HomeMy WebLinkAbout96-00041
'-"
I
- ~--,..- - \.
',l_-.
..
.!. ,
.J
.,
,.
::f
\'~.! .
20. If L1n. 19 IIgr.al.r than lIn. 19, .nl., the diR"'"'1 on lIn. 20. Thllls the OVERPAYMENT.
aD
21. II lln. 18 isgr.oter .hon lIn. 19. ."f.r th. djfftr.nc. on lint 21. This i. Ih. TAX DUE.
A, Enl., ,he int.,.., on the balance du. on lint 21A.
8. Ent.r tht tolol allin. 21 ond 21 A on line 21 B. This i. the BALANCE DUE.
Make Ch.ck Payabl. 10: R.glst.r of Will., Ag.nt
~ ~ BE SURE TO ANSWER ALL QUESnONS ON REVERSE SIDE AND TO RECHECK MATH -<-<
Und.r penchi" 01 p.rjury. I d.dor. that I hay. uomin.d this ,.turn, including accompanying schedul.. and IIOI,menU. and to ,h. b.I' of my .nowl.dg. and b.li..
il II tru., corr.ct and compl.,.. I d.dor. thot 011 reo! '''01. has bttn report.er alttu. mar." ...alu.. a.duration of pr.par.r Qlh.r Ihan th. p.nonol r.prtl.ntotivt I
ba..d on 011 inform' of which pr.por.' hot any Ilnowl.dg..
"0 "'0 "" """ nU'N AOO"" I I '\ 11'lld"'-, 1t1tf IlIA ')/ r-t: >L 0'" /1._ /D- /OQ/
/ttWl vl(l-? 7 W' (->'{ f',.V(t:;V(/ / _ L';, 1111\ [:c 11/ IIT- ~. 0/ {{l::>
UUNfATl'o't ADeusS ' DAIl
1\ 'vo12J c.{o ~'.1\"<-~4 ,",we Zl~ P,~. Si. 110~ BB~ ,''''',;,&- (It 11108 U:.e. 18, 1~1"
IrY.'Sr:GU+I'.ll"l
l!!
..:5"
blf~
:C:fil~
us"'
//, -/'fj-7
.1
L.....
*'
'O.DITUO'DIA'HAm..2/2119. CHICIlHI.
.. A I'OUIIL
,ovl.n CUDIT II CLAIMID 0
PILI HUM'"
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
~
~
..
COMMONWIAlfH O' PfNNS'f'lYANIA
OI'AUMfNf O' IrvlNuI
DfPfUOflOl
HAIlIUUIO.'. 11121-0601
N ' NAM II" , II ,AND MIDOI INI IAII
1'l1nl'lOlI, Hnrll' Sd1:'l1t::
$OCIAl UCUIIIY HUM."
Ole DIN'1o M'U AOOI
'lOIIl I':-h', '\"1<1",. Hn',,1
fl"l'h;'l1fl'nhllrf~, P^ 170r,r,
CO",III r.IIMh,. r 1 :Inct
AMOUN' llCIlVID IUIIN".UCIIONIoI
~ I
COUNTY COOl
,)(,
YEAR
/.0
NUMII
OAte 0' OlAf"
11I1-OI-67J5
01/13/lJ6
I" ,,",IUIU,IUIYI,IHQ VOo/I'" Pol_Ill"". Ilnl ""'0 .,00t. INIIIAl!
Gg\ 1. Orlginol R.lurn
o 2, Suppl.m.nlal A.lurn
o 3, R.rnaind.r A.turn
(for da'.. of d.ath prior 10 12.13.8;
o 5, Fed.ral Elfal. Toa A.lurn R.quir.d
::'l~
0:..
0:20
82
o ... Umil.d Ellat. 0 Aa. Futur. lnt.r..t Compromis.
(10' dOl. I 01 daolh oh.. 12.12.82)
l::ik6. O.c.d.nt Ol.d T .stol. 0 7. O.c.d.nt Molntoln.d 0 living T ruse
IAlloch copy 01 Willi IAlloch copy of Trull)
AU CORRESPONDENCE AND CON.IDENnAL TAX INPORMAnON SHOULD BE DIREcnD TO.
NAMI COMPUTI MAllINQ AOORlU
::I:.1.1M1 I. (;I\PII^RT
21n PIliP St., P.O. IInx IIR6
, .. . lOP. PA 1710R-01IR6
...Ll.B. Tolal Numbtr of Saf. a.padl 80x.s
Shnlll1 1\, O'Tnolo
TUIPHONI NUMIU
717 232-1[151
Ene 1Ii ""II
20
5!
j
~
III
0:
1. Raol E,lo.. (Schadula AI 11 I
2. S.oel.. ond 80nd. (Sch.dul. 81 ( 21
3. Clo..ly Hold SlodcJ'arTnanhip Inl...,1 (Schadul. q ( 31
4. MOrTgog" and Nol., Rae.i.obl. (Schldul. D) ( 4)
5. Cash, Bonk O.pasill & Mile.llan.ous P.nonal Prop.rty ( 5 )
ISchadul. E)
6. Joinlly Own.d ',opany (Sch.dul. FI 161
7. TranI"" (Schadula G) (Sch.dul. l) (71
8. Tolal Gron An"1 (Iolallin.. 1.7)
9. Fun.ral Exp.ns.tl, Adminlstrotiv. CoslI, MiK.lIaneous ( 9 )
Expon... (Schadul. H)
10. D.bll, MorTgoS' Uobilili.., U.n'ISchldula II (10)
11. TOlol Dad.dion. I,olallln.. 9 & 10)
12. N., Valu. of Estat. (lin. B minus lint 11)
13. Chorilobl. and Gov.rnm.ntol a.qu"ls (5th.dul. JI
lA, N.t Valu. SubjKllo Taxllln. 12 minus Lin. 13)
15. Spou.al Tranal." Ifo, dala. of daa.h ah.. 6.30.941
S.. Instrudions for Ar,pllcabl. P.runtag. on R.v.ra. (15)
Sid., (Indud. valu.s rom 5ch.dul. K or 5ch.dul. M.I
16. Amount of Lin. lA taxabl. 01 6% rol. (16)
(Indud. volu.. from 5ch.dul. K or 5ch.dul. M.I
17. Amount of lIn. 1 A taxobl. at 15% rol. (17)
(lndud. valu.. from 5ch.dul. K or 5th.dul. M.)
lB. Principol tox due (Add lax from lIn.. 15, 16 ond 17.)
19. Cr.dils Spousal POvtr1y Cr.dil Prior Paym.nfl
+ 9.000.no +
R7,500.00
71.';"1.';11
!("I(,9.3R
23,337.n5
4{.5.14
IS)
182,692.90
23,832.79
153.060.17
1111
112)
(131
(UI
150.860.17
)(._-
1511,360.17
)( .06_
9,531.61
)( .15 .
20
..
~
....
E
:II
'"
u
(18)
Int.r..t
Oiscounl
473.6fl
9,473.68
119)
(201
:l
....
CliN~ here if you arc requesting a refun~ of your overpayment.
(21)
(21A)
(2181
57.93
1.01
r,0.9f1
Act '48 of 1994 provld.. for the r.ductlon of Ih. lax rol..lmpo..d on Ih. n.I volu. of Iron.f.,. 10 or for
Ih. u.. of Ih. .pou... Th. ral.. a. pr..crlb.d by the .Iolul. will b.l
. 3% (.03) will b. appllcabl. for ..101.. of d.c.d.nll dying on or aft.r 7/1/94 and b.for. 1/1/96
. 2% (.02) will b. appllcabl. for ..Iat.. of d.c.d.nll dying on or aft.r 1/1/96 and b.for. 1/1/97
. 1% (.01) will b. oppllcabl. for ..tal.. of d.c.d.nl. dying on or aft.r 1/1/97 and b.for. 1/1/98
. Spou.ol transf.,. occurring on or aft.r 1/1/98 will b. ex.mpl from Inh.rltanc. lax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK (.....) IN THE APPROPRIATE BLOCKS.
YES NO
1. Did decedent make 0 tronsler and:
x
a. retain tho use or Income 01 the property translerrod, .......................................................
b. retain the righl to designate who sholl use the property translerred or its income, ...............
x
x
c. retain 0 reversionary interest; or ...............,.................................,..................,..............
d. receive tho promise lor life 01 eilher payments, bonelits or cora' ,......................................
x
2. II doath occurred on or belore December 12, 1982, did decodenl within Iwo years preceding
death tronslor property withoul receiving odoquato consideration' If death occurred alter
D.cember 12, 1982, did decedont tran.lor property within one yoor 01 death withoul receiving
adequate considerolion' ,....,................................,.,..........................................................
v
..
x
3. Did decedenl own an 'in Irusllor' bank account at his or her dooth9......................................
x
_ IF T~ A~ER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU~ST ~OMP~TE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
o~ ex: d
,;~ .u
I),.. 0
. - N U
\\ ..
"..i '_' c.J
8.:2 c
O~
OlD
~o:
~
..
., .D
<:E
uO
SCHEDULE A
REAL ESTATE
...........................................................................
BSTATB OP MARIB SCHANTZ THOMAS
PILB NUMBBR 21-96-40
...........................................................................
ITIM
NUMBBR
DESCRIPTION
VALUE AT DATB
OP DEATH
1.
Residence -
5018 Erbs Bridge Road
Mechanicsburg, PA 17055
$87,500.00
TOTAL
$87,500.00
I
to ~
Fill' No.
12G 12.-12
'00 1114G J[llCU,lJ Il.-uU~ f\.1 crtHIILl.
PnGE
2
'/1'/ 'IGI 883"
A(IKt:KMIl:N'I' .'UM l'HI<,; HAl..; ANU l'lIMl.:IIAHY. 0.' ".:AI. .:"'I'A'J'.:
Thl, 'orm fuumm.nd.&J .n.t ."prond fut. flu' nnl tllI,ttled In}.
. UN hy m..nb.u u' .hl (Ir..,., ...ul.hur, ^"u\:IIUon nf "'1~^I.TO,,9.
~AOPNT PO/, SA!.!.UR;] I .". ..".,' '0' '''''''"'J \ ."".','0','""" iJ
I!,.,''''I'('~/' ../;. 11:..,-. i!J.l:I.,J).II.U 1../::;, /.1U~'t..'
/l/6/1l t~,al(/. Ur. /))6/)L ,t'....'J..CLrf. :;..~C.
PA,'L1CUNSnO UROKUR PA, I.ICIINSUD IJROKI!R "A. 1.ICIlNSllO IIROKJlR
Thll A........n' m.~' 'hll ~51j, d.. or ----L'LilI~ le~.
I. r.:~t~".~lJI.a'."., r- <' :;:~- s:;;~~~.M~#;;- -~-~;S~b~~..J'''';-:' ';7~"'" ~
h....tn.h.r call.&! ~I.rl and ~tl... L I _A. :.!Jjl~.J -:-n
(..,ldln. .14"1'/ '.~ ,. -.,/..; J I' J( ):.,' \r'/!...1/' 0:', t..;1"#(I''1 \...N1,11'J., A, /)II/"4/...JL.4,'t.,"
herelna".r called 8u"., . ('; t/ ;'" , '1
I. PIlO.ItRT'Y1 S,II" h.ubr ..r... 10 '011 .nd &:onny 10 Duv.r. VIIhn h.ub" I.'''' tn ,"Hch...! AI,'" TU~T CHftT IN Lo. or pl.co . I
or round ~Uh buUdln . and Imp,over.nla 1I;'.,.nn .,1fC1 . I' ,ny, known .a, -!)~ : .
. , ,." I ..1.' - - ,- ~ 't:: _ " .
.1. ZON NQI Zonlni'CI.aalnea on " J' il. H J J .L r
Fallur. at thll "Ir..mlnllo conlatn the &onln. d...lncallon ..cepl in caa.. where the proJMfl, Cor ..ch pa,cellher.ar. if lubdlvldablc)
II aanM 101.1, or prlmull)' 10 permit Ilnlle.r.mlly dwellln.. .hall rend.r lhl. A.rumenl yoldaMe II thl option of th. pu)'er and Ie yolded
dopoa", lendefed by thl Buyer ~Jl.1I b returned I~ Ih. Duyer wJI o';u a rcqulremclu or C:p':lrt ~C:I~O I , ,
.c. naMal CI) Purchase Prlc:.' .
rY.l.II/1A .4..- f.lAI d... 0 11t11
10 be paid by the Opyu .a foUowl; ,
(') Dl'!rnllT CMc" lOll e..tI L'. ....1. CJ a, 'h. 11,.1... .f ,hll
a._..... ,.'11..... .hlrh I. ...,., IW_~~'" .,.,.,..
., NOf'\ '" "' ,",_..t .11 or 11"01. IhI _ d., IIf -~
It) APPIT ONAI. IJIPOIIT IIIt1 ... ., b.loff I'"
d.,.o'
ad) aALANC'II np PUIlCnAIt' ...ICIl II .-tllftn.nl
Cual'l. anln.d ct.n_, and/., fII"".... 'UJl,h) . . . ,.. . ,.,.... ..
s
/
() () ()
..,1'_.
'5 t. ~'()O
zr? rl(J
'Ii TOTAl. ..l......,.... S _ ,t'U
Wrill.. .ppr..'.o' ..n. t. 1M on., ..ro,. III. u. ,2'/ ~ ..,or 1!::...-fV..Jlu.'IJ , I'~,
....IM.... lit ~ ........ on Of 1M'.,. 1M /.f1. day or ill''''' , "'lb~ . I.~
TN 'Dlln.,n. .han bt .~I__ "''''.'1 aa ., .IMI II 11m. o( "Ia.m..,,: Tun u 1."Me! .", ._ued. n"lI. 111I..... ~" .....1.... auunlptlonl. ro.d_IMu," r~
OM ~..,' .uortodOn ,... If U1W, ..'If' .ftd/or ...., '....11 If .IIY. '....her .lIh .n, v4hlf IIcn.bU mwnklpal _.ku, All 11I...11, Tnn.r... T.... ,h.U 1M dl"I'H
....ml' "".... ..~I.. ....-W_ ~,III. J.
I. rIlU,..n .KTU.KMEHT CflNTINCarcC."W. nl. I".._n' I. .ubJIIC' 10 .... "'11."",..' .1 I'll pI'. pfoprrlt loa"" .1 l.. 't:L..
.1"_'"
S
~
(0)
m
onurba'"._.
,. FlHo\pljC1NC CUpljn"'C~CYlltll. ..,.....nt I. '"b;en.u Ihl ".."d". a. (.U..I:
f.. rlllNCIPAL. AMOUNT' ,,~ ~-}l)(j J, J 1'7 I ,) TYrO __...r: 1'1-1
MAXIMUM: INITI^lI'_ ...-
INTlla&IT aATS ...JI'~ _ MAX.MlJM TOTAl. POINTS, INCLUDlNU &..OliN o"IOINATI
TO.M:INAL DAT8 r., o..aR\ht. P\ft&Aaln. (lMMIkllwul ---RIU'L" ,....,.... .I.'-'.L . C
arolllf ..a, .."'.. allYIf of .....w. lain... ar mon,.I' run~1 h\1l ta.llot ...u~ ,.."",.1 II', r.i 0.."1..1,,. uu,.,'. fIlA"..... II ..1.1 "'.n Clllnot he nbl.lfted
a. betICn rw""Id~. lrul ".,..tnml .11I" 1M HULL AND VOID and' aUdcpa.11 "'~t'llrl Ihln... r.lu''''~ lu .1'1' 8ur-t;r on ~r ba'." till. or lcallem."' .. plI",ldl'd "er.llI.
lb. ~lIU"J:I::li::t:~ ~::":;'::::.."riJ~:a::~r:~;.,.~~~t. ~I'" 1..llhllllM (a' 'N ..Id ta... _Ithlo, ''l raWn4., 4.,. (ream the ~11If'. 'rptDw.1 "......r.
I1\ould 'M "ur" rail to "'.". ,uet. ""'fllnrd .ppllullnn .11..111I1'" .r<<tnlld Ilml. 111...11 b, allh. .r.'lo..rnr Ihllltl"l .1I1t'1I n.,. u. ulol"d... ...,. I".,..n., UI~
(II Perl.,. ,hi. Afl"ftlll.AI NUI.L AND "010.- AI _hkh lmo.l. all "0111.. ..-14 Ofl,"CMlnl ..III 1M 'lI' .lIrd 10 S.lIn It I quId..... d.m..... _IlJIleI 10 Ih. 'hlln .nll
lIIe","lklrll. ,he PIfll......aN. ...1 ."". COWWIIlld.lI. 0'
Oil In ,NlnHo( .rlu", f1..1n I. thlB..." b, U...en. dllel.,I"1 .tII. A.,..me'" NULl. AND VOID.lh, rondlllan II'" r_lln""II:Y "..a.ldaI It\f' In Ihl. p.'II.n~h.
:~':."::,:':~n'~LO~~.":~~:,' mll~~:~~~~~~::' ':=~ ':'=I~~:~n~r '::::~11I."'~C;; ~h,:~IJ~ 1-." pr...II. .nd 'lilt A.'M""'" 11'1111 ,_.In ,,,.al.. aoc.rd "I
te) ~~~ ~~f:=,t.~:t.'=t~~~,:'~~~~h:;::~~'~td ~"~l::~ ~:'.::~:.,.~' !~rl:~': ~~~:I:-a~~:':Wo:-~'::t:r~I~:I~'1 dlr~:d"d~ltltn'~~:~1 'I:~~.C~:II\~"'~:~
u ,tI.1 d.I'..' '11' _hit" II",. IlIn..fl" du,l".'''' I"," of 11\11 A.r..mtnl '''1111. hili not ""ontll". daa. .( '~rM a' fCC'Io...,........I..".... to, Ih. Salle!". u, Alrnl. II.
Iled". '1111 A,,""""I NULL AND YOlO. br .,IU.II ftOIlClIU 'II' Bllr.er or "t4lbrr d.d,IOrll" CAIIC", .l_hl..b II"'. .1111I.,.-.' fIIonle. ....Id.n ~unl,".II" ,..""....
.. ,,,, th,,..,. 'II~J"" I. IhI pI,.~.,,1 '.II\IIU', If .",. p,a,td.d ro, "r.n.'.rtl U(~)~ tit. (UI, _rl4 elll)
hll !loal'" herd., "UII ID ,."lIlllllllMCtlon, tor .uthollud IIprr.I..", ,.""..M. unlnrn .nll/nr Itll"" II ~,"IM uqul," h)' I.... landl... ,,,ullu.k.,. nr IlIl\ul". _,.rorlu
I" SIll" ........Y ..r... U' rl, Mdllte..ll mOrl.... dlM:uunl palnll Intl/v' IDln arl.III.II9".rn 'n 10." fI' . bu..... utol.11I11I1 n...ItCIII, frum .. Iendlll, IMlllllllon requltlnl
11II" ftfI' ., lilt or .rnr..... r"I, rrnvldl". 11'1I11)..1 ", Ill' 'm dlll'l "01 ..~.... -J..,.',,_" I.Ir 'h. ',"~n' nf ,h. '"Olt..... . .
7. "rAT'" 0' WAn. AND IroW'.Il, SIlk' """1'" 11\11 thl. ","rwn)' I. ",,,Irld br ,11'./(" {..c..c........ .1I1tt' Intl--!:;:1. c.1.' {..I \!... .
....n. runh". ..\I., ..,,_n" ,tI.1 1M.. .,1...,..1 u' (lilt, r.l~ rM ."~. II "r ,h. '.1' lOr 'hi. .j,"m.nt 'N I" 1I.I.r...'~r, o",ralln. CClftdhlOlI. ., .11".., ."",...14 .,.Iem
I. pli...,.. IIIUItt' ..."'tll' ItI.1 ...,.h. "It no "oil... f,nm ,he mu..I~lr.llIY 0' "om ,"",,,leI,.1 ."Ih..rlllll 11'111 I"lIhlle Wllllf .".lInt _If ""'II. ........t t\f' IfllI.IIN.
I, "'UNIClPA'.IW'''O\'~&Nnl "'1<1,1.11... nOlle.. ~r 'nlllllclpllll"llt'!'a"'mmIlCIIICtl II II~h..lh. tllf.... ...., "c.p'__ ~'-/"-"'--"'" .--
-r'~' \0 ....~~~ ";' :~':~"~'''jh'~'i~!'~//.~'~'''~h~.&'-'~'''''~.;''::'''~~~'.;.'~'fir; '~~~:~n.:::~..' T;';'~~"':'~~:"
. .. ,.l.I.~hl"'.!Y:-_.o:.--'--":_"':t!. J!j" ~_.;!_. I.'t..[.{.{"..'....
I' 'Ii jl ;J :i t;' ~.,-.~ ;1,. ..."! .. ^,-~"ld:t.l'~
L ~JI,r, t \./)/4 ," t,' .:1 n ~, " I - U. II t./I l..,t ,/ ~
'4.~~. .
I'. ATTACH Kit KoDtENDA .r. mild.. pe" nr ,tll. AI,.,m,,,': Wood l"h_IU.n n .140" Dhc,,",",. C "rh... W.I,,'OII.~I.. ".... ~'HA/YA
..., 1....1 At''''' Co"tlnI C HIfII. In'perllo" 0 OtlI'lffIJ! ., .-
11. "~I.n, All "I.aln. ....UlllW"'. .....1".. '.,-conMllo"I". '"' U.I'IIln. nllll," II"du~lrI. ch.lld.I.." IInd nlll... ,.,,,I...d '''''"" .ppllU...."1 'l'Ier... IIMI rOl~hl'
. p...II"'''_'. and Ulh., fI'I'Im"..... n.I.....", ....fll.. In ,.n.".I.un~I' IUu. T ,Yo ,..'.nll.', mll.1 .nll rll4M "11""1. tOI""" .lIb ..1110 .,U ""pell",. """It. "arm
...h .nd'" 4Dot'1 ......... a.nl':r.' .......d_ IIlIndl. callpllll'_ 'eM" '''~"la ......,. .n. d""I. .u. ,a.d..lor at...,I. c..."k... ".11f ..n.,,"I. 'l1et1.,.. "''''-'. d'a~,
lad., drlpl'l" ,..., """..". nrl "'...{ "'''II" red tI",..". ,II U .1'111"""', pl"ui".' n.. In or .ft prn,..n" .'''1' liDO' DpIfI"', lheIIlll' ''')'1 .",.... lpallfklny
cu..rtadlll ,N. AIf"'"..... .,ellKtlld", "IN..1e .,,01 rwrr:h.M p,ln. flftr.' 11'1, .bftu mmll....~ II."" ....11 be remand or IUto.llt"'.d br Ih. StIli., 'om rr'""'''' .,",
1111. ."hI. Al''''''''"' An.. ""'.Inln. .....1". .""/''' ti_kl". ru.1. "n.M on 11'1. ....""1... .111"".,r..nllmetl' .r. 1IIlIIJlClluJ.... und., 1"1. lI.rMflM'ft'. Sellrf ..".bor ..".nll
I"" "I'.h. ..II d.Il"" .newlllll. '0 .11 '" Ill. .nlel.. 11.....,IMd In 11'111 I"'...."h. ."11 _n, ",h., OIlU'" n, 11",,1 or Pf,...."IJ" IP<<ll1ullr U'l'IIdu..... In be Inrlu"'" I" ,hi.
-.1.. "UI'I' ..,,,..,,.11 plll",""n,. 1,"11".. .1~cl'n~III.llIlfI.. m.....ullnl .,,4 .IIC'.'I..II,"rftl. Intlllllllruftrn' .,,~ .rrll.IICCIIIl.... I" "fOPltt' .0,.1011 CHd., .'11"1. "r ""lamanl,
T~h1' ......" .....;:. -'~.u:~o;;. ~~at:t~~~.. "',J;.: v~ ~j:':;JCll~.~.ti,': ~...:: ','~"~'1l"1~' :~?~j'1fJ;;<~~7~ii1;;.~~L'.. ':'
.. "(!. i~~'(t." '11,1" {(i >1.l:"; (.1.:r I !"~ INo- """''':! v.,.,,; ._ Ii,.... ,.. ,;"k.---: .l'fri.. .., 'Jm ,IJ-.': 1.11
"....' ~':f.
MINIMUM T.aM .':0/J I,.fl',:} i .,~
'J --3
PIle. !,O .. PAlO ,Ill' TH.r nu.,.Ii~:_.....
.. 'PU"tAL 4.:1.AU'UI
, ~,~~.
~~~V*~.~~~~I
~~.~~~~e.
\. ',,\'.i\\\- \ .
Write In Thla Splice) ~~~
~,~ ~-.~~
~,~, --~~~~' '-..
~~-:-, ~ ~
--.,~~~""-....::::.~ ,~
FIUF No. 125 12/12 '96 11147 ID'COLD BANKER 1t11 CAMPHILL 717 761 8837
f'AGE
3
~.. ,'.',' ~ :':::~'I~~~" .._..........,........~, .........,__,~, "...nII I..., aU a.... .....,."'.fM:..1ln4 .......... ..nP1INU .IO".""..lhlI 'M"_'"'l
1.1,1111' ....."...... 'ftUlwtklll.. ,....,......, _.......r ,_.I', "...111I"..... II."".' ~.tl. ..,.1., ,_,,,'''1.,. ., .,."., ._Ml' '" ""'''11.,,'11 ....... u~ IN .,.....,
..19.....1... ,... Utili UII", 'Mt'....,.~ ,... .,1'" ....11 1M .... ..... ....11.......... _h .. _.. loti ",,,.,M .., . ,,....w. .1111I1......." """"...., .. the ,,,,,,-, "'"
eN . 1M all)'Wf .11I ,... 'M 'M ,.........'
CO, l'" ,.,....hHII ,. lUll ....IN...., ....."1.. I... "WI..,... -..MIl.' $11M ....... ... r.. ,., ......n..I"" u' -...M.. I' ."..
1.' I.. ,,"''''h.. Jut n-.4 I...'.... IPMI".. fI" "'...,...... _Iih ..1.".... "...nt'. I....'."". "11.4., .",..,.. ., ItM'''''__ 'N, I' .."
I" I .......'~... ,.- .... ,,,..... ~tlIl. ........ '" ,,..,,,,..-. II .".
I. ....,.,.. ....'''.1 ..................... Me""'" "'".... _hef.t.. ...,.. tI,nlll.
hi ...", ......,., ...,"... .tlN" "'., "'"1.1'_ 1I,.hot .1t."I"...n""'l' C_p.n.. "'11.. .....'..'1... .uum.., ,., '''.&:."......_.'.'' ......\t.......I.....'I..U... .',h.
.......... ''''' I'" "'-"__''''''''0. ....11... _"''''I''''I"IJ 'II'~, 1M ..."..' ....."... .", ..,....., ,"'........d ,... ~ I'"~ ""',.,.. ,...\tl,... to, fill ""w...... .1..11
1M _"'M .... ,.w '1M' " U.. ..,...
loll I" I..... "'.... 1,.11I...., II Ifn.....II..... .......... ",,,,......11I1. 0' .ltC'h.. .,11'" l"IIf""" .. IIryt.MOIIl,1II ,_"'"". ........1. .r."..... .".." .-'alf ",,, .h.
.,..... .,.."". a"''' Ill" .. '1'1. "'-lilt ..... ~". .lIhn.. ....~"IW .., ".. at ., "'.... "...14 ... "If"'"1.. ,.,.. .., .h. ...... '11 ,... ...... - ..-... ., .... ....""...
,.,,,. .,""hI' "U".III ,.I",~",'" ,ht all," 10' ..... "'"....~"... It, IfI' II"....' '1M' Ih.... h."'. 'f'oH'.hl\lllt I.....,.ph IIC'" h..... 111. fit., lltu.... I.. P.....,.ptt 11101,
.". III'''' I...., ....."tI... .1'1.11'" _ Iff' "I,.-..NI,.., ..I....left UfI ,,1I.1f .., 'h. ."1.... ''""A.... ,"I. ....,...,," ...... ...._. Nl LL ......... VUIIl
IJ. P"'W"'INT Ut" n~"'MII' U'~I. ,.."......1'... ,.... 0' r-o,-- ....,'" f'OI'..... ............ ra,-, .hulM ~.. ......' r. ,... .......,..... ...U'......'k. ~
.11. _II'. ..'_., "",It ,.....ut"...IIQ. 1M' ,","1"'11.... .r Ihl. .............. I" .""1..,,..11, .lIh .M ..........blt I... .... '..iIt..'I..... ......'" r., .... hi.., ""., .. h"., ..., IIO'N
""U_. MW .., II........... .h... ......... ~...... ...".... 'h. _..........., 11,1. .."". .
II ...... It. tll,,,,".IMI_ 'M 1Iu"" ..... 'h. ..,.. ..w, .h. It ....1'....'.'... .......,. ....-' .ill "-M ... '''I''6,"b.... ,-'....... ...~. ..... _III 'IM ... h.W. .. "'hI'
....... ...."-,....... rill 'tfll"'.,." '......M....... ..w........ ... .~"... .'h.... ..'_..... Wi..." .1l,.....M ...,..... "..w .-*"....... ...,.. ."4 ""... ..... 'hall
~ ,"" ...... .he A.... ....,ow .......... .....1. J-"'-I '" 11.1..,.... 'M I'" ''''II''' ., .....-II ....n&.t.. .... A.-m'. .,..,., ........... ,......... ....."",'. r... ..... .... ..1
.. ...w "W' ... ..'., 1...HfI, .... A.._I ... NuIl.....-. .
... .....DalUN ANn nNU~1
Ctl t"\N..-.fll. lU to. ....I....... .., ....., ..,. ..... ph,tlnl ,ot......." .. . ..UM "".kll", elt '"u ., ~." ,n.I .,.... IIr ...,..fII...., '" ., .... .... ....,"""", 01 "h'h,.
I-'I.\l..........t ............. "~',"I_" 11ft... _ow..... ...... .."f.r ..... A.'_..., _I... ,......,...........rw 11I<<.. ..,. .11I.......... 'U.II,. .....t.,
~ WI .. '" ..Id .......) ., "... .r ~ ., .hh ....'.._1 .., ..~ If ....", ...."....
I". a.n. ..IN.... ...., I.... .",... .....,. _l1c'... "'P6lG".' ..1111... .....,.1. It .n" tot ....UI....1 t....I.1 'u,,1IoI' "'~ """""" U,,",,' ,"II'", II",,"'" el.... .u,...
." 1'''''''111,,""," fI,.lI .N&Ul_......1Id .."n"... IIIVIIO It h.'....' ..."....
hll 'h.,.., ,...".. '1M ,I.hl I" '''I... "'''IIN'''',,. 1",.-,40.. 0' .h. ."","'1 ",...1..., .M .,M ....."1. .,...,,1." .._M....II~....r ..-II.N...."'..
II. .... 0' 1oOII.1
"1 .... .MJIIII.iftI,"" 'M..",", fl.....J.. .JII~_ _11......111 ".,.....h IIIII.,..",.IMI '11, pluon.1 prOpl'lI' ...,OuIh """"'''' .......1111.. rt.... ,.;..dHIOII.
_...1 __ .... ,.., .."""'....
1M "-1M' ,h." "'If ,It. ..r I.... n_ n,. Of ..."" ...110II1, '"1111 "",...1,..11...",. I.. ,.... .,,,.1 .1 "'-'.... I. '1'1' "'.....n' .., n,. UI "'..., ....k" n.~ ....11 II.". ,1M
I.,....'" "' .at,;J"dl.. 11'1'. 'r.:"I"'''' aad '...."1... lI.r"'"'OI", pal" .. "'1"'11' Of ., "'"I'll.. IN ~,..", I.. I.. 'Nn 1I11f1l11t1_ ..1111..,. .....,.... .r ""l' I_.~.
,..."" .....1".... tI,.., " DIl,., III ...,..., ,uollrOed 11011 ". III., I....'. ".. eqI,...... 1111.,.... 11I,1I111 pt.,.,,, .. .r III. II... ., ..... ~...... "' 'hi. ...-..n,
It. Mt.rltgl!:"""rATIUNIf! II .. 111",,,"001I ,II.. nu,,, 1o..1...IM'\....d .tI. r",,...t,. A' fl.,." .."" Ih. ,I/hlla de lO.nd ".'.N IIu ..&r....... Pu"""''' II 1,........( 'lKh
Ir,,~IOII ...... "'" "",",,," 01 '" 1" "U"," ""'. an, "1If_"IIIIa.. m.dI .., .h. ...U., .r _, 11I1"" II 0-. ...",,1'1' .r .r;r.~= ..r "'''''1 .0' to, ,,,. 11...1 .r It.. '11'111', nr
'"lilt ,...1.",,'.. ...,."..... ..... ""~t'M' IN' II,. coopt""'" D,n"" I' .n,." u,.r hi.,,,,, "lnpeflOIl' lIfW1 "" _.. thai ...',he.......,...... fl'UIIII...11
I" ,. pi","' ,,""....1.... ",..... ......._1.. .r-tfl,;i .....111 .".. ",,'h., .,......t.oI,.. 111.1 .hI .rat."""'...."... plntd .,. II" ...lIn... 'II ......., ... ...."'" .. CIIIaIIIllIuk"'l
"0......-1"'. Ill' .n.I,lNuIlo"N&I JIII"'","".d .h.llh. ""I'll' II.. ""II .d,latd 11'111 ""ltooI m.~ .......11. 'If .1." I. '-' 'M ...".......,....,.. MIl""" n.-.. h.. rllll"l'" .........._
Ih.I Ihl. ^""ulClU tollllllltl'" lllhu-!. "I",*MUII "'1._' ,... ,",U", .",,1 D",.., ",".he,. .,. .......11I"1""... ."'1........ 10"11II"'''. ....,_,.....".. ""'_nl'I>>' ",.niIl'kl..
ulIl III PlIhn_j...., .n, .111.0.1 _h"...n.' ~.,.I".I"I. ..Ie, r"n....'II'l...... 'hi. ....'""".. "'.11,..." II. al",..... ._II4aI. ".........., "'....10..4 cu.. '" .,11111' ...ulid
I.. IhI .."ltI .."'...,
I', AIrXUaUIN(;1 rhl, ..'ea....' .haM nnl till 'IICDI'ded I.. Ih. time. I.., Itw IIKIINln. 0' o..dll.r In .n, uHte' .rne. Of pl....r ",~11c ~.. ..... I( a",.. ....u ,.....4 Ihl.
.If......'" .. 1M.... Dl pI',"lil .111 _M 10 tM 'KOf""'. k\l.,. fU,. .1 hi.'..... .p<<.II. .1.... Ie, ""1 I""" 110II:, .. . "'..... .f ~ ...-_."..
II. :,-:-",:~~,~":'.~~:':.:==;I'::::::'I:'rh~r.'::,'li'II~~":f.~lli.n~::~::~"~~1~~.~::\lI~~I'A~;:;"~:~:=':I":'..'~:r.-.."'==~.'r.:'=.:,ha....-="n::'.I'::r.::~II
... NON.UAaILln ..... All "NT, C""",,, 11'I" ... .......Idtd ". . up."" ..rc_II' ", .114..04.... 1"11\11 ....'''''''.''1. A,"wt.) 0' IN~,,,,,."'''I.I' .." .,. ,..pr.....li... s.u.rr.
'0UI1t.. ."t".
II .. ...'....1. .............. .fl4 ...,... ....._lht INnl.. h..I'I" 1111I' 'h. ....'rin 11'11'I'" ...~... ..I.n.., ..I......'..... ..... .11I,1..... ... u, .rllM, to' .....Iotff 0' .....1 .""
..., o:oo,......,..lIt'ul.1" I"" hit'...... ::'C'eon. .".. .II....~ .11I4 .,,~ IIln...... 0' p.n." II' Ih. "oapcraU... ........,..... Mil.. It ...... unl, I" INI...... I". ...,.... aII<IIIldN'
:r:-''::;:~,~~~ ~"C::;."h~IUCW" Mid w..... JYUl' , ... _'1' , '0 III"" ....', r... Ilia p"r."m.,.. Y.' .0' 1.1_ IIf 110.......... .r 1"1, A.,..,...". II' 'ar 4........ r...
JI. Itk'AU...T - TlMr. III or THIt ....ItHCI.. Tha ..III Ilona ro, MUN,""tI .n. .11 1M"" II"'.. "'.,rnl.. 111I' 'b. pIIIfDl."MOI' .r an, Dr IIII' ,.W,"I...,.r Ihlt A"__111
... fw,,~ ..,...,. a... hII .., a... IDlNiWI 0' ,1\1, AIfMIIICIU. Sbaald II.. tllIrcor:
::~ ~,I"r..:,;:r.: :~.=I=J;1=:....,.It.:=n::.;. 1;':'l:.~.4~ .1..... I'" 1IID1'.... I....". --...hI.1I ......... n...IIdeI....IlII,... ''''1111 ........."
III. .IM Pfoo:ll.I". n( .h. "'..n.... 1M" ....I'"tian, whkh Mil ..o..~ luuh III .h. ,.111111: 10 ulllll" ."- .,.",0...1 ar: "'11ft.... kaen cum"'"...."I. Of
Co'!l ,,~... UI' llIlltta r"lrul_d pII'o,,, .11".' .ha...,,,. 01 ~ll"'.II'" 'f1I. ..........I.IM. ,bra In ...oJ! ".....U <kJl6l.lII'llDIIIII MIl ..'M' ",...,.W "r..... au,., .0.. ...."..u..,
.., ,... r-,..h- pt_. ......."', ....11I,,,, .., 11'11. AJ"I'I"'I:I.... Of "OIl, 11'I" .... ,.wtlCd:
~il "W' ,... II"'" _ w.o:eu'" ., ,....c:till- rt'"'. .hlMollcI Ih. ..I... de......... I'" r..n "",chaw p,l"_ 01"
el,' :: n:;:::.:: :::,~~~..I,lI'::: II,'::.~.d""I'" ",
.. I" ~I" .... ........ .,MlIII I.......IN ,,,. Ih_ &diu .1.... III r...III.h. "ION" .. 1111101".1'" d..'..... In "".:""JIJ,U *NIo P.'.'''t'h lOfc'ClUI. the ~II", .hMI be ,,,....
'ro_ .. w.ww" .. ......,'- _ ..... AaI....... ,WI'" NULL AN" \"UIU.
11. JlICOYUY t'tJNPI ... n.1 ..Ill. ,........,.., '.Nt IUII.II tD ,,,'mll.r_ .., peno". .hol hll ..blll."d . n"., "..lIlttdlln""1 ........ . r_..'ti...nl. ,..1 ...UII tIftftMI a_In.
~~~.=.;I~':"=I~:...~:..:':.11"111,li.,..~~~::',.J.".".1('1I.. Iftd w,,_ II.. .,.." ....".. In CO'II'""I'... JII..........I .fI... ..h....lI.. .11 ...... aM ...."'1.... ,.........., ..'" "INn'
u. ,.1tAI. brl'Al1C UIIIrllTK MJt:WJUlnOP\l ."1I1TW1 ^,," dlt"........ .:1AI11' .,iulI, ..., I" 01 ,,1111"'111 thl. ....,I:Iftt.nc..... bt_h.' ,Nt A""'I:III Of .... acnk. "'"........
I.. ,.11I1Pft...Nt A&t.._1 ,....II 1M ...bllUllaJ'llI ~I..-I.. '_f1"_ wI'h 'he 1I".....Ad "".pclalfCl..r'M a..1 bll' DC."". ....\Ilkoft _"II..... Dllpul_ ....fl Inct.oMk
"'P'..,.K1MltInfllf. to, ,.,. ~\I'''', ..I...., Of..... ",oler. .ICDI. If,lh...... Of Dt....r PC'WIIVI ..,"'., ill CCl""ICt~.. _I'h III...... pw...... n.l&AC~. ...,.a"~.t. at ......, .......
..,..... ptll('lWl, In _hlch 'hl,=.II. r-,alu Indu.......\.hhO'" 1111I11'11"... ''''lIatlon, ar Ir.__.nl. ...1tt.,.,......II... MaSl,.et .rId/Of (fllld.
1.... P'V.W- ar ltal. fill..' .......11. UI ~.ou. .11.1 11I,..1". ..u......... un 'h. "'..~ pt'u",", ., ...,..., .......11.... .,.Illa ..............
..",.., .........." .u........., IhI, ht..I"eNI...... ,.......... un4ernUMIlh. ......... .......--. .'ocll"'..... ,,,.. .114 ",CICIM'" IOf I"" IlqJ ...... l>hput. ......1..
.11", .........
11. DIUf(.:XI",Va tI&ADINU. '11.. Macrl'd.... ......1.... 11_01 twld..,. ru, w.."..."" ..AI" .NlIII., .11 ...'1...11.... ..111II..... aU., ,... ....... HI lJM __'_.hkb '011...
'M"'. ACIiDIN4...,. '.... .hU h.", .. ell. ........."', Nt ........111111. ,.... ~ III' ...1I.1II1on. .r 1M parll_,
14. AOalllaAdNT. THI. AO.....,4INT CONTAlpa THe WHOLW Aa.....M."" IIBTW~r.N 1HII.ILL.. AND BUY... ma.R A.I NO ont81t TI!....~, O.uO....
TION....ffiV.NANnJl....UtHT...nONJ, STATeMIIIN'T'I all CONDmON.. oaAL oa OTIUlflWI... 01' ANY kiND WHAnKJlv'a coNcaa....INU 'I"HII
"....... ...-,;IPT AS A"...CHaD TO THII OONTIlACT, ' . ',: .. ", '
..
.' 1....1
.100 Not Wrlle In Tbla Space)
.1.....,.
..,1
'"
.,1 '.; ~""
....,..,..."
tol..II,"II...
."""
..
',..'
.'
.,
'.
Thl. Ie . I...ll~ blndaa. conine'; If .ot IIlIdentaod. CODl...t ,our anorMY.
,..........11 TN. p.;._II """ ... 1'UC\f.... .., .... I.,.., Of ...""" ..... "...taI..... I. ,... IMhef I... ..KIIIIIIII " "'..,... ,.,.... ..1QflIII ..... ........ I.. .1IdI........ .....
Po:M.'VIIWM _II .. w..... .. ......." ......,... to, .... pullet ... 'N 01111",,1 dClCVftlnu.
,
AODNT ny,
..aun.,lnwU"",wMtlllll.t1I.p.nlnl.."IIII.ll'Ilcl'ldI...,.toalll,..U,M_d hlf~b'" h. .~m. ...........~' II ...__.....Ih............ tit.. ."'"'."......
_ .._ .u... _ ~.I'_' ~0'"" - . ._:e......LI
aUYE ... -~-:::k.,L;.A ),C'.ALI
.
hi, /!.7~ ..,~' ~~ .GC:."""
'..u... c::::.:,. IJ.-.-:" I:. ~
-{GAl' ~ ~~~LLBB _ __ _
.J1I'9 ~ ~ H.... .10
/?-t:.""t'?-/~~_
eIl8AL>>
e""L)
JIM
.
SCHIDULI I
CASH, BANK DIPOSITS AND
MISCILLANlOUS PIRSONAL PROPIRTY
...................................n.......................................
ISTATI or MARII SCHANTZ THOMAS
rILl
NtOOlIR
21-96-40
..........................................................................
ITIH
NtJIIIlIR
DISCRIPTION
VALUB AT DATI
or DRATH
Mellon Bank -
1.
Premium with Interest account #112-106-5880
Statement Savings account #00250-408204
$45,756.85
25.766.73
2.
TOTAL
$71,523.58
lh:h II Itl N N. \0 \0
... 0 II II Itl Itl
. . . . . . 8'
... \0 N N \0 \0
N '" ., ., N N ::l
'" '"
U
~ 6
..
8'..~
li!1 ........
I> III :2
III U
Itl \0 III'"
'" N N \0 '"
II .. II II Itl Itl .. .. -.l lo.
. . . . . .
Ie '" N N \0 \0 S'.:..8
Itl \0 ., ., N N .......i
.. .. '" '" 0 0 ~;2U
. . . . . .
Itl Itl \0 \0 0 0 lIIlo.r~
., N '" '"
.... ..
..a ..
"'i~~
IUil :2~~=
~M.... 0
..
a I
i . I I
III
II Itl N N \0 \0 I . . .
... 0 II II Itl Itl XUU
. . . . . . . . . .
.. \0 N N \0 \0 lII~c:lX
N '" ., ., N N i ~i
'" '"
i........c
hh ..
..
..
.. .. ..
~ .. ..
ll'1II"
U a U a
...............
.. II 0 0 0 0 "'I>'"
~~ II \0 0 0 0 0 .......... .
. . . . . . ..1II")
II 0 0 0 0 0 .. ..
N Itl 0 0 0 0 .. .. .. g
.. .. 0 0 0 0 uau
. . . . . . ~!I'i
Itl Itl \0 \0 0 0
., N '" '"
.. 0 ..
o III U 110
.. .. a
l!IlII"'l
;1 I I I .
...
. . . .
UlIIUJ:
. . . . . . . . .
i III U U U U l!IlII"'IIo
. . . . .
1II ... ... ... ...
..
..
..
..
'" ... '" 0 0 "
it .. .. '" ... 0\ 0\ .. ll' .. S'
.. .. 0\ .. .. .. a a
'" Itl .. II 0 0 H.... 0'....
N .. .. N '" '" ... a...
.. N .. .. .. .. -flU "'u
... '" II .. .. .. " .. I> "
.. .. "'6"'11I6
0.. 0 J: .. III
.. ll' 'ill 8.... ..
.. .. .. .. .. .. .. ..
= = Ii I~ I~ II a .. 0 ..
...al:l.8"
OO.,ouo uoeuoeuo'lj ... 0 a
IItlOtlltl 'tlo 'tlo Itl UIJ."....
II N Itl 11I11 tl'" tlN III iD ....... . "
-i &n CD CD M U') IQ 6" 1II111:S
1'0 ... . .N' M' ,.,.. .. 11011I11011I
\Ocn...cn\OU)f04OU) ....UJ .....cn... I
o I to ,...::ECO Xeo , I I , I
Is rotaolJOCltJOG OlD OGG
1...."1.... I........ .....>.I....>tl.....rt . . . .
N"'N,",O"'''O'''Olfts..O''''''ID ...Ul:lIIIU
"';2o::!Itl::!"'Itl::!..ltllO..Itl::!'" ~~uiO:=
'" 0 N II1N Io4NXIo4N 111
SCHBDULB I
DBBTS OF DBCBDBNT
MORTGAGBS, AND LIBNS
.................................................................
BSTATB OF MARIB SCHANTZ THOMAS
FILB NOI 21-96-40
.................................................................
ITEM
NUMBBR
4.
TOTAL
DBSCRIPTION
AMOUNT
1.
PP&L - final electric bill
$31. 73
2.
PA American Water Co. - final water bill
15.8l
3.
Jim Petrosky - replacement of
birthday check
25.00
5.
Internists of Central PA
- Uninsured medical expenses
Internists of Central PA
- Uninsured medical expenses
Bell Atlantic - final phone bill
West Shore Emergency Medical Service
- Transport to hospital (1/10/96)
Keystone Urology - PC (Dr. Kochel)
- Uninsured medical expenses
152.20
45.08
54.91
6.
9.41
7.
111.00
8.
$445.14
f
!'.
COMMONWIALTH Of ..NNSYLVANIA
COUNTY OF CUMIULAND
I
,
)
III
E1Rie T. 5chwert. now known nil ~:I n I f' IIrnnkll,
b.lng duly IIworn
according 10 I.w, d.po... end ..y. Ihetnh. III tilt' Ey.eclltrlK
of Iha Estal. of fj"rl.. Schnl1t1. 'l'honnll
lala of --1iQIQUlili-aI,lil:.li.J:.ulllbnd.llIllL _ , Cumb.rland County, P.., d.c....d and Ih.t Ih.
within I. en Inv.ntory m.do by hor , Ih. ..Id ~:::"clltril(
of th. anllr. ..1.10 of ..Id d.c.d.nl, con.l.tlng of oil Ih. porsonol profldrty .nd r..1 ..t.I., exc.pl r..1 ..tat. oullld.
Ih. Commonw..llh of P.nn.ylv.nl., ond Ihet Ih. ligur.. 01'1'0.11. ..ch II.m of Ih. Inv.ntory r.pr...nt It'. fllr valu.
es of Ih. dalo of d.c.donl'. d..lh. [I/" j /' .~ /",
C .J..<.c- -J' :..b-t..e,,1 ""'-'
It
Aworn
and .ub.crlb.d b.for. m.,
19
(..1 IN. r-";;iIWJ A..,,,
KtI"'<\:-u., 1'''
Add....
Dal. of D..th
13
Day
01
M..lh
96
YII'
INSTRUCTIONS
I. An Inv.ntory must b. flI.d withIn Ihr.. monlh. aft.r appolntm.nt of p.non.1 r.pr...nl.tlve.
2. A .uppl.m.nt lnvonlory mull bo flI.d withIn Ihlrly day. of dl.cov.ry of .ddltlonol ....11.
3. Addillonal .h..h may b. attach.d II to p.nonalty or rOllly
4. S.. Artlcl. IV, Fiduclari.. Act of 1949.
~ .,;
W II
w
~ l- ..
W ~ Ul II ...
Do :!i ~ U II
0 ..
e w VI .. Z C '" ,..
a: w 0 .. II
:c Do -' u. 15 ..... .; Do ~ E
Z I- 0 .... 0
u. -' ~ 0 Do 0=
W 0 <( N ..c: i- ~<(
> Z a: ...
~ " c:
Z 0 c c " 0
- '" Z ... (l
0 a: u c .
Z w < Ul '" ... <.oJ
Do ...
..:1 c: "
~I ... ~ "
0 ~ "
:!il II ..c:
A 'V oW Ul
..., II E 0
I - .
.:l " it 0
0 ..
1:5-'71{ - 'i(
NI-ERJ1' ANCET AX RETURN
RESDENT [ECEDENT
(TO BE FLED N DlPLCAlE
\MlH REGISTER OFWLLS)
~EV'l504/EX'(1-8~) *
COMM()HIN[AL nt OF PENNln.VANIA
DEPARTMENT Of R(vtNUf
OfPT 211Cl&Ot
IW\I\IDDURO. PA 17llDllDOl
,DECEDENrS NAME (LAST. fiRST, AND MIDDLE INITIAL)
i
, DATY, EVA G.
"OCIAl SECURITY NUMaER . DATE Of DEATH
,
i _ 2~2.20.1789 . ! 10122/95
il' ~I ~~ 1pouM', NMI.I18tt, F..l M4MddlIlMlII)
i'
.
'or dltll 01 dOlth Inor 12/31/91 chick hero If I
,pouIII povorty Clldrt I. clllmed lJ
FILE NUMBER
21 96
COUNTY CODE VEAR
DECEDENrs COMPLETE ADDRESS
221 lIonoybrook Road
:DATEOfDlRTH ,Corllsle. I'A 17013
04/24114 ! COUNTY Cumbcrlond
J ;
SOCIAL SECURITY NUMSER iAMOUNT RECEIVED (SEE INSTRUCTIONS)
I
. 1. Original Return
4. Limited Estate
2. Supplemental Return
'+1
NUMBER
3. Remainder Ratum
(for dates of death prior to 12-13-82
l' 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
I....,
I!! ,.,
"'I B ' [ I 4a. Future Interest Compromise
G ~ (for dates of death aller 12.12.82)
. 6. Docedent Died Testate i 7. Decedent Maintained a Living Trust 0
,.:: (Attach copy of Wilt) (Attach copy ofTrusl)
. i ALI:CORRESPONDENCEAND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
i!z INAME .. ---.. -- . - j COMPLETE MAILING ADDRESS-
~ I Stephen L. BLOOM : MARTSON, DEARDORFF, WILLIAMS & OTIO
l5: ! TELEPHONE NUMSER -. - 10 Eost High Slrcet
_.)( 717 )2433341 Carlisle. PA 17013
1. Real Estate (Schedule A)
2. Slocks and Bonds (Schedule B)
3. Closely Held StocklPartnershlp Interest (Schedula C)
4. Mortgages and Notes Receivable (Schedule D)
5. Cashl Bank Deposits & Miscellaneous Personal Property
(Scnedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G) (Schedule L)
8. Total Gross Assets (total Lines 1.7)
9. Funeral Exp.enses, Administrative Costs, Miscellaneous
Expanses (Schedule H)
10. Debts, Mortgage Liabilities, Liens (Schedule I)
: 11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
i 13. Charitable and Government Bequests (Schedule J)
I 14. Net Value Subject to Tax (Line 12 minus Line 13)
_____)____.___._____._______________ m_ .n'_ ..
, 15. Spousal Transfers (for dates of death after 6-30.94)
i (Include values from Schedule K or Schedule M)
i 16. Amount of Line 14 taxable at 6% rate
. (Include values from Schedule K or Schedule M)
17. Amount of Line 14 taxable at 15% rate
(Include values from Schedule K or Schedule M)
18. Principal tax due (Add tax from Lines 15,16, and 17)
I
I. 19. Credits Spousal Poverty Credits Prior Payments Discount Interest
+ + 298.86 (19)
I 20. If Line 191s greatei than -Line -lB,~nterth~djite;e~ce on -Llne:ZO. Thl~-Is the OVERPAYMENT (20)'
: A. [] Chock here If you are requesUng a refund of your overpayrnenl
I 21. If Line 181s greater than Line 19, enter the difference on Line 21. This Is the TAX DUE. (21)
A. Enter the Inlerest on the balance due on line 21A. (21A)
B. Enter the total of Line 21 and 21A on Line 21B. This Is the BALANCE DUE. (21B)--'-- '-S5;678.42
Make Check Peyable to: Register of Wills, Agent
__. ". .P._________ ___.n.__.__ --- - -- - -- -
___~____m ------- --------.;-BE-SURE-TOANSWER"ALl.- QUESTIONS ON REVERSE SID~ AND TO RECHECK MATH..
undOr ponini..'of POr1u,y,ldeCia"'-lhallhavo oxamlnod Ihl. rotum, 'Includlng aCcompanying sChodul.. '-';d.talemanl., and 10 lha best 01 my knOWledge and
bollaf, III. truo, corroc\ and complalo. I doclaro that ali real IItalo has boon reportod at truo markot valua. Doclaration or preparer othor than tho porsonal
'l'p,rolOnta)!v.o I~.b~~~ on. alilnfo-"n~ti!'~ 01 which preparer ha. any knowlodga.
stG FPERSONRESPONSI8lEF 11INQRETURN ADDRESS DATE J 6/ -
Y 221 Donnybrook Rd..Corlisle. PA 17013 III~ 9t:,
SIG R ADDRESS DATE -
10 E. High St.. Carlisle, PA 17013 /II~ /9.6
i5
~
!
a:
z
s
I
s
(1)
(2)
(3)
(4)
(5)
(6)
(7)
1.123.91
8,119.36
37,700.00
(8)
(9)
(10)
7,094.75
(15)
(18)
(11)
(12)
(13)
(14)
x .00 :::
x ,06 =
(17)
39,848.52 x ,15 =
(18)
46,943.27
7,094.75
39,848.52
. 39.848.52
5,977.28
5,977.28
298.86
5,678.42
"
,
.
B
~
ilt.
"
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING AN (Xl IN THE APPROPRIATE BLOCKS.
1. Old the docedent meke a tranefer and:
e. reteln the uee or Income of the property transferred,
x
b, reteln the right to designate who shall use the property transferred or lte Income,
x
X
X
c. reteln a reversionary Interest; or
d, receive the promise for life of either payments, benefits or care?
2. If desth occurred on or before December 12,1982, did docedent wlthln two years preceding death
transf.r property without receiving adequate conslderaUon? If death occll'red after December 12,
1982, did decedent transfer property v.lthln OI\e year of death wlthout receIving adequate
conaldereUon?
X
3. Old dscedent own an 'In trust' bank account at his or her doath?
X
IFTHEANSWER 10 A~ OF THE ABOVE QUESTKlNS IS YEs,
YOU MUSTCClVIPLElE sa-tEDULEG AND FLEITAS PART OF THERE'TlRN.
-'~TN" _VAlIIA
IIIJOII_ '" ._
-..au II" IIIlIVIIIUIl. IAlID
...,. raMlI
_,-." mu....1
*'
I'ILI MO. Z1
ACH 95159121
DATI 1Z-1Z-95
TYPE OF ACCOUNT
EST. OF EVA G BATY ~ SlVD181
8.S. NO. ZOZ-ZO-1719 Clll!CItIllll
DATE OF DEATH 10-ZZ-95 nasT
COUNTY CUMBERLAND Cl~'.
nIlIT PAYIIIII1' 11II ,_ TO'
REGISTER OF.WILLS
trJ QO rDI"\'17 CUMBERLAND CO COURT HOUSE
~~~ L1 CARLISLE, PA 17013
INFORMATION NOTICI
AND
TAXPAYER RISPONSE
..,..lJlIUWfU....
L II IIATY
Z21 1I0NNVIIROOK RD
CARLISLE PA 17013
ta!LLIII PI'S .... ....1_ _ __t .111I _ I"_tl.. 110_ ..I... ...1... _ -. _ III ooIaWotJne -
,.tentJal a. .... n.ir ,...",. 1nIIICllto ht It U. ....... .f the ...,. ........t, ,.. ..,.. . joint ....,...,...t.ww .. VIII -..t.
If ..... feel tftll In.....U. 11 l.....,..t, ,1... ..bin wlttan ....,..U., ,,.. .,. ,1IwItla1 lnttltutl." ott:lllft . .." te thh ...
~ "turn 1t to the ...... ........ Thh.-wnt 11 __1. In ...,.."... ..lth the IMerlbMe Ta L.... .f U. .. ,,,,.f Pwvqrlwnlo.
Iluutl_ _ .. ..- W _1I1na (nn 7'7-UZ7.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILINQ AND PAYM!HT INSTRUCTIONS
-..t No. 112-132-6053 Dat. 04-10-61
btellU_
16,231.72
50.000
8,119.36
.15
1,217 .90
-..t ~
.........t Taebh
-..t _J.t to Tox
Tox ..to
I'ot..Uo1 Tox _
T. J...... "..,.,. __It tI ,... .....t, '-
(I) owl.. .f thll ..t1_ _t ... ....
_t .. _ ....10.... of MIlIl. ....._
,.,.a.1. till ....ht8r ef Mill.. .......
x
,I ...'
11Ift. If t.c ,.,....a .. __ .1ttlJn tilt-.
(J) .-tftI .. the ........ .... .. ..tII,
,., -w ....., . II 111-' .. tM _ ....
.... ~I_... _ .111_ 0101_
"1M (tJ ~tM .ft.- tIW ... .. "VI.
x
PAIIT TAXPAYER RESPONSE
[I]~~~!~m,r_.~_~_
I. 0 The ..... tn.....Uon .. ta ... I, ...,.... .
1. You..w ~ to ~1t ,.,..., t:a tM ",lIter If IIUla .1trt t-. ....1.. ef tI\.1. ..tJ_ te ..aln
. cU_t or ...111 1ntwnt, Of' ,., 88JI .... .... ... ... return title ..tlee t8 a. "let:.- ef
MU1. ... .. .ffl.lal ....~t ,1111 be ..... n u. PA a.-taMt ., .......
I
I. 0 TN ...,. ....t hu .... ... ..Ill bti ,.....ted ... ta "l~ ..ith tM .....,lwnl. trlwrl~ Ta ...turn
to bti flied by tM deoIldInt.. ,.."....tlItlw.
c. 0 TN ...,. tn......Uan 1,,,!'J.''1o...,..t ...uor~t. ... .....tione .... "i~ IIY ,.,.
V., _t ....l.te NIT l!J...u... PMT L!J ......
If lIDU lndl....t. . d1ff.......t tox rote, ploo_ .t.te _
rel.tlon8h1p to dlclJlntl
[CHECK ]
ONE
IILOCK
ONLY
\
PAIIT
l!I
TAX RETURN - COMPUTATION OF TAX ON JGZ"'UTRU3T ACCOUHTS
LINl 1. Dot. Eetobllohod 1
Z. _t 101_ z
3. P......t Toxoble 3 x
". -..t _J.t to Tox "
5. Debb _ _Uon. J-
.. _t Tuelll. .
7. Tax Ret. 7 x
e. Tox _ e
PAIlT
l!I
DATE PAID
DEBTS AND DEDUCTIONS CLAIMED
PAYEE
DESCRIPTION
AMOUNT PAID
I I
TOTAL (Ent.r on LinIo i of Tox ~t.Uonl .
_ __lUe. of ...rjurJo, I _"- thot tho f.b I _ -u.r _ _ t...., -.-.at -
~l.te to tho ~t of Q _loclgo II)" boUef. HOME C' )
<V_ ~_1. t:-1..d;;:-- · WORK C) '//1/9(_
,
..,
"j' ~:
\ :*,
-,
- :;'
oj'
,
1',
111\1111' III' ~ I
! f'~l
n L~J
~l!l,,~-
~~; ~$.:~ ),1
i!::ll.,~t
:to III
I~ ~
~ ~R
~ ~~.
UQ LO:!
Cl,lHl
.. ..
~..,,~
~er.:
w~t:,'
U .
_10.0
t:UU
oo:e
".,::;;
cae....
.....'"
~u\61
g~;
~ 11
THIfI DEED
~@[Pu
'I' ,
HADE THE :.l:Jnl daY ot
thoullnd nln. hundrld
N~:Jt-- ln the Y"U ot our Lord
e19hty-nlne (19B9).
onl
"
BETWEEN EVA GRACE BATY, eln91e womln, end LUCY BtANCHE BATY,
11n;11 va.an, li.tlr., both ot South Middleton Town.hip, cu.ber-
Ilnd county, pennlylvenle, GRANTORS
IJID
JIJIET L. BATY, Iln91. women, thelr nlece, ot Bouth Hiddleton
Town.hip, cuab.rland county, Plnn,vlvania, GRANTEE.
WITNESSETH, th.t in conlld.r.tion ot ONE ($1.00) DOLLAR, in hand
paid, the receipt whereot il hereby ocknowl~dged,.the laid
Grantorl do hlreby qrant and convey to the ..1d arant.., hlr
heira an~ ...1;nl,
ALL THAT CERTAIN lot ot 9round located on the .a.t lido ot
Townlhip Road No. 516 ln south Hlddleton Town.hip, cumberland
county, Plnn.ylvania, morl particularly bounded and d..cribld ..
tollow..
\ . '.~ . ...l
BEGINNING. at 0 nolI in the cont~r Ilne ot .ald public roadl
thence by an exiatin; tenca 11ne between the property hereby
conveyed and property noW cr formerly ot Iv. Sham>>au9hr thence
along I.ld Shambaugh property, South 85 degrees 13 minutes East
two hundred thirty-ei9ht and titty-ono hundredth 0 (23B.51) teet
to a fence post, thence along lands of Larry Lehman and wite,
South 4 degrees 37 minutes We.t one hundred sixty-eight and
twenty-tlve hundredtho (16B.25) teat to 0 tence poetl ~honce by
tho oame, South B7 degre.. IB ainuto. Ea.t thlrty,o~x and
eeventy-oiK hundrodth. (36.76) teet to a tence pO.tl thenco by
the sam., South 0 degre.. 45 minutes Welt three ~pndred twenty-
tour end nineteen hundredth. (324.19) teet t~ ar,-lrpn plnl thenc.
by the .oa., south B5 degree. 30 minuta. 45 ~~c9nd.'~a.t throe
hundred .iKteen and ninety-aeven hundredth. .(315~97) teet to a
noll in th. center ot oo1d 'l'ownohip Roadr thonce.in the center ot
.aid Road, North 6 degrees 23 minute. East five hundred forty-one
and .iKty-~ive hundredth. (541.65) teet to the place ot
BEGINNING. Containing 3.30 acres and described in accordance
w~th a oUrYey aado by Noal B. Smith datad January, 1969.
BEING part at the same premis.. which Kate A. Baty, widow,
~ ~~I~:e~t~1~:di~a~~~~0~2Cu~:~io~~dc~~~~~~o~I~~.~~~a~!;0~~o~o~~
~ Book "SIf, Volume 23, page 74g, granted and conveyed unto Eva
~ Grace Baty and Lucy B~anc~ B~ty, tho\Grantors h8r~ln.
"" EXCEPTING HEREFROH all that lot previou.lY convoyed by the
__ Grantoro her.in to Loren A. Baty and Mildred Baty, hio wito, by
M deed dated Septoaber 1, 1987 and recorded in Ceed Book "X",
EO Volumo 32, Page B63 in the Racordor'. ottico atora.ald and more'
~ tully deacribad oa tollow..
."
ALL THAT CERTAIN lot ot 9round locat.d on the ea.tern aide
ot Townlhip Rood IS76 in South Hiddl.ton Township, cumborlaqd
county, Pennsylvania, more particularly bounded end'd..cribed .a
tollowOl . , .. .,..
BEGINNING It 0 point in the center ot .aid pubilo road whioh
point 10 in the line ot the .outhern .lda ot the .d.ting . .,.
driveway into the building. on the land ot Grantors, thence: , '1/' .
eootwordly at ri9ht 'on91el' to .00d publio road one hun.dred f"""f'Y
(105.GO). telt to a point I thenco .outhwardly by,a_lino para e,t',illT,,',
wlth .aid publio rood, one hundred (100.00) teetr thonc. ,,,,,".~' '
we.twlrdly by a line. at right ,ongle!:.~o .00d. ~ullli,l'l;r~l'o~"':-;.;~,I;:,1
. ,): '.. ""'r'" ..~,\Oh
., '," ;.1.' :.-. 1: ~., \,' : ,'." ~.~..;..." '
It:'O:- atlltt
'1
1....... '., ,..'...'. ,'.. ',' . .'..-,; '...._-....-~.~. ,...-.-.~_..._._~~- .----.-
, .' ..;........ #O:;~''':.,...''
I
I
\
\
I
I
I
\
\
I \
,
: I
I '
: '
I
I
"-;
.,
\!
,
_' I
1
:l
I
I
I
1
,.
1i
)
I
\
\
i
i I
\
\
I
\
,
I
,
'.:!" '.\\
" ,-~,
..." ~\\
. '. ~'\ f:\)
._.... - -- ...---;.....-....".. <.. ~ .": 'I'
....--_.--~..._...__......~........" ,,',
,'...',,:.
, ~,
. ." ~
\
,
~
~~..- "",,,,",.,..~..
-0.;1"
-
.--.. .
r .:',
'''',
--. .._-......'~-
,
,.
..
..
,.
hundred flve (105.00) feet, thence northw.rdly .lon9 the center
of ..1d pUbl1c road, one hundred (100.00) feet to the place of
BEGINNINO.
EACH GRANTOR HEREIN RESERVES A LIFE ESTATE IN FAVOR OF
HERSELF AND FURTHER RESERVES A LIFE ESTATE IN HER ONE-NALF (1/2)
INTEREST IN THE PROPERTY IN FAVOR OF HER SISTER FOR AND DURINO
EACH OF THEIR HATURAL LIVES SO THAT THE SURVIVOR OF TIIEH SIIALL
IIAVE A LIFE ESTATE IN TilE ENTIRE PROPERTY AND IIOT JUST IN ONE-
IIALF (1/2) OF SUCN PROPERTY.
AND the .ald crantor. hereby covenant and agre. that they and
each ot them will warrant qenaral1y the property hereby convey.d.
IN llITNESS 1lllEREOF, .dd Gr.ntoro have hereunto .at thelr
hands and ..a1a the day and year first abovo written.
SIGNED, SEALED.AND
DELIVERED.IN THE
PRESENCE OF.
~.J~~ C)# 4- ' . -
~ ,. I
f;':-~?f~{jf;fjij (SEAL)
;{ ~H'MC/!!;.~'<<BA~-.g:r(SEAL)
S",,~A m..J J I.d...
:. ~1 Df#. Cumbo co.. PI.
; 1',::', 1 "A..1E"".Trent'"T..
:.1,'":,,,: DJI,').oo'$1/Amt. 33,,,,3
COHHOITIiu.ij~ 'O.F' PEIIlISiiLVANIA' I'J':.~~ V4-~
COUI/TY OF .i:iiKsEill.A/llj : SS. Cumb.Co.D'ltCoU;t. '"
On thi.;'tho. .:l:J..{ day Of,v~ ,A.D. 1989,
bltore ...th~,und.r.19n.d of ticer, personally appeared Eva Crace
Baty and Lucy Blanche Baty, known to m. (or satistactorily
proven) to b.,~. perlonl who.. names are IUbscribed to the
. within inltrumant, ,and acknowledged that they oxecuted the aama
tor the P~~pOD.. ,therein contained.
IN WITNESS' WHEREOF, I hereunto ~et my hand .nd offlcl.l
seal. .'
tJ.dL' O:1/~~_J
V.
.,
. ,
(1jllklL~E.vlld.(.J ii1 .
Notary Public . '".
!>'''!.~''',JJII/t., ".l" .
S..:tlnol Dill Cumb Co P. '"m,/nO lil ~.' , "I'
. .... C oTI '.;, ". 1/"
~%P"IE"1l1.T,.n'f.rTu ~u... ;. " "~~.:,,
'" I~ '" ".., t . ~J:'
03" ,So,' Am~J& , T .~, . ~. ""'. ,.;\,t.Q!
J-" O,te .;~, h'
fA""'*- #-. V'~.... 0 ..~.t'.:&.~':'P~~/
CIII'"\IJ Cn nl~ CoI.Ag1. h .-.... '. :..::>.- Io_:,'~"":'
Cvmb.Co.uilt.-.1iil .':) \..~
",..... ,
I do heraby certity that the precise ra.idanc. and complete
post ottice add res. ot the within named Grant.. ie
::t;>.3 -a.?'nyb...,of.l Re!. Q.u.r\;sle, PA 170'3
$1.110 of POnn:lylvtltllDi , 't"~
County 0' CUnlb:lrlnn:f i t...'\ J () n A r J /J I J ~ '''"t:">
R~eOrdOdlnth~orrl':'flort:.j~l.,("II;..,j:)J.f'"',~d".'" ~J.r.~D...4. z::.,~d'1:
~._I,\.nd for Cur"u"'l ;,: 1;,,:':,::1 1-';,. lJ"~~'tt:'!; ~"'" Attorney tor Grantee
,~ OOOk..~ Vn..3'1'. ~.: 1 V:..r;\~"""', . ( )
wlln, 0l1h n~~;~:"i'~l~';:~'r.l;'.!< ~~"'~\l N. r. S.
Cr.rll:>lo, '" ." "~i'\'~ '~ ~~:Pl 2
~~~ ~.,'~i ~4r.tt 2
Racortlo::~. \,'; "~,,,';',';~","\,../ eOQ'<...L ~ _
...",1. ........., ',..,
....."., ct." ~":.,,
a............
-...
"*"'1_"__
."'_e..._""",
1.I'~(I!lhI"""'20.lm
",..,.btr.'~~"'OlftJ''l"
.'
"
;~.. .
"
,j '.
, .
,
;1
'j
:!
.,
::
I,
I
<!
,I.A.
..I..
,
, ..
.J
-"
,"~rt, Ih..~
1~M'ft,Adlllll" 22fJ~:t~ ~~~~_--===-C;!t'~U~J~(-' _ _ _.__ "'!iiA~_~ _ 1.IIA"'" lW'
'....Iloto"'''' lmllJbill:..~1l!UI.I_____.___ __. SQ,JUttlldJIDlmTlW'dllp. -""". ().Jltxlrlml
Aauuorll'ltr..No ~~________...___,. _.__.T~. .'nt"_1!IlJ fir :."~_'...~!,40_. rc...~tl~.,.'''''_.....,.ry''
(bfOWRl ",. (AJlllofIfO'WI..,:~-i --JWv c.....""'.. (";\0...,.. r'-ll,.,~,,,t I I V.,w"
~rmo.rt.,tlll'IA....-1 1-V'",!Wrl'1.'-lll',l'4't.._, ''t'....O(fTYI...! I ,,,n I 1(:"nh'''fllll,"nlUl)l~ldwl Illl'" tn'l1 ,U,I
~hnoda f'ruMtWnlt nla _~._____._~!l_~~~~_.~____.,__ _ ~"'_~~~'~"'_~'W
Be"":~~ (~'u~su. n/e 1::~~:~.;ril-=-~~W~lli~-'~~~~~17OiJ'_u-,-,-
~_ -~~~~ ....... 9DAmAii1"tiii-ual.ij"~-;"{YifiljjllOl.1-u---
locAlm lJIban &b.-bfIM l( ,"'.. P,edomlnlnl ~'"'" nousI!'O ",.,tnt"nd ".... runau.. ch.,.
".~ N' @ 0
&lit tV CMf 75'" X ~5.75' lkItloI 0'5' ~~ncy 'mol'll h~1 01l'ArnIw' _00_ No...""fOtt I.......
OttM-th file I( nAI_1 Stili"" !"lkJW I-'i Owf.... ~ ~ow _~ 1.~ IlWfIIfy ~_ II In IltflCflU
~.'" v.... )t h:ntaSlnQ SIal:. Olockwl;l ~ 'l"f\oV1t ZiJ 1fV1 =-~ "-,",I..,My 0 fo ~!__
Denwd/aWy Stnlllglt JC hblln". CMot-.n:Iy JC VatantlOS\1 ~ Comnwtllll-S
MatblrolWM UrOw3Ml1 JC 3.8rrol o-..en'Ct t-: ""'CMI"11
Notr. RKe .nd lhe rad.tl compoalllon of lhe ne6ghbofhood .ft ~ .pp'....1 IKtOfI. "-
~h:xxtboond.1f"lardc:h"'lfac.tensln Ch t:hJ tbrttl by 5aJth ~ Q!nin 9tmJt, 0'1 tht &1st by flDtBrrb.r'g fmj. 0'1 uar
Sa.III1 by I\rllll!r lJnJ !I'd lJ1 tIIIlbt by PA FbJte 34.
Fachn ~t allecllhll mM~abllll't ollhl! P'~I!,:I.lIllt., nrIIJ:IIotnodIJ_lnlrnrl.J II) t'n'foIoyfTWtOl.!~ /UT1P,fMt.,.. pmpbylt'rnt r.l~'tthrlllf! m.lf.,'I.'!!CJ
1l1l ab'ect ia 1ocoted In 0 rurol onttlIn 2 mllm IlllJlll of UIl'lialB !I'd "'I mllm I'CltIwEt of I """"". 1h1B
foot1Jnlo 0ld!Jr l>o IIlDnIIuros fmn olll flllllB !Xl I1Wlr t'lIrlEr '!,Jl!-.JJr.",~L~Jit- ~'I
2-etory....... Itl8t of tIIIllrd ia ogrlOJll1JnJll1Jt io I>tim ~ itViirrors .
~nrge of IIIPIapmt <wJl'l11litlm !I'd mlCM1lTll of ltIl l'Iltll!I In tho of Po.
UNIFORM RIIIDINTIAL APPRAIIAL RIPORT "..w.. !b-1I-24
tMrlo#ol COI'dlU'lS In 1M ...'CI rwoqllntood 1..:u-I"WJ ...""1 I~ lho nlxMt cord,$JIIW rPl.lll"d 10 It.! IIrrd 01 J)fOl:lPfly vnb~s, drm.lIdISl(lf:iy, IWd m.UIwl'I1Q lorf1IO
I T~hl"' dlla on Crn;h(; r=l~ l~l~n the nl"ahb1:'3\~"~C::~':U:I~~:l~eMrJ'~I~~br::MVI
Ie I\mIB :1a1ll flrm:ln:llo fmn Incal srMraI!I'd llXnl!l'd 1_. l<D1 ~-
i ~BrO rot ammo
PtotKt Informlltk:ln lor PUDI II '~I' .lslhe~/I>>l"'f InCMlfoIollhelbMOIrtroM.' AuocIBllOnlHOAl1 DYes 0,..,
~almlll.loCal~ cltnl.1n the ~ prOfl'd ApfwOJltMIe lotallUYtJel' 01 Uf'Ils lor """10 !he Il.tlfPCI projf!cl
DnCllbe eommon~. It'd rKtt'ahon.1t IacM",s
0wnf0n&i0nI Topogr8~
Sdaarea---3..00 krm ~ ~ ill){ fD::nn:i'Il Corrulot DY~' (i]No Si:"
SptociI'Ic: ZOl'W'Q dlS8lfallOl'1~ ~scr~1OI1 SNIpe
lonrQCClrTlJIi.1rceliJlegol LfIOII,........~"o1I~nlI.alherNlIStl DIIeQaI DNozOI'\I"O OrBlMOl'
l~bHflM"~ A-~1J8e I IOflwusel~.plalt\l , v_
UlIIIU.. f\.tlhc; OfhPf orr.en. tmpnwement. Typo ~ Pr~te lArdSCDpn'J
Ek!clliclly S~ PIMJj ft'fV"ft'h!l ~ fz: Ol~ SulfAt"
G.u ..... - Coob'"",,, ttmllb1! 1= i- -.."..""""".illJlall utili~~
Wltl'f ~.::-..." SOlwalk Jt;:re p.. F- rEMA~FIoodIt.".ydAtPa UYtlI ~ No
San.t,,,yM'M!f ",*" ....-.t-i,. Slfet>lhghll tbl! 1= 1= FEMAZom C M.1POaI~11I4/B1
St(J'm ~ ~ AJkoy f.tnl FEMA M.1p No 4CU371 (J)1O 8
Commeols laJl).lIPnf ~ t'8sumPn",l-'f'OoochmPrll., ~ IU~IIlTll'flIs. &Ide 8feas, iIll!onI at ~ nc:nconlorlTllrYJ z~~. ete I The site is
tvolall ftr till ""'''tti.t rite In till reLJl>..lu.d. It ClJlfunm witlllncal zmirQ, 1m '" IllM!roo
.&JJ.!m
A~'-'"
-
bllmle ftr reLJ 1>..1 u.d
A~'-'"
GUlERAl OESCftIPTtQN EXTERIOR OEscntPllON FOUNDATION BASEMENT
. No clUNl! fhR ro.Jfd1tlOl'\ ~_ Slab tb"e Alea SQ Ft 4EJJ
No of SIOIIe' i..n Eatl!f1(J" Walts ~ Q8Wl Space Kit. Brm .. rnshMt 0,.
Typo 10M 1,1.111 noor Sullnc" 9UralB.nut Ball!fOOlll oortiBl (Alling n/s
DPU)nISl.,te1 - ~ Outm & DwnItts Yas-<<Dt81 ~ P\Jfrc:I tbl! Wals n/s
Eallling/F'fopolfld ~ ~ WII"dow Type ~1f;;; 041T'ClMS! tb eviO:n:::s a FIoot st:ae
10tJ IY") )+. Sklfm/5crt!l!fll Yoo/Yas 5m11M1Pn1 tb evicb'm a: Qutlde Entry Yas
EllectMl Aqe IV,,) rl.&. ManJlaclured 1b.Ju Inlollatm to evian:e rr
. ROOf.AS rO)'!l" IJW1g 0tnInQ KltChln Den Family A'n ~,J\'n 8l!>drooms "811M uuroy
.........
.l~l 1 1 1 1
If"o'e'l2 3
NSUlATK)N
Roo! - ~
c..""" -
""n, -
''''''
-
None
-
........ -
01.... MOl SQ FI
T.D
4IIJ
Fn&hI!d .e.uboYe grade eonlalnl 6 noon-.; 4 ~.!. 1 81tt'll.!. 1aD SQ.we FHt of Gtossl.Mno Are3
tNTErllOR MBIl!fota/eooo.llOl'1 IIEAlNQ KITCHEN EQUlP ATTIC AA4ENlTtES CAR STORAGE
. Fkxn vI.n.ll T~ ~ rwflQlllalor JC NonlI 0 r..p.'W;t(II' -L ~ fb1e 0
Wins D1.o:ster Fl'!"t Oil n.\fYJll/Own It St.'\IfS [!] f'nto JC GntIlQL'l' 1 , of e.vs
TI~frnatt ".!!!)Il'VIIh'1t"R1 Cordtm f81r Drspow Olop Slaw ~ Dtock. C AttncMd
D.\lh rhol';:;;:;;;;- COOLrIG o.st1W~ 5aJ1tWl FUtch F ~achI!>d JC
n.\lh YmlOlCof rmn:nite c.ntf.al tc ronltbod rloof JC rM:ft ~ (hl"'o
OJoIs WXJj 0ItW'f tb-o MictOWlMt '....lllod ~ CNporl
&11 .... .... om r.lr CaUlm NJA ......,l>... 'n""" n ~ l>....,., X
M1.liOnfll fealur", 11PflOo" "It'l''lf ."llCllII1t rtPmt. ~te I Tm l-c:m" (J!nIJ) is ett..odnI to ttc Wt.octoj tmn.1lJt.ad'Dj 8l.lTTlIJr k.itdm
with IIttlIduf IInXI 0 botI1nm livlm raJ1\ !I'd lxxlnxm l.IJIld os . a.mt .
. eo.""'K\fl of 1M 1fT1Y0'0'f'fTIt'l'1'1. ~Kiahon IrhiKaI ~1Cloonal. anJ tulf-'ft\3ll. If'IlroIS nH'dPd, tJ.IOlIly of comIructJJl1. 'P/nOdrIIf"Q1a<..t"IOOS, I-'te, The ab cct
ia In rolr anlltla1 with till olectric IlIlMco II1l till fumlal rmIirg l(Jdlted. Exterior In rml of II1l
1l1l botI1nm !I'd Idtdm IIl'O aJtdltIJd. Evldn:o of oott1mmt In tIIIldtdm IInXI IIdd1 _ _ !Xl till
tam,
Ad.foIse f'fMforllTW'lllal COI'w1ol000s IlkJCh as. b.Jt not ,,",,1.'<J 10. lio1lltlbA ""..r... to..::: abll3f1C~" elc I peosl'lll Irl 111'l ~9'!'"~I' on Ihe "!.P. or III II..,
Ifr..'....~le ~'t ollhf! aJt'll"Cl P'CfII"It't llm'8 ant rn bon or fIM!nJ8 mv1l'a'mJ'1tal anntia1s t:fOt WJ.JJtl
...-twlu ,..- lJ1 till \11IM .
',,-.,.....llI'"rn'" 1n lI.gl
1;001
JWOf I CW 1
III '.''ff'" "',... ',~. ,.,~~, ""'.',,, I ""'I
r........I,t...,.......I(}()t 1\.'1'1
DEFINITION 01' MARKET VAWE, Th. m'KI probable p,lce _hl,h I pm",lIy Ihould brlnl In I ,,,,",,,tltI.. Ind
open mar'e. under aU condillo," rcqui,ile 10 . ralr IIle. the buyer and sellcr. each Kiln, prudenlly. hO'flled.ubly
Ind luumlnl Ih. prl<< I. no( Irrecl.d by undue .tlmulu. Impllcll In Ihl. d.nnltk>n I. Ih. ,nn,ummlllon or a ..Ie
"' 01 I .""lllfd dlle Ind lhe p...111I or tltI. rmm ..lIer 10 buye, under ,ondltlnn. _bereby, (I) buye, Ind ..lIer
Ire Iyplnlly moll,"t.d, (2) bulh l'I,tI.. are ...lIlnrorm.d 0' ...11 ad,loed. and mh aClll1lln _hal h. ,nnlid." hi.
...n best Inlerell. m I rellOllObl. lime I. llloMd r", "poIure In lbe oJlCn ma.lCl, (4) "",menl I. mad. In lerm.
01 mh In U. S. doll." 01' In lerm. 01 nn.nclal 1.III11.m.nll eom""lIbl. lberet", and (5) Ih. p,l<< repre..nt. Ih.
normal conakttraUon for the property IOId unarrecled by speel., 01 cftatlw nnaneln. or IIle. conccllion.. Inntcd
by .nyona UIOClaled _llh lhe ..I..
'Adjultmcnlllo the complrablc. mUll be made ror l,.eelll or crnllve nnlncln, or IIlc. c:oncclllonL No IdjulImcnll
Ire nccruary (Dr thole COIl. which are normllly paid by Kilen II . rclull of tradition or IIw In . market .,U;
Ih... 'OIt. Ire readily Id.nllfl.b1. rlnc. Ih. "lIer I'IY' Ih... '0111 In "lIually .11 ..I.. IlIn..,tlon. 5JlCcI.1 01'
crullve OnanclR, adjultmentl can be made 10 .he compaflblc property by I:OmparilOfll 10 nnanel", lerms orrcmf
by I Ihln! I'IlIy Inllllutlonal I.nder lhat I. no! llready Invol..d In the pmJlCllY 0' IlInucllon. Any adJu.lm.nl
.hould not be cal,ulaled on a mechanical doll.. ro. dolla, 'OIl or Ih. nn.ncln. Of ,onceulon bul lh. dollar
amount of any adjullmcnt should .pprodmate lhe market'l reaction to the nnancln, or conceulonl based on the
appraiser', Jud,menl.
STATEMENT OF UMITINO CONDITlONS AND APPRAISER'S CERTIFICATION
CONTINOENT AND UMITlNO CONDITIONS, Th. IPPIII..,'. certin'.tlon lhal .pJlC.n In the .ppral..1 report
iI.ubject 10 lhe roll....111I ,ondlllon~
I, The Ippralser wlll nol be relponslble ror matten or I lepr nature thai arrect either the property beln, .ppraiKd
or the title to Il The appraiser ulumel thai the title II ,oad Ind marketlble and, .hererore. will not render In)'
opinion. aboul Ih. 1It1.. The \lRlJlCrty I. appral..d on Ih. bul. or II beln. under "'\lOIl.lbI. ....n.nhlp.
2. The .ppral.., hu provld.d . K.l,h In the .pplllul report 10 "'.... .pprodmale dlm.nslons of Ih. Impro"m.nll
.nd lh. K",h I. Includ.d only to will Ih. reader or the re\lOrt In ,1.u.Uzlnl Ih. proJlCrty .nd und.nl.ndlnllh.
Ippnlser', determination of It I tize.
3. The appnl.., hu .umln.d Ih. ...Ilabl. nood maps lhat are provld.d by the Fed.1I1 Em''1.ncy M......menl
Alent')' (or other dati lOurcel) and hu noted In the appraisal report whether the lubject lile il located In an
idenllned Special Flood Hallrd Area. Beause the appraiser II not a lurveyor, he or she make. no ,Uranleel.
..pre" OT Implied, repn!11lI thl. det.rmlnatlon.
4. The appraiser will not ,Ive leltimon)' or appear in court becaule he or me made an appraisal or the property In
question, unlen lpecific arranaemenu to do 10 have been made berorehand.
5. The .pplll.., hu "limaled Ih. ..tu. of the land In lbe 'Oil approa,h ., III hilh"l and besl u.. .nd the
Impl'OYtmtntl at lhelr contributory value. These separate valuations or the land and Improvemenu mUlt not be
ulCd In conjunction with any other appraisal and are InYllid Ir they are 10 used.
6. The appraiser hat noted In the appraisal report any adveRt conditions (such II. needed repaln. depreciation, Ihe
presence or haurdous WlStes, tode lubstances, etc.) ob5cntd durlnl the inspection or the lubJect property or that
ht or she became aware of durin,the normal research Involved In performin,the appraisal Unleu otherwise stated
in the Ipprailll report. the appraiser hal no bowled,e or any hidden or unapparent condillons or the property or
adverse environmental condillonl (Includin, the presence or hallrdous Wlstet, todc lubslanCes, etc.) that would
make the property more or leu valuable, and hu usumed thai there are no such conditlonl and makel no
,uaranletl or warranties, expreu or Implied, reprdln, the condition or Ihe property. The appraiser will not be
responlible ror any luch conditionl that do ulst or ror In)' enaineerln, or testin, that miaht be required to discover
whether such condltlonl exlsl Because Ihe Ippralser il not an expert In the field or envlronmenlal hallrdl, Ihe
appraisal report mUll not be comideml u an environmental useumenl or the property.
7. The appraiKr obtained the Inrormation. eltimattl, and opinions that were elpressed in Ihe appraisal report rrom
lOun;el lhal he or she cORllden 10 be reliable and lkllevel them to be lrue and correcl The appraiser docl not
auume responsibility ror Ihe ICcurat')' or such items that were rumllhed by other partin.
8. The appraiser will nol disclose Ihe contenU or the .ppnilll report excepl u provided ror in the Unirorm
Standardl or Proresslonal Apprailll Practice.
9. The appraiser hu based hll or her appraisal report and valuation conclusion ror In appraisal that is subject to
utid'aclOry completton, replln. or aUentlons on the usumption lhal completion or Ihe Improvements will be
performed In a workmanlike manner,
10. The appraiser mUll provide hi. or her prior written consent berore the lender/client specified In the Ippralsal
report can diltribute the appralul report (lncludil1J conclullons aboul the property value. the appraiser'l Identity
and proreulonal deli,nallons. Ind rererencel to any professional appraisal orpnilltions or the nrm with which Ihe
appraiser is auoclated) to anyone other than the borrowtrllhe mortpaee or Its lucceuon and wlans; Ihe mortpa;e
Inlunm consultan... proreulonal appollll orpnlzatlona; any Ilate or rederally approved financial Institution: or Iny
department. qent')', or Instrumentality or the United Stales or 'OY state or the District or Columbia: ucept that
Ih. l.nder/,II.nt m.y dl.tribule Ih. \lRlJlCrty description ..ctlon 0( the re\lOrt only 10 do.. ,oIlectlon 0' re\lOlIll1I
....Ie<(.) wlthoul .....1111 to obllin the a\l\llll..,', prior _ritl.n ......nL The .ppnllCT'. writ,," ......nt and
.ppro,1I mu.l 'Iso be obIaln.d berore the Ippral..1 <In be eonI'<)'Cd by Inyone to Ih. public throu.h ad"rtl.11\I.
public rdationl, news. Ilks, or other media.
Freddie Mle Form 439 6.93
Pap/0(2
F.nnl. Mo. Form 10048 6.9l
..... a w....... J" ww.., A~.......... aWl I 1(100) uJ-Ut'
-.....
1I~.':<"...."~,,,,:>c,..1\n'
APPRAISER'S CElmFlCAnON. Tho Appnlorr c.rllOeI .nd ...... lhal,
I. I ha.. .....rched the lubjtcl man'l .... and h... orlecud . minimum .r Ih..a ..unl ..Ie. 0( _rtl.. mosl
"mila. ond proalmalt Illlh. .ubjtcl _rt, ror cllIIlide..tlon In Ih. ..... """""rilllll anal,.l. and ha.. mad. .
dolla. odjullmenl when appmpn.1t 10 ..11ec1 the marbt ....lion 10 Ih"" lI.m. 0( 'IanIOe.nl ...lallllll. If .
.1,ntOe.nt lIem In . com""..bI. property I. .uperior 10, or mont r.....bIt lhan, Ih. lubjtcl propert" I ha.. mad.
. nepll.. odjullmcnl 10 ..due. the odjulled ..Ie. pric. 0( Ih. com""rabl. .nd, Ir . ".nln..nllllm In . com""..bI.
propert, I. Inl'orior 10. or .... r.",..bI. lhan the .ubjecl property, I ha.. m.d. a poslil.. odjullmcnl 10 Inc..a.. lhe
odju.1Id ..... prko 0( the com""..bIe.
2. I ha.. labn Inlo conlldc..11on Ih. r..t... lhal ha" on Impacl on ..Iu. In my d,..lopm,nl 0( Ih. ..lImall 0(
markel ..Iu. In the aPl'fll... ..port. I hl\'o not k"""lnaly ..Ithheld .ny .1.nIOe""1 InrOfmll1on rrom Ihe .ppnl...
..port ond I bell.... Illth. be,lo( my k"""Iedce, \h.ol .11 1I.I.m.nll and Intormallon In lhe .ppnl..1 ..port ...
I"'. .nd comet.
3. I .....d In lhe appnlul ..port only m, own pellOllOl. unbllled, .nd pror,"1ona1 an.I,.I~ oplnlon~ .nd
conclullon.. whkh err .ubjtet only Illlh. conllna.nl .nd IImltlnl condlllonl .pecln,d In Ihl. ronn.
4. I ha.. no present or proopccll.. In...... 10 Ih. property Ih.1 I. the .uhJect 10 Ihl. ..pori, and I h... no p....nl
Of proopecU.. peroonal In....1I Of bIu wllh ...peet 10 Ih. ""rtlclpanb In Ih. t"_llon. I did nol bo", .Ither
""rtt.11y or compl.tel" my .n.""I. .nd/or Ih. ..lima.. or m.net vslu. In Ih. appnl..1 ..port on Ih. ...., colo.,
..lIllon. .... 1wId1ap. romlll1l .talu~ Of nollonal orialn 0( .llher Ih. prospeell.. ow.... d' accu""nll or Ih. lubjtcl
property or 0( the prtKnt ownerl or oceupanU of the propertlel In the vlclnlly of the IUbject property,
S. I haw no pmenl or eontemplalCd fulurt Inlertlt In the lubject property. Ind neither my cumnt or f\J(Urt
.mplO)'mcnt nor my compcIIJIllon rOf performlna Ihll .pp..I..II. contlnaenl on Ih. .pp..lord Vllu. or Ihe property.
6. I was not rtqulRd 10 report a predeltnnlned value or dll'tCtion In value Ihll flVon the cause 0( the cUenl or
Iny related party. Ihe lmount of the value elOmate. Ihe lualnmenl of I lpeelflc ftlult, or the occurrtnce of I
lubsequent ewnt In order to l'Kelvc my compensation and/or employment for perfonnlna the IpprlisaL I did not
base lhe app:t!uJ report on I requested minimum valuallon, a lpeclfle: valUltlon. or the need 10 approve I lpeclnc:
mOr1pJe Joan.
7. I perfonned thl. approl..1 In conrormlly with th. Unlrorm Sltndlrdl or Pmreulonol App..I..1 Procll<c lhol ...:re
odOp1Cd .nd promuipted by Ih. Applli... Standardl Boord or The App..I... foundation .nd lhal "".. In pi... u
or the cfrectlve da.. or Ihl. .pprol.... ..llh Ih. ....ptlon or th. d.parture provlllon or Ihose SlInd.srd~ ..hieh don
not .pply. I aeknowlcd.. that on "lima.. or . .......b1. 11m. ror ..posu.. In th. open mmelll a condlOon In
Ihe dennlOon or markel value .nd Ih. ..lIm.te I developed I. conllltenl "Ith the m.rtetina lime no..d In Ih.
nclahborhoocl ..cllon or tht. ..port, unk" I have othcrwbc lilted In th. reconcllllllon "ellon.
I. I ha.. pmonoIly Inspcclld the In..rio. .nd ..I.ri", .reu or the .ubject property .ne! Ih. ....riD< or 011 properties
lilted u compuobk. In th. .pplli..1 ..port. I !\Jrther <Crtlry thai I ha.. noted .ny .ppa..nt or known .d..",
conditiono In the .ubject Improvemcnll, on the .ubject lite, d' on any II.. within Ih. Immcdla.. vicinity or the
.ubject property or ..hlch I am 'WI" .nd have mad. odjullmenb rD. th... od..", condition. In my anal)'ll. or
lhe proper1y nJue 10 the Cltenl lhat I had markel evidence to IUpport them. I hIVe allO commented IboUI the
err"l or the odvenc condlliono on the m.n.tablllty or Ih. .ubjeCI property.
9. I penonoll, prepared .11 conctu.l,,", and opinions .boutlh. ruI ..lite lhot we.. "I rorth In the .pp..I..1 ..port,
.r I relied on .I,nln...t pror",lonal wiltonc. rrom .ny Indlvlduol d. Indlvlduol. In the perfo"""",. or the
.ppnl..1 or the prepa..,lon or Ih. .pp..r... ..port, I have named .uch Indlvlduol(ll .nd disclosed th. .peelnc tul.l
performed by th.m In Ihe reconclll.tlon mllon or Ihl. .pp..l... ..port. I ecrtlry that .ny Indivlduol 10 namcd I.
quaUOed to pcrfonn the luI.L I ha.. nol .uthoriud onyonc 10 m.te . chlnae to Iny Item In Ihe ..port: the..r....
Ir .n un.ulhoriud chon.. I. made Illth. .pproJ... report, I ..III tate no ..,pon.lbllty rD. IL
SUPERVISORY APPRAISER'S CERTlFlCAll0N,.r . lupcnllOl)' .ppllilC' llaned the IPpnlu1 ..port. he or ""
certifies ond q.... IhsL I directly .upml.. Ih. appnI... "00 prr""..d the .pp..I'" ..port. ho.. revic""d th. .pprol..1
..port, ..... ..Ith the II.temenb ond cCX1ClullonJ 0( \he .pproI.... q... III be bound by Ih. .ppllilC'" certir...tJons
numbered 4 throu.h 7 .bove. ond om lIk1na rull IClpons1b1ll1y ro. lhe Ipprolul ond \he opp..11ol ..port,
ADDRESS OF PROPERTY APPRAISEo.
221 ~ !bod, Qlrllolo, PlrreylVll1la I1lIJ3
SUPERVISORY APPRAISER (only Ir ..qul..d~
APPRAISE~R' ~
S1.naIUR: ......-----.-- _ ~ ~
NAme: '
OlleSlanedl ~ 21. 1!Rl
511.. C.rtlf1catlon.. molTl1l1>.l PA
or Sllte Ueense'l AJ.OO77S..4 PA
SI.to: ArrBvl-..
E.plratlon 00.. or c.rtlOcation or Uc.nsc: 513MB
SiJnllure:
Name:
Olle Si,ned:
Stilt CenlnClllon'.
or State L1cenle'l
SIIIc:
E.p1..llon 00.. or Certln..,lon d. L1c.nse:
o Did DDid"'__
F..ddie M.e Fonn 439 6.93
....<2 on
F.nnl. M.. Fonn 10048 6.93
..... w....... JIS......,. A"";.... ltm.,crOUII 1(100) 2As..ts,u
_nUllO
SKETCH ADDENDUM
1== HIl~ot Uoty
~'~~18 ~1Ird .!!'L-~l...u.o
I
I
I
i
r
J
FW.nA
I~I
~
'la'
.
.i
ZI.Oodo 111113
'I
"
Elf'
r
,. ,
e tIIO'OrII'IIMd~1nt..31S"""'......"""""""CloeSl1""~AeIItwd tf.xllIU-<lSU
"
u
.. la'.
.
.
'\aM'" a
K"'" III .
..
0
I ~,
~r-1
t '"
,
1"H en,...
h"."
. .
1&'
, i
'.'
, ..
"
,
,
, .
: .
......1l29J'l
,
-,
,-
.'.....
.1"
"'.
PHOTOGRAPtl ADDENDUM
~~___mJln.tL,- Dlty __._
~-"-1i:'-'- i"l1 ~ fblil._
E'1__()!r_I.o___ _.____~_Couo"L Q/lbQrIlnl
....... .
_.._..~__..~ __,__u' ___,
RI... f\JnIylYllll4 _ _ __ _ _~". C0d011ll1J____
!'RONT 0'
SUBJICT PROPIRTY
REAR OF
SUBJECT PROPERTY
smElT SCENIl
)if ADDmONAL PHOTOGRAPHS ON REVERSE SIDE
IllAilrwooolk.lV<<"'('IIN1 11110(1\..,.1004
-:-_.._~----_..t""~~'1._."
co
CO\.ll'!''i /." c:s
,,\.11'1 Ill'! I ' .-, I ~
\) :1/1 I I
. W! 0
J _ - / :',' :: 'i) coU
~$' ~ ,0) ',,- .~}. ~o I[]
, ~ <:~ m~ ~I :1 ;; ""z
\' I).~V;' '1.. yo: ...w
\'1~ 'l.l,_J~ i I~I ~&1 J J
i u-l I J
~~..f ~, t'l-,',O' '," - .,
" .
... 0. II<a)'
, ~-!<.\ ~" ~,,- ~ ."
'. ~_~:.~ 1," ,,-- 0( II~Jri
- ~:>( \ '11. :::.
!
r' ,~' IU~' ."
_ < _ _ '"'l I ~" ~
\ ...- 'iC',. / l... I ~ rOJ I
~(-....~s ~ .'. '''''I~.yO ( I
~ \1il.liil ~ '-- · ,,'" I
~ \ II , ' 7, if. 11 . I " I
Q. " - ' '
~' .. ,e. . , ,- .
["" ~,,';;; .xr"lr~~'
~ !~.~ 1(1, "1.,,,1 - ~ ~.
, ' i g ~" ". ...q;,-( ~
\~ i/, ~'iIl'\:' '-'! 1-'
\~l..I~ ~~. · ~" 'm..,
, ' It" · \"",-.."~ 'r ...
,M'~ .-'" "~l,~" r'\ "
,,;;1. b.~ mti ,<~j)
l1[,"" ,/ '1$:,1.
, '.:J' &" '" 0 ~/ ":?"" ,;.li
>f!.J'lIt ~ .nu((1Ir\~
. Ie' _" i))IJ ~..C>.: .....\, ,'"
\' '. . . :\ ," . ~.Sll tf
. . 1,;-' - \ .0
: :.~:iv ""'" . " a f;kl'
. ,I ' ':>.' ,.;~ '
i -, ~ It"< _ - ,,<<1' ,.+-:
,,"_ ',,'''If'.' 'I "
\- '" ., J <" ,-"," "
0,. ~ ' .. ." "",. " "~ "
<'\-O': "'~ ',' , · II .,~
.~:~ mi ' ,(1"" '-J\~-^"'" .
I " -\.~0;' X'JtI' ~W: .
, ~ f' I ' C!l. '. _r'"
, \. \l- Il'>') ,'f"' '" .' ,I'::;; .I
" ,,:::;' .... - J. \ ~ /
. ~ i\: '.
I . . 'r.-,~ 'Jt ~ ~''r
, .. .~ .
I . . ~ ~.,.~ ! r;-r- ,-
,
,
! '. ,. Ie) '/ t" c.o.,,::,>A"\
! ......, \ leil. iI1'1 ~'i-\.\>A I
,\/ I W \~I'
'~'1 I
I
... I ...
Co) I
\
;;c
...
...
'I
II d! : I
~][][ I : ii,
JIB I: 1;;
III . I~
I ! I . r I
, '.
i I I
...
w
...
...
~
?
<3
It)
It)
~
~
...
C\ (\
\~\ \
\ \\
\\\
~
V1<
'/0
...
N
N
'n.' I II'
!~~ ' :l
~.,~ ~!'III',!il
U. I"
~ ~ Ir Ilii
.... I~ ~il BII[
I " 11110.
I C~ i hi! ,
. ~Ilrll I
I
.._....-.~
QUALIFICATIONS OF N>PIIAISeR - - LAIIIIY W. SLUSSER
EXPERIENCE:
1990-PRESENT:
PrincIpal 9rokor - Lorry W. Slu.lor, REALTOR
Rool Eltoto Apprlilol.
909 Ar..trong Ro.d
Corlillo, Ponn.ylvonio 17013
(717) 249-9340
19B5-1990:
AI.ocioto 9rokor and Approilor:
Donald E. Oiohl, Rool Eltoto
Corlillo, Ponnlylvonio
AI.ocioto Brokor and Approilor:
L. B. Phlllipl, REALTOR
Corliole, Ponn.ylvonio
IBB3-lBB5:
1976-19B3:
REALTOR
Goorgo L. Ebonor and AIsociotoo
Corliolo, Ponn.ylvonio
EOUCATION:
Tho Ponn.yIvonio Stoto Univoroity AppraIsal Cour.os-Rooidsntiol Raol Estoto
Approiool, Advoncod Rool Eototo Appraioing and Raol Eototo Lsw. Stondordo of
Procticoo and Ethico for tho Raol Eotota Approisor, Tho Uniform Rosidontiol
Approi.ol Roport, Appraisal of Vacant Rasidontial Land, Valuing 0 Log Homo,
Proporing A Norrotivs Appraisal Rsport, Condominium Approioolo, Approiool of
Mobilo Homo. and Guidolinoo On Being An Expart Witnoso Approilar.
PROFESSIONAL LICENSES:
REAL ESTATE BROKER - RB-043776-L, Commonwealth of Ponnsylvonio.
REAL ESTATE INSTRUCTOR - RI-D00971-L, Commonwaolth of Pennoylvonio.
RESIOENTIAL APPRAISER - RL-OOOB02-L, Commonwaolth of Penn.ylvonio.
PROFESSIONAL MEMBERSHIPS:
MEMBER: Corliolo Board of REALTORS, Pennsylvania Association of REALTDRS,
Notional A.sociotion of REALTORS. Licenaod Real Eototo 9rokor - Stoto of
Ponnsylvonio. Liconsod Rool Estota Approisar and Cortifiod by tho Stoto
of Ponnsylvonio. Licen.od Rool Eototo Instructor by tho Stoto of Pann.ylvonio.
APPRAISAL EXPERIENCE ANO CLIENTS:
Approisolo for purposos of mortgogo loano, buyero, oallero, ostotoo, vacant
land, apartments, commercial, and foreclosures hova boen mode for tha following
partial li.t of clionto in the Stoto of Ponnsylvonio.
FINANCIAL INSTUTIONS: Army National eonk, Commonwealth Notional Bonk, Cumborlond
County Notional eonk, Oofon.e Activitioo Foderol Crodit Union, Firat Notional
Bonk of Livorpool, Fidolity Bonk, Firat Unitod Mortgsga Sorviceo, Franklin
County Toochorl Crodit Union, Monoy Storo Invostment Corporation, PNC Bonk,
Ponn Control Notional eank, Socurity Pacific Finonco Company, The Monoy Store,
United Fodsrol Bonk, Unitod Telephona Fedsrol Crodit Union, Formaro Home
Adminiotrotion, Schuylkill Hoven Trust Company
OTHERS: Attorneyo and Individualo.
INSTRUCTOR CERTIFICATION:
Lorry W. Slus.or hao boan cortifiad and licansed by the Real Estate Commiooion
of tho Commonwealth of Ponnsylvanio to tooch tha following CDursoo:
Raol Eototo Proctico
Rool Eototo Soloo
Raol Estoto Invootment
Appraisal of Rooidontiol Property
Approiool of Non-Reoidontiol Proporty
Rooidontiol ConotructiDn
.
Sch8ckl1l H
FLI1..1 Elq)erwa, Ac:m~1frItIw CoetI
and MIC8III'IIOUI ExpcI1_
I
I
i
: FILE NUMBER
i Estale 96
~THOF HNNlnVAHtA
_IUTAHCI TAXIlITIJIlH
IlIIUHT DlCSDlNT
. ~___.~ ..._..... .~____~...._ ______.. . ~V'"
.-._-~~----_...'"'.--~--_._-- .
ESTATE OF
BATV, EVA O.
.-..-..-...-----..-----
N~TJ~ER DESCRIPTION I AMOUNT
A. -.'r~' F:~~~~::~:~~ii;.~~~~e:~:~~~il~.:;~.......:..~:....................:......................:.........................:.......:...:..:.......F...........:.....:~~:u~:-
"-'2:-- Oeoiiei"'F'/owei'i:.t'8iTrire.'P~....................................................-......................................................................1.....................'1'9'8:75
. wii'il'Ilyi:li.c;i'iiiiiiiicr----.................-.................................-...............-...............................................L...................rou:O'o
B.
......-......--.-......--...................................................................................................................................................... !....................................
I
....-...... -...---............................................................................................................................................................................!....................................
I
---_......----.....__..._.....:..=::~::~.:::.:.~.:==.~:::.:.=:.::=.:..~....:....:...:....:..==.=:I~.::~:~.::~............._...
Admlnlllnltlve COlli
PellOnal RepresentaUve Commissions none
I
i
I
I
1.
Soclal Security Number of Personal Representative:
Year Commissions paid
2.
Attorney Fees MARTSON, DEARDORFF, WILLIAMS & OITO
1,950.00
3.
Family Exemption
Claimant
Addresa of Claimant at dacedent'a death
Street Address
City
State ZIP Code
none
Relationship
4. I
Probate Feea
.____._.._...____.________----.L___
C. Mllcenlneoul Expanlll:
.-r 'Ciiij W..S1iisser,..i'ia'l.Ci18ieiipjiiiiSiiI......................................................-................................................... ....................2'50.:00'
""'27"" oS!8ge---. -..--......--..........................---..............-...------...-...-.......--...-.......... ................_..n:ou
-r RegISter O'fWilIS,..liIiiig.lCc-..-.-......-................-......-........-......-..........................-......................... ...............-......1.5:UO'
...........- CsCrVc'ilTofiid'aillonal'iiorii'iiiis1iiiiivecxpciisessiii:'h"'asposliigcaiid'giiS'iiTiiieii'iiQ'piejiiiilion 0 ..--.........-750:0'0
income tax returns and possible probate fee
----..----....--...----......----------................--........................... ......-.........-..........
Schedula H TOTAL
7,094.75
.
C~THOFHHHSYlVAH'"
~."AHCITAX.ITUAH
.. _'h ._...._.I~~H.T llfCIDlHT
L
Sch8ckl1l J
Bel.~'"
-!STATEOf---- - . ..
BATV, EVA 0,
_~..~'_". ,.'__~__'_"V_"~'_"_ ....____
~_._-_._..._--,_. -_.---_.._.~..,-_.__..~
N~~~ER NAME AND ADDRESS OF BENEFICIARY
~:-TiiitiliBiqul.lif-n-.. -.
lucy BliiiClicBiiiY-- ---_. .-..
221 Bonnybrook Road
Carlisle, PA 17013
FILE NUMBER
Hslate 96
,
i RELATIONSHIP
SHARE OR AMOUNT
OF ESTATE
I.
SIsler
. 1000/0
.....................................................................................................................................................................................................
-ITEM _._____n._ ._______________m__.n___._____. --- -.. --- -AMOIJNT'ORn.-
NUMBER NAME AND ADDRESS OF BENEFICIARY SHARE OF ESTATE
B. Chlrllabll InaGovemmentiil.Bequii18:-.n..-n_n_------------- n._______.._______.___
---............-..............-...............--............................................................................................................................................... ...................................................
-.................... .......................................................................................................................................................................................................... ............................................-.
-................... .......................................................................................................................................................................................................... ...................................................
....................................................................................................................................................................................................................................................................................
.........-...-. .......................................................................................................................................................................................................... ...................................................
....................... ..............................-...............-..................................................................................................................................................... ...................................................
_._______,__._._~__,..,.___ _.,._____ . __u. ._._. _.. _.....,.__.____ __,.._.__'n
.---------.--...-----.,..-..'
Schedule J TOTAL
URT ifILL ANO TI!8TAMI!NT or EVA GRACI! RATY
I, I!VA GRACI! BATY, of the Townlhip of Routh Middleton,
County of cuaberlend, end state of Penneylvenie, bein9 of aound
end dilpoain9 mind, .e.ory end undlrltendin9, do .eke, publilh
end declere thil tc be .y Lalt Ifill end Telte.lnt, hlreby
revokin9 and .aking vcid all former Willi by .e et eny ti.1
heretofore made.
1.
I diract tha paymant of all .y jUlt debta and funeral
expen.el al loon a. ccnveniently mey ba aftar .y decea.e.
2.
All tha rest, residue and remeinder of my Estete, real,
personal and mixed, whetsoever end wheresoever situate, I give,
devise and bequeeth unto my sister, LUcy Blenche Baty, for her
own use absolutely.
3.
Should my said sister, Lucy Blanche Baty, have predeceased
me, then all the rest, residus and re.ainder of my Estate, real,
personal and mixed, whateoever and wheresoever situate, I give,
deviee and bequeath in six (6) equal shares, as follows:
A. One (1) share tc Romilda Rae Mcclung Baty, the
wife of our beloved deceased brcther, OWen Carroll Baty,
currently of Okeene, Oklahoma. Should she predecease me,
her share is to be divided equally among my brothers and
sisters named below.
B. One (1) share to my sister, Linda Mae Baty smith,
currently of Penn Township. Should she predecease me,
her share is to go to her spouse. Should both of them
predecease me, then this gift shall lapse into the residue.
C. One (1) share to my sister, Erma Lae Baty Heiser,
currently of 911 Burnthouee Road, Carlisls. Should shs
predscease me, her share is to go to her spouse. Should
both of them predeceasa me, then this gift shall lapse
into the residue.
(0) One (1) share to my brother, Clyde Harold Baty,
,
1
_........,..-"".~-,..".._,-~._. .'-~..>-_.....- .
curr.ntly cf cincinnati, Ohio. Should he predecea.e .a,
hi. .hare i. to go to hi. .pou.e. Should both of th..
pr.decea.e .e, then thia gift .hall lap.. into the
r..idu..
(BIOne (11 .hare to .y aiater, Mary Loui.e Baty
Spangler, curr.ntly of Boiling Spring.. Should .he pre-
decea.e .e, her ahare ia to go to her .pouae. Should both
of them predeceaae .e, then this gift .hall lap.e intc the
rel1due.
(FI One (11 share to my .ister, Edna Lillian Baty
Yinger, currently of Creek Road, Mechanicsburg. Should she
predecea.e me, her share i. to go to her spouse. Should
bcth of them predecease me, then this gift shall lapse into
the residue.
4.
I nominate, constitute and appoint my sister, Lucy Blenche
Baty, to be the Executrix of this, my Last Will and Testament.
If she should predecease me, or for any other reason be unable to
act as Executrix, I appoint my niece, Janet L. Baty, currently of
223 Donnybrook Road, Carlisle and Lucinda Heissr, currently cf 34
White Oak Drive, Carlisle, to bs the Co-Executrices in her place
and atead. I further direct that they shall not be required to
file bond or other security in the Office of the Regi.ter of
wills for the purpose of administering my Estate.
,
5.
I authorize and empower my personal representative, in her
sole and absolute discreticn, to purchase or otherwi.e acquire
and retain eny investments of which I die seized, cr any real or
personal property cf any nature, to sell, lease, pledge,
mortgage, transfer, exchange, dispose of, or grant options in
regard to any or all property of any kind forming a part of my
Estate for such terms and such prices as she may deem advisable,
to borrow money for any purposes connected with the protecticn
and preservation of my Estate, to mortgage or pledge any real cr
personal property forming a part of my Estate, or to join in or
2
,,,~".il>r..,..,~,,,,,'ITn"-"'~"" ;.n,
"
llcure the partition of la~el to co~pro~ile any clai~1 or d.~andl
of my !Itate againlt othlrl or of others againlt my Eltatel to
make diltribution in kind and to cause any Ihare to be co~polld
of calh, property in undivided fractionll sharel in property
different in kind fro~ any other Ihare, and to Ixecute and
deliver luch inltru~entl al ~ay be nlclllary to carry out any of
th..e powera.
IN WITNESS WHEREOF, I have hereunto aet my hand and eeal
thil Q:u.J. day of N~^" , A.D. 1989.
tr~/ $~"J frSEALI
Signed, eealed, published and declared by the above-named
EVA GRACE BATY, as and for her Last Will and Testament, in the
presence of us, who at her request and in her presence, and in
the presence of each other, have hereunto subscribed our names as
witnesles.
jjoJdw ~~!3?
4
E.I-?A ~..,;L a. I1..A II
..
3
--. -. .- - ,. -.., - . ' ~
,
. r-- P~t~12,' COMMONWlALtIt O~ PENNS:LVANIA-- -- -- - -- - ------
.i$j.'l';J..''''~Cw.IIIC_'''=:'=_''D'''''r.. .
_ 'etO Nfll
"
RECEIVED FROM:
i
ACN
ASSESSMENT P:'
CONTROL ~
NUMBER
AMOUNT
BLOOI1 8TEPHEN L
10 E HleH STREET
101
.O.6"U,"~
CARLISLE, PA 17013
ESTATE INFORMATION:
!II filE NUMBER
Y el-1996-00ltl
!II NAME Of DECEDENT (lAST)
I;iI BATY EVA G
II DATE Of PAYMENT
m POSTMAR E
COUNTY
SSN eoe-eo-l789
(fiRST) (MI)
DATE Of DEATH
REMARKS
m TOTAL AMOUNT PAID .!5.67B.lte
VZ
G....,' () V .
RECEIVED BY l'lt~G'r.';'2:'/:""~ /l"u,
MRY C. LEWIS ' /("v"./. q7
REGISTER OF WILLS
SEAL
BLANCHE DATY
C/O STEPHEN L BLOOM ESQUIRE
CHECK. 9581
REGISTER OF WILLS
.--.-..----------------------
'11 . f" .: \
..1 ..," ~ ~
, I.' f I~ '
. - . t
... . I,.... .,
.,;.
,
."':1'
.l
to" .
I,
"
,
\
\. -,
-, .
~.
~
.,
.. ~. # --' ...
. .-.-' ..---'
I
,
L-,-
----",..,.,..... -.......
11
. ... --- . -.-..-..--
I
r
J
I"
\j!./'
RIV-1547 IX AFP (12-95*
COfIOM'ALTH f1f PlHHlYLVANIA
1l['..TIl[NI Off 1l(V(1OJ[
tLM:1U Of INDIVIDUAL "XU
DrPf.,.....
KUttllllltG, 'A 1111.-....
NOTICE Of INHERITANCE TAK
APPRAISENENT. ALLOWANCE OR OISALLOWANCE
Of OEDUCTIONS ANa ASSESSHENT Of TAK
ACN 101
DATI! 04-22-96
FILl NO.
DATI OF DIATH 10.22-95 COUNTY CUMBERLAND
NOTE. TO INSURE pROPER CREOIT TO VOUR ACCOUNT. SUIHIT THE UPPER PORTION Of THIS fORM WITH VOUR TAK
pAVHENT TO THE REGISTER Of WILLS, HAKE CHECK PAVAILE TO "REGISTER Of WILLS. AGENT"
REMIT PAYMENT TO:
STEPHEN L BLOOM
MARTSON ETAL
10 E HIGH ST
CARLISLE PA 17013
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
AllOUnt R..ltted
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiEV:is4"7.EX-Aj:ji-n'F9sT"iioi"icEncWYtiiiEifiiiliicE-i"AX-APPRA-isEHEiij-'--ALi-ciiiilNcE-iili-m__m._m__-
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BATY EVA G FILE NO. 21 96-0041 ACN 101 DATE 04-22-96
TAK RETURN WAS I I X J ACCEPTEO AS FILEO
( I CHANGEO
RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Reel E.tete ISchedule AJ (lJ
2. Stach _ land. ISchedule IJ 121
S. Clo.ely Held Stock/Pertnerohlp Intere.t ISchedule CI 151
4. tIort_.lNote. R_hellle ISchedule 01 141
S. Ce.wa_ Depodt8INhc. Per.onel Property (Schedule EI 151
6. Jointly Owned Property (Schedule FI 161
7. Tren.fer. ISchedule GI 171
a. Total AI.et.
,00
,00
,00
.00
1.123.91
8 . 119 . 36
37.700.00
III
46.943.27
APPROVED DEDUCTIONS AND EXEMPTIONS:
7,094.75
,. Funerel EKPen.e./Ade. Co.t.INI.c. Expen... ISchedule HJ 1'1
10. Oebt./HortGege Llebllltle./Llen. ISchedule II 1101 ,00
11. Totel Oe_U.n. 1111
12. Net Vel"" of Tex Return 1121
IS. Cherlteble/Gove~tel leque.t. ISchedule JJ 1151
14. Net Velue of Eltete Subject to Tex 1141
NOTE: If an assassmant wa. issuad praviously, linas 14, IS and/or 16, 17 and 18 will
reflact figuras that includa tha total of ~ raturns assassad to data.
ASSESSMENT OF TAXI
IS. Aaount of Line 14 et Spau.el rete 1151
16. Aaount of Line 14 texeble et Llneel/Cle.. A rete 1161
17. Aaount of Line 14 texeble et Colleterel/Cle.. I rete 117J
11. Prlncl,el Tex Que
7.0Q6 71t
39,848.52
.00
39.848.52
.00 K'OO.
.00 K .06.
39.848.52 K .15.
IlII
.00
.00
5.977 .28
5.977 .28
TAX CREDITS:
PAVIlENT
OATE
01-18-96
RECEIPT
NUltBER
AA082512
OISCOUNT loJ
INTEREST I-J
298.86
AIIOUIfT PAlO
5.678.42
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
5,977 .28
.00
.00
.00
. IF PAlO AFTER OATE INDICATEO, SEE REVERSE
FOR CALCULATION OF ADOITIONAL INTEREST.
IF TOTAL OUE IS LESS THAN 11, NO PAVHENT IS REQUIRED.
IF TOTAL OUE IS REFLECTED AS A "CREDIT" ICRJ, VOU HAV IE OUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. I
'.
~~ :5! ;o~
3 .,'
c:- r.>n
~ (" '.::
~ ~~. C
!! ,-' ,-;.
0 ~ "
c
C
p , ;p :? \-,
(.0 \0 :::: tI.l
:Oc VI (50
):i~ -
"'"
RESERVATION. Eat.t.. of decedent, dying on or before Dec.-ber 12, 1"2 -- If ~ future 1nt.r..t In the ..t.ta J. tr~.f.rred
In po.....lon or ~JOY8ent to el... . (call,t,r.l) beneflcl.rl.. of the decedent ,'t,r the expiration of ~ I.t.t. for
Ilf, or for year., the Co..onwe.lth hereby Ixpr."., rl..rv.. t~ right to eppr..,. ~ ...... tren,'.r Jnherlt~ 'IX"
at the lewful Cl... . (coll,t,ral) r.t. on eny ~ future Int.r..t.
P\IIPOSl Of
NOTICE. To fulfill the 1"'..,11"'...... of Section 2140 of the Im-rUMe. IInd Elt,t, Tax Act, Act ZZ of 1991. 7Z P.S.
Section 2140.
PAvtEHTl DetKh the tot' portion of thh Notice IInd IUbIIlt with your p~t to the R.glltsr of WUlI print... on the rever.. ales..
--..... check or ~y 01"'.1'" PI,lIbl1 tal REGISTER OF MILLS, AaEHT
AU PIVMntl recelyed "'11 fir.' tt. epplled to MY lnt.rut which RY be dull '11th .." r_I..., .,.11_ to the tax.
RU\ICD (tah .. r.,,", of . tax credit, which .... not requested on the t.x R.turn, ..y be requested by cMIIlaUng an -AppllcaUon
for Aafund of Pennsylvania Inheritance .nd Estata T..- (REV-I)IS). applications are available at the Office
of the Reglstar of Wills, any of the Z3 A.v.nue District Dfficas, or by calling the tPeClal Z4-hour
anlWerlng s.rvlce ~r. for for.s orderingr In PennSYlvania l-100-36Z.Z150, out.lde Pennsylvania ~
within local Harrllburl ar.. (717) 711.1094, TOOl (111) 17Z-ZZ5Z CHa.rlng 1~.lred Only).
aUCTIONS, Any party in inter..t not s.tllfled with the IIPPrall-.nt, .11~ or dl..l1owenc. of daducUons, or .....lMnt
of tex Uncludlng dhcount or Int.r..t) .s shown on thll Notlc. .,.t object within .Ixty C60J dIIn of rac.lpt of
thh Notlc. bYI
--written prot.st to tha PA Dep.rt...,t of Ravenue, lo.rd of Appea", Dept. ZlIOZl, Harrisburg, PA 11UI-I0ll, OR
...lectlan to haY. the ..U.r det.r.lned at MJdIt of tha account of the perlonal rapra.."tatlva, OR
........1 to the Orpfgn." Court.
&llHIH
IIT11ATlVE
CORRECTlONSI
Feotual .rror. dlacovarad an thls .........,t should ba addrnHd In writing tOI PA DepartMnt of Revenue,
luraau of Individual T.x.., ATTNI Po.t A........,t R.vlew unit, Dept. Z10601, Harrl.burg, PA l11ZI-0601
Phone (711) "'-6505. Sea p... S of the bookl.t -In.tructlon. for Inherltanc. Tax Raturn for a R..ldant
Decadent- CREV.1501) for an axpl~tlon of ~Inl.tratlvaly correctabl. .rror..
DISCOUNTI
INTERESTI
If any tax due II p.ld within thr.. C)) ulandar --.th. .ft.r the decadent". de.th, . flv. percent C5%) dlacount of
the tax paid h al1~.
Intera.t 11 charged batlMlnt with flr.t dar of del1nquancy, or nl,... C.) ....th. Mid one U) dIIy froe the dIIt. of
death, to the data of p.....t. T.... which bac... delinquent bafora JMuary 1, I9IZ bear Interest .t the rata of
IIx C6]I:) percent per ....... calcul.tad at a ally rata of .000164. All tb.. which bac... dellnquant an .nd after
J~ry I, ."Z will beer Int.re.t at a rata which ..Ill vlry froe calender yaar to calendar ,.ar with that r.ta
...-..,cad by the PA Depart...,t of Rev........ The 1IPP1lcabl. Intare.t rat.. for 1911 through I'" .rel
!!!! Intara.t R.ta Dally Intar.st Factor !!!r Inter..t bte Dalh Intarest Factor
1'.Z ZDX .00054. .'.7 OX .OOOZU
I9IS 16% .00041' .'11.."1 IIX .000501
19M IIX .OODSOI 1"2 OX .00OZ41
1'.5 ISX .000]56 199).1"" 7X .00019Z
I'" lOX .000214 ."5-.'" OX .OOOZ41
--Inter..t I. calculatad .. fol10111"
IIITEREIlT . IALAHCE OF TAX UNPAID X IlUIlBER OF DAYS DELIHQUEHT X DAILY IIITEREIlT FACTOR
."Any Notlc. luuad aftar the tb bacoea. delinquent ..11. raflect en Intar..t ulcul.tlon to flft..., US) day.
beyond the date of the .........t. If p.....t 11 Ada .ftar the Intanst cOllPUtaUon dIIta ItM*n on the
Hotlc., additional Intara.t .,.t ba c.lcul.tad.
..R:,:i&ooEX'(7'~1 .
COMMOHYftAl TH OF r[NNSYlVAHlA
DEPARTMENT or RtV!NUf.
OfPT 21OftOt
IWVlIIIUAO. PA 11I2S 000.
: DECEDENTS NAME (LAST, FIRST, AND MIDDLE IHITlAll
DATV, EVA 0,
1. Real Estate (Schedule A)
2, Stocks and Bonds (Schedule B)
3, Closely Held StocklPertnershlp Interest (Schedule C)
4, Mortgages and Notes Receivable (Schedule D)
5. Cashl Bank Deposits & Miscellaneous Personal Property
(Scnedule E)
6, Jolnlly Owned Property (Schedule F)
7, Translers (Schedule G) (Schedule L)
6, Total Gross Assets (total Lines 1.7)
9, Funeral EXQanses, Administrative Costs, Miscellaneous
Expenses (Schedule H)
10, Debts, Mortgage Liabilities, Liens (Schedule I)
11, Total Deductions (total Lines 9 & 10)
12, Net Value 01 Estate (Line 6 minus Line 11)
13, Charitable and Government Bequests (Schedule J)
14, Net Value Subject to Tax (Line 12 minus Line 13)
n_ 'rj5: SpousaITranslers--(fordates-ol dealllofler 6.30-94)
, (Include values Irom Schedula K or Schedule M)
16, Amount 01 Line 14 taxable at 6'10 rate
(Includa values Irom Schedule K or Schedule M)
17, Amount 01 Line 14 taxable at 15'10 rale
(Include values Irom Schedule K or Schedule M)
16, Principal lax due (Add tax Irom Lines 15, 16, and 17)
19, Credits Spousal Poverty Credits Prior Paymenls
I!!
i~~
~
i
II
~
I
a:
z
~
!;
~
~
IS -7~ -'(
t.lIt:RITANCETAX RE1U~
RESDENT IECEDENT
(10 BE FLED t.I DlFLICA 1C
\MlH REGlSlCR OFWLLS)
'IOCtAl neURITY HWOER
202.20.1789
'or dillS 01 death In.. 12/JI/Vl chick he" II I e.-
spoulIl po.erty cred,lls clllmed .
FILE HUMBER
21 'Ill
COUNTY CODE YEAR
DECEDEHTS COMPLETE ADDRESS
221 IIl1nnybrullk Illlud
DATE OF BIRTtI Corll,le, I'A 1701 J
04120111" COUHTY Cumberland
SOCIAL SECURITY NUMBER AMOUNT IlECEIUEO ISEE INSTRUCIIOHSI
"I
NUMBER
. DATE OF DEAnl
1012219~
'11~) SurvI'tl"lQ SpouM', H""_II..t. rut And MdeN 1nlI.-I)
3. RemBlnder Relurn
(lor detel 01 death prior 10 12.13.82
5. Federal Eslate Tax Return Required
Total Number 01 Sale Deposit Boxel
1, Original Relurn 2. Supplemental Relum
I 4, Limited Estate 4a. Future Interell Compromise
I " (lor dales 01 death aner 12.12.82)
'Y' 8. Decedenl Died Testale 7, Decedent Maintained a Living Trust 0 8,
. ,. (Allach copy 01 Will) (Allach copy 01 Trust)
. j ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
iNAMe ,,- --. .___n - COMPLETE MAiliNG ADDRESS
I
Slephen L, DLOOM MARTSON, DEARDORFF, WILLIAMS & OTIO
'TELEPHONE NUMBER 10 East High Slreel
. (717 )2433341 Carlisle, PA 17013
- .- ..'---~'- ..-
__. _u .. ~_ ____.___
7,071.04
7,071.04
. 7,071:04
1,060,66
1,060.66
+ + (19)
i 20, II Line 191s greater than Line 18, enter the difference on Line 20, This Is the OVERPAYMENT (20)
A. [] Check here If you are requeltlng a refund of your overpayment
: 21, II Line 181s graater Ihan Line 19, enter the difference on Line 21, This Is the TAX DUE,
A, Enter the Inlerest on the balance due on IIna 21A,
II' B, Enler the total 01 Line 21 and 21A on Line 21 B, This Is the BALANCE DUE,
Make Check PlYlble to: Reglltar of WIlli, Agent
~._______~______.___.__....__. ~U_ .._._.._ __ __ . -
'---~ -~----'---.;BE-SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH M . ...
U;,dOr-pe;;aili4l,,-ofPe~UrY~I(jiiClirethail-hav.-exa";ij,8dlhi.r.ium,Including accompanying schedules and slatements, IInd 10 Ihe best 01 my imowledge'lInd
:':~I~I;e,ltlIS :~:'I~~,~ ~,nnd~'ifI~fo~e.tlo~e:'lrel~~a~,.~1 ':~res~:I:n7:n=~J;~~rted al lrue mar1<el.alue. Declaralion 01 preparer other Iha n I,he personal
SIGNATpR OF PERSON ESPO 1 lE FOR F RN I. 0 55 DATE
....~ . .a, Donnybrook Rd.,Carlisle,PA 17013 3-1-'17
SIGNATU OF PREP R 0 R NTATM DRESS DATE
10E,HighSI.,Carllsle,PA 17013 "3/4/97
(21)
(21A)
(21B) .
1,060,66
60,52
- U$I;Ut:18
It'\ ~;t
- I{)
O,!!l ~ <)
~t;: Q.. :l c:i
c,,);:. "U
..;;-.:
......... 0 Q
c' " ~
;:J '- ~ ':;
It.' '1.1 :::
tJ in '.1)
~'g> ,0
P\ =E
lllO
a: a: 0
'*
5checllit F
Jolrllti CMnod Property
COMMONYttAlHtOl rlNNlvtVAHLA
IHttU4llANC[ IA.Il. H' 1UflH
HIII()UH [)fUllrN'
ESTATE OF FILE NUMBER
IIATY . EVA 0. oil E,llIle lj(,
Joint tlnlnl(I):
..~,:..Y:,'..~,~~,::~~,~:..~,::~................................",.............R~;,~:;!,~;~.;~;~:;:?~'.;~::::,~....,................................................,.........r.~::~.:....",......,..",....,..................................",....
JolnUy-ownld proplrty:
Lellar Doller Vllue
~ M~d~ ~~ ~
N~~'J:lr Joint I e Dllcrlptlon of Property of Allet % INT. of Decedent'l
Tennlnt Joint Intarelt
I. A, 11/13/74 $100 U,S, Saving' lIond, Series E, issued 11/1974 330,I2i 50% I 165,06
"''''''''2:''''''''' ........,'/\........, .....37IrmS.... STOrmS:'Siiviii'gs'Uiii'ia:"Seiiiis'l'!:"iiSii'iia''j7l'97S'''''''''''' ""'"'''''''''''''''ll'O'.'BBj'''''Sll%''''' ..........................Ton.~
'"''''''3':''''''''' ..'......7i........ "'''7nI7S'''''' STllO.u:S.,..S.iiviiigsllii'iiiI;'Sci'ic's'TI;'issucil'7/1I75..'......... ''''''''''''''''''''''j2'5:ll8j''''''SO%'''' ,....,....,.......'......'HjB~'
..........~':........ ......,..'/\......... "'TTmI7S'" STOll'U:S:'Siiviii'gs'Uiiii'a:"S'ciiiiS'l'!:"iiSii'iia"ITlTlJ7S"""'" ""'"'''''''''''''''H8''7~'''''Sll%''''' '''''''''''''''''''''''''''I'S9:3'O
........'5:........' '........7i........ ....:I'Tl'onS"... SIllO'U:S:"SiiviiigS'llii'iiil;'Sci'ics',!!;'iS','uiiil'371lJ70""""'" ..."'..,.."'......''jllJ:~.8 ......SO%"'+,.."'..,..,"'........'159:7~'
..........0':........ """""Ji"""'" ......'7~nli....' S'I'Oll'U:S:'Siiviii'gs'Uiiii'a:"S'iiiiiiS'l'!:"iiSii'iio'7T1'97li""""'" """""""''''''''Hl7' ....'Sll%..'..I"....,...................T5li:!l'8
.........7:......... .........7i........ ....TT79nli.... SIll0'U:S:"SiiViiigS'llii'iiil;'Siii'iC"'E;'iSS'UCiITI71'97li""""'!"'"''''...."'.....'j07:501..,...SO%....I.............,..,.........153:78'
..........8:........' ..........Ji..'...... ......07978]".... S'I'OO"U:S:'Siiviii'gs'Uiiii'a:..S'iiiiii5'l!',..iiSii'ii0"671'9'8l"'........, ............'....'....T:r~'.'20i '"''Sll%''''' ............,..,..'.."'..'..n:ro
......,..lJ:........, ........'7i'..'.... ""7T1'378],,'" SYllO'U:S:..Siiviiigs'Bii'iiil;'Siii'i'C's'!!;'jS.,'ucil'7/YlJ8r.......... ............,..,....'T~:r::!OI......SO%.... ................,..'........72]0'
.........1'0.:......' .........'/\,.....,.. ..,..87IllI1IT..'ISTOll'U;S:'SiiViii'gS'Uiii'io:..seiiiis.E:..issii'iiO.'871'9'81'''''''''''' ......................m',~O!"'..Sll%.."'I.............................':no
....'..'rr:'..'.... ....'....7i........ '.."lJll}l1l'l....'. SYUO'u:S:..S'iiviiigs'Bii'iiil;'Siii'i,;'s''!!;'i,','uiill'97TlJ8.1'''......,"I,..,..,',..,........'.I'~:r:2.ol","50%..,..I,.....,....,..,..,.......'..72.:l'O'
'..'..'..'.2.:......' ..'...'..'Ji'....'..' ....1.07Jj'I1l'!'" S.I'OU'U:S:.Siivii'igs'Uiiii'a:'.Siiiiiis'E:..issii'iio..10'/llJ8.1"......"j..........'.......'."r:r4.,'2oj'..'.SU%..'..j..'....'.....'..'..'.'......'n:1.0
..,....'IJ:........,...."..'!i........I..'YTI2'07B1..,'SYUO.u:S:..Siiviiigs.Bii'ii1l;'Sei'i,;'s''!!;'i''s'uiill'lT71'9'8T.........I......................I'~U:Urn.."''50%..T..........................'70:'Oll'
'..'..'..I.~.:'...... ..'..'..''Ji....'''.. ....'rmI1l'T.... S'I'OU'U:S:'Siivii'igs'B'iii'io:"S'iiiiiis'E:"iiSii'iia'T27TlJB'1'......,.. ..........,..'..'....'r:ro':oo!',..'SU%.....J'...............,........,....'U:O'0
""''''r5:'''''''' .........'!i......" ..'.'TI1l'I1l'2....'. SYllO'u:S',..Siiviiigs.Bii'iill;'Sci'i'C.s'E;'i,'suiill'T'/llJB'2.........., ,....,....,.....,.,...I'~U:O"OI'.....SOW... ''''''''''''''''''''''''''''70:'00'
........T6':......'I'....'..''/\....,..,. ....'.273783'..'.. {2J'STO'OO'U:S':'SiiviiigS'Bii'iills;'Siii'iii5'1;;'issuiill'2'/l'9BJj..................Z;~~7:2tt.....SU%..,..I.,..,..,..,..,..,..,...Y:~lJ:'60
.......'r7:"".... ....,..,"!i"'..,..I.."Zm7B:I'.... STUO.U,S:..SiiViiigS.Bii'iill;'SCi'iC.S''!!;'iSS'Uiiil'271'98J'''..'....,t......."'..........,'1'2'1'::1'01,....'50%,....1..........,..,..............'60:'08'
.........IK..'.... ........,~.........i..'..272:rI1l'J'... S'SO'U:'S:"S'iiviiigs'Bii'iill;'Siii'i'C's',!!;'jS','ifell'27YlJ8'1"'"......... """""''''''''''''''liO~08''''''SU%'''''j'''''''''''''''''''''''''''''30':3'~
........T'9:........I........,'!i,....,.. ...':r7I'r78:1'.... STUO'U:S:"Siiviiigs'Bii'iill;'Sci'ies'E;'iss'uiill'~71lJB'j"'"''''''1..'..'............'...1'2.1':3'0!.....'50W..'I..'........'..'..'.'.'.......60:'08'
........ZO:....,..,I.........~....,.... ....'~'/l'I'11l'3".. S'50'U:'S:"S'iiviiigS'Bii'iill;'Siii'ic'5"I;;'iS','uiill'~7T'98J"""'''''''' ....,....,....,....,..,''60:'08j''..'SU%'.... ....,..,.."....,..,...."..'3U:3:r
......"2.1':..'....""..,....,'!i........ .."'6T1'~7B3..... (2}'SSU'U:S:'Siivii'igs'Uiii'ias:"Siiiiiis'E:"iiSii'iio"671'9'83"'" ..'...'....''''...'...I.Y.S:0'01....''50%''.. ,....,...,....,.............'57:SO'
........Z2':.......I......,..~........'I..'..0'/l:rI1l'J".. SZOU'U:S:'Siiviii'g5'D'iiii'o:"S'ciies'E~'issii'co''671'9'83''''''''''..1....,..............'..23'0:'OO,.....SU%..,..I..........,..,.....'......'I'15:0'0
....'...2'1:..'...., ........''!i..''''.. .."771'378:1..... sruo'U:S:..Siiviiigs'Bii'iill;'Siii'i'C's''!!;'iss'ucil'7/1'98'j..'....'..,t..........,........'..ITS:0'0!....''50%,....I........................'..''57:SO'
,......'Z~:"..,.., ,....,..X'..,.... ..'..7/T:I'I1l'J"" S.SO'U:S:..S.iiviiigs'Bii'iill;'Sei'i'C'sE;'jS's.uiill'7/T'98'j..'........,.. ....,......,.......'...''57:S0'.....SU%'....j..........,...........'..'...2'8:7S
........2'5:'...."'I.........'!i'.......[..,'1]TI'0783'.... sruo'U.s:"Siiviiigs.Bii'iill;.Siii'ies''!!;'iss'ucll'971'98'j..........'1..'.."...........,...'.Y.S:0'0!,....'50%'.., '....'........'..'..........5i.'S0'
........Z6',......'..."'....'/\......... .....9I1liI1l'3.... S'50'U:S:..S.iiviiigs'Bii'iiil;'Sci'ic's''!!;'iss'uiiil'971'98'j..'''..'''.... .........."'..........''57:'Sot....'So,%..,.. ............."'....'........2'8:7S
........27:........ ..'......'!i'.......t...T2'1I.37B3'... SYUO'u:S:..Siiviiigs'Bii'iill;.Sci'i,;'s'TI;'iss'ucll'Y'271'9'83..'......,..,..............,...'I'YU:8'41..'..'50%',.. ..,..,..''''..,....'''......'5S:'~2'
"..'...~8.:"'.... ..,......~......... ....1'27r:l.11l'3..' S50'u:S:'.SiiviiigS'llii'iill;'Siii'ie.s''!!;'iss'uiill'T'271.9.83...'.......,j'...".......,..,....."'5S:.42.'.."Sll%.....!....,.....,..,..,"'......,..27:71
"''''''2'9:'''''''' ......,..'!i........t....T71'278;1"... (2HmO.U,'S':'Siiviiigs.Bii'ii'ds;'Sci'iesT;.iss.ueiIT/TlJ8.4..j.....................'22T:liBI.....50%....I,.......................'TI'O:'B~'
.......'3'O~"'.... ..,......~......... .....27r711l'4.... S'I.00"U:S:'Siiviii'gs'Uiiii'o:'.S.iiiiiiS'l'!',..issiieo''271.9'8~...'....''''I.....................T1'O':B4.....'SU%..,..I''............_,.........'''5S:~'2
........3'r:......" "..,..,..i'i"...."I'..'Z7I'778:r.... SSU'U;S:'Siiviii'ifs'B'iiii'o:"Siiries'E:"issii'iia'Z71'9'8~""'''''''''' ,...."..,..........,..'5S:~.2!,....'50%'..'I........'..,..,..,....,.."':z7,7l'
................,~:,~..........1..,~..,~~,~,~'........::'....~!.~,~~~,:',~,~..,I..~:'~,~~,:~,:~,::.~~~.~~,~~:~,?~.?:...~~,~~,~~:~:..,~~~,~,~,?..,~:.!,?.~?.....:..,~............................,~:,:.:,~:~t....,~,?.,~,:~..,....,~,'..............,:'..~..~~..~,:~!.~~?,~
Schedule F TOTAL
57,071.04
.# -. ,.. ......- '..,
,
---------- ~_.- ~'-'- ------ --- ---- ...--
,..~ .'_ _...n._....... .~_____._._._________~,
!
. ,,~~~'1*y~;':~_l.:.i'",);r~'~r~1_,_~,\I..,',';\.,: :1"_~1" . "_ . '(. . "," , .'. ,
, ",-1rr,40,,',8, ',,-tt'2',"S"'a', ",::,',j~,'c"',o,~,",,,.MOmvlA, LTHO' "NNSY"LV.,~,NI,A, ,', ", ,-
";~'i'I:~ ~ . . -\r':'p "':~"~'J' - - ....'. .,"',.. ;.~ . '-,
'~~'1;1~1~a.~bi~~~:.::="C:=~ClAr.DaikaTAX'"
RECEIVED FROM:
&
ACN
ASSESSMENT P:'
CONTROL ~
NUMBER
AMOUNT
STEPHEN L. BLOOM, ESQ.
10 E. HIGH ST.
101
.J,H!J.1B
f
CARLISLE, PA 17013
ESTATE INFORMATION.
!II IL NUMln
II 21-1996-0041
EJ NAME Of DECEDENT (LAST)
II E 0 PAYMENT
II POSTMAR
COUNTY
"
I
HlI."/II 1
I
SSN EOE-EO-17S9
(fiRST) (MI)
"
.
: t
CUMBERLAND
DATE Of DEAlH
REGISTER OF WILLS
m TOTALAMOUNTPAID .1.lE1.1B .':~
PB -"~
: ~
. . { '~
RECEIVED Bv9);,r,.i,1 (. ;f;(...~:) ~.k:=
/ SlGNArUII ' l/i, B
MARY C. LEW'IS ,;r!:U;11;lYf-:' ,:
REGISTER OF WILLS '::
REMARKS
SEAL
LUCINDA HEISER
C/O STEPHEN L BLOOM
CHECK" 1
ESQUIRE
--.-------------- -- -----------~
---~
,. . . -. ~""','"
..
--::-~
r
/5-1 J'-,p-
IURrAU OF IHOIVIDUAL TAkrl
IMHlI.'ANCI 'al DIVIIION
III"" U....
twnIUIUIO, PI 1111.....1
COMMONWEALTH OF PENNSVLVANIA
DEPARTMENT OF REVENUE
HOTlcr OF IHHERITANCr TAk
A~~RAIIEHEHT, ALLOWAHcr OR DISALLOWANCE
or OEDUCTIOHI AND AISESSHrHT or TAk
STEPHEN L BLOOM
MARTSON ETAL
10 E HIOH ST
CARLISLE
DAT!
UTAT! OF
DAT! OF DEATH
FILE NUMIER
COUNTY
ACN
05-12-97
BAlV
10-22-95
21 96-0041
CUMBERLAND
101
'.aunt ~..ltt.d
PA 17013
c...
*'
....It., II.U lfI..,.
EVA
o
MAKE CHECK PAVABLE AND REMIT PAVMENT TOT
REOISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiE'v:isijj"Eii-Aj:ji-fii3':9'rj-iioYicE--ciiluiNHEiiiTANci-YAi-A-PPRA'isEHiiir-,--,m.-ciiiANci-jili-.nmmm-m
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTAT! OF BATV EVA 0 FILE NO. 21 96-0041 ACN 101 DATE 05-12-97
APPROVED DEDUCTIONS AND EXEMPTIONS I
9. Funeral Expen.../Ad.. Coata'Hllc. Expen... (Schedule H) (,)
10. Oobt./Hortgogo Llobllltlo./Llon. (Schodulo II (101 ,00
U. Totol OoducUon. (UI
12. Hot Volue of To' Roturn (121
15. Chorltoblo/Go.or~ontol Boquo.to (Schodulo JI (151
14. Not Volue of eototo Subjoet to To. U41
NOTEI If an a.lell.ent wal illued previouIIy, lines 14, 15 and/or 16, 17 and 18 will
reflect figural that include the total of abh returnl allel.ed to date.
ASSESSMENT OF TAXI
15. Aoount of Lino 14 ot Spou.ol roto US I
16. A..unt ef Line 14 to.oblo ot Llnool/Clo.. A roto (161
17. Aoount ef Line 14 to.oblo ot Collotorol/Clo.. B roto 1171
lB. ~rlnclpol To. Duo
TAk RETURN WAS, (XI ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI SUPPLEMENTAL RETURN
1, Rool E.toto (Schodulo Al UI
2. Stock. _ Bond. (Schodulo BI 121
S. Clo.ol, Hold Steck/Portnor.hlp Intoro.t (Schodulo CI (51
4. Hortgogo./Noto. Rocol.oblo ISchedulo 01 (41
5. Ca.h/Bank Depolita/Hi.c. Personal Property (Schedule EJ IS)
6. Jelntl, Ownod Proport, (Schodulo FI (61
7. Tr~.f.r. (Schedule OJ (7)
a. Tetol A..ot.
I CHAHGED
NO, 01
.00
.00
,00
,00
,00
7 .071,04
,00
lal
.00
.00 k .00.
.00 k,06.
46,919.56 k .15.
ual
TAX CREDITS I
PAYHENT
DATE
01-18-96
03-10-97
DISCOUHT ('1
INTEREST/PEN PAID (-I
298.86
60.52-
RECEIPT
NUHBER
AA082512
AA185258
AIIOUNT PAID
5,678.42
1,121.18
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
HOTEl To Inlure proper
credit to your account,
.ub.lt the uppor portion
of this for. with your
tax paYl*"lt.
7,071.04
nn
7,071.04
.00
46,919.56
.00
.00
7,037.94
7,037.94
7,037.94
.00
.00
.00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIOHAL INTEREST.
( IF TOTAL DUE IS LESS THAN '1, HO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I
'.
..,
II : ( ,
"
O.
I
~..-
...1~
-.
iijC1.: (-
a: p, ;., :;
0c.;
R(I[RYATIDNI [,t.t.. of decedent. dVlng on or before Oeceeb.r 12, 1'" -- If eny lutur. Int.,..t In the ,,'at. 1. tten,'.rred
In po.....lon 0,. enJo,..nt to Ch.. I (co11,t."U MMllcl.rl.. 0' the dKI."t .ft.r the uplr.tlon 0' eny .It.t. '0,.
11'. or 'or VI.r., the C~.lth hereby ..pr..,ly r...rvI, thl right to appr.... ~ ...... tren,f.,. Jnherlt~. ,....
.t the l.wful Cia.. . (eo11,',r,1) t.t. on env luch lutur. lnl.r..t.
PURPOSl OF
MOTlCE:1 To fulfIll the requlr,""'. 01 SKtlon nu of the Inherltenc. Met ht,t, r.. Act, Act 21 of ."5. (71 P.S.
Section '140).
PAYMENTI DetKh the top portion 0' thl, NoUe. Ilftd lubIIlt with your Ply",,' to thl Rlllla.,,. of Willi printed on the tev.r.. dde.
........ eMck or RNy or.,. p'YRle to. REGISTER OF MILLS, ADENT
REflIm (CAli A r,'\nI of . tllll credit, whIch .... not '.q"utlld on the Tax Rlturn, ..y be ,...,..tecl b)' c~l.tlng ., -Appllutlon
for R,fund of Penn.,lvenl. Inherlt~. end E.t.t. t.x~ (REV-ISIS). Appllc.tlon. .r. ~.Il~l. .t t~ Offlc.
of the R..l.t.r of Will., eny of the 2S R.v~ DI.trlct Offlc.., or b, c'lllng the .peel.l 24-hour
."....rl"l ..rvlce nullber. for for.. orct....ng: In P"",.,lv.,.. l.aal.36Z-ZISI, outside P.,.,.,lv.,l. end
within local Harrisburg .r.. (111) 7.1-.194, TDD' Cl1l) 112.ZZSZ CHe.rlng 1.,.lred Onl,).
OIJECTIDHS: An, p.rt, In Int.r..t not ..tl.fled with the .ppr.I....,t, .llowanc. or dl..llovanc. of deduction., or ......-.nt
of hlC Clncludlng dhc:ount or Int.r..t) .. lhown on this No tic. IN.t obJ.ct within .lxh (61) uys of rec.lpt of
thh Notice b)':
--wrltt., prot..t to the PA o.p.rt-.nt of RIVenu., lo.rd 0' App..l., D.pt. 2.1IZ1, Harrisburg, PA 1112..1021, OR
--election to hIIve the ..U.r deterllned .t eucllt of the .cc:~t 0' the perlOftlll npr..."t.tlvl, OR
--.....1 to thl Orph."." Court,
AllHIH
ISTRATlYE
CDRRf:CTlOHS a
Factual .rror. dl.cov.red on thl. .......ent .hould b. .ddr....d In writing tal PA o.p.rt-.nt of R.y~,
lurlau of Indlvlduel T...., ATtNI po.t AI....eent Rlvlew unit, o.pt. 2a1611, Harrllburg, P. 111'..1611
Phone (717) 7'7-'5IS, S.. Pili 5 0' the bookl.t ~In.tructlon. for Inherltanc. t.. R.turn for 1 R..ldant
o.cldlnt~ CREV-15IU for In ..plenetlon of edIIlnhtntlv.h c:orrlCt~l. errorl.
DISCOLICT a
If en)' ta. due I. p.ld within thr.. CS) c.lend.r ~th. .ft.r the dec.dent'. d..th, . flv. percent C5%) dl.count of
the t.. p.ld 11 allowed.
PENAL TV I
~ IS% talC lIne.ty non.p.rtlclp.tlon plnSlty I. coeputed on the tot.l of thl ta. end lnt.r..t ......ed. end not
p.ld be'or. Jenuery II, 1996, the flr.t d.)' .ft.r the end of thl t.. lIne.ty p.rlod. Thl. non.p.rtlclp.tlon
pene1t)' 1. ....11b1l In the .... .....,.r end In the the .... tI.. per lod .. you would IIPPI'. the tI. end Interllt
tMt hili bien ......ed II lndlc.ted on thl. notlc..
INT[R[STa
Int.r..t I. ch.rged beginning with flr.t d.y a' ct.llnquency. or nine C,) eonth. end one CI) d.y fru. the date of
....th, to thl d.tl of Plpent. TI... which bee... delinquent ba'on Jenuary 1, 1'12 bier Inter..t .t the ret. of
.1. ClX) percent par ennu. cllcul.tld .t . d.ll)' rat. of .IIOI6~. All t.... which b.c... delinquent on end .ft.r
Jenuery 1, .'12 will be.r Int.r..t at . r.t. which will vlry frol calend.r y..r to c.lendar y..r with that r.t.
..-.,ounclMl by the P. Depert..,t of R.venue. ThI eppllclbla Interllt r.ts. for 1912 through ."1 .r.a
!!!! Int.r..t R.t. Dally Intar..t Fector !!!! tnt.r..t R.t. D.llv tnter..t F.ctor
I'IZ ZOX ,llasu 1917 9X .aaDZ~7
I'll lOX .DIDUI 1911.1"1 IIX . DDUDl
1'14 IIX .DDD301 I99Z 9X ,DDDZO
1915 UX . DDn56 ."S.I'M 7X .aIDI"
1916 lOX .DDDZ1~ 1"5.1"1 9X .ODD2U
--Inter..t Is c.lcul.ted n '~I1CMl1'1
INTEREST . BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Motlc. I..ued ,'t.r the t.. blcu.e. delinquent will r,'lact an Int.r..t c.lcul.tlon to fifteen (15) d...
beyond the d.t. of the ......-.nt. I' P'Yllnt I. .ade .ft.r the Int.r..t coeput.tlon d.t. .hown on the
Motlca, Iddltlonal Int.rnt Milt be calculated.