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OR PItOTOOflAPlI, COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF HEAL T11 VITAL RECORDS LOCAL REGISTRAR'll CERTIFICATION OF DEATH CEAT, NO, 2120974 -~~~'fi:?I.~'{lt/ Narne of Decedent ___'____JO~ -rjL______'____m_'_m,L___,___,_....___.--.-l!:.~!:t_,- rll11 ,1,ddl<l 1.,,'1 Sex __ (-- ___..__Soclal Security No,__~.9J.:...~Ljpi€..!l....___,___,Date of DOAth_L-/'r _eN Date of Birth J -.,N ....3.1...___ Blrthplaco_ _m JJ):<IY~IJ!!_I~~~~~_ _______.______,____ Place of Death ~(ItC-U~ IIO-lp'IAL _~-'i,lJ!:eUIWf) ,,,gf.}1.~,~+.!;f Race _lAJ,"-IITt:' Occupation -1..LQ(x..l,;/ll/4 tiio-?- ____...,_u_,__, Armed Forcos? (Yes or No) ----. Deoedent's .. LJ Marital Statul.!ll C f:Lt;-/.)_ Mailing Address __~lf f!1_?_~.J.!.(:.- _ _ jJb1(.JI/,ID:, ril ../7tW tloHll!).1' f>tlt"l ' CI'~ Of 10l'<n Informant ,GII(t.( S 1; IJ IV h 1 ufI1____...__ Funeral Director ___jJ11 C-1I1l- ~-<... j, .~l!1l.f!;V1 ~. Name and Address of C (If :J .A, ,.. {1 /,I" Funeral Establlshmant ~!IAjl!J..V~ __...!?J..,C&.,(!jJftc ~__ _M-M.J/:,lht1~, rtr ~' -lJ- : Interval Betwaen Part I: Immediate Cause : Onset and Death I (a) __.Q_Q..Q L u!. ( ~~~ 0 fb '" 1J:H(--llkTfji'H:6.. ,,1)./ .l~~13r! -.---.....:..i---.---- , (b) ....___.._,____..___,-: I I , ___.._.._..__.,____4______1 , , I .____1.-- Penflsvlvan!J!. 51,'111 (c) (d) ._ Part II: Other Significant Conditions Manner of Death: Natural III Accident 0 Suicide 0 Descrlhe how Injury occurred: Homicide Pending Investigation Could not be Dotermined o o o Name and Title of Certifier ,.,_fll1L..Jf.fJ1-L( /11001(..( ~_...._,_. _ __ 1l ,\ f" (M,D" 0,0" Coronar, M,E,) Address.. ();, (fl1!f:I.A.JIlY,_U.t../u..,- /)((j-r;'!f.j)_1!!J_s.!2y.1:_6...__,_!i.~7.t2'./-_, '----:__ This Is to certify that the information hero glvon Is correctly copied from an original certificate of death duly flied with me as Local Registrar. The Iginal certlflcato will he forwarded to the State Vital Rocords Office lor permanent filing, ...... _..__ '0AiLl __ ~l!c!JrlfJ.~_/~~._.,,:j'J, t(.jz._ ~ ' ("J ,,, ,(./,;1.,,,,,,,. .rJ- ",,'''''", .:-~.._.?, ..,,:tlfl::!.. /!..-f_L@--:1:.fd.--2f-IfQ-=::,.,./ ;"';iOC""."",:i?!:~l.gqV: c" " ",,,,, /~ ""1"""'1<" '0'''''''' W /2341 R PFA~TZ/SELfpsm/03-12-92 , , LAST WILL AND TESTAMENT OF RUTH T. PFAUTZ I, RUTH T. PFAUTZ, presently of 21 Sample Bridge Road, Meohaniosburg, Cumberland County, Pennsylvania, deolare this to be my Last Will and Testament hereby revoking all Wills and Codioils previously made by me. I have three (3) ohildren, now living, whose names and dates of birth are as follows: REBECCA PFAUTZ SCHWALM Born June 4, 1964 SUZANNE PFAUTZ HAMMAKER Born May 31, 1966 KRISTEN PFAUTZ Born April 15, 1970 All referenoes in this Will to my ohildren inolude only the ohildren named above. ARTICLE I I direot the payment from my estate of the expenses of my last illness and funeral as soon after my death as oonveniently may be done. ARTICLE II I give any vehioles whioh I may own at the time of my death to CHRISTIAN F. WAY if he survives me by thirty (30) days. ARTICLE III I give all of my household furnishings and tangible personal property to CHRISTIAN F. WAY provided he survives me by thirty (30) days. If CHRISTIAN fails to survive me by thirty (30) days, then I give all of my household furnishings and tangible personal property to my children to be divided among them as they are able to agree; if they are unable to agree, then said property and furnishings shall pass with the residue of my estate. ARTICLE IV I give the rest, residue and remainder of my estate to CHRISTIAN F. WAY provided he survives me by thirty (30) days. Should CHRISTIAN F. WAY fail to survive me by thirty (30) days, then I give the rest, residue and remainder of my property as follows: 1. One-fourth (1/4) to my daughter, REBECCA PFAUTZ SCHWALM or if she is not then living, to her issue per stirpes. 2. One-fourth (1/4) to my daughter, SUZANNE PFAUTZ HAMMAKER or if she is not then living, to her issue per stirpes. 3. One-fourth (1/4) to my daughter, KRISTEN PFAUTZ or if she is not then living, to her issue per stirpes. If any of my daughters predecease me and is not survived by any issue, then such daughter's share shall be distributed pro-rata among my surviving daughters. 4. One-fourth (1/4) to be divided as follows: Page 2 of 10 a. One-half (1/2), in equal shares to the following organizations: i. UNITED METHODIST CHILDREN'S HOME, Mechaniosburg, Pennsylvania, to be used for general purposes. ii. TEEN CHALLENGE, IN HONOR OF REVEREND TED WILLIAMS, Rheresburg, Pennsylvania, to be used for the rehabilitation of young adults.. l.i 1. HARRISBURG AREA COMMUNITY COLI.EGE. I direot that these funds be used toward the establishment of a scholarship for. the benefit of music students. b. One-half (1/2), in equal shares to the following individuals: i. CARROLL COOK, 431 Dewalt Drive, Pittsburg, Pennsylvania 15234, if he survives me by thirty (30) days. If CARROLL fails to so survive me, then his share shall pass to his Wife, DORA MAE COOK. ii. HARVEY COOK, R.D. #2, Box 253, Millerstown, Pennsylvania J.7062, if he survives me by thirty (30) days. If HARVEY fails to so survive me, then his share shall pass to his Wife, DOROTHY COOK. iii. DAISY R. SHOPE, R.D. #1, Box 234, Loysville, Pennsylvania 17047. iv. OSCAR RUSSELII COOK, P.O. Box 32477, Oakland, California 94604. Page 3 of 10 v. CHARLES C. COOK, 4200 Bransoomb Road, Laytonville, California 95454, if he survives me by thirty (30) days. If CHARLES fails to so survive me, then his share shall pass to his Wife, SHARON COOK. vi. IRMA MENKE, R.D. #2, Box 71, Dunoannon, Pennsylvania 17020. vii. ELIZABETH MORRISON, 315 High Street, Duncannon, Pennsylvania 17020. If any of the above named individuals fail to survive me, I direct that their share be distributed pro-rata among those named individuals who survive me. ARTICLE V If CHRISTIAN F. WAY and I should die under oiroumstanoe which render the order of our deaths unoertain, it shall be oonolusively presumed that CHRISTIAN F. WAY survived me. ARTICLE VI A. I appoint CHRISTIAN F. WAY as the Executor of this Will. In the event of his death, resignation, renunciation or inability to act in that capacity, then I appoint my daughter, SUZANNE PFAUTZ HAMMAKER as the Exeoutrix of this Will in his place and stead. Page 4 of 10 ARTICLE VII My Executor shall have the following powers in addition to those given by law to be exercised by them in their absolute discretion, which powers shall be applicable to all property held by them, effective without the order of any court and until the actual distribution of all such property: A. To retain any investments at discretion including stock of any corporate fiduciary, or of a holding company controlling it; B. To invest and reinvest at discretion without restriction to so-called Hlegal investments,H with the specific right to invest in common and preferred stocks and in such common trust diversified, money market and mutual funds as they deem appropriate; C. To sell, to grant options for the sale of, or otherwise convert any real or personal property or interest therein, at public or private sale, for such prices, at such time, in such manner and upon such terms as they may think proper, and to execute and deliver good and sufficient conveyances, assignments and transfers thereof without llability of any purchaser to see to the application of the purchase money; D. To borrow money and to secure its repayment by mortgage or real or porsonal property, pledge of investments or otherwise, without liability on the part of the lenders to see to its application; E. To compromise claims by or against my estate; Page 5 of 10 F.. To make distributions in cash or kind, or partly in eaoh; G. To register investments in the name of a nominee or to hold the same unregistered in suoh form that they will pass by delivery; H. To join in any reoapitalizatioll, merger, reorganization or voting trust plan affecting investments, to deposit seourities under agreement, to subscribe for stock and bond privileges, and generally to exeroise all rights of security holders; I. To manage, operate, repair, alter or improve real estate or other property, and to lease real estate and other property upon such terms and for such periods as my Executor deems advisable; J. To deduct administration expenses upon either the federal estate tax return or fiduciary income tax return, with or without adjustment between principal and income, as my Executor shall determine; K. To join with CHRISTIAN F. WAY and file any income tax or gift tax returns that may be due on my behalf and to pay so much of such taxes as my Executor may deem appropriate; L. To retain accountants, custodians, investment advisors and their agents as my Executor shall determine and to compensate such aooountants, custodians, investment advisors and their agents out of prinoipal or income or both as my Executor shall determine; Page 6 of 10 M. To do all other acts and things necessary or appropriate in the management, administration and distribution of my estate; N. To engage in litigation and oompromise, arbitrate or abandon olaims; O. To borrow money from any person including any fiduoiary aoting hereunder, and to mortgage or pledge any real or personal property. ARTICLE VIII No Exeoutor under this will shall be required to give bond or other security for the faithful performance of his duties. ARTICLE IX All estate, inheritance and succeseion taxes, together with any interest and penalties thereon, payable as a result of my death and imposed with respect to any property, whether or not disposed of by this will, shall be paid out of the residue of my estate. ARTICLE X If any provision of this Will or of any oOdioil thereto is held to be inoperative, invalid or illegal, it is my intention that all of the remaining provisions thereof shall continue to be fully operative and effective so far as it is possible and reasonable. Page 7 of 10 , , " ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA I I SS. COUNTY OF DAUPHIN I, RUTH T. PFAUTZ, Testatrix, whose name is signed to the attaohed or foregoing instrument, having been duly qualified aooording to law, do hereby aoknowledge that I signed and exeouted the instrument as my Last WillI that I signed it willingly I and that I signed it as my free and voluntary aot for the purposes therein expressed. ~J ~J ti~ -R T. PFAUTZ ' (/ Sworn or affirmed to and aoknowledged before me, by RUTH T. PFAUTZ,Testatrix, this 12'\ltlay of (Y'\tl..\,ck , 1992. No~'lrial Seal '!1d<Y I.. filz, Nol",y P\b1o HMiw"rg, Dnupt;" G.Ju,11Y My CQfI'''li''''n'II''p'll< r\~" /I, 11104 ijiiiFifji,llu,iiil.iIiJ;r.I~j!\Vi'lil'IW 1I''1~ Page 9 of 10 , !" COMMONWEALTH OF PENNSYLVANIA I COUNTY OF ~"R DAUPIIIN I HI Christian F. Way, Executor of the Estate of Ruth T. Pfautz, ".-, - .,- ---. -.,.,_._- --.--..- - .--~--- .-,.---- belny duly ._lll'I,o.rn. _ ,__ ._. according to low, do poses and soys that he.., ~a..J!:Xecutor_._. . - ,-..- .- ____..____u,_ ___H. __,.__._ .,_. of tho Estato of _~ll!~.!~_~~~t!!.~.J...~!k/~_~ll,!:}:_.!_~~ay late of _,]4. Fox Lane, Newville,_, Cumborland County, Po" deceased and that the within Is on Inyontory modo by.. \1~11l .___m....___, tho uld.__Ij:XQ.g,yj;or .--- of tho entire estate of sold decedent, consisting of 011 the perlonal prop'.rly and real estate, except real estate outside the Commonwealth of Pennsylyania, and that the figures opposite each IIem of the Inyentory repre..nt It's fair value 01 of the dote of decedont's death, Sworn to _ and subscribed before mel .__.. _..' ..' __. __...__40__ __,. _,._._____.. ... --------- Auqust 11 19.JJ_ Eneute, . Mmlnhtro'er Christian F. Way _ J_4.__f(J.L~~1.!l~/_NewviJ.l.~/_J'_~_l 724 L_. ...__,"_,,____ _,~ _h ,___._____~__.,___._.._~__._ Add.." Dote of Death ___. ._- 19th March 1994 ..~_.___~__..____._~_... ,_..~._._.______H__._ Day Month v.., INSTRUCTIONS I, An Inyentory must be flied within three months after appointment of personal representative. 2. A supplement Inyentory must be filed within thirty days of dlscoyery of additional OIsets. ], Additional sheels may be attaohed as to perlonalty or realty 4. See Artlole IV, Fiduciaries Act of 1949, ~ ~ . Eo< :Il EoI P I'<: ~ f- ro i ..... ~ .>: .. '<1' ~ g ..... " ell ro u 0 " "I' ~ w Q 1 "" 0 QJ " j!: . E I ... ...l u- N rl r .. 0 "I' ...l ~ 0 81 rl "- ell W u- P 'H ~ M ~ 0 ~ cr: ,:t, ~ :i: N o Q r... c ~ ~ - III Z z d 0 ffi < ~ Z . ... r... ." c ... .. :Il 0 "l: ~I " .Q ." .... " e 0 1'<:1 ... " j ~ it 0 u "" Inventory of the real and Ilersonal estate of RUTH R. PFAUTZ, a/k/a RUTH T. WAY deoeased -. - .:====-=.::.- 1. Bristol-Myers Squibb Company. 96.8013 shares of common stock. Value at date of death: $54.09 per sharel 2. IDS Tax-Exempt Bond Fund, Inc. 13,816.120 shares. Value at date of death: $3.958 sharesl Dividends accrued to date of death: 3. Merrill Lynoh - IRA rollover account ,aocount .#872-75257: TOTAL: t." ""1 :, ", ", ''-. " . ()() , , \ r.... ,d " " ~, , I:; I " , " V' " , ',l:J I',) ''-:1 , " I J " , , , , ~ ;-:..,\ \.11 ". , " , " , " " ' ," " " 4,695.08 54,684.20 215.35 78,035.83 137,63 .46 ,,:.0 ,;1('\ " ; ('j ~",. ' ' ... ai ~ ... Q * COMMONWeALTH 0' PlNNIYlVANIA OePA_TMINT 0' _eveNue om. 210601 IIA__ISIU_O, 'A 17121-0601 N '5 HAM lLA , IR . AND MIDDL /Y--2./l!'// . INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) NUMBER lIV.l.lOO 11.~ 112..11' PILE NUMBIR c~ ' 19, II IIn. 181. grooler Ihan IIn. 17, .nler Ih. dlffer.nce on IIn. 19, Thl. 1.lh. OVERPAYMENT, m 20. II IIn. 17" groo'" Ihon IIn. 18, .nll, Ih. dlffer.nce on IIn. 20. Thl.I. Ih. TAX DUE, A. enll' Ih. Inllroll on Ih. bolonce duo an IIn. 20A, B, enler Ih. 10101 0' IIn. 20 and 20A on IIn. 208. Thll II Ih. BALANCE DUE. Mo.. ChlCM Payabl. tal Regl.ter of Will., Ag.nt , .\'(;";,;;,;,';!,'."ri,l.l;,'"~.'.IE;SURr;TOfAN,swER.1AW:QUESTION~()Wl~I)~IDE'AND1TO:REClfIClQMA~~ ,nd., pltnalll,. of perjury, I declar. Iho, I naVl uamln.d Ihl, return, Including accompanying schtdul.. and .tollmenll, and 10 Ih. bl.' of my knowl,dg' and bell,f, i. tru., (atrlC! and compl,'" I dldor. Ihal 011 real ."at. has betn r.poned at lru. mark" value. Oeclaratlon of pr.par., olh" than Ih. plnanal r.pr"lnlollvI I. ,0' d on ~II information of which pr,par., nos any knowledge. A Uft N' N t I IN kN ADDIIUS l'?" - "l'\_ 74 Fox Lane, Newville, PA 17241 o H A V AODREU P.O. Box 650, Hershey, PA 17033 ... ~ l'!-.l:j ~~u ::00 u"'... ",al '" <l, ~8 "'Q "'z 00 v.. z o ;:: :3 ::) ... ~ '" z o ;:: ~ ::) .. :l; o u g 2194..0494 INI At COUNTY CODE DEceDENT'S COMPUTe ADDREsS YEAR PFAUTZ, RUTH T., a/k/a NAY, RUTH T. 74 Fox Lane Newville, PA 17241 Coo,,, cumberland o 3, R.malnd.. Rllu,n (for dalll 01 deolh prio, 10 12.13.821 US. F.d..al ElIal. Tax o R.,u," Requlrod _ 8, Talal Numb.. 01 Safe D.pot/180," lAt S /IllY NUM. R o . H . OAT 0' JlMTH 208-2e-6678 119 1. Original R.lurn o 4, L1mll.d ellale 3/19/94 11/24/36 o 2. Suppl.menlal Relurn o 40. FulUr. Inl....1 Comp,amh. Ifa, dale. 0' d.alh 011.. 12.12,821 IXJ 6, DlCed.nl DI.d T.lIall 0 7, DIC.d.nl Malnlaln.d a Living TrUll (A"ach copy 0/ Wi/ll (A"ach copy 01 Trulll 'ALI!C.()R~ISP.o.~DENCE'ANPICONF,lE!~rI(~A~INf,QRtanbt!!Sllq"'!;DjlE(DIREC11D':rO~ NAM; ~C:OMPt!'" MAllINQ AOO~U Susan E. Lederer, Esquire 20 Valley Road, P.O. Box 650 H N MI Hershey, PA 10<H3 533-3280 1. R.al ellal. (Sch.dul. AI I 11 2, Slack. and BondI (Sch.dul. 8) ( 2) 3, Clollly H.ld SlockJParTn...hlp Inllllll (Sch.dule q (31 4, MarTgog.. and NOli. R.,.lvabl. (Sch.dul. 01 ( 41 5, Ca.h, Bank D.pot/" & Mhcellanoau. P...anal Prop.rty( 51 (Schedul. E) 6, Jointly Own.d Prop'rty (Schedul. FJ 7, Tran",,, (Sch.dul. G) (Sch.dul. L) 8, Tolal Grall Au." (Iolalllnll 1.7) 9, Funeral e.p.n..., Admlnlll,oll.. COlli, Mhco/lanoau. ( 91 e.p.nll' (Sch.dul. H) 10, D.bl., Martgago Uablndll, U.n. (Schedul. II (10) _ 11, Tolal Dodudlan. (10101 /lnll 9 & 10) 12, N., Valu. 0' e,'al. pin. 8 mlnu.lln. 11) 13, Charilabl. and Go..mm.nlal 8oquIII' (Schedul. JI 14, N.t Valu. Subll<! 10 Tax (IIn. 12 mlnu. /In. 13) 15, Amount of /In. 14 lax obi. 01 6% '01. (Indud. .alulI from Schedul. K a, Sch.dul. M,I " ' " ,'f' t '''t " . 16. Amount_' IIn. 14 taxabl. oj 1.5%.,..,.' '.,' (Indud. "0 lUll from Schodul. K 0' Sch.dul. M,) 17, Principal lox duo (Add 10. "am IIn. 15 and f,am IIn. 16.1 18, Clldlll Pria, Paym.nl' DII,ounl 59. 59..!L.63 78,035.83 '..1) ( 6) (7) (8) $137,630.46 23,698.70 23,69R.70 (11) (12) ._ (131 (14) 113,931.76 6,835.90 (15) 113,931. 76 )(.06 Q (161 )( ,IS. . (17) 6,835.90 Inlerl" 0.00 + (181 (191 . . Check fiNe If you arc ,cquestin9 n rcfund 0' your overpayment. (201 (20AI (20BI 6,835.90 6,835.90 o.rr dJ-' I L ''7'-/ 9 -/ z.. -'1'-( . . .. . "~lSlIlh(M'1 ISfATI Of RUTH T. ITEM NUMBER A. B. SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES PI.a.. Print or Typ. --rm NUMBER PFAUTZ, a/k/a RUTH T. WAY ~PA 2194-0494 ~:i~ COMMONWeALTH 0' PINNlVlVANIA INHIRITANCI TAX mURN R11IDINT DICIDINT DESCRIPTION AMOUNT 1. 2. Puneral bp.n"ll Michael J. Shalonis Funeral Home. Rice Memorial $14,603.70 2/842.,00 1, Admlnlltratlv. COlt11 Personal Repr..entatlvo CommJlllons Social Socurlty Numbor 01. Person"J Repr..entatlvOl Vear Commissions paid 2, Attorney Fo" James, Smi th & Durkin 4,000.00 3, family Exemption Claimant Christian F. W~ RelatlDnshlp ..1IU!'lh..nn Addroll of Clalm,"nl at docodontls doath Stroot Address 74 Fox Lane City Newville 2,000.00 Stato PA Zip Code 17? II' 4, Probate fo" Register of Wills 238.'00 C. Mlle.llan,oul bplnl'" 1. Register of Wills - fil~ Pennsylvania Inheritance Tax Return 15.00 2, 3, 4, 5, 6, 7, 8, . TOTAL IAlso enter on line 9, Recapitulation) S 23 / 698 . 70 (If mort Ipaee II n"d.d, Inl.rt additional Ih".. of lam. III'.) .., ..",,,''''-'''-- ,,~f 1'.,'1"'" " / ~'I <J. 'II. - .:'.> ~ I Lj. .) I '1 - /1 ~ 101 oV REV01S47 EX AFP (08094* CDHHOHWEAllH Of PEHNSVlVANIA DEPARIHEN' OF REVENUE IUREAU Of INDIVIDUAl lAMES DEPI. lI06D1 IlARRISIUflDI PA 17121-0601 ESTATE OF PFAUrz--= T FILE NO. DATE OF DEATH 03'19'94 COUNTY NOTE I TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHIT THE UPPER PORTION OF THIS FORH WITH YOUR TAX PAYHENT TO THE REGISTER OF WILLS, HAKE CHECK PAYABLE TO "REOISTER OF WILLS, AOENT" REMIT PAYMENT TOI NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ACN DATE SUSAN E LEDERER C/O JAMES ET AL 20 VALLEY RD HERSHEY PA 17033 REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 E:unt R!!!lttod CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ il 'EV: ili4'7' EX'AF p"'i 0'8":94 T "iloi'" i OR' 'OF' i"N'HEiii TAiicE' TAX "APPRA"isEifiilr;' Ai:. rciWANCE' iili' ..--. OM.......... DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX RUTH T FILE NO. 21 94"0494 ACN 101 DATE TAX RETUR'l WAS, I ) ACCEPTED AS FILED I Xl CHANGED SEE ATTACHED ESTATE OF PFAUTZ 12'26-94 NOTICE RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE APPRAISED VALUE OF RETURN BASED ONI ORIGINAL I, Rod E.toto ISchod\Jh A) 11) 2, Stock. ond Bond. (Schodule B) (2) 3, Clo.oly Hold Stock/Portnor.hlp Intorl.t ISchldul1 C) IS) 4, Hortglgo./Notl. Rocolvlbll (Schodull Dl (4) 5, CI.h/Dlnk DopocltI/Hl.c, Por.onol Prcp.rty (Schldulo E) 15) 6, Jointly Ownod Proporty ISchodulo F) (6) 7, Trln.flr. (Schodulo 01 (7) 8, Total A..oto ,00 59.5~4,63 ,00 ,00 ,00 ,00 ,00 (8) 59,594,63 APPROVED DEDUCTIONS AND EXEMPTIONS I 23,698,70 9, Funorll EHpon.I./Ado, Co.t./H1.c, Expon.o. (Schodulo H) (9) 10, Dobt./Hortgogo Llobllltll./L1In. (Schldulo I) (10) ,00 11, Totll DoducUon. Ill) 12, Not VIluo .1 Tox Rlturn (12) 13, Chlrltlblo/Oovornoontll Blquo.t. ISchldulo J) (13) 14. Nit Vlluo of Eltoto Subjlct to TIX (14) NOTEI If an a.....m.nt waD i..ued previou.ly, lin.. 14, 15 and/or 1&, 17 and 18 will reflect figure. that include the total of ab1 return. a.....ed to date. ASSESSMENT OF TAXI IS, Aoount 01 Llnl 14 ot SPDUDIl roto liS) 16, Aoount 01 Llno 14 toxlbll It Llnoll/C11.. A roto (16) 17, Aoount 01 Uno 14 toxlbll It Collotorll/Clo.. Brito (17) 18, Principal Tox Duo TAX CREDITS I PAYHENT DATE 09-19-94 ,~.;;q8 70 35,895,93 ,00 35,895,93 ,00 X ,00. 35,895,93 x, 06. ,OOX,15. 118) ,00 2,153,75 ,00 2,153,75 RECEIPT NUHIER MM91i!960 DISCOUNT INTEREST I') I,) ,00 AMOUNT PAID 6,835,90 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST TOTAL DUE 6,835,90 4,682,15CR ,00 4,682,15CR . IF PAID AFTER DATE INDICATED I SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST, IF TOTAL DUE IS LESS THAN '1. NO PAYHENT IS REQUIRED, IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU HAY IE DUE A REFUND, SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS,) ,'~ " '" Ii " ',I " At!IERYATI!fI' Eltatll of dfctdenh dYlntl on or b,'or. D.o.ltber 12, 19112 -- If any future Int.rllt In the IIh'e h 'nnlf.rred In po.....lon or enJoy..nt to Cia.. B (colht.ral) b.n.fJchrlllof the d.o.dlnt .ft.r the ')lplrltlon of any 'Itate for llf. cr for Yllrl, the COHunw.l1th hlrlby ')lprll.ly r...rVII thl right to IPpr.'.. Ind ......'rtn.f.r tnherUilnc. TIK" at thl lawful CII.. B (coU.tlr.l> rltl onatty 'uoh future Interut, fl\JlIf>OSE OF NOTICE. To fulfUI the requlre'lnb of S.ctt,," 2140 of thl Inhlritanc. end Ethtl TI)I Act, Aot 22 of 1991. 72 P.S, S.oUon 2140. Detlch thl top portton of thlt Nottcl and tubalt with your PIY'lnt to the Righter 0' WUh printed on the rlvlr" tida. -'H.k. ,h.ok 0' ..".. o,de, p...bl. to, REGISTER OF NILLS, AGENT Ul peyaentl rac.IVld Ihell flrlt b. IPPU.d to .ny Inter..t which .ay b, due with any r"IInd.r applied to thl till', A re'und 0' a taK cr.dlt, whlch WI' not rlqullted on the Te)( Return, eay b. raqualted by c;olplttlng In "Application for Rlfund of PlMlylY.nla Inh.rltance and Eltata Tal(" tREY-UU). AppllcIUonl ar. aVllhbla at the Offlc. of 'h. R.glater of Willi, any 0' the 2S Rlv,nu. Dlstrlot OffiCII, or by call1na thl .p.ela. 24-llour ,"Iw.rlna IIrulc. RUIIb.rl for ''''ral ord.rlngl In PIM'Ylvanl, 1-800-562-2050, ouhldl P.nnlylyltll, end within 100"1 Hlrrl.burg ~r,. (717) 787-8094, TOO. (717) 772-2252 (H.arlng IIp.lr.d Only), PAYHEHT. REFUHO (CR). OIJECTlOHI. Any party In Intlrllt not IItlsfhd with thl apprats..,nt, allow.nc. or dlsallowlno, of dlduClUon., or ......""t of hK <lnoludlng dhcount or Interllu II thown on thlt Nottcl .u.t obj.ot within .bb (60) day. 0' reollpt of thh Notlcl bYI " '[ i \ ADHIN IITRATlYE CORRECTIONS. Feotull errort dhcoYlrad on this a.......nt Ihould bl addrauld In wrlttng tOI PA Dlpart..nt of RIV"",t, Bur.lij of tndlYlduil TaM.I, ATTNI Pn.t A....s..nt Rlyl... Unit, DEPT. 280601, Harrl.burg, PA 17121-0601 Phon. (717) 187-6505. $e. pig. 5 of thl bookllt "Inltruotlonll for Inh.rltanotl Ta)l Rlturn 'or a R..ldlnt Dfll'dlnt" (REY-1500 for In explanltton ef IdIIlnlltreUvl1v correatlbl. ~rror'.. If 8fty tll( CfUI Is p,ld within thr.. (5) cIl.ndlr tenth. Ifter the dtctdlnt'. dllth, a flvl perunt (5:0 dhoount of thl tlX plld It Illowed. --wrlUIn protnt to the PA DIP,rt..nt of R.y.nuI, Board of APPII1t, DEPT, Z81021, Harrisburg, PA 17128-1021, OR -".lIotlon te hay. the .ettlr dlter'ln.d It eudlt of thl account of the p.raon.l raprn.ntIUv" OR --IPPIII to the Orphan.' Court. OISClllMT. INTIAt!IT. Int..rllt It charg.d b.glnnlng with flr.t day of d.Unquenoy, or nine (9) aonth. and one (1) dlY frOll the dlt. of dllth, to thl dati of pIyeant. TI)l1I which bla... cltllnqu.nt blfore Janulr)l 1, 1982 bltr Intarnt at tl\e rah of the <6X) p.rclnt pllr IMUII calculat.d at I dally rlt. of .00016~. AU tal(lI which b.e... d_Unquent on end If tar January 1, 1982 wUI bur Interut It I rat. which wUl yary 'rOl Clll.ndar Yllr to ul'nder y..r with thlt rat. .nnounotd by thl PA D'Plrt.,nt 0' R.Ylnu.. Th. apPUCable Intlr..t rete. 'or 1982 through 1995 lrel !!!! Interllt R,t. Dally Int.rllt Factor !!!r Interllt Rita DIUy Inte"u Factor 1912 lOX , 000541 1917 9X ,000147 1915 16X ,0004ll 1911-1991 llX ,000301 1914 lIX ,OOOSOl 1991 9X ,000147 1915 IlX .000356 1991-1994 n ,000191 19" lOX ,OOOlT6 1995 9X ,000147 --Int.rllt 1. ollculltld .. follow'l INTEREST a BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR ._~y Notlc. I..ued Ifhr thl tll( blcOltl. d.lInquent will r.U.ot an Int.rllt c.loul.Uon to flftHr'l Us) dlV' beyond thl d"1 of the ........nt. If p.y..nt II lid. Iftar the Interllt coap~t,UO" dlt. .howI on thl Notice, addltlONI Int.r..t MIlt b, c.lculltad. PAVII!NT, . DetlOh thl top portion of thl. H~tlc. ana .~Jt wIth your p~\,'nt ,Ide p.~lbl. printed on thl r.v.r.. .Ide. ~R t51 :0 :T)m (',I CJ " :u I) (.,' , ......,\ P , ?; \ ]" ~o ',- " I ~ ), r, q , ,- , , I' ,-" ) a~ r:~ (>.' l.I (;:1 VI () , :Ot " -. )>;i 0 O? t. thl n"l and add..... -- If RESIDENT DECEDENT .Ill<. ch.ck cr .cnlY crdtr .tY.blt t., REGISTER OF WILLS, AGENT, -- If NON-RESIDENT DECEDENT ..k. ch.ck cr .cnty crd.r .tY.bh t., COHHONWEAL TH OF PENNSYLVANIA, All paY',nt, recllvld .~al1 b. appll.d first to eny Int.r..t which "Y b, dut with any rt..lnd.r IPpll.d to the tlM. REFUND (eR)l . r.fund of a taM or,dlt, which wa. not rQqualt.d on thl Tlx Rtturn, "IY bt r.quI.tld by co.pl.tlng In "ApplloaUon for R.fund of Ptnnlylvanhi Inh.rltancl and Elht. TllIC" (REY.U13l. AppUcaUon. 8'" av'Uabll at the OffiCI of thl R.ot.t., of Willi, any of thl 25 R,v.nuI OtttrJat Offlc.. or 'ro~ thl O.part..nt'. 24-hour Intwerlng ..rvlel nu.b.r. for for.. ord.rlngl In PennlYlvanle 1-800-162-2050, out.ld, Ptnn.Ylvanll and ..Uhln loc.l Harrhburg arll (717) 787-8094t, TOOt (17) 172-2252 CtIurlng hlplired onh), REPLY TO. Qu..tlon. r.gardlng .rror. oont.lntd on this not Ie. .hould bt addr....d tOI PA D.pert..nt of R.venu., Bur.au of Indl",ldul1 TlICII, "TTNI po.t ".......nt R.",I... Unit, D.pt, 280601, Harrhburll, PA 17128.0601, phon. (7171 787-6505. DISCO:JNT, If ,nv talC due I. Plld within thrl' (1) cal.ndtr .onths .ft.r thl dlCldlnt's dlath, I flvl plrclnt (5X) dllcount of the tllC paid il Illowed, INTEREST, Jnt.r.st II charg.d blglnning with first day of dellnqulncy, or nine (9) 'onth. and one (1) day fro. the dati of dtlth, to the dati of peY'lnt, 1IICII which blee.. d.lInqu.nt btfcrl January 1, 1982 bltr Intlr..t at the r.t. of Ilx (6X) p.rotnt ptr a~nu. c.leulattd at a dally rlt. of ,OD016~, All talC" whJch blce.e dellnqu.nt on and .ft.r January 1, 1982 will bur lnt,,"t at a rah which will vary fro. caltnder Yllr to ealtMLfar Yllr with th.t rate announOld by the PA DIPart.ent of Rlvlnut. Thl appllcabl. Int.r..t ret.~ for 1982 through 1995 ar'l V..r Jnt.rllt R.te OIJly Jnt.r..t factor V..r Int.r..t Ret. D.lIy Jnt.r"t fac ~or 1982 2D~ ,000548 1987 9~ .000247 19U 16~ .000458 1968-1991 m ,000301 19" 11% .000301 1992 9~ ,000247 19U U~ ,000356 1995-1994 n ,000192 1916 10~ ,000274 1995 9~ ,000247 --tnt.rllt I. caloul.tld a. followlI INTEREST . BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR .-Any Hotlc. i..u.d aftlr the tllC bleo... delinquent will r.flact an Int.r..t a.loul.tlon to fJft,.n (1&) diY' ~.yond the date of thl ........nt, If pay..nt i. -.d. aft'r thl lnt.r..t cOIPutatlon dlt. .hown on thl Notlcl, additlon.1 lnt.r..t lU.t b. a.lcullttd, _,,'... ,_'" ,.l,~"_,, '- 'I'; I', ,....,..........,..jJo' l~iJ ';, """M." \; \, \! I, " /; , " '. " , " " " I' \, " " ; ,; " " " 1,1, " \, .. .' " , \ , " .", , " " " , I' " I,' If, ,\ 'I " , , ~::-- A.~Wi ~, S[~ 1\'M . .:-- : . . 1.2,1:: : . . . us. POSTAGE : ,1-'" ," ", I '. ",' h ,", j,'i,l.; 0;' , " :.'111'; ;' " :,i' /1) " , 'r.' , ,,', 1.1 , R&lff.l(R 5 \8l 000 '~ CI."i'f ,Cum" "., FIRST CLASS MAIL "I , , LAW OPPlcn JAMrts, SMITH &. DURKIN '10 vALLny ROAD p, 0, BOX un IfSRSHBY, PSN~SYLVANIA 17033:0650 " " Of:fice of the Re'lister of l"ills Cur'berlanc1, County Courthouse Cne Courthouse SOllare Carlisle, :'.1 17613 '." , " " , , " " " ';' ~'."." ,. " '. "... ~.. y'I,'1 ' .. j, , " ;, " t< 1.1 , ., "".'," I I' " \' 1" ., " f '*;JI, ", ',l 1 j'-" ,,' ," " ,/ " "t' 1 ..I....~-":".__... \1""~-'r'~'" i rt-t'l"':.,.\.t'..;'t.,,,?"'''' " ".. 'I" f. ,