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HomeMy WebLinkAbout96-00094 t, ~:" . .' j :.; ~ " ";r '. .---- .--......... '-'- ,. j , . __ _ ..._~,- __. _ ~ .___ ___ ._.._ _'. ,_J __._ .__.~ .___ __ ___ __ .-_._. ._ __ -. -- "';j7'.";I.-' },'::'il~~~i!!,t.~:tf~.'i'l'.f""~ '~:'~~~:';l':.";':;~ j;,i.-i>:;-':' .~.;~l,~~,'-!':"i:';" .~ :f" '-;,.: :', .. ". .' ~,. ,: .~ ',' . ~';..';';.' ~'~~~~'F,,-,'_'.::_:;..~,~,tr._1:7'F~~'~' to:.~ ~."'~~J;.:i--.v.\,(~~jl:'~~_1;~j'rNW\.'~"'f'~;.i""". 'I:;!,;I'N,~.::.J:[.,I"'\ ',~;"''',r'~-;''\-''''~'''''i.'' .,..'.. ~.' ..' J~,;',.: ~;'., .;--"':." -.,. :.~t_.. ,.-:,' . ".~"~;(-_'r.'_.J tt~' '_uUA .' .O...."NilV..,~NIA.:.'..-,.. "":.,,. ,.,...,,,,..,>, \'''''''' ~ 1; '~". . ,_-\~ ~.~....~. __ -.;,:r;,;,,,_",:,;,:,_~'_',";'-',-';,:,,,::,/:,:,~:""'itl.!~~' '~l, 'r.' If, .. (\1:L'~""'if"},;"'~'''~'.'.''''''''-~'-~ ......'OP.'.,,-.~..--,:... U ".~-,"- d"..'...,-_., ,.,~.... ..--,....... '.'-';-'.":,,:,~.,,,:.r.....,. r1 " ~ -, " '. UYIN I'" ....0.".... ,., .. '.. ''',' " . ", "'1 ~I." '.""'+"",,-. "~""T-/'--'l"\..._..j",-._I"'.' "_~"",,,,"'.>._.,f.U ',' ','Z _ < "..... ....",;. -h. .' 'lO!,'.>,~ " . ,.' ,.... '.~ -', \ '''_ .. <r.. .-..". '.... ~'; '," '~."'. ..., . , :idt;-i_",{i~~A1Nl"iiTANat'l!"DmAl1:TAX ,"; ",:..:;,\t';.,. .' ".....,................m....... ..."...~..... ...... .. . .1 RECEIVED fROM, & ACN ASSESSMENT P:'I CONTROL I:iI NUMBER AMOUNT ADAMS H ANTHONY 12e E KJNG ST 101 S7,blJ.'0 .' SHJPPENBBURG, PA 172:57 ESTATE INfORMATION, FJ' MIR 21-1996-0094 !II NAME Of DECEDENT (LAST) ~ BUTTS LULA BELLA IIIWE Of PAYMEN~ II POSTMARK DATE COUNTY SSN 202-46-:57:51 (FIRST) (Mil CUMBERLAND DATE Of DEATH I 3 !5 REMARKS RJCHARD L BUTTS & MILDRED P KOONTZ SEAL CHECK" 0ge C/O H Anthony MllmB m TOTAL AMOUNT PAID '7,61:5.70 . ) CW { \...:... RECEIVED BY /(, L I ,'. .V..."t..1 . f~(... MARY C. LEW IS ""J //(.t~./ /, f)' REGISTER OF WILLS REGISTER OF WillS -,!,",""",,!.~-----,--- ---- -- _._-.-- --- - ------- - - -- -~,- -... -.- ~... . . ~ , t I~ 'I ~. .+',1 ,I i ,. '. \ -. . P,' :< ... r .f .- ..--' r~ III ....,: .~~ y ....--.. , -- --'~ ,. r PETITION FOR PROBATE and GRANT OF LETIERS ;;::/:n1.._~2 pQ.ll~t\I!l1ttt~<> 0 <.L ~~; ~ -lq9~ - OqLJ. ~_~::i!~ Register of Wills for the Deceased. CounlY of Cumbedand in the Social Securl/y No. lUl-4b-~/~1 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut ors in the last will of the above decedent~pated 1966 and codicil(s) dated Ilone named , 19_ (SIIIC rein-ani circumuances, e.,. renunciation, dealh or executor. eIC.) Decendent was domiciled at death in lJ Imlv>,.1 nnrl 11 p,. last family or principal residence at Newvi I.le ) , , (1iIlIlf<<l. number and muncipalily) County, Pennsylvania, with Decendent, then 89 years of age, died !If>cpmlv>,. 1, at CL1l11becland Q)unty, ppnn~y I v:m;" Except as follows. decedent did not marry. was not divorced and did not have a child born or adopted after execution of t~~ wYkof[ered for probalC:: WjlS not the victim of a ki Ii and was never adjudicated incompetent: us lid/executor dled - Ie - Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled In Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: .19 QC\ None S 100,000 no S S S WHEREFORE. petitioner(s) respectfully request(s) the pro ate of the last will and codicil(s) presented herewith and the grant of lellers \. \, .' \ ''', (-., theron. (testammt.rYi admlnistrallon c.I.a.: adm1ni6lrMioo-d.b.A e.'.L) L ~ ~ P. }/rLf)C?t U -1iji)1:~~Lfi;;,(lw~jJ ; 7 'E~ ~o ! Vi ,1tt.{J ~() ~J 6~,tJ; ~~ k'~ f;v. ....V/L II /77.4/ OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA } 8S COUNTY 0.' Oblll)(!,.lllnn The petitloner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen. tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. -' /} ) Sworn to ~r affirmc. d and subscribed { -Y)\d fl./Id. A. r1.1A.!:j)t$- '" before me thiS 2nd. day of ~2 (:.;~-!J- 00' ~:0J~!~~;;;~"('; ,~td!~;U'~~" .. 1 15'~':l.-3- J No. CJ.I-Iqqtp -OQlf &Iale of Lula Bella Butts , Deceased DECREE OF PRODA TE AND GRANT OF LETTERS AND NOW FiDQUAll.Y 5 19-9L, In consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the Instrument(s) dated 1 QI;I; described therein be admitted to probate and flied of record as the last will of and Letters are hereby granted to Jlt1a B911a P.1I..t~ ^~'nl .....\. \ ".l'\'\dn (~T"(l... Mildred PearLKo.a.I~? " "nrt U~,..hD,..rI Too Rllt", Will Book N Page MARY C. ~{;:JrlJ(l, ~u.t~{ ..t2{Jl /I\...IIY)I.. f31V(CU LEWI ~ Realsler or Wills fJp:t;y- FEES Pbt L'E 5200.00 ro a e, etters, tc..... .. . , . Shl!.rp~FFJ}ycates( ).......... 5 1 ~ : 8B- Renunctailon ................ 5 ,1CP 5 'i.00 TOTAL _ 5 220.00 Filed. F.EB.RUAR:t, 5.,. .19.96........... H. Anthnny Arl"mc: ?~..O? ATTORNEY (Sup. a.-r.D. No.) 128 East King Street, ~hil'l"'nc:hurg, Pat ADDRESS 717 5J:l-.tl7Q PHONE (', ~ ';:.;' l'~ {"-I I "i ':::'... 1..- f... - :. ~J UU MAILED LETTERS AND ORDER TO ATTORNEY FEBRUARY 6, 1996. ~ / - 199!t' ~ tJ91- ('-! --'~ .<!: 'i-.~ - ,oj <r..;- r.. C'-! I ..:,: ..) .. I WLI. p' 5 c.: iju MCCREA' MCCREA AnDlutl AT LA. NlWILLI I .HI"'II...... 'uu. . r -.'" . . LAST WILL AND TESTAMENT I, Lula Bella Butts, a resident of the Township of North Newton, County of cumberland, State of Pennsylvania, being of sound mind and memory, do make, publish and declare this to be my Last Will and Testament, hereby revoking any and all Wills by me heretofore made. FIRST: I hereby df.rect my Executor, hereinafter named, t pay all my just debts and funeral expenses as may conveniently be done after my decease. SECOND: I give, devise and bequeath the full sum of One Hundred ($100.00) Dollars to the EUB Church located in Oakville, Cumberland County, Pennsylvania. THIRD: All the rest, residue and remainder of my estate, be it real, personal or mixed, I hereby give, devise and bequeat all to my husband, George E. Butts, for his own proper use and be hoof forever. In the event my husband, George E. Butts, predeceases me, or we should perish in a COlllllOll disaster, then in that event, I hereby give, devise and bequeath all my estate, be it 281, personal or mixed to my two children to-wit: Mildred Pearl Koontz and Richard Lee Butts, or their heirs, equally, share and ahare alike. FOURTH: I hereby nominate, conllitute and appoint my husband, George E. Butts, to be the Executor of this my Last Will and Testament. ,... ;'. '. ". IN WITNESS WHEREOF' I have hereunto set my 1umd and seal to this my Last Will and Test8lll8ftt, written on two sheets of paper, dated this , 1966. day of f~A (}./U I(jL~ 13~SEAL) This insLl;"T "II was by the Testatrix, tub Bella Butts, on the date hereof signed, published and declared by her to be her Last Will and Test81lllmt, in our presence, who at her re quest and in her presence and in the presence of each other, we believi her to be of sound and disposing mind and melllOri', have hereunto subscribed our names as 1<<1. tnesses. -!J'7~ ~ ,.., , ,.; h~J.;I '?::\j~,:;!" 4(OMMONW(AltH or p(tUUnV...tllA OU'AA'MUn or .[V(NUl DIn 210601 tlAUlstUIlG. rA 1'''1,0601 N' M l . I .Ml MI IS"-"i 2.- :3- INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) I[Y.UOO EX+ (I P~ll .:r 'OR DATIS 0' DEATH AnIR 12/31/91 CHICK HIRI " A SPOUSAL POVERTY CAlDIT IS CLAIMED 0 fill NUMBER ~ o ... u ... o ~ lSiiil2 ......u ,.;00 u"'... ...... ... c( ~!i "'... "'0 Oz UO ... z o 3 i:! ii: ~ ... '" " I COUNTY CODE D[ClOfNT'S COMPl(1[ AOOII:(55 YEAR 90 'Nutl Butts l..u1a Bella $OCIAl s(dHu1Y fiUMttA IliAllororAltt ]lMlfUTliifll 12-13-95 10-9-06 o 2. Suppl.m'"lal Relurn 210 Big Spring Road Newville, PA 17241 Co.., Cumberland 03, 05. 202-46-5751 (t] 1. Original Return o A. limited Ellalt 0 Aa. Fulure Inletoll Compromise (lor dol.. of d.arh aft" 12.12.B2) SJ 6. Oeced,nl Died tellole 0 7. Cecedenl Maintained a Living TrUll (Alloch copy 01 Will) (Allach copy 01 Tru'l) ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO, AM (OMru If MAlllNG ACORUS _B. H. Anthony Adams, Esquire H t4 M 128 E. King Street Shippensburg, PA 17257 r)<) 1. R.al E.laleISch.d,l. A) ( I) ___._._. 2, Slack. and Band. (Sch.dule B) I 2) .-1'0,.336.. 31 3, ClalOly H.ld SlocklPa,lnor.hip In'.ro,' (Schedul. C) I 3) __. 4, Marlgag.. and Nal.. Recelvobla (Sch.dule D) ( 4) 5. Co.h, Bank D'po.lrs & MI.collan.ou. Personal P'aporly( 5) ~ 493.65 (Sch.dul. E) 6. Jainlly Own.d P,ope,ly (Sch.dul. F) ( 6) 7. T,on.I". (Sch.dul. G) (Sch.dul. l) ( 7) B. Talal G,an An.ts (rolallln.. 1.7) ( B) 9. Fun..al E.p.n.... Adminislroliva Co.r.. MI.collan.ou. ( 91 _7.901.33 E.p.n... (Sch.dula HI 10. Debts, Ma"gaga lioblllll... li.n. (Schadulel) (10) 11. Tolal Daducllon. (10101 line. 9 & 101 (11) 12. N.I Valu. 01 E,'a'ellln. B mlnu.lln. II) (12) 13, Charitable ond Gav"nmen'al B.qu..ts (Schedul. J) (13) U. Ne' Volue Subj.d 'a T.. (IIn. 12 minu.lln. 13) (14) 15, Amaun' allln. 14 '..obi. 01 6% 'ale (15) ,126..928_.3fi x ,06 = (Include vol,.. Irom Schedul. K or Sch.dula M,) 16, Amaunl 01 IIn. 14 I..ablo 01 15% '01. (16) x ,15 = (Include valu.. I,om Schedule K 0' Sch.dul. M.) 17. Prlntipallo, duo (Add ro. Irom IIn. 15 and Irom line 16,1 (171 18. Credits Spousol Poverty Credil Prior Pormenh Discount Inler.I' + + (IB) 19, IIlin. lB Is graal" rhan line 17. .nrer Ihe difforenco on line 19, Thl. i.lho OVERPAYMENT. (19) ~O 20. IIl1n. 17 I. groale' ,han lin. lB. enl.. ,h. difforonca an line 20. This Is Ihe TAX DUE. (20) A. Enl.. rhe inl"a.' on Iha balanco due on lin. 20A. (20A) B. Enl" Ih. ,oral 01 line 20 ond 20A on line 20B. Thl. i.lh. BALANCE DUE. (206) Mak. Check Payabla 101 R.gl.ler of Will., Ag.nt ...... BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH.. ,,' ;':":'" Under Plnolli" 0' perjury. I d.do,. that I 110'18 uomined ,his rerurn, Including occompanying Ichedules and Slal,menU, ond fa Ih, bell of my knowledge and b.li,f, Ills trUI, correct ond compl.'e. I d.dat. Ihot 011 real ellor. hOI been ropolled olltuI morhr value. D,c1atotion of prepar.r olh" than Ih. personal "prtllntallvl II bcn.d on ollln'ormollon of which pr.parer hOI any knowl.dge. . ..m.:J7..S~ .~S'ONSIIII'O' /lUNO lII~.N , .oo.!~ o-t'~ :.:: ry /3 ( / 95 .rnrm~i.k-, . '/ ~ 7, 7 y~ 532-3270 z o !i !; ... ~ o u )( :! Chrck hele If yoLJ ota 'equastlng a ,c'lJtld bf yoU! avotpaymohf. Remainder R,turn ('or dolo. of d.alh prior 10 12.13.B2) F.dOlol E.lole To. Relurn Required T orol Numb" of Sol. D.po.i' Bo.a. . .:.. ... ,:~ <:. !-...1.;'i1,";,~ '''; r- . :a ~lrJ ~ ...;, L:J 1 l;') .<- r-.l 134,829.% 7 .901.33 126,928.36 126.928.36 7,61'1.70 7,61'1.70 7,615.70 7,615.70 COMMONWML TIt or- rENNSYI. VANIA INIIEmTANCE TAX 1lF.1UIlN RESIUENT UECEUENT mt.TE Or- SCII"IJULl: """ I:ASIl AND MISCr:l.I ANEllUS I'EIISUN^L I'IIUI'I:II IV '---.... . .."- . i'ii.e iiuf.iuiHi . Lula Bella Butts t^1I "rop",y lalll'ly'o..;~;.r;;w;-ii~'I.iiiDill~inl~;~ilru;iilll; illtliii;;Jii~illl~;i'~'-1 Gc.iu'Ij"I,,";;j:::i-'.' ITEM -----....,-----.----. '-"--'''''-- NUMOER Ur:SCIlII'IIUN ---------... .------.--..-... VALUE AT lJAlE lJr- UEA111 7,132.32 1. Mellon Bank Checking Account # 412-136-9922 2. Mellon Bank CertificBte No#: 410-0551772-C Mellon Bank Certificate No#: 00094103 Mellon Bank Cerfiticate No#: 0-A08835-C Mellon Bank Certificate No#: 410-066028-C 4,500.00 3. , 20,861.35 4. 20,000.00 5. 4,000.00 .------....-...---.----..- ...---.---... 'I U I AI. IAII" rl1lr' '''' Ih,r Ii. 1l."Ol'lIl1lol1lll1) $ ..-----..-.-...--.,. - ..... , tlf flllIIlI '1111,.. II ...111..,'...." .11111111111'" .1111." 01 lalll' Ih.1 _'.UUII. P.'II mAUOF ITEM NUMBER .9.',~,'~ '1:\IU',:!' COMMOltWIAUl1 or 'IIUlsnvAUlA UUlIII.IIA1'el 'AX ,..IUAU aUIDUII DlelDlfll SCHWULE II FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES Pilau Prlnl or Type IlfilUMliER DESCRIPTION A. Funeral bp.nu.. B. A. C. 1. 2. 3. A. 5. 6. 7. 9. I. Fogelsonger-Bricker 1. Admlnl.hullv. Ca.1I1 Pallonal nep.alOnlollve COIII",I"lon. Sodol Sacurlly I~urnbar of POllonul nap.o.onlallve: Yoa, Comml"lan. paid 2. Allornay Fea. - H. An thony Adams " 3. Family Exampllon Clalmanl Addro" 01 CI~lmanl 01 deudenl'. dealh Shill Add,o" Clly Zip Code Ralallon.lllp Slala P,obala Fee. Reinbursed + Filing Fee'Return to H. Anthony Adams '. Mlec,ellanaou., bpenu" , Tristan Assoc. (expense of last illness) Emerald Drug (expense of last illness) . Presbyterian Home (final bill on health care) Graham Medical Clinic " ." ' : . . ~ TOTAL (^Iso enla, on "no 9, Racapllulollonl S III molt .pau I. n88ded, Inu,l addlllallal sI'881. o'.ame .1...1 AMOUNT 4,324.00 ,750.00 234.00 1.92 155.49 2,417.71 18.21 " LAST WILL AND TESTAMENT I, Lula Belle Butts, a resident of the Township of North Newton, County of Cumberland, State of Pennsylvania, being of sound mind and memory, do make, publish and declare this to be my Laat Will and Testament, hereby revoking any and all Wills by me heretofore made. FIRST: 1 hereby direct my Executor, hereinafter named, t I pey all my just debts snd funeral expenses as may conveniently be done after my decease. SECOND: 1 give, devise end bequeath the full sum of One Hundred ($100.00) Dollars to the EUS Church loceted in Oskville, Cumberlsnd County, Pennsylvania. THIRD: All the rest, residue and remainder of my estate, be it real. personsl or mixed, 1 hereby give, devi6e and bequeat all to my huaband. Goorge E. Butts. for hie own proper use 8\d be hoof forever. In the event my husband, George E. Butts. predeceases me, or we should peri6h in a common disaster, then in that event. 1 hereby give, devi6e and bequeath all my estate, be it 201, personal or mixed to my two children to-wit: Mildred Pearl Koontz and Richard Lee Butts, or their heirs, equally, share and shsre alike. FOURTH: 1 hereby nominate, conditute and sppoint my husband, George E. Butts, to be the Executor of this my Last ,...-,..,......,,,... ',' . ..., '.-J. I', I. f'" ,. ,- i: ~ ,!.; H. ANlliONY ADAMS. ESQ, 128 E. KING STREET, SUITE A SHIPPENSBURG, PA 17257 T~"" REGISTER OF WIllS '~" CUMBERlAND (DUNTY (DURTIlOUSE CARLISLE, PA 17013 .r t, '. . ".J ~", ~.. (.. ) . " w ( ~ ,.\ 'n ,i . . I!,., \ . ,0 :',. ,.. f (' .. . . , " " ~. ,.., . ,I I t> . '. -. ,,' \' -, ~ . ":: " . .".-._~., ^ .-.~.~- I r=-- .. .---",.J I ---~ :...- ;". -'.'. " ." . --. ..... .- _. ..--- \. .--..- - -,_.. IS- fJ-3 COHHDNWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE C-; IUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION D[pT. ZlUO 1 HARAISIURC, PA 111'..0601 NOTICE OF INHERITANCE TAX APPRAISENENT, ALLDWANCE DR DISAlLDWANCE OF DEDUCTIONS AND ASSESSNENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUHBER COUNTY ACN 11-19-96 BUTTS 12-13-95 21 96-0094 CUHBERLAND 101 H ANTHONY ADAHS 128 EKING ST SHIPPENSBURG ESQ PA 17257 Allount R.llltt.d *' In.II4'U'''''"", LULA B HAKE CHECK PAYABLE AND REHIT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALDNG THIS LINE ... RETAIN LOWER PORTION FDR YOUR RECORDS ~ iiEV:is4i-Ex-"FP-fil7":9,'-j-iioi'"icE--oF-YNHEiiii'iliicE-i'"Ax-'APPR'AiS!Hiiii'-,--"L'LoiiilNcE-eilimmmnmm DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT DF TAX ESTATE OF BUTTS LULA B FILE NO. 21 96-0094 ACN 101 DATE 11-19-96 APPROVED DEDUCTIONS AND EXEMPTIONS I 7,901.33 9. Funeral E.panaaa/Ado. Caata/Nlac, E.panaaa ISchedula NI 191 10. Dabta/Nartg898 Llabllltlaa/Llana ISchedula II 1101 .00 il. Total Daduatlona 1111 12. Net Value of Ta. Raturn 1121 IS. Charltabla/Gavarnaantal laquaata ISchedula JI 1151 l~. Net Value of Eatata SUbjact to Ta. Il~1 NOTEI If an a.......nt was 1..u.d pr.v1ou.ly, 11n.. 14, IS and/or 16, 17 and 18 will reflact f1gur.. that 1nclud. tha total of abb r.turn. a..a..ad to data. ASSESSMENT OF TAXI 15. Aaaunt of LIne l~ at Spau.al rata 1151 16. Aaaunt of Line l~ ta.abla at Llneal/Cla.a A rata 1161 17. Aaaunt of Line l~ taxabla at Callataral/Claaa I rata 1171 lB. Principal Ta. Due TAX CREDITS I PAYNENT DATE 08-02-96 TAX RETURN WAS, I X I ACCEPTED AS FILED RESERVATIDN CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN 1. Raal Eatata ISchedula Al 2. Stacka and Banda lSchedula II S. Cla..11 Held Stack/Partnership Intaraat ISchedula CI ~. Nartgagaa/Nataa R...lvabla ISchedula DI 5. CaahlBank Dapaalta,"laa. Paraanal Prapart1 ISchedula EI 6. Jalnt11 Owned Propart1 ISchedula FI 7. Tranafara ISchedula GI B. Total Aa..ta RECEIPT NUltBER AA146591 DISCOUNT INTEREST 1+1 I-I .00 I I CNANGED III 121 151 I~I 151 l61 17l .00 78.336.31 ,00 .00 56.493.65 .00 .00 IBI HOTEt To in.ur. proper credit to your ec:count, auboolt the uppar portion of thla fOMB with 10ur tax pa_t. 134.829.96 7.Qnl ~~ 126,928.36 .00 126,92B.36 .00 7,615.70 .00 7.615.70 7.615.70 .00 .00 .00 w IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATION DF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN '1, NO PAYNENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF TN IS FORN FOR INSTRUCTIONS.I .00 126.928.36 .00 X .00. x.06. X .15. IlBI AItOUIlT PAID 7,615.70 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE l.-; ~ ; " ..~ ....J '_)C) RESERVATION I E.t.t.. of d~edent. dying on o~ before a.c..ber 12, 1911 .. If ~v future Int.r..t In the ..t.t. I. tr~.f.rr.d In po.....lon or ""JOPMt to el... I (coU.t.r.1I Mneflcl.rl.. of the d.c.dent .fter tfMI .xplr.tlon of ~v ..t.t. fo~ Ilf. o~ for v..r., the e~.lth hereby .xpr...lv r...rv.. the rlDht to eppr.I.1 end ....1. tren.f.~ Inherlt8nC1 T,xI. .t the l..ful el... I (collat.ral) r.tl on env .uch future Int.r..t. PIIIPIlS[ ., NOflCEI To fulfill the requlr--.nt. 0' Section 1140 0' the Inherltenc. end E.t.t. T.. Act, Act II 0' 1991. 71 P.5. 5Htlon 214a. PA~TI Det.ch the top portion 0' thl. Notlc. ~ .~It with wour p.~t to the Aegl.t.r 0' Will. prlnt.d on the r.v.r.. .Ide. ......... chec:k or IIOMV order pev.,l. tOI REOISTER OF MILLS, AGENT All p.reent. rec.lv.d shell flnt b. eppllltd to MV Int.r..t which uv be due with MV r...lnder eppllltd to the talC. RUUND (CA) I A r.f\AI 0' . t.. crMIt, WhICh we. not requa.ted on the 'a. A.turn, uv be requa.tM by cHIII,Une en "Appllc.tlon 'or A.fund 0' Penn.ylvanl. Inherltanc. and E.t.t. f.... (REV"151J). Appllc.tlon. are ~Illbl. .t the O"lc. 0' the R..I.t.r 0' Will., WlY 0' the 2J Revenue DI.trlct a"lca., or bV c.lllnt the specl.1 24.hour an....rll'll ..nice nullben 'or 'or.. orderlnga In PennnlvWlI. t.,aa"56Z..zasa, outside Penn.vlvenl. end within local Harrisburg .r.. (717) 7'7"1094, TDD' (717) 772"2152 (He.rlng 1~.I,.ed Onlv). OUeTlONSI My party In Int.r..t not ..thflad with the eppr......"t, .UOW8nC. or dlnUowanca 0' deduction., or .........t 0' t.. (Including dl.count or Int.r..t) .. ~ on thl. Notlc. .u.t obJlCt within .I.ty (6a) day. 0' rec.lpt 0' thl. Notlc. bva -.wrltt.,.. prot..t to the PA Dep.rteant 0' ..v~, lo.rd 0' Appe.I., Dept. lllaZI, H.rrl.burg, PA 17111-la21, OR .....I.ctlon to MY' the ..tt.r det.,..lned .t eudlt 0' the eccount 0' the perlOl'\lll npr..."t.tlv., OR .-appe.l to the Orphen.' Court. "'IN lamATlVE CORR[CTIONSa FlCtuel .rro,.. discovered on thh ..........t should be addr...ecI In .,rltlna tOI PI Dep.rt.....t 0' ..v....., Iur..u 0' Individual T...., ATTNJ po.t AI....eant R.vlew unit, Dept. 2'0'01, Harrisburg, PA 17IZ.-a'01 Phone (717) 7.7.'5a5. S.. page S 0' the bookl.t -In.tructlon. 'or Inherltenc. TI. R.turn 'or. ...Ident Decedent- (R[Y.IS01) 'or .,.. .xpl~tlon of ~Inl.tr.tlv.ly correctable Irror.. D I SCOUrfT I 11 WIV to M h p.ld within thr.. U) c.I""r Nnth. Ift.r the decedent'. delth, . five pere.,..t (U) discount of the t.. p.ld h .UDWlId. PDlALna The 15% tl. eane.ty non.p.rtlcl,.tlon penalty I. coaputld on the tot.1 0' the to end Int.r..t .....IId, and not p.ld before Jenu.ry II, 1996, the 'Ir.t d.v aft.r the end of the t.. eana.ty period, Thl. non.p.rtlclpatlon PlNlty h .,.al8bl. In the .... eenner Md In the the .... tI.. period .. you would lIPPeal the t.. end Int.re.t that he. been ......Id .. Indlc.tlld on this notlc.. INTEREST I lnt.r..t I. charged beglnnlnt with flr.t dlY 0' delinquency, or nine C9J eonth. end one (I) d.y froe the date of death, to the det. of P'YMl'it. f.... tlhlch bee.. delinquent before Jenulty I, 1982 belt Int.r..t .t the nt. 0' .Ix C'~) percent Plr InnUa calcul.tld at a d.llv r.t. of .0aOI64. All t.x.. which bee... delinquent on end ,'t.r Jenuary 1, 1911 .,111 be.r Int.r..t .t . r.t. tlhlch .,111 v.ry froe caland.r y..r to c.land.r V"r .,Ith that rat. ennouncld by the PA DIp.rtaent of A.'1InU1. The appllcebl. Int.r..t r.t.. for 191Z through 1996 .r.t '!!!! Int.r..t Rat. aallv lnt.r..t Factor :!!!! lnter..t Rate Oally Inter..t ractor I98Z zn .aODS4i 1911 OX .OOlZO I.IS lOX .aOlUI 1911.1991 IIX ,aaUGI I... IU .unal I99Z OX .auzu 1915 UX .aou" 199J.19M nc ,aOOl92 I'" lOX .uazn 1995"1996 OX .aaazu ....lnt.r.U I. c.lcul.ted a. 'ollow.. INTEREST . IALANCE OF TAX UNPAID X NUHIER OF DAYS DELINQUENT X DAILY INTEREST FACTOR ....Any NoUe. ...ued .ft.r the ta. bacHa' delinquent .,111 r.flect en Int.r..t e.lcul.lIon to flftHn US) dews beyond the d.t. of the ........"t. If ,.v....t II .8dI .ftlt the Inter..t Coaputltlon d.t. &howl on the NoUe., eddltlonel Int.re.t .u.t be calculated,