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Home My WebLink About96-00355 \; ~ , ~ ..... \ 0 CD ... . a 0 ... en Z LLI - .... PETITION FOR GRANT OJo' LE1TEnS (n: ADMINISTRATION Estate of _. ulJO klloWII UJ J (jJi4..~~~Xi() .C!!.L'l No. To: __._.___21 .')f). 35.5 ,-~--~- --' --..----.-- I{cgblcr of Wills for thc ('ollIllY of _':..WBEW!#J in Ihc Common\\callh of Pcnnsylvaniu ----------.---- -.-----...------. ~-_. _~______. f)('('('clWt!. Sodal SI'<'lIritl' No. 2..\lJ..LLLfl,LJ--..... The pCliliul\ of thc IIm]C"igncd rc,peclflllly rcprc'cllIs that: YOllr pctitioner(s), who is/urc 18 years of age or older, appLl.o.-,S___ for lelters of adminiSlrution on Ihe estate of (d.h.n.; pemknlt' Iile; duranle "tHenll;l; ~U1;IIIIt' lIlilHlrilalcl the ubove decedenl, Decendelll was domiciled at demh in ~Wn.d.- CounlY, Pennsylvania,. wilh h li'R... laS! family or prindpul residenceal_.a~_~~nu'T 'C.,- C!J:Irr1p 1-l,,1. ) (li,1 \lrt'(I,IIUrnher ami lTlunidllilhl)') l(....l~n)pcl't.Y) Decend~m, th~n b. ~ /_l'ears uf uge, died .--1-=-~9 ' 19 9(, at IW~l?R.te, 1l~~..!.DLk Deeendent al delllh owned property with eslimuted values us folllows: (If domiciled in Pa.) All personal properlY (If nol domiciled in Pa,) Personal properlY in I'ennsylvunia (If not domiciled in Pa.) Personal properlY in COllmy Value of reul estate in Pennsylvania situated as follows: q()('"), ~ s s S $ I'etitioner_ufter a proper seureh hu_ ascerlained that decedent left no will and was survived by the following spouse (if any) und heirs: Namr ~n N. +olT2..JR, IT Residence n TrIP 1-1;11, PA l? ~ THEREFORE, petilioner(s) respeClflllly request(s) Ihe gram of Iclters of adminislrution in the ~ appropriate form to the IIndersigned. t ~ /6.:7~" t./- 7dJ),-- "'~ -g.g .'- -;oJ: 1:~ ~ 0 ;; c .. iii OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF ruM!3EIU,l\NJ } ss 8 :o~ PI n ::-; 0 nCi sw- ::1:;' 0-' .." IT1 OJ N w The petitioner(s) abow-named swcar(s) or affirm(s) that the statements in the foregoing petition are true und correct to the best of the knowledge and belief of petitioner(s) and that as personal representativc(s) of the above decedent pelitioner(s) will well and truly administer the estale uccording 10 law. :g IJ o W v. 8. iJC :t- .c\ . J f. ~Cl) ~ - :> - .. c Oll Vi Sworn to or arrirmed and subscribed J before me this 2 i day of ~;;~~~~'''~ /u,u~+-~1 " r ' Regisler if r . , <('(j~~ No. 21-96- iC;C; Estate of JUI\NNE Il FULTZ , Deceased GRANT OF LETTERS OF ADMINISTRATION AND NOW mRfltJl\llV 2 i 1I11 2000, in consideration of the petition on the reverse side hereof. satisfactory proof having been presented before me. IT IS DECREED that BF.NJT\MEN H F\)LTZ is/are entitled to Lellers of Administration, and in accord with such finding, Letters of Administration are hereby granted to REN.1I\MEN H F\lT.1'Z ----- ------ ..---.----- - in the estate of .1' ,r,M'!' R RIr.1'Z ~1/a~NN0'U)A'1' /,,Q~ Rcsislcr of Wills FEES Lellers of Administration .,... S 1 R. 00 Short Certificates( )...,...,.. S 3.00 Renunciation ..,......,.,..,. S JCP S 5.00 TOTAL _ S 26.00 Filed. f)';e.,.u........... A.D. Nl..2llllll ATTORNEY (Sup, CI, I,D. No.) ADDRESS pHONE ~~~ - . _.-------..~A. _ _ T ~y. 'l'wJ,l. .. 3538 CllCStllUt Street Camp IIi 11 ,1'11 1'10 .,.. c~___.Cultwerland". ".Ll ::=.=.. ----- ;;<<J1i..llIs......................_!o.<._ .....""s.................,,..,...., 'I Nth ~I Gc..r..tt.udc...Jl ...,Of......'S........'l"'..h.~ toIlJI'.....,....,POQ.lJOftfSS,,,...t....,.-_I"t<... ~ Mr. Deniarroin II. Foltz l!L..lUa r1Ul.5.t.n . ....'HOOOfc.~11Olf ~A('("'Oo$""~"_"c;_",u_-, lOCAlOf. ....- .... .,.-..- lJ ......ll c._kl _._......U 1-31-96 ..~_. Cremation Socic y r- tJM<l'"oc......L----_ _~_ r l '. 1." '~....t'tltll.UOIItI.....rtlY'C'''n..~'l)tl''UI5O'fAC'...).'SlIt" '0i;".....0ftNN" Ol0694-L ...U(UOO....._OfUOf'AU.'''Crcmation Society of Ph ItI L~.JLt (, ( [v..u,. '.~ ,! JOnc.n1.cwn UrL II,'1rr iE ,-",_".~__,-"'" ......_..._,......................''''.-.1......--....,-....... .0(:1..'11....-101 lJ.II(~,HI ......-.-..-..-..-. ......-....,,- _....., .....,-...- ". 1- =~;':"':::l-::~ 'fU(f/'X:J~-1! -F~-r' ~}"UlJi7:Il","'j.:; c.;' J 9 Q /. 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N '0 I "0 " ,- ",0 ffi ~~ o -~ u.. ~.:: {:J o tJl .0 &jQl !3 ': ~ a: a: ~5 Uu COtCMOHWE&L tH Of PENNSYLVANIA OEPARtHENt or R[VEffJE IUR[AU Of INDIVIDUAL tAX[S DEPt. 1I06Dl ItARRlSIURC, PA 11121.0601 * /-:(- INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO. Zl - 0". 3~-.s- 96113575 04-ZZ-96 In.'''' II ,,,I1.nl r,~ EST. OF JOANNE R FOLTZ 5.5. NO. Zol-18-48Z3 DATE OF DEATH ol-Z9-96 COUNTY CUMBERLAND TYPE OF ACCOUNT o SAVINGS o C~ECKING !Xl TRUST o CERTIF. 0,-., o:J I!) N /:.: - I " REHIT PAYHENT AND FORHS TO. REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 >- JEFF,RY E FQlTZ C/~~3538 CAESTN~T ~T CAM/': lULL 'D P/lo 17011 (1)' I (1\ ..) .) 0:- . GO FIRST FEDERAL SAVINGS has p..avld.d the D.pa..t..nt with the Infar.atlan Iltt.d b.low which has b..n u..d In calculating the pot.ntlal taM due. Th.l.. r.card. Indlcat. that at the d.ath of the above dec.d.nt, you w.r. a Joint awn.r/b.n.flclary of thl. account. If you f..l thl. Infor.atlon I. Incar...ct, plea.. obtain written corr.ctlan fro. the financial In.tltutlon, attach a copy to thl. far. and r.turn It to the above addr.... thl. account I. taM~bl. In acco..dance with the Inh.rltanc. TaM laws of the Ca..onw.alth of P.nn.ylvanla. Que.tlon. .ay be an.w....d by calling (111) 181.1321. COM~LETE PART 1 BELOW . . ~ gE~ Account No. oZ06066593 D.t. e.hblhh.d REVERSE SID~ rOn o4-1z-83 rILIi~~ "::': CAu:~r.NT ::rJ~.TnU:TI,)NS Account a.lanc. P.rc.nt Tex.bl. Anount Subj.ct to Te)( Ret. Pot.nti.l T.x Due 17,160.91 100.00 17,160.91 .06 1,OZ9.65 TAXPAYER RESPONSE FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSNENT BASED ON THIS NOTICE To In.ur. prop." cr.dlt to you.. account, two (2) caple. of thl. notice .u.t accaapany your pay..nt to the Regl.t.r of Will.. "aka check payable tal ~R.gl.t... of Wills, Agant~. x x HOTEl If taM pay..nt. ar. .ad. within th.... (~) .onths of the dacadent" date of death, you .ay d.duct a 5% dl.count of the tax du.. Any Inh...ltance taM due will b.ca.. delinquent nln. (9) .onths aft... the data of d.ath. T.. PART ill .- ~ /..: '//\ " [CHECK ] ONE BLOCK ONLY A. h:1 Th. above Infor.atton and tex due It carr.ct. ~l. You .ay choos. to ....It pay..nt to the Aeglst.r of Will. with two copl.. of this notIce to obtain / a discount a.. avoid Intar..t, or you .ay ch.ck bOM ~,~ end r.turn thl. notlc. to the R.gl't... of wills and an official a......ant will b. I..ued by the PA D.pa..t.ent of R.v.nue. B. c=l Th. abav. a.s.t has b..n 0" will b. repart.d and tax paid with the P.nn.ylvanla Inheritance TaM return to be fll.d by the dec.d.nt's r.pre..ntatlv.. C. c=J The above Infar.atlan I. Incorrect and/a.. d.bt. end deductions w.r. paid by you. You .u.t ca.pl.t. PART ~ and/o.. PARt ~ below. If you indicate a different tax rat., pl.esa .tet. your r.letionship to d.c.d.nt: OFFICIAL USE ONLY 0 AAF PA DEPARTMENT OF REVENUE PART ~ TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS I.YfoIE 1. O-f:.. F,h,hll..hlltd 1_ ----- 2. Account a.lance 2 3. P.rc.nt r.xabl. 3 x 4. Anount Subject to T.x 4 5. D.bt. and O.ductions 5 6. Anount Taxabl. 6 7. T.)( Ret. 7 X 8. Tax Du. 8 PART ~ DATE DEBTS AND PAD I 2 3 4 5 6 7 8 DEDUCTIONS CLAIMED PAID PAYEE DESCRIPTION AMOUNT PAID I rOTAL (Ent.r on Line 5 of r.x Conput.tionJ Under penelti.. of perjury, I declere th.t the fects I conpl.t. to 'ha belt of MY knowledge and bellef. ,: ).-.' J t, II'-~ . /,1 '., . \. TAXPAVER SIGNATURE, I , heve report.d .bov. .r. tru., correct .nd I ' l' (. HOME (., 'I ) " WORK (.; I ,: ).,' I TELEPHONE NUMBER , , I '1/,::,1 ii' DATE GENERAL INFORMATION 1. FAILURE TO RESPOHD WIll RESULT IH AH OFFICIAL TAM ASSESSHEHT .I.h ...lIc..l. Inl.,... b.... on In."..tlon .ubII1Uad by tn. flnllnClal In.tltutlon. Z. Inheritance tax baea..' delinquent nlna eonth' .f'ar the dacadant" data of d..th. S, A jotnt account ,. taxable even though the dacadant" na.. ~.. added ft' . ..t,.r of convenlenc.. .. .ccoun" (Includln. ,hq" h.l. b....on hu.bond ond .1'" .hlch .ho ..c...n' .ul In J.lnl n.... .I.hln on. y..r .rl.r .. d..th .r. tully \allabla .. trM,I.r,. . 5. 'cc?Un" ..tablllhed Jolntlv betw..n hu.band and wlf. aor. than on. y..r prior to d..th ar. not t..abl.. 6. Account. held by . decadent "In ,rult for. another or othar' ar. ,..able fully. REPORTING INSTRUCTIONS - PART 1 _ TAXPAYER RESPONSE I. ILDC". If .h. Inf.,...lon ond c..pu...lon In Ih. no'lc, .,. c.rr.c' .nd d.duc.lon. .r. no' b.lng cl.I..d, .1... an .,. In bl.ck ... .f ..r' I .f ,h. .T.'..y.r ....on... "c'l.n. SI.n ... c.. I.. .nd .ub.I' .h.. .I.h your ch.ck f.r ,h. ..oun' .f ta. to the Raal.,.r 01 Will. of the county Indlca'ad. th. PI Depart..n' of Ravanue will l'lu. an official ........n' CFor. REV.1548 EX) upon r.calpt of the return fro. the Ragl,t.r of Will'. 2. ILOC' 1 . If tho ..... ...clfl.d .n ,hl. no'lc, h.. b..n .r .111 b. r...rt.d .nd .., ..Id .I.h .h. P.nn.yl.anl. Inn.rl'onc. T.' .,'urn fll.d by tho d.c.d.n.'. r.pr...n...I.., .I.C' an -,- In bl.ck .1. .f ..r' I .f tho .T.,..y.r .....n... ..c'lon. Sign on. c..y and r,'urn .. .h. .. D...r...n. .f ....nu., lur.au .f Indl.ldu.l T.,.., D..' 210'01, H.rrl.bur., P' 17121-0.01 In ,h. anvalopa provided. S. ILOC' C . If .h. n.'lc' In..r,.'I.n I. lnc.rr.c' and/.r d.duc.lon. .r. b.ln. cl.l.od. ch.ck bl.ck .C. and c...l... P.r" 2 ond S .cc.rdlna .. .h. In..ruc'l.n. b.I... SIan ... c.. I.. and .ub.l. .h.. .I,h y.ur ch.ck f.r .h. ..oun' .f .., ..yobl. .. .h. ...I,'.r .f will. .f ,h. coun'Y Indlc...d. Th... D...r...n' .f .,.,"". .111 I..uo an .fflcl.1 ........n. IF.r. .'Y-I..I ,., uoon r.c-I.' of the nturn fro. the Raghtu of WUI.. TAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Entar tha date the account originallY wa. ..tabll.had or tltlad In the .annar ..I.tlng at data of daath. HOTE: for a dacadant dvlng aftar 12/12/82: Account. which the d.c.dent put In Joint na..s within on. Cl) y.ar of daath .ra '.,obl. fully.' 'ran.f.r.. H.....r. 'h.r. I. an .,clu.l.n no' .. .,c..d 'S,OOO ..r 'ran.f.r.' r...rdl... .f .h. ..Iu' .f the account or the nuebar of accounts h.ld. If a double a,tarlsk C..) .pp..r. bafor. your flrlt n..a In the .ddras. portion of thl. notlc', the 15,000 .xclu.lon alr.ady has bean d.ducted fro' the .ccount b.lanc. .1 r.portad by the flnancl.l In.tltutlon. 2. Entar the tot.l b.lanc. of the account IncludIng Int.r.st accrued to the data of d..th. 3. The p.rc.nt of the account that I. tax.bla for .ach lurvlvor I. d.t.r.lned al folloWI: A. The percent taxable for Joint ....t. e.tabll.hed ~re than one y.ar prior to the dec.dent'. da.th: 1 DIVIDED aY TOTAL NUMBER Of JOINT OWNERS E..~la: A Joint a..et t'lIl.tared DIVIDED BY TOTAL HUMBER OF X 100 . PERCENT TAXABLE SURVIVING JOINT OWNERS In the n..' of the dec.d.nt and two oth.r p.rsonl. 1 DIVIDED BY S CJOINT OWNERS) DIVIDED BY 2 (SURVIVORS) . .161 X 100 . 16.1~ (TAXABLE FOR EACH SURVIVOR) I. Th. ..rc.n. ,.,"1. '.r ...... cr....d .I.hln on. y..r .f .h. d.c.d.n.'. d",h .r ..c.un" .wn.d by ,h. d.c.don' bu' hold In trust for another IndlvhtuaH') (trust b.n.flclarl..Jl 1 DIVIDED BY TOUL HOHBER OF SURVIVIHG JOIHT X 100 . PERCENT TAXABLE OWNERS OR TRUST BENEFICIARIES "...1.: J.ln' .cc.un' r..l...rod In ,h. n... .f .h. d.c.d.n' .nd ... ..h.r ..r..n. and .,..bll.h.d .Ithln .n. y..r .f d...h by the deced.nt. 1 DIVIDED BY Z (SURVIVORS) . .50 X 100 . SO~ (TAXABLE FOR EACH SURVIVOR) .. Th. aooun' .ubl'c' .. .., (lln. ., I. d...r.ln.d by oul.I.lyln. tho .cc.un' b.lane' {lln. 21 by tho ..rc.n' '.,obl. (II.. SI. 5. Entar the total of the dabtl and d.duction. ll.t.d in Part 5. .. Th. ..oun' '.,.bl. {lln' ., I. d...r.ln.d by .ub.r.c'ln. .h. d.b', and d.duc.l.n. (1In. ., fr.' .h. ...un' .ubl'c' t. .., (lln. ". 7. Entar the aooroorlata ta. rata Cline 7) .s detar.lnad balow. A. for d.tas of de.th occurring .ft.r 6/30/94, tha taM rata. for tranlf.r. to .pousa' ar. .s follows: 1. Oat.. of d.ath on or aftar 7/1/94 and bafore 1/1/95 the rat. Is 3~. Z. Oat.. of d..th on or aftar 1/1/95 tranlf.r. to SPOUI.I wlli ba ta..d at D~ t.. tat.. Hot.: for dat.. of d.ath prior to 7/1/94 transf.rs to spous.s ar. ta..bla at 6~. B. Tranlf.r' to lln.al d.sc.ndants Includlnll fath.r, .othar, son, daught.r, grandchlldr.n, son-in-law, daughtar-In-law, st.pchlld and thalr Issua ara taMable at liM p.rcant (6~). C. Transf.rs to all oth.rs Including broth.r, sllt.r, unci., aunt. n.ph'w and nl.c. ar. t..abla at flft..n p.rcent CI5~). D. If you chang. the taM rat.. pl.... sp.clfY your r.latlon.hip to the d.c.d.nt 1n tha ar.. provid.d. 8. The aaaunt of tax due Uln. 8) Is datar.lnad by .uttlpJylng tha aaount taxabh Uln' 6) by the taM reta Clln. 7), CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowabl. d.bts and d.duction' ara d.t.raln.d a. follow': .. You 1...lIY .r. r..pon.lbl. ..r ..y..n', .r ,h. ...... .ubj.C' .. .d.lnl..r..lon by . ..r.on.l r..r..on'.'I.' I. In,ufflclon' to pay the d.dUCt1bl. 1\.... a. You actuallY paid the debt. aft.r d.ath of the d.c.d.nt and can furnl.h proof of payaant. C. D.b', b.ln. cl.I..d ou.. b. 1...lz.d fully In P.r' S. If addl.lon.1 ..... I. n..d.d. u.. .1.ln ....r 1 1/2. ,II.. .roof.f pay..nt .ay b. r.qu.lt.d by the PA D.partaent of R.vanue. TAXPAYER ASSISTANCE IF YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANY REGISTER OF WILLS. PA DEPARTMENT OF REVENUE DISTRICT OFFICE OR CALL THE BUREAU OF INDIVIDUAL TAXES. TAXPAYER INQUIRY UNIT IN HARRISBURG AT (717) 787-8327. TDDI (717) 772-2252 (HEARING IMPAIRED ONLY) .'--.... CO""ONWril III or III NNSVI VANtA DLPiAt"LNT or AIVI.NUI !UAUU Of' INDIVIDUAl 1AlltS orPI. ;'80&01 tlARRISBURC, PA 111;'8.0&01 ~~ INFORMATION NOTICE AND TAXPAYER RESPONSE FILE ACN DATE NO.21 96-0355 96122350 06-11-96 'h.".11I II' ,'-UI EST. OF JOANNE R FOLTZ 5.5. NO. 201-18-4823 DATE OF DEATH 01-29-96 COUNTY CUMBERLAND TVPE OF ACCOUNT rxJ SAVINGS [J CHECKING [J TR'JST D CERTlF. JEFFRV E FOLTZ 160 BATTlE AVE WHITE PLAINS NV 10606 REMIT PAYMENT AND FORMS TO: REGISTER OF WIllS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 PSECU has provldod tho Oopllrt.ont with Iho Inforullon Ilslod bolow which hns bun uud ill calculating the pat.ntial tax duo. Ih.lr rocords Indlcat. that at Iho d.alh of Iho abovo docodonl, you w.r. n Joint ownor/bonoficiary of this account. If you fo.1 this Infor.atlon Is Incorroct, plolls. obtain writt.n correction fro. tho financial Institution, atlnch II copy to this for. 1'1.... ......'.... ... ,.. '''A ~"AII. .."'........- '..I.. .........1... !. ,,,,,,,"1.. I.. ....r..........n... ..llh t.,. ,..........'..'r... TI!i" '''lWP n' 'I.., r..."'..""'4....1Ih o' P.....,'vl..lInl... Cuutlons .ay b. 1Il1sw.rot.l by clllIJng (7111 781-8317. COMPLETE PART 1 BELOW Account No. 0201184823 Dat. Established REVERSE SIDE FOR 06-06-94 FILING AND PAYMENT INSTRUCTIONS . . . SEE Account aalanc. Parcant Taxabl. Anount Subjact to Tax Tax Rata Potential Tax Du. x 66,909.29 50.000 33,454.65 .06 2,007.28 10 Insuro propllr crodlt to your account, two (ll capilli of this nollcll .usl acco.pany your pnyllllnt to the Rllglltor of Willi. Milko chock pnyablo to: "Roglstllr of Wills, Agllnt". x NOIE: If taM plly..nts IIr. .ndo within thr.o (31 .onlhs of tho docodont', date of doath, you .ay doduct a SZ discount of the taM duo. Any Inhoritnnco tllM duo will boco.. dollnquent nln. (91 .onthl aftar tho dllt. of denth. PART TAXPAYER RESPONSE COI FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSNENT BASED ON THIS NOTICE A. I~IhQ abOVll Infor.atlan Bnd tBX duo Is corroct. ~ 1. You ~8Y chaos. to ro.lt pny.ont to tho Roglst.r of wills with two capias of this notlc. to obtllln a discount or avoid Int.r.st. or you .1IY chock bOM "A" and roturn this notice to th. Poglltor of Wills Bnd nn official ftlsess.onl will bo issued by tho Pi Vepart.llnt of Pllvenuo. [CHECK ] ONE BLOCK ONLY B. c=J Tho obove nssot has b.on or will bo r.portod and taM paid with tho PonnsylvlInlll Inhorltance IlIx r.turn to bo fll.d by tho decod.nt's ropro'llntftllvo. C. ~ Tho above Infor.ntlon i. incorr.ct nnd/or debts Bnd d.ductlons w.r. Pft~~you. You IIUSt co.plete PARI CD nnd/or PARI 0 b.low. :~ ;:. -.r: PART ~ TAX RfTURN - COMPUTATION LItiE 1. Dat. t.st.l)l1shed 2. Account Balance 3. Percent Taxable 4. Aaaunt Subject to Tax S. Debts and Deductions 6. Aaount Taxable 7. Tax Rata 8. Tax Du. OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 X 4 5 & 7 X 8 .. ?J OFFICIAL USE ONLY: D AAF PA ~EPARTHEItT OF REVENUE ; z ".', ---.-,-....- - . ~ If you indicat. a differant tax rat., pl..,e stata your relationship to decedent: PART [!J DATE DEBTS AND DEDUCTIONS PAD ! 2 3 4 5 6 7 8 CLAIMED '..:.:11 . ',,' ........... '" ! , t.l -, PAID PAVEE DESCRIPTION AMOUNT PAID TOTAL IEntar on Line 5 of Tax Computation) I $ Under penalti.. of perjury, I declare that tha facts I hay. reported above are tru., corr.ct and c<i~Pl!,to t~,t?O, ~~..t-,!-f.' ny ';!'~lo~~d boUol. HOME (,,'!-I ) '>71 U) J, ',..' <" ('(-I. WORK (](~) icy .1';b;' TAXp,~VER SIGNAT,' E - , . '-~ TELEPHONE NUMBER . / GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSHENT with "1Iplh:Bbla Int.ru' bnud on Infor.ntlon lub.Bted by thlll flnn"cl"l Institution. Z. Inherlt.nelll tllll baea... delinquent nlna eanths Blhr thlll dllleudant'. ill'll. of duth. 5. & Joint account i. tn."bla IlIvan though thlll dllle.dllln"s nft.. w"' ndded nl n ~"ll.r of tonv.nlgnelll. It. Accounts I Including thou hald bat....n husbftnd nnd wifal whiCh thlll dlllcadlllnt Ilul In lolnt ""_8' within onll yur prior to death are fully laxabl. "' Irn",f.r.. 5. Account. 1lI.labti,had Jointlv blllt....n hUlbnnd and wlf. .or. than ana yaar prior to deAth "r. nol In.able. 6. '~count. held by II dlllcadant "In trult for" Bnother or other. ar. In."ble fully. REPORTING INSTRUCTIONS - PART I - TAXPAVER RESPONSE 1. BLOCK A - If thlll Infor.atlon and co~putatlon in tho notlco ar. corract and doductlons aro not baing clal~od, placa an "X" In block "A" of Part I of the "Taxpavor Response" section. Slon two copies and subait thea with vour check for tho aaount of tax to the Raolstor of Wilis of the county Indlcaled. Th. PA Oopart..nl of Rovonu. will Issue an official assass.ont (For. REV-IS48 EX) upon rec.lpt of the return fro. the Roglster of wills. 2. BLOCK B - If tho as~.t spoclfled on this notlc. has bo.n or will be reportod and lax paid with the Ponnsylvanla Inhorltance Tax Roturn fllod by \~e docedent's representative, place an "X" In block "B" of Part I of th. "Taxpayor Rosponse" ,action. Slon on. copv and return to thl' PA Oepart.ent of Revenue, Buroau of Individual Tau" Dept 280601, Ilarrlsburg, PA 111Z8.0601 In Iho envolop. provided. ], BLOCK C - If the notice Infor.atlon I' incorrect andlor deductions are bolng clal.od, check block "C" and coaplete Parts Z and 1 :e=~"':Hn. :c. ~!1'l1 11.;......u-1 l.....1.... :ii., t'o'U cocler ,r.. s~t..,1:1t ~h41: ..hr. ~'Oui'" c.."..... fl..' "'.HI oI",CUO' .J: tl!l' pft'lel:ll. Ie. U,a RCiil.~:'; of Wills of the county Ir.dlcahd. The PA Dllpart.onl of RlIvenue will Issue 8n official anuullnt Irore REV-IS48 EX) upon r.celpt of the return fro. tho RII~III.r of Willi. TAX RETURN - PART 2 - TAX COMPUTATION liNE 1. Ent.r HOTE: the date Ihe account originally was ostabllshod or titled In the .annllr exllllng at d81. of doath. For 8 d.c.dllnt dving after 12/1Z/82: Accounts which the decedont put In joint nae.s within one II) v.ar of doath are taxablo fully al transfors. Howevor, thoro Is an exclullon not to o.cood $],000 per transfllree regardlesl of the valuo of tho account or tho nuebllr of accounts held. If a double astorlsk (.x) apPllars b.fore your first na.o In ,ho addr.ss portion of this notice, tho Sl,OOO oxcluslon alroady has b..n doductod froe the account balance al rllportod bv tho financial Institution. 2. Entor the total balance of the account Including Intorllst accrued to tho date of death. S. The pareent of tho account that Is taxable for each lurvlvor Is detar.lnod as follows: A. Th. porcent taxable for joint assotl eltabllshlld ear. than one voar prior to tho dllclldent's d.ath: DIVIDED BY TOTAL NUMBER OF JOINT OWNERS Exa.plo: A joint alsot reglstarad DIYIDED BY TOTAL NUMBER OF X 100 . PERCENT TAXABLE SURVIVING JOINT OWNERS In the naeo of the docedent and two oth.r pllrsons. 1 DIVIDED BY 5 (JOINT OWNERS I DIVIDED BY 2 (SURVIVORS) . .161 X 100 . 16.n CTAXABlE rDR EACtt SURVIVOR) B. Tho porcllnt taxabl. for ass.tl created within one voar of tho dllcedent's dllath or accounts ownod bv the decedllnt but hold In trust for anothor lndlvlduaits) I trust bllnllf!clarlnh I DIVIDED BY TOTAL NUMB[R Of SURVIVING JOINT OWNERS OR TRUST BENEFICIARIES X 100 . PERCENT TAXABLE EMaeplo: Joint account rogllterod in tho naall of tho dacadont nnd two othor pllrsons ond established within one yllar of doath by the docedont. I DIVIDED BY 2 CSURVIVORS) . .SO X 100 . SOil: lTAXABlE fOR [ACtt SURVIVOR I .. S, Tho aeount subject to taM Illne 4) Is detor.inlld bv eultlplving tho nccount balanc. Cllno 21 bv the pllrcent taxable Clln. 11. Entor tho total of the dobts and deductions lisled In Part S. ....... t...--. ...........\ "'~-'~ I, "J'-~-'."" ..... .....-....1... ..... ..-..... -...... ......,....1: "1". 1:\ ,.~:- ..... .,~:'...'... ,:~'!:."j~=~'" .... ,!,..":, to' i~t8r i~~-a~p~~;;iat;'t~ll.rato ~1;~o~?i-~ti-d.t~;~I~;~'b;1~~. .0_.0.._.. ....w . ~ .. A. For datal of d.ath occurring after 6/10/94, Iho taM rates 'or transfors to spouses ar. as follows: I. Data. of doath on or after 111/94 and boforo 1/1/9S the rate Is li1:. Z. Oatlls 0' daath on or after 1/1/9S transfers to spouso. will b. tallod at Oil: tax rato. Hot.: for datos of doath prior to 7/1/94 transfors to SpOUSIlS ar. taMable at 6%. 8. Tranlfors to Iln.al dese.ndants Including fathor, eother, son, dauohtllr, grandchlldrlln, son-In-low, daughter.ln.lnw, stepchild and their Issu. are tallabl. at sht: p.rcent 16i1:J. C. 'ronlf.rs to all others Including brother, .Istllr, unci., aunt, nephew ond nloco ora taxable ot flft.en porcent (IS%I. O. If ~ou chang. the tax rate, pl.as. spocifv vour relatlonlhlp to th. declldont in the area providod. B. Th. aeount of taM dug (lln. BI Is detor.lned bV .ultlplvlng Iho neount laxablo Illne 61 bv tho tnx rat. Illno 7). CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowabl. d.bts and doductlons are deterelnod as follows: A. You I.gallv are rosponslble for pave.nt, or tho os tate subject to ad.lnlstratlon bv a pllrsonal ropresontatlvo Is Insufflelont to pav tho doductlble Ilo.s. B. You actually paid tho debts nfter dllath of tho docedont and can furnish proof of pay.ent. C. Dobtl being clal..d .Ult be Ito.lzad fullv In Pnrt 1. If additional spaco II n..ded, uso plain papar 8 I/Z" 1I II". Proof of paveont .ay be requested bv tho PA Depart.lInt of Rovenue. TAXPAYER ASSISTANCE IF YOU NEED FURTHER INFORMATION OR ASSISTANCE. CONTACT ANY REGISTER OF WIllS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE OR CALL THE BUREAU OF INDIVIDUAL TAXES, TAXPAVER INQUIRV UNIT IN HARRISBURG AT (717) 787-8327. TOOl (717) 772-2252 (HEARING IMPAIRED ONLY) " . \ \ ' , .- -==x C- .,r:-- , ", .'. . ~J .' .' . ,. <, " VI ~ -) ,;--'" --~ ~ ~ "1 ~ V\ - \.!:; '~ ~ '.) '1 ..'1 ~ , ;.-j ..~ ~ '" " W~ " z~ NWZ ...~ . ......'" c z ...w- ~.. "'...~ ...... ~caw ... ... ...,,- ~~$ L. " ,,- : IV '" - - ~ = -- - <'1 - ~ \" -" -" -- ~ \- .,) -' '-- "...,) '-...J 1:) "'-.J "t: <' '-t-_ Q ',l ... .... ,..l ~ '~ :; - I..!.l ~ V"\ '- "!::' ~ -" ".'I ;> \' .,. ..... ''-.) '--.J - .. . , ,,("' -, , ',0 ~'\ '. ': 'J GU .--" -- r.- -~..o::-~-7""'~~. '.1. *..... ..,':-. D 112948 COMMONWEALTH OF PENNSYLVANIA NO. AA OIPARTMINT O' RIVINUI OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX ,. Il'I-n62 P lU., D ACN ASSESSMENT CONTROL NUMBER m AMOUNT RECEIVED FROM: 'f61cc'~50 $<:,,00'1.<:'1:1 JEFFREY E FOLTZ 160 BATTLE AVENUE WHITE PLAINS, NY . 10606-2133 ESTATE INfORMATION: f:t filE NUMBER U 21-1996-0355 !II NAME Of DECEDENT (LAST) ~ FOL TZ JOANNE R II DATE Of PAYMENT B POSTMARK DATE COUNTY S5N 201-18-4823 (fiRST) (Mil CUMBERLAND DATE Of DEATH fa TOTAL AMOUNT PAID $2,007.28 CW REMARKS JEFFREY E FOL'fZ SEAL CHECI(lI 673 RECEIVED BY ... I ,',',. 'II :' II StGN"TU~l ( REGISTER OF WILLS MARY C. LEIH 5 REGISTER OF WILLS - --- ."'-- .--- ---. ,..-- ..,""-;'" " ...-.- ..-.. . i j , : - ' __1 ~ . -.---.-Il4. _ - 1::" . (OI'4"OHwl." .11 Of i"IHHSYI VAHIA mPA"I",!"I or III V! NlJ! IlUNI AU Of INnlvlllUAI IAXI S D[PI. ;'8111.01 ItAN"ISIlUIIC, IIA 111;'8-01101 ~~ 1;t~' FILE ACN DATE NO.21 96-0355 96128',87 07-23-96 INFORMATION NOTICE AND TAXPAYER RESPONSE 'h,.\,IIII" d tU TYPE OF ACCOUNT EST. OF JOAHHE R FOLTZ 5.5. NO. 201-18-4823 DATE OF DEATH 01-29-96 COUNTY CUMBERLAND SAVINGS CHECKING L~ TRUST iXJ CERTIF . TO: GERTRUDE N SWANSOH 2206 KENSINGTON ST " HBG PA 17101\'" REMIT PAYMENr ANa FORMS REGISTER OF WILLS CUMBERLAHD CO COURT HOUSE CARLISLE. PA 17013 HARRIS SAVINGS BANK has provldlld thll DlIpnrtlllllnt with thll InforlllBtlon Ilstlld billow which hils blllln uSlId In calculating thll potllntlal tlue dUll. Ihlllr rllcords Indlcatll thnt ,lt thll dllllth of thll "bovll dllClIdllnt, 'IOU wllr. II Joint ownllr/bon.fldllry of this llccount. If you fa. I this Inforlllatlon Is incorract, pl.aslI oblnln wdUon corroctlon frol1 tho fin.1nclal Institution, llttach il copy to this forlll clIna ratu:"" .t to tho nt...;v. ,100r.ss. :nls ac....unt Is t"~..,,hl in .ir:r....l;".r..~.. ..I::. tl'.n l:'l"....it..r... to.. I"....., ,.... ,.~__~........It.. ., n~......~.I"~-l:.. QUllstlons anv bll nnswerlld by calling (111) 181-85Z1. COMPLETE PART 1 BELOW . Account No. 01-16-008887 . . SEE REVERSE SIDE FOR 07-15-80 FILING AND PAYMENT INSTRUCTIONS D.t. Established To Insure propor credit to your account, two (ZI caples of this noticlI "ust ncco_pnny your paylllllnt to thll RlIgist.r of wills. 1'411~. chllc~ paynbla to: "Regislar of Wills, Agllnt". PART [TI 35.584,85 50.000 17.792.43 .15 2.668.86 TAXPAYER RESPONSE FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT BASED ON THIS NOTICE Account Balance Percent Taxable Amount Subject to Ta)( Rate Potential Ta)( Due x HOI[: If tn_ paYlIlllnts arll "ad. wilhln thrlla (!) "onths of thll dllClldant's dat. of dllath. you "ny dllducl a SZ discount of thll ta~ dUll. Ally Inhllritnnca tall dUll will bllC01II1I dllllnqUllnt nln. (9) "onth~ nftar tho datil of dllath. Ta. x [CHECK -, OIlE J BLOCK ONLY A. Il Th. abovlI lnfor"atlon and ta~ dUll Is corrllct. __ I. You "ny chooslI to rlllllIt paY"lInt to thll "aglstllr of wills with two coplas of this notlcQ to oblaln a discount or avoid Intllrllst, 0" you nay chllc~ bOll "A" and rllturn this notIcll to tho R.glstllr of Wlils nnd an official ~ssll~s.Qnt will bll IssulId by thQ PA DGpart~lInl of RavllnulI. B. r-l Tho above ass.t has blllln or will b. rllportod and ta~ p~ld with tho PlInnsylvanla Inhllrltanco Ta~ r.turn -- to bll fllQd by Ih. dllClIdllnt's roprQsllntatlvll. c. c=J The nbovll Infor"lItlon is Incorract and/or nllbts and dllductlons WlIrll paid by 'Iou. You .usl cOlllpllltll PART ~ and/or PART ~ billow. PART ~ If you indic.te a different taxrratT' please state your relationship to decedent: let lCr OFFICIAL USE OIlLY 0 AAF PA DEPARTMENT OF REVEIlUE -... ...--....... I"" n..I""'''. -.....-..-. ---.. """"I'I"UI"I..."".. -- -.. .....-..- .--..-- . ...--....-.... FAD WO" '..n w" """....'1' ,n"""" , """""""""..,~ 1 7/15/80 1 2 35.584.0C 2 3 x 507, 3 4 17,792.43 4 5 5 & 17,792.43 6 7 X 67, 7 8 1,067.54 8 DEBTS AND DEDUCTIONS CLAIMED LINE 1. Oate Established 2. Account Balance 3. Percent Tax.blG 4. Amount Subject to Tax S. Debts and Deductions 6. Amount Taxable 7. Tax Rat. 8. Tax Due PART ~ DATE PAID PAYEE DESCRIPTIOIl AMOUHT PAID TOTAL lEnter on line S of Tax COMPutation I $ ~/' Under penalties of perjury, I declare that the facts I have reported above are true, correct and (I/CD.~ht,e to}.I~~, b t of .y knowledge and belief. E 1l0ME ( 911,) 997-2633 "r~/ ~/l..: ': J('ffry Foltz, "~(,clltor, statCWORK (.'11-) I," ,/, "}<':/'I. f , ,or Gert- rude N. Swnn!;on /.. il l. . TAXPA ER SIGIlATURE 11Icd 5/4/96 TELEPIlOIlE IlUMBER ~! )U~ & DATE GENERAL INFORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OrrrClAl TAX ASS[SSH[NT wllh .IIIIIIllo1ll1.. !rlloral,l 11<"11111111 Inlnrllln'lun "ub_ln.d hv tho '111","cl;11 I".tllutlon_ L. Inh.rltanco 'ft. bocOI... dollnfluwnl nino 11I011111, "ltar tho doCtuhmt'" d"to 01 IllIltll1, .5. A Joint necount I. '''J..blll ovon thuul,h Iho dllealllmt', 11.,_. w,n '!llIhH' "" 11 1II11ltlll II' lllflvunltU1CO. It. Accounh I Including tho.. hold b.h....m hU1t101nd "nd wlfo. ..hh;h II,., c1I1UlIlant Ilul In Joint "......1 within II". 'tMnr Ilrlor III do.lh "r. fully t"....bl. ill tran,f.r.. !t. Accounts .stnbllshod Jointly h.two." tnnbnnd "nd ..If. I"ora Hllm II"" Vllnr Ilrlor to doltl" .lra not 1.1011111.. b. Accoun.. hold by /I dllcodent "(n trUI' fa," "110111111 or other. nr. 1110'111)0 fully. REPORTING INSTRUCTIONS - PART 1 - TAXPAVER RESPONSE 1. BIOCM A - If Ih. Inforlllllllon and co.pulallon In tha "ollell;UII eorrllel ;Inti tllltluctlons IIr. 1101 hlllng CI.,1IUld, plnca Itn "ll" In block "A" of Part 1 of thll "TII'p"y.r Puponsa" Ulctlon. SII)Il two coplin .llld 'Iou1l1ll1l th.. wllh your chack far tho nlllount of Ill. to Iha RIIglslllr of Wills of Ih. county IndlcntQlt. Tha I1A DIII'ltr"'","t of Pevllnua will luua iln olllclnl /tnasuant 'For. PEV-I~~II Ell' upon recalpl of tha return frolll the Paylster of Wills_ BlOCM B . If tho IIUllt spac1f1od on Ihls nollca hns bllan or will 110 rtmorlnd IIntl tll' Illtid wlth tha Pnnnsylvltnln InharltMea 'a. Relurn filed by tha docodent', raprosantntlye, pl.lea ;)0 "ll" In bloc" "B" of I1Mt I of the "'.1JpaYllr P.sponse" soctlon. SI!!n ono copy and r.turn to the I1A Dopllrllu,"1 of RllllyenUlI, Bura"u of Illdlvldual ,,,.IIS, D.pl ;'BObOI, Illlrrhhur!!, PA 111~B-0601 in Ih. anyeloplI provldad. 3. BLOCK C . If thll notice Inforllllltlon Is Incorrocl and/nr do<tuclions MO bolng cllliJU'd, chec~ blocl< "C" and cOlllplato Pllrh ;'. nnd 3 IIccordlng to Iha Instructions balow. Sign two cop IUS lIno sUOllllt \111111I "';\(\ ,0...1 ..I...... t.., .:,. "..cI.~..,.: ..: te.. ;::;;,::~1~ te t~'3 o":lr..r of wills of Iho county Indlcaled. Iha PA Dap.lrl"ant of Rovunua will Inua nn official nnoss.ant Cror. R[V-ll3..11 EllJ upon receipt of Iha raturn froll tho Re91stllr of wills. TAX RETURN - PART 2 - TAX COMPUTATION LINE I. Enlllr NOTE: the data tha account originally WIlS astabllshed or tltlod In tho "nnnar o_lstlng at d~tD of denth. For ~ decodant dying after IZ/IZIIIZ: Accounts which Ihe docodant put In Joint na.as within ong II) YOllr of death are ta.lIble fully dl trnns'ors. Ilowavor. thare il an a.cluslon not to e.ceed $3,000 per trllnsfora. rggnrdloss of tho valu. of tho llccounl or tho nu.ber of accounls held. If ft double IIsterlsk (..1 nppears befora your 'Irst na.a In the addros. portion of this notice, tho $3,000 oxclusion IIlroady hili beon daductod fro. Ihe account bnlonco as rgportod by tha flnanc!1I1 institution. Z. Entar Ihe total balllnca of the account Jncluding intarllst IIccrued to Ihe date of dllnlh. 3. Ihe porcont of tho account that Is tnxable for allch survivor Is dator.lned liS follows: A. The percant taxable for Joint assets eslabllshad noro thlln one yaltr prior to the decodenl's denth: DIVIDED BY TOTAL NUMBER OF JOINT OWNERS Exa.ple: A joint assot reglslerod DIVIDED BY TOTAL NUMBER or II 100 . PERCENI "'lIABLE SURVIVING JOINT OWNERS In the "a.e of tne daclllldont Bnd two othar persons. I DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY Z (SURVIVORSI . .167 II 100 16.71: crAllA8lE rOR [ACIl SURVIVORI B. Iho Pllrcent ta.abl. for ".sats crelltod within ona yonr of tho daClllldenl's delllh or accounts ownad by the docodant but h.ld In trust for anothar Individual(s) (trust ban.flclnrlos): I DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT OWNERS OR TRUST BENEFICIARIES II 100 P[RUNT TAlIABl[ Exa.pla: Joint account roglsl.rlllld In the decodant. 1 DIVIDED BY Z (SURVIVORS) . .SO X tha nllllle of tho dacndent and two oth.r person. nnd .stnbllshad within ana yaar of dOllth by 100 130:<: (TAllABIE rOR [ACIl SURVlVOAI 4. The a.ount sUbjoct to ta. (line 4) is detor.lnad by .ultlplylng tho Account balllnca (llna ZI by the parcenl taMable (1lna 3). ~ r"t.r th~ tntnl of tho d.bts nnd dllllductlonl ll.tad In Part 3. 6. The a.ount ta.llble Illn. 61 Is dalllr.lnlllld by 5ubtr"ctlng Ih. dllb" and deductions Illne Ij) 'rolll Inll <'Inount SUbject to till{ lllne 41. 1. [ntar Ihe IIpproprlate tnx rllte (llna 1) as datorllllnad b.low. .. For datas of donlh occurring IIft.r 6/30/Q4, tha tnx ratDs for trnllsf.rs to spousa, ara <'IS follows: I. Dntal of dllllath on or a'tor 1/1/Q4 and bafora 1/I/q13 the rale Is 31.. Z. Dlltos of doath on or nftllr 1/1/913 trllnlfllrs to SPOUSIIIIS will bo taxAd at 07. tn. rllt.. Not.: For data' of dallth prior to 7/1/94 tr~"sfors 10 spousas are tn.ablo al 67.. B. Transfers to lineal dllscend,,"'s Including fnthar, "othllr, son. dauyhlor. grandchlldron, son-In-Inw, daughler.ln.law. stepchild nnd their luue are ti.."ble at sl. perconl Cbi:!. C. Transfers 10 all othars inCluding brother, sister, uncle, aunt, naphaw and niece are tnMoblo at flft.an percont 11~7.J, D. If you changll Ihe tn. rllt., plllllale spoclfy your rolatlonshlp to thg docodant In Ihe aran provldlllld. 8. Ih. 1I.0unt of tllM due flln. IIJ Is detorninod by nultiplylng Iha a~ount tllxltblo (1lno 61 by tho tax rllto Cllna 71. CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Allownble dabts "nd dllllductlons are dotllllrnlned liS follows: .. You Illgally ar. rOlponslble for plly"ent, or tha IIslate sUbjact to ~d.lnlslrlltlon by ~ personnl roprAsantlltlvo II Insufflclgnt to plly the dllductlble 11..s. B. You actually pnld tha dobts IIftor dllllllth of the docodAnt ~nd cftn furnish proof of plty..nt. C. Dllbts baing clal..d .ust bo Ito.ited fully In Part 1. 11 .lddltlonnl Spltta Is n,,"od, usa plllln pnper B 112" . ll". Proof of pllyllent ."y be rllllquastod by Ihe PA Dopartm.nt of Rayanuo. TAXPAVER ASSISTANCE IF YOU NEED FURTHER IIlFORMATlOtl OR ASSISTAtICE, CONTACT ANV REGISTER OF WilLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE OR CALL THE BUREAU OF INDIVIDUAL TAXES. TAXPAVER INQUIRV UNIT IN HARRISBURG AT (717) 787-8327, TDD' (717) 772-2252 (HEARING IMPAIRED ONLY) , I 1 to I (i((((( I i I I \ I .' -'7'-:-~ \\ \ ' ... ~}. ~.' ~: c;:; +;: n ~: " \ \~" , V"I .j .j ~ V' ,..:; -4" l'!) --',. --- ,- \.:..} ('-.I \~ .... .-' .-> -' --- '--> '., " -. ....\.. <j "-.3 <:\' ~............ -..l.... , '.~ ~. r.J < \~ "; -.I -.J -J V'I 'SO; -. ."r..... ~ t:::-J , ~ - -' ~ -.. '-.) ~,_.J II II tl r) , I" .' o r- .. \ , d .; .J..... W 1:'-' -'-"-' '~ ~ -;--, ,'''-- , ' " -- ) , .)l) ~ .,.. " I ) .~ ~ . N -c ~ ..~.. .... ~ 0.. .. ........ t'~ ... ~O::~ ......,,.co "...;C'" I~ ~~"1;,. .. . ; O~ , , --'.-:; ---- . ....v ...,.. -:-:-..........--.-N.~ ~ m TOTAL AMOUNT PAID ,'~ \1\ ," ;; , ' l,..... RECEIVEDBY "/(1.""-' C' /ruJ..,J '//v' IGNAT R / J /", MARY C. LE' IS ;,~ ,'t:JilF ')- REGISTER OF WILLS' / 0 DNO.AA 146679 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX . ,,~'WUI."') ACN ASSESSMENT r:" CONTROL ... NUMBER AMOUNT D RECEIVED fROM: cU.12B!U.l7 '51,01.7.54 JEFFRY E FOLTZ 160 BATTLE AVENUE WHITE PLAINS, NY 10606-2133 'r-'OtDH(II ESTATE INFORMATION: a FilE NUMBER 21-1996-0355 E1 NAME OF D~ff~~i J'tfaltNE R ., DATE OF PAYMENT ~ 08/30/96 r.II POSTMARK DATE g 8/28/96 COUNTY CUMBERLAND SSN 201-10-4823 (FIRST) (MI) SI.067.5Lt DATE OF DEATH 01/29/96 REMARKS JEFFRY E FOL T2 SEAL CHECKtl 725 REGISTER OF WILLS .. -..- _. - ---' ...------- _.-~ --- --- - --- _.~ -..-.. ._.- ---- .-... I." "I' , -- "7~~---:--"---".M. r.. - r. PB r < . . ~ ) (', PURPOSE OF NOTlCE I To fulfill the requlr...nt. of S.ction 2140 of the Inh.rltanc. ond Estat. To. Act, Act 22 of 1991. 112~P.S. Sect Ion 2140)_ PAVHENT I D.tach the top portion of this Notice and sub~lt with your pAYM.nt to the Reglst.r of wllis prlnt.d on the nv.rse side. _. Hake ch.ck or Mon.y ord.r payable tOI REGISTER OF WillS, AGENI. All pay..nt. r.c.lv.d shall first be appli.d to any Inter.st which MAy be due, with any r..alnder appll.d to the ta.. REFUND I CR I: A r.fund of a taM cr.dlt, which was not r.quest.d on the ta. r.turn, .ay be request.d by co"pletlng an "APplication for Refund of P.nnsylvanla Inh.rltance and Estat. Ta." CREY-IlI]). Application. are avallabl. at the Offlc. of the Regl.t.r of wills, ony of the 2] R.v.nue DI.trlct offic.' or by calling the sp.clal 24-hour answ.rlng ..rvlc. nu~b.rs for forMs ord.ring: In Pennsylvania 1-600.36Z.20~0, out.ld. P.nnsylvanla and within local Harr Isburg aru (7111 767-8094, TOOs (711) 772.22~2 lIt.arlng I,.palr.d Only), OBJEctiONS: Any party in lnt.r..t not satl.fled with the apprals...nt, allowance or dl.allowanc. of deductions or as......nt of taM (Including discount or Int.rest! es .hown on thl. Notice .ay obJact within s}MlY (60) day. of r.celpt of this Not Ice by: ..writt.n prot..t to the PA D.part.ant of R.v.nue, Board of App.als, C.pt. 281021. Harrl.burg, PA 17128.1021, OR ...l.ctlng to have the .atter det.r.ln.d at the audit of the account of the p.r.onat representatlv., OR -.ap).al to the Orphans' Court ADHIH. ISTRATlV[ CORRECTIONSI Factual .rrors dlscov.r.d on thl. as..ss.ent should be addr.ss.d In writing tOI PA D.part..nt of Rev.nu., 8ur.au of Individual Ta..., AT1NI Post A....s..nt R.vl.w Unit, DEPT. 280601, Harrisburg, PA 17126.0601 Phon. (111) 187.6~OS. See page 1 of the bookl.t "Instructions for Inherltonc. ta. R.turn for a R.sld.nt O.ced.nt" (REV-ISOI) for an e.planation of adMlnl.tratlv.IY corr.ctabl. .rror.. DISCOUNT: If any taM due Is paid within thr.. Il) cal.ndar .onths oft.r the d.c.dent's d.ath, a flv. p.rc.nt ISZ) dI.count of the ta. paid Is allow.d. PENALTY: The 15Z taM aen.sty non.partlclpatlon penalty Is cOMPut.d on the total of the taM and Int.r.st assel.ed, and not paid before January 18, 1996, the flr.t day after the end of the taM aMn..ty periOd. This non.partlclpatlon p.nalty II app.alable In the .o.e Mann.r and In the the 10.. tl.. p.rlod as you would app.al the ta_ and lnt.re.t that has b..n ass..s.d ftS indicated on this notice. INTEREST: Int.rest Is charg.d beginning with flr.t day of d.llnqu.ncy, or nine C~I "anthl and on. (11 day fro. the date of d.ath, to the date of pay".nt, ta..s which beca.. delinquent b.fore January I, 19&2 b.ar int.rest at the rate of sl_ (6ZJ perc.nt per annu. colculat.d at a dally rote of .~001&4. All ta..' which blcane d.llnquent on or after January 1, 19&2 will b.ar Int.r.st at D rat. which will vary frol calendar year to calendar year with that rat. announc.d by the PA CApart".nt of Revenu.. The app1icabl. Int.r.st rate. for 19&2 through 1996 are: Vear Interest Aate Dally Internt Factor Venr Int.rnt Rat. Dally Int.rest Factor 1911Z 20Z .000"4& 19&7 9Z .000247 19113 16:<: .00043& 1988.}I11J1 lIZ .000301 1984 lIZ .000301 1992 ., .000l47 1965 13:<: .0003~6 11)'13-1994 1Z ,000192 1986 IO:C .OOO114 IfJCJ5-ICJ9& 9Z .000l47 --Interest Is calculated .. follows: INTEREST = BALANCE OF TAX UNPAID X NUnBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR .-Any Hotice i.su.d aft.r the tn. b.co.e. delinquent will refloct an Int.r..t calculation to fifteen (I") dayS b.yond the date of the ass.ss.ent. If pay..nt I~ eade after the Inter..t co~putDtlon date shnwn on the Natlco, ndditlonal Interest ltUst b. calculated. -, ,() PURPOSE or HOItCE: 10 fulfill the ,.quln..nts of Section 21..0 of the Inh.rltnnn Dnd [state 'n. Act. Ad lZ of IIJIJI. In P.S. Section 21..0). PAYHENI I a.tnch the top portion of this Hotlce and sub.lt with your pay..nt to the Aegister of Will_ printed on the rev.r.. side. .~ "aka check or .oney order payable to: REelstER Of WIllS, ACENt. All pay..ntl received shall flr.t be npplled to any Inter..t which .ay be due, with any t..ainder npplled to the ta.. REFUND (eA II A r.fund of a tax credit, which wal not reque.ted on the tax return, any be requested by co.platlng an "Application for Aefund of Penn,ylvanla Inheritance and [stat_ Inx" CAEY-131!). Applications er. available at the Office of the Aeglster of Will., any of the 23 Revenue District O,fic.. or by calling the sp.clol l4-hour onswering service nu.b.r. for for.. ord.rlng: In Penn.ylvanlo 1'800-56l-l0~0, out.lde P.nnsYlvonla and within local Itarrhburg ar.. 0171 187-8094, TOO- 0111 71l-ZZ~Z Wearing I.palr.d OnlYl. OBJECTIoNS: Any partv in Int.rest not satl,fl.d with the appralse..nt, allowanc. or dl.allowanc. of d.ductlon, or ass.s...nt of tall (Indudlng discount or Int.rnt) as shown on this Notice .ay obJ.ct wlthln .btv 1601 dav. of r.celpt of this HoUea by: --written prot..t to the PA nepart..nt of Rev.nue, Board of Appeals, n.pt. l81021, Harrl.burg, PA 17128-IOll, OR ".lacUng to have the .att.r det.r.ln.d at the audlt of the account of the personal r.presentatlve, OR --app.al to the Orphan.' Court AOHIH- ISTRAllY[ CORRECTIONS: factual .rror, dl.cov.r.d on this a,.e....nt should b. addr.ss.d In writing to: PA o.part..nt of R.v.nue, Burlftu of Individual Tan.. AnH: Post An.n..nt R.vlaw Unit, DEPT. 280601, Itllrrhburg. PA 17128-0601 Phon. (7171 787-6505. S.. page J of the bookl.t "Instruction. for Inh.rltanc. Tax R.turn for a R..ldent O.c.d.nt" (REV-ISOI) for an a.planatlon of adelnlstratlv.lv corr.ctable .rror.. DISCOUNT: If any ta. due I' paid within thr.. (l) cal.ndar .onth. after the dec.dentO, d.ath, a flv. perc.nt (5X) dl.count of the tax paid I' allowed. PENALTY: The I~X ta. aen..tv non-participation penalty II coeputed on the total of the tax and Interelt ol.....d. and not paid b.fore January 18, 1996, the first dav after the end of the tax a.n..ty period. Thl. non-participation penal tv I. appealable In the 'a.e eann.r and In the the .a.. tl.e period a' you would app.al the tax and Int.r..t that has been a......d a. Indlcat.d on this notice. INTEREST: lnter..t ,. charged beginning with flrlt day 0' d.linquencv. or nln. (9) .onthl and on. (II day fro. the date of d.ath, to the date of pay..nt. Taw.s which b.ea.. d.llnqu.nt b.fore Januarv I. 1982 be.r Int.r..t at the rat. of ,Ill (6l) p.rc.nt p.r annu. calculat.d at a dally rat. of .000164. All ta..' which beea.. d.llnqu.nt on or aft.r Januarv 1, 1982 will b..r Inter..t at a rate which will vary fro. cal.nd.r v..r to calendar v.ar with that rat. announced by the PA Oapart.ant of R.v.nue. The applicable Inter.st :at.s for Iq82 through 19q6 are: 1982 1985 Iq84 1985 1986 --Int.r.,t lOX 16X llX UX 10l I' calculated as .000548 .000458 .000501 .000556 .000214 follows: Year (nt.r..t Rat. Dally Int.rnt factor 1981 .X .000241 1988-1991 IIX .000501 Iq92 'X .000241 199]-1991, lX .000192 Iq95-1qq6 qZ .000247 Y..r Inter.,t Rate Oally Int.rnt rtletor INTEREST = BALANCE OF TAX UNPAID X NUnBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Hotlce I.,u.d .ft.r the taa becoe.. d.llnquent wlll r.flect tin Int.r..t calculation to flfte.n tlS1 day. b.yond the date of the as.."..nt. If pay.ent Is .tld. att.r the Int.r..t coeputatlon date shown on the NoUceo addltlonlll Interut lIIU,t b8 calculahd. / :' , , ,/ ,;' ,./ , , . v REV-1S48 EX AFP t12-9S1*, COH"ONW[AlllI or PlNHSYlVAHIA ~.. a[PAAINCHI or PlV[HU[ BUREAU Of INDIVIDUAL lAX[S ., ~ . ' DEPT. zaDbOl HARRISBURC, PA 111<'8-0601 ~~ NOTICE OF INIIERITANCE TAX APPRAISEHENTl ALLOMANCE OR DISALLDMANCE OF DEDUCTION', AND ASSESSHENT OF TAX ON JOINTLY IIELD OR TRUST ASSETS DATE 09-30-96 ESTATE OF FOLTZ JOANNE R DATE OF DEATH 0\-29-96 COUNTY CUMBERLAND FILE NO. 2\ 96- 0355 S.S/D.C. NO. 20\-\8-4823 ACN 96128487 GERTRUDE N SWANSON 2206 KENSINGTON ST HBG PA 17104 REMIT PAVMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 Aaount Renitted CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .... R-Ev:is4-s-Eif-AFP--ii;i:ijsi------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLV HELD OR TRUST ASSETS DATE 09-30-96 ESTATE OF FOLTZ JOANNE R DATE OF DEATH 01-29-96 COUNTY CUMBERLAND FILE NO, 21 96-0355 TAX RETURN WAS. S.S/D.C. NO. 201-18-4823 (X) ACCEPTED AS FILED () CHANGED JOINT OR TRUST ASSET INFORMATION ACN 96128487 FINANCIAL INSTITUTION: HARRIS SAVINGS BANK ACCOUNT NO. 01-\6-008887 TYPE OF ACCOUNT: (I SAVINGS ( I CHECKING ( ) TRUST (Xl TIME CERTIFICATE DATE ESTABLISHED 07-15-80 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate X Tax Due 35,584,85 0.500 17,792.43 .00 17,792.43 .06 1,067.54 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAVMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE TO. "REGISTER OF WILLS, AGENT." TAX CREDITS: PAVMENT DATE 08-28-96 RECEIPT NUMBER AAl46679 DISCOUNT (+) INTEREST (-) ,00 AMOUNT PAID 1,067.54 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE . IF PAID AFTER THIS DATE, SEE REVERSE FOR EALCULATIDN OF ADDITIONAL INTEREST. . I IF TOTAL DUE IS tESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREon" ( CRI, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. I 1,067,54 .00 .00 .00 PUAPOS( Of HOllCEI PAVHLHl, A[rtmD ICAh '\ j 10 fulfill th. '.'tult...nh III \.1111111/1"0 II' Ih. Inh.,lt",,(.. .nd [atIlt. 11111 Act, Act ZZ of 1991. (72 P.S. hctloo IhOI. D.t.ch the top PI" 'Inn of Ihla Holln ....\11 1111..11 with .,our p..,..nt to th. R.ght.r of Wills prlnt.d on the r.v.". .Id., .. H.... dl.... or .nu.., Qltl., ,u..".hl. lot "I OUtl " Ill' WillS, ACnn. All pu..nlt ,.ulnd ,h..ll fir" h. ..",111.11 10 IIOV Int.r..t which ..y b. du., with My r....lnd.r appll.d to the tlllt. A r.fund of .. t... cr.tlll, ..hlth .... flut '.'III.,tedon the 1.11 r.turn, _av b. reque.hd by co.pletlna 8n "Appllc.tlon for H.lund of ".nru.,lv""I" Inh., IlItllU "nil 1,'"1. If.... IHLV-I3I3J. Applications are available at the OffiCII of 'h. R.,h'.' of W1Ih, tMIV of "'II IS ".v.nllll Plair lei Olrlc.. or by calling thll sPllclal Z4'hour answ.rlng ..rvlce nuab." for for.. IlId.rlnUI In P.nn..,I",,,,,11I 1'1I00.}b/'101,0, oultlde Pennsylvllnlaand within local Harrlsbur. ,,'ea (111) 1"-flO"", 11Il1' (/11) 111-111,1 fllurlng (.Plllred Onlyl. OBJ(ClIOHSI Any par-tv In Int.,..t ""I ...'hfl.d wllh Ih. "p,,,..Is...nt, 1'I110wftnCII or dhallowanc. of daductlon. or a.......nt of te. Ilncludlno dluoun' IIr Inl.r..'I... thown on 'hit No'lce."y object within sbty (60) days of ncelpt of this Hot lu bvl --wrltlen p,ot..1 to Ih. I'l n.,I.,I.."1 01 1I.",.nll., lIn.rd 01 APP..", D.pt. 141011, Harrisburg, Pl 17lZIII'lDZI, OR ".I.ctlng 10 hi"'. th. ."tt.r 1I.1.,.III.d III Ihl /ludlt of the lIecounl of the p.rsonal r.pr...ntall",e, OR . ..PP.II to Ih. Oqllum.' Cour I AD"IN. ISIAATlVE caRRECIIONSI DISCOUNII P(NAltYI INllllrSlI r.ctuII .rro,.. dlUoVllI.d on Ihls I........n' .hnuld b" /lddr....d In writing 101 PA Deparl..nt of RI",.nul, BurelN 01 Indlvhtull I...., ""'II IIOSI A.......n' !levl.w Unlt, DlPI. Z8060l, tllrrhburg, PI. 171Z8.0601 Phon. (Iln 111-.\01,. S.. P"O" Sol the bno"l.t "In.ltucllon. for (nh.r1IMClI Iu Rlturn for. R.sld.nt Dlcedln'" UI,V-I\OII fa' "" ..I,IMlllllon of .d.lnlsl,"II","ty corrut"bl. .rrors. If .nv "II due Is ,...Id wllhln Ihr.. 1.\' c"IIIlII,,' lIonthl .fl.r the d.c.dent'. d.ath, a flv. p.rc.nt (S:O dlscoun' of 'he t... p"ld Is 11110.1". lh. 1\)[ ,,,. "M..t., "nn.p,,"h:htlttlHl ,I.n.lty I. co."ut..1 nn Ih. totlll 01 the tall .nd Inhre" au....d, and not P.ld b.lor. JlN1Ua,y I', I"., 'h. ra,., II"., ..Ihr Ih. .nd 01 Ih. tall alll1..ty p.rlod. Ihls non-partlclpatlon f1.neltv I, ""II..I"ble In Ih. '''1' I,"VI.r .nd In the the .11.. II.. p.rlod .. you would appul the talC and Int.r..t Ih,,1 h.. ".lIn .......11 .. Indl,,,I... IIn Ihls notl,.. Inh,..t Is ch.,.e" h.olnnln" with fl,., tlllY of lh.llnquencv, or nln. (II) .onlh. .nd on. (IJ day fro. Ihe "e'. of "..Ih, 10 Ih. 11..1_ 01 11...,.enl. I.... which b.ca.. d.lInqu.nt b.for. Jllnuary 1, 191Z b.., Inh,..1 ..t Ih. ..I. III III CUI ,'.'U"t per ftI1nUI ulculll,.d lit a dally rat. of .000164. All ,".., whllh ".U.. d.lln....'.nl IIn or .,I.r JMU.r., 1,1981 will bear In'e,..st at a r.t. which will vary fro_ <<:.I.ndl' y..r to f..I.nd.r .,..r wllh ItI"t rll'e .Mounc.d by Ihe PA D.part..nt of R.",.nu.. Ih. applicable 1r11.,..1 r..I.. ftu ''1'' thrUlIlIh 1""" "'., y..r Inl.,..t Wel. n!illy 'nl.,..t '"clor V.ar Inhr..t Rat. Dally Inbr..t Factor 1981 .~ .00QZ41 1988.1991 IU: .000501 1991 91- .000Z,.7 11191.199" 1~ .00011lZ 1119S.1996 .~ .OOOZ'" I'" l"lt I"'" 1'.\ I'" Inl".., "" IU II. I" III I. lellulel.d ". ,000\1It' ,GOo"s. .00nOl ,oonl,,, ,00DIlIIt 10110wII INJUUT . &ALANel: or TAX UNPAID X NunDER OF OAYS DELINQUENT X DAILY INTEREST FACTOR I", Ml1lln I,,".d ."., Ih. I'll b.eo... d.llnqu.nt will refl.ct an Intere.t c8Icul.tlo" to flft..n lIS) days ""II"d Ih. I,.t. of Ih. ........11'. If Plly..nt I. ."d. lIfter the Int.r.st co,putatlon d.'. .hown on Ih. H..' h., ".'.11' I INI.. I I"hr..' ..", ... C:lllculltt.d. STATUS REPORT UNDER RULE 6.12 Name of Decedent: 30 RnJ\e_ ULLl~ Date of Death: \ - d q - 9-~ Will No. ZI-qlt1- OsS- 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 ~ether administration of the estate is complete: Yes ,Y' Nu_____ 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 sl'pilr'ate Or'phans' (""urt No. (if any) for the personal representiltive's account is: c. Did t.he pel'sonal r'eprespntative state an account informally to the parties in intel'pst? 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: ?J;.-"/O! I .1 I! . II-. ,,( ~.~(l~ll-..., l' Signat:.ur. lti~ I j'1 (5EI1/V/].ll/t! d, r0Li?, J.1... Name (Please type or print) ,] r~"'~7 ~ ~/C:J >~ .",- Add niss" )~- ''','J.1J~ .'-I'l..1 . /./} ~~ if" S'l/f)? Tel, N,.'. CdpdC i t y: / :/ Personal Representative Counsel for personal l'epresentative (MAfl:rmf/AM3) \ ,