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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'\(~4() Dcccdcnt, then '>F, ycars of age, dicd _ ___t~!:-'LJ..b__I.S______. 19'!l, at f cJ.)...LLlcDc..~:...._____,___ Dcccdent at dcath owned propcrlY with estimatcd valucs as follows: (If domicilcd in 1'01.1 All pcrsonal ,,"'pert)" (If not domicilcd in POI.) I'c"onal pruperty in I'cnns)"lvania (If not domicilcd in Pol.) I'c"onal propcrty in COllllty Value of rcal c.tatc in I'cnllSyl\"ania situated a, follows: _ s '-'C"c, ("c, S S $ PClitionc,__ aftc, a propc, scarch ha~_ ,,,ce'taincd that dccedcnt leflno will and was su,vivcd by thc following spousc (if any) and heirs: Nam,' Rclatinnshi" Rcsidcncc H,--'thc.I' !v\ ((~:~~:'," ,~- 'J c,c.'s.;,; l r C:_~'Ir'\\{.L- C' .J _ .'\"' L ~l\ .. I -r.,\ \"' ~. f "-, \......\\ f )(C1hr:.L ,<..,..-...., '~-:.\"'t(.\,'1(,\,( dr, lv .P/) , 11 <1(..- \.(~_\ \-1.J.~ ~~: '{It<_l r:J\cI0-.f11ld IJ~tl((':" 'KI':' \ ~-(I'''''r ,c" rA THEREFORE, pClitioncr(\) ,c'pcelfully ,cqnc'U') thc g,anl of leners of administration in Ihe app,opriatc fo,m 10 thc undcrsigncd. i v C u .,,- .iif "'u c .,,0 c.= C'S.:: -:;::~ ....~ ;0 ;; c .. Vi \ ~.',), (1"(' n - ,.-;. ;\! I Cl.u...L__ K\), ?J ,:"; , NelL' ?,I;--;~:~<.I._I'iY,v 1,\ - /5-' 'ill' ,;;l U'M'I~IlI~ .~"" ,frt Inu I... CfRllhC4" I.." 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 "....".....,. ,,<S\Il\ Of Pfi" l~ :i.'.. i-, _ .v~_. I~.' !jI\'" ."<;'~\ ; .::t';:, , ... ',J-' ~ :lc;:i:* .... . ,~) '\w I.;,_r! I II" '.., . i .X"" . 'f , ~_ I:"'...! ...~1/ . of, .., 'i>'ir ~~~~~~~~/' 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 ----'11;-';' Il..~..-:;::;-;::,-~ , .. ','';;'~' ~,:~', 9Ib.CjJ~~~!.:;.(f.,;.Altc/L/..--u:-.-;;;-~p.:A5 5 101 8arnett St"New 8loomfield, PA 17068 - - -------- .-;;-~;-.:;'.-:~--'~---------'-' '---'-'--:::i,-Il,"w;~.-T,.."~".,, 3-22-96 (')(') c: . . -. . \,', (',~ . :-.) " ,-. I' 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 -\J . r', '.~ . '.(v,\c..L,b.., I , c.... '\, Signature of Witness l'-' ..:'\ '-c <--.L.:c.L----.::; IIIV'~OOt.. ('<;~) / ') - {l (I . " ~ .r- INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE , WITH REGISTER OF WILLS) jCOU'HY CODI ,~I YEAR 1 (, ";;'-;;;.;;''''';;;'-..".-----------------,""''''''.-.."-,-,,,,,,,, """'" {J' 1=\ I- L\ I -\\~8tr.:~1 ',,~"""" ~~~:,~;~.\e~O;~i~:~I~ .!'.e, f> -\-~-~: 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 ----- _______N\\\ I Nlf\ i 2 Supplt.'mtJn1al Rl'turn ~ 9... .v "4.~~~ ,\(\ .....). .JJP 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\~~\ .J..(_~' NUM8[R ~ z W Q W U W Q w ~ lIl::!U) u"''' wo..u zQQ u"'~ 0..'" 0.. .. ~I []4 [J 6 limiled Ellale .~ J Remnindor Retutn lfar date, 01 death ptior 1012.13.821 j 5 Federal Eltotn fm Relurn Requited Original Relurn '.... "z Ww "'Q "'z ::lie ~.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) => ~ 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) "'o(,s- \!:! 0\ :0 :OIl> tlJ n '--:::.",-:;n-::::.:-:;:_;c;~-::::..:....= ._;. -" 'J~ ~.. F~ o CJ I:' " I.. - -.J , .. .;; . r . ,.. ~~ a - Vi C7'\ =-:" (i) Q. I':J:J:) 2.""2- NIG ( 8) '1 ~ ':). "1 Ct -.-----...-.-.-..-- -~- Z Q ;:: ~ => 0.. '" Q U >< .. .... 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 , I I I ~.~ ~ ,.. :~.~ ." . :!. h (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 . _..- ? ::;: c:::i :: z co U1 en N <:T ~ t: ;, Uj ? :;J '" ... ; .. S ~ o lJl Cl) ..g .. .- '- ;"':1':0'(, +-oJ ;,s:- lJl--..... :::..:r:;:: :J -"'''''i ..J;;:-;: ..,..., ::!-:.r.?! \,J.~z.. c:;:~Z~1 --..~ ......~:t";I; -C~"':~ '''-'-- ==t:;:::;: ._i7:,!:: ~::::Z ..,..., :.: ..... -< o -' o lJ ~~I~. ~" F.I.C,A. 1,.,,1 I.' I --L 1~~. '-Jl ..5J .,.D<j .~ 0 r - ~ \ cot:.: ':' ...., 0..- ;1. " Q -c "Qi q: L. t u) 8 ~I~ U>~ -::CoO rf) o ~ ~v;lJ " "'" (.) V<n/ Lf ~(t , " > .0" Z ... U ., " o " ... " " TRIANGLE CAR WASHES RATE :J.c.:: FED. W IH C:L.. t:o.: EMPLOYEE'S NAME AND SOC. SEC. NO. t"I..t t::l~.U.: :JI:llJLlot<, 111',IJlilY 1 i..~'I'-.1 u......)lil~b ~! u ,. u " " ,. '~ u '" , :~ -- , ,- ,/) .' "' '0 ... ., L; '" ~ on REGULAR EARNINGS OVER TIME EARNINGS OTItERPAV "A TE AMOUNT UNITS t.:}',I. ,Jl ..'lb. \), DEDUCTIONS sTATEW/H i I II ,I II I I I. II II j I: I ~ I I I " b. ..... ~'I.. \.0...1 .. ,',. t 1--1 :.J .. . ~ 11. IJ 1'1 I ,1.111 1;1.. ',Il,.l I I W, .',: M"'<~: , " o I::~; o '~t! ,. o \0 :~ r.- '" () . . ~, o ti z o c ~ W :J ~ ~ Cl ~ Z Cl Vi UJ <t (/) a: o I.L W ...J rll Vi Z o 0- UJ W a: !!! a: o z o c W :L .... ~ o >= ., '. () o 'L U hi .:> -' ;} o '" ,- :! 0" ;:: </) UJ .-;{. ~I 1. ~..". " " ,. "' :: ;~ ;: x. HIO_II'II~ I ll.~. I....' J I ' i l'i I .~', IWldil.1 \ 11'1.::1_1',:" l.j-:l.111 1111\ 111--)1 111:1:1,'" I I ._:ll..:,U. .' '.I I GROSS " I I I \ ~: ," 1" '," , .\ .. , .1'.. , " "'.1 ,-,": '" "1-' !_,.f . (, ;._, 101 ii u h (j' I'. If .111' I'll ;._ <'. f.'~: (J .[.t .~) [~~: 0: :;::l ~.' ii~ in - .-.1 U ~tI. 1_ .J'll'l ~f: _1 :1'(:: I.) .t,n 1- ;- rr:" .j.'l LJ ,,. '.".' (J '" UJ a: o </) o o o G C\ I,Ij iJ, ~-; 1< '" "-.. >--- 00 Z;:: </)'" .,ill Iii: -". -,-' ;;0 aU O</) OJ' <J 1- n 'I () u :r , u b on !; i.1 '. i'\ OJ ~" 'J " , "' :-: "' ,; ~5 ~ "", ~~ ~~ ~ :I.tr: 1--'_) llln. ." -_L' PERIOD ENDING l ')1.:1. ;':"t ..:,...1..'-..11.1 TOTAL GROSS ~',l,;\. '}t ~I. ~I( '::l~. 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'" ~!-'.li'X -,,~. ~ ~ ~i~~~_~~~1~~~ u j ~i.2'C \1~t)...::~:"te-> 1Il\:1, l::,lt'Qct,t1,=sn:~- ',r\ t- J ~; ~ -'\,) ';q' ~ ~ ~ ~ s v,..., ~ -;:u: Rf).c'\)''''.:;c~E , .... tll.c- ur t",... ~ ~ c{Ct <t jg~~r~ "'> .. :1 io;. ~. toH~ ,0 '5 j ~"; CiI'O =!U .!! ~ ~. E 'tV o O.lll" C;, lJ -.... f.! UJ - 001 .. 0 - 1II~'" IX: .tJ._c~ u --, m .$ J; i;;-o -, E';: ",,~Ofll._~- III."~" ,~~ ;~~:,:~ :..~e~ o =o=~zo ~n~p:E IX: Si!:liQ~ t".~l' ~1 E!E"Ga ~!~~t....-..\:.-;~ a::: ~J;.:t~~ o~.:d'E . ,- o ..:!fizc: ~~l;"''' " t- ~~ce.:(8. nlXOlt U ~ ~ ~=8~a::~41~.Eto. - ~ h... ..N'; c.... ~ 11I-..':.. -, ~I, J oil -:.1: "J: IZ- U a 8 -e " . ~ o,~ m.. - - , 'Q ::) t III ~ U . E U :. .;;...., u'-~=.a"<t~::t:.Q;~ !I >' ;1I"';UO~;'f.Q.Q.t ~ a:: a..! tnlz~ B~'!'t, \ ~ '2~6~~:J=IIi~:o~ lit ~ ~'Q"2= ,!"u-i i:l":!~ :-s: ..!: .:I...O.l:O ----o6i::t-:'} ~ t:EoOICI-O~.III~:;E.lJ> . ~ 2 \;.0 .. Z UJ >" ~ Q f ~ J UJ c..lII:l!J<-=g.....o-! ' .:(:> ~;.::::~~w-=..I..c. . 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" ~ ~ ;X ;X g ~ " ... .. ell onow ronM RICE MEMORIAL WORKS ~ Od""""""'.' . . I, .1.",..'1 1I1!/I'Il' I - MHlOIlIAI.S- Ordor 3 5 7 9 7 Supphor Ack.N Oalo Roc'd Found. ordorod v-- Complelo SOLD TO: RD. 2, Box G^.9, \V. MJln Sired, New Bloomfield, I't\ 170GH . (717) SH2-2;,12 . {l'" nUle In.'~IIl/I'IL' ~llj(Jrd .1' J}l; r " n /', "('I , IJ I Iv..,,~ 1:"'/ PositIon votitlod 1/ .~j.- /..{ I (! r- 1(J r.." l( Oalo of Ordor II Iii A~ ,~ ,/ ,,/ . / /! 1'_" 0)"... i ! I f~ ,'..') f) () ... -t" I I Graves 19? & :3.QU '11 ^' ( I' /,( .::: A..1 .) , I" I. Comotery ! / '( 1..) I . \' location Conlcr Ovor Phone (H) .C'.\'.:J - ~'" if. (p (W) Approx Dale 01 Completion Len"rlng ~J I' ~ . , , , (0' It + . " (~-'(r l \1~,JS 'v 1)' /..1..,').)<'/ (,;: _~ I' ,... ~-t. r 7- /.1 ,j T / i 'I ^ 'EICLEI:? -:1 'J I 'J I i 15b I. I ,) J II ( ,~ /1 1'/ '! ~ I .;.:~,.. lYpe 01 Momorlal Size ..2 - () X ..., , ,.- f" r. " ~ M..,-- k", X tl. (/ Finish Malarial I'~;/ . I,) )( r r (: . ) 1 "0 r L e.r I (" ,.. ("ct- J /. () Bose X X Finish Misc. Design Y.' , # '-f .t:{' () , \ Location: L.. " o Vase C Cornor Posts @ ~ \0) (0) 1~0 \ \.1 ' _0', \ 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 ?'::J. ()O I fu'lhOr agloo to pay tho balance "Iilled tor lhe work florlormect under Ihls conllact wlhln Ihllly (30) d.lfS I'll rncoipl 01 1M 'innl involco 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 ..-/' //' " (II.!..-' s s s S TOTAL l!.~~s DEPOSIT I,-/L/:PS Foundallon - Doaler I.-I ". )l.{.-.I / _ L Cll51omor lih . II f....l~.er 11\1'81'111,., 1110 allOW T\4lmll'. lpe long 31!'/.OQ 3 '1:;, 00 o WHIT['Ot!.ce Typo 01 5.1!O yeLtON rrM.IC~.M B s U. 14<laI1l,areCOIIIIo..""11 Snte~man C- f'111I",C...!lI:'I"N.r 0.1l0 EnlOlcd GOlOE'lROO Orllr.cn ."1-' COMMONWEALTH OF PENNSYLVAWA OEPARTMENT OF REVENUE BUREAU OF INDIVIOUAL TAXES DEPl.2BOOOI HARAI5DURG. PA 17128.0601 \' * No.AA 379164'lEV"'.""""" PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT RECEIVED FROM: r ACN ASSESSMENT CONTROL NUMBER AMOUNT S;"'jA;or.; ~' Sf: I G!-.Ef.: l'.'L ~. ,:1" t;' :). It c.:.:. .. " ~ DO\, ~:FJ "S~~ 8~OOMrIELD. p~ 1~1)6~ - fOlD HERE fOlDIiERE ESTATE INFORMATION: F'LE NUMBER NAME OF"DECEOENl (LAST)' I11Sl) .MII ....-,.- - "" - " 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_ ~.,; , '~ ::i (J(J 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- j 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. r- ~ , ..~I " \ ',-~, ;\CI~U:Y\ ~ . ~ u () t ( \ Signature rJ C,. .. N~~:~\((\~i:~se ~ype:-~(;' \;~~~ \1.,1)\ 'h)'~ J;~ Nt:...: \?:'\n.,'(\(, (11.\ 91\ At.!dress I \:1CI.'$ DIll ~)S l- C,;LiL\ls Tel. 110, Date:J"/_-\ L -Cl~ \0 If) '0$ ~'i~~ ~ g -:::~ ,0; q . " r:; , . ',..' ~-:. . '.J '::, 0::;; o Q) III 0: 0: t..:l <=I ~ ;11 .....l =E ~B Capacity: 'I. Personal Representative Counsel for personal representative (MAli: rmf/ MIJ) 1