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HomeMy WebLinkAbout01-0008 . REVM lSao EX + (6-W) OFFICIAL USE ON\.. Y CAPB HpRL EplO CRAC KoTK ES C P o 0 R N R D E E S N T C o M T P A ~ X A T I o N REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21-01-Dtv? D E C E D E N T COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST. FIRST. AND MIDDLE INITIAL) Stull Beatrice L. DATE OF DEATH (MM-DO.YEAR) DATE OF eIRTH(MMMDD-YEAR) COUNTY CODE YEAR SOCIAL SECURITY NUMBER 174-05-2996 THIS RETURN MUST BE ALED IN DUPUCATEWlTH THE NUMBER REGISTER OF WILLS SOCIAL S CURl YNUMBER X 1. OrIginal Return 4. limited Estate X 6. Decedent Died Testate (Attach copy of Will) o 9. lItlgation Proceeds ReeeI\,/eQ 3. date of death . Reman'Kler Return prior to. 'Z-'3-B2) 5. Federal Estate Tax Return Required a. Total Number 01 Sa1e Oeposit Boxes 2. Supplemental Return 4a. Future Interest Cornpromise (date of death after 12-12-82) 7. Decedent Maintained a livIng Trust 1 :%~j'" o 010. 11. Election to tax under Sec. 9113(A) NAME Ro er B. Irwin Es . FIRM NAME (Jf Applicable) IRWIN McKNIGHT & HUGHES TELEPHONE NUMBER 60 West Pomfret Street West Pomfret Professional Bldg. Carlisle, PA 17013 R E C A P I T U L A T I o N 3 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. inter-Vivos Transfers & Miscellaneous Non-Probate Property {7} (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (S) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 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 V.lue Sub'eel to Tax (Line 12 minus Line 13) (8) 5,330.22 (11) 4,168.24 (12) 1,161.98 (13) (14) 1,161. 98 NOh~' NOne None (1) (2) (3) c~ OFFICIAL_~ONLY (4) Is) None 5,330.22 (6) None None 3,239.37 928.87 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES x o 0 (15) 0.00 X .045 (16) X .12 (17) 1,161. 98 X .15 (18) (19) ....... :'i1):w~~m:;m'it~m~~imm 0.00 0.00 0.00 174.30 174.30 Copyright (c) 2000 form software only The Laclcner Group. Inc. FormREV-1500 EX (Rev. 6MOO) Decedent's Complete Address: STREET ADDRESS One West Penn Street CITY I STATE I ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Cred~s/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 174.30 8.72 Total Cred~( A + B + C) (2) 8.72 3. lnterestIPenalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E) (3) 4. It Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 10 request a refund (4) S. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) B. Enter the lotal of Line S + SA, This is the BALANCE DUE. (SB) Make Check Payable 10: REGISTER OF WILLS, AGENT 0.00 0.00 165.59 0.00 165.59 'ii;ji:!i:::::::::::~i:::\:m( .l\\\W!\!!:\i!!::[:._~~~;~;;:m;i;;!iii;iii~,:';:';:!f;i;i~il:[ii!r;;!.~:i.'\\\~j:!i~;:~i:H:i::[n~i':'.;:"':'":........_ .__"".".'_ .'..'.' _.'_' ._,0 _ ,_,' '. .... . ." _ .... PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN 1. :1~~j~1 Did decedent make a transfer 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; . e. 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. o o o IT] IT] IT] Under penalties of perJury, I declare that I have examined this return, IncludIng accompanying schedules and statements, and to the best of my knowledge and belief, it is true. correct and complete. Declaration of preparer other than the personal representative Is bised on all InformatIon of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN SIG Sarah W. Finnen 812 Gobin Drive - - 'Cari-fsi;; ,"PA - - i J-6i3- - - - - - - - - - - - - - - - - - - - - -. - -.. IRWIN McKNIGIIT & HUGHES 60 West Pomfret Street - - -carYfsi;;' - PA - - i f6i3- - -. - - - - -. - -. - - - - -. - - -. - - -. For dates of dea 0 r alter 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 s 3% [72 P,S, 9116 (a) (1.1) (ill 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% (72 P.S. 9116 (a) (1.1) (ii)]. The statute does not exemDt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are stm 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 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"10, except as noted in 72 P.S. 9116(1.2) [72 P.S, 9116(aX1lJ. 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(a)(1.3)]. 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 software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6~OO) AEV~ 1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Beatrice L. Stull SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY SSIf 174-05-2996 10/10/2000 FILE NUMBER 21-01- Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 M&T Bank, checking account 776.12 2 M&T Bank, savings account 132.35 3 M&T Bank, certificate of deposit 4,301.75 4 Personal property 120.00 TOTAL (Also ontor on lino 5, Rocapitulation) $ 5,330.22 (If more space is needed, insert additional sheets of the same size) Copyrlght(c} 1996 form software only CPSystems, Inc. Form REV-15G8 EX (Rev. 1-97) REV-1511 EX +(1-97) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCETAY. RETURN RESIDENT DECEDENT ESTATE OF Beatrice L. Stull 10/10/2000 FILE NUMBER 21-01- SSIft 174-05-2996 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES, 1 Hoffman-Roth Funeral Home 2,462.37 B. ADMINISTRATIVE COSTS, 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City State Zip - Year(s) Commission Paid: 2. Attorney's Fees IRWIN McKNIGHT & HUGHES 750.00 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. Other Administrative Costs 1 Register of Wills - filing fee 27.00 TOTAL (Also enter on line 9, Recapitulation) S 3,239.37 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form $oftware only CPSY$tems, Inc. Form REV-1511 EX (Flev. 1-97) REV-15t2 EX +(1-97) COMMONWEALTH OF PENNSYLVANIA tNHERITANCETAX RETURN AESIDENT DECEDENT ESTATE OF Beatrice L. Stull SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS SSf! 174-05-2996 10/10/2000 FILE NUMBER 21-01- Include unreimbursed medical expenses. ITEM NUMBER 1 Carlisle Hospital DESCRIPTION AMOUNT 776.00 2 Comcast Cable 2.51 3 Gary L. Blacksmith MD 46.00 4 Penn Power & Light Co. 38.47 5 Ronald M. Schlansky MD 53.70 6 Sprint Telephone 12.19 TOTAL (Also enter on line 10, Recapitulation) $ 928.87 (If mace space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97) REV-f513 EX +(1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Beatrice L. Stull SCHEDULE J BENEFICIARIES SS!! 174-05-2996 10/10/2000 NUMBER I. 1 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions): Sarah W. Finnen 812 Gobin Drive Carlisle, PA 17013 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Niece FILE NUMBER 21-01- AMOUNT OR SHARE OF ESTATE remainder ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 17, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS, A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 0.00 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET S (If more space is needed, insert additional sheets of the same si2e) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1513 EX (Rev. 1-97) LAST WILL AND TESTAMENT I, BEATRICE L. STULL, of the Borough of Carlisle, Cumberland County, Pennsylvania, declare this instrument to be my Last Will and Testament, hereby expressly revoking all Wills and Codicils heretofore made by me. 1. I direct my executrix to pay all of my debts, funeral and administrative expenses as soon as may be done conveniently after my decease. 2. I give, devise and bequeath all of my estate of every nature and wherever situate to Sarah W. Finnen. 3. I nominate and appoint Sarah W. Finnen to be the executrix of this my Last Will and Testament; she is to serve as such without bond. Should she die before my death, renounce or refuse to serve for any reason, or die leaving any of my estate unadministered, I nominate and appoint Susan Olson, as substitute executrix, also to serve as such without bond, with the same powers as are given herein to my executrix. 4. I hereby suggest that my personal representative retain the services of Irwin, McKnight & Hughes, as attorneys in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 2j2,TH day of July, 2000. (J.uJxUj- -J" ~-,jL BEATRICE L. STULL (SEAL) Signed, sealed, published and declared by BEATRICE L. STULL, the Testatrix above named, as and for her Last Will and Testament, in the presence of us, who at her request, in her presence and in the presence of each other have subscribed our names as witnesses hereto. (}o//~dl ~/~ / /z!fld) 2 ACKNOWLEDGMENT AND AFFIDAVIT WE, BEATRICE L. STULL, CHERYL L. CLELAND and MARTHA L. NOEL, the testatrix and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her Last Will, and that she had signed willingly, and that she executed it as her free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the Will as a witness and that to the best of their knowledge the testatrix was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. (r...wi0; /I '-;/, A I; jf/ BEATRICE L. STULL ~~-f ~~.t- CHER L. CLELAND (7I}fJ!~~J lUJ-efJ MART A L. N L COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged before me by, BEATRICE L. STULL, the testatrix herein and subscribed and sworn to b~ by CHERYL L. CLELAND and MARTHA L. NOEL, witnesses, this 28TH day 0 2000. // ( S.aL .-N 3fia\ Seal Roger B. Irwin, Notary Public Carlisle 8oro, Cumberland County : ,'IV \ :llJllmlSsion Expirp.s Or.! '1."'00 ':;^~enn5yl\janja ASSOC1(1fj{)I: ()' '1'.;~;~lles ~M&rBank December 29,2000 RE: Estate Search The Estate of: Date of Death (D.O. D.) BEATRICE L STULL 10/10/2000 To Whom It May Concern: Identified below is the account infonnation requested. 1 M&T Bank accounts in which the decedent's name appears: Account Account Number Account Title Opening Branch Type CHK 2672053143 BEATRICE L STULL 4319 ACCT OPENED 8126187 SAY 15004200904842 BEATRICE L STULL 4319 ACCT OPENED SARAH W FINNEN POA 1216/95 CD 31003911156692 BEATRICE L STULL 4319 ACCT OPENED 1/9/90 2. Loans, Mortgages, or other obligations titled in the decedent's name Account Numher Amount Owed D.O.D. Accrued Interest Balances (Includes Accr. Int.) $776.12 $.00 $132.35 $.00 $430175 $1.75 Account Description A Sare Deposit Box titled in the Decedent's name existed at our HIGH STREET CARLISLE OFFICE. The Safe Deposit Box Number is 0003439. If you have any questions about the infonnation provided, please contact our Records Department at (7 I 6) 635-40 I 0 or 1-800-724- 2440 outside of the Buffalo, NY calling area. Thank you. Sincerely, M&T BANK CORPORA nON BY: --e~ ~=fs'lA Authorized Signature DATE: l L~ J- '9 -DO Manufacturers and Traders Trust Company' 1100 Wehrle Drive, Po. Box 767, BuHalo. NY 14240.0767 In Re: Estate of Beatrice L. Stull IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION No. 21-01- '8 ORDER AND NOW, this ~ day of January, 2001, upon consideration of the Petition of Sarah W. Finnen, it is hereby ordered and decreed that Sarah W. Finnen shall receive the distribution of property of the Estate of Beatrice L. Stull, deceased, subject, however, to deductions for any amounts found to be due the Commonwealth of Pennsylvania for inheritance tax purposes and any and all oustanding debts of decedent. Petitioner is hereby authorized to receive, collect and distribute the property as herein set forth and to make any and all necessary assignments and transfers. By the Court: ./li J. .':~~ Estate of Beatrice L. Stull IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA : ORPHANS' COURT DIVISION NO. 21-01- PETITION UNDER SECTION 3102 OF THE PROBATE, ESTATES AND FIDUCIARIES CODE FOR SETTLEMENT OF SMALL EST ATE TO THE HONORABLE JUDGES OF SAID COURT: Sarah W. Finnen, your Petitioner, filed this Petition for Settlement of a Small Estate under the provisions of Section 3102 of the Probate, Estates and Fiduciaries Code and in support thereof avers that: (1) Your Petitioner, Sarah W. Finnen, is a competent adult residing at 812 Gobin Drive, Carlisle, Cumberland County, Pennsylvania, and is the niece of the above decedent. (2) Beatrice L. Stull, aunt of the Petitioner died on October 10,2000, at the age of90 years, but prior thereto lived and was domiciled at One West Penn Street, Carlisle, Cumberland County, Pennsylvania. She died with Will (a copy of which is attached hereto as exhibit "A") and no letters of administration have been issued. (3) Beatrice L. Stull had no probate estate when she died other than three bank accounts at M&T Bank which totaled $5,210.22 (a copy ofletter of notice showing value is attached hereto as exhibit B). (4) The sole heirs and next of kin and their relationship to the decedent are as follows: Sarah W. Finnen niece (petitioner) Florence H. Pittenger sister (joinder attached) (5) Your Petitioner avers that the only claims unpaid known to your Petitioner are Ronald Schlansky MD $53.70 and Hoffman-Roth Funeral Home $2,462.37 (copies of statements from each are attached hereto as exhibit "C"). WHEREFORE, your Petitioner respectfully requests that an Order be made authorizing distribution of the sum of$5,2120.22 plus any accrued interest to Sarah W. Finnen pursuant to Section 3102 of the Probate, Estates and Fiduciaries Code. By ~.d~ rw n, Esquire IRWIN c GHT & HUGHES 60 West Pomfret Street Carlisle, P A 17013 (717) 249-2353 Supreme Court #06282 Dated: January 3.2001 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SARAH W. FINNEN, being duly sworn according to law, deposes and says that the facts contained in the foregoing Petition are true and correct to the best of her knowledge, information and belief. ~ tJ), ;J~ SARAH W. FINNEN Notarial Seal Jacqueline L. Drawbaugh, Notary Public Carlisle Boro, Cumberland County My Commission Expires Aug. 14,2003 Member, Pennsylvania Association ot Notaries JOINDER I, FLORENCE H. PITTENGER, sister of Beatrice L. Stull have read the Petition of my daughter, SARAH W. FINNEN for settlement of a small estate, and consent thereto and join in the request thereof. :!~ cU, ~~ FLORENCE H. PITTENGER Notarial Seal Jacqueline L. Drawbaugh, Notary Public Carlisle Boro, Cumberland County My Commission Expires Aug. 14, 2003 Member, Pennsylvania AsSOCIation of Notaries LAST WILL AND TESTAMENT I, BEATRICE L. STULL, of the Borough of Carlisle, Cumberland County, Pennsylvania, declare this instrument to be my Last Will and Testament, hereby expressly revoking all Wills and Codicils heretofore made by me. 1. I direct my executrix to pay all of my debts, funeral and administrative expenses as soon as may be done conveniently after my decease. 2. I give, devise and bequeath all of my estate of every nature and wherever situate to Sarah W. Finnen. 3. I nominate and appoint Sarah W. Finnen to be the executrix of this my Last Will and Testament; she is to serve as such without bond. Should she die before my death, renounce or refuse to serve for any reason, or die leaving any of my estate unadministered, I nominate and appoint Susan Olson, as substitute executrix, also to serve as such without bond, with the same powers as are given herein to my executrix. 4. I hereby suggest that my personal representative retain the services of Irwin, McKnight & Hughes, as attorneys in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 22TH day of July, 2000. (:; -i -r .-.2 .i:t I L 1../ ~,,(./CLm~ c/ '..u, . . BEA TRICE L. STULL (SEAL) Signed, sealed, published and declared by BEATRICE L. STULL, the Testatrix above named, as and for her Last Will and Testament, in the presence of us, who at her request, in her presence and in the presence of each other have subscribed our names as witnesses hereto. (}fl4jllf ~AI '/J{ i~/ )li~J 2 ACKNOWLEDGMENT AND AFFIDAVIT WE, BEATRICE L. STULL, CHERYL L. CLELAND and MARTHA L. NOEL, the testatrix and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her Last Will, and that she had signed willingly, and that she executed it as her free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the Will as a witness and that to the best of their knowledge the testatrix was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. (-J~ -IAi;uli BEATRICE L. STULL ~/L~f CHER L. CLELAND if Q /~ -J~~ ~T AL.N~ COMMONWEAL TH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND Subscribed, sworn to and acknowledged before me by, BEATRICE L. STULL, the testatrix herein and subscribed and sworn to b~ by CHERYL L. CLELAND and MARTHA L. NOEL, witnesses, this 28TH day 0 2000. Notary Pu 3. cth-. _ arial Seal Roger B. Irwin, Notary PubliC GarllSle Boro. CumbArland County I' "miSSion Explr~:; Qr.I. '00 :lIl1syhlaOlo A::>sur.latlOl 'f .' lies DEC-29-00 FRI 02:04 PM RECORDS M AND T BANK ::AX NO. 718 635 4561 P. 02(03 . ~M&TBank Decembl'f 29, 2000 R!':: Estate SC~ reh Tile Est~te of: J)~te of neath (0.0.0.) 8EATIUCE L STULL 10/1012000 To Whom It May Concern: Id~n\ilied bdClW ;, the aCCClunt illr()tmal;Cln requested, I, M&T Bank account> in which the decedent's name appears: SA\' 2672053143 ACC'f OPENED 8/26/87 15004200904842 ACCT OPEl'o:ED 12/6/95 31003911 !56(,92 ACeT OPE1',ED 1/9/90 BEA TRCCE L STULL .1319 0,0,0, Accrued lnt~rcst B:.llnnccs (Includes Accr. 1m.) $77612 $,00 Account Type ^eeo..nt Number Account Title Opening Branch CHK BEATRICE L STULl, SARAH W flN~t::N POA ,j319 S 13235 $.00 CD BEt< TRICO: L STULL \319 S4301.75 $1.75 2, Loans. Mortguges, or OIher obli!l~rjons titled ia the decedent's name Account Numher Arnow,! Owed Account Description A Sare Depusil Box tilled in the Decedent's name exist~d at Qur IlIGH STREET CARLISLE OFnCE. TIle Safe Deposit nox ~umber is 0003439, If ~'ou have any questions ab<.>ut the infOlmation provided, please eontaCt our Record, Department at (71 G) 635-4010 or j.Wo-724. 24~O outside oflne Burfalo, NY ,~lIing area. Thank you. Sincerely, )"1&T BANK CORPORA nON BY: _.6i~--- Authorized Signatur~ DA'tE: 1 'l.. ~ ,''2- '1 - QJ MLlnufa::[.JrefS anci 1(;;ldGrs Trust Comp.3r,y . rIco ';"J\:!~~r:e [)fi'~1:l. P.O. t30x. 701, Eul1f1iO. N'" ~42~Q..0767 12/29/00 13:57 TX/RX NO.3820 P.002 . Cat'lisle PA 17iZ1U Date: :~:Inpll)y~t' L I). No.: ;=:.~;':::H:S174 Pllill1l'?: 111 -;;:4.~- !:::dB +-------------------------------.----------------------------------------------+ I [ -. I IJlldr'ant Or' L~dget' I v I ..... J I 1-.-----.... .- ... -......--... -.. .-....-....... -.. -. ----- - .. -. -. _... .....- . .. -. - -.- - -.......-.-----------------...-..-.-.-------. I I [ ~) I Oon ~ I '~1 J I .. ! I .- -- -.- - -.. ... - ... . .. .. .... .. ...... .. ... -- .. -- .. .- .. .. .. .. ... -- .. ... ... -.... .....' ..' ... .- .... --. -- .. -. ... .. ... ... --. .. .... ... .....- -- -- .. - - --.. -. ! + I I :31;1l11,neatl"ice L Phone 7.lT-<~4'J----;~;?36 Last Pay Dt "}~-/*;f/** I I I 1 West Penn Street Crd Cd Class mer Last Pay S 0.00 I I I Apdi"f;ll1en-!; ;,~04 At Co 1 0.00 Lst Plan PI;' ,x'.X-/:F.t-/:'(,* I I I Carlisle PA 1"0L~ TotBaJ f~90.00 Lst Plan $ 1tI.00 I I I ..- .......... ...,... ---- ... - -'-'... - ............... ..--..... .. .-.... .. -- - ..... ... .. .... .. ..... ... '--'" ...-.-.- .-.-.-...--... ........ .-.. -- -- .. -- .-- .-- ........ .... .-- ----- I I I CUr'r'ent lZI;:";l-iZIE,Qj 0E.1-0SQI 0i:;1-=Ji;;"~'l 1;:"1+ I Unapj:d.iec: I I I Guar 0.00 0.00 0~00 0.00 0.00 I 0.00 I I Plan 238.00 52.00 0.00 0.00 0.00 I 0.00 I I I [Visit O-l:; ;hll 01". :'::'r"Dt::edIH"e - l:i1e.::k/U:: #: Plan ~~'il()UiitJ I I I [03/16/00J 66161 rms Office Visit, Est. Patient Travelers Me[ 52.00)1! I ItU/IG/00 66161 ~li;llllJH{~atr'ice L Asn? y 01"1" car 5;.~.V.M (----------- I I 1[03/03/00] 65661 rms Initial Consul., Office Travelers Mer 178.00JI I I i':'1"IJ.~edur'e NDG>?~ :'}.::;.IIt) d>?du.::tible I I I [04/17/00J 65661 Paid 04/17/00 Adj~Medicare Writeoff Travel[ 0.00J I I I n~.:'5/03/1.()~:1J 6:.56(,1 r'lllS SI1I<3.1l ,J()il1t/iJUl'~':;a ~'hght Cr"aveler's Me[ i-=,lZ1.00J I I I [04/17/00J 65661 Paid 04/17/00 Adj:Medicare Writeoff Travel[ 0.00JI I I [IlI.3/0.'5/00J 6561;1 r~m'; Est' Tr"ave I er's Me [ 12. 00J I I [04/17/00J 65661 Paid 04/17/00 Chk:56353311 Travel[ -4.91J I I (~iiter Function Key:J Ivl +------------------------------------------------------------------------------+ Hoffman-Roth Funeral Home, Inc. 219 North Hanover Street Carlisle, P A 17013 (717)243-4511 November 3, 2000 Sarah Finnen 812 Gobin Street Carlisle, P A 17013 REVISED BILL The Funeral Service for Beatrice L. Stull 13326-185 We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please feel free to contact us if you have any questions in regard to this statement. THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT, AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS. (A) OUR SERVICE: SERVICES OF FUNERAL DIRECTOR&STAFF,EQUIPMENT&FACILITIES . FUNERAL HOME SERVICE CHARGES . . . . . . . . SELECTED MERCHANDISE: Camry Casket. . . . . . . . . . . . . . . . . . . . . . . Monticello Interment Receptacle. . . . . . . . . . . . . . . . . THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE THATYOUHAVESELECTED . . . . . . . . . . . . . CASH ADVANCES Opening Grave. . . Newpaper Notices Out-of-Town Clergy Offering . . . . . Certified Copies of Death Certificates. Flowers. . . . . . . . . . Hairdresser. . . . . . . . . TOTAL CASH ADVANCES AND SPECIAL CHARGES . CONTRACT PRICE HISTORY 10/18/2000 SecurChoice TOTAL AMOUNT DUE fhis statement is net and payable in full within 30 days of receipt. $3390.00 $3390.00 $1570.00 $980.00 $5940.00 $325.00 $20.00 Addit'l charge $50.00 $16.00 $132.50 $30.00 $573.50 $6513.50 $-4051.I 3 $2462.37 Please return this portion with your Remittance .................................................. -............ -- ---.................. --- - -.... -........................ $ Amount Enclosed Service 10 # 13326-185 Beatrice L. Stull \ /b-/fx-~q COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ~l C/ ,/ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 11128-0601 NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ROGER B IRWIN IRWIN MCKNIGHT & 60 W POMFRET ST CARLISLE DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-05-2001 STULL 10-10-2000 21 01-0008 CUMBERLAND 101 *' REY-1S47 EX AFP 1l2-lIl BEATRICE L HUGHES Amount Remitted ,', PA 1 ~"OI3-2300 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV=l5'4j-i:x-iFr;-fi'2=oOY-NOYici:--Oj:-YNHER-iTAi'-CE-YAirAPPRAisEiiENT~--iLrOWAirCE-OR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF STULL BEATRICE L FILE NO. 21 01-0008 ACN 101 DATE 03-05-2001 T AX 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. Hortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets ll) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 5,330.22 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) UO) 3,239.37 928.87 (1) (2) (13) (14) NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 5,330.22 4 . 168 24 1,161.98 .00 1, 161. 98 NOTE: If an assessment was issued previously, lines 14, IS and/or 16, 17, 18 and 19 will reflect figures that include the total of M:..b. returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (5) .00 X 00 ::: .00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) .00 X 045 ::: .00 17. Amount of Line 14 at Sibling rate ll7) .00 X 12 ::: .00 18. Amount of Line 14 taxable at Collateral/Class B rate ll8) 1,161.98 X 15 ::: 174.30 19. Principal Tax Due ll9)::: 174.30 TAX CREDITS: PAYHENT RECEII'T DISCOUNT (+) AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 01-03-2001 AA47-7383 8.72 165.59 ~?'.??.3J? TOTAL TAX CREDIT 174.31 BALANCE OF TAX DUE .0ICR INTEREST AND PEN. .00 TOTAL DUE .0ICR . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) j(P ~/tfY<-13 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT (~I u / '/ REY-1607 EX AFP (12-00l ROGER B IRWIN IRWIN MCKNIGHT & 60 W POMFRET ST CARLISLE DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 04-16-2001 STULL 10-10-2000 21 01-0008 CUMBERLAND 101 BEATRICE L HUGHES Amount Remitted Fiji.-,17013 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE __ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-V= i61fj-Ex-AFP--n1f:ooY------...--iNifERITANCE-TAx-sTA-fEMENT-'(fF"-AC-coi:itff--i"i.---------------- - - --- ESTATE OF STULL BEATRICE L FILE NO.21 01-0008 ACN 101 DATE 04-16-2001 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 02-26-2001 P R I NCI PAL TAX DUE: ........__.............................._........................_......... 174.30 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 01-03-2001 AA477838 8.72 165.59 TOTAL TAX CREDIT 174.31 BALANCE OF TAX DUE .01CR INTEREST AND PEN. .00 IE IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .01CR SIDE FOR CALCULATION OF ADDITIONAL INTEREST. 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