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HomeMy WebLinkAbout95-00518 , PETITION nm PIWIIA TE "nd GltANT OF LETTERS t:.IIII.. OfJ)/JIr~~15__.-r1"'llb____ Nu. __Q;1-=_'7S-51 ~ "/HI kl/OIl'1/ u.\' __.____... Tu: .--..--.....----- Regi,ler nr wm'M'PERtil ......_._. IJ""",,),'d, Cllllllll' nr cu u NO in Ihe Sod,,1 Sr<'llrilY No,/2'i..~ - rfo-J. 0 Y- Conllnunwellllh ur Penllsylvllllill The I'elilioll of Ihe u",lerslgued re'I'eclfully rel'r,',elll' Ihlll: Your Ileliliuller(,). who i,/ure I H l'ellr, uf uge ur ulder IIl1lhe execulJfi.5 inlhe 111" will uf Ihe ahuve dec,'delll. dilled ---5!:.:::~- ~ (p I """ codidl('l dilled nllmed ,19_ t~III1~' ,..-It'\1l1l1 dh:lllll~IlIlI~'t'\, t',it. fl'lllllldallull. tit'illh (II """'..-lIlul, clC.) I>ecelldelll WII, dumiciled III delll h in G..eua . h~ ~',fllllllll' oHrilldpal re,idellce IIIIJF~.f- ...t:::4..J::.k ."-_/:J1._L7."" ~ (h~1 'IIt't". flllmhl" i11111 1II1111r.'iflilli1U COUII~ PennsYI~ia, wilh ~re~..:s=:7'::7:J. IIL/' v-e I>eeendenl.lhell "'"'/ l'ea"ufllge.died {, -,;I P ,19,R,t- , lII__/:I.~m': , EXcel'III' folluws, deeedelll did nOlmurr)', WIIS 11111 tlivorccd IInd did "'II hllve II child born or adopted affer execuliou of Ihe willllffered 'or proh:lle; WII' nOlthe vlclim of a killillg and was never adjudicaled incolllllclcm: Deceudeullll demh owued properl)' wilh e,'hl1llled vlllues liS follow,: (II' domiciled ill I'll,) All pClSoulI1properll' (If nOI domiciled in I'll,) I'ersonnl properl)' in I'enmylvllllin (If lIot domiciled in I'll.) I'ersonlllproperl)' in Countl' Vuhu.. ul' renl \,'Mntc in PCIII1S)'IVUlllu silmlled 'IS follows: s .;) (), 7>Pl.C).":;-0 S S S WHEREFORE. peliliollerlsl respeclfulll' reqfEgfAM~NT){~V"le of Ihe last will and codicil(s) 11Ie'ellled herewilh alld Ihe gralll or lellers Ihclun. t1t'\!i1ll1C,'IIIIUY: lulmini\Unlhlll c.I,II.; admlnlmntlon d,h,n.c.l.a,} , " iJ '0- l"' o:~ E'E ;f. ,,= ~ ~ ;; " :;; ~ U".3;). . .~_._ . .. .~_?/!;,j_20l.3_. ~!l~ 3~~~--. .. !-~.~ i/- t~ -I-~~ f7~!{' /'.nAtl'4:rltv OATH OF PERSONAL ImPRESENTATIVE COMMONWEALTII OF I'ENNSYLV ANIA } 'S COlJNn' OF CUMBERLAND IS SW~1fn In (~r nlTirmcd Hnd Tflh\crihc(~ helme me thts -iliY----.il.- dllS 01 --w1-4-~ 7)],;' h'.ll.9 - ./..l/atI.,tJ..;, r=~.'kJ . 15- 4 3 ~AJo ru. LEWIS 1l"Jii.\It'r The pelil;ollerl,) lIhllve.nllmed ,weurl') or IIffirml') Ihal Ihe SllIlemellls illlhe foregoing pethlon arc true ,md coneetlo Ihe heS! of Ihe kllowledge 1I11d helieI' of pethiollerls) ulld Ihlll as persollal represell. lluivcl') of Ihe IIhove decedelll Ilelilioner(s) will wellund trul)' IIdmilliSler the esuue lIecordillg to IlIw. ~~ I'l 00' " ., ~ B: " !c,,,\;";":;:.-i~-j:;;Y.f';'''''~:;J-~.,;,h:,-Xo.;-.;H>' ------7) , No. 21 - 95 - 518 Eslalc of DORA B. SWARTZ , Deccascd DECREE OF PROIIA TE AND GRANT OF LETTERS AND NOW JUL Y 10, 19..2L, in eonslderntlon orthe petition on the reverse side hereor, sntlsraelorl' proal' hnving been presenled berore me, IT IS DECREED thai the Instrul1Iellt(s) dnled AUGUST 5 , 1961 described therein be admilted to probnle and nled or record as Ihe Inst will or DORA B. SWARTZ TESTAMENTARY DOROTHY L. SHATTO, LEWIS E. SWARTZ and RICHARD H. SWARTZ and Lellers arc hereby granted to FEES Probate, Lellers, Etc, ""..... S Short Certlficates(2 ) """.,., S R5~~nclatlon .."""",..,., S S TOTAL _ S 71.00 Filed ........ JUlY. ,10".. 1995 ...... .. . .. 717CL1tr [:. '&11,,:0 fl'A.fJm. Oftr{lr.. Real.tor of Will. (fo MARY C. LEWIS 60.00 6.00 A1TORNEY tSup, Ct. I.D, No,) 5.00 ADDRESS PHONE ,...... t~"'" -- I:J C.> ...~~ ~o: ~ , m ", -~ :. <:.1'': ; m~ Lr\ I .. , , ~ ,-, .., '. 0 '." .n u m ~ .; E IDa: Ui::J a: UU Called Richard H. Swartz on 7-11-95. , HI Thb j, III l'L'nil)' thilt lhe il1(lIll11,llioll 11t'1l' ';1\1'11 l~ lllllnd)' luplnl hum .111 lIri1-:ill.l1 Il'llilk.lIl'1I1 lIt;!II,',!hll)' 1iI1'" with lilt' il!rl l.ot:.tllh'gl'Hlilr, TIll' Ildgiu.11 (nlili, ,lie' will Ill.' 1l1lW.lldl'll IIllhl' SI;lh' Vil.1! Hn.'llIlh Olliu' 1m pC.'nll;\lIl'lll 1I1111J.!. WARNING: Ills lIIegolto duplicllto this copy by photostat or photograph, Fcc tor Ihb Cl'rtirk.1W, $1.00 r:J _l.:.l..\"- ('~!.,..Q,S?-l:~~-=i~~~\- . LUl':l1 Hl.'giMnlr 2997512 -----.- N.;:--..------ _-=~Do~ .a\<:::\-\'"S- ~li1e "IMt..,~...tf COMMONWEALTH OF PENUSVLVANIA' D!PARTMIENT OF HEALTH' VITAL RECORDS CERTIFICATE OF OEATH . Dorn 8. Swnrtz \II<<lI.IOM' I. to . HP'L.IoC'~_ _ .. ~Oo.~ "...'.....ea,.lI Hnr,I7,1911 Cumberlond co,r '~"'''''''''ll 1OCIA4 MeuM' HWIIIl ,174 -20 -9204 DtoIICIf AI"~I>>o--S .June 29, 1995 ~. No" ",..., t:.-, D ~ " ._. -. IIbno '" .......-- ,. ~ 0\ Cumberland N. Hlddleton Twp . - 1 ....._.___ . r*...,......-.........., , Homemarker OCt4<<... "..~,,"iO"ClOIlt..I1i'_ (..O~'- ....1"'''-. 183A Sterrett~ Gap Avr.~ " c"r1191e. PA 17013 'IQ'IOC...,......"......,.. ~",l narry Cornmnn "'''''T .......'i ~lchord II. Swartz 'h,C .. - M.' CumberlnnL-.......... ".O::"'~'::: lIIOl"I",.Io.U.tI!"._"'_""- "..m...._...... . N. Hiddlfl!tnn -. ~ ..___",..0 ~ PI' r.vuM" 008102 L Idn Ensminger v~.. Carlisle I PA 17013 iOI'f. Ie. . . Hiddleton Twp, . .. .. 1,.1\;11 o .......II"'..'.___...,,~_."J1,._._""",......... ,"""".......,'I"t' tJ.' '-P..l...... 1'. j.J~...... ,'" lit"" 'j"_. ,_, /:5<.> P. <O/o>~I'iS 'II .."...._............I~__"_......,'" _......IlII_"'.,....Ml\.~I.._......._'......_I.......,...... ~......-_...._.... 3Z"'U" ::'0 L 'is ... Iollln'_' ,., -- I-~ ,.;:S ....-...--..........-.... .................~-.........,..,.'I \: DIJIftltv'lI'.CrJ"~I~,ll<tIVI W'III..U ,,'<IfQIOIQ _,...."'..Ollftl COU""ll~ Of C.uu 01 Ol.'M' "''''''NfIlOlOl.''' OolJIOlIHJUIII' _.Ot-r_1 ,~, ....., WAil., 1IfI()fl. " "*-tIOWlItJVfl, .... ~.. '}<t o 1:1 ~-~ '---.........'.... o o r]~ IItJUfl""'_"'..!"'''' ~_"'''-'1l _ 0 "",0 ~- .... 0 ""f'i' ,.. I" tf"...'"f!..........._ .tfill.'"_"""lCl.,.'........._t....o"'\Il....,,__.....'...~...._...P_t't...._t<P-'_UI ,......,tI..'~...-.........II...__.....II_.'_.._...--',... ...... ........ ....... ............. ~,o ~p.a, ""$ c-...."'"..._ u ...-. ....IDIC"L.."..,"ll'lICOIlOHIIl Of\.,........"'.."""'....,.....,..""...lt.II....lll..'......IoIl...II1l...""ldttlll.Il/Ol4...1.....,.,.....II'4l"".,.1Ile......l.l.... ...~_.....IM".".....................,....,.,......".....,......,...",.....,.............................. , l::l,\ ,';:1,,,:::.1 .. .. ."lIIOMOUlOCtttO.OOOC.iII'''''_''"'..ICIA.ftI'''-....'............o<~__UON......_IlI-. ,...._....,.-w,..___..._"'...._._._,....,_........._.,_.._.._ ~:~~;-:~~~^:.:~~~~~~~~~~~~~~.c~:~~.~.~,:,~~~~~~l:~-. ~',- .~~~::, =~i:~.~~:~,,~"~;~~;i.- 21 - 95 - 518 , . , ~ ; I I , J I , . , , r- -~ , ',~, ., ~~ :. /.:~~~ ",:;&.ttl "-'. ;'-;I!~I ;. " ;.'~~ .~~N'~' .:!~ :;-.~,;, . ,~::'1 , .. LAST WILL AND TESTAMENT 1, DORA n. SWARTZ, of North Middleton Township, Cumber- land County, Pennsylvania, being of sound and disposing mind and memory, do hereby malte, publish and declare this to be my Last Will and Testament, hereby revoking any and all former Wills or Codicils by me made. 1. 1 give, devise and bequeath all of my estate, both real and personal, unto my husband, Lewis A. swartz, absolutely, and 1 hereby appoint my said husband as Executor of this my Last Will and Testament. 2. In the event that my said husband shall predecease or fall to survive me, then 1 give, devise and bequeath all of my estate, both real and personal, in the following manner: A. 1 give, devise and bequeath all the rest, residue and remainder of my estate, In equal shares unto my children, Dorothy L. Shatto, Lewis E. Swartz and Richard H. swartz, absolutely and I direct that any advancements made by me to any of my children, ac- cording to my records, shall be Included In said es- tate and deducted from the share of my said child In the estate. B. I hereby appoint Dorothy L. Shatto, Lewis E. Swartz and Richard H. Swartz as Executors of this my Last Will and Testament. IN WITNESS WHEREOF, 1 have hereunto .afflxed my hand and seal this 5th. day of August, 1961. l1?^l1SDlJlvL g~ (SEAL) . Dora B. Swartz WILLIAM F. MARTSON ATTOIlHIVA,LAW CAftLlILl, I'A. ,. t,: WILUAM F, MARTSON :!.;~- ,<~tfG""1Y ~T LAW_. ~:~20~\~~~;~:1;;~;;?;' ~r~/~:::::lV' .''); ~'~Jr~1 },:t . , ,'i' "~-I :. '_'~"";: ,_ .r;]. {;sr~;:-r j'. tt;;~:'f,!~j~~\1{'..~ ?~~?f.;.:-?!;:f;'> ". 'T .H ,..,;:_t;"" .'. {;-::\~.?J{:,:' ~.'J'. ~~ ';X~;!~ ~;\t<~~J.';>i' f - '. '. ; i,. ~-' "'-, .. Signed, sealed, published and declared by the above named Testatrix, Dora B. Swartz, as and for her Last Will and Testa- ment, In the presence of us, who have hereunto subscribed uur " .~. iJ.. ~4 .-: ".," '.'/1.' -\I' 'i' '.',. f-' o '-. i;~;;;:lgl~;~~:li~rl,~0~~~~~~€;~~t~;\:;;i'~~i~i!:~~~~;~~J~r~J~S~::t ~. ' ,,', .- " ,-', '. i , ....~ ,,~ ,,:;, ...."'1, ,v;:~ ~f~'~ ,.. .,u ,--~ l~ 21 - 95 - 518 REGISTER OF WILLS OF COUNTY OATH OF SUBSCRIBING WITNESS -"~.- (each) a subscribing witness to the law, depose(s) and say(s) that ~- codlcil_/~~ wlll.,presented herewltt1.(each) being duly qualified according to . '. " present and saw ~_.... ".... ..- .. the testal , sign the lame and that......... signed as a witness at the ~ ...... request of testa I In ~ presence and (in the presen~Of each other) (In the presence of the other subserl~lng wltness(cs)), " / Sworn-(o or affirmed and subscribed before me this ~ day or (Name) ':~ r.1 ~Q<C 19_ .., - - !:"..J (Address) LrI I ;;;! -, Reglsler (Name) , .., ~ UJI.: -=> UU (Address) 8 :Ii' IDa: a: l!') r>' REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF NON-SUBSCRIBING WITNESS ./,--r- r r::.. t, UJ ...r/ fI' Sun i" f:>-.. ).CL<..JI_~ 2. StAhl.;"( ~ (each) a subscriber hereto. (each) being duly qualified according ).f? law, depose(s) and say(s) that ,,'\. n ~ 0 familiar with the signature or ~l^"'. B IS''' ~ ..1. , cMl4:ll.. ...." testa~ or (one of the subscribing witnesses to) the will presented herewith and x..u-II, that ),~ believes the signature on the will Is In the handwriting of <;0 b-4- I?, , ~ u -. -:\.~ to the best of fM.J. A - knowledge and'ttllef, /J J L Sworn to or affirmed and subscribed before y;sy!..Jl",.,tJ/. ~ ,tl ,me this 1~~Y ~~~...~ ~~) ~. O../.'.t/~ J>,., /?,o~ ~~1~ L(J;tW(~/lp .~::~~~;C h ;r;:::45 (Name) $""....)<':S~. k../u ~ tal....j.>) A( a.z.r/ z-- (Address) ._. "'-0 _ .......~ _. ._'.. , [' -'-.-- --,--- -- - ------ -. --- - - -- - - - - -.- -- -. --- _. - - - -- -- ---- --- - --' \ . \ " e..""" . _ . 'D' "". A""I.'048092 COMMONWEALtH OF PENNSYLVANIA 'W: NO. ft. DEPARTMENT OF REVENUE I '''~I;'' """; OFFIClALRECEIPT . PENNSYLVANIA INHERITANCE AND ESTATETAX ;, ,., ' I J I RECEIVED FROM, FJ ACN ASSESSMENT I!' CONTROL iii NUMBER AMOUNT RICHARD H 6WARTZ 183e STERRETTS GAP AVE 101 .1.e29.6~ CARLISLE PA 17013 - 'OtD HUt ESTATE INFORMATION, 1:1 FilE NUMBER U el-199~-0~18 EJ NAME OF OECEOENT (lAST) II DATE OF PAYMENT EJ POSTMAR COUNTY SSN 174-20-8e04 (FIRST) (Mil OATE OF 0 A H RICHARD H SWARTZ m TOTAL AMOUNT PAID *' ,1'1'9."'!'l REMARKS SEAL CHECK II 11 REGISTER OF WILLS MARY C. LEWI REGISTER OF WILLS I I ----,-.---:-:-~~,~."":"":'"',~'-~-~ -.-- a__ -----------.- --.~T':"'_-- --::'7 r;- . ..,.;...,. -~'" , '- / ,,' '" . i .: ..-~. -~ ... '",,--.'-'- . ---._-~.~~. t..- oJ ~.--. ! ' \ l' -. ..- .--._-, (!oJ(v 15-'/3.-/0 '!V.''''!I+ 1'''1 ~ fOA DATIS Of DIATH A"IR 12/31/91 CHICK HIAI '~iA'9 INHERITANCE TAX RETURN ~o~::~l~:~DIT IS CLAIMID 0 ,. ~ RESIDENT DECEDENT fill NUMIIA 9~~ (/ COMMONW!A"HQf'INNmVAN,A (TO BE FILED IN DUPLICATE." S/t!J DIPAIIMENt or UVINUI L."",,/ H..",fJ:~. ~~nl,,_. on WIT~ REGISTER OF WILLS) COUNTY CODE YEAR NUMBER Df N' AM IIA ,fIU.ANDMIDOIINIIAlj OIClDIN"COMPLIIIAODltBiBi "1::i / ....D #vJr- /,f-.J,'1 S-r..r..eT J "..~/. '''' '(/I!J./':s'~ ,p,4.. 17""3 l!! "':S12 bile", "'li!9 "'S'" o 4. L1mlled Estale 0 "a. Futur. Int.r.st Compromise (for dat.s of death after 12.12.02) 06. DeCldenl Died teslole 0 7. Oec.denl Maintained 0 L1...lng Trusl (Attach copy of Will) (Allach copy of Trusl) ~LL CORRISPONDENCI AND CONFIDINnAL TAX INFORMAnON SHOULD BE DIRECTED TO. / (OMPUIE MAllIN ADOIlU /, 011 ref / ,?.3).- '{;'T T: ... H "/T:L EUPHONt: HUMin :z..-.. ... , PI1- 15 III bI " - 1. Original Relurn o 2. lil15 oc" OCz B~ z " 5 ! oc 1, Real Ella'e (Schedule A) 2. S'Dck. and Bond. (Schedule B) 3. Clollly Held Slack/Partnership Int.,est (Schedul. C) ... Mortgages and Notes Recel...able 1Schedule 0) 5. Cosh, Bonk Deposlls & MhClllaneous p.,sonal Property (Schedule EI 6. Jaln.ly Owned PrDpe"y (5,hedure f) 7. T,a,,'e..(Schedule G) (Schedule l) 8. Total Gran Aue" (Iotolllnes 1.71 9. Fun.,al bpens.., Admlnlstrollve Cas.., Mlsc.llan.ou. bp.n..' (Sch.dul. HI 10, Debit. MDr'gage lIabillllll. lie.. (Schedule I) 11. Talal DeduellDno ('alalllm 9 & 10) 12. N.I Valu. of eslot. (lIn. 8 minus Un. 111 13. Charltabl. and Go...ernm.ntal B.qu.." ISchedule J) 1.4. N., Valu. Sub.et to Tax (Un. 12 minus Un. 13 15. Spousal Transf.,. (for dol.. of d.olh afl., 6.30.9..) Set In"ruc1lon. for Appllcabl. p.,cenlog. on R.....,.. Sid.. (Includ. valu.. from Sch.dul. K or Sch.dul. M.) 16. Amount of Un. 1.4 taxabl. at 6% rol. (Includ. volu.. from Sch.dul. K or Sch.dul. M.) 17. Amount of Un. 1.. laxabl. 01 15% rol. (Includ. volu.. from Schedul. K or Sch.dul. M.) 18. Prlnclpol talt du.(Add lalt from Un.. IS, 16 and 17.) 19. Credill Spousal Pa....rty Credll Prior Parm.nll z ~ ~ . B ~ - 03, 05. R.malnder R.turn (lor dale. 01 dea,h prior 1012.13.82) F.d.,ol eUol. TOJll R,'urn R.qulred _ 8. Totol Numb., 0' Soft D.poslt Box.. (1) .<./., Nr (2) --11.,.1,., (3) tI" ,1<- (A) A'_ II c (5)...J1'" 'f .r-: .7 t, . (1)) ";,A/' (7) --11-" ",/.' (9) (101 ,fJ,\ -'/. of"' :>.... ;y",t';k + + 20. If L1n. 19 I. greoler than L1n. 18, .nter ,h. dIH.,.nc. on L1n. 20. Thl." the OVERPAYMENT. 1iJ0 21. If L1n. 181s great., than L1n. 19, .nl., the dIH.,.nc. on L1n. 21. Thl.1t Ih. TAX DUE. A. Enler Ih. Inl.,..1 on the balance due on L1n. 21 A. B, En'er Ihe 10'01 allln. 21 and 21A an Line 21 B, Thl. I. Ihe BALANCE DUE, Mob Ch.de Payabl. tal R.gllter a. Will., Ag.n' 'fIM :' .'.i81 1II.'fC)"ANSWER'ALL'QUISTlONION'RIVIUUIDI'ANDTO R 1ClC; Under p.naltl.. a' p"lury, I d.c1ore Iholl ho.... examln.d thll relurn, Including accompanying sch.dul.. and Ital.m.nl., and to the b..t of my knowl.dge and b.llef 11 " 'ru., correc1 and compl.'e. I d.c1ore that 011 real .1I0le hot betn reporl.er at Iru. morlt.1 volu.. D.c1aratlon of prepor., oth., than Ih. p.nonol repr...ntallv. Ii b on olllnfor atlon of which pre orer has on knowl.dg.. tON fU 'PI.. iHJNitl fOI"IlN WIN ADOIIU__ DAtl_/.._/ _ 7, 1_ C ",y" <" 'X/f.'/t?5, AOOlUBi DXiI / (151 (16) (17) I/lr)h .J c' ,'I 'I '/. I ~/ x .06 . X.__ - x .15 . Dhcounl Inl.,.sl CllI'dl: IIl'Il' II you (III' "'llul...tinq n Il..fund of your oVl:!rpuynwnl. (21) (21A) (21B) ~r.~.,; '.:,~~~'- ~.~; "~.,-:(:.!,"t: '~,::i.:~.. (;..."',P. ,Au'C= I (g) ~~Jyr.?"'J (11) (121 (131 (141 ,{l..CU ,po 2- :)(9 ..../-.;'/. / ~I - I I -- {} / I~:l-(.I...,~ (18) (19) (20) -- I~.). 9.t:.-.!> I') ~Q.v..\.- ... Act '48 of 1994 provld.. for the r.ductlon of the lax ral.. Impo..d on the n.t valu. of trand.,. to or for the u.. of the 'POUI.. Th. rat.. a. pr..crlb.d by the .Ialul. will b.l . 3% 1,03) will b. appllcabl. for ..101.. of d.c.d.nl. dying on or aft.r 7/1/94 and b.for. 1/1/96 . 2% 1.02) will b. appllcabl. for ..101.. of d.c.d.nll dying on or aft.r 1/1/96 and b.for. 1/1/97 . 1 % 1.01) will b. appllcabl. for ..Iat.. of d.c.d.nll dying on or aft.r 1/1/97 and b.for. 1/1/98 . Spou.al trand.,. occurring on or aft.r 1/1/98 will b. ex.mpl from Inh.rllanc. tax. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (,,) IN THE APPROPRIATE BLOCKS. 1. Old decedent moke a transfer and: a. retain the ule or Income of the properly transferred, ............,......................,..............,.... b. retain the right to designate who shall use the properly transferred or Its Income, ........,...... c. retain a reversionary Interest; or ................................................................................... d, receive the promise for life of either poyments, benefits or care' ..,......................,..,.......... 2. If death occurr!,~ on 9r. pefore December 12, 1982, did decedent within two years preceding death' t,~ansfer', properly;:wlthout receiving adequate consideration' If death occurred after December 12, :~982, did decedent transfer properly within one year of death without receiving adequate conslderation9.;........ .... ................. ....... It......... ....... ..... ............... ..... ........f. ...... 10 t;(} I 3, Old decedent ~~n an 'In trust for' bank account 01 his or her death'....,................................. YES NO ./ <./ ~ , ~~ u' 1(\ .~-: a: lF TlU AflIMVER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. IlIVUIIII.I'II, . " ITEM NUMBER A. . SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES CQMMONWfAUH Of PfNNSYl\lANIA INUfRllANCf tAX RUURN RUIDfNI DfCfDfNr Pllall Print ar Typl NUMBER DESCRIPTION Funeral Explnlll' 1. tl..ff'M"'/ ~uTh r-::.',...,,,-;L! rI..n7-':"":;/J.. "H7"4 INI,/'/ /eTiiY r/l?6. Co ,.."-rev",,,'Nt',d.. N .., 11'1",# t.. c.,......J ,"J Ie. j!11c::......DI-/tI /.... ..('e~v /,,"'- Ii""'1..u,'I[ I tf...#<'1 ~r"M'C- "T /I Tj;..' oS r; ,v/I ,./ II- ,-" ;;:: ')t~ c 1/ lo~..s #~ 77 ~ -e B. Admlnlltratlvl COlt.. 4, C, 1. 2. 3. 4, 5, 6, 7, 8, 1, Personal ReprelenlallYe Commllllonl Social securlly Number af Pellanal Reprelonlallve' Year Com million I paid )./ tn<l c:. - . 2, tlo lie Atlo'ney fee. 3. family e.ompllan Claim anI Add,o.. af Claim anI at docodonl'l doalh sl,eot Add,o.. Rolallan.hlp Clly Zip Code Slale Probale fee. Mllclllanloul Explnll" , . / IJ l' ,I)..L ~ I ~ "n / ~ p, -- __ ',/ 0,</ t: 'Ie p..>< /N)"') pi? SJ({J;"J,.:-4 r-u-/~ / jJ, , '/ .. / I- pA.. -;;/c...j' h "He-. ~/ /. .J,." T... 'Y " ;-rh 'f\, CO" J./~ Ie S'v./....lo-)",J! ~V't:..v,..' ~~..- TOTAL (AlIa enlo, on IIno 9, Rocapllulallon) (If marl apacI II n..dld, Inll" additional ahol" of aaml 1111,) AMOUNT ;;.. f., rs. . ,:>-0 -.. UO ,J.J, ~ . ~.5'. ~ '-17 ~ Y I {) 7.~~r '/J-era 7.00 '1?,crO 5 'Z-- IlIv.UU ,.. IUrJ . W COMMONWEAltH O. "NN'nVANIA INHII"A"CI fAl .nUIN IUIDINfD.ClOINf SCHEDULE J BENEFICIARIES .. ESTATE OF FILE NUMBER ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE OF ESTATE A. Taxabl. B.qu,,'" I. Jc,-, ~ ~ E" S-;)l../3 P. f) ). (HI X'D .sw~ t:/": A....J.Cl. /<:( S -r Fit.. 3;l,N":l-. 50/0.( /3 1(, c-h It).. ,.. J tI. ~W,l- r-r;.... Sc:>~ j{ )... .5 -r; r rc,.-r7J G-~f /J c.J r: I.f- J> J- C,a"" /';.1 /.~ ?,A.. / 7" / !:> 3 po ~o-rh1 J.,.. .s f/ fJ TfO 0. ~rf,.~... 1 / c../-,,Q..HN-e..t. Di?/v c:.. .3 c p ,.. j. ;.s I r: ) Iii- 170/3 ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY AMOUNT OR SHARE OF ESTATE B. Charllabl. and Gov.rnmenlal Beque.tll I. TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (AI,o "n'"r on IInl 13, RlcopUulollon' S (II mar. .pact I, n..d.d, Inllrt addlllonal ,h..ts al .am. ,II') , -." ......,,--....,;..;..;'._~.."._....,..~ - ~ CERTIFICATION OF NOTICE UNDER RULE 5.6Ia) Name of Decedent I -p, II' iI. &-;-9- Date of Death, B , ,S';&'J ~ -,-;:- c?.s- Will No. l~fJ'-'-f)()_C/~ Aclmin. No. ;).. I 9..r ~ n .C-/ P-- To the Registerl I certify that notice of beneficial interest required by RUle 5.6(a) of the Orphans' Court ~ules was served on or mailed to the f~1c;;~~enef~ciaries of the above-captioned estate on ~ Address J....;J /3. ,.)',p, ;:/~ .....'V, F .,.t./../ .5( tJRIH"'Oo '''"1- 3 >;f/L Do..o,hi 'I..ft,..-r'1i3 I r_/..Jlvo<.'oel D~/vf! r.u"/',J'h<.. ~ l/o!'lI'J ' Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date, '0'~~~- /'~4q/t..de . _-d ~e ~ Name/?tu,tl,.cll!. ,-fwid-;/i- . Address I.f'),l- c::r.;.....J'7r ;;"""'p JlItl"P " C.4" /",(\ /.,. A / 7CJ I'J Telephone It, '7) ;) t/ ? t,. .n;'. ~ CapacitY:~sonal Representative Counsel for personal representative <a t-:c:( '10.. I.., , lS ifl - .. a -- ,~: ' .J <::t N !;;'5 LC ., ,] . . ':; 110; a:: ~ .'-~ 'C:.: u8 " . Y' .J_O- NOTICE OF BENEFICIAL INTEREST IN ESTATE BEFORE THE REGISTER OF WILLS, COUNTY OF C'", rn n In re Estate of Do'?,'+- {3 ' ..S'u......" ;:/., - , PENNSYLVANIA , deceased, No. of ,. () -r-- .J.l,~- TOI And'S 13. ~;'H,"'/J-- o~-;J.'1J E .A~L'I.s:/,j,;"","";;J..(beneficiary) j).'/-o.Jlh-{ ., t, 6/-/ 0 (otl./ C/wh'r'L i).;v.' C"j/~ I" MI"-'J)(address) ;:1l_.t.... ~d ~.Gv'J/~T'-0"'J' s.,;;"....n:; 1.-; Ave' ,"." ..i.1 t'~ /?W~) Please take notice ot the death of decedent and the grant of letters to the personal representative(s) named below. You may have a beneficial interest in the estate as follows I o 1-1 to;; ," I :~ I (.0 P 19,1 /.if we "". t1 P. /:2.!>' I d 1<:, (if additional space is needed, use back of page) Name of decedent ~Do R J) 8 . SlA../tl ;:;;:' /J v or' Last known address J.~-".~-I of decedent (~ 1- L,'oJ f,ot. r/,J. , ~" I 7M3 .51:. ,. .. ,<,-:(7:, Date of death (p -;). 9 . 'P,} Place of death 1.1 " ,..,7 (' - County of grant of original letters (:", ...., 3r-~ /.. ,,/ Decedent died t,/Jf/9~' testate intestate. A copy of the will ____ is is not attached. Name(s), address(es) and telephone number(s) of all personal representatives appointed f. ",,<..VI J Ti . . nDr oThi R,d?. rc/ s:.vIJ.;:/ ,=- -.ft " T70 SIA/.J 1'1:-- Address ~ Telephone _ ~ :>,r/ >- .;.: '-'07- J.771j117J .~-::l'1J ,-;:. kA- /<'( S r {II' j, ," ~ P;" I 0 I' ,. L a ..1 'f.J'7-J-U'1 / CI1dW.JN n"....t- (../"J.tJ ~ /0001$ Irr~ I- S '{...- y. c::TlJ {.T:J /) j} v~. , J' 1 i? / 7"-'>/.3 ';'Yf_iJ>.,!,'"c,,'L- C"",, IJ '- / ,,-. Name ~ ," I - . ~~---' , Name(s), address(es) and telephone number(S) of all counsel Telephone Name Address ;{o t-(~ Additional information Date ~/~"(flJ'- J I may be obtained from rJ/"Jer'f/ffed. () . ..i1-- Signatur~~ Name f,G.J.;J ,../ t!:;. ,- r:;:, M~ 72- Address l.l"':~). ~ _e ",yo '" T7i (".,1) Au ~ , , , (?.tl'" J.1.sf r" p,.. /70/ J TelePhon(.7(~ :J.<I 9- td7.,... 'Z..-. capacity I personal Representative Counsel for personal representative -0'-.- , ( .'.-;;1-': , i i . , .f, ~ t\ .- ~~> -'\i/ . 1" f i.,',' "'.',', ,k,' ,', ~l-"_ ~- ;r !~> l~: ' '..') C1:J'.. - .. 0" cr: oc:r' '1'1, .~ . ''C~ " ,":>0.;, . f"M_'_-..,, 1-- . ":0 ;I;r,). . ;,-'1 -;."~~"- .' '. \f): .,.0 ~a , . . ... --~ .'-, ',. o.~ '.... "- 1.:-.. " ~:.~ 0-..1) U_tV wO:: 0:: :'t '19. ." , " j, -O'-~'~._'t{ ;-,'(. .:.~ .', " 'n ,_ " .. , . .,,= ~ f 00 t:!'(. - 'c . , "'0.: fq c:> U i ~ .,., .:-'"-; ~ >, t.;i. " ,1(..)' ~ .~ '.. ,j N ,~ 6Il' .'\ -,-! "to) ~.' <ii ~1' ,~:l '_:,j;) t.." ~~I ~' - to: "'0. OJ:> 0: - UU .,' I I ,.. ! i ~ ~ . . Ft\Rf\U:ll.S Tlll!Sr ~-- / .;,J.. IlJ:'''~ ~ (.~: $,.;!Sl) ,.i ;! f,'-I' .' ..."..c1L.,.) hft,;//. h_ ... /,./i~:'" DOI,LAHS :1 FOR Ctftt i......~~A.(: .~f:./(.2.A.~L.. V ";'.",01 tnt' !l~,:.J~"f\.J/-.:.. I _~..~.f~:,,,, {(~~f/(...{L:7'" .~.L:k,u:.// ",},,//{. J' J" -I' I I It- ~; ,'~~r'J'- ...'L4:','" _,' ,. '. - ~ . 1:0 J ~ 30 l, ? WI: II' ~ 2'" b 28 '1011' -, ;;.,".000002 ~,OOO", PAY TO THE L-_.._.... ...~'" ...'" .. '" "'... - ... . "'...'" ....... ...... ,N~ I~ ...::> ~-. N I to- .... to- cc c.. u.. o ffi ..... - :z :::I W In ::> .. o ~ ffi~ i: ~ S! -'::> '" .; ,l(~o", 0. =' 2:::>> c <0 .. >-1Il .. ZUI . we> .- "'''' "''' ::>J: UU .. ww.. ;:)1.1 . Oz :l: >-:3 !:i ~aI ~ 8 'I' ~ III >- Z w ::I >- III ::> a '" ...-' ..s 00 I~ NW j~ 0'" .,0 I~ ...- z ::> .. .. III 0 N >-w ' ffi2: 2 ::IW ,.u "'w ..'" .u. !i!o >- iii::> uQ M- u.~ u.lD 0-' " U1C UI iii' Z'" M- U1'" ::>ll; Ill'" .. ~t3 N oe> .. ~~ N ",:r ..u .. .. . ... (I).".", WNr- l!l ~ '" cI: :z: u ... z W ~ ~ ::l U g\ . ... \ ;... ,--... ~r' ", ~ --. . . \'. C'"'" -- w " '" .. .. :;; >- u. o " u '" co ~ Q w " Z ;: z 8 >- '" < :t -. 5 III '" W H '" '" < U (l)CC 0 ...~~ c Z ' W ~ III ::J ., Q < .. ... ",II. we> HQ 1t~1- "'...... It:: I- U::>< UI -' .. I- o I- ~ ~ a " " " . < " '. .. , ,. " j.... ;6 '.~ .,u '" .t" "'- U " " => '" ~ ~ .. :; a '. U! I ~o ... :: ~ ,~ -, 'u '" ~ u .c on .. " .. ~ x U -- ...:..,-: u. ,.- N~ - 'w .~ 04""", IU ~_ .... .-. .-. "'~ - ,- ,- - (; ;:; ~ ~ " "' 0; '0 1" " ~ \/\ OJ'" :. - '.- ~ I:,.' I.., . I"" ;~ w ... (to !6 "'I ij it!: --, 'a I~ ~ ~ Illg - I iZ I ~ - " ~) \' ~ . .... ( ". ',. ," " . ',', Nu .' M' M' '" ~ ._1_ U. ..g ~ I .... ';tl 51 I~je! l~:~ i l:v: 'I~ .~ ,.. 1.lO) ~ I :u.:a .~ I'" :: l~l~ ';5 .. I...... , .~ lOr. .., i'~ ".-, ..,. \",j~ ~: !\lII~' n u. ~ " - I~I~:: '" f 1~~ I j~~ ll~l'" ~1 W l:I& ~ -:;;~:: ~ DP.lI;J t_ '-l rn_ g~~ ., " .. ~~ .. '. .' .., ::: n. ~.; " IO~ ..'- ," " .,~ k !IJ-- };:'~ ,', ...... ., ;r~ 0:: ~3~ _-~ ; tj ~ ,< .-~.;.'.-' .',' oq. ~~; ~ N. hQ -~- ~h - __F t:,> ..,.i "?_-~j-,- , 'I '\ i;-~ ri,- <; !!l <DC; 0:' -~ d'- , I- ,/ 15 - Y 3 _It) C/ REV"1547 EX AFP 112"941* CO~AlTH OF PENNSYLVANIA DEPARTMENT OF REytHUE BUREAU Of INDIVIDUAL 'AXEl MPf. ZlO6U HARRISBURG, PA 171tl.0601 NOTICE OF INNERITANCE TAX APPRAISEHENT, ALLOWANCE OR OISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX ACN 101 DATE 10-02-95 FILE NO. 06-29"95 COUNTY CUMBERLAND NOTE. TO INSURE PROPER CREDIT TO YOUR ACCOUNT. SUBHIT TNE UPPER PDRTION OF TNIS FORH WITH YOUR TAX PAYHENT TO TNE REGISTER OF WILLS, HAXE CNECX PAYABLE TO "REGISTER OF WILLS. ACE NT" REMIT PAYMENT TO: RICHARD H SWARTZ 1832 STERRETTS GAP AVE CARLISLE PA 17013 REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 A.ount H..Ht.d CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ iiE'v= Hi4'i " Ex"iiFi.-"nZ-:94Y"Nci'ficEno"-YNHEiiifANci!-TAi niPPRiiisEHiNr-;-iiL'i."oiiANCi!"ijii-_mn_-"mn-- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SWARTZ DORA B FILE NO. 21 95-0518 ACN 101 DATE 10-02-95 TAX RETURN WAS. I X I ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN 1. R..l Eat.t. (Sch.dul. AJ (1) 2. Stock. and BondI (Schedule 8) (2) 5. Clo..ly Hald stock/Partnership Int.,...t (Schedul. C) (5) 4. "arta.D../Not.. Raceivable (Schedula OJ (4) S. C..h/Bank Depoaita/Hi.c. Pa,.lon.l Proparty (Schedul. EJ IS) 6. Jointly Owned Property (Schedule fJ (6) 7. Tranl1a,.1 C Schedule 0) (7) IS. Total Au.t. I CHANGED .00 ,00 ,00 ,00 21.348.96 ,00 ,00 IBI 21.348,96 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funa,.al E~p.n.../Ad.. Co.t./H1Ic. E.p.n... ISch.dule H) (9) 10. Debt./Hortgage Liabilitie./Lien. ISchedule I) (10) 11. Total Deduction_ 12. Net Value of Ta. Raturn 1S. Charit.ble/GovarnMantal Baqu..ta (Schedula J) 14. Nat Valua of E.tata Subjaot to TaM 854,82 .00 1111 1121 1151 114) R~4 R? 20,494.14 ,00 20,494,14 If an assessment wes issued previouslY, linos reflect figures that include the total of ~ ASSESSHENT OF TAX: 15. A~ount of Line 14 .t Spou..l rat. (15) 16. Amount of Line 14 taMable .t Linaal/Cla.. A rata (16) 17. A.ount of Line 14 ta.able .t Coll.taral/Cl... B rata (17) 18. Principal Ta. Due 14, 15 and/or 16, 17 and 18 will returns assessed to date. NOTEI ,00 X .00. 20.494,14 X ,06. .00 X ,15. I1B) ,00 1.229,65 .00 1.229,65 TAX CREDITS I PAYHENT DATE 08-08-95 RECEIPT NUHBER AA048092 DISCOUNT (+ I INTEREST I-I 61. 48 AHDUNT PAID 1.229.65 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST TOTAL DUE 1.291.13 61,48CR ,00 61,48CR . IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATIDN OF ADDITIONAL INTEREST, IF TOTAL DUE IS LESS THAN .1, NO PAYHENT IS REQUIRED, IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND, SEE OF THIS FDRH FOR INSTRUCTIONS,) no t'il :0 c: -, :J l'i' :;:'n r:~. R -l I b '. '-OJ W <? ,. ~u ' C. :P-' O:l RESERVATIONt Elt.t.. of dlc.dent. dying on or befar. D.c.~.r 12, .9S2 .- If any future lntat..t In thl ,,'at. I, ttln.fatred In po.....lon or en'oy..nt to el... . (colll'lral) blnaflel.r." of thl dlCldlnt .,t.r thl Ixplratlon of eny I...t. for 11'. or for y..t., thl Co.-onw..lth hlt.by ..pr..ilv t...tV.' thl right to appral.. and ...... tran,'.r Inherltencl T.... at thl lawful el..' . (colll,.ral) tat. on any auch future Intlr.,t. PURPOSE OF MOUCEt To 'ulflll thl rlqult...ntl of Slctlon 21~a of thl InhlrltlnCl and E,tatl ,.. Act, act zt of ."1. 72 P.I. sectlon 2140. O.tlch the top portion of thl, Hotlel end ,ub.lt with your ply..nt to t~ Rlglttlt of Willi prlntad on the r.v.r'l .lda. ..Hakl chuk or IIOMY order plyebll tal REGISTER OF MILLS I AGENT All p.y.ent. r.celvld .hall flr.t b. .ppll.d to any Int.r..t which .ty b. ~ with any r...lndtr BPPllld to the tlM. A r.fund of . tax crldlt, which wt. not r.qu.tt.d on the T.x Raturn, ..y b. r.qu..t.d by co.pl.tlna en "Application for Rafund of penn.ylvanll Inherltlnca and E.t.t. T.x" (REY.1S1S). Appllcttlon. .r. .vallabl. at the Offlca of the Ragl.tlr of Will., any of the 2] R.v.nua DI.trlct Offlc'" or by c.lllng the .p.elll 2~~hour In.w.rlna .arvlce nuabar. for for.' ord.rlngl In P.nn,Ylvanla l-laa-S6Z.2aSa, out.ld. Pann.ylvanl. and within local H.rrl.burg .r.. (717) 717.la9~, TOOl (717) 772-Z252 (H..rlng laptlrad Only). Any p.rty In lnt.r..t not .Itl.fled with the .ppr.I....nt, allowanc' or dl..llowlne. of d.ductlon., or ........nt of t.x (Including dl.count or Int.r..t) .. .hown on thl. Notlca .u.t obJ.ct within .Ixty (60) d.y. of rlc.lpt of thlt Notlc. bya ..wrltt.n prot..t to the PA Dlparte.nt of Ravlnu', Board of Appl.I., a.pt. ZllaZI, HarrlabUrg, PA 17IZI-1021, OR ...I.ctlon to have the .att.r dttareln.d .t audit of the account of the ptr.on.1 rtprt..ntatlv., OR ..app..l to the Orphan.' Court. PAYKENTI REfUND (CR) a OBJECTIONS 1 AD"IH ISTRATlYE CORRECTIONS I INTEREST' F.ctual .rror. dl.cov.r.d on thl. ........nt .hould b. .ddr....d In writing tal PA D.p.rt..nt of R.vlnue, BureaU of Individual 'a)C'" ATTNI po.t A.......nt R.vllw Unit, Dlpt. 280601. Il.rrhburg, PA 1712.-0601 Phon' (117) 7.7-6S0S. S.. paga ] of thl bookl.t "In.truetlon. for Inh.rltenc. T.)C R.turn for a Ra,ld.nt o.c.dant" (REY.1S01) for en .)Cplanatlon of .dalnl.tratlv.lY corractlbll .rror.. If any tax due I. paid within thr.a (]) c.landar eonth. .ft.r tha d.e.d.nt". d.ath, . flva parc.nt (SX) dl.count of tha tax p.ld I. allow.d. Jnt.r..t I. chargld blglnnlng with flr.t day of dallnquancy, or nln. (91 lonth. and on. (1) day fro. tha d.ta of d..th, to thl d.t. of paya.nt. ,.)CI. which baca.. d.llnquent b.for. Janu.ry 1, 19'Z b..r Int.r..t .t the rat. of .1. (6X) p.rc.nt p.r ennua calculat.d at . d.lly rata of .00016'. All t.... which bae"1 dallnqu.nt on ~ .ft.r January 1, 1912 will b..r Int.r..t .t a r.t. which will vary 'ro' cal.ndar y.ar to c.lendar y..r with that r.t. announcad by tha PA Depart..nt of R.v.nu.. Tha appllc.bla Int.r..t rata. for 198Z through 1995 ar'l ~ Inter..t Rat. Dally Int.r..t F.ctor ~ Intarast Rata Dally Int.r.st Factor 191Z ... ,OODS". 1987 OX .0002"7 1915 16X .000". 191."1991 llX .OD0501 198' 11;( .000101 199Z OX .aoozu 1915 lSX .000556 199]-19" 7' .00019Z 1986 10;( .00027' 1995 OX .aOOZU ..In"rllt II c.lcul.t.d .. folloWII DISCOUNT' INTEREST D BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY Ih~EREST FACTOR ..Any Kotlc. l..u.d .,t.r thl t.. b.eo... d.llnquent will r.fl.ct an Int.r..t c.lculatlon to flft..n CIS) day. b.yond the d.t. of the .......ant. If paye.nt I. ..d. .ft.r thl Intar..t coaputatlan d.ta .hawn on the Notlc., addltlon.1 lntar..t au.t b. c.lcul.t.d. t/' ;5 ~'-/3.~ 10 INHERITANCE TAX STATEMENT OF ACCOUNT DATI! 12-18-95 RI!V-1607 I!X AFP (12-95* COHMQNWULTH Of PENNSYLVANIA DEP,UTHEHT CW RfVEHUE aURfAU Of INDIVIDUAL TAXEI DfPr. lI060. HARRJSIURO, PA 171'1.0601 ACN 101 SWARTZ DORA B FILl! NO. 21 95-0518 DATI! OF DEATH 06-29-95 COUNTY CUMBERLAND HOTEl TO INSURE PROPER CREOIT TO YOUR ACCOUNT, SUBHIT THE UPPER PORTION OF THIS FORN WITH YOUR TAX PAVNENT TO THE ADDRESS SHOIIN. NAKE CHECK PAYABLE AND RENIT PAYHENT TD I , RICHARD H SWARTZ 1832 STERRETTS GAP AVE CARLISLE PA 17013 REGISTER DF WILLS CUMBERLAND CO COURT HDUSE CARLISLE, PA 17013 AIoou\t R..ittH CUT ALONO THIS LINI! ~ RETAIN LOWER PORTION FOR YOUR FILI!S .... iii::v:iliiii"iif"AP'P--iiz=9Sr-----..ii-iNii€iii'fA'Nci'"fiiif-STAfiiiE-rif-ii"-iiifcciriiff--iiliir--------m--------- I!STATI! OF SWARTZ DORA B FILl! NO.21 95-0518 ACN 101 THIS STATEHENT IS PROVIDED TD ADVISE OF THE CURRENT STATUS DF THE STATED ACN IN THE NAIlED ESTATE. SHOWN BELDW IS A SUHNARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYNENTS, THE CURRENT BALANCE. AND. IF APPLICABLE. A PROJECTED INTEREST FIGURE. DATI! 12-18-95 DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT, 09-25-95 PRINCIPAL TAX DUE.. 1,229,65 PAYMENTS CTAX CREDITS), PAYMENT DATE 08-08-95 12-04-95 RECEIPT NUMBER AA048092 REFUND DISCOUNT C+) INTEREST Co) 61. 48 ,00 AMDUNT PAID 1,229.65 61.48- TOTAL TAX CREDIT BALANCI! OF TAX DUE INTEREST TOTAL DUI! 1,229.65 .00 .00 ,00 · IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST, I IF TOTAL DUE IS LESS THAN .1, NO PAVNENT IS REQUIRED. IF TDTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORK FOR INSTRUCTIONS. I t./ () t", r..::. .: PI \:.' ~~-~ ~r, PAYltEHT. DIIttteh the top pa..Uon of tha. NoUc. .... ....It ..Ith your ,.~t ... ,.v.bla to the "... .. ........ prlntMl on the rew.... .1.. ..- If RUIDDfT D(CGOff ..... cMck or 1ICIne. order ,.)'IlIbla tOI REOISTER 0' WILLS, AGENT. -- If _-AUIIl€HT Dt:CEIlEHT _. __ .. _ ..... _I. t.. C_EALlH OF I'E_VLVAHIA. All ,.~b recelvMl ....U be eppUMI flr.t to -w Intar..t which -v be due with MY r_I"'r ...11... to the tax. REFUND Catll A r.fund of a tax credSt, which .... not r.....ted on the 1M Raturn, ... be r.....tlld by CDIIIPhU". .. -AppllcaUon for R.hnt of PennQ'IVWIII Inhlrlt.nc. INt E...ta 1u- CREV-1SIS). ,",UaUon. .r. ..,.Uebl. .t the OffIce of the Rlal.t.r of WIll., ..v of the Z3 R~ DI.trlct OffIce. or froe ~ Deperteent'. 2.-hour ......rl". ..rvlce hUIlbIn for fa,... ordllrlnsu In P"'QIVMI. l-loa";I62-2050, DUbl. P......,lv.,.. INt withIn lDOll HarrIsburg .r.. (717) 1.1-.094, TDD. (717) 172-Z15Z (~rlnl I.,.lred onlv). REPLY Tat DurllUon. r...retlna .rron cont.IMCI on thll noUe. Ihould " Mldr..... tOt PA a.plrbMlnt of A..,.,.., au....., of tndlvlduel Tu.., ATTNI po.t A....llent -.vl.w Unit, Dept. Z.O'OI, Herrllburg, PA 17121-0601, ~ (117) 1.1"65a5. If MY tax due II plld within thr.. (5) e.l..... .....th. .ft.r tM decedent.. ..th, . ftve peirClint 15%) dhcount of the tax p.ld 1. .Ilowed. , I ., DISCOtJrfTI IHTEMITI In......t II cherpd bellmlna ..1th flr.t d.. of dIIUnquwtCV, or nine (9) .onth. ..t .,.. (1) chi, frOWl the dIIt. of ....th, to the date of p.~t. T.x.. which beceM delinquent before JWMlrlt I, 1912 ....r In"r..t .t tn. r.t. of 0" C'X) percent per ....... e.lcul.ted .t . dlUv rat. 0' .000164. All t.... whIch Me... .lInquent on Ilnd .ft.r Januarlt 1, 1"2 ..Ill be.r Int.r..t at . r.t. which ..Ill v.r. froe c.lendar ..... to c.lendlr v..r ..Ith thet rat. ~ed bv the PA "Dep.rt.."t 0' R.venue. The appl1cebl. lnt.r..t r.t.. for 1"1 through 1'" .r'l V... Intlr..t Alt. a.ll. Int.r..t faotor V... Int.r..t R.t. D.lhI Int.r..t 'IIOtor 1912 ZDX .aaa541 19'7 'X .OOal47 1913 UX .OODUI 1'11-1991 IlX .aOOSOl 1914 IlX .001501 1'" OX .011247 I... 11% .000S56 I"S-l"" n .001192 1916 lOX .IOU14 1"5-1996 .X .000247 --Int.....t I. calculated .1 'ol1Oti1I1 IIlTEIEIIT . BALANCE OF TAll UNPAID X HVK8ER OF OAVB DELINQUENT X DAILY IIlTEIEIIT FACTOR ....Anll' Notlc. hlUild .ftlr the tu Me.... .11".."t ..111 ...n"t en Int.r..t e.lcul.Uon to ,1ft... (5) _. beyond the date of the ........,t. If PIVHnt h .... .ftlr the Int.relt COIlpUt.tJon dat. ....., on the Notice, additional Intlr..t .u.t be cllcul.ted. "."""""'''~-p-.,.~~.."