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PETnIO~ Fon PIWIIATE 111111 (;JtA~T OF LETTEns
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OATil OF PEnSONAL nEPlmSENTATIVE
COMMONWEALTH OF I'ENNSYI.\' ANIA l HH
COllNTY OF CU':ll""\Ll lID. J
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The pl'lili\llll't(\} ahu\'(....n~ll11crJ \\h'ar(~) or arnrm(\) thai the Ma1CmCnIS ill the foregoing pClitlon me
truc nlld ~urrl''':llo the he", tlllhe I\no\\'lcdgc and helief of pl'litilllll'r(s) Ul1lllhul us personul rCJ'lrcscna
lalin,'(,,)nf the aho\c dl't:cdcllt Pl'liliorlt."(\) will well illld truly mlminislf..'r the c\la1c according to Inw.
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COIlMOIlWEALTH OF PENNSYLVANIA. OEPARTMENT OF HEALTI!' VITAL nECORDS
CERTIFICATE OF DEATH
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LAST WIf,L AND TESTAt'1ENT 01-' l~LOHENCE N. HIDER
I, FLORENCE N. mDER, of the 'l'olmohip of Silver Spring, County
of Cumberland and State of Pennsylvwlia, being of sO\ll1d und disposing
mind, memory and Itnderotonding, Lio multe, publish and deolore this
my last Will und Testament.
1.
I direct the paymont of all my juot debts und runerul expenses
as soon after my decease as tho same can be conveniently done.
2.
All the rest, residue and remainder of my estute, real, personal
and mixed and wheresoever situate, I give, devise and bequeath \ll1to
my dear husband, David T. Bider, absolutely and un'conditionally.
3.
In the event that my said husband should predecease me, or should
he die at about the same time as I no, such as in an accident common to
both of us, then in such event, I give, devise and bequesth my entire
estate, real, personal and mixed, to my two daughters, Charlotte E.
Towsen and Janet Louise \~agner, shal'e and share alike.
In the event that my s uid husband should so predeoeaoe me, then
for the purpose of faoll:l.tRting the settlement of my estate, I hereby
authorizo and ernpower my Exeoutrices, hONlinaft'H' named, to sell any
and all reul eo ta te whioh I may own a t the time of my decoaoe, at either
publl c or pri va to salo or sole s and to oonvey the surne to tho purchaser
or purchasers thereof by good and suffioient deed or deeds in fee slmple.
LASTLY, I nominate, consti tute and appoin t my husband, David T.
Rider, Executor of thia my last Will 1U10 '.l'estament, and in tho event that
my tIBid husband should predecease me, then in such event, I nominate,
consti tute and appoint my daughters, Chnrlotte E. TOl-lson ann Janet Louise
Wagner, or the survivor of suid two, Executrices of this my last Will
and To s tornan t.
IN 1-lI'l'NESS WHEliEOF, I have hereunto set my hand and seal this 7fh
day of TIA Lr ' A. D. 1961.
7~ & CJ11, 02.~__(SEAL
Florenco M. Rider
.~\. ,
Signod, soaled, published and declared by th~'above named, Florence
M. Rider, as and for her last Will and Testlltmnt, in the presence of us,
who have subscribed our names hereto as witnesscs, at thn request of said
testatrix, in her presence and in the presence of each other.
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COMMONWEALIH Of f'(tm~'flVAUI^
Of PARIMf NT Of Nf \lWUf
OfPt 280001
.IU,_RAI~&UIlG. PA 1111,B,ll0J1
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
fOR DATlSOf DEATH Ann 12/31/91 CHECK HERE
If A SPOUSAL.
POVERTY CREDIT 15 CLAIMED I ]
FiLiNuMiiEIl-2]:9h':'7ri~ ------
COUNTY CO.OE .1')94 YEAR 0079? NUMBt.R
OI(IDIHI~ NAMlll"'~1 flJl~l, AND MIUOH Illll'Alj (HOOINI ~ (OMf'lllf "'OOIl(~~
!lIDER Plol'onco H. 43 Toxnco Rond ,
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pq I. Original Return I 1 2 Supplemontol Return fJ 3. Rllmaindttr Return
. -- (for dale' of dealh prior to '2.1 3-B2)
[] 4. LImited hlale ! ) 40. fuluro Intere,I Compromise D 5. federal Ellole To. Relurn Required
I'or dole I of dealh oher 12-12.B2)
lxJ 6. Dondenl Died Tellale ['J 7. Detedent Moinlained a living Trull .l.- B. Tolal Number of Sole Depolit Boul
(Attach copy 0' Will) (AlIoch copy of Trull)
ALL CORRESPONDENCE AND CONFfDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO.
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J. RObOl't Stnuffor, Atty.
THEPHo,n '.VMBIII --.---
L717.1...7_6_(,~.9f)_73.._==c.~~===7
20. If line 19 i, greater Ihon line lB, entor Iho dilferonce on LInD 20. Thlllltho OVERPAYMENT.
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21. If Lino IB II groalor Ihan line 19, enler Iho differ once on lIno 21. Thil Illhe TAX DUE,
A. Enler the interell on the balonce duo on line 21 A.
B. Enler the 10101 of line 21 and 21A on line 21B. Thh illhe BALANCE DUE.
Molee Chulc Poyabl. 101 R.gls'.r of Wills, Ag.nt
>- >- BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH ..c:..c:
Under penaltiel o~ perjury, I do clore thai I hove eltomlned Ihi, rolurn, including a((ompanring "hodulel and Ilatemon", and to Iho bent of my knowledgo and belief,
il illrue, correcl and complele. I dedare Ihol all rool 011010 hal been ruporled 01 Iruo morkot Italuo. Declarolion of preparer olher Ihon Ihe petlonal reprelentoHlte i,
baled on 011 informal ion 01 which preporer ho, any knowledge.
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1. Real E'lote (Schodule Al
2, Sloth and Bond, (Schedule B)
3. CIOiOI)' Held Slock/Partnenhip Inlere,1 (Schedule q
4. Morlgoge' afld Nolel Recalvoble ISthedule 0)
5. COlh, Bonk Oepo,ih & MilCollaneoul Pemanel Properly
(S<hodulo E)
6. Joinlly Owned Properly (Schedule Fl
7. TronlfetllSchodulo 01 (Schedule L)
8. Tolal Gran Aue" (10101 L1no' 1-7)
9. funeral EKpen,el, Adminhlrolive COlli, Milcel1aneoul
EKpen,e, (Schedule H)
10. Deb", Morlgage liabilities, lIo", (Schedule I)
II. Tolol Deductionl 110101 Linel 9 & 101
12. Not Value of E'lalo lLine B minUlline 1 ')
13. Charilabl., and Governmental Bequellt (Schedule JI
14. Nel Value Sublecllo Toll. (line 12 minus line 13)
15. SpoulOJ Tran,lotl (for dolo, of deolh after 6.30.94)
See lnllruction, 'or Ar,pllcoblo Percentage on Ro...~no (IS)
Side, (Include Itoluel rom Schodule K or Schodulo M,l
16. Amounl of lIno I A IOltablo 01 6% rolo
(Include Itoluo, Irom Schedulo K or Schedule M.)
17. Amount 01 line 14 IOltoblo 01 15% role
(Include valuo, from Schodule K or Schedule M.)
lB. Prindpollolt due (Add IOIt from line I 15, 16 and 17,)
19. C'edill Spoulol Poltorly Credil Prior Palmenh
__. 0.00 + 12LQ.y0.00+
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(10)______._____(,-21....].3.
(B 1
149..~3......?8
__..JJ.b 8y,0. 9y,_
__~__306 1986. .311:.
0.00
-306.. 986....3!1:.
(11)
(121
(131
(141
(161
...._.___...._.. _...._ u. 0...0.0.., ...._..=
306J.9JI.6.3l~. .06 a
..._0.o.~'15 a
O.QQ
...~g.L4~.2~~~.
.____ __Ou..()-0..
18 ,LI.l9 .18
12,600.00
-.-------
OLOO
____.._ _____2.!J:l19-'1...~
o 00
..-......-.-----......---.L.a
.._._____............5.JJ~J_9_._L
(171
(IB)
Di"ounl
600.00
Inlo'.2.11
u.OO
(19)
(20)
Choclc horo If you or. roquestlng a rofund of your ovorpoymont.
(21)
121AI
121BI
Act #48 of 1994 p.ovldes for Ihe reduction 01 Ihe lax role. Impaled on Ihe not value of Irandorl to or for
the ule of Ihe .pou.e. Tho role. a. pre.crlbed by Iho .Ialulo will bel
e 3% (.oa) will be applicable lor ellale. of decedonll dying on or after 711/94 and belore 1/1/96
. 2% (.02) will be applicable lor ollale. of decode nil dying on or ofler 1/1/96 and beforo 1/1/97
. 1% (.01) will be applicable for e.lole. of decedenll dying on or after 1/1/97 and before 1/1/98
e Spllu..1 trandllrl occurring on or after 1/1/98 will be exompl Irom Inherlta"co lax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK (.....) IN THE APPROPRIATE BLOCKS.
1. Old decedent make a tronsler and:
a, retain the use or Income 01 fhe praperty translerred, ..,....,..............................,......,......,..
b. retain the right to designate who shall use Ihe properfy tronslerred or its income, ..,........,...
c, refoin 0 reversionary interest; ar ,......,..............,..............,......................................,......
d, receive the promise lor lIIe al either paymentl, beneFIts or care' ,......,..,..,.....................,..,
2, II death occurred on or belore December 12. 1982, did decedent within Iwo years preceding
death transler property without receiving adequate cansideration' II death occurred oher
December 12, 1982, did decedenl fransler property within one year al death without receiving
adequafe consideration' ",.." ....','.."",....",.."".."."".."""."""""""""""""...."",.... '..,.,'.
YES NO
J/
3, Old decedent own an 'In trust lor' bank account at his ar 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.
,,--,
11_
,_.
")
_tv.1S03 III ~ 1'101
-t~~
COMMOt4....f"~ftt 0' "twaI\V"NIA
It"jfItIUH~f tu -1'~-t4
;:. ___ _ ~ lU1PW OIClC" .~~
ISIATE OF
I SCHEDULE B I
i STOCKS AND BONDS
"~~-;:'~;'="-~.:'::;';.~.-;~.":::.---.~~r.=__ _.- -- ~
FilE NUMBER" 2l-9J~':79!>
1991,-0079!>
FLORENCE II. HIDliJl
!~ii P'O~!'ty !.!!~!:~~ wli!~~!~i');fVI~!;.-hi;-;~~~i'}!.!~!~i~!.!!'-~~).~~~.~~!.!!.:L=___.___:-_=- _
IIEM
NUMBtR
DESCRIPTION
VALUE AT DATE
OF DEATH
1.
ll~l uhm'eo of pl'oferrod 0 took of Cumbol'land Valley
Co-opel'n~lvo Anooclaplon, ut ~;10.00 pOl' ahnre.
,
$ 1,410.00
iJ
S
1,t 10.00
TOTAL (Also onlor on line 2. Reeo itulotion
(" mort IpUCfI il Ileedod. imo" ode/itionallh..ls of lame siu.)
'.
1I\"l~09I.. III It,
_9.,~,"
'C:t{f!~
COMMONWtAUII Of PENHSYIVANIA
INHUIIAUCf TAX RffURN
RUIDfNTO[CrO[NT ___~_..'_ ___
.--------..----- -~-.------- .-.-+...-..-----....---.~-. -.----~-..,--.'".., =-- - -;;1'-
ESTATE OF IrnfNuMDER 21-91j.-7')5
_______. FLOHlmC1~ !_~~~IDlm _________ 1- 19%-QQTI!.l_
SCHEDULE F
JOINTLY.OWNED PROPERTY
Joint lananl(')1
NAME
--.--
A, CHARLOTTE E. mmn
,....~.-_._..~ ... .-- .---.-.-.--------"...
ADDRESS
-RELATIOr.isHIPTO DECEDENr'-'
9~6 Wont Trindlo Rand
J.!oohnniollburB, l'A 17055
Daughter
0,
c.
Jolntlv..ownld propertVI
ITEM LmER DATE
FOR TOTAL VALUE DECD'S DOLLAR VALUE OF
NUMDi:I JOINT MADE DESCRIPTION OF PROPERTY OF ASSET %fNT. DECEDENT'S INTEREST
TENANT JOfNT
--- -
1. A. 10/24/ PNO Bnnk, N. A., Oortii'i-
1989. ante of Deposit No. 0413- 5~ $
2701336~2. 1,468.02 734.01
2. A. 3/5/ PUC Bnnk, N. A., Oertifi-
1991. onte of Deposit No. 01~13- 5~
200165~,23 . 10,OOI~.~4 5,002.22
3. A. 1~/12/ PNC Bank, 11. A., Certii'i-
1991 onte of Deposit No. 0413- 5~
2001p661~5 . 10,030.00 5,015.00
I~. A 5/15/ PlIC Bnnk, N. A., Certifi-
1992 ante of Deposit !lo. 01~13- 5Oj~
200176438. 1~0, 107.73 20,053.87
TOTAL (AI.o enter on line 6, Recopltulallonl 5 30,805.10
(If mOlO spOCO ;s needod ;nso,' adeli/jano' shool. of lome silO)
" of ,\ II I. I '~"I
SCHEDULE H
,,~.i;~(\ FUNERAL EXPENSES,
COMM""WIA;;' O~"""YlV.IlI. ADMINISTRATIVE COSTS AND
""j:~:~\!~W~I~H~'" MISCELLANEOUS EXPENSES Plaa.a Print or Typo
~~~~I:_OF'=: __.!'~~~~:'1~9_1' H :.I~~~J~~~___n_~____~ -___-. ~-~=TlmmMB~R ~~9~~o6~~5
ITEM
NUMBER
-_._---- -_._--_._--~--_.._._-_.-~-.-_.__.._.__._---_..-
DESCRIPTION
AMOUNT
1.
A. Funeral Expensesl
~.
Hyoru Funoral lIomo, Inc., 37 E. Hain st., Hechanios-
bUl'S, Pa., funoral oxponDOD. It>
'l'rindlo SprInGD Lutheran Church, funol'lll lunohoon.
B. Admlnl,'ratlve Cas'" (Ilono)
I. Personal Reprelentative Com minions
Social Sacurily Numbar of Parlonal Rapra.anlallva,
Vaar Camml..ian. paid ______
2,
3.
4,
C.
1.
2.
3,
4,
5,
6,
7,
8,
Allornay Foo. J. Robort Stauffer, Eoq., attol'noyl D foe.
Family Exomplian
Claim anI _
Addro.. of Clalmanl al docodonl'. doalh
SIrool Addra..
Cily _______
Rolallan.hlp
51010
Zip Cado
Prabalo Foo. - Regis tel' of Hills of Cumberland County,
Ponnsylvania, Lottero Tostamentary.
Mlscallanoous ExpoRlel'
U. S. Pooclll Depal'tment, pootago.
SallunonD frv Cable, telovioion cable l'en1;al duo.
York Haate Disposal, Inc., dumpster rental.
Johnson ImaGine, Inc., copies of roal eotato plot
plan.
\'lillitlln I~err, roimbw'oomont for tolephono charges
incurred in preparing for funoral, otc..
Cumberland Lali Journal, Extato 110tice.
Exxon, Inc., balance due on oredit card account.
Penna. POlier & Light Co., Septembor 1994 eleotrio.
5,051.00
75.00
8,750.00
290.00
29.00
0.25
50.00
3.60
23.92
40.00
86.73
54.06
S Carried Forw
TOTAL (AI.o onlor on lino 9, Rocapilulalionl
(II moro space Is noodad, Insar' additional .hooll of same sin.)
PAGE - 1
~.~.Q SCHEDULE It
".IM,'" fUNERAL EXPENSES,
<o'.II,'o"w,:~;, ~;';''''':''I'^'''' ADMINISTRATIVE COSTS AND
"'''''''^"':< lA, ""'''' MISCELl.ANEOUS EXPENSES 1'100.0 P,lnl or Tyro
o __...... _ _..~~'.~~I_I!~II!(-'.~~!!__'~!_.._ -- ..-
i:!.\^i~ oj,..-...........-----n.. ........ ." n ..' .-........ .....-......'."-lrilE nUl.'iilE"F~21=-94=79r~"''''~
PLOnJmCJ~ 1.1. llIDEH 19%-0..Q12~
~ ~_~~[;'I~~~_="_~=~=-~~:=.~-~~~~::,'-~..,U~~_~.R~~~~~!~~~~-.."'..-:~.-:-~_~~=~~~~:I.. ~MOUN;-
9. Bell Atlantic, Soptalllbol' 1991~ telephone. $ 59.23
10. Dale Kaopel', Soptembor 1994 lawn caro. 30.00
11. Yor1t Haste Dispo:lal, Ino., refuse collection
to Hovember 1991~.
Bell Atlantic, Octobol' 1991~ telephone.
Penna. Power & Light Co., Ootober 1994 e1eotrio.
Dale !Casper, Ootober 1994 lawn oare.
Looter W. Erb, Inc., heatinB fuel.
Hartman & AS:looiates, Ino., ourvoying roal
eotato and proparing plot plana.
Stovon 1,01. BU1'rott Renl Estate, Carlislo, Pa.,
appraioing roal estate.
The Sentinel, Estate Notico.
York \~aste Disposal, Ino., dumps tor rontal and
disposal of traoh, refuse,ete..
Old Guard Imlul'unce, fire insurance and extendod
coverago on real ostate (dwolling, barn und
outbuildinGs)
Laster H. Erb, Inc., heating fual.
Penna. Power & Light Co., Novomber 1991~ eloctric.
'rorminix, Inc., tOI'mi to inspoction and treatment
at dwolling at 1~3 'fexaoo Road, Hechaniosburg, Pa.
Old Guard Insurunce, additional premium on firo
and extended coverage insurance.
Old Guard Insurance, premi\tm for liability, eto.,
due to fact premises at 1~3 Texaoo Road, Mechanics-
burg, Pa., is vacant and not inhabited.
Penna. PO\{el' t: Ilight Co., Decembor 1991~ oleotrio.
rec1:' s Soptio Sorvica, pumping septio tank at 43
'foxaoo Road, Hochanicsburg, Pa.
I,ostor vI. El'b, Inc., hoatinG fuel.
Penna. ]'0\'101' & 14ight Co., January 1995 electl'io.
York \'Iaste Dinposal, Inc., final char130 for
dWllpster and hauling tl'aah.
Ponna. Powor f.: Light Co., l"obruary 1995 e10ctl'ic.
Leotor \'I. Erb, Inc., hoating fuol.
J[ f,,; R Block, Inc., preparing 1994 Incomo Tax Roturns.
Penna. 1'01'101' e" 14ight Co., ].larch 1995 olectl'io.
IJooter \'1. Erb, Inc., heating fuol.
Eric Nuce, lUHn oare for April 1995.
Debra Basohoro Wieot, Tax Collector, 1995 County and
To~rnship Taxes.
Ponne.. Powor e.: Light Co., April 1995 olectric.
Eric Naco, lawn caro for Hay 1995.
JUcholbergors, Inc., \mtor teot at 43 Toxaco Road,
Hechaniosburg, l'n.
\Hlliam Korr, I'eimbul'soment for Pedoral Expross
charGes and photo copioo.
_II It II 11' l~ I 'j
12.
1;3.
14,.
15.
16.
17.
113.
19.
20.
21.
22.
23.
21~,
25.
26.
27.
20.
29.
30.
31.
32.
33.
31,..
35.
36.
37.
38.
39.
40.
4,1.
35.04
22.tJ4
36.B9
25.00
33.18
1,975.00
350.00
72.20
296.93
441.00
41.87
3/3.28
887.22
36.00
119.00
34.71
I~ 7/3 ./33
118.40
31.51
230.00
33 .1~8
93.79
69.00
27./38
89.31
40.00
189.55
29.70
9,5.00
19.00
13.71
Carriod ForwaI
PAGE - 2
rh'''III', '/.'1
"
,,9,:61~'~-
-.;E~
. Oll..,n'INIAI!l1 or "llInH~AUIA
IW.UUAHClIAI,.tUI"
. __H_" _ _ u_ _._,.,!~I!4.I_~_I~I~_I~I.m_ .
[STAIr; or--
SCHEDULE J
BENEFICIARIES
FILE NUMBER
21-91~-795
1 '.24=007.95__
AMOUNT OR
SHARE OF ESTATE
j?LOnBllCE 11. IUDlm
-- .- _..~ - .__.__..._._._.~._._..._..._~--_._. ...---.--.----..-,-.--.--.--.--
IILI.\
NUMnER
RELATIONSHIP
NAME AND ADDRESS OF BENEFICIARY
-. .-... --~_._---_._.._----..- ..---.......--------..-- -..-.--- _.-...~---~-~._------ ----.-- ---'--'---
^. Tnkoblo BoquoI";
I.
CJlARLOT'l'B E. TO\-lSgll lOmR
956 \-lost Trindlo Road
Hechanlcsburg, PA 17055
JAllET LOUISE \-IAGlrrm
5002 Trappers Road
vlll/lon, llol'th Carolina 27896
Daur;htor
One-halt 01' toto]
Estate.
..,
,__
Daughter
Ono-halt 01' total
Estate.
IHM
NurAnER
AMOUNT OR
SHARE OF ESTATE
NAME AND ADDRESS OF BENEFICfARY
B. ChOfllablo and Govolnl1lonl(ll DoquO)l"
I.
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS IA"o onlor on IIno 13, Rocopilulallonl S
(If mOl. .poco Is no,d,d, In..rt ,addltlonalsh..t. of .ome .b.)
< . ~.
c,-- ,.57.3, Il,,.,)
O AA 047821 COMMONWEALTH OF PENNSYLVANIA
NO, DEPARTMENT OF REVENUE
OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
.1~-II61I'I'~11
~'i:~
. IT: \:
'\ :11 ",
RECEIVED FROM:
i
ACN
ASSESSMENT 1;'1
CONTROL ...
NUMBER
AMOUNT
STAUFFER J RDf.lErn
MARKET SQUf\RE BUlI.DI NG
101
'It;).ljJ"".lU
MECHANICODURG 1'/\ 17055
'OION'" -i
!:lSN ?09-3h-556e
(FIRSlf IMII
-__09.LOB/-2l1
REMARKS CH/\RLOTTE E KERR
r:1 TOTAL AMOUNT PAID _______ $:"~ll.L~l!l
CW
SEAL
CHECI<II 1/14
;
RECEIVED BY _~'
SIQNATURf
REGISTER OF WillS
MArlY C. LEWIB
REGISTER OF WILLS
.0.- ___ _~_ .~.~.~,._ __ _._'...4_.........._.__~ w. _n'___"_"'__.___~ ".'_ _,.
- -~. - - ~-- --~. ---. ..- ...~ --. -"- ..-. '- .-.- -- ---
4" O~ .................,..",--
".~..........-u.....".. .. J.. -.
JREV-lS47 EX AFP 112.941*t~ ]
COHPtOHWUl TIt OF P[HHSVLVAHIA
DlPARTHEHr OF RtVOU:
BUREAU Of INDIVIDUAL TAX[S .
DEPT. 180601
ftARAlSaURC, PA l1ua.06DI
ESTATE OF RIDER 'rI1lREN
DATE OF DEATH 09-08-94
/ 'I - 3 :L.:;' - (
C/
NOTICE OF INHERITANCE TAM
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAM
ACN 101
FILE NO.
COUNTY
DATE 09-04-95
~95
CUMBERLAND
NOTE, TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS FORM WITH YOUR TAM
PAYMENT TO TIlE REGISTER OF WILLS. MAKE CllECK PAYABLE TO "REGISTER OF WILLS, AGENT"
REMIT PAYMENT TO:
J ROBERT STAUFFER ATTY
MARKET SQUARE BLDG
MECHANICSBURG PA 17055
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
AMount R..Ht.d
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .....
iiE'v:i:54i"Ex-iiFP-irZ-:94rNoYicEuciF-YriHEiifi'AN-cE-Ylix-iiP'piliifsEifEN'r;-iii.rciwANCE-iili-mu----mn--
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF RIDER FLORENCE M FILE NO. 21 94-0795 ACN 101 DATE 09-04-95
TAM RETURN WAS, I X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..l E.t.t. (Schedule A) (1)
2. stock. and Bonda (Schedule 8) (2)
3. Clos.ly Hald Stock/Partnership Intar..t (Schedul. C) (3)
4. "ortgag../Not.. Receivable (Schedule DJ (4)
5. Cash/Bank Deposita/Hi.c. Paraonal Property (Sch.dule EJ IS)
6. Jointly awned Property (Schedul. FJ (6)
7. Tr.,..lfara (Schedul. OJ (7)
8. Total A...t.
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expens../Ad.. COlta/Hi.c. Expansas (Sc~dula H) (9)
10. D.bt./Hortgaga Liabilitia./Li~. (Schedula I) (10)
11. Total Daduction.
12. Hat Value of Tax Raturn
13. Charitabla/GovarnMental aequa.t. (Schedul. J)
14. N.t Value of Eltat. Subjact to TaM
If an assessment was issued previoUSlY, lines
reflect figures that include the total of ALL
ASSESSHENT OF TAX:
15. .aOlrlt of Un. 14 .t Spou.al r.t. Cl5)
16. A.ount of Lina 14 taMabla at LInaal/Cla.. A rat. (16)
17. A.ount of Lina 14 taKabla at Collateral/Cl... a rata (17)
18. Principal Tax Due
NOTE:
TAX CREDITS:
PAYMENT
DATE
10-11-94
05-31-95
RECEIPT
HUMBER
MM913060
AA047821
DISCOlMT I +I
INTEREST I-I
631. 58
.00
I CHANGED
259.000,00
1.410,00
,00
,00
58.612,78
30,805,10
.00
181
349,827.28
42,143.81
697.13
1111
1121
1131
1141
4;>,840 q4
306,986.34
.00
306,986,34
14, IS and/or 16, 17 and 18 will
returns assessed to date.
.00 M .03.
306,986.34 M .06.
.00 K .15.
I1BI
.00
18,419.18
.00
18,419,18
AI10UNT PAID
12,000,00
5,819,18
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
18,450.76
31. 58CR
.00
31.58CR
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN '1, NO PAYMENT IS REQUIRED,
IF TDTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. I
-,
lU
R[SaRYAIION, [Ihl.. of dec.o.nh dJl,. on or &Mfa" o.c..., It, 1911 .. If "''1 futu,. Int.r.., In the ..htl .. I'M,f.rred
In po......on ar enJo.,.ent to Cl... I leolla'"aU ..flel,rI.. of ItMI deC~t aft,,. the uplratlon of MY ..'at. for
II'. ar for .....,., 1M C____IU'l Mr.o., ..punt., r.l.tv.. the rIght to IIPPr.I.. .w1d ...... I,.",h, IrIMIrlt.-.ca ,....
at the I..'ul ell.' . leoll,'.,all r.t. on ."... such future Int.,..t.
"""""'OF
NOllerl 10 fuUlIl the rlMlUlr..-n1l of Section "'D of 1M lm.rU.-.u Md (stlt, ,.. Act, Act II of 1991. 11 P.I.
Section 11".
PU"HII o.lKh the top POrtlDfl of thll Notlu IIt1d .~It with yaur PI,..,' to tMII...hh,. of "lIlI ptlntM on the tav.'.. .Ide.
.-""". cMdt or MMr order paptala tal REGISTER OF' NtLt.B, AOEKT
111 p,,,""h raulnd .n.1l 'It,t 1M ,,"lied to My Int.,.., ~Idt NY be dIM with MY ,...1,., IIPPllM to tn. t...
RfflJoCD ICAII .. ,.fWld of . t.. er~lt, which ".. not '....IM on 1M r.. A.turn, ur be '~.Iad b'J' c.,..htlng Iln '"Appl1caUon
for Raf\n4 of PIIM..,h,..,,11 I~rltlnta rod E.hta h." Ul[Y.UUJ, Appllntlon. ara Ivallabla at thl! Offlca
of thl R..htar of Wllh, ...., of thl IS RlvltlUll DI.trlct OUlc.., or b., nil I,.. thl IPKhl ,..hour
....werlng .arvlca nu.blr, for lora. ordlrlngl In Penn..,lvantl 1.600.161.'0~O, out.lde PInn,.,lv...11 ~
..lthln lout 'tlrrhburg era. 11111 111-1094. lOOt tll1) 111.nU tIIaarl~ IlIPa.rM Dnh>>.
OIActlONSI An., partv In Int.r..t root ..thflM \Il1th the IlPPr.h~t, .UQWtWlCa or dl..UOWVtC. of deductlons, or ..........t
01 h. (Inch.slng dhc~t or Intar..t) .. showt on thh Holies .ut obJ.ct within .lIth no) dI" of rec.lpt of
thh Mot Ic. bY,
"writ.." Hot." to thl P' o.plrt..,t 01 Rn_, laird 01 aw-Ih, ~t. 111011, Herrllburg, PA 171Z1.IOll, OR
..IIKtlon to hllVI thl _ttlr dlt.,.lln.d at Mldlt 01 thl ItCC~t of \hI ".rsonal rNlr..enhtlvI, OR
.....,....1 to thl Drphlln.' Cou,t_
'(>>tIN
IS1RAlIY[
CORRH 11 OMS I
'Ktu.1 .rror. dl.cov.red on tnl. .....~t ~Id be lIddr...ed In Mrltlng tal PA o.part.."t 01 RIV_,
tura..... 0' IncUvl~UlI ,...., '''"I Po.t .......--.t Revl... 1iI1t. o.pt. 11060\, ".rrlsburg, PA I1Ua.0601
PhorM C 111l 1I1-6!10~. S.. PItG. 1 of 'hi bocMoht "Instruction. for Inherltanca la. A.turn far I R..ldent
Dec..s.rtt" IPlY-UOll lor fln ..pINUlltlon of ItdIIlnhtrellnly carrKtabl. .,ror..
INTlRfSll
If MY tell dI.M II peld \lflthln thr_ 11) calendar MJrlt". Ifter thl dec.oant'. o.lth, I fiv. "runt C~X>> dhcCM.M1t 0'
the te. Plld II IlIowed.
Int.r..t II char~ beglmlno IiIlth first de., 0' dall~y, ar nine (9) MJrlth. rod OM II) dey Ir.:. the dlt. uf
OI.th, to thl dll. of papenl. ,.... .."Ieh bac... dallnquMt bafon J.nuar., I. I'U bear lnhr..t.t IhI r.t. of
.t. IUI ptIrc.,1 par IIItY1UI calculated el I Mlh r.h of .00Dl64. All t.... wt1ldl bloC... dallnquenl on IW'd .H.r
J~r., I, I,al ~II. baer Inllr..t .1 I r.ta lilhlc:h 1iI111 Vlry Iro. tBl~r .,..r to cellndar yl.r Mlth Ihlt r.t_
ftnnOUnCld by In. P" u.p.rtaant 01 R.vanua. 'hi eppllc8bl. Inl.r..t rlt.. lor l,al through 1995 .re.
DISCOUNt I
V..r tnt.r..t Itll. D.11y In tara. I 'ItCtar ~ lnl.ra.t Itlh DIIlh lnl.,..t rador
l'll '" .00OYoa 19111 .. .000l'"
I'IS 'U .OOOU" 1.11.1991 ". .OD0101
.... ". .OOUOI .." .. .ODO''''
I'IS ,n .0001S6 1991.1"'" ,. .0DOI9l
.... ... .OOOU" ,.., .. .0ODlU
.~Jn"r..t I. calcul.l~ .. followu
INTEREST " BALAHCE OF TAX UNPAID X HUKBER OF DAYB DELIHQUEHT X DAILY IHTEREST FACTOR
..Any Notice luuact .lIer IhI I.. ~OIII' dall~1 ~III rellKt .., Inl.,..t calcul.tlon to 1111.., US) da.,.
beyond thl deh of thl ........,t. If pa.,..,,1 II .eeM a".r 1M Inhr..t coarput.tlon dlt. IhaIiIn on IhII
Nolin, ItddltlDnlI Inh,..t aI.t be calcuhtld.