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I)ETITION rOil PROD A TE Ilnd GRANT OF LETTERS
Es/o/r rif _\0I_.ll.:h.J r:: C ,.. VI " s~, No, ~~.H - I 00 4-
ul.... k/Wll''' as To:
Reglsler of Wills for Ihe I
Drl>!o......I. Counly oft',,-, "",I:>",')"'..."'lnlhe
Surlol Srl',,,I/)' Nu, ~7? . 01' '1"t fi~ Conmlonwellhh of I'enn.ylvllnlll
The pellllon of Ihe under.lgoed re.peetfully represent. Ihllt:
Your pelllloner(.), who IS/lire 18 years of IIge or ~er IInlhe eseeul", . :s
In the lasl 11'111 of Ihe above decedenl, dilled ..1 'j 1:1-
and codlcll(s) daled
'~Il!fd
,19
l'lal~ f~I~\'nnl drCll,"'lnll~'(". c." ft'l1Il1ldallnl1. d~alh ur e\l"CUlnr. ~It'.)
Deeendent, IlIen 7,...8..1- YI'ars of age, dledC ' 9 "f 4-
al I!:].... \tI/ '''- . .
Escept as follows, decedelll did nOlmurry, WIIS nol divorced IInd did nol have II chll born or IIdopled
aner esecullon of the 11'111 offere fo robllle; WIIS nOllhe vlcllm of II killing and WIIS never adjudicated
Incompetent:
Deeendelll III delllll owned properly wllh esllmllled vulues liS follows:
(If domiciled In I'a.) All pcrsonlll properlY
(If nol domiciled In I'll.) I'ersonul property In I'ennsylvllnla
(If nOI domiciled In I'll,) I'ersonal properly In Coullly
Value of real estate In I'enn\ylyunlll
shualed liS follow.: N~ VIe
S ,3"".::>0. <>0
S
S
S
WHEREFORE, petllloner(s) respeclfull)'
presenled lIerewllh and Ihe grunl of lellers
lheron.
reyuesHs) Ihe probple of Ihe last 11'111 and eodlellls)
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OATH 0.' PERSONAL REPRESENTATIVE
COMMONWEALTH m'l'ENNSYLVANIA }~!1
COUNTY Oil (,U~B&IU.AND
The pelitioner(s) above-namcd swear(s) or arnnn(s) Ih'lIlhe sllllements In the foregoing petition are
true and eorreel 10 lhe hcslof Ihe knowledge and belief of petitloncr(s) and lhlltlls personal represen-
IUtlve(s) of the above decedenl pelitioner(s) 11'111 II' Id truly adminisler I~~stale according to law.
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Sworn 10 or affirmed and snbscribed {X. .... -'. ,L -L !/ v,..",- . "' '-../ '"
before me Ihls ?l:ith un)' of 00'
'":J2:Jaa::.o.'tfldrn5 19-9-4_ ~-rY(J1<I/e 6.Iv'ltl'l.,;i:-' ~ 1
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No. 21-94-1004
Estllte of
WALTER P. CORNISH
I Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
and Lellers
are hereby granled to
AND NOW NOVEMBER 30 19-2..4-, In consideration of the pellllon on
the reversc sldc hcreof, satlsfaelory proof having bccn prcscntcd bcforc mc,
IT IS DECREED that thc lnstrumcntls) date" MA Y 12.19 B 7
described thercln bc admlllcd to probatc and med of rceord as Ihc lasl will of
WAr,TF.R P. CORNISH
"'~C::"'I\MENTARv
nmJIIT,n R C'ORt.lTRH liNn nOt.lllT.n R. C'ORNTRH,.lR.
"monAd c. ~,,~', 0" .p~,~~
Resister of Will. l ,
FEES
Probatc, Letters, Ele, ....,..,. $25.00
Shorl Certlneatcsl 2) ... . . . . . .. $ 6. 00
Renunciation ................ S
. xpsges $ 3.00
jop TOTAL _ $~
Filcd ........ NOVEMBER. 3.0 ...1.994..
AlTORNfiV (Sup. Ct. 1.0, No,)
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I.m:alllt'gislrar. Till' Clligill.l1 fl'rrilil',lH' will be tt'lw.II,h.d III till' ~l.Ih' VII,1I 1(, \11,,1, I llllll' llil )'1'11II;lIll'1l1l,hl1,l:
WARNING: Ills Illegal to duplicate this copy by photostnt or photograph,
21-94-1004
Ft,t. (or lhi!i ll'l"cHic,IlC. $2,UO
2683341
No,
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COMMONWEALTH OF PENNSVLVANIA. OEPARTMINT OF HEALTH' VITAL nECOROI
CERTIFICATE OF DEATH
....,........
IOC&Al HCUNIT HWIlI'''
.. 173 - 09
NMtI: DUff 'Il~.'_
I. Walter P. Comish
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lnst Blill nuh Qf~$tnmtnt
of
Walter P. Cornish
I, WALTER P. CORNISH, of the City of Williamsport,
County of Lycoming, Commonwealth of PennsYlvania declare this to be my
last will and testament, hereby revoking and making void all former
wills by me at any time heretofore made,
IMPRIMIS: I order and direct that all my just debts and
funeral expenses be fully paid by my executrix or executor. as the case
may be, hereinafter named, as soon as conveniently may be after my
decease. I desire my burial in the family cemetery lot in Lewisburg,
Pennsylvania.
I TEM I:
I bequeath all my tools and equipment to my
grandson, DONALD B. CORNISH, JR.
ITEM II:
I devise and bequeath the residue of my estate
of every nature and wherever situate as follows:
A. One-half (1/2) thereof to my son, DONALD B. CORNISH.
B. One-half (1/2) thereof to my grandson, DONALD B. CORNISH
JR., or his heirs, equally.
ITEM Ill: I appoint my son, DONALD B. CORNISH. and my
grandson, DONALD B. CORNISH, JR" co-executors of this my last will.
ITEM IV:
I direct that my personal representative or
executors shall not be required to give bond for their faithful perform
ance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
this /~-u.. day of ,{.-17
,1987,
/1.J~P1.v... v::.[7~
Wal ter P. Corni sh
.
The preceding instrument, consisting of this and
and other typewritten page each identified by the
signature of the testator, was on the day and day
thereof signed, published and declared by Walter p,
Cornish, the testator therein named, as and for his
last will, in the presence of us, who, at his request,
in his presence, and in the presence of each other
have subscribed our names as witnesses hereto.
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21-94-1004
REGISTER 01" WILLS OF COUNTY
OATH OF SUDSCRIBING WITNESS
codicil
leach) a subserlblnll witness lO Ihe will presented herewllh. leach) being duly qualified aecordlnllto
law, depose(s) and say(s) that present and saw
lhe testa I , sign Ihe same and lhat signed as a witness at the
reqUest of lestal-In " presence and (In lhe presence of each other) lln the presence or lhe
olher subserlblnll wltnessles)).
Sworn to or affirmed and subscribed before
me this day 0 f
19_
IName)
IAddress)
,
Reg/.rler
(Name)
(Address)
REGISTER OF WILLS OF CUMBERLAND COUNTY
OATH OF NON-SUDSCRIBING WITNESS
o co ..,.. I.J l3 C "..- " : ~ h
Dtn..h (lJ, t~rnisl. .Jr.
leach) a subscriber hereto, leach) being duly qualified according lO law, depose(s) and saYls) that
WE ARE familiar with the slllnature of WALTER P. CORNISH
dClllilliI
will
leslal OR
presenled herewith and
lailllllll<
believes the signature on lhe 11'111 15 In the handwrltlnll of
of lone or the subscrlblnll witnesses to) the
Ihal
WE
WA~T~R P. ~ORNT~H
to lhe besl of OUR knowledge and belief. \\
Sworn lO or affirmed and subscribed before )::j ..-vI -(. /J... .:8,
me lhls '<;I-h day of
199-4-
Ga<.-~
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e~ (JB. fU\
n I (Name)
1\1 e. \IV C.J "'" h~r" I ~ .., <=L!:tl
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(A ress) ,.
hl/.IL (d. 4t1~, ~'1
tltn f I~ 1(. !'/.o~/!c i/
(Addrrss)
Register
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RCC'OI"~"", 01
Ril") ::..; l \I,IIS
CERTIFICATION OF NOTICE UNDER RULE 5,61a}
\ ./ '9') APR -3 PI'I5
Name of Decedent I W .a. 1+... (' e Co ("VI; c::.. l.-, ,
I I I 0 I I Q Cl .LL CIUl, ' ; .(Jurl
Date of Deathl /J ( I l--r Cum"" I:., rA
Will No. 2../ - '14 - 1004 Admin. No.
To the Registerl
that notice of beneficial interest required by
Court :Rules was served on or mailed to
of the above-captioned estate on
!!!!!!!!!
00 t1;;L.1 a/
001'1.1. ( ",,{
5. Corl'J,'~h
B. COY-VI /5 {,.,
Address f- .
'7Q3-/(.t-f.. 5+l""e~' :::!
N...w Cun'lh.....~-I.3j1)d IA ('1010- 1 ""b
., In 3 L i" VI c:/ j" D.','';e..
~ V. C:..l. l"n r ,~; I . PA I .., 0 / I
Notice has now been given to a 1 persons entitled thereto under
Rule 5.6(a) except 0 VIe.
Datel 3/30 II'1cr5"
, ,
Address
Ne..w
Counsel for personal
representative
.
,
UY.1S00 U+ 1'."4'
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
liJc' 'I
NUM8ER
"
fOR DATU Of DEATH ArTER 12131/91 C!lICK IIIRE
If A SPOUSAL
POVIRTY CRIDIT IS CLAIMID 0
PILI NUMIIR
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COMMONW\AlIH 0' PfHHSnVANIA
DUA. MIN' 0' _,VlNUl
DlP, 10
"...",u.<'. lA rJ 21.060'
MI. I . t MID
Cornish, Wlllter
OCI L Ilcuany HUMIU
DA1l 0 1111111
17070
COUNIY CODE ,,2.1 YEAR '1'1
oeD' OMI'I 0
703 Sixteenth Street
New Cumberland, PA.
Cumberland
MOV llIe IVIO nllHI lluellONII
III
P',
DAII or OIA It
I" ...'''''....III.u.vrrlltQ ,'OUtl'. HIJIIIlAII.II..'.....D ""DotIINIt,A'1
COVill
11/8/94
173-09-7484
I!! OIl. Original Return 0 2, Supple menial Rtlur" 03, Remainder R,tur"
ldiB I'or dol.. 01 d,olh prior 10 12.13,B21
04, limited Ellal, D.o. Futur. Int.'I.1 Compromllt 05, Fed.ral Edol. TalC. Relurn Required
:0:"'9 (lor do'" 01 d,o,h olror 12,I2,B21
"'E- 0 7, Olcld,nt Maln/alned a livIng Trutt Q... B, Tolol Numb., of Safe Olpolll BolI.8.
(Attach copy 0 Tru,11
III Iii
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B2
Donald B. Cornish
lI'no UMIUI
717 774-3496
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I, R..I E.,o" (Sch.dul. AI
2. Sloch ond Bond. (Schedul. BI
3. Clollly H.ld S,oc~/Polln."hlp In' ""' ISch.dul. CJ
... Morlgag'. and Not.. ReceIvable (Sch.dule D)
5. Cash, Bonk C,poIIII & Mhc.Uonloul Plnonal Prop.rl)'
(Schedul. EI
6. Joln'ly Own.d Prop""y (Sch.dul. f)
7, Tronol... {Schedul. GI(Schedul. II
B. Total Gran A..,,, (Iolollln.. 1.7)
9. funeral hpln..., Admlnhlrallvl Co.", Mhe.lIon,ouI
E.p.nll' (Sch.dul. HI
10. O.b". Mor'Bog. 1I0blllll.., 1I.n, (Schedul. I)
11. Tolol O.dudlon. (Iotollln.. 9 & 10)
12, N., \1olu. 01 Ellol. 11In. B mlnu. lIn. I II
13. Charitable and Governmental 8.qu'I" (Schedull J)
'4. Ntt Value Sub tet to Tax lint 12 mlnu.l1ne 131
15. Spoulal Tran.'," (for dal" of dealh aftlr 6.30.94)
S.. Instruction' for Applicable Plrc.nlag' on RIVI,.t
Sid,. (Include valu.. Irom,5chedull K or Sch.dule M.)
16, Amount of lint 1A loxobl, at 6% rolt
(In dud. vDlulI from Schedule K or 5ch.dule M.)
17. Amount of Un. 1A laxabl. at 15% roll
Ilnclud. volulI from Sch.dul. K or Sch.dul. M.l
lB. Prlnclpollo, duo (Add '0' from lInll 15. 16 ond 17.1
19. C"dlt. Spoulal Poverty Cr.dll Pllor Po)'mlnft
+ +
20, 1I11n. 1911 groo'" Ihon lIn.. lB. .nl" Ih. dlll".nco on lIn. 20. Thl,lIlh. OVERPAYMENT.
EI O...I'ftI"I!'IIIII.lI...I_..."_.'I...UtIOlU.'IIllil.-._llIl"ft"I'nn_.~.I'I-.1.',UIJUJ..Io..,,'..11
1211
121A)
(2181
..
~
~
.
'"
...
~
1191
(20)
21.
.
,
I'
Ad .41 .f 1994 provld.. for the reduction of the tax rate. Impo..d on the n.t valu. of trand... to or for
the u.. of the .pou... Th. rat.. a. pr.lCrlb.d by the .tolut. will b.1
. 3% (.IS) will b. appllcabl. for .Ilat.. of d.ced.nt. dying on or aft.r 7/1/94 and b.for. 1/1/96
. 2% (.11) will b. appllcabl. for ..tat.. of dec.d.nt. dying on or aft.r 1/1/96 and b.for. 1/1/97
. 1% (.01) will b. appllcabl. for .Ilat.. of d.c.d.nt. dying on or aft.r 1/1/97 and b.for. 1/1/98
. Spau'" trand... occurring on or aft.r 1/1/98 will b. .x.mpt from Inherltanc. tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
IV PLACING A CHECK MARK (..0-) IN THE APPROPRIATE BLOCKS.
1, Old decedent make a transfer and:
a. retain the use or Income of the property transferred, .......................................................
b. retain the right to designate who shall use Ihe property transferred or Its Income, ...............
c. retain a reversionary Interest; or ..............."...,....,.................,...........,....,......"..............
d. receive the promise far llIe of ellher paymenll, benefits or care' .......................................
2. If death occurred an or before December 12, 1982, did decedent wllhln two years preceding
death transfer property without receiving adequate consideration' If death occurred alter
December 12, 1982, did decedent Iransfer property wllhln one year of death without receiving
adequate conaldoratlon' t..,......... to",., ........, ......" 00.'..."'........., ,....., ............'....1 ......... to,..."
3. Old decedent awn an 'In trust far', bank account at his or her death'......................................
YES NO
x
x
X
X
X
X
X
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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.
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1IIlDINT DleIDIN'
E t TE OF
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
Walter Paul Cornish
(All pt.p.,'v lolnlly.ow"od wIth Ih. RI,h' .f lu,vl..,.hlp mull b. dlul...d on Ich..ul. '1
ITEM
NUMBER
1.
2.
'_~1"t':;:;;~L'?,;,;r{>',k1,;-_::
DESCRIPTION
Cash
Clothing
...
Plea.e Prlnl ar T e
VALUE AT
DATE OF DEATH
$ 12
525
fAlloch addltlonaI8Y.'''' M 11"" ,h..lt If mot. .pactll n,.d,d,t
TOTAL Alia enlor an line 5, Reca Itulallan S 537
".,.,'
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,
UY.IS03 U. '4.161 ,.
C0'4~/jW/,1~~IOI.t'li.~~IlrANIA
1\".,Nl.lCloEN,
o
SCHEDULE B
STOCKS AND BONDS
ER
.
Walter Paul Cornish
. (All proporlV lolntlv.ownod with Right 0' Survlvo"hlp mu.1 bo dl.c1o.od on Schodulo ',1
ITEM
NUMBER DESCRIPTION
VALUE AT DATE
OF DEATH
1. 135 Shares of Keystone Financial, Inc.
(Common Stock Fair Market Value $29.00 per shar) $3.915
TOTAL Alao onlo, on IIno 2, Roca lIulatlan
III more .poc. ,. "tleI.el, In..rf orlcJillonol .h,II of .om. du.}
3,915
s
'.-'.00"7:-- '..:_.,' .~,.~,r-.-1~~~r"".,
.
"
,
.
l.v.IJIlII.I'"'
.
COMMOHWfAmt O' '(HHIllY"HI'"
INHUIIANCf tAX UTUIN
..IIDIN' DICIDI"'
Walter Paul Cornish
ITEM
NUMBER
A. Funoral Exp.nlO"
1.
B.
1.
2.
3,
.a
.
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
PI. a.. Prlnl or T .
NUMBER
DESCRIPTION
AMOUNT
Pafthemore Funeral Home, Inc.
$6,669
Admlnl.tratlv. Co.l..
P."onal R.pr.senlatl.. Commlnlons
Social Se.urlly Number of Pe"onal ReprelOnlatl..1
Y.ar Cammlnlans paid
Attorney Fe..
Family EK.mptlon
Clalmanl
Add.... of Clalmanl 01 de.ed.nl's d.olh
SI..el Add,e..
Clly
4. Probal. Fees
C. MI.cellan.ou. Exp.n....
1. C.P.A. Fee
2.
3.
4.
S.
6.
7.
8.
R.lotlonshlp
5101. Zip Cod.
75
TOTAL (AI.o enler on line 9, R..opllulatlonl
(II mar. spoc. I. n..d.d, Ins.rl oddltlonal .h..I. 01 .am. .1...1
S 6,744
-~_.---~~.~..-
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ESTATE 0.
ITEM
NUMBER
ITEM
NUMBER
1.
2.
1.
'*
COMMONWIAltH or "NNlnVAHll
IHMII"AHCI lAX InUItN
IIIIDI", MClDIN'
SCHEDULE J
BENEFICIARIES
.ILI NUMBER
Walter Paul Cornish
NAME AND ADDRESS 0. BENE.ICIARY
RELATIONSHIP
A. Ta.ablo Boquo.h.
Donald B. Cornish
703 Sixteenth Street
New Cumberland, PA. 17070
Son
Donald B. Cornish, Jr.
103 Linden Drive
Camp Hill, PA. 17011
Grandson
NAME AND ADDRESS 0. BENE.ICIARY
B. Charllablo and Ga.ornmonlal BoqUIIl1l
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS IAI.a onlor an IIno 13, Rocapllulallan) S
(If mar. .poc. II n..d.d, InllFt additional ,hll" of lam. ,II.)
," , ':'.t'
.___.~.__-"'-"_..o.,'
.
AMOUNT OR
SHARE O' ESTATE
50%
(1,146)
50%
(1,146)
AMOUNT OR
SHARE 0. ESTATE
t/REV-1S47 EX AFP (12-94*
COHHONWEAlTH OF PENNSYLVANIA
DEPAAT"EHT OF REVENUE
BUREAU DF INDIVIDUAL tAMES
DEP'. 2806l1l
"ARRISBURO, Pi 17121-0601
/.6 .-1-1
u
ACN 101
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT DF TAX
DATE 02-21-95
o FILE NO.
DATE OF DEATH 11- 08- 94 COUNTY CUMBERLAND
NOTE, TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHIT THE UPPER PORTION OF THIS FORH WITH YOUR TAX
PAYHENT TO THE REDISTER OF WILLS. HAKE CHECX PAYABLE TD "REGISTER OF WILLS, AGENT"
REMIT PAYMENT TO:
DONALD B CORNISH
703 16TH ST
NEW CUMBERLAND PA 17070
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 170I3
A.aunt RI..itt.d
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiE'v:istii-ixu"w-n'Z:li4T"NOYICEuOF-YNHEiiITANCE-YAx-A'PPRA'IsEHENT-;-"L'LowANcE-oii------------m--
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF CORNISH WAL TER P FILE NO. 21 94-1004 ACN 101 DATE 02-21-95
TAX RETURN WAS, I X) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL
1, R..l Ed.t. ISchedul. A) (1)
2. Stock. and Bondi (Schedule 8) (2)
5. Clo..1y Hald stock/Partner.hip Int.r..t (Schedule CJ (3)
4. Horta.a,,/Not.. Receivabl. (Schedule DJ (4)
S. C..h/Sank Oapollt./Hilc. P.rlona1 Property (Sch.dul. E) 15)
6. 401ntly Owned Property (Schedul. f) (6)
7. Trlnlfar. (Schedul. OJ 17)
a. Total A...t.
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funar.l Ekpan.../Adll. Co.t./Hi.c. Expan.a. ISchedule H' (9)
10. Dabta/Hortgag. Liabiliti../Li.n. CSchedule I' cia'
11. Total Deduction.
12. Nat V.lue of Tax R.turn
13. Charitable/GovernMantal aequ..t. CSchadul. J,
14. Net Value of Eat.t. Subjact to Tax
If an aSS.SBment was issued previously, lines
reflect figures that include the total of abh
ASSESSMENT OF TAX:
15. AMount of Line 14 at Spou.al r.ta C15'
16. AMount of Lin. 14 taxable at Lin.al/Cla.. A r.t. C16'
17. AMount of Lin. 14 taxabl. .t Coll.taral/Cl... Brat. C17'
18. Principal Tax Due
NOTE:
TAX CREDITS:
PAYHENT
DATE
RECEIPT
NUHBER
OIsCOUNT 1_)
INTEREST C-)
) CHANGED
.00
3.915.00
.00
.00
537,00
.00
.00
(B)
4.452.00
6,744.00
,00
Ill)
lI2)
lI31
(141
6.744 nn
2.292.00-
.00
2.292.00-
14, lS and/or 16, 17 and 18 will
returns assesssd to date.
.00 X .03.
.00 X .06.
.00 X .15.
lIB)
.00
.00
.00
.00
AHOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
.00
.00
.00
.00
IF TOTAL DUE IS LESS THAN fl. NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIGNS.)
.
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RESERVATION. E,t,t,. 01 dlcldlnt. dvlng on or balor. Olcl.o.r 12, 1'12 -- If any lulur. Intsr..t In thl I.t.t. I, transf.rrad
In po.....lon or ."Joy..nt to el,.. I (eol1It.rel) bln,flcl,rl.. of thl dle.dlnt .'t,r thl .~plr.tlDn 01 any I.t.t. for
II" or 'or y..r., thl Co..onw..lth hlt,by Ixpr...lv r...rv.. thl right to IPpral.. and ...... tran.,.r Inherlt~c. Tlx"
It thl lawful CI... . (coll,t,r.l) t.t. on anv such lutur. Int.r..t.
PURPOSE OF
NOTICE. To fulfill thl requlr...nta of S.ctlon 2140 of the Inherltancl and E,t,t. Tlx Act, Act ZZ of 1991. 72 P.S.
boUon 2140.
PAYHEHTI Detach the top portion of thl. Hotlcl and tun-It with your ply.ent to thl R.gi.t.r a' Will. prlnt.d an tha r.v.r.. .Id.,
--H..... cMck or "n.y ord.r p.yabl. tal REGISTER OF MILLS, AGENT
All pav..nt. rac.lv.d ahall 'Ir.t ba .ppll.d to Iny Int.r..t which .ay b. due with an_ r...lnd.r appll~ to tM t.x.
REFUND (CR). A r.'und a' . tlx cr.dlt, which w.. not r.qu..t.d on th. Tax R.turn, .._ bl r.qu..t.d by co.pl.tlng an "Appllc.tlan
'or R.,und of P.nn.ylvanl. Inh.rltanc. and E.tat. TI~" (REY-1SIS), Application. Ir. IVllllbl. It the O"lc.
of thl A.gllt.r of Will., .ny a' the 23 A.vanu. DI.trlct O'flc.., or b_ c.11lng the .pael.1 2~-hour
en.warlng ..rvlc. nuabar. far 'or.. ord.rlngl In Pann.ylvanl. 1-100-362~2050, out,lda P.nn.ylvanla .nd
within lac.1 H.rrl.burg .r.. (717) 7a7~ID9', TOOl (717) 772-2252 (H.arlng 1.,.lr.d Only),
\
.
~
I
OIJECTIDHSI Any p.rty In Int.t..t not ..tl.flad with the .ppr.I....nt, .llow.nc. or dl..llowanc. of deduction., or ........nt
of t.x (Including dl.count or Int.r..tJ .. .hown on thl. Hotlc. au.t obJ.ct within .Ixty (60) da_. of r.c.lpt of
this HoUc. bYI
-~wrltt'n prot..t to thl PA D.part..nt of R.v.nuI, Bo.rd of App..I., D.pt. ZII021, Harrl.burg, PA 17J2a~lD:l,
--.I.ctlon to have Ih. ..tt.r d.t.relnad .t .udlt of the .ccount of thl p.r.onal r.pr...nt.tlv., OR
--lpp..1 to thl Orphan.' Court.
OR
,
ADMIN
IITAAnVE
CORRECTIONS I F.ctu.l .rrar. dl.cov.r.d on thl. ........nt .hould b. .ddr....d In writing tOI PA Dlp.rt..nt of A.v.nue,
lur.1U 0' Indlvldu.1 TIXI', ATTHI po.t A.......nt Rlvl.w unit, D.pt, 210601, H.rrl.burg, PA 17121-0601
Phon. (717) 717~6505, S.. p.ga 3 of thl bookl.t "In.tructlon. for Inh.rltlncl T.x Rlturn 'or I A..ld.nt
Decldent" (REYa1501) far en I~plln.tlon of .dalnl.lr.tlvely corr.ct.bl. .rror..
I
INTEAfll1
If any t.x due I. paid within thr.. (3) c.l.ndar .onth. .ft.r thl d.c.dlntf. d..th, I flv. Plrc.nt (5~) dl.count of
the t.x p.ld Is .Uow.d.
Int.r..t I. ch.rg.d big Inning with flr.t d.y of d.llnqu.ncv, or nln. (9) .onth. and on. (1) dlY fro. the d.t. of
d..th, to th. data of p.y..nt. T.~.. which b.c..e dlllnqu.nt b.fore Janulrv 1, 1912 b..r Intere.t .t the r.t. of
Ilx ('~) parcent p.r annul calcul.tld .t a d.lly r.l. of ,000164. All t.~.. which blc... dlllnquent on and ,'tlr
January 1, 1912 will b..r Int.r..t at . r.t. which will v.rv froe cal.ndar _'Ar to c.l.nd.r y..r with th.t rat.
announcad b_ the PA Deplrt..nt 0' A'V.nul, Th. .ppllcabll Int.r..t r,II' for 1912 through 1995 Ire I
DISCOUNTI
~ Intltllt R.te D.lh Intltllt Factor mr Intl".t R.tl a.lly Intl".t F.cto"
19IZ ZOX .DOD5~1 1917 .~ ,000247
191J 16~ ,DDDU8 1988al991 II~ .00OSOI
1984 II~ .DODSOl 1992 .~ ,OUZ"
1915 U~ .00OS56 1993aI9" '" ,OOQ19Z
1916 lOX ,oOOZl~ 1995 .~ ,OUZ41
--Int.rllt 11 calcul.tld .. foUow'l ....
INTEREST . BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
"-Any Notice I..u.d .ft.r th. t'M b.co... d'llnqu.nt will r.fl.ct In Inl.rl.t calcul'llon to flfllan (IS) d.y.
b.yond thl d.tl of th. ........nt. If pay..nt I. ..d. .,t.r th. Int.t..t co.putatlon data .hown on thl
Hotle., additional Int.,...t .u.t b. c.lculat.d,
.
STATUS REPORT UNDER RULE 6.12
Date of
\1\/ ~ I t e v"
Death: I \ /s / <1+
I / oa
2/ -94-foOLtAdmin. No. J '~14 -01004
Name of Decedent:
p
Corn ('s I/)
Will 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 estate:
1.
Stat~yhether administration of the estate is complete:
Yes-A- No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
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
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? Yes 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.
~) ~CO.II
b n-,-,,J..Q. ." .~, ~~
Signature -
l~on.:1. I d /3. Cc>v VlI's> ~
Name (Please type or print)
ry 03- /f.o+ h Sh, ~e.. +
A~~f~s e" Q oJ "1 b c:: ,-- I ... VI 01 I..JA
,
(']1 '71 'l'l+-- .34-q("
Tel. No.
Date:
IQ/30 I~la
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'X Personal Representative
Counsel for personal
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