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OATil 01; PEHSONAL HEI)HESENTATIVE COMMONWEALTH OF PENNSVLV ANIA COUNTY 01: CUMBERI,AND } ss ("')Q r: (', I \r) (j, ::0 :rJ ~~ The petitioner(s) above. named swcar(s) or "ffirm(s) lhat thc slalements illlhe foregoing petition arc lrllC and corrcello lhe best, of the knowledge and belief of petilioner(s) and thnl as persolllll represenlative(s) of Ihe above decedent petilioncr(s) will well alld truly adminisler lhe eslale according 10 law. ~ ..' Sworn 10 or nffirmcd and subscrihcd 1 C\\~' :,.. ... before me lhis 10 day of Thomas t.- Briqht. Esq, _,lL.(l~~' :.. ,~,m '" i5~M7f Renbiler l f { ~: '-"", l.J <::> .' . , ':'J (I' - ., J::> ~ ~ 'it ~ " ~ .. ;, Vi No. ~1 - 96 - 445 Estate of Jerry L. Butcher I Deceased GRANT OF LETTERS OF ADMINISTRA nON AND NOW JUNE 6 19--2&-, in consideralion of lhe petition on the rcvcrse side hereof, salisfaclory proof havillg beell presenled before me, IT tS DECREED lhal Thorn,," To Rr; ght, F."q is/are enlitlcd 10 Lellers of Administration, alld in accord with such finding, Lellers of Adminislralion are hereby granted 10 Thorn,," To Rr; ght r F."Q in the cSlale of .1prry T. 'Rl1tt"ha.l" ~ " / " I:" r r' ' t . ';/ . " ' it - I !JJh., /I- . 'J' " , " v I C:,. /~, 1/17 l/lJ {J?.tO' I /1 I ' :' , .1 Register or Wills MARY C. LEWIS ~ fEES Lellers of Adminislration Short Cerlificalcs( 1 y . . . . . . . . . . Renuncialion .............,.. JCP S 70.00 S ~6.00 s--5-.illL S_5..illL TOTAL _ S 116.00 filed ...... ~~.~~. !i......... A.D, 191.L- Thomas L. Briqht. (300661 ATTORNEY (Sup. Ct. 1.0. No.) 10000 Mollv Pitcher Hwv ADDRESS Shippensburg, PA 17257 (717) 'i17_Q04t; 1'1l0NE , Mailed letters and order to attorney on 6-7-96. 21 - 96 - 445 00 ~~ :o~ c P,-- -, '.,' " ,., l " (' ~ -. -< .. w 0 -, .. ; -, r...:,.'1 y," ~i-~ -:i - U1 21 . 96 . 445 RENUNCIA TION In Re Estate of JERRY L. BUTCHER, dcccascd. To the Register of Wills of Cumberland County, Pennsylvania. The undersigned BEULMI L. BUTCHER, Mother llfthc abovc deccdent hereby renounces the right to administer the estate and respectfully asks that Leller of Administration be issued to Thomas L. Bright, Esquire. 10000 Molly Pitchcr Highway. Shippcnsburg. PA 17257. WITNESS my hand thisU dayof MAY. 1996, ~Jv.~ BEULAH L. BUTCHER 00- :0 0 :0'" c( :-.... (t ., ,.. " , ~ "'" '..oJ Cl <.. .:,.~ (/ 0 " .. ~ ,.J.- - "";,,J. U1 Name of Deceden\: JERRY l. BUTCHER Date of Death: MAY 10. 1996 Will No. Admin. No. 1996.00445 To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above.captioned estate on June. I~ J.9ll.i: NmM Address Beulah l. Butcher Pleasant Hill Health Center Pleasant Hill. Missouri 64080 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: June 1~ . 1996 n\.~ (fB= Signature Thomas l. Bright, Esquire 10000 Molly Pitcher Highway Shippensburg, P A 17257 17171532.9046 ,', ..) r-- .- - ,. .. , ~. .. n. r-- ~ 0:-1 '(.) p~ .. ::J UU Capacity:L Personal Representative ..L Counsel for Personal Representative o~ ll: IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: ESTATE OF JERRY l. BUTCHER, DECEASED : NO. 21.96.0445 FAMILY SETTlEMENT AGREEMENT THIS AGREEMENT is made and entered into this 1'5 'aay of (1 P Kll- .1997, by and among Thomas l. Bright, as Administrator of the Estate of Jerry l. Butcher. Deceased (hereinafter referred to as "the Administrator"); and Beulah l. Butcher, thereinafter referred to as "the Beneficiary"). WITNESSETH THAT: WHEREAS. Jerry l. Butcher of Shippensburg Borough, Cumberland County, Pennsylvania, died on May 10. 1996. having died without a will; and WHEREAS, Thomas l. Bright, duly qualified and are now serving as Administrator of the Estate of Jerry l. Butcher. Deceased lIhe "Estate"); . WHEREAS. Beulah l. Butcher is the sole person entitled to inherit from Jerry l. Butcher; and WHEREAS, Beulah l. Butcher does acknowledge to have received from the Administrator cash as an advance distribution, as evidenced by the allached Partial Receipt. Release. Refunding and Indemnification Agreement. which is attached hereto and marked as Exhibit "A"; and WHEREAS, at least four (41 months has elapsed since the first advertisement regarding grant of letters testamentary; and WHEREAS, each of the parties to this Agreement has been furnished with a complete listing of the estate assets. receipts. disbursements and distributions as set forth 0 the Accounting attached hereto and marked Exhibit "B"; and WHEREAS, the duties and responsibilities of the Administrator incident to the administration of the Estate have been substantially completed; and WHEREAS, the Beneficiary desires to have the balance of the Estate distributed without a formal accounting by the Administrator to the Orphans' Court Division 01 the Court of Common Pleas of Cumberland County, Pennsylvania lIhe Court having jurisdiction over the mailer). in order that expense. delay and publicity may be avoided. NOW, THEREFORE. the parties hereto, for good and valuable consideration receipt of which is hereby acknowledged. and intending to be legally bound hereby, agree with one another as follows; 111 The foregoing provisions of this Agreement are incorporated hereby by this reference. 121 Each party hereto acknowledges and agrees that the Administrator will not file an Account or Petition for Distribution or secure a Oecree of Distribution from any Court having jurisdiction in the matter of the Estate of Jerry l. Butcher, Deceased and further acknowledge their right to compel an accounting which right is hereby waived. (3) The Beneficiary acknowledges and agrees that the Schedule of Distribution attached hereto as Exhibit "B " is satisfactory and proper and accepts distribution in accordance with its provisions and by executing this Agreement acknowledges receipt from the Administrator of the property allocated to her on Exhibit" B " in full and complete satisfaction of her legacies as mother of Jerry l. Butcher. Deceased. ~ ~ I The B\neficiary \ereby f~Tever reJeases ~d discha~ges tlW Adm)~istrat~r from an\.and 'i.l, ~ ~ all c ims a d liabih ies of '~y kind or n~t.ure whatsoever. arising from orrelatedto his services or status as ij>' ..(, ~\Admi . strat ~ of th Estate. \ \ . . .' n-II~W' \' ' ~: . (5) It is the e~pressed i~tention of the parties hereto that the legal effect intended by the Agreement be the same in each and every respect as would be obtained had a Decree of Distribution in this Estate been entered by the Orphans' Court Division of the Court of Common Pleas of Cumberland County. Pennsylvania, which Decree has become final and unappealable. t61 This Agreement shall be interpreted pursuant to and governed by the laws of the Commonwealth of Pennsylvania. and shall inure to the benefit of and be binding upon the parties hereto. their personal representatives and heirs at law, as the case may be. ", SUMMARY AND INDEX fA.G.E 5 PROPOSED DISTRIBUTION $38.619.23_ 1 1 1 1 1 2 2 PRINCIPAL Cash Personal Property Stocks & Bonds Real Estate Receipts TOTAL PRINCIPAL $92,848.12 $22,014.43 13,573.53 43.346.40 .Q. 13.913.76 DISBURSEMENTS 3 Debts $ 3,666.73 3 Funeral Expenses 6,812.66 4 Administrative Expenses 331.00 4 Taxes 7,808.00 4 Fees & Commissions 14.610.50 4 TOTAL DISBURSEMENTS 33.228.89 5 DISTRIBUTIONS 21.000.00 5 TOTAL DEDUCTIONS $54.228.89 5 RECAPITULATIONS (Balance on Handl $38,619.23 PRINCIPAL RECEIPTS illIl $ 8,106.87 1.53 90.30 13.609.96 205.77 Dauphin Deposit. Chacking Account Accrued Interest to date of death Accrued Interest to date of settlement Dauphin Deposit. Checking Account Accrued Interest to date of settlement Total Cash: $ 22,014.43 PERSONAL PROPERTY 1994 Oldsmobile Sedan Furniture. Clothing, Misc. Books Coins Stamps Total Personal Property: $11,000.00 1.626.85 465.10 305.15 176.43 13.573.53 ~TOCK AND BONDS U.S. Savings Bonds Accrued Interest Total Stocks and Bonds $42,175.20 1.171.20 43,346.40 DEAL ESTATE None .0. 1. ADMINISTRATIVE EXPENSES Register of Wills Cumberland Co. Letters Testamentary & Probate Fee Filing Fee. Inheritance Tax Filing Fee. Family Agreement Cumberland Law Journal. Advertising News Chronicle. Advertising . Appraisal '(coins) . Appraisal .(stamps) TOTAL ADMINISTRATIVE EXPENSES: $ 116.00 15.00 50.00 60.00 40.00 25.00 25.0Q $ 331.00 FEDERAL AND STATE TAXES Federal Income Tax !Reserved) PA Income Tax (Reserved) Register of Wills Cumberland County PA Inheritance Tax.Paid at discount 8.1.96 Register of Wills Cumberland Co. PA Inheritance Tax.Paid 10.24.96 TOTAL FEDERAL AND STATE TAXES $ 200.00 50.00 7,500.00 58.0Q $ 7,808.00 FEES AND COMMISSIONS Auctioneer's Fees Administrators Fee Disbursed as follows: Thomas L. Bright Baird Brock Attorney's Fee. Thomas L. Bright TOTAL FEES AND COMMISSION $ 484.50 5,233.00 2,000.00 7.233.0Q $14.610.50 TOTAL DISBURSEMENTS OF PRINCIPAL; $33,228.89 4. . . co ~ (", ." ~ ~ ,'" '~ .' (;)u: u: r-- p\ .=! :l {...J{j , -. ~. ',- ;'~ ~~ <Il g~ t:~ ::l .. o ~ ~ U.:!l CO ;,.., eo ::s ~~~~ o 0 ~ 0 U.~ ~" "'C ::: 0 c u..c <: co...Jt::c.. i: .::s,.: ~ U 0 - .o.U~ E C. <J- ::s C'3 c = U~OU .~ \, , -' 0.- :::>'" ,~"'. '."'" . ... ~ . ;.. :( ....::: .J:: ::: t; boO ~ f~ 0:""::::: """ w .... u~ u. . o...:l ;: en <l: ~ ~ S o .J:: E-o ) " n:;i; '" =ti U'" t::::J 0.0:: ~YJ ....'" ....'" 00. _0. ~= ",iij 8 " ", .1 . v -- --..- .>~.----...A. rle- 4--(~Y A'1:. 15- II,t, - II II[V-"OOU'II-O'I INHERITANCE TAX RETURN roll DATES OF DEATlt AFTEII 12131/91 CIlECK IlEIIE IF A SPOUSAL RESIDENT DECEDENT POYEIIT'>' CIIEDIT IS CLAIMED COMMONW[AWtOr I'[NNOYLV_NIA (TO BE FILED IN DUPLICATE FilE NUMBErl O[PAIlYfwUNT OF IUVlNUl "AIIR"~~::~,~~~~:\...o". WITH REGISTER OF WILLS) COUN;;"\ODE ;[~6 OECEDENT'S NAME (LAST. FIRST. AND MIDDLE INITIAL) DECEDENT'S COMPLETE ADDIIESS Bt.rra~ER. JERRY L 60 11est King Street DECEOENT SOCIAL SECURITY NUMOER DATE OF DEATH DATE 01 Ollnll Shir,p:'l1sburg P^ 17257 486-50-0777 05/10/96 06/1'I/J 94/. COIlIIly Olllu::m-land (IF ^"PUCAULl}5UtlVIVlfolG ~I'OU~L't) NAMlllJ\~l. SOCIAL SECUIUTY NUMUEH I,MOUNT HECEIVEO (SEE INSTIIUCTIONS) FII\5T AND MIDDLE INITIAll 14. Not ValuD Sub oct to Tnx (Uno 12 minus Uno 13) 15. Spouu.ITtAn,r." (lot dltu 01 dulh aile, 6-30.9.). See In.truction,'or AppllCAbl.perc:.nt.geon P.ge2. {lnC:lud. vllulI horn Sc:hedullK or 5th.dul. M.I 16. Amount of Una 141nxablo ot 6"/0 rala (Includo voluos from Schodulo K or Schodulo M.) 17. Amount of Uno 141BXOblo at 15% uUo (Includo voluos from Schodulo K or Schodulo M,) 10, PrlncipollllX duo (Add IIlX from Unosl5. 16 and 17.) 19. Credits SpousAl POI/eft)' Cred'l Prior Payments Discount + 7,500.00+ 375.00- 20. "Uno 10 Is grootor Ihon Uno 10. onler Iho dllforenco on Lino 20. Thi' " lI,e OVERPAYMENT. A. Check horo tt au are requostln a rofund of our eve aymont. 21. II Uno 10 Is groater than Uno 19. onlor tho difference on Una 21. TI113 I:; ttle TAX DUE. A. Enler tho Inlor051 on tho balance duo on Uno 21A. B, Enlo' Iho tolol of Uno 21 and 2,A on L1no 210. Thi' i, 1110 BALANCE DUE. Mako Chock Payablo to: Ro Isto, or Wills. Agont .. .. BE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND TO RECHECK MATH'" ... Undor ponalties 01 perjury, I declaro tllalll1avQ Qxammed Ihl5 relurn, including nccompanVlIlq ~;chcdulc:j ilnct ~li1fcmQnts, and 10 ttlo besl 01 mv knowledgo and boliol, 11 Is truo, corroct and complate. I declare 111(11 aU real cslnlo has bccl1l(~porlcd at Uuo market value. Declaration 01 plcparcr other than tho person;]1 loprosontallvD Is basad on 011 inlorm;]hon 01 WhIch prepare! has any knawlodqc SIQNATURE OF PERSON RE:iPONSIDLC FOR FILING A[TURN ADDRESS DATe CHECK APPRO- PRIATE elOCKS CORRES- PONDENT RECAPIT. ULATION TAX COMPUTA- TION SIGNATURE 0 15001 - 0445 NUMBER ,. Original Rolurn Supplomenl.ll f1cluln J. Remamder Return IIClrd,l.luoldulhPFlOtlo12-13-a21 o 5, Foderal EOlBto Tax Return Required o 4. Umitod E3tota o 411. Futuro Intmo!.1 COrT1prorn~o (lor datu5 01 t.!u3th allm 12-12-02) o O. Decadent Diad To:;lalo 0 7. Ducedenl Mmntmnod.1 Living Tlu:;1 ..Q! O. Tolal Number 01 Sofo Deposit Bexos (Attach copy 01 WJlI) (Allach cop.,. 01 Tlu~l) ALl. CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME 'IHCW.S L BRIGHT TELEPHONE NUMOER 717 532-9046 " Rool Eslolo (Schodulo A) ( 1 ) 2. Slocks ond Bonds (Schodulo 0) ( 2 ) 3, Cfo'oly Held SIOck/Pllr1norship InloreS! (Sch. C) ( 3 ) 4. Mortgogos and Noles Roceivoblo (Schodulo D) ( 4 ) 5. Cosh. Bonk Dopo,'I, & Miscellaneous Porsonal ( 5 ) Proporty (Schodulo E) 6. JolnUy Ownod Proporty (Schodulo F) ( 6 ) 7. Tronslors (Schodulo G) (Schodulo l) ( 7 ) O. Tolol Gross Assols (10101 Unosl-7) 9. Funeral 8lpensos, AdministrotivQ Costs, ( 9 ) Miscolloneous Expon,os (Schodulo H) 10. Oobls. Mortgogo Uobililios. Lions (Schedulo I) (10) 11. Tolol Doduclions (10101 Unes 0 & 10) 12. Not VoIuo of Estolo (Uno 0 minus Une 11) 13. Choriloblo and Govornmonlol Ooque,', (Schedulo J) COMPLETE MAILING ADDRESS 10000 MJLIJY PITCHER HIGlWAY SHlPPl'1JSBURG, P^ 17257 ,-" None 42.174.00 None None 105.846,00 9,444.00 None ( 0) 157,464.00 21.932.00 3,314.00 (11) (12) (13) 25,246.00 132,218.00 None (14) 132,218.00 (15) x , = (16) 132,218.00 x ,06 = 7.933.00 (17) 0.00 x .15 = 0.00 (10) 7.933.00 InlarC:;1 (19) (20) 7,875.00 (21) (21A) (210) 58.00 0.00 58.00 ADDR[S:; DiT! ' (\,~. 2.'-\ ,i<"\Ci \" 10000 MJLLY PITCHER HIQ-ll'/AY .1\C"'b kr,f,'(./IrSHIPPENSBURG. PA 17257 lJ4Neleo,lne. N94PAOOI PA REV-l500 EX (7-04) Pogo 2 ACI 1148 011994 provides lor Ihe reducllon ollho lox ralos Imposod on Iho nol valuo ollranslors 10 or lor Ihe usa 01 Ihe spouse. Tho ralos as proscrlbod by Iho slalulo will bo: . 3% (.03) will bo appllcablo lor oslalos 01 docodonls dying on or altar 7/1/94 and boloro 1/1/96 . 2% (.02) will be applicable lor eslalos 01 docodonls dying on or alter 1/1/96 and boloro 1/1/97 . 1% (.01) will be applicable lor estales 01 decedenls dying on or ollar 1/1/97 and belore 1/1/98 . Spousallranslers occurring on or oller 1/1/98 will be exempllrom Inherltanco lax. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (v') IN THE APPROPRIATE BLOCKS. YES NO 1. Old docodonl mako 0 Irons lor and: a. rOlaln Iho USll or Incomo ollho proporty Iranslorrod.. . . . . . . . . . . . . . , . . . . ' . . . . . . ...................................... b. rolaln tho right to doslgnalo who shall uso Iho proporty "anslorrod or lis Incomo... , . . , . . , . , . . . .. .. . . .. . . . . .. .. . .. .. .. .. .. . X c. rotaln Brovorslonmy Inlorosl; or. .. .. ,.. .., , .. .... , ... ... , .. . , .. . .. , .. . ... . , , . , ... .. , . . , . . . . .. .., . . .. . .. .. .... .. X d. rocolvolho promlSlllor lilo 01 ollhor paymonls. bonolils or caro? .. .. .. . , .. , .. , .. . .. , . , , .. , . . . , .. .. . .. .. . .. . . .. . . .. .. . . X 2. 11 doath occurrod on or boloro Decomber 12. 1902. did docodonl within two yoars proceding doath tronsler proporty without recoiving adoqualo consldoration? II doolh occurrod oftor Docombor 12, 1902, did docodontlrans'or proporty within ono yoar 01 doalh wilhoul rocoMng adoqualo consldoration? . . . . . . . . . . . . , . . . , . . . . , . . , . . . . . . . , . . , . . , , . , , . , . , , . . . . . . . . . . . . . , , . . . , . . . . . . . . . . . . X 3. Old docodonl own an 'In \nJsllof bank accounlal his or hor daalh? , . . .. , . . . .. , .. . . .. . . . .. ... . , , . .. .. . ... .. . . . .. .... .. .. 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. PA15002 NTFeo" Copyright Fo,m, SOltwlo" Only, 111I4 N.ICO,lne. N84PA002 X REV-150:JUt(4.UI SCHEDULE B STOCKS AND BONDS COMMONWEAL Ttl OF IlENN5YLVAN1A INHERITANCE TAll R[fUI1N RESIDENT DECEDENT ESTATE OF FILE NUMDER JERRY L BUTOIER (All properly lolnlly-owned wllh Right 01 Survivorship must bo disclosed on Schedulo F.) ITEM NO. OESCRIPTION 1 $10,000.00, United States Savings Bond, Series EE, purchased May 1992 2 $1,000.00 United States Savings Bond, Series EE, purchased May 1992 3 $10000.00 United States Savings Bond, Series EE, purchased February 1993 4 $1,000.00 United States Savings Bond, Series EE, purclused February 1993 5 $1000.00 United States Savings Bond, Series EE, purchased February 1993 6 $1000.00 United States Savings Bond, Series EE, purchased February 1993 7 $10,000.00 United States Savings Bond, Series EE, purchased M:Irch 1993 8 $5,000.00 United States Savings Bond, Series EE, purchased March 1993 9 $1,000.00 United States Savings Bond, Series EE, purchased March 1993 10 $1000.00 United States Savings Bond, Series EE, purchased March 1993 11 $10,000.00 United States Savings Bond, Series EE, purchased January 1994 12 $10,000.00 United States Savings Bond, Series EE, purchased January 1994 13 $10,000.00 United States Savings Bond, Series EE, purchased January 1994 14 $1,000.00 United States Savings Bond, Series EE, purchased April 1993 15 $1000.00 United States Savings Bond, Series EE, purchased April 1993 Tbtal from continuation e(s) TOTAL (A150 enlor on Ime 2. RecapllulallOn) (If morc spaco is needed, in::;crt addlllonal :;hcels 01 samo ::;120.) PAI5031 NT..212 Copyright Fermi Soltw." Only, 1814 Nelco,lnc. NII4PAO:J1 21-1996-0445 VALUE AT OATE OF OEATH 6,212.00 621. 00 5,800.00 580.00 580.00 580.00 5,672.00 2,836.00 567.00 567.00 5,488.00 5,488.00 5,488.00 565.00 565.00 $ 565.00 42,174.00 ~ Estate of: JERRY L BuraiER Page 2 21-1996-0445 Item ~. SOiEOOLE B - - Stocks and Bonds - Description Value at Date of Death 16 $1,000.00 United States SaVings Bond, Series EE, purchased April 1993 565.00 'lOmL. (Cany forwam to main schedule) . . . . . . 565.00 , nlV..nol U'II_I', SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAl( RETlJRN RESIDENT DECEDENT ESTATE OF JERRy L Bt.1IOQ All r e olnl/ -Owned wllh Ihe AI hI 01 SUMvorahl rTEM NO. PloasQ Prlnl or T 0 FILE NUMBER muo. be dlocloood on Schedule F 21-1996-0445 OESCRIPTION 1 Dauphin Deposit Bank & Trust VALUE AT DATE OF DEATH Account no 0011085233, per attached statement aCCXUed interest aI::ove account 8,107.00 Account No. 0022020284, per attached statement aCCXUed interest aI::ove account 2 1994 Oldsrrobile Oltlass Ciera, sale price as per Bill of Sale dated July 2, 1996 3 F\1rniture & Personal Prcpertyat auction June 29, 1996, Final Settlement Attached 4 Stanps, per attached appraisal 8/17/96 5 Cbins, per attached appraisal, 7/2/96 13,610.00 2.00 11,000.00 1,607.00 162.00 6 Books sold to BamI\OOd Books 107.00 7 Books, sold to No~ Books 8 Books sold at Shi~ University 9 AE:lNA annuity aCCOUnt, present value at date of death per attached correspondence dated August 8, 1996 10 Final salary )?ayrrent fran Shippensb.Jrg University, check no 0727600, July 5, 1996 11 Pennsylvania Blue Shield, rredical reimbursement 12 Pennsylvania Blue Cross, rredical reimbursement 13 State Farm Insurance, refund 14 New Republic, refund 15 Publishers Clearing House, refund 16 R.A. RappaPOrt Publishing Inc., refund 17 T.V. Cable, refund 'lbtal fran continuation e (s) 250.00 62.00 143.00 64,929.00 3,599.00 233.00 921.00 27.00 61.00 7.00 12.00 13.00 PA15081 NT. U" TOTAL (AI.o onlor on lino 5. Rocapitulalion) $ (Anach oddltlonal 0 T/2" x II" shoOlsll moro .paco 's nOOdod,) 992.00 105 846.00 Cllp)'flghl Forma SOU.I'. On')', 1RR4 Nelco,lnc. NR4PAO.1 , 0.00 2.00 REV-l~ EX. (12-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIOENT OECEDENT ESTATE OF JERRY L Btn'OlER SCHEDULE F JOINTLY-OWNED PROPERTY I FILE NUMBER 21-1996-0445 Jolnttenanl(a): NAME A BEUU\H L Btn'OlER ADDRESS PLEI\SI\N1' HILL HFALTH CARE CENTER PLEI\SI\N1' HILL, 11) 64080 RELATIONSHIP TO DECEDENT MJrnER JolnUy-owned property: LETTER DATE DOLLAR VALUE OF ITEM FOR MADE DESCRIPTION OF PROPERTY TOTAL VALUE DECD'S DECEDENT'S NO. ,JOINT OF ASSET \lINT. TENANT JOINT INTEREST 1 A 06/92 5,996.00 50 2,998.00 $10,000.00 United States Savings Bond, Series EE, purchased June 1992 2 A 06/1992 5,996.00 50 2,998.00 $10,000.00 United States Savings Bond, Series EE, purchased June 1992 3 A 06/1992 $10,000.00 United States 5,996.00 50 2,998.00 Savings Bond, Series EE, purchased June 1992 4 A 06/1992 $1,000.00 United States 600.00 50 300.00 Savings Bond, Series EE, purchased June 1992 5 A 06/1992 $500.00 United States Savings 300.00 50 150.00 Bond, Series EE, purchased June 1992 TOTAL (Also onter on hno G. Rccapilulalion) $ 9,444.00 PA1S091 (If mora spoco is ncodod, insert addlllonnl shoots of samu sizo.) NTF 121DA Copyright Forml SoHwA" Only, 1994 N,Ic.o,lnc. N94PAOD1 .. REV""11 U.I'....' SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES Pl.... Prlnt.r Typ. COMMONWeAL TIt OF PENNSYLVANIA INt1EnlTANC[ TAX "ElURN RESIDENT DECEDENT ESTATE OF JERRY L BUTOlER rTEM NO. A. Funeral Expen.e.: FilE NUMBER 21-1996-0445 DESCRIPTION AMOUNT 1 Stanley & Son FUneral Hare Pleasant Hill, 11) 2 Butler l>bnlllrel1t O::l1pany, Inc. 6,096.00 717.00 B. Admlnl.lrIUve C..ta: 1. P.r..nal Roprosontativo Convnlsslon. Social Security Numbor of Porsonal Ropfosonlalivo: 211-38-7076 Yoar Convnlsslons paid 1996 Narre: Tharas L Bright, Esquire 7,233.00 2. Attorney Fee. Narre: Tharas L Bright, Esquire 3. Family Exomption Claimant Rolationshlp Addre.s 01 Clalmanl al decedont's doalh 7,233.00 0.00 Streel Address City Slalo Zip Co do 4. Probalo Foos 116.00 C. MlsceUaneous Expen.as: 1 Valley Bank, lock ixlx inventory 30.00 332.00 25.00 25.00 17.00 60.00 40.00 8.00 $ 21,932.00 2 Dan Hershey Auctioneering Services 3 Carl L Spidel, coin appriasal 4 I.any Lee, stanp appraisal 5 Register of Wills, filing fee Family Settlerrent J\greerrent 6 C\Jmberland Law Journal, advertiserrent of letters 7 News C!=ti.cle, advertiserrent of letters 8 Kenny's Auction, fee TOTAL (Also onlor on linD 9. Rocapilula!ion) (If mora spaco Is needod. Insert additional shoots of samo slzo.) PA1511 I NTF.." Copyright Form. Softw.r. Only, 1114 N,lco,lnc. Ng4PA111 nlv-un EX .tlal7) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATI! OF SCHEDULE J BENEFICIARIES FILE NUMBER JERRY L BtJTOlER ITI!M NO. 21-1996-0445 AMOUNT OR SHARE OF ESTATI! NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP A. T811ablo Boquosls: 1 BEUIJ\H L BUl'OlER PLE'ASANl' HILL HFAL'ffi Cl\RE CENI'ER PLE'ASANl' HILL,!<O 64080 ~PIl-IER 132,218.00 ITEM NO. NAME AND ADDRESS OF BENEFICIARY AMOUNT OR SHARE OF ESTATI! B. Chllrllablo ond Govcrnmonlal Bcqucsls: None TOTAL CHARITABLE ANO GOVERNMENTAL BEOUESTS IAlso cnlo, on hno 13. RllOcpllul.hon) (If mora spaco Is neoded, Insert addltlonal sheols of sarna size) $ 0.00 PA15131 HTF 12"A copyright Fo,m. Soltw.f.Only, t194 N.leo,lnc, NII4PA1;1t . D^ui'lltN Dll'O!>ll U^Nt..: ^Nll lHU'>l C{ 1MI'M...... 11,\lllU'.lll IlH~, I', ~~N"""" \',\t..'A 1'^-,l I'^'.. No, 3 of 3 Tu Thomas L. Bright Name: Jerry L. Butcher SSN: 486-50-0777 000: 05/10/96 Account No. 0000048334 4301729532001932 09500260 ------...------------- ------------------------ -------- Type I R A Charge Card Safe Deposit Box ----------------------- ------------------------ ------ Date Opened or Issued 08/27/93 09/01/89 01/01/91 ------------------------ ------------------------ ------------------------ Date Closed or Matured 06/11/96 (Closed) ------------------------ ------------------------ ------------------------ Date of Death Balance $4,008.65 $284.66 Not Applicable ------------------------ ------------------------ ------- PLUS Location: Date of Death Accrued Int. $35.09 Philadelphia Ave. Office ------------------------ ------------------------ ------------------------ Joint OMlers (if any) None None None ------------------------ ------------------------ --------------- Date of Joint OMlership ------------------------ ------------------------ ------------------------ Beneficiaries: ------------- Eldon Butcher Beulah Butcher ------------- ------------------------ ------------------------ ------------------------ Special Convnents: N/A Additional information availablo at $20.00 por hour. Ona hour mintmUft. Date Prepared: June 17, 1996 Prepared by: Cheryl A. Bowers CUstomer Management Information Dept. (CMI) Telephone No. (717) 255-2054 . . ., I FINAL SETTLEMENT SR.'N<ME f;~J7.~#'fJ E~k. ADDRESS j . It; .' ~~' J~t/r; ~ aJ,O k/lhr /ffftyN'Y I I I -- LOCATION OF SALE G..J)A9 ~.e-/ J?;1.1lrJ!( .-x:Y_S a' fA h r" AUCTIONEER Jht/ (2,,<2,)' ..,.t/ J!f-l"i.. ,~~..v: (J , DATE OF SALE ~/;2 f/9 (,. PHONE ZIP PHONE' 5'.3.,z -~.6 ~/ 7 ),,: ,.:~i:~~/:~t2B:'i!;r.~:~:::;~"" ",' ;::. ("\":d~RECEIP.TS",..:, ) ',.':~:i.~~:f;~ r~~J,~~. .._.....~;, PI I" ~' CASH $ $ CHECKS OTHER RECEIPTS TOTAL RECEIPTS $ $ $ $ $ /61; ?,.;l.5J LESS TOTAL EXPENSES $ . 33,,2. &(1 t~ NET PROCEEDS PAYABLE TO SELLER $ /.2 7S, ',' ,.: '" "'--.': '. I (or we), Ihe seller, occepllhis seulemenl and acknowledge receipl ollhe above specified nel proceeds Irom Iho auclion of my goods and properly sold on Ihe above dole. I accepl all responsibilily for providing merc nloble lille 10 all goods. and properly sold, and for delivery of 1Ille 10 the purchaser. AU7Iione'er~~~' C\~~TIc~:,ure) Dolo 1-1.-'9v ~/2;;/f6 . Dolo Dolo 7 (Sellor's Signa lure ) " . ... . ~~'''JIlIf/l'JAj1/ll.".~....tIUI4'''~''I''''''''''''~tL__.''''''';''I''''''.~~"""".,..,-;WIt f/;; (,~ (j) o 'HtIllJM f3().J6;f~ A-I/t/' ftl///1,oaJ :f /JII/lt, fJA. CARL L. SPIDEL COINS 1423 Brechbill Rd. Chombersburg, Po, 17201 Ph. 717.263.4257 ANA RII3213 J@/ ~I /'l9G [OJ fa:t;.. 0:( J:rI"/ /... 1?tdc../i6r .- lJ.. 0,0, 5" --/j.. f(. b - fJe4aE iCJ~'-LJiI'~ /s't.~:i.-g/ 1~~ ).(.~V/i~A....A j..J: j) iJ 1tv.-t;"J ~ffef-!OAJ 6""'1- fdO&~ /fJ"2 -/9rJ'.,) WC",'A/:i) 1..l>[J 1,,3. ~5'''''' fJa-t.:fiJ (drtJk- /2.oo~V4'/t. /070 jtlt4""-I?g-~ ~1. Co/~~) '3 -1'l7S-RelldJ..t{llo.()~Af 1}1(edClol).!/I3/- MciJIIJ-~. t9hJ//ur {t: 8 PI/5CG /'176 'J/l.flelL (JI'U)')F "SE1' j. /97'1 I.{. S'. Pl<ouj:. ~k"l ~: @ 11/7C. PROOF 5eri .l1.5. (". 1'177 P/J..oo F fer a. j', 7. In/ U.5.fJlUo,f 5er. K. 1. -/977 t!/.;tL1};JL '(3lJ..o/J7.,lr I lJl1tt Y.I{'.AL.IrN::.'JJ,,{.s. . 9. /, ~ fJ/lE'fIIE"'77ill #JEMu -l3fiPAlU: 10. rRIJIl7J: of /&1h-) I'i'-A.) ~ (!.cuu/o/ e.o/NJICM-v71' II. F1lJihUE tJP J..wc-o/..J) /lJii/J}g/lJ~1J CftAJP ~9 a/Nil / t.. PM..,./4L. /.;:. 130(;/<' /9'11- /77 c.. \ IS. 1. - Pltn.rlltl- i t I3pr/0 /'10'7 - Flty N. A#-I07AL.. 'R;Q~EVeJ.."'" Nt .B~6.f. i9J'Y./97,f.D f 3cq.tJ~, ~ /S'. j, fll/fi..r/~t.. ~eFFe.nsIJl.l S'"<t ,gWitS, /;.;;f-I'182- n.. /'1 (/p,e 6"0'1' J'17/-I'laJ I 17. -r~IJ,v &J/1'e(I).IllJl- 11~ (; , /11/ $(;1}p'oPE~ , 6 t. 16, {,(, j"IIK.D/Q Ie I I tufpLd" j;!'J "3Can-t'~..,.I l<;d fwue' /9. I<.fk., .4A1C,6t.A.I, FDn... IdRoI..J2.t= II1EI:Jtii...S j," ~ } I~ 13/:,e, zip IM~. j.~. 1777' S'13/)t>JIiv...., 3''!:'~J /95"K'S7J<7., /o../Fk.f::,7N '7..n)" ~/. m/IJ/f/1ttU=. i'fk. - -j.,o fJoJ...Oi../J. )..03 L ~ 3. U~ 7.00 '3.1.. s- f B. 55 '].. 01 3.~ $': t1'~ t...n '-/.O{} J.S' (lttOfraH! aJfI~) s:.,.. . ~ j, 10 ;J. 'Id 1..7 S" 7.00 . 'l.5' " -. ~ -. ~ Shipp.ensburg University Foundation (717) 532-1377 Shippensburg. Pennsylvania 17257 June 19, 1996 Thomas L. Bright, Esquire 10000 Molly Pitcher Highway Shippensburg, P A 17257 Dear Tom: As you requcsted,I have enclosed a photocopy of the Leller of Intent Dr. Jerry Butcher signed on January 22, 1995, which indicates his intention to contribute $3,000 to the Shippensburg University Foundation for the "Building for a Beller Future: The Campaign for Shippensburg University" capital campaign. Dr. Butcher paid S 1,800 toward his commitment leaving a balance of$I,200. The Shippensburg University Foundation requests payment of$1,200 from the Estate of Dr. Jerry L. Butcher to complete his $3,000 commitmenlto the capital campaign. Please make the check payable to the Shippensburg University Foundation/Capital Campaign. I would appreciate your attention to this request. If you require additional information, please give me a call at 532-1377. John E, Clinton Executive Vice President Enclosure A(""d~OO (1:.' IlQAI W .. 31(:5'" u"''' w..u ::c:c9 ufca .. "" I!:)- 1[1 (f -, I h~/~:9(\ _fJ}"" COMMONWUHU Of rrWj~'fI\lM~IA O(PARIMHH Of R('w'(NUt DrP' 180MI !~lllmeUIlG, PA 1~1?80601 O(CIOINI'~ flAMI (LAH '1'~I. AP4D MIIltILI IIIIIIAII fOA DAnS Of DIATH Ann 12/31/01 CHICK HIRr If A SPOUSAL " povn" CAIDIT IS CLAIMID, LL flU HUMin ~I COUNIY COOl INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) 1l)IJh YEAR OM,S NUM&ER IJt(111I,,1'~(OM1'1(11 AOO.t~~ .. z W fil u W <> BUl'CIIER. .mRRY I.. ~OCIATIf(UiillY--t~uilii il--~~ -~----~ ~jiij,'IOI '01....."..--. ----jOiff.O'.BllllI1 ,_._,..~--~ 5/IO/9h h/17/~2 ___,_u~_ _n__"..~'--~'--Ijoo' -~-~~-~ I,I """O<:""llllIJ1.",I4I'\'ou\l l"""'III"'~! ".~! ....'ll..._'::..=~l !lICU/lII' fIU""'BI' 48h-50-0777 ... "'z Ww "'<> "'z S~ o I. Original Return o 4. limited Estate fulure Interest Compromise Ifor date, of death after 12.12.821 o 6. Decedent Died Tellate [.1 7. Decedent Maintained 0 living Trusl (Allach copy of Will) IAllach copy of Trult) ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO. NAM( COMPlfll MAIliNG AOOllfU l'homos I.. Bright 126 Eost King Street llI"HON!NUM'" Shippensburg, PA 17257 [Al 2 [] 40, Supplemental Return Remainder Return (for dates of death prior 10 12.13.82) federal estole Tax Return Required _ 8. T 0101 Number of 50fe Deposit Boll:Os 532-8833 z <> ;:: :s ::I .. G: "" u W '" 1. Real EUele (5chedule AI 2. SIoch and Bond, (Schedule 0) 3. Closely Held Sloc~JParln'f$hip Inlerelt (Schedule CJ 4. Mortgages and Nole' Receivable ISchedule 0) 5. Cosh, Bonk Depo,ih & MiICellaneous Perlonol Properly (Schedule EI 6. Jointly Owned Properly (Schedule fJ 7. Tren"... (Schedule GI (Schedule L) 8. Tolal Gran Aneu (tolollines 1.71 9. funeral Expenses, Adminiltrotive CO$l$, Miscellaneous Expenses (Schedule HI 10. Debu, Mortgage Liabilities, liens (Schedule II 11. Total Deductionl (tolol Lines 9 & 101 12. Net Value of eslalo (line 8 minus line 11) 13. Choritobl" and Governmenlal Beques" (Schedule JI (111 (12) (13) (14) 2.309.30 111._~~_.____u 121_,. 131 ( 41 (5) __3,23.2.54 16) 17 ) 203.00 720.24 ( 8) 3,232.54 (9) (101 923.24 2.309.30 z <> ~ .. ::I .. '" <> u >< "" .. 14. Net Value Subjec' to TOl( lline 12 minus line 13) 15. Spousal Tranlfen (for dates of death after 6.30.94) See Ins'ructions for Ar,plicable Percentage on Revene (15) Side. (Include values rom Schedule K or Schedule M.) 16. Amount of line 14 taxable 01 6% role (Include values from Schedule K or Schedule M.I 17. Amounl of Line 14 taKobl" 01 15% role (Include values from Schedule K or Schedule M.I 18. Principal tax due (Add lOll from lines 15, 16 and 17.1 19. Credits Spou,al Poverty Credit Prior Par.manh Discount Interelt __ + ___'-2..:!!'.....:.. ~rom 12-23-?~ opproisemen~19) 20. If line 19 is grealer than line IB, enter Ihe difference on line 20. This i, Ihe OVERPAYMENT. (20) aD 19.74 X._= (16) 2,309.30 x ,06 = 138.56 (17) x ,15 = (181 138.56 Check here if you ore requesling 0 rofund of your overpayment. 118.82 21. If line 18 is grealer thon line 19, enter the difference on lino 21. This is Ihe TAX DUE. A. Enler tho inlerest on the balance due on line 21 A. 8. Enler the tolol of line 21 and 21A on Line 218. This is the BALANCE DUE, Malle Chuk Payable 10: Reghler of Willi, Agent ~ ~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH ~ ~ Under penalties of perjury, I declarelhat I hove examined this relurn, including accompanying schedules and statements, ond to the be" of my .nowledge and belief, it isltue, correct and complete. I declare thot all real ell ate has been reported ottruo marht value. Declaration of preparer ather than Ihe perianal represenlative is based on all information of which preparer has any .nowledge. SIGNATUIlE Of P(Il~ON IIHPON!lIBlI fall fIlING '!JUIIN AOORI!.!. OAn (21) (21A) (21&) ADO"(~!. OAt( l'homos I.. llright. 126 Eost Kil1~ Street. Shippensbuq:. I'A 17257 , II ~ 11 -C-j 7 - 'h ~':" I.. 11"1 ,,~:J~:?l\ ....;..~Jho COMMONWUUH Of PfNNS'fWANIA INHUITANCI TAX UTURN 'UIOIN' DICEDINT J SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY L Plo~so P(i~IO~O _ FILE NUMBER ESTATE OF Jerry I.. Ilutcher (iii" prop.rtv lolntlv.owned with the Righi of Survlvor,hlp mu.tb-;dh~~d on Sch.i~~--'~---_. -._--_._._---._~--- --.---- 21-96-0445 ITEM NUMBER DESCRrPTlON VALUE AT DATE OF DEATH 1. Blue Cross - refund received 10-29-96 110.00 2. Texaco - credit cord refund received 11-7-96 7.99 3. Book of the Nonth Club - refund received 1-7-97 37.35 4. Hoar's Auction - proceeds of stomps received 1-14-97 337.10 5. PA Deportment of Revenue - tax refund received 2-6-97 186.00 6. Internal Revenue Service - tax refund received 8-8-97 2.554.10 TOTAL (Also Onlo( on lino 5, Rocopilo~ 3.232.54 (Alloch addilionaI8V," )C 11" shee" if more .poce it ntteded.) 1!v1\1l1"1'"1 ESTATE OF Plea.. Print or Type ., .u__ - L NUMB~RI_96~04'4~ . SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES COMMOUWlAl1It Of PWN\Y1.....Ut.. INHUll"Ne( I". .(lURN RlSIOfNIOlCIOlHI Jerry L. Butcher ITEM NUMBER A. Funeral Expen...: 1. DESCRIPTION B. Admlnl.trotlve Co.Is: 2. 4. C. 1. 2. 3. 4, 5. 6. 7. e. 1. Personal Represenlalive Commi..ians Thomas L. Bright Social Security Number of Personal Represenlative: 211 Vear Commi..ians paid 1997 38 7076 Allorney Fees Thomas L. Bright, Esquire 3, Family Exemption Claim anI Addre.. of Claimanl 01 decedenl's dealh Slreel Addre.. Cily Slale Zip Code Relationship Probale Fee. MI.eellaneou. Expen.es: Register of Wills, Cumberland County - filing Supplemental PA Inheritance Tax Return TOTALIAlso enler on line 9, Recapilulation) (If more .pace I. needed, In.ert additional .heels of .ame size.) S AMOUNT 94.00 94.00 15.00 203.00 SK OJ,! ;...,.:) RECEIVED BY /" 1.,1A, / (, .~J (/".., ,}/ /:(J-l/ . ISIGNAtUAr.... " '.f J" MARY c. LEWI S ~' /, '111.-:/.'-;/1 ,V REGISTER OF WILLS ' DNa' AA 146597 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT Of REVENUE OFFICIAL RECEIPI' . PENNSYLVANIA INHERITANCE AND ESTATE TAX . .1~1l':I"I"""1 ACN ASSESSMENT I'i' CONTROl ~ NUMBER AMOUNT RECEIVED FROM: a BRIGHT THOMAS L 115 E KING STREET 101 ~7,:sOO.OO SHIPPENSDURG, PA 17257 ESTATE INFORMATION: I!:t FilE NUMBER Y 21-1'796-0445 1:1 NAME OF DECEDENT (lAST) i:I BUTCHER JERRY L f!I DATE OF PAYMENT Iii 08/06/96 m POSTMARK DATE COUNTY SSN 1,86-'50-0777 (FIRST) (Mil CUMBERLAND DATE OF DEATH 05/10/96 REMARKS THOMAS L SR 1 GHT Ef,QU I RE m TOTAL AMOUNT PAID "'7,500.00 SEAL CHECK" 12 REGISTER OF WILLS --- ..- .--. ..-.. --- .--_ .__ ___4 __.__ ___. -.". --- _..- ...-.-.' _._~........."..- -....~..ibI.~ _'-...17 .1:. /., Ir.."~. / / COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE * . L' BUREAU OF INDIVIDUAL TAXES INttUtlAHCL IAll DIVisiON DlPt. 110.01 ttAAA I SlUMO , PA l1ua-O.Ol NOTICE OF INHERITANCE TAX APPRAISEHENT, AllOWANCE OR DISAllOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX II'. lit' III'" IU.tll THOMAS L BRIGHT 10000 MOLLV PITCHER SHIPPENSBURG PA DATE ESTATE OF DATE OF DEATH FILE NUMI1ER COUNTY ACN 12-23-96 BUTCHER 05-10-96 21 96-0445 CUMBERLAND 101 JERRY L HWY 17257 Alnount R...1tbd MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMeERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .... REV:isW-EX-AFinri:9&T"HoricE--oF-YNHERii'ANCn'-,iir'AppiiAISEHEHT-;-'\i.i:OWANcE-oli--------.-------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BUTCHER JERRY L FILE NO. 21 96-0445 ACN 101 DATE 12-23-96 TAX RETURN WAS' (X I ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Reel Estste ISchedule AI III 2. stocks end Bonds ISchedule BI 121 3. C1o.elY Held stock/Partnerahip Intere.t (Schedul. C) (3) 4. Mortgage./Hote. Rac.ivabl. (Schedule D) (4) 5. C.ah/Bank Depo.ita/Hiae. Parsonel Property (Schedule E) (5) 6. JointlY Owned Property ISchedule FI 161 7. Tranlfers (Schedule GI 171 8. Total A..eta ) CHANGED HOTE; To in sur. proper credit to your account, aub"it the uppar portion of thia far. Mith your tex pay"ent. .00 42 .174.00 .00 .00 105.846.00 9.444.00 .00 (B) 157,464.00 21, 932.00 3.314.00 Ill) 112) 113) (14) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expena../Ada. Cost./Hlac. Expense. (Schedule H) (9) 10. Debts'Hort;oge llobllities'liens IScheduie I) (10) ll. Totel Deductions 12. N.t Ve1ue of Tax Return 13. Ch.rlt.ble/Governaental Beque.t. (Schedul. J) 14. Net Velue of Estete Subject to TeK ?I;.'G~ nn 132,21B.00 .00 132,218.00 If an assessment was issued previously, lines reflect figures that include the total of ALL ASSESSMENT OF TAX: 15. Aaount of Line 14 .t Spou.al r.te (15) 16. Aaount of Lln. 14 t.xable at Lina.l/Cl... A rate (16) 17. Aaount of Lln. 14 taxable .t Col1.t.ral/Cl... B r.t. (17) 18. Principal Tax Du. 14, 15 and/Dr 16, 17 and 18 will returns assBBsed to date. NOTE: .00 x,OO: 132,218.00 x .06: .00 x .15: 1181 .00 7,933.00 .00 7,933.00 TAX CREDITS: PAYHEHT DATE 08-06-96 10-24-96 RECEIPT HUHBER AA146597 AA146869 DISCOUNT 1+) INTEREST I.) 394.74 .00 AHOUHT PAID 7,500.00 58.00 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 7,952.74 19.74CR .00 19.74CR . IF PAID AFTER DATE INDICATED, SEE REVERSE FDR CALCULATION DF ADDITIONAL INTEREST. IF TDTAl DUE IS lESS THAN .1, NO PAYHENT IS REQUIRED. IF TDTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU HAY BE OUE A REFUND. SEE REVERSE SIDE DF THIS FDRH FOR INSTRUCTIONS.) 00 :0 ~> '<1l~ cr.; ;, n " ' ~, ,", a ',' - C'> N "" .', >,' ~ Vi .... '2. '. ;;, ;;~ \0 RESERVATION: Estat.. of deCedent. dying on or befar. D~.-b.r 12, 1982 -. I' any future Int.r..t In tha ..tat. I. tran,farrad In pOI.a.llon or .nJoyaent to Cle.. a (coll.t,rell beneflclarl.. of the decadent .ft.r the ..plr.llon of any a.tat. for Ilf. or for y..r., the Co..onwealth hereby axpr..,lv r...rv.. the right to appral.. and ...... tran,f.r Inheritance Tax.. at thl l~ful Cia.. B (collatara.) rat. on any luch future Int.r..t. PUIII'OSE Of NOTICE: PAYttEHTI REf\JHD (CR) I OBJECTIONS: ADltIM ISTRATlVE CORRECTIONS: Dlscot.ltTI PENAL TV I INTEREST I To fulfill tM nqulrl""ta of Section Zl4D of ttMI Inheritance ..-1d E,tat. ra. Act, Act 22 of 1991. 12 P.S. Section 2140. Detach the top portion of thl, Hotlcl and ,uball with your pay.-nt to thl Raglltar of Willi printed on thl rav.r.. .I~. .-"aka chIck or ~y order paYable tal REGISTER OF MILLS, AGENT All pay.ents r~.lved th.11 first be applied to any Int.r..t whiCh ..y be due with any r..alnd.r applied to the tax. A r.fund of . tax credit, which wa. not r.que.ted on the fa. R.turn, .ay b. r.qua.ted by co~l.tlng an MAppllc.tlon for R.fund of Penn.ylvanla Inherltanc. and E.t.t. T.xM (REY-I]I]). Appllc.tlon. ar. avallabla at the Dfflc. of the R.alstar of Will., any of the Z] R.venue DI.trlct Dfflc.., or by calling the .p.elal Z4-hour an.~rlng .arvlc. ~erl for for.s ordering: In penn.ylvanla 1-800-]6Z-Z0S0, outside Penn.ylvanl. and within local Harrisburg araa (117) 187-8094, TOO. (111) l1Z-ZZSZ (Haarlng 1~.lred Only). Any p.rty In Int.re.t not .atl.fled with the appr.llaeant, allowanc. or dl..llowance of d~tlon., or .......-nt of tax (Includlna dl.count or Int.ra.t) a. ahown on thl. Notlc. .u.t object within .Ixty (60) d.y. of receipt of thll Notice by: --wrlttan prote.t to the PA Dapartaant of Revenue, aoard of Appeal., Dept. ZIIOZI, Harrl.burg, PA --alectlon to hava the ..ttar datarainad at audit of the account of the par.on.1 rapr..antatlve, __eppa.1 to the Drphen.' Court. 1712ft-I021, OR OR Factual arror. dl.covared on thl. a......ant .hould ba .ddr....d In writing to: PA Oepart.ant of R.venue, Bur.au of Individual T.x.., ATTN: po.t A..a...ent Ravlew Unit, Dapt. Z10601, Harrl.bura, PA I11ZI-0601 PhorM (111) 181-6505. 5.. p8Q41 5 of the bookl.t Mln.tructlon. for Inherltanc. Tax Raturn for a R..h.."t OacadentM eREY-ISOI) for an ..planatlon of adalnl.trativ.ly correctable .rror.. If any tax due I. paid within thr.. e]) calendar eonth. .ft.r the dac~t". d..th, . flv. percent (5X) dl.count of the t.x paid I. allowed. The IS:< t.. aana.ty non-p.rtlclp.tlon penalty 11 coaputed on the total of the tax and Interut ......ad, and not paid b.for. January la, 1996, tha flr.t d.y aft.r tha end of the tax a~.ty period. Thl. non-participation penalty 11 appe.labla in tha .... aatVl8f' and In the tha .... tla. parlod .. you would appa.l the tax and Intarnt that h.' bean ......ad a. Indlcat.d on this notlca. Intera.t I. ch.rged beglnnlna with flr.t dav of delinquency, or nine (9) eonth. and one el) day fro. the data of daath, to the data of pa~t. Ta... which bee... delinquent befora January I, 191Z ba.r lnt.r..t at tha rata o' .Ix 16X) parcent per annua calculated at . dallv rata of .00016~. All taxa. which bac..a d.llnquent on and ..tar Janu.ry 1, 19aZ will bear Intar..t at a r.t. which will vary fro. calendar yaar to calendar y..r with th.t rata announced by the PA Dapartaent of R.venue. The appllcabla lnt.ra.t rat.. for 198Z through 1991 ar.1 '!!!r Intara.t Aat. Dally Int.rnt Fllctor !!!! Intarut Allt. Dally tnt.r..t FftCtor 198Z ,n .D005U 1981 .. .OOOZ~1 1985 16X .OOO~:Sa 19ea-I991 1I~ .0aUal 1'" 11~ .aoolDI 1'" .~ .0OOZU 1915 U~ .OOUS6 199]-1994 7~ .aaal9Z 1.116 1'~ .aaoz1~ 1995-1991 .~ .aoaZ41 --Intar..t 1. c.lcul.ted a. follow.: IKTEREST = BALANCE OF TAX UNPAIO X NU"BER OF OAYS OELINQUENT X OAILY INTEREST FACTOR --Any Notlca Iuuad aftar the tax beeOMI delinquent will raflact an lnt.ra.t calcul.tlon to f 1ft.." ClSI d.ys beyond the date of the .......ant. If P'YMf'It Is aede .ftar the lnt.rut cOlPUtatlon data .howl on the Notice, Itddltional lntar.1l .....t ~ calculated. i5-lc16 II COHHONWEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE c/ BUREAU or INDIVIDUAL TAKES IHHLMIIANC[ tAlC DIVISION DIPI. :80bOl IlARNISIUllG. PA IIlla-abOI NOTICE or INIIERIT ANce TAK APPRAISEHENT, ALLOWANCE OR DISALLOWANCE Dr DeDUCTIONS AND ASSESSHeNT Dr TAK THOMAS L BRIGHT 126 EKING ST SHIPPENSBURG DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 02-09-98 eUTCIlER 05-10-96 21 96-0',45 CUMBERLAND 101 PA 11257 AMount Renitted ,*, till." 1111' In..'' JERRY L HAKE 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 .... Fifli:E;'4""i"Eif"AFP-io9-:ii:;-j-iioTicnWYNHEFiiiANCE-TAX-APpiiiiiSEttENT-;-.U.i"owANcE-iilimm_uu_- ---- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BUTCHER JERRY L FILE NO. 21 96-0445 ACN 101 DATE 02-09-98 If an assessment was issued previously, lines 14, 15 and/or 16, 17 and 18 will reflect figures that include the total of ahh returns assessed to date. ASSESSMENT OF TAX: 15. Anount of line 14 at Spousal rat. (15) 16. Anount of Line 14 taxable at Line.I/Class A rat. (16) 17. Anount of Line 14 taxable at Collateral/Clals Brat. (17) 18. Prlncipel Tax Due TAX CREDITS: PAYHENT DATE 08-06-96 10-24-96 11-19-97 TAX RETURN WAS: (X) ACCEPTED AS rILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN 1. Ro.l Est.t. ISchodul. Al (11 2. stocks and Bonds (Schedule 81 (2) 3. Closely Held stock/Partnership Interest (Schedule C) (3) 4. Hartg.gas/Not.. Receivable ISchedul. OJ (4) 5. Cash/Bank Oeposits/Hisc. Personal Property (Schedule EJ (51 6. Jointly Owned Property ISchedule FI 161 7. Transfers (Schedule G) (7) 8. Total Assets NO. 01 .00 ,00 ,00 .00 3,232.54 .00 .00 ISI APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ad~. Costs/Hisc. Expenses ISchedule HJ 10. Oebts/Hortgage Liabilities/Liens ISchedule IJ 11. Total Oeductions 12. Net Value of Tax Return 13. Charit.ble/Govern.ent.l aeqUests; Non-elected 9113 Trusts 14. Net V.lu. of Estat. Subject to T.. 191 1101 203.00 720. 24 1111 1121 1131 1141 (Schedule JI NOTE: .00 X .00: 134.527.30 x.06: .00 X .15: I1SI RECEIPT NUHBER AA146597 AA146869 AA242477 DISCOUNT I') INTEREST/PEN PAID (-I 394.74 .00 .00 AHDUNT PAID 7,500.00 58.00 118.82 BALANCE OF UNPAID INTEREST/PENALTY AS OF 11-20-97 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION or ADDITIONAL INTEREST. NOTE: To insure proper credit to your eccount, sub.it the upper portion of this forn with your tax pay.ent. 3.232.54 gn ?4 2,309.30 .00 134,527.30 .00 8,071.56 .00 8,071.56 8,071.56 .00 8.28 8.28 ( Ir TOTAL DUE IS LESS THAN Sl, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU HAY BE DUE A RErUND. SEE REVERSE SIDE OF THIS FDRH rDR INSTRUCTIONS. I RESERVATION: E.t.t.. 0' d.c.dant. dying on or b,'ora O.c.ab.r IZ, 1982 .. I' any 'utura Intere.t In tha ..t.ta I. trans'err.d In po.....lon or .nJoy..nt to Cia.. B (collat.r.l) bene'lclarl.s 0' the dac.dant .,tar the explrltlon 0' any Istat. 'or ll'e or 'or yaar., the Co.eonwaalth haraby expre..ly raserve. the right to appralsl and .sle.s trans'ar Inheritance Taxas .t the law'ul Class 8 (collateral) rat. on any luch 'utura Interast. PURPOSE Of MOUCEI To fulfill the requlra.ants of Sactlon Zl40 of the Inheritance and E.t.ta Tax Act, Act 21 of 1995. (7Z P.S. Sactlon 9140 J. PAYH{NTI Detach the top portion of thll Notice and lubelt with your pay.ent to the R.gllter of Wills prlntad on the reverse side. n"ake check or eoney order p.yabl. to: REGISTER OF MILLS, AGENT REf'UHD (CR'I A re'und of . ta. cradlt, which WIS not raqueltad on the Tax Return, .ay be raquelted by cOlplatlng an -application 'or Refund of Pennlylvanla Inherltanc. and E.tate Tax- (REV.1515'. Application. ar. available at tha D"lc. 0' the Regl.ter of Wills, any 0' the 25 R.v.nue District Offlc.., or by calling the .peclal Z4.hour Insw.rlng I.rvlce nuaber. for for.s ordarlngl In Pennlylvanla 1.800.56Z.20S0, outs Ida P.nnsylvanla and within local HarriSburg ar.a (7171 787.8094, TOO' (717) 77Z.22SZ (H.arlng Iapalrad Only). OBJECTIONS: Any party In Int.r.st not .etllfl.d with the apprall...nt, allowanc. or dllalIowanc. of d.ductlonl, or als.sl.ant of tax (IncludIng dllcount or Int.r'lt) as Ihown on thl. Hotlc. .ult obJact within sixty (60) dayl of racelpt of this Hotlce by: ..wrltten prote.t to the PA Dapartalnt of Revenue, Board of Appeal I, napt. Z81021, Harrllburg, PA ..ellctlon to have thl .atter det.ralnad at audit of the account of the parsonal repralent.tlve, ..apPlal to the Orphans' Court. 17128.IOlI, DR DR ADKIN ISTRATIVE CORRECTIONS: Factual error. dlscover.d on thl. aSI.lla.nt should b. addrelled In writing tal PA aepart.ant 0' Ravenue, Bur.au of Individual Taxes, A1TN: POlt AI.eSle.nt R.vlew unit, aept. Z80601, HarriSburg, PA 17128.0601 Phon. (717) 787.6S0S. Se. pave S of the bookl.t -Inltructlon. for Inheritance Ta. Return for a Ralldent D.c.dent- eREV.ISOI) for an ,.planatlon of adelnlstr.tlvely correct.ble errors. DISCOUNT: I' any ta. due I. paid within thr.e (5) cal.ndar aonths eft.r the decedent'. daath, a flv. perc.nt (S%) dllcount of the ta. p.ld Is allowed. PENALTY: Th. IS% ta. a~.ty non.partlclpatlon penalty I. coaput.d on the total of the tax and Inter.st alle.lld, and not paid b,'or. January 18, 1996, the first day after the and 0' the t.. aan'lty parlod. This non.p.rtlclpatlon penalty I. .ppe.l.bla In the sa.. ..nner and In the the .... tl.. parlod .s you would app.al the ta. and Intar..t that ha. been .....I.d as Indicated on thl. notlc.. INTEREST I Int.r..t I. Charged beginning with flr.t day of delinquency, or nine (91 eonthl and one (11 day fr~ the data of death, to the date 0' pay.ent. T.x.s which becaee delinquent be'or. January 1, 198Z be.r Int.re.t at the rat. of .Ix (6%) parcent p.r annu. calculatad at a dally rata of .000164. All taxa. which baca.. d.llnquent on and a'tar January I, 1982 will ba.r Int.rest at a rate which will vary fro. cal.ndar year to calendar year with thet rat. announc.d by the PA Depart.ent of Ravenue. The .ppllcable Interelt rata. for 1982 through 1998 ar.: !!!! lnterut Rate Dally Inter..t Factor !!!r lnt.rut Rata Dally Inllr'lt FBctor 1982 20X .000S48 1987 .~ .0002" 1985 16~ .000438 1988.1991 llX .000501 1984 IU .000l01 1992 .~ .000247 1985 U~ .0001S6 1993.1994 7~ .000192 1.16 I.~ .000l'" 1995.l998 .~ . DOQZ" "lnter..t I. calculated as 'olIOMI: INTEREST . BALANCE DF TAX UNPAID X NU"BER DF DAYS DELINQUENT X DAILY INTEREST FACTDR ..Any Notice Is.ued .ftar the tax beco.a. delinquent will re'lect an Intare.t calculetlon to fifteen (IS' day, beyond the date of the .'IIII..nt. If p.yeent I. ..d. aftar the Intara.t coeputatlon d.t. lhown on the Notlca, addltlonel Intare.t ~.t be c.lculated. , ~ - __....:...--..7"-..~~. t.- - . 1"'"- .. c I -... r COMMONWEALTH OF PEm~SnVAW^ ()[PAlHMENT or m:VH~ur BUREAU OF INDIVIDUAL TAXES DCPT 2B0601 tiARrUSOURG, PA 17126-0601 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL ReCeIPT .,q'.lt.Q. ~ NO. AA 2 S 9 807 """.lEX ,,,',,,, RECEIVED FROM: r THOMAS L BRIGHT ACN ASSESSMENT CONTROL NUMBER AMOUNT 6 WILLOW RUN SHIPPENSBURG, PA 17257 , () I OJ;rf ;J~ ; 1.._ , fOW.tfR[ ESTATE INFORMATiON: FilE NUMBER 21-1996-0445 SSN 486-50-0777 NAME OF DECEDENT IlASTI IFlRST, IMI' BUTCHER JERRY L DATE OF PAYMENT 3/03/1998 POSTMARK DATE 2/~.lL15'98 COUNTY fClD HERE . .BERLA~D DATE OF DEAHl TOTAL AMOUNT PAID $8.28 REMARKSTHDMAS L OR I GHT ; ill ~ ) :; i ~ ' ! r:_ 'II I, '; . . SK . ~,' /,- /'.-: ...<..- . " RECEIVED BY ."//''''''': ,~, /{/," /.~}...IfV MAflY C. LE;',fIs '// Y'/'/:'()L~ REGISTER "Or lHLLS;;.-,r'(t.JI'.A:j/. (;/' SEA/;HECK II 0158 . ..---....-.--------- j ,.... .--, -r~"""""'- - -"'~1" -,:.... _.:....._u. -.'~A. _ __ , ; COMMONWlAlllt OF P[FlNSYlVAUlA D[PMOMUH OF H[V[t~U[ BUREAU OF INDIVIDUAL TAXES DEPT 260b01 HAfUUSnUfW. PA 17128.0601 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT \' W.~' ~ -. , NO. ^A 2 4 2 4 77 "IV".' [X ",.., RECEIVED FROM: r' ACN ASSESSMENT CONTROL NUMBER AMOUNT THOMAS L BRIGHT ESQUIRE 1n1 q.11j:l Q;J 126 E KING STREET SHIPPENSBURG. PA 17257 'QWH[H1 fa.D HERE ESTATE INFORMATION: FIlE NUMBE R 2 1-:..L'B.f=Q~'i5 NAME OF DECEDENT llASTI SSN 486-50-n777 (FIRSTj IMII -B.UICt!EfLLEB.B.LL DATE OF PAYMErH 11/19/1997 POSTMARK DATE 0/0010000 COUNTY cur1BERLAND DATE OF DEATH (, Qq REMARKS THOMAS L BRIGHT [SQUI~E TOTAL AMOUNT PAID $118.82 vz SEALCHECKII 137 RECEIVED BY "lARY C. LEW I S REGISTER OF WILLS , ,..) ,.'/:./ r'- "','j()! d', : ,/// ,i" 'ir.-,- . I ' ., /' " ( ;:;~.' /{ ------------=..=..:..-...:..:..- t.-, " ! ~: - , ..... - . - .-"- ..- """""'4)10..,..,...,- ~.'--"...N"~ _-'-T ~.:. 15/[.',' II COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT * BUREAU OF INDIVIDUAL TAXES IHI1UIUHCl lAIC DIVISION D[PI. ,,80bOI liARRISaURC, PA I1lla-obot ."."" II'" III.tll THOMAS L BRIGHT 126 EKING ST SHIPPENSBURG DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 04-13-98 BUTCHER 05-10-96 21 96-0445 CUMeERLAND 101 JERRY L PA 17257 Anount Re.itt.d MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 HOTE: To In.u~. proper credit to your .ccount, subnit the upper portion of this for. with your tex p.yn.nt. CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ..... iiE'v:ir.ifi-EX--iiiip--io3':i,jiy---miiiiii-iNH€iiiTANC'E-i'AiCsi'A'iEilENi'-ifF-iiifcciiiiiiuiiiiimm------m------ ESTATE OF BUTCHER JERRY L FILE NO. 21 96-0445 ACN 101 DATE 04-13-98 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORO ADJUSTMENT: 02-02-98 PRINCIPAL TAX DUE: 8,071.56 PAYMENTS (TAX CREDITS), PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 08-06-96 AA146597 394.74 7,500.00 10-24-96 AA146869 .00 58.00 11-19-97 AA242477 .00 118.82 02-21-98 AA269807 8.28- 8.28 TOTAL TAX CREDIT 8,071.56 ..' BALANCE OF TAX DUE .00 INTEREST AND PEN. . IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL DUE .00 .00 IF TOTAL DUE IS LESS THAN '1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDn" ICRI, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. PUrENT; O.ll<h lho I.. .Drllon .f Ihl. NDII.. ond .ub.11 .Ith ,Dur ..,..nt ..d. ..,.bl. ID Ih. n... ond oddr." print.d on th. r.verl. lid.. If MSIDENT DECEDENT uk. .h..k Dr ...., Drd.r ....bl. t., REGISTER OF WILLS, AGENT. If NON-.ESIDENT DECEDENT .... .h..k .r .onOY .rdor ..,.bl. 1., connONWEALTN OF PENNSYLVANIA. .EFUND 'C," . r.fund .f . t., .r.dll, .hl.h ... n.t r.....I.d .n tho T., ,.Iurn, .., b. r.....I.d b, ....l.llng on -...,I..llon fDr ..fund .f ..nn.,I..nl. Inh.rllonc. ond E.t.l. T.'. "E.-ISIS'. ...,I..llon. .r. ...11001. .1 Ih. Offl.. .f tho ...I.t.r .f .111., on, .1 Ih. ,S ...onu. OI.trl.1 Offl... .r fr.. Ih. o...rl..nl', ,'-h.ur .....rlng ..r.I'. nu.b.r. f.r f.r.. .rd.rln., In ..nn.,I.onl. l-aOO-S6'-'0'O, .ul.ld. ..nn.,I.onl. and within local HarrllbUrg ar.a (711) 181.809~, TOOl (117) 77l.ll~l (HI.ring I~alr.d only). M.L' TO. Du..II.n. r...rdln. .rr.r. ..nl.ln.d .n Ihl. n.II.. .hould b. .ddr....d I.' .. o...rt..nl .f ...onu., Our... .f Indl.ldu.' T.,." .TTN. P..t ........nl ...1.. unll, O.pl. '00601, H.rrl.bur., P' 171'0'0601, pbonO (1111 781.6S0~. DISCOUNT' If on. "" duO I. ..Id .Ithln Ihr.. 'SI ..I.nd.r ..nlh' .fl.r Ih. d...d.nl'. d..th. . fl.. ..r..nt "XI dl..ount of the tax paid II allowed. PENALT't: Tho I'X t., .on..t, n.n-p.rtlel..tl.n ..n.'t' I. .....t.d on tho t.I.1 .f Ih. t., ond Inl.r..t ......od, ond not paid bafore January 18, 1996, the firlt day aftar the and of th. taM aanalty periOd. INTEREST: Int.r..t I. .h.r..d b..lnnln. .llh flr.t d., .f d.'ln...ne', .r nln. ", ..nth' ond on. '11 d., fr" tho d.l. .f d..th, I. Ih. d.l. .f p.,..nt. T.,.' .hl.h b.e... d.llnqu.nl b.f.r. Jonu.r, I, 1'0' b..r Int.r..t .t lho r.t. .f .1, 'OX, ..r..nt p.r annu. ..I.ul.t.d .1 . d.ll. r.t. .f .00010'. ." I.,.. .hleh b.e... d.lln...nt on .nd ..I.r Jonu.r, I, 1'0' .111 b..r Inl.r..t .t . r.l. whleh .111 u.r' fr.. ..I.nd.r ,..r t. ..,ond.r ,..r .llh Ih.t r.t. onnoune.d b, Ih. P' o...rt..nl .f ....nu.. Th. ..pll..bl. Inl.r..t r.t.. f.r 1'0' Ihrough 1"0 .r.. Vaar Intlralt Rata Dally Intaralt Factor Vaar Intarut Rate DailY Int.r..t Factor 1982 lOX .0DO~48 19&1 'X .DOOZU 1981 16:< .DDD"n 1988.1991 11;( .000JOl 198" 11;( .00DSOl 199% 'X .ODOZU un UX .OODSS' 1995.199~ ]X .000192 1986 lOX .OO0l7" 19'95.1998 'X .OOalU .-lnter..t II calculatad .. followll INTEREST = BALANCE OF TAX UNPAID X NUnBER OF DAYS DELINQUENT X DAlLY INTEREST FACTOR __An, N.II.. I..u.d .fl.r tho I.' b...... d.,lnqu.nl .111 r.".el on Inl.r..1 e.l.ul.tlon t. .Ifl..n 'I" d.,. b.,ond Ih. d.l. .. lho ........nl. If ..,..nl I. .od. .,".r Ih. Int.r..t ....ul.tlon d.l. .noun on lho Hotlc., additional lntara.t ault ba calculatad. Name of Decedent: JERRY l. BUTCHER Date of Death: MAY 10, 1996 Will No. Admin. No. 1996.00445 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above.captioned estate: 1. State whether administration of the estate is complete: Yes No x 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: December, 1996 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_. b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes _ No_ o:l d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. ':. q o. r-- - , -, , ~.~ 0: 0: ~ ) ~-l\ ..2 ::.i UU '. STATUS REPORT UNDER RULE 6.12 - Name of Decedent: I, H,/Z Y Date of Death: <-)-\(1 'C\\IJ will No. L6,.t\I.'..'v,vV' Admin. No. 2.1 -\CI'\l,. -1.\4.5 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of th~ above-captioned estate: , j " ,I .1 1. State whether administration of the estate is complete: Yes"; 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. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No ~ . b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes J 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. Sign:J~ 1r 1\-\Ot.\t\S l-..\~gIG\-tT Name (Please type or print) Date: Lv-n,~C\9, \;fd ' 11'1' , .lUIn:J II~I~ \Ll~ E:, \1-\ tV(;, S\/ Address 8l: ld 61 Nnr 86, 51": .', :-It:! )') , '::;ntj D\ 1) 'S~ l - ~tl~'~ Tel. No. Capacity: ~personal Representative Counsel for personal representative (HAH: rmfl AM3)