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HomeMy WebLinkAbout94-00778 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH 01' I~ENNSYLV ANIA COUNTY OF CUHlIERLANIl } 56 The petltloner(s) above-named swear(s) or afOrm(s) thai the statements In Ihe foregoing petition are true and corrcetto the best of the knowledge and belief of petltloner(s) and that as personal representatlve(s) of the above decedent pelltloner(s) will well and truly administer the estate according to law. -;;;- '1l' !; - to Q Vi Sworn to or afOrmed and subscribed ~ before me this 2ND.daY of ?: ""..~"'Cd' S~PT~BER '} 19' Li-- d . ' ,I. -Ilf'(/'~ .J.~/>L'II"I-/; J,' . MAR C. LE I S Register I No. 21-94- 778 ~ '. ! I I Deceased Estate of Harv R. Stambaugh L: ~>>NT OF LETTERS OF ADMINISTRATION AND NOW SEPTEMBER 13. 19~. In consideration of the petition on the reverse side hereof. satisfactory proof having been presented before me. IT IS DECREED that Glenn A. Stambau h Is/_ entitled 10 Lellers of Administration. and In accord with such finding. Letters of Administration are hereby granted to Glenn A. Stombaugh in the estate of Harv R. Stambaugh {!' \ {! , J.AjYm .CI:tv ~J:o Re,).t" of Will. . r 0 MARY C. LEWIS FEES Letters of Administration $ Short Certlficates(1'l ........ ., $ Renunciation ................ $ JCP $ TOTAL - $ Filed .., ?~.p.W~~.~~ ,).3.\.. A.D. Roger B. Irwin #06282 ATTORNEY (Sup. Ct. 1.0, No.1 60 West Pomfret Street ADDRESS Carlisle. PA 17013 I'HONE 270.00 n? 00 l; 00 317.00 19JL 717-249-2353 Called attorney on 9-13-94. 'I'hi~ i... III n:nif)" Ih,1I I Ill' illlUl'IlI.llillll hl'll' ,.;iYl'1l I'" lll!lully ,opu.d hum .Il1llli,cill.d u'nifil'.lIl' III dl,.lfl~ dill)' filc:d with me .I!I l.lll:.a1lh'g'\Ir.ar. The.-' oligill,t1ll'r1ililall' \\ ill hi' lorW;lhll.t1lll !Ill' Sl,lll' Vit,d Itt'tll"h (Hfill' 1111" Pl'l'IIUlIl'lIl II II IIg. WARNING: Ills 1I10galto duplicate this copy by photoslat or photograph. Fl'C lor thit, u'l'Iifk,IIt:. 52,00 _______.._t~fL5 '994 1>.1Il' li:...... ~,~eu-&-.-t"u-.\.V~LJ . "'_.___n ____._________.~ l.ollll11cl-:iMrUr 2420102 --..-----"------.----- No. "101.111,,",1111 COUMONWEALTH 0' PlHNIYLYAHIA . DEPAATMENT 0' HEALTH. VITAL RICORDS CERTIFICATE OF DEATH .... -, ... - ...,__e-.r.t lWI.orOlRtl,..,..o...~ 1269 . Au 4, 1994 ----.........-- ...0 ::::"'0 -......-.... lIhi te ........ ,,-...-- ,,,()C-._....- art etan .. I. Her .-- , - 98 "It- . Ji.1 Cumborland .Middleton Twp. .~ ....=:~"=".:=;:j Homemaker Own Homo OlttOl""'~ACION""'..~.""'hlc.. OIe(OI..'" 1171 Claremont Rd. ~~~ I Carlislo, Po 17013 ....::::::-- 'RMII..MAlltIl........LMIl ,,.......--P... '" .. - .... Cumberland --.' I,.D~"'="~.. WO'...Il.~..'.. ""-_~ arthe B Ii B .....'INO... ... _fI 1171 Cleremont Rd. Cerlisle 1 .-.-. Pe 17013 - u h .. . ...... AU9ust 6, 1994 ...-. 010343 L .~_. ... till'll loll ~........... ...0 .. ..~. .........._"......._.,t_..._-._...........,....... '" -- -- --- I Ii"t- '1~ ~ ...,. ...~::':\==.,"': I: ""(l......~~ l.j,o-J. <X;.-u.- "'" ,.,. ft'I:N~..'..OOOfG. ......_,IlOlDllOU'l -.."u.U,.,.,..kl COWf'l~lYeAUU ,_. \<S. "'''''''" -... - 0 ......- ..~ ...0 ~O ... 0 c:...llI..........--. CW'OIf""""'" -ee.,_. ,....01'"-"'" ~'IIIWQl11111' DlKM.t.ow...utfCXQ.llllillo. o o o ~1~1'lN'I""''''_''''''''''''''''-''''''' Y. ---......1Sc*tM * ..... CJ ,...CJ UXlONlSo'M.~ .. t'fe}f'''..... O"l'___WO - .~ "'"...." Q<<o -- .tI'"In"'IQ...,IJO..jIf~._._,,____..."'IC"_M_"""t__tJ1 ,.....-....,....-.............__..........01........._....'"'" ,. ... ...., .".,......, ... _._. .. .~IIIQ.IoOC..~...'1C'A.."".OC___.1_.....I-........_r1_1 ,...._.....,....-..,..IIl..t_........_._._......._.........._.I~.._...,.... 'Y'DIC"l'I"Y'H'AiCOIlOMr. OlltJloe...I....._.UIft._.......ll.II...........'''''''''',.'ItIlWI_'IIII.. ""1_. l1li"',1"''''''. .....l1li............."'.,.... ....._.......1...,.............. "...........,.......,.,..........._..........................""........ ., -:~~~~ 1aiJaL':lJ .. 21 - 94 - 778 (:-) ;:~- ci:: -.. t3".'. '~'Lf-' ~~l~g Du ;-1- d: - ~.. - ....." _. -" ~-------------------------------- RECEIVED FROM: I ACN ASSESSMENT r:w CONTROL 1;1 NUMBER AMOUNT IRWIN ROGER B ESQ 60 W POMFRET ST lul .! 1 ,"t;)/.ts:l CARLISLE PA 17013 'OtD Hili lOtD Hr., a EJ II B ESTATE INFORMATION, Me 21-1994-0778 T saN 170-38-1269 MI 5 UNTY REMARKS m TOTAL AMOUNT PAID 511 ,1,37. 8:5 fllt ~. "",wo" . ~, ..4 MARY' C. LEWI . REGISTER OF mLLS GLENN A. STAMBAUGH SEAL CHECKll '5750 REGISTER OF WILLS ..- ~- -- ---,---------,-,-:--.- -- - -- -----.--- -- --- - -r- ~ . ..' ~. . -.-._.----:-:.....--._.tI '" "'t~!" ...t...., I - , \ / LJ .. ;;':3, , ( h II INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS REV ~ \li00 EX. (l1-lTl) , CD"~F~:tMN \tOF PMIi'il'~r'NI' H'''RR,sR5J\t,~1~'2a.0601 I DECEDENT'S NAME (L.AST. FIRST ,AND MIDDLE INITIA.l) STAMBAUGH HARY SOCIAl. SECURITY NUMBER 170.38.1269 I X 1. Original Relurn ~ t 0 4. Limited Estele ~ 1 ~ 0 6. Decedent Died Testale l (Anech eopy 01 Will) 041. 07. L..- FOR O"'YESOF OEATti AFTER 1Z""" CHECK tiERE IF ASf>OUSAL 0 reVERT'( CREDIT 15 Cl.AlMED .' _ ., ;" > FILE NUMBER COUNTY CODE 21.94.778 '!'EAR DECEDENT'S COIr.lPLEl E ,lODRESS R 1171 CLAREMONT ROAD CARLISLE, PA 17013 CO" CUMERLAND NUMBER Futu,. Inteles1 Compromise (for deles 01 dealh aher 12.12.82) Deced.nt Maintained a Living Trust (Anach a copy 01 Trust) 3. Remainder A.lurn (for dlles 01 dealh prior 1012.13.82) o 6. Fed...1 Estale Tax Return Required o I, Total Number of SaIl Deposh Boxes R E C A P + U L T o N T ~ C o M C I T o N (6) (7) 24,908.00 NonD C P ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TOl;, .,',' o 0 NAME COMPLETEMAlLlHQADDRESS ~ ~ ROGER B. IRIIIN lRIIIN, MCKNIGHT & HUGHES 5 ~ IELEPHONE NU"OER 60 IIEST POHFRET STREET T 717.249.2353 CARLISLE PA 17013 1. Real Estale lSchedula A) (1) 120 , 000.00 2. Stocks and BondslSehedule B) (2) 65.336.29 3, Closely Hald StoekIPannarshlp Inlarest (Sehedule C) (3) None 4. Monglges Ind Notes Receivable (Schedule D) (4) None 5. Clsh, Bank Deposhs & Miscellaneous Personal Property (6) 10 ,538.92 (Schedule E) 6. Jointly Owned Property lSehedule F) 7. T,ansfers (Schedule G) lSehedule L) 8, Tolal Gross Assetsltolallines 1.7) 9. Funeral Expenses. Administrative Costs, Miscellaneous Expenses (Schedule H) 10. Debts, Mongage Llabilhles. Liens (Schedulell 11. TOla' Deductions !total lines 9 & 10) 12. Nel Value of Estalelllne 8 minus llna 11) 13. Charhable and Governmental BequestslSchedule J) 14. Net Value Sub eel to Tax (tIne 12 minus line 13) 15. Amount clline 141axable aI6". rale (Include values from Schedule K or Schedule 1.1.) 16. Amount 01 line 14 taxable at 15'/. ,alo (Include valuos from Schedulo K or Schedule M.) 17. Prlnelpa' tax duelAdd lax from line 15 and from line 16,) II.Cradlls/Sp Poverty Prior Paymenls Dlseount 0.00+ 0.00 + 603.04 19. II line 18 Is grealer then line 17. enlerlhe difference on line 19, This Is Ihe OVERPAYMENT. ~ 0 ICheck her. It you are reque.tlng. r.fund 0' your overPlyment.1 20. If line 17 is 9realo, than line 1 e, enler the difference on line 20. This Is the TAX DUE. A. Enler the Interest on the balance due on ~ne 20A. B. Enler the lotal ollino 20 and 20A on line 20B. This Is the BALANCE DUE. M_k" Check PI able to: Re Ister 0' Wills, A ent .. .. BE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 ANa TO RECHECK MATH ~ ~ nd.' penl '.'0 per Uf)'. dte .,.thlll Ive.... oed this Ilium, nt Udlng I,company ngac u ...nd Illllmenla,lnd 10 thl 10 my now ge. ie , I slrue, correel nd complele, deel.,. th.I.II re.l.sl.l. h.. been reporled It Irue IMr..t VlI~. Oecl.t'lIon of ptep'tel othet th'n the penot'lll r.p'...nl.U....'. baNd on IUlnfotmlllon of whIch pr.patat ha..ny knowladge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS (e) (9) 17,816.12 (10) 1,952.25 (11) (12) (13) (14) x .06: (16) 201,014.84 (16) 0.00 X.15: (17) Interest 0.00 (10) (19) (20) (20A) ( 208) (' ,," ,j". j) )7 " -u.~-t.-.-v :I /t:l.l..d_.l}......,.,.~v.-~ SIGNATURE OF PREPARER OTHER THAN nEPR~ TATlVE '/)/G ^ , 011..- I " 1 COPYl1llht(c) 1stl ,maollwlla only Canla' Piau Sollw.,a, Inc. GLENN A STAMBAUGH ii'ii' c'iliD-iofif .ROiiri............ ................. cARi.iS"LE" 'PA" 'i7oi'j --....... --.. ......... --...-- ADDRESS ROGER B IRIIIN IRIIIN, MCKNIGHT & HUGHES 60 'iiE!i'f' i>OMFRET' STREET........ ....... .... ...... CARLis.LE.' .PA" 'i7oi'j................... .... ...... "'.. 220.783.21 19.768.37 201.014.84 None 201 014.84 12,060.89 0.00 12,060.89 603.0/, 0.00 11,457.85 0.00 11,457.85 CATE 10-27-94 CATE 10-27-94 form 1500 (Rev, 11.11) REV - 1601 EX + (3..'1) SCHEDULE F JOINTLY-OWNED PROPERTY Co"'r..\l\lftW.<\\,~,WhY'N" ESTATE OF MARY R STAMBAUGH SS# 170-3B-1269 Jolnltlnlnlll); A. NAME GLENN A STAMBAUGH B, C. JolnUy-ownod proportyt 08/04/1994 ADDRESS 1171 CLAREMONT ROAD CARLISLE, PA 17013 FILE NUMBER 21-94-77B RELATIONSHIP TO DECEDENT SON ITEM LETTER DATE DECD'S DOLLAR VALUE OF FOR MADE DESCRIPTION OF PROPERTY TOTAL VALUE NUMBER JOINT OF ASSET % INT. ECEDENTINTEREST TENANT JOINT 1 A 12-08-58 CPS INTERNATIONAL . 768 38,688.00 50.00X 19,344.00 THRU SHARES HELD JOINTLY IIITH THE 04-24.92 DECEDENT AND HER SON GLENN A STAMBAUGH. FIRST PURCHASE IMADE 12-08-58 AND LAST PURCHASE MADE 04-24-92. DATE OF DEATH VALUE 50.3750 PER SHARE - 38.688.00 AT 1/2 VALUE - 19,344.00. 2 A 12.31-86 OMEGA FINANCIAL 428 SHARES 11,128.00 50.00X 5,564.00 THRU HELD JOINTLY IIITH THE 11.20-92 DECEDENT AND HER SON GLENN , STAMBAUGH. FIRST PURCHASE 12.31-86 LAST PURCHASE 11-20.92. DATE OF DEATH VALUE - 428 SHARES @ 26.00 - 11,128.00 AT 1/2 VALUE IS 5,564.00 TOTAL (Also Inlol on Ii.. 6, Reco.hulation) 24.908.00 " (U more space is needed, ms.rt additIOnal sheets of lame size.) Copyrlghl (e) '"' fDfm aoflw... ont)' C.nt.r PIec:. Sollw.r.,lnc. '''m 1500 ......... F (.... ..'..) SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES REV.lall EX' c....) . . co"r.m~~~,WhYAHI' ESTATE OF PJeIS. Print or T FILE NUMBER 21-94-778 MARY R STAM8AUGH ITEM NUMBER A. B. c. SS1 170-38-1269 08 04 1994 DESCRIPTION AMOUNT I Fun.ral Exp.nl.11 CARLISLE MEMORIAL SERVICE INC 81. 00 2 FUNERAL EXPENES - SECOND PRESBYTERIAN DISCRETIONARY FUND ($106.31) GRAVE 935.86 (see continuation schedule attached) Total of Continuation Schedule(s) 5,653.00 1. Admlnl.t'IUVO COltl' Personal Representative Commissions Social Socurlty Number of Po""nal RoprosonllUvo: 188 - 32 .4048 V.., Commissions paid _ 0.00 2. Attornoy Fo.. IRWIN. MCKNIGHT & HUGHES 10,077.67 3. Family EMOmption Claimant Address of Claimant al dlcedent's death Street Addr.ss City 0.00 Ralatlonship Stato Zip Codo 4. Probato F..s LETTERS OF ADMINISTRATION 317.00 1 2 Mlleolllnooul Exponlo.. ROGER B IRWIN - NOTARY FEE 12.00 225.00 PATRICIA A ROSENDALE, CPA - 1994 PA AND FEDERAL TAX PREPARATION FEE AND FIDUCIARY TAX PREPARATION FEE. 3 PIERSON K MILLER INC - REAL ESTATE APPRAISAL FEE PRUDENTIAL SECURITIES FEE FOR LIBERTY ALL STAR STOCK REDEMPTION 100.00 4 296.00 (sea continuation Rchedule attached) Total of Continuation Schedule(a) 118.59 TOTAL (Also .nl., on lin. 9. R,ca hutalion) (If mort spac. is nt.ded,lnsen additional she,lS 01 111M Slzl.) COP'l,llIhllc:} '191 fOfmlOllw.,. only C.nt.rPltc. Saflw.", Inc. I 17 816.12 Fonn 1500 Schod... H (...., 7.../ Estate of: MARY R STAMBAUGH SSn 170.38.1269 08/0~/199~ CONTINUA1'JON SCIlEOULE Continuation or Schodulo /l.A ITEM (J OESCRI PTION AMOUNT OPENING ($800.00) TELEPHONE CALLS ($15,05) STAMPS ($14.50) 3 HOFflolAN.ROTH roNERAL HOME, INC. . roNERAL EXPENSES 5,653.00 ................. 5,653.00 r j, !o, i' ! ; ---. ,.- I, ;1 I' I, , i, i: i I l' I i. ci , i' . ' i r; Estata of: MARY R STAMBAUGH ssg 170-38-1269 08/04/1994 CONTINUATION SCHEDULE Continuation of Schedule H-C ITEM g DESCRIPl'ION AMOUNT 5 PRUDENTIAL SECURITIES FEE 69.59 FOR TRAVELERS STOCK REDEMPl'ION 6 RECORDER OF DEEDS 24.00 7 REGISTER OF \/IllS - FILING 25.00 FEE ---..-.-..----- 118.59 &-Sul- t!-. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Mal)' R. Stambaul]h Date of Death: Au~st 4, 1994 No. 21-94-778 Pursuant to Rule 6. I 2 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 whether administration of the estate is complete: ..L Yes _ No 2. Ifthe answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. I is Yes. state the following: a. Did the personal representative file a final account with the Court? _ Yes ..L No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? ..L Yes _ No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphan's Court and may be attached to this report. Date: 1 1/09/95 //};[J '3 ~ Signalure ( _ IRWIN, McKNIGHT & HUGHES 'no ROller B, Irwin Name (please type or print) 60 West PomfTet Street or' Address '.~ I Carlisle, PA 17013 City, SUIte, Zip (717) 249-2353 Telephone Number " , J .. . ,~, ! ti' ~ j' u- I," Capacity: ':! x Personal Representative Counsel for Personal Representative CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Harv R. Stambaul\h Date of Death: AUl\ust 4 , 1994 Will No. Admin. No. 21-94-77!l To the Registera 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 following beneficiaries of the above-captioned estate on Name Glenn A. Stambaugh Address 1171 Claremont Road, Carlisle, PA 17013 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date:_'I'!s, fi( /"J~ ,.-'7.. --IJ " ,::7~/ J. c./~, Signatur~J Name Roger II. Irwin, Esquire Address 60 West Pomfret Street Carlisle, PA 17013 Telephone ( 717) 249-2353 u. Capacity: Personal Representative X Counsel for personal representative ,j(:i ::: -- EsUte ofl DUI of Death I County, IIIVDmlllY HARY R STAllliAUCI\ Autun '. 199t. CUHtRI.AND ..........~.~~..~~~~~~~.~...~~~~...~~~~~~~~~........................... Ca.hr 1 TIlt CIlURCH or COD HOHI:, INC. RJ:IlIND or OVERPAYKDn' 2 HERCHANTS AND bUSINESS M[N'S MUTUAL INSURANCE CllHPAh'l' POLICY . 00)7217014 C~IH . 00gJ,2743 DATE or LOSS 07.15.94, PAl'IlEHT IWlE AlTER DATE or DEA11l. 3 HELLoN BANK .CHECKING ACCT' 112 S62 5960 IN TIlt DECIJlEm"S NANE ALONE. DATE or DEA11l1lAU.NCE 4 HELLoII bANK . CH[C~ING ACCT . 112 1&2 5960 IIlTEREsr AS or DATE or DEA11l. 5 SOCIAL SECURI11' CIlEC~ roR JULY or 1994 Subtotal 6 7 Stocks/Ltaud: 600 aharea, AL1JXaOCNY PaVER '22.25 per abare 8 1213 ahar.a, LIBER11' ALL STAR . 10.4375 per .her. 5 aher.., PA INS. HUNI SER'64 . 947.IS per .her. S aharel, fA INS HUNI StR"l @ 673.30 per .hare 10 aher.., PA INS HUNI SER'31 . 171.92 per ahere 9 10 11 12 13 14 15 1000 .hor.., PENNSYLVANIA POWER AND L1ellT @ 21.81) per ahare 16 aharal, SOUTHtRH COMPANY' 19.50 per ab.r. 100 ahares, TRAVElLERS Pro . 26.50 per ahare 100 ahar.., UNISYS Pro . 3S per ab.r. $1200, BOND US~ . .9725 per ahere Subtotal R.ahy; 16 REAl. ESTATE LOCATIJl AT U.S. ROOfE 11 AND HARHONY HAll ROAD, CARLISLE, HIODLESI:X TOIINSHIP, CUHBERUJm Courm, PA. APPAISED VALUE AS or DATE or DEA11l. 17 REm'. TOR TIlt HOI/J1I OT AUC1J5T Subtotal Total Jnventory 2,364.05 1.464 .02 5,021.62 5.21 412.00 9,33B.92 11.350.00 12,660.69 4,735.90 3,366.50 1.719.20 21,175.00 312.00 2,650.00 3,500.00 1,167.00 .............. 65,336.29 120,000.00 1,200.00 .............. 121,200.00 195,S75.21 I ,REV-1547 EX AFP (08-94 * ~ COHHOHWEAlTH OF PENNSVlVANIA . DEPARlHEHT OF REVENUE BUREAU OF INDIYIDUAl TAMES DEPT. zaD6Dl HARRISBURG, PA I7Ua-0601 / /1 ) ),,1. 11 ACN 101 NOTICE OF INNERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE 01-24-95 ESTATE OF FILE NO. DATE OF DEATH 08-24-94 COUNTY CUMBERLAND NOTE. TD INSURE PROPER CREDIT TO YDUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS FORM WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS. MAKE CHECK PAYABLE TO "REGISTER OF WILLS, AGENT" REMIT PAYMENT TO: ROGER B IRWIN IRWIN ETAL 60 W POMFRET ST CARLISLE PA 17013 REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLIS~.{)>A 17013 :0 :J ct' $ :0 m Allount R.nut.d. ,', -/ G ~ l, N .-- P~_l_~~P_~~_I_~!~__~!~~_______~____~_~!~}_~_~P_~~~_~~~I_~~~_J:~~__~~~~__~~P_~~~.___~_~_____;__~~_________ REV-1547 EX AFP (08-94) NOTICE OF INHERITANCE TAX APPRAISEMENT, AL~OWANCEoPR _-', DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX _ ,;.., ESTATE OF STAMBAUGH MARY R FILE NO. 21 94-0778 ACK;\?~OI ,", DA'11P 01-24-95 -J TAX RETURN WAS I (X I ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL 1. R..I est.t. (Schedule A) (1) 2. Stocks and Bonds (Schedul. 81 (21 3. Clos.ly Held Stock/P.~tn.~.hlp Int.rast (Sch.dul. C) IS) 4. Hartg.g.s/Not.. Raceiyabl. (Schedule OJ (4) 5. Cash/Sank Deposits/Hllc. Parlonal Property (Schedul. E) IS) 6. Jointly Owned Property (Schedule f) (6) 7. Transfars (Schedule GJ (7) 8. Total A...t. APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Fun.ral Exp.n.../AdM. Co.t./Hi.c. Exp.n... ISch.dul. HI 191 10. Dabt./Hortgag. Liabiliti../Li.n. CSchadul. II 1101 11. Total Deduction. 12. N.t Value of Tax Raturn 13. Charitable/GovarnMantal aeque.t. ISchadule JI 14. Net Value of E.t.t. Subjact to Tax I~ an assessment was issued previously, lines re~lect figures that include the total of ahh ASSESSMENT OF TAX: 15. AMount of Line 14 at Spou..l 16. AMount of Lin. 14 taxabl. .t 17. AMount of Line 14 t.xabl. .t 18. Principal Tax Du. CHANGED 120.000,00 65.336,29 ,00 ,00 10.538,92 24.908,00 ,00 181 220,783.21 17.816.12 1.952.25 (111 1121 1151 1141 lQ.76R 37 201,014.84 .00 201,014.84 NOTE: 14, 15 and/or 16, 17 and 18 will returns assessed to date. rat. Lina.l/Cla.. A rat. Collat.ral/Cla.. a rat. I1S1 11&1 1171 TAX CREDITS: PAYHENT DATE 10-26-94 RECEIPT NUMSER MM913115 DISCOUNT It J INTEREST (-J 603.04 .00 X .03_ 201,014.84 X .06_ ,DO X .15_ 1181 .00 12.060.89 .00 12,060.89 AMOUNT PAID 11,457.85 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST TOTAL DUE . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 12,060.89 .00 .00 .00 I IF TOTAL DUE IS LESS THAN .1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU MAY SE DUE A REFUND. SEE REVF.RSE SlOE OF THIS FORM FOR INSTRUCTIONS.J RESERVATIONI E.t.t.. 0' d.c.d.nt. dying on o~ b.for. D.c.ab.~ 12, 1912 -- I' any future Int.r..t In the ..t.t. I. tran.f.rr.d In po.....lon or enJoy.ent to CI... I (collat.ral) ben,'lcl.~I.. 0' the d.c.dant .'t.r the ..plratlon of any ..tet. 'or Ilf. or for y.er.. 'he Co..onw.e)'h h.r.by ..pr...ly r...rv.. 'ha rlaht to appr.I.. and ...... tran.f.r Inherltanc. T.... .t the I.wful CI... I (collet.ral) r.t. on any .uch future Int.r..t. PURPOSE or HOTICEI To ful,11I tha raqulra.ant. of S.ctlon 21~0 0' the Inh.rltanc. and E.tata Ta. Act, Act 22 0' 1991. 12 P.S. S.ctlon 21'0, D.t.ch tha top portion 0' thl. Notlca and .ub_lt with your pay.ant to tha R.gl.tar 0' Will, prlnt.d on the r.v.r.. .Id., ""ak. ch.ck or .on.y order plyabl. tOI REGISTER OF MILLS, AGENT All ply..nt. r.c.lv.d .hall flr.t b. appll.d to any Int.r..t which ..y b. due with any r...lnd.r appllad to the t... REFUND lCR)1 A r.fund 0' at.. cr.dlt. which wa. not r.qua.t.d on the Ta. Raturn, ..y b. r.qu..tad by co~latlng an ~APpllc.tlon for R,'und 0' P'nn.ylvanla Inh.rltanc. and E.tat. Ta.~ (REV-I!l!). Application. .r. avallabl. at the O',lc. 0' the R.gl.t.r 0' Will., any of tha 25 Rav.nu. DI.trlct Of'lc.., or by calling the .p.cla. Z"-hour an.w.rlng ..rvlc. ~ar. 'or for.. ord.rlngl In P.nn.ylvanla 1-laO-56Z-ZaSO, out.ld. P.nn.ylvanla and within local Harrl.burg ar.a (111) 111-109', TOO' 11111 llZ-ZZS2 (~.arlng I.p.lr.d Dnlyl, PAYHEHTI OIJECTIONSI Any party In Int,r..t not .atl.fl.d with the ~ppral"e'nt, allowanc. or dl.allowanc. 0' d.ductlon., or ........nt 0' ta. I IncludIng dl.count or Intara.tl a. .hown on thl. Notlc. .u.t obJ.ct within II.ty (601 day. of r.calpt of this Notlc. bYI "-written protnt to the PA D.p.rt.ant of Rlvanu., loard of App.als, DEPT, U10ZI, tlarrhburg, PA 11128-IOZI, OR --.Iactl~n to hava the ,att.r d.t.r.ln.d at audit of the account of the p.r.onal rapr'..nt,tlv., OR --.pp..1 to the Orphan.' Court. AOKI" ISTRAlIVE CORRECTIONSI F.ctu.1 .rror. dl.cov.r.d on thl. ........nt .hould b. .~dr....d In writing tOI PA D.p.rt..nt of R.v.nu., Bur..u of Indlvldu.1 T...., ATTNI Po.t A.......nt R.vl.w Unit, DEPT. Za06al, H.rrl.burg, PA 111Z.-0601 Phon. (117) 7.7-6505, 5.. p.g. 5 of the bookl.t ~In.tructlon' for Inh.rltanca T.. R.turn for. R..ld.nt D.c.d.nt" CREY-1501) for an ..plan.tlon of ad.lnlltratlv.ly corr.ctabl. .rror., DISCOUNT I If any t.. due I. paid withIn thr'l (5) cal.ndar .onth. .ft.r the d.c.d,nt'l d..th. a flv. parc.nt C5~) dl.count of the t.. p.ld I. allow.d, INTEAEST I Int.ra.t II chlrg.d bIg Inning with 'Ir.t d.y of d.llnqu.ncy, or nlna (9) .onth. and on. II) d.y 'ral the d.t. of d..th, to the d.t. of pl~..nt. T.... which b.c... d.llnqu.nt b.for. J.nu.ry 1. 1'8Z ba.r Int.r..t .t the r.t. of al. C'~) p.rc.nt p.r .nnu. c.lcul.t.d .t . d.lly r.t. of .000164. All t.... which b.c..a d.llnqu.nt on .nd .ft.r Janu.ry I. 1'.2 will b..r Int.r..t .t . rat. which will v.ry fro. cel.nd.r y..r ta c.l.nd.r y..r with th.t rat. announcld by the PA Dap.rt.ant 0' R.v.nu., Th. appllCabl. Int.r..t rat.. for I'IZ through 1'95 .r'l !!!! Inter..t A.t. D.lly Int.r..t f.ctor !!!! Inter..t Rete D.lly Inter..t factor 1911 ZOX ,OODS'" 1917 'X ,oaoZ'7 1915 16;( .OOOU. 1911-1991 IU .000501 191' llX .00OSGl 1992 'X ,OOOZ" 1915 I5X ,OOOS56 1995-199'" 7X ,aaaln 1916 1D~ .00021' ~99S 'X ,OOOZIt1 --Intarnt II c.lcul.t.d .. followu INTEREST . SALANCE OF TAX UNPAID X NUnSER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Hotlc. I..ued aftlr the t.. b.cue.. d.llnquent will r.fl.ct an Int.r..t c.lculatlon to 'I't..n CI51 d.y. b.yond the d.t. of the ........nt. I' pay.ant I. ..d. aft.r the Int.r..t coeput.tlon d.t. .hown on the Hotlc.. addltlon.1 Int.r..t lU.t be c'lcul.tad. ~. _.. ..- '''.' --, -- . . " - _._- .-- - -_.~-- -.-- ~ .-.- "---~.. -. .._- --- ~"-- --. --'- .._~-- .-..,. '--- ---~-- -.-- -'"- -.-." ~~ ,.- -_.-. ,._._~- ~.~- .-.+'- D NO. AA ,-.' .: \-: :'. :'- '(',- ~;.';,A!_ '<,-t., :i~_tf:M n;-'J;'-~ttlr"ft":~:::1i~-)t;'L~;;i ~-.:y: ;:::::-:::Y::c:' ';_':\~:, -;,:..'- /_,::_ ',"_,'; ;';~: "__' '_";:',:':' . ~'_:".:'~, 14654 7::'Co,~9~WEALT':tOFPEN~SVL~ANIA. ,.' .. .' .,.... >;; . ....~~DI'ARTMI'"O'I!IV.NU. .:. .. .... . . '. OFFicIALRlcliPT.' PINNSYLVANIAINHERITANCIAND ISTATITAX .......6.................. . ........ '.:' .. . '--' ,,'~.- " 'U'ltIl62 IX '~'J RECEIVED FROM, ACN ASSESSMENT 'l' CONTROL ~ NUMBER AMOUNT & SMITH & SMITH PC 101 .10,81:5.19 12~ N MAIN STREET MOSCOW, PA 18444 ESTATE INfORMATION. ~ fltE NUMBER iii 21- J 994-0878 ~ NAME Of DECEDENT (lAST) 1;,1 MERVA MARY M II DATE Of PAYMENT m POSTMARK DATE '" COUNTY 'O<<OHII, SSN 179-07-2275 (fiRST) (Mil CUMBERLAND DATE Of OEATH REMARKS m TOTAL AMOUNT PAID \, ',j, . ".- RECEIVED BY / /. !~ I \" , ~1 SIONAJURf t / "10,015.19 00 SEAL PAULINE A MARTIN C/O SMITH & SMITH PC CHEC/(1I 115 ....,,' REGISTER OF WILLS MARV C. LEWIS REGISTER OF WILLS ','1 _c. -- - - - - __ __ __ __ _ _. __.. _.,-. -. . --- -. - '.. ---- ._, --. .-- --- -- ,-- - .--- r-' .. , -... .......-.......,-- , . -,.~ _ '---'~'..-""""-4.~ 4."~1:-'. ..:.,.:.. \ ,