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DEe 2 7 lG95
3283895
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1M'
No,
COIIIIONWEALTH OF PENHSYLVAHlA. OEPARIIIEHT OF H!ALTH. YITAI. RECORDS
CERTIFICATE OF DEATH
'OP M
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L
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SOOAI..a.Iln.......ul
L 007 18
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L
.OfteN.......... Dh....'
4444
_0 _0
,..................,.".,...
...tN...O..........~
~....--_.
MAlI .. .
-
--
Harried George H. l\IreS
,...01................. lilITtXien
II.... .......,...
....
...
-
..... .
.......... "..o::"'-=:.='
wo,......"*I~...~.........---
Lelll (brow
Hill PlI 17011
._-
ElIst IllIrrlsburg CrEmlItOIY
""rrisburg, PlI
rs-Hamer funerlll Hare Inc
~_ MI D
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'EV.llOOU+I'.9') *'
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
fOR DATIS Of DIATH AnlR 12/31191 CHICK HIli
If A SPOUSAL
POVIITT ClIDn IS CLAIMID 0
fill NUMIIR
'l
COUNTY CODE
OleIOW'-' COMma ,a,OOIlU
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bllEts
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COMMONW[AlTH OF PENNSYlVANIA
DEPARTMENT Of RlYENUE
DE'T.210601
HAlRISIURO.,A 17121.0601
citrOINT" NAME {L,U . flUt. AND MIDOll INITlAll
Ames, Barbara J.
WCI....l SECUlltY NUMllIIt
<!..
l'
l'ltf
NUMBER
YEAR
4305 Motter Lane
Camp Hill, PA 17011
007-18-4444
Count
AMOUNT IlCflV[D IUE IN!otlUC110N!l1
-0-
Ames, Geor
1K]1. Original R,lurn
o A. Llmil.d EI,o',
e H.
o 2. Supplemental Relurn
o 3. Remainder R,lurn
(lor dol" 01 d.o,h prior'o 12.13.821
o S. fed.ral hlal. Talt Relurn R.quired
DAD. Fulur. In'tr.,' Compromise
(lor do'" 01 d.o,h oller 12.12.82)
[Xl 6. D.cedenl Di.d Tlllol. 0 7. Dlced.nl Maintained 0 living Tru,'
(A"och copy 01 Will) (A"och copy 01 TIUI')
ALL'.~NDlNCI AND CONFIDENTIAL TAX INFORMAnON SHOULD BE DIRECTED TO.
NAMI CO,..,PltTE MAIUNG ADDUSS
AOOIUS
_8, Tolol Number 01 Sale D'palit BOIlII
BALL, SKELLY, MURREN & CONNELL
P 0 BOK 1108
(1)$ -0-
(2)--=.0-
(3) -0-
(A) -0-
(51 500. 00
-0-
-0-
(6)
(71
(8 )
DATl Of OfAtH
pf AmlUllIlllll'ilYIHGIPOUII'1 N,Ullltut. fllll "NO MlOOlIIHlll"ll
13m
"'''
"''''
8~
(9)$1,990.00
-0-
(10)
(ll)
(121
(13)
(IA)
$ 500.00
1,990.00
(1 ,4QO 00)
-0-
(1,4QO 00)
-0-
-0-
-0-
(181
-0-
".
C
S
E
~
bl
'"
1. R.ol E.,o', (Schedul. A)
2. S.ock. and Bond. (Sch.dul. B)
3. Clolt1y H.ld S.ocklPortn.nhip In'.r,,' (Sch.dul. C)
A. Mortgages and Not.. Receivoble (Schedule 0)
5. Calh, Bank Oepalill & MiscellaneauI Perianal Property
(Sch.dul. E)
6. Joln.1y Own.d Prop.rty (Sch.dul. f)
7. Tron"'" (Schedul. GI(Sch.dul. l)
8. Total Gran Anets (tatallin.. 1.7)
9. Funerol bpens.l. Administrative Calh. Mlscelloneoul
Exp.nlt' (Schedul. H)
10. Debts. Martgag. liabilities, lie", (Schedule II
11. To.al O.dudlon,('olol Lln.. 9 & 10)
12. Net Value of ellate (line 8 minus line 111
13. Charitoble and Governmentol Bequelll (Schedule J)
U. Net Value Sublect to Tall (line 12 minus line 13)
15. Spoulal Tranlfe,. (lor doles of death oker 6.30.904)
S.e Instructions for Applicable Percentage on Rlverle
Side. (Include volu.. Irom Schedule K or Schedule M.I
16, Amount alline 1.4 tOlloble 01 6% role
(Include valu.. from Schedul_ K or Schedule M.I
17. Amounl of line 104 taxobl. at 15% rote
(Indude values from Schedule K or Schedule M,)
18. PrincipallaJt due (Add lox from lines 15. 16 and 17.)
19, Credill Spoulal Poverty Credil Prior Poyments
(151 _0_
(16) -0-
(17) -0-
Discount
+
x._-
-0-
-0-
-0-
-0-
-0-
. . BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH ' " -.
Under p.nolli" 01 perjury. I d.doro .ho. I hov. oxomin.d .hll r,'urn, indud;ng occomponying "h.dul.. and ,'ol.m.nh, and '0 ,he b.., of my knowl.dg. and b.li.f.
11 is Itu., corrod and campi.... I d.doro .hol oil rool "'0" ho. b..n r.por',. o. 'ru. morko' vo1u., O,daro'ion 01 proporor o,her ,hon .h. p."onol rop",..'o.lv. II
balld on allln'ormation of which preporer hal any knowledge.
SIGH rUII O""SOH '" H5I . flUHO '!lu.H ADDII" ,. ' ( P /.1 DAI! / /
O,!,- L-If?JC Ctntt' (7Ic..L, /f)7 17011 Y It 96
,
z
..
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...
~
:IE
..
...
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...
__x ,060
)( ,15 IS
Inlerest
21. If line 18 Is gr.aler than line 19, .nt.r Ihe difference an line 21. Thil Is the TAX DUE. (21)
A. Enter the inter..' on Ihe balance due on line 21A. (21A)
8. Enltr.he '0'01 01 Llno 21 ond 21A on Lino 216. Thil il.h. BALANCE DUE. (2181
Make Chuk Payabl. tOI Regl,..r of Will., Agenl
OAt(
, .
IWI. ... p.t'l
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SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
PlIo" Print or T I
~WIA~ 0' P1NNIYlVANIA
IHHIIOTA I 'AX InulH
I""," DICIDIHT
F M
Aml'!A, BArbArA J.
(All pIOIIOIIY ....tly-ew..d whh the Right .1 S"",I_chlp mutt ~. dl......d .. S,h.d." '1
VALUE AT
DATE OF DEATH
ITEM
NUMBER
DESCRIPTION
~
$500.00
1.
Personal possessions
-
(Anach addirional 8Ya" )( 11" P"" If mON ,poUlI. nHded.1
'.
.
,bUill'. P"I
'~'.'~'~n~_;o.-""'<'.".."'"' ",'
~:~
COMMONWIAUH O' "NN"lVANIA
IHHIIITANCI 'A. .nUIN
.1I10INIOICIOIN1
ITEM
NUMBER
A.
Ames, Barbara J.
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
Ploa.. Print ar Ty 0
AMOUNT
B. Admlnl.tratlvo Casts I
DESCRIPTION
$1,990.00
1.
Funoral bponsoll
Myers Harner Funeral Home
1903 Market Street
Camp Hill, PA 17011
1.
2.
3.
-0-
Personal Represenlotive Commissions
Social Security Number 01 Personal Represenlative:
Vear Commissions paid
Family exemption
Claimant
Address 01 Claimant at decedent's death
Street Address
Attorney Fees
City
4. Probate Fo..
C. Mlscollanoous Ellponsell
1.
2.
3.
4.
S.
6.
7.
8.
-0-
-0-
Relationship
Slate Zip Code
S 1.990.00
TOTAL (Also enter an line 9. Recapitulation)
(II moro spaco Is noodod, Insort additional shoot. of .amo .1.0.1
tI'
/:) - y '/ - /
(1 f./'
RIV-1547 IX AFP 112-951*,
CQtItOtMAlTH Of' PfNNS'f'LVAHIA
D[PARUtl"' Of' A(VU.Jl
IURUU Of INDlVIDUAL TUts
001. 11060'
HA.."saURO, PA 17UI-0611
ACN 101
NOTICE OF INNE~ITANCE TAM
APP~AISEHENT. ALLOWANCE O~ OISALLOWANCE
OF OEOUCTIONS AND ASSESSHENT OF TAM
DATI 06-05-96
FILl NO.
COUNTY
CUMBERLAND
DATI OF DEATH 12-23-95
HOTE. TO INSU~E P~OPE~ C~EDIT TO YOU~ ACCOUNT, SUBHIT THE UPPER PORTION DF THIS FORH WITH YOUR TAM
PAYNENT TD THE REGISTER OF WILLS. NAKE CHECK PAYABLE TO "REGISTER OF WILLS. AGENT"
REMIT PAYMENT TO:
RICHARD E CONNELL ESQ
BALL ET AL
PO BOX 11 08
HBG PA 17108
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
Allount Re..itt.d
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ....
iiEV:iS4TEX"AFP"n'F9sY-iiiiricE"-OFniNHERii'AiicrfAx-jipPRjiiSEHEiiT~--Ai.LOiiAiicE-ORm--"--------m
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF AMES BARBARA 'J FILE NO. 21 96-0194 ACN 101 DATE 06-05-96
TAM RETURN WAS' I X I ACCEPTED AS FILED
I I CHANGED
RESERVATION CONCERNING FUTURE INTEREST " SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Roo1 Eatoto ISchedulo AI (11
2. Stocka and Bonda ISchodulo BI 121
S. CloaolY Hold Stock/Portnerahlp Intorolt ISchodulo CI ISI
~. Hort_a/Not.. Rocd.ablo ISchodulo DI I~I
5. Cash/Bank Deposita'Hi.c. Parsonal Property (Schedule EJ (5)
6. Jointly Owned Proporty ISchedulo FI 161
7. Transfara (Schedule OJ (7)
I. Total A...t.
.00
.00
.00
.00
500.00
.00
.00
181
500.00
APPROVED DEDUCTIONS AND EXEMPTIONS:
,. funeral Exp.nl../A~. Coata'H1lc. Expans.. (Schedule HJ (9)
10. Debta/Hortgogo Llabl1ltlol/Llona ISchodulo II 1101
11. Total Doductlona
12. H.t Value of Tax R.turn
15. Ch.rltabl./GoY.r~nt.l Bequa.t. (Schedule J)
1~. Not Value of Eatoto Subjoct to To.
1.990.00
.00
1111
U21
USI
U~I
1.qqn nn
1,490.00-
.00
1.490.00-
NOTE: If an assessment was issued previously, lines 14, 15 and"or 16, 17 and 18 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Aaount of lIno 1~ at Spouao1 rota 1151 .00 M .00= .00
16. Aioount of Llno 1~ to.ablo at lIneal/Ch.. A roto (161 .00 M .06= .00
17. Aooount of line 1~ to.abh at Collotorol/Ch.. 8 rota (171 .00 M .15= .00
lB. Principal T.. Duo I1BI .00
TAX CREDITS:
PAYHENT
DATE
RECEIPT
NUttBER
DISCOUNT I-I
INTEREST I-I
AHOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
.00
.00
.00
.00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FDR CALCULATION OF ADDITIONAL INTEREST.
I IF TDTAL DUE IS LESS THAN .1. NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI. YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
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RESERVATION, E.t.t.. of d.c.dent. dylnt on or ~fore Deceeber Il, 1912 -- If any 'uture Inter..t In the ..t.tl I. tren.,.rred
In po.....lon or enJovaent to CI... I (collat.rall bln.flcl.rl.. 0' the decedent .,t.r the .xplretlon 0' any e.tat. 'or
11'. or 'or y..r., the C~.lth h.r.by .xpr...ly r...rv.. the right to appr.I.. end ...... tran,'.r Inherltanc. Tlx"
It the lev'ul Cl... . (coll.t.r.ll rlt. on any .uch 'uturl Int.r..t.
_01'
NOTICE I To 'ulflll the requlr.-.nt. of Sactlon 21~O 0' the Inherltanc. end E.t.t. Tlx Act, Act II 0' 1991. 72 P.S.
Section 2140.
PAYflEHTI DetlCh the top portion of this Notice end ....It with your pIYllant to the Reght.r of WUlI prInted on the r.vI,... llde.
--Plake chick or lIGnIy ord.r p.yabl. tal REGISTER OF MILLS, AGENT
All PI~t. rec.lved shall flr.t be applied to any Int.r..t whIch .IY b. due with any r...lnder appll.d to the t.x.
Rff1JGJ (CA), A rl'und 0' a t.x credit, which d. not r~.ted on the TllC R.turn, ..y be r.que.ted by coaplatlnt an "Appllcltlon
'or RI'und 0' Penn.ylvanl. Inheritance end E.tlt. Tlx" (REV-ISISI. Appllc.tlon. II" Iv.llebl. at the Offlc.
of the RIII.t.r of Will., any of the 2S R.venue Ol.trlct Offlc.., or by callIng the specl.l l4-hour
an....rlnt ..rvlc. ~r. for for.. ordering I In P.nn.ylvanla 1-100-S62-2050, out.ld. Penn.ylvanla and
within loc.1 Harrlsbura ar.. (717) 7a7-.0~, TOOl (717) 772-2252 CH.arlng I~.lred Only).
OIJECTIOHSr Any p.rty In Int.r..t not .atl.fled with thl appr.I....nt, allowanc. or dl..llowance of deduction., or ......eent
of t.lC (InelucUno dhcount or Intarllt) II .hown on thll Notice au.t obJ.ct within .lxty UO) din nf tlc.lpt of
thh Notice byl
--wrlttan prot..t to thl PA Dep.rt.ant of R.v~, lo.rd of App..I., DlPt. Z11021, H.rrl.~tg, PA 17IZI-I021, OR
n.lection to have the ..ttar det.ralned .t audit of the account of thl p.r.onal tlprllantltlv., OR
neppaal to the Orph...." Court.
AI.nN
ISTRATlVE
CDRRfCTIDHSI
Factual .rror. dl.cov.red on thl. ......lInt should ~ addr....d In wrIting tOI PA O.p.rtllnt of R.venue,
lur.au of Individual T.x.., ATTHI Po.t A.....llnt R.vl.w unit, a.pt. Z10601, Harrl.burg, PA 17121-0601
Phone (717) 717-6505. Sa. pea- S of the bookl.t "In.tructlon. for Inherltanc. T.x R.turn for. R..ldant
Dec~t" (REV-1S0l) for an .xplanatlon of adalnl.tratlv.lY corr.ct.bl. .rror..
OISCCUtTl
If Iny tax due I. p.ld within thr.. CS) c.lendar .onth. .,t.r thl decedent". d.ath, . flv. percent (SX) dl.count of
thl talC paId I. .1Iowed.
PENAL TVI
ThI IS~ tax eane.ty non-p.rtlclp.tlon penalty I. coaputld on the total of the telC and Int.r..t ......ad, and not
p.ld ~for. January II, 1996, the flr.t d.y .ft.r the and of thl t.lC 1In..ty period. Thl. non-partlclp.tlon
panalty 11 appealable In the .... 'IfV\Ir and In thl tM .... tla. P.rlod ,. you would ,pp..1 thl taM and Int.,.lIt
that h., bean ......ed .. Indlc.ted on thl. notlc..
INTEREST I
Int.r..t I. ch.rged begInnIng with flr.t dlY of d'llnquency, or nIne (9) aonth. and one (I) d.y 'rOl tM d.t. of
de.th, to the data of p.~t. T.... whIch bee... d.llnquent b.for. January 1, 191Z be.r Int.r..t .t the r.t. of
.Ix (6X) percent per annua c.lcul.ted .t . d.ltr r.t. of .0001". All tax.. which bec.. d.lInquent on and .U.,.
January I, 1912 will be.r Int.r..t .t . rat. which will v.ry 'roa calind.r y..r to c.lander y..r with that r.t.
announcld by thl PA OIp.rtaant af R.venue. 1M appllcabl. Int.r..t r.t.. 'or 1911 through 1996 .r'l
!!!! Int","t R.t. O.lly Int.ra.t F~tor !!!r Int.,...t A.t. Dally Int.r..t Factor
1912 20X .000548 19.7 9% .000l47
I9IS 16X .000451 19.1-1991 IIX .00OSOl
19.~ IU .00OSGl 1992 9X .000247
1915 UX .0oaSS6 1995-1994 7X .000192
1916 lOX .D00l74 1995-1996 9X .000247
--Int.,...t I. c.lcul,tld .. followlI l
INTEREST . SALANCE OF TAX UNPAID X NunSER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice 1..1.Md .Uar thl t.x bleOM' delinquent will reflect an Int.,.lIt c.lculatlon to flft.en US) d.,.
beyond the chit. of the ........,t. If payunt 11 .Id. aftar the Int.,...t c~t.tlon d.t. Ihown on the
Notlc., additional I"tar..t .u.t ~ c.lculated.