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HomeMy WebLinkAbout94-00627 I. I .... ~'. -- ......... ..... ..~-.. i,.// PETITION )<'OR PROBATE and GRANT OF LETTERS Estao'e of _.CLAR~NCE !~~IKE No. .!o...~_L:__9' ~ (,.1 L__ also knoll'/I (IS _____.__________ To: _.______.______ Rcglstcr of Wills for the {JI'I,olls"ll COUltty of Cumberland in the --- -'-U9~'9--' 1 q 2' ,. Social Secllrlty No, __ - - ____ Commonwealth of Pennsylvnnin Thc petition of the undersigned respectfully represents that: Your petitioner{s), who Islare 18 years of nge or older nn the cxecut or in the IlIst will of the above decedent, dated June 28 IInd eodlcll(s) dated ________.__.___. named .19.~ (stille rl.'Ic\'i1nl drClllll~l<lIll'l'~, I.'.~. rellunciatlon, death of C\t:Clilor, CIC.) Decendcnt was domiciled lit demh In. Cumberland IliS__~~~I~tllt~\lpinA~rrrs~~I~c~~~n 20 N. 25th (Ihl ~lrccl, lIulllhcr 1I1ltlllHllldpality) County, Pennsylvania, with Street Dcccndent, thcn _~.---rr.year'i of l\)jC, died =1--"" July 9 at !IO.l.y.,~lrlt flospl~a , "amp filII, PA Except as follows, deccdcnt did not marry, wns 1I0t divorccd and did not hnve a child born or adoptcd after execution of the will offcrcd for problltc; was nolthe victim of a killing and was ncver adjudicated illeompetcnt: _________. Deeendent at death owned propcrty with estimated valucs as follows: (If domiciled in I'n.) All personlll property (If not domiciled in I'a.) Personlll property in I'ennsylvllnin (If not domiciled in Pn.) Personal property in County Value of rC1I1 cstllte in I'ellnsylvllniu ~~~cd as f(~loW~.zs-'N;-7O'tl1---strem:, camp Hl.lr;--p1\ ,19 94 L__50,000 $ $ $ bU,lJUO WHEREFORE, pctitioncr(s) rcspcctfully rcqucst(s) the Pfobn~ of thc Inst will and codldl(s) prcscntcd hcrewith and the grunt of Icttcrs es amentary thcron, (ICillllll"lllnry; udmlnl\lrntinn c.t,n.; admlnlstrnllClIl d.n,II,C,I,n.) E ~- 5~ "'. 'tiC 0'0 "il 010. ll'~ 3 C ~ Iii p~ \ ~ ./ ~ Market: tree a Hill, PA 17011 OATH m' PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLV ANIA COUNTY OF _._....cJJMJiERLAND } 8S Thc pctitiollcr(s) above.named swcar(s) or uffirm(s) Ihllt the statcments in thc forcgolng pctillollllrc truc nnd COrrel'l to thc best of the kllowledge and belicf of pctitiollcr(s) und thut ns personul rcpresen. lative(s) of the IIbove dcecdent petitiollcr(s) will wellun.~rUI~' ndminist.cr thl' cst ute uccording tollllV. , ('J ,I" y Sworn to or affirmcd aud subscrihed {' ____., _LI.>_.._...1:'_~~___ \Il heforc me this ___..J.?th..____.__ duyol' ____._L ___ _.__________,,_________. ~' YYl--~LY.,-----.--,C:19-,,-9.L _nu/-. -----.:....--..-. i1 , 'IrL1t.---(I!YJ-fiil...f.Ii.':;"H~l!t.l1ff( =_==-=--=::::==.=.=----==--=-_=-_=_~ ~ ILj. do~'1.3 Additional information may be o~hined from the unders.i.gried. Date I August 1, 111!l4 John E. slIke POBOX 737 CAMP HILL, FA 17001-0737 Phonel 717/737-3405 Counsel for personal representative " I " , : ,. " , " ,I , , " " " " , " ,I" , ,I. , , , " SAJDIS, GUIDO, SHurr " MASLAND 21011 MarkO! Slfoel Camp Hili, M ." ,\ " " ,. '" " " " ' ",1 , , I"i" " ' Additional information may be obtained from the undersigned~ Oatel August 1/ ,1994 ,John E, slike POBOX 737 C~P HILL, PA 17001-0737 Phone I 717/737-3405 Counsel for personal repr~sentative " , ' I , , t. 'i I. "I" , , 'I, ,', (.' , " , , " ,. , I' , " " BAWlS, GUIDO, " SHUFF '" ','.' 'll., I MAS LAND 1109 /dukel 5"..1 c..mp Hili. PA " " , " ., I'" ,. ,. " , " ',., .. , ,. " , , , I.' , t' I, , ' Alidit'ional information may be obtained from the \mdersigned. 'Datel August 1, 1994 . John E. SHke POBOX 737 CAMP HILL,'PA 17001-0737 Phone I 717/737-3405 Counsel for personal representative i. , ' ,,', " " , I '., ,,' " I'., , " " " " , /. " " ';-i , " " " . II., " , ,. " " , " " , " , " "j, ,. , , 'L \. i, , ' " SAIDIS, GUIDO, ,"1. i', SHUFF" " , ", " ". MASLAND " 210'1 MukelStreel , " , " ," , Camp HIli, PA , '. ,. ..',' ,"I. ','''- "__~~""'",,," "'........l:,.. '., ..~. ' ...-. -...... - Add.itional inforl)\ation may be obtained from the undersigned. I '1 I f" SAlOIS, GUIDO, " .'1' I. I' IlHUFF & I MASLAND \.1 , I 2109 Markol 81leOI I " Camp Hili, PA , " I. Date: August 1, 1994 ". " 'Ij ,. John E I Slike POBOX 737 CAMP HILL, PA 17001~0737 Phones 717/737-3405 Counsel for personal represontative .' ". ' " ,. 'I I I' , I I' I 1.1 , I " ,. "" I, ". ,. ", I' I . I,' "I, I' I" " ;' , '\ , , II', I, ,1,1 . I, , , " I' ,I , . ", J. .... ~.. _ ~...... .~ (, COMMONWEALTH OP PENNSYLVANIA COUNTY OP CUMBERLAND } Itl .JOliN E. BLIKE bolng duly sworn _ eccordlng 10 lew, dopolel end leYI thel h. Is Exoculor 01 the Estele 01 Clnronco 11'. Sllke lete 01 ___.Cnm.p._J~1~L~(~:.?~~~~'____._ , Cumberlend Coullly, PI., deceased Ind Ihet Ihe within Is In Invenlory mede by h 1m " the lelcP.Xcculor 01 the .ntlre "llle oluld decedonl, consllllng 01111 the personll prop.~rty Ind rul"llt., .xcept r8l1llhll outside the Commonwullh 01 Pennlylvlnle, Ind Ihll Ihe IIgurel opposlle uoh Item 01 the Inventory reprllenl It'l Illr v.lue 1\ 01 tho delo 01 decedonl'l dulh, . ~ ~ .t!_ 6 end lublcrlbod bolore me, p Novomber 4, 1994 Ew..ulor . Admlnl. Streel NOTARIAL SfAl THelMA S. McCAUSLIN, NOlary Public Camp Hill, Cumberland Counly MyCommissior[xplres ,July 3,1996 -....-.. ~.--.,_.._-- Dele ol Dulh Cnmp lillI, PA 17011 Addltll ..' Oay July 1994 Month v." INSTRUCTIONS I. An Inventory mUll be filed within thru monthl eller eppolnlment 01 personAl reprlunt.tlve. 2. A lupplement Inventory mUlt be IlIed withIn thirty d.YI 01 dlloovery ollddltlonellluts. 3. Addltlonel Iheets mey be IIIeched el to perlcnelty or rully 4. See Article IV, Flduclerlll Act 011949. ~ ~ C5 1! g .. ~ 5 .. 0' ~ ~ !:! .. l3 ~ M .. ~ W H 0 Q '" =- i!: <C ...l o:l : . ... -' u. Ul i ~ e -' ~ 0 ::l 0 u. , ~ LU 0 ~ 0>: :< H { 0-1 > ;E: tIl ~~ Z o 0 u 3 ~ . - m ~ ~ <3 w 0 ... Z ... "0 ~ " 0 u ... .. ~ -.: 0 Jj .. e "0 ... ... .. 0 j a it 0 CD /1 C. Illv. UllillJ( t(IHII) Fon OATES OF OCAHI ArtER 12/~"\ll emu.. HEAr. IrAUflOUMl 0 rOvEfllv cnEOIT 15 CLAIMED FILE NUMBER !lOCIAl !IECUflIlV NtJMnEn 189.09.1.1112 -I rn 1. Ollglnal A.turn ~ ~ 0 4. Lll1\itod e,lalo E 0 CCIvl K l ~ tJ:J 6. Docndunl DlOd Tu'talo ~ (Attach copy 01 Will) Co P AU CORRESPONDENCe AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: A 2 NAME CO'-Wl FTE MAll.INO AnOflF!HI R 0 John f:. Sl1kll, Efl'llll.l'll SlIldlH, l:llldo, Shllff & Mllfl1.lllld E E S N T[LEfltlON[ ~lUMBEA T 717 'l37-)1.05 1. Aoal E'lalo (Schodulo A) 2. Slack, and Bond, (Schodulo B) 3. ClooolV Hold Slock/PMnolShlp Inloro,1 (Schudulo C) 4. Mongago, and Noto, Roeolvablo (Sehodulo 0) 5. eMil, Bank Doposits & Mlscollallooun Poraonnl Propnrly (Sehodulo E) 6. Jolnllv Ownod PropllllV (SCllOdulo F) 7. T'all9IIl1' (Sehodulo G) (Selllldulo L) O. Tolol Gin"" A"ot, Ilotalllno, 1-7) V. Funoral e'pon,os, Adl11lnl'ltallvo Co, I'. MlSeollanoou, e'pon,o, (Sehodulo H) 10, oObl', Mortgago Llablllllo,. Lion' (Sellodulo I) 11, Total Doducllon, (totalllno' 9 & 10) 12. Not Valuo 01 e'lato (II no 0 mlnuo IInu 11) 13, Charlfablo and Governmontal Boquo't, (Sehodulo J) 14. NOI Valuo Subjoct to Tax (IIno 1~ mlnu, IIn, lJ) 16. Amounl 01 IIno 14 IdXablo al 0% rato (Ineludo valuo, Irom Schodulo K or Schodul, M.) 16. Amounl 01 IIno 141axablo 0115% rolo (Inclu~o valuo, from Sellodulo K 01 Schodulo M.) 17. P'lnclpoltax duo (Add lox Irom IIno 15 ond 11011111'1016,) 10.Crodlt'l5p povorty Prior Pavmont' ol,counl + 1.2 ,000.00 + 631. 58 IV. If IIno 10 I' g,oalor than IIno 17. onlor tho dllloronco on IIno 10. Thl' I, Iho OVERPAYMENT. II] 0 ICheck her. H you ar. r.queallog a ralund of your ovarJllvmant.1 20. If IIno 171' gloater Ihan IIno lC, ontor tho dlllor""co on linn 20. Thl' I' Iho TAX DUE. A. Enlor tho Interosl on tho balanco duo on II no 20A. B. Entor tho lotal 01 IIno 20 ond 20A on IIn, 20B. Thl' I' tho BALANCE DUE. M.ka Chook Payabloto: Roglstor 01 Willa, Agont .. .. BE SURE TO ANSWER AU QUESTIONS ON PAGE 2 AND TO RECHECK MATH . . Undll p,n41llfl 01 peflu'y, I dect.r, 1I1l11 halle ...mlnelllllll "turn, Inchidlnllaccomp"nYlnuschel1uluand Ilalernerlll, .nd 10 Ihe bul 01 my knowledge and belial, Ill' l'ue, cOIfI,1 and complll.. 1 decl.,elhal all rul..tal. h,. bun reporl.dAllrul mar I<.e t ~at~e. nlcl"r.llOn of fllep.", olhlf lh.n Ihl Pllrlon.IlIprUlInl,\llllel. oued on alllnlorm"llon 01 whiCh pflp.'1f has IIny I<.nDWlldgo. 'eoMNm'(\~N TIWf,':flWll'6l^'''^ i'l.t~, ""01 'IMUIHJ IJlih, "A t7118.U601 INHERITANOE TAX RETURN RESIDENT DEOEDENT (TO BE FILED IN DUPLIOATE WITH REGISTER OF WILLS C(Jlmrvc:oor I DlCEUCNI'.!l NAME (t.A!\I, FIIISI, AND MIDDLE ItMlflLl SLI KE, CLARENCE W, O[C[{JEN1'!1 CoMPtF I[ A(lDIIE'.}!'. 25 N. 20t.h St.rOllt. Cnlllp 11111, I'A 170ll OATE OF Uf.AIH 0'/ /09 /911 02, CUUIII.,. CUllllll1l' 1 and TIJ, 06, o 4a, Futuro IlIloro,1 Co"'prornlHo Ilor dol on 01 doalh 01101 12-12-62) o 7. oncodolll Malntolnud 0 Llvlllg T'U,I (AII,eh 0 copy 01 Tru,l) n09 CnlOp Mnrket: St:t'l'et: II III , "A '1'/011 81, ,900.00 89,125.52 NOllll NOlle 35 , 71,11.20 ~ C A p I T U L A ! N (1) (2) (3) (4) (6) (0) (7) 61. ,292 .01, NOlle (9) 22,OuO.85 (10) 11,71.0.88 (16) 237,950.03 ~ 21.-!III.Of,n ','rArl IWMlIlfl Romalndor Rolurn (10' dato, of doath pilar 1012-13-62) Fodoral Estolo Tox Aoturn Hoqulrod 8. Tolal Nurnbol 01 Salo oup",1I Bo""" (0) 271,661.16 (11) (12) (13) (14) x ,00. 33,111.73 237,950.03 None 237,950.03 14,277.00 (10) 0.00 X,15. 0.00 C o M ~ I ! N Inloro,1 SIGNATURE OF PEnSON flEsrmHIIOl.E r;ol1 nWlG fI[TlJlltl AlJDRESS (17) II. , 277 , 00 (18) (IV) 12,631.58 0,00 (20l. ( 20A). (20B) 1,645.42 0.00 I ,61,5,1.2 OArt J)~' , ,r' ..At f1l1lPAflEn OHIEf! I AN flEfll\[SEN1ATtVE ho<i' iin l:ki;t' S i'I:~~'t' -...... -............. --.. -.... ci1inp' iilii': '\i;'" --Oliff.... ........... .......... -.. ~:!~/r<l AOOrtUi5 .fl . /}."It ~)I'W~.:;;t~~(.I~~'l:~~:r.f;L~..~~~.~~[1~I................ ~ 'Itf-. ci;,n\;' iim',"i';'" "j 7lifi.... ........ -.. ............. "" I..m IOlIw,," only Coo,,, ""CO S,"w.", loc. '''m'; 0 I!.?,t,,, AEY - 110. EX + 13-Uj ~oM~'lJ\1rM~\'Wtw~jhYANIA ESTATE OF CLARENCE W, SLIKE SS~ 189-09-1142 Jolnlllnlnl(l)1 A. NAME JI)hn E, Slike ~ William H, Slike C, Lorna R. Slike D. Mary Jane Slike Jolntly-ownod proplrtyl SCHEDULE F JOINTLY-OWNED PROPERTY 07/09/94 ADDRESS 1705 Linewood Drive Camp Hill, PA 17011 100 Ridgewood Drive Camp Hill, PA 17011 1705 Linewood Drive Camp Hill, PA 17011 100 Ridgowood Drive amp FlU! NUMBER 21.91,-0627 RELATIONSHIP TO DECEDI!NT Son Son Daughter-in-law Daughter-in-law U!TIER DATE ITEM FOR MADE DI!SCRIPTION OF PROPERlY TOTAL VALUE DECO'S DOLLAR VALUE OF NUMBER JOINT OF ASSET " INT, pl!CEDENTINTBREST TENANT JOINT DAUPHIN DEPOSIT ACCOUNTS: 1 ,B,C,D 04/04/88 C,D. #8000146266 25,262,80 20,00% 5,052.56 2 ,B.C.D 04/28/88 C,D. #8000146320 25,278.16 20.00% 5,055.63 3 ,B.C,D 06/16/88 C.D, #8000146363 25,308.87 20.00% 5,061.77 4 Mil 10/12/90 C,D. #8000146975 10,027.37 33,33% 3,342.46 5 Mil 07/01/92 ACCT. #4350964009 128,338.84 33,33% 42,779,61 . , , , TOTAL (Also entsr on line 6, RoonpittJlltlon) 61 292.04 (If mors Spice Is needsd, In&en addltlona/sheet. of ..me olzs,) Capyrlght(olll1' form lOft......." only Clnltr PIle. Soft"""."jlno. Form 1500 Sch.dul. F (Aev. 12-8Ij REV- "" EX + II.", SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES Please Print or T e FILl! NUMBeR 21-94-0627 COM~N\l\l~{\W~~NI~ !STATI! OF ~RENCE W, SLIKE ITEM NUMBER A. Funllll ExpIn"I' SS# 189.09 -1142 07 09 94 DESCRIPTION AMOUNT 1 2 Myers-Harner Funeral Home Gingrioh Memorials - inscription 6,450,00 60,00 B. AdmlnlltrlUvl eollll 1. Personal Representltlve CorM1lBBlons 4,883.00 Soolll Securtty Number of PerBonal RBpr8gentatlve: 251. 69 4606 Year Cornrr/BslonB paid 1995 a. Morney Fees 9,767,00 3. Famly Exsmpllon "/r+ Claimant RolaUonshlp Address 01 Claimant at decedsnt's dsath Stroot Address CIly Slats Zip Code .. Pro bats Foos 267,00 O. MllCllllnlOull!lcpInl..' 1 Register of Wills - short oertificates 18.00 2 Patriot-News Co. - legel ads 45.53 3 Cumberland Lew Journal - logal ads 40.00 4 Recorder of Deeds - filing fee for corrective deed 14.00 5 Dauphin Deposit Bank - check charges 31. 32 6 Register of Wills - filing fees 25,00 7 Reserved for taxes and future expenses 400,00 TOTAL Also IntI! on line 8 RIO Itullllon (If more BpllC811 neede1, Insert addl1lonli Bheets 01 same Bin,) CoPyrloht(o) 1'" fOlm loft"",. only Clnl" Pllce8oftw.rt, Inc. . 22 000.85 Form 1100 Sonedul. H tRoY, HI' ~1547 EX AFP (08094* ( COHHONWEAl TIt Of' PENNSYlVANIA O'I"O'H'H' OF orV'HU' NOTICE OF INHERITANCe TAK 8UO"U UF 'HOIVIOUAl rms APPRAISEMENT, ALLOWANCE OR DISALLOWANCE ~;:~is;:::~' 1" 1111"'601 " . . OF DEDUCTIONS AND ASSESSMENT OF TAX DATE 02- 06 - 95 Esf'ATrOF- snl(E"=~~==o=,o""='="/';tliiH!N ''E' '=I;t==~=='o"="="====='=~~=='==FTCE'==NO: ====="2r94:=-O-6Ir'===='= DATE OF DEATH 07-09-94 COUNT V CUMBERLAND NOTE, TO INSURE PROPER CREon TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS FORM WITH YOUR TAK PAYMENT TO THE REDISTER OF WILLS. MAKE CHECK PAYABLE TO "REDISTER OF WILLS, ADENT" REMIT PAVMENT TOI t.5 / "I / Ij_)) I .!) JDHN E SlIKE ESQ SAIDIS ETAl 2109 MARKET ST CAMP HIll PA 17011 ACN c 101 REGISTER DF WIllS CUMBERLAND CO COURT HDUSE CARLISLE, PA 17013 f=~~-~~~nt =:~~ t h~._ - J CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .... R i!V: is';, - E if' j., i:i; 0 f ii s-: 94 -,- 0 NOY i c F. 0"6 F - YNti iii iT ANC E' YAX 0 'A-P'pii Xiii Eioi€Nr; oj., i. i:ciWAtic E - iiFi 0 0 0 0 0.0 -- 0 0 0 0 0 0 0 0 DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SLIKE CLARENCE W FILE NO. 21 94-0627 ACN 101 DATE 02-06-95 TAK RETURN WAS, I X) ACCEPTED AS FII.ED RESERVATION CONCERNING FUTURE INTEREST 0 SEE REVERSE APPRAISED VALUE OF RETURN BASED ONI ORIGINAL I. R..I E.t.t. IScn.dul. A) 2, Stook. .nd Bond. ISoh.dul. a) 3. Clo..ly Hlld Stock/Plrtn.r,hlp Intlr.,t IScn.dul. CI 4. Mortglgl./Notl. Rocllv.bl. ISoh.dul. D) 5. CI.h/Blnk D.po.lt./MI,c. Por.onll Prop.rty IScnldul. E) b. Jointly O_n.d Prop.rty ISoh.dull FI 7. Trln.f.r. IScnldul. 0) 8. Toto1 Au.ts APPROVED DEDUCTIONS AND EXEMPTIONS I q, Funer.l E~p.n.../Ad~. COlts/HisD, Expen..a (Sohedule H) 10. Dlbt./Mortglgl LI.bllltl../LI.n, ISon.dull II 11. Totol D.ductlon. 12. Nit Vllul of T.. Rlturn 13. Chorltobll/DovlrnHlntol B.qu..t. ISohodul1 JI 14. N.t Volu. of E.totl Sunjoot to To. NOTEI I ) CHANOED III 12) (3) 141_ 15) (b) I7l 84,900,00 89,725,52 .00 .00 35,744.20 61 ,292.04 .00 18) 271,661. 76 33.711 73_ 237,950.03 ,00 237,950.03 If an asselsment was issued previously, lines 14, 15 and/or 16, 17 and 18 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAXI IS. AHount of Llno 14 .t Spou.ol rota liS) lb. AHount of Uno 14 h.obll at Unool/Clo.. A rota lib I 17, AHount of Lln. 14 to.oblo at Collot.roI/Clo.. 8 rot. 117) 18. Prlnolpol To. nuo TAX CREDITS I --- PAYMENT DATE 10-03-94 11-07-94 19)_ 1101 22,OOD.85 11 ,710,88 tll ) 112) 1131 114) .00 K .03, 23/ ,950. ~l. K' 06, .00 K .15, 118) --- RECEIPT -'--r---OiSCDUNT 1+) AMOUNT PAID NUMBER I INTEflEST I" I MM913023 L' ----63'r:sa-------r2~-000.00 MM913150 .00 1,645.42 t/ · IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX CREDIT BALANCE OF TAX DUE ------ INTEREST ----------- TOTAL DUE .00 14,277.00 .00 14,277,00 14,277.00 ~ ,00 .00 .00 --~--- I IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF rOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU MAl' BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ,.... ~~ ri .... IJ) ., r :.-, N l:> '~ i:-; rr: () -' ,:! .'_. 1,,1 " " '.\ , () ., 00 '\\ . I \ ,J f! , ~. t~ t ti~ ';1 '.J'i/, :1' 8'~1i , . ')) '. .C) <.: " ~. 't" E <1)0: <il .. a: 08 AESEAVUJO~1 Eltat.. of dle.dlnh dvJng on or blfor, n,cIMb.r 11., 1982 .. If any future .tnterut In thl utah II trlln,flrr.d In Po.....lon or .njOYR.~t to Cla.. a (0011at.ral) bGn,flclarlt. of thl dacedlnt after the ,~p'ratlon of any ..\at. for llf. or for Ylar., thl CORRonwlalth h,rebY uwpr..,ly r...ryos tho right to appral.. ftnd a..... tranlf.r Inherltanc. Taw,. Itt thl lawful Cia.. . (oolhhraU rat. on any suoh lutur. Int.rut. PURPO~E Of HdllCEi To fulfill thl requlre..ntt of Slctllln 2140 of thl Inh,rJtancI and E'tllt, Tlue Aot, Act 22 of 19~1. 72 P.S, Stetlon 2140. PAVHEHI, O,tfUJh thl top portion of this Hotlu and IUhllllt wlt~ your payunt to thn R.gl.ter of Wills prlntod on the r,v.r.. .In., --Hako ch.ck or "cnoy ordllr p.ynblll tal REGISTER OF HILLS J AOr.NT All pay"ont. rocolvod shall flr.t b. appllld to any Intlr..t which "ay b. dUll with any re.alndor applied to the taM, REfUHO (CRI, A refund of a tax credit, which was not requllted on the TalC Heturn, "IV be r.quutod by co.ploUng an "AppllaaUon far R.fund of Plnn.ylvanla InhllrltnnCl and EI'l~ate Tax" (REY'1313), AppllcaUon. are available at the OffJcI of the Rughhr of Wllh, IIny of thl II RevenuI District OffiCII, or bv calling the .p.olal 24.hour IInlw.rlng IIIIrvlo. nlllber. for forlll orderlngl In Jllnn'Ylvanla 1-800-362-2050, outllde P.nnlylvllnla and within local tlarrl.burg aru (7171 181'809(1, TOO. 0171 77l.ZZ5Z U1urlng hlpalr'd Onl'll, OBJECTIONSI Any party In Int.r..t not ,atl.fl.d with the appral....nt, nllowance or dllal10wanol of dlductlon., or a.......nt of tllC (Including dl.count or Intlrlltl a. shown on thlt NoUcl lIlu.t objlct within .b<h (60) dllV' of rlc.lpt of thh Notlcl bVI "wrltt.n prot..t to thl JlA nlPartlllnt of R.v.nu., 80ard of ApPlIlh, DEPT. 281021, tlarrhburg, PI, 17128-1021, OR --ollctlon to hay. the '"ltter d.ter.lnld llt audit of thl necount of the per,oMI repre..nttltlvI, OR --apPlal to the Orphan,' Court. AO"IH lS1RATlYE CORRECTIONS, Faotual .rror. dhcovlred all thlt lIU'lIlIIent should b. acldr....d In writing tal PI, OIParhllnt of Rlvlnu., 8urlllu of IndIvidual TaMil. ATTNI POlt h....".nt Rlvl.w Unit, DEPT, 280601, IIftrrhburg, PI, 1712"-0601 Phon I (7171 787-650!i. Sit page 3 of lh, book lit "Inltruotlon. for Inhlrltenc, frIl( R.turn for II Ruldlnt nleld.nt" (REV.IS01) for an Illplanlltlon of "dlllnlttrattvllY corrlcbble errorl, DISCOUHT, If any tax dUI II patd within thr.. (l) calendar Ilonth. aftlr thl dlc.dlnt'. dlllth, ft flv. p.rcent (SiO dhcount of thl tax paid I. ftllow.d. IHTEHESTl tnter..t It chllrg'd blglnnJng with flr.t day of dellnqulnov, or l'\lnl (9) Ilonth. lInd on. (I) day froll thl dati af dlath, to thl dftt, of paY.lnt, TaM" ~hlch beea.1 dlllnqu,nt bofore Jftnuary I, 1982 h.ar Intlrl,t at thl rate of lhe (6%) plrc.nt plr annulIl calculatld at a dnlly rnt. of ,000164. All taXlI which blCI'lIll' dlllnqulnt on ftnd IIfhr January I, 1982 will bear In\lrllt at n rntl ~hlch will yarv froll cnhndar VUr to cahndar YlIlr with that ratl announcld bV the PI, DIPart.lnt of Rlvlnul. Thl applicable Intlrl.t ratll for 1982 through 1995 arGl ~ Int.r..t Rlltl Dally Intlrllt Fllcter ~ Interut Rat. Dally Inttrut factor 1982 20% .ooom 1967 9% .000247 I'a! laX .000458 1988'1'191 11% ,000301 1964 IIX ,000501 1992 9% ,000247 1965 U% .00OSS6 IfJ9]-1994 7% ,000192 196a 10% ,000274 1995 9% ,000247 ulntlr..t 11 clllculahd no followl1 INTEREST . BALANCE OF TAX UNPAID X NUKBER DF DAYS DELINQUENT X DAILY INTtREST FACTOR --Any Notlcl hluld aftlr thl till bleo... d.llnqulnt will rllhct an Int.rut clllculatlon to flftlln ('IS) day. blyond thl date of thl a..I".ent. If paY"'nt It .ad. aftlr thl Int.r..t cOllputatlon dati .hown on thl Hottel, "ddl tlona! Inter..t lUst b, calculated. ". i,'. \i. ....~~".,...,,..~l....._..., . -, , ............ " , , I' , " , I.i I, " '" IIi,. ,: \. f.", ,," . , ' t;.. t" " Ii , :.,' '-i '"' " "~I , I' -,"~I' " , , q,. "\' \, ! " ,. 1-" II " " " _.4r " i'l' " ,-,/. "" , . 1\ 'i, ~~~",,'~w.IJ!1"''''.'',-, ' "" '" ," ,,"'., I,' .. ,"i" - I." ,. .,i- _ I' I "-..(.,,, ",\~~,!.~~~~,\l\\IIrN_*tl't.~~'~'~J~~~~\~\~~"-.tl"'~)lJ'Nrt''''1;."_~rlr~;Vrr!"~~'t~' i! ~; , , " , , Ii" \. ., l'l: ': " f . .f LIIW OI'PIc:nS SAIDIS, GUIDO, SHUlfF & MASf.AND 210QMARkllT ~lRI!CT ,\ O. ltOX 737 . CAMP HILt, !'IINNHYLVANIA 17001'07:17 '..' '. t~J:~' " . :\.'11' . If!:"' ~I ; , ,'1 ... 'c : .. :' ,--.. , . ., "'. L' I I I.. ,~ 1\> ,'1 'U ., ., " 1- .' g I.' '(1\ :J f:. ~j() ,S' OFFICE COUN'J'{ COURTHOUSE 17013 REGISTER OF 1'/] CUMBJl::RI,AND CARL1~.l"E PA 1111111."111,,,11,111111,1.,1,1 ".~~r . , 'I .' -IT 15f.... -. V" , .. "" ".\ " " I " "" ,.I ",' !I J.rf'~'tI,________""",_~ , '.; I, ' 'I ., '~ , .',. I' \ '1.( (I, ;,,\ ',4' , ' i'. " ,. '~, " " " " ,. J, "1' " " " 1 " " iI ,i, " " , , ,. " i, "~I ,.c,' .. ,. ,I, ',I " " ,,' II" .. 'I I, : 'II \, " , '"~ '10 , , " II, ,. ., " ,I ,. , ,'( f;' ", , .. " ':i " " ,I, I. " ..- ..".. ...~." ........'. ........... -...~.. ........-......... ",..-'""'''''-... ........~........_'. I'; I, '. -, ':'.. .'_ Itd,- ,....',-:, . "\' . '1,1 ...~.,j.l.~ . "/'.' ",',i...'. ." "'. \. 'i {, ' . '\-4 . :. "" I ;, ~" . 'd .rf<t, .1, ."r "~I : . .. ,,.' "I, ~ '1 ..;: f 1 'V, \ "',0 ..... If J J , '...' "r .' \ . ,', '. ,f ",: .. ',. " !\j,!, t!..~ . ",., "i" ". ' I ., , - : ~ f. ," " I , , .;" .., , ....,. ~:r'.._.-. ...-....j;r .11f~'" " ~... ~~. '- .. ....-..- ., " ,1,1'1 ('" /" ..1/" , I \ I, I' '{'II " I' " ~. i , I, If' , i \ ,.' , ! ..4, ~ (")(") r: (j-; \ri ,T1:JJ (11 (I' t~ hI STATUS REPORT UNDER RULE 6.1~ { ) / !(J ;) I' , :u" ( 'Ill ( ",'''' . .. Name of Decedent I )( (',- ~ '(, ;.:,. 'J, :.., , (', '.' (,'J ~ Date of Deaths , I I Will No. ---1 If ((e/I f- . Admin. No. 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 estatel State w~ether administration of the estate is completel Yes_L No___ 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete I 1. 3. If the answer to No. 1 is Yes, state the followingl a. Did the personal reprftsentative file a final account with the Court? Yes No_ ~ . b. The separate Orphans' Court No. (if any) fOL" the pereonal representative's account iSI c. Did the personal representatIve state an account informally to the parties in interest? Yes I~ 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 l/r/7 (, r ( ,f.) ,I J2-A- c' I t Iv.' !.' t t /.( t . Name (Please type-or print) I):,,, 'I') / (~!III/) ;/" I /~ Address . I /c (' I / I:' ! ( 'Ii ) t,,) Te 1. No. ,')(/{!.J ." Capaci t Y I v Personal Representative ~'counsel for personal representative (MAHlrmf/AM3)