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Home My WebLink About11-16-05 REV-1500 EX (6-00) II OFFICIAL USE ONLY COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 21 COUNTY CODE -9!2...... 0196 ___ YEAR NUMBER I- Z W C w o w C DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Zei ler Anna DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 2/24/2005 6/1/1911 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 185-50-0896 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE W REGISTER OF WILL SOCIAL SECURITY NUMBER W I- ~~lI) OO:~ wll..O :1:00 00:...J 11..11I II.. <( [X] 1. 04 006 09 o 2. Supplemental Retum 0 3. Remainder Retum (date of death 8rior to 12-13-82) o 4a. Future Interest Compromise (date of death after 12-12-82) 0 5. Federal Estate Tax Retum Requi~d o 7. Decedent Maintained a Living Trust (Attach copy of Trusl) L 8. Total Number of Safe Deposit Bo~es o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) 0 11. Election to tax under Sec. 91 d(AliAllach Sch 0) Original Retum Limited Estate Decedent Died Testate (Attach copy of Will) Litigation Proceeds Received THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS l- Z W o z o 0- m w ll:: ll:: o U 44 West Main Street Richard C. Snelbaker FIRM NAME (If Applicable) Snelbaker & Brenneman, P.C. TELEPHONE NUMBER Mechanicsburg, PA 17055 717-697-8528 1 Real Estate (Schedule A) (1) 65,000.00 0.00 0.00 0.00 38,472.48 0.00 .OFFICIAL USE o~~;f ) """) ~1: ~!: 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) (4) G" 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) ...L CD 11 z o i= :3 ::) l- ii: <C o w 0::: 6. Jointly Owned Property (Schedule F) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) (6) '-f1 - 0.00 8. Total Gross Assets (total Lines 1-7) (8) 15,631.96 3,174.83 103,472.48 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (tolal Lines 9 & 10) (11) 18,806.79 84,665.69 0.00 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for YAlich an election to tax has not been made (Schedule J) (12) (13) 14. Net Value Subjectto Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (14) I 84f665.69 15. Amount of Line 14 taxable at the spousal tax z rate, or transfers under See, 9116 (a)(1.2) o ~ 16. Amount of Line 14 taxable at lineal rate l- => ~ 17. Amount of Line 14 taxable at sibling rate o o 18. Amount of Line 14 taxable at collateral rate )( ~ 19. Tax Due 20. [KJ .0.00 3,8<)9.96 .0.00 :0.00 ! 3,8~9.96 0.00 84,665.69 0.00 0.00 x .0 L(15) x .0 45 (16) x .12 (17) x .15 (18) (19) CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 3W4645 1.000 II Decedent's Complete Address: SlREET ADDRESS 142 West Green Street Mechanicsburg Bere, Cumberland County CITY I STATE I ZIP Mechanicsbura PA 1705S- Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 3,809.96 0.00 3,000.00 150.00 Total Credits (A + 8 + C) (2) 3,1150.00 3. Interest/Penalty if applicable D. Interest E. Penalty 0.00 0.00 TotallnteresUPenalty (D + E) (3) 0.00 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) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) ~59.96 A. Enter the interest on the tax due. (5A) 0.00 8. Enter the total of Line 5 + 5A. This is the BALANCE Make Check (58) 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;. . . . . . . . . . . . . . . D ~ b. retain the right to designate who shall use the property transferred or its income; . D ~ c. retain a reversionary interest; or .. . . . . . . . . . . . . . . . . . . . . . . D ~ d. receive the promise for life of either payments, benefits or care? . . . . . . . . . D ~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . .. D ~ 3, Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? D ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. D ~ ! IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RE!TURN. 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 co plete Declaration of preparer other than the personal representative is based on all infonnation of which preparer has any knowledge. . Executrix I 1l/15/0t DATE o ER THAN REPRESENTATIVE Mechanicsburg, PA 17050 DATE 1l/15/0 44 West Main For dates of death 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 surviving spouse is [72 P.S. S 9916 (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 The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosl 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 I or a stepparent of the child is 0% [72 P.S. 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%, I NAP 1) ~~-r .n, ,~~ 0" S;:Q116 (a) (1.1) (ii)] Jle even if tive parent, 39116(a)(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. S 9' individual who has at least one parent in common with the decedent, whether by blood or adoption. 3W4646 1.000 3102, as an II COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE REV-1502 EX + (6-98) ESTATE OF FILE NUMBER Anna W. Zeigler 21 050196 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 fads. Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT iJATE OF DEA TI1 Property known and numbered as 142 West Green Street, Boro of Mechanicsburg, Cumberland County, Mechanicsburg, PA, sale value (settlement sheet attached) 6~,000.00 3W4695 1.000 TOTAL (Also enter on line 1, Recapitulation) (If more space is needed, insert additional sheets of the same size) $ 6$,000.00 r .A. Settlement Statement U.S. Department of Housing and Urban Development ~ ,r OMS Approval No. 2502-0265 B. Type of Loan 1. 0 FHA 2. 0 FmHA 3. O. Conv. un. ;:r".'"m~ 4. 0 VA 5. 00 Conv. Ins. 271509 C. Note: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(p.o.c.)" were paid outside closing; they are shown here for informational purposes and not included in the totals. 7. Loan Number 8. Mortgage Insurance Case Number D. Name and Address of Borrower E. Name and Address of Seller F. Name and Address of Lender JASON L. RINGQUIST BETTY Z. SPONSLER, EXECUTRIX MEMBERS 1ST ESTATE OF ANNA W. ZEIGLER FEDERAL CREDIT UNION 24 EAST KELLER STREET 5000 LOUISE DRIVE MECHANICSBURG PA 17055 MECHANICSBURG PA 17055 G. Property Location H.SeltlementAgenl MEMBERS 1ST SETTLEMENT SERVI4ES, LLC TAX PARCEL NO. 19-23-0567-089 : 142 WEST GREEN STREET Place of Settlement I. Settlerinent Dale MECHANICSBURG PA 17055 44 WEST MAIN STREET 10/2$/2005 MECHANICSBURG PA 17055 Disburs~menl Dale Lot: Block: 10/25/2005 J. Summary of Borrower's Transaction 100. Gross Amount Due From Borrower K. Summary of Seller's Transaction 400. Gross Amount Due To Seller 1 01. Contract sales price 65,000.00 401. Contract sales price 65,000.00 102. Personal property 402. Personal property 103. Settlement charges to borrower (line 1400) 1,704.19 403. 104. 404. 105. 405. - - Adjustments for items paid by. seller In advance Adjustments for items paid by seller in advance 106. City/town taxes to 406. City/town taxes to ..- 107. County taxes 10/25/2005to 12/31/2005 59.83 407. County taxes 10/25/2005 to 12/31/2005 59.83 108. Assessments to 408. Assessments to -~------ -- -- ..-----~-. 109. SCHOOL TAX10/25/2005to 6/30/2006 643.38 409. SCHOOL TAX 1 0/25/2005 to 6/30/2006 643.38 110. to 410. to -- , 111. SEWER 10/25/2005 to 12/31/2005 69.05 411. SEWER 10/25/2005 to 12/31/2005 69.05 112. REFUSE to 412. REFUSE to 113. to 413. to 114. to 414. to 115. to 415. to i -- -._-- ----- -- 120. Gross Amount Due From Borrower 67,476.45 420. Gross Amount Due To Seller 65,772.26 200 Amounts Paid By Or In Behalf Of Borrower 500 Reductions In Amount Due To Seller 201. Deoosit or earnest money 5,000.00 501. Excess deposit (see instructions) 5,000.00 202. Principal amount of new loan(s) 61,750.00 502. Settlement c~arges to seller (line 1400) ! 953.42 203. Existing loan(s) taken subiect to 503. Existing loan(s) taken subject to 204. 504. Payoff of first mortgage loan 205. 505. Payoff of second mortgage loan 206. 506. 207. 507. 208. 508. 209. 509. - .. ._~l!!stments for item~unpaid bv seller Adjustments for items unpaid by seller 210. City/town taxes to 510. City/town taxes to 211. County taxes to 511. County taxes to i 212. Assessments to 512. Assessments to 213. to 513. to -...-- 214. to 514. to 215. to 515. to 216. to 516. to 217. to 517. to 218. to 518. to 219. to 519. to i 220. Total Paid By/For Borrower 66,750.00 520. Total Reduction Amount Due Seller 5,953.42 300. Cash At Settlement FromlTo Borrower 600. Cash At Settlement To/From Seller ,. l Settlement Charges -_._--- ..- 700. Total Sales/Broker's Commission based on price $ 65,000.00 @ %= Paid From Paid From Division of Commission (line 700) as follows: Borrower's Seller's 701. $ to Funds At Funds At Settlement Settlement 702-,-$ to 703. Commission paid at Settlement 704. 800. Items Payable In Connection With loan ---.----.---,.-- 801. loan Origination Fee 61,750.00 % 802. loan Discount 61,750.00 % 8.2~"- Appraisal Fee to 804. Credit Report to -....-. 805. lender's Inspection Fee , 806. Mortga9El. In_surance Application Fee to 807. Assumption Fee : 808. APPLICATION FEE MEMBERS 1ST ($350.00 P.O.C.) 809. 810. 811. 812. 813. 900 Items Required By lender To Be Paid In Advance Exclude last day in cales - line 901 - ,,_. 901. I nterestfrom 10/25/2005 to 10/31/2005@$9.3048 / day 65.13 902. Mortgage Insurance Premium for months to 903. Hazard Insurance Premium for ye!:lis_ to 904. years to 905. 1000. Reserves Deposited With lender --.- 75.751 1001. Hazard insurance 3 months@$ 25.25 per month --..--......---- 1002. Mort9.a.9El.lrlsurance months@$ per month 1003. City property taxes months@$ per month 1004. County property taxes 9 months@$ 27.16 per month 244.44 1005. Annual assessments months@$ per month ---_.._---~ 1006. SCHOOL TAX 5 mOnths,@$ 78.91 per month 394.55 i 1007. months@$ per month 1008. Aaareaate Accountina Adiustment -583.43 1100. Title Charges _.-_.--- 1101. Settlement or closing fee to 1102. Abstract or title search ta 1103. Title examination to ------ 1104. Title insurance binder to ----...-,--.".-- 1105. Document preparation to SNELBAKER & BRENNEMAN P.O.C. 1106. Notary fees to ; 11 07. A!!ol11ey~ fees to _ "....Jln_c1udes above items numbers: ) 1108. Title insurance to MURREL R. WALTERS, III, ESQUIRE 723.75 ~-'- -.JlI1cludes above items numbers: 1101-1104,1108 PENN AITORNEYS TITLE INS. CO. ) 1109. Lender's coverage $ 61,750.00 endorsements 100,300, 8.1 , 1110. Owner's coverage $ 65,000.00 , 1111. 1112. 1113. 1200. Government Recording and Transfer Charges --------_.~._._._~~ .. 1201. Recording fees: Deed $ 38.50 ; Mortgage. $ 68.50 ; Releases $ 107.00 .!2()2. City/county !<l~stamps: J2eed $ 650.00 ; Mortgage $ 650.00 1203. State t<l..x1stamps: l2.eecl $ 650.00 ; Mortgage $ 650.00 1204. RECORD ASSIGNMENT OF MORTGAGE 27.00 1205. 1300. Additional Settlement Charges 1301"-Sll.rv.tl~. to ---------_._~. ~02. Pest inspection to BIECHLER & TILLERY P.O.C. 1303. 1304. 2ND, 3RD & 4TH QTR. SEWER/REFUSE MECHANICSBURG BOROUGH .~ 303.42 1305. 1306. REV-1508 EX + (5-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Anna W. Zeiqler FILE NUMBER 21 050196 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 DESCRIPTION VALUE AT DATE OF DEATH 1 Bricker's Auction proceeds from sale of household goods $,420.25 2 Capital Blue Cross refund unused premium 101.87 3 Commonwealth of Pennsylvania 2004 property tax rebate 500.00 4 M&T Bank Interest accrued to 2/24/2005 Checking account # 446610 lEIl,216.48 0.04 5 Susquehanna Oil Company refund account balance 456.78 6 Wachovia Interest accrued to 2/24/2005 Certificate of Deposit # 247412041450562 12,228.83 10.38 7 Wachovia Checking account # 1010058127801 100.33 8 Wachovia Interest accrued to 2/24/2005 Savings account # 3083381200022 ~,437.34 0.18 3W46AD 1.000 TOTAL (Also enter on line 5, Recaoitulationl $ (If more space is needed, insert additional sheets of the same size) 38:,472.48 'REV-1511 EX+ (12-99) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Anna W. Zeigler ITEM NUMBER A B. FILE NUMBER 21 05 0196 Debts of decedent must be reported on Schedule I. DESCRIPTION FUNERAL EXPENSES: 1. Myers Funeral Home, Inc. 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. Snelbaker & Brenneman, P.C. Attorney Fees 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. 1 Barry L. Heckard, Sr., Tax Collector 2 Bricker's Auction appraisal fee Total from continuation schedules . TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) $ 3W46AG 1.000 AMOUNT ,706.00 2,500.00 306.00 1i,282.63 80.00 , 3',757.33 151 631.96 Estate of: Anna W. Zeigler 185-50-0896 Schedule H Part 7 (Page 2) 3 Bricker's Auction commission on sale of household goods sold at auction ,657.25 4 Cumberland Law Journal advertise Executrix notice 75.00 5 L.G. Connor Real Estate Appraisers Ltd real estate appraisal fee 300.00 6 Patriot-News advertise Executrix notice 126.27 7 PPL Electric electric service 81.43 8 Register of Wills filing fee for Inheritance Tax Return and Inventory 30.00 9 Settlement Charges associated with sale of real estate a. Transfer taxes - $650.00 b. Mechanicscburg Boro, sewer charges - $303.42 953.42 10 United Water PA water service 13.52 11 Verizon phone service 20.44 12 Reserve for filing fees, accounting costs and other miscellaneous costs associated with the administration of Decedent's estate 500.00 Total (Carry forward to main schedule) 3,757.33 REV-1512 EX + (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Anna W. Zeigler SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21 05 0196 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER 1. DESCRIPTION VALUE AT [lATE OF DEATf-i Hospice medical services 3,000.00 2 Neurology Center PC medical services 110.00 3 PPL Electric electric service 36.48 4 United Water PA water service 6.76 5 Verizon phone service 21. 59 3W46AH 2.000 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 3:,174 . 83 \ \ REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYL VANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Anna W. Zeialer SCHEDULE J BENEFICIARIES 1 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers underSe~ 9116(~0.~] Betty Z. Sponsler 7 Village Road Mechanicsburg, PA 17050 FILE NUMBER 21 05 0196 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE NUMBER I 100% Residue: 84,665.69 Daughter 84,665.69 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN PSOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET I \I NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS " 3W46All.000 TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET (If more space is needed, insert additional sheets of the same size) $ 0.00 I JANNA W. ZEIGLER, of the Borough of\>lcl:'anlcsbu County.;' of. Cumperland and s'tate ofPennsylvani3.) bCLng of mindJ memory, and understanding, do make, publiL:l <.,nd iecl this to be my last Will and Testament, hereby r':vc'~ct.ng an making void, all former wills J codicils and OtlL!' dispositions by me at.any time heretofore made. 1. i"di'rect my 'executor J hereinafter' name~., k) pay a soon as practicable after. my decease all my jur;; c.ebts an the ,', expenses of my la~t illness .,and burial. 2. All the rest, residue and remainder cf 'JY ,estate rea1) , , ' '. . 4lf persollal, and.miX~g.;;-'J ':f~e;l,'ve.;'d(:}vlse" and bequea':;h unto my _~,..(:-,;.;:t.i- : r ,,!,,;~,,)i:'';_;_- husbl:llld~' '.John>:A.~ ;'a. zeigler. ~ J,' .",. :& . j". , ..... . 3 ~:l(~~~~~~~\~~~pr.~~e?ease me, i:1en an.d 1n hat event; .I give, :devlse'and;~b~,queath all of my ,suld estate to my daught~r, Betty Z'. Sponsler. 4-~ ~,,-').. .' I hereby/nominat,e, .consti tute and apI,c<J. ;:.t John A.. H.Zelg1er, executor of this my last~,~Lll ana. IN WITNESS: WHEREOF J I JANNA W. ZEIGLE:R l t1e 'J~esta ~ -. '.. Shoula:my saidhusband:];lr~decease me, then ar:.d in hiE: , I . ~ffl'} ".;, ':,;.~L:,,'.,/l>:':t?; 't~, "', ' ..' .,' hereby"nominate Il~cop.!:;ltltut~:'~d' a,ppointmy sG.lcl d,.:n.~hter, .;; .' . ,~'G.' ,;f,f,~,~,:t",;),I;:~;~"'". ,,':",";, ' , Betty:Z. . S:ponsle~Jexecutrlx'of' this my last~d 11 ana, Tes 1>. ......: , ,'A. '-" .,; '<.',_, '-~' _' ',' . have hereunto set my h~d axld.. seal to this m~' ] as u Wj.ll Testament th:1:s: '0 ~~;",,:.>, ';' _ ~ ' " . :'l,;.p"'~;_-(,: :'",; y:"i;~i~.i.;:: 'il1 ,".", ,.,1.'.... , <,.J'. '~f~,\t~31"i;.;e~,f$, ',0 .,'.,'S" O'rfAn '_ . -' ~6,). ~.e~~,( SEAL COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 II REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 006002 SNELBAKER RICHARD C 44 W MAIN STREET MECHANICSBURG, PA 17055 ACN ASSESSMENT CONTROL NUMBER AMOUNT -------- fold 101 $659.~6 ESTATE INFORMATION: SSN: 185-50-0896 FILE NUMBER: 2105-0196 ZEIGLER ANNA W 11/16/2005 11/16/2005 CUMBERLAND 02/24/2005 DECEDENT NAME: DATE OF PAYMENT: POSTMARK DATE: COUNTY: DATE OF DEATH: TOTAL AMOUNT PAID: $659.96 REMARKS: CHECK# 129 SEAL INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAlJJGH REGISTER OF WILLS REGISTER OF WILLS