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(l1.VII kllOIl'1I al'.
PETITION liOl{ IJIWBATE und (mANT ()I<' LETTERS
f' 1.,(.',\1," '" I'/o..::ll ..9 II ..dtJj.
To:
Rcg"I<'r of Wills 1'01 Ihe .
, nl'I'I'asl'i/. COUIIII' of ..c:>t'J/,.j'~'./.f:v""'_h In thc
Sol'/a/ SI't'lIl'ify No,:' / '/., '/e . '., '13 ,,~! . ('olllnionwcnlth of I'cnnsyll'nnln
The pelltion of Ihe under,lgncd rcspcclfully I,<'prcscnls thlll:
"ollr p<'tilloncl('), \l'ho is iil 1<' Is ycars of IIgc or oldcr lIulhc c,scenl ....__._......,..._,~___ nlllllcd
In t hc IlIsl will of Ihc IIhol'c tkCI'dcnl. dllllld ..g- .'1.~ ,~?'.fL... .., .n .__" ......-,-_., 19__,__
lIud eodicll(s) dilled . .. _...... ._, ,..m"'" .....,,_.. .. ___......._.._.....__.h_______
. _'"on__''' _.___.__.___m_.~.___..___ .._____.._,._..__..____h___..._.___.__.__~
. ..-_....-,.. -...,- --..--_.~-_. .-----+-_.._._.--_.._-._.__...._-.-.__._-.'.~
('lUll' It'il'\'Unl drl'lIlJl,llllllV-" 1..',1: H'lllIlIdatllll1, <11.'.1111 Oll"H'l'Ulur, l'll'.)
l.lecl1l1dcnl \l'IIS dOluiclll'd IU dClllh In.. . (""I~ti!:.,rJ1..,,:;J .... ;r' ,('ounty, l'eunsyll'lInlll. with
IL<.:'tI'!. . Ills I flllllilyor prlnclplIl resldencc 1I1...~(i'i'~....1/",.".'i!:/~ h-~d.':f(---~:r~--
.._.._....,.. .."..,... . ,. .__._.___:.<'".~~,Y&:'<:..-Ltt..LZ..P.J!--_--
(ll~, '"1.'\'1, 1111ll1hl'r llud I1lllndpnllt~.)
1\l1~~ccnd~~I;~~~n .. ,: <l;;r;,~I" or I~~ ~~~r6~Z.~ ~~'~J{H-;~->/o'~~2]i~~'2. ~_.:
hcepl ns fol?;:I'\, dcccd<'nl did nollllurry, "'liS not divorced nnd did nOI hlll'e II child horn or IIdopted
nncr execlltion or the will orrered ror prohllll'; WIIS nolth<' I'lcllm or II killing IInd \l'lIS never IIdjndicllled
IncolllpI'I<'nl: .,. " ... ..~.. _. _n ,-.., -..........~, ..---.--".----
Dcceudenl III dl'iltlr o\l'ned property with e.Sllnnlled I'lIlnes liS rollow,s:
(If dnllllclled In I'll.) All personlll property
(If nnl dOlnklied in I'll,) I'crsonill propert~' In l'ennsyll'lInill
(I I' nnl domkilcd In Plio) I'ersonlll properlY In Cnnnty
Vlllne of relll C'IiII<' in 1'<'nllsyll'lInlll
sllnlll<'d lIS 1',,11011":
$__3 .~~~.~~
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_.__. ___+_____. .u._..._. _ _ ___ ....___ __.._._______. ...~_.____..___.__._..________~___________
WIIEIWFORE, pelitioner(s) respeelfnlly reqnesl(S) Ihl' pr"hUle III' the IllS I will IInd codicll(s)
presenled herewllh und the grllnl nr le!lcrs.__...__.___._. -.--,,-,~-----,.----,--
(tC,lUIl1Clllilr~'; Udlllllll'llrlllhlll 1',1,11.; lldl1lllll~lrallnllll.h.II,C.I,",)
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OATIl OF PEW';ONAL RE"IU~SENTATIVE
COMMONWEALTII OF I'ENNSYLV ANIA l:1:1
COUNT\' OF .. (,lJMIU~RLI\ND,m._u.._, J
The peliliollel(') ,,11("'t"II"II\ed "",,,rts) 01 "llillll(') Ihllllh<' sllllell11'lIls in Ihe foregoing petition lire
trlle IIl1d COIn'l'llo 111l' h<',1 ollhe ~I\lIwlc<lg" "lid helieI' 0' pelllloller(s) IIl1d Ihlll liS persolllll represen.
IllIil'e(.s) 01 Ihl' "hovt' <lc,,'dt'1I1 pelilioller(sl will ~'~<:II)II,I;~I,{~"IY 7Ilisl,e1.;.the e.sI,I\:~~Uing IOI:~\~,
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WARNING: Ills IlIugnllo dupllcalu thlG copy by photoslal fir photograph,
I\'l' fill' lid., a'lliliL',1Il', S.'.OO
21-q4-341
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COMM\lNWeALTH OF PENNSYLVANIA' QfJ'ARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
-'--
"'female
I,
1Wo'I00D"""""'''''''''''''' L
I, lllenora ". , eoneo
,f,OI(\Mle.hW"rl UHlIlRI 'l'1! UHOEfUDAV OAtIOl"emhl
t.I<<-lht 0111:I1 .WKAM \I,l<:<'" 0,11"""1
71 ,,, Aprll 21,19
en ,IORO. 1''''01 DEAtH 'ACIUT'fI4AJ.lE\ltr0<:4tl..IA(\,o,y,.",ftlllINlroJfuwl
E. P~onBboro Twp. 1I0ly Bp1r1t 1I0ep.
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'UNO Of WllillS!t'\tlQll!Il!'!- ......!IOCC"OENT ~!EMI OCCfl.l€N1'8 EINCAllON
. - us M\aACo'on Ell __~.Q!1t1 . lI!.f.ltW~-
n r-.l "'1:'""'"""" """" "''''
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man1ed
VlvlHQiPOOS(
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John S. Looneo
U,",.._M<l
"1lt'_""II,~f(j,"11lm.''''-
lolOlllUrStlAt,l[[fIU_1,M"I,I."",nSul"#oiIj
Gertrude Hyland
It! Of\ AHl'81.1AlLIHOAOOREn~uHl,c...,tv..".SIaM,lopCodlI
1 Doeler Ave. !.Bmoyne I Pa,
PlAEOt'(lI'PO'tlOH.NIlTIt04CflT"'tty,Crl/lllJOfV l
QI 01"'1 'i'
Ii: , lan1eburg Crematory
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Cumberland
8111 Boeler Ave. Lomoyne.l'a,
04
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t!tl1'o.ldllr\lll16UIt[l
1994
lICEtjSl!NUl,IIlPl.
0112~~ L
AU 'AONOUNCt!DoeAtJl~<l(ilI, Olll"l
P" Maroh 6, 1994
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On 1M ,..II 01 .lIm!rIlUon tro4IOI rn."llgtllon, In my opinion, dt.lh OI:Cl,lutd .1111. Um., dllt, tnd pI.c.,.1'ld dll.lo Iht UllM(I,.nd
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Han1sburg, Ilauph1n
tlAlr.lf, ANO AOOOEIS Of fACIl.1TY
eaelman ~uneral 1I0me 1no.324 Hummel Ave.Lemoyne
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I. Real E.lal. (Schedul. AI ( II .
2, Slack, and BOlld, (Sch.dul. B) ( 21
3, Clo.ely Hold Stock/Parlne"hip Inlere,l (Schedul. q (31
4, Mortgage, and Nole. Receivable (Schedule D) ( 41
5. Ca.h, Bonk Oepo,it, & Mhcelloneou, P."onal Praperly( 51 ..___2.~L~':!~_.19______
(Schedul. EI
6, .lalntly Owned Properly (Schedule FI
7, Tra"fe" (Schedule GI (Schedule II
B, Talal Gro" Allel. (10101 line. 1.7)
9, Funeral Expe"e" Admlnlllrallve fou,". MI"ellonuau, ( 9) .-----~-'l~g_~.QL___._
Expen.e, (Schedule HI
10. Deb", Marlgage Llablllll... lien, (Sch.dule II (10)
11. Tolal Deducllon. (tolollln.. 9 & 10)
12. Nel Value of E"ole(line 8 mlnu.llne 111
13, Charitabl. and Governm.nlol Bequell' (Schedule JI
14, Nel 'Iolu. Sub/eel 10 To~2 mlnu, line 131
15, Amounl of line 14 taxable 01 6% ral.
(Include value. from Sch.dule K or Schedule M,)
16. Amounl 0' line 14 laxoble 01 15% ral.
Ilnclude volue, from Schedule K or Schedul. M.)
17, Prl",lpallax due (Add lox from line 15 and f,am IIn. 16.1
lB. Credit. Spou.al Pover~ Crodit Prior Paymonl' DI"ounl
-L$-ill~ ~b 6 ~sed _800.00_ L_ -O-=-.
19. If IIno 18 h greater than IIn. 17, enlor Ihe difference on line 19. Thl'I,'he OVERPAYMENT.
arnli!.n.'llIIIII~.TI'I'.IIII'I'i.IhI"ITlI"'."'l"l!J1n_''''I'I.'l"IJIl.l.1lTjnI'Iil~
20, If line 171. greater Ihan line lB. enler Ih. difference on line 20. Thh I"he TAX DUE,
A, Enler Ih. In'e,e.' on Ih. balance due on line 20A.
B, Enler ,h. 10101 of IIn. 20 and 20A on line 20B. Thl, h Ih. BALANCE DUE,
Mak. C:hock Payabl. tal R.gl.lor ef Wlfl., Ag.ot
.. 81 SURe TO ANSW'A ALL QUESTIONS ON REVERSE-SIDE AND TO RECHECK MATH".
Under pencltl.. of perjury, I dedo,e thaI I ha~ned Ihh relurn, Including accCJmpo~g 1che'dvlos Clnd lIalomenll, and 10 'h~of my knowledge and bel/ef,
It II Irue, correcl and compl'I', I do clare thol all real Itlale hOI been reporlecf allrue markor valuo, Declaration of preparor other than the personal repreunlalive II
baled on alllnlotllJa1iol) of which pre parer hOI any knowledge, '~~
.11000!~-nIQN RU' !IIlE fORll('INll1IElU~N AOOmr- -C/o--P-l--a--c-e--y..--& - WiIgllt------------- bAlE--,L.'I G' /
//,/, .-/"..- 's' ,.,~" f'''i' .-.~ ':' .' . . Box ~9 lib., P^ 17108 /',', r .,),
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-----RL9.!l.:LrCWI.~-!'.!-<l.~ L~ij~ __-?-I30L9 J L_111l9. _, J:_^ _171 0_8. __ ____ -m----~(~.:4'.
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COMMO.....WEAlTH m PENNSYlVANIA
DEPARTMENT OF REVENUE
OEPl.1I0601
'. HARRISBURG, PA 17128.0601
--IDECEDENT'S NAME (lAST, '1 ,N MI
/ l! ";',1 . (f - ((
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
/.--
-'
'OR DATlS O. DIATH AnlR 12/31/91 CHICK HUI
" A SPOUSAL
POVIRTY CRlDIT IS CLAIMID ~
"L1 NUMIIR
21
COUNTY CODe
----...fDEN"S. COMPLETE ADDRESs
1994
YEAR
00341
NUMB~~
III L
LEONZO, Glenora R. 841 Bosler ^venue
SOCiAl SECU~"V NUM8E~ Fifo' OW".-..lDATfO"i~ii,.--...-- Lemoyne, P ^ 17043
314-16-9321 I 03/06/94 04/21/2?___ ~~y_m....QI,I!!ll:erlanL______
IXI 1. O,lglnal Relurn [J 2, Supplornenlal ROlurn [] 3, Romalnder Relurn
Ifar do'o. of d.alh prior 10 12.13.82)
[J 4. L1mlt.d ElIate [J 40, Fuluro Inlere,l Camproml.e [) 5, Fedoral Ellale Tax
(for dole' of dealh after 12.12.821 R,'urn R.qulred
IXI 6, Do"d.nl Died Te,'al. [J 7, Decodonl Mall1lainod a living TrUll _ 8, Tolol Number of Sof. Depo'lt Boxe.
(Alloch copy r' Will) IAlla-,~_copy ~~Tr_"..'!L_ __.."______.._.___.
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO.
"AMERichard L. Place~, Esquire -'-..rCOM~~~'~~~(r~O~~~~GHT
fElEPflONE NU^,IE~ '-----,------- -- 232 North Secdnd Street
I P.O. Box 99
U~7 I 236-9~77 ..-liaqi!lbur'k.J'l\._,_lU.JlJ__
( 61 _ _._."...___...______.__________,_
( 7) -------.---_________n.__
F 8) -12, 622 . 70
ii,
:(11) ------!L130~...QL__._
'1121__16,d_i2""!'li___
(l3) .
'(141 '
(151 ----~dJl.~_~~__x .~..
I
16,492.63
989.56
! I,
(161.,________._,__,____x ,f5..
(17) _._
989.56
InlerOSI
-0-
(181 ---1./2(!,2~2...____
1191 ..-------8..Q.9~.9_L____m
(20).___._________,
(20AI _.u______'_m________
(20BI --..--.------____mm
, "
1
, "
"
"
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1
, '
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK ("') IN THE
APPROPRIATE BLOCKS.' .'
_'(!~ _ J:!Q
1. Old decedent make a tranafer and:
a. retain the use or income of the property transferred, ........".............................
b, retain the right to designate who shall use the property transferred or its Income, X
X
c. retain a reversionary interest or .."............................".................................. X
d. receive the promise for life of either payments, benefits ar care~ ....................... X
2. If death occurred on or before December 12, 1982, did decedent within two years
preceding death transfer property without receiving adequate conslderatlon~ If death X
occurred after December 12, 1982, did decedent transfer property within one year of
death without receiving adequate conslderatlon~ "...............................................
3. Old decedent own an 'in trust fori bank account at his or her deathL........,........... X
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
, YOU MUST COMPLETE SCHEDULE G AND FILE .IT AS PART OF THE RETURN.
,
" ",.
" , .'1'
"
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" " ,
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COMMONW!AlIH or /lNNlVlVANIA
INH!!ITANC/ IAI !!TURN
I!lIU!NI P!C/Plllf
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
PI. all Print or Typ.
L NUMBER
mAfiOF
GLENORA R. LEONZO
ITEM
NUMBER
DESCRIPTION
1.
Ao Funeral hp.ns..,
2 .
Musselman Funeral Home, Inc.
Matthews International Corporation - gravemarker
inscription
1.
B, Admlnlltratlv. COlt11
20
3,
4.
Co
'1.
2,
3,
4.
5.
6.
7,
8,
Pellonal Representative Commlnlons
Social Security Number of Pellonal Representative,
Year Commlulons paid
Attorney Fees
Placey & Wright
Family Exemption
Claimant John S. Leonzo Relationship
Addreu of Claimant at decedent's death
Street Addr81S 841 Bos ler Avenue
Spouse
City
Lemoyne
State PA Zip Cod. 17043
Probate Fees Cumterland County Register of Wills
Mllc.llaneous hpvnllsl
Holy Spirit Hospital - debt of deoedent
Reserved for future oosts, taxes and expenses
TOTAL IAlso enter on line 9, Recapltulotlon)
(If molt space II n..d.d, Inltlt addltlonalsh..t1 of some slz.,)
AMOUNT
$ 2,630.00
125.00
N/A
500.00
2,000.00
79.00
296.07
500.00
S 6,130.07
..,.\lIl'/.I',I,'I. ~
'~....t..,~
-
(OMMONWIAUH Of :'NN,nvANIA
INMllltANCltA.lnUIN
IUIOIN1 DtC'OIHI _
ISTATE O'
SCHEDULE J
BENEFICIARIES
PILI NUMIIR
GLENORA R. LEONZO
AMOUNT OR
SHARI O' ESTATE
ITEM
NUMII.R
NAME AND ADDRISS O' IIINI.ICIARV
RELATIONSHIP
A, Ta.able Bequ..'"
Spouse
Entire Estate
1.
John S. Leonzo
841 Bosler Avenue
Lemoyne, Ph 17043
,
,
,
,"
"EM
NU,.,IIR
NAMI AND ADDRISS O' IIENIPICIARV
AMOUNT OR
SHARE O' ESTAlI
B, Charllable and Gavernmental BequOl11I
1.
TOTAL CHARI1ABLE AND GOVERNMENTAL BEQUESTS (Alia ent., ,an line 13, Rocapllulallan)
III more .paco I. needed, In..,' addlllonol .hu" 0' lame .110)
s
...0.,
rh',lb~8(:((1,Q21 J I
~j;~ spouslf~~~ELR\~ CREDIT
COMMONWEALTH OF PENNSYLANIA
.__INHeRHAN~E_1A_~.o~VI~!ON JAVAILABLE FOR.DECE!!ENTS DYING AFTER 12(31/91L_ _ h
E5TATE OF IFILE NUMBER
GLENORA R. LEONZO ___ -L__
..-.----fh'i;,ch.dul~m~lI'b~c;mpi;i.d-;;nd fll.dlfio~-ch.ck.d the .pou,ol pov.rly credli box on Ih. cov.r ,he.t.
. . '.
I. Taxable Allolllolal Iram lino 8 (cov.r ,hooll ".""""""""""".."""""""".".."".".",,""""
I. ___1.~2 2 . 70
2, ___11404.57
3, -0-
4. 89,535.01
5. -0-
2, In.uran" Procood. on lIf. 01 Docod.nl ""..""""".."""""""""..""".""".""""""""""..,,
3, Roliromenl Bon.fi"..""""."".,,,...,., ,,,.'..,,,,,,,.,,,, ",..."......,.""",.,.,."."...,.,."......,."."..,',.
4, Joinl Aile" with Spau.o ""."".".".".""""""""..""..""".".""""""".""""",,.,,..,,"""""
5, PA lollory Winning. "",,,,,...,, ""....""""""" "..."""""."".".""". ".".""""""".",,,,,,, "."
60, Olhor Nonlaxabl. Aile", ll.t (Allach "h.d'JI. II n.collaryl" 60.
Real estate situate in Indiana
7,500.00
6b,
6c,
6d.
a, Tolol Aclualliabilllio.."."."""""".."."""",,,,,,......,,,,,,....,,,,,,......,,,,,,."."""."...".".,,"" a.
Q, NOI Valuo of E,lale (Sublraclllne a from IIn. 7)"".............""."........"..".".."...""..."....." q.
I1lme 9il grealer Ihan $200,000. STOP Th. '1'01, il not eligible'o claim th~ cfedil. 11 nol, conlinu. to ParI II.
PART 11_ CALCULATION OF JOINT EXEMPTION INCOME - (Attach capies of Fedcral Individual Income
TalC Returns far decedent ClOd spouse.) .
7,500.00
123,062.28
3,051.07
120,011. 21
6, SUBTOTAL (Lln.' 60, b, c, d) ..".""""""...""..."".."...."""..."...".".""""."..."""..""..,, 6,
7. Tolol Grall Allo" (Add lino. Ilhru 6)"".........""""""......""......"".".""......".""."...".., 7,
a, SpOU\O
.."..".... ~
438.00__
1.:.. TAX YEAR, lQ92
_20, 438.00
11>__
2,. _WH.OO
2d
3, TAX YEAR, lq93
30 438 . 00
~.
3,. --L218.00
.3d ________
Income:
1. TAX YEAR, lQ91
b. Doced.nl """"...."
Ib
Ic. _:1",076_,00
c. Joint
d, Tax E"mpllncomo.", ld,
o. Other Income nol
lislOd abovo ,,,,,,..,,, 10,
2e, 3e,
21--~l,8~~~_..1J_ 1,656.00
LJoLoL,,,~'c"'~"'c=~lL 1,514.00
4, Avorag. Jalnl Exemplion Incomo Calculollon
40, Add Joinl Ex.mplion Incom. Irom abov.,
(1I1_J,5H,QQ___ + (21) _J_,J!J1.2..&Q_- + (3fl__LJi5_Q_.JtL_,__ = _-5_,_~~....QO___...
.______l:UL___
4b, Averag. Joinl Exomplion Incom............................""...................................................... = ._!L~90. 00
II line 4(b) is gr.al.' Ihon $40,000 . STOP, Th. 0"0'0 i. not oligibl. 10 claim Iho crodil, /I nof, conlinu. fa Pari '".
. . I. . . . ..
Insorl amounl ollaxoblo Iransl.rllo 'pou.. or $100,000, whichov.r is 1.11.".......................
1. 22 622.70
. -,_...~------,-
2, .06
4
Multiply by cr.dit perconlago I'.. in'lructlan.) ""............."...."."......"....................."..,,'"
Thi, i.lho omoun' ollho Ro,id.nl Spou.al Pov.rly Crodil, Includo Ihi.liguro
in tho calculolion of 10101 crodih on linn 18 of tne cover shool ..." '" .... ,....,
For Nonrosidonts, onlor Iho rolio of thn docoden"s gron 051ato in PA 10 tho value of tno
ooccdont'\ gross oslolo.....,.,... ...""...,............-............"'....." ..........,......""........."... "
Mull'ply Ii no 3 by lino 4 and onlOr Ih. 10101 horo, Thi. i. Iho amounl of Ih. Nonro.idonl Spou.al i
PO',Hrly (roelit Inclu10 this fil)uro in Ino cCl1culalion of 10101 uodils on lin/) 18 of tho coyor shoot. 5, I
3,
1,357.36
2,
3,
J.
F
,
~ 1040
Label
f,:'uctions
on pSg<l11.)
Use the IRS
Isbol.
OlhOlw190,
plos,., prlnl
or Iypo,
PruldenUal
Eltotlon Campaign ~
(500 psgo 11.) ,
Filing Stelus
Chock only
ano bo)(,
Exemptions
(Soo pSgO 12,)
II mora Ihsn six
dopondonls,
BOO psgo 13,
Income
Attach
Copy B o' your
Form. W-2,
W-2G, Ind
l099-R hero,
II you ctld nol
gal s W-2, soo
psgo 10,
Ansch chock 0'
rnoney o,de, en
lap 01 any Fom19
W-2, W-2G, or
1099-R,
AdJultments
to Income
(Soo psge 19,)
Adjusted
Grosll Income
O.plttm,nt 01 tn, T'u,~",y -Inllfn.l A'VlnUI SlrVICI
U.S. Individual Income Tax Return
1991
----~
Igg, Indln ,10 _' OMO No. U45-Il~
lut oam. Your IOClIIUCU'IIV numb"
EMOYNE PA 17043
Do you wsnt $110 go to Ihls lund? , , . , . , , , , , , , ,
II oint return, doo. our. ouso want $110 010 Ihl. lund?,
Single
Ma"lod IIIlng lolnl'olllln (even II only one hod Incomo)
Ma"led filmg .oparale rotum, EnlOl apou.o'a SSN abovo & lull n.mo hore, ~
Hosd 01 houaohold (wllh qualilylng peroon), (Soo pago 12,) IIlho qualllylng po,oon I. a child bulnot youl depen-
denl, entOlIlII. child'. name hOlO, ~
Qualilylng wldow(er) wllh dopendonl child (year opou.e died ~ 190 ), (Soe page 12,)
Yourself. II your p,r,nt (Of lom.on. ,Iulean clllm you II' dlp'ndt"l on hi' or her Iu } No. 01 b01l1l
lIlUln, donol clllck bOll8d. Oul b.,urt lochlClI.lh, bOllon hn.,l'Jbon p.g1l2.. , .. ;~~~kb'd on 8.
..EJK] SpOU'O, """"""""."""""""".",.
c Dependents: C~lJ,f PIIIIg. lor older, (41 O,p,nd.nl" mb$Jt~~'I~"d No, of yout
'."'.',' dllllnd.nl', "",'o110no~,lllll Iny""","",fI'1' chlldr.non ac
(l)NAfI'1.(llrll,lnllll.I,.ndlutn.m.1 .acl.lllc~b.r .. whO:
Forlh. ..rJ.ln,-O.c,31 lIiil otolhuln nrb' IMIII
Vou, Ilr,l nam, and Inltl.l
L
A
B
E
L
OHN S. LEONZO
IIIJolntr.luIn,.poulII',llr.lnam..ndlnllll.1
luln.m.
LENORA R. LEONZO
Hom. .ddr..'(nurnb~r Ind ,ltul), (II you hl~'. P.O. bo_,." P.II' 11,)
Apl,no,
~
R
E
41 BOSr,ER AVE.
Clly, lo.....n ot pal.l OlfIC.,.I.I., .nd ZII' cnd',lll you h.~, .lor"lIn .ddr,.", "' p.ll' II,)
1
2
3
4
x
5
60
x
d II yout child didn't h~. .....Ilh you but I' cl.,med U youl d.p,nd.nl und,!. p,... IOU .orum,nl, ch.cI hi" II-
o Total number 01 oxom tlons clalmod, , , . , , , , , , , , , ,
7 Wagos, oalarlo., tip., elc, (anaoh Form(o) W-2) , , , , , , . ,
6a Taxoblolntooosllncome (also .lIach Schodulo B II over $400),
b Tax"exempt illlllullllcom, (III PO, Ill), DON'T IlIclud. on Ilnlll. ,. 8b
9 Dlvldond Income (also anach Schodule B II ovor $400), . .
10 Taxoblo rolunds 01 slalo and locallncomo laxes, ilony, Irom .....otk.h..l 011 P.II' III
11 Allmonyrecolvod. , , , , . , , . , , , ,
12 Bu.lne.slncome or (loss) (an,ch Schodule C), , , , , , . . .
13 Capllal gain or (loss) (~nach Schodule 0) , , , , . , , , . . ,
14 Capllal gain di.trlbutlon" nol ropMod on line 13 (000 pago 17)
15 Olhoo gain. or (Iossos) (anaoh Form 4797).
t6aTotallRA distribution. , , , ~j O. 16b Tsxablo amount I'" p.,. "I
171 TOIII Plnllonund .nnUIIII" ' , l..!!!J O. 17b Taxable amount (JIll plgl 17)
16 Aonls, royoltlo., purlnorshlps, ostalo., trll.t., ate, (allocll Schodulo E) ,
19 Farm Income or (10'.) (ottach Schodllle F), '" , , , " '" ""
20 Unemployment compen.allon (Insul8nco) (soo pogo 10), , , . , 'tt:.K.lf:'C' ,(:'("\'
211 Social aocurlly bonofil., , ,~ 11, 890. 21li'1'J,xp,\,uQDI,,\..I~ "
22 Other Income (1I911ype ond .mollal- "".,. 191 u.. u u .~':= u _... u.... u u u
23 Add Ih..mounl..ho.....1I In Ih. '11 tlghlelllumn lor Ilnullhrougl! 22. Thl, I. youl total Income , , , ,II-
241YoIU IRA d.duellllll, Irom .pphcabl. .....ark.h..t on p.lI' 200r 21 24a
b Spou....IHA d.duell/ln, ham .pplicabl, .....ol~.h..1 011 p.g. 20 or 21., 24b
25 Ono-hall olaoll-omploymunt lax (aoo poge 21), 25
26 S.t1-.moloy.d hllUh In'U,'.nCI d.ducllon, ham wOfllh'!l1 on p.ge 22 26
27 Koogh rell,oment plan and .oll-omployod SEP deduclloll 27
26 Ponolly on ea,ly w'tl1drawal olaavlng" 28
29 Alimony paid Aoclplonl'a SSN ~ 29
30 Add Ilnos 24a Ihrou h 29, Thoa. ora our tolal ad uslmonls , ,~ 30
31 ~Ubtroclllno 30 /,o,,/llno 23, Thl. I. your adlu.led groaa'ooomo. Illhl' omo'''lt I. 1000 than
rn2r.\;~ ~~O~I~,~W~n~~~ ~III,l ~O~",aoo, p,a~d,45 ~o ,m,ld, a,lll, il,Y?U, c,a~ ~ ~i~ t,h~ ',E~r~O,d, ,II- 31
o.
o.
O.
O.
O.
195-07-1784
SpOUU'. .ocl.lueurltv numb.,
314-16-9321
For Prlvlcy Aollnd
Paperwork ReducUon
Aot Nolleo, ao.
Inotruollons,
Nato:
Cn.Ckinll"VU.
w Inolcll.ngo
~~~~ ta~u~r,~'~nd,
2
. h~,d .....Ilh you
. dldn'llIv......ilh
you due 10 dl~prCl
Ot IIP3t.\lon \...
p.ge 14)
No,oIOlh"
d,p,nd,nl' on tic
Addnumb.r.
.nl.r'don
Iines.bov.
~ 2
7
61
982.
9
19
11
12
13
14
16
16b
17b
16
19
20
21b
22
23
69.
o.
25.
438.
o.
1 514.
o.
Dill] For f'lap'I\IIUrl n,ducllon Act Nolletl,~" Inltl,
CopyrlQhl (c) 1991 lorm SOItWMI only Cerlt.r Plec' Sollware, Inc,
'"m 1040 (19"'- OIIlelal V.r.lon
1 514.
Form 1040 1991
Tax
Compu-
tation
If VOU wlnt
tho IRS 10
lIgure vour
flXl800
plgo 24,
Credit.
(Sea
pago 25,)
Other
Taxell
Payments
Attach
Fo,ms W-2,
W-2G, and
1099..R lu
pago 1.
Refund or
Amount
You Owe
Sign
Here
Koop a copv
of Ihl. return
for vour
rocordo.
PaId
Preparer's
Use Only
32 Amount ~om line 31(ldjustod groS8lnoolOO) . . . , , . . , , . , , . . , , , , . , , ,
33a Chock II: 00 You ''''.IIuatlltd",D Dllndi 00 Spou.. wuUor(lldlf, 0 DUnd,
Add tho numbur 01 box.. chockod lbovo ond onlo, Iho lolal hOlO, , . , , , , . ~ 331
b If vour plllonl (or 8OI1'OOne also) Clr, claim VOU as 0 dopondent, chock hero, , ,~ 33b
o If VOU ore n1IITlod flllng ~ Doplrlle rolurn Ind vour spou.. Itomlz.. deducllons,
0' VOU ore a duaHlllus allen, 600 pago 2:J and chock hOle, , . , , , . , , , ,~ 33c 0
Itlmlzed doduoUonl (from Schodulo A, IIn. 26), OR
S"ndard daduotlo" (ohown bolow for vour filing slalus) CauUon: If VOU
chockod .ny box on IIno 331 or b, go to pago 23 to find vour olandard
deduction, If VOU chockod box 330, vour olandord doducllon 10 zoro,
. SII19Io - $:1,400 . H.ad of hoU90hold - $5,000
. Marrlod filing jolnllv or QUlllfylng wldow(o,) - $5,700
. Marrlod filing soporalolv - $2,650
3S Subl,act IIno 34 ~om IIno 32 , , . , , , , , , , , . , , , , , . . , , . , , , , , , . . , ,
3S If IIno 32 Is $75,000 ur laos, mulllplV $2,150 bV Iho lolal numbor 01 oxompllono clalmod on
IIno 6<l, If line 3210 ovor $'/5,000, 000 p.go 24 lor Iho amounllo onlO,. . . , , , , , . , .
37 Tlxablllncoml. Subtroc: line 36 f,om IIno 35. ~Ino 36 10 rooro Ihan II no 35, llnlor -0-.) , .
30 Entor talC. Chock If from I [[] Tu hbll, b U Tu AlII !lcnldul.., C D Sch.dul.o,
or d D Form I511U (IU pg 24~ IAmounl,.' Iny, from Forml.jlS1l14 ~ . ,),
39 Addillonal tlllWS (000 PO 24), Chock If Irom . 0 Form 4670 ~.
40 Add IInos 36 and 30 , , , . , , , . , , , , . , , , , , . , , . ' , , , , , , . , , . ,
41 C,odlt for child end dopondonl coro oxponoos (ollach Form 2441) 41
42 Crodlt for lho oldorlv or Iho dl.ablod (allsch Schodulo R) , , ,. 42
43 Forolgn lax crodlt(allach Form 1110) , , . , " "".,. 43
44 Olhor crodllS (000 p~ 25), Chock If f,om I 0 Form 3600
b D :i~8 0 l!J :i~T d D f.~r'~IIY) __ 44
45 Add llnos 41 Ihrough 44 , . , , . , , , , , , , , . , , , , , , ,
Ie Subtraclllno 45 from llno 40, (If IIno 451. rooro Ihan line 40, onlor -0-.
47 Solf-omplovmonllax (allach Schodulo SE), , , , , , . , , , . . , , .
4S Attornativo minimum lax (alloch Form 6251) . , ' , , , , , , , , . , . , , , . , , , .
49 Roospturataxo9(,uplij.2a"Ch,cklflrom 10 Form.255 b DForm8811o 0 FormU26
50 Social soourlty and Modlcaro lax on ~p Incomo nol roportod 10 omployer (all8ch Form 4137),
51 TOJ( on an IRA or a quallflod rollromont plan (attach Form 5329) .
52 Adva~ oamod Incomo crodll pevmonlo Irom Form W-2 ,
53 Add llnos 40 Ihrou h 52, Thlols our tota,.... , , . , ,
54 Foderal Income tax withhold (tl Iny tllrom FormlllIO;9. ch.ck 54
55 Ul9,ullmal.d 111I Plymenl' .nd Imount Ipphld Irom ,ago ,.ILI,n, 55
58 Earned Inooml credit (attach Schodulo EIC), , , . , , , 58
57 Aroount paid with Form 4600 (oxlonolon roquool), , . ' , 57
58 Ex"".. social socurlly, Modlc",o, & RRTA lax withhold I..' ""IT! 58
50 ~tCr~=~1~: ~a~~ ~7~, ~h~k, ",f'~~.., [J, F~r.m, 2,439. 59
50 Add llnos 54 th,ough 59, Thoso are Vour total paymlnl& , , , , . , , , , . . , , . .
81 If 11110 60 Is mora Ih.n lino 53, ,ublroclllno 53 Irom IIno 60. '''',''''' ,moun! ,,,OVERrAtD,
82 Amnunl of line 0110 be REFUNDED TO YOU , , . , , . , , , . . . . , , , . , , . . , ,
53 Amount ,"m' 11" b, APPLIED TO YOUR 1992 ESTIMATED TAX~ 53
64 If line 53 Is moro Ih.n line 60, ,ublraclllno 60 Irom IIno 53. Thlo10 Iho AMOUNT YOU OWE.
AIIach chock or roonov ardor fa, full aroounl pavablo 10 "Inlornal Rovonuo Sorvlco." Wrllo vour
naroo, address, social ,ocurlly numbor, daylimo phono nllmbor, and "1991 Form 1040" on It . , 64
85 Esllmatod tax ponal!v ('00 pago 20), Also Includo on line o~ 0 . I :
lJndll plttlllt.. of Pllluty,l dlelllllhlll hlllll IM.mlnld Ihl. 'Ihllnlnd .ccomplnylng loh.dLlI..lnd .tltemlnll,lnd 10 Ihl b..l 01 myknowt.dgl.nd
bill I', thlY'" I'LlI, corf.cl.lnd compll'l, O.cl.,.Ilon 01 pllp,,,'lolhft Ihln IUPlYII)11 baud on IlIlnlo,mllion 01 which pnptle' hu .ny ~l'\Owtldg"
34
EI1I01 too
I.rger
of
vour:
~ You,slgnstult
~
Dill
Youroccuplllon
RETIRED
SpoUU"ltgn.IUrt(11 JOlnl"lurn, noTtt mUIIIlgn)
01'1
SPOUI,"OCCuplllon
HOMEMAKER
flllPI'ft'l ....
Ilon.lult ,.
Ftlm'ln.m./oryourl ~
IInll-ImploYld)
Ind.ddrtu
RICHART'S TAX SERVICE
618 BRIDGE STREET
NEW CUMBERLAND PA
32
1"1"1
1'1,11'1'
'1111,,11111
l:'iri,
1111'1'1'1
'Ii!.'
il: 'i,:I'1
fl'j,
'11'11'1
.II',., j,I,
'1"""1
'1 .'1: 1,1 ~ i II
.llllllj'll
34
illil,.III,'II,1
'II!
,Iilll'jll.
35
36
37
3S
39
,~ 40
45
,~ 46
47
48
40
50
51
52
53
.~
O.
O.
O.
.~
.~
.~
O.
P 2
1,514 .
7 OO.Q..:.
4 300.
O.
o.
O.
o.
O.
O.
O.
o.
O.
O.
O.
PnpIIII'I.OCI..lucu,llyno,
232151646
17070
ForPaptrwo,. nldllclmn Act Nollce,II.lnltl,
CopyrluhllCl191l1 Intm ,ullwll1lllnly Cllnl" fllect fiollWIII,lnc.
Form 1040 (\!l9lJOtf1clal Version
JOHN S. & GLENORA R. LEONZO
Schedule B - Interest and Dividend Income
Plrt I
Inleflll
Inoome
(See
pages 1&
Ind <13,)
Noll: II you
received a Form
1099-INT, Form
1Ci99-010, 01
aubsUlule
stalemenl, from
. broklKage firm,
11011110 firm'a
name ..Iho
p.yer and anlar
lhe 101allnlal081
lhown on 11111
form,
Plrt II
~ivIdend
Incom.
(See
p.ge. 16 and
43,)
Noll: II you
received a Form
1099-0IV, or
OlIbsUtula
stalement, Irom
a brokarage
firm/lI.t lho
firm 0 name as
lhe P'Y., and
enler lho lolal
dividend. shown
on Ihal form,
Plrt III
Forllgn
Aooounll
Ind
For.lgn
Trulta
(See
pago 43,)
II you rlOllved mar. Ulln S400 In IlIxabl. Inllfllllnoom., or you .,1 otllmlng the exclullon ollntarul from a.rill
EE U.S. IIvlnga bondllllUod ~lter 1M' (_ page 43), you mUll oompt", Plrt I. UII Alllnl.rlll r_lvod In
Plrt I, II you r....ved mar. thin S400 In IIxlblelnta,,"llnoom., you mUMlll10 comptll. Part III. II you received,
Qtl nomln.., Inllrlll thll lotuIlly bIlongolo Inoth.r ~n, or you r_lvod or paid .oaruod Intarlll on
tlCurftllllrlnallrTlCl be_n Inllflll .nl dalll, III 43.
Inloro.llncome
Inllll...t Income. (Us! name of payer - II any InlO!09llncome /. from aollar-flnanced
mo~g.gos, '100 InatructJon. and 11.11111. InlolO.1 fir,\') ..
p.~~ _ p.~!,: ~~1Jl~I)~ _ J:g................ ...-_-...........-_-...-...-:.-.-.-.-.._-.-.-.-.-.-.-.-...-...-
Amounl
O.
982.
O.
~.._._...-..._.._.._..-.__......._._.._..._....._-......................
........................................................................
........................................................................
................................~...................................................
X~~;~}.:~jif :$~~~9~~X::::::::::::::::::::::::::::::::::::::::::::::
982.
O.
O.
O.
O.
982.
........................................-............................................................
.................................................................................-..............
..............-.................................................................................
..............-..............................-......................................................
2
3
2
Add lhe amounl. on llno 1 . , , . , , , , . . , . , , . , , , , . . . . . , , . , . . . , , , . .
Enler lhe excludablo 'avlng9 bond Inl"e91, II any, from Form 681&, line 14, Anach
Form 681& 10 Form 1040 . . . . . . . . , , . . , . . , . . , , , , , . , . . , . . , . . , , ., 3
4 Subtract line 3 from llno 2, En"}f Iho result holO and on Form 1040, line 6'. . . . . . . . , . . . ~ 4
II you rlCllved more th.n S400 In grail dlvlcloncla .ndlor other dlltrlbuUonl on Ilock, you mUll oomplel. P.rts II
Ind III, If you received, II I nomln.., dlvlcloncla th.I .ctull balon 10 .nother raon, III 43.
Dividend Income
982.
Amou nl
5 Dlvidlnd Incoml. (LI.t naml 01 pi V" - incluLlI on lhll IInl uplllll Olin dlalllbuUonl, nonlllqbl. dl.lrlbulionl, Ilc.) ..
...................................................................................-.................
O.
23.
71.
X$:r:: ~X$~tjR<?~:: ~N{9!:i~::::::::::::::::::::::::::::: {~:$ I::::
R~R9;I;,9~ _ .~l:l5:....... _........... ........ ._....... ...... - -.-..........
............................................................................................................
...................................................................................................
5
..................................................................................................................
.........................................................................................-...................
..............................................................................................-..................
..............................................................................................-.................
p.!~!~~n~: :$~~~9~~X::::::::::::::::::::::::::::::::::::::::::::::
94.
O.
94.
.....................................................................................................
Add tile amounle on llno 6. , , , , , , , . . , , . , . . . , . , . , . , . . . . , . ,
Capitol goln dl.l11buUon.. Enler horo and on Schodulo 0'. . , . " 7 25 .
Nontaxable dlstrlbullon., (See lhe In'\' for Form 1040, line 9,), . ., . 0 .
Add lines 7 and 6, , , , , , . . . . . . , , , , , , , , ' . , , , . . . . . , , , , . . g
SubtrAClllne 9 ~'om I'no 6. Enlor tho resull hero ond on Form 1040, IIno 9, , . ,~ 10
. If you received oapltol goln dl.l~bullon' bul do nol need Schodule 0 10 ropon any olhO! goln. or 10"""", 900 Iho
InstrucUon. for Form 1040,1100:113 and 14.
II you roc.lvod mor.thln S400 ollnlerlll or dlvlclondl, OR II you h.d . lorolgn eocounl or w.r. I
granlor 01, or . IrInaleror 10, I 10r.lgn trult you mual 1~lwer both qUIIUonl In P.r1I11.
III AI any Umo uurlng 1991, did you h,v, en Inloro.tln or a slgnalura or olllar aulhorlly ovar a flnanclalaccoul1l
In' forolgn country (suoh ao a bank ,ccounl, soourlllo. accounl, or olhar flnonclol accounl)? (500 page 43 lor
oxcepUon, and filing loqulromenl' lor Form TO F 90-22,1,) '. """""".",.".,.,.
b II "Yo.," onlor tho n'ma of Iho forolgn counlry ~ .............................................. _...
12 Woro you 1110 granlor 01, or Iron,'oror 10, a forolgn Iru.llh" oxlslod during '991, wholllor or nol you h,vo
,ny bonoflclallnloroslln \[7 If ''Yos: ou ma havo 10 fIIo Form 3520, 3520-A, or 926 , . , , . , , , , , , , . . . .
..../'. .',
, ;/, ., /.-("" \, /'1"''' r}
cop)(1g'li'!rc) 19q1'1'Ofnl inTlIII'"rl only fllece Sorr~..l"c,
.
7
.
g
10
.
25.
69.
x
For r"Plfwor_ Rlducllon ACl Nollce, 1111'"111.
,
.>)/~,
/
, ,Fblm 104Q./!lcllldul1 B (l11g'l
~J' ~ ,::.~. /L '11_;(,., (.: I
.-".., .
2 PAYER'S name, address, city,
state and zip Cede
HARRISBURG TAXICAB
RECIPIENT I S
ID Number
195-07-1784
RECIPIENT'S nnme(first,middle,last)
PAYER'S Federal
IO Number
JOHN S. LEONZO
Street address (including apt. no.)
841 BOSLER AVE.
city, state, and ZIP code
LEMOYNE, PA 17043
Account number (optional)
Form 1099-R (Replaces Form W-2P)
\
[ J CORRECTED (i f
11 Gross distrib.
438.
cheoked)
I
2a Taxable amount
438.
~b Taxable amount Total
not determined distribution
[ J [ J
3 Amount in Box 2a 4 Federal income
eli1ible for cap. tax withheld
ga n election
O.
5 Employee oontrib. 6 Net unrealized
or insr. premiums appreciat. in
emplyr's sec.
7 Distribution IRA/ 8 Other %
code SEP
7
9 Your percentage of total distribution
10 State income tax 11 State/Payer's
withheld st.at.a number
/
12 Local income tax 13 Name of locality
withheld
; 1040
"
Label
(Soo
Instructions
on pago 10)
Ua. the IRS
label,
OlhorwlDo,
ploa.o p,lnl
0' Iypo,
Prealdentlal
Elootlon Campaign ~
(500 pago '0,) ,
Filing Status
(500 pago 10,)
Chock only
ono box,
Exemptions
(Soo pago 11.)
II molO Ihan sl,
dopondollls,
soo pago 12
Income
Attaoh
Copy B of your
Form. W-2,
W-2G, and
lOSS-A here,
II you did nol
gOI . W-2, soo
pago e,
AUach chock or
monoy ardor on
lop 01 allY Forn"
W-2, W-2G, or
I099-A,
Adjustments
10 Income
(500 P"go 10)
Adjusted
Gross Income
(JI;lJ'jrll.ntollllelrl.l'uly-lnllllll,\llle..'rlue:,tll..,r....
1992
-.!1&. Indlvldunllncome Tax Return
,1QH,.nr1Hl
Ifl~ UU(lIlI~. (Ill un! WIll. Of SIJl!llllfl Itul'D4G'.
YOIlI'OCI.IUcurl,ynlJmb.r
00 you wan: $1 10 go 10 Ihl. IUlld7 , , , , , , , , ,
II olnl rolurn, doo~ your 9 OllSO Wl1lll $1 10 0 10 lhl!llllfld?,
Slnglo
Mllfliud filing jolnl roturn (ovon II only 0110 hacllncort)o)
Married lIIing soparato tolllrn. Enlor !lpOWIO'!l SSN nbovo & lull namo horo. Ii>
Haad 01 hOllsutlOld (willi qUlIlilying p'Hson). (Soo paqo 11,) litho qunl,'ving por!Jon 19 a child but nol your dopon-
donI. onler 11113 clllrd'j nnrno horo. ~
QualllylnQ wldow(or) willi dopondolll e/llld (yom spoo.o d,od ~ 19 ), (500 pogo 11,)
Yourself, II yOIJf I,,,'ellllor ,urneontlll")UIl cl.l,m you u a (Jepen~'"1 Or! hi' or t", lol.
fllurn, (Iv nfll ~~eCk tlOll 6J, flul tie SlIfl 'u ChICk Ihe tlor on line JJlt on 03;11 2.
Fu'lh. uIJu,,-[l,cJl.l'ilQ1.IIIuln.rU.y..H IlI'l ,nn'nf!
You' 111"fllm, Inll Illl'tll
tHlrl.lme
L
A
o
E
L
If
E
A
..
JOHN S LEONZO
IIIJOlnlll!lJln.l/lnUU'lf"llnlm.lrHllll",.,1
l.Ulnam.
GLEN.ORA H LEONZO
Horn. Idrlreu ("urntJ'l .nd .lrul) It you h4~1" 1'.0. flU., ~It' 1',I~e 10
Apl,no.
841 BOSLER AVE.
CI'y,lown 01 PlIll otlle', .tJl., Jlld II"cOll'.1I '1'011 h'~, 4 lOlfll.l'lddlJIDII, Uti p4ge 10,
LEMOYNE
PA 17043
1
2
3
4
x
6
Oa
x
~ous.
o Dependents:
'"
n, "
under
~\Ie I
(3)lla\lo lornlder,
d'p,ncl,n!,.
10CI.lluclJrl! numfler
(4)Oepln(lllnl'l
fll,lllon'hlP
'n ou
(ll Nam'I',I$!, In'I'41, ,l'"l(j IHI n.'me)
I~) No. 01
mlln\llll'~'l:l
InVulIr horn.
In 1992
,lO
(IMlIN".15,u'OOI4
195-07-1784
SpOUI,'.IOCI41"cuhlynllrnb.,
314-16-9321
For Privacy Act and
Paperwork Reduotlon
Act Notice, aea
Instruotlona.
Note:
~n,'~~lnt~in'g'"
~~~~ ~;u~rr~'~nd
}
No. 01 b,"~u
ChlCk.don6.1
.lncliH,
2
tjfl,nlvnur
chllllr.nonSc
Nho
. h....d'hllhVOU
. dldn'lh....'hllh
~ou du,'o dlyorc.
P~J:Pl\,).lion IU'
o
o
NO,olothlr
tI.p,ndenllon6c 0
d II ~OUI ch,'d didn't liv. wllh ~ou bV' " tl.llm'd as ~Illi' depend en' und.,. pl'- IQUagrtemeht, Ch.Lk ~ Add nurnbe"
.nl.r,don
e Tolal number 01 Q)wrnp!lon9 clalmod, . . . . , . . . . . . . , , . , , . . ,. ,.,..", hn....bo~. .... 2
7 Wago., salollo" I,ps, Ole, Allaell Form(s) W-2 ,
aa Taxable InlolO91lncomo, AUoell Sellodulo B II ovor $400,
b Tax..exempt IIIIerUllncom.{u. PQ 1$), DON'T InCludl on hll' Sa
8b
9 Dlvldond Ineomo, Allaeh Sellodulo B II ovor $400 , , . . ,
10 hubl. r.fund5, ;r.dlh, or ollle!s 01 ".1'1 and locallntom. la.., from worklh", on PJge I"
11 Alimony loeoll/od. . , , , , , , , . , ,
12 Bu'llIosslneomo or (109S), Alloch Sehodulo C 0' C-EZ , , , ,
13 Copllol gain or (10'"), Alloeh Schodulo 0, , , , , , . , ,
14 Copllal gain dlslrlbullons nol ropollod on 11110 13 (900 pogo 15)
15 Olhor gnlns or (Iossos). Allneh Form 4797 ,
laaTolallRA dlSlrlbullon9, ,~
17aTolalp.n.,on..anddnnull,n ,~
18 Aonts, loyoIIIO!l, pmtnorul1ip9, 091il109, lrllsls, utc.
1& Farm Incomo or (1099). Alltlcll Schodulo F
20 Unomploymonl eomponsallon (900 pogo 17), , , , , , , , , . , , ,
211 Soelnl soeurlly bOllolll.. ,l1!!L 12 I 320. 21b Ta'oblo omoUIIII""", 1/)
22 Olller lncomo. lIsllypo and amounl ~ lei page 18 .... . .. . . . .. u. . . . . . . .. . .. . . . . .
23 Add Ih. arn,"unllln Ih"ar /lgtll wlumll lnr hn.s 71hfough 22. Ttlll15 ~olir total Income "",....
.24a YoullRA deduction !rom ap'lhcabl. ....ork.h..l on P'g~ 19 or :20. 24a
b 5poul.'s IrlA d'llllcl,on Ilonl appl,cUllt 'hor~I'lllllt on p.ge III or )0. 24b
25 Olio-hail 01 soll-omploymonllo, (900 pngo ~O). 25
26 5elf-1100loYld hullh IIISUrJnte d.ductlOn (ue p,lge 2U). 26
27 Koogl! rotlromonl plnn ollll noll.nfJlployoel SI;P doductlo/l 21
2a Ponally Oil oally wllhdrewol 01 savlllg, 20
29 Alimony paid, ROelplOlIl" SSN ~ 2S
30 Add Ilnos 24u Illrou II 20, TIIlJ.'ltl am our total ad u9lmonts . ..... 30
31 ?ublrr,cl hnQ 30 !rorn hno 2:}. ThiS is your adlu~ted gr09sJncome, II Ihl!llInlounl i!lI{i591han
rllo~ ero~I~"roh~I~~~~~ ~1It.' ~O~", u~o. p.a~d, E.'~"~ '.0 .III~ ,O~II.II,y~lI. c~n ~la.l~ I~'~ "E~rr~o~... 31
o I 1Gb Taxnbro nmounllttt p.". IG}
01 17b Ta'i(oblo amollnl !see ro.lg. 16)
A11nell Sellodlllo E
o.
7
8a
1 355.
9
10
11
12
13
14
15
16b
17b
18
19
20
21b
22
23
106.
o.
o.
438.
o.
1 899.
.' ~l '5 COPY
01111 Fa, Paplrwo,k R.dutllon Act flO"tl, 1lllnlll,
o.
o.
Cop~rlghlltlligllorm 1011'11"" only Cfnl~' f'I.r.1 !iotl"'lrl.ln~.
rOfll1 1040 (19921 - OfficIal Version
1 899.
30llN 'S & GLENORA R LEONZO
FOlm 1040 (1002)
Tax
Compu-
tallon
(500 pogo
22,)
II you wanl
Iho IRS 10
Iiguro your
lax, 900
pogo 23,
Credits
(500
pogo 23,)
Other
Taxes
Paymsnts
Anach
Forms W-2,
W-2G, ond
1 099-R 10
pago 1,
Refund or
Amount
You Owe
Mach chock or
monoy ardor on
lop 01 FOlm(s)
W"2, (ltc., on
~
Sign
Hers
Koop a copy
of Ihl, rolurn
lor your
records,
Paid
Preparer's
Use Only
195-07-1784
Pogo 2
1 899.
32 Amounllrom IIno 31 (adjlwlod grons Incomo) "
33a Chock If: [K] You wu. 6~ Of UI<lII,O Blind; [KJ Spouso wH a~ or OW'f, D (]hnd
Add 1110 number 01 be,o. chockod abovo and onlor Iho 101011111I0, ,. 33a 2
b II your paronl (or somoono also) con claim ynu o. 0 dopondolll, chock l1oro, ,. 33b
c II you oro marrlod liIing soparaloly and your upouso jlum;zos dudLlcllorls
or you SID a duaHilallm allan, 900 pago 22 and chock hora. . , ,
Itomlzod d.ducltono 1r01ll SCllOdulo A, 11110 20, OR
Standard deduction ohown b<Jlow fOf your IlIlng glahJs But If you
chtlckod Iny box on IIno ~3a or 0, go 10 pg. 22 10 llnd YOUI alondord
doducllon. II you chocked box 33c, your 91ondord doducllon In zoro,
. Singlo - $3,000 . Hood 01 hou,ol1old _ $5,250 ' , ,. 34
. Mal/iod I,ling jolnlly 01 Qualilylng Vlldow(or)- $0,000
. Mal/lad 1111119 'oporololy - $3,000
35 Sublracl IIno 34 from IIno 32 ' , , . . . . , , , , ,
36 IIl1no 32 Is $70,950 or 10"', mulliply $2,300 by Iho 10lnl numbol 01 o'omplion' clolmod 01'
hna 60. lllino 32 j'l ovur $70,950, 90(J 1110 worksllOol on pago 23 leI ltHl o01ollnll0 Ofl!or,
37 Taxable Income. SubtrD.clltno 30 trom IIna Jr" IIlillo 30 IS moro ttUlIlllno 35, onlor ~O. ,
38 ~nlor Iw<. Chock i1lrom 0 [K] la, Tabla, b 0 To' Rala SCllOdulo" c 0 Scl1odulo 0,
01 dO Form 8615 (soo P9 ~3) Ami, II any, Irom Form(s) 6014 . 0
39 Addll,onollo,o, ('00 P9 23) Chock i1lrom. 0 Form 4970 b D Form 4972,
40 Add 11009 36 and 39 , , , , , , , , ,~
41 Crod,'lor child and dopondolll cora o'ponsos, Allach Fo.m 2441 41
42 Crod,l for Iho oldolly DI 1110 d"ablo(!. AIIach Scl1odulo R 42
43 Forolgn Ill)( crOll,!. Alloeh Form 1110 , , 43
44 Olhor c,odl" ('00 paQo 24), Cl10ck i1lrom a 0 Fo,m 3000
b D :~~~ c 00 ~g~T d 0 rt~r:C1IYI
4; Add IInos 4111110U9h 44
46 ~ubl(aclllno 151rom Uno 40. If Iino 45 19 more than Iino 40, onlor -0-
47 Soli-employment lax. Alloch SctlOdulo SE. Also, !IOO llno 25,
48 Altornalivo minimum tax. Aflach Form 6251. ,.
49 Recapturo lay-os (SOD pg, 25), Cl1t:k II 110m a D Form 4~~5 b DfOf~' U;1 1 C D form !1\1!
50 Socia' socurity and ModlClHO Inl( on lip IIlcon"lO nol ropoflod 10 omployor. Allnch Form 4137 ,
51 To, on qualil,od roliromonl plans, IOcludlng IRA" AIIach Form 5329 ,
52 Advanco earned incomo credit paymonl9 !rom ~'orm W~2 ,
53 Add 11110' 46 Il1rouqh 52, Tills I. YOll,lolal la" , , , ,
54
55
58
57
S8
59
32
,. 330
o
34
Enlor 1110
lorger
01
7 400.
YOII/:
35
36 4 600.
37 O.
36
39 O.
40 O.
44
o.
O.
45
.~ 46
47
48
49
50
51
52
,~ 53
O.
O.
o.
Feder"lInCllm'l"~ wlthhelcl. II InylS /rom ~O'm(tlIO~~, ct>IlC~ .. 54
1992 eslimatod lax pnymon19 and amI. appllod from 1991 mlu," 55
faroad In com. crodll. Allnah Scliodlllo EIC , S8
Amounl paid VlIII1 FOlm 4066 (o'lon9lon roqllo,,) , 57
Exce9s soclal9oclHity, Modicare. & RATA la'lC withhold (500 pg. 20) 58
01110' poymom, (soo pago 26), CllOok IIlrom a 0 Form 2439
b 0 Form 4,36, ' , ' , ' " """"""", 59
60 Add IInon 54 lhrouC}tl 59. Tllc.no ora your total payment9 , , , . .. 60
61 11110060 I' mala Il1an Iil10 53, sllblraol hno 53 110m 11110 00, Tills Is 1110 0011, YOll OVERPAID, . ~ 61
52 Amollnl 01 hno 61 YOll wonl REFUNDED TO YOU . . , , ' . , , , , , , , , , ,~ 62
63 Am"""""",,, bo APPLIED TO YOUR 1993 ESTIMATED TAX~ ~ O.
64 IIl1no 531, mora II10n Ilno 60, ,"bIrOCI hno 60 Irom IIno 53, This Is Ilia AMOUNT YOU OWE,
Allocl1 chock or monoy oldor 101 lull omollnl poyablo 10 "ll1lornal Rovonllo SOIVlco," Willa YOllr
nanlO, addro!\s, oaclal socurlty numbor, daytlmo phone numbor, and "1092 Form 10<10" on 11. . , 64
65 Es!lmalM I'" ponolly (soo poqo 27), Also Includo 011 hno 04, 85 0 .
O.
o.
O.
O.
o.
Ulld" p'llllll'l of P'qu'y,1 dllCIAtt ll'lll I hh' e..mlnld Ihll f.lurn .and otGcomnal1r"I~ ICh.llull'5 Jnd SIJlem,nIS, MId 10 tne n"I 01 my ~nowlld~, Ind
bllllel, IheyA" Ifll', COIIICI, .nd camp Ie Ie 0,,1"41,on of pf,p,uef (Olll,f 1"411 U~psrt'lIS lased un JII'IlIIHmlll",n or whlen pfeplI'" nu any knowlltdgl,
~ 'l'ollftlgnllutt
~
Ootll
YOUfOGCupatlon
ETIRED
notle
Srou.e'soGGup"Ilon
SpouU'S "gnUI'f'.1I tOlnt "Ivrn, BOTti mll,l "gu.
OMEMAKER
P"f1lr,,'1 ...
""nllll" ,
ChlCkllu".
employ.d
r,.p.f.f'ttOCIAIUCUf.IYflo.
Flfm'.flAm.(oryOUf,
IlulI-emPloy'd)
AlId Add,...
~ ~ICHART'S T SERVICE
r 618 BRIDGE STREET
NEW CUMBERLAND PA
23-2151646
17070
ForPIP"work n'dlltllonAcl NollC." ...Intlr,
CopYrlght(rJ 19911o,m .oflw"" onl.,. ClntlH PI~ce ~oltNMf!. Int
foom 1040 1",,,Offlclal V.rslon
08
Schodlllo B (Form 104011902
Narnu(uj Stl0WIl on fOlln 1040,
JOHN S & GLENORA R LEONZO
Schedule B - Interest and Dividend Income
Part I
Inter..t
Income
(500
pOg09 14
ond 6..1.)
Note: II you
recoivod a Form
1099-INT, Form
1099-010, or
subslllulo
slalomonlllom
o brokOlogo 111m,
"SI tho lirm'9
noroo os Iho
poyor ond onlor
Iho tOlolllllol091
shown on IIlal
form,
Part II
Olvlde~d
Income
(Seo
pOg09 15
nnd 6-1.)
Nole: II YOll
rocolvod a Forl1l
1099-0IV 0'
SlIb91111110
otatOfTKHlI, hom
a brokOlago
111m, h911ho
fjrm's nllmo liS
Iho poyor ond
onlor tho lolnl
d,vldond9
9hown on Ihnl
form,
Part III
Foreign
Account.
and
Foreign
Trusts
(500
pogo B-2,)
195-07-1784
II you had Dvm $400 Illlilxoblu mllllo!!l inCOn\(1 ()R ynll "m clAiming lhn nxclu!ilol1 01 inlor(Jnl horn UlIIlll!l EE
U.S, 9Jvlngs bond9 l..lIod ohOl 1009, YOllm,ml cemplolll Ihln pOll. Linl ALL inloronl YOll rocoivod, II YOll hoel
ovm $400 in taxablo IntOlosllncorno, you nUll'll nl90 complolo Pmllll. II you rocolvod, 09 it 1l0rllmou, lnlmosl
lhol ocluaUy OOlon99 tu 01101110( porDOIl, or YOIl rocolvod or paId aecluod Inloro!ll on IJOCllllllo!ll/nl\!llorrod
botwoonlnlorost paymonl dalos, BOO p8g0 B~ 1.
Inlmo91lnconlO
List noma 01 payor - it tlllY 1Ill00onl incomo 19 from Bollor~lillnlleod
01O~gOg09, .00 pogo a-l nnd 1i911hlO Inloront IIIDI ~
~lil!'!. pJ:At!'!I]l!'!I)}:,. JlL,.............. ......,.........................:..............................
............................................................................
...........................................................................
.........................................................................
X~~~i~~t: :$~i~~<?~~X::::::::::::::::::::::::::::::::::::::::::::::
............................................................................
..............................................................................
.............................-.............-.............................
...........................................................................
............................................................................
2 Add 1110 onlO1II1I. on 11110 1 2
3 Excludablo savings bond Inlo(o91, II ony, hom Forlll 0015, lino 14. Allnch
FOIm 001010 Form 1040 , , 3
4 Sublrocllino J 110m II no 2, Enlor 1110 ,onllll horo and on Form 1040, lino on, ,~ 4
II VPu had ovor $400 In gl09S divldond!l and/or olhor dl9trlbulion9 on ~Jlock, you mU~1 complalo Ihi9 pnrl and Part Ill.
~ocolvod, o. a nomlnoo, d'vldondn Illolocluoliy bolong 10 onolllor por.on, DOO ago B-1.
Olvldond Incomo
5 Llsl o.mo of payor - Incluelo on Ihl. linn copllol gain disl,lblll,ons, nonlo,obl. dl'lrlblllions, ole, ~
..................................................................................
"iST'HARRISBURG'" sANcoR'.................. ........ -...........
....... _ _............ J.................,......... . . .......... ...........
.~~?1?I.9~..I.l:I~.... ............... ........ ......... ......' _,.... ......
.............................................................................
...........................................................................
...............................................................................
5
..............................................................................
.......................................................................................
............................................................................................
R~x!i:l~n~: :$~~~<?~~X::::::::::::::::::::::::::: :::::::::::::::::::
.........................................................................................
6 Add tho amount9 on 1100 5. . , 6
7 Cnpliol goln dislllblllionn, EnlOl horo ond on Sclloelulo 0' ,7 0 .
8 NooIo,oblo di"rtbul,on9, (Soo Iho In,' lor Form 1040, hno 51 ,8 0 .
9 Add linon 7 and 0 , 9
10 5ublraelllno 9 from 11110 O. Ental Iho IO!luIlIlOlU and on FOlm 1040, 1111(1 {I .... 10
, Ii you locoivod copilol gOlll d,,'rlbullonn bul do nol nood Schodlllo D 10 ropo" arty 01110' goin" 01 10390', 000 Iho
In!llmellons lor Form 1040. lin09 13 nnd 14.
II YOlll!od avot $40001 Inloro9t or dlvldond9 OR had 111010lgn neeOUllI Of woro 0 glonlor aI, 01 n transforor 10,
o lorololl Iru.', you munl complolo Ihi. porI.
11. AI any limo durlog 1902, did you hovo a" Inlorosl in or a .Ignnllllo or olhor D""lorlly ovor ol,oollclolACCOll,,1
In a lorolgn counlry, such an n bank aecounl, noeuril/oo 8000111111 or olhor llll/lnellll nccot/nl? SOD pago BM2 lor
oxcoplion. and IiIlng roquiromontn for Form TO F 50-22,1,
b II 'Yo,," onlOl 1110 nomo 011110 10lOign counlry ~ ......'.....,.,.......,.. _ . . . . . . . . . . , . . . . . . . . . . , . .
12 Woro you tho granlor aI, or Iranslolor 10, 0 forol~n trlJ91thnl cWllod cll"H1~11!102. wholhor or 1I0t you luwo
any bonoflclol Inluro91ln II? If ''Yos.'' 'lOll may havo 10 1110 Form 3520. 3!)20.A, 01 020
f-o,P'U""'Ofl fllld",IHlnll:l'/()I"I.'.Ullnllf
c,lr~rlilhl (el ''1Ij~ 101111 pt'...Jlll nrll~ {,nltr I"II~IJ !,Or,..."" rill
10"" 1040 ~i.;'lflllul" Bll'HlJ
x
AnlOunl
O.
1 355.
O.
1 355.
O.
O.
O.
O.
1 355.
1 355.
Amount
O.
25.
81.
106.
O.
106.
O.
106.
Ve. No
x
Department of the Treasury-Internal Revenue Service
Filing Assistance Program
Do I Need To File-Worksheet
Use this worksheet when your only taxable income for 1993 was from one or more of the
sources listed below. Enter the amount of income for each item listed below,
I. Wages, Salaries, lips $
2, Taxable interest income $
$-
$
$
$
3. Dividend income
4.
5,
Fom\~;
,Q,J,4,B, No, lS4s.131e
Eil>of." 7.85
-- .
I 0 q 5", :5 '/
I
1;1 /,
(t"'I~
Taxable Refund (state and local income taxes)
Taxable Retirement Income
(Pensions, Annuities, IRA Distributions-Taxable amount)
./.,.. 4.('
'r :' f.( ,
6. TOTAL GROSS INCOME Add lines 1 through 5
/ !..5".r,'11
,
If line 6 is less than the Total Gross Income shown on the chart below for your filing status,
you do not have to file a Federal tax return. Please keep a copy of this worksheet for your
files. NO further contact with the IRS is necessary.
Do I Need To File-Chart
Marital Status
Filing Status
Single (including
divorced and legally
separated)
Single
Head of
Household
Married,
Joint Return
Married,
Separate Return
Married
Age
Under 65
65 or older
Under 65
65 or older
Under 65, Both
65 or older One
65 or older Both
Any Age
Total
Gross Income
$6,050
$6,950
$7 800
$8,700
$10,900
$11,600
$12300 --
$2,350
The above chart is used for individuals who cannot be claimed as a dependent on another
person's tax return,
PAPERWORK REDUCTION ACT NOTICE- Your use
of this worksheet Is optional. It is provided to aid you in
determining whether you mwt file a Federal Tax Return. The
lime needed to complete this work5heet will vary depending
on individual :ircummnces, The elllmated average time Is 30
mlnules, If you have comments concerning this time estimate
or suggeuions for making this worksheet more simple, we
would be hiPPY to hear (rom you. You can write to both the
Internal Revenue Service, Washington, DC 20224,
Attention: IRS Reporu Clearance Officer T:FP; and the
Office of Management and Budget, Paperwork Reduction
Project; (1545.1316); Washington, DC 20503. DO NOT lend
this worksheet to ehher of these offlces; keep the worksheet
(or your flies.
Form 9452A (7.93)
~ U.S. Gov.rnment Prlnllng Office: 1993-504-658
R\.'KI'fJWL~-'
commonwealth of Pennsylvania
55
County of Cumberland
I, Glenora R. Leonzo, the testatrix whose name is signed to .
the attached or foregoing instrument, having been duly qualified
according to low, do hereby acknowledge that I signed and executed
the instrLll1ent os my last Willj and that I signed it willingly
and as my free and voluntary act for the purposes therein exprEssed.
.a,1. ..~ ~.n
~ Leonzo
Swurn to or affirmed and acknowledged before my by Glenora R.
Leonzo, the testatriz, thl.s 11"/' day of ~~J ,1988.
STEPHEN ~. f10GG, IlOT~,?Y PUBLlO ~
MY Commission r.xplrel Juno 19, I~n~ "r..-
~Il.. PA Cumbo,land Coun~ ary ublic/At ney'
AFFIDAVIT
Commonwealth of Pennsylvania
ss
County of Cumberland
We, SuSql1 .nt, (!Ql"v.t.r and ~eN\I.L1>.~JkUS ,
the witnesses whose names are signed to the attached or foregoing
instrument, being duly qualified according to law, do depose and
say that we were present and saw the testatriz sign and execute the
instrument as her Last Willj that the testatrix signed willingly
and executed it as her free and voluntary act for the purposes
therein expressedj that each subscribing witness in the hearing
and sight of the testatrix signed the Will as a witnessj and that to
best of our knowledge the testatrix was at that time 18 or more
" years of age, of sound mind and under no constraint or undue in~
. i (~{.::r,~~:~.n9\' . 71/1 /"1.' , ^ ~'i'\ e ' ..
,1'/ LAWOFFIOE80fl(',l : I.'~ .~'d/u, ./'.' l.v/(<lJJA {)~~....~)"J...AJ. .....A........., -
I \ l . " -.: - . '
" STEPHEN J. HOrrG:. ' '"'' ,~"Swornto or affirmed and subscribed to before me by witnesses,
135 N. HANOVER ST, \' ,\\':-:' <:. ~f< ' ~f- ", ",' \ '
',_CARLISLE, PA 17013 .','&.\ \fhl~/ f day of , ,1.1 . .
f~'\::'~.~... ': , ' 'l! 1" 1IlEP.~~-'~. HOGG, NOT~~Y..P,U.B~I. ':.(,: ' ' .' " , '
~ltl\,j;'.:.,\:",.".,... '1i;j:;~"IIi'~ExplrasJUM,191;1,9~1I:",~,.. t licl orne .m.., "," ,
,.",..,J. :.., .~ ' 'I"';;~:"'.!~I'." . "J' "':;.'dC6;:..L...,.\.,~,. ' .' . 'I'" ,.'"
't!i(.,.,~;,I.I"~~~" ""'1. ~~IJ"~:t~.!A"'I""~f Jum~..n nllt"\"lY,"/~ ~/ 'l,'~ ';~~'~~l:~' t \t'~'!" ,,';'1. r....:'.~~,~..: ',,'
";)",I"~"""'):""J ,ftu!. '~'" l~f:'l ~"~l'~" II ~1" I ""'i"'1'''7~:'~'.'I'''''' ',"i!"
"'AI, 1\"''':'1> ,) 1'.... ., IJ.'" I' ;lI~.fl' :"".. "'.. 'I (., '. '..,. ,'-'I,.J ~ , , .., "
~~~!^,I:I~,''tri''l'',t',.'" ",11 . ' "\~' ....,' ,>... ,,';::' '"~,, 1,1'i'" "'T" ",'~;y,'ll;,""'" .'.'" .;,:.,~., ,
ij~w.' ,,,.~,:;.) /,., I, .,:. . ,'; ~,\ ,,",,'"i'~''~''''' ./q.".,,'I:i,' " " ....J.,.'Jj ,,~'I\"';.... ,,; ," "fl., "',/1.".,. .,..... '
;' l"~" I
:J/ \II
F/)(//. J
REV-1547 EX AFP (08-94*
COHHONWEAl m or PEHHSVl VANIA
DEPARIHEHT Of REVENUE
~URUU OF INDIVlilUAt TA)I[S
DEPf. 280601
HARRISBURG, PA 11\2a-0601
'OTATE OF -m'lmr~"'~=--Gtrllo'Ri --"I(
DAT! OF DEATH 03-06-94
c/ (/
NOTICE OF INHERITANCE TAM
APPRAISEHENT, ALLOWANCE DR OISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAM
ACN 101
FILE NO.
COUNTY
DATE 01-16-95
. 21 94.:0i41--'
CUMBERLAND
-
NOTE, TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHIT THE UPPER PORTION OF THIS FORH WITH YOUR TAM
PAYHENT TO THE REGISTER OF WILLS, MAKE CHECK PAYABLE TO "REGISTER OF WILLS, AGENT"
REMIT PAYMENT TO:
MICHAEL S LEONZO
116 NAGLE ST
HBG PA 17104
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISL~, PA 17013
l__ _~'!.ount_'!!.ltt~d l
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiEV: iSfii. iiiC" A"P." f OS": 94"i. NO;'- i c r"O F-YNH iiiii T ilNC E - TAX" jiri' PRAYs ii i.fE' NT"; -A i. l"OWAN-C E - 'OR - - --.".. -.... -...
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF LEONZO GLENORA R FILE NO. 21 94-0341 ACN 101 DATE 01-16-95
If an assessment was issued previously, lines 14, 15 and/or 1&, 17 and 18 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. A~ount of Lln. 14 .t Spou..l r.tl liS)
16, Anount of Lln. 14 tlx.bl. .t Llnlll/Cl... A r.t. (16)
17, Anount of Lln. 14 tlxobl. ot Collltlrll/C1111 B rltl (17)
18, P,'lnolpll Tlx DUI
TAX CREDITS:
PAYHENT
DATE
03-06:94
06-02-94
TAM RETURN WAS, (X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL
1. R..l E.bb (Schldull Al III
2. Stock. Ind Bonds ISchldull B) 121
3, Clolliy Hold Stook/Plrtnlr.hlp Inllrlot (Sohldull C) 131
4. Hortgogu/Notu Rooolv.bl. (Sohldlll. 01 141
5, C.oh/nonk O.po.lt./HI.c, P.roon.l Prcp.rty ISch.dul. E) (5)
6. Jointly O.n.d Prop.rty (Sch.dul. F) 161
7, Tr.nsf.rs ISch.dul. 01 (71
8, Tcto! A...to
APPROVED DEDUCTIONS AND EXEMPTIONSl
q, Fun.rei Exp.n,../Adm. Co.t~/Hi.c, Expen... (Sch.dull H) (9)
10. D.bto/Hortg.g. LI.bllltl.s/Llan. (Sch.dul. I) (10)
11. Tolo! D.ductlcno
12, N.t V.lu. cf Tox R.turn
13, Chorlt.bl./Gov.rnnont.l B.quI.ls (Schldul. J)
14. N.t V.lu. cf Est.t. Subj.ct 10 T..
NOTE I
RECEIPT
NUHBER
SPOUSAL
MM886133
OISCDUNT
INTEREST
(+ I
("I
,00
,00
) CHANGED
,00
,00
,00
.00
22,622.70
.00
.00
(8)
22,622,70
6,130.07
.00
III )
urn
(13) _
(14)
6.130 07_
16,492,63
.00
16,492,63
,OOM'OO.
16,492,63 X,06.
,DO M .15.
(18)
,00
989,56
,DO
989,56
AHDUNT PAID
989,56
800,00
TOTAL TAX CREDIT
------
tALANCE OF TAX DUE
-,- INTEREST I
TOTAL DUE
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST,
1,789,56
800.00CR
.00
8UO.00CR
IF TOTAL DUE IS LESS THAN .1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREOIT" ICRI, YOU HAY BE DUE
A REFUND, SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
.,
.-.....
~'~ tsl ::oifi'
f;-~" . (0 n
'f") 0
~ :. ~' , -,
nr:'.
~ - ". ~;.'
., N ,
C. c. .~
0 .'i
~' ,
-0 '.---,-
, '.) :"',1ttl
" -- liTe
~~ l..:. ,I
-
N
RESERVATION I I:,t,t.. of dle,dlnh dvJng on O~ biter. D.c..be, 12, 19112 .~ If any' future Interut In thl ..tat. It transferred
In Po.....lon or .nJoYI.nt to Ch.. a (collet"'Il1) blndle!"I.. of thl dle.dlnt aft.r thl IKplratlon of any ..tat. for
lUt or for v..r., tn. Co..onwIIlIHh her.bv IICpr...lV r'..rvII tht right to oppr.t.. and as.... tranlhr Inh.rlhnol fax..
at thl lawful CIa.. B (eelhlt,r,1> rat. on anv .uch future Jntu..t.
PURPOSE OF
HOmE,
To fulfJ11 thl r.qulr...nh 0' Slotlon 2140- 0' thl Inheritance and Eltat. Tax Act, Act 2Z 0' 1991. 7Z P.S.
Stetlen 2140.
PAVHENT.
Olhch the top portion of this Hotlcl and ,uhtlt with your pay..nt to thl ktghtlr of W11l1 printed on thl r.v.r.. lid,.
e.Hak. chick or .0n1Y ordlr payabll tal REOISTER OF HILLS I AGENT
All pe~'ln,. r.ceJVtd .hall flr.t bt appll.d to any Int.rltt which .a~ bt due with any r..eJnd.r applltd to 'h. ttx.
REFUND ICRI,
A rtfund of 8 talC Cf'tdJt. which Wit "ot rtqo..hd on thl TalC Return, lay b. r.qu..ttd by cOlpletlng an "Application
for Rlfund of Plnnlvlvanla Inheritance and E.tat. TalC" (REV-1313L Application. Qr. avall.bl. .t the OffICI
of the Rlgl.tlr of Willi. any of the 23 Revlnue DI.trlct OffiCI'. or by ceilIng thl 'Plolal 24-hour
anlwlrlng ..rvlc. nu.b.r. fnr for.. ord.rlngl In P.nn'Ylvanla 1-800-362'1.050. outtldl Penn.vlv.nla and
within 10cII Htrrhburg .r.. (717) 787-4094. TOOl (717) 17Z-Z2SZ (Hlarlng Ilpalr.d Only),
OBJECTIONS.
Any party In In'er..t not .a11IfJ.d with the .ppraJ....nt, ~llowancI or dl.allowancl of d'ductlon., or n.......n'
of talC (Including dl.count or Intere.t) .. shown on thl, Hotlc. "Ult onjlot within tllCty (bO) day I of rle.lp, of
thh Hottc. by I
ADN1N
IBTRllIVE
CORRECTIONS.
..wrlttln prot..t to thl PA Dlpartllnt of Rlvlnu., Board of APPIII., Df.PT, 281021, Harrisburg, PA 1712&-1021, OR
.-Illotlon to have thl lattlr det.relnld at audit of thl aooount of thl plrsonal raprlslntatlvl, OR
..'PPI1I to the Orphans' Court.
DlSCDl.llT.
Ftotu.1 .rrors dhoov'I'ed on thlt ........nt should bt .ddr....d 1n writing tOI PA D.part..nt of Rlv,nul,
lurlau of Indlvldu.l TalC... ATTNI Post A....s."nt R,vJ,w Unit. DEPT, 2&0601, Harrhburg, PA 17124-0601
Phon. (ll7l 747-6S0S. S.. pig. 3 of the bookllt "In.truotlon, fnr Inhlrlhmc. hlC Rlturn for a R..ld.nt
Olo.dlnt" (REV-1SOI) for an IlCplan.tlon of adllnJ.tratJVllY oorraotahll ~rror..
If tny te~ due I. paid within thr'l (3) cal.ndar Month. aft.r the d.cldlntt. d.ath, a flv. plrc~nt (5X) dJ.cQunt of
thl talC paid 11 'allow.d.
INTEREST,
Inter..t I, charged beginning wJth flr,t d.v of d.llnqu.ncv, or nine (9) lonth. end one (I) day frOM the date of
dleth, to thl date of paY'.nt. TalC.. which bllJe'l dellnqu.nt blfor, January I, 19112 bur lnter..t at th'e rete of
.b: 16~) plrc.nt per annUR calculated 8t a dally rat. of ,000164. All ta>lll which b.cue delinquent on 'nd after
Janulry I. 1982 will bur Inter..t at 8 rat. which will vary frOll callndar yur to cal'ndar Y18r with thet ret.
ennounced by the PA O.part.ent of Rev.nu., Th, epplJcabl. Inter..t rat.. for 1982 through 1995 are I
'!!!!; Intlrut Ratl Dallv Int.r..t Feotor ~ Int.r..t Rat. DallY Inttrlllt Faetor
1942 20X ,000548 1941 9% .000747
1983 lOX .000438 l'U-I'91 l1X ,000101
19B4 l1X ,000301 1992 9% .000747
1985 m .00035b 1993.1994 7% ,000197
1966 lOX ,000274 1995 9% ,000747
"Intultt I. ealculat'd a. fellowsl
INTEREST. BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
..Any Hottcl Inu.d aftlr th. t.~ b.eo... d.Unqulnt will "fhot .n Intlr..t oalcUlltlon to flftlln (IS) d.~.
beyond thl date of thl .....s..nt. If P'Y'lnt It .ad, aft.r the Inhr..t COlllpuhtJon dUe .hown on thl
Hotlc., Iddltlonal Int.re.t IU.t be o.lculbt'd.
the Bstate of Glenora R.
.,
Leonzo
Benefioiary of
";"
"
",
, '
"
H
"
John S. Leonl'lo
841 Boaler Avenue
Lemoyne, PA 17043
"
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~IV.1607 IX AFP 02.94*)
C_AlTH OF Pf.HIIIVlVAHIA
MPAIlTI4ENT OF REVEIIUE
IlftAU 01' INllIY1POAl TAKES
MPT. Z10601
IWltUIIURIl, PA I1IZI-0601
> '. ' 01/
(J' ,"J ,'; -' I
/ 1- .j(//~ (I 1/
ACN 101
XNHERITANCE TAX
STATEMENT OF ACCOUNT DATE 06-05-95
DATI OF DIATH
LEONZO
03-06-94
tlLENORA
R
FILE NO. 21 94-0341
COUNTY CUMBERLAND
.
NOTE I TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUB"IT THE UPPER PORTION OF THIS FOM" WITH YOUR TAM
PAVHENT TO TNE ADDRESS SHOWN. HAKE CHECK PAYABLE AND REHIT PAV"ENT TO. ,
MlCHAEL S LEONZO
116 NAGLE ST
HBG PA 17104
REtlISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
t
AMount R.Mltt.d
l
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR FILES ....
Ri.Y:i6o".EX..AFP..ilif:94i-..-........iNiiiiiT'ANCi-.TAX..sTiifEHifNf.iiF.AC.COUN-f...........................
DATI 06-05-95
ESTATE OF LEONZO GLENORA R FILE NO. 21 94-0341 ACN 101
THIS STATEHENT IS PROVIDED TO ADvISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NA"ED
ESTATE. SH~WH BELOW IS A SUMMARY OF THE PRINCIPAL TAM DUE, APPLICATION OF ALL PAV"ENTS,
THE CURRENT SALANCE. AHD, IF APPLICABLE. A PROJECTED IHTEREST FIgURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT I 01-09-95
PRINCIPAL TAX DUEl,
PAVMENTS <TAX CREDITS) I
PAYMENT
DATE
03-06-94
06-02-94
05-16-95
RECEIPT
NUMBER
SPOUSAL
MMS86133
REFUND
DISCOUNT (+)
INTEREST (-)
.00
.00
.00
AMOUNT PAID
989.56
800.00
800.00-
~
'"
,
't',
- .
"
~., ~ (
,t).
rv',
~
'~j
')
., >,
cr.:,
'J C
. :'1
UU
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTlRE8T
TOTAL DUE
} \
A IF PAID AFTER THIS DATE, SEE REvERSE
SIDE FOR CALCULATION DF ADDITIONAL INTEREST.
I IF TOTAL OUE IS LESS THAN II,
NO PAVHENT IS REllUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI,
YOU HAV DE DUE A ~~FUHD. SEE REVERSE SlOE OF THIS FOR" FOR INSTRUCTIONS. )
989.56
989.56
.00
.00
.00
I
I
I
I
I
i
I
I,
I
,
,
PAVMENT,
Dttlch ttM top portion of thh HoUel and lubIllt ~lth your Plly..nt Hde pIVlblt to thl "... and tddrell
prlntld on t~ r.v.r.~ lida.
If RESIDENT OECEDEHT ..kl chick or .only order Plyable tot REQISTER OF WILLS, AGENT.
If NON'RESIDENT DECEDENT .... eh.c' cr .cn.y crdor "vablo tCI COHHONWEAL TH OF PENNSYLVANIA,
All PIVMnh r.c.ivld .hlll b, IIppll,d 'Ir,t to any Intarut lilhlch lilY b, dut with any r...lndtr applied to thl true,
REFUND (CRh A r.fund of I talC cr.dlt, which Will not rlquostld on thl Tax R,turn, "'I bt r.quuttd by coaplaUng an
"Application for R,fund of Plnn.Ylvanll Inh.rltanc. and E,tth TIlle" (REY~U15). Application. ar. available .t
thl Offlcl of thl Righter of Willi, any of thl 25 R,venutl Dlttrlct OHlc.. or frol thl D.part.,nt', Zit-hour
an.w.rlng ..rvlel nueb,r. for for.. ordtrlnlll tn Ptnnlvlvnnla l.eOO-36Z-Z050, out.ld. P.nn'Ylvanta
and within 10cII Harrltburg arll (717) 181-8094, TDDI (111) 712-2252 lH..rtnll IIPllrld only),
REPLY TOl Quntion, rlgardlng errors contained on thh no tie. should b, eddr....d tOl PA Dlpert..nt af A.vlnul, !UrllU
of Individual TalC.., ATTNI POlt A....".nt Alvllw Unit, DIPt. 280601, Harrllburg, PA 17128-0601, phon.
17171 707-6505,
DISCOUNT. If any tlX due II paid wlthln thr.. (3) callndar IKln'h. after th. dKldlnt', dlath, a flv. perc.nt UiO dheouut
of thl tax paid I. allowld.
INTEREST I Int.r..t It eharg.d beginning with first day of d.lInqu.ncy, or nlnl (9) tonth' and Dna (1) day frol thl dati of
d.lth, to the dati of paY'lnt. TaXI' which blc", d.llnquent blfor. January I, 1982 blar Intlrl.t at thl rlt. a'
she (6:() p.rc.nt per annUl calculat.d at a dally rlt. of .000164, All tax.. which blca.. d.llnqu.nt on and after
January I, 1982 w111 bllr lntlr..t lit n rat. which will vary fro. calendar y.3r to calendar Yllr Hlt~ that rate
announe.d by th. PA DIPart..nt of R.Ylnut. Thl applloabll Int.n.t rat.. for 1982 through 1995 arl.
Vtar Intlr..t Rate DailY Int.r..t factor V'1r Intlnlt Ratt DaUy Inter..t factor
1902 m ,oomo 1907 9% .000247
1963 16% .000438 1901-1991 11% .000301
19a6 ll% ,000101 1992 9% .000247
198. m ,000lS6 1991'1996 7% .000192
19a6 10% .000274 1995 9% ,000247
..-tntor..t h Cllculat.d a. followlI
INTEREST . BAL^NCE OF TAX UNP^IO X NU"SER OF DAYS DELINQUENT X O^ILY INTEREST FACTOR
--Any Notice 'uu.d llfhr th. tu b.co.... delinquent wlll ,.fllet an Intlr..t calculation to flU..n (15) day,
blYond the dato of th. a.......nt. If pay..nt II .tde after th. Inttr..t COlPUtllltlon dltl shown on the
Hotlc., addJtlonal Int.r"t .ult b. calculat.d.
STATUS REPORT UNDER RULE 6. 12
Name of Decedent I rrl f.f,}OIlf\ ~ L'lIp 1.. ~
Date of Deathl 3~,,~q~
Will No. Admin. No. 1-./- I f?'! ~ l!ll
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, 1 report the following with respect to completion of
the administration of the above-captioned e~tatel
1. State whether administration of the estate is completel
YeB,~ No__
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete I .___
3. If the answer to No. 1 is Yes, state the following I
a. Did the personal representative file a final
account with the Court? Yes NO~.
b. The separate Orphans' Court No. (if any) for
the personal representative's account iSI
c. Did the personal representative state an
account informally to the parties in interest? Yes No
'>4
,
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to t.his report.
'~A(/~
S' nature 6-- ---
/?//eh_( 5 L e<-'A)j-.:.>
Name (Please type or print)
II" AI'#-11e /1 III. fl Illpf
Address v' -;'
('JIll 2.3 t 73:;'"
Tt'l. No.
Datel~~
\I'd "n:\ (')'!,."t'I1IUno
\.111(':,' pOlO
00: OlV 6Z MdV 96.
SllIf'\ I" I ;'j:jIlOU
)0 r':;il!I.I!'I)OJ():)o8
Capac i ty I V Personal Representative
Counsel for personal
representative
(MAH IrmU AM3)