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INSOLVENT
~~ 1,19~ INHERITANCE TAX RETURN
" "~',~ RESIDENT DECEDENT
COMMONWlA\lH 01 ''''NlllVANIA (TO BE FILED IN DUPLICATE
OlPAIllMINl Of R(V(NU(
H""I~J:~, ~~o\"i:!'O",I. WITH REGISTER OF WILLS) COUNIV COD.E.. ~/.
M . N MI I I I M A
GARllERIClI, MARY n. c/o l,I'o1(]I'r NurHin'l 110m"
R>llilIRUin, NuMIIl------.lliAn.Ol.blilfi. "'lbi71/( 0.'r..',"/""I"81) rJ" I.~~;: ~7 ;.~~' \~ ~. 170. I
204-15-1895 4/27/95
___._____________ ~_~~~..J___ C umu e..r 1 iJ Ild__
~~ 1. Original Relurn 0 2. Supplemental Return [] 3. Remainder Return
(for dol.. of d.alh prior 10 12.13,B2)
[] 4. limited ellale [J 40. Future Inlerel' Compromile LJ S. Federal Ellole To.ll
(for dalel of death after 12.12.82) Relurn Required
n 6. Decedent Died Teltale 0 7. Decedent Mainlolned a living Trull _ 8. Tolol Number of Safe Depalit 80.1181
(Alloch cop 01 Willi (Allach co y 01 Tru"1
ALL CORRESPONDENCE AND CONflDlNTIAL TAX INFORMAnON SHOULD II DIRECTED TOI
NAM M I MAIII ~ A DR
John J. Krafsig, Jr., Esquire 292. N. Front St.
UllPHONlNUMIU lIarrlsbureg, Pat
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'O"'A'1I0fDIA'HA""12'~1'" CHICKHIRI
If A S,OUSAL
'OV!l!rT C~DJrJ!C~AJMU?J;;J___
fiLl HUM".
9lJ..
VE~R tfJ:_ NUMBER
17110
-I717
I 236-2109
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1, R.al Ello'. 15ch.dul. AI ( I) ...___.Nollc_____..__
2, 510c~. and Bond. 15ch.dul. B) ( 21 ..._~Qn"
3, Cla..ly H.ld 5locllPo"nenhlp In'.r..' (5ch.dul. q I 31 ____NQn~____
4. Ma"gaB.' ond No'.. R.c.lvabl. 15ch.dul. DI I 41 _ -1'lOJ1~
S. Ca.h, Ban~ D'po.l.. & MllC.llan.ou. P...onol Prap.rlyl 5) _$J,,_:U1i_. 4 B.
15c..dul. EI
6, Jolnlly Own.d Prop."y 15ch.dul. F) I 6) _.._t:l..9JL~___
7. Tran"... 15ch.dul. G)15ch.dul. LI I 71 N.2..n..Q___
B. Tolol Groll Alleh (10101 line I 1.7)
9. Funeral E.Ilpensel. Adminlltrative COI", Mlscellaneoul ( 9) _L4..L;t~ 6 .99
Exp.n... 15ch.dul. H)
10, D.b... Mo"gag. lIoblllli.., lI.n. 15ch.dul. I) liD) _.l!9ne ___
I L Tolal O.duction.I'o'ol Hn.. 9 & 101 (II) _$JA.. 246.99
12, N.'ValuooIE,'ol.(lin.Bmlnu.lln.ll) (12) None - Insolyent
13, Charllabl. and Gov.'nm.nla~B'qu."'15ch.dulo JI 1131 _$.!..., 000.00
.. 14, N., Valu. 5ubjoc, 10 To'IHn. 12 minus Hn. 1,:JL_____.__,____.___._~L-:NonQ..:-..!~lE;OI ven"t
IS, Amounl 01 Hn. 14 'a. obi. a'6% '01. 1151 .._....>< ,06 a ..Nll\___.___."
Ilnclude valuel from Schedule K or Schedule M.)
16. Amount of line I A ta.lloble 01 15% role
(Include valuel from Schedule K or Schedule M.)
17. Prindpalla.ll due (Add ta.ll from line 15 ond from line 16.)
18. Crediu Spoulol Poverly Credit Prior Poymenll Discount Inlerest
--~~ + ----- +.-..-- - -_._-~-~-
19. If line 1811 grealer than line 17, enler the difference on line 19. Thll II the OVERPAYMENT.
aD
20. If line 17 II grealer rhan IIna 18, enler the difference on line 20. Thil II the TAX DUE.
A. Enter the Interell on the balonce due on line 20A.
I B) _$...L 335.48
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117) _Nollc-=_Insolv..cnt_
IIBI_.._._N/rl______._
1191 .__--1':I.O..ll e
Chock horo if you 010 requolting 0 ,olund of your overpayment.
120) t:l_<?Jlg__-=-lJ!.50 .!Ys.n L_
(20A)_____..N/^--____
120BI _NQnQ~I_'J!3.Q.Ly_L~n..L
B, Enl.r Ih. 10'01 of Iin. 20 and 20A an Iin. 20B, Thl.l. ,h. BALANCE DUE.
Make Ch.dc Payobl. fal R.ul.t.r of Will., Au.nt
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PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (,,) IN THE
APPROPRIATE BLOCKS.
1. Did decedent make a transfer and:
a. retain the use ar incame af the property transferred, .......................................
b. retain the right to designate who shall use the property transferred or its income,
t . v r . . t t.
c. ra oln a ra e slonary In eres or ....................................................................
d. receive the pramise for life of either payments, benefits ar care~ .......................
2. If death occurred on or before December 12, 1982, did decedent within two years
preceding death transfer property without receiving adequate consideration~ If death
occurred after December 12, 1982, did decedent transfer praperty within ane year of
death without receiving adequate consideration~ .................................................
3. Did decedent own an 'in trust for' bank account at his or her death~......................
J.ES Na.
x
x
x
x
x
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.
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'IvIlClII.II'lI
, ::~_l SCHEDULE E
~ CASH, BANK DEPOSITS AND
CCMMO"WULTH 0' ",,"mV'''1A MISCELLANEOUS
'HHU"'HClI" IIIU'H PERSONAL PROPERTY
USIDINT DlctDINT _ ____ __
ESTATE OF
MARY B. GARBERICH
J
__ PloCI. !rln! or Typ..
FilE NUMBER
(All pIOp.f')' jolnlly.o...n.d ....ith th. Righi of Survi\'onhlp mUll b. diulol"d on Slhd"l. '1
ITEM
NUMBER
DESCRIPTION
VALUE AT
DATE OF DEATH
1.
2.
Social Security check
Refund of moneys on deposit with Leader Nursing
Home, Inc.
$263.00
$983.94
3 .
Refund from moneys on deposit with Reese Funeral
Home Trust Fund for prepaid funeral bill and
expenses
$88.54
-,
TOJAL Al,a .nlor on lino 5, Roca lIulatlan S
I 335.48
IAtloch oddilionol8'hot )II 11" ,heeh if more 'poc. It n..d.d.1
IIYUIII.. V"I
ITEM
NUMBER
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_..~'l~
COMMONWIAl1tt 0' PlNHSY\VANIA
INtURIlANCI tu .nU.H
.UIOIH' OICfOWt
J
Pllal. Prlnl or TVpI
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
FI
GARDERICII
DESCRIPTION
AMOUNT
A. Funoral Explnl..1
B.
2.
3.
4.
C.
1.
2.
3.
4.
5.
6.
7.
8.
1.
Prepaid to Reese Puneral lIome
N/A
T.
Admlnlllrallvl Co.'"
Pononal Rlp....nlatlvo Cammlnlan. Kenneth
Social S.curlly Numb., 01 Ponanal Rop....nlatlvOl
Voa, Camml..lon. paid 1995
$200.00
ReesQ...
Alla'noy Foo. - John J. Krafsig, Jr., Esquire
(Legal fee and costs & expenses)
Family E.ompllan
Claim anI
$325.00
N/A
Rolallan.hlp
Add.... 01 Claim anI 01 docod.nl'. doalh
51..01 Add,o..
CHy
51010
Zip Co do
P,obalo Fo.. - Register of Wills of Cumberland County -
Piling Petition and Inheritance Tax Report
Mlle.llanlau. Explnl."
Bell Atlantic - Services to decedent $6.47
$ 4 5.00
Commonwealth of Pennsylvania - Department of Welfare
Medical assistance rendered to decedent $13,670.52
TOTAL (Aha .nl., on IIn. 9, Rocapllulatlanl $14, 246.99
(II marl Ipac. II n..dld, Inllrl addlll.nallh.... 01 lam. Ilzo.)
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SCHEDULE J
BENEFICIARIES
ESTATE OF
M/\IlY B. GI\RBERICII
FILE NUMBER
ITEM
NUMBER
ITEM
NUMBER
2.
3.
4 .
5.
6.
2.
1.
1.
NAME AND ADDRESS OF BENEFICIARY
RElATIONSHIP
A. Tallable 8equluh:
AMOUNT OR
SHARE OF ESTATE
Richard C. Walker Nephew $500.00 bequest &
1102 Columbus I\ve., Lemoyne, Pa. 17043 ~ of residuary.
Suzan Stratten randdaughter $200.00 bequest.
318 Larkspur Plaza, Larkspur, Cal. 9493
Rose Polek randdaughter $200.00 bequest.
3705 Reichert Rd., Harrisburg, Pa. 1711
John Garberich Grandson $200.00 bequest.
3209 E1mwood Dr., Harrisburg, Pa. 17110
Kenneth Reese None Marble top table.
781 Poplu1ar Church Rd. , Camp H11, Pa. 7011
Richard C. Wa 1 ke r Nephew Marble top wash
1102 Columbus I\ve., Lemoyne, Pa. 17043 stand .
*N.B.
No assets for distribution, in
ursing Home.
NAME AND ADDRESS OF BENEFICIARY
8. Charltablo and GOY ern mental Bequel'l:
First (United) Methodist Church of West Fairview
2nd & North Sts., West Fairview, Pa. 17025
Speicer's Men's Bible CI~ss, Market Sq. Presbyterian
Market Sq., Harrisburg, Pa. 17101
.N.B. No assets for distribution
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS IAI.a on'o, on lino 13, Rocapi'ulalianl
(If mo,. .pan f. n..d.d, In..,f addltlonal.h.... of 10m. III.)
AMOUNT OR
SHARE OF ESTATE
$500.00.
Church
$500.00.
5
1,000.00
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WIU. AND TESTMIDNT
11, HAllY D. GAIIU~:IUCII. Widow of lIarrisburg
ill the Cuunl)' or Dauph1n uUtI State IIC Peufllylvunlu, lJeluH' DC IUUIIlJ mlllLl.
1I1l'IlIlIrr nllll UlItJcrllolllJlulC, elo 1Il1l1.e Gnu lJuLlllh tills my last will alld tClt4l11ent, hereby revolduJ:r
11I111 nlllkillK vuId all (urnaer will. It)' file At 011)' tlllIe hereloCorc nUHle.
.\lId (iral, 1 dJrect thot IIIJ" (ununllJe cunducled in manlier corre.llul1dillg with my ealnle Bud
ailllllllulI 11111(. alld thnt nil III)' jlllt deht. nlld (1Il1ernl "1""'" I,. (1111)' Jlnlli and aatl.ned sa auulI UI
cun\'ellientl)' IOn). be aller 111)" decease.
Aa to luch eltnle al it hath plellsed GUll III illlrullllle willi, I dispuse IJr the sUllie AS Culluw_.
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r first diroct that sll of my dObts, taxos alld costs of
my administratioll bo first paid. alld if 1I0coosary doduct it
f,rom my residuory oDtate, and after the paymont of the sarno,
I hereby make the following bequestsl
A. I boquoath tho sum of $500.00 to tho First Hothodist
Church of West Folrviow, Pennsylvania.
D. I bequeath tho sum of '500.00 to Spuicer's Mon's
Dible Class, of the Market Squaro Presbyterian Church,
Harrisburg, Pennoylvonia.
C. I boquooth tho sum of $500.00 to Richard Walkor,
my nephew.
D. I boquonth tho sum of $200.00 to my grnnddaughtor.
Buzan Stratton, prusently residing in the State of California,
E. 1 bequoath tho sum of $200.00 to my granddaughter,
Rose, presently of t1urrisburg, Pennsylvania.
F. I bequeath the Bum of $200.00 to my grandson, John
Garborich, prusently of lIarrishurg, Pennsylvania.
G. 1 bequoath my marble top end table to Kenneth Reoso,
of the Reese Funeral lIomo.
II. I bequeath my marble top WAsh Btand to my nophew,
Richard Walker, presontly of Lemoyne, Pennsylvania.
II. ^Cter the distribution of the above specific bequests sot
forth in paragraph 1 of this Will, which afe made tax freo,
I hereby grant and bequeath all of the rest and residue of my
personal property, both tangible and intangible, wheresoever
situate, and devise Any real estate or any interest I may have
in any real ostate, wheresoever situation, equally, share and
sharo aliko, to Kenneth Reeso and Richard Walker.
III. I immediately direct that upon any death, that Kenneth Rooso,
of tho RoeBe Funeral lIome, who shall be my Executor, shall be
immediately informed of my death to make all nocessary funoral
Bnd burial arrangemonts, that I have previously discuBsod with
him durillg my lifotimo.
IV.
V.
I horoby diroct thot my fUlloral
out by the Reose Funeral lIomo,
funeral and burial expunoes.
I hereby nominate an~ appoint John J. Krnfsig, Jr., Esquire,
to serve as the attorney for my estato.
and buriol shull bo carriod
with who," I havo propaid my
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CERTIFICATION OF NOTICE UNDER RULE 5.G{a)
Name of Decedent. MARY B. GllRBffirCII
Date of Death' ^pril 27, 1995
Will No !\dmin. No ,.:}/- q tJ- -. '17;::1-1
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 es~te on Novembe r 27, 1996
Name Address
United Methodist Church of West Fairview. - 2nd & North Sts., West Fairview, Pa. 17025
Spei\".l.:....";o I.h:u";o Dibl\,,; Clu;o~ - M,.u.k.!,;;'L ~I Pj..l,;;oLyL\,,;j.';'ul. CJ.urd'l lIolj..l.,Lu'""JI Pa.17101
Richard Walker - 1102 .CollUTlbus ^ve., Lcrnoyne, Pa. 17043
Suzan ~tratten - ~ln LarKSpUr Plaza, LarKspUr, ~al. ~q~~~
Rose Polek - 3705 Reichert Rd.. Harrisburq, Pa. 17110
John Garberlch - J2U!I Elmwood Dr., Ilarrlsburg, Pa. 1I1lU
Kenneth Reese - 781 Peolar Chnrrh Rn.. Camp Hill. Pa. 17011
Notice has now been given to all persons entitled thereto under Rule
5.S(a) except None
Date' J1p"PI11hpr n 1 qq~
~~~
Address 2921 N. Front Street
Ilarrisburq, Pa. 17110
'Telephone{ 717) 236-2109
Capacity: Personal Representative
x Counsel for' personal
representative
IN RE: ESTATE OF
MARY B. GARBERICH
deceased
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS DIVISION
NO.
1995
PETITION FOR SETTLEMENT OF ESTATE
NOT EXCEEDING TWENTY-FIVE THOUSAND DOLLARS
TO THE HONORABLE, THE JUDGES OF CUMBERLAND COUNTY:
AND NOW, comes Kenneth Reese, Executor and Petitioner,
of the above mentioned decedent, Mary B. Garberich, who respect-
fully petitions as follows:
1. Your Petitioner is an adult individual
residing at 781 Poplar Church Road, Camp Hill, Cumberland County,
Pennsylvania 17011.
2. The decedent, was a legal resident of the
Leader Nursing Home, situate at 1700 Market Street, Camp Hill,
Cumberland County, Pennsylvania 17011; and the decedent was
ninety-nine (99) years of age, who died testate on April 27,
1995; her date of birth being July 15, 1895.
3. No application for Letters Testamentary or
Letters of Administration have been made by your Petitioner or
any other person of record.
- 1 -
4. The total assets of the decedent's estate,
consisted of $1,335.48.
5. The Petitioner has seen to it that the
decedent was properly and decently buried and incurred reasonable
expense in attending to the last repose of the decedent.
6. That your Petitioner, who also conducted
the funeral for the decedent, by prior arrangement made by the
decedent, provided for her burial services in full.
7. That only known creditor of the decedent,
is the Pa. Dept. of Welfare, who has a claim for medical assist-
ance rendered to the decedent, in the sum of $13,670.52, which
exhausts all assets.
8. That the decedent was a widow and by the
terms of her Will, a true and correct copy of which is attached
hereto and marked as Exhibit "A" made bequests as set forth in
the Exhibit. However, due to the fact that there are absolutely
no assets to pay the said bequests, a letter has been sent to
all beneficiaries, apprising them of the fact, that no assets
exists to pay any bequests and that this Petition will be
presented so apprising the Court. Attached hereto is a a copy
of the notice sent to said beneficiaries, marked as Exhibit "B."
9. Pursuant to Rule 5.5 of the Rules of Orphans'
Court of Civil Procedure, notice under date of November 16, 1995,
was sent to the Office of the Attorney General of the Commonwealth
- 2 -
,
of Pennsylvania, a true and correct copy of which is attached
hereto and marked as Exhibit "C," together with a copy of Proof
of Service by Certified Mail, Return Receipt Requested.
10. That your petitioner has been required to
engage the services of John J. Krafsig, Jr., Esquire, to handle
the numerous correspondence, paper work and the like, for which
he has incurred reasonable costs of $325.00; costs to the Register
of Wills for filing the Small Estate Petition and the filing of
an Insolvent Estate Return for the sum of $45.00; the sum of
$200.00 for the Petitioner for his services in carrying out this
petition under the Small Estate Act; and $6.47 to Bell Atlantic.
11. That the Petitioner and his counsel have
previously filed an Insolvent Estate Inheritance Tax Return.
12. That your Petitioner therefore desires and
requests the approval of your Honorable Court, after first
deducting the above mentioned expenses, that the balance of
$759.01, be awarded and directed to be paid to the Commonwealth
of Pennsylvania, Department of Welfare, upon their priority
obligation.
13. That your petitioner therefore desires and
requests the approval of your Honorable Court to settle the
Estate without the necessity of incurring any further costs of
administration and desires to invoke the provisions of the Small
Estate Act; he prays that an Order of Court be entered forthwith
- 3 -
authorizing and approving the administration of said Estate,
without the necessity of making legal advisement thereto or to
conduct formal administration.
WHEREFORE, your Petitioner prays your Honorable Court
to order and direct, that from the funds presently held in
escrow, that the sum of $325.00 be awarded to John J. Krafsig,
Jr., Esquire, for legal fees and related expenses/ the sum of
$45.00 to the Register of Wills of Cumberland County, Penn-
sylvania/ and the sum of $200.00 to Kenneth Reese, Executor of
said Estate for his administration/ $6.41 to Bell Atlantic/
and that the balance of $159.01 be awarded and directed to be
paid to the Commonwealth of Pennsylvania, Department of Welfare/
and that the Order shall direct that the said Estate shall be
closed out without the need or requirement of making legal
advertisements, or conducting formal administration, pursuant
to the Small Estates Ac~ of the Commonwealth of Pennsylvania.
AND HE WILL EVER PRAY/
11110
Dated: December 21, 1995
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JOlIN J. KIL\.FSIG, JR., INC.
ATTORNEY'AT'LAW
HARRISBURG. P'ENNSYLVANIA
17110-1281
;ZGal N. FRONT STREET
TUt 717'Z3G'210D
December 27, 1995
'-'4UIO."
PIHHlnvAH'A B."
Dln"ICT a, COLU....I... SA"
In Re: Estate of
MARY D. GARBERICH
To: First (United) Methodist Church of West Fairview
Speicer's Men's Bible Class
Richard C. Walker
Suzan Stratten
Rose Polek
John Garberich
Kenneth Reese
Please be advised the undersigned is attempting to
determine if he will involve himself in preparing a Small Estate
Petition in the above mentioned Estate.
Mrs. Garberich left this world with an estate of
$1,335.48 after 99 years. Against the sum, involving costs
of preparing and filing Small Estate Petition and Insolvent
Inheritance Tax Return, with numerous telephone calls, corres-
pondence and notices regarding the said Estate, and the claim
of the Pennsylvania Department of Public Welfare for maintenance
claim of $13,670.52 to C/R 2l-0069537-PA.
This means that the above named beneficiaries in her
Will, will not receive any payment, pursuant to 20 P.S. S 3392,
which mandates the priority to the Dept. of Welfare, where there
are insufficient assets.
Because her Estate is so pitiful small and the State
has a priority claim, I request you send me a letter by no later
than January 8, 1996, to advise if you object to the claim of the
Department of Welfare. Anyone who does, should file a claim with
the Register of Wills of Cumberland County and be prepared, at
your expense, to pursue the matter, as there is no money for me
to be involved in any such proceeding and to notify the Pa. Dept.
of Welfare of your objection.
Otherwise, there will be no probate of the enclosed Will
and a Petition to close out the Estate will be filed with the
Cumberland County Court on January 9, 1996.
JJK/sls
Enclosure
Very tru\~yours,~/\
JOhn~K~~r '
Exhibit "8"
_. .r7$"
~?~. . .
7\. --
i
JOlIN J. KnAPSIG, In., INc.
ATTORNEY'AT'LAW
HARRISBURG. ptENNDYLYANIA
17110'ln1
r/
Z8al N. FRONT STfUET
TI:L.l 717.ne'210D
t.4'Malll
~lhHULY.NI" I."
Dln'tlel 0' COLUM"" 8..
November 16, 1995
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Charitable Trust section
Office of the Attorney General
Commonwealth of pennsylvania
14th Floor - Strawberry Square
Harrisburg, Pennsylvania 17120
In Re: Estate of
MARY B. GARBERICH
Date of Death: 4/27/95
Age: 99
Cumberland County
Orphans' Court
NOTICE PURSUANT TO RULE 5.5
OF RULES OF CIVIL PROCEDURE
1. The caption of the case: The Estate of Mary B.
Garberich, deceased, (no number assigned, as yet) Orphans' Court
Division, Cumberland County Court of Common Pleas.
2. The nature of the proceeding is the filing of
a Small Estate Petition to secure the payment to the Pa. Dept.
of Welfare towards their claim for maintenance, see attached
Exhibit "A."
3. No Petition will be submitted to the orphans'
Court until clearance is first obtained from the Office of
Attorney General, with a total estate of $1,335.48 to administer.
4. The decedent's name is: MARY B. GARBERICH.
5. A copy of the will making two charitable bequests,
is attached hereto and marked Exhibit "B."
6. The name and address of the charities are: First
Methodist Church of West Fairview, West Fairview, pennsylvania
17025 and the Speicer's Men's Bible Class of Market Square
Presbyterian Church, 21 S. River Street, Harrisburg, Pa. 17101.
EXHIBIT "c"
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,~ "
JOlIN J. KllAFSJG, In., INC. .
ATTORNEY-AT-LAW
HARRI&DURD, "rNNBYLYAHIA
17110'1281
nit N. 'RONT STREET
TUI717'23"II08
MINDE"
PINN,nvAHIA I.."
DI.-r'UCT 0' CO&'U"'IA BA"
- Page 2 -
7. There are no funds available to pay the charities,
by reason of Small Estate Petition costs and the claim of the Pa.
Dept. of Welfare in the sum of S13,670.52, which will exhaust all
assets.
party.
8. There is no future interest conferred upon any'such
9. There are no unresolved claims or questions involved.
10. There are no fiduciaries involved.
11. There are no counsel for any fiduciaries.
12. There is no known legal representative of the said
charities.
Please note the same on your Official Records and acknowledge
receipt of this notice.
Very truly yours,
John J. Krafsig, Jr.
JJK/sls
Enclosures
of
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VERIFICATION
,~.,,~ "'1:..
AND NOW, to wit, this -~
day of December, 1995,
I, Kenneth Reese, the Executor and petitioner for the Estate of
Mary B. Garberich, do hereby certify and state the facts as set
forth in the foregoing Petition, are true and correct to the
best of my information, knowledge and belief.
I understand that false statements herein are made
subject to the penalties of
18 Pa. C.S.A. 54904 relating to
unsworn verification to authorities.
~(#rlJ--~-
Kenneth Ree:~u tor :nd
petitioner for the Estate
of Mary B. Garberich
"
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REV-1547 EX AFP 112"95*
CO""ONWULTH Dr PfHHSYlVAHU
D[PAR'"ENI or AEY[HU[
BUREAU Of INDIVIDUAL fAkES
DlPI. rauo.
IWtRISIUAG, PI. l1ua-UOl
ACN
101
NOTICE OF INHERITANCE TAX
APPRAISENENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIDNS AND ASSESSNENT OF TAX
DATE
04-08-96
CUMBERLAND
FILE NO.
COUNTY
DEATH 04-27-95
NOTE. TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBNIT THE UPPER PORTION OF THIS FORN WITH YOUR TAX
PAVNENT TO THE REGISTER OF WILLS. lUKE CHECK PAVABLE TO "REGISTER OF WILLS. AGENT"
REMIT PAYMENT TO:
JOHN
2921
HBG
J KRAFSIG JR ESe
N FRONT ST
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
PA 17110-1429
AMount R..ittad
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiE'Y:is,.-n,if""FP-n'F9l;"j-iioTicniF"YtiHEiiii';.ii'CE"TAin-ppiiiiisEHiiii"-,--"i.i.-OW;.ii'cE"oli---"-------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
MARY B FILE NO. 21 95"0972 ACN 101
TAX RETURN WAS, ( I ACCEPTED AS FILED I Xl CHANGED SEE
ESTATE OF
GARBERICH
04-08-96
DATE
ATTACHED
NOTICE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN
1, R..1 Eat.t. (Schedul. At (1)
2. Stock. and Bonda (Schedule BJ (2)
3. tloa.ly Held stock/Partnership Int.r..t (Schedule C) (3)
~. Horta.gal/Not.. Receivable (Schedule OJ (~)
S. Caah/Bank Deposita/Hi,c. Par.onal Property (Schedul. EJ 15)
6. Jointly Owned Property (Schedule FJ (61
7. Tran.fara (Schedule G) 171
8. Total A...t,
,DO
.00
.00
.00
1.335.48
.00
.00
(BI
1.335.48
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funaral Ekpan.../Ad.. Co.t./Hi.c. Exp.n... (Sch.dul. H) 19)
10. D.bt./Hartgage Llabiliti../Lien. ISchedule I) 110)
11. Total Daduction.
12. Nat Valua of Tax Raturn
15. Charltabla/Govarnnant.l a.qua.t. (Schadula J)
14. N.t Value of E.tata Subj.ct to Ta~
14.246.99
.00
1111
U21
US)
U41
14.?46 gg
12.911. 51-
.00
12.911.51-
I~ an assessment was issued previOUSly, lines
re~lect ~i9ures that include the total o~ ~
ASSESSHENT OF TAXI
1S. A.ount of Lln. 14 at Spou..1
16. A.O\.l\t of Lin. 14 h~abl. at
17. AftOUnt of Lin. 14 t.~.bl. at
18. Principal T.~ Due
TAX CREDITS:
PAVNENT
DATE
14. 15 and/or 16, 17 and 18 will
returns assessed to dete.
NOTE:
.00 x, 0 D_
.00 x. 06_
.00 X .15_
UBI
.00
.00
.00
.00
r.t.
Lin..l/C1... A rat.
Collataral/CI... a r.t.
USI
(161
1171
RECEIPT
NUNBER
DISCOUNT (t)
INTEREST (-I
ANOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
.00
.00
.00
.00
. IF PAID AFTER DATE IIIDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
I IF TOTAL DUE IS LESS THAN fl. NO PAVNENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI. YOU NAV BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. I
- -., ~..
RESERYATIONI E.tete. of ~~t. d,lne on a~ befar. Dec~~ I', ..., -- If ~, future Int.r..t In ~ ..tat. I. tr~.f.rr~
In po.....lon a~ enJa~t to Cia.. I Ccall.t.r.l) bene'lcl.~I.. of the dec~ent .ft.r ~ ..plr.tlon a' any ..t.t. fa~
11ft or fa~ v..r., the Ca..anw..lth h.r.b, ..pr...lv r...rv.. the right to apprll.. and ...... tran,'ar Innerltenc. T.x..
.t the I~ful CI... I Ccall.t.rall rata on any such future In'.r..t.
.......... or
HOrICEI To fulfill 'h. r...ln.antl of Seetlon 21'0 of the Inhtirltanc. end E.tets Ta. Act, Act 21 of 1991. 71 P.S.
Section 11'0.
PAYHEHTI Ds'ech the tap portion of 'his Notlc. end suIMIlt ..hh yaur P'VII..t to the R.ght.r of Willa prlnt~ on the r.....rs. .IH.
--Mak. chsck or aDMV ardsr p.,ebla tal REGISTER OF MILLS, ACEHT
All p.,.ent. r.c.lved sh.ll flr.t b. applied to ~, Int.r..t which .., b. du. with InV r...lndar applied to the t...
REfUND CCA)I A r.fund of I ,.. credit. which .... not reque.t.d on \hi Tax R.turn, ..y b. reque.t.d b, coapl.tlng an -Appllc.tlon
far A.fund of Penn.ylvanl. Inherltanc. end E.tat. Tax" CREY-1S1S). Appllc.tlon. .r. Iv.llebl. .t 'hi Offlca
of thl A.,I.,.r of Will', any of thl '5 Aevenue DI.trlct D'flc.., or by c.lllng 'hi .peelal 2'-hoUr
an....rln' ..rvlc. nueber. far far.. ard.rlngl In Penn.vlvenla 1-80a-S6Z-1050, aut.ld. Penn.,lv~l. end
within local Harrisburg .r.a (7I1J 7'7-80lM, TUDt (717) n2-Un (....rlng lap.lnd Onlyl.
OIJECTlONSI Anv party In Int.r..t not ..tI.l1" ..Uh the eppr..---.t. .Uowene. ar dl..Uowancl of deduction.. or .....Mlnt
of talC C Including discount or Int.r..t) .. .hawn an this Notice au.t abJact within .ixty C6a) dlv. of recllpt of
thh HQtlce bVI
--writ'," prat..t to the PA Dspartsant a' A.VInUl, ~d a' Appell., o.pt. Z81a21, H.rrl.burg, PA '71"-1011, DR
...lectlon to hav. 'h. ..tt.r d.t.r.lned at audit of the eecaunt of the p.r.on.l r.pr..entatlv., OR
--appall to the Orphan.' Caurt.
ADMIN
ISTRATlVE
CDRRtCTIOHSI
Factusl .rrar. dl.cav.red on thl. ......sent .hould be addr..." In writing tal PA Dep.rt.ent of Ravenus,
Bu,..... of IncUvldu.1 h..., ATTHI Pa.t A.....""t R.vl... Unit, O.pt. 180601, tlsrrhburg, PA 17UI-0601
p~ (717) 787-6505. 5.. peg. 1 of ~ bookl.t -In.tructlons far Inherlt~. ra. Raturn far. A..ldlnt
Decedent- (REV-1501) far an .xplen.tlon of tdalnl.tr.tlv.ly carreetBbI. .rrar..
INTERtSTI
If any t.. dua I. p.ld within thr.. (SI c'lend.r eonth. .ft.r the dlcedent'. d..th, . flv. psrcant (5%) dl.count af
the t.. p.ld II .IIOMI'd.
Int.r..t I. chargld beginning ..Ith flr.t da, af ~llnquancv, or nine (,) eonths and one (II d.y froe th. data af
death, to tM d.t. of p.~ant. TaXI' which bite.. cMllnquent befar. JlnUlrv 1# 1912 beer Inter..t .t the rat. of
.1_ (6~) p.rclnt p.r ~ calcul.tad .t . dally r.t. of .aODI64. All t.... which b.c.. delinquent an end .ft.r
Januarv I, 1"2 ..Ill b..r Int.r..t at . r.t. which will v.r, froe calendar v..r to c.lsndlr ~..r ..lth th.t r.ta
announcad bv the PA D.p.rt..nt af R.vlRUa. The eppllcabl' Int.r..t r.t.. far 1912 through 199' .r'l
DtSCOllfh
~! Int"..t A.t. D.11y Int.,...t Factor ~ Intar..t A.t. O.l1v Intl,...t Factar
1'82 ZDX .ODDi41 1917 OX .0aOlU
1915 lOX .aDDU' 19"-1991 IlX .oaalal
I'" 1l~ .0DDlOl 199. OX .ODDl'7
"15 15% .0DOl56 I99S-I~ 12 .000192
1916 In .00017' l'U-I996 OX .aaazo
--Inter..t II c.lcul.t.d .. fallowll
INTEREST a BALANCE OF TAX UNPAID X HUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--An, Natlc. luu.d aftar thl tax bleDMI deU,""*,,t will ,.fleet an Inter..t ulcul.tlan to f1ft..n US) dlv.
bevond the date of th. ......IInt. I' ply_ant I. .Ide aft.r the Int.r..t casput.tlan data .hown on th.
NotlC', addltlon.1 Int.r..t lU.t be c.lcul.tad.
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