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HomeMy WebLinkAbout96-00407 a1I tA - :J . w 0 tI't ::I'" - . <) ..s ...l ..... 0 ! i . J! 1 ~ 0 Z an ~ ~ ~ -' Thi... i... 'II \l'1I11) 111.11 lhl II1Il'1111,1l1"1l 11.!t :'1\( (I ), l.,'T. 'I, 1.1Il,lIl\l'g.\tr.lr Thl" II i}~I1I.t11 t'l filii ,Ill ',\ dlllc I,., \\ (I.I( ,I 1., I t. :1; Ill'" ';'TI'.j " T t Ill' III "I '!l .Il II '\Id.. 1111.[ ,,\ .111 Illl ..... ; 11 \ II ; I I; (" ,I l~ 11111, t l'li l'i 1111,111\ III I rlll H: WARNING: It Is Illegal to duplicate this copy by pholostat N photograph. i\'u ",<'~\lii"Di,'p';:~; .' \\\." .., "'-- l~', . ...,JJ~.~". I"'" ~:-', ,..~.~.,..-:" r,,,,,i "',' '\;:.",1 lr~, . . . -r),\ w 1-- , ..' . ,l. ~ ~ ~ ","'. ~ "11 \<:<>," ", ~II .."..;> , <>;:"" "-- 7,ffl~1 n\ ~\"" ~~...e:~1' \.. ,~~",,~., .' .,'.' , /'.. I ',. - '-. ....-...../...;../ I ,,,.oIl\n:l~rl,lr I"u'llll till'" lI'IOIt(.tl\" ~.Jj!!) ')f" (' [ ') JO~.O\J:,...) " " I II , /'/ "'J "4(." 1),111' "!os..,"--", COMMONWEALTH OF PENNSYlVANIA. DEPARTMeNT OF tlEALTH. VITAL RECDnDS CERTIFICATE OF DEATH r,...,_T . '.IlII1.u.tJtT Uta... .......QIlOll.C;WUC ,..-.~ . LOIS E. WISER .u .,Female "',"'-" Sol;lC.OAl...CUI'Irr.........u!o . 159 - 09 - 0561 o.<f,QIlOlNH_c...--. . Hay 10, 1996 1 .-- O<IlICJI_UII ,-0..-' -,~"..- sa...f.._C--.t Waterloo, PA. "-'"C'CIl'OlAI"'-'-.. ....-__..__ ......- ......0 I~O :::"'0 86 - - . " <I . :1.I Franklln Chambe'rsburg ~ "","DV'"'''' Chambersburg Hospital A t Home ....DtCltltNthtr..... uaA,fU,llo,onctSJ ...0 ...00 Dt.tUll,.;," uouc.uOQOl _\Al.IWUI._ --- -- Widowed ,,..{J ____...... White ....... ""'"" .-epoe-..... ""M~ ..:"'.:.-;.c::.....i.1-:'i' _ " ii'omemaker , DlCUlUff'...........:I.r.DCN....ISt..~....,~~ 120 Walnut Bottom Road .. Shlppensburg, PA. 17257 ...lCIf.........'..._'--' - ....... ~ .'11 5 tIle.CUI'.' "N~ ......"" - -- ...- PenMvlvanfa c;hfppPMhllrg - .n .. - .... Cumberl and -.' ",,0 ::"-"::":::.. UO'..If.........~....___~ . NQNUr.lf .ru.t.ol(l........... Edmund Gibbons John A Wiser Jr. ....... [i eo..- 0 .-.-__...0 ~~. ~IUfOl~SlIOH -...- o .. Hay 13, , WflOlIIYMI"lUoIUIllIADOIliN~ ""'.l.c:... 122 Walnut Bottom Road ~OI~lut._.,c-,.c;.-. .....- Carrie Crouse ... i 1996 lX.I.rcu_NIII Fd 008140 L ... filii 010... ... ..0 . __...,....____.....""Dol........_......._nt_._--,....._.__. 1""-- ~~__~__ l~~ ,"- 0............._--.._.... ............~_...""""l " \: D\.IlJO!U'.lI. "",.. tlUIJOUI,o"s.Wc.LOUl..:tU} ..; <II o -' lII'lllll"'UTtlPS.f--.GS ..........0IDlA/1I ~lU:l'flOIfO IIQtOltloUU - B" - ...... - 0 .....- ...0 ..0 - 0 c:.........__ o.<IlOfIlUJlt' -...- '....01""""'" ~'",JIIIOIlIIr ouc-~..........,~o - - Clll'fll'IIJlIO-"__ .""'n_"""~,..,....uNIe'O_,,___~...._.,__~_11l _...........,--.....----...--.11--..-................................................ .. o o o .v.cI(Jl'~1"""_-'_IenWy._" ..........- * '" Cl ...0 a i a J ". --MDClJllnr1"NO""'IIOAM,..,...----.--~.~"...... ........"'..,~-__M...-._..............._...._..__............................... "ItftlCAlDAUdM:OROftI" CM~MA'I""-* tftA'w................ .............. ---....~ _..11........................ .......ell.... -..............................................................................,....................... U. N o 11,/,l,L,?1 ).1 - 1('/ CfLt. - ~Iol 00 ..0 ::uffil e(jl :1 ~'^ 0'1 , ~) () ~1'" '. , . '.J ~ .. .- -: N Cl , , ~ :) ~ ~o \0 '-1- '1, . {.j Q. :t- ::. w '"' -. ~- ..... Name of Decedent: LOIS E. WISER Date of Death: MAY 10, 1996 Will No.1 '1%-00407 Admin. No. 25.6540176 To the Register: I certify that notice of beneficial interesl required by Rule 5,6lal of the Orphans' Courl Rules was served on or mailed to the following beneficiaries of the above.captioned estate on May 17. .ll!92.. : N.am.e Address Gladys Wiser Esther Wiser Church of Good 100 Cleversburg Road, Shippensburg, PA 17257 15 Firehouse Road, Walnut Bottom, P A 17266 447 South Fayette St., Shippensburg, P A 17257 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except NONE Date: 8/30/96 ~'"'~ Signature Foresl N. Myers, Esquire 10000 Molly Pitcher Highway Shippensburg, PA 17257 17171532.9046 Capacily:_ Personal Representative ':"" ...L Counsel for Personal Representative t..... I L: ll.. . -, U(l / -~) /_, / ( ,', R<Vol,oon.tH') INHERITANCE TAX RETURN 1'011 DATES OF DEATIi AFTER 12131/91 CIiECK HERE IF A SPOUSAL RESIDENT DECEDENT POVERTY CREOIT IS CLAIMEDO COM~~~:"[t~~~lo.i;,~~~~~~~AN'A (TO BE FILED IN DUPLICATE FILE NUMBER HARR,,~~~~.'~~~~~"'O"I WITH REGISTER OF WILLS) COUN;; CODE ~~;R6 DECEDENTS NAME (LAST. FIRST, AND MIDDLE INITIAL) DECEDENT'S COMPLETE ADDRESS wiser, Lois E 120 ~lillnut I'Dtton Road DECE ENT SOCIAL SECURITY NUMBER DATE OF BIIHli Shipp2nsbuJ:tJ PA 17257 D 159-09-0561 05/10/96 11/03/1909 Counly Cuml:erland (IF APPLlCAOLCI'U"V'V'N. 'I'OUO'" NAMLlIA". SOCIAL SECUIIITl' NUMBER AMOUNT RECEIVED (SEE INSTRUCTIONS) FIRST AND MIODL.E INITIAL.) 0407 NUMBER I 1. O'lglnol RoIU," lID' dAtu of dlllh prlD' to 12-13-82) o 5, Fedoral EstatD Tax Roturn Roqulred o 43. Futuro In1Olo:;1 ComplOml!;O lIar dalos 01 death nlter 12-12-02) ~ 6. Decodont Dlod To,'010 0 7. Docodont Ma'nlalnod a LIVIng T"IOI (AUach copy 01 W,II) (Mach copy 01 TIO") ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS Forest N ers 10000 l<bUy pitcher Highway TELEPHONE NUMBER Shi[::pensburg, PA 17257 717 532-9046 1. Ronl Estalo (SChodulo A) 2. Slock. and Bond. (SchodulO B) 3. Clo.oly Hold SlocklPanno"hlp Inlo'osl (Sch, C) 4. Mongago. and Noto. Recolvablo (SChOduIO D) 5. Cash, Bonk Deposits & MiscellanoouS Pmsonal Proporty (SChodulo E) 6. JolnUy Ownod Proporty (SChodulo F) 7. Translor.lSchodulo G) (SChOduIO l) 8. Totol G,os. Assol. (total Uno. 1-7) 9. Funoral E>cponso.. Admlnlstrotivo Co.". Mlscononoou. E>cponso. (SChodulO H) 1D. Dobl.. Mongago Uabilillo., Uons (Schodulo I) 11. Total Doductions (total Uno. 9 & 10) 12. Not Valuo 01 EslolO (Uno 0 m1nu. Uno 11) 13. Chmitablo and Governmental Boquests (Schodule J) 14. Not Vnlue Sub oct to Tax (Uno 12 minus Uno 13) 15. spou,,' Tranlllu Itor datu 01 death ~t1l!r 6-30-94). See Inltrutllonl tor Apphtabll Plftlnl.lgl on Page 2. (Intlude valutllrorn 5th,dul' Kor Sth.dule M.) 16. Amount of Un014 t""oblo at 6% ralo (Includo valuos Irom Schodulo K or Schedulo M.) 17. Amount 01 Uno 14 taxablo at 15% rota (Includo valuos from Schodulo K or Schodulo M,) TAX 18. Principal t"" duo (Add t"" from Uno. 15, 16 and 17.) COMPUTA- 19. Crodits Spousal povlrty Credit Prior p3.ymonlS Qlscount TION . 2,500.00. 125.00 - 20. U Uno 191. ..ator thon Uno 10. onlor Iho d,Uoronco on Uno 20. Thl.l. Iho OVERPAYMENT. ~ Chick hero tf ou are r. uoatln a refund of our Dve a ent. 21. II Uno 1615 gronlOr than Uno 19, onter the dlllOfence on Lino 21. This i:> tho TAX DUE, A. Enter tho lnterast on tho balanco due on Uno 21A. B. Entor tho tolalol Uno 21 and 21A on Lino 21B. Thi.l. tllO BALANCE DUE. Make Check pa abto 10: Rogl.tor 01 Will., Agonl ;I)' ,,-',...... BE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND TO RECHECK MATli .. .. 'i '\ ;';',) ndor ponalUo. ot pOljury, I decla.. thai I havo o.omlllod tI". rolurn. ,nClud,ng occompanYlllg SChodulO. and .talomon... and 10 tho bost ot rrT/ knowlodgo and boliof, It I. tlUO, corrocland complolO. I docla,o Il1at all roolo.lalo ho. been IOpOlted all;ue malkol valuo, Doclarat,on 01 plepar.. 01""' Ihan tho porsonal ro rosonlaUvo Is basad on nil inlormatlOn 01 which ptCpOlCr ha!i nn knawlcdQu. 5IaN~T AE p PERS9~ n[SPONSI~I.[ FOR~II.ING J\ETUIlN AOOAESS )<. I t I.. I (;,. u" '." See Schedule attacbed SIGNAJUR~PREPAREROTHER THAN REPRESENTATIVE ACORESS ~-J 15001 NTFee18 CHECK APPRO- PRIATE BLOCKS o 4. Umllod EOIolO CORRES- PONDENT RECAPIT- ULATION CopynghtForma Software Only, 18114 Nalto,lnc. N94PAO01 :). Rcmnindor Roturn 0, Total Numbor 01 Solo Dopo.1I Bo'O. (1) (2) (3 ) (4 ) (5) None None None None 34,734.91 ( 6) ( 7) None None 34,734.91 (0 ) (9) 3,712.90 (10) 3,231.78 (11) (12) (13) 6,944.68 27,790.23 6,000.00 (14) 21,790.23 (15) . . = (16) 2,074.93)( .06 = (17) 17,000,00. .15 = 2,550.00 (10) 2,674.50 InlClcst 2,625.00 (10) (20) (21) (21A) (21B) OAlE 1<:' . .l." -'>lie. DAT[ 10000 Moll pitcher Hi hNa Shippensburg, PA 17257 Il:>-L'-\-'SII:. 124.50 49.50 0.00 49.50 PA REV-leo<l EX (7-04) Plgo 2 Act H48 of 1994 provldos for Iho roducllon of IhD lox ralos ImposDd on IhD nDI valuo Df Iransfors 10 or for Iho uso of Ihe spouse. The rales as proscribed by Iho slalulo will bo: . 3% (.03) will be applicable for eslales Df docodenis dying on or of tor 7/1/94 and bofDro 1/1/96 . 2% (.02) w1l1 be appllcablo for osiales 01 dacodonls dying Dn or altar 1/1/96 and balora 1/1/97 . 1% (.01) w1l1 bo applicable IDr esiales 01 decodonls dying Dn Dr al10r 1/1/97 and bofore 1/1/98 . Spousaliranslers occurring on Dr alter 1/1/98 will be exempl IrDm Inherl1anco tax. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (oJ) IN THE APPROPRIATE BLOCKS. YES NO 1. Did docodonl mllko a trlnsfor Ind: .. ,oteln tho uso or Incomo of tho proporty translorrod. . . . .. . .. .. . . .. . .. . . . . . .. . . .. .. . .. . .. . . . . .. .. . . . . .. . .. . .. . .. . . . .. X b, rotelntho rlghlto doslgnotowhoShelIUsothoproportytronsforrodorllslncomo..,.............,..,.........".......,.... X c. roteln BlovOl8lonary Intorost; or... ...... .. .. .. .. ... ... .. ... ....... .. .., . . . . . . . .. . .. . .. . . ... , .. .., ... .., ... .., .. X d. rocolvothopromlsofo,liloofolthor paymonts. bonolitsor CBlO?.. ..................................................... X 2. II doath occurrod on or bofero Docombor 12, 1002, did docodont within two YODrs preceding doath transler proporty without rocolving Idoquoto consldoraUon? II doath occurrod ollor Docombor 12. 1002. did docodont transfor proporty withla ono yoor of doath without ,ocolvlng adoquato consldoraUon?.. .. .. .. .. .. .. . . .. . . . . .. . . .. . .. . . . . . . . .. . . . .. . .. . .. . .. . . . . .. . .. .. . . .. .. . .. . .. .. . X 3, Did docodont own on 'In trustfo~ bank account at his or hor dooth?.. .. . .. . . . .. .. . . . . . .. . . .. . .. . .. .. . . .. .. . .. . .. . .. . .. .. . X IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. PAl5002 NT..... copyrtahl Form.Sall...ar. Only. 1114 H.ICO,lnc. N04PA002 . REV"'UII eXfl7.II, COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETUnN nESIDENT DECeOENT SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES Pl.... P,lnl or Type FILE NUMDER 21-1996-0407 ESTATE OF Lois E Wiser ITEM NO, A. Funeral Exp.n..,: DESCRIPTION AMOUNT None B. Admlnl'lnIUvo Co'llI: 1. Porsonal Rapra.anlaliva COmml,slon, Social SecUrity Numbar 0' PcrsonnJ Rapra,anlaliva: 180-26 -5077 Voor CommissIons PoJd 19% Naroo: John A.Wiser, Jr. 1,735.00 2. AUamay Foos Naroo: Forest N Myers 3. FIWIy Exomplion Clalmanl 1,735.00 Addross 01 CloJmant at docadont', daalh Ralalion.hlp 0.00 SIrOOI Addro,s CIty Stata 2ip Coda 4. Probata FoGS 0.00 C. MI.eo/l.noous Expan...: 1 News Chronicle, advertiserrent of letters 63.90 2 99.00 Register of Wills 3 OJmberland raw JOUInal, advertiserrent of letters 65.00 4 Register of Wills, filing fee Inheritance Tax Return 15.00 TOTAL (Also antaron lina 9, Rce'Pilulalion) $ (It mora opaco Is neododl Insert addItional !Jhoots or Dama !Jlza.) PA15Ul NTF '21' CoPyrlghl Fo,",_ Soltwlt. Only, IU4 N.lea,lne. N9'PAl t I 3,712.90 "IV-U" u.. 'tlnl COMMONW(AL TU OF rr;NIUVLVANIA INHEnlTANct TAX nr;TunN n[BIO(NT OeCtDeNT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES AND LIENS Pl.... P,lnt or T . FILE NUMBER 21-1996-0407 ESTATl! OF Lois E Wiser ITEM NO, DESCRIPTION AMOUNT 148.50 70.00 76.00 135.00 10.70 23.20 736.00 96.70 19,08 16.51 136.95 70.36 19.59 16.20 10.84 23.64 59.03 561.53 10.57 3.56 18.46 72.00 12.80 884.56 3 231. 78 1 John A Wiser, Jr., reimburserrent for luncheons follCMing funeral 2 Eby Granite Works, engraving date on grave marker 3 R&A Bender, Inc., rerrcval of trash fran residence 4 John A Wiser, Jr., reimburserrent for rental of trash dUllpster 5 Carlisle Imaging Associates, rredi.cal bill 6 C\Jmberland Ear, Nose & 'Ihroat, rredi.cal bill 7 Carlisle Hospital, rredi.cal bill 8 M:lffitt, Pease & Lim Associates, Inc., rredi.cal treatrrent 9 Penelec, elctric at residence 10 United Telephone, telephone service at residence 11 Chantiersb..u:g Hospital, rredi.cal treatrrent 12 M:lffitt, Pease & Lim Associates 13 Dauphin Deposit Bank, checks 14 Chantiersb..u:g Hospital, !redical treatrrent 15 RWC Eh'ergency Physicians, rredi.cal care 16 Philip Carey, M.D., rredi.cal treatrrent 17 ~y Energy Products, heating fuel 18 Barry Negley, tax collector, real estate taxes 19 Penelec, electric service 20 Carlisle Imaging Associates, rredi.cal treat, rrent 21 RWC Eh'ergency Physicians, rredi.cal care 22 CFJMA, sewer bill 23 C\Jmberland Valley Medical Services, rredi.cal treatrrent Total fran continuation e (s) TOTAL (Also onter on line 10, Rocapitul:Ulon $ (II moro space Is neodod, Insert odditionnl shools of soma slzo.) PAT5121 NTF 2110 Copyright Form. Sollw.t. Only, '184 N.lCO,lnc. NUPAl2' -- " REY..IIU EX .12.17) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX REllJRN RESIDENT DECEDENT ESTATE OF LDie E Wiser ITEM NO. SCHEDULE J BENEFICIARIES FILE NUMBER A. Taxablo 8oquosts: NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP 21-1996-0407 AMOUNT OR SHARE OF ESTATE see Schedule attached ITEM NO. B. Charll0blo and Govornmonlol BoquoslS: 1 Church of Gcd 447 South Fayette Street ShippensbJrg, PA 17257 NAME AND ADDRESS OF BENEFICIARY AMOUNT OR SHARE OF ESTATE 6,000.00 TOTAL CHARITABLE AND GOVERNMENTAL BEOUESTS (Also onlor on lino 13. Rocopllulolion (It mora spaca Is needed. Insert addlUonal sheats 01 same SilO) s 6,000.00 PAI5131 "TF 122" CoPyrtllhl Forma Soli.'" Only. "'" NllCO,lnc. NII"PA131 Estate of: Lois E Wiser Page 2 21-1996-0407 SQIIDJLE J, Part A -- Taxable Bequests Item No. Relationship J\rroUI1.t NaIre and Address of Beneficiary 1 Nancy Wright Woods Road Shi~, PA 17257 granddaughter 159.61 2 Esther H Wiser 15 Firehouse Road Walnut Bottcm, PA 17266 3 Gladys Wiser 100 CleversbJrg Road Shippens1:w:g, PA 17257 4 William Wiser R.D. #2, Box 154B Newville, PA 17241 Daughter in Law 8,000.00 Daughter in Law 9,000.00 grandson 159.61 5 TaTmy wiser 100 CleversbJrg Road shippens1:w:g, PA 17257 grandson 159.61 6 Salluel Wiser 470 East King Street Shippens1:w:g, PA 17257 7 Clay Wiser 1874 Black Gap Road Fayetteville, PA 17222 8 Roy Wiser 356 East King Street Shippens1:w:g, PA 17257 9 Linda Ruth 5201 Gibson Hall Road Edinboro, PA 16412 grandson 159.61 grandson 159.61 grandson 159.61 granddaughter 159.61 10 D:lI1na Myers 11 Robert wiser granddaughter grandson 159.61 159.61 12 Wayne Wiser, Jr grandson 159.61 159.61 13 Gregory Wiser 14 Kimberly M::Kenrick grandson granddaughter 159.61 DNa' AA 146611 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OFFICIAL RECEIPT · PENNSYLVANIA INHERITANCE AND ESTATE TAX *' 1I\l.IWD(4".' RECEIVED FROM: ACN ASSESSMENT fl' CONTROL iii NUMBER AMOUNT & MYERS FOREST N ESQ 10000 MOLLY PITCHER HIGHWAY j (J J ~~,~oo.oo SffIPPEN58URG, PA 17257 ESTATE INFORMATION: !:I FilE NUMBER ~ 21-1996-0l'07 1:1 NAME OF DECEDENT ILAST) ~ WI5ER LOIS E II DATE OF PAYMENT m POSTMARK DATE COUNTY 55N 159-09-0561 (FIRSTI IMI) CUMBERLAND DATE OF DEATH REMARKS m TOTAL AMOUNT PAID $2,500.00 JOHN (.\ WI5ER JR C/O FDREST N MYERS E5DUIRE CHECI\/I 12', Cw " t I , , ~ " / RECEIVED BY /./;;",'.' ( ,.r.., . ~v ,.. SIGNATURE. __ . . ~Q~i5~ERL5~I~I:~~ '!'N'l~r SEAL REGISTER OF WillS ---- - _... -...... -.~ _._ u . . -. ~ .- - . . . - -- ,..-- -'-' _n ___ --._. ----- I-~ T --1:. __..obI.~ .4 'OtOHftr. I ~ - ----.- . . It'- .~ , . I: ~ i). I ..... t) ( I , I ,- l ')\ I, \.. , h~ (II:.' I.:: I" ~ Ii\' .eoi' I~ , ,; r~ ~~, l ~ . ~ : .....J~':. I "'.. ~ ~ I~ .... I';"'" ,', ~, ~ l~. . :r. <( '" ... ~ t.} ~ U ~~ t W ~ ~I ~ u 0 u k . cr I- o ~ ~ il J III ~ C .. Z oJ oJ 'r. ~ ~ ~ ~ 0 '" t 0 o ~ 0 ~ 9 .' -. -----......... ~ ~ ~ ~ f- c<: ::Jw.,: Oc<: U< >-:J Ulf-O ..:l Z :n ...:I .-. t.:..: (Ii -: H.....,Icn_-: .,. O.~ 0 _ .- U...... r-- -: 0_= t.:.. 0...,...,- : Z -...._ O"';:f-c..: ~ "; 0::: L.W : w.,:Q1::J....J....: 01.:..10"'= ~c:lU:: :: 0'::1.:..Ic<:= Ur__..,--: :..u::J Z ~ : C<:UCU_ = -: ...: ...: = '," .... N '" r':t (.) I (':1 .. '" 1- .. .. , ':rv ~ L.. \ ~ -'J ~.t .. oj r ). 'Cl ,1 ,< \ . .' .., r,: \ .. ~ ' \. '.1,1' i/ , , " q . " ,"') , 0' J " i" . '"" \ .' ;'01>' ~ \, .~' ~, .f .._--," -- ,,-.. t... _ Ir ,~. ----~,:~. -- --,_. - .-.... :.:..;..... ",r. . N, " II " . '1 /.) / (e.') ~ ('1 .~ COHHONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE . '/~k I~" BUREAU or INDIVIDUAL TAXES IHHtAI tANet UlC DIVISION DtPl. zeotJol UARR.SIURGI PA IIIla-OIlOI NOTICE or INItERlT ANCE TAX APPRAISE"ENT, ALLOWANCE DR DISALLOWANCE OF DEDUCTIONS AND ASSESS"ENT or TAM Ut.ih'" ,,'IU.hl 02-10-97 WISER 05-10-96 21 96-0407 CUMBERLAND 101 LOIS E FOREST N MVERS 10000 MOLLV PITCHER HWV SHIPPENSBURG PA 17257 DATE ESTATE OF DATE OF DEATH FILE NUMBER CDUNTY ACN AIlount Relllt t.d MAKE CHECK PAYABLE AND REHIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV:is_r;n.X-AFP-nF9&T"NOTiCr-OF-YNHEiiiTiiiiCE-TAic-APPRliiSEHENT-,--AlLOWANCE-OR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX LOIS E FILE NO. 21 96-0407 ACN 101 ESTATE OF WISER SEE DATE 02-10-97 ATTACHED NOTICE TAX RETURN WAS' 1 I ACCEPTED AS FILED 1 X I CNANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUf. ~F RETURN BASED ON: ORIGINAL RETURN I. R.ol Eolota l~ch.duLa Al III 2. Stocko ond Bond. ISch.dul. BI 121 3. Clo.alY Hald stock/pactnacohlp Inlaca.t ISch.dula CI 131 4, "octg.;../Nola. R.cal..bla ISch.dula DI 141 5. C.sh/Bonk D..o.lt.I"loc. Pacoonol pcopacly ISchadula EI 151 6. JolnllY D.nad pcopacty ISchadula FI 161 7. Tcan.f.c. ISchadula GI 171 8. Tot.l Assets HOTEl To 1nsur. proper credit to your account, lubait the upper portion of this forn "lth your tax paYlnanl. .00 .00 .00 .00 34.734.91 .00 .00 181 34,734.91 3,712.90 3.231.78 1111 1121 1131 (V)) It.qt." ;;A 27,790.23 6.000.00 21.790.~3 and 18 will date. APPROVED DEDUCTIONS AND EXEHPTIONS: 9. Funacal Ex.an.ao/Adn. Co.I.I"loc. Expan..' ISch.dul. HI 191 10. n.btol"oclgoga llabllltl.o/ll.n. ISch.dul. II 1101 11. ~ot.l Deductions 12. Hat Value of tax R.turn 13. ~h.rlt.bl./Gov.rnll.nt.l Bequa.ts (Schedule J) 14. Hat Value of Est.te Subject to Tax If an assessment was issued previouslY, lines 14, 15 andlor 1&, 17 reflect figures that include the total of ALL returns assessed to ASSESSMENT OF TAX: 15. AMount of Llne 14 at Spou,.l rat. (15) 16. AMount of Lln. 14 taxable at Lin..l/Clasl A rat. (16) 17. AMount of Linn 14 taxable at Collat.ral/Clall 8 rat. (17) 18. Principal Tax Due NOTE: .00 1.307.42 ,00 1,306,42 .00 M'OO: 21,790.23 M .06: .00X.15: 1181 TAX CREDITS: PAY"ENT DATE 08-08-96 11-08-96 A"OUNT PUll 2,500,00 49.50 RECEIPT NUI1BER AAl~6611 AA146922 DISCOUNT I +l IHTEREST I-I 65.32 .00 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 2.614,82 1.308,40CR .00 1,308,40CR . IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATION or ADDITIONAL INTEREST. I IF TOTAL DUE IS LESS THAN $1. NO PAY"ENT IS REQUIRED. IF TDTAt DUE IS REFLECTED AS A "CREDIT" ICRI. yoU "AY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS,I RESERYATIONI E.t.t.. of d.c.d.nt. dying on or before C.c..b.r 121 1982 -- If any future Int.r..t In the ..t.l. I. Iran.f.rr.d In Po.....lon or anJoy.ent to CI... B (collat.ral) b.n.flcl.rle. of the d.ced.nt aft.r the ..plratlon of any ..tat. for Ilf. or for v..r., the Co..onw..llh h.r.by .xpr...ly r...rvI. the rlaht to .ppr.I.. and a..el, tr.n.f.r Inh.rltanc. Ta... at the Ilwful CI..s B (coll.ter.l) rate on any .uch future Inllr..t. PURPOSE OF HOnCE: To fulfill the r.qulr...nt. 0' S.ctlon 21~D of the Inh.rllanc. and E.lall Ta. Act, Act 22 0' 1991. 72 P.S. S.ctlon 2140. PAYHENTs D.tlch the top portion 0' Ihl. Holle. and .ub.lt wllh your pay..nt 10 the Rlgl.llr of Wills prlnl.d on the rlv.r.. .Id.. --Hlk. chick or .0n1Y ord.r pay.bl. tal REGISTER OF MILLS, ACENT All paY.lnt. r.c.lv.d .hall 'Ir.t b. appll.d 10 any Inllr.st which .ay b. dua with any r..alnd.r appll.d to th. ta.. AEFUND (CR)I A rl'und 0' a taM cr.dlt, which w.. not requ..I.d on the T.. R.turn, .ay be r.qu.sted by co.pletlng an "Application 'or Re'und of P.nn.vlvanla Inheritance and E.tal. Tax" (REV-I111). Application. .r. av.ll.ble al the Of'Ic. of the A.glst.r of Will., any of the 21 R.v.nu. DI.lrlct Offlc.., or by calling the .p.cl.l 2~-hour answ.rlng ..rvlce noBb.r. for for.. ord.rlngl In Penn.ylvanla I-BOD-36Z-2DSD, oul,ld. Penn.ylvanla and within local Harrl,burg .r.. (1111 la7-aD9~, TOO' (1111 112-Z2S2 (H.arlng I.palr.d Onlyl. OBJECTIONS I Any p.rty In Int.r..t not .atl.fl.d with the .ppr.l.e..nt, .llowanc. or dl..llowanc. of d.ductlon., or ........nt of taM (Including dl.count or Inl.r..t) .s .hown on Ihl. Hotlc. .ust obJlct wllhln sixty (60) d.y. of rlc.lpt 0' thb Notlea bYI .-wrltt.n prot..t to the PA D.parl..nt of R.v.nu., 8o.rd of App.als, D.pt. 2BID21, Harrl.burg, PA --.I.ctlon to have the ..tt.r d.tar.lnad at audit of the account of the parson.l repre..nt.tlve, --appeal to the Orphln.' Court. HUB-lOll, DR DR AOHIN ISTRAtlVE CORRECTIONS: Factu.1 error. dl.coverad on thl. ........nt should b. .ddr....d In writing tOI PA C.parl..nt of R.v.nu., Buraau of Individual T...., ATTNI Po.t A.......nt R.vlaw Unit, Dapt. Z8D60l, Harrl.burg, PA 171ZB-0601 Phone (717) 787-6505. S.. page S of th. bookl.t "In.tructlon. for Inh.rltanc. Ta. Return 'or a Re.ld.nt D.c.d.nt" (REY-ISOII 'or an .xpl.n.tlon 0' .d.lnl.tr.tlvlly correct.bl. error.. DISCCUHTI If .ny t.. due I. p.ld within Ihr.. (3) cal.nd.r .onth. .ft.r Ih. decad.nt'. d.ath, a flv. p.rc.nt (S~) dl.count of the la. p.ld I. allow.d. PENAlTV, Thl IS~ taM aane.ty non-p.rtlclpatlon p.naltv II co.put.d on the tot.l of the I.. and Int.r..t ....ss.d. and not p.ld b.for. Janu.ry IB, 199~. the flr.t day .ftar the and of the t.. aan..ty parlod. Thl. non-p.rtlclpatlon penalty 1. app..lable In the 'ft.. .anner and In Ih. Ih. .... II.. p.rlod .. you would app.al tha taM and Int.r..t thlt ha. b..n .......d a. Indlc.t.d on this not Ie.. INTERESTs Int.r..t I. ch.rg.d b.glnnlng with first day of d.llnqulncy, or nln. (9) .onth. and on. el) d.y fro. the d.t. of d.ath, to tho data of p.y..nt. T.... which bac... d.llnqu.nt b.for. January I. 1982 bear Inl.r.st at the r.t. of six e6~) per cant p.r .nnu. c.lculated .t a d.lly rata of .000164. All t.... which b.ca.e d.llnquant on and .ft.r January I, 198Z will b..r Inter..t at . rat. which will v.ry fro. calend.r y.ar to cal.ndar V..r with that ral. announced by the PA D.part..nt of R.v.nu.. The .ppllcabl. Int.r..t rat.. for 198Z through 1991 ar.1 ~ Inler.st Rnt. Dally tnl.rut Faclor !!!r Int.rast Ante Dally Inl.r.st faclor 1982 2n .OOaS48 1987 'X .000Z~7 1913 16~ .DD04la 1988-1991 1I~ .000301 198~ 11;( .000301 1992 .X .000241 1985 In .000356 1991-199~ n .DOOI9Z 1986 1O~ .00OZ7~ 1991)-1997 'X .000247 --Inl.r.st Is c.lculat.d d. follow.: INTEREST = BALANCE OF TAX UNPAID X NUnSER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice I..u.d after the t.. b.co.., d.llnquent will r.fl.ct an Int.r..t calculation 10 flfl..n CIS) dfty. b.yond the dat. of the ........nt. If pay..nt I. .ad. aft.r the Int.re.t co.putatlon d.l. shown on the Hotlce, additional lnt.r..t .u.t b. calculat.d. ..-- ... Date:~ -~-.J~ Signature FOREST N. MYERS, Esquire 10000 Molly Pitcher Highway Shippensburg, PA 17257 (717) 532.9046 Capacity:_ Personal Representative X Counsel for Personal Representative