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OATH 0.' PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUNIlERLANll
Hu(. : 01
} l1ui ,II\~
ss
'~M JflH 13 i\\1 :1\1
Clb:, lur\
CUll I', '.. P^
The petltloner(s) above-named swear(s) or afflrm(s) that the
statements in the foregoing petition arc true and correct to the best
of Ihe knowledge and belief of petltloner(s) and that as personal
representatlve(s) of the above decedent petltloner(s) will well and
truly administer the estate according to law.
affirmed and subscribed J -~\.,; \ m rn Q ",In l-D ""'
13TH day of Connie N. Nanges \I' I
ARY 19...2.L) K<<.r., .1. ~1r,,~ ~ '"
~~-a- Katie Fay Stover
Reg/sler l -, Vi
No. 21 - 94 - 167
Estate of George L. Shoemaker
, Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW FEBRUARY 23, 19~, in consideration of the petition on
Ihe reverse side hereof, satisfactory proof having been presented before me,
lT IS DECREED that Connie H. Hanges _and Katie Fay Stover
Is/are entitled 10 Lellers of Administration, and in accord with such finding, Lellers of Administration
are hereby granted to. Connie H. ~langes and Katie Fay Stover
In the estate of Georlle L. Shoemak.er
FEES
Lellers of Administration ..... $ 18 . 00
Short Cerllflcales(S ) . . . . . . , . .. $_1.5...00-
Renunciation .,.............. $---
JCP TOTAL _ ~ 3~:!
Flied ... f.~~~VM~. ?.3. . . .. A.D, 19.-9.4.
Thomas L. Br1ltht. ESQuire II 30066
ATTORNEY (Sup, CI. 1.0. No.)
HARK~ WF.IGLE AND PERKINS
!1~"ast nnw .straM
ADDRESS
Shippensburg, PA 17257
PHONB
(717) 532-7388
Mailed letters and order to attorney on 2-23-94.
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COMMONWEAllIl Of PENNSYlVANIA
DEPARTMENT Of REVENUE
om, 180601
HARRISBURG, PO\ 17118.0601
. HTjS NAME IlAST. 'IRST, A,ND MIDDLE It.mlAII
'OR OATIS 0' DIATH AmR 12/31/91 CHICK HUI
IP A SPOUSAL .
f()_V'!!!_~R~~L~_'S .r.LA.LMID I J
PILI NUMBlR
21-9/1-0167
ICCl.UN1Y c<:)u~ _ __ . _ _Y_E_A.R
ON' MPUH ADDRESS
.:nv,lloo',I. 11',9'1
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
NUMBER
_.._ _u..._...._
ffi
a "Shoemnker. Geol1\~Jl" '=r-~'''---'' "l^ II ,.-., ----- --
~ O\.IAlmURIIY NUMBER DA. Or OtAltl uA Of BIRTH
.._~,_ ___!.ZJ::44-8836 .____....___L9.-12:9J.. ___.1::11.-.11..,__
I!! IX) I. Original Relurn [] 2. Supple menial Relurn
~~E [J 4, lImlied E"o'e 0 40. FUlu,e Inlerell Compromlte
oog lIar dole. 01 deolh after 12.12.B2)
~1Il [J 6, Oecedonl Died Te,'ole [J 7, Docedonl Molnlolned 0 living Tru,' _ B.
__~._ (Attach copy 01 Will) .__~~.0_c~f'E'_T!."...!l___,___.___________,
ALL CORRESPONDENCE AND CONPIDENTIAL TAX INFORMATION SHOULD BE DIRECTBD TO.
NAM -." . ----1COMPffffMMUNOAliOilll
Thomas L. B~!B.!!tL.~'!.(~ire ._______".. ___" flARK, WEIGLE AND PERKINS
ill!PHONfNuM8fn 126 East King Street
_____ L.717 J 532-7388,o,~~=,="",=~""~S~~~~~~==~:I~~:_~A,__, 17257
1. Rool E,'ote (Schedule AJ ( 1) ,---,,-.. ..-- ,-,...."
2, Slack. and Bond'ISchedule B) ( 2) ---..----..- ..---...--.."-----
3, Clo.ely Held Slock/Porlne..hlp In'e,elllSchedulo q {31 -----..-- -......---. ---,---..-
4, Mo~goge. and Nole. Receivable (Schedule 01 I 41...._____..,,________
5, COlh, Bonk Dopolli. & Mllcelloneou. Por.onol Proparlyl 51 ,___~'-12<)lLd9______
ISchedule E)
6. Jolnlly Owned Prope~y ISchedulo FI
7. Tronde.. ISchedule GI (Schedule LI
B, Tolol Grall Allel.llololllne. 1.71
9. Funeral Expen.e.. Admlnlltro'ive COlli, Mlscelloneou, ( 9) ,_~_~.!E_6!!_&~___
Expen,e. ISchedule HI '
10. Debts. Morlgoge lIobllllle.. lie.. (Schedule I) (10) .____
11. Tolol Deductlo.. 110101 line. 9 & 10)
12. Ne' Voluo of E,lolelllne B mlnu.llne 11)
13. Charitable and Go,ornmonlol BoquOllIlSchedule JI
14, Ne' Value Sublecllo Tax IlIne 12 mlnulllne 13)
15. Amoun' of line 14 loxoble 01 6% role
Ilndude value. from Schedule K or Schedule M,)
16, Amounl 01 line 14 'oxoble a' 15% role
Ilndude value. f,om Sch.dule K or Schedule M.I
17, Prlnr.lpollox duelAdd lox Irom line 15 and f,om line 16,)
18. Crodih Spousal Poverty Crodil Prior Paymonll Discount Inleroll
-------....---..- + ...------------ + ,,"'--'-'--'" - -----
19. II line lB I. greolOr ,hon line 17. enler the dlHerence on IIr,e 19. Thlt I"he OVERPAYMENT.
Ii1D
20, II line 17 II greoler Ihon line lB. enler Ihe dlHerenc. on line 20. Thl. IIlhe TAX DUE.
A, Enler ,he Inle,e" on Ihe balance due on IIno 20A.
B. Enler Ihe 10101 of line 20 and 20A on line 20B. ThllII Ihe BALANCE DLlE.
Make C_hlCk Pav~~!!..t~1 R,gl~t.~,f WIUI, _~g.!ot ,_ mo' ___.
.. BE SURE TO ANSWER ALL QUESTIONS oifREVERSE SIDE-AND TORECHECKMATH".
Under ponallhu of poriury, I doclare !hall have tuwmlnlld Ihll return, Including C1ccompanylng Hhe'dule, and '1Cllemonh, Clod 10 the bell of my knowledfle and bIU,(
il II IrulI, corroe! and compl.le. I dotlore Ihal all realllltale hal been reported at Irue mnrket volve. Doclarallon of preparor other than the perlonal repre1tnlnllve 11
baud on all Information of whlc:h preparer hen any knowlodgo.
JIGNAfuRE01 PfRSONAE1pONStelE' 'OR 'lliNGRffLiR~ -AODRESS- -- - u_. - ---.---- --~.--.---- - -~-- CMfC-- ---
~! I,'f,tjyr:t..lryJ! ,)}1/t4/,IlJJlj_~~ie ~~.:!a!,~ge~~_~_~_~!~n~!~_~_~I~ppengb_urg. '1~57 JL.l.tJj
Im~1l, lfRl-1 p Ji'~,l~ IV~ A DII~;)' vAlt
-~-#-V- Thomas L. Br~~~t..!__l~~_~-,_~ing St.. Shipp_:~sbl~:~~PA 17257 I, iJ-'i'f
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106 Locust Street
Shippensburg. I'A 17257
c~~'L_ Clll1\~.!_~an~___________..__________
Cl 3, Romolnder Relu,n
I'or dole. 01 dealh prior 10 12.13.821
[] 5. federal E,'o'e Tax
Relurn Requl,ed
T 0101 Number of Sole Depo.11 BoXOl
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o
3
E
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( 61.........--,----------
( 7) _""..__..'___u___________
( B)
2,608.19
(11) _.2,664.82
(12) _ (56.63)
(131 ---
(141
(151 ___________~ .06" NONE
(56.631-.
- INSOLVENT
(16) ____________.__ ~ .15" .
z
o
~
..
j
~
o
u
g
(171
11BI _____
(191 --______
Chcc:tl: hefO if you mo fNlucstin!)lI rofund of your ovorplIymcnt.
(20) ______.._.___
(20A) _____________________
120B) _.___________
.. 1t~',UIl:.-' (7.111
urATE OF
ITEM
NUMBER
A.
B.
4.
C.
1.
2.
3.
4.
5.
6.
7.
8.
. -', . -.... .....
---. "
~:i;;
1~ SCHEDULE H 1
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MIS~E.LLAN~~US EXPENSES _ Pleall Print or TVpI
~NUMBER
Shoemaker 21-94-0167
COMMONweAlTH Of 'ENNSYlVANI"
INHIRITANCI lAX mURN
RISIOENT O"/OENT
George ~.
DESCRIPTION
AMOUNT
1.
Funeral Explnull
Egger Funeral Home
150.00
1.
Admlnlltratlve COlt11
Pellonal Represenlallve Commlulons
Social Security Number 01 Personal Represenlallve.
Year Commlulons paid _______
,2.
Hark, \~eigle and Perkins
182.57
Allorney Fee.
3.
Family Exempllon
Claimant Connie H. Han&!llL-.. Relallon.hlp ....5.I1.Q.l!se - Common I.aw_
Addreu of Clalm.nl 01 decedent'. death
Slreet Addreu.. 106 Locust ~treet
City Shipl'ensburlt State --M_ Zip Code 17257
2,000.00
Probate Feel Register of Wills, Cumberland County - Letters of
Administration and Short Certificates
Mllelllonloul Explnltl.
Cumberland County Law Journal - advertising Letters of Admin.
38.00
40.00
News Chronicle - advertising Letters of Administration
65.00
Vital Recorda - d~ath certificates
15.00
Franklin County Coroner - report
100.00
Register of'Vills, Cumberland County - filing Insolvent PA
Inheritance Tax Return
Hark, Weigle and Perkins - reimbursehlent for postage, xerox
copics, and long distance telephone calls
Internal Revenue Service - copy of tax return
10.00
10.00
4.25
Hark, Weigle and Perkins - preparation of 1993 income tax
returllB
50.00
TOTAL (Also enler an line 9, ,Recapitulallonl
(II more .pacI II n..dld, Inurl addlllonollh..h 01 lame 1111.)
S 2,664.82
REV- U4'7 EX AFP (01'94*
~ALTH OF PENNSVLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL rA~ES
DEPT. 210601
HARRISBURD. PA 11121-0601
!STAT! 0 =- --- FILE NO.
llATE OF DEATH 10-12-93 COUNTY CUMBERLAND
NOTE I TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHIT THE UPPER PORTION OF THIS FDRH WITH YOUR TAX
PAYHENT TO THE REOISTER OF WILLS. HAXE CHECK PAYABLE TO "REOISTER OF WILLS, AGENT"
REMIT PAYMENT TOI
I ij)t;i,) -- t)'
'1
c..,
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSF.SSHENT OF TAX
ACN
101
DAT! 12-05-94
THOMAS L BRIGHT ESQ
MARK ETAL
126 EKING ST
SHIPPENSBURG PA 17257
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
l
A.ount R..lttod
-
'--J
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~
RiV: i54'j' EX" AfoP"j 08:94 Y" tliifici" "OF' "iNti Eii iTAH'C E' T"AX' i\"P'piiiii Ii EHENT ~""A r.10WANCE 'OR'"" ,m""" - -" -"
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
GEORGE L FILE NO. 21 94'0167 ACN 101 DATE 12-05'94
TAX RETURN WASI ( I ACCEPTED AS FILED ( XI CHANGEbdEE ATTACHED NOTICE
~It \tJ .~
:~l '\, .r..", .OCll
(.,,, roo
~ :J (I
l. b t::J "('
. 0 C"'J . '1'
,00
.00 ~
. DO,
..lIo };-~
::P COO I,ll
;;-' --:"00 U1
lal
ESTATE OF SHOEMAKER
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL
1. Rid E ltoto (Sohldul. A I
2. Stookl Ind Bond. (Sohldull BI
3. Clo,"ly H.ld Stook/Plrtnlr.hlp Int.r..t (Sch.dull CI
4. Hortg.gll/Notl' Rlc.lv.bl. (Sch.dul. 01
5. C..h/B.nk Dlpo.ltl/HI.c. Plr.on.l PrcPlrty (Sch.dul. EI
6. Jointly Dwn.d Prop.rty (Sohldule FI
7. 1'rln.1I.. (Sohldule 0 I
a. Tohl A...to
III
(21
(31
(41
(51
(61
(71
.~.. (-)
~.... \ ,
t'ii Cl
~.
.00
APPROVED DEDUCTIONS AND EXEMPTIONS I
9. Fun.r.1 Exp.n.I./Ad.. COlt./MI... Exp.n..1 (Sch.dul. HI (91
10. D.bh/Hortglg. 1l.bllIU../Lllnl (Soh.dul. II 1101 .00
11. Tohl D.ductlonl (11 I
12. N.t Volu. of T.x R.turn 1121 _
U. Ch.rltlbl./Oov.rn..nhl Blqullh (Schldule JI (131
14. N.t Volu. of E.t.h Subjlot to T.x (141
NOTEI If.n ......ment w.. i..ued pr.viou.1Y, line. 14, 15 .nd/or 16, 17 .nd 11 will
reflect figure. th.t include the tot.l of e1k return. ......ed to date.
ASSESSMENT OF TAXI
1&. A~unt of Llnl 14 .t SpoU.11 rlt. 1151
16. AlIOunt of Lln. 14 t.x.ble It Lln..l/Cl... A r.t. 1161
17. A~unt of Lln. 14 t.x.bl. It Coll.t.r.I/CI.11 Brit. (171
la. Prlnolp.l TI. Du.
TAX CREDITS I
PAYHENT
DATE
.00
DO
.00
.00
.00
,on
.00
.00
X .00.
X .06.
X .15.
lIal
.00
.00
.00
.00
RECEIPT
HOHlER
DISCOUNT 1'1
INTEREST (-)
AMOUNT PAID
.~
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
.00
.00
.00
.00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF AODITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN fl, NO PAYHENT IS REQUIRED.
IF TOTAL OUE IS REflECTED AS A "CREDIT" ICRI, YOU HAY BE DUE
A REFUND. SEE REVERSE SlOE OF THIS FnRH FOR INSTRUCTIONS. I
....
~
RESERVATION. E"lt.. of dtctdlntt dying on or blfor. Dec.-btr 12, 19.2 4_ l' InW future Int.r.tt In thl I.tlt. I, tten.fltred
In po.....lon ar tnjo~t to e1... . (cDl1.'.r,.) btneflcl,r... of the ~.dtnt after the IMp.r.tlon of InY ..tlt. 'or
life or for VII", thl COMOnWt.lth hereby Illprullv nurvtl thl rlDht to IPpr,lt, Ihd ...... ,rlnd.r IMirAtlnc. T..II
It ttw h,,'ul ell11 I (colllt1re1) r.t. on anv luoh future Int.rllt.
PUllPOSE OF
NOTICE I To fulfill thl rtqulrHtntl of S.otlon 214Q of thl Jnherltencl end E.tlt. TllC Aot, Act 22 0' 1991. 72 P.I.
I..llon mo.
PAVMENTI D.tKh the top portion 0' thit Hotlc. end lubtlt with your PlY""' '~a thl RIglttn of W1111 prInted on the r.v.rll lide.
..H.... chock or 00l10' ord.r p"obl. to, REDI9TER DF HILLS, ADENT
All p.v-.nh r",lvld ,hill flret bI epplled to any Int.r..t whloh ..y be ckHl with any r...lndtr applied to the tlM.
RE'UND (CA)I A refund of . till or.dlt, which WII not r.qullttd on the TIM Rtturn, ..y be rtqu..ttd by capl.Unll In "Appllc.Uon
for R.fl.nt of PIM.ylvII1l. InhlrltlnOt .wid E.t.t, riM" <REy..nUL App1Jc.Uon. Ir' Iv.Uabl' at thl Offlct
0' the Rlllhtu 0' Will., any of the 2S R.venu. Dhtrlct OfUc.., or by c.Ulnll the ,peel,l U-hour
,",verlng 'trvlct ~r' 'or fori' ord.rlngl In Penn,ylvanl. 1.I~O.~2.2aI0, out.ldl Ptnn,ylvlnll end
within 10011 Hlrrltburll Ir.. (711) 711"1094, TOO. (717) 772-2252 (Iit.rlng IIPtlrld only).
OIJECTlOHI, Any p.rty In Intutlt not ,.thfltd wUh the IPfIrt.....nt. .110wanc. or dl..llowlnt. 0' cMduoUon., or ..........t
0' tlX (Includlna dl.count or int.r..t) I' .ho.n on thl. Notle. .u.t obj.ct within .Ixty (60) d.y. 0' rlellpt ef
thlt NoUe. bYI
....wrUtln protut to the PA Dl9trtMnt 0' AIVlnut, aoard of APPIIlI, DEPT, UtUl, Hurhbyrll, PA 17121"1021, OR
-.Ileotlon to hlVI thl ..U.r det.rtlned It IUdU of thl tecount of the ,.rtontl rtprn.ntIUvI, 0"
."IPP..I to thl Orpt\en.' Court.
AIlftIH
UTRATlI'E
C_CTlllHS,
IHTfIlt!IT I
F~tuIl .rror. dl.cov.rld on thl. ......tent 'hould be tddr...td In writing tOI PA o.,lrt..nt 0' AIV~,
&Urteu 0' Indlvldu.l T.MII, ATTN, Po.t A......."t A.vl.w Unit, DEPT. 21060l. tI.rrhburll, PA 17121"0601
Phont (717) 7.7-6501. SM P'" S of the ~l.t "In.truatlon. 'or Inherltlnc. Tlx Atturn for I R..ldtnt
Dtcldent" (REV-lSOI) for In 'Mpllnltlon 0' IdIlnl.trltlvlly correotable Irror..
If MY hM due It p.ld wUhln thrH (1) clllnd.r tonth. Ift.r the dectdent'. dllth, I flvl p.rctnt (5;() dhcount of
thl tlX p,ld It l11owtd.
Inter..t It chlrpd beginning with tolrtt dlY of deUnqwncy, or nine (9) IOnthl end OM 0) d.y 'rOIl the dltl of
alth, to thl dlt. of PIYHf'lt. TIIC.. which bec... dlUnquont btforl Jln\llry 1, 1912 b.ar Int.r..t .t the rite of
11M C':CJ perunt per ~ c.lc:uhtld It . dllh retl of .0001". All tlICII lthlch bIG'" d.lInqwnt on end .fter
JllnUllfY 1, 1912 will bllr Inten.t It I ret. Which wll1 vlry frOll clltnd.r Vllr to nlwtr Yllr with th.t rlt.
~td by thl PA o.p.rt-.nt 0' Rlvenut. The .ppl1clbl. Int.rl.t r.t.. far l'I! throufh 19~ .rll
DIKOUIlT'
'!!!r Interut Ad. Dilly tnt.rllt Flctor, !!!r Int.rllt R.tl Dilly Int.r..t FlCtor
191' lOX .000111 191' 10~ .000176
"15 I'~ .000111 1917 9~ .000167
I"~ m .00010\ 1711.ml 1I~ .000101
I'U m .OOOIS' 199Z ,~ .000167
I99S.lm 7~ .0001'2
.~Jnt.rllt It a.lcul.tlel .. folloWl1
INTEREST . BALANCE OF TAX UNPAID X NUNSER DF DAYS DELINQUENT X DAILY INTEREST FACTDR
....Any NoUn IlIutd IH.r thl talC beao... dtltnqulnt will r.fI.ct "" Intarllt nlcullUon to ,lftHn (15) dlY.
b.yond thl dlt. of the ......."'t. If pIYllnt It Itcft Ift.r the Int.rut caputttlon dltl .hown on thl
HottCl, IddlUOnIl Inter..t lU.t be calcultttd.
REV, lHO EX (8.881,
INHERITANCE TAX
EXPLANATION
OF CHANGES
COMM9NWEALTH Of PENNSYLVANIA
,.i1!PAR1MENT Of REVENUE
. - BUREAU OF INDIVIDUAL TAXIS
, DEPT. 280601
HARRISBURG, PA 1712B'0601
DECEDENTS NAME
, SCHEDULS
ITEM
NO.
, ,
Ocorge ShCltllllUktll'
1 fiLE NUMBER, '
=r:
2194M0167
101
EXPLANATION OF CHANGES
Via phono dllcuulon auspondlng this return until such Hill! you IIrc relldy
to rllfllo with verifiCAtion origlnnlly requllatcd.
" ,
~~' '~ :o~
&0
" co r'1 C ,.......
~,'i ~_! (1
" F.i III ~J
,j ,.' ."
i.I" , h,'" ~ 1
bj;;~" ~:a. \... :
" . .."
"'l
ie ,"" ~)
Jg "",
:;n' .,
, .... iii'
, .
Ul 0
U1 ~
.i..______' /-,. .".....
'I. .
"
f.:,
,"
, '
. ',_ ,I_
.,Ii;,'
, '
,
, ,
"
.1'.,
!-',--'
" .
.
"
'\-. I,
"
,
I
, '
! ,,'
"
TAX EXAMINER:
tJOl'Clfllh WIlRh Ington
, PAGE
05-19-97
SHOEMAKER
10-12-93
21 94-0167
CUMBERLAND
101
AMount Rod UOd=:]
, il '} .-
IJ - It,/) - J
IUREAU OF INDIVIDUAL TAXES
IIHRIlAHCE TAM DIVISION
Ilt:PT. 210601
IWlRIIWlO, PA 17111-0'01
COMMONWEALTH OF PENNSVLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
AppRAISENENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
DAVID C SCHANBACHER ESQ
MARK ETAL
126 EKING ST
SHIPPENSBURG PA 17257
DAT!
~STATE OF
DATE OF DEATH
FILl! NUHlER
COUNTY
ACN
c'
'*
tn.lld II "" m.tU
GEORGE
L
MAKI! CHECK PAVABLI! AND REMIT PAVMI!NT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONO THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ..
iiEV=iscif-ixu"i'iji"ioj"=97Y"ilcii'"icinOFuiNHEiiifAtfcE"T"A'X"XpPR'A"iiiiiiiilr;-"i.l"OWAtici.iiriu........."m""
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF SHOEMAKER GEORGE L FILE NO. 21 94-0167 ACN 101 DATE 05-19"97
If an allellMent wal ielued previouI1Y, linee 14, 15 and/or 16, 11 and IS will
reflect figurll that include the total of m rll1:urnl allelled to date.
ASSESSMENT OF TAXI
15. AlIOUIlt of Llno 14 ot Sp""..l r.to 115) .00 X .00.
16, AJIount of Llno 14 to.ablo ot Llnool/Chn A roto 1161 .00 x' 06.
17. AlIOUIlt of Line 14 to.abl. ot CoU.torollChn I roto 117) .00 X .15.
18. prlnolpol To. Duo (181
TAX CREDITS I
pAYHENT
DATE
TAX RETURN WAS I I X I ACCEPTED AS FILED
I ) CHANGED
RESERVAYION CONCERNING FUTURE INTEREST . SEE REVERSf,
APPRAISED VALUE OF RETURN BASED ONI SUPPLEMENTAL RETURN
1. Roal Eltoto IScho<luh A) 11)
2. Stockl and londl ISchedulo I) 12)
S. Clololy Hold Stock/Portnarlhlp Int.ro.t lSchedulo C) IS)
4. Hortgogoo/Noto. Rocolvoblo ISohodulo D) 14)
5. Co.h/aonk Dopo.lt./Hllc. Por.onol Proporty (Sch.dulo E) 15)
6. Jointly Ownod Proporty lSch.duh F) 16)
7. Tron.foro ISohodulo Q) 17)
I. Totol A..otl
NO. 01
,00
.00
,M.
.00
2,608.19
.00
.00
III
APPROVED DEDUCTIONS AND EXEMPTIONS I
9. Funarol E.pon.o./Aa.. Co.t./Hllo. E.p.n... (Sohodulo H) (9)
10. D.bh/Hodgnuo LloblllUu/Llon. ISchlduh II 110)
11. Totol Doduotlonl
12. Not Volue of T.. Roturn
15. Ch.rltoblo/Govlrnaantol loquolto ISchedulo J)
14. Not Volue of Eltot. Subjoot to To.
6,284.03
.00
Cll)
112)
115)
114)
NOTE I
RECEIPT
NUHaE~
DISCOUNT I')
INTEREST/PEN PAID 1-)
AHOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUI!
INTEREST AND PEN.
TOTAL DUE
NOTE. To Inluro propor
arec1! t to your ~oQunt I
.ub.lt the upp.r portion
of thll for. with your
h)( p.y"."t.
2,608.19
1t.2A4.n~
3,675.84-
.00
3,675.84'
.00
.00
.00
.00
.00
.00
,00
.00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAl. INTEREST.
IF TOTAL DUE IS LESS THAN '1, NO PAYHENT I~ REQUIRED,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU HAY IE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
PQ
..1 ~
.I,
\\1
~'.l
:0
:lJ{T) ,
;:, /,
. I, ~
~~:
-,
-
\(.J
'I)
t,,) ifl,)
H_l1IIINI r.t.t.. af *_t. dVl.. on ar bofaro Doo_r Il, 1"1 .. If ony futuro Int....t In 1.1;:.:..t.t. i.!tron.fm,c(
In ~II...IOI"I or enJov-ent to Cl'" . (ooUI',rIU btnIflol.r... of tttl deClldlnt .ftlr he 1.lr.tNrl of ItJY "'It. for
U'. or far Vllrl, the CMMf'INI.lth hlrebV' .xprul1w r...rvII the rl~t to ."rt... Md "NII trlnl'.r Jm.rltenoe Taxi.
It tM 1.'ul Cl.1I I (ooll1t.rll) r,,'e on InV .uch 'utur. Interllt.
-"
MOTlal To fulfill thl '....1'....,'. of section 2140 of the Jmerltencl end Elt.t. Till Aot, Aat Z1 0' 1"1. en P.'.
loollon 9un.
PAYMEKTI DetlMlh t.... top portion of thh Notlel end .ubI\t with your PlY"'" to the Rttht.r of WUlI printed on the nv.r.. llde.
"1IoIl. ahoek or ....y ordor ."obl. tal REOI8TER OF HILLB, AOENT
lIlU\HI (aUI A rlkr.d of . tu orecllt, which WlI not rltql.~..ttd on the TI.H Rlturn, Ny bt ,"untld by o_l.U.... WI "Appl1olt1on
'or R,fund of Penn'v!"enla InhtrltlnC. and E,t,t. TI.H" (REV-ISI)), lpplloltlonl ar. IVIlleb11 It thl O,flcl
of the Mlthtlr of Nl1h, MV of the Z5 RlvlnUt Dhtrlot OfficII, or bv cIUlnt the ,~111 U.hour
,",werl"l ..rvlcl ~r' for for'l orOlrl"l1 In Penn.vlvan', l-100~36Z.Z0S0, out. Ide Penn,vIII,"le Ind
within loc.1 H.rrllburg .rl. (717) 717.1094, TDDI (717) 772-2252 (HI.rl"l IlPalrld Onlv).
OIJECTlOHSI Anv pertv In Intlrllt not .,U.flld wHh the appr.hHlnt, .1II*MlCI or dh.llo"lnc. 0' dtduotton" or ......lint
0' hle UnolucUng dllcount or Int"..U II .hown on this Hottel ...,It obj.ot within .hetv UO) dlYI 0' r.c.lpt of
thh Notlo. bYI
"'wrltt., prot"t to thli PA DIp.rt...,t 0' RIVtnUit, aolrd of Appe.ll, Dept. 211021, Harrlsburl, PA 17UI-1021, O~
--lllOtlon to hlvt thl ..tter dttlr.lned It IUdlt of thl ICCOW\t of the PlrI,,",1 r."untetl"l, OR
........1 to thl Drphtn.' Court.
lllltlN
111RlTIYE
CORRIC1IONS.
FlMltu.l .rrorl dllcov."d on thh ......lint .hould be Iddr....d In writ1nt tOI PA DIPlrt..,t of RIVenue,
lure"", of Indlvldull TI)(II, AllNI Po.t AUIUMnt Rlvl... Unit, Dept. Zl060~, Ulrrhbur" PA 1712'.0601
Phone (717) 711-6501. See Pili S of thl bookht "Inltructlonl for IrhlrltlnCl fa)( R'turn 'or I Rllldlnt
Decedent" (REY-lI01) 'or In Ixpl~tlon of IdIlnl,trttlv.ly correatlbl. Irror..
If tnV' tu duI II plld within thr.. (S) OIltnOIr IIOnth. Ifter the MctKtentl, dnth, . flvI peroent Ul,o dboOWlt of
tho t.. ..Id II .11_.
The 1I~ tlle ......ty non.p.rtlolp.Uon penaltV' It cotllPUtld on thl totll of thl tu end Intlr..t IIHINd, and not
p.ld before JInuIry II, 1"', thl flnt eMY Iftsr the end of the tl)( ..,.Itv period. Thh non.psrUalplUDtI
,..1 tv It .....111I1. In thl ... RMlr Ind In thtl thl ... U.. period II rou would ..,..1 the taM end Inter'"
tNt hll bMn IIHlled .1 JndleltlNt on this MUel.
DIICWf1.
_m,
IHTERI!IT.
Intor..t 10 'horllld ....lml.. .lth lI"t 11<I. af doll_., ar nino 19J _tho ond DIll 1Il doy froo tho "'" of
_th, to the ca.tl of p.yaent. Ta)(Il Mhloh No.. dllI".,."t before Jenutrv 1, 1911 bMr Intlrllt It thrt rltl of
Ihe CO) percent per am". e.loul.,1Nt It I dilly ntl of .000164. All tUII whlctl __ deU".,..,t on .. liter
.....rV' I, un will betr Interllt It . rltl IIItllnh will Vlry froe OIlendlr VHr to c.ltndtr wllr with tNt rlt.
InMOUnGtd by the PA o.plrt.-nt of Rlvenue. Thft IPPllolbl. Intlr'lt rl'l. for 1'" through 1..7 .rll
1m Intlr..t At" D.llv Interllt Fl<ltor X1!r Inhrl" Rltl D.llv Intl".t Fector
1911 lOX .GOOS.' 1917 9X . DOli"
1911 IU .OIUII 191'-1"1 lIX . DOOSII
19M IIX .010511 1"1 9X . DOli.'
1915 nx .000516 I"S-I'" IX .D01I91 ,
I'" lOX .00Dl'. I"S'I"' 9X .ODOI.'
".Interllt II ollcultttd II 'lJllC*1I
IHTERIIT . IALANCE OF TAX UNPAIO X ~IER OF DAY. DELINqUENT X DAILY INTERIIT FACTO.
.'lny Hotlo, I..uod .ft.r tho t.. boo.... doll.....t .111 r.floot on Int.r..t o.loul.tlon t. flftoon 1111 dIy.
beyond thl d.,. of tM ........"t. If PIYIIII1t I. ... IUIr the Int.rll' OOlflpUt.Uon de'l thoNn on tht
Motlot, IddltlOMI Inter..t IUlt be alloulltld.
" /1"
'i.
",
.1"
fl,
"
.....~...."'""'~ ~..............
,..,
.-.........
.....,....
"
I'
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"
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MARY C, LEWIS
Regleter 01 Willi' Cllrk 0' Orphlnl' Court
Cumberland County Courlhouse
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THOMAS' L. BRIGHT, ESQ.,
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