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PETITION nm PIWBATE IInd (;nANT OF i.ETTEnS
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named
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ilttcr l'\,.,:fo.'UIHHl Ullhl' \'.ill olf"n.:tl fHr J1fOhme; "01\ 110t thc \'il,'lil11 of a killing nnll wus nc\'cr udjudicntcd
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(II' ""midle" III 1'01.) All 1"'''''''''\ p"'pert!
(If nnt dOIllh:ill'd ill Pil.) PCI'llHHlI property ill Pcnll\yl\'ania
(II JWI domkikd ill !'iI.1 P~r"lnal proJlcrlY in County
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OATil OF J>EI~SONAL Iml>lmSENTATIVE
l'O:\JMO:--;WE:\LTIl OF PENNSYLVANIA I H>l
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rhl' 1'L:!Il1t;Ill'It...) ilbll\l"lIllllll'd ..,\\l';l1(\) Of aHil"ml\) Ihat the ~latCIl1L'I1t\ in the foreguing pClillon ure
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S\\\1111 . II' 01 aflill1wd :1!1l1 ...::h'lcrihcd I
heton.' Ii"" 1111" lst_ dai nf
Novemlr.>r I" 95
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Nt) 21-95-826
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Estate of Dorothy F. Miller a/k/a Dorothy G. Miller . Deceased
DECREE OF PROnATE AND GRANT OF LETTERS
AND NOW Novcrnber 3rd 19~L. In ~on,iderotlon of Ihe petition on
the reyerse side hereof. ,otl,foctor)' 1'1001' hu\'illg been presented before me,
IT IS DECREEllthllt Ihe il1llrllmcl1l(') dllled__, August 9,1967
described Iherein be IIdmhteJ 10 prohllle IInd filed of rccord "' the 1051 will of --_._-
tbrothy F. Miller, a/k/a Dorothy G. Miller _______
olld lellers Testamen tary
ore hereby grmlled 10 Marion M. SWatt, a/k/a.~Arion Miller Swatt
C);ltlJ'!J:c' 4~, /,.!2,1/;"-I ,1;tI-<L
Rt,I\ICf or Will~ . I
MatY c.Lewin
FEES
Probole. lellers, Ele. ...,.,.,.
Short Certlficotes(2 ) ,.. , . . .. . ,
Renunciation ."..........,..
x-Pages (2)
JCP
$ 18.00
S_6~D!L
S
S 6.00
TOTAL _ S 5.00
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ATfORNE\'ISup, Cr. I,\), No,}
"1l11RESS
Filed
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Mailed letters and order on November 6th,1995. .
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LAST WILL AND TBS1'AMENT
OF
DOHOTHY F. MILum
KNOW ALL MEN BY THESE PHESENTS That 1, DOROTHY F.
MILLER.
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of TI'ucksvillc, l<ingston Township, Luzcrue County, Pennsylvania,:
I
being of sound and disposing mind and memory, do hereby make. constitute
and declare this, as and for my Last Will and Testament, hereby revoking
any and all Wills and Codicils to Wills by me heretofol'e made,
ITEM I: I direct my Executor. hereinafter named, to pay all
my just debts and funeral expenses as soon after my death as may be
practicable,
ITEM 11: In the event my husband, DONALD A. MILLER,
survive me, 1 give, devise and bequeath all of my estate, real, pCl'sonal
and /01' mixed, of whntsoovP.l' kind and wheresocvcr situate, to him and his
heh's forever.
ITEM 111: In the event Ulat both my said husband and myself
shall die under circumstances in which it cannot be ascCl'tained which of us
shall have died first, I direct that it shall be conclusively pl'esumed that he
survived me, and I direct that my estate shall be administel'ed in accordance
with the provisions of his Last Will and Testament.
ITEM IV: In the event, however, that my said husband shall
not survive me, then and in that event, I give, devise and bequeath all of my
said estate, real, personal and '01' mixed, of whatsoever kind and whercsoevc
situate, to my daughter, MAHlON MILLI.:n SWATT. or FulI:; Church.
Virginia, to her and her heh's forever
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ITgM V: In the event that. neJtlwl' my Raid hushnnd nOl' my said
daughter llhnll have sUl'vived me. then and in that event I give. devlRe and
bequeath my Hald uHtate to my Hun-in-law, KENNI~TIl ANDIU~W SWATT. In
trust, neverthelesll. to administul' the Hame fOl' the llupport. maintenance,
care and education of my two grandchlldl'en, MAHI< STEPHEN SWATT and
JULIE LYNN SWAT'I", in uquul shul'ell, dUl'ing the pl!l'iod of thelt. minority.
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i! My suid Tl'ustee shall have fulluulhOl'ity to e:-'lJend both principal and income.
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in his dlllcreUon fOl' and on behalf of my suld grandchildren for the purposes
ahove set fOl'th. My suid Trustee llhall huve full power to sell. mortgage.
lealle, or otherwise dispose of hoth personal und I'ual pl'operty constituting
all 01' uny pal't of my estate. M~' suid Tl'ustee shall fm.ther have power to
invest und re-invest the same in his discretion without heing restricted to
investments uuthorized hy the luws of Pennsylvania 01' uny other state,
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hereby appoint my said Trustee us Testamentary Guurdian of my said grand-
children during till! period of theil' minority.
ITEM VI: As each of my said grandchildren shall attuin the age
II of twenty-one (21) yeurs, my snid 'l'I'ustee shall pay over to such grandchild.
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or to his OJ' hel' lawful issue, his 01' her I'especlive shal'e of any unexpended
prlncipul and intel'est then in his hunds.
ITEM VIl: In thu event that eithul' of my suid grandchlldl'un
shall have died priOl' to attaining thu age of twenty-one (21) years, without
leaving lawful issue. tlll!n and in that event the share of such child shall be
administered by said Trustee for the benefit of the survivor thereof and shall
be payahle to such survivor upon his OJ' her I'eaching the age of twenty-one
(21) years,
i'
- 2-
REGISTER OF WILLS OF COUNTY
OATH OF sUnSCRIIUNG WITNESS
~----
codicil
(each) a subscribing witness tn Ihe will presenled herewilh, (each) being duly quullfled uccordlng to
law, depose(s) und say(s) Ihul presenl and saw
Ihe lestul , sign the sume Ilnd thul signed us u witness ut lhe
request of teslUI_ in II- presence Ilnd (In Ihe presence of euch other) (in Ihe presence of the
olher subseriblng wltness(es)).
Sworn to or uffirmed und subscribed before
me this dllY of
19_
(Name)
(Address)
Register
(Name)
(Address)
REGISTER OF WILLS OF cunberlan~ COUNTY
OATH OF NON-SUBSCRIBING WITNESS
::Ju../ic.: /,.-r1~()r"p5()r. MAH <:::;"S'l,JA-n-
(each) a subscriber herelo, teaeh) being duly qualified Ilccordlng 10 lull', depose(s) and say(s) that
Thev are famillur wllh Ihe slgnalUre of Dorothy F. Miller, a/k/ <!
Dorothy G. Miller oeoIieiI
leslalate.- of (one of Ihe subscribing witnesses to) the 11'\11
Ihat
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presenled herewllh and
eetIleII-
believer Ihe slgnalure on the 11'\11 is In the handwriting of
Dorothy F, Miller a/k/a Dorothy G. Miller
10 lhe best of Their knowledge and belief. J 1
Sworn to or uffirmed and <ubseribed before r:/,' /. ;
me Ihls ..1 ,.J _ day of '
c:.\.._ll.JD1 ' ____ I~ ,}107 (.)
~C.cfiJw",,'~P1LJ.,1t1..... Jf1A;
,Mnr.y C. LeWis 'Register
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(Name)
(n\i('(IJ.rq l,lf1c (;X)/r.., PA !'10rJS
(Auaress)
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/ (Name)
V"~,of!."1I ~~;!es:,) CAi\1? ~/"<-L- n 17011
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CERTIFICATION OF NOTICE UNDER RUI.E 5.6 ( a)
Name of Decedent: --UC'I"('\\, 'I (.,- 11'\, II t' 1-
Date of Death: lC'jl' ~, I '-I. /11 c;
Will No. I t\~S _(''co S'::J. I.., Admin. No. (l(. S :?_ (r
To the Register:
I certify that notice of beneficial interest required by
Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to
the following beneficiaries of the above-captioned estate on
Name
Address
I'1IJA'~ 10 /1 J1.1
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C A \'\1 -p ,,-J, /I ,
SHI4.,T
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PA- / 7(j II
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except
Date: 1;;)- 1:5 - 'f5
"-rn (\.ru..l"CIA. YH :~ , \. 1",,8-
Signature
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Name YV\ 4 P. Inn YVI ,') I..UA T/
Address 2\-/ U'C~()l'.IA. 'AI" ....,
( A )/1.( r ).J, II , (J A- I '1 (1 ~ I
Telephone (717)
7 ,3 .:t - & I .:J.. l/-
Capacity: t---Personal Representative
Counsel for personal
representative
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NOTICE OF BENEFICIAL INTEREST IN ESTATE
BEFORE THE REGISTER OF WILLS, COUNTY OF ( "".,h. r In "cl , PENNSYLVANIA
In re Estate of J)rI' rTI.\'/ (- tI" L (r l:' , deceased,
No. R;)I" of 1'1 '1.;
TOI /1104 Kif II' dl (-~' l7
.) lll..Jof
:':)./ U/C ~,' R I'" U,IA'I
C'An'I?'iJ,II, 0,.. /1011
please take notice of 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
(benefic iary)
(address)
1'y"" r' () "\ rtt ". II II rl-
(if additional apace is needed, use back of page)
Name of decedent-\:)cl.!r1 \," r:..~ iIJ1"U<'I-
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Last known address ~,:. I \ l,( t('rel A \'\.' A 'I (' A'" P f..-\ I \ I, P,4- 1"1 () 1 J
of decedent 1)" () I' t \, '/ ('.:,. 1'\1. I I/" "
Date of death (\. r I- I ~I 1(1'1 S
,
Place of death :') I \ I" ,\ ,'~ , (\. \.\ I" " ( "tl.1\1 fJ 14 I 1/ /)4-
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County of grant of original letters C" 1\\ \11 \' \ (I. I, cI
Decedent died
V" testat.A
intestate.
A copy of the will
is
is not attached.
Name(S), address(es) and telephone number(s) of all personal
representatives appointed
Name
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Address
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Telephone
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Name(s), address(es) and telephone number(s) of all counsel
Name Address
Telephone
Additional information may be obtained from
Date /.-;; -;5". 1S Signature
the undersigned.
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NameJ1J1., 1,-,(.1\1 /1'1 3W4-TT
Address .) I U 1 r +(1Q IA LUA '/
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C f) )H ,") I j . II PA- I 70 (I
Telephone
7.3~ -Ie (:J..<-/
Capacity: ~ Personal Representative
Counsel for personal
representative
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fOR OAn50f OfAIH AnlR I2/J 1/9 \ CHECK HERE
INHERITANCE TAX RETURN ~cf'vm!,u~:tolT 15 CLAIMED" I I
RESIDENT DECEDENT fiLE HUMIER . ------
(OMMONWIAIlHOfP'NN"'V"'" (TO BE FILED IN DUPLICATE "/ q5 8ol~'
OIPARb~~~Wto1.\V1NU' WITH REGISTER OF WILLS) 0<- YEAR NUMBER
H"","URG,!' "''',,~I (OUNTY (ODE
DIClOINT"S NAMIILAU ".~', AND MltlOl1 l~jlIIALI Ill(l{J1t4l!l (Ololrll n AUDIII U vJ
(\1\ LLLE"B..,-l.'luJ.LJD0 Lh"_ G-l,,- ".__ ) I \J '()h\\I-~I\'\\ {)~'I 11<> II
rcXoii1\c~, NUM'" .","" ...," D,~" 01 11'11., '" " '--, .. f\ '1'\'\, \ ...." ' - I'"
:'.J. .. .. 3' It> 1- ~1:_Lcj.'?:,l5J):(..3(' I~'/S cJ'"~' .."Lu..\~\."u.\'... \\ c(
P' ...",..,,, ".......0 "0"," NO" '"'' .,." ..., .'"",,.., '"''__CC''' ""~'~~""~I~_.__ ~:.~.., """,. I>ll "'''"''"0''''
~ 1. Original Return [) 2. ~upplemenlol R.lur" [] 3. Remoind., Return
(for dot.. of death prior to 12.13.821
o A. limited hiD'. LJ 40 Future Inter..' Compromi.. I] 5. Fed,ral Estal. TOil Return Required
(for dole. 0' dealh alter 12.12.821
D:l 6. Decedent Died Testate f.J 7. Decedenl Maintained a LIving Trusl
(Alloch copy of Will) (Attach copy of Trus'l
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO.
NAM COMPltn MAIUNQ AqOflU~
S\.~~I :;" I U,,:,:IN~IA ,^-II"'I
C 1\ '" P i-\, II, pn. 11''''
"
REY.ISOO (It.. (7.QAI
w
...
..:!!..
frllE~
=09
u"'...
~
l'A.
~~~
...
is
fil
u
w
o
lilffi
"'0
"'z
fl~
111
_ 8. Tolol Number of Safe Oeposlf Boxes
I II __ ___..:=.=--=-_____m'"
7" - ('0
( 21 ______ --1.;)",------
131-
(41 _______,___,_
(51 _0._k~Llr,,~L(L_____.
(6)
171
(91 ~...j.l.9. 00
(B)--1R~{,II. o.f~__
..
o
S
E
~
III
'"
1. Real E'to'e (Schedule AI
2. Stach ond Bond, (Schedule 81
3. Closely Held Stock/Portnerlhlp Inleres' ISchedule q
4. Morlgog" and Notes Receivable ISchedule D)
. 5. Cosh, 80n~ Depo'its & MI"eHoneous Perlonal Properly
ISch.dvl. EI
6. Jolnlly Owned Property (Schedule FI
7. Tron,fe,. (5thedul. 0) ISthedule 1I
8. Tolal Gran Anet. Ilotol LInes 1.71
9. Funeral hpen,." Admlni'lrative COSh, MileelloneouI
hpens., ISchedule HI
10. Debt" Mortgage L1abllitl", lien, ISchedl.le II
11. Total Deductions (total lines 9 & 10)
12. Nel Value of Eltole (line 8 mlnu, line 111
13. Charilabl. and Governmenlal BequIIls (Schedul. J)
14. N.. Value Sublect to Tax 11In. 12 minus line 131
15. Spoulal Transf." (for dotes of death after 6.30.94)
S.e Inltrucllonl for Ar,plieable Percenlage on Rev""
SIde. (Include volulI rom Schedule K or Schedule M.)
16. Amount of Line 14 lax obI. 01 6% role
[Include value, from Schedule K or Schedule M.l
17. Amounl of line 14 tall able at 15% role
(Indude volulI from Schedule K or Schedule M.)
18. Prlnclpollall due IAdd tax from lines IS, 16 and 17.}
19. C,.dils Spou,ol Poverty Credil Prior Paymenll
+
(10)
1111 ~L ql q 00
(121 L-'5').'-' '-IS
(131
(14) L.-:iJ. '1 41
z
o
!i
...
~
:II
o
...
(15) __,_____._____,,,__",_, D
(161 ___._ _...,___,__,___... ,,,-, " ,06.
q/~_:5.._____
(17)_______.____" ,15 D
(1B)
9J~~_
Dlscounl
Inlet..t
+
(191
120)
~
...
20. If Line 19 II greal.r than line 18, enler the djfference on line 20. Thll h the OVERPAYMENT.
miD
Chock hOIU if you oro roquostiog 0 rofund of your ovo,poymonl.
121)
(21AI
(218)
q L35__
~-
21. If LIne 18 Is greoler than line 19, enler the difference on Line 21. This il Ihe TAX DUE.
A. Enler the 1"ler.st on the balance dUll on line 21A.
B. Enl.r the 10101 of L1n. 21 and 21A on Line 21B. This Is the BALANCE DUE.
Make Check Payabl. tal Regl.t.r of Willi, Agenl
I. SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH
Under penollill of perjury, I declor. that I han uomlned this relurn. Including accompanying IChedule, and Ilalemenh. and to Ihe bll' of my ~nowledge and belief,
It I. trUll, correct and complele. I declare that all nal ellote has been reporteer 01 true market ~alue. Declaration 01 preparer other than Ihe per,onal ,epre,entalive i.
bas.d on 011 Information of which p"par.r has any ~nawledge,
SlQHATU_e o. PU~ON IUPONSIIU fOI fllINO '(fUW AOOII i~------ . Doll!
"j'"}',,) 'II 14 1JJ__~':"'Lo~._t~_,_________'~:_J__LI!~l..'-..!.._'-f~_~~_.L~U:-f~J~1'lA 1<.-.1 - f.J ~'~_.
SIQNATU'( Of P<<!(PAflU OTttU IHAN .(PIUH.,,,tl"l AVOII ~s I ' OAlf
Act #48 of 1994 provldol for tho roductlon of tho tax ratollmpolod an tho not valuo of transforl to or for
tho UIO of tho IpOUIO. Tho ratGl 01 prolcrlbod by tho Itatuto will bo:
. 3% (.03) will bo appllcablo for oltatol of docodontl dying on or aftor 7/1/94 and b.foro 1/1/96
. 2% (.02) will bo applicable for eltatel of docodonts dying on or aftor 1/1/96 and before 1/1/97
. 1% (.01) will bo applicable for eltatol of docedonts dying on or aftor 1/1/97 and boforo 1/1/98
. Spoulal transfors occurring on or aftor 1/1/98 will bo exempt from Inhorltance tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK ("') IN THE APPROPRIATE BLOCKS.
YES NO
1. Did decedent moke a transfer and:
a. retoin the use or Income of the properly transferred, ..............,.................................,..,...
b. retain the right to designote wha sholl use the properly transferred or its income, ........,......
t/
c, retoln a reversionary interest; or ...................................................................................
l/
d. receive the promise for life of either payments, benefits or core' .......................................
2. If deoth occurred on or before December 12, 1982. did decedent within two years preceding
deoth tronsfer property without receiving adequote consideration' If deoth occurred after
December 12, 1982, did decedent transfer property within one yeor of deoth without receiving
adequate consideration...,........ ......,.... to...................................... H................... II ..............
v
v
3. Old decedent own an 'In trust for' bank occount ot his or her death"'..,......,..........................
,/
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN,
REY. ua3 Eh 1...61
~..~.Q.
~
SCHEDULE B
STOCKS AND BONDS
COMMONWEAllH OF pfNN,ytYANIA
INHUIlANCE lAX RUU.N
RUIDENl DECEDlNl
FILE NUMBER
ESTATE OF
])OlLoTl-\y C~
/111 LLEI!.
(All proporty lolntly.ownod wllh RighI olSurvlvonhlp mUll bo di"lolod an Schodulo F.)
VALUE AT DATE
OF DEATH
ITEM
NUMBER
1.
DESCRIPTION
~ P~l t
tj, y,).;:, =P r e.. rl~ u r <'_ d. S-'-C\<:- K.
t./ S hC\.)-~5
t... I V:).
)i,
y shn.l'~ '.,
'" t'J ;).'/&.. bel
~.
,4 '" T
CDIVll'l10rv S+nc. Ie.
If S k/Lr".s
(., ~ .E4
)(
8 shClr('-~
:= oR L{ qq. <'CJ
s
TOTAL AI,o enler on I1ne 2, ReeD Itulallan
(II mare spaClls ne.d.d, Inlet' additional she.h a' some Ii,..)
l)fllN tl'17"1'/:II III:rNIJWS INf:.
301 Markel S'"",', I'. (), /I,a 12();j,~, 11m/is/11Im. I'll I7/tlH-!I!}()(j
r"/"fl'''''''' /717} 255-(j(j1j(j
I (/IDOl 670-0CJ7.i
December 5, 1995
Mrs. Marion M. Swatt
21 Victoria Way
Camp Hill, PA 17011
Mrs. Swatt:
As requested, the prices below reflect the high, low, and closing
prices as of October 13, 1995.
Security
PP&L 4.50 Pfd.
AT&T
High
61. 500
64.250
Close
61.500
62.375
Low
61. 500
62.375
If you have any questions or require any additional information,
please do not hesitate to call.
Sincerely,
ia-7
~ard N. Pearce, Jr.
Account Executive
,
11'1 1~0I11. 12 "I
~'J~'~_
'f.$r
COMMONWfAlIH OF PfNNIYlVANIA
lNHllnANCI YAX .nUIN
.UIDEN' DIC.DIN,
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
1_
Plea.e Print or Type
FILE NUMBER
ESTATE OF
'Doli..oiHr C~ n1/ LLt::~
(All p,op.rty lolntlv-ownld with thl Righi 0' Survlvonhlp mu.1 iI. dl.c1o..d on Sch.dule '1
ITEM
NUMBER
DESCRIPTION
VALUE AT
DATE OF DEATH
I
'PAle. BAil l.
l-hJ..vdeJ2. LANe ( 13r(\'l\(h)
CAmP 1-\,\\, PA 11011
AC'C+ T~ Sc>S-N) S"'-/5/
C h~c. k.,,, '1 A <<: f.
-is lPq(p,L/'J
,
VreflC>.ld ~u.Y\el"'t\.I1>IA,.j ,.... Iq?8
Wu..ql... Ie, ~~u.'1h,,!) a SOl-' ~u.IH.r,,-/l-\n"'e...
lClLl'-l W'Io1'V\lv'1 A'\Je...
~o,-t't Cc>\!.t PA- 1'a?OL/
;) ,0'5 3,('Jo
TOTAL (AI.a enter on line S. Recapllulatlan S
(Attach additlonaI8V." IC 11" .h..fllf mOrl 'pac. I, n..d,d,)
1U44 W)'tHl1l11g A\"('our, rurl)'
Hugh n. lIughu, Sr. UlrrtllH\
TillS IS Nlll A S1'An:Mt:NlIlH A IIF.QlIF.SlFIl1I1'AVMt:Nl
Thio II .0 ..p'oo.'ioo 01 ,hIlJ" a. ..11 .. . ..,,, 'J".m,ol r,,,.ol.d ,,, ,0n'I"""" .IIh Ih' .,.d.fI' Trulh 10 I.,odio. A" .od Ih. ".ul.,loo. "I Ih.
l',o"'11\IOi. SII" "o.t'fIF~o"~I.I~"''}'' II? J
FUNERAl. Ill' ~~ a. 7ll /'tNh I>An: OF IJt:ATII Rut'.. I I Jq? g
FUNt:RAI. Mt:llcl!bl",J,lUiE:.ern - .10
Cash I ., u'ecled~ j-CI- ~ ___I
ItBhter hook. .dnowled.ement urd, (uP tn 100). ,ice ,ecuuh tl
.nd incl\ldin,. bu1 no' limited 10;
pla)'!:1 ...nh (UP '" 100). rtlil1ious nectui1iu as requiredS
,5 7,J). tX)
PERSON At. II< PROFESSIONAl. St:llnct:S (un · 14 huu, hul'l:
1.0'" "mo,,1 hom 1"'" 01 d..'h;.1I "'hol",.o.I'I"<i.I,,..I.kilh o..d..t io Ih. p"pllllioo .od ,,,'orolioo 01 ,h. bod1.
io"ud'oJ .mb.lm'o.. di.inl,,,'on. bllbin.. .h.mpnoi". .nd b.i,d""in. by our ...n. ,,,.m,,I,lo.. d"..lo. .nd p'"in. body 10
",k'" ,oun..lllo. .ilb l.mil1 .od ""JY p,io'lo, du,io. .od .h" Ib' Ino...,.."I." I,lio. .11 O,,'''"Y ,,"iO,,'''' no'i", .od
.u,bo,ifllloo lo,m' In<iudlo.. bul 001 liml"d '0, d,alb ",till'"", "bilnlll.., S"",I S"u,ilY .od V"m.. d,"h cI.im lo,m"
p,nooa,.up,,'i.ion /10 di""lon "I ,'i.illlloo. luoml.."i" & io""o'OI & ,"uli ...lin. .1 "m""1' "fln.ln. "I Oorol IIlbu''',
roIIo. & k..pio. 01.11 0""'''1 ",n,d. ....,..,........,..,......,......"..,......,.......,...............,.... S
/.J 'lIJ, 00
FUNt:IIAI. 1l0ME FACII.ITIt:S ANI> t:QlIll'Mt:NT:
u.. 01 1'''1'11I1100 ,oom. i.."um.ou .od .quirm.o" u.. 01 ",,,,..1"11"0 .""m .od 'qulpm'o', u.. olluo".1 hom' I"\lili,,
.od ,qulpm'OI Inr ,i.il"io" .nd l"n.rol.."I" in""dinJ. h,,1 n") liml..d '''. '0001 10' .i.ill.inn .od lunm' IIIvi<<. "flo..m,o' o.
.dmioi.""lve 'oum. '0"'0<< (0)'....lou08'. ,n' '0001'. p"kio. "... ".ill" .....11, no." ...od., ,..k,1 bi.... mlU card ".y
&/ or pro1" flit 10 Ii.u 01 ,b'r,'I"i1i1I", .11 o.",...y ,quipm,ol .od .ddi,loo.I.lanlo, ,hurcb luomll or luomh ,oodu",d
hom 1.01111 ",id.n". .. .. .. , .. . , . .. ... . .. . , , .. , , . . . , .. . . . . .. .. .. . , ,... .. .. .., , .. ." ' . . .. , . . . , .. .. . . . . . .. . . . . .. 5
AUTOMOTIVE EQUIl'MENT:
1.0,,1 "010,,1 vebl"" ,..k,1 ,o"b '0 10,,1 <<01""1' nOfll 'If 10 10"I"m""Y'''' 10,l.mily '0 10<11 "m''''Y'''' 10' cI".Y
'010,,1 <<m""Y" ,..... " ,.,.".... ,..,..,. ,....,..,..... ,...... "..,.,..,... ......,.........,..... ...... .... 5
c3/f 11, 00
1/)."01), 00
I.~S (), ()()
TOTAl. OF ABOVt: LISTED MERCIlAN\lISE, SERVICES, FACII.ITlt:S II< EQUiPMENT.............. 5
ADDITIONAl. ITEMS OF SEIIVICt: 9J!.MEIlCIlAI1D1S~:,. "f
Cave.p,ool ou". "<<I'll'" .. ..I.",d tJJklrlcf4tJ&f ~ s ;;? 7/;: O~
Clothin.
....................... S
...... ,................ S
.. ..... ............. ,.. S
....................... S
Transportation outside 10c.1 area
Additional automo1ive equipment
Additional .cknowledgement cards
~ ?s, 00
.........,...,.,............,.........,................................,.... S
TOTAl. ADDITIONAl. ITEMS OF SERVICE OR MERCt!ANDlSE.....
5
CASt! ADV ANCES ("llm.led .~ tlmj o~lhl. .~re.m'nl):
C,m""Y or ",mIlO')' ,harB" ..&~v;n...,~....
New,paper obitu.ry and/or other c~lI.r~es:..}: ~ .:.j............... ......... .........
Floweu(Camlly nowen onl)')....~..~.............
Certified copie' of death cer'inclte............. .~......... ........ ...... ..,
Clergy honnrarlum........................................... ....... .........
Other funeral directoU charSes ................................................
Telellram, or lon& di'llnce 1elephone ...........................................
Tran,portatlon (commercial or pri\,.te) .........................................
Permit fcc' and/or 111'\Ii1ies ..................................................
s 1(0,1=), ()CJ
.
s
s ll)l=3 , 00
s 10. Ot)
s
s
s
s
s
s
s
............................................................................
............................................................................
~.2 8.1'L?
TOT At. CASII ADVANCES..................................,.................................,. S
:<.. C) 5'~ 00
TOT At. CIIAIIGES Ilncludlng wk.' .. ..,.md. 1''''00.1 ,& p,ol...ion.! .."I.... luo<lll bom' 1"i1I1I" /I< 'quipm,o'.
.u.omoli" ,qulpm,ol. .ddllloo.ll"m. 01 mvl" 0' mmb.ndl... .od ",h .dvao"') . . . , .. . . ,. .. . ... ...... . .. . . . ... .. S
TERMS: Thill.. ",b ,rao.."loo poy.bl' io 600l.y, (rom ,b. da" ollbil .g",m'ol. Al." 60 d.y" IIIvl<<,hllg' 01191> 1''' moo'b .moun.log.o 1l9l> per year
.ill b. .ppli,d '0 II" uop.ld b.,.n<<, Tb.loIII,h...,uho.o II< jull "llmal,d .od "0.,, only 'h.I'B".d upon up lo.b, hour ullhl"g,<<m,.I, Aoy .ddlllon.1
mvi", or m,,'bondl.. o,d",d 01'" lb, d." 01 .bil ag,<<m,ol .iII b, ,00.ldmd I'"' nl 'his .g,<<m,ol .od 0111 be .dd,d 10 .b, 00.1 IU'<III"'lem,ol, W,
sU'Ke,' you conlull wilh our office hdore rendering payment to determine ,he exlC' total eharlu.
'Ih, und",ign.d 1111" .h.. h,lIh, I..' ,h, ,ulho,1I110 arraog.lor .h, lun".1 ol'b. abuve ..m.d d""..d, ond do" ,ulho,;" lIugb 0, !lulh.. ASoo
1'..0<11111 ..." .orak. ,bar8' 0111\, body ol.h. .b.." ,,'01' d."...d .od p"p.~:m' lor vlsllolloo .odlor bu,i.l.od 10 .upp'Y ,b, .bove lined mmb.ndl.. .od
....i<<'. .nd 1',,,011.. 10 p'Y lIu.h II, lIu.bn & S".. I'uo<lllllom<lh' .um 0 ?-?~.:t. .' Odoll.....bls beio..bcaBB"..".mounlolfuo<llhcrvl<<"nd
nlerChllndiu' Ullleled and appro\'tll by fIlt/IU al Ii"ed "hove.
lIu,h \I, 11...1\.. /10 SoO I'unmlllo",. lO.k" ".. 01.11.,,11. "p"..,d ." hopli.d. ..ill'" '" "'.,. p"loloin.lo ..y luo<ll' mmb.odi.. provid,d u.d" Ibis
'M".""ol Th. 0,,11 .,,,,"Ii,, ari.ln. ,,"I ..llh' 1.."...1 ,,,,rch.,,dls.Ii",d b"do n" Ih. "p".ud .rillen .OIrao,I... il .oy. "..od,d by lb. m.ouf"lu,,,, 01
,he funtl'" nle"hllUHlf seleclcd limier Ihll altfeelllt'llt.
Sl"lemenlln
^I!llrtU
C'If Nu._
(...1)
I(V15I1I.. ''''I
ESTATE OF
ITEM
NUMBER
A.
B.
4.
C.
1.
2.
3,
4.
5.
6.
7,
B,
~J.,:~l\
_ *Pu.
COMMONWlAltH Of plNN,nVANIA
INHUItANCl TAIl IUUIN
IUtDfNT DfC(D[Nl
1_ SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCEL~ANEOUS E~PENS~S,.J . Pllall Prln' a!,!yp" ,_
FILE NUMBER
J)l'I~otl-l'( C.... (Y\,LLl:.~
DESCRIPTION
1.
Fun..al Explnllll
L.Oe>\:. C'\,\ c..MaCk".! ~hl<"'~
1.
Admlnlltrallvl Call II
P.rlanal R.p....ntatlv. Camml..lanl
Social S.eurlly Number of P.nanal R'p,,".ntatlYII
V.ar Camml..lanl paid
2.
Allarn.y F...
3.
Family Ex.mptlan
Claimant
Add.... of Claimant at d.e.d.nt'l d.alh
S,...t Add....
Clly
Slat.
Zip Cod.
R.latlanlhlp
Prabal. foOl
MllelllanlaUI Explnllll
qe.::. (:t>Ii CCL\- (-CHn'\CAt\qd~'\1 -\.(0 ,\=Ot~1
'-'-? 'l-h,,-'r"- ..en' ;)..dn...., S ,_ 'Ihoe", bel..< k.
c..loiv.~ '.!H"';S - :;'\-.0"'"
(.."--::.1:. ~- ~ S \''''''''1 0 f + I c'''-> \C. r S
~c>n d.
r"t1 )
",So ()l,I.
",.30,:.
TOTAL (Alia .nlor on IIn. 9. R.eapllulatlan)
(If more IpaCI II n..dld, Inl..I addltlanallh.... of laml II...)
AMOUNT
i-J, 5:;1 q. (/0
,5.00
100.
I <-10.
75.
s
0(,
00
00
00
illig" B. Hugll,'s & Snil. Inc.
Futl~'~M. llQML
10.1.' W....OMI"O .,\VF.t'UE
FORT" FonT. PEr.NSVLV.l~NIA t 0"04
T1::t..E.PHONE (7 11) ;~UO.93.' t
t1UCitI fl. HUGHES. .m" ~urt"vlt.OR
MICIiAEL \Y. UAnRISOU. ASSOCIATe
No
""~"'''iil ,'. 1.1,.(.,.,....
DECEASED __.!--._~__ ____u...'~ ..-_...,__..... ....
'. ''- r L' "" 11./ ,";"';''-'::
DAlE OF DEATH ____:..-_'.. -':"'~------l- ----.~--.
PLACE OF DEATH --.:~j~_U{U-_.l-__._. LJ~_~__...
. ..... ",. r I, . tj I'" ,~::-
DATE OF STATEMENT ___'~, ,.' .' .,-.Cc"
.:.' .(f' '~.rl'(~
A. CHARGE FOR SERVICES SELECTED
1. ProfesslonalServlcea: .
',',.:" ,',
Basic Sorvices of Funeral Direclor & Slall..... ._~'...:- --,-;0----
Embalming................ ,......... . .. ,--~.:.:....::~
,"J'- ,..,"'"
Olherproparalionotbody.................. ,~-.--_
.....................................-----
~{2r!.;-..~' _
2, Fecl/ltles. Equlpmenl & Staff:
Use 01 Facihlies & Stalf 10f Vlewing/ViSllalion...
Uso 01 Focilitles & Slall for Funeral Ceremony. . .
Uso 01 Facilities & Slall for Memorial Service. . . .
Use 01 Equipment & Slaff tOf Graveslde Serv~e . .
Uso 01 Equipment & Staff for Church Servlco . . . .
:~ ~.':. r....
........................................
,:.;.-:- t:'('
3. Transpor1al/on:
Transfer 01 Remains to Funeral Home. . . . . . ~ . .
Hoarse................................. .
Llmousino.. ......... ..............'.. ...
Sodano . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Sorvlce/UllhlyVohlcla..................... .
."~ C-r)
1~("..rJ:"",
.~., ~f,'
.r'.... ('"~
:;''i''- nr"\.
4. Other Services / Fecll/lIes / Equipment:
. ~'-~"'" !-:-:', ":... :'~', :l.t". If. . :~': t ......\.. :.J,'>. -:'.': ,{('. f..c... . .
::.':".l ro
TOTAL OF SERVICES SELECTED.,....."...,.,.......$
,.,.., -::o~-'::n
..,~..
B. CHARGE FOR MERCHANDISE SELECTED
Cn&kot lor olhOt loceplDclo) . . . . . . . . . . . , . . . . . . . . . . . . . , . . . . . . . ,
Nnmo/N(). 0" j ,./1 Tl.f:;_~~:.......___~,___.__
Material .--:' , . . '-,~' i..... ':'~L...:~~~___
....
COIOf ,. '" i- ,A...
Oulor Burial Container. . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . ,
NamCINo._ t", . ," ..: I. /o' 'J ~)
,
Mlllori.., ;.>.,,",-., '..!:.-
Acknowlodgoment Cards.,..................................
RcolslorOook.... ...... .............,.. -..... .............
Memory Folders/Prayer Cords. ....................,........,
CloUling........ ....... .........,..,..........,..........
!.~("". 'y-l
Iy.-r,n
ro"
Nf,.
_-.d.1~__
---".!.j<:~-
...........................................................
Cromnllon Urn. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.......................................................... --~---
~'c;~~~ O~ '~~~~'~~~~;~~'~~i~E~~E~',':::: '.'....:::::: '. '....::: $. /'7.(.ic:,-:O
C. SPECIAL CHARGES
o Forwarding remains 10:
Cl nocolvlng remains flom:
Inllllodmlo Ourinl . . . , , , , . , , , . . , . , . . .
1>1Iocl Cumlilhon . . . , , . . , . , , , , . . .
Othm,. ..,.........
TOTAL or SPECIAL CltAnClES"
"""."" $,
TOTAl. FUNEflAI. IIDME CIIARGES , , , " "" ,',","','" $,
(111/!i (1)t.1Ic1llOJ/l/lllllclll(llJ Cas/'Aclv.lllc(I!lJ
~.. l.. 'I.' "
SIAII'~lENTOF
FlJ:-I1' Ili\ I. I ;1)( 1I JS i\:-IIJ SEIlVIlTS SFI.ECTEIJ
Cfl,llJlf'5 .1'" only 1", 1111I5" ,!,'IIIS ''',It y011 Ilf'/,)rlf'(I ('I tlt,ll ,1111
"'1111/tf'd " I\(I ,1f" ")'111I"'11 I~y 1,,1\' O( by n Cf'flll-'/m)' 01 crOflW!O/)'
tl) ust' .111)' /t('IIIS. no WII/ O)/II.lln Ihfl!f',IS,"IS III nnlmg t,,,low
" you ,('I!Jel"" a tUflnf,"lflitt "My I('l/U'ff! em/iii/mUla. blK.h aJ ,1
IUrlOfOJ/ ".,tlt \'/Ol'olflg. you m.ly h.wfI 10 ".lY 1m emb.l/mUlg You do
no' have '0 pay 101 omb.llm'''1I you did not approve II yOIl
5elecled arraIlQf.'/tlf'nts suell IlJ II t1/1t1d "oma/loII or '1III1Wd,.1/0
In",." 11"0 cha'{/t'tl t01 emtl.,llmml1. .,,, ",11 tnp/",,, "hy btl/OW
CASH ADVANCES
CNllIlod Copies 0' DlMth CmtlllCi\lo
.:.:( _C$,__-:-._~':_["'I
rr r','"t
(litch __..___ S__._.._~--_-
.Clergy.._. -- ,---.- -...--.--
r:,""'fot'!uJ('..
~U~lCj.11'! _._...____.~_.__
~:=1?S2~r.:~~.
___7..r Ci':..
~~ld Ntl~~p~pC!_ ~O!ICIL_. ..___
,CI1rT!9!9.'Y__..._
'-~---ro
-y"CC _
.9.!.!!!L____
-~------TOTALCASHAOVANCES S~i::',9'" ="
We chargo you '01 OUf services In oblalning: (specify cash advanco items).
SUMMARY ':)9 ~'I rc,
Tolal Funeral Home Charges.......,.,.,....., $J . . _
Local Sales Tax (II applicable) " .. , , . . .. . .. .. . . $ ,"
Slalo Salos Tax (ilapplicablo)..,. ,..........,. $ . r""" .. ~7;
r:~.r;j.J
Tolol Cash Advoncas, , " ,,," ~~~~~ ~'c;~~~' ':~"'.:' 9(t~
Loss Credits and Payments
$
$
1(}J/lIl Crod-!!.-,....."....... '1...'... ,$
BI~:g:O ~I ~rl t~[;;~~~U.~j.$l ~~f!; ~~~~
DISCLOSURES
Re~son tor embalming
,., " :'~.(",.. ~ 1"1i., '..
IInny law, cemetery or cromntol)' requirements have requiled rhe
pl/fChnse of nny items tisted. tho taw or requ/roment is oxplainod below.
_~~i!...~.~.'-'__L~::"''''' I ",1 I I I: ':'8:--_
1(.'.... (" . J : _ ~ 1-".'. '-, .1.- 1 ~ /0.- '..
_~1_.:--1_~__1_~.~~~__J..-~._____
ACKNOWLEDGEMENT AND AGREEMENT
I horeby acknowlodge Ihal I havo Ihe legal right to arrango the linal
services lor tho decoased, and I authorize Ihls funeral eslablishment
10 porlorm sorvlces, lurnish goods, and Incur oulside charges
specified on Ihls Slalement. I acknowledgo Ihat I have ,eceived tho
Genoral Price Lisl and Ihe Cllskol P,ico Llsl and the OuIO, Burial
Contllhle' Plice Lisl,
.f,.' .
r
I r-,-,'.
I ,. r (
Terms 01 Paymont:
-.:.....!_.f:...-~--.!:....:l.l(
Full paymenlls duo no lator Ihan :;',- LI:.' j .-;'
"any payment Is nol paid whon duo, an unanlicipaled LATE. CHARGE
of _/':i.- ~:. pOI month (ANNUAL PERCENTAGE RATE ~ ~o)
on Iho unpaid balanco will bo duo, I agreo 10 pay Iho Dalanco Duo
listod on Ihls Statomenl. plus nny Lalo Chargo. In tho ovonll dnrautlln
payment 10 Ihls lune,al oslablishmont. I agree 10 pay roasonnblo
allornoy's loos nnd coull cosls in addillon to any Lato Charge
npplicablo. I understand and Dgroo that I om assuming potl.orlnl
liability IOf Iho charges sol lor1h In this Slatomont and that Ihis is If1
nddl}lon to Iho Iloblhly Imposed by Inw upon Iho oslole ollho
docposod Oy my slgnnluro bulow, I horoby 00'00 10 nil 011110 abovo
~l nC,~n~~I~: :n:a::~ :~~ ~"Y:~I'::~:~:'~;.:~
t~1f'd 11."..,1
~~'lIl?I.>C.lI_'~~H~.?'--~I_ .__
r+11,~i ".lr,~,
ACCEI"A"C[ Thl" IUllnlilll'1,li!tlhhm[lnllllllllrOlln ,,,ovlllllltll ''''1\'1(',,"
/II1.tdlillll!l\1l fUlIl rn'h n!l~illlCl!R md,cilllIll Oflltll!l !U"'""1ll1l1
Oy"
.- ~ ~ '!.i. J-,.
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11.1'111'4 nl'l
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COM>>ONW(AUH OJ ""H"I.....HI..
IHMllltANCI tAl InUI"
InlOlN1 olerol"t
SCHEDULE J
BENEFICIARIES
J
ESTATE OF
FILE NUMBER
D(l/!,,,rtly (:" n\, L lC /:
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
RELATIONSHIP
AMOUNT OR
SHARE OF ESTATE
A. Takabl. Bequlih:
1.
('(\1\ 1<.1(1 1\..1 1'1'\:; u IA TT
J"""II\ \t.:"
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
AMOUNT OR
SHARE OF ESTATE
B. Charitable and Gavernmental Bequell"
1.
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Alia .nl.r on IIn. l~, R.cap;lulallon) S
(If more .pac. I. n..d.d. In.." addltlonal.he." o' .ame .In)
/
,
_ "':1
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to:'
REV'1S47 EX AFP 1IZ-9S*,
COMOHWUl TH Of PlNN$YLYAHIA
DlPARlHlHT or R(V(NlJ[
IUR[AU OF INDIVIDUAL TAX[S
MPT. :10601
UARRISlURG, PA .,IlI'OUI
ACN 101
NOTICE OF INNERITANCE TAX
APPRAISE"ENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESS"ENT OF TAX
DATE 04-08-96
10-14-95
FILE NO.
COUNTY
CUMBERLAND
NOTE. TO INSURE PROPER CREDIT TO YOUR ACCOUNT. SU~IT TNE UPPER PORTIDN OF TNIS FOR" WITN YOUR TAK
PAV"ENT TO TNE REGISTER OF WILLS. "AKE CNECK PAVABLE TO "REGISTER DF WILLS. AGENT"
REMIT PAYMENT TO:
MARIDN M SWATT
21 VICTDRIA WAY
CAMP HILL PA 17011
REGISTER DF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
A.ount R..l tteel
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
ifEY=is'4"7"EX'AFP--Ciz:ij5T"iiiificni,,'i"NHEiiii'AiicE'i"AX'A'PPRA'iiiEii€iii',.uALi."ciiiAiicE'ifli----"---u------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MILLER DOROTHY G FILE NO. 21 95'0826 ACN 101 DATE 04-08-96
APPROVED DEDUCTIONS AND EXEMPTIONS:
4.919.00
9. Fun.ral Expen.../Ad.. Caata/Hi.c. Expen... (Schedule HI (9)
10. D~t./Hortg.g. Liabiliti../Llana (Sch.dul. I) 110) .00
11. Tot.1 Deductions Ill)
12. Net Value of Tax R.turn (12)
15. Charitable/Gov.rn..nt.l Bequ..t. (Sch.dul. 4) (15)
14. Net Valu. of E.t.t. Subject to Tax (14)
NOTE I If an assassment was issued previoUSly. lines 14, IS and/or 16, 17 and 18
reflect figures that include the total of ~ returns essessed to dete.
ASSESSMENT OF TAX:
15. AltOunt of Lina 14 at Spou.al r.t. US)
16. AltOunt of Lina 14 taxable at Lin..l/Cl... A rat. (16)
17. Aaount of Line 14 t.Mabl. at Coll.t.ral/Cla.. Brat. (17)
18. Prlnclp.l TaM Dua
TAX RETURN WAS. I X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real E.tata (Schadul. A) (1)
2. stock. and Bond. (Schadul. 8) (2)
5. Clo..ly Hald Stock/Partnar.hlp Int.ra.t (Schedula C) (5)
4. "ortgap./Not.. Raealvabl. (Schedul. D) (4)
S. C.ah/Bank Depo.lt./Hlac. Per.on.l Property (Schedul. E) (5)
6. Jointly Owned Property (Sch.dul. F) (6)
7. Tranaf.ra (Sch.dul. C) (7)
8. Tot.l A...ta
TAX CREDITS:
PAV"ENT
DATE
12-15-95
RECEIPT
HUIIBER
AA082416
DISClMIT l+ I
INTEREST (. J
4.57
I CNANGED
.00
745.00
.00
.00
5.696.49
.00
.00
181
6.441.49
4.Q]Q no
1, 522.49
.00
1.522.49
will
.00
1, 522.49
.00
K .00.
K .06.
X .15.
1181
.00
91.35
.00
91. 35
A"OUNT PAID
91. 35
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
95.92
4.57CR
.00
4.57CR
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIDNAL INTEREST.
IF TOTAL DUE IS LESS TNAN .1. NO PAV"ENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI. YOU "AV BE DUE
A REFUND. SEE REVERSE SIDE OF TNIS FDR" FOR INSTRUCTIONS. I
O,!!!
hl~
P;.o
\0
r: ~
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0-
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RESERVATlOth E.tlt.. of decedents dVlng on 0,. bIIfor, DecHber Il, 1M2 ... If MV future I"t.r..t In the ..ht. a. trend.rred
In po.....lon or enjoveent to el,.. . (coll,t.r'l) beneflel.,.I" of the dec~t ,ft,,. thl ..plr.tlon of any I.t.tl for
Ilf. or for v"r., thl Co-.onwl,lth h.rebv ,xpr...lw rlserve. the rIght to 8PPr'I.' ~ """ trlft.f.r lnhlrltenc. T....
.t thl I..ful CI,.. . (coll,t.,.II' r.t. on In" such fulur. jntere.t.
PURPOSE OF
NOTlCEI To fulfIll thl requlr...nt. of S.ctlon 2140 of the Inhlr1tenc. ~ [.t.t. T.. Act, Act 22 of .991. 72 P.S.
Section 2140.
PAVHEHh DtitlCh thl top portion of thh Notice end .ub,1I vlth YOUr P'lw-ent to thl Aqhl.,. of WUII printed on the nv.,... .Ide.
..HIlk. chick Dr .onlV ard.r peYable tal REOIB1'D OF' MILLS, AO'EHT
All peyeenll rec,lved shell fir.t bellPPU.d to 8nV Inl,r.,t which ..v be due ..lth ....Y r...1nd1r .,1111II to the t...
REFUND (CA)I A refund of , hIC cr.dlt, which V" not nquutld on the Tn Return, .ey be rlqu..tect bv cDlPlltlno In -Appllcltlon
for A,fund of P..""ylvenll Inhlr lIene. end E.t,tl T'" (REV..nU). Appllcltion. Ir. .v,Uab1e ,t thl Off lei
of thl A.al.t,r of WIll., any of thl 21 Alvenue D1.tr1ct Office., or by cllllng the .peel,1 24.hour
en'Wlrlno ..rvlc. nueb,r. for far,. ord.rlngl In p.nnsylvenl. l.aOO")'Z.Z050, out.lde Penn.yl"....I. end
..lthln locII HI,.rhburll ,r., (117) 717.8094, TDOt (717) 772.Un CH'lrlng IlPllred Only).
Oa.JECTIDNSI Any plrty In Int.r..t not ..U.fled ..Ith ttM ","'I~t, ,UlNInC' or dltlUowance of deduction., 0,. .........,t
of tlIC (InclUding dl.count or 1nt.r..t) I' .hown an th1. Matlce lU.t object within .I.ty (60) dly. of rec.lpt of
thh Notlc. bYI
".wrlttwt prot..t to the PA D,p'''''lnt of R.v....., ao.nI of ApfMMh, Dept. UlDll, H.rrlsburll, PA l1UI-1I21, OR
p..l.ctlon to hlv, the ...U.,. d...,..It*t .t tudlt of thl ItCCCM'It of thl p.r,anll rlPr...nhtlv., OR
".epp..' to thl Or~hen.' Court.
ADtlIH
ISTRATlVE
CORRECUDNSI
factu.l .rror. dl.cov,rld on thl. ........nt .hould be add,....ed In wrltlno tal PA D,part.ent u' R.venue,
Bur.au of IncUvhtue1 TIUC.., ATTNI Po.' A"''''IIlt Revl... Unit, Dept. U0601, HarrisburG, PA 11121.0601
Phon. (117) 787.6505. S.. peg. 5 of the bookl.t -In.tructlon. fa,. Inh.rltenc. ,.. R.turn for.. RI.ldent
D.c.dlllt- (REY.1501) for an ..plen.tlon of ~Inl.tr.tlv.ly corr.etDbI. .rror..
DISCOlMT.
If any tl. dUe I. p.ld within thr.. C)) cellndlr eonth. .ft.r the decedent.. dI.th, .. flv. p.,.cent (5~) dl.count of
the t.IC p.ld I. Illowed.
Int.,...t It chlro.d b.glnnlno with flr.t dlY of dlH.....,."cy, 0,. nl,... ('J IIDnth. end one (1) dlY froe thl date of
dI.th, to the dlt. of p.y,ent. T.IC.. which bee... dllJnquent befar. Jenuery I, 198Z b..r Int.,...t It thl rlt. of
.IIC C6~J p.rcent p.r ennui cllcul.ted at . d.lly rlt. of .0001'4. All t,... which bee... d'llnquent on end .ft.,.
Jenu.ry I, 198Z ..Ill b..,. Inte,...t It .. rlt. Which ..III very froe c.lend.r Y.lr to cII.ndar y..,. with thlt ,..t,
announced bv the PA D.p.,.t.ent of AIVInUe. 'hi IPPllcabl. Int.r..t r.t.. for 1912 through 199' Ir.1
INTEREST I
~ Int.r..t Aet. Dilly Int.r..t Factor !!!!' Int.r..t R.t. O.lly Int.r..t Fector
1912 ZOX .000541 1987 OX .0DOl417
191) 16ie .000418 1'88.19'1 Ilie .00UDl
"14 lIX .OOUDI ,,,. .X .0002417
1985 UX .000556 199).)'''' 7X .000192
1916 lOX .OO027~ 1995.199' OX .OD024'
..Inh,..., I. c.lcul.t.d .. followtl
INTEREST. BALANCE OF TAX UNPAID X NUnBER OF DAYB DELINQUENT X DAILY INTEREST FACTOR
..Any Hotlce luued .ft.,. thl teIC bee.... d.UnquIIlt will reflect an Int.,...t ce1cul,tlon to flIt'IIl CiS) dey.
b.yond the dlt. af thl ......-.nt. If p.r.lnt I. aedI .ft.r \hi Int.r..t coeput.tlon dlt. .hown on the
Notln, Iddltlon.1 Int.,..t .u.t be c.lcul.ted.
~ e.'
't .-
',' " -Ill",:
~1' .}
~
N
'5
~
.)
~.., '" .J t:
\ ;c.t P'
a: __ :3
UU
PAYf'[NT, a.tlch the tap portJon of thl.
pr '"l.d on thl t.v.,.. ,Ide,
Notlcl ttnd 'uNit ..Uh your Plw..nt lade p..,abll to thl n... and Hett...
If RESIDENT DECEDENT lakl chick or .onl., ordlr p.webh tal REGISTER OF WILLS, AGENT.
If HON-AESIDfNT MCEKNT lak. check Dr .on.., ord.r plyabl. tOI COHHONWEAL TH OF PENNSYLVANIA.
AU p..,..,.... recelvld ,hIIU b. ~lI.d flr.t to M" Int.n.t which .." tM w. with any r_.lnd.r .pUld to the hx.
REF~D (CAli' nf..-,d of . t.. cndlt, which ".. not r.qu..ted on thl T.. R.turn, ..y bl requested by co-...etlnG In
-'ppllcatlon far R.fund of Plnnl.,I".,,11 Inherltencl and E.tet. ,.." CREV-IJII), ,ppllelllona .r. IVlllabl. It
the OfficI of thl ..._,.., Df Will., MY of the II R.v~ District Dfflc.. or frol thl D.p.,t.."t', Z4-hoUr
an,wlrlng ..rvlcl nuab.,. 'or 'ore. ord.rlnOI In P.nn'Ylyanla l-100-S62-205D, out.ld. p.nn'Ylvanla
and ~Ithln local "-rrl.buro araa 1711) 111-109", TOO' 11171 712-2252 CH.arlno 11P.lr.d only).
RtPLV Tal Qua.tlon. r.oardlno .rror. contaln.d on thl. notlc. should b. addr....d to' PA D.p.rt..nt 0' A.v~, Bur.1Y
of IncHuldual T...., ATTHI po.t A.......nt A.vl.. Unit, a.pt. 210601, H.rrlsburll, PA 11121-0601, phon.
1117) 111-65Di.
DISCOUNT I
PENAL TV'
IHf[REUI
If MY t.. dua II p.ld within thr.. U) c.l.nd.r aanth. .".r th. d.ud.nt'. d..th, . flu. p.rc.nt (5ln discount
of th. ta. p.ld II .1I0wed.
Th. 15X ta. lanasty non-p.rtlclp.tlon p.n.lty I. coaput.d on th. total of the t.. and Int.r..t .......d, and not
paid bltora January 11, 1996, th. flnt day a".r th. Ind 0' th. t.. a."..ty parlod.
Intar..t II charoad bllllnnlno with flnt d.y of d.llnqu.ncy, or nln. 191 aonth. and on. III d.y frol th. date 0'
d..th, to the da" of pa1..nt. T.... which b.e... d.llnqu.nt b.for. J.nu.ry I, 1'82 b..r Int.r..t a' the r.t. of
.1. (6X) p.rc.nt p.r annua c.lcul.t.d at . d.lly ra'a of .0001". All t.... which b.c... d.llnqu.nt on and .ft.r
J.nuary I, 19.2 will b.ar Int.r..' at a r.t. which will v.ry 'rol cal.nd.r y..r to c.l.nd.r y.ar with that rata
announcad by tha PA a.p.rt..nt 0' R.v.nu.. Thl appllclbl. Int.r..' rat.. 'or 1982 through 1996 Ir.,
V..r Int.r..t A.t. aally Int.r..t r.ctor har Int.r..t Ratl a.lly Intlrl.t rlctor
19U lOX .000541 1911 'X .000247
1915 I6X .OOOUI 1911-1991 IlX .000JOl
1914 \IX .ODOSOI 1992 OX .000241
1915 UX .00OS56 199)-1994 lX .000192
1916 laX .000214 1995-1996 'X .000241
"'Int.,..t I. calculat.d a. 'ol1owlI
INTEREST . BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Hotlc. I..u.d ,'t.r the t.. b.co... d.llnqulnt ~Ill r.'I.ct an Int.r..t calculation to '1"lln 115) da1'
blYond thl d.tl 0' th. ........nt. If paY.lnt II aad. ,'"r the Inter..t cDlPUtatlon d.tl .hown on thl
Notlc., .ddltlon.l Int.,..t IN.t b. ulcul.tad.
.
,/ I' ,I 'J
..
II i,l.
It
I j 'f \ ,i' ~ f., " 't
') \:.. 1, I!
,I // t.
< ~,," /
STATUS REPORT UNDER RULE 6.12 nn
c- tV :0
:1 ~ 0, "l'"
!; .(;
.' ,.
~I-r-I',~ tJ., }' r
Name of Decedent: (~ r'Y}II/e.r- ~
Date of Death: Dc ~ I '-I, / r; C) s Dl
;..
....;~.I ~ '7'5-08';) y ~.::: ;- ,.
will No. Admin. No. C1
",' tr~
.t>;.. <::> "-
.,.
pursuant to Rule 6.12 of the Supreme Court orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes t.-/ No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes No v/
b. The separate Orphans' Court No. (if any) [or
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest? Yes 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.
Da te: to - ':J..;;J. - (1 ~
~aiU..{n,L f1i[, S.L~
Signat.ure
-LYlAI?/MJ IN! )LtJIt-IT
Name (Please type or print)
,C) I UI{J,VII CL Wo,..ll G Y\1 P .ll,l \ () A-
Address ' ' ,
(17) i3,';)-lJ,/;).LI
Tel. No. .
Capacity:
~'Personal Representative
Counsel for personal
representative
(MAH:rmf/AM3)
.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
'*
BUREAU or INOIVIDU~l TAXES
IHllUIIANC[ IAtt DIVISION
D[PI. laUD1
IIARRI5!tJRO, ra 111711'01101
f" Itlt II ""11 'II
MARION M SWATT
21 VICTORIA WAY
CAMP HILL
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
06-t7-96
MILLER
to-t4-95
21 95-0826
CUH8ERLAtlD
lOt
Allount R..., ~~.~
G
DDROTHY
PA t7011
1-
HAKE CHECK PAYABLE AND REMIT PAYMENT TOr
REGISTER DF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
tJC:TE I T: In~u,.a prClpar Cl"'c:U t to ycur c:ccun!, :ll.:!:r.l t 'ha up:"cr r=rt!on of this fer'M wJ t., ~."u,. hJ'! r\lY.H""~'
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
RE-V=i60-j.E)f.AFji-foJi=96j".".'..."iNifERiirAHCif.fA)f.STAiFEHE1if'iiF.ACl:OUiif".'..........,""",.,...
ESTATE OF MIllER DOROTHY G FILE NO. 21 95.0826 ACN 101 DATE 06-17-96
TIllS STArEIlENT IS PROYIDEQ TO ADVISE or TIlE CURRENT STATUS OF TIlE STAlED ACN IN TIlE NAilED ESTArE. SflOWN BElOW
IS A SUIlIlARV OF THE PRINCIPAl TAx DUE. APPLICATION OF All PAVIlENTS, TIlE CURRENT BALANCE. AND, IF APPlICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSHENT DR RECORD ADJUSTMEtlT, 04-01-96
PRINCIPAL TAX DUE. 91.35
PAYMENTS (TAX CREDITS),
PAYMENT
DATE
12-15-95
06-03-96
DISCOUNT t+)
INTEREST (.)
4.57
.00
AMOUNT PAID
f35 :0
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C .- r.
I., ;57- ;' '-' ~
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)::0:'\ .
RECEIPT
tlUM8ER
AA082416
REFUtlD
TOTAL TAX CREDIT
91.35
.00
.00
.00
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
. IF PAID AFTER TIllS DATE. SEE REYERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
, IF TOTAL DUE IS lESS TIIAN n,
NO PAVIlENT IS REQUIRED.
IF TOTAL DUE IS REflECTED AS A "CREDII" fCRI.
YOU tlAV BE DUE A REFUND. SEE REVERSE SIDE OF IIIIS FORti FOR INSIRUCTIDNS. I
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