HomeMy WebLinkAbout96-00169
ii',,;
.,"
,i'
. ~ .'
.::..,:,
. ....
:'CU~"
," j...
.I
.tIt"
UI
X
."
,
. .
". ~.
-. ;,"
,
",
:i 'r "
;" I'
:
,'.
'.'
":..\A'."
'~,: ).\,~; ~~
" :'~'
.:'
,.' . .
.-/'.';" :'.'.
".,'
"
. .,
,
,
'~'.
,'"
, :;.\":;y::
t ~.
.... ;',1/,
.~. " . ~
'"
, ,'."
.,
, '
'j,
.
" ,.
, .
, ,~. ~ '
. ..,'
x
.-;;
".
. ..
,
.,
,").,."
OATH OF PERSONAL REPRESENTATIVE
l...)',
"
- ,
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
} 58
( , . ~
The petllloner(s) above-named swear(s) or affirm(s) that the
statements in the foreaolng petillon are true and correct 10 the best
of the knowledge and belief or petilloner(s) and that as personal
representatlve(s) of the above decedenl petltloner(s) will well and
truly administer the eslate according 10 law, ( 4- . 7
Sworn 10 or affirmed anet subscribed J _ .~~ - ? ~~7~
before me this '2. "3 d day of ( ./
19' "] 9;
- I ", - 1 777If:r 1(;- .
Reslsttr L : 4-
J
No. 21 - 96 - 169
Estate of
MARY LOU HOII ISTFR
, Deceased
GRANT OF LETIERS OF ADMINISTRATION
AND NOW FE8RUARY 23. 19...2.2....... in consideration of the petlllon on
the reverse side hereof. satlsractory proof having been presented berore me,
IT IS DECREED that LAWRENCE A HOLL ISTER
Islare entitled to Letters of Administration, and In accord with such finding, Letters of Admlnlsuatlon
are hereby granted to
LAWRENCE A HOII ISTFR
In the estate or
MARY 1011 HOII I~TFR
FEES
Letters of Administration ."., S
Short Certlficates( 'I) ..... .. ... S
Renunciation ................ S
JCP S ~ no
10TAL _ S 33.00
flied..... f.E,~~~. gU.~\, A,D. 19~
.
~ I
Li 7(1-b {1tJ I
25.00
1 nn
,,, E N'~O~ F~P,({,t;yN:rJe:-
ADDRESS
...:s"l01 rvlA..eI<e-r-S"",
PHONE
<!. P1 4I'l PHI ~ c , )"'7,4- )"1 f) I I
let. J (7- T~7,OJ,r'C/
P 11- S 'Q't. !Vo 0,6 ~SO
Mailed letters and order to attorney on 2-26-96
WARNING: IT IS IllEGAL TO ALTER THIS COPY OR
TO OUPLlCATE BY PHOTOSTAT OR PHOTOGRAPH.
COIIIIONWE~LTH OF PENNSYLV~NIA
OEP~RTMENT OF HEALTH VITAL RECOROS
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
CERT, NO. 1468782
tzc t. ~ ~~ ,... L,t.!.J..
Name of Decadent f11f1i.~7 1.0Jrl.... (j-(/~lLjIo/As1tR.
Sex hlffA/~ Social Security No, IJJ.-~D -0I.6"~() DateofDeat~f. 11 J99L
Date of Blrt~lPt: 1(,/ /'1.3.5" BirthPlace~tA/~ ~tt1~/'rr5'.A' '
Place of Deat~ J), ~cicJ.j J}/{I'Vf. (1(,A,.,1!..~ J Aft J ~~ft!!.~~;!...~1A "J Pennsvlvanla
Race Whlt~ Occupation h(flls(".,,'f"t. Armed Forces? (Yes or No) h'P
, J Decedent's J I It? MA I . I
Marllal Status m A~ A It' Mailing Address Oll ~ MNdA VJUvt {'{HI! IIle lc70L
InformantLtht'rU.NCt fl. I/o//'$h,. FU=I Director r."J.LIlC'.
Name and Address of rf.J.... L . t:f.
Funeral Establishment\' " I ( .' 1itJ , 111I f /,
Part I: Immediate Cause
(aJf'Y/l7A9 fA t,~
(b)
(c)
(d)
Part II: Other Significant Conditions
Interval Between
Onset and Death
a",C'iR. 10 fltf f//,J""'fH
(fAr'"nllft 7 UVkJ'/'WN)
Manner of Death:
Natural [J}/'
Accident 0
Suicide 0
Describe how Injury occurred:
Homicide
Pending Investigation
Could not be Determined
o
o
o
Name and Title of Certifier /21"" ~ / !/~Jt fi, m.JJ.
Address/~~ S. f,tbU f 7/,~(hlf""~ !?bv.'j!
This Is to certify that the Information here given is correctly copied from an original certlllcate of
death duly filed with me as Local Registrar, The original certificate will be forwarded to the State
Vital Records Olllce for permanent filing.
(M,D" 0.0, Coroner, M.E.)
~d-2-i?-
F;.. Cl. 0. ~ LD --.I: i..J 14 .. - 'L'1..1
lo-c:"II'9,I'I'otV~.1 -~'---7-~ --
_;L'-la-_~_._~_('J/_Li.L__fi-r. (I AAM,t.LP.....
S,,_ Adr3'." 'cc,. lkoI'h,og1'l r-"'P .
,
*
COMMONWEALTH Of PENNSYlVANIA
DEPARTMENT 0' lfY[NUf
OlP'. 21060 I
HAUIS.Ula, P.. 11121,0601
DfC(DfN '$ NAME IlA' . flUT. AND MIODH IHIllAII
15-81-5
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
~
~OR OATIS O. DIATH lonER 12/31/91 CHICK HIRI
If A SPOUSAL
POVIRTY CRlDIT IS CLAIMID
PILI NUMln
2/~ '1b-o/{,9
COUNTV CODE VEAR NUMBER
O(CfDIN1'SCOMPlfU AOO'(U
l!V.'-.'IlD IX. (7...(
'"
....
w::!UI
fdlE~
:ca9
u~..
....
as
lil
III
a
HOLLISl'ER,
$OCIAI UCUlllh' NUMIU
OAn 0' of"T"
DAn 0' I'IIH
.,;'6/35"
212 Linda Drive
Mochanic6burq, PA 17055
Co... Curber1and
AMOUNt UC(IV(O I1U IN'''UCIION$1
161-30-2580
10/9/92
~ 1. Original R,lurn
fJ 2. Supplemental R.lu,n
R.mainder R,turn
1'0' dol.. 01 d.olh p,io, 1012.13.821
federal Eliot. TOJt Return Required
o A. limited Eltal' 0 Aa. Future Inler,.1 Compromi..
(for dOlt. of death aft., 12.12.82)
o 6. O.c,d,nl Di,d Te.,ol. 0 7. Deced,n' Maintoined Q living Trull
(Alloch copy 0' Will) (Alloch copy 0' Trulll
AU. CORRISPONDENC. AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO.
NAM COM'UTf MAIliNG "'OOAU!.
Henry F. Coyne, E6quire 3901 Market Street
'm'HON' NU.'" Carrp Hill, PA 17011-4227
737-0464
1. R.ol E.,o'. (Sch.dul. AI
2. Sloch ond Bond. (Sch.dul. 8)
3. Clo..ly H.ld Slock/Partnership Inl.,.s' (Schedule C)
A, MOIIgag.. and Not.. Receivoble (Sch.dule 01
S. Cosh, Bank Oepollll & Misc.llaneoul Penonal Properly
(Sch.dul. EI
6. Jointly Owned Prop.rty (Schedule FJ
7. Tron"... (Sch.dul. GIISch.dul. II
8. TOlol Gran AUI'I (tolallin.. 1.7)
9. Fun.ral Exp.n..., Administrativ. COIU, MIsc,lIaneous
bpI"'" (Sch.dule HI
10. O.btt, Mortgage liabilities, liens (Schedule I)
11. Tola1 D.dudionl (ratallin,. 9 & 10)
12. Nel Value of Ellal. (line 8 minus line 11)
13. Charitable and Governmental aequllh (Schedule J)
14. Net Value Subftd 10 To~ (line 12 minus Line 13)
IS. Spousol Tron,r.r. (for dot.. of death ohe, 6.30.94)
Se.lnstructlons for Ar,plicobl. Percentage an R.vene (1511..189_...8.7
Side. (Include valu.. rom Schedul. K or Sch.dule M.)
16. Amount of line 1 A loxabl. ot 6% rol.
(Includ. valu.. from Schedul. K or Schedul. M.I
17. AmQunl of Lin. IA toxobl. of 15% rol.
(Include values from Schedul. K or Schedul. M.I
18. Principal lox due (Add tox from Lines IS, 16 and 17.1
19. Credits Spou.ol Po....rty Cr.dit Prior Po)'m.nll
+ ~C1lL- +
~
....
03.
05.
Q8,
T 0101 Number of Sof. D.po.il 80....
I" .'1\1(..'111 'UIW1V'HG lPOuU 'N....'I\.U. "'11 ."0 "'OOiI'N'''I'1
........
",as
a:a
a:z
8f
z
a
S
=>
~
u
...
a:
z
a
8
~
"
a
u
"
. '!..
.'
(II N~
(2 1 None
(3) None
(41 None
(51_None
(6)"0,000,00
(7) None
.~
'-1 (h
cr
!..I.
f,.
-,
c.
(1'0
::.:0
-,~
,'. Co
-::-.!)
.; \.l.
,,0
_ :';1
..~ ~
:.:.: (.J
ii>o
-
~
:0
N
(h
(
f-'
~h
-u
N
(~
\0
10,000.00
(9) 7,998.13
(8 )
(101
812 DO
(16)
(III 8.810.13
(121 1.189.87
(13) None
(141 1.189.87
lllLa 71.39
)( .06 IZ None
)( ,IS Q -1'/nnA
(171
Discounl
(18) 71.39
(19) >> 'I J.J
1201 /3,10
121) N.oA e
(2110)
(2181
Interest
- ~..,JS_L-
20. If Lin. 191, greol.r than Lin. 18, .nl.r .h. diff.rence on Lin. 20. Thil i. Ih. OVERPAYMENT.
m~
21. If Lin. 18 Is gr.oler than lIn. 19. enler the djff.r.nce on Lino 21. Thi,l.th, TAX DUE.
A. Enter th, inl.rll' on Ih. balance due on Lin. 21 A.
8. Enl.' Ih.'olol ollin. 21 ond 2110 on line 218. Thi. it Ih. BALANCE DUE,
Mah Cheel, Pavabl. tal R.gllter of Willi, Ag.nt
t IE SURE TO ANSWER ALL aUESnONS ON REVERSE SIDE AND TO RECHECK MATH.. '. ,
Under p.nolti.. of perjury. I d.c1are thai I ha.... examin.d this relurn. including accompanying uh.dul.. and ..ot.m.nts. and 10 Ih. b.11 01 my ~nowl.dg. and b.Ii.I.
i111 Iru., corr.ct and compl'I.. I d.c1are thai 011 real '1Iat. hal b..n r'port.d 01 true morht ...alu.. Declarolion 0' pr'parer oth.r than th. p.nonal repres.ntati.... II
based on alllnformalian 01 which preporer has any ~nowl.dg..
SIGNAtUl f SON IUPONilll( flUNG U!.I1. AOOllU OAf(
:n~....--, . ~e. 'J..l Li...lA t)l.- ?l.!'clc..;e,tll'fl.. 17o:>~' ,ho;/9{,
Of PUPAIU OtH(I THAN lIPI (NtAlIvl AOOIU!. OAlf/" ...,
Che(~ heft.. ., you o,e feque,ting 0 refund of you, overpayment.
Ad '48 of 1994 provld.. for the r.ductlon of the tax rot.. Impo..d on the n.t valu. of trand.r. to or for
the u.. of the .pou... Th. rat.. a. pr..crlb.d by the .tatut. will b.:
. 3% (.03) will b. appllcabl. for ..tat.. of d.c.d.nll dying on or aft.r 7/1/94 and b.for. 1/1/96
. 2% (.02) will b. appllcabl. for ..tat.. of d.c.d.nt. dying on or aft.r 1/1/96 and b.for. 1/1/97
. 1% (.01) will b. appllcabl. for ..tat.. of d.c.d.nll dying on or aft.r 1/1/97 and b.for. 1/1/98
. Spou.al trand.r. occurring on or aft.r 1/1/98 will b. .xempt from Inh.rltanc. tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK (,,) IN THE APPROPRIATE BLOCKS.
YES NO
1. Old dec.d.nt make a transf.r and:
x
X
a. r.taln th. us. or Incam. of the prop.rty transf.rr.d, .......................................................
b. r.taln th. right to d.slgnot. who sholl us. th. prop.rty transf.rr.d or its Incam., ...............
c. retain a reversionary interest; or .......................................................u..........................
x
d. r.c.lv. th. promise for Iif. of .ith.r paym.nts, b.n.fits or car.' .......................................
2. If d.ath occurr.d on or before D.c.mb.r 12, 1982, did dec.d.nt within two y.ars pr.c.dlng
death transf.r prop.rty without r.c.lvlng ad.quat. con sid. ration' If d.ath occurr.d aft.r
Dec.mber 12, 1982, did d.c.d.nt transf.r prop.rty within on. y.ar of d.ath without r.c.lvlng
adequate consideration' .. ........................ ............ ...........",. .................. ........................ ....
3. Old d.c.d.nt own an 'In trust for' bank account at his or h.r d.ath'......................................
x
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YESr
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
..
HOLLISTER,
ITEM
NUMBER
A.
'1'#111111+ v....
2.
3.
B.
A.
C.
1.
2.
3.
A.
S.
6.
7.
8.
....~"'-':.'
I
'*'
COIoIMOHWIAlJIt O. P1NNIYlVANIA
INHIlIIAHCllAllllU.N
'!SIOIN' OICIOINI
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
Pleas. Print or Ty'pe
r
Lou
N
Pl/- 7{' -0/'
DESCRIPTION
AMOUNT
1.
Funeral Expensell
C.J. Lucas F\1neral Hare,
Mt. Canrel, PA
$3,765.65
370.26
100.00
F\lneral Dinner
Mass Meroorials
1.
AdminIstrative Coslll
Personal Represenlalive Cammllllan. N/A
Social Securily Numb.. af Personal Repre.enlallva,
Year Commllllans paid
2.
Allomey Fees
Henry F. Coyne, Esquire
1,500.00
3.
family Exempllan
Claimant Lawrence A. Holli..terRelatlan.hlp
Address of Claimant 01 decedent's dealh
Slreet Address 212 Linda Drive
Cily Mechanicsbura Stale PA
Zip Cade 17055
HUSMm
2,000.00
Probate Fee.
33.00
Miscellaneous ExpenSell
Legal Advertisement - Patriot News
51. 70
Legal Advertisement - Curi:lerland Law Journal
Certified Mail
60.00
Filing Fee - Inheritance Tax Return
2.52
15.00
100.00
Reserves
TOTAL (Also enlor an line 9, Recapilulatlan)
(If more space I. needed, Insert addltlanal sheela of same size.)
S 7,998.13
\
-'-. - -, .... -.....
f
i ,
I .
&O:'~~.:...:. _ -- ~ -- ____ __ _ __, _ _ '0,_, __, _. _. _ __ _ _ __ _ ____ .
,
I
RECEIVED fROM,
,.
AtN m
ASSESSMENT AMOUNT "
CONTROL
NUMBER
101 S100.00 .
,"'
~
COYNE HENRY F
3901 MARKET STREET
CAMP HILL, PA 17011
rotOHfll
(lAST)
SSN 161-30-e~80
(fiRST) (MI)
II POSTMARK
COUNTY
DATE Of DEArH
REMARKS
I
I. I
RECEIVEDBY ):/11/" ,f J,.'J:" "'$ .J".I' .
. - / '1;UNtJ!r.. . \ !
MARY C. LE(WIS - l'UI.,(.i'I-:J-"it
REGISTER OF WILLS ~ :J
--------------------j'-;--; : 1-
m TOTAL AMOUNT PAID
Stoo.OO
LAWRENCE A HOLLISTER
CIO HENRY F COYNE ESQ
CHECK" 3771
PB
SEAL
REGISTER OF WI LLS
--- --------------:0--.---.
'.\.
.
\.
,.'"
~. ...
-, .
~.
.~
.- -. ..-
,
i.,
I
I .
. ..j......"
-~-_.._,:;r
.f
1!
,-'-'
,
--,
r-
File. ~
CERTIFICATION OF NOTICE UNDER RULE 5.6/a)
Name of Decedent: Marv Lou Hollister p~ o.d :0
!!! -- ..,. Z'11l
rr . !Co
Date of Death: ~tnhPr 9. 1992 r J ~ if: n
t: .:- h
-, .. 1'1
Will No. 1996-00169 - I\Q~iR . u...... > f ~ f: ~ '\
(i
o
.; t J
1":'
~c.:
)i~ W
U1
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
ADdl 26. 1996
2:l
~
~:- C)
:::'(IJ
WO
-
To the Register:
~
Address
Mr. Lawrence A. Hollister. 212 Linda Drive. Mechanicsburq. PA 17055
Ms. Marv Anne Hollister. 212 Linda Drive.. Mechanicsburq. PA 17055
Mrs. Kathleen Hollister-Peooerman. 16 ArdrrDre Circle. New Curberlarxi. PA 17070
Ms. Patricia M. Brennan, 13 Oakwood Avenue, Mechanicsburg, PA 17055
Mr. Lawrence B. Hollister. 212 Linda Drive. Mechanicsburq. PA 17055
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except None
Date: U; ktJe qt,
s~ fLq
Name Lisa Marie Coyne, Esquire
Address 3901 Market Street
Camp Hill, PA 17011-4227
Telephone/711 737-0464
Capacity:
Personal Representative
Counsel for personal
representative
x
,
I
T
I
_ I
'.'.'1
~-,
!t
-Ii" ..j
;,' 'J
f(
,oj.:;--,.
"
"'
-i
]
I
!
,
.,
I
--..............
".
"
"'---.._-,..,
.-----......-.--.-
,
.,
. ..~,. ....,.;....~,
".- .-. .~. ---..
-"- ...,---..---.- "r-'
.
.
l
I.
e
0.
"
"
,
,.
~
.~.
'1 . ,. .
: ~{-. ,\ ,
t" { ...~.I-...
....\ '.
(
~
"
"
;
.r ~ . '.:j
:':. .....~, ': )-
..
:.. w' \
'u .. . ",.
r.. I
11 . ,. :l .
kf I~
...' ,
I
'1.,
.
"
..' ...;
,
.j I
i"
'.
..... \
\. -, "
'. ~
,
.f
..--. --~. ....J
-'
,
.
INRE: ESTATEOF
MARY LOU HOLLISTER
(Deceaserl)
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
: ORPHANS' COURT DMSION
: NO, 1996-00169
nR'l.AIMKR
We, Mary Anne Hollister (daughte:) of 212 Linda Drive, Mechanicsburg, Cumberland
County, Pennsylvania: Kathleen Louise Hollister-Peppennan (daughter) of 16 Ardmore Circle,
New Cumberland, Cumberland County, Pennsylvania: Patricia Maureen Brennan (daughter) of 13
Oakwood Avenue, Mechanicsburg, Cumberland County, Pennsylvania: and Lawrence Brian
Hollister (son) of 212 Linda Drive, Mechanicsburg, Cumberland County, Pennsylvania. the
surviving children of Mary Lou Hollister, Late of the Borough of Mechanicsburg, County of
Cumberland, Pennsylvania, do hereby state and agree as follows:
1. Mary Lou Hollister, died intestate on October 9, 1992. at Mechanicsburg,
Cumberland County, Pennsylvania.
2. At the date and time of the death of Mary Lou Hollister, she was survived by her
husband, Lawrence A. Hollister of 212 Linda Drive, Mechanicsburg, Cumberland County,
Pennsylvania; her daughter, Mary Anne Hollister of 212 Linda Drive, Mechanicsburg,
Cumberland County, Pennsylvania: her daughter, Kathleen Louise Hol1ister-Peppennan of 16
Ardmore Circle, New Cumberland, Cumberland County, Pennsylvania: her daughter, Patricia
Maureen Brennan of 13 Oakwood Avenue, Mechanicsburg, Cumberland County, Pennsylvania;
and her son, Lawrence Brian Hollister of 212 Linda Drive. Mechanicsburg, Cumberland County,
Pennsylvania.
3, On February 23, 1996, Letters of Administration was issued to Lawrence A.
Hollister by the Register of Wills of Cumberland County, Pennsylvania.
4. Under Sections 2102 (20 Pa. C.S.A, 2102) and 2103 (20 Pa, C.S.A, 2103) of the
PEF Code, the above-named children of the decedent are entitled to certain shares of the residual
intestate probate estate of the Late Mary Lou Hollister.
-. :"jSff~,?J1r};;/15~~;~\,r.~'-::
..;~
h
."
I
I
I
i~
5. Under Section 6201 (20 Pa. C,S,A, 6201) of the PEF Code, we. the undersigned.
hereby disclaim any and all interest. without reservation. of and in the intestate interest we and/or
our issue. heirs. or lIlIlIigns may have or otherwise be entitled to in the Estate of our Late Mother.
Mary Lou Hollister.
6, This disclaimer may be filed by Lawrence A. Hollister. the Administrator of the
Estate of Mary Lou Hollister. with the Clerk of the Orphans' Court Division of the Court of
Common Pleas of Cumberland County. PCIlTIlIylvania. plmuantlo 20 Pa. C.S.A, Section 6204.
117~ ClM\.I Y~4..
MAR \<\NNE HOLLISTER
212 Linda Drive
Mechanicsburg. PA 17055
IN WITNESS WHEREOF. we. the undersigned, on our own behalves as well as on behalf
of our minor children. their heirs and assigns, do hereby duly disclaim and renounce any interest
we may have in the Estate of our Mother. the Late Mary Lou Hollister and have signed in
agreement with this docwnent this (f'Z-~dayof ~ . 19.!L6-,
8~1 t 5ItuJ?I,(t(J~'
Witn
,
/~vll jl qtlA-~",-L,<.->/
Witness/ CJ
OALt'1 t J/u{fpJ' ttrr
WItness
f!4/';jst R Stud,,, k/~
Witn r
'--
(SEAL)
~'''11i;t~I1~1Sr.ALJ
KATHLEE OUISE HOLLISTER-PEPPERMAN
16 Ardmore Circle
New Cumberland, PA 17070
~ Mc.I.---'2~~'-(SEAL)
ATRICIA MAUREEN BRENNAN
13 Oakwood Avenue
Mechanicsburg, PA 17055
2
COMMONWEALTH OF PENNSYLV ANlA
COUNTY OF CUMBERLAND
)
) 85.
personallY appeared before me, a Notary Public in and for the said State and County,
KATHLEEN LOUISE HOLLISTER-PEPPERMAN. who. being duly sworn according to law.
deposes and says thalthe facts set forth in the foregoing are true and correct to the best of affU\llt's
knowledge, infonnation and belief.
~:;'p~.'" (SEAL)
KA EEN LOUISE HO ISTER-PEPpERMAN
Sworn to and subscribed before
methis 8" '1--d day of ~
19!ib..
. .
1M~~""t~
Notary Public
NOTNll~ SEAl.
IENRYF. COYI.E. NOTIl1Y F\J!llJC
Iw.IPOEN 1\\1'. CUJol86LlMl 00.
MYCOMMISSiOO ElCAIel.IJNE 17. 1!Kl1l
4
, .
COMMONWEALTH OF PENNSYLVANIA )
) 81,
COUNTY OF CUMBERLAND
PerBOIIally appeared before me. a Notary Public In and lor the laid Stale and County.
PATRICIA MAUREEN BRENNAN. who. being duly Iwom eccordlng to law. deposes and lays
that the facta set forth In the foregoing arelnle and COl1llCtto the beat of affiant's knowledge.
Infonnation and belief,
~r U l"". ,-,~~~ /SEAL)
MtRICIAMAUREEN BRENNAN
Swom to and lubscribed before
me th1a ~ z..,d,ray Of~.
19~.
NOTMl/l.stIi
I<<;VlY F, 00YlE. HOTill\' I'Ia<l
HMFOEN n\'P, an.IlBlJMl 00
lIYll:lIAlJtllOOElCl'lIO.lJM!17, ,.
5
. .
. .
U'\ ~~
'a -
..
3~ -
2 :s
~o 0
- .."0
8~ ~ .~
. ,,-:
~~ ~ s!
a:
i
V
/5..J/-5'-
to
~ ...../
REV-1547 EX AFP (12"95*"
COHHONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. ZI0601
HARRISBURG, PA 1712a-0601
NOTICE aF INHERITANCE TAX
APPRAISEHENT, AllaWANCE DR DISAllaWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
ACN 101
DATE 08-12-96
ESTATE 0
DATE OF DEATH 10-09-92
FILE NO.
COUNTY
CUMBERLAND
NOTE. Ta INSURE PRDPER CREDIT TO YOUR ACCaUNT, SUBHIT TN" UPPER PORTION OF THIS FoRH WITN YOUR TAX
PAYHENT TO THE REGISTER OF WIllS. HAXE CHECX PAVABlE TO "REGISTER OF WIllS, AGENT"
REMIT PAYMENT TO:
HENRY F COYNE ESQ
3901 MARKET ST
CAMP HILL PA 17011
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
Allount ReMltt.d
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ....
REV=is4"j-EX"AFP-n2':ijiff"iioYicEnO;:-YNHEiiiTANCE"YAX"APPRAisEifiii'r;-ALUiwAiicE-iiRmmnmmm
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HOLLISTER MARY L FILE NO. 21 96-0169 ACN 101 DATE 08-12-96
TAX RETURN WAS. C X I ACCEPTED AS FILED
( I CHANGED
RESERVATION CONCERNING FUTURE INTEREST " SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Rool E.tote (Schodule AI (II
2, Stock. end Bond. (Schodulo BI C21
3. Cla.oly Held Stack/Portner.hip Intoro.t CSchodulo CI C31
4. "artD.ga./Not.. Receivable (Schedul. DJ (4)
S. Caan/Bank Deposita'Hilc. Paraonal Property (Schedul. El (5)
6. Jointly ownod Praporty (Schedule F) C61
7. Transfara (Schedule OJ (7)
a. Totol A.sot.
,00
,00
,00
,00
,00
10,000,00
.00
(B)
10,000.00
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expans../Ad.. Coats/Hilc. Expans.. (Schedule H) (9)
10. Dobt./Hort;o;o liobilitio./lions CSchedule II CI0)
11. Total Deduction.
12. Nat Value of Tax R.turn
13. Charitable/Govern..nt.l aequa.t, ISchedul. J)
14. Nat Valu. of Eat.t. Subject to T.x
7,998.13
812.00
Clll
Cl21
CUI
Cl4)
8,81 D !:'I
1.189,87
.00
1.189.87
If an assessment was issued previOUSly, lines
reflect figures that include the tDtal Df ~
ASSESSMENT OF TAX:
15. Aoaunt of lino 14 ot Spausol roto (151
16. AMount of Line 14 tex.ble .t lln..l/Cl... A rete (1'.
17. A.ount of line 14 taxable at Coll.t.ral/Cla.. 8 rete (17)
18. Prlnclpel Tex Due
14, 15 and/or 16, 17 and 18,will
returns assessed to date.
NOTE:
.00 X .00=
.1,189,87 x.06.
.00 X .15.
ClBI
,00
71. 39
.00
71. 39
TAX CREDITS:
PAYHENT
DATE
04"24"96
08-05-96
RECEIPT
HUHBER
AA1l2762
REFUND
DISCaUNT C-I
INTEREST Co)
15.87-
.00
AHaUNT PAID
100.00
12,74-
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
71. 39
.00
,00
,00
. IF PAID AFTER DATE INDICATED, SEE REUERSE
FaR CALCULATION OF ADDITIONAL INTEREST,
( IF TaTAl DUE IS lESS THAN Sl, NO PAYHENT IS REQUIRED.
IF TaTAl DUE IS REFLECTED AS A "CREDIT" (CR), vau HAY eE DUE
A REFUND. SEE REVERSE SIDE OF THIS FoRH FOR INSTRUCTIONS.)
.-- -. ~ -,.".-..-....
.........
~ '!:'~
"li I[) ..~ c..
(.~ l"J
(.:L
f'"\
~
8
.....
"
.:' J \JJ .;
:uu' .
:-" "I :)
a:- 00
RESERVATION I E,t.t., of decedent. dying on or b.for. Dec.~r II, 19., -- If any futur. Int.r..t In the ..t.t. I. tren.f.rr.d
In po.....lon or enJoy.ent to CI... . (coll.t.r.l) blneflcl.rl.. of the d.cld.nt .ft.r th. .xplr.tlon of eny ..t.t. for
11ft or for y..r., thl C~.lth h.r.by ..pr...ly r...rv.. the rlDht to .,pr.I.. end ...... tren.f.r Inhlrltanc. T.x..
.t thl I~ful CI... . (coll.t.r.l) r.t. on any .uch future Int.r..t.
P\IIPOR llI'
NOTlCEI
To fulfill thl nqulr"lnU of S.ctlon IUD of thl Inherltanc. end Est.t. Tn Act, Act lZ of 1991. 7Z P.S.
Section U40.
PAYftEHTt
Dlt.ch thl top portion of thl. Notlc. end .ubllt with yoor p.yeent to thl R.gI.t.r of Will. prlnt.d on thl r.v.r.. .Id..
..,... chick or lMlMy order p.yebl. tOI REGISTER OF MILLS I AGENT
All p.~t. r.c.lv.d .hall flr.t b. .,pll.d to ~y Int.r..t which ..y b. due with eny r...lnd.r IPPlled to thl t.x.
AEflJHD (CR).
" refund of . t.. credit, which w.. not rlqUl.t.d on thl T.x R.turn, ..y b. rlquI.ted bV co.pl.tlng en "appllc.t1on
for R.fund of P,"".vlvenl. Inhlrltenc. end E.t.t. T.... CREV-Illl). Appllc.tlon. .r. .v.llabl. .t thl Offlc.
of the R.gl.t.r of Will., env of thl 13 R.venue DI.trlct Offlc.., or by c.lllng thl ,peel.1 Z4.hour
en'Wlrlng ..rvlc. nuIbIr. for for.' ord.rlngl In Penn.ylvenl. l-laO-56Z-10S0, out.ld. P.nn.ylvenl. tnd
within loc.1 H.rrl.burg .r.. (717) 7'7-8094, TOO' (717) 77Z-ZZSZ (He.rlng IIP.lr.d Only).
OIJECTlONSI
Anv p.rty In Int.r.,t not ..tl.fled with the .ppr.I....nt, .llowanc. or dl..llowanc. of deduction., or ......IInt
of t.. (Including dl.count or Int.r.,t) .. .hown on thl. Notlc. lU.t obJ.ct within .I.ty (60) d.y. of rlC.lpt of
this HoUc. bYI
.....rltten prot..t to the PA Dlp.rt.",t of An.nuI, lo.rd of App...., O.pt. 211OZI, H.rrhburg, PA 1712'8-1021, OR
...I.ctlon to have the ..tt.r det.r.lned .t audit of the ICCount of the p.r.on'l r.pr.,ent.tlv., OR
-.."..1 to thl Orphan.' Court.
ADtUN
ISTRATlYI!:
CORRECTIONSI
feetu.1 .rror. dl.cov.r.d on thl. ~.......nt .hould b. addr...ed In writing tal P' Dlp.rt,,"t of R.v~,
Sur.1U of tndlvl~1 T...., ATTHI Pa.t A......lftt R.vl.w Unlt, D.pt. 280601, H.rrl.burg, PA 1712'-0601
PhonI (717) 7'7-6S0S. S.. p.g. 5 of thl bookl.t "In.tructlon. for Inhlrltanc. T.. A.turn for. R..ldent
OIeedent.. IREV-ISOI) for en ..plan.tlon of adllnl.tr.tlv.ly corr.ctabl. .rror..
DIKeu.. f
If any ta. due I. p.ld ..Ithln three (5) c.lendar aonth, .ftlr thl d.cedent'. dl.th, a 'Iv. p.rc.nt ISX) dl.count of
thl t.. p.ld II allow.d.
tHymST.
ThI IS~ t.. aene,ty non-p.rtlclpatlon plnalty I. cOlpUt.d on th. total 0' thl t.. tnd Int.r..t ......ed, and nat
p.ld b.for. Janu.ry 18, 1996, thl flr.t day aftlr thl end of the t.x .-nI.ty p.rlad. Thl. non.p.rtlclpatlon
pen.lty II IPPI.IIbI. In the .... .ann.r and In the the .... tla. p.rlod .. you would appa.1 thl t.. Ind Int.r.,t
that hel bien .......d .. Indlc.t.d on thl, notlc..
lnt.r..t I. ch.rg.d blglnnlng with flr.t d.y 0' d.llnquency, or nine (9) eonthl and one (I) day froe thl d.t. of
d..th, to the d.t. 0' p.yaent. T.... which blc... d.llnqulnt b.for. Janu.ry 1, 19.1 b..r Int.ra.t .t the rat. of
.Ix 16~1 p.rc.nt p.r annue c.lcul.t.d .t . dally r.t. 0' .000164. All t.... which b.c... d.llnquent on and .ft.r
January 1, 19'2 will be.r Intar.,t .t . r.t. which ..III vary fro. c.lendlr y..r to c.l.nd.r y..r with th.t r.t.
~.d by thl PA aap.rta,"t of R.v.nue. Th. .ppllclbl. Int.r..t r.t.. for 19.2 through 1996 .r'l
PENAlT'f1
!!!! Int.rllt R.t. D.llY Int.rllt hctor !!!! Intl".t Rat. DlIllY Intlr..t 'actor
1912 zn .000S48 1987 'X .000247
1985 lOX .OD04J1 1985.1991 IlX .OODSOI
1984 IlX .000JDI I99Z 'X .OODZU
1915 lSX .000lS6 19U.I994 'X .000192
1916 lOX .00027' 1995.1996 .x .000247
-.Int.rllt I. c.lculat.d a. followlI
INTEREST' eALANCE or TAX UNPAID X Nun8ER or DAYS DELINQUENT X DAILY INTEREST rAcyaR
.-Any Hotlc. I..ued .fter thl ta. b,cDl" d.llnquent will r.fl.ct an Int.r..t calcul.tlon to 'lft.In (ISI day.
beyond thl date of thl ........nt. If pay..nt i. ..d. a.t.r the lnt.ra.t coaputetlon d.t. .hown on thl
Hatlc., ~ltlon.1 Int.r..t lU.t bl c.lculat.d.
PAYMENT I
Detach t.. t. po,.Uon of \hh HoUce end .ub4llt with you,. P.lIIant ..d. p'V_I. to ttM n... and Metn"
p,.lnted on ttM revar.. 11es..
If RESIDENT DECEDENT .ak. check or .OMV ord.r p.v.,ll tal REgISTER OF WILLS, AGENT.
If HOH~RESIDENT DECEDENT ..1 ctMCk or .onav ord.r pn.tlll tal COtltlOHWEAl TH OF PENNSVlVANIA.
AU p.vanh rec.lved shaU be .pplled flnt to anv lnt.r..t which ..v b. due with ."v ,....lncMr .pplled to ttM tax.
REFUND (CA)I A r.fund of . \Ix credit, which w.. not r.que.t.d an the Tax R.turn, ..v b. r.que.t.d by CHIII.Ung en
wAppllc.tlon for R.fund of pann.ylvanl. Inherltanc. end E.t.t. T.x" (REV-ISIS). application, ar. .v.II~la .t
~ OffiCI of the Regl,t,,. of Will., any of the ZS R.venua Dlatrlct offlc.. or froe the Dapa,.taant'. Z4-hour
In...rlng ..rvlcl nu-bar. far for.' ordarlng, In pann.vlvanl. 1-800-161-1050. out.lda pann.ylvanl.
and within local H.rrlsbUrg .rla (717) 787-80'~. TOOl (717) 772-2152 (H..rlng lapalred only).
REPLY Tal
Due.tlon. ,....rdlng arrar. contained pn thl. notlca .hoUld be addr....d tal PA Oap.rt.-nt of A.vanua, Bur.au
of Individual T..... ATlNI Po.t A.....eant Aavlaw Unit. Dept. 110601, Harrl.burg, PA 17121-0601, phone
(717) 717-6505.
DISCOUNT I
If env t.. due 1. paid within thraa (5) c.lend.r aonth. .ftar the decadent'. d.ath, . flva p.rcant (5X) dl.count
of the t.x paid I' allowed.
PENALTY'
The ISX tax .-na.ty non-participation penalty I' coaputad an the tot.l of the t.. end lnt.r..t .......d. and not
p.ld blfor' Janu.ry II, 1996, tha flr.t day aft.r thl and of the t.. aane.tV parlod.
INTEREST I
Int.ra.t I. chargad blglnnlng with flr.t day of d.llnquencV. or nine (,) aanthl and one (1) day fraa the d.t. of
death, to the data of p.yeant. T.... which bec'" delinquent bafar. JanuarV I, 1'12 b..r lnt.r..t .t the r.t. of
11. "X) parcent p.,. ..... calc:ulltad .t . dally r.t. of .aDOI64. AU t.... which bee'" ctellnqusnt on and afta"
January 1, 1'12 will bI.,. Int.ra,t .t . rata which will v.,.y 'rot caland.r ya.r to calend.r yaa,. with that r.t.
announced by the PA D.part...,t of Ravanu-. ThI appllcabla Intar..t rat.. for 1'12 through I'" aral
Va',. In tan It Rata D.lly tnt.r..t Factor V..r Intl',...t R.ta D.lly Intar..t Factor
1912 zox .000"' 1917 .X ,OODZ47
1.11 16% .aDOUI 1911-1"1 IIX .aaDnl
I'" IIX .000501 I"Z .X .aODZ47
I9S5 ISX .aDnS6 l"S-I~ 7X .000192
1.16 lOX ,OOOZ7~ 1'95-1996 OX .OODZ47
--Int.,...t I. c.lculated .. fallOW"
INTEREST . BALANCE OF TAX UNPAID X NUnSER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
__Any Notlca I.sued .fter the t.. bec~' dallnquent will r.flact an Int.,.a.t calculation to flftaan (IS) day.
bayond the data of thl .......ant. If p'V""t h aeeM .ftar thl! Intar..t coaputaUon data ,hovn on t"-
Notlc., addlUOMl Inter..t ault b. calcul.t~.
.----.--'Wf~"".-......""......~
..~
"'T~~