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Home My WebLink About96-00089 '" :' .~ j~~ :, ~ ,,' ',' " ." , '.':.' . ~ ,'~;\., 1;~ ',' ,:" " '\ ~. . ,,',,' .' ",;. ..l!\>~ ,:',,'.! ',,',?,,: I HEREBY CERTIN 'lllAT 'llIE ATrAOIEO IS A TRUE COPY OF A RECORD 00 FILE m 'llIE DIVISION OF VITAL RFJ.~. ;I. /~,~7p DATE ISSUED: 01 loSI" ,j.J ., jL .t>~-~ J...... I' ~TE ~S'rnAR OF VITAL Rro>RrS .._......""".._..11) '200....000".. ......000" ANNA ROSE~~__,~~~~..RTH1t' .'___u'_______ :JA"N~~O~', 19v~~_J.2:34_~!:! q"tcllJNIIM(1IncfNtl'utO\f1MIItHf~"umbtNJ 14b CIy', TO'M'I,orLocallOl"lclOMIh 4c.Co.rlfy'oIo..lh FT. WASHINGTON HOSPITAL CENTER FT. WASHINGTO Prirce <mrgeS .2~~;; 'l.,~J~-~i~T ...~~_~~)I ~1~; j ~(~~~ I~~~~:- rr~il] ~~~i;'~- U.ue1 ~ cI Dectdent '~:'a~--r~;:~';~;~-----J~-c:.y,~~lFt~ Spriogs - , --]JOd~:.~~- 1';l~~';;"Avenue -----1~~;;07 ----- - - '--j'Og-c..;;tSli'c......<r1 i 12 w..o.c.dtnCEVllhU'S--J tiW..-~oIHjlPlnIC0r~7(C::;...-y..OfNo-- I'_.'"".':'",:~~-.'~--l.......t-e--:----- II. UatILIISC.lul ArmedFOfU.7 "y....ptCIfy~Meflean~Pu.,,"'r~...cl ....,... l' __;~;::~n~~m.d e~~~A~~!.~~ ____ ~ ~~~~. 21J~n S~ __ _ ~ _ L _ __h_______ ____ I "o.o.cs.nr.EdUCIIIon I'lSl o.c.drilU.uaIOeeupaIlOn leb KnloIBumutilndulN'Y (_...~higIoo"II""com""''''l (G..."".._.....~...".._>>g N C bid _~(o-") [ ~(I"""l '10 OGNGT..._ ew urn er ao 1~ Secretary Army Depot ~ '~:;;'~:(I"~~"II) ,__,____ ----=~__~ "A~~i~i~:;;'~.;;s~.} ,"- ...............--Ip(7)po, Pm,) lJ' M............ (---..,.._,_.-. c.<y.. r_ SIaM, lI>C<<*' Patricia Alichwek 412 Gleon Ave, Boiling Sprlogs, PA 17007 2Oa. t..W'Dd at Dispotltoft 2Qb. Pla~ aro.spotllOn (Name d i-~ [-~ t.ocIllon. CIy ot Town.. Stitt a,..... a a ,*".'1)'. CtMl"O?' 01 oth<< ,u~) :00......... .'ii,,:,,'"';~"""'"''''SIOl' Rolling Green Mem. P~ 1/6~9~ Carnphlll, PA ".~~.._.-r;; ee- Le) ..,....._............d." Eli F I H ~ ' , /,. # ~ t.1. oe uoera orne ~-, , 934 S. Maio St. , Harnpstead, MD 21074 na. P,"t. Enl_ IN cI...... OIcompllc&tlonIlt\al cau.eellhI dMlh. Do noc em" the modi 01 dying. Iud'll. carellc 01 flsplrlloty 'fTMt, -----; ~I. Ihodl, 01 tIN., '''ut,. U" onfy one caUl' on IImliM. I ~ BtitwMtl I 0nMe IIld OM" , , , , . , , . J , , , , , , , I , VALID OOLY WI'm , IMPRESSED SEAL J 9/ J I z i t ' I a J I ~ ! i ~ hI '0 nil lUll eHjI ~ Ii-' ~ tlU. ~ I ill ~ I fl I ~! til f i jl i ~ ~ it ! ~ J It ~ 1 2) ~hh c ,u~ IH' ZN .t ~I~fi 1nwnecIa"C.UM(Fi\aI clMtM 01 condAlOn tMUllr'lgW\dMltI) . -11\A.lt oJ:~._~~~v~,d~ Ou>>t~(OI"'COl'l~oI); Due 10 IOf II' conMq'*'Oe 01): --. CIA 10 (0111. COl'lMqUll"lClt 01): d. 22b. Old IObKco UN contrUlutllO... c.-. of dMCtl1 tOr.. ,,,..,. PM It. 0Iher IIgn#kM1 condJUonl conttt)ulJng 10 dellh but not tI.ulli'\g In the ~ taUI' gHen n Part I. 2&b.W.....lAoptyrlndlnge IV~ p10r 10 ~olClU.. ,~ ,a.. .JI4:t.. ,a.. 2t PleC! 01 0..1h.lCh!!* (WI~ Mfl Holpllll.lDlnotllene zDQEf\IOufpItltnl 3D~ClNr. 40NloWthgHom. 50~ eOONt{Sp<<:i#yJ ... DOl........" f'" T..... J'........... 'Id -........,......... f'Uan1l, a.,r..,J Jnt.J'Y VIM" I ~ _.., . , _L~..3-9b_....!~IS-l~ lav.. ')l(." ~~~ ~h,'114l>'\ 28. Plata ollnJ\oIt)'. AI hom',llnn, .;.At,lldOt)', offICI 2M location (5rrHt and MInlw 01 RutaJ IbM ~_ _ "'_"',(_1 eJ- c.<y..'_Sl''''/{t-tf,2,IO ~S_""",<< ":.rr:e ' Ilcul<,,-~_I(_,"'Q_______ 2Va. CetttItr to Certtfytng PtlJlldan: To 1M be.1 of my knowIedgII, dMlh oocurTId II IN I&'M, cStl. and place, anddl..-fotN UlUM(.) and m.....,., I. "I" "'**... 206I~ceI t.Iamlnw: On IN be... of ..wnNitlon anltor 1rMIIlglllOn, n my ophIon, dilllh oocurTId .1 IN lime, cStl. and pIaoa, and due to.... callM(.. ~ - ~^ and rnaMef .tlled. w.;-q~ (~-.J"'O~~. ];~~~~;;~~'-.-' >>Name and Iddr... 01 'IIho oompIrIC<<f cawae of dMlh (tIIfn :311 (T~, Pmtl . tUll,-;r:~lhJrl::-..1IIO 111 Penn Street. Baltimore.._H_a!:l(],all.c:L2,1201 :It. 0.11 fled j'IIonI\ OIlY. rwT JAN 0 1 2". W.. an .utOCMY ..........., . 21. WI' ca.. ....enltd 10 m~1 III ..- I~ ":"'"*,'::~..~,,".ap_ ~ i'l't'UliglllOn 3 0 SuIdcM I 0 Could noc be 40Hom~ de1l~Nd ] i ::I ,. ". "'" , ,t ~~: ;7:~~ , ~.. , ' . - . .}f\~.' I ..~__.__ . .,,__._.~.~....{~"!;,,~~?.:;1tf.t""'""~ ..', ~ t.~~'.-""'l ""^"'~~ -"",,, -"'-"'~""'''''-'''''''-'''~' ,', J'), , It. ! { / ~'T~ 001 CODB IPS ACCT 5441310001758597 CYCLB 24 AGENT 1522 (INQUIRB PRBVIOUS STATBMBlI'r) 1111I II 1I11II II II II 11I111I II III II II I II III II II II II II => MCCARTHY ANNA R $ 2,043.28 PAYMNT DUE DATE 01/20/96 CLOSING DATE 12/26/95 TO PDAT TDAT AMOUNT RBFBRBNCB NUMBER MERCHANT DBA CITY ST ....-",._",.-.- ,..,. ...,...' ..,..... cooii"- 0404 1226 1226 $ 11.79 CASH ADVANCB .~INANCB CHAR 1I111I11111IIII1II11111III11111111111111I111111I11I1111111111111111111111111111 PRBV BAL 1,975.62 I PURC F/C 15.74 1 a/PUR BAL 1,114.26 PURCHASB 0 .00 1 CASH ~/C 11.79 1 O/CSH BAL 833.74 CASH ADV 0 .00 1 LATB CHG .00 1 a/MIS BAL .00 MISC CHG 0 .00 1 OVl\L ~BE .00 1 a/ADD BAL .00 CRBDITS 0 .00 I INS ~BB .00 I a/PUR ~/C 30.97 PAYMBNTS 0 .00 I PAST DUE .00 I o/CSH ~/C 24.18 cURR BAL 2,003.15 I LIMIT 2,000.00 I MIN pYXT 53.15 < 001 > O~ <.001 >11< 11 / 95 >111111111111111111111111111111111111111111111111 PFI 5-PRV STH' 6-NXT STMT 7-BWD PAGE a-FWD PAGE 10-RESTORE PF KEYS FOR TCSI ""'..-__--.,~~h<~,~.:,i'~1".!<.,:..'t!!t~~~~~1f.if.o;.::t~~~~~t;...i:~~-'r.' l"'I 5~ - N OIJJ 33 N ,~ . 0- c.B 0'0 co 'O- N .-0 Cl) (~l ~ - ~ 0:;; '- ~.- ::J B~ ~.a ~a: ~ .-c E ~a " I C~ALTH OF P(NNSYlVAHIA DlPARTtU:NT OF RElf[HlJ( IUAfAU OF INDIVIDUAL TAXES DEPT. nun HARRIUURC, PI una-D60. *' INFORMATION NOTICE AND TAXPAYER RESPONSE EST. OF ANNA R MCCARTHY S.S. NO. 208-24-4008 DATE OF DEATH 01-03-96 COUNTY CUMBERLAND FILE NO. 21 96-0089 ACN 96122384 DATE 06-11-96 TYPE OF ACCOUNT o SAVINGS !Xl CHECKING o TRUST o CERTIf. .....kl ..,,, 0-"' DEBRA L OTT 2681 SPRING RD CARLI SLE PA 17013 REHIT PAYHENT AND fDRHS TDJ REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 PHe BANK ha. provld.d thl O.putlent ..lth thl lnlor..tlon lI.ted below which hI' b.M ul.d In ulcul.Ung thl patentla. 'IM due. Their r.card. Indlc." thlt It the d..th of the above dlcad.nt, ~ou w'" I joint owner/beneficiary of thl. ICCount. If you '..1 \hl. Infor..tlon I. Incorrect, pl.... obt.ln ..,Itt.n crtrlctlon ftOI thl 'Inancl_1 Jnltltutlon, Ittach . copy to thl. for. ~ r.turn It to thl abov. addr.... 1hl, "ccount ,. ...abl. In accordane. with the Inheritance T.. t.... of thl C~..lth 0' P,nnsylvanla. U\tt"lc~1 "'.v D' 1,,,,If.,8" bY ,Rl f ~":J 1'1. 1 ,,! -1I't1 COMPLETE PART 1 BELOW . Account No. 5140039639 . . SEE REVERSE SIDE FOR D.t. 04-01-69 E.hblhh.d FILING AND PAYMENT INSTRUCTIONS Account blanc. 1.464.13 P.rcant T...bl. X 16 . 667 Aooount Subj.ct to T.. 244.03 T.. R.t. K .15 Potentl.l T.. Du. 36.60 PART TAXPAYER RESPONSE COI FAILURI TO RISPOND WILL RESULT IN AN OFFICIAL TAX ASSESSHENT BASID OH THIS HOTICI I A. );;7f The abo..,. Infor..Uan and t.. 00. Is corr.ct. ~ I. You "Y choo.. to r..lt pay..nt to the R.al't.r of will' with two cop I.. of thl, not Ie. to obt.ln . dl.count or ...,old Int.r..t, or you .ay check bo. "A" and r.turn thl' notlc. to the R.al.t.r of will. and an offlcl.l ........nt NIII b. l..ued by the PA D.p.rt.~t of RI""nu.. To In.ura prop.r cradlt to your account, tNO (Z) copt.. of this noUn ,",.lit .CCO..,MY your PIY.lnt to the R.al.t.r of Willi. Hak. check p.yabl. tOI "Rlal.t.r of Willi, Agent". HOtEl If tl. pay.ent. ar. .ade within thrll (3) .onthl of the d.cadent', date of d..th, you .ey deduct . 5~ dl.count of the ta. due. Anv Inhlr Ilence ta. duI ..111 bKOII d.llnquent nl", (91 .anth. aft.r the date of de.th. [CHECK ] ONE BLOCK ONLY I. r=J Th. .bo..,. I,..t ha' b.an or will ba reported and ta. paid Nlth the p.nn'vl..,anl. Inherltanc. T.. return to b. fll.d by the dec.dent', r.pre'lntatl..,.. C. D Th. abo..,. Infor.etlan I~ncorrlct and/or d.bt, and dlductlon. Nare paid by you. You .u,t coapl.ta PART l!..J and/or PART ~ blloN. PART [!] DATE DEBTS AND PAD 1 2 3 4 5 6 7 8 DEDUCTIONS CLAIMED OFFICIAL USE ONLY 0 AAF PA ~~RTHEIU OF RIi1JENUE - -:' ~ 3?~ i_-,~ ' _ - ,.i\ 1) ~ :,-J'--- r- d ,.... (X '.,> ~,J " If you Indlcat. a different tax rate, pl.... .tat. your r.l.tlonship to dec.d.nt: PART ~ TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS LINE 1. D.t. r.tobll.h.d 1 2. Account Balanca 2 3. Parc.nt Taxabla 3 X 4, A.ount Subjact to Tax 4 5. D.bt. and Daduction. 5 6. Aaount Taxabl. 6 7. Tax Rate 7 X 8. Tax Due 8 ~~~ . ..>I . . ~. . , , ' V)o \0 PAID PAYEE DESCRIPTION AMOUNT PAID I TOTAL CEnt.r on Line 5 of Tax CoaputatlonJ perjury, I declare that the fact. oMl.dge and beli.f, I . and DATE \ .. - ~ ._- ---.-...--- , - GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OfFICIAL TAX ASSESSHENT .lth _11...1. In...... b.... on Inl.r..tlon ......Ittad by the flnencl.1 In.titutlon. Z, !nMrltww;e t.1C bK... dell"....,t nlM eonth. .ft.,. the dec.dent". dIIt. 0' de.th. J. A Joint ICCOU"lt II t'lCeble.VWl though the decedent". n... .... addad .. . ..tt.r of conv.nlenc., 4. Account. ClMlucUng tho.. held bet...." hu.band and ..lfe) which the decH."t put In Joint n.... ..Ithln one v.ar prior to de.th .r. 'ully t..abl. .. trln,'.r.. 5. Account. ..tebllahad JoIntlY between hu.band and ..I'. lOr. than one v..r prior to d..th .r. not t..abl.. ,. Iccount. h.ld by a d.cadent ~In tru.t 'or~ another or other. .r. t..abl. fully. REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE I. IlOCl I - If the In'or..Uan and CQ8PUt.tlon In the notlc. .,.e correct and d.ductlon. are not baing chl.ad, placa In ""X~ In block ~A~ 0' P.rt 1 0' the ~T,.p')'Ir Ra.pon..~ .ectlan. Sign two copla. end .utHllt tha. ..lth your check for the HOW\t of t.. to the Ragl.tar 0' will. 0' the county Indlc.t.d. The PI Dep.rt-.nt 0' R.venue ..Ill I..u. en o"lcl.1 ......aent (For. REV-IS41 [X) upon r.c.lpt 0' the r.turn 'ro. the R.gl.t.r of Will.. Z. BLOCK I - I' the ....t .pacl'led an thl. notlc. h.. baan or ..III b. r.portad and t.. p.ld with the Pann.vlvanl. Inherltanc. Ta. Rlturn 'IIH by the d.cldant'. rapr..entltlv" pl.cI an "X" In block "B~ 0' P.rt 1 0' thl "Ta.p.v.r Re.pon.e" .ectlon. Sign ana copy end r.turn to the PI Dep.rtaant 0' R.v.nue, lur.au 0' Indlvldu.1 T...., D.pt 210601, Harrl.burg, PI 11121.0601 In the anvtIlopa provided. J. ILDCl C - I' the notlcl In'or..tlon I. Incorr.ct andlor deduction. ~rl baing clal.ed, chack block "e" and coapl.ta P.rt. Z and J __rr4l~ t~ thoot ''''.truf'tl....,,, twll_. ~IIP" two capla" IN'1d .ut.1t t.... with "'our dMck for thl MCM.W1t of b'll p.",.l. to thl RHlttar of Will. of the county Indicated. The PI Dap.rt.ant of R.venu. will I..u. an o,flcl.1 ........nt (For. REV.1541 EX) upon rec.lpt of the r.turn 'roa the R.gI.tar of Will.. TAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Entlr the d.tl the account originally w.. I.tabllshed or tltlad In the .ann.r .xl.tlng .t d.t. of de.th. NOTE: For. dacac*\t dvlng .ftar lU1Z/1l1 IccOI.W1t. whIch the dacadant put In Joint naMe ..lthln on. Cl) v..... of de.th are taxabll fullv .. tran.f.r.. Howev.r, thlr. I. an ..clu.lon not to IXC.ed 'S,OOO p.r tran,'.r.. r.gardl... of thl v.lue 0' the acCCM1t or the ,...r 0' accounts held. If I doubl. a.t.rlsk (xx) appe.r. ba'or. your 'Ir.t naea In thl .ddr... portion 0' thl. notIce, thl 'S,OOO axclu.lon alraadv hili bean deductH 'rOIl thl acccx.nt b.lanc. II r.portH by thl flnancl.1 In.tltutlon. 2. Ent.r the tot.l bllanc. of the account Including Int.r..t .ccrued to the data of de.th. J. The parcant 0' the acCCM1t that It t.xabl. 'or .ach .urvlvor II det.r.lned a. 'allow.: A. Tha ~rcant taxabl. for JoInt ....t. IItablhhed lOre than ana v.ar prIor to the decedent'. d..thl 1 DIVIOED IY TOTAL NlJIBrR Of JOINT OWNERS [..-,1.1 A Joint ....t r.tl.tarld DIVIDED BV TOTAL HUMBER OF X 100 . PERCENT TIXIBLE SURVIVING JOINT OWNERS In the "... of tha dac.dent and two othar p.rton.. 1 DIVIOED IV J (JOINT OWNERS) DIVIDED IY Z (SURVIVORS) . .161 X 100 . 16.7% (TAXABLE FDA EICH SURVIVOR) I. The parcant t.xabl. for ....ts created within ana v..r of thl d.cadent'. daath or accounts owned by the dacadant but held In tru.t 'or anothar Indlvldu.lh) (tru.t ban.flcI.rl..)1 1 DIVIDED IV TOTAL NUttIER OF SURYIVINC JOINT OWNERS OR TRUST aEHEFtCldlES X 100 . PERCENT TAXABLE [x.-,I.I JoInt account r.gl.t.rad In the n... of the d.c.dent and two other Plr.on. and ..tabll~d wIthin one v..r of de.th by the decadent. 1 DIVIDED BY Z (SURVIVORS) . .50 X 100 . 50% (fIXABLE fOR EACH SURVIVOR) 4. The aaount subJ.ct to t.. \lln. 4) I. dat.raln.d bv .ultlplYlnt the account b.lancl (line Z) by thl p.rcant t..abll (line J). S. Entlt thl total of the dab . end deduction. 1 htad In P.rt J. ,. The aaount t..abla (11nl 6) I. det.ralned bv .ubtr'ctlng the dabt. end deductIon. (line 5) frOll the aaount .ubJact to tlx (lIne 4). 7. [nt.r t~ appro~rl.t. t.w r.t. (lIne 7) .. rl.t~~.lned b.lcw. A. For dati' of death occurring Ift.r 6/S0/94, the t.. r.t.. for tran.f.r. to spou... .r. .. 'ollow'l 1. Dat.. of de.th on or .ft.r 1/1/94 and b,'or. 1/1/9S thl r.t. I. JX. Z. D.t.. of d..th on or aft.r 1/1/95 tran,'ar. to .pou... wIll be t..ad at OX t.x r.t.. Note: For dltl' of death prior to 7/1/94 tren"lr. to .pou... ar. t.xabl. .t 6X. B. Tran,f.r. to Iln"1 d..cendant. Includlna ,.tha..., lother, .on, daught.r, grandchildren, .on.ln.I..., daught.r-In.I..., .tepchlld and thllr I..ua Ir. t..ibl. .t .1. p.rcant (6XI. C. Tran.f.r. to .11 othar. Including brothar, .I.tlr, uncia, aunt, nephew and nl'CI ar. t..abl. at fl'taen percant (15%1. D. If vou eh.... thl tax ret., pl.... .paclfY your rel.tlonshlp to thl dacadant In thl ara. provldH. I. The aaount of t.. due Cline I) h d.hralned by aultlphlnt the uount taxable Cllna 61 by tM tl. reta Clln. 7), CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Illowabl. dabt. and daductlon. .r. d.t.r.lned .. follow.: A. You l89llly .r. r..pon.lbl. 'or P')'IInt, Dr thl ..tat. .ubJ.ct to adalnl.tr.tlon bv . par.on.1 r.pr..ant.tlv. 1. In.ufflclent to p,y thl deductlbl. It.... I. You actu.lly p.ld thl debt. "t.r de.th of thl d.cadent and can furnl.h proo' of pav.ant. C. Dabt. baIng clal..d ",.t be It..lzad fully In P.rt J. If additIonal sp.e. I. ne.dad. u.. pl.ln papar I 1/2" . II". Proof of P')'WInt "V b. r.qu..tad bv tha PI Dep.rtaant of Rlvanua. TAXPAYER ASSISTANCE IF YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANY REGISTER OF WILL5, PA DEPARTMENT OF REVENUE DISTRICT OFFICE OR CALL THE BUREAU OF INDIVIDUAL TAXES, TAXPAYER INQUIRY UNIT IN HARRISBURG AT (717) 787-8327. TOO' (717) 772-2252 (HEARING IMPAIRED ONLY) RECEIVED FROM: & ACN ASSESSMENT '=' CONTROL i;I NUMBER AMOUNT ESTATE INfORMATIONJ m fll NUMB R " 21-1996-0089 SSN m NAME Of DECEDENT (lAST) (FIRST) ~ MCCARTHY ANNA ROSE II E Of 'AYMENT B fOSTMARK ~TE COUNTY IOtIJHII' PATRICIA A ALICHWER 412 GLENN AVENUE "10.lcc.:Jtf3 .",o.ou BOILING SPRINGS, PA 17007 208-24-4008 (Mil CUMBERLAND ~TE Of DEATH REMARKS ------------~----; m TOTAL AMOUNT PAID .36.60 CW (': I /j ,/ U RECEIVED BY" f,{uL I / ,(;",.....<p P:'~,:, NAU I . MARY C. LEWIS ( />,,1 ( JfjJ", REGISTER OF WILLS I , If' PATRICIA A ALICHWER SEAL CHECK.. 4147 .. ~-",-,-.--------_._----_._-- REGISTER OF WILLS 'W .~ _.~. -.- -- --'...- ..". r-' \. FORM 93..0. C. DIVISION IN THE COURT OF COMMON PLEAS .. .OF... CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: ESTATE OF No. 21.96-89 o[ 1996 ANNA R. MCCARTIIY, (Deceased) CI.AIM 00 -.d c '" =1 Ch C. ,; :'-, - en '" - N .. 0\ ( '1 ...:~ :D ~l'r, "I; ,., To the Clerk of Orphans' court Division: '. :-v I.- . . Index aod make proper entry in your official records of the claim o~'Advantoge Receivable Solulions for GM CARD SERVICES. (Claiman!) in the amount of $981.44 against the estate of lhe above named decedent. This claim is filed under Section 732 (b) (2) of the Fiduciaries Act of 1949 as amended. The said decedent, who resided at 412 GLENN AVE, BOILING SPRING. PA 17007- 9527, died on 01.03-96. Wriuen nOlice of Ihis claim was given to DEBRA LYNN 01T, 2681 SPRING RD., CARLISLE, PA 17013. (Personal representative, :f an~r counsel) ....~f'..I.9......... 19.Q(;... ......\t~~.......... (Clalmnnt) Advanlage Receivahle Solulions 7171 Mercy Road. Suire 307 Omalm, Nebraska 68106-2611 (Clalmnlll'S AddrrO\) ,...~~_:~. I. IN RE: ESTATE OF ANNA R. MCCAllTlIY Otnlsrd " , No 21.96.89of 1996 Claim .ADV ANT AGE RECEIVABLE SOLUTIONS FOR GM CAito SERVICES FeeS Flied ................................................................................ ............................................................................................ Allor.., rorm 93 . Itjq~ - fr'f E- . COURT OF COMMON PLEAS OF CUMBERLAND ORPHAlIS' COURT OIVlSlOll COUNTY ESTATE O,F ANNA R. MCCARTHY SOCIAL SECURITY NUMBER 208-24 4008 , Deceased 110. 219689 oCl9 OUR ACCOUNT NUMBER 4428-5603-0060-1167 ~otice oC claim by ** FIRST DEPOSIT NATIONAL BANK ** filed pursuant to Section 3532(b) (2), of the PEF -Code. ("')("') 5 n; \-:) " 1-', :II :TIm -;-, " rn -0 I W -r) To the Clerk of the Orphans' Court: Of" :!;:.~ (,,; N r.i C Enter the claim of FIRST DEPOSIT NATIONAL BANK (~JIQ",..lJ ill the amoUllt of $ 4 ,434.42 , agaiast the above entitled estate. The decedent, who resided at 412 GLENN AVENUE. BOILING SPRINGS. PA 17007 ...".., "4".~ ,died on JANUARY 3. 1996 ''',".1 . Wcittellnotice of .said claim Will given to OTT PATRICIA A.AILICHWEK 'f , 1 2681 SPRING ROA[)..._aJ ""um'.';tI.. o,bl, CDUII,.t CARLISLE, PA 17013 BOILING SPRINGS, PA 17007 kIIowlI to claimant, at AUG 28 l!9& t../d (allli,....1 . C}w I- J 011 Clain:ant"s coUIISel CATHERINE H. PICKHOVER, C/O FIRST DEPOSIT P.O. BOX 9053 PLEASANTON, CA 94566 , Claimant OPERATIONS OFFICER C ...,.z..J (800) 266-5380 N/A (""...,,1 ~:~~~;;,,:yj,,~,,-~_.:~~_'._.~'~-"'_~~:7~~':",'~J:?!~ , ., ~ TCSI 001 CODE IHB ACCT 4428560300601167 (- 12' uONTH HISTORY ) ... ... ... ... ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . '.1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... . ... ... ... ... ... ... ... ... . ... ... . ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... CYCLE 28 AGENT 0104 - SCREEN SELECTION ( S CURRENT PAYMENT 122995 MIN PYMT PURCHASE 010296 CASH ADV 010296 CREDITS 122293 MISC CHG INS FEE LATE CHG OVRL FEE PURC F/C CASH F/C LIMIT BALANCE o .00 90.00 o .00 o .00 2 65.74 o .00 .00 .00 .00 .00 .00 5,000.00 4,434.42 K S 4 (01) I I I I I I I I ) 07/29/96 o .00 720.00 o .00 o .00 o .00 o .00 .00 .00 .00 .00 .00 5,000.00 4,500.16 (02) 07/03/96 o .00 630.00 o .00 o .00 o .00 o .00 .00 .00 .00 .00 .00 5,000.00 4,500.16 (03) => MCCARTHY ANNA R 06/03/96 (04) 05/03/96 o 0 .00 .00 540.00 450.00 o 0 .00 .00 o 0 .00 .00 o 0 .00 .00 o 0 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 5,000.00 5,000.00 4,500.16 4,500.16 ... ,................... ....................................... ..................................... ....................................................................................................................... ................. ....................................... ....................................... ................................................................................................................... 20. If lIn. 1911 9r.al., than L1n. 18, .nl., th. diff."nc. on Un. 20. This I, the OVERPAYMENT. 1J]ii1 21. If L1n. 18 I, greal., Ihon L1n. 19, .nl., the differ,nCl on lIn. 21. Thl, 11th, TAX DUE. A. Ent.r ,h. Inl.'II' on ,h. balance due on Un. 21A. B. fnlor ,h. 10'01 01 Un. 21 ond 21A on Un. 218. Thlo" ,h. BALANCE DUE. Make Checle Pavabl. '01 Right., or Will., Ag.n' '~;(i::'" '", .'.' ~~ BE SURE TO ANSWER ALL QUESTIONS ON,REVERSE SIDE AND TO RECHECK MATH ...c:...c: Und.r Plnahi.. 01 perjury, I d.do,. tholl hove IXomln.d ,hi, ,,'urn,lntludlng accompanying sch.dule. and ,tOI.mlnll, and 10 th. bill of my .nowl.dg. and b.li,f, It I. true, correct and complel.. I declor. that all rial .stol. hos bun r.port.d altrul maib' valu.. Declaration 01 preparer olh., thon the p'rlonal rtpr.llnlotlvl I, baled on olllnformolion of which pre parer ha, any .nowl.dg.. I'vNA1U "1 N In'ONSIIlf 'O.~NG IttUIN A.n DAI( - . 71:>') 'l/,Jo/9y .''''11 ~l q~ IIY.llDO '" P.941 w ... ..:s.. u"''' ......u ",co 9 u~.. . :r I I Q, INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) NUMBER ).r.. rOI DATlS or DIATH Anll 12/J1I91 CHICK HIli " A SPOUSAL POVUTY CIIDIT IS CLAIMID 0 1IL1 HUMIU 00 (.... /'''- 00 1'196> ,- 000 0' 7 ... ",'~ 7 ... 15 fil III co COMMONWfAlfH O. r(NN$nVANIA DfPAUM(Nf O' UV(NUf Of". 210601 HAUISIUIO,'" 11121.0601 D(( D NI' NAM ItA , IU, AND MI /l'Je CAl?rHY , wc~"'t '((UIlIT HUM.U OJ'-.;l'l- . *'0:1 l INIIAl COUNTY CODE YEAR D IDIN' "A O. , - lit:;!. t?I...d"IV-U A Vi: ;0'''<''/.0& s~t;f!)(rs, 1'/1 1'7()(>'7 c..., ' (J A N $C)" 7' H "'MOUN' ..(IIVID ISII IN".UCUONSI ~f' 'row~:>rl , N/A ,...J/~ ~ 1. O'lglnol R.Ju,n o 4. u",u.d f,'ol. o 2. o 3. R.malnder R,'v,n (10' do'.. 01 d.olh p,io, '0 12.13.B2) o .5. fld.,al Ellal. Tall: blu,", R.qul,.d .?'la. Talol Numb., af Saf. O.pnlil 80..1 t's15 "'co "'z Be o .ca. futu,. Inllt.., Comp,aml,. 110, dol.. 01 d.o,h oflOl 12.\2,821 o 6. O.e.d.n' Di.d lIslal. 0 7. O.e.d.nl Malnlaln.d 0 U.,lng T,ull (Atloch copy 01 W;1I) (Atloch .opy 01 T,ul') , ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMAnON SHOULD BE DIRECTED TO. NAMf COM'LlII MAltiNG "DOlin (11 (21 (3 ) (4) (5 ) L!-I.;J. G-LC'IVAI At/&" &1(..11l.I(, 5Pte,IlJ6-S e-- e e- e I#-. 7,;1 .Pr 6.3cf 15 .35~ , ALI(:Ht..Jc CJ 790 1-',4 I t0u 7 '" co ;:: :5 ::> ... :i III '" \, R.ol f,'o'. (Sch.dul. AI 2. S'o.k. ond Bbnd. (Sch.dul. BI 3. Clo..ly H.ld SlocklPo,'n",hlp I.,,,... (Schedul. q ... Mortgag.. and Nol.. R.e.i.,obl. (5eh.dul. OJ .5. Cash, Bank O.po,il' & Mite.llan.aus P."onal P,op.,ly (Sch.dul. fl 6. Joinlly Own.d P,op'''y (Schedul. F) 7. T,on"", (Sch.dul. GI(Sch.dul. l) 8. TOlol G,on Au." (Iolallln.s 1.71 9. funltal hp.n.... Admlnhl,oUn CoslI, Mlac.llan,oul bp.ns.. 15eh.dul. HI 10. O.bll, Mo"gage LJabiliti.I, U.nl (5eh.dul. I) 11. Talal O.dudions (Iatallin.s 9 & 10) 12. N.t Valu. af Euor. (lin. 8 minus lint II) 13. Cho,itabl. and Go.,.,nm,nlal B.qu.s" (Seh.dul. J) I.e. N.I Vol~~~I'd 10 Tall: (lin. 12 minus Un. 13) 1.5. Spousal T,anl"" (fa, datil of d.alh of I., 6.30.9.4) S.. 'nsl,uctians fa, Applleabl. Pe,,,n'oo. on R.nne Sid.. (Indud. .,alu.s I,om Seh.dul. K 0' 5eh.dul. M.) 16. Amaunl of lIn. U taaabl. 01 6% ,al. (Indud. volu.. "0'" Sch.dul. K 0' Sch.dul. M.) 17. Amaunt of lint 14 IOIabl. 01 IS% ,al. (Indud. .,aru.. ',am Seh.dul. K 0' Seh.dul. M.I 18. P,lnclpol'o. duo (Add 'OK "0'" Un.. 15, 16 ond 17.) 19. C,.dill Spaulol Po.,.t1y C,.dit + P'lo~..~m.n" + (\9) (20) (6) (7) (81 19) II. ::/70 , .itS} 8LJ.fD 110) z co ~ ... iI! :E co u (III 57 . IIG> (121 <~/, 7(,,'1-/ . (13) .3 (,,3"1 (14) < 4~ 39r1> (15) lC.__- .e-- (16) <iI~.) .398) . .06. e- 117) . .15 . .e-- (191 ,er In'.'." Discount '73 7.3 ~ ... Chock hero II you orC' ,('quosting a ,efund of yau, overpayment. sJ}fI /' /" (21) (21AI (218) Act '48 of 1994 provld.. for the r.ductlon of the tall rat..lmpo..d on Ih. n.t valu. of tran.f.,. to or for the u.. of the .pou... Th. ral.. a. pr..crlb.d by the .Ialut. w\ll b.l . 30/0 ,.03) w\ll b. appllcabl. for ..tat.. of d.c.d.nt. dying on' or alt.r 711194 and b.for. 111196 . 20/0 ,.02) w\ll b. appllcabl. for ..tal., of d.c.d.nt. dying on or alt.r 111196 and b.lor. 111/97 . 10/0 ,.01) w\ll b. appllcabl. for ..tat.. 01 dac.d.nll dying on or alt.r 111/97 and b.lor. 111198 . Spou.al tran.l.r. occurring on or alt.r 111198 w\ll b. .xempt from Inh.rltanc. tall. , PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (,,-) IN THE APPROPRIATE BLOCKS. YES NO I 1. Did decadant moke a transfer ond: a. retoln the use or income 01 the property translerrad, ....................................................... b. retain the right to deslgnote who sholl use the properlY translerred or lis income, ............... c. retoln a reversionory Interest; ar ................................................................................... d. receive the promise for life of ellher payments, benellls or care1....................................... 2, \I death occurred on or before December 12, 1982, did decadent wllhln two yaors preceding deoth tronsler property without receiving adequote considerotlon1 If death occurred alter December 12, 1982, did decedent tronsfer property within one yaor 01 death without receiving odequota conslderation1................................................................................................... 3. Old decedent own an 'in trust for' bonk account ot his or her deoth1...................................... IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOu MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ~' tDMDHWULtH Of PLHHSYLVANIA .,'IUCNt 01' atvtNUt aUlEAU or INDIVIDUAL lA.[1 Olll. IIUII HAI.IIIURG, p' 17111.0'01 * INFORMATION NOTICE AND . TAXPAVER RESPONSE FILE NO. 21 96-0089 ACN 96122384 DATE 06-11-96 TYPE OF ACCOUNT o SAVIHCS [Xl CHECKIHC o TRUST o CUTU. ",.\lU ...".,..., EST. OF ANNA R MCCARTHY 5.5. NO. 208-24-4008 DATE OF DEATH 01-03-96 COUNTY CUHBERLAND DEBRA L OTT 2681 SPRING RD CARLISLE REHIT PAYHEHT AHO ,ORHS TO. REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 PA 17013 PHC BANK hll .,.vld.d .h. D.,.....n' vllh .h. In'OI..II... I"..d .01.. ....1... h.. ...n und In ..1..lolln. ,h. ,...n.I.1 ... du.. Ih.l. ..c..d. Indl.... ,h.. .. ,h. d...h ., ,h. ...v. ......n.' yOU v.., . J.ln. ....,,....'I.I..y ., 'hl. ....un.. I' y.u ,..1 .hl. In,.....I... I. Inc.."'" ...... ob..ln v,I...o ...,...1.. ".. .h. '1....1.1 10..I.u.I.... .....h . ...y .. .hl. I... ...... ..~.." I, .. .._ ..,... ....... "" .....:.~. .. "v,",,1o ,,; _...._. ..It. t.. ......11_."... ,... ., lho C........llh .1 ...........1.. .....11.01 ..y L. ..,....'.. bY ..111... 17171 11f.Un., ' COMPLETE PART 1 BELOW M M M SEE REVERSE SIDE FOR FILING AND PAYHENT INSTRUCTIONS Account No. 5140039639 o.te 04-01-69 Eshblhh.d Account Bohne. ' 1.464.13 p.rc.nt T...blo X 16,667 Avount Subj.ct to TaM 244.03 - -- To' Rot. X .15 potentio1 T.. ou. 36.6 a PART - TAXI'AVER RESPONSE ill ,~(\;~~.~l~~,T!l~,l:lE~~P.!lPi;~J~g~au!J.!lili ~.tlJ9,!i;tEIRi~~9~a!:!J!\f_~J!.tCJ.~!~[,I!MJ.tl9.JJA'E.,'1 ,. 'n",n ".,.r .nd" 'I .our lecount,. two tn c",.. If 'hit ne,t.. ....t. ICUI''''' rou' ,.v..nt t. 'h' .....t., .1 VIII.. Make ch.ck ,',Ibll t.I ......t., .1 viii., ,..nt-. ~t[I If ta. "V.."t. I" ..d. wlthtn thr" eS) .on'h' 01 thl d.c.d.n'". d.t. .1 d..th, .ou .aw d.duC' . U dlecoun' II thl ,.. dU'. lnY 'nh.rl'cncl '.M due will'..'.' d.lln4Utnt ft'"' (,) ~'ht .It., tho da" II d..th. [CHECK ] ONE BLOCK ONLY the above tnlor..'lon tnd t.. ~. I. corr..'. I. you ..y .ho." .. ,..1' "Y'''' .. ,hO ...1.1.' ., Will. vl'h .v. ...1.. ., .h', no.I.. .. ....10 . .I.coun' .. .v.ld 101.,..., ., yOU ..y ch.ck ... ..- ond ,..urn .hl. ...1.. .. ,h. ...1.'" '., wlU. and en .ffl"" .......en' "In be "I'M" "y tho 'A D.,.".."t II .."""". .. [:] 1h. .b... ..... h.. b..o o. viii b. ..,....d ond ... .... v"h .ho ,."".ylv..l. 1""..11.... T.' ,,'u.n \0 bt IIhd bv th. d.cadent'. ,.,,...ntotl".. . .. c. [:] Th. .b'V' 10,....11... IJ-I."'''OC' ond/.~.b" ond ......11.... vcr. ..1. by you. 'Iou ....., co.ph" PIRT l!J Wtd/or PARt \!.J belOW. If you Indlc.t. . dlfforont tax rat., pl.al' .t.t. your rllatlonshlp to dlcldlnt. OF TAX ON JOINT/TRUST ACCOUNTS 1 z 3 X 4 5 - 6 7 X a PART ~ TAX RETURN - rOHPUTATION LIH! 1. D.t. elt.bll.h.d 2. Account ealancl 3. porc.nt Towabll 4. AMount Subj.ct to Tax 5. nobt. and Dlductlon. ,. A~ount Tawabll 7. Tallt R.t. a. Tal( Du. -' DEBTS AND DEDUCTIONS CLAIMED PART ~ DATE AMOUNT PAID PAID PAYEE DESCRIPTION , .nd plrjury, 1 doclaro that tho facta MY knoW odgo and bllllf. DillE :I',...,.tp-Ut ~ .1,: t .... 'I' I. GENERAL INFORHATION 1. fAILURE TO RESPOND WILL RESULT IN AN OffICIAL TAX ASSESSHENT .lth ...11..0.. Inlo'''' ........ In"'''''''' tub_aUIlIII '" thl fI"II\el,' _ntHtullan. I, Inh.rltance ,.. b.eo... d.llnqu.nt nln' .onthl .,.., thl ;.e.d,n", dl" If d..th. S. A J_l"' .,.ount I_ ,...bl. IVI" IhOUOh th. d.c.d~t.. ~. WI' 1d4.. II . ..tt., If 'DnVtnl.nc.. .. Account. C Inc1ud'''' thou ....Id h.tw.." h4,1.bMd Md vlle) -..hl,h the d.nd'"' put .ft j.ln' ".... vlthln 0I'l1 ,.., ,d., tt d.lth .r. 'ull.. ,...bll .1 tran.I.'" S. Account. ..',bll,h'd JointlY b.t"I'" hu,bMd and vi'. lor. then on. ...., ,,10' t. "'1th .t. not '..,bl.. ,. Account. h.ld bW . dle.d,"' -In 'ruI' fo'. ~th4, It .ther. .r. ,...bl. fullr. REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE 1. ILOCI('. If thl In'o,..tlon and CO.,utttlon In the noUn Ir. CO"'" ~ ..dutUItI. .r. not 11I11", d,I,.d, ,IMI en .X" In block .,. 0' p"t I ., the "1,.pIV" Rt.pon..- ...tlen. III" twe '0,1.. ~ tubolt t~. wlt~ wowr .~c_ lor tho ..ount of t.. to tho ..,1.'.' of Will. of 'h. countw Indl"t.... th.'A D.,.,t.~t .1 ..v.nue will I..uo ~ IIfl,lol .......ent CFo'l R[Y.I'" [XI upon rlc.lpt of 'ho r.tu," Ir.o 'hi ..ol.t.r II VIII.. t. 'lOCI I . If tho ....t .,.clfl.d on thl. notl.. h.. b.~ .r will b. r.,.rt... end t.. ,old wlt~ tho ,~.,Ivenl. Inherltonc. ,.. ..turn fll.d b, tho d.c.d.nt'. r.pr..~t.tlvl, ,I,co en ... In block ... .1 ,.rt I .1 tho .,..,.,.r 'I,Pon... 'I.tlon. SII" on. cop, ~d r.tu,n to tho PI D.p.rl.,nt .f ..v.nu., lu"ou .f Indlvldu.1 T...., D.,t r..'II, H.rrl.bur" ,. IJI,...,.I In 'h. .nv.lop. "ovld.d. S. IlOCI C . If tho "otic. Infor.ltlon I. Incorr.ct ~/or d'ductlon. 0" bll". cl,I..d, chiCk block .C. end coapl.t. '.rt. , and S w..r~"fttI _ I .,\\ In.'':'....... ICln. ,....... U,n. t..o cIIP1.. ~ ,..bwll lIMoI unh W,,)Wo" c.".ck for tl\4l ...oun\ "' tIll ..,'&1110 t~ t.... ;..lIh.' 0' "III. ., 'h. county I"dle.ltd. Th.,. D'P.,t.."t of ,.v.nu. will luu. !WI .fflll,1 ........nt C'orl .[V.UU UI upon tI..lp' 0' ,h. ,.turn fro. tho A..I.t.r of Will.. TAX RETURN - PART 2 - TAX COHPUTATION LINt: I. [nt., 'h. dl" 'h. .cc~t orl.ln.II' w.. ..tlbll&h... ., tltl.d In th. .ann., ..I.tlnt .t d.t. .1 d.,th. NOT[I ,.,. dlc.d.ntl..,lno of'.' 1,/11'.'1 Accoun'. ~Ich 'hO dlc,d~t put In j.lnt na... wlthl" one (1) ,.., ., d..th I"~ t,.,bl. 'ullv .. t,.n,'.r,. How,v", th.,. I. In ..clu.lon not to ..c..d 'J,III ,., t,on,"'" ,.o.,dl... ., thl v.lul 0' the ICCOU'lt or tho N>>b., 0' ICcounh h.ld. I' I doubl. l.t.,I.k C,ol ."..,. b,'or. ,ou' 'I,.t "... In tho ,dd,... ,ortlon 0' thl, notlc., tho .S,IOI ..clu.lon .1'I.d1 h., b..n dlductld "0' tho ICCount b.lonc. ., ,.po,t.d by tho flntftCl.1 In.'ltutlon. Z. En'.' th. tot. I b.lonc. 0' tho .ccount Includlno Int""t Iccru.d to tho dot. 0' d.'th. J. Th' ,orcont 0' 'h. ..count 'h.t It t...bl. 'or .och .urlllv., It d.t.,.ln.d II 'OU"," &. Th. ,.'c~t "..bl. '0' Joint ....t. ..t.bllahld .or. ,hIn on. WI" ,,10' t. tho ".e.dent', d..thl I DIVID[D IV TOUl NUMIU Of DIVIDED IV JOINT OWNERS E.,.,I.I & Joint ...., 'IOII'I'ld In tho n... 0' TOTAL NUttiER 0' X III . p(RC[NT T&WULE SURYIYING JOINT OWNERI tho dl'ldon' ~ two oth.r ,.r.on.. I DIVIDeD IV J (JOINT OVNtRSI DIVIDED IV Z (SURVIVORS) - .167 XIII - 1'.71 CTAIAllE '01 EACH SURVIve. I I. tho PI,c.nt ,..,bl. 'or ....t. cr..t.d within one V..r 0' tho dlCI"ont'. d..'h or IcCount. own.d bV the dlc.d.nt ~t hold In tru.t '0' InGth., Indlvldu.I(.) ('ru.t bon.'lcl.,I..), I DIVIDED IV TOTAL HUNI!R or SURVIVING JOINT OWNERS OR TAUST !EME'leIAAIES [...pl.1 Joint .ccount "II,t.r.d In tho n... ., 'h. d.c.dont end two .thl' ,."onl and I.tobll,h.d within one WI" 0' ....th b" the dlcld,n'. I DIVIDED IV Z CSURVIVQRS) . .5' X 110 . "X (TAVAlll ,aA EACH IURVIVOII X ... - P[RC[NT TAIfUL[ 4. Thl ,Iount .ubj.ct to t.. Illn. 4) I. d.tor.ln." bW wultlplvlno ,he .ccount ,.Ionel Clln. Z) bv tho 'I'C~t t...bl. Cllnl J). . S. [n'.' 'h. totll ., thl d.bt. .nd dlduc'lon. II.tld In p.rt J. .. '... .~t .......1.. 111_ 10) 10 d...,.I..d b" lubt,..t1". 'hi d.ht. IN" dldIHtlon. (U". I) ".. tho "OU'It .ub!ect to t.. Uln' 4). 7. tnt" tho 'H'OP''''O t.:.e r.t. ., I,u 71 .. d.CI,.h,.d Mlo". A. '0' ...t.. a' dl.th occur,lnG I't., "SD/f4, th. t.. rlt.. '0' t,on,'.r. t. 'POU'" .,. .. 'ollow., I. D.t.. 0' d"th on 0' If tor J/I/'4 end b,'or. 1/1/.5 the ,.t. I, JX. Z. D.tl' 0' d..'h on 0' ,ft., 1/1/.5 tron,'lr. to .pou... will b. t..,d It IX t.. ,.t,. Not., Fo, d.t.. 0' d.,th p,lo, to J/I/,4 t,on,"" to .pou..' I"~ t,..bl. .t 6X. I. Tr.n"I" to Iln,.1 d..c.ndont. Includlnl ,.thl', loth." .on, d.uoht.r, ,rondchlld"n, .0n-ln.l.w, d~lh,.,.ln.II", "I,chlld Ind thllr I..u. Ir. ,...bl. .t .1. ,Irc.nt ('XI. C. T,on.,.r. to .11 olhl" Includlno b,othl', .I.tlr, unci., ount, nl,how end nl.c. .r. 'I.,bl. .t ,1",ln ,.rc.nt C15%). D. I' you ch,"O' 'h. tl. ,.", pl.... .p.el'v ,ou' r.lltlonahl, t. tho d.c.dont In ,he "11 ".vld.d. .. Thl ..ount ., tl. duo 111n. II I. dltl,alnld b, .ultl,I,lno 'hi .,ount ,...bl. Clln. 61 by the tl. ,.t. Clln, 71. CLAIMED DEDUCTIONS - PART 3 DEBTS ANO DEDUCTIONS CLAIHED Allowlblo d.bt. end dlductlon. "1 d.t.,.ln'd I' fOllow., A. You l'o,llw Ir. r."on.lbll 'or ply.lnt, ., thl .".t. .ubJ..t to .dolnl.t,.tlon bv , ,.,.on.1 r.p,..entltlv. I. In,u".cl.n' '0 "V tho ...ductlbl. It.... I. You Ictu.IIV p.ld Iho debt. ,ft., d..th " 'h. dlcldont and con 'u,nl.h ".., " ,.y..nt. C. a.bt. b.ln. cl.l.ld .u.t b. It..I,.d 'ullv In '.rt J. I' Iddltlon.1 .p... I. na.d.d, u.. ,1.ln ,'P" . 1/'- . 11-. 'roo,.f p.,.,n' ..y bl ,.qu,"ld b, 'h. ,l D.p.'t,.nt 0' ....nut. ,i<',""',, '" ".~)%:t'gqfAXp.AVEiWAs~lSIAtltiHMtWH;j*:H~(@hi: .,., '" '" ., ."'."..".',, ',', , .'IF,',yOU. NEEll;~F(jRTH(;RfWF.ORHAllOfl!i'ORrASSISTANCE';:fCONTAI::T';ANY',:p:.'" , ,. ""('?{~;::'", REGIS.TER,.,OF.'\llLJ;,S"N:)~IWDl;PAR.nll'!i'l'WO"<{~~VEtll!Ed)lS'rRICnOfF:ICE)";\'\~iii: ':':,;'. <OR. CALt'THEBUREAU,',Oftd, /jP.IVID,UAL'~'IAXE.,S:~#r;AXPAV,ER:;'INQUI~V\UNIT,';I/j'wr,"..'"" .,. '::-: I:IA.R.~ ISB U~~':-.~ 1\.( 7~:I?;~~:Z~Jt:~:~;:~:l~ll').!%~R!~lMt..:::?::Ut1R~&i,~~~>~11:~,.~.~.~.l~,9t~!~t~l',~~R.~ ,p./:.9.",.. :'!~(~ . ;....-,. ~ : PNCBANIK. S"UIIM:Cl1lnll. PA Statement - - ]'Ob L C~ . ANNA R MCCARTHV PATRICIA A ALICHWER DEBRA LVNN OTT 4],2 GLENN AVE BOILING SPRINGS PA ],7007-9527 TATEHENT NUHOE~ 51-4003-"3' - NTEREST CHECKING (CONT) tCOUHT NUHIER -- 51-4003-'..5' PAOE ~.~R IORI'!.YJ.Q.f!:..U...L. DAILY ACTIVITY AIl EXPLANATION OF T~ANSACTI0N ACH C~EDIT A S4.317S 0 CSA US T~EASU~Y 3.7 CIVIL SERV 1-13 ACH C~EDIT 201244..IA SSA US T~EASURY S03 SOC SEe CHECK 5422 ~EF' 211.43Z' CHECK 543S REF' 2118.57. CHECK 54Z' ~EF' Z117'415 CHECK 54Z0 REF' Z111177' CHECK 54Z5 REF' zal'05'1 CHECK 5411 REF' za17.a71 1-14 CHECK 5434 REF' 1007063S CHECK 5436 REF' 18074630 CHECK 54Z1 REF' 11173136 CHECK 54Z7 REF' laO'1011 CHECK 541. REF' 10074'54 CHECK 542' REF' 1106.317 CHECK 54Z1 REF' 110'4114 CHECK 5435 REF' 2Z132126 CHECK 5431 REF' 110'lSla CHECK 5424 REF' 1107511' I-IS ACH DEalT 01.072100000 PIIO~ITY 50 PLUS JAN DUES CHECK 5430 REF' 253.5170 CHECK 5432 REFt 251..455 1-0. CHECK 5423 IEF' 2S51305' 1-10 AUTO TRANSFER DEOIT TO 51304074" INTEREST PAYHENT CHECKS AND OTHER DEOITS DEPOSITS AND OTHE~ CREDITS 63..01 OALANCE 1,501.70 172.DO 15.00 zo,OO 3'," 40.00 50.DO 5s.ao 10.00 20." 55.00 n.u U.DO 65.00 112. DO 155.00 170.DO 217'.25 ".00 l,4U.70 541.41 31.3' 100.00 ...0 45.DO .4' 40'.12 St. .5Z 351.U ACCOUNT INFORMATION IINIttUl1 BAUNCE ,VERAOE BAUNCE NG COLLECTED BAL HA~OES/FEES AHOUHT ,HeCKS PUD 'ELEPHONE T~AHSFERS '0.77 5Z5.10 5Z5.1O 2.00 46 o INTEREST PAID TNIS PERIOD IHTERE5T PAID TNIS YEA~ THE ANNUAL PERCENTAOE YIELD EA~NED CAPYEI IS. THE'NUHOER OF DAYS IN TNIS IHTEREST PERIOD IS. THE AVERAOE DAILY OALAHCE USED FD~ THE APYE IS. THE INTEREST EARNED DURING THIS PE~IDD IS. 0.'7 X 33 525.10 .46 SUMMARY OF CHECKS CHECK tMlW 4..2 4'" 4..4 4..5 DATE A!l2llI!I WI! 19.00 12-12 70.00 12-12 55.00 12-12 100.00 12-11 CHECK I!IIIIWI 4'" 4.97 4.91 4'" DATE AII2llllI WI! 110.00 12-12 25.00 12-11 za.OI 12-12 171.DO 12-12 CNECK lMIll& sa 00 5400- 5401 5402 DATE A!I2llIlI lliI! 15.00 12-11 12.47 12-11 11.00 12-10 101.00 12-14 000 3IMlOOO2 A.... 2/V. , TATEHENT HUHIE. 11-4005-"5' ~~~E~.~HEC~I~80~~Tl PNCBANK Sllul""..".I. PA Statement ANNA R HCCARTHV PATRICIA A ALICHWER DEBRA LYNN OTT 4],2 GLENN AVE BOILING SPRINGS PA 17007-'527 :LOb PRIORITY 50 PLUS ----.--- SUMMARV 01' CHECKS .. ",- - - LAST PAlE PUE CHECr. DATE CHECK DATE CHECK DATE tlllIIW AI1llllllI un IlWW AI1llllllI un lMIW AI1llllllI WI! '1405 20,00 12-11 1411 10.01 12-21 5~Z7 ..... 01-0~ 1404 21.U 12-11 I~U 15.00 12-2' 1~21 51.00 O1-n 14.. 7," 12-11 1417 17.2'12-2' 142' ".00 O1-n I~U 10.00 12-1~ 1~18 15.00 01-05 I~SO 51.n 01-05 1~07 ",00 12-21 I~n 40.00 01-04 1451 170.00 01-0~ lua ",U 12-15 IUD 40.00 01-05 nsz 100.00 01-05 140' .,.. 12-20 IU\ 102.00 01-04 1455 20.00 01-05 1410 50,00 12-19 IU2 15.00 01-05 145~ 10, 00 01-0~ 1411 11,0" 12-20 1~2S '.40 01-09 1~S5 155.00 01-0~ 1412 1O.n 12-21 IU~ 217.21 01-04 I~n ZO." O1-n 1415 141.00 12-2' IUS 10.00 01-05 1414 40.00 12-27 1~2' 50.00 01-05 lAP IH VOUR-CHECK-SEQUEHCE 000 3A~ A.v :1'/9.1 UV.UIOIK+ (2,17) J SCHEDULE G ~ TRANSFERS "--~-',~=~-------===~ - FILE NUMBER PtEASE PRINT OR TYPE ______u_ . COMMONWULTH 01 ,!NNSYlYANIA INHIII''''NCI fAX .nUIN IISIDINT ~~~"~I. ESTATE OF -AAUltLB~,;__f),c...J~~_&TH y 1'i9(P - 000 ~9 ,______,_____ THIS SCHEDULE MUST BE COMPLETED AND FILED IF THE ANSWER TO ANY OF THE QUESTIONS ON THE REVERSE SIDE OF THE COVER SHEET IS YES. ----~._. ITEM DESCRIPT NUMBER Indud. nom. 01 'h. ',onl''''', 'Ii ION Of PROPERlY TOTAL VALUE DECO, DOLLAR VALUE EXCLUSION ... Of DECEDENT'S .it ~1It91o rlf(fl/.nt, dON 01 ',onl'.r. Of ASSET _-1m~ INTEREST , -- If:.A ACc..OU1oJT (p 3.~. Ic" I CO';b U 3j~.,~ 8 -2..4-0+ oog "=> AI... t..HWe;'.-: - OAUfrll n: ~ ~Ti - f)/H... c..-14 TCR.. .e Co-o :rq(p Il€(:n.y As 0.. 5 ,c,." AT-e :I Art.IES . - TOTAL 141M ,nl., on I1n, 7, R.capltulation) S ~3~ pt.J(. BANK 'Ff 'f:l.D nUw&F <!'IZ. eE' PAFp_,f..,A o C1?o,:,,~ '" nAN:.r:e fl. PAlO O. B El\lE FI '-' LD- (II MOte 'po<< is "..J.d, ;'11." orl""iono' ,h.... allom. 1111,' l , i . II~UIII..P"11 C)~.~ ~!Jlbf COMMONWEAltH O' PfNNSYLYANIA INHII,tANCI TAX anUIN IU1DlNT DICIDINT SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES . .~ -. PI. a.. Print 0' Typ. FILE NUMBER ITEM NUMBER A. Funoral Exp.n..., B. 4. C. 1. 2. 3. 4. 5. 6. 7. 8. DESCRIPTION 1. M YtrR~- HA~Bn. l"ul'lt!:lU\t.. HoMG C.AfTlPrlll..L- ,PA b I7..I\V661 re' - 1<0 L L I N(i.. G-le.t:c Ai C-eMG rAlt-Y ,;]. 1. . Admlnlltratlv. Co.t., P.rsonol R.p,...nlaliv. Commission. Social S.eurlty Numb., 01 Personal R.p,e.enlallve: Yea, Commission. paid 2. Atlo'ney Fee. 3. family Exemplian Claimant rA'r~IC.IA AI1.r.~ Wim. Relatlan.hlp DAU/,-HTti:R. Address 01 Claimant 01 decedent', dealh Slre.1 Address _':::1.L.2.- b L t::)J AJ A \) ~ City &... .l\.l& SPR.JI\lb-s' Slale PA Zip Cod. 1700ry Probale Feel MI.e.llanlou. Expln.I.1 C.OUR.T Fc:E$ TOTAL (AI,a ente, on line 9, Reeapllulolian) S (If more .paCI I. n..dld, In.lrt additional .h..t. of .aml Slzl,) AMOUNT ~ I c,'t '3 '7Qo 3, sac, 37 . ...11IS1S..". '*' CQMMONWIAUM 01 'INHI'l\W,NI4 .......1nAH(. tu InUIH lIItOI'H'OICIDt"f ITEM NUMBER ~ _..~..,-~--'-"- - -~- SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES AND LIENS Please P,lnl 0' Type FILE NUMBER I ~ ..OOOp e )I DESCRIPTION AMOUNT 'I, </.3:5'. 2.9 1. c'I'7AC- IqCj'f po..,T,AC, 6u",e.I~P I.OAN ~AL.~"'C5" '# SW5'-8'7.1J.aOM~ -1/9'7 #: ofl,ilt- t>>~/- ::Joo.J - ,/~71 -# .:JL/c) 9 - 'No 7 - S'.30't - 15'.3 I '#' St'Y/- 3100 ,. OI7S - ~S9'1 # .r'f.3? - 0<>01 - osz,J'- .;J95'.? #: S.x>1 - oo.rtO - a<!-71 - j''/a3 # lIO I I - o(>;}S - .33S" - tf~1I -p: 0 1.3 7 - ,;)15 ~ - ()':'-dG. - 903 ,tf: '/-,;/U" - 3d'll} - ~i99o -.:)(".30 WE1.J.:, PIl(2Crlt #= Y7tJ(. - 3t..S - <131- 010 f'RCJv'lJIAAJ I3AIl!COI:P' :II' '-I'f.;Jfl- se,o..3- (jOt...o . IllI'7 :r Co Pe.7\JAlt:"V #' (l 7:;1 - ;131:.- 5:1S-1 1'1. L.lAIUJ~ -# 1/l4- .:13.:.-- .lIS' :I. CRtrDlr ~A.eD.s AS,!,'(lc-IA'Tl:S c!. 1 r I I3,qAl.K :rIl.J7'"t~Mt. Crt: c.tI~o (, /'1 cA,etJ 1'7 e L. L.oAJ , IJ J.J c." u G];l. A $.:;0<. L.utlAJ BAAJI<' oAJe rA~",oJ,) IJUI? boA.) 'ra"'; L 04)6 ~ '/, ')"'1. lI:)' l., S''JI, c.i<P (..1" 7c... 77 .:J, 00.!J. IS' 9U.# I, '57. I~ .3, '1.30. 3l.> 1,t.I?~ I, ? 'I? .p'l .;), liS7, .39 :# ~ootf- &"57- 33?()- 7.J?9 ..p:. 0.5'9- rJ?l- /9'1 #" $It.. - 00.::11- O(lOlllJ'7 If. :;00. IV. 3;;19. S::i" I, 9S.3 ..;Jts, 11.;1., '73 J't.. . If.? /POD ,uC"1 TOTAL IAho .nlll on IIn. 10, RlCopllulollon) III md,. .po.. ;. n..d.d, ;n..1I odditiOlJo' .h.." 01 .om. .i.e.' S lI-S 'I 'liP. '10 W cQMMONW'''''" Of rlHN"lVAHIA .......l1AMe. IAI 1,"'1" ."",,H1.,ClMHI SCHEDULE J BENEFICIARIES . ..v.un... (J.I7I fiLE NUMBER ESTATE Of fY)c.. C~ RELATIONSHIP '111 y N~T~~ER NAME AND ADDRESS Of BENEfiCIARY A. T..obl. Bequ..I" I. PAT~IC.IA AL.Il..HWeR.. l..\-12- &LtnvA.J Aver \3..'II.INV '5PIl-Ir-JI7S I PA I-TOQ'7 '117- ,!)4f/- C/'1QO ~\+ 1'\~'SY--I\ll Oe:t?~A oil ~{,.'31 S f'P-1 T\)(r CAIZ-t..I:''''C: I P/"r '7/7' :/sS'- 11'l~~ S":>~ ~o.'.l-SI.D.qD4\ OAUb-I.rr~ Ol\U&l-l''!"'bi?- :;. P_oAO 1,013 ITEM NUMBER NAME AND ADDRESS Of BENEfiCIARY I. B. Chorllobl. ond Goy.rnm.ntol Bequ..t" E>r: ::rOHl\.l e;VAI\lG. e:l-l c:.At. c.l-\.c.Jlt.~K III Wl'\l.rv<.JT' ::'T'R.~'T" 100, '- I rJI.r- oS PP-II\.l(l-~ I Pr-l (t:.t.orHIAJ(" Co/'lr:,', :SII~€-:;) AMOUNT OR SHARE Of ESTATE 311.08 01,.03 AMOUNT OR SHARE Of ESTATE 0)00.>,00 TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Aho .nl., on Iln. 13, R..opitulotlonl S '3 (If more .po.. I. n..d.d, In..rt oddlllonol .h.... of .om. ,1..\ , STATE OF PENNSYLVANIA IN THE MA TIER OF ESTATE OF: ANNA R. MC CARTHY IN THE ORPHANS COURT OF CUMBERLAND COUNTY ESTATEII: 21-9689 STATEMENT OF CLAIM I. The creditor, BANK ONE, COLUMBUS. N.A.. certifies that there is due and owing by ANNA R. MC CARTHY deceased, the sum of ONE THOUSAND NINE HUNDRED TWENTY-TWO DOLLARS AND TIIIRTY-EIGHT CENTS ($1,922.38). 2. The naturc ofthc claim is Visa Curd aceountnumber 4266839999902630 whieh was established on April 6, 1995. 3. nle nume and address of the claimant is: BANK ONE COLUMBUS, N.A., 800 Brookedge Boulevard. Westerville. OH 43081. 4. The name and address of the claimant's agent is: MELISSA A. PERRON. Estate Recoveries, Inc., P. O. Box 24566. Baltimore, Maryland 21214. 5. This claim is not contingent and is not secured by any liens or judgments. The last payment made on said account was made on January 2. 1996 in the amount of $40.00. 6. This claim is not based on anyone instrument. Said balance has accrued since the account was established. On behalf of Bank One. Columbus, N.A.. creditor. I do solemnly declare and affirm under the penalties of perjury that the information in the foregoing claim is true and correct to the best of my knowledge. infonnation and bclief. u~UIYXv f}ve MELISSA A. PERRON Estate Recoveries, Inc. 1'. O. Box 24566 Baltimore, Maryland 21214 (410) 426-9782 State of Maryland, County of Baltimore: IN WITNESS WHEREOF. I hereunto set my hand a~ Notarial Seal . o[$e. LjI,'W. I r-. (;. I?",o/-( ,'\: g Lisa M. Gerke, Notarfpublie ~ '. .: My Commission Expires: September 30, 1996. . HOTA'R!tS~ ~ERKE BALTIMORE c~ N[ Commlaalon IxDl1M lIOP',,"btt :10. tlll- - , - C. : c; ~ ~1~J - l \0 ii, :ot: 0 So )>~ N ,;i:~i;':::~"";;",.;):l:;i~ti~J:} ;;:~:',;. .;~'i;~~1i;.jj:'~?1!!J~11i:tt~;': .' :.;.:;. il(tHE' COURl.OF.. tQ~~pll.. P,L~.A,~ O.Fe\iirii:ie~,l!l~!,i.~.,: P~IIHSYLVA.rH.A.::. ' . .....' '.' '"0 "'.. t' .' . . .' . 'ORPHANS' COURT DIVISION" " . * * * File 110, 21-9689 Estate of Anna R. Me Carthv -' Deceased * " " !lOTICE OF ClAUI by, Bank One, ColumbUS, N.A. Filed Pursuant to Section 3532 (b) (2) of the Probate, Estate, and Fiduciary Code, 20 Pa. C.S.A. bS32 (ll) (2), , To the Clerk of the Orphans' Court Division: Enter the clai~ of Melissa A. Perron, Agent for Bank One, Columbus, N.A. (Claimant) in' the amount of S 1,922.38 , against the above entitled 17007-9527 (city) 1/3/96 at 412, Glenn Avenue Street Address " ., . Cou n ty , Cumberland ng Springs, PA estate. ihe Decedant, ~ho resided . '. ( Date) \lr1tt~n not; ce Pennsylvania, died on " of s~id claim ~as giveo to Deborah Lynn Ott and Patricia A..Alichwer C~Personal Represent~tive, or If known to chim^nt, at 2681 Spring PA. 17013 his Counsel) 41i Glenn Avenue, Boiling Sprongs, PA. 17~Oon ~p 6, lQQA: . , (Address). . /J (Date) .. (;VVl.uvY.uu {?VL- ,C I! I ma n t Melissa A. PerrQn, Agent .. P.O. Box 24566, Baltimore. MD. 21214 (Address) . , Claimant's Counsel: (Address) - FLU UISA CLASSIC 01'01'1996 0000000 IAHK CA.D DIUISIOH COLS 0" 43271-0556 _______e.._________________________________________._ IH,v A44~..., Pi.... .,.Int .ftl~ ,~. nlv !Itr..' Iclt~..tlt...I. 't.,.,~.".1 J 'fer 'n'ern,t,on., 144r... ,nly I I.,,,n',....,.,... c... 'nfl"l.tlo".I , -' , , , ACCT HI. 4266-8399-9990-2630 "f. ~., 'I.J62.38 ,.~ 4~' 4... JI"u'r~ 1. 1996 "In I..un' .0. '39.00 ..----------.---.-------------..------------..------. AHNA . nCCARTHY 412 CLEHH AUE 10lLINC SPRCS PA 17007-9527 IAHK ONE P.O. 10K 182158 COLUnlU5 OH 43218-2158 UHIIED SlATES or AnERICA ------..------.-....----......---- , ft..vn' .,....... t , ____________________________._.M__ n.,. chIC" ,.~'~I. t. I lANK OHE Acc, .~. 4266-8399-9990-2630 5"'..'n' .,t. D....~.r 7. 1995 P.,I 1 .f 2 " C..." II... '2.000.00 . Cro.I' .~.It.'t. '37.62 ,.~ 4uI .1', J'"u'r~ 1. 1996 "In I.."n' 4"1 139.00 R..,"'" Iu"'rt" ---------..----------.------------------------------------------------------------.------------.--- pr.v"v, III.Unc. -Oth.r .'urch.... I tr... '~4 cr..", c"h '4v.nc.. '.Ju"..~t. 'rJ"AHCE CHARCES .H,. ~"'""c' -,..,..n'. --------------------.------------------.--.-------------------------------------------------------- 11'.nc. It curr.nt rlt. 1975.23 0.00 0.00 27.15 1962.38 40.00 0.00 --------------..----------------------------------------------------------------------------------. 1.tal 1975.23 40.00 0.00 195Z.38 0.00 27.15 0.00 Ou.. t ..~., cllll ""It.1 -.--------------------.----------------.--.-----------.-..-.--------.--.---....--.--------.-..----- Cu.t...,. ..rvlc. 1'800-945-2026 TOLL rREE I.~. C.". R...."ch '....rt..n. aSS] c.I..... OM 43271-0553 -----------------------.--------------.---------------.-------------------------------------------- Lo., ." .tol.~ c.r. 1-800'945'2026 lOLL rp.EE T.I...h.~'n, ulll not 'r...,.v. rov" ,.I,~t '. 41.~v'. _lllln, .,.,..,... S.~. ~lllln, In_ul,.I.. .n. c,...lt .....~c. ,..fv~. ,...v.." to tho Cu.,..." S.,.vlc. ...,.... ._.v.. cu,.,..~, t"'~"ct,.~, --.---------..----------------------------.----.------__e. _____________.__._.__.______._________.__ ''''~'IC: tI O~ 4... ,..tI~J .... A..",~' D..crIO'IOft --.-.------------------------------.---.-.-----..----.---------------.-.------------------------..- 11120 11 '20 PAvnENT . THA"~ yOU LI2165324011 H OOOOOOOAIAO 00000010000002UUT021 100010o~~ '~O.DO FLEX' UISA CLASSIC 01'31'199&' 0000000 IA"K CARl DIUISIOX COLS OH 43271-0.56 ...-..-...-.----------------.--.....----..-...---..-- ,",w A44r...? ,..... prln, 'nl~ 'he n'M "'1"" ICI'''''''''.II. It.I.,h.ft.. t "01' 'nt.r"""~'1 144..... .nlp '..~".r~.'..t.l ..4. .nf.....'....., , , , , , ACCT "IR 4266-1399'9990'2630 "t. ~., 11.949.17 ,.. 4.. 4". J...... 31. 1996 nl" I..~"t 4". 'JI.OO ---------.-.-----...----------------------...------.. ....---------.--..--.--........... ANNA R nCCARTHY 412 CUN" AUE 10lLINC 5PRC5 PA 17007-9527 lANK ONe '.0. lOX 11215B COLUnlUS ON 4321B-215B UNITED STATES or AneRICA , A..vn' ."...... . , ------............---..-...-----.. n... Ch.c.. .1.,..., t. I lANK ONe Aee' ~~. 4266'1399-9990'2630 St",.,n' .It. J'ftVI..., I. 1996 P... I .f 2 C'.41' '1.1, 12.000.00 Cr.." IVllla,., 150.11 ,.., 4". .It. J.nUlrp ll. 1996 ftlft a'."n' 4v. '38.00 A...,,,,, ."......, ........----.....--.---.....---.................................................................... P.....,.". .au..c. .Oth.r 'P~rc~a... a 'r... aft~ C...4'" ca.h a~~l..C" a4JU"..ftt. 'rlMAftCr CH~RCe5 eft.. ~'I'.e. .Ph...... ................................................................................................... .a"..e. a. Curr.... ral. 1962.]8 40.00 0.00 0.00 0.00 ................................................................................................... 27.49 1949.B7 1...1 1962.3B 40.00 ..on 1949.17 0.00 0.00 27.49 0"'...,.... ') (II' . ...rl'" ................................................................................................... c"'.t....,. ..,...Ic. 1-800-945-2026 TOLL rRee II.., C.,.~ R"'I"c~ 'l,.'r h.", 055) ..1..... OH 43271-0553 ................... .............................. ............. ...................... t~.. ~,. "~t... .~"4 '-800-915'20Z5 lOLL rRrr f.I""..,.., ...111 ..., P,....r~. ~.",. ,."" " 41.p...t. .,.. .t~ '''''0'',. 5'''4 ~t'II.., ....~Irl.. .... cr.." .'I'"C' r"u"4 r..v..,. .. .~. ~v.'~..~ 5'''~lc. ...,.... .~.u.. C",.,...., '''a"":,,,~. ................~................................................... f,.....actr... .... ,.",... .... ........................ D..,. .... '... ...................... ............................................................ "..vn. IlI.O~ lil'll: 'H'("i,-: . Tn",... \',U; L I16S50nl57 " ~~~~O~OH..~ OOaOaOIOOaOOO:~~;O:1 laOaIO.~~ ........................ .~O.uO ..i;."...;.,-;"d:..;... ;,;...,,~._.........<;.l ~ . . , ... ,..c 1'1 . ,..c U 1'1 :z: H +l d Ql CI .c .., , s: III " III ... HID ), ~ID \.I 1'1 IIlL"l" 1'1 >v:c 0 ON c:l U ' I C4X.GJ...~.. ~ 0 \.I .... I!l 0 ... III IS EoC ,.,.c ""'" .cO.&) 0 Eo< ... ,..c III . rl '<l" IIlIl<R ..... I>: III s: d .c , C o ... ... Ql ~ ClI CD III ClI I ... 1'1 .. '" o III Eo< r.: Eo< tJ . .c III III Ill, or! ...t Ql X :c H ..: t-l u , ... , . .' , .. , t. " , , :' , '" .. . " .', '~..:i:'l' .'. . . :.~' J ;..' . . .~. ".' . t' ~..~ ;';". .'.';' ... . ...... . .' ~.. , , . ~.~. ...' ." .:....:... ~.,. . ,.o. :...,p. : '. .: ..... '." ........ ..:1'....\",.'... 't ....(..... :.' ," ; " .. " '" " . : r I" ...... ., .:.... .'t, .. f '. ~. .. . ....~ : " . 'P. .. ",~, CERTIFICATION OF NOTICE UNDER RULE 5,6(a) Name of Decedent:~A u-- VM'-C~ C'f\<t(l rutt~'--I \ Date of Death:--.J- ~'Cl", Will No, \C\o.Lo -~9 Admin, No, To the Register: I certify that notice of beneficial interest required by Rule 5,6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on Name ~ l,,~~ DIl' ~(~o...C\........... ~(~_k~ Address 'dL,~ I \..\\~ ~\1'-o. ~J, C' 0->-0.:' OD }6'-\l~ Qu.-Q. ~;"l),,:, ~ ~..,,~ 'b " Notice has now been given to all persons entitled thereto under Rule 5,6(a) except Date: 5-Q.-~1o Qlh'-~~ 'gnature ' ~ 5~ 0$ - .. N I:" l\} ~;: 5: ') . .~i'$ "08 c. '0 0\ -n I , 1? ~'-: ~ <.j . ~ . t;.::, ;..., ~'g) " .0 ~ =E a: a: ~c3 Nam~(\. L'\~~ D\T Add ress d..~"t.\ 'S,~"'\ X. d C'o...\\...\~. ~"'- nQ\~ Telephone(l\; ~'::,~ "?,9d.:S capacity:~ Personal Representative Counsel for personal representative , ....(~ 0 5~ - - .. :3 ~ o~ N ,~~ 5: J.8 ;r.:_ 0\ ~'O Co I (I': ~, .. ~ 'l':! ='-;: '2 ,Q) 0" :~~ fr~ ~ Qj GJa: 0 a: .. h'" PIMPDU <IF MOTlCEI PA'ntDfT1 RDlICD(CAh nn :-: 1:.1 To fulf1ll the requlr..-nt. 0' Section 21~O of the l~r1t~. ~ [.t.t. Tax ADt, ADt 22 a' 1"1. (72 P.I. Saotlon 21.0). Oatec:h the t.. portion of thl. Natlc. ~ S\M1t with your paYNnt to the A....ter of MU" pr1nted on the raveI'll .Ida. __ MIlk. chKk or NMY o"'r payabl. tDI RECISTER OF MILLS, AG[Hf. AU p.~te rec.lved shaU flnt be applied to ...., Int.....t which .., be dua, with an)' r_lndar applled to the tax. A r.fund of I tax credit, which .... not r....tlld on the tex raturn, ..y be r....tad b, c..,l.tlng en .Appllc.tlon far R.fund of Pann.,lvenla t~rlt~. ~ [stata Tax. (REV-ISIS). application. '1'. avalllbla .t the Offlca of the A..I.tar of Will.. "" of the 2S Rev~ D1str1ct Offlca. or b, call1no the .peel.1 2~ohour ",....rlng .arvlc. nuebar. far far.. orderIng. In Pann.,lvenla l-100-36Z02050, out.lde Pann.,I","I. ~ within loc.l Harrlsbur. ar.. (717) 7'7-1094, TOOt (717) 772-ZZ5Z (Klarlno 1.,.lred Onl,). DlJE:CTtDHI. An, p.rt, In Intlr..t not ..tI.fled with the -..pr......"t, .Uowanc. Dr dl..Uowanc. of deduction. or ........,t of tax (lnoludl.... dllCount or Intar..t) a. thowt on thl. NoUc. A' abJIGt within .lxt, (60) da,. of rKIIl,t Df thh Natlc. b,. uwrlU.., prata.t to the PA Dep.rt.."t of .Ivanua, laard of Appel", Dept. ZlUn, Harrlsburl, Pi 17UI-1Oll, OR ...lecU.... to have the AUar detar.IMd .t the ..It of the IICCount of the parlOftll r...r....,teUv., OR .......1 to the Orpt\ln.' Court AIIIIIN- IITRATlVE CDIIII[CTlDNI, DI1COI.IfT1 PDULTYI INTtREITI Fectual .rron discovered on thl. ........,t should be -sdr...ed In wrltlno tOt PA o.,erteent of Ravenue, lureeu of Individual T...., ATTNI Pa.t A....l8Int Aevl.. unit, DEPT. 2'0601, Harrl.burg, PA 171ZI-0601 Phone (717) 717-6505. See P'" 5 of the bookl.t .In.tructlon. fDr Inhlrlt~. Tax ..turn 'or a R.sldent ~t. (REV-1501) far en .xpl~tlon of edIlnl.trat1v.ly carrectabl. .1'1'01", If an)' tax dua h paid within thrH (J) c.lllnder eontha .fter the dlcldlnt.. de.th, a fill" percent (n) dl.count of the tax p.ld I. .llowed. The in tax __.t, non-pa..tlo1p.tlan penaltY .. CNPUted on the tot.l of the t.x ~ Int.r..t ......ed, ~ not p.ld befa... Janua.., 11, 1"', the flnt da, aft.r the ... of the t.. ..,..ty pe..lod. Th" non-partlclp.tlon ,.,.1\), h .....1.1. 1n the ... ...... ~ In the the ... U_ paf'lod .. 'ou would .....1 the tax ~ Int.....t that has bHn ......ed a. Indlc.tad on this noUe.. Inter..t h cherlld betlmlng with flnt dII, of dallnquenc" or nlM (t) eonth. ~ ana (1) dII, fl'. the data of ....th, to the dllte of p.yaant, Tax.. which bee.. delinquent be'ar. J.......r' 1, 1"2 be.r Int.r..t It the rat. of .1. (6%) p...cent par ~ ealcul.ted .t . d.ll, rat. of .000164. All t.... which bee... delinquent an or .,t... Janu.ry 1, 19.2 w111 bI... Int.....t .t a rat. which will VII" frOll c.lendar y..r to calendar va.r with that r.t. announced b, thl PA o.,.rt.-nt of ..vanua. ThI appllcabl. Int.r..t rat.. far 1..Z through 1'" .ra. y.a.. Inte,,"t Rat. Dalh Int.rllt Factor y.a.. Inta....t R.t. Dalh Intlrllt Factor 1917 'X .DOOl47 .,g-I". lIX .DODSOl 1"2 tX .DOUU I"S-l994 n ,000192 1"5-1'" tX .DOUU In2 19l5 1'" un 1916 ulntar..t lOX In lIX UX lOX II calcul.ted a. ,OD0541 ,000451 .00DS01 . DODS56 .DOOl74 follow.. INTEREST . BALANCE OF TAX UNPAID X HUKlER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Hatlc. I..uad .ftar the tax blcOll. delinquent will r.flact an Int.....t ealcul.tlon to fl'teen (15) da,. beyond the dIIt. of the ........,t. If p.,.."t .. .... .lter the Int.ra.t cGIIPUtltlan dIIt. thawl on the Hatle., eddltlanal Int.ra.t au.t be c.lcul.ted, ~~ ~ CT " Cl ~ C'"J U .... N Cj r ( :J:l c N :O~ 0 :P::l U1 :Dill' .1) 0 <<.:..'0 _..~ ~l S! l' '.. " (' '.;" '. ~(v <nO ~ PIMPDU <IF NOTICE I To fulfill the requlre..,,1a of Section 1140 of tM Inh.rltllnCl Met Est.t. ... Ict, Act ZZ of 1991. (72 P,S. Section 21UJ. P'\'IENT I DetHh the top porUon of this Natlel ~ ,ubIIlt with )lour PIYHnt to the R'llshr of Willi prlntlld on the ,....,.. .Sde. -- .... check or IIOnIIW order ,Iyebla tal REGISTER Of' WILLS, IctNT. AU ,.penh received ,hell flrst be eppllltd to ....y lnt.rnt which ..y b. due, with MY ,...1", .pUItd to thll tn. RUUND (CA)! A r.fund of I tax crildlt, which .... not r.....ted on U. ta. return, ..y ba rilCl'Mltect by cHIIlatlne .... "&PPllcaUon fa, Aefund of Penn.wl"'....I. Jnher1t~. ~ E.tata T.... (REV-IJI}). applications .r. avallebl. at the OfficI of the _..I.tar of Willi. ....y of the 21 A.v~ District Offlc.. or by cIlllng the special I.-hour .....werlng ..rvlc. nu.ber. 'or for.. ordering I In Penn.wl"'....1. l-IOD-J6Z-lD50, out, Ida Penn.wl"'....S. Md within locII He,rtabur, .,... (717) 7a7-IOlM, TOOl (717) nt-tn! (H..ring I....lred Dnh). OIJECTIONSI An, p.rt, In Int.r..t not ..tl.,led with the ~r.I..-.nt, .llow~. or dl..llow~. a' deduction. or ......aent of t.. (Including dl.count or Int.r..t) .. ahown on thl. Not1c. .., .ObJ~t within .I.t, (60) 41,. of r~.lpt of this Motle. b,1 --written prat..t to the PA Dep.rt.ent of R.v~. la.rd of App..I.. Dept. 211021, H.rrllburg, PI 17121-1021. OR --.l~tlng to hey. tM ..tt.r dIIt.r.lned .t the audit of the ~caunt of the perlONll npr....,t.tlv.. OR --."..1 to ~ Orphen.. Court AllIUM- ISTA.TlVE CORRECTIONSr hcw.l .rrars dlscov.red on this ........,t should be eddr...ed In writing tar PA Dep.rt...,t of ..venue, lur..u af Indlvl~1 Tax.., 'TTNI Pa.t ,.......,t R.vlew unit. DEPT. l,0601, Herrllburg, PA 111ll-0601 Phone (717) 7'7-6505, See pea. S a' the bookl.t "In.tructlon. for Inhlrltenc. ,.. R.turn far. R..ldent Decedent" (REV-1501) far an .xpl~tlon af ~Inl.tr.tlv.l, correctable .rrar.. DISCDLWT I If .." t.. due I. p.ld within thr.. (1) c.lendar -.nth. aft.r the dec.dant'. deeth, . five percant (5~) discount of the t.. p.ld 1. allowed. PENALTYI The 15% to ..,..t, non-p.rtlclp.tlon penalty Is caaputacl on the total of the ... and Int.r..t ......ad, and not p.ld ba'ar. J....ry .1, I"" the flr.t 41y .ft.r the and of the t.. MnI.ty perlDel. this non-p.rtlclpatlon penal ty Is .....labl. In the ... I."",.r and In thl the .... tiN period a. you IitOUld ~.l the tax and Int.r..t tMt has bMn .....tad .. 1ncll~tad on this noUu. INTERfSTI Int.rut I. charged e.g1,.,lng with flr.t de, of dellnquMCY. or nine (9) Mnth. and one (1) d.y fraa thl deb af de.th, to the d.t. of peyaent. T.... which bee... delinquent ba'or. JMUlr, 1. 19l1 ba.r Int.r..t at the rat. af .1. C6~) p.rcant per ~ c.lculated .t . d.lly r.t. of .000164. All t.... which bee... dal1nquant on ar .'t.r January 1, 19.1 will be.r Int.r..t at a rata which will v.ry fraa c.lendar y.ar to calendar ,a.r ..lth that rat. arnounced by the PA Dlpart.."t of R.venut. ThI appllcabl. Intar..t r.t.. far 1912 through 1997 .r.r V.ar Int.ra.t Ra" D.lly tntar..t factor V.ar tnt.r..t Rat. Dalh Int.r..t factar 1982 lOX .ODDS41 1917 'X .DoOln I9IS 16X .0DDUI 1911-1991 IlX ,OOOJoI 19" IlX .0OOSOI 199. 9X ,DoOlU 1915 I>X .ODDlS6 .99)-1994 7X ,DoUtz 191' lOX .0OOZ7. .995-.997 9X ,OOGZU ulnt.r..t I. calcul.ted a. foUawu INTEREST . BALANCE OF TAX UNPAID X HUftBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR "Any Notlc. ...ued .ft.,. the ... bacON. delinquent ..Ill r.Uect .., Int.r..t calcul.tlon to flft"" (IS) dtir' barond tM dtit. of thl ..........t. 11 p.rMI't Is aade .ft.r the Inter..t caaput.tlon data shawn on thl Notice, eddlUanal Int.r..t MIlt be calcul.ted. pUll OF XNIlIVIllllAL TAllES IIIDlTNOCIlAX DIVIIIGII IPT, u"'l -'_, PI 171U-'''1 IS-- cSl-l).. COMMONMIALTH OF PINNSYLVANIA DIPARTMINT OF RIVINUI INHERITANCE TAX STATEMENT OF ACCOUNT ~- .._"0 D ." 'U"', DAT! lZ-16-96 UTAT! OF MCCARTHY ANNA R DAT! OF DIATH 01-03-96 FILl NUMlIR ZI 96-0089 COUNTY CUMBERLAND DEtRA L OTT ACN 961ZZ584 Z681 SPRING RD [ _t R.1Ueel J CARLISLE PA 17013 MAKI CHICK PAYAIILI AND RIMIT PAYMINT TOI REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 11013 IllITE. To 1n..... p..-er 0.....1t to your _tt ..-it the _r pOrUon of th11 fa" .ith your tllC PI~t, CUT ALONG THIS LINI ... RITAIN LOMIR PORTION FOR YOUR RICORDS ... ...,;I60'-;;r;;.,r;:i6r--=-i...""'Nlif.-,,;r;;";;;;oii-,.-.---...----------------- ..TA" ,,_RTHV "" R "" NO-" ,,-00" "" ",,,... .." U-16-" THIS STATEHENT IS pllDI/IDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACIl IH THE tWIED ESTATE, sttoIIlIlELOlI IS A sutlARY OF THE PRlIICIPAL TAll DUE. APPLlCATlDll OF ALL PAYI1ENTS. THE CURRENT IALAIlCE. AND. IF APPLlCAIlLE. A plIO.lECTED INTEREST FlIlURE, DATE OF LAST ASSESSMENT DR RECORD ADJUSTMENT. lZ-09-96 PRINCIPAL TAX DUE. PAYMENTS (TAX CREDITS). DISCOUNT (+) INTEREST (-) ,00 AMOUNT PAID 36,60 PAYMENT DATE 01-Z9-96 RECEIPT NUMBER M146S66 TOTAL TAX CREDIT BALANCI OF TAX DUE INTEREST AND PEN. TOTAL DUI . IF PAID AFTER THIS DATEt SEE REVERSE SIDE FOR CALCULATlDll OF ADDlTIDllAL INTEREST, I IF TOTAL DUE IS LESS TtWI 11. HO PAYI1ENT IS REQUIRED, IF TOTAL DUE IS REFLECTED AS A "CREDIT"' ICRI t YDU HAY IE DUE A REFUND. SEE REVERSE SIDE OF THIS FORK FOR IHSTRUCTIONS, I 36,60 36.60 ,00 ,DO ,DO . ReCO:U0:J "!''':' or REJ(J!',I(.~ ( Wills "96 ole 30 AID :33 C/e//.,. " . Cu b "' ,.u.JII m 1;"1.;,:(; Co" PA NY!DT. Dlt8ah the tap porUon of thl. MotS.. ... ...It wUh rout' ,.,....t .... ""11 to tM ~ ... ........ printed on U. rwer.. ,.de, .. If IUIIlOII DEaIIEIIT .... _ or _ o_r _I. to. REllISTER Dr VILLS, AUNT, -- If IIllN-RDllIOlT IlECDOlT.... _ or _ o_r _I. t.. ~EALTH Dr rE_YLVAIIIA, All _to ...1.... ...11 bo _lIod IIr.t to ... Intoro.t "'I"" _ bo .. vltto ." ...1_ _lIod t. tIoo tole, RE7\III (eI). , rtIfvld of . tax .....1t. ...,loh ... not ~.ted on thI lID 1etW'n, __ be ,.....bd bJ' ....t.tan. .. -"'1I0Itlan tar ltaf\nd of Pwwt"I.,.,11 Jnhtrlt.no1 .... [Ibl, T..- ClIEY-UI!). .,.1I_tlan..,.. .wlll".e It the aff1_ of the "'l,t", of 111111, ..., .f the D A..,.,.. Dlltr!.t Off1.1 or ,.... the .......'-'t.. "~ InMMl'ltw ..,..1_ ,....,.. for forw. 0,.,,1,..1 In Penn.,lnnl, l-I".S62-IIII, auhlde PennlYlwnll Inlf .,1V'l1" 1..1 Hllrrl~ .,... (717) 7.7.IIM, TUD' (717) 771"'Z151 (...,.1"11 1.....1..... on"). REPL' TOI au.lt1on. "".MU", .rron oontllned on thll noUN Ihould be 11III,....... tOI PA Dap4rt.wlt of R~, ........ If Indh,.dua. ,...., Ami Po,t A.....,t Rev1_ Unit, Dept. 01601, "'rrhbu,.., PA 17111-0611, phone 17171 7'7-'"1, DIICCUtTI If ~ tu ... 11 ,.Id ..1U\ln thrM (J) 0111....,. ~U\. .fur the ~t'. dalttI, . flVII ,.....,t (IX) d1....,t of the ta ,.ld 11 .11..... PPW. TV. n. lU tu: __dy non-,.rUal...tlon ,.,.lb 11 ~ted on the total of the to 8nd 1nt.rllt .....IId, ..... not paid befon ...ry II, 1"', the flr.t dq .fhr the end of the t.. ......tv per1od. 11IlDDT. Inbr..t 11 Clh8rwlId beIIlmll'll tdUt flnt _ of dell~, or nl.. (9) 80ft"'. ... .. (1) _ f~ the .ta of _Ut, to the dot. of ~t. T.... wdch bee-. .l1".,.,t t.fo,.. .......ry 1, 1HZ bear lnto,...t .t the rota of Ih. (62:) ,.rcent per ...... C8lcul.tld .t . da1h r.t. of .01I1M. All t.... which ..... dllI.......t on MIl aft.r ........., 1, IMZ ..Ill beer Inhrlllt ot . rote Wllch "Ill \"IN ,~ ~l""r veer to _1...... VMr ..1'" thet ,..\8 ~ by the Pi Deperw.nt 0' ...,..... The ...11_11 Inton.t rot.. for 1HZ thrOUIh I'" .r.. Y- Inter...t Rato Dl111 Int.r..t ,..tor YlOr Int.r..t Rat. 01111 Int....1t r..tor I"Z III ,...SU 1"7 tX ....Z47 1"5 161 ....411 1'"-1"1 IIZ ...UOl 1'14 III ,"0511 I"Z tX ,...247 IHI ISZ .11.156 1"5-1994 n .1I11t1 1m 101 ,...214 1"1-1"7 n ,...147 "olnt.,...t I. coloul.tod .. fall.... IIlTEIEIT . UWCB OF TAll UllPAID X III/DEII OF DAYI D!LIIlIIUEIIT X DAILY IIlTEIEIT F&CTDI --Any Motloo 11.... .ft... tho till ..... dllI,..aMt ..Ill rlU..t on In'.r..t alouloUon to flfteM ClI) _. ber<<d the ..... of tho .....~t. If ~t I. ..... .ftor tho Inb,..d ClOIlIIUtatlon dlt. .... In tN Mltloo, ..Utl_l Intonlt ...t be _l.,l.t.... . /6- sl- (:)- * c... COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ''''REAU Of INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. "0601 KARAtSIURa. PA 171r'.D"1 INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS DAT! ESTAT! OF DAT! OF DEATH FILE NUMBER COUNTY SSN/DC ACN IU_IIM II ." cu,'" PATRICIA A ALICHWER 412 GLENN AVE BOILING SPRINGS PA 17007-0000 12-18-96 MCCARTHY 01-03-96 21 96-0089 CUMBERLAND 208-24-4008 96122383 _t R.lttod ANNA R MAKE CHECK PAYABLE AND REMIT PAYMENT TOI REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ..... ---------------------------------------------------------------------------------------------------------------- REV-1604 EX AFP (12-96) MM INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS MM DATE 12-18-96 ESTATE OF MCCARTHY ANNA R DATE OF DEATH 01-03-96 COUNTY CUMBERLAND FILE NO, 21 96-0089 ADJUSTHENT BASED ONI S,S/D.C, NO. 208-24-4008 ADHINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION ACN 96122383 FINANCIAL IrlSTITUTIONI PNC BANK ACCOUNT NO, 5140039639 TYPE OF ACCOUNT. () SAVINGS (X) CHECKING ( ) TRUST () TIHE CERTIFICATE DATE ESTABLISHED 04-01-69 Account Bdence Percent T.xeble X Amount Subject to Tex Debt. end D.duction. Texeble Amount Tex R.te X T.x Due .00 0,166 ,00 ,00 ,DO ,15 .00 NOTEI TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER'OF WILLS AT THE ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE Tal "REGISTER OF WILLS, AOENT." TAX CREDITS: PAYHENT DATE DISCOUNT (+) INTEREST (-) RECEIPT NUHBER AHOUNT PAID TOTAL TAX CREDIT .00 BALANCE OF TAX DUE ,DO INTEREST AND PEN. TOTAL DUE . IF PAID AFTER THIS DATEt SEE REVERSE FOR CALCUlATION OF ADDITIONAL INTEREST, I IF TOTAL DUE IS LESS THAN .1, HO PAYHENT IS REQUIRED, IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YDU I1AY BE DUE A REFUND, SEE REVERSE SIDE OF THIS FOIlll FOR INSTIlUCTJOHS.1 .. . PAY't€NT1 Qetech the top portion of "'II Hatlce w.d ~It ..lth your p.pent ... pa...le to the n-. w.d -'dr... pr lnted Dn the raw,." ..de, ..- _. cMck or ......, a....,. pllnbl. tal REGISTER OF WILLS, AGENT. All p.~h r.eelv'" ....11 be ...Ued ftrst to .,y Int.r..t liIhlch My be du. with MY r..lndlir 1IPP1Ied to thII la. AEf'UND (CAh , raf\nl of I tax credit, tlh1ch .... not r~.tlld an the Tax .eturn, .-y be r.....tect by ~l.tlna ." -AppllcaUan for Refund of Pennnl.,.,la Inherit.... WId hlat. Tu. eREV-UUJ. APIIllCIUanl '1'" ""."111, at the OfficI of the _..llt.1" of Willi, Iny of the ts R.v~ Dlltr1ct OffiCI' or fr.. the Dep.rt.ent'. 24-hour ....rlntl ..nice ".,..n far far... ardrlr'lnlll In PennlYlv.d. l-Iao-UZ-USI, out,.. '.....'1".,,1. 1M ..1"'1" 10Clll Herrlsbur. '1"" (717) 7.7-"M, TDOI (711) nz-ztsz (....rlng 1..lred anb). . REPLY Tal QuesUon. nprdlna .rrars contained on tnl. notice ItIoUld be eddr.... tal Pi DeperbMt of A~. Bur... of Ind1vl~1 ,...., ATTNI Polt ,.....-ent Rev1ew Un1t. Dept. Zlo'Ol, Harrisburg. Pi 17121-0'01, Phone (717) 717-6515. alSCDLlf'h ~f MY tu .. I. peld ..lthln thr.. (5) cal__r ..,thl aftar the declldent', Hath, . flw per,*,t (IX, dllCOU't of the tax peld .. .UCMMld. PENALTYI TM 15X tax .....ty non"perUolp.Uon ,...1 ty .. eGIIPUt... on the total of the tax WId Int.r..t ......., snd not peld befar. J....ry .1, 1"', the flnt dQ aft.r the snd of thll tu ......ty ,.rlad. 11fTDUT. Int."d .. c:hsr.... ....Imll'll ..lth flnt dQ of .U~ or "1M (t) ..",th. WId ..... (1) day frOll the clst. of dMtn to the det. of ~t. Tu.. .....Ich bec_ deUnquMt billa" Jsnusry 1, lnZ bMr Int.r..t .t the "t. of .hI (61) perCMt per .... caloul.hd .t . dslb nt. of .000164. AU tu.. Wllch becMs deUnqusnt on If'Id .ft" Jenulry 1, ltlZ ..111 besr Int.r..t .t . r.t. which ..Ill v.ry 'rOIl calsndar y..r to e.lsndar y..r ..lth that r.t. ~ by the PA Dsperbwlt of R...,.,.,.. TM ..".Ue_l. Int.r..t r.t.. for Ita' thraugh 1"7 .nl V..r Int.r..t A.t. O.lly Int.r..t FlOtar Y... Intlr..t ht. O.11y Int.r..t FlOtor I'll lOX .000S41 1'17 'X .GOun l'U 16X ,00049 1'....1"1 IlX .00OSOl It" IlX ,ODOSOl I"Z tZ . nun 1915 ISX .OOOSH 1"5-1'" n .GOOl9Z I'" lOX .00U74 1"5"1'" tZ .GOOZ47 "-Int.r..t I, calcul.tld .. fOU....1 llITEIEIIT . BALAllCE OF TAll UllPAID X IlUIIIIEI OF DAYII DELIIlQUEICT X DAILY llITEIEIIT FACTOR __My MoUe. luUld .'tlr the tax becoM. dlU"....t ..111 nft"t In Int"..t e.lcubUan to flft"" (5) diy, beyond the dIIt. of the .........t. If P'JMf\t Is .... .ft.r thl Int"..t ~t.Uon clst. showI an the Notice, eddltlansl Int.r..t .u.t be calcul.t.... . PAYMDn'1 o.tKh the t.. portion of thll Notloe Md ....It ..lth your pa)'Mnt ... ~la to the ,... Md .scIn.. pr1ntMt on the revere. a1de. -- ...... ..- or -.0' ardor p.....I. to, REDISTER OF WILLSt ADEKT, AU ,.,....t. received ..11 be ..lied flnt to env lntar.1t .....Ich ..v be due ..Ith env r_Inder ...lIMt to the tp. REF\ICD (CAh A r.knI of . tu credit, .....Ich .... not reque.ted on the ,.. Raturn, .-y be r...lted by coeplatll'll en """,UC8t1on for Raf\n:l of PerrI.,lnnl. lmerltence end E.bt. ,.... (Rf:V.UU). ""'lIatlona er. nellebl. at the Offloe of the R..1.tar of N111., env of the 15 Revenue D1.trlct Offlce. or f~ the Depert8ent'. Z4.hour an...rl"l ..rvlce nu.ber. far fa~. ordering I In Penn.,l"",la l..II.36Z.ZISI. out.1de Pann.,lnnl. ... .,lth1n lGCIII Herrl..... ar.. (717) 7.7".OM, TDD' (7171 nz...zzsz C....rl,.. 1..1red anl~)._ REPLY TOI eNtation. ~rdl"l .rran contll1ned on thll notlce Ihould be addn.Md tOI PA Daper~t of RevrMue, aur... of Indlvl"'l T...., ATTMI Po.t A....~t Rwl... Unit, Dept. ZII'Il. Harr11bur1, PA 1712....0611, Phone (717) 717.'SDS. DIICOIMTI ~f any tu ... .. paid ..lth1n thr.. (S) calendar IIOftth. aftllr the decedent-. _th. . flv. parnnt (52) discount of the tu paid 11 .Uowed. POCAUYI n. IlX tax ..,..tv non.partlolpatlon panel tv la COIlPUted on the tatlll of the tax end Int.re.t .......... .... not paid before .....1")' 1.. 1"'. the flnt day aft.r the end of the t.. ..,..tv per1ad. 11f1DEST. Inter..t 11 ctwread ....Imlng .,Ith fint day of deU~ or nIne (9) .......,. and one (1) _ f~ the date of _th to the data of p~t. T.... .....Ich *- daUnquant before January 1. 1HZ bHr Intar..t at the nt. of .1. (0) percent Pet' ..... celculatMt .t a dally reta of .laol64. All tax.. which *- daUnquant an end .fbr ........ 1. 1HZ ..111 bHr Intar.1t at . nta whlch ..Ill vary fro. cal__r y..r to call1ndl1r year ..lth that r.t. snnounced by the PA Oeper.....t of A..,.,..".. The appUCMI. Int.n.t nta. far 1HZ through 1"7 .rel Year Intara.t Rata Dally Jnt.r..t rector Voor Jnt.n.t Aat. Dallv Jnt.r..t rector ItIZ ,"X . aaoS41 1917 'X .OIUU IHS 161 .nlOt 1'11-1"1 llX .0lnOl 1914 llX .nnll 1'" 9X .OUZU 1"5 15% ,001556 1"5-1'" n .00019Z 1.11 10% .IIU74 1"5-1"7 9X .IGUU "'-Int.ralt 1a calcuJated .. follow'l IIlTEIIElIT . "WCE OF TAX IIIIPAIO X HVKIER OF OAYS DELINQUENT X DAILY IIITEIlEIIT FACTOII --Any'Notlce 1.aued .ft,r the tu ~a dllJ~t ..Ill r.flect en Intera.t calcul.tlon to f1ftean (IS) dQ. beyond the eMt. of the .....-.tt. If p.~t .. .... after the Int.re.t ~t.tlon at. Ihowl an the Notlca, additional Intara.t ault be calculated. /S-cfl-/c:<. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' IU..AU 0' INOIVIOUAL TAIlES .....UANCI TAl DIVIIICII DDT. II"" ~JIIUIG, PA 17111-"'1 C!.-- lI'f-l'U II an IU.NI DEBRA L OTT 2681 SPRING RD CARLISLE DATE ESTATE OF DATE OF DEATH FILE NUHlER COUNTY ACN 12-23-96 MCCARTHY 01-03-96 21 96-0089 CUMBERLAND 96122384 _t R_ittood ANNA PA 17013 MAKE CHECK PAYABLE AND REMIT PAYMENT TOt REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLEt PA 17013 NOTE I To In...... p,,-r credit to your ...caunt t ......it the _r portion of thh fa.... with your tax p._t, CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ... iily:Il.iii"u-AFi.--ciz:96j-------...--iiliiiRii"AiicE'-YAX-ii'i'A"fEijENY-O..-AC"Couiif--.-iii-m-------m- ------ EITATI OF MCCARTHY ANNA R FILE NO. 21 96-0089 ACN 96122384 DATE 12-23-96 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACH IN THE MAHED ESTATE, SHOWN BELOM IS A SUHHAIY 0' THE PRINCIPAL TAIl DUEt APPLICATION 0' ALL PAYHENTSt THE CURRENT BALANCE. AND. l' APPLICABLE. A PROJECTED INTEREST FIDURE, DATE OF LAST ASSESSMENT DR RECORD ADJUSTMENT, 12-17-96 PRINCIPAL TAX DUE I. ,00 PAYMENTS (TAX CREDITS), PAYMENT DATE DISCOUNT (+) INTEREST (-) AMOUNT PAID RECEIPT NUMBER - OJ!] f'.:':":' ~j ::: lI'\ \"') o 6: ~~ ~ , ..'J . I 0\ I ~ .. ') ~'. ~-.. I"J .:.', o'ffJ Ow &}a: ~ ,.... P> ...:) ::E 08 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUI ,00 ,00 ,00 ,00 . l' PAID AFTER THIS DATEt SEE REVEISE SIDE FOI CALCULATION OF ADDITIONAL INTEREST, I IF TOTAL DUE IS LESS TNAN n t NO PAYMENT IS REIlUIRED, IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI. YOU IIAY BE DUE A REFUND, SEE REVEISE SIDE OF THIS FOIIN FOI INSTIlUCTlONS, I R PAntDfTl DetKh the tap portion of th1. Notlell WId ..-It _I th your p~t .. "ylbl. to the "... WId addr... prlntMt on the r.wr.. .Ide. -- If RESIDOfT DECEDENT ... cMck or -.y order ,"10 tal REGISTER OF "ILLS, AGENT. -- If _-REIlOOfT IlECDlEHT _. __ or _ oMlor ....... to. C_EALTH OF PENNSYLVANIA, All ~t. ~Ived ~II be ."IIMt fSr.t to ~ Intere.t Nhlch .-y be due _Ith eny r...lnder ~IJ" t. ~ t... IEP\MI (CAh A r.fund of a tax c....St, Mltlch .... not r....t... on ~ To Roturn, -.y be r....tad b1 CfIII'I.tll18 on "AppU~t.ton fa,. A_hind of PamQ1YOnI. 1m.,.lt.M:o WId E.t.t. Too, (REV-ISIS). ApplJClltlon..... ""UIIIII. .t tM OffIce of tho _..ht... of NUll, eny of u.. n Aewnue DI.t,.lot OffiCII, or f,.. the .....t-.t'. "-hour on.....". ..,..leI ....n fer fa,... orderJ"l1 In PwlnQIVWll. 1-IID-S6Z-Z0S0, autil. Pennnl'l.'l1. ~ _Ithln local Horr1~r. .roe (711' 711-1.94, TDO' (711) 77Z-ZZSZ (Hoerll18 1.,.lrod only'. .RlPt.V Tal blitton. "..-.flng .rra,.. conhlned on thh notice IhauJd be .......... tOI PA Dopwt-.t of ...,.,.., Bur.., of Incll'll....1 Tu.., 'Tnh Po.t ,......,t A...,I... Lnlt, Dept. ZI06D!, Hlrrbburl, P' 11121-0601."" (7171 717-6505, DIICCIIITI If .., tax .... h PII1d _lthln ttu-.. (S) col..... ....th. aft.r the -...,t'. ..th, . flv. percent (D) dlOOOWlt of ~ tax pold II .U....... POW. TV. The ID tax ....b non-,.,.t10IPIIUon ,..1 tv h COIIpUtMt on ~ total of ~ tax ... Int.....t ........., WId not ,.Id befo... .Mnuoty I', I"", the flrat day .ft.r ~ end of u.. t_ ....0 ,.,.lad. INTDEITI Inter..t 1. c:her.... _lmlng .,Ith flr.t day of doll~, or nino (f) -.nth. WId one (1) dey f~ the dog of "th, to ~ doh of ~t. Tu.. NhSch bocoM dell.,.,...t before January 1, 1HZ beer Int.....t .t ~ ...t. of .11( (Q) ,..r~t pe,. ...... CIIlcuJ.tMt at . dalb ret. of .001.M. AU tu.. .....Ich ___ doll"....t on .... 1ft.,. ..JInuwy 1, .HZ .,111 __r Int.,...t at . rat. Nhlch _Ul wry fr.. c.l.....,. year to eIIl.... YM" _Ith tMt nt. ....,... by thrI PA u....'-'t of........ fI:1e ","cabl. Int.,...t r.t.. far .HZ ttlrouIh 1m .r.1 y..,. Int.....t ltat. DlUy Int.....t 'ooto,. ..... Int.,...t ..t. Dally Int.....t ,..to.. I..Z ZOX . ID 0 541 1"7 ox .1"Z47 1m 161 .OOOU' 1"'-1"1 I1X .IUstl 1914 I1X .011101 I"Z ox .IOU47 1..5 13X .00OS56 1"'-1"" n .OfI1'" 1... lOX .UOU4 ."5-."7 ox .10'"7 --Int"..t 1. calcul.ted .. foU....t Ih,.......r . NLAIlCB OF TAX UllPAID X IMlIER OF DAD OELINQVEIlT X DAILY I."...., F~ --~ Notice ilIUM aftar tho tax bacoM. deu"..,t _Ul rtUlIOt on lnt,..... colcul,"" tI flft.... (11) _. bllwonc1 tn. .to of the ........,t. If ,..,...t II .... ,ft.,. tho Jntortllt ~t.tI.. dlt. .... on tha Notlca, addltlONI In..,...t .,.t be calcullted. .,: jS=SI-/ ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STAT~MENT OF ACCOUNT c. * IUREAU Of INDIVIOUAL TAXES IHHEllTANCE TAX DIVISION IIOIT. 2'''01 HARAlllURQ, PI 17111-0'01 In-UU P ." CU-N' PATRICIA A ALICHWER 412 GLENN AVE BOILING SPRINGS PA 17007 DATE ESTATE OF DAT~ OF DEATH FILE NUMBER COUNTY ACN 12-23-96 MCCARTHY 01-03-96 21 96-0089 CUMBERLAND 96122383 ~t R.ittecl ANNA R MAKE CHECK PAYABLE AND REMIT PAYMENT TOI REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE. To In...... p,...".r credit to yeur _t, oubooit the _r portion cf thh fcrtl with yeur tax po_t, CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ... ii'iV':i6'oj-iX-AFP-nZ':iiifm---.iiii-iNiiiliii"ANc!'-TAX'-sTAiEii'i1i-r-iiF'-AifC'ciiiiii--iii.--------------------- ESTAT! OF MCCARTHY ANNA R FILE NO. 21 96-0089 ACN 96122383 DAT! 12-23-96 THIS STATE"ENT IS PROVIDED TO ADVISE Of THE CURRENT STATUS Of THE STATED ACN IN THE MANED ESTATE. SHOWN BELaN IS A SUHHARY Of THE PRINCIPAL TAX DUE, AffLICATION Of ALL PAYMENTS, THE CURRENT BALANCE, AND, If APPLICABLE, A PIOUECTED INTEREST fIguRE, DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT, 12-17-96 PRINCIPAL TAX DUE, ,00 PAYMENTS (TAX CREDITS), PAYMENT DATE RECEIPT' NUMBER DISCOUNT C+) INTEREST (-) AMOUNT PAID In ~~ - r;') 0 ~ Jet; 0 :. (1):-:: c;: " i'; t-?~ - 0\ ....) I ,) ,- ,;; ,', ~ t, ,,', .- ~. " .., ',J 0 U " ..:... 0 .j) r- ::E Ula: P' ~c3 a: . If PAID AfTER THIS DATE, SEE REVERSE SIDE fOR CALCULATION Of ADDITIONAL INTEREST, I If TOTAL DUE IS LESS THAH t1 t HO PAYMENT IS REQUIRED, If TOTAL DUE IS REfLECTED AS A -CREDIT" ICRI, YDU IIAY BE DUE A REfUND, SEE REVERSE SIDE Of THIS fOIlll fOR IHSTIlUCTIOIIS, TOTAL TAX CREDIT IIALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE ,00 ,00 ,00 ,00 \. -, r .- PAYlEJrfTI Deblch U. top portian of th.. Notice end ....It w1th your p.Yl*tt .... p~h to thil ".. end Ilddr... printed an the rever.. .1.. -- If IlUIIlOfT Il(CEDEHT _. ..- .. ..... ...... ._1. tal REGISTER OF WILLS, AGENT, .. If __1lU11lOfT Il(CEDEHT _...- .. __v ...... _I. t., C_EALTH OF PEIIISVLVAHIA, AU ,.,..,h reoe1ve11 "'U be -w11" flret to ~ Inten.t ....lClh ~ be ... w1th MY r...inder -.11.. to thlI tD. ~ (cah A ,....... of . .. credit, ...lch .... not r..,.st.. an- thII Tax Return, ->> btI ~.ted by ~l"U"l WI -.UCIIUan for hfW1d of PennllY1vsn1. InherltMOl ... E.tat. T..- (REV"1S1!). ,"UClltlan. In ...U.1. .t the Gffl.. of the .....t... of NUll, ~ of the ZJ hftnua alltrlct Gff1os. or fr.. the Depvt.wtt'. Z4"hour ..-.rl". ....iOll ,....... for lorn o.....ri"ll In Pennq1vsn1. l"IOO")6Z"Z05o, outll. Penn.,l""l. .. within 1GC111 .....rl....... .,.. (717) ,',",oM, mal (717) "Z"ZISZ U.....i,.. 1...1,.., anb'. A!PI. Y TO I ....Uan. r.......l"I .rror. contained an thl, noUce 1hou1d .. edlI,.,MII tol Pi o..rt.Mt of RwMue. IurMu of Incll'li"l T...., Ami P..t ,....~t hili.. ~It, Dlpt. Z.0601, ttlrrhburl, PA 171ZI..I6U,...... (nn 717"'115. DIIaUlTI If 8n1 ta .. .. ,.hl w1thln u"... (J) oa1....r ___th, .fhr the dMedlnt'. dMth, . fiv. .....CIf'lt (IX) dllCOl.ltt 0' the ta ,.Id .. .U..... P!IW. TV. ThII 151 tax ....tv nan",.rUol~tian ,.,.10 .. ~ted an the totl1 of thI ta end 1ntare.t ........, .... Mt ,.Id III..... ~ 11, 1"', the first _ .ft... thIl ..... of the ta ....ty ,."IDd. 11lTEIIDT. Int....t .. ....... ....Iml"ll w1ttt flret _ of .U.....-.v, or nl,. (9) ....th. ... .... (U _ fNIII the _te of dMttt, to the .t. of ~t. Tex.. "'Ich ___ .U,..,.,t lllfo,.. ..-...,.y 1. 19IZ bier Int.re.t .t the Ate of .s. (0) perCWIt ,.r ..... C111cul.tld .t . .U. r.te of .Ull... All taxe. ...leII beG.- deU"..,t an ..... .ft.,. ~ 1, 1HZ .,111 ...... interen It . rate "'Ien .,111 "~ fr.. cel__r yew to callender YIW with tMt rIIt. ~ by the PA -.rt.Mt of R..,.,.,.. ThI ...UCllble Interut Ate. far 191Z thrGUlh 1'" ....1 v.... Int.r..t RIIte Dllh Inten.t FlMtar V.... Int.r..t Rat. Dll1W Inten.t FlMtor 1HZ ZIX .GlOS41 1m 10 ,...451 19M IIX ...nll 1915 In: .011556 1_ lOX ,...U4 ....Inter..t 1, C111cuhbd .. fo11...1 1917 19"-1"1 I"Z 1"1-1994 1"5.1'" n IIX 'X n n .OUZ41 ,a"lll ,UOZ41 ....192 ."OK7 In.......f . ULAIlCIl OF TAX UllPlID X HIIIIIEIl OF DAD DELIIIQVEIlT X DAILY Ill........ FACrOI .....an, NetlC8 1I1U1d .It... the ta ....... .11"..,t ..111 r.Ueot WI Inten.t 0I1..1.t1on to flft... US) dip beYOftd tM dlw of tM .....--.t. If "'w-tt h .. .ft.,. the tntenst ~t.tlon .t. ..... an the Matl_, 1dd1t1eral Inten.t ...t be C111cul.tld. 15~ yl - /;s COHHONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE c BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. ZlUD1 HARRlllURG, Pi 11121-D601 NOTICE OF INHERITANCE TAX APPRAISEHENTt ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX PATRICIA ALICHWER 412 GLENN AVE BOILING SPRINGS PA 17007 DATE ESTATE OF DATE OF DEATH FILE NUNSER COUNTY ACN 03-09-98 MCCARTHY 01-03-96 21 96-0089 CUMBERLAND 101 AlIOUnt Ro.lttod *' In-IMI..." In-II' ANNA R MAKE CHECK PAYABLE AND REMIT PAYMENT TOI REGISTER OF WILLS CUMBERLAND CD COURT HDUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ iiE'v :i5'4"'i"EX-"FP--foij:97Y"NOi"icE--OF-YNHEiiii'AiicE-i"AX-A'pjiiiA'iiiEiiiNi'-;-"LroiiAiicE-il-R----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF MCCARTHY ANNA R FILE NO. 21 96-0089 ACN 101 DATE 03-09-98 APPROVED DEDUCTIONS AND EXEMPTIONS I 11,270,00 9, Funor.l Expen.../Ado, Co.t.IHI.o, Expon.o. ISchodul. HI 191 10, Dobtolllcrtll_ Llobllltl../Llon. ISchodulo II 1101 45,846,00 11, Totol Doductlon. 1111 12, Hot Voluo of Tu Rotum IUI IS, Chorltoblo/Govo~tol Boquo.t'l Non-oloctod 9115 Tru.t. ISchodulo JI 1151 14, Hot Voluo of Eobto SUbJoct to Tu 1141 NOTEI If an a.......nt was issu.d previously, lines 14, 15 and/or 16, 17 and 18 will refl.ct figures that includa the total of ALL returns assessed to date. ASSESSHENT OF TAXI 15, Aaount of Llno 14 ot Spou.ol roto 1151 16, Aaount of Llno 14 to.oblo ot Llnool/Clo.. A roto 1161 17, Aaount of Llno 14 tuoblo ot Collotorol/Clo.o I roto 1171 11, Prlnclpol Tu Duo TAX RETURN WAS, I X I ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALU~ OF RETURN BASED ON: ORIGINAL RETURN 1, Rool E.toto ISchodulo AI 2, Stock. _ Bond. ISchodulo II 5, Clo.oly Hold Stock/Portnorlhlp Intoro.t ISchodulo CI 4, KortllOllO.lllcto. Rocolvoblo ISchodulo 01 5, C..hlBonk DepooltoIHlIo, Por.enol Proporty ISchodulo EI 6, Jointly Donod Property ISchodulo FI 7, Tron.for. ISchodulo 01 a, Tot.1 A...t. I I CHANGED III 121 151 141 151 161 171 ,00 .00 ,00 .00 14 ,718,00 .00 634,00 III .00 .00 .00 X'OO. x .06. X ,15. 1111 TAX CREDITS I PAYllENT DATE 07-08-96 07-29-96 03-02-98 DISCOUNT It I INTEREST/PEN PAID I-I ,00 ,00 ,00 RECEIPT NUIlIl E R AAl 6515 AA146566 REFUND AIlDUNT PAID 36,60 36,60 73,20- TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE HOTEt To In lure proper credit to your Kcounl, IUbolt tho uppor portlon of thl. for. with your tox po_t, 15t352,OO C;7.11~ nn 41, 764,00- 3.634,00 45t398,OO- ,00 ,00 ,00 ,00 ,DO .00 ,00 ,00 o IF PAID AFTER DATE INDICATEDt SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST, IF TOTAL DUE IS LESS THAN fl, NO PAYllENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YDU HAY IE DUE A REFUND, SEE REVERSE SIDE OF THIS FORK FOR INSTRUCTIONS,I '..'""il.J ,- ' ,~ t:-: REIONATtDHI ht.t.. of -..nt, d11"1 an or be'or. Dee...,. 12, 1HZ'" Sf WIV future Int.r..t In the ..t.t. I, tr.,tfarrld In po.....1an or anJo)'Mftt to CI... . (call.ter.U benef1c1.,.1.. a' thai decadent .ftar thai .xplratlan of WtY ..t.t. far Hf. or for "ar., the CMIOrWIIIlth heraby .xpr...1y ra..rv.. the rlDht to appral.. Met ...... tran.far InhlrltMCI hx.. .t the lawful Cia., . (call_t.ral) rata an any IUCh future Int.ra.t. PIMPDU <IF HaTlCEI To fulfill the r~lra.ant' of Section ZI~O of the Inhlr1t~ ~ E.t.t. Tax Act, Act ZI of 1"5. (7l P.S. Seotlan 'I~I). PA\'JEHT. DetlCh the top portion of th" Motlet ~ aut.lt ..I th your PayIWlt to the R....tar of WUlI prlntld on the rlVlna llde. ......... chick or ..".y order PI)"IIbla tal REGISTER OF KILLI, AaEHT REF1ICII (CAli A rahrod of I tax crldlt, ....Ich WII' not raqua,tld on the T.. R.tum, ..y be requtl,tId by ~1,tI"I ., -AppllCIIUon for R.hrod of ......'Ylvanl. InhlrltMCa and E.tata T..- (REV-ISIS). Application. .r. IYIIlhltll. .t tM OffiCi of the R..I.t,r of Will., .,y of the ZJ RlVenue DI.trlct OfficI', or b, cllllng tM fPIOI.l Z~.hour .,lMer1"1 IIrvlc. ~r. far fora. orderlngl In Penn.,lvanl. l"100-S6Z.Z050, aut.lde Penn.ylvanl. ~ ..I thin local Harrhbur. .r.. (717) 717-IOM, TDD' (717) nZ-ZlSZ (Hearing hi.,.lrld Onh). OIA:CTllIIS1 IIty party 1" Int.r..t not utl.f11d ..Ith the IIPPrel......t, .Uowanc. or d1uUowanca of dlductlon., or ........,t of tax Uncludl"l dhCOU"lt or Intar..U ., showt an thl, Notlctl ...t abject ..Ithln ,bch (61) dayS of racllpt of thll Notice b1' --MrIU., prot..t to the PA DlparbMt of R....., laird of Appall', Dlpt. ZlU21, ttlrrhbur" P' 17121-1021, OR ...Iactlon to ...... the ..Uar det.ralned .t ....It of the ecCClU'\t of the pa,sanal raprauntatlve, OR .......1 to the OrphM.' Caurt. ADltIN IITllATlYE CCIIlI:CTllIIS1 feetual .rrare dhcovarld on t..1I ........,t lhauld be .wra..1d In ..rltlng tOI PA Dlparblnt of R....., aura.u of Ind1vldull T...., ATTN. Po.t A....lllnt R.vl.. unit, Dept. Z10601, ttlrrlsbYr" P' 17121-0601 PhonI (717) 717-6511. III PIlI 5 of the booklat -In.tructlon. far Inhl,lt~ T.. R.tum far a R..ldent Dacadant" (REV-1501) for an explanation of ~Inl.tr.tlv.l, carrectabl. .rror,. If any tax ... .. PIlei MI thin thrll (S) e111...... -.nth. .ftar the dlCldlnt-, death. a five pa'e....t (5%) elhcCU1t of the t.. pilei 1, allOlifld. DltallIlT. PENALTY. The 15X tax ....tv non"partlclpatlon ,...1 tv h CCIIIfIUtld on the tatal of the t.. and Intlr..t .....IId, and not PIlei befar. January II, I"" the flrlt da1 .ftar the end of the tax ....h ,.rled. Thl. non-p.rtlollNltlon ,..,.Itv II .....labl. In U. ,.. ......, and I" the the ... till ,.r1ed a. you woulel ...-1 the t.. and Intar." ht hi. bien ......Id .. 1ndleatecl an thh notice. 11ITDnT. Inter..t I. chertld besllMl"I .,lth flrlt day of dell".,...cy, or nine (f) -.nth. and OM U) da, fr. the date of death, to the date of p.~t. Tu.. ....Ich bIceM delinquent before January I, 1912 be.r Int.r..t .t the rat. of .he (~) percant per ...... ulcul.tld .t . dellv rat. of .1101M. All tu.. ....Ich '*=.. dellnquant an and .ftar Jlnuarv 1, 1'12 .,111 baar Int.r..t at . r.ta which ..111 Vlry frOll calendar ,..r to calandlr yal' ..Ith that rata IMIM'CId by the PA Oaparblnt of RIV..... The appllcabl. 1nt.ra.t r.t.. '0' I'az through .,.. ar.. !!!! Inter..t Rata Dallv Int.r..t Factor !!!! Int.ra.t Ratl Dlllv Int.r..t Factor 1"1 IIX .100541 1917 'X .100247 1_ 161 ,00041' 1'''-1''1 IIX .IIUIl I'M IIX ,OODSOI 1"1 tX .1002.7 I'" 151 ,OODS56 1"1-1'" n .010192 1'" lOX ,000174 1"'-1'" tX .110247 ..Interllt 1. calculatacl ., follow.. I/lTElElT . IAWCE OF TAll UllPAIO X IlUIIBER OF DAYB DELlHQUEIIT X DAlLY I/lTElElT FAl:TOR ..Any Notice luUld aftar the tu beeOll. dlU".,.,t ..Ill raflact ., Inter..t c.lculatlon to flft.., US) _. beyond the cIata of the ........"t. If p.~t II ... .ft.r the Inter..t COIIpUtatlon data IhawI on the Notice, addlUonal Inta,..t ...t be CII1cul.tld. \. STATUS REPORT UNDER RULE 6.12 . \ \ I ~ l"."R.r'l L!', Name of Decedent:' '", '\ I, :--t"~~ "" '('\'~"'-'-t Date of Deathl \-~-qlp Will No, d.\- \qC\~-oD~'1 Admin, No, Pursuant to Rule 6,12 of the Supreme Court Orphanst Court Rulest I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes ".J No 2, If the answer is NOt state when the personal representative reasonably believes that the administration will be complete: 3, If the answer to No, 1 is Yest state the following: a, Did the personal -tepresentative file a final account with the Court? Yes No~, b, The separate Orphans' Court No, (if any) for the personal representative's account is: c, Did t.he personal representative state an',. account informally to the parties in interest? Yes No' d, Copies of receiptst releasest joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphanst Court and may be attached to this report, Date: ,'':,- '~'9C(; . ~ _ 1\ ,". )~"\' ''':_It-,,t'-V-(~ Signature . '.....,' N C:i -""lnco h.",,,, D\T Name (Please type or print) dlp'j,\ ~'M Qc\ (1 o."\\~'" pJ\ IlCl\~ Address . c..; ~ ..: ,. " , -..' ('1V\) d5(, '0\;,)"S Tel. No, . .- .-' U<.:. Capacity: " Personal Representative Counsel for personal representative (MAH: rmf/AM3) .. ~ ... JRD/JuDe 30, 1992/17858 REGISTER OF WILLS Cumberland County Courlhouse One Courthouse Square Carlisle, PA 17013 NOTICE PURSUANT TO RULE 6,12 PENNSYLVANIA SUPREME COURT ORPHANS' COURT RULES To: Persooal Representative nFlwn r. ('\~.~, aNn pa~'IIT(,T a ar.T(,HW~:H Counsel: RE: E5\ate of ANNA HOSE MCCAHTHY , Deceased, Late or SILVEH SPHING TWP F.&tate No.: 21-1996-0089 Date of Decedent's Death: 1- 3 - 9 6 Pursuant to Rule 6,12, the above named personal representative or the above named attorney, if applicable, within two (2) years of the decedent's death, and annually thereafter until administration is completed, Is required to file with the Register of Wills a StalUs Repon as required by Rule 6.12, in substantially the prescribed form, showing the date by which the personal representative, or attorney, as applicable, reasonably believes administralion will be completed, The purpose of this Notice is to advise you that unless the requisite StalUS Report is filed with the Register of Wills or Clerk of the Orphans' Court, u appropriate, within ten (10) calendar days after the date of this Notice that the 'Register of Wills Is required to DOtify the Orpbans' Coun Division, Coun of Common Pleas of such delinquency and to request that said Coun conduct a hearing to determine whether sanctions should be Imposed upon the tIeIiDqueut penoaat representative and the delinquent personal ~resentative's counsel, If any, AccordlDgly.lfthe requisite Status Repon Is not filed by 3-16-98, ,19_, you are hereby advised that. request will be submitted to the Coun in accordance with Rule 6,12. Dale: 2-26-98 ~ Distribution to Estate File