 4. Probate Fees 323.50 5. Accountant's Fees 6. Tax Return Preparers Fees 7- Other Administrative Costs 2,691.59 See continuation schedule(s) attached I TOTAL(Also enter on line 9,Recapitulation) 9,960.09 Copyright(c)2009 form software only The Lackner Group,Inc. Form PA-1600 Schedule H(Rev, 10-09) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued ESTATE OF FILE NUMBER Zies, Marjorie E. 21-14-0632 ITEM NUM ER DESCRIPTION AMOUNT Funeral xnenses 1 Giant-food for funeral luncheon 50.00 2 Sullivan Funeral Home-funeral bill 4,375.00 H-A 4,425.00 Other Administrative Costs 3 East Pennsboro Township-trash and sewer bill 128.70 4 East Pennsboro Treasurer-partial school tax payment - 472.33 5 East Pennsboro Treasurer-balance of school tax - 944.67 6 PPL 72.00 7 PPL 48.74 8 PPL 29.69 9 PPL 21.56 10 Recorder of Deeds-fee to record deed 80.00 11 Register of Wills-Short Certificate 5.00 _ 12 RESERVES: -Costs to conclude administration of Estate, including preparation and filing of 750.00 final personal income tax returns and fiduciary income tax returns 13 Santander Bank-fee for date of death valuation letter 20.00 Copyright(c)2002 form software only The Lackner Group, Inc. Form PA4500 Schedule H(Rev.6-98) SCHEDULE H FUNERAL EXPENSES AND ADMINISTRATIVE COSTS continued _ ESTATE OF FILE NUMBER Zies, Marjorie E. 21-14-0632 ITEM NUMBER DESCRIPTION AMOUNT 14 Spot Talk-long distance phone service - - 2.58 15 Verizon 62.86 16 Verizon 53.46 H-67 - 2,691.59 Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98) REV-1613 E%.10140) ' pennsytvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF " FILE NUMBER Zies, Marjorie E. 21-14-0632 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON($)RECEIVING PROPERTY DECEDENT {Words} {$$$) I, TAXABLE DISTRIBUTIONS [include outright spousal distributions,and transfers under Sec.9116(a)(1.2)] Russel[G.Zies Son Rest,residue 12 Wentzville Road and remainder Enola, PA 17025 Total Enter dollar amounts for distributions shorn above on lines 15 through i8 on Rev 1500 cover sheet,as so Prop riate. NON-TAXABLE DISTRIBUTIONS: II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS r TOTAL OF PART 11 -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEE Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule J(Rev.01-10)