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(/!.III kllllll'lI (/1 ,,_ VERNA..,JANE. .COVER _ _
PETITION nm PIWUATE nud GHANT OF LETTlmS
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CIIllIlIilllllleahh Ilf Pennsylvania
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after e\e(lllj\ln "I' Ihe \lj~'l1lered fur pmhale; wa, nllllhe I'iclim of a killin" and wus nel'er adjudicated
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(If dllmkilcd in I'a.) All peNlnalptoperty
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OATil OF PEI{SONAL REPHESENTATIVE
Co:\IM()~WEr\I.T11 OF l'E~~S\'I.\'r\i'iIA ! ss
cm :\n' OF uCUnfiBE_RLjlND_ J ..
I hI.' p"'liliOlll'I(\1 ilho\l'.llallll'd '\\I.'arl') or allirm(q lhat Ih~ ...latCl1Il'nl'" in Ihe foregoing pClition me
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WARNING: It Is 1II0galto dupllcato Ihls copy by photostat or photograph.
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3655753
'JU'/ 2.1 1996
No.
COMMONWEALTH OF PENN$VlIIANIA . OlPAfITMEflT OF HI'AlTH. VITAL RECORDS
CERTIFICATE OF DEATH
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IN WITNESS WHEREOF. I have hereunlo 'elIllY hand Ihi, 9th
. 19 94 ,10 Ihi, my Lasl Will and Te,lulllenl,
day of September
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Sign,"ure (?'
IV. WITNESSED:
TIlis Last Will and Testamenl of Verna ,Jn 1Y' Cover
was signed and declared to he his/her La,1 Will and Testamenl in our pre,encc anti al hi"her reque'l and in Ihe
presence of each olhcr, we do hcrchy wilness same on Ihi, day of , 19
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Wilness Signa
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Wilness Signalure
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Address
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Slale of
PENNSYLVANIA
, County of n IMRRR! .liNn
ss
We,
KIMBERLY J ANDRUS
RRT hN (' ThV! C)R
HAROLD W SANDERS and \lP.RNh ,1 ("()IJP.R ,
the teslalor and Ihe wilnesses, respcclively, whose names are signed 10 Ihe allached and foregoing instrumenl, were
sworn and declared 10 Ihe undersigned Ihal the leslator signed Ihe instrument as his!her Last Will and that each of the
wilnesses, in the presence of Ihe leslalor and each 01 her, signed the will as "1~sses.
Teslator:,c.~~ ;. t='~ Wilncs 01tn
Wilness
Wilness
Slate or PENNSYLVANIA }
Counlyaf CUMBERLAND
On SEPI'EMBER 9. 1994 bclare me. KAREN R SCHAEFER. NOI'ARY ruBLIC' .
appcared VERNA J COVER. KIMBERLY ANDRUS, BRIAN TAYLOR, HAROLD SANDERS
pcrsanally known 10 me (or proved 10 me an Ihe basis or sallsraclary evidence) 10 be Ihe pcrson(s) whose name(s) Islare
subscribed 10 Ihe wllhln in.numenl and acknowledged 10 me Ih.1 he/she/lhey neculed Ihe s.me In hislher/thelr BUlhanzed
capBcily(ie.), and Ihat by hislher/their slgn.turc(.) on Ihe inslrumcnllhe pcrson(s), or Ihe enlily upon behBlr or which Ihe
pcrson(s) aCled, executed Ihe In.trumenl.
WITNESS my hand and a . seal.
Signature
Notlnal Sea!
I<.1ren R. Scha"~er. Ncl,VY PLj"/<:
New CuTborland Ila<o. Cumbo:1.nJ County
IAI Cooll!1ission Exp;ms June 22, 1!Y.16
1>1ember, ytvania Assoaallar. at NOI"...'Il
Alfianl _Knawn-X-Produced ID
Type or ID Ph nRT\lP.R<:; r. TrJ;'NC:J;'
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you doubllht rann', filM" for )'11!Jr J'UfllO't Ind u\t [,Z b~..1 h'l'm' anJ Ihr rrl~ltr makr no rrprr~nlJllon ('Ir tUrTanl)'. ttrrt" or lmplird. tlmh rttprcl to the
mrrchltlllbrlil)' urdUt rflfm f.'l' an InlrndtJ u\t IIr J"ItJ'lll't
Inventory 01 the real and personal estate 01
Uv i '1(1 J(/ /iI' (, UU<',
... deceased
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
II:
n ~ 17j~;. J}
being duly 'r'~ )_/,:; 1,,'1 , accarding to law, depolOl ODd saYI 'h.t ho 5 __ .11,'
_t:',"f.tk:~o<- "_) ,n -r 'I 0' the Est.te a' _l'_\__.L!l~_J!1JL"__~)f<:'_'____
Iota a' _n L iY"'" ) -- II.", 1/ 0 I. " " A.' f' \ _" Cumberl.nd Ca~n'y, P." docoosod onel th.t the
'th'l . t db C li;,I" /, ( ,",' I \' ~"(",',,, ('!-'h 'd "'VI'! 1,'/dt-
WI In S an I"Vetn ory ma 0 y.. - . - J'~' - - ... ._.1-_.._ _ T- _~~ ..... ,.~ _ f--__1 0 lal _j______.~_
a' tho ontiro olto'a a' I.id docodent, cansiltlng a' .11 the perlon.1 prap..ty .nd rool est.to, o.copt re.1 elte'o outsido
tho Cammonwo.lth a' Pennlylv.ni., end th.t tho figures appasito each item a' the Inventory roprosent it's '.ir voluo
.s a' tho d.'o 0' dace dent's death,
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.nd subscribed bo'aro me,
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19 " ,,-,
D.to a' Do.th __ __h.,Q__
D.y
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Month
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INSTRUCTIONS
I. An inventory mUlt be flied within three manths .fter .ppaintmont 0' porsanol ropresent.tivo.
2. A supplemont inventory must ba filed wi'hln thirty days a' discovery a' additian.1 ...ots.
3. Addition.lsheets m.y be ."ached .s ta persan.lly ar rea"y
4. See Artiele IV, Fiduci.ries Act a' 1949.
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
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I' fOR OATIS Of DEATH AnlR 12/31191 CHICK HIRI
If A SPOUSAL ,
'POVIRTY CRIOIT 15 CLAIMED [ :
fiLl NUMBlR
d\
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S.3 ,
COUI<lY CODE YEAR
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rt\l!.eh""'lSbutj) PtI J'Jo~::.
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NUM8ER
I J 3
I J 5
08
limiled E'tale
, 7 5'ppl.m,,",ol R.","
Remainder Return
(lor dote, of dealh prior 1012.13.82)
Foderol Ellale To.. Relurn Required
j.ta FUlurfl Inlere,1 Compromi,e
{lor dole' 01 dOOlh alter 12.12.821
Decedenl Died T edole ] 7 Decedent Mainlained 0 living Tru'l
(Attach copy of Will) IAllach copy of Tru'l)
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO,
NAM' f\ I R C.. -n1"" COM""' "A""~ 'po"" I, C R)
L- 1(;( e. ,/otJe.r'J)J:" }tfO ,jn~(lnS jury .
11I""0,' Nut... '2 4---4 --- -- -- C.o ,\ es fo c..' P rJ ' ,. 'b
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95) ? DO
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'"
1. Real eslale (Schedule A)
2. Slacks and Bonds (Schedule BJ
3. (lo,ely Held Slock/Porlnership Inlere,' (Schedule q
4. Morlgages and Note, Receivable lSchedule D)
5. Calh, Bonk Depo'ih & MilCelloneou, Penonol Properly
ISth.dula EI
6. Jointly Owned Properly (Schedule F)
7, T,anllon(Schadula GI(Schad,la l)
8. Total Gran Anel' (tolalline, 1.7)
Q. Funeral E..penses, Admini,lralive Co,", MilCelloneou,
Ellpen'" (Schedule H)
10. Debh, Mortgage liabilitie" lien, (Schedule II
11. Total Deduclionl 110101 line, 9 & 10)
12,
13.
T 0101 Number of Safe Depo,il Boul
14.
15.
lb.
17.
z
C>
;= 18.
"
~ 19.
=>
..
'"
C>
U
>< 20.
"
~
Net Value of Ellale (Une 8 minu' line II)
Chorilable and Governmental Seque," (Schedule J)
Ne' Value Subject to To.. (Une 12 minus line 131
Spou,ol lranlfen lfor dote, of death aher 6.30.Q4)
See In'truClton, lor Ar,plicoble Percenlage on Rovene
Side. llnclude value, rom Schedule K or Schedule M,)
Amoun' of line 14 lallable 01 6% rote
(Include value, from Schedule K or Schedule M.I
Amount of line 14 fOllable 01 15% role
(Include value, from Schedule K or Schedule M_)
P,incipalloll due (Add 1011 from line\ 15, 16 and 17.)
Credil' Spou,al Poverly Credil Prior Paymenl'
-
(11
PI
(3 )
(4 I
(5)
'J../JI:.3 3~7 t.
+
(b)
171 _
191 /b)(; 1/ I.~
18 I
9 <i5 333 'lJ-
- - - }--. --~-~,_. ------
(101
(lIILG-.I__GJl-_':!J.-.___
(17) .. '8..1)721., ...3.t.~__
(131 -..... . .--"cr------
___~_____________.1!~L_$JI 72-.'2..,- .~-----
(151
------
..
=
(161
ffJ/722
~
,
_ X 06 =
If; ~Oj,
33
--
(171
. .15 =
(181
If.!? 03, 33
1. 4S; !!-
+ J.}1''S; I~-
. .
Inlcro,t
P9)
(201
If line 19 is grealer Ihan line 18, enler the differonce on line 20. Thi' i, 'he OVERPAYMENT.
aD
Check here if you are requesllng a refund of your overpayment.
4.1 b.S-<?, 17
21. If line 18 i, grooler Ihan line 19, enler ,he difference on line 21. This is Ihe TAX DUE.
A. Enler the inlere" on the balance due on lino 21 A
B. Enler the 10101 01 line 21 and 21A on line 21B. Th;, i\ the BALANCE DUE.
___~h Chede Payable to: Reglst., of Wills, _A!I!~_t_________
(711
171AI
171B)
). >- BE SURE TO ANSWER ALL QUEST"IONSON-REVERSe--SIDE ANliTO iicH-eCK MATH -.:;c-~..- ______u
~~der penallie, 01 perjury, I dedare Ihol I hove e..omined Ihi\ rei urn, including accompanying "hedule\ and\tQtl!mcnh, and 10 Iho besl af my ~now'edge and belief,
III' lrue, carr eel and complele I dadoro thai 011 rcol estote ho\ been reported atlrup. morket ...oluf! Declorahon or preparer olher Ihon Ihe penanol ropre'l!nlollve i,
baled on 011 information of which preporor ha, any knowledge
It'" O"T-O~\''ff:..~'~fi}:T . Sl;~:\k}' e Oc.'_1 It; -~
iio...iuo "'''''''0'';''''''';'''''''''''';'' /fo "'''''' Fe"7 R"./ c"e.~1QI h}fJJ //s/(. ,,,(, r;
Act #48 of 1994 provides lor tho roductlon 0/ tho talC ratoslmposad on tho not valuo 0/ trans/ors to or for
the use of the spouse. The rates as prescrlbod by the statute will be:
e 30/0 (.03) will be applicable for estates 0/ docedents dying on or after 7/1/94 and before 1/1/96
. 20/0 (.02) will be applicable for estates 0/ decedents dying on or after 1/1/96 and bofore 1/1/97
. 1 % (.01) will be applicable for estates of decedents dying on or after 1/1/97 and before 1/1/98
. Spousal transfen occurring on or alter 1/1/98 will be exempt from inheritance tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK (v') IN THE APPROPRIATE BLOCKS.
1. Did decedent make a transfer and:
a. retain the use or income oflhe property transferred, .......................................................
b. retain the right to designate who sholl use the property transferred or its income, ...............
c. retain a reversionary interest; or ...................................................................................
d. receive the promise for liIe of either payments, benefits or care~ .......................................
2. If death occurred on or before December 12, 1982, did decedent within two yeors preceding
death transfer property without receiving adequate consideration? II death occurred alter
December 12, 1982, did decedent transfer property within one yeor of death without receiving
adequate consideration?....... ...................... ............................ .........................................
3. Did decedent own an 'in trust for' bank account at his or her death?.....................................
'[ES J!~
0(
':f..
:x
D<
I)(
K
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
I
~. ~,. ~.
llY.UOJ IX. IU"~I r
~
COMMONW(Al'.t Of PlNN~'flVANIA
INH[llfANCf IAll .(tURN
IUIOrN' OfC[O(Nf
SCHEDULE A
REAL ESTATE
ESTATE OF FILE NUMBER
Ve.rne.; .J1l1l"- C.over ?./'i';-OS3{
(Prop.rly lolnlly.own.d wllh RighI 0' Survlvonhlp mUll b. dlscla..d an Schedul. F) All real 11101. Ihauld b. "porl.d al 'air mork'l valu.
which II defln.d olthe price al which prop.rly would b. e"hang.d bltwlOn a willing buy.. and a willing ..II.., n.lth.. b.lng camp.lI.d
~~",y_!!-,"II,bat.h.h_avlng ,,_alanabl.knawl.dg. a' Ihe "I.vanl 'actl.
ITEM
NUMBER
VALUE AT DATE
OF DEATH
DESCRIPTION
1.
RQ~IJe/H ~ n;f "
V ~ '( (\ ({ .:r Cl/H. Q,o V e..r
10lif Soufh market-sf,
JrlQ.c.hu.I1 ic~ bUt I /,1 l'7bSS-
Q urI\bu lei,,) CcJ.
HeWt"l hH/l +r{i..~5fQ.fe.'/ -P-rom C./7Je. R.
Cuve.r fo lIt..(t'lCl ~.)ver ~ 1\ De.c. /0/ 19ft
( 13cok ~'l~ p";r-7 3')
{)/per J+11e.1\ TOI.VI\ sl;/
'Bric.k QIl.) rr4me. rtlll.c.A t,le otwelli{-
Lof!Va 31- /3' , "7)1' \ J I
. I fer:: K IJ I 1\ Co. ~ 12. r fA I r\ P 4/1
o P 10+5 k n ~ I.V /l Q.J
CumhV/41l'/ C" Reco'/s Ottrle flbl1
pU;Q.. 13
WE 8E f? tRo fT
130lJk
'CJS;9 Or)
IS;
_______..~______ u J~~~L_(~I,o e~ter on line I,~!~opi!ulolion)
(IF more spac. is n..d.d, insert additional she.ts 0' some sin.'
s.7S; 900
IIVIKNIlltU"j ~I
,,~:.~9l\
...~ijs.,;
COMMONW(AUH Of jo![NN,nYANIA
INHIIIIANCI fAX InUIN
IIIIDIN' DICIDINr
ESTATE OF
Ve.rflU
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
.... Ploa.. Prinl or_!},l'e
FilE NUMBER
"2196-0,!J3/
,,'1 11 ~ C...u ver
IAII proporty lolntly-own,d with th, Right of S",,,lvouhlp mutt b. dlulo..d on Sch.dul, FI
ITEM
NUMBER
VALUE AT
DATE OF DEATH
DESCRIPTION
I.
I Cf ~ If J3 u ;c K C. e (\ f f). r r
pJi ti !-I'T Y 71 31
~
I) 000,-
2.
)J]i5C. CU~ k all.l f{e.PuMI.s
-4')) I-j 33, ?J-
TOTAL (Allo enter an line 5. Recapitulalion) S 1.
'3 J 7:2.
(Allo(h additionaISV," )( II" sheetl if more 'pan i. "..d.d.J
_'V!)Illu 1'''1
ESTATE OF
ITEM
NUMBER
A.
1.
B.
C.
# -. ~.. ~. '.
~ .~-.)
~~'N*.;!'
(OMMOUW(AlHt Of 'WN!lYl'~At~IA
INH(IlI1AN(( 1A1 Il(1UIlU
..t~lD(NI O(ClO(.HI
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
I _ _ Plea Ie Print or Typo
fiLE NUM-OER
'L1'I6-0S-3/
L----u--r--------- ---
i AMOUNT
._.______~_._._..__.._.__._t__-.---'-...-.~-.
U~r (tl~-___I(j(l ~____ C<QV.~L__________ ----
DESCRIPTION
~.-_-~--_._---- ------....
Funeral ~xpen.": I
G-u-MI/./ fu-Il ~'"
~r<l."1/. s,:Js..
t-h.-..~ St'II"-
F'lo "" co
F~.J )
Pc.~ l.., (.F'" Il~""
Rf!.~~~t."S,lpl,'4$ ..f...1
Admlnl.tratlve Ca.t..
po dc, (m....." I. 0 50
Orr-"id- 50
,4/
0) l.SS" 2 7
H..'tl'l.. ~53(..SD
I
lSd, -
'IOJ.ll,-
1'1/.I'f
/, .3. ill
'S,-
rS,4't
1. I Penonol Represenlativo Commissions - -
i Sacial Security Number 01 Personal Representalive: --------. -----
I Year Commissions paid
2. I Allarney Fees
3. Family Exemption
Claimant
Relatianship
Address a' Claimant at decedent's death
Streot Address
City
______State ___ Zip Code
4.
.11
Probate Fees I:l. t-
~um/'c,I,,~.1 ~"... J""I, , CD C",lisl.. 50/\ t;.~.1 '151, 'J~ ..; 2. ,3 <[). .2!L
Mlscellaneau. Expenle..
ppy.L.. ?.~/. O'f
f3e./1 fl-t ,,,,,i,,- 9S' . '?3
UlldJ w",fe.,.. ?~ ,,s-O
/)."'fer~Ik-f\'TW/,(5""<() '7/,lr --?/ I IIG
v-' I ~ 17, .-
Q hem lCH.v f\ .5"'1, 3
Wai1(. mC." of Co"f\, PI) 3 6_, 12..
I'.)G ~i"f\ IN ,,)0(., Jl1.. f, (F.(~ J:1l5.) 9..!:J , ,511
5c-oHJ' 'fu1l~UI' (rt BuiLl- r()~Ml /09. 7/
.fur Sf< I... \ r. J . (.\
.J ~c.l" I,.'I)"-.')
TOTAL (Also enter an lino 9, Recapitulation) S 16 b'1., ~
(If mare space I. needed, In.ert addltlanal .hee" a' .ame sI...)
1.
2.
3.
4.
5.
6.
7.
B,
i
l
I
;
I
~
~
/j--If) -It.)
BUREAU OF INDIVIDUAL TAKES
INlfERllANCE tAx DIVISION
OEPf. 180.01
HARRISBURG, PA 11121-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE DF INNERITANCE TAK
APPRAISEHENT, ALLOWANCE DR DISALLOWANCE
DF DEDUCTIDNS AND ASSESSHENT OF TAK
CLYDE R COVER III
140 SHENKS FERRY RO
CONESTOGA PA
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
17516
12-23-96
COVER
06-20-96
21 96-0531
CUMBERLAND
101
Anount R..I U.d
c
*
III."" II"UlU,'"
VERNA
J
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 ~
iiEV:is4i"EiC"Fji-iiF96riloYicniF-YNHEiiii'ANCE-YAX-jiPPR'Ais'EHEilT",--"L'LciwANcE-oR'--m------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF COVER VERNA J FILE NO. 21 96-0531 ACN 101 DATE 12-23-96
TAK RETURN WAS: (X) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..l E.t.t. ISchedul. A) 11)
2. Stock. and Bondi (Schedule 8) (2)
]. Clos.ly Held stock/Partnership Int.r.at (Schedule C) (3)
4. Kortg.gel/Not.. Receivable (Schedul. OJ (4)
5. Ca.h/Bank Deposita/Hi.c. Parlonal Property (Schedul. EJ IS)
6. Jalntly Owned Property ISch.dul. F) (6)
7. Transfar. (Schedule C) (7)
a. Total ....t.
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expen.../A~. Calta/Hilc. Expens.. (Schedule HJ (9)
10. D.bt./Hartg.g. Llobllltl../Llenl (Schedul. I) (10)
11. Tat.l Deductlan.
12. Net Value of Tax R.turn
13. Charltabla/Covarn..ntal Bequalt. (Schedula J)
14. Net V.l"" of E.tet. Subj.ct ta TIIX
) CHANGED
95.900.00
.00
.00
.00
2.433.12
.00
.00
(8)
16,611.43
.00
Ill)
(121
113)
114)
NOTEI To Insure proper
credit to your account,
sub. I t the upper portion
of this for. with your
ta. pay.ent.
98,333.12
1~.~1I 43
81. 122.29
.00
B1. 122.29
If an asseSSMent was issued previously, lines 14, 15 and/or 16, 17 and 18 will
reflect figures that include the total of ~ returns assessed to date. .
ASSESSMENT OF TAX:
15. A.aunt of Line 14 at Spousal rat. (15)
16. Aeount af Lln. 14 t..ebl. .t Llne.l/Cl... A r.t. (16)
17. A.uunt of Line 14 t..abl. at Coll.tere1/Cl... Brat. (17)
18. Principal Ta. Due
NOTE:
TAX CREDITS:
PAYHENT
DATE
09-17-96
RECEIPT
NUl1BER
AA146747
DISCOUNT 1+)
INTEREST (-)
245.17
.00 X .00=
B1.722.29 K .06=
.00 X .15=
(leI
AHOUNT PAID
4,65B.17
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
.00
4.903.33
.00
4,903.33
4,903.34
.01CR
.00
.01CR
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATIDN DF ADDITIONAL INTEREST.
I IF TOTAL DUE IS LESS THAN II, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YDU HAY BE DUE
A REFUND. SEE REVERSE SIDE DF THIS FORH FDR INSTRUCTIDHS.)
2~
::3
r\"
\0
a.
:0:0
(tJ~
.-., .~
c:::l
OJ
N
W
u
~ :::;.:
~ - V)'
:1JL .. 0
RESERVATION. Elt.t., 0' decedent, dying on or be for. Dec~r 12, 191Z -- I' any future Int.r..t In ~.t.t. ~ trBnlf.rr~
In po.....lon or enJo'tllent to t1... . (colhhnlJ bentlflcl.rI.. 01 the d.c~t ,ftar tM Ixplr.tl'iJ. of any uht,
11', or for v..r., the C~..lth her.by IMPr...lv r...rv.. the right to appraise and ...... tran".r I~rltanc.
at tM l~ful Cll" a (co11,t,r,l) rat. on any such future Int.r..t.
'.'
for
Tax..
PlIIPOSEOf
HOTlCEI
To fulfIll the r~lr..ent. of Section Zl~D of the tnharltencl end E,t,t. 'a. Act, Act ZZ of 1991. 72 P,S.
Section ZlU.
PAYPENTI
o.tach the top portIon of thl, Hotlel end .~lt wIth your P.~t to the RIglltar 0' Will, printed on the rlv.r.. .Ide.
...... check or IKIneY ord.r payable tal REGISTER OF MILLS, AGENT
AU ply.."t, ree.hr" ,hall first be; appUed to any Int.rnt which a.y be due ..lth eny n..lndtlr eppll..:t to the talC.
REF\MD (CR) ~
A nfU"ld of a ta. cr..:tlt, which .... not nqu..t..:t on the Ta. Raturn, NY ba reque.t..:t by COlIPlatlng en "application
for RafU"ld of Pannlylvenl_ Inn.rltenca end E.tata T.... (REV-ISIS). Application. .ra .v.llebla .t the Dfflca
of the Real.tar of Will., eny of the 2S Ravenu. DI.trlct Dfflca., Dr by calling the .pecl.l 24-hour
...warlna .ervlca nueber. for for.. orderlnal In Pann.ylvenl. 1-800-S62-2050, out.ld. Penn.ylvanla end
..Ithln loc.l H.rrlsburg .r.. (717) 787.8094, TOOl (717) 772-2252 (He.rlna IIIP.lr..:t Only).
OBJECTIONS I Any p.rty In Inter.st not latlsfled ..Ith the eppr.I...ant, .Ilowanc. Dr dl..llowenca of deduction., or .......ant
of tn ClnclucUna discount or Inhr..t) u shown on this Notice ....t object ..lthln sI.ty (60) day. of rec.lpt of
this Notice bys
--..rlttan prota.t to the PA Dap.rt.ant of Rev~, Bo.rd of Appe.ls, Dept. 211021, Harrisburg, PA 17128-1021, OR
--.Iectlon to helve the .atter detaralned .t audlt of the account of the parsonal r8f:'r..antatlva, OR
--1Ipp..1 to the Orphan.' Court.
ADMIN
ISTRATlIIE
CORRECTlONSs
Factual arror. dlscoverad on thl. .......-nt .hould be addr...ed In ..rltlna tal PA Dep.rtaant of Ravenue,
lur..u of Individual T...., ATTNI Po.t A......ant R.vl... unit, Dept. 210601, H.rrl.burg, PA 17121-0601
Phone (717) 787-6505. S.. pag. 5 of the booklat "In.tructlon. for Inherltanc. Ta. R.turn for. Re.ldant
Decedent" (REV-IS0l) for an ..planatlon of adalnl.tr.tlvely corractabl. .rror..
DISCDlIITl
If any ta. due I. paid ..Ithln thr.. (S) calendar .unth. .ft.r the decedent'. d..th, . five parcant (SX) dl.count of
the t.. p.ld I. .llowed.
PENALTY I
The 15X tu ......ty non.p.rtlclp.tlon pen.lty h cDIIPUtad on the tot.l of the t.. and Int.rut ......ed, and nOt
p.ld b.for' January 18, 1996, the first d.y .ft.r the .nd of the ta. "",.ty parlod. This non-p.rtlclp.tlon
pan.ltY Is appe.labl. In the ..... .ennar and In the the ... tla. parlod a. you would appaal thl t.. .-'II Inter..t
thllt has bean ......ed .. Indicated on this notlc..
INTEREST I
Int.r..t Is ch.rgad bealnnlna ..lth first d.y of delinquency, 0" nine (,) .onth. end one (1) d.y frOll the data 0'
d.ath, to the d.ta of P.~t. Ta.a. which bac... delinquent before January I, 1'12 baar Int.r..t at the rata of
.1. (6X) parcant par annul c.lculated .t . dallv r.ta 0' .000164. All t.... which bac... delinquent on and afta,.
Janua,.y I, 1'82 will ba.,. Int.,...t at . ,..t. Which ..III v.ry ,,.01 c.lende,. ya.,. to c.lend.,. ya.,. ..Ith th.t r.t.
announced bV the PA Dap.rt..nt 0' R.venue. The appllcabl. Intara.t ,..t.. for 1'12 through 1997 aral
!!!! Int.rut Rat. DeilY Inter..t Factor !!!!' Interllt Aat. D.lly tnt.r..t r.cto,.
.912 zax .000541 1917 'X .00020
19I5 lOX .OOUSS 19&8-1991 l1X .00OSOI
191~ l1X .000301 199' 'X .000247
1985 UX .Ooos~ 1995-1994 7X .000192
1916 ..X .00027~ 199~.1"7 OX .000247
--Intar..t 11 celculatMt .. follCMIIl
INTEREST = BALANCE or TAX UNPAID X NUHBER or DAYS DELINQUENT X DAILY INTEREST rACTOR
--Any Notlc. I..ued .ft.r the t.. bacoaa. delinquent ..III r.flact en Int.r..t calculation to flftean (1~) day.
bayond the data 0' the ........"t. If p.yaant 11 .eda .ftar the Int.r..t CCMIPUt.tlon data shown on the
Notle., additional Inter..t .u.t be calcul.ted.
(,
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Ve r(1Cl J, C-over
Date of Death: r u 11\:_ 10, J? 7'
.
will No. J ? 9 b - 0 () S ~ ( Admin. NO.-2J 9~ - 0.5"3/
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 wnether administration of the estate is complete:
Yes V 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 t.he personal representative stat~ an
account informally to the parties in interest? Yes ~ No
d. CQpies of receipts, releasesr 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.
0/ A~_lt/tvc'~
sigI)l!ture
c.l d~ Rob~r
Nam (Please type or print)
No She.llk; Fe.rrl( 'fJ., t()M~101t\./J4
Address (' I7SIt.
(717) 'i72 -If2 1f7
Tel. No.
Date:
'2 - -!:>- - 'I 7
JIL
t.o U~r J1L
o:~~
-.
In
r;-}
:; ~~(
_.4...
~
r-.
I
IZJ
uJ
'-
r, .
u ;:,
&r..:
r--
P'
"
.: E
.!!!::J
UU
Capacity:
~~Personal Representative
Counsel for personal
representative
(MAH: rmfl AM3)