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Home My WebLink About96-00241 '1'111'" I' 10 It \I Iii 111.11 tiled Hlp,ll.ll nl(' till 11;t'011'1111"!! 1.< ,"', :1, " '1','1'. '11:1\. III ,1'1 'ii, !,,!, I dl.J .'.111\ il" " 1 H:'II d" I'll.. ;It '.' I,' !.< t. '. " I' I llllq I'd I"!!) II" 1'1 !lilli" WARNING: Ills IlIcgnllo duplicale Ihis copy by pholoslat or phologrnph, I tT I'll t111~ II lldl' .Il( " ' (I( I ....\.\\,il..iii 'pi;', ,...~,' ".1':. .l..~,' . 'I~;. t:..." ....~.,;,., 'I ~', ?" ' y\\ /, L.;i: . ...... ' \ :"t' ~I II, (..1\ ,,".1 " .i':~1 1;*(' ~.....1 \\~-,..,..~ . " '1 ,\~,.,,,,.- ,.-.:.t~l! ~,"'.9: ,,' ,''i:~lY ~"'L~!,2~,~;." ' " , . , :: .... r It ,. \. '. (,'/' , ..' .:..~ .. ';". .>" I ,,, .11 !: t \" ~ll ." " "- il '-~ -, ~'j oj 2 " i ~Il ; i iJ 1),11t ..'a'I'"..z'" COMMOUW[ALTH OF PENUSYlVAWA' DEPARTMENT OF HEAl.TH' vITAl. REconos CERTIFICATE OF DEATH ... .. .....tVctUtt..,................. Ronald R. ~cn~cr '" ....,.,'...-.. \VC'..~I(V.'l.......'".. ~"I COIL""'"'' ~...-' ~. I, Nalc . 173 - 38 8623 , rob. 8. 1996 L8 :.I'Of.t...o.. _!V_.. ....,.."..U(...... "-"l:lrl[A......_.........~_....'."...__.._ .,.......,..,~"'.-.. toCSoI"l.4 ......_ [] t~_;: h ,.CUfl-....... ,~"<;<...~_ 7......-."4~......... .- - '"",......, .1<4(....-..... t."'llf:",..t... -- ~... UltJ..fl-OfW''' ~.lCI.._..._"" __........oc ........ ~\ .. Cllmberlanlt OICltJ(."" USV'~ 'c,,"IT..,.. .....-...;.-:;-~.:,;~..::::;L;;" " Owner & 0 crator " Print Sho ct(IDl'" ""'IuI.OOOQ"OOfII"(~_ U'o'_ 1oo_IClC""", tolUOl"'" 261 ~cst Ridge St. ~i~~fLooct Cnrlislc. PA 17013 ~-~~ '. k Cnrlislc ., \/hltc 1~"Mt.oV; ,-- ---- .. """,,,,".fUS..._ ...-....-- ~..,~.... II Harricd C.uol Bmun .~ CUr.lhcrlnnd '" --. --. _..... ".0_..-__.. - 11.".. ."c... \".........-- ".t~,__.._.... Carl i!'lilC' ,...- ,.I.....".....t........,,,,...., . Albert \I'ca\'cr ....QAO.I.I.., ,...I....., ..~....'4"\ Carol B. ~e;l\'cr uo...,..,...I....,......,,..................r.. ., Rennil ~h.crs >of"""'''' ,...\......IW'I $",._ '." .,,",~,.....r '-,.... .._.._Sl....J 261 \..'(-'~t RidQC St.. en .....((~l)l<...l1....("'..._...c._....t:>_...... ..0:_"... ~ PA 17011 ,:x.h~ c...~ :\>1" t~c.- , I ~ \<I..U""'....I.. .,Hanover. York r:lan- 0 1 unera w:ll" 1 0.1'1 Soof,"ID ...._0...... Co.. PA orne 1996 Rest !lm'en Cemctery . .I(."'.O.$~lJ(... ..<I"~'Il,;"I\.I.M ...........U.DOPIUOfI.IC..'l'f 0 1- 01271. "'....1_.......""'......,......_....,...,.......,_.,.........1'.......... ...,.............- 21 N . .. ,'.HII'o, 1....__'... _......a"O"'ot*<.._......._'.....,... C:OO_.-......_"'",,""oQ .......,.........""......,...- .-........~...... ~.__IO............~_ ).1 ~I~" ...\.:.'..I..i.t.."'O.O..,~"'l......I~(.,;.aoooI"'. -., ...;.;v O.l( ""';"'lI.."<i:!t<4 .0......... ~.. ...", .. ..(VO...... ;.......-... .....-......... 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(I~""ll"" "'.1"""It....... ,., LAST WILL AND TESTAMENT OF RONALD RICHARD WEAVER THIRD Should my spouse, CAROL BRAUN WEAVER, predecease me or die on or before the sixtieth (60th) day following my death, then I give and bequeath ten percent (10%) of my entire estate of whatever nature and wheresoever situate to ST. PAUL'S EVANGELICAL LUTHERAN CHURCH BENEVOLENCE ACCOUNT. I give, devise and bequeath the rest, residue and remainder of my entire estate together with all insurance proceeds thereon of whatever nature and wheresoever situate in equal shares to my children, CHRISTOPHER JAMES WEAVER and KIMBERLY ANN WEAVER, who survive me by sixty (60) days, per stirpes. FOURTH My executor is authorized and empowered to exercise from time to time in his, her or its sole discretion and without prior authority from any Court, in respect of any property forming part of any trust hereby created or otherwise in its possession hereunder all powers conferred by law upon trustees or executors and the testator intends that such powers be construed in the broadest possible manner. FIFTH I nominate, constitute and appoint my spouse, CAROL BRAUN WEAVER, Executrix of this my Last Will and Testament. In the event CAROL BRAUN WEAVER is deceased, unable or unwilling to serve or shall cease to serve for any reason whatsoever, then I nominate, constitute and appoint my children, CHRISTOPHER JAMES WEAVER and Page 2 of 3 ') ,I f-" k f. l :.i' ,} ," " LAST WILL AND TESTAMENT OF RONALD RICHARD WEAVER KIMBERLY ANN WEAVER, to serve instead. In the event CHRISTOPHER JAMES WEAVER and KIMBERLY ANN WEAVER are deceased, unable or unwilling to serve or shall cease to serve for any reason whatsoever, then I nominate, constitute and appoint RENNA WEAVER, as personal representative of this my Last will and Testament. I direct that my personal representative shall not be required to give or post bond for the faithful performance of his, her or its duties in this or any other jurisdiction. SIXTH I hereby declare it to be my expressed desire that my personal representative employ the Law Office of Ron Turo of Cumberland County, Pennsylvania, for legal advice and assistance regarding this my Last will and Testament, they having considerable knowledge of my affairs, views and wishes respecting any matters that may arise at the probate of this instrument, the administration of my estate, and the execution of the powers herein mentioned. IN WITNESS WHEREOF, I have hereunto set my hand to this my Last Will and Testament this / I rlo day of '~(" VI 1)/ I, t k./ , ) . ,).. 1 / ", '. .' . /(~'7L(llj ,<. (<,./L.J Ii. 'J!&-<~'1 RONALD RICHARD WEAVER Page 3 of 3 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA 55. COUNTY OF CUMBERLAND We, l."L"'-f'T ,j. IJ;,II)."/'/{. and '7 --- / Oot) I..., /\ c: , the witnesses whose names are attached to the foregoing document, being duly qualified according to the law, do depose and say that we were present and saw testator sign and execute the instrument as his Last will and Testament; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testator signed the Last Will and Testament as witnesses and that to the best of our knowledge the testator was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. ,,' Sworn or affirmed subscribed before me by this /1'Ih day - .J0.1 ( I, J. '} \" 1// ,lJi.lliy'and "-nnll./ ;, . of ~"{ L) ,1992. and ) ... flU /I, , , /1' l r. Jet \ Ii It ~ (l (I ( . ~' ).il~ Not"""s..'li BnrtJa~i1 E. s........ . "" uv PublIc Cart-sJeBor.).f:ll',,\,:I"':U-.1ec.,..JOty MyComrni::i'",....l~.~.'esJt,.l;e3. 1996 R['t', ,~OO n. 11QII w ~ ~~.." u"'''' w...u :z:"'''' u"'~ ..... ... c< ^~ COMMONWfAUH Of P1NNSn't'MHA 01PAIIIMfNf 0' R('t'WUf 0(" 280001 HAIIIlIUUIlG, PA 11111.0001 OICI0INl~ NAMl11A~f. 111~f, Ar~O MIOOll 'fOR DAns Of DIA'H AnlR 12/31/9\ CHICK HIRI ilf A SPOUSAL ~, I.POYI!!TT SUD!',!~~LAH.\I!d"~__,__, ___ i fill NUMBIR I 21 ..lcoUNIY"CODE INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) 00241 {J (j YEAR NUMBER '~IIIIAII OllltJlNI ... U,:MPt( II 01.00.1...... ~ z w '" w u w '" \~eaver, l<onald r,. 261 \~e,;t l<ldgp SI reel ~OC'Al ~(CUIIT" ~~UMUI DAllO' [)(AU'- ]OAllUTlIiilit--- Ca I II s Ie, P/\ 1701 3 173- 38-862 3 2/8/ % 3/15/47 CO""" r:uITlheT'\ and l' "'r11("'1l1 'U.W1WI....G ,rouu, N""'III"" '1\1.,..0 ....uull "'I'''~OCI''~CUIITY tlUMlfl A""OUtll-II(lfVlD l"'llIN"'IIUCTtO~''''l Weaver, Carol B. 1187-38-9013 353,102.22 00 1. Original Return [] 2, Suppl&mental Return [J 3. Remainder Relurn lfar date, 01 deolh prior 1012.13.82) o 4, limited E'Iale Q Ja. Fulure Inlere,I Campramile 0 S. Federal Elfate Tall. Return Required {for date, of dealh after 12.12.821 rn 6. Decedent Died Teltate 0 7, Decedent Maintained 0 li....ing Tru't ..Q.8. TOlal Number of Safe Depolit BOll.ltl (Attach copy of Will) (Anach copy of Trultl ALL CORRESPONDENCE AND CONFIDENnAL TAX INFORMATION SHOULD BE DIRECTE .~ "'z Ww "'''' "':z: "'''' u... COMPllt( MAlllNG AOOIU", NAMl Ron Turo, S5qul~e UlEPHONLNUMllR 71/ 245-9688 32 Soutll Bedfo~d Street Cal:llsle, PII 17013 z '" ., :5 ::l ~ c:: c< u w '" I. Reol ElIoTe (Schedule A) 2. S.ock. ond Bond. (Schedule BI 3. Clolefy Held Stock/Partnership Interest ISchedule q 4. Mortgages and Nale' Recei....able (Schedule 0) S. Cash, Bank Deposits & MilCellaneou, Perlonal Property (Schedule EI 6. Jointly Owned Property (Schedule FI 7. Tran,fe" (Schedule G) (Schedule l) 8. Totol Gran Auelsltotallines 1.7) 9. Funeral Expen,e" Adminillralive COlIS. Miscllllaneou, EJlpenses (Schedule H) 10. Debts. Mortgage liabilities, lien, (Schedule I) 11. Totol Deductions (total lines 9 & 10) 12. Nel Value of E,Iate (line 8 minu, line 11) 13. Charitable and Go....ernmental Beque," (Schedule 1) 14. Net Value Subject to Tal( (line 12 minu, line 13) 15. Spousol Tranlfen (for doles of dealh after 6.30.94) See Instructions far Ar,plicable Percenlage on Re....ene Side, (Include va lUll, rom Schedule K or Schodule M,I 16. Amount of line 14 tOll.able at 6% role (Include ....alues from Schedule K or Schedule M.) 17. Amount of line 14 tOllable at 15% role (Include ....alue' from Schedule K or Schedule M,) 18. Principoltall due (Add lax From lino, 15. 16 and 17.) 19. Credits Spaulol Po....erty Credil Prior Payments + + (8 ) 112,000.00 (9) 21.05 (101 (111 5,518.77 (12) 106,481.23 (13) 0 on (141 106,481.23 x..Q..= 0.00 x ,06 = 0.00 x ,15 = 0.00 (181 0.00 (19) 0.00 1201 0.00 0.00 (21) 0.00 (2tA) (21B) 0.00 (15))53,102.22 0.00 0.00 (161 (17) z '" ;:: c< .... :> ... '" '" u >< c< ~ Dileount lnlere" 20. If Une 19 i, greater than line 18. enter the difference on line 20. This is the OVERPAYMENT. IJIO Chock here if you are requesting a refund of your overpayment. 21. If line 18 is greater than line 19, enter Ihe difference on line 21. Thi, is the TAX DUE. A. Enler the inlerelt on the balance due on line 21 A. B. Enler the total aFUne 21 and 21A an line 21B. Thi, il the BALANCE DUE. Mak. Ch.ck Payabl, tOI Regilt., of Will., Ag.nt .... BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH <II( <11('" Under penaltie, of perjury. I declare thai I have ell.omined thi, relurn. including accompanying lChedules and IIalementl. and 10 the bes' of my knowledge ond belief. it j, Irue, correct and complete. I declare Ihot 011 real estate has been reported 01 Irue market ....alue. Decloration of preparer other than the personal reprelenlalive is bo,ed on 011 information of which preparer ha, any knowledge. SI(iNA1UR( Of 'U~ON IlUP SIBll fOR filiNG I(1UIIN ADOAI...!. OAt( / /. Q!!cN......... ~(,.,L-w fL~" ~.7a.J!~ riJ AT!vt ~OIl!.S /' 0101( .-')~ S ~(!_ _/~":!t2.S I- G.I.kM I ::C11 UV.UOIlh (1"11 SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY PI. as. Print ar l' . FILE NUMBER 2196-00241 . COMMONWI!ALTH 0' 'fNNSYlVANIA INK.IIIANel TAX aouaN IISIDINT DICIDINT ESTATE OF Ronald R. Weaver IAII property lolntl.,....wn.d with the Right of Survlvonhlp mu.t be dluloMd on Sch.dul. F1 VALUE AT DATE Of DEATH 1,000.00 ITEM NUMBER DESCRIPTION 1. Datsun 500.00 2. Honda TOTAL (AI sa enter an line S, Reca itulatian) 5 1,500.00 (Anach additional 8"''' )( 11" ,h..ts if mar. 'pac. is n,.d.d.1 11~ltQllU.lll'''1 ~ COMMONWfAUH O. PENNSYLVANIA INHERITANCE TAX I:lTURN RESIDENT DECEDENT ESTATE OF Ronald R. Weaver Joint tonon'(II. -------+_._-_..+----+---- - NAME L Carol B. Weaver B. C. Jolntly.ownod p,oporty. SCHEDULE F JOINTLY.OWNED PROPERTY ADDRESS 261 West RJdge Street Carllsle, PA 17013 FILE NUMBER 2196-00241 RELATIONSHIP TO DECEDENT Spouse ITEM LmER DATE FOR TOTAL VALUE DECD'S DOLLAR VALUE OF NUMBEI JOINT MADE DESCRIPTION OF PROPERTY OF ASSET % INT. DECEDENT'S INTEREST TENANT JOINT 1. A 1990 The Pri.nted Image 50,000.00 50 25,000.00 2. A 1986 \~eaver and Turo 160,000.00 50 80,000.00 3. A 1982 Weaver, plantholt. & Turo 16,500.00 331/3 5,500.00 TOTAL (Alto enter on line 6, Recapitulation) S 110,500.00 (If more 'pace it needed inser' additional theets of some ,jze) 11\11)111" tl'JI '*' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES AND LIENS Ploa.. Print or Typo I FILE NUMBER 2196-00241 COMNoONwlo4lTH 0' PlN..\,,~.".I'" IN"lIlIo4"'(I '...llllUI.. InID(NIDIClDINI ESTATE OF Ronald R. Weaver ITEM NUMBER DESCRIPTION AMOUNT 1. Tax bill for 205 Kltt.anni.ng Run, Greenfi.eldr PA, Blair County 21. 05 TOTAL (Also enler on line 10, Recapilulation) S 21.05 'If more space is needed. in,erf addi'ional shee's of ,orne ';:0.' LAST WILL AND TESTAMENT OF RONALD RICHARD WEAVER THIRD Should my spouse, CAROL BRAUN WEAVER, predecease me or die on or before the sixtieth (60th) day following my deathr then I give and bequeath ten percent (10%) of my entire estate of whatever nature and wheresoever situate to ST. PAUL'S EVANGELICAL LUTHERAN CHURCH BENEVOLENCE ACCOUNT. I give, devise and bequeath the rest, residue and remainder of my entire estate together with all insurance proceeds thereon of whatever nature and wheresoever situate in equal shares to my childrenr CHRISTOPHER JAMES WEAVER and KIMBERLY ANN WEAVER, who survive me by sixty (60) days, per stirpes. FOURTH My executor is authorized and empowered to exercise from time to time in his, her or its sole discretion and without prior authority from any Court, in respect of any property forming part of any trust hereby created or otherwise in its possession hereunder all powers conferred by law upon trustees or executors and the testator intends that such powers be construed in the broadest possible manner. FIFTH I nominate, constitute and appoint my spouse, CAROL BRAUN WEAVERr Executrix of this my Last will and Testament. In the event CAROL BRAUN WEAVER is deceased, unable or unwilling to serve or shall cease to serve for any reason whatsoeverr then I nominater constitute and appoint my children, CHRISTOPHER JAMES WEAVER and Page 2 of 3 -) . , ie. k.t..-i...J..:lv""'l LAST WILL AND TESTAMENT OF RONALD RICHARD WEAVER KIMBERLY ANN WEAVER, to serve instead. In the event CHRISTOPHER JAMES WEAVER and KIMBERLY ANN WEAVER are deceased, unable or unwilling to serve or shall cease to serve for any reason whatsoeverr then I nominater constitute and appoint RENNA WEAVERr as personal representative of this my Last Will and Testament. I direct that my personal representative shall not be required to give or post bond for the faithful performance of his, her or its duties in this or any other jurisdiction. SIXTH I hereby declare it to be my expressed desire that my personal representative employ the Law Office of Ron Turo of Cumberland County r Pennsylvania, for legal advice and assistance regarding this my Last will and Testament, they having considerable knowledge of my affairsr views and wishes respecting any matters that may arise at the probate of this instrument, the administration of my estater and the execution of the powers herein mentioned. IN WITNESS WHEREOFr I have hereunto set my hand to this my , 1 . , ,7''' d f "f ' I / Last W~l and Testament th~s , , ay o' /I: I~ ill U,.lj r , I /1 ,1 . . I( // /7 ." :' ;;' , ~Lt'l.ff.::l/ ,<U;.-~~I RONALD RICHARD WEAVER , , I I {.. iJ.id<A.Ni-1 Page 3 of 3 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA 55. COUNTY OF CUMBERLAND --- We, i..~I.\.~""~- .,;. I.:~.i...~";/';/"/r;. /7 ---I I I' .- / /_ CA_' :-- L. r the and witnesses whose names are attached to the foregoing document, being duly qualified according to the lawr do depose and say that we were present and saw testator sign and execute the instrument as his Last will and Testament; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testator signed the Last Will and Testament as witnesses and that to the best of our knowledge the testator was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. . Z' .' . ~ ," ';," /-/,' _ . }f' . /.-/ /-,~-:,f- ;~/::(;;~:~"'~' '~ " ' - \ //' /' // C. ....,:..J ! ~ j, I [ . ' .... Sworn or affirmed '),l!.) Li I, J- 'j IY"" ~ d_ I '. IJ' and , ii' of \-i1,; 'li. /'( 1\ (,-,I r 1992. I and subscribed -) '-.- r,,37L /, ,__i , before by me I this / / '/./1 day ~r' L ~ .?YLl '( ) 1.( 'j r,. {'I '. , I I . . -.J ,"1 / NO'.:m,1 &oil! Bt1rtW3 E. S.,.''...,. ~ !M"ry Pt.t-!lC Car\Sle l3tY'l.I:lI'7"l'l:!"lf~lC""Jnt'f MyComrnr.>-....,..e....'esJUl"'J. :596 "J .f' -) " I. \ ."\ BUREAU OF INDIVIDUAL IAXES IHllINI TANCI TAl UI\lI!OIOlol hlP'. :&DbOl HANAISBUNG, I'" 1":S.ObOI CDMMONWEALTH OF PENNSYLVANIA DEPARTMENT DF REVENUE NOTICE OF INHERITANCE lAX APPRAISEMENT, ALLOWANCE OR DISALLDWAHCE OF DEDUCTIONS AND ASSESSMENT OF lAX RON TURD ESe 32 S BEDFDRD ST CARLISLE PA 17013 DATE ESTATE OF DATE DF DEATH FILE NUMBER CDUNTY ACN 01-20-97 WEAVER 02-08-96 21 96-0241 CUMBERLAND 101 ~~i~~~~ ~rJ~ Ih.:hl 11111 I:I-hl RONALD R : A"ount Re"itt.d r-_-=-'-'_~.;;.."---'-='_.'::-==~='-~--.;="=..=c--....;--_.= MAKE CHECK PAYABLE AND REMIT PAYMENT TD: REGISTER OF WILLS CUMBERlAHD CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN lDWER PORTIDN FDR YDUR RECDRDS ..... iiiv: is'4TEif -Ai: j:i - i i if: 96Y- Niii"- i cE- -liT -iNHEii i i ANcE - T A it- APPRiI-iSEiiENT-'--ALi.-liwANcE - 'OR - --- - - - -- -- - - - - -- DISALLDWANCE DF DEDUCTIDNS AND ASSESSMENT DF TAX ESTATE DF WEAVER RONALD R FILE ND. 21 96-0241 ACN 101 DATE 01-20-97 If an assessment was issued previously, lines 14. 15 and/or 16, 17 and 18 will reflect figures that include the total of abh returns assessed to date. ASSESSMENT DF TAX: 15. Anount of line 14 at Spousal 1&. Anount of line 14 taxable at 17. Anount of line 14 taxable at 18. Principal Tax Due TAX RETURN WAS: I X) ACCEPTED AS FILED RESERVATIDN CDNCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE DF RETURN BASED ON: ORIGINAL RETURN 1. Red Est.te ISchedule A) 11) 2. Stocks and Bonds ISchedule SJ (2) 3. Closely Held Stock/Partnership Interest ISchedule CJ (3J 4. Hortg.ga./Notes Receivable (Schadule D) (4) 5. C.sh/Sank Deposits/Hisc. Parsonal Property (Schedule E) (5) b. Jointly Owned Property ISchedule fJ IbJ 7. Transhrs ISchedule GJ (7) 8. Total Assets APPRDVED DEDUCTIDNS AND EXEMPTIDNS: 9. funeral Expenses/Adn. Costs/Hisc. Expanses (Schedule H) 19) 10. Debts/Hortgage Liabi1ities/Lians ISchadule I) ClO) 11. Total Daductions 12. Het Value of Tax Raturn 13. Charitable/Governnental Saquests (Schadule J) 14. Het Value of Est.t. Subjact to Tax NDTE: rat. Line.l/Class A rat. Collataral/Class S rat. llSI llbl 117) TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT 1'1 INTEREST I-I CHANGED .00 .00 .00 .00 1,500.00 110,500.00 .00 IBI 5,497.72 21.05 1111 1121 1131 1141 106.481.23 X .00: .00 X .06: .00 X . IS: llBI AMOUNT PAID i TDTAL TAX CREDIT I :BALANCE DF TAX DUEl I INTEREST AND PEN. ! TDTAL DUE HOTE: To insura proper credit to your account, subnit the upper portion of this forn with your tax paynent. 112,000.00 ~.~IR 77 106,481. 23 .00 106,481.23 .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 THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU MAY BE DUE A REFUND. SEE REUERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) Fif"" i', c>r :) '9',' J^' ",; 17 rill :,16 Clli Cur(,~; ~~t\. RESERVATION: [,tat., of decad.nt. dying on or bofor. Dec..ber 11. Iqat ~~ if Any future int.ro.t In the ..tat. I, transf.rrod In pO'I...lon or enJoy..nt to CI.I. B (coIIAt.ral) banaficln,!.' of the d.cad.nt aftar the ..pitation of any .,tat. for Ilf. or for y.ar., tho Co..onwaalth hareby ..pr...lv ra.arva. the right to appral.. and .S.811 tran,fer Inhorltance Ta... at the lawful Cia'. B lcallnl.tal) rat. on any luch future lnt.ro.t. PURPOSE or NOtiCE: To fulfill the raqulrll..nh of Sactlon thO of the lnharltanu and E.tat. Ta. Act, Act lZ of IIJ91. 11. P.S. Section 21'+0. PAV"ENT I Detach the lop portion af this Hotlc. and lubait with your pay..nt to the Raglstar of Will. printed on the tavars. ,Ida. .-Hak. check or lIonoy order payftbl. to: REGISTER OF HILLS, AGENT All pay.ant. recei~.d shall first b. nppll.d to ftny Intarast whiCh .ay be dua with any re.ainder appllad to the tax. REFUND (CA)1 A r.fund of a tax cr.dlt. which was not requasted on the Ta. R.turn, .ay b. requ.st.d by co.platlng "n ~Applicatlon for Rafund of P.nnsylvania Inharltanca and [stata 'a.~ (R[V~llll>>. Applications are available at the Offic. of the R.glst.r of Wills, any of the Zl R.v.nu. District Offlca., or by cftllln; the sp.clal Z~~hour answ.rlng ..rvica nu.ber. for for.. ard.rlng: In Pannsylvanla 1~800~36Z~Z050, out.ld. Pannsylvenla and within local Harr hburg area (1111 181.809~, TOO' 1111) nz-usz 1I1.ar ing lapalred OnlY I. OBJECTIONS: Any party In Inter.,t not satl.fled with the apprals..ent. ellowance ar dl.ellowanc. of d.ductlan.. or .....I..nt of tax (Including discount ar Int.relt) as shown on this Hotic. .u.t obj.ct within li.ty 1601 d.y. of rec.lpt of this Natlce by: .-writtan prot.st to the PA O.pert..nt of Ravanue, Board of App.ell. Dapt. t810Z1. Harrisburg, PA 17128-1021. OR ..el.ctlan to hev. the .att.r d.t.ralnad at audit of the account of the parsonal r.pre.antatlve. OR --app.al to the Orphan.' Court. ADHIN ISTRATJVE CORRECTIONS: Factual .rror. dllcov.r.d on this a....s..nt should b. addrelsed In writing tal PA O.part.ent of Ravenu.. Bureau af Individual Ta.... ATTN: Palt A"."a.nt R.vl.w Unit. Oapt. 280601. Harrl.burg, PA l11t8-0601 Phon. (117) 787-6505. Sae page 5 of the booklet ~Inltructlon. for Inherltanca Ta. R.turn for a R.,ld.nt O.c.d.nt~ IREV~1501) for an ..planation of adalnlltretlv.ly correctable errorl. DISCOUNI: If any tax due I. paid within threa Il) calendar aonth. aftar the dec.d.nt'l daath. a flv. p.rcent (5~) dllcount of the tax paid i. allow.d. PENAL TV: The 15~ tax a.n.sty non.partlclpation p.nalty i. coaput.d on the total of the ta. and Int.r..t al....ad. and not paid before January 18, 1996, the first day after the end of the tlllx a.nesty p.rlod. Ihl. non.partlcipatlon panalty il app.alable In the sa.e aann.r and In the tha sa.. tl.e p.rlod al you wauld appeal the tax nnd intarelt that has b.en aSI"I.d a. Indlcat.d on this notlc.. INTEREST: Intarast II charged beginning with first day of delinquency, or nln. 19) .onths and one II) day fro. the date af death, ta the date of pay..nt. la.e. whiCh b.cae. d.llnquent b.for. January I. 1981 baar Intere.t at the rat. of .Ix 16~) percent per annu. calculated at a dally rat. of .000164. All ta..s which b.ca.e delinquent on and after January 1. 198t wlll b.ar intere.t at a rat. which will vary fro. calondar year to calendar y.ar with that rat. announced by the PA Depart.ent af R.venu.. Tho applicabl. Interelt rates for 198t through 1991 ar.: 1982 19U 19ft" 1985 IlJ8f1 --Inter..t to;( 16~ 1l~ Il~ IU I. calculated a. .000!:.48 .000438 .000lOI .00Dl~6 .000214 follows: !!!r Inter..t Rate Dally Interest r",ctor IlJ81 .. .000t41 IlJ8ft-1991 1I~ ,000301 199t IJ;( .0002'" 1993.llJlJ" n .oooln 1995-1991 9% .0002fo1 !.'.!r tnterut Rate Daily Interelt Factor INTEREST = BALANCE OF TAX UNPAIO X NUNBER OF OAYS OELINQUENT X OAILY INTEREST FACTOR "Any Notic. Issu.d after Ihe tax b.co... d.llnqu.nt will ref'.ct ;m Interut ulculation to flft..n (15) day. beyond the date of the al,.,s..nt. If payaant is aade nfter the interelt co.putatlon date shown on the Notice. additional Inter.,t .Ult be calculated. STA1~S REPORT UNDER RULE 6.12 ----.------ Name of Decedent: llolVAt-O /> LV (/ q (...{' Yl_ J7't/c;r;; Date of Death: Will No. ~/- /99(; .- J '"I! Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rulesr I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: yes,k:_ No__ 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No ~ b. The sera l'a te Ol'phans' Cuurt No. (i f any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes >< No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. Si9"~ 170",) Name (Please type or print) ~ 5. B"J'PA/ s;:f- Address CO, U<.. ~/f-1_701.J L~lj') ~ I(S-_ '70'? J ore 1. No. Date: 3'- /1 3 )c, y l<.AnO Capacity: Personal Representative ~counsel for personal representative (MAH:rmf/AM;)j;