HomeMy WebLinkAbout95-00840
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MARK, WEIGLE AND PERKINS
Attorneys At Law
126 East King Street
ShlppensbulJI, PA 17257.1397
Mary C. Lewis, Register of Wills
Cumberland Counly Courthouse
3 South Hanover Street
Carlisle, P A 17013
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~~~"li~'\;~.,',:,," <, OffiCIAL c:EIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
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RECEIVED FROM:
&
ACN
ASSESSMENT r:t
CONTROL ~
NUMBER
AMOUNT
PERKINS DAVID P
126 E KINB STREET
101
.10,oeo.oo
SHIPPENSBURB, PA 17e~7
- fotD "UII fOtD HUE
ESTATE INfORMATION,
~ filE NUMBER
U e 1-1 '9'9~-OB40
1:1 NAME Of DECEDENT (lASTI
~ PETERSON MIRIAM C
~ DATE Of PAYMENT
Iii 11 lOB 1'9~
\ II POSTMARK DATE
COUNTY
CUMBERLAND
DATE Of DEATH
OB/07/'9~
REMARKS NOVIA L NORTON
CIO DAVID P PERKINS
CHECK4I 131
SSN 36e-3S-eel'9
(fIRSTI (Mil
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m TOTAL AMOUNT PAID
$10,000.00
VZ
ESQUIRE
RECEIVED BY !;ll:',fd L ,WVJ/1/ - ,/
NAU. (,
MARY C. L.fWIS ./. "'11,( bIt' I.
REBISTER OF WILLS j
SEAL
REGISTER OF WILLS
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
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COMMONW[AlTH O. "[NN!oYlVANI4
DE....lltM[Nt OF Il[V[NU[
Of"'.2IObOl
IU,IlIlIUUIlO. ,.. 1712I,ObOl
OICIOINt.' NAMI IlAIo . '1Iln. "NO 1011001 INlllAl1
Peterson, Miriam C.
'OC1AlIlCUII" HUMIU
I 5 - ld.r ;;L
fOA OATIS Of DEATH AnEA 12/31/91 CHECK HIAE
If A SPOUSAL
POVEATY CAlDIT IS CLAIMED 0
fiLE NUMBER
21-95-0840
.--f.
./
YEAR
NUMBER
DAft Of DIAtH
362-38-2219
8-7-95
COUNTY CODE
DIU OINt., COM'lllf AOOIlU
717 Brenton Rond
Shippensburg, PA
CDI/III Cumberland
AMOUNt 1"lIvIO l'U IN,uuelloN'1
I" .."11(...."1 ""I~'VI..O "OlIn, ..A'" """. lint ....0 "'0011 ...,t...u
17257
1-22-08
03,
05,
Remainder Relurn
(for datil 0' dealh prior 10 12.13.821
hel.ral Eslale To. R.lurn R.quir.d
o 2. Suppllm.nlol Relurn
[E 1. Original R.turn
o A. lImil.d hlol. 0 Aa. fulure Inl.,.II Compromll'
(for dol. I 0' deolh after 12.12.82)
06. D.c.denl Died r.SIO" 0 7. D.nd.nl Malntoln.d a living Trust
(Attach copy of Willi (Alloch copy of Trull)
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO.
NAM[ COM-'IUI MAIliNG AOOI 10
MARK, WEIGL AND PERKINS
126 Enst King Street
Shippensburg, PA 17257
1, A.ol E,lo', (Schedul. Al 111
2. Stock, ond Bondi (Schedul. BI 121
3. Clolll1 H.ld Slack/Partnership Inlerll' (Schedule q ( 3 )
A. Morlgog.. and Noles R.nlvobl. (Schedul. 01 ( .. )
5. Cosh, Bonk Oeposlll & Mlsulloneous P,nonel Property ( 51
(Schedule EI
6. Jolnlly Owned Properly (Schedule f)
7. T,onll.n (Sch.dul. G) (Sch.dul. LI
8. Tala I Gran Ane" (Iololllnll 1.71
9. funerol bpen..._ Adminlslrotlv. Cosh. Mhcolloneoul
E_pen..s (5ch.dul. H)
10. D.b.., Mortgog. 1I0bilill.., Uens (Schedule I)
11. Tolol D.ducllons (lolcIUn.. 9 & 10)
12. Net Value of eslole (Un. 8 minus line 11)
13. Charitable and Governmental aeque'ls (Schedule J)
1.4. Nel Volu. Sub ocllo Tax (line 12 minus line 131
1 S. Spousal Tronl'e,. (far dohu of deolh after 6.30.941
s.. In,lructlons for Applicobl. p.,Clnlog' on Rev.,.. (15)
Side. (Indud. .,olu.. from Schedule K or Sch.dule M.)
16. Amount of line 1A lax able 01 6% role
(Include volulI from Sch,dul. K or Sch,dule M,)
17. Amount of lIn, 1A lo.obl. at 15% role
Ilnclude volu., from Schedul. K or 5ch.dull M.)
18. Principal 10. due (Add to. from lIn.s 15, 16 and 17.)
19. C"dill Spousal Poverty Credil Prior Poym.nll Discount
+ 10,000.00+ 526.30
20. If line 19 Is 9reoler than Un. lB, .nllf Ihe differ.nct on Un. 20. This II Ih. OVERPAYMENT,
DID
21. If Un. 18 II greoler than lIn. 19, ent.r Ih. differ,n" on Line 21. This II Ih. TAX DUE.
A. En'er ,h. Inle,." on Ihe balance due on lIn. 21 A.
8. Enler Ih. tolol of lIn. 21 and 21 A on lIn. 21 B. Thll h the BALANCE DUE.
Mah ChICk payable tOI Reol..., O. Will., Au.nt
_ 8. ToIol Number of Soft Deposll BOlIIs
, "
PROBATE ESTATE
INSOLVENT
IS
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David P. Perkins.
tlll'HONI NUM'U
717 532-7388
Esquire
161
171
272.37
209.72
203,683.04
IB) 204,165.13
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191
11,586.79
110)
(11) 11,586.79
(121 192,578.34
(131
(14) 192,578.34
)(._1iI
)( .06. 11,554.70
)( .15 II
I1BI II ,554.70
(191 10,526.30
(20)
(21) 1,028.40
121AI
121BI
(161
192,578.34
117)
Inl"e.t
Checll: here if you oro ,equosling 0 refund of you, ovorpayment.
~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH .....,.. ",~i."
-lor p.nolll.. of p.rjury, I d.c1ore thaI I hove ...omined Ihls return. Including accompanying schedulll and ,lol.m.nh. and to Ih. bill of my ~nowl.dge and b.Ii."
Iru., correct and complel', I d.c1ore Ihal 011 real e.lole hot been reporl.er at hu. morllel valu.. Dedorolion of pr.por., olhor than the p.nonal repres.nlotlv. Is
ed on olllnformolion of which pr.porer has any ~nowledge.
jAtUIll 0' 'lOON IlUI'ONSIIU '0. 'IUNO IlltUIlN AOOIIU DAn
e? L '
ensburg, PA 17257
DAn
.-Novin L. Norton, 717 Brenton Rond, Shi
ADDIllU
PA 17257
Dnvid P. Perkins. 126 E. Kin St.. Shi
Act '48 of 1994 p~ovld.. for Ih. r.ductlon of Ih. lax ral.. Impo..d on Ih. nel valu. of Irand.,. 10 or for
Ih. u.. of the .pou... Th. ral.. a. pr..crlb.d by Ih. .Ialul. will bll
. 3% (.~ will be oppllcabl. for ..101.. of d.c.d.nl. dying on or aft.r 7/1194 and b.for. 1/1/96
. 2% (.02) will b. appllcabl. for ..101.. of d.c.d.nl. dying on or aft.r 1/1196 and b.for. 1/1/97
. 1% (.11) will b. appllcabl. for ..101.. of d.c.d.nll dying on or aft.r 1/1197 and b.far. 1/1198
. SpeuMII .....d.r. occurring an or aft.r 1/1/98 will b. .x.mpl from Inh.rltanc. lax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK (..-) IN THE APPROPRIATE BLOCKS.
YES NO
1. Old a1eceolent make a transfer and:
o. retain the use or Income of the property transferred, .......................................................
x
b. retain the right to designate who sholl use the property transferred or ils income, ...............
x
c. retatn a reversionary interest; or ...................................................................................
x
d. receive the promise for life of either payments, benefits or core' ............................,..........
2. If death occurred on or before December 12. 1982, did decedent within two years preceding
death transfer property without receiving adequate consideration' If dealh occurred after
December 12, 1982, did decedent transfer property within one year of deoth without receiving
adequate consideration' ....... ........... '0' ...... ..0 to ....... .... .......... .............. ........ ......... .......... ..... X
x
3. Old decedent own on 'in trust for' bonk account at his or her death"'....................................
x
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDW-EcG AND:1ijtlIT AS PART OF THE RETURN.
IJn'): ".." ,_ 'POlO
n>: au L- AV\.I 96.
Sll!~\, 10 rl;:;;:'>"C1
10 ,':: ;'.. :'I'),U)OCl
11\1-1.".11.1'1
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SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
Ploa.. Print or T 0
FILE NUMBER
21-95-0840
COMMONW!4lTH O. P!HNlYlY4NI4
INMllnANCI 'A. lnu.N
.IIIDINt DICIDINY
ESTATE OF
Miriam C. Peterson
(All pr....rty lolntly.ownl" with the II,h. of Survlvorthlp mu.t II. ..1.eI..... on Sch.elul. '1
ITEM
NUMBER
DESCRIPTION
VALUE AT
DATE OF DEATH
2.
8lue Cross/8lue Shield - refund 9-7-95
198.20
74.17
1.
AAA Auto Club - refund 8-30-95
TOTAL Alia .nlor on IIno 5, Roeo
s
272.37
(Anoch oddlllonol 8)1," 1C 11" ,h,,1I11 more 'poce I, n..d,d.)
".".....I".~ .
COMMONW(ALlH O' rlNNIVlVANIA
INHUnANCI TAl UtUII.N
.ESIDENT DECEDENT
SCHEDULE F
JOINTLY.OWNED PROPERTY
Miriam C. Peterson
FILE NUMBER
21-95-0840
ESTATE OF
Joln"lnon'(.).
A.
NAME
Novis L. Norton
ADDRESS
717 Brenton Road
Shippenaburg, PA
RELATIONSHIP TO DECEDENT
Daughter
17257
B.
Wayne W. Peteraon
221 South Pine Avenue
South Amboy, NJ 08879
Son
C.
Jolntlv..owned propertVI
ITEM LmER DATE
FOR TOTAL VALUE DECD'S DOLLAR VALUE OF
NUMBE JOINT MADE DESCRIPTION OF PROPERTY OF ASSET '" INT. DECEDENT'S INTEREST
TENANT JOINT
1. A,B 7-21-69 NBD, N. A. - Checking Account
0100020633406 629.15 1/3 209.72
TOTAL lAlla Inflr on IIn. 6, RecapitulatIon) $ 209.72
(If more .paCt 1. "..rJ.el in'lrl odclilionol .h,." of .ame .in)
REv.lSla Eh 12.171
.
SCHEDULE G
TRANSFERS
PLEASE PRINT O~ TYPE
~.. .
COMMONWEAlTH O' PlNNIoYlVAN1"
INHUITANCI TAX UTURN
RIIIDINT DICI~t~_L _'-'';'' ._:
Es-tATE OF
THIS SCHEDULE MUST BE COMPLETED AND FILED IFTHE ANSWER TO ANY OFTHE QUESTIONS ON THE REVERSE SIDE OFTHE COVER SHEET IS YES.
--;TEM DESCRIPTION OF PROPE;;-;;---.------ -;~~;~:c;-~.I..;~~~~Alu;-r iii~D~'l 8P~I~~~t~V,\
NUMBER 'ndud.nom. o"h "on"'f...lh.!~.!!~~ion."ip 'o.~tc.d.n'~_t!!..'~_~~.'.'on."!.:.... ___._ ,__._.,?_'._A-=~_~.._.l _ .IHT.." 1 INTEREST
I
I
Miriam C. Peterson
I
I
FILE NUMBER
21-95-0840
.~---,._,--~-,...'~_.- --, -,~--_._,- --,.-.--.,. ----.- ..- .- .
1.
Northwestern Savings Bsnk & Trust -
Certificste of Deposit #043004829,
opened 7-13-94 joint with Novia L.
Norton, daughter, matured 7-21-95
for a total of $6,197.36, at which
time the total proceeds was given to
Novia L. Norton, daughter
3,000.0
3,098.68
98.68
2.
Edward D. Jones & Company Account
#484-00224-1-4, opened 10-4-84
joint with Novia L. Norton, daughter
waa cloaed 3-28-95 for a total of
$6,969.26, at which time the total
proceeds of $6,969.26 was given to
Novia L. Norton, daughter, and
Francis Norton, son-in-law
o
3,484.63
3,484.63
o 110,000.00
3,000.0010,000.00
10,000.00
7,000.00
3.
Novia L. Norton - cash gift 3-1-95
4.
Francis Norton - cash gift 3-1-95
5.
1984 Buick Regal Automobile - given to
Wayne W. Peterson, son, and
Lynnette D. Peterson, granddaughter,
on 8-4-95
750.0 1,500.00
750.00
6.
Proceeds of sale of real estate in
Cadillac, Michigan - sold 5-11-95,
cash proceeds of $185,349.73 given
to Novia L. Norton, daughter, and
Wayne W. Peterson, son
,000.00 185,349.73
182,349.73
--_._-,- _._----- -----~"~_. '.' *- -- ._--
.- TOTAL (Aho .~!!!~!!!'.!!. R.cop.il.ulolion) _~~~3 .!8~ .04____
", mort Ipan il n..d.d. inl'" oddilionol Ih..h 01 10m. Ii,,)
_'VIlli'" ""1
ITEM
NUMBER
A.
B.
4.
C.
1.
2.
3.
4.
S.
6.
7.
8.
,,~.J~'~.
~.W~.
COMMONW'AlTH 01 p(NN,nV.t,NIA.
INHUITANCE TAk .(YUIN
II:UIDENT DEClDENr
SCHEDULE H tl
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
E
PI.a.. P,lnt or Typ.
e
21-95-0840
Miriam C. Peterson
DESCRIPTION
AMOUNT
1.
Fun.ral Expu...,
Fogelsanger-Bricker Funeral Home - PA
3,601.63
2,988.00
Peterson Funeral Home - HI
Thank You Notes postage
Bill's Handyman Service - maintaining gravesite
Bendle-Long Hemorials - engraving
Family Travel expenses to both funeral sites
Admlnl.trallv. Ca.t"
1. Personal Ropro.onlotive Com million.
Social SoeurUy Numbor 01 Pononal Repro.onlative:
Year Comml..lon. paid
32.00
24.00
65.00
4,862.16
2. Allornoy Foo.
3.
Fomlly Exomplion
Clolmanl
Add,o.. 01 Clolmonl 01 decedonl'. deolh
Slreol Addro..
Clly
Slole
Zip Co do
Rololion.hlp
Probole Fo..
MI.eellonlou, Exp.nllll
Register of Wills, Cumberland County - filing Insolvent PA
Inheritance Tax Return
14.00
TOTAL (AI.o enler on IIno 9, Rocapllulolion)
(II mar. .pac. I. n..d.d, In..rl additional .h..II of .am. Iln.)
s
11,586.79
. .
. .
_IV,UIU" 'II"
*
COIlltMONWIA"tt Of ,INN,,,VA"'"
INHU"ANel IU .nUIM
IUIOlm DIUttl'"
SCHEDULE J
BENEFICIARIES
FILE NUMBER
:!I-95-0840
ESTATE OF
Miriam C. Peterson
ITEM
NUMBER
RELATIONSHIP
AMOUNT OR
SHARE OF ESTATE
NAME AND ADDRESS OF BENEFICIARY
A. TOKobl, Seque'"t
. .
1. Not relevsnt as probate estate is insolvent.
ITEM
NUMBER
AMOUNT OR
SHARE OF ESTATE
NAME AND ADDRESS OF BENEFICIARY
8. Charlloble and Gavernm.nlol Bequeslll
1.
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (AI.o enter on line 13, Recopltulo.lon) S
(I' more .pace I. n..ded, In..rt additional ,h..t. of lam. .Ira)
. . .t..:'Settlement Statement
~
,r
U,O, Ooporlmtnl olltoutlng
alld Urban Otvelopmenl
OMB No. 2502.0265
B. Typo 01 Loan
1.oFHA 2.0FmHA 3.IXIConv. Unllle 4:l'iliillull1 "
4.oVA 5. oConv. 1110. 2931
.,:Liiiill 011I r
O. rig age nBurancu 018 umber
'l'gH 2516482
C. Nole: Thlllorm II IUll\loh.<I 10 Olvo you a IIalom9nl 01 ocluallolllo,nonl c0616. A",ounl6 paid 10 and by Iha ..IU.ln.nl .o.nl .r.
.hown. lIen1l ",olkaLl "'u)o.c.r woro paid outDldo tho closing; they nrfl shown horo for Informational purposel and ore not
Includnd In Iho lolnlo
D. Namu and A'tWlu.. OrDUIIUWU' lflJnliiiliiltfA'daiU.i'OTSullur
Earl E. Elgl10 Hi dam C. I'eternon
Loia J. EIgao 1315 E. l,ake Mitchell Dr.
1'.0. !lox 826 Cadillac, Michigan 49601
Cadillac, MiChigan 49601
. orne and A druss 0 nder
NUD Mortgage Company
103 N. Mitchell St.
Cadillac" MI 49601
G. P'DpOlIy LOCllllon
1315 I::' Lako Mitchell Dr.
Cadillac, Michigan 49601
Lot 9, Grubor'a I'lat, 50lmo'I\oII1.
WoxCord County
Ii. 6.III.m.nl o.nl
Uacon & McDonald Title Co.
P co 0 6.tllom.nl
Tho'Maoonic Uuilding
Cadillac, MI 49601
I. 6.IU.ment Dol.
5/11/95
J. Summary 01 BorroWDI'1 Tr.nlaellon
100. Oroll Amounl Du. From BorrowDl
10\. Conlfact lal.lprlea 198.500.00
102. Porlonal P'Dp.rty
103. Solllomonl char 01 to IJorrowor lino 1400 1. 484 .60
104.
105.
Ad ullm.nll lor 1I0ml oollor In advanca
100. CII nown 10k.1
107. CounlV lun
108. Allaum.nlo
109. .
110.
II\.
112.
120. Groll Amounl Duo From Borrowor
K. Summary of Sellor's Tranlacllon
400. Groll Amounl Duo To Sailor
401. Contract 6alos prico
402. Porsonal ro .rI
403.
404.
405.
o
o
Ad ullmenl. lor 1I0ms Did b
406. CIl /town la.os 10
407. Count la.os 10
40B. Assossmonts to
409.
410.
411.
412.
sollor In odvonee
199,984.60 420. Oro81 Amounl Duo To Soller
198,500.00
200. Amounl Pold B Or In Beholl 01 Borrower
201. D. III or oorn061 mono
202. P,lnclpol omounl 01 now Ioan(s)
203. E.lollng 10an(l) takon subJoct 10
204. " .
205.
206.
207.
206.
209.
500. Reductions In Amounl Due To Seller
501. E.eos. d. 0.11 soolnslrucllons
502. SOIlI.monl char oslo sollar IIn.1400
503. Exlslln loan s lakon sub oelto
504. Po all ollirst marl a a loan
50S. Po 011 01 socond mort a . loan
506.
507.
506.
509.
Ad ullmonl. for Ileml un old b 80ller
510. Cllllown 10.01 to
625.97511.Countta.os to
512. Assasom.nls to
513.
514.
515.
516.
517.
51B.
519.
10 I, 475 . 97 520. Tolol Roducllon Amounl Duo Sellor
600. Cash AI Selllemonl To/From Soller
601. Gross amount duo 10 sollor Iin.420
10 I, 475.97 602, Loss roduelions In amt. duo sollor (II no 520)
98,508.63 603. Ca.h lXlTo OFromSell.r
13,200.271
185,299.73
Ad uolmonll for 110m. un old b lollor
210. Cllllown la,oB 10
211. CounlV 1..01 1/ 10
212. Allollmanll to
213.
214,
215.
216.
217.
218.
219.
220. Tolol PaId By/For Borrow.r
300. Calh AI Selll.monl FromITo Borrower
301. Grosl amounldu. from borrowar lin.120
302. La.. 0010unl6 pnld byllor bOllow.r (lino 220)
303. Cooh 1XI From 0 To Borrowor
7
13,200.27
r 50.00
-
I rrs,~"''l.13
PrevlaU' EdlUon IIOb.olele
Inwl\Jllllll
HUD-I (3.B6)
REGPA, HB 4305.2
'l. Sa111ement Chsrges
700. Tolal Selol/Broker's Commlulon b. on p,lee$ 198.500. 00@5.00%.9. 9
Division 01 Commission line 700 a. follows:
701. $ 9 925.00 10 Centur 21
702. $ 10
703. Commls.lon paid 01 Solllomont
704.
800. lIoms Ps eble In Conneellon Wllh loon
801. loen Orl Inellon Fee %
802. loan DI.count %
803. ,00.al Feo to uadrant Northwest
804. Credit Report 10 Online S stems
805. londe,'.lno oollon Foo
B06. Mort e olnouraneo A Ilcallon Foe to
807. Anum tlon Feo
B08. Tax, Ins. Ver. to NBD
B09. Mort. Brok Fee to NBD Bank
810.
811.
900. 1I0ms Ro ulred B lender To ee Paid In Advoneo
901. Intoroottrom 5 11 95 10 6 1/95 $ 22.60
902. Mort 0 0 Insuraneo Promlum lor
903. Hazard Insuraneo Promlum 10'
904.
905.
1000. Reeerves De o.lIed Wllh lender
1001. Hazard Insu,ance
1002. Mort 0 olnsuranco
1003. Clly property laxo.
1004. County proporty laxe.
1005. Annual asse..monl.
1006.
1007.
1008
1100. Tille Chor os
1101. Sottlomonl or closln 100
1102. Abslreet or tllle .oa,ch
1103. Tlllo oxemlnatlon
1104. Tlllolnsuranco blnder
1105. Documonl proparatlon
1106. NOla foos
1107. Attorno '.100.
Includos abovoltems numbor.:
110B. Tlllolnsuranco
Includo. abovoltams numbo,.:
1109. londofs co.ora 0
1110. Owner's covers 0
1111.
1112.
1113.
1200. Government R.eordln end Tran.lar Char e.
1201. Roco,dlng feeo: Dood $ 10.00 : Man 0 e $ 19.00
1202. Clty/counlyl.tamp.: Deod $ : Mortgage $
1203. Slalolaxl.tamp.: Doed $ 1 , 702.80 ; Mortgego $
1204.
1205.
1300. Addlllonal Setllement Char e.
1301. BulYo to WADE-TRIM INC.
1302. Po.tln. oetlon 10
1303, Water Test
1304. NBD Doc Pre -200
1305.
.00
Paid F,om
Borrowors
Fund. 01
Sottlomonl
Paid From
Sollo,'.
Fund. al
Sonlomonl
9.925.00
240.00
48.00
($2.000.00)
100.00
P.O.C.
Ido
monlh. 10
oars to
oarB to
474.60
monlh. $
month. $
monlhs $
monlhs @ $
monlh. $
monlhs $
monlh. $
monlh. $
a, monlh
or month
or monlh
po, monlh
or monlh
or mon1h
or monlh
or month
5
15.00
10 Bacon & McDona 1d
10 Bacon & McDonald
to
10
10
10
10
10 Bacon & HcDona1d Title Co.
208.00
866.50
$ 100 000.00
$ 198 500.00
@ 208.00
@ 866.50
. Roloase. $
29,00
1 702.80
295.00
15.00
to C-21
to NBD
25.00
1400. Tolol Setllement Cherge. (enler on Une.l03, Secllon J and 502, Secllon K)
1 484.60
12 574.30
I havo carelully reviewed the HUD.l Setllemenl Slolemenl and 10 be.t 01 my knowledge and beUel, Ills 0 Irue and accurale
otalemont 01 011 receipt. and dlobursement. mode on my account or by me In thl. tran.acllon. Ilurlhor corllfy thsll havo
recolved a copy 01 the HUD.l Sottlemont Stalemenl.
BortOw~~4'- Earl E. Elgas
.~..j('/.0~
~ (/ . 1
LcllS J. E gas
The HUD.l Solllement Stotrlent hlch I hove prepered I. a true and aceurale account 01 thl. transecllon. I hava causad or
will csu.o the lund. to ba dl ur d In accordance with this statement
s/!.. 0. ~{/.. . -::z:, (
- 'f1'.jjL;:..LJ.;J!JJ iLL (l ,uQ.t: l'itt:
SetUsmentAgenl Baco McDonald Title Co. Dole (File H 2931)
WARNING: Ills 0 crlmet knowingly make IsI.e slalemenls to Ihe Un lied Sletes on this or sny nthor slmUer lorm. PonalU..
upon convlcllon con Include 0 fine and Imprl.onment. For detaUe oee: Tille 18 U. S. Code Secllon 1001 ond Sscllon 1010.
,
/It,,~
SeUer
c? ;4c~
, ..
Hlrlarn C. Peterson
~--. -........--.--'.. ...
~,~... ..'---,,' -....-,.---- --.._-- .-.-- ------------ ,-----"-
ReceiveD 'ROM,
&
ACN
ASSESSMENT '!'I
CONTROL iii
NUMBER
AMOUNT
PERKINS DAVID P
IHb E KING STREET
101
tl,OI!S...O
i
1
,
SHIPPENSBURG. PA 17207
'010 HUI
21-1990-0840
DECEDENT (LASt)
PETERSON MIRIAM C
"'MINT
seN 362-:m-2219
(FIRST) (Mil
~
STMARK o.t.TE
I
i
,1
,
!
'/
COUNTY
CUMBERLAND
o.t.TE OF DEATH
REMARKS
m TOTAL AMOUNT PAID
SEAL
NOVIA L NORTON
DAVID P PERKINS
CHECK" 1150
ESCl
U ,028.40
VZ
RECEIVED BY .h11i~Sl(::'T~-"~'PPv :
MARV C. L WIS ;J1t~ J~~ :
REGISTER OF WILLS
REGISTER OF WILLS
-----~---_._-~-~------------------~.
, . r \
.1 1 - ~
'1.' f .r'
;.. .
, .
.' ..
0:' ,.....
.j !
i'
'.
....
\ '. t.
. .
. ,
,
'.- ... -. - _.-
. --.- .._--
-~ -"
to. - . 1"
~. . '-----, ~
. ..----- '-.-.---."-
,
-.....-
. .----...~ J
1
'.
.--
v
15.- &J0 '=<
c ,~
REV-1547 EX AFP 112.95*
COHHOHVEAlTH OF PENNSVLVANIA
DEPARTHENT Of REVENUE
BUREAU OF INDIYEDUAL TAKES
DEPT. UD6DI
HARRISBURG, PA 171za.D6Dl
NOTICE OF INHERITAHCE TAX
APPRAISENENT, ALLOWANCE OR OISALLOWANCE
OF DEDUCTIONS AND ASSESSNENT OF TAX
ACN 101
DATE 08-05-96
OF FILE NO.
DATE OF DEATH 08-07-95 COUNTY CUM8ERLAND
NOTE. TO INSURE PROPER CREDIT TO YOUR ACCOUNT. SUBNIT THE UPPER PORTION OF THIS FORN WITH YOUR TAX
PAYNENT TO THE REGISTER OF WILLS. NAKE CHECK PAYABLE TO "REOISTER OF WILLS, AGENT"
REMIT PAYMENT TO:
DAVID P PERKINS ESQ
MARK ETAL
126 EKING ST
SHIPPENSBURG PA 17257
REGISTER OF WILLS
CUM8ERLAND CO COURT HOUSE
CARLISLE. PA 17013
Allount R..itt.d
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV:isfii.EX-,'ii:'p-nZ:9ifj-iiiificE--OF.i"NHEififAiicE-TAX.iiP'jiiiiiisEHiii'i'-;-,'ii.i:oiiAiici"iili............._...
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF PETERSON MIRIAM C FILE NO. 21 95-0840 ACN 101 DATE 08-05-96
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 Elt.t. (Schedul. A) (1)
2. Stock. and Bondi (Schedule 8) (2)
3. Clo..1~ Held stock/Partnership Int.r..t (Schedule C) (3)
4. Hortgag../Not.. Receivable (Schedule DJ (4)
S. Calh/Bank Deposita'Hi.c. Parlonal Property (Sch.dul. E) IS)
.6. JointlY Owned Property (Schedul. FJ (6)
7. Transfara (Schedule OJ (7)
8. Total AI..t.
I CHANGED
.00
.00
.00
.00
272.37
209.72
203.683.04
181
204.165.13
APPROVED DEDUCTIONS AND EXEMPTIONS:
11,586.79
9. Funeral E~p.n.../Ad.. Coata/Hiac. Expen.el (Schedule H) (9)
10. Oabt./Hortgage Li.bi1itieI/Lien. ISchedu1. I) (10) .00
11. Total Daduction. Ill)
12. Net Velue of TaM Return (12)
15. Charit.b1e/Govern.ental O.qu..t. ISchedule J) 115.
14. Net Value of Eatllte Subject to Tax 114.
NOTEI If an assessment was issuad previously, lines 14, 15 and~or 16, 17 and 18 will
reflect figures that include the total of ~ returns assessed to dste.
ASSESSMENT OF TAX:
15. Allount of Line 14 .t Spou..l r.te (15)
16. A.ount of Lin. 14 taMable .t Lin..I/CI... A r.t. 116J
17. AMOunt of Lin. 14 taM.bl. at Coll.t.r.l/Cl... Brat. 117J
18. Principal TaM Due
TAX CREDITS:
PAYNENT
DATE
11-06-95
05-07-96
.00
192,578.34
.00
X .00.
X .06.
X .15.
1181
RECEIPT
NUNBER
AA082299
AA112808
DISCDUNT 1+ I
INTEREST I-I
526.32
.00
10,000.00
1,028.40
ANOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
11 . ~86 7Q
192.578.34
.00
192.578.34
.00
11,554.70
.00
11.554.70
11,554.72
.02CR
.00
.02CR
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN .1. NO PAYNENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU NAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. I
.- ~c(
':'{ ell\.
'0 '" N ,
:\ t\- .',
;~, ',j
.t: L{' .;
~ .
',--:
,.
" ..
0.....') \9- <t=
o~ oj c3
,va: 13
a:
R[SUVA TI ON I
Uht.. of dlu""t. dvlnll on or beton o.ullb.r U, 1911 .- if any future Inh'''' In the ..t.t. 11 t'M'f.tred
In po.....lon or .nJoYlant to el... . (coll.,.,.l) bln,flct.rl.. of thl dlc.den' .ft,r the ..plr.tlon of ~y ..tet. for
11'. or for v..r., thl c~.lth hereby Ixpr...ly r...rv.. thl rlDht to ,ppr,I.. Iftd ...... tr~.f.r J~rlt."c. T.x.,
It the l~ful Cia.. . (cOllet,rel) r.t. on ~v .uch future Int.r..t.
PURl'OSEllf
NOTlCEI
To fulfill thl r.qulr..~t. of SICtlon 2UO of thl InherUllnu and fll,h hie Act, Act U 01 1991. 71 P.I.
Section 2l4D.
D,tlltCh the top portion a. thh NotlCI end .ub_1t with your p......nt to thl RIgllt.r 0' "Ula prlntld on thl nv.r.. lid..
n"ek. chick or 110M)' order, PI...lbh tOI REGISTER OF MILLS, AGENT
AU p.plnt. received ,Mll flr.t bl applied to any Int.r..t which ..y b. due ..Uh MY ,...lndlr -..lIld to the hll.
REFUND (CR)I A r.fund 0' . t.1l crldlt, which WI' not r.qu..t.d on the la. R.turn, .IY b. r.qu..t.d by co~l.tln. In "Application
for Re'und of P.nnsvlvMI. Inh.rltance and E.tat. Till" tREV-UU). APpllcatlon. ar. avallabl. .t the Offlc'
of the R.gl.t., 0' Willi, any 0' the Z5 Rlvenue DI.trlct Of,lc.I, or by c.lllng the .p.cl.1 Z4-hour
an.w.rlng ..rvlc. nu-a.rl for for.. ord.rlngl In Ptnn.ylvsnla 1-IOO-S6l-Z0SD, out.ld. P.nn,Ylvanl. and
within loc.l H.rtl.bUrg .r.. (717) 787-1094, 1001 (117) 77Z-ZZSZ (Haarlng E~.lr.d Only'.
PAYHEHTI
alJEtTION$I Any party In Int.r..t not ..tl.fl.d with the appr.I....nt, allow.nc. or dl..llowsnc. of deductlonl, or ......eent
0' tall (Including dl.count or Int.r..t) .. shown on thl. Hotlc. au.t obj.ct within .I~ty 160) day. of r.c.lpt 0'
thl. NoUc. byl
--wrlttan prot..t to t~ PA Depart.ent of R.v.nue, loard 0' App..l., D.pt. ZlloZI, Harrl.bUrg, PA 17121-1021, OR
--.lactlon to have the .att.r dater.ln.d at audit of the .ccount of the per.onal r.pr...nt.tlv., OR
--appaal to thl arphsnlt Court.
ADMIN
ISlAAlIVE
CQRRtClIDHSl,
rletull .rror. dl.cov.r.d on thl. ........nt .hould b. .ddr....d In writing tOI PA Dapart.ent of A.V'nuI,
lur.w 0' IndlvldU.l TI~", ATTHI Po.t A.......nt hvllw Unit, D.pt. 210601, "ar,hbUrg, PA 17121-0601
Phon. (717) 787-6505. S.. p.g. S of the booklet "In,tructlon. 'or Inh.rltanc. Till R.turn 'or' RI.ldant
o.cld.nt" (REV-1S01) for en ..pl.nltlon 0' ad.lnl.tratlv.ly corr.ctlbl. .rror..
DUCOUHrl
If any ta. due II p.ld within thr.e (S) callndar lonth. .ft.r thl d.c.dlnt'. da.th, . 'Iv. p.rc.nt C,~) dllcount 0'
the t.1l p.IJ It .Uo..-d.
The IS~ till .~.ty non-partlelp.tlon pan.lty I. COlPut.d on the tot.1 0' the t.x end Int.r..t .......d, ~ not
paid b.for. January 18, 1996, the flr.t dlY .ftar thl .nd of the t'll una.ty pltlod. lhlt non-p.rtlclp.tton
pen.lty b app..I.bl. In thl .... ..nn.r .net In th. the .... U.. p.rlod .. you would .pp..1 the t.. and Int.r..t
thlt hi' bien .......d a. Indlc.t.d on thl. notlc..
PENAL TVI
INTEREST I
Int.,..t b ch.,g.d b.glnnlng with flr.t d.y of d,lInqu,ncy, or nln' (9) .onth. and OM II) d.y fr~ tM d.t. of
dI.th, to the dlt. of ply..nt. T.... which b.e... d.llnquent be'ore J.nu.ry I, 191Z be.r Int.r..t It the ,.t. 0'
.111 (6~) p.rcent p.r .nnua c.lcul.t.d .t a dilly r.t. 0' .00D16'. All t.... which b.c... delinquent on and .ft.r
J.nu.ry I, 1912 will b..r Int.r..t .t . rat. which will v.ry fro. c.l.nd.r y..r to c.lend.r y..r with th.t r.t.
announced by the PA o.p.rt_ent 0' RlvlnUI. Th. appllcab,1. Int.r..t rat.. for 1912 through 1996 .r.l
'!!!t Int.r..t A.t. DillY Ent.r..t Flctor I!.!r Int.r..t R.t. D.llv En"r..t F.otor
190Z ..~ .000541 1917 OX .000247
1915 I'~ .OOD411 1911-1991 II~ .aDUOl
1914 II~ .00nOI 199Z OX .ODot47
1915 IS~ .OODU6 1995-199" 7' .aDol'Z
1916 I" .ODGZ7" 1995-1996 .. .ODOl47
--Ent.,..t II c.tcul.t.d .. follow"
INTEREBT . BALANCE OF TAX UNPAID X NUNBER DF DAYB DELINQUENT X DAILY INTEREBT FACTDR
--Any Notlc. I"uld .,t.r the t.1l b.CD'" d.llnqu.nt ..III r.fl.ct an Int.,..t calculation to ,I,t.en (15) d.y.
beyond the dlt. of tha .......ent. I' plyaant l. ,Id. .,t.r the lnt.r..t co.put.tlon d.t. .hown on the
NoUce, .ddltlon.1 Int.r..t au.t be calcul.t.d.