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I)ETITION FOR PIWnATE lInd GRANT OF LETTERS
21-94- tlif:3
---+-P. _.. _.___ . ......
[:\(11((' (~l __DJl.Y.~r:I.\~. ~h.rincr.
11/.111 kl/oll'l/ (/.1 __._
No,
To:
Regisll'r of Wills for Ihl'
, /1/'('('11.\/'11, County of . qlJl1lb.~Jl{\nd..m.. in Ihe
S';/:/II/ S(';'/Irlty Nil:.. 716-:(J5':'7~68 . COllllllonweahh of I'l'nnsylvnnlll
The pel it ion of Ihe nndersigned respeclfully rl'prelents that:
Your petilioner(X). whols/al'l' IH yeurs of nge or older un thl' executrix.
in Ihe lasl will "I' the ahove dl'cl'denl, dated _ S~Ptellll>eLJ.Q
lll1\l(lClIll~H~lOOc4tl< __..,_ ..
nllllled
..19.9.L._
hlUh' Id\'\ltlll drl'llll1l,lalll,\'I" l'.V. r~'Il11lldati(lll, (killh ot l"l'l'Ulm, ell',)
Ileceodl'nt was dOlllkikd al dl'lIth in. Cumberland....... Connly, l'ennsyll'l\nill, with
hi~___. lasl ramily or pri~cillallesidl'\lI'e ai, 1 el Em~r8onp~iycl.Gn.r.U~1.~L.~..._.___
h.nnsYlv{\nJI\U(l13n_L~;->Ull th m Ido <.: lull. [""f...J. .. _H_.__._.__._".m__n__
(Ii,l \lll'l'l, 111I1Hl1l'l illlllllllllldp;llll)'
Ileccndenl, Ihcn.. _ 88 . yeal's of age, dkd .. . AprilJ 1.._ ....m__._..._., 19..2!L__.
III .._C!lxJ.isle.llospi ~{\l. .C.<\rUslc. PennsYlvlIo!{\ .._ .. .......m..____.._. .__..__".,
('xeeptas follows, decedent did nOllllarry, wa, nol divorced I\nd did nol have a child hom or adopted
lifter eXl','nliou of Ihe will offered for prohme; wa, nOllhe I'klilll of a killing ami WIIS never adjlldiellted
incompetent: ..... ._..... _._._.__._...._._...___~._
Ilecendenlat dealh owned (,rOpL'ny wilh estilllaled I'alaes as follows:
(II' domiciled in I'a,) ^II personal property $___~~.'7!600.~~._._._
(II' nol dOllliciled in I'a,) I'ersonal properlY in Pennsylvania $,~_____m.._._..
(II' not dOlllidled in I'a,) I'l'r,onal properll' in Connly $___9.o..,.o.oo...o.Q...w.
Value of J'L'illcsIUil' in Pl'llll\vl\'llnia $......_~_..___.__._.- _.__~_.__.
sitllllted as folloll'S: 131.'E11\~rsol1Driye,CarUs.L~IJ_E!l1!J.~Y1Ylll1J.!LnQl;L.._._.___
.___...__ ....,_. _ _ SOl1.th_ l1idcj 1(Jt(Jn1o\oln~hip.._._ _.__.u_.._._._... _ ..... h. _.._ ___ _
IVIIERI'i'ORE, pelilioller(!() re'peclfully reqlle.lt(s) the prohule of Ihe Illst will mllXldillilt~
presellted herell'ith alld IhL' gralll of lellel'. ..test.am(J.l1~.ary~..__.____u." _.un.._._..______..
((l.~I,lI11l'nlar>; ndlllillhtrlllltllll'.l,ll,; udmlllhlrltllOIl d,h,n.r.l.n,)
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_.. ......_._ ...._._.__.._ 'm~___._.._.__._.. _,_ .___._.____on... n__.~.__ ___~'."_
OATH OF PlmSONAL REPRESENTATIVE
~~~~~,(~~~~rA~6~;~~i~t~~~':~~~\'."~~~'~.... J ~IH
The pelitlolll'I(K) allol'L"llamed slleall') 01 al'lllm(l) Ihat Ihl' slalemellts illlhl' fOlegoillg pelitiollure
Irtle ulld <'Ollwt lotlil' he,1 of tlie ~uowledge alld IwliL'f of peliliollelbl) alld lliallll persollul lepresell"
lati\,elx) of Ihl' alHIl'l' de<,edellt pL'lilioIlL'rlx) lIill well alld trllly admillistel tlie eslUle a<"'llIdill~ to lull',
J) J ' (;;, /
sworll. 10 .01 af.fi.rIl1C'L .'III.d 'lIh'\l'Ii.b.L'd~ .~.' iL{;'(VJ. U. Ct.t{:,~
bdOl'l' I Ill' this. . . '12TH[~ day 01 .,j(athy II.. Hobb
7(f1cii<rf6UJJ~~,t:{) I" L" l)lrtt /{j
T r{(KRY C. LEWIS lIl'gi'fl'1 .' (!
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No. 21-94- 443
Estate of
David W. Shriner
, Deceased
DECREE OF PROBATE AND GRANT 01<' LETTERS
AND NOW MA Y 13 I 19_ 91, I In consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me.
IT IS DECREED that the Instrumcnt(R) doted September 1OL-1992
described therein be admllled to probate and riled of record os the lost will of David W. Shriner
and Lellers ~.l}ID.~ntary
ore hereby granted to Ka thy A .J.9.I2Q.
FEES
Probate. Lellers, Ete, """", $ 305. QO
Short Certifleates(?) ."""", $ 21.0.0
Ren\!nclatlon ..",."""",. $ .
. X-pages $ 9.00
JCP - 5.00
TOTAL _ $ 340,00
Flied "," ,M~ y, ,1,~, , ) ,9,~4 . , , , , , , , . , , , , , .
f.i.'d.dd--<..o7--~..I ;M-<l b (iA:c p..<..-
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Regl'ter of Ills' . U 0
MARY C. LEWIS .
--B~er B. Irwin #06282
ATTORNEY (Slip. CI, I.D, No,)
60 West Pomfret Street
Carli"r.. Penn"ylvania 17013 __
ADDRESS
717-249-2353
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Called attorney on 5-13-94.
1!lCl(tt ~i 11 Club 'ijftstnmmt
I, DAVID W. SHRINER, of South Middleton Township, Cl.IlDber-
land County, Pennsylvania, declare this Instrument to be my last
will and testament, hereby expressly revoking all wills and
codicils heretofore made by me.
QliK: I direct my ~xecutrlx to pay all of my debts, funeral
and administrative expenses as soon as may be done conveniently
after my decease.
TI'lQ: I authorize and empower my executrix to sell any
realty owned by me at my death, at either public or private sale,
and to give good and sufficient deeds therefor, In fee simple, as
I could If living.
TImJ!:E,: I give, devise and bequeath all of my estate of
every nature and wherever situate as follows:
(a) My silverware to my son, Robert W. Shriner;
(b) $10,000.00 and my grandfather c1 ock to my
daughter, T. Louise Craine;
(c) $10,000.00 to my grandson, James L. Craine, II;
(d) $20,000.00 to my granddaughter, Kathy A. Bobb;
(e) $10,000.00 to my son, Rober t W. Shri ner;
(f) $20,000.00 to my grandson, Robert W. Shriner, III
(g) $10,000.00 to my grandson, David M. Shriner, wi th
this share to be held by his father and used for
him personally;
(h) $10,000.00 to St. Paul's Lutheran Church, Carlisle,
Pennsylvania;
(i) My car to my granddaughter, Kathy Bobb;
(J) $10,000.00 to my great grandson, David Craine
Bobb;
(k) $10,000.00 to my great granddaughter, Katie Louise
Bobb;
(I) $10,000.00 to my great granddaughter, Heather Ann
Craine;
(m) $10,000.00 to my great grandson, James L. Craine,
I I I ; and
(n) $10,000.00 to any other great grandohild born or
adopted before my death.
FQ!!R.1 I give, devise and bequeath a1 I the rest, residue and
remainder of my estate to my living grandchildren and great
grandohlldren, share and share alike.
Fill: I nominate and appoint Kathy A. Bobb to be the
executrix of this my last will and testament; she is to serve as
such without bond. Should she die before my death, renounce or
refuse to serve for any reason, or die leaving any of my estate
2
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ESTATE OF DAVID W; SHRINER
, ,
LIST OF BENEFICIARIES
01, I
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'Robert W. Shriner, II
23 Walmar Manor
DlIIsburg, PA 17019
David M. Shriner
330 "F't Street
Carllsle,IPA'17013
St, Paul's Lutheran Church David Craine Bobb
201 W, Louther Street 153 Rlchland Road
Carlisle, PA 17013 ' Carlisle, PA 17013
,
Robert W, Shriner T, Louise Craine
330 "F" Street 501 Glendale Street
Carlisle, PA 17013 Carlisle, PA 17013
" .
James L. Craine, II , Kathy A, Bobb
1883 Esther Drive 153 Rlchland Road
Carlisle, PA 17013 Carlisle, PA 17013
",' Katie Louise Bobb Heather Ann Craine
153 Rlchland Road' 1883 Esther Drive
Carlisle, PA 17013 Carlisle, PA 17013
James L, Craine, III
188~ Esther Drive
Carlisle, PA 17013
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COMMONW\AllH Of PlNNSnVANIA
Of PAR ME NT 01 R(V(NUf
lOll OI"C! 10' 1m
H.RRISlURO, PA 1110~,eJ~1
0' NM NAMr-jIAii:-',iSl, A;ji;;;i5&ri'NilIAQ
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Remainder R.turn
liar dolll of doolh prior 10 12.13.82)
Fod"al Ellalo Tax
Rolurn Roqulred
Tolal Numb" of Solo Dopolll BoxOl
PILI NUMIIR
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLSl
YEAR
21 - 94 - 443
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COUNTY CODE
ON' OM I A $$
131 Emerson Drive
Carlislo. PA 17013
1~::~::~5 ___ C~~ut8u~URt~~Bn TownBhip
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NUM~~~
1. Roal Ellolo ISchodulo A) ( I) __.1illl.illl(hQQ
2, Sloe", and Bond. ISchodulo B) I 2) 1JLJ 6
3. Clo.oly Hold Slock/Porlno"hlp Inloro.1 ISchodulo C) I 31
4, Morlgogo. and Nolo. Rocoi,oblo ISch.dul. 01 I 41 ___
5, Calh, Bank D,pollI. 8. Mllcellon.ou. Perianal Proporly! 51 _ 249 , 867,60
IS,nodulo E)
6, Jolnlly Ownod Proporly (Schodul. F)
7. Tranlf", ISchodulo G) ISchodulo l)
8, TOlol Grall AIIOI. Ilololllnol 1.71
9. Funorol Exp""o., Admlnlllrall,o Call., MI.collanoou. ( 9)
Exponlll ISchodulo H)
10. Dobl', Morlgago LiabilillOl, Lionl (Schodulo I)
11. Talal Doducllon. (Ialalllno. 9 & 10)
12, NOI Valuo 01 Ellolo Ilino B mlnullino 11)
13. Charllablo and Governmonlol BoquoII' (Schodulo JI
14, NOI Voluo SubloCllo Tax (lino 12 minullino 13)
15. Amounl 01 IIn. 14 loxoblo 01 6% ral.
(Includo ,aluol from Schodulo K or Schodulo M,)
16, Amounl 01 IIno 14 laxablo 0115% ralo
Ilncludo ,aluol from Schodulo K or Schodulo M.)
17. Principal lax duo (Add lox from lino 15 and from Ilno 16.1
18, C,edill Prlor Paymen" Discount
------ +
19, If line 1811 groo'" Ihan lin. 17, onlor Iho difforonco on IIno 19, Thill. tho OVERPAYMENT.
alJ
20, If lino 17 II groal" Ihan lino IB, .nl" Iho diff"onco on lino 20, Thlllllho TAX DUE,
A. Enlor the Inlelell on Ihe balancCl duo on line 20A.
B, Enllr ,ho 10101 01 lino 20 and 20A on lino 20B, Thl. " Iho BALANCE DUE,
Mako Chock Payablo tal Roglller of WillI, Agonl
.. ..BE SURE TO ANSWER ALL QUESTIONS ON REVElSE IIDE AND TO RECHECK MATH....
Under ponalll.. 01 p"lury, I doclare Iho' I ho,o "ominod Ihll rolurn, inciudlng accompanying ICh.dulll and IIolOmonll, and 10 Ih. bill 01 my knowlodgo and boli.r,
II h tru I COftlct and cOMpl'I.. I declore Ihol 011 t.al'llal. hOI bun report.d 01 Irue mark'l VOIUI, D.claration of pr'parer olh" than Ih, pltlonal '.prll.nlallv. II
bal d n alllnformalion of whlth preparer nOI any knowledge.
URN I 1'1 lOR ""NO mUON AOOR!l! KATHY A, BOnn OAT!
I';~ YJC~1l1,A~D ROAD. CARLISLE. PA 17013 11- 14
.0 RI I 1l0GER B, IRWIN, ESQUIRE om
60-Wllf~l'-S:rJlEET. C411ITSI,F,-FA '7m) 11- 14
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I DAVID W.
IAL u 'fniuMm----.--rvrol OI"H
716-05-7368 104..11-9/.
----..---------------
fg I. Orlglnoi Roturn [J 2. Suppl.m.n'ol Rolu,n
04, llmilod Ellalo 040, Fuluro Inl"OII Comproml..
liar dalll of doolh altor 12.12.82)
XX 6. Decodonl Dlod TOllalo 0 7, D.codonl Malntainod a ll,lng Trull
IAllach copy 01 WillI IAllach copy 01 TrUll)
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TOI
NAM - M l MAlliN A R!$S
03,
05,
.l. a.
IRWIN, MCKNIGUT /, HUGHES
60 WEST POKFRET S'rREET
CARLISLE, PA 17013
UM
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( 8) .-149.895.76
43.549,43
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11.299.61
(151_285...046.72
(111 54,849.04
(12) 295.046.72
(13) 10.000.00
(14) 2~~,04(,J::2:_
K ,06 a -1h! 02,80.
(16) _
K .15 a
(17) _-1LI02.80
Inlerl,1
{;hcck hare if you ora requc5tino 0 'rofund of your ovorpnvmolll.
(I BI
(19)
(201 __ 17 t!Q~-.!_~O
(20A) __
(20B) 17,102.80
-94
,.tv ISI)f It~ 1).1'1
ESTAH OF
Ploaso Print or Typo
fiLE NUMBER
21 - 94 - 443
~'I~I V
"'..\..,.'C\
....~..,..J.I>
CO~"r\ONWfA\Hl Of PfNUSYLVAN!A
INNIIIlANCI lAX IITUIN
~!lIOIN' OlClplNl
J
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
DAVID W. SIIRINER
IAIl p,;p-;;'v IOl~iiy.own-.'~r;~~h;-i~hl ;; Si~~~lIhlp--;-~;tb-;-d~~;.d on Sdlldul. PI-='.
ITEM
NUMBER
1.
2.
3.
4.
5.
6.
7.
8.
, 9.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
DESCRIPTION
1993 Federal Income Tax Refund
Grandfather Clock - Reproduction
Silverware - appraised value
1993 Oldsmobile VIN . IG3CW53L7P4308848 appraised value
Eric Insurance Company policy Q03250661611 premium
refund auto policy
Patriot Newspaper - refund
Mutual Beneficial Association of Rail Transporation Employee ,
Inc. Account 09439. Date-of-Death value
York Federal Savings & Loan Association
Account 100-201418 Titled David W. Shriner & Diora B.
Shriner. Diora B. Shriner was the decedent's wife and
she predeceased him on April 9, 1991. Dats.-of-Death Bal
Meridian - All accounts in the decendent's name alone or
joint with his deceased wife. Diora B. Shriner
predeceased her husband on April 9, 1991
CD4003533850 opened 09-07-93. Datp,-of-Death value
CD4001933961 opened 09-08-92. Date-of-Death value
CD4003609346 opened 01-11-94. Date-nf-Death value
Farmers Trust - in the decedent's name alone
CDI03104 opened 06-08-93. Date-of-Death value
Cash FQund in Safe Deposit Box Inventory
1993 PA Income Tax Refund
Mellon BanK - decedent's name alone
182-107622 checking opened 09-12-75. Date-of-Death balan e
CD19-A49801C opened 09-03-91. Date-of-Death value
Personal Property - public sale
Coins - sold
American Travellers - Refund of unused premium
Sentinel - refund
AARI' - MembHship refund
Masland Associates, Inc.
Real Estate Settlement tax adjustment - County $42.02,
School $768.93
VALUE AT
DATE OF DEATH
$ 1,600.00
250.00
40.00
18,000.00
428.00
67.80
77,090.76
10,010.38
25,014.97
10,045.56
10,501.07
11,032.80
1,002.00
193.00
49,865.83
27,017.50
6,234.25
274.25
277.40
81. 00
15.77
14.31
810.95
_TOTAL (Also onlor on lin! 5. Rocapltulallon $ 249,867.60
IAllach addilionol 91'," )C 11" ,heel5 II mOle 'pate h needed.)
1,.v,UIl".I'UII
ESTATE OF
ITEM
NUMBER
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COMMONWIAI1H 0' "NNmV.NI.
INHflUTANC( 1Ak U1URN
IElIDI"! DIC!DI."!
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
DAVID W. SHRINER
DESCRIPTION
A. Funeral bp,"""
8,
4,
C.
1.
2.
3.
4.
5.
6.
7.
8.
9.
1,
1.
2.
3,
Hoffman - Roth
Cumberland Valley Memorial Gardens
Luncheon - Bethnny Guild
George I s Flowers
,'.
PI.DI. Print or T e'
fFiLDiUMBER
L.21 - 94 - 443
Admln,.lratlve Ca.lI, . Kathy A. Bobb
Pellonal Reprllonlallve Commllllanl
Social S.curlty Number 01 P.rlonal Repr.senlallve, 162 - 48 - 1'575
Year Commllllonl paid
AHorney Fell Irwin, McKnight. & Hughes
Family exempllon
Clolman,l
Addrell 01 Clolmont at decedent'. death
Slree' Addrell__
C~ ~~
Relatlanlhlp _
Zip Code
Probole fell Letters Testamentary
Mllullon.ou. hp.nll"
Register of Wills - Filing Fee
Cumberland Law Journal
The Sentinel
Public sale - expenses - Brickers Auction
Carlisle Coin Shop - appraisal fee
1994 PA & Federal Income Tax Preparation Fcc
Fiduciary Tax Preparution Fee
Kathy Bobb - reimburscd for expenses
Roger B. Irwin - Notary Fee
AMOUNT
$ 5,455.00
550.00
100.00
113.95
17 ,'600.00
17,600.00
340.00
25.00
40.00
65.48
1,050.00
10.00
250.00
250.00
50.00
50.00
TOTAL (.11110 .nl" on IIn. 9, Recapitulation) $
(If m,,. .pact I. n"IIo4, kilt" ,11.:1111'"01 .htth e4 Mmt .111)
43,549.43
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
}
III
KA1'IIY A 1l.01l1l
, SWORN
bDlng duly .__._ __._.__.__u__ according to I.w, dopolOl end saYI that Ah. -lw tho
J.1'J!.l;!!triJL______._ ....._.______.__. of tho Eltete of llAVIJUl.,-SlIIUNI:R
let. of -SOUl'II,MID!lLE1'ON --..... .--... -. -._ -. _I Cumberl.nd County, P." d.culld .nd th.t tho
within II on Inventory mode by .__ ______, the uld
of tho entlr. IIt.te of uld decedent, conllltlng of .11 the perlon.1 prop.rly and rill ..t.h, nc.pt rill alht. oullld.
tho Commonwlllth of Pennlylvanle, and thet the flgurOl oppollte eech 110m of the Inventory r.pronnt 11'1 fair valu.
II of the dot. 0' decodont'l death,
,.... \; \-(,h-.i",", "
19.i~
__i~JJL .iL. (L I ~.
Kathy D~bE..~~nhl,.to'
SWORN
end lublcrlbDd bofore mo,
!53 Ric.!!.!lInd Rond
C_lllUuJ l!.J'UIO 13
Add,o"
Dot. of Duth
II
DIY
.J!.4.
Month
94
v..,
INSTRUCTIONS
I, An Inv.ntory mUlt be filed within threo monthl .lter appolntmont of porlonal "pr.nntatlv., '
2, A lupplemont Invontory mUll bD filed within thirty d'YI of dllcovDry of addltlon.1 011I11.
l. Additlon.llhoo" may be attached Dl to porlon.lly or realty
<t. See Article IV, FiduclarlOl Act of 1949.
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Inventory of the real and personal estate 01
llAVIll W. SIIRINW(
deoeased
1. 1993 Federal Income T.~ Refund
2. Grandfather Clock - Reproduction
3. Silverware - appraised value
4. 1993 Oldsmobile VIN I lG3CW53L7P4308848 appraised value
5. United Statee of America Savings Bond Serios EE L495601076EE
Face vnlue $50.00 iflHuod 12,.1991. Cash Valuo
Erie Insurance Compnny Pl1Ucy Q03250661611 premium refund auto poUcy
Pntrlot NeWHIl/lper - rl'fulld
Mutual Deneficinl Aseocintion of Rail Trnneportation Employees, Inc,
Account 09439, Dnte-of-Denth vnIue
9. York Federnl Savings . I~an Associntion
Account 100-201418 Titled llnvid W. Sbriner nnd Diora D. Shriner,
Diora D, Shriner was the decedent's wife and she predeceased him on
April 9, 1991, Date-of-Death Balilnco
10. Meridian - All nccountH In the decedent's nllme alone or joint with hie
deceaBed wife, D!orn B. Shriner predeceufled her husbnnd on April 9, 1991
Cll4003533850 opened 09-07-93. Dute-of-Denth va]ue
CD4001933961 opened 09-08-92, Date-of-Death value
CD4003609346 opened 01-11-94. Date-of-Death vnlue
11. Real Estate:
131 Emerson Drive
Carlisle, PA 17013 SOLD
South Middleton Township
12. Farmers Trust - in the decedent' n name. alonn
CD103104 opened 06-08-93, lJlltn-of,.Dnath value
13. Cash Found in Safe Deposit Dox Inventory
14. 1993 PA Income Tax Re fund
15. Mellon Bank - decedent's name alone
182-107622 checking opened 09-12-75, Date-of-Death balance
CD19-A49801C opened 09-03-91. Date-of-Death vnlue
Personal Property - public sale
Coins - sold
American Travellers - Refund of unused premium
Sentinel - refund
AARP - Membership refund
Maeland Asaociates, Inc.
Real Estate Settlement tax adjustment - County $42.02, School $768.93
\.
'/:
1,600 0
250 0
40 0
18,000 0
28 16
428 0
67 80
77,090 76
10,010 38
25.014 97
10,045 56
10,501 07
100,000 00
11,032 80
1,002 00
193 00
49,865 83
27,017 50
6,234 25
274 25
277 40
81 00
15 77
14 31
810 95
349.895 '16
/'1- )/1-- (I
fl1!V-lS47 EX AFP (120941*
V' COHHOHW[AlHl Of PUolNSYl"ANIA ACN 101
OEP'RTMENT Of REVENUE NOTICE OF INHE RIT ANtE TAM
8UR"U Of INDIVIDUAl lAKES APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
~miS:~:~~lp, 17118-0601 OF DEDUCTIONS ANU ASSESSHENT OF TAM DATE 02-15-95
ESTATE 0". sfUffRtR -'-w\iffD--~-~ - FILE NO. "IT 9ff"0443
DATE OF DEATH 04-11-94 COUNTY CUMBERLAtm
NOTEI TO INSURE PROPER CREDIT TO YOUR ACtOUNT, SUBHIT THE UPPER PORTION OF THIS FonH WITN YOUR TAM
PAYHENT TO TNE REGISTER OF HILLS, HAKF. CHECK PAYABLE TO "REOISTER OF WILLS, AGENT"
REMIT PAYMENT TO:
'\
V
-=-
IRWIN ~CKNIGHT & HUGHES
60 W POMFRET ST
CARLISLE PA 17013
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
A.ount R..I Hod
-
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ....
R E Ii'- is;'-i" Elf' A j: ii or i if: 94 T - NOi'" i c r -OF 0 i"IiH E if i fANc E" i'" AX' 'A"p pilA"i sEi.fEN'f;' A L l"liwANcE' "(iff -. 0 0 0"""""" 0 0 0 0 0_
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF SHRINER DAVID W FILE NO. 21 94-0443 ACN 101 DATE 02-15-95
TAM RETURN WAS, I X) ACCEPTEU AS FILED
( I CHANGED
RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL
1, Rool E.toto ISohodulo Al
2, Stook. ond Bonds ISohodulo B)
3, Closol~ Hold Stook/Portnorshlp Intorut (Sohldulo CI
4, Hortgogos/Notos Rloolvoblo (Sohodull 01
5, Cosh/Bonk Dlposlts/Hlso, Porsonll Prop.rt~ (Sohodulo EI
6, Jolntl~ Ownod Proplrt~ (SohOdulo Fl
7. 'Trln,flrs (Sohadul. OJ
8, Totol Asslts
III 100,000,00
(21 28,16
(31 ,00
(41 ,00
151 249.867,60
161_ .00
(71 ,00
(8)
349,895.76
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funerll E)(pln.../4dn. COlh/Hilc. Exp.n... (Schedull H) (9).
10, Oobt./Hortglgo Lllbllltlos/Llons (Sohldulo I) 1101
11. Totol DlduoHons
12, Not Voluo of Tox Roturn
13. Chorltoblo/Govorn.ontol Boquosts (Sohodull Jl
14. NIt Vol"o of Estoto Su~joot to Tox
43,549.43
11 .299,61
1111
1121
1131
1141
54.A4Q n4
295,046,72
10,000,00
285,046,72
If an ananmant wall isllued previoullly, line I
reflect figural that include the total of Ahh
ASSESSMENT OF TAX:
15, A.ount of Llno 14 ot Spousol roto (151
16, A.ount of Llno 14 toxoblo ot Llnoll/Clos. A roto (161
17, A.ount of L1no 14 toxobla ot Collltorll/Clau B r.to (17)
18, Prlnolpol T.x OUI
NOTEI
14, 15 and/or 16, 17 and 18 will
raturnll alsaBlIed to date.
,00 M. 00,
285,046,72 M .06,
, 00 K. 15,
1181
,00
17,102,80
.00
17,102.80
TAX CREDITS I
PAYHENT
DATE
11-17-94
RECEIPT
NUHBER
MM913201
DISCOUNT I + I
INTEREST 1-)
,00
AHDUNT PAID
17,102,80
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
17,102.80
,00
,00
.00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
I IF TOTAL DUE IS LESS THAN tl, NO PAYHENT IS REQUIRED,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FDRH FOR INSTRUCTIDNS,I
RESERYATION, Eltlt.. of d.q.d.nt, dYing an or before Dec.~blr 12, 1982 .~ If Iny future Int.rl.t In the I,tlt. I. tran,f.rrld
1 In pa.....Jon or .njoY~lnt to Cla., a (collateral) bt"eflolarl.. of the d.c.d.nt aftlr the eKplratlon of any e.tat. for
Uf. or for year., thl COllllllonwulth hlrlby upre..ty r..,r,," thl right to appral.. and at.... ,tran'f.r Inhlrltancl TaM"
at the lawful Cia.. e (collateral) rate on any 'uch future inter..t.
PI-"lPOSE OF
HOnCEI To fulfill thl roqulre"lnt. of SlcUon 2140 of tho Inhorltaflu, and E.tatl talC Aat. Aat 2Z of 1991. n. P,S.
StcUon 2140.
PAYHEHTI D.tach the tap portlcn of thlt Hotlcl and .uti~1t with your pOYlllnt to thl RIlII.t.r of Will. printed on the r.v.r.. ,ldl,
..Hake check or lIonlY order payable tOI REGISTER OF' HILLS, AGENT
All pay~ent. recelvld .hall first ba applied to any Interl.t which lIIay b. dUI with any re..lnd,r applJed to the taM.
REFUND (CR)1 "r.fund of a talC oredlt. which wo. not requlltld on thl Td)( Ruturn, IIay be requ..tlct by oOlphUng nn "Applloatlon
for Rlfund of P.nn.ylvanla Inheritance and [staU TalC" (REV-1313). Applloatlonl arl availabl. at the Offlo.
of the Rlght.r of Willi, any of the 23 RUVlnuu Dlltrlot OffiCII. or by calling the ,p.olal Z..-hour
an.w.rlng ..rvlce nURbor. 'or 'or.. orderlngl In Plnn.ylvanla 1-8000362-2050, out.ld. PennlYlvanla and
within 100al Harrltburg arDft (717) 181-3094. TOOl (1111 nz-zzsz (Hearing IIPalred Only),
OBJECTIONS I Any Pflrtv in Inter..t not utl.flld with tho opprrll....nt. allClwllnc:o or dllallowancl of d.ductlonl. or a.......nt
of taM <Including dltaount or Intero.t) al .hown on thll Notlcl IIUft ubJeot within .lMh (60) day I of rlr-lipt of
this Hotle. hYI
.'wrlttln pro,..t to thl PA DIPart.ent of R.vlnu., Board of Appeah. DIPt. 281021, tlarrhburg, PA Illla-I021, OR
...1Ictlon to havo thl latter dltor~lnod at audit of thl acoount of thl p.r.onal rlpr"Gntntiv., OR
~'app"'al to tho Orphan.' Court,
AD"I"
ISTRATIVE
CORRECTlOHS.
Factual .rrorl dllcou.rld on thl. a.......nt .hould bo addro..od In writing tal PI. D.part~lnt of Rlvlnu.,
lurtau Q' Individual TalCII. AnN I Po.t A"I"II.nt Rlvllw Unit, Dlpt, 280601. tlarrltburg, PI. 171l8.0601
Phon. (1111 787'6505, S.. pag. 3 of the bookl.t "Inltruction. for Inherltancl Ta~ Rtlturn for a Rllldlnt
Olc.dent.. (REY.1SOl> for,," IlCplnnatlon of adllnhtratJv'h oorrtctllbll errorl,
OISCOUHT,
If nnv taM due I. paid withIn throe (1) callndar lonth. aftor thl doc.dlnt'. dlath, a flv. p.rclnt (5~1 dllcount of
the taM paid II allowld.
IHTEREST,
Intlrut h charg.d b.glnnln" with firflt day (If dlllnqulnoy, or nine (91 1I0nthl and ani (1) day frollth. date of
dllth. to thl dati of pay..nt, taMil which b.catl d.lInqu.nt bofon January I. 1982 bur Interllt lit thl ratl of
.IK (6X) p.rcent p.r annu~ calculatod lit " dailY rate of .000164. All talC" which b.ClI.I dtllnqu.nt on lInd after
Januarv 1 j 1982 will bur Intorllt at a rotl which will "arv fron calondar y.ar to callndar y.ar with that rat.
anncunud by the PA OIPartlllnt of R.v.nu., Th. ftpplloablo Inttrut rat.. for 1982 through 1995 lIrtl
'!!!!: Inter..t R!!! Dally 1nt.rut Factor ~ Intlrut Rllh DailY Int.rllt Factor
19a! 20% .0005..8 1987 9% ,0002_7
1985 16% .000438 1988-1991 11% ,000301
1m 11% ,000301 1992 9% ,0002_7
1981 U% .00U56 1993-1994 7% ,000192
1986 10% ,ooom 1995 9% ,000241
o~ln\tr..t I. caloulatld a. follow'l
INTEREST' BALANCE OF TAX UNPAID X NU"8ER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
..Any Notle. hluld after the tu blec.1I d.lInqu.nt will refllot IIn lnt.rut calculatll'ln to flftlln (15) day,
b.yond the date of thl a.......nt, If paY'lnt I. iliad, a'tor thl Intlr..t co.putatlon date .hown on the
~otlo., additional Int.rut IUlt b. oaleul,t.d,