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PETITION FOR PROBATE and GRANT OF LETTERS
,:;)/- ((4 - 5J-O
Estate 01 WILLIAN L. RAYHOND, JR.
also known as
No,
To:
Register of WI~ fo{}he
14 312Iileceased, County of urn erland In the
Social SecurUy No. ~ -1 b - Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petltloner(s), who Is/are 18 years of age or older an the execut rix
in the last will of the above decedeot, dated".,. September 2 9
and codlcll(s) dated March (; (;, 1994
named
, 19B-
(stale relevant circumstances, e,8. renunclallon, death of executor, elc.)
Decendent was domiciled at death In Frankl in ~ COllIltYJ Pennsylvania, with
his last fallllty or principal residence at q/liOll.V~eW HOad,
Camp lIill, East Pennsboro Township, FA
(1I1l 'U"I, numb.. and munclpallty)
Decend~nt, then 7~_ years of age, died June 6 ,19 94
at Chamborsburq Hospital, Chambersburq, I'A .
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned property with estimated values as follows: ;I. ').
(If domiciled in Pa.) All personal property $ ~ i 000
(If not domiciled in Pa,) Personal property in Pennsylvania $
(If not domiciled In Pa,) Personal property in County S
Value of real estate In Pennsylvania $
situated as follows:
WHEREFORE, petitloner(s) respectfully request(s) the probate of the last will and codlcll(s)
presented herewith and the grant of letters testamentary
(I.mm.nlOry; admlnlluallon c,t.a,; admlnlmallon d,b,n,c,l.a,)
theron.
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C/O)L--nl.... .. \.:' r1 '\fttA 11'1,1..... rl.,
VOnnellHaymond ' '
47 Golfview Road
Camp Hill, FA 17011
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH O}' PENNSYLVANIA } ss
COUNTY OF CllMBERLl\ND
The petltloner(s) above-named swear(s) or afflrm(s) that the statements In the foregoing petition are
true and correct to the best of the knowledge and belief of petltloner(s) and that as pl:rsonal represen.
tatlve(s) of the above decedent petltloner(s) will well and truly administer the estate according to law.
!
Sworn to or affirmed I!nd SUbscrlbedtJ ! c'" ,,' r ,I\({'I","",L
before ~ 'JU 5TH ~ '
~~ C', LEW~' ,~~{) Register rtg
//{ - ;? ~O.- ((
I
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No. 21 - 94 . 580
Estate of
WILLIAM I,. RAYMOND, ,TR.
_I Deceased
DECREE OJ.' PROBATE AND GRANT OF LETTERS
AND NOW JUL Y 8 I 19~, In consldcratlon of the petition (m
the reverse side hereof, satisfactory proof having been. prmentmedeberfor.ll Jl1,C, 1992
IT IS DECREED that the Instrument(s) dal~d sapt b ;!~ I and l1aroh22, 1994
described therein biudmllled to Plobate andlUed of record HS the last will of
Wi liamL. Raymond, Jr.
and Lellers _ Testamentary
are hereby granted to VonneV.Raymond
Will Book N
Paae
FEES
Probate. Lellers, Etc. .. , , . . . ,. S 60.00
Short Certlficatcsfl ) . . . , . . . . '. S 9.00
Re~~~c~~t\~n ..",.,.....".' :-1~'.~~
X-Pages --ro:oo-
JCP TOTAL - S 5 ee
Filed ...., ~~.L.X. ~"..1 ~~.4..,.,... 'PA :op,
'2" Jl / L A /..... .J PHONB
td~:v. jJt.O(Ja.~~~ /'..tl_~('C"" / z./c:: 9v
John E. Slike, 06262
ATfORNEY (Sup, Ct, I.ll, No,)
Box 737, Camp Hill, PA 17001-0737
ADDRESS
737-3405
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Mailed letters and order to attorney on 7-8-94,
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LAST WILL AND TESTAMENT
OF
WILLIAM L. RAVMOND, JR.
Ii WILLIAM L, RAYMOND, JR. of East Pennsboro ~ownship,
Cumberland Couhty, P~nnDylvania, 'declare this to be 'my Last Will
"and Te~tament, hereby revoking any will previously made by me.
I . I di rect. tha t all inhed t:an(!l~ and (~stat(, taxes
becoming due by rNlSon of: my death, whether such t:a,xes may be
payable by my ,e:;tate or by an~' redpien\: of any property, shall
be paid by my exeoutors out of t.he ~)rOpl~rty passing unde r this
will, which is not specifjunlr~ devised or bequeathed, as an
expen&. and oost of ndministrntion of my estate. My exeoutors sha1l
. ,
have no duty or obli~ation to obtni" reim~ursome~\: for any 'such
tax pai'd even though on prooeeds of insurtlnoe or ,other property
not passing under this will.
I
II .,,1 hereby eKeroise ~ll powers of appuintm~nt which I may
hav. at the time of my denth ~n favor of: my exeoutorsiand all
property subject \:,0 all SlIoh powers of. appointment shallb.e
iricluded iri my estate.
,III- I' give and bequeath, nbsolutely and in fee simple,
"
all of: my household f.urniture and furniphing, books,. pictures,
jewelry, silverware, wearing "ppnlo] and all othernrLicles of
. household or,porsonal use or adornment to my wife, Vonne D.
Raymond, if living at the Ume' DC my ,(,kid,}',. If: sho isnnlJiving,
said pr6perty shall
_-1tI1L:-
be dislributad in accordanoe to the attached
Pag(~ ],
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(2')' 16% to illY wHe"fJ nephew, Ward E. Green III
2818 Rathton Road
Camp ~ill, PA 17011
(3) 16% to my wife's nephew, 'Jeffrey'D. Green
'2109 Cnmpfire tout-t
Silver Spring, MD 20906 I
"
, "
('I ) 30% to my wHo'D Sister, Mary D. Walsh
24 Elm street
Dover, NH 03020
"
(5 ) 20% t.o my wife's Brother, Sherman A. Dardis
345 Taulman Road
, Orange, CT 06477
, VI - When USllcl in t.his wi 11, the t.erm "iss1.1e" shall be
\ ~onstrued ,to and shall include natural issue and adopted issue.
"
VII ~,An~ person who shall have died at th~ Same time ~s
Testat,ot or in 11 common disaster, wHh him, or under such
circumstances t~ut it is difficult or impossible to determine who
,died first, shall he deemed to have predeceased him.
VIII - If at any lime any minor ,child shall be entitled to
receive any funds hereunder, the father of such child shall act
as guardian of the f~nds payable to fJuch childi if the father'is
unavailable or has abandoned such child, the mother of buch child
shall act a~J such guardian. If t,he mother also i!l unavailable
, ,
Dr has abandoned such child, CCNB Dank, N.A., Camp Hill,
Pennsjlvania, shall act as guardian of the funds payable' to such
,
,child, Such guardian may receive and admini(ller all funds
authorized by law and sewll havo full authol'ity to use such ff\llds
in any manner such guardian ShMll deem advisable for the best
intermit of such dd,lc1, innluc1!ng ,coll('ge oi: higher ecllwatic.m,
. rh-/f2- ' .
_~_.~-!~jj.-.J_.~_._____._____"
Page 3
21 . 94 . 580
RENUNCIATION
In Re B.late of
WILLIAM L. RAYMOND, JR.
deceased,
To the Re.lster of WlIIs of
Cumberland
County, Pennsylvania,
The under.l.ned
of
the above decedent, hereby renounce(s) the rl.hl to administer the estate and respectfully ask(s) that Lellers
Testamentary
VonneJlRaymond
be Issued to
WITNESS
my
tI
hand this 5' da)' of July
94
,19_,
PNC BANK, N.A., formerly
CCNB BANK, N.A.
bot 2/::-iK.'1f ~~: .
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(Addreu)
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lAW OPFICES
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,SAlOIS, GUIDO, SHUFF & MASLAND
^ r"oflR~5101'ML COl\rC)f\ATION
JOHN E, SLIKE
ROBERT C, SAlOIS
BDW^RD B, oUIDO
GEOffREY s. SHUPP
^UERT H, M^SVlND
JOHNN^ J, DEILY
TIMOTHY 1.1, ^NSTlNf,
WILLI^M C, VOHS
;]IOQ M^RKF.T STRI:r,T
P,O, BOX 737
CAMP HILL, PENNSYLVANIA 17001-0737
Ill?1737<i40S
FAX 17171737'3407
Ladies I
september 1, 1994
,C^RLISLE OFFICB:
a6 WEST HIOH sTREET
C^RLISLB, P^ 17013
1717\ a43,eaa"
PN< 1717\ a4~'64.8
liE PLY TO C^MP HILL
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Enclosed is a check in the amount of $2,500 as a
payment on account of inherit.ance tax for the above-
I'eferenced estate.
JES/MoC
EnolosUrelcheck"
Very truly yours,
~ DIS, GUIDO, SHUFF , HASLAND
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lAW OfFICES
SAIDJS, GUIDO, .SHUFF & MASI.AND
2100 MARKET .sTREET
p, 0, BOX 737
CAMP HILI" PENNSYLVANIA 17001'0737
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REGISTER OF WILLS' OFFICE
CUMBERLAND COUNTY COURTHOUSE
CARLISLE PA 17013
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SAID IS, GUIDO,
SHUFF &
MASI,AND
26 W, High Slreol
C",liJlo,PA
,
.
IN REI ESTATE OF WILLIAM L.
RAYMOND, JR., DECEASED
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 21-94-0580 CIVIL TERM
ORPHAN'S COURT DIVISION
PETITION OF VONNE D. RAYMOND, EXECUTRIX OF THE
ESTATE OF WILLIAM L. RAYMOND, JR., DECEASED
FOR APPROVAL OF SETTLEMENT AND APPORTIONMENT OF
SETTLEMENT FUNDS PURSUANT TO 20 Pa.C.S.A. S 3323
1. Petitioner is Vonne D. Raymond, Executrix of the Estate
of William L. Raymond, Jr., deceased.
2 .
Petitioner was the wife and is the sole beneficiary
"
named in the Will of decedent, William L. Raymond, Jr.
3. The said William L. Raymond died as a result of
injuries sustained in a motor vehicle accident on June 6, 1994
along Interstate 81 in Guilford Township, Franklin County,
Pennsylvania.
4. Petitioner retained the firm of Saidis, Guido, Shuff &
Mas land to investigate and prosecute a claim for survival and
wrongful death damages arising from the aforesaid accident.
5. The decedent, William L. Raymond, Jr., was born on
November 5, 1921 and was 72 years of age at the time of his
death. He was a retired engineer collecting social security at
the time of his death.
6. 'rhe decedent, William L. Raymond, Jr. was rendered
unconscious at impact and died of his injuries shortly
thereafter. He never regained consciousness.
SAlOIS, GUIDO,
SHUFF &
MAS LAND
26 w, HISh Slreol
Carll.lo, PA
7. The potential defendants have offered to settle all
outstanding claims between the Estate of William L. Raymond, Jr.
and his widow, Vonne D. Raymond, for a lump sum payment of Two
Hundred Thousand ($200,000.00) Dollars.
8. No suit has been filed and Petitioner desires to avoid
litigation.
9. Petitioner and her counsel believe that said settlement
is fair and adequate under the circumstances of this case
10. Petitioner, as the sole beneficiary under the Will of
decedent, is the only one entitled to share in the damages under
any survival action.
11. The decedent had no surviving issue.
Therefor.e,
Petitioner is the only person entitled to share in the damages
under any wrongful death action,
12. Petitioner proposes that said Two Hundred Thousand
($200,000.00) Dollars be apportioned and paid as follows:
a. Twenty Thousand ($20,000.00) Dollars to Vonne
D, Raymond, Executrix of the Estate of William L.
Raymond, Jr., deceased, for the claim under the
Survival Act (42 Pa,C.S.A. S 8302).
b. One Hundred Eighty Thousand ($180,000.00)
Dollars to Vonne D. Raymond, individually for her claim
under the Wrongful Death Act (42 Pa.C.S.A S 8301).
13. The proposed apportionment is reasonable since thet'e
was little, if any, pain and suffering or othar damages
recoverable under the Survival Act. By far, the greateut item of
2
, '1
IHvlITORY OF THB RIAL .AND' PIRSONAL'ISTATB or
WILLIAM L. RAYMOND, JR., DBCBASBD
Delaware Group IRA account #5157009821
1994 Buick LeSabre
Proceeds of survival action v. Naussaux-Hemsley, Inc.
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$48, 8BB~ 90
20,000.00
17,000.00
$85, BBB . 90
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
}
UI
Vonne D. Raymond
being duly sworn aeccrdlng to law, deposes and nys thatS he
is Executrix 01 the Estata 01 William L. Raymond, Jr.
I East Pennsboro Township C bid P d d d h h
eta 01 --...--.-.. ,-----...,.., .---.,.,_. , um ar an County, e., acaase an t at t a
her Executrix
within Is an Invantory made by ._" the sald_
01 the entire estata 01 nld decedent, consisting 01 all the personal prop'.rty Ind rill estate, except rill utete outside
the Ccmmonwealth 01 Pennsylvania, and thet the ligures cpposlte uoh Item 01 the Inventory represent It's lair value
81 of the date of decedent's death. .
Sworn to and subscribed Leloro me,
+-fJ- December ~19
';fre~ JJ, d cf~4tl~
I
NOTARIAL SFAL
THELMA S, McCAUSLIN, Nolary Public
Camp filII, Cum~crland Counly
My Commission [xpir~ JiI~~3'J~~
Date 0 seth' -...
D.y
94
"\ ,/hv>"-L rli. ~1<'h'Y\..QY\,',l,
En"to, . Admin"',,'o,
47 Golfview Road
Camp Hill, PA
Add""
June
-.'
1994
-
Month
v..,
INSTRUCTIONS
I. An Inventcry must be flied within three months alter appointment ~I personal representative.
2. A supplement Inventory must be flied within thirty days of discovery 01 additional usets.
3, Additional sheets may be attached as to personalty or rulty
4. See Article IV, Flduelarles Act of 1949.
III
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FOR DATEO OF DEATH AFrER 11/" lei CHECK fIERF.
IFAOFOUSAL 0
POVERTYCRF.DIT IS CLAIMED
FILE NUM8ER
REV~ 1500 EX . (lHll)
;4. ,~,~ () - / c)
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS
COM~m'hm Tt~OFl~~'m'brAN"
HARn's~5~~,112\~ 118'0101
COUNTY CODE
DECEDENT'S COMPL.ETE ADDRESS
47 Go1fview Road
Camp Hill, PA 17011
OECEDENT'S NAME (LAST, FIRST,ANO MIDDLE I/fITlAL.)
RAYMOND, JR., WILLIAM L.
SOCIAL SEr.URITY NUMBER
11.2.16.3124
Xl, Original Aoturn
DATE OF nlRTH
/ 06~_ C"'"
Supplomontal AOlurn
Cumberland
o 4.
[]] 0,
041,
07.
Os.
Llmllod E'lalo
Fuluro Inloro,l ComplOml.o
(lor dalo' 01 doalh ahor 12-12-02)
Dooodonl Malnlalnod a Living Tlu.1
(ANsch a copy 01 Tlu'l)
Dooodonl Dlod Toslolo
(Atlach copy 01 W,II)
o 8.
C P ALL COIlAESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
o 0
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E E
9 N
T
NAME
John E. Sllke
i!.~
2194.0560
'fEAR
NUMOEA
3, Aomalnder AelUrn
(lor dale' 01 deolh prior 1012-13-02)
Federlll Eslale TlIlC
Aelurn Hequlred
Tolo' Numbor 01 Solo Depo'lI Boxo,
TELEPHONe: NUMBER
2109
Cam
COMPUTE MAILlNO ADDRESS
Saidls, Guido, Shuff & Mas1nnd
Es ulre
717 737.31105
1, Aosl E,loto (Sohodulo A)
2, Slocks end Bonds (SchsUul. 0)
3. Closoly Hold SIOck/PDMnDfShlp Inloro'l (Schodulo C)
4, Mongsgos snd NOlo. RllColvsble (Schodulo D)
6. Cash, Bank DopOSlls & MI3i:ollaneous POlsonal Proporty
(Schodulo E)
&. Jolnlly Ownod Ploporly (Schodulo F)
7, Trans/ors (Schoaulo G) (Schodulo L)
8, Tolal Gross Assols (Iolnllinos 1-7)
e, Funsral Exponso" Admlnl'lrallvo COSls, Ml,collaneou,
Expon,e, (Schodulo H)
10. Debl" Mongago L1ebllillus, lI.ns (Schodulo I)
II. Tolal Doducllons (lolalllnos9 & 10)
12, Nel Valuo 01 E.lalo (line S minus IIno 11)
13, Ch..llablo and GovernmsnlOl Boquo,ls (Sohodulo J)
14, Nel Veluo Suh ocllo Tax lino 12 minus IIno 13)
16, Aroounl of ;,no 14Iax,bl." 0% ralo
(Includo veluos from Schsdula K or Schodulo M,)
16. Aroounl olllno 14 laxsbl. 'Il~% rals
(Includo valuoslrom Sch.dulo K 0' Schodulo M,)
17. Principal lax duo (Add lax Irom IIno 15 and Irom IIno 16,)
10, Crodils/Sp Pov"ly Prior P.ymonls DISCOUnl
. 2 , 500 ,00 . 131. 56
Ie. II II no 18 Is groolor Ihan Ilno 17. enlDr Iho d,lloronce on IIno 10, Thl91s Ihe OVERPAVMEKT.
~ 0 [Cheek hIre II you ara loquaotlng I rafund 01 your overpayment I
20. IIl1no 17 Is greator Ihan line 18. enl.. Iho dmoronce on IIna 20, This 19 Iho TAX DUE,
A, Enlor Iho Inlolo.1 on Ih, balancs duo on IIno 20A,
8, Enler Iho fOlal 01 line 20 and 2DA on IIno 20B, This I. Iho BALANCE VUE,
Make Chlok PI Iblato: AI 'sllr ot Wille A Inl
.. .. BE SUAE TO ANSWER ALL QUESTIONS ON PAGE 2 AND TO RECHECK MATH .. ..
Undll ptnilllll 01 Plqurr.l d.clUI thill hhl Illmlnlld thll "Iurn, l"c1udlng Iccomplnylng Ichtdul.. and sl.tlm,nll, .nd 10 lht but 01 my knowltdg. Ind blllll, III, "UI,
corr.el.nd compl"I,1 diet.,. th.IIIl,,,,luIU, hll bun repollld Illlue mtrk" .....Iu., O.cl'/lllon 0' pflp""r Olh,r thalllh. plrlon,1 rep'...nl.U.....I. !lUlU onalllnlormallon 01
whiCh JHlp.", h..,nYkMwl'dgl,
R
E
C
A
p
I
T
U
L
A
!
N
(1)
(2)
(3)
(4)
(6)
Market Stre~t
11111 PA 17011
None
None
None
None
66,868,90
(6)
(7)
None
None
(e)
10,693.73
(10)
1 , 717 , 00
(16)
76,278.17
T
~
(8)
66,866,90
(11)
(12)
(13)
(14)
12,610,73
76,276,17
None
76,278,17
4,576,69_
)( .06.
(16)
0,00 X ,15.
0.00
C
o
M
P
U
I
T
6
N
InlolO,l
!I10NATURE OF PEASON IlE SPONSIBLE FOR FiliNG AETUflN
AODRESS 'I
. f.....:! \,.,\."/J. .1:\ C~~) ll" l: .r-.l......................
47 Go1fview Rond
Ci.'mp' iiiir: . Pi>.' .'i 7ciii............................
AOORE'5S
Snidis, Guido, Shuff & Mllslnnd
2i'69' ;.iaa(~'l:' S'tl:~ei:""'.'..""'.""..."""'"
Cilin;' iiii i': 'Iii>."'i 7oii............................
910NATURE or flA,EfJARER OTHER hlAN REPI\[SEWATIVE
'I
( I {
,--'" \_ L/I.....
pm .ollwu. on1r C,n!., PI'GI SollwI'" Ine,
(17)
4,576,69
(18)
(le)
2,631,56
0.00
(20)
(:WA)
(208)
1,91.5,11
0.00
1 , 945 , 11
DATC
I.' 1 '1,1
DATE
!' ( Y'I
Form 1600 (R'v, 11-\11)
,I REVo1!147 EX APP (120941*
~ COHHONWEALTH Of PENNSVLVANIA
DEPARTMENT Of REVENUE
IUREAU Of INDIVIDUAL TA'ES
DEPT. 210601
tlARRISIURO, PA 11121-0601
DTATI! OP 1fAVRO'N PILE NO.
DATI! OP DEATH 06-06-94 COUNTY CUMBERLAND
NOTE. TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHIT THE UPPER PORTION OF TNIS FORH WITH YOUR TAM
PAYHENT TO TNE REOISTER OF WILLS, HAKE CHECK PAYABLE TO "REOISTER OF WILLS, AOENT"
REMIT PAVMENT TOI
t:61Lt s
&:..t~Av ~,,'j 0 p<~\)""J I
\ l\" '\ I) lJ '- \()
ACN
NOTICE OF INHERITANCE TAM
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAM
JOHN E SLIKE ESQ
SAlOIS ETAL
~1 09 MARKET ST
CAMP HILL PA 17011
,
101
u
DATE 0~-~8-95
) CHANOED
no
~,,~ ~
'. ,00
.00 !;:
.00 UJ
,00 f)i
88 '~,88 , 9.1."
. .00 i;
on ~.. 00 ~
~ _' 1,1
, (8l' )
,00
76,278,17
.00
M ,00,
M .06,
M .15,
(18)
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
L
Anouni R..lttld
J
CUT ALONO THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiiV': is'fjj - ix -A j: if - i ra-; 9ft')" -Nor-icE" -OF - INti ii( i f ANC E - Wi X - XP' PRA- is EHENr; -A miwAifc E -OR - - - - - - --- - 0 - - - - --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF RAYMOND WILLIAM L FILE NO. 21 94-0580 ACN 101 DATI! 02-28-95
APPROVED DEDUCTIONS AND EXEMPTIONS I
10,893.73
9, Funorl' F..plnIlI/Ad., Co.h/Hho. E.pon... (Schldull HI (91_
10. Dlbh/Hortglgl LloblllUI./Llln. (Schldull I) (10) 1.717,00
11. Totol DlduoUon. Ill)
12, Nit VolUI of To, Rlturn (12)
15. ChlrltlblI/OoYlrn.lnt.l Blqu..t. (Sohldull J) (151
14. Nit Volu. of E.toto Subjlot to TIH 1141
NOTEI If an assessment was illued previoully, line, 14, lS and/or 16, 17 and 18 will
reflect figurel that inolude the total of ~ returnl assessed to date.
ASSESSMENT OF TAXI
15, Anount of Lln. 14 It Spou..l r.tl (151
16, Anount of Llnl 14 tl.lbll It Llnlll/C11.. A rltl (16)
17. Anount of Lln. 14 t.,"bl" It Colllt.r.l/C11.. B r.t. (11)
10, PrlnolPll T.. DUI
TAX CREDITS I
PAYHENT
DATE
09-01-94
12-06-94
TAM RETURN WAS, I X I ACCEPTED AS FILED
RESERVA7ION CONCERNINO FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL
1. R.Il E.toto ISoh.dull A) (11
2. Stock. Ind Bondi (Schldul. D) (21
5, Clollly Hold Stook/Plrtn.r.hlp Intor..t (Sohldulo C) (5)
4, Hortglgl./Notl. Rlollv.bl. (Sohldull D) (4)
5. C..h/Bonk DIPoo! h/Hho. Plr.onll Prop.rty (Schldulo E) (5)
6. JOintly Ownld Proplrty (Sohldull F) (6)
1, Trln.f.r. (Sohldull 0) (1)
O. Totol A...h
RECEIPT
NUHBER
MM912903
MM913259
DISCOUNT (+)
INTEREST (-I
131.58
,00
AHOUHT PAID
2,500.00
1,945.11
[- TOTAL TAX CREDIT
r~ALANCE OF TAX DUE
INTEREST
TOTAL DUE
/
:u
:(lID
\'.It)
(jl u
~,
88,888.90
1~,61n 13
76,278.17
,00
76,278.17
,00
4,576.69
.00
4,576,69
4'576'~9
,00
.00
,00
" IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST,
( IF TDTAL DUE IS LESS THAN fl, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), VDU HAY BE DUE
A REFUND, SEE REVERSE SlOE OF THIS FORH FOR INSTRUCTIDNS.)
RESERVATIONl t.tat.. 0' dlcld.nt. dying on or b,'or. Olc..blr 12, 1982 -- I' anv futurl Int.rl.t In thl I.t.t. I. trlnlflrrld
In ~o"I..lon or enJoY'lnt to CII.. I (ooll.t.rll) blnl'lol,rl.. of thl dlcldlnt ,ft.r thl IMplratlon 0' tny I.t.tl 'or
11'1 or 'or y..r., thl Co..onwlalth hlrlbv 'Mpr...lY re.,rv.. the right to appral.. and ...... tran,'lr Inh.rltlncl '1M..
.t thl IIw'ul CI... I (oolht'ran rat. on .ny .uch future Int"..t.
PUIlPOSE OF
NOTICE, To fulfill thl requlrt..ntl of Stotion 21~O of thl Inherltlncl Ind E.t.tl TIM Act, Act 22 of 1991. 72 P.S.
Slctlon 21ifO.
PAVNENT I
Olhch the top portion 0' thlt HoUel and .lIbtlt with your paY.lnt to thl R,githr of WIUI prlntld on thl rlV"" ,Id',
'04"1;,' ohlck or .on.y urder PlYlbl. tOI REaISTER OF MILLS, AGENT
All ply..ntl rlc.lvad .hlll flr.t bl .pplt.d to any Int.r,.t which .ay b. dUI with any r...lndlr Ippllnd to th, tlK.
REF UNO (CR), A rlfund of . tlK crldlt, which wal not r,quI.tld on thl TaM Rlturn, .IY bl r,qulltld by cOlplltlng an "Applloatlon
'or R,fund 0' PIM.ylvanla tnhlrltance and E.tltl Tax" (REV"UUI. AppllclltJonl Ira ava.lhbll lit the OffiCI
0' thl Rlgl.t.r of Will., Iny of thl 2S Rlv.nu. Ol.trlot Offlel'l or by ellllng thl 'Plellt 2~-hour
In,wlrlng ..rvlcl nu.blr. for fer.. ordlrlngl In Pnnnlvlvlnl. 1-800'362-2050, out.ldl Plnnlvlvanla Ind
within loell Hlrrl.burg .r.a (117) 781-8094, TOO' (7t1) 712-2252 (Hlarlng I.palr.d Only).
OBJECTIONS, Any party In Int.rllt not ..tl.flld ~Ith the appr.l.a~'nt, allowancl or dl.allowanc. of dlductlonl, or .......'nt
of hlC (lnoludlng dltcount or Int.rllt) a. IMII" on this Notlel IU.t obJtet within .ll(ty (60) dlY. 0' recllpt 0'
thlt Hotlol byl
-.wrltttn protl.t to thl PA D.part.lnt of Rlv.nul, BOlrd of ApPlel., DIPt. 281021, Herrllburg, PA 171Z8-1021, OR
UII.otlon to hlv, thl ..tter detlrtlnta at audit of thl account of thl Pltlonll rtprt..ntaUv., OR
-"lPpul to thl OrphanJl' Court.
AONIN
ISTRAIIYE
CORRECTIONS,
FaetuII Itrort dltcovltld on thlt a.......nt .hould bl .ddr....d In writing tal PA D'Plrt..nt of RIVlnut,
lurllu of Indlvldull TaICII, ATTNI POlt A.......nt RIVllw Unit, O.pt. 280601, Hlrthburg, PA 1712a.0601
Phonl (717) 7&1-6505. SI. pagl 3 of thl bookllt "In.truotlonl for Inhlrltlncl TIIC Rlturn for I R.lldlnt
Dlcldlnt" (REV"ISOI) for In .xplanatlon of ftdtlnl.'rlt\vlly oorr.ctabl. Irror'.
INTEREST ,
If any till dUI 11 "'lid ~lthln thru (]) cII.ndtr aonth. Iftlr the d,cldlnt'l dllth, a flvl p"c.nt (SiC) dltcelNlt of
thl 'aM p.ld I. allowld.
Intlrl.t II chlrgld blglnnlng with flrlt day of dlllnqu.ncy, or nln. (9) lonthl and ani (1) day frol the d,t. of
dll'h, to thl dati of ply..nt. TIMII which b.ca.. dlllnqulnt baforl J.nuary I, 1982 bllr Inttrll' at thl ratio'
IIx U:O pltolnt p" Innu. cdculat.d at a dally rill of .000164. All talC" which b.c... d.UnCN.nt on and after
Janu"y 1, 1982 will blar Intlr..t at Irati ",hlch will vary frell oal.ndar Yllr to cal.nder Yllr ~lth 'hat ratl
announc.d by thl PA D,parta.nt of R.v.nu.. Thl appllcabll Int.rl.t ratl' for 1982 through 1995 ftrl'
DISCOUNT'
'!!!!; Interllt Ratl Dally Int".., Faotor !!!! (n,,,..t Ra'l Dalh Int,,"t Factor
1912 20% ,nOm8 1'81 9% .000241
1.11 16% ,000438 1988'1"1 lI% .000101
1.84 11% .000301 1992 9:1. .000241
I'as 13% ,000356 1"3'1'94 n .0001'1.
1986 10% ,DOOZ1~ 19'5 9% .000241
." tntlrnt 11 calcul.t.d .. foUewl'
INTEREST Q BALANCE OF TAX UNPAID X KUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
uAny Hutlet IlIuld ,fter the tllC bleo... dlllnqulnt will reUlet an In,,,..t cllcuhtlon to flftun (15) dlVI
blyond thl d.tl 0' thl ........nt. If ply..nt I. lIedl afttr thl lntlr..t eOIlPut.tlon dltl .hown on thl
HOtlCI, "ddlthlntl Inllr..t IUtt bl oalculated.
-
2Q
~ (0
i
\0
'"
.0:0
. <u
f'> l}
, (J
"
Coj
F'
STATUS REPORT UNDER RULE 6.12
....
o
Decedentl_U;~~~, :) .R~<
Name of -Jf;l~L,'
~ /#11
Date of Deathl
Will No. 07/- 9-1- sflo Admin. No.
;,'~
u
i.~
N
U) il
n.,
Pursuant to Rule 6.12 of the Supreme Court Orphans /
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate I
State w~ether administration of the estate is complete I
Yes~ No__
2. If the answer is No, stat.e when the personal
representative reesonably believes that the administration will be
completel
1.
3. If the answer to No.1 is Yes, state the followingl
a. Did the personal representative file a final
account "11th the Court 7 Yes No v'
b. The separate Orphans' Cuurt No. ,If any) fur
the personal representative's account iSI
c. Did the personal representative statg an
account informally to the parties in internst7 Yes v/ No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to thIs report.
Datel 1"7'-9(,
~
f
" 1-1 ~ C. ...5 L. I K-c...
me (Please type or print)
.iX 1J1 e.o9w)fI f//~(.. ti; 17~/-(J7a7
Ad ress' /
(1/7) jJ 7- .3 ~i
Tel. No.
Capacity' _____Personal Representative
~counsel for personal
representative .
(MAHl rmUAM3)