HomeMy WebLinkAbout96-00661
Oath of Personal Representative on
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Commonweallh 01 Pennsylvania ' ,
Counly 01 CUMBERLAND L:.'
1,.1
Tha Pelltloner(l!) above.named swear(s) or nrnrm(s) Ihallhe slatemenls In the 10regolnlfPellllon are lrue
and correct 10 the best ollhe knowledge and bollof of Pellllonoc(91 and lhal. as personal rep!esenlallve(t) 01
Ihe Decedent, Pellllone~ will well and truly administer Ihe estalo occordlng to law. I' l'
SWorn to or afflnned and subscribed '.. I 4..t>3M I!J ~~(J'~e - . : ~~
~n D. wacfne
belore me thle -11l!1--day 01
A 19-1f7-
r A (, WJ~) ^ J-<.J ~)l/(JtJ lJU:L1 .
(For the Register ( r - (
MARY C. LEWIS '
No. 21 - 96 - 661
Estate 01 ANN R.' WAGNER Deceased
Soclol Securily No: 203-20-4360 DateolDealh: Auqust 5, 1996
AND NOW. AUG1l5T ?7 , 19 96 , In conslderallon
01 Ihe Pellllon on the reverse side hereon, sallslactory proof having been presenled before me,
rT IS DECREED Ihat LellersJOl Testamentary 0 01 Admlnlslrallon
d b.n.c.la.; pend.nt. ~.; dUIMII 1Ib..,..I.: d...ant. rnIl'lOllal.
are herebygranled to Susan D. Waaner
In Ihe above eslale and Ihallhe Inslrumenl(s) doled October 4. 1989
described In the Pellllon be adrnllled 10 probale and lIIed 01 record as Ihe lasl Will of Decedent.
FEES
Letters ..................... $
Short Certrncole(s) ...? $
Renunclallon ............ $
Afndavlls ( )............. $
Extra Pages ( ) ......... $
Codicil ...................... $
JCP Fee ................... $
Inventory .................. $
OIher ....................... $
TOTAL ............. $
....
340.00
15.00
Allornoy:
1.0. No:
william R. Bunt, Esquire
21529
3.00
Addro55:
109 South Carlisle Street
New Bloomfield, PA 17068
(717) 582-8195
5.00
Tolophono:
363.00
F"",,'RW.' Plgl 2 012
Pllpated b)' Ih, rennlrtvMIl, ON ^uodnlSon 1;91
Mailed letters and order to attorney on 8-23-96.
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WARNING: It 15 IIIcgnllo dupllcntc lhls copy by photoslnt or photogrnph.
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AUG 0 6 1996
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COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
~OfO(ClDlHT"" M4H u.a
I. Ann R, Wagner
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- 4360
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.,August 5, 199b
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New Cumberland
18 9th St..New Cumberland, PA
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518 9th Street
"New Cumberlsnd, PA 17070
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Frederlck Ramin
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Susan D. Wa ner
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668 S. 82nd Street, IIsrrisburg, PA 17111
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LAST WILL AND TESTAMENT
OF
ANN R. WAGNER
I, ANN R. WAGNER, of New Cumberland Borough,
cumberland County, Pennsylvania, being of sound mind, memory and
understanding, do hereby declare this to be my Last will and
Testament, revoking all former wills or writings in the nature
thereof and any codicils thereto made.
FIRST:
I direct my hereinafter named Executrix or
alternate Executrix, as the case may be, to pay all of my just
debts, funeral expenses, costs of administration and inheritance
taxes out of the corpus of my estate as soon after my decease as
is practicable to do so.
SECOND: I give, bequeath and devise all of my estate,
real, personal and mixed and wheresoever situate, unto my two
(2) daughters, Susan D. Wagner and Debra S. Wagner, in equal
shares, share and share alike, provided the same survive my
decease by a period of thirty (30) days.
In the event that either of my daughters
predecease my decease or fail to survive the same by a period of
::s thirty (30) days, then and in that event, I give, bequeath and
~. devise the share of said deceased daughter's share of my estate
unto my remaining daughter surviving my decease.
WILLIAM R. aUNT
Ano_N&. AT LAW
108 I. CULI.La 'T
Naw a",OO,.,.IILD, PA,
'70.'
TIL. nl71 ...'....
Page 1 of 2 pages
.'
THIRD:
I name, constitute and appoint my daughter,
Susan D. Wagner, as the Executrix of this my Last Will and
Testament.
In the event that my daughter, Susan D.
Wagner, does not serve to complete the settlement of my estate,
then and in that event, I name, constitute and appoint my
daughter, Debra S. wagner, as the alternate Executrix of this my
Last Will and Testament.
My Executrix or alternate Executrix, as the
case may be, is hereby excused from the posting of any bond or
security notwithstanding any provisions of the law to the
contrary.
IN WITNESS WHEREOF, I have hereunto set my hand and
seal to this my Last Will and Testament this.q tJ, day of
0<.. .,.OhcrR,' 1989.
(LA A ...j) I).) 1.0" .'"U (SEAL)
Signed, sealed, published and declared by the above
named Testatrix, as and for her Last Will and Testament, in our
presence, who, in her presence, at her request and in the
presence of each other, have hereunto set our names as attesting
witnesses.
a-A";,, aI-I<. 7J&.d:-fL
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WILLIAM Ill. BUNT
A"O""&' AT LAW
,oe e. CAIl"".U aT
Na. 8LOON,IILD. PA"
170'.
T1'L .717' ..a..18.
Page 2 of 2 pages
CER'l'IF Il:~'I' ION llJ"_!IQTI CIUJ!!!)I\ll_IUJI,_~, _~.',flJQ.),
Date of Deat/II
Name 0 f Deceden t: ANN fl. WAr.NUl
Will No,
To the RegisLer:
AlJr.lJSl '" 19'J(,
Admin. fir:.
19%-llll(,61
I certify that notice of beno[jcjal interest required by
Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to
the following benoficiaries of Lhe above-captioned estate on
Auguot 21, 1996 :
Name
SUSAN D. WAGNER
DEBRA S. ZEMBDWER
Address
66B S. B2nd Street, llarrinhurC], PA 17111
123 S. 31nt Street, Camp llill. PA 171111
Notice has now been given to all persons entitled Lhereto under
Rule 5.6(a) except
Date: January 10, 1997
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Name WIlLlAt1 R. BUNT, ESQUIRE
Ill9 S. Carlisle Street
AddressP. O. Box 336
New Bloomfield, PA 17ll6B
'l'elephone(717) 51l2-B195
Capacity:
Personal Representative
x
Counsel for personal
representaLive
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COMMOHWfA\W Of 'WN!I'flVAt~I"
VfPARtM(NIOf IU....(UU(
or" 110Wl
HAUI~I,~R~C!, PA 17118 ~W_l
DICIOtu :Ii t~A"'1 1\10)01, '11\ APm MIOUI' It/lllAII
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
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[E] 1. Original Return
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'OR DATlS 0' DIA1H AnlR 12/31191 CHICK HIRI
" A SPOUSAL -
POVIRlY CRlDIlIS CLAIMID [.1
fill NUMBIR---
21 - 'J(, - (,(,\
cout'" CODE YEAR
lillUUIIIIT(Ol,l.tllll Alm_I~"
'>111 ')111 ~it 1'....1
N,,., rllll1ll1'r IlIlId, I'A 1711711
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L 1 3, Remainder Retu,n
110' dolo' 01 d.olh prio, 1012.13.82)
[] 5. Federal Ellole Tollt Relurn Requir.d
.!... B. Totol Number of Safe Depolit BOlll8'
I 40, Fulure Inlerell Compromi..
Ilor dotel 01 death oher 12.12.82)
[XI 6. Decedenl Died Tellole 1 7. De(edent Mointoined 0 living T,u,1
(Atta(h copy of Will) (Allo(h (Opy 01 Trultl
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TOI
IOAH 01 ftllltt
111-21-27
_ rO:"_~I~:~~"U"'"
Supplemental Relu,n
o A. limiled Ellate
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Will inm n. BUill
nUPHON( NUI,I.IU
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1. Rool Eoro'. IS,hodulo AI
2, Slo,h and Bond. (S,hodulo BI
3. ClolOly Held Slod:lPatlnenhip Inleunl (Schedule q
A, Mo,tgagel and Notel Receivable ISchedule 0)
5. Cash. Bonll Depolits & Miscellaneou, Per,onal Properly
IS,hodulo EI
6. Joinlly Owned P,operty IS(hedule Fl
7. T,onll." (S,hodulo GIIS,h.du'o LI
8. Total Gran Auen (totallinel '.7)
9. Funeral Expenses. Adminiltralive Co,t,. Miscelloneou,
Expen'eI (Schedule H)
10. Debts. Mortgage Liobilitiel. lien I (Schedule I)
11. Tolol Oedudianl (10101 Linel 9 & 101
12. Net Value of Ellole (line 8 minu, line 11)
13. Charitable and Governmenlal Boquo,ts (S(hedule J)
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14. Net Value Subject 10 Tax (line 12 minulline 13)
15. Spousal T,anden (for datel of dealh ofter 6.30.94)
See Inllructions for Applicable Pe,centoge on Revene
Side. (Include voluel from Schedule K or S(hedule M.)
16. Amounl of line 14 laxoble at 6% ,ale
Ilnclude valu" from Schedule K or Schedule M.l
17. Amount of line 14 taxable 01 15% rolo
(Include value, from Schedule K or S(hedule M.l
18. P,indpallall due (Add lOll from line, 15. 16 ond 17.)
19. Credits Spaulal Povorty Credit Prior Payments
+ 2Il,DUO.OIl +
COMPI( H MAltltl(, AOOAU~
109 S. CIII'I inl"
1'. D. Bnx ~J(,
N",. II In"",! ield,
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DilCounl
1,052.611
(181
Inlerell
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(21)
(21A)
(2IB)
NUMBER
577, ')42 .4D
JIl,671.26
547,271.14
60,665.14
4B6,606.00
29,196.36
29,196.36
21,052.60
1I,14J.76
OAf(
~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH -0(
Under penalties 01 perjury. I declare that I hove ellomined Ihil return. including accompanying lchedulel and \Iatoments. and 10 the blllt of my Ilnowledge and belief.
it is true. calrect and complete. I declare Ihat 0\1 real III ate ho, been reported at true mo,kel volue. Dedaration of prepa,er other Ihon the p.nonal ,eprelOntative il
based on alllnformalian of which prepa,er has any knowledge.
$IGNAlUR~O"(R$ONR( N!ll8lEf RflUNGRElUAN ") AOOI($S6(,O S. B2nd StreeL OAIf
_ ' a.. "11-1-1 .t'.-l-~.....-C'ilalTiBl1l1I'CI. PA 17111
"'0........,01 ,""'N", """',, / 'DO", '111') S. Carlini!! Sll'''L'l, 1'. 0. Bllx .1.1(,
11_ ~ Z --'~ NlltLllluUlllU.c.W..J~L7lJ611
20. If line 19 il grealer than line lB. enler Ihe differen(e on line 20. Thi, il the OVERPAYMENT.
iii O...:r.r:lI!IIiI<lI..I....I...I...t,..III,I-tIl.Il....,1rwr.r.n"'j'lll.'1..t,U:.ll1'.IoI<I,1
21. IF Line 18 il greater than line 19. enler the difference on line 21. This i, Ihe TAX DUE.
A, Enler Ihe inlerlllt on the balance due on line 21 A.
8. Enler Ihe 10101 01 line 21 and 21A on Line 218. Thil is Ihe BALANCE DUE.
Make Check Payabl. to: Regilter of Wills, Ag.nt
~.,
Act '48 of 1994 provide. for the reduction of the tax rote.lmpo.ed on tho net voluo of transfers to or for
the u.e of the .pou.e. The rate. a. pre.crlbed by the .tatute will be:
e 3% (.03) will be applicable for ellate. of decedents dying on or after 7/1/94 and before 1/1/96
e 2% (.02) will be applicable for e.tate. of decedent. dying on or after 1/1/96 and before 111/97
e 1% (.01) will be applicable for e.tate. of decedent. dying on or after 1/1/97 and before 1/1/98
e Spou.al transfers occurring on or after 1/1/98 will be exempt from Inheritance tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK (vo) IN THE APPROPRIATE BLOCKS.
YES NO
1. Did decedent make a transFer and:
a. retain the use or income of the property transFerred, .......................................................
x
b. retain the right to designale who shall use the property transFerred or its income, ............... X
c. retain a reversionary interest; or ................................................................................... X
d. receive the promise For liFe of either payments, beneFits or care' ....................................... X
2. If death occurred an or before December 12, 1982, did decedent within twa years preceding
death transFer property without receiving adequate cansideration' If death occurred aft"r
December 12, 1982, did decedent transFer property within one year of deoth without receiving
adequate consideration'...................................................................................................
3. Did decedent own an 'in trust For' bank account at his or her deothL....................................
X
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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WILLIAN fl. BUHT
AnOIlHI.' ..., LAW
IDe I, C"'IlLl'U .,
N.w ."OO""IILD. ......
170"
T... '7171 .Ia.llea
1.IIS'I' WI J,I. IINIl '1'1';S'I'IIMEN'1'
o Ii'
IINl1 11. WIIGNEII
I, liNN Il. WIIGNEH, of Hew Cumberland Borough,
cumberland County, Pennsylvania, being of sound mind, memory and
understanding, do hereby declare this to be my I.ast Will and
Testament, revoking all former wills or writings in the nature
thereof and any codicils thereto made.
FIRST:
I direct my hereinafter named Executrix or
alternate Executrix, as the case may be, to pay all of my just
debts, funeral expenses, costs of administration and inheritance
taxes out of the corpus of my estate as soon after my decease as
is practicable to do so.
SECOND: 1 give, bequeath and devise all of my estate,
real, personal and mixed and wheresoever situate, unto my two
(2) daughters, Susan D. Wagner and Debra S. Wagner, in equal
shares, share and share alike, provided the same survive my
decease by a period of thirty (30) days.
In the event that either of my daughters
predecease my decease or fail to survive the same by a period of
"3 thirty (30) days, then and in that event, I give, bequeath and
~ devise the share of said deceased daughter's share of my estate
unto my remal.ning dan<Jht:er surviving my decease.
Page 1 of 2 pages
1 nilme, const! Lute and appoint my daughte~~1
susan D. Wagner, as the Executrix of thllo; my I,ast Will and ll;~,
t --," ~
'rHIRO:
Testament.
In the event Lhat my daughter, susan D.
wagner, does not nerve to complete the settlement of my estate,
then and in that event, I name, constitute and appoint my
daughter, Debra S. Wagner, as the alternate Executrix of this my
Last Will and 'I'estament.
My Executrix or alternate ExecutriX, as the
case may be, is hereby excused from the posting of any bond or
security notwithstanding any provisions of the law to the
contrary.
IN WI'l'NESS WHEREOF, I have hereunto set my hand and
seal to this my Last Will and Testament this.q tl, day of
O,,-ro6e-1?' 1989.
(L, ., 11))!:.0- ,.A J (SEAL)
Signed, sealed, published and declared by the above
named Testatrix, as and for her y,ast will and Testament, in our
presence, who, in her presence, at her request and in the
presence of each other, have Iwreunto set our names as attesting
witnesses.
(~kll." aLl< '-IJt!IA(-'
__J!.!dtUl/}I~ -If -;&tf1~
tlLLlAM It. BUN'
Anall"" AT LAW
. I. CAIl"'"U I'
W 1"'00"'1"'0, PA.
170'.
t. t1'17) .U,.1,80
Page 2 of 2 pages
.\
~
,
ESTATE OF ANN R. WAGNER
Redemption Value
8/51196
U.S. Series E Bond #Q2635724937E dated 2/72
U.S. Series E Bond #Q5028293447E dated 6/72
U.S. Series E Bond #Q5068826136E dated 12/72
U.S. Series E Bond #Q5083346082E dated 5/73
U.S. Series E Bond #Q5125999460E dated 10/73
U.S. Series E Bond #Q5167496237E dated 3/74
U.S. Series E Bond #Q5210323519E dated 8/74
U.S. Series E Bond #Q5244262217E dated 1/75
U.S. Series E Bond #Q6015544188E dated 6/75
U.S. Series E Bond #Q6040257105E dated 11/75
U.S. Series E Bond #Q6075875735E dated 4/76
U.S. Series E Bond #Q6111581 025E dated 9/76
U.S. Series E Bond #Q6151068001E dated 2/77
U.S. Series E Bond #Q6184661598E dated 7/77
U.S. Series E Bond #Q6223744648E dated 12/77
U.S. Series E Bond #Q6257239654E dated 5/78
U.S. Series E Bond #Q6303946229E dated 10/78
U.S. Series E Bond #Q6330453708E dated 3/79
U.S. Series E Bond #Q6370339308E dated 8/79
U.S. Series E Bond #Q6396122215E dated 1/80
U.S. Series E Bond #Q6408610551E dated 6/80
U.S. Series EE Bond #L45913812EE dated 1/81
U.S. Series EE Bond #L70557616EE dated 8/81
U.S. Series EE Bond #L90389109EE dated 2/82
U.S. Series EE Bond #L 109536069EE dated 9/82
U.S. Series EE Bond #L 136526291 EE dated 4/83
U.S. Series EE Bond #L 158819322EE dated 10/83
U.S. Series EE Bond #L 181267182EE date,d 5/84
U.S. Series EE Bond #L203033833EE dated 12/84
U.S. Series EE Bond #L22055245'lEE dated 6/85
U.S. Series EE Bond #L233980227.EE dated 1/86
U.S. Series EE Bond #L278610742EE dated 8/86
U.S. Series EE Bond #L314666943EE dated 2/87
U.S. Series EE Bond #L337339980EE dated 9/87
U.S. Series EE Bond #L369060131EE dated 4/88
U.S. Series EE Bond #L396766820EE dated 10/88
U.S. Series EE Bond #L416839213EE dated 5/89
$ 97.90
95.32
93.86
92.23
93.56
88.27
89.32
87.76
86.23
84.53
82.26
80.79
81.81
80.36
71.75
66.32
65.20
64.71
65.49
64.81
64.18
80.70
76.48
74.26
70.00
62.56
59.30
56.54
55.42
54.34
53.28
52.22
44.86
42.20
40.92
39.68
37.82
TOTAL $2,597.24
.
Prudential Securities ~
ChurlL'" A. KliCh, ,Jr.
Vice P,e"iJenl . 11I\'c~lIn':lll~
ltuJ1II1U1I1 (i. \1'11,,,1,. ,I,.,
\,j.,-i: 111~..illi:1I1 111\"'111':111..
Shelly A. Wdhley
{'helll S':l\i~, ^....".j.ll..:
AUG 2 B 1900
August 26, 1996
Mr. William Bunt
PO Box 336
New Bloomfield, PA 17068
RE: Estate of Ann R. wagner
Dear Mr. Bunt:
The following is a list of securities and values, as of 8/5/96,
held at prudential Securities in the name of Ann R. wagner.
Acct. 'O~~-223~1~-87
Keystone Financial Inc.
P P & L Resources Inc.
Hechanicsburg Area Sch Dist
O.OO'!. 09/01/96
FA Higher Ed Ser I. Bond
4.70'!. 06/15/98
Eaton Vance pa T/F Harathon
Eaton Vance Pa Lmt Haturity
prudential 11uni IIi Vld Bd Fd
prudential PA Mun! serios
Van Kampen Herr!tt PA Value
CD ITT Fed 6.50'!. 10/27/97
CD HBNA Amer 5.60'!. 08/11/97
command Tax Free Honey Hkt
pru Discovery Plus Annuity
Hartford \,Jfe 10 Vr Annllity
168 Shares
186
20,000
20,000
2599.983
2272.211
2782.931
2843.602
575
4,000
22,000
3,684
As Of 7/17/96
As Of 7/19/96
1I044-R165~3-87
1l1ackl-or;l~ 19911 '('enll '('rllst
citicorp Pref 2nd series
Gabelli Value Fllnd
I Bl1
putnam Diversified Income TR
CD Ancho)- 5. 311'!. 06/115/97
pru Honeymart Assets
Acct.
1,000
200
48.810
12
862.740
8,000
566
$ 3,864.00
4,347.75
19,951.64
20,185.00
27,299.82
23,108.39
30,222.63
30,284.36
7,043.75
4,000.00
22,000.00
3,684.00
60,665.14
06,527.68
9,125.00
17,675.00
630.14
1,311.00
10,447.78
8,000.00
566.00
please don't. hesit.ate to call, if I can assist you further.
sincerely,
('~):L (( 'i1
Shelly A. w~ibley
Client Service Associate
Pr\K.tonl~~ Soc;ullirm IncolpolilhNl, '11111)(11 t;tn:I\1M~ I "l!ivt', , ('IIMI)11f!,II^ lit),U-11,() BllX 7 c'::ul~lllln PA 17(XJl
Tcl717701,7344 IKX)o1(~I.fUill~) , '
APPRAISAL
Personel Property of 1)t<Jtf,III~_Li~d,'!Ai. r ""
Appraised by Chuck E. Bricker AU094-L
--~...._.~ ,.-.------- ~--_.-.'" ..-.... -_.~_..-...-.--_..-
ITEM VALUE ITEM VALUE
~_..-...- .----.....-. ..-..-......... .-- ..- ---'--'-- ---------..------
Cui l>~ TV ---.- ., . (~(l/'i,~ C !I'[f /J' _ It <J !1',,!,j31 L________ Il)iJ,iJu
1-./1.1, P-.t-\ , SVI rr -.._-- -'--~,,9.'..)_ _C!./(~li.l~.----_._._---- It), dtl
LA 2,,/ Any' .~_. f{ ] LQ~ __LlL21LLJlj {/ - 10. do
Ct(~f..I-Y U//"1f' r/J fJ Lt _ _,':;b, VO ,;' /'c 1.fL._i-'N. 0. t' I Ftc C;O,vtl
C:t u I'-e IJ /t )J }J elM t IC- ::!lhE~ _~L!-j:.LH ( ;.:/ 11 (I. .2o,otl
C uf.l-l-y SF1Ve:t SO ci. -'3fl1' i.''//''{ (-" 20, d.
_-=-_t-=--
Ct{CU,:1 Dflbf LF, r.1 /J U j,<.,T),vu L { Oi"I{-L1N I 1 (j, db
,;l. r/1BL6 L.4n/~ ..?tJ,~ ( II' ~r . {I - I.)J~I.U(S Sh,II
rLD(Jf.. t4 M I' _ld,d~ __/~_LU! f'J.c.l.:J.f\\(- ID (J,H
?IN~ lvl}.5'I(5;n9,U<,{ ! J..iJ. u~ ..J!..fft;JI/LLL(( I a G,o,O
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As.sr. LAWIJ ct(./l t It s ;)0. oj) ) C;/!Jt ....L' 1 50 3(J,tlil
G-fZlLl L/ 0 .~'C> .-Lb~LT/) c c S' 3D.o
"]V -rIJ} Y S oli. {)t ~iliJfJ 1'1 0 (IX f!- 811. d il
5/'c. l'1odt;,{.1J tJ4J<.&.J 1-11. So f(/Ju,t~ ~)N- C;u.lI~L u 1....[ It 100.6,)
CHt!l-r KtJ6t /(dU /Jcs Ie. ~) , .-La '<Il (./1 tj,Ut'K..- l!-b.o'O
il. l'll
aMI-. c/'ft'6T -.2(.), 0 b jl S :, L.il!llt ,I ( tJ To 1)( <; 4D.01
CLCC-. sew l'-t4c ,It' 1,(.0 t: /(\.lItJ II ~ C r p/ :;I{I'~ 2:Jo. '0
~-,)"I
lvAI-,/ll..oJ3e ~1l.ILl .-!l :'s C,-.J.!..t12.:...iliJJ5 (' f<, IS?,. b1>
At.!"1 c/q/l '1
_,,_0, LI ,) .,
t<OJ COLd/_ TLI b'(' () lJ ~lL'ld~!.L''J';0Ir~ I} L '71 391tJ 00
____L___
F {SHe[ sn/-f b ._(/I.',/J~ __-----4...L-- ' ,~
C1/illVcr " " ,; .) . /. b-'
. _~.!!.!(~_L j::LJ:___cuft- cc ;.Lu} ( t..l,..~ q I-t..'-"\
B IJd r..R.A cf.. /) _2 J t2!./y. t.. 5'-.2 S' 9tr
. .1_ t.'!" ~._
VI/ cl/f1 ,0~~
ffifl..C 71>>1)) Dl'l.t J.l1'/{l~~ ----
f1Il fee /J/.5JIt'/ .5T.-9,v'/ ;:'!fI,l.'i)
!Z6u-/#OL ;J Ij', b I)
-- ..---- -.-..-
~r..w/cu1lf. __/~l~!QV --'-
t3L~c., o 1...9 ,4"; -, ~D_la'L ......-. -~--- ----
_DIN/IJ<J 17} I3U ,)- Of-II f.S -.----. ..'::!~l ~.~_ ___u ...... ___.___ -------.-----
r./.ll3t)JET ---- _/ ('_L.Jt. ..-- ..._"--_._~.
~ Serf S/('C"('..t..1t-/9 :?o ,Ill
--..--- _._l___ -~-- .-,- ---.- --.-.----.
poLL 1/1" I}y J?c.( ;10 ,,~
. -- _-..__.4___ .- -" -- . -.---..-------.-.--
t-/};<-/fS --- -.... .~~(! ,.~l~ ..--, - - --.. .---".--...-'----
Df!.Jt v,!t ,llfte!? --- -- ':I~~!r..!:! . "-' .-._-- -.------
-... _.~...___h..~...._. .....-- -.- -- ' -'. -, .-....-------.--
I, / j' .1\' ,/1:'j (L:'>.L!d,{!L~\:!..f..!:.'/o-llL n;),
Dale [( .)7- ') 4>
)
~
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REV.lllt eXt(7-al1)
ESTATE OF
COMMONWeALTH o~ peNNGYLVANIA
INHeRITANCe TAX RetURN
ReGlOI!NT DeceDeNT
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
PLl!Aae PRINT OR TYpe
FILE NUMBER
21-96-661
Ann R. Wagner
ITEM
NUMBER DESCRIPTION
AMOUNT
A. Funeral Expensos:
1,
Stone and Murray Funaral Homa
$ 2,07400
B. Administrative Costs:
4,
C,
1.
2,
3,
4,
5,
6,
7,
8,
1, Personal Represenlalive Commissions
Social Security Number of Personal Represenlativa:
Year Commission Paid
2,
Attorney Fees - William R, Bun!, Esquire
16,000,00
3, Family Exemption
Claimant
Relationship
Address of Clalmanl at decedent's death
Slreet Address
City
Slale
Zip Code
Probate Fees
Miscellaneous Expenses:
Cosls Advanced 10 William R Bunt, Esquire - pro bale fees
517,28
Robert Morris, CPA (reserved)
Che~es Bricker - Appraisal Fee
300,00
60,00
7,200,00
56,00
Commission on Sala 01 House and Transfer lax
Pinnacle Health Hospilal
Lehigh Anesthesia Associates
23.53
36,74
Dlanon Syslems
A, Z, Ritzman Associates
41,89
TOTAL (Also enler on I,"e 9, Recapllulation)
(If more spaco Is nceded, Insert additional sheets of same siZe)
$30,671,26
. .
SCHEDULE H
(continued)
Miscellaneous Expenses:
10. West Shore Pathology
11. PA Gastroentology Consultants
12. Digestive Disease Institute
13. PP&L
14. Patnol News
15. Suburban Cable
16. Arnold Fuel 011
17. Bell Atlantic
18. PA Amencan Water Company
19. Borough of New Cumberland - trash
20. New Cumberland Fire Department
21. Children's Wish Foundation (pledge)
22. The Storage Depot
23. Home Paramount (pest inspection)
24. New Cumberland Borough (trash, sewar)
25. Miscellaneous Settlement Expenses
32.16
48,29
81.52
423.52
4.70
263.25
674,03
91.83
88.61
51.47
25.00
20.00
486.94
24.00
26.50
40.00
,. - &\
UV.l~OO U. t1-qAI
w
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U",,,
w"U
",0""
Ua:-~
....
..
""
10-11..1- II
,,~:.A'rC\
...!ffJI".
COMMONWfAlTH Of PfNN!,YlVANIA
DEPAIlIMENT Of IlEVfNU[
OffT '80l.ol
UA~RISeUIl~c;_:_!,~ 171180601
O((fOlt~l!> UAMI [LA!>l, fll!>'. AtlD MIOOII ltllllAII
fOR OATIS Of DIATH AnlR 12131/91 CHICK HIRI
If A SPOUSAL ..
POVIRTY CRIDIT IS CLAIMID U
__..._u____
fill NUMBIR
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
21
COUNTY CODE
96
YEAR
661
.t:l.UMB.ER
OICIOIW!>(OMPIlII AOIlII!>!>
....
z
w
o
w
U
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o
;;Jt,?fWSfi.~ruP.i~lUI,. .10'" 0' 0'.'" I'~'~ ;"'2';';" 2 7._
_~Q3.=-~.0_:n6L _B/5/96 I
; I ml'(."111V~~','~~.~0~~~_:=I~l.~! ,.\! ."l' ~,['(lll""'.ll ~O(:t ~1~UNI" tlUMa!R
[J 1. Originol Relurn XX 2. Supplemenlol Relurn
o A. Limiled E'lole [ J 40. FUlure Inlere't Compromise
(for dole' of deolh after 12.12.82)
o 6. Decedent Died Te,toto r] 7. Decedent Maintained a living Tru,t
(Alloch copy of Willi IAlloch copy of Tru,tl
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Remainder Return
liar dole' 01 death prior to 12.13.821
Foderol E,late Tax Return Required
518 9th Street
New Cumberland, PA 17070
CO,"" Cumberland
.'..I."O"",.'.cl".O['" ""'ou~'",,"i--:=-~-
rl J
[] 5.
_ 8 Total Number 01 Safe Deposit Boxes
.....
"'z
Ww
"'0
"'z
S~
NAM(
(OMPL(T[ MA!tl'lO AOOAE!>!>
_\'i.i.~tU~am_R.._llun t., ...Esqu ire.
T[I(PHON( NUMlfR
P.O. Box 336
109 S. Carlisle Street ,
... ...~c_cc_c.!il:!w'c.J318.9I1!fJ~Lct.-Ii'~ 17 06.!l
_L]).?_L5-~t~::JlUl5 _
.--_. -,---~----_._...
-------.--..-'" -.-..--
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=>
....
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1. Reol Eslote (Schedule Al
2, Stocks and Bonds (Schedule B)
3, Clo,ely Held SlockJParlnership Interest {Schedule q
4. Morlgage' and Notes Receiyoble (Schedule 0)
S. Cosh, Bank Deposill & MiIColloneous Penonal Properly
(Sch.dul. E)
6, Jointly Owned Property ISchedule Fl
7, Tronlfor. (Sch.dul. G)ISch.dul. l)
8. Total Gran Aneh Itololline, 1.71
9, Funerol Ellpenses, Admini,trotive Cosh, Miuolloncous
Expen,es (Schedule H)
10. Debh, Mortg:lge liabilitie" lien, (Schedule I) (lO)
11. Total Deduclion,ltolol line, 9 & 10) Ill) __.________.~_______~__
12, N., Volu. of E"o,.(Un. 8 m;nUl Un. II) (12) ...4, 52.B.J6_..__.....__
13, Charitable and Governmental Bequosts (Schedule JI (13)
14, N., Volu. Subiec' '0 To, (Un. 12 m;nUll~._l!L__~_._____.____._._..._.__~._, A, 528 ..16
15. Spou,al Tronsfors lfor date, of deolh ofter 6.30.94)
See Instructions for Applicable Porcentoge on Reverse (IS)
Side, (Indude value, from Schedule K or Schedulo M.I
16. Amount of Line 14 taxable 01 6% tote
Ilnclude value, from Schedule K or Schodule M.)
17. Amounl of line 14 toxobl" at 15% rote
(Indude value, from Schedule K or Schedule M.I
18, Principal tall due (Add lax from lines IS, 16 and 17.1
19, Crodih Spousal Povorty (redit Prior Poymenh
(I)
(2)
(J)
(41
(5)4,528.16
16)
(7) .
(B)
.4 , _5.2JL.l~__.___
(9)
__)(.
=
(161
4,528.16
)( .06 =
271_.~9__
(17)
. .15 =
z
o
;::
'"
....
=>
..
:E
o
U
><
'"
....
(18)
271.69_
Discount
Intorosl
+
+
(19)
120)
20, If line 19 is 9reoter than line 18. enter the difference on line 20 Thi, i, the OVERPAYMENT.
ao
Check her., If you are requltstlng a .efund of your overpayment,
(21)
(2IA)
12181
271. 69
21. If Line 18 is greater than line 19, onter the difforenco on lino 21. This i, the TAX DUE,
A. Enter the interest on the balance due on Line 21 A.
B. Enter the total ollino 21 and 21A on line 21B. Thi, is the BALANCE DUE.
Mak. Chick Payabl,'o:.RI9~~!~_~.~f..~I_IIs., A~~nl
~ ~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH -<-<
:.Jnder penalties of perjury, I declare that I have uomined this return, including accompanying schedule, and staltlmenh, and 10 the bell of my (~i~dge and belief.
t i, true. corree! and completo, I declare thot 011 roo1 estate hot been reported otttue market volve_ Declarolian 01 prt'pOrtH other thon Ihe personal repre,entotive i,
1J0,ed an all information of which preparer hot ony knowledge.
~ t:':~;r~~~.::::;:~:r.Ji~;~l::~~ l!rr::il"",,,,o~f?:(~; I
b -_.___Ncw..J31oomheld,.PA_L7068_____ 2,_ ~,
r ."
Act #48 of 1994 provldDl for the reduction of the tax ratellmpoled on the net value of tranlfers to or for
the ule of the Ipoule. The ratel 01 prelcrlbed bV the Itatute will be:
. 3% (.03) will be applicable for e.talel of decedentl dvlng on or after 7/1/94 and before 1/1/96
. 2% (.02) will be applicable for eltatel of decedents dvlng on or after 1/1/96 and before 111/97
e 1% (.01) will be applicable for eltatel of decedents dvlng on or after 111197 and before 111/98
. Spoulal transfers occurring on or after 1/1/98 will be exempt from inheritance tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK (,,1 IN THE APPROPRIATE BLOCKS.
YES NO
1. Did decedent make a transfer and:
xx
o. retoin the use or income of the property transferred, .......................................................
b. retoin the right to designate who sholl use the property transferred or its income, ............... xx
1
I
,
2.
j
I
il
3.
c. retain a reversionory interest; or ................................................................................... xx
d. receive the promise for life of either payments, benefits or care? ....................................... xx
If death occurred on or before December 12, 1982, did decedent within two yeors preceding
death transfer property without receiving adequate consideration? If death occurred aher
December 12, 1982, did decedent tronsfer properly within one year of death without receiving
odequate consideration?..... ............................................................................................. xx
Did decedent own an 'in trust for' bank account at his or her deothL.................................... xx
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
I
,I
...
11\(!SOIlIt 11'1J
L~ SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
+. '--
L
-e~
COMMONWlAllH Of PlNNS\'lVANI4
INHllnANCI 'AX .nU'N
'1IIDINJ D.eIDIN'
Ploa.o Prinl ar Typo
FILE NUMBER
21-96-661
ESTATE OF
Ann R. Wagner
(All prop.,ty ,olntlr-awned with the Righi of Survlvor.hlp mu" b. dlulo..d on Sch.dul. FJ
ITEM
NUMBER
DESCRIPTION
VALUE AT
DATE OF DEATH
Under date of April 28, 1997, Decedent's estate
unexpectedly received a check in the amount of
$4,528.16 for an inheritance by the Decedent.
Receipt thereof is being reported within thirty (3
days and the Estate of Ann R. Wagner believes
neither interest nor a penalty should be charged
thereon. 4,528.16
(see attached copy of check)
TOTAL (AI.a onlor an lino 5, Roca Hulatian) S 4 , 528 . 16
(Attach addilionolSI1H x !lH .h.." if more 'poce b ne.ded.)
""":*-"-;"'{l"i,~',,,,,,,,',, ,- ii,,' ';:4
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COMMor~W1:^t."1 OF P[NNSVlVAUlA
OEPAI\1MEtH OF HEVEUUE
BUREAU OF INDIVIDUAL TAXES
DEPt 28060'
I-tMUUSOURG, PA 17128.0601
~..
.' ..~
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO, AA211689
nl!J.llfillK (tl-961
RECEIVED FROM:
1-
ACN
ASSESSMENT
CONTROL
NUMDER
AMOUNT
BUNT WILLIAM R
1('1
<oil :as
POBOX 336
NEW BLOOMFIELD. PA 17068
f(ADI~lH[ FOlOH[RE ..
ESTATE INFORMATION:
FILE NUMOER
-----ill-=l9-'lO=-Obt. 1
NAME OF OECEOENT ILAST!
_....wAGNER 01\11\] R
DAlE OF PAYMENT
C:;Sl'La03:ao="3.!>0
tFlRST)
IMII
e !:~9 /19Q7
POSTMARK DATE
e /2A/19Q7
COUNTY
TOTAL AMOUNT PAID
$2.35
_CUl'\tl.ERL.AI>IO
DATE OF DEATH
PB
RECEIVED DY
REMARKSWILLIAM R BUNT ESO
/,
~'ARY C. L&: IS';/, It H
REGISTER OF WILLS
SEAiCHECKII 1619
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COMl..tONWtAlltl or peNNSYlVANIA
O[PMHMENf OF ru:Vcr~UE
ounEAU OF INDIVIDUAL TAXES
OErr 280601
I-tMHUSouna, PA 17128-0601
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
~D
NO. AA 2113 6 4 "[V 1102 ex Ill",
RECEIVED FROM:
,.-
ACN
ASSESSMENT
CONTROL
NUMDER
AMOUNT
WILLIAM R BUNT ESO
POBOX 336
109 S CARLISLE STREET
NEW BLOOMFIELD, PA 17068
101
oJ;?71. e9
fo.Otj{Jl1
ESTATE INFORMATION:
FILE NUMBER
""-IQQJ..-0661
NAME OF DECEDENT IlAST)
~AGlIII'"R al\]N R
DATE OF PAYMENT
rOt.DHERE _
<;SIlL2O;.J-PO_l. 360
IFIRST)
IMII
'5/'30/97
POSTMARK DATE
o /-OO.LQo
COUNTY
-CUl':IBFRI liNn
DATE OF DEATH
TOTAL AMOUNT PAID
$271.69
REMARKS SUSAN D WAGNER
C/O WILLIAM R BUNT ESO
SEALCHECKII 2198
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RECEIVED BY I
"IAR)' C. LEw IS
REGISTER OF WILLS
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146889 COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OP REVENUE
OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
.
RECEIVED fROM:
ACN
ASSESSMENT t:'
CONTROL ~
NUMBER
AMOUNT
..~n"III,",'1
fJ
101
$11,1,1,11,10.1,11,1
BUNT WILLIAM H
109 SOUTH CARLISLE STREET
NEW DLOOMFIELD, PA 17068
EST"'TE INFOR/MTION:
m FILE NUMBER
g 21-1996-06b1
t:I N.o.ME OF DECEDENT {L/.ST]
Ia WAGNER I~NN R
II DATE OF P...YIoIENT
B POSTM...RK IE
COUNTY
5!:iN 203-20-l,360
(FIRST] (loll)
CUMBERLAND
D"'TE Of DEATH
m TOTAL AMOUNT PAID
$10,000.00
CW
REMARKS
DEBRA W ZEMBOWER
SEAL CHECK" 0581
REGISTER OF WILLS
_ __ _.... ___4 _._ - - - .-- -- .--- ... - .---- ..---.. .
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PURPOSE OF
NOTICE:
To fulfill the requlr...nt. of Sactlon 21~0 of the Inherltanc. and (.tat. Ta. Act, Act ZI of 1995. (72 P.S.
Sact Ion 9140 J.
PAmNTI
Dltach the top portion of thl. Notlc. and .ub.lt with your pay.ant to tha Rlglatar of Will. prlnt.d on the
r.var.. lid..
.. Maka ch.ck or .onay ordar p.yabla tal RECISTEA Dr WillS, ACENT.
REFUND (CR):
A r.fund of . ta. cr.dlt, which WI' not r.qu..t.d on the taM r.turn, ..y bl r.qu..tld by co.pletlng an "Application
for R.fund of P.nn.ylvanla Inh.rltanc. and E.t.tl Ta." CAEY-IlIl). Application. .r. .vallabl. at the OffiCI of
thl Algl.t.r of Will., any of thl Zl Rlv,nu. DI.trlct Office. or by calling the .p.clal 21t-hour an.w.rlng ..rvlc.
~blr. for for.. ordlrlngl In P.nn.ylv.nla l.aOO.16Z-Z0S0, out.ld. P.nn.ylvanla and within loc.l
Harrisburg .r.a (111) 181-8094, 100' (717) l1Z-ZZSZ Otllr1ng lapalred Only).
08JECTIONS: Any party In Int.r..t not ..tl.fl.d with the appr.I....nt, .llowanc. or dl.allowanc. of d.ductlon. or ........nt
of tax (Including dl.count or Inter..t) a. .hown on thl. Notlc. .ay obj.ct within .I.ty (60) d.y. of r,cllpt of
this Nolin byl
.-wrltt.n prot..t to the PA D.parta.nt of Rlvenue, Bo.rd of App..l., O.pt. Z810ZI, Harrl.burg, PA 17128-IOZI, OR
--.I.ctlng to halo" the ..tt.r d.t.raln.d .t the audit of the .ccount of the p.r.on.1 r.pr...nt.tlv., OR
--app.al to the Orphan.' Court
AD"IN.
ISTRATlVE
CORRECTIONS I
Factual .rror. dl.covlr.d on thl. a.......nt .hould b. addr....d In writing tal PA D.part'.nt of R.v.nu.,
Bur.au of Tndlvldual Ta..., ATTN: Po.t A.......nt A.vlew Unit, DEPT. Z80601, Harrl.burg, PA I11za-0601
Phon. (111) 787-6505. Sea pagl 5 of the booklet "In.tructlon. for Inharltanc. Ta. R.turn for a R"ld.nt
D.cld.nt" (REY.1501) for an a.planatlon of .dllnl.tr,tlv.ly corr.ctabl. .rror..
DISCOUNT:
If any t.. due I. paid within thr., (1) cal.ndar .onth. aft.r the d.c.d.nt'. d.ath, a flv. p.rc.nt (5~)
dl.count of the tax paid I. allow.d.
PENALTY:
Th. 15~ ta. 1In..ty non-participation p.nalty I. co.put.d on the total of the ta. and Int.r..t .......d, and not
paid bafor. J.nuary 18, 1996, the flr.t day aft.r the and of tha ta. ..n..ty p.rIOd. Ihl. non-participation
p.nalty I. .pp.alabl. In the .... ..nn.r and In the thl .... tl.. p.rlod .. you would .pp..1 the taM and Int.r..t
th.t ha. b..n .......d a. Indlcat.d on thl. notlc..
INTEREST:
Int.r..t I. charg.d bIg Inning with flr.t day of dellnqu.ncy, or nln. (9) .onth. and on. (I) day
fro. thl d.t. of daath, to the data of pay..nt. 1.... which beca.. d.llnqulnt b.for. January I, 1982
b..r lnt.r..t at thl rat. of .1. (6~) p.rc.nt per annu. c.lculat.d at . d.lly r.t. of .000164.
All t.x.. which b.c... d.llnqu,nt on or aft.r January I, 1982 will b.ar Int.r..t at a rata which will vary fro.
cal.ndar y.ar to c.l.ndar y..r wIth that r.t. announc.d by the PA D.part..nt of R.v.nu,. Tha epPllcabl.
Int.r..t ret.. for 1~8Z through 1991 .r.:
V.ar Intlrnt Rata D.lly Intlr..t factor Vear Inter..t R.t. D.lly Inter..t Factor
1982 ZO~ .0005"8 1981 .~ .000Z41
UU l.~ .oooua 1988-1991 IU .000301
191' ll~ .OOUOI 1992 .. .000Z41
1915 U~ .00U56 1995-19~4 7~ .00019Z
1986 In .00027" 1995-1991 .~ .000241
....tnter..t Is ulculat.d O. followlI
INTEREST = BALANCE OF TAX UNPAID X NUNBER DF DAYS DELINQUENT X DAILY INTEREST FACTDR
.-Any Notlc. I..u.d aft.r tha t.. beco... dallnquent will r.fl.ct an Int.r..t calcul.tlon to flft..n (IS) days
blyond the data of the ........nt. If pay..nt I. .ad. .ft.r the Int.r..t co.putetlon date Ihown on the
Notlca, additional Intarllt "".t ba calcul.t.d.
CDMMOfM"Alltt or PU'c'YlVAHIA
DlPAAIHlHI or R[YUU
IURlAU or INDIVIDUAL f'kll
DlPI. nUll
tWlAIIILltO, PA 11111-0.01
'*'
/:) / ',J I J I
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
.t',U'I" U, 1'."1
('
FILE NO. 21 96-0661
ACN 96161522
DATI! 12-30-96
EST. OF ANN R WAGNER
5.5. NO. 203-20-4360
DATE OF DEATH 08-05-96
COUNTY CUMBERLAND
TVPE OF ACCOUNT
o SAVINGS
!Xl CHECK ING
o TRUST
o CERTIF .
SUSAN 0 WAGNER
668 S 82ND ST
HBG
REHIT PAYHENT AND FORNS TO.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
PA 17111
AHERICHOICE FEDERAL CU h.. provided the Departeent with the Infor..tlon Ihted below which hu b.en u..d In celcul.tlnQ the
potential taM due. fhelr rl<ord. Indl,.te that at the d.ath of the ebov. decedant, you ",.re a joint ownar/beneflclary of thl. account.
If YOU f.al this Infor.atlon Is Incorr.ct, pi.... obtain written corr.ctlon fro. the tlnancbl In.tltullon, attach. copy to this for.
and r.turn It to tha Abov. .ddr.... Thl. ar.count ,. t.xebl. I" accnrdarr.e with tha Inharltanc~ T~w law. of the Coa.~nwaalth nf P.nn'vlvftnl..
Que.tlon. .av ba an.wared by calling (111. 181-8321.
COMPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAVMENT INSTRUCTIONS
Account No. 1024-013 Doh 10-13-80
E.t.blhhed
To In.ura proper cradlt to your .ccount, two
(2) copla. of thl, notlca au.t .ccoapanv your
pav.ant to tha Ragl,tar of Will.. "aka check
p.Vable to: "Ragl,tar 0' Will., Agant".
Account Bolonco 575.00
Porcont To.obl. K 50.000
Allount Subjoct to To. 287 .50
T.. Rot. K .06
Pot.nU.1 T.. Du. 17.25
~~ TAXPAYER RESPONSE
[01 FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL TAX ASSESSMENT BASED ON THIS NOTICE
HOTE: If t.x pav.ant. .re .ada within three
(3) .onth. of tha decedent'. date of daath,
YOU .ay deduct a S~ dl.count 0' tha taw dua.
Anv Inharltanca t.. due will baco.e dellnqu.nt
nln. (9) .onth. .ftar'the d.t. of da.th.
A. ~rha above Infor..tlon and t.w dua I. corr.ct.
~ 1. You .av choo.. to r..lt pay.ant to tha R.gI.tar of Will. with two copl.. of thl. notlca to obtain
a dl.count or avoid Int.r.st, or you .ay ch.ck box "A" and r.turn thl. not Ie. to tha Regl.tar of
Will. and an offlcl.l ........nt will b. ls.u.d by the PA O.part.ant of R.venue.
[CHECK ]
ONE
BLOCK
ONLY
8. c=J T~ ftbove ....t h.. ba.n or will b. r.ported and t.. p.ld with the P.nn.ylvanl. Inh.rltanc. T.w r.turn
to b. fllad by the dec.d.nt'. r.pr.s.ntatlv..
C. c=J Tha above Infor..tlon I. Incorr.ct and/or dabt. and deduction. were p.ld by you.
You au.t co.pl.t. PART ~ and/or PART ~ balow.
If you indicate. different tax r.te, pla..e .tata your
ralation.hip to daced.nt:
PART
~
TAA RETURn - ~OKPuTAT.ON
LINE 1. D.t. Eatobllah.d
2. Account Balanca
3, Parcent T.xable
4, A.aunt Subject to Tax
S. Debt. and Daduction.
6. A.ount T.xabla
7. Tax Rate
8. Tax Dua
OF TAA ON JO.~T/1KUST A~~uuNi~
I
2
3 K
4
5
6
7
B
f'AU
1
2
3
4
5
6
7
8
DEBTS AND DEDUCTIONS CLAIMED
K
PART
~
DATE PAID
PAVEE
DESCRIPTION
I
TOTAL CEntar on Lina 5 of Tax Co~put.tion)
OFFICIAL USE ONLY 0 AAF
PA D~.cllTHENTOF REVENUE'
~ m,. 'lEl :;g :0
. . .1.
p;. ..... . (!::- n .
h.~
::0
, '4
: :'::1
?' .~
'- ....1
~
.~.,;.~
-"
uT
Q.
AMOUNT PAID
I
.
Undar penaltie. of parjury, I declare that the
cODPlete to tha ba.t of .y knowladge and baltef,
'~"-:l'" /cO g~rJ"l(1
AVER SIGN Rf
fact. I h.va reported aboye are true, corract and
HOME (7/7) Sc.." ' 7,.J.,:) 0
WORK (7/7) tr / J . ,.:}.::. 10
TELEPHONE NUMBER
GENERAL INFORHATION
1. fAILURE TO RESltONO WILL RESULT IN AH OffICIAL TAX ASSESS"EHT with "PPllubl. Int.,.., IUUM on Infor..tlon
IUbIIIUIId b., the flRMClI,. InltltuUon.
I. IntMrlhncl till bK~. delinquent nine Mnth. .ft.r the dKedent', dl" of d..th.
S. A Joint acCOU1t II '..abl. Iven though the decedent', nu. iii" lidded .. .. ..tI.,. of tonvenlWlU.
4. AccOWIh (Including tho,. held bet...." hulbllnd and IiIlhl which the dlud-.t put In Joint ",I'" ..lthln one yet, prior to
deaU, Ir. fulh '''lib., II I'''''''.r,.
S. Account. "I~llahed Jolntlv bet...en husband And ..If. .uti IhftO one ."., prior to d,ath .r. not ".IIb!,.
.. Accounh held b., .. dee.....' "In truI' fa," anat"-r Dr othe" .r. '...bl. fullw.
REPORTING INSTRUCTIONS - PART
1
- TAXPAYER RESPONSE
1. BLOCK A ~ If the Inlor..tlon IInd c~t.tlon In thl nollel Ir. correct and deduction, .r. not baing c1alaed, piece an "X"
In block ..".. 0' P.rt 1 0' thl "r..PI.',. R..pon.... ..ctlon, Sign two copl.. end tubalt th.. with your check 'or the ~t of
I.. to the A-vlthr of Wllh 0' the county Indlnled. 'he PA Dap.rt.."t 0' Anenu. will It.ue en offlcl.1 ........"t
(for. A[V-lS4a EX) upon r.c.lpt of the r.turn '1'0' the R.gl.l.r 0' Will..
z. alOCk. - If the ....t 'p.clflad on Ihlt not Ie. h., b.." or will b. r.port.d end IIIll paid with lhe Pam.ylv."l. Inh.rltanc.
T.. A.turn 'Il.d by the d.c.dent'. r.pr.l.nlatlv., plac. en -X- In block -a- of Part I of lhe -T..pay,r Aa,pon,.- ..ctlon. Sign one
copy and relurn to tM PA Deput.."t of Rn.nu.. aur.", of Indlvldu.l ,...., D.pt 280601. Ii.rrhburg, PA 111Z1-06DI In the
env.lopa provided.
s. BlOCk C - If the notlc. Infor.'tlon I. Incorrect andlor d~tlon. .r. b.lng cl.I..d, ch.ck block ~C- and cOIpI.I. Part. 2 and S
.ccordlng to tha In.lructlon. b.low. Sl~ two coal.. .nd lubalt th.. with your chack far the ..ount of t.. p.yabl. 10 Ih. R'al.tar
of Willi of the counly Indlc.tld. Th. PA D,p.rt..nt of A.v.nu. will 1.lu. en offlcl.1 ........nt (far. REV.15~1 EX) upon r.calpt
of the r.turn frol the RIglltar of Will..
TAX RETURN - PART 2 - TAX COHPUTATION
LINE
1. Enlar tM d.t. lhe .ccount arlgln.lly w.. ..Iabll.h.d or tltl.d In lhe .ann.r ..I.tlng .t d.l. of daath.
HOTE: for a decadent dYing .flar IZlIZ/IZ: Account. which Ih. dac.dent put In Joint n.... within on. (1) yaar of d..lh ar.
t..abl. fully.. Iran.hrs. !towevar. thar. h ." a.c1u.lon not 10 ..c..d H,DDD par trl!lnlfar.. ,..gardl..1 of Iha valua of
the account or tha ~bar of account. h.ld.
If a dOubl. a.t.rl.k (..) appalr. b.for, your flr.t n... In Ih. .ddra.. portion of Ihl. notlc.. Ih. IS. 000 a.clullon
.lr'ady ha. ba.n deduct.d fru. the account balanc. a. raportld by the flnancl.1 Inllltutlon.
Z. Entar the lotal b.lanc. of the .ccount Including Int.ra.t accrued to Ih. d.l. of daalh.
S. The parcent of the .ccount thai I. la.abl. far .ech .urvlvor I. d.taralnad .. fallow.:
A. Tha parcant t...bla for Joint ....t. a.t.bll.had aar. than on. ya.r prior to the d,c'dent'. d'.lh:
1 DIVIDED ay TOTU HUHIER OF
JOINT OWNERS
E.aapl.: A Joint ....t raglst.r.d
DIVIDED IY TOTAL HUHBEA OF X 100 - PERCENT TAXAllE
SURVIVINC JOINT OWNERS
In the n..a of tha d,c.dent and two oth.r p.r.on..
B. Tha p.rcant ta.abla for ....t. cr.al.d within ona YI.r of tha dacadant's d..th or .ccount. ownad by tha dec.d.nt but h.ld
In tru.t for ano~r Indlvldual(.} (tru.t b.naflclarl..):
1 DIVIDED IY S (JOINT OWNERS) DIVIDED BY Z (SURVIVORS) _ .161 X IDa _ 16.1~ (TAXABLE FDA EACH SURVIVOR)
I DIVIDED BY TOTAL NUHlEA OF SURVIVINC JOINT
OWNERS OR TRUST BENEFICIARIES
X 100 . PERCENT TAXABLE
E.aap1a: Joint .ccount r.gl.t.r.d In lhe nae. of Ih. dacld.nt end Iwo olh.r par.on. and ..tabll,h.d within ana ye.r of d..th by
lhe d.ced..,t.
1 DIVIDED BY Z (SURVIVORS) . .50 X 100 . 50~ (TAXABLE FOR EACH SURVIVOR)
4. ~ .aount .UbJ.ct to t.. (1In. 4) I, detar.ln.d by aulllplYlng lhe account balanc. (1lna Z) by the parc.nt t..abl. (lln. S).
5. Ent'r the tol.1 of the dabt. and daductlon. II.t.d In Part S.
o. Tit.. ___Ii,. ~.JllIIlIl.. ~..ilt" 0; i. ....'w,..IIIW\J gy IUUUtlCO~.i.IoV "", loJ.uu ..Id l.l1fUU1;.iul'I. ,ill... 5; ir... U.., 1NU\M1' .uOj~i. ~'" i.... ,..i,,. ~;.
1. Ent.r thl approprl.t. I.. r.t. (I!ne 1) .. dater.lned b.low.
A. For deta. of d.ath occurring .'tar 6/S0/94, the ta. r.t.. far tran.f.r. to ,paUla. er. a. follow.:
1. Oal.. of d..th an or aftar 111/94 and b.for. 1/1/95 the r.t. I, SX.
Z. D.ta. of d..lh on or .fter 1/1/95 tr.nlf.r. 10 .pOu... will b. I...d el OX I.. r.ta.
Not.: For dat.. of daath prior 10 1/1/94 tran.f.r. 10 SPOUI.. .r. I...bl. .t 6~.
8. Tran,f.r. to llne.1 d..c.ndent. Including f.th.r, lolhar, son, daught.r, grandchlldr.n, .on-In-l.w,
deught.,.-In.lew, .tepchIJd and th.lr I..u. .,.. t..abl. .t .Ix p.rcent (6~).
C. Tran.f.r. to ell oth.r. Including broth.r, .I.t.r, unci., aunt, naph.w .nd nl.c. .r. la.abl. at flflean p.rcsnt (15~).
D. If YOU changa the t.. rat., pl.... sp.clfy your r.lallon.hlp 10 the d.c.d.nt In the .raa provldad.
I. The aaount of t.. due (line I) I. d.t.r.lned by aultlplYlng the .aount la.abl. (1In. 6) by the t.. r.la C1Jna 1).
CLAIHED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIHED
Allowabla debit and deduction. a,.. datar.ln.d at follow.:
A. You "gaily .,.. r"POnt!bl. 'or p.Y'",t, or the I.tat. 'ubJlct to ad.lnhtratlon by . personal rapruantatlva h In'ufflclant
to p.y thl deductlbl. It....
a. You actU8lly paid the debt. aft.r daath of the dac.dant and can furnl.h proof of p.y-.nl.
C. Debit baing chlNd IN.t ba Ita. bad fully In P.rt S. If additional .pac. It na.dad, u.. plain p.per 8 11l- x 11-. Proof of
payaant uy be raqu..lad by IhI PA D.p.rt.ent of R.venutl.
,'." 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)
I'; - /.:<1 - 1/
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU or INDIVIDUAL TAXES
INIlfRIUH(l tAll DIVISION
DlP'. laDl~OI
"""AI nUllO, III 1I1i'II"ObOI
NOTICE or INIIERIl ANCE lAX
APPRAISEHENT, ALLDWANCE DR DISALLOWANCE
or DEDUCTIDNS AND ASSESSHENT or lAX
WILLIAM R BUNT
109 S CARLISLE
PO BOX 336
NEW BLOOMFIELD
ESQ
ST
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
PA 1706B
t
.,
" -
06-23-97
WAGNER
08-05-96
21 96-0661
CUMBERLAND
101
Altount R.1I1 Had
~~
/ / ~
t'folJ. .r;-
,It lhl" IU III.H,
ANN
R
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 ....
REV :iSr.""i"EX-AFii- (iii-:ij'fi -NoricE--ciF - "iNH Eii i lANCE -"r"Ax-jiP"jiiiiiisEHENi'-'-- Ai. rciliANcE- oli---mmu - - - - --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF WAGNER ANN R FILE NO. 21 96-0661 ACN 101 DATE 06-23-97
If an assessment was issued previously, lines 14, 15 and/or 1&, 17 and 18 will
reflBct figures that include the total of ~ returns assessed to date.
ASSESSMENT OF TAX:
IS. Allaunt of Line 14 at Spousal rat. tiS)
16. Allount of Lina 14 taxable at lin..l/Cla.s A rat. (16)
17. Allaunt of tin. 14 taxable at CollateraI/CI..s Brat. el7)
18. Principal Tax Due
TAX RETURN WAS, (X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..I Est.t. (Schedule AJ 11)
2. Stockl and Bonda (Schedule 8) (2)
3. Closely Hald stock/PartnershIp lnt.rast (Schedula CJ (3)
4. Hartg.gal/Hota. Raceivable (Schedule OJ (4)
S. Cash/Bank Deposits/Hisc. Personal Property CSchedule EJ (5)
6. Jointly Owned Property (Schedule F) (6'
7. Transfers (Schedule G) (7)
8. Total Asset.
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funerel Expensas/AdM. Costs/Hisc. Expenses lSchedule H) (,)
10. Debts/Mortgage Liabilities/Liens (Schedule II (101
11. Total Deductions
12. Het Value of Tax Return
13. Charitable/Governaental aequests (Schedule JI
14. Het Velue of Estate Subject to Tax
NOTE:
TAX CREDITS:
PAVHENT
DATE
11-01-96
11-01-96
03-05-97
05-30-91
RECEIPT
NUHBER
AA146889
AA146B90
AA185249
AA211364
DISCOUNT I')
INTEREST/PEN PAID (-)
526,32
526.32
.00
.00
) CIIANGED
120.000,00
432.428,57
,00
,00
25,513,83
,00
,00
181
30,671.26
,00
1111
(12)
1131
(14)
,00 X .00=
486.606.00 X ,06=
,00 X .15=
U81
AHDUNT PAID
10.000.00
10.000.00
8.143.76
271.69
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
NOTE: To insure proper
credit to your account,
subnit the upper portion
of this forn with your
tax pay...n t .
517.942,40
30,671 76
547,271.14
60.665,14
486.606.00
,00
29.196,36
,00
29.196.36
29.468.09
271 .73CR
,00
271 .73CR
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FDR CALCULATION OF ADDITIDNAL INTEREST,
( IF TDTAL DUE IS lESS TIIAN $1. NO PAYHENT IS REQUIRED.
IF TDTAL DUE IS REFLECTED AS A "CREDIT" ICRI. YOU HAY BE DUE
A REFUND, SEE REVERSE SIDE OF TillS FORH FOR INSTRUCTIONS. I
~)rj
'i'
,
.J
RESERVATION I E.tat.. a' d,c.dent. dYinG an or b.for. O.c.'b.r 12, 1982 .. I' any future Int.r..t In the ..tat. I..tran,'.rr.d
In po.....lan or .nJoy..nt to Cia.. I (coll.t.r.l) bene'lcl.rl.. of th. d.c.d.nt aft.r the ..plr.tlon of any ..t.t. for
11ft or for y.ar., the Co..onw..lth h.r.by ..pr...ly r...rv.. the right to appral.. and ft..... tr.n.f.r Inh.rltanc. f....
.t the la.lul CIa.. I Icollat.r.11 rat. on any .uch lutur. Int.r..t.
PURPOSE OF
NOflCE:
To ful'lll tha r.qulr...nt. 01 S.ctlon Zl~o 01 the Inh.rltanc. and [.t.t. 'a. Act, Act 21 01 1995. 112 P.S.
S.ction 9IltO).
PAYMENT,
D.tach the top portion of this Notlc. and .ub.lt with your pay..nt to th. R.gl.t.r of Wills prlnt.d an the r.v.r.. .Ide.
"-Hak. check or .an.y order pay.bl. to: REGISTER OF KILLS, AGENT
AEfUND ICA) I
A r.'und of a taM cr'dlt, which w.. not r.qu..t.d on the TaM A.turn, .ay b. r.qu..t.d by co.pl.tlng an "ApPllc.tlon
for A.fund of P.nn'Ylvanl. Inh.rltanc. and [.t.t. Ta." IREV-131]). Appllc.tlon. .r. avall.bl. .t the Dfflc.
of the Aagl.tlr of Will., any of the Z3 A.v.nua District Ofllc.s, or by c.lllnG the ,p.cl.l ZIt.hour
an...rlng ..rvlc. nuab.r. far for.. ord.rlng: In P.nn'Ylvanl. 1-8oo-36Z-ZoSO, out.lda P.nn.ylvanla and
within 10c.1 H.rrl.burg ar.a (717) 781-809", lDO' (717) 712.2252 CHa.rlng lap.lr'd Only).
OIJEClIONS'
Any p.rty In Jnt.r..t not ..tl,fl.d .Ith the .ppr.I....nt. allowanc. or dl'.llow.nc. of d.ductlon., or .".""nt
of taM Ilncludlng dl.count or Jnt.r..t) e. .hown on thl. Hotlc. ~.t obJ.ct within SIMty (60) d.y. of r.calPt of
this NaUc. bYI
ADttIN
ISlAAlIVE
CORRECTIONS I
....wrltt.n prota.t to the PA Dep.rt..nt of Alv,nu., lo.rd of App..I" D.pt. Z81021, Herrl.burg, Pi
-..Iectlon to have the ..tt.r dat.raln.d .t audit of the account of the p.r.onal r.pr,s.nt.tlv.,
....Pp..1 to tha Orph.n," Court.
DR
11128.1021,
OR
Factu.l .rror, dl.covar.d on this ........nt should b. .ddr".ad In .rltlng to: PA D,p.rt..nt of A.v,nu.,
lur.au of Individual T...., ATTN: Po.t A"....,nt A.vl,. unit, D.pt. 280601, Harrl.burg, Pi 17128.0601
Phone (717) 781.6505. s.. P.g. 5 of th. bookl.t "In.tructlon. for Inh.rltance TaM A.turn for a A.,ld'nt
D'c'dent~ (REV.ISoI' lor an ..pl.natlon of 'dllnl.tratlv.ly corr.ctabl. .rror..
DISCOUNT:
II any taM due I, paid within thr., (3) cal.nd.r .onth. .ft.r the d,c.dant". death, a five p.rc.nt (5~' dl.count of
the t.M paid Is aUO..d.
PENALlY'
Th. 15% t.. .~..ty non'partlclpatlon p.nalty I. co.put.d on the total of the taM .nd Int.r,.t .......d, and not
paid b.for. Janu.ry 18, 1996, the flr.t day aft.r the .nd of the ta. .en..ty p.rlod. Thl, non'partlclpatlon
p.nalty I. .PP.alabl. In the .... .ann.r and In the th. .... tl.. p.rlod .. YOU would apP'al the taM .nd Int.r..t
thet ha. b..n .......d a. Indlcat.d on this notlc..
INTEREST,
Int.r..t Is charg.d b.glnnlnG with flr.t d.y of d.llnqu,ncy, or nln. 191 'onth. and on. II) day Ira. the d.t. of
d.ath, to the d.t. of p.y'.nt. T.... which b.ca.. dellnqu.nt b.for. January I, 1982 b..r Int.r..t .t th. rat. of
.Ix C6~) p.rc.nt p.r .nnu. calcul.tad at a dally rat. of .oaoI6~. All t.... which b.c... d.llnqu.nt on and alt.r
January I, 1982 will b.ar Int.r..t .t a rat. which will vary fro. cal.ndar v.ar to c.land.r y..r with that rat.
announced by the PA D.part..nt of A,v.nu.. The apPllcabl. Int.r..t rat.. for 1982 through 1991 ar.:
!!!! Int.rut Aat. Dallv Inhr..t r.ctor !!!r Int.r.st A.t. Dally Int.r..t ractor
1911 20~ .Oa05~8 1931 OX .000ZIt7
1983 16~ .000lt38 1988'1991 11~ .000301
1981t II~ .000301 1992 OX .0001"7
1985 15;( .000356 1993.199" 'X .000192
1986 lOX .00021" 1995"1991 OX .ooazo
..Int.rut Is Cllculahd .. followlI
INTEREST = BALANCE DF TAX UNPAID X NUNDER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
..Any Hatlc. IssU.d aft.r th. tax baco... d.llnquent will r.fl.ct an Int.r~st calculation to flft..n (IS) d.y.
b.rond the d.t. of the ........nt. If pay_ant Is 'ad. .ft.r the Int.r..t co.putallon data .hawn on the
Notlc., addltlon.1 Int.r.st .u.t b. cllcul.t.d.
/.'J '/ ,1/ . /j
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
<:~
... , ,:/1:
, '...'~ rP.
.!~l:~,~~i~\'
r.L?:.t'r..,. l,s::J
'-"i.."!!~ .t:~"
('/
BUREAU OF INDIVIDUAL TAXES
INllUfIUHCl lAll DlvlSIUN
DIP'. :801101
IlANR1SBUNC, IIA 1Il,.".OI,OI
NOllCE O[ INIIIHITANCE lAX
AI'I'NUS(HlNT, AUOWANCL OR DlSAllOWAHC[
or OEDUCTIONS AND ASSLSSN[HT or TAX
... ,\.'" 6tt oll HI
WILLIAM R BUNT ESa
109 S CARLISLE ST
PO BOX 336
NEW BLOOMFIELD PA 17068
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
08-25-97
WAGNER
08-05-96
21 96-0661
CUMBERLAtlD
501
AWl
'..~':,~:A,~i~;;_\"]l~~H~d:'::::-l
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER DF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV: is"4""7" EX" Ai: p-- ioi-:ij'fi-Ncj'fi tniF' "iNHERii ANC E --r-AX - APPRiii 5 EHENT -; -A L i:oiiANcE - b-li' .---- n__ - - - -..-
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ANN R FILE NO. 21 96-0661 ACN 501
ESTATE OF WAGNER
DATE
ATTACHED
08-25-97
TAX RETURN WAS:
I ACCEPTED AS FILED
I X I CNANGED
SEE
NOTICE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: LITIGATION
1. R..I Est.t. ISchedule AI
2. stocks and Bonds ISchedule 8)
3. Closely Held stock/Partnership Interest (Schedule CI
4. Hartg_ges/Hotes Receivable (Schedule OJ
5. Cash/Bank Deposits/Hise. Personal Property CSchedule EJ
6. Jointly Owned Property (Schedule FJ
7. Transfers (Schedule GI
8. Total Assets
RETURN
III
121
131
141
151
Ibl
17l
NOTE: To insure proper
credit to your eccount,
submit the upper portion
of this form with your
hx payment.
,00
.00
,00
,00
4 .528,16
,00
,00
181
4,528,16
APPRDVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule HI (q)
10. Debts/Hodgage Liabilities/Liens (Schedule U n01
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests CSchedule J)
14. Net Value of Estate Subject to Tax
.00
,00
1111
1121
1131
1141
00
4.528.16
,00
4,528,16
If an assessment was
reflBct figurBs that
ASSESSMENT OF TAX:
15. A~ount of Line 14
16. Anount of Line 14
17. Anount of Line 14
18. Principal Tax Due
TAX CREDITS:
PAYMENT
DATE
05-30-97
issued previously. lines 14. 15 and/or 16. 17 and 18 will
includB the total of abh returns assessed to date.
NOTE:
at Spousal
taxable at
taxable at
rat. C1S)
Lineal/Class A rate C161
Collateral/Class Brat. (171
.00 K'oo:
4.529,16 x,06:
,ooX.15:
1181
,00
271 ,69
,00
271. 69
DISCOUNT It)
INTEREST/PEN PAID (-I
,00
AMOUNT PAID
RECEIPT
NUMBER
AA211364
271 ,69
BALANCE OF UNPAID INTEREST/PENALTY AS OF 05-31-97 I TOTAL TAX CREDIT I
BALANCE OF TAX DUEt
I INTEREST AND PEN. I
I '
I TOTAL DUE
271. 69
.00
2.35
2,35
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FDR CALCULATIDN OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN $1. NO PAYMENT IS REQUIRED,
EF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI. YOU MAY BE DUE
A REFUND, SEE REVERSE SIDE OF TNIS FDRM FDR INSTRUCTIONS. I
R
":
RESERVAIIOHI E.t.I.' 0' ..c...nt. .,In. on or b.lor. O.c..b.r I', I'.' -- I' .n, lutur. Int.r..t In tho ..t.t. I. Iron...rr..
In .0.....lon or .njo,..nt to tl..' . Icoll.t.r.ll b.n.flcl.rl.. 01 tho ..c...nt ..t.r Ih. .,.Ir.tlon of .n, ..I.t. for
II'. or 'or ,..r., Ih. to..on...llh h.r.b, .,.r...I. r...r..' Ih. rl.ht to o..r.I.. .n. ...... Ir.n.,.r lob.rll.nc. t.,..
at tho lawful Clall B (collateral) rate an nny suCh future Intar.st.
PURPOSE OF
HOTlCEs
PAYMEHT l
REFUND (CAI:
OBJECTtOHS:
ADHIH
lSTRATlVE
CORRECT IONS I
DISCOUNT:
PEHALT't:
INTEREST:
To 'ulflll Ih. r.oulr...nl' of S.ctlon 'I" 0' tho lob.rlt.nc. .n. E.t.l. T.' Act. Acl 'I of I.... 11' .,S.
Sactlon 1)1"OJ.
O.I.Ch tho 10. .orllon of thl. Hollc. .n. .ub.lt .llh ,our ..,..nt to tho R..I.I.r 0' Hill. .rlnt.. on Ih. r...r.. .1...
.-Hak. chack ar 1lI0ne.., order payable to: REGISTER Of MILLS, AGENT
A r.fun. 0' . t., cr..II, .hlch ... nol r.qu..I.. on tho T.' R.lurn. .., b. r.ou..I.. b, co..I.lln. .n .A..llc.tlon
for R.lun. 0' ..nn.,I..nl. lob.rlt.nc. .n. E.I.t. t.,. IREV'ISISl, A..llc.llon. .r. ...II.bl. .1 Ih.O.flc.
of Ih. R..I.I.r of Hili., .n, 0' Ih. ,S R...nu. OI.lrlcl OI.lc.', or b, collin. Ih. ...cl.1 ,'-hour
.n...rln. ..rvlc. nu.b.r. 'or 'or.. or..rln.: In ..nn.,I..nl. I.....S.,.,..., oul.I.. ..nn.,I..nl. .n.
.Ithln 10c.1 H.rrl.bur. .r.. 1111' ,.,.....' TOO' 11111 """" (H..rln. 1...lr.. Onl,l,
An, ..rl, In Int.r..t nol ..11..1.. .llh Ih. ...rol....nl. .llo..nc. or .1..llo..nc. of ...ucllon., or o....s..nl
0' I.' Ilnclu.ln. .Iscounl or Int.r.sll .. sho.n on Ihl. Hollc. .u.1 obj.cl .llhln .1,1, 1'" ..'s 0' r.c.I.1 0'
this HoUee by:
...rlll.n .rol.sl to Ih. .A o...rl..nl of ....nu.. Bo.r. 0' A....I., 0..1, '.1"" H.rrlsbur., .A
...I.cllon to h... Ih. ..tt.r ..t.r.ln.. .1 .u.11 0' tho .ccounl 0' tho ..rson.' r..r.s.nt.tl...
.-appeal to tho Orphans' Court.
171za-lozt,
DR
r.clu.1 .rror. .I.co..r.. on Ihl. ..s.....nt shoul. b. ...r..... In .rltln. tOI .A o...rl..nl 0' R...nu.,
.ur..u 01 In.I.I.u.1 Tn'.s, "TH: .0.1 A.....o.nl R..I.. Unll. O..t. ,...", ".rrl.bur.,.A \11,.'.."
.hon. "1" ,.,...... S.. .... . 0' tho boo'l.t .'n.tructlons lor Inh.rlt.nc. T., R.lurn lor. ...I..nt
nocodont" (REY'l~Ol) for an ..planatlon of adllllnlslrellvel" torraetable .rror'.
" .n, t., .u. I. ..1. .Ithln thr.. 'Sl c.l.n..r .onth' .It.r Ih. ..c...nt'. ...th. . fl.. ..rc.nt I'" .I.count of
the taM paid 1_ allowed.
Th. '" t., .....t, non...rtlcl..tlon ..n.lt, I. co..ut.. on tho tot.1 0' tho t., .n. Int.r..t .....s... .n. not
..1. b.' or. J.nu.r, ", I.... tho 'Ir.t .., ..t.r tho .n. of th. t.. ..n..t, ..rlo., Thl. non...rtlcl..tlon
..n.lt, I. .....,.bl. In tho .... ...n.r on. In th. Ih. sn'. tl.. ..rlo. .. 'ou .oul. .....1 tho t., .n. Int.r.st
that haS b..n aSI.,s.d a. Indicated on this notice.
Inl.r..t I. ch.r... b.. Inn In. .Ith first .., of ..llnou.nc" or nln. '" nonth' on. on. (I' .., 'ro. tho ..t. 0'
...th, to tho ..1. 0' ..,..nl. T.'.' .hlch b.c... ..llnou.nt b..or. J.nu.r, I. I'.' b..r Int.r..t .t tho r.t. 0'
.1' 1'" ..rc.nt ..r .nnu. c.lcul.t.. .t . ..11, r.t. of ....,... All t.,.s .hlch b.c... ..llnqu.nt on .nd .ft.r
J.nu.r, I, "" .111 b..r Int.r..t .t . r.t. .hlch .111 ..r, 'ro. c.l.n..r ,..r to c.l.n..r ,..r .Ith th.t r.t.
.nnounc.. b, tho .A o...rt..nt 0' R...nu., Th. ...,'c.b'. Inl.r.st r.t.. 'or 1'.' through ,.., .r.1
'!!!! tnt.ro.t Rat. DallY I",tornt ractor ~ tnt.rast RlIt. DallY Inl.,ut Factat
llJ8Z zo7. .Ooo~"a 1'J87 "" .00U47
l'JU 167- .000ltS! 1'Jas-l'J'J1 117- .00nOl
IlJ8lt 117- .000301 llJlJ2 "" .000247
IlJ8S 131- .0003S6 1'JlJ3-llJlJlt '" .000llJ2
1lJ8ft 107- .00021/t llJlJ~-lqfJ' "" .OOU/t'
__Int.'.., h calculat.d OS fol1owI1
INTEREST = BALANCE OF TAX UNPAIO X NUHBER DF DAYS DELINQUENT X DAILY INTEREST FACTOR
,'An, Hotlc. I.su.. .ft.r tho t.. b.cO.o' ..llnou.n. .111 ro'l.ct .n Int.rosl c.lcul.tlon to .I.t.on 11" .0"
b.,on. tho ..t. 0' tho .s...s..nt, I' ..,..nt I. .... ..t.r th. In..r..t co..ut.tlon ..t. .hown on tho
Notiu, additional lnt.'.., .us' b. calcuht.d.
OR
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-. .
STATUS REPORT UNDER RULE 6.12
Name of Decedent: ANN R. WAGNER
Date of Death:
8-5-96
Will No,
Admin, No, 21-96-661
Pursuant to Rule 6,12 of the Supreme Court Orphans' Court Rules, I report the following
with respect to completion of the administration of the above-captioned estate:
1,
State whether administration of the estate is complete: Yes
No X
2, If the answer is No, state when the personal representative reasonably believes
that the administration will be complete: three months
3, If the answer is to No, 1 is Yes, state the following:
a, Did the personal representative file a final account with the Court?
Yes No XX
b, The separate Orphans' Court No, (if any) for the personal representative's
account is: None
c, Did the personal representative state an account informally to the parties
in interest? Yes XX No
Date:
d, Copies of receipts, releases, joinders and approvals of formal or informal
accounts may be filed with the Clerk of the Or~ns' Court and may be
attached to this report, rf(
,J/; &/9 7 SiQlt/~i
f f Sig ture
William R, Bunt. Esquire
Name
.~.,
") '..
~""J .. ,"
,"
f'~
t:
""
:.;
.....
P' ..I :>
UU
109 S, Carlisle Street
p, 0, Box 336
New Bloomfield, PA 17068
Address
_1"
0: .-
(717 1582-8195
Tel. No,
Capacity:
Personal Representative
X Counsel for Personal
Representative
STATUS REPORT UNDER RULE 6,12
Name of Decedent:
Ann R. Wagner
Date of Death: 8/5/96
Will No,
Admin. No. 21-96-661
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 XX 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. I is Yes, state the following:
a. Oid the personal representative file a final
account with the Court? Yes___.__ No XX
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Oid the personal representative state an
account informally to the parties in interest? Yes XX No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be at ache 0 this report.
Date: 9/30/98
,.-
signat.ure
William R. Bunt, Esquire
Name (Please type or print)
b~6.sgg~h35grlisle Street
NGa'al Illoomfield, PA 17069
-A ress
i" ~
,
( 717J 582-8195
Tel. No.
,.
,. "I
c:.:"
.""1
';)\
Personal Representative
.n :;
,]c.;
Capacity:
XX Counsel for personal
representative
(HAH: rmfl AM3)