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I'ETITIOi\; FOH I'IWUATE :Il1d GHANT OF LETTEHS
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OATil OF PEI{SONAL REPRESENTATIVE
COMMO:\\\"EAI.T11 OF I'E:\:\SYI.\'A:'\IA l '"
COlJ:\TY OF CUMBER~AND________ J ,;.
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Nil. 21 - 96 - 392
Estate Ill'
DELORES MAE DEltART
. Deceased
DECREE OF PROnATE ANI) GRANT 01<' LETTERS
AND NOW MAY 14, 19~, in consideration of the petition on
the Teverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the in<lrument(s) dated JUNE 29. 1994
described therein be admitted to probate and filed of record as the last will of
DELORES MAE DEHART
and Letter< TESTAMENTARY
arc hereby granted to CINDY MARZULLO
'-
Rcgj'tcr of Wills
MARY C. LEWIS
&:to 9rt.
FEES
Probate, Letters, Etc. ...',.'" $ 40.00
Short Certificates( 2) ,...".,.. $ 6 .00
Renunciation "....."".,.,. $
X-Page $ 3.00
JCP 5.00
TOTAL _ $-54-rllG-
Filed ..... t'l!\.Y, .1 ~,', ,m.q . . , . , , . , , , . . . . ,
ATTORNEY tSup. CI, 1.0. Nu.)
ADDRESS
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COMMONweALtH Of PEHHSYlVAllIA. OEPAnTMEUT OF IlEALTII. VITAlnEconos
CERTIFICATE OF DEATH
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'FEMALE . 177 - 24 - 6323
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LAST WILL AND TESTAMENT
I, DELORES MAE DEHART, being of sound mind, memory and
understanding, do make, publish and declare this my Last will and
Testament, hereby revoking all prior wills and codicils made at any
time before by me.
FIRST: I direct that all my funeral expenses and just debts
be paid as soon as practical after my death.
SECOND: I direct that all my property be it real, mixed or
personal of whatever nature or kind be sold, at either public or
private sale and the proceeds thereof be distributed equally among
my children, Shirley Mowers, Delores Neil, Carolyn Kirby, Charles
Dehart, George Dehart, Kathy Hockersmith, Carl Dehart and Cindy
Marzullo, in equal shares, share and share alike, per stirpes.
THIRD:
I hereby nominate, constitute and appoint Cindy
Marzullo, as the Executrix of this my Last will and Testament.
IN WITNESS WHEREOF, I, DELORES MAE DEHART, to this my Last
Will and Testament, set my hand and seal, this J(~tl'\ay of June,
1994.
.&L~ N'I< J01s-tcL;;X
Delores Mae Dehart
(SEAL)
Sworn to and subscribed, declared and ~
published by DELORES MAE DEHART, as . -P;;,~. ---. .
her Last will and Testament, and so ,--~J2 )'L:.. _~ ~:-.l
done in the presence of we the " '-.....
witnesses, who sign at her request, /;' c-- -~
and in her presence, and in the ~ I. - . .
presence of each other. ". A 'i. J I. >l t tJ-U" u..... Ut.6....-.--
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COMMONWEALTH OF PENNSYLVANIA:
:SS
COUNTY OF CUMBERLAND
I, DELORES MAE DEHART, whose name is signed to the foregoing
instrument, having been duly qualified according to law, do hereby
acknowledge that I signed and executed the instrument as my Last
Will and Testament; and that I signed it willingly; and that I
signed it as my free and voluntary act for the purpose therein
expressed.
.k \\, \. ....,,,~... no ,u " fj>:\' cud-:
Delores Mae Dehart
Sworn to and acknowledged, before me,
by DELORES MAE DEHART, the Testatrix,
's ~i~ day o~ Ju e, 1994.
\
.:;M..SEAL
.. . ') P, Notary Public
. . 'land County, PA
1$ Feb. 5, 1996
NC
DAWN MN' .
Shippen~b:: .
My co:.:::~-::,.: ,
Notary Publl.c
COMMONWEALTH OF PENNSYLVANIA:
:SS
COUNTY OF CUMBERLAND
We, H. Anthony Adams and Sharon Coleman Adams, the witnesses
whose names are signed to the foregoing instrument, being duly
qualified according to law, do depose and say that we saw the
Testatrix sign and execute the instrument as her Last Will and
Testament; that she signed willingly and that she executed it as
her free and voluntary act for the purposes therein expressed; that
each of us in the hearing and sight of the Testatrix signed the
Will as witnesses, and that to the best of our knowledge and the
Testatrix was at the time at least eighteen (18) or more years of
age and of sound mind and under nO,c3nstraint or undue influence.
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H. rony Ad'",_. "'''" ~
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, "pi t">u Ii {~'LCIi" Od:.<l""-'
Sharon Coleman Adams
sworn to and subscribed before me by,
H. Anthony Adams and Sharon Coleman Adams,
e. witnesses, this ~)'7.'" ,day of June, 1994.
'luv\ \ llel L U C''r~ )(f)
Notary Publl.C :::;,
tlOT MlIAL SEAL
DAWN MARIE SHOOP. Notary Public
ShlppOnsbufg, Cumborland Co~n\y, PA
My Commission Explros Fob,S, 1996
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CEH'l'1 F I CAT I ON 01': .f1nT r(.~.I~I!tll?.r~!i... HIJ!.!~. ",.6 [ <1 )
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Name of Decedent: Dr \ (ic.c.s_.D " ~\:)pr::o.cl
Date of Death:--8pu.l-lli-._\.Q q (0
"DFt 0<,. ,::) \ ClLJ . C'3 C't@
Will NO.~I~ tV!lnin, No,
To the RegisLer:
1 certify that notice of beneficial interest required by
Rule 5.6(a) of the Orphans' Court Hules was served on or mailed to
the following beneficiaries u[ the above-capLioned estate on
, \ l )(""C- L1, l.9.B!a.-:
,
Name
Address
.Sn i ( \~l) (~ () :'Ct . I' (' ':"
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. <:. hr./'. 1).) nQ~)
,.:;} A\\VIYy':',., I (\.(,11 ...).~rlCUCF-)
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except Cd\ nCt\i-(";c'ef
Da te: . \l X"'\C c.), I Cj Clle
C'lridtl ~. / )1 CLN.l-J.lD
signatur17 l ~
NameLindll S oJ arlu/lo
Arirlress \Ol \ C e \ec:-~j (, T:::xit Ie='
,.:.'--, \ \ \ (Jpf' (l sb J( S I, PF\ n d.-Y) -<(~
Telephone(711 5's,,;). S S"IU
Cap<lcily:~rsonal Representative
Counsel for personal
"'~presen ta t i.ve
C0l1110HWI ,1,1111 III t'I NHSVI VAHIA
tJ1I1ANII'41Ht or Il[VIHU[
f!UUUU 01 INDIVIDUAL TAlIJS
DLlII. :1101101
lIAPNISRUUG. PA 11Il11-0bOI
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INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21 Q6-0392
ACN 96127359
DATE 07-10-96
'h'lhl !II" ".'\1
TYPE OF
ACCOUIH
o SAVINGS
o CItECKING
[] TRUST
ii] CERTIF.
TO:
EST. OF DELORES M DEHART
5,5. NO. 177-24-6323
DATE OF DEATH 04-16-96
COUNTY CUMBERLAND
CINDY S MARZULLO
1071 CELESTE DR
SHIPPENSBURG PA 17257
REMIT PAYMENT AND FORMS
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE. PA 17013
ORRSTOWH BANK hIlS provided the Dapitrt"ant with tha InforMtion Ilstod below which hitS beon used in calculating the
potential ta~ du.. Thalr records Indicate that at the death of the above dac8dant, you ware a joint ownar/baneflclary of this account.
If you fael this infor~atlon Is Incorract, please obtain written correction fro. the financial Institution, attnch a copy to this for.
n~~ r.turn It to the above adrlress. This accou~t Is ta.a~le In accordance with the lnharltance taM laws of the Con_onwaallh of PannsYlvanla.
Cuestlons ~ay be answered by callJng 11111 lSi-lllZl.
CDMPLETE PART 1 BELOW . .
Account No. 0030051131
. SEE REVERSE SIDE FOR
o.tu 02-06-95
Established
FILING AND PAYMENT INSTRUCTIONS
Account Balance
Percent Taxable X
Amount Subject to Ta~
Ta~ Rate X
Potential Tax Due
500.9B
50.000
250,49
.06
15.03
TAXPAYER RESPONSE
RESULT IN A~ OFFICIAL TAX ASSESSMENT BASED ON THIS NOTICE J
To insure proper credi t to your nccount. two
IZJ capias of this notlc. nost acco"pony your
pay.ant to the Peglster of wills. Make check
payable to: "Register of Wills, Ag8nt".
NOtE: If taM pay.ents ore .ade within three
(1) nonths of the decedent's date of death,
you "ay daduct a ~% discount of the taM due.
Any InharltanC8 ta~ due will beco_e delinquent
nine Iql Months a,ter the date of death.
PART
COI FAILURE TO RESPOND~ILL
, CHECK
ONE :
BLOCK J
ONLY
A. .. n lhe above inforllatlon nnd taM due Is corrllct.
j ~ 1. You "ay choose to ra_1t pllynant to the Peglstar of wills with two caples of this notlc. to obtain
~ a discount or avoid interest. or you ""y check bo~ "A" and raturn this notlco to the Ragistar of
Wills nnd an officlnl nssoss~.nt will bll Issued bv the PA Doparl~ent of Pavonue.
8. c=J The above asset has been or will be r.porlod and taM paid with the Pllnnsylvania Inheritance 'n~ r.turn
to be filed by the dacedent's roprasantative.
C. L-j the above Infor"atlon Is incorrect and/or dubts and daductlons waro paid by you.
You ~ust co_plote PART ~ and/or PART ~ bolow.
---..--,
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",,",,"II ...'rol.....,....... ,"n ....., ""....I.I~ I""""" r._...~v.,....
OFFICIAL USE OIlLY 0 AAF
PAc9~ARTM~IlT OF R~VENUE
_ c- ',;- .....:.:~... ...~~~__
,.-.
PART
~
If you indicate a different tax rat., please state your
relationship to decedent:
-...
'"^
iA:i
LINE
1. Dat. Established
2. Account Balance
3. Percent Taxable
4. Amount Subject to Tax
S. Debts and Deductions
6. Amount Taxable
7. Ta~ Rate
8. Tax DUB
1
2
3 K
4
5
b
7 K
8
1
2
3
4
5
6
7
6
DEBTS AND DEDUCTIONS CLAIMED
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PART
[!J
DATE
PAID
PAYEE
DESCR I PTI ON
AMOUNT f'.AID
TOTAL (Enter on Line 5 of Tax Computation)
Under penalties of perjury, I declare that the
complete to ,the be.t of my knowledge and belief.
I
$
I ;
TAXPAYER SIGNATURE
facts I have reported aboye .r. tru., correct .nd
HOME 1
WORK ( 1
TELEPHotlE /lUMBER DATE
GENERAL INFORMATION
1. FAIlUR~ TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSt1ENT with jl111111c<\blu Jnturnt tun"dun lnfrn....,tlnn
IUblllllthd by the flnl'lnclltt Institution.
Z. Inh.rltanc. 1ft. beeOIl..1 dollnqu..nl nino 11I0"1111 .1ft., th" IIIlCluhmt', I1lth, II' ,h'/lth.
1. .. joint .,(count 11 ("."111_ IIVU" though th" decadent's 'HI". ..ns mlllinl .n .1 ".lU.., II' conllonlllnell,
4. Accounts (Including tho'lI hlll11 b.t....n hush,,"d It"d wlfel which Ill" dllcDI!tml Ilut In Joint 1M""" wlttll" m,.. ""fH flrlnr In
"O..th a'. lully '"."blll as tron".r..
!to Accounts lI.tllbllsh.d jointly h.tw.en husbAnd IInd wlf. nor. tl1nn onll yo." f1r1m to dOlllh Mill 110t \ft..Illl".
6. Accounts hllld by .1 dllClldll,,1 "In trust for" {,"other or oth.r. .n. tn.'llllo fully.
REPORTING INSTRUCTIONS - PART
I
- TAXPAYER RESPONSE
I. BLOCK A - If Ih. Inforlllatlon I\nd cOlllputatlon In the notice .ue Lorr.et .1nrJ Illlductlnn'\ Me not b.lng clllh'l.d, plnee IIn ")("
in block "A" of Pllrt I of the "Ta"paYllr RII5Ponu" sllctlon. !;Ign two cOld liS <lnd sublllit thlllll with your ch.clo fnr the lI"ount of
ta. to tho Reglshr of Wills of tho county IndlClltod. The "A DepMt""nt of Rllvllnue will luu. ,In olflclnl .1nes"",.nt
(Forlll REV-I~48 EXI upon reclllpt of the r.turn frolll the ~.glstor of wills.
Z. BLOCK B - If thll .1IUt speclflod on this notice has boen or will b. nUlorhd imd tall pllld with the Pennsvlv"nln Inhoritllnco
fall Return flied bV the decedent's rllprlls.ntative, plocII itn "K" In iliacI< "BOO of Part I of tho "la_pllyor Pesponso" section. Sign ono
copy and rlllurn to the PA Departlllllnt of Rllvenue, Burllau of Indivldu<'ll ,.....s. nllpt lM601. Ilarrhburg, IIA IIIZa.ObOI In the
onvolop_ provided.
3. BLOCK C - If thll notlclI Infor""tlon Is Incorrect lind/or dDducllons arn being ClllliJIlld, chllck blocl< "COO nnd cOlllplete Parts Z IInd 3
ttc.:uroir.c t~ tn. ,..s.rI..~..lu,,~ ......0..
:>iw., h... ..I,..~i..... ...... "........ ..,... ...... ......... ......... ~..
"". ..__....; ...:
. - .
.<lA ....,..... ~ ... .... ".,.......
of wills of the county indicated. The PA D.partlllent of Rllvenuo will IssuII IIn official aSSllss"'"nt Irorlll REV'IS48 [I() upon rllc_lpt
of the return frolll the Rog)stor of wills.
TAX RETURN - PART
2
- TAX COMPUTATION
LINE
I. Enhr
NOTE:
the dato thll account originally was IIstobllshed or titled In the ""nner elllstlng lit dato of doath.
For a dllc.dllnt dying after IZ/IZ/8Z: Accounts which tho dllclldont put In joint nalllllS within ona III voor of denth are
tallabl. fully liS trans"'rs. liowllvllr, thllro h .1n .1IclusJon not to QlIcolld Sl,OOO pllr transferoo rogardltlss of the valuo of
the account or tho nu.bor of accounts h.ld.
If a doubl. ast.rlsl< I..) app.ars bofore your first nafto In the ~ddross portion of this notice, the S3.000 ellcluslon
alrondY hns boon deductod frolll tho account balanCII as roportod by tho flnnnclal Institution.
Z. [nt.r the total balancII of the account Including Intorllst nccrulld to tho date of dDath.
3. Tho percont of thll account that Is tallnble for oach survivor Is d.t.r.lnlld os folJows:
A. Tho p.rcont tallablo for joint assots established nore thnn onll Yllar prior to tho dllclldent's d.ath:
DIVIDED BY TOT~L NUMBER OF
JOINT O\I"ERS
Ellalllplll: A joint assot registorod
DIVIDED BY TOTAL NUI1BER or II 100 PERCENT TAXABLE
SURVIVING JOINT OWNERS
In tho na.o of tho d.codont And two other porsons.
I DIVIDED 8Y 3 IJOINT OWNERS 1 DIVIDED BY Z ISURVIVORS) . .167 I( 100
Ib.7% lTAllABl[ rOR [ACIl SURVIVOR)
B. Tho porc.nt tnllnblo for ass.ts croatod within ono yoar of the docedont's doath or ~ccounts o~nlld by the doced.nt but hold
In trust for anothor Indlvlduallsl (trust bllneflclorlesl:
t DIVIDED BY TOTAL NUI1BER OF SURVIVING JOINT
OWNERS OR TRUST BENEFICIARIES
II 100 . PERCENT TAlIABlE
[llalllplo: Joint account roglstllrod
tho decedent.
I DIVIDED BY Z (SURVIVORS) . .SO
In tho no.e of the docodllnt nnd two othllr p.rsons and tlstAbllshod within on. YOllr of death by
II 100
SOl: I 'AllABlE rOR [ACIl SURVIVOR)
4. The Rllount subJllct to tall (line 4) is doterllllnod by nultlplying the .1ccount balanco Illno Z) by the percent talloble Illnll 3).
~. ~n.~r tho total of tho debt, nnd dftductlons II.tad In P<'lrt 3.
6. The a,;,'"iunt tallable tlln3 61 Is dehrllllnlld by sublractlnl) tho !Jobh and doductions Illnll SI tro. tho aAount subjllct to tall Illne 4),
7. [ntor the approprlato tall rato Illne 71 as dlltorllllnod below.
A. ror datlls of dllath occurring 8ftllr 6/30/94, tho tall rat os for trAnsf.rs to spousos orll dS follows:
I. Oat.. of dllath on or aftllr 1/1/94 And be for. 1/1/9S thll rato Is 1%.
Z. Oat.. of donth on or after 1/I/qS transfllrs to spouses will b. tall.d at 0% tall ratll.
Not.: For dnt.s of dllnth prior to 7/1/94 transfllrs to spousos arll 1a_abl. at b%.
B. Transfors to Ilnoal d.scondanh Including fathllr, Mothllr. son, daughtor, grnndchlldr.n. ,0n-ln'lnw,
daughter-In-Iow, stopchild and thlllr issue aro trtllnble at 5110: Ilorcont IlIi:!.
C. TrAnsf.rs to nil others Including brothllr, sister. uncle, /lunt, flophow .1nd nlllce nro ta_flbl. .1t flftolln porcont liS;:).
D. If you chango tho tall rato. plllaslI sp.cify your relationship to 1h. dec.dAnt In the Ar.n provldod.
8. Tho illllount of tall duo Illne 81 Is detoHtlnlld by r.tultlplvlng Ihll 'llllount tMoble Illne tol by tho tnll rat. Illnll 11.
CLAIMED DEDUCTIONS - PART
3
OEBTS AND OEDUCTIONS CLAIMED
Allowable dobts and deductions lire detar_lned AI fQIlo~s:
A. You logally are relponslble for paYlllont, or tho IIstal. subjllcl to ndllllnlltratlon by 8 porsonal roprtlsonlatlve Is Inlufflclent
to pay tho doduct Iblo ltOIllS. .
B. You actuallv paid tho d.bh nftor duth of tho decedont .,nd c"n furnhh proof of PI'lY.8"1.
C. Dobts blllno clalnod IIIUSt bo Unlrod fully In PMt J. If .lddltlonnl spnce II n.llded. un plnln prtper ., In" Jl U". Proof of
pnYIII."t IIIny bo roqu.stod by the PA Depnrt..nt of Rov.nue.
TAXPAYER ASSISTANCE
IF YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT AllY
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. TDD' (717) 772-2252 (HEARING IMPAIRED ONLY)
.-." _._--- -.-" _..
D NO. AA
146568 COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT Of REVENUE
OffiCIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
.
INo1l61IJlIIi..AI
ACN
ASSESSMENT '='
CONTROL ~
NUMBER
AMOUNT
RECEIVED FROM:
6
'iblC:!/";j';)9
~l';).\)";j
CINDY 5 MARZULLO
1071 CELESTE DR
SHIPPENSDURG. PA 17257-8998
ESTATE INfORMATION:
I:t filE NUMBER
~ 21-1996-0392 SSN
I:t NAME Of DECEDENT (lAST) (FIRST)
~ DEHART DELORES MAE
II DATE Of PAYMENT
m POSTMARK DATE
COUNTY
177-24-6323
(Mil
CUMBERLAND
DATE Of DEATH
m TOTAL AMOUNT PAID
'U:S.03
CW
REMARKS
CINDY S MARZULLO
r
J -I'
RECEIVED BY" /.0', ,', I",.,
SIGNATURE
,/ ,:,..-:.,
SEAL
CHECKIt 0976
~ i ,;_ ,: I
MARY C. LEWIS ,/"."i I
REGISTER OF WILLS I
REGISTER OF WILLS
~ ---. ....-_. .-- ".*.
.4_'_ --~ .
- .
..---
-."'-
-..---.....N.~ .._~.-'V .,:.
kJ / t<' - {!
BUREAU OF INDIVIDUAL TA~ES
IHtlLRI'AHC[ fAlC DiviSION
D[PI. ~ao.Ol
IIARRISBURC. III l/lla-OhDI
CUMMor:WEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
/ ~*'
NOTlCt OF INlltRITANCt TA~
APPRAIStHtNTL ALLOMAllct OR DISALLOMANCt
OF DtDUCTION>, AND ASStSSHENT OF TAX ON
JOINTLY IItLD OR TRUST I,SSETS
II. Ihl U II' lI,h.
CINDV S MARZULLO
ID7l CELESTE DR
SHIPPENSBURG PA 17257
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
12-16-96
DEIlART
04-16-96
21 96-0392
CUMBERLAND
177-24-6323
96127359
DELORES
M
A~ount R.nltt.d
MAKE CHECK PAVABLE AND REMIT PAyr,ENT TO:
REGISTER OF WILLS
CUMBERLAND CO CDURT HOUSE
CARLISLE. PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
R-iv:isirS-Eif-AFii-fi-i:9&i------------------------------------------------------------------------------------
NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE DR DISALLOWANCE OF
DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS
DATE 12-16-96
ESTATE OF DEHART
DELORES M DATE OF DEATH 04-16-96
CDUNTV
CUMBERLAND
FILE ND. 21 96-0392
TAX RETURN WAS:
S.S/D.C. ND. 177-24-6323
(X) ACCEPTED AS FILED ( ) CHANGED
JDINT OR TRUST ASSET INFORMATION
ACN
96127359
FINANCIAL INSTITUTION: ORRSTOWN BANK
ACCOUNT NO.
0030051131
TVPE OF ACCOUNT: () SAVINGS ( ) CHECKING ( ) TRUST (Xl TIME CERTIFICATE
DATE ESTABLISHED 02-06-95
Account Balance
Percent Taxable X
Amount Subject to Tax
Debts and Deductions
Taxable Amount
Tax Rate X
Tax Due
500.9B
0.500
250.49
.00
250.49
.06
15.03
NOTE: TO IhSURE PROPER CREDIT TO
YOUR ACCOUNT. SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH VDUR TAX PAVMENT TO THE
REGISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEV ORDER PAVABLE TO:
"REGISTER OF WILLS. AGENT."
TAX CREDITS:
PAVMENT
DATE
07-29-96
RECEIPT
NUMBER
AA14656B
DISCDUNT (+)
INTEREST (-)
.00
AMOUNT PAID
15.03
TOTAL TAX CREDIT
BALANCE DF TAX DUE
INTEREST AND PEN.
TOTAL DUE
. IF PAID AFTER TNIS DATE. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .
I IF TOTAL DUE IS LESS THAN $1. NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CRI. YOU HAY BE DUE A REFUND.
SEE REVERSE SIDE OF TillS FORH FOR INSTRUCTIONS. I
15.03
.00
.00
.00
PURPOSE Of
NOTICE I
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To fulfill the r.qulr...nt, ~f S.~tlon 1140 of the Inh.rlt.nc. .nd [,1.1. f.. A~t. A~I 11 of 1~91. III P.S.
S.ctlon Z140).
PAVHENT: D.tach the top portion a' thl, Natlc. and sub.it with your p.y..nl to the ~.gl't.r of Wills prlnt.d on the
rev.rs. sid..
.- H.k. ch.ck or .oney ord.r p.yabl. to: ~EGISTER Of WILLS. AGENT.
All p.y..nts r.c.lv.d sh.11 first b. .ppll.d to any Inl.r.st which .ay b. du., with .ny r...lnd.r .ppll.d 10 the t...
REfUND (CR): A r.fund a' . t.. cr.dlt, whl~h wa. not r.qu..t.d an Ih. la. r.turn. a.y b. r.qu.st.d by caapl.tlng an "Application
for Rafund 0' P.nn.ylvanla Inh.rlt.nca .nd E.tal. T.." (REY-Illl). Appllc.tlon. .r. av.llabl. at Ih. Offlc' 0'
the R.gIst.r of Wills, .ny 0' the Zl R.v.nu. DI'lrlct Of,lc.. or by calling Ih. ,p.~I.I Z~-hour answ.rlng ..rvJc.
nu.b.r. far for.. ard.rlng: In P.nnsylv.nl. 1-800-36Z-20S0. aul.ld. P.nnsylvanla and within 10c.1
Harrisburg ar.a (111) 181-8094. TOOl (717) 71Z-Z2SZ (Hearing lapalr.d Only>>.
OBJECTIONS: Any party In Int.r.st not .atllfi.d with the .ppral,...nt. .llawanc. or dlsallawanc. of d.ductlon. or .....s..nt
of t.. (Including discount ", Int.rut) as shawn an this Natlc. .ay abj.ct within shtty (60) day. of r.c.lpt of
this Notice bYI
--wrltt.n prat..t to the PA D.part..nt of R.v.nu.. Board of App.al.. D.pt. Z81021. H.rrl.burg, PA 17128.1011. OR
--.I.ctlng to have the ..tt.r d.t.r.ln'd at the audit of the .~caunt of the p.rsanal r.pr...ntatlv.. OR
--app'al to thl Orphans' Court
ADI1IN-
ISTRATlVE
CORRECTIONSI
01 SCOUHT J
PENAL TVI
INTERESh
Factual .rrar. dl.cov.r.d on thl. a.......nt .hould b. .'dr..s.d In writing tal PA D.part..nt of R.v.nu.,
Bur.au of Indlvldu.1 T..... ATTNI Pa.t As......nt R.vl.w Unit. DEPT. 180601. H.rrlsburg, PA 171Z4-0601
Phon. (717) 747-6505. S.. pag. 5 of the baakl.t "Instruction. far Inh.rltanc. Ta. R.turn far a R..ld.nt
D.c.d.nt" (REY-1501) far an ..pl.natlan of ad.lnlstratlv.ly corr.ctabl. .rrars.
If any ta. due I. paid within thr.. (1) calendar .anth. aft.r the d.c.dent'. d.ath, a flv. p.rc.nt e5~)
dl.count of thl t.. paid I. allow.d.
Th. 15X t.. a.n..ty non-p.rtlclpatlon p.nalty I. co.put.d on thl total of the ta. and Jnt.rlst ass.ss.d. and not
paid b.for. January 14. 1996. thl flr.t day aft.r the .nd of the t.. eane.ty plrlad. Thl. nan-p.rtlclpatlon
Plnllty I. .pp..l.bl. In the .... .anner and In the the .... tl.. p.rlOd I' you would app..1 the ta. and Int.r..t
that h.s be.n a......d .. Indlc.t.d on thl. natlc..
Int.r..t I. ch.rg.d b.glnnlng with flr.t day of d.llnqu.ncy. or nln. (9) .onths and on. el) day
fro. thl date of death. to the data of pay..nt. Ta..s which b.~a'. d.llnquent b.for. January 1. 198Z
bear Int.r..t at the rat. of .1. C6~) p.rc.nt p.r annu. calculat.d at a dally r.t. of .00016~.
All t.... which b.ca.. d'llnqu.nt an or .ft.r January I, 1982 will blar Inter..t at a rat. which will vary fro.
cal.ndar y..r to cal.ndar y.ar with th.t rat. announced by the PA O.part~.nt of R,vlnu.. Th. appllcabl.
Int.r..t rat.. for 1911Z through 1997 ar'l
V.ar Int.r..t R.t. Dally Int.r..t Fa~tar V..r Int.r..t Rat. Dally Int.r..t Factor
1982 ZO;: .OGOSIo8 1987 .~ .000Z~7
1981 16~ .0001018 19118-19'1 11;: .000101
1984 11;: .000lGl 1992 .~ .GGOZU
1985 ll~ ,000lS6 1991-19910 I~ .GOOI':
1986 lOX .0aoZ1~ 1995-1991 .~ .000Zlo7 . '
--Int.r..t Is calculat.d a. follow'l
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notlc. I.su.d aft.r the ta. b.~a~I' d.llnquent will r.fl.~t an Inl.r.st c.lcul.tlon to flft..n (15) day.
b.yond the date of the .......ent. If pay..nt I. .ad. .ft.r Ih. Int.r..t ca.putatlon date .hawn on the
Notlc.. additional Int.r..t aust b. calculated.
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
COMMOUW""" 01 "",,,nvAl". (TO BE FILED IN DUPLICATE
Dl'.AR1MfNIOf RIV(NUI
~,...~,fJ:~. }~\'J:"O""I WITH REGISTER OF WILLS) COUNTY CODE J L
DlcrolNn tU.M( IIA\I, 'IU1 Arm MI(IO\( INItiAl! hlCl (Jill! \ CQ""IL,II A~ll~U\
JJ.LUcuJ.,_LY.:..IC(C'. {II ! i' )11'(1',('
SOCIAl \ICU~ll' HUM'II JOA" 01 PIAhl ~ jlJATI 011111111 ~ ~ I 'j / r. . I, (
LL:..L..::l..!./_w.J..d...L ~L~J I c' 111, L :..' /" /.L~r/ co.']" - . ..'. .--'
1,1 "'''II(Ulll \u..,.It.Q VOu\I' tu..., It"U 11\1 .t,o... [>ll, I ";' &<1 \(){IAI \1(UllIl' ~'UI.\II11 "MOU'" Rlelll/tO 1\lllfl\1IUC1,OUSI
1.1 I m_ __. .________'_____ ----:--
Original Return [I 2. Supplemrmlol Relurn Ll3.
[J 5.
. .
Il(V.I~OO('" I1?AI
>-
x
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o 4. limiled E'lole f] 40. Future Inletl'" Compromil'
./_ (for do"" 01 death oltel '2.12.821
,06. Decedent Died 1.,1010 [] 7. Oecedent Maintained Q living Trus'
(Attach copy 01 Will) (Allach copy of Tru,11
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECT I
f COM'UH MAILING AODIl(SS CO
, \ '( , .L (~\ \ " J (; ,. I (('I(3,:t.j
IT
~ ','J _ " L ( 'j;,. ) ('"., b~.."
20. If line 191s grealer Ihon line lB. enler the difference on line 20. This is the OVERPAYMENT.
a 0 .":r.r.I'IIil>l~'.I"TI'I'.'I~'.~'I.I.(~tllll~ ...~;l rtr.r.1r.'I..T.I.I'I..1....l,U.I~1..~ 'II,J,I
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1. Reol Ella'e (Schedule A)
2. S'ock. o,d Ba,d.(Schedule B)
3. Closely Held Stoc~/Partnership Interesl (Schedule C)
.4. Mortgages and Notes Receiyoble (Sclledule D)
5. Cosll, Bank Deposils & Miscellaneous Personal Property
(Schedule EI
6. loinlly Ow,ed Properly (Schedule F)
7. 1ro",le.. (Schedule GI(Schedulel)
8. Tolol Gran Anets (10101 lines 1.7)
9. Funeral Expenses, Adminlstratiye Costs, Miscellaneous
Expenses (Schedule H)
10. Debls. Mortgage liabililies, liens (Schedule I)
11. Tolal Deductions (10101 lines 9 & 10)
12. Net Value of Estole (line 8 minus line 11)
13. Cllorilable and Goyernmental Bequesls (Schedule J)
U. Nel Value Subiect to Talt (line 12 minus line 13)
15. Spousal Transfers (for doles a' deolh after 6.30.94)
See Instructions for Applicable Percentage on Reyerse
Side. (Include values 'rom Sclledule K or Sclledule M.)
16. Amount of line 1.4 loxable ot 6% role
(Include values from Sclledule K or Schedule M.)
17. Amount of line 14 taxable 01 15% role
(Include values from Schedule K or Sclledule M.)
18. Principol tax due (Add tax from lines 15, 16 and 17.)
19. Credits Spousal Poverly Credit Prior Payments
+
.J
fOR DAIlSOf DlATHAnER 12/31191 CHlCK HIRI
If A SPOUSAL
POVERTY CRlDIT IS CLAIMlD I I
fill NUMBER
_1(/~
YEAR(jC, NUMBER
,',fJ", '"Iicr.r!
., I . , , /'7 ;;J ~ '7
Remainder Relurn
(for doles of dealh prior 1012.13.82)
Federal Estale Tax. Relurn Required
.::. 8. Totol Number of Safe Deposit Boxes
\Q :om
/NILX'C"n
t'- CJ
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x .06 =
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(171
x ,15 =
(I B) .._-=:!.3_;:'i C)')
Discount
Inleresl
+
(19)
120)
. c: '1 ..c.37
1211 __.l_l-<:'l '
(21 A)-'",--r- '"'I:i-,
(21B),_,~"" .
21. If line 18 is grealer thon line 19. enler tile difference on line 21. This is the TAX DUE.
A. Enter tile interest on Ille bolance due on line 21 A.
B. Enter Ihe totol of Une 21 and 21A on line 218. This i\ the BALANCE DUE.
Make Check Payable to: Reglst.' of Willi, Agent
~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH .0(
U"der penolties 01 perjury. I dedare that I hove examined this relutn, including accompanying \chedules and ,talemenl\, and 10 tile belt of my knowledge and belief.
it is Irue, corred and complete. 1 declare Ihal 011 real eSlate has been reported otlrue morket value. Declaralion of preparer olller than Ihe penonal representalive is
based on 011 information of which preparer has any knowledge.
~17~:u;[ 0' .,",ON,IlUPQNSIIU'7. filING RtTORN -'/~ ...oOil(~!. --;.. ; ,1 "'---.--- DAlf
, ~rll t \. (1. .CLJ.{Ld(C. _JC7.LL:,.,-:'.)IL[1_,~;-lbS).&' .,; 11- " A /3,' l 9!/1
!oION uRl Of PU,.,. ~HAN tPlll~tuTA1~l ACORUS 1 DAH
\' ,-
.- ---~.__.- ------------...--... --- -
--.---- --'--'--'-'--~--- .--...--- ~----_.._---_..-
..'I'o'I\lIII.'l".1
~ :~ "
". ~:'~'C'
... t~'~
(OMMONW(Alftl Of ppmSHiM'IA.
ItmUU4NCI IU Il(lUlm
RUID(NIDlCrDWI
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
I .... ,. . ,~Iease Print or Tv~e
'FilE NUMBER
-\'-,\\.' --
\ . _ . \i-.
, I'...... ( ~, 'r' :rl
- E.' \t.,"\.-:.... 1,_1 _ "
, .
(-~ \ \ ~."\,.,"~ \ \-\ r-. \ . \\ \ \ (_ I \:' /-:' .
(I., r' \'c _., , ). .;,. ,__
._\\',,\\1 \.jt,.(.-..\)t......~ \ ,..~(., t-J.J_(.,
-, 3 )-':'I~(
\ Irr",1 q (-)1 ('c",',I',C,..':J.'('.i,':r)
.'
",' r\-\C \
"r\ \' . \ .. _ .
( \. '.... C ':J\I_)' ~-.' '\ 111 1(, !,-',--..,( " \,
; ( \ \ ,".J' \ 'ii--
B. ' Administrative Costs: I ,r ,\ (
1. Personal Ropresentative Commissions
Social Security Number of Personal Representative: ____.____h__
Year Commissions paid
2.
\ '('j\ -\("' \---.-....( (--,
m'o
ESTATE OF
'j x:\(- \ (', \' \ '._,r\'" -( I
' .--------- ...--.-__..._.!....!..L______________ --------1-----.-------
ITEM
NUMBER DESCRIPTION I AMOUNT
..-------,.-. -'------
A. Funeral bpenses: /
I. \\Cbc:\\ I.,.
4.
C.
I.
2.
3.
4.
5.
6.
7.
8.
Allarnoy Foos
I
I
, Family Exomptian
Claimant
3.
r--\ ~I --, ('
Rolatianship ___
Addroll of Claimant at docodonl's doalh
Stre.t Addross
City
Slato _,_ Zip Co do
Probate Foos - 'I'A' \ \ \ ('
\ -'\
(,I:' f '\ .\ ('Ur, \ Ie. ,
Mlscellanoaus Expenses,
~)\ )(;( -\ c.. C\ 1 \ r, \ ((',J ('~>
\" ')
,_ \~ \ \'cc
"
l_U(f'\\X:( I Clf,r1
-
l "c -., - \
.)1 J. _\ \ 'l'.,.
.0< ',- --
c.~ \0.\<::, \~'O-\', c.C' C \ \y I ~'Ek'.' (~h(,;:"f)" cl ( )
',' \.,~ \.~' \. OJ ~ :/'. ,--:. t' ..c:
TOTAL (Also onlor an lino 9, Rocapitulatian)
(If moro space is needod, in..rt additional sheots 01 same size.)
'11 , " ,~ r' (Ie\
If'(n .:J,'.I'~'.j
.
I tdr.. I ~"~(\.ic c.)
,7 I C)C. \;(,.:'1
..J t/ C. . C (I
.,
rj .(.,::"
';).CC)
,y
,1, 1.I(;.((j
,'Ii 3' c-
, '--1'.Le J
S 1..1, /Jl.L16 1./5
110'''11','1'';
. .
,,~~~:~C\
,...,n,f}",..
(0......n'....14111101"',I,'.I.llI".
INHUlf"NClI'" "'UIN
IIIIOINIOleIOIN'
SCHEDULE J
BENEFICIARIES
ESTATE OF
-, ~~~YC~L \ )~:~E:::~~~~::~~~BENEFICtARV
A. Taxable Bequo,":
I. "<1\ ,,,- It '( P.. (y\ C'~C<',-~)
GJ3l,;V ~.j., )1)(, Ccr,L (~('C.-L
l)\\uI"blf',6l"-'Ji PCI' n_~c'
0. :J)e\o~-t'!-.. k nlC-l \
I (~ '", t.. "J n\\:~. ,\.\ ;c. ,\ Cb rc' C" I' Kc (. ~
L..) i \ \ C l":'.l-L II, t)... 17') '11
.9 (: (I r C hi' J L IJ; I I.) ~/...,
~~L ~:::;t,; 2 tJr II ~b I"'\-~f ku.eL
;J\\; (1pl'I):; IJLlI'1 J II.. 17:)') 7
'-/. ChCi,. If,) OJ. 31' /)e rf .J.::...
t2. H II, ,11,.,1 .1...('1) ~
011'- )iJ t 115 /)lll'~ /)Cu_J:I'}.:)!
N~~~R NAME AND ADDRESS OF BENEFICIARV
B. Charitablo and Governmental Bequo,":
1.
FtLE NUMBER
RElATtONSHIP
J (Ilj (r11-1 t r
I
I
c\11li~l /)~C:-I'
I
I
I
I
ot'lt<jJ'l-!c ..
J Cd)
AMOUNT OR
SHARE OF ESTATE
1/ C1 .1 he:
If{. d
I~c":, I (Ie. I
,=- .ie .i,
Yrl"'/' -( II <,_
, '
II' r ~ ,duc, It.' ",-/.;-Ie..
1'[( L.I it. "-
;<r>)'-dl,(, / ~>s..J,.-I t
'/8' c-L' t II r....
1-J~r'!>lclllq I ~51"f~
AMOUNT OR
SHARE OF ESTATE
I
f
I
~
. .
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Aha cnlOr on line 13, Recopi'ulo.ion) S
- --_.---_._--~--~-_._-- -~----
IIf more Ipace II needed, Jnlert additlonallheets of lame size)
II... 1,111L' 1'-'1
,,~:J~:~(\
-,~"'"
(Ol,l...ON....IA\h. Of "ut.~'I...AUlA
INHUnANCI ,.1.1 IITUIN
.._ __ _. _m ____.-'_~I~!.~'_~~E!OI_N' _
ESTATE OF
't)e \(:(C~':>
SCHEDULE J
BENEFICIARIES
FtlE NUMBER
\Y\\:,C\,"JI. ( ~-
--^---~--_..-_.--_. -------
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICtARY
RELATIONSHIP
AMOUNT OR
SHARE OF ESTATE
A. Taxable Bequel":
'/<:;, \ Cc;ckc..1
(.':.:1~'.t"!
\)c\'CI.( -\
,.' \ C\, .C:) \.:.
1.
(, C(" (~::r r '\
,'.' '. C-,.. (:, (1.( \'.
.',~" -:.
- I. ' .- 'r' r "
. ')"'\":'\' Cl" :- ~,_.,,)
, I, 'fA I
('" 1(""
{ .--> .\'.1
( '.' \,. ,'-'
" (\ \
1\,)(=") I -, :-~ :-.1'--'1
'\.. \ \j \. '" ".,r....ct
Ll\.( '\,~, 'v \.:)
_ (', Ie -\ (IlhCC\.d.
\,...." ~ \ \.)1 .) " I
0-
\\\c ,..UU I \ \ I?:
~ (,\ -,
--I
'/0
'-'
~,...... (:..;,
\ --, ;:.; '_I \
.\-1.,0\\''') \\.::,('~.,('( ',\1 ,;-\\,
'\4"'1 ,\-'. ,\ \,C <' \ \, ,,~ \
" .. \_ ," \ ,.'. >\. " '\ C, \ / I
... ,\.', \ \1 ~.... 1.-' -~ I
...,,J,
\ () \.-,!r n
0:1 \"1 \ T.I.
1/(-
"
Ie ':"clco.f
CS1A 1""1'
I J "-'_1---'
I~ \ f I. 0. ') \\ \.cU-L \.... \ \ ()
\r,'l.\ (' E" (I <:''-.\'
---/ '-- -.'- -)
')('- ~',h" (',
, \ .,~,. .,...
,\(.,',1 i' ,(.r
f_ ".-
I(~, I f"~; (i (.:l.\,!
. ,......-ir{t'-r;
("' /'.' -
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICtARY
AMOUNT OR
SHARE OF ESTATE
B. Charitable and Governmen'ol Bequel";
1.
-------- -
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Aho onlor on lino 13. Rocopil,IOlion) S
(If more span 11 n..dad, Insert addltlonalshee" of same Ibe)
I
I
i
I
i
i
r
(
~
11~
....~
.:;~
~~f' ..
~....
~ !l;
if
N 50':
'l5~ M
"'1' "
~~ a.. o c'
l;::~ .e; (::5
ot; Ij" :-.:1
"0,. ~ .Jd
Q.I(l) '-
'OM ~
" <ll
"'. '.0
8~ P\ 'CE
~o: od
r-
oo
~
I
. l")
Wo
r-
<l.J <.U -
'0 ~ <(
dQ0=
I .c l!J~
"i-_
-+ \- ()
~ .:5.-
:j \:) \:
oc.Jd
C)-c..)
3
~
....
1'-.,,:.
,
!
- . ,-.' ~ -'- --- .-'-- -+-- .-,-- -- -' --
-+ ---' .-'- ,---_. --.'- ....- '-"--- -.-- --- --.+' ..--'-- -~. ~
D 185038 COMMONWEALTH OF PENNSYLVANIA
NO. AA DEPARlMENT OF REVENUE
OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
'*
RECEIVED FROM:
D ACN m ,
ASSESSMENT AMOUNT /
CONTROL
NUMBER
i
101 "'1IJe.1f7
1..,.'Wll,,",'1
CINDY 5 MARZULLO
1071 CELESTE OR
5HIPPENSBURG, PA
.
17257-8998
'OlD HUf";
EST"TE INfORIAATION,
m filE NUMBER
Ii 21-1996-0392
m N"ME Of DECEDENT IL"ST)
~ DEHART DELORES MAE
~ D"TE OF P"YMENT
Iii 0 1/03/97
B POSTM"RK D.'ITE .
COUNTY
5SN 177-24-6323
(fiRST)
(Mil
CUMBERLAND
D"TE Of DE"TH
04/16/96
REMARKS CINDY MARZULLO
m TOTAL AMOUNT PAID
f,792.97
CW
REGISTER OF WILLS
.....,
IJ 'I' "
RECEIVED BY Ii' i i! I '" , ,I ,''./
T . i $IGNA1URf I .
MARY C. LEWIS ,/ 'i //i.T,
REGISTER OF I~ILL5 r
SEAL
CHECK" NO CHECK #
.-- -- ---.
_.----' -----.
_____,,__ __d'_'
'---
'-
-."--.~.""1iJ .'~i...v .';1:.
/) ,.//) -r - '/
BUREAU OF INDIVIDUAL TAXES
INIl[RlfANC[ fAit DIVl51DN
D[PT, :80bOI
HARRISBURG, PA I/ll8'ObOI
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INItERITANCE TAX
APPRAISEMENT, ALLOWANCE DR DISALLOWANCE
OF DEDUCTIDNS AND ASSESSMENT OF TAX
CINDY MARZULLO
1071 CelESTE DR
SHIPPENSBURG
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
PA 17257
r
l~"
05-12-97
DEHART
04-16-96
21 96-0392
CUMBERLAND
101
Aftount Raftitt.d
,~
1I,.a,' 11." 111,"1
DelORES
M
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ....
ifiV:i5(ji"EX-AFi'--io:i:m--iioYicnij:-YN'HERiTANCE-YAi("APPiiAisEHEii;--;-AL.LDWANCE-eili--u-------uu--
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF DEHART DELORES M FILE NO. 21 96-0392 ACN 101 DATE 05-12-97
TAX RETURN WAS: I X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Raal Estate (Schedule A) U)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Stock/Partnarship Interast (Schedule C) (3)
4. Hortg.ges/Hotes Recaivable (Schadule D) (4)
5. Cash/Bank Daposits/Hisc. Parsonal Property (Schadule E) (5)
6. Jointly Owned Property (Schedule F) (6)
7, Transfars (Schadula G) (7)
8. Total Anets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral E~panses/Adn. Costs/Hisc. E~penses (Schadule H) (~)
10. Debts/Hortgaga Liabilities/Liens (Schadule I) (10)
11. Tot.l Daductions
12. Hat Value of T.~ Return
13. Charitabla/Governmantal Baquasts (Schedule J)
14. Hat Value of Estate Subjact to Tax
CNANGED
.00
.00
.00
.00
12.300.B3
.00
7.555.73
181
6.640.45
.00
1111
1121
1131
1141
HOTE: To insure propar
cradit to your account,
subnit the uppal" portion
of this forft with your
b~ payftant.
19,856.56
6.640 45
13,216.11
.00
13.216.11
NOTE:
14, IS and/or 16, 17 and IB will
returns assessed to date.
If an assessment was issued previously, lines
reflect figures that include the total of ALL
ASSESSMENT OF TAX:
15. Anount of line 14 at Spousal rate (IS)
16. Aftount of Line 14 ta~8bl. at Lineal/Class A rate (16)
17. Anount of Line 14 taxable at Collataral/Class B rate (17)
18. Principal Tax Due
TAX CREDITS:
PAYMENT
DATE
01-02-97
RECEIPT
NUMBER
AA185038
DISCOUNT 1'1
INTEREST/PEN PAID I-I
.00
.00 X .00=
13,216.11 X.06:
.00 X .15=
1181
AMDUNT PAID
792.97
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
.00
792.97
.00
792.97
792.97
.00
.00
.00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS TitAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. I
"
- . -)
.:.;~
~.
RESERVATION: Estat.. of decadants d~lng on or bafor. Oac..bar 12, 1982 -- If any future Intar..t In the ..tat. I, transf.rrad
In pOII..slon or enJay..nt to Cla'l B (col1.t.ra1) banafleAarl.. of the dacadent .It.r the ..pltation of any .,tat. for
11'. or for y..rs, the Co..onw..lth hareby ..pr."lv r...rve. the right to appraise and ...... Iransf.r Inherltanc. f....
at the lawful Cia.. e (co11ater.l) rata on any such future Inl.r..t.
PURPOSE OF
NOTICE:
To fulfill the requlr...ntt of Sactlon Zl~a of the Inh.rltance and E,t.t_ 'a. Act, Act 21 of 1995. (72 P.S.
Sactlon 914DI.
PAYHOIT:
Detach the top portion of thl. Notlea and lubalt with your pay..nt to tho Reglst.r of Will_ printed on the ravar.. ,Id..
.-Haka chack or 80ney ordu payable to: REGISTER OF MILLS I AGENT
REFUND (CR):
A refund of a taM credit, which was not requested on the TaM Return, ..'1 be requested by cogpletlng an "Application
for Refund of Pennsylvania Inh.rltance and Estate TaM" (REY-llI51. Applications are available at the Office
of the Register of Wills, any of the 23 R.....nu. District Offlc.s, or by calling the special 24-hour
answarlng sarvlc. nuabers for foras ordering: In PannsYlvanla 1-800-562-2050, outside PennSYlvania and
within local HarriSburg area (7171 787-8094, fOOl (717) 772-2252 IH.arlng Iapalred Only).
OBJECTIONS:
Any party In Interest not satisfied with the appralse.ent, allowance or disallowance of deductlonl, or assess..nt
of taM (Including discount or Interest' as shown on this Hotlce .ust Object within sl.ty (60) day. of receipt of
thlt Notice by:
--written protest to tha PA Departaent of Revenue, Board of Appeal., Dept. 281021, HarriSburg, PA 17128-1021, OR
--election to have the aatter deteralned at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
AOHIN
ISTRATIVE
CORRECTIONS:
Factual errors discovered on this alsess.ent should be addressed In writing to: PA Depart.ent of Revenu.,
Bureau of Individual Ta.es, ATTN: Post Assesseent Revl.w Unit, Dept. 280601, Harrisburg, PA 17126-0601
Phone (717) 787-6505. Se. page S of the booklet "Inltructlons for Inh.rltance Tax Return for a Resident
Decedent" (REY-ISOI) for an explanation of adalnlstratlvalv corractable arrorl.
DISCOUNT:
If any taM due Is paid within three (]) calendar aonths after the decedent's death, a five percent (SX) discount of
the taM paid I. allow.d.
PENAl TV:
The IS~ taM aanasty non-participation penalty Is coaputed on the total of the taM and Intar..t as.a.sad, and not
paid be for. January lB, 1996, tha first day after the end of the tax a.ne.ty period. Thl. non-participation
penalty I. appealable In tha .a.a .anner and In the the sa.e tl.a period a. you would appeal the taM and Intere.t
that ha. been asselsed a. Indlcatad on thl. notice.
INTEREST:
Interelt Is char gad beginning with first day of delinquency, or nine (9) .onths and one III day fro. the date of
daath, to the date of payaant. Ta... which b.ca.e delinquent before January I, 1982 b.ar Int.r..t at the rate of
.Ix (6X) parcant par annu. calculatad at a dally rate of .000164. All ta.es which baca.a dallnquent on and after
January I, 19B2 will b.ar Intere.t at . rate which will vary fro. calendar year to calandar year with that rat.
announcad by the PA Dapart.ant of Revenue. Tha applicable Interest rate. for 19B2 through 1997 ara:
~ Inter.st Rat. Dally Int.r.st ractor ~ Inlar..t Rllt. DailY Int.r.st rllctor
1982 20X .000548 1987 .< .000247
1983 16X .000418 19B8-1991 llX .000301
1984 lliC .000]01 1992 .< .000247
1985 llX .000356 199]-1994 n .000192
1986 lOX .000274 1'J'J5-1997 .< .000l47
--Inlarast Is calculat.d a. follow.:
INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Hotlca Illued attar the ta. b.co... d.llnqu.nt will r.flact an Int.re.t calculation to tlft.en (15) day.
b.yond th. data of th. a.s..s..nt. If pay.ent Is allda aftar the Int.r.lt co.putatlon date .hown on the
Notlc., additional Intarest au.t b. calculatad.
S'l'A'I~I!S._Il_~':I'()Jl.:!'__Vtll)!':H ,,!l!JI,E 6. J 2
Name of Decedent: ~C1C' ( " H(" ,(, \ Ii, I
of Dea t h : ll\.\.L:J._J.Li", : (Iii
Date ' , , ,
" ,
, " 1',.1
Wi II 'c\ 01. ( ( " i I, J, .' 1 ',I. Admin. No. '/ I ' II ) I ( )
No. ,
, ---
Pursuant to Hule 6.12 of the Suprome Court Orphans'
Court Rules, I report the following wi th respect to completion of
the administration of till? above-captioneLl ostate:
1.
State wl)ether administration of the estate is complete:
Yes--K. 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 Ves, state the following:
a. Did the personal repr~ntative file a final
account with the Court? yos.______ No ._k::::...'
b. The SPJ"'I."t" Orphans' ("'"rt No. (it any) for
the personaJ represenliltivp's accnllnl is:
c. [) id '-he p,nsona J l'epl'es"nta tive statliY'an
account informally to the pal'tles in interpst? 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: .'~/Fi IC;(I
/' I 'j
Signature "
(' \ "I (\l} c:) \\ \ n (I \ ,\ \(',
Name (Plea.e type or print)
(C \c: '';'\ C 1-:)\ - \ \,.i(
c C'
/ ./,~
(~, ()
\( 11
A'J(fi='e 5 s
'.\.\-,,<
. \". \ ) ~') )
r i,' ,11 . . ) - ;' ,.: LIe.
'--1_ "J ,... ,J I ~,
'I'p1. No.
Capacit.y:
,./
,/Personal Representative
( MAil: rm flAM3 )
Counsel for personal
represent,lt i ve