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HomeMy WebLinkAbout95-00513 20. If lIn. 1911 9r.ot., Ihan L1n. 18, .nt.r ,h. diff.r.nc, on L1n. 20. fhl,lIth, OVERPAYMENT. aD 21. If line 181, great.r than L1n. 19, .nlt' Ih, dlff,,,ncl on L1n. 21. Thl," Ih. TAX DUE. A. Enl., Ih. lnt.rt" on the balance due on line 21A. B. En'I' Ih. tolol of lIn. 21 and 21A on lint 218. Thl, II the BALANCE DUE. Mak. Ch.ck Pavabl. 10J R.gllt.r of Willi, Ag.nt >- >- BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH -0( -0( .'," Under Plnaltl.. of perlury, I d.c1or. lholl have nomlned rhlt ,elur", Including accompanying schedul,. and lIar. mini., and to lh. b..t of my knowl.dg. and b.lI.f, It I. Iru., correct and campl.I.. I declar. thol 011 r..ol .1101. hOI b..n r.portld a' trUt morbI valu.. Oeclaratlon of pr'par.r orh., Ihon Ih. plrlonal rtprel.nlollv. I, baud on olllnformollon 0' which preparer hat any ~nawledge. IGN IIfO' lIS N l~NSIILffOllftUNOllnUIIN ADDIIIU 541 Lexington Avenue ~l L (kc ~ ~~S~~C", 1--:)- -\0 ttA IfrUINf flVI ADDlUS One Wes t Ma n DAIf _ . _ , (ILL Shiremanstown 17011 7-5 "/S Sheely, REV.1500 fX. (7.lUI ~ ...s.. Illl!:~ =09 uE'" ~ ~ 'OR DATlSO.DIATHAfTIR 12/31/91 CHICKHIRI If A SPOUSAL POVIRTY CRIDIT IS CLAIMID 0 fiLl NUMBlR ,;)..1 COUNTY CODE DICIDWI'S COM'UIf ADDIlUS 1.$- -- II 3-,j- INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) 9's SZ3 NUMBER 5 fil III c COMMONWU.UH Of PfNNSYlVANIA D(p...a'MfN' Of R(V(NUE Dfn 210601 HAUI5IURO. PA 17121.0601 DICIDIN '5 NAMlllASf. '111$ . AND MIDDH IHUlAII Voris, Doroth I. SOCIAL SlCUIlIIY HUMIIII DAIf O' IIITH 547 Lexington Avenue Mechanicsburg, Ph 17055 c.,,, Cumberland AMOUNt llCllVID ISU IHSlltUClIOHSI YEAR DAn O' DIAl" 165-16-2281 04/09/95 08/28/21 II' ""IIC..smlu.vlvIMllrouul "'&1\111"". fII" ""'D ..IODIIINlIt"ll SOCIAL SlCUIII" NUMUIl o 2. Supple menIal Return o 3. Remainder Relurn (for dole. of dealh prior 10 12.13.B21 o 5. Federal E,'ot. Tax Relurn Required -.2.=B. Tolal Numb.r of Safe Oepolll Bou. :ilS "'c "'z 8~ [1g 1. Original Aelurn o 4. limited EUot. 0 40. Futur. Inlere.t Compromllo 110, dol.. 01 d.olh olt., 12.12.821 ~ 6. Decedent Died Teslole 0 7. Decedent Malnlalned 0 living TrUll (Attach copy 0' Will) (Allach copy of TrUll) ALL'CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO. NAME COM'LIU MAnlt..O ADDIIU Andrew C. Sheely, Esquire One West Main St. UU'HONE HUMin Shiremans town, PA 17011 ; l.,i~ 1',' .I~ z c 5 E ~ III '" 1, R.ol E"o'. ISch.dul. AI ( I I 2. S'ock. ond Bond. ISchedul. B) I 2 I 3. Clo..ly H.ld S'ockIPor'n."h'p In'.'." ISch.du'. q 13 I .t. Marlgag" and Nal.. Receivable (Schedule D) (A I 5. Cosh, Bonk Depol!h & Milcellaneau. P.rlanol Property ( 5 1 ISch.dul. E) 6, Joln'ly Own.d P,op."y (Schedul. FI I 6 ) 7, T,on.'." (Sch.dul. 0) ISch,dul. L) ( 7 I B. Talol Gran Au." (Ialallln" 1.7) 9. Fun.ral bp.n.... Admlnlltratlve Calli. Mil(ellaneaul (9 ) bpenl" (Sch.dule H) 10, D.b.., Mortgog. L1oblll,'.., L1.n'ISch.du'. II (10) 11. Talal DeductIons (10101 line I 9 & 10) 12. Nel Value of Ell ate (line B mlnu. line 11) 13. Charitable and Governmenlal BequesU (Schedule J) 14. Net Value Sublect 10 To.. (line 12 mlnua line 131 15. Spau.al Tran,'.n (for dal's of dealh after 6.30.941 5.. Instruction. far Appllcabl. Percenlage on Reve,.e Side. (Indude volu.. from Schedule K or Schedule M.) 16. Amounl of lIn. 14 laxabl. 01 6% rol. (Include valu.. from Schedule K or Schedule M.I 17. Amount of line 14 taxabl. 01 15% ral. (Include valu.. from Schedule K or Schedule M,I lB. Principal lox due (Add lax from lIn.. 15, 16 and 17.1 19. Credit. Spousal Paverly Credil Prior Paymenll + 101.48 (191 (20) 106.82 1,613.00 7.602.07 7.434.81 I B I 9,215.07 7.434.81 1,780.26 (11) (12) (131 (141 1. 780.26 z c S ~ :II o u ~ ... (151 (161 1,780.26 (171 DilCaunl Inlerelt + 5.34 )(._- )( ,06. 106.82 )( .15 .. (19) Cl1uck hOle If you aro fcqucsling a refund of your overpayment. -0- 1211 121A) (2181 -0- Act #48 of 1994 provld.. for the r.ductlon of the tax rat.. Impo..d on the not valu. of trande,. to or for the u.. of the .pou... Th. rate. a. pre.crlbed by the .tatut. will b.l . 3% (.03) will b. applicable far ellate. of decedenll dying on or after 7/1194 and b.for. 1/1/96 . 2% (.02) will b. applicable far e.tat.. of decedent. dying on or after 1/1196 and b.fore 1/1/97 e 1 % (.01) will b. applicable for .lIate. of decedenll dying on or after 1/1/97 and b.fore 1/1/98 . Spou.al trander. occurring on or after 1/1/98 will be exempt from Inh.rltance tax. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (....) IN THE APPROPRIATE BLOCKS. YES NO 1. Old decedent make a transfer and: x a. retain the use or Income of the property transFerred, ....................................................... b. retain the right to designate who shall use the property transFerred or its Incomll, ............... X c. retain a reversionary interest; or ................................................................................... X d. receive the promise For life of either poyments, beneFits or core9 ....................................,.. X 2. If death occurred on or before December 12, 1982, did decedent within two years preceding death transfer property without receiving adequate conslderallon9 If death occurred aker December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration' .......... ..............0... ..... ........ .......... .... ........... ..... .................... to.. 00.. X 3. Old decedent awn an 'In trust for' bank account at his or her death"-.................................... IF TNJ: ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU;MUST~~OM~fETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. (.\4 1" I _J -~~1 'J , ) r:~ L: ___ :J 00 '.1 .~) fl). - a:u' ~ .1~ISOl". (117) '*' COMMONWUlTH 0' '!HHSYlVANIA INHlanANCI TAl( am aN I.SIDINT DlelDINT SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY Pleall Print or l e FILE NUMBER ESTATE OF Dorothy I. Voris CAll prop.rty Iolntly.owned with the II,hl .f Survlvonhlp musl be dl.cl...d on Schedul. PI ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. Personal property and contents of home per attached appraisal $ 1,060.00 3. 53.00 2. 1987 Chevrolet VIN J81RG5174H8434913 per attached appraisal Cash on hand 500.00 TOTAL Alsa enter an line 5, Reca S 1,613.00 (A"och addItional 8"'- )C II- sh.."11 more .pac. I. n..ded.) ~#- Frank Potteiger Auctloneor . Complete Auctlonoerlng Service . Your locallon or mlno . or I'll buy your entire lot \O~.. ~_ 1. ~o<\~ ~ - ~ 1:,q_~_., m.' .-, "'. .- _,_ S._ -'r~~\~&~" ,.~~~II~IO',PA ~~~~.3 ..' ..(.7~! 243'1~~~ _. ... ,..,. ,. _...' ....._~ P.-"\~...~v..'1()1~,'\Jl)5S.._,... .', -..... -~\~~- - TW\"~~,,i,';"~G ~;..,,__~~F~-t~\'~_~\UL 1IribO~ . .' ,__... ., .._ _._ _...__ .._ _ __ _u. ,_. ...__ _ . ~ .__ . ~\ ,",\,-,\,!\~ ~.~\~ ... ___:;; _u_ \\5 ... .. ~ ~..._. __0- . _0' r: 01) .... .. __9.~.!.. _.. .__.,...... ... . ,----. ....-- So7Q "'\~S~a""'oo--' ,..., ..... ---_00' ....- \.\~~o' 6'1l\~L.) . ....--- . ?:.o~o L-ro-\~L~' ,.., . , ... . , ;1.070 Lt~tWll) , .--..o. . . . ( .., ,., ..... ..." ...... .. .... ,,,...._, \.. 4~o. oJ --y..\\&' .., __d _.u..,. u...' ...~... ...., ..--~-_..._.- __ -.\).)~\)(2... .. .. \()'t>~C> (~~\'''. .--.' -..-- ,.--- . ~ oc. 'C;~-; '" ..-..-. "; .. .~~S_") -}--~t~-- ...~~- ' ." ..~~ . .". ,-- -.. -- .. .., .' ... ...\(\\~ ~';)~ \\'YU-~(O \ ~';.OQ ... ~ .-....-. . . .\ 1S~21 .._" ..._ . . ";;,S,:o. . . .,.. . ,. . . ~ S?tl :\e.~ ~ (.30o~) " . ---., ., 11\l.lJot,.. III.", * COMMONWfAUH 0' 'rNN.nV,l~NIA INHfltlfANCI! TA): UTU.N IUS/DINT DI!CIDINT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF Dorothy I. Voris FILE NUMBER JolnttDnontl.l, NAME A. John P. Voris ------.-----ADDRESS 541 Lexington Ave. Mechanicsburg, PA --.--.-- RELATIONSHIP TO DECEDENT Son 17055 B. C. Jolntly-ownDd propDrty. ITEM LmER DATE TOTAL VALUE DECD'S DOLLAR VALUE OF FOR NUMB!:! JOINT MADE DESCRIPTION OF PROPERTY OF ASSET % INT. DECEDENT'S INTEREST TENANT JOINT 1. A. N/A Milla1 B:r1k Personal Checking 1,947.07 50% 973.54 Account No. 161-931-0913, date of death balance $1,947.0' 2. A. N/A Mellon Bank Statement Savings 3,236.69 50% 1,618.35 Account No. 00160-400871, date of death balance $3,235.17, accrued interest $1.52 3. A. 6/14/93 Mellon Bank Income Cert. 5,017.12 50% 2,508.56 Account No. O-S19331-C, date of death balance $5,000.00, accrued interest $17.12 4. A. 4/4/94 Mellon Bank Income Cert. 5,003.24 50% 2,501.62 Account No. 0-S21810-C, date of death balance $5,000.00, accrued interest $3.24 ; TOTAL IAI.o Dnle, on line 6. Rocopllulollon) S 7,602.07 (If more space it needed intlrl additional sh../s 0' 'ame sin) Mellon Bank Mullon Ilunk, N.A. Mellon flunk Cenler P.O. BOI ;899 I'hllndelflhln.I'A 19101.;800 i'llIy .10, .l1l1l5 Hr. Andrew C. Sheely JMES D. BOGAR Attorney at Law One West i'llIl11 Street Shlremanstown, PA .1701.1 Roll: Estate of Dorothy 1. Vorls Dear Hr. Sheely: In accordance wlth your request, the followlng lnformatlon ls provlded as of Aprl1 9, 1995. Please see attached letter. P.lease contact thls department If you have any questlons. !2~wY' ank, N.A. Wrltten Communlcatlon (199-5380) P.O. Box 7899 Phl1a., Poll. 19.106-7899 PGldmd .f82 ~h:!; .. Cl ~i!; 'I ~ ~ t s2i~ agaQ HI Af~~~ :~ ~~ ~I QCl i~ ~s w w ~ w 0 .... .... 0........ ... ... ...... o w 0 III WOO W ~=-'C~~'C 'C~ :>.~ Cft -oeo 'CUO'U_O QI-t:> 0.... t> I>.... I....>> I 0 ... 0 .."'.,.;....,., .~.... >.. ~'flAfC)'fl"'~"''fl=:'flAf IO.llIOO.ll....llONO.ll ....... ....... eEl weQk 10 8 0 0 0 0 100 I 0 0 .... ~Ot:l...,O..,CII0Q.., '-..~-,.........-,_.~-..-,..-,,: ... C) . ... ... '" . ... .. . tJ . Af ..c ... IZl .. o C) .. ... C) . ... ... '" . .. .. C) .. ... ... . III CO> N . CO> . I/) . I/) ~ .. o ... ... . CD .. '" 10 . 10 CO> N . CO> N III . ... . tJ . ... CO> '" ... ... ... ... 10 ._-'~--.....-.._.... --.. C) ... . 10 ... '" CD . ... CD N .. . ... ... C) . III .. 01 ., Il 41 " .... ., ..c :. '" ~ '" U 1/)... ... ~~;1t' Il... .. OJ ." .. " ,Q ~::!tJ;I; I/) '" -!1 '2 ,&J Cl) ill lD c::'I 0 .u ... 0 .. OJ "x<.:>'" ::!~;;i~ >e t-4 .... l:J " Il I i . I I I/) I . . . XtJtJ uixc,;:E :tl~~:tl ::Ef-tf-tC) ... N . CO> C) C) . III N ... . ... ... ... N . CO> C) C) . C) C) C) . III ., .. " " ".. ., .,,, '" 01 '" ., u s:t u s:t .........rot H "':'''' ;1~;1 . .. .. > " ., " S tJ Il tJ :0 -!1 m ~ 'm i ., 0 ... o ra u tl.l .. ., OJ C)CI.IHI I I I . ... . . . . tJl/)tJ:<; . . . . eJrnHPo. C) C) . C) C) C) . III . tJ . ... ... '" ... ... ... ... .. o ., .. 41 .. ~S' ..S' I-t.... "'.... ... 1l.>C 'fl~.,'~~ ~ a ';; ~ a 01 ':! 8.... .. ~ 1\1 II 0 till .... CI ,:a 0 II .>C 0 ,.Q OJ U IfJ II III of'4 GJ ......, to') II) .<:I" '" "':0 tJ"'I/)"'lQ I I I I .. I . . . . ~~~~~ W"'I/)AflQ bl OJ ~ " a Iry.UlIlh(7."1 ,;~ COMMONWUUH O' 'INNSYLYANIA INHflUTANCf TAX RlTUItN ItfSIDINT DECIDIN' SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES Ploa.. Print or T po E Dorothy I. Voris ITEM NUMBER A. Funlral Expon.... B. 4. C. 1. 2. 3. 4. 5. 6, 7. 8. DESCRIPTION AMOUNT 1. Myers Funeral Home - Funeral and burial expense Taylor's Memorials - Grave marker $ 6,223.30 485.00 2. AcImlnl.trallvo Ca.t.. 1. None Claimed or Paid Porsanal RopresonlallYll Cammi..lan. Social Socurlty Numbor of Porsanal Ropro.ontatlyo: Voar Comml..lans pold 2. Allornoy FOOl - Andrew C. Sheely, Esquire as per agreement 500.00 3. Family Exomptlon Claimant None Claimed or Paid Rolotlon.hlp Addro.. of Clalmanl at docodonl'. dooth Slrool Addro.. City 51010 Zip Codo Proboto FOOl MI.cellanoou. Expon..., General Water Co. - Final water bill 49.51 PP&L - Final electric bill 77 .00 Reserves to conclude administration of Estate including filing of PA Inheritance Tax Return and Inventory and related 100.00 TOTAL (AlIa ontor on IIno 9, Rocapltulatlon) 5 7,434.81 (If more .paco I. no.d.d, In..rt additional .h..to of .am. .1...) I I I l. - - 1l1rtst ~Ulill alt~ ml'shtlltl'ltt or unnlll' I, WIllS If llR1I11Y 1. WRIS, DC JOC) rJr\(.'IoUOt) Prlw. Shln.1M1l1tcMl, CUdJCrlnnd Duu)', Pt'ImylvonJa, tmko, pOOU.h Rnl! declare Uti.. Aft nod Cor ~ IJ1ftt WJI1 In! Toalml!nt, hereby revdtlng aU oUter Will. nnd ChllcUa IlIJretoforo rmdo by 00. !:!!~J) t dln!Ct the JUI~lDlt DC aU my junt dehts and the CXJ1CnIIoa DC tn)' last Uloo88 and fUlCra1 (run tn)' estate. na aeul oCter rJtf death 118 cotVl'fllently IM)/ be WIle. ~: I OOviso md bcquclltJl 811 tho reat, redtb! IInd mmll'Mk!r of nv estate DC w\Btewr natura and WM!n!Wr sLtunto mto my dll1drm, f'f'.a;y J. ant, RI111I A. fAAZER and Jatl r. \UUS, or their 18allO, In cqunl aMres. ~I ttJ Executor and persaud ropreaent8tlw ahall MW tho (oHewing (lOoo'Ora in nddltlm to t.tcao wated in t.hmI by ll1W' md lrt othor pro" v1alml DC thla Will, applicable to all properly, excrclaoblo without court approval and effectlve mtU actual dbtrlbutlm of nll properlyl (A) To sell at public or private aolo, or to lease, Cor Pl1)' period DC tlrne, any rul or personal property and to g1ve optima Cor aalC!8, exc~e8 or leases. Cor auch pricea and LqlOn Buch tCtll'6 or cxnIItlons R8 arc dcmrd proper. (0) To CXltfJmn1Bo ony claim or ccntt'OW!rsy. (C) To invest in aU lonm of property, lncluding stocka, lXJ1TJ'OO trost Cmtla and oortgagc inwstJtmt fulda, without rcstrictim to invcatnmtfl aUU'Drlzed Cor rcmaylvan1.4 ctWcIoriea, DfI they dean proper, without regard to any princ1plo of diversiflcation, risk or productIvity. (D) To exercise my option, right or privilege granted in insurance policies or in other lnvestIl'cnta. (E) To nv1ko dlstributlms to ntf horoln nm-ed beneflclnries in kind. !!!!!mil Ml taxes that m,1)' 00 lU18e8H~1 In (''OI18eque11CO DC Il!/ {~nth oC toAllItowr nnture lUkI by ..hatover jurhdlctlal JIlpt}U'LI shall be cOJvddored n pnrt of the expense oC tha nllnlnlstrotlm of my C8tntO, and my penrod reprenentntlve ... f'MLl haw tho absolute pa..oer in his or her di8crotion to poy the emIt at mce i ~lI!U1Cr or not tbo Inw U1dcr ~,ld1 they are lnflOOOd pemlts tho poeIt'poncnI:lnt of .;.. all or part of thmt to a later tlzm. <, "--. COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND i. J UI John P. Voris accordIng to law, dopol" and lay I that ho _ is Execu tor _ 0' the Eltato 0' Dorothy I. Voris loto 0' _,U-pp'er_~llen_T()w,nsh.i.p, ___,_.,_____, Cumborland County, Paoo docealod and that tho within Is an Invontory mado by him _ .__ _____, the said Executor 0' tho entlra astato 01 said dacadent, conllltlng 0' all the person.1 prop.rty and real ....to, axc.pt real ....t. ouhld. the Commonwe.lth 0' Pennsylvanl., and th.t the figures opposlt. o.ch It.m 0' the Invontory r.prosont It's fair valuo II 0' tho dato 0' docodont's do.th. bolng duly sworn July ~ 1995 ~~ ~, ~t\^;~ __ Encutor. lIhIoldnctJcr Joti P. Voris 541 Lexington Avenue -~anrcsburg, PA 17055 Sworn and subscrlbod bo'oro me, 'f~'- 'L , e, "'t(--4~ Nolarlal 50.1 Joan E, Brothers. Notary Public ShlromanBlown Boro, cumbOrlnn~ County My CommlBslon Explros Fob, 12. 199B ~- Add,... Day April Mo"'h 1995 Dato 0' Death V.lf INSTRUCTIONS I. An Invontory mUlt bo ruod within throe monthB .ftor .ppolntment 0' porsonal reprosentatlvo, 2. A Bupplomont Invontory mull be 'i1ed within thirty d.ys 0' dllcovory 0' addltlonal auots. 3, Additlon.1 sheets m.y be .tt.ched II to person.lty or re.lty 4. Soo Artlcl~ IV, Fldu~orl.. Ac,,<<>' 1949. '. tt'!. (""....l . \" '-1. ,:- r- I -~ .. -..., n l) ,_' ~ U) ~.: I!JO' e: - -=> UU Ql k 'M '>"1 g. .<: lJl lJl ~ ~ 0 -.i . ~ I-< >. w .. o-i M ~ ffi ... en c .. Ql ~ H Ql .. Ql a- u 0 l>: M .. .. .c: ~ w ::J ~ M C '" en ~ '" .. .. i!: a- -' u. .0: ,,; a- E ~ 0 . 0 u. -' . k a- U ~ W 0 < H Ql to > z "" ;. Z 0 c Q >< " Ql '" Z :I: ;J 0 k 0 "" < I-< ... 'tl Z w a- 0 ." C l>: c .0: 8 - ~ 0 ~ .. I .Q ." ... .. E .. 0 . - " 0 I .. it -' U rD If) - y 3 - 5" REV.1547 EX AFP 02.94* C~ALTH OF PENHSYlVAHIA DEPA'UHENl Of REVEMJE BUREAU OF INDIVIDUAL TAXES DEPT. IID601 HARRISIURa, Pi 171,1-D601 CJ ACN 101 NOTICE OF INHERITANCE TAX APPRAISEHENT. ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX DATE 10-17-95 D FILE ND. DATI! DF DEATH 04-09-95 CDUNTY CUMBERLAND NOTE, TO INSURE PROPER CREDIT TO YOUR ACCOUNT. SUBHIT THE UPPER PORTION OF THIS FORH WITH YOUR TAX PAYHENT TD THE REGISTER OF WILLS. HAKE CHECK PAYABLE TO "REGISTER OF WILLS. AGENT" REMIT PAYMENT TO: ANDREW C SHEELY 1 W MAIN ST SHIREMANSTDWN PA 17011 REGISTER DF WILLS CUHBERLAND CD COURT HDUSE CARLISLE. PA 17013 A.aunt R..ltt.d CUT ALDNO THIS LINE ~ RETAIN LOWER PDRTIDN FDR YOUR RECDRDS ~ iiE'v:i5'4-j-EX.AFP.fi2':94"j"Noi"icniFuiNHEiiii'liNcpf"in-piiiiA'iiiENiNr-;-.m.-oiiliNci.cili..............._. DISALLDWANCE DF DEDUCTIDNS AND ASSESSMENT OF TAX ESTATE OF VDRIS DORDTHY I FILE ND. 21 95-0513 ACN 101 DATE 10.17-95 APPRDVED DEDUCTIONS AND EXEMPTIDNSI 7.434.81 9. F...,a,.al E)Cpen.../AdJI. Coat./Hhc. b:pan... (Schedule HJ (9) 10. Debt./Hortg.ge Llebl1Itle./Llen. ISchedule II 1101 .00 11. Totel Deduction. 1111 12. H.t Valu. of Tax R.turn (12) IS. Charitable/Governllent.l a.quaat. (Schedule J) CIS) 14. Hat Velue of Eatete Subjeot to Te. Cl41 NDTE: If an assessment was issued previously, lines 14. 15 and/or 16, 17 and 1B will reflect figures that include tha total of Abb returns assessed to date. ASSESSMENT DF TAX: 15. A~unt of LJna 14 at Spou..l rat. 1'. A.aunt of Lina 14 ta)Cabl. at Lin..l/CI... A rat. t7. A.ount of Lina 14 ta)Cabla .t Col1.t.,.al/Cl... Brat. I'. Prinoipal Tax Due TAX RETURN WAS' C X I ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE APPRAISED VALUE OF RETURN BASED DNI ORIGINAL RETURN 1. Reel E.t.t. (Schedule A) (1) 2. Stock. and Bonda (Schedule B) (2) S. Cloa.ly Held Stock/Pertnerahlp Intereat (Schedule C) (S) ~. Hartgagea/Hat.. Receivabl. (Schedule D) (4) 5. C.ah/Bank Depo.ita/Hiac. Peraon.l Property (Schedule E) (5) 6. Jolntl~ Owned Propert~ ISchedule FI 161 7. Tr.naf.r. (Schedul. G) (7) a. Tat.l Aaa.ta 1151 1161 1171 TAX CREDITS: PAYHENT DATE 07-07-95 RECEIPT HUHBER AA047972 DISCDUNT I_I INTEREST 1- I 5.34 I CNANCED .00 .00 .00 .00 1.613.00 7.602.07 .00 181 9.215.07 7.4~4 AI 1.780.26 .00 1.780.26 .00 1.7BO.26 .00 X,OO. X.06. X .15. IIBI .00 106.82 .00 106.82 AHQUHT PAID 101. 48 TOTAL TAX CREDIT BALANCE DF TAX DUE INTEREST TDTAL DUE . IF PAID AFTER DATE INDICATED. SEE REVERSE FDR CALCULATION OF ADDITIDNAL INTEREST. 106.B2 .00 .00 .00 IF TOTAL DUE IS LESS THAN el. NO PAYHEHT IS REaUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI. YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF TNIS FDRH FOR INSTRUCTIONS. I 0\ l.(.; oJ _ " ~ ';'- 0'\ L, 0, ~ l- V'! C.;> " j)~ liJlt.; '< a: .'25 UU RfIERVATlDfh Elt.t.. of deoHenh dylna on or before DecHbe,. 12, 1912 -.. 11 MV future Int.r... In the ..t.t. I, tr."I'lrncl In po.....Son or MJOYMnt to el... . (COUlt,,..U beneflolarl.. of the d.leI."t .f..,. thll ..plr.Uon of MY ..t.t. for Ilf. Dr for y..,.., thll C~.lth h.r~y '.pr"'lv rl'.rv.. the right to "'''11,. and ...... tran,'e,. InherltlnCl T.... It the lew'ul el.,. . (collltl,.I.) r.t. on MY IUCh 'utur. Int.r..t. PUIIPOSl! Of' NOTICEI To fulfill t~ r,qulr--.ntl of Section 2140 of the J~rltanc. and Est,., T.. Act, Act IZ of .991. 72 P.I. Section lUG. PAVHEHTI Detach the tap portion of this NotlcI Md lutMllt with your PIYHrlt to tr. RegIUI,. of WUh prlntH on tM revlr.. Ila. ...,... cMck or lIOMy order p'v'-'.' tal REGISTER OF MILLS.. AOEHT All PIYMnt. r.cllv.d ~ll fir.' be ~lJ'd to any lnt.,...t which "V b, ~ with eny r...I~r applied to the t... REfUND (CRh , r.fln:t of a t.1C cr.dlt, whiCh w.. not r~..tH on the hx R.turn, "V' ~ r~.ted b~ co.pl,Una an "APPlication 'or R.,und of Penn.ylvanl. Inherltanc. ~ Estat. f.x" (REV-ISISJ. Application. .r. avallabl. .t the D"lc. 0' the Real.tar 0' Will., 8ftW of the Z5 Revenue District D"lc.s, or bw call1na the .peelel Z4-hour ~.werlna ..rvlce ~rs for 'or.. orderlnal In Penn.wlv.nla l~aOD-56Z-Za50, out.ld. Penn.wlvanl. ~ within loc.1 Harrl.burg .r.. (717) 717~1094, fOOt (717) 772-Z25Z (H..rlna I~elrad OnlyJ. DIJECTIDHS. Anw p.rty In Int.r.st not .atl.fled with the appr.I'888ftt, allowanc. or dl..llowanc. of deductIons, or ......-.nt 0' tIX (InclUdIng dl.count or Int.r..tJ .. shown on thla Notlc. .u.t object wIthin 'Ixtw (60) d.w. of rec'lpt of thla NoUc. by. ADttIH ISTAATrY! tDRREtTlDHII --wrItten prot..t to the PA Dlpartaant 0' R,v~e, lo.rd of App..I., D'Pt. Za.OZI, H.rrl.burg, PA 171Z8-1021, OR --elactlon to h.v. the aatt.r dlteralned .t audIt 0' the .ccount of the p.r.on.. r.pr.aant.tlv., OR --app..1 to the Orphan,' Court. DISCDllfT. Factu.l .rrora dl.cov.rld on thl. ......eent .hould be addr"'ed In writing tal PA D,p.rtaant of R.venue, lur.", of Individual Tax.., ATTNI Po.t A......ant Aal/law Unit, D.pt. U0601, tlarrhburg, PA 17121"0601 Phone (717) 787-6505. S.. pIg. 5 of the booklat "In.tructlon. for Inhlrltanc. rax R.turn for. R..ldant Dee.dant" (REV-150IJ 'or an 'lCplanatlon of .~Inlatratll/aly corr.ctabl. .rror.. If Iny talC dua I, paid within thr.. (5J c.landar aonth, aft.r the d,c.dant.. d..th, . flv. p.rcant (SXJ dl.count 0' the tax paid h .Ilowed. INTEREST I Intar..t I. dlarged baglMlng with flr.t daw of dallnquency, or nine (9J aonth. ~ one UJ daw 'rOIl the deta of death, to the d.t. 0' paw-ent. Tax., which bee... delinquent b.for. January 1, 19a2 baar Int.r..t .t the r.ta of .Ix (6%J percent par ~ calcul.tad at . dallv r.t. 0' .000164. All tax.. which bee... delinquent on and a't.r January 1, 19a2 will baar Int.r..t at a rata which will vary frOll calendar v.ar to c.lendar v.ar wIth that rata announced by the PA D.partaant of R.vanul. fhe appllcabl. Int.r..t rat.. 'or 191Z thrOUgh 1995 ar" ~ Intarut Rat. D.llw Int.r..t Feetor ~ Int.r.st Rat. a.lhI Int.r..t FNtor 1~IZ ZOX .010541 1917 9X .000Z47 1915 16X .OOOUI 1911"1"1 1I~ .000SOI I... 1I~ .010501 .99Z 9X .000241 1915 UX .000356 1"1"1994 7~ .00019Z 1.16 ..~ .0IOZ7" 199' .~ .000247 ulnt.r..t II c.lcul.tad .. followsl INTEREST. BALANCE OF TAl( UNPAID l( NUnBn OF DAYS DELINQUENT l( DAILY INTEREST FACTOR --Anw Hotlc. I..ued .ft.r the tax baeo... dllln~t wJl1 r.'I.ct 8M Jnt.r..t c.lcut.tlon to fl,t.an CI5J dlw. b.vond the d.t. of the .......ant. If pay,,"t I. aeda .'t.r the Int.r..t coaput.tJon d.t. .ho,," on the Hotle., addltlona. Int.r..t .u.t b. c.lcul.tad. STATUS REPORT UNDER RULE 6.12 Name of Decedentl Dorothy I. Voris Date of Deathl April 9, 1995 Will No. 21-95-0513 Admin. No. pursuant to Rule 6.12 of the supreme Court OrphanB' Court Rules, I report the following with respect to completion of the administration of the above-captioned estatel 1. State whether administration of the estate iB complete I Yes X No 2. If the answer 1s No, state when the personal representative reasonably believes that the administration will be complete I 3. If the answer to No.1 is Yes, state the followingl a. Did the personal representative file a final account with the Court? Yes No X b. The separate Orphans' Court No. (if any) for the personal representative's account iSI ,".,.j ~"~1' <--.... ~-- . .' t'l ;~j ~ f.i ~l ii-l 'J f c. Did t.he personal representative state an account informally to the parties in interest? Yes X 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. D.'.'~ ~ C~ ~A:;:::r:. Sheely, EQre '" Name (Please type or print) r One W. Main St. Shiremanstown, PA 17011 Address 1,,: " ( 717) 737-8761 Tel. No. ..: ;..;J ')0 personal Representative X counsel for personal representative Capacity: (MAH 1 rmf/ AM3 )