HomeMy WebLinkAbout96-00268
I)ETITION I'OR GRANT 01' LE'IIERS OF ADMINISTRATION
E.rlul,' "f J~l0L. \.L\' \J, _~t.:. \ (-')u..C - -
al,w knowII Ql __ow ___...._ ..'_ _.. __~_~______._
No, _c2.L-5_~_~A~ ~___
To:
__ ____._._..~ .._. ___.~.___. IJt'C('lI\l'd.
S '/0 . N I'; y -,\'-. (\r'~I.
(Jcw..,rcuruy 0. _ :.._______.'-"-_____:n~.___"
Reg;,le, of Wills lor the
COllnlY of ~:.!l~~~!~I:..A~!!.._____ in thc
('ol11l11ol1\\c<11111 of Pcnmlyl\'ullia
Thc pClition nf thc Ilndcr\ig'll'd rc\pectfully 'CI"e\enl' thaI:
Your pClitioner(s). who is/all' IR yca" of age III oldc" apply 1nl:_ _._._ for letters of adminimalion
____________._ __.__ .________ ______.___n______ onthc estatc of
(d.h.n.; ('I\.'lHklll~' hl~'; llUlalll~' ;11l\l.Uli,t; lltH.lIIll' IlIHH':ll,l!l.1
thc abovc dccedcnt.
Dcccdcnt was domiciled al dcath in (~'c..D~.b<:-_d~'l.ld.._~_ COllnty. I'cnn5ylvania. with _
h I S last family III p,incipal rc\idencc ill '\~\''1_(:L'.f..\....:ll!..l...!;.~P\ l\ ~c,' \")"_D':\ i" t I :"J
lli~t strt'l't. nUllll)('r, Twp. fir Bure..' ($\ \\Je'f S~('\ 'C'\(~4()
Dcccdcnt, then '>F, ycars of age, dicd _ ___t~!:-'LJ..b__I.S______. 19'!l,
at f cJ.)...LLlcDc..~:...._____,___
Dcccdent at dcath owned propcrlY with estimatcd valucs as follows:
(If domicilcd in 1'01.1 All pcrsonal ,,"'pert)"
(If not domicilcd in POI.) I'c"onal pruperty in I'cnns)"lvania
(If not domicilcd in Pol.) I'c"onal propcrty in COllllty
Value of rcal c.tatc in I'cnllSyl\"ania
situated a, follows: _
s '-'C"c, ("c,
S
S
$
PClitionc,__ aftc, a propc, scarch ha~_ ,,,ce'taincd that dccedcnt leflno will and was su,vivcd by
thc following spousc (if any) and heirs:
Nam,' Rclatinnshi" Rcsidcncc
H,--'thc.I' !v\
((~:~~:'," ,~-
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\.(~_\ \-1.J.~ ~~: '{It<_l r:J\cI0-.f11ld IJ~tl((':"
'KI':' \ ~-(I'''''r ,c" rA
THEREFORE, pClitioncr(\) ,c'pcelfully ,cqnc'U') thc g,anl of leners of administration in Ihe
app,opriatc fo,m 10 thc undcrsigncd.
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WAIINiNG. II IS II LfOAI 10 ALlLll rHIS COPY 011
10 lllJPIICA.1E IlY PIIC)[O~;rAT on PHDH)(.illAI'H
C(H,4'.HH~WI III III III I't N,~.;'t VANIA
(l[PAHTMI 'n n( HI_At III Vlf^l III C()IHI~
lOCAL REGIS TIlArl'S CER TI FICA TlON OF OEA TH
CERT. NO. 3039728
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3-27-96
.,'_ ,.' '....,. "'" ~.., .r. ,,,
Name of Decedent
Timothy
I,,'
K ,
Seigler
;,,'
Sex __.Mal.e,
SocIal Secunty No
184-48-9056
Oat!! of Death. ...3~.16..:96__m.__
Oat!! of Birtl, .J- 6 -195,6
13"1I1pl<lc,,
Harrisburg, P/I
Place of D!!ath
Residence
u _.~_!_~_u~;_;"._,' ;n_
Cumbe.rland
'... ..S.il v.e.r._SPJ'.i ng Twp.. Penn~Jyania
, ',I'"." w..,. "".""1
Race .,..Wh i,t.e
Washor
Apt, 4
7067 Carlisle Pik~
Arnwd Forces? (Yes or No)
. N.o___.u___
Occupation Ca r
[)l'c"dent"s
Mmital StatusN.E!Jl.er ,marriedM<lIiIl1<) A(ltlr",s
K .
Informant _~!1jl.rQDSe ig ler
Name and Add",ss of
Fune,al EstablIshment
',.'
Carlisle, __._~A...1L01.3
, .,... . i ..... ',U'~
Fllnt~fal DIf(~ctOf
Mark S. Foor
Nickel Funeral.Home, P.O. Box
910,. Loysv.ille_,J'.A_1?Q<U_..
I nt('rval Between
, Onset and Death
Part I:
Immediate Gause
(a) ,._...lie_a.d.aJ1dab.dQ.m_ill.a 1 t.rauma
(b). ,__Bl.unL1;r.auma
(cl._____...mu.
Part II:
(d) _..__,._-.__.._._ .OU'...____._--..
Olhe, SignIficant CondItions
-,._..,--_..~~--------
Manner of Death.
Natural 0 Homicide "l
l_>
Accident X~ PendIng InvestigatIon r-'
~ ..J
Suicide 0 COlJld not be O!!!Nmlnpd [J
Oe,;crrbe how ",jury occlJrred.
Fe!l fr~rn_.m.o'y~!!g. pJ,.c:!..::J!F. truck.
Name and T,tle of Cer1lftcr
Michael L. Norris Coroner
u . .... ....-.u.-.--..---..{i,,;,.:-O::-6~o.. Co'oner, M.E.)
u~'echa.nicsburgLX~!.~05_~ ,.._.
Add ress _u_____!()!'i_f'.~~.r.I_I.ay_O'r.iy_e..
This is 10 certify that the ",formallOn h,'", rJ"'''fl IS correctly copIed from an original
death duly filed with me as Local Re(Jlstrar TI", orlC)lflal certlflcato WIll be fo,warded
Vital R!!cords Ollic!' for pnrrnanenl tlllnq
ce,tificate of
10 the State
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9Ib.CjJ~~~!.:;.(f.,;.Altc/L/..--u:-.-;;;-~p.:A5 5
101 8arnett St"New 8loomfield, PA 17068
- - -------- .-;;-~;-.:;'.-:~--'~---------'-' '---'-'--:::i,-Il,"w;~.-T,.."~".,,
3-22-96
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CER'l'lFlCATlON OF t!Q'l'.lO; J.l.!!y..!m IllJJ,~L.~~.i.W 0
Name of
Deceden t: ,_1l/ry}(~tjl.(1 II __JLLtill^-'
LeI 0
Death: 3-/Y- II./J ._
.'
u.
\0
Date of
Will No.
I\dmi n, Nrl.1 CJ 9~; - (:;('(), (0 \5
To the Register:
I certify that. notice of benef ielal interest required by
Rule 5.6(a) of the Or[~ans' Court Rules was served on or mailed to
the following bene f ic iar ies u f the allove-captioned estate on
7- $( -q(p :
~
SA~~.~ ~;;,~
Address
BDiL_lJ1~{L:-/~:~ ~(t )705 J
RDI 0171 /)> ~ L PA- /;(Jy()
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except
Date: 1- '8 -(Ie"
vf;/LfU.CY1 J( \ 1,:, · .611
Slgn<1tuH.! ~
Name S~_/i(1)~l J( _ ~('i 71 ('r
Address 1,1) ( I~J)<, ::>)6
~fJd 73/N\)n-ht'/d f'il tiDier
Telephone Oil) 5"ff 2 -[it,t/(f
Capacity: )( Personal Representative
Counsel for personal
representative
March 25, 1996
21-96-268
I, Arthur Maynard Seigler, upon the death of my :Jon 'l'imothy
Keena Seigler, did not want anything to do with the funeral
arrangements for my son. I am giving up my rights to any of
my son, Timothy Keena Seigler's estate and request that my
daughter, Sharon Kay Seigler, assumes sole administrator and
benefeciary to her brother's estate.
dzz/c^^ /' ~,'1
Signature of parent
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Signature of Witness
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IIIV'~OOt.. ('<;~)
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
, WITH REGISTER OF WILLS) jCOU'HY CODI ,~I YEAR 1 (,
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-\-~-~: 4~ - 0.05 ~ i 2. -I 'l. -Y<" I rIll" I Sip ("', c..JtI\\:>erlo.nd
1'..."1.(....'" ~ul". .."~""I\' ........... '''\' "'.' ".,; ... i 1'.1 '.'''. i"l)( '''l ~'(U~lr, t.\I"'MII r A'~lJIJ/j' 1I1(II,lO 1'.1' It.~l~U(rl[H'~1
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2 Supplt.'mtJn1al Rl'turn
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fOR DAlIS Of DIAltl AnER 12/31/91 CHICK HIRI
If A SPOUSAL
POVERn CRIDIT IS CLAtMID
fill NUMBER
(OMMOtlWfAIIH 0' rlt.t.~YI"A,rj,"
OtrAIlIMltH OIII'....ItHJI
OHI lllUfoOl
ttAIlQ15BUAG PI. l' 1}f1 Ow I
DI~II'd.A"'IILA"1 "IH
~OCtAI ~'~~YS1\~~\
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NUM8[R
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limiled Ellale
.~ J Remnindor Retutn
lfar date, 01 death ptior 1012.13.821
j 5 Federal Eltotn fm Relurn Requited
Original Relurn
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~.so Fulure InltHI"I Compromi,o
(fOf dotel of death Ohftr 12.12.821
Decedent Diod Ttntote j 7 Deeedf'nl Moinloined 0 Living fru,'
IAllaeh copy of Willi IAllaeh copy 01 TrulII
ALL CORRESPONDENCE AND CONFIDENTIAL TAX-INFORMATioNSHOiiLDBEDtRECTED TO,
~\MII _
~UJLJ~__S<':J,\ll'x""
TUfPHOm NUMB! II ..)
L:717--1 _S>.:,!: ~;(,,:L~-_c
- 8 f 0101 Numbor 01 Safe Oepolll 80."1
I. Real Eslale (Schedule AI II)
2. Sloeks ond Bondi (Schedule BI 12)
3. Closely Held Stoek/Porlnership Interes' (Schedule CJ (3 )
4. Morlgages and Notes Receivable (Schedule OJ (4 )
5. Cash, Bank Depo'its & Mi"elloneous Personal Property (5)
z (Schedule EJ
Q 6. Joinlly Owned Pfoperty (Schedule FI (6)
;::
:s 7. T,am'en (Schedule GJ (Schedule L) (7)
=>
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0: 8. TOlal Gran Ane" (Iotol Unel 1.71
..
u 9. Funeral e.~ensel, Adminiltrotive COSh, Miscelloneaul ( 9)
w
'" e..penses I chedule H)
10. Debts, MOtlgage Liobililiel, Lienl (Schedulo II (10)
II. Tolal Deductions (10101 Une, Q & 10)
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12. Nel Value of Ellale (Line 8 minus Line 11)
13. Chariloble and Governmental Bequests (Schedule J)
14. Net Volue Subject 10 Tall. (line 12 min~1 Line !!L__ ____________
15. Spousal Tranlfen (fot dales 01 dealh of lor 6.30.941
See Imlruc!ions for Af,plicable Percentage on Re...ene
Side. (Include value, rom Schedule K Of Schedule M,I
16. Amounl of line 14 to.oble at 6% role
(Include 'Iolues 'fom Schedule K Ot Schedule M.I
17. Amount of Une 14 tOll.oblo 01 15% rate
(Include 'Ioluel from Schedule K or Schedule M )
18. Prindpalloll due (Add 1011 from Unol 15, 16 and 17.1
19. Cfedih Spoulal Poverty Credil Prior Paymenh
+
(II)
(12)
(13)
-__h--1~~'-_
u _ _.I C-J_I;J:', 2. <-____
'": '3 ~ \_J.:2...~_
"1 '5, OD_____
-:.~'3.2..LZ3
(IS) rJ\f\
116) I\J\A
117) 0
Discount Inte'e~1
+
20. If line 19 il greoler !hon line 18, enter tho difference on line 20. fhil Illhe OVERPAYMENT.
aD .1f:m.'W".lf,.I.'l'!'.'U...hlll_Jtl"I!...l-IITt":T:~.'L'lIJ.'l"I~~'.hII.1i1
)It.... BE sURfro ANSWER Ali-tiliesrio-NfON-iivERsE.SIDE ANDToREcHEcK-MATH ~.or( __ ____,______
Under penallie, 01 p.rj"y, I d.c1or.'ha'I ha,e ..ominnd 'h"rn'u,n. ,n;;;;d,ng occompanying "h.d,ln. ond IIalnmnnls, ond 'a 'h~ ,;;;,-.;t;;'y ~now'.dge ond b.li.l.
" i, '''e. CO"." ond (omple'.. I d.c1... 'ho' 011 '.01.1101. ho, bn,'n "'patlnd a' "'. m,,~., '01,. Dnda'ol,on 01 p'npa'n' olh., Ihan 'h. p."anal'.p'...n'ol;,.;,
bo'ed on 011 informalion 01 which preparer ha, ony ~nowll!dge
~'~~;-~;U:'-k~'it,\'RD\ \lX)~ );., Ne_,,- -\:-)\Cl'Y~clc\ P/-lllO(;S N"12__I~_(\\t--
"(.,,,,,,,, 01 ,,,,,,,. 0/""-'''''' 'IP'''''''~' "''''0''" . "~'I
21. If line 18 il greater than Une 19, enter the difference on line 21 Thi~ illhe TAX DUE.
A. Enler the inlere't on the balance due on line 21 A
B. Enter the tOlol 01 line 21 ond 21A on line 21 B fh;1 j, Ihn BALANCE DUE,
Malee Check P'!.~~~I.! to:_~l!.g!S!..~_~~ ~iIIs, Agent
.1',n~I" 11111
.tj~
COMMONWfAlrH Of PINNSnVANIA
IHHIIITANCE TAX "WIN
.U10INr OICEDINT
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
Pleas_e Print a, .!YJ'e _
filE NUMBER
ESTATE Of
Sc.~~ec\\rn X'n \L...
(All propefly 10U\ -owned with ,he Righi of survlv nhlp mutt b. dlnlo..d on Schedule f1
_.~_._'.-
ITEM
NUMBER
0\
DESCRIPTION
VALUE AT
DATE OF DEATH
c...usn Dr'I nane. \.. s-\-i 1\ '\1"\ -\\m' 5 WQllc,\' \ \\4,00
i
g
4.00
02. c.nec.\J..;,,~ ~C.C.Dclr-.\- \\ C"t>"2..()<:)I'i)I't, ex
Cor\.-ncrc.c. 'l!>o.n\l... S<:nuk. "Avenue. ~ -e."~ura Rd
c..c.......~ y,; \ \. ~ l\ \\C> 1 \
~ \'\. ";),'1
I L\.~"
0:' Sov;",<;>,;> P.c.c.o\.Jr\\ ~.. l\~oo'\:!:>~-t><t..
0.' Cof"rnc.rc.e. ~:x..n\(. - 'Sc.-.o;~c. f\v<: ~ 'i:.rl=c,ro Rl:\
c.o.f"I"\~ v.',\\, Q~\ ,"'0\\
6 ~d., C\8
~O2. .Gg
c'" .~;~c. \ \,c..'I.creC.\<" -ho,.... e.mplo'j rnc.-.+ CI.X
\r'''''!j\c C.or v.hsh._v.c., ClY!. ~'51- ."10.' -
~c..),",,'jro.\\'p. no-Iv, ......';)\..Gd
1'1,\:\,;
1l'i.'L\
cf.> \0.<=\\ "'= '-ere,c.>: <:r ( . .
,^\;>~rQI5ed 1-.. DnVc.rnblc..
0.'1- c..o.sn. '""1 It:e\n-onl- I"ci-or Cc,
V4\U<.. d. ,\h,,;> .ca
\,5.00
\ 15. DD
do Wc.or."n. (\~"a."c.\ ~
? \,C-0i:, 'n
:f'c.v..c'r ';C>d(< ." ,S ....ts
r:)hu:~ v. \. ~...~S \ br\'c.(s
'1S.CD
15.(){)
J.__.
TOTAL (Also ente' an line 5, RecapilulatianLh..'1 '\:) (\ c;
(Altoeh additionol 8hH )( UH Ihellh if more 'poce is needed.)
._____._.,_,._,_u
ESTATE OF
Sei~~<;~
ITEM
NUMBER
A.
.'
11\-'\11,.. i.",;
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES I Please Print a, Type__
------ ---- ------- -~FlIE-NUMBEil
,
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(QMMONWr"lhlOf r1Nw.n"'''NIA
IWHIIlTAN(( 'AIIlITUItN
Rr~IO(Nf Ol((DEUI
\'i N"\cJh'i
\,:',
DESCRIPTION
1.
Funeral Exp.nl;~:'---- _n_. ------- --- ........, r~ ,( y\ \ f \., It -~ .(\,1 ,i \11._1 \t'
C. \.' It_I".... cJ-, L y"",'~ 1 I}',({" \'.1). -
(e.mc..n<.)f"\ "'II ,-,-,-,. v.. '>\".'{\ ,.Al.lt I" Yl" l.ul(d(~
C"-.ro.\IC ~in:) \\'il5.("0 _ J~I<;'~"-l'::..s.tJ.~11C,,'1
10 ,....-. L'-- C. .\", _ \> "-
'-"'C'n \ Cot"... I... t.!o.\-<: S ~ ~L {)U CL.ch d-CJ.W'
c"("c,,, Co tJ\o.rll.c... ~ -,!,.' -:J . ,
- "'.OC; _ \1'1(1.... '\'\('l\'(~ Il.~ V-_('It"-J
\'.il L ,,>,, (." 'I
W "'l~lf\ 'J" \."' l,
"'c~~ nIL, ....\h..I<~ I jl 1.1 \ -lLL:'~
B, Administrative Cosls:
4.
C.
1.
2.
3,
4.
5.
6.
7.
B.
1.
Porsonal Representative Commissions
Social Secu,ilY Numbe, of Personal Rep,esenlalive:
Yoar Commissions poid
2. Alla'ney Fees
3,
Family Exemption
Claimanl
_...._._.____..___ _ Relalionship
Add,ess of Claimant 01 decedent's dealh
Slreel Add,ess _____..___________....
City
._ . __..__nSlale ___.. .___ Zip Code
P,abale Fees
Miscellaneous Expenses:
ro',sc.' of \qC\\ (,eo:. 1rc.c.l<.c.r Ct,"\Jc,""l:>\~ b.. e,c.\~" "^ +
,~ "'~-' c' _".. -'-"'I (. ,.,~...... ...oo..e"
o.:.l.>$c .-....." v....c~\ ,,,c-... UOb"'l"'c:.\d,\'~ 1->{)1I>'i! ll.\5.0l:l
r~ h<<;)l'lc",\ - '<. \", ~<'i$ n"...c. t
S\-.-c.u. ~"""\'.:}c.\,ii......(., ~~ 1'\11:> b - n~u...Co"c<:, Co,""!>",,,\ . <lCMc t'I\"......
c.o-~,,-,",,~. ~D \!'h u."" ~.!. 10 ~n$'-''''''c.r L;k .,,~
~ ,. \ '-M"'~ \-\-ill p' ~.. . '-'\.),..~
c.n,",,,,\'\, l<:.\\c.,- {. . ...,,,,C>\
b ~lY\\"i:;\f" \,
S'r-oN Cc..r~r. ' c.nCf\
"c...c..:h:.s
~"u"c.;o.\ ;",n I:.. '1e.c.0
~~c ~e.c.s
~v,...-.:, ~..o...... C."....ocf.lo.r.<.\ C .
o. (-bVrt'~O\j~
sn"ff\f~ l \6 ~ .32.) 3.2.0
TOTAL (Also enle, on line 9, Recapitulation) S
(If me,e space is needed. Inse,l addillanal sheets of same size,)
AMOUNT
U 11:lCl(). 0 C>
8S.Ct>
d,C.ClC
'" old.O<:l
$ IS.CO
8,c<..
?.S .Ot>
G.O\.)
10.<:,(:)
S.Ct;
I,C,-,>
3.26
INVENTORY 0F WEARING APPAREL BELONGING TO TIMOTHY SEIGLER, DECEASED
7 pa i rs of jeans
8 pairs of socks
13 pairs of shorts
14 shirts
1 jacket/coat
1 pair beach sandals
7 pairs of underwear
5 pairs dress pants
1 robe
1 pair slip-on sneakers
Above items all donated to
Gnnnwi'1 Tnr1I1~t:ri~q. Npwpnrt, PA
on
np~pmhpr 7. lqqfi
. '
'mi.od b; t(/~/{'>>lq?
y
Employee's Name Receiving clothes
RECEIPT FOR PAYMENT
-------------------
-------------------
Cumberland County - Reqister Of Wills
Hanover and High Street
Carlisle, PA 17013
Receipt Date
Receipt Time
Receipt No.
4/02/1996
10:40:29
1007553
SEIGLER TIMOTHY K
File Number 1996-00268
Remarks SHARON K SEIGLER
------------------------
Distribution Of Receipt --______________________
Payment Amount Payee Name
Transaction Description
PETITION LTRS ADM
SHORT CERTIFICATE
RENUNCIATION EXECU
JCP FEE
COPIES
25.00
9.00
10.00
5.00
1. 00
CUMBERLAND COUNTY GENERAL FUN
CUMBERLAND COUNTY GENERAL FUN
CUMBERLAND COUNTY GENERAL FUN
BUREAU OF RECEIPTS & CNTR M.D
CUMBERLAND COUNTY GENERAL FUN
Check# 1409
Total Received.........
$50.00
$50.00
.
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Agroement: A 50'4 depO$llls roquJrM Ilrror 10 commopcomonl of work.
^oree to pat slaled balance uPon eroctfon ;egord'oss ollilhor troublo, or r.h1pmonl' or ony oll'or (10011 rOilson, This o,dor or conlrnct
cannOI bo uncetl&d by customer unIon ogreod b)' bolh POlliOS Tho Miele horoln monllonod Sti,l:! remain thO pwpml)' 01 Jim.. R.
Gingrich M,morlll, unlll paid In M and Ihey fOSOr\'O the ,ight 10 removo tho same II nol paid as &l,llucl
IllgroB to carefully proolread an namos and dolos for accurBcy nnd nccopllull rospOnslb,!ol.,.lm any onOlS 01 omiss,ons THERE WILL BE
AN ADDrTlONAL CHARGE FOR ANY LETTERING ADDEO TOTHIS MEMORIAL AFTER ERECTED ON THE CEMETERY.
Price
301 0, 00
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and further ogroo lhallnloloSllhol1 occruo Ollho '010 of one and onoha~t porconl (1 1.'2-.) pm monlh on "'0 ullpll'd blllanco !Mod to
Jim.. R. Gingrich M.morlll. nol paid wllhin thlrly (30) daY' 0' Iho IrwoiCo da!o In o1Cfd;llon IhorOID, I /llJ'OO IIII bocomflS nOCo,sary tot
Jim" R. GIngrich M.morl.l.lo 'nslllu10 lognl proCOodln{) 10 Col'oct nn.,.lund~ duo !rom mo for my nccounl btl'na pit!>l dl18 Ihlrly (3D)
days, to flTr'/ all cou,l caslS and anornoys foes incurtod by J.m.. R. Gingrich ....morl.t.lo co:locl thl) sarno
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OEPARTMENT OF REVENUE
BUREAU OF INDIVIOUAL TAXES
DEPl.2BOOOI
HARAI5DURG. PA 17128.0601
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No.AA 379164'lEV"'."""""
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
RECEIVED FROM:
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CONTROL
NUMBER
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fOlDIiERE
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F'LE NUMBER
NAME OF"DECEOENl (LAST)'
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DATE OFPAYI.1ENT
I r. ~ , l"'"
POSTMARK DAtE
I^ I ~
COUNTY .
TOTAL AMOUNT PAID
'1. 'jc. . \';-'-=':'. _ ,.;1
-. ..,. -.....
DATE OF-DEATH _.
:. j
REMARKs . - , ".
5~,A~ON v S~rG~C~
'.....
,
./.~
RECEIVED BY
'... '
. /
.I .f
I'''' (I
. , .
/
..r
"':..., -::",,/:.:
::E'~;:.:-:.'TEr;' ':';:''' ~':':'.....L.~ .'..'/r.,/ -w-':~
sEALC~:::C~'" <261 b
q[Gi.~~:.:I~i~ nf-:- \'/l! l.~)
----
-- .-.-
.........b4.~ ~-.'''T
,
,
. ~:.
, .-
COHHONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
*
J
.,
!
,
TAxes
BURrAU OF INOIVIOUAL
INlI[RIUHCL TAIl DIVISION
OCPI. 160ttOl
IIARWISBl.RC. fI", 17118-0&0)
NOTICE OF INIIERIlANCE TAX
APPRAISEHENT. ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASS[SSH[NT or tAX
."_1\6'U &I' 111."1
SHARON K SEIGLER
RR 1 BOX 38
NEW BLOOMFIELD
DATE
ESTATE OF
DATE OF DEATH
FILE NUHBER
COUNTY
ACN
12-20-1999
SEIGLER
03-18-1996
21 96-0268
CUMBERLAND
101
K
TIMOTHY
AMount H."Hted
PA 17068
HAKE CHECK PAYABLE AND REHIT PAYHENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
ifEV :is4i-Eif-;'j=i>--ioY:99Y-NoYicE--oi=-YliHEififANcE-YAx-jippR'A-isEHEN,.-,--;.ii.-OWANCE-OR----------- - -----
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
TIMOTHY K FILE NO. 21 96-0268 ACN 101
ESTATE OF SEIGLER
DATE 12-20-1999
ATTACHED NOTICE
TAX RETURN WAS:
) ACCEPTED AS FILED
I X) CIIANGED
SEE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN
1. Re.l Est.t. (Schedule A) IU
2. stocks and Bonds (Schedule BJ 12J
3. Closely Held stock/Partnership Interest (Schedule CJ (3)
4. Hortgages/Notes Receivable (Schedule DJ (4)
5. Cash/Bank Deposits/HIsc. Personal Property (Schedule EJ IS)
6. Jointly Owned Property (Schedule fJ (6)
7. Transfers (Schedule GJ (7)
8. Total Assats
NO. 01
.00
.00
.00
.00
231,400.00
.00
.00
18)
NOTE: To insure proper
credit to your account,
sub.it the upper portion
of this for~ with your
tax paYllent.
231.400.00
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. funeral Expenses/Ad~. Costs/Hisc. Expenses ISchedule H) (9)
10. Debts/Hortgage Liabilities/Liens ISchedule I) (10)
11. Tot.l Deductions
12. Net Value of Tax Return
13. Charit.ble/GoY.r~ental Bequests; Non-elected 9113 Trusts ISchedule ~J
14. Net Value of Est.te Subject to Tax
15.00
.00
Ill)
112)
113)
114)
1 ~ 00
231. 385.00
.00
230,502.71
If an assessment was issued previouslY, lines 14, IS and/or 16, 17 and 18 will
reflect figures that include the total of ~ returns assessed to date.
ASSESSHENT OF TAX:
15. Allount of Line 14 at Spousal rate (15)
16. Allount of Line 14 taxable at Lineal/Class A rate (16)
17. Allount of Line 14 taxable at Collateral/Class B rate (17)
18. Principal Tax Due
NOTE:
.00 X .00=
.00 X ,06=
230,502.71 X .15=
118)
.00
.00
34,575.42
34.575.42
TAX CREDITS:
PAYHEHT
DATE
10-25-1999
10-25-1999
DISCOUNT 1+)
INTEREST/PEN PAID 1-)
.00
.00
RECEIPT
NUHBER
AA379164
WRITEOFF
AHOUNT PAID
34,575.42
8,323.58
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
34.575.42
.00
.00
.00
. IF PAID AFTER DATE INDICATEO. SEE REUERSE
FOR CALCULATION OF AOOITIONAL INTEREST.
I IF TOTAL DUE IS LESS TIIAN $1. NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREOn" ICRI. YOU HAY BE OUE
A REFUND. SEE REVERSE SIDE OF TillS FORH FOR INSTRUCTIONS.)
RESERVATION I E.tatos of docedents dying on or b.foro Docoaber 12, 1982 .. if any futuro int.r.st In the .stat. i. transf.rr.d
In posse.slon or .njo,.ent to Class B Icollaterall b.neflclarie. of the d.ced.nt after the expiration of any e.tato for
Ilf. or for year., tho C~onwealth hereby expre..lY re.orves the rIght to appraise end a.ses. transfer Inheritance Texe.
at the lawful Cla.s B Icollateral) rate on BnY such futuro Interest.
PURPOSE OF
NOTICE I To fu1f1l1 tho requln.ents of Section 2140 of the Inh.rltance end Estate Tax Act, Act 21 of 1995. (12 P.S.
S.ctlon 9140).
PAYKEHT: Detach tho top portion of thIs Notice and subelt with your pay..nt to the Reglstor of Wills printed on the rovors. sid..
uHake check or .oney order payabl. to; REGISTER OF MILLS, AGENT
REFUND ICR): A r.fund of a tax credit, which we. not roquested on the lax Return, .ay be r.quested by coepletlng an -Application
for Refund of Penn'Ylvanla Inheritance and Estate Tax- IREY-13131. Applications are available at the Office
of the Register of Wills. any of the 23 Rev.nue District Offices. or by calling the special 24.hour
answering .ervice nuebers for for.s orderlngl In PennsYlvania 1.800-362-2050, out. Ide Pennsylvania and
within local Harrl.burg aroa (717) 181-8094, TOD' 1-800-447.3020 IServlce for taxpayer. with special
hearing end .peaklng needs).
OBJECTIONS: Any party In Intorest not satisfied with the appral.e..nt, allowance or disallowance of deduction.. or a...ss.ont
of tax I Including discount or Intor.stl as shown on this Notlco BUst object within .Ixty (60) days of r.celpt of
this Notice by:
..wrltt.n protest to the PA Depart..nt of R.vonue, Board of Appeals. Dept. 281021. Harrisburg, PA 17128-1021, OR
-.ol.ctlon to have tho .att.r dotoralned at audit of tho account of tho por.onal reprosentatlve, OR
uappeal to the Orphans' Court.
AOKIN
ISTRATlYE
CORRECTIONS:
factual orrors discovered on this a.ses...nt should be addres.ed In writing to: PA Depart.ent of Revenue,
Bureau of Individual Taxes, ATTN: Post Asse.s.ent Review unit, Dept. 280601. HarriSburg. PA 17128.0601
Phone 11171 781-6505. See page 5 of tho bookl.t -Instructions for Inherltanc. Tax R.turn for a R.sldant
Decedent" (REY-1501) for en explanation of adelnlstrativoly correctable errors.
DISCDllfT:
If any tax duo Is paid within three (31 calendar .onths after tho decodent's doath, a five percent (5XI discount of
the tax paid Is allow.d.
PENALTY:
The 15X tax eone.ty non-participation ponalty Is co.puted on tho total of the tax and lnt.re.t as..s.od, and not
paid before January 18, 1996, tho first day after the end of tho tax aanesty p.rlod. This non.partlclpatlon
penalty I. appealable In tho .... .anner and In tho the .... tl.. period as you would appeal tho tax and Interest
that has beon asse.sed a. Indlcat.d on this notice.
INTEREST:
Intere.t I. charg.d b.glnnlng with first day of delinquency. or nine (9) .onths and one (II day froe the dato of
death, to tho date of pay.ont. Taxes which bec..e delinquent b.fore January I, 1982 b.ar Inter.st at tho rate of
six (6X) perc.nt p.r ~ calculated at a dally rate of .00016~. All taxes which beca.. delinquent on and after
January 1. 1982 will boar int.rest at a rat. which will vary fro. calondar year to calendar y.ar with that rat.
announced by tho PA D.part..nt of R.venue. Tho appliCable Intere.t rat.s for 1982 through 1999 are:
~ Inter.st Rate Dally Int.r.st rector !!!r Interest Rat. Oallv Inter.st ractor
1982 ZO. .0005U 1988-1991 llX .000101
1983 16:C .000438 1992 OX .000241
1984 1\' .000301 1993-1994 1> .000192
1985 13' .000356 1995-1998 9% .00Ol41
198& lOX .000214 1.... 1> .000192
1987 OX .000241 2000 ax .000219
--Inter..t Is calculated as follow.:
INTEREST = BALANCE OF TAX UNPAIO X NUNBER OF DAYS OELINQUENT X DAILY INTEREST FACTOR
_.Any Notice Is.ued after the tax boCOH' delinquent will r.flect an Interest calculation to f1ft..n liS) days
beyond the dato of tho 8".'''8I1t. 11 pa)'Hnt Is aackt after tho Inter..t caoputat1on date shOwn on tho
Notice. additional Intere.t ..st bo calculated.
"t~14'H.I'UI
,gt~
INHERITANCE TAX
EXPLANATION
OF CHANGES
COMMONWEAL m OF PENN5YlV^NIA
DEPARTMENT OF IlEVENUE
BURE^U OF INDIVIDU^L T^XES
DEPT 280601
UARRISnURG PA \7128.0001
DECEDENrS NAME
mE NUMBER
2196.0268
101
SEIGLER,TIMOTHY K
REVIEWED BY
ACN
Sandra Eslinger
SCHEDULE ITEM
NO.
EXPLANATION OF CHANGES
Applicd cxcess deductions Irolll prior rClnrn(s).
ROW
Page 1
z
o
J;
~g
1"11.
:I
o
u
,
1(\1"11'1"'1 ~t
C~~S\'lVA"A
OEPARTt.I[NT Of REV(HUE
OEPl1II0601
HARRJ , I
Df.a.[)(HTIHAUE (lAS', rIRI',NtOMlDOlE "TW,) lM.liIrlMDdIlI.....n.
v'/
REV -1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
!z
w
Q
W
U
W
Q
S E I r. L [. Il
foi () III Y
K.
t.., 1'.i'0I'
,<...:.') / ~ "'
~.~~''''_~''''..li..'..1.
~
l>;.,.
(,
u
5OCW.Sl.CURITYff..I,I8lR DATE OF DfAnt
8 4" 4 U- 'J 0 S h"::J, '~::;"r';;~r;'~9~ '~.
(f APPLlCAlIlE)St.IMW<<] SPOUSF&1oWoIE (\.AS', FIlST,NiO"'DDlE INTlALJ SOCIAL SECURlTYNl..UBER
!Xl 2. Su~IAIRetum 0 3. Remainder Reluml_d_"",b 1I.1U1l
o 40. FuIute In_ Compromise I_ d_ "'" '1-lI~~ 0 5. Federal Eatale Tax Retum Requited
o 7.OecedenlMe~_OUvIngTIUS1~""dINIQ _ 8. To1Ill Number 01 Safe lleposl1Bo,..
010. SpousaJPOVIItyClIldll_d__lI.",...,., IS) 0 II.Electiontolaxunders.o.9113(A)~...c
,ALL I!ONDE'A F1 NTIA"1 INFORMATION. LO B RECTED TO:
COt.ftETE w.A.1NG ADORfSS
R. fL 1/1 Box 38
12. Mol Val.. 01 Elloto (line 8 minus Line 11)
13. Charllable end Govemmenllll BequesblSec 91 13 Trusts fO".filch M eledlon to lax has not been
made (ScIIedule J)
14. MelValu. Subjtct 10 Till (line 12 minus line 13)
15. Amount 01 line 141axable." '.
.iI -,I
oll!leapousallaxrale.., ,.".1 . .... . '!'..
See ils1JudIons on reverse side for appllcsble pen:entaga
16. Amounl ollne 141axable .
al6%rale , .'
17, Arneunle' Ine 14laxoblo
0115%rale
r!
II!
~
I
o 1. 0!'91ne1 Retum
o 4.linI1ed EOIllIe
o 6.DecadentOIedT"Ill\e~""dWi)
o 9 Ullglllon PIIlOHdI ROCIlIYod
:nt
......
haron K, Sej ler
nRMNAME (I'~I
TElEPHOfl:H..NBE:R
717 582-8646
z
o
g
:J
I-
~
U
W
II:
1, Reol Estale (Sd1edule A)
2. Stocb end Bonds (Sd1edule B)
3. CIoIeIy Held Co<porallon,Par1nersh1p or SOle-Proprletmhlp
4. Mottgag.. & Notes Receivable (Schedule OJ
5. Cash, Bank Daposits & Miscollaneous Pensonal Propel1y
(Schedule E)
6. Jointly Ownad Propalty (ScIIedule F)
7. Inler.\'Mls Transfers & Miscelaneous Non.probale PropaIty
(Sd1edule G or L)
8. ToIII Groll AlIIlI (1Ota1 Liles 1.7)
9. Funenli Expenses & Admlnlstrativa Costs (scI1edule H)
,.
10. Debb of llea!denI. ~ago Llabiilles, & liens (Sd1edule I) (10).
11. ToIoIOaductlonl(lOtalllnes9& 10)
,. ..J. "~
2
3 1 I 3 8
18. Tu Due
DATE OF BIIHH
....r....' ~..."," "... " - . -..' .. .
fli~. () 7/ () f, /1 9 5 6
, '.
.
,.
,
-
THIIRfTURH MUIT BE FUD IllOUPUCATE WITH TIt
REGISTER OF WILLS
New Bloomfjeld PA 17068
Cli.,:;:l. ,~i ;:Il. ",-.
~
.
I
(3) }'
-; i 'f
,..,.!.., .........
~
,-: .". ~. ".o.:'~\ .~.:~.
. ~ '
. '2 3 '1 ;4
.. ,J .... ,., -r '. .......~..'. "f" . 1.
'.
... 'll.:.
- "'-,.1
(4) ;,
(5) ,,"
,
00 ~.
.."...........
(6) .~;-~...~..r.-.~ .,~~ l~j~.~," 1..4K,~.. . i
.,. ... ~.. ~. ....,---~_.....!
I' ." I 'i. .~. c....._,.....,......___........_
(6):"231 400.
~ ......._._.:::."'....,.._.__Jry~:...I'.'~..:.::.. ........ -..,'. -
(9) ~".~,.." .'I~.."'_~ r~;I..._"':'(.. :.1..~I'?~I.., .. ,,~,:
~~ s.
I "
(7) .
'j
(111 ;
:::: ~.. ..: <<.~1,2
l I
1 5
.31, .r 3 .8 . 5 ~_~"
(14) I 2
3 s 3 8 5
'I
i~'i ~
.'. x ..",0. .. ~
(15) }..",,: i
. :1.'
,
'c.
;
;., ..'
.
"~' ". .,.. Jo''', . .
x
(16) t.
[
(17)
.De
.15
'.''''
5 .
34 707
7
5
x
(18)
ADDRESS
\\',','.J,-< C{f
DATF
Decedent's Com lete Address:
SIR1ET AllORESS
7or,7 Carl i II' f'ikp ^". 4
OTY
STATE
"^
ZIP
1701 1
Carl i sl e.
Tax Payments and Credits:
1. Tax Due (Page 1 Une 18)
2. CredltslPaymenls
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1) 34.707.75
Total Credits (A' B. C) (2)
3. InteresVPenally If applicable
D. Intarest
E. Penalty
TotallnteresVPenalty ( D - E) (3)
4. If 1100 21s greater than line 1 -line 3, enter the difference. This Is the OVERPAYMENT,
Check box on Plgel L1nl19to rlqueltl refund (4)
5. If line 1 -line 31s glllater than lina 2, enter the difference. This Is the TAX DUE. (5) 34 . 707. 75
A. Enter the Interest on the tax due. (5A)
B. Enter the total of Une 5 - 5A. This Is the BALANCE DUE, (58)
Maka Check Peyable to: REGISTER OF WILLS, AGENT
I I -
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Old decedent make a transfer and: Yes No
a, reteln the use or Income of the property treneferred; .""".""".,,,...,,.,,..,,,,,...,,...,,,,,,.,,,,.,,....,, 0 0
b. retain the right to designate who shall use the property traneferred or Its Income; """"".",,, 0 0
c, reteln a reversionary Interest; or"."."",,,,,,,.,,......,...,,....,.....,,.....,,.......,......,..,,..,,..,,......,.".....0 0
d. receive the promise for life of either payments, benefite or care? ......"."'.................""........0 0
2. If death occurred on orbafore December 12, 1982, did decadent within two years
preceding death transfer property without receiving adequate conelderatlon? If death occurred
after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? .,....".....,.""...,.........,....,,,.....,,.......,.....,..............".,...,.....""" 0 0
3. Old decedent own an "In trust far" 0' peyable upon deeth bank eccount or security
at his or her death? ...."........."".............,........"...........,....,........."..,......,,'..""....,.."............"...,.. 0 0
4. Old decadent own an Individual retirement account, annuity, or other non.probete property?",. 0 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES.
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN
72 P.S. ~9116 (a) (1.1) (I) provided for the reduction ofthe tax rate Imposed on the net vatue oflransfers to or for the use of the
surviving spouse from 6% to 3% fordetes of death on or after July 1, 1994 and befo,e Januery 1, 1995,
72 P .S. ~9116 (a) (1,1) (i1) provided for the reduction of the rate imposed on the net value of transfers to or for the use of the surviving
spouse from 3% to 0% for dates of death on or after January 1, 1995. The statute does not exempt a transfer to a surviving spouse
from tax, and the statutory requirements for disclosure of assets and filing a tax return are stili applicable even If the surviving spouse
Is the only beneficiary.
FOR DATES OF DEATH ON OR AFTER JANUARY 1,1995. Please answer the following question by placing an "x" In the
appropriate space.
Old the decedent create a trust or similar arrangement which Is solaly for tha surviving spouse's baneflt for his or her antlre
IIfeUme? Yes 0 No 0
If you answered yes to the above question, the tax on the trust or similar arrangement Is postponed until the death of the second
spouse, at which time It will be fully taxable at the rate(s) applicable to the remainder beneficiary(les). Enter the value of the trust on
Schedule J, Part II, In order to remove It from the calculation of the tax due In this estate, You may wish to file Schedule 0 In order to
make the election available under Section 9113. If the election Is made, the trust or similar arrangement Is taxed in the estate of the
first decedent spouse, the portion of the trust or similar arrangement which benefits the surviving spouse Is taxed at the zero tax rate,
and the remainder Is taxed at the rate(s) applicable to the remainder beneficlary(les). If you choose to make the election, you must
attach Schadule 0 to a tlmely.fiIed tax retum, along with Schedule(s) K and/or M in orde, to show the apportionment of the trust or
clmllar ::lIrn:lnnlllm~nt hplwppn thp ~IINiuinn r;.nnllr;.A Anri thA rAmAinr1Ar hAnAfir:i::lN/iAR)
..~""".".~ .
C()I,OlAOOW[AlTIi or PENNSYlVANIA
INItERltANCE TAX RETURN
R I T f ,.,
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Timothy K. Seiqll'r
FILE NUMBER
21-%-00268
Debll 01 decedent mUll be repolled on Schedule I.
ITEM
NUMBER
A. FUNERAL EXPENSES:
1.
DESCRIPTION
AMOUNT
B. ADMINISTRATIVE COSTS:
1. Personat RepreoenlaliYe'l CommissiOn.
Name of Personal Represenlative (.)
Social SilOIri1y Numbe~.) I EIN Number of Personal RepreoenlaliYe{.)
SIrooI Address
CiIy
Slate
Zip
Yea~s) CommissiOn Paid:
2. Al!omey Fee.
3. Fami~ Exemption: (If decedenr. address is nollhe same os daimanr., attach explanation)
Claimanl
SlrootAddress
CiIy
Relationship of Claimanl to Decedent
Slale
Zip
4. Probate Fees
5. Aca"mlanr. Fees
6. Tax Relum Preparef. Fees
7.
Filing fee - supplemental return
$15.00
TOTAL (Also enler on line 9, Recapifulalion) S 1 5 . 00
(If more space is needed, insert additional sheels oIlhe same size)
6-9'!- )
BUREAU or INDIVIOUAL TAMES
l~ttLNI1AH[l lAIC DIVISIOflt
DlP'. :ao.nl
IlANRlSIUNG. PA IIl:a.ObOl
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
"I
C
;*,
NOTICE or INHERITANCE TAM
APPRAISEMENT_ ALLOWANCE OR OISALLOWANCE
or OEDUCTIONS ANO ASSESSNENT or TAM
11'.lhl III" O'-hl
SHARON K SEIGLER
RR I BOX 38
NEW BLOOMFIELD
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
03-10-97
SEIGLER
03-18-96
21 96-0268
CUMBERLAND
101
TI MOTllY
K
PA 17068
Anou"t Renitt.d
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 ~
iiEV:iscii-EX--Ai=i.--m-:9bY-Nor-icniF-i-NHEifiiAN-Cn:',iiD-PPRA-isEifENr-;-AL.i.-liwAN-c"E"ifJimmnmm_--
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF ~EIGlER TIMOTHY K FILE NO. 21 96-0268 ACN 101 DATE 03-10-97
TAX RETURN WAS: (X I ACCEPTEO AS F1LEO
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..I Est.t. (Schedule A) U)
2. Stocks end Bonds (Schedule 81 (2)
3. Closely Held stock/Partnership Interest (Schedule CJ (3)
4. Hortg.ges/Note. Receivable (Schedule DJ (4)
5. Cash/Sank Deposits/Hisc. Personal Property (Schedule EJ (5)
6. Jointly Owned Property (Schedule FJ 1&)
7. Transfers (Schedule GJ (7)
8. Total Ass.t.
CHANGEO
.00
.00
.00
.00
745.99
.00
.00
(81
NOTE: To insure proper
credit to your Bccount,
subn!t the upper portion
of this forn with your
hx paYllent.
745.99
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adn. Costs/Misc. Expenses (Schedule HJ 19)
10. Debts/Mortgage Liabilities/Liens ISchedul. I) (10)
11. Total Deductions
12. Net V.lue of Tax Return
13. Charitable/Govern..ntal aequests CSchedule J)
14. Net Value of Estate Subject to Tax
1,553.22
,00
1111
1121
1131
1141
1.~~3 ?7
807.23-
75:00
882,23-
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. Allount of Line 14 at Spousal
16. Allount of Line 14 t.xable at
17. Allount of Line 14 taxabl. at
18. Principal Tax Due
TAX CREDITS:
PAYNENT
DATE
rat.
Line.l/Class A rat.
Collateral/Class a rate
1151
1161
1171
.00 X .00:
.00 X .06:
,00 X .15:
(18)
,00
.00
.00
.00
RECEIPT
NUNBER
DISCOUNT (+ I
INTEREST (-I
ANOUNT PAlO
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
,00
.00
.00
.00
. IF PAlO ArTER OATE INOICATEO, SEE REVERSE
FOR CALCULATION or AOOITIONAL INTEREST.
IF TOTAL OUE IS LESS THAN $1, NO PAYNENT IS REQUIREO,
IF TOTAL DUE IS REfLECTEO AS A "CREOIT" (CRI, YOU NAY BE OUE
A REFUNO, SEE REVERSE SlOE or THIS FORN FOR INSTRUCTIONS.)
'~.- .
u,
, ,
C)
-
c.r.: ..-
r_
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RESERVATION: E,tat.. of dlcadents dying on or b.for. D.c..b., Il, 198Z -- If any lutur. Intar..t In thl ..tat. I_ tran,f.rr.d
In pOls..,Jon or .nJoy.ent to Cia.. a (coll.t.rall b.n.flclarl., 01 the dlced.nt aft.r the ..plratlon of any I.tat. 'or
11'. or for y..r., the Co..anw.8Ith h.reby ..pr..sly r...rv.. the right to apprals. and ."'SI tran".r Inh.rltanc. T....
at thl lawful Cia.. a (collateral) rat. on any such future Int.r..t.
PURPOSE OF
HOTICE:
To fulfill the requlr...nt. 0' S.ctlon 2140 of thl Inh.rltanc. and E,tat. Ta. Act, Act Zl 0' 1991. 12 P.S.
S.ctlon lUO.
PAYMENT I
D.tach the top portion of thl. Hotlel and lub.lt with your paY'.nt to thl R.gllt.r of Will, printed on the r.v.r.. ,Id..
--"eke chick or lonoy order payabl, to: REGISTER OF' HILLS, AGENT
All pay..nt, r.calv.d shall flr.t b. appll.d to any Int.r..t which .ay b. due with any r..alnd.r applied to the t...
REFUND (CR): A r.fund of . tax cr.dlt, which was not r.qu..t.d on the "M R.turn, .ay b. r.qu..ted by co.pletlng en MAppllcatlon
for R.fund of Penn.ylvanla Inh.rltance and E.tat. Ta.M IREY-I1I1I. Application. ar. avallabl. at the Offlc.
of the R.gI.t.r of Will., any of the Z1 R.venu. DI.trlct Offlc.., or by calling the ,peclal Z~-hour
an.w.rlng ..rvlc. nu.b.r. for for.. ord.rlng: In Penn.ylvanla l-aOO-36Z-2050, out.ld. Penn.ylvanla and
within local H.rrl.burg ar.. (717) 7a7-a09~, TOO' (717) 772-2Z52 (H.arlng I.palred Only).
OBJECTIONS: Any party In Int.r..t not .atl.fl.d with the apprals...nt, allowance or disallowance of d.ductlon.. or I".'...nt
of ta. (Including dl,count or Int.r..t) .. .hown on thl. Notlc. .ust object within .I.ty (60) daYI of r.c.lpt of
this Notice by:
AD"IH
ISTRAJlVE
CORRECTIONS:
--wrltt.n prot.lt to the PA Depart..nt of R.v.nu., Board of App.all, Dept. 281021, Harrllburg. PA 11128-1021, OR
--.I.ctlon to have th. .att.r d.ter.ln.d at audit of thl account of the per.on.1 repr...ntatlv., OR
..Ipp.al to the Orphanl' Court.
Factual .rror. dl.cov.r.d on thl. al.e.I..nt Ihould b. addr'.I.d In writing to: PA Oepart..nt of Rev.nu..
Bur.au of Individual Ta.el, ATTH: Po.t A".ss.ent Revl.w Unit, Dept. Z8060l, Harrl.burg, PA 17128-0601
Phone (717) 787-6505. S.e page 5 of the booklet "In.tructlon. for Inh.rltanc. Ta. R.turn for a R..ld.nt
O.c.d.nt" (REV-1501) for an ..planatlon of ad.lnl.tratlv.lY corr.ctabl. error..
DISCOUNT:
If any ta. due I. paid within thr.. (1) cal.ndar .onth. afl.r Ih. d,ced.nl'. d..th. a flv. p.rcent 15~1 dl.count of
the ta. paid I. allow.d.
PENAL TV:
Th. 15X ta. a.n..ty non-participation p.nally I. co,puled on the total of the ta. and Inter..t a"...ed. and not
Plld b.for. January 18. 1996. the flr.t day aft.r the .nd of the ta. a.n..ty p.rlod. Thl. non-participation
p.nalty I. app.alabl. In the .... .anner and In the the .a.. tl.. p.rlod al you would app..1 the tax and Int.r..t
thlt h.. b..n .','...d a. Indlcat.d on thl. notlcl.
IHTEREST:
Int.r..t I. charg.d b.glnnlng with flr.t day of d.llnquency, or nln. (9) .onth. and on. (II day fro. the date of
d.ath, to the date of pay..nt. T.... which b.c... d.llnquent b.for. January I, 198Z b.ar Int.r..t at the rate of
.1. (6X) p.rc.nt p.r annul calculat.d at a dally rat. of .OOOI6~. All la.e. whiCh b.ca.e d.llnqu.nt on and afl.r
January 1, 1982 will b.ar Inter..t at a rat. which will vary fro. calendar y.ar to calendar y.ar with that rat.
announc.d by the PA aepart..nt of R.v.nue. The appllcabl. Int.r.st rat.. for 198Z through 1991 ar.:
!!!! Int.,...t Rat. Dally Int.r..t Fllctor !!!r Inl.r..t Ral. 01111'1 Inter..t Factor
1982 ZO;( .OO05~8 1987 .~ .OOOZU
1981 16X .000"11 1988-1991 11;( .n0301
198~ 11;( .000lDI 1992 .. .all02~7
19115 In .000156 1993-199~ n .000192
1986 10~ .00021" 1995-1991 .~ .000241
uInt.r..t I. c.lculat.d .. foUow.:
INTEREST = BALANCE OF TAX UNPAID X NUN8ER OF DAYS OELINQUENT X OAILY INTEREST FACTOR
.-Any Hotlc. I..u.d aft.r the ta. b.co... d.llnqu.nt will r.flect an Inl.,...t c'lculatlon to flft..n liS) day.
beyond the date of the .sl.....nt. If pay.ent I. .ad. aft.r the Int.r..t co.putatlon date .hown on the
Hotlc.. additional Inl.,..st ault b. calculated.
(.2-
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STATUS IlEI'OIlT UIIlJEIl IlULE 6. 12
Name of lJecedent: \-\\IY\\\'~
Date of lJeath: -) . \ '!,. ( \ t,
)
Will No.
1/\
(-)L\("\\C'C
.J
Admin. No. ').ICIli' C';~LL,~
Pursuant to Rule 6.12 of Lhe Supreme Court Orphans'
Court Rules, I report the following Idth respect to completion of
the administration of the abuve-captionet.! estate:
I. State whether administration of the estate is complete:
Yes'y No
2. If the answer Is No, state when the personal
representa t1 ve reasonably bel ieves tha t the administra tion will be
complete:
J. If the answer to No. 1 is Yes, state the following:
a, Did the personal representative file.a final
account with the Court? Yes X No'
b. . 'fhe. separate Ot'phans' Court No. (if any) for.
tile personal representative's .account' is:
c, Did the personal representative ~tate 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 ant.! may be attached to this report.
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Signature rJ
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N~~:~\((\~i:~se ~ype:-~(;' \;~~~
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At.!dress I \:1CI.'$
DIll ~)S l- C,;LiL\ls
Tel. 110,
Date:J"/_-\ L -Cl~
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Capacity: 'I.
Personal Representative
Counsel for personal
representative
(MAli: rmf/ MIJ)
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