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I'ETITION (I()I{ "ROIJA'I'I~ IIml GRANT ()Ii' LETTlmS
No. _021=_i~_51i---_-
To:
/islale of Ellner H. i'!yars
al,w klfowlf lIS ___
_______.______..__.. _ .....__ ,_____. I\egl~ler of WIII~ fur lhe
..__.._ _.__.... /Jeceaml. Counly of CUlIlbor1and In the
Suclal Secllrlty No. I fJ 1- O~ 'm!.H3----- COllllllonweallh of Pennsylvania
The pctltlon of lhe undmlgncd re~pcclfUlly reprmnt~ that:
Your pellllonrl(~), who h/nre IR YClll~ of lIge or older nnthe e~eclIl..orEl______- Ad
In the la~t will of lhe nbove decc~enl4 dnled j4ilQpt olllb.ol'...2....... ' 19 -
nllll codlcll(s) dalcd __JANlIAR 2 ..1_19..9.__ -.-----
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------..
(1IRIC I ('lrvRllt clrclllll~I"IlCCl, e.,. renullclatlol1, deRth ur ('Aeculur. etc.)
Ul
~ Decendenl wa~ dumlclled at dcath In Cumborland County, Pennsylvania, with
,I,:,.',=J, ~ ILis l~st famllv or principal rcsldcncc at B19 1iQ~(A 11 A" ~it....., l'laohanicsburg,
_~\tlonroo Townf!.W,pl _,______..
~ (lhllllerl, llumber nnt! 1Tl1l11cljlRIlIY)
~ Dcccllde\ll, Ihell_,J!~__.- ycars of age, died April 19. ,19 91~ ,
!~1 ~ al E~~~;( ~~ I';;;I~~I, deced~nt dld~\(Jtmarry, -;y;; not dl~;;;;(i-allll d~fnot have a child born or adople<i
~ aftcr c~ccnllon of the 1'111I oHeled for probate; was not the victim of a killing alld was nevcr adJlldlcaled
~'~ Incompctent: ------- ..-----
'1'1
[_: ~ IJccendent at death owned propcrlY wllh c~tlmatcd valucs as fulluws:
'J\ (If domicllcd InPu,) All personal plupcrlY $ 55,000.00
A (If not domiciled In Pa,) Personal propcrly In Pennsylvania L
rs . (If nol domlcllcd In Pa,) Personal propcrty In County $--
r'1 N Vallie of relll e~tale In Pennsvlvanla $-~ 000.00
g N sltual!:!1 as follows: )Iotlse and Lgt...Q.f...C1round located at
:." ~I 019 Vies t l:effir' street I ].!echani.coh",,'" Pp 170r,';
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WlIElREFOI\IJ, pelltloner(~) re~peclfullY Icqpesllsl the probate of Ihe last 1'1111 Bnd codlcll(s)
presentcd hcrewlth 1I11l11he gmnt of IcUm '1 est arno nt (lry - -
(,,,,.,,,,,,,",y; adllllnl.,railoa c,I,a.: adllll"l.,railon d,b,II,c.I,a,)
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I 0 ar Hol man
bO Horth Hereford T,ana
f.radison, Indiana [.7250
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-.- Irone sternoe'r /
* Burke Pond Lane
BUT' {a. Virr.inTii.. 22015
OATH OF I'EHSONAL HEPHESENTATIVE
C()MM()NWI~AL'I'II 011 I'ENNSYLV ANIA }
COUNTY 011 CUI'\B:mLililD ss
The pctltluncr(~) ahovc, nllmcd swcar(s) or arnrm(~) that the statcments Inlhe foregoing pelltlon are
tine nnd concctto the hc~t of the knowledge allll hellef of petltloncr(~) and lhat as personal reprelen-
tatlvc(s) of lhc ahove decedent pctltluner(s) will wcll and truly admlnlslcr the eslate according lolai'l,
SW(JIII. to or. afflrmcd and SllbSCrlbed.r 'J:'.cl1.1" '.1 \ \.'I"j(llilll" I-:l
heforc mc lhls 2.,TH ~da of ~". ;, ,. \ ,', ~.:...::" .j }'
. .' ./ _JLAElUl__ i (\lg I ,. I I
7JJiiiiit<:;l,'ilr,! I',..,-;yJ/;- Ii 'Vli' ~ I
III "){ (; MA'~ C, LEWIS !leglslc, , , ...
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21 - 94 - 394
REGISTER OF WILLS OF ()lJiJf31~HI.^lm COUNTY
OATH OF SUBSCRIBING WITNESS
J. Robart Stauffer
)gl>*JJik
(cach) a subscribing wltncss 10 thc will prcscntcd hcrcwlth, (cadI) bclng duly quallflcd according to
law, dcposc(s) and say(s) that _..nO-l'/an prcscnt and saw
Elmer n. J.!yeru _,
the test at OT' , sign the same and that he signed as a wltncss lit the
rcqucst of tcstatOl!...- in h.L'L- prcscncc and (In thc prcscncc of cach othcr) (In thc prcscncc of the
olher subscribing wltncss(es)). p.-; A_\')
Sworn to or affirmcd and snbscrlbcd bcforc ~'//~ql
mc this ./.!" day of, (Nam,
,1"1' 19~ HG:r:ltet SqUUI'e Bld . 011eohaniosburg,
/ .,' I l~ '/'
o 1'0 " ,I I 0 " , (Addrcss)
,I I
PA 17055
Register
~1tBt~SI'II
~~~.'Ir
'-'/"'" Nov G. 1007
(Namc)
(Address)
R~GlSTER OF WILLS OF OUH[M1LAND COUNTY
OATH 01<' NON.SUBSCRIBING WITNESS
{(I
\"!
': Harp:nret .r. Soul'bier
(each) a subscrlbcr hercto, (each) being duly qualified according to luw, dcpose(s) and say(s) that
"I sh~ is . " _ familiar wilh the signature of. Elm~~ R. Hyers
u. () U xodidIX
testat~ of (01Io:;.ofxtbKxsntls<:rilllllg:X\IIltlit~N; WJ Ihe will prcsented hcrewlth and
lIi~
that, she bellevcs the slgnaturc on thc will Is In thc handwriting of
teslat~ bclicvcs the signature of thc will prcsentcd hcrcwlth and that a.he
xoclicijx
bellevcs Ihc slgnaturc on the will Is In (he handwriting of .Elmer R. Hyers
10 thc bcst of her _ _, knowlcdgc and bcllcf. ( ,
.. , I '
Swurn to or afflrmcd and subscrlbcd bcfore . '" '/1) ,'('.'7/,.1 J.lX~{ ',' ,:-:... /,u,;.Je.(.r!jr/
/ ' '
me this 25TH __ day of ,", (Name)
"A RJL ----/felli. __.. ,.()~! ~i:. Portland St.. l1eohanioabUI'g,
y C. L:WI~' "I.,:U~:glster Y"I- (Address)
(Name)
PA 1705p
(AddleSs)
.'
REV.llOO EX, 111'.'1
'.
I y. "'0"6- 3>
'OR DATIS 0' DIATH Ann 12/31191 CHICK HI"
" A SPOUSAL .
POVIRTY CUDIT IS CLAIMID []
;]l.ltftiMiiil'--..'-----'--..----
'(
"V'I;""'~~
,..\)W';;..
COMMONWEALTH Of PENNSYlVAN,A
DEPARTMENT Of REVENUE
OEPT.1'0601
HARR!S~'!.RO. PA )7'1',060'
.~NITIALJ
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
;~1 'J!,.-03911.
.YEA~
COUNTY CODE
..... ~i'f-i["Ao'ciRE55
e19 Wont Kollar St.
!.!aahanl.anburtt" l'A 1'10SS
NUMBER
~ liygW" J':111101' 11.
. ; ,____ ~~i!2Sic~1;T~~~~t\E(;(l =~-.-~i~~~;,,~_-_-rJ;!~~~I;:
I!! I'.lI 1. Original Rell'rn [I 2. Supplemen,al Ro'urn
~~l:! [I 4, lImlled E.'ale [J 4a. Fu,uro Inlerel' Compromilo
029 Ifnr clale' of doalh of,or 12.12,821
...10 IitI 6. Decedent Died T o.lole [] 7. Decedon' Malntalnod 0 Living T ru.1
~ IAllach copy 0' Willi IMach copy of T ru"l
.----.--~-- ALL COARISPONDENee AND CONPIDENTlAL TAX INioRMATION-sH'oliLD.'B-lfim~Ecjll'-TO',------
~ l; AM!' 'lCOMPfEffl,^'"NO ADDRESS
III ill J', Hobart Stnuffor, Atty. Hnr'lcot ~)qunre Blcll~. _
~ ~ IfHPHciNfllUMBER-------'--..--------- ---- lloahnnj,onburr;, PA 1705!.>
v2
____._ _I 717 I 766-96'1~ _ '_ ' '===o~~__~,,_~~_~__~,'_,,_....=.,~~,'=_~==~~_===
I. Roal E.,ate ISchodule AI ( I)
2, Sloe.. ond Bond. ISchodule 8) I 21 _"n
3, Clo.oly Held Slock/Par,nollhlp Inloro., (Schodulo c) I 31__
4. Morlgage. and NOlO. Receivable ISchodulo D) ( 41 '
5, Ca.h, Bank Dopo.ll. & Mhcollaneou. POllanal ProperlY( 51 .,
(Schodule E)
6, Jolnlly Ownod Proporty ISchodulo F)
7. TraOl'''' ISchedulo GllScheduloLJ
8. To,al Groll Allo" 1'0101 line. 1.71
9, Funeral Expen.e., Admlnlllratlve Co.II, MllCollanoou. I 9) "_.._.n_n...J,!ult(l0.!.2~
Expen.o. ISche.ule H)
10, Debll, Mor,gago llabllltle., lion. (Schedule I)
11. Total Deduction. Ilotalllne, 9 & 101
12. Nol Volue of E.late (II no 8 mlnu.llno 11)
13. Charllablo and Govornmen'al Bequoll. (Schedulo JI
14, Nol Value Suble'llo Tax llino 12 mlnu.llno 13)
15, Amoun, 0' line 14 loxablo at 6% ra'o
(Include value. from Schedule K or Schodulo M.I
16. Amoun, of line 14 laxable at 15% ra'o
(lncludo value. 'rom Schedule K or Schodulo M.I
17. Principal tax duelAdd lax from line 15 and 'rom IIno 16.1
18. Crodill Spou.al Pover,y Credl, Prior Parmo~. DllCoun, Inloro.1
__.-----..2..00 + ..0_,.Q()J.'nO +.300,00 -._...9_!gQ
19. If IIno 18 h grea,er than line 17, entor tho dlff.ronco an lino 19. Thl. h ,ho OVERPAYMENT.
gO
20, If line 17 I. greater than line 18, enler tho differenco on llno 20. Thil II ,ho TAX DUE. 120) ......, ,_,
A. Enler ,he Intere,' on Ihe balance due on IIno 20A. 12MI .....
8. Enler ,he ,otal of line 20 and 20A on IIno 20B. Thh h ,ho BALANCE DUE. (208)
Mak. ChICk Payabll 1., Rlgl.ler 01 Will., AgI,~!___n.__ un_ ., .._" .. .....____"n..____________
.. II IU_I TO AN.WI. ALL QUESTIONS ONR'EViisiSiiiiANDTO.iiicHECK'MAT.ii.-.---------
Under ponaltlel of perjury, I declare thai I hove u.amlned lhh fulurn, Including accompanying Iche(h;ltll and I'olemonll, and 10 the bel' of my knowledge and belief,
II II true, correel and complele. I declore Ihat all rIal (1Ilale has been reported 01 IrU8 murkot value. Doclmation of proparor other Ihon the perlonal reprtllllnlallvlI II
baled on alllnformallon of whIch prepare' hOI any knowledge.
S'ONATUiil PER ONRESPomj~i7'ORFllI ORETURN Aooms{;O"j(~'n][O-r'(~f'OI'(l Luna, HI.\ciloorJ, -n, ilAff')',725lT....-~-
"-"'" ~ . 'IlAl. .._...(LIIJ1'_I.\_l(1'1~o !)ond LanD, nUl'lco, V^ ;!2()1~ 7.S'~-f).t..--
nTlfOfHlRIHA R !NA,/ff~ AOOR'SI IInr'J,ot. ~ifJ.\lfl.l)O lllrl';. OAI,
'~-~'~___H --- j.!ochftniosbJH'[:,J'^ ;l70~::: ? /-rI1-1---
,
Clwck .11(>'(.' If you (If 0 IUf!U(t$t'r-n (I refund of your ovcrptIY'11cnt.
z
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. _.. C~""'LUUT~I))Or). E\ nCl_,.. ._.___._ _,_,___.
[13. Romalnder Rolurn
(for dole. of doath prior 10 12.13,821
[ 1 5, Foderal E.lo,e Tax
Ro,urn Requlrod
(L 8. To,ol Numbor 0' Solo Depo.1t Boxo.
.. ..l02,00Q.OQ
. ...._..Q.OO
,... ..,,0.00
-.. '....hh..2!.QQ
n ,...__ _~2!1!:!f.J.:.~.? 0
'''1
. .
I 61 __."___h__~gQ
171..... hm__m__h_Q...Q.Q
I' 8) 0_, o....} 7i~_~1l:!i~. 29__
23.68
(10) ..h..__...h__________
(151.
1L~,50!1..19
(11) m____.__,____,___
(121 _____~.56., 937.01 ,
1131.-___._,_____Q.!,Q.Q..
(14\ h __.._._'J.5J~J_9307..! 01...
.------'i) '-'-2L----..-m':1l.
_,_u_~2_ ,--9 n!.2.~ ~ ,06 ~ '.U__.._mu 9, .J.(h ~;;::_
1161,
_..__.__n..,9_. 90~ .1.\ ~,-------..-_____--..9_!..QQu
(17)
m__u .9,4;1,,9-.22_
1181 _.____
(19) . .._h____
,. _6.aQg~.Q()__
_.__QIO.Q,
3 116.22
'__h__uL_.._______
u.. ... Q,O()
3Lll~..g?
U'I.IUI IX. 1',11'
ESTATE Of
ITEM
NUMBER
A,
B,
A,
C,
1.
2.
3.
A.
S.
6,
7.
8.
PI.a.. Print or T .
MBIR
&1;&
COMMONWIAltH O. PINNSYlVAN'A
'NHIRilANCllAX mURN
RII'DINT DICIDINT
J
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
mJlmn n. HYBnS
DESCRIPTION
I.
Punllal bp.n'"1
None - prepaid.
1.
Admlnl.lratlv. Co.hl
Pellonal Representallve Comml..lons
Socl~1 Seeurlly Number a' Personal Repre.entollvel
Vear Comml..lons paid
2.
AlIorneyFe.. J. nobert Stauffer, JiJsq., Attorney's Fee.
3.
Family Exemption
Claimant
Add".. 01 Claimant at decedent's death
Street Addre..
Clly
Stale
Zip Code
Relallonlhlp
Probate Fe.. ner;ister of \'Iills of Cumberland County,
Pennsylvania, T,etters Testamentary.
MI.e.llan.ou. bp.n,",
Metropolitan Edison Company, eleotrio to 4/21/94.
Bell Atlantio, telephone to 4/19/94.
Hetropolitan Edison Oompany, eleotrio to 5/19/94.
Bell Atlantio, telephon to 5/19/94.
General \'IaterHorlcs of PA, Ino., water rent to 5/10/9 .
Oumberlnnd TJllH Journal, Estate Notj,oe
The Sentinel, Estate Hotioe.
Briokers Auotion, Auotioneer's oonnission, olerks,
advertising and labor for sale preparation.
TOTAL (Also enter on line 9, Reeapllulallan)
(If mall .pae. I. nlld.d, In..rl addltlonal.hlll. of .am. .111,1
2194-0391j.
AMOUNT
$ 5,000.00
268.,50
22.61
2,3.01
,30.07
24.62
28.89
40.00
75.,56
1,470.00
S Oarried FOrHt\l
PAGE - 1
.
.
IIv.,m...I""IW
CO/AAlONW...."H m PlNN\nVANIA
INlltllI.ANCI 'All WU'N
mlDIHIOICIDINI
UTATI Of
mL}1m1l II.
ITIM
NUMIlIR
SCHEDULE I
DEBTS OF DECEDENT, .
MORTGAGE LIABILITIES AND LIENS
HYJiJIlS
DeSCRIPTION
PI.a.. Prln' or TVl!.-
I 'ILl NUMIlIR
. .' 2l94..039~_,
AMOUNT
-r--
"
Dentral Nedioal lDquipmenb 00., due for rental of
equipment.
23.66
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TOTALIAlso enter on IIno 10, Rocnpllulatlon)
IIf more .poce II noodoil, In.ort'oddlllonal shoel. ol.omell~e,)
$
23066
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PAYHENT.
REFUND (CAli
AEPLY
TO.
DISCOUNT I
INTEnESTI
,
Dttech the top po~tJon of thlt Hotlcl and tub.lt with your pay.,nt lada payable to thl ."1" and .~dr... printed
on the r.v.r.. .Irt..
AI. Ply..nt. recllvld .hlll flr.t b. applied to any Intarlet which lay bt dut with any r...lndlr ,ppll.d to the taM.
A r.fund of . to~ or'dlt, which waf not rlqul.ttd on the Tlx R,turn, .ay bt r.qua.tld by cOlplatJnij In
"Appllo.tlon for R,fund of Plnn,vlvanl. tnherltance Ind elt.t. Tlx" (REV-ISIS), Application. ar. avallebl, at
thl OffiCI of the Rlgl.t,r of ~ll1., any of the 24 Rav.nuI Ol.trlot OffiCI., or by cll11ny the ,plcl,l l44hour
III.wlring ..rvlcl "ullb,r. for for.. ord.rlng, NEW HI PENNSYLVANIA 1-800-]62-2050, Gutlla. Plnn'Vlvlt'd,
and within th, local Harrhburg arll (717) 781.8094.
QUI.tlons rag,rulng Irror~ contained on thl. notlol .hould b. addr....d tOI PA D.part~lnt Qf Rlv.nul, Bur..u
of Individual Ttl<U, AllNl POlt A....u.nt Rlvhw Unit, DEPT. 280601, Harrl.burg, PA 11121.0601, phonl
17171 717-6505,
If any h)( dUI 11 paid within thr.. (1) cal.ndar lonth. after thl dlc.d.ntl. duth, . fl.... plrc.nt (5;() dhcount
of thl tal< paid II .11owld,
Intlrut II chargld blglnnlng '11th flr.t day of dtllnqu.ncy, or nln. (9) lonth. and on. (I) day fro. thl d.t, of
dllth, to the dati of Ply.."t. TeMe. which becl" dlllnqu.nt blfcl" January 1, 198Z btar Int.rnt at thl rltl of
.1l< (6X) ~Irc.nt per ennuI oalculettd at . dailY rat. of ,000164. All tal<" which bloa.e dellnqulnt on Ind aftlr
January IJ 198Z will b.ar Intlr..t at a rat. which will ...arv fral cal.ndar Ylar ta callndar y.ar '11th th.t rat.
ennouncld by the PA nepHrtl."t of Rlv.nu.. Thl applloable Intlre.t ratl' fcr 1982 thrOUGh 1995 ar.t
~ tnt.r..t Rat. DallY Tnhrllt Factor ~ Intertlt Rat. D.lly Int.rllt Feotor
1912 lOX ,00051,8 1917 9% .000247
19&! 16l ,000(,58 1988.1991 III ,000301
1914 III ,000501 1992 9% .000247
1915 m .000556 1993-1994 7l .000192
1916 10l ,000274 1995 9l .000241
"Int.r..t I. oalculat.d a. followlI
INTEREST . BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
..Anv Notloo t..u.d aft.r the tal< b.eo... d'llnqu.nt will rlfllet an Int.r..t calculatlen to flft.ln (15) d.V'
beyond the dati of the un...."t. If pay..nt II IIde aftlr the Internt cClputatlo" dlt. .hown en the
Hotlol, additional Interllt "Ult bl tnlculat.d.
I
,
5'
\
,1)0 ~;
G
REV-l!147 EX AFP (08094'.
COIOlOllIIUL!H Of' PfNllSVlVANIA
OfPAAlItEN! Of' AEVEIU
BURUU Of INOIVIDUAL TAXES
DEPT. 280601
HARRISBURG, Pi 171l"0601
ACN 101
NOTICE OF INHERITANCE TAK
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAK
DATI 11-?'8-94
~
--
FILE NO.
DATE OF D!ATH 04-19-94 COUNTY CUMBERLAND
HOTEl TO INSURE PROPER CREDIT TO YOUR ACCOUHT, SUBHIT TH~ UPPER PORTION OF THIS FORH WITH YOUR TAK
PAVHENT TO THE REGnTER OF WILLS. HAKE CHECK PAVABLE TO "REOISTER OF WILLS. AGENT"
REMIT PAVMENT TOI
J ROBERT STAUFFER ATTV
MARKET SQUARE BLDG
MECHANICSBURG PA 17055
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
t:=----_Anount~lnlttld
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
iik V: is'(ii. ii[ "AFP" "fo ii: 9ft"!"" NoT"i Ii r "O'F ""INHiifif ANC E" T"A' j(" 'A"PPiiA"iiiifENT~" "Ai i."O'wAiicE" b"Ii"""""""..""""""""
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MVERS ELMER R FILE NO. 21 94-0394 ACN 101 DATE 11-28-94
TAK RETURH WAS I (X) ACCEPTED AS FILED
( ) CHANOED
RESERVATION CONCERNING FUTURE INTEREST 0 SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONl ORIGINAL
1. R.d E .tot. (Sohedulo A) Ill.
2. Stook. ond Bond. (Sohldull B) (21
3, C101a1~ HIld Stook/Plrtnlr.hlp Intlrl.t (Sohadula C) (31
4. Hortgaga./Nota. Rlollvabla (Schadull DI (4)
5. C..h/Bonk Dapolitl/Hllo. Par.on.l Prop.rt~ (Sohadul. EI (5)
6. Jolntl~ Ownad Prop.rt~ ISohadula FI (61
7. Tr.n.f.r. (Soh.dul. 0) (71
S. Totol Au.to
102,000.00
,00
,00
.00
69,441.20,
.00
.00
(S)
171.441.20
APPROVED DEDUCTIONS AND EXEMPTIONSl
14,480.51
9. Funar.l Expan.../Adn. Co.t./HI.o. Expln.a. (Soh.dul. NI 191
10. D.bh/Hodgag. Lllbllltl../Llln. (Schadu1a I) (10) 23.68
11. Totol Daduotlon. (11)
12. N.t Value of Tox R.turn 1121
13. Ch.rltobl./Govlrn..nb1 Baquuto (Schadull J) 1131
14. Hat V.lua of E.t.t. Subj.ot t. Tax (141
NOTEI If.n ......ment wal illued previoully, linel 14, 15 and/or 16. 17 and 18 will
rmfleot figures that include the total of abh returnl a.Belled to dat..
ASSESSMENT OF TAX'
IS. Anount of Lln. 14 .t Spou..l r.tl
16. Anount of Llna 14 t.xabl. .t Llnl.l/C1... A r.t.
17, Anaunt of Lln. 14 t.x.b1. .t Coll.t.ral/Cla.. 8 r.t.
18, Pr Illolpol T.x Du.
TAX CREDITS I
PAVHENT
DATE
06-14-94
07-14-94
1CL~n4 lQ
156,937. 01
,00
156.937.01
1151
1161_
(17)
,00
156.937.01
.00
K ,00.
K .06.
K .15.
IlS)
.00
9,416.22
.00
9.416.22
RECEIPT
NUHBER
MM886169
MM886296
DISCOUNT (.)
INTEREST (-)
315.79
155.02
6,000.00
3.11&,22
AHOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOT AL DUE
9,587.03
170.81CR
.00
170.81CR
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN .1, NO PAVHENT IS REQUIRED,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR). YOU HAV BE DUE
A REFUND I SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
\
,
IItlER'lATlOH..
PtJIlllOSEDF
NOTICE.
PA'IlIENT.
REFUND (CRI.
DlJECTlDHS .
AllItlN
IITRATlI/l!
CDRIltCTIOllS .
DIICDIIfT.
INTEIltIT.
E.,.t.. of ."ntl dvlne on or afore Deottlblr 12, 1912 -.. 14 any future Int.rll' In the IIt.t. II tran".rred
In pOlltlllo" nr InJov.."t to C111i1t I (coOll,t,r,1) benefio""." of tht deoldent .ft,r thl Ixpiratlon of any IItatt for
11'. or for y..r., tht Co-.onwtllth her.bv Iwprol,lv r...rv.. thl right to Ippr.t,. Ind ...... trin,'.r Inhtrltinel rIXI.
t' thl llWful CII.. . (eol1,t,r.l) rlt_ on .'V luch future Inter..t.
To fulfill the requll'lnntl of Stotlon C!140 of thl Inhtrltlnct end Eltat' rllC Aot, Aat 22 of 1991. 12 P.S,
Slatlon 21~O. '
DttlCh thl top portion of thit NoUel and tubtJt with your Ply"nt to thl Rlght,r tJf NUll prlntld on the rlvlr.. tide.
..1\1I<. chock or ocno. erd.r p....I. tel REGISTER OF NILLS, AGENT
411 plvaent. r.celv.d .hlll flr.t be applied to any Jntlr.,t which "V bt due wIth anv r"llnd.r applltd to t~ tlM.
A r.fund of I taM orldlt, whloh w" not r.que.tld on thl TIM R.turn, ..v bl rlqu..t.d bv oOlplltlng In "Applloltlon
for Rlfund of Pennlvlv""l. Inherltanol and Eatltl TIM" (REY-ISIS). Applioetlon' Ir. Ivalllbl. at thl OffiCI
of the R.gl.tlr 0' Will., .nv of thl ~S Rlv.nul DI.trlot Offlol., or b~ o,lllng thl .p~ol.l 24-hour
."I",rlng ..rylo. nuHir. 'or for.. ord.rlngl In Plnnlvlv.nl, 1-100-362-2050, out.ld. P.nnlvivant, I'nd
within looal H.rrltburg art. (717) 717-e09', TOOl (717) 772-2252 (H.lrlng tapalr.d Onlv).
Anv party In Int.r..t not .Itl.fl.d with the .ppr,III.,nt, allowanc~ or dl..lloNano. of deduotlonl, or ......lInt
of taM (lnoludlng dhoount or Int"..t) II .hoWl on thlt NoUcl MJ.t obJlct within .lxty (60) dlv. 'of recllpt of
thlt NoUo. bVI
--wrltt.n prot..t to the PA DePlrtllnt of RIV.nul, Icard of ApPllh, DEPT. 2&1021, HlIrrllburg, PA 17121-1021, OR
--.Iecllon to hav. tht ".Uer d.ter.ln.d at audit 0' the aooount of th. p.r.onal 1'.pr...ntaUv., OR
--tpp..1 to thl Orphan,' C6urt.
'IOt~'1 arror. dltoovar.d on thlt ........nt .hould b. addr....d In ..rHlng tOI PA O.p.rtlttnt af R,vlnu"
lur.1U of Indlvldu.1 T'M", ATTNI Po.t A.......nt R.vllw unit, oEPT, 210601, Harrl.burgJ PA 171tl-0601
Phone (717) 717-6105. S.. Pitt S of thl bookl.t "In.truotlonD for Inh.rltlMca T'M R.turn for. R..ldant
Dtc.dlnt" (REY-ISOD far an .MpllMUon of Idllnhtratlvltv correotlbt. Irror..
If tnv t.x due I. p.ld within thr.. (S) oatlnd,r .onth. aftlr th. d.e.d.nt'. daath, .flvl p.ro.nt (SX) dl.oount of
th. tl)l p.ld It .lIONld.
Int.rut It charllld big Inning with IIrlt do of delinquencvJ or nln. 191 .anth' Ind ana (1) dlV 'roe tM at. 0'
dtlth, to the data of PlvHnt. Ta)l" which bloall NUnquant bllora J.nuarv 1, nlz b.n Interlllt .t the rat. of
,JM (6~) p.rcent p.r '"~ cllout.t.d It a dlllv r.t. of .000164. All tIMI. whloh b.ol.. d.llnqutnt on and aftar
J.nu.rv 1, 1982 will bur Int"..t at a ratl which will vlrv frol c.ltnd.r ,Yllr to o.ltndlr Vllr with thlt ratl
ennoun~td bv thl PA O.p.rt..nt of R.v.nuI. Th. Ippllo,bl. Intlr..t r.t'l for 1982 through 1994 .r'l
~ Int"..t R.t. Olllv Int.r..t Factor !!!! Intlr..t Rite Dilly Int.r..t Flotor
"" lOX ,000541 1916 lOX ,00027~
1911 I6X .00001 1917 9X .0002~7
191~ IIX .ooom 1911-1991 IIX .ooom
I9li m .000356 1992 9X .OOOZ~7
199301994 7X ,000192
ulnt.rut I. olloulatld I. follow'l
INTEREST. BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT lC DAILY INTEREST FACTOR
....Anv Hotloe IUUld If tit thl tll( blOOM" dtUnqu.nt will raU.ot IIn Intar..t oalculltlon to flftun (11) dlV'
b.vond the dlt. of thl ........nt. If p.v..nt I' aide aftlt thl Int.r..t cOlPutltlon dltl "hown on thl
Notlel, additlon.1 Intlr..t lU.t b. c,lculatld.
. . ,
I ~
'"
STATUS REPORT UNDER RULE 6.12
Name of Decedent I I~T,l'IEn n. NYlmS_
Date of Deathl April 19, 1991~
Will No. 19%-003%
Admin. No.
Pursuant to Rule 6,12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estatel
1, State whether administration of the estate is complete I
Yes X No
2. If t:hfJ Ilnswor I s No, stat.e when the personal
representative r.easonably believes that the administration will be
complete ,__,
3, If the answnr to No, I J.s Yes, state the foJ.J.owing I
a. Did the personal representative file a final
account with the Court? Yos No X
b, Tho separate Orphans' Cour.t: No. (if any) (or
the personlll representative's account iSI
c. Did the personal representative state an
account lnformally to the parties in inter.est? Yes-x._ No
Personal J"epresentativCls aro solo ))o\1of'icinx';los nnd levatoos D.r gstate.
d, Copies of receipts I releases, joind~rs and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be .tllC ed to this report.
Datel Hay 11... 1..296
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a: fJI $::1
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J. no be rt S taufi'sr
Name (Please type or print)
Harkot Squf\T'o131dg.
Hoehn niusburg, PA 17055
Address
L7l?) 7(,().9(>73
Tel. No.
Capacity'
Personal Representative
x Counsel for personal
representative
(MAlIlrmf/AM3)