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'f" '." ,,' "" " , , " I. I;', " 1[1,".1 .',J,I~ j ,,' " ", 'r" " , ' '. " " " '"~ " " ':~: ' , .,' , , \' ;,'. d' I', ", ",l.~'<~!::'i>' , I::;',. \, ' , , I" " . 11.",1;' " '.1, '" ~ ,I ':,< ,,' ,,, , ',' , .. ' "P " " )'" " "'i .. " ,1:,1 \' I.II,J',,. \' 'I , i" >,', ! I., ~l . 't" I;;, I'.' " Ii. '" "I, " ',\I,." , 'I. '.:. :1 ..\'1'.1, ,'t"" 't, ,," , /"1 '.j. , ' , \, ," ..iti' '" , i' .. !i ~ \ ," " " , " ....' "I-' " " " ',.I 0'; II( - ,)(J.', '/ INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) REV,1l00 LX. 111,911 I!:! ~~B :tOO U"'... ...Ill ... c( m15 '" Q o Z U~ z o ~ E g '" z o 1= $ ~ 8 ~ /0. OATIS 0/ DIATH Am. 12/31/Vl CHICK HIU II A SPOUSAL POYlllY CUDIT IS CLAIMID 0 IIL1 HUM". ffi ~ Q '( ~'(i".),'" 1~'~~iw~ COMMONWEALTH 0/ PENNSYLVANIA DfPARIMENT Of RfVENUE om, 110601 HARRISBURG. PA 11121.0601 NAME IlAST, 'IRST, ANDMIDDlf INlll~ 21-94-0354 COUNTY CODE YEAR DECEDENT'S COMPlETf ADDRESS NUMBER RICE LYDIA FRY OCIAl E RllY NUMUR 267-38-0178 3033 Chestnut Street Camp Hill, PA 17011 Cumberland o 3, Remainder Relurn (for dolo' of deolh prior 10 12.13.82) o 5. Federal E'Ialo Tax Relurn Roqulred _ 8, Tolal Numbor of Sofo Dopo,lI 80xOl o do, Fuluro Inl"o,I Compromile (far dalOl 0' deolh akor 12.12.821 UI 6, Docodonl Dlod Tellole 0 7, Docodonl Malnlolnod 0 living Trull (A!lach copy of Will) (A!lach copy 01 T ru,l) ALL CORRESPONDmNCE AND CONfiDENTIAL TAX IN'ORMATlON SHOULD DE DIRECTE!) TO. AM M l MA Ai5'5RESS Esquire La~1 Offices - Marlin R. McCaleb 219 East Msin Street, P. O. BOK 230 MechanicsburU, PA 17055 DI 1. Original Rolu,n o 4, lImlled E,lalo HICKEY -rAflOflifAT A 0 II." 101/17/94 12/17/1910 o 2, Supplomenlol Rolurn C"UMy 1. Real Ellale (Schodulo AI ( 1) 2, Slack, and 8and, (Schedulo BI ( 2) 3, Clololy Hold SlocklPonnollhlp InlorOlI (Schedulo C) (3) 4, Mongago, und Nolo' Rocolvoblo (Schodulo D) ( 41 ' 5, Calh, Bank DopollI, & Milcollanoou, Po"onal Prapony( 51 (Schodulo E) 6, Jalnlly Ownod Propony (Schodulo FI 7, Tron,f... (Schodulo GI (Schodulo l) 8, Tolal Grall ,0."01' IIolalllno' 1.7) 9, Funorol Expen,ol, Admlnhl,otlvo COlli, MI"ollanoou, ( 91 Expon,OI (Schodulo HI 10, Dobl', Mongogo lIabllltlol, lion. (Gchodule I) 11. T 0101 Doductlon, (Iololllno' 9 & 10) 12, Nol Yaluo of E'lalolllno 8 mlnu,lIno 11) 13, Charitable and Gavornmonlal Boquo." (Sch.dulo J) 14, Nol Yalu. Subjoct 10 Tax IlIn. 12 mlnu.lln. 131 15, Amaunl of IIno 14 loxablo 01 6% rale (Includo value. from Schedulo K or Schodulo M,) 16, Amaunl of IIno 14 loxobl, 01 15% rolo (Includo voluo, franl Schodul. K or Schodule M,) 17, Principal lox duo (Add lax from IIno 15 and from IIno 16,1 18, Crodlll Spaulol Pavony Crodll Prior Paymonll DI"aunl Inloro,I 0.00 + ~.!:1.000.0~ + 578.95 0.00 19, If lino 18 I. groalor Ihan IIno 17. onlor Iho dlfforonco on IIno 19, Thl,l'lho OVERPAYMENT. aiD ,fJJ.Iia'.w.l'lUI 20, If IIn. 171. groalor Ihon IIno 18, onl.r Iho dlfforont, an IIno 20, Thl," Iho TAX DUE. A, Enlor Iho Inloroll on Iho balonco duo on IIno 2,'A 8, Enlor Iho 10101 of 11110 20 and 20,0. an IIn. 20B, Thil I, Ihe BALANCE DUE. Ma~e ChlC~ Payable tOI Reglator of Will., Agent .. liE SURE TO ANSWER ALL QUESTIONS ON REVUSE SIDE AND TO RECll~CK MATH". Under penelllel of perjury, I declare that I nove examlnnd Ihll relUrn, Including accompanying sch.dule. and lIol,menl', and 10 lh, bell of my knowledge and bell.f, II II true, correct and complete. I daclar. Ihal all real 1,lale hOI bun reporled at Iru. market valu.. Oee/arallon of prepare' olh'r than th, perlonal ,epres.ntatlve Is balld on alllnformallon of which p'l~arer hOI a y knowledge. ~"'''"''''_'.ORftllNG 'A~l ADDRE$S DAlE . , ~ ~ '),' j, ~ .,., C U ..~' ,< ^ I j...., ,/. "1-,I, I 3033 Chestnll.t St " Camp nUl. FA 17011 O'~"",;<{ I 'R!P~!I ~AN. PRESENIAIIVE I AOaiESS . DATE ~~ JIc;.~L 219 E. ~ St., Hechanicsbur9, PA 17055 'J':-.z':.9Y 717 I 691-7770 None None Non.e_ None 104.00 ( 6) (7) 147,501.29 None 10,193.21 (101 17.81 (15) 0.00 (16) 137.394.27 '--r I 81 147,605.29__ (11) (121 (13) (141 10,211. 02 137,394.27 None 137,J94.27 )( ,06. 0.00_ )( ,15. 20,609.14 (17) 20,609.14 (1BI (191 11,578.95 o.OQ_ (20) (20,0.1 (20BI 9,030.19 0.00 9,030.~, be determined by the Administrator and the Board of Trustees of Asbury Acres, in the exercise of their sole and absolute discretion. If the principal of said Trust shall ,. b, or boo"" tOO ,moll to p.."'d, ,uffid"t In""" for th, u" ,p,dfl,d in th, , ~ , '",../ :\ "-', . \ . '::0 '. '\:' }!' " , '. , . ...... , 'j , v '"" '~ p""dlng "t",n,". th,n I ,uthorl" ,nd d."t th' Trurl" to u" ,rod prindpm to purchase furnishings for a room or rooms, or for the purchase of equipment, or . " both, or for the building of a room or rooms, in whole or in part, as the Administrator and the Board of Trustees of Asbury Acres shall determine in the exercise of their sole and absolute discretion. Such furnishings, equipment or ',' rooms are to be identified as memorial gifts as specified in the first sentence of this sub-paragraph D. SEVENTH. I further direct that in no event shall any public sale be made of any of my property, either real or personal, instead a proper private sale shall be camed out by my Executors named in this my Will and my Attorney, Marlin R. McCaleb, Esquire, of Mechanicsburg, Pennsylvania. It is my express wish and direction that for purposes of the distributions provided in Items FIFTH and SIXTH of thls, my Will, the assets of my estate shall be liquidated or sold by my said Executors so that the entire residue shall be given to the beneficiaries named in said Items in the fonn of cash bequests. EIGHTH. I direct that all estate, inheritance and succession taxes, and interest and penalties thereon, which may be due and payable by reason of my death with . respect to any property included in my grosS estate for taX purposes, whether or -4- .._..~ .IV,UO'U+IH11 ~ SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSON~L ~Ro.!~~T_X. _.._,. fil:fN(j/';;Bt~oll Print_or Type SS' 267-38-0178 01/17/94 21-94-0354 COMMONweAllH OF P!NNSYLVANIA INHIRIlANCI lAX RlTURN RlllDINI DICIDINI ESTATE OF LYDIA FRY HICKEY RICE -----_._.__...~----_.__. ~-~~,~-...._.. (All propltly lolntly.owned with the Righi of Su,vlvotlhlp mull u. dllcl~lId on ~chodul. fl -----.------...... ... _..~.._.._...~.-,-..~~_.-. ITEM DE9CRIPTION VALUE AT NUMBER DATE OF DEATH _...._._.___~...M ...._____.. _,,_.~.__T____."__ 1. Internal Revenue Servico, rofund cf 1993 incomo tax. 76.00 2'. PA Department cf Revenue, rofund of 1993 Lnoomo tax. 28.00 "I " , , " , ", I" . , ," I,. ,"' '1.: , . , , " , I.'; " " " ,.. , " ,I, " " "~, " --"------...- $ 104.00 IAU.,h "dellllo..1 IV," . II" ,hull II mo.. .po" I, ,,,d,d,) UIJ.IJ09UtI12"q ~;i~ COMMONWEAlTH Of PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F I JOINTL Y .OWNED PROPE~_ FILE NUMBER SSi 267-3B-0178 01/17/94 21-94-0354 ESTATE OF LYDIA FRY HICKEY RICE Joln"lnan'I')1 n 4_._______...~ ..___,.____~._.___.._. NAME A. Franoes Chand1ee Hiokey ADDRESS 3033 Cheotnut Street Camp Hill, PA 17011 RELATIONSHIP TO DECEDENT Sister B. C. Jolntly.ownod proportYI ITEM LEnER DATE FOR TOTAL VALUE DECD'S DOLLAR VALUE OF NUMBER JOINT MADE DESCRIPTION OF PROPERTY OF ASSET % INT. DECEDENT'S INTEREST TENANT JOINT I. A 8/92 $10,000.00 Certificates of B,900.00 50% 4,450.00 Accrual on Treasury Securities Series R, 0%, due 8/15/96, issued to decedent and France Chand1ee Hickey as Jt. Tenant 2. A 1/13/93 $10,000.00 Limites States 7,800.00 50% 3,900.00 Treasury Strips,O%, due 11/15, 98, issued .to decedent and Frances Chand1ee Hickey as Jt. Tenants. 3. A 3/56 Checking Acct. No. 00427B6967 62,582.11 50% 31,291. 06 Dauphin Oeposit Bank & Trust Co. , in names of decedent and Frances C. Hickey. 4. A 2/69 Checking Acct. No. 00716B9B18 21,243.B5 50% 10,621. 93 Dauphin Deposit Bank & Trust Co., in names of decedent and Frances C. Hickey. 5. A 6/B6 Money Market Acct. No. 009437- 7,216.05 50% 3,610.B7 1458 Dauphin Deposit Bank & Trust Co., in names of decedent and Frances C. Hickey (includEs int&~est to 0.0.0.) Total from attached Continuat on Schedu1esl 93,627.43 TOTAL IAho enler on IIn,e 6, Recopllulallan) S 147,501.29 IIf more .poce i. needed in..rl addilional .heets 0' .ame siz.) Estate of: . Lydia Fry Hickey Rice SSIiI 267.38-0178 01/17/1994 CONTINUATION SCHEDULE Continuation of Schedule F 21-94-0354 ITEM iii LETTER FOR JOINT TENANT DATE HADE JOINT DESCRIPTION OF PPTY TOTAL VAL OF ASSET DECO'S VALUE AT DATE , INT OF DEATH 6 A 6/68 Passbook Savings Account No. 8,648.24 50% 4,338,04 4913705075, Dauphin Deposit Bank and Trust Company, in names of decedent and Frances C. Hickey (includes interest accrued to 0.0.0.). 7 A 9/92 Certificate of Deposit No. 10,014.55 50% 5,007.28 04-56-223916, Harris Savings Bank, issued 9/23/92 to decedent and Frances C. Hickey (includes interest accrued to 0.0.0.). 8 A. 2/92 Certificate of Deposit No. 10,014.03 50% 5,007.02 04.54.217761, Harris Savings Bank, issued 2/20/92 to decedent and Frances C. Hickey (includes interest accrued to 0.0.0.), 9 A 5/90 Certificate of Deposit No. 10,014.90 50% 5,007.45 04-56.175553, Harris Savings Bank, issued 5/25/90 to decedent and Frances C, Hickey (includes interest accrued to 0.0.0.), 10. A 4/91 Certificate of Deposit No. 10,017.53 50% 5 , 008 . 77 04.58-195113, Harris Savings Bank, issueo 4/5/91 to decedent and Frances C, 0 Hickey (includes interest accrued to 0.0.0,), 11 A 7/69 346 ahs., Affiliated Fund, 3,750.64 50% 1,875.32 Inc., mutual fund, issued to decedent and Frances Estste of: Lydia Fry Hickey Rice SS# 267.38.0178 01/17/1994 CONTINUATION SCHEDULE Continuation of Schedule F 21-94-0354 ITEM # LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PPTY TOTAL VAL OF ASSET DECO'S VALUE AT DATE , INT OF DEATH Chand1ee Hickey as joint tenants, @ $10.84. 12 A 11/10/93 650 shs., Bond Fund of 9,425.00 50% 4,712.50 America mutual fund, issued to decedent and Frances Chandlee Hickey as joint tenants, @ $14.50. See attached affidavit. 13 A 7/91 2,000 shs., Comstock 20,040.00 50% 10,020.00 Partners Strategy Fund mutual fund, issued to decedent and Fr.ances Chand1ee Hickey as joint tenants, @ $10.02. 14 A 5/86 3,635 shs., Franklin 25,772.15 50% 12,886.08 Custodian Funds, Inc. , U.S. Government Securities Series, mutual fund, issued to decedent and Frances Chand10e Hickey as joint tenants, @ $7.09. 15 A 12/86 1,359 shs" Putnam High 12,176.64 50% 6,088.32 Income Government Trust mutual fund, issued to decedent and Frances Chand1ee Hickey as joint tenants. @ $8.96. 16 A 5/83 1,426 shs. Corestates 38,056.38 50l 19,028.19 Financial Corp commo~, CUSIP 218695 10 4, issued to decedent and Frances Chand1ee Hickey as joint tenants, @ $26.6875. 17 A 1/92 4 shs. Doskocil Companies, 44.75 50% 22.38 Inc., common, CUSIP 258486 30 7, issued to decedent and Frances Ch~nd1ee Hickey as Estate of: Lydia Fry Hickey Rice SS# 267-38-0178 01/17/1994 CONTINUATION SCHEDULE Continuation of Schedule F 21-94-0354 ITEM # LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PPTY TOTAL VAL OF ASSET DECD'S VALUE AT DATE % INT OF DEATH JTWROS, @ $11.1875. 18 A 8/87 1,500 shs. The Global 10,781.25 50% 5,390.63 Government Plus Fund, Inc., common, CUSIP 378907 10 9, issued to decedent and Frances Chand1ee Hickey as joint tenants, @ $1,1875. '19 A 12/87 500 shs. MFS Government 3,531.25 .50% , 1,765.63 Markets Income Trust, CUSIP ., 552939 10 0, issued to decedent and Frances Chand1ee Hickey as JTWROS, @ $7,0625. 20 A 6/69 13 shs. PA Power & Light Co. 836.88 50% 418.44 pfd, 4-1/2% series B, no CUSIP, issued to decedent " and Frances Chand1ee Hickey as JTWROS, @ $64.375. 21 'A 2/85 15 units, The Corporate 5,141.85 50% 2,570.93 Income Fund, 60th Monthly Payment Series, CUSIP 219896 87 5, issued to decedent and Frances Chand1ee Hickey as joint tenants, @ $342,79. 22 A 1/63-4/73 85 U. S. Savings Bonds, 8,960.89 50% 4,480.45 Series E, $25.00 dellomination, issued to Lydia Hickey Rice or Frances C. Hickey, 1963-1973. See attached list. '...oo.................. .. 93,627,43 February 8, 1994 Marlin R. McCaleb Frankenberger Place P.O. Box 230 219 East Main street Mechanicsburg, PA 17055 The inforMation Rice Deceased Account !lumber(/;) Class of Account Dllte Opimoc! Principlll Dalanco ACC%"Jed !nterellt Dalance at Dote of Death Ac~ount Ownerllhip lIame of Joint Owner, if an:! Dnte Ownnrship Wns Estnblir.hod Additional Infor- mation 1l~()\Inntcrl IDHARRIS"' Iil SAVINGS BANK Hartis Savings Operations Celller 635 North 12th Street LemoYl1e, Pennsylvania 17043 7171731.1440 717/731.0859 Fax whi ch 'fOU . (!;odnl requontod on the nccount(o) of ~.n~urity Humb~r 1.67-38-017~) Lydia Hickey is os follovlO. 04-56-223916 04-54-217761 04-56-175553 6 Mths. Cert. 1 'ir. Cert. 2-20-92 5-25-90 $10,000.00 $10,000.00 14.03 14.90 10,014.03 10,014.90 Joint Joint 1 'ir. Cert. 9-23-92 $10,000.00 14.55 10,014.55 Joint Frances Chand lee HIckey same same 9-23-92 2-20-92 5-25-90 Please have the survivor of these accounts sign the enclosed W-9 form and return it to us. Thank you. AFFIDAVIT I, FRANCES CHANDLEE HICKEY, hereby certify and state: That I am the sister and next-of-kin of the decedent herein, Lydia F. Hickey Rice, who died on January 17, 19941 That the decedent resided witl. me in my home at 3033 Chestnut street, Camp Hill, Pennsylvania, since the 1950s1 That the decedent and I shared several joint bank aocounts, investment accounts and other investments, into which we each contributed our funds and which we held as joint tenants with rights of survivorship; That one of our joint investment accounts was Prudential Seourities Account No. ONH-152943-02, which we held as JTWROS for several years; That on January 27, 1991, while the said Prudential Securities Account No. ONH-152943-02 was held and owned by us as JTWROS, funds from that acoount, in the amount of $10,649.42, were used to pUI'chase a certificate of deposit from the East River Savings Bank, New York, that was due to mature on November 2, 1993, which certifioate of deposit was held by us in that account as JTWROS; That on November 2, 1993, when the said certificate of deposit matured, it was redeemed in the total amount of $10,438.58, from which proceeds the sum of $10,306.00 was then temporarily invested in the Prudential Moneymart Asset Fund, which was held by us in said account as JTWROS; That on November 10, 1993, the proceeds of said Prudential Moneymart Asset Fund were used to purchase 650 shares of Bond Fund of America, Inc., in the amount of $10,159.50, which shares were held by us in said account as JTWROS; That the said shares of Bond Fund of America, Inc., although acquired within one (1) year prior to decedent's death, were acquired with assets or funds that were previously held jointly by the decedent and myself for more than one (1) prior to decedent's death and are therefore exempt from inheritance tax pursuant to Protest Board Decision, 78-2, 28 Fiduc. Rep. 352; That the foregoing statements are true and correct to the best of my knowledge, information and belief; That I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904, relating " U. S. SAVINGS BONDS, SERIES E, $25.00 DENOMINATION, ISSUED TO LYDIA HICKEY RICE OR FRANCES C. HICKEY: ~ aerial N2.t. lUYe Date DaD Value 1. Q5089431486E 4/73 79.56 2. Q5083157779E 3/73 81. 95 3. Q5069608588E 1/73 81.74 4. Q5048542622E 12/72 80.96 5. Q5042994458E 10/72 80.79 6. Q50362991B6E 9/72 83.21 7. Q5029116969E 8/72 83.21 8. Q5014137509E 6/72 82.57 9. Q5005260889E 5/72 82.34 10. Q2630152187E 4/72 82.34 11. Q2617369967E 2/72 84.45 12. Q2610503105E 1/72 84.26 13. Q2599153197E 11/71 84.61 14. Q2593233217E 10/71 84.61 15. Q2591691262E 9/71 85.73 16. Q2595781582E 7/71 85.58 17. Q2571393821E 6/71 87.17 18. Q2564627225E 5/71 86.92 19. Q255930!!138E 3/71 87.93 20. Q2547167516E 2/71 87.93 21. Q2539141705E 12/70 95.18 22. Q2526919913E 11/70 94.97 23. Q2520774300E 10/70 94.97 24. Q2501728172E 8/70 98.52 25. Q2501711778E 7/70 98.30 26. Q2494474005E 5/70 96.88 27. Q2488520337E 4/70 96.88 28. Q2475261859E 3/70 100.51 29. Q2473736644E 1/70 100.26 30.' Q2459746300E 12/69 99.32 31. Q2458305873E 11/69 98.80 32. . Q2445563606E 9/69 102.51 33. Q2432300733E 8/69 102.50 34. Q2421891921E 6/69 101.29 35. Q2416508022E 5/69 102.38 36. Q2407669688E 4/69 101.40 37. Q2400787396E 2/69 101.40 38. Q2382259923E 1/69 105.20 39. Q2382230855E 11/68 103.80 40. Q2368883337E 10/68 102.80 4~. Q2367472982E !l/68 102.80 ,42. Q2347852697E 7/68 106.66 43. Q2341546171E 6/68 106.67 44. Q2334479125E 5/68 105.41 .45. Q2326859842E , 3/68 104.38 46. Q2322235144E 2/68 104.38 47. Q2306361315E 12/67 108.30 48. Q2297556448E 11/67 107.00 49. Q2283868395E 9/67 105.97 , ,50'. Q2279570318E 8/67 105.97 151. Q2261500566E 7/67 109.94 52. Q2260369949E .5/67 108.75 , ' 53. Q2254623914E 4/67 107.72 " , , 54. Q2242930341E 2/67 107.72 55. Q2231474716E 1/67 111.76 56. Q2229154446E .12/66 111.75 '57. Q2195664676E 7/66 111.65 58. Q2183484125E 5/66 110..52 , .59. 'Q2173038983E 3/66 109.46 60. Q2169383795E 2/66 110.53 -2- 6'1. Q2149574433E 10/65 113.74 62. Q2138547889E 8/95 113.18 63. Q2132430791E 7/65 112.09 64. Q2124225584E 6/65 112.09 65. Q2115343197E 4/65 115.94 66. Q2112144722E 3/65 115.95 67. Q2103381279E 1/65 125.79 68. Q2096323062E 12/64 125.79 69. Q2091669876E 11/64 124.98 70. Q2081460221E 9/64 128.73 71. Q2069666598E 8/64 128.13 72. Q2060715862E 7/64 126.90 73. Q2052557528E 5/64 126.06 74. Q2051764173E 4/64 129.84 75. Q2047251127E 2/64 129.23 76. Q20:ll264385E 1/64 128.00 77. Q2026825013E 12/63 128.00 78. Q2017912026E 10/63 In.03 79. Q2015048343E 9/63 131.03 80. Q2009999179E 8/63 130.41 81. Q2003589350E 6/63 129.14 82. Q1996556875E 5/63 128.17 83. Q1992005788E 3/63 132.03 84. Q1985964791E 2/63 131.42 85. Q1974759314E 1/63 130.15 TOTAL $8,960.89 . -3- uv.un IX. 17.11' ,,~:JIit, 9~ ..sri;,.; COMMONWIAIlH Of "NNmVANIA INHllllANCllAX mUlN mlOINT OICIOINT SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCEllANEOUS EXPENSES F LYDIA FRY HICKEY RICE SS. 267-38-0178 01/17/94 ITEM NUMBER 21-94-0354 DESCRIPTION 1. A. funeral Exp.nsll' 2. 3. 4. B. 1. 2. 3. 4, C. 1. 2, 3. 4, 5. 6. 7, 8, Myers-Harner Funeral Home, funeral. White Rose Cemetery Memorials, engraving gravemarker Pealers Florists, flowers for funeral. parltside Cafe, funeral dinner. Admlnllllatlv. COI"I Perianal Reprelentatlve Cammlulonl Social Security Number of Pellonal RepresentatlvlI Year Commlulonl paid Attorney Feel Marlin R. MoCa1eb, Esquire Family Exemption Claimant Franoes C. Hiokev Relatlonlhlp Sister Addrell of Claimant at decedent'l death Street Addreu 3033 Chestnut Street City Camp Hill Stale PA Zip Code 17011 Probate Feel Mllc.llan,oul Exp.n"ll Register of Wills, filing Inheritanoe Tax Return MoKonly & Asbury, preparing deoedent's 1993 inoome tax returns TOTAL (Alia enter on line 9, Recapitulation) (1/ mar. Ipac. II n..d.d, Inl.rt addltlonallh.... of lam. IIz..) AMOUNT 6,706.00 90.00 161.39 176.82 2,500.00 104.00 15.00 440.00 S 10,193.21 . , /RBV-l547 F.X AFP (08094* COH"OHWEAl'"U Of PEHHSVllJAHU Df."UTH'HT Of REYERUE NOTICE or INHERITANCE TAK BUREAU Of IHDIYICUAl lAKES . APPRAISEHENT, ALLOWANCE OR DISALLOWANCE om, /BD6~1 or DEDUCTIONS AHD ASSESSHENT OF TAX DATE 12 19 94 HARRISBURD, PO 111/H601 - - ESTATE OF - RICE =,--_. -- FrL't"No. ' r 9-Fots4="~= DATE OF DEATH 01-17-94 COUNTY CUMBERLAtm NOTE, TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHIT THE UPP~R PORTION OF THIS FORH IIITH YOUR TAK PAYHENT TO THE REGISTER OF WILLS, HAKE CHECK PAYABLE TO "R~GISTER OF WILLS, AOENT" REMIT PAYMENT TOI 5~/'/'i-S- 'II 'I,') '). Co) l'i ".I , MARLIN R MCCALEB 219 E MAIN ST PO BOX 230 MECHANICSBURG PA 17055 ACN 101 G (II- REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 F---~~"!'t R~lttod - "l CUT ALONO THIS LINE ~ RETAIN LOWER POR~'ION FOR YOUR RECORDS ~ R i!V: iS47. Elf -A F ii -(0 S-: 94 T' NOT i oE" -OF o "iN HE if if AtiC' E. TAX. 'A.PPRii i ii EH"ENi'", - -A L row A tiC' E. '(ill............. - -.. DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX LYOIA F FILE NO. 21 94-0354 ACN 101 If en ellellment wel illued previDully, linel 14, 15 end/Dr 16, 17 end 18 will reflect figurel thet include the tDtel of ahh returnl allelled tD data. ASSESSMENT OF TAXI IS, AMount of Lln. 14 .t Spou..1 r.t. 16, AMount of Lln. 14 t.xlbl. .t Lln..l/Cl... A rlt. 17, AMount of Lln. 14 t.xobl. .t Coll.t.,.I/Cl... B r.t. IB, Prlnolp.1 T.x Du. TAX CREDITS I PAY HE NT RECEIPT DISCOUNT (') DATE NUHBER INTEREST (.) 04-15-94 XA885965 I 578,95 08-25-94 MM91?864 ~ ,00 INTEREST IS CHARGED FROM 10-18-94 TO 12-27-94 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM ESTATE OF RICE TAX RETURN WAS I ( ) ACCEPTED AS FILED RESERVATION CONCERNINO FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ONI ORIGINAL 1, R..I E.t.t. ISch.dul. A) 2, Stook, .nd Bond, ,Schldul. Bl 5, Cln,"ly HIld Stook/Plrtn.r.hlp Int.,..t ISoh.dul. CI 4, Hortglgl./Not.. R.c.lvlbl. ISohldul. 01 5, CI.h/B.nk DIPo,lt,/HI.c, Plr.onll Prop.rty ISohldul. EI 6, Jolntl~ O.nld Prop.rty (Sohldull F) 7, Trln.f.r. (Sch.dul. 01 B, Tobl AII.ts APPROVED DEDUCTIONS AND EXEMPTIONS I 9, Funlr.l EXPln..,/AdM, Co,t,/HI.o, Exp.n,", ISchldul. HI 10. Dlbt'/Hortglg. Lllbllltl."LI.n. (Soh.dul. XI 11. Totll Dlductlon. 12. H.t VIlul of T.x nlturn 15. Ch.rltlbl./Gov.rnM,nt.l B,quI,t, (Schldull JI 14. N.t VolUI of E,bt. SUbj,ot to T.. NOTE I . IF PAIR AFTER DATE INDICATED. SEE REVERSE FOR CALCULATION DF ADDITIONAL INTEREST, I X I CHANGED DATE 12-19-94 ATTACHED NOTICE SEE III -.J!JL 12) ,00 151 ,00 141 ,00 151_____ 104,00 1&1 147,501.29 171 ,00 (BI 147,605,29 191 110 I 10.089,21 17,81 111) 1121_ 1151 1141 10.107 O~ 137.498,27 ,00 137.498,27 115) 1161 117)_ ,00 .00 137.498,27 ,00 ,00 20,624.74 20,624.74 K .00, K .06, K ,15, I1BI AHOUNT PAID 11,000.00 9,030.19 TOTAL TAX CREDIT ---- BALANCE OF TAX DUE ---- INTEREST TOTAL DUE 20.609,14 15.60 ,21 15.81 ( IF TOTAL DUE IS LESS THAN U, ND PAYHENT IS REQUIRED, IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI. YOU HAY BE DUE A REFUND, SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIDNS,) ,. " , RESERVATION, Estat.. of dlold.nt! dvlng on or b.fore DlQub.r 12, 1912 4_ If IMW future Int.rut In th, ut.t. it tr.nll'rrtd In pO..I..lon or ,nJoVI."t to Cl... B (coll.t.rall btn.flcJarlt. of thl d.c.d.nt .ft,r the ,.plratlon of anv I.t.tl for llfl or for v.,r., the Co..onw.tlth h,r'bV ..pr..'I~ rt.,rVI. tht right to IPpr.I.. tnd ...... trln.f.r Inntrit.no. Ta.l. It the lawful Chll a (oolllt.ral) rat. on lln~ luch future lntlrllt. PURPOSE OF NOTlCEI To fulfill th.. r.qulr"lntl of Slotlon 2140 of the Tnh.rltllno. and E.tat. t.,. Act, Act 22 of 1991. 12 P.S, S.ctlon lUG, PAVIENT, D.taoh the top port In" of thl. Hat Ie. and lub.lt with your paY.lnt to th. Algl.t.r of Will. prlnt.d on the r.v.r.. ,Id.. "-Hak. chick or .on.y ~rdtr p,yabl. tOI REOISTER OF HILLS, AOf.HT All Ply..nU r,ollvld .htU flr.t b. IPpll,d to any InUrllt which lIlay b. dUI with tny r,"alnd.r llpp1ltd to the tile. AEFUHll (CA), A r.fund cf I tax crldit, which WII not rlllquutld 01\ the Te. Alturn, .ay bt rtquutld by cOlplttlng an "Appllcttlon for Rlfund of Plnnlylvtnh Inhlritanel and Eltate 111." (Rf.V-UI3I. A~'p11cltlonl arl avallabl. at th. OfficI of the Atgl.tlr of Will., 3ny of the Z] R,vlnu, DI.trlet Offlc.., or by calling the 'Plcltl Z44hour tn.w.rln~ 'Irvlc. nUlblr. 'cr for" ordlrlngl In Plnn.ylvanla 1-800-56Z-Z050. cut.lde Plnn.vlvanla .nd within 10cII Harrisburg ar.. (111) 187-8094, TOO' 0171 17Z-2251 CIlurlng I'Pllrld Only), OBJECTIONSI Any p.rty In Int.rl.t not .Itl.flld with thl ~ppral"'lnt, allawlne. or dl.ellawlnrl of dlductlon., or a.......nt of "'. (Including dlscoutlt or lnt.rllt) II .hown an thll Notlc. .u.t objtct within .iletv (60) day. 0' r.c.ipt of thll Hotlcl by' uwrltten prat..t to the PA Dlpart.,nt of A.v.nu.. loerd of ApPIII., OEPT. ZaIOZI, tlllrrllburg, PA 17128-IOZI, DR ".llctlcn to hlv' the utter It.ttrlln.d at audit of the account of the plrlonal r.pr...ntltlv., OR: 4~app.al to the Orphln.' Court. AINtIN ISTRAIlYE CORRECTIONS, Flctull .rror. dl,coVlrld on thl. ...y....nt .hculd b. .ddr....d In writing tOI PA O.partlent of A.vlnu., lur.eu a' IndlvlduMI Tax.., ATTNI Po.t A..o....nt A.vlew Unit. DEPT. Z10601, tlarrl.burg. PA 171za-0601 Phon. (717) 187-6505, S.e pig. 3 0' thl book lit "Inltructlons for Inh.rltanc. TaM R.turn for I R..ldlnt Ole.d.ntft (REV-1501) 'or an Ixplanatlon of ad.lnlstratlv.ly corr.ctable .rror., DISCOUNT' If any tlx dUI 18 Plld within thr.. (5) cal.ndar lonth. aft.r the dlcldlnt'. dlath! n flvl perc.nt (5X) dl.count 0' the t.. Plld I. IJlcWld. INTEREII, Int.r..t I. cherOld b.olnnlng with flr.t day of d.llnqulncv, or nln. (9) tonth. and on. (1) day 'rol the d.t. of duth, to tho dati 0' plyltnt, TIXII which b.c... d.Unqu.nt b.,ore Jloulry l, nlz bltr Inter..t It the rltl of .Ix (6Xl ptrc.n~ plr annUll calculatld at t dally ratl of ,00016<,. AU "... which b.ee.. d.l1nqu.nt on Ind aft.r JI~Jary I, 191Z will b'lr Inter..t It I ratl which will Vlry frol ctl.ndar Ylar to cll.ndar Yllr with that ratl Innouncld by the PA Olpart..nt a' Rlv.nu.. Th. appllclbl. In tIre It rlt.. for 198Z through 199~ nrl' '!!!! Intlr..t Rtt! ~Inttrut Factor !!!! Int.,lIt Rlltl Ollly Interllt Factor 1911 20X ,000541 1986 lOX ,000274 1981 16X ,000438 1987 9X ,000201 1984 IIX ,000301 1988-1991 IIX ,000301 198i UX .ODOi56 1992 9;: ,000241 1995-1994 7;: ,000192 199i 9% ,000241 --Int.r..t I. ctleul.t.d " fallowsl IHfERE8T . BALAHCE Of TAX UHPAIO X HUHBER Of DAYS DELIHQUENf X DAILY IHTEREBT fACTOR --Ant Notlol I..u.d .ft.r thl t,M b.cc... dellnqulnt will rlfllct an Int.r..t c.leul.tlon to fl't.ln <IS) dlY. blyond th. d.t. of the ........nt. If Pftv..nt I. .Idl nft,r thl Intlr..t C019utttlon date shown on th_ Notlc., addltlonll Int,,,", IU.t bl c,leulat,d. .. .., ,....... ........ . " ...:.I _..:... __..._ __. _;.....- ._. .__ .,. o~.. __ _ ~ _...._ __. _. .._ ._.. .... _.. ,'_,". __ __._ u , . ... _... _~ _0.'_- ____ .__ __ _";'._..._'__ ____....... 5'17,/'6' c. D' .. AA 022624 . COMMONWEALTH OF PENNSYLVANIA ,Nc). , , . DEPARTMENT O' RIVINUI OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATI TAX UV.11621X1U4J M ; 1 )1 ',:', ~ RECEIVED FROM: f3 ACN ASSESSMENT ITI CONTROL ~ NUMBER AMOUNT , , , MC OALEB MARLIN R e19 E MAIN STREET Ivl .1lr.8l MECHANICSBURG PA 17055 ESTATE INFORMAlIO~ t:I FILE NUM8ER 'I 21-1994-0Se4 SSN E1 NAME OF DECEDENT ILASTI IFIRST) . RICE LYDIA F HICKEY II DATE OF PAYMENT le/~p/QI.I EJ POSTMARK DATE COUNfY 00/00 CUMBERLAND DATE OF DEATH 01/17/94 REMARKS MARL I N R. MCCALEB, ESGl. 2b7-:38-0178 IMII m . TOTAL AMOUNT PAID . SEAl, CHECK" 7815 ,/ , / ../ t..... RECEIVED BY , tH5.BI ~! ) \ . ,I &, ",,' . 4), AIURf- I REGISTER OF WILLS . ' ! -.--------"--.-~~-..-~._~,_______._t_._..o_.o..__._____.________.__~-.-..----~_.~ ".... ........,"'..-- \1. .. _ ,-"-'-': ..........-4., .."'"rr'" 1" I \. PAYtlENT, , REFUllO ICRI, REPLY TO, DISCOUNT, INTEREST' OI'IQh the top portion of thl, Notlcl end IUbllt with your pay.,nt ..d, pavabl, to the ne.. and Iddrtll prlnttd on the rev.r.. ,ld,. All ply..nt. recelvld .~.11 flr.t b, applied to any Int.r..t which lay b, dUI with any r...lndtt applied to the tlK. A r.fund of a tlK crtdlt, which we. not t,quI,tGd on the T.~ Rlturn, ..y be r.quI.tld by cOlplltlng an "AppUcatlon for R,fund of PIMlylvanl1'i Inhnltanct and Estatl TalC" (REY.U13). Applicatlon. >It. avallabl, .t the OfficI of the Rlgl.t,r of Wll1~, any of the 24 Rlv.nul Ol.trlct O'fle'l, or by calling th. ,0101al 24~hour .n,wlring "tV lei nUllb,r, for flltU ord.rlngl HEW IN PENNSYlVANIA 1.80(1-162-2050, out.ld, Plnnlvlvant, and within t:... local Ilarrhburg arn (717) 187.8094. au..tlon. rtg.rdlng .rror. contained on thl. notlc. .hould b. addr....d to' PA D.part..nt of R.v.nu., Bur..u of Individual Texu, ATH41 Po.t A.......nt R.vi.w U"it, DEPT. 280601, Hllrrllburg, PA 1712a~060I, phon. 17l7l 787-6505, If an!i tax dUI II paid within threl (3) callndar lonth. aft.r thl d.e.dant'J dllth, a flv. Plrelnt U:O dltaourU of thl tax paid 1. allowld. Int.r..t II charg.a bllllnnlnll with first day ot dl 11 nqu.ne!i , or nlna (9) lonth. IInd on. (1) dlY fro. tha dati of dlath, to thl d.t. of plIYllnt. TllCU which b.ca.1 dlllnqulnt b.fore January I, 1982 bur Intarut .t thl rate of .Ix (6X) plrclnt par annul calculated at a dlllly rata of .000164. All tax.. which bloa.. dtllnquent on and .fttr January 1, 1982 will baar Intara~t at a rllt. whiCh will varV frol cal.ndar !itllr to olll.ndar y..r with that rat. announc.d bv thl PA Dlpart.,nt of Rav.nuI. Thl applloable Int.ra.t rllt.. for \982 through 1995 ar.l 'L2!; Inttrl.t Rah Dallv lnt.rut Facter Y.!!! Intuu t Rat" Dally Int.rut FflOtor 198Z 20i( .000548 1987 9i( ,0002'7 19&1 1(,i( .000.10 1908-1991 11% ,000101 198. m ,000101 1992 9Yo ,0002.7 1985 11% .000356 1991-199. n .000192 1986 10% .000214 1995 9i( ,0002.7 ..Inhrut II o.l<:ulahd .. fnlloN'1 INTEREST . 8ALA~CE OF TAX UNPAID X NUH8ER OF DAVS DELINQUENT X DAILY INTEREST FACTDR ..Any Hotlnl I..uld aftar thl tax u.eo... dtl1nqu.nt will r.fltct In Int.r..t oalculatlon to flft,'n (15) daVI blyond the data of the a.....".nt. If pay..nt II .adl .ft,r th. lntlrt.t cOlputatlon data .hown on thl Hqtloa, additional Jnt.r..t IU.t bl calculatld.