HomeMy WebLinkAbout96-00141
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This is to ccrci(y thac the inform;lIion hcn' Ri\'cn is corrnely writ." from ,Ill origin,II (cuificatc IIf dc.lIh tlllly fiI~d with me 35
Local Registrar. Th~ origin.IIl"l'uif;"llc will be forw;mlc:d 10 lhl' Srilte: Vil,11 Rl'lonls Offill' (or pCrm,H1l'nc filing.
WARNING: 1111 Illegal to duplicate this copy by photo stet or photogreph,
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No.
MI.ltJIIlItorW
COIIMOHWWTH 01' PEHHIYUIlHIA . OUMTMlHT 0' HIAUH' YflAt. RECORDS
CERTIFICATE OF DEATH
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LAST WILL AND TBSTAMBNT
OF
BDITH A. GOLL
I, EDITH A. GOLL, of 712 Messiah Village, Mechanicsburg,
Pennsylvania being of sound mind, memory and understanding do
hereby make, publish and declare this as my Last will and
Testament, hereby revoking and making void any and all wills and
codicils heretofore made by me.
ITEM I - I direct my Executor to pay the expenses of my last
illness, funeral expenses and estate and inheritance taxes as soon
after my death as may be found convenient.
ITEM II - I direct that my remains be cremated, the ashes to
be interred in the Goll Family Plot in Auchinbach Cemetary,
Reading, Pennsylvania.
ITEM II I
I give all my tangible personal property,
including, but not limited to, any and all automobiles, furniture,
furnishings, china, silverware, jewelry, ornaments, works of art,
books, pictures and wearing apparel, together with all policies of
insurance thereon, but excluding cash on hand and tangible
evidences of intangible personal property to the Messiah Village
Endowment Fund, Mechanicsburg, Pennsylvania.
ITEM IV - I give the refund of the purchase price for my
apartment at Messiah Village which is due my estate at my death to
the Messiah Village Endowment Fund, Mechanicsburg, Pennsylvania.
CLICKHrR . 'IAREN
A"OIlUTS ., "A.
M....I..U... 'IHMnLVAHIA
PAGE ONE OF THREE
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ITEM V
I give, devise and bequeath all the residue and
remainder of my estate, real and personal as follows:
A. One-third (1/3) thereof to the OAKWOOD BAPTIST CHURCH,
4315 Chestnut Street, Camp Hill, Pennsylvania.
B. One-third (1/3) thereof to the aforesaid MESSIAH VILLAGE
ENDOWMENT FUND.
C. One-third (1/3) thereof to MESSIAH COLLEGE, Grantham,
Pennsylvania foe the purposes of scholarship encowment.
ITEM VI - I hereby nominate, constitute and appoint WILLIAM
FEAREN, ESQUIRE, as Executor of this Will.
If WILLIAM FEAREN,
ESQUIRE, is unable or unwilling to act or continue as Executor, for
any reason whatsoever and whether before or after my death, I
appoint RICHARD W. CLECKNER, ESQUIRE, successor Executor. My
Executor is directed to proceed with the expeditious administration
of my estate.
If my estate shall not have been fully settled
within one year from the date of my death and such delay is not due
to an unavoidable delay in securing the necessary approvals of
State and Federal taxing agents, then my personal representative
shall be removed in favor of the next personal representative named
in my Will, and if none of them is available to serve, then such
removal shall be effected and the Register of Wills of Cumberland
County, Pennsylvania, shall appoint an Administrator, CTA.
CLlCKNrR . nAREN
InOO;111 A' UW
MUIII'UtI. .IM""LYAM.A
PAGE TWO OF THREE
COUNn O' CUMIIRLAND
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N'
WILLIAM FEAREN
sworn .ccordin9 10 I.w, d.po.., end "y' Ih.1 h. is Executor
01 Ih. e...I. 01 Edith A. Goll. a/k/a Edith Ann Goll
1.1. 01 _..YP.E.!!.~ ,!\l~~!I_~~~nship _. - , Cumb.rl.nd County, ,.., d.c....d .nd thtl the
wilhln I. .n Inv,nlory m.d. by Wi 11 iam Fearen , Ih. ..Id Executor
01 the ,ntlr, ..1.1, 01 ..Id d.c.d.nt. con,ltlin9 01 .11 the p,non.1 prop'4rty end rill ..I.t" ncept r..1 ..t.l, ouhld.
Ih, Commonwullh 01 P,n",ylvlnil, .nd thll the fi9ur.. opposlt, IIch It.m 01 Ih. 'nvenlory r.pr..'nt It'. Illr v.ru,
.. 01 Ih, d.l, 01 d.ced.nl', dlllh.
end lub,crib.d b.lor. m.,
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426 Deerfield Road
Camp Hill, PA 17011
AJJron
8th
of
February
1996
D.y
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INSTRUCTIONS
i I. , An Inventory must b. fiI.d within Ihrll monlhs .ller Ippointm.nl 01 penonel represent.tlve.
~,supplement Invenlory mu~ be filed wilhin Ihirty dlYI ~I dilcovery 01 ,dditionll .1S.h.
Addi'lio,;.' Ihllh m.y b. ditch.d II to porson,IIy or rulty
Sit Article IV, Fiduci.ries Act 011949.
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Invenlory of Ihe ,.al and personalesta'e of
EDITH A. GOLL, a/k/a EDITH ANN GOLL
deceased
'10..
1. Harrisburg Belco Federal Credit Union Account '032290
2. AARP GNMA and U.S. Treasury Fund Account .531101918
3. 335.112 Shares The American Funds Group Capital Income
Builder @ $37.62/share
4. 5,662.479 Shares Delaware Group, Delchester Fund A
Class @ $6.30/share
5. PNC Money Market Account .5130104767
6. PNC Interest Checking Account '51-4002-3813
7. Harrisburg Belco Federal Credit Union Life Insurance
8. PA Blue Shield Reimbursements
9. Medicare Reimbursement
'10. Prudential Life Insurance Proceeds
11. Messiah College Annuity Payment (replacement of 11/95
check never cashed)
12. Jewelry
13. Miscellaneous Old Coins
14. Bell Atlantic Pension
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TOTAL
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30,449 88
2,399 21
12,606 91
35,673 62
2,488 35
21, 189 19
500 00
1, 070 07
89 70
8,590 36
786 10
i2,300 00
1, 000 00
308 05
129,451 44
llY,1500 fX + (7.9'1
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15- 85-1
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
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COMMONWEALTH O' PENNSYLVANIA
DE,,,UMfNT O' REVENUE
DE". 2.0601
HARRISBURG, 'A 1712'-0601
DECEDINT'S NAMIILA$T. 'IUT. AND ,..IDDtf INltlAll
GOLL, EDITH A.
SOCIAL SfCUtlfY NU"'IU
CAU Of DEAtH
'OR DATlSO'DIATHAnlR 12131191 CHICKHIRl
If A SPOUSAL
POVIITT CRlDIT IS CLAIMID 0
fill NUMIlR
21
96
0141
COUN1Y CODE
YEAR
NUMBER
DECEDENT'S COMPUU AOOIUS
712 Messiah Village
P. O. Box 2015
Mechanicsburg, PA 17055
COlin' Cum 1
AMOUNt ItCll'dO I!lU IN$lIUClION$1
062-07-0212 02/0B/96 07/16/12
II' "PlICAIUIIUlmlHQ 'IOUU" H.....I ",UT. ,..n AND ..IDOIIINITI,I,II SOCIAL UCUI.IY NUMUI
None
00 1. Orlginol Relurn 0 2. Supplemenlol Relurn
o A. Umit.d Ellat. 0 Aa. fulure Inler"t Compromise
(lor dOltS 01 deo,h oher 12,12,82)
[X] 6. D.ced.n' Di.d T..loI. 0 7. DIC,d.nl Maintained a living TrUll
(A"och copy of Will) (Alloch copy 01 Tru"1
~RRESPONDENCEAND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO. ",
COM'LIH MAILING ..ooun
LECKNER AND FEAR EN
. O. Box 1l8470~ N. Secont1St.
arrisbur . PA ~1'JI08'>': 847 :DCI
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Esquire
20, If Un. 1910 greoler Ihon Line 18, .nler the difference on L1n. 20. Thi. i, ,he OVERPAYMENT,
aD
21. If lIn. 181, g,.o'er than lIn. 19, .nl., thl diFf".nc. an lIn. 21. Thill. the TAX DUE.
A. Ent.r Ih.ln'.'II' on ,h. balonc. due on lIn. 21A.
B. Enltr,helolol of Line 21 ond 21A on L1n. 218, Thillo Ihe BALANCE DUE,
Mok. Check Poyobl. tOl Regl.t.. 0' Will., Agent
~\iHiiJ:;ijli1nV' ,.BI SURE TO ANSWER ALL QUEmONS ON REVERSE SIDE AND TO RECHECK MATH t~':;"';" en,;' ' f..',;
Under Plnchl.. of p.rlury. I declor. thot I hay, ....amin.d ,hi, r.turn, including accompanying sch.dul.. and "olemenlt. and 10 the b", of my knowledge and blll.f,
III. lru., corr,d and compl.t.. I declor. IhlJl all r.al .1101. has bit" r.port.er atlru. market value. Declaration of prepare' other than thl penonal r.presentative II
balld on alllnformallon of which prepare' has ony knowledge.
1I0HA O"'''OH '0' ""HO "'U'H A.."" WILLIAM FEAREN, 426 Deerfield Road. .A~\c-J ~ 101
Carn Hill, PA 17011 ~
A.."" ANN E. RHOADS, CLECKNER AND FEAREN, ~
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a:
I. Reol Ellole (Schedule AI
2, Sloch ond Bond, ISchedule BI
3, Cloltly Held S'ocklPorlnellhlp In'erell (Schedule q
... Mongoo.. and Nol.. Receivabl. (Schedule OJ
5. Ca.h. Bank D'po.it. & MilC.llan.ou. Penanal Property
ISchedule E)
6, Join,ly Owned Properly (Schedule F)
7, TronsferslSchedule G)ISchedule l)
B. Talal Gra.. An... (10101 Lin.. 1.7)
9. Funeral.f:...p.n.... Admini.ltativ. Ca.", Mbcellaneou.
bpenlt' ISchedule HI
10. D.bll. Martgag. llabiliti.., lien. (Schedule I)
11, T 0'01 Deduction. 1'0101 lintS 9 & 10)
12. N.t Valu. of e.lat. (lin. B minu. Line 11)
13. Charitabl. and Governm.ntal Bequ.'" (Sch.dule J)
14, Ne' Volu. Sublect 10 To_lline 12 minulline 131
15. Spou.al Tran.f.n (far do'.. of death aher 6.30.9A)
5.. In.trudlan. for Appllcabl. Percenlage on Rev"..
Sid.. (Includ. valu.. from Schedul. K or Schedule M.l
16. Amount of lint 1,C ta...able at 6% rate
(Include valu.. from Schedule K or Schedule M.)
17. Amount of lIn. 1.4 ta...abl. at 15% rate
(Includ. valu.. from Sch.dule K or Sch.dule M.)
lB. Principal to... due (Add to... from Lin.. 15, 16 and 17.)
19. Credill Spau.al Pav.rty Credit Prior Paym.nll
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(lor do'tS 01 deo,h prior '0 12,13,82)
o 5. F.d"al e.tat. To... R.turn R.quired
.1. 8. Total Numb" of Safe C.po.it Bo.....
',"'-... .,.c.i.j';.':::...';r; ,:
....-.....
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(1) 0.00
121 50,679.74 1;-1
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(4)
IS) 68.521.57 ::-="
(6) 48.727.59 '!. -. l..-;
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(71139.175.81
(8) 307,104,71
(9) 12,926.00
(10) 7,824.71
(151 0.00
(16) 0.00
(17) 0.00
OilCount Inl"'"
+
(111 20.750.71
(121 286.354.00
(131 286.354.00
(14) 0.00
X._II 0 00
X .06 II 0,00
)( .15 II 0,00
(18) 0.00
(19) 0.00
(20) 0.00
Chcck hl"eo if you au! rcquC'\ting a refund of your avcrpayn-umt.
(21)
(21A)
(21BI
0.00
0,00
0.00
Ad '48 o' 1994 provld.. 'or the r.dudlon o' the tox rat.. Impo..d on the n.t valu. o' tran.'.r. to or 'or
the u.. o' the .pou... Th. rat.. a. pr..crlb.d by the .tatut. will b.:
. 3% (.03) will b. appllcabl. 'or ..tat.. o' d.c.d.nll dying on or aft.r 7/1/94 and b.'or. 1/1/96
. 2% (.02) will b. appllcabl. for ..tat.. o' d.c.d.nt. dying on or aft.r 1/1/96 and b.'or. 1/1/97
. 1% (.01) will b. appllcabl. for ..tat.. o' d.c.d.nll dying on or aft.r 1/1/97 and b.'or. 1/1/98
. Spou.al trand.,. occurring on or aft.r 1/1/98 will b. .x.mpt 'rom Inh.rltanc. tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK (...) IN THE APPROPRIATE BLOCKS.
YES NO
1. Did decedent moke a tronsfer and:
X
a, retoln the use or income of the property transferred, .......................................................
b, retoin the right to designote who shall use the property tronsferred or Its income, ............... X
c, retoln a reversionary interest; or ..................................................................................,
X
d. receive the promise for life of either payments, benefit. or coreV .......................................
2, If death occurred on or before December 12, 1982, did decedent within two yeors preceding
deoth transfer property without receiving odequate conslderotlonV If deoth occurred after
December 12, 1982, did decedent tronsfer property within one year of death without receiving
adequate conslderation'.................o.................................................................................
X
X
3, Old decedent own on 'In trust for', bank account at his or her death9..................,................... X
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN,
lIY,l5oi IX. 1""1
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SCHEDULE B
STOCKS AND BONDS
COMMONWEALTH 0' PENNSYLVANIA
INHEIIUNCE TAX tlnUIN
IUIDlNl DECEDENT
FILE NUMBER
ESTATE OF
GOLL, EDITH A.
21 - 96 - 0141
(Ail property lolntly-own.d with Right 0' Survivorship mull b. dl"lo..d on Sch.dul. F.)
ITEM
NUMBER DESCRIPTION
VALUE AT DATE
OF DEATH
1,
AARP GNMA and U.S. Treasury Fund
Account No. 531101918
155.894 Shares @ $15.39
$ 2,399.21
2.
335.112 Shares American Funds Group
Capital Inc. Builder @ $37.62/share
12,606.91
3.
5,662.479 Shares Delaware Group,
De1chester Fund A Class @ $6.30/share
35,673.62
S 50,679.74
TOTAL (AI.o onler on IIno 2, Roca ilulallan
(Ir mort spac. ;, n..d.d, ins.rt addi'ionol ,h..,. 01 lam. sill.)
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SCHEDULE F
JOINTLY-OWNED PROPERTY
COMMONWfAUlt O' PENNSYLVANIA
INHUltANCl! TAX UTURN
IISIOIHT OlaOINI
ESTATE O'
GOLL, EDITH A.
FILE NUMBER
21 - 96 - 0141
Joint tonanl('I'
A,
NAME
Messiah College
ADDRESS
Grantham, PA 17027
RELATIONSHIP TO DECEDENT
Charitable benef c ary
B,
Oakwood Baptist Church
4315 Chestnut Street
Camp Hill, PA 17011
Charitable beneficiary
C,
Jolnlly-ownod property.
ITEM LmER DATE
FOR TOTAL VALUE DECD'S DOLLAR VALUE OF
NUMBEI JOINT MADE DESCRIPTION OF PROPERTY
TENANT JOINT OF ASSET % INT. DECEDENT'S INTEREST
1. A 11/94 Certificate of Deposit 25,179.76 50% 12,589.88
'000021001021067 PNC Bank
2. B 02/89 Certificate of Deposit 72,275.41 50% 36,137.71
'21001020453 PNC Bank
TOTAL (Aba onl., on lin. 6, Rocapilulalion) 548,727.59
(II mar. spac. is n..d.d ins.rt addilional she.ls or sam. sill'
II~UIlI" Poll]
~-._..,~.,..-.--_.- .
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COMMONWfAU'H 0' 'INNSytyANIA
INHllltAHCI TA. InUIN
.ISIDIN! DICIDINT
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
.1..
I
I Plea.e Print or Tvpe
FILE NUMBER
. 121 - 96 - 0141
GOLL, EDITH A.
ITEM
NUMBER
A. Funeral Expen.ell
1,
B.
4.
C.
1,
2,
3,
4,
5,
6,
7.
8,
DESCRIPTION
1.
Admlnl.tratlve CO.t., William Fearen
""nonal Rep",.enlolive Comml..ion.
Social Security Number 01 ""nonal Representative:
Year Commi..lon. paid 1996
201 - 18 - 3551
2.
Allorney Fee. Cleckner and Fearen
3,
Family Exemption None
Claimant
Add",.. 01 Claimant at decedent's deolh
S'",et Add",..
City
Slale
Zip Code
Relollonship
Probate Fee.
2/14/96 - Register of Wills, Probate
MI..ellaneou. Expen.e'l
4/01/96 - Cumberland Law Journal - Advertising
3/25/96 - Betty Guy Tax Service
3/25/96 - Patriot News Co. - Advertising
TOTAL (AI.o enler on line 9, Recopilulation)
(II mar. .pace I. needed, In.ert addltlanal.heet. of .ame .I.e.)
AMOUNT
6 , 178 .00
6,170.00
159.00
60.00
272.00
79.00
S 12,926.00
.
..-...--.-'
. .
ITEM V - I give, devise and bequeath all the residue and
remainder of my estate, real and personal as follows:
A. One-third (1/3) thereof to the OAKWOOD BAPTIST CHURCH,
4315 Chestnut Street, Camp Hill, Pennsylvania.
B; One-third (1/3) thereof to the aforesaid MESSIAH VILLAGE
ENDOWMENT FUND.
C. One-third (1/3) thereof to MESSIAH COLLEGE, Grantham,
Pennsylvania for the purposes of scholarship encowment.
ITEM VI - I hereby nominate, constitute and appoint WILLIAM
FEAREN, ESQUIRE, as Executor of this Will.
If WILLIAM FEAREN,
ESQUIRE, is unable or unwilling to act or continue as Executor, for
any reason whatsoever and whether before or after my death, I
r:,. appoint RICHARD W. CLECKNER, ESQUIRE, successor Executor. My
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Executor is directed to proceed with the expeditious administration
of my estate.
If my estate shall not have been fully settled
within one year from the date of my death and such delay is not due
to an unavoidable delay in securing the necessary approvals of
State and Federal taxing agents, then my personal representati ve
shall be removed in favor of the next personal representative named
in my Will, and if none of them is available to serve, then such
removal shall be effected and the Register of Wills of Cumberland
County, Pennsylvania, shall appoint an Administrator, CTA.
<<CItHE. . FrAUM
"'olllns Af uw
IIlU... ,e'UllnYAlrUl
PAGE TWO OF THREE
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COHHONWEALTH OF PENNSVLVANIA
DEPARTHENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE 'AX DIVISION
DEPT. lIO.o1
ttARRUlUAC. PI 1112'-0.01
NDTIC" OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE DR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
ANN E RHOADS ESQ
CLECKNER 8 FEAREN
PO BOX 11847
HBG PA 17108
DATE
ESTATE OF
DATE OF DEATH
FILE NUHBER
COUNTY
ACN
12-02-96
GOLL
02-08-96
21 96-0141
CUMBERLAND
101
Allount R...Ut.d
~
.1f.1I.,..".l.,....
EDITH
A
HAKE CHECK PAVABLE AND REHIT PAVHENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiEV:isiij-EX-AFji-ioY:9r.T"iicificE--cii'uiliHEiiifliNCE-i:iiiD-PPR'AisEHEiiT-,uAi.i.-ciwliNCE-iilimum-umm
DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF GDLL EDITH A FILE NO. 21 96-0141 ACN 101 DATE 12-02-96
APPROVED DEDUCTIONS AND EXEHPTIONS:
12,926,00
9. Funeral Expen.../Ad.. Co.ta/Hise. Expens.. (Schedule HJ I')
10. Debh/Horloaoa LlabUIU../Uan. ISchadule II 1101 7.824,71
11, Total Deduction. 1111
12. Net Valua of Ta. Raturn 1121
13. Ch8rltabl./Cov.r~.nt.l alqua.t, (Schedul. J) (13)
14, Nat Valu. of E.tata Subjaot to Ta. (141
NOTE: If an assessment was issued previOUSly, lines 14, 15 and/or 16, 17 and 18
reflect figures that include the total of 6hh returns assessed to date.
ASSESSHENT OF TAX:
15, Aoount of Lln. 14 at Spou.al rata 1151
16, Aoount of Line 14 ta.abla at LlnaaI/Cla.. A rata 1161
17. Aoount of Line 14 ta.abla at Collataral/Cla.. B rata 1171
lB. Principal Ta. Due
TAX CREDITS:
PAYMENT
DATE
TAX RFTURt: WAF I (X, ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Raal E.tata ISchedula AI
2, Stock. and Bond. (Schadula BI
5. CIoa.ly Held stock/Partnership Int.r..t (Schedule CJ
4. Kortg.gal/Hot.. Receivabl. (Schedule OJ
5. C..h/Bank Oapollta'Hllc. Parlonal Property (Schedule EJ
6, Jointly Owned Proparty ISchodula FI
7. T~an.f.r' ISchedule GJ
8. Total A...t.
I CHANGED
III
(21
(31
(4)
(51
(6)
(71
,00
50,679,74
,00
.00
68.521. 57
48.727,59
139.175,81
leI
,00
,00
,00
x,OO.
X ,06.
x ,15.
Ilel
RECEIPT
NUMBER
DISCOUNT 1+'
INTEREST 1-)
AMOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
NOTEI To jnlura proper
credit to your account,
sub.it the upper portion
of this for_ with your
taM payaent.
307,104,71
'0.71;0 71
286,354,00
286,354.00
.00
will
,00
,00
.00
,00
,00
,00
,00
,00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST,
I IF TOTAL DUE IS LESS TNAN tl, NO PAYMENT IS REQUIRED,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU HAY BE DUE
A REFUND, SEE REVERSE SIDE OF TNIS FORM FOR INSTRUCTIONS,I
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RESERVATION. r.ta'.. of decedent' dying on or before Dec.-ber 12, 19'! .. I' ~y future In'ar..' In the I.'at. I, tr~".rred
In po.....lon or InJo~t to Cl... . (col1,',r,1) bene'lcl"... of the decedent I,t,r the ..p.rtllon 01 InV ..'at. 'or
11'. or for y..r., the Co..onwellth h.rabv ..pr..'lv t...rva. the right to .",.... end ...... ttln,f., Jnh.rlt~. ,....
at the l.wful C1I.. . (co11,',r.l) r.t. on 8nV luch lutur. Int.r..t.
PUIlPOSf: OF
HOIJtE, To fulfill the requlr.-.ntt of Section Zl~a of the Jnherltencl ~ Elt.t. ,.. Act, Act II of 1991. 72 P,S.
Section 2141.
PAMNTI o.tach the tap portion of thh NotlcI Met luI*lt .,lth you,. PIVMI'l' to the _..ht.r 0' WUlI prln'''' on the revl'" ,...
..M.... check or -., order pI,.tII_ tOI REGISTER OF MILLS I AGEHT
All P.~t. r.cllv.d ~11 flr.t be ~11'" to 1n1 In'.r..t which "V be ~ with 8nV ,...Inder ~11ed to the t...
RU\JrCD caul A nfund of a ta. cnellt, ..,Sch .... not r..,..ted on the T.. Raturn, ..y be reque.ted by cDllPlaUno an "Appllc.Uon
for _.fund of Pennlylvanl. I~rltanc. and E.t.t. T.... (REV-1313). Appllc.tlon. ara avallabl. .t the afflc.
0' the R..I.t.r of Will., any of the ZS Rayenue DI.trlct a'flc.., or by c.lllne the .peelal 24-hour
antwerlng ..rvlc. nuaber. 'or for.. orderlngl In Penn.ylvanl. 1-.00.S6Z.2050, out.lde PennlYlvanla and
within lOCal Harrhbur. .r.. (717) "'-'OM, TOO' (111) 712-2152 (He.rlng I.alred Onlyl.
alJECTIDHSI Any p.rt, In Int.r..t not ..tl.fled with the apprall..-nt, .llowanca or dl.all~anc. of deduction., or .......-nt
of tax (Including discount or Int.r.,t) .. shown on thl. Hotle. .u.t ObJact ..Ithln .I.ty (60) d.y. of rac.lpt of
thh MoUe. brl
....rlttan protatt to the PA Dapartaant of AlylnUe, loard of App.a", o.,t. 211021, Harrhbur., PA 11121-1021, OR
....INUon to have the ..tt.r clat.ralned at audit of thl account of thl p.r'ONI r.,r..ant.Uv., OR
-......1 to the Orphans' Court.
AlliUM
IITIlATlYE
CQRRfCTIDHSI
'aotual .rror. dl,cOY.red on thl. ......eant should be addr...ed In ..rltlng to. PA O.,arteent of R.yenue,
lur.au of Individual Ta..., ATTNI Po.t i.....aant R.yl... unit, D.pt. 210'01, Harrisburg, Pi 11121-0'01
Phone (717) ,.7.6505. S.. page 5 of thl booklat "In.tructlon. for Inherltanc. T.. R.turn for I R..ldant
Decadent" (REV-1S01) for an ..planatlon of ~lnl.tratIYaly correctable .rror..
DISCOUNT,
If any tlx due I. paid ..Ithln thr.. (SJ c.landar eonth. aft.r thl dIe.dant'. death, . fly. parcant (IX) dl.count of
thl t.. paid I. .llowed.
The IIX tl. .-na.ty non-p.rtlclpltlon panalty I. c~tld on the tot.l of thl t.. and Intar..t ......Id, and not
p.ld bafor. Janu.ry II, 1996, the flr.t d.y .ft.r the and of the t.. aana.ty p.rlod. Thl. non-p.rtlclpatlon
penalty I, .....Iab.. In thl ... unnar and In the the .... tI.. par lod II YOU would appa,.l the tl. and Int.nlt
that haa baan ......1Id a. Indlc.tad on thl. noUc..
PfHALTVI
INTEREST.
Intarllt h charted baglnnlng with first day of d.lInquency, or nine (tJ eonth. and ana (II day froe the data of
death, to the d.t. of p.,.ant. T.... which bac... d.llnquent bafor. January 1, l'IZ b..r Intar..t .t thl rat. of
.he (IX) p.rcant par ........ calculatlld .t . d.lh rata of .000164. All t.... which bec... delinquent on and .ft.,.
Janua,.y 1, .'12 will ba.r Intar..t at . r.t. which will v.ry fro. c.land.r y..,. to c.landar y..r ..Ith th.t r.ta
announced by thl Pi Dap.rt-.nt of R.vanua. Th. appllCabla Int.,...t ,..ta. fo,. 1982 through 1996 a,..1
!!!! In'',nt "t. Dally Jnt.r.at Factor !!!r Jnt.r..t R." Dally tnt.,...t Facto,.
1912 lOX .000548 1911 'X .00DZ47
1915 lOX .00001 1911-199. IIX ,000501
1'.4 IIX .000301 1992 'X .OODZU
I.n UX ,OOnS6 1993-1994 1X .0001'2
.'.6 In .00027_ 1995-199' 'X .OODZU
--Int.r..t It c.lculat.d n follow..
INTEREST . BALANCE OF TAX UNPAID X NunBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Motlca I..ued .ft.,. thl t.. b.c... dallnquent wIll rafl.ct an Intarllt calcul.tion to flft.an 1151 d.y.
bayond thl d.t. of the .....a.ant. If payeant I. .ada .ft.r the Int.,...t co~t.tlon data .hown on thl
Notlca, addltlONl Int.rllt "".t be c.lculat.d.
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IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
IN RE:
ORPHANS' COURT DIVISION
ESTATE OF EDITH A, GOLL,
a/k/a EDITH ANN GOLL,
Deceased
NO. 00141 - 1996
AGREEMENT REGARDING DISPOSITION
OF CERTAIN ASSETS AND RELEASE
FILED ON BEHALF OF:
WILLIAM FEAREN, EXECUTOR
Ann E. Rhoads, Esquire
Attorney I,D. No, 49631
CLECKNER AND FEAREN
31 North Second Street
P. O. Box 11847
Harrisburg, PA 17108-1847
(717)238-1731
-_:_-
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AGREEMENT REGARDING DISPOSITION
OF CERTAIN ASSBTS AND RELEASB
'"
THIS AGREEMENT, entered into this L day of
1996, by and between WILLIAM FEAREN, individually and
of the Estate of Edith A. Goll, also known as Edith Ann Goll,
deceased; Messiah Village on behalf of its Endowment Fund; Oakwood
Baptist Church; and Messiah College,
WHEREAS, Edith A. Goll, also known as Edith Ann Goll (herein-
after referred to as "Decedent"), late of Upper Allen Township,
Cumberland County, Pennsylvania, died February 8, 1996, having left
her Last Will and Testament dated March 5, 1990, which was duly
admitted to probate by the Register of Wills of Dauphin County on
February 15, 1996, File No. 1996-00141; and
WHEREAS, WILLIAM FEAREN was duly appointed as Executor of
Decedent's Estate on February 16, 1996; and
WHEREAS, the parties in interest under the Last Will and
Testament of the Decedent are:
(1) Messiah Village Endowment Fund
100 Mt. Allen Drive
Mechanicsburg, PA 17055
(2) Oakwood Baptist Church
4315 Chestnut Street
Camp Hill, PA 17011
(3) Messiah College
Grantham, PA 17027
; and
WHEREAS, the bequests to the above-named beneficiaries by the
Decedent in her Last Will and Testament were as follows:
- 1 -
'~_"'_'''''''_''~.'':;W'-'''_''''_''''''.''__
"\
,"'-'"
.
ITEM III - I give all my tangible personal property,
including, but not limited to, any and all automobiles,
furniture, furnishings, china, silverware, jewelry,
ornaments, works of art, books, pictures and wearing
apparel, together with all policies of insurance thereon,
but excluding cash on hand and tangible evidences of
intangible personal property to the Messiah Village
Endowment Fund, Mechanicsburg, Pennsylvania.
ITEM IV - I give the refund of the purchase price
for my apartment at Messiah Village which is due my
estate at my death to the Messiah Village Endowment Fund,
Mechanicsburg, Pennsylvania,
ITEM V - I give, devise and bequeath all the residue
and remainder of my estate, real and personal as follows:
A.
One-third (1/3)
CHURCH, 4315
Pennsylvania.
B. One-third (1/3) thereof to the aforesaid MESSIAH
VILLAGE ENDOWMENT FUND.
thereof to the OAKWOOD BAPTIST
Chestnut Street, Camp Hill,
C,
One-third (1/3) thereof to
Grantham, Pennsylvania for
scholarship endowment
MESSIAH COLLEGE,
the purposes of
; and
WHEREAS, in addition to her testamentary bequests, Decedent
made lifetime transfers to each of the above-named beneficiaries
through various mechanisms, such as but not limited to, outright
gifts, annuities, beneficiary designations and the creation of
joint or payable on death accounts; and
WHEREAS, the Decedent also held the following assets at the
time of her death which she had titled "EDITH ANN GOLL TRUST, Edith
Ann Goll, Trustee, FBO OAKWOOD BAPTIST CHURCH UtA DTD 10-30-91":
- 2 -
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ASSET
DATE OF DEATH VALUE
(1) 100 shares common stock,
DSC Communications Corporation
$ 3,337.50
(2) $25,000.00 Dauphin County General
Authority Senior Mortgage Revenue
Bond, Series of 1991
(3) Wheat, First, Butcher, Singer
Account #3595-5011
25,000.00 (est,)
11,375.59
and
WHEREAS, after diligent search, the Executor of Decedent's
estate has been unable to locate a Trust instrument as referenced
in the title to the assets listed above or any evidence other than
said titles that such an instrument ever existed; and
WHEREAS, as a result of the above, the parties have come to
believe that the Decedent was attempting to create an informal
trust for the benefit of Oakwood Baptist Church by titling the
above assets as described; and
WHEREAS, while each of the parties hereto understands the
existence of a potential challenge to the title to the above-
mentioned assets which if successful would bring said assets into
the probate estate, each is nevertheless willing to forego such a
challenge to allow the Decedent's apparent intention with respect
to said assets to be fulfilled; and
WHEREAS, it is the desire of the parties to this Agreement
that disposition of the above identified assets be agreed upon
without the expense, delay and publicity of litigation.
- 3 -
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NOW, THEREFORE, in consideration of the mutual promises,
covenants and agreements recited herein and with the intention to
be legally bound, the parties agree as follows:
1. Messiah College, Messiah Village on behalf of its
Endowment Fund and the Estate of Edith A, Goll, also known as Edith
Ann Goll, do hereby waive, disclaim and release any and all
interest any of them may have of any nature whatsoever in the
following assets, in favor of Oakwood Baptist Church: 100 shares
of common stock in DSC Communications Corporation, represented by
stock certificate No. DS 79730, CUSIP 233311-10-9; Wheat, First,
Butcher, Singer Account No. 3595-5011; and a $25,000.00 Dauphin
County General Authority Senior Mortgage Revenue Bond, Series of
1991 (Messiah Village Project), represented by certificate No,
R0872, CUSIP: 238259 SV 8.
2. Each of the parties to this Agreement does hereby release
and forever discharge William Fearen, individually and as Executor
from any and all liability in connection with his actions as
Executor of the Estate of Edith A, Goll, a/k/a Edith Ann Goll
regarding the assets which are the subject of this Agreement. The
parties further agree to indemnify and hold harmless the said
William Fearen from any and all liability which may arise against
the estate or him by third persons relating to the assets which are
the subject of this Agreement.
3. The parties each acknowledge and agree that this Agreement
is an amicable resolution of an unclear legal situation and
- 4 -
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agreement hereto and shall not constitute an admission as to the
merits or lack thereof of any party's possible position with
respect to the legal effect of the way in which the Decedent titled
the assets which are the subject of this Agreement. The parties
each further acknowledge and agree that each has consulted its own
legal counsel regarding this Agreement or hereby waives its right
to do so,
4. Each party to this Agreement acknowledges that this Agree-
ment shall be indexed and recorded in the estate proceedings and
that the terms hereof shall be binding upon their respective
successors and assigns,
WITNESSES:
~..-(~
WI LIAM F N, Indi viduall~
as Executor of the Estate of
Edith A. Goll, a/k/a Edith Ann
GOll, Deceased
W~~~
MESSIAH VILLAGE, ON BEHALF OF
ITS ENDOWMENT FUND
.;;(
BYrJd ),'1: /'
OAKWOOD BAPTIST CHURCH
//~.ff./~/;;f: -?:t~4tP,//~4~.(/ By ~~ (f.?~,,-)
(J L~~~;~
MESSIAH COLLEGE
. '-jl(& :> BY~ roo ~ C
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SUMMARY OF ACCOUNT
proposed Distribution to Beneficiaries:
$ 34,169.54
princioal
Receipts
$129,411,44
Less Disbursements:
Debts of Decedent
Funeral Expenses
Administration Expenses
Federal and State Taxes
Fees and Commissions
$11,245.69
0,00
718,12
256,00
12,900,00
Balance Before Distributions
Distributions to Beneficiaries
Principal Balance on Hand
- 25,119,81
$104,291.63
73,300.00
$ 30,991.63
Income
Receipts
Less Disbursements
Income Balance on Hand
$
967,44
0,00
Combined Balance on Hand
Adjustment
Adjusted Combined Balance on Hand
$ 967,44
$ 31,959.07
2,210,47
$ 34,169.54
RECEIPTS OF PRINCIPAL
Assets Listed in Inventory
(Valued as of Date of Death)
Fiduciary
Acquisition
Value
~
Harrisburg Belco Federal
Credit Union Account #032290
AARP-GNMA and U.S. Treasury
Fund Account #531101918
$30,449.88
2,359.21
PNC Money Market Account
#5130104767
2,488,35
PNC Interest Checking Account
#51-4002-3813
21,189,19
Pa. Blue Shield Reimbursement
1,070.07
Medicare Reimbursement
89.70
- 2 -
DISBURSEMENTS OP PRINCIPAL
Debts of Decedent
03/29/96 - Messiah Village $ 4,515.49
07/08/96 - Bankers Trust (repayment
of Bell retirement) 2,233.38
07/08/96 - Medical & Surgical
Centers, Inc. 1,236.82
RESERVE - Robert Conrad - services
performed as Power of
Attorney 3/93 - 2/96 3.260.00
$ 11,245.69
Funeral ElCtlenses
None
Administration Exoenses
02/14/96 - Register of Wills $ 159.00
03/21/96 - Ann E. Rhoads (travel) 3,41
03/25/96 - Patriot News Co.
(advertising) 79.00
03/25/96 - Ann E. Rhoads (travel) 3.41
04/01/96 Cumberland Law Journal
(advertising) 60.00
08/20/96 - Postmaster 18.30
08/21/96 - Register of Wills 25.00
09/12/96 - Register of Wills 120.00
RESERVE - Register of Wills,
Account Filing Fee 250.00
$ 718,12
Federal and State Taxes j
03/29/96 - Pa. Dept. of Revenue :;
(1995 income taxes) $ 56.00
RESERVE - 1996 income taxes 200.00 t
,
$ 256.00 ~
- 4 - ~~
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RECEIPTS OF INCOME
Dividends
Wheat First Butcher
Singer Account:
04/29/96
05/14/96
$
79.71
68.41
$ 148.12
Interest
Dauphin Deposit Bank &
Trust Company Checking
Account:
04/96
05/96
06/96
07/96
08/96
09/96
10/96
$
13,97
90,65
157.06
172,01
160.85
110.69
114,09
$ 819.32
TOTAL RECEIPTS OF INCOME
$
967,44
DISBURSEMENTS OP INCOME
None
Income Balance on Hand
Principal Balance on Hand
Combined Balance on Hand
Adjustment
Adjusted Combined Balance on Hand
$ 967.44
30,991.63
$ 31,959.07
2.210.47
$ 34,169.54
PROPOSED DISTRIBUTIONS TO BENEPICIARIES
TO: MESSIAH VILLAGE, in satisfaction
of gift in ITEM III of Will
02/21/96 - Furniture, Household
Goods, miscellaneous
old coins, jewelry
$13,300,00
$ 13,300.00
!
- 6 -
.
IN WITNESS WHEREOF, I have hereunto set
my hand and seal to
o f)-I ~<A. e-I?.. , 1990.
this my Last Will and Testament this _ day
\" --:
ISI (r, .:.t..,t(A..o
EDITH
Signed, sealed, published and declared by the above Testatrix
as and for her Last Will. in our presence, who, at her request, in
her presence and in the presence of each other, we believing she is
of sound mind and memory, have hereunto subscribed our names as
witnesses.
,~ i:,~)d
of ~U'" M(l \l. int..h\. ~
.
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of
C-rJ. I .
'~~'''-r'<~'''< <-c .fJA.<'j-
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CUCKHU . 'UIU
A"oun. " u.
MU'IIIU.'. ,Ullln.....A
PAGE THREE OF THREE
.
Proof of Publication of Notite in The' Patriot and The Evening News
and The Sunday Patriot-News
Uade. Act No, AT, "rpro.rd May 18, Isr-o,
Commonwtalth 01 Ptnn8"lvonia, }
County 01 Dauphin RR:
""""""'......,,,.....f.,!:~,n,Js,..;r,',,"~p.l!!.J;:,..,,...,,",,..,,,,,,,,,,,,belnlf duly sworn according to law. deposes and says:
Controller
That he Is the "",.."""",,,,,....,,,,of THE PATRIOT -l\EWS CO" a corporation organized and existing
under the laws of the Commonwealth of Penns)'lvanla, with Its principal office and place of business at
812 to 818 Market Street, in the City of Harrioburg, County of Dauphin, State of Pennsylvania, owner
and publisher of THE PATRIOT and THE EVENING NEWS and the SUNDAY PATRIOT-NEWS
newspapers of general circulation, printed and published at 812 to 818 Market Street. In the City,
County and State aforesaid; that THE PATRIOT and THE EVENING NEWS and the SUNDAY
PATRIOT. NEWS were established March 4th, 1854, and February 15th, 1917 and September 18th.
1949. respectively, and all have been continuously published ever since;
That the printed notice or publication which Is securely attached hereto Is exactly as printed and
M~tro l~c~t 5th, 12th, and 19th
published In their regularA!dttlons ana Issues which appeared on the ,...""""....,.....".."..",,,,,,,,,,,,,,,,,.,,,,,,,,
days of March 1996.
........................................................................................................................................................................................
That neither he nor said Company Is Interested In the subject matter of said printed notice or adver-
tlsln8'. and that all of the allegations of this statement as to the time, place and character of publication
are true; and
That he has personal knowledge of the facts aforesaid and Is duly authorized and empowered to
verify this statement on behalf of The Patriot-News Co. aforesaid by virtue and pursuant to a resolu-
tion unanimously passed and adopted severally by the stockholders and board of directors of the said
Company and subsequently duly re.:orded In the office for the Recordin of Deeds in and for said Count)'
of Dauphin In Mise.llen,oul Book "M", Volumr l-l. Pe~r 317, ~ P. C; --
Copy of Notice or Publication '''''''''..,..~~'''''''''' ,;~..jU:.,.._""""""'.."".........
S~nio and subscdt('od1iefore me ~~" ,.t."",day of
M~,!:,S~ ...", A, D, I I':' ' I'} {(j "/A~-f/ /
T~ty Isi.':'~~d~' ,,{.! ".."f.. ,/t;:;,:i;""..,,-;l.=,
My Co:'mlMi:l1i e;piros Jun~~lC Notary Public
"'-es""""""" """,...""
Statement of Advertising Costs
IITA'. NOTICI
NOTIC. II HIR.IV alVI!N fha' Lt"....
,..MmtntcrY In 1M I...... Ifldlth A Gon. alto
kMwn OIlIdlth AM 0.011. loft ef U..... AIIfl'l
,..".,.llIf Cumbtrklnd Ctunty. Itenn.ylvanlo.
dIctOMd. haYt IMtn tronttcl to !hi uncI<<1llMd.
.. 011 ........ I~ .. IOid ftIatt en r..
...,.. .. matt IrnmedkttI NYfMftt oncI thoM
_..ctoI....."..-,_...._,..,
WI.....'.... ..
at DIIrfItM....
OIfftJH....'..'ml
.-
..
AM....................
---
...O....,IN7
JI N.",. ....., Itnet
. H__.....'A tn.'M7
AfttnttYI
c l,'i:j;.kn~l:',..,(i....F.li\ilX;~')..,......................"'......"",,....,..,
lIa r r t!!,l?,!:1,r..g,I......r,~"..,.."f.1.LQ.~................,...............,
To THE PATRIOT-NEWS CO,. Dr.
For publishing the notice or publication attached hereto on the
above stated dates . $..........?~,:..9,R...."
Probating same $....."...,,~,:..~,~,..,"
79.00
Total $...........,..........,....,
Publisher's Receipt for Advertising Costs
THE PATRIOT-NEWS CO" IJublisher of TilE PATRIOT and THE EVENING NEWS and the
SUNDAY PATRIOT-NEWS, newspapers of general circulation, hereby acknowledge receipt of the
aforesaid notice and publication costs and certifies that the same have been duly paid.
TilE PATRIOT-NEWS CO.
By....,....,..,......,....,....,...........,..................,......,.....,..,.......,
EXUIBLT "A~I
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU Of INOIVIOUAL TAXES
IHHUITAHCE ."Ax DIVISl.ON
DEP'. 210601
HlRRlSaUAG, PA 1712"0601
NOTICE' OF INNtRITANCE TAX
APPRAISEHENT. ALLOWANCE OR DISALLOWANCE
Of OEDUCTIONS AND ASSESSHENT OF TAX
ANN E RHOADS ESQ
CLECKNER & FEAREN
PU nnx 11847
HBG PA 17108
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
12-02-96
GOll
02-08-96
21 96-0141
CUMBERLAND
101
Allount R..Ht.d
..
tl,o\It' ....'.U..II
EDITH
A
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ Rt~~ LOWER PORTION FOR YOUR RECORDS ~
'ff:.y: is-;'''j''E3f-^!=p--f~;-''-96-f-~~~ff!3i- . ..~~..~~ ~f~^~-~~"~~~~"! ~"?P'!-;':r~~f');'-:-.~~l"o~~.~-~f-~~D-----------""" ---
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF GOLL EDITH A FILE NO. 21 96-0141 ACN 101 DATE 12-02-96
TAX RETURN WAS I (X I ACCEPTED AS fILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1, Reel Estete (Schedule Al (11
2, Stocke end Bonds (Schedule BI (21
3, Closel~ Held Stock/Pertnership Interest (Schedule CI (31
4. Hortg.gal/Hot.. Receivabl. (Schedule OJ (4)
5. Ca.h/Bank Dapollt.'Hlac. Parlonal Property (Schedule E) 15)
6, Jointl~ Owned Propert~ (Schedule fl (61
7. Tranafara (Schedul. GJ (7)
e, Totel Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expens../Ad.. Coat./Htle. Expans.. (Sch.dul. H) I')
la, Oebt./Hortgege Liabilities/Liens (Schedule II (101
11, Tote1 Deduction.
12. N.t Value of Tax R.turn
13. Charitable/Covern..nt.l aequa.t. (Schedul. J)
1~, Net Velue of Estete Subject to Tex
I CHANGED
,00
50.679,74
,00
.00
68 ,521. 57
48,727,59
139.175.81
(el
12.926,00
7.824.71
(111
ll21
(131
ll~1
HOTEl To Insure proper
cradlt to your account,
sub.lt the upp.r portion
of this for. with your
tax pay..nt.
307.104.71
?n.7~n 71
286.354,00
286.354,00
,00
NOT~:
14, l~ and/or Ib, 11 ana IH Wl~~
returns assessed to date.
l' an assessmen~ was Issued preVIOUSly, lInes
reflect figures that include the total of ALL
ASSESSMENT OF TAX:
15. A.ount of Llna 14 at Spousal rata 115)
16, A..unt of Line 14 t..ebl. .t Lin.el/Cle.s A r.te (161
17. A.ount of Llna 14 taxabl. at Collataral/Class 8 rata 117)
11. Principal Tax Du.
TAX CREDITS:
PAYHEHT
DATE
RECEIPT
HUHBER
DISCOUNT (t I
INTEREST (-I
,00 X ,00.
,00 X .06.
,00 X .15.
nel
A/tOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
EXHIBIT "B"
. If PAID AfTER DATE INDICATED. SEE REVERSE
fOR CALCULATION Of AOOITIONAL INTEREST.
,00
.00
.00
,00
,00
,00
,00
,00
I If TOTAL DUE IS LESS THAN ll. ND PAYHENT IS REQUIRED.
If TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI. YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE Of THIS fORH fOR INSTRUCTIONS,'
--..-- -.-.'
.~._'~"'-.. ~~
RllllVAflONI (,..... I' decedent. d'lnt on I' blfo,. Dtcllblr 12, "" .~ I' InV 'utur. Int.r..t In thl ..t.t. I. trln.ferrad
I" ,......Ien .r '"J.,-.nt tl CI... I Ic.ll.t.r'll ~flol.rl.. 0' \~ dIc~t ,'t.r the .xplr.tlon of eny ..t.t. for
II'e or 'or v..r., the C..-onw...th he'''' ..,r.,.I, r...rv.. th. rl~l \D ~,.I.. and ...... tren.,.r I~rltanc. T....
.t the ...'ul CI... I Ic.II.,.,.11 ,.t. on en, .uch 'utu,. I",.,..t.
~1lI'
NOTltr:1 ,. fulfill 'he r...ItMlfth If SIIUon 'UO o' the IMirltanc:. Md ht.,. 'lie Act, Act ZZ of 1"1. 72 P.S.
SIIUon "".
"'MHh DetlCh 'hi to, ,.rtlon of thlt NotlCI Met ......11 ..lth vour ,.'tHnt to thl ...lIt.r 0' Wllh prlntld on thl rIVer.. .ldI.
""-l. chick or MM' or'" ,.veb.. t" Rtell.fEII OF MILLS, AGENT
all ,'yMn" r"'lv'" wll first bI -..1I1d to anv Int.r..t which Ill' be ..... ..Ith ....V r...lndar appllld to the tax.
ltl'UND CClII a ,,'\nII .f I t'll ItHII, w.lch .... not r.....tld on the hll Return, ... bI r..,.".d by cOIIPhtlng .... "Appllc.tion
'Ir ."und I' '~.vlvenll IMir1t1nC1 Met [.t.,. t.... CAtY-ISISI. Appllc.tlon. .r. IVllllbl. It the Offlc.
.f thl _..I.,., .. Will., InV of thl II _.venue DI.trlct Of'lc.., or bv c.lllng thl .peclll 24-hour
en...,I", ,.,vl.. nueblr, '.r for.. .r"rlntl In Penn.vlvenl. 1-1.0-S'Z-Z050, out.lde Penn'rlvenl. end
within 1...1 tta"ltbu" .n. "111 """M, '001 11111 711~ZZSZ IHI"lng 1....lnd Onhl.
OIJlCTIONII AnV ,I,t, In Int.r..t not ,..llflad with thl ep".II.-.nt, Illow.nc1 or dl..llowlnC, of deduction., or .....~t
.f t.. (1",ludl", dl.count or lnt.,..'1 .. shOwn on thl. Hotlc. ~.t object within .llItv e601 day. of ,acelpt of
thlt "'U.. "VI
....'IU.. ,r.tnt t. thl PA Dep.rt-.nt of .'VII'IUI, laird of Appea", Dept. lllDZ1, ",rrhburl, pa IlUI-IDZI, OR
--.1....... t. hew. thl ..tt., .....relned .t IUdIt of tM HCount 0' thl P."onal repr..."tetlv., OR
.......1 t. the 0'''''''' Court.
ADIIIM
IIIUIII/(
C_CIIIlNI,
,..tuII .rr.r. ~1'clV.r" on thl. ......eent .hoUld bI Iddr...1d In Nrltlne tal PA o.,.rt-.nt of A.venue,
aur.., .. .ncllvldllll h..., afl"1 POIt A......ant a.vl... Unit, Dept. lID601, H."laburl, PA 17UI-D601
PhenI 17111 ,.,-".,. S.. ,... . of the bookl.t "In.t,uctlon. '0' Inherltanc. T.. R.turn 'or I A..ldent
~,.. IRlY-I'.11 'e, en ..,Ianatlon a' IdIlnl.tr.tlv.lv corrlCtabl. .,rorl.
DIICllUIIt
.f ...v ,.. due I' ,eld within th,.. ISI c.llndar .onth. aft.r thl decedent'. d..th, I 'Iv. Plrcent 15~1 dl.count .f
the ,.. ,.I~ I. .11......
'he lit t.. IInt.,v non-p.rtlal,atlon ,~Ity I. COlPUttd on thl tot.1 0' thl t.. and Int.,..t ......Id, ~ not
,.Id bI..,e Januar, '1, 1..6. thl fl,.t d., .,t.r the and of thl t.. -.na.tv period. Thl. non-p.rtlcl,.tlon
"",It, II ..,..111I1. In thl .... lomer and In thl the .... tI.. ,.,locI n ,ou would ""11 thl t.x Met Int"..t
thlt hi' bean ......... n Indlc.tld on thll notlct.
'lOLlY.
INI[IIlIl,
In'.'.., I. ch.rted bltlnnl", with flr.t d., 0' d.llnquency, or nine e'l -.nth. and one ell d.v frol thl d.t. 0'
""h, to thl d.t. .f p.yeant. '.X.. which bee... d'llnquent bI'o,. Janu.ry I, I'll blar Int.r..t .t thl r.t. 0'
.1. ('XI parc...t par ~ c.lcul.tld .t . dlllv r.t. of .000164. all t.... which bee... delinquent on end .ft.r
Janu.r, I, 1'1' will ba.r In'.r..' .t . r.l. which will v.r, frol c.landlr ,..r to c'land.r y..r with that r.t.
~.. by thl pa DeI.rtlln' of A.vlnUl. ThI appllcabll Inter..t rat.. for I'IZ through 1996 .r'l
US! Int.,.., _et. O.lly Int.,..t 'acto, !!!! Int.,..t .lte Dally Inte,..t Factor
"., IU .OIUU ...7 n .OOOlit7
...S I.X .OIOU' 1....1"1 IIX .OODSOI
I". m .00DSI1 199Z n .000lU
U.. III ,DOOU. 1995-I.M 7X .OD01'Z
I'" IU .OODZ" 1"5.1'" n .ODOlU
-'In,,,..t I. c.lcul.tld " 'ollowll
INTEaElT . BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
..an, Notice l..uId .ft., thl t.. bec.... delinquent ..Ill "fI.ct .,. Inhr..t celcul.tlon to flft.1ft 1151 d.v.
be,and thl da'. of thl .......ant. I' P'~""t I. .ldl ,'I.r IhI Inl.,..t cQlPUtltlon dlt. shawn on thl
NotlCl, IMSdIt lon'l Intlrllt IUlt be calcullted.