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HomeMy WebLinkAbout01-1108 CAPB HpRL EplO CRAC KOTK ES C P o 0 R N R D E E S N T C o M P T U A T X A T I o N REV-1500 EX + (6-00) J 7 -;;),5-(", REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY D E C E D E N T COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE o EPr. 280601 HARRISBURG, PA 17128-060; DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAL) McConnell Leona M. DATE OF DEATH (MM-DD-YEAR) FILE NUMBER :l.J 0 I COUNTY CODE YEAR SOCIAL SECURITY NUMBER 171-07-3118 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE Copyright (c) 2000 form software only The Lackner Group, Inc. DATE OF BIRTH (MM-DD-YEAR) 11/01/2001 03/03/1914 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) JJ 0'1 NUMBER REGISTER OF WILLS SOCIAL SECURITY NUMBER X 1. Original Return 4. limited Estate X 6. Decedent Died Testate 2. Supplemental Return 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a living Trust 0 (Attach copy of Trust) 3. date of death . Remarnder Return prior to 12-13-82) 5. Federal Estate Tax Return Required 8. T ota! Number of Safe Deposit Boxes (A1tach copy of Will) o 9. litigation Proceeds Received D 10. Spousal Poverty Credit 0 11. Election to tax under Sec. 91'3(A) (date of death between '2-31~91 and 1-1-95) (Attach Sch 0) . .TIiIS:SECrIONMUSr,iBE'CQMPtETE!l,~l$elllltflssPOl1lDE~~.~'fililb}: .1:t~::f~~tIlt~~~fl:!~ltl\QuuD.aE~j;llfllc~p~'if' NAME COMPLETE MAILING ADDRESS Gre or K. Richards Es FIRM NAME (If Applicable) JAMES, SMITH, DURKIN & CONNELLY, LLP TELEPHONE NUMBER 134 Sipe Avenue Humme1stown, PA 17036 7 533-3 80 1. Real Estate (Schedule A) (1) ~ 9 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation. Partnership or (3) ~None t:J Sole-Proprietorship C":l 4. Mortgages & Notes Receivable (Schedule D) (4) C'None I .,. R 5. Cash, Bank Deposits & Miscellaneous Persona! Property (5) 800.00 E , "'0 C (Schedule E) W A 6. Jointly Owned Property (Schedule F) (6) 13 , 9Zl ;~1 Ui P I 0 Separate Billing Requested 0 T 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) 68,000.00 U L (Schedule G or L) A T B. Total Gross Assets (total Lines 1-7) (B) I 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 3,261.52 0 N 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) None 11. Total Deductions (total Lines 9 & 10) (11) 12. Net Value of Estate (Line 8 minus Line 11) (12) 13. Charitable and Governmental Bequests/See 9113 Trusts tor which an election to tax has not been (13) made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due .0 0 ,0 45 .12 ,15 (15) (16) (17) (IB) (19) OFF~ SEONLY f0 ('; (.t.'" ~~") 0"'" .'1, 82,725.21 3.261.52 79,463.69 79,463.69 3,575.87 3,575.87 79,463.69 x X X X Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 33 William Penn Drive f/3 CITY I STATE I ZIP Camp Hill PA 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 3,575.87 178.79 3. Interest/Penalty jf applicable D. Interest E. Penalty Total Credits ( A + B + C) (2) 178.79 Total Interest/Penalty ( 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 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (s) A. Enter the interest on the tax dUe. (SA) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58) MakeCheck Payable to: ..Fl.J:.c;ISTER OF. WillS, AGENT 3,397.08 3,397.08 :';;Lii::Hi:iUiHi::!i::l:;::iiF:H:!;;iHUUj::i:i!i;i[:jH!j:::UiH!;H)::iji;:i:U/iUjUf:!iiiu:u:n:::i::ijU:i;Hi{iHij;iii;;<'ijiiUHiHii;i:iHiHHiH::Hiiii[ii;ji;ji:::::iJ!iiHUjjii;:U:::i!:i]]ii:iiniiini:Hii iHCHii;jjii;iUnnUin:ijHH;:;:H;i]iiH;::::';;;" 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: ~ ~iX b. retain the right to designate who shall use the property transferred or its income; . c. retain a reversionary interest or. d. receive the promise for life of either payments, benefits or care? 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . 0 IT] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? 0 [Jg 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? 0 IT] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FilE IT AS PART OF THE RETURN. Under penaities 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, c. rec and complete. Declaration of preparer other than the persona) representative is based on all information of which preparer has any knowledge. Maureen M. Conrad DATE 33 William Drive -------------------------------------------------.--- Carn Hill, PA 17011 JAMES, SMITH, DURKIN & CONNELLY, LLP - __1.c~L,_ _~~p,,_ _~~,,_,,~~__ m_ ____ mm______ _ __ __ __ ___ Hummelstown, PA 17036 For dates 0 h on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the ouse is 3% [72 P.S. 9116 (a) (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% [72 P.S. 9116 (a) (1.1) (ii)]. The statute does not exemot 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 twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2)). The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116(1.2) [72 P.S. 9116(a)(1)1. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(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. 6-00) R!:V-1508 EX + (1-971 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX.. RETURN RESIDENT DECEDENT ESTATE OF Leona M. McConnell SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY SSil 171-07-3118 FILE NUMBER 11/01/2001 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 NUMBER 1 Pre-paid funeral DESCRIPTION VALUE AT DATE OF DEATH 800.00 TOTAL (Also enter on line 5, Recapitulation) $ 800.00 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-150B EX (Rev. 1-97) REV-:509 EX.. (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCET/JY.. RETURN RESIDENT DECEDENT ESTATE OF Leona M. McConnell SCHEDULE F JOINTLY-OWNED PROPERTY SSII 171- 07 - 3118 11/01/2001 FILE NUMBER SURVIVING JOINT TENANT(S) NAME If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. A. Maureen M. Conrad B. Pamela A. Ped10w c. Sandra M. Weisner ADDRESS 33 William Penn Dr. Camp Hill, PA 17011 3000 Locust Lane Harrisburg, PA 17109 605 Antelope Way Las Vegas, NY 89145 RELATIONSHIP TO DECEDENT Daughter Granddaughter Granddaughter JOINTLY -OWNED PROPERTY' 06/22/95 Waypoint Bank - Checking Account 11500034610; Opened 06/22/1995; held jointly with Maureen Conrad, daughter and Pamela Ped1ow, Granddaughter LETTER ITEM FOR JOINT NUMBER TENANT 1 A DATE MADE JOINT 04/24/92 2 A B DESCRIPTION OF PROPERTY I nclude name of flnanc!al Institution and bank account number or similar Identifying number. Attach deed for Jointly-held real estate. Bank of St. Petersburg _ Checking Account 11125001915; jointly held with Maureen M. Conrad, daughter; account opened 4/24/1992 DATE OF DEATH VALUE OF ASSET 1,515.77 % OF DATE OF DEATH DECD'S VALUE OF INTEREST DECEDENT'S INTEREST 50.00% 757.89 33.33% 13,167.32 39,501.95 TOTAL (Also enter on line 6, Recapitulation) $ (If more space is needed insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. 13,925.21 Form REV-1509 EX (Rev. 1-97) REV -1510 EX... (1-97) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OJ::" PENNSYLVANIA INHERITANCETIV< RETURN RESIDENT DECEDENT ESTATE OF Leona M. McConnell SSf! 171-07-3118 11/01/2001 FILE NUMBER This schedule must be completed and filed jf the answer to any of questions 1 through 4 on page 2 is yes. ITEM NUMBER 1 DESCRIPTION OF PROPERTY RELA Wg~M~,~ f~ b~~~B~~i~r.jHf4~lfB~EJF t~~~SFER. AT"LACH A COPY OF THE DEED FOR REAL ESTATE. Bank of St. Petersburg - Certificate of Deposit #7157008819-2199; owned by the decedent along in trust for Sandra Conrad, granddaughter; account opened 6/24/1993 DATE OF DEATH VALUE OF ASSET 5,000.00 % OF DECD'S INTEREST 2 Bank of St. Petersburg - Certificate of Deposit #7157008822-2198; owned by the decedent alone in trust for Maureen M. Conrad, daughter; account opened 6/24/1993 20,000.00 3 Bank of St. Petersburg - Certificate of Deposit #7157010823-2408; owned by the decedent alone in trust for Pamela Pedlow, granddaughterj account opened 2/28/1994 8,000.00 4 Bank of St. Petersburg - Certificate of Deposit #7157010852-2408; owned by the decedent alone in trust for Maureen M. Conrad, daughter; account opened 2/28/1994 10,000.00 5 Bank of St. Petersburg - Certificate of Deposit #7157010881-2412; owned by the decedent alone in trust for Sandra Conrad, Granddaughter; account opened 3/7/1994 10,000.00 6 Bank of St. Petersburg - Certificate of Deposit #7157010962-2426; owned by the decedent alone in trust for Pamela Pedlow, Granddaughterj account 10,000.00 Total of Continuation Schedu1e(s) TOTAL (Also enter on line 7, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. EXCLUSIDN (IF APPLICABLE) TAXABLE VALUE 5,000.00 20,000.00 8,000.00 10,000.00 10,000.00 10,000.00 5,000.00 68,000.00 Form REV-1510 EX (Rev. 1-97) Estate of: Leona M. McConnell Sac See #: 171-07-3118 Da~e of Death: 11/01/2001 Continuation of Schedule G (Inter-Vivos Transfers & Misc. Non-Probate Property) Item Description of Property i! Date of Death % Deed Exclusion Taxable Value Value of Asset Intrst opened 3/22/1994 7 Bank of St. Petersburg Certificate of Deposit #7157011660-2509; owned by the decedent alone in trust for Sandra Conrad, Granddaughter; account opened 9/23/1994 5,000.00 5,000.00 5,000.00 REV-1511 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERiTANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Leona M. McConnell SSli 171-07-3118 FILE NUMBER 11/01/2001 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES, 1 Cremation Soe iety of Central PA - Additional amount paid on 308.52 behalf of funeral (over pre-paid amount) 2 Funeral Luncheon and Flowers 313.00 3 Mus ic and Father's fee for service 200.00 Total of Continuation Schedulers) 800.00 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's Fees JAMES, SMITH, DURKIN & CONNELLY, LLP 1,400.00 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 Trash removal from apartment 125.00 2 Register of Wills, filing fee for PAIT 15.00 3 Reserve for addi t i anal administration expenses 100.00 TOTAL (Also enter on line 9, Recapitulation) $ 3,261.52 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97) Estate of: Leona M. McConnell Sac See #: 171-07-3118 Date of Death: 11/01/2001 Continuation of Schedule H-A (Funeral Expenses) Item i! Description Amount 4 Pre-paid funeral 800.00 800.00 REV-1513 EX + (9-00) COMMONWEAL TH 0:: PENNSYLVANiA INHERiTANCE TAX RETURN RESIDEN; DECEDENT SCHEDULE J BENEFICIAR IES ESTATE OF Leona M McConnell SSf/ 171-07-3118 11/01/2001 FILE NUMBER 1 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS fincludeoutright spousal distributions, and transfers under Sec. 91 16(a)(1.2)] Maureen M. Conrad 33 William Penn Drive f/7 Camp Hill, PA 17011 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE NUMBER I. Daughter 100% of residue ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, 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 TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) Copyright (cl 2000 form software oniy The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-00) " jRetnh ~ November 1-"\ 2001 uf ~L ~ehr5hurg Stephanie L. Gaffey James Smith Durkm & Connelly P. O. Box 650 Hershel', PA 17033 RE: ESTATE OF LEONA M. McCONNELL, DECEASED Dear Ms. Gaffey, In response to your Jetter dated 11/7/01 requesting mfomlatJOn on the accounts of Leona M. McCOlmell, the details are as follows: 1. Checking account, 125001915, joint account with Maureen M. Comad, balance on 11/1/01 was SI515.77, Interest earned from 1/1/01 to 11/1/011S SI13.89, accrued interest from] 1/2/01 to 11/14/01 is approxImately $2.24, account opened 4/24/1992, no changes to account in past 12 months. 2. Certificate of Deposit, 7157008819-2]99, sole owned, beneficiary is Sandra Conrad, balance on 11/1/0] was $5000.00, interest earned from 1/1/01 to 11/1/01 is $238,53, accrued Interest from 11/2/01 to 11/]4/01 is approximately $9.01, account opened 6/24/1993, no changes to account in past 12 months. 3. Certificate of Deposit, 7157008822-2198, sole owned, beneficiary is Maureen M. Conrad, balance on 11/1/01 was $20,000.00, interest eamed from 1/1/01 to 11/1/01 is $953.99, accrued interest from 11/2/01 to 11/14/01 is approximately $39.06, account opened 6/24/1993, no changes to account in past 12 1110nth5. 4. Certificate of Deposit, 7157010823-2408, sole owned, beneficiary is Pamela Pedlow, balance on 11/1/01 was $8000.00, mterest eamed from 1/1/01 to 11/1/01 is $323.57, accrued interest from 11/2/01 to 11/14/01 is approximately $13.16, account opened 2/28/1994, no changes to account in past 12 months. 5. Certificate of Deposit, 7157010852-2409, sole owned, beneficiary is Maureen M. Conrad, balance on 11/1/01 was $10,000.00, interest eamed from 1/1/01 to 11/1/01 is $405.61, accrued interest from] 1/2/01 to 11/14/01 is approximately $16.38, account opened 2/28/1994, no changes to account in past 12 months. 6. Certificate of Deposit, 7157010881-2412, sole owned, beneflciary is Sandra Conrad, balance on 11/1/01 was $10,000.00, Interest earned from 1/1/01 to 11/1/01 is $477.17, accrued interest from 11/2/01 to 11/14/01 is approximately $47.17, account opened 3/7/1994, no changes to account in past 12 months. PASADENA OFFICE 777 Pasadena Avenue South S1. Petersburg, Florida 33707 Phone (727) 347-3132 . Fax (727) 381-1692 34TH ST OFFI::E 3065 34th Street North St. Petersburg, Florida 33713 Phone 1727) 520-1444 ' Fax 1727) 52D-1135 " /, Certificate ofDeposlt, 7157010962-2426, sole owned, beneficiary is Pamela Pedlo",., balance on 1 )llIO 1 was $10,000,00, interest eamed from l/lIO 1 to JlIlIO 1 is $452.22, accrued interest from 11/2/01 to 11/14/0115 approx1mately, $17.81. account opened 3/22/1994, no changes to account in past 12 months. 8. Certificate of Deposit, 7157011660-2509, sole owned, beneficiary is Sandra Comad, balal1ce on 11/1/01 was $5000.00, interest eamed from 1/1/01 to 11/1/01 is $221.46, accrued interest from JlI2/01 to lllJ4/01 is approximately $9.10, account opened 9/23/1994, no changes to account in past 12 months. As per our conversation this afternoon, at this trme we will Jeave the checking account as is for now. We will close and issue checks on all seven (7) Certificates of Deposits. All checks will be 111ilde pay~b}e 1O Le0l;.alvf 1\1c.Connell i~ trust for.her named beneficiaries, and enclosed with this letter. If I can be of any further assistance, please feel free to contact me. Sincerely, BAYf OF ST. PETERSBURG / ! / J(/ /V \/j~/Ui9!~;;r /~ <- Renee H. Gentes Customer Service Representative rhg Enclosures (7) - .. j 1/08/2001 ~I Wayp,.qi!lJ W"'LL GET YOU THERE. LOOK FOR US. _ C2.. JAMES SMITH DURKIN & CONNELL Y POBOX 650 HERSHEY PA 17033 n, iof,~,,;o, wbieb yO, "q"",red 0, ili, ~"~'( 'J of LEONA MCCONNEll DECEASED (Social Security Number 171-07-3118) is/are as fol1ows: Account Number Class of Account Date Opened Principal Balance A ccrued Interest Balance at Date of 39501.95 Death 500034610 CHECKING 06/22/95 39501.95 Account Ownership JTO Name of Joint MAUREEN Owner, if any CONRAD at': PAd/CUI 1'CJ)~C<,j Date Ownership 06/22/95 Was Established Account Number Class of Account Date Opened Principal Balance A ccrued Interest Balance at Date of Death ACCOUnt Ownership Name of Joint Owner, if any Date Ownership Was Established Iditional Onnation Juested PLEASE COMPLETE VV.9 ;'a;;,lY~t11[ KAiHY Yo6No cJ SENIOR SERVICES REP. NSYLVANIA 17/05-1711 8 1711 HARRISBURG. PEN waypointbank.com P.O. OX . (I 866-929-7646) . www. 66 WAYPOINT - Toll Free 1-8 - jl\II.<.\IIIIIDlhl\I.-c\:.((..-..III\III. I III Olllf}' J.S.).( d J -6) -I J 0 ~ December 4, 2001 Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, P A 17013-3387 RE: ESTATE OF LEONA M. MCCONNELL, DECEASED Stephanie L. Gaffey Paralegal slg@jsdlega1.com Dear Sir or Madam: I am enclosing herewith the Pennsylvania Inheritance Tax return (3 copies) for the above- referenced decedent. There was no estate opened for the decedent as there were no probate assets. I am also enclosing a check in the amount of $15.00 representing the filing fee for the inheritance tax return along with a check made payable to the Register of Wills, Agent in the amount of $3,397.08 representing the Pennsylvania Inheritance tax OWIng. Please file the inheritance tax return and return the stamped copy to me in the enclosed, self-addressed, stamped envelope. I have also enclosed the Estate Information Sheet for the Department of Revenue. Thank you for your attention in this matter. Sincerely, ~~~~ Paralegal :slg Enclosures 134 SIPE AVENUE HUMMElSTOWN, PA 17036 MAILING ADDRESS PO. BOX 650 HERSHEY, PA 17033 TOll FREE 1.800.942.3660 TEL. 717.533.3280 FAX 717533.7771 www.jamesestateplan.com COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT MAUREEN M CONRAD 33 WILLIAM PENN DR APT #3 CAMP HILL, PA 17011 -------- fold ESTATE INFORMATION: SSN: 171-07-3118 FILE NUMBER: 21 - 200 1 - 1 1 08 DECEDENT NAME: MCCONNELL LEONA M DA TE OF PAYMENT: 12/04/2001 POSTMARK DATE: 1 2/03/2001 COUNTY: CUMBERLAND DATE OF DEATH: 11/01/2001 NO. CD 000594 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $3,397.08 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: MAUREEN M CONRAD NO CHECK NUMBER SEAL INITIALS: PB RECEIVED BY: REGISTER OF WILLS $3,397.08 MARY C. LEWIS REGISTER OF WILLS /7-~S -6 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG6 PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE Of DEDUCTIONS AND ASSESSHENT OF TAX ReCOfGC . . Re~jj.'.J!c> DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN .02 GREGORY K RICHARDS JAMES ETAL 134 SIPE AVE HUMMELSTOWN JAN 25 P 2 :06 Clerk. ~Jril9~61; k) PA 01-21-2002 MCCONNELL 11-01-2001 21 01-1108 CUMBERLAND 101 ~C)~ ~)U REV-l547 EX AFP (12-00) LEONA M A..ount Re..itted CHANGED (1) (2) (3) (4) (S) (6) (7) .00 .00 .00 .00 800.00 13.925.21 68.000.00 (8) 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 ~ REY=is4-j-ix--AFP-fi'2-:ooi--NOY-iCE--OF-'rNHiififAifcE-YAX-APpiA-iSE:irENT~--Ai.i-owAiiCE-(rR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF MCCONNELL LEONA M FILE NO. 21 01-1108 ACN 101 DATE 01-21-2002 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ad... Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Govern.ental Bequestsj Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax I~ an assessment was issued previOUSly. lines 14. IS and/or 16. 17. 18 and 19 will re~lect ~igures that include the total o~ abh returns assessed to date. ASSESSMENT OF TAX: 15. A.ount of Line 14 at Spousal rate (IS) 16. A.ount of Line 14 taxable at Lineal/Class A rate (16) 17. A.ount of Line 14 at Sibling rate (17) 18. A.ount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX RETURN WAS: (X) ACCEPTED AS FILED 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) S. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule f) 7. Transfers (Schedule G) 8. Total Assets NOTE: (9) nO) 3,261.52 NOTE: To insure proper credit to your account, sub.it the upper portion of this for.. with your tax pay.ent. 82,725.21 3 261 5' 79,463.69 .00 79,463.69 (19)= .00 3,575.87 .00 .00 3,575.87 .00 (11) (12) (13) (14) .00 X 00 = 79,463.69 X 045 = .00 X 12 = .00 X 15 = TAX CREDITS: PAYHENT RECEIPT DISCOUNT (+) AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) 12-03-2001 CDOO0594 178.79 3,397.08 TOTAL TAX CREDIT 3,575.87 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 · 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.)