HomeMy WebLinkAbout96-00408
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CUMI IEHI.ANI)
Register of Wills 01 !:k~k'.o!l\iU County, Pennsylvania
PETITION FOR GRANT OF LETTERS
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No.__________
[SHltu 01
Lillian Cloll
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also known as
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S()~lill SI!~ll"IV NIP9-03-7791
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COIIIIONWEALTH OF PENNSYLVANIA. OEPARTIIENT OF HEALTH' VITAL RECOaD'
CERTIFICATE OF DEATH
(Coroner)
l'WlIUIJ DtH'I'nt~'-'
I. Lillian
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.Female
ORIOIDlRH~o.,.~
< Hay 6, 1996
Clem
CloIiIIOl'M'H IlIlfWiVCl~_
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Oct.14,191J PhUadelphia,PA _0
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u.aurr NAUlIIPIlll--. """,._...~
422 Bridge Street
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, Lily Ann Phlll1ps
'*OlI'lloWfl"IU.oUHQACOIUIan.c.~ c..,..
545 r Lane, Dillsbur
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New CUmberland
, PA 17019
1996 ~.. .'
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LAST WILL AND TE5TAI1EIlT
OF
LILLUN CLEI1
I, LILLIAN CLEI1, of the Borough of New Cumberland, County of
Cumberland, Pennsylvania, being of sound mind, memory and understanding,
do hereby make, declare and publish this as my Last Will and Testament,
revoking hereby all prior Wills.
FIRsTI
funeral shall be
be convenient.
I direct that the expenses of my last illness and
paid by my Executrix as soon after my decease as may
1. I direct that I shall be
CEI1ETERY situate in Fairview.Township, York
further direct that my Executr; \<. hereinafter
estate the cost of a proper ihscription on
burial lot.
buried in the liT. OLIVET
County, Pennsylvania. I
named sholl payout of my
the marker erected on my
RRHJ:lNrll I Qive and bequeath unto my daughter, PATRICIA A.
sI1ITH, all of my household and personal effects, together with any
insurance thereon, with the understanding and expectation that she will
divide such items among her brothers and herself; providing, however,
that if my daughter, PATRICIA A. sI1ITH, should predecease me, then all
of such household and personal effects shall be given to my sons, DANIEL
H. CLEI1 and A. PETER CLEI1, or to the survivor of t~em, under the, same
general understanding.
THIRD: If I still own the business known as CUI1BERLAND sTAI1P
CO. at the time of my death, I give and bequeath the business to my
daughtf.Or, PATRICIA A. sI1ITH, ..providing that she survives me by thirty
(30) days I otherwise, this bequest shall lapse.
. .
FDURTHI All the rest, residue and remainder of my estate,
real, personal and mixed, of whatsoever nature and wheresoever situate,
I give, devise and bequeath, in equal shares, unto my children, PATRICIA
A. sI1ITH, DANIEL H. CLEI1 and A. PETER CLEI1.
FIFTH: The interests of the beneficiaries under this my Will
shall not be subject to anticipation or to voluntary or involuntary
alienation.
SIXTH: I direct t~at all estate, inheritance and succession
taxes that may be ~ssess~d {n consequence of my death, of whatsoever
nature and by whatsoever jurisdiction imposed, shall be paid out of the
principal of my general estate to the same effect as if said taxes were
expenses of administration, and all property, includible in my taxable
estate, whether or not passing under thin my Will, shall be free and
clear thereof.
SEVENTH: . I
son, DANIEL H. CLEI1,
passes, either under
appoint my daughter, PATRICIA A. sl1ITH, and my
Testamentary Guardians of any property which
this Will or otherwise, to a minor, and with
respect to which I sm authori2ed to appoint a Guardian and have not
specifically don~ DO.
1. My Testamentary Guardians shall have power to use
principal as well as income for the minor's maintenance, education,
welfare, comfort or emergency need, and the receipt of any person
selected by my Testamentary Guardians to disburse such principal and
income shall be a sufficient acquittance therefor.
EIGHTH I I nominate, consti tutl,! and appoint my daughter,
PATRICIA A. SMITH, as Executrix of this my Will.
1. In the event that my daughter, PATRICIA A. SMITH,
fails to serve or to continue to serve as Executrix, I designate and
appoint, as substitute or successor Executors, my sons, DANIEL H. CLEM
and A. PETER CLEM.
2. In addition to powers granted by law, my Executrix
and my Testamentary Guardians shall hav~ power to compromise claims and
controversiesl to sell, exchange or lease, for any period of time, any
real or personal property owned by me at the time of my deathl and to
give options for such sales, e~changes or leasesl to distribute my
estate in cash or in kind, and to postpone distribution by agreement
with any beneficiary; and to accept in kind, retsin, invest and reinvest
in any form of property, without being limited to legal investments, and
vi thout regard to any principle or diversification, risk or
productivity, to exercise all rights of ownership vith respect to such
investments, and to hold investments in the name of s nominee.
NINTH: I direct that my Executrix shall not be required to
furnish security in any jurisdiction in vhich she may act.
ave hereunto set my hand and sesl this
1991, at the end hereof, composed
~.( [c &{_--->( _
L llian Clem
(LC~-y...u
(SEAL)
\~ LTNESSE'T11 :
Name
Address :>1 '1
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Address
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CERTIFICATION OF NOTICE UNDER RULE 5.6 (a I
Name of Decedent:
Date of Death:
Lillian Clem
.1",,1 -7 ']"/' '2-'
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5/6196
will No.
lQQf\_nn.10Q
Admin. No,
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To the Registerl
I certiti that notice'ot beneficial interest required by
Rule 5.6(a) of the orphans' Court Rules was served on or mailed to
the (ollowing beneficiaries uf the above-captioned estate on
.._.6/:J/.Q(.,
Name
-
Address
Mrs. Patricia A. Smith, 545 Mumper Lane. Dillsburq, Pa. 17019
Mr. Daniel H. Clan. 651 Walton Street. Lennyne, Pa. 17043
Mr. A. Peter Clan, 220 West 98th Street New York N.Y. l002
Nntice has now been given to ail persons entitled thereto under
Rule 5.6(a) except none
Dal;Ie t96
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5
Name fpq;l;1=I R H;:mnlpY" f.'c:::.'1
Address 319 Market Street
Harrisburg, Pa. 17101
Telephoneo17 I ?1,,-?nnn
Capacity:
Personal Representative
Counsel for personal
representative
y
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO DE FILED IN DUPLICATE
WITH REGISTER OF WILLS
,on QAl[!jor O[A1U AflEA lZIl1l91 CHECK HERE
Ir Ii ""OU!.AL 0
,'ovnnycn[OIT 1<; Cl AII"U: 0
FilE NUMBER
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C:OUNIYCOO[
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YEAR
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NUUBER
cO"~Fr.:r,\~0'1' 'il ''In;,\~'''''
IIAIHU!iHrJIS~ i~h~\/R 01.01
()( nUlNI!;COt.Af'l[It AOon[~S
ft~~ UrldBO Stroot
Now Gumlwrlllnd, Pa.
l7070
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!",OCIAl !;[cunItY NUMOEA
OAII Of IIIIHt'
10/11'/1'111
Gumhu rlllnd
AMOUNt RECEIVED (SEE IIlSTRUCTlONSI
0.00
(:lIlInl.,.
Rom.,indef Return
(lor da'es 01 dealh p,ior 10 12.13-S2)
Federal Estate Tax Return Required
Total Number of Sale Deposit Boxes
B 2. :iuPJl'ornonl'11 nolUrn
4.. fuhllo IntOlo\t ComplorT\lSO
(IOf d,llo\ 01 do.llh .1110112.12-82)
O.ud.nl (l1.1t 1.\t.le [J 7. Decodent M,llnl,llned a liVing Trust
(Allich CU) 01 WIll} (AIMch a co 01 Trust)
C P ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMA TlDN SHOULD BE DIRECTED TO
o 0 NAMe COMPLETEMAILINGADORESS :...::
R g 1.0,111" II. IIl1ndlu.. Hundlor and Illenor
~ ~ '[ll."""l "u" III II 319 Markot Street
_ T 717 ?18.?O(\l) Hurrl"bur PA 17101 -
I. n..1 [.10'" (Schldull Al I lV., 500.00
2, S'och,"d Oood. (Schldule 01 (2) Nono
3. Clo..ty ""id SlockfPa,loe..hlp 'n,e,e.1 (Schedule C) (3) NQne
4. MOIIOIO" .od Nol.. noce,vable (Schedule D) (4) None..
.. Cnh, O.ok Depo... & M"cen.1neou. Pe..o".1 P'opelly (Sch. E) (5) 23,790.08
5. JOlolty Owoed PlOp.'IY (Schldule F) (6) 61, ,115.36
7, TrAn.I... (Schldule G)(Schedul.ll (7) Nono
e. Tolal Oron AS"lts holal Lines 1.7)
9. Funeral E,pln".s, Admni"tra1lvI Costs. MIscellaneous
E'plns.s (5ch.dull H)
10. Deb", Mollgage llablll'''. liens (Schedule I)
11. TotAl DeducllOns l!olallines 9 & 10)
12. Nil Valul 01 E.la'e (line 8 minus line 11)
13. Charltabl. and Governmental Bequosts (Schodulo J)
14. Net Value Sub ect 10 Tax (line 12 minus Lino 13)
15. Spou.a' Tran.le,s (lor da'es 01 dealh a"e, 6.30-94)
See Instrucllons for ApphcablE. Percentage on page 2.
(Include values ham Schedule K or Schedule M.)
11. Amount 01 line 14 taxable at 6'/, rate
(Include valu.. hom Schedule K 0' Schedule M,)
17. Amount of Line 14 laxable aI15'/, rate
(Include values hom Schedule K 0' Schedule M)
la. PonClpalla. due (Add la. hom line 15. 16 and 17,)
19. Credrts/Sp Poverty Prior Payments Discount
o . 00 + +
20, II line 191. g,eale, Ihan line 1S, enle, Ihe d,IIe,ence on line 20 ThIS is 'he OVERPAYMENT.
~ 0 Check her. If ou are re UtlU" a refund 0' our over a ment.
21. It line 18 is grealer than Line 19. entor tho dtlforence on Uno 21. This is tho TAX DUE.
A. Enter tho interesI on the balance due on Uno 21^
B. [nle, Ihe lo'al oll'ne 21 and 21A on line 21B This i. Ihe BALANCE DUE.
Make Check pa able 10: R. I,'e, of Wills. A enl
~ ~ BE SURE TO ANSWER Alt QUESTIDNS ON PAGE 2 AND TO RECHECK MATH · ·
,. .rl~N I no I~I Ufy. ~ .,.I.t .v.... oed Ihl"elurn.lnc udlnr.J .ccomp.nylng ,chedu el Iond sIAlemenls..nd 10 Ihe besl 0 my knawledge.nd beUe . II' Irue.
,ooo<,.nd ,.....,.,., Oo<""lh.I.II".'e."'. h.. ......."".1.0.1 U,," m....1 ",... 0."...110..' p..",." .Ih" 'h.olh. 00.....' ..p,...."U" I. 0.... o..III.f.'mAlI..of
whkh 11I.p.r.r hat IrTf .nowl.dQ.
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202,405.44
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18,805.07
31,,51.1.1.3
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53,346.50
149,058.94
(11)
(12)
(13)
(14)
149 058.94
(IS)
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(20)
(21)
(21A)
(21B)
8,91,3.54
0.00
8.943.51.
!ItGNA1Ufl90F PEnSON RESPONSIBLE FOR FILING RETURN
I,... . ,Lief-... /
~IGNA1UnE o~ PAEPAI'Ef4 OTHER THAN nEPI'ESENT ATlVE
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~'Cop~rIQht fell 94Iormtoflw.,. onty CpSy,'.ml.lnc.
Patrlelu A. Smith
5~,_~ _f:l~!'!l!!':. _~~!'_" -. - - - -." -, -...... -.-. -. ...,......
DII1"bur ,PA 17019
Handler and Wlonor
319 Market Street
iliirr is'bur-':' PA" i iilii-" -. .... -. -. -. -.... .......
DATE
I.t 0 17
DATE
//,:;/;'/
1/_1/' / /
Form 1500 (Rev. 7.94)
REV. 15., EX . (1-11)
COMH.m/!;\ll~\\\~,lVhYANIA
ESTATE OF
SCHEDULE D
MORTGAGES AND NOTES
RECEIVABLE
Pleas. Pllnt 01 T .
FilE NUMBER
Lillian Clem
5511 179-03- 799l
05/06/1996
(All ro a
ITEM
NUMBER
olnl -ownad Wllh Iha RI hI 0' Su,ylyo..hl mUll ba dllcloud on Schodula F.)
DESCRIPTION
VALUE AT DATE
OF DEATH
TOTAL (Also onlo, on lino 4. Roc. ~ulalion)
(If more space is needed. insert additional sheets of same sill.)
Copyright (e) '"4 form IOlIwl', only CPSYII.ms,lnc.
s
0.00
FOlm lSOD Schodulo D (Ro.1'1I)
),,/.,./.,(, (. "''':J,
I NVENTOIlY
OF ClIHIlEIlLANIl STANI' CO.
AS OF NAY h, 1')%
HOUNT STRIPS
1/4 INch 22 1.30 ca. 28.bO
3/8 inch n
1/2 inch 19 \.')0 28.50
')/8 inch 16 I.W 2').60
3/4 inch 20 \. 70 34.00
7/8 inch 20 \.80 36.00
I inch 10 1.90 19.00
1 1/8 inch 0
1 l/4 inch 0
1 3/8 inch 8 2.30 18.40
11 inch 12 2.4') 29.40
I 5/8 inch 5 2.60 13.00
I 3/4 inch 10 2.75 27.50
2 inch 4 3.05 12.20
2 ! inch 4 3.25 13.00
2 1 inch 5 3.45 17.25
2 3/4 in. 1 3.65 3.65
3 inch 5 3.85 19.25
3t inch I 3.32 3.32
31 inch 2 3.65 7.30 ,
3 3/4 in. 3 3.90 11.70 \
4 inch 6 4.15 24.90
372.57
IIANDLES
No. 1
NO. 2
No.3
No.4
500
1500
25
30
69.00
247.00
7.00
15.00
338.00
PACKAGING SUPPLIES (~Ii:;c. haws. ha~o; & tapc)
100.00
POLmAR SUPPLIES
1/2 dell Polymar
I Cube Fixcr
I Cube Developer
Substrotes 50
Film
Delcrgenl
Posl Exposurc powdcr
Cover Film
Pollet'n POlymar
1.21
200.00
47.30
61.55
60.50
232.50
112.00
25.00
32.00
45.00
815.85
CllNIIElIl.MiII S'f',\~lI' (INVEN'f'llIO' - I'f\. 2)
'f'1I0IlA'f' 1'111 N'f'YS
1,910 ~llJdel H
1,1111 Nod,,1 '11
1,'J12 NOlie J ~H
1,913 Nodel 50
4915 Nodel 19
1,926 Hode I 19
2.:\1) ell.
2. .'1)
'1,I,ll
I, .16
(..1 ')
(..7ll
IH.loll
Hh ,1,1)
I') 7 . ;!ll
2llH.110
117,(ll
In'-IO
75~.OO
----
IlATEIIS - SEI.F INKINr;
4710 Hodl/I 7
4 750 ~lodel 7
4923 Hodel 9
4924 /I 3
7.0~
9.HC,
4.89
Ill.05
1,1).35
(.H.95
44.01
:\0.15
192.46
SELF INKEIIS
No. 11 5
No.6 2
10.59
16.98
52.95
33.%
86.91
CASTEll IIACKS
No. 16 1 14.00
No. 8 I 7.50
No. 10 1 9.00
No. 20 I 15.00
No. 12 1 10.00
No. 6 1 7.00
Strip Rack 2 4.00
14.00
7.50
9.00
15.00
10.00
7.00
8.00
70.50
STAHP PADS (Hiscellaneolls sizes & colors)
INKS (Hiscellaneolls sizes and colors)
EHBOSSING 1'0WIlER
50.00
40.00
12.00
LINE DATERS 17
2.12
36.0U
NUHIlEIIERS (Hisc. sizes)
30.00
INSPECTOR STAHl'S
60
msc. REI'LACEHEN'f' PADS
1.25
FOR 5.1. PA'f'ERS
75.00
:15.00
278.00
CASH nECEIPTS
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lOTAl RECElPIS TIllS PAGE
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CASH RECEIPTS
I
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S4S Mumpor lono U./
DIII.bulg, PA 1701~
. .
MIE fROM WHOM ^Nt> FOR WI I^' MlOUt~F
TOI^L C^RRIED FORWMD FROM rRECEOING MGE 7o:<'~ 53
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tOt^L RECEIPTS tHIS PAGE ' J 3c.:< 2(;,
.
--
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\
"tv. 1!09[X. (IZ.lIft)
co"r"9.l\~r~\~~~'WOO~ilit'""
ESTATE OF
1.11111111 Clom 5511 17<).03.7'191
Jolnttenlnt(.):
SCHEDULE F
JOINTLY-OWNED PROPERTY
FilE NUMBER
05/06/1 <)9(,
A.
NAME
Plltriell1 A. 5milh
ADDRESS
5',5 Mumper Strool
DIU"lmql, I'll. 17019
RELATIONSHIP TO DECEDENT
dllughter
B.
Dlllliel II. Clem
651 IIl1ltoll Slrllet
l.emeYlIll, I'll. 170/,3
HOIl
C.
A. Pater Clom
220 lies t 98lh S trellt
Now York, N.Y. l0025
son
Jointly-owned property:
lETTER DATE DECD'S
ITEM FOR MADE DESCRIPTION OF PROPERTY TOTAL VALUE DOLLAR VALUE OF
NUMBER JOINT OF ASSET .'.INT. ~ECEDENTINTEREST
TENANT JOINT
1 A 02/20/86 Sav.Acct. 5130060047
PNC Bank 611,213 .19 50.00r. 32,106.60
1 A 00/00/90 Conunerco Bank 5,250.03 50.00r. 2,625.02
hcct. 9063
1 A lnt - DaD 111.29 50.00r. 55.65
1 ^ 00/00/90 Commerce Blink 5,202.93 50,OOr. 2,601./.7
Sav.l,101I,660/,
1 ^ Int. - DaD 32 .1,8 50.00r. 16.24
2 B 03/01/70 PNC Bank 10,050.7/, 50.00r. 5,025.37
heet-51/,OO119/,3
3 C 0/,/2l/70 Dauphin Deposit 1,3,36/,.68 50.00r. 21,682.34
Chkg.002307l265
3 C Int. - DOD 5.33 50.00r. 2.67
TOTAllAlso enler on I,"e 6. Recoprtulahon) 6/,,115.36
(II mote space is needod, insert addilional shools 01 same size.)
Copy.lghl(C) 1994 fo,msoflw'feonlyCrSysl,ms,lnc.
Form 1500 Schedule F (Rev. 1Z.ee)
REV 0\510 EX + (l.871
COIAt:.\ltlrrrt.{\''Ml,~~jhY'N''
ESTATE OF
SCHEDULE G
TRANSFERS
Ploas. Print Of T .
FilE NUMBER
Lillian Clom SSfl 179-03.7991 05/06/1996
THIS SCHEDULE MUST BE COMPLETED AND FilED IF THE ANSWER TO ANV OF THE OUEST IONS ON PAGE 2 IS YES
ITEM DESCRIPTION OF PROPERTY EXCLUSION TOTAL VALUE DECO'S DOLLAR VALUE OF
NUMBER Include name of th, 'ran,II'H.thel, OF ASSET DECEDENT INTEREST
1.laUon.hIDlodKedlnl d,llo' tra""I". 'I. INT.
TOTAL (Also enler on line 7. Recapdulat;on) ~ 0.00
(If more space Is needed, insert additional sheets of same size.)
Copyr~hl (c) 1994 form softwar. only CPSysttms.lnc.
Form 1500 Schedule G (RItY. 2.87)
"
;J/~,~f,\~" .AII.I '&,Vkflflr
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1"
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t/lJllll"'lrIlA~lIl1lh
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CASH DlsuunSEMENTS
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REV. 1SU [X + (Z.1I71
CO"~Ni1flt.~{~~V~lhY'Nl'
ESTATE OF
SCHEDULE J
BENEFICIARIES
SSII 17<).Ol.7'llJl
o 'l/O (, IlJlJIi
1.llllan Clem
ITEM
NUMBER
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
RELATIONSHIP
1
A. Taxablo Bequests:
Patricia A, Smith
/.22 Bridge St., New Cumberland, Pa. 17070
laughter
2 Daniel H. Clem son
651 lIal ton St, , 1.emoyne, Pa, 170/,3
3 A. Pater Clem son
220 II. 98th St., New York, NY lO025
NAME AND ADDRESS OF BENEFICIARY
B. Charitablo and Governmental Bequests:
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also onlo, on I,no 13. Rocap,tul.'hon)
(II more space is needed. insert addltlon.l! sheets 01 sarno slle)
Copyrlghl (c) '994 form sottwlt. only CPSyslem.lrc
FilE NUMBER
AMOUNT OR
SHARE OF ESTATE
507. or 6li213.l9
or 32,106.59
!OO7, Cumberland
Stamp Co.
l/3 or residue
507. lO, 050.7/,
or 5,025.37
l/3 or resldue
507. /.3,36/,.68
or 21,682.3/.
l/3 of rosiduo
AMOUNT OR
SHARE OF ESTATE
s
0.00
form 1500 Schedul. J (Rev. 2.117)
CUMIli-:HIANIJ
Honislor 01 Wills 01 ~Hf.~~~' Cuunly, Punnsylvania
INVENTORY
I "lain III L.l.lliLlll \.:lull
fJtJ
1'.l'Il,-I)(),l!11,1
also known as
(Jaw 01 (JI!llth
u'j/L/%_______
, DncnilsmJ
SIIcial Se<:ullly Nil. ___17~:JlJ.=1]~
. ------------.
I'nf~nnnl Rrp,"';""ll1tl\ll1I!>1 ollhn n!ln\/f) [!';lnl". f1111:nul'lnll. \lmily thlll Illn 11.'111<; "I'I"'.1I11l11 11I'111.1,,110.....11I11 ",v"IlI."V llu;ludllllll
01 Ih" 1"!!'UlUII u!I,nl!t wl"tf"...,,, !lllunt" !lnil 111101 Ihn 'nnl n!tlnln ill lIut CUIIUllUllW,,,,Uh 01 f'nl1l1'l'jlvlIl1ll' III !Inu' Oncf!dnnl. tlml
Iho \lnhli1tmn I.b,en.. nPPoslht Qllell II!!III 01 slIltllnvnlllury ((!fllll!>llIll!> it!> 1;lir vIIlun II" III IIlIt dlll~ III Ih" Ill!t:l!lhlllt'!; cJnllth. IIll1l
thill UncOIlnllt ownnd 110 10111 n!itllln oul,,!l'n (II Illn C0l111110nWnnllh ul (1nllll!Oylv(llun ,,_en,,1IhIl1 wlm:h 1I11pnll'" III " ","",o,lIlldum
III Illn .,nil 0111.." invrmlolV. IN/II \tfHilV lhllt Ill" ~llIle",olll!l fllllll" ill Ihl'l 11I\tllllllllV fl'" I'U" lint! f'",II!I:1 lIWr undlllstillullhnl
lul!l" IIlnl"1II0nlll h"'flllI 01" rnndll Rutll'lI:' 10 Ihll 1111111111.00 01 10 I'n. c.s. $lId"'" 490., ,"111111I\1 In ,,""!.WUlII l"hllltCllllIJll 10
nulhulllill'"
Umnllul
Alturlll!Y: _____Leslie._B___l1:l1ldlcr_______.__.______
1'1'1""11"; 1:~111I~"1'1l1'111\t1" ( I
__ jtiL0.d ,- Ui)y'CI~
Patricia A. Smith
1.0. Nu.:
---O7l90-
_J19..MaI:keLStreeL-,------- --, -----
.JJaq.i!,ipJ,u;g ,_-"<l.o-_U10J._______"
r.I'phollC: (717) 238-2000
1 - (C! {Il
Ollletl
Add,ess:
OoscrirJtion
Value
l.
2.
Pa. 17070
^,rerican
114,500.00
Real Estate: 422 Bridge St., New Cwriberland,
Mutual Funds - Certificate #77029957 held at
Express Financial Advisors Inc.
Inventory of CUmberland Stamp Co. as of 5/6/96
U.S. Treasury - Social Security for April
Capital Blue Cross - refund - unused portion
Accts. Receivable of CUmberland Stamp Co. on 5/6/96
West Shore Tax Bureau - 1995 Refund
Haar's Auction - Mdse. sold at auction
Donald Keller - proceeds from sale of books
^,rerican Traveler Life Ins. Co. - Refund (Pol. 245252)
Personal Effects
Phone Reinhlrsarent froll Cumberland St itlllp
N
c::
"
I, -
9,857.69
5,844.29
1,509.00
117.55
2,362.26
66.00
932.40
70.00
123.54
2,787.00
J20.3S
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Co. (l'.A.Sl11it
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MAKE CMECK PAYABLE MID REMIT PAYMEllT TO:
REGISTER OF WILLS
CUMBERLAllD CO COURT HOUSE
CARLISLE, PA 11013
.."" ",,, "",OM ,OR "... ..",... ... ,.
____:._. .___,--- ____------.,..,- ",0'"''---''' "~'''-'''--_..- .--------- -
COMMOllWEALTH OF PEllllSYLVAllIA
DEPARTMEllT OF REVEllUE
-
1(1.1541\'''' uHn
BUR~DF tNDtVtDU~l l~XES
1.....1 t.x OlVIS10N
OEl'I. zaG'
HARRls.ORG, p. 1711..0601
NDTttE OF tN"ERtl~NtE l~X
~PPR~tSE"EN1, ~llO~~NtE OR DtS~llO~~NtE
DF DEDUt110NS ~ND ~SSESS"ENl OF l~X
01-01-91
CLEM
05-06-96
21 96-B408
CUMBERLAND
101
LILLIAN
~
...
--
DATE
ESTATE OF
DATE OF DEATH
FILE llUMBER
COUllTY
ACll
""aunt R."ltted
JUL ~ 1997
LESLIE B HA~~
HANDLER & wfi!lfeIltI.IVED
319 MARKET ST
HBG
PA 17101
"
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^l... ^'''"ll1l'.II~..~,,''
^l.., nfl.I.,,"t,II'^. ,au'
^1...^,LIlIIlr.IU,.lrI..'....
July 3, 1997
Office of the Register of Wills
UJJnber1llnd County Courthouse
One Courthouse Squllre
Carlisle, Pa. 17013
Dellr Sirs:
Rc: Estate of LElian Clem
File No. 21 96-0400
Dllte of Death: 5/6/96
Anticipating llssessment of inheritllnce
enclosed II check to the order of Ibgister
$1,000.00.
llbove estate, please find
^gent, in the lllT'Ount of
tllll on the
of Wills,
Very truly yours,
WINDLER J\ND WIENER
LBII/b/w/encl
cc: Patricill ^. &nith, EKecutrill
By:
Leslie 13. IIllndler
".:,-
, ..
-~
...:'
!
CLEM PROPERTY
422 BRIDGE BT, 717.nH138 .
. NEW CUMBERLAND.- ~A: 17070 . -.. ..
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COMMONWEALTH or PENNSYlVANIA
OEPARTMEUT OF REVEUUE
BUREAU OF INDIVIDUAL TAXES
OEPT280601
HARRISBURG. PA 17128.0601
~~~.
f' :.;
"'r. .
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
I
NO. M\ 211.499
n(V-1l62 [)t (l19fJ)
RECEIVED FROM:
r
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
1 (\ I
.r.1 .f:1(\n on
HANDLER LESl.lE D
BOX 1177
HARRISBURG. PA 1710B
rOlD ""l[ rOlD HERE -,
ESTATE INFORMATION:
FILE NUMBER
21-1996-0408
NAME OF DECEOENT ,LAST)
CLEM LILLIAN
DATE OF PAYMENT
7/0"//97
POSTMARK DATE
7/03/'17
COUNTY
SSN 1'l9-03-'l7rn
,FIRST)
IMII
TOTAL AMOUNT PAlO
'~1.800.00
CW
__CU.tlIl.Q3kBl'1J)
DATrornr...TII
_ 5/6/96__
REMARKSPATRICIA A SMITH
C/O LESLIE B HANDLER ESQUIRE
SEALCHECKII 544
,'/ ;'
RECEIVED BY I "
MARY C. LEWl'S
nEGlSTE.H OF WILLS
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
'*
UNO. AA 185074
ACN
ASSESSMENT r;t
CONTROL ~
NUMBER
RECEIVED FROM:
&
AMOUNT
LESLI E [j HANDLER ESQU I HE
lul
"t::I.'1't;;J.::lLt
319 MARKET STREET
HARRISBURG, PA 17101
ESTATE INFORMATION,
1:'1 FilE NUMBER
~ 21-1996-040B
~ NAME OF DECEDENT (lAST)
I;iI CLEM LILLIAN
II DATE OF PAYMENT
EI POSTMARK DATE
COU NTY
SSN 179-03-7791
(FIRST) (Mil
CUMBERLAND
DATE OF DEATH
m TOTAL AMOUNT PAID
"'8,943.54
VZ
REMARKS
PATRICIA A 5MlfH
C/O LESLIE B HANDLER EHQUIRE
CHECI<" 004
I ,-I
RECEIVED BY'" " I' j.'ll"_/A~ ~"J/
, ~GN' "I ' . I;
, // J' 't
MARY C. LEWI S/'...../j/I-J:/AJj' I.
REGISTER OF WILLS' ,
SEAL
REGISTER OF WILLS
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COMMONWEAlTtt OF PENNSYlVANIA
OEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEIll280601
HAfmISBURG. PA 17128.0601
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
~.~~
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, . .
NO.l'\A211545111V"."""'.'
RECEIVED FROM:
1-
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
LESL I E B HArWLf::R ESD
319 MARKET STREET
R 0 BOX 1177
HARRISBURG. PA 17108
1 <) 1
$73.80
FOlDH!lI(
FOlD HERE
ESTATE INFORMATION:
FilE NUMBER
NAME oFaEl:RJ)iIl\6\U.~,jlB
SSN tFIl!m-03-7791 (Mil
OATE o,r;"'~TCrU:TI\'fJ'
PosTMAR:<rfAlrt7''fr
COUNTY -"7'OOIO!)
TOTAL AMOUNT PAID
DATE Om~\l1ch'LAI\IL'
$73.80
V /
PATRICIA SMITH
C/O LESLIE B HANDLER ESO
SEAL CHECK II 553
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RECEIVED BY'. : '(/." i-
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!'IAf'lY C, LC,J! 5 >>,: /1'; ";;'1'..) f);f:t ;
REGIST[n OF WILLS
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MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
ifEV:is4TEX-"Fi;-Co:f:97T"iioficE--lin-NHEififiiiiCE-YAX-jiPPiiiiisEHEii;--;-"Li-liwANCE-ifR"-----------------
DISALLOWANCE DF DEDUCTIONS AND ASSESSMENT OF TAX
LILLIAN FILE NO. 21 96-0408 ACN 101
TAX RETURN WAS: ( ) ACCEPTED AS FILED I X) CHANGED SEE
If an assessment was issued previouslY, lines 14. 15 and/or 1&, 17 and 18 will
reflect figures that include the total of ~ returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spou.al rat. (15)
16. A~ount of LIna 14 taxable at Line.l/Cla.s A rat. (16)
17. Amount of line 14 taxable at Collat.ral/Class 8 rat. (17)
18. PrincIpII Tax Due
TAX CREDITS:
PAYHENT
DATE
01-14-97
F"/c'5 -I}
BUR[~U O' INDIVIDUAL TAXES
IHtlERlTANL' TAX DIVISION
DEPT. :80601
HARRISBURG, PA l11Z8'0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
DF DEDUCTIONS AND ASSESSHENT OF TAX
LESLIE B HANDLER
HANDLER & WIENER
319 MARKET ST
HBG
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
PA 17101
ESTATE OF CLEM
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..l E.bh ISch.dule A) III
Z. Stacks and Bonds (Schedule B) (2)
3. Closely Hald stock/Partnership Interest (Schedule C) (3)
4. Hortg.ga./Hata. Receivable (Schadula OJ (4)
S. Cash/Bank Deposits/Hlsc. Personal Property (Schedule EJ 15)
6. Jointly Owned P~ope~ty (Schedule f) (6)
7. T~.nsfe"s (Schedule G) (7)
8. Tot.l Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. fune~al Expenses/Adn. Costs/Hisc. Expense. (Schedule H) (9)
10. Oebts/Hortgage Liabilities/Liens (Schedule I) (10)
11. Tot.l Deductions
12. N.t Value of Tax Raturn
13. Cha"itable/Gove~n.ental aequasts (Schedule J)
14. Net Value of Est.te Subject to Tax
NOTE:
RECEIPT
NUHBER
AA185074
DISCOUNT 1+)
INTEREST/PEN PAID (-I
.00
c..'
07-07-97
CLEM
05-06-96
2l 96-0408
CUMBERLAND
101
A.ount RellHt.d
114,500.00
.00
.00
.00
23.790.08
64 .115.36
.00
(8)
18.805,07
4.541.43
Ill)
1121
1131
114)
.00 X .00=
179.058,94 X .06=
.00 X .15=
IlBI
AHOUNT PAID
8,943.54
INTEREST IS CHARGED THROUGH 07-22-97
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
*
,n.I'" II'" 111-'"
LILLIAN
DATE
ATT ACHED
07-07-97
NOTICE
NOTE: To insu~e p~op.r
c~edlt to your account,
subait the uppe~ po~tion
of this fo~a with your
tax pay.ent.
202,405.44
:03 . 346 ~n
179.058.94
.00
179,058.94
.00
10.743.53
.00
10.743.53
8.943.54
1.799,99
73,80
1,873.79
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TDTAl 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 THIS FORH FOR INSTRUCTIONS.)
.. -
RESERVATION! Eltat.. of dacad.nt. dying on or bafor. Dac..bar 12. 1982 -- If any future lnter..t In the 8,tal. I. tran,f.rrad
In pOI....lon or .njoy..nt to CI... B (co11et.re1) ban.fleterl.. of the dacadant aft.r the 8MPlratlon of any a.tat. for
llf. Dr for ya.rll the Co..onwealth hareby aMpr..,ly r...rv.. the right to appraise and aliI.' tran.f.r Inheritance 'aM.'
at thl lawful Cia.. B (collaterall rata on any such future lnt.r..t.
PURPOSE OF
NOTICE:
PA\'ffEHT;
REfUND (CR):
OIJECTlDHS;
IDlUN
lSTRATlVE
CORRECTIONS:
DISCOUNT:
PENAltY;
INTEREST,
To fulfill the requlr...nt. of Slctlon 2140 of the Inherltanca and E,t.t. Ta. Act, Act 21 of 1995. (lZ P.S.
Section 9140).
Detach the top portion of this Hotlea and sub.lt with your pay.ent 10 the Alglat.r of Will. prlnt.d on the r.v.r.. .Id..
--"ak. check or Bon.y ord.r payabl. tal REDISTER OF MILLS, AGENT
A r.fund of a taM cr.dlt. which wa. not r.qu..t.d on the Tax R.turn, .ay b. r.qu..t.d by coapl.tlng an -Application
for R.fund of P.nn.ylvanla Inh.rltance .nd [.tata Tax- (REY-I111). Application. ar. available at tha offlc.
of tha R.gl.t.r of Will., any of the 21 R.v.nu. ol.trlct Offlc.., or by calling tha spacl.1 24-hour
an.warlng ..rvlca nuab.rs for fora. ord.rlng: In P.nnsylvanla 1-800-162-Z0~0, out.lde Pannsylvanla and
within local Harrl.burg ar.a (717) 787-8094, TOO' (717) 772-ZZ~Z (Hearing r.palred Only).
Any party In Intere.t not .atl.fled with the .ppral....nt. allowance or dl..llowance of deduction., or a.......nt
of tax Clncludlng dl.count or Int.re.t) a. .hown on thl. Hotlc. au.t Object within .Ixty (60) days of racelpt of
this Hotlce by:
--wrltt.n prot..t to the PA oapart.ent of R.venue, Board of Appeal.. nept. Z810ZI, Harrl.burg, PA
--.Iactlon to have the .attar det.ralned at audit of the account of the p.r.onal repre.antatlve,
"appeal to the Orphans' Court.
171Z8-IOzt.
OR
DR
Factual error. dl.covered on thl. ...a....nt .hould b. addra..ed In writing tal PA D.part..nt of R.v.nu.,
Bur.au of Individual Tax.., ATTHI po.t A.......nt R.vlew Unit, n.pt. 280601, Harrl.burg, PA 171Z8-0601
Phon. C717} 787-6505. s.. page 5 of the booklet -In.tructlon. for Inh.rltanc. Tax R.turn for a R..ld.nt
n.c.d.nt- CREY-1501) for an awpl.natlon of ad.lnl.tratlvely corr.ctabl. .rror..
If any tax dua I. paid within thr.. Cl) c.lendar aonth. after the dec.dent'. d.ath, a flv. p.rcent C5~) dl.count of
the tax paid I. allow.d.
Tha 15X tax aan..tv non-participation p.naltv I. co.put.d on tha total of the tax and Int.r..t a..a..ad, and not
paid bafor. January 18, 1996, the flr.t d.y after Ih. and of the tax a.ne.ty p.rlod. Thl. non-participation
panalty I. app.alable In the .aee .ann.r and In the the .a.e tl.. p.rlod a. you would appeal the tax and Int.r..t
that h.. b.en .......d a. Indlcat.d on thl. notlc..
Int.r..t I. charg.d beginning with flr.t day of d.llnqu.ncy, or nine (9) aonth. and on. (I) day fro. the date of
d..th, to th. d.t. of pay..nt. Tax.. which bec... delinquent b.for. Janu.ry I, 198Z b.ar Int.r..t at tha rat. of
.Ix (6X) p.rcent per annu. calculated at a dally rate of .000164. All taw.. which b.ca.. dallnquent on and aft.r
Janu.ry I, 198Z will b..r Inter..t at a rat. which will vary fr08 cal.ndar y.ar to cal.ndar y.ar with that rat.
announc.d by Ih. PA Depart..nt of Revenu.. Th. appllcabl. Intere.t rat.. for 198Z through 1997 .r.1
'!!!! Int.r..1 Aate Dally Inl.rut Factor ~ Int.,.e.t Rat. Dally Inler..1 Factor
1911Z ZOX .0005411 19117 'X .000247
19111 16~ .000418 19118-1991 llX .000301
1984 In .000301 199Z 'X .000Z47
1985 UX .000356 1993-1994 7X .00019Z
19116 10~ .000Z74 1995-1997 'X .0002,.7
ulnt.r..t I. calculat.d a. followtl
INTEREST = BALANCE OF TAX UNPAIO X NUN8ER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notlc. I..ued after the t.x beco... d.llnqu.nt will reflect an Int.r..t calcul.llon to flfte.n CIS) d.y.
b.yond the data of the ........nt. If pay..nt I. .ad. a't.,. the Int.r..t co.putatlon data .hown on the
Notlc., additional Int.r..t au.t b. calcul.t.d.
/5 lei.) f=)
CDMMON~EALTH OF PENNSVLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
('
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'(,V':~~"--":-:i
:~r:l,:~t .,
..,,:wt'~ ~
__}..L_ .c#;l' .
BUREAU OF INDIVIDUAL TAXES
IHII(lHlANC[ lAX DIVISION
DlPl. O'aollOl
IlAIUft58URG, II. Ill;"a-ObOl
.,..;.:1111"':1-'11
LESLIE B HANDLER
HANDLER & WIENER
319 MARKET ST
HBG
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
OB-II-97
CLEM
05-06-96
21 96-040B
CUMBERLAND
101
LILLIAN
AlI"lount Re,d Ued
PA 17101
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, subll"llt the upper portion of this for" with your tax payne"t.
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~
R-EV:i60-j-EX--AFfi-io3i:97i-------...--iNiiERiifANCif-TAX--STA-iEHifNT-O-F-Ac:Couiii--.-..---------------------
ESTATE OF CLEM LILLIAN FILE NO.21 96-040B ACN 101 DATE OB-11-97
THIS STATEHENT IS PRDVIDED TD ADVISE OF THE CURRENT STATUS OF THE STATED ACH IN THE HAHED ESTATE. SHDWN BELOW
IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT 8ALANCE, AND, IF APPLICABLE,
A PRDJECTED INTEREST FIGURE.
DATE OF lAST ASSESSMENT OR RECORD ADJUSTMENT: 06-30-97
PAYMENTS (TAX CREDITS),
PAYMENT RECEIPT ' DISCOUNT (+) I AMOUNT PAID
DATE NUMBER 'INTEREST/PEN PAID (-)
01-14-97 AA1B5074 .00 B.943.54
07-03-97 AA211499 .01- I,BOO.OO
07-17-97 AA211545 65.35- 73.BO
. IF PAID AFTER THIS DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS lESS THAN $1,
NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR1,
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FDR INSTRUCTIONS, )
TOTAL TAX CREDIT I
IBALANCE OF TAX DUEi
! INTEREST AND PEN.
i
i TOTAL DUE
IO,751.9B
B . 45CR I
.00 I
B.45CR!
PAYHEHT t
~~tach the top portion of thl. Notice and sub.lt with your pay~ent "ade payable to tha na.. and address
prlntad on tha r.var.a .Ide.
If RESIDENT DECEDENT "aka check or Money order payable to: REGISTER OF WILLS, AGENT.
If NOH-RESIDENT DECEDENT lIake chack or ftonay order payable to: COHHONWEALTH OF PENNSYLVANIA.
REFUHD (CR)I A rafund of a tax credit, which was not requelted on the TaM Return, .ay be reque.led by co.pletlng an
"Application for Refund of PennlYlvania Inheritance and E.tate 10M" CREV-1313). Applications ara available at
the Office of the Regl.ter of ~III'I any of the 23 Revenue DI.trlct Office. or fro. the Depart"ent's Z~-hour
anlwerlng larvlce nu.bars far forll' ordering: In Pann.ylvanla 1-800-362-20501 out. Ide Pennsylvania
and wtlhln local Harrisburg area (7111 181-809", 100_ (111) 112-ZZ52 Wearing I.palnd only).
REPL V TO:
Queltlan. regarding errors contained on this notice .hould be addrelsed tal PA Depart.ent of Revenue, Bureau
of Individual Taxas, A"H: Po.t A..eulIlent Review Untl. Dept. 280&01, Harrisburg. PA 171:8-0601, phone
(711) 7.!Il-b505.
DISCOUNT:
If any taM due I. paid within three (31 calendar .onths after the decedent" death, a five percent (5~) discount
of the la. paid I. allowed.
PENALTY I
Th. 15~ tax ..ne.ty non-participation penalty I. cOMPuted on the total of the taM and Intere.t al,e.,edl and not
paid before January 18, 1996, tha first day after the end of tha taM a.ne,ty periOd.
IHTEREST;
Inter.st I. charged beginning with flr.t day of delinquency, or nlna (9) .onth. and ana (I) day froe the data of
d..th. to the data of pay..nt. Ta.., which baca.. delinquent b.for. January I, 1982 b.ar Int.r..t at tha rat. of
.1. f6~) p.rc.nt p.r annUM calculal.d at a dally rate of .00DI6~. All laMe. which beca.. delinquent an and aft.r
January I. 198: will b.ar Inlere.t at a rata which will vary fro. calendar y..r to calendar y..r with that rat.
announc.d by the PA Depart..nt of Revenue. The applicable Int.rest rat.. far 1982 through 1997 are:
Ve.r Intere.t Rata Dally Intere.t Factor
Vaar
Inter.st Rat.
Dally tntara.t Factor
1982 20~ .0005"8 1981 .~ .0002"7
1913 16~ .000,.38 1988-1991 11:< .0003Gl
191,. 11~ .000301 1992 .~ .0002"7
1985 13~ .000356 1993-1994 1~ .000192
1986 l'~ .00027,. 1995-1991 ., .000247
uInt.r.,t Is calculated as follaw'l
INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Anv Notlc. I.su.d afl.r Iha taM b.co... d.Jlnquent will refl.cl an Int.r..t calculation to flfl.en (IS) day.
b.yond the data of the DSI.ss.ent. I' pay.ent I. .ad. 4'1.r Ih. Intor.lt co.putatlan dal. Ihown an tha
Hotlca, additional Int.r..t .ull b. calculated.
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VouelWI' (m'Olce
Check Date
37085
Descl'i Ilt iou
CLEM LILLIAN
05/24/96
LILLIAN CLEM
LBH
,
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HANDLER & WIENER
Amount
LILLIAN CLEM
15.00
15.00
Check total
J. / - 9 (;. !j () Y
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PI.F.AsE FilE 111IS REPORT Wl1111N 'lW YEARS OF DATE OF DFXl1I RID\RDLESS OF '1l1E S1i\TUS OF TIlE
FSIATE. IF FSIATE IS NCIT <DWlEI'FD, FilE ^ 6.12 FORM YEARLY Wl'II. <DWlErION.
s'rJ\'!'us HEPun'!' UI1DEH nULE 6, l2
Name of Decedent: LILLIAN CL~
Date of Death: 5/6/96
will No.
}.:Jl).. -00,.08
Admln. !In.
Pursuant to Hule 6.12 of the Supreme COUL't orphans'
Court nutes, 1 report the followIng with respect to completion of
the administratiun of the above-captiom.!u estate:
1. State whether administration u1 the estate is complete:
Yes x No_____
2. If tho answer is No, state whf!ll the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes No
x
b. The separate Orphans' CUUL-t No. (if any) {or
the personal representative's account is:
c. Did t.he personal representative state an
account informally to the parties in interest? Yes x No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounLs may be filed with the
Cerk of the Orphans' Court and may be attached to this rElfort.
/~ .~~ /?
;( ~.d I/~~)
Signature '
Date:
5/19/97
Leslie 13. Han~
Name (Please type or print)
319 Market st.. lIarrisbura. Pa. 17101
Address
;;.J
1-1J7) 238-2000
Tel, flu.
, L~ .
o "
..j0
Cdl'acity:
Personal Representative
\I
Counsel for personal
representative
(MAHs rmt/ AM3)
RW-27