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PETITION .'OR PR08A TE and GRANT m' LETTERS
LJ:llaW of }!}a.gJLLlJ_il.,.J.;qJJt..,_,.. No, ._.u~J.:j4f,-}_~.~..___
Illso kllolVlI as _____.__,.._.......' .._.. .,..,__,... To:
___,._,_.._.___.__.n__~_U _......,._...._." Regiswr of ;Wills for Ih9 ,
--.....---.-----.--.0-0--...'..'..' /Ji'c('as('l(, COUllly ofL:.(Ltn/QeL~_.. In the
Sodal S,'<'llrll)' No, uLl1.u..-__D..b-:"'o__3.fi...?,J COllllllonwealth of I'ellllsylvnlliu
The pelitioll of the undersigned respectfully represenls Ihm:
, Your petitioner(s), who is/ure IH yeurs of uge.ru:.older ulllhe exeeutRI.)(,.....,._..__.___ nUlll):d
In the lust will 01 the ubove dee('delll, dilled .___.u,ec: n' .1 1..__,._.___.______" 19-2j{l_
und eodleil(s) dated ...__...__...n_'___'..."'__' .nm. ...-... ,.- .,...----....-.
____.___._.______.______..____._.._...n___~.____n . ____.____. -.... - -...-----------.--...-.
____._______~__n____..__.__________.... _ ......____.___.__...__ _u_____.___....._____.______
_~____________n_..__ m_______________._." .__._________..... ..___.._____~_m___.__
bllll., rCI"'illIll'im"""iI(j' q, "",,,,,'h,,lo,,, \1",,11 01 ."OC"'OI, ",,)
Deeendellt WI~S d~)lllieiled, at ,death i~l ...J,IJl1.K>{!/i:-j[l t~l. "'_hcouljlY'll'ennsYIVUniU, wllh
h1.:> IU'Mulll~I~~r pnnelplIl,!:eSldellce IIUH.","'-- t'J.S'!:;~4il . _j,,_J, frt~
_ e. _~tLL~Sr2J{J(Cju~~.I::'k..______u_u..Uf\{l.<:{,_iUJ i\ ~
(Ihl 'lri:c!l~ 1ll1ll1hcr and l1lul~\aIiIY)
lit [)eejlJ'.~~J..:~I_~dt7I~e~~'~lrag.e~~I~~(~.:.::::.:.___~~:~..'l :__~.:.::=::=::~-.., '.931--::
Except liS follows, decedent (litlllolmllrry, WIIS lIot divorced IIl1d did 1101 hllve II child born or udopled
lifter exceutloll of the will offered for probatc; WIIS nOltbe victim of u killing IIl1d II'IIS lIever IId)lIdicUled
ineompetellt: ______...___,__.,____.__.'.n__" -.......----- _ ..--...-.----
()eecll(iL'ntlll dellth owned properlY with estimlltcd vlllue, as follows:
(If domiciled in I'll,) All pcrsolllll properlY
(If not domiciled in I'a,) I'monal properlY in I'ennsylvllnill
(If not domicilcd in I'll,) I'crsonlll property ill COllnly
Vlllue of relll eslUte in I'ellnsylvllnill
situllled liS follows: ______..._.._..__._'.._....__...._.________
$ ,...M4 tH-d ,
$
$
L
00
---------.----------.---..
WHEREFOR~. pethioner(s) re~pcctfllllY re~!test(~)Jthe probUl~ or the IlIst will IInd codleil(s)
presentcd herewllh and thc grunl 01 lellers__._ e ~.k.iLW..eJl\~+ '
(lc..IIIIllCllll1ry; lIdmlni'lrllllnll \,:,1,11.; lul11l1nlmnllon d,b.floC.I.Il,)
theron,
:g
6
'0_
.~~
",0
c
'0.2
~il
...
U~
SO
~
Vi
- ...)
~~ a.lkd(/ .~e ~I-
~-f ,f~ft, . f~ ~~~{ 11() S ~--~~.. (
=~~~~t~LL~-L '~=--==-::-
____.___..____~_____. ___._.___..u__.____._..~_._~____. _______.. _ .._
_._._____'04____. __.__.__._ ,---____._.______ -..-~---.---.-
OATH m' IJERSONAL REllRESENTATIVE
COMMONWEALTH OF I'ENNSYI,V AN.IA } HS
COUNTY OF .. CumberJ~nL___
Thc pelillollcr(s) abovc.namcd .\WCIll(S) or afnnn(s) thaI the slalements in the foregoing petition ure
true and corrccttothe besl of the knowledge and belief of petltiollcr(s} and Ihulas per,onul represen.
talil'e(s) of the above dccedent pelitioner(s) will W't~~Uljadmin~'~te ,the,Cs~~brdi9fo IIIW,
Sworn 10 or affirmed and subscribed I ('" .~j<llqf!4); .u~/Lk:-/!...-d:/2; ~
before me this .__.L6.th,.... ,n day of ..jL-( .,.u~u)i . ",n___'_'.,-___ ';g
'-7Ni" "..Au~.ua,~u.u" .--, 1994.. 1 /2,fr.~u,'L.9..?t"J~n.:.,m--... ~
_L,.;UJU;ju;,'-)hL. (,;"V",:j).ddtf' (,..--;-IVGi1,ui' ~
o R.~l ~u~,,\"\ R('~isl<,r ./')uu"(;~_._"_u__~
-f:) 30 . I D
\
tHO\lUAEV 8.86
l'EE FOil nus
CErHlFICATEUOOI
WAHNING: IT IS II.I.EOAL TO AI. TEll lHlS CUPY Oil
TO OUf'ttCA TF BY PIlOTO~;IAI 011 f'1l0TOGHAi'11.
COMMONWEAL TlI OF PWNSYLVANIA
OEPAHTMENT or IlEAL TIt VITAL HECOflOB
CERT. NO. 2233423
August 4, 1994
.'.-'ollliiOTiWiOiJTihi'SCiiTiTic.tiQn
. Marvin K. Light
Name of Decedent .__.._'___..____:.___. ." '"._....._...._.....
rU'I1 ~I, II" 1<\1\
SeK Male ,Social Security No,____.,1.~8-,OS~BS38 Date of Death August 2, 1994
Date of Birth ..__~=.20~~~_.... BlrtllplnGo_. __.. S.Annville _'IW!J'~_.~~~~ _..___._.__..
PI f D tl ~lessiah Village Cumberland Cb. Mechanicsburg
ace;) ea 1
--'-~J:iij;;)-------.~._'~- .-- '''(::'~Jr,i~. - .-..--.-.-----H-----------c.tv.1L;-i,Wiiii[;TfO;nllllp
White ,Machinist NO
Race Occllpatlon _........,......,.. AnnnrJ Forces? (Yes or No) .
M I Widowed De~ede~'~d Messiah Village, Mechanicsburg, Pa. 17055
arlta Status ___,_..._._..____ Mallng ( ross u____ ." _, ........."..._..._._......._____.
tl,'I1I!"" ~!lI",,( (;'1'1 or Town
Infor nt Betty Dianond Funeral Dimctor steven R. Kreamer
ma .______...__.___........__.... ...... _...."._._.._....._____,
~~~e~a~n:S~~11~~s~~~t _"_' Kr.~~__F.~~~_'-61~...~. Main st.,._~v_i:~~'_~~~~7~~~_...~____
P0nnsvlvanla
Sllto
Part I:
: Interval Between
Immediate Cause : Onset and Death
,
a Respiratory Failure :
( ) --..--------'------.......---------.---....--....- ...--..---------+-
,
,
,
_o____._._+._____-'-o..___o_._o____t______
,
I
(c)______,______,__._....__._..,.___,.._"____._,_.__,..:
,
,
.
I
(b)
(d)
. Part II: Other Significant Conditions
_o__.__.__....___.._~_________.________.~____~__
Manner of Death:
Natural iOI:
Accident 0
Suicide 0
Doscrlbe how Injllry occurred:
Homicide 0
Pending Investigation 0
Could not be Determined 0
, , El:lward 'lhanpson
Name and Title of Certlflor .____._.._.".__.__'_h.____ ____.______. '...__._'h.h______'
Address 122 S. Filbert St. Mechanicsburg, Pa. 17055
(M.D" [J,O" CereRef, M,E,)
-----.____.__._._.___.__.._____.___,____..__._,,_ ".U___"_'_ .. ....__...____ ___...__..__.______.__.___. _,.__..+___...
This Is to ce/tlfy that the information horo (Jlvoll is ~orroclly copied from nn original certificate of
death dllly flied with me as Locnl Roglslrnr, Tho or igI!l'"I conlflcnto Villi bo forwardod to the State
Vital Records Office for plllrnanont filing, . (lIJ /J ^ \""""/1 p-O"
...><.;!A-1)UtU. LItV/ C!..R) 38-357
I", ,1110, 1'1"," iol Vol 'Ill.' .'1,1\ -!l.li!;;:,tjl~ --- .
August 4, 1994 159 N. Railroad st.,Palmyra, Pa. 17078
-+-.Ii:iT.i".li;:71;~;;"--[\;I-'~.:ilii,1i;iit:-I;---. -'-
.".",.\11','"
,.,.,; 1l,;~..;;jl;-.i;;;;I.II~~---.--.-.
I, I :.
"
LAST WILL AND TESTAMENT
OF'
MAHVIN K. LIGHT
I, 11ARVIN K. LIGHT, of J\nnville, Lebanon County, Pennsylvania, being of
sound and disposing mind, momor'y and understanding, do hereby make, publish
I
I and deolare this to be my Last Will and Testament, hereby revoking and making
II void any and all prior' il1lls, codiciltJ, writings t.hereto, by me at any time
I
Ii heretofore made.
I ITE~ll. It is my express desire that I be interred in the oemetery plot
I in South J\nnville Church of t.he Brethren Cemetery, J\nnville, Pennsylvania.
I direct that the payment of my debts and the expenses of my last illness
and funeral shall be paid from my estate as an administrative expense as soon
I after my death as conveniently may be done.
I
I' If tnere be no oemetery plot avaHable for my interment, owned by me at
I the time of my death, I authorize my Executrix to purohase suoh oemetery plot ,
with a oontraot for perpetual oare, using therefor funds from my estate in suohl
I :
I amount as my Executrix shall consider necessar'y and desirable, and I authorize !
I my Executrix to cause title to, or ownership of, such plot so purchased to be
I '
i I vested in suoh person as my Exeoutrix shall designate.
I F'urther, in this conneotion, I authorize my Executrix to expend funds
,I from my estate in suoh amount as my Exeoutrix shall oonsider neoessary and
: I desirable for the pur'ohase, erection and inscription of a suitable marker
I, f
'lor my grave.
I ITEM II. I speoifioally give, devise and bequeath all the rest, residue
I
:1 and remainder of my estate, realty, personalty and mixed, wheresoever situate,
I 1'1.1 If; J' b 1// I( X /ltNMN
I, to my five (5) ohildren, ELIZABETH JANE LIGHT, ,~W.RAY LIGHT, HICHARD DALE
I. LIGHT, KENNETH OWEN LIGHT and JOANNE RUnl SHInI, HI EQUAL SHARES, PER STIRPES.
I
I ITF'.M III. Tn addition to powerfl given to them by law, my r.xecut.rJ.x nnd
i
" her ilucoessor( B) tlhall 11l1ve the followinll powers, applicable to all property
"
II
::
I
'I
I,
"
held by them, affeotive withQut Court Ordor and until aotual distl'ibution:
Page 1 of II Pages.
1;/"<-1/Z-.1-:JI J{. f."d-,/r!-
~. LIGHT '
(SEJ\L)
I,
'.
"
"
Ii
'I
I.
:1
I (a) To retain any property reoeived by t,hem, inoluding the stock of
,
i any oorporate fiduciary aoting hereunderj
II .
i' (b) To sell real estate for any pur'posFJ, publicly or privately, for
"
I,'
suoh prices and on suoh terms as they deem pl'oper, \~ithout liability on the
I'
i'
i
I
,
I'
,
purohasers to see to application of the purchase moneys i
(c) To oompromise oontroversiesj
(d) To distribute in oash or kind or both at suoh valuations as they
, may fix.
,
I:
I'
ITEM IV.
All taxes, interest and penalties thereon payable by reason
I, of my death with respeot to property oomprising my gross taxable estate,
whether or not passing under this IHll, shall be paid from the prinoipal of'
my residuary estate.
ITEM V. I nominate, constitute and appoint my daughter, ELIZABETH JANE
, LIGHT, Executrix of this my Last IHll and Testament, and my son, RICHARD DALE
II
LIGHT, as alternate. No fiduoiary acting hereunder shall be required to post
bond or enter seour'ity in any jurisdiotion.
IN WITNESS WHEREOF, I have set my hand and seal to this my Last Will
"
, and Testament, consisting of' this and one (1) other page at the end of which
I have also set my hand and affixed my seal for greater security and better
identification, this 11th day of Deoember A.D. 1986.
,
"
,(
t??l'lue". N. '1~<--djvf
MAR IN K. LIGHT vi
I
1\
,
:I
,
I
I; We, the undersigned, hereby certify that the foregoing Will was
signed, sell led , published and deolared by the above-named Testator as and
for his LI:\st ~Jill and Testament, In the presenoe of LIS who, at :11s request
and in his presence and in the presence of each other', have hereunto set
.r our hands and seals the day and year above wrlttcn, and oertify that at
the tIme of execution thel'eof, said Testator \IaS of sound and dIsposing
mind, memory and understanding.
/) Q) ",
. I,i /' . Ire f'r',,.
(SEAL)
,
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-'lcsirlinl', at ,~(\ (/ [J. J}l(NUV7I'(1
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'/kl.J, , r/~ , I 7 () J 'i'
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ResIding at~~"" '.:~:' I ( .{".<--_
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....~-~.jl(. '/;Jl","'4( .oJ. N~'l(" \~./(i..J, I (...1",
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Pal~e 2 of 11 Pages.
((5'- 1.3'377~PI
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CER'l'IFICATION OF NO'rICE UNDEH RUIJE 5. 6~1
Name of Decedentl N!JRU"YJ r{, ~;Jht
Date of Deathl IJU.9(jst ~ /qq'f- ....
Will No. e:< I -q J/. - 0 7 J. go Admin. No, ;)./-9t.f- (j7,~f
-
To the Re9isLerl
I certify that notice of beneficial interest required by
Rule 5.6(a) of the Orphans' Court ~ules was served on or mailed to
the follo~~,$l beneficiaries uf the /lbove-c:aptlonect estate on
11- (- 'it I
Notice has now been
Rule 5.6(a) except
Address
101 0 S_~.&&HkF ~C!41el ~La".bu/e?1
-:-) I) l tfI- , ::I:E 1I01Qlj-
'3 31C] KO~,fdaVll l.::-+,l2khLLnTCi H 4-~O 17
!nI13f., $'ot<'Rdl Df(j ~ hIoHK..J -1) z3~c~
~th lClh.~ bt, SQhcLl/el1s !f/oul1ta;n
,I f(J 678?o I
given to all persons entItled thereto under
Name
,-;) I,
MCI ,eO, Vl f\ h./8ht:
K"e~~,te.& '1J, ~ht
_KQ.l'lne~CL_~hl:
'JOat1n~ rn"-K
Datel 1-.31- qb-
tLddi! r1.
Signature (f I, ' '
Name Gli1..a.bd'f1 -!t: ,,-, ,c-
Address48S [;, ElmwtJod A-"e
~'7€eJ1i:!VI;t~hti K'1. --?II- 1'1 tJs.r
TelephoneJ2LL'li.!.C, - () 4/.:t
~o
.~ t'I t:~
() :~ :'1(,1;
.,l .'. ()
t'C (
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lrlw ';1
ccO: .~ "i'. ,.:
IllS
0
CapacitYI_~ Personal Representative
Counsel for personal
represen ta t i ve
J
I ^. I,' ,) I)' lC)OhJ"", .
nl'l f-lt l" \:.ItD'
, .
JRD/June 30, 1992117858
In Re: Estateof . Marvin K. L iaht
Late of Upper A 11 en Twp.
ORPHANS' COURT DIVISION,
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
Estate No.:
21 - 94 - 7?8
.
. .
No.
,
NOTICE OF FAILURE TO FILE CERTIFICATION AND REQUEST TO
CONDucr A HEARING PURSUANI' TO RULE 5.6(e), SUPREME COURT
ORPHANS' COURT RULE
Personal Representative: Eli z a be t h Ja ne L i g h t
Counsel for Personal Representative:
Date of Grant of Original Letters:
August 19, 1994
January 5, 1995
Date of Delinquency Notice:
The undersigned, Mary C. Lewis, Register of Wills, In accordance with Rule 5.6, Supreme Court
Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of
Cumberland County, that neither the above named personal representative nor the above named counsel
for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his,
horor Its certification required by Rule 5.6(d), Supreme Court Orphans' Court Rule and that the requisite
notice, pursuant to Rule 5.6(e), Supreme Court Orphans' Court Rules, was given by the Register of Wills
on Jan , 5 , 1995, and that the ten (10) day notice to file the certification has expired.
Accordingly, in accordance with Rule 5.6(e) the Court Is hereby notified of such delinquency and the
unclenlgned requests tbat a Court conduct a hearing to determine whether sanctions should be imposed
upon tho delinquent personal representative or counsel for the delinquent personal representative.
Date: Jan, 25, 1995 0.' JJ!;/ffu ~,
Lewis, Register of Ills . 7J (j ,
Distribution: Personal Representative
Counsel for Personal Representative
Estate File
A Hearing is set forTlu~'oV.V .1-9-9.1 at J:j()/:'m.
in Court Room No.1. 7-
If the Certification of Notice is filed prior to the hearing date, the hearing
,Will automatically be cancelled. ~._~ ~j
rt ,,', 01<' (J.1(uQ ;J - " .'15;_ /r.. :I..(.1t it
~) Har F, PP
L^ST WILl, MID TE.Sl'MIEJIT
Of'
flMIVlI1 K, LIGIIT
I, fl^RVIII K, 1.1011'1, of ^,lnvlllo, Lobonon Coullty, POlIlISylvOlllo, boillg of
ooulld and dispOllillg IIIlnd, 1001l101'y olld Ulldol'StOlldiIlK, do ho,'ohy lOoku, pUbllnh
olld dooio,'o thlo to ho IOY LlIot WBl olld TOlltlUlIOllt, hOI'Oby ,'ovoking IIl1d lIIuking
.
void ony ond ull ,"'ior Wills, oOdioils, Wl'itillgo tho,'oto, by 11I0 at ony tilllo
horotofol'o 100d.,
!'!!lu. It is lilY oxproso dooi,'. that 'i bo int,er,'ocl In tho oemotory piot
in South ^,lnvBlo Churoh of the Brothren Cellletory, ^nnvillo, Penllsylvanlo.
I diroot that tho payment of lilY debts and the ox pens os of lilY hnt illlles
and fWleral shall be paid from lilY os toto os 011 adminintrativo expo line as soon
aftor lilY death os oonvooiolltly may bo dono.
If there be no oemetol'y plot available for my intonnont, owned by me at
the timo of my death, I authorl7.e my Exoout,'lx to purohoso ouoh oemotory plot
with 0 contmot for pel'potnal oaro, uOing tho,'ofol' fund. fl"m my ontato In suol
llmOunt es my Exooutrix ohaB oonoldol' "Oooonary and dosi,'ablo, olld I authorizo
my Exooutrlx to oause titIo to, 0" owne,'ohlp of, suoh plot 00 purohosed to be
veoted in ouoh POl'oon 00 "y Exeoutl'ix .holl deoigoote,
further, io this oOlloootlon, I euthorize my Exooutl'ix to expolld funds
from IOY estuto In ouoh llIIIount as my Exooutl'ix sholl oOnnldol' nooonsul'y ood
desiroblo for tho purohoso, oreotion snd iosoription of 0 "ultoblo "nr'kor
for my grovo,
ITEfI II. I speoifiooBy glvo, dovise and bO'lueoth 011 the I'est, roslduo
and remainde.. of my estato, l'oOlty, per!lon9lty and mixed, WhOI'O:JOOVor' sHunt",
' 1:1.//(j it. 1/11< X I\IM\1IN
to my five (5) Children, ELIZ^BETlI JIJIE LIOIIT, ~ RAY LIOIIT, RICIIMID DALE
1.10111', KEf/NETII OWEII LIOIIT ond JOMIIIE RUTII Sl>IITII, III t:QU^L SIIMIES, fEll STIIlpES,
ITEfI III. In addition to powel'o given to them by low, my F.xooutl'lx nlld
hOI' ouoooo.or(o) sholltlOvo tho fOllOWing pOWOI'S, nppliooblo to 011 PI'OpOl'ty
hold by them, et'Cootlve without Court Ol'dOl' ond untll sotu.l dl"t,'lbutloll:
Pago 1 of II Pogoo,
~ '~ {, .
''; 'I. -'6J:1.
1 Ii~Wtlb1rl' ~ '-!
(SE^L)
. " '''. . 'I' .
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/t/ J.';(' J(!
RtV, IlllO EX. I" ,911 'OR DAbll 0' DIATH AmR 12/31191 CHICK Hili
'h~'h9l\ INHERITANCE TAX RETURN ~o~::TlmDIT Ilf.LAIMID 0
.')fn" RESIDENT DECEDENTiii'i-NllMIIC-----------
COMMONWEAlTlI Of PENNIYIVANIA (TO BE FILED IN DUPLICATE 1\ I q /1 0 7~ '8
DEPARTMENT OF REVENUE "" T
IIARRII~J:id~n\l8'0601 WITH REGISTER OF WILLS) COUNTY COilE. YEAR
~ i.'/~"t IU'RIT, AM~D~LvNthl .. ~', ..gN;/;MPJ;7;DJ~S;al;.tj7(;;~
~ SOCIAI'~UM8:R T1EOf61AfH.....ri.ifoniiflf. .... lr1ef!j'/llflit.~b"li!.rl?~ 1?()6-0-
___.~_.._ I !t~ 05- t,,3 0 ?- _~:_lI..'tJO-1 0 - l.:t C"."Y. (julllbeJ:J~f1d,_....__.____.__
}C 1. Original Rolurn [I 2, Supplomo"lal Rolurn ["' 3,
[J 4, lImlled E.lale [J 40, Fuluro Inlo,o.1 Comprolni.. [ I 5,
Ifor dolo. of d.o,h aflor 12,12.821
~ 6, Oecedenl Died T e'lale [I 7, Decedent Malnlalnod a living T ru.1
(Allach copy of Willi IAlloch copy of T IU.II
ALL CORRISPONDINCI AND'CON.IDINTIAL TAX INPOAMATlc:iN-SHOULD'liii'DIRICTIO-rO,---'--
NAM w_ ~_ _, ~_. cOMP(HnJiiiIiNOAOOR"E"sS-P------
E!i'{..a.heth .T 'i:J/c1Ynlh'ld 4- g 6' t:, ElrnuJtJ cJ J.
fffiP7;-7U~BfR-'7 ~ 4_ .. fJ ~./~~~~:~:~-=,"~O~ Me ~l~f~'I.~~~J~~~I:~,1t
1. Real E.lale (Schedule AI I 1) ~ . .
2, Slack. and 80nds (Schedule B) I 21 Jf if..; .. If 3, ,Ij'f.
3, Clo.ely Held Slock/Parlnershlp Inlere" ISchedule q I 31, S J g c4 P.. 00_
4, Morlgages and No'es Recoivable ISchedule D) ( 41
5, Cash, Bank Ooposlts & Mlsc.lla"eou. Personal Properly( 51. .J< Jj'1 O.ll., ..5".,rd.7__
(Schedule EI
6, Joinlly Owned Properly ISchodulo FI I 61 . ..,'._.._....._,__
7, Tra..fers (Schedule GI (Schedule LI I 7) , , ",... m"_.._.,__,
8 Tolal Grall AlIOlI (Iolalllnes 1.71 a iQ J 11
9, Funeral Expe..es, Admlnlllrollve CO'II, Mlscellanoou. I 9) ....._..,.I../2_.._0.__L1.L.__
Expenses (Schedule HI
10, Oebll, Mortgage lIabllillos, LienslSchedule I) 110) .._____....
I 1. T 0101 Oeducllo", 110101 line. 9 & 101
12, Nel Value of Ellalelllne 8 minus line II)
13, Charllable and Governmonlal Bequesll (Schedule JI
14. Nel Value Subloct 10 Tax I"ne 12 mlnu. line I JI
15, Amounl of line 14 laxable 01 6% 'ale
Ilnclude value, from Schedule K or Schedule M,)
16, Amounl of line 14 laxable 0115% role
(Include values from Schedule K a' Schedule M,I
17, Principal lax duelAdd tax from line 15 and from line 16,1
18, C,edlll Spousal Poverly Credil Prior Paym"l. Oll\ounl
___________ + __._.._... +.. I ~5".. _.
19, If line 18 Is grealer Ihan line 17, enle,lhe dlUerence on line 19, Tni. II Ihe OVERPAYMENT,
mlJ
20, If line 17 Is groaler Ihan line 18, enler Ihe difference on line 20, Thi. II Ihe TAX llUE, ('10) ...:2/ "J..3.-7_L()./1...__
A, Enler Ihe Inleresl on Ihe balance due on line 20A, (20AI n_..._ .."._.m_..."...._____
B, Enler Ihe lalal of line 20 and 20A on line 20B, Thi. Is Ihe BALANCE DUE. 120BI .. m_. ..,. ...,..._______
M,,-ke Check Payable. tal Rel!.l,ter of WIII,~,~gent mu_.__...'m.__._..._m__.m____'______
.. . II SUII TO ANIWI. ALL QUESTIONS ON Rlv'iRSESIiiiAND ToiiicHicKMATH""
U'i\der penelll.. of perlury, I dlclor" Ihall havlIJ examined thl. return, Including accompanying "he'dulls and .Iolementl, and 10 the bell of my knowledge and bell,f,
Ill, IrUb, corr.cl Clnd comple'l. I declar. that all real IItale has b6tln reported allrue markor vCllue. Declaration of preparer other thon ,he peflonal ropresentatlve I.
~~ !~/~ft~~T~'C 1f~PFT~;.~;z..knowl,d2~6R(SS"n....m... .. . .......-." no_.mm."..,___......_ DATE
~~ ~IHJ . ~tA illITj.~AOtiLtt-rf ~IJtt(:.~~!JAi()..-:-~/-=-q-f
l!:!
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:z:00
V.....
..Ill
~
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NUMBER
Remainder Return
Ifor dales of dealh prior la 12.13.82)
Federal Eslale Tax
Relull1 Required
L.8, Tolal Number of Safe Oepo.1I Boxe.
4ue."
170S'S
z
o
3
E
~
I 8) .._'=~ ff 4,1.;J. f.L.7L_
1111__j.,b:tO ,1.1_
1121 ,'3.!lJlT3.A1..1.f.tf-
1131 __m_.___n__...~____
. ___ -6 (141 -J-.'1-11i...a.~_.I-ff...if =-
(151';'l'/!:!T &8&'L.jJFX ,06 = ,-u~~,-if.f.>.th..,fJ-'__
(161,
x,15 =
;c
o
~
!5
~
u
~
1171 '
. ,~~-,-i~-()_I~L__
I 1~3,o;J...
...,....------.--..----.------
Inlorosl
(18)
(19)
, ,
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.' I I"
,,,
. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A C;HECk MARk (~) IN THE
APPROPRIATE BLOCkS. . . . . . .
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred, """"""""""""......,,,..,,..
b; retain the right to designate who sha/l use the property transferred or Its income,
c, retain a reversionary Interest or ""..""..""..""....,...."..""....,................,;.."..
d. receive the promise for life of either payments, benefits or care? ...."........."",...
2. If death occurred on or before December 12, 1982, did decedent within two years
preceding death transfer property without receiving adequate consideration? If death
occurred after December 12, 1982, did decedent transfer property within one year of
death without roceiving adequate consideration? '".....,.."..",,,..,...............,,,,,,.....
3, Did decedent own an 'In trust for' bank account at his or her death?.".......,....''''.. V
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
"
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REV'"0JEK~I"861 ~~ ~SCHEDULEB~
COMMONWrAlIIi Of PrN"SYlVANIA STOCKS AND BONDS
INIlfRlIANCf 'AI( A[IUAN
_ RESIOlN! DECEDENT _
ESTATE OF FiLE NUMBER
N!ClRvln K, (Ijkt
(All property 'olnllv.ownod with Right of Survlvonhlp mUll bo dhclolld on Schodulo P.)
,;J, 1- 9'1- - 07:1. g
ITEM DESCRIPTION VALUE AT DATE
NUMBER OF D~ATH
1. :res '/3 D)1d H( tl d. 4ac!t, -#4,..~0?3 'O-o9(r b-- OO;J. I~ ",of. 1f!J-
I
:(., " " f/ " 51, ~o'13. 5"Z'l'" If -OO:l I q, ~ oE, f:J-
E, " " " " '71. :J.O'l3-b-'i9"..:t 'OO.:l. ''1, (goE,/fS'
if, " I, " " g('~/J73-5'l%. I -00;1. I q (,02. 4-3
,
s: " /, . " (PI. :J.()?3. 521/P - 3 - tJ(J rJ. I q (p 0 ~, ~,-
,
S(lb ~bl 'l~'Olfo.,~,
tfljh .
~, ]..1)$ ~fe.ld ~tl~' AH},1i'f&,I'5'079- 5'l%-()-oo:l. K' Qoa,73
I
7, I, " " I, " :JJ- ~()78' sf'/'" If - oo.:l K' ,/oa,13
,
~, " " " I, /, $1.b7J'13,,!r~'~r.-3 -oeJa &', tJ~1, 32
q, " " " " " 'f/- bo7a-j-Z'/(p- a" ooa [,9aa,,73
16, " " " I, /, ~1" ';71'13- ~-Z9". I - oO,'J 1; 9o~,1.1
,
.s~ b :-r;r c1 ( If. if I~g, 30
II. IDS ftx eJ ,q'/ln u; t~ A-u+,l'q3oo-/3'fs - 'lO!J-'- q 50'l?,ID
I
la, I, " " I. q 3 00 - Ilfol- ~ 33- 9 /1 lZ'o,93
,
13, " I. " " ~~OtJ-/lfo()" Z'0G, - I ~I 96JtJ.o3
,
IIf ' " " I, " 9300' ~/J /. ("/~ _ 1 A:J. 37t;; 13
/
IS', I. I, II I. 'f3 00. /5'3,:), - 'lQ'] - If- ID AIO,7f
,
J~, " I, 'I II ~30D-17qli- :1''' If - I Ii&, ~".!J~ 73
I
17, " '. I, II f~oo- fJ,ifl?- ~-?I - b- 1"Qil,93
IS, '1 I, II '1 9"~ 0 0" ~lD 9 (JI'" :Jiro . If {p 000,35"
I
/q, " " I, f, q ~DO 'B~(p3- I ao '-1 ~ 7, ~?3, !J~I
~o, " '1 I, I, 1 ~ lJo.33tt:," ".!J'tl_ D '" f I a.. 'f, 9:;,
I
:).(, I, 'I " /. ~joo. al1lJ' 3(1'7, , 7 '91, 'IF
Sub -'T7ria/ I
Ut' zt,.:1
TOTAL_(Allo-,!~!!r_-"t1JI~~~,-aeiIUI~,I!.~nt_.__._________ _~_______.,_._..___
(/I mort .poco I. n..d.d, In "" oddillono/.h"" 0' 'onlO .1...)
LIll R26686 130C L~FE INQUIRY
NEXT SCREEN: ID NUM: 9300 1450 806 1
OWNER MARVIN K LIGHT ANNUITANT SAME AS OWNER
ANNUITY VALUATION AS OF 08/02/94
959 FIXED RETIREMENT ANNUITY l-YR DE FGH ! J KL SER POLICY DATE
NON-QUALIFIED SINGLE PAY 14 110 0 7 70 254 07/16/84
RA'rE GUARANTEED THROUGH
PREMIUM TAX PAID TO DATE
TOTAL LOAD PAID TO DATE
AVERAGE ACCRUAL RATE
LOAN/WITHDRAWAL BA~~NCE
LAST F->V TRANSFER DATE
TELEPHONE TRANSFER
LIFE INQUIRY
9300 2121 616 1
ANNUITANT SAME AS OWNER
ANNUITY VALUATION AS OF 08/02/94
959 FIXED RETIREMENT ANNUITY l-YR DE FGH I J KL SER POLICY DATE
NON-QUALIFIED SINGLE PAY 14 110 0 7 70 735 11/25/88
RATE GUARANTEED THROUGH
PREMIUM TAX PAID TO DATE
TOTAL LOAD PAID TO DATE
AVERAGE ACCRUAL RATE
LOAN/WITHDRAWAL BA~NCE
LAST F->V TRANSFER DATE
TELEPHONE TRANSFER
FIXED PAID IN
VARIABLE FAID IN
NET FIXED PAID IN
NET VARIABLE PAID IN
CURRENT CONTRACT VALUE
VARIABLE VALUES
10,000.00
0.00
10,000.00
0.00
21,960.03
0.00
BKT
o
INT RATE
5.02
FIXED VALUES
CASH VALUE CVI EARNED
21,341.21 618.82
Lll1 R26686 130C
NEXT SCREEN: ID NUM:
OWNER MARVIN K LIGHT
FIXED PAID IN
VARIABLE PAID IN
NET FIXED PAID IN
NET VARIABLE PAID IN
CURRENT CONTRACT VALUE
VARIABLE VALUES
15,000.00
0.00
15,000.00
0.00
22,375.13
0.00
BKT
o
INT RATE
5.29
FIXED VALUES
CASH VALUE CVI EARNED
21,716.68 658.45
- 7.
11:32:22
08/03/94
21,960.03
CURRENT VALUE
21,960.03
01/31/95
0.00
0.00
5.02%
0.00
NONE
YES
% ALLOC 07/16/84
100.000
CVI YEAR END
1,068.34
11:32:39
08/03/94
22,375.13
CURRENT VALUE
22,375.13
11/30/94
0.00
0.00
5.29%
0.00
NONE
YES
% ALLOC 11/25/88
100.000
CVI YEAR END
1,140.73
"
11:30131 OB/03/94
'.
LIF~ INQUIRY
9300 1105 531 4
ANNUITANT
ANNUITY VALUATION AS OF
989 INCOME PAYABLE LIFE DE FGH
NON-QUALIFIED 14 321
LIFE INQUIRY
9300 1116 814 1
ANNUITANT SAME AS OWNER
ANNUITY VALUATION AS OF 08/02/94
989 INCOME PAYABLE LIFE DE FGH I J KL SER POLICY DATE
NON-QUALIFIED 14 321 0 0 73 094 07/23/81
. ~U.l R26686 130C
'NEXT SCREEN: 10 NUM:
OWNER MARVIN K LIGHT
FIXED PAID IN
VARIABLE PAID IN
NET FIXED PAID IN
NET VARIABLE PAID IN
CURRENT CONTRACT VALUE
VARIABLE VALUES
1,,111 R26686 130C
NEXT. SCREEN: 10 NUM:
OWNER MARVIN K LIGHT
FIXED PAID IN
VARIABLE PAID IN
NET FIXED PAID IN
NET VARIABLE PAID IN
OURRENT CONTRACT VALUE
VARIABLE VALUES
SAME AS OWNER
08/02/94
I J KL SER POLICY DATE
o 0 73 095 06/08/81
17,000.00
0.00
17,000.00
0.00
II q3D,I:, 0.00
./ 0.00
0.00
0.00 \
NONE
0.00
NONE
YES
, ALLOC 06/08/81
100.000
PREMIUM TAX PAID TO DATE
TOTAL LOAD PAID TO DATE
AVERAGE ACCRUAL RATE
LOAN/WITHDRAWAL BALANCE
LAST F->V TRANSFER DATE
TELEPHONE TRANSFER
FIXED VALUES
0.00
11131102
.08/03/94
10,000.00
0.00
10,000.00
0.00
~ oH, Ir" 0.00
I 0.00
0.00
0.00
NONE
0.00
NONE
YES
, ALLOC 07/23/81
100.000 .
PREMIUM TAX PAID TO DATE
TOTAL LOAD PAID TO DATE
AVERAGE ACCRUAL RATE
LOAN/WITHDRAWAL BALANCE
LAST F->V TRANSFER DATE
TELEPHONE TRANSFER
FIXED VALUES
\ .
0.00
,',
, ,
,"
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"
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"
I BaIcor I
Balcor Management Services, Inc.
4049 GolI Road
Skoklo, illinois G0077
(700) 677 ,2900
,!(k
,
(/J~1udl~U-~) ,
~vtMA.A..fl.(..fV
August 8, 1994
Elizabeth Diamond
485 E. Elmwood Avenue
Mechanlcsburg, PA 17055
RE: Marvin K. Llght
Balcor Colonial Storage Income Fund-B5, Taxable
Confirmation No. 1718-43
20.0 Interests
Dear Ms. Diamond:
Thank you for your recent Inquiry regarding the above-referenced
Investment in Balcor. Pursuant to your request, please refer to the following
chart for confirmation and most recent net asset valuation for this investment:
NUMBER OF RATE PER PURCHASE
INVESTMENT'" /lliOUNT /INTERESTS INTEIlEST -PATE AffRAlS.ED VALUE
",
" "
Balcor Colonial '$5,000/20.0 $ 250 07/18/B5 $263.00 per $250 Int.
( Storage Income (as of 12131/93),
~, Fund-B5, Taxable ) ~ 0- ~(; 0 o;......tti.d:
, . Additionally, enclosed are the Assignment of Interest forms YO/J requested. I
hope this Information is helpful to you, Should you need further assnstance, please
contact us at 1 800422-5267.
~/VJl1 {f 1~
Very Truly Yours,
J'\~ e I ~~~ (\
Inves tor Representatl ve
Investor Services Department'
JT:mm/75441
Enclosures
-
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ESTAte OF
ITEM
NUMBER
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COMMONWL^'ltIOf PfNN$YlVANIA
INtlE'''ANCE lAX REI URN
,__ m,!,!~' DI~ED!N'n
J
K,
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
",ISCELLAN_E~U_S EXPE~SES . _ ____..!J!a~~ Print ar T~!"
I ' . CTNUMiER
"'-IQht ~ I .t1'IJ. - a'7J.8
.:..J---------...---- .---.-.-'-- __.,u'n'.__.-___'
DESCRIPTION AMOUNT
MaRvin
-------..--.-.---.---.------.--.----.---- -,.-"--'-'-'--"'.-.--'
A. Fun.ral bp.n.." f;
1. 'KRca tYl e ~ pI.{ Y1 e IUl { f.for'YI e. 10 oqq ,6-0
.Q. , F low e,(~ ~ <1 b~, ~ 3
(see. t1Hl1tAed s-L at "'.m eHt....)
8, Admlnlltratlv. COIIII
4,
C.
1.
2,
3,
4,
5.
6,
7,
8,
1.
Porsonal Rop,olontatlvo Cammllllons
Social Socurlty Numbe, of Personal Roprelontatlvo,
Yoa, Commilllanl paid _._it], q ~--,--,
~ DO 100
1'10 - ,9, 8 - ~,(POI(,
2. Allorney Feel - Yl em e.
3, Family Exemption
Claimant _ Relatlonlhlp
Add,ell 01 Claimant 01 docodenl'l doath
Street Addrell
City _
__Slale
Zip Code.
ProbaloFeel .1i-l:'d:i~)1 feR f,r?obJI:e. J d1O(~t (!eldd1Qill:.e"
extRa. pu~e"', :JQ.? fee., 'P"l.'/. e-tl1!ft.1jC (~t'Q ~11Ul!tlt!!~ ,
Mllcellan"oul bp~n'''l ._ " I!Qf..~lp1'I
/I1e~: ~ Ia.h Udlc1Lj e (~~ d a~s I..:Y t. Z, 15) ?l1d/Cmd.e~ ~ 7q ,'/-3
, . ,I , lRef~II'H d.t1ul'llC((
~loL-h~ S (Ru.ffi ,v,1-19htl ,heach CleRLiflcnLe.1;
Keciisb.!.(((f ~ ~~ r<{, Flel~ 1l1<111 GI'Il!ri~~" ;-Pv~b((e.
llnj'ellc{ med,Q,a( b;lI~ (/~eEtl;p't~ Jtl~u.lll'I()
-/idepf!ullc' e~pe.vIS(!~
(!f)p~ Ini ush - I!n" ?er@ .'.J-,..4. 41,
_~6'YY1iY1;ssi~ -.rbR s{oQ.!( S'(t I E::. - ~4:)'-I(b"~e5;lle 10 ,~iJ
le~r.gI~'~oj:~~~~~LI:~&_~~~~t~'~~1 ~~. _~ ~~/;:'~~'t~~(Jtf,:_u.____u_u. o~ ,~-o
TOTAL lAlla onlo, on line 9, Rocapllulallnnl S q 511 (), 17
91/, , b-
~3S'i, Z'f:,
I;). , oc
~~,Lj.Z
p-, :J.'f
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7, f6
(If mar. .pace II needed, Inlerl additional .heu" of lame Ilxe, I
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(OMMOtlYlUlftt (JI ,hltUYlYAWA
INHUlIANCI 'AI( IUlUlN
.I~I~~~~ DtqOINf_
J_
SCHEDULE J
BENEFICIARIES
ESTATE OF 'J J
NJRVI/1 "', 1-.;3111:.
-- - --
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
___4._____~___._._________..._~__.___..__ ____ _~___~__.
FILE NUMBER
"'1.qtf--CJ?~8"
0_0__-
-
---.
----- 4-----.~-_..____.._._~_.o_~________... __~~________.~ .._____~_____ ___.____. _______
A, TaKabla Boquo.,,: ;1.0 t4
1. JOa.n 11 e R, S 1Yl',~h (' ~1r~c;;, 1:)a tl; e() cJU1" /;e./?
fa Hea,1::ti kil/le L3cl)( ""
Se.hoo lev!; N/ou'l1tol.itl/ N"~ MH?cJ
.;2, .Kenneth 0. t-.;iht. . Sl>1L ~ot(}
OW 3{" SOR ~Q ( '"ORI~'e,
Mubb~et< ,.:r.:C 83:ol.o:J, ~ 0 ''f/J
3. :R;ehilRJ~. ki~hf: SO)1
33/" (}~kli/. Id (EoWRS
:ellb In , () H Jl..3" I '1
,/-, .Ma(2.vin 1<" h..;~ ht ~~ :AD to
IOho So~~6 jd~e. h1Lhe,
S'e. a.urn bue.(/ l::r.:h!. t..O/9'f- (}.,oi/J
b~ j;/;-':"ilbeih J": 't;;),al'rJln1ct ((v1rcs, S'P"R.o) ~au9h/;~~
,
4-;56- e, E/mw(lcJd 4ue'I
. MeUlql'\ ia.skHH{C/1 7.4 I'10!f!r
RElA TIONSHIP
AMOUNT OR
SHARE OF ESTATE
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
AMOUNT OR
SHARE OF, ESTATE
B, Cho,lIablo and Go.ornmonlal BequolI"
1. n~e.
!
--
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS IAho onlor on lino 13, Recapllulallon)
(Ii~" .pa~;!;~-;';d;;j;' In''';'-~ddjii~~~i-.h;;;;-;;-~;';;;-;';;r-
---
S
---_~_o
'.
C./
101
COHMONWEAl TIt or PENNSVlVANIA
""ARI"E"I 01 REVENUE NOTICE Of INHERITANCE TAM
IURI AU Of' INDIVIDUAl "'" S APPRAISEHENT. ALLOWANCE OR OISALLOWANCE
Of"', 180&01 u 9
lIARRmURU."A 11111-0601" Of DEDUCTIONS AND ASSESSHENT Of TA. DATE 02-06- 5
Elf TAU -OF~"1'fOiW'~'~~===HAlWfIl .._=it'~-~~'~~'=="=~""='=FIL-lt'NO. -== rr-~C4. m8
DATE OF DEATH 08-02-94 COUNTY CUMBERLAND
ACN
NOTE, TO INSURE PROPER CREDIT TO YOUR ACCOUNT. SUBMIT THE UPPER PORTIDN Of THIS fORH WITH YOUR TAM
PAYMENT TO THE RfOISTER Of WILLS, MAKE CHECK PAYABLE TO "REGISTER Df WILLS. AGENT"
REMIT PAYMENT TOI
ELIZABETH J DIAMOND
485 E ELMWOOD AVE
MECHANICSBURG PA 17055
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
1-- ._:.i,ii~u_;;t R~~~d __ l
CUT ALONG THIS LINE . RETAIN LOWER PORTION FOR YOUR RECORDS ..
R 'EV: iS4"7 - E if -A j: ji - f 0 ji: 94") - NOi" i c r.o F - "iNtiEif if AifcE - i" AX - A P pi\lii sEM"ENr; -A i rOWANCE - bii - - - - - - - - - - -.. - - --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF LIGHT MARVIN K FILE NO. 21 94-0728 ACN 101 DATE 02-06-95
If an assessment was issued previouslY, lines 14, 15 and/or 16, 17 and 18 will
reflect figures that include the total of Abh returns assessed to date.
ASSESSMENT OF TAXI
IS. Aeuunt of Una 14 at SpoulOl rato USI ,00 M' 03,
16, Aeount of Una 14 tlxablo at Unaal/Clo.. A rato lib) 374.338.54 M ,06,
17, Aeount of Una 14 toxabla at Collalord/Clos. B rata U7l ,00 M ' 15,
18. Prlnolpd Tox Duo I1BI
TAX CREDITS I
PAYMENT
DATE
10-31-94
TAM RETURN WAS, I X I ACCEPTED AS fiLED
RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL
1. Raal Eltata ISchadula Al
2, Stockl and Bondi ISchadul. BI
3, Clolaly Hold Stock/Partnar,hlp Intaralt ISohadula CI
4. Hortslg../Not.. Racalvlbh ISohadllh 01
5, C..h/D.nk Dlpol! h/Hhc. Plrsond Proplrty I Sch.duh E)
6, Jointly OHnld Proparty ISchadule fl
7, Trlnlfarl ISchldul. G)
8. Total AI.atl
APPROVED DEDUCTIONS AND EXEMPTIONS I
9. Funerll Expln'I,/Adn. Costs/Hisc. Ex~.n"1 (Sch,dule HJ
10. Dlbtl/Hortglga Lllbllltla,/Llanl ISchadula II
11. Totll Daductlonl
12, Nat VIlua of Tax Raturn
13, Charltlbla/Govarn.antll Baqua.t, ISchadula JI
14, Not Valua of Eltata Subjact to TI'
NOTEI
RECEIPT
NUHBER
MM913144
.--
DISCOUNT (+1
IIlfEREST 1- 1
1.123,02
I CHANGED
III
121
131
141
IS)
161
171
.00
354,643.44
5.260,00
,00
24,025,27
.00
,00
181
383.928,71
q ,~qn 17
374.338,54
,00
374.338,54
,00
22.460,31
,00
22.460.31
22.460,31
.00
,00
,00
. If PAID AfTER DATE INDICATED. SEE REVERSE
fOR CALCULATION Of ADDITIDNAL INTEREST,
( If TDTAL DUE IS LESS THAN II. NO PAYHENT IS REQUIRED.
If TDTAL DUE IS REfLECTED AS ^ "CREDIT" ICRI. YOU HAY BE DUE
A REfUND, SEE REVERSE SIDE Of THIS fDRM fOR INSTRUCTIDNS,I
191_
llOI
9.590,17
.00
UIl
U21
1131
ll4)
AMOUNT PAID
21.3Ti-:-29
TOTAL TAX CREDI~-
BALANCE OF TAX ~
-- TIO~TAELR~;:E - ! -
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RESERVATION I f..tat.. of dleedlnh dylno on or before Dlc..ber III 1982 -- If IInv future lnt.rut In the .'tate II tran,f.rr,d
In po.....lon or .nJO'illlnt to Cia.. a (collat.tall bln,f1clarl.. of the dlc.dtnt after thl uplratlon of any ..,.te for
1111 or for yearl, the CO.llonwlalth hereby 411cprattly r...rv.. tht right to appr"lu llnd II..... trnn.far Inherltancl True..
at the lawful ChIli a (Clollaterat) rat. on any .uch lutu,. Int.rut.
PURPOSE OF
HOTlCEl To fulf111 tho rlqulruflnh of Slotlon 7.140 of thl Inh'rllllnCI and E'ht_ rrlle Act, Act 12 of 1991. 12 P,S,
Stctlon 2140.
PAV"ENTI
O'tach the top portion of thl. Hotlel and tub..lt with your pny~.nt to tht Rlgllter cf Will. printed on the rl....r.. tide,
"Make ehlek or lIonlY order pavable tal REOISTER OF HILLS, AGENT
All pay.ent, recalyed ,hall first be applied to any Intere.t whleh ~ay bl dUI with any rl.alnder a~plled to th, taK,
REFUND lCA11 A rlfund of a taK credit, whleh Will not requ..hd on thl Tax Return, ~fty bl rlqulltld by eo.pletlng an "Applloatlon
for AefJnd of PlnnsYlvanln Inh.rltonellllnd Eltnte TalC" (REY'BUI, Applleatlon, arl Ilvalltlbl. a' th.O"lee
of thl R.gI,ter of Willi, any of the 23 Revenu. Oll'rlct Offle.l. or by oalllno thl Ip~olal 24-hour
antwlrlng t,rvlol nu.b.r. for forlll ord.rlngl In P,nnsylvanla 1-800-362-Z0S0. out.ldl P'nnlylvanlll and
within 100111 Ilarrlrburg arall <7171 78'1-8094, TOO_ 17ln 772-2252 Olearlng Inpnlred Only),
OBJECTIONS I Any pllrty In Intlrelt not IIItllfl.d with th. npprah...nt, nllowance or dllllllowane, of d.ductlon., or a......'nt
of tax Clneludlng dl.count or Intlrlltl lI' Ihown on thlt Notlcn IIU.t objlct within .lxty (601 dny, of ruelpt of
this Notlc. bYl
..wrltten protut to the PA CIPar,,",nt of RevenuI, Board of AppealJ, DErT. 281021, tlarr!lburo. PA 17128-1021, OR
--ullctlon to havI thl lIIatter dotarllln,d I'It nudlt of the l'looount of thl Plrlonal r.prauntatlvl, Op.
--app.al to the Orphan,' Court.
AOHIH
I:iTAAUYE
CORRECTIONSl
Factual .rrcr. dltcoverld on thl. a'".'..nt thould hI addr"l8d In writIng tal PA D.partlll.nt of Alvlnue,
lIuroau of Individual Tallu, ATTN. POtt A....u.nt Hevlew Unit. DEPT, Z80601, lIarr!tburg, PA 17128.0601
Phone (7171 181-6S0S. S.. pagl 3 of thl hookl.t "Inltructlons for Inherltancl Ta~ Return for l'l Rllldant
Dleld,nt" (REY.ISOn for an explanation of ndllllnlttratlvllv eorrlctabll errOrl,
DISCOUNT I
If eny tall nu. h pnld withIn thrll OJ cbllndar .ontht nfter the dlcedlnt', duth, l'l flvl percent (S:O dhcount of
thl tax paid I. allow.d,
IHTERESTI
tnttr..t I, chargtd b.otnnlng with 'Irst dny of dlllnqulmlY, or nIne (9) IIIcnthl and on. (I) dllY 'rolll thl date 0'
duth, to thl datI of paYlllnt. TalCII which blea." dellnqulnt blfore January I, 1982 hear Intor..t at thl raU of
Ih (6iD p.rcent pllr nnnulI calculatld lit n tlnlh ratl of .000164, All h!lCU wldch bucanl d.lInquDnt on and after
January I, 1982 will bur Intorut at n rata which will vltry froll calendar Y'l'lr to clthndar yllllr with that rllte
announCld by thR PA DIPartllent of R.vonul. Th. nppllcnble Inttrlllt rateu for 1982 through 1995 arel
'!!!! Int.rut Rllte Dally Inhrllt Factor ~ Inttrllt Rnto DailY Inter...t Factor
I'IZ 20~ .OOO!i411 )'1/ 9% ,OQ0241
1'13 16~ .0004311 lf/lla-t991 11% ,000101
1'14 II>' ,000101 1~9l 9% .000?41
I.IS 13% .OO03~6 1'193'1994 7'1. .00019,
\'16 10>. .000274 1995 9~ .000247
--Int.rut I. calculat.d II' followll
INTEREST' BALANCE or TAX UNPAID X NU"BER or DAYS DELINQUENT X DAILY INTEREST rACTOR
-'Any Hotlct IlIued lI1ter thl tnlC blCOIllII dlllnqu,nt will refl.ct IIn Inter..t 'alevlatlnn to flftlln ll!i) day,
blyond thl dat~ of thl 1U10....nt. If payllflnt \_ IInd. niter thl Inter..t co.pvttltlon dati Ihown on th.
Notlc., additional Interut "Vlt hu calculated,
-,
.
STATUS REPORT UNDER RULE 6.12
Name of Decedentl
Date of Death:
I }t~{;v
g. ,':{ - (('-(
fii
Will No. ,qqtf - 00'1,',),!'"
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 sstate:
I. State whether administration of the estate is complete:
Yes v' No
2. I f the answer is No, stute when the personal
representative reasonably believes that the administration will be
completel
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes No v.
b. The separate Orphans' C"urt No, (if any) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest? 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.
,{;{J
I.c:., I::L
Signa
[11~abeL-h' ~X~(J~~JIQOldl,l/
Name (Please type or print)
If g.'i ( q m I1I~wf !fue
Address /iI: clUll1 H!_I. /11/1c~1 ,T'.ff. /r;I.)"):~ ,.
( 7/ '11 '7 H' OJ-/ liJ.
Tel, No,
Datel
(1)-'3/-7'"
'1
f--.
,
,
" .:J
()O
Capacity: v Personal Representative
(MAHlrmf/AM3)
Counsel for personal
representative
"
V
v'
.'