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COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
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CounLy, l'enn:;ylvanJa, deelal'l' LIIL; In:;Ll'lw\,:nL La l", my la;;L NIIl and
tentalllcnt, lWl'el>y eXfll'l';;:;ly l'cvoldnl; all \,;Jll:; ami codIcIl:; hel'eLol'ol'c
made uy me,
1. I dIrect my exeeuLor to flay all 01' m.y dcbt;;, l'uneral and
adminl;;tratlve expcn;;e:; a;; :;oon a;; m'IY Uc dunL' convunlcntly af'ter
my dcc ca:;c .
2, 1 authoI'J::e and empoVicr my eXecutaI' to ;:ell ariy I'calty o~lI1ed
uy me at my death, and not ;;pccIl'lcally devl:;ed aI' llequeathcd hel'eln,
at eithcr puullc 01' prIvate ;;ale, and to gIve good and ;;ul'l'lclent
deeds therefor, In l'ee ;;lmplc, a;; 1 could do 11' lIvIng.
3. 1 ckv':':;\.: and lJequeath all or my L';;tate of' evel'Y nature and
wherever ;;ltuate to my hU;;lland, [,Jul'lln '1', ;,jlllel'; pl'ovlding he ;;hall
survive me by ;;lxty day;;.
4, Should the gll't In l'al'agl'aph 110. 3 not tal(c erfect, 1
dcvlne and lJequeath all of m,Y e;;tate of' evef'Y nature and ~Iherever
situate to my chIldren, ;;hare and ;;hal'e a11l<e, the clllld 01' children
of any decea;;ed chIld takIng the ;;hare thell' parent would have taken
if Hvlng,
5. I nomInate and appoInt i.ial'lln 'I'. iUller to be the executor of
thi3 my lant \'1111 and te;;tament; he i;; to ;;epve a;; ::;uch \'Ilthout bond.
Should he dIe ue1'orc my death, I'enounce 01' rcfu;;c to nerve 1'01' any
rea30n, or dIe leavIng uny of m,V e;;tate unadmlnl;;tel'ed, 1 nomInate
, and appoint Gonnle Lou!;;e :;tought and Sandl'a Elallle Keller, au 3UU-
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
5S:
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_ Goon~" _I,. Stought and SIIO<!~I"" ~:~~Ke}_l.'r_ ______ '
_ according 10 law, deposes and says Ihal they_, aTe_the_e_xe.cu.t:rJxefl---,
01 Ihe Estale 01 ___H1!!!!lLIl-L-IlU.tllr--,--,-.----
being duly ____1l.,!0_r.1l__
1.10 01 __South Hiddleton Towoflhip , _,_____ ,_ _, Cumberl.nd Counly, P.,. doco.sed .nd th.t tho
within is .n invenlory m.do by ,_ _ __ ___ _them_____ -. __ __ ____ ,__, the s.id executrixefl
01 tho ontiro ost.lo ols.id docodonl, consisling 01 all tho porsonal prop.rly .nd roal ostato, oxcept ro.1 osl.lo outsido
tho Commonwo.lth 01 Pennsylvania, and Ihal Ihe ligures opposito e.ch itom 01 tho Invenlory roprosont it's I.ir v.luo
.s 01 tho dato 01 docodent's doalh,
.nd subscribod boloro me,
Connie I.. Stoullht
C~'-"L.L~r~J;:,~",lv
.~ --------Ell-;cutr1xcs
Sandra E. Keller
Sworn
a;:;.{l>LffiJJ.j
9 Cr:~am~D~,].Q.a.!!
807 Sandbank Road
1I-,,11inll. Spr-1l1&fI.LJ'A
17001 Add,."
Ht. 1]0 llY2p'r ings . I'A
17065
o.to 01 ooath
_____________ _.4__...______~__________.___._____.
06 03
1996
O'Y
Month
Y..,
INSTRUCTIONS
I. An invontory must bo Iilod within three monlhs alier appoinlment 01 porson.1 roprosenlative,
2, A supplomenl invenlory musl bo Iiled within Ihirty days 01 discovery 01 addition.1 ...ots,
3, Additional shoots may bo attachod as to porsonally or really
4, Soo Articlo IV, Fiduciarios Acl 011949.
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Inventory of the real and personal estate of
Habel H. HIller
deceased
'"
1. 605 Copper Circle, South Hiddleton Township, CarliRle, Cumberland County.
2. Dauphin Deposit Bank & TruRt Company - Certificate of Ileposit 18000127997.
3. Internal Revenue Service - 1995 Income Tax Refund.
4. Hasland Industries, Inc. - Final PenRion Plan Payment.
5. Hiscellaneous Personal Propertyll1ousehold Goods, including 1987 Buick l.aSabre
6. Farmers Trust Company - Certificate of Deposit 1116248
7. Farmers Trust Company - Certificate of Deposit 1116301
8. Farmers Trust Company - Certificate of Ileposit 179603.
9. Farmers Trust Company - Certificate of Deposit 1105352
10. Hellon Bank, N.A. - Personal Checking Account 1192-106-3739.
11. Hellon Bank, N.A. - Income Certificate 1180-091368-C
12. Hellon Bank, N.A. - Income Certificate 1180-091431-C
I,:, ()
95,000 00
25,104 79
110 00
11 24
3,73000
1,784 68
27,939 79
5,109 17
5,015 03
1,211 81
5,035 88
5,189 83
175,422 28
I ~, ,. l :-, . .-"
REV. 1500 EX. (7-94)
fOR OATL:SOF OEAHt AftER IZIllll)l CtiECK HERE
IF A ~.POU~AL
pov lYr.n Ifl";1; AU.4[
FILE NUMBER
CAB
H P L
E P 0
C R C
K 0 K
P S
COM"'ONW~'lliH, OF P[~NSYlVANIA
OEPAR ~.~~9FnIVENUE
HARRIS rlJ h.vi~~ 28-0&01
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS
COUNTY CODE
21-96-0256
YEAR
COMPLETE MAILING ADDRESS
IRWIN, McKNIGHT & HUGHES
60 West Pomfret Street
Carlisle PA 11013
(1) 95,000.00
(2) None
(3) None
(4) None
(5) 29,016.03
(6) 51,346,25
(7) None
(8)
(11)
(12)
(13)
(14)
=
(18)
(19)
(20)
(21)
(21A)
(21B)
S0.TURE OF PERsa" RE~a"S1BLEFOR FILING RETUR" Conn Ie Stought/Sandy Keller
~("1..~- 7- ->>4,~u 1...1 ?__~~~!,!,!<:~y_ ,~y~q?__~~~~_~~~!t, _~~_.... on _........
'" ,I Bollln S,r!nr.s t, Hall Sorln s, PA/PA'
SIGN'TUREOFPREP.RER OTHER TH' REPRESE"tA"VE I r" In, McKn Ight & Hughes
-: 1.\1 '1 C{"--. ~~rY~-~i/-~~I!-"h6-ij~~'~"-"--"--""""""''''''
Copyright {cll9'941 m solt....lfe onlf CPSy~lcm:;, tnc
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DECEDENT'S NAME lLAST, FIRST, AND MIDDLE INItIALI
Miller Mabel
OECI:OEtH'S COMPLETE ADDRESS
605 Copper Circle
Carlisle, PA 11013
M
SOCIAL SECURITY NUMBER
199-01-5011
DATE OF DEATH DATE OF BIRTH
03/06/1996 10/24/1911
Cou",y Cumberland
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST.FIRST AND MICDLE INITIAL) SOCIAL SECURITY NUMBER
NUMOER
AMOUNT RECEIVED (SEE INSTRUCTIONS)
0.00
X 1. Original Aelurn
4. Limited Es1ate
o 5,
o 8.
Remainder Return
(fa, dales 01 death prio, to 12.13-82)
Federal Estale Tax Return Required
Total Number 01 Safe Deposit BOlCes
2. Supplemental Return
4a. Futuro Interost Compromise
(for dates 01 death a<<er 12.12.82)
[!] 6. Decedent Died Testato D 7. Decedent Maintained a living Trust
(Anach copy 01 w,ul (Anach a copy 01 Trust)
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULO BE OIRECTED TO:
R
E
C
A
P
I
T
U
L
A
T
I
o
N
(9)
25,621. 12
C P
o 0 N....E
R N
R 0 Ro er B. Irwin, Es ulre
~ ~ TELEPHONE NU"'BER
- T 111-249-2353
1, Real Eslate (Schedule AI
2. Stocks and Bonds (Schedule Bl
3. Closely Held Stock!Partnership Interest (Schedule C)
4. Mortgagos and Notas Roceivable (Schedule OJ
S. Cash, Bank Deposits & Miscellaneous Personal Property (Sch_ E)
6, Jointly Owned P,operty (Schedule F)
7, Transle" (Schedule G) (Schedule L)
8. Total Gross Assets !total Lines 1-7)
9. Funeral ElCpenses, Administrative Costs, Miscellaneous
ElCpenses (Schedule H)
10, Debts, Mortgage Liabilities, Liens (Schedule Il
11, Total Deductions !total Lines 9 & 10)
12. Nel Value 01 Estale (Line 8 minus Line 111
13. Charitable and Governmental Bequests (Schedule J)
14. Net Value Subiect to TalC (line 12 minus line 13)
15. Spousal T,anslers (lor dates 01 death alte, 6-30-941
See Instructions for Applicable Percentage on page 2.
(Include values from Schedule K 0' Schedule M,)
16. Amount of line 14 taxable at 6'1~ rate
!include values from Schedule K or Schedule M,)
17. Amount of line 14 talCablo at 15'/. rate
(Include values from Schedule K or Schedule M.)
18. Principal tax due (Add lax from Line 15, 16 and 17,)
19.Credits/Sp Poverty Prior Payments Discount Interest
0.00+ 8,250.00 + '.3'..21 0.00
20. If line 19 is grealcr than line 18. enter the dIfference on line 20. This is the OVERPAYMENT.
~ D ICheck here If you are requesting a refund 01 your overpayment.l
21. If line 18 is greater than line 19, enter the difference on line 21. Thi:> is Ihe TAX DUE.
A. Enter the interest on the balance due on Line 21A.
B. Enter the total 01 Line 21 and 21A on Line 21B, Th.. is the BALANCE DUE.
Make Check Pa able to: Re Ister 01 Wills. A enl
. . BE SURE TO ANSWER ALL QUEST'ONS ON PAGE 2 AND TO RECHECK MATH . .
Under pclMlllesol perJury,1 a~l<1re th<1t 1 "....e eumlrle-d thl5fe-lurn.lncludlr\l) .cccmp.nylrlg SCtledules .na sldlemenls, .nd 10 IhlS! best 01 my ~no....ledgelnd belief, It Is Uue,
corr~tlnd complele,1 ded.re Ih.t.lllltllltsl.llt has be-en repclled <1IlruelNllkul....tue, O~l""allonol ptepale, olhe, lh.ln the pt'rsof'lo1l ,cptesenl.U...e Is b<1sed on IUlnlortn.lllonof
....hlch plltp.J.11t1 has.rry kno....ledge
(10)
3,135,07
(15)
0.00 X
(16)
146,665.49 X ,06 =
T
A
X
C
o
M
P
U
T
A
T
I
o
N
(17)
0,00 X ,15'
115,422.2B
2B,156.19
146,665,49
None
146,665,49
0.00
B,199.93
0,00
8,799.93
8,684,21
0.00
115.12
0,00
115.72
Form 1500 \Ru~ 1.94!
Rtv - 150? EX. (1Z.861
cO~~J/;\t~~c\\W~~ihY'"1A
ESTATE OF
Mabol M Miller
SCHEDULE F
JOINTLY-OWNED PROPERTY
SSI/ 199-01-5011
03/06/1996
FILE NUMBER
21,96-0256
Jolnllen.nl(.):
A.
NAME
Sandra E, Keller
AODRESS
801 Sandbank Rood
Mt, Holly Springs, PA
RELA T'ONSHIP TO OECEOENT
daughter
170 5
B.
Connie L, Stought
9 Creamery Rood daughter
Boiling Springs, PA 11001
C,
Jointly-owned property:
ITEM LETTER OATE TOTAL VALUE OECO'S DOLLAR VALUE OF
FOR MAOE OESCRIPTION OF PROPERTY
NUMBER JOINT OF ASSET '!.INT. ~ECEOENTINTEREST
TENANT JOINT
1 A&B 07/1995 Farmers Trust Company, 1,184.68 100,OOr. 1,784,68
certificate of deposit
1/116248 (confirmation
attached)
2 A&B 09/1995 Farmers Trust Company, 21,939.79 100,OOr. 27,939,79
certificate of deposit
1/116307 (confirmation
attached)
3 B 04/1989 Farmers Trust Company, 10,218.33 50.00r. 5,109,17
certificate of deposit
1/79603 (confirmation
attached)
4 A 02/1985 Farmers Trust Company, 10,030,05 50,OOr. 5,015.03
certificate of deposit
1/105352 (confirmation
attached)
5 B 12/1911 Mellon Bank, N.A" personal 2,543,13 50,OOr. 1,211.87
checking acct, 1/192-106-313
(confirmation attached)
6 A 01/1990 Mellon Bank, N.A" income 10,011,16 50.00r. 5,035.88
certificate 1/180-091368-C
(confirmation attached)
1 B 01/1990 Mellon Bank, N.A., Income 10,319.65 50,OOr. 5,189.83
certificate 1/180-091431-C
(confirmation attached)
TOTAL (Also enter on line 6. Recacitulation) i> 51,346.25
or more space IS needed. Insert additIonal sheels of same size)
COP/fIght (cl 199<1 'o'msofl'W.)fttQnlyCPSY~lrtm:3, Inc.
Form 1500 SChedule F IRcv_ 1~.a81
Estate of: Mabol M Millor ssg 199-07-5011 03/06/1996
CONTINUATION SCHEDULE
Continuation of Schedule H-C
ITEM
II
DESCRIPTION
AMOUNT
7 Register of Wills, short
certificates
8 Register of Wills, filing
fee
9 The Sentinel - estate notice
publication
10 Settlement charges for 605
Copper Circle, Carlisle
11 Spahr's Antiques, appraisal
fee
9.00
25,00
78.38
7,925,34
70,00
8,107.72
f,CKllO\1LEOIlE;I:EiI'l' MID r,FFlt:'^'!IG.
\~e .
NABEL i,l. iULLER
:lIAROII L, SCH\1ALi'l
and KATHLEEN 1.1. KEillIEY
the testatrix and witneo~eo
respectively, whose names are signed to the foregoing inotrument,
being first duly sworn, do hereby declare to the underoigned
authority that the testatrix signed and executed the inotrument as
her Last Will and that she had signed willingly, and that she
executed it as her free and voluntary act for the pUI'pooe herein
expressed, and that each of the witnesses, in their presence and
hearing of the testatrix, signed the \1ill as a witness and that to
the best of their knowledge the testatrix waD at that time eighteen
years of age or older, of sound mind and under no constraint or undue
influence.
97/;f"~@' >#~
tMBEL ~l. fULLER
vM/j.A~(, d vJ-.../,,!A linG.-'
/ SHARON L;- SCH\oI LN
,
CO~1~10N'I1EI\LTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
so
Subscribed, sworn to and acknowledged before me
i-lABEL i-I. iULLER
. the teotatrix. and subscribed and
sworn to before me by
SHARon L. SCHHA!..;.l
, and
Q",.,..1
, '.1i tnesses, this f..?-
day of
KATHLEEN M, KENilEY
1,la:;
, 1983,
~'" N '''\
r !I.\ MIS'i1,O'I, 'i'Jl:J;V ?~?.lIO
.. ,',,: n",'I" t'lIl\;'~:;I."D (mj:':~Y
~ ....._ .l.i.... ... '.' ""I
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"
'II. ..
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A, U.I. DI,...II". Of "II\IIU'; ,UII ...... p'Vllfn'''' ," ,- -- ---- - 0, - 1l1'1 "I - IhA' ----".-.- ..-
Ulllnllll IIA''''''
I. II '" " II fllHA \. II ftJtj.... IJlI''I\.
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-- ---------- ..--._-- n_____.________. -
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___^P~!.lll_._________r^:I):J?1I_n__
ft, H:JlIH....I,( III". USI lIO.l
-
"Ir, Ihh '01. II hlfnl.hrd to 11I1'0'1' ~0lJ . IlIIlNhl'fll 01 1I11l'" ul I 1"""111 CD'lll. "''''''-''JlII "..hl tQ ...1 hi Oh.
..Ul_nl Igf'flt .r. thow". It""" 1I1I""'d "(fl,O.C.)" "tl. 'Itlld ouuld.. Ih. (10\11'1: lht'y lit' Iho.." h..u '0'
InhllNt IONt p,rpn... I.d .,. nol Inc:h.tf'(j Inlhf' 101,,1.,
D. .... 01 ItJIItUII 108(11 I. A'MOl , 1,14 ...IIIH.... SitU'
[HUH O. "'*>11 RnlllllG sr'AlNGlj, "
.. """ or SlllUI [SUn: 0' HABll M. HHUt
,. lAM[ Of lI~UI fllSt UIlIlfO HOllIr.Ar.[ SUVICES 49JI [ARlISt( rilE
fU[llAlllCSBIJlti, ..
.. ,l(I'lIn 60S corn I CIRCU
lOCAllDfI CAlIISU, ..
o. a:IIlUI:l1l ...CUII 'UCMAn A. SCH[au
'lAC[ or SltfUM'11I1 t1lJfSI StllIH SUUI (717) 149.U11l
mUM,..PLl191l
~1111"".~1~6:96
J. SlJW.U OJ I(JIReJoKR'S lRANSACI!{It It. Sl~~!.J!.f2Itt~~~!.A~~g~,*
100. ClOSS AKIJ111 01.1: FlIIt 8CJUlrul: ~~0!~~U'_UQ2tIIIR:
101. Conlnel ul..prln 9~~Q99.PL- ~~~!~!!~I !l81(''!_p':rlr~ ----2S onn.OQ
!~~!...!!~~~y (,~?~f_!~~~'-Y!.Ppt''!!'(
10J. 5~ltt('ft"nt ch.rg~1 10 horL~~Ul!~~~~QQ1 _~,I\I,1l ~Ol.
104. !oO/'.
'oS. ~O~.
Adh_IIIIt'f1I. 10' It,. r'IOld by-.!.~~!!....1!,~,,!:nt'U A~U'I""'11 '0' It"'" IlIolld 1!1-!!.Itt"r In ad"lIncll
106, Clly/town lu to /'06. Clty/IOWf1UI to
~07 . COU'llyl.1 9[6 to lUll-- '\.,l~ (,07. Coun!J lal 9/6 10 lWI- ',db.-
!08. AnullII!'ntl to (,Q~!.~~~~~"!. to
!Q!,J'I!t'lUlL'llUUllD 911.1,_ (,~t!lQlJUI( 9[fl_ULMsn m.l!-
110. !.I~.
111. (,!I.
Ill. ~!l.
no. ClOSS AIII.I DIll' JR(JIJ fl(Jfarul _.!Ql.1HJ~_ ~~n. 1:10<;5 IJt!UI~ Dllr 10 snuI '~t!~061...~L-
100. AlDINIS PAID" OR ''I lUAU or 8(1l!~; '~.:...!~~ICII~!..!~~llNtJM..!L~~11 fR:
?01. Otpa,ll or tlHot'lt mr~y' -----1,~~9In~ ~nl. r~.!!...!.I!'L~!U!!!...!!'!!!!!C..!.!...OI],)
101. Principal ....", of Ol'W IOflnCs) _fl4~~nO.I}l!..-- '~~l~!..!.!~'!L!_t~7(" to ~~!!!!-t!'!~~Q!l.L .--l.Y!1.1L-
10J. hl"I~J.~!!!(!il.-!!\t'n slbJ~UL-... ~1~h..!!!~!~7_!~~t!~~~~.2J('el to
104. ~~~:.!~'y'!~L~L!.!~~L.~2~2t' 1M!"
'M. '~~~..'-!'~Y~~!'L!!~~!.!....~!.!7:!7(' Ion"
'06, ~Q~.
107. 'i07.
~D!I. ~2!1.
109, ~~~~
AdJlnl.-n11 '0' 1~.!M 1Jf1!!!!t~"f_~!~~~r ___~!tjl~I'!.:'~!!...!!lr_!!~._2_.~!~.!!)'_!!!!~.
l!h.!!!r/town lal to ~!Q. CltYHown tn~ to
l11. COU'lty t.1 to ~11. COI.,lylnl to
llZ. Alltlllll!'nU 10 'i!~~~~~!!~!~ to
In. 'i!,~.
l14. ~!"
liS. 'i1'i.
l'6. ~~~.
117. ~!7.
~1!1. ~1~.
~19. 'i19.
110, TOlAl 'AID 1!IUII ICSICVI, '"".9Qn.~!!..- '?~!...!!!!~L!~~U~5 our S[t~tl: -1l.9ll.lL-
100. CASK AI SCHUMNI "()llIlO 1fJl~~~: f~~~AS~~!-!!..~~'_"_'-!L!Qt!~I!!.J'_t!t~L_ __
!01. Gfon ......."1 die fr(lll bnrrowC!~,t!l~~l _!Ql.'",~~_ 6Q!~~~~~_~~,U~~!~C!IIf'r tlimo '?QL- _9~.P~!,9!_
~~~L~~by/for borr~!Jl!!'!??~) _M.OQO,po_t ,Q~!~!...!.!~_'!!.!~!_~I!!L~!~~~I'!u.!.!'!~?~~ _I,?/l.,IL-
3D]. CASK C II fIlClt) I II 10) 8llUIClJU: 116,]14.19 60]. CASK C II 10) ( II '"" ) SHUt:1 188,136.6J
11I0.1 Stltl.....nt Slalf'11lt'nl
If". S.e.a
hDf' ,
It'\rtlll'\olvf'r (111I)
HtO.1 n.Ml
IurA, HII 4JnS.1
-2-
Guest Ilcdroan
1. 'l'vlo pc. bcdroan suite with boxspring and lMttress $ 95.00
2. Misc. table light, pictures, clothing, floor fan, etc. 20.00
Recreation Roan
1. Sylvania color television
2. Upholstered sofa
3. Pair upholstered swivel chairs
4. Desk
5. Patio table and chairs
6. r1isc. tab1e1ights, pictures, etc.
25.00
15.00
30.00
20.00
35.00
15.00
Garage
1. Misc. lawn chairs, garden and hand tools, etc.
25.00
Basement
1. Kenmore autcmatic washer
2. General Electric autcmatic dryer
3. Bag cart
50.00
45.00
10.00
Car
1987 Bukk laSabre with air conditioning, power seats, and power
brakes. Two door sedan, v6 cylinder, fuel injection with 48,571 miles
2,450.00
Total - $ 3,730.00
Sincerely,
~ C -=.D~~-
'" ~ - -:..--r-,---
-
Charles Spahr
CS/ab
D
Dauphin Deposit Bank
and Trust Company
MAIN OFFICE, 213 MARKET STREET. HARRISDURG. PENNSYLVANIA 11101
7112!)5.2'21
,-
Decedent Confirmation
Name: Mabel M. Mi ller
Social Security No.: 199-01-5011
Date of Death (000): 03/06/96
Account No.
8000127991
Type
----------------------- ------------------------ ------------------------
Certificate of Deposit
Date Opened
or Issued
------------------------ ------------------------ ------------------------
02/05/88
Date Closed
or Matured
------------------------ ------------------------ ------------------------
02/05/97 (Maturity)
----------------------- ------------------------ ------------------------
Date of Death
Balance $25,000.00
PLUS
------------------------ ------------------------ ------------------------
Date of Death
Accrued Int. $104.79
------------------------ ------------------------ ------------------------
Joint CNlners
(if any) None
Date of Joint
CNlnership
------------------------ ----------------------- ------------------------
---------------- ------------ ----------------
-------------
------------- ----------------------- ------------------------ ------------------------
Special Convnents: N/A
Additional information available at 120.00 per hour. On. hour Minimum.
Date Prepared: March 20, 1996 Prepared by: Carolyn A. Berkebile
Customer Management Information Dept. (CMI)
Telephone No. (717) 255-2054
Form DD-020-Z1e (REV 7/93)
Page 1 of 1
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D NO, AA
112896 COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
.
1I\l1l.2IXI....1
RECEIVED FROM:
i
ACN
ASSESSMENT r;t
CONTROL ~
NUMBER
AMOUNT
IRWIN ROGER B ESU
60 W POt1FRET ST
10J
$B,250.00
CARLISLE, PA 17013
'010.,,,,-;
ESTATE INFORMATION,
1:1 FilE NUMBER
li 2 J -1996-0256
1:1 NAME OF DECEDENT (LAST)
I:iI MILLER MABEL M
II DATE OF PAYMENT
m POSTMARX
COUNTY
SSN jrN-07-5011
(FIRST) (MI)
DATE OF DEATH
REMARKS
m TOTAL AMOUNT PAID
-.a.250.Q.o
CW\
ROGER D IRWIN ESQUIRE
SEAL
CHECI(1I 10576
" ,
';
RECEIVED BY : I,!:,
REGISTER OF WILLS
" ,. ,'. 1,1 ~, :.,
SIGNATUII.,.. . ,.'
f" / I' ,
MARY C. LEWIS "'," /, '." ,/:',' /'
REGISTER OF WILL6
- '
----
.--- ._-. -.~~...bcI"'9li\. __ .. .-?:.
COMMONWEALTM OF PENNSYLVANIA
DEPARTMENT OF REVENUE
, '/.'1 ,I
,,"j ~ '} -.....
I L.' .....
BUREAU Dr INDIVIDUAL TAXES
lHtUNIUNCI ,.. DIVISION
01 PT. :eOtJOl
ttU1MIS!lUWC, .1" 1/1:a'ObOI
('
NDllCE or INItERITANCE lAX
APPRAISEMENT, ALLDWANCE DR DISALLOWANCE
Dr DEDUCTIDNS AND ASSLSSMENT Dr TAX
I~-
'I" ~h' II I" 1 .,.,..
DATE
ESTATE OF
DATE OF DEATM
FILE NUMBER
COUNTY
ACN
01.20.97
MILLER
03'06-96
21 96-0256
CUMBERLAtlD
101
Anount R.lliTt~'-'"
- --_",.~"-,,,-_=-,""'..c"-~:=:-'.~'..:_-=--==.l
ROGER B IRWIN ESQ
IRWItl ETAL
60 W POMFRET ST
CARLISLE PA 11013
MABEL
M
I
~
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ..
ifE'v: iS4TEif"Aj: p-- f i Z:9& Y- NO;'- iCE - -OF - -iN"HEiii T ANC E - ''fAx -ii ppiiii is EHENr; - m:ow ANC E - DR" - -- - - --- - - - - -- - --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MILLER MABEL M FILE NO. 21 96-0256 ACN 101 DATE 01-20-91
TAX RETURN WAS: I X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..l Est.t. (Schedule AJ
2. Stocks and Bonds ISchedule 8)
3. Closely Held stock/Partnership Interest (Schedule CJ
4. Hartg.ges/Not.. Receivable ISchedule 0)
S. Cash/Bank Deposits/Nile. Personal Property (Schedule EJ
6. Jointly Owned Property (Schedule f)
7. Transfers (Schedule G.
8. Total An.ts
APPROVED DEDUCTIONS AND EXEMPTIONS:
q, Funeral Expenses/Ad". Costs/Nile. Expanses (Schedule HI
10. Debts/Hortg.ga Liabilities/Liens ISchedule 1)
11. Total Deduction,
12. Net Velue of Tax Return
13. Charitable/Governnental aeque,ts ISchedule JI
14. N.t Value of Estate Subject to Tax
III
121
131
141
151
Ibl
171
CIlANGED
Q5.000,OO
.00
,00
,00
29.016,03
51.346.25
,00
181
25,621.12
Iq)_
1101 3.135,01
1111
1121
1131
1141
NOTE: To insure proper
credit to your account,
subnit the upper portion
of this forn with your
tax paynent.
115,422,28
?R ,7~6 H
146,665.49
,00
146,665,49
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 OF TAX:
15. Anount of Line 14 at Spousal rata
1&. Anount of LinB 14 taxablB at Lin.al/Clal' A rate
17. Anount of Line 14 taxable at Collateral/Class B rate
18. Principal Tax DUB
NOTE:
TAX CREDITS:
PAYMENT
DATE
06-04-96
10-28-96
RECEIPT
NUMBER
AA112896
AA146880
DISCOUNT I-I
INTEREST I - I
434,21
,00
1151
I1bl
1171
.00
146.665,49
,00
X,OO,
X .06,
X .15,
1181
AMDUNT PAID
8.250.00
115.72
TOTAL TAX CREDIT I
'BALANCE OF TAX DUE!
INTEREST AND PEN. 1
TOTAL DUE
,00
8,799.93
.00
8,799.93
8,799,93
,00
.00
.00
. Ir PAID ArTER DATE INDICATED. SEE REVERSE
rOR CALCULATIDN or ADDITIDNAL INTEREST,
IF TOTAL DUE IS LESS TNAN $1. ND PAYMENT IS REQUIRED.
Ir TOTAL DUE IS RErLECTED AS A "CREDIT" ICRI, YDU MAY 8E DUE
A REFUND. SEE REVERSE SIDE Dr TNIS rOR" rOR INSTRUCTIDNS,I
Ii
,
"
~' /
J!\1i 17 .11
;: :,17
ell,
CUI,
r'.'\
RESERVATION: [stato. of doceaonts dying on or before Cec..bet 11. 1':181 .. If ~"Y future 1nt.r..t In the Gstat. Is transf.rrod
In pOI,e'llon or .njay..nt to Cla'l B (collateral I benoflclnrle. of tho decedent aft.r the ..piratlon of flny ..tat. for
Ilf. or for year.. the Co..onw.8Ith hereby olproslly r...rv.. the right to appralso and ftIS... tran,f.r Inheritance la...
at the lawful Clal. a lcollaterall rale on any such future Int.r..t.
PURPOSE OF
HOllCE:
10 fulfill the ,.qui,....nt. of SectloR 0'140 of the Inhlilr!tllnc8 IInd hint. lal Act, Act II of 1':1':1). 11 P.S.
Section 1140.
PAYMENT:
D.tach the top portion of this Notice IInd sub. It with vour Illly..nt to tho Aeglster 01 Wllh printed on the ,.\I.rn s.Jd..
"Make check or .oney order pllynble to: REGISTER or MILLS, AGENT
All pnyeent. received shall first be applied to "ny Intere.t Mhlch oay be due Mlth nny reoalnder ~pplled to tho ta~.
RErUNO (CR): A r.fund of a taK credit, Mhlch Ma, not requested on the 'II. Return, OilY be reque,t.d by coopletlng an HAppllcatlon
for R.fund of Penn,ylVAnla Inherltnnee nnd [,tnt. Tn.H (R[V-1515). Applications ar. avallabl. lit the Offlc.
of tho Reglst.r of Will', any of tho Z5 R.venue District Off Ie.,. or by calling the ,p.clal Z4-hour
nn'Merlng servlc. nu.ber, for foro, ordering: In Penn,ylvanla 1'800.3&l.lO~O, out,lde Penn,ylVllnla and
Mlthln localltarrlsburg ar.. Uln 181'8094. TOOl (1111 l1l-ll~llllurlng I.pelred Onlyl.
OBJECTIONS: Any pllrty In Int.r.,t not ,atl,fl.d Mlth the npprlll.e..nt. alloMllnc. or dl,allowanc. of d.ductlons, or Ilss.".ent
of ta. (Including dhcount or Interull lIS shOMn on this Notice .u,t object Mlthln .hty (60) day. of receipt of
this Notic. by:
UMrlthn prot..t to tho PA aepart..nt of Reyenue. Board of Appeals. a.pt. ~81011, tlarrhburg. PA 17IZ8-101I. OR
.'el.ctlon to hllve the latter d.ter.ln.d at audit of the 3ccount of tho personal repre.entatly.. OR
..lIpp.al to the Orphnns' Court.
ACHIN
ISTRAflVE
CORRECTIONS:
ractual .rrors dl,coyer.d on thl. Il"e"oent should b. Ilddr.'sld In Mrltlng to: PA aepartoent of Reyenue.
Bureau of Individual fa.... ATTN: Po,t Anen.ent RIVIIM Unit. Oept. 180&01. tlarrlsburg. PA 11I18.0bOI
Phone 1111) 181-&~0~. S.. page ~ of the bookl.t "Instructions for Inh.rltanc. faK R.turn for II A.,ldent
D.cedent" (R[V.I~OI) for an ..plenlltlon of Ild.lnl,tratly.ly corr.ctable error,.
DISCOUNT:
If any tll. due I, pllld Mlthln three 1]1 cal.ndar oonth, after thl d.cedent's death, a fly. perClnt (~%) dl,count of
the tllK paid I, alloMed.
PENAl TV I
Th. IS~ taK a.n.,ty non-participation penalty I, co.puted on the total of the tll. And Intere,t ""I"ld, and not
paid before Jllnuary la. 1996, the flr,t dllY lifter the end of the tB. Aene,ty period. Ihl, non'partlclpatlon
penally Is Bppealable In the sa.e "anner and In the the sao. tl.. periOd a, you Mould nppeal lhe ta. and Intere.t
that ha, bl.n a"."ed a, Indicated on Ihl, notice.
INTEREST:
Intere,t Is charged beginning Mlth first day of d.llnquency, or nine lql ~onlhs ~nd on. (1) day froo lh. date of
death. 10 the date of pav.ent. la.e, Mhlch becao. d.llnquent before January 1. 19aZ bellr Int.rest at the rate of
,I. (b~1 perc.nl per annul cnlculat.d at a dally rat. of .000Ib~. All ta.e, Mhlch beca.. d.llnqulnl on and afler
January I. 1981 Mill bear 1ntere,t "t a rat. MhlCh Mill vllry froo calendar year 10 calendar yoar with thai rat.
announced by the PA a.pnrt.ent of Revenue. Ihe appllcabl. Int.r.,t rate, for 19a1 through 1991 are:
~ Inl.r..t Pltte Dally Int.,.,t '-"ctor ~ Interest Rat. Oally Inhr..t rille lor
19a1 ,"0% .000~48 19a7 'J% .000l41
1983 10% .000438 lCJ8a-IIJ91 lIiI:: .000301
1984 11% .000501 19n 'J% .000;'41
198~ Bi: .0003S6 19CJ3'I,)CJ~ Ii: .0001CJZ
1986 10% .000214 IfJCJIi-1991 q~ .000;47
ulnt.,..t Is cnlculahd ft' folloM':
INTEREST = BALANCE DF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST rACTDR
'.Anv Notlc. issued aft.r tho taK blcooes delinquent Mill r,flect Iln Int.r.,t clllculatlon to fifteen liS! dllV'
beyond tho date of the a"",..nt. If paY"nt I, .ad. after Ihe Intere,t coeputatlon dale shoMn on tho
Hotlcl. additional Int.r.,t ou,t be calculllted.
BUREAU or INDIVIDUAL TAXES
INlllAITAHC[ UX DIVISION
Dl.Pf. 280.01
ItARRISIUAC, PA 11'&'8-0.01
IS- It.J'- 1
COMMONWEALTM OF PENNSYLVANIA
DEPARTMENT OF REVENUE
(>
NOTICE or INNERITANCE TAX
APPRAISE"ENT, ALLOWANCE OR DISALLDWANCE
or DEDUCTIONS AND ASSESS"ENT or TAX
CHARLES H STONE
414 BRIDGE ST
NEW CUMBERLAND
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
04-20'98
WOODWARD
02-28-91
21 91-0256
CUM8ERLAND
101
ESQ
PA 11070
Allount He.Ht.d
*
1!W.lhll1&" 11t'''1
CLEMENTIN D
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 11013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ..
iiEV: is'4T Eif"iiFP""io9":97Y-Nor"icEuo,:--iNHEiiiTAticE"YAic- AppRA-isEilENi'";-iii.'LoiiiiiicE"eili-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF WOODWARD CLEMENTIN D FILE NO. 21 91-0256 ACN 101 DATE 04-20-98
If an assessment was issued previOUSly, lines 14, IS and/or 16, 17 and 18 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Anaunt of Lin. 14 at Spousal rat. (15)
16. Aaount of Lina 14 taxable .t Lin..I/Cla.s A rat. (16)
17. A.aunt of Line 14 taxable at Coll.t.r.l/Cla.. Brat. (17)
18. Principal Tax Du.
TAX CREDITS:
PAY"ENT
DATE
05-28-97
11-26-91
02-10-98
,
TAX RETURN WAS: C X) ACCEPTED AS FILED
( ) CNANGED
RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN
1. R..I Elt.t. (Schedule AJ C 1)
2. stocks and Bondi (Schedule 81 (2)
3. Closely Held stock/Partnership Int.r..t (Schedule C) C3J
4. Hartg.gal/Hot.. Receivable (Schedule DJ (4)
5. C..h/Bank Dopa.ltl/Hisc. P.rsonal Property (Schedule EJ 151
6. Jointly OMnad Property (Schedule FJ (6J
7. Transfers (Schedule GJ (7)
8. Total ASlet.
NO. 01
,00
.00
.00
,00
10,100,00
.00
5.843,15
(81
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adn. COlts/Hisc. Expenses (Schedule HJ
10. Debts/Hortgage Liabilities/Lien. (Schedule IJ
11. Total Deduction.
12. Het Value of Tax R.turn
13. Charitabl./Governn.nt.l a.qu..t.; Non-.l.ct.d 9113 Trust. (Sch.dul. J)
14. H.t Valu. of Eat.t. Subj.ct to Tax
19)
1101
496.00
61.90
CllJ
1l2J
113)
114)
NOTE:
,00 X,OO=
.00 X ,06=
514,981.80 X ,15=
118)
RECEIPT
NU"BER
AA211360
AA242506
AA269145
DISCDUNT ('1
INTEREST/PEN PAID C-)
3,150.00
,00
,00
A"OUNT PAID
11,250,00
8,850,29
2,396.98
BALANCE OF UNPAID INTEREST/PENALTY AS OF 02-11-98
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
· IF PAID ArTER DATE INDICATED, SEE REVERSE
rOR CALCULATIDN or ADDITIDNAL INTEREST,
NOTE: To insure proper
cr.dit to your account,
aubnit the upp.r portion
of this fora with your
tax paYII.nt.
16,543.15
~6~ QO
15,979.85
,00
514.981. 80
,00
,00
86.241.21
86,241.21
86,241.21
,00
43,81
43.81
1 IF TDTAL DUE IS LESS TNAN 11, NO PAY"ENT IS REQUIRED.
Ir TOTAL DUE IS RErLECTED AS A "CREDIT" fCR), YOU "AY eE DUE
A RErUND, SEE REVERSE SIDE or TNIS rOR" rOR INSTRUCTIONS. I
RESERVATION: E.tat.. of d.c.d.nt. dYing on or b.for. D.c..b.r IZ, 198Z -- If any future Int.r..t In the ..tat. I. tran.f.rr.d
In po.....lon or .nJoYI~t to Cia.. B (collat.rall b.n.flclarl.. of thl d,c.dent aft.r thl .xplratlon of any I' tat. for
11ft or for y.ar., the Co..onwealth h.,.ty .xpr...lv r...rv.. the right to apprll.. and a..... tran.f.r Inh.rltanc. Tax..
at the lawful Cia.. B (collat.rall rat. on eny .uch future Int.,..t.
PURPOSE Of'
NOTlCEI
To fulfill the r.qulr..ent. of S.ctlon ZI40 of thl Inherltanc. and [.tat. Tax Act, Act 21 of 1995. (72 P.S.
Slctlon 91411).
PAYMENT,
D.tach the top portion of thl. Notlc. and .ub.lt with your pay.ent to thl R.gl.t.r of Will. prlnt.d on the r.v.r.. .Id..
""ak. chick or lOnIy order payabl. to: REGISTER OF MILLS, AGENT
RUlJfD (CRI:
A r.fund of . tax crldlt, which was not requelted on the Tax Return, lay b. r.que.t.d by coepl.tlng an -Application
for Rdtnt of P.m'vlvanla Inherltanc. and Eltat. Tax- (RCY-UU), Application. are avallabl. at the Office
of the R.glst.r of Will., any of the 21 R.venu. District OffiCII. or by call.lng the 'PICI.I Z4-hour
anlw.rlng .,rvlc. nueblr. for for.. ord.rlng: 'n p.nnlylvanla 1.800.16Z-20SD, out.ld. P'm.ylvanla and
within local Harrl'burg ar.a (111) 181-8094, TOD' (111) 112-2Z5Z (H.arlng 'lpalr.d Only).
OBJECTIONS I Any party In Int,r..t not .atl.fl.d with the appr.II..lnt. allowanc. or dl.allowanc. of deduction., or a.......nt
of tax (Including discount or Int.,..t) as .hown on thl. Notlc. .ult obJ.ct within .bty (60) daya of rec.lpt of
thlt Notlc. by:
AD"IN
ISTRATlVE
CORRECTIONS:
--wrltt.n prot..t to the PA D.part.."t of R.VWIUI, Board of Applals. D.pt. l810ZI, Harrhburg, PA I1U8-1021, OR
--.I.ctlon to have the .att.r det.r.lned at audit of the account of the p.r.onal rlpre'entatlv., OR
.-app.al to the Orphan.' Court.
Factual .rrorl dl.cov.r'd on thll a""I..nt lhould b. nddr'lled In writing to: PA D.part.ent of R.vanu.,
Bur.au of Individual Tax." ATTN: POlt A......ent R.vl.w unit. D.pt. l80601, Harrl.burg, PA 11128-0601
Phone (111) 787-6505. S.. peg. 5 of the bookl.t -In.tructlon. for Inh.rltanc. Tax R.turn for. R..ldent
Dlc.d.nt- (REV-ISOI) for an .xplenatlon of adalnlltr.tlv.ly corr.ctabl. .rrorl.
DISCIU(T:
If any tlx due I. paid within thr.. (1) callndar eonth. aft.r the d.c.dent'. d.ath, a flv. pI,c.nt C5X) discount of
thl tax p.ld It all~.
PENALTVI
The IS~ tax aan'lty non-participation penalty I. c~ted on the total of thl t.x and Int.r..t a.....Id, and not
Plld b.fore January 18. 1996, the first day afh, the .nd of the tax ,.,..ty p.rlod. This non-participation
penalty Is app.alabl. In tM I... .ann., and In thl the .... tiN p.,lod as you lfOUld app.al tN tax end Int.,...t
that has b.en al....ed .. Indicated on thll notlc..
INT[RfSlr
Int.r..t I. chargld b.glnnlng with flrlt d.y of delInquency, or nine (9) aonth. and one (I) day fro. tN date of
death, to thl date of payaent. Tax.. which bee... d.llnquent b.for. January I, 198Z be.r Int.r..t at the rat. of
.Ix (6~) p.,cent per annua calculated .t a dally rat. of .000164. All tax.. which bee... dellnqulnt on and aft.r
January I, 1982 will b.ar Int.r..t at . rat. which will vary fru. callndar v.ar to cal.ndar y'lr with that rat.
announced by the PA Depart-.nt of R.venu.. Th. appllcabl. Int.,..t rat.. for 198Z through 1998 ar.:
!!!! Inler..t Rlllt. Dally Int.r..t FltCtor !!!! Inhr..t Rate Dally Inter..t Faetor
198Z to:C .000548 19U .~ .OOOZ'7
198] 16:< .OG0413 19ea-I991 1l:C .aOalOl
1914 1l:C .GOOlOI 199. .~ .aaOlli1
1985 U:c .aOOn6 19'91-1994 n .GOOn2
I'" I.~ .aGOn' 19'95-1998 .~ .aoaZli1
--Inle,..t Is calculated .. followl:
INTEREST = BALANCE OF TAX UNPAID X HUKBER DF DAYS DELINQUENT X DAILY INTEREST FACTOR
.-Any Notlc. I..ued aft.r the tax beeO"1 delinquent will r.flect an Int.r..t calcul.tlon to flft.en CIS) day.
bevond the dat. of thl .........,..t. If paY1Mt\t Is ode aft.,. thl Int.,..t c~tatlon dati .hown on the
Notice, IKfdltlonal Int".lt ..,.. be ulcuhtld.