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HomeMy WebLinkAbout02-1139 '<"'.",')1' INFORMANT'S REPORT G REV-1500 17-/0 q~ 3 ~*' ., CO~~~N~~~0~~~A OF I:, 'lilli. :. DEPARTMENT OF REVENUE ) OEPl 280601 ",.; ,'. . I. HARRISBURG, PA 17128-0601 INSOLVENT INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER a..,IOL 3.~. COUNTYCOOE YEAP J I nUl0HER SOCIAL SECURITY NUMBER ... Z W o W () W o DECEDENTS NAME (LAST. FIRST, AND MIDDLE INITIAL) Sunday, Daisy C. DATE OF DEATH (t-;M:DD'YEAR)--'~-r- DATE OF'BIRTH (MM-DD-YEARI 05-02-2002 06-23-1920 ._~.~-_._-~--_._~ ,._-_.'--.~'- (If APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. fiRST. AND MIDDLE INITIAL) N/A SOCIAL SECURITY NUMBER 160 05 8969 THIS RETURN MUST BE fiLED IN DUPLICATE WITH THE REGISTER OF WILLS W 0- ::s::S"cn u"'" W"'U ,,00 u"'~ "'OJ '" " ~ 1. Original Relurn o 4. limite.d Estate 06- Decedent Died Testate IAl1ach COil/' of Will) o 9. Uligalion Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (dale oldNlh after 12.12-82) o 7. Decedent Maintained a living Trust (AMach copy of Trust) o 10. Spousal Poverty Cred~\ Idale 01 death belween 12-31.91 and 1-1-95) o 3. Remainder Relum j\l~\\J oj u&a\h pilOT IQ 12- 13-82) o 5_ Federal Estale Tax Return Required 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) IAfI~(;h Sr;hO) 0- Z W o z o '" '" w '" '" o u THIS SECTION MuSt BE c'()MI!,LETED. AI-L CORRESPONDENCE NAME Jane M. Alexander, Esquire FIRM NAME (If AppliCilble) .10 IAL. 'AX INFORMATION SHOULD BE DIRECTED TO: COMPLETE MAILING ADDRESS 148 S. Baltimore street Dillsburg, FA 17019 TELEPHONE NUMBER (717) 432-4514 Ut,I;ICll\i USI- i '~,1I '1 z o ~ ::J t- ii: <( () w a:: 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule 6) 3. Closely Held Corporation, Partnership or Sole.Proprietorship 4. Mortgages & Noles Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Joinlly OW\1ed Property (Schedule F) o Separate BiHing Requested (1) (21 (3) (4) (5) (6) $3.257.62 (7) 7. inter-Vivos Transfers & Miscellaneous Non.probate Property (Schedule G or L) (9) (10) (B) $5.049.07 $58.24 (11) (12) (13) ($1,849.69) -0-- $3,257.62 8. Total Gross Assets (total lines 1-7) 9 Funeral Expenses & Administrative Costs (Schedule H) 10. Debts 01 Decedent. Mortgage liabilities, & liens (Schedule I) 11. Total Deductions (lotal Lines 9 & 10) $5,107.31 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 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) (14) ($1,849.69) SEE INSTRUCTIONS ON REVERSE SlOE FOR APPLICABLE RATES z o ~ I- ::J Q. ::!: o () >< ~ 15 Amount of Line 14 taxable at the spousal tax r~te, or transfers under Sec. 9116 (a)(1 .2) ,.0 __ (15) -0- ,,0_ (16) 16. Amount 01 Une 14 taxable atlineaf rate 17. Amounl of Line 14 taxable at sibling rate , .12 (17) _______ -0-- , .15 (18) 18. Amount of line 14 taxable at collateral rale 19 Tax Due (19)~~ . ----~.Q-=--- 200 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS oN ItI:VERSE 1llOE AND RECHECK MATH < < Decedent's Complete Address: STREET ADDRESS 908 Nixon Drive CITY I STATE --~----Tiip Mechanicsburg, 17055 Tax Payments and Credits: 1. Tax Oue (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) -0- Tolal Credits ( A + 6 + C ) (2) 3. InteresUPenalty if applicable D. Interest E. Penalty TolallnteresUPenalty ( D + E ) (3) 4. If Line 2 IS greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Une 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) -0- 8. Enter Ihe lotal of Line 5 + SA. This is the BALANCE DUE. (SA) (58) A. Enter the interest on the tax due. -0- Make Check Payable to: REGISTER OF WILLS, AGENT ,',:>~~:~;"'{;r'.;;;~..~';~",., ..J PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS ................0 [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 1. Did decedent make a lraosfer and: a. retain the use or income of the property transferred; b. retain the right to designate who shall use the property transferred or its income; .. C. retain a reversionary interest; Of.. d. receive the promise for life of either payments, benefits or care? .. 2. If death occurred after December 12, 1982, did df2cedenl transfer property within one year of dE';.']th without receiving adequate consideration? 3. Did decedent own an "in trust for" or payable UPOIl death bank account or security at his or her oeath? 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ... ..."............. Ves o .............0 ...............................0 .........................0 .............. [J ............0 No [] Ii] Ii] [] [] ~J Under penalties of perjury, I declare that I have examirled this return. including accompanying schedules and statements. arld to the best of my knowl;" J and belief, il is true, correct and complete Daclaratior'l of preparar other than the personal representative is based on all information 01 which preparer has arlY knowledge DATE) Id./' OA "_:..':.!::P}~.::\-,~~;:~,~%~J?;,;l._~, For dat s of death on or after July 1, 1994 and before January 1, 1995, the lax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% {72 PS 99116 (a) (1.1) (I)l For dales of death on or aner January 1, 1995, Ihe tax rate imposed on the net value of transfers to or for the use of 'he surviving spouse is 0% [72 P.S. 99116 (alll1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure 0: assets and filing a lax return are still applicable even if the surviving spouse IS the only beneficiary. For dates 01 death on or aner July 1, 2000 The tax rate imposed on the net value of transfers from 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. 99116(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%, excepl as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1 II The tax rate Imposed on the net value of Iransfers to or for Ihe use of the decedent's siblings is 12% [72 P.S. ~9116(a)(1.311. 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. "".,.....".... COMMONWEAlTH OF PE/lNSYLVANlA INHERITANCE TAX RETURN SI NTO NT SCHEDULE F JOINTL Y.OWNED PROPERTY ESTATE OF Sunday, Daisy C. dl- 001 FILE NUMBER 1139 If In I..et wo.llllde joint within one yel' of the dlcedlnt'. dltt of dllth, If mull III reported on Schedule G. SURVIVING JOINT TENANT(SI NAME ADDRESS RELATIONSHIP TO DECEDENT A.patricia A. Sadler 307 York Road, Carlisle, PA 17013-3159 Daughter B. c. JOINTLy.oWNED PROPERTY: LEtTER {}ME DESCRIPTION Of PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE Include name of finaoclallnstilulion <W1d bank a::counl number or similar idenlifylng number. AIt8ch DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT deed torjoinUy-heId real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. Citizen Bank checking account no. 142-892-1926 $5,442.25 50' $2,721.12 2. A allfirst account no. 8-000-000-1798934 :.$1.073.01 50% $536.50 . TOTAL (Also enter on line 6, Recapilulalion) $3,257.62 (If more space is neerle<!, insM a<1ciitinnal shAAl, of tho ..m. ';7.\ NOV-26-2002 11:41 CITIZENS BANK 5' ~ ft '"l:I ... S' G g 8 fa. n e ~ ~. >- S III >- 0 >- n - n ...... t:l:l t:l;I n n a E.. t""' n ~ n g e- o ~ ~ ~ ~ III 5 a l:Il ~ i .... 't l:Il n ~ .... .... ~ ~ ~ 9 i-:l S ~ l:Il III ... g. 0 a. rn 2- ::t. 0 ~ 0 ~ Cll ~ 8 ...., ....., 0 s- o 8 ~ 0 g 0 '"t;i III 9". n ..... III >- C/.l - 0 ~ ~ ~ ("J ~ g. N VI VI g- ...... I ~ .j:o, 0 ~ 00 .j:o, .j:o, ~ ~ ID N N ~ N - I N N $' ID ...... w w CIQ 0\ ~ 1.0 0\ III N _. 0\ ~ C/.l c 8- ~ 412 5665610 P.02/02 .)1 - 0 :z. - I L?:> 1 8 n .... ~ .... N ~ Z fJ'J ~ ~ TOTAL P.02 !l allfirst November 20, 2002 Jane M. Alexander Attorney at law 148 South Baltimore Street P.O. Box 421 Dillsburg, Pennsylvania 1 7019-0421 'lifir~l Hnandal Ct'nLer N,/\. P(). \)(!.\ ')lll) t\liJlsb(n(), Dr ]l)<.J(l(-; RE: Estate of Daisy C. Sunday Date of Death: May 2, 2002 Social Security Number: 16lXlS-8969 Dear Ms. Alexander: In response to your request, please be advised of the following account the above-named decedent had with this bank and the balance on the date of death. Account Type........................... Statement Savings Account Account Number....................... 8000000] 798934 Ownership (Names 01)................ Daisy Sunday or Pauida A. Sadler Opening Date........................... ]0/02/00 Balance on Date of Death...........$ 1,072.83 Accrued Interest...................... .] 8 Total......................................$ 1,073.01 This response does not apply to any assets held with Allflrst Brokerage, where Allfirst Bank ;s serving as a tnlstee, nor to any credit cards owned by Bank of America bearing AlI/ltSt Bank's name. For further account infonnalion, closures and/or reimbursement of funds refer to below branch: 5219 Simpson Ferry Road, Mechanlcsburg, PA 17055, telephone 717-255-2031. Sincerely, "?ll. C? '~Ulc'/~' Mary Anne Macielag Associate l/elS (302) 93+2240 REV-1511 EX+ (12-99) . . ~. .:0:.'. .""'. , COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS al - OL-I/3,c,/ ESTATE OF FILE NUMBER Sunday, Daisy c. Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Myers Fw1eral Home - Duneral expense $4949.07 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State __ Zip Year(s) Commission Paid: 2. Attorney Fees Jane M. Alexander, Esquire 100.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State ~ Zip Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. TOTAL (Also enter on line 9, Recapi1ulation) $ 5,049.07 (If more space is needed, insert additional sheets of the same size) A I/fllldllrd ofexcel/(,lIH! ill Ce/ll/'(l/ P<!IIIl.,yll'<lllia .rincf! /9/0 cil - 0 '<... - II ~31 noyo L. MVI!:RS, JR., SUplrvisor )711. MAIN mr~n MECIIANll'SIIUIl.(i.I'I'NNSYL\lANIA 11U~S (117)1(,(,..:\411 lyef€> Funeral Home, Inc. , .EMENT OF FUNERAL GOODS AND SERVICES SELECTED . (h~l~ ,J af~ unl)' for IhuM.: ilcnlllhalj'Ou 'jf;lcct~d or that all: fC,/ulll:d, If wc are r~,/Ilircd b~ law or bj' I cemeter) or cfenlawl~ IU llIie In~ Ilems. we wm c~plaln in wrillng b~low. . 1ll'''U lekdtd a funer~lth~1 mal' retjulreembalming. ~Udl as a funeral with "kwlng, you may have 10 pa~ f"r-embalm;nll, VtIII dullO( have 10 pit. for emlnlmloll l'JU did nol al'llf""~ if )'ou IiCk'ued ~'r~ng<mcnll 'Udl;ll a dlreu tremall"n or immediate burl~, If we ch~r~ fur embalming, we will uplain wh~ lM'luw fur tlje Senke of /),:-:",....., t ~"".....J......I Pateoflkatb S~l-o"'L Charge to: fJ~-h,";4' II -s...J.I"", , '(.;D-I y",h (2L C.,hl. p,~ 17()1"'.7 Name Addrc'J <:ill' 5lale A. CIIARGE fOR SERVICES SELECTED, l. I'ROfESSIONALSERVICES Scryke,o(funer.l DirctlOrlStaff fombidminll Olherprepawi"nofbod! s:r"'C1 5~ 5"'-;'.1 SUR.fOTAL OF PROfESSIONALSER\'ICES I;AULlTIH AND ~tR\'lCt~ lIleoff~cililie, and ,dl'it., (ur l'icwing(VisilaliunIW.kej 50"1""..., I U,>eufbcililk,andr.c[l:icn (v,fun('l'Jlcertmvn,.. \ 5 :r....~., L',c ufbcililie,.ml ,cn'icc,> for MemuriaISerl'i,," s~ lI>eufcquil'mellland >l:rl'ins fvr IIl'::I."e,iJt 'tn'ite S 'f~~. , OIDtrme "f(.dlilic, AIL:&.I..-! Al S :r;..~ , Linl!lmillC l.ocal !'amilyt... Lonl Hu\\"er tar 0' noul displlsilion Local Lt:uJur":l'.'gj"....r I.<,,'al Carforpallbl:arcrs Loc.1 OUI of town lramporc.tion 5/.....1 ,\:1_... sr.....f ,- ,- S---=:::::...... ,- SlIB.TOTAL Of AUTOMOTIVE EQUlPM,ENl'. Tm'M. Of I'ROH$SlONAt SERYICES, FACILITIES AND AUTOMOTIVE EQUIPMENT A51~ AI~.J B. ClIARGE fOR ~IERCIIANDlSE SELECTED, ..." Ca_>~Cl _,.. .. . _ ,_, S 11<;':; . {Dt;GiptionJ-2.." ",4 t".:;.lIr, (J--..f...:(: f r~,..,., OlhtrRe(epl.dc 5_ Ilk....rirll<'ni__.~_______.____ OultrlJ.uriai,"Hllainn 5~ ([)e'Uipli"nJ-8,( (r....._iuj l~r"ll IPun'ha'tr) Olhcrclolhlnf, Crem.honum (Descriplion) OTHER '- '- '- TOTAL MERCHANDISE SELECTED C. SPECIAL CHARGES, fo"nrdiull"fn'maill510 lFunendilome) Recdving 01 remains from (fu~rlIHomel ImmedWeBurial \ OjreuCrrmalion SUB-TOTAL OF SPlOCIAL CIIARGES D. CASlI ADVANCED Opening G1JI'e Celll<ltryElJuipmcnl. /'ot.lld Oceo.! Ne,,",p.prrNOllccs-/.IKal Nrw,papcrNOlicel-Out."f-lown. Tekphone &; Tdcgraml Airfare Cklg)'IMalsOffcring. P",jbur~n ~~:::~~~l;o,ilt~e !l;3Ih PoJinElmrl flower!. VaultSer~keChw6c . SliB.TOTAL Of ADVANCES We ch~rge)"ou 101 our,crrktl ill OOlaini"ll ('perlfJ'(IlWlldll<ln'e~lb<illareJlla~.IlPJ ^"Il"1. ," .- .- '- J~ ."Lfti..' SUMMARY m CHARGES A. Prufe"ionaI5trl'i(el. hl"dlties ~nd lquipmcrll. ~no.! AUllunotll't E.qul~m(m II Mer,h.ndiliC C SpemiChargc, II C;llhAd""Kt' rO'LU Of All SfCTIONS PAID AT TIME OF OR !,RIOR TiJ ARRANGEMENTS I~d. .Q)If> BALANCE DUE. .. ;io/';' 'Pl_-'.J.~., .1" ~ ('SlLS- Adn"wkd~rn""ll..~r<h ~f""..I,) REASON FOR EMBALMING V7- r-v~ - ,.:II ...1 kegi.ltcrh""~(l) S~ <'-""/< ......'~_ 7'- ~knl<>')" (ol,ler, S S....I If anl' l~\\', nJ]let~r)". '" ..r~mallr;. requilCment~ hao'< ,e'luircd the purchalC Pra,.tr(~,d.> $_._ lJ(!nvj.l(lheilt:",Jj_'ltdah"l'cthel~wurrClluirclllellli'cxl'lajncdl>c[UW j'mlp",ar)'~..,cmJf~e;._ (If:, I"'J ;l.!:%; -1...- 1I"r'IJld<llh!ll/! s_ ~_~,~J C...(;j~'~'.~ c.>"'~ I ~~rec lh.n J 11..'r ex.mint'd tile ileml u~ glll!d.land "'(I'keB~kcled ~1101'r an.! fOUIld lhom llJ ho wrrt..r Jnu ~'....rdi"g I" Ihe ....njlCm<n" I hnr rr'l""'ltd, I .(kno"''''dxe ~"t'l'l "f~ "'I'! "f till.> ~I"ll'mcm "f fun<ral ('00.1, an<l ]!~,nre> Selec(ed .llepl"t>'<\\\ j'\ I ~'jSt .uffi<il'n\ Illmb lnil.lhlc In, pal"llcnr "I Ill< I'a,ll IlIil'< hll Ihe /llkllb and >ell"t' r.chltu J ~bu .g<tC}",Ukt paymcm o(S.'~ '-<4/', "'nhi'1I .... da...I, I "[('few"" ~>inll)' amlsel'er~lJr li)/)Ie ""ilh 'nI'on< ell\.' wllo ''/In, hduw, A laIr ,h.l/l" of . " ..(~ . , per month .nlU~nlln, 10 ---L'L"L~ per rca, w,l1l", aplli1e<l III lhe ulIl"'id bala...:r ocJlinllin/l.:iLL- ""rs I~I"OJ ~ht <l!l.-U~ Ill" J/lr.,:menl. 1.~!1I ,1'0 PAllO the l'une"llllreum .iIItA50n~hIe ~(lSll paid b\' Iht j.""."lll,,<<:I,.. 1.1 toll."1 ''''"um, I ,IWe un.ler IhiJ 'l\fc(lnem ~,,"J" ,o',~::':~_llldUdc,;juomey\ l""~, coun ,,,,,,, "'}i3<l '>1M' ~-'>>l~, AIIJ 'oIddllluIl;d KT"f"el or Illerrnan<l. ". unlr:r<d 0. rcqurltttl Aller lilt dAle uf lhi. agrrem.m ,,'ill ,,.. (1111,,<1,...._1" I 0 thl.l agre<mcQ! ~ o.! t CO,t ,. of 1..,1 "" rcnel"l<:<i on Ihe lin.i bill or 'l.t<nlC'H 1'1<.,1) /r..A_ '.1:._. n I' ~~ 2 ~....... IPu'c.''''l a'/.7 \\)110> , - I ILkenlCdfollCr!IOi'cl"lOrt-. "''''TI' I',""~ 0"".. ~hU:O"""",''''',"'' a~ ,'- CI~ 1~\lM ...a1'\ . . rod ,-' .- .~ .= '- .ti.:..'" ;np". .'- '- '- .- '- '- '- J~ o 1lBS....: .~-:.. 1J.1!1.L ; Lo.S ... ) I~~ I' <0"'"""0,,'0"0. COMMONWEALTH OF PENNSYlVANlt\ INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF sunday, Daisy C. FILE NUMBER Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1. verizon - debt of decedent - phone service AMOUNT 34.44 2. United Water, pennsylvania - debt of decedent - water se:mlices 23.80 TOTAL (Also enter on line 10, Recapitulation) $ 58.24 (If more space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-00) . . 'c,j,,t,~ '. ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF 1- 0'2... FILE NUMBER 3Ci Sunday, Daisy C. NUMBER I NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DlSTRIBUTIONS [include outright spousal distributions, and lranslers under Sec. 9116 (a) (1.2)] RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE 1. Patricia A. Sadler 307 York Road, carlisle, PA 17013 Daughter 1/3 residue 2 Michael J. snnday, Jr. Range End Road, Dillsburg, PA 17019 s~ 1/3r~idue 3 Jerry sunday 9520 Carlisle Road, Dillsburg, PA 17019 Son 1/3 residue ENTER DOLLAR AMOUNTS FOR OISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18. AS APPROPRIATE, ON REV-1500 COVER SHEET Il NON-TAXABLE DISTRIBUTIONS, A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. None B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. None TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets 01 the same size) ~,. ~~ 4' Name of Decedent: Date of Death: STATUS REPORT UNDER RULE G.12 Daisy C. Sunda May 2, 2002 W111 NO . _ Tax docket no. 21-02-1139 Admin . No . Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the foi'ewinq with respect to completion of the administration of the above-captionec:~es~ate: 1. State whether administratien of t:~e estate is complete: Yes x No .Z. If the answer iJ No, s~3t2 when the personal representative reasonably believes t:~at the administration will be complete: .3. If the answer to No. 1 is Y?s, state the following: a. Did the personal representative file a final account with the Court? Yes No x b. The separate Orphans' Court No. (if any) for the persoral representati~~e's account is: c. Did the personal =epresentative state an account informally to the parties in i.^.ter~s*_? Yes x No d. Copies of receipts, r=leases, joinders and approvals of formal or informal acccunts may be filed with the Cerk of the Orphans' Court and may b~ attached to this report. Date: `~ ignature Jane M. Alexander, Esquire Name (Please type or print) 148 S. Baltimore Street Address Dillsburg, PA 17019 ( 717) 13,x, _ ~.~14 Tel. No. (MAHsrmf/AM3) Capacity: PersonaloRepresentative x Counsel for personal representative /~-/oy ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 JANE M ALEXANDER ESQ 148 S BALTIMORE ST DILLSBURG PA 17019 DATE 02-10-2003 ESTATE OF SUNDAY DAISY C DATE OF DEATH 05-02-2002 FILE NUMBER 21 02-1139 COUNTY CUMBERLAND ACN 101 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETA_IN LOWER POR_TION_ 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 SUNDAY DAISY C FILE N0. 21 02-1139 ACN 101 DATE 02-10-2003 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 B) 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 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (q) 5,049.07 10. Debts/Mortgages Liabilities/Liens (Schedule I) (10) 58.24 11. Total Deductions (11) 5.107.1 12. Net Value c)f Tax Return 1 849 69- 13. Charitable/'Governmental Bequests; Non-elected 9113 Trus (12) ts (Schedule J) (13) , . .00 14. Net Value of Estate Subject to Tax 1 849 69- (l4) , . NOTE: If an assessment was issued previously, lines reflect figures that include the tot l f 14, 15 andior 16, 17, 18 and 19 will a o ALL ASSESSME returns assessed to date. NT OF TAX: 15. Amount of Line 14 at Spousal rate (15) ,00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 00 X 17. Amount of Line 14 at Sibling rate (17l . 00 X 18. Amount of Line 14 taxable at Collateral/Class B rate (18) . 00 X 19. Principal Tax Due . X DATE /PEN PAID (-) ~ AMOUNT PAID 00 _ .00 045 - . 00 12 - .00 15 = .00 (19)= . 00 TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ^ IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 E% ~FP (O1-OS) ( IF TOTAL DUE IS LESS THAN 51, 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.) (1) .00 NOTE: To insure proper [2) .00 credit to your account, (3) .00 submit the upper portion (4) .00 of this fora with your (5) . 0 0 tax payment . (6) 3 , 257.62 (7) .00 (s) 3,257.62 RESERVATION: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B [collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S. Section 9140). PAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side. --Make check or money order payable to: REGISTER OF NILLS, AGENT REFUND (CR): A refund of a tax credit, which was mat requested an the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax^ (REV-1313). Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices, or by calling the special 24-hour answering service for faros ordering: 1-800-362-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-3020 (TT only). OBJECTIONS: Any party in interest not satisfied with the appraisament, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone [717) 787-6505. See page 5 of the booklet ^Instructions for Inheritance Tax Return for a Resident Oecedent^ (REV-1501) for an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid within three C3) calendar months after the decedent's death, a five percent (5%) discount of the tax paid is allowed. PENALTY: The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same tine period as you would appeal the tax and interest that has been assessed as indicated on this notice. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6%] percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2003 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Vear Rate Factor 19g2 20% .000548 1987 9% .000247 1999 7% .000192 1983 16% .000438 1988-1991 11% .000301 2000 8% .000219 1884 11% .000301 1992 9% .000247 2001 9% .000247 1985 13% .000356 1993-1994 7% .000192 2002 6% .000164 1986 10% .000274 1995-1998 9% .000247 2003 5% .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown an the Notice, additional interest must be calculated.