HomeMy WebLinkAbout94-00541
Sodll/,\I','ul'i/.l'No.
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180-09-0299
\TE !lud (;J(ANT OF LETTEI(S
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m Upper Allen Township, Cumberland County, Pennsylvania.
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COllNTY OF CUMIlERI,AND r H,
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COMMONweAUIl O'F PENNSYLVANIA' DEPARTMENT OF HE!At.Ttt , VITAL flECOflDS
CERTIFICATE OF DEATH
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPUCATE
WITH REGISTER OF WILLS)
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COMMONWlAllH 01 PINNIYlVANIA
OIPAUMINT or nlv'Nul
om 21060
HAUIIIUR,9, PA 11121,0601
o CIO NI" HAM! IlA$1, 'IUT. AND MIOOL!INIII....LI
OTSTOT. ARTHUR L.
SOCIAL HCURI1Y NUMIU
180-09-0299
OAlf or DeATH
6/7m
ii' ,"'"'Cdll! "llVI'I1NO S1OlJU~ ,o.MlllAlI. filII "H' MIOOIIINIIIA,ll
POUATUOPDIATHAnUI2"1191 CHICX~":i
IP A Il'CIUIAL,
POVI." CIIDIY II CLAIMID 0 ' ,
PILI HUMII.
21
COUNTY CODE
9/1
05~1
NUMBER
YEAR
DAn or IIUti
~/15/12
OICIOINT'S COM'lrT! ADOl.SS
19~3 South York street
Mechanicaburg. PA 17055
Cumberland
AMOUNt IUCllVfD IS!! INSTRUCTIONSl
eo"
[J; I. Original Rlturn
o 2, Suppllmlntal Rllurn
o 40. Future Inler..f Compromll'
(lor dalll of dlalh alter 12,12.921
[!J 6, OlCldlnl Dlld TIlIall 0 7, DlCldlnt Malnlalned a living 'rult
(Allach copy 01 Will) IAllach copy of TrullI
ALL CORRESPONDENCE AND CONfiDENTIAL TAX INfORMAT1ON,5H01ILlT.BI:mRECTED~lPl ,;. ';:2-;.;'..:
N.....' Richard C. Snelbal<er. Esq. COM"'" MArLlNO .DORlll
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2, Stocll and Rand'ISchldull BI
3, Clollly Hlld SlockJPaNnl"hip InlorllllSchldul1 q
4, Mortgagll and NOIII Recllvabl. ISch.dull 01
5, Co.h, Bank Dlpoli" & MllClllanl<lUl Po"onal ProplNy
ISchldul1 EI
6, Jolnlly Ownld Prop. Ny ISchldul1 f)
7, Tran.l... ,Schldull GI ISchldul1 Lj
9, TOlal Grall Alii" (Iotalllnll 1,7)
Q, Fun.ral Exp.nlt., Administrative COlli, Mllcellaneous
e.pen... (Schldull HI
10, Dlbl., Mortgagl l'ablllllll, L1ln. (Schldull I)
11. Tolal Olduc1ianl Ilalalllnll 9 & 10}
12, Nil Valul a' ElIall Illnl 8 mlnul lint 11)
13, Charitnbll and Governmlnlal B.qUlII.ISchldull JI
lA. Nor Valul Subflc1 to To. (lInl 12 mlnu. llnl 13)
15, Spoulal Tron.fl" (/or dolll 01 dlalh ok.. 6.30.941
S.. Instruction I 'or Applicable Pernnlage on Reverlll
Sldl, Ilncludl va lUll from Sch.dull K or Schldull M,)
16, Amounl of lInl 14 la.abll 01 6% ratl
I'ncludl valulI 'rom Sch.dull K or Schldule M,}
17, Amounl of llnl 14 la.abll at 15% roll
(Includl valulI Iram Schldull K or Schldull M,I
19. Principal 10. dUI (Add 10. frem Llnll 15, 16 and 17,)
19. Credll. Spou.al Povlrty Credit Prior Paymlnl.
+ 15.000.00
o 3, Rlmalndor Rllurn
lfa, dolll 01 dlOlh prior to 120\ 3,921
o 5, Flderal E.tal. To. Rllurn Rlquired
!L 9, Talal Number of Safl Dopa.11 Bo...
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171
~~ West Main Street
Mechanicsburg. PA 17055
56.U7.06
15.000.00
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17.131.66
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15.750.00
Int.,. II
20, Illinl 19 II greallr Ihan llnl 19, Inllr Ihl dlfflrence on lInl 20, Tlrh II Ihl OVERPAYMENT,
110
Chc(~ lu~'e I you ore requesting (1 refund of you, OYNpavmconf.
1.381.66
1211
121AI
121BI
1. 361. 6L-
21. lllinl 19 h g..allr Ihan llnl 19, oolor ,h. difference on lInl 21. Thi. II Ihl TAX DUE.
A. En'er In. Int"III on lne balonce due on line 21 A.
B, Enler thl 10101 of line 21 ond 21A on llnl 21B, Thi. II Ihl BALANCE DUE.
Make ChICk Pavabll 101 Rlgl.'er 01 Willi, Aglnl
~. BE SURE TO ANSWER ALL QUESTIONS ON R!VER5E SIDE AND TO RICHECK MATH -or( 0(
Under penaltle. of perjury, I declare fhol I nove uC1mlnld tnls relurn, including accompanying Ichedull' and lIallm.nh, and 10 Ih. bell 01 my knowl.dge and belief,
if j, Irue, corretl and complelD. I declare Ihat all real ellole has been repatlea ollrul matkel valu.. O.:lorollon 01 preparer other Ihan lh~ p.rlonal r.prellnlaliv. i,
baled on alllnfotmallon of which preparer hal any knowledge.
S A1ITWlii" mlON ',""ON"'" 10! '~LlNO ""U'N .oOR'" 923 F.mily Drive o;,H~/.,/ '
II!. y' I'" I I /1. yr'
"", /_ \ 'Ir", ' '" M~hanicsburg. P^ 170~~ ' ,,' 7 J
SIONAIV~"" ," Il "'" N'-'IV' ADD"" 4~ West Main Stroet OAI! ,1 /
:;NI'.JJB N AN P.C. 'W.' or.
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COMMONWEAlTH m PfNNSVlVANIA
INHeRITANCf TAX RETUAN
R!SIDINI DIC/DINI
ISTATI'OF
OTSTOT, ARTIIUR L.
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SCHEDULE B
STOCKS AND BONDS
FILE NUMBER
21-94-0541
(All prap.rty lalntly.awned with RighI of Su,vlva"hlp mU8t be dllCla8fd an Schedul. F,I
ITEM
NUMBER DESCRIPTION
1. 15 United states of America, Series II Bonda, $1,000.00 Face
Value, redeemed 11/9/94, Account #14094311042
VALUE AT DATE
OF DEATH
$15,000.00
$1,000.00 Issued 6/1/79 #Ml778727811
1,000.00 Issued 6/1/79 IM1778727911
1,000.00 Issued 6/1/79 IMl778728011
1,000.00 Issued 6/1/79 IM1778728l11
1,000.00 Issued 6/1/79 IMl778728211
1,000.00 Issued 6/1/79 #M1778728311
1,000.00 Issued 6/1/79 #Ml778726411
1,000.00 Issued 6/1/79 #Ml776726511
1,000.00 Issued 6/1/79 IMl778726611
1,000.00 Issued 6/1/79 IM1778726711
1,000.00 Issued 6/1/79 IM1778726811
1,000.00 Issued 6/1/79 IMl778726911
1,000.00 Issued 6/1/79 #Ml778729011
1,000.00 Issued 6/1/79 IM1778729l11
1,000.00 Issued 6/1/79 IM1778729211
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TOTAL IAI~ .nt.r on IIn. 2, R.CDpltuIDllor!L..~..:.....__l.....~!..~~...'.~~ "
(If more spaeo il noeded, inIO,' ndcJllional,h(lols of lame size.)
SCHEDULE J
BENEFICIARIES
OTSTOT, ARTHUR L.
21-9~-o5~1
8 Kenneth Smith, Jr., 16~0 Williams Grove Road Nephew 2.5~ of residue per
Mechanicaburg, PA 17055 Item Ninth(fl of will
9 Paul Molasky & Bonnie Molasky, 101 Cabin Hollow None 2.5~ of residue per
Dillsburg, PA 17019 Item Ninth(fl of will
10 Emmy Lou Taylor, 310 Courtland Avenue Niece 2.5~ of residue per
Shiremanatown, PA 17011 Item Ninth(f) of will
11 Dorothy Martin, 327 W. Lisburn Road None 2.5~ of residue per
Mechanicaburg, PA 17055 Item Ninth(fl of will
12 Mary D'Amico, 122 Kim Acres Drive None 2.5~ of residue per
Mechanicaburg, PA 17055 Item Ninth(f) of will
13 Tad smith, 1640 Williams Grove Road Grand-Nephew Painting per Item
Mechanicaburg, PA 17055 Second of will
14 Donald Haines and Shirley Haines, 923 EmUy Dr. None painting, .32 Calibre
Mechanicaburg, PA 17055 Revolver, Sbasta Pine
China, per Item Third
of will
15. Donald Haines, 923 Emily Drive, None Boat with Trailer,
Mechanicaburg, PA 17055 and motor, per Item
Eighth of will
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LAW OFrlOtl
NELBAKER Q; E:l.ICIo:ER
Eisenhour plate, my Two Dollar bill stamped at Washington" D.C.
on July 4, 1976, and my Chain Reference Bible unto CATHERINE
OTSTOT, absOlutely.
EIGHTH. I give and bequeath my boat, boat motor and boat
trailer unto DONAL.n HAINES, absolutely.
NINTH. I order and direct that all the rest, residue and
remaInder of my Estate, real, personal and mixed, whatsoever arid
wheresoever situat~d, be converted into cash as soon as
practicable after my death, and the fund so created shall be
distributed and disposed of in the following manner:
A. I give and bequeath ten per centum (10%) of
my said residuary estate unto ROBERT OTSTOT (SR.),
absolutely, if he survives me.
B. I give and bequeath ten per centum (10%) of
my said residuary estate unto HELEN SMITH, absolutely.
C. I give and bequeath twenty per centum (20%)
of my said residuary estate unto SHEPHERDSTOWN UNITED
METHODIST CHURCH, absolutely.
D. I give and bequeath thirty per centum (30%)
of my said residuary estate unto CATHERINE OTSTOT,
absol u tely.
E. r give and bequeath ten per centum (10%) of
my said residuary estate unto KENNETH E. M~ERS,
absol u tely.
F. I order and direct that the balance of my
said residuary estate shall be divided into nine (9)
equal parts, and I give and bequeath one such equal
part unto the persons named in each of the fOllowing
-2-
f.
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LAW o"ICU
BNE!..OAI<ER a ELICKER
nine aUb-parag raphs I
(1 I HERBERT OTSTOTI
(2 I DONALD OTS/rOT I
(3 I EDWARD OTSTOTI
(4 I GLADYS OTSTOTI
(5 I KENNE/rH SMI TH, JR.,
(6 I PAUL MOLASKY and BONNIE MOLASKY,
or the survivor of them in the event
that either should predecease mel
(7 I EMMY LOU TAYLOR,
(8 I DOROTHY MARTINI and
(9 I MARY 0 I AMICO.
If there ia a lapse in the bequests in Paragraphs A, B, D and E
above because of the deaths of the beneficiaries, I order and
direct that the subject matter of such lapsed bequests shall be
added to and distributed in accordance with Paragraph F. If
there is a lapse in the bequests under Paragraph F above because
of the deaths of the beneficiaries, I order and direct that the
balance to be distributed under said paragraph F shall be
distributed among those persons who in fact survive me.
L~. I nominate, constitute and appoint DONAI,D HAINES
and SHIRLEY HAINES (or either of them who may qualify) to be the
Executors of this, my Last Will and Testament, each and both to
serve without bond or other security as a condition of
qualification hereunder.
IN WITNESS WHEREOF, I, ARTHUR L. 0TSTOT, have hereunto set
my hand and seal to this, my Last Will and Testament which
-3-
t.
~~~::~~m r~F O~,:~~~~VIVAHU NOTICE OF INHERITANCE TAX ACN 101
BUREAU OF INDIVIDUAl TAKES . APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OEPT. Z80601 . A AU 07 31 95
HARRlS!URO, PA 17118'0601 ' OF DEDUCTIONS AND SSESSHENT OF T " DATE --
Eifi\TCOF DTSTDT ARTH L 'FILE'NO. - 21 94-offi
DATE OF DEATH 06-07-94 COUNTY CUMBERLAND
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 "REGISTER OF WILLS, AGENT"
REMIT PAVMENT TOI
RICHARD C SNELBAKER ESQ
44 W MAIN ST
MECHANICSBURG PA 17055
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
c
j
A.ount Ro.ittod
CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ....
R"E"IT: is''-; - EX -11 j:p - i i z-: 94 r NoYfe r -oF-YNH ER-f;: AifcE - YA X - Xi> PR'A"i SEM ENT~. -11 Lrci'wAN-c E. oR. -.... - OM........
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ARTHUR L FILE NO. 21 94-05111 ACN 101
If an assessment was iSSUBd previously, lines 14, 15 and/or 16, 17 and 18 will
reflect figures that include the total of ahh returns assessed to date.
ASSESSMENT OF TAXI
15, A.ount of Lin. 14 .t Spou..l roto 115)
16, A.ount of Lin. 14 t..obl. .t Lino.l/Cl... A r.t. 116)
17. Alount of Lin. 14 t...bl. .t Coll.t.r.l/Cl... B r.t. 117)
18. Prinoip.l T.. Ou.
TAX CREDITS:
PAYHENT
OATE
09-06-94
03-27-95
ESTATE OF OJSTOT
TAX RETURN WAS, ( ) ACCEPTEO AS FILEO
RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL REJURN
1. R..I Eltot. ISch.dul. A) III
2, Stock. .nd Bond. ISch.dulo BI 12)
3. Clo..ly Hold Stock/P.rtnorlhip Int.r..t (Sch.dul. C) 13)
4. Hortg.gOl/Noto. R.coiv.blo (Sch.d"l. 0) 14)
5, C..h/B.nk O.po.it./Hlle, P.rlonol Prop.rty ISch.dulo E) (51
6, Jointly O.n.d Prop.rty ISoh.dulo FI (6)
7, Tr.nsfor. (Schodul. G) 17)
8. Totol A...t.
APPROVED DEDUCTIONS AND EXEMPTIONS;
9. FunarI! Explm.../Adn. COiltl/Hlsc. Explns.. (Schedula H) (9)
10. Doblo/Hortg.g. Ll.billtlOl/Ll.n. (Schodul. II 1101
11, Tot.l D.duotion.
12, Not V.lu. of T.. Roturn
13, Ch.rit.bl./Govorn.ont.l B.quo.t. ISch.dulo JI
14. N.t V.l"o of E.toto Subj.ct to T..
NOTE;
RECEIPT
NUHBER
MM912906
AA022969
DISCOUNT 1+)
INTEREST 1-)
789,47
25,87-
( X) CHANOED
DATE 07-31-95
ATTACHED NOTICE
SEE
56,417,08
15,000,00
,00
_...!!..!L
92 ,901. 68
,00
,00
18)
164,318,76
21, 554,74
.00
(UI
1121
(13)
(14)
?1 .554.74
142,764,02
2,588,80
140,175,22
,00 X ,00,
,00 X ,06,
140,175,22 X ,15,
1181
,00
,00
21, 026,28
21, 026,28
AHOUNT PAID
15,000,00
1,381,68
INTEREST IS CHARGED FROM 03-28-95 TO 08-08-95
AT THE RATES APPLICABLE AS OUJLINEO ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
17,145,28
3,881.00
128,45
4,009,45
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST,
( If TOTAL DUE IS LESS THAN II, NO PAYHENT IS REQUIRED,
If TOTAL DUE IS REFLF.CTED AS A "CREDIT" (CRI, YOU HAY BE DUE
A REFUNO, SEE REVERSE SIDE Of THIS FDRH FOR INSTRUCTIONS,)
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'.<I(i, 11, 00
C1:
RESERVATION.
Eltet.. of dlCldlnt. dYing on or beforl O.c..b.r 12, 1982 .. If any future lnt.r..t In the .'tltl I, trftnlf'rr,d
In Po.....lon or enjoy..nt to Cia.. a (col1at.ral) bln,flclar.,. of the dlc.dlnt .ftir thl IKplratJon ~, IOY ..tat. for
11'. or for Ylar., the CO..ORw..lth hlreby IHpr...lv r...rv.. thl rtoht to Ippral.. Bnd n..... tranl'.r Inh.rltln~. 11~'1
at thl hwful Chu a (collet,rlll> rtlt, on any ,uch future Intlr..t.
PURPOSE OF
NOT/CE.
To fulfill tht r.qulrl..ntl of Station 2140 of thl Inherltanc. and E.tat. Tal( Act, Act 22 0' 1991. 72 P.S,
SteUon 2140.
PAYHENT I
Dttach tht top portion of this Notlc. and luh,1t with your pay.,nt to thl Rlght,r of Willi prlnt'd on thl rlv.r.. ,Idt.
"Hakt chtck or lonty ordtr payabl. tol REGISTER Of' HILLS, ADENT
All pay.tnt. rtc.Jv.d .hall flr.t b. epplled to any Jnter..t which May bll due with any rl.llndlr applJld to thl tax.
REFUND (CRI,
A rlfund of a tlx orldlt, which wa. not rlqu..t.d on the TaM R.turn, lay b. r.qul.tld by co~lltlng an "ApplJcltlon
for R.fund of P.nnlYlvllnla Inh.rltancl and E.htl Tax" (REV-UU), ApplleatJon. are aVIUablt at th.Offlo.
of the R.gI.t.r of Will., knv of the lS Rev.nUI DI.trJot Offlc.., or by calling the .p.clal 24~hour
an.",.rlng urvlcl nu.b.r. fo" for.. crd.rlngl In Ptm.vlvlnla 14800-362.2050, ouhld. Plnn.ylv"nla It'd
within local tlar r hburg arn (711) 7a7.109~, TOOt (11'1) nZ.215Z Hllarlng IIpalr.d Only),
OIJECT/O..,.
Anv party In Jnter..t not Illthll.d with the llPprahe..nt, allowanc. cr dls.lIowancI of d.duotlon., or aI.......nt
of ta~ (Inoludlng d).count or Interl.tl a. shown on thl. Hotle. IU.t cbjlct withIn .IMty (60) day. of reollpt of
th1l Hotlc. bVI
AOKIN
ISTRAT/VE
CORRECT/ONS I
"wrltt.n prot..t to the PA O.part..nt of R.Vlnu., Board of Appeal., DIPt, 2&1021, tlarrlsburu, PA
'..I.ctlon to have the .att.r det.r.ln.d at audit of thl account of the p.rsonal r.pr...ntatlvl,
~-app.a1 to the Orphan.' Court.
171Za~1021,
OR
OR
F.otul1 Irror. dl.covlr.d on thJ. ........nt ~hould b. addr....d In writing tOI PA Dtpart..nt of A.v.nu.,
BUrleu cf IndJvldual TalC", ATTHI Po.t A.......nt RllvJlw Unit, O.p\' 250601, Ilarrhburu, PA 171za-0601
Phon. 171n 117-UOS. S.. r.g. 3 of thl bockl.t "In.tructlon. far Inhtrltanc. Tal( Rlturn fcr a A..ldlnt
D.o.d.nt" (REV~1501) for an 'Mpllnatlcn of adllnl.tratlvllv oorr.otable .rror..
DISCOUNT.
If any t.N due I. paJd within thr.. ell oal.ndar lonth. aft.r thl d.c.dlnt', dlath, a flv. p.rc.nt (5~) dl.count of
thl t.. paid I. allow.d,
Int"l.t 11 charUld b.glnning with flr.t day of d.lInqu.ncv, Dr nine (9) lonth. and ant (1) dav fro.. the d.t, of
d.,th, to the dati of pav'tnt. Ta... which b.oa,. d.linquent b.for. January 1, 19&2 blar Int.r.tt at the ratl of
,b (6)0 Plre.nt p.sr a~ calculated.t a dallv rate of ,000164. All tUII which blea.. d.llnqulnt on and Ift.r
January I, nlz wUl bllr Int.r..t I'It a rllt. which will vary frol onllndflr ~ur to oal.ndu Yllr Nlth thlt rate
announcld bV thl PA D.part..nt of R.v~, Th. appllcabl. lnt.re.t rat.. for 1982 through 1995 ar'l
INTEREST.
!!!r Int.r..t Rat. Dally Inter..t faotor ~ Inter.. t Rat. DailY Int.r..t Faotor
1912 20~ ,ooms 1917 9% ,000217
19U 16X ,OOO43S \981'1991 11% ,000101
1914 II~ ,000101 1992 9% ,000247
1915 U~ ,000156 1995'1994 7X ,000192
1916 10~ ,000274 1995 9% ,DOOm
ulnt.rut it e.leullt.d .. fol1owlI
INTEREST. BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
-4Any Notle. 1..Uld Iftlr the ta. bac~. d.llnqu.nt Nll1 r.fl.et an In'.r..t caloulation to flftlln(lS) dlYI
blvond the dlt. of the a.......nt. If ply..nt I. lad. aftlr thl Intlr..t co.,utatlon date .hoNn on the
Hotle., adcUtlonll Int.r..t .u.t b. ctlculat.d.
REV-1547 EX AFP (12-95_
~~~~~:::::\ l~f ~l:~~~Y\Y'NU ' " NOTICE OF INHERITANCE TAM
'UREAU Of IN"IYIDUAl TAKES , ' APPRAISEHENT, ALLOWANCE DR DISALLDWANCE
ofP!. 10'.'1 OF DEDUCTIONS AND ASSESSHENT OF TAM DATE 04 22 96
Il.RRmURO. P' 1111."." - -
ESTAfnIF-"'JACODS~~~"~~"~' ~c. EllI TH'" ~. ~M""~~'=~~"""=-'= c. ~.= 'FiLE'"iG~ ,~c_ '"~r 9 4~-b.t~ -.=.="
DATE OF DEATH 05-10-94 COUNTV-; c, CVrIBERLI\AAI.
NOTE, TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHIT TIlE UPPER PORTION DF TlIIS FDRH WITH YOUR TAlc' ::
PAYHENT TO TIlE REOISTER OF WILLS, HAKE CIIECK PAYABLE TO "REOISTER OF WILLS, AOENT" :.ji
REMIT PAYM6NT Tal
~
REGIST~~ OF WILLS
CUMBERLAND CO :ctlURT 'HOUSE
CARLISL6. PA :17013 VI,:,
). ."' ('.1 ,
.., U'I
1__=---:---A;;O~.~t i._~!.!.t;d j
;,\,
II
ACN
101
GEORGE A VAUGHN
ANDES fTAL
525 N 12TH ST
LEMOVNE
III
PA 17043
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS .....
iiEV: is iti - EX- -A pi; - i i'F 95 Y. NO Y if. r -oF - i"H'1i E ifi;: A'iicE - YA'x - iiP' pilii is c'i-fi Nr, -. Ai. row A tic Ii - OR - - - - - - - - - - - - - - - --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT or TAX
ESTATE OF JACOBS EDITH M FILE NO. 21 94-0641 ACN 101 DATE 04-22-96
TAM RETURN WAS I I X I ACCEPTED AS FILED
I I CHANOED
RESERVATION CONCERNING FUTURE INTERES7 - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI SUPPLEMENTAL RETURN NO, 01
1. R..l E.hh ISch.duh Al 111_
2, stock. Ind Bondi ISchluul. BI 121
3, Clo..ly Hold Stock/Plrtn.r.hlp Inhr..t ISch.dul. CI 131
4. Hortg.g../Not.. R.c.lvabl. ISch.dul. DI 141
5, C..h/Blnk a.pol! hltlilc. P.rlonll ProPlrty (Schedul. E) (5)
6, Jointly O.nld Prop.rty ISch.duh FI 161
7, Tr.n.hr. ISchlduh 01 171
B, Tot.l AI..tl
,00
,00
,00
,00
1.500,00
,00
,00
181
1,500,00
APPROVED DEDUCTIONS AND EXEMPTIONS I
9, Fun.rll Exp.n..I/Adn. COltl/HI.c, Exp.n... ISch.dul. HI 191____
10, D.bll/Hortg.g. L1.blllll../L1.n. ISch.dul. II 1101
11, Totll D.ductlon.
12, Nit V.lul of Tox Rlturn
15, Chlritable/Qovern..nt.l aequ..t. ISchedul. J)
14, Not V.lul of E.tlt. Subj.ct to Tlx
,00
,00
Illl
1121
1131
Cl41
nn
1.500,00
,00
28.358,85
If an assessment was issued previously, lines 14. 15 and/or 1&, 17 and 18 W1ll
reflect 11gures that include the total of ~ returns asses sod to date.
ASSESSMENT OF TAXI
15. Altount of Line 14 It Spou..l rate lIS)
16, Ancunt of Lln. 14 tlxlbl. .t Llnl.I/CI.I. A rlt. 1161
17, Anount of Lln. 14 tlxlbl. .t Colllt.r.l/Cl..1 B r.t. 1171
IS, PrincipII T.x Ou.
NOTEI
, 00 M ' 00,
28.358,85 M .06,
, 00 M ' 1 5,
1181
,00
1.701.53
,00
1.701.53
TAX CREDITS I
PAYHENT
DATE
08-05-94
11-30- 94
03-13-96
RECEIPT
NUH8ER
-MM886384'-
MM913251
AA112614
DISCOUNT
INTEREST
1'1
I-I
63.16
,00
8.83-
AHOUNT PAID
1,206~
348,37
90,00
INTEREST IS CHARGED FROM 03-14-96 TO 04-30-96
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX CREDIT
-.__._----~--_.
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
1,692.70
8.83
.10
8.93
· IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST,
IF TOTAL DUE IS LESS THAN fl. NO PAYHENT IS REQUIRED.
If TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU HAV BE DUE
A REFUND, SEE REVERSE SIDE DF THIS FORH FOR INSTRUCTIONS, I
"~I
'!l()'
RESERYATIONl t"lll' of dlcedant. dvln~ on or bafar, Uocaabar 12, 1982 .. If any future Int.r..t In the I.t,t, I, trln,flrr,d
In po....llon or '"Jav..nt to Cl,.. B (00111\"11) bln'flol,rllI of th. dtudtnt tfttr thl IlIplratton of .ny ..tat. for
II'. or for y..r., the Co..onwlllth h,r,by llepra..lv r~'.r~.' the right to appral.. and at.'.. tren,'.r Inherltancl TIK"
at the lawful Cl... a (col1at,ral) r.t. on any .ueh tutur. Inter..t.
PURPOSE Of
NOnCE I To fulfill the raqulr...nh of SloUon 21"0 of the !nhtr1tancI IllI\d [,tat, TalC Act, Agt 22 of 1991, 72 P,S.
Slotlon 2140.
PAVHfNTI Cahch thl top portton of thil Notlc. and tubalt with your paYH"t to the Rlght,r of Willi prlntad on the rav.r.. ,Ida!
e-Halc.a chick or .onlY ordar Plvabh tOI REGISTER or MILLS, AGENT
All Ply.tntl rloeiVtd Ihlll f Irlt bt .ppUed to .,,~ Intere.. Whlch 'I'i tMI due with en~ r..,lnd., appllld to the tlx,
REFUND (CRII A rlfund of . tax orldlt, which wal not rlque.tld on thl Tlx Rtturn, .,v bl rt~.ted bV cOIP11tlng an "Appllcltion
for Rlfund of Plnnlvlvll1l. Inherltanc. and E.tate lax" (REV-UU)' Appltc.tlon. Ire .v.l1_bl. _t thl OfficI
IIf tht R.gl.t.r 0' NUll, Inv of the 25 R.vQnu. Ol.trlct Office., Qr by c.lllng thl 'Plclel 2~~hour
anlwlrlng .Irvlol nu.b.rl for 'or.. ord.rlngl In Plnn.Ylv.nla 1-800-562-2050, out,ld. P.nnlvlvanla and
within 10cII Harrhburg er.. (111) 781-8094, TOOl (717) 172~22!i2 Ol..rlng IlPalr.d Only).
OBJECTIOHSl An'i p.rt'i In Inter'lt not .,tl.flld with thl .ppr.I....nt, allowancl or dl..llowanc. of d.ductlon., or ........"t
of till (Inoludlng dhcoont or Inter..t) .. .hown on thlt HotlC:1 IU.t obJ.ct within .h(h' (60) day. of r_c.lp, of
thlt Notlc. bYl
-~wrlttln prot'" to the PA nepart..nt i'lf R."enu., Bo.,d 0' Appuln, n.p\, 2811)21, tllrrllburg, PA 17128-1021, OR
--.llotlon to hlv, thl ..tt.r d.tlrlln.d at audit of the .ccount of the p.rlonal r.pr..."t.tl"., OR
--app'll to thl OrPhan.' Court,
AOIIIN
ISIRATlYE
CORREClIllN'l1
DISCOONI I
Factull .rror. dl.cov.rld on thl. a.......nt .hould b. "ddr....d In writing tOI PA DIPlrt.,nt of R.v.nut,
Ihlr"al/ of lortlvtrlllll hI/II, ATTN. Po.t A........nt Rlvl.", Unit, D.p," 2e0601, tlarrllburA, PA 1712a-0601
Phonl (717) 187-6505. S.t p.g. 3 ~f th. bookl.t "In.tructlon. for Inh.rlt.ncl T'M R.turn 'or. R..ld.nt
D'Cldtnt" (REY-1501J for an .Mplanlllon of Idltlnlttl'ftUvaty cOl'rtoUtbl, error..
H any tex due 11 paid within thrll (l) calendar lonthl after the d.c.d.M', dllth, a flvl puc.nt (5~) dllcount of
the tlk p.ld I. al10w.d.
INIERESI'
Intlrl,t 1. charg.d b.glnnlng with flr.t dlY of dlllnqu.ncy, or nln. (9) aonth. and on. (1) da'i froa thl dlt. of
d.ath, to the d.,. of ply..nt. TaICII which b.e... d.llnquent before Janulrv I, '982 baar Inter..t at thl rat. of
.1M (6iO put,nt par annul calculated at a dally rat. 0' .000164. All talCCIt which beca.. d.llnqu.nt on and 8ft.r
January 1, 1982 will blar Int.r..t at a r.tl which w111 varv fro~ c:al.ndar y..r to calundar y.ar wtth that r.t.
announc.d bv thl PA D.partl.nt of R.v.nu., Th. appllcabl. Int.r..t rat.. for 196~ through 1996 ar.,
~ Inter..t Ratl DailY Intarllt fie tor ~ Interllt RI" 0.11. Inttrllt Flctor
1911 lOX ,000541 1911 9X ,000141
1961 16X ,000411 1988'1991 IIX ,000101
1984 llX ,000101 1991 9X .000141
1981 IlX ,DDDlS6 1991'19~ 1% ,000191
1986 lOX ,000114 1991-1996 9X ,000141
ulnt,,...t I. clacul'tld I' 'oll~'1
INTEREST. BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR'
--an'i Hollcl IUUld .ft.r lh. tu b.coa.. d.lInqu.nt wlJ I refl.ct II' Int.,...t c"lcuhtlon to fllt"n (IU dlY.
beYond th. dtt. of the ........nt, If p.y..nt I. ..de '''ar the Int.r..t c:olputatlon data .htuff' on the
Hotlc., tddlUon,l Intar..' "'It be Cllcul.tt.d,
,
P~YHENT'
D.tach the top portlo~ of thJ, Hotlel and IUbtlt,wlth ~our Ply..nt lad. payable to thl na.. and addr...
prlnt.d on the r.y.r.. Ilde,
.. Hake chick or lItonty order paYable tal REGISTER OF WILLS, AGENT.
All paYI.nt, rlc.lved ,hall h, applied fir.' to any Int.rllt which .e,;, b. dut with any re..lndt, applied to the tiM,
REFUND (CR)1 A rolund of a tax credit, which waf not requI.t.d on the Tax R.turn, .'1 b. reqUI.t.d by cotpl.tlng an
"Application for R.fund o~ P,nnlvlvflnh Inherltllne. nod E.tat. TIlle" (REY41Sl.U. App1Jcatlonl Ilrll "VIlII.blt at
the OffIcIo' the Algl.t,r of Wllh, any of thl 23 RIVenul Dhtrlct OffiCII or frol the O,putl,"t', 24~hour
anlwlring I.rvlc. nUlb,r. for for.. orderlngl In PannIYlv,nl. 1.aOO~36Z-2050, out.td, P.nnlylvanl.
and within local Ilurrltburg ar.a (717) 787-&094, TOOl (717) 712-U52 OlurlnA I.palrtd only),
REPLY
TOI Qu..tlon. rtglrdlng .rrorl cont~lntd on thl. notlct .hould bt ftddr....d tOI PA Dtpart.tnt of R.v.nu., Bur.au
of Individual TaM'I, ATTHl POlt A.......nt R.vl'M Unit, D.pt. Z80601, Harrl.burg, PA 17128-0601, Phon,
(7171 767-6505,
DISCOUNT I
If anv taM due 11 paid whhJn thr.. (1) cal.ndar 1l0nthl IIfhr the dllcedent', duth, II flvl p.rcant (5iO discount
0' the taM paid I. allow.d.
INTER1iST,
Int.r..t II chnrgld blglnnlng with flr.t dllY of d,llnquency 01 nln. f91 .ooth. nnd on. (1) day frol th. dati of
d.,th to the dati of pay..nt, TaM" which b.ea.. d.l1nqu.nt b.for. Janunry 1, 1982 btar lnt.r'lt at the r.t. 0'
.IM (6;'0 p.rc.nt p.r annul calculat.d at a dally rat. of ,000164. All tltMII which btea.t dtl1nqu.nt on nnd aft.r
Januarv I, 198Z will bfar lnt.r..t at a rlltf which will vary 'ro. cal.ndar y.ar to cnl.nunr v.ar with that rat.
announe.d by the PA D.part..nt 0' R.v.nut, Th. ftpplJcnbl. Int.r..t rnt.. for 19&2 through 1996 ar'l
OW! Int.r..t Rah Dally Int.rut rector :!!!! lntfrut AIltt pally Int.r..t Factor
1982 Z~X ,000546 1987 9% .000247
1983 16% ,OOO4!6 1988-1991 IIX .000101
1986 11;1, ,000301 1992 9X ,0001H
1985 13X ,000156 1991-1994 7% ,000192
1986 lOX ,000274 1995-1996 9X ,000267
nlnt.r.., I, calculat.d a. folloMl1
INTEREST . BALANCE OF TAX UNPAID X NUHBtR OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Hotlc. I..u.d aft.r the taM btca... d'llnqu.nt will r.fl.ot an Int.r..t cnleul.tlon to ,I,t.1n liS) dlY'
b.yond tht date 0' tht a....'..nt. If pty..nt II ."d. nftll' tht Inttr..t ca.put"tlon datt thOMn on tht
Hottc., additional Inttr..t Ilust b. Clllcutattd,
,I'
PAV"E"' I
Oeteoh U,. top portion of '''" Notlel and tUb,it with YOllr ply..nt ..dl plyabl, to till na.. and addr..,
prInted on the river.. Ilde,
If RESIDENT DECEDENT 'ake check or lon.y order ptyabl, tOI RECISTER OF WILLS, AGENT.
II "O""PESlOE"' OECEIl[HT Ilkl chick or Ion.. ordor P.,lbll 101 COHHONWEAL TN Of PENNSYLVANIA.
All PlY..,," rlC.IVfld .hal1 b, apPUld first to any Inhrut which lilY b, due with any r""lnd.r appll,d '0 the tlW.
REFUND (CR'1 A refund of a talC cr.dlt, ~hlch Will not rlqullted on thl Tax Rlturn, lIay b. rlquutld by cOlplltlng an
"ApplIcation for R.fund of Plnnlylvanla 1nhlrHann and Eltltl TalC" IREV'I3UL Appllcatlonl art flvallabl1 at
thl OffiCI of thll Rlgtshr of Wills, any of th. Zl hVlnu. Olltrlct Offlcol or frat thl DIPfttt'.nt', l4-hour
anlwering ..rvlcl nUtb't. for foru ordlrlnlll In r'M'vlvanl. 1.1I0(l-36Z-l0~O, outside Plnn'Ylvan~.
and ..1thhl local tttlrtltburg Mall I1IIl 761-8094, TOO. (111) 17l.Zl~2 CHurlng I,pl'dttd onlyl,
REPLY TOI Qu..tlon. rlgardlnll urror. contaln'd on thl. not lei .hould b. addrl'.ld tOI PI Olpart.lnt of Rlvlnul. Bur.au
of Individual TalCu, A"HI Polt A..IUltnt Rlvlew Unit, alpt. Zt0601, Harrllburg, PI 11128-0601, phone
(111) 781-6S0S.
DISCOUNT I If any tllC dut I. Pftld within thrll (3) call1ndar llooths after the tJlclldent'. dut", a flvl P"clnt (S%) dhc:ount
of the tu paid I. ftllo~ld,
INTEREST I Int"e.t II chtrg,d blgJnnlng with f!tlt day of dlllnquency, at nlnl 191 lonth. and ani (i, da., fro, thl dati of
death, to thl dah of Ply'.nt. TnMU which INc... dlllnqulnt b.fotl Janunty I, 19112 bur Int"ut at th. rah of
six (6%) p"clnt Pit annue calculatld at a dally ratl 0\ .DOOI6~. ~ll tnll" Which bOCIlI' dlllnqulnt on and aft"
January I. 1981 will bur Int"ut tit a tah which will vnry ftOIl callndar '1ltr to callndar yur wlltt tht' ratl
annaunctd by thl flA a.part..nt of Rlvlnlll. Thl ItPpllcabll Irlter..t rat.. fot 1911l ~hrollllh 1996 arel
Vur Int""t Rat. Dally Intlr..t t.ctor Vlar Int"..t Ratl DailY Intlr.st ractor
1'82 lO% ,000548 198J' 9% .00024J'
IOU 16% .00043& 19118-1991 m ,OOml
198~ m ,000301 19'2 9% .000l41
t.85 m ,00nS6 J9U-I~ 1% ,0001'2
1.86 10% .000274 1995-1996 .% .000l41
.'Interllt It calculat.d .. followlI
INTEREST . BALANCE or TAX UNPAIO X NUHBER or OAYS OELINqUENT X OAILY INTeREST FACTOR
.-Any Notlcl l,sUld .ftet thl tall b.caal. dlllnqulnt will rlfllct an Int.rl" calculation to flftl.n (15) dlyt
blYond thl dltt 0' the u"..lItnt. If PIyunt h udl aH" thl Inhtl" co.putatlon d,tl lhoNtl on the
Notice, additional Int,,", ~.t b4I calcuhttd.
L.^W OPl'lc:I:O
SNEI.IlI\.:I~H
1\
BnCNNf.MMl
ESTATE NO. 21-94-0541
STATEMENT OF PROPOSED DISTRIBUTION BY DONALD
HAINES AND SHIRLEY HAINES, CO-EXECUTORS OF
THE ESTATE AND UNDER THE LAST WILL AND TEST-
AMENT OF ARTHUR L. OTSTOT/ DECEASED, LATE OF
UPPER ALLEN TOWNSHIP, CUMBERLAND COUNTY,
PENNSYLVANIA
DONALD HAINES and SHIRLEY HAINES, Co-executors and
Accountants herein, propose to distribute the balance of the
Estate of Arthur L. otstot, Deceased, to wit: $129,498.19 in
aooordance with the Last Will and Testament of said Decedent as
follows:
1. TO: Shepherdstown United Methodist Church:
20% of residue as per Item Ninth of will:
$ 25,805.64
2. TO: ROBERT OTSTOT, SR., brother of the decedent:
10% of residue as per Item Ninth of will:
Household Goods: .25 ea libre revolver:
$ 12,902.82
30.00
3. TO: HELEN SMITH / sister-in-law of the decedent:
10% of residue as per Item Ninth of will:
$ 12/902.82
4. TO: CATHERINE OTSTOT, sister-in-law of decedent:
30% of residue as per Item Ninth of will:
Household Goods: Mantle Clock
$ 38,708.49
80.00
5. TO: KENNETH E. MYERS, no relationship to decedent:
10% of residue as per Item Ninth of will: $ 12,902.82
6. TO: DONALD OTSTOT, nephew of decedent:
2.5% of residue as per Item Ninth of will: $ 3,225.70
7. TO: EDWARD O'rS'l'OT, nephew of decedent:
2.5% of residue as per Item Ninth of will: $ 3,225.70
tAW OFf'lCI:lI
SNEL.!IAK!:R
Be
8Rr.NNE:'M"t~
8. TO: GLADYS OTSTOT, sister-in-law of deoedent:
2.5% of residue as per Item Ninth of will: $ 3,225.70
9. TO: KENNETH SMITH, JR., nephew of deoedent:
2.5% of residue as per Item Ninth of will: $ 3,225.70
10. TO: PAUL MOLASKY AND BONNIE MOLASKY, no
relationship to decedent:
2.5% of residue as per Item Ninth of will: $ 3,225.70
11. TO: EMMY LOU TAYLOR, niece of decedent:
2.5% of residue as per Item Ninth of will: $ 3,225.70
12. TO: DOROTHY MARTIN, no relationship to deoedent:
2.5% of residue as per Item Ninth of will: $ 3,225.70
13. TO: MARY D'AMICO, no relationship to deoedent:
2.5% of residue as per Item Ninth of will: $ 3,225.70
14. TO: TAD SMI'rH / grand-nephew of decedent:
As per Item Second of said will:
Household Goods: Painting
15. TO: DONALD HAINES AND SHIRLEY HAINES, no
relationship to decedent:
As per Item Third of said will:
Household Goods:
Painting
.32 Calibre revolver
Shasta pine China
$20.00
?O.OO
50.00
16. TO: DONALD HAINES, no relationship to deoedent:
As per Item Eighth of said will:
Household Goods:
Boat Trailer
Boat with Motor
$100.00
150.00
TOTAL DISTRIBUTION:
2
$
20.00
$
90.00
$ 250.00
$129,498.~9
George A. Vauglm, III
Allorney at Law
3904 Trlndle Road
Camp HIli, Pennsylvania 17011
(717) 975.9102
FAX (717) 975.9105
'.
April 26, 1996 .
Mary C. Lewis, Register of Wills
Cumberland County Court House
Carlisle, PA 17013
RE: Estate of Edith M. ,Jncobs, Fllc #21.94.0641
Dear Mrs, Lewis:
"
In accordance with the Notice of Inheritance Tax Appraisement dated April 22, 1996, a
copy of which is enclosed, please find an additional payment of interest due for this estatllln the'
amount of$8.93, Kindly process this payment accordingly,
. . V cry truly yours,
~~ghn, III
Allomey at Law
01\ V /dj
Enclosul'o
cc: Mr. Ronald R, Kirkland
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Attorney at Law
3904 Trll1dle Road
Camp Hill, PA 17011, . i
.,rlt>ri"Ollice 0
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Cumbcrland County Court House
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