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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-961
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
GARDINER JAN M
524 LANDSVALE ST
MARYSVILLE, PA 17053
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ESTATE INFORMATION: SSN: 198-03-2235
FILE NUMBER: 2105-0886
DECEDENT NAME: KAUFMAN PARKER E
DATE OF PAYMENT: 05/17/2006
POSTMARK DATE: 05/1 7/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 10/02/2005
NO. CD 006707
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $10,316.03
I
I
I
I
I
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I
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TOTAL AMOUNT PAID:
$10,316.03
REMARKS: JAM M GARDINER
CHECK# 1028
SEAL
INITIALS: CM
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
~j
FORM 16 REG. WILLS
INVENTORY
of all real and personal estate of
PARKER E. KAUFMAN
deceased, late of
615 HILLTOP DRIVE
NEW CUMBERLAND
(Number and street)
(city)
(Borough or Township)
,Cumberland County, Pennsylvania, 17070
(Zip Code)
NEW CUMBERLAND BOROUGH
who died
10/02/2005
(date of death)
PERSONAL ESTATE SCHEDULE
PLEASE SEE BELOW:
SCHEDULE A REAL ESTATE
$204,528.88
SCHEDULE E PERSONAL PROPERTY
$55,181.02
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Copyright 2000 David James Thorpe, Esq.
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AFFIDAVIT OF EXECUTOR OR ADMINISTRATOR
QCommontuealtb of ~enntt!,lbanta
QCount!' of CUMBERLAND
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ss:
Personally before me,the undersigned authority, a
NOTARY PUBLIC
in and for said County
who, being duly sworn according
and State, appeared
JAN M. GARDINER
to law, deposes and says that he is the executor or administrator of the estate of
PARKER E. KAUFMAN
, deceased, that the foregoing schedules constitute a complete inventory
and appraisement of the real and personal estate of
PARKER E. KAUFMAN
deceased, except real estate outside the Commonwealth of Pennsylvania, that the figures opposite each item of real and
personal estate in the foregoing schedules are determined and stated by the undersigned to be fair value of said items as
of the date of the decedent's death.
thi.s
day of MAY 2006
G. W\.~~
~.'~ARDINER
Sworn and subscribed before me
}
EXECUTOR-ADMINISTRATOR
NOTARIAL SEAL
CARMEN MALDONADO. Notary Public
Camp Hili BOlO, Cumberland County ADDITIONAL INSTRUCTIONS
I M~' CommiSSion Expires January 19, 2010
"r--il1e-jnventory s a be i1ed no later than the date the account is filed or the due date, including any extension, for the
filing of the Inheritance Tax Return (9 months from the date of death) whichever comes first.
2. A Supplemental inventory must be filed within thirty days of discovery of additional assets.
3. An original and two copies must be filed.
4. Additional sheets may be attached as to personalty or realty.
5. See Section 3301 et seq. Of the Probate Estates and Fiduciaries Code of 1972, as amended.
6. The inventory must be typed.
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Copyright 2000 David James Thorpe. Esq.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF
PARKER E. KAUFMAN
FILE NUMBER
21-05-0886
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 which is
jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
$204,528.88
REAL ESTATE- 615 HILLTOP DRIVE
NEW CUMBERLAND PA 17070
NET SALES PROCEEDS-SEE ATTACHED SETTLEMENT SHEET
TOTAL (Also enter on line 1, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$204,528_88
Copyright 2000 David James Thorpe, Esq.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
PARKER E. KAUFMAN
FILE NUMBER
21-05-0886
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.
DESCRIPTION
VALUE AT DATE
OF DEATH
BELCO ACCT 36690
A. SAVINGS
B. CHECKING
C. MONEY MARKET
$1,703.16
$48.80
$3,349.16
BELCO CERTIFICATE OF DEPOSIT
2. #37110 C.D. $30,509.98
3. #41177 C.D. $5,001.14
4. WACHOVIA CHECKING ACCOUNT $1.894.66
5. 1996 CADILLAC $4.265.00
6. PEERLESS INSURANCE-REFUND $276.22
7. CONTENTS OF HOUSE-FROM AUCTIONEER $1.860.00
8. RADON REBATE $190.00
9. HOUSEHOLD FURNISHINGS $5,885.00
10. COM CAST REFUND $12.34
11. MONTOUR OIL $185.56
TOTAL (Also enter on line 5. Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$55,181.02
Copyright 2000 David James Thorpe, Esq.