Loading...
HomeMy WebLinkAbout95-00693 , ~, .~ " ..-.' ,'.-. , '\. ~.'; <-, '-y , . ~ .; , ~, '","; ,i". ~ ~,::~,:~ .:':~. ~ -'J; I ,-." ""," ',-- ~t.. I ru ;s INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WiTH REGISTER OF WILLS) REY.1500 fh 11.9.1 l!! ~~t! ..~~ z <> ~ .. <> .. g . Iii iii III .. COMMONW,AUH Of PENNSYLVANIA CEPAI MfNT Of REVENUE om, 210601 H"UISlUIIIO, P... 11 '1.0601 OlelD N 'J AMI LAn, .. . AND MIDOl WAGN ffi EO'JA R. $OCtAL UCUllfY HUMin DAn 0' OIAfH 03/18/95 IHIllAI 183-12-4431 (II ""UU."IIIUIYlYlNO lPOUU'l HAM' IUS!. ,.." AHO"IOOlIIHlIIAq N/A rn 1. Original Relurn o 2. oAa. o 7. oA. IXI 6. limited Eslat. o,c.d,nt Di,d r,,'at. (Allach copy of WillI FOR OATIS OF DUTIl AfTER 12/31/91 CHECK HERE IF A SPOUSAL POVERfT CREDIT IS CLAIMED 0 Fill NUMBER c.9J COUNIY COOE.;1./ YEAR q S- O CfOlt'.' .l.e M'l It. II \ MtA APARTMfNTS 1067-0 ALLfNDALE ROAD M I LRG, PA 17055 NUMBER 09/03/18 Supplemental Rtlur" o 3. Remainder Relu,n ('or dol.. of dealh prior to 12.13.821 05. fld,ral Ellalt Tallt Rtlurn Required --0-8. Tolal Numb.r of Safe O'poIIl Boxe. Ful",r. Inl.r", Compromht (for dolO. of deolh aft.. 12.12.821 D.udenl Maintained allying TruI' (AlIoch copy of TrUll) ~ n CQ.MPU H MAlj'ti . <:80 Ht:, ROAD MECHANICS!lJRG, III Iii .... "z fill! z <> ::: :5 g III .. PA 17055 (II (2 I (31 (A 1 480. 46 (51 (61 7,699.58 (7 ) (9 ) 6,382,70 (101 156,19 ~:);-'} :-' I. Reol E,tal. (Schedule AI 2. Stoch and Band. (Schedule B) 3. ClolOly Held SlocklParlne"hlp Inl"ell(Schedule q A. Mortgage. and Note. Receivable (Schedul. 0) 5. COlh, Bank Oepotlts & Mllcellaneoul P.rlonol Property (Schedufe EI 6. Jointly Owned Properly (Schedule FI 7. Tran,'on (Schedule G) (Schedule II 8. TOlal Grall Anetl (.otollln'l 1.7) 9. Funerol Expen..l, Admlnblralive COlli, Mlscellan,oul hpen... (Schedule HI 10. Oeb.., Mongage lIabilltl.., lien. (Schedule II 11. Tolol Oedudlon. (10'01 lIn.. 9 & 101 12. N.I Value of ellate (line 8 mlnul line 111 13. Charitable and Governmental eequ'I" (Sch.dule JI lA. Net Value Sub eet 10 TalC (line 12 mlnul line lJI 15. Spoulal Tran.f.,. (for dot.. of d.ath oher 6.30.9A) S.. Inltructlons for Ar,pllcable P.rc.ntage on Rever.. (15) Side. (Include valu.. rom Sr.hedule K or Schedule M,I 16. Amounl of line 14 ta.able 016% role (16) 1,641,15 (Include valu.. from Schedule K or Schedule M,) 17. Amount of lIn. IA taxable 01 15% rol. (17) (Include valulI from Schedule K or Schedule M,) 18. Prlnclpolla. due (Add 10. ',om lIn.. IS. 16 and 17,1 19. Credltl Spoulal Poverty Credit Prior Paymenll Dilcounl Inler..1 + + 20. 1I11n. 191. grealer than line 18, enter the dlffer.nce on line 20. This II .he OVERPAYMENT. iii 0 21. II L1n. 18 I, greoler than lIn. 19, enter the dlffer.nce on line 21. ThilII Iho TAX DUE. A. Enler ,he Inl.r.lt on the balance due on line 21A, 8. Ent..,he 10101 a' line 21 and 21A on line 218. Thl,I,'he BALANCE DUE. Male. Checle Pavabte tal Reghter of Will., Ag.nt :BEISURE\,[O:'A'NSWER ALL'.QUESTIONS ON REVERSE SIDE AND TO RECHECK' MATH .~\W;jlrr ';""';''1', Under penalll'l of perjury, I declaro that I have examined Ihis rolurn, Including accompanying Ich.dulel and Ilal.m.nh. and 10 the bill of my ~nowl.dge and b.li.f, It II tru., corred and campl.to. 1 d.c1ar. that all real oltol. has bltn reported at Irue mark.t value, D.c1arotion of pr.parer olh.r Ihan 'he p'rlonal r'pr.lenlativo II based on all Information of w h pre ar.r hal any ~nowl.dg.. IIGN In 0" AS le 'ON 'lY'~'IU G lUUAN AODAU5 DAtf ~ MECHAN I CSBURG , PA 17055 9-/f- Y5' lOTH THA PA (NT"TIV( AOOAU5 P.O. BOX 1331 DAn HARR I SBURG PA 17105 '11.3 /i~ , , (81 ,8,180.04 (11) (121 (131 (14) 6,538.89 1.641.15 1.641.1~ X._II x .06 II 98.47 x .15 II (181 98.47 1191 (20) Chcck IlCrc if you arc ,equesting 0 refund of your'overpoyn1l!nt. ~'-~-~. o. 0 ~ ~\ ~ ._ o~.... 0 -<".J__~At _ _ 98.47 (21) 121A) (2181 98.47 Act '48 of 1994 provide. for the reduction of the tax rate.lmpo.ed on the net value of tran.fen to or for the u.e of the 'pou.e. The rote. a. pre.crlbed by the .tatute will bl! . e 3% (.03) will be applicable for e.tate. of decedent. dying on or after 7/1/94 and before 1/1/96 i "4 'ri>;-'l .' v J '.,'_ '1 "11 ,../1 ':<." '.,. ',-j j 1 "',j ! ',j; '.: i J! ,'q I ! ~~<j : :1 ;'1 {~';-I j 't'?;~J i ',d: ,.,..,~ I' ,':,-- ; :,',',: ~lJ : ;"1 i ':/1! . -, ',I "t:1 " ~I ,'j, ;.,ll e 2% (.02) will be applicable for e.tate. of decedent. dying on or after 1/1/96 and before 1/1/97 e 1% (.01) will be applicable for e.tate. of decedent. dying on or after 1/1/97 and before 1/1/98 e Spou.al tronden occurring on or after 1/1/98 will be exempt from Inheritance tax, PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (....) IN THE APPROPRIATE BLOCKS. 1, Old decedent moke a transfer and: YES NO o. retain the US8 or Income of the property transferred, ....................................................... x b, retain the right to daslgnote who sholl use the property transferred or Its Income, ..........,.... x c. retain a reversIonary interest; or ................................................................................... x X d, receive the promise for life of either payments, benefits or care' ,....,................................. 2, If death occurred on or before December 12, 1982, did decedent within two years preceding death transfer property without receiving adequote conslderotlon' If death occurred ofter December 12, 1982, did detedent tronsfer property within one yeor or death without receiving adequate consideration'................ ................,..... ...... to. ................... to.... ........... ....... ......... X 3, Old decedent own an 'In trust for' bank account at his or har 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. " ' " ~'J. llYolJOlU.P"lI '* SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY Ploo.o Print or l' 0 MBER COMMoNWfALTH Of .ENNSYLVANIA INH.IITANt. rA' mUIN _UIDINT Dle.DINT S1: fE OF En'JA R. WAGNm (All property Iolnt1v-ownld with the Right of Survlvouhlp mu.. 1M dltcf...d on Schedule 'J N~k~ER DESCRIPTION VAWE AT DATE OF DEATH 1. 1980 PONTIAC SUNBIRD 2. BB.L ATlANTIC - CRBlIT BALANCE R8'UND 3. ATICNooIIDE INSURANCE - CANCaLATIOO CRBlIT R8'l.ND 4. MEADCl'vMOOD APARTM~TS - SECUUTY DEFOSIT R8'UND 300.00 2.84 17.00 160.62 S 480.46 (Aflath addlllonal 8W' )( 11" Ihlllllf more Ipoce II n..dld.) UV.UotUt 11211) .. SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWfALJH OF PENNSYlYANIA INHERlTANCf TAX a!YUaN AESIDENT OECrOENT ESTATE OF En-JA R. WAGNm I FILE NUMBER Jolnl 'ononll." NAME A. RooALD L. DEITCH ADDRESS 280 HEISEY ROAD MECHANICSBLRG, PA 17055 RELATIONSHIP TO DECEDENT SOO B, C, Jolntly-ownod proporty. ITEM LmER DATE FOR TOTAL VALUE DECD'S DOLLAR VALUE OF NUMBER JOINT MADE DESCRIPTION OF PROPERTY OF ASSET %INT, DECEDENT'S INTEREST TENANT JOINT 1, A 01178 FARMmS TRUST COMPANY CHECKING ACCOLNT 115-34935 7,428.36 SOX 3,714.18 2. A 10/81 FARMERS TRUST COMPANY CmTIFICATE OF DEPOSIT 11001-A78583-C 3,985.40 SOX 1,992.70 3. A 10/81 FARMmS TRUST COMPANY CmTIFICATE OF DEPOSIT 11001-A 78 582-C 3,985.40 SOX 1,992.70 TOTAL (Aho enler on line 6, Rlcopilulotlon) 5 7,699.58 (If more space is needed insert additional sh..,. 01 some size) . 11'11111".1'''1 . SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES PI.a.. Prlnl or T . (OMMONW(AUH O. PfNNSlIVANIA INHUI1ANCr TAX .UUlN IRUIDENl DlCIDfNT F EIJ,lA R. WAGIIIR ITEM NUMBER A, Funeral Exp.n...: 1. 8, 1. 2. 3. A. C, 1. 2. 3. A. 5. 6. 7. 8. DESCRIPTION AMOUNT HOFFMN-J-ROTH FLNIRAL I-G'IE, INC. WESTMINSTIR CEMETIRY, INC. - GRAVE MARKIR REV. JOI-N A. ILE - MINISTIR FARM hOMENS GROJP - FLNIRAL FOOD DCNATION $ 5,530.20 87.50 150.00 100.00 Admlnl.lrallv. Ca'I': P.rsanal R.presentallve Cammlsslan. Saclal Security Number af Persanal Repr..enlallve, Vear Commlsslan. paid Allarney Fee. Family e.empllan Claimant Address af Claimant at decedent'. dealh Slreet Address City Relallon.hlp Stale Zip Cade Probale Fe.. MI.c.llan.au. Exp.n..., MCKONL Y (; ASBl.RV - ACCOLNTING FEES ClJoIBIRLAND COLNTY REGISTIR OF WILLS - INHIRITANCE TAX FILING FEE 500.00 15.00 TOTAL (AI.a enler an line 9, Recapitulation) I" mare .pac. I. n..d.d, In..rt additional .h..1I of .am. ....,) $ 6,382.70 .--.......--.,. -.01-",,- ,~",,"'-"'_~."'''''h.'"''_''';'''''''''L,>r._..~.~ ~ .'- n-oc::;-C';,;;i~l..~--'::'..''$J~.l;';~''''"''''''---:-'~'-:.'>-:'~' :--. ESTATE OF EDNA R, WAGNER FORK: REV-1n3 EX SCHEDtn.K J. BENIlFIOIARIES ITEK AMOUNT Oil NUMBER NANK AND ADDRESS OF BENBFIOIARY RELATIONSHIP QlARE (p I!SIYt.'IE A, TAXABLE BEQUESTS: 1, RONALD L, DEITOH SON ONE-SIXTH 280 HEISEY ROAD MECHANIOSBURG, PA 17055 2, JACOB R, WAGNER SON ONE-SIXTH 4400 KlLE DRIVE !NOLA, PA 17025 3, REGINA SHUKAKER DAUGHTER ONE-SIXTH 241 WALDORF DRIVE YORK, PA 17404 , 4, JOYCE WILBURN DAUGHTER ONE-SIXTH 2050 S, RIDGE WOOD AVENUE APT, P.8 SOUTH DAYTONA, FL 32019 5, LEE WAGNER SON ONE-SIXTH 5002 TRAPPERS ROAD WILSON, NC 27893 6, DONNA MELLOn DAUGHTER ONE. SIXTH 420 HEISERS LANE CARLISLE, PA 17013 " J I ..:.1 "4 ," "j .j 'I ~\.! , " " ;,~, .'. ../- :t"~:;'~i i,' ", ':" I,::' j'.\. .:"J ., " I ""1 I " " (I , .:( 1'~1 " . . , ,.'., , ~" ,I , , " . .... '!t .-- .... .'.,. :,.._,.jl"";~>'i~" 1"" ,,;,';' , ' , " ';'1 'r.,I'-IJ,.'..... ~,...~ j..;..;,,,,,, ;,~.;d'!oI\~.~i.~,:\,-~t~;o\'J~ ~ \ ,.'',;.lIP~la~ . "-:'.~ . .,.,'1. . " ..', .'~ I ..r...;,-..'.....,. 'I ..~_';::t ":;'~l~"'. ) f'.." .....j. I ,,':i LAST IIlLL AND TESTAMENT ,I .~ " , .' " , I, Edna R. lIagner, of Cumberland C~unty, Pennsylvania, bsing of sound mind and bOdy, haraby revoka my prior wills and declare this to be my will: FIRST: General Bequast: I hereby bequaath 011 of my ostato, reol, porsonal and mixod to my husband, Loe P. Wacner, if he aurvives me by tbirty dnys. Sbould my huaband pradecease mel I give 011 of my estate, reol,personsl and mixsd to my ,'" I r ch Idren, Ronald L. Deitch, Jacob R. lIegner, Rogena 6humeker, l" ((..')J' Joyce Wilburn, Lee~. Wagner end Donna Mellott, shera and 1 "1 sharn alike. ' ,10- 4J-.I'..-f' , IlECOIW: Dioposition of Prope~ty: In order to promote .,.., harmony among my childrsn 1 hers y speoirically direct that All of the property conatltuting my estste be sold at auction in accordance with ths lawo of the Commonwealth of Psnnsylvanie, snd ths procseds thsrefrom be distributed among my children. This provision shall not apply if my husband is my heir. TIIIRD. Appointment: I heraby sppoint my husband as executor of my will. Ilhou1d my husband predeceaas ma, I appoint my two childrsn ao co-exscutors, Jacob R. Wagner and Ronald L, Deitch with the power to do any and all tbings necessary to admInister my astate without bond and without 1eava of court, FOURTH: Protective Provision: No interest in income or principal shall be assignable or aVAilable to any person having a claim agninst a baneficiery before aotua1 payment to the benericiery. FIFTH: Dceth Toxeo: All fedarel, atate snd otber taxes poynb1e becnuae of my denth shall, whather on property paseing under tbis will or otherwise, shnll be paid out of the principal of my eat ate ond none sholl be chorged to any beneficiary or othor fund. EXECUTED thia #dOY Of'~, 1975 fe/II a. ;(. /J,Jcttv,j Edno R. Wagnor In our presenco, the declored it to be he p~cse ce and tbe pre .--- ...- -.- nbove named teatator eigned thie and will and now at her requsst and in her snce of each other, we sign as witnesses: [J.) 1....1 l:.i,j I':. r.,' b" ft, j:'..: .~; ,\;" '::;i ,~~I '~:j' I, ,t ~1 ,; . ! " 'jl ,. /!#r_ /rt'/~.I.IN/> ~ '. "'/. ~ /?-D. f- )/It?-C-U--v' /C>C-"~ =-tt-" ., k'i " -.<'0~~ f(<.-lkC-lA-t "- "~"'-"'~"-~""-"'-- , ~-JI7JlI'l ' ":~ ,"r, ";, ':. "'~:' "',~.,' ','j,;' ':'I~;'1...,pr.41jfl"~J~"'fl'; "', ~(,~i , ''''''',',,' ;";':' "':', ',",";' 'h"',/" '~~t~j,;r.r;,'\"'; ';:iJ/r, "J'; I" :; ~,\,\! "l"~J,,~;'I.,,!:< 1'r.:"'~~~'''~:''';;,:,~!<.f:oJ "...., ",:". ",,11,' ,(" 1,,^I!i.... '''''''~''', :...."1:1:. " , . ';" :'0'''./, 11;l'4~';".:~"'< -; ''-''.~~ H I_I Tlll'i I~ H. I' Ilil) ,h.11 1111 IlllnlllUllllII 11I~lllhp..Il.11 1111 1I11~:1I1.111t1Itlh.114 h,'f{ gl\I'1l '" lllllll II\' I Lll'll'l\ 110m _Ill oli.cm.d n'niliriIlL' III dt'illl,' .dlll)' fill'll \\'1111 \, dill(" I", w.lntllllll lIu' ~I.IH. Vil.1I Ht-\..lIrd~ (Hti~l' fur pL'r1nilIlL'nl flhl1J.l. 1111.'.1-' WARNING: It I. lIIegnlto duplicate this copy by photoatal or photogrsph. Nil 2j..!~~~ ~~~-r:~\...... ~ ... . I.lKal R(.,ltistru;WII\.~ 1"1'1'1111 Ihi\ "'11I11l.1t1'. S/_IH) 2872772 MAR 2 1 1995 D.llt ......".......' COMMONWEALTH 0' PENNSYLYANIA' DEPARTMENT OF HEALTH' VITAL RECORDI CERTIFICATE OF DEATH .. . - - .. It~_ .......'_ra_ot IWI"._. HI IoOClAl.HCLAn_1I ., 183 - 12 - 4431 QlIOl.~ .. . .. ... .. 7~ ,.. h.,.,,,, 01 M s '" ...... .....' Onuphl. ,,_..~.~:::~:1 "=-~..~ -- \/hIt. ...... ..---- ) ""'''''''JlfQ~''._C''''''-''''''c- tlfmdo\iWood AptR. 1067-0 AUe.dllle Rd. u...... PA 0., ,,.Kl-._..... - ~.. c.umhllilUld- ---' ,..0 ~-===tI lOO'....-........f1f___~ "pp"''' Al1"n - .~ . -.- ~_.....o ~ o ._- 1OOt.'-tI ~ Westminster ~ClC.IIIIOOI, - 1995 1\l.....IoHIJNlOfIII..Ol'~'" lIoffmnn"'Roth Funernl lome ,. , ...- -- ~O -10 . J...., . pUln~'" Nl;Ul, I~' : .......Sfi1_~<;,~ 1_- I=-':= . 0-"".........._---.._... ..-.....,.~-.-..""". I , .r-l- , U "'"......~Of . ......Uf""'Ol'l'O ~nlOHOICllIU .-. ~ 0 ~PiI"M' -- ...- .......- (J ~O _0 .... 0 ~-"'..- 0 MI~"""""" _0.._1 '_OI,",^"," _,__, DilKIIoM_""",,"~D .... 0..0 . ~ "" ~/ ... ,- "'""11"1...__ .C'I.,......-""'IItl,.....__...--._"'___.....""'......__"'......_c'""l;__I.. .....-.....,..--..,. ..-__......__"__H_. . .., .. I'\.IoC OI'~,....__..._.-..,.,.. -..... .100:_ - '. -UIlDCI.'.,...a""acull.....__,._...__~__.........._ .......................-..,-.....-,-.-......__......."""'1..__.._ o ...OC.f.L.........IL<OIlOfol... 001......_ ....-....., """_ lItollt/fIl_,'" "".....-, ...'" -.c1Wl" t1lJ\f 1.......11.. _.....,,_""1. IN '.....e.I_ 111--.........."..........".....,..''''. "".. ......"......"......,.........,..............."......".. l\lil~.>oO_t1. ',,,, ~,'\'''''-'''\~Q.>.~''';.;,... Q\ ~~ o .. .. -.......--........ .-.... , 1 ~.ftif~;.i;~;lX;': j. ~"..' CERTIFIED , P 573 933 001 u...,t>"..." .I>u.....u"...u U.S. POSTflGE p,,)P MrcH..\I!og~URG.P" Sl~! Ifl. '95 tjP10LJIH ~. ooop REGISTER OF WILLS C~lBERLAND COUNTY COURTHOUSE CARLISLE PA 17013 t . ".................--.....-^'. i I" . ..J :' '. ,'" {. )0 . . .. ., 'w, . _r.~ 1\ 1"- . .. ;. 'I".; ,...\. , ~. "0. , .J la , ':fo ; , " .' ..._---~ I --- r- '. .., '. "" . ,j J t" '.0 \, -. ~. ~. r . .f .,. r"'"14 .... -. ~. --~. to. - I .1.~ ...,'", ~- , ' , I , , \ '.r .-" ..-.,...... - 'OlD HUl .,- _.. ..- -.-' ... -'~ - - , --- -----~--.~-..,.-------- ---- ---- - ------ -------- - ------: -'.", .-i!'l' ~-;',";:'\,;.~;". . . .'0-,""',,'':;'. . 1, NoA~ "082152 " COMMONWEALTH OF PENNSYLVANIA , " , . DEPARTMENT O. REVENUE ',; , , : .i.".; ~....~ ' ,'; OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX * RECEIVED FROM, & ACN ASSESSMENT P:'I CONTROL i;,I NUMBER AMOUNT RONAI.D I. DEITCH 101 eY6.'+7 eso HEISEY ROAD MECHANICSaURG, PA 170SS ESTATE INFORMATION, !:II filE NUMBER 5i1 el-199S-0693 EJ NAME OF DECEOENT ('MT) II DATE OF PAYMENT m POSTMAR E COUNTY SSN la3-le-4431 (FIRSTI (MI) . OAff OF DEATH REMARKS m TOTAL AMOUNT PAID .9B. 47 ""'" ~f1!.~;44J MARY C. I.E~ REGISTER OF WII.LS RONAI.D I. DEITCH SEAL CHECK" laBS REGISTER OF WILLS j~;;;::...-=Z::~77'"~~'--'-"----------""""':"'::-::-::~7"~',:--:-..7>"'"":::;-7':_=~;:"':'::--::-7"':":'.-:",.-----~;T,~.---:.~ ''', . ...... .', et;' ...~ J :-:. . I '. \' ", ., ' ,., t 'f ..--.' ~..-. 1! -~ ~ -- ~, ~_. I I ...~._. . \ ~._>_..- --.- r - i /5-56-1 REV-1S47 EX AFP (12-95* CDHMOHW(ALTH OF PEHHSYlVAHI. DErAATttEHf or REVENUE BUREAU OF INDIVIDUAL tAXES . DEPr. ZI0601 ItARRU.URa, PA 17lZ'~a601 ACN 101 NOTICE OF INNERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEOUCTIONS ANa ASSESSMENT OF TAX DATE 01-02-96 FILE NO. 03-18-95 COUNTY CUMBERLAND NOTE. TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS FORM WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS. MAKE CHECX PAYABLE TO "REOISTER OF WILLS, AGENT" REMIT PAYMENT TO: RONALD L DEITCH 280 HEISEY RD MECHANICSBURG PA 17055 REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 Altount R..Htad Q) 00 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ iiiiV=is4TEXnAFpnm-':9ifniiiYicE--OF-YtiHEifii'liiici-TAX-iipjiiiiiisEif€ii'r;-ALt"OwliNCini'ru--m--------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF WAGNER EDNA R FILE NO. 21 95-0693 ACN 101 DATE 01-02-96 TAX RETURN WAS I I 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. ISch.dul. Al III 2. stock. and Bond. (Schedul. B) (2) 5. Clo..1>> Hald stock/Partner.hip Intar..t (Schedul. C) (3) 4. Hortg.g../Hot.. R~.lvabl. (Schedula OJ (4) S. C..h/Sank Dapoltt./Hllc. Parlonal Property (Schedule E) (5) 6, JoIntly Ownod Property CSchedule FI 161 7. Trandarl (Schedul. 0) (7)' 8. Total A...t. APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Fun.rat EKpan.../Ada. COlta/Hlle. EKPan... (Schadul. H) (9) 10. Dabta/Hortgag. Liabiliti../Llana (Schedul. I) (10) 11. Tot.l Deduotion. 12. Net Value of Tax Return 15. Charitable/Covern.ental aequ..t. (Schedule J) 14. N.t V.lu. of Eat.t. Subject to rex NOTEI If an assessment wss issued previouslY, 1inss reflect figuras thst include the total of ~ ASSESSMENT OF TAX: 15. A.ount of Line 14 16. A.aunt of Line 14 17, Mount of LI"" 14 18. Principal Tax Du. TAX CREDITS: PAYMENT DATE 09-16-95 I CHANGED .00 .00 .00 ,00 480.46 7,699.5B .00 leI 8,180.04 6,382,70 156.19 Clll 1121 C151 1141 ~.~3R RQ 1,641.15 .00 1, 641.15 14, 15 and~or 16, 17 and 18 will returns assessed to dete. .t Spou..l t.)(able .t t.)(abl. .t rat. Lineal/CI... A r.t. Collateral/CI... a rat. 1151 1161 1171 RECEIPT NUHBER AA082152 DISCOUNT I + I INTEREST C-I ,00 .00 X .00, 1,641.15 X ,06. ,00 X .15. llel .00 98.47 ,00 98.47 AItOUNT PAID 98.47 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST TOTAL DUE · IF PAID AFTER DATE INDICATEO, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST, 90.47 .00 .00 .00 IF TOTAL DUE IS LESS THAN fl, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU HAY BE OUE A REFUND. SEE REVERSE SIDE OF TNIS FOR" FOR INSTRUCTIONS,) POi I 1,\ (i. 0() RESERVATION. Estat.. of elK....... dying on 0,. "for. 1*:..,. 12, 19.2 -- If Wly futura Int.,...t In tM .U.t. Is t""','.rract In po....llon or "Jo~""t to el... . (coU.t,,..U ~flc",.I.. 0' th. d.e""t .ft.,. ..... ..pl,..tlon of .,,~ ..t.t. for 11ft 0,. fo,. y..,.., thl e~.lth he,..by ..pr...ly r'I.,.V.. thl ,.lght to .",..... ~ ...... tranlf.,. Inharltanc. Taxa. at thl lawful Cia I' . (colllt.,.al' ,..t. on any luch futu,.. Int.r..t. PIlRPOsl! IIF NOTltEl To fulfill tha r..,lra.."ts of SecUon ZUD 0' thl InhllrltMC. and E...ts T.x Act, Act zz of 1991. 7Z P.S. S.eUon 2140. PAYHEHT. DltKh thl top portion 0' this MoUc. and IUblIt ..lth YOU" P.~.."t to thl Rlllbtl,. 0' WUb p,.lntld on the revlr.. aide. ._"ak. chick 0,. ltOnIy orde,. p.y.tJII tOI REGISTER OF HILLS, AGENT All PIYNnt. nc.lvld shaU U,..t b. applJad to MY Intarllt .....Ich Ny " due ..Ith Ifty ,....Ind.,. epplJld to tha tlK. A n'~ 0' . t.. c,.ldlt, which .... not raque.tacl on thl Ta. Rlturn, "y 1M- requa.tld by CDtlpI.tlnll ... "Appllc.tlon 'Dr R.,und of Pann.ylvanl. Inha,.ltanc. and Elt.ta T.... (REV-1313), Applicatlonl .,.. .v.llabl. at the O'flc. of the R'.latar 0' NUb, My of th. 13 R,vlnlM Dlst,.lct O"lc.., or by C'Ulnll thei '...chl Z4-hou,. .......rina ..rvlc. ~r. fa,. fa,... o,.da,.lngl In PannlYlvanla 1-'00-361.~050, out.lda Pann.ylvani. and ..I thin loc.l Har,.l.burg .rl, (717) 7.7-1094, TDD. (7t'J 77Z.,ZSZ (H..rlng IlPalred Only). REFLlCD (CR)I OIJECJlDHS. Any plrty In Int.rllt not ..tl.flad ..Ith thl IPPr.I",,"t, allowane. 0,. dl..llowanc. of d.ductlon., Dr ......sent 0' ta. Unclucflna discount or Int.rllt) II lhown on thb Motle. au.t obJ.ct ..lthln .hlh (6OJ d.ws 0' r.c.lpt of this Halle. bYI ADffIH IlTAAJlVE CDRRECTJDHS. .....rlttlM prot'lt to the PA D.p.rt.."t 0' RIVenul, loard 0' App...., D.pt. ~.1O~1, H.r,.hburg, PA 1711'''1021, OR ....I.ctlon to hlVI thl aatt.,. d.t.ralned .t audit a' the account 0' thl p.r.onal raprl.ent.tlv., OR ."lappall to ttM Orphanl' Court. DISCOUNT I Factu.1 .rrorl dlscov.rad on thh ........"t lhould b. IKkfr....d In ..,.ltlng tOI PA O'Plrt..nt a' RIVanu., lur.eu a' IndlvhNI1 Tlx.., ATTHI Pa.t A......flnt Rlvl... Unit, D.pt. 2110601, Harrisburg, PA 171211-0601 Phone (717) 7.7-6505. II. Page 3 a' thl bookl.t "In.t,.uctlon. fa,. Intllrltanel TI. Rltu,.n '0,. . Rllld"'t Olcldant.. (REV-IS01) for In I.planltlan of .daln..trltIVlly corractabl. Irror.. If IMY t.. due II Plld within thra. (5) c.llnd.r 'onth. .U.,. the dlcld.nt'l duth, I fJv. p.,.c."t U:U dllcount 0' the t.. Plld J. .llowed. INTERUT I Int.rllt .. char lid b.glMlna with flrlt d.~ of delinquency, or nine (9) eonthl and ana U) dlY 'rOl the data a' d..th, to the dlt. of pava."t. Te... which bec... dellnqtMnt ba'or. "'snulry I, I'.Z b'l,. Int.rllt It the r.ta of .1. (6~J parcent plr annua c.lculatld .t . d.ll~ rat. 0' .000164. All t.... which bee... delinquent on and 'ftar Janu.ry I, I'.Z ..III blar Int.r..t at a rlt. which ..III vary 'rol c.l.ndar v'lr to c.l.nd.,. y..,. ..ith that ,..tl Innnuncad by the PA DIp.rt.ant of R.venue. Tha appllcabl. Int.r..t rlt.. 'or 1912 throuDh 1996 .r" ~ Int.rlet Ratl O.lly Inh,...t Factor l!!r Int.rllt R.t. Dally Intlr'lt Facto,. 19.2 .OX .000541 1917 OX .000247 191J lOX .00045' 191'.1991 112 .000501 1914 11:( .000301 1992 OX .0ODZ47 1915 UX .000556 1995-1994 'X .00019Z 19'6 lOX .000274 1995aI996 OX .000247 "Int.r..t II cllculltad .. follo"ll INTEREST. BALAHCE OF TAX UNPAID X HUHSER OF DAYS DELIHQUENT X DAILY INTEREST FACTOR ..Any NoUcl l"U'd .ftlr thl t')II b.cCNN, delinquent ..111 r."lct an Intlrl" es1culltlon to flfhlM UU de)'l blYond the d.t. of the ...........t. If p.,."'t h .ade ,Ulr tfMt Int.rllt coeput.Uon d.t. Ihown on the Molles, .dcfltJon.1 Inhred ...,.t bl Cllcul.tld. BUREAU OF INOIVIOUAL TAXES lMilRITAHCE TAX DIVIIIDH DEPT. ra061l HARAISIURO. PA 17121-DlDl V /5<;(, -I COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE XNHERXTANCE TAX STATEMENT OF ACCOUNT v* tn.IIIII.'" 111,'" DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN H ANTHONY ADAMS ESQ 128 EKING ST SHIPPENSBURG PA 17257 07-08-96 8AER 07-22.94 21 94-0693 CUMBERLAND 101 AMount R..itt.d DOROTHY M MAKE CHECK PAYABLE AND REMIT PAYMENT TOI REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 NOTE I To Inaure prop.r cr.dlt to your account, sub.it the upper portion of thl. forM with your t.K pay..nt. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .... iiEii=iliiWiinFp.-nI3:91.-immii..--iilifiliITANC'Ci'iilc-sTATEiiE'IWiiF"-iiccoiJiW-iiiii-mm-mmm-m ESTATE OF BAER DOROTHY M FILE NO. 21 94-0693 ACN 101 DATE 07-08-96 TNIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE, SHOWN BELOW IS A SUNHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT. 06-03-96 PRINCIPAL TAX DUE._ 1.474.20 PAYMENTS (TAX CREDITS). PAYMENT DATE 03-06-96 06-18-96 RECEIPT NUMBER AA112591 AA112951 DISCOUNT (+) INTEREST (-) 116,16- 2.45- AMOUNT PAID 1,495.00 97.81 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN, TOTAL DUE 1.474,20 .00 .00 .00 . IF PAID AFTER THIS OATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. I IF TOTAL DUE IS LESS THAN .1, NO PAYMENT IS REQUIRED. IF TOTAL OUE IS REFLECTED AS A "CREOn" (CRI, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS, I C> 1-,.( C; R ->0. !j N , ,. n.. " \ ~\ 1-: \0 , .) " - ,." =l ,.1 ':; ill '.J " ;::-1 U r,\ ~ ~~ ma:: a; PAYtt[HT I DIItach the top portion of this NoUn and luNit with your p.y..nt ,Mia p.yabll to the n.. INMI Keit... printed on the river.. ,Id., If RESIDENT D[CfDENT ... chick or 10M>>' order p..,able tal RECISTER OF WILLS, AGENT. If NOH-RESIDENT DECEDENT lakl chick or MCMMY order Plylabl. tal COKHONWEALTH OF PENNSYLVANIA. All p.w-~t. received .~11 b, ~lled flr.t to any lnt.r..t which ..y bl due with any t...lnd.,. applied to thl t.x. REFUND (tA)1 A nfWMI of I tllC credit, which .... not r.~.t.d on thl Tax A.turn, ..y bl r~.t.d by cO,,-.IUnll en "Applic.tlon for R,fund of P~'ylYInI. Inherlt~. and Est,t. TIIC" (REV-ISIS), Appllcltlon. It' IVIllabl. It th. OffiCI of the Regllt,r of Willi, en, of the 25 R.venue DJ.trlct Of,lc.. or 'roe the Dlp.rt-.nt'l 24-hour en.~rlng ..tvlel ~t. for for.. ord.rlngl In Pennlylv.nla l-100-'62-20S0, outlida Pennlylvanla ~ within loc.1 Harrisburg .r.. (717) 717-1094, TOOl (717) ~72-2251 lHelrlng 1~.I~ad only). REPLY TOI aulltlonl r.g.rdlng .rrurl cont.ln.d on thl. notlc. lhould b. addr.s.~ tOI PA Dap.rt.ent of R.venut. Bur.au of Indlvldu.1 T...., ATTHI Po.t AII.lleent Revllw unit, Dept. rl0601, Hlrrllburg, PA 17111-0601, phone H17) 717-6505. DISCOUNTI II eny telC dua h paid within thr.. ell c.l.ndar .onthl Ift.r the dlcedant'l d..th. a flv. parc."t C5X) dhcount of the t.. plld I' allow.d. PENALTY I T~ 15X te. Mnllty non.p.rtlclpltlon plnl1ty Is cOllpUt,d on thl totll of thl tlW: and lntera.t .....I.d, and not plld b.for. Janulry la, 1996, the flrlt dlY Iftlr the Ind of tha taw: a~'lty plrlod. INTEREST I Interllt Is chargld baglMlng with flrlt dlY of delinquency, or nln. (9) eonthl and on. (l) d.y froa tha d.t. of dllth, to the dltl 0' paye.nt. TI.II which bac... dlllnquent b.fora Janulry 1, 1912 b.ar lnt.rllt It the r.t. of 11M C6in perclnt par IMV"UlIl ulcuhhd .t I d.lly r.t. of .000164. All t.... which blc... dallnquent on and aftar Janulry 1, l,a2 ..Ill b..r lnt.rllt It . rat. which will vlry fro. cllend.r Vllr to cal.ndlr V'lr with th.t r.t. IMCK.W1c.d bv tM PA D.part..nt of A.\/lN\UI. The appllcabll Interllt ret.. far 1911 through 1996 ar'l YI., Int.r'lt Alt. DIIlv Intlrllt Factor Yaar Intlrllt Aatl DillY Intlrllt f~tor 1912 ZOX .ooo~a I'" 'X .000247 1915 lOX .00auI 1"1-1991 U;,c .GOOSOI I." IIX .0003n 1992 'X .000241 1915 UX .00OSS6 19'1S-1994 7X .000192 1916 lOX .000274 1995-1996 OX .000241 "-Interllt Is cllcullt.d II folloWl1 INTEREST . BALAXCE OF TAX UXPAIO X NUNBER OF DAYS DELIXQUENT X DAILY INTEREST FACTOR .-Any Hotlcl Illued I,t.r thl t.. baeDleI dlllnquent will r.'llct ~ Intlt'lt cllculatlon to ,l,tlan CIS) d.ya beyond thl dltl 0' thl ........"t. 11 PIVIlant Is allda Ifter the Inbr..t COlPutltlon data lhown on the Notlu, addltlonll Intarllt ...,It bl calculltad.