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Home My WebLink About05-31-06 --.J 15056041046 REV-1500 EX (05-04) PA Department of Revenue f Bureau of Individual Taxes ~.2' '.' ,l>. Dept. 280601 ~ ~~ Harrisburg, PA 17128-0601' ."~ ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY County Code Year File Number d-..I (j (-, [.' '.~"3 't' Date of Birth 11,3 ;>...'1 9;J.o I O? ~ I f' ;2. <7 630?a..OOCc Decedent's Last Name Suffix Decedent's First Name MI COI'JAfid.. Uiol.e.-r f (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW - 1. Original Return c::> 2. Supplemental Return c::> 3. Remainder Return (date of death prior to 12-13-82) c::> 4. Limited Estate c::> 4a. Future Interest Compromise (date of c:> 5 Federal Estate Tax Return Required death after 12-12-82) c::> 6 Decedent Died Testate c::> 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) c::> 9 Litigation Proceeds Received c::> 10. Spousal Poverty Credit (date of death c::> 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number [Ll1-iNe Firm Name (If Applicable) Pf HIf~ b l> 1,J. 1/ 7 ),,9;.. 06!,'1 REGISTER Of; WILLS USE ClNLY First line of address 16 f ; N e ~ 01. J- ~ ~ 0 It- J Second line of address City or Post Office State ZIP Code DATE FILED ~ITS~ /; ell.. (", ;e) Iff /73/6 --J Correspondent's e-mail address: 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 complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATU E OF PERSON RESPONSIBLE FOR FILING RETURN /11, DATE 5-3 ADDRESS SI~;;TUt ~;RE~:~1t~ER~~~pJE~~;AtVE (j t'~tl ~. jJ /f /7 .3/~ DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056041046 15056041046 --.J ;\ / '\...;, /~~j ---.J 15056042047 REV-1500 EX Decedent's Name: Decedent's Social Security Number /6.3J...<t QJ...ol RECAPITULATION Real estate (Schedule A). 2 Stocks and Bonds (Schedule B) 3 Closely Held Corporation. Partnership or Sole-Proprietorship (Schedule C) 3 4. Mortgages & Notes Receivable (Schedule D) 5 Cash. Bank Deposits & Miscellaneous Personal Property (Schedule E) . 6 Jointly Owned Property (Schedule F) c:::> Separate Billing Requested 7 Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) c:::> Separate Billing Requested. 8 Total Gross Assets (total Lines 1-7). 9 Funeral Expenses & Administrative Costs (Schedule H). 10 Debts of Decedent. Mortgage Liabilities, & Liens (Schedule I) . 11 Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) . 13 Chartable and GO'Iernmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) TAX COMPUTATION. SEE INSTRUCTIONS FOR APPLICABLE RATES 15 Amount of Line 14 taxable at the spousal tax rate. or transfers under See. 9115 (a)(1.2) X 0__ 16 Amount of Line 14 taxable at lineal rate X o !LSD ) gl f~ s..ft.'? 17 Amount of Line 14 taxable at Sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X 15 . 19 TAX DUE 10. 11 12. 13 14. 15. 16 17. 18. 19 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15056042047 ,. I / 0 3 DO D. 00 '160.00 2 4. . 5. J.. I :J- 'I' .;z.. · <if 'Jt 6 . 7. 8 I 3 II 8' 1./0 9 q 'I d).. · g: :J.. /?3.<t9 ([;ll.l? (j 8' 59 If · b lr ? .b >2:>.4 8'. (' Y' . 8~ 0 ?Jll.{ 6'. /-9 3 -:;r ~ "5". ((; '/J . . . C) 15056042047 ---.J REV-1500 EX Page J File Number ();;, 3 r Decedent's Complete Address: DECEDENTS NAME J J/()L~ + E. &ttJMrI- STREErAODRESS /0/ LO.AlJ- /Jt~dd'()u) Sf. hi eeJvr-AJ ;es b t( ~ CITY fl.: STATE Pit ZiP /7a.rJ Tax Payments and Credits: Tax Due (Page 2 line 19) 2. Credits/Payments A Spousal Poverty Credit B. Prior Payments C Discount I' /9 'l ;}.8' (1) :,3 ~'g-i'~2___. , Total Credits (A + 8 + C ) (2) ] (.I). y /. ll__________ , 3. Interest/Penalt'! if applicable D. Interest E. Penalty Total Interest/Penalty ( 0 + E ) (3) 4. If line 2 IS greater than Line 1 + Line 3. enter the difference This is the OVERPAYMENT. Fill in oval on Page 2, 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. (5) "3 0y/3 Y . A. Enter the Imerest on the tax due. (5A) B Enter the total of line 5 + 5A. This is the BALANCE DUE. (58) ~, (0 91 _39 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACiNG AN "X" IN THE APPROPRIATE BLOCKS 2 Old decedent make a transfer and: a retain the use or income of the property transferred:. b retain the right te 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'? . if death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .. D!d decedent own an "In trust for" or payable upon death banK account or security at his or her death? Old decedent own an Individual Retirement Account. annuity, or other non-probate property which comains a beneficl3rY deSignation? .... Yes 3 4 il No ~ ~ ~ ~ ~ ~ i---: 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 January 1, 1995, the tax rate Imposed on the net value of transfers to or for the use of the survIving spouse IS three (3) percent [72 PS S9116 (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 zero (0) percent [72 PS S9116 (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 zero (0) percent [72 P.S. S9116(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 four and one-half (4.5) percent, except as noted In 72 PS S9116(12) [72 PS. s9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S s9116(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-1582 E><+ (6-98) j.-, ..~/-li~ '[::,~WJ~ COMMO~JWEA,LTH OF PENNSYLVANiA. IM1ERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER iTEM r~UMBE R , ~.~-------...... , ____j)-'oLe"t F_ &NIli:d~_~ All real property owned solely or as a tenant in common must be reported at fair market value, Fair ;narket value IS defined as the orice at vvhlch property v.'Olld be ex:hang'2rl t,etween a willl~q buyer ar:d a Willing seller neither being compelled to buy or seil. both Ilavlcg reasonable know'edge of the re'evant facts Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F. -- I I i i i I I ! I tJ;<3f/ DESCRIPTION VALUE AT DATE OF DEATH A t1JUcA houSe. , .;{ i5 ed /(O(M'/ /"; ;?1 () ;1) /l 'f) e. -rWjII. C U /h be,U,r;,;L C()tl jfJ ~ ~ //()/ otJo. ex) TOTAL (Also enter on line 1, Recapitulation) S 110, OOO.OiJ (if more space is needed, insert additional sheets of the same size) IF TAXES ARE ESCROWED, FORWARD TO MORTGAGE CO $1.00 FEE FOR ADDITlONAL RECEIPTS PAYABLE TO MARY A. MURRAY. TAX COLLECTOR 1375 CREEK ROAD BOILING SPRINGS, PA 17007-9656 DESC ASSESS. NO -22001684 MAP NO: 22-24-0785-051 101 LONGMEADOW STREET ACRES .210 DEED 00185/ 00781 TRINDLE SPRING MANOR LOT 32 PB 4 PG 4 Residential Building RESIDENTIAL TAX PAYER CONRAD, VIOLET E 101 LONGMEADOW STREET MECHANICSBURG PA 17055-4035 OFACE MAR-JUNE MON & WED 5PM-7PM HOURS SPEC HRS: APR 19 & 25 5-PM-7PM JUL Y-DEC SEE SCHOOL BILL PHONE: 717-258-6420 Assessed Land Improvement Mineral Total Values 25 000 76 940 0 101 940 COUNTY OF CUMBERlAND DIscount Face Pen Rates .00219700 .00219700 2 % COUNTY R/B 54.93 169.04 219.49 223.97 241 Rates .00018000 .00018000 2 % COUNTY LIB 4.50 13.85 17.98 18.35 21 TOWNSHIP OF MONROE Rates .00020000 I .00020000 2 % MUNIC. R/B 5.00 15.39 19.98 20.39 2: TAX AMOUNT DUE-> $257.45 $262.71 $28 I~ Paid On or A1ter ~~~1/2006 5/01f2006 7/01/ I~ Paid On or Be~ore 4 30/2006 6/30/2006 Control No: 022 - 001684 TAXPAYER COPY 2006 Statement of Real Estate Taxes Bill Date' Bill No: IF NOT PAID BY 1211512OO61H1S BIll. Wll BE RETURNED TO TAX ClAIM BUREAU FOR COl.LECl1ON AND RUNG OF A UEN AGAINST YOUR PROPERTY. 3/01/ 12/1 sr.t .. SEE REVERSE SIDE OF BILL FOR A BREAKDOWN OF YOUR COUNTY TAX DOLLAF Return Bill with Payment. For a Receipt, Enclose Self Addressed Stamped Envelope. t1RS VIOLET E CONRAD 101 LONGMEADOW ST MECHANICSBURG PA 1705 PPL Corporation Two North Ninth Street Allentown, PA 18101-1179 Dividend Check Account Number: 3015339800 Dividend Record Date: Payment Date: APRIL 1,2006 Check Number: Amount: $110.00 Print Number: 03/10/2006 02545406 49845000738 Number of Dividend Class of Stock Shares Rate PPL CORP COMMON 400 .2750 Dividend Amount 11 0.00 You can have your dividends deposited directly into your bank account. To request a Direct Deposit Authorization form, or if you have any questions regarding your account, visit the Investor Center at www.pplweb.com or call toll free: 1-800-345-3085 To access your account online, please visit www.shareowneronline.com Please detach and retain this statement for your records. 01 REV.1508 EX + (1-97) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERiTANCE TAX RETURN RESIDENT DECEDENT ESTATE OF t//oLe+ ;;. t-~;J121h1 FILE NUMBER O~JY 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 {;"6 f/l'te e,ket-k./;uJ. 1J..cJ.. '12S~i,J /f.e (It e d~1 .,; ,f f€~5()N Ifl P /lot oQ,t.:t,t /3 .3 70. ~(p , f, C'}J... c SY. 3,100.00 TOTAL (Also enter on line 5, Recapitulation) $~/;,2. if/;( . g....~ (If more space is needed, insert additional sheets of the same size) Total Banldllg Statenlellt i'~" C E;11l k ~~ PNCBANK For the period 03/30/2006 to 04/26/2006 Primary account number: 50-0475-5366 Page 1 of 3 Number of enclosures: 0 ELAINE M HARBOLD 15 PINE RIDGE RD EAST BERLIN PA 17316-9134 g For 24-hour banking, and transaction or L.=. interest rilte infonniltion, sign-on to 'ft' Account link'f,) by Web on pncbilnk.com. For customer service call1-888-PNC-BANK between the hours of 6 AM ilnd Midnight ET. Pilril servicio en espilrlol, 1-866-HOlA-PNC Moving? Pleilse contilct us ilt 1-888-PNC-BANK (!5J Write to: Customer Service PO Box 609 Pittsburgh PA 15230-9738 !Q; Visit liS ilt pncbilnk.com ~ Iil TOO terminill: 1-800-531-1648 - For hCZlring imp;jirerl client.<; onh- Reiationship Overview Bank Deposit Accounts Description Rq;lIL'1 Clre< kill.~ P/~l'h)n~~:-l!ll.~t-.~ !\I/)l!~\- \l:,ll-kt'.,t Account Number Deposit Balance S()-() 17S-")3GG SO-eH)] :2-2182 '2,:2:10IjO I f;7~)1 2,:\97 .94 Total Deposits For' information on exciting offers and promotions for our free Online Bill Payment service} stop by any PNC Bank office} visit pncbank.comJ or call l-BOO-PNC-BANK for further details. Senior Checking Plan Reguiar Checking Account Summary ,'\ccount number: 50-0475-5366 Eliline M Harbold Balance Summary '1.072 .St> 110.00 Checks and other deductions I,~),)U)I; Endi ng balance :2,:2::1O.GO Pleilse see the Activity Detail section for additionill information. Beginning bzd cHlce Deposits and other additions Avel'age monthly balance 2,B(i.IO Cllarges and fees .00 Transactioll Summary Checks paid! \vithdrawals Check Card pas Signed transactions Check Card/Bankcard pas PIN transactions 7 o (J Total A TM tr.:msactions PNC Bank ATM transactions Other Bank ATM transactions o (J (J As of 04/26, il totill of $2.08 in interest WilS eillned this yeilr. Interest Summary ,6.nnLJal Percent.?lge Y;plrl Earnprl (APYEI Number of days in interest period Average collected balance for APYE Interest Earned this period o ()( 1% o 00 . on REV-1511 EX+ 112-99) '~: t>1~1,,'1 ft" ;~Yi :r~ r~)~l1>>~" COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF () ;(J L'€. + E. (!t'UJ) /2 H d Debts of decedent must be reported on Schedule I. FILE NUMBER ()).,3 f ITEM l DESCRIPTION NUMBER AMOUNT A. FUNERAL EXPENSES: 1 /lilt-I.. fJ e z, z- , , FtlIlJUtA-L #oP\.-~ 6, 15/. C;9 e <</II b~,l.t ~cf tJ.;til~ /h t!--,II1 oIL , . tf--( (j-Jf/1t(/' e"cl J . /, /JtJ.ou 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 Fees 3 Family Exemption (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address I City ___________________________ State _____ Zip I Relationship of Claimant to Decedent 4. Probate Fees ~ fp' .00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. TOTAL (Also enter on line 9, Recapitulation) $ 3'.17 ).tftj (If more space is needed. insert additional sheets of the same size) R.EV-15'2 EX- f ~,~,," I}::,W~ c:)r\"i~/C\\'VE.A.L TH OF PENNSYLV::',N:.!'J, !MjFR!-;'NCE T~X RETL'RN RES!DEm DECEDENT ESTATE OF I SCHEDULE I I I DEBTS OF DECEDENT, I I MORTGAGE LIABILITIES, & L1E~-' --------_.~-------~--,_..._~,--" .------------,-..---.--..---------. -_._-_._--~_.~---'---------_.__._----_._._---,-_._-----_.~--------------_.._-- FILE NUMBER Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses -N~~;B~~~- -r---------- n------------DESCRIPTION---~-----------r---\;~1,~ED~TA~~TE--- --------- ---------+------------------ tv /1-6 h/~,j- fa,,; I I I I I I I I I I --------~-_._._--- /h(kt-H~ - fh.a1L fa;-~ ',/0, l/J../.17 ---.--~--------__r___-~- ------------ ~OTAL_(AISo enter on ~e 10, Rec~p~~~~IO~)_~i1o~ !I~LLq_____ (If more space IS needed, insert additional sheets of the same size)