Loading...
HomeMy WebLinkAbout96-00335 4 ~ ~ ~ ~ I ~ <..9 cr \ -- ~ '0 CI) .. . 0 0 1;; z ,.- " q t i 'I I ! 111' ,d, , d ,~l d h ';\1 h I dl ,I \~ II II lilt 1... 1 IHI'!' I'.' 11,1111 1,1 Id1t1r Till, " III 111111\ lh.ll tilt 1I1I"1I11111,,11 Ii' II ,'j\ 1.,It.d Hq',,>I',lI lIlt ,"tl,I~'Il" llltdll dl.\ \il ill t,.1 I: " 'I, 1:". WARNING: It Is IlIe!)olto dllplicatl' Ihi. COIIV bV photostnt e>r photogrnph, ,:'/ 1(. ,..; S~) .../.-" //) J'Jp./, 7'1. (.JIf!.,.\!,?:'..1 /.. /0 I... ,:~,.,'~~~~ .- II t' '''I dll~ II llrlll ,IH ~.' (fll ".,,<~\,i\'oipi1>" (I.:t~. :~/~, , .):., ...... .. r;:~ \\ I :!~', ~.' ".~~\ \' '.. >~ . ,~ . ' 'i &,' ..,. . ,:.. \:~..! ~ " -1'." 1,.""/ '~~t!!.~~J'/ :(j~ re? I, ';' 1),LIt 3399575 Nil COMMONWEAlnl OF PENNSYlVAUlA' DEPARtMENT OFHEALtIt. VITAL REconus CERTIFICATE OF DEATH '" , Female '...11'......'_" .;,UD.l.At:l;Jl'!l........t111t . ISO - O~ lllo.(orlllollllolu.,h.., -, . ~'cbruary 5, ll)f)() I1AW( Of OlClOlHT ,I'. ....,... IMI 1 renc I.. IInrn !Jlol(lIIlIDll' -,.---- -'!-- ~tOf""ltl U.....,h.._1 .;HltlfO\M:l.l...... ........tl...'l'.....'t ......cl n. ~lJlun........<....- _, .'..1.............._ IIC~LlL .' -- .- """".....rJ 0&01 "..,ItoW.wrt UHOl",\'1.>>l ......- i 00"- I Aug. IJ,ltJllll York COllnty,l'A , on IlOftO rvw,.OfDtIJIt I"'-.ll'"a,^,''''''~''''''' .)...."'"oJ.~..,_. Wldte ~IIolQSI'OU!ol ,.-,..-....- IUoCt_._..._IIlMt..-.- ,~...I,I ~I':'",{J Cumbcrlallll tt.i'!J~:=':::.. YO~fh,\lIy'"1Mtr8"'''''' .....IO"~'..... !1 ""Qr6#oHG}~~~~r;ft~mfm1"~ysbl1rg, PA 170f,3 l!L J'\aUOf' D1$f'OSo1110H.~DlC;;'-"""""'1Dfl L(x;,uIQH.c:,.,.,....It...,.c:... 0I0lf40..... Holling Green Hemadnl ltk Camp lIill, It,\ 17011 , .......,,I,fIOUJOlUpDfTAC..IIX bid I'A 11010 SloncMltlrrayl:1140B Jrd St New Cum cr an t ... 1 $lG""II.ITII""'DI11It~IR.11I2 -/~' l' ~. l!L__n.L~c(L~< (d'<t? 1<'I"UtIllI,lNA JO SIQJl(~Ju.o"UI'!_1 III" .l!JiJ~j?hf:~/---,'~~'''''' ~#il- "'I,I[lHtIoUlOt'ns.OfA'~Mlttll'\ottOc;OJt"'f)tOc:.wSf:OJ[it'1I1 ~ .......nfypu."""'..I.,t"..../ ,)~{,...~.. IOJ'(_-4I.:. ./~".'" ~f/7(J;-:J 9S '" COUI'tn 01 tuJlt " Cumberli.llld Worrnleysburg 1,I....."'ISWU~ 1,1...... ".,..........,"'_... O'-I.or.......ltl Widowed ~lOOOOfllll~!i DlCI()(N1SllSU.I.lOCC:\.INl~ 1l~:u.~~'t:.'a;:.::::J.:~ , lIollSCWl l~ 11 DlUDlN'.S......IHO..OOMUr.,a... C..,.\}oon r.w.1",CnWl nume OlCIDlN'S 'f""" flUCl(tfC.1. ,--............. ...~- Wormll!ysburg 76 Grecnwuod Circle .. Wurmleysburg, ItA 17043 'alHlASKAMl...II.......'.1Il , lU.1QC l.yt Ie ""'0f\M0Ul1..........11~"'.- Hary I.ouise Strickland loIltltOOOf SI'O"IllOH ...... ~ c......- 0 AeoNoIII.."",It..O l;llNr1'>i*-'" ". Of'UHI.~YAW;IUCl W. ~ Z."""" ._".c....,......~ _.........-u_Dldf.... ~..-IIl.._ 1~....&I. ,""....a..-._ .__..01...... , r~uJ-- ~- , : , O"'''OfOo~SlIU'f ,.........0.._1 II. }o'l!hnHlry I), 19'16 tlCIN~1 NlJfoltllM fll OI2J42-1. LlCl,,!tI,HUl,Itllfl OIlIIiGHlO ,........0..,_. IIMlQftA...." OAl..PIIONl)Ut4CIDOlAD,I,I.... 1"1 ..... MSc;;.l~ ....'1 fll\f.U 10 Ioll~ ll.UllttlfllCOAONIAt .....{] ,.~ 1'Af!11; O"'f9"Il<"'~_"""""OI"- ....1.-.......~~lil'"....."""'1 " lL " ""'t; ......._..............IQIOICIlolIII__"~lNdf"" Or!NII......._IIi""""I1 toUl"'.._..........""...- .,........"".u. ,..",_,_OOI.IIJI_ {t (fC ,rl;H ,..1f-'~"f\' 42L1~"'LJ.LA1L-.- DUllOlUl~.t~OU(NC:It.A1 // I: DUlIOIlfIA,$"LlIi''''OUf.t.ci.~._.- ----.----~. ---- DUI ~lidiiji'"""".(;Tjii----------- --- , , _....__.____l. ',U[OfINJl.JA' ..JUtl,,uWOfl.ill O[!jCAllllt<Oi'l~'OCCUNllO O"'[(>I'HIIJ'" ......., I", "..~I Mftf..UroPS"IHlItHCiS IolANltfROfOlAlM --."..f'N)A1O (OUf'l.."ClHDfC"UU l'll {] OIOU'M' .... -~ ".- II P..oJot.._.......... [I _D ... [} ..~ [I '-~.~...'_...t II K'f-_________._ "'-._-~ PI..Kt(JflkI\iflY.,,_ ,_ ",...I...-.QIIll. ~IIC,:.._..\ ... ....1 [] .....l'l N5.- __ Ht.--- LC)(;AJlOHl......\,;~'''_'Mr.. .. ... ""IIIIlA .u...... '.e1 '""'nINO""'''''......'''',.. _,,,,,,",._ <J ...... oil... ~'._lI'.'" _, .nl.......~ ......... ...~I..........,....~ .'1, ,...........,_..-'""'....IIIK.""............._II.....-'.....'... '~IHQ..HClC.IIl'..'IHQ,.,"tCI.lJ1,"........b.......'......._....I,.'.~'..... .... ......1 r.... ......."" ,........ ",".""'1'" .1.... _,.... .... "M.,........'" ...,.......,.... .......... " ..,,'" ...IPICA&. U""IJfI",COROfolIIl On 1II.,...... ......-III)Oft .....,.. 1n.'.'''"00ft. Ill"" DfI"'OOft,d..I"OCI'"'''' .111'1.1...... ",... ,1>4 pioN'. .ndd...,.,,,. ,.....t.,.,., "...._'...111.. ....................... ............... .. .' .. ...., -- '..GI~llUR'\lG.lt...uM~ .r. /.?,7 ~,./..,~_ ~(dILJLl [J II 't....~,.~. :'...~"'~'7Z i / 'J 9t. 1-, . . RIV.UOO(K'I,QJI w .. ~~cn ..,,,,,,, w~u xC'" u"'''' ~'" ~ .. ... "'z Ww "''' "'z 8~ , , 'J ( (\ 'J ~' A~:'r. 'r~ rJ"., .,~ '....)... ...,.". INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) I fOR DATlSOf DIATHAmR 12131191 CHICK HIRE If A SPOUSAL . POVERTY CRIDIT IS ClAIMID I fiLE NUMBIR bll 9~ 33.r COUN1Y CODE YEAR NUMBER fXll. Original Relurn D 4. limiled E\tale [1 .to. Future Inlere" Compfomi$o Ilot dolen of death oher 12-12,821 Qg 6. Decedent Died Te\late [] 7. Decodenl Mointained 0 living Trull (Aneth copy of Will) (Alloch copy of Tn"'l) ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO, (OMMONW(At1H Of PEUUSYLVAtllA OIPARlM(NT Of RfVfUUE DIPI 780bOI _,_~H~~~!~_8U~.o. P'A I !~, ?8~bOl_ OICIOItH!I ,.,.AM{ Il"'~I.II''.II. M.O MICOlt ItHlJAtl .. z w " w u w " lIorn, Irene L. ,oc,~ :~U~'~~~~i~~;~r'~ ;~'~.;~ I" "'L'{UIII 'Uh',"'(, vouu ~ '.....'Il." ".$' .....ll ....(,(:d ..,1"11 NA II 2 NAME Mrs. Mary Louise Strickland TElEPHONE NUMIER :.63-82R 1 Ot(IDlrn'')(O~Pllll ,100011'.1') _ \U~'~~'~'~'i;900 r"'~"(U"'","M'" __ Supplemcntnl Return 76 Greenwood Circle wormleysburg, Pa. 17043 ("""'f Cumber land - A,..oUi~1 At(tl\l(OI~tt .t.I,)TIlU(lIOtl~'-~- ~ - - --- - ---- -- --.--.- z " 3 => .. A: .. u w '" 1. Real e,tale (Schedule A) 2, SIocl. ond Bond. (Schedule BI 3. Clo,ely Held Stock/Parlnenhip Inlere" (Schedule C) 4, Mortgage, and Note, Recei'Voble (Schedule D) 5, Cash, Bonk Depo,it' & MiICellaneou, Penonol Property (Schedule EI 6. Jointly Owned Property (Schedule F) 7, Tran.fe" (Schedule GI(Schedule l) 8, Tolal Gran Aneh (10101 line, 1.71 Q. Funerol Expense"~ Adminl'troli'Ve Cosh. MilCellaneou, Expen,e, (Schedule H) 10, Debt,. Mortgage liobilitle" lien, (Schedule I) 11, Total Deductionl (total line, Q & 101 12. Net Value of e'late (line 8 minus line 11) 13, Charitable and Go'Vernmenlal Beque'I' (Schedule JI 14, Ne' Value Subject 10 Tax (line 12 minus line 13) Spou,al Tran,fen (for dole' of death after 6-30.941 See In,truction, for Applicable Percentage on Re'Vene Side, Ilndude 'Value, from Schedule K or Schedule M.) Amounl of line 14 tall able at 6% rate (Indude 'Value, from Schedule K or Schedule M.) Amounl of line 14 tallable 01 15% role (Indude 'Value, from Schedule K or Schedule M.I Principal tall due (Add tall from line, 15. 16 and 17.) Credih Spou,al Po'Verty Credit Prior Poymenh [j3 [J 5, .o....B Remainder Relurn (lor dale' 01 dealh prior 10 12.13.82) Federal E,late Tall Relurn Required Tolal Number 01 Safe Depo,il Balle' IS, 16, 17, z " !i lB, ... 19. => ~ '" " u >< 20, .. .. 21. COMPltTt MAtllt~G ADORns 76 Greenwood Circle Wormleysburg, Pa. 17043 (1) __.m__'_~_____"__ 121._ .--. - - -, ---~--- (3)______~___- 14) -___________ (51 _ ..-~------ ,-----.----~ ._LV8.,_li.?l,_!~__ ( 61 (7) ._---_._-_..._.._~._---_._--~ (BI_.~ 218,_651.15 19) 6,618.76 ---.-.------ --~_._---------- (10) _"__ (11) ~_6.L6l8. 76 (12) __._~~_'032. 39 (131__________,____ (141 212 032_-3'.l o (IS) o ____. ___.__)C. ___~= (16) _212,032.,39 o ___.J 2_, 721,.94___ o x ,06 = (17)_- ,___ox ,IS = (lBI ___1.2_, 721,_~4.__~ DiICounl Intere,1 + $12,085.84.$636.10,- (lQI (20) 12.721.94---- If line 19 is greater than line 18. enter the difference on line 20. Thi, i, Ihe OVERPAYMENT. aD ...:r:n1l,(,jl..t..j.II...,..,-I,IIUtlhI!-'.'.II'IT."r:~.'.l'lll.'l''(.U~'.I,,(.111 If line 18 i, grealer than line 19. enler the difference on line 21. Thi, i, the TAX DUE, A. Enler the inlere,t on the balance due on Uno 21A. B. Enter Ihe lolal of line 21 and 21A on line 218. Th;, i, the BALANCE DUE. Make Chick Payable 10: RlgIII., of Will,,_ Ag,nt >- >- BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH -<-< ~~der penalties of perjury. I declare Ihall hO'V8 examined thh rei urn. including occompon}'ing ,~hedule' and ,Iolemen". and 10 the be,' 01 my ~nowlodge and belief. Ill' true. corrccl and complete. I dedare thai 011 reol fnlole has been reporled 01 true marlel ...alue. Dedaration of prf!parer olher than Ihe personal repro'onloti'Ve j, bo,ed on all information a' which preparer ha, any knowledge ~IG:aTUA[ Of PEASON A{SPON~IBH fOf! ~~~~-f~:ii~~-~D-DiiT~~---- "7 6G-r-ce-n-Wt;o(f-.c~1. rcTeU----H.------.-------- O-Aff __,/))14~.ili'::'::'::':~::..,.40~~~,..t.;-.-L.--.. _Wormlcysburg, Pa. 17043-.---- 4/25/96 51GNATU1f 0' 'rPARfA OTHlA 'HAr~ IlIPlllSftllATI\lf AO~~(SS ci:ii------------ (21) 121A) (21BI Act #48 of 1994 providoslor 11,0 roduction 0111,0 lax .alos irnl'olud on Iho nul vllluu 01 "nnslu" 10 or lor tho use 01 the spouse. The roles as prescrlbod by Iho slalulu will 1,0: . 3% (.03) will 1,0 applicable lor 0510101 01 docodonh dylllg on o. lilt.. 711/94 "'HI hulo.o 1/1/96 . 2% (.02) will 1,0 applicablo lor 0110101 01 docodonh dying on o. olt.. 1/1/96 IInd helaro 1/1/97 . 1% (.01) will 1,0 applicablo lor ellalol 01 docedonh dying an or alter 1/1/97 anti holor. 1/1/98 . Spousal Iransfers occurring on or altor 1/1/98 will 1,0 oxompllrom Inh.rllanco lox. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (V") IN THE APPROPRIATE BLOCKS. 1. Did decedent make a tranlfer and: YESTNO I I i i X -----.t--.--- ! X a. relain the ule or income 01 the property Iranllerred, b. retain the righlla delignale who Ihail Ule Ihe properly IraOlferrod or ill income, t--- I , X 1-- , ! X c. retain a reversionary inlerelt; or ........,....,........,....,...., d. receivo tho promilo lor lile of eithor poymenll, bDne/ill or caro~ , ' ,.-.-- i ! ~+---. I X 1 ~-~ I X ,_-1- 2. If death occurred an or before December 12, 1982, did decedonl wilhin Iwo yen" preceding death Iransfer property wilhout receiving adequole conlidornlion~ II delllh occurred oller December 12, 1982, did decedent Iranller properly wilhin one yelll of denlh wilhoul receiving adequale cansideralian~..,..,..............,..............,.." ......, ........' 3. Did decedenl own an 'in truII lor' bank accounl III hil 01 1111, rl.lllh~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. .. . .. IIYI\l'l9f1. pi III w SCHEDULE F JOINTLY -OWNED PROPERTY COMMQt4W[AUlI OF rWUS'flVAHl4 INnUItANCf IAll AE1URI4 IUS\D[HI DECED[Nt 1E NUMB~R ESTATE OF lIorn, Irene L. Joint II"ontl')1 - --- -----.- - ------ --- NAME ADDRESS RELATIONSHIP TO DECEDENT _n ______ .~_.__.__ A. lIorn. Irene (.. 76 Greenwood Circle Wormleysburg, Pa. 17043 Self B. Strickland, Mary Louise 76 Greenwood Circle Wormleysburg, Pa. 17043 Daughter c. Jolntly.owned prop.rly: ITEM NUMBE LEnER FOR JOINT TENANT A - B 8/6/9_ $85,000. 2~ yr.CD "3054872 First National Bank of Marysvi11e A. CREATElJ CD. SEE PROO' ATTACIIED - EXIIIBIT ]. DATE MADE JOINT DESCRIPTION OF PROPERTY TOT AL VALUE OF A5SET DECD'S DOLLAR VALUE OF % INT. DECEDENT'S INTEREST $95,234.72 000 50% $ 47,617.36 1. (6% ) 2. A - B 1/4/9 $100,000. ] yr. CD $100,461.33 50% "3057545 First National nOD (6%) Bank of Marysvil1e ROLI.ED OVER FROM DAUPIIIN DEPOSIT BANK & TRUST CO. A. CREATED CD. SEE PROOF ATTACIIED - EXIIIBIT 2. 50,230.67 3. A - B 3/28/ 5$90,000. 3] mos. CD $95,621.00 50% "8]0065739-4 Dauphin nOD (6%) Deposit Bank & Trust Co. ROI,LED OVER FROM YORK FEDERAL SAVINGS & LOAN A. CREATED CD. SEE PROOF ATTIICIIED - EXlIlIHT 3. 47,810.50 4. A - B 2/8/95 $40,000. 2 yr. CD $42,837.48 50% "300-]730-5, "3821 Pa. DOD (6%) State Bank. ROI.LED OVER FROf1 FIRST NATIONAl. BANK OF MARYSVILLE. A CREATED CD. SEE PROOF ATTACIIED EXIIIBIT 4. 21.410.74 . -------.---------.----.. --_._-~-- TOT Al (Aha enter on line 6, Recopilulolion) SCONTINUED (U more 'rncr. is t1prdl!d ;"'1'1" oclelilinnol ,hefl" or some ,iz'!} . - ll"'U~U.III'1) j * COMMOHWE,lUH Of rEHNSnVAtUA IUHERltAHCE 'AX UIURH RESIDENt DECEDENt _ SCHEDULE F JOINTLY -OWNED PROPERTY .._._...,... u....._...__-._ -----.-----.- --.-.....- -, . --..--' - rili NliMiiii E5TATE OF Born, 1 rene I.. -.. ._~.._.._..-_.._- Jolnllononl(')' .. - - - - - --..- APDun RIlA 1I0NSltlP TO DEClDlNT __~.M_ _______.___ NAME ---_._._-~_..- Hot r A. Born, lrene L. ., (, (~ll'f'nwtIlJfI f'i I f'l f' WOlml"ynlllll<), I'd. 1'IO~1 B. strickland, Mary I,QulRe 7 (, (~"fll'nwnf)ll (" I f'l r' Wlllmll'ynllln<). 1'/1. l'IO~:1 Ilnughter c. ---------...-- Jolnlly..own.d prop.rtYI ---- ---------.. ..-- - ..--'--- .. ,.----. ITEM LEnER DATE FOR TOTAL VALUE DECD'S DOLLAR VALUE OF NUMBE JOINT MADE DESCRIPIION OF rROPlRTV OF ASSET % INT. DECEDENT'S INTEREST TENANT JOINT -----.-.--.-- ...u._....____ ICO TINUED: 5. 8/6/9, $50,000. 3 CIl $56,~56.06 50'/, 28,228.03 A - B yr. fl025(,1~7752 FlrRI 1l0D (6% ) FCllernl of Barr I RIlIIrg A. ClmATEI1 CIl. Rim 1'1100 . ATTACII"11 - 1':XIIII1IT 5 . 6. A - B 10/29/' 0 Commerce llilnk, Camp Bil ,$~5,197.30 50% 22,590.69 1'/1. 1701\ DOll (6% ) Checking Account flOr,1201(,213 7. A _ 11 1/271, (, Two (2) $75. Un \lell Slnll'" Silvln(lR 1I111H1R, (6%) SI'rtl'" E $ l,49~.32 50% 1l01l 747 .16 ___..__. +... u__'__ _.._.__ -- TOTAL IAllo onl.' o~ ~n~.6:Ro~llp~u~:~0~1___s.1.)..!!.!-65l ~~- (If mOl" 'roc" is ",..efflC' in"",' mld.'ionol ,'u~nl, of 10,"" sill"} U\lI)II(..I'''1 ESTATE OF ITEM NUMBER ~~!~.~(\ .....,.,. COMMONWUl1tt Of PWNS'l'lVAlUA IIUIUIIIANC( tAX Af.)URU AlSIDENt DECEDENt SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPE_NSES Ploa.. Print or Typo ~FILE NUMBER ._~______ __..____.__.._ __.__. ____.--1 1I0rn, I rene I,. DESCRIPTION AMOUNT A. Funeral Expon..., 1. 2. 3. 4 . B. 1. 2, 3. d. C. 1. 2, 3, d. S. 6, 7, 8. $ 5,769.00 stone & Murray Funeral Borne, New Cumberland--include clergyman and organist fees, opening of grave, etc. pealer's Flowers (altar vases and casket spray). OJ's Catering, New Cumberland, Pa. - Luncheon follow- ing Funeral Services. 226.79' 145.75 Borst Memorials, Palmyra, Pa. - Bronze Marker, etc. Admlnl.tratlve co.ts: 427.00 Personol Represenlative Commissions Social Securily Number of Personal Repre.enlative: Year Commissions paid Allorney Fee. Family Exemplion Claimanl Address oJ Claimanl at decedonl'. death Street Addrell Cily Rolalion.hip Slate __ Zip Code Probate Fee. MI.cellanoou. Expen.os: Telephone Toll Charges - Bell ^tlantic & ^T&T 22.96 Certified Mail, Return Receipt & stamps 12.26 Register of Wills, Cumberland Co., Filing Fee 15.00 TOTAL (Aha onter on line 9, Recapitulation) (II more spaco Is neoded, Insert addlllDnol shoo" 01 sarno .Ize.) s 6,618.76 1'1 ( I ~ / / ~ ' l' NOTICE OF INHERITANCE TAX \ APPRAISEMENT. ALLOWANCE OR DISALLOWANCE \ OF DEDUCTIDNS AND ASSESSMENT OF TAX L FILE NO. COUNTY - ACN 101 REV-1547 EX AFP (12-951 ~ CO""ONWEALTH OF PEHHSVl YANIA ' DEPARtMENt OF REYENUE BUREAU OF INDIVIDUal fAXES ,~-~. ~ OEPt, :80601 ~ HARRISBURG, PA 171za-0601 '&:: DATE 05-27-96 Zl 96-0135 CUMBERLAND ESTATE OF HoRN DATE 01' DEATH OZ-05-96 IRENE NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT. SUBMIT THE UPPER PORTION OF THIS FORM WITH YOUR TAX PAYM~NT TO THE REGISTER OF WILLS. MAKE CHECK PAYABLE TO "REGISTER OF WILLS. AGENT" REMIT PAYMENT TO: MARY LOUISE STRICKLAND 76 GREENWOOD CIR WORMLEYSBURG PA 17043 REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 A"ount Re,d U.d (" CUT ALDNG THIS LINE ~ RETAIN LDWER PORTION FOR YDUR RECDRDS ~ rtEV:i54j-EX-AF-p-n-Z:9SY"NOTicE--OF-YNHERiTANCE-TAic-APPRAisEHENi'-;-Ai.t'owANCE-oli----------------- DISALLOWANCE OF DEDUCTIONS ANO ASSESSMENT OF TAX ESTATE OF HORN IRENE L FILE NO. ZI 96-0335 ACN 101 DATE 05-Z7-96 Z18,651.15 TAX RETURN WAS: I X I ACCEPTEO AS FILED I I CHANGED RESERVATIDN CDNCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE DF RETURN BASED ON: ORIGINAL RETURN 1, R..I Est.t. (Schedule AJ (11 2. stocks end Bands (Schedule B) (2) 3. CloselY Held stock/PartnershiP tnterest (Schedule C) (3) 4, Mortgages/Not.. Receivable (Schedule OJ 14) S. Cash/Bank Oeposltl/Hlsc, Personal Property (Schedule El IS) 6, Jointly Owned Property (Schedule fJ Cb) 7, Transfers (Schedule G) (71 8, Total Assets .00 .00 .00 .00 .00 Z18 ,651.15 .00 IBI 6,618.76 .00 Illl 1121 ll31 ll41 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funerel Expenses/Ad", costs/Mise, Expenses (Schedule H) (9) 10. OobtslHortgogo L1obilltles/L1ons ISchedule II llOI 11, Total Deductions 12, Net Value of Tax Return 13. Charitable/Governnenta1 aequests (Schedule J) 14. Net Value of Estate Subject to Tax 6,61R 76 ZlZ.03Z.39 :00 21Z.032.39 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 dats. ASSESSMENT OF TAX: 15, A~ount of Line 14 at Spousal rate (15) 1&. A~ount of llne 14 taxable at Llneal/Class A rate (lb) 17. Anount of Line 14 taxable at Collateral/Class a rate (11) 18, Principal Tax Due NDTE: .00 X,OO= ZlZ,03Z.39 X.06= .OOX.15= lIBI .00 lZ, 7Z1. 94 .00 lZ,7Z1.94 TAX CREDITS: PAYMEHT DATE 04-Z5-96 RECEIPT NUMBER AAllZ715 DISCOUNT I + I INTEREST (-I 636.10 AMOUNT PAlO lZ.085.84 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TDTAL DUE lZ, 7Z1. 94 .00 .00 .00 . IF PAID AFTER OATE IHDICATEO. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. I IF TOTAL DUE IS LESS THAN '1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREOn" ICRl, YOU MAY BE DUE A REFUHD. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) '.. U'l <::> ~ r'" ("\, ~"" ,',l C::i r"l >- ~~ c";: C: ,...0:.: ci '.l.J PI ..0:5 UU RESERVATION I E.tat.. of dlcldent. dying on or bllor. Oec..b.t 12, 198Z .. If any lutur. I"t.r..t In thl ..tat. II tran.f.rred In pal....lon or enJoy..nt to Cia.. 8 (col1at.ral) bln,flelarle. of thl dlcldlnt aft.r thl Ixplratlon 01 any ..tat. for 11'. or for Ylar., thl Co..onwaalth hareby Ixpr.s.ly r...rva. thl right to appraise and 8"1" tran,f.r Inherltancl ,.... at thl lawful CIa.. 8 (collat.r.l) rat. on any such lulur. Int.r..t. PURPOSE OF NOTICE: To fulfill thl requlra..nt. of Section 214Q of thl Inherltancl and [.tat. Tax Act, Act ZZ of 1991, 72 P,S. Section 2140, PAYKEHT: D,tach thl top portion of thl. Notlcl and .ubalt with your pay..nt to thl Ragl.tar of Willi printed on the revlrsl sldl, uHah chick or .oney ordlr payable tOI REGISTER OF MILLS, AGENT All pay.ents rlcelvld shall flr.t be applied to any Interest which .ay bl due with any rl.alndlr appllld to thl tax. AEFUND (CA): A refund of a tax crldlt, which was not rlqulsted on thl rax Return. .ay bl requastld by co.platlng an "Application for Aefund of PlnnsYlvanla Inhlrltance and Estatl Tax" (REV-IlI3). Application. ara available at the OffiCI of thl Alglstlr of Wills. any of tha 21 Rlvlnue District Off leIs, or by calling the sPlclal 24-hour answ.rlng service nu.bers for for.s ordlrlng: In Plnnsylvanla 1-800-362-2050, out.ldl PannSYlvanla and within local Harrisburg ar.a (717) 181-8094, TOO' (717) 772-2Z52 Ollulng IIlpalrld Onh). OBJECTIONS: Any party In Int.rast not satlsflad with thl appralsa..nt. allowanel or dlsallowancl of dlductlon., or asslss'lnt of tax (Including discount or Interlst) as shown on this Notlcl MUst objlct within sixty (60) days of rlcllpt of this Notice bYI uwrlttln protnt to the PA nlparblnt of Rlvlnue, Board of Appaals, Dlpt, 281021, Harrisburg. PA 1712a-U2I, OR "elactlon to havI thl .attlr datlr.lned at audit of thl account of thl plrsonal rlpresentatlve, OR .-applal to the Orphans" Court, ADNIN ISTRATIVE CORRECTIONS: Factual errors dlscovlred on this as.ess.lnt should bl addressed In writing to: PA Dlpart..nt of RevenuI, Bureau of Individual Taxe., ATTNI Post Assass.ent Alvlew Unit, Oept. 280601, HarriSburg, PA 11128-0601 Phone (717) 781-6505. Sel page 3 of thl booklat "Instructions for Inhlrltance Tax Rlturn for a Re.ldent Dlc.d.nt" (REV-ISOI) for an e.planatlon of ad.lnlstratlvelY corr.ctable errors, DISCOUNT I If any tax due I. paid within three (3) calendar lonths aftlr the deCldlnt"s dlath, a five percent (5~) discount of the tax paid Is allowed, PENALTY: The 15X tax aanesty non-participation panalty Is co.putld on the total of the tax and Interest assessed, end not paid blfore January 18, 1996, the first day aftlr the end of the ta. .anl.ty plrlod, This non-participation plnalty Is appealable In the sa.e .annlr and In the the sa.e tl'e plriod as you would apPlal the tax and Interest that has bien as.essld a. Indicated on this notice. INTEREST I Intere.t I. charged beginning with first day of dlllnqulncy, or nine (9) .onths and one (1) day fro. thl dati of daath, to the date of payelnt. Taxes which blcaee dellnquant before January I, 1982 blar Interest at the rat. of SIM (6~) parcent per annul calculatld at a dally rate of ,000164, All taxIS which blca'l dlllnquent on and aftar January I, 1982 will blar Interest at a rale which will vary fro. callndar Ylar to calendar year with Ihat rate announcld by Ihe PA Dlparlaent of Rlvenue. The applicable Interest ral.s for 1982 Ihrough 1996 are: !!!!: Intarest Rat. Dally Interest Faelor :!!!r Inlerest Rale Dnlly Inlerest Fnclor 1982 20% .000S4a 1987 9% ,000241 1983 16X .OD043a 1988-1991 1l~ ,000301 1984 l1X ,000301 1992 9% ,000247 1985 13X .000356 1993-1994 7% ,000192 1986 10;( ,000274 1995-1996 9% .000247 uInllrnt I. calculated .. follows I INTEREST = BALANCE DF TAX UNPAIO X NUnBER DF OAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notlca Issued aftar the la. beeo... d.lInquent will reflect an Inlarlst calculation to flft.en (15) dan beyond Ihe dall of the anen.lnt. If pay..nt Is .ad. aftar the tntlrut coapulatlon date shown on the Nottce, addltlonel Inlerast .ust be calculated,