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REV-lS43 EX AFP (8-941*,
COHHDNW[AL TIl OF PENNSYlVANIA
D[P~AT"EH' OF REVENUE
BUREAU Of INDIYIDUAl TAXES
DEPT. lllD6Dl
HARRISBURe, PA 1712'.0601
I .:5- .:::; LI-,.;v
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE
ACN
DATE
e
NO.21-1S-,3SI
95115164
04-25-95
ESTATE OF DONALD LEHMAN
5.5. NO. 190-42-3519
DATE OF DEATH 01-26-95
COUNTY CUMBERLAND
TYPE OF ACCOUNT
~ SAVINGS
CHECKING
n.UST
CERTIFlCATE
REHIT PAYHENT AND FORHS TO,
REGISTER OF WILLS
CUM8ERLAND CO COURT HOUSE
CARLISLE. PA 17013
THERESA LEHMAN
718 W MULBERRY
SHAMOKIN
5T
PA 17872
FIRST NATIONAL TRUST B hi' provided the nlp.,-t..nt with the tnfor..Ua" lI,t.d b.low which hI' b..n used In ulcul.t1ng the
pot.ntl.l l'M du.. Th.lr r.cord. Indlc.', th.t .t the d..th of tha abova dacadant, you wara . Joint owner/banaflclary of thl. account.
If you f.. 1 thl. Infor..tlon I. Incorract, pl.... obtain wrltt.n corr.ctlon fro. thl financial In.tltutlon, attach a copy to thl, for.
.nd r.turn It to the above .ddr.... Thla account I. I..abl. In accord.nca with the Inheritance T.. law. af the Co..unwa.lth of P.nn.ylvanla.
Uua.tlon. ..V be an.war.d DV c.lI1"8 t,ll) '~/.asz,.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No. 12-84204-4-62 Doto 05-07-84
Eatabl hh.d
Account Bal.nce
Pa~c.nt T.~abla
Altount Subjat:t to
T.x Rat.
Potantial Tax Due
10.103.07
50.000
5.051.54
.06
303.09
TAXPAYER RESPONSE
FAILUR! TO R!SPOND WILL R!SULT IN AN OFFICIAL TAX ASSESSNENT BAS!D ON THIS NOTIC!
To Inlur. proper cr.dlt to your .ccount, two
eZ) cop I.. af thl. notlc. .ult acco.plnY your
pfty..nt to the A.glltar of will.. Hak. ch.ck
p.yabl. tal "A.gI.tar of Will., Ag.nt".
x
x
HOTEl If t.M pay.ant. at. ..d. within thra.
(1) .onthl of th. d.c~ant'. d.t. of d..th,
YOU ..y d.duct a 5% dllcount of the t.M du..
Any Inh.rltanc. ta. due will b.co.. dallnqu.nt
nlna 19) .onth. .ftar the data of d..th.
To.
PART
[!]
[CHECK ]
ONE
BLOCK
ONLY
Io. [lJ'1h. above Infor.IUon and taM due Is corr.ct.
1. You ..y chool. to r..lt ply..nt to the R.al.t.r of Wlll. with two copl.1 of thl. not Ie. to obt.ln
. dl.count or .vold Intar..t, Dr YOU 'IY ch.c~ baM "A" and r.turn thl, notice to the A.gI.t.r of
Willa .nd .n official .......ant will ba I..u.d by thl PA D.part,.nt of Ravenua.
B. c:J Th. above ....t ha. b.an or will b. raport.d and tlM paid with the P.nn.vlvanl. Inharltanc. TaM raturn
to b. fll.d by the d.cadant'. r.pr..entatlve.
C. ~ the above infor.atlon I,~ncorr.ct and/o~abt. .nd daduCtlon. w.ra paid bV you.
You aUlt co.pl.t. PART ~ and/or PART ~ balow.
If you indicata . diffa~.nt tax ~.t., pl.... .t.t. your
~.l.tlon.hip to dac.d.ntl
OFFICIAL USE ONLY 0 AAF
PA DEPARTMENT OF REVENUE
PART
~
TAY.
LINE
RETUn~! - eaMrl..!T^T!O~J 01'
1. D.t. E.tablhhad 1
2. Account Bal.nca 2
3. P.~cant Tax.bla 3
4. AMount Subjact to T.~ 4
5. Dabt. and Daductlon. 5
6. AMount Tu.bla 6
7. Tax R.t. 7
8, Tax Dua 8
TAX or: Jo:t:r .ITr.!.!OT Acccur:TC
r.~
....
PART
~
DATE
1
2
x 3
4
5
6
x 7
8
DEBTS AND DEDUCTIONS CLAIMED
PAID
PAYEE
DESCRIPTION
AMOUNT PAID
I
TOTAL IEnta~ on Lina 5 of Tax Co~putatlonJ
I
.
Undar panaltla. of parjury, I d.clar. th.t tha f.ct. I
conpl.ta to th. ba.t of MY knowladg. and b.ll.f.
'___~. ,'. iJ
'/I,~ 1~ ",../~ ,..l.~,/(",,<.4"-'
T..~ ,YER SIGNATURE
haye r.portad abova .ra tru., co~r.ct
HOME (,//;/1 t'~F S:')~7
WORK ( 1
TELEPHONE NUMBER
ond
DATE
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFfICIAL TAX ASSESS"ENT with appllnbla Int.r..t b..ed on Infar.atlon
tub.JU.d by the Unancl_. In.tltutlon.
1. Inh.rItMeD tall bUD." daUnquant nln. aonth. aftar tMl dandent". dIll of d..th. A
J. A joint account II hubl. 1\oIIn though the dICldlnt", nu. "., added .. . ..thl'" of cDnv,nl.nu. (:{', (If
4. Accounh Uncludlnll tho.. held bat".." hu.band and wU,) which the dlclldlnt put In Joint n.... within on.fra',:'ptlo, to 'iJi'~
d..th .1"'. fulh 'Iubl_ at trMI'a".
5. AccOt"'" ..teblhh,d Jointly bat...." hUsband IlI1d ..Ua 110'. th." on. 'I.'" prior to d..th .1"'. not ,...bl.,
6. Account. held by . dacld,nt "In trult for" Mothar or ot~r. .1"'. t...ble fully.
R~PORTING INSTRUCTIONS - PART
'y, MY 19 P2 :'7
- TAXPAVER RESPONSE '.
1
1. BLOCK I. ~ If the Infor..tlon and cOlIputaUon In the notlc. .1"'. corr.et ..,d deduction. .1"'. not baing uJda.d, piau M "X" 'lrt
In block "A" of Port I of tha "T..p.v.r R..pon.... ..~tlon, Slon two cop I.. and .ub8lt tha. with V~F~k for tho .-ount of~
ta. to the AIII.t.r of Will. of tho county Indlc.t.d. Th. PA D.p.rt..nt of R.v.nua will I..ue .n ofl1c(.I'~".,laent ., ~I\
CFara REV-IS41 EX. upon r.c.lpt of tho r.turn froa tho Aogl,t.r of wills_
Z. BLOCK I - If tho ...st .paclfl.d on thl. not lea hs. b.on or will ba rlPortad .nd t.x p.ld with tha P.nn'Vlvanla Inh.rltanca
T.x A.turn fll.d by tho d.csd.nt'. r.prs.snt.tlv., placa en ..X- In black "B" of Psrt I of th. -T..pay.r A..pon.... I.atlon. Slln on.
copy and rsturn to th. PA D.p.rt.ant of R.v.nu., Bur.au of Indlvldu.1 Taxa., D.pt 210601, H.rrl.burg, PA 17121-0601 In tha
anv.lop. pravld.d.
5. BLOCK C - If tha notlc. Infora.tlon I. Incarr.ct andlar deduction. .r. baing cl.la.d, ch.ck block ..C- and coapl.t. P.rt. 2 and 5
aecordln: to tho In:tru~tlon, h.l~w. Sic" 'we cop I.. Nn~ ..~.It th.. with Y~lr ch~e~ 'or tha ..ount 0' t.. p.y.bl. to th. R.ol.tar
of Will. of tho county Indlc.t.d. Th. PA Dap.rt.ant of A.venu. will I..ua an o'flclal ........nt (For. REV-IS'I EX) upon r.c.lpt
of tno raturn froa tho A.gl.t.r 0' Will.,
TAX RETURN - PART 2
- TAX COMPUTATION
UNE
I. Entar tha dlt. tho .ccount orlgln.lly w.. ..t.bll.h.d or tltl.d In tho aannar .xl.tlng at d.te of d..th.
NOTE I For. d.c.d.nt dylnl aft.r 12/12/1Z1 Account. which tho dacad.nt put In Joint n.... within ana (I) v..r of da.th .r.
taxable fully.. tran.f.r.; Haw.v.r, th.r. I. an .xclu.lon not to axc..d '5,000 p.r tran.f.ra. r.gardl... 0' tho volu. of
tho .ccount or tho nueb.r of .ccount. h.ld.
If 0 doubl. ..t.rltk (n) app.ar. b.for. your first n... In tho addu.. portion 0' thlt notlca, tho n,ooo ..elullon
alr..dy h.. b..n deduct.d fro. tho .ccount balMC. .. r.ported by tho flnancl.1 In.titutlon.
Z. Ent.r tha tot. I b.lanc. of tho account Including Int.r..t .ccruad to tha data of d..th.
5. Th. porcent of tha .ccount th.t I. ta.abl. for a.ch .urvlvor I. det.r.lnad .. follow'l
A. Tho p.rcent t.xabl. for Joint a...t. a.t.bll.h.d .or. than on. v.ar prior to tho doc.d.nt's da.thl
I DIVIDED IV TOTAL NUMBER OF
JOINT OWNERS
Ex..plol A Joint ....t r.gl.tar.d
DIVIDED IY TOTAL HUMIER OF X 100 . PERCENT TAXAllE
SURVIVIHG JOINT OWNERS
In the no.. of tho doc.d.nt and two oth.r p.r.on..
I DIVIDED IY 5 (JOINT OWNERS) DIVIDED IV Z (SURVIVORS) . .167 X lOa . 16.7% (TAXAILE FOR EACH SURVIVOR)
a. Th. porcant t...bl. for ....t. cr..t.d within o~ y.ar of the d.cad.nt'. d.ath or account. ownad by tho dacadant but h.ld
In tru.t 'or anoth.r IndlvlduIIC.) (tr~.t bano,lcl.rl.s)a
I DIYIDED IY TOTAL NUH!ER OF SURVIVINg JOINT
OWNERS DR TRUST !EHEFICIARIES
X 100 . PERCENT TAXAILE
Exa.pl.a Joint account ragl.t.rad In the ne.a of tho d.c~dant and two oth.r p.r.on. and ..t.bll.hod within on. v..r of d.ath by
the d'Cld.nt.
I DIYIDEO IY Z CSURVIYORS) . .50 X laD . 50~ (TAXAILE FDA EACH SURVIVOR)
..
5.
6.
7.
Th. ..ount .ubJ.ct to t.x Cllno ~) I. d.t.r.ln.d by .ultJplylng tho .ccount b.l.nca (1In. Z. by th. p.rc.nt tl.abl. (1lno 5).
Ent.r the tot.1 of tho d.bt. .nd d.ductlon. II.t.d In P.rt 5,
Th. ..ount t..ebl. Clln. 6J I. dator"nld by .ublrectlng tho a.bl' ana d.ductlon. llln. 51 'roe Ino alount
Ent.r tho .pproprl.t. tax rat. (1In. 7) .. d.t.r.lnad bolow.
.uoJac l to tax
',0
U,
lUna ",.
A. For d.t.. of daath occurring oft.r 6/30/9', tho tax r.t.. for tran,'ars to .pou... ar. .. 'allow..
I. Oat.. 0' d..th on or aftor 7/1/9' .nd b.fora 1/1/96 tho r.t. I. 5~.
Z. O.t.. of d..th on or .ft.r 1/1/96 .nd b.foro 1/1/97 tho reta I. Z~.
5. oat.. of d..th on or .ft.r 1/1/97 and b.foro 1/1/ge tho ret. I. l~.
4. O.t.. of d.ath on or aft.r 1/1/,e tr.n,'.r. to .pou... will b. .x..pt fro. tax.
Hot'l For dlt.. 0' da.th prior to 7/1/" tran,'or. to ,poula. .r. t...bl. at 6~.
I. Tran.f.t. to Ilno.1 do.c.ndont. Including ,.th.r, .uthar, .on, d.ughtat, grandchlldr.n, .on.ln-Iaw,
daughter-In-law, ,,,pchl1d and th.lr Inua .r. tu.bl. ot .Aw parc.nt C6~). ...'
C. Tran.f.r. to .11 othar. Including broth.r, .I.t.r, unclo, .unt, naphew and nloc. .r. ta.abl. .t flft..n p.rc.n~~"SX).
D. If you chang. tho tax rat., pl.... .p.clfy your t.latlon.hlp to tha d.cad.nt In tho ara. preyld.d.
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Tho Mount of t.1I due Ulno I) It dot.raln.d by wltlphlng the .aount tax.bl. Ulna 6} by the tax r.to Cline 7).
<::>
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CLAIMED DEDUCTIONS - PART
DEBTS AND DEDUCTIONS CLAIMED
3
Allow.bl. d.bt. .nd d.dUctlon. .r. d.t.r.ln.d .. 'ollow'l
A, You logllly Ir. r..ponslbl. far pavaant, or tha ..tat. .ubJ.ct to ad.lnl.tratlon by . p.r.on'l rapr...nt.tlv. I. In.ufflclant
to PlY tho doductlblo It....
I. You actullly p.ld tho d.bt. .ft.r d..th 0' tho d.cadent end can furnish proof 0' p.ya.nt.
C. O.bts b.lnl cl.I..d au.t b. It..I,ad fullv In P.rt 3. I' addltlan.l sp.c. I. n.odad, u.. pl.ln pap.r I IIZ" . 11-. Proo' 0'
pey..nt ..y b. r.qua.t.d by the PA Dop.rt..nt of Rovonue.
TAXPAYER ASSISTANCE
IF YOU NEED FURTHER INFORMATION OR ASSISTANCE. CONTACT ANV
REGISTER OF WILLS. PA DEPARTMENT OF REVENUE DISTRICT OFFICE
OR CALL THE BUREAU OF INDIVIDUAL TAXES. TAX PAVER INQUIRV UNIT IN
HARRISBURG AT (717) 787-8327, TDDI (717) 772-2252 (HEARINO IMPAIRED ONLVI
....".
1.---
I)ETITION FOI{ GHANT OF LETTEI{S (W ADMINISTHATION
E.,WI" of J2llnald.\i._l..ehmun-------,------
III,,,, kt/Ol\'1t II,' ----------
No. ...,___2.L:_95 _-_.).81
To:
__~__..__ /Ji'('('ll.\'L'tl.
Socllll S",'urily No. J9Q=92~3519_----,-
Reghler "I' WiI" fur Ihe
COli Illy "I' Cumberland- ill Ihe
COllllllollweallh of l'ellll,yl"lInlll
The pellllllll of Ihe nnde"lgned re,peell'nlly lepre'elll' Ihlll:
Your pelllloner(,). who hlme 1M year, of IIge '" older. nl'plies-- _ for leller' of ndmlnlmllllon
on Ihe eslllle of
.~_.----~.
(d.h.n.; 1,,'nl1cnlc lilt; dUrlIlIlc Uh\CII111l: lhllUllh.' ml1ulIllitlC)
Ihe utlove deeedenl.
Deeendenl WIlS domiciled III delllh In _C!Jl!l!:ll;lclmxl ' Connty. l'ennsylvulllll, wllh
h is IlIst I'lImlly or principal reshlenee III _l!!JLThJ;,eILSquaJ;e HollolLRdo-Newburg,...2L\
((hi \111."\'1, lIumber mll~ 1I1unldl':dil)')
Deeendenl, Ihen -!t3- yems of IIge, died _January....26,
Ul HOpeWE,ll TOlmship-,_ClIDberland_Count.y-.-EA-._-
,19.95--.
Deeendenl III delllh owned p,opert). wllh esllnnlled vnlne, ns I'olllow,:
(If domiciled In I'n.) All personul property
(If nol domiciled In I'll.) I'ersonlll property In Pennsylvania
(If not domiciled In I'll,) I'ersonlll property In ConnlY
Vulue of reul eslUle In l'enns)'I"anlu
slluuled us follows:
$-3.,.o~
$
$
$
None
I'elllloner_ ufter a proper search hll-5.- IIseertnlned lhlll deeedelllleft no wlllllnd wus slIrvived by
Ihe following sponse (If nny) lIllIl heirs:
Name
BArbarA K.-Lebman
GregorV W, Lehman
Nar:k IJ, Lehman
Christo e
RcllIllonshlp
~pousP
child
_chUrl
child
Re,ldenee
llt31Lllu:euqllArp Hnllnw Rd, Newburg,PA
117_lleJ:s~ Rrl. T M R J Shipp, PA
llt31Lllu:elLSqllArp Hnllnw Rd, NeIYburg
.1431t-'l1u:elLSquare..Hollow.. Rd. Newburg
-_._--~_.-.-.----_..-
THElWFORE, pelilionerl') re,peelflllly re<\lIe,I(,) Ihe granl of IClIe,s of udmlnlSlrllllon In Ihe
IIpprop,llIle form 10 the nnderslgned.
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t-)\ l\-(,h 1::l.9...<./.D_
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
} 58
The petltloner(s) above-named swear(s) or arnrm(s) that the
statements In the foregoing petition are true and corrrctto the best
of the knowledge and belief of petltloner(s) and that as personal
representatlve(s) of the above decedent petltloner(s) w\1l well and
truly administer the estate according to law.
'rR ..,A.\.ll\O.....'
.
t
Vi
.
subscribed ~(\, 1'In \ r\ -V
~,' ~~ Of[~~ 1
Register L "f11' .
Sworn to or arnrme~Ttwd
before me this
MA
C. LEWIS
No. 21 - 95 - 381
00
3 v ~~
.
, ,Dec~ed
_~:o
'1\11
; (I
Estate of
DDNALD W, LEHMAN
N
GRANT OF LETTERS OF ADMINISTRATION'
, m
~D ': . . t'J (.
}-,,~ f' \ .~'.
AND NOW JUL Y 5. 19~, In consideration of th~'petltlor. on
the reverse side hereof, satisfactory I!roof having been presented before me,
IT IS DECREED that Barbara K. Lehman
Is/are entitled to Letters of Administration, and In accord with such finding, Letters of Administration
are hereby granted to Barbara K, Lehman
In the estate of Donald \~, Lehman
FEES
Letters of Administration ,.... S
Short Certificates( 2) .... . ... .. S
Renunciation ................ S
JCP S 5,00
TOTAL _ S 36.00
Flied ...... ...)V~.'( .~...... A.D. 19-2L
~.
11. Anthony Arl"m~1 r.~q"irp ?'i'iO?
ATTORNEY (Sup. Ct. 1.0. No.1
128 E, Kin~ Street. Shipvensrnlrg, PA 17257
ADDRESS
(717)-532-3270
PHONE
25,00
6.00
Mailed letters and order to attorney on 7-5-95.
21 - 95 - 381
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INTEREST I
Int.,...t 11 .chera-d bqlmlnt ..Ith flnt tMV of dellnquency, or nlM (9) IIGnth. and aM (1) MY
frOll ttMI d.t. of d..th, to the clltta of pn.."t. Tu.. which bee_ cMllnquMt before J--..,.y 1, 191Z
~r Int.,...t .t the rat. of .1. (lX) parc.lt par ~ calcul.tad .t . dellv rat. of .000164.
All tax.. which bee.. dell~t on or aft.r J...,.".ry 1, 1'82 ..Ul baar Inhr..t .t a rate which ..Ul vaN frOll
"lender VIaI' to ~I..,..r y..r ..lth tMt rate ...-..need by the PA D8fI.rtMnt of R.v...... ThtI 1IPP11~1.
Int.r..t r.t.. for .'82 thrOUGh 1995 '1'"
P\lIlPOSE ...
HOTtCfI To fulfill the raqulr.....t. of Sactlon 2140 0' tM IntMrltMCa and Estata Tu Act, Act U 0' 1991. (72 P.S.
SecUon 2140).
PA'lttEKT1 u.tach ttMI top portion of thll NoUca and .__It wlth your paYMnt to thl R....t.r of Willa prlntact an the
ravar.a ald..
n .... check or IIOMY order p.y_l. tal REGISTER OF WILLS, ACDfT.
AU pa.,.."t. r"llvld ..,.11 flnt be applied to any Int.ra.t which MV be dua, ..Ith any r.Mlndar .."UId to the tllC.
REfUND (CA)I A re'und of . t.. credit, which .... not raqua.tld on the tn raturn, a.y b. raqua.tad bV caapl.tlna an "Appl1utlon
for Rafund 0' Pann.vlv.nla Inherltanc. and E.t.t. T.K" (REV-ISIS). Application. '1" avalllbl. at the Offlc. of
the Rql.t.r of Will., any of the 2S Rlvanus DI.trlct Offlc.. or by calling the spacla. Z4.hoUr an....rlng .arvlc.
~r' for fora. ord.rlngl In P~,Ylv,"l. .-800.562-2050, out. Ida pann.ylvlnl. and ..Ithln local
Harrl.bUrg ar.. (717) 717.1094, TOOl (717) 772.2252 (~rlng IIP.lrld Only).
alJECTlONSI MY party In Int.r.at not ..U.fled ..Ith the ~r.I.....,t, .UOWWICI or dlnl1OdM" of dIduOtlon. or .......-nt
of tu (including discount or Inter..U .. thown an thl. Hatlc. "V object ..Ithln .lxty (60) clltVI of rec.lpt of
thl. MoUca bY1
-....rltten prota.t to thtl Pi DeP.rtsent of Rlvanua, loard of Appaal., DlPt. 211021, H.rrllburg, PA 17121,,1021, OR
"-allOtlng to h.va tha ..ttar dataralned .t the audit of thl account of the per.anal rapr..antatlva, OR
--lIPPIal to thl Orphan.. Court
AllnN-
tsTllATlVE
CORRECTIONSl
Fectuel arror. dhcov.red an thi. ......aant IhoUld be addre..ed In writing tal PA o.p.rtMnt of R.vanua,
Buraau of Indlvl~1 Taxa., ATTNI Po.t A.....eent R.vi... unit, DEPT. 210601, Harrltburl, Pi 17121.0'01
Phone (717) 717.6505. S.. page 5 of thl bookl.t "In.truotlon. for Inherltanc. Ta. R.tum for a R..idant
Decadent" (REV.lI0.) far an axplanatlon of ~lnl.tr.tlv.lv correctabl. '1'1'01'1.
DlstDUHT I
If any tax dua 11 paid ..Ithln \hI''' (5) calendar ItQf1th. .fter the dacadant.. death, a flva parc.,t (IX)
dl.count of the taK paid I. .llowed.
~ Inbnst Ast. DlIllv Interalt FlHltor
UIr
Int.r.d Rllta
DII.lv tnt.rll.t Faetor
1911
1'"
1...
1985
1'"
--Intera"t
zox
1611
11X
1'"
l'X
la calcul.ted a.
.000S41
.0000.
.ooosal
.00D556
.000274
'oUOWIl
1987
1918-1991
l"Z
199'.1"'"
1'"
.X
11X
'X
n
'X
.000247
.oonn
.OOOZU
.000192
.000247
IItTEllEIlT . BALANCE OF TAX UlfPAID X HVlIBER OF DAYS DELIHQUEItT X DAILY IHTEIIEIlT FACTOR
--Any Notlca l..uad .ftar thl tax ~. delinquent ..Ill raflect an lntlr..t calculation to fifteen (15) day.
beYond the data of the ..~.....,t. If pa\fMftt III ... afllr thl Intar.st COIIPUt.Uon det. ahIMfn on the
Nouc., addltlonel Int.ralt ..,.t bII calculated.
/
o
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Donald IJ, Lehman
Date of Death: 1-26-95
Will No,
1995-00381
Admin. No. 2190:;-0381
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1, State whether administration of the estate is complete:
Yes X No
2, If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No, 1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes No
b. The separate Orphans' Court No, (if any) for
the personal representative's account is:
c, Did the personal representative state an
account informally to the parties in interest? Yes No X
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,
~_\\ C~~
Signature
Date:
1-?4-q7
Ln -,(
.~ N
0 Y.l :;6.:
~ .,
~:,;~ cc ') :i
. ."1... ,
" r-
" N ,--
, :' ~
d-:;
(5" ,
~~i .0
U p; .::E
ala:
a: ~8
H, Anthonv Adams, Esquire
Name (Please type or print)
128 E, King Street, Shippensburg, PA 17257
Address
( 717) 532-3270
Tel. No.
Capacity:
Personal Representative
X Counsel for personal
representative
(MAH: rmf/ AM3)
1':)- 3 (/ _ ~ c.
".,.,00 Ik' 1",91\ L fOR OATIS Of DEATH AnER 12/31/91 CHICK HIRE
~, :. ., INHERITANCE TAX RETURN ~tv::~yU~:~D\T IS CLAIMIO 0
'!::\,~r"~",." RESIDENT DECEDENT
fiLE NUMBER .'3<:': I
COIAMOHWlA"" or rtf""1lVAf,,^ (TO BE FILED IN DUPLICATE 0
D(P~RIM(tH or RlvUHJ[ , q .-
"...,,~J:~,~~'m"0601 WITH REGISTE~ OF_ WILLS) COUN1!.-c9_DE.;l.' YEAR ~ NUM6ER
blttUUIf" U,A,M[ 1\1.\1. f1'R1':'Af1[fl,mmmnffiMl llU;IOUU'!lo COMmtf'AUUll:':'
LehmnnJ Ocnald IV, 1434 1nree Square Bollow Road
IoCiA\lWI.i1TI1UMiIR \UAlrorliIA'" \"iJrorOiiilii- Newburg, PA 17240
lQO-4?-3'j1Cl ?-2(,-Cl'j (,-2 - c.,., bP..1nnrl
[] 1. O,lglnal Ro,u,n 0 2. Supplomo,,'al nolurn 0 3, Romalnder Rolurn
(la, dOlO' 01 d.alh p,larla 12.13.62)
o 4. lImllod E.la'o 0 40, Fulu'O lnto,o.' Campramlto 0 5, Fodo,al E,'ato To.
(lor dolo. 01 doalh alto, 12.12.621 Rolurn Roqul,od
o 6, Docodonl Oiod To.lalo 0 7. Decodont Malnlalnod a lIvlno T,u.t _6, Talal Numbo, 01 Solo Dopa.11 Ba.o.
(Mach cap 01 Will) (Mach co 01 T,u.')
AL~ CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO.
M ZOMPll1[ MAllINO AODRf!lo~
ffi
~
w
"
~
~~8
wOO
0"''''
a.'"
a.
<(
~ffi
",,,
oz
uO
a.
;.. ..,~::,<L;-')f' "',.""iin'.~..
H, Anthony Adams, Esquire
1lLIPUOUf HUMI(R
128 E, King Street
Shippensburg, PA 17257
(")C"'l
- '
-,
:0
...'
'.'-.< lJ
. ,')
c.
I 717 L-5J?-3?JO
- ---- .-
z
o
3
E
a.
i5
...
'"
1. Roal E.'a'o (Schodulo AI ( 1) ,__:9:
2. Slock. and 6and. (Schedulo 61 ( 21
3. Clo.oly Hold Slack/Pa,tno"hlp In'o,o.' (Schodulo C) (3) --=J2=...
4. Mo"gago. and Nolo. Rocolvablo (Sch~dulo D) ( 41
5. Cosh, Bonk Dopod!s & Miscellaneous Perlonal ProporlY( 5)
(Schedulo E)
6. Jolnlly Ownod P,aporly (Schodulo F)
7. T,an.lo" (Schedulo GI(Schedulo l)
g. Tolal G,an Amlt (Ialallln.. 1.71
9. funeral Expenses, Admlnhtrotl'lo COIU, Miscellaneous ( 9) -3-JLSfL 60
Expon.o. (Schodulo H)
10, Doblt, Ma,lgagollablliUol, lIo" (Schodulo 1) (10) --
II. Ta'al Doductlan> ('alalllno. 9 & 10)
12. Nel Volua 01 estole (Une B mlnu. lino 11)
13. Charltablo and Governmental Bequo," (Schedulo J)
lA. Not Voluo Sublect 10 Tux (IIno 12 mlnullino 13)
15. Amount olllno U IUKohlo at 6% rolo
(Indudo valuoI horn Schodule K or Sehodull) M.)
16. Amount a' Ilno 14 taxable at 15% ralo
(Indude valuoI from Schedule K or Schedule M.)
17. Principal to)t due (Adello'" from Iino 15 and horn \lno 16,)
1 B. C,odin Spousol Poverly Credit Prior Paymonts
+ +
19. If Iino 18 h groaler thon Iino 17, enlor the difference on 11110 19. lhil h Iho OVERPAYMENT.
ao.",:r.n!llIl,u,.I&"'11.,",.r.r'IIf'll'lIh...1.1nr-rl1":"l1l'r.1I1..1'1.liltllIi'IIII.III"
(171
(IB)
(19)
(20) -0-
(2M)
(2061 -0-
:i';
;n
.!.J
.'
i;, '
::l
loJ
l>.
OJ
~ " )
t.'.1 S~
-0-
( 6)
( 7)
-0-
-0-
( 61
3,458,60
-0-
(11)
(12)
(131
(14)
-0-
-0-
(15) ,__,___,'_'
_>< ,06"
(16)
>< ,15"
z
o
~
...
:::r
...
:Ii
o
u
)(
<(
...
Discoun'
Intorolt
20. If line 17 b greater than Une 19, enter ,he differonce on line 20. 1hls h tho TAX DUE.
A. Enter ,he Inlerelt on Ihe balance duo on line 20A.
6, Enl.. Ih. latal alllno 20 and 20A an IIno 20B. Thlt " tho BALANCE DUE.
Make Check Payabl. IOl Regble, 01 Will., Agent
...... BE SURE TO ANSWER A~L QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH" .. """;'.\:'~'
Unde, pooa',lOI 01 porlu,y. , dodo,o ,ha' I havo ..omln.d Ihl. ..Iurn, Including accompanying "hodul.. end ,'olom.nll. and 'a ,h, bo.t 01 my knawlodgo and b,lI,l,
U II t,u., co"o" and complolo, I decla.. Ihat 011...1 ..loll ha. b..n ,0po,lod alilu' "a,ko' ,alu., Docle,a'ian 01 p..po,., o,ho, ,han Iho po"onal IOp'OIonlollvo II
ba..d on alllnle,mallan 01 whi,h proporo, ha. ony knawl,dgo, .
~IQ"AIUR! of "'$OH ..m;rn;, . I .!fUif. A"li1il\~ bA"
, " ,,\r-....(\"-~,,_., 1434 Three Sgllnre lIoJ101. Road, Newburg, PA 2-27-Q7
!JID.li>;. A"U;[~\ bAlE
128 E, Kin Street, ShippensbJrg, PA 2-27-q7
COMMOI.wrA\IH 0' rr'III\T\VAUlA
IIU1UIIAttf,;( '^~ 'IIUU4
USIDItH blctDWI
SCHEDULE "A"
REAL ESTATE
.
FllnWMiiER
milTi' OF
...........DonaldJ~. . Lehman , " ..., ,___.._._....n<;l~-03!l1__.
(P,op..IV loln,lv.owned with Right Dr Su,wlvouhlp ,nUl' h. dluloud on Schedul. IIf") All ..01 ..tat. should I,. report.d 01 fair math.
yaluo which I. dollnod a. 110. P"" at which plopllly would bo o..Ioangod b.twun a willing buyo, and a willing 1011", nollh" bolng
compell,d 'a buy or ..U, both having ftalOnobl. 5cnowl.dg. of Ih, ..llvanl 'acll.
NUl TMEMBE R DESCRIPIION VAlUE AT DATE
Of DEATH
I.
N/A
__._ .. ... '" .., ,,!C?~~~J^It.o ~".!o!. on.~n...I, R.o!!,plru!2!lon)
(II mOl. 'pot.t II "..eifel'""" oelelitionol .h..h 0' .ome ",..J
-0-
s
mAnuI'
Donald \~, Lehman
ITEM
NUMBER
lI'I'UIIII. P'''I
,',l,9
&\l(w,:!'
COMMOIIWI"UIl or ,Ullln'VAW'"
IIUlllutAIICI '^l{ JIlllJllfl
_UIOtfll (HerDUII
SCtlEl.lULE II
FUNERAL EXPENSES,
AIJMINISTRAlIVE COSTS AND
MISCELLANEOUS EXPENSES
Ploa,o Prln' or TVPo
f1UllUMtih
2195-03(11
UESCRIPIION
AMOUNT
A, Funoral EMpln,ou
B.
d.
C,
1.
2.
3.
d,
5.
6,
7.
8.
,.
Fogelsanger-Bricker Funeral Home, Inc,
3,422,60
I.
Admlnhlrollvo CO,'"
Perlonal ReprolonlaHvo COlllmhllolll
Social Socu,lly I~umbor 01 ro,lonol nop,o'onloll.o,
Voar Comml..lon, paid
2.
Allo,n.y F.o,
"
3.
Family EMompllon
Clalmanl
Add,... 01 Cly'manl 01 doud.nl', doalh
SI,o.1 Addr...
Clly
Zip Co do
R.lallonlh'p
Slato
Probato ro.. - Register of \~ills
36,00
"
Mllc..lla"~ou.. Expln..,.
" .
," "
;. .
,':.' . ~ '
TOTAL (Allo onlor on IIno 9, R.capllulallo")
(If more 'poco " 1I..dod, In,,,' addUlonal .110.1. 01 .am. ,III,)
S 3,458,60
IIV,1I1l"III",
"~,'~~}I\
" :j . ~..
SCHEDULE J
BENEFICIARIES
.
. .
CO.....0t1\lIIAI1MUf "'U".IWoIIlIA
ItUlI'UAIIU'oI,IItU'"
.nlDllllllfUOlIll
ESTATE OF
FILE NUMBER
~, Lehmnn
2195-0381
ITEM
NUMBER
RELAlIONSIlIP
AMOUNT OR
SItARE OF ESTATE
I~AME AND ADDRESS OF DEtlEFICIARY
I.
A. Ta.obl. BlqUtlhl
Barbara Lehmnn
1434 Three Square Hollow Road
Newburg, PA 17240 ..
100%
Infe
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
AMOUNT OR
SHARE OF ESTATE
B. Cha,llable and Governmenlol Bequeslll
1.
TOTAL CItARITABlE AND GOVERNMENTAL BEQUES'S IAho .nl., on Bn. 13. R,copl.ulollon) S
li;;;;;;;~.;~'j;-~;~-d.d, 1;;;;e;JJiii:;;ltlt,~i, 0' ,ami ,III)
HOTEl To inaura propar
cradit to your account.
.ub.it tha uppar portion
of this fora with your
tax pay.ent.
IS: 3'1-..{
BUREAU OF INDIVIDUAL TAXES
INttERlfANC[ fA. DIVISIO"
OfPr. 110601
f~ARIS'URQ. PA 171'..0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
C--
*'
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
IIf.l..'II ar. tll.f1I
H ANTHONY ADAMS ESQ
128 EKING ST
SHIPPENSBURG PA 17257
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
DDNALD
06-30'97
LEHMAN
01-26-95
21 95-0381
CUMBERLAND
101
Allount Ra.ittad
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ~
ifE'v=isr.TEif"AFP--r03-:9'rj-NOYicni,,'YNHEifiTANCi'TAi("APpiiiiisEifENT';'jiLi;owANcriflin-----,---__n_-
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF LEHMAN DONALD W FILE No.21 95-0381 ACN 101 DATE 06-30-97
TAX RETURN WAS' I X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..1 Eat.t. ISch.dul. Al (1)
2. Stoc;.'~a and Bond. (Schadule B) (2)
5. Clo.aly Hald stock/Partnership Intareat (Schadula C) (3)
4. Hortgaga./Nota. Recaivabla (Schadula D) (4)
5. C..h/Bank Daposit./Hisc. Par.onal Proparty (Schadula EJ (5)
6. Jointly Ownad Proparty (Schadula F) (6)
7. Tranafar. (Schadula OJ (7)
8. Total A..at.
) CHANGED
.00
.00
.00
.00
.00
.00
.00
IB)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Fun.ral Expanaa./Ada. Co.t./Hi.a. Expanaa. (Schadula H) (,)
10. Dabt./Hortgaga Liabilltlas/Llana ISchadula I) 110)
11. Total Daduction.
12. Nat Valua of Tax R.turn
13. Ch.ritabla/Covarn.ant.l B.qua.t. CSchedula J)
14. Nat Valua of E.tat. Subjaot to Tax
3,458.60
.00
1111
1121
CU)
(14)
3.4~R 6n
3,458.60-
.00
3,458.60-
NOTE:
If an assessment was issued previously, lines
reflect figures that include the total of abh
ASSESSMENT OF TAX:
15. Allount of Lina 14 at Spou.al
16. A.aunt of Llna 14 taxable .t
17. Aaount of 1.ina 14 taxabla .t
18. Prlnoipal Tax Dua
14, 15 and/or 16, 17 and 18 will
returns assessed to date,
.00 X .00.
.00 X .06.
.00 X .15.
UB)
rata
Llnaal/Cla.. A rata
Coll.tar.l/Cl... B rata
US)
116)
U7l
TAX CREDITS:
PAYHENT
DATE
RECEIPT
HUHBER
DISCOUNT U)
INTEREST/PEN PAID C-I
AHOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
.00
.00
.00
.00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIDNAL INTEREST.
IF TOTAL DUE IS LESS THAN '1, NO PAYHEHT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF TNIS FORH FOR INSTRUCTIONS.)
.00
.00
.00
.00
W
.00
'"
...
\.0
N
~
1-.. ".
L< ~h .J ~
RESERVATJDH,Li-"lt.. of ~'C'd~t~y~g on or ba'or. D.c.~.r 12, 1'.2 _. If ~y future Int.r... In the ,,'at. t, transflrred
In po.....lon Dr enJoYI.,.' to Cl... I (eotht.r.U bln.flelarl.. of thl d.c.d~t 1ft.,. the Ill'plntJon 0' any...... for
11'. or for v..r., thl Co.-onw..lth her.by IMpr..,lv r...rv.. the right to apprll.. ~ ...... tr~"'r Inh.rlt~. 'IMI.
at thl lawful CI... . (co111'.r.l) r.t. on any .uch lutur. lnt.r..t.
P\lIIPOU 01'
NOTICE, To fulfill thl r.qulr...nt. of Section '..0 of thl Inheritance ~ E,t,t. 'Ill' Act, Aot 21 of 1995. (72 P.S.
Sectlon'IU).
PA~TI o.t.eh the t~ portion of thl, Hotle. 8nd ,ubalt with vour pIYlent to thl Aeallt.,. of Will, prlnt~ on the rav.r.. .Ide.
""lke check or NMV order p'v.aJl. to, REGISTER OF MILLS, AGENT
REFUND (CAh A r.'urHt 0' . t.. crltdlt. which .,.. not nqu.,tlMi on the TalC R.turn, "'1 ba r.qu..tltd b., co-..I.Ung an -application
for R.fund of Penn.vlwanl. Inharltanca and E.t.t. Ta.- (REV-1515), Application. ara av.llabl. at the OffICI
of the R.gl.t.r of Willa, InV of the Z5 Rlvenu. DI.trlct Dfflc.., or b., calling the .pecla. 24-hour
an'warlng 'ervlca nuaber. for fora, ord,rlng. In P.nn.vlvanla ..800.562-2050, out. Ida P.nn..,lvanl. and
within local Harrl.burg .ra. (111) 181-10'4, TOD' (111) 112-2252 (H..rlng I.p.lrad Onl.,).
OBJECTIDHS. An., p.rt., In Int.r..t not ..tl.fl.d with the .ppr.I....nt, 1110Nenca or dl..llowanca of deduction., or .......ent
of talC (Including dl.count or IntarnU .. .ho,," on this Notice .....t Object within .1xlv (60) d..,a of rec.lpt of
this Hotlc. bYI
".Nrltten prot..t to t". Pi O.partaMt of Ravenue, loard of App...., O.pt. 281021, Harrisburg, PA 17121.1021, DR
.....lectlon to have the .att.r dataralned at BUdlt of the account of the p.r.ona. rapr..ant.tlv., OR
nappa.1 to the Orphan.' Court.
ADtUN
lSTRATlYE
CORRECTlDHSI
F.ctu.. arror. dl.cov.rad on thl. .......ant ,hould ba .ddr....d In writing tal Pi D.p.rtaant of R.vanue,
Bur.." of Indlvldu.1 Ten., ATTN. po.t A.......nt R.vl'N Unit, Dapt. 280601, lIarrhburg, PA 17128-0601
Phone (7111 111-6505. 5.. plga 5 of the bookl.t -In.truotlonl fcr Inharltanca Tax R.turn for. Rllldant
Dacad.nt- CREY-I501) for an axplan.tlon of ad.lnlltratlvalv corr.ctabl. arror..
If any talC due I, paid within thr.e (5) calandar .onth. .ft.r the d.c.dant', d..th, . flv. p.rcant (5X) dl.count of
the talC paid I. allowed.
The ISX tax aane.ty non"p.rtlclpatlon pan.lt., I' coaputad on the total of the tax and tnt.r..t ......~, ~ not
paid b.for. January II, 1996, the flr.t d.., aft.r the and 01 tha t.x aanaltv p.rlod. Thl. non-participation
panalty I. app.alabla In tha .... aann.r and In the the .... tt.. p.rlod .. .,ou would appe.1 the t.lC end Int.ra.t
that h.. baen ......ad .. Indlc.t.d on thl. notlc.,
OISCDUHTI
PENALTY I
INTEREST.
Intlr..t Is charged tMglMlng with Itr.t d.., of d.lInquency, or nlM (9) .onth. Bnd one cn d.., f,.u. the d.t. of
da.th, to the data of pa.,eant. T.x.. which bac... d.llnquent balor. Janu.ry 1, 19.Z b..r Int.r..t .t the r.ta of
.Ix "XJ ptIrcant par ~ c.lculatltd .t . d.lh rah of .000164. All t.... which bac... dallnqutWlt on and .ft.,.
Januar" ., 1912 will baar Int.r..t .t . rat. which will var., fro. celendu yur to calandar .,.ar Nlth that rata
announced b., the Pi Dap.rta."t 01 R.venue. The appliCable Intar.at nt.. for 191Z through 1"7 ar.r
!!!! 'n"r.st Rlt. Ually Intlr..t Factar l!!! Int.,...t Rat. DaU., Intarut Factor
.912 tU ,0005.. 1917 OX .000Z47
.'15 lOX .000411 1,.1-1991 IlX .000301
"14 IlX .000501 1992 'X .000241
1915 UX .000556 1t95al"4 7X .00019Z
.'86 laX .000214 1995"1997 'X .000247
"'Int.r..t II c.lcul.tad .. follow..
INTEREST . BALANCE OF TAX UNPAID X NUHBER OF DAYB DELINQUENT X DAILY INTEREST FACTOR
"-An., Notice luuad .ftar the hI( baco... d.lInquent wtll r.fI.ct an Intar..t ulcul.Uon to fifteen OS) diU
ba~ond the d.ta of the ......eent. If pava.nt I. aade .,tar the tnt.r..t coaput.tloq data .hown on the
Notice, adcUtlon.l Interut .,.t be c.lcul.tad.