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F AMIL Y SETTLEMENT AGREEMENT and DOCUMENT A nON OF RECEIPT AND
RELEASE: ESTATE OF ISABEL BETTY WIER
Estate Number Z- 005"- 0 () <( K S
The parties to this agreement named herein under declare the following:
1. They are willing to forego the formal administration of the Estate of Isabel Betty
Wier of Mechanicsburg, Pennsylvania in the interest of economy.
2. They are fully aware of all receipts and disbursements that have occurred in the
estate.
3. They agree to the method of distribution of the assets of the estate ofIsabel Betty
Wier.
Additionally, the Executor/Personal Representative declares that all debts, taxes and other
liabilities of the estate have been paid and satisfied from the assets of the estate and that
the disbursement of the remainder of the estate to the sole beneficiary has been
accomplished.
Additionally, the sole beneficiary declares that she has received the distribution ofthe
estate and that she releases the Executor/Personal Representative, K. E. Wier Chrisemer
of 102 School Lane, Trenton, New Jersey, from all liability which may arise from his
service as a fiduciary.
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This agreement is dated and sworn on the 'tD day of July, 2006.
K.e. uj~ ~
Bernice L. Wier, beneficiary
by K. E. Wier Chrisemer, Power of Attorney
K. 8. (j)vJ ~
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K.E. Wier Chrisemer, Executor/Personal Representative of the Estate ofIsabel B~y
Wier
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Witnessed by:
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
REV-1607 EX AFP (03-05)
CHRISEMER WIER
102 SCHOOL LN
TRENTON
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
07-03-2006
WIER
06-17-2005
21 05-0985
CUMBERLAND
101
ISABEL
B
Amount Remi Hed
NJ 08618
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, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE
~
RETAIN LOWER PORTION FOR YOUR RECORDS
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REV-1607 EX AFP (03-05)
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~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ...
ESTATE OF WIER ISABEL B FILE NO. 21 05-0985 ACN 101 DATE 07-03-2006
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY 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: 05-29-2006
PRINCIPAL TAX DUE: 82,229.37
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
04-14-2006 CD006562 10.00- 82,239.37
06-06-2006 CD006803 432.07- 432.07
TOTAL TAX CREDIT 82,229.37
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
IE 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. )
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~ 1041
Department of the Treasury-Internal Revenue Service
u.s. Income Tax Return for Estates and Trusts
~@05
OMB No. 1545-0092
A Type oi entity (see instr.):
00 Decedent's estate
D Simple trust
D Complex trust
D Qualified disability trust
D ESBT (8 portion only)
D Grantor type trust
D Bankruptcy estate-Ch. 7
D Bankruptcy estate-Ch. 11 City or town, state, and ZIP code
D Pooled income fund/re ~\ t-(N'I. f\.) J 10 ~ i l f?
B Number of Schedules K-1 F Check rA1 rcl
attached (see applicable 0 Initial return is Final return
Instructions) .. boxes: 0 Chan e in fiduciary
G Pooled mortgage account (see page 14 ot the instructions): D Bought
For calendar year 2005 or fiscal year beginning , 2005, and ending , 20
Name of fstate or trust (If a 9rantor type trust, see page 12 of the instructions.) C Employer identification number
r. t. ().::r: S' c, e... . :J.Y- 7.-0 : ~ 1"1. f {" 7 r-
Name and title of fiduciary 0 Date entity <;reated
I c.h.J';~< v...~I ~(17 05-
Number, street, and room or suite no. (If a P,O. box, see page 12 of the instructions.) E Nonexempt charitable and spllt-
interest trusts, check applicable
boxes (see page 13 of the instr.):
D Described in section 4947(a)(1)
D Not a private foundation
D Described in section 4947 a (2
D
/O~
5" c..L,,- 0 () I
L. c.{ /I\. e.
1 Interest income. 1
2a Total ordinary dividends. 2a i 0/"2.'"1 <r? I:
b Qualified dividends allocable to: (1) Beneficiaries . _. . .. .. _ _. _ _ _ . _. _ _ (2) Estate or trust _ _ _ . _ _ _ _ _ _ _ _ _ _ _ . . . _
III 3 Business income or (loss) (attach Schedule C or C-EZ (Form 1040)) 3
E 4 Capital gain or (loss) (attach Schedule D (Form 1041)) . 4 Ir,"1. '1.. <t' " ~ <I
0
(.) 5 Rents, royalties, partnerships, other estates and trusts, etc. (attach Schedule E (Form 1040)) 5
.5
6 Farm income or (loss) (attach Schedule F (Form 1040)) 6
7 Ordinary gain or (loss) (attach Form 4797) . 7
8 Other income. List type and amount ..---...----.-.----.---..--------.--.------...--------------. 8
9 Total income. Combine lines 1, 2a, and 3 through 8 .~ 9 .,y., c..;,,, <is'
10 Interest. Check if Form 4952 is attached ~ D 10
11 Taxes 11
12 Fiduciary fees 12 -Z,". ",Sf) of)
13 Charitable deduction (from Schedule A, line 7) 13
Vl 14 Attorney, accountant, and return pre parer fees 14 --z.. "Z.. S 00
c:
0 15a Other deductions not,;>ubject to the 2% floor (attach schedule) 15a
+:
(.) b Allowable miscellaneous itemized deductions subject to the 2% floor 15b
::l
'0 16 Add lines 10 through 15b 1~5' 16 .( ~,f-') 00
III . r 17 h.-1
0 17 Adjusted total income or (loss). Subtract line 16 from line 9 I" ~
18 Income distribution deduction (from Schedule B, line 15) (attach Schedules K-l (Form 1041)) 18 "2 1c,C;t(S' l.tl;.-
19 Estate tax deduction (including certain generation-skipping taxes) (attach computation) 19
20 Exemption 20 In CO CO
21 Add lines 18 through 20 - .~ 21 "l.1 i4l: 'IS-
22 Taxable income. Subtract line 21 from line 17. If a loss, see page 20 of the instructions 22 0 DO
23 Total tax (from Schedule G, line 7) 23 -" t:'JO
24 Payments: a 2005 estimated tax payments and amount applied from 2004 return 24a - -
Vl
... b Estimated tax payments allocated to beneficiaries (from Form 1041- T) 24b
c:
III Subtract line 24b from line 24a 24c
E c
>. d Tax paid with Form 7004 (see page 20 of the instructions) 24d
(U
Q. e Federal income tax withheld. If any is from Form(s) 1099, check ~ D 24e
'0
c: Other payments: f Form 2439 __ __ _ __ __ __. __.. __ __ _ __ _ ; 9 Form 4136 __ __ _ __ __.. _ __ __ __. __. __ ; T otal ~ 24h
(U 25 Total payments. Add lines 24c through 24e, and 24h . 25 f\ (yo
>< .~
~ 26 Estimated tax penalty (see page 20 of the instructions) 26
27 Tax due. If line 25 is smaller than the total of lines 23 and 26, enter amount owed 27 '" 11l~
28 Overpayment. If line 25 is larger than the total of lines 23 and 26, enter amount overpaid 28
29 Amount of line 28 to be: a Credited to 2006 estimated tax .. b Refunded ~ 29 0 1......0
Under penalties of pe~ury, 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,
Sign correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Here ~ ~{)~ QP~ I ':/..1 l 0 I' r May the IRS discuss this return I
( ? ~.., with the preparer shown beiow
Signature of fiduciary or officer representing fiduciary Date EIN of fiduciary if a financial institution (see instL)? 0 Yes 0 No
Paid ~ Preparer's , Date I I Preparer's SSN or PTIN
Check if
Pre parer's signature self-employed 0
Firm's name (or ~ I EIN
Use Only yours if self-employed), I
address. and ZIP code Phone no. ( )
D
For Privacy Act and PapelWork Reduction Act Notice, see the separate instructions.
Cat. No. 11370H
Form 1 041 (2005)
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PA.41 · 2005 (09-05)
PA Fiduciary Income Tax Return (I)
PA Department of Revenue
Harrisburg, PA 17128-0413
PLEASE PRINT IN BLACK INK
Federal Employer Identification Number Decedent's Social Security Number
0504110024
10 07Z.g~(5
"( 2.
~ 5 i 0 <?
Daytime Telephone Number
Co O{]e, -z. i)2-?(
OFFICIAL USE ONLY
Name of Estate or Trust (See Instructions)
':/.-- ..'........""" .~.....
~J.JLCs ft. IS. E L. l?> E'.-T -r r Wi C R J
C6 ;l Name and Title of Fiduciary
~J: i/
lIi:i 11J ( 2- {<. c. H R I S f. 11-( E- (2,
r:,: j Address of Fiduciary (Street Number and Name, etc.)
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c::> Extension Enclosed.
c::::> Amended P A-41. If filing an
amended return, fill in this oval.
c::> Fiscal Year Filer. Fill in this oval.
FY beginning _/_/ 05
and ending _/_/_
c. s y-,fl-r (::
t
Ii
~l;,j \ 0 L.
oe.( "City or Post Office
.~~j J
t.... '1 ~ ~ I
-c- IL ~ ~ c: "'"
SCf\.Oo
L
<... A- t\J c:.
Residency Status. Fill in only one oval.
..., R Pennsylvania Resident
c::> N Nonresident
If "N", Name of Stale
State
ZIP Code
OS uJ&'
Final Return.
- F Enter Ending Date:
o ~f; ~/!!2P
TO rJ
IV;;-
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~ Estate or Trust Identification Change. Fill In this oval if any of the identification or filing information you NO
entered is different from the 2004 PA-41 , or if the estate or trust did not file a 2004 PA.41.
Submit all required Pennsylvania supporting schedules. I If Line 3, 4, or 5 is a LOSS, fill in the oval ~
next to the amount. .,.
Do You Want a 2006 PA-41 Booklet?
Fill in this oval completely jf you do nol
want a 2006 PA-41 Tax Booklet.
1. PA TAXABLE INTEREST INCOME... 1.
Dollars
Cents
2. PA TAXABLE DIVIDEND INCOME. . . . . . . . . . . . . . . . . . . . . . . . . . . . . " 2.
3. NET INCOME or LOSS from the Operation of a Business, Profession, or Farm. lOSS
. . . . . . . . . . . . . . . . . . . . . c::> 3.
.
O'l '2.7.~ b
4. NET GAIN or LOSS from the$aJe, Exchange, or Disposition of Property.
.
5. NET INCOME or LOSS from Rents, Royalties, Patents, or Copyrights.
................,...",...,."..... .
lOoSoS
c::> 4.
~s 2Y'Z.S-9
...,',......,..... .
LOSS
'" c::>
5.
6. ESTATE or TRUST INCOME. . . . , . . . . . . . . . . . . . . . . . . . . . . . . " 6.
7. TOTAL TAXABLE INCOME. Add only the pOSitive income from Lines 1, 2, 3, 4, 5, and 6.
Do not add losses. ,..................,.........................,........... 7,
.
.
8. DEDUCTIONS from PA SCHEDULE DO.
8.
71.{ 0 2.. 0 . C) )
;1{ 02. O.l(s
19.VO
9. NET PA TAXABLE INCOME. Subtract Line 8 from Line 7,
...,..,."....,..... ,
9.
10. TOTAL PA TAX LIABILITY. Multiply Line 9 by the tax rate 3.07% (0.0307) .
. .. . 10.
I.') . 0 a
11. 2005 ESTIMATED PAYMENTS and CREDITS. . . . . '.. " . . . . " . ,
11.
12. NONRESIDENT TAX WITHHELD from PA SCHEDULE(S) NRK-1. . . . 12.
13. TOTAL CREDIT for TAXES PAID by PA RESIDENT ESTATES or TRUSTS to OTHER
STATES or COUNTRIES. , . . . . . . . . , . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.
.
14. TOTAL OTHER CREDITS from PA Schedule OC. . .
, . . . . . . . . 14.
15. 2005 PAYMENTS and CREDITS. Add Lines 11,12,13, and 14,
.......,.......... .
.. 15.
16. TAX DUE. If Line 10 is more than Line 15, enter the difference here.
,..........,.... .
16.
0.00
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EC
Fe
0504110024
0504110024
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