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NOV 2 1 1995
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COIlMONWlAl.TH Of PEHNIYI.IIAHIA' DEPAATMEHT Of HlAl.TH , VITAL Rl:CORDI
CERTIFICATE OF DEATH
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LAST WILL AND TESTAMENT
OF
MICHAEL J. BELICIC
I, MICHAEL J. BELICIC, of Lemoyne, Cumberland County,
Pennsylvania, declare this to be my Last Will and revoke any Will
previously made by me.
ITEM I: I direct that all my just debts and funeral
expenses, including the cost of a suitable gravemarker and per-
petual care for my burial plot, shall be paid from the assets of
my estate as soon as practicable after my decease.
ITEM II: I give all automobiles, and all other articles
of personal or household use, together with all insurance
relating thereto, to my wife, KATHRINE R. BELICIC if she survives
me by thirty (30) days. If my wife, KATHRINE does not so survive
me, I give all such property and insurance to be distributed in
accordance with my residuary clause.
ITEM III: I give, devise and bequeath all the rest,
residue and remainder of my estate, real, personal and mixed,
wheresoever situated, to my wife, KATHRLNE R. BELICIC provided
that she survives me by thirty (30) days: if my wife, KATHRlNE
does not so survive me, I give the residue of my Estate as
follows:
(A) I give, devise and bequeath any interest that
I have at the time of my death in the property located
at 148 Herman Avenue, Lemoyne, Cumberland County,
pennsylvania and all personal effects such as furniture,
appliances therein situated, to my daughter, KATHRlNE
Page One (1) of Six (6) Pages
and her husband KENNETH MOSE.
(BI I give, devise and bequeath to my son, MICHAEL
J. BELICIC, JR. the sum of Three Hundred ($300.001
Dollars.
(CI I give, devise and bequeath the rest, residue
and remainder of my estate to my three daughters,
MARY K. MICHAELS, JoANN M. BELICIC and KATHRINE MOSE
in equal shares, per capita. Particular items can be
allocated among my daughters as they agree and if they
cannot agree, my Executor shall decide.
No interest in income or principal shall be
available to anyone having a claim against a
actual payment to the beneficiary.
ITEM IV:
assignable by, or
beneficiary before
ITEM V: All federal, state, and other death taxes
payable on the property forming my gross estate for tax purposes,
whether or not it passed under this Will, shall be paid out of
the principal of my residuary estate just as if they were my
debts, and none of those taxes shall be charged against any
beneficiary.
I authorize my Executor:
(al to retain and to invest in all forms of
real and personal property, regardless of (il any limitations
imposed by law on investments by executors or trustees, (iil any
principle or law concerning delegation of investment respon-
sibility by executors or trustees, or (iiil any principle of law
concerning investment diversification;
(bl to compromise claims
property which, in my Executor's opinion, is
ITEM VI:
and to abandon any
of little or no
Page Two (21 of Six (61 pages
value; to borrow from, and to sell property to others, and to
pledge property as security for repayment of any funds borrowed;
Cc) to sell at public or private sale, to
exchange or to lease for any period of time any real or personal
property, and to give options for sales or leases;
Cd) to join in any merger, reorganization,
voting-trust plan or other concerted action of security holders,
and to delegate discretionary duties with respect thereto;
Ce) to use administrative or other expenses
of my estate as income tax or estate tax deductions and to value
my estate for tax purposes by any optional method permitted by
the law in force when I die, without requiring adjustments bet-
ween income and principal for any resulting effect on income or
estate taxes; and
Cf) to distribute in kind and to allocate spe-
cific assets among the beneficiaries in such proportions as my
Executor may think best, so long as the total market value of any
beneficiary's share is not effected by such allocation.
These authorities shall extend to all real and
personal property at any time held by my Executor and shall con-
tinue in full force until the actual distribution of all such
property.
All powers, authorities, and discretion
granted by this Will shall be in addition to those granted by law
and shall be exercisable without leave of court.
ITEM VII: I appoint my wife, KATHRINE R. BELICIC,
Executrix under this Will. Should my wife, KATHRINE fail to
qualify or cease to act as Executrix, I appoint my daughter,
Page Three (3) of Six (6) Pages
MARY K. MICHAELS, Executrix under this Will. I direct that
any fiduciary acting hereunder shall not be required to enter
bond or other security in any Court or jurisdiction in which said
fiduciary may be called upon to act.
IN WITNESS WHEREOF, I have hereunto set my hand and seal and
caused this my Last Will and Testament, consisting of six (6)
typewritten pages, including this attestation clause, and the
following ACknOWledgmeii and Affidav t, to be executed, declared
and published this tv day of ~",,_L.f>~, 1985, at
/~)d/ , pennsylvania.
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MICHAEL J. BELICIC
Page Four (4) of Six (6) pages
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA:
COUNTY OF DAUPHIN : SS:
I, MICHAEL J. BELICIC, the Testator, whose name is signed to
the attached or foregoing instrument, having been duly qualified
according to law, do hereby acknowledge that I signed and exe-
cuted the instrument as my Last Will, that I signed it willingly
and that I signed it as my free and voluntary act for the pur-
poses therein expressed.
'~'~";~t.#"h.'4'<--r;1 !J --L~~A~~
MICHAEL J. BELICIC
Sworn or affirmed to and aCknowled~~~ me by MICHAEL J.
BELICIC, the Testator this~day of , 1985.
~
Notary Public ~
(SEAL)
My Commission Expires:
Edi. J. F.,linq. n,bry Pub6c
My (ommiu;"n hj)ir:1 MaTch n. '988
lunbb"'l. PA Douphin Count,
Page Five (5) of Six (6) Pages
AFFIDAVIT
COMMONWEALTH
COUNTY OF
j~e.(,ckA...CY t2 '7'({d...........
U
,/"'-.., and
, the witnesses, W ose names are signed to
the foregoing instrument, being duly qualified
according to law, do depose and say that we were present and saw
MICHAEL J. BELICIC sign and execute the instrument as his free
and voluntary act for the purposes therein expressed: that each
of us in the hearing and sight of the Testator signed the Will as
witnesses: and that to the best of our knowledge, the Testator
was at the time twenty-one (21) or more years of age, of sound
nd nstr nt or undue influence.
. Residing at (,4'CJS' ~~. ~ ,a...
~~"':4-~ .~_ /7&15"r
Residing at.27L.ji8~l((J fie" ('-;fy
flQ'1JU'J/..1(UO ~A- ;rl/ / ~
Residing at tjJo ~.41~ g
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med to and acknowledged before me by
, /,I:.'..l?(\~9a~''''d ,.......,~ , and
, the wi Ii/esses, this {J ~h day of
, 1985. .
Notary PUb~{.lA.~j
(SEAL)
My Commission Expires:
&~
E<Ii.1. FJlli'J, t1c1ny Public
M'f' C,.11'f.Il":lr. [.;1:1 ','m~ U, 1988
H."ilt.ur,. i.\ DJu;?t:n Coun1l
Page Six (6) of Six (6) Pages
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,
COMMONWEALTH OF PENNSYLVANIA
INRE:
ESTATE OF
MICHAEL 1. BELICIC,
DECEASED
ORPHANS' COURT DIVISION
No. 0009 OF 1996
FAMILY AGREEMENT
Filed on Dehalf of:
Mary K. Michaels, Executrix of Estate of
Michael 1. Belicic, Deceased
Counsel of Record for this Party:
RANDALL L. HARTMAN, ESQUIRE
PA 10# 68732
Randall L. Hartman, PC
438 Market Street
Lemoyne, PA 17043
(717) 761-8490
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NOW THEREFORE, in consideration of the mutual promises, covenants and agreements
hereinafter contained. the parties hereto agree as follows:
I. Approval of Partial Dlstrlbuto!'!, Each of the parties to this agreement docs
acknowledge to have rcceived from the Executrix the sum of Six Thousand ($6,000,00 ) Dollars as
an advance distribution evidenced by Receipts for Distribution which arc auached hereto, Each of the
parties to this agreement docs acknowledge to have received from the Executrix the sum of Seven
Hundred Sixty Seven and 68/100 Dollars ($ 767,68) as a final distribution of the Estate on December
10,1996.
3, Wnlver and Relense, The parties:
a, specifically waive the requirement that the Executrix file an Account
with the Orphans' Court Division. Court of Common Please of Cumberland County;
b. agree and acknowledge that they have fully and carefully examined the
account auached ll.'l Exhibit "A" and find the Account to be true, correct and acceptable, and further
acknowledge that they have received a copy of this Receipt and Release and the Account;
c, hereby accept and approve the distribution to the trustees and agree
to refund to the Executrix of the Estate any amounts which may be necessary in the future, to
discharge any liabilities of the Estate which arose before the date hereof, which are properly
chargeable against and payable out of the assets of the Estate compromising the distribution set forth
in the account (such as additional expenses of administration, death or income taxes), and of which
the undersigned may hereafter receive notice;
d, hereby remise, release, and discharge the Executrix and the Estate,
individually, and collectively, of and from all manner of act, suits, claims. accounts, accountings,
debts, dues, and demands whatsoever for or by reason thereof in connection with the administration
of the Estate,
4. Miscellnneous,
a, Each party to this agreement acknowledges that this agreement shall
be indexed and recorded in the Estate proceedings and the terms hereof shall be binding upon their
respective heirs, successors. administrators, and assigns,
b, This agreement shall be governed by and construed in accordance with
the laws of the Commonwealth of Pennsylvania,
c' The parties hereto agree to execute such other or additional documents
as may be necessary to effectuate the agreements set forth herein,
3
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
eON "" A
'~B \-\ (Or-MOM. A.J~
Le\M01.l tJ.- PA- ,?1l<(:S
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A"'OUNt IICIIVID I' IINnluellON
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COMoloAONW\A\T" O' peNNSYLVANIA
0"" MINT~' 'I'INUI
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.0. DATIIO. DIATH AnU 12'~1"1 CHICK HUI
If A IPOUSAL
POYIUY ClIDIT II CIAIMID 0
.ILI NUM'"
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COUNTY COOl
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.7 \910
CO"l'l1
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05,
o 2. Supplemtntal Relurn
o A. limited hlalt 0 "0. Fulur. In'tr..1 Compromitt
(lor do'.. 01 d.o,h oh., 12,12,82)
06. O.ud.nl DI.d T..lol. 0 7. O.ctd.nt Moinlalned a living Trull
IA!loch copy 01 Willi (A!loch copy 01 Trulll
ALL CORRESPONDENCE, AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO. . .... ,-' .' ,'r" Y;.(,:A"i:;.~: '.
COM'lIl1 MAILING ADOIIU \ J... _L
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2, S'ock. ond Bond. (Sch.dul. B)
3, clollly H.ld StocklPonne"Mp Int.,..t (Sch.dul. q
A. Mortgag'l and No'.. R.c.i...oble (5ch.dule 0)
5. Calh, Bank Oepolll. & Milc.llaneoul P.nonol PIOptrty
(Sch.dul. E)
6, Joi"'y Owned Prop.ny (Sch.dul. fl
7, Tro"I.,. ISch.dul. GI(Sch.dul. L)
8. TOlal Glon Antll (lolollinu 1.7)
9. Funeral Expen..., Adminblrativt CoslI, Milc.lloneoul
bp.",. (Sch.dul. H)
10, O.bh. Mongoge Uobili,I... U." (Schedul. II
11. TO'ol O.ductlo" (,otolUm 9 & 101
12. Ntl Volut of Estotellin. 8 minuI lint 11)
13. Chalitoble and Govllnmtnlal B.qu,uI (Schedule JI
lA, Nel Value Subj.ct to Tax 11Ine 12 minuI line 13)
15, Spoulol Tro,,'... (for do'.. 01 d.oth oh" 6.30,94)
5.. Inllrudlonl fOl Af.plicobl. P,lctnlage on Reven.
Sid., Ilnclud. volu.. rom Sch.dul. K or Sch.dul. M,)
16. Amount of lint U loxabl. 01 6% 101,
(Include valu.. flam Schedule K 01 Schedul. M,)
17. Amounl of lIn. lA loxable 01 15% lalt
(Includ. volu.. from Sch.dul. K or Sch.dul. M,)
18, Principol to. duo (Add to. from Un.. 15. 16 ond 17,)
19. C"dill Spousal Po....rty Credit Plior Paymtnts
+
20, IIUne 19 is groot" thon Lint 18. en'" tho din","" on Une 20, Thi. i. tho OVERPAYMENT.
110
21. If lint 18 Is gllotlllhan Un. 19, .ntlllh. diKt"n'l on lIn. 21. Thll il ,h. TAX DUE.
A. Enltrlh.lnl."lt on tht bolonc. dUI on Un. 21A.
8, Enlt. ,h. totol 01 Une 21 ond 21,1, on Une 218, Thl. is ,h. BALANCE DUE.
Mok. Check Payobl. 101 Regl.,,, o. Will., Ag.nt
t', . " . BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE'AND TO RECHECK MATH', ~H~'4i\~';:';':'<llJ~";')
Undll penelli.. of plllulY, I d.c1are that I hove uamin.d thi. IIluln, including accompanying ached..,l.. and tlolem.nll, and to ,h. bill of my knowledgt and b.li,f,
ltl. 'rut, COlltct and compl.I.. I declor. that 0111101 .Ual. hOI bltn "port.er alllu, morh' volu.. Declolation of pr.parll olhll than Ih. pt"onolltp"..nloliv. II
bOlld an alllnfolmatlon of .....hlch pllpa'" hal any knowl.dg..
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ChNI.. hl!ll' ., you ore rcque,ting 0 refund 01 your avelpayment.
z.ZD,73
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(21,1,1
(218)
Ad '48 of 1994 provld.. for the r.ductlon of Ih. tax rat.. Impo.ed on the n.t valu. of tran",,, to or for
the u.. of the .pou.., Th. rat.. a. pr..crlb.d bV the .tatut. will b.,
. 3% (.03) will b. appllcabl. for ..tat.. of d.c.d.nll dvlng on or aft.r 7/1/94 and b.for. 1/1/96
. 2% (.02) will b. applicable for ..tat.. of d.c.d.nt. dvlng on or after 1/1/96 and b.for. 1/1/97
. 1% (.01) will b. applicable for ..tat.. of d.c.denll dvlng on or aft.r 1/1/97 and b.for. 1/1/98
. Spou.al tran".r. occurring on or aft.r 1/1/98 will b. .x.mpt from Inh.rltanc. tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK (.....) IN THE APPROPRIATE BLOCKS.
YES NO
1. Old decedent make a transfer and:
a. retain lIie use or Income of the property transferred, .......................................................
b. retain the right to designate who shall u!e1he properly transferred or Its income, ...............
'c. retain a reversionary Interest; or ...................................................................................
, d. receive the promise for life of either payments, benefits or care9 .......................................
2. If death occurred on or before December 12, 1982, did decedent within two years preceding
death transfer properly without receiving adequate conslderatian9 If death occurred alier
December 12, 1982, did decedent transfer properly within one year of death without receiving
adequate c~nllderation'...................oo..............................................................................
3. Old decedent own an 'In trust for' bank account at his or her death9......................................
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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COMMONWIA~~ 0' P1NNmYANIA
IN~\~'~~N)ID~~'~I~~'N
SCHEDULE B
STOCKS AND BONDS
fill N MIIIR
Vv\'C.~c.\ ~, "6~\C.\L-
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(All ,.....rty lolntly..wnod with Righi 0' Survlyor.hlp mU'1 bo dl.clo.od on Schodulo P.I
ITEM
NUMBER DESCRIPTION
VALUE AT DATE
OF DEATH
I.
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15, "3~~.:!.~
TOTAL (AI.o onlor on IIno 2. Roco ilulotion)
(If more spac. ;s nHdld, ;nl.rt additional shuff o( 10m. du.}
s \~
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COMMONW!ALfH Of PlNNlYlVANIA
INHUltANC! TAX .nUIN
lUIOIHT OICIOIHT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ISTATI 0'
M\c...~<..
PILI NUMBEI
z.\ G:. - 000
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NAME
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ADDIISS
l"le, \\cu,~ l\.v~tJu~
Le.W.\)l M. \ f't4- l'>c<l '3
IILATIONSHIP TO DECEDENT
v~~t -te r
B.
C.
Jolntly-ownod proporty.
LETTER DATE DECO'S DOLLAR VALUE OF
ITEM FOR TOTAL VALUE
NUMBE~ JOINT MADE DESCRIPTION OF PROPERTY OF ASSET 'lfIINT. DECEDENT'S INTEREST
TENANT JOINT
1. A 1'Z-{1/Q3 a."=f.~oc.~ ~""50 - ~lf"\S 1\,80'3.1.(, ~ 5',1:\0\.":;
2.. A t."'ec~..II'l~ 'f\~()U d\-'. 1\,53~~1 s-6'!o 5; 710 7.q \
s,..v;js. - ? rJe....
TOTAL (AI.o onler on lino 6. Rocopi'ulo'ion) S 1!.I,,1tA St.{
(II more spoce js need.d jnsert additional sheers or lame size}
.: ._-~"-..,......--.--\-......~---~----,...~,.,
1,'#llIlU.,.I..
ITEM
NUMBER
A.
1.
2...
B.
.
SCHEDULI H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
PliO,. P,ln' or T I
Co.woNWIAlI" O' 'IHHIYLVAHIA
IHHllltANCllAllIIUIN
''''DIN' DICIDIN'
Z.\~G:. . coe
DESCRIPTION
AMOUNT
Fundrol bpln'lI'
M~c.c\.~ fJNe,I,,~
Flowu:s, ~\A"":'\'1I<t-C.~'''''''' fV.lo.J,~,e:\'L
S; 'f 'l ~ t>-I
~<t~ ./t'J
1.
Admlnl,'ratlvl CO"'1
Pononol Rlprosenlotive Commission.
Sodol Slcurily Number of Personal Represenlotlve:
Veor Commi..ions paid
2.
Allorney Foes
I, 3.1l.. IN
3.
Family exemption
Claimant
Add.... 0/ Claim anI at decedent's death
St..e' Add....
Relationship
Stale Zip Cod.
CI'y
A. Prabal. Foes
C. MllclUanlau. ExPOn'lI:
1.
2.
3.
A.
5.
6.
7.
8.
Z. 'Z..,ct..7c
TOTAL (Also onler on line 9.. Recopilulotion) S
(If mall .pa.1 I. n..dld, In...' addillonal .h.... of .am. .Izo.)
MIV UOOUt 112.'"
. 91~~ INHERITANCE TAX RETURN
~~j- RESIDENT DECEDENT
COIol"O/lWlAlIllOllltl/llnvA/I,. (TO BE FILED IN DUPLICATE
DI,,,.1M(Nlor UV(NUl
tt..mfJl~J~mllo"" WITH REGISTER OF WILLS) COUllTyconE YEAR
. ~ . Utl~~[~~~:i~I~'D~:;'H}~;~"-ir""AT'-- _u --- ~-_U_'-lo~~~m~~OM~~~A:~%~~': ~ve -:----
~ ,otlAfllW,,"-N'uMIIM"-' "I"nit Of (I[nlll Ion" 0""'" . - Mt. Holly Springs, PA 17065
o 195-32-0594 11/20/94 11/18/41 c~,.. Cumberland
-~o( E\ 1, Orl9in~ Rc'ur:--- --.-- "f:j 2, Supplomontal R~lur~' -.. --- L. ---['J 3, Romainder ROlur~-----
it_OIl (for dolo. of doalh prior 1012.13.82)
&::g:~ 0 A, LImited ellatl! [J 40. Fulure Intorenl Compramilo 05. Federal ellalo To~
029 (for dolo. of dealh of lor 12,12,821 0 Rolurn Roquirod
~ID 016. Decodenl Died Tellate 0 7. Decoden' Maintained 0 Living TrUll _8. Talal Number of 50ro Dopodt Box"
0( (Attach copy of Will) (Attach copy of Tru.')
ALli.CORRESPONDENCE AND COtl~ENTlAL TAX INFORMATION SHOULD BE DIRECTED T01,''." \,',:
NAM . - MPlE1E MAILING ADDRESS
Anthony L. DeLuca, Esquire P.O. Box 358
~. 113 Front street
258-6844 Boiling Springs, PA 17007
+
19. If lino 18 II groalOr Ihan lino 17. onlOr Iho diH"onco an lino 19, Thi.l. Iho OVERPAYMENT.
liD
20. Illino 1711 groal" Ihan lino 19. onl" Iho diH"onco an lino 20, Thi. II Iho TAX DUE.
A. Enlor Iho Inl"..1 an Iho balanco duo an lino 20A,
8, Enlor Iho 10101 allino 20 and 20A an lino 20B, Thi. II Iho BALANCE DUE.
Mako Chock Payablo 10: Rogl.lor 01 Will., Agont
"i;.;;~~~~~~'D!PQITQ'AIllwa.ALtQUISTIO~llpJt;.~~~~rer;~rl:,l"l;":'''~;;':;,~
Under plnolll.I of plrfury, 1 declor. thai I hove examined thl. r.turn, including accompanying schedul.. and Ilot,m,nu, and to 'he bllt of my knowltdg. and belief,
it i, tru.. carrld and complet.. I d.c1ar. Ihol all r.ol 11101. has bltn ,.poned at IruI mor..t value. O.cloration of pr.parer ath" than th, p4nonal rtpr"'nlollvl il
bOI.d on 011 Information Ich prtpar hot allY knowledge.
I NA I IN UNA
IDg
<<0
<<z
82
z
o
3
i:!
i:
:5
...
<<
1. Roal E.lal. (Sch.dulo AI ( I)
2, Slack. and Bond. (Schodulo B) ( 2)
3, Clallly Hold SlocklPartnorship Inl,,"1 (Schodulo C) (31
A, Martgag.. and Nal.. Roeolvablo (Schodulo D) ( AI
5, Ca.h, Bank Dopa.il. & Mlscollanoau, Po..anal Praporty( 5)
(Scoodulo E)
6, Jainlly Ownod Prap.rty (Schodul. F)
7. Tran,fo.. (Schodulo G) (Schodulo l)
8, Talal Gra.. Auo" (Ialallin.. 1.7)
9. Funeral bp.nse., Administrative COlli, Miscellaneoul ( Q)
Exponll' (Schodulo H)
10, Dobl., Martgago lIabilili.., lion. (Schodulo I)
11. Talal Doductian. (Iatallln.. 9 & 10)
12. Nol Valuo of E.lalO (lino B mlnu,lIno II)
13. Charitablo and Gavornmonlal BoqulI"ISchodulo J)
lA, Nol Valuo Sub oct 10 Tax (lino 12 mlnu.llno 13)
15. Amount of lino lA laxablo 01 6% ralo
(Includo valu.. Iram Schedulo K or Schodulo M,)
16. Amaunl of IIno lA laxablo 01 IS'*' ralo
(Includo valu.. Iram Schodulo K or Schedulo M,)
17, Principal lax duo (Add lax from Ii.o 15 and from lino 16,)
18. Cr.dit. Prior Paymlnt. Discount
z
o
g
a.
:E
o
u
;
15-3-~
I
rill ~IUMO'R
~I
q~
101.{-0
tlUMBER
-0-
10,425.00
-0-
-0-
3.500.00
( 6)
17)
-0-
-0-
( B)
13,925.00
10,435.03
(10)
1,042.11
(IS)
2,447.86
-0-
(II) 11.477.14
(12) 2,447.86
(13) -0-
llA) 2,447.86
)( ,06. 146.87
)( ,15.. -0-
(17) 146.87
(16)
.
Inter'I'
-0-
-0-
(IB)
(19)
Chce." hl'fc if you Ol~ rl.'qut'din~ 0 H~fund of you, overpnyment.
146.87
(20;
(20A)
(20B)
DATE
, ~~p~
Sp'. Or?~(t
RIY.1I0' Ill+ ""11
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAlC RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE "0"
MORTGAGES AND NOTES
RECEIVABLE
FILE NUMBER
Ray E. Killinger
IAU propMy Jolntly-oWMd with "llhl af lurvlvorshlp mun b. dltclottd on Ichedul. "filii
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1.
NONE
-0-
TOTAL (Also enter on line 4, Recapltul.t1on)
$
-0-
(If more 1I)IC8 I. needed InMrt eddltlcuwl ,heet' of ..me ,I,,)
.....,1111 "fl"ll
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE "fl"
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCEllANEOUS EXPENSES
ITEM
NUMBER
I.
2.
3.
4.
5.
-.- -,_. -'
Ray E. Killinger
DESCRIPTION
A. Funcral Expcnscs:
Gibson HOllinger Funeral Home, Inc.
501 N. Baltimore Ave.
Mt. Holly Springs, PA 17065
Cumberland Valley Memorial Gardens
1921 Ritner Highway
Carlisle, PA 17013
Brachendorf Memorials
2131-2143 Herr Street
Harrisburg, PA 17103
Paster Richard Reese
Mt. Holly Church of God
Permanent Records - Memorials for Funeral Home
1. PeltOnal Represenl.llve Commissions
B. Admlnlslrallve Costs:
2.
3.
1.
2.
3.
4.
Attorney Fees An thony L. DeLuca, Esqu i re
Family Exemption - resided with spouse at death
C. MlsceU.neous Expenses:
Probate Fee
Legal Advertising - Cumberland Law Journal
Legal Aavertising - The Sentinel
Inheritance Tax and Inventory
L
FILE NUMBER
AMOUNT
$5,635.00
600.00
1,580.00
50.00
14.00
325.00
2,000.00
94.00
40.00
72.03
25.00
S 10,435.03
TOTAL (Also enler on line 9. Recapllul.llon)
(If mor. IpIC. 'I needed In.lW1 .ddltlonll IhMtI of ..m. Ilr.l
.'
.. .~-~-.....-."-- .-....
"",'III"~ IM'I ,
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
REIIDENTDECEDENT
ESTATE OF
Ray E. Killinger
SCHEDULE "I"
DEBTS OF DECEDENT,
MORTGAGES, AND LIENS
FILE NUMBER
ITEM
NUMBER
OESCRIPTION
AMOUNT
1.
First USA - Credit Card
$ 121.55
779.93
140.63
2.
GM Card - Credit card
3.
Core State Bank of Delaware, NA
TOTAL (Allo enter on line 10. Recepltuletlon)
. 1,04
(If more epee. I, needed InMft eddltlonllaheets of ..me 1111)
>
_.....__...._'_.._..__.,.:-.,:h.r.. ..
:..U'f:.-:..".............-",-- .
_'~.',.~,..~_...'V_'_._
LAST WILL AND TESTAMENT
OF
RAY EUGENE KILLINGER
I, RAY EUGENE KILLINGER, a resident of 319 S. Baltimore
Avenue, Mt. Holly Springs, Cumberland County, Pennsylvania being
of sound mind, memory and understanding, do hereby make, publish
and declare this to be my Last Will and Testament, hereby revoking
all Wills and Codicils heretofore made by me.
ITEM 1: I direct that all my just debts, the expenses of my
last illness and funeral expenses be paid as soon after my decease
as the same can conveniently be done.
ITEM 2: I direct that there shall be paid out of my
residuary estate all estate, inheritance and like taxes together
with any interest or penalty thereon imposed by the government of
the United States, or any state or territory thereof, or by any
foreign government or political subdivision thereof, in respect to
all property required to be included in my gross estate for
estate, inheritance or like tax purposes by any of such govern-
"
ments, whether the property passes under this Will or otherwise,
excluding, however, any property over which I have a taxable power
of appointment, provided, however, that no residuary beneficiary
shall by reason of this provision be denied the benefit of any
deduction, credit, favorable rate of tax or other benefit which by
law enures to such beneficiary.
/1~
J . .
7;;'" - .~,
RA~UG E KILLIN~t..
" .,.
.- .......-. ----. ..-'--- -~.
I./\S'I' WH.I. AND '\'I.;f,'I'AMI':N'J'
01,'
HAY gUGgNE K 11.1, I Nm:n
ITEM ,3: I give, rlovillo and bequPIIt.h /111 (If the felll, residue
and remainder of my ostnte, real, pPf/lonnl /Inn mixed, of whatso-
ever kind and nature, and wherelloevur /lltual.o /It the time of my
death, unto my wife, VALERIE JUNg KlI,LINGEn, provided, however,
that she survives me and is living nixty (60) days after the date
of my death.
ITEM 4: If and in the event that my wife, VALERIE JUNE
KILLINGER, does not survive me and is not living sixty (60) days
after the date of my death, then and in such event, I give, devise
and bequeath all of the rest, residue and remainder of my estate,
real, personal and mixed, of whatsoever kind and nature, and
wheresoever situate at the time of my death unto the DAUPHIN
DEPOSIT BANK & TRUST COMPANY, as Trustee in Trust. The Trustee
shall divide the then principal and any accretions thereto and any
accumulations of income into as many equal parts as there are then
living children of mine and then deceased children of mine
"
represented by then living issue. The Trustee shall hold one such
share as a separate Trust for the benefit of each living child of
mine, and one such share as a separate Trust for the benefit of
the issue of each such then deceased child of mine, per stirpes.
./',~ L-/' .' ./
....;1') ...~ c.. .~~ -...t:C t... . f./.A.)
RAY GEN KILLINGER ?
-2-
_..--~,~.--.~,--..___,..",~.,..,_,..,.,M' -"0"7";'
..'t. _, ,,_u, -''-:-':'7''1::':"-.-~-':';''T."";,''''.o-:'-""" '~"'-"--'''-'--
!,AS'l' IHLL AND '!'ES'l'AMEN'!'
OF
RAY EUGENE KILLINGER
A. In each Trust thus established for a then living
child of mine, the Trustee shall quarterly pay to or for the
benefit of such child all of the income and so much of the
principal of said Trust, as, in the discretion of the Trustee, may
be necessary to maintain such child in the proper station in life,
including proper support, maintenance, medical care and college or
higher education.
Upon such child's attaining the age of twenty-five (25)
years, the Trustee shall pay to such child one-half (1/2) of the
then principal. Upon such child's attaining the age of thirty
(30) years, the Trustee shall pay to such child the balance of the
then principal and said Trust shall terminate.
Should such child die before final distribution of the
assets of said Trust, but be survived by then living issue, the
Trustee shall quarterly pay to or for the benefit of said issue,
per stirpes, all of the income and so much of the principal of
said Trust, as, in the discretion of the Trustee, may be necessary
for the payment of the issue's college education; as soon as any
one of said issue attains the age of twenty-one (21) years, and in
no event late= than twenty (20) years following the death of my
child, the Trustee shall pay over all of the then assets in the
-/
~ ~ ~j"
C4 ' -~.....:. ~~~':""l-'"
RAY ;tGENE ILLINGER e/
-3-
-~~;"'...;".~1<<J!It~_...",,,:-;,;,~
. .,' ;-"..;..._'d' - ,----,-- .
I '<~;,_>.:.~:>:.--,.i~~~..":'~:'~,""""~",,.~,,;, ~ _:--~
I.
I
'if"
..
i,
.
__'.._..._._ ___.,____.-'., ~.-,"T--- --;.,""!....---
. ',."., _,..' " _,......_...____:-'....'?l"":~-- '.1":1'"...... _.....,.~,- ...... '''-'
LI\ST IHI.I, lIND 'l'ESTlIM~:NT
OF
RlIY EUGENE KILLINGER
Trust to the then living issue of my deceased child, per stirpes.
Should such child of mine die before final distribution and not be
survived by then living issue, the provisions of subparagraph (c)
herein shall obtain.
B. In each Trust established for the benefit of the
issue of a deceased child of mine, the Trustee shall quarterly pay
to or for the benefit of said issue, per stirpes, all of the
income and so much of the principal of said Trust, as, in the
discretion of the Trustee, may be necessary for the payment of the
issue's college education; as soon as anyone of said issue
attains the age of twenty-one (21) years, and in no event later
then twenty (20) years following the death of the survivor of my
wife and myself, the Trustee shall pay over all of the then assets
in the Trust to the then living issue of my deceased child, per
stirpes.
C. If at any time before final distribution of the
assets of any of the Trusts established for my children or the
issue of my deceased children, there are no living beneficiaries
of said Trust, the Trust shall terminate, and its assets shall be
added to the other then existent Trust(s) created herein for the
benefit of my children or their issue. Provided, that if any of
\
,
I
,,-,--,
I
._ _~_"'~'~~~-".~:-'" '-'-r.:~-' . ~-'I'~" ~_..
:.... ",'1'-:'''-' -.-'.,'
"',..',.,c.., .___..".. ,~".~'_"~_~~'''''''-:',' -,'.~"~,~""'or- .....".....~
1.IIST WII.I, IINO 'l'l';S'I'IIMEN'I'
OF
RIIY IWGENE KII,J,INGER
kind. In the event a division or distribution is made in kind,
such division or distribution shall be made at the fair market
value of the property at the date of division or distribution.
Should it appear desirable to partition any real estate, the
Trustee is authorized to make, join in and consummate partitions
of lands, voluntarily or involuntarily, including giving of mutual
deeds, recognizances, or other obligations with as wide powers as
can be exercised by an individual owner in fee simple.
C. To sell either at public or private sale and upon
such terms and conditions as the Trustee may deem advantageous to
a Trust, any or all real or personal estate or interests therein
owned by a Trust severally or in conjunction with other persons,
and to consummate said sale or sales by sufficient deeds or other
instruments to the purchaser or purchasers, conveying a fee simple
title, free and'clear of all trust and without obligation or
liability of the purchaser or purchasers to see to the application
of the purchase money, or to make inquiry into the validity of
said sale or sales; ,also, to make, execute, acknowledge and
deliver any and all deeds, assignments, options or other writings
which may be necessary or desirable in carrying out any of the
powers conferred upon the Trustee in this paragraph or elsewhere
/1 "
d ~' ,-~~,' "
~/.' ;'~./ ..u-pMJ- ,,,: ~ ~...-.-,-1.-
RAY -EuGENE .1{iLLINGER .' ,/-"'.'. - - , . - --
-6-
I
,
I
I
i
.'u......_,.~....-
.,.._""Jt_.n:n.""I.._:..,t~I"''1-lr:--:
::-_,:"..,~_...._",....~~..;.nc.tr!!":. ":'"'.r.:~fK.-,4""'~ ~___1ZJJf
I
LAST WILL /\UD 'J'E~:'rAM~~NT
OF
RII': EUGENE KIl,I,INGER
in this instrument.
D. To mortgage real ~state, and to make leases of real
estate, ext.ending beyond the term of the Trusts hereur,der.
E. To bClrow money from any party, including tbe
Trustee, to pay indebte<1n(:ss of a Trust and taxes, and to assign
and pledge assets of a Trust therefol.
F. To pay all costs, taxes, expenses and charges in
cl.nnection with l.hE' administration of a Trust, including a
reasonable compnnsation to agents.
G. To assign to and hold in trust an undivided portion
of any a!;set.
H. To do all other acts in its judgment deemed
necessary or desirable for the proper and advantageous management,
investment and distribution of the Trusts.
ITEM,6: I hereby nominate, constitute and appoint my wife,
"
VALERIE JUNE KILl INGER, Executrix (,f this my Last will and
Testament, with full power to do any and all things necessary for
the complete administration of. my estate, and dir~ct that no bond
or other surety is required of he r in this or any either
jurisdict.ion for her performconc:e of this office.
, 6. I .
'- K., . . . -.I''''' . /
,..,1:;'"";. ~~~~/"', /t.:.'-,-....r,./....
RAY <-EUGEN!: KILLIN(;~:R .'
-7-
;~
~~
r.(~~tv;~f:;"f' 'q
;r.i.-t~"';.,,,~r,.-:o~ ,-, ,
~:f
-.~--~~"""--
\. "
-'
~,
,~~~.-
. "~,,,~,~~,~,~':-::!.c,~;_~~,.,,~___~'--:''''''''-''.''''':''",,,(-~:~'';/I1'. ~:--~ ,~.. .",h"',;a.<.,..."'"
L1\5'l' WII,I, I\ND 'n:S'l'l\t,mtl'1'
OF
HAY EUGENE KILLINGlm
If and in the event that my wife, VI\LERIE JUNE KILLINGER,
does not survive me and is not living sixty (60) days after the
date of my death, or does not complete her duties as Executrix,
then and in such evept, 1 hereby nominate, constitute and appoint
CHARLES R. MILLER, Executor, of this my Last Will and Testament,
with full power to do any and all things necessary for the
complete administration of my estate, and direct that no bond or
other surety is required of him in this or any other jurisdiction
for his performance of this office.
ITEM 8: If and in the event that my said wife, VALERIE JUNE
KILLINGER, does not survive me, and is not living sixty (60) days
after the date of my death, I hereby nominate, constitute and
appoint JOHN C. MECHAN of 1471 East Ridgeview Terrace, Mustang,
Oklahoma to be the Guardian of my minor child WAYNE CLIFFORD
KILLINGER.
ITEM 9: I specifically disinherit KAREN SUE GOTSHALL and
direct that she be excluded from sharing in the proceeds of my
estate.
ITEM 10: If any provision of this Will or of any Codicil
hereto is held to be inoperative, invalid or illegal, it is my
intention that all the remaining provisions thereof shall continue
to be fully operative and effective, so far as is possible and
reasonable.
1 .
J Co ..4/ '
fl;)'::f. C",~c-..... .rC~~~ <<...-vv
RAyvEUGENE KILLINGER "
;..~~..4I'.__".":~I,.......-......~.~1't'l"!.-.:rI!,~~,',::;:J'!rtfZT'1~'";.~i:~~'~-
LflST \'IlLL fiND 'rES'l'flMBN'!'
Or'
RflY EUGENE KILLINGER
IN WITNESS WIJEREOF, I, RflY EUGENE KILLINGER, the Testator,
have to this my Last will and Tcstament, typcwritten on nine (9)
consecutively numbered pagcs, subscribed my name and affixed my
seal this /ltI...day OfjU,u>- ,1986.
~,~ >&~M~
, (SEAL)
,Af,
/':"~:; ...,
Signed, sealed, published and declared by the above named
EUGENE KILLINGER, as and for his Last Will and Testament,
presence of us, who have hereunto subscribed our names at
request, as witnesses hereto, in the presence of the said
Testator, and of each other.
, - (
~~ ii '
"I "-!' .....
" .' ,,:' - ~ (.J siding at
RAY
in the
his
.;7/)/ ;.; /r.:':;, r:.';:'! ..,i,:,",.;:esiding at
.1
"
-9-
-
~
RIV-1547 IX IIFP (12-95'.
COMMOHWIALt" or PlNN"LVA"IA
O(PUTICHl 01 _(VOU
IloWtUU 01 INDiViDUAL tun
Dr". U1m '
HAJtI.IIUltO," 1711......
NOTICE OF INHERITANCE TAM
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
DF DEDUCTIONS AND ASSESSHENT OF TAM
IICN 101
DATI 09-02-96
DATI OF DEATH 11-18-95
FILl NO.
COUNTY
CUMBERLAND
NDTEI TO INSURE PROPER CREDIT TO YOUR ACCDUNT, SUBHIT THE UPPER PORTION OF THIS FORH WITH YOUR TAM
PAYHEHT TO THE REOISTER DF WILLS. HAME CHECK ,PAYABLE TO "RECISTER OF WILLS, ACE NT"
REMIT PAYMENT TO:
RANDA~ L HARTMAN ESQ
438 HAllKET'Sf:
LEMOY~E PA 17043
REGISTER OF WILLS
CUM8ERLAND CO COURT HOUSE
CARLISLE, PA 17013
~ AMOunt R..ltt.d
Pi q'2..1. , 0
")
CUT ALOHll ':HI~ L~N~ !'r. p!'.T^rN L('I,~E:", !')!'T!(!Il r"!l YOUR RECO:!"S <
REWis4'ilii-AFP-:nF9SriiiificE--CWYriHEiiiTANCE-Ylix-iippiiA'iSEi.;"€iiT";-,m.-ciiiANCE-iili-mnnnn---..
. ()~SALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BELlCIC MICHAEL J FILE NO. 21 96-0009 ACN 101 DATE 09-02-96
TAM RETURN WAS' I I ACCEPTED AS FILED I Xl CHANCED SEE ATTACHED NOTICE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
'1. R.ol E.tot. ISchodul. AI (II
2. Stocko end Bond. ISchodulo BI , 121
's. CIo.oly Hold Stock/Portnor.hlp Intoro.t ISchodulo CI ISI
4. Harig.g.I/Not.. Rlcllvable (Schedul. DJ (4)
S. Cach/lank Deposlta/Hllc. Perlonal Property (Sch.dull E) IS)
6. JoIntly Ownod Prop.rty ISchoduIo FI 161
7. TrAnsflra (Schedul. 0) (1)
a. Tot.~ A..ot.
,00
15.364.39
.00
,00
500,00
11.669.54
.00
(al
27,533.g3
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expans../Ad.. Coata/Mhc. E)Cpln..Jl ISchedul1 H. (9) 8,490.70
ID. D.bh/Hortgogo LhbIUUu/Lhn. ISchodull 11 llDI .00
11. Tohl DoducUono 1111
12. Hot Voluo of Tox'R.turn 1121
15. Charitabll/Govlrn.lnt.l alqUI.t. CSchldull J) CIS)
14. N.t Volu. of e.tot. Subj.ct to Tox (14)
NOTE: If an assassmant was issuad previouslY, lines 14, 15 and/or 16, 17 and 18 will
. reflect figures that include the total of abh returns asaeased to date.
ASSESSMENT OF TAX:
15. Aoount of LIno 14 ot Spou..1 roto 1151
1&. A.ount of Lln. 14 t.x.bl. .t Lin..l/Cl... A r.t. (16)
17. A.ount of LIn. 14 to..blo .t CoIIot.roI/Clo.. B r.to (17)
1~. Prlnclp.l r.x Dul
A.4Qn 7n
19,043.23
.00
19.043.23
.00
19.043.23
.00
M .00.
M .06.
M .15.
Ilal
.00
1.142.59
.00
1.142.59
TAX CREDITS:
PAYHENT
DATE
04-25-96
RECEIPT
NUIIBER
AA1l2777
DISCOUNT 1+1
IHTEREST ,I-I
.00
AMOUNT PAID
220.73
INTEREST IS CHARGED FROM 08-19-96 TO 09-10-96
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
220.73
921.86
5.24
,927.10
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF AODITIONAL IHTEREST.
I IF TOTAL OUE IS LESS THAN $1. HO PAYMEHT IS REQUIRED. ,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI. YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
Recordeu C.Iiiico 01
_, . I. ...r ,,,':11,,
-
RANDALL L "ARTMAN, PC
Attorney It uw
438 Muktc 51....
POIIOIl33
I.emorno. PA 1700
~
--
-
"'_9__
-
'96 SEP -3 P2:1B
Clo:'
Cunl' C
:"ft
.... 'J., :':.t\
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
1",111,..111"",,11,.11,1..1,1
'.
171113-3322 112
1",I/I",/II"""II"/I",II."'li,,',I,,',I'I,,,",'II.,,"
,\
---.,- .~'".-_..~-- --...........-..----'...- -,-
RECEIVED FROM,
."
HARTMAN RANDALL L
439 MARKET 8T
.
LEMOYNE, PA 17043
ESTATlINFORMAJION,
II
II
I
,
21-1996-0009
AME Of DECEDENT lLAS!)
BELICIC MICHAEL J
E Of MYMENT
II POSTMARK IlotJE
COUNTY
SSN 193-07-4311
IfIRS!) IMI)
CUMBERLAND
IlotJE 0 DEATH
REMARKS
SEAL
MARY R. MIOfAELS, ,
C/O RANDALL L HARTMAN ESQ.
CHECK" 1001
REGISTER OF WILLS
'l!
\.
--._-~....,_. '-
&
ACN
ASSESSMENT I!I
CONTROL Ii:iI
NUMBER
AMOUNT
.lul
_c:c::v. ,,d
m TOTAL AMOUNT PAID
.220.73
PB
RECEIVED BY 9JloA>j e ~)N, ~ I~,'I-'(;
(, SIGN
MAR V C. LEWIS 1",1/J/./
REGISTER OF W1LLS k;1trr
Co
-- -,---.------r--r----,--..,.:'-.
" ,.,-; f >, ' -
, ,
.
, ..
0,' -..
" I
"
~,
"'"
0,
.f
..--'
---~~ ...'.
.
. .. ~--
,
. ~~" ~ - ,.,..
---
r o'
/
I '
RIV'1547 IX AFP 112-95*
CQMOtMAl I" or PlNNI'flVAHla
D(''''tMlNI 01 RfVfHU(
IURfAU or INDIVIDUAl ".1'
Pl'," ,.....
HAUIIIURG, PA I1UI'DUI
/ .'1 ) (. h '/
c~
ACN 101
NOTICE OF INHERITANCE TAX
A~~RAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
DATI OF DIATH 11-18-95
DATI 09-02-96
FILl NO.
COUNTY
CUMBERLAND
NOTE. TD INSURE ~RO~ER CREDIT TO YOUR ACCOUNT, SUBHIT THE U~~ER ~ORTION OF THIS FORH WITH YOUR TAX
~AYHENT TO THE REOISTER Of WILLS. HAKE CHECX ~AYABLE TO "REGISTER Of WILLS, AGENT"
REMIT PAYMENT TO:
RANDALL L HARTMAN ESQ
438 MARKET ST
LEMOVNE PA 17043
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
AMount R..lttad
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiE'y:is4i-EX-AFP-nF9SY"iiiificEuOF-YNHEifii'Aifcn'-A'x-jipjiiiAisEHiiiT~--Ai.i"ciiiANcE-iiR-------u_m_m
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
MICHAEL J FILE NO. 21 96-0009 ACN 101
TAX RETURN WAS: I I ACCEPTED AS fiLED I XI CHANGED SEE
If an assessment was issued previOUSlY, lines 14, IS and~or 16, 17 and 18 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
IS. A.ount of Lina 14 at Spou..l rat. liS)
16. A~unt of Lina 14 taxabl. at Line.l/CI... A rat. (16)
17. A.ount of Llna 14 taxable .t Collateral/CI... Brat. (17)'
1a. PrlncJpal Tax Due
ESTATE OF BELICIC
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED. ON: ORIGINAL RETURN
1. Rod Estete ISchodulo AI III
2. Stock. and Bondl.C$chadula 8) 12)
5. Clo..ly Hald stock/Partnership lnt.r..t (Schedul. C) IS)
4. "artD.D.I/Not.. Receivable (Schedul. OJ (4)
5. C..h/Benk Deposits/Hisc. Person. 1 Property ISchedule E) 15)
6. Jointly Owned Property ISch~dul. F) (6)
7. Transfers ISchedul. C) (7)
8. Tot.l As.et.
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funer.l Expen.e./Ad.. Co.ts/Hi.c. Expen... (Schedule H) (9)
10. Dobts/Hortaoao Liobilitios/Lions ISchoduio II 1101
11. Totol Doductlons
12. Net Velu. of rex Return
13. Cheriteble/Covern.entel aequests (Schedul. J)
14. Net Velu. of E.tete Subject to rex
NOTE:
TAX CREDITS:
PAYHENT
DATE
04-25-96
RECEIPT
NUHBER
AA1l2777
DISCOUNT It I
INTEREST I-I
,00
DATE 09-02-96
ATTACHED NOTICE
,00
15.364,39
,00
,00
500,00
11.669.54
,00
IBI
27~533.93
8,490.70
,00
IllI
U21
1131
1141
8.4Qn 7n
19.043.23
.00
19.043,23
.00
19.043.23
.00
.00
1.142.59
.00
1.142.59
X,OO:
X .06:
X .15:
UBI
AHOUNT PAID
220.73
INTEREST IS CHARGED FROM 08-19-96 TO 09-10-96
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
220,73
921.86
5.24
927.10
. If PAID AfTER DATE INDICATED. SEE REVERSE
fOR CALCULATION OF ADDITIONAL INTEREST.
I If TOTAL DUE IS LESS THAN Sl. NO PAYHENT IS REQUIRED.
, If TOTAL DUE IS REfLECTED AS A "CREDI~" ICRI, YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE Of THIS FORH FOR INSTRUCTIONS. I
..
INHERITANCE TAX
EXPLANATION
O' CHANOES
cOMMONWIAUH O. 'INNIYLYANIA
OI'AUMINT O. IIYINUI
IUllAU or INDIVIDUAL TAXII
om, 210601
HAUIIIUIO. 'A 17121.Q601
'N
III NUM.II
Hlehael J. BoUcle
2196-0009
101
A
ICHIDULI
ITIM
NO.
IX'LANATION Of CHANOII
I
1
Per our eonvereatlon on Auguat 22, 1996, thla debt ha. bean dlaalloved
"iie'caii.. <iC'ln.iiftiCient vedflcatlon "lth no'ver1fleadoilfrciidaany'~'-'-"
~
Aree.lia Byrd
TAX EXAMINER:
PAGE
..
III
,"
i,)
0
,")
n.
Ul
1_")
,ilt.; ,,) .,
p' "':::l
a: Uu
PAM"'I
DetKh the top partion of thh Notle. end lutHI!t witt! your ply..nt ..da plyltbl. to thl n... end add,...
printed on the rlv.r.. ,ld.,
If RESIDENT DfCEDfNT .._ chick or lIOnay order PIYlbl. tOI REGISTER OF WILLS, AGENT.
If HON-RESlDENT DECEDENT .ake chick or aonly ordar p."lIbla tell COHHONWEALTH Of PENNSVLVANIA.
All pnanb recllved Ihall ba IlPPlled flnt to MY Int.,..t whlch ..y tM ....,. with eny r...lnder applied to the t...
REF1ICD (CA)I A r.fund of . ... credit. whIch .... not raqu..tad on thl TllC R.turn, ..y be raqua.tld by co.laUna .....
~Appllc.tlon for A,fund of Penn,vlv.".a I~rltanc. end E,tata ,.." (REV-ISIS). application. .r. Ivallebl. at
the OfficI of the Rlgllta, of Willi, eny of the ZS Ravenul District Offlc.. or fr~ the D.~.rt.."t'. Z4-hour
......verlng ..rvlel ~r. for far.. ordlrlngl In P.nn.yl"....... 1-100-362-2050, out,ld. Pennsylvania
end within local H8rrlsburg araa (717) 717-1094, TOOl (717) 772-2252 e>>-arlng I.,alr.d only).
.
"
REPLV TO.
Questions raa.rdlng arrors contelned on thll notlc. should be eddr....d tOl PA Dep.rt.."t of R.venue, lur."
0' Indlvlcbll T.ns, ATTNI Post A......."t Rlvl.w lk'llt, Dept. za0601, H.rrllburg, PA 17121-0601, phone
(717J 717-6S0S.
OISCClUNTI
If any t.M due II Plld within thr.. (1) c.lend.r .onths .ft.r thl dec.dant's d..th, I 'Iv. p.rcent (SZ) discount
of the t'M p.ld II .llowed.
I
,
\,
PENALTV.
The 15% t.M .-nesty non-plrtlclpltlon penalty I. coeputld on the tot.l 0' thl t.. end Int.r..t ......~, ~ not
p.ld before Jenuery II, 1996, thl flr.t d.y .,t.r thl end of the t'M .enesty period.
I
JNT[R[ST.
Int.r..t I. ~rgld begInnIng with flr.t d.y of delInquency, or nine e,) eonthl and one el) d.y 'roe thl d.t. of
de.th, to the dlt. of p.yeent. Tax.s which bee... dlllnquent b.for. Janu.ry 1, 1912 b..r Int.r.st .t thl r.t. cf
.1. e6X) parcent par annul c.lcul.t.d .t . d.llv rlt. of .000164. All t.... Which b.c... d.llnquent on and .'t.r
Jenuery 1, 1912 will ba.r Int.r.st at . rat. which will v.ry frol c.land.r y..r to calendar y.ar with th.t r.t.
snnouneld by the PA Dlp.rt.."t 0' R.venue. ThI appllCabl. Int.r.st rat.s for 1'12 through 19'6 .r.1
(
i
/
,
,
I
V"r Int.r..t R.t. D.lly Int.r..t r.ctor
Int.rast R.t.
O.lly Int.r.st Factor
Vllr
1912 ZOX .OOOS"I 1917 OX . 000247
1911 16Z .ODDU' 1911-1991 IIX .000101
1'14 IIX .000'01 1992 'X .000247
I9IS IJX .OOOS56 1995-1'94 7X .00019Z
1.16 lOX .000274 1995-1,,6 OX ,000247
--Int.rllt Is c.lculated .. followl'
INTEREST . BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
,
\
~'
--Any Notlc. llwad Iftar the t.. bee"l delinquent will rafl.ct en Int.rllt Cllcul.tlon to flft.an CIS) dav.
beyond thl d.t. of the ......""t. If PlYlant II .ad. aft.r thl Inter..t CQllPUt.tlon data shown on thtl
Hotlc., additional Int.r..t ault b. celcul.tad.