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HomeMy WebLinkAbout96-00279 PETITION FOI~ PHonATE :lnd GI~ANT OF LETTEHS Nil. _________n _,)./-. ~t :.;1,7.9_ Tll: /:.'1111.' II} ____I.~n~II__:;. _~lIb...1 et__ __ __. _ __ (/Iw kilO"''' 'u __._______'_ .--- ____._________ ______ ____ ______ .__._.__ ___ _ __..___...___ Register III' \\'i1h for the __ _______________.__ ________.., /J.'n'a.\c'd, Cllllllty of __(;!'-lIlbe.r.!lInd___ ill Ihe SlIcial S.'mr;ty SII, 179-30-368',- C"'III1111llweahh of Pellnsylnlllia The pClitiol1l1f Ihe 1II1d\.'p,igIlCd h."'PCClflllly ll'prC'll'lIt\ Ihat: Your pClililll1crl",). whu j,,';Ul' IX year, of age or older an Ihe C.\Cl.:UI!'~~_______l1aml'c..I ill the I:"t \I ill of Ihe ahllle <le,e<lelll, <late<l_ t'.~-,,!,)!..!J' 20 , 1')J!.5._ an<l e",licil(s' <I:IIe<l 1<,1;\11.' rdl.'\;llll ..:ir~.U1Il\l;III(L". l'.~. rCIlUlld,uiulI, t!l';lIh (If 1.'\\"(111111.1.'11.'.1 De,en<lelll \las <lllmicile<l :II death in Cumberlllnd ConlllY. Penmylvania. with h~_ la,t falllily or principal re,idenee :11-'-'&2 Brlld1.mr-.l>..Livc. North Hiddlcton Township (lj\1 \Ul'I.'I, numher illlJ IIIUIh:ipilliIY) Dee~n<lelll, then 58 Far; of age, died t'cbruary 24 ,19 96 at Sarah .jI~T.!'dd Hemorial Homc E.'"ept a, folill\\', dc,,,delll did nUllllarry. was not dim,,:ed and did nUl have a ehild born or adopted aftlr execlltion of the \\ill offered for probate: was nUl the I'ictilll of a killing and wa, neser adjlldicated inCl'Il1I'Clcnl: Dccendent at death ol'"led properly with e,timated vallie, as follows: (If dumiciled in l'a.J All personal property (If not dOllliciled in Pa.) Personal property in Pennsylvania (If nol domicikd in I'a,) Personal property in COllnty Value of real cs:a:c in Pcnns\'I\'~1J1ia sitll:lIed 'IS follows: 1402 Bradlcy Drivc Carlis1c. PA 170LJ S 41,000.00 S S S 36.000.0Q \\'HEREFORE. petilioner(s) respectfully request(,) the probate of the last will and eodicil(s) presented herewith 'lIld the grant of lellers tcstamcntary (h"'laIllCII1.H~; ~u.lmini,trillltll1 f.:.I.a.: adllliniQr;ui\Hl d,h,n,!.:.I.",) theron, , - :: ~-; ~": ~,! - ., ,0- ;~ ::; ~~A_ Sara G. DlIDJ> 22 Tiffany Drive Carlislc, PA 17013 717-243-8844 OATH OF J>EHSONAL HEPHESENTATIVE COMi\lOl"WEALTli OF j'Ei'li'l!iYLVANIA I ,. j ~~ COUl"TY OF Clf'riBF.It!"~!L The PC:iIlO,";f(S) ahove-named 'WC~lI~') or affirmh) that the \1atcmclH, in the foregoing petition me true and .:oriu:t It) 111..: bC:o.lllf 'he kno\'.h:ugc amI hl'licf of pl.'titinncr(s) and that as personal rcpn:scn. tali\'c(s) \}f Ihe aho\'l' dCl.:cdcnt IH:lit:tJm:r(<-.) will \\.:11 aI truly ~l~btl.'r the estate at.:cllnJillg to law. S\\()rt1 i'J ,U a:'firl11cd nllll :o.uh.... :-ihcd I ~1u.A-- Cr. helon: 1I1l,' thi, 6th da\ of Sara G. Dann .;:' '7;'''' K-')~~~_~=-:--pl-fL 1 -- ~ -_L~~.L.<.A..=t..JJ./'.L.,.x1..LLk~<;,I. /;'1------- ------ ~ (/ MlIRY c. U"IlS II"~/ltl'r ,-_____________________:2 /-5 - 91" - /.3 No. 21-96- 279 Estate or I. Indo S. Gnbrlcl . nee eased DECREE OF PRonATE ANn GRANT OF LETTERS AND NOW April 2, 19...2.6-, in consideration or the pctilion on the reverse sidc hereor, satisractory proM having bccn presentcd berore me, IT IS DECREED that the instrument(s) dated Febroary 20, 1995 described therein be admiltcd 10 probatc and riled or record as thc last will or \.inda S. Gabriel and Lelters Testamentarv are hereby granted to Sara G. Dann 'J d :C) \,;. I 1. . n(l/'CL/.... \ .',~\~{Wc-' ,'/: /i... ,,.~/7U,~1 L~1,.j_ ,/ Reg;"..'of Will. MARY t:. LEWIS rl FEES Probate, Lelters, Ete. ,..""" S 200.00 Short Certiticates(4) ..,.,....' S 12.00 Renunciation...""......,., $ x-Pages (2) $ 6.00 JCP TOTAL _ $ 5.00 Filed ".l\pril. 2,.1996".,.,~. ~~~:.~~.. IRWIN. KcKlnGH'l & HUGHES Marcus A. KcK~i~bt. III ?5476 A".OR:<F.Y (Slip. Ct. 1.0, I'll,) 60 West Pomfrct Street Carlisle. PA 17013 ADDRESS 717-249-2353 PHONE CALLF.:D ATIORNEY ON 4-3-96. Thl\ '" tll tt Ill!; 1I1,lt rllt Ill/""Ii \l1,,1! Ii' II ", i' 11H..IIHl~I,.I1.lt lilt '\[1l'1I1dl!ltltll.,:, '\lil! t'l " 'III I, d','11111 .t:tdl'I~1 .t ,1'_I'il !,,j, Ii!,.! '_\I:!I Ill! I. .r,. ,II."",! 1,(1111'11"11,:11,11,(1.111111.., WARNING: It 15 IlIc!lnllo duplicate Ihl' copy by pholostnt or pholog,aph, 1'(1' 1111 1111" d ltdh ,Ill .' tltl ..,...~..... "<':(~~1I10f/r;"',, /'-"'," -<~, ~' ..'\\ 'I~'_' ~ '-.\' i ""I, .' \;"j ,/"-" , "'I ,tv. ':'1 ~;:r I, * If . ~/ J \~ -,.', */1 "-:6, ,~"~// , 1'.f", ' 'i;:'il ~?,f{ENT ~\ ~~,"- ~"::..."!.!"!!!!!:!-,,-_., 1).lll' '- ::."', ...., ,.: ~ ~/ .-~::(.I/: .--- I'i' ,II HI'l;""II,1I ? 1 ,-' ,-, " 'I d it l. 1 b (j .1. i\:1l , ) I ," ~' !,.,. .."'.1"..-- I ...' " "''''1.,11...111' COMMOUWEALltl OF PEUNSYlVAPllA. OCPAnTMrtn or tlEALlIl . VITAL RCCOROS CERTIFICATE OF DEATH :""'N' ,. UIIIN1 '_'NIl u. '''''''''_" IoOCI-llU'......"_NII .....OfOlCIDl.."....._UIlt 0, Linda Cnbriel ""....".....,.., tI'f~"I~U,A _ 000 I FF.MAt.E 179 lO - ]6B4 .,..,,,,,,-,,,,,.;,,.-.1 "..U(llIOl.r"IV'" ""'.."...,.0......' HQ''''t&~ ~llAH8ERSBURC PA ;-- 0 .~Il~t1....lf"l......-...-v.-.._"'.,_, U"lIll\I na, -':- =",0 58 ..... ""'" 'Oftc....." "'""-t._.~_.""',_eoc ~#ol . \IllITE ;)./ CARI.ISLE CUMBERLAND '. "''''U~,I",U''''_ _.._,- c-..rsr-~ It DIVORCED 'Vf'lV1\tooOi'OUW ..-......--- ."S...l'$.-....tl<J~"" ....'UlItIU..II..."... u, '''''It,,Ofl(I$~ ~.O '""~ Ol((Ol""lU_~ ...1>()Of ....0 ...:..,:;:.."::':::3.;1 I" 1I0USEwt FE , DlCltllNl lUAlI,.>>.tUOO"',"No_ C~ louo.. /'1'0$1 HOME OlCUA,t11-' OC'U'~ "."DI""<< --..... --- "rO,,"___~ f.tt::lA. CUM8ERI.ANIl U.,,"... w --- --. _....' 1402 BRADLEY DR. CARLISLE PA 1701] .. ,"''''''''...''11'........... ~Wl ....--- 1" ___... CARLISLE I"'C,-" W'H(II,,,,,,,, ,". u""'" .........:.,..~~ .!1 ESTIIER BROWN ....uP......".......Po<).VlJf'l\lI1<>_'...__I.,""'"' 22 TIFFANY DR, CARLISLE PA 170ll E. STOllER 1)9(, "",,(t Of- "'~ro~IO()tO...._..,_1t'l ~._, ..Cl"to,.,... \oc.tlU"l.~"...,'.C"O' SMITIlSBURG MO alA.'lI'(;. PA 17201 ~'.$-(I"IO .~(Ity-I I . ....'(."Itl.L"..IOIO..tD'O;;"l.I...........IKIJOIUOoI'" ..0 ." ,. I 0 1 2 1 1 9 - t. t....._.."".-...."'...........,.........,.... ,1I.............._ s.v.ev"""'-I UU,.U_HA . '_VOlOl" ..l7J . 6:00 n.. t '" "'I. 11.''''''11, ,......._...._...........rD<"PC..__"c_..."'.... 00..4........_.."''''i .....~II...O>><..._.......-..' .-........'.~. ""....._c_.....~.... '.Utll ""'*'____..._......_..."\1.......... "'" """_........~c._............",. I: ~.\.P-'...>,.,., ~. lw. ~"lo"(7iii!;:;....tUlI I '\""<.W,._l"",, _Cu..":U'/ 1l\)('O......."'....,.....v-..ti;.Yt-'i- 1""....- ,.......- ,-..,,,,,..~ , ---1.....,"", : \.va.~ fu<;lo;' Ob<l"<-....~h ~~~ """ ,\),(,A'.~'~,"",~I\o'\lV<<..l VI ___H : Cl..iv,'u.n. ~[""'llJf"jj",'" ....,#-00....1 It> .'ILC'OI............._..'-,....._.......,...n ,....""'.-ct,..." - ...0...0 """"."'I'o(.At.' ""-~''''''''lf'UUII.(J(.C"....(1) ...1..l.u'Ol'lo""'O'...' ....~AO'II.,>l _UIlU'"(lq1O COU",(1OOlOt'C'U~<< "~. ~ -~ 0 Of"OI.'"' ...- 0 ..-,-.'....... [j ...0 ~['l: .... 0 c-....._ 0 .. Ik ,.. CII""""lU_.....~ .CI"I.'-.a""'.IO"'...~_~....."__._.I......._""'lII__..J_..,.....__:" T...._..""'..........._...""""_.....t~.I__...-......,.".., . J ~I"ICl"IQ.....ocr"'.,'-...o....noCl.ltl'__.....p.........."'II__...,.,.........,,_... .,._........,................._t_"..._._.._,.....__.._I_.I.~_"...... 'U<<DC"'LIXA~~OMf" 0It-....",. .....-.IItO'l_" IIon.IIt...,,",,,, .,.......,...IIIMI\Il'I...M"'-""'-, .tI.,.... pt............ hi..... '_'111'''' -""............,.........,.....................,...,.........................,..,......,.-,....,.....,... ... NO<STI'WtI .. ,.- OEl ':J~ :~? :.;.. '...I~ -.;r '::t N 0.. "5cf o \_; 'i ..... r.J .- , ) 'J ".1- ;:J ,",I . C ~'. ~& 0:: ~ ~ l~ ,.) ..w . E Q):;) Gu 6LZ-96-n: Name of Decedent: Date of Death: Estate No,: To the Register: ( CEH'rlFICA1'ION OF NOTICE liNDEn mJJ.J~ 0.0(11) LINDA S, GABRIEL Febnml)' 24. 1996 21-96.0279 I certifY that notice of the beneficial interest required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on April 8. ] 996 Name Sara G, Dann Alice G, Bin~aman Dale: lJ.l/OH/96 0 - ~ ~~ o~ .. 11.r.._ N 0 , ~ a.. U . .::;.-:. .08 ,) c, cp ,. ... . 'T) '.J .7 ?; ~ lJ ~ .: " OJ '. U) u Cl ~.o wa: ~ '=E a: uG Address 22 Tiffany Drive. Carlisle. PA 17013 P,O, Box 5] I. Stockton. NJ 08559 / / NWlle Marcil' A. McKni.hlllL E""nire Adtlre.. 60 Wesl POIllfrel Slr...1 CurH,le, P ^ 170 13 TelephollcI7I71 249.B5~ Cupacil)': Personal Rcph:scntnli\'c x Counsel for Personal neprescnllllil'c Inventory of the real and personal estate 01 1.INIlA :i.._GI\!I!Uf,I. Real Property: Unit A-lIl. 1402 Bradley Ilrive. Pheasant Run CondominIum. Carlisle North Hiddleton Township Personal Property: Capital Blue Cross. refund Chambersburg Trust. checking account 1159-1327 1983 Honda Sedan Herrill Lynch cash investor account #697-13523 University Hospital. refund TV Cable of Carlisle. refund co c 1[:. " (~ ..J I~__. ~ I Cl L:~ , \~] a:L:.. p, .l ::> Go , , deceased n ____ _______ ---------- 38.500.00 180.70 5,971.50 1.700.00 65.98 454.25 24.97 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND 55: __l'l'!l^_c;, l)~N_ ___. being duly ___.J1worn._ __ _ . .. _ according __ Exc_C;.!'t~i~. ____ 10 law, deposes and says that flhe _. ___.__J.s_thc__.. of the Eslale of ____.___I,l.rul!LS.._GlIbdeL- lale 01 _.. ._ North Hlddlcton Township ...____n_ .___, Cumberland Counly, Pa" deceased and that tho wilhin is an invento,y madc by __ _ _n _ _ . ..___ Iu:r__ .___ . __. n' n__ ____, the said --Executrix of the entirc cslalc 01 said deccdenl, consisting of all the personal prop.r1y and rcal estate, except real ..tale ouhid. Ihe Commonwealth of Pennsylvania, and Ihal Ihe ligurcs opposite cach item of Ihe Inventory represent it's fair value as of tho dato of deccdent's dcath. Sworn and subscribed belore mc, ~._.~ Encutor . Adminhtu'or n _ _._~!_'!_i!~any Drivc tariat Seat .laa1uollne L Drnwb<UJgh, Notary Publ" Ca~isle Boro, Cumberland Coun!} My Commission E.plras Aug la.' 999 "'\.~rtA..". PorV'lS)'Mri.l~1tJOn at Notne Date of Death ___.24 DIY _______C!!rlislc. l'A l7013 Addr." ___.'cbruary_____ _ Month 1996 Vur INSTRUCTIONS I. An invcntory must be filed within threa months aflar appoinlment of parsonal represantalive. 2. A supplemant inventory must bc filcd within thirty days 01 discovery of additional a"eh. 3. Additional sheeh may be allached as to parsonalty or really 4, See Arlicle IV, Fiduciaries Act of 1949. , c:i. :a '" ~ I >- ~ -d CJ ... I- W ~ '" I << t- o .. ... .... ~ w <( ... CJ ... N 0. t- ell ~ u I 0 VI C> a ... '" I 0 w w '"', 'tI C '" .c >- '" ::c << ~. 'tI " CO CJ t- o. 0. c: I I ... ..J U. ~' .... .. .... ~ ... I z <( 0 :c 0. I ~ 0 N LL ..J t:l :l: W <( w .c' > 0 ~ ,;. ~ <( Z ., ... c i I I, z 0 C tIl '" :J 0 . .; VI Z < :z;: 0 I <I << u z w <( !ij' ... 0. -0 i 61 '"' c ..:l .. - -.: 0 '". I CJ :l'!l .0 ... I .e E ." ~ 0 I .. :J 0 ..J U ii: CD I D E C E D E N T ':. 't /{ I, . INHERITANCE TAX RETURN RESIDENT DECEDENT cO"~~t'."t.~rt~~\Y,~fl'v'fiJMANIA (TO BE FILED IN DUPLICATE ..AIIAISRlIlibtrol,..D<<l, WITH REGISTER OF WILLS COUN1YCOOl OECEDENY"S NAU[ IlAST. rmSl. AND ....IOOlE INITlAll O(CEOENT'SCOMPLETE AOOIl[S~) Gabrlol Lindo S. 1/,02 llradloy Drlvo SOCIAL SECURitY HUUOER OAT[ OF DEAW DATE OF mRTH Cur 1 isle, PA 17013 't[AIt NUMOEn rO"UA'[~Or Q[AlttAFI[H Wll/l.:1ClllCKItEnC II A SPOUSAl 'H . IT~. AI FILE NUMBER REV. I~OO[X .(7.84) C P D 0 NA"E R N R D Marcus A. McKnl he Ill, Es ulre ~ ~ TELEPHONE NUMBER - T 717-249-2353 1, Real ESlale (Schedule A) 1 2. Slacks and Bonds (Schedule B) (2) 3, Closely Held Stock/Pannership lnlerest (Schedule cl (3) 4. Moogages and Notes RecelvablelSchedule 0) (4) 5, Cash, Bank Deposits & Miscellaneous Personal Property ISch E) (5) 6. Joinlly Owned Property (Schedule F) (6) 7, Translers (Schedule G) (Schedule Ll (7) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses. Administrative Costs. Miscellaneous Expenses (Schedule H) 10. Debts, Mortgage Liabilities, Liens (Schedule I) 11. Total Deductions (tolal Lines 9 & 10) 12. Net Value 01 Estate (Line 8 minus line 11) 13. Challtable and Governmental Bequests (Schedule J) 14. Net Value Sub"ect to Tax (line 12 minus line 13) 15, Spousal Transfers (lor dates of death after 6-30-94) See Instructions for Applicable Percentage on page 2, (Include values Irom Schedule K or Schedule M,l 16. Amounl of line 14 laxable aI6.'. rato (Include values from Schedule K or Schedule M.l 17. Amount of line 14taxablo at 15'1. rate (Include values from Schedule K or Schedule M,) 16, Principal lax due (Add lax from Line 15, 16 and 17.) 19.Crodits/Sp Poverty Prior Payments Discount Interest 0.00 + 2,500.00 + 131. 58 0.00 20, If Line 19 is greater than Line 18, enter the dlfterence on Line 20. This is the OVERPAYMENT, ~ 0 ICheck here II you ar. reque.ling a refund 01 your ove,payment.1 21. If line 18 is greater than lino 19, ontor the difference on line 21. This is the TAX DUE. A. Enter the interest on Ihe balance due on line 21A. B. Enter thelolal 01 Line 21 and 21A on Line 21B. This is the BALANCE DUE. Make Check Pa able tal Re Isle, 01 Wills, A ent .. .. BE SURE TO ANSWER ALL QUESTlDNS ON PAGE 2 AND TO RECHECK MATH .. .. Under perwlllesot perjury,l deca.,e that I hall" examioed Ihls 'Blurn, Including accompanying sche-dul.,s.nd slalemenls.and 10 Ihe beslol my knowledge.nd beliel,llls true, eorreel.nd complete. I doclare that all realesl.lo has been repolled .Iltue market \/.Iue. OKlat.Uon at preparer othc' than the pe,sorwl ,ep'l!sontalilll:f Is based on .lIlnlotnwllon of which proparer has.ny knowledge. Sara G. Dann ?~- .'!'!!.~~~Y. .~~_I:~~ - - - - - __ ..__ - - __ _. __.. ___ _.. _. ____ Carlisle PA 17013 SIGNATUAEOr")9'J'EAOTHEATHANAEPAESENTA"VE IRIIIN, McKNIGlfi' & HUGHE.S ~V4./1II.L--' 60 1!!l.~t:_.P.~~~F_~t:.!>.t."~!l.L..________........____..___ . ~ I' r-F Carlisle, PA 17013 Copyrlgh (c) 1994 form sollwa,o only CPSysle . CAB H P L E P 0 C R C K 0 K P 5 21.96-0279 179- 30-368/, 02/2/,/1996 12/0/,/1937 Cumberland County Remainder Roturn liar datos 01 dealh pilar to 12-13-82) Fedoral Estate Tax Return Required Total Number of Sale Deposit Boxes <IF APPLICABLE) SURVIVING ~POU5E'S NAME ILASI,FIRSI AND MIODLE INIfIAL) SOCIAL SECURITY NUMBER AMOU~1 R[CEIV(OISEE INSTRUCnONSJ 0.00 2. Supplemenlal Return 4a. Futuro Interest Comprorruse (for datos of dealh aher 12-12-82) rn 6. Docedent Dlod Testate D 7. Decedent Maintained a living Trust (Anach co 01 Will) (Anach a co y 01 Trust) ALL CORRESPONDENCE AND CDNFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TD: X 1. Onglnal Relurn 4. limlled Estale D 5, o 8. R E C A P I T U L A T I o N COMPLETE MAILING ADORESS IRWIN, McKNIGHT & HUGHES 60 West Pomfree;Seteet.. Carlisle PA 17013 38,500. 0 None None Non.. 8,397./,0 26.00 13,942.11 r -~ 0) (6) 60,865.51 (9) 9,6117.33 (10) 6,057.88 (11) (12) (13) (14) 15,705.21 1,5 ,160.30 None 1,5,160.30 (15) 0.00 0.00 X = (16) 2,709.62 1,5,160.30 X .06 = T A X C o M P U T A T I D N (17) O.OOX,lS= 0.00 (18) 2,709.62 (19) (20) 2,631. 58 0.00 (21) (21A) (21B) 78.0/, 0.00 78.0/, CATE OAlE Form 1500 tRe....7-94) SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY REV. 1S01 EX . 12.17) COMr..mftW.c\\,~MhY'NI' ESTATE OF Please Print or T II FILE NUMBER 21-96-0279 5511 179,30,3684 02/2/,/1996 Linda 5. Gabriel (All 10 I ITEM NUMBER 1 olnll -owned with RI hI 01 SUlv\vollhl mUll bl disclosed on Schldull F) VALUE AT DATE OF DEATH 180.70 DESCRIPTION Capital B1ueCress, premium refund 2 Chnmbersburg Trust, checking account 059-1327 (confirmation attached) 5,971.50 3 1983 Honda,VIN 1HG5Z7450DA015340, sold 05/17/96 to Mary Dornan 1,700.00 4 Merrill Lynch cash investor account #697-13523 (confirmation attached) 65.98 5 University Hospital, overpayment 454.25 6 TV Cable of Carlisle, refund 24.97 S 8 397,1.0 TOTAL (Also Inler on line 5, Reca nulalion) (Anach addnional8 112' x 11' sheels ~ more space is needed.) Copyright (c) 199.4 formsoltw.tI only CPSyslems,lnc. Form 1500 SchtdLde E (Rev. 2.171 REV. U09EX + (1Z.68) cO"'tlR,wgflm~~~~lhY'NIA ESTATE OF Linda S. Gabrlol SCHEDULE F JOINTLY-OWNED PROPERTY SSII 179.30- 368/, 02/2/,/1996 FILE NUMBER 21-96-0279 Jolnll.n.nl(.), A, NAME Sara G. Dann ADDRESS 22 Tiffany Drlvo Carllslo, PA 17013 RELATIONSHIP TO DECEDENT daughtor B. C. Jolnlly-owntd p,op.rty. ITEM LETTER DATE TOTAL VALUE DECD'S DOLLAR VALUE OF FOR MADE DESCRIPTION OF PROPERTY NUMBER JOINT OF ASSET ."INT. ECEDENTINTEREST TENANT JOINT 1 A 06/1995 Harrisburg BELCO Foderal 26.00 100.00l: 26.00 Credit Union, savings acct. #734470 (confirmation attached) TOTAL (Also enler on line 6, RecaD~ulalion) 26.00 (If more space is needed, insert additional sheets of same size.) Copyright Ie) 1994 'arm SOIlW"'1I only CPSYllllmt. Inc. Form 1500 Schedule F lRev. lZ.88) REY..1510EX + (Z.17) cO"'HJm~{\'~JVbY.~I. ESTATE OF SCHEDULE G TRANSFERS Please Print or T e FILE NUMBER 21-96-0279 Linda S. Gabriel SSn 179-30-3684 02/24/1996 THIS SCHEDULE MUST BE COMPLETED AND FILED IF THE ANSWER TO ANY OF THE QUESTIONS ON PAGE 2 IS YES, ITEM DESCRIPTION OF PROPERTY EXCLUSION TOTAL VALUE DECD'S DOLLAR VALUE OF NUMBER Include rwme o'1he1f1ns'"... 1helr OF ASSET Y.INT. DECEDENT INTEREST r.I..llonshlp 10 decedent d.le O'I"MI.r. 1 Sara G. Dann, daughter, cash 3,000.00 16,9/12.11 OO.oox 13,942.11 02/09/96 TOTAL (Also enler on line 7, Recap~ulalion) ~ 13.942.11 lIf more space is needed, insert add~ional sheels of same size,) CopyrJghl(c) 1994 formaallwlr. ontyCPSys1ems.lnc.. Form 1500 Schedule G (R..... 2.87) REV .1512 EX t (1.13) ESTATE OF CO......f\liWE.LT~F PENNSYLV.NI. IN R"'N TA)( RETURN R SIDEN ECEOENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES AND LIENS Pie'" Print of Type FILE NUMBER 21-96-0279 Linda 5. Gabriel 5511 179-30-36811 02/211/1996 ITEM NUMBER 1 10 11 13 DESCRIPTION AMOUNT 10.19 Amoco credit account (1452-917 -853- 7 2 1,206.37 Care Apothecary, account #, 48037600 3 1,092.90 Carlisle Hospital, patient (/1260827 4 58.94 Carlisle Hospital, patient #1294156 5 Carlisle Hospital, patient #1297431 6.25 6 Carlisle Imaging Assoc., acct. #126082-7 38.80 7 11. 46 Carlisle Pathology Associates PC, acct. #A126-00159l7-0l 8 Central Credit Control, 1995 Cumberland County Per Capita Tax (overdue) 28.50 9 Central Credit Control, Cumberland County per capita tax due for 1995 28.50 Emerald Drug, account #GABRL GRP-G 697.94 5tate Farm, insurance coverage 60.89 12 Mas1and Associates, account #17098-11 457.90 Chembersburg Trust checking account check #1136 cleared after date of death, payable to Pheasant Run Condo Assoc. 70.00 (see continuation schedule attached) Total of Continuation Schedu1e(s) 2,289.24 TOTAL (Also enter on line 10, Reca itulalion) (II mor. space is needed, Insen add~ional sheets 01 same size,) CopyrIght (e) 1994 form aoltWI" onl1 CPSysl.ms.lne. $ 6 057.88 Form 1500 S<hod.lel (Rev, 1-911 Estate of: Linda S. Cabrie1 ssg 179-30-3684 02/24/1996 ITEM II CONTINUATION SCHEDULE Continuation of Schedule I DESCRIPTION AMOUNT 14 Penn Power & Light, acct. 11520 4510 001 230.53 15 Robin K. SolIenberg, 1996 personal county tax 10.00 16 Carlisle Surburban Authority, wat/sew acct. 110600757.02 98.44 17 Sareh A. Todd Memorial Home, resident #237100715 1,810.38 18 United Telephone, eccount #, 717-243-0054 (728) 17.49 19 University Physlclens, acct. 11657832 122.40 2,289.24 A, SeUl.mer.. Sl.\~menl UI lIu.,'...."1 "I ",...."'. I..d U,h" II..."'''....", ...:... ,r (11,1" "'~ ,\D'01" n~plI of lo.n I. Oft.. 2.0 htIA J. Gl (o,,~. Unl", 4.0 VA ~.D (onv. Ins. C. NOTE: 1hls lorm 1$ IUfn"hOd 10 gfV8 ~ou . "11010001 01 aClual SOlllomonl co!>I". Amounls paid 10 Ind by 1110 lulHorTlOflI Igool .ro ,hOM, lIoms n\lrt.ed 'po,c.' wet. paid oulslde 01 clcnng; Ih8'f .r. shown here lor ~lormaUon.1 purpous and .f8 not ~c""d&d i1 Iho 101,1\. O. NAME .AND ADDRESS Of OORROWER; JA(~ V uurMA~ end OUlillA M OUfIU.N 269 ClOUSfR AOAD, N[[ItANICSBUAG. PA l105S SARA O"'lilrl [.l((UIRlx or [SlATE or LIliDA 5 GABRIH 111111lJ1fjlt!r (jAt!liIH lo,lnli~t'r l4i.1rlq"It' In~ur4f1Ul CUt! 1i.MTt.t!r E. NAME AND ADDRESS OF SELLER: F. NAME ,.NO .ADDRESS OF L(;NDER; G. PROPERTY 1402 BRADI[Y DRivE lOCAnON: CARLISLE. PA 11013 H. SE:TnEMENT AGENT: PLACE OF SETTlEMENT: I'" - 2)-I,,"S)1) I. SETTlEMENT DATE: IRWIN, MdJOGlH .. tUj!tES 60 \lEST PCMFRET STREET, CARLISLE, PA, I7D13 J, SUMMARY OF BORROWER'S TRANSACTION K, SUMMARY OF SELLER'S TRANSA TI N 100. GROSS AMOUNT nUE FROM 8QRROWER: 00. GROSS AMOUNT DUE 10 SEILER: 101. Colli'''' ..... ,,1(1 ,5UU.OU '0\. CollllICI 141" ~IU .5UU.UU IOJ "~u~I.I"OCl"" 0'....1I01l1IClI'p.n' In ,.IIl,"',", ChAl,1I 10 ~'1I0."; ... ,..,,,,,III.UOCI 1 409.56 ". ... ". .el. ADJUSTMENTS FOR ITEMS PAID BY SEllER IN ADVANCE: ADJUSTMENTS FOR ITEMS PAID OY SEllER IN ADVANCE: let 0I,1'I0_"1U" .. ....01'11'.111.... .. lor. COwM'..... 71 7196..121 1r/96 95 44 '0'. COwM'I.... 7/17/96,,12131/96 95.44 te.. A"llIftll.." .. .C.. ".....m..... " ... IiHIfR/\/,ufR 77 .08 ... UlJfR \/ATrQ 77.08 Ito. 110. tit. . ' '" 33 90 '". moc AT'O' '" 33-00 ,It. ... 120. GROSS .AMOUNT DUE FROM BORROWER: 40,115.98 .ro. GRO-C;S AMOUNT DUE TO SEllER: 38,706.42 200. AMOUNTS PAtD BY OR IN BEHAlF Of BORROWER: SOIl. REDUCTIONS IN AMOUNT DUE 10 SelLER: 1CI1.0,ClOU 01 "'11..1 mOll', 1. UUU. UU hOI. hc... ll.,Cl.f11 1..1 1ro1l,..CII,,1I11 10' "'~cl,1l ,mOlIIlI 0111'. 1a1"'I' lO,.llllnl.mllll chllOIl to ..... {1lI1 11001 J87.00 ,UfolIlIPlOlallllIIIlU".wtll.CllO .0'1 (0,,,.., 1o'~IIJ """ htlj.CllO 10'. 'ca. ".,olfol toll mOIlO,glla." ". 'U, P.,OIf ol..allll "'Ollg';1 10.11 ... lOt. '" '0'. 'c.. 'U. ... ,.. ADJUSTMENTS FOR ITEMS UNPAID BY SEllER: ADJUSTMENTS Fen ITEMS UNPAID BY SELLER: '10.01,110." ..... .. 110, o,,~o."I"1I .. ,". CO,,"I... ,.... .. II1.CO..."I'I.... .. "'.A.....",."II .. ... AI..II....~" .. ... ("1.00' fJ.Xn 7Hlli Tn 7 706 35.53 lU. ''''''''I ill'S 1196 10 "19' 35.53 ... 'I~. 'II. liS. ... ... 111. '". ... ... ... ... 220. TOTAL PAID BYIFOA 1,035.53 sro, TOTAl. REDUCTIONS 422.53 BORROWER: IN AMOUNT OUE SElLER: 300. CASH AT SET1l.EMENT FRQMfTO BORROWER: 600. C.lSH ,1.1 SETTlEMENT 10IFROM SElLER: ~ W 6-;::1"~nt D.l"rromhnrro",e" In 0 ~ 115.981r,ot r.ro!- IlrMunt '''If! '0 "ll"r '1In- 4,nl 301. leu amount nald h\l1for borro.er '11M 110) .015.5 601. less rc>mlct'n, tn 4"'1. rlte SIIl1crlllne S?O :JQ3. CASH I !!fROM) (0 TO) OORROWER: 39,080.45 603. CASU ( gTO) ( 0 FROM) SCUER: 38,283.89 July 17, 1996 HUO-l (3-86). RESPA. HB 4305,2 PAGE 1 1'''''" II~ ,ln/M" ..un. /11.. ,.., L, 100. TmAL SAlUiItlIlOl'.urS COMMI~SIUN SETTLEMENT CHARGES II.flIO u..I'1l11T . ... I'AI[)'"0M 1I0111\OWI rrs nmns AT f,[nUM[m I'AI() rllOP..4 5(1I[n'5 FmmS AT fiCTn[f.,4[t4T OIVISION Of COMMISSION 111N[ 7001 AS fOllOWS: u, '0 rot 'co '01 ("AI"'''''tI'J..U'''I'"'',,,,.n, ,.. 800 IIfM. PAY AntE IN NNl:' 11 fI WITIt I AN' .. 10' lu.. o"a""IO~ ... .., .... Ul-b1l<J o. n d .,' 1ft ,.. ~1I ... "I ....... , '10'" .~, ....\l"'~lIc.. ,.. .n 900. llEMS RE WREO BY LENDER 1 DE PAID IN ADVAN E: .. ..... """ .....,.. ''''......'0' . " I .....,.. ...t, .n 1000. RE EAVE DEP liED WITH lENDER: " mOIO'ft'''' "'O"'~' O. "'....,~. O. ",,,..'..'.1 ",""110'01 ",""110'. I ",""'11'01 ",....'0.,0 . llll~nl pel ",I"'~ pH "''''''11 pe, ",'~III p.''''''1OI1I ,""'''''111 ","""'11 ,""'""'11 ..'"'"..." " " . .. .. , " IOO!A......IlIIlW ........ A re lie Aeco4lnt1 1100. 11TlE HAR E : Escrow A '01 III ",...1 ,(l0"" ,0 Ab "" f II' ..,eh , . llf II'''' ,.. ... 10 0 ",nl' ., ", , 1101, AIllu",,', ,... 10 MARCUS A HcKNICilII III [SQUIR[ "'c" b."'" "'..... 1l0'.Tnl,lnh'I"UII 5.0 . .' " " , 0... .' " 1111. 111:1 1200 GOVERNMENT AE CROIN 1701 nlco,''''1I hll' flld' 01'"", I."", AND TRANSfER HAR IE 385 ~o'8 o 85.0 ." , o 1r01. UOI. 1300. ADDm NAL mlEMENT HAR E 11\ ell "I ,,, l)fi. ~97 srtoo ".. 77 uCle 130' , 1 409.56 387.00 I h'.' ca,...." ....I... III' IND'1 81111,,,,..., I'"'''''''' .... I. 1111 bill 0' m, k...._II,g, ,.., bel.1. It I' . ".., ,.., ,C(~rll' .1I..m.M of U ,.u'p" .n, "th'II"""" ",II. U""I~eow"''''',m'''''ft''"I''II~II"n IIWIlII"CI'I'I"IIUIII""'Clt..'.e"PrOI'ft.tl;'/~~,tJ-f'. lI~rro..,. \(.,. J -r:~J--- 0,1,1/1/96:;::'," M.ht:ttsJ-l..ut...Ii.A.601vr.,utflll.1/1/96 /JAL\ V I;AurM"" /1 SAil" DAI,N u{clJfRIX or [StAn or lll,OA s C.AIlII!H ,.",.." /S),~ /l1 K+~ DlA'mA M !J.UfHAN D.": 1/ 1/96 a.t., 01 A"M: D,": P.u. '0.." 1/ 1/96 WARNING: h I. . ell"', I. '~o.lngry m.u 11'11 '"11""~U 10 'II. lI"hl 8tlln ,.. ,~'. 1111 ..., "t~" 'I.... 'olm """I. fit fI'''' .." 'hi' nU8 00'.8."....1001 U' ""'0"10'0 1I,'eUOIl U~ ...eloo'l .1In, '"' Im~IUlIl' Shepard'a/McGraw.HIII (800) 522.1050 PAGE 2 I I . ,7'0' "i:h'i; '::: ':' i:,.{i3..!J ~l~ [ij~i::"1 t;.1fJ';l oj i jL'1i:;rr.!i.1JJ~.1U\:-~:,~,:,:,:..~r(f~' ~,:;-~.: 1'1 ,/ '.H'- . """--- --......'1.... -- ..- ".. -"--~"f'''~ --.- - "'fltt' ~. ~ I.h' "" I " ... ...--- --- '--- ---- --:--- ,"{'" .>: f"'. O[r.AnTf.1r tiT nr TRANSPO~T,6T10N . . 'I~ r~>',/' CCRTlrJCAH OF TITLE FO~_ A_~_~~_~~~E3'697 . ,;;,,;~j: I:,;~j "",,'.1 '" "''''"/..",, ",,/, \..,"'" !I,,, ../1/.. I.'" /, 1...1" ,,,/,, 7'<, /',,,,,..,..,,,,,, {"""'/"'",..I.I,."",.. : .:"'1- ,,\:,. 872570015006596-001. . ':., k-, I 1,'\ '((,.c, LINDA 5 GA"RIEL I )Xi' :;"! ~ I' ""'"_I " 803 E CATHERINE 5T cooru:Gum I i?:~i' CHAMBERSBURG PA 17201 ^. M'"OllfvrHIC'( :'!i:J ,... c .. CI AS!-l!C '.'ftll:' r II.....' j.i~"~lj f ~ t~~~~~T~rl~~~{l'~~:",CLr, ':':( '~:,.'''..~.'"...';:.jj.I.:'' r." n . nrCOf'STnUCt[O V(IlICl ( I X . r om.ICnt Y A lAxl I 'l:.~' II';;" ". ':ii.,: i:';-' , " ~ '::"1 I "f': :f:;-.''i 35427744902 G~r'o 83 HONDA ;:;;~1'i ' .. :. ".' . -. ._..~. :. .,." ','.'r 0' ",,'Ct1 I!:f;;,jl ,I': "~ 1HGSZ?450DA015340 i,;'~'\ \1I"":lIrl'lf.l"f,', . ','.h,ln ,II. "-,'" IIltr,",~,"r(J"'u\',t,;"T 'l j [Ii; J)).;.' I u..,."..",',...., :1I,2~,t~~L.!207.<~~(,,83 on 37!J30, _ (0""; '~1, lilt ,.1.,,1. ,(1'\1"11''',,1 'U II 11I1 II 11I1)1"""'11 Jf'''III'';u~IiI/l\: r ""l ::;~~~'; 11U'111"'I-\\fII(f1I; Ilr"UUI:\"iIU I...:-,"'/" 11\11 .:0.. ! {:I,::., :i;-f" I.." :.~::!'. I "" "..",,, , "'1' " ~l ,': .:. l:\ _ -;,',-" ,,--- _I -.:"'. ",' , ,...... " "'!"j 'I f "'"111' I \\'"1/ ,'. '1'.1'4 11!::,:'i1' III' III'1EISlIl --;:", : ,,::> ,.: J I ;~~\ III ".",..",," ;,:,,;i..~.:..~.l1'" u 111"1:1111'1<11'111'1"'1111 _' _ I:;' . 'il!, "~I :" 1 / ."'i{. "".. """"",,,, "d.,,,,,, ',,,, ~.." "'.., '" ........"...,. II" ""...""." 'i :'i~'l'l ~ ;':~:' 1",,,"",1,,,,/., U/'/'!','r'"'''/'''''rI''''UII''' 1111. ,",,,, 11111I1, ,/",,,,_.,11....,,,,. I .. I "",I "",'111, 1"",'11"""'''''/''1'''' ,,,,,11.1,..,. I.....m"t.."/, .u;.t""rl"..,..,,, I . '"U''''''' ,1,. '''11I11I1' 1.1 ,lri. 111/"" ..I. """'/tl~. /1" "1'1'1" "'" 1/. ,,,.. ,..1"",", .., ,. ... .. \.".J ,. ~ I ~.';:':j .....1.01",/, 11/"..1..." /,....", II,,,,,,, ""'.,,1.,,, ,,,,,,,..,,/1,,....... II.. .."..".1 f~~Y ",.,,,1. "I //,. /'1'"'''''''''''1/1'1',,''''''''' .., I,,,..,f''''''''''''' "!I..' ,/,,,, ..",f J - I ...:.":J.",',.,,,....,...,,, /".,..1"",,,... "". "',,,', ,,,...,... ...."",.".""..".. r I . -' Irr 1;./ ;-- ~--- . '. _. -----~ _ . :YA: li1 '. ..tl.., "J'~ ..... ,.... ....... ,III', ,Il~r' ,:. .... :' i'. ;:f,'?,::;,-..1;:!~"t\:'...'.\r- =.....~y:. . .~:r.;j .~Il,!",::<' ::1.'. Xll.~li!j"i=.:''''i..'JIIJ.'i..lIJf;,Ul-....I;r, ,;.'::'ii." " 'l.-"':'~" U ,...J ,,, '.......~.'-.'7.:...,_,....,. . ~!I~~~;.~.~-';~~~1l..:.:..'!.;~IO!:...Jt..:.:..:!.~.. "':"..1 EMERALD DRUG 81 LL lNG- OEF',. 'Z300"N,)'RTJ:i"THYRO- 'stREEt".. . i-iARRi s. PAS DUE ** ."e.. IFTHEREISANYREASON ; WHY PAYMEHTS ON YOq" . PAST DUE ACCOUNT : HAVE HOT BEEN MAOE PLEASE LET US KNOW I I I I I I fA ~~~~ + ,v + ,.,. = (,97.<:J _ .00 - - DETACH HERE tOAS~.UIl[ PIlOl'[R CJl((jIT Pl[A<j[ ....Illll 'fOUll f'ATlftH ',UMUlIl Ot4 ~01Jf1 CII(C/o. AlID Ill'WIl4 W'''l n 1't)llT10f41';11U R(l.!ltlAllC[ DATE DESCRIPTION OUANTlTY AMOUNT O~/Z5/q& DLUE CRO~~ AUTO CIA liP 1 2.553.9~CR 021021% IlRI~T BRACE 1 55.00 03/25/Qb BLUE CRO~S IU~URAIICE PAV/I[IIT 1 4,3,.1.6(ICR OS/Ob/9b GLUE CRO:;:; III:URI.IICE PAVIILIIT 1 4,3n..5BCR 05/0./% DLUE CRO~~ IIl:URMICE PA'IIIEIlT 1 4,3(.1.66 05/07/% OLUE CRO~~ IlIPATIEIIT AOJU~TIICIIr 1 2.553,qz 05/07/% BLUE eRO:;S IfIPATItUr ADJU~n1EUr 1 2.571. 52CR ~ . c w " > " w . ~ ~ . c g " . ~ ~ u ~ ~~~ ill) ~ w " > . > . ~ /"1 . c tlO~ " ,,,", ......J,J\ , - ( 'I 1/'" : It ~ ~7\ :'1 ' , , IMPORTANT MESSAGE j.>Alltt41 t4AM!: L1I1DA S GADRIEL PAlIEPH !lUMaEA TlIAIIK YOU rOR U51t1G TIlE SERVICE5 OF TIlE 12.0027 CARLISLE H05PITAL. TillS IS A ZELr PAY ACCOUlIT. AIIO TIlE DALAIlCE IS COll510EREO ACCOUNT SUMMARY YOUR RESPOI15IDILITY, IF YOU HAVE IIl:;URAIICE COVERAGE PLEA5E FILL ItI TIlE IIlrOOIlATlOII 01 PREVIOUS 7.901.00 BAl,AP4CE THE RE'IER:;E OF TlI15 DILL. IF YOU HAVE AN'! QUE~TIOII~ CALL 249-.676 DETIIEEII 9AII AIIO t4E'N 55.00 CHARGES 4FII. I'A'fI.lElHSi OTH[R 6.943.IOCR ADJUSlI.IEt4TS CWlllENT ACCOUIH 1.092.90 OISCltARG[ I SER....ICE AAlAtICt' DATE O~/OO/96 IIEEO IIELP HITH OTIIER IlCDICAL DILL5 7? f1AH,I['H 06/03/96 AGREtMWT OUtDATt CARLISLE U05PITAL CLAlrl CARE 717-&:(.5-5158 A"'OUNT .00 PAY RET..m TIllS POATlOtl P"'fMPHS R[C[IV(O AlTER BlllllIG DAIE,\lll APPEo\I~ O't Pl[XT STATEM['jT THIS 1,O9~.90 AMOUNT 1 1 . I 1 ~ I j 1 1 I J D NO. AA 146582 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX "k 1I~1I62UI'."1 RECEIVED FROM: 6 ACN ASSESSMENT ':'I CONTROL ~ NUMBER AMOUNT MC KN I GHT r11'1RCUS 1'1 I I I 60 W POMFRET STREET 101 "'78.01. CARLISLE, PI'I 17013 ESTATE INFORMATION: t:I FILE NUMBER g 21-1996-0279 t:I NAME OF DECEDENT (LAST) ~ GABRIEL LINDA 5 II DATE OF PAYMENT m POSTMARK E COUNTY S5N 179-3(1-3684 (FIRST) (Mil CUMBERLAND DATE OF DEATH REMARKS m TOTAL AMOUNT PAID MARCUS MCKNIGHT $78.04 DO REGISTER OF WILLS 'y' RECEIVED BY , f,l,l" j J ,.' ,';:" IGHAt , . , I . ' ') MARY C. LEWIS '/. 1/.......". REGISTER OF WILLS SEAL CHECK II 10766 . - ---- . _ ~~.--...-N..... __.--1"1" a"}':. COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE *' BUREAU OF INDIVIOUAL TAMES ."I[AIlAHCE 'AX DIVISION OCPT. 110ftOl ItARRlnURQ, PA 11111-0601 NOTICE OF INHERITANCE TAM APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAM n'.I"""'''Ul.H) HARCUS A MCKNIGHT III ESQ IRWIN ETAL 60 W POMFRET ST CARLISLE PA 17013 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN S 10-22-96 GABRIEL 02-24-96 21 96-0279 CUMBERLAND 101 LI NDA Anount H..Ut.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 ~ iiEij:i54"i-E;CAFP-fo7":96Y-ijffrYcniF-YNHEifiiANCn'-liniPPRiI-iSEii€ijT~nA[DiwANCE-ifR------n--------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF GABRIEL LINDA S FILE NO. 21 96-0279 ACN 101 DATE 10-22-96 TAM RETURN WAS: I X) ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. R..l E.t.t. ISch.dul. A) 11) 2. Stock. and Bond. ISchedul. B) 12) 3. Clos.ly Hald stock/Partnership Int.rest (Schedule CJ (3) 4. Hartg.g../Not.. Raceivabl. (Schedule D) (4) 5. C.sh/Bank Deposits/Hisc. Parsonal Property (Schedule EJ (5) 6. Jointly Own.d P.opo.ty ISchedul. FJ 16) 7. Transfers (Schedule G) (7) 8. Total A...t. ) CHANGED 3B.500.00 .00 .00 .00 8.397,40 26.00 13,942.11 18) NOTE: To Insure proper cr~Jt to your account, subnit the upper portion of this forn with your tax payn.nt. 60.865.51 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expans../Ad.. Casts/Hi,c. Expans.. (Schedule HI (9) 10. D.bt./Mo.tg.g. Llobl1ltl../Ll.n. ISch.dul. I) 110) 11. Tot.1 D.duction. 12. N.t V.lu. of TaM Ratu~n 13. Cha~itabl./Gova~nn.nta1 a.qu..t. (Schedule J) 14. N.t Value of est.t. SubJect to Tex 9,647.33 6,057,88 Ill) (12) (13) 114J I ~,70~ :>1 45,160.30 .00 45.160.30 NOTE: If an assessment was issued prBvious1y, 1inBs 14, lS and/or 16, 17 and 18 will reflect figures that include the total of ~ rBturns assessBd to date. ASSESSHENT OF TAX: 15. Anount of Lin. 14 at Spou..l ~.t. (15) 16. A~t of Lin. 14 taxabl. at Lin.aI/Cla.. A ~at. (16) 17. A~t of Line 14 taMable at Coll.t.~.I/CI... 8 ~.t. (17) 18. Principal Tex Du. .00 M .00= 45.160,30 M .06= .00 X ,15= (18) .00 2,709.62 .00 2,709.62 TAX CREDITS: PAYMENT DATE 05-23-96 08-01-96 RECEIPT NUMBER AA112868 AA146582 DISCOUNT 1+) INTEREST 1-) 131.58 .00 AMOUNT PAID 2,500,00 78.04 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 2,709.62 .00 .00 .00 · IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN '1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU HAY BE OUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) f)' RESERVATIONs E.t.t.. of d.cedent. dyIng on or before Dec~r 12, 1982 -- If any future Inter..t In the ..t.t. 1. tran.f.rred In po.....lon or enJay.ent to Cia.. 8 (coll.ter.l) beneflclarl.. of the decedent aft.r the explr.tlon of any ..tat. far llf. or far y.ar., the Co.-onw.alth her.by .xpr...ly r...rv.. the right to appral.. and a..... tran.f.r Inherltanc. ,.... .t the lawful CI... B (callat.ral) r.t. on any .ueh future Int.r..t. PlJRPO<( Of NOTlCE1 To fulfUI the r.qulr....,t. of Section ZlltO of the Inherltanc. and E.t.t. Ta. Act, Act 22 of 1991. 12 P.S. Section ZlltD. PAVHOf1': Detach the top portIon of thl. Hotlc. and .ub.lt with your p.y.ant to the R.gl.t.r of will. printed on the r.ver.. .Id.. __.... check or lIOn8y order p.yabl. to: REGISTER OF HILLS, AGENT All payaant. rec.lved shall fIrst be applied to any Inter..t which .ay b. due with any r..alnder applied to the tax. REfUND(CRh A r.fWld of a t.lC credit, which wa. not r~.ted on the TalC Return, .ay b. r~.tad by cOIlpI.Ung an "Application far R.fund of p~.ylvanla Inherltanc. and E.tat. T.... CREY-IlI]). Application. ar. .vallable at the Offlc. of the Reglst.r of NUh, any of the 23 R.vltl'lU8 District Offlcu, or by calling thtl .pKlal 2"-hoUr answering servlc. nuabar. far far.. orderlng1 In Penn.ylvanla 1-800-362-2050, out.ld. Penn'Ylvanla and within local Harrl.burg ar.a (717) 787-809", TOOl (117) 77Z-2252 CHaarlng lepalred Only)_ OBJECTIONS: Any party In Intere.t not satl.fled with the appr.I...-nt, allowance or dl.allowance of deduction., or ....sa.ant of talC Clncludlng dhccx.nt or Int.rut) .. shown on this Notice IN.t Object within .lxty (60) d.y. of rec.lpt of thl. Matlce bYI "written protut to the PA tktpartaent of R.v8tll.M, Board of Appeals, Dept. Z11021, Harrisburg, PA UUI-IOZl, OR --.lectlon to haY. the .att.r dtItBr.lnad at audit of the ecCOU'1t of th. per.onal rapr..entaUv., OR --appeal to the Orphan.. Court. A'"tlN ISTAAT1VE CORRECTIONSI Factu.1 error. dlscav.red an thl. a......ent shoUld be addr....d In writing tal PA D.part.ent of Aev.nue, Buraau of Indlvldu.1 T...s, ATTNt Po.t A.....eant R.vlew unIt, Dept. 280601, Harrlsburg, PA 17121-0601 Phone (717J 787-6505. See page 5 of the bookl.t "Instruction. for Inherltanc:8 T.. R.turn far II R.sId.,..t aecadent.. (REY-1501) for an ..planatlon of adIIlnl.tratlv.ty carrect.bl. error.. DISC(U(l1 If any tax dutl Is paid within thr.. (]) calendar .ontht after the dec.dent". death, a flv. p.runt C5X) dlscOU'1t of the t.lC paid Is .1lC>>HId. POUl TV: The ISX tax __.ty non-partlclplltlon J*\8lty Is cCMIPUted on the total of the talC and Int.r..t ......ed, and not p.ld before January liS, 1996, the flr.t d.y IIft.r the and of the talC ,..,.sty period. This non-p.rtlclpatlon pen.lty I. eppBalabl. In the .... .annar and In the the .... tl.. p.rlod a. you would appeal the t.lC end Int.re.t that ha. bean .....sad III Indlc.tact on this notice. INTEREST I Inbrut Is charged beginning with first day of delinquency, or nine (9) IIOMth. and ana (1) day frE* the d.t. of death, to the date of p.YHnt. Tax.. whld1 bee-. cMillnq.MW\t bafare Janu.ry I, 191Z b.llr Inbrut lit the rat. of .1lC C6in parcent per""""" calculated at a d.lly rat. of .00011A. All tax.. whld1 bee... cMi1Jnquent on and aft.r January I, 1912 will bear Inter..t lit a r.t. which will v.ry fro. calendar year to calend.r y..r with that rat. announced by the PA Dapartaont of R.venue. The appllcabl. Int.r..t rat.. far 1982 through 1996 .r.1 '!!!! Int.re.t Rate Dalh Inter..t Fector ~ Inter..t Rat. Dally Int.r.st F8Ctar 1912 'OX .000548 1917 .~ .000Z"7 1915 IU .000411 19&1-1991 It:( .0DOlOl I... Il~ .000301 I'" 'X .0002U 1915 UX .DOQ!56 1995-1994 "IX .00011JZ I'" I'~ .00027" 1995-1996 .~ .0002U --Int.rest I. ulcullltad .. follows: IKTEREST = BALANCE OF TAX UNPAID X HUftBER OF DAYS DELINQUENT X DAILY IKTEREST FACTOR --Any Hotlce I.sued .ft.r the tax beca... cMillnquant will r.flact en Int.r..t c.lcul.tlon to flft-.n (15) day. beyond the date of the a....a.ant. 11 Pllywent Is aada aft.r the Interut Cu.putlltlon date shown on the Notlc., additional Int.re.t MIst be calcul.ted.