Loading...
HomeMy WebLinkAbout01-1113 -, L- REV-1500 EX + (6-00) OFFICIAL USE ONLY 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 INHERITANCE TAX RETURN RESIDENT DECEDENT 17-Z5-/\ 1113 FILE NUMBER 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) Fidler Anna E. DATE OF DEATH (MM-DO-YEAR) NUMBER 21-01- COUNTY CODe YEAR SOCIAL SECURITY NUMBER 171-30-6626 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE DATE OF BIRTH (MM-DD-YEAR) REGISTER OF WILLS SOCIAL SECURITY NUMBER X 1. Original Return 4. Llmltec::lEstate 3 date of death . Remainder Return prior to 12-13-82) 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 2. Supplemental Return 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent MaintaIned a Living Trust (Attach copy of Trust) D 10. Spousal Po....ertyCredlt D 1,. Election to tax under Sec. 9113(A) (date of death between 12'-31-91 and 1-1-95) (Attach Sch 0) niltfjt$l$EC~gtjB,eoMlil,;~!~;:im'eQR~~Ii!NC:.iie~I'1!i~i\'lAtj~;il~QRM^'tl~i'll$j;jQm;,,!!~,)g;~Ii:!I'Qi NAME COMPLETE MAILING ADDRESS X 6. Decedent Died Testate (Attach copy of Will) D 9. Litigation Proceeds Recei....ed Ro er B. Irwin Es . FIRM NAME (If 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 49- 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) D 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) (9) 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/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Sub'ect to Tax (Line 12 minus Line 13) 13,312.11 (1) (2) (3) N i!fcJ Nao!i 6,010r5 i r '.OFFICIALU!;ONLY ~ :Oro roo .,:~:!, (J c::J ',- . :~ C"":) i:p I 0"1 (4) (S) 15,033.62 -0 N f,J CO () -h ,. " NOQl> (6) ;).< (8) 21,044.37 7,505.72 226.54 (11) (12) (13) 7.732.26 13.312.11 (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(aX1.2) 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 20. o 0 .045 .12 .15 (IS) (16) (17) (18) (19) x X X X 0.00 599.04 0.00 0.00 599.04 13,312.11 Copyright (c) 2'000 form software only The Lackner Group, Inc, FormREV-1500 EX (Re..... 6.00) Decedent's Complete Address: STREET ADDRESS 21 Winchester Gardens CITY I STATE I ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 599.04 29.95 Total Credits ( A + B + C) (2) 29.95 3. InterestlPenalty if applicable D. Interest E. Penalty 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 10 requeel a relund (4) 5. 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 total of Line 5 + 5A This is the BALANCE DUE. (58) ..........;.;" .,"'~~~~.,?heck Payable 10: REGISTER OF WillS, AGENT ';;~;;:~~::~~~~~::~:~~:!~~Lt~W[~6"';(j~;~;6~s'BYPLACINGAN:~~!!!!jN'''f~''~'''~P~~~~:~I:~~~':~t~~~:~:!'!!'",::': 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ~ ~xxx 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? . 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. 0.00 0.00 569.09 0.00 569.09 D D D [R] [R] [R] 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 bellef, it Is true, correct and complete. Declaration of preparer other than the personal representative is based on all Information of which ptElparer has any knowledge. SIGNA RE OF PERSOt:t~ FOR FILING RETURN <4M.- 7.:, lJ~~ SIGNATURE OFPREPARER OTHER THAN PRESENTATIVE Debra A. Nevins Duane R. Dietz DME 1200 Sadler Drive 155 Greenbriar Rd. - --CarE~ie-,--PA--i'i6i3------Eiii';ti:-;b;;r--,--p;C 17024 IRWIN McKNIGHT & HUGHES DME 60 West Pomfret Street ----------------------------------------------------- Carlisle PA 17013 iL(t!CI iLl ,( 0, For dates of ath on r 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 surviving spou 7. [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 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 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 benefjciaries is 4.5%, except as noted in 72 P.S. 9116(1.2) [72 P.S. 9116(aX1Jj. 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(aX1.3)]. 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) ,REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Anna E. Fidler SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY SSII 171-30-6626 09/07/2001 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 NUMBER 1 M&T Bank, checking DESCRIPTION VALUE AT DATE OF DEATH 4,438.49 2 1987 Chevrolet Celebrity; 2.8 liter V6 sedan, 68628 miles 700.00 3 Miscellaneous personal property 394.50 4 Winchester Gardens, security deposit 477.76 TOTAL (Also enter on line 5. Recap~ulation) $ 6,010.75 (It more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Jnc. Form REV-1508 EX (Aev.1-97) ,REV-1510 EX +(1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCETAX RETURN RESIDENT DECEDENT ESTATE OF Anna E. Fidler SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY SSlI 171-30-6626 09/07/2001 FILE NUMBER 21-01- This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. DES~RIPTlON OF PROPERTY %QF ITEM INCLUOETH NAME OFTHE TRANSFEREE THEIR DATE OF DEATH DECO'S EXCLUSION TAXABLE VALUE RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. NUMBER ATTACH ACOPYOF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) 1 MetHfe Annuity 15,033.62 1.5,033.62 TOTAL (Also enter on line 7, Recapitulation) $ 15,033.62 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1510 EX (Rev. 1-97) ,REV-1511 EX +{1-97} COMMONWEALTH OF PENNSYLVANIA lNHER1TANCETAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Anna E. Fidler Debts of decedent must be reported on Schedule I. ITEM NUMBER A. B. SSfF 171-30-6626 FILE NUMBER 21-01- 09/07/2001 DESCRIPTION AMOUNT 1 FUNERAL EXPENSES, Giant, meal 164.81 2 Harrisons Flowers 236_91 3 Lebanon United Church of Christ 100.00 4 Nickel Funeral Home 5,864.00 5 Rice Memorial, inscription fee 70.00 1. ADMINISTRATIVE COSTS, 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. 3. Attorney's Fees IRWIN McKNIGHT & HUGHES Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address 1,000.00 City Relationship of Claimant to Decedent State Zip 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Other Administrative Costs Carol Cox, apartment cleaning 55.00 2 Register of Wills - filing fee 15.00 TOTAL (Also enter on line 9. Recapoulation) $ 7,505.72 (If more space is needed, insert additional sheets of the same size) Copyrlght{c) 1996 formsoftwareonlyCPSystems, Inc. Form REV-1511 EX (Rev. 1-97) .REV-1512 EX +(1-97) COMMONWEALTH OF PENNSYLVANIA INHERlTANCETAX RETURN RESIDENT DECEDENT ESTATE OF Anna E. Fidler SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS SSfF 171-30-6626 09/07/2001 FILE NUMBER 21-01- Include unreimbursed medical expenses. ITEM NUMBER 1 Blue Mountain Anesthesia DESCRIPTION AMOUNT 36.11 2 Corncast Cable - final bill 13.88 3 PP&L 115.07 4 Sprint Telephone 61.48 TOTAL (Also enter on line 10, Recapitulation) S 226.54 (If more space is needed, insert additional sheets of the same size) Copyright (e) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97) .AEV~ 1513 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Anna E. Fidler SS# 171-30-6626 09/07/2001 FILE NUMBER 21-01- RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] 1 Shirley I. Bender 133 Cameo Drive Fayetteville, PA 17222 Daughter 1/6 remainder 2 Dale E. Dietz 3 Jeffrey Drive Columbia City, IN 46725 Son 1/6 remainder 3 Duane R. Dietz 155 Greenbriar Road Elliottsburg, PA 17024 Son 1/6 remainder 4 Maynard D. Dietz 233 Seventh Avenue Burnham, PA 17009 Son 1/6 remainder 5 Debra A. Nevins 1200 Sadler Drive Carlisle, PA 17013 Ida J. Wine 6510 East Canal Fort Wayne, IN Daughter 1/6 remainder 6 Daughter 1/6 remainder Painte Lane 46804 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 $ 0.00 (If more space is needed, insert additional sheets of the same size) Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9~OO) '.-. LAST WILL ANIl TESTAMENT I, Anna E. (Clouse) Fidler, presently of Aspers, Menallen Township, Adams County, Pennsylvania, hereby make and publish my Last Will and Testament, revoking and making null and void any other Wills or writings in the nature thereof by me at any time heretofore made. Item 1: All my just obligations shall be paid as soon as may conven- iently be done after my death, including my funeral, burial, memorial, hospital, medical and nursing expenses, and including all transfer inheritance, estate and other death taxes, as well as estate settlement expenses, all of which shall be paid from the residue of my estate. Item 2: I give, devise and bequeath all the rest, residue and remainder of my estate, of whatever nature and wherever situate, unto my six children: Dale E. Dietz, Shirley I. Bender, Maynard D. Dietz, Ida J. Wine, Duane R. Dietz and Debra A. (Dietz) Nevins, share and share alike. In the event that any of my children fail to survive me, I give such share unto his or her children or issue taking equally but per stirpes; and if any of my children who fail to survive me leave no children or issue surviving me, I give said share unto my other above named children, or to their respective children or issue, taking equally but per stirpes. Item 3: As Executors of my Will, I appoint and constitute my two children, Duane R. Dietz and Debra A. (Dietz) Nevins, and I direct that none of them shall be required to furnish bond. IN WITNESS WHEREOF, I, Anna E. (Clouse) Fidler, have to this my Last Will and Testament subscribed my name and affixed my seal in the presence of two witnesses, who, in my presence and in the presence of each other, subscribed their names in attestation hereof this J .( t?~ day of June, 1980. Signed, sealed, declared and published by Anna E. (Clouse) Fidler as and for her Last Will and Testament in our presence, and we, at her request, and in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses on the day and year last above written. ./ .( ,. (,' I. ,," Ll :,!i .) // . / ~ ll,. (SEAL) / ..:.L :"'-~-.:/..;- .~_ - (_ ----" p . L. ,1 f; ( [' I, ,(.t'LL[[;, 'II (I ~~ .,. ~l ;"'1, ,,'. 'I,j '1./ Anna E. (Clouse) Fidler mM&TBank October 17,2001 RE: Estate Search The Estate of: Date of Death (0.0.0.) ANNA E FIDLER 9/7/2001 To Whom It May Concern: Identified below is the account information requested. I. M&T Bank accounts in which the decedent's name appears: Account Type Account Number Account Title Opening Branch D.O.D. Accrued Interest Balances (Includes Accr. Int.) $4438.49 $.00 CHK 2679018867 ANNA E FIDLER 4335 2. Loans, Mortgages, or other obligations titled in the decedent's name Account Number Amount Owed Account Description A Safe Deposit Box titled in the Decedent's name existed at our NORTH MIDDLETON OFFICE. The Safe Deposit Box Number is 0000525. If you have any questions about the information provided, please contact our Records Department at (716) 635-40 I 0 or 1-800-724- 2440 outside ofthe Buffalo, NY calling area. Thank you. Sincerely, M&T BANK CORPORA nON BY: y;;(LU-f1....~/'-J2 h-t"',AA~~'~ Authorized Signature / . DATE: (0- \, ~ () \ Manufacturers and Traders Trust Company. 1100 Wehrle Dnve, PO. Box 767, Buffalo. NY 14240-0767 10/10/2001 15:38 IB/l~/2Bel 13:34 71 ?541, 1198 19182528273 METLIFE METLIFE TUl...SA PAGE 02 Pi>RE. 02 _..- ,->'- -- Met"otOM'-" l.i't l~urarv:. :omp,l"y MtlI.IB CllsiJlmOl Sorvco 00R0l . Mil 1:zal2 Eul51S1 $I.... P') 6e' z2Qe9 Tulsa. OK 74121-206& MetLife DUANI: R DIETZ FAX 717 54' 1198 RE ANNUITY DEATH CLAIM DECEASED ANNA E FIDLER CONTI'IACT 073 30Z 938 AB 0.., Mr Dietz T"la ie In ,.spOt'se tel your cln to our toU free number r.questlng the date of dleth valull for thll above contrlct. ConUllct 073 302 939 A8 ia non-Qualified and all menl.. are cOmliaarad tllllble In the yeer receiVlld. The data of death value II of s.pt.mb.r 07,2001 " ,'5,033.82. If you hive any quel1:lons, ple.I' feel fr.. to caR our toil-frill number .t '-100-I3I- 7732. One of our CUltomer Service Consultanta will be happy to IIIlilt yeu. Sincerely ~ A-rl""..,I85 Rltll Andernn,ACS AMUltY Oe.th Claim Unit AnnUitY Administrative Operll1iona October 10,2001 11/28/2001 13:58 7175411198 METLIFE PAGE 04 MltropoHlln Uflllnsulll1C8 Company ...0I1.I1t1 CUldDnw SlMce Center - Tulsa 12l102 EGlS1Sl SlrI8l. PO Box 22069 111111, OK 74121-2069 MetLife DUANE R DIETZ 155 GREENBRIAR RD ELLIOTTSBURG PA 17024 RE ANNUITY DEATH CLAIM DECEASED ANNA E FIDLER CONTRACT 073 302 939 AB Deer Mr Dietz . -'-'.. Your claim for tha daath benefit under the above contraat we. proce..ed September 26,2001. Your shere of the settlement tateled ",487.8B. The full benaflt plid was $7,324.52. The payment details for your shara Is: Settlement Amount Cost Basis Amount le.. Federal Income Texes Withheld Las. Stlte Income Texes Withheld Claim Payment Amount $7,487.88 $6,904.46 $163.36 $0.00 ",324.52 This contrect is non-qualified end all proceeds over the co.t ba.l. are considered tsxable in the year received. The cost besls Is listed ebove. If you hive Iny other questions, pleeae feel free to call our toll-free number at 1. 800-838.7732. One of our Customer Service Consultlnt. will be happy to e,,'at . )'ou. ---'---'. -"'. Slnceraly i6r4.4 ,",'''rI.Aes Rita Andarsen.ACS Annuity Death Claim Unit Annuity Administretlve Operetlons September 28, 2001 Metropolitan Life Insurance Company MetLile Customer Service Center - Tulsa 12902 East 51st Sfreet, PO Box 22069 Tulsa, OK 74121-2069 MetLife DEBRA A NEVINS 1200 SADLER AVE CARLISLE PA 17013 RE ANNUITY DEATH CLAIM DECEASED ANNA E FIDLER CONTRACT 073 302 939 AB Dear Ms Nevins Your claim for the death benefit under the above contract was processed September 26,2001. Your share of the settlement totaled $7,487.89. The full benefit paid was $7,324.53. The payment details for your share is: Settlement Amount Cost Basis Amount Less Federal Income Taxes Withheld Less State Income Taxes Withheld Claim Payment Amount $7,487.89 $6,904.46 $163.36 $0,00 $7,324.53 This contract is non-qualified and all proceeds over the cost basis are considered taxable in the year received. The cost basis is listed above. If you have any other questions, please feel free to call our toll-free number at 1- 800-638-7732. One of our Customer Service Consultants will be happy to assist you. Sincerely ~it4 r1~.AeS Rita Andersen,ACS Annuity Death Claim Unit Annuity Administrative Operations September 28, 2001 MILLER'S AUCTIONEERING SERVICE KEITH R MILLER 494 BRICK CHURCH ROAD NEWVILLE, PA. 17241 (717) 776-6692 I am an Auctioneer, licensed by the Commonwealth of Pennsylvania, having ten years experience in sales and in appraising personal property. Purpose of Appraisal The purpose of this Appraisal is to estimate the market value of the subject personal property. The type of value placed on all items listed is fair market value. I have no present or contemplated future interest in the personal property. Definition of Fair Market Value The most probable price, as of a specified date in cash or in terms equivalent to cash, or in other precisely revealed items for which the specific property rights should sell after reasonable exposure in a competitive market under all conditions requisite to a fair sale, with the buyer and seller each acting prudently, knowledgeably and for self interest, and assuming that neither is under undue duress. (Appraisal Institute - 1992) Reference material for obtaining prices includes past sales tickets. Keith R Miller AUL2863L MILLER'S AUCTIONEERING SERVICE KEITH R MILLER 494 BRICK CHURCH ROAD NEWVILLE, PA.I7241 (717) 776-6692 APPRESIAL REPORT OF PERSONAL PROPERTY Prepared for: Duane Dietz EXECUTOR Prepared for: Debra Nevins EXECUTRIX ESTATE of: ANNA E. FIDLER 21 WINCHESTER GARDENS CARLISLE, PA. 17013 ATTORNEY: Roger Irwin AS of: October 04, 2001 Purpose: Inheritance Tax BY: Miller's Auctioneering Service 494 Brick Church Road Newville, Pa. 17241 Keith R. Miller, Auctioneer # AU-2863-L BEDROOM # 1 TV Trays Night Stand Double bed w/box springs & mattress Box of material & pictures Red white kitchen stand Sewing stool Fan Blue chair Tins BEDROOM # 2 Blue chair Sewing machine (white brand) Black bedroom suite (bed, night stand, 4 drawer dresser & dresser w/mirror) Floor light I side chair Black & white TV Linens Walker HALLWAY & LIVING ROOM Small modern book case Small desk TV stand White shadow box w/mirror End table Coffee table Brass floor light Plaid sofa & chair Brown recliner Towels Lawn chairs Magazine rack Black floor light $2.00 $6.00 $35.00 $1.00 $2.00 $3.00 $2.00 $1.00 $ .50 $1.00 $3.00 $45.00 $6.00 $2.00 $8.00 $4.50 $16.00 $22.00 $4.00 $12.50 $2.00 $3.00 $6.00 $12.00 $18.00 $6.50 $1.00 $1.00 $4.50 KITCHEN Pots & pans Waffle iron Coffee pot Toaster Popcorn popper White metal kitchen cabinet Wooden modern dinette set 4 chairs w/extension 1983 small freezer Microwave stand 1985 microwave $6.00 $1. 00 $2.00 $2.00 $ .50 $27.50 $72.00 $27.00 $14.00 $12.00 $394.50 TOTAL 1987 Celebrity Chevrolet Vin # 2GlAW51W3H2100678 2.8 liter V6 4 door 64,628 miles $700.00 $1094.50 "\/?~ l2~-- / / BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT * REV-IU7 EX AFP <12-'" ReOJ1c,::;i {Jf Re:~F;. ..:i ROGER B IRWIN IRWIN ETAL 60 W POMFRET ST CARLISLE .02 FEE 19 A 8 :49 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 02-11-2002 FIDLER 09-07-2001 21 01-1113 CUMBERLAND 101 AlIOunt Re.itted ANNA E Cj~~i~: pl:l.~b15-::::' P/\ 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, subeit the upper portion of this for. with your tax payaent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-Y=i6Cfj-EY-AFP-fi";f=ooi-------...--iNH€iiTANC'E-fix--STATEMENf-OF-ic-couirf--iii.--------------------- ESTATE OF FIDLER ANNA E FILE NO.21 01-1113 ACN 101 DATE 02-11-2002 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE HAMED ESTATE. SHOWN BELOW IS A SUMKARY 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: 01-14-2002 P R I NC I PAL TAX DU E : ..__~._.......__.._.m..m....__..m.._.._...._......_.........~.__......._.~............._.......__................._.._~........_.m.___.._.______.._............__. 599.04 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 12-06-2001 CDOO0608 29.95 569.09 TOTAL TAX CREDIT 599.04 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, 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. ) 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 IRWIN ROGER B 60 WEST POMFRET STREET CARLISLE, PA 17013 _____n_ fold ESTATE INFORMATION: SSN: 171-30-6626 FILE NUMBER: 21 - 2001 - 111 3 DECEDENT NAME: FIDLER ANNA E DA TE OF PAYMENT: 12/06/2001 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 09/07/2001 NO. CD 000608 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $569.09 I I I I I I I I TOTAL AMOUNT PAID: $569.09 REMARKS: ROGER B IRWIN CHECK#18085 SEAL INITIALS: VZ RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS / 7-;JS--I/ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX Recor,J~, RehJ< elATE ',<ijHSESTATE OF DATE OF DEATH FILE NUMBER P 2 ~NTY ACN 01-21-2002 FIDLER 09-07-2001 21 01-1113 CUMBERLAND 101 ROGER B IRWIN IRWIN ETAL 60 W POMFRET ST CARLISLE .02 JAN 25 *~ REV-1547 EX 'FP el2-001 ANNA E ClerK.'; PA 17013Clunbenai,J Allount Rellitted d '. FA, 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 ~ RE-Y-=is47-iX--iFP--fiz:oo.r"No'Tici-OF-'rN'HiifiTAiiCE-YAx-"A-PpiAisiiiENT~--iiioWAifcE-CrR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF FIDLER ANNA E FILE NO. 21 01-1113 ACN 101 DATE 01-21-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED If an assessment was issued previously, lines 14, IS and/or 16, 17, 18 and 19 will reflect ~igures that include the total o~ ~ returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (IS) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due X CRE TS: PAY E DATE 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) S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (S) (6) (7) .00 .00 .00 .00 6,010.75 .00 15,033.62 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (I)) (10) 7,505.72 226.54 (11) (12) (13) (14) NOTE: .00 X 00 = 13,312.11 X 045 = .00 X 12 = .00 X 15 = REC IP NUMBER C T (+) INTEREST/PEN PAID (-) AMOUNT PAID PAYMENT MUST BE MADE BY 06-07-2002*. TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE · IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 21,044.37 7.73~ ~It 13,312.11 .00 13,312.11 (11))= .00 599.04 .00 .00 599.04 .00 599.04 .00 599.04 IF TOTAL DUE IS LESS THAN $1, 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.) J 1- ;;. 5 -II BUREAU OF iN6IVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *51: REV-l'Ol EX AFP <12-00> ROGER B IRWIN IRWIN ETAL 60 W POMFRET ST CARLISLE .02 JAN 25 q~TE ",~'STATE OF "''IlATE OF DEATH FILE NUMBER P ~~!lTY 01-22-2002 FIDLER 09-07-2001 21 01-1113 CUMBERLAND 101 ANNA E Recoru" Re~Jj~;te' A..ount R...itted Cierk"_ PA 17013 r,umbetkkiC , PA 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, sub..it the upper portion of this for.. with your tax pay..ent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-y=i6o'-ix-AFP--liZ-:ool-------...--iNHERITANc'E--YA;f-STATEMENY-O-.:-ACfcoUNT--...--------------------- ESTATE OF FIDLER ANNA E FILE NO.21 01-1113 ACN 101 DATE 01-22-2002 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUHHARY 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: 01-21-2002 PR I NCI PAL TAX DUE: ....................._m......mm....m.......m..........................................................m............................................m......m............................................. 599.04 PAYMENTS (TAX CREDITS): PAVMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 12-06-2001 CDOO0608 29.95 569.09 TOTAL TAX CREDIT 599.04 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 . IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR1, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )