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HomeMy WebLinkAbout96-00582 Thi, I' III H'llily Ih,lI lilt lilt. 11 111.111,)11 JIll t' ,'1\( 11 I -' I' '! It \ T I, 111\,IIHq~I"'II.lr lllllllh'lIl,d'llldl..!It,\\tlIIWI"j\.\ll,i! 1, WARNING: It Is IIle!]nl to duplicate Ihh copy by pholoslnl or photo!]rnph, , li".1\ 'II ..) I 'Ill Ii, (11111' 3tl~.?~r tilt.! '.'1111 lilt' .1... ! L, " 'I !' I }j! I" 1,,1 1,,1 III liP III I tllIlt~ 1"0 1111 ,lib \t Iltlll .Ill. ~.J !Il/ /,.(~\ii'lii;Pit", /~~, :tJ~" t~~~\">':~ ~~:.!~p ~';.~,:,~...", ~p '\ '>'-9. . ~""'.t' "',j4fENl U\~/ :t~~..'!"!!'J~'__' 'J .. It L " ,) , ~ ! () ~ll <:::: -, t...~!J.;...4 ~.. .,. ,~.\r~\\l."'.: , .il 1\1"1:1',11,11 ~;.syr:' ....... : tl' : ~ ' I (., j 1).llt "'0' '"Ill.. 2-,' COMMONWEALTH OF PENNSYLVAWA. DEPARlMENT OF HEALTH' VITAL RECORDS CERTIFICATE OF DEATH '...f.......""" 1o.:<..I)ln...h....."'~I. COffr.ltt.h."'_t..,_, 'Il,"' . ,"I'" .~. ....... v uuu...,.... "'...,....., ,.. ~(OlIDf""""-._.__ ._..............__..... .- - 'roo....LJ I. Ha 'Q(..."~ Luctnda lIetnze \IOIt'f1l....lII 1JIoOf1l1Q.lT -. c.,. .......1"'_ I. femlne C.ll(]1I""" ....,.-0.._, ."''''",""(.1<,.,_ ~"'"'''Y'(''''''' '-'CY,1.~ P ....._0 , Johnsto....n,,\ .. "(ll.I'~ ".W .......,...Un- _..__ __. 86 ... ""'QlI)UJ'H ~""" ,,()to(.... ,.:';,1 rumbcrlnnrl . Of('OII..I'''\I.I.~_'.....ll..JOo "'N"...=:::~~.,:::;J.=-:' Homemaker Own Home . II I. CfUDI'"''''.....WO.fICIlUlf...... u..'- _lC'CtwtooI Allcnberry. ISS9 Boiling Springs Rd. " '>1..'II'..."'(.,.".......u.. otClOl'"I '(ff...~ "fK1:"<C1 ..~ ,..,..- ".".. PA Cumberland ." ....,,,<lI'IJ...,,(,,.."'<Jd\O"'_~~.... 17007 , " .....()II..... S.....II.~...i1 John Jacob fetnzc ""??oo V'C"1()foo e......Uc,__D 0--1"__" 177 - SO - 1228 .Inn. 5. 1996 ~ ,"'0.0............ "4(:1._..__.......... "..IIo;M " ~hilC __-..oVQl.l$l .'_7"'___ .. -- ~.. -' "'....,..s:c",......... -"'......."'- """-_&c"" II Widowcd ".(]....__.. , -I Honro~ ",0:';"'-=':::.. ,~- " ...'Ofl.....'I...~aaGIO("~...(~,....lo(""" ISS9 Boiling Springs Rd, Boiling ".acl ~lQ'O...._..(_..,c,_...., .lXIoIoO"I.C ..c.-...".-:. Sprinr,s.Pn ....t,c.... 010343 L ,. \t,'cstmlnster Cemetery lJf4l'~CO<<~,""""'c.,.", . ..,:JllLl -,Q n._fl. 1........__ _......_.'__.._""''''Il~ .._........._..."..."..........."'..... ....,..,_ .............,,'..... ~......._,_....kI'I_ L:-\./A- Ot;ffgQl.'.CO'....Ul..f-...:[r.1 I: ...,,,,.u'OPu....Oo<oo<';\ ."IUl"'I~," t:OUP\I'OCOfOlt:l,,.... (]It'lfaf... :;. Niddlclnn. Tw Climb r.('I P;l S~~rt.Wm~?~"pKunf7BI3Ho~c K/..J /iPl./qs<l L. ,-...-. ;......,,- ,.......001""... ;/j~ ..Ill. O_............__~._II"'l..... ...,._..........~__..~ll {..fo)J CA tooA 'O'~.~';;'LO'~('Jl.(-''''.t'''' -_..__.._~--~._~.- ---.-..--....- -.-.-- ----_._~_.._-_._-------- 0Uf 'Olt,..'.U"...l......l.<C' "1 .-. ~ .,- S ....~ . , , -._..__._~-~-----_. ~ -""'.-;;;;:;;;---J.."'..... I~~"'~" ~'<-'~~""'A_' "". ..,....' ~ ~ 'J "" .... ..0 C ~Cf(''''^'tl'..._..._~........_.'' 'OC....,..i...~(;.l'9o_SW" -....,".~.,. * "'.....'.l>IOf.... -.- ,,--,...........,..... ... [J ~r, ...0 ~O """"'_M.w.- ... UlII'.'IIl,{,..._,... 'CllII'''''1IIQ ,....,.1(.1....,......... '."_ ......... e~ _ ....... ,IP'...... .H,. ......., ....~.~" ....._1 __ll '....-"...,.-.................-......,-..".........-.."...,.. .. .'IlIOOof)uIoC1IoQ...OCflllllnItoQN'lrc'I......W4f'r.-..."'......."""'l_.......,............"..,'I4:/,,..., ,.__"..'"..~....,..........."...._,.... ....................................................... 'Vl00ClLIU..,..tlll.'COlllO..11'I Or! "" """.'..._tt_ ._.. ...."1,..._. ....., lIf_. dill" ""Ct."... ..,~. .,.... ...... '~d "Itt. '~d "". I"l~. clw"'ll."~ "'."....1111...... '" " :%-....:.~'~\'~:.;~~\g..~=s,~\ Q( Q.:.L8..u9J * ,<>,,"vn.'''O'''II,W ". X' " . I I. ~:: :~..}ti'j'O" '{ .. '1:1 .c.J::;' ~:::;'tN S: ".'/ 7/~_ .....,...o.N:f'f"(\f'I..'O......'-'O(O""-f.\OC.U\lOil~.... , ~''''~.''~ ~:..:" \h:I \.\)4 .- " \'..1\\<: , C.U \'\J~" \\' [""".....j~.." I., \Cow,. 21-96- 5M2 REGISTER OF WILLS OF COUNTY OATH OJr SUnSCRIIUNG WITNESS codicil //' (each) a subs ' Ing witness to the will presented herewith, (each) being duly,qGajified according to law, depose(s) an y(s) that / present and saw , the testal , sign the me and Ihat / signed as a witness at the request or testat In presence and (in Ihe p~nce or each other) (In the presence or the other subscribing witness(es)). (Name) Register (Address) , 'f,vame) '''-..., (Address) ',,--- ',,- -', ". REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF NON.SUBSCRIBING WITNESS Jere S. Heinze (each) a subscriber hereto, (each) being duly qualified according 10 law, depose(s) and say(s) that he is ramiliar with the signature or Mary Lucinda Heinze codicil will test at or (one or the subscribing witnesses to) the presented herewith and codicil believes Ihc signnture on thc will is in the handwriting or thai he Sworn to or aflirmed l\l!d subscribe:! bcrore 'Ie<, me this __.---.:_______ day or L l///n'(II.d:L...u i9'/h I)} {I X:' (j. , y" 1- 'Q 1'4 ''d.J..1 \4) J', I"~ 1.( 11..,-,: (- L1 i/ .L", I-.d) Register Jere 17007 Mary Lucinda Heinze to the best or _!~~ knowledge and bclicr. 1'.0. !lox 7, (Address) (Name) (Address) -, .' g .:;-- CER'l'IF1C:!lT10N OF JIOTLCJU!!l_DI:F -'l{~LI5. 'i~l.QJ Name of Decedent: ;fltJ-Wj /.u ~//(-z~ Date of Death: r \: (''''~, . ~ , rei'i& will No. q(p - 5~ z.-. Admin. No, To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' COUI:t Hules was served on or mailed to the following beneficiaries of the above-captioned estate on Name Address r llhl,/k';nl!. joJ<t? 4l~-H? I .1.tc..'~/~"<' ~~z~ .Jflttd/e f' ja" "("I.V 4,;,-<<, J".",~(:"',J. Ck',c.lcs /IH~ ~ ~c~1 ~., ,. A,(,.r:,;.utl..... (~..tft'Y , ;t~1 ;t."II(,{~l'y't'ff - ;&t(~:5;~.d~::, . (l.. . #t(~ ~t.IY - n:..., c-.,..s:.'__,(.~ I ~_____._ Notice has now been given t Rule 5.6(a) except entitled thereto under Date: k6 d-I , 1'117 \1~! " l.1r~ " ,-" ----- ~~ -., ...--- ign'lure. ( Name ' JtJ/~r ~J t//f'Z.e Address /'dIYf i ;6, fl.'! 5j!.y/-gs I ~. Ifi'tJ1' TelepllOne(7/71 '1-S~_:YJ.I' 'lJn:;) 7~pacity:__~ Persona) Representative 9,: Id IZ B:L! 'r '-t!. Counsel for personal representative ~')'I'I . , " " :,. '. " ,'"'. . - I:J l/ RIV.'IOOU .17...1 . ! ,. 1 ' i l!l tl l!l I!! If:S. !I!U uS~ i ~~ l!jo u'" .. (' Ii I;' I , , /,'f." I, <.~- fOR OATU Of OlATH AlTER 12/21/'11 CHECK IlIR! If A IPOUaAl. POVlRTY CREDIT 1I CLAIMED I ?I COUNTY Cd Dr q~ YEAR si.z .~ I 1...\ ( (I' INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) u""r COlNONWI IL nt OF P[HHIYl VAAIA OIPN\TMf.HTO' Rl VlHUI O[PT. a;)S)1 HMRIIIIURO,PA 1JI2S<le01 DlC1DlNT .NNM LAlT, U\lf, NiU MIOUU IHlTlH.l HEINZE MARY LUCINDA .ocw. IlCURI1'V HUMB[R UIClUlN' . c;o....U 11 HJORt" P.O. BOX 7, ALLENBERRY DAIl or .,,,,, BOILING SPRINGS, PA 17007 03/04/09 c.... CUMBERLANO 'OCLAL I[CURITfNUMB[R lNOUNTftlCIMD 11[( ....""UCnoH.' o 3, Romolndet R."m 1101 d.... 01 d..1h priot III 12-13-1l2l o 6. Fod",oIE1totllT&JC R.lUm RoquIrod L 8, To'" Nurri>o, 01 5.1. CopoIlt B_ t;Y::::':!?I:,:~~:::('(f&~:.reg::4t::t;f DATI Of DE Am 177-50-1228 1/05/96 .,jIffUCJIOl(llUN\NIlPQl.II:..N,Ih( lJIUt'.MS1' MJMa11 1N1IAJ ~ 1. Origlnol R."m o .. lMrilod E .toto KI o 1. Supplomon'" R.lUm o ~. Futuro lntcrolt COI11'rOlllilo IIOId.lo. 01 d..1h .f1.r 12,12,82) o 7. D.cod.ntMllnlolnod 8 U\lngTN.t IAlloch copy 01 TNlU DeN IDENTT INFOR L CQIwV'l[TE ~l1NO AQORl51 52,887 26,025 (8) 78,912 P.O. BOX 1331 HARRISBURG, PA 17105 7,798 25,000 1111 (12) 1131 1141 32,798 CLARENCE E. ASBURY nLIPHOH[ HUMBER ~ ~ !l u III .. (717 761-7910 1. R." E.toto(Schedul. Al III 2. 5_ end Bond. ISchedul. BI I 2) 3. CIOIoIyHold StDckA'8f1nOrolip Inlo,..tISchedul. CI 131 ., M>r1llogetl end Nolo. Rocolwbl.ISchedul. CI 141 6, C..h, Bonk Dopooito & M.cellonoou. P...onoI Prop.rTy I 51 ISchedul. EI 8. Jcln~yOv.nod P,op.rTyISchedul. FI 16l 7, T,onol.roISchedul. G) ISchedul.LI 171 8. TotoI G,OI. AI..IIIIo'" Uno. 1.71 9. Funeral E)lponaol, Adrri,.ltratiYII COlts. MsceUaMouI (9) E>!>.ns..ISchedul. HI 10. Cohill, M>r1ll00. UebiU;.., U.ns ISchodul.n 1101 1 I. To'" Doduc;ons lIo'" Uno. 9 & 101 I:!. N.I VoIu. 01 E.,." (Uno 9 mnu. Uno 111 13. Cherilobl. end G.....rrvnon... Bequ..IIISchedul. JI 14. N.IVoIu. SubjeClloTexlUno 12mnu. Uno 13) 16. Spou.oI T,onsl.roUOI dolo. 01 doolh .llor &3().941 Soo InsU\JctiOOl for Appli~o Porcentago on Rowrlo (15)_ Sid.. (lnclud. wlu.. Irom Schedul. K or Schadul. MJ 18. Amount 01 Uno 14tl1Xl1b1. 016%'.10 116l (lnclud. wlu.. from Schedul. K 01 Schadul. MI 17. AmounloIUnoI4tl1Xl1b1oeI15%r.1o 1171 (lnclud. wlu.. from Schedul. K 01 Schadul. Ml 19. Principoltoxdu.IAdd tox from Uno. 16, 16 end 17J 19. Credill Spou.oI P.....rTyCrodil PriOl P..,.,.,nll Ci.counl 46,114 X. . '6,114 x.06 . 2,767 z o ~ !; ~ u g x.15 . 1191 lntarolt + + 20, If Uno 191. gr...., then Uno lB, .nlo' the diff.r.nc. Ofl Uno 20. TH.I.the OVERPAYMENT. ~ Check h.roll yciu'oI.t. D..Ung. r.lund 01 your OY." 'm.nl.,? 21. UUno 181. gr..tor then Uno 19, .ntor the dill.'.nc. Ofl Uno 21. TH. I. the TAX CUE, A. Enlo' the Inlor..1 Oflthe bolenc. duo Ofl Uno 21A. B. Enll' the 10101 01 Uno 21 end 21A Ofl Uno 21B. TH. I. the BALANCE CUE. Make Ch.ck Payabl. to: R.glltar o' Willi. Agant 1191 1201 1211 2,767 121Al 121B) 2,767 >\1';'." ",\!i)@;MhJC we " 'CUlt SURE TO ANSWEIIALL OUESTIONS CN REVERSE SIDEANCTO RECHI!CK,MATH.." J%':WW,f;,,,,,,*Wi9W0.0M , . of p.r <V,I d.d...thell heYo ....,.;nod iii. ,."m.lncluding eccllfTllenllng .chedul.. end .Iolomenll, end 10 the belt 01 myknowodge end bCIIi.I, . nd .,.. t d.d...thel 011 r.oI ..,.18 has b..n repor1Bd .1 IN. morl<.t wlu.. C.d..o;Ofl 01 prep...' othe, then the peroonel '.p'....n,.;'" I. f 0 Wllch proparor has enyknowedga. .0"Ll fa. ....~ .'l\Jf\' "fP~.0 BOX 7. ED I LI NG SPR I NGS. PA 17007 Rt [5 TA ADDR[SS ~ P.O. BOX 1331 HARRISBURG PA 17105 :An~~X:t 1- .,., ..4:1'...,' ftly.,auttJ.t7J SCHEDULE E CASH, BANK DEPOSITS AND MSCELLANEOUS PERSONAL PROPERTY Please Prlnl or Typa FILE NUMBER CQMMONWIIL TH O' 'INNIVLVN41A INHINTMCI TUftlNUI "IIIDlNT DlelDINT IITATE OF MARY LUCINDA HEINZE IAlI p,.pOIty 1.lndy........d Nth th. RighI.' Bu,vlv.r.hlp mUll b. dllet...d .n Bchldull FI ITEM NUMlER VALUE AT DATE DF DEATH DESCRIPTION I. 2. PNC BANK CHECKING ACCOUNT . 51-4044-8168 fiNANCIAL TRUST CORP. ACCOUNT . 00D45Z505 1,309 24,716 TOTAL (Also enter on line 6. Recaphulalion) . 26 025 lAaach oddIdonolB 1/2" X II" lhoollll more Ip..oll noododJ .""A0UQ2"" \ .. ! ftlY.tI'UKtll'. SCHEDULE H FUNERAl. EXPENSES, ADMNISTRATIVE COSTS AND MSCELLANEOUS EXPENSES Pi.... Print or T . COMMOHWIH.lW 0' 'INN.v\' VN4lA tlHlftITIINCI TAAIU1\JRN " MARY LUCINDA MEINZE ITEM NUMBER AMOUNT DESCRIPTION A. funeral Elt\Ienl8.: MOFFMAX-ROTM FUNERAL MOME 7,798 1. B. Admlnl.tradve Co.ts: Pe,sanal Rep,esentaliW Commissions Social Secu,lty Number of Pe,sonal RepresentaliW: Year Commissions paid 1. 2. AtlDmey fees 3, family Exemption Claimant Relationship Add,ess of Claimant at decedents death SlIeetAdd,ess City 4. Proba1a fees C. M.celleneou. Expenl8.: 1. 2. 3. 4. 6, 6. 7. 6. Slate _ Zip Code TOTAL (Also enter on ine 9, Recaphulation) · 7798 (If mora .pece I. needed,ln.erteddldenel .heots of I8mo .Ize.) Ilf PM2021P.12 . - -. "-' - ~. , ,..... ~'.' .' o DEFERRED PLEDGE AGREEMENT In consideration of my interest in education, for and in consideration of the similar promises of other dDnors and for other Rood and valuable consideration, the receipt of which is hereby acknowledged, an~ intendinR to be leRally bDund hereby, I, MARY LU BBHlZE, of Boilinp, SprinllR, Pennsylvania, hereby irre- vocably pled~e and promise that my a5tate sholl be obligated to pay THE PENNSYLVANIA STATF. UNIVERSITY (the "University"), subse- auent to my death, the sum Df TWENTY FIVE THOUSAND AND 00/100 ($25,000) DOLLARS, The aforesaid sum, when paid by my eXeclltDr frDm my estate, shall be used by the University for the School of Hotel, Restaurant and Institutional Management and shall entitle me or my family to nome the administrative 5uite in the new facility to house the SChDOl of Hotel, Restaurant and Institutional ~anagement. I direct my executor, administrator or other personal representative to pay the aforesaid sum within one (l) year frDm the date of my death, without interest if so paid within such period. J acknowladge that the aforesaid use by the University and the University's promise to use the amDunt herein pledged by me for the purposes specified shall each constitute full and adequate consideratiDn fDr this pledge. This pledge is to be irrevocable and 0 binding obligation upon my estate, This Deferred Plcd~o Agreement may also be satisfied in part or in full by payments made at my discretion :'(' UL..,LJ-"'~ ~,,-,_ur I -'.<:." I <:.... . ' J, D 1 LI . ..;>1):0... ';.11.'">:. 111'11". ;11,) LJ'~'''' IIU,IJLJ,j r.I_I.' Deferred Pledge Agreement Page 2 during my lifetime and so designated by me in a writing dolivered to the University at the time Df the ~ift. Any amounts paid by me to the University from the date of this Agreement to the date of my dQath which are so designnted s~all reduce the amount my estate is obligated hereby to pay after my death. Any amounts not so designated shall conclusively he presumed nDt to be in reduction of the amount pledged herein. In the event that the University is a heneficiary under the terms of my duly prohated will or living trust, whether a specific or residuary lORateo, the amount rec~ived by the University under the ter~5 of said will or living trust shall l'Oduce the amount herein pledlted. This A~reement shall be interpreted under the laws of the Commonwealth of Penn5yl~ania. BXBCI/Tp.n this :;..:.~ day of iltttl C!../i.." . 1990. WITNBSS: /7)~~~fr{S.ALJ 'l~^ 1. ACCEPTANce The undersigned, bein~ a duly authorized officer of The Pennsylvania State University, does hereby accept the within , pledge. THE PBNNSYLVANIA STNrB UNIVBRSITY BY: ~.r. · DavId e. Br~-- Asslslanl Treasurer 10/119 fa TOTAL AMOUNT PAID _2.767.00 /~) SK (/j. /, / RECEIVED BY , /;fJ'2~.1 (. >if/(L".-t. ,:/t.. " ~IGNA1'UREJ f / MARY c. LEWIS ..::.'/IC '(/'.', REGISTER OF WILLS -, .-..... UNO. AA 146557 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX . .1~1"21114."1 ACN ASSESSMENT Ii' CONTROL Iii NUMBER AMOUNT RECEIVED FROM: a CLARENCE E ASBURY 101 ~.::, } b J . 00 POBOX 1331 HARRISBURG, PA 17105 ESTATE INFORMATION: ~ FilE NUMBER ~ 21-1996-0582 SSN ~ NAME OF DECEDENT (LAST) (FIRST] ~ HEINZE MARY LUCINDA II DATE OF PAYMENT m POSTMARK DATE COUNTY 177-50-1220 (Mil CUMBERLAND DATE OF DEATH REMARKS JOHN J HEINZE C/O CLARENCE E ASDURY CPA CHECK" 527 SEAL REGISTER OF WilLS M '~._ . -- --" --~_. -_..- -_._- ~-- ----- -_._- --- -.--- - ........,.,.."..- - ""'" M..... _ ......... ~ . ~)' ! II: (, BUREAU or INDIVIDUAL TAXES IHIIt NIIAN(f ,All IIIVI\IOH 1Il11f, .'II~bQI IIANM:\IUJNQ, JIA IIlta-aUI COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ,* e NDTlCE OF INIIERITANCE TAX APPRAISEMENT. ALLDWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX 1('-lhll1 ", 111-"1 CLARENCE E ASBURY PO BOX 1331 HBG PA 17105 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 10-28-96 HEINZE 01-05-96 21 96-0582 CUMBERLAND 101 MARY L Anount Renltted 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 ~ il-EV:is4TEx-"i=p-io7-:96-nlOTicEuO"-YNHEifii'ANCE-TAX-APiiR'A-isEHiN,.-;-"Li:owANcE-olimmm-------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF HEINZE MARY L FILE NO. 21 96-0582 ACN 101 DATE 10-28-96 TAX RETURN WAS: (X I ACCEPTED AS FILED CNANGED RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE APPRAISED VALUE OF RETURN BASED DN: ORIGINAL RETURN 1. Red est.t. (Schedule AJ tll 2. Stocks end Bond. (Schedule 8) (2) 3, Closely Held stock/Partnership Interest (Schedule CJ (3) 4. Hortgagel/Not.. Receivable (Schedule OJ 14J 5. Cash/Sank Dapollts/Hlsc, Personal Property (Schedule EJ IS) 6, Jointly Owned Property (Schedule fl (6) 7. Transfers (Schedule G) (7) 8. Tot.l Anet. NOTE: To insure proper credit to your account, subnit the upper portion of this forn with your tax pay"ent. .00 52.887,00 .00 ,00 26.025,00 ,00 ,00 (8) 78.912.00 APPROVED DEDUCTIONS AND EXEHPTIONS: 9. Fun.~al Expans../Adn, Costs/Hlsc, Expenses (Schadula H) (9) 10. Debts/Hortgag. liabiliti.s/lians (Schadula I) CI0) 11. Total Deductions 12. Hat Valua of Tax Ratu~n 13. Charitabla/Govarnmental aaquasts (Schedula J) 14, H.t Valua of Est.t. Subject to Tax 7.798.00 25.000,00 1111 1121 (13) 1141 3;>,7QR no 46,114.00 ,00 46,114,00 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. Anount of lina 14 at Spousal rat. CIS) 16, Anount of line 14 taxabla at linaal/Class A rat. (16) 17. Anount of lina 14 taxabla at Collat.~al/Cl.ss a ~at. C17J 18. Principal Tax Due NOTE: .00 X .00= 46.114.00 X .06= .00 X .15= 1181 ,00 2.767,00 ,00 2,767.00 TAX CREDITS: PAYHENT DATE 07-25-96 DISCOUNT (+1 INTEREST 1-) .00 AHOUNT PAID 2,767.00 RECEIPT NUHBER AA146557 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 2.767,00 .00 .00 .00 . IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATIGN OF AODITIDNAL INTEREST, ( IF TOTAL DUE IS LESS TIIAN Sl. NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI. YOU HAY BE DUE A REFUNO, SEE REVERSE SIDE OF TillS FORM FOR INSTRUCTIONS. I r ~. RESERVATION: [Itata. of decadent. drlni on or be for. Dec..ber 12, 1982 -- If any future Intere.t In the a.tate II t,an,f.rrad In po.....lon or enJoy..nt to Cia.. B (collat.ral) beneflclarl.' of the dlCldlnt .,ter thl ..pitatlon of nny ..t.t. for 11f. or for YI.r., the Co..anw..lth hereby a.pr.ssly r...rv.. the right to apprals. and a..... tranl'., Inherltftnca f.... at the lawful Clas. B (coll.t,r.1) rat_ on any such future Inter..t. PURPOSE OF NOTICE: PAY"ENTI REFUND eCR}: OBJECTIONS: AD"IH lSTRAT1VE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requlr...nts of Section 214Q of the InherItance and E.tate Ta. Act, Act ZZ of 1991. 12 P.S. Section 2140. c.t8th the top portion of thl. Notle. and sub.lt with your pay..nt to the Regl.ter of Will. printed on the r.v.r.. wid.. "Make check or .onay ord.r pllyabla to: REGISTER OF MILLS, AGENT All pllyaants recalved shall flr.t ba applied to any Intere.t which .ay be dua with any raaalnd.r IIppllad to the ta., A rafund of a tll. cr.dlt, which wa. not r.qu..t.d on tha T.. R.turn. ..y b. r.qua.t.d by co.pletlng an -Application for R.fund of P.nn.ylvanla Inharlt.nc. .nd Estllta f..- (REV-IlI1), Appllc.tlons ara avallabla at the Dfflc. of the Ragl.t.r of Wills. any of the 21 R.venua DI.trlct Dfflc.s. or by C.lllng tha .p.clal 24-haur an.w.rlng s.rvlc. n~b.r' for for.. ard.rlng: In Pannsylvanl. 1-800-362-20S0, out.ld. Penn.ylv.nl. and within local HarriSburg ar.a (117) 787-8094. fDOI (717) 172.22S2 (H.arlng Iap.lr.d Dnly), Any party In Inter.st not satl.fl.d with the appralsa..nt. allowanca or dlsallow.nce of deduction.. or .....s..nt of tax (Including dl.count or Int.ra.tl as .hown on thl. Hotlce .u.t obJact within .Ixty (60) d.y. of r.celpt of this Hotlce by: "wrltt.n protnt to tha PA Dapart.ant of Rallanue. 80ard of Appeal.. D.pt, 281021. Harrisburg. PA 111za-loll, OR ...lactlon to halle the .attar detaralnad .t audit of tha account of tha personlll repr.santatlve. OR .-.pp.al to tha Orphan.' Court. Factu.l errors dl.covared on thl. .....s..nt .hould be addras.ed In writing tal PA D.part..nt of R.vanua, 8ur.au of Indlvldu.l T.xa.. ATfN: Post A.s..s.ent R.vlew unit, Dept, Z80601. Harrisburg, PA l11Za-0601 Phone (717) 787-650S, Saa p.g. 5 of tha booklat -Instruction. for Inh.rltance f.. Raturn for a R.sldant D.cedant- (REV-ISOI) for an explanation of adalnlstratlv.ly corractabla .rror., If any tax dua I. paid within thraa (3) calandar .onths after the decadent's death, a five p.rc.nt IS~) dl.count of tha tll. Pllld I. allowed, fha IS~ tax a~e.ty non-participation panalty I. coaputed on tha total of tha ta. and Int.ra.t IIssas..d. and not paid bafora January 18. 1996, tha flr.t day aftar tha end of the ta. aanesty parlod. Ihl. non-participation panalty I. appealabl. In the sa.a .anner and In tha the sa.. tl.. periOd a. you would appeal tha lax and Inlar..t that ha. b..n essaw..d as Indlcat.d on Ihls not Ie., Intarnt Is charged beginning with first day of delinquency. or nln. (91 eonths and on. et) dillY froa the data 0' de.th, to tha data of paye.nt, Ta... which becae. dallnqu.nt b.for. January 1, 198Z baar Int.r..t at th. rat. 0' .Ix (6~) p.rcent per annUM calculated at a dally rata of ,000164, All ta... which b.cae. d.llnqu.nt on and .fl.r January I. 1982 will baar Intera.t at a rat. which will vary froe calendar y.ar to cat.ndar y.ar with that rata announced by tha PA D.part.ent of Revanu.. Ihe applicable Int.re.t rate. for 1982 through 1996 aral '!!!!; tnterest Rate Dally tnternt Fector !!!! Intarest Rat. DAily Intera.t ractor 1982 20;( .000S"8 1987 9X .000Z47 198] 16i! ,000418 1988-1991 m .000301 1984 m ,000301 1992 9X ,0002'" 1985 13;( .G001S6 1993-1994 IX ,000l'lZ 1986 lU .000214 1995-1996 9X ,OOO~H -.tn"re.t Is cnlculated .. foUows: INTEREST = BALANCE OF TAX UNPAID X NUnBER OF DAYS DELINQUENT X DAILY INTEREST fACTOR --Any Hotlca Issu.d after tha tax becoa.. d.llnquenl wUl raflect an Int.ra.1 calculation to f I' I..n 11"1 da.. b.yond the data of th. asse.s..nt, If payeant il .ad. aftar the tnter..t coeputatlon data ,hQwn on tha Hotlce. additional Int.r..t aust b. calculat.d. STATUS REPORT UNDER RULE 6.12 Name of Decedent: NARY I.U ImIN7.E Date of Death: JANUARY 5 . 1996 Will No. ,~J -qL, ...SlI',;l.. Admin. No. 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 x No 2. If the answer is No, state when the personal representative reasonably beiieves 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 X 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 approvals of Cerk of the Orphans' Date: ~~'1 (~~ :'~~ ,[ J..: c6.;..g na: eu r e \ JOHN J. HEINZE Name (Please type or print) P.O. BOX 7 BOILING SPRINGS, PA. 17007 Address '" c,. "- "J '::1 '..;J '~. ,. , ;3~ , ,'J ::i 00 ( 717) 258-3211 Te I, No. Capacity: Personal Representative Counsel for personal representative (MAH: rmfl AM3) ,