HomeMy WebLinkAbout96-00508
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COMMONWEALTH OF PENNSYLVANIA. DEPAnTMENT OF HEALTH. VITAL AEconos
CERTIFICATE OF OEATH
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]AST HiLL AND TESTAHEm'
I, JOliN A. PATTERSON, uf North Newton TowlI~h I.p, Cumllerlllnd
County, pennsylvnnia, being of sound mind, memory Ilnd understanding,
do make, publish llnd declnrc this llS and for my Last Will and Testament,
hereby revoking and making void all former wills by me at any time
heretofore made.
FIRST. I direct all my just debts and funeral expenses be fully
paid and satisfied out of my estate by my personal representative
hereinafter named as soon as conveniently may be after my decease.
SECOND. I give, devise and bequeath all my estate, real and
personal, to my wife, Olie C. Patterson, if living, otherwise iQkqual
shares to my sep-daughter, Mary W. Moore, and my step-son, Carl A.
Wiser, Jr.
LASTLY, I nominate, constitute and appoint my step-daughter,
Mary W. Moore, Executrix, of this my Last Will and Testament, and I
direct that Henry L. Stuart, Esquire, be retained as attorney in the
settlement of my estate due to his familiarity with and knowledge of
my affairs and business.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
I
u;
L day of
;:i..l..'t
I /
, 1979.
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(SEAL)
Signed, sealed, published and declared by the above named
Testator, John A. Patterson, 8S and for his Last lolill and Testament,
in the presance of us, who, at his request and in his presence and
in the presence of p.ach other, have hereunto subscribed our names as
witnesses thereto.
; (at',! " !c.u.".(
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21-96-508
REGISTER 0... WILLS 0... CUHIIEllI.ANIl COUNTY
OATH OF SUnSCIUUlNG WITNESS
Henry I.. Stunrt and Knrull (':. ~'nlrcloth
l\.tliQMI<
(each) a subscribing wilness wthe will presented herewilh. (each) hdng dnly 1I11ulified according to
law. depose(s) and say(s) thaI they were I'resentnnd saw
John A. Patterson
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the test at or . sign the sallie and Ihat __-.they .__' \i~lIed a\ a wilnes\ !lIthe
request of testat.2.J:_ in t...!.!!-. presence and (in the presence of eaeh other) (in the presence of the
olher subscribing witness(r.;)),
Sworn to or affirllled and subscrib,'d hefore :/C. ~I ,~, CI.-<.uo. L C
I
me this .;' (, day of "I (Nalll~)"" 1
(j'PlliU ]. :~1G ') $,/.r:,...-,.t'':vU ,,--,te{,It. 1/<1 17{' /3.
9lU{11 t diu<(~~!5l/.{, t~/'Lj, _ / . (Address) .
MARY CLEWIS lIeRisler ~("" I' C~ ' -fa L !..(I[ I-t/'
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i / (Name) ( I / / / I rt . / '
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(Address)
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~ lISTER OF WILLS OF C~~N'l~
~OATH OF NON-sunSCIU8ING WITNESS
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(each) a subscriber hereto, (each) being duly qualified according to law, depii:\1:{s) alll@1l'(s) that"
. _ ramiliar with the signature or
codicil
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that
presented herewith and
codicil
believes the signature on the will is in Ihe haudwritiug or
lestal_ or (one of the subscribing witnesses to) the
10 the besl or
knowledge and bclier,
Sworn to or amrmed and subscribed before
me this day of
19_
(Num~)
(Address)
ReRisler
(Nail"')
(Add",....)
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20 If lIn. 19;. greoter Ihon L1n. 18, .n'" rho diffe,..,.. on Lln. 20. Thil ;.'he OVERPAYMENT.
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21. If Line 18 II G,eol., man lIn. 19, ent.r the differ.nc. on lint 21. This is th. TAX DUE.
A. Ent.r the Inltr.lt on th. balonc. due on Un. 21 A.
I, En"r ,hi '0'01 01 L1n. 21 ond 21A on Lint 218, Thh 1.lh. BALANCE DUE.
Mab Ch.eI, Pa abJ. tal ..eitt., o' Will" A ent
, ",:.. . . "'\;'t",:I;" )o'!.' BElSURE TQ'ANSW.Ell ALL QUEmONS ON REVERSE'SIOEoANO'TO Rf.CHGtK MAtW :-< <. '~"., '."" "
Under p.noltilt1 of p.riury. I d.do,. thOf I hov. uami",d ''''is reiurn, induding octoft'lponying "h.dul.. and Irol.m'l'\h, and to the b.1t of my "nowl.ag. and beho!t
.' it it trut, (orr.ct and compl'I', I d<<lor. that 011 r.ol ,ulale he, b..n r.port.d 01 'rue morktl valu.. D.c1aratlon of j:lr'pof.t oth.r thon I~' p.tlonal "pr.II"IOllve I
bal.d an all informollon of which preparer hat Dny knowltd e.
t Not. U 0' ,unOH IU N I " C' NINe; 'elU'-N loOp_US
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'OIDAmO'DI"tH"mll12/JII9I CHICKHUI
I' A SMUIAL
POVIII" CIIDn tS CLAIMID C
fill NUMBn
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
50H
COMMONWU,U14 or 'I!NNULYAN'A
OIP.IlI.IN' ~"\VINVI
Hm"fJ.A, ~1191:1~"'1
N' N.Ml ll.A . , f,""i'N6 ""'IDO. Ihl '''LI
Pnttenwll John ^.
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COUN1Y coot
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NUMRtF
YrAR
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1020 (;rel'll Spr 1111\ HOi,,1
Newville, 1'/\ 172101
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AMOUNT IICIIY!D IUt IN:' U I
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VII'" fly".,l .
0"11 0' O!Aln
DAU Of III ~
179-IH-JOn
11/10/%
II 12H/I',
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C 2, Suppl....ntal R.lu,n
03.
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A.rnalndtr R'lu'l'I
(for date. 01 d,alh pri(H 10 12. \3.112'
hd.rol Eval' TOil: R'lwrn Requir.d
O,iglnal R.lu,n
Limited Ellal.
C Ao. future I",e,tal CQmpromi't'
(lor do'.. of doo,h ok.. 12.12.82)
o 7. O.e.d.n, Maln,ain.d 0 Lvil'''9 T,ult
(A"od! copy of TruIII
IDEmI~" lNFORMAnOIUlfOOLD lIE
<:o.u.'UII MAIUNO ADOU5$
I, N. Ilnnovu r
Cnrllsle, P/\
Street
170lJ
_ B. Tolal Numbll af Safe O'POill no..,
D,e,d,n' Di,d Tlllo"
I""och copy of Will)
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.Jnhn H. IIrouJos, Esqulre
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" Rool Ello'e (Schedull AI ( I)
2. S'ockl ond eondllS,hldull 81 (2)
3. C1o.ely H.ld S'otk/Po"nlnhip Inl.roll(S,h.dul. q (3)
A, Mortgog.. ond Nolo. R.,";.obl. ISch.dul. Dl I A )
5, Co.h, Bonk Olpo.i,. & Ml.tlllonloul P.nonol Prope",. I S I
ISchldul1 E)
6, Joinlly Owned Prop.",. (Schedull F) ( 61
1. Tronlf... (Sthodull G) (Schedul. LI (1)
8, TOlol Grou AUI" (Iolollin.. '.n
9. funeral bp.n.... Adminhtroliv. Colh, Mi".llanH2us (9 J
E.p.nlll (S,hedull H)
10, D.b", Mo"gogl li_blliti". U.n. IS,h.dul. II (10)
11. Tolol Oodudion. (10'01 Un.. 9 & 10)
12. Nil Volul of EIf_IoILi.1 8 minu.linl 11)
13, Charitabl. and Governmln1al Bequ,u, (Schedule J)
lA. Nfl Value Subiect to Toll. (lIn. 12 minus Line 131
115. Spoulol Trondor. (rar dol.. of d.orh ok.. 6.30,9AI
S.. In"r\l(fion. for Applicabl. P.rCln'age on Reven. 1151
Side. llndude values from Sehedul. K or Sc.),edul~ M.I
It>. Amount of Une 1.4 taJlable 01 6% 'ole (16)
(Indud. volu.. from Schldull K or S,hedull M,)
17. Amoun' of Lint 14 'a.-obi. 0' 15% rOl. (In
(Incllolde valves from Seh.dul. K or Schedule M.I
lB. PrincipoltaK due (Add lOX from Un'l 1.5, 16 and 17.)
19. CredilS Spou'tol Povllly Credit Prio, Poymtnll
J7.500.00
69.514.02
J,OH7.09
9,970.00
(8 l
110,010.11
16.000.60
25,976.60
84,OJJ.51
(111
(121
(13)
(I A)
84.0J3.51
X,_D
81, 011. <;1
K ,06"
5,042.01
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(18)
5,042.01
Oiscount Intllesl
(19)
120)
Ch~~" hcr(" If you ore- requel.finq 0 r<"fund of your overpaym('nt.
(211
(21A)
(219)
5,042,01
26.1 <;
5,06H.16
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Act #48 of 1994 provldel for the reduction of the tox rotellmpond on the nel valuo of Iransfors 10 or for
the UI. of Iho Ipoule. Th. ratel 01 prelcrlbed by Ihe Ilatulo will be:
. 3% (.03) will be applicable for ellalel of d.cedenll dying on or after 711/94 and before 1/1196
· 20/0 (.02) will be applicable for ellalel of decedenll dying on or aftor 111196 and bofore 1/1197
. 10/0 (.01) will be applicable for ellalel of decedenll dying on or after 111197 and before 1/1198
· Spoulallransfers occurring on or after 111/98 will be exempl from Inherilance tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK (v) IN THE APPROPRIATE BLOCKS.
YES NO
1. Did decedent make a transfer and:
a, retain the use or income of the property Iransferred, ...............,......,........,.......................
b. retain the right to designote who shall use the properly transferred or its income, .........,....,
c, retain a reversionary interest; or .....,.............,...............,..,....,......,..,.,.....,..,..,...,...........
d. receive the promise for life of either payments, benelits or care? .......,.................,............,
2, If death occurred on or before December 12, 1982, did decedent within two years preceding
death Iransfer properly withaul receiving adequate consideration? If death occurred after
December 12, 1982, did decedenllronsfer property within one year of death without receiving
odequale consideration?.., ..... ........,..,.."..,.,..",.."..,......"""..,...., ,..",. ...."..""" ,..,'....", ,..,.
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3. Did decedenl own an 'in trusl for' bank occount 01 his or her deothL:....,..,..J.R,\u;t..\',lO;~..
v
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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Commonwealth of PennsylVania
Inheritance Tax Return
Resident Decedent
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
.,__._~.=____..~~~,~.~=~~~,.,=~.~~.~=.r"~=~='===--=='~r~=r.~=~ ,..~,,,~.~~~'''r'rr.,~==,,~====
Estate of
File Number
1996-00508
John A. Patterson
(All properlY Jolntly.owned with the Right of survivorship must be disclosed on Schedule Fl
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ITEM
NUMBER
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
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DESCRIPTION
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CD No. 21001053380
Issue dats 6/23/94
CD No. 21001053414
Rsnewal date 10n/95
360. Communications - rent
PNC Checking
Car. '84 Chevrolet Impala
PA Blue Shield
Bankers Life & Casualty Co. - nurse home policy
Bankers Life & Casualty Co. . nurse home policY
Bankers Life & Casualty Co. - nurse home policy
Blue Cross & Blue Shield Retail Pharmacy Program - refund
Government Group life Insurance Claim _Insurance
Penn Treaty Life Ins. Co. - Insurance
Blue Cross & Blue Shlsld chscks (4)
Monumental Life Ins. - Insurance
Personal propsrty
Rifles and shotguns
TOTAL (Also entsr on line 5, Recapitulation)
VALUE AT
DATE OF DEATH
$ 10,435.45
3,621.91
127.38
25,288,06
550.00
21.50
6,716.00
7,616.00
605.71
480.14
5,270.84
4,100.00
86.03
600.00
3,370.00
625.00
$ 69,514.02
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Fully licensed & Bonded
Public Soles & Appraisal,
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DAN HERSHEY AUCTIONEERING SERVICE
DENNIS L. GOTSHALL, P,op"e'o,
3 Btown Rood. Shippensbulg. PA 17257
Telephone 17171 531.4647
Form. Rrol Estate. Hounlhold . Anhques . Tent Rental
Ano"o'e. CI1ARlES H, MARriN 17171531.8323
AMOS M, MclAUGHliN 17171 532.8008
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Estate of John A. Patterson
List of Firearms
Make, Model, SiN, etc.
Est.. Value
J 7S,t)o
Revelation .22 Cal. Uolt Action Rifle. Single Shot
(Western Auto) Model 100A Good Condition
Mossberg Mod. 1B5KA 20 Ga. Shotgun. Bolt Action Clip
2 3/4" Chamber. Var. ChOke Good condl.tion
Remington Mod. ~B70 20 Ga. Pump Shotgun 2 3/4"
SiN 25B136X Worn. Broken St.ock
Single Shot Hinge Act.ion .10 Ga. Shot.gun Poor
H & R Single Shot Hinge Action Shotgun 12 Ga Fair
SiN A12455
f 5 b. ~o
11/2. S ,tJo
1/ u....,
1/ 7'5. <9'1>
Savage Mod 340 Bot Action, Clip 30/30 Cal. Rifle
Extra clip. Good Condition
Izr.~
Winchester Mod. 1200 2 3/4" Chamber 12 Ga. Pump Shot tj Si 111!>
gun. SiN L642210 Full Choke. Quik Point Sight EX. Condo t b.
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Commonwealth of Penneylvanla
Inheritance Tax Return
Reeldent Decedent
SCHEDULE F
JOINTL y-oWNED PROPERTY
-=..::.=: ::: ~..::.--.;;::.,; ~;...: .;--:.: ,;.:...: ;.;' : :.:.:;. .; .o: ~.o..::.':: :- :c.,. :-::: :..:;.-,.;..; :.; ;. ,.: "'-.;.::: ;..: :-.; :.: ..z. ,. :.:c ". ,::.;:: -:....::: :.:;....::. _ -;,.:-,;-::; ;. .; :..:-: -: :.:--.:.."....;;;-:::-:,..::.-.".:_"'.::-:
Eetate of File Number
John A. Pattereon 1996.00508
JoInt tenant(s):
NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A.
John A. Patterson
Docedent
B,
Mary W. Mooro
20 Bridgewater Road
Newville, PA 17241
Stop-daughter
---------------
JoIntly-owned property:
LETTER TOTAL DOLLAR
ITEM FOR DATE DESCRIPTION VALUE DECD'S VALUE OF
NO, JOINT MADE OF PROPERTY OF % INT. DECO'S
TENANT JOINT ASSET INTEREST
1. A,B 2/20/95 CD No, 21001053712 4,080,60 50% 2,040,30
2. A,B 6/20/95 CD No, 21001053717 2,093,57 50% 1,046,79
TOTAL (Aleo entor on line 6, Recapitulation)
$ 3,087.09
Commonweelth of Pennsylvania
Inheritance Tax Return
Resident Decedent
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES AND LIENS
-;:::..:,-,:::..;:'-;'':';T.~r.~,",""'-;-:. :'--l:.-_:. to-: :.;:;:__:. ~ t-:;. :.:-,:-.::~-::.,t--,: .:':'_:';'''::'''=_~_ :::Z'-l.'-~.~_::.'; .;: :::-",:-;: ::c""'-:: ;.,.1.:::-":: c:-; -.:~-;":.::.:; ::,::',:"'-~"::~:,'::;';;.",,,,'~";'::::-:~:.:-:-:; ";-.:;-.:: :; -:--.::-:::.,:~ :;::.~:.;
Estate of
File Number
John A. Patterson
1996-00508
---_.._-_._-_._~~~._-------- ---------.---.-- -_.~--_.._----_.-.~----_._-
ITEM
NUMBER
DESCRIPTION
AMOUNT
------------~,._._. - - -- .-------_..--,.- -.---..-----------------..-------- ~ ~..._---
1.
Presbyterian Homes
$ 10,147.90
2.
Emerald Drug Stores
708.00
3.
Darlene Pittman, Tax Collector
748.50
175.00
47.70
5.
B.H Agency Appraisal Services
Chevy detaH cleaning
4.
6.
Claim of Mary W. Moore for care and maintenance for 4 years
4,160.00
7.
Carlisle Community Ambulance
21.50
TOTAL (Also enter on line 10, Recapitulation)
$ 16,006.80
Commonwoalth of PennsylvanIa
Inheritance Tax Raturn
Resident Dacedent
SCHEDULE J
BENEFICIARIES
--~
- ..~::;.::---_.. -- -==:::.:;-==-==:=.:=~--==--:.=.=---- --- -=---~::_-=.::-=
Estate of
File Number
John A. Patterson
1996.00508
ITEM
NUMBER
NAME AND ADDRESS OF
BENEFICIARY
RELATIONSHIP
AMOUNT OR
SHARE OF ESTATE
A. Taxable Bequeats:
1,
Mary W. Moora
20 Bridgewater Road
Carllale, PA 17013
Step-daughter
500/.
2.
Carl A. Wiser, Jr.
Slep.son
50%
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
AMOUNT OF
SHARE OF ESTATE
B. Charitable and Governmental Bequeals:
1.
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS
(Also enter on line 13, Recapitulation)
$
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L '010 Hill
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D NO. AA
18533 7 COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT 0' REVENUE
OFFICIAL RECEIPT · PENNSYLVANIA INHERITANCE AND ESTATE TAX
.
.IVOI162bf....1
RECEIVED FROM:
f3
ACN
ASSESSMENT '='
CONTROL ~
NUMBER
AMOUNT
JOHN flROUJOS ESQU If~E
1 () I
$~,Olt~.Ol
4 N HANOVER STREET
CARLISLE. PA 17013
ESTATE INFORMATION:
1:1 filE NUMBER
~ 21-1996-0508
~ NAME OF DECEDENT (LAST)
~ PATTERSON JOHN A
II DATE OF PAYMENT
9 POSTMARK DATE
COUNTY
SSN 179-18-3092
IFIRST' IMI)
CUMBERLAND
DATE OF DEATH
06/10/96
REMARKS
m TOTAL AMOUNT PAID
$5,0112,01
PB
SEAL
MARY W MOORE
C/O JOHN BROUJOS
CHECKtl 107
ESQUIRE
RECEIVED BY
'SIGNATURE
REGISTER OF WILLS
MARY C. LEWIS
REGISTER OF WILLS
..--. -_._- ."-' .---.~.- _.
- -.-----.-_.
.... _...__u.
_.~. -~..........-
...----.~.~ .4-~f.''I' ~'1:.
, .
/'; 11/ .-?
COMMONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
BUREAU OF INOIVIDUAL TAXES
IHlIlRIIANel IAll: DIVISION
D[Pf. :aOttOI
IIARIJ,SBURG. PA 111:a-DbOI
NOTICE DF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .....
Rifv:i54'"j"E'jCAi=p-iii9-:97Y-No~"-icE--ciF--iNiiEifi;:AiicE-~"-A;("APPRA-isEilENT-;-ALi-ciwAN-cE-ifR'-m--m--mm
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
JOHN A FILE NO. 21 96-0508 ACN 101
JOHN H BROUJOS
4 N HANOVER ST
CARLISLE
ESQ
PA 17013
ESTATE OF PATTERSON
TAX RETURN WAS: I
1 ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..I Est.t. (Schedule AI
2. Stocks and 8~nd. (Schedula DJ
3. Closely Hald stock/Partnership lnt.r..t (Schadule C)
4. Hartg.gas/Not.. Raceiyabl. (Schedule OJ
S. Cash/Bank Deposits/Hisc. Personal Property (Schedule EJ
6. Jointly Owned Property (Schedula f)
7. Transfars (Schedula CI
8. Total Assat.
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expan.../Adn. Costs/Hisc. Expanse. (Schedule HI
10. Debts/Hortgaga Liabilities/lians (Schadul. II
11. Total Deductions
12. Hat Valua of TaK R.turn
13. Charltabla/Govarnnent.1 OequastsJ Non-electad 9113 Trust.
14. Hat Valua of Est.te Subject to TaK
NOTE:
r-
10-27-97
PATTERSON
06-10-96
21 96-0508
CUM8ERLAND
101
Alllount Ranithd
I Xl CHANGED
III
121
131
141
151
161
In
191
IlOl
(Schedule J)
SEE
37.500,00
,00
,00
.00
69,514,02
3.087.09
,00
IBl
9,970.00
16.006,60
Illl
1l2)
1131
1141
('
.~
~~t!,
11,.jh' II &/' IIt.HI
JOHN
A
DATE
A TT ACHED
10-27-97
Non CE
NOTE: To insure proper
credit to your account,
subnit the upper portion
of this forn with your
tax paYllant.
110.101.11
?G.Q76 60
84.124,51
,00
B4.124.51
If an assessment was issued previOUSly, lines 14, 15 and/or 16, 17 and 18 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Anount of Lin. 14 at Spousal r.t. (15)
16. Allount of Lin. 14 taxable .t Lin..I/Cla.. A rate (16)
17. Anount of Line 14 taxable at Collateral/Cla.. 0 rate (17)
18. Principal T.x Due
TAX CREDITS:
PAYMENT
DATE
03-31-97
03-31-97
RECEIPT
NUMBER
AA185337
AA18533B
DISCOUNT C+ I
INTEREST/PEN PAID I-I
.00
20,69-
BALANCE OF UNPAID INTEREST/PENALTY AS OF 04-01-97
,00 X .00=
84.124.51 X .06=
.00 X ,15=
IlBl
AMOUNT PAID
5,042.01
26.15
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN,
TOTAL DUE
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATIDN OF ADDITIONAL INTEREST.
,00
5.047.47
.00
5.047,47
5.047,47
,00
5.49
5.49
IF TDTAL DUE IS LESS THAN $1, ND PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRl. YDU MAY BE DUE
A REFUND. SEE REVERSE SIDE DF TNIS FORM FDR INSTRUCTIDNS.l
RESERVATION. E.tat.. of d.c.d-nt. dyIng on or b.for. aacaaber 12, 191Z .- If any future Int.ra.t In tha a.t.ta I. tran.f.rrad
In po.....lon or anJoy.ant to Cia.. a (collat.ral) baneflcl.rl.. of the d.cadant aftar tha axplratlon of any ..tata for
Ilf. or far y..r., the Co..onwaalth h.reby axpr...IY ra..rv.. the right to appral.. and a..... tran.far Inherltanc. Ta...
at tha lawful Cia.. a (collataral) r.t. on any .uch futura Intar..t.
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PIlRPOSE OF
NOTlCEI
To fulfIll the raqulra..nt. of s.ctlon ZI~D of the Inherltanc. and E.tat. T.x Act, Act 21 of 1995. (72 P.S.
S.ctlon 9IU).
PAYtt[NTI
a.t.ch the tap portion of thl. Notlca and .ubalt with your p.v-.nt to the A.gI.t.r of will. prlnt.d on tha ravar.. ,Ida.
--Hak. chack or .onay ordar payabla tal REGISTER OF MILLS I AGENT
AEFUHa (CA).
A rafund of a tax cr.dlt, which wa. not raqua.tad on tha Ta. Aaturn, .ay ba raqua.tad by coaplatlng an "applicatIon
for Rafund of p~.ylvanl. Inherltanca and E.tata T.x" (REY-I]I]). Appllc.tlon. ara avallabl. at tha Offlca
of the Aagl.tar of Will., any of tha Z] Ravanu. al.trlct Off Ie.., or by calling tha .pacl.l Z'-hour
an.warlna .arvlc. nuabar. for far.. ordarlngl In penn.ylvanla 1-100-]62-2050, out.ld. Pann,Ylvanl. and
wIthIn local Harrl.burg .raa (717) 717-10,., TOOl (717) 77Z-Z252 (Ha.rlng lap.lr.d Only).
OBJECTIONS. Any p.rty In Intar..t not .atl.flad with the .ppr.I....nt, .llowanc. or dl..llowanc. of daductlon., or ......lInt
of tax (IncludIng dl.count or Int.r..t) a. .hown on thl. Notlc. au.t obJ.ct within .Ixty (60) day. of r.calpt of
thla Notlc. byl
.-wrltten prot..t to the PA D.p.rt..nt of A.venue, Bo.rd of Appa.l., aapt. 211021, Harrl.burg, PA
--alactlon to have the .attar det.r.lned .t .udlt of tha account of tha par.on.1 rapr..ent.tlve,
--app..1 to the Orphan.' Court.
171ZI-UZl,
OR
OR
AOftIN
ISlAATlVE
CORRECTIONS I
Factual arror. dl.cov.r.d on thl. ........nt should b. addr....d In writing tal PA D.part..nt of R.v.nua,
Buraau of Individual T.xa., ATTNI po.t A.'....ant Ravlaw unit, aapt. ZID601, Harrl.burg, PA 17128-0601
Phona (717) 717-6505. Saa page 5 of the bookl.t "In.tructlon. for Inharlt.nc. T.. Raturn far. Ra.ldant
D.c.dent" (REV-15DI) for an .xplanatlon of adalnl.tratlv.lY corr.ctabl. .rror..
DISCOUNT.
If any taM due I. p.ld wIthin thr.. (]) c.lend.r ~th. aft.r the d.c.dant'. de.th, . flv. parcent (5%) dl.count of
thl t.. p.ld I. .llowed.
PENALTY I
ThI 15% t.. .ana.ty non-p.rtlclpatlon pan.lty I. coaputad on the tot.l of the t.. and Int.r..t .......d, and not
p.ld b.fore Janu.ry la, 1996, the flr.t day aftar the .nd of tha t.x .an..ty p.rlod. Thl. non-p.rtlclpatlon
pan81ty I. appa.labl. In the .a.. .~r and In tha the .... tl.. parlod .. you would app.al the t.. and Int.r..t
that h.. b..n .......d a. Indica tad on thi. notlca.
INTEREST I
Int.ra.t I. ch.rg.d b.glnnlng with flr.t day of delinquency, or nine (9) .onth. and ana (1) day fr~ the d.ta of
d.ath, to thl d.ta of pay.ant. T.xa. which bee... d.llnquent b.fora January I, 1912 ba.r Int.ra.t .t thl r.t. of
.1. (6X) parcant par ~ calcul.t.d .t a dally rata of .DOD16'. All t.... which bee... d.llnquant on end .ftar
January I, 1912 will be.r Int.ra.t .t . rata which wIll vary froe caland.r y..r to c.l~ar y..r with that rat.
announcad by th. PA Dap.rt.ant of Ravanua. The appllcabl. Int.r..t r.t.. far 1912 through 1997 .r'l
'!!!! Int.rut A.t. D.lly Int.rut factor !!!! Interut Aata aally Int.rut factor
1912 :'X .DDD5~a 1917 OX .DDD2"
1911 16X .ODDU8 1918-1991 llX .DOUDI
1914 11X .DDUDI I..: 'X .DDDZ"
1'85 1]X .000356 199].19~ 1X .GDDI9Z
I'" I'X .ODDZ74 1995-1997 'X .GGDZ47
ulnt.r..t I. c.lcul.ted .. followlI
INTEREST a BALANCE OF TAX UNPAID X ~BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
.-Any Notlc. I..ued .ftar tha t._ b.cDl" dallnquant will r.fleet an Intara.t calculatIon to fIfteen (IS) day.
beyond the data of tha .......ant. If payaant II aede aftar the Int.r..t coaputatlon da.. shown on the
Motlc., additional Internt ...,st be c.lculated.
.-~..#.,
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JRD/June 30, 1992/17858
REGlSfER OF WILLS
CUlllberlund Counly Courlhuusc
One Courlhouse Square
Carlisle, PA 1701J
NOTICE PURSUANT TO RULE 6.12
PENNSYLVANIA SUPREME COURT ORPHANS' COURT RULES
To: Personal Representative
Counsel: JOHN H. Bk'OUJOSI r;W'1
RE: Estale or JOHN A. PATIEHSQN , Deceased, Lale or
JIOIm-I NEW'Iu.I lWP
Estale No.: 21-1996-0508
Dale or Decedent's Dealh: 6-10-96
Pursuant to Rule 6.12. the above named personal representative or the above named attorney, if
applicable, within two (2) ycars of the decedent's dcalh, and annually thereafter until administration is
completed, is required to file with the Register of Wills a Status Report as required by Rule 6,12, in
substantially the prescribed form, showing the date by which the personal representative, or attorney, as
applicable, reasonably believes administration will be completed, The purpose of this Notice is to advise
you that unless the requisite Status Repon is filed with the Register of Wills or Clerk of the Orphans'
Court, as appropriate, within ten (10) calendar days after the date of this Notice that the Register of Wills
is required to notify the Orphans' Coun Division, Court of Common Pleas of such delinquency and to
request that said Coun conduct a hearing 10 detennine whether sanctions should be imposed upon the
delinquent personal representative and the delinquent personal representative's counsel, if any,
Accordingly, if the requisite Status Repon is not filed by 8-J-98 , 19_, you are hereby
advised that a request will be submitted to the Court in accordance with Rule 6,12,
Dale: 7-15-98 '-2e~l~li~~I~fWt-V n JI}'fU~
Distribution to Estate File
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
John A, Patterson
Date of Death:
June 10, 1996
Will No.
Admin, No. 1996-00508
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 1999
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
d.
Copies of receipts, releases, joinders and approvals
of formal or informal accounts may be-Eiled with the
Clerk of the Orphans' Court an ~ be atta~ed to
this report. . :.\ \ ~' v/
, /' /) /J ~~~~~
v" <-(L7 John H
'-
Date:
v
BROUJOS & GILROY, P.C.
4 North Hanover Street
Carlisle, Pennsylvania 17013
717/243-4574 -- 717/766-1690
FAX #717/243-8227
Capacity: Counsel for personal representative
(MAH:rmf/AM3)
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SUPPLE~mN'I'^L
REV -1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
".:.
fUNUMOOl
2 1 9 6
tr.l.IffYaIlI' 'l'JAA
o 0 508
w_.
llI""lnl.'jl"l ~~.2..
COtoA~~5YlVANIA
OlrAR'~[NI or R(V[NU[
ocr, l!O601
HARRI n RG PA 171 I
DlCLOlHfSNAM((lA$f,JIAST,NfJYOOl[ NTlAlllM.t:tribb:1t:J"'ClA'_llO'lft
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P ^ T T E R SON
J 0 II N
^.
(If Al'P\.ICA8l[l SURVMHG Srolf..["SfW,ll (\.AST. JIHST. NlJUlOOU "TW.I SOC1AL SlCl..mYM..lA8lR
11/28/15
rHIS RETURN Musr BE fUD IN DUPllCArE WItH THE
REGISTER OF WILLS
o IOnginalRelum ~ 2 SupplemenlalRelum 03 RemainderReluml...."_....lI,IHII
o 4. Lvnrted Eslale 0 4a, Fulure Inle""'ICompronll$lll....".......',,".n 0 5, Federal EslaleT"" RelumRequited
o 6,lle<:edent DMld T..lale I""'''' ""I 0 7.lle<:edenlMa~IaIl'edaLIvingTI\J$II_...,"lMO _ 8 TOIaI Number 01 Sale DepoMBo.es
o 9, Libgabon Proc.ec!$Rec:eived 010, SJlOIl'alPoverty Credrtl...."...._lI,I'," ""'''1 011, Election low under Sec. 9113(A) 1'U<hS<h01
THIS SECTION MUST BE COMPLETED, ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
N.W( COUP\.E1E lAMING AOOftESS
John II. Broujos, Esquire
!Z
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P. C.
4 N. lIanover St.
Carlisle, P^ 17013
o 0
o 2
o 9
,168,601.11
o 0
6 0
2 5 ,9 7 6
6 0
SQCl.Itli(CWlIYN\JJlMR
OATlOf[)(Altl
OAllOf OINltl
,142,624
5 1
179-18-3092
06/10/96
,142,624
5 1
1 Real ESlale (ScI1edule AI
(1)
9 6 ,0 0 0
8,5 5 7
4 7
2 Slocl<s and Bonds (ScI1edule BI (2)
3 CIose~ Held Corporabon.Par1nership Dr Sole.Propnelorshlp (3)
z
o
5
::l
l-
ii:
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u
W
0::
4 Moogages & NOles Recoivable (ScI1e.lule 01
5 Cash. Bank Depo$J1S & MJSGenaneoos Personal Property
(ScI1eduleEI
6 JOintly ONned P10peJ1y (ScI1edule FI
7. lnler.Vrvos Transfers & Mcscellaneous Non.Probate Property
(ScI1edule G Dr LI
8 Total Gross Amts (Iolal lines 1.7)
9 Funeral E.penses & Administrative Costs (ScI1edule H) (91
181
9 ,9 7 0
16,006
1111
8,5 5 7
4 7
(4)
(5)
6 9 ,5 1 4
3 to 8 7
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
Under ~ of peIJ\If'1.1 decl.Ye thai I hMeaanned hs return, Indudll"lg~)'VlQ Wl(ld1Jlcs...., st.llements, WId tlltle besl 01 fTlJ ~ Nk1 bellel, II ~ true, coned a1d rompIele
, J 1$ 11'I -.h CWl k
SIGtIATURE Of PERSON RESPONSIBLE FOR FILING RETURN
)
ADDRESS
.lo drl~.{elv:,k. r<
. ADDRESS
'-it '. j/"<.'!..E:...~,':'~_)L{:" ,-(id( I P/~(]
(61
(7)
10, Debts of lle<:edent MOl1gage L~b;hbeS. &L~ns (Sdtedule I) (101
11. TolJl Deductions (t01a1 L1n.. 9 & 10)
12 Nel Value of E,tate (LIne 8 minus LIne 111
13. Chanlable and Govemmenlal BequeslslSec 9113 Trusts lor whid1an electron 10 Ia. has nol been
made (ScI1edule JI
14. Nel Value Subject to Tax (LIne 12 mInus LIne 131
(121
1131
(14)
15, Amounl 01 hne 14 taxable
al tt1e spousal lax tate I ,
See instructions on reverse side for applicable percentage
16, Amounl 01 hne 141a.able
aI6%rall!
17. Amounl01 Ime 14 taxable
al15%rale
x .0
(15)
142
624
5 1
x ,06
(16)
(17)
(IB)
x .15
18, Tax Due
19.
.rJCWlol~tf...v~olhef
- . -" ~.~
,-'
IS"- / t.'r--~
I ., l ofr
,~Q'-"III( (,t
o E
(-
DATE
t
I)' ~ 2 (..'.u;,o
Decedent's Complete Address:
~;IHlfIA[l()j:t:i!". '.--. --- - .~. .~_.~---.___.._____
1 020 Grc"ILJ~12E_i'!9.mJ.lgi~-'-._____.___.___. ,..
. .----' J
OIl'
NCW~ i ;l~---'-" ------- --, C:"~;~~-~l';172 41-!
Tax Payments and Credits:
1 Tax Due IPage llmo 181
2 Cred,ls/Payments
A Spousal Po,erty Crodlt
8, Pnar Payments
C Discount
(I) ..Jl.,.5R.A1__.__
_~_,Q.4_Z!..QL__
3. InleresUPenally If applicable
D,lnterest
E. Penally
TOlilICr",liIs/A'R,CI II' -2.,042.01
Tota'loteresUPella~ly I 0, E I 131
4. If line 21s greater than Iioe 1 . line 3. enter the dlffereoce ThiS is Ihe OVERPIIYMEfIIT,
Check box on Page 1 line 19 to request a refund (4)
5 If line 1 .I,oe 3 IS grealer than 'me 2, enler the difference ThiS IS Ihe TAX DUE. (5)
3,515.46
l:>..
A Enlerlhe Interesl on Ihe ta, due, 15AI
8 Enter Ihe total oll,ne 5. 5A ThIS IS Ihe BALANCE DUE. 1581
Make Check Payable to: REGISTER OF WILLS, AGENT
1- - 1IIWiJ:;ffl'j~~1.'ll1~!3'3l:,'
PLEASE ANSWER THE FOLLOWING OllF.STIONS
BY PLACING AN "X" IN THE APPROPRIATF. AI.OC:KS
1. Oid decedenl make a Iransfer and
a, retain Ihe use or income of Ihe property transferred, '
b, relain Ihe righllo deSignate who shall use Ihe property Iransferred or ,Is Income."
c, retain a reversionary 'nlerest. or,
d receive the promise for life of e,lher payments. benefils or care' "1 :'c'
2 If dealh occurred on or before December 12. 1982. did decedent within two years ~.
preceding dealh Iransfer property wllhoul receiving adequale conslderalion? If dealh occurred
after December 12. 1982. d,d decedentlransfer property within one year of dealh withoul
receiving adequale conslderalion? .. , 0
3. Did decedenl own an -in Irusl for' or payable upon death bank accounl or secunly
al his or her dealh?, 0
4, Did decedenl own an individual retirernenl accounl. annuity. or olher non-probale property', 0
Yes
o
....,0
o
o
No
o
o
o
o
o
o
o
IF THE ANSWER TO ANY OF THE AROVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN
...-.-ow ---. __mutl:t__~"'~'~'.m':~IlI~'1~.~~:~~~~~~,~.l~_~!?~"';'
72 P.S. ~91 16 (a) (1.1) (.) provided for Ihe reduction of Ihe lax rale imposed on the nel value of transfers 10 or for the use of Iho.
surviving spouse from 6'10 10 3% for dales of dealh on or after July 1. 1994 and before Jilnuary 1. Ig95
72 P.S, ~91 16 (a) (1, 1) (II) provided for the reduction of the rale imposed on Ihe nel value of Iransfers to or for Ihe use of Ihe surviving
spouse from 3% 10 0% for dales of dealh on or after January I. 1995, The sial ute doc,s nol exempl a Iransfer 10 a surviving spouse
from tax. and Ihe slalulory requiremenls for disclosure of assels and filing a lax return arc sllll applicable even if Ihe surviving SPouse
is the only beneficiary
FOR DATES OF DEATH ON OR AFTER JANUARY 1, 1995. Please answer Ihe follOWing question by placing an 'x' In Ihe
appropnale space.
Old the decedent create a trust or similar arrangement which Is solely for the surviving spouse's benefit for his or her entire
lifetime? Yes 0 No 0
If you answered yes 10 Ihe above question. Ihe lax on Ihe Irusl or similar arrangement IS postponed unllllhe death ollhe seeonlt
spouse. al which time it will be fully taxable at the ratc(s) applicable 10 the rcmu;nd~, b.:::nc.~C'JfY(lCS) En:~r t:~e vulue of the !rust O~l
Schedule J. Part II, "' order 10 remove II from Ihe calculallon of the lax due in IhlS eslatf! You may Wish 10 file Schedule 0 ,p 0,(1e1 In
make Ihe elecllon avarlable under Seclloo 9113 If IIIe elecllon IS milde. the trllsl or simllilr arrangemenl" toxen,n the eslate of 11lf!
first decedenl spollse, Ihe portIOn of Ihe Irusl or Similar arrangernenl which benefits Ihe sllrvlvrn9 spouse IS ta'en al the lero la, 'ai',
and Ihe remainder is la'ed atlhe ratels) nppticable 10 Ihe remainder beneficlary(les) If YOll choose 10 make the eleclion. you rnllst
allach Schedllle 0 10 a Ilmely.filed la, return, along wllh Schedule(s) K andlor M In ordo,lo show Ihe apportlo","enl ollhe Irusl or
similar arrangement hclween Ihe survIVing spouse and the remainder beneficlilly(res)
.
INHERITANCE TAX RETURN
SCHEDULE A
REAL ESTATE
Estate of John A. Patterson
File Number 21.96.508
j
,I
I
ITEM
DATE
NUMBER
DESCRIPTION
VALUE AT
OF DEATH
1,
1020 Green Spring Road
Newville, PA 17241
(cinder block, 3 unit building on 6 acres)
$ 96,000,00
TOTAL (Also enter on line 1, Recapilulallon)
$ 96,000,00
.
. - ~ . -.. - .... . .-. - . ---- .
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT.2B0601
HARRISBURG, PA 17.28-ll601
'*'
NO. AA 425698 REV.lIIl2EXlll'''1
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
RECEIVED FROM:
r
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
BROUJOS JOHN ESO
4 N HANOVER ST
101
-'3.515.46
CARLISLE. PA 17013
FOUl HVlE FOUl HERE
ESTATE INFORMATION:
FILE NUMSER
21-1996-0500 SSN 179-18-3092
NAME OF DECEDENT (LAST) (FIRST) (MI)
PATTERSON JOHN A
DATE OF PAYMENT
6/16/2000
POSTMARK DATE
0/00/0000
COUNTY
CUMBERLAND
OATE OF DEATH
6/10/1996
REMARKS 11 ~J ~1 t I:.
C 10 JOHN H 8ROUJO!5 ESUU lI~C
CHECK" 172
SEAL
TOTAL AMOUNT PAID
$03.515.46
AC
,) \",.0
RECEIVED BY ///ft.lr. l .".;rS" '.(..1
I1AR Y C. U;i1 j G . V . /fl.#.:
f<EGISTD~ ,t.-- W1L.LS4-IiI.~c..A7j7.
REGISTER OF WILLS
-,------_._----- .------------- .--.-----.--
.. ---.-- -_. - ._-. ----- -~-_._---_._----
..---
-..~.lld.~ _ r-T .-1:.
MAKE CHECK 'PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
ifEV:i5'4'j-EX-AFP-mf:99Y"NiificE--OF-YtiHEiiii'ANCrfJiin,ppiiiiisEHiNj-,--,U.LoiiA"NcE-oli--------mm---
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
JOHN A FILE NO. 21 96-0508 ACN 101
If an assessment was issued previously, lines 14, 15 and/or 16, 17 and 18 will
reflect figures that include the total of abh returns assessed to date.
ASSESSMENT OF TAX:
15. AMount of Line 14 at Spousal rat. (15)
16. AMount of Line 14 taxable at Line.l/Class A rat. 11&)
17. Anaunt of Line 14 taxable at Collateral/Class Brat. (17)
18. Principal Tax Due
/5--111 ~ ;J.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
1t.....RltANCf lAX OIVI!illlH
PlPI. 180bOl
IlAARIS!UkG. PI. 1111ft-Obal
NOTICE OF INItERIT ANCE TAX
APPRAISEHENT. ALLOWANCE OR DISALLOWANCE
or DEDUCTIONS AND ASSESS"ENT Of YAK
\.
JOHN H BROUJOS ESQ
BROUJOS 8 GILROY PC
4 N HANOVER ST \.
CARLISLE :PA 17013
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
07-24-2000
PATTERSON
06-10-1996
21 96-0508
CUMBERLAND
101
AMount R..1tt.d
ESTATE OF PATTERSON
TAX RETURN WAS: (
I ACCEPTED AS FILED
( X I CNANGED
SEE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN
1. Reel Estete (Schedule Al (II
2. stocks and Bonds (Schedule OJ (2)
3. Closely Held stock/Partnership Interest (Schedule CJ (3)
4. Hortg.ges/Hote. Receivable (Schedule DJ C4)
s. Cash/Bank Deposits/Hisc. Personal Property (Schedule E) 15)
6. Jointly Owned Property ISchedule F) Ib)
7. Transfers ISchedule G) (7)
8. Total Assets
NO, 01
58.500,00
,00
,00
.00
,00
.00
,00
(81
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral EKpenses/Ada. Costs/Hisc. EKpenses ISchedule H) (9)
10. Debts/Hortgage Liabilities/Liens ISchedule I) 1101
11. Total Deductions
12. Net Value of TaK Return
13. Charitable/Governnental Bequests; Non-elected 9113 Trusts ISchedule J)
14. Net Valua of Estate Subject to TaK
,00
,00
nIl
tl21
n31
n41
NOTE:
.00 X .00=
142.624.51 X ,06=
,00 X ,15=
n81
TAX CREDITS:
PAYHENT
DATE
03-31-1997
03-31-1997
06-16-2000
DISCOUNT (+ I
INTEREST/PEN PAID (-I
,00
.00
26,15-
RECEIPT
NUNDER
AA185337
AA185338
AA425698
AHOUHT PAID
5.042.01
26.15
3.515.46
BALANCE OF UNPAID INTEREST/PENALTV AS OF 06-17-2000 TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
u,*
Inlh"1 '" 111-'"
JOlIN
A
DATE 07-24-2000
ATTACHED NOTICE
NOTE: To insure proper
credit to your account,
subnit the upper portion
of this forn with your
taK paYlnent.
58.500,00
nn
58.500.00
,00
142.624.51
.00
8.557,47
.nO
8.557.47
8.557,47
.00
942,74
942.74
. IF PAID AFTER OATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS TNAN $1. ND PAYHENT IS REQUIRED,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR I, YOU HAY DE DUE
A REFUND, SEE REVERSE SIDE DF TNIS FORH FOR INSTRUCTIONS. I
RESERVATION.
PlOlPO$[ OF
NOTlCEI
PAYHENTI
REF1JND(CRh
OBJECTIONS I
AD.nN
ISTRATlYE
CORRECTlOHSI
DISCOlItT I
PEHALTYI
INTEREST I
.
E.tat.. of dacedent. dylna on or before Dec.-bar 12, 198Z -- I' any 'utur. Int.r..t In the ..t.t. 1. tran".rred
In po.....lon or enJo~t to CI... B Ccoll.t.r.l) ~'Iclarl.. 0' the dec~t a't.r the ..plratlon 0' any ..tat. for
Ilf. or for year., the eo..onw.alth hereby .xpr...ly r...rv.. the right to appr.I.. and ...... tran.f.r Inherltanc. T....
at the law'ul CIa.. B Icollat.r.l) r.t. on any such future Int.r..t.
To fulfIll the raqulr..-nt. 0' Section 2140 0' the Inh.rItanc. and E.tata Ta. Act, Act 21 of 1995. (7Z P.S.
S.ctlon '140).
Detach the top portion 0' thls Notice and .ub.1t with your p.yaant to ttMl Reglst.r 0' Willi printed on the r.v.r.. sida.
--...... chack Dr ltDMy order payable tOI REGISTER OF MILLS, AGENT
A refund of . tal( cradlt, Mllch .... not requasted on the Te. R.turn, .ay be r.que.ted by cNPl.tlng en "ippllc.tlon
for Rafund 0' Penn.ylvanIa lnherltanc. end E.t.t. T.." (REY-1SIS). Application. ar. av.llabl. at the O'flc.
0' the R.gl.t.r of Will., any 0' ttMl 2S R.venue DI.trlct O'flc.., Dr by calling the spacl.l Z4-hour
an...erlng ..rvlc. ~.r. for for.. ordering: In Penn.ylvanla 1-800-36Z-Z050, out.lde penn.ylvanla and ..I thin
loc.l Harrl.burg .r.. (717) 787-8094, S.rvlc.. for t..pay.r. ..Ith .paclal hearlno and .p.aklng need.:
1-800-447-S0Z0 CTT only).
Any party In Int.r..t not ..tl.,I.d with the .ppr.I....nt, .llowanc. or disallowance 0' deduction., or .......ant
of t.. (Including dl.count or Int.r..t) .. shown on thl. Notlc. .u.t ObJ.ct within sixty C60) day. of rac.lpt of
thls Notlc. bYI
--..rltten prot..t to the PA Dep.rt.ant of R.venue, lo.rd of Appe.l., Dept. Z810Z1, Harrisburg, PA
--.l.ctlon to have the .att.r det.r.lned .t audit of the .ccount of the parsonal rapr...nt.tlv.,
--appe.l to the Orphan.' Court.
OR
171Z8-1021,
OR
Factual .rror. dl.cover.d on thl. .......ant .hould be addr....d In ..rltlng to: PA Depart..nt of R.v.nue,
lur.eu of Individual Ta.e., ATTNI Po.t A.......nt R.vl.w unit, D.pt. Z80601. Harrisburg. PA 171Z8-0601
~ (717) 787-6505. S.. page 5 0' the bookl.t "Instructions for Inherltanc. Ta. R.turn for a R.sldant
Decadent.. IREY-ISOI) for an ..planatlon of edalnl.tr.tlv.ly corractabl. arrors.
I' any t.1( due I. paid ..Ithln thr.. (]) c.lender .onth. .'tar the d.cadant.. death, a flv. p.rc.nt (5X) discount of
the t.. p.ld 1. allow.d.
The 152: tax eana.ty non-p.rtlclpatlon penalty I. cCMlPl!t.d on the tot.l of the tal( and Int.ra.t ......ed, and not
p.ld ba'or. January 18, 1996. the flr.t day .ft.r the and of the ta. -.na.ty period. This non-p.rtlclp.tlon
penalty 11 appealabl. In the .... .8fWl8r and In the the .... Ua. p.rlod .. you would appeal the tal( and Int.r..t
that has bean .....nd a. IndIc.tMt on thh noUc..
Int.r..t I. charged beginning vlth flr.t day of d.llnquency, or nln. (,) .onth. and one (1) day froa the det. of
death, to the date of p.yeant. 1.... which bee... delinquent bafor. January 1. 198Z b.ar Int.r..t at the rat. of
.Ix 16~) percent per annue c.lculated .t a dailY rat. 0' .000164. All ta.a. which bec... delinquent on and .ft.r
Januery 1. 1'8Z viII baar Int.ra.t at . r.t. which will vary froe cal.nder y.ar to calendar year vlth that r.te
announced by the PA Depart.ent of Ravenua. The appllcabla Int.r..t rat.. for 1'8Z through ZOOO aral
'!!!! Int.r..t Ret. Dally Int.rast F.ctor :!!!! Inter.st R.t. Dally Int.r.st Factor
19a2 2U .000548 19&8-1991 IIX .00UDl
1983 16X .000U8 1992 9X .000Z1t7
1'84 IIX .000301 1993-1994 7X .000.., :.
1985 I3X .0003S6 1995"1998 9X .OOOZU
1986 IU .000Z71t 1999 7X .0001'Z
19a7 9X .000ZIt7 2000 ax .000Z19
--Intar..t I. c.lculatac:l .s 'ollow.:
INTEREST a BALANCE OF TAX UNPAID X NUHBER OF DAYS OELINQUENT X DAILY INTEREST FACTOR
.-Any Notlc. I.sued .ft.r the t.. bacoaa. delinquent viII r.'lact an Int.ra.t calculation to fifteen CIS) day.
b.yond the det. of the .......ant. If papant Is .ade .ft.r the Int.r.st cCMlPl!t.tlon data shown on the
Notlc., ~Itlonal Intar..t .ust ba c.lcul.ted.
-,
ftlV-UfOll,,"UI
~.
INHERITANCE TAX
EXPLANATION
OF CHANGES
COMMONWEALTtl OF PENNSYLVANIA
D' PARTMENT OF REVENUE
Bbl".lAU OF INDIVIDUAL TAXES
DEPT 280&01
IlARRI URO PA 17118.0001
DECEDENrS NAME
FILE NUMBER
2196-0508
101
JOHN A. PATTERSON
REVIEWED BY
ACN
CHARLES WRIGHT
SCHEDULE ITEM
NO,
EXPLANATION OF CHANGES
Accepted additional assets.
ROW
Page 1
,1
1
... "
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
'*
BUREAU OF INOIVIDUAL TAXES
IHlI[RI1AHC[ lAX DIVI~IOH
DE~i~60I
HARR/ a, PA 17128.0601
.
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLONANCE OR DISALLONANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
..,-thlll &I, Ill,",
JOHN H BROUJOS ESQ
BROUJOS & GILROY PC
4 N HANOVER ST
CARLISLE
07-24-2000
PATTERSON
06-10-1996
21 96-0508
CUMBERLAND
101
baunt Reeittod
A
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
JOHN
9y2-.'y
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ......
---------------------------------------------------------------------------------------------------------------.
k
,
PA 17013
l'
.
,;
.
., ,
,
~
\
-----
,
._--.-- -.........~.~ J .. T ...,:..
_.. "--
..,'-
\
PA\1tENTI
htltCh the top portion of thh Notice and .oo.lt with your pay""t HdIi pay.tJl. to the ,... .nd 8ddr...
prlnt.d on tM r.ver.. .Ide.
If RESIDENT OCCEDEHT ..... ctMck or ~y ord.r payable to: REGISTER OF WIllS, AGENT.
If NOH-RESIDENT DECEDENT .... check or aOMy order payabl. to: COftttONWEAL TH OF PENNSYLVAHIA.
AEfl.WD (eRII A nfund of . taw credit, which wa. not reque.tad on ttM Tax R.turn, uy tHI reque.ted by cOllPl.Ung ..,
"'Application for R.fund of Pam,ylvlN1ia IntMlr1tanc. and E.t.t. Taw" IR[V-UI3). Application. ar. avaHabl. at
the Offlc. of the Reglst.r 0' Nills, any 0' the Z3 Ravenue District Offlcas or froe the o.part.ant', Z~-hour
an...rina ..rvlca nuab8rs for for.. ordering: In Penn.ylvanla 1-800-36Z-Z050, out.lde Penn'Ylvanla IInd
wIthin local HarrIsburg araa (717) 787-8094, Sarvlca. for taxpayar. wIth spacial hearIng and spealt,lng
need. I 1-800-447-30Z0 ITT only).
REPLY T01
Quastions regarding arrors cont.inad on thl. notice should be addr.ssad to: PA Dapart.ant of Aevenue, Buraau
of IndivIdual T.xa., ATTHI Po.t A......ent Aoview UnIt, Oapt. 280601, Harrl.burg, PA 171Z8-0601, phone
(717) 787-6505.
DISCOUNT:
If any tax due Is paid wIthin thraa IS) c.lendar aooths .,t.r the d~edant'. death, a five p.rcent 15%) dIscount
0' the taw paId I. allowed.
PENAL TV:
The ISX taw aanasty non-participation panalty I. cu.puted on the total of the tax and Int.r..t ......ed, and not
p.ld tHlfor. January 18, 1996, the first day aU.r the and of the tax lIMa.ty parlod.
INTEREST:
Intar..t I' Charg.d beglmlno wIth flr.t day of dellnqu.ncy, or nlna (9) .ooths and ~ II) day froe the data of
death, to the date 0' pay.ent. Taxa' which baca.. d.llnqu.nt be'ora January 1, 1982 b.ar Int.ra.t at the rata of
_ix 16%) parcent par annua calculatad at a dailY rata of .000164. All tax.. which bec... d.linquent on and aftar
January 1, 198Z will tHI.r Intar..t at a rata which will vary froe c.lendar y..r to cal~ar ya.r with that rata
mnnouncad by the PA Depart.ant of Aav.nue. Th. applicabl. Intar..t rata. for 1982 through ZOOO .r.:
Y.ar lnt.rut Rat. Dally lntar..t r.ctor Yaar lntar..t A.t. OaUy Intor..t hctor
198Z ZDX .000548 1988-1991 lIX .000SOI
1983 16X .DOO~38 199Z 9X .000Z47
1984 lIX .000301 1995-199/t 7X .000192
1985 13X .000n6 1995-1998 9X .000247
1986 lOX .000Z74 1999 7X .000192
1987 9X .ODD247 ZOOO 8X .00DZ19
--lnt.r..t I. c.lculated .. follow.:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notlc. h.wd aUar the t.x tMCOHI dallnquw\t will r.flect M Int.r..t c.lculatlon to flft..... US) day.
tHlyond the data of the .......ant. If p.yaMt II _ad. aU.r the Int.ra.t coaput.Uon det. shown on the
Notice, additional Int.rast ...t be celcul.tad.
, .
,/ ,('II - r~)r'
roo l'.) I f,
J~
...../
"'. <r
jfmllil,-, iilrttlrmrnt ~lJl'rrJllrnt
'7 ::-+"-
HilS is unugrccmcnl cntcrcd into this ~~tJay of Novcmhcr, :!OOO. hy allll hclwccn Mury W,
Moorc, Excculrix und Bcncliciary undcr thc cstalc of John A, l'uUcrson. of 20 Bridgcwalcr Road,
Ncwvillc,l'A 17241 (Excclltrix). and Carl A. Wiscr. .Ir.. )0) Ilummond Roud, Shippcnshurg, I'A
17257, Bcncliciary, whosc namcs urc Scllhrth as signalorics at thc cnd of this agrccmcnt.
WHEREAS:
A. John A, Paucrson, of 1020 Grccn Spring Road. Ncwvillc, P A 17241, dicd on Junc 10,
1996.
B. On June 27,1996, LeUers Testamenlary were granted to Mary W, Moore al File No. 21-
96-0508 in lhe Regisler of Wills Offiee lor Cumberland County, Pennsylvania.
C. Executrix has adminislered the Eslale of John A, l'aUerson, up unlillhe presenltime and
has paid all debls of the estalc, including Inheritance Tux owed,
D. John A, PaUerson died lestale, thereby vesting all righls and interest in his personal and
real property to Mary W, Moore and Carl A, Wiser, Jr,
E, Eslale of John A, PaUerson has received asscts valued al SI79,214,39 plus income of
S 13,1 0 1.31 as set forth in Exhibit A; has paid debls and expenses in the amounl 01'$36,646,81 as
set forth in Exhibit B; and has made dislribulions in the amounl 01'$30,870,95 as set forth in
Exhibit C.
F, There remains for distribulion lhe sum of S I 0 1,758.94,
G, Exeeulrix and Beneficiaries desire to forego a fonnal aecounling and schedule of
distribulion and desire 10 conclude the cst ale by virtue of the filing of this document
NOW, THEREFORE, Executrix and Beneliciaries intending to be legally bound, slate as
follows:
I, The Execulrix and Beneliciaries agree lhatthe Exccutrix of the Estale of John A.
Patterson need not file a fonnal accounling or schedule of dislrihulion,
2. Exeeulrix stales lhal all cosls of lhe estate arc paid,
3, Beneficiaries agree thatlhe final distribulion of all estate assets remaining after paymenl
of debls and expenses shall be made 10 the Beneficiaries, with lhe exception of S5,OOO,OO 10 be
held for a period of up 10 6 months or longer if necessary in escrow by Counsellor lhe Estale.
John H, Broujos of Broujos & Gilroy, P.C" lor Iinallax retums and other unlllreseen expenses
und uny rcquircd udjustlllcnlllf inhcrituncc tux, wilh thc huluncc III hc distrihutcd cqually to
Bcncticiurics with unuccounting which shullnllt hc Iilcd with thc Rcgislcr lIf Wills, Upllll wrillcll
uuthllrizutillnllf clIunscltothc hcncliciurics,
4, Thc purtics ucknllwlcdgc thul uny distrihulillllllludc hy Exccutrix pursuunt tll this
Agrccmcnt is Ull "Ut risk" distrihution purswmlto 20 I',S, 3532, Bcncliciurics hcrchy rclcusc
Exccutrix with rcspcctlo ucts or omissions inlhc udlllinislrution und distrihutilln of lhc cslutc und
hercby agrec to rcturn such funds us wcre distribulcd undcr thc udlllinistrationllf thc eslulc us
may be rcquircd for lhc puymcntllf uny propcr c1uims nol dischargcd prior 10 this distribution,
5, The partics dcsignutc this slulcmcnt us a "sutisfactilln of uward" alld hcrcby uuthorize and
dirccl thc Clerk of Orphans' Court 10 muke sutisfied of record any award which may
subscquently be made by the Court with respeet 10 the distribution Illudc 10 lhe distributees in
this Agreement.
6. The parties agree thutlhis Fumily Sclllemcnl Slatelllent shull be tiled wiih the Clerk of
Orphans' Court in finul selllemcnl of the estutc of John A, Pullerson, subjecllo lhe provisions
hereof.
IN WITNESS WHEREOF. Mary W, Moore, Exeeutrix, and Bcncficiaries, inlending to be
legally bound hereby set their hands and scals lhe day and ycar first above wrillen,
r
WITNESS:
\
.
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
: 55
Onlhis, the ~day of Novembcr, 2000, beforc Ille, the undcrsigncd ollicer, personully
appearcd Mary W, Moore, known 10 me or satisfitclorily proven 10 be the person whose name is
subscribed to thc within documenl, and acknowledged tlml she execulcd thc same lor the purpllsc
therein contained.
IN WITNESS WHEREOF, I have hcreunlo selmy han
(Qf eu-J
NOTARYIUBLlC
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t:XIIIIIIT A
ASSETS
Renl Propeny- 1020 Green Spring Road, Newville.PA
($52,947 - Alltel: 24.365 cnsh nnd 20.000 nute rrom Kun Muore)
PcrsonalPropeny
PNC Checking Account
Ilealth Insurance Proceeds
CDs - principal nnd interest
Totnl Asscts
7-22-96
7-25
7-30
8-9
8-12
8-12
8-28
9-]0
9-27
10-10
10-10
10-21
11-7
11-19
11-20
12-16
1-13-97
1-22
1-22
1-22
1-22
2-13
2-26
3-13
3-25
4-11
4-14
4-23
5-7
5-7
5-13
5-29
6-13
6-23
$ 97,312,00
13.439.20
25.255,14
26.524.72
16,683.33
$179.214.39
INCOME
PNC chccking intcrcst
Pcnn Trcnty Lirc Ins. Co, - premium rerund
3600 Communications
Amcrican Travelcrs Lire Ins, - premium rerund
IRS - income tax rerund
PNC checking intcrcst
3600 Communications
PNC chccking intercst
Rcnt
PNC ehccking interest
PNC bonus ror chccking account
Rent
PNC chccking intcrest
PNC ehccking intcrest
Rcnt
Rcnt
Checking intcrest
Rent - 3600
'84 Chcvy Impala
Car insurance rerund
Rcnt
Intcrest
Rcnt
Interest
Rent
Intercsl
Rent
Rcnt
Rcnt
Incomc lnx rcrund
Intcrest
Rcnt
Interest
Rcnt
,
32.92
218,79
127,38
249,12
334,71
27,68
127.38
43.71
120,00
34.33
50,00
247,38
32.34
12,76
187.38
187.38
36,93
127,38
550,00
103,10
60,00
40.33
307.38
36,92
247.38
37,64
247.38
60,00
127.38
364,00
43.71
60,00
53,60
187.38
'.
7-11-1)7 Intcrest 45,72
'.22 Rcnt 187.38
8-13 Intcrcst 50,94
8-21 RcntO 127.38
9-4 Rcnt 187.38
9-12 Intcrcst 52,03
10-7 Rent 127.38
10-)0 Imcrcst 47,27
10-20 Rcnt 60,00
11-7 Rcnt 187.38
11-13 Intcrcst 51.94
12-12 Intcrcst 88,69
12-29 Rcnt 247.38
1-13-98 Intcrcst 96,73
1-27 Rcnt 187.38
2-13 Interest 110.18
2-26 Renl 314,76
3-13 Intercst 87,86
3-3\ Rent 187.38
4-\3 \ntercst 94.65
5-4 Rcnt 187.38
5-\3 Intcrcst 64,70
6-9 Rent 187.38
6-12 Intcrcst 54.09
7-\ Rent 187.38
7-\3 Intcrcst 49.30
8-5 Rcnt 187,38
8-\3 Intcrest 52.69
9-9 Rcnt 187.38
9-\1 Intercst 52,08
9-30 Rcnt 187.38
10-13 Intcrcst 50.83
11-4 Rcnt 187.38
11-13 Intcrcst 56,27
12-2 Rcnt 187.38
\2-11 Intcrcst 48,10
1-5-99 Rcnt 187.38
1-13 Intcrcst 45,64
2-3 Rcnl 187.38
2-12 Intcrcst 21.21
3-2 Rcnt 187.38
3-12 Intcrcst 17,5\
4-5 Rcnt 187.38
4-13 Intcrcst 19,50
5-4 Rcnt 187.38
5-\3 Intcrcst 19,23
6-\ \ Intcrcst 19,65
6-21 Rcnt 247.38
7-\3 Intcrcst 19,28
7-14-99 Rent 187.38
8-13 Interest 21.53
8-30 Rent 187.38
8-31 Rent 127.38
9-13 Interest 15,85
9.30 Renl 127,38
9-30 Ineome 129.40
10-12 Deposit item returned (Alltel rent ek) (127.38)
10-12 Fee for deposit item returned (5.00)
10-13 Interest 51.44
11-12 Interest 104,70
12-13 Interest 95,02
12-15 Deposit 330,00
1-13-00 Interest 110,56
2-11 Interest 134,92
3-13 Interest 126.01
4-13 Interest 134,53
5-12 Inlerest 134,68
6-13 Inlerest 130.54
7-13 Interest 126.39
8-11 Interest 129,63
9-12 Interest 129,73
10-30 Interest 162,26
Tolallncome $ 13,101.31
,
EXIIIJIIT II
EXPENSES
7-26.96 ck# I $10,174,91 I'rcsh)tcrilln Ilulllcs. Inc,
7-27 2 706.02 Emcrnld Drug
8.6 3 748,58 IJllrlcne Pillmnn - rcnl csllltc lax
8.19 4 7011.110 Mill)' \Y. Muure -lilllcrnl cxpenses
9.3 5 1 75,Oll 11.11 Agcncy Apprnisal Service
9.22 7 29,25 1'1'&1.
10-21 8 26,ll4 1'1'&1.
11-21 101 25.81 PP&L
12.23 102 44,65 PP&L
1.22-97 103 83.40 KOllgh's Oil Scrvicc - oil
1-23 104 43.02 1'1'&1.
2-23 105 39.34 PP&L
3.25 106 45.91 PP&L
3-27 107 5,042,lll Rcgistcr of Wills - inhcrit:IllCC tax
3.27 108 1,500,00 Ilroujos, Gilroy & Ilouston - fecs
4.3 109 100,00 II & R IIlock - incomc tax lcc
4-14 110 75,Oll D,E,W. & Sons - cmpticd scptic tank
4-19 III 678,00 Danllershey Auctionccr Scrvicc - advenisemcnt
4-21 112 299,00 Ilarleysville MutulIl - firc insurancc
4-21 113 1711,OO lIarleysvillc Mutllal- homcowncr's insurancc
4.22 114 75,05 Kun D, Moorc - installcd drain pipe for apt. I:
c1cancd septic line for apt. 2
4-22 115 174,78 Darlcnc Pillman - taxes
4-23 116 38,24 PP&L
5-20 117 28,34 Paticnt Accounting Servicc - amhlllancc scrvicc
5-22 118 16,15 PP&L
6-26 119 12,53 PP&L
7-24 120 10,79 PP&L
8-19 121 748.58 Darlcnc Pillman-taxes
8-21 122 27,77 PP&L
10-22 123 7.38 PP&L
10-31 124 1,500,00 Richard L. lIurley - roofing and rcpair to roof(advancc)
11-6 125 89,68 Kongh's Oil Scrvicc - oil
11-12 126 1.000,00 Richard I., lIurley - matcrials and lahor for roof repair
11-15 127 223.66 Newville Builders Supply - rcnlal repairs
11-19 128 12,66 1'1'&1.
12-24 129 14.78 1'1'&1.
1-27-98 130 14,70 1'1'&1.
2-25 131 11.69 1'1'&1.
3-4 132 194,57 Darlenc Pillman - cOllnty and lownship taxcs
4-1 133 14.43 1'1'&1.
4-13 134 287,00 Ilarlcysville Mutual Ins, -lirc insnrnncc
4.17 137 174.00 lIarlcysl'iIIc Mutllallns. - homeowner's insurancc
4.21 138 9.48 PP&L . .
5-21-98 \39 1\.95 1'1'&1,
6-12 140 1)\.89 Ilough's Oil Scrvicc
6-~~ 141 1),83 PI'&1.
~~
7.22 142 Ill,27 1'1'&1.
8-4 143 794,75 Durlenc I'illmuu - school tux
8-21 144 Ill,80 1'1'&1,
9.22 150 10,01 1'1'&1.
10-22 145 1),74 1'1'&1.
11-19 146 8.15 1'1'&1.
12-17 147 5011,OO Wolfc & Sheurer Rcaltors -upprnisul
12-22 148 10.63 1'1'&1,
1-23-1)9 151 29,21 I'I'&L
2-24 152 19,24 PP&L
3-2 153 11)4,57 DlIrlcuc I'illman - county and township taxcs
3-24 154 20,67 I'I'&L
4-27 14,25 checkbook fcc
4-22 155 463,00 Harleysvillc Mulllallns, - tirc and homcowncr's ins,
4-22 156 207,65 Valley Quarrics - eoneretc for garagc rcpair
4-23 157 1 \.63 PI'&L
5-24 158 1 \.70 PP&L
6-23 159 10.28 PP&L
7-25 160 1\.63 PP&L
7-26 161 20,00 Mary Moorc - notary work
7-29 162 \32.5 5 Ncwville Buildcrs Supply - lumbcr for pump housc
8-13 163 1.500,00 Richard L. Hurlcy - roof rcpair
8-21 164 6,18 PP&L
8-25 165 847.51 Darlcnc Pillman - schoollaxcs
9-1 166 650,00 Richard L. Hurley - roof rcpair
9-22 167 10,15 PP&L
10-28 168 10.47 PP&L
11-26 169 10,81 PI'&L
3-21-00 170 400,00 H & R Block -tax prcparation
3-14 171 150,00 Wolfe & Shcarcr Rcaltor -appraisal
6-16 172 3.515,46 Rcgister of Wills - inhcritancc tnx
6-16 \73 63,00 IRS - incomc tax
7-14 174 8.91 Commonwcalth of PA - penalty on '1)8 income lnx
8-4 175 74.98 IRS - penalty nnd inlcrcst on '98 incomc tax
9-8 176 450,00 Boyer & Rillcr -lax prcparation
9-18 177 942,74 Rcgister of Wills - inhcritnnce tux
$ 36.646,81 Total Expcnscs
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STATUS REPORT UNDER RULE 6,12
Name of Decedent:
John A, l'allerson
Date of Death:
June 10. 19%
Will No.
Admin. No,~96.00508
Pursuant 10 Rule 6,12 of the Supreme Court Orphans' Court Rules, I report the following with
respect to completion of the administmtion ofthe ahove.eaptioned estate:
\, State whelher administmtion of the estate is complete:
Yes X No
2. If the answer is No, state when the personal representative reasonably believes thatlhe
administmtion will be complete:
3. If the answer to No, 1 is Yes, state lhe following:
a, Did the personal rcpresenlative Iile a linal account with the Court?
Yes No
b, The sepamte Orphans' Court No, (if any) for the personal representative's
account is:
e, Did lhe personal representative state an account informally to the parties in
inlerest? Yes No
Date: -,7. \
d, Copies of receipts. releases, joinders and approvals of formal or infomml
e>e? ;::,,;;,~:.'y '" m,d w""'" C],~ "0'"'[ " C~~2"""'''
John II, Broujos
4 N, Hanover Street
Carlisle, P A 17013
717.243.4574
,......:.
~..,.
Capacity:
I'ersonal Representative
X Counsellor Personal Rep,