HomeMy WebLinkAbout94-01009
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I)ETITION 1o'0H PHOnATE Ilnd GHANT 0.' LETTERS
,;},/ ~qtJ -Ioaj
Eslale of L.I-I.J:N -L/Illt.y Ole.l!I
al.w kl/lJIVII us ~LuL-"f, OR,T1/
No,
To:
Reglsler of Wills for Ihe
. De,','uJrd. Couuly of eu",.,,,H''' 0 iu Ihe
Sodul Sel'/lrlly No, .....o~t::.9 't - .:! 't 00 COllllllUIIWellllh uf PellllsylvlIlIllI
The pellllolluf Ihe undersigned respeclflllly repre'enls IInll:
Yuur pelitluner(s), whuis/nre 18 yenrs of IIge or older IInlhe execnl
Inlhe IlIsI will of Ihe IIbuve decedelll, dilled PU 11.l. II' r I
nnd codlcil(s) dnled .
nnmed
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, e\lalt' n:lt'vulll clrclU"'titl1l't'\, (.Il. rClIllllclitlinn, dClllh uf r\a:t1lur. (IC.)
Decendelll wns domiciled nl denlh In
h Ul.. Insl fnmily or prlncipnl residence nl
~ U IfIau..AJ41tJ1J
Ib ,.? A '~I.L.
CounlY, Pennsylvnnln, wllh
ARlcJl "'L.c!.u.dAJ/GJIJ u..~. J-A.
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elI'l urC('I, 1I11111hcr arut mundpnlil)')
Deeendenl,lhen III ycnrsofnge,dled ~'f l':JCrDBEtl. ,19 f'i ,
at 101':1 IIP'I.L J'JRuJL. ~1:J:jI",~,c~~&JAG1A' .
Exeepl ns follows, decedenl did nOlmnrry, wn. nol dlvorced/nnd did nol hnve n child born or ndopled
nrter exeeulion of Ihe will offered for probnle; wns nollhe vlclim of n killing nnd wns never ndjudlcnled
Incompelenl:
Deeendenl nl denlh owned properly wllh esllnlllled vlllnes ns follows:
(If domiciled In Pn.) All personnl properlY
(If not domiciled In I'll,) PersonllJ properly In Pennsylvnnln
(If not domiciled In Pn.) Personnl properly In COllnly
Vnlue of renl eSlnle In Pennsylvnnlll
shunled ns follows: If" 7
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$
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$ . 7~ "00
M~"-A..Jl.c.J. Dun...':: PA.
I
\ 70~
WHEREFORE, pelilloner(s) respeclfully requesHs) Ihe probnle of Ihe Insl will nnd eodlcll(s)
presellled herewith nnd Ihe grunlof lellers
(ICSliI111ClllnT)'; ndllllnl\ITUIIOII c.t.n.; udmlnl,tralloll d,h.n.c.I.II.)
theron.
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"TIIC>>i~ .... DR.'TH
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OATH 01<' PERSONAL REPRESENTATIVE
COMMONWEALTH OJo'I)ENNSYLVANIA }' l:lS
COUNTY 011 __
The pelilloner(s) IIbove'IlIUlled swcnr(s) or nffirm(s) Ihnl Ihe slnlemenls In Ihe foregoing pelillon nrc
true nnd cor reel lolhe beslof Ihe knowledge nnd belief of pelilloner(s) nnd Ihnl ns personnl represen-
Inllve(s) of Ihe llbove decedenl I'ellllnner(s) will well nnd lruly lldmlnlslCr Ihe eslnle neeordlng 10 Inw.
Sworn 10 or nrrirmed nnd
before me Ihls ~ ,t;'" at
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subscribed 71t ~i-' (f),su if 1
dllY of { 71 "A"r., Yll.' 'j-c./.O '?
19~ 'I
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No. 21-94-1009
Estllte of
ELLEN M. ORTH a/k/a ELLEN M. ORT~Decellsed
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW DECEMBER 2 19~, In consideration of Ihe petition on
the reverse side hereof, sntlsfaetory proof hnvlng been presentcd before me,
IT IS DECRBBD thntthe Instrument(s) dnted DEe. 12.1991
described therein be ndmilted to probate and OIcd of record ns the Inst will of
ELLEN M. ORTH a/k/a ELLEN M. ORTH
and Lellers TESTAMENTARY
are hereby grnntcd to THOMAS M. ORTH AND MARGRET M. ZERFASS
'-tQn"'d (!,. ~~ Do. p.~ CJ,^,,~
Realsl" or WI^. I
FEES
Probnte, Lellers, Bte. ......... $ 200.00
Short Cerllnenles( 3) .. , .. .. ... $ 9 . 00
Renunciation................ $
'x-pages $ 6.00
jc:p TOTAL _ L22.B.:.liH:
Flied ...,.. DECEMBER. 2, . .19.94.. . . . .
ATTORNBY (Sup. CI. 1.0. No.)
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WARNING: Ills 1II0golto dupllcnto this copy by photostat or photogrnph.
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2596790
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No.
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CO..UONWEALUlOF Pf.NNIYLVANIA. DEPARTUENT OF HEALlH. VITALRECOAOI
CERTIFICATE OF DEATH
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'Ootober 24 1994
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LAST WILL AND TESTAMENT
OF
ELLEN M: ORTH
I, ELLEN M. ORTH, of 1013 Apple Drive, Mechanicsburg,
Cumberland County, Pennsylvania, being of sound mind, memory
and understanding, do hereby make, publish and declare this to
be my Last will and Testament, hereby revoking any and all wills
by me at any time heretofore made.
]TEM I - I hereby direct my hereinafter named Personal
Representative to pay all of my just debts, funeral expenses,
estate and inheritance taxes as soon after my death as may be
found convenient.
ITEM II - I give and bequeath to my son, THOMAS M.
ORTH, any automobiles that I own at the time of my death, gun
collection, china chocolate set, my father's pewter pitcher,
wooden rocking chair and Lionel train set.
ITEM III - I give and bequeath to my daughter, MARGARET
M. ZERFASS, my Hamilton wristwatch, my jewelry (including my
diamond ring), my Beleek china tea set, silver tea service and
my mother's chair, desk and antique mirror.
ITEM IV - All of the rest, residue and remainder of
my estate, whether real, personal or mixed, of whatsoever nature
and kind and wheresoever situated, I give, devise and bequeath
to my children, THOMAS M. ORTH and MARGARET M. ZERFASS, in equal
shares.
If either of my children should predecease me and leave
PAGE ONE OF THREE
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issue surviving him or her, then the share of such deceased child
shall be distributed to his or her issue, but if such deceased
child shall die without issue surviving him or her, then the
share of such deceased child shall be distributed to my surviving
child.
ITEM V - In the event I am not survived by my children
or any issue, then I give and bequeath all of the rest, residue
and remainder of my estate to my sister-in-law, ELEANOR. T. GRIFFIN,
and my nephew, MICHAEL J. GRIFFIN, in equal shares, but if either
of them should predecease me, then the share of such deceased
beneficiary shall be distributed to the beneficiary who survives
me.
ITEM VI - I appoint THOMAS M. ORTH and MARGARET M.
ZERFASS, as Co-Executors of this my Last Will and Testament.
IN WITNESS WHEREOF, I
seal this l.t r.: day of December,
have hereunto set my hand and
1991.
_-ff! J!A A1 / )n. C9J;;tb
Ellen M. Orth
Signed, sealed, published and declared by the above
Testatrix, ELLEN M. ORTH, as and for her Last Will and Testament,
in our presence, who at hor request, in her pr...sanc.. and in the
presence of each other, we believing her to be of sound mind
and emory, have ereunto subscribed our names as witnesses.
of ').;;. I fh~ 5" r
'} /fzuAh~ A 1')/0/
~. fC(.~c4. of 22../ ;u......: tH'.
~~ 7?f 17/(11
PAGE TWO OF THREE
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COMMONWEALTH OF PENNSYLVANIA :
ss.
COUNTY OF DAUPHIN : ~etVT /-I, ~ ,~~1I1\.1
We, ELLEN M. ORTH, Testatrix, '- t .
and ~I A. D,'/It'o/./ , witnesses, respectively, whose
names are s gned to the attached or foregoing instrument, being
first duly sworn, do hereby declare to the undersigned authority,
that the Testatrix signed and executed the instrument as her
Last Will and Testament and that she had signed willingly, and
that she executed it as her free and voluntary act for the purposes
therein expressed, and that each of the witnesses in the presence
and hearing of the Testatrix, signed the will as witnesses and
that to the best of their knowledge, the Testatrix was, at that
time eighteen (18) years of age or Old~ sound mind~ under
no constraint or unuue influence. . ~)11 171
r AA/ . A /
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Subscribed, sworn to and acknowledged before me, by ELLEN
ORTH, the estatrix, and supseribTd~and,swqrn to before me
and l'r\,r"OOL-O' ~I lh(\(\ , the witnesses,
day of December,-1991.
My Commission Expires:
I(J NOTARIAl. S;:M.
MBE~I.v A S:O::!l Not:!I)' rub/Ie
M Hnrr.ShIJrfJ. C,'Junhm r."',m'
't. CnmIf1Jl":!n"!JI~t:~Uir.jl i~..:~} _.lS~f~,!.
PAGE THREE OF THREE
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CERTIFICATION OF NOTICE UNDER RULE 5,6(a)
Name of Decedent. o! I..I...E.N 11], O~ 711
Date of Death. nJ'f OCr 7'1
Will tlo, ~/- 1'1- 0100'1 Admin. No.
To the Register.
I certify that notice of beneficial interest required by
Rule 5.6(a) of the Orphans' Court :Rules was served on' or mailed to
the following beneficiaries of the above-captioned estate on
.
Name
Address
71/tJI'ltlJ hJ. ()/UH
A1IJtt';AlI rr- ~ ZZ/(I""I'/,u
101.1 111'/'I..E. 1Jt?IVl.
J f.r ).>tJlJbdA Ill-IIIJ
A1N'.I"4jIJ/~J .nIHIl:. /'11 I }()J';j-
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IPOY~III'~lftJ I t",.," / F'-f('f>
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except
Date. ItJ liMIt.. ,r "/ .., (f)Jl<[
Signature 7
Name TlIOhA.J' l' ,r) R. (H
Address 101 ::r 1#1'tr. ~,q (LIe
\0 t':'~
~.~ If.' ~a.: filEr' 10111 ~ Ie J /.J i.I ,qc.. ;a/l.. 17oS'.r
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':1 . ~ 1 Capacity. X Personal Representative
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~ iJ' ~ .' E Counsel for personal
a: a: ~a representative
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
ITO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
Il:!Y.!SOO UI..'...;l,4UI
COMMONWfAIUf OF 'ENNSYIVANIA
Dlr...R1M(N10f UYENUr
om. ",..\
HAUISlUIl:O.'A 17 11.0601
N ' NAoMI II'" . " . AND MIDDI INl 'AlI
_Q&TJi. _ e Li.E N tJ, _
.ex,., "'''"''' ""Lou r''',,' OIA'" "." 01 ...",
,...~9,!:",?l~i~"?~..~~1 ,9.~[ r(:oclA' ~!u'~:'~M!.~
L8I I. Original R,'urn 0 2, Suppllmlnlol R.lu,"
20. If lIn, 191. or.al., than line 18, ente, the dlff.r.ncl on line 20. Thl, II the OVERPAYMENT.
gO
21. If Line 18 II o,ealer lhan line 19, enler ,h. djff"encI on line 21. Thl, II ,h. TAX DUE.
A. Ent., thl Inl.,..1 on the bolan,. due on line 21 A.
B. Enl., ,h. 10101 01 L1n. 21 ond 21 A on L1n. 21 B. Thl. I. Ih. BALANCE DUE.
Malee Chicle Payable tal R'gllt., of Willi, Ag.nl
i ~ ~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH -<-<
Under plnalll.. of perjury, I declor. .holl hay. uamlned this '11 urn, IncludIng accompanying schedul.. and lIal.menll. and ta Ih. b.I' af my ~nowl.d9' and b.lI.f,
1111 I'u., corrlct and compl.'e. I d.c1ar. lhal all r.al .Uat, has been reportea allfue market value. D.c1aratlon of p,epar., alh.r ,han th, personal r.pre..n'alive Is
bas.d on allln'ormatlon 01 which preparar has any ~nowledDe.
llONAfUu 0' 'USON ,u'otn~. flUNO UIU.U .lobo_tiS bATt
/ /..... ,U!~ IDLJ._Ir!t~IJt. I!t.WJt1A.1Ic.r,jjl/~r; M.I?HT 17 Vif/'J9.s-
SIONATUU 01 '.I'....n HU hlAt~ _('RUltHA',...[ "'bDIIUS { "-I DAII
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lj:!512
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ula
o A. L1mlt.d EI'a'e 0 40. Future In'''..' Compromise
Ifo, dot.. 01 d.ath oh., 12,12.B21
Dl6. Dlcedenl DI,d T,,'ola 0 7, DlCadenl Maintained 0 living Trus'
(Alloch copy 01 WillI (Allach copy 0' T'''"1
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO.
HAM (OM'IIH MAltiNG ADOlllU
TllMdLJ4. r!)R. ..-.
UfPHOtn NUMUII
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109
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I. R.ol E.tol. (5ch.dul. AI
2. S'oe.s ond Bonds (Schedul. OJ
3. Closely H.ld Stoc~/Portn.,.hlp Inler." (5ch.dule CJ
A. Mor'gao.. and Nol.. Racelvobl. 15ch.dul. D)
5. Calh, 8an~ Deposlls & Miscellaneous Personal Properly
(5ch.dul. EI
6. Jolnlly Owned Proper'y t5chedule F)
7. T,on"... (5ch.dul. OI15ch.dul. LI
8. Talal Oron An... (10101 lines 1.7)
9. Funeral hplI"ses, Admlnll',a,lv. COlli, Mheollanooul
hp.n"l ISchedule HI
10. D.bl.. MOllgog. L1obllill.., 1I.n. (5ch.dul. II
II. Tolol D.dud'on. (tolollln.. 9 & 101
12. N.I Volu. 01 Ellal.(lIn. 8 mln". lIn. 11)
. 13. Charltabl. and Governmental BequeIll15ch.dul. J)
lA. Nel Value Sub ecl'a TOI( lIn. 12 mlnul line 131
15. Spoulal T,onl"" Ifor dot.. of d.alh oft" 6.30.941
S.. InUructlonl far Applicable Parcenloga on Rave,.e
Side. Ilnclud. volu.. from 5ch.dule K or Schedul. M.)
16. Amount of lIna 14 IOllabl, al 6% ro'a
(Include volu.. from Sch.dule K or Schedule M,)
17. Amaunl 0' line 14 tallobla 01 15% role
Ilnclud. yolu.. from 5ch.dule K or Schedule M.)
18. P,lnclpallol( due (Add 10K from L1n.. 15, 16 and 17.1
19. C"dill Spoulal Poverty Credil P,lor PoymGnll
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'OR DATIS 0' DEATH A"IA 12131/91 CHECK HIAI
If /I SPOUSAL
POVIRTY CAIDIT 15 CLAIMED 0
fill NUMBlA
Oil-
COUNTY CODE
OICIOW '~(OM'IlU ADOlf
?Lf
YEAR
1009
NUMBER
10/3 ftpr;.t. J)~'VE:
tl1 e C.H AN leG (3 UA. (4, 1'/1, /7 tJJ";S'"
CDIIIII
AMOUUt II[(U"'IO Illl INnllUClIONSI
03.
05,
Remainder Relurn
(for dot.. of d.olh prior 10 12.13.021
Fed.rol Ello'e Tax Relurn Requlr.d
_ 8. Total Numb" of Sofe Depolll Bolltll
(I I 7-',-')Cfl) .
121
131
(41 -
(51_~D1/_03Y03.
161 -
(71 ------
I B I ., ~,_~'l~. -
(II) 9 7.3 7. -
(121 l!A/"o,,-
1131 -
U (,0'-. -
14
M._-
M .06. S:..a:J_4 . 34
M .IS II
_J.J22~. II
(181
(191 '" .1'\3, .!!.i.
1201
(91__'1_73.7,
(101
(151
(16) _'iL'L"'_QI,.
(171
DIlCounl Inllflll
+-..D.5_~,,- -
Check horo'lf yau aro rGqu..llnD a ro'und 0' your overpayment.
LJJ~. ~
121)
(21AI
(21BI
.
,..c_
Act #48 of 1994 provldel for Ihe reduction of Iho lax ralel Impoled on Iho nel value of Iranden 10 or far
Ihe ule of Ihe Ipoule. The ralel 01 prelCrlbo~ bV.lhe Ilalule will bel
, , ,
. 3% (.03) will be appllcablo for ellalol of decodenll dying on or aflor 7/1/94 and boforo 1/1/96
. 2% (.02) will be applicable for ollalel of decode nil dying on or afler 1/1/96 and before 111/97
. 1% (.01) will be applicable for ellalel of decedenll dying on or aft.r 111/97 and b.fore 111/98
. Spoulal Irand.rl occurring on or afler 1/1/98 will be exempl from Inherllanc. lax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK (,,)IN THE APPROPRIATE BLOCKS.
1. Old decedent make a transfer and:
Q. retain" rh'e use or Income of the property transferred, .......................................................
b. retain the right 10 designate who shall use the property Iron;lerred or It I Income, ...............
c~ retain. a reversionary Inlorest; or .... ......... ....... ........... ............. ........... t.. ............ ... ..........
d. receive the promise for life of either payments, benelltl or care' .......................................
2. If death occurred on or before December 12, 1982, did decedent within two years preceding
death transfer property without receiving adequate conslderallan' If death occurred alter
December 12, 1982, did decedenttranllor property within one year of death without receiving
adequate consideration'....... ,oo .................. .....,..... ......... .......Of... ....... '"......... ..... .................
3. Old decedent awn an 'In trust far' bank account at his or her death'......................................
.
.!!'_s_ ~Q..
x
x
X
X
~ 1::
'0 1{)::Jet:
. ,,~IF TJ# ANSWER TO ANY OF THE ABOVE QUESTIONS IS YESr
yoti :';'UST ,.c:O,.,Pi1ETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
,', :~ - "
'~'.U! 3: -: i
_oJ) =, .
j~' ~ ~j
ITEM
NUMBER
1.
L
-
SCHEDULE A
REAL ESTATE
1
DESCRIPTION
r;c of'I.A.T'I /tor '0.:1 1lf'P..C ob.( I "I: , t't(4HllfoJ Ic.s 6UltG, Prt.
VALUE AT DATE
OF DEATH
7:1, "00
.
TOTAL (Alto onto, on IIno I, Rocopltulotlon)
(If more .pace Is n..ded, Ins.rf additional ,h..,. 01 same .;,..)
..L7~/1>~
.."'~".IJ.l1J
,'_~~~~m~5:'t~~1't#.1~'("'~-;-~l' --,,~,-~~,-,-~ ;;.".:..>"L. ~;',-.:: j',~ " ,,-,: .. :<,,~,+':Rw,,"f'.t;~~lffl'i"#<4::
'*'
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
COMMONweAlTH OF peNNSYlVANIA
INH..nANCI TAX lnulN
IIIIDINT Dle'DIN'
ESTATE OF
ORTH , E.u..E.N ,41,
CAli property folntly.ow"ed with the Right .f Survlyonhlp mu.I b. dl.d..ed on Schedule PI
ITEM
NUMBER
I.
01.
J.
'7.
.s:
4,
7.
Pllase Print or T e
FilE NUMBER
DESCRIPTION
1'l1<7D"'O~/"C. - 17't;' oIlAYUI.A.,l.l64(O'"
oS 1/ VINd.oS
,qC(,O'MJ'T"_ 'DII'"&....& CAI.I>IT uNIoN - "(,7
I'lccou..7 - l:JLPI"4 c.,(.L,ur U"/CAJ ... 137"~
t
oSllu,-.J 0. ~
..s'AII''''C,r
~ 'l:Du..r-
J>LPL..J Clf.tefT" "001 '~lI'" ~ 9D'.,
VALUE AT
DATE OF DEATH
I, 100. -
7, '1''1.-
001l, -
'I, ~38.
r..s, -
. -
g~o.-
GoOD. -
I ~oo.
&50. -
10D.-
CHtC.~'AJ' A-c.c.o.....r- f>Nc' .(311"-11<
U' 0'/- "(<<>'(- 79r(J
r; Ul\l c.. '-~I:r:. T/ON
CHIIo.JA
8'. ~uT't;ur. PUIlOJ,TUA.E..
s rJ:l 03
10.
vLWI.L IV'
/O"/o..&.... 71lt1,~ ~c.T- (IUtUt fllU'I'lIA /ltuoIr.:o)
TOTAL Also .nter on line 5, R.ca
IA"ach additionallY." )C II" ,hull I' mare 'pace II needed.J
~, :
"
~.:
;!.~
'i:
~,
II'#UlI I.. 1'.111 .
ITEM
NUMBER
A.
B.
4.
C.
1.
2.
3.
4.
5.
6.
7.
8.
... 'I'.'
. "'_ ~..;...' . ~'.'. .,_......-"',........-:<!1'ri.;'l>s!..~..,.~
'~":. -,;'"
.
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
Plea Ie Print or T .
(OMMONWIAlfH 0' 'ENNSYlVANIA
INHunANCE fAI InUliN
IIUIDENf DECEDENf
DESCRIPTION
AMOUNT
1.
".
Funllol Exponsea,
"'4,P,U.l:J: ""IoIClVlIo HDIo1t., ttteCHltAJ/ CIoal/IC., PIi.
"'ANrll/' C"", - "...,,~ - Pit 7'll IlIlUNO"," VI'!.-....
!HeePTII'" CUrol AfOre"" PVAJIAIH. - 1'laCH/II.,IY.u.o.G
Rl.ecl'n." CClt'r<t 1f'1'/"III- O~IC/"'Io _ V/".'Al/I'l
H"l1c ("~AI''''6 - Itle&,,.,stJ
,,-a.-
.:3.
"ltJ~. -
1 t.g. -
I ?.,. -
,g;'tl.-
.,.
..r.
Admlnlatratlvo COlli'
T/ltWCL./ I'll>"'/ c!D~
1'10. -
1. Porsonal Rop",sonlatl"" Commissions
~ .,
Social Socurily Number 01 Personal Representotlve.
Veor Commllllon. pold
2. Attorney Fees
3.
Family Exemption
Clolmant THOI'fA.r
c)),6"O.-
.50"
O/tJH
Relotlonshlp
Add",ss 01 Clolmant at decedent's death
SI",et Add"," /rJ(.lf ~PA.I. Z>A' 1Vt.
Cily M,l!JlllIJICl"UIJr" Slole fA Zip Code J 7DS.r
..
Probote Fee. R&ol,srlA 0'" to)l....S / F 1&.1(>)110 FLL
.:1;1.0,-
/&-.-
Mllcollaneaua Expensll'
.eUc!T7C1C!. IJ/Io,"o$ 7b "",...,.,./AJ HtJ~C (V"~T)
pu~.. Ir/I..Lo 7"f) 1'l1follU'rlHIU NO....t.. (,ClAoeA..T)
.J"(tl. -
3/11.-
(.7(...-
HtD.sPIT/r-l.. QI'-L. -H-G..'Y .cPIft.IT
~Ur o,('H~ r9o<tO..I.,If.#JC.C
flu, C/I.,.-no", ~ ll'lCNtlKrtJ
"jlJ.-
of
~r4 TO IJl.ifloTII 8tJt.JJ": c..t ItIIJU
9"~.-
TOTAL IAI.a enler on line 9, Recopilulallon)
(II mare apace Is noedod, Insert oddlllonalahoeta of lame alII.)
s
979'1. -
,
4''''. __... ..'_'.
s
.....0.-----...--- ___~__ _ ________ _ _______ _ _. _ ___ __ _ _ _ __________
j >', '.~, . - . . . -. :'
a'NO: AA022724, COMMO~~~~~~T ~:R~:~:YLVANIA
'11~1I" ..I....' ,OFFICIAL RECEIPT e PENNSYLVANIA INHERITANCE AND ESTATE TAX
..
RECEIVED FROM,
&
ACN
ASSESSMENT III
CONTROL ...
NUMBER
AMOUNT
THOMAS M. DRTH
10lS APPLE DR.
101
.4,81!1!.!S4
-..,..
MECHANICSSURB PA 170ee
~J;c).
~;f.'"
, )', " . . ESTATE INfORMATION,
I!:t filE UMBER
511 el-1994-I009
I!:t NAME Of DECEDENT IlASTI
1;1I OATH ELLEN M
II DATE Of PAYMENT
m POSTMARK DATE
COUNTY
'040Hflf
SSN 00S-09-e900
(fIRSTI 1M I)
CUMBERLAND
DATE Of DEATH
REMARKS
THOMAS M. ORTH
m TOTAL AMOUNT PAID
.4.see.!54
REGISTER OF WILLS
~
SEAL
iir-~.-- - ---~:--_-----~-~,- - - -~-- - - - - - - - -- - - -- - - - - -,--,7-:- ~-,--
. ',t to f....' '
.
.
, .'
~
.",
'.
, I
""
" '
1
"
.
\
---.....-_.:.,..~ -
I"~
w~
-- .
1:. ,
.
..
.'" h ~"',
1/
16-/-~
C-
.RUV-1548 EX AFP (12-94*
COHHONWEALTH Of PENNSYLVANIA
DEPARTKENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
MPf. nUll
HARRISIURG, PA 17128-06Dl
NOTICE OF INHERITANCE TAX
APPRAIeEKENT, ALLOHANCE OR DISALLOHANCE
OF DEDUCTIONs t. AND ASSEIS"ENT OF TAX 0"
JOINTLY nELD OR TRUBT ASSETS
DATE 08-28-95
ESTATE OF ORTH
M DATE OF DEATH 10-24-94
COUNTY
CUMBERLAND
ELLEN
FILE NO. 21 94-1009
S.S/D.C. NO. 008-09-2900
ACN
95123869
MARGARET M ZERFASS
185 ROBODA BLVD
ROVERSFORD PA 19468
REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
AMount R..1tt.d
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
iitii:is4-i-iif-AFii-iiif:941------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 08-28-95
ESTATE OF ORTH
ELLEN
M DATE OF DEATH 10-24-94
COUNTY CUMBERLAND
FILE NO. 21 94-1009
TAX RETURN WAS.
S.S/D.C. NO. 008-09-2900
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
95123869
FINANCIAL INSTITUTION, MEMBERS 1ST FCU
ACCOUNT NO,
8967-05
TVPE OF ACCOUNT, (lO SAVINGS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 11-04-92
Account B.1ence
Percent Taxab1. x
Amount S\'bject to Tex
D.bt. nrJ Deduction.
Taxeblo Amount
T.x Rate X
Tax Du.
22,505.09
0.166
3,750.92
.00
3,750.92
.06
225.06
NOTE. TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF TH"S NOTICE
WITH YOUR TAX PAVMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEV ORDER PAYABLE TO,
"REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAVMENT
DATE
07-13-95
RECEIPT
NUMBER
AA048005
DISCOUNT (+)
INTEREST (-)
.00
AMOUNT PAID
225.06
.
TOTAL nx CREDIT
8ALANC~ OF TAX DUE
INTEREST
TOTAL DUE
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATIDN OF ADDITIONAL INTEREST. .
IF TOTAL DUE IS LESS THAN '1, NO PAY"ENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRI, YOU ItAV eE DUE A REFUND.
SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. I
225.06
.00
.00
.00
PIJlIl'OU ..
NOT!a,
PA'nEHT.
RU\IQJ (au I
OIJECTIDHI.
ADttIN.
JITAATlVE
CORRIECTlOHII
DIICDLWT I
INTERflT I
.tr.:~\':-
N t: --:-.(
If!
" il) _.:0.:
It-..
CJ_ j'1
0
rr,
" ~
""
il , "
,) ~ ,',' E
(~I u: G8
0:
To fulfill the ,...,Ir...... of IHUon IUD ., U. InPMrlt_. IWMI hta'o talC Aat, Act 12 of lnl. (12 P.I.
leotlon 1140).
Detach the tDfl portion of thl. Notlco WId ,UIMIlt tilth )'our POYMnt to ttM _..ht.,. 0' N11l1 printed on the
rovor.. .Ide.
... ".... check or ItOMV oreM" pIIl_lo tal REGIITER Dr' "ILLI, AGENT.
AU pov-entl roc. and ,h811 fir.' tNI ..-,l1ed to MV 1ntor..t which ..y ba due, with M)' ,....1""" 1IPP11.. to the t...
A ,..fWMt of . t.. credit, Mhlch .... not roqu..t.. on the talC return, ..V H ......'N bv' cHPlat1na en "Applt.atlon
for Rafund 0' PennnlvMl1 Inherlt_. Md Eltato ..." (REY-UU). applications .r. IvallMlt. at the Offlco of
the Reahta.. 0' WUh, MV of ttMI 23 ..venue DSalrlet Dfflc...r bV caUlng the ~I.l ZlIi-hour ......,.Jng Mrvlca
~r. for for.. orderlna. In Penn.vlv~l. l-IOD-J'Z-ZOSO, outsSd. P~svlv.nS. and wSthln locsl
Herd8bur. .r.. (17) 7.7..aOM, TDDI (717) 772-U52 (He.rlng 1"llrM OnlvJ.
Anv plrtv In Inti"'" not ..tlsflMl with thtl ...n.......t, .I1DN~1 or dh.lhtNMClI of deduction. or .........t
of tlX (Including dhcCM'It or Int.r..t) .1 Mow! on thll Notlc. ..v obJlot within IIlIty (,0) d.n of recll,t of
thl. Hath. bVI
uwr1ttM prot..t to 'he Pi Dep.rt..,t of Rev........ laird of Appe8h, Dept. zalaU, Hlrrhburll. PA 17UI-lall, OR
....lecting to have thl ..tt.r deter.1h1d .t the Mldit of the eccount of the per.Dftl1 repn..nt.tI"l, OR
-.......1 to the Orph.".. Court
F.otu1 .rrorl dhcovlr.d on this ........nt .hoUld b. .dd,....d In wrltlnll tOI Pi o.p.rtaent of A'''.NII,
lur.", of IncU"ldutll T..... ATTN. POlt .........nt R...,I... Unit, DEPT. 110601, Harrlsburll, P" 11121.0601
Phone nl1) 7I7"65OS, S.. pa.. 5 of the bookl.t "In.tructlon. for InherltMCl' Tex Alturn for I Auldent
Decedent.. (Rty-tsoll for." .xplsnaUDn of ...lnhtrltl..,.1v correchbll .rro....
If ....y t.x dlM h p.ld within thr.. U) ul."der ItOnthl .ftar the d.c.d.nt'. d.lth, . fI". p.rcent (I~U
dhClount of thl tlX p.id 11 .Uowd.
Int.r..t .. chirgMl b.glmlng with fir.t dn of d.Unquenov. or nln. Ct) lonth. Met OM (I) dav
fr. the dlt. of dllth, to thl dlt. of PIVIIlnt. T.... which bee_ d.Unquent befar. J.......v I, .'12
belr lnt.r..t .t the nt. of ,Ix 16:t) percent p.,. ____ cl1wllt.d It . dlllv nt. of .0001'..
"U tl.l. which bee... delinquent an or .ft., JenulrV 1, 1912 .,Ul be.r Int.rllt .t I ret. which will v.rv fr_
calender Vllr to e.llndlr v..r with thlt nt. ennou'\Ced bv thrl PA Defllrt"",t of RevlnUl. ThtI eppllclllle
Int.r..t r.t.. far .'11 through 1995 Inl
'tW Inhr..t A.te Dill" Int.re.t Fletar Iur Inh,.,t A,t. O.lIv Inhr..' F.etal'
.'11: lOX .0005"1 1917 OX .01l1U
1..5 I'. .000411 19"-1991 11. .GOalDI
..." IIX .000501 1"2 .. . DIU'"
.91' ISX .OOOS" 1995.1". 7lC .001192
I'" lOX .00027" .995 .. .0'1241
"'Int.r..t I. calculated II fa111*.r
INTEREST . BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAILY INTEREBT FACTOR
"Anv Notlc. h.UICI .ft,r the tall bee_. delinquent will r.flect .., Int.r..t c.1cuhtlan to flftHn UI) diva
blwond thl dlt. of the ...........t. If p.yaent II .... after the Int.r..' cc*putaUDn dl'e .hoNn on U-
Notlel, Iddltlonll Int",", .,.t be calculltad.
,I.,
-,,'-
-.i
j:
,
'.
,..
R
,j!
:j
.REY.1548 EX AFP (12.94*
C~AlTH OF PENHlYLVAHIA
DlPARTttlNI OF REy[NUE
BUREAU Of INDIVIDUAL TAXEI
DEPT. II.'. I
HARRISIURG, PA 17121-.'.1
NOTICE OF INNERITANCE TAX
APPRAIIE"ENT. ALLOMANCE OR DIIALLaMANCE
OF DEDUCTION. t. AND AIIESI"EHT DF TAX DN
JDINTLY nELD OR TRUIT AIIETI
DATE 08-28-95
ESTATE OF ORTH
ELLEN
M DATE OF DEATH 10-24-94
COUNTY
CUMBERLAND
FILE NO. 21 94-1009
S.S/D.C. NO. 008-09-2900
ACN
95125983
MARGARET M HECKER
185 RDBODA BLYD
RDVERSFORD PA 19468
REMIT PAVMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
A.ount H..Hted
CUT ALONG THI8 LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~
Ritii:i54-i.iif.AFii-ii2~94i--------...-_..-.--------_.__..----------------------------....---------....--------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLV HELD OR TRUST ASSETS
DATE 08-28-95
ESTATE OF ORTH
ELLEN
M DATE OF DEATH 10-24-94
CUMBERLAND
COUNTY
S.S/D.C. NO. 008-09-2900
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION. MEMBERS 1ST FED CREDIT UNION ACCOUNT NO.
95125983
FILE NO. 21 94-1009
TAX RETURN WAS.
ACN
8967-41
TVPE OF ACCOUNT. () SAYINGS ( ) CHECKING ( ) TRUST (lO TIME CERTIFICATE
DATE ESTABLISHED 04-26-82
Account Balance
Percent Taxable X
Amount Subject to Tex
Debt. and Deduction.
Texeble Amount
Tex Rate X
Tex Due
3,143.52
0.500
1,571.76
.00
1,571.76
.06
94.31
NOTE. TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOYE ADDRESS. MAKE CHECK
OR MONEV ORDER PAYABLE TO.
"REGISTER OF WILLS, AGENT,"
TAX CREDJ:TS:
PAVMENT
DATE
07-13-95
DISCOUNT (+)
INTEREST (-)
.00
RECEIPT
NUMBER
AA048005
AMOUNT PAID
94.31
.
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
If PAID AfTER THIS DATE,..SEE REVERSE fOR CALCULATION OF ADDITIONAL INTEREST. .
If TOTAL DUE IS LESS THAN 11, NO PAV"EHT IS REQUIRED.
If TOTAL DUE IS REFLECTED AS A "CREDIT" I CRI, YOU KAV BE DUE A REFUND,
SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. I
94.31
.00
.00
.00
N ,~ .:(
1/)
L# !f{ 10.:
c!_ .
}
0
1"1
.t' ~
"'"
t---; '~
l,l \li ~
(I,O" ~8
0:-
PlllPOU .,
HOTlClI
To fulfill t~ r.qulr.-.nt. of Section '140 of the lnharltenc. ~ E,t,t, Tax A~t, Aot " of 1"1. .71 P.I.
hotJon llU).
PAYlOr I
DetKlt the top portion of thl, HotlCl and subll" ..Uh your PIPent to the R....t.r of WU1. print" on the
rlVlr.. .Ide.
on .... chKk or HMY ardtir paVIbI, tOI REOllfER OF WUlI, AaENT.
All p.~t. r.c.lved .hall flr.t b, applied to ~v lnt.r..t which "V b. ~, with anv r...l~r 1PP11" to the tiM,
REfUND (CA).
. r.fund of . tax cradlt, which .... not r.~.ted on the t.. return, ..y be r'quI.tad by co__ll.I"I In "applicatIon
for R,fund 0' Pannlylvanla lnn.rltlnCl and E.t,t, Tlx. (REV-IllS). applIcation. .r. .v.l1~1. at the Of,IcI of
the RIII"ar of Will., any of the IS Revenue DI.trlct D"lcI' or by c'111ng the ,plola. Z4-hour en.werlng ..rvlcl
~r. far for.. ordering, In P~.vlvanl. .-I".)62.Z050, out.tde PInn.>>lvant. and ~Ithtn loc.l
Hlrrt.bur, .r.. (717) 717.109~, TOOl (717) 77Z.!Z5Z (He.rtne I~.lrld Onl>>).
OIJECTIOHSI Anv p.rtv tn lnt.r,.t not ..tt.,ted with the .ppr.t....nt, .Ilow~' or dl..llowlnG' of deduatlon. or ......eent
0' t.x (Includln, dl.count ar Int.r..t) .. shown on thl. Hotlc. ..>> obJ.at ~Ithln .Ixtv (60) dlv' of rac,.pt a'
thh MoUc. bVI
..wrltten prot..t to the PA D.p.rt-.nt 0' A.yenue, IOlrd of 'pp..I., O.pt. 2110ZI, H,rrl.bur" PA .7IZI.1021, OR
....aotlng to h.y. thl ..ttar d.tar.lnsd .t the audit of the ICCount of the par.on.. r.prl..nt.tlv., OR
..app..1 to the Orphan.- Court
ADHIN.
IITAATlVE
CDARfCTlDNSI
Factu.1 .rrar. dllcoy.r,d on thl. ........nt .hould b. addr....d In writing tOI PA D.p.rt"nt of R.y~,
IUrI..., a' Incflvldual h.... ATTNI Put A.....""t A.vl... Unit, DEPT. ZlO6DI, H.rrlsburg, PA 17121.0601
Phone (717) 7.7.6505. S.. pa.. ) of thl bookl.t ~In.tructlon' 'or Inh.rltanc. T.. R.turn 'or I A..ldent
Decldant~ (REY.lSOU for an ,.planatlon 0' act.lnhtraUy.h corrlctlbl. errars.
DIICDUNTI
If anv t.. due I. p.ld within thr.. C)J e.l.nd.r ~"th. .ftar the dle.dlnt'. dI.th, . flv. p.rclnt CS~)
dl.count of thl t.. p,ld I. .llowed.
INTEREST I
Int.r..t I. ch,rgad blgl""ln, with flr.t da>> of dlllnquanc>>, or nln. C,) .unth. and one (I) d.v
fros the dlt. of de.th, to the d.t. of p.y..nt. 1.... which blc... d.llnquent bl'or. Janu.ry I, 19.Z
ba.r Int.r..t .t the rat. of .1. C'XI p.rc.nt p.r annua calcul.t.d .t . dlllv r.t. 0' .OOO.'~.
All t.... which ~c... d.llnqu.nt on or .,t.r Janulry 1, 1912 will b.ar Int.r..t .t . rata which will v.ry fro.
elland.r v..r to c.lend.r v..r with that rat. announced by the PA Depart-.nt of A.vanua. The appllc'bl.
Int.r..t r.t.. 'or 1.12 through .995 .r'l
bit Inhr..t R,ta D,llv Int.ra.t Factor xur Int.r..t R,t. D.llv Inhr..t Flctor
1912 rax .0D05~1 "17 OX .000241
191) ISX .000451 ltal.I"1 11:: .OOOJOI
191~ IIX .000l01 I"' 'X .0002~1
1915 IIX .00OJ56 1"'.1"" 7X .000192
1916 lOX .000Z7~ 1"5 OX .000241
--Jnter..t ,. calcul.tad .. fal1ONI!
INTEREST . BALANCE OF TAX UNPAID X NUllBEa OF DAYS DELINQUENT X DAILY INTEREST FACTOR
"-Anv MoUe. IlIuad .ft.r the t.ll blCDlII d.lInquent will r.flect an Inter..t c.lcul.tlon to 'lit"" US) d.v.
bayond the d.t. of thl .......ant. If p.y-.nt I. ..0. .ft.r thl Int.r..t cu.putatlon d.t. shown on the
Notle., addltlon.l Int.r..t .u.t bI c.lcul.tld.
V
REV-154B EX AFP (12-94*
. CO~AlTH OF PENNSYLVANIa
IJl,PAnTHE:Hf Of REVENUE
lURE AU Of INDIVIDUAL "k[1
D!PT. IID601
HAARlSlUAG, Pi 171"-0601
/5 -/ - ~
c:
NOTICE OF INNERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONs t. ANa ASSESSHENT OF TAX ON
JOINTLY HELD OR TRUST ASSETS
DATE OB-2B-95
COUNTY
CUMBERLAND
ESTATE OF ORTH
ELLEN
M DATE OF DEATH 10-24-94
FILE NO. 21 94-1009
S.S/D.C. NO. 008-09-2900
MARGARET M HECKER
185 RDBODA BLVD
ROYERFORD PA 19468
ACN
95125984
REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HDUSE
CARLISLE, PA 17013
Anaunt R..1tt.d
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
Rifv:is4-i-i)f-AFji-iiir=94i------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS. AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 08-28-95
ESTATE OF ORTH
ELLEN
M DATE OF DEATH 10-24-94
COUNTY
CUMBERLAND
S.S/D.C. NO. 00B-09-2900
(X) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION. MEMBERS 1ST FED CREDIT UNION ACCOUNT NO.
FILE NO. 21 94-1009
TAX RETURN WAS.
ACN
95125984
8967-40
TYPE OF ACCOUNT I ( ) SAVINGS ( ) CHECKING ( ) TRUST (lO TIME CERTIFICATE
DATE ESTABLISHED 04-26-82
Account Belance
Percent Texable X
Amount Subject to Tax
Debt. end Deduction.
Taxeble Amount
Tax Rate X
Tex Due
3,143.52
0.500
1,571.76
.00
1.571.76
.06
94.31
TAX CREDITS:
PAYMENT
DATE
07-13-95
RECEIPT
NUMBER
AA048005
DISCOUNT (+)
INTEREST (-)
.00
NOTE. TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO.
"REGISTER OF WILLS, AGENT."
AMOUNT PAID
94.31
94.31
.00
.00
.00
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ·
IF TOTAL DUE IS LESS THAN '1, NO PAVHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREon" I CRI I YOU HAV BE DUE A REFUND.
SEE REVERSE SIDE OF TNIS FORH FOR INSTRUCTIONs. I
.
P\IIPOU ...
MOTJal
P&YlENTI
RUlIfD leA>>,
N ,'.-(
If) 'in:
;-2 .,
r"
0
1'1
8
,- ""
c.'
'J j\ !5: G~
ll.lu.;
II:
To fulfill t~ requlr..-nt. 0' Ieotlon 1140 0' t~ l~rltlftC. end Est.te 'aM Aot, Aat II of ."1. (71 P.I.
IMUon 2140).
DetMh the top portion of thl, Notle. end IW.1t with your Plyant to the _....t.r 0' NUll print... an the
r."..... .Ide.
... .... dMtck or INIMV orde, PI",MI.I tal ftCllTER IJlI' MUll, AGfH'.
AU plyHnh noalv" IhIiU flr.t be IfIPllH to MV Intan.t .....lch ..v be due, with MY .....Ind.r ...lIed to the tlIC.
A n'und of . talC credit, which .... not r.....t" on the t.. raturn, "V H r.que.tM by cOllPlat1no en '"Appllutlon
for R,fund of Pennavivlnl, Inherlt~. end E.t,t. ,.... (AEY-1SIS). application. .t. 1"111_.1 at the 0"101 of
the R,,'ltar of Willi, eny of the ZS Ravenue DI.trlot Df.lc.. or by Cl111ng the .,.0111 Z_ahour enawer!", ..rvlcl
nu.ber. for for.. ord.rlnal In Penn,vlven.. 1.'DO-S6Z-1050, out. Ide PennlY1vlnla end within local
Harrllbur. .r.a (717) 7'7~'D94, TDD' (717) 771~1151 CHe.rlng 1...lred Onlyl.
OIJlCTIDHSI Anv party In Intar..t not .atl.fled with the ~r.I...-nt, .IIOM~. or dl..IIOManca of d.ductlon. or .......-nt
of tlX (Including dl.caunt or Int.r..t) .. lhown on thl. Hotlc. ..y abject within Ilxty (601 daVI of racalpt of
thl. HoUc. bVI
-~wrlttan prota.t to thl PA Deplrt..nt of Rav~, laird of Appaal., Dept. ,.10,1, H.rrlaburg, PA 1712'-1021, OR
"~.lactlng to have the ..ttar dat.Mllnad at the audit of ttM account of the parsonal repr..antatlva, OR
"lIPpaal to the DrphM.' Court
ADttlN"
lSTRATJYE
CDRRE:CTJONSI
DIIC~TI
INTEREST I
Factu.l arror. dl.cov.r.d on thl. ........nt .hauld b. .ddr...ed In writinG tal PA Dep.rt.ant of R.v.nue,
lur..u of Individual T.xa., AtTNI po.t A......ant Aavlew unit, DEPT. 210601, Hlrrl.burG, PA 1712.-0601
Phone (717) 7.7.6505. Sa. p." 5 of the booklat Rln.tructlon. far Inherltancl Tlx Rlturn for. RI.ldent
DacadantR CREV~IIOl) for ~ Ixplanatlon a. ~Inl.trltlv.lv corr.atabla .rror..
If anv tlx due I. paid within thr.. CS) clland.r eonth. .ft.r the d.cedent'. de.th, . flv. p.rcant C5X)
dl.aount of the t.x p.ld I. .llaved.
Int.rl.t I. chargad baalnnlng with 'Ir.t dav of dellnquencv, or nlna C') ~th. and one Cl) d.v
fro. the data of d..th, to the d.t. of ply._nt. TIXI. which b.c... d.llnquent bafor. Januarv 1, 19.,
baar Int.rl.t at thl rlta 0' .Ix C6X) parcant p.r ~ calculatad at I dallv r.t. of .000164.
All tIX.' which bac... dallnquent on or .'t.r Januarv 1, 19.Z will baar I"tar..t at a rata which will varV fro.
calandar Vllr to calandar valr with th.t rata announcad by thl Pi Daplrt.-nt of Rlv~. The appllcabl.
Int.rl.t rat.. for I'.' through 1995 .ral
'tUr tnt.r..' R.t. D.llv Int.r..t F.etar l:Ur tnt.r..t R.ta nallv tntar..t FlMltar
1911 rox .DOOM. 1'.7 OX .000147
I'as 16X .DOaU. I...~I"I IIX .0OOSOI
I'" \1X .DOISOl l'ot .. .000147
1915 IIX .ODOSH I"S"I994 7X .000192
I'" lOX .000274 I'" OX .IOU'7
ulnt.r..t I. c.lculatld .. follOM.1
INTEREST . IALANCE OF TAX UNPAID X NunlER OF DAYS DELINQUENT X DAILY IHTERElT FACTOR
"'Anv NoUea I..u.d .fler the t.x bac.... d.lInquent wUI raU.ct an Intara.t calcul.tlon to f1Uaan ClIl day.
bevond thl data of \hi .........,t. If p.YMftt II ... .ftar the lntar..t cDlPUtatlon dat_ .twtwn on thl
Notice, IIddltlonal Int.r..t .....t be calculltad.
\
. .,.--.----.
IS" 1- ~
~
r" _
.
\ DATI C.
08-28-95
COUNT" CUMBERLAND
AcN 95125985
HaTICE Of IHHERITAHCE TA~
APPRAIIEHEHT, ALLOMAHCE OR OIIALLOMAHCE
Of DEDUCTIOH ,. AHD ABlEISHEHT Of TA~ OH
JOIHTLY nELD OR TRUIT AlltTI
RIV-1B41 IX AFP 112-94>*1
. c(Jtl'tOHW(A\.'" OF p[HH,nVA".&
D['AATt<<"t Of' RtVlHUl
IURI!.AU Of INDIYIDUAL ,...u
OfP'. U060l
HAAAtIIURO, PA .,111.0601
ESTATE OF DRTH
ELLEN
M DATE OF DEATH 10-24-94
CUT ALOIIO THIS LINI ~ RETAIN LOIIIR PORTION FOR YOUR RECORDS ~
,~,,;"".".i'~.l~i;"'.....................----..............---..---.-......-.---.----.-----.-.------...
NOTICE OF INHIRITANCE TAX APPRAISEHENT, ALLOIIANCE OR DISALLOIIANCE OF
DEDUCTIONS, AND ASSESSHENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
D TE
FILE NO. 21 94-1009
S.S/D.C. NO. 008-09-2900
HARGARET M HECKER
185 ROBOOA BLVD
ROYERFORO PA 19468
"
r
REHIT PAYHENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
t
A.ount R..l Heel
]
ESTATE OF ORTH
ELLEN
H DATE OF DEATH 10-24-94
COUNT" CUMBERLAND
S.S/D.C. NO. 008-09-2900
(X) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORHATION
FINANCIAL INSTITUTIONt MEMBERS 1ST FED CREDIT UNION ACCOUNT NO.
TYPE OF ACCOUNT I (> SAVINGS ( ) CHECKING ( ) TRUST (Xl TIME CERTIFICATE
DATE ESTABLISHED 11-22-88
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST (-)
07-13-95 AA048005 .00 45.49
TOTAL TAX CREDIT 45.49
BALANCE OF TAX DUE .00
INTEREST .00
TOTAL DUE .00
. If PAlO AfTER THIS DATE SEE REUERSE fOR CALCULATION Of ADDITIOHAL INTEREST. ·
FILE NO. 21 94-1009
TAX RETURN WASt
Account Ba1ence
Percent Taxeb1e ~
Amount subject to Tex
Debt. end Deductions
Taxeb1e Amount
Tex Rate y.
T aX Due
1,516,41
0.500
158.24
.00
158.24
.06
45.49
TAX CREDITS I
AcN
95125985
29064-46
NOTEI TO INSURE PROPER CREDIT TO
"OUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH "OUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONE" ORDER PAYABLE TOt
"REGISTER OF WILLS, AGENT,"
I If TOTAL OUE IS LESS TH1N II, NO PAVHENT IS REQUIRED,
If TDTAL OUE IS REflECTED AS A "CREDn" I CRl, you HAY BE DUE A REFUND.
SEE REVERSE SIDE OF THIS fORH fDR IHSTRUCTIONS. I
~;,~.~.
,.
'" 1::.:1:
',.. If!
, Ul "(1,
.- ~
CL ,
I
0
I""
~
=
U "
'-' .;, ~ " E
iii a:
a:. ~8
-...
NOnCE I
To fulfill t~ r.qulr...ntl of sactlon Z14' of the Inherlt~. ~ Eltlt. TI. Aot, Aot ZZ of 1"1. C71 P.I.
hoUon ZI40J.
PAntDCT,
Det.ch tM tDP portion of thh NoUc. Met lubIllt ..lth your PIVHrtt to tM R..ht.r of Will, prlntld on tM
r.v.r.. .Ide.
.~ "ski check or ~y ord.r Plrebll tal REDISTER OF WILLI, ACENT.
all PI,..,." rec.lnd .h,ll flr.t be 'PP1I1Sd to any Int.r..t Mhlch ..v be duI, with anv r...lndtlr IPPUId to the t...
A!:FUND CtAJ I
A r.fund of . taM crldlt, Mhlch .... not nqu.,tlSd on the tIM r.turn, .IV be n...t.d by cHPleUng an "AppllnUon
for R.fund of Penn'Ylvanl. Inherlt~1 8nd Est.tl T.." CREV.ISIS). Appllc.tlon. .r. IVlllable It tM Dfflc. 0'
tM Rlalst.r of Will., InY 0' the ZS Revenul DI.trlct Dfflc.. cr bV cllllng the .plclll Z'~hour ..,.warlng ..rvlc.
nueber. for for.' ordering I In P.nn.ylvlnll 1.IDO~S6I~ZD5D, out.lde Pennsylvanl. end within 10cII
Harrl.bUr, .r'l (717) 7'7~ID", TOOl (717) 77Z.ZISZ CHelrlng I.,.lrld Dnly).
DIJlCTIOHSI Anv plrtv In Int.r.st not ,.tlsfllSd ..Ith thl appr.I...-nt, .llawanc. or dl..llowancl of deduction. or ........nt
of tl. Clncludlng dl.count or Int.r..t) .. shown on thl. Notlc. ..v obJact ..Ithln sl.ty C6D) days of rac.lpt of
thh HoUc. bVI
..wrltten prot..t to thl PA Depart..nt of R.venue, Ia.rd of Appa.I., Dept. 111DZI, Hlrrl~rg, PA 17IZ'~IOII, OR
..,lactlng to hava thl aattar dat.ralned at the audit of ~ account of thl par.onal rapr...ntatlve, OR
.~IPPI.I to thl Qrp~,' Court
ADtUN.
ISTRAnVE
CORRECTlOHSI
F.ctu.1 .rrar. dllcov.r.d on this ......eent .hould be .ddr....d In writing tal PA D.port.ant of R.v~,
Buraau af Indlvldu.1 T...., ATTNI po.t A.....eent R.vl... unit, DEPT. Z10601, Harrl.burg, PA 17IZI.0'01
Phone (717) 717.6505. S.. psoa S of the boOklat "In.tructlon. for Inharlt~. T'. R.turn for. Ra,ldent
Decadent" CREV.IIOI) for In ..planatlon of ~Inl.tr.tlvely corractabl. .rror..
DISCOUNT,
If any te. dUe I, p.ld ..Ithln three IS) cal,ndar .unths .ft.r thl dacedent.. death, a fly. p.rclnt IIX)
dl.count of the t.. p.ld Is .llowed.
INTERESTI
Int.r..t I. charlld baglnnlng with first day 0' delinquency, or nine C,) aonth. and one Cl) d.y
fro. thl date of d..th, to thl dats of payaant. T.... which bae... d.llnquent bafor. Jenuarv I, 1"1
baar Int.r..t .t thl rat. of .1. 16%) parcent p.r ~ calculat.d at . dellY rat. cf .000164.
All t.... which bee... d.llnquent on or ,'t.~ January 1, I'll will ba.r Int.ra.t .t . r.t. which will varv fr~
calandar v..r to c.land.r y..r with thet rat. announc.d by thl PA D.part.lnt of R.vanua. ThI appllcabl.
Int.r"t r.t., for l'IZ through 1995 aral
UIr tnt.r..t A.t, n.lhl tnt.ra.t Factor xur Intlr.st Ra" nallv tnt.r..t Factor
"II ..X .000541 .." 'X .UU"
1915 I6X .DDO'" .....1"1 lIX ,DDOlOl
I'" IlX .Oaosal I'" .X ,OOU47
.." ISX .0aoSS6 1995."" 7X .DOD"Z
1916 I'X .aoU74 I"S 'X . DOU"
ulnt.r..t Is calcul.t.d .. 'ollow'l
INTEREST . IALANCE OF TAX UNPAID X NUHIER OF DAYI DELINQUENT X DAILY INTEREST FACTOR
..Any Hotlc. 1.,UId a,t.r thl ta. bacOll' delinquent will r.fl.ct an Int.r.,t calcul.tlon to fl,teen CIS) day.
bawand the dst, D' thl ......MI'It. If p.pant II aade .ftar thl Intarllt CMPUtatlon d.t. .hewn on thl
Notlea, ad.Utlonal Intarllt au" ba calcul.tlMl.
'~.
f"
-+: .
':\
~c,
:1.
:~;
"
f :~
~
v
c
10- (- tp
,REV-1!48 EX AFP (12-94*
CDHHONWfALTH Of PENNSYLVANIA
DEPARTItfHT OF' RlYt:HUE:
IUREAU OF IHDI~IDUAL TAXll
DEPT. 110601
HARRIS'URO, PA l11rl-0,01
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOHANCE DR DISALLOHANCE
OF DEDUCTIONB,.AND ASIESSHENT OF TAX ON
JOINTLY nELD DR TRUST ASSETS
DATE 08-28-95
ESTATE OF ORTH
ELLEN
M DATE OF DEATH 10-24-94
COUNTY
CUM8ERLAND
FILE NO. 21 94-1009
S.S/D.C. NO. 008-09-2900
ACN
95125986
MARGARET M HECKER
185 ROBODA BLVD
ROYERFORD PA 19468
REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
AltOunt R..l tt.d
CUT ALONO THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ..
Rifv:i5iri-ijf-AFP--ri2~94i-----.-----------..----------------------.-.-------------.-------------.--....-----.
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 08-28-95
ESTATE OF ORTH
ELLEN
M DATE OF DEATH 10-24-94
COUNTY CUMBERLAND
S.S/D.C. NO. 008-09-2900
(X) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION, MEMBERS 1ST FED CREDIT UNION ACCOUNT NO.
95125986
FILE NO. 21 94-1009
TAX RETURN WAS.
ACN
29064-47
TYPE OF ACCOUNT. (l SAVINGS ( ) CHECKING ( ) TRUST (lO TIME CERTIFICATE
DATE ESTABLISHED 11-22-88
Account Behnce
Percent Texable X
Amount Subject to Tex
Debt. end Deduction.
Texeble Amount
Tex Rete X
T.x Due
1,516.47
0.500
758.24
.00
758.24
.06
45.49
NOTE. TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
DR MONEY ORDER PAYABLE TO,
"REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT
DATE
07-13-95
RECEIPT
NUMBER
AA048005
DISCOUNT (+l
INTEREST (-)
.00
AMOUNT PAID
45.49
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
. IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .
IF TOTAL DUE IS LESS THAN 'I, NO PAVNENT IS REQUIRED.
IF TOTAL DUE IS REFLECTEn AS A "CREDIT" C CRI, VOU IlAV SE OUE A REFUllD.
SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. I
-- ~...- -~--.-' -,--._-.. ._, ,~.___~__ --~- 1--..-_...~~.....- '" .' _ _. -<---,' .-_
45.49
.00
.00
.00
..;.-._,;..-..;.:._."....~..._~.
;i. "~,i.~~tJ,;~~:.;>>-.:..;~'
N e.'(
't.. V)
" ~1 .l-L
~ ,...,
D.
0 (....
l'1 I
I'
III ~ j
1't ".,
.;J
lJ LJ..' ,'1
II m ~ ~~
o1Ju:
a:
_or
MOfIal
To fulflU the r..,lreMfth of I.otlon IUD of tM Inhlrl"no. .... lItat. Tax Act, Aot II of 1"1. (71: P.I.
hetlon 1141).
PAYttOfTI
o.tlCh the totl portS.. of thh Notlc. 8nd .utMllt ..Ith wour p.yant to the .....t.r of Will. prlntlMl on the
reverN .Ide.
.. .... chsck or ..ntv order p.vlbl. tOI REOIlTEA OF' WILLI, ACOn.
All ,.penh rlC.lvld ahlll first bI ."UM to 8nV Int.r..t Mhlch ..~ bI duI, ..lth M~ r...lnder ...,UId to the t...
RUUND ((A)I A refund of . taw credit, Mhlch .... not n.,..tld on thl t.. r.turn, ..v be reque.ted bw cMlPI.Uno sn "AppllcstSon
for A.fund of PMr1SVlvMI. Inherlteno. end E.t.t. Tax" (AtV.ISIS). AppIlCltlon..n .v.lllbl. .t the Dfflc. of
the A..ltter of WU1', MV 0' thl U A.v..... DI.trlot OffiCI' or bv clUing thl .~01.1 U"'hoUr 1In......lng 'Inrle.
nuebe... for for.. ordlrl"'l In p"",.vlnnle 1..U.16I.IOII, out.lde Pinn.w!VMI. Md ..Ithl" loc.1
",..rlabu... '1'.' (717) 7.7.1094, TOOl (717) 771.ZlIl (HI.rlng 1~llrM OnIV).
~
OIJl!CnONSI Anv ,...tv In Int,,,"t not ..Ullled ..lth the eppre.......t, ,UOMInC' Dr dl..Uowenol of dlduCUonl 0" ........"t
of t.. (Including d"count or Intlrut) u lhown on thlt Notlc. ..v obJHt within .btv (6OJ dlye of renl,t of
th" Notlc. b~1
....rltt.n prot..t to thl PA DIp.rtsent of R.v~. ".rd of Appeal., Dept. '1lall, Harrl.burg, PA 1111:1"IDll, OR
".I.otl", to h.v. the ..ttlC'" det.r.lned .t the Midlt of thl account of the p.rlOMI r.,r..ent.Uv., Ollt
.......1 to the Orphln.' Court
,
.
i
!
AD.UN.
IITAAllVE
CORRECllONSI
'ectuel .rror. dllcav.red on thl. ......-.nt should be addr.I.1d In yrltlng tOI PA Dep.rt~t 0' Alvenue,
lur..u of Incllvlduel TaUI, ATTNI POlt A......."t R.vl... Unit. DEPT. ZlIIDI, Herrhbur'f PA 1711:1.1111
PhoM (7111 717.65D5. SII pao- 1 of the bookl.t "In.tructlonl for Inhlrltenc. Ta. R.turn for. A.lldent
Decedent" CREV.IIDI) for ~ ..plan.tlon of ~Inl.tretlv.lv eorrectlbl. .rrorl.
DtSCOUNTI
11 .ny tn due I. p.ld ..lthln thn. (5) calend.r IIOnth. eft.r thl decedent'. deeth, . flv. ".re..,t n:u
dl.count of the t.. p.ld I. .Ilay.d.
JNTDfITI
Int.r..t .. wr.ed b..lmlng with first dew of dllInquMC~, or nl,.. Ct) eonthl and OM (1) dill'
fr.. the d.t. of dI.th, to tn. dlt. of plw.lnt. T.... which bee... d.llnquent before Jenuery 1, 191r
bell' Int.r..t .t the r.t. of .1. (6X) p.rcent par ~ c.lcul.ted .t . dlll~ r.t. of .DDDI64.
All t.... which bee... dlllnquwtt on or .ft.r JlnUllrv I, I'" ..Ill bI.r Intlr..t .t . r.t. Nhlch ..111 v.ry fl'.
ellend.r w..r to c.lend.r v..r with th.t r.t. ~.d bV the PA o.plrtllnt of A.venue. Th. ~llcIOI.
Int.r..t r.t.. for I.., thr~ 1"5 .r'l
1'12
1,IS
1'"
"II
It..
....Int.....t
lOX
IlX
IIX
ISX
lOX
II c.loul.tld ..
.GDDMI
.DDDUI
.GnSlt
.GDDJ56
. DaDl7'
foUow..
%air Inbr.d Alta D.U., Inhra.t F~tor
1t17 tX .DDU47
ItH.I"1 IIX .DDDSIl
1"' tX .Duru
I"S.lfM 7X .DDDIU
I- tX .U1l47
lair Intera.t A.t. D.U" Intaraat Factor
JIfTEIIElT . IALAHCE OF TAll U"PAID X "UllBEI OF DAYB DELJ"QUEICT X DAILY JIlTEllElIT FACTOR
"Anv NoUc. ".ued efter the t.. b.c.... delinquent ..UI r.flect '" Intlrut c.lcuhtlon to ,1ft.." nl) d.v.
blrand thl ut. of thl .......snt. 11 PI18snt Ie ..... .fter the Int.r..t COIIfIIUt.Uon d.t. IIhOwn on the
Hotlc., Iddltlonel Int.rut ...t b. c.lcullted.
.Ii'"
,fr'
"/.;0.
l:~
~'-;
~'
,~
~
!it
lI;;;','
,~'
~;f,
~
't.J
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. jl~
"
i.~'
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:.';'
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tti
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.;:
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,-". .~.- .
~,. ".. .~ ..,'''''':..-.'<'....'',''"''''~,...........~.,'_..,..
r/
15-'-("
C,.
REY-IB48 EX AFP (12-94*
. CDMlDMILTH Of' PffillSYLVANl1
D(PARUEHT Of' A[ytNU(
IUAUU Dr' INDIVIDUAL TAXEI
DEPT. "'" 1
HARRtllURa, PA 171"."11
NOTICE OF INNERITANCE TAX
APPRAIBE"EHT, ALLDMANCE OR DIBALLDMANCE
OF DEDUCTION" t. AND ABIESB"ENT OF TAX ON
JOINTLY nELD OR TRUST ASSETS
DATE 08-28-95
ESTATE OF ORTH
EllEN
M DATE OF DEATH 10-24-94
COUNTY
CUMBERLAND
FILE ND. 21 94-1009
S.S/D.C. NO. 008-09-2900
ACN
95125987
MARGARET M HECKER
185 ROBDDA BLYD
ROVERFORD PA 19468
REMIT PAVMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
A.ount R..S Hod
CUT ALONG THI8 LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ...
Riiv:iiiri-ijf-AFji-riif:94i------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLV HELD OR TRUST ASSETS
DATE 08-28-95
ESTATE OF ORTH
EllEN
M DATE OF DEATH 10-24-94
COUNTY CUMBERLAND
S.S/D.C. NO. 008-09-2900
(X) ACCEPTED AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTIDN, MEMBERS 1ST FED CREDIT UNION ACCOUNT NO.
ACN
95125987
FILE NO.
21 94-1009
TAX RETURN WAS.
29064-43
. TVPE OF ACCOUNT. () SAYINGS ( ) CHECKING ( ) TRUST (XI TIME CERTIFICATE
DATE ESTABLISHED 04-22-85
r
,
~
;
;
Account Bdence
Percent Texeble x
Amount Subject to Tex
Debte end Deductione
Texeble Amount
Tex Rete x
Tax Due
2,061.27
0.500
1,030.64
.00
1,030.64
.06
61. 84
NOTE. TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAVMENT TO THE
REGISTER DF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEV ORDER PAVABLE TO.
"REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAVMENT
DATE
07-13-95
DISCOUNT (+)
INTEREST (-)
.00
RECEIPT
NUMBER
AA048005
AMOUNT PAID
61.84
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
. If PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATIOH OF ADOITIOHA IHTERES..
I If TOTAL DUE IS LESS THAN '1, NO PAY"ENT IS REQUIRED.
If TOTAL DUE IS REFLECTED AS A "CREDIT" C C~~l YOU HAY SE DUE A REFUND.
SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIons. I
61. 84
.00
.00
.00
PIIIPClSE 01'
NOTICE.
PAYlt[HT I
RUUHD(CAU
OIJlCTlDNII
AllttIH-
ISTRATlVE
CORM:CTJDHSI
DllC~TI
INTEREITI
;'.
~Ih
"' ,~~.......:- --.
'(:;
.(.'}
,-
N
L.f.I
t'--c
",n:
"
~
r.._
Cl
..,
)
'.\
~
~ ...1
U Ii'
lLJIY+
ce'-'-
~
. E
->>:>
Du
To fulfIll the requlr..enta of section 2140 of the Inherlt~. end Eltat, ,.. Act, Act II of 1991. (72P.I.
bOtton 1140).
DetKh the top portion of thh NoUn _ IW.1t with YDUr PIYHf'tt to the AI,htl" 0' "Ult printed on the
reye.... ,leN.
... Helca check or MM. order Plvabla tal REGISTER Of WILLI, ADEMT.
AU Plwants recalved thaU flrat be IIPPUad to ...y IM.n.t liIhlch -.y be dI.M, with ."y ..__Inde.. ...,11... to the ta..
.. ..afund of . taM cradlt, .....Ich .... not nqu..tld on the tllC ..atum, Dr ba requllted by cOllPlaUnll ." "Application
for R.fund of PennlVlvln.a Inheritance end Eat,t. '.x- (REV.1SIS). applications .t. Ivallabl. at the O,.lcI of
the Aaglltl" of Willi, any of the II Ravenue Dl.trlot D"lc.. or by CIlllng the ,pecla. 24-hour ~'Ylrlng .arvlc.
~r. for 'ar.. orderlnal tn Penn.vlv~la l-100-S62-2050, out.lde Penn.vlv~la ~ within local
"-rrJaburl ar.a (717) 717-1094, TOO' (717) 772-2252 ("-arlng t.,.ired OnlV).
Anv party in int.r..t not AU.fled with the ..,pu......,t, .U_ene. or d"aUowWW:I 0' deduotlanl or ........"t
0' t.. (Including dl.count or Int.ra.t) .. shown on thi. Notlc. ..v object within .Ixtv (60) d'vI of r~lpt of
thh Nottc. bVI
--written prot..t to the PA Dap.rt.-nt 0' R.v.nua, Ioard of Appa.I., Dept. 211021, Harrl.burg, PA 171ZI.l021, OR
..allCltlng to MV' thl ..ttar d.tar.lnad at the audit of the accCU1t of thl par.onal rapr..ant.Uva, OR
.....,..1 to thl Drphwl.' Court
Faotu.l .rror. dl.covarad on thl. .....s.ant .hoUld ~ addr...ed In writing tOI PA Dapart-.nt of R.venue,
Jur.au of Individual T...., ATTNt Po.t A.......nt p.vl.w unit, DEPT. ZI0601, Harrl.burg, PA 17121-0601
Phone (717) 717-650S. S.a P"I 3 of thl bookl.t .In.tructlon. for Inherltww:a Tlx R.turn far. Aa.ldlnt
Decadent" (REY-1501) far ~ ..planatlon of adalnl.tratlv.lv carreat~l. .rror..
If anv t.. due I. p.ld within thr.. (3) callnd.r ~th. aft.r the dacadent'. death, a flv' parcent (IX)
dl.count of thl t.x paid I, allowed.
tntar..t .. chargld beglMlna with first day of delinquency, or nlna (,) IIOnth. ~ OM (1) day
frOlt thl data of death, to thl data of payJl.nt. Ta... which bee... daUnquant bafar. Janu.rv I, 1912
baar lnt.r..t .t thl r.t. of .1. (6%) parcent ,.r ~ calculat.d at . dallv rat. of .000164.
All ta.a. which bec'" dlllnquent on or .ftar Januarv I, l'IZ will balr Int.r..t at a r.t. which will varv fro.
calendar Vlar to calend.r vaar with that r.t. announced by thl PA o.,art.-nt of Rlvenue. ThI ."llclbl.
Int.ra.t rata. far 1'1' through 1995 aral
lilt Int.r..t R.ta Dall" Int.,.... FlHlto,.
Iur In..,...t A.t. Oall", Int.,...t FlMltor
1,.7 9% .00U47 ;
1'''-1''1 lIX .0GaSDl I
I'" ,. .OOUU I
ltU-ltM 7X .0001" ,
1"5 9% .00U47 t.
191'
I,.,
I."
1..5
19"
"'Int.r..t
lOX
lAX
lIX
UX
lUX
I. calculated ..
,ODO"I
.ODOUI
.00OSDI
. DOOS56
.000274
followlI
INTEREST . IALANCE OF TAX UNPAID X NUHIER OF DAYI DELINQUEnT X DAILY INTEREST FACTOR
..Anv Hotlc. Issued .ftar thl t.x beeaae. delinquent will rafllGt an Int.re.t c.lculatlon to flftean (IS) days
~yond thl dat. of the ......eant. If P.y-.nt I. -.da after the Int.ra.t coaputatlon date IhoMn on thl
Hotlc., additional Inter..t au.t ~ calculat.d.
t//
15./- (.,
,:
. R!V-154B EX AFP 112-94*
CDHMOHW[ALTH OF PENNSVlYANIA
Dlp&AttttNr OF REVENUE
BUREAU OF INDIVIDUAL TAXEI
DEP'. ZlO601
HARAIS.URa, Pi 17121-06Dl
nOTICE OF InHERITAnCE TAX
APPRAISE"EnT. ALLONAnCE OR DISALLOWAnCE
OF DEDUCTIOn" t. AnD AIIESS"EnT OF TAX aH
JDInTLY uELD DR TRUST ASSETS
"
.
~
t
'.
.
,_-.. -.., -' ." L.
~
DATE 08-28-95
COUNTY
CUMBERLAND
ELLEN
M DATE OF DEATH 10-24-94
ESTATE OF ORTH
T
S.S/D.C. NO. 008-09-2900
FILE NO. 21 94-1009
MAROARET M HECKER
IB5 ROBODA BLVD
ROYERFORD PA 19468
ACN
95125988
REMIT PAYMENT TOI
REOISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
A.ount R..ltt.d
CUT ALONO THIS LINE . RETAIN LOWER PORTION FOR YOUR RECORDS ~
i-iv:isiri-iiC-AFii-ri1i:94i------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 08-28-95
ESTATE OF ORTH
ELLEN
M DATE OF DEATH 10-24-94
COUNTY CUMBERLAND
S,S/D.C. NO. 008-09-2900
(X) ACCEPTED AS FILED () CHANOED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION, MEMBERS 1ST FED CREDIT UNION ACCOUNT NO.
FILE NO. 21 94-1009
TAX RETURN WAS,
ACN
95125988
29064-42
TYPE OF ACCOUNT. () SAVINOS ( ) CHECKINO ( ) TRUST (~ TIME CERTIFICATE
DATE ESTABLISHED 04-22-B5
Account hlance
Percent Texable X
Amount Subject to Tex
Debte end Deductione
Taxable Amount
Tex Rate X
Tax Due
2,061.27
0.500
1,030.64
.00
1,030.64
.06
61. 84
TAX CREDITS:
PAYMENT
DATE
07-13-95
RECEIPT
NUMBER
AA048005
DISCOUNT (+)
INTEREST (-)
.00
NOTE. TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAYMENT TO THE
REOISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO,
"REOISTER OF WILLS, AOENT."
AMOUNT PAID
61.84
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INT R ST. .
IF TOTAL DUE IS LESS THAN '1, NO PAV"ENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" I CRI, YOU ItAV BE DUE A REFUND.
SEE REVERSE SIDE OF THIS FOR" FDR INSTRUCTIDNS. )
.
61.84
.00
.00
.00
PIIRPOSEIlI'
NOUCE.
PAYtEHTI
RUl.IfD (CRJ,
OBJECTIONS,
'OftIN-
ISTRATlYE
CDRRfCTlDHSI
DIICou.TI
IHTERElTr
'I!'"
If' , (t~
::1
~. "
[1.
0
,.,
f." "
__.:J
....,:: .,
l) ,
" t'J r:,; .~
mo.;
0: JJ .
G
To fulfill thl rlqulr..-nt. of l~tJon 2.4' of t~ Inher.t~. ~ E,t,t, T.. Act, Aat II of 1'91. (72 P.S.
boUon 2140).
UellCh thl top partlon of thl, Hotle. ~ Iub.lt with your Plv.ent to thl Rills",. of Will. printed on the
r.v.,... .lde.
.. Hake check or ~'Y ordtr Plvlbla tOI REGISTER OF WILLS, AGENT.
All p.~h recelvld ,hill fir.' tt. ItPPllad to ..,y Int.r..t Which NY b, due, with ...y r..lncMr .,11M to the ....
A nfund of . tax crult, which .... not ,......dH on the ... return, ..y btI ,.,queUed by cOIIphUna en "AppUcIUon
for Refund of Penn.ylv~l. Inherltinel ~ E.tat. ,..- (REY-ISIS). application. ar. IVlllable It the O"lcI of
the R".lt'r of Willi, MY of the 25 Ravenue DI.trlal Offlc.. Dr by cIlllna the ,plcla. "-hour ..,.~rlng ..rvlc.
nu.ber. 'or 'or.. or~rl",1 In Penn.ylvlnll 1-'00-562-2050, out.ldI Pann.ylvlnll Ind within locII
Harrisburg .r.. (717) 7.7-1094, TOOl (717) 772-2252 (H..rlng 1~.lr~ Only).
Any party In Int.r..t not .atl.fled with thl ~r.I...~t, .llowancl o~ dl..llowlnc, 0' deduction. or .....~t
0' t.. (Including dl.count or Intlra.tl .. shown on thl. Notlcl ..y ObJlCt within .IMty (60) day. 0' rtc.lpt 0'
thlt Notlc. byl
--written prot..t to the PA D.p.rt-.nt of Aevenua, loard 0' Appe.I., Dept. 211021, HlrrlsbUrg, PA 17121-1021, OR
--.I.ctlng to hay. ttM ..tt.r dlt.r.lned .t tM tudlt 0' ttMI IICcount 0' the ptIr.onal repr..",t.tly., OR
--app.al to thl Drphan.' Court
F.ctual .rror. dl.cov.r.d on thl. ......-.nt .hould b. addr...td In writing tal PA D.part.-nt of A.Ylnue,
lura.u 0' Indlvldu.1 T...., ATTN, Po.t A.....-.nt R.vl.. unit, DEPT. Z.0601, HarrlabUrg, Pi 17121-0601
Phone (717) 717-6505. S.. p.gl 3 of the bookllt "In.tructlon. for Inhlrltancl T.. R.turn 'or I A..ldent
Dlcldlnt" (REV-1501) for an IMplan.tlon of ~lnl.tr.tIVllY corrlGttbl. .rror..
I' InY tl. due I. Plld within thr'l (SI c.l.ndar .onth. .ft.r the dec~t'. da.th, . fly. p.relnt (SXI
dl.count 0' ttMI taM p.ld I. Illowad.
Int.ra.t I. charged blglnnlng with flr.t dlY 0' dallnqulncy, or nine (9) aonth. end Ont (I) day
fru. the ~ta of d..th, to thl d.tl of p.~t. Tft... which bee... dellnqu.nt before Janu.ry I, 1'12
b..r Int.r..t .t the r.t. of .1. (6X) p.rcent Plr ~ calcul.tld at . d.lly r.t. 0' .aOOI64.
All tIX.' which blc... d.llnquent on or .ft.r Janulry I, 1'12 will baar Int.rl.t at . r.t. which will v.ry 'rOl
e.land.r YI.r to cllandlr y..r with that r.t. announcld by thl Pi Dtp.rt-.nt a' RIYtnUl. ThI appllctbll
Int.r..t r.tl. far 1'12 through 1995 '1'"
lilt Int.r..t R.t. D.lly Int.,...t Fllctor %lie Int.,...t R.ta D.lly Int.r..t Factor
I'., lOX .000548 1917 OX .a00247
1'1) lOX .0DD45' 1'18-1"1 IIX .DOI.501
1914 IU .DOUal 199' OX .D00247
1915 ISX .OOOSS' 1995-I'''' n .DOO192
1916 lOX .OIU74 1995 'X .00DZ47
--Int.r..t It c.hul.t.d .. fallow"
INTEREST . BALANCE DF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
i
i
,
--Any Notle. 1..ued .ft.r thl t'M btCOlt. delinquent will t.fltct In lnt.t..t c.lculatlon to fl,tteR (15) d.y.
b.yond tha d.t. 0' the ......."'t. If p.yaent I. .ad. .ft.r the Int.r..t co.put.tJon dlt. .hown on thl
Notle., tddltlonal Intar..t .u.t be c.lcul.ttd.
-. -. ..-......... ...,
~ '
,;:.J_____ _ __ _ _~___..... __ _ _ ___..__ _ ._. _.__ ___.._,_ _ __ __ __ _ ___ _ ____ ____~__j
\/ \
DJ.A, A'04800S' COMMONWEALTH OF PENNSYLVANIA'
'1,0. ," . DIPARTMINT OF RIVINUI
"i,...ll":.'." OFFICIAL RECEIPT .~ENNSVLVANIA INHERITANCE AND ESTATE TAX
.
RECEIVED FROM:
&
ACN
ASSESSMENT r:w
CONTROL Ji:,I
NUMBER
AMOUNT
MARGARET M. ZERFAB8
te:5 ROBODA BL.VD
9:51e3869 se2:5.06
9512S98B .61.84
lj!Oll!~.,e3 .43.4'9
93125987 Sbl.S"
IOjDH",
9312:5986 S43.49
9:31E:39B4 .,,..Sl
'f31C!39S3 .'f" . ;,11
ROVERBFORD PA 19468
- '010 HU'
ESTATE INFORMATION,
1:1 FILE NUMBER
Ii 21-1994-1009 SSN 00B-09-2900
. m NAME OF DECEDENT (LAST) IFIRST) MI)
II DATE OF PAYMENT
EJ POSTMAR E
COUNTY
DATE OF OEATH
REMARKS
MARGARET M ZERFASB
m TOTAL AMOUNT PAID
/I
RECEIVED B~Z /'
SbEB.34
SEAL
CHECK" 2707
REGISTER OF WILLS MARY C. L.EW S ,
REGISTER OF wtL.L.S ~
---.- ---------:-- -----:----- - - - - - -- - - -_._-- --- ----~"~..,"~';.~..~- ; \
;.
,1 . '
. "l." ~ :.,.,
.
, .'
..
.,.
.
, /
,
",
" /
. .
. .
.
"
..
,- -
,
--:;-
..........-....
-~
_ _ 1. ~':-,..
! '
\
~lS47 EX AFP (12-94*
CQHHONWEALTH OF PENNSYLVANIA
DEPAAhtEHT OF REVENUE
. BUREAU Of INDIVIDUAL TAXES
DEPT. 210601
HARRISIURG, p, 17121-0601
/5-/- (,
ult..
@
v
ACN 101
NOTICE OF INHERITANCE TAM
APPRAISENENT, ALLOWANCE DR DISALLOWANCE
OF DEDUCTIONS AND ASSESSNEHT DF TAX
DATE 05-15-95
o FILE NO.
DATE OF DEATH 10-24-94 COUNTY CUMBERLAND
NOTE. TO INSURE PROPER CREDIT TD YOUR ACCOUNT, SUBNIT THE UPPER PORTION OF THIS FORN WITH YOUR TAX
PAYNE NT TO THE REOISTER OF WILLS. NAME CHECM PAYABLE TO "REOISTER OF WILLS, AOENT"
REMIT PAYMENT TO:
2=
-<
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ~
iiE'\i:U,.'f"iiC-jiFP-nZ':94T"iliificEuOF-YNHEifii'Aircn"liin-P-PR'AiSEHEil'r,--ALi."OWAircE=-lfrin-----m-m---
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX -"
ELLEN M FILE NO. 21 94-1009 ACN 101 i',; DATE' 05-15-95
.:..-.
I CHANo.!ll".:l
THOMAS M DRTH
1013 APPLE DR
MECHANICS BURG
PA 17055
ESTATE OF
DRTH
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 Eat.t. (Schedule A) (1)
2. Stock. and Bondi (Schedule OJ (2)
5. Clo..ly Held stock/Partnership lnt.r..t (Schedule C) (3)
4. Horta.g../Not.. Receivable (Schedule OJ (4)
S. Ca.h/Bank Depolita/Hilc. Parlonal Property (Sch.dul. E) (5)
6. Jointly Owned Property (Sch.dull F) (6)
7. Tran,fara (Schedule G) (7)
8. Tot.l A...t.
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funaral Expan.../AdM. Coata/Hisc. Expan.a. (Schadule H) (9)
10. D.bt./Hodgag. Uabiliti../li.n. (Schedula 11 nO)
11. Total Daduction.
12. Net Value of T.x R.turn
13. Ch.rit.bl./Oova~n..ntal B.qu..t. CSchedul. JI
llt. H.t Valu. of E.t.t. Subjaot to TaM
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLHciA 17013
c-,-
__ Alloun I Ralli ttllct }
\..J
0'1
72.000.00
,00
.00
.00
22.343.00
.00
.00
IBI
94,343.00
9,737.00
.00
1111
ll21
1151
ll41
g.737 nn
84.606.00
.00
84.606.00
NOTE I
14, 15 and/Dr 16, 17 and 18 will
returns assessed to date.
If an assessment was issued previauely, lines
reflect figures that include the tatal af ALL
ASSESSMENT OF TAXI
15. A.ount of lina 14 .t Spou.al r.t. C 15)
16. Allount of Lina 14 t'Mabla at Lin..l/CI... A rat. (16)
17. Allount of line 14 t'Mabla at Collat.r.l/Cl... B rata (17)
la. P~incip.l TaM Due
TAX CREDITS I
PAVNENT
DATE
01-17-95
RECEIPT
NUNBER
AA022724
DISCOUNT 1+'
IHTEREST (-,
253.82
.00 X .03.
84.606.00 M .06.
.00 M .15.
llll
.00
5,076.36
.00
5,076.36
AHOUNT PAID
4,822.54
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
5,076.36
.00
.00
.00
. IF PAID AFTER DATE IHDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN '1, NO PAVNENT IS REQUIRED.
IF TOTAL DUE IS REFLECTEa AS A "CREDIT" ICRl, VDU HAV BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. I
REV-1543 EX AFP (80941*
CO'HHONWfAlTll OF PENNSYLVANIA
P(PAR1HEHl or REVENUE
BUREAU OF I~DtVJDUAL tAMtS .
DEPT. 210601
HARRISIURG, PA 111za-0601
/5--/-(.'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
NO.21 94-1009
95123868
05-30-95
TYPE OF ACCOUNT
~ SAVINas
CHECKINa
TRUST
CERTIFICATE
REMIT PAYMENT AND FORKS TO.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
FILE
ACN
DATE
eJ ,(
0\-
ESTATE OF ELLEN M ORTH
5.5. NO. 00B-09-2900
DATE OF DEATH 10-24-94
COUNTY CUMBERLAND
THOMAS M ORTH
1013 APPLE DR
MECHANICSBURG
PA 17055
"EHlERS 1ST FeU ha. provIded the Dlp."taM1t with thl tn'or..UDn tltted below whIch h.. b.~ u..d In nlcuhtlng tM
pot~tl.l tax due. Thai,. rlcord, Indlcat. thlt at thl d..th of the abavI dlcldlnt, YOU ~r. I Joint owner/benefIciary of thl, account.
If you ,... thl, Infar..llon I, Incorract, pl.... obtain written corrlctlon fro. thl flnanc)al Inltltutlon, attach. copy to thl, for.
~ raturn It to t~ above .dd,..... Thl. account I, tl.lb!. In .ceordenel with thl J~rltanc. ta. law. of thl Co..anw..lth 0' Pennsylvania.
ou..tlon. aav ba an.wered b~ ceiling (111) 111-8121.
COHPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYHENT INSTRUCTIONS
Account No. 8967-05 Dote 11-04-92
E.tablhhed
Account S.lanca 22,505.09
Percent Ta.able )( 16 . 667
Aoount Subjoct to To. 3,750.92
T.K Rat. )( .06
PotenUol To. Duo 225.06
PART TAXPAYER RESPONSE
[!] ,..,. ,F'AILURI:rO RISPOND"lIILL RISULT IIt,AH,',OF',F'JCJAL ,.TAX . ASSI!l!SHIHT'IIASID OH.THJS HOTZel
A. c:J The above Infor.atlon and tax due I. corract.
1. You ..v chao.. to r..lt p.waant to the R.pl.t.r of Will. with two copl.. of thl. notice to obt.ln
. dl.count or .vold Intara.t, or vou "V c~ck box ~A- and raturn thl. notlca to the Ra,l,t.r of
Will. end an offlcl.l ......eant will b. I..uad b~ the PA Dapartaant of R.vanu..
To In.ur. proper credit to your .ccount, two
(2) copla. of thl. notlca au.t Iccoapany your
p.y.ant to the RI,I.tlr of Will.. "aka chick
payabll tal ""Aaalttar of Will., Aalnt~.
NOTE I If t.x plyeent. ar. ..d. within thraa
(.1) unth. of the dacadant". d.ta of daath,
you .ay deduct. SlC dltcount of the t.x dl.M.
Anv Inherltanca tlX due will baco.. dallnqu.nt
nlna I') aonth. eftar the d.ta of d..th.
[CHECK ]
ONE
BLOCK
ONLY
B. ~ Tha abova ....t ha. ba." or will b. raportad and tax paid with the Penn.ylvanl. Inharltanc. TIK r.turn
to b. fllld bv tha dacadant". repra.entatlv..
C. 0 Tha abova Infor..tlon IMncorract and/or dabts and deduction. wera p.ld by YOU.
You au.t co.plata PART l!J and/or PART ~ balow.
If you indicate. different tex rat., pl.... .tate your
relationship to decadant.
PART
~
TAX RETURN . COttFUTATJON
LINE I. Doto Eotobllohod
2. Account Salanea
S. Parcent Ta.able
4. A.ount Subjact to T.x
5. Debt. and Deduction.
6. A.ount TaKable
7. Ta. Rata
a. TaK Dua
PART
~
DATE
DEBTS AND DEDUCTIONS
PAD,
1
2
3
4
5
6
7
8
CLAIMED
. tAL IlSEONLl(, 0 AAf'
" PA DEP:4RTHBtf.rOF llE'Jt;NUE ,.:
, Ie ~ '_:.;;
t~
OF
1
2
3 X
4
5
6
7 X
a
',ur..~
-:-.
oJ
. .
'-.,
;,.
TAX eN JOINT~T~U~T ACCOUNT~
-<""(')
.,..
PAID
PAYEE
DESCRIPTION
AMOUNT PAID
'.
I
TOTAL (Enter on Lina S of Tax co~put.tion)
l
.
Und.r pen.ltl.. of perjury, I daclare that the
eo_plete to the be.t o~~. and beli.f.
/ ~",,1J UIt..A4'
TAXPAYER SIGNATA~E
fact. I hava reported abov. ar. tru., corract and
HOME (117 l/("t,;JIYF
WORK ( l oJrl", L
TEI.EPHONE NUMBER
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAM ASSESSHENT with appllcabla Int.,.U b..... on Infon.Uon
lub.lttad by thl URlnelal Inltltutlan.
2. InheritancI t," beeDe" dallnquant nln. lonlh. aft., thl dlcldent" data of d..th,
S. . Joint account 1. t..'ble Iven though thl dlcld.nt'. n... .... added .1 . ..tt.t 0' cony.nlane..
". Accounh Clncludlnt thOlI hlld bllw.'n husband anc:I wtlal Which the daudIn' put In Joint n.... within one 'I'" prior to
d..th .t. fully t,.abl. .1 tran.'""
5. Account. ..tabll,hed jointlY blt....n hulb,nd and wlf. lor. than one y..t prior to d..th .t. not t...bl,.
6. ACCCM1h held by . dendent "In truI' fa," enoth.r Dr ather. .r. t..abl. ful1W.
REPORTING INSTRUCTIONS - PART 1
- TAXPAVER RE~PONSE
1. BLOCK A - If the lnfat..tlon end c~ut.tlon in thl notlCI .t. corraet and d.ductlon. .r. not baing cla...d, pl~. an "X"
In block "A" of Plrt I of the "TI.plv.r R..pon.." ..ctlon. Sign two capl.. and .ub.lt th.. with vour ~ for the .-aunt of
t.. to the R.gl.tar a' Will. of the county Indlc.ted. The PA D,plrt.ant of R.v.nue will 1..uI an o'flcl.1 .......ant
(For. REV.asu EXI upon r.c.lpt of thtl rlturn frOll thai R....t.r of Wills.
,f
2. ILotK B-1' the ....t .p.cl'l.d on thl, notlc. hi. bean or will ba reportad and t.. plld with thai PannlvIV8nI. I~rlt~a
Ta. R.turn fllad bV the d.c.dant'. rIPr...nt.tlv., plac. an "X" In block "B- 0' P.rt 1 of the "T..p.yar Ra.ponea" ,action, Ilgn one
copy and r.turn to the PA D.p.rtaent 0' R.v~, Bur.au 0' IndlvldU.1 T...., Dapt Z10601, H.rrl.burg, PA 17121.0601 In the
anv.lope prOVided.
s. ILOCK C - If the notle. In'or..tlon I. Incorract endlor deduction. .r. baing cl.leed, check black "C" ~ cu.pl.ta P.rt. Z and 5
~cordl~ to t~ In.tructlon. b.lo~. SID~ twn ropl.. and .~It th.. with vour chock ror the 'IOunt 0' t.. plyable to the R.gIster
a' will. 0' the county Indlc.tad. The PA Dap.rt.ent of R.venue will I..ue an o"lcl.1 ......eent (Far. REV.I". EXI upon rlc.lpt
a' the r.turn 'roe the AI,I.tar 0' Will,.
TAX RETURN - PART Z - TAX COMPUTATION
LINE
1. Ent.r the d.t. thl account orl,ln.lly w.. ..tabllshad or tltlad In the .~r ..I,tlng .t dlt. 0' d..th.
HOTEl For. dec.dant dying ,'tar lZ1lZIIZ. ACCCM\h which the d,cldant put In JoInt n.... within one (1 I v.er 0' delth .r.
t..abl. fully.. tran,'.r.. Howev.r, th.r. I. an ..clu.lon not to ..e..d '5,000 p.r tran,'.r.. regardla.. 0' the v.lul 0'
the account or the nuIb.r of Bccounh hald.
I' . daubl. ..t.rl.k (MMI appe.r. bafor. your 'Ir.t n... In the .ddra.. portion of thl. notlca, the '5,000 ..clu.lon
.Iraady hat been deductad fro. the .ccount b.lanc. .. r~rt.d by the 'Inancl.1 In.tltutlon.
Z. Ent.r the tot.1 balanca 0' the account Includlna Intara.t ~crued to the data 0' daath.
S. ThI Plrcant 0' the .ccount that I. t..abll 'or .ach .urvlvor I. datar.lned a. 'allow.,
A. The parcent ta.abla 'or Joint ....t. ..tablllhad eor. than one y..r prior to the dlcldant'. d.atht
I DIVIDED IV TOTAL NUKlER OF
JOINT OWNERS
[..-plal A Joint ....t r.,I.t.r.d
DIVIDED IY TOTAL HUHIER OF X 100 . PERCENT TAXABLE
SlINIVIHO JOINT OWNERS
In the n... 0' thl dac:.dant and two other per.onl.
I DIVIDED IY 5 (JOINT OWNERS) DIVIDED IV 2 (StJRVlVORSI . .167 X 100 . 16.7X (fAXABLE FDA EACH SURVIVCNIJ
I. 'OM percent tlllabl. 'or ....t. cra.t.d ",lthln OM y.ar 0' the dec.dant'. daBth or KCountl otfnId by the dacacs.nt but held
In tru.t for IN'IOttMr IncUvldullU.1 (tru.t ban.Uclarll.Jt
I DIVIDED IY TOTAL HUHIER OF SURVIVING JOINT
OWNERS OR TRUST BENEFICIARIES
X 100 . PERCENT TAXAILE
.$
I
[.aspl'l JoInt .ccount raal.tlrld In thl nee. of thl dleldant and t",a other plr.on. and a.tabll.~ "'Ithln ana y..r 0' death bv
thl d.e.dlnt.
I DIVIDED IV 2 (SURVIVORSI . .50 X 100 . SOX CTAXAILE FOR EACH SURVIVOR)
,.. ThI MOUnt .UbJlct to t.. Cline .1 It d.t.raln.d by aultlpJylng the account b.lanc. Ulna 2) by the perclnt t...bl. (lInl 51.
S. Entar the tot.1 0' the d.bt. and d.ductlon. II,tld In P.rt S.
.. IhI ~,t ta..bla lllna 6J II dltlrllnea by .Ubtr.ctlng the daOt. .nd dlductlon. (line 5) troa the ~t .ubJ.ct to tl. (line .).
7. Entar thl IPProprllt. t.. r.t. (11nl 71 .. dltar.lnad b.lo",.
,
(
A. For dat.. 0' dl.th occurring .'t.r 6/50/9', the t.. r.t.. for tran"lr. to .poula. ara e. 'allows.
I. D.te. 0' da.th on or .ft.r 7/1/.4 .nd bafor. 1/1/96 the rat. I. 3~.
2. Dat.. 0' d..th on or .ft.r 1/1/.6 Bnd bafor. 1/1/97 the r.t. I. 2~.
5. D.t.. 0' d..th on or .ft.r 1/1/., .nd b,'or. 1/1/9. the rlt. I. 1~.
.. Dat.. a' d..th on or .ft.r 1/1/.8 tranl'lr. to .pou... "'III b. a..~t 'r~ t...
Not" For d.ta. of d..th prIor to 7/1/'~ tren,'lr. to .pou... .r. t..lbll .t 6~.
I. Tran.fI,. to llne.1 d..c.nd."t. Includln, f.ther, eothair, Ion, d.ughter, gr.ndchl1drllll, .on-In-Ilw,
daught.r-In-lew, .t.pchlld and their I.'ua ar. t..lbl. at .1. p.rcant (6XI.
C. Tranafan to .11 othlr. Includlna brother, .ltter, uncll, .unt, nlphl'" and nile. er. ...labll at flft.." percant Cl5:U.
D. I' vou changa the t.. r.t., pi.... .pacl,y your r.l.tlon.hlp to tha daCldlnt In ttM .r.. provided.
I. ThI -..,t a' ta. due Cllnl II It detar.lnad by aultlpJylna the ..aunt t.llabl. Cllna 61 bV the t.. rat. Ulne 7).
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
Allow.bl. dlbt. end d.ductlon. .ra d.t.relned .. folio"'.,
A. You lag.lly .r. r..pan.lbl. for pav..nt, or the ..tet. .ubJ.ct to .d.lnl,tr.tlon by . p.r.onal repr.,antltlv. I. Inlufflelant
to PlY tha daductlbll It....
I. You .ctu.lly p.ld tha d.bt. .ft.r d..th 0' th. d,cldant and CIM 'urnl.h proof of p'lIant.
C. D.bt. baing clalmld au.t b. It..lz.d fully In Plrt S. If addltlon.1 'PIC. I, ne.d.d, u.. pl.ln pap.r a 1/2" . II". Proof 0'
P')'lIIRt .IY b" rlque.t.d by the PA Dlpert.ent of Revlnut.
~..
TAXPAVER ASSISTANCE
IF YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACTANV
REGISTER OF WILLS. PA DEPARTMENT OF REVENUE DISTRICT OFFICE
OR CALL THE BUREAU OF INDIVIDUAL TAXES, TAXPAVER INQUIRV UNIT IN
HARRISBURG AT (717) 787-8327. TDDI (117) 77~"~~52.. (HEARING IMPAIRED GNLV)
FILE NO. 21 94-1009
ACN 95124714
DATE 05-30-95
TYPE OF ACCOUNT
~ SAVINGS
CHECKING
TRUST
CERTIfICATE
REHIT PAVHENT AND FoRHS TO.
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
IS' 1-'"
REV-1543 EX AFP 18-941_
COHHoHwEAlTH OF PENNSYLVANIA
otPAATHEHr OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEP1. ZIID601
IIARRlhURC, PA I1UI-0601
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
\"
, I
'()\-
HEMBERS 1ST fED CREDIT h.. provided the a.p.rt..nt with the Infor..Uon Ihhd below which h.. b.." used In ulcuhtlng the
potentia. tax due. Thalr racord. Indica', that at the d.ath of the abovI dlcadent, YOU Wit. a Jalnt ownar/beneflclatv 0' thl, IcCOunt.
If you ,..1 thl, Infer..tlon 1. Incorrect, pl.... obtain written corractlon frol the 'Inanclal Institution, attach a copy to thl. for.
and raturn It to the above .ddr.... Thl_ .ccO\~t J, t..~l. In accordanc. with the Jnh.rJt~. TaM law. 0' the C~..lth of P.nnlvlvanla.
ou..tlon. ..V be "'.w.r.d by c.lllng (717) 787-8527.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 29064-45 o.t. 11-22-88
E.tabl hh.d
Aa.aunt Balan.. 1 ,516 . 47
Parc.nt Taxabl. )( 50,000
Aaaunt Subj..t to T.. 758.24
T.. R.ta K .06
Patenti.l T.. Ou. 45.49
PART TAXPAYER RESPONSE
[I] I FAILURI!TO RISPOND IIILL>RI!SUL T IHAM, OFFICIAL TAX ASS!llSHEHT BASlD OHTHIS HGTICII
A. 0 TM MlaV' In'or..t1on W1d talC dI.M h correct.
I. You ..y chao.. to r..lt p'v-ent to the R-al.ter a' Nil I. Mlth two cople. 0' this notice to obtain
. dlsc~t or evold Interest, or you .av ch.ck bolC -A- W1d return thl. not lea to the Raglst.r 0'
Nllls W1d en o'flclal ......-.nt will b. I..ued by the PA o.p.rt..nt 0' Rlvenue.
ESTATE OF ELLEN H ORTH
S.S. NO. 008-09-2900
DATE OF DEATH 10-24-94
COUNTY CUMBERLAND
THOMAS M ORTH
1013 APPLE OR
MECHANICS BURG
PA 17055
To In.ure prop.r cradlt to vour .ccount, tMO
ez) copla. 0' this notice ~.t accoap~y your
psyaant to the Rlalst.r 0' Nil Is. H'ka ch.ck
paylbla tOI ""Raahtar 0' Nllh, Aaant-,
HOTEl J, tllC pa~ts era .ade within thr..
(5) eonth. 0' the d.cadent's det. a' d,eth,
YOU ..y deduct a 5X discount 0' the t.. due,
Anv IMtirlhance ta. dull Mill baco., delinquent
nine e9. ~th. ,'tar the date 0' death,
[CHECK ]
ONE
BLOCK
ONLY
8. ~ Tha abo.". ....t h.. ba.n or Mill be reportad and ta. paid with thl PM'lnsylvanla l'nherltWICI Till return
to be filed by thl dec.d.nt', r.pr,s.ntatlva,
C. 0 Tha above In'oraat1on I~ncorract ,"d/a~.b" end deduction. ..era peld by you,
You .u.t coaplet. PART ~ Dnd/or PART L!J balow.
If you indicat. . diff.r.nt tax r.ta, pl.... .t.t. your
r.lation.hip to dacadent.
PART
[!]
TAX R~TURN . COMPUTATION
LINE 1, Dat. E.tabli.had
2. Account Balanca
3. Parc.nt T.wabl.
4. Amount Subj.ot to Taw
5. Dabt. and D.duction.
6. A.ount Taxabl.
7. Tal( Rat.
e. Tax Due
OF
1
2
3 X
4
5
6
7 X
e
PAD
1
2
3
,,01
5
6
7
8,
CLAIMED
TA~ O~ JOIAT/TRUST ACCOUHTD
PART
I!I
DATE
DEBTS AND DEDUCTIONS
PAID
PAYEE
DESCRIPTION
..
I
TOTAL tEntar on Lin. 5 of Tax Co.put.tion)
OFFICIAL USE ONLY 0 AAF
PA DEPARTNENT OF REVENUE
0(1
C'
..-: ..'
=1 '..'
r.'
tf,
-1~
\;: :...1
,
~...:
-
I?i
;-;
. -0
W
to ()
;' .-. j"-~
AMOUNT PAID
I
.
Undar p.n.lt!a. of perjury, I d.clara that tha
coeplat. to the b..t of .y knowladg. and bali.f,
T~P'ER ~~1~R~~~1
HOME
hav. r.portad above ar. tru., corr.ct and
7/71 'Jt,(, ':J;I'(\
WORK ( 1 \fA", ..
TELEPHONE NUMBER
feet. t
.il\"
REY-1543 EX AFP IS-941_
CDttHONWEAlTII or PENNSYLVANIA
DrPART"ENT OF REVENUE
BUREAU Of IHDIVIDUAl TAMES
nEPT. Z8D6Dl
IIARRISIURQ, PA 171Z8-06Dl
IS /' ,.
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
NO.21 94-1009
95124723
05-30-95
TYPE OF ACCOUNT
~ SAVINGS
CHECKING
TRUST
CERTIfICATE
RENIT PAYNENT AND fDRNS TO.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
FILE
ACN
DATE
(" I,
'0'r-
ESTATE OF ELLEN M ORTH
S.S. NO. 008-09-2900
DATE OF DEATH 10-24-94
COUNTY CUMBERLAND
THOMAS M ORTH
1013 APPLE DR
MECHANICS BURG
PA 17055
"EHlERS 1ST FED CREDIT h.. pravld.d the D.part.."t "lth tM In'or.atlon lltt.d balow which ha. b.en u..d In calcul.tlna the
potentl.1 tax due. Their r.cord. Indlc.t. that at the dl.th 0' the .bov. dacadant, you "ar. . Joint awner/bene'lclarv 0' thll account.
If you '.al thll In'or..tlon Is Incarract, pl.... abhln wrltt." cornctlon 'roe tha I1nancl.1 In.tltutlon, attach a copy to this 'or.
and return It to the .bov. .ddr.... Thla .C~"''"t II t.w~l. In .ccardanc. "Ith the Inherltlnce T.x L.... of the Coaaonwe.lth 0' P~.vl"anla.
Qualtlon. ..v be ~...erad by cllllng (717) 787-8S27.
COMPLETE PART 1 SELOW . . . SEE REYERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 29064-44 Data 11-22-B8
Edeblhhad
Acoount 8alanoe 1, 516 . 47
P.rc.nt TeNebl. )( 50 . 000
Aaount Subjaot to Tax 758.24
Tax Rate X .06
Potential Tax Due 45.49
PART TAXPAYER RESPONSE
m IFAILURI:.i!:ORI8POHD.!IILLRESUL TIH~,:a!,PIC~ALTAX, A88E88HIHTBA81!D0HTHI8. HOTICI .,
.. 0 The above Infor..Uon and tu due II carr"t. ("') ("') _ ~
1. You .'V chao.. to r..lt peyaant to tM Regl.ter of Will. with two copS.. 0' t~'i notlce-1mr-Gbt.ln
. dl.count or ,vDld Intere.t, or you .IY check box "A" and r.turn tHII notlceltd thl Realat.r a'
Willa and an D"lcl.l .....lIIMt "Ill b. I..ued by the PA o.plrtaant 0' R.v~.
,
B. ~ The lbo"e ....t h.1 bl.., or ..111 be reported end tlX paid with the P~.yl".,,11 I~rltanc' T.~ return
to b. ,Illd by the d'cldent'. rlprl.lnt.tl"l. ~
"-'
C. 0 Th. abOVI In'or.atlan IMncornct Ind/O~'bt. Ind dlductlon. "er. plld by you. \0
You .u.t cOlplete PART 2 Indlor PART 5 balD".
.',1
To In.ure proper credit to ~DUr ICCount, two
e2) copl.. 0' thl. natlc. .u.t accoaplny your
pay.ent to the Algl.t.r 0' Will.. "aka chIck
payable tal "Magl.ter 0' Will., ADlnt~.
NOTE. I' tlX payeant. are .adl ..I thin thrl'
eS) aonth. a' the decldent'. datI 0' death,
you ny deduct a 52C discount a' tM tax due.
Any Inheritance tax due "III blco.. delinquent
nine ('I aonth. a,tlr the d.te of de.th.
[CHECK ]
ONE
BLOCK
ONLY
If you Indlcat. a differ.nt tax rete, pl.... .tat. your
r.l.tion.hlp to d.cadent.
PART
~
TAX RtTURN - COMPUTATION
LINE 1. Data E.tabll.h.d
2, Account Balanc.
3. P.rcant TaN.bl.
4. A.ount Subj.ct to Tax
i. D.bt. and Deduction.
6. A.ount T.Nabl.
7. TaN R.t.
&. Tax Dua
or TAl: ON JOINUTRUOT ACCOUNTS PAD'
1
2
3
4
5
6
7
8
DEBTS AND DEDUCTIONS CLAIMED
O~~~.CIAI.; SE Oltt.~?. 0 AAF
flA.D~ARTHE@ OFREYENUE..
1
2
3
4
5
6
7
e
x
x
PART
[!]
DATE
PAID
PAYEE
DESCRIPTION
AMOUNT PAID
..
I
TOTAL CEnt.r on Llna 5 of T.x COMPut.tion)
d.clare that the fact. J
and b.lhf.
I
.
have r.port.d aboy. ar. tru., carr.ct
1 7tt.1/1fJ-
1 ,(
and
HOME
WORK
(7/7
(
IS
ii,
"'0'1./
REV-1543 EX AFP (8-941 *
CINtOHWEALTH OF PENNSYLYANIA
DEPAATHENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DlPT. zaa601
HARRISBURC, PI 171z8.0601
ZNFORMATZON NOTzeE
AND
TAXPAYER RESPONSE
FILE NO. 21 94-1009
ACN 95124724
DATE 05-30-95
TYPE OF ACCOUNT
~ SAVINGS
CNECKING
TRUST
CERTIFICATE
REHIT PAVHENT AND FDRHS TO.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
ESTATE OF ELLEN M ORTH
5.5. NO, 008-09-2900
DATE OF DEATH 10-24-94
COUNTY CUMBERLAND
THOMAS M DRTH
1013 APPLE DR
MECHANICSBURG
PA 17055
HEHIERS 1ST FED CREDIT h.. prollllded the Dep.rt..nt with the Infor..tlon 11.t... below which h.. b..n used In ulculIUnD the
pot....t1.1 h. du.. Their record. Indlcat. that .t thl d..th 0' thl above dle.dant, you ",.r. I joint own.r/b....flcl.rv 0' thll ICCount.
If you f.. 1 this Infor..tlon It Incornct, pl.... obtlln ..rIU.... corractlon 'rOIl thl financial Institution, aUKh . copy to thll for.
and r.turn It to the =0"1 lI1c!rc... 1"'1. BeeCH,",t 1. tl)l,.t!l" In IccordltrtCl with thl rroh.rlt~. "1Il 1_' 0' tN r.~...lth of Pannlvlvllnl..
Du..Uon. ..y b. anlw.rld by cIUlna (711) 717~.527.
COHPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYHENT INSTRUCTIONS
Account No. 29064-41 Date 04-22-85
EatabUshad
[CHECK ]
ONE
BLOCK
ONLY
Account aalanc. 2,061.27
P.rc.nt T.xabl. )( SO. 000
A.ount Subjact to Tox 1 , 030 . 64
T.lC R.t. )( .06
Paten tiel Tax Dua 61. 84
PART TAXPAYER RESPONSE
lIJ I,.. FAUURIl'tO RI!SPOND lfUL\RESUL T IHAN O~~XCIAL 'I'AX ASSI!8SHI!HT, BASED OHTHIS NOnCtt I
A. 0 Th. above Infor..tlon and t8x due 11 correct.
1. You ..y choo.. to n.1t P'YMI\t to thl R.ght.r of "1111 with two copl.. of thl. notlc. to obt.ln
I discount or Ivold Int.nlt, ar YOU ..y rm.ck box "A" Md rlturn thh notlCI to thl R.glst.r af
will. and In afflclal .....~t ..Ill b. I..uld by thl PA o.p.rtaent of R.venue.
(")0 . :0
I. ~ Thl lbov. 1..lt hI' b..n or ..UI ~ reporhd Ind tlX p.ld with thl P".ylvenl. Ihhlrltenc!I'T.x rlturn
to b. fll.d by the decedlnt.. repr"lntatlvl. :1. \ .,
To In.ur. praplr cr.dlt to your ICCount, two
U) cop I.. of thh notlu MI.t Icco.pany your
plYlent to the RIgI.t.r of Will.. HIk. ch.ck
payabl. tOI "A'III.ter of Will., Allent".
HOTEl If tlX p.Y.lnt. .re ..d. within three
e)) eonth. of the decadent'. d.t. of d..th,
you ..y deduct I 5% dlscOl.W1t af tha t8x du..
Any Inherltanc. '-X due will beco.a delinquent
nine (9) eonthl .ftar thl deta of death.
c. [] The above Infor..tlo" I~"correct and/or d.bt. and d.ductlon. ...tl PIJd by yau.~
You lU.t coapt.t. PART l.!.J and/or PART ill bat ow. ~
If you indicata . diff.r.nt t.lC r.t., pl.... .t.t. YDur
r.l.tionship to dec.dent;
PART
~
TAX RETURN - COHPUTATION
LINE 1. Oat. E.tabli.hed
2. Account a.lanc.
5. P.rc.nt T.xable
4. A~ount Subj.ct to rax
S. O.bt. and D.duction.
6. A~nt TaK.bl.
7. T.x Rata
a. TalC Dua
TA^ O~ JOIH;;;RUST ACCOUNTS
...' OFFICIA 5E ONlY, OAAf
~A .~~~ARTHIi~T Of~~,YENUE, '
~1
,
j;:4
.':;
c.
\oI~ c.
--.
OF
1
2
3
4
5
6
7
e
PART
[!]
DATE
DEBTS AND DEDUCTIONS
PAD
,f
,2
3,
4
5
6
,7.
.,,8 '
CLAIHED
K
K
PAID
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Ent.r on Line 5 of raK COBPut.tionJ
I
.
Under panalti.. of p.rjur~, I d.clara that the fact. I
cOMplat. to the bait f knowledga and bali.f.
hava r.portad abova ara tru., correct
HOME (A> 7 1 ;>6(/.:t ILl ~-
WORK ( 1 -1.'1/.1 C
and
REV-1543 EX AFP 18-941_
CDHHOHWEAlTH OF PENNSYLVANIA
DtPAATHEHT Of REVENUE
BUREAU OF INDIVIDUAL TAXES
DOT. :80601
IlAAAlfiiBUAD, PA 1nU-06U
IS ;- C.
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21 94-1009
ACN 95124725
DATE 05-30-95
TYPE OF ACCOUNT
~ SAVINGS
CHECKING
TRUST
CERTIFICATE
REHIT PAYHENT AND FORNS TO.
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
(jol
O.
ESTATE OF ELLEN M oRTH
5.5. NO. 008-09-2900
DATE OF DEATH 10-24-94
COUNTY CUMBERLAND
THOMAS M oRTH
1013 APPLE DR
MECHANICS BURG
PA 17055
"EHBERS 1ST FED CREDIT ha. provided tM Dlfllrt..nt with the Infor..Uon llltad below whleh h.. beM uhd In calCUlating the
pot~tJ'1 t.. dul, Thalr rlcord. Indlcat. that at thl d..th 0' thl above dlcldant, yOU "Ir. . Joint ownerlbene'lclary of thl. ICCOunt.
.f you '..1 thl. In'or..tlon fa Incorr.ct, pl.... obtain written corr.ctlon fro. thl financial Inatltutlon, .tt~ . COpy to thl. for.
~ r.turn It to t~ ~y. .ddr.... This account I. t..~l. In accordance with thl Inherltanca 'I. l.w. of thl Co.-onwealth of Pennlvlvanl..
Question. ..y ~ an.~r.d by c.lllng (717) 111.1527.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 29064-40 Dot. 04-22-85
e.tabl1shad
Account Bdenc. 2,061.27
Percent Taxable X 50,000
AMount SUbject to Tax 1,030.64
Te. Rat. X .06
Pot.nth1 T.. Du. 61.84
PART TAXPAYER RESPONSE
IIlIFAILURE:rO RESPOND. MILL RESULT IH,AH OFFICIAL TAX ASSESSH!HT BASEDOH '1'HIS HOTICE I
A. 0 Th. Ilbav. Infar..Uon Ilnd tax due .. correct,
I, Vou ..y chaos. to r..lt p.~t ta t~ Rlgllt.r of willi with two capl.. of thl. notlc. to abt.ln
. dl.count or .vold Int.r..t, or you .ey check ba. "A" ~ r.turn thl. natlc. to the Regl.t.r af
Will. and en afflcl.l .......~t will b. I..ued by the PA D.p.rt..nt af R.venu.,
To In.ur. prap.r cr~lt ta your .ccaunt, two
(2) capl.. of thl. notlc. .ult .ccoapeny your
p.y..nt to the R.gllt.r of Will.. "ek. check
p.yabl. tal ooq.glster of Wllh, Agant",
HOTEl If tax p.yeant. er. .ad. within thr..
(5) unth. of the decedent'. da" of d..th,
you .ey d-.ct a 5X discount of tM tax du.,
Any Inher1t~. t.. due will b.ca.. d.llnquent
nln. I') eonth. .ft.r the d.t. of d..th,
[CHECK ]
ONE
BLOCK
ONLY
I, ~ Th. abav. ....t h.. b..n or will be r.part.d end te. paid with the Pennsylvania Inh.rltanc. T.. r.turn
to b. filed by the d.c.dent'. repr...nt.tlv.,
..
c. 0 Th. above Infor..Uon I~ncarr.ct and/or dlbts end deduction. wer. pm~,' you, ..
You au.t co~l.te PART l!J and/or PART 0 below, ~ (;. ~l~
:IJ
:--r'n
If you indicat. a diffmrent tax rate, pl.... .t.t. your
ralationship to d.c.d.nt:
PART
~
TAX RETURN . COMPUTATION
LINE 1. Date Eatab11.had
2, Account a.lanc.
5. Percent TaKable
4. Anount Subject to TaK
S. Dabt. and Deduction.
6. A.ount TaKable
7. TaK Rate
8. Tax Due
TAX ON JOINT/TRUST ACCOUNTS
,QFFICIAlr,USE ONt.;.DAAF;
PA;. DEPARTM!OO' ,OF" REVENUE.',.. "..'
, . ,-' ".~-: '.' . .-.. .. .. ... :"'"
r" .
1.0
PART
[!J
DATE
DEBTS AND DEDUCTIONS
PAD
1
2
3_
4
5
6
7
8
CLAIMED
.'1"'
. ..~
L~J
~.
;"."..'
;"-:;-"
OF
1
2
3
4
5
6
7
e
X
,v.~,
~..
X
PAID
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL (Ent.r on Lina 5 of TaK COMPutation)
of perjury, I declare thet the feet. I
.y knoNladg. and b.lief.
I
.
'4:J
have raported above er. true, correct
76/dllLf'S"
",....,,.'tc.
ond
HOME
WORK
1 '71] )
( )
DATE
I:, I ,.
l!' I
01-
Ii
NO.21 94-1009
95124726
05-30-95
REY-lS43 EX AFP 18-941_
COMMONWEALTH OF PENNSVLVANIA
DtPARTHEHT or R[V[HlJ(
BUREAU OF INDIvIDUAL TAKES
MPT. 210601
HAARlnURU, PA 111l1-0UI
INFORMATION NOTICE
AND
TAX PAVER RESPONSE
FILE
ACN
DATE
THOMAS M ORTH
1013 APPLE OR
MECHANICSBURG
TYPE OF ACCOUNT
~ SAVINGS
CHECKING
TRUST
CERTIFICATE
REHIT PAYHENT AND FORNS TD.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
ESTATE OF ELLEN M ORTH
5.5. NO. 00B-09-2900
DATE OF DEATH 10-24-94
COUNTY CUMBERLAND
PA 17055
"EHlERS 1ST FED CREDIT h.. provldad the Depatt.."t with tn. In'or..tlon lhhd balow which h.. ba.n ..,..d In cllculaUng thl
potentia. t.. au.. Their racordl Indlcat. that at thl d..th of the above dlcad,nt, yoU ..ar. . Joint ownar/bantflcl.rw 0' thl, ICCOunt.
If you f.. 1 thl, In'or..tlon I, Incorrect. pl.... obtain written corr.ctlon Irol thl financl.l In.titutlon, attach. cOPW to thIs for.
~ raturn It to thl abov~ .~r.... Thl. ac~ount I, ,...hl, In accordanca with thl Inherltanca ,.. Lawl 0' the C~onweelth of P~.yIYlnla.
Due.tlonl ..y bl .n.w.rld by cllllna (7171 1a7~a)Z7.
COMPLETE PART 1 BELOW . . . SEE REYERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 8967-43 Doto 04-26-82
Eatabliahad
Account aalanca
Parcant Taxabl.
MOunt SubJoct to
Ta. Rat.
Potantial Tax Du.
To In.ur. prope,. crldlt to your account, two
CZI cop I.. of thll notice .u.t acco.p.ny your
pay..nt to the R.allhr of Wills. H.k. chick
p.yable tal "R.gl.t.r of Willi, Agent".
PART
[II
3,143.52
50.000
1,571.76
.06
94.31
TAXPAYER RESPONSE
, FAILUR!TO R!SPOHD IIILL'RI!SUL T<IHAH,Ol'l'ICIAL TAX ASSESSH!HT BAUD OHTtllS HOTlC!
x
Te.
HOTEl If tex p.y..nts .,., ..de within thr..
()I .anth. of the d'c.dent'. data of d..th,
YOU .ay d.duct . s:c: dllcount of the t.x du..
Any Inhe,.ltence tax due will beco.e d.llnquent
nine (9) .anth. .fhr the dll' of d..th.
x
[CHECK ]
ONE
BLOCK
ONLY
A. 0 Th. abOY' Infor..Uon and tax ctu. II correct.
1. You '.y choo.. to ,..,It p.y.ant to the R'DI.t.r of Will. with two cop I.. of thl. notlc. to obteln
. dl.count 0,. .vold Int.ra.t, or you .ay chick box "A" and raturn thl. notice to tha Rlgllt.r of
NIII. and an official .......ent wIll b. ISlu.d by the PA Dep.rt.ent of Ravanul.
I. ~ The .bov. ....t h.. b.an or will b. r.po,.tad and ta. paId with the P.nn.yl....nl. Inh.rltanc. Ta. raturn
to b. fll.d by the dlc.dlnt', rlprl'lntatlvl.
C. 0 Th. above Infor.atlon I~ncorr'ct and/or debts and d.ductlons WIIr. paid by you.
You lU.t coapl.tl PART L!J and/or PART ~ b.low.
If you indicat. a diff.r.nt tax rat., pl.... .tat. your
ralation.hip to dacadantl
PART
~
TAX RETURN . COHPUTATIOrl OF
LINE 1. Doto E.toblhhod 1
2, Account aalanc. 2
3. Parcant Taxabla 3 X
4. Anount Subjact to Tax 4
5. Dabt. and Daduction. 5
,. Anount Taxabl. 6
7. Tax R,ta 7 X
8. Tax Dua 8
PA
TAX ON JOI~T/iRUSi ACCOUNTS
DEBTS AND DEDUCTIONS
PAD
1
2
3
4
5
6
7
8
CLAIMED
. ..
N
,.....
;..J
.
.6.
v-' c::
~.n('
~.-
PART
@J
DATE
PAID
PAVEE
DESCRIPTION
AMOUNT PAID
..
I
TOTAL CEntar on Lina 5 0' Tax COMput.tion)
. .
I
.
Undar panaltia. of
conpl.ta to tha ba.t ~f
parjury, I daclar. that tha
l.dga and baliaf.
<...::
fact. I hava raportad abova ara trua, carract
HOME (All A:.t~/'f.J'-
WORK ( 1 Ii' c_
ond
REV-1543 EX AFP 18-941.
C~llTH OF PENNSYLVANIA
. DEPARTHEHT Of REyoell(
BUREAU or INDIVIDUal TAKES .
DEPT. Zl0601
ItARRlnURG, PA HllI-0601
/5 I ~,
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
ESTATE OF ELLEN M ORTH
5.5. NO. 008-09-2900
DATE OF DEATH 10-24-94
COUNTY CUMBERLAND
FILE NO. 21 94-1009
ACN 95124727
DATE 05-30-95
TYPE OF ACCOUNT
~ SAVINGS
CNECKING
TRUST
CERTIFICATE
REHIT PAVHENT AND FORHS Tal
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
(, I
\..,'U'-
THOMAS M ORTH
1013 APPLE DR
MECHANICSBURG
PA 17055
"EHlERS 1ST FED CREDIT ha. provIded thl Dep.rt..nt with the Infor..Uan IhtMt btllow which h.. b..n uud In calcUlating thl
PQt~tl.l tlX due. Thalr rlcord. Indlcat. that at the d..th of the abOVI d4cadent, you ...t. . Joint awnlr/beneflcl.tv 0' thl. account.
If you ,..1 thl, Inlor.atlon I' Incorr.ct, p..... obtain written correction 'roe the 'In~l.l In.tltutlon, attach a copy to thl. for.
NMS r.turn It to tM 01;:0'" INttiru.. 'hit .~c~t h h"...t. In ",r.ord~' with the IntMrltMtCI T.. LI... of the C~1th 0' P*"'.v1.....,'..
Due'llon. "V be ~.w.r.d bv cllllng (717) 71'-1)21.
COMPLETE PART I BELOW M M M SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Aooount No. 8967-42 Oet. 04-26-82
E.t.blhh.d
Account Balance
P.rcent T.Mable
A.ount Subj.ct to
TaM R.t.
Pot.ntial T.M Du.
To In.ur. pro~r credit to your account, two
(Z) copl.. of thl, not Ie. .u.t eccalpany your
p.y..nt to t~ R.gI,t.r af Will.. "ak. chack
Ply.bl. tal "R.gl,tl~ of Will., Agant-.
PART
ill
3,143.52
50.000
1,571.76
.06
94.31
TAXPAYER RESPONSE
FAILURI.'tO RISPOND WJLLRI!SUL TIH"" .O~FICIALTAX ASSISSHEHT,BASI!DOH:ntIS,HO:nCI
x
HOTEl If tlX pey..nt. Ira .Ide within thr..
(l) IOOth. of the decedent'. dlt. of d..th,
you "V deduCt . SX dl.count of the t.x due.
Any Inhlrltenc:. tax dull will blcDII' d.lInq\.llnt
nln. (,) .onth. ,ft.r thl d.t. of d..th.
T..
x
[CHECK ]
ONE
BLOCK
ONLY
A. 0 T~ abov. Infor..Uon and t.. dull h corr.ct.
1. You ..y chaD.. to r..lt pa,..nt ta t~ A~~'t.r af Will, with two copl., of thl. notlc. to obt..n
a dl.eount or .vold Int.r..t, or you ..y cheCk box -A- Ind r.turn thl, notlcl to thl RIgl,tlt of
Will' Ind en offlcl.1 ......-ent will b. I..ued by thl PA Dep.rt.-nt of Revenue.
a. l8l T~ ,bov. ....t h.. blsn a~ will tM r.partld and tlX p.ld with t.... PIM,vlv."l. Inherltanc. Tlx rsturn
to b. fll.d by th. d.e.d.nt'. r.pr...ntatlv..
c. t=J Th. above Infar.atlan I~ncarr.ct and/or d.bt. and d.ductlon. w.r. ~,~~ you.
You w.t calpl." PART 1!J sndIor PART 0 bllow. c:: ;..-:- \r"
, II,
If you indicate a diff.rent tax rat., pl.... .tate your
relation.hip to dacedent.
:1J
:nr....
PART
~
TAX RETURN . COMPUTATIOH
LINE 1. O.t. Eat.blt.h.d
2. Account Belence
3. Parcent T.Mabla
4. A.ount Subjact to Tax
S. Dabt. and Daduction.
6. AMount Taxabl.
7. Taw Rat.
&. Tax Du.
,....iPFFICIALUSEWll:Y ." DAAF!
. "..'. PA' REPARTHetlT, OFiREVENUE "i
T"l( OH JOINT/TRUST ACCOUNTS PA~i,.:,:;;;,~,~;.i:
.,'.2' ...t:.' ..,'..... '..', ',..;...'....,::1
, "",,;,
3 : " , .~ /. ,..::~~\...,
D~' .!.'
: ~::. ~ ~'l'
6
7
8';
DEBTS AND DEDUCTIONS CLAIMED
OF
1
2
3
4
5
6
7 K
e
x
;-:
)::'::
PART
~
DATE
DESCRIPTION
AMOUNT PAID
PAYEE
PAID
1
.
I
TOTAL CEnt.r on Lin. 5 of TaM Co.putation)
Und.r penaltSe. of parjury, I d.clar. that the fact. I
oo.pl.t. to tho b.~t O~nO"l'd.' .nd b.lt.f.
TAXPA~R SI~~U~E .~
h.v. reportad above are truo, correct
HOME I: 7) ~e,& tO/YJ-
WORK ( ) '-JArlfE
TELEPH E NUMBE
DATE
and
REV-1543 EX AFP (8-941_
C~HW(ALTH Of PENHSYLVANIA
KP.aATHE"I Of' REVENUE
IURUU Of INDIVIDUAL TUtl
DEP" ,.0.01
ttAllR"IURG, PA 11111-0601 1C
i5( /-"
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
L~ Woo
FILE NO. 21 94-1009
ACN 95123869
DATE 05-30-95
MARGARET M ZERFASS
185 ROBODA BLVD
ROYERSFORD PA 19468
TYPE OF ACCOUNT
~ SAVINGS
CHECKING
TRUST
CERTIFICATE
RENIT PAVNENT AND FORNS TO.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
ESTATE OF ELLEN M ORTIl
5.5. NO. 008-09-2900
DATE OF DEATll 10-24-94
COUNTY CUMBERLAND
"EHlERS 1ST feu hu prD'IJcMtd the o.p.rt..nt with U,. Infar..Uon lhhd belOtf which h.. b..n und In ulculeUnll the
pa'antle. ... ctu.. Thill' record. Indlut. thlt .t the d..th of the .tIOY. dliuant. vou ...,. II Joint IMmllr/beneUcl.rw of thh lecount.
If )IOU '..1 this In'or..Uon II Incorr.ct, P..... obllln tlrAn." corr.cUon froll the UnMeI.t Institution, .U.clt II cop)' to this for.
rf'd ,.tu"" It t" thl .b.,,,~ .cktr.... Th" ..-cnllnt I, 'lIwahl. In Hcordencl with the InherltlnClI ,.. l"" of the C~otIWfI.lth 01 Pennlwhl.,I..
Due.llone .'V bll ."....r.d by Cll11ng ("7) 767-ISI7.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYHENT INSTRUCTIONS
A...unt No. 8967-05 Doto 11-04-92
Eot.blhhod
Ac..unt Bobn.o 22,505.09
Por.ont Te.811le X 16 . 667
A.ount SubJo.t t. T.. 3,750.92
T.. ht. X . 06
PotenUol T.. Duo 225.06
PART TAXPAYER RESPONSE
[!] I FAILURE 'to RESPOND. MILL RUUL T IHAN. OFFICIAL TAX ASS!8SHEHT..BASED OHTHIS NOnCtt I
A, 0 The abova Jnfor..tlon land ta. due I. corraet.
I. You .aw choo.. to r..lt paw-.nt to the R.al.t.r of wJII. with tNO capJ.. of thl. not Ie. to obt.ln
. dl.count or avoid Inter..t, or woo .av check box -A- ~ r.turn thl. notlcl to the Rlal"lr of
Will. and en official ......-.nt will be I..ued bw the PA Depart.ent of Rav~.
To In.ura prop.r cradlt to your account, two
U) copl.. of thh notice .u.t aCCOlplllW waur
pay..nt to the Rlal.tar of Will.. Hake chack
paYabla to. -Raal.ter of Will., Agant-,
NOTE. If ta. p.w..nt. .r. .ad. within thr.1
IS) ~th. of tha dlcldent'. dlt. of death,
wou ..y dMfuct a 5X dhcount of the till dUI.
Anw Inherltanc. t.. due will beea.1 dallnquant
nlns (9) .onth. .ftar the date of de.th.
[CHECK ]
ONE
BLOCK
ONLY
I, c:J The abave ....t h.. been or will b. rlpart.d and ta. p.ld with tha p.nn.wlvanl. Inherltanca T.. r.turn
to bl 'Illd bw thl dec.dent'. rapra.ant.tlv.,
C, c=J Th. abova Infar.atlon I~ncorrlct and/a~.bt. and dadUctlons wer. paid by you.
You .u.t coaplata PART L!J and/or PART L!J balow,
If ~ou indicat. a diffar.nt taK rat., pl.... .t.t. your
r.lation.hip to dec.d.ntl
PART
~
TAX RETURN - COtlPUTATION
LINE I. Doto Eotobllohod
Z. Account Balanca
5. Peroant TaKable
4. A.aunt Subjact to TaK
5. Debt. and Deduction.
6. Aaaunt Te.811lo
7. TaK R.ta
8. Tax Due
OFFICIAL USE ONLY 0 AAF'
PADEPARTHENT OF REVENUE
PAD~Q
1"1 '"
. 2 ~': .
3 "
4
5
6'
7
8
DEBTS AND DEDUCTIONS CLAIMED
TAX O~ JDINT~TRU~T ACCOUNTD
OF
I
2
S
4
5
6
7
B
!l!
7nf1l
.Vj
,I.
..: :~- - ('.
~
':.1,
x
~
....
,(
,
:::;;,.
x
: :\~ f:':
",f
PART
I!l
DATE PAID
PAYEE
DESCRIPTION
AMOUNT PAID
I
"-..f:
,.
TOTAL IEn .r on Line 5 of Tax COMput.tionJ
.
Unde~ penaltia. of p.rjur~, I declare that tha
1..'J ollpleta ~~ ~ ba,". I .f IIY kno.,ledg. and beUef.
/, (],(.,...(. . (. a.,
feet. I hava reportad above are tru., correct and
HOME (((O/L!) '1'9'.1'- 9.rXJ
WORK ( ,./ V ) ,. 'f'l - (., J.YCI
FILE NO. 21 94-1009
ACN 95125988
DATE 06-07-95
TYPE OF ACCOUNT
~ SAVIHGS
CHECKIHG
TRUST
CERTIFICATE
REMIT PAVMEHT AHD fDRMS TO,
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
REV-1543 EX AFP 18-941 *'
COMMONwEAL'H OF PENNSYLVANIA
DEPAATMENl OF REV[HUE
BUREAU or INDIVIDUAL lUEI .
DEPl. 110601
f1AAP.U,IURQ, PA 11ua'0601
/5'-/0
OIL
HE"BERS 1ST FED CREon h.. provided thl Dlplrt._", with thl l"'ar..Uo" llthd baloM which ha. b..n uud In ulcuhUnlJ thl
potentia. tlW due. 'halt racord. Indlcat. that at thl d..th of tha above dlCldlnt, you w.t. I Joint ownar/blnaflcl.ry of thl. account.
If yOU f... thl. Infor..tlon I. Incorrlct, pl.... obtain wrlttan corr.ctlon frol thl financial 1n'lllutlon, attach. copy to thl. for.
and raturn It to the aboy. .ddr.... Thl. account 1. tl.lbl. In accordancl with thl Inh.rltenca Taw 11"1 of thl Co..~..lth of Pann.ylvanl..
Du..tlon. ..y b. In.w.rld by calling (7171 '17-ISl'.
COHPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYHENT INSTRUCTIONS
Account Ho. 29064-42 Dot. 04-22-85
Eahbliahed
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
ESTATE OF ELLEN H ORTH
5.S. NO. 008-09-2900
DATE OF DEATH 10-24-94
COUNTY CUMBERLAND
MARGARET H
185 ROBODA
ROYERFORD
HECKER
BLVD
PA
19468
To In.ura propar cradlt to your .ccount, two
eZI copla. of thl. notlc. IU.t .cco~any your
pay..nt to tha Ragl.tar of will.. "aka ch.ck
payabl. tal "Raal.ter of Will., Aaant".
Account ealanc. 2,061.27
Percent raxabl. X 50. ODD
A.ount Subjoct to T.. 1,030.64
To. Rat. X .06
Potenti.l rax Dua 61.84
PART TAXPAYER RESPONSE
COI FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSHENT BASED ON THIS NOTICE
A. 0 Tha above Infor..Uo" and tu due II corr.ct.
1. You ..y chao.. to r.alt p'Y"nt to the Raal.tar of Will. with two copl., of thl, notlc. to obtain
a dl.count or avoid Int.r..t, or vou aav chIck bo_ "A" and r.turn thl. notlc. to the Rlal.t.r of
willi and an offlcl.l .......ant will ba I..uad bv thl PA Dapartaant of R.v.nu..
NOTE I If ta_ pava.nt. ar. .ada within thr..
(1) aonth. of the d.c.d.nt', data of daath,
VDU ..v d.duct . 5X dl.count of the taM dua.
Anv Inh.rlt.nc. t._ due will baCDe' d'llnqu.nt
nln. C.) .onth. .ft.r tha data of d..th.
[CHECK ]
ONE
BLOCK
ONLY
B. c:J Th. above ....t has b..n or wIll b. r.port.d and t.M paid with the Pann.ylvanla Inharltanca Ta. r.turn
to b. fllad by tha dac.dant'. rapresantativa.
C. 0 Th. above Infor.atlon I~ncorr.ct and/o~abt. and d.ductlon. war. paId by you.
You au.t coapl.ta PART l!.J and/or PART l!.J balow.
If you indicat. . differ.nt tax r.t., pl.... .t.t. your
ralation.hip to dac.d.nt.
PART
~
TAX RETURN - COMPUTATION
LIHE 1. D.t. Eotoblt.hod
2. Account O.l.nca
3. Par cent raxabl.
4. Anount Subj.ct to Ta.
S. Debt. and Deduction.
6. Anount Taxabl.
7. Ta. Rata
8. Ta. Dua
TAX ON JOINT/TRUST ACCOUNTS
OF
1
2
3
4
5
6
7
e
x
PAD
1
2
3
4
5
6
7
8
CLAIMED
OFFICIAL USE ONLY 0 AAF
PA D~"AliTHENT. OF REII!NUE
., c: ~ ' ,'.("!:: ::V'l~
r,:'
(,; ~
, r
, -
~
.- :=:.:
-r-t(" "
po - t.
.... <:.,
x
-' ~.
AMOUNT PAID
.
PART
~
DATE PAID
o
DEBTS AND DEDUCTIONS
PAYEE
I
-c
~
DESCRIPTION
'(),
TOTAL CEnt.r on Line 5 of Tex CoftputatlonJ
parjury, J declare that tha fact. I
y kno ladge and bell.f.
have reported abova .r~ trua, correct
HOME ("I'D ) '/'Ir- 9..)'/J
WORK ((,Ie) ) ffl'l'/- {..J.'1(j
.nd
REY-1543 EX AFP (S-94',*
CO~~EAL'H Of PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU Of INDIVIDUAL TAXEI
DEPT. U06Dl
HAR,!SJuaD, P' 171'.-0601
/5./-(.
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
(' Ok
.
ESTATE OF ELLEN M ORTH
5.5. NO. 00S-09-Z900
DATE OF DEATH 10-Z4-94
COUNTY CUMBERLAND
NO. Z1 94-1009
951Z59S5
06-07-95
TVPE OF ACCOUNT
~ SAVINGS
CHECKING
TRUST
CERTIFICATE
RENIT PAYNENT AND FORNS TO,
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
FILE
ACN
DATE
MARGARET M
1S5 ROSODA
ROVERFORD
HECKER
BLVD
PA
19468
HEHBERS 1ST FED CREDIT h.. prayldad the a.p.rt..nt with the I"'ar..tlan lI,t.d balow which h.. b..., ",..d In ulcul.Ung thl
potent lei t.. due. Their r.cord. Indlcat, thlt It the d..th 0' thl above dlCldlnt, ~ou ~.r. I Joint ownar/blnaflclarv 0' thl, ICCOunt.
If you ,..1 thl. tnlor..tlon 1. Incorr.ct, pl.... obt.ln wrlttln corr.etla" frol thl 'In.nelll In.tltutlon, attlch . copy to thl. for.
and r.turn It to thl abovI .ddr.... Thl. account I. tl.lbl. In eccordancl with thl Inhtrltancl ,.. Llwt 0' thl C~..lth 0' Pennlylvanla.
Ca.ltlQnl ..y ba anlwer.d bJ c.lll~ (717) 7'7-')27.
COHPLETE PART 1 BELOW . . . SEE REYERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account Ho. 29064-46 o.t. 11-2Z-88
Eat.bli.h.d
Account Bo1onc. 1 ,516 .47
P.rcant Taxable )( 50.000
Allount Subj..t to T.. 758 . 24
Tax Rat. )( .06
Pohntlo1 T.. Ou. 45.49
PART TAXPAYER RESPONSE
[!] I FAILURE TOR!SPOND ifILL. RESULT IN AN OFFICIAL TAX ASSESSNENT BASED ON THIS NOTIC! I
A. 0 Th. abov. Infor..tJon and telC due 11 corr.ct.
1. You ..y choole to r..lt p.y..nt to the Raglltar of Willi with two copla. of thl. not lea to obtain
. dllcount or avoid Intara.t, or you ..y ch.ck bOlC ~A" ~ raturn this not Ie. to tha Ragl.tar of
Wills and an o"lclal ,.,a'l.ant will ba Is,uad by tha PA Daparteant of R.vanue.
To In,ura propar cradlt to your account, two
CZ) copla. of thl. notlc. au.t accoepany your
p.y.ant to the Ragl,t.r 0' Wills. "aka chack
paYabla tOI ~Ragl.tar 0' Will', Agent".
HOTEl I' talC pay.ent. ar. .ad. within thr..
e)1 eanth. 0' tha dacadent's d.ta a. daath,
you .ay daduct a SX discount a. t~ ta. du..
Any Inharltanca ta. dua will baco.. dallnquent
nlna (9) aonth. ,'tar tha data 0' daath.
[CHECK ]
ONE
BLOCK
ONLY
a. c:J Tha abova a"at he. baan or will ba raportad and talC peld with tha Plnn,ylvanl_ Inharlt~a T.. raturn
to ba filed by the dacadant', rapra.antatlva.
C. 0 Tha abova In'oreat1on l~nco,.tlct and/o~abts and deduction, wa,.. paid by you.
You .ust coaplata PART L!J end/or PART ~ balow.
If you indicata a diffarant t.x r.ta, pl.... .t.t. your
ral.tionship to d.c.dantl
PA
OFFICIAL USE ONLY OAAF
~TMEN'rlT OF RE~NUE
.c~ ""'f~
:;1 ',' '. :.~ ~.~~
PART
[!J
TAX RETURN - COMPUTATION
LINE 1. Data Eatabli.h.d
2. Account Oalanc.
3. Parcant Taxabl.
4. AMount Subjact to Tax
5. Oabt. and Oaductiona
6. AMount Taxabl.
7. Tax Rat.
a. Tax Du.
OF TAX ON JOINT/TRUST ACCOUNTS
1
2
3 X
4
S
6
7 X
8
" -
A-
PART
I!I
DATE PAID
,.~
DEBTS AND
PAD
1
Z
3
4
5
6
7
8
DEDUCTIONS CLAIMED
L. .,!
i""
~ .,'
~~
,
"f"o ~'
p~
:.:.
.,.
.1.1.1 C;)
er,
PAVEE
L'1 I .
DESCRIPTION
AMOUNT PAID
1
HI!';
7
TOTAL (Entar on Lina 5 of rax COMPutation)
.
parjury, I daclara that tha fact. I
.Y knONl.dg. and baliaf.
hava raportad aboY~ ara true,
HOHE ((,I'D ) 111. 9s
WORK ((010) ',eN' fo.dJ
corract and
s-
oJ::
C-
FILE NO. 21 94-1009
ACN 95125987
DATE 06-07-95
TYPE OF ACCOUNT
~ SAVINGS
CHECKING
TRUST
CERTIFICATE
RENIT PAYNENT AND FDRNS TO.
REoISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
"'"
"
15-/(.,
INFORMATION NOTICE
ANO
TAXPAYER RESPONSE
REYo1543 EX AFP (80941*
CDHI10HWEAllll DF PENNSYLVANIA
DEPARTHENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES .
DEPT. 280601
HARR1SIURG, PI 111:8.0601
ESTATE OF ElLEN M oRTlI
5.5. NO. 000-09-2900
DATE OF DEATH 10-24-94
COUNTY CUMBERLAND
MARGARET M HECKER
185 RoBoDA BLVD
RoYERFoRD PA
19460
HEHBERS 1ST FED CREDIT h.. provIded the C.p.tbent with the In'o,..tlon lI.t,d balol(ll ~1d1 hu bun u.ed In calculatlnll the
pot,ntlel taM due. Their record. Indlcat. thet .t the d..th of the above dacadanl, YOU w.,. , Joint owner/bln,'lcla,. of thl. account.
If you ,..1 thl. Infor..tlon I, Incorr.ct, pl.... obtain w,ltt.n corr.ctlon "08 thl 'Inanal.l In'lltutlon, attach. copy to thl_ for.
end nturn It to thl above addu... This account h 'aubaa In accordanc. with thl Inh.,U."u ,.. tew, of the CO..ol'lMe.Uh of Penn,v!"eni..
Que,tlon' e.v b. anlwe,ed bv cellinI (717) 717.I)Z7.
COMPLETE PART 1 BELOW . . . SEE REYERSE SID! FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 29064-43 Doto 04-22-85
eatabli.h.d
fa Inlure proper crldlt to your eceo"",t, two
III cop lei 0' thh noUn .u,t eeeoep,,";, your
plyllnt to the Rlgl.ter 01 willi. Hike check
pe.abl. tOI "R.glltl' of Willi, Aglnt".
2.061.27
50.000
1,030.64
.06
61.84
TAXPAYER RESPONSE
FAILURE TO R!SPoND WILL R!SULT IN AN OPFICIAL TAX ASS!SSH!HT BASED ON THIS NOTIC!
Account Bdanc.
P.rcant Taxabla
A~ount Subj.ct to
Tax Rat.
Potantial Tax Du.
M
M
HOt[ I If tu paY.lntl Irl aad. within thr..
ISI eonth, of thl dleldent" d.t. of dllth,
"au I'" dlduct . s:c dhcount of the t.. du..
An" Inhe,ltlmc, t.. due will beeo.. d.ilnqu.nt
nine I'. .on'hl .,t., the d.t. of d'lth.
To.
PART
rn
A. 0 Th. abo". Infor..Uon Itt\d h. due II co".ot.
I, You ..v choo.. to r..lt p...'nt t. th. .,gl't,r .f Will, with two copl., of thl' notlc. to obt.ln
. dllcount or ."ald Int.r..t. or you ..., ch.ck bOil "A" and r.turn thl, notle. to the R'allt.r of
willi Itnd Ian afflohl ........nt wlU b. lllu.d by the PA o.,.,t.."t of Re".nu..
[CHECK ]
ONE
BLOCK
ONLY
8. 0 Th. .bo'" ....t hu b..n fir will III ,.port." ttnd tn plld with the p.nnsrl"anl. Inhl,!tenu Tax r.tu,n
to b. fll.d by the deull.nt.1 PI,.r...nt..."..
c. 0 1he aba". I"'ar..tlon 1,~\"ur"41' 1tf1d10r_,~'t'h" IN\d d.dueUonl we,. pald bv you.
You WIt eo.l.t. PAM' l!J ."d/or PAllt (~b,low. 00
If you indicate a dlff.r.n a~ r. " pl.... . . . your
ral.tlonship to d.c.d.ntl_____~
PART
[!J
TAX RETURN 0 COMPUTATION OF
LINE 1. Doto Eatobllahod I
2. Account Balanc. 2
3. P.rcent T.~.bl. S
4. A~ount Subjaot to T.~ ~
5. D.bta and D.duotion. I
6. A.ount Taxabl. .
7. T.~ Rat. 7
8, Ta. Du. .
TAX ON JOINT/TRUST ACCOUNTS
.
PAD
1
2
3
4
5
6
7
8
CLAIMED
.
PART
[!]
DATE
DISTS AND D!DUCTIoNS
PAYEE
DESCRIPTION
'0'
PAID
TOTAL (En ar an Lin. 5 of Ta. COMPut.tion)
:u
lIJi, .lCIAL'-'USE Oli, V; 0 AAF
PA DEPARTMEtITOFREVENUE
, '. . f'.'
l'"
1,,1
~"...
-
-oc
:.: -.
. .
...
.l>o
..;.-
AMOUNT PAID
.
I haY' ~.part.d aboY._a~~ ~u.})corract
HOME (&10) Y'II yj";"J
WORK ((,rD) ('VY' li>JJ<!
facts
ond
TYPE OF ACCOUNT
~ SAVINGS
CNECKING
TRUST
CERTIFICATE
RE"IT PAV"ENT AND FDR"S TO.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISL~, PA 17013
",
v.
15"-1-1,,-
REV-1543 EX AFP (8-941_
CO~OHW[AL'H OF PENNSYLVANIA
OfPAR'"EHT OF REVENUE
BUREAU OF INDIVIDUAL l'XES.
DEPT. raD6al
HARRISBURG, PA 171"'0601
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
ESTATE OF ELLEN M ORTH
5.5. NO. 008-09-2900
DATE OF DEATH 10-24-94
COUNTY CUMBERLAND
MARGARET M
185 ROBODA
ROYERFORD
HECK ER
BLVD
PA 19468
FILE NO. 21 94-1009
ACN 95125986
DATE 06-07-95
"EHBERS 1ST FED CREDIT h.. provldad the Dlpart..nt with the Infor..Uon llstad balow which hu ba." uud In ulculatlnll the
pot~tl.l t.. due. Their racordl Indicate that at the d..th of thl above dlcadant, you WI,.. a joint owner/benefIciary of thl, account.
If you f.. I thl, Infor.atlon I. Incorract, pl.... obtai" wrltta" corractlon fro. the fJn8nclal 1"ltltutlon, attach. copy to thl_ fa,..
and raturn It to the above .dd,..... Thl.. account 1. huhl. In acr.ordllnca with the Inherltanca talC L"w. of th. C".~..lth of P'M.vl",.nle.
Qu..tlon. ..v b. an.~.r.d bv ceiling (717) 7.7.1327.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 29064-47 Oat. 11-22-88
E.tablished
To In.ure prop.r cr.dlt to "our account, t~o
(2) cop I.. of thl. notice .u.t accospanv vour
p."e.nt to th. Raol,tar of WIll,. "aka ch.ck
payabla tOI -Raol,t.r of Will., Auant".
1,516.47
50.000
758.24
.06
45.49
TAXPAYER RESPONSE
RESULT IN AN OFFICIAL, TAX ASSESSMENT BASED ON THIS NOTICE
Account Bal.nc.
Percent Taxable
AMount Subject to
T.x Rat.
Pot.ntial Tax Due
x
NOTE I If t.x p.ya.nt. ar. ..d. within thr..
(3) .onth. of th. d.cad.nt', d.ta of d..th,
vou ..y d.duct a 5X dl.count of the ta. du..
Any Inherlt.ne. t.x du. will b.co.. d'llnqu.nt
nln. (9) sonth. .ft.r th. dati of d..th.
x
T.x
PART
rn
FAILURE TO RESPOND WILL
A. 0 Th. abov. InforsaUon anc:l taw du. 11 corr.ct.
1. You .av choo.. to r..lt pav.ant to tha Aaol.t.r of will. with two copla. of thl. notlc. to obtain
a dl.count or a",old Int.r..t. or YOU aay ch.ek box -A" and r.turn thl. notlc. to th. R.ol,tar of
will. and .n official ........nt will b. I..u.d by the PI Daparta.nt of Ravanu..
B. r=J Th. .bav. ....t ha. ba.n or will b. r.port.d and tax paid ~lth th. P.nn.yl",anl. Inharltane. T.. raturn
to b. fllad bV the dac.d.nt'. rapr..antetl",..
C. r=J Th. abav. Infor.ation I~ncorr.ct and/or deb" Bnd deduction. wara paid bv you.
You aUlt co.plet. PART l!J .nd/or PART ~ b.lo~.
[CHECK ]
ONE
BLOCK
ONLY
If you indicat. a diffar.nt tax rat., pl.... .t.t. your
ralation.hip to dacadantl
PART
~
TAX RETURN - COMPUTATION OF
LINE 1. Data E.tablhhad 1
2. Account a,lane. 2
3. Pare ant Taxabla 3
4. Anount Subjact to Tax 4
5. Dabt. and Daductions 5
6, Anount Taxabla 6
7. T.x Rat. 7
8, Tax Du. a
TAX ON JOINT/TRUST ACCOUNTS
x
PAD
1
2
3
4
5
6
7
8
CLAIMED
x
PART
[!l
DATE PAID
. 0-
DEBTS AND DEDUCTIONS
PAYEE
Ll2r I .
DESCRIPTION
70'
TOTAL CEnt.r on Lina 5 of rax COMPutation)
parjury, I declar. that the fact. I
no"ladga and bali.f.
PA
OFFICIAL USE ONLY 0 AAF
Dtf~TMEN~ OF RE~NUE
-.. ...... '.:[.
:.~ _' \Jl 1'(1 ,,)
.
t.,;;..
r-
~
"""
-,....,
-.
"f;:::-4
u,
.
AMOUNT PAID
.
'.)
hava report ad above ar. tr~~, corract
HOME (( I ) '1'1 f. 'IS9.-1
WORK ((elL!) &'Ytf~ '. J<'
and
OK.
(!.
I'lL! NO. 21 94-1009
ACN 95125984
DAT! 06-07-95
TVPE OF ACCOUNT
~ SAVINOS
CHECKINO
TRUST
CERTIFICATE
RENIT PAYNE NT AND fORNS TO.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
,
1';; 1- 6
INFORMATION NOTICE
AND
TAXPAVER RESPONSE
.
R!V-1543 !X AFP 18-94) *
.CDffHOHW[Al m OF PfNHlVlVANIA
lM.lIAATMlNl Of' R[YOM:
IURUU or INDIVIDUAL lun
Dl:PT. rlUD!
II'~AU'UAO, PI HUI'UOI . <
eSTATr. or ELLEN M ORTH
S,S. NO. 008-09-2900
DATe OF DeATII 10-24-94
COUNTY CUMBERLAND
MARGARET M IIECKER
185 ROBODA BLVD
ROVERFORD PA
19468
HEHIERS tlr FED CItEDIT hi' provld.d Ih. P....tt.ent wUh Ih. In,.,...tlon lhhd b.l.w which h.. bun used In ulcul.tlng 1M
pat.ntl.1 "M duI. Ih.I, ,.cordl Indlc.', Ih.t It the d..I" ., the above dlc.dent, vau w.t. I Joint own.r/ben.flcl.r, ., thl. lecount.
If you '..1 thl. In'.r..llon 1. Inco,r.ct, pl.... obl.ln written carrletlon 'ro. the fln~l.l In'tltutlon, .tl.eh . cop, to thl. 'or.
.nd ntutn It to Ih. .boy. .dd'.... 'hll .ceount Is I...bl. In .cClDrdanCl. with Ih. ."".,UMe. h. L.... of the COMOnW..lth of P.nnnl"anl..
au..tlon. _ey b. ~'wer~ by rellln, f7171 '.'.1."
COMPL!T! PART 1 BELOW . . . I!E R!V!R8! SID! FOR FILING AND PAVMENT INSTRUCTIONS
ADDDunt No. 8967-40 D.t. 04-26-82
Eot.blhh.d
ADDDunt blonD. 3,143.52
P.rc.nt T.M.bl. )C 50 , ODD
A.Dunt SUbj.Dt to To. 1,571.76
T.. R.t. X .06
PDt.nthl T.. Du. 94.31
PmT TAX PAVER RESPONSE
I FAILURI TO RI8POND MILL RI8ULT IN AN OFFICIAL TAX A8SISSHENT BASED ON THIS NOTICI
i. c:J 'h. Ibov. Infor..tlon end t.. due I. corr.ot.
I. '101' "V ohoo.. to r..1t P'Vltnt to the R.ghhr of Willi with two copl.. 0' thh notlc. to obt_ln
. dl.count or .vold Int.r"I, or you "V ch.ck bo. "i" ~ r.turn thl. not Ie. to the R.gl.t.r 0'
Will. end en o,flcl.1 .......tnt will b. I..ued bv thl Pi o.p.rt..nt of R.venue.
'0 In.ur. prop.r cr.dlt to your .ccount, two
(U cop I.. of this notlu INlt .ccallPtny your
p.y..nt to the R.gl.t.r a' Will.. ".k. ch.ck
p.y.bl. tal "R.gl.t.r 0' Will., agent".
HO'E, I' t.. p.v..nt. .r. .Ide within thr..
(S. .onth. of the d.c.d.nt.. d.t. a' d..th,
you IIV d.duct . 5X dhcount 0' the t.. du..
Anv Inherltanc. t.. due will b.co.. d.llnqu.nt
nln. C91 ~th. .'t.r Ih. d.l. 01 d..lh.
[CHECK ]
ONE
Bl OCK
ONLY
I. 0 'h. Ibov. ....t hll bltn or wUI b. reported .nd I.. p.ld with the p.nn'vl..,,,,,I. Inhtrltenc. TI. r.turn
to b. '11.d bv the d.c.d.nl'. r.pr,,'nt_tlv..
C. 0 Ih. .bov. In'or..tlon I~ncorr.ct .nd/o~'bt' and d.ductlon. WIt. p.ld bv YOU.
'Iou .u.t co~l.te PAAI L!J and/or PAA' L!J b.low.
If you india. . . dlff.r.nt t.. ret., pl.... .t.t. your
r.l.tlon.hip to dec.dent.
PART
[!]
TAX R!TURN . COHPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LIN! 1. D.t. hhbl hh.d 1
2. Aoaount .el.no. 2
s. ~erc.nt T...bl. S M
4. A.ount SubJ.ct to T.. 4
J. Debt. and D.duotlon. .
,. A.ount T..ebl. ,
7. Te. Net. 7 M
e, T.. Due I
OFFICIAL USE ONLY 0 AAF
PA DEPARTHENT OF REVENUE
PAD ...--C n . :;;a'
1 -------~ (1J :~ :.u ~
2 h J 0;'
3 F' 1.'
II
5
6
7
8
CLAIH!D
PART
[!J
DATE
D!BTS AND D!DUCTIONS
PAVEE
DESCRIPTION
PAID
,., y-
TOTAL IEn .r on L1n. 5 of T.. Co.pu e ion)
of p.rJury, I d.oler. th.t th. fect. I
y knowl.dg. .nd b.li.f.
-
"
l:!ia
:tic:
AMOUNT PAID
.
. ,
ond
Cc -...10 -Y)-
DATE
, ,
.
REV-1543 EX AFP 18-941.
.COHHOHWEALTH or PENNSYLVANIA
Dl1'ART"EHl or REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. ZlD6al
IlARRaSURG, PA 17UI-060!
15 -{- ~
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
Ok C
ESTATE OF ELLEN M DRTH
5.5. NO. 008-09-2900
DATE OF DEATH 10-24-94
COUNTY CUMBERLAND
FILE NO. 21 94 -1 009
ACN 95125983
DATE 06-07-95
TVPE OF ACCOUNT
~ SAVINGS
CHECKING
TRUST
CERTIFICATE
RENIT PAVNENT AND FORNS TO.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
MARGARET M HECKER
185 ROBODA BLVD
ROVERSFORD PA
19468
HEHBERS 1ST fED CREDIT h.. provided the Dlp.rt..nt with thl Infor.atlon IlItad balow which h.. b..n u..d In ulcullUng thl
potlntlll t.. dul. Thalr r.cordl Indlcat. that It thl d..th of thl aboy, dlcldlnt, VOU ...r. I Joint owner/blneflclarv 0' thl, lecount.
I' YOU ,..1 thl. Infor..tlon 1. Incorrect, pl.... obt.ln ..tltt.n corr.ctlon frol thl 'Inancla. Inltltutlon. attlch. copy to 'hi, for.
and r.turn It to thl aboVI .ddr.... Thl. account I. ".'bl, In accordanc. with thl IRhatltlnC. ,.. l... of the Coeaonwealth of Pann.ylvant..
QuuUon. ..y b. ."....,.d by cIUlna ClUJ ,lIaIU'.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAVMENT INSTRUCTIONS
Acccunt No. 8967-41 Doto 04-26-82
E.tabUahed
Account ealanc. 3,143.52
Parcant TalCabl. )( 50 . 000
Amcunt SUbjoct tc T.. 1,571.76
T.. Rot. K .06
PohnUo1 To. Duo 94.31
~~ TAXPAYER RESPONSE
[!] I. FAILURI!.TO RI!SPOND.WILL RI!SUL T IMAM OFFICIAL. TAX ASSI!SSMI!HT BAUD ON THIS MOnCI!
A. 0 'h. .bov. Infor.aUon anet till due h correct.
1. You ..y choo.. to r..1t ply..nt to the A.ahhr of Wllh with two copl.. of thl. notlc. to obt.tn
. dl.count or avoid Int.r..t, or yoU ..y ch.ck ball "A" end r.turn thl. not Ie. to the A.al.t.r of
WUII and an offlcl.1 ........nt wUI b. '.uuld by the PI DIP.rt.ant of A.vanlM.
To In.ur. proper cr.dlt to your account, two
(21 copl.. of thl. notlc. ~.t .cco....ny your
ply..nt to the RIgl.t.r of NIII,. Hak. ch.ck
ply.bl. tOI "A.gl't.r of Will', Ag.nt".
HOTEl If talC ply..ntl .re ..d. within three
e5. _onth' of thl d.ud.nt', data of daath,
yoU ..y daduct a 5:( dhcOW1t of tn. tall du..
Any Inhar Itanu tall dua will blcHa d.l1nquant
nlna e') .onth' aftar th. d.tl of daath.
[CHECK ]
ONE
BLOCK
ON LV
s. E:J Tha aboy. a.,.t h.. b..n or will b. raport.d .nd t,. p.ld with the P.nn.ylvanla Inh.rlt."ca TalC r.turn
to ba fllld by thl dlCldlnt., r.pra'lntatlva.
C. ~ Thl abova I"'or..tlon I~ncorract .nd/o~.bt. and d.ductlon. wara paid by you.
Vou .u.t coaplat. PART l!J and/or PART l!J balow.
If you indicat. a diff.rent tax rat., pl.... .tat. ~our
ralation.hip to dlllc.dentl
PART
[!)
TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Doto E.tob1hhod 1
2. Account 8alanc. 2
5. Parc.nt Taxabl. 3 )(
4, A.ount Subjact to TalC 4
5. Dabt. and DIIlduot1onl 5
6. A.ount Taxabl. 6
7. Tax Rat. 7 x
a. Tax Dua a
PART
[!]
DATE
DEBTS AND
PAD
1
2
3
4
5
6
7
8
DEDUCTIONS CLAIMED
OFFICIAL USE ONLY 0 AAF
PA DEPARTMENT OF REVENUE
(') ('). 5i c. ::0
l:: d , _,J './0
.1..', ' ' ,f:t<t
PAID
o.
PAVEE
,'-
DESCRIPTION
AMOUNT
. ./(
PAID
'.
TOTAL CEnt.,. on Line 5 of Tal( Conpuh 10n)
.
.
MARY C. LEWIS
ROlllollr of Wlllo " Clerk 01 Orphlno' Court
Cllmbe~ond County Courlhoule
Ce~lalo, PeMlylvanle 17013
"I
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HBG.PA 170
THOMAS M. ORTH,
1013 APPLE DR.,
MECHANICSBURG, PA 1705~
17"55-341" 1l
-;:,'-\ ",-,;-,
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RETURN TO SENDER, , 'J
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STATUS REPORT UNDER RULE 6.12
Name of Decedent I E. L.L f N 11. tOle ,H
Date of Deathl CJC7'lJBl!..1!.. :J."f I /'111-
will No. ;).,\- 1l/.4'i- IDoq 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 estate I
1. State whether administration of the estate is complete I
Yes X No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete I
J. If the answer to No. 1 is Yes, state the followingl
a. Did the personal re~esentative file a final
account with the Court? Yes No .
b. The separate Orphans' Court No. (if any) for
the personal representative's account iSI
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.
Date:
-
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Signature
I hD:"H M..h~t:1 AKaL
Name (Please type or print)
i!\ u: II ~ c.s rtl:l f2{, I
R . POf>
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"Box: 7..:J..~
(7/1) 7/;;:11'1 J
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Address
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CapacitYI ~personal Representative
Counsel for personal
representative
P\
(HAM I rmf/ AMJ)
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