HomeMy WebLinkAbout94-00428
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PKflTION FOR I)ROIIATE anti GRANT OF LETTERS
HIIIII(' of j"-e!e.JnjYL MU/);A.1 . No, H~~(-2j~fJ.l-:_ .L/.tM:.___
1I1,1'1I kllllll'lI (/.\..__, To:
_~_u,~__~_______'" _ _ _ Rcgistcr of Wills for tll('
_'______~__"w_____/0;7..,---H-- _, .p('('('6,I:J.I, COllllty of ._GY~JlJR.~t.ND_ln the
Social Sl'cllrlly Nil, . ,o;r..-[};b- ad-/'l. COllllllollwclllth of I'ennsylvnnlll
The pctltion of Ihc IIl1dersigned respect 1'11111' represellts 111111:
YOIII' petitloner(s), who hiurs' 1M yeal's of lIge or older In the ex(F"I.CV--~----~n_-._n'_- I)~ed
ill the Inst ~Yill of the 1I11(we den'dent, dals'd,.... '" ,:.t-!,.' hn/.~T--' "..'..'n___nn____' J9W~
I1l1d eodkll(s) dnted ",w. _ . ". .._, _, __,n_,...., _"'__..______~ n
(,tall' Id~'\'''111 \.'irl'lIl1l'lal1l'('~1 clt. rCllrlll.'jllll\ll. dl.'H1l) of l'\l'I,,'t1ltH. ell'.)
Dcecndcn.t WI~~ d~lI~llcil~d III ,(klllh, i~1 _q?..~~~t';_,~ ,,;f, ~'ollnt~ \'cnnsyIYlInln, with
h_~__llIsllnnllh or pl'IIl~iplll resl(lclf',,"~-3~*"~. _nJC1.I'1_.~-'-._______n'_
--..lV1-&MlV'\.~ ~.~ '~l-i,!~;r::~lnt';I~llJj~{~I;~.ip,~iil~:I'-----'---'- ____.__n______.
lit ~~~Cn(I~lIt,C!:C~-1~Jr~ I'S~~f;~gC: ~i~t ~::~~__-::--:~~. -- ___n_' 1') '1 'I:
Execptlls follows, dcel'denl didr~l~lllr~ WlIS not dil'orecd 1I11d did 110t hllye II child horn or ndoptcd
lIftcr excs'lItion of thc will offcred for prohlltc; \\'IIS not the yktilll of 1I killing IIml WlIS ncvcr lIdjlldlellted
il1eOlllpetellt: m__ __n_ ,__~.'~.. _____n__'_n___~~
Ikeendem lit dellth oWl1cd properlY with cstilllllted vlIllICI liS follows: ~
(If domiciled illl'a.) All perlol1al properly $-1.3 ~J
(If not dOlllklled in I'a,) I'crsonalpropcrty In I'cnnsylynnlll $
(If nol domiciled 1111'11.) I'crsonnl propcrty In Connty $
~:::~:~e;;f 1~~1I:(~;::~~~: inl'l'lln:yl_l'llIliu____ })~'~.n~.__n~___ _n_n__n__ _u $ n
WHEREFORE, pctitioncr(s) rcspc~tfnily rp']lIeSlls) thc pro hi c of the
prl'senlcd hcrewith nnd thc grnllt of lellcrL,_~~.t.~\--"'L_n _~_
(IC'IUlllClllllf)'; lldllllnhlHll' Ill'.I.II.; adllllnl"lrllllClIl d,h,II,C,I,a.)
_ will nnd eodlell(s)
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n-;44t'1.~ Co.'firl-9o &- ~-
.____ n'__'un______.__. _)_~__
.----.---.--
-------------
.. m__.o __n _..__._._.____~__... __.______.___ ....
... -. ------------~----.--_._------
OATIl ()I<' I)ERSONAI, REI)RESENTATIVE
COMMONWEALTII 01' l'ENNSnV ANIA .} tltl
COlJNTY OF __~QMBJBL~N_L,_n_n_~___
The pelitioller(l) nhol'c-nallled Iwellr(l) lllllffirm(s) Ihnt Ihl' stall'mcnts In thc forcgolng petillonllre
Irlle lInd cor reel loth~ hesl of the kllowledgl' nnd helieI' of pClitiollcr(s) nncl thntns pcrsonlll rCJlresen.
llItll'e(s) of the nhol'e ds'es'ds'nt Pl'litiodCI(S) willwelllll!lllrllly ndministcl' the estntc neeording to IIIII',
Swnrll to or affhmed. IIl1d Sllhs~rih~ed .. ((liJUI.._.,.(iLl{i' ~'r)_-u.~_'.n_ ~
h(~fore me t,)Ji~ . 4TH. day 01 . /ltJJ-;.1U L- /I :'J)Jf!;-/;:'{t.-_1._-:k,____ ~'
---}~ I (!'l'/)\M~Y,:i..,-fa..?,?~. '~\~. .__..~'____~______n_ ~
I, a. ~H .. .1lliLvto f.. )J I . _.. . ..,-~--~---- ~
M~fY C. LEWIS Reg/I/I'r (__ .... ... .m____nu___ ~
J ~I - (;) I D -- ?
No. ?1 - q4 _ 428
Eslate of
HELEN M. MULLEN
, Deceased
DECREE OF PROBATE AND GRANT' OF LETTERS
..,
and Letters
, are hereby granled 10
AND NOW -_ MAY 6, 19~, In eonslderalion of Ihe petillon on
the reverse side hereof, sallsfaelory proof having been presented before me,
'IT IS DECREED Ihat the Inslrumenl(s) dated JUL Y 1..1_t... 1969
deSCribed Ihereln be admllled 10 probate and flied of record as Ihe last will of __
HELEN M. MULLEN
TESTAMENTARY
HOMER L. MULLEN and ANNA M. KEEFER
FEES
Probate, Lelters. Etc, """'" $
Short Certlflcates( ~ ' , , , , , , , " $.
Renunciation "",........", $
X-Page $ 3.00
JCP . 5.00
Photo cO~ies TOTAL -'-- $ l' 00 '
Flied"" ,,~,Y, ,Q" ,1,~9~""", ", M;OP,
'712u;+f2l2~ ~ am. (!tafMn
(U R"III" of Will. ' ~ (J
MARY C. LEWIS
50.00
6.00
ATTORN1!Y (Sup, Cl, 1,0, No,)
ADDRESS
PHONE
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Mailed letters and order to 'attorney on 5-6-94.
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Ul~.ll~ nev 11.86
(PEe'OR HUS '
tEFltlflCATE .~ 00)
WARNING: n IS ILl.EUAL TO AL TEA 1 HIS COPY on
TO DlJPI.I(:ATE BY PHOTOSTAT OR PHOTOGflAPH,
COMMONWEAL TIt OF PENNSYLVANIA
DEPARTMeNT OF fWAI.TlI VITAL RECOADS
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
CERT. NO. 2125219
.~-71~.71l~I~t~iir1"ICIl'IOfl-
Name 01 Decedent
Helen
fUll
______.._._,. ... ....M,. .,."._.,._""_.___.,_.__,...._ ,.__._.M.ull.ll.n__
~'dlll,. I.'"
Sex
Fe ma 1 e ___.Soclal Security No,___l~.z.~_??::!l.? 9 Q........ ._.,_,._,._, Dete of Death
2-4-94
Date 01 Birth
6 - 27 -l11JlL__ Blrthplece___.......,CJlntr.e..Iwp.. .,_~ur.y. _CJl.q...f:A..._
Place 01 Death __Carlisle Hospital
faChll" ~Um.
_._.C.l1!!1.Q.~_r lillQ___..__.C a.rJ~ Pennsvlvanla
(;011101, (;111'.lllrUu\;I,OfIUI'<fUl,,1'
Race
White
.. Occupation ---':lQ.U,1l.8,I'LiJ.e......,...... _. ...,_ .. Armod ForcDs? (Yos or No)____N.o___
Decedent's '
Marital Status JoU.ill>J'L,___._ Mailing Address ..._3J2.. W.....Ma irL.S,t.__...__..... Me.\: h.anic.alllLr.Q_...EA...llD5 5
I'\'lnllm !illo'l!! (:111' 0' h,...n !i!alo
Inlormant Est h er J1u.1.i.e1L.______,..._.,'_.. Funeral Director... .. .D_Qu,gl.tLL.L_.Jio.y.e,r.._..__._
Name and Address 01
Funeral Establishment ______~9.Y_e r _.f_I,HlerllLIlQme.,..N.e w..JUJl QJIlf.ield..._.E~..J.l.O.6.a_,__
: Interval Between
: Onset and Death
,
,
(a) ___illdiI;LL81:r.Mt.._.__.._..~.__ ....__~_~__ ~._.____,._, _. ._...._....~.._--Hio.u.t e A
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M v 0 g_a rd i!lLw.!!r c t i 00._.____._._.______,____--..;_..0.5 Y s
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Res p ir e tQ1:"y-Ea il!!1'J1__.___u____...____...,..__....____.:.
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-.~_.__________i..___
Part I: Immediate Cause
(b)
(c)
DaYfl
(d)
Part II: Other Significant Conditions
Manner of Death:
Natural g
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Describe how Injury occurred:
Accident
Suicide
Homicide
Pending Investigation
Could not be Determinod
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Name and Title 01 Certifier ,_____,_.________,J!9_u.g.1 a s .)-1.._11.Q\:'Iil.Fu_u___ M . Q . _,_
(M.D.. 0,0.. Coroner. M,E,)
Address _____ Car 1 i s !.tl...J:tQJlp.it.a_!LgJl.!'.U !l.JJ!,ue.LUQJ_L_______.__________
This Is to certify that the Informotion hero glvon Is oorrectly Coopled from en original cortlficate of
death duly filed with me as Local Registrar, rho orininal certificato will be forwarded to the State
Vital Records Office for permanent filing, f7 IklLJ>t:.".,w. .a!/cin~..i.!. u__.. ~Q~~ 5 5
~I rl.,..IIIl'''''i!rlt",rl/''IIIl'''''I<I~ [)I~I'''ltjo
2-7-94 101 Barnett St, ,New Bloomfield PA 1706B
(JAllt rtl)Cfll~lld by lnt:~llh.'{1;iliA"-'-'-- . .. :':1;(~" ,,;;,',I.,rll . .... . . . . -.... ,-- (~I'I-i.tl;;'Ii'~jl-'.-l~;,,;iii~" _____d.__
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LAST WILL AND TESTAME~
.QE
HELEN M. MULLEN
I, HELEN M. MULLEN, of New Bloomfield, Perry county,
Pennsylvania, being of eound and disposing mind, memory, and
understanding, do hereby make, publish, and declare this my
Last Will and Testament, hereby expressly revoking all other
writings in nature testamentary by me at any time heretofore
made.
FIRST: I direct that all my debts and funeral expenses
be paid as soon after my decease as may be practicable.
SECOND: I hereby give and bequeath all of my stocks
and bonds to my grandchildren in equal shares.
THIRD: I hereby give, bequeath, and devise all the rest
and residue of my estate and property, real, personal, and mixed,
of whatsoever nature and wheresoever situated, of which I may die
seized or possessed or to which I lTiay be entitled or of which I
may have the right to dispose at the time of my death, absolutely
and in fee simple to my children in equal shares.
FOURTH: I hereby appoint my son, Homer L. Mullen, and
my daughter, Anna M. Keefer, as Executors of this, my Last Will
and Testament, and further appoint them guardians of any minor
children that shall be entitled to receive property under this,
PAGE ONE OF TWO
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CO/AMONWIAlTH 01 P1NNIYlVANIA
DIPARTMINT Of RIVINUI
D!P1,210601
HARRIIIURO. PA Ima,0601
PI -;),} 0 - ''I
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
NUMBER
.01 rAm O' DIATH Anll 12111191 CHICKHII.
If A POUIAL
'OYII" CIIDIT I' CLAIMID 0
PILI HUMI.I
21 94 428
RIV.l5oo IX. (11,911
1. Roal Ellalo (Schodulo AI ( 11
2, Slack. and Bond. (Schodulo BI ( 21
3, C'ololy Hold Stock/Partn."hlp Inl.ro.t (Sch.dul. q (31 ________
4, Mo~gag.' and Nato. R.c.'vobl. (Sch.dulo D) ( 41
5. Co.h, Bonk D.po.It. & MllClllan.ou. POMnol Prop.rty( 5) $14, 226 . 72
(Sch.dul. EI
6, Jointly Own.d Properly (Sch.dul. F) (6) $ 4 3 . Ll.lLl.3
7, Tron.I." (Sch.dul. G) (Sch.dul. LI ( 7)
0, T 0101 Grall AlloII (Iolollln.. 1.7)
9, Fun.rol Exp.n..., Admlnl.trollvo Co.II, Mllcollonoou. (9) $8,597.78
Expon.o. (Sch.dulo H)
10, D.bl., Mo~gog. L1oblllll.., L1.n, (Schodul. II (10).-
11. Tolol D.ductlonT (totallln.. 9 & 10)
12, Not Valuo of E.talo (IIno 8 mlnUllino 11)
13, Charltablo and Gov.rnmonlal O.quo," (Schodulo JI
14, Not Valuo Subjoct 10 Tax (lin. 12 mlnu.lino 13)
1,~, Amount ollino 14 taxablo at 6% rate
(Includo valu.. from Schodulo K or Schodulo M,)
16, A,nounl a' IIno 14 toxablo at 15% rote
(Includo valu.. from Schodulo K or Schodulo M,)
17, Principal tax duo (Add lax from lino 15 and from IIn. 16,)
10, Crodlt. Spou.al Povorty Crodll Prior Paymonll Dllcounl Into,o"
------ + ----- +----------- - -----
19, IIl1no 181. groalor than lino 17, ontor tho dlfioronco an lino 19, Thl.l. tho OVERPAYMENT,
liD
20, IIl1no 17 I. groolor than lino 10, ontor tho dlfioronco on lin. 20, Thl.I.,ho TAX DUE,
A. Enl.r lho Inloro.t an tho balallco duo on lin. 20A,
B, Enl.r tho total a' lino 20 and 20A an lin. 20B, Thl. 1.lh. BALANCE DUE,
Ma~o Cho.~ Payabl. to, ROII,.t., of Will., Allont
.. II .un TO AN'WIll AU QUIITlON. ON .IV.... IIDI AND TO .EHICK ~TH.:.' ,"~I, :''',,\'I!\~i';':':(
Under penaltl'. of perjury, I declar. thai I have examined this r;lurn, Including accompanying tch,'dul.. and Ilot.menll, and 10 th. bill of my now edge an .1. ,
It It true, corr.ct and compl.I... I d.clartthat all real 11101. hat been r.port.d allrue mark'l valu.. Oeclaratlon of preparer other than the p'rlanal r'p,...nlatlv. I.
bated on alllnformall..,n 01 whIch pre arer hat any knowledge.
1I0NA!1%,~~!SON ,moNS! 2. R IINO mURN ADDms RDl Box 419, New Blocrnfield PA 17068 lill'r
~jp.~. ... 1t- 913 Shirerront Dr. Mechanicsburg m 17055 la '7-1
IV! ADDR(ff'Center Square, P.O. Box 232
<:: ~ - ~ ..ew tllm>mfielcL PA li.Q..6~_ IJJ
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COUNTY CODe
VEAR
Mullen, Helen M. 312 W. Main Street
-mllmYmIMi'fr" T"AllOTlilAlH-riAlflifIfRllf-- Mechanicsburg, PA
12/4/94 6111103__ C,"",
o 2, Supplomo,,'al R.'urn
rJ 4, Llmllod E.tal. rJ 4a. Fuluro InlorOlI Campromllo
(for datol of doalh ohor '2.12,021
[1 6, D.codont Dlod Tollal. [J 7, Decodonl Malnlaln.d a living Tru,'
(Mach co y 01 Willi (Mach copy a' Tru'l)
AU. COII'If'ONDlNCI AND CON~IDINTlAL TAX INPOllIt1AtlON 'HOULD .1 DlIICTID TO.
N;,MI M
Center Square
P. O. Box 232
New Bloomfield, PA 17068
17055
182-22-8290
[~ 1, Original Rllu,n
Cumber lal1d ,______,._
[] 3. Romalnder Rllurn
(for dot.. of d.olh prior 10 12,13,a2)
05, Fod.ral Ellalo Tax
R.lurn Roqulred
_ 8, Tolal Number of Sofo D.po.1I DaxII
Gerald K. Morrison, Esquire
l N MIE! - -
17"7
SR2-230CL.
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( 81 j,57, 944.95 ___
(151..149,347.17
(11) LL.597.78
(12) $49,347.1_~_
(13)
(14) _ti..9..tl.!7 .1 7
K,06. ,$ 2.96!Lli
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(16) _h'
K ,15.
(17) .LW.6Jl..D_______
(18) .__H__________.__.__
(19) _______________
Cbt.(~ 11I"1' If you (If{..It'(IUI'\III\~J (I It'fund (If your o\lI"pUVI1lC'nl
(20) .1..2..,..9_6.0.. 8 3
(20A) _____
(~OBI _L2-,-~!i_~l!~_.__
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IIV,ls.31U.IU11
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-
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
Plea.. Print or Type
FILE NUMBER
21-94-428
COMMONWI~HH O',flNNIYWANIA
'N'Vll'Dftft'JtCl:rNV'N
ESTATE OF
Helen M. Mullen
(All P''''''v ,"Inllv._nod with tho Riehl of SurvlVOllhlp mUlt bo dl..lo..d on Ichodulo '1
ITEM DESCRIPTION ~ VALUE AT
NUMBER DATE OF DSATH
1. Farmers Trust CDH65408 $ 2,016.76
2. Farmers Trust CDH68933 $ 5,031.94
3. Farmers Trust CDH08455 $ 2,006.85
4. Farmers Trust CDH96411 $ 2,002.42
5. Farmers Trust CDH63654 $ 2,018.75
6. Ida V. Baughman - loan $ 1,150.00
-','
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$14,226.72
,AUach addUI.nal 8Yo" . 11" Ihllll II m.lI.pacoll n..dld,J
,
11~'MltU.112'''1
I
(OMMONWIALTH O' 'INNIYlVANIA J
INHIRITANC! TAX mUIN
RIIIDINT DI(IDINT
*'
SCHEDULE F I
JOINTLY-OWNED PROPE~ __
PILI NUMIIR
21-94-428
-
ISTAT! OP
Helen M. Mullen
Joint tonanll.11
NAMI
A, Esther M. Mullen
ADDRISS
312 West Main street
Mechanicsburg, PA 17055
RILATIONSHIP TO DICIDltiL
Daughter
I,
C.
Jolntly.ownod proporlYI
ITIM Linn DATI
NUMII FOR MADI DISCRIPTlON OF PROPERTY TOTAL VALUE DECD'S DOLLAR VALUI OF
JOINT JOINT OF ASSET % INT. DECEDENT'S INTEREST
TINANT
1, A 1/11/85 Farmers Trust Checking $7,075.02 ~ $ 3/537.51
Account #10-04166
2. A 8/4/76 Farmers Trust Savings $25,168.23 ~ $12/584.12
Account #10-000974
3. A 1959 160 shares of Be11south 9/250.00 ~ $ 4/625.00
corr. Common stock @
57- 3/16
4'. A 1959 204 shares of Nynes Corp. $ 7,930.50 ~ $ 3/965.25
Common stock @ 38-7/8
5. A 1959 453 shares of AT&T Corp. $25,056.56 ~ $12/528.28
Common stock @ 55-5/16
6. A 1959 238 shares of Bell $12,956.13 ~ $ 6,478.07
Atlantic Corp. Common
stock @ 54-7/16
TOTAL (Alia onl.. on IIno 0, Recapitulation)
(I' mort IpOCO II nooeloelln...' odelll/ona/lhll" 0' lamo .Ize)
$43/718.23
UV.UI1U'I'.1I1
I SCHEDULE H
fUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES Pllall Print or TYPI
]'IU-NUMBIR
21-94-428
---
~'~'~
If', ,'II
~'-
COMMONW!AIlH 0' P!NN!YlVANIA
INH!RIlANCI TAR R!lURN
R11IDINT D!C!DIN!
ESTATE 0'
Helen M. Mullen
ITEM
NUMBER
A. Funeral bplnllll
DESCRIPTION
1.
Douglas Boyer Funeral Home
B. Admlnlltratlvl COltll
1. Personal Reprellntatlve Comml"lonl
Social Security Number of Perianal Reprelentatlvel
Year Commllllons paid
4,
C,
1.
2,
3,
4,
5,
6,
7,
8,
2,
Allorney Feel
Gerald K. Morrison - legal services
Family Exemption
Claimant F.Flther 11. Mill] en Relatlonlhlp Dllughter
Addrell of Claimant at decedent's dealh
Street Addrell 31 2 We FI t MaiILS.tl:.ee t
City MenhaninFlhllrg Slatel?A.._ZlpCode-11055
3,
Probate Fees
Mary C. Lewis - estate letters
Mllclllonloul bplnlt"
Dr. Stoken - medical account
Carlisle Imaging Assoc. - medical account
Car lisle Cardiopulmonary assoc. .. medical account
Masland Associates - account
Barry L. Heckard, Tax Collector - 1994 taxes
Gingrich Memorials - gravestone lettering
Cumberland Law Journal - estate advertising
The Sentinel - estate advertising
AMOUNT
$ 5,445.00
$ 711. 34
$ 2,000.00
$ 65.00
$ 15.00
$ 70.06
$ 10.80
$ 19.14
$ 9.80
$ 126.00
$ 40.00
$ 85.64
(If mort IpaCI II n..dld, Inltrt additional Ih..tl of lame 1111.)
TOTAL (Also enter on line 9, Recapitulation) S 8 597 7
, . 8
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RECEIVED FROMI
&
ACN
ASSESSMENl Il'
CONTROL Ili
NUMBER
,
AMOUNT
MORAISON GERALD K
CENTER S/ilUARE
P 0 BOll E/SE/
NEW BLOOMFIELD I)A 170hB '.
101
fe,'160.B3
OF n~,hI:FN HELEtiJL
SBN lB&"ea"SE!90
IFIRSl'f . M
--
1,_'
CUMBERl.AND
i\fIr'
REMARKS
Jrp4
ANNA M. KEEFER
r-
*e,'.0.&l3
PB /
\.-
SEAL
CHECK.. II
REGISTER OF WILLS
~~Gre~ERL ~I~
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/I/,j/(J", 7
R~V 1547 nx AFP (0.094*1
NHOHWEAllH OF PENNRYlVANIA
PAH1HENT OF REI'ENlIf NOTICE OF INHE~ITANCE TAM
' IUllfAU or INDIVIDUAl TAXES APPRAISEHENT. ALLOWANCE OR DISALLOWANCE
/I,' ~:~i.~~~:1 PA 17121-0601 OF DEDUC~~NS ~ ASSESS~F.NT OF TAM
M FILE NO.
DATE OF DEATH 02-04-94 COUNTY CUMBERLAND
NOTE I TO INSURE PROPE~ CREDIT TO YOUR ACCOUNT. SUIHIT THE UPPER PO~TION OF THIS FORH WITH YOU~ TAM
PAYHENT TO THE REGISTU OF WILLS, HAME CHECM PAYAILE TO "~EGISTER OF WILLS. AGENT"
REMIT PAYMENT TOI
~
ACN
101
DATE 01-24-95
GERALD K MORRISON ESQ REGISTER OF WILLS
CENTER SQ CUMBERLAND CO COURT HOUSE
PO BOX 232 CARLIS'PrlA 17013
NE' BLOOMFIELD PA 17'" ~ 'M~i l
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ,~") .'
Riv: iAW. iiC"A FP' i 0 ij: 94 T .iiii'fi cE" .O'F' Y NH iifii'Aiicii. TAX. 'A'PPR'A'i 9Ej.fiiiT~.. A ~i."O'WAN'C ~R..".. ',~_.'" ...,
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT ~F, ~AX"'O '. . .
ESTATE OF MULLEN HELEN M FILE NO. 21 94-0428 ACN'faI~rOI ~ Dllj;t~ 01"24-95
TAM RETURN WAS I I X) ACCEPTED AS FILED () CHANOet>.4 lj\ -..
RESERVATION CONCERNINO FUTURE INTEREST . SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL
1. Rool E.tote ISohodulo Al II I
2. Mook. ond londl ISohldule BI 12)
5, Clololy Hold Siook/Porinorlhlp Iniorooi ISohodulo C) (5)
4, Horigogo./Noiol Rooolvoblo ISohodulo 01 141
S. Co.h/Bonk Dopo.li./Hllo, Porlonol Proporiy ISohodulo E) IS)
6. Jolnih Ownod Proporiy ISohodulo F) 161
7, Tron.for. ISohodulo G) 171
8, Toiol A..oh
,00
,~
,00
,00
1(1.226,72
43.718,23
,DO
(8)
57.944,95
APPROVED DEDUCTIONS AND EXEMPTIONS I
9, funerol E.ponlo./Ado, Co.i./HI.o, E.pon.o. ISohodulo HI 191
10. DObh/Horigogo L 10bU I HulL Ion. I Sohodule II II 0 I
11, Tohl DoduoHon.
12. Noi Voluo of To. Roturn
15. Chorlioblo/Govorn_ontol loquo.i. ISohodulo JI
14, Not Voluo of E.toto Subjoot io To.
8.597,78
.00
Ill)
1121
(15) _
(14)
8,597 78
49,347,17
,00
49.347,17
NOTE I
If .n ......m.nt w.. i.au.d pr.viou.ly, lin.. 14, 15 and/or 16, 17 .nd 18 will
r.fl.ot figure. th.t inolud. the tot.l of ~ return. .......d to d.t..
ASSESSMENT OF TAXI
15, A_ount of L1no 14 ot Spounl roto liS)
16, A_ount of L1no 14 h..blo oi L1nnI/Cla.. A roio 1I6l
17, A_ouni of Llno 14 io.oblo oi Colloiorol/Clo.. B roio (17)
18. Prlnolpol To. Duo
TAX CREDITS I
PAYHENT
DATE
10-24'94
.00 M' 00.
49j347,17 M,06.
..ll M ' 15.
(18)
,00
2.960,83
,00
2.960,83
RECEIPT
NUHBER
MM913110
DISCOUNT I')
INTEREST 1-)
,00
AHOUNT PAID
2.960'~rr-
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
2,960,83
,,00
,00
,00
· IF PAID AFTER DATE INDICATED, SEE ~EVERSE
FOR CALCULATION Of ADOITIONAL INTEREST,
IF TOTAL DUE IS LESS TNAN 81, NO PAYHENT IS ~EQUI~ED,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" IC~). YDU HAY IE DUE
A ~EfUND, SEE ~EVE~SE SIDE Of TNIS FO~H FD~ INST~UCTIONI. I
\
"
RESERYATlONI E.t.t.. 0' d.ClIMnU d~lng on or blfor. D'Cllb.r 12, 1912 .. If tny future Int.rllt In the ..tet. II tranlf.rfld
In pOI.I..lon or 'nJov.."t to Cia.. I (colllt.r,l) bln,flcl,rl.. 0' thl dlcld.nt .ft,r thl Ixplr.tlon 0' tny ..t.t. for
11" or for y..r., thl Co..onw,llth hlr.by Ixpr...ly rl..rv.. thl right to appral.. Ind ...... tr.n,',rlnhtrtt.nol f.~..
It thl I.w'u. C1I" I (ooI1.t,r'.) rtt. on .ny .uch future Int.r..t.
PlMPOIE OF
NOTICE I To fulfJl1 thl r.qulrt..nt. of Seotlon 21"0 0' thl Inhtrltanc. and Eltat. fix Aot, Aot Z2 of 1991. 12 P,S.
Slotlon 2140.
PAYMENT I D.tlch thl top portion 0' this NoUo. and tubeit with your pIYlllnt to thl AIght,r of Willi printed on the river II ,Id..
--Hlk. ch.ck or .on,y ordtr Plytbl, tOI REGISTER OF MILI.S, ^DENT
All PI.,.."t. flclJII.d Ihall flrlt ba appllad to anv Intar..t which ..v bl dua with anv r...lnd.r appll.d to the tilt.
REFUND (CA), A r.fund of . tu er'dlt, which WII not rtquuttd on the Tile Return, .ay bt r.qualttd b'i coaplttlng an "AppllOltion
for Refund of Ptnnlvlvanla Inhtrltanca and E.t.t. hit" (REY-UUL Application. ara t",allablt at tha OffiCI
of thl RIghtlr of Willa, anv cf the 2S RI"'lnu. Ohtrlot Offlou, or bV l:all1ng the ,plclal Z4~hour
an,wlring IIrviel nu.barl far for.. ordlrlngl In Plnfl.vlvl"le l-aOO~36Z~ZOSO, outlldl Ptnnlvlv"nl. ."d
within local Harrl.burg ar.a (717) 787-8094, TOOl (7\7) 772-2252 (Hllrlng I.pelr.d Onlv).
OBJECTIONS, An'i PII'tV In Intlrut not "tI.flad with th. apprail..,"t, allowanea or dilallowanol of dlduction., or u......nt
of t'M (Including dltcount or Intara.t) .. thown on thl. Hatlce .u.t obj.ot within .Ixtv (60) dav. of rae_lpt of
thla HoUca bVI
-'wrlttan prot..t to the PA DIPart..nt ~f Rav.nua, lo.rd of ApPlal., DEPT. Z810ZI, Harrlaburo, PA
..al.otlan to havI the .att,r datar.ln.d at ftudlt of thl Hccount of thl Plr.onal rIPr...ntatlv.,
--,pplal to th. Orph.n,' Court.
17m-1021,
OR
OR
ROlliN
IIlRATlYE
COAREClIOHS,
Faetu.1 .rrora dl.cov.rod on thl, .....'..nt .hnuld b. .~dr"'ld In writing tOI PA D'Plrt.ant of n."'tnua,
lur..u of Indlvldull TaK", ATTHI POlt A.......nt Rlvl.", Unit, DEPT. Z80601, Harrl.burg, PA 17128'0601
Phon. (711) 717-6505. S.. pa" 5 of thl book1tt "In.tructlon. f~r Inhtr Itanca TIll R,turn for a Ruld.nt
olc.dlnt" (REY-ISOl) for In 'MPla"atlon of ftd.lnlltratlvllv corrlctabla 'rror..
OIICOOHI,
If aM taK dUI 11 p.ld within thr.. (11 clllndar aonlh. aftar thl dlcld.nt'. dllth, I five plrc.M (5%) discount of
thl tall paid JI .llowad.
INTEMII.
Intlrl.t II chlro.d b.olnnln, with 'Ir.t dav of dllinquency, or "Ina 191 .onth. and ani (1) dav fro. thl dati of
dl.th, to thl dati of plv.lnt. TIK" which ble..1 dlllnqulnt blforl Januarv 1, 19a? blar intara.t .t thl rat. of
II_ (6X) plrclnt p.r Innue calculatld at a dlllv rat. of .000164. All t'XI. whiCh blca.. dlllnqulnt cn and .ftlr
Januarv I, 1912 will b.ar Intarllt at a rat, which will varv fro. lllhndar v..r to elland.r Vllr with thlt rate
announcld b'i t~1 PA D.part.ent of Ra",.nuI. Th. appllcabl. int.rl.t ratl' for 1912 t~rouoh 1995 Irll
'!!!!: ~!!!.~ Dallv Int.r..t rlctor ~ InUrut Rite Dallv Intlr..t F.etor
1111 20~ , OOOS~I 1917 9~ ,0002~7
1911 1lX ,000.sa 1911.1991 11X ,000501
1m 11X ,000301 1992 9~ ,0002~7
1m m ,0001Sa 199).1996 7~ ,000192
1916 10~ ,00027~ 1995 9~ ,0002H
-.Intarllt II calcul.ted II follow. I
INTERElT . IALANCE OF TAK UNPAID K NUHIER OF DAYS DELINQUENT K DAILY INTEREST FACTOR
--Anv Hotlca IlIlJId aftar thl taK bICOH. dellnqulnt will raUaet In Intarllt ulculaUo" to flft..n (IS) d,vI
b,vond thl da'. of thl ........nt. If Plv..nt I. .Id. aftar thl Inter..' cOlputatlon dlt. .hown en the
Notln, addltlonll Intlr..t au" bl cllculat.d.