HomeMy WebLinkAbout96-00292
PETITION "'OH PIWnATE llnd GHANT 01; LETTERS
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I{cghtcr Ill' Wills for thc
Cuuntyof CUlIllll.'rl.llld in the
Cllmmllnwcalth Ill' Pcnnsylvania
Thc pctitilln III' Ihc nndcl\igncd rcspeetfnlly rcpTcscnts that:
Yonr pctitillncr(s), whll is/arc 1M ycals Ill' agc or Illder .mlhc cxccnt .. \."",
inlhc last will Ill' Ihc ahllw deccdcnt, datcd ~1I"t 21.,
and cllllicil(s) dalcd N/ ^
namcd
, 19...2lL-
(\lalC fcIC\iIllIl.:Hl:lIIl1\IOlIll:C\, C.lo!. rCllundaliun. dealtl nf c'l'('UltH. cle.)
Deeendent was domiciled at death in Cumber'l and
her last family or principal residence at Cumberland County
Niddlcscx Township, Cumberland County, PA
(Ii\( \trcCI. number ilnd mundpalil)')
County, Pennsylvania, wilh
Nursing lIome,
Decendent, then 9) years of age, died ~Iarcb 12 , ,19 96
at Cumberlanu County Nursinq !lome, Hiddlcscx 'l'ownshin. Cumbcrlc1nd County. .1'/\.
Except as follows, decedent did nol marry, was not divorccd and did not have a child born or adopted
after cxecution of the will offercd for probate; was notthc victim of a killing and was never adjudicated
incompcccnt: no except i cns
Decendent at dcath owned propCrlY wilh estimalcd values as follows:
(If domiciled in Pa.) All pcrsonal propcrlY
(If not domiciled in Pa.) Personal properlY in Pennsylvania
(If not domiciled in Pa.) Pcrsonal properlY in County
Valuc of real estatc in Pennsylvania
situated as follows:
$
$
$
$
2,500.00
WHEREFORE, petitioncr(s) respectfully request(s) thc probate of the last will and codicil(s)
pTesented herewith and thc gTam of lellcrs tes tamen ta rv
(tclitamcnlary; admini\tr3lion c.t.a.; admini!lU31ion d.b.n.c.l.a.)
theron.
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Goldie Naltz oj
200 Nilbur St.. Liverpool, P^ 17045
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. , Iluth Hoyel!
0\ Nillow Hill Park Ild., Hechanicsburg, PII
17055
OATH 01; PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA }::;8
COUNTY OF CU~IBElll.^ND
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The petitioner(s) above-named swcar(s) or affirm(s) thatthc statemelllS in the foregoing petition are
true and correct to thc besl of thc knowlcdge and belief of petitioner(s) and thut as personal represen-
tativc(s) of the abovc dccedent petitioner(s) will well and truly administer thc estate accoTding to law.
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No. 21-96-797
Estate of
pgAUI. I. IlUFF I NG'l'ON
I Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW APR (L 9. 19~, in consideration of Ihe pelilion on
Ihe reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED thatlhe instrument(s) dated Au<)ust 24. 1990
described lherein be admitted 10 probate and filed of record as lhe lasl will of Pe,," I I.
Uuffington
and Lellers Testamentarv
are hereby granted 10 GOI,DU, \~^I:rz and HU'I'II HOygU
. ~~ (' Il) Ii' (\1- II
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1/ Rogisle' or Will> U
, ~lARY C. LEWIS
FEES
Probate, Lellers, Elc. .........
Shari Ccrtificates( 2) .. . . .. . . . .
Renuncl3l1on ................
'X"-~age
JCP
S 25.00
S 6.00
S
3.00
S 5.00
TOTAL _ S 39.00
APRIL 9 1996
.............,.....................
Harlin U. HcCaleb (063531
ATTORN~y tSup. Ce. 1.0. No.)
219 E. Main St.. P.O. Ilox 230
t-1cchnni cshurQ. PA 17055
ADDR~SS
Filed
(717) 691-7770
PHONE
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M^,U.IN II t." t Al III
~ST WILL AND TESTAMENT
I, PEARL I. BUFFINGTON, of the Township of Lower Allen,
county of Cumberland and Commonwealth of Pennsylvania, being of
sound and disposing mind, memory and understanding, do make,
publish and declare this as and for my Last will and Testament,
hereby revoking and making void all former wills and codicils
by me at any time heretofore made.
FIRST. I order and direct that all my just debts and
funeral expenses be paid by my Co-Executrices, hereinafter
named, as soon as conveniently may be done after my decease.
SECOND. I order and direct that all my furniture and
household contents be liquidated by my Co-Executrices,
hereinafter named, and sold at public sale.
THIRD. I give and bequeath and amount equal to five (5%)
per centum of my Estate unto the CHURCH OF THE BRETHREN, of
Mechanicsburg, Pennsylvania, for use in the general fund.
FOURTH. I give, devise and bequeath all the rest, residue
and remainder of my Estate, real, personal and mixed,
whatsoever and wheresoever situate, in equal shares unto my
nieces, GOLDIE WALTZ and RUTH MOYER, share and share alike,
absolutely and in fee simple.
~STLY. I nominate, constitute and appoint GOLDIE WALTZ
and RUTH MOYER, Co-Executrices of this, my Last Will and
Testament, to serve without bond in this or any other
jurisdiction.
IN WITNESS WHEREOF, I, PEARL I. BUFFINGTON, have hereunto
set my hand and seal to this, my Last Will and Testament which
consists of two (2) typewritten pages to each of which I have
affixed my signature this
, ,
Po '.(
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, '. '; ~ . l
day of
A.D., One Thousand Nine Hundred Ninety (1990).
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; , -:' (, / /, ::"'(.1 ,q:~ (SEAL)
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The preceding instrument, consisting of this and one (1)
other typewritten page, each identified by the signature of the
Testatrix, was on the date thereof signed, sealed, published
and declared by PEARL I. BUFFINGTON, the Testatrix therein
named, as and for her Last will and Testament, in the presence
of us, who, at her request, in her presence, and in the
presence of each other, have subscribed our names as witnesses
hereto.
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS
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.j ;.:i 110'.: :'li II I{Odd
::l::l~I'I:I~; (,: .:.i;l;;. ;'.'" . i<. ~ ;l;~~ '::1.":;-1 ;l.(;~ . . (-\-).).; .... . ... . .
""""1
~ -" ~'
. ~t.~ ;(.lIteil ,~'cli.
r: C t', ." .1" II':' \ 'H' " ,... ,... ~ ^ .'.. ',,: .... I..' ;.......
Ln..' 01 f iCt.s . ;.1;lrl ill H. :'ICl:.i!"h
:) Ytj' i':~I'~::" :.i.; i ;\.'s r ;.~:,~t.:' .1; ~ l)',. .j;';IX..'; .~i;.". ..... .
.................-.......-.......-.....-.............
:'kchall ic';hul"j.., 1',\ l.-'(h')
......-
~-: ...
in ::>..
'i ,/1'>8.(,&
57.620.19
(1.8,1& I. :,3)
Now.-
(118.161.5'1)
0.00
0.00
IJ.OIJ
0.00
0.00
O.IJO
0.00
O.IJIJ
~..H
1..2-//-y.(
;10":(
/..1-11-9("
,," ISOO I"... ~, ",
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A MARK (X) IN THE APPROPRIATE BLOCKS.
YES NO
1. Old dcccdOnll1\Jko il tl.:lI\:1IC1 and'
x
a. Iclam tho use or II\C0l110 011110 PIOPCI'Y lr.lIl~IUlICd
x
b. retain tho IIghllO deslgnJte "hho ~l1all u:;u 1110 PlOptJlt'o/ uan~lollod or liS 111COnlO.
x
c. !clam a JOVCI!;ionJIV IIlIClost or.
x
d. recolVo tho plOltllSO tOllile 01 QllllCr pavr11{1I11~. bUIlUl,l!; 01 c.lle}
2. It death accuned on or I:clof(~ OCCClllbf.:1 12. '9f:2. d.d decedel1t Wlll11111'hO VC~lIS plcCCdlllg ooall1
transtnr plOpC1tV wllhoullCCCl\lttlq .:ldCqUil!C COI\:.lom al.Oll? 11 doath DeclInud JIICI OcccmbCl 12.
1982. did dccodcnllranslcl propcllV 'o'iltlllll Olle waf 01 dualll WllllOllt ICCWVlllg adequate
conslderiltlon?
x
3. Did decedent own on '1I1lrusl 101' bonk .Jccounl iltlllS 01 her dC.:lIIl?
x
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES.
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
~Of'" 1500 ;R".... !~'+ll
COOV"qttlltl1991 'mm 101t".1'IIO nf'I'1 ':""'~' ....:t' ':",I!,..I<" ,',
,._~
,
'(,
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"
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IAwonltp.
f.'^RLlN R McC^LEU
LAST WILL AND TESTAMENT
I, PEARL I. BUFFINGTON, of the Township of Lower Allen,
County of Cumberland and Commonwealth of Pennsylvania, being of
sound and disposing mind, memory and understanding, do make,
publish and declare this as and for my Last will and Testament,
hereby revoking and making void all former wills and codicils
by me at any time heretofore made.
FIRST. I order and direct that all my just debts and
funeral expenses be paid by my Co-Executrices, hereinafter
named, as soon as conveniently may be done after my decease.
SECOND. I order and direct that all my furniture and
household contents be liquidated by my Co-Executrices,
hereinafter named, and sold at public sale.
THIRD. I give and bequeath and amount equal to five (5%)
per centum of my Estate unto the CHURCH OF THE BRETHREN, of
Mechanicsburg, Pennsylvania, for use in the general fund.
FOURTH. I give, devise and bequeath all the rest, residue
and remainder of my Estate, real, personal and mixed,
whatsoever and wheresoever situate, in equal shares unto my
nieces, GOLDIE WALTZ and RUTH MOYER, share and share alike,
absolutely and in fee simple.
LASTLY. I nominate, constitute and appoint GOLDIE WALTZ
and RUTH MOYER, Co-Executrices of this, my Last Will and
Testament, to serve without bond in this or any other
jurisdiction.
IN WITNESS WHEREOF, I, PEARL I. BUFFINGTON, have hereunto
"
CO,""VONWfAL 1" Of 1'[~lN';'fl VA"-IA
IN~llHl' A!>jC'oTAlC Ill" I UlHiI
fl[SlOENl (ClOt,...'
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
Plll,I!;" PUlll 01 Tv "
FILE NUMBER
;>L -%-02'J2
RtV. ,~o. [).. 11-81)
ESTATE OF
55:: IHIl-lll-ll%)
U3/12/I')%
Pearl 1. BuffInGton
All 'opo
ITEM
NUMBER
1
oint! -ownod with Ale hI O' SUfvlvorshl must be disclosed on Schedulo F)
VALUE AT DATE
OF DEATH
1,837.31
DESCRIPTION
CumherIaml CounLY Nursl nG
Home I blllanc(! of decedc'nt I s
guest home account.
2
Capital 811", Cross. refuud
of insurance pl'PlIliulIl.
196.10
3
ACCOlnlt _100-117479. York
Federal Snvi ngs tv. I.oall
Assoc.. pn.'.pilid llllll'L'~ll
account.
7.410.26
4
ACCOlnlt _100-117479, York
Federal SavinGs & 1.0''''
Assoc. I interest ,1ccl"tu.d to
0.0.0.
11.. 99
S <J ,115H. 66
TOTAL (Also clllel UIl hllL!~. Rl.'C.lr.lllll.1l101l)
(AII.1e11 adl.hllOnal 0 1/2' l( 11. ~11(.'d:i II I1KlIU ~pilCO I:; Ilcoedud ,
Copyllghtlc)l991 fOlm loll.....'" llf11, Cf'"It'1 P'f'Cf' !;()tt"'J'f', lnt.
I""" 1500 '3t"",\1u1fl E I"..... 1-e11
(L~\H,.II)I.W( II( III 1" 1'1 ';~"'~i \ill"'"
''''''lllITA';rr 1AIIlI lPll';
Il( ~,1(J( NlllL<-L lJl ,,\
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
PIU.l!.U Pllll! 01 Tvpo
FILE NUMUER
1l-<J(,-02Yl
IlL V . l!ol' r. . l~ fll
ESTATE OF
Pt.arl I.
ITEM
NUMBER
A.
/lull ill '! ,,"
SSII IHlI.ln.!)'lh)
Ill/I.' /1 "'II,
OESCRII'1I0tl
AMOUNT
Funoral E)lponsou:
Nycrs FlIIll'ral
hi 11.
110111(', f lt11l'ra I
6,900.1,0
2
Rice Memorial Works,
engravillg 111~lrk~r.
60.00
B. Administrative Costs:
1- PClso'l;,)1 RCPIU5CIllJIlVO COllUlll~;SIOt1:j 300.00
Social SCCUllly Number 01 FClSOlwl Rcple$uIIIJh...l.' 16:'-26-'>21,7 and 186-24-9722
Yoar COI,"n15f.ioIlS pi:ud .-1227
2. AflOIllOY Fuc:; I,OU.OO
3. FamIly E)(cl1lpholl 0.00
CrJlIllJllI Rul.l11011511ip
Address 01031111.1111 al deCL'dcnf:; d(~all'
Sllcel AddlCSS
City 5';110 ZiP COdo
4. P,obalo Feos 11,9.00
C. Mlscellanoous Expenses:
TOTAL (Al<;o 1'1l1t~1 onllllt! 9. R(!C.lpllul.lllOll)
(IImolO ~1);.lC<! 1$ lIt..'eded IllSCll .ldcl11Ion,,1 ~;I1(:t:t$ 01 ~;,Jlll() :;IZO)
5
7.809.1,0
COPY'II'.1tlIIC! t 'J91 tn' ", ~,,11"',"" ""I't ;::,,"1... P,"c.. '~'" I!" .)'" ."
f! ".,1500 SClll'<.lull' H IRl'~.1.~tl
!\[V. Ul1El+ {1o'Plil
ESTATE OF
COMMO~jW[Al tIt OJ 1"lj!<l':''fl \lAfljIH
INIl[RlfA!<lC[ TM IlrlUllf'i
R[5IDEN10('[U(,..'
SCHEDULE I
DEBTS OF DECEDENT
MORTGAGE LIABILITIES AND LIENS
FILE NUMBER
21.9f>.0292
Penrl I. BuffLnl\ton
SStI IHO.I0-05U2
03/12/1996
ITEM
NUMBER
I
DESCRIPTiON
AMOUNT
25.00
NovnCar(~ 0 f P(~nllsy 1 Will i at
medical expense. ,aCCOllllt
pnyable.
20.",.5.25
2
Commonwealth of
Ponnsylvania, Depnrtm{!I1t uf
Pub 11 c We lfnre. cln 1m 1'01'
relmbursellwnt fol' IIl<'dlcnl
expenses paid fol' sel'Vlces
rendered to dec",lellt Id thlll
finnl six months.
29,3[.0.54
3
COllllllonwea 1 th 0 I'
Pennsylvania, (),.pnrtm,,"t of
Public Welfal'e, claim 1'01'
reimbursement for lII('dlcnl
expenses pnid for "('I'vices
rendered to decedellt prior
to finnl six months.
$ [.9.810.79
TOTAL (Also cnlC1 on hno 10, Rccapllulahol1)
(It male spoco is needed, IlISOll addlllonal sheels 01 some SI20.)
Copyl'ght leI '991 101m sotlw"'. (lllly C.ntf' PI.'. Snlt",,,'f, Ine
FOlm 1500 5ehfch.lt' I (Rev. '-!Il)
~
~
I ~ ~
-;iJ, :l:-
COMMONWEALTH OF PENNSYL VAfllA
DEPARTMENT OF PURLlC WELFARE
BUREAU OF F1tIAlIC1AL OPERATIONS
TPL SECTIDtI . CASuALTY urnT
P.O. BOX 8480
HARRISBURG. PA 17105
July 5, 1996
MARLIN MCCALEB ESQ
POBOX 230
MECHANICSBURG PA 17055
Eotate of: Buffington, Pearl
C!R: 21-0071327
Date of Birth: 11-30-1902
Social Security #: 180-10-0562
Dear Attorney McCaleb.
Please be advised the Department of Public Welfare maintains a claim in
the amount of $49.785.79, against the above-ment ioned estate. This claim is
for restitution of medical assistance granted on behalf of the decedent for
which the Probate Estate is now responsible to reimburse the Department
according to Act 49, 62 P.S. 1412, effective August 15, 1994. as amended by
Act 20-95, effective June 30, 1995. Enclosed is the Department's itemi:ed
Statement of Claim.
A portion of this medical expense, namely $20,445.25, was incurred
during the last six months of the decedent's life; therefore, it is a Class 3
claim pursuant to Section 3392 of the Decedents, Estates, and Fiduciaries
code, 20 Pa. C.S.A. 3392(3). The balance of the claim, namely S29,340.54, is
to be entered as a priority class 6 claim against the estate.
please acknowledge receipt of this letter and advise whether the
Commonwealth's claim is admitted and when payment may be expected.
_:rc1Jt~.-J~
Thomas H Gar! ic
Claims Investigation Agent
(717) 772-6725
Enclosure: Statement of Claim
. ,
_._._-~-----_.."---
--~
I DATE: 07/03/96
COMMONWEALTH Of PENNSYLVANIA
DEPARtMENT Of PUBLIC WELfARE
STATEMENT Of CLAIM
NAME BUffiNGTON, PEARL
10 550127354
J
MEDICAL CLASS 3 CLASS 6
INPATIENT 0.00 0.00
OUTPATIENT 0.00 40.5?
LONG TERM CARE 17,981.52 25,865.84
DRUG 2,463.73 3,434.11
TOTAL 20,445.25 29,340.54
TOTAL REIMBURSEMENT TO OPW
49,785.79 I
Ij.....'l/
rOil r,,,,rr"', or O[ATH M 1 [n 1}1'11111 r.ll[~\f., Il[l~(
IrA':."')U....r.t 0
rDv[lIlf (nr~l' I~ l;Lf.I',.tO
FILE tlUr.1U~n
INHERITANCE TAX RETURN
RESIDENT DECEDElH
(TO BE FILED III DUPLICATE
Willi nEGISTEIl OF WillS!
r';'lt41,'-.1[l[
"ri,ll
API - l!lOO EJ t{I'.911
o
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C
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o
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E P 0
C R C
K I K
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C p
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R rl
R 0
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CO""""(\NWr .'1 TII (w PI PHI"",lL \lMjl.\
ul.l'Antr.Hrlf ,-,r lit \lIIHH
'/11" :~,'r,'1I
'l^nlll~IIJlIli,I'A It':~ III.UI
UIJ',lfHII
UlCr.Ol tIT'':. t:{)r.~PL[ 1[ ....unlll ':.~
o(croEt"'S rIAM( II.A!JI. [Hl!;.T, AtlU ",HUULE Ifllll.llI
BuffinGton
Pearl I.
375 Claremont Drive
Carli.nle, Ponnnj'lv\lnia 17013
SOCIAL ~Ecunl''( 'juI.10[ n
180-10-0562
X 1. 00g1l1:11 RClurn
f',,':'f(.r!lllltti
[] 6. Decedenl Died TCSIJ10
(Moch copy 01 W,II)
1113011 "02 ':"",, ClImh" rtand
SupplcrtlonlJI Rehllfl 0 J.
o 4a. Future Inlcre51 COII'PIOI1W..O 0 5.
(lor dales 01 doalh Jllm 12-12-B~)
o 7. Decedent f.1JllIIJIllf!d " U'/Hlg flU:;1 8.
(AI1:\:11 J copy 01 TIU:;I)
Rem,llndcl RC:IUIIl
(101 dales 01 dCJlll pllor 10 12-1:]-O::n
Fl!C.lelal E:;tillO TillC
R'~IUln RCQUlred
TalJI fhlll1ber 01 Sale D.!PO~lt Boxes
o 4. Umllod EolOlO
ALL CORRESPOrlOEIlCE AIlO COIlFIOErlTlAL TAX IIIFOnr,IATIOIl SlloULO OE olflECTEO TO:
NAME
Hnrlin R. HcCal~).
COMf'lE Tt '..1A1Lllj(j AconESS
Law Officos - Harlin R. McCalob
219 East Hnin Street, P.O, BOK 230
t-h>chanicsIJllri'.. PA 17055
tlol1o
EStuire
R
E
C
A
P
I
T
U
L
A
T
I
o
Il
TELEPHOU[ '~uM()ER
717-691-7770
t. Real Estalo (SCII(!duIC A)
2. Slacks "lid 8o"d~ (St:llCdulc B)
3. Closoly Held StackiP<111llClSlllP 1111010:;1 (Schedule C)
4. MOltgJqo~ and Nolc~ RCCC1VJble ISclledule 0)
5. Ci1sl1. Bank O~po:;IIS & M1SCCll.lIlCOUS Persoll:11 Frape,'.,.
(ScllCdulc E1
6. JOlllUy Owned PIOPP.lty (Schedule F)
7. Ttanslers (Sclmdule Gl (Schedule L)
8. Tolal GlOSS Assels (Ialal hnes 1-7)
9. Funeral ElCpcnscs. AdlllllllSII<lILIJC Cas's, r.k;ceIIJIH'!OtIS
E1ponscs (SCIll!dulo H)
to. QoblS. t.1ollqJge LIJ~lhIlCS. Liens ,Schedule I)
11. TOIJI QeducllOIlS (lot.111t11cs 9 & 101
12. tlet Valuc 01 ESIJle (hllO a mlllUS hne i1)
13. Cholltabio and Govcll1mOnlJl8oouCSI~ ,Schedule J)
t4. Net Valuo Sublcct to TJlC thllO 12 mum:; 111\11 1:!}
t5. Amounl 01 line 14 IJx.:tble 31 G'~;.IJ'C
{lncludO values horn Schedule K or Sch(;dulu r.1.1
16. Amounl of linc 14 laxJble a115~o IJle
(1I1CluOO VJIUCS 110111 SchctJule 1\ 01 Sclu'dule r.l )
17. PnllclpallillC dlle (Add IJX Irem hlle 15 Jud Irom IIl\I! Hi I
18.CICdll:USp Poveltv Pllor PJ'/rnems D,~cou"l
o . 00 . I) < 00 0 . 00
t9. IIlino 10 IS qloalOf lIlJIl hne 17. Oilier IlIe dlllelcllca all hila 19, TIlls IS 1110 OVERPAYMEUT.
~ 0 Check here It you are requesting a retund at your ovcrpOlVIl1Cnt.
20. 1111110 HIS greater UlOI1 hne 10. OilIer 1110 dlllcrcnce on hne 20. TIlls IS t1H! TAX QUE.
A. Enter 1110 mlerest Ol1lhC billJnCO duo online ':OA.
B. Enlor Iho total 01 hne 20 alld ::OA on 11110 208 TIll!; IOj Ill(! BALAUCE QUE.
Make Check PJv.:tblc 10: RC(listcr 01 Wills, Ancnt
(,0)
( ,OM
( ,08)
0.00
0.00
0.00
(I)
(,)
(3)
(.1)
(5)
tJOtlt.'
l'lolle
l10ne
9.h5B.66
NOlle
NOlle
(6)
(7)
9.458.66
(B)
(9)
7.800.1.0
49.810.79
(10)
57.620.19
(/.8.161.53)
NOlle
(48.161.53)
0,00
(15)
(II)
(I,)
(lJ)
(14)
o < 00 '06.
T
A
X
C
o
r~
p
U
T
A
T
I
o
tl
(16)
U.8.161.S3'\X,15=
0.00
(17)
O.Oll
IlUmest
0.00
(IB)
(19)
0.00
O.llO
~ ~ BE SURE TO ArlSWER ALL OUESTIOIIS OIlI'AGE ,Arm TO n~CItECK r,IA TIt ... ...
Una!!, Dfn,ul'fI\ al t:~'t..,v, I afltl,lrfll"JII t..l.l" l'..,,,,..,~(t I"'~ '~'U"l. ,,- ~;..., .H.:n"'ll.:l"""'~~'- ,,~'.!....... ,1",J ~Ul","~"l~ _1".11:'l1.... r~!I:' '''y .~.,..,~~:f' ~'.., tfl"~1 ,I" HUfI
COlll'tl ,,"tI CO...c;,.~f'.1 d..CIJ'~ ",-,'.:III If'd' ~\l.)'fI ",n- t..~...t~l("'f'o:l." ..~~ '"I'.''' .-.1,,,,, S"C'J'.I" In 'I' :.,~:,,\'''' .,,1'(" '''l" 1". t''''~O''l' '.~'''!f'''.\1 .f"'\ ~,I!..o.1 on .I'I,"UHmJI'C" 01
",'11th al.flJI~1 r'J5 .1"'" "'0 ""f'<lCl"
::tI.f[
Slc.tlAfuRt OF ;I!:;;SO~' n[~f'OW3l1.!L[ ::i11 FIL'~Hj;o[ L ,'fj ol.LC;'lE '.:;
Ruth t. 1.lover
4. .',;i i't"~;: :ilii' <p.~;,;i....'--.."........ ........ ..-
it~.~I;:l;;i~::i;t;':i:.: .i'~;;I;,;~,Y'.:,;;,.i.; -. Y:'I<IS<S" - -.... <..
I), -/1-7t
o..tt:
o\lJC:;t:~
Law Offices. Marlin R. McCal~h
2Y~i .E:;!;c. :.r;i ;1' .~; t i'~:(;r-.. OIl ~ t)',. 'B~)~.:o .2~()'...... ...
_jl;":'< <..,' ::,i;,;i:j;': .i',:':. .Ui..:i:i' <......... <...........
.""...41..'"
REV-lS11EX + 11-851
COMMONVwE' AL TH O~ PENN5VL VANIA
IN"'E~lrolNCE TAx ~ETURN
RESICENT CECECENr
ESTATE OF
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
03/12/1996
Pe.1r1 I.
ITEM
NUMBER
A.
Buffington
55= 180-10-0562
DESCRIPTION
1
Funeral Expenses:
Myers Funer31
bill.
Home. funeral
2
Rice Memorial Works.
engraving marker.
TOTAL (101::0 entcr on line 9. RCC0101111t011101\l
(II mOIC space IS IIcooed. lIl!;Clt JCdlllonal StlCt.!I!: at same ::;1:0.1
CCCyfll~"II'll9!il1 tafm lal1Yfn. only Cen'" P,~,e 501110111' ....,
Pl0;1~C PfIIlI or Typo
FILE NUMBER
21-96.0292
AMOUNT
6,900.40
60.00
Is
7.809.40
/:J- 'IS -/,0{
BUREAU OF INDIVIDUAL TAXES
INlIlRIlANC[ tAll DIVISION
DlPl. ..aobOl
ItARRISBUMG. I" 111:8-01.001
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE Dr INIIERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
MARLIN R MCCALEB
219 E MAIN ST
PO BOX 230
MECHANICSBURG
ESQ
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
PA 17055
03-17-97
BUFF ItlGTON
03-12-96
21 96-0292
CUMBERLANO
101
Amount R..,lt ted
(I
~
~ ~
"'to. ~f~
~ ~;~'4J.;~
~I..;\t~
Ut.l",...It lll-".
PEARL
I
MAKE CHECK PAVABLE AND REMIT PAVMENT TO:
REGISTER OF WILLS
CUMBERLANO CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiEV:i54j-E'iCAFP-io:i:iiiY"iioYicE--OF--itiHEiiifiiiicE-YAX-iippRiiisEHEiir-;-,n.i."'OWANCE-OR----m----------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BUFFINGTON PEARL I FILE NO. 21 96-0292 ACN 101 DATE 03-17-97
If an assessment was issued previously, lines 14, 15 and/or 16, 17 and 18 will
reflect figures that include the total of ~ returns assessed to date.
ASSESSMENT OF TAX:
IS. A~ount of Line 14 at Spousal rat. (IS)
16. Anount of line 14 taxable at llne.l/Class A rat. (16)
17. Anount of Line 14 taxable at Collateral/Class 8 rat. (17)
18. Prlnclpal tax Due
TAX CREDITS:
PAYMENT
DATE
TAX RETURN WAS: I X) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..I Est.t. (Schedule AJ 11)
2. Stocks and Bonds (Schedule OJ (2)
3. Closely Held stock/Partnership Intarest (Schedule C) 13)
4. Harts.ges/Hote. Receivable (Schedulo D) C4)
s. Cash/Bank Deposits/Hisc. Person.l Property CSchedule E) CS)
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Ada. Costs/Hisc. Expenses (Sch.dul. H) (91
10. Dobts/Mortg8go L18bl1ltlos/Llons ISchodu1o II 1101
11. Total Deductions
12. Net Value of Tax R.turn
13. Charit.ble/Govern~ental Bequasts (Schedula J)
14. Net Value of Estate Subject to Tax
NOTE:
RECEIPT
NUMBER
DISCOUNT I')
INTEREST/PEN PAlO 1-)
CHANGED
.00
.00
.00
.00
9,45B.66
.00
.00
(81
7,809.40
49.810.79
1111
1121
1131
114)
.00 X .00=
.00 X .06=
.00 X .15=
118)
AMOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
NOTE: To insure proper
crodit to your account,
sub~it the upper portion
of this form with your
tax p.y....nt.
9.4:i!!.:.M.
~7 .6:>0 Ig
48,161.53-
.00
48,161. 53-
.00
.00
.00
.00
.00
.00
.00
.00
8 IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS TNAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. I
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RESERVATION: [stat.. of dacadents dying on or bafor. Deeeabet 12, 1982 -. I' any future Intero.t In the ;;tata i~Cfran".rr.d
In pOI.e.slon or enJoy..nt to Cia.. a teol1.taral) beneflclarl.. of the dacadant a,t.r the ..plratlon of any a.tate for
11'. or for y..r., the Co..onw.8Ith hlreby ..pro.slv t...tve. the right to apprals. and .I.a., trans'.r Inherltanca Ta...
at the lawful CI... a (eollat.ral) rat. on any such lutur. Int.r..t.
PURPOSE OF
NOTICE:
To fulfill the requlr..onts of Section 214D of the Inheritance and Eltata Ta. Act, Act 21 of 1995. 72 P.S.
Sactlon 914D.
PAYMENT I
Detach the top portion of this Notice and lubelt with your pay..nt to the Raglstar of Will, printed on the ravar.e .Ide.
.-Hake check or 1II0ney order paYllble to: REGISTER or MILLS, AGENT
AEFUND (CA 1:
A refund of a taM credit, which was not reque.ted on the Tax A.turn, .ay b. reque.ted by co.pletlng an "Application
for A.fund of Penn'yl~anla Inh.rltanc. and E.tat. Ta." CAEY~I!ll). Application. are a~allabl. at the Offlc.
of the Aegl.t.r of Will., any of the 21 A.v.nue Ol.trlct Offlc.., or by calling the .peclal 24-hour
an.w.rlng ..rvlc. nu.b.r. for for.. orderlngl In P.nn.yl~anla 1-&00~162.2050, out.ld. P.nn,ylvanla and
within local Harrl.burg ar.. (717) 781~&094, TOa. (111) 77Z-ZZ52 (Hearing I.palr.d OnlyJ.
OIlJECTlONS:
Any p.rty In Inter..t not .atl.fl.d with the appr.I....nt. allowanc. or dl.allowanc. of deduction., or .s......nt
of taM (Including dl.count or Int.r..tl a. .hown on thl. Notice .u.t obJ.ct within .Ixty (60) day. of r.celpt of
this Notice by:
ADHIN
JSTAATlYE
COAAECTIONS:
.-wrltten prote.t to the PA O.part.ent of A.v.nue, Board of App..l., Dept. 2&1021. Harrl.burG, PA l1IZ8-1021, OR
~~.Iectlon to have the ..tt.r det.r.lned at .udlt of the account of the p.r.onal r.pr..entatlv., OR
.~app..1 to the Orphan.' Court.
Factual .rror. dl.coverad on thl. ........nt .hould b. addr.'lad In writing to: PA aapart.ant of Rev.nu.,
Bureau of Indl~ldual T...., ATINl Po.t A..el...nt Aevlew Unit, aept. 280601, H.rrl.burg, PA 17128.0601
Phon. (711) 7a7~6505. 5.. page 5 of the bookl.t "Inltructionl for Inheritance Ta. Aeturn for. A..ldent
Oec.dent" CAEY'ISOl) for an ..planatlon of .d.lnl.tr.tlvely corr.ctable .rror..
DISCOUNT:
If any taM due I. peld within thr.e (]) calendar .onth. .fter the dac.dent.. d.ath, . fl~. percent C5~) dl.count of
the t.. paid I. allowed.
PENALTY :
Th. 15~ tax a.ne.ty non~partlclp.tlon penalty I. co_putad on the tot.1 of the taM and Inter..t ..I..I.d, and not
paid b.for. January 18, 1996. the flr.t day .ft.r the and of the taM a.n..ty p.rlOd. Thl. non'partlclpatlon
penalty I. app.alable In the .... .annar and In the the .... tl.. period a. you would app.al the t.. and Int.r..t
that ha. b.en a"..led a. Indlcat.d on thl. notlc..
IHTEAESTr
Int.r..t I. charg.d b.glnnlnG with flr.t day of dellnQU.ncy, or nln. (9) .onth. and on. Cll day fro. the date of
d.ath, to the date of pay.ent. 1..e. which beca.e d.llnquent b.for. January I, 1982 b.ar Int.r..t at the rat. of
.1. C6%) perc.nt p.r annu. calculat.d at . dally rat. of .000164. All ta.e. which beca.. delinquent on and after
January I, 198Z will bear Intere.t at a rate which will ~ary fro. calendar year to calendar year with that r.t.
announc.d by the PA a.part..nt of A.~.nue. Th. applicable lntere.t rat.. for 1982 through 1997 are:
'!!!! Inter..t Aat. Dally Int.rnt Factor ~ Int.r..t Aat. Dally Int.r..t Factor
1982 20iC .000548 1987 n .000241
1981 16~ .000438 19B8~1991 II~ .000301
1984 II~ .000301 1992 .~ .000241
1985 In .000356 199]~1994 7~ .000192
19&6 lD~ .000274 1995.1997 .~ .00QZ41
"Intere.t I. calculated as follew.:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
.~Any Hotlc. I..ued after the tax b.co..s d.llnquent will reflect an Intere.t calcul.tlon to fifteen CIS) day.
beyond tha date of the a..e...ent. If pay..nt is aade after the Inter..t co.putatlon date shown on the
Notice, additional Int.re.t .u.t be calcul.ted.
. ,
STATUS REPOHT UNDER RULE 6.12
Name of Decedent: ~AA't.. I ,i? '" /-y/AlG raN
Date of Death: ~~ /~I IrP6
Will No. .:1/- 9~ - tU7i!.- Admin. No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes X No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No. I is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes No )( .
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest? Yes)( No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
Date: A,r.'/ '"it 1993 1u-M2 ~
Signature
;l(IVI,;;R. ~c-&h
Name (Please type or print)
/If).,thx ~J'cJ. ~,..t!h- IJ4
Address I ~,
Vd (
IJr,
"qUIrl~
"'1::1
[0: W ZZ I!r1V 86.
(or'i') CI/- ?7?O
Te I. No.
S,..-
l!"
)0
Capacity:
Personal Representative
)( Counsel for personal
representative
0U
,):)~18
(MAH: rmf! AM3)
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