HomeMy WebLinkAbout96-00633
PETITION Hm PIWUATE llnd GHANT 01' ....:rnms
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rhl' pClilion of 1IIl,' lImk'l,i~m.'\lll"Ill''':ltully II...I"I.....L.1I1' that:
"'HII pl'lilhll1l'r(\). \\IUll,!all' IN ~l'.H'" ,,1 :ll!l' tU \lldl'l an the l'\,,'1.:1I1 (- ,. "u ______.______ m'll1~d
inlhc la'l \\111 tlllh,,' .IIH1\l' t1l'l'l'dl'I1I, d,lll'd /.I;:~ '" A J~~ _ ___ ___.___~.____.f 19_t.z..'
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t\lall.'rd\."\ilnl nl~'llIll'lilll~'l". l..~, 1~'IlIlIKI"lillll. dr.tlh Ull'\l'(UIUI. cIC)
1>l'~l'mll'1I1 \\a\ domidh.'d al dc:uh in ~n.C~(.~~.!...A~,"'A-'1(!..____.._ _ County, P~nns)'lvania, with
IL'.~'..':_"__ la,t family or principal re,idclh:C al ___~LJ~."J__(::12~~'::'~ A .1."_ .-I__/;.?1,Jc hif '.'1' '.. J J6'.:~~
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Ill-I '1Il'~'I, 1I11Illh~'1 alld 1II1111~'ir.lll1~ I
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Ik"e11llcnl, Ihen __~ S"O__ yea" or age. dkd _~_~...:,_L I
al _ j 'I 3fl! 1/__M~:!r...L!L<:'.fJi~~,J <5 '-~g/.,_...22'-_/ ;',., ~
h,el'l :1\ rulh\\\\. de"ede," did nOlmarry. wa, nut ili\'or""d and did nol ha\'e a ,hitd born Of adoplcd
ahef e,e""lion or Ihe \I ill orrer"d rur I'rob:lle; wa\ nOllhc \'klim or a killing and \\'a\ Rc\'cr adjudkalcd
ilh.:nmpl'lcltl:
Ik~elllkl1t at dealh owncd propcrly wilh c!'ItimatcLI valuc!'l a!'l 1'0110\\":
(II' domidlcd in Pa.) AlIl'e"'1lIall'rol'erlY
(I I' nol dumidlcd in Pa.) pc"un:lll'roperlY in Pcnn'yhania
(II nOI dumkilcd in I'a.) l'e"'llIall'fOl'erlY in l"onnlY
\'ahll' of real ....'latC in Pcnn'yl\';tnia
,iluall'd ;,h follow,:
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\\ IIEREFORE, I'elilioner(" re'l'e"lrlllly reqIlC\I!>) Ihe proh:llc or Ihe laS! will :1I1d codicil(s)
prc,entcd hcrc\\ilh ilmJlhc gran I of kllcr'._---;t~~.b.,.,',v~~!..~
11\."lilllll'1l1;1I~: adltlllll'ir.llh\!1 ":.1.01.; allmini\ualion d.h,n.".I.".)
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OAnl OF PERSONAL REPRESENTATIVE
COMMO:'l;WEAI.TII OF l'EN:'IlSYI.\' Al'iIA
COl' :\T\' OF ~___ CUMBERLAND
1
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The I'l'litiul1cJ(..) "hmc.nal11cd ..wcar(,} or arnrmh) that thc 'IatCl11l'nl\ in (hc foregoing pelition arc
UII\.' and 1.'11rn..~t 10 (hl' hl',lof till' ~IH1\\lcugc ami helief or pl'lilioncr(,) ami that iI!\ personal reprcsen-
tati\cl"'ll,r Ihl' ahoH' dc\.'cdl'nl pClitiolll'J(!'rI) will \\ell Hnd ~r,uly adminiloolcr the C\I:'HC ih.:cordillg 10 law,
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S\\lll." Il' or. at'filmcd and !'rIlIlhl.ril~'l'd~7 lo-~_~. ~ . .~(.--r:_. ~
her.,,'e 11'" lhi, . _. ~.J}IH_ _ __ da~ ur ~ ________ ':i
"::::)v/"-"~eij.AUGUSL_-- ra~JlJ 1. {}t~ ~
j I{lLllJ.' '(jJ..t.(ct.v[U'YJIJ - u I '>1-J,J.-: ~
II" I' !MARY C. LEWIS IIl'g;II<'r'.L.-O--- -- 2
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MARY C. LEWIS
FEES
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3.00
Probate, Letters, Elc. ......... $
Shorl Certifieates(1) .......... $
~'1:~unciatiDR ................ $
$
TOTAL _ $ 33.00
Filed ..... .~~~~.S.~ . ~ ~'" . m.~ . . . . . . . . . . .
ATTORNEY (Sup. Co. 1.1>. No.)
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COMMONWEALTH OF PENNSYLVAIIIA _OEPAnTMlNI OFIIEALTH. VITAL nEconns
CERTIFICATE OF DEATH
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. Female
Mildred E.
lich
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Penosylvania
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III Clerk II
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4934 Simpson Ferry Road
.. Mechanicsbur9. Pa 17055
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mcI~gene M. Baldwin
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LAST WILL AND TESTAlfENT
011'
IfILDRED E. TIOHY
I, IfILDRED E. TIOHY, 011' PHILADELPHIA,
DECLARE THIS TO BE ffY LAST WrLL, HE~EBY REVOKING
PRrO~ WILLS AND OODrCILS.
i
PENNSYLVANIA,
ANY AND ALIJ
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FIRST: I DrltECT THE PAYffENT 011' THE EXPENSES OF I
LAST ILLNESS, FUNERAL EXPENSES AND JUST DEBTS BE PAID OU~
ffY ESTATE. I
SEOOND: I Glr-E, DEV'ISE AND BEqUEATH ffY ENTIRE I
ESTATE, CONSISTING OF ALL PROPERTY, REAL OR PERSONAL, WHE~E~
SOEr-ER SITUATED, TO ffY HUSBAND, WILLIAIf G. TIOHY, IF HE I
SUR.Vlr-ES ffE BY SIXTY DAYS. I
I
SHOULD ffY HUSBAND PREDECEASE IfE O~ 1I'.A.I L 2'0
DAYS, THEN I GIVE, DEVISE AND BEqrTCATH I
ffY SON, EUGENE BALDWIN, OF IfECHANICSBUlt.G,
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FOURTH: I NOffINATE, CONSTITUTE AND APPOINT IfY I
HUSBAND, WILLIAIf G. TIOHY, AS EXECUTOR. OF ffY WILL. SHOULB i
ffY HUSBAND BE UNABLE OR UNWILLING '1'0 SO ACT, THEN I APPOINT i
ffY SON, EUGENE BALDWIN, AS ALTElt.NATE EXECUTOR OF ffY WILL. I
,
HEItEUNTO SET ffY HAND "
'1'0 THIS ffY LAST WILL
THIRD:
SUlt.VIVE ffE BY SIXTY
ffY ENTIR.E ESTATE '1'0
PENNSYL VANIA.
IN WITNESS WHEREOF, I HA VE
SEAL THIS 5TH DAY OF If ARCH, 1969,
TESTAffENT WRITTEN ON ONE PAGE.
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SIGNED, SEALED, PUBLISHED AND DECLARED BY THE i
ABOVE NAffED TESTATlt.IX AS AND FOR. HER LAST WILL AND TESTAffENf.
IN OUR PRESENCE, WHO, IN HER PRESENCE AND AT HE~ REqUEST AN~
IN THE PRESENCE OF EACH OTHElt.,HAJf'E:HEREUNTO SET OUR HANDS
AS ATTESTING WrTNESSES.
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ADDRESS
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_ 12'1. ()
ADDR.ESS
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: ,~/I?~ / E; /t e-,{v
f~/ yl, ;'
Date of Death:
Will No. 1'l<7{, - 006 3J Admin. No.
To the Register:
I certify that notice of beneficial interest required by
Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to
the fo1l9wJ,ng beneficiaries of the above-captioned estate on
il,!..! 6
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Address
/ 3 //,// ftrrlc' .#f{.c,~"I/::'s.,0/,. ?4" /A>JY-
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except /7CJ""'~.
Date:
IIP6,#,b
,
~..P-.....-/4~ ~--&:~
~re
Name h Tt'"".~ py: R ~VN7
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Address 1,/3 //.// ,,4r/~.
/ffi'c"~o:'/C..r;:(/"-f, ?r- //,oJ./-
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Telephone.l2!.2l 761'-.3("/0
Capacity: ~ersonal Representative
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Counsel for personal
representative
COMMONWIALTH OF PEi>fNSYLVANIA
COUNTY OF CUMIERLANI)
II:
_ .ccording to I.w, dopa..' .nd ..y. th.t ho --~--_._-- ~- -~-
~. ~. .~_ . ._~ _ of tho E...to of -
I.t, of .- -----. --~-, Cumb.rl.nd County, P.., d.c....d .nd th.t the
within II .n Inventory m.do by . ... . n_'_~~ ..h ._- -~ ---~-, tho soid
of the ontiro est.to of soid docod.ot, con.isting of .11 tho pe"on.1 propdrty .nd rool estote, except re.1 estete ouhid.
the Commonwe.lth of Pennsylv.ni.. .nd th.t the figure. oppo.ito e.ch item of the Inventory repre.ent it's f.ir v.lue
II of tho d.to of decedont'. d..th.
b.ln9 duly.
_ .od .ubscrib.d b.foro m.,
Euclltor . Adminhhator
19
Add,."
Dote of Dooth
Doy
Month
Yu,
INSTRUCTIONS
I. An inventory mu.t bo filed within three mooth. efter .ppointm.nt of pe"on.1 reprosentetive.
2. A suppl.ment inventory must b. filed within thirty d.y. of di.coyery of .ddition.1 essets.
3. Addition.1 .hoots m.y bo .tt.ched .. to p."on.lty or re.lty
4. S.e Article IV, Flduci.rio. Act of 1949.
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Inventory of the roal and personal eslale of
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'OR OATIS Of DIAfH AnER 12/31191 CHICK HUI
If A SPOUSAL
POYERTY CRlDIf IS CLAIMID [ I
fill NUM8ER
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
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COMMONwt"UtI Of PINN~YlV"NI"
DIP".'MINlOf IH\lltWI
DIPl 2BOllOI
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DICfDIN1') NAMIII"!.', '11111, AtW MIOO~ IWIlAII,..
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,OCI.l>"U"r...."UMII. - ~ ~ 0'1[ 01 01'''' '. 0 All 01 111\11 ,
Ib":2.-0'l~ Gf 1.l- ')(I-t'~JL _C'!:v..L!.L
I" A"\lutlll 'unlw'NG'~U' 1i'''''III'''l.''' "ID lol'OOlI ""'''I) !.O(IAL !.ICUIIII' rlUMI11l
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of f' .J V J:" ..../.J(.., /~4'r'//.' ,.
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CO~1^"6S7i ;(to"r,~f'fliil%"'O"'-I-h
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YEAR
21
COUNTY CODE
NUMBER
[llfIOIW'!) (UMrLI If AUOII!)!)
o I. Original Relum
o 4, limited Estale 0 40. FUTure Inlerest Comp,omise
(for dot~s of dealh after 12.12.821
o 6. Decedenl Died Telolole 0 7. Decedent Mainlained 0 living Trust
(Anach copy of Willi (Anach copy 01 Tru"1
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO.
NAME COMPLEtE MAilING "ODU!.S
1'13 11-'/1" 4_'""-- _ _ _
4t'JL~,t-"''''t.cJ 61- -:}", ?~ //&J J
[J 2. Supplemental Relurn
[J J.
05.
Remainder Return
Ifor doles of deolh prior 10 12.13.82)
Federal Estale To. Relurn Required
_ 8. Tolol Number of Safe Deposit 80.1lI
1. Real Eslole (Schedule A) 11) 11'"',,~I"'I'~
2. Slach and Bond. (Schedule BI (2) "C.'oI'\.~
3, Clolllly Held Slock/Portnenhip Inleres' (Schedule q P) """.."1...(.
4, Morlgaglll ond Noles Receivable (Schedule 01 (A) ,..,,'..... ""--'
5. Calh. Bonk Depolill & Miltellaneous Penonol Property (5) 2.~.nr, <'V"
(Schedule E) ,
z J. 77')-' ~f-
0 6. Joinlly Owned Property (Schedule F) (6)
~
= 7. Tran.re.. (Schedule G)ISchedule l) (7) II"'?v,.. J.t-..
I: 8. Tolol Grou Auell (tolallinlll 1.7)
Co.
00( /, It';, r1.-
u 9. Funeral e.~enses, Adminislrolive Costs, Miseellaneoul (91
w
'" Expenses ( chedule H) .
10. Debls, Mortgage liabilities, liens (Schedule I) (l0)~ NC./r
,
11. Total Deductions (10101 Unlll 9 & 10)
12. Net Value of Estale (line 8 minus line 11)
lJ. Charitable and Governmenlal 8equests (Schedule J)
lA. Net Value Subject 10 Tax (line 12 minus line 13)
(B)
6, Iff. lJ-
.
(11) /~ :,-/1, J..
(121 -s: ..T11.Jr
,
(lJ) o.e'v'
(14) ~" ..0/
x,_= (>,<"Z""
x .06 = CJ.c-'"C"
x .15 = CJ r'V'
(lBI ".OZJ
(19) O. l'V'
(20) I.", cf?--
(21) C'...C"~
(21A) " . '7'
(2IB) 1..) .~"'Z/
15.
16.
17.
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.... 19.
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21.
Spoulol Transfen (for dallll of death after 6.30.941
See Instructions for Ar,plicable Percenloge on Reverse (15)
Side, (Indude values rom Schedule K or Schedule M.I
Amount of line 14 laxoble at 6% role (16)
(Indude valulll from Schedule K or Schedule M.I
Amount of line 14 laxoble at 15% role (171
(Indude valulll from Schedule K or Schedule M,)
Prindpal'ox due (Add lox from lines IS, 16 and 17.)
Credits Spousal Poverty Credil Prior Payments Diseount
Inlerelol
+
+
If line 19 is greater Ihon line 10, enler the difference on line 20. This is the OVERPAYMENT.
gO
Check here if you oro requesting a refund of YOur overpayment.
If line 18 is greater Ihon line 19, enler the difference on line 21. This is the TAX DUE.
A, Enler the inlerest on the balance due on line 21A,
8, Enter the 10101 of line 21 and 21A on line 21B. This is Ihe BALANCE DUE.
Make Checlc Payable 'a: Reglat., of Wills, Ag.n'
~ ~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH -<(-<(
~~der penalties of perjury. I declare that I hove examined this return. including accompanying schedules and stalements, and to the be'l of my knowledge and belief,
IllS true, correct and complele. I declare that 011 real ellole has been reporled 01 true markel value. Declaralion of preporer other Ihan Ihe personal repreloenlalive is
based on 011 information of which preporet has any knowledge.
SIGNATUU Of N IlEsrON!.IIlE fOil ~G R,?; . AOO.U!l!l _ OAT( ~
"...,.?:. ~4"_ /'f-3 #. /r' .(.,...~ /lkc /c, '/IC" J j,.,~ m I";tel S 1./3//'.6
SIGNATURE PIl(rAllfll OlHfll: THAN II[PIlUENIAIlV( AOOIl(!l!) -- 7~ OAT(
Act '48 of 1994 provide. for Ihe reduction of Ihe lax role. Impo.ed on Ihe nel valuo of Irande,. 10 or for
Ihe u'e of Ihe 'pou.e. The ralu a. pre.crlbed by Ihe ,Ialule will be:
. 3% (.03) will be applicable for o.Iale. of decedenll dying on or after 7/1/94 and before 1/1/96
. 2% (.02) will bo applicable far e,Iale, of decadents dying on or aftar 1/1/96 and before 1/1/97
. 1% (.01) will be applicable for 0,1010' of decedenll dying on or after 1/1/97 and beforo 1/1/98
. Spou,al Irander, occurring on or aftor 1/1/98 will be exempt from Inheritance 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. retoin the use or income of the property Ironsferred, .......................................................
b. retain the right 10 designate who sholl use the property Ironsferred or its income, ...............
c. retain a reversionory interest; or ...................................................................................
d. receive Ihe promise for life of either poyments, benefits or care? .......................................
2. If death occurred on or before December 12, 1982, did decedenl within IWD years preceding
death transfer property without receiving adequale con,iderotion? If death occurred alter
December 12, 1982, did decedent transfer property within one year of deoth without receiving
adequate consideration?..... .............. ........... .................... ........... ........ ................ ....... ......
3. Did decedent own on 'in trust for' bank account at his or her death?.....................................
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDUk,E G AND FILE IT AS PART OF THE RETURN.
.! "'l':J
f-/:'
, \~. ~
t f- L .
'.
, ., ~. .... .....' .... .,- .
1I....(sott.tIJ.l1J
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
Ploaso Priol or l' 0
FILE NUMBER
/7yt -00/.33
~:'~'~l\
,~
COMMONWEAlTH Of PENNSYLVANIA
INHII.TANCI TAX InUIN
IlSlDINT DICIDINT
ESTATE OF
/?/f1cl'1l-</ ~ T..J(
(All proporty lolnllv-ownod with tho Right of
rvlvonhlp mUll b. dl.cfo.ed on Schedule F)
ITEM
NUMBER
VALUE AT
DATE OF DEATH
DESCRIPTION
I
:;l.
:3
/'j?~ 8,,/,,/: J~}'Ie<rfc
~ ~T7. ...'?J""
~ //I";/i., , <:..--
I" 20~, ~
k ""J..A./")"
.2rv, <-'7r-
TOTAL IAlsa 0010' 00 lino 5, Roea ilulatian) S
~ .rr~. cmr
(Attach odditionol ey,'" )C 11'" .h.." if mar. 'pace i. needed,)
11'lI11O'I1I.IUIII
9.,t.9_
1::_
COMMONWrAl1H O' PENNSYlVANIA
INHUIJANC[ fAX IUtuRN
_(SIDEN' orCEDlN'
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
.$''I:/.''e j L~ kAT
-_.,.~..,---_..._--'_"_.'"
Jolnt'"nonl(.).
FILE NUMBER
I 'i '1t- () 0 C 3::;
NAME
A. hifer1e A' 8, Il~/""
ADDRESS
1'1 3 j/- / / L'"" '-!-
/%e c' 4.,,,,. C, 60' '," ;F';f'
//
/;7,'.>7-
RELATIONSHIP TO DECEDENT
SO...........
B.
C.
Jolnlly-ownld proplrty:
ITEM LmER DATE
FOR TOTAL VALUE
NUMBE JOINT MADE DESCRIPTION OF PROPERTY DECD'S DOLLAR VALUE OF
TENANT JOINT OF ASSET % INT. DECEDENT'S INTEREST
1. "hft2. C j,,,, f:;"J /Ice!. #ltJ.-.I~.>- '1U; 3 6 .$"07., ~l{:l. 6.,f-
? If" 'I '-
#.:./fo M B..,k
.2. tj,Az- M~" /kn 8<.,,{;. - Ji""'J.f 4 j.2t..S"3 f"v/o ~;ztJ2l
l'Ie~/. /I- ylI6-7$"C//7
TOTAL (Aha enter on line 6, Recapitulation)
(IF more space is needed inser' addilionol sheels of some size)
s J. 7/fJ: fJ-
U...."IU.. 1111,
ESTATE OF
"~k~:9,,
_ ~f!lu..
COMMONwEAlTH Of P[NNSY~V.ANI"
INH(RllANCI TAX RETURN
RESID[NT DECEDENT
I
J
h~___
DESCRIPTION
L .PI.a.. Print orTypo
FILE NUMBER
1 /71t,- OO(,:.?J
~- ---~-----r------ ~----~
i AMOUNT
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
/?/,'k/--~i .1:.:
ITEM
NUMBER
A. Funeral Exp.n.."
1.
B.
~e/'.) ,r:;:;/)~t/ 176- (?/ ..h-1G.
31 C; I~"/I J;.':
/~d /?CJ]-
/?1e (' 4 (',,""C5 0'''7'/ /T
~ 70'?-[2-
i
Admlnl.tratlve Call"
1.
Personal Representative Commissions
Social Security Number of Personal Representotive:
Yeor Commissions poid
0" ,;-zr
2. Allorney Fees
4.
C.
1.
2.
3.
4.
5.
6.
7.
8.
3.
Family Exemplion
Cloimont
Address of Cloimaol al decedenl's death
Slreel Address
C~ ~-
Zip Code
Relalionship
Probale Fees Co / / I /"
...- ~k~t LE>.
3c;..cro-
MIscellan,oul Expense"
C~!.(cf:-
c-
.
g./c'j-~ /~c/-;......-" "'.....--
"/
'I2/. Cn.---
TOTAL (Also enler 00 line 9, Recopilulalioo)
(II more .pace II needed, Insert addltlonollheotl allame .1...)
s ~ /6'f.rz.-
. - . ._,-t.__......._...
, -
IIv'IIII"I"" ,.
(()MMONWIA,IH 01 PI""'"V4NIA
INHIIIIA"(lI'" IlIU'N
.nIOINIOICIOINI
l MORTd.:.~-r~~~f~U'.:'JD U,NS . Pl.". "",..r,,,
__~__,___r:~;~R_ 0 "633
ESTATE OF .Iet, I
m Fl"~
[
;7;c4-
I
ITEM
NUMBER DESCRIPTION
AMOUNT
1. dell /?r~,,~c- ft ~t",~
2. .5~C\.."s C~"'l"'- c_,..(
.3. r;".f";- t(",IP;1 //YnJh..... C'-An?" e.
.y-. ~..J? I j=?-f) w"- / /. 'jf'-o,.,:!-
f' I.t
77~ Ir
:2.7?-3. oft'
bOO. ozr
TOTAL IAho enler on line 10. Recopilulolion)
,,, mo,.. spoce j, needed, inter' oddilionol sheeh of lome size.)
S
3?lb' '10
i -. 0".' -..
~ ~
- .. -.- ~ -.." -
PREVIOUS BALANCE I. .'~J 0.1 r~6N POST OFFIC[ BOA ~6J~'ili
PURCHASES/ADJUSTMENTS ,CO. CHARLOTTE. NC :!8::!56-J96G
CASH ADVANCES .00. CUSTOMER SERVICE PHONE " 1-800-359-3862
CREDITS .01- AVERAGE PERIOOIC COllllr'-'''C'jD,",C ANNUAL
PAYMENTS 1,72J.OJ- DAILY BALANCE RATE .....PIUM PERCENTAOE
FINANCE CHARGE .01+ ptllcrr,TAr.l"A'f RATE
OTHER CHARGES .00+ CASH ADVANCES
'.85 1. 179 t I IJ.1S 14.15
NEW BALANCE .00 MASTERCARD PURCHASES
GOLD ",246.87 1.1791 ' 14.16 lJ.15
'THE PERIODIC ATE MA Y ARy
ACCOUNT NUMBER CREDIT LIMIT AVAILABLE DAYS IN BlUING OATE PAYMENT MIIlIM?M
CREDIT BILLING CYCLE OUE DATE PAYMEN DUE
5410-5320-0015-0909 "1,250 '000 29 07/09/1996 '.00
5415-9610-3102-0663
FOR YOUR CONVENIENCE. OUR PERSONAL REPRESENTATIVES ARE AVAILABLE
BY CALLING 1-000-J59-3062 -- 365 DAYS A YEAR, 24 HOURS A DAY.
POSTiNG TRANSACTiON
DATE DESCRIPTION OF TRANSACTiONS DATE REFERENCE NUMBER AMOUNT
HO I DAY HO I OAY
07/02 PAYMENT - THANK YOU 07/02 C7541053618494J1DD210059 1,723.D4PY
07/09 "FINANCE CHARGE (BASED ON PERIODIC RATE) 07/09 75410536191000191064201 .01
07/09 SMALL DEBIT BAL W/D CASH 07/09 7541053619100D191D79J57 .0ICR
cci>~~'" dlt.ch and nlUfn bottom po,llon wilh your paymen1. NOTICE: See ravCIIU Side fOf impoft.nt information.
_________________ ____ _____ _ ____ ____ _ __ _ _____ _ _ __ __ _ _ __ _ _-!~'!..I!!!...O~9..! _ _ _.
MASTERCARD GOLD
PAYMENT COUPON
ACCOUNT NUMBER
5410-5J2D-0015-0909
AMOUNT ENCLOSED
$
NEW BALANCE
$.00
MINIMUM PAYMENT
$.00
DUE DATE
Please mark any addresslname changes below:
VB 74 83065
MILDRED E TICHY
4934 SIMPSON FERRY RD
APT #3
MECHANICSBURG PA 17055-3630
MAKE CHECK
PAYABLE AND
MAIL TO
1"11.,.,11,1,1,,,1.1,,.11,,1.1,.11,,1.1,1,,,1,.,11I
CARD PRODUCTS CENTER
POST OFFICE BOX 2357
BRUNSWICK, GA 31521-2357
..
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.~... '.;-~ Hi'
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~~~~~"
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8541596HOOIOT9HJ2 PAYMENT - THANK YOU
'FINANCE CHARGE. PURCHA~ES $23.84 CA~H ADVANCE
TOTAL
FINANCE . NEW BAL,lNCE
CHARGE
2698.03 1000.00 0.00 0.00 0.00 0.00 25.01 1723.04
AN AMDUNT FOLLOWED BY A MINUS SIGN (-) IS A CREDIT OR ^ CREDIT BALANCE UNLESS OTHERWISE INDICATED.
." . ;~.-' ':. :-"
PREVIOUS
BALANCE
PAYMENTS .
CREDITS
PURCHASES DEBIT LATBOTHER
. AND ADVANCES' AOJUSTMEtITS' CHARGES
yOU WERE NOTIFIED IN A LETTER EARLIER THIS YEAR THAT YOU
WOULD RECEIVE YOUR NEW FIRST UHIOH CREDIT CARD DURIHG THE
MONTH OF APRIL. PLEASE HOTE THIS REISSUE DATE HAS BEEN
MOVED TO JUNE 1996. YOU MAY CONTIHUE USIHG YOUR FIRST
FIDELITY CARD UHTIL YOU RECEIVE YOUR NEW FIRST UHION CARD.
Send Inq,uirteS To:
~
:W~
TYPE OF CREOrT TO
WHICH RA TES APPLY
PURC~"SE3
"O.......NCES
GFC
See reverse side for impcrtant informaticn.
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ACCOUNT SUMMARY
-
1..,111,..111""1,\"1,1",11..11.,,,1\,1\.,,,,11,,1,,1,,\\,1
IHI.DRED TlellY
" 3
4Q3(, 5 HIPSDlI FIIY RD
r.IECIlAIlCSDRG PA 17055-3630
p"''.'lnll.' \lil.\!1l,"!
r:l'/Il\l!I\I~. :'... d,,'ht';
PllrL '1,1:',"~i
1~1l\1'f \:t1:"I,I"';
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FINA~lc:I:.CI~~~E____._--- -~lj-,:
tlt!':/lpLlIll:\l
5377. 18
St;lliJdullJtl p;wmt1nt:
SZHO
-
-
-
Mlnlmlll1l dllo' 50.00
Duo dalo, April 6, 1996
HELPFUL INFORMATION
Avail"lIlo Credll: 56,078
Ir thl! ~motlllt pf AV:lil;ll1lt! Crtldit IS not
5l1ffidcllt, or VOU havo ;l qtlDstiOn, Crill:
1.800.3017.8414
M . S 9.9. SUN 12.5 ET
c\'lail :lllV hilling error naliens to:
6 NESH INTRPLX .~2lj
TREVOSE PA 19053.0687
-
-
TRANSACTIONS
FIlII 21 p.\\'MENT. TlM,~K I'OU ~
. -S2J.OO
TIMELY OFFERS FROM SEARSI
Keep your C",(t~I1I"n "lI1nin9 like" Cr"!tsl1l,,n. Bring your
Craft~aniln lawnl1\ower in for a pre.seasol1 tune.up. (;111
'.800.4BH.1222 for 1110 service 10CMionne"resl YOII. For
Cr"II~I1I"n tracto," "'1<1 riding mowers c,,1I1.800.473-7247.
Please inchHta your ;\ccount
I1llmher \"Jith :lny correspomlonce.
-
SEARS BONUS CLUB
Grear Newsl Now Ihe Soars Bonus Clull
pays VOll h:"lc1:. in money-saving
certific~te~ every time your S13ars
occounl pllrchilsOS bllild lip 10 5300 or
moro.
FINANCE CHARGE
SCHEDULE
AveraOO
Daily
!iala"r.~
over SO.OO
over $0.00
ANNUAL Monlhly Average FINANCE
PERCENTAGE Periodic Daily CHARGE
RAJE Rate_ B"I""r.e --
13.0% 1.D- S564.93 S8.~7
21.0'~:' l,7S~/o J04.16 7.07
Tal'" S155J
Sears
5t~;,\ls National Brink
J ':0
NOTE: See oilier ~i(le for imporlant information
.. -. - - -- - - - - - - .- - -- - - - - - -- - - - - - - - - - - - - -
16-- /10 - n
BUREAU OF INDIVIDUAL TAKES
INIlfRI1ANet fA)! DIV1SIOJll
DElll, :.0&01
ItURI'SBlJlm, II", IIHI-OhDI
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TlK
APPRAISEHENT. ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT Dr TAK
EUGENE M BALDWIN
143 HILL LN
MECHANICSBURG PA 17055
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
11-19-96
TICUY
04-01-96
21 96-0633
CUMBERLAND
101
(.
.-
;~-
'!I.lhl 1111' III.'"
MILDRED
E
~"OUnl R..lll.d
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-EX--"FiQoY:96Y-NoYicE--oi'--fNHEifiTAN-Cn:.AX-i\-ppiiiiisEHENi'-,--"Li-oWAiicE-OR---mm--n----
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF TICHY MILDRED E FILE NO. 21 96-0633 ACN 101 DATE 11-19-96
If an assessment was issued previously, lines 14, 15 and/or 16, 17 and 18 will
reflect figures that includa tha total of ALL returns assessed to data.
ASSESSMENT OF TAX:
15. Anount of Lin. 14 at Spous.l rat. (15)
16. AMount of Lina 14 taxabl. at Lin..I/Cla.1 A rat. (16)
17. AMount of Lina 14 taxabl. .t Collat.ral/CI... 8 rat. (17)
18. Principal Tax Due
TAX CREDITS:
PAYHENT
DATE
TAK RETURN WAS: 1 X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..l Elt.t. ISoh.dul. Al III
2. Stock. and Bondi (Schedul. 8) (2)
3. Clos.ly Hald stock/Partnership Int.r..t (Schedul. C) (3)
4. Hortg.gas/Not.. Receivable (Schedule 0) (4)
S. C..h/Bank Deposlts/Hise. Pa,.sonal Proparty (Schadula E) (5)
6. Jointly awn.d Pro..rty (Soh.dul. FI 161
7. Transfars (Schadula G) (7)
8. Tobl Assat.
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funaral Expansas/Ad.. Costs/Hisc. Expansa. (Schadula H) (9)
10. D.btI/Hortg.g. Ll.bilitl.I/L1.nl ISoh.dul. II 1101
il. Tot.l D.duotlonl
12. H.t Value of Tax Return
13. Charitabla/Governmantal aequests (Schedule J)
14. Net Value of Est.t. Subject to Tax
NOTE:
RECEIPT
NUHBER
DISCOUNT It I
INTEREST I-I
AHOUNT PAID
CHANGED
.00
.00
.00
.00
2.454.00
3.745.95
.00
(BI
7,164.52
4.346.78
1111
I1Z1
1131
1141
.00 K .00=
.00 X .06=
.00 X .15=
1181
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
NOTE: To insure proper
credit to your account,
submit the upper portion
of this farm with your
tax paYllant.
6.199.95
11 . ~11 30
5,311. 35-
.00
5.311.35-
.00
.00
.00
.00
.00
.00
.00
.00
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN $1. NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REflECTED AS A "CREDIT" ICRI. YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I
.1(,'
RESERVATION I E.t.t.. of dac.d.nt. dying on or b.for. O.c..b.r lZ. 198Z -- If any future Int.r..t In the e.tat. I. tr.n.f.rr.d
In po.....lon or .nJoy..nt to Cl... I (call.t.r.l) b.n.flcl.rl.. of the d.c.d.nt aft.r the ellplratlon of any ..tat. for
llf. or far y.ar., the co..onwaalth h.r.by axpra..ly re..rva. the right to appral.a and a..." tr.n.fer Inh.rltanc. Tax.'
at the lawful Cia.. I (callatar.l) rata an any .uch future Int.re.t.
PURPOSE OF
NonCE 1
To fulfill tha requlre..nt. of s.ctlon Zl40 of the Inh.rlt.nc. and E.tata Tax Act. Act ZZ of 1991. 7Z P.S.
S.ctlon Zl40.
O.tach the tap portion of thl. Notlc. and .ubalt with your payeent to tha Ragl.t.r of Will. printed an the r.v.r.. .Ide.
.."aka check or .on.y ordar payable tot REGISTER OF MILLS, AGENT
All pay.ant. rec.lv.d .hall flr.t be applied to any Int.r..t which .ay b. due with any ra.alnd.r appll.d to the ta..
A r.fund of . tax credit. which w.. not r.que.tad on the T.x Raturn, .ey be r.qu..t.d by coapl.tlng an "Application
for Refund of Pann,Ylvanl. Inherltanc. and E.tat. T.x" (REV.l!I!). Appllc.tlon. ar. avall.ble .t the Offlc.
of the Ragl.ter of WIll', any of the Z! Ravenue Ol.trlct Office., or by calling the .p.clal Z4.hour
an.werlng ..rvlce ~.r. for far.' orderlngl In P.nn'Ylvanla 1.800.16Z.Z050, out.ld. P.nn.ylvanl. and
within local H.rrl.burg ara. (717) 787.8094, TOO' {7171 772.2Z52 (H.arlng I.palr.d onlyl.
Any party In Int.r..t not .atl.fled wIth the .ppr.l....nt, .llowanca or dl.allawanc. of deduction., or .......ant
of t.x (Including dl.count or Int.r..t) a. .hown on thl. Notlc. au.t Object within .Ixty (60) d.y. of r.c.lpt of
thh Notice byl
PAYHEHTI
REfUND CCR) I
DIJECTIONSI
..wrlttan prota.t to the PA Depart.ant of R.v.nu., loard of App.al., O.ot. 281021, Harrl.burg, PA
.-.I.ctlan to have the .att.r d.taralned at audit of the account of the p.r.onal repr...ntatlv.,
..app.al to the Orphan." Court.
17128-1021,
OR
OR
ADMIN
ISTRATlYE
CORRECTJONSI
Factual .rror. dl.covar.d on thl. .......ant .hould ba addr....d In writing tat PA Dep.rt.ant of Ravenue,
lur.au of Individual T.x." ATTN: Po.t A..a...ent Ravlaw unIt, Dept. 210601, Harrl.burg, PA 171Z8-0601
Phone (717) 717.6505. S.. page 5 of the bookl.t "In.tructlon. far Inharltanc. Ta. R.turn far a A..ldant
Decedent" (REY.150U far an .xplanatlon of adelnhtr.t1v.1y cornctable arrars.
If any ta. due I. paid wIthin three Cll calendar .onth. aftar the dec.d.nt". daath, . fIve parcant (52) dl.count of
thtl ta. paid hallowed.
The 15~ ta. aMn..ty non.partlclpatlon pan.lty I. coaput.d an the total of the ta. and Int.r..t .......d, and not
p.ld bafore January II, 1996. the flr.t day aftar the and of tha t.x aan..ty p.rlod. Thl. non.p.rtlclp.tlon
penalty I. .pp.alable In the .... .ann.r and In the the .... tl.. p.rlod .. you would app.al the ta. and Int.r..t
th.t h.. b..n .......d .. In~lc.tad on thl. notlca.
DISCOUNT:
PENA LTV I
INTEREST:
Intar..t I. charg.d bag inning with flr.t d.V of d.llnqu.ncy, or nln. (9) .onth. and one CI) d.y fro. the d.t. of
d.ath, to the data of p.yaent. T.x.' which beea.. dallnquent b.for. Janu.ry I, 1912 b..r Int.r..t at the rat. of
sl. (621 parc.nt p.r annuB c.lculat.d at a dally rata of .000164. All t.~.. which bec..a dallnquent an and aft.~
January I, 1982 wIll b..r Int.re.t at . rat. which will vary fro. calendar ya.r to c.landar y.ar with that rat.
announc.d by the PA D.p.rt..nt of R.vanua. Tha appllc.bl. Int.re.t r.t.. for 198Z through 1996 .ral
'!!!! Intere.t Rat. Oallv tnt.rut Factor !!!! tnter.st Rate DailY tnt.r..t F.ctor
1912 20:C .000548 1917 'X .000247
1983 16:C .000,.38 191!H991 l1X .000101
al4 11:C .000301 19'2 .X .000247
1915 132 .000156 1,9S" 199,. IX .00019Z
1986 lOX .000Z74 1995.1996 'X .000247
ulnt.r..t Is c.lcul.t.d a. foUow"
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
..Any Notlc. I..u.d .ft.r tha tax b.Co.., d.llnquent will rafl.ct an Int.r..t calcul.tlon to flft..n {151 day'
bayond the d.t. of the ........nt. If pay.ant I. .ade aft.r the Intar..t co.putatlon d.t. .hown on the
Hatlc., additional Int.r..t au.t b. calculat.d.
COHHONW{Allll 01' III HNSYl VANIA
DLPARIHLNI or RLVIHUL
IIUReAU or INDIVIDUAl TAlltS
DEPI, :801101
1I1RRISlURG. 1'1 1IIUI-ObOl
*
FILE NO. 21 - (ill If j ))
ACN 96128301
DATE 07-18-96
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
l(1-\\<IIII" 11.'\1 i
TYPE OF ACCOUNT
EST. OF MI LORED TICHY ,I SAVINGS
S.S. NO. 182-09-6592 [x] CHECKING
DATE OF DEATH 04-01-96 [J TRUST
. COUNTY CUMBERLAND =:: CERTlF.
REHIT PAVHENT AND FORHS TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOU~E
CARLISLE. PA 17013
EUGENE M BALDWIN
APT 3 ....
4934 SIMPSON FERRY RD :::1'
MECHANICS8URG PA 17055
HELLON PSfS hal pro",idlld the Dllpa-t.ent with the infor.ation listed billow IoOhleh hili been usod In ealculaUng the
ootentlal t.~ du., Their rllcords indicate that at the death of the nbovII dllclldllnt. you 100111". a joint oloOnllr/bllnllflelary of thil .ccount,
If you f.lIl this infar..'lan is incorrect. plllase obtain wrlttlln corrllctlon fro. the financial institution. attach a copy to thll for.
and r~turn It 10 the above addr..s. Thl~ account Is ta_able In accardancII with the Inhllrltance Ta_ lawI of the Co...onwllallh of Pllnnlylvanla.
Question. ..y bl .n~w.r.d by calling (7171 787-83l7.
COMPLETE PART 1 BELOW . . . SEE
Account No. 162-203-7842 Doh
Established
REVERSE SIDE FOR
06-17-92
FILING AND PAYMENT INSTRUC'rIONS
To In.ur. propllr crlldlt to your account. two
(ZI copies of this notlc. ..u.t acco.pany your
paY..llnt to the Rllgls'lIr of Wills. Hake (hllck
payable to: "Aeglstllr of Wills, Agllnt".
PART
[!]
965.36
50.000
482.68
.15
72.40
TAXPAYER RESPONSE
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSNENT BASED ON THIS NOTICE
Account Balance
Percent Taxable
Amount Subject to
Tax Rat.
Potential Tax Due
K
NotE: If ta_ oay..nt. are ..dll within three
(3) .onth. of thll deelldllnt"s date of dll.th.
you ..y deduct . ~Z di.count of the ta_ dUll,
Any inhllrltance taK due will beco.. delinqullnt
nlnll (9) .anth' aftllr thll datil of d.ath,
Tox
x
[CHECK ]
ONE
BLOCK
ONLY
A. c=J Ihll abo",e infor.ation and taK due is corrllct.
I. You "ay choosll to re.lt pay..ent to Ihe Register of Wills with two cople. of this notice to obtain
a discount or a",old Intllrest, or you ..ay check bOil "A" and rllturn this notice to thll Allglstllr of
Wills and an official .ssess.llnt will be iSlued by the PI Dllpart..llnt of AllvenulI.
II. r:J The aba",1I ass.t has bll.n or will bll rllportlld and ta_ paid with the Pllnnsylvania InhllrltanclI Ta~ return
-- ~II flllld by the deced.nt', rllpresllntati",lI.
C. 8'1."11 "bove Infor..Uan Is Incorrect and/or dllbtl and doductions wor. paid by you.
You .Ult co_plete PART ~ and/or PAAt ~ billow.
PART
~
If you IndIcate a dIfferent tax rate, please stat. your
relationship to decedent:
OFFICIAL USE ONLY 0 AAF
PA DEPARTMENT OF REVENUE
.'."'~'I".1l"
n..._..........
~.ft
.....
-..-....... :::~~:JT;. ":'%0:: ~~ ..v ~.o ,,....... ...."..,.....
n.......lu. .. ,'ou ':"~ ....--.... .........
, ,
1- Dete EstabUshed 1 I f
2. Account Balance 2 " c
3. Percent Taxable 3 K
4. Amount Subject to Tax 4 4,' >./ '
5. Debts and Deductions 5 y(' f. J J
b. Amount Taxable b ,. I
7. Tox R.ie 7 X 0 ' .
8. ro. Duo 8 , ,
_.n
1...1\
1
2
3
4
5
6
7
8
DEBTS AND DEDUCTIONS CLAIMED
LINE
PART
~
DATE PAID
. /.'0 I~ i
DESCRIPTION
AMOUNT PAID
PAYEE
,-
I,-if '-.""
/ '.
. _I,' I' J, ,
~.I"." .-~
.'
/', .,..t I
." :--t
,
I
TOTAL
I "',' '!'t ,. '1
I - ,
I
I
. o'
1.-'
, ~ ...1
IEnter on Line 5 of Tax Computation)
$
Under penalties of perjury, I declare that the facts I have reported above are true, correct and
conpl.t. to the best of my knowledge and belief.
c
DATE
GENERAL INFORMATION
1. fAILURE TO RESPOND Will RESULT IN AN OfFICIAL TAX ASSESSHENT with applicable Inhr..' blind on Infor..Uon
lubaltt.d by the financial Institution.
l. Inh.rltance tlM bleo... d.llnquent nln. aanln. .ft.r the dlcadlnt', dllt. of d..th,
3. A Joint account I. t...bl. '~.n though Ih. dlcadlnt', nil.. wa. added a. a a"ttar of convenllnee.
4. Account. (Including tho.. hlld betw..n hUlband nnd wlf., which Ih. dlc.dant put In Jalnl ""... within Dna y..r prior to
d.ath ar. full~ t...bla a. Iranl'.r..
S. Account. .,tabll,h.d Jointly bat....n hu.band and wlf. lor. than on. y..r prior to d.ath lit. not t.."bll.
6. Account. hlld by II dlcadlnt "In tru.t for" anolhar or othar. nt. t"M"bl. fully.
REPORTING INSTRUCTIONS - PART
1
- TAXPAYER RESPONSE
1. BLOCK A - If the Infor.atlon and coaputatlon In the notJc. ar. correct and d'ductlons ar. not baing clal..d, placa an "X"
In bloek "A" 01 Part 1 01 the "T..payer R.,pon.." '.ctlan. Sign two copl.. .nd .ub.lt th.. with your ch.ck lor the a.ount 01
tax to the R.gI.ter 01 Will. 01 the county Indlcatad, Th. PA D.part.ent 01 R.venu. will I..u. nn olllcl.l a.......nt
IFor. REV-15~a EX) upon r.celpt 01 the r.turn Iroe the R.gl.t.r 01 Will..
2. alaCk B - II the ....t ,pecllled on thl. notlc. hat b.en or will b. repart.d and tax p.ld with the P.nn.Ylvanl. Inheritance
Ta. R.turn Illed by the dec.d.nt'. repr..entatlve, olace an "X" In black "BOO 01 Part 1 01 1he "Ta.payer Response" '.ctlon. Sign on.
copy .nd r.turn to the PA aepart..nt 01 R.v.nu., Bur..u 01 IndlvJdu.1 Tall", Dept 2a060l, Harrl.burg, PA 1112a-0601 In the
.nv.lop. provided.
5. BLOCk C . II the notice Inlor..tlon I. Incorrect andlor deductions .re being cl.le.d, ch.ck black "COO .nd co.pl.te Part. Z .nd 5
U\,,,;u,'.;ill,,, 0\1 ~i,_ i.....I.....i....... \I..,..... Sir' ..... "'.....:... ...... ...;,....:. ;",..... ..:,.. ....., ...,......... ;... ..... __w'..... \u.. ~........;.. :_ .;.. i:..:.:.,
01 Will. 01 the county Indlcat.d. The PA Dapart.ant 01 R.v.nu. will Is.u. an olllcl.1 ........nt IFor. REV-15~a EX) upon r.c.lpt
01 the r.turn fro. the R.gl.t.r 01 WJII..
TAX RETURN - PART
2
- TAX COMPUTATION
liNE
I. Ent.r the d.t. the account orJgln.lly w.s a.tabll.hed or tltl.d In the ..nner e.l.ting .t data 01 d.ath.
NOrE: For a dec.dent dying alter 12/12/a21 Account. which the decedent put In joint n.... within on. Cl) y.ar 01 death are
ta..bl. fully a. transfer.. Howev.r, there I. an '.clu.lon not to ellc..d '5,000 p.r tr.n.fer.e r.gardl.s. of the valu. of
the .ccount or the nu.b.r of account. held.
If a doubl. a.t.rlsk C..) .ppear. be for. your flr.t n..e In the .ddr..s portion of thl. notlc., the 15,000 e.clu.Jan
alr.adY ha. b.en deduct.d fro. tha .CCount b.lance a. reported by the flnancJ.1 Institution.
Z. Entar the total bal.nce of the account Including Int.r"t accru.d to the data of d.ath.
3. Th. o.rc.nt of the .Ccount th.t I. t..abla for .ach survivor I. d.t.r.Jn.d a. follow.:
A. The p.rcant ta..bl. ror Joint ....t. ..t.bll.h.d .ore th.n on. y.ar prior to the d.c.dant'. d.ath:
DIVIDED BV TOTAL NUHBER OF
JOINT OWNERS
E.a.ple: A joint all.t r.gl.t.r'd
DIVIDED BY TDTAl NUMBER DF X 100 . PERCENT TAXABLE
SURVIVING JOINT OWNERS
In the na.. of the d.cedent .nd two oth.r p.rlonl.
I DIVIDED IV 3 (JOINT OWNERS) DIVIDED BV 2 (SURVIVORS) .. .161 X 100 . 16.1X (TAXABLE FOR EACH SURVIVOR)
B. Th. p.rcent ta..bl. for allet. cr.ated within on. y.ar of the dec.dent'. d..th or .ccount. ownad by tll~ v~~edent but h.ld
In trust for anoth.r Indlvldual(.) (trult beneflcl.rJ.sJ:
I DIVIDED BV TOTAL NUHBER OF SURVIVINC JOINT
OWNERS DR TRUST BENEFICIARIES
X 100 .. PERCENT TAXABLE
E..'ple: JoInt account r.gl.t.red
the dec.den t.
I DIVIDED BV Z (SURVIVORS) . .50
In the n.., of the daced.nt .nd two oth.r perlon. .nd elt.bllshed wJthln one year of death by
X 100
50~ CTAXABlE FOR EACH SURVIVOR)
4. The ..ount ,ubJect to t.. Cline 4) I. deter.Jned by eultJplYlng the .CCount balance Clln. Z) by the percent ta.abl. (line ]).
5. Ent.r the total of the d.bt, .nd deductions listed in P.rt 3.
6. Th. ..aunt t...ble (line 6) 1. det.r.lned by .ubtr.ctlng the debt. .nd deduction. ClIne S) rro. the a.ount lubJect tu ta. Illne ~).
7. Enter the .ppraprlate t.. r.te (line 1) .. d.t.r.ln.d b.low.
A. For d.ta. of death occurring aftlr 6/30/9~, the tax r.te. for tr.nlier. to SPOu.a. .r. .. follow.:
I. O.t.. of de.th on or .ft.r 1/1/94 .nd blror. 1/1/95 the r.t. il 3~.
Z. D.t.. of de.th on or .ft.r 1/1/95 tr.nlfar. to ,poule. will b. t..ed at OX t.. r.te.
Note: For d.t.. of death prior to 1/1/94 tr.n.rer. to .paUI.s are t..able .t 6~.
B. Tranlfer. to llne.l delcendant. Including father, _ath.r, son, d.ughtar, gr.ndchlldran, Ion-In. law,
d.ught.r.ln-Iaw, .t.pchlld .nd th.lr I,IU. .re ta.able .t .J. parc.nt (6~).
C. Tr.n.f.r. to all oth.r. InclUding broth.r, sl.ter, uncle, .unt, neph.w .nd nl.c. .r. t.xable .t fJft.en parcent (15X).
D. If you ch.nge the tax rat., pl.... specifY your r.l.tJonshlp to the dec.dent In the .r.. provided.
8. The ..aunt or tax due (line a) Is deter.ln.d by .ultlplylng the a.aunt t.xabl. Illne 6) by the tax r.t. (lln. 7).
CLAIMED DEDUCTIONS - PART
3
DEBTS ANO DEOUCTIONS CLAIMED
Allow.ble dabt. .nd deductions are deter.ln.d as follo~.:
A. You leg.lly .r. responllble lor P.Y'.nt, or the a.tet. ,ubJ.ct to .d.lnlltr.tlan by . perianal r.presant.tlve J. Insufficient
to pay the deductible Ite.,.
B. Vou actu.lly p.ld the debtl .ft.r d.ath 01 the decld.nt .nd c.n furnish proof of pay.ent.
C. Debt. being cl.l.ed au.t be Jte.lz.d fully In P.rt 3. If addltlon.1 spac. I. n..d.d, us. pl. In pap.r 8 I/~" . II". Proof 01
p.y.ent ..Y be r.quest.d by the PA Depart.ent of Revenu..
TAXPAYER ASSISTANCE
IF YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANY
REGISTER OF WIllS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE
OR CALL THE BUREAU OF INDIVIDUAL TAXES, TAXPAYER INQUIRY UNIT IN
HARRISBURG AT (717) 787-8327. TDD' (717) 772-2252 (HEARING IMPAIRED ONLY)
C"MMllNWUlllt Of PlNNSYlVANIA
D(PAIUMlNT or R(V[NUE
eUAUU or INDIVIDUAL lAk[S
DEP'. ;'aDbDI
IIARRIS~UAG. PA I/IZa-DbOI
.
ACN
DATE
FILE NO. 21 %-- ~ L. .i ~
96128302
07-18-96
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
.(o,\hlll U. ".UI
EST. OF MILDRED TICHY
5.5. NO. 182-09-6592
DATE OF DEATH 04-01-96
COUNTY CUMBERLAND
TYPE OF ACCOUNT
iXJ SAVINGS
o CHECKING
[J TRUST
o CERTIF.
EUGENE M BALDWIN
APT 3 c,
4934 SIMPSON FERRY RD
MECHANICSBURG PA 17055
REMIT PAYMENT AND FORMS TO:
REGISTER OF WILLS
CUM~~ULAND CD COURT HOUSE
CARL1SLF, PA 17013
HELLON PSFS r:_ has pravldlld thll D.pllrt.llnt with thll infor.atlon Ihhd bolow which has blllln u'lId In calcuhllng thll
potllnlllll tll)( dUll. Thlllr rllcord. indicate that at thll dllath of thll IIbovo dllcodllnt, you Wllrll II joint ownllr/bllnllflclary of this IIccaunt.
If you flllll thl. Infor.atlon Is Incorrect. pleaslI obtain written correction fro. thll financial institution, attach a copy to this for.
~nd rllturn It lo.the abov. ad~rll's, This ac~,unt Is ta)(ablll In accordance with thll Inhllrltance Ta)( laws of thll Co..onw.~\th nf Pp"~'vivanl~
QUIIstions _ay_pe;an.wllr.d_by call1~J\717) 7a7-&JZ7.
COMPLETE PART' 1 BE!;Olf)- _ _ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No.
416-750117
Oat.
Established
06-17-92
To insure propllr crodlt to your account. two
(Z) capilli of this notlclI .ust aCCOllpany your
paY.llnt to thll Rllglster of willi. Hake chllck
paYllbl. tal ~R.glster of willi, Agent".
PART
m
6,526.53
50.000
3,263.27
.15
489.49
TAXPAYER RESPONSE
FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSNENT BASED ON THIS NOTICE
Accou~t aalance
Percent Taxabl.
Aaount Subject to
Tax R.t.
Potential Tax Due
K
NOTE: If tal( pllY.llnts are .ade within three
()) 1I0nthl of the decpdllnt's date of dllath.
you lIay dllduct II S~ discount of the talC due.
Any inhllritllnCII talC due will becolle dellnqu.nt
nin. (9) ~onths after thll date of d.ath.
Tax
K
[CHECK ]
ONE
BLOCK
ONLY
A. r=J Thll above Infor.atlan and talC du. il correct.
1. You .ay choose to r..it paY.llnt to thll Allglster of wills with two cop III' of thil notice to obtain
a discount or avoid Int.rll.t. or you lIay chllck bOl( ~A" 3nd return this natlclI to the Rllgl.ter of
Wills and an official asse"lIent will bll Issued by thll PA Dlloart.llnt of RllvllnulI.
B. [] Th. above assllt hns balln or will bll rllported and tal( paid with thll PennSYlvania Inhllrltance Tal( return
~bll filed by th. declldllnt's rllPrllsllntative.
C. [!J T_he above infor.atlon Is Incorrect 3nd/or d.bts nnd deductions waro paid by you.
You IIUst coaplete PART ~ and/or PARI ~ billow.
PART
~
If you indicate a different tax rate, ple.se state your
rel.tionship to decedent: '!/
OFFICIAL USE ONLY 0 AAF
PA DEPARTMENT OF REVENUE
:.:c:~~::':'c
rAn
t,.^
-..-.,....
".....,,,,,
............t........... ....-
.....'"..,',.......... v.
".W' ,... ....-..... ...............
Inn ..... .....,..... ..........
c /" I',.
(. ,-f ./", J --'
1
2
3
4
5
6
7
8
CLAIMED
LINE 1- Date EstabUshed 1
2. Account aalance 2
3. Percent Ta:uble 3
4. Aaount Subject to Tax 4
5. Debts end Deductions 5
6. Aaount Ta)Cable 6
7. Tax Rate 7
8. Tax Due 8
x
j c.'',
,. :..' (. f. .J'/
....,l' I' j l
K
"
PART
~
DATE PAID
DEBTS AND DEDUCTIONS
PAYEE
DESCRIPTION
AMOUNT PAID
,., ,_~ /'f I..
I /,/1 . '.I
Il"',,,,,, i"
I
I
(. hI', ,., I.', !t.. ~ ( I
l ' .. . ;( ,,' ~,~ '....
t., )~ ',; , L
';, ,t ~ L . ~
." I .""./
. I
,t"',,, I.. (I,"! l,'" I,.
.
,
TOTAL CEnter on Line 5 of Tax Computation)
,
. L/, I. I
~-
Unde~ penalties of pe~jury, I declare that the hcts I have reported above ...
coapl.t. to the be.t of my knoN~edge and belief. HOME (' 00 J : i; I
o ~ . .
4 /d " /' / WORK ( "/" J I't-
. AVER' SIGNATU~E TELEPHONE NUMBER
true, correct and
.i,"
..1
DATE
GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT with "Pllllcnlll. I"hr..t blind on Infor.allen
.ub.ltted by the flnandal Institution.
z. tnh.rltanC8 tu beco." dellnqu.nt nine 1Il0nthl afhr tho Ilecedunt" ditto of dll"th,
3. A Joint account I_ talabl_ even though the decadent" "".. WA' "dded ft, n ."tt.r of conv.nl.nca.
ft. Accounts (Including tho.. h.ld betw..n husbllnd nnd wlf.1 which the duaclgnt f1ut In joint n"... wlttlln on. y8/1r prior tn
d..th ar. fully 1.~lIbl. III tran.f.rl,
5. Account. ..labll,had JointlY b.tw..n husband nnd wlf. .or. Ihn" one Yllllr prior to II_nth nr. not t".nble,
6. Account. held bv a d.c.dant "in trust for" nnoth.r or othert ar. tl'uobl. hilly,
REPORTING INSTRUCTIONS - PART
I
- TAXPAYER RESPONSE
1. BLOCK A . If the Infor.allan and cOlllputlltion In the notlc. Dr. correct "nd deduction. IIr' not baing Cllll..d, place an "X"
in block "A" of Part I of the "fakpaver Response" s.ction. Sign two caples and subelt thee with your check for the aaount of
tak to the Register of wills of the county Indicated. Tht PA Depart.ent of Revenue will Issue on official asst.s.ent
(Fora REY-1548 EX) upon receipt of the return frae the Register of wills.
z. BLOCK B _ If the n.set specified an this notice has been or will be reported and ta. paid with the Pennsylvania Inhtritonce
fa. Return filed by the dtcedent's representative, place an "X" in block "B" of Part I of the "Ta.paver Response" section. Sign ant
copy and rtturn to the PA Deparbent of Rtvenue, Bureau of Individual 1IIIlIIS, Dept l1l0601, Harrisburg. PA I7llll-0601 In the
envelope provided.
3. BLOCK C . If the notice Infor.atlon Is incorrect ond/or deductions ore being claieed. check b:~ck "C" and coaplete Parts Z nnd 3
6ccoralnlil to ...e 1".tru..tl..oI' 0..1010, ~;"'I ..u "....;.... a.~ ...._...;, .:,... .;.;, ,...., ..".:. :.., .:,. -.......,.. ..~ ,,;,.. ...1,....:.. ::. \l",a ~l.::.t:.:-
of will. of the county indicated. The PA oepart.ent of Revenue will Issue an official assesseent CFore REV-15411 EXI upon receipt
of the r.turn fro. the Regl.t.r of Wills.
TAX RETURN - PART
2
- TAX COMPUTATION
lIHE
1. Enter
HOTE:
the date the account originallY was established or titled In the eanner elllstlng at date of death.
For a dlctdent dying after 12/12/82: Accounts which the decedent put In joint na.es within one (I) Ylar of dlath are
taxabl. fully os transfers. However, there Is an ekcluslon not to e.ceed $3,000 per transfer.e regardless of the valu. of
the account or the nu.ber of account. held.
If a double asterisk C..) appears before your first na.e In the address portion of this notice. the $3,000 e.cluslon
already has be.n &educted froe the account balance as reported by the financial institution.
z. Enter the total balance of the account Including Interest accrued to the date of death.
3. The percent of the account that Is taxable for each survivor is detereined as fallows:
A. The p.rcent takable for joint assets established .ar. than on. y.ar prior to the decedent's death:
DIVIDED BY TOTAL HUMBER OF
JOINT OWNERS
[xa.ple: A joint ass.t regl.tered
DIVIDED BY TOTAL NUMBER OF JC 100 . PERCENT TAXABLE
SURVIVING JOINT OWNERS
In the na.e of thl decedent and two other persons.
I DIVIDED BV ] (JOINT OWNERS) DIVIDED BV 2 (SURVIVORS) . .161 JC 100
16.7:( (TAXABLE FOR EACIl SURVIVOR)
B. The percent taxable for ass.ts created within on. year of the decedent's death or accounts owned by the decedent but held
In trust for another indlvldual(s) (trust blneflciarles):
1 DIVIDED BY TOTAL NUMBER OF SURVIVING JOINT
OWNERS DR TRUST BENEFICIARIES
X 100 . PERCENT TAXABLE
Exaaple: Joint account registered In the na.e of the deced.nt nnd two other p.rsons nnd established within one yenr of death by
the decedent.
I DIVIDED BV Z (SURVIVORS) . .50 X 100 . ~O~ (TAXABLE FOR EACH SURVIVOR)
4. The a.ount subject to taK (line 4) is deterained by aultiplylng the account balance (line 2) by the p.rcent taMable Cline ]).
5. Enter the total of the debts and deductions listed In Part 3.
6. The aaount taxable Cline 6) Is det.rained by sUbtracting the debts and deductions (line ~) froe the aaount sucject to tft. Cline 4).
7. Enter the appropriate tax rate (line 7) as deterained below,
A. For dates of death occurring after 6/30/94, the tax rates for transfers to spouses are as fallows:
I. Date. of d.ath on or after 1/1/94 and before 1/1/9S the rate Is 3%.
Z. Dates of death on or aft.r 1/1/95 transf.rs to spouses will be taked at 0% tak rate.
Nate: For date. of death prior to 7/1/94 transfers to spouses are ta.able at 6%.
B. Transfers to lineal descendants Including father, .ather, son, daughter, grandchildren, son-In-law,
daughter-In-law, stepchild and their I.sue are tawable at six percent (6~).
C. Transfers to all others Including brother, sister, uncle, aunt, nephew and niece are taknble at fifteen percent (15%1.
D. If you change thl tax rate, please specify your relationship to the decedent In the area provided.
8. The aaaunt of tax due (line II) Is deteralned by ~ultlolylng the aeount tawable lllne 61 by the tax rate Cline ]).
CLAIMED DEDUCTIONS - PART
3
DEBTS AND OEDUCTIONS CLAIMED
Allowable debts and deductions are deterelned as follows:
A. You legally are r~spon.lble for payaent, or the estate SUbject to adalnistratlon by a personal representative is Insufficient
to pay the deductible Iteas,
B. You actually paid the debt. after d.ath of the decedent and can furnish proof of payaent,
C. nebts being clalaed aust be it..I,ed fully in Part 3, If additional space Is needed, use plain paper 8 I/Z" . II". Proof of
payalnt aay be requested by the PA Departe.nt of Revenue.
TAXPAYER ASSISTANCE
IF YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANY
REGISTER OF WILLS. PA DEPARTMENT OF REVENUE DISTRICT OFFICE
OR CALL THE BUREAU OF INDIVIDUAL TAXES. TAXPAYER INQUIRY UNIT IN
HARRISBURG AT (717) 787-8327. TDDI (717) 772-2252 (HEARING IMPAIRED ONLY)
JRDlJune 30, 1992/17858
REGISfER OF WILLS
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
NOTICE PURSUANT TO RULE 6.12
PENNSYLVANIA SUPREME COURT ORPHANS' COURT RULES
To: Personal RepresentativeEUGENE BALDWIN
Counsel:
RE: Estate of MILDRED E. TICHY ,Deceased, Late of
HAMPDEN TWP
Estate No.: 21.1996.0633
Date orI)ecedent's Death: 4.1' 9 6
Pursuant to Rule 6.12, the above named personal representative or the above named attorney, if
applicable, within two (2) years of the decedent's death, 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 Report 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' Court Division, Court of Common Pleas of such delinquency and to
request that said Court conduct a hearing to 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 Report is not filed by 6.1-98 , 19_, you are hereby
advised that a request will be submitted to the Court in accordance with Rule 6.12.
Date: 5.12.98 "-1Y\r1JrJ,f t'R 0.. 1JI.. iJ/ it ~m
DepUty Ri:gister bf Wills I
Distribution to Estate File