HomeMy WebLinkAbout95-00508
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D"":"AA; 0411171!f,i :;~':CC)MMONWEAqH,Of:PENNSYLVANIA
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\';~~'i"li'~~/' : ./;;: ' OFFICIAL RECEIPT- PENNSYLVANIA INHERITANCE AND ESTATETAX
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ACN
ASSESSMENT I!I
CONTROL ~
NUMBER
AMOUNT
RECEIVED FROM.
lu1
.1,';)lU.OO
RADC~IFF DIANE GILBERT
344b-3448 TRINDLE ROAD
CAMP HIL~ PA 17011
ESTATE INFORIMTlOl'h
m FILE NUMBER
U 21-199:5-0MB
!!t NAME OF DECEDENT (LAST)
iii SWLMH
II DATE OF PAYMENT
g POSTMARK DA E
COUNTY
SSN 2B9-03-b2eo
(FIRST) (Mil
CUMBERLAND
DATE OF DE/>JH
fa TOTAL AMOUNT PAID
.1,510.50
REMARKS
EDWARD M MYERS
C/O DIANE G RADCLIFF
CHECK" bOS7
MARY C. LEW
REGISTER OF WI~LS
ESQ.
RECEIVED BY
SEAL
REGISTER OF WILLS
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.OR OATIS OF DIATH AnlR T2131191 CHICK HIRE
"A SPOUSAL
POVIRTY CRIDIT IS CLAIMID 0
PILI HUMin
21 1995
COUNTY CODE
o C OINI' OM'LUI Aooun
204 SALT ROAD
ENOLA, PA 17025
CUMBERLAND
.~~
/5-I+Z-/Jf
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ITO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
lS
fil
III
=
COMMONWfAlTH O. P(NNSYLVANIA
DIPARTMINT O' R(V(NU(
DUT, "060'
MAllIUUIG. P... 17121.0601
DIC DIN' NAMIILA . IUI. AND MIDDU INI IAlI
MYERS, WILLIAM H.
IOCIAL IICUIIIY NUMIU DAIl O' DIAl"
269-03-6260
06/14/1910
CO"I'II
AMOUN' nellvlD lill INlnuellONSI
U I. Original R.turn 0 2. Suppl.m.ntal R.lurn
o A. L1mll.d Eilal. 0 Aa. Futur. Inllfll' Ccmpramh.
Ilor do '" of d,a,h ah.. 12.12.821
o 6. D.ced.nl DI.d T..tal. 0 7. D.c.d.nt Malntaln.d a living Trull
(Attach copy of Will) (Attach copy of Trull)
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO. ','. ,', ,,(', ,c ",f n:.,:' .\".~ ',.'
NAMI COM'UIl MAIUNO ADDIUS
DIANE G. RADCLIFF, ESQUIRE 3446 TRINDLE ROAD
m"HONINUMIIO CAMP HILL, PA 17011
II' ..,,,I(AIII,.utv,,,,,HO "OUII'I N-"II CLAII. '1.1t .NO MICOlllNltlAI!
:illS
..=
....
5le
111 26.500.00
121
131
IA)_
(5) 2,110.77
..
5
,g
III
..
(61
(71
191
2,034.91
1. Roal Ella" (S,hodulo Al
2. Stockl and Bondi (Sch.dul. B)
3. Clo..ly H.ld SlocklParfn,nhlp Inl.'.I' (Sch.dul. C)
A. Mortgag'l and Nol.. Rec.lvabl. (Sch.dul. 01
5. Calh~ Bank O.pollu & Mllctllan,oul P.nanol Prap.rly
IS,n,dulo EI
6. Jainlly Own.d Prop.rly (Sch.dul. F)
7, Yranl'''' IS,h,dulo GIIS,h,dulo II
8. Tolal Gran Au," (Ialollln.. 1.7)
9. Fun.rol Exp.n.... Admlnillroliv. CO'II, Miscellonaaul
E.p.nl'~ (Sch.dule H)
10. D,bu, Morlgog. lIabllill... lI.n. (Sch.dul. I)
11. Talol D.ductionl (lolallln.1 9 & 101
12. N.t Valu. of e.lol. (line B mlnul L1n. I I)
13. Cha,ltablll and Go....rnm.nlal B.quI"I (Sch.dul. JI
lA. N.t Valu. Sub 'CI to Tax lIn, l:2 minUILln. 131
15. Spou.al Trond,,. {for dat'l of d.alh ah.r 6.30.9.41
S.. Inllructlonl for Applicable P.,c.nlag, an R.v.,.. (151
Sid.. (Includ. volu.. ham Sch.dul. K or Sch.dul. M.)
16, Amaun' of L1no 1A 'a.ablo 01 6% ral, (161 26,321.46
{Indud. valu.. ham Sch.dul. K or Sch,dul. M.I
17. Amaunl of L1n. 14 10.llabl. 01 15% roll
(Indud. valu.. from Sch.dul. I( or Sch.dule M.)
IS. Princlpollox au. (Add lOll "am lInll IS, 16 and 17.)
19. C"dit. 5pou.ol Pav.rly Cradil Prior Palm.nll Discaunl
+ 1 ,51u.50 + 75.5::!
20. If lIn. 191. gr,ollt Ihan lInLJ..8, .nter Ih. dIH.r.nu on lIn. 20. lhll It Ih. OVERPAYMENT.
a [8..rr.r.II"'II'II'.I.'J'I'.""~'I"""U"I'.'. 1I'1tTT':'t'l lr."I.'I.'I'I... 1'..1 I !J.U""lo.I.'
21. If L1n. 18 It g,.ol., thon lIn. 19, .n1., In. difi.,enu on lin. 21. Thillt ,h. TAX DUE.
A. Enler Ih,lnler." on ,h. balonc. due on line 21A.
B, En'.. 'ho'a'al 01 L1no 21 and 21.0. an L1no 21B, Thl." ,ho BALANCE DUE.
Malee Chec!t Pay obi. tal Reghter of Wills, Ag.nt
. >- >- BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH ~ 000( .
'l.,d.r penahi.1 of p.rju,y. I decla,a Ihal I have lJIomln.d Ihll relurn, Indudlng accompanying Ich.dul.. and Itol.mltnll, and 10 the b.lt of my knowl.dge and b.lief,
, Iru., cor"cl and complel.. I dlclar. thai 011 ftal fila Ie hal bun reparllla 01 true morbi value. Oedaronon of preparer other Ihon the p.llanal r.pre..nlallv. h
...d on 011 Information of wh,lch rt artr halon knowledge.
S'GNA'U~( 0' 'USO~j ItU'ONSIIlI 'o~ IIUNO u'u~u ACORUS
(101
(171
..
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ACC~lU
v
0506
YEAR
NUMBER
o 3. R.malndtr R.lurn
(lor do'.. 01 doalh prior 'a 12.13.B21
o 5. fed.ral EIIOI. Tax R.turn R.quired
_ 8. Total Numb.r of Sof. D.pallt 80x..
18126,610.77
(Ill
(121
(lJI
IIA
2,034.91
26,321.46
26/575.66
)(._-
)( .06 _
1 ,594.56
)( .15 II
(ISI
'nl.'.1I
1,566.03
(191
1201
1211
(21.0.1
121Bl
6.53
DAft ,/
1117/?!>'-
DIotl
t/I,I"j-
Act .48 of 1994 p"ovldo. for tho roductlon of Ihe tax role.lmpo.ed on the nol value of transfe,. 10 or for
tho u.e of Ih. .pou... The rat.. a. prOlcrlbed by the .tatuto will bel
e 3% (.031 will bo appllcabl. for 0I1atOl of decedenl. dying on or aftor 7/1/94 and before 1/1/96
. 2% (.02) will bo appllcablo for o.talOlof decodents dying on ar aftor 1/1/96 and beforo 1/1/97
o 1%(.~1)lNIII bo appllcablo for o.tate. of decodonts dyIng on or aftor 1/1/97 and boforo 1/1/98
o 'Spou.al Iran.fo,.' occurrIng on or aftor 1/1/98 will bo oxempt from Inherltanco tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK (.....) IN THE APPROPRIATE BLOCKS.
YES NO
1. Old decedont make 0 IransFer and:
x
o. retatn the use or Income of the property transferred, .......................................................
b. retain Ihe right 10 designate who shall use the property transForred or Its Income, ...............
c. retain a reversIonary Interest; or ,.......,.........................................,......."................,......
x
d. receive the promise For liFe of either payments, beneFits or carei .......................................
2. IF death occurred on or boFore December 12, 1982, did decedent within two years preceding
death transFer property without receiving adequate consideration' IF death occurred aher
December 12, 1982, did decedent transFer property within one year of death without receiving
adequate consideration'.... ............. ......,. .......................... to ...... to.... ...... ......., ........ ............
x
x
3. Old decedent own on 'In Irust For', bonk account at his or her death"'....................................
x
"
.-
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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{50
.......I'OIlhl1..1]
..
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
I Ploa.. Prlnl or Ty 0
FILE NUMBER
21-1995-0508
COMMONweALTH 0' ,fNNSYLVANIA
INHIIlTANCI TAX IITUIN
I..IDINT DICIOIHT
ESTATE OF
WILLIAM H. MYERS
(All prop.rty folntly-own,d with th, Righi of 5urvlvonhlp mUll b. dhdo..d 01'1 5ch,dlll, f)
N~~~ER DESCRIPTION
VALUE AT
DATE OF DEATH
1 Resident Account -- Cumberland County Nursing
Home (see attached statement)
2 Capital Blue Cross/Blue Shield
Security 65 coverage refund
1,983.57
127.20
S 2,110.77
(Allach additional 8~" )( "" ,h..tsl' mOl. .pace ",...d.d.1
...,.UI1D.V-IIJ
ITEM
NUMBER
A.
2
3
B.
4.
C.
1.
2.
3.
4.
5.
6.
7.
8.
'*'
COMMQHWUUH O. ,!NNSYLVANIA
. INHlllTANCI TAX UrulN
UIIOI!NT D!C!D!NT
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
PI.a.. Print or T .
WILLIAM H. MYERS
21-1995-0508
DESCRIPTION
AMOUNT
1.
Fun.ral Exp.n....
Musselman Funeral
Total Bill
Pre-payment
Netl
337.73
Home
$4,366.00
4,028.27
337.73
Deissler's Flowers and Greenery
162.18
670.00
1.
Rolli,ng' Green Cemetary
Admlnlstratlv. CO.t.1
Per.onal Reprelentatlve Camml..lans
Social Security Number of Personal Represenlatlve,
Vear Camml..lans paid
2.
Diane G. RadCliff, Esq.
850.00
Attorney Fees
3.
Family Ex.mptlan
Claimant
Addr... of Clalmonl 01 dec.denl's dealh
Slr..' Addr...
City
Zip Code
Relationship
5101.
Prabat. F..s
MI.eellan.au. Exp.n.e.,
Inheritance Tax Return
15.00
TOTAL (Also onlor an IIno 9, R.c~pllulallan)
(If mare space II needed, Insert oddlllanal .h.els of lame Ilze.)
$ 2,034 . 91
.. . . ,
',~ i1ii~~~!."~{~~~'t~H*l.~\~:f~,,,;~'i~" ,~_~.f'
.-
Capitol
PeJUlllyl
HAAl\
URBINO IIOME
OlrrACH AND REtTAIN THIS STATEMENT
,...... ",""CMSn CHieM I. 'N ..",,,"'FN' D" .,,,.... DF."C",.'D f1nnw
.... Na' ca..".CT ""."'". Na""" U. ~O"''''L''' NO n.e.,,",, P..,"'D
oeSCRIPTION
AMOUNT
THE ESTA1
WILLIAH ~
375 CLARE
CARLISLE
DELUXE. FORM NWCP.2 V.2
120360
'3084 William Myers
$1983.57
close out guest fund aCCDunt
111111111111111111
PERIOD OF
/1~
I I'-l::c.
s;f-. 9/9.'-'
7<;, _/,-' ,
REFUND RE
TVPE OF C
SECURIT
+ If CoplloJ B1ueCro88
PcIU18ylvonlu D1ucShlcld
. . HARRISBURG, PA. 17177
actA ......"
198693
THE ESTATE OF
WILLIAH HYERS
375 CLAREHONT DRIVE
CARLISLE PA 17013-8820
AGREEHENT NUHBER
172269267
************************* EXPLANATION OF REFUND *************************
PERIOD OF REFUND
FROH. 04/15/95
TO I 06/15/95
REFUND REASONI CANCELLED DECEASED
TYPE OF COVERAGE I
SECURITY 65
TOTAL REFUND AHOUNTI
REFUND AHOUNTI
U27.20
U27.20
:;
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'I
, i
;';'
000 :11100121 ReY. 111:1
AceT. NO.
L 112705
'!JU ten
GENERAL LEDGER
ACCOUNT NAME CD CLOSEOUT
ORlGINATlNQ OFFICE
COlT ClNTEft ,
j ooootaM ]
108
CDB IIAA ACCT, NO.
108-327-0158113
\--------.............'.--.'
$1 I
- ---""70'28727"
AMOUNT
CUSTOMER NAME AND ADDRESS
I
WILLIAM H MVERS
BURIAL RESERVE ACCT
200 SALT RO
ENOL A
17 025
.J
G:VnmM5~ {'t~YI<ff? 200."1.000 1.1:0 2 i! 'ftlSOOOC wn ...'"
i;,tI
AUTHDRIZED BY
PNC Bank, National Anoclatlon
PA
.
{4,L /l~
'l . of ~7/jD ()
Tfl.{...1f.1l1 ~J. ~-L RA.....t- (J f)Jo[[au
<Jo, \J f"'-'-
FUNERAL
SERVICE 0 ul ~
cR.nJmJ -tL '~",- -~. oy.)
o rL' NAME Q' OEefA.SEO
~~'~k"
o Social Security
o V A aenelil
o '7r':'~
~ ~8 19~!By
ORIGINAL
3346
ACCI,No.
o
""
, If 3".
lAST
aAl
cR~adl;~J f~o/l1
IntS....
C"v.la"
,_"mini
Sub. Tot
ClId,ll
bUP',"'l
.;11
'-I 0 ~ 8.
MUSSELMAN FUNERAL HOME, INC.
~ ' ~BllSHED 1895
~<'-1. IJ~
':Jr..", ryo.
HEW
BAL.
. 337.73
3421
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~OR
ACCOUNT
BlCINNING
B"lANCI
AMOUNT
PAID
B"lANCI
OUI
CASU
CHICK
MONt.,.
ORmR
B
TAX PARCEL NUMBERI 09-13-100DO-12A
This Indenture, Made the
September
19th day of
In the year of one thousand nine hundred and ninety five (1995)
Between
EDWARD M. MYERS and MARY L. MYERS, husband and wife
(hereinafter called the Grantor), of the one part, and
DREW A. KUGLER and JOAN R. KUGLER, husband and wife
(hereinafter called the Grantees), of the other part,
Witnesseth That the said Grantor for and in consideration of the sum of Fifty-Three
Thousand and 00/100 Dollars ($ 5 3, 000 . 00) lawful money of the United States of America, unto him
well and truly paid by the said Grantees, at or before the sealing and delivery hereof, the receipt whereof
is hereby acknowledged, granted, bargained and sold, released and confirmed, and by these presents does
grant, bargain and sell, release and confirm unto the said Grantees, as tenants by the entirety, their heirs
and assigns,
ALL THAT CERTAIN piece or parcel of land situate in East pennsboro
Township, Cumberland County, Pennsylvania, bounded and described as
follows, to wit:
BEGINNING at a pin in the center line of the Salt Road at corner of land
now or formerly of Charles F. Auxt, formerly Mary J. Bixler;
THENCE along land now or formerly of Charles F. Auxt, north 71 degrees
45 minutes East, two hundred ninety and four tenths (290.4) feet to an
iron pin;
THENCE along land now or formerly of Edward M. Myers and Mary Louise
Myers, south 45 degrees 49 minutes east, thirty-two (32) feet to an iron
pin;
THENCE along land now or formerly of Edward M. Myers and Mary Louise
Myers, south 46 degrees 03 minutes west, two hundred sixty-six and
seventy-one hundredths (266.71) feet to an iron pin in the center of the
Salt Road;
THENCE along the center of the Salt Road, north 42 degrees 30 minutes
west, one hundred fifty seven end ninety-six hundredths feet to en iron
pin, the place of BEGINNING.
BEING the same premiBes which William H. Myers, a widower, by his deed
dated January 31, 1977 and recorded in the Office of the Recorder of
Deede in and for cumberland County, Pennsylvania in Book Z-26, page 736
granted and conveyed unto William H. Myers and Edward M. Myers. The
said William H. Myers died on April 10, 1995 veeting sole title in said
real estate in Edward M. Myers, a married man. The said Mary L. Myers,
wife of Edward M. Myers, joins in this conveyance to convey any right,
title or interest she may have in and to said real estate.
To ge th e r with all and singular the buildings improvements, ways, streets, alleys, driveways,
passages, waters, water-courses, rights, liberties, privileges, hereditaments and appurtenances, whatsoever
unto the hereby granted premises belonging, or in anywise appertaining, and the reversions and remainders,
rents, issues, and profits thereDf; and all the estate, right, title, interest, property, claim and demand
whatsoever of the said grantDr, as well at law as in equity, of, in and to the same.
To have and to hold
the said lot or piece of ground described
hereditaments and premises hereby granted, or mentioned and intended so to be, with the appurtenances,
unto the Baid Grantees, their heirs and assigns, to and for the only proper use and behoof of the said
Grantees, their heirs and assigns, forever.
An d the said Grantor, his heirs, executors and administrators do covenant, promise and agree, to
and with the said Grantees,their heirs and assigns, by these presents, that the said Grantor and his heirs,
all and singular the hereditaments and premises hereby granted or mentioned and intended so to be, with
appurtenances, unto the said Grantees, their heirs and assigns, against the said Grantor and his heirs, and
against all and every person and persons whosever lawfully claiming or to claim the same or any part thereof,
by, from or under or any of them, sholl and will SPECIALLY WARRANT and forever DEFEND.
In Witness Whereof, the party Df the first part
his hand and seal. Dated the day and year first above written.
hereunto set
Sealed and Delivered
IN TIlE PRESENCE OF us:
~A ../~~ _
EDWAR~ M. M~. !11
~~~~~
{SEAL}
-;J7i!Dnn ~ r/. ~
{SEAL}
. - .
Commonwealth of Pe~~vJnl~
County of ~
as:
On this, the 19th day of september, 1995, before me,ll Notary Public for the Commonwelllth of
Pennsylvania. County of Cumberland the undersigned Officer. personally appellred EDWARD M. MYERS
and MARY L, MYERS known to me (Slltlsfactorlly proven) to be the person whose name is subscribed
to the within InstrUment, and llcknowledged that he executed the slime for the purposes therein contained.
I hereunto set my hand and offlcllll selll.
,((J h-AAO li),JJ. /!lHt1nr
Notllry Public
The address of the above-nllmed Grllntees
Is:
Nolallal seal
Dtbof!Ih \.. oonlB1. ~\&IY Pulll1C
Camp HIM Borv\o~aridCoijnIY
My~""","&apt.23. \999
MerrIle'. cl
204 salt Road
Enola, PA 17025
.
101.AT_W."anly DHdh Short form, Act Dr 1909.
Hanry HIli. Inc.. India " Pa.
-
-
~bt~
119ttbt
MADE THE 31st dall of ,JlUlU:lry
of our Lord 0116 thouaana niM hUMrlld sevent}'.seven ('HI77).
in the lIeM
BETWEEN
WILLI#t II. MYUllS, I~ido\~er, of tho 'l'llIi1lship of E:lst POlUl!lboro, County
of ClDnberlnnd nnd Stnte of Pennsylvania,
Grantor ,
and
WILLI#IIi. MYERS and EDWA/U) ~I. MYERS, of the Township of East
Peruisbol'o, County of ClDnberlnnd nnd Stnte of Pennsylvanin, as
joint tenants with the right of survivorshi~ and not ns
tenants in common,
CJrontce s :
WITNESSETH, tllat in considIlnItion of -----One ($1.00) OOllnr.---------------
. ' 1JfiJMY:B,
in 1uuId paid, the receipt whllf'lJI)f is Mrebll acknowledoed, the Baid grantor does herebll grant
and clOnll6ll to the Baid grantees, their heiTs and nssigns, ns joint tenants Idth the
right of survivorship, and not ns tenants in connen:
AU. that certnin piece or pnrcel of llJI\d situate in Enst Pennsboro TOlmship,
Cumberlnnd County, Pennsylvanin, bOWldcd wld described ns folllll~S, to-wit:
BEGINNING nt n pin in the center line of the Salt Road nt cornel' of llJI\d of
Charles F. Auxt, formerly ~lnry J. DixIeI': thence along llJI\d of Chnrles F. Auxt,
North 71 degrees 45 minutes IJnst, tl~O hundred ninety nnd foul' tenths (290.4)
foet to lJI\ iron pin; thence nlong lnnd of Ed\~ard M. and Mary Louise Myers,
South 45 degrees 49 minutes Bnst, thirty-two (32) feet to an iron pin; thence
along land of Edward M. nnd Mary Louise ~Iyers South 46 degrees 03 minutes
West, two hundred sixty-six lJI\d seventy-ono hundredths (266.71) feet to nn
iron pin in the center of the Snlt Hoad: thence along the center of the Snlt
Road North 42 degrees 30 minutes West one hundred fifty-seven and ninety-six
hundredths (157. 96) feet to nn iron pin, the plnce of BEGINNING.
HAVING 1llERlJON IJRlJCfED n one-story brick nnd aluminum dwelling house, snid
premises being known nnd nunbered as 204 Salt Rond, Enoln, Pn. 17025.
BEING the swne piece or pnrcol of land I~hich Bd\~ard M. Myers lJI\d ~lary Louise
Myers, his wife, by deed dnted April 17, 1972, and recorded in the Cumberland
County Recorder's Office in Deed !look "1''', Volume 24, Pnge 277, grnnted and
conveyed unto Williwn H. Myers and Evelyn D. Myers, his wife. TIle snid
Evelyn D. Myers died on November 28, 1976, whereupon the entire estnte becwne
vested in Williwn H. ~lyers, the surviving tenant by the entirety.
TIHS IS A CONVEYANill from fnther to father and son and is, therefore, exempt
from taxation under the Pennsylvanin Realty Transfer Tax Act.
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,DOOKZ.26 FAC.~ 736
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. AND t/wl .md gra4Itior h.erebll OlWonant s and aornes that
GENERALLY the properl1l.'I1n'.blI 00lI1IBl/'d. '.
he
will warrant
. '0'
-.-'
IN WITNESSWHEREOF,saJ4 grantor
.. t/wl 1141/ and 11- fIr.t Gl/01I. written.. .
ha s hercnmto..t
his
hand. and.eal
. CDlllnell, cPcalcll anll Jltllbmll
~ In tilt 1BrrllcntC of
~1~.
.... JI). .a--
W~~ Myers'7 - ~
- ._-~~
-_."-~~
-_._-~
"
-.:, ,
Sfau 01 Pennsylvania
Countll 01 CUnberlartl
. On thil, t/wl
} ... ...
January
,10
77 belor'IlI',
31st
clail 01
the undBrrilllll11t ofjl.c.r, p.r.onaUII appearecL Willinm H. Myers, widower
known. to flIII (or .ati8factonlll pro1Ien) to lIB the per.on whol'Ml7IB is lUb.orib.G to the
wit1I.ln. inltmmen.t, and acknowlBdDed that h. .:c.outed the safllll for the purpo... th.rrin.>>"~"",
contained. . ..<'\\\.0 cl . i ':"'"
IN WITNESS WHEREOF, I hereunto.et mll/ulmd.ando/lu:iaheal.",~)\-:.:::.l{.r,"'1 '
, '''''\'''''' . ',' '(('
. . ~' ...,., , A. ,,-/-:'.' ,,~,;"", .
_ I~ ;lu..~"'::': e.AlI .1- ....1 :.:
, , " c..').... 0:' .....;
.~ .." . -:
'" lito'. ,..;"
DETTiEM.1WAAY5.NOtirv l'u),1iO---Tit;;;;;ojji:;;;;....;..'7j ~,,\\' ~;'
r.hlttmullown. Cumberland Co., P" t' , .," 0 ,'),~ .0"
M, Comml"I,. bplrll Jul, 10, 197~ /'1 ":l \.. " "
. ......
BOoltZ26 rAGE 737
W.A..-(.'~" N. /"?'I'I-<>
:J.o" Sa.LrN---".
~",.-4~, C'>n. 17u "'1-\-
, ~
~
" , tl, ".ft: ~
i~'" }.." ~ ,-- \.' ^ "'io" 0 +oJ
~ ,: ',:-9.' /'.. ,'oti" ......'Eh'l::
.' cw' .: :";~. / f ,Iii . lQ'l=! s::
\ 60....,~(. I'.""........'...!)';.'.."'.I,-. ,it" ' '"d
._t,.~,f'~I~";.,'!,'" gJ . Cl.l C
. ,~(~! l1:,iI:~I;.p;~lr.:,i' ~'',\ ~".p i1l~.;,
ffi" ;... '0 ... ~.p.!'l'
. ,I' I"':rl'" ;I~tl'_ 1'::C '. '~~ 8
"~. ~ ii'~~
~ ~ Iii... ~.~
...._...L~.!?..:..~...................
Attorney for .....G?'::':.=.~.._.............................
.0
,: ~,~
.1 \'1
, . :i;fi
~ :a '. H " . .;"g~,i:,'t.{~;~i"M~
z ~, .' . ,oM !t,l~,;:;{,\+:F:\I~:#~
< ' . . ~ . . ~ ........,,,...... oM. Jij'+'t...U' '. r\il\JJ
~, ;'i, .i;;l~ij"1;~i't;tf-;m""~1
~ ID rii ....;; oM l1l+'i
'i ~ ~ i : l!:a
ct Il:\ ~ p,. ... :t;N Vl
:::O:'~~~6~;:;!lA. .... r ss.
RECORDED on thl8 __.L:'9l.._... day of ........jld!.~......
A. D. 10Z7 in the Recorder's OOlce of said County. in Deed Book z:..
Vol. ._....ale....... Paoe ._...2';?'..1R....
Given under my IUlnd a2:;J:;. said oOlee, ~he date above turitten.
~'J :It.:~.~.......... Recorder.
800K:226 rhGE 738
., ,
A, Settlement Statement
U,S, Depar1menl of Ijou.lng
B, Type of Loan . ond Urban Devo\oomenl OMB No, 2502-O26ll
1. OFHA 2, OFmHA 3, oConv, Unln., S, Alo Numbo, 17. Loon Numbo, 10, Mortgoge In.urance Co.o Numbor
~, OVA 5, OConv,lnl, . KUGLER
C Nolo' t')....."IO,.e: . · It!!' 'l' .,cliii!.'!~_m;~~i~~ plmo .nd by Iho '~m m':.j.:\:flOWn....
, , (l1A1f1llf<ll:~~ .... ~!ii~!!.'tIDmt~~fi~81~~':iP: II,
0, NAME OF BORROWER: DREW A. KUGLER ond JOAN R, KUGLER
ADDRESS:
E, NAME OF SELLER: EDWARD M, MYERS
ADDRESS:
F. NAME OF LENDER:
ADDRESS:
G. PROPERTY ADDRESS: 204 SALT ROAD, Eo.1 Ponnlbaro Town.hlp, ENOLA, PA
H. SEmEMENT AGENT: DIANE G, RADCLIFF. ESQUIRE
PlACE OF SEmEMENT: 3448 mlNDLE ROAD, CAMP HILL, PA 17011
I, SEmEMENT DATE: O9Illl1115
J, SUMMARY OF BORROWER'S TRANSACTION:
100, GROSS AMOUNT DUE FROM BORROWER 400.
lOt, ConIrocl.....prIco 53 000.00 40t.
102, Potoonol"'-"Y 402,
103, _.nt cllo'O..Io_,(... 1400) 993.50 403,
t04, 404,
105, 4OS,
AdllJ.tmonto lor lteml oold bv lonor In odvonco
Clvllown tu..
County 10.. 09/19/95 10 12/31/95
AI....mentl
SChoolTu 1II1D/1lS._
W.ter_1II11l11l5.1lI3OI1l5
100,
101.
108.
tOll,
tlO,
tlt.
tl2,
120,
200,
2Ot.
202,
203,
204.
72.45
703.99
11.52
54 771.35
GROSS AMOUNT DUE FROM BORROWER
AMOUNTS PAID BY OR ON BEHALF OF BORROWER
Depot, or ..mil' money
Prlnelool MIount 01 now"'''
Ex.&g loIn('}...." .UbilCtto
3,000.00
205.
200.
201,
200,
2011,
Adlullmonto for Iloml unoold bY 10110'
210. Clynown tax"
2tl. County 10..
212. A.....m.nta
213,
214,
215,
2tO,
2t1,
2tB,
210,
220, TOTAL PAID BY/FOR BORROWER
300, CASH AT SEmEMENT FROM OR TO BORROWER
30'. Oro.. amount due From bonowtr (lne 120)
302. L... amounts poIld tyylfor bomMer (In. 220)
3,000.00
54,771.35
3,000.00
"
!
K, SUMMARY OF SELLER'S TRANSACTION:
GROSS AMOUNT DUE TO SELLER:
Controc:t..lnprlco
Po..onol_
53.000.00
400,
401.
400,
4011,
410,
4tl.
412,
420,
BOO,
fiGt,
602.
fiG3,
110I,
Adlullmonto lor lIoml oold bY lolIor In odvonco
CIV"own tax..
County 10.. 09/19/95 10 12/31/95
A.....m.nts
SChoolTu 1II11l11l5._
Wot.tISowo,1II11l11l5.1lI3OI1l5
703.8B
11.52
72.45
53,787.85
GROSS AMOUNT DUE TO SELLER:
REDUCTIONS IN AMOUNT DUE TO SELLER
E><cu' Depool (...Inotructlon.)
Settlement chlrgn to ...., (line 1400)
E><1I1>10"'n!.)lokon ,ubjocllo
p~otf of Flnt MCMtgag. Loan
3,000.00
530.00
1S05, PoyoIf 01 Socond M"'O.ge Loon
&10,
fiG1.
508,
500,
510,
5tl.
512.
5t3,
5t4,
515,
510.
Bt1,
510,
010.
520,
BOO,
fiGt,
1lO2,
Adlu.lmonto lor Iloml unoold bv lollor
Clyllown 10..
County ten.
Allnlmenta
3 530.00
TOTAL REDUCnON AMOUNT DUE SELLER
CASH AT SEmEMENT TO OR FROM SELLER
Gro...mount due to ...., (In. 420)
L... reduction amount due ...., (Ine 520)
53 787.85
3.530.00
303, CASH FROM BORROWER
51,771.35 1103, CASH TO SELLER
50.257.85
D~~~~o~rl.~~*er~~~~~.~o.:~~~ncWI"llJ.og::..~:.r~!\r,1. '~\~o~~inR~:"":'I..Io~Jn\==...SoIvk:e,
{hilt. hi' noI bef.n ,.JMX'ed. The Con(t:G 81... p~' dltc;t;.'d on 1lnI701 lboY. conltlulH the oroi.'proc:;];d thil.~:t;:'.'ctlon.
SELLER INSmUCTION9: W 11I11 _I ..Ioto wo. Y9'" ortnclpolrooldonco.No Fotm 2110, 8010 or E><cho... 01 Prlnelool R..Id.nco, 'or.ny O.In, _ you, -
tu ,.tum: lor othe, tranlKUont, comp6ele the IppICI61e plrtt of Form 4,91. Form 02&2 Indlor 8ehtdu"-o (Form 1(40).
VOII........!rod bv tow Io=DIANE Q, R.o.=FF, ESQUIRE W'rlOll' c=r Io!:., Id.nll'lcodon numbo"
r YO\ldo ""'....k1.,YOII, '...', Id.... nomOO" yOll m bo ouo 10 c or crln\...1 PO"'_ Impoood by tow, .nd Under ponolloo 01 porjony,
tenrythatUHlnurnuer'hownon .Itattment myCOfTedWP'Y1t .nllb nu ,.
TIN: / SElLER(S)BIONA TURE(9): I
5t.Lltlt 1 tit:llt:tt li 5t.lLt:" 1 Sl:.llt:tt ~
REV, HUD-I (3186)
" .
U,S, DEPARlMENT OF HOUSING AND URBAN DEVELOPMENT
SETTLEMENT STATEMENT
Fila Number. KUGLER
PAGE 2
L SEmEMENT CHARGES PAID FROM PAID FROM
700, TOJAL SAtEBlBROKER'S COMMISSION beoed on lH1ce S 53,000.00 8 0.000 - BORROWER'B BELLER'B
DIvI,"" "'......10."" (h TOO) ..,......: FUNDS AT FUNDS AT
701, 5 10 SEmEMENT SEmEMENT
702, S 10
703, Comma.1on Dlkt .1 s.ttIement
BOO, ITEMS PAYABLE IN CONNEcnON WITH LOAN
801, I.oInOrig.,.tIonFH 0.00011
802, loan mtcount 0.00011
803, """""looIF..
804, Cnldl RopotI
805, Lond.... 'nopoc:tlon F..
805, Mortg.g_ Applcatlon FH
807, "'"umptk)n Fee
BOll,
BOO,
810,
811,
llOO, ITEMS REQUIRED BY LENDER TO BE PAID IN AOVANCE
1101, 101....' From 10 es l.ny
1102, MoftO.g.l",ul'II~ Premium for 10
1103, Haunt Inturance Premium for 10
1104,
llO5,
1000, RESERVES DEPOSITED WITH LENDER FOR
1001. HlZard Insurance mo,eS lmo
1002. MortoagllnlUl'llnce mo,eS lmo
1003, CIy_T.... mo,OS lmo
1004. County "'-IV T.... mo,eS lmo
1005. Annual ",,,,,,"*,II mo,eS Ima
1008, mo,eS lmo
1007. mo,e5 lmo
1008, mo.es Imo
1100. nTLE CHARGES
1101, lleltllmontorclooklgr..
1102. AblltlctortlSe.urch
1103, TIlo oxammllon
1104. TISe murance binder
1105, Documonl~
1108. Noll"y F_
1107, _"'_
(lnclud.. .boYe lema No: I
1108. TISIlnsurance 10 DIlIlE G. 1WXL1FF. EStmRE 441.50
(ncludet ,bov, a,ms No: )
1100. Ltnder't Cove,.g. S
1110. Owne(, eav.,.o. $ 53,000.00 - 441.50
1111,
1112,
1113,
1200. GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. Recortlklg F... Dood S 12.00 : MoIto.g. $ : Relu,. S 12.00
1202. ClylCounty IuIolampo Dood S 530.00 ; Motto.a. S 530.00
1203, Slat. ToxIIlamoo Dood S 530.00 : Mortg.g. S 530.00
1204,
1205.
1300, AODITIONAL SEmEMENT CHARGES
1301. Surv.y
1302. Pett Inspection
1303,
1304,
1305, Ov.m~h' M.I 10 Diane G. JbWo 11 f'f', Fs:I.
1308,
1307,
1308,
1400, TOTAL SEmEMENT CHARGES (Inll' on In.. 103. Section J .nd 502. SecUon t() 983.50 530.00
relulhlm_ "'. HUD-l _.n' Slat.m.n,.nd '0"'. bo.l 01 my .nowlodg. .nd bole', I. . '." .nd .....'.,. .lal.ment "'.1 recolplo
.menta mid. on trrf ccoun thll transaction. I furtn., cenry thafl h,VI reetNed I copy of the HUo..1 SttUemenl Stltoment.
,.) ~.Id'i~
I ~~nt Slal.....nl whkh I h.V.~rod 10 . I.,. .nd Eret' Iccounl of th. tr.n'Ii-lon. I h}VI C'Ultd or will CIU.. hind. to be d.buratd
II1Io.lal.....nl. Q \.~ :t
,~ ~~.g5:
WARNING: "10 I Iv ..... '.10'-'..'....... 10 th, nft. 51.,.. on 'h. 0' .'::II1."lmlo' '0'"'1 P.n,'1H upon
conv~ can In: ... Ipneonment. for dlllllt Ie.: Ukl18 . S. COd. Section 1001 and Section 10 O.
~.J~~/~.. ~~1""--
~~5'" ,
REV, HUo-1 (3186)
.
15,,-/;J-/cj
( ,/
REV-1547 EX AFP (12"95*
CotftOHW(AL TIt or P[NHIYLYANIA
DEPARtMENT Of' AEY[NU[
BUREAU Of INDIYIDUAL 'AXEl
DEPI. rlUD1
IWtAIIIURG, PA Ulla-DiOl
ACN 101
NOTICE Of INHERITANCE TAX
APPRAISEHENT, ALLDWANCE DR DISALLDWANCE
Of DEDUCTIONS AND ASSESSNENT Of TAX
DATE 04-22-96
FILE NO.
DATE OF DEATH 04-10-95 COUNTY CUMBERLAND
NOTE I TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBNIT THE UPPER PDRTIDN Of THIS FDRN WITH YDUR TAX
PAYNENT TO THE REOISTER Of WILLS. NAKE CHECK PAYABLE TO "REOISTER DF WILLS. AGENT"
REMIT PAYMENT TO:
DIANE G RADCLIFF ESQ
3448 TRINDLE RD
CAMP HILL PA 17011
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE. PA 17013
Altount H..1 tt.d
CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiifv:is'4-i"iif"liiiP-"ii2':9sY"ilcificni"-YNHEiiifiiticE"i:Ax"APjiRAisEiiiilr",-"m.-ciiiAiicE-ifR-mmm-------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HYERS WILLIAM H FILE NO. 21 95-0508 ACN 101 DATE 04-22-96
TAX RETURN WAS' (X I ACCEPTED AS fILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..l E.t.t. (S.h.dul. .0.1 (11
2, Stock. and Bonda (Schedul. B) (2)
3. Cloa.ly Hald stock/Partner.hip Int.r..t (Sch.dul. C) (3)
4. "arig.g,,/Not.. Recelvabl. (Sch_dul. DJ (4)
S. C..hJ8ank Dapollta/Hllo, Parlonal Property (Sch.dule EJ (S)
6. JointlY Owned Property (SchedUI. F) (6)
7, Tran.fara (Schedul. QJ (7)
e. Tot.l A...t.
I CHANGED
26.500.00
.00
.00
.00
2.110.77
.00
.00
(Bl
28.610.77
APPROVED DEDUCTIONS AND EXEMPTIONS.
9, Funaral Expen.../Ac., Coatl/HiIO. Expan... (Sch.dul. HJ I')
10. Debte'Hortg.g. Ll.bl11tl../Ll.n. (Schedu1. I) (10)
11, Tot.l D.ductlon.
12, N.t Va1ua of Tax Return
1S, Charitab1e/GovernMent.l Oequ..t. (Schedu1. J)
14. N.t V.lu. of Eat.t. SubJ..t to T..
2.034.91
,DO
1111
1121
1151
1141
:>,034 91
26,575.86
.00
26,575.86
If an aBBDBBmDnt waB iBBUDd prDviouBly, linDB
rDflect figurDB thDt includD the totDl of ~
ASSESSHENT OF TAX:
IS. "ount of Line 14 .t Spou..l rate (lS)
16. Aaount of Line 14 taxabl. .t Lina.1/Cl... A rat. (16)
17. A.aunt of Line 14 taxabl. at Callateral/Cla.. 8 rat. (17)
18. Principal Tax Due
TAX CREDITS.
PAYNENT
DATE
07-07-95
11-08-95
04-15-96
NOTE I
14, IS and/or 16, 17 and 18 will
rDturnB aBBDBBDd to datD.
.00 K .00_
26.575.86 X .06_
.00 X .15.
IlBI
.00
1,594.56
.00
1.594.56
RECEIPT
HUIlBER
AA047971
AA082296
REFUND
DISCOUNT
INTEREST
l+l
(-I
79.50
.00
.00
AHOUNT PAID
1,510.50
8.53
3.97-
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
1,594.56
.00
.00
.00
. If PAID AfTER DATE INDICATED. SEE REVERSE
fOR CALCULATION Of ADDITIONAL INTEREST.
If TOTAL DUE IS LESS THAN .1. NO PAYNENT IS REQUIRED.
If TOUL DUE IS REflECTED AS .0. "CREDIT" (CRI. YOU NAY BE DUE
.0. REFUND. SEE REVERSE SIDE Df THIS fDRH fOR INSTRUCTIONS. I
.
2~ ~ :offil
3 ',1. to 8
(7' ft~"
(T, ') ;B ... -,
:.1 1'~ r;>
In ';f
to, -t (,.~
~ ,"
("';..
1') C) :x:> "'-:d'
~f.J
l.,~ \0 lii'
:t1!3 0
li1 _.
~
RESERVATIONI Eltat_, of decedent. dYing on or belor. D.c.~r 12. 19a2 .. .f ~y lutur. 1nt.r..t In the ..t.t. I. tr~.f.rr~
In po.....lon or ~jD~t to C1I.. . (collat.tal) beneflelarl.. of thl dlcadent .,t.r the Ixplratlon of eny I.tat. 'or
II'. Dr 'or y..t" the C~'lth her.by Ixpt...lV r"'tV" the right to appral.1 and ...... ttenl'.r Inh.rlt.nca ,....
at the llMful el... I (col1at.t.l) t.t. on enY loch lutur. lnt.t..t.
........ Of'
NDTJCEI To fulfill ttMI raqulnunta of Section 2140 of thl IntMrltencl .nd E.t.ta Tn Act, Act 2Z of 1991. 72 P,I,
SecUan 2:140,
PAvttEKT. u.tKh the top portion 0' thit Natlc. Ind .ut.1t with your PIP"" to thl R.gllt.t of MI11t printed on the nv.r.. deM.
.-HItk. chKk or ItOMY order Plyiabla tal REGISTER OF ItILLS, AGENT
All PlyHnU raulved wU ,Iut ba 1PP1l- to any Int.ra.t which ..y ba dUe with any re..IrMlar .,lllld to UMI t...
REfUND (CAli A refund of at.. cr_lt, Mhlch wa. not reque.ted on the Ta. Rlturn, ..y be rlque.tad by clMlPlaUng an "Application
for Rafund of Penn.ylvanla Inherltanc. and E.tat. T.... (REY-ISIS). Application. .ra .vellable at the D"lce
0' tha R.gl.t.r 0' Will" any 0' the 15 Revenue DI.trlct O"lcI., or by calling the .pacl.l 14.hoUr
an.varlna ..rvlca nuaber' for 'or.. ord.rlngl In p.nn.ylvanl. 1-100-562-1050, out.Sd. Pann.ylvanSI Bnd
within locel HarrS.burg .ra. (117) 111-1094, TDDI (117) 711.1152 (H.arlng lapllrad only),
alJECTIONS. Anv p.rtv In Int.r..t not ..tl.,led with the ,ppral...ant, .llowanc. or dl..llowanc. 0' deductSon., or .......ant
of t.. (Including dl.count or Int.r..t) .. .~ on thl. Notlc. au.t obJ.ct within .I.tv (60) day. of r.c.lpt a'
thh Notlcl bv.
--wrlttan prot..t to the PA D.partwant of R.venu., loard 0' App..I., a.pt. ZI1011, H.rrl.burg, PA 11116-1011, DR
.-alecUon to hav. the; ..ttar d.t.r.ln.d at audit 0' the accCM1t 0' the p.r.onel r.prll.nt.Uve, OR
..."..1 to the Orphan.' Court.
AlltlN
lITRA1'lVE
CORRECTIONS.
INTEREST I
Faatu.1 .rror. dl.cov.rad on thl. ........nt .hould b. eddr....d In writing tal PA D.partaant of R.venue,
auraau of IncUvldual Tax.., ATTNI pa.t A......ent R.vl.w unit, D.pt. Z10601, lIarrhburg, PA 17111-0601
Phon. (717) 717-6505. 5.. page S of the bookl.t "In.tructlon. for Inharltanc. Ta. R.turn for a Ra.ldant
O.cadwlt" (REY-UOJ) for an .lCplanatlon of .dalnhtr.Uv.1Y corractabl. arror..
I' any t.. dUe I. paid within thr.. (5) cII.ndar aonth. .ft.r the d.cldent.. d..th, . 'Iv. p.rc.nt (5X) dl.CCM1t of
tha tax p.ld It .Uowed,
Inter..t I. ch.rgad baglnnlng with flr.t day of d.llnqu.ncy, or nlna (9) .unth. and one (1) d.v frOl the; data of
de.th, to the d.t. of p.v-ant. T.... which baC'" d.llnquent bafor. J~.rv 1, 19.1 be.r Int.r..t .t the rat. of
.Sx (6X) parcant p.r ~ calcul.tad at I dlllv r.t. of .000164. All t.IC.. which bac... d.llnquent on Bnd .,tar
January I, 19.Z will b..r Int.r..t et I rate which will Vlry frol cII.nd.r y..r to c.land.r y..r with that r.t.
~.d by the PA Dlpsrt..nt of R.vanua. Th. .ppllc.bl' Intar..t rata. for 1,IZ through 1996 ar.l
~ Int.rllt Rate O.lly Internt Factor ~ Intue.t R.t. D.lly Int.r..t Factor
l'.Z 'oX .000541 1'.7 'X .000247
1915 lOX .00041. 1'....1991 IIX .00nOI
I'" IIX .GOnGl 199' 'X ,000247
1915 UX .OGOS56 1995-1994 7X .000191
I'" lOX .000114 1995-)'96 OX .OOG2't7
nlnt.r..t II c.lculstad ., follow"
D1SCDUHTI
INTEREST' BALANCE DF TAll UNPAID X NUnBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
uAny MoUe. i..uM 1ft.,. thl t.1C tMlcOH' HUnqu.nt ..II 1 rafl_ct M Intarllt ulculstlon to flft.an US) d.y.
baYond thl data of thl ......eent. If p.yeent I. .ad. .ft.r the Int.r..t ca~t.tlon data shown on thl
Katie., addltlonal Int.ra.t .u.t " n1culatad.
/5 'l;)- 1'/
REV-1607 EX AFP (12-95.
COttHOHWULtIt OF PENNSYlVANia
DEPAATHfNT DF REVENUE
IURfAU OF INDIVIDUAL TAMES
DEPT. ZI0601
IIARR1SlURO, PA I1Ua-0601
ACN 101
INHERITANCE TAX
STATEMENT OF ACCOUNT
DATE 04-29-96
OF MyERS WILLIAM H FILE NO. 21 95-0508
OF DEATH 04-10-95 COUNTY CUMBERLAND
NOTE, TO INSURE PROPER CREDIT TD YOUR ACCOUNT. SUBHIT THE UPPER PORTION OF THIS fORH WITH YOUR TAX
PAYHENT TO THE ADDRESS SHDWN. HAXE CHECK PAYABLE AND REHIT PAYHENT TD' ,
DIANE G RADCLIFF ESQ
3448 TRINDLE RD
CAMP HILL PA 17011
REGISTER DF WILLS
CUMBERLAND CD CDURT HDUSE
CARLISLE. PA 17013
AJlount R...itt.d
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR FILES ....
iikV:i6'iii-EX-"Fii-iiz:9l'fju----...--iNH€iiiYANCif-;:AX--S;'ii'feiiEN;:-OF-A'i:cciiiiif--ii..-----------------m-
ESTATE OF MyERS WILLIAM H FILE NO.21 95-0508 ACN 101
THIS STATEHENT IS PROVIDED TO ADVISE Of THE CURRENT STATUS DF THE STATED ACN IN THE NAHED
ESTATE. SHOWN BELOW IS .0. SUHHARV Of THE PRINCIPAL TAX DUE. APPl.ICATION Df ALL PAYHENTS.
THE CURRENT BALANCE. AND. IF APPLICABLE. .0. PROJECTED INTEREST fIGURE,
DATE 04-29-96
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT, 04-15-96
PRINCIPAL TAX DUE, 1.594.56
PAyMENTS (TAX CREDITS),
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST (-)
07-07-95 AA047971 79,50 1.510.50
11-08-95 AA082296 .00 8.53
04-15-96 REFUND .00 3.97-
. IF PAID AfTER THIS DATE, SEE REVERSE
SIDE FOR CALCULATIDN Of ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN .1.
NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REflECTED AS .0. "CREDIT" ICRI.
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS fORH fDR INSTRUCTIDNS, I
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
1.594.56
.00
.00
.00
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PAYHEHTI
Oellch thl top portion of this Hotlc. and ,utMllt with your ply.,n' lid. PI.abl, to
prInted on thl r.v.r.. ,Ide.
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If RES1Df:NT DECEDENT .ake chick or eonlY order pIYlbl. tOI REGISTER OF WILLS, AGENT.
If HOH-RESIDEN' DECEDfNT eak, chick Dr ItOnlY order plyabl. tal COMMONWEALTH OF PENNSVLVANIA.
All pay.."t. tlulwld ,hlU bl IPPUld flr.t to any Int.r..t ,-hlch ..y bl due .,lth any n..lnd., IPPUld to thli h..
REFUND (eA)1 A r.fund 0' . tllC credit, which .... not rlq\Mlt,d on thl hx R.turn, ..y bl r.quntad by cDIIPIIt1na M
"Appl1caUon for Refund of Plnn,ylvanla Inh.rltanc. and Eat,t. 'ax" (REV.UU). Application. .t. IvaUabl, It
t~ OfficI of thl Rlal.t.r of Will., any of thl 25 Rav.nul DI.trlct Offlc.. or fro. thl alparta."t-, Z4-hour
anl.,.rlng ..rulc. nu.b.rl 'or 'or.. ord.rlngl In P.nn.vlu.nl. l.aOO.S6Z.Z0SD, outlld. PlnnlylvBnl.
end within 10c.1 Hlrrl.burg .r.. (717) 711.8094, TOOl (711) 77Z.ZZ5Z CH..rlng I.Pllrld onlv).
DISCOUNTI
Du..tlon. rl.ardlng .rrorl cont.ln.d on thl. not Ie. .hould b. .ddr....d tOI PA nlpert..nt 0' Revenu., lur..u
a' Indlvhtuel hll", ATTNI po.t b......nt Rnl.", Unit, D.pt. Z80601, Harrisburg, PA 17UI.060l, phon.
(717) 781.6505.
If any talC due II p.ld within thr.. (!) ul.netsr .onth. eft.r the dlced.nt'. d..th, . flv. p.rc.nt (5X) discount
0' the tllC p.ld II al1ow.d,
REPLV TOI
INTEREST I
Int.r..t I. chargld b.alnnlng with 'Ir.t dlv 0' d.llnqu.ncv, or nln. (9) lonth. Ind ana el) dlY 'ro. tha de'. 0'
duth, to th. d.t. 0' paV'lnt. hili' which blea'. d.lInquent b,'or. Janulrv 1, 1982 bur Int.r..t It the nte 0'
.1. 16~J p.rcent p.r annu. calculat.d .t e dallv r.t. of .000164. All t.... which b.c.,. dellnqu.nt on .nd eft.r
Januerv I, 198Z will bur Int.rl.t .t . rat. which will vny 'ro. cII.ndar vur to elllndar Vllr with th.t r.t.
announcld by the PA D.part.,nt 0' R.vlnu.. Th. appllcabll Int.r..t rat.. for 198Z through 1996 .r.1
V..r Int.r..t R.II Dlllv Int.r..t F.ctor V.ar Int.r..t Ret. DIllv Int.r..t Fletor
.91l 20~ .000541 1987 OX .000Z47
1915 16~ .0004S8 1968-1991 lU .000lDl
.914 IU .00DSOl 19'Z .~ .000247
1'15 1S~ .000556 1995-1994 n .000192
1986 lOX .000274 .995-1996 .~ .000Z47
-.Inllr..t .. ulculltld ., 'olloWII
INTEREST . BALANCE OF TAX UNPAID X NUHBER DF DAYB DELINQUENT X DAILY INTEREST FACTOR
uAny Notlcl luuld Ift.r thl till b'co." dlllnqulnt will r.fl.ct an Int.rllt e.lcul.t1on to flft.ln 115) din
b.vond thl dlt. 0' the ........nt. I' ply,.nt I. .ed. a,t.r thl Int.r.., co.put.tlon d.t. .hown on the
Notice, .dclltlon.1 Int.r..t MI.t bl c.lcullt.d.