HomeMy WebLinkAbout08-04-15 (2) pennsylvania 1505618403
DEPARTMENT OF REVENU
�X (03-14)
REV-1500 OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN
Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 15 0595
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
05 08 2015 02 07 1952
Decedent's Last Name
Suffix Decedent's First Name MI
BURKHOLDER LARRY D
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
M 1. Original Return 1:12. Supplemental Return 3. Remainder Return(date of death
prior to 12-13-82)
4. Agricultural Exemption(date of 5. Future Interest Compromise(date of 6. Federal Estate Tax Return Required
death on or after 7-1-2012) death after 12-12-82)
7. Decedent Died Testate ❑ 8. Decedent Maintained a Living Trust 0 9. Total Number of Safe Deposit Boxes
(Attach copy of will) (Attach copy of trust.)
10. Litigation Proceeds Received 11. Non-Probate Transferee Return 12. Deferral/Election of Spousal Trusts
(Schedule F and G Assets Only)
13. Business Assets 14. Spouse is Sole Beneficiary
(No trust involved)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
ROBERT C SCHOLLAERT ESQ 717 264 5194
First Line of Address
82 WEST QUEEN STREET
Second Line of Address
City or Post Office State ZIP Code
CHAMBERSBURG PA 17201
Correspondent's email address:
REGISTER OF WILLS USE ONLY
REGISTER OF WILLS USE ONLY
DATE FILED MMDDYYYY ry
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1505618403 1505 ,18403
1505618411
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: Burkholder, Larry D.
RECAPITULATION
1. Real Estate (Schedule A) ....................................................................................... 1. 160,479- 00
2. Stocks and Bonds (Schedule B) ............................................................................. 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ......... 3.
4. Mortgages and Notes Receivable (Schedule D) .................................................... 4.
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E).......... 5. 55,807- 04
6. Jointly Owned Property (Schedule F) ❑ Separate Billing Requested ............ 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) I ❑ Separate Billing Requested ............ 7. 921440- 30
8. Total Gross Assets (total Lines 1 through 7) ........................................................ 8. 308,726- 34
9. Funeral Expenses and Administrative Costs (Schedule H) .................................... 9. 28,911. 6 0
10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule 1) ............................ 10. 1-,405. 9 5
11. Total Deductions (total Lines 9 and 10) ................................................................ 11. 30-,317 . 5 5
12. Net Value of Estate (Line 8 minus Line 11).......................................................... 12. 278,408 . 7 9
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J) ............................................... 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) ............................................... 14. 278,408 - 79
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec. 9116
(a)(1.2)X .00 15. 0. 00
16. Amount of Line 14 taxable
at lineal rate X .045 2781408- 79 16. 121528- 40
17. Amount of Line 14 taxable
at sibling rate X.12 0 . 00 17. 0. 110
18. Amount of Line 14 taxable
at collateral rate X.15 0. 110 18. 0- 00
19. TAX DUE................................................................................................................ 19. 12,528. 40
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Under penalties of perjury, I declare 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 person responsible for filing the return is based on all information of which preparer has
any knowledge.
SI U E O R SPO G RETURN Larry D. Burkholder, a/k/a Larry D. DATE
ADDRESS
66 West Main Street, Newville, PA 17241
SI TU E OF P EPARERCHEAR�THANN RREPR�SENTATIVE Robert C. Schollaert Esq. DATE /
l� F/lam - l--2-7 l 5
DDRESS
82 West Queen Street, Chambersburg, PA 17201
111111111111111111111111111111111111111 IN Side 2
1505618411 1505618411
REV-1500 EX Page 3 File Number 21-16-0696
Decedent's Complete Address:
DECEDENT'S NAME
Burkholder,Larry D.
STREET ADDRESS
66 West Main Street
CITY STATE ZIP
Newville PA 17241
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 12,628.40
2. Credits/Payments
A. Prior Payments 11,901.98
B. Discount 626.42
Total Credits(A +B) (2) 12,628.40
3. Interest (3)
4, If Line 2 is greater than Line 1 +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) 0,00
Make Check Pa able 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; .................................. H
x
c. retain a reversionary interest;or ............................................................................................................... ❑x
d. receive the promise for life of either payments, benefits or care? ............................................................ ❑
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? .................................................................................................................... ❑ ❑x
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 ❑ ❑
containsa 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.
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 172 P.S.§9116(a)(1.1)(i)].
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)(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 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 parent,or a step-parent 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)]. 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.
Rev-1502 EX+(12.12)
SCHEDULE A
pennsylvania REAL ESTATE
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Burkholder, Larry D. 21-15-0595
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts.
Real property that is jointly-owned with right of survivorship must be disclosed on schedule F.
Attach a copy of the settlement sheet if the property has been sold
Include a copy of the deed showing decedent's interest if owned as tenant in common.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Real estate lying and being situate in the Borough of Newville, Cumberland County, 132,759.00
Pennsylvania, having a street address of 66 West Main Street, Newville, Pennsylvania - tax
assessment value as per attached tax bill
2 Real estate lying and being situate in the city of Pittsburgh, Allegheny County, Pennsylvania, 27,720.00
having a street address of 45 and 47 Rostock Street, Pittsburgh, Pennsylvania - tax
assessment value as per attached tax bill
TOTAL (Also enter on Line 1. Recapitulation) 160,479.00
(If more space is needed,additional pages of the same size)
Copyright(c)2012 form software only The Lackner Group, Inc. Form PA-1500 Schedule A(Rev. 12-12)
Rev-1508 EX+(08.12)
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, & MISC.
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Burkholder, Larry D. 21-15-0595
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 Orrstown Bank checking account #106004474 - date of death value 13.681.17
Accrued interest on Item 1 through date of death 0.49
2 Orrstown Bank money market account #106002105 - date of death value 20,815.36
Accrued interest on Item 2 through date of death 2.65
3 Orrstown Bank money market account #106005558 - date of death value 2,093.26
Accrued interest on Item 3 through date of death 0.11
4 2002 Ford F-150 Lariat pick-up truck, VIN #1FTRX18W22NB14928 - Kelley Blue Book 4.862.00
valuation
5 2008 BMW 528i sedan, VIN #WBANU53598CT19855 - Kelley Blue Book valuation 13,531.00
6 Personal property - (shared a home with son, daughter and three grandchildren) 500.00
7 2014 1040 tax refund 321.00
TOTAL (Also enter on Line 5. Recapitulation) 55.807.04
(If more space is needed,additional pages of the same size)
Copyright(c)2012 form software only The Lackner Group, Inc. Form PA-1500 Schedule E(Rev. 08-12)
Rev.1510 EX+(OUS)
SCHEDULE G
pennsylvania INTER-VIVOS TRANSFERS AND
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Burkholder, Larry D. 21-15-0595
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OFDECD'S EXCLUSION TAXABLE
NUMBER THE
INCLUDE
NAME
F TRANSFER.ER TRANSFEREE,
THEIR CORELATIONSHIP
OF THE DEIED FOR REAL ES ATE. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
1 Orrstown Bank IRA account #608000041, son, Larry D. 92,440.30 100.000% 92,440.30
Burkholder, Jr., beneficiary - date of death value
TOTAL (Also enter on Line 7. Recaaitulation) 92.440.30
(If more space is needed,additional pages of the same size)
Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule G(Rev. 08-09)
REV-1511 EX+(08.13)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RE
RESIDENT DEC DENTTURN ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Burkholder, Larry D. 21-15-0595
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 13,013.66
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zio
Year(s) Commission Paid
2. Attorney's Fees Black and Davison 9,062.19
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 3,500.00
Claimant Larry D. Burkholder, Jr. and Christina M. Darr
Street Address 66 West Main Street
City Newville State PA Zio 17241
Relationship of Claimant to Decedent Children
4. Probate Fees Cumberland County Register of Wills 195.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 3,140.75
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 28,911.60
Copyright(c)2013 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev. 08-13)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Burkholder, Larry D. 21-15-0595
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Expenses
1 Fogalsanger-Bricker Funeral Home - funeral expenses 12.189.83
2 Larry D. Burkholder - reimbursement for funeral expenses 823.83
H-A 13,013.66
Other Administrative Costs
3 Allegheny County Recorder of Deeds - deed recording fee 162.00
4 Black and Davison - reserve for closing costs 500.00
5 Black and Davison - administration expenses advanced 471.97
6 Cumberland County Recorder of Deeds - deed recording fee 81.00
7 Miller Insurance Associates, Inc. - fire insurance on Newville real estate 839.00
8 Miller Insurance Associates, Inc. - fire insurance on Pittsburgh real estate 878.00
9 The Sentinal - legal notice 208.78
H-B7 3,140.75
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev. 6-98)
Rev-1512 EX+(12-12)
SCHEDULE 1
pennsylvania DEBTS OF DECEDENT,
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN MORTGAGE LIABILITIES AND LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Burkholder, Larry D. 21-15-0595
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 AT&T - debt of decedent 118.99
2 Friendship Hose Company #1 - debt of decedent 800.00
3 Health Network Laboratories - debt of decedent 21.59
4 Health Network Laboratories - debt of decedent 61.42
5 Orrstown Bank checking account #106004474 - check written prior to death but cleared 82.45
death after death
6 Orthopedic Institute of Pennsylvania - debt of decedent 210.50
7 Robert Wyrick - debt of decedent 28.00
8 William J. Phelan, M.D. - debt of decedent 83.00
TOTAL (Also enter on Line 10, Recapitulation) 1,405.95
(If more space is needed,additional pages of the same size)
Copyright(c)2012 form software only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-12)
REV-1513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Burkholder, Larry D. 21-15-0595
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT
(Words) ($$$)
Do Not List Trustee(s)
I� TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers
under Sec. 9116(a)(1.2)]
1 Larry D. Burkholder Son 50% of residuary
66 West Main Street estate
Newville, PA 17241
2 Christina M. Darr Daughter 50% of residuary
66 West Main Street estate
Newville, PA 17241
Total
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet as appropriate.
NON-TAXABLE DISTRIBUTIONS:
II. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule J(Rev. 01-10)
District 27-
TaxesPROUGH OF NEWVILLE
ayable To: IIIII�III�II�Illll�lilll�llll Big Spring School Dist t 2015-2016 Real Estate Taxes
JERRY SPANGLER, TAX COLLECTOR Control Number 27-27000044 Bill Number: 89 Mailing Date:07/01/2015
4 WEST STREET Parcel# Land Value: 31,600
NEWVILLE, PA 17241 27-20-1754-058. Improvement Value: 102,500
Temp Return Service Requested Land Use:102 HS Exclusion: -9,892
Office Hours: . 66 W Main Street Total Assessment: 124,208
MONDAY 3 7PM Big Spring School District 2%Discount Face Value 10%Penalty
LAST SATURDAY OF MONTH 9AM-12PM Borough Of Newville
717-713-5687 REAL ESTATE TAX
For a receipt, enclose aself-addressed stamped envelope
_>Rate:0.0132885 $1,781.99
Taxpayer: HS/FS CREDIT $131.45
BURKHOLDER, LARRY D
66 WEST MAIN STREET TAX DUE -> $1,617.53 $1,650.54 $1,815.59
NEWVILLE PA 17241Unpaid tax bills are returned to 07/01/2015 09/01/2015 11/01/2015
to to � to
the County after Dec.31 08/31/2015 1 10/31/2015 12/31/2015
- - Return two copies of bill with payment.If paying Installments,
�-- fb use the coupons below with payment.Missing the first
Tax Collec or Signature(f r ' g/e payment only) Date Installment Indicates you will be making a single full payment.
District 27-
ROUGH OF NEWVILLE
Taxes Payable To:
IIII�IIIIIIIVIIIjII I�)IgIIII Big Spring School Dist t 2015-2016 Real Estate Taxes
JERRY SPANGLER, TAX COLLECTOR Control Number 27-27000044 Bill Number: 89 Mailing Date:07/01/2015
4 WEST STREET Parcel# Land Value: 31,600
NEWVILLE, PA 17241 27-20-1754-058. Improvement value: 102,500
Temp Return Service Requested HS Exclusion: -9,892
Land Use:102
Office Hours: 66 W Main Street Total Assessment: 124,208
MONDAY 3-7PM Big Spring School District 2%Discount Face Value 10%Penalty
LAST SATURDAY OF MONTH 9AM-12PM Borough Of Newville
717-713-5x67 REAL ESTATE TAX
For a receipt,enclose a self-addressed stamped envelope
=>Rate:0.0132885. $1,781.99
Taxpayer: HS/FS CREDIT $131.45
BURKHOLDER, LARRY D
66 WEST MAIN STREET TAX DUE -> $1,617.53 $1,650.54 $1,815.59
NEWVILLE PA 17241Unpaid tax bills are returned to 07/01/2015 09/01/2015 11/01/2015
to to to
the County after Dec.31 08/31/2015 10/31/2015 12/31/2015
Return two copies of bill with payment.If paying installments,
use the coupons below with payment.Missing the first
Tax Collector Signature(for single payment only) Date installment indicates you will be making a single full payment.
Taxpayer: Taxpayer: Taxpayer:
BURKHOLDER,LARRY D BURKHOLDER,LARRY D BURKHOLDER,LARRY D
66 WEST MAIN STREET 66 WEST MAIN STREET 66 WEST MAIN STREET
NEWVILLE PA 17241 NEWVILLE PA 17241 NEWVILLE PA 17241
INSTALLMENT PAYMENT 1 INSTALLMENT PAYMENT 2 INSTALLMENT PAYMENT 3
27-Borough Of Newville 27-Borough Of Newville 27-Borough Of Newville
2015 STATEMENT OF 2015 STATEMENT OF 2015 STATEMENT OF
REAL ESTATE TAXES REAL ESTATE TAXES REAL ESTATE TAXES
Big Spring School District Sch Dist Big Spring School District Sch Dist Big Spring School District Sch Dist
DUE BY: DUE BY: DUE BY:
Aug
Face Amount Due: 31 Face Amount Due: Se 30 Face Amount Due: Oct 31.
$550.18 $550.18 $550.18
2015 2015 2015
After August 31,2015 After September 30, 2015 After October 31,2015
No Payments by Resolution Pay at Penalty @$605.20 Pay at Penalty @$605.19
Control#:27-27000044 Bill#: 89 Control#:27-27000044 Bill#: 89 Control#:27-27000044 Bill#: 89
Parcel#:27-20-1754-058. Parcel#:27-20-1754-058. Parcel#:27-20-1754-058.
Tax Collector Signature Date Tax Collector Signature Date Tax Collector Siqnature Datr
C�Ountij of ';k11rg4rU-v
JOHN K. WEINSTEIN 2015
ALLEGHENY COUNTY TREASURER TAX STATEMENT1
412-350-4100 - TOLL FREE 1-866-282-TAXS (8297)
2015 ALLEGHENY COUNTY REAL ESTATE TAX STATEMENT
M OWNER NAME AND PROPERTY ADDRESS
A
OC
L BURKHOLDER LARRY D BURKHOLDER LARRY D �
66 W MAIN ST 5 ROSTO ST ^N. 1�`C
T NEWVILLE PA 17241-1011
O ' 2 D - PITTSBURGH,
X00 j.
LOT & BLOCK NO: CODE & LINE NO: 124 00222 1
1) FULL MARKET VALUE (as established by the Allegheny County Office of.Property Assessment) ....
$19,400
2) HOMESTEAD EXCLUSION SEE TAX BULLETIN FOR MORE INFORMATION................................... 0
3) TAXABLE MARKET VALUE......................................................................................... S 19 400
4) ALLEGHENY COUNTY MILLAGE RATE..................................................................... 4.730
5) GROSS TAX................................................................................................................. $91.76
6) SENIOR TAX RELIEF (if applicable)SEE TAX BULLETIN FOR MORE INFORMATION..........................
7) ADJUSTED GROSS TAX PAYABLE BY APRIL 30, 2015 .......................... $91.76
OR SAVE 2%
8) PAY THIS DISCOUNT AMOUNT DUE BY MARCH 31, 2015................................... $89.92
A5%PENALTYAND 1%INTEREST FOR EACH MONTH DELINQUENT WILL BE CHARGED BEGINNING MAY
FOR MORE INFORMATION ABOUT YOUR TAX BILL OR
IMPORTANT SERVICES PROVIDED BY THE TREASURER'S
OFFICE, PLEASE REVIEW THE ENCLOSED BULLETIN THAT
INCLUDES THE VARIOUS PAYMENT OPTIONS AVAILABLE.
ZPLEASE DETACH HERE AND MAIL ENTIRE TAX BILL Q_ BELOW WITH YOUR ^
%L110untij of
JOHN K. WEINSTEIN 12015
- ' ALLEGHENY COUNTY TREASURER TAX STATEMENT
412-350-4100 • TOLL FREE 1-866-282-TAXS (8297)
2015 ALLEGHENY COUNTY REAL ESTATE TAX STATEMENT
M OWNER NAME AND PROPERTY ADDRESS
A
I
L BURKHOLDER LARRY D BUR DER LARRY D
66 W MAIN ST47 S 0 K ST
T NEWVILLE, PA 17241-1011
O WARD - PITTSBURGH
LOT& BLOCK NO: CODE & LINE NO: 124 00223 9
1) FULL MARKET VALUE (as established by the Allegheny County Office of Property Assessment) .... $
2) HOMESTEAD EXCLUSION SEE TAX BULLETIN FOR MORE INFORMATION................................... �.
3) TAXABLE MARKET VALUE...........................................................I.............................. $5,800
4) ALLEGHENY COUNTY MILLAGE RATE..................................................................... —4.730
5) GROSS TAX................................................................................................................. $27.43
6) SENIOR TAX RELIEF (if applicable)SEE TAX BULLETIN FOR MORE INFORMATION..........................
7) ADJUSTED GROSS TAX PAYABLE BY APRIL 30, 2015 ............................................... 7.4
OR SAVE 2%
8) PAY THIS DISCOUNT AMOUNT DUE BY MARCH 31, 2015.................................... $26.as
A 5%PENALTY AND 1%INTEREST FOR EACH MONTH DELINQUENT WILL BE CHARGED BEGINNING MAY 11 2d95�,
FOR MORE INFORMATION ABOUT YOUR TAX BILL OR - - •
IMPORTANT SERVICES PROVIDED BY THE TREASURER'S •
OFFICE, PLEASE REVIEW THE ENCLOSED BULLETIN THAT - • -•
INCLUDES THE VARIOUS PAYMENT OPTIONS AVAILABLE.
BLACK AND DAVISON
Attornevs-at-Law
82 West Queen Street, Chambersburg, PA 1.7201.
(717) 264-5194
Robert C. Schollaert Jan G. Sulcove
Elliott B. Sulcove Jerrold A. Sulcove Mark T. Orndorf
Estate of Larry D. Burkholder PAGE 1
BILLING DATE: 07/27/15
ACC'T NO.: RCS-19621.01
RE: General
DATE EXPENSE AMOUNT
05/22/15 Travel expense 6.33
05/25/15 Travel expense 6.33
05/25/15 Notary fee 5.00
05/28/15 Cumberland County Register of Wills- probate fee 330.50
05/28/15 Cumberland County Register of Wills- additional 30.00
fees
05/28/15 Travel expense 15.53
06/08/15 Cumberland Law Journal -legal notice 75.00
06/23/15 Postage 3:28
Total of New Expenses: 471.97
ACCOUNT SUMMARY
PREVIOUS BALANCE: $0.00
NEW SERVICES: $0.00
NEW EXPENSES: $471.97
NEW PAYMENTS: $0.00
TOT.CURRENT PERIOD: $471.97
CURRENT BALANCE: $471.97
Please make your CHECK payable to "Black and Davison". If paying by CREDIT CARD,
please provide the information required above or call our office. We accept VISA,
MASTERCARD, AMERICAN EXPRESS, or DISCOVER. Thank you.