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HomeMy WebLinkAbout96-00687 ;L E 0 ::J ~ t- u 0<> .:3 { I ~ -' i 0" I ~ ..... ~ 0 ".l: LIJ :S ~ CD f1 ~ ri\ .. ~ . D ~ <J; 0 VI .. ::l :>- ci, Z '" ~ ~ ~ U ("i \ PETITION FOI{ PHonATE aud (;nANT OF I.ETTEHS dJ - ICV,0., (J)t'l ^Ilna C. F\11{,(\1II(11' No. 1'0: H"II/(I! 0/ arm known us ~_.___. ._.._.....__._.. Regbler or Wills ror tile _____._.____. ..___.. . ......__ _ _j Drrrl/"l'd. County or COlllbeE 1;,"'(1.__._ In Iile Sodal Sl'l'lIrily No, ._..JO.H.~.(J2-~g.'.~I________... Commonweallh of Pennsylvania Tile pelilion of Ihe undersigned respeclrully represenls Iilat: Your petilioner(s), who is/ar.c 18 years of age or aider an Iile execul______...._.__...____,.__.... /l!!n)ed in the last will or Ihe abol'e decedent, dated _.._......,1l1l1-"...9_._.._____..._______, 19.....0__ and eodieil(s) daled __.._.._~.o..'2"---_..- ..- ....-...-..--...---.-.---.....--.-------.---- Elllonuel J. Fulcomer INdeceBsed - death certificate attached --'~le 11 oi;li,,'n k'.IIo-r,;e rI'y'1;iic=~r:.rl~~~"::N:-i t j 0 nii'Cil,ink:,;rSh j p ptm, s b u rgt -[1:'9 -:: . _.____._.J en 0 .illl(gsL.::.... [Qll11il.<;'~ a '-1..0 lL.ilJj:1J.gl\Q\!.~E.lfu1J)l!AL,I. L Fu I C 0If&L.......!J:.L...DL9JlJ Y child "I (Slille: rdC\'lHlll.'ircllmsHlIlCCs, e,g. r~'nllnd;lIic'll, death of c:c;eClllO" etc,) deCOflHL'd - renlltH::idtJon attached Decedent "'" domiciled al dealil in __i:_~-",-be.!"l,~.____ Count)', Pennsylvania, with h_er last family or prineipal residence al_S.c'\IJ!ILTQ.,I"LJlome ,,2Q.JIOQr.Q)Jl_nd Avelltle,-- Cn r 1 Is~.1'6..1._~i.Q.LL......______.__________.___. lIi!<l ~ln'('l. lHHllbt'r, 'J'wp. or Bond Deeederll, Ih,'n __..9,Q _____ )'ears of age, died June 2 , 19~~, at _..Sa Ul.b.._J.\l.d.g,lhlI110-,---20_1:lool'el an"LAY.~J)J.I."-.L Car Us le,_..Eh 1701.l... ' Except as follows, decedent did nOI marry, was not divorced and did not have a child born or adopted after execution of the will orfered ror probate; was not Ihe victim or a killing and was never adjudicated incompetent: __...JlQD.Q.___.._._..-_~_--_-__---.__-_ Decedenl at dealh ollned properlY wilh estimaled l'allleS as follows: (If domiciled In Pa.) ^II pcrsonal properlY (If not domiciled in Pa,) Personal properlY in Pennsylvania (If not domiciled In Pa,) Personal properlY in County Value of real estale in Pennsylvania situated as follows: _.____!lene______. $ 26,000,00 $- $--- $.. WHEREFORE, petitioner(~) respectfully reqnesl(s) the probate of the la~t will and codicil(s) presented herewllh nnd the granl of Icllers_. of admj nlstration c, t. a. t~,c..ron. 1/ ~--- L).. ((L- h -\r;er~;' .A:-L~ll~ Q~sl? . 19 =~__=_--- .J..c:=- 3~ .f-~-- "~ 30 11 " Vi ((C~Il\l1lcnlary; "dmlnlSlration C,t,a,; admlnl'ilralloll d.b,n.c,C8,) 126 East KlnR Street Shipp"nnb\lUl,J1} 17257 (717) 532-73BS .-\. -- .- ~ ----------- ___N_._.._,_N______.~__ - ----_._.._-~_._-_..__..._.- ..-.__.-.".._----~,--_.._----- OATH OF PEHSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA } ss COlJNTY OF ___i;jJtl!U~El"\!_iJ)__.__._ The petitioner(s) above.named \'wear(s) or affirm(s) Ihal the S1atements in the foregOln~' Illon are true and correct 10 the hest "f Ihe knowledge and belief of pelitioner(s) and Ihat a pers I rerresen- tallve(s) of Ihe ahol'e deceden! I,etilioner(s) wil\ well la. nd truly admlDlster th[e.sl:~ ae~ .1 &_to Inw. \ l'-/\ ('ti ~7Q ) ~;worn to or affirmed anti suhscribed . __'..:.r (_._,_._~..::--:-.::. _.!:....... ~ -! Co" before me Ihis ._"'~_ _ ~ II].. day of _...-'!~'_rn..6.cJ'!~.~J;J.~ ----. . ~. " " J" " ,. ,,--. 19 . " ._}jJoJzru I M13I;;.\:i~.. .- .'., -';,'-l.1/-t1H>- ~\__._.m._..__~__________t - ~ 1'j-Ia.~'-7t[, l~u....,...~L )lL.Lf,f1 .,) -. ~. ---------------\ - ~ MAi\:y c. \,1': . -S lie~lJ;l~ _~.i;i.-.-..-m-__.-.-._---.--..J...-.- ~ ,).1 - I ('/e/ Li" - ltJ ~ '7 ~(") .~ :-nfr ~ ~~ '-''-;' ' (, n , " ., I: ;- Jt. ( I , - " -\;l .u t...i :..;,.;. (11 (I, (J )> -~ Ul " -' ~.sa J~-~: ~T,'.' q.~ ~l 1';., "1 ',- R <;~ 8'-'(i') 0,' IJ)CC 0: U"l 'I) N-; 0... i::",!; . ;--~: Q" I". . " G~ t-:_J tp ~ ~ c- ~j) 6~ := ~, ~. > t~ !Xi fly a ~ . u 't1 ~ ~ ~ . oi -Q ~ ~iq ~ ~ ~ ~ w . :E ~ ~ w tI . !Xi . '" ~ 0.. ~ ~ u Ii <: ~ Cl ~ ~ ~ ~ z n: .~ :E Q::J ..-1 ~ ~ d M ~) M o < Z ~ " ' ..-1 .J~W~ ~ ~ <: S ~ :r III ~ -, "." . , ~ t~<~ 'i-.'. ,.:( :1 Cl. I:) -";J' 0.. r-. I 8 .::;; "i !I ( lO f. Iii ci~ ~'i eM CJ~ ;\ RENUNCIA TION In Re Estate of Anna C. Fulcomor deceased. 1'0 the Register of Wills of Cumberland . County, Pennsylvania. John Schall. Trust Of Heer of Mollon Bank, Shippensburg. formorly The undersigned _ National Bank _of Shippensburg, Jll<eeutor appointed under the .w,UI Tho of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters of AdminiRtration C.T.A. be Issued to WITNESS my h d hi d f August _ an t s ___ ay 0 96 ,19__. #i;~ .John Schall (SlsnatuTe) Trust Officer Mellon !lank One West King Street, Shippensburg, PA Nolarlal Soal Shl Olivia J, Zlnn. Notary Publlo Ml8~~~~ig,~~W~g,~~~J~~~ :-f~'3~ , (AIeOiiii, Pennsylvrwa~1Ioo 0/ (Add....) (SI8n8iUro) (Addres,) ~ (818n81"'0) (1"\ t'rE ,,-.. 'to'; (I 0:' CI 'L... ....... (Add,es,) If' n_ "'J {/ , . " r I , , \IJ , (I) if' VI co;) .:., CC' (je) REGJSTgR OF WJJ.LS. CUMBERLAND COUNTY STATUS_REPORT UNDER RULE 6.12 Name 0 f Decedent I Anna C. Fulcomer Date of Death: Juno 2, 1996 Will No. 21-96-0687 Admin. No. . Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules / I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complote: Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: :3. I f the answer to No. 1 is Yes, s tate the following: a. Did the personal representative file a final account with the Court? Yes No X b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes~__ No d. Copies of receipts, releases, joinders and approvals of formal Or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to t is r ort. Date: '1_ j- ? 7 ,.... "1,') ~. , ..' I,') ; ;)~ 0\ ': ,- I I",\-': ~} ~" " f" OJ ::l () U Jerry A. Weiglo, Esquiro Name (Please type 0 print) MARK, WIlIGLE AND PERKINS 126 East King Street Address Shippensburg, PA 17257 .LzJ 7) 532-7388 Tel. No. ,. ,1.'!l.J_ 1.1: Capac ity I X Personal Representative ( MAH : rm f / AM 3 ) X Counsel for personal representative Il( \,; +, '" w _~ ll., ~ ~ .... Q~.s~ 'l'... rJ)_ -o:-o:r-o: Ii.< fIl iC Il. ~ rii ~. .. c l.LJ ::; "':: '" ~-O:;!l5 :i ~g; ~ :a < I.I'! ~ \ 'j ',,1 \\ ,.. "c' ,-" .-. ,"JI p, j.j ~ ::> (> u " ~ '" H .. <II g U '" ..... III 0 .... H ..... H 'M ;J: 4-1 ~ 0 <II .. 1Il . ::> <II <II 0 H j.j .C1 1Il 1Il j.j '.,., 'bI, .. H ;; .. <II 0 '" ~ U U ","J -"Iill '0) --) " - - - - -- ::: - - "-;: - - :: - ~ - ~ =: ~ - I' , .! " ,J. " . t~~ "- ----- ---. .,A. . ~ 4;f"1nl ..... ~ "9/- nqLI'.nL~I,' 7 u g~ tri :TI :J:HD Cl c,-' (I) (j , ,. - ((' ~-~ F t':, J, I ! ..':) -:'- '-,' r<J or [) "f) i- UI '~b :l':R;'_\ IJ1 I, , ) ;., - .----- '""",A.~ ....-L~...... / ,', /'J', '/ _1 INHERITANCE TAX RETURN FOR DATES 01' DEAnl AFTER 12131/91 CflECK HERE IF A SPOUSAL RESIDENT DECEDENT POVERTY CREDIT IS CLAIMED I.! , .,., ',-',- "'M~:)'~:;I\~t'~\I::I';\,Nv~'~:,iANI>\ (TO BE FilED IN DUPLICATE FILE N~~BER 1'1')(, (.)(,1\'/ lJU'T,~lHHHl1 WITH REGISTER OF WillS) IIAIII"""UII","A '71" "'"11 ' COUNTY CODE YEAR NUMBI'.'1 DECEDENT'S NAME (LAST, FIRS'!', AN'D'MI.i~;'l:'".IN.'.'I.{IAI)~.' -- "..... ..'1' II!'~;EDI~. ;~;-'~;(~M.';;I{;il'^I;;;li~;;'~='='''''-''''"''-==~= Fulcaner, Anna C, ,';,11,,\1 '['c:dd IIQw.' , ',() ~bJl'"lalld AW'i\ue SOCIAL SECURITY NUMBEH -plATe ciF-liEA1Ij--'] [JAIl' OF'IJII1i'11 (',u'l [n.!", I'A 1'/013 DECEDENT 208..03-2098 O()/O~/% OIl/;'l/I'iO', COllol 1.\.lIllborland \"'I1A:rr~~ll~~:<';I,'I~r:~:1,'~i: """~',;r '" NA:~::iT;-t~~~A'L:'~~.fl~:,::Mi3EI1 AMOUNT RECEIVED (SEE INSTRUCTIONS) 1. On~ino.l RotUfn TI 2, SUppIO!llOfltc11 Roturn .-----0-:3, RomalndOl ROlurn 14, Nol Valuo Sublocllo Ta, (L1no 12 minus Llno 13) 15. Spousal Translof8(lor datil'! o! C!lhlth nflorO'.30-94}. 500 Inslrucllonr.lo/ Applioable PllfGetltJ~O on Pago l, (In~l(Jdll values from 5~horlulo Kor .'3eho/lulo M,l 16, Amount of Une 14 tnxablo at 6% rale (Include valu8slrom Schodulo K or Schodule M.) 17, Amount of L1no 14 taxnble al15% rata (Inoludo valuo, from Schodulo K or Schodulo M,) 18, Principal la' duo (Add lax Irom Lines 15. 16 and 17,) 19, Crodlls !lpolJs;'l1 POVlllty Cllldll PrlOl' Payments Discount + 650,00 + 32,50 - 20, II L1no 19 Is groalor Ihan Line 19, on lor 1110 dllloronco on L1no 20, This Is Iho OVERPAVMENT, ~<:h.~~ h,'l H yc>u~r.!!!lll..~,ng.r.'und~' your (>vernavrl1.nt, -...J 21, If Uno 18 is groator than Uno 19, onlo, tho difloronca on L1no 21. Tills Is 1110 TAX DUE. A, EntOl tho lntolost on 1110 balanco duo on L1no 21A. 8. Enlot tho total of Lino 21 anc/21A onl.lno 218. Tlli!! i~l 1110 BALANCE DUE, Mak. Check ~ayable to: .Reglster of Will" Agant __ ... . ... BE SURE TO ANSWF.R ALL QUEstiONS ON-PAGE 2 AND TO RIlOtlaOKMA'rt!...... ". Undor ponalllcHl of pO/jUI'Y, I declaro tl1nlI h'AVooxUlYllnOd thl~l lotUln, Including acoompal1ylng Ilcllodulwl and Hlnlomunls, and to Iho bost 01 my kllOwloclqo and bOllof, II is lillO, carmel and complatn, I doclor tl1IlI all ,oal anI ala Il[W hoon ropotfod allnlO mmkol vnluo. Doclaratlon of propmor olhw lllun 1110 pOlf1onal --. to9onlal1vo Is ERood on alllnformntiuf1 01 whlel ~n.!E~~ kllowIClCj~O, ~__~_ ____..._ ,--_'01' N^e.r;" I'I(O~.",:I'l):Ir:tJ":Nr, ill ''')" ;;::~u ~~'hedllJ~:....Cl.l~:'::'.'2hed __ '1L~ 'l~:__ ~;II1~~AllJllf ("If IlLPAflrn:\THlfllHANfHf'fH.r lAllvr All{)HI','; DAIl" !i 1~;6 l~tnt Kin9... StrenL Pit6001 Nil n,,,, ShipP:.,I1Sbllrq, rr\-i'7^'~--------- -----..-.-...-. n;v l~I)() ["0:. 11-\1<1) CHECK APPRO- PRIATE BLOCKS CORRES- PONDENT RECAPIT- ULATION TAX COMPUTA- TION [J 4. L1mitod Esta\o 0 4a, rtlluro l!ltoront ComplollllBO (fOf clfllan 01 doath aftor 12-t2~82) fB 6. Docodent Diad Testalo 0 7. Docodont Mnlnlflinocl a living TrllHI (Allach copy of Will) (Alluch copy of TiIl"I) fuCORRIl$i'ONDE~ca AN~ OONFlb~NrlAlTA)(INFORMATI6N SHOUlD ll~DIREC't~DTO: NAME COMPl.F.TE MAILING ADDRESS ,Je A. Wei le, McArk, Weigle and Perkins TELEPHONE NUMBER 1?-6 Gast King Street (717) 532..7388 sbi Jensbu.tg, PA 1'7257 1, Roal Eolnlo (Schedulo A) ( 1 ) None 2, Slacks and Bonds (SOllOdlllo B) ( 2 ) None 3, Closoly Hold Slock/Porlnorslllp Inloro'l (SCIL C) ( 3) None 4. Mortgagos an(i Nolo' Rocolvablo (Sohodulo 0) ( 4) None 5, Ca,h, Bank Deposlls & Mlscollanoous Porsonal ( 5 I 19 , 37 Proporly (Schodulo E) 8, Jolnlly Ownod Proporly (Schodlllo F) 7, T,an,lofS (Schodulo G) (Schodlllo L) 0, Tolal Gross Assol, (Iolal L1nos 1-7) 9. Funeral El<ponA09, Admlnlstr alive Costs, Miscellaneous Expansos (Sclledulo H) 10, Dobis, Morlgago L1abilillos, Lloos (Schodulo I) 11. Tolal Dodllellon, (1olal Llnos 9 & 10) 12, Nol Vah,o of ESlalo (L1no 0 minus Llno II) 13, Charllablo and GOVOlnmonlal Boquosl' (Schodulo J) C(Jpyrl\fhl f IIrm~ ~illnW/Hf)()nly, 1'J!14 NulLO, In, N'14I'AfI(" (for (jalll!! 01 dllltltl prwf tll 1~' ']'I\~) o fj, Fodoral Estato Tal< Rotum Rnquirod o 0, TOlal Numbor 01 Solo Doposit Boxos ( B) ( 7) 5,353,78 None .---- (8 ) 5,373.15 (0 ) 7,910,3~ (10) 6,381.19 (11)_ (12) (13) 14,291.57 (8,918.42) None (14) (8,918.42) (16) , , . (16) 0.00, ,06 . 0.00 (17) 0.00, ,16 . 0.00 (10) 0.00 Inlufo~l (19) 682,50 (20)____682. SO (21) (21A) (218) Est.ate of: l\I1I1a C, Fulc~r 21-1996-0687 "" foll~"" _I"~ "... ,_ tl-.. ,._" ....._to,,""(., of '''' .."t,,, Jerry A, weigle M3rk, Weigle 'and Pet'kins 126 East King street Shipr:ensbur9, l?A 17257 REV-lf,ao EX + (12-00) i J COMMONWEAI.TH OF PENNSYLVANIA SCHEDULE F IN~~~~AENN~EDTE"c'i,~~1~RN . JOINTLY-OWNED PROPERTY ~-STATE OF - - -. -=- I FILE NUMBER Anna C, Fulcomer 21-1996-0687 Joint tenallt(s): NAME A 'Erranuel J, Fulcomer, Jr, ADDRESS 133 Rumson Road LittleSJ.lver, NJ 07739 RELATIONSHIP TO DECEDENT Son Jolntly.ownsd property: LETTER DATE DOLLAR VALUE OF ITEM FDA MAOE DESCRIPTION OF PROPERTY TOTAL VALUE DECDIS DECEDENT'S NO. JOINT OF ASSET %INT, TENANT JOINT INTEREST 1 A 5/14/85 Mellon Bank f'ibney Market 10,676,86 50% 5,338,43 Checking Account #410-070-6458 opened 5/14/85 joi~t with Eimnuel J; F'ulcaner, Jr, A 5/14/85 Interest on above item accrued 30.71 50% 15.35 as of deced~lt's death PA16091 NTF 121M TOTAL AI,o enler online 6, Rec~ 111I1.llon (If mom 'pace I. neodod, Insort .ddllion.1 .heel' of ..ma .1'0,) 5 353.78 Cop)'rlgtl\ rOrlna SOftWRrfl Only, 11194 Nfllco, lnr., N94t'AOgl STATE OF NEW .JERSEY SS, COlJNTY OF lI<.v,Jt{oL(1'1( . .,/ rt0 /,', I' On this, the ( " day of /1' /(c!C./(...) , 1997, before me, II Notnry Publie in and 1'01' suid County and State, the undersigned of'lker, personally appeared EMANlJEL .J. FlJLCOMER, .JR. , known to me (or sntisfactol'ily provcn) to be lhe person whose IUlme is subscribed to thc within instrumcnt, and acknowlcdged thut he exccutcd the same for the purposes therein eont,lined. q;::~:d r1~~ My comn1~ on expit'cs on: TRUDY tDOlf A NolIlY PulIlIc"" ...., My Comm_ Ea.... 0cIIIIIr A 2001 (SEAL) MARK, WEroLl: AND P'U~KINS. ^TroRNt:vs Al UIW ." 12ft E^!H KINO sTHtn - SHtPPF.NSl\lIRC-i, PA 170'!,7.I]fJ7 " -~.....~. ---....---..- I'" ..... -- ". 'f: DISBURSFMENTS OF PRINCIPAL Estate of ,Anna C, Fuloomer For Period 06/02/96 Through 3/20/97 Administration Expennes (Prin) 9/5/96 Register of Wills, cuml::erland. County - Letters Testamentary and Short Certificates 9/5/96 Cumberland Law Journal - advertising Letters Testamentary 9/19/96 Register of Wills, Cumberland County - PA Inheritance Tax payment at discount 10/31/96 Carlisle Sentinel - advertising Letters Testatrel1tary 12/4/96 Register of Wills, CUmberland County - filing Insolvent PA Inheritance Tax Return 3/20/97 Mark, Weigle and Perkins - reimburserrent for postage, xerox copies, and long distance telephone calls 3/20/97 Linda K. Klein - notary fee 3/20/97 Register of Wills, C\nnberland County - filing Family Settletrel1t Agreerrent Fees and Cam1.i.ssions (Prin) 3/20/97 Mark, Weigle and Perkins - attomey feE;' Funeral Expenses (Prin) 9/19/96 Fogelsanger-Bricker Funeral Home 9/19/96 Emanuel J. Fulcomer, Jr, - reimbursement for preparation of cerretery lot Other Expenses (Prin) 9/19/96 Sarah A, Tbdd Memorial Home - 5/31/96 staterrent $ 87,00 60,00 650,00 69,88 '10,00 15,00 10,00 60,00 -............--..-... $ 5,833,50. 325,00 --...--............. $ 4S0,05 Page 2 $ 961. 88 1,500,00 6,158.50 I o.!!! 9~it:;-- "~-y~' N \'J 0\' ""i, --~-;' I , , i~ i~;~ '. - CL~~o) O;l:n --- ala: 0;:" ~, r~,--, P' ~~ "" Qj ~ 1IJ ~~ Qj I Z; . (J ~ ~ ' l M <II ~"" ~ r~! I ;~ ~'" U ,~~ ~ ~! .....00 ~ tIl'" .....0 I ' '~~Ao""~ o . >1 VJ Z ,... I ~i .....'" , ~!:l:Olg;;;E ~'" u J 1 sa~~~z~ e-<..... i 0 ~N \oj 0 III 0 .. f Ii 80 fil ff;~~~~E tIl ;z; ~ = ~~ I . ~ ~~ ~ t ~ ~ ~~ ~~ tIl ~ , MARK, WEIOU: ANP PERKINS, AlTO.N>:". u tAW UII RAn "INO St.>:r;r; SHIPP>:N""'''. PtNN', 17287 'fM.>rllllNt:, (7171 $31.7.11I ...., (717) $3106Sn ;l'. }" /- !-', I. I ) - BUREAU Of INOIVIDUAl TAMES I MtlUU IANC!. Ul< lJllJlSION lJrPT, 130601 HARRISRURG, 11... 11128-0601 COMMONWEALTH OF PENNSVLVANIA DEPARTMENT OF REVENUE NOTICE or INIII:RITANC[, TAM APPRAISEMENT, AllOWANCE OM DISAllOWANCE Of DEDUCTIONS ANO ASSESSMENT Of TAM DATE ESl'A TE OF DATE OF DEATH FILE NUMBER COUNTY ACN 02-17-97 FULCOMER 06-02-96 21 96-0687 CUM8ERLAND 101 JERRV A WEIGLE ESQ MARK ETAL 126 E KIIIG ST SHIPPENSBURG PA 17257 } , *' "1,)~41 f. ." Ill-HI ANNA C [:~ A.o~ni.,R.~_~t1.d:_:J MAKE CHECK PAVABLE AND REMIT PAVMENT TOI REGISTER DF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV'- iS47 -EX' -A F P - i i 2":96 Y - Noi'-i C E - -OF - i NH Eii i;: AN-C E - Yi. X - iiP' PRAYs EMENT ~ - -AL i'-OWANCE - eili - - - - - - -- - - - - - - - -- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF FULCOMER ANNA C FILE NO. 21 96.'0687 ACN 101 DATE 02-17-97 TAM RETURN WAS, I X) ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. R..l E.t~t. (Schedule A) 2. stock. and Bond. (Schedule Bl 3. Clos.l~ Held stock/P.rtn.rsh~p Inhr.at (SchCldula C) 4. Hortg.gal/Not.. Receivable (Schedule Dl S. Calh/Bank Deposits/Hilo. Parlonal Prop.rt~ (Schedule eJ 6. Jointly Owned Property (Schedule f) 7. Transfar. (Schedule Gl 8, Total An.ta APPROVED DEDUCTIONS AND EX~MPTIONS: 9. Fun.r.l Exp.n.../Ad~. Co.ts/MiIO, Exp.n... (Soh.dull H) 10. Debh/Hodg.o' liabiliti.s/lhnl {Soh.dull IJ 11. Tobl Deduc:Uona 12. 14.t 'i'due of Tax R.turn 13. Ch.rit~bl./Gov8rnMent.1 8.qu..t. (Sch.dul. J) 14. Net Vdu. of Eat.te Subject to hx If an assessment was issued previously, lines reflect figures that include the total of Abh ASSESSMENT OF TAX: IS, Anount of Lina 14 16. Anount of Un. 14 17. AMount of linM 14 18, Prinoipal Tax Du. NOTEI at SpaLl..I taxable at taxable .t rat. line.I/CI..e A rat. Coll.ter.l/CI... 8 r.t. TAX CREDITS: ..----,-.--.--. ----"--~~ PAYMENT RECEIPT DATE NUMBER - 0 8 - 2"9"=96-' --riAT46 680 DISCOUNT (+) INTEREST (-) ,00 CHANGEO III ( 2) (3) (4) (5) (6) (71 ,00 ,OQ.. ,00 ,00 19,3L 5,353,78 ,00 (8) HOTEl To insur. proper credit to ~our account, lub~it the upper portion of thil forM with ~our ta)( paYII.nt. 5,373,15 14.'91 ~7 8.918,42- .00 8,918.42- 14. 15 and/or 16, 17 and 18 will returns osselsed to dote, 115) 116) 1171_ ,00 .00 .00 x ,00. .00 M ,06. .00 x ,IS. 2L (18)__--:J!..!!_ ._--~$ ----~ TOTAL TAX CREDIT 650,00 .~---,._-_._--- -- - BALANCE OF TAX DUE 650,00CR - "- ._--~--~_._._~ INTEREST AND PEN. .00 TOTAL DUE 650. OOCR ___..._.... "'_ on. ___'''__________._______.. __... ....,,~_ _.__ .___......_.____._______ (9) 110) 7,910,38 6,381.19 (11 ) Cl2) 113) Cl4) . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CAlCUl~TIDN OF ADDITIONAL INTEREST, AMOUNT PAID 650.00 IF TOTAL DUE IS lESS THAN U, NO I'AYMENT IS REQUIRED. IF TOTAL DUE IS REflECTED AS A "CREon" C CR). YOU HAY BE DUE A REfUND, SEE REVERSE S:DE Of TNIS FORM fOR INSTRUCTIONS.) f'I"\ [1 <.. ,. f"~d, j cC en .:'i~, co ..... tn Lu LL f) ~l~ tt 0: '-,- f" (I) L: -:::> 00 RESERVATION I E.t"t.. of dlc.dent. d~tng on or before O,olllltMr 12, 1982 M~ H any future IntlrGlt 1n thlli ".ht, II trall,ferrld in POi'I.,ion or InjoYlllant to Cta.. B (0011,tlrel) blneflcia,.!.. of the dleedlnt eft,r thl .~plratlon of any ..tat. for I1f. or for year., t.h, Co..cnw'81th hlreby .~pr"lly r...rv.. tho right to appral.. and ~I"" tranlfer Inheritanoe T~x.. at the lawful Chi.. B (col111hrltl) rat. on ftny .uch future Inter..t, PU!lPOSE OF NOTICE I T(I fulfill the requlr"lInh of Sadlon 2140 of th, Inh,rltftnClo find E,trlt, Hlle Act, Act U of alii), 72 P.S, Seotlon 2140. PAVHENTl O.ttKln the top portion of thh Nottel! and iliubllllt with your pay..nt to the Reglst,,. of Wi1h prJntlld on the rlVlrl. ,Ide, uHllIke Check or 1Il0nllY ordllr payable tOI REGISTF,R OF MILL8J AGENT All paYllllntl r.colvlld Ih.,U firlt bel I'lpplhd to any lnterlllt whIch 1II11Y be dllCl wIth an~ r8lllslnd.r applll1d to thll tal<. REfUND tCR) I A refund of III hll< crlld1t, loIhich ~lal not raquutGd on tho Tal< Roturn, IIftY b. reqUQltGd by eo.pht!ng an "Application for Refund of PennsYlvania Inhl1rlh"1Ca <'Ind Estate 18)1" (RP....nBJ. Appl1cll,t1ons tlrll l!IVlldhble at the OHlce of the Regiltor of Wllll, !my of t;1e 23 RQvOInua District OHltu, or by cf'lllinQ tha Itpellial 2Ciwhour answering I8rvIco nUllIberl fOl' for.. orderlng1 In PennlvlvMh! 1-800-]6Z-?'OSO. ouhlde Ponnsylvrsnla l!Ind within local tlarrhburg arlla (ll?) 787..809(" toOl (717) 772-2252 (Hellrlng hpftlred OnlY), OBJECTIONS: Any party In lnterut not Ifttl8fl.d with tt\l~ l'lpprfthlllNent, allow9nce or dtsftllowance of deduction., or 'us....ent of hue C1nc1udlnn discount or Inhrolt) fill shown on thlt Notice IIUlt Object within 8lxty (60) dftYI of reclliptof this NotJc:z bYI ADMIN ISTRATIVE CORRECT10NSI -wwrltt.n probst to ttl~ PA Oopftrhumt of RIIVlmljO, !loarn of ApPIIllll, Dept. 2610ZI, Harrisburg, PA InZ8~102:1, OR --lIlectIon to hlwe thlll IIllthr ulllterlllned l!It Iludlt of -tho /locount of th. perlonlll reprelen"tnt1ve, OR -..nppcll,1 to the Orphlln.' Court. Factual IIrrorl dhcoVlllfUd on this elSSCllnlllnt should hili t1ddrnsad In writing tOI PA Olllpftrt..nt of Revenue, Bureau of IndIvidual Tl'lxCII. ATTNJ Post hS81uclnt Rlllvlew Unit, Dept. 260601, tlllrrllbufll, PA 17128MD601 Phone (711) 787M650~, SUIl pt'lue 5 of the hooklet "Instructions fur InhClrltanclI Tax Rlllturn for ft ROlidant Decedent" (REV.1501) for Iln IIIxplltnatlon of /ldlllnlstrlltlvflh' corrClct81)ICI Clrrorl. DISCOUNT I if Iln:i taJol due it pllld tdth!n three (5) clllllndnr 1I0ntlu nftllr thlll decadent'l dlll'lthl a five percent (5:0 dltt:ount of the till< paid is allClwed. PENAL TV, Th. IS;': tax "cmuh non-partlclpftt.lon Jllllnll1ty lti CClellputlld on thlll tohl of th.. tal< Imd inhrut ftllltlllld, and not pnid befarll JtlOullry 16. 19'J6, thlll first dny nttlllr the IIHld of thlll tl'lX AllllUtv period. Thill IlonMpnrtI"lpatlon pemtlty 11 ,.ppllalflbh In tho IUO .!lnnur llnd In the the SIlIIII t1l,e rHlrlotl ftS YOU would oppul the tllx and JntClrut that hal hIMIn Ilue...d all 1ndicllted on thls notlclII, INTERESTl Int.r.lt Is cilarg.d begJnnlng wIth fIrst (IllY of dallnquen.::}', or nlnlll (I)) Monttll ftncl one (I) dllY froll the dllt. of a.th, to the date 0' paYllent. TIIXliiII which becll1l8 dtlllnquclnt belfora Jnnul!lry 1, 1962 blllllr lnterut l'!lt the rat. of Ill< (6ll p..rcclt\t per ""nue tlllclll~ted lit ft dlllly rl'lh of .000164, All taxu whIch beellll" dellnqullnt on and flfter January 1, 1982 will blllllr Int8r8't at II rlltll which will VlIl'Y fl'CM r.l'llllndllr Yllftr to c~lllndar year with that r~te announcfld by the PA Depllrt.ent of ReVlInue. Thill ftpp!Jcabllll !nhu.ut rlltu for 1962 throllgh )997 ar8/ '!!!r Intlll'e,t Rllte Oally lnt..rut Fllctor :!.2r ~!..LE!.!! Vl'llly Inhrut FlIctcr 1982 ~O;': ,000548 1981 9% .000247 1983 16l . 00fl4~1I 1986-1991 11% .0OOJOl If}84 11% .000301 1992 'X .000241 19ltS In ,000356 1993.191)4 7% .000192 1986 10% ,000214 1995~1997 ,X .000247 "Int.rut Is oftlculatDd .. '0110WII INTEREST. BALANCE OF TAX UNPAID X NUHDER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any NoUc. l"uRd !!lIter the hx heCOIll" QIIllnqu.nt wlll rllfllld 80 lnt.rut cltlcullltlon to flft..., (15) day. beyond the dl!lt. lJf the "..ell..nt, If Jll'ly..nt ,. _",dIM aher the Inter.st co.puhllon dl'lt. .hown on the Motta., additional Inhrut ltU..t be cfllcullJted. PAYMENT I C'J 0\ I ~;:~ .." '!.liC U~: ~, ( ~:~ :.) DO 1J'~'oh the top portion M thh NoticI and lublllt with VOllr paY"ent JI!!Ide paYl'lbhto the nl\"l and addr... printed on the rOVersl lId., If RESIDENT DECEDENT lI"k. chuQk or !!lonlY ordar p.,yable tOI REGISTER OF WILl.S, AGENT, If NON'R~stDENT D~CEDENT "'aka chllok or ",onlllY order paYrlblo tOI COHHON~EAl. TH OF PENNSVLVANIA. REFUND (CRJI A rlfunn of a tax lJredlt, whloh was nat requlIIted 011 thfl Tax Return, flIay b, rllqUlIIted by COMpletIng an "Appllcation for Refund of PennsylvanIa Inh.rltance and Estate Tax" (REVkl~13l, ApplicatJons are available at the Offl01 of thl! Regist,r of Wills, any of the 23 Revenue DIstriot Offices or froM the Departllent'R Z4~hu~t .n.wlrlng s.rvic. nUMbers far forlls order!ngl In Pnnnsylvanla lk800k36?k2050, outlldo Pennsylvania and w1thJn 10(l1l!l1 Harrisburg erea (717) 787~8094, TDDIt (717) 772'2252 "iellring hpelrlld only), REPl Y Tal DISCOUNT I PENAlTYI INTERESTl. QUlIIUonll ragardll1g .rrors oontaJnl.ld on this notIce rlhould bll addrU58d tOI PA Dllpartlllen~ of Rovenue, Burllau of Individual h!xu. ATTNI Post hSUSIIllnt RevJllw Unit, O"pt. 260601, Harrhburg, PA 17128-0601, phon. (711) 787'6505, If ~ny ta~ dUll J. puId within thrll8 (3) ealllndar ~onths aftllr thll dllelldent', doath, a fIve porellnt (S%) dlsoount of 'he tl!l~ paJd Is allQwed, The IS% tux afllnuty non-partIolpatlon pen!llty Is cOlllputed on the tutal of tho tax ftnd Inttrlllt auuu,d, and not paid bofaro Janu.ry 18, 1996, tha fJrst day !lftar tho I1nd of the tax aMnllsty perlod. Intllrl,t 11 char lied lIoglnn1nll with fJrst day of deUnqueney, or nlnll (9l 1I0nthll and on. (1) dllY frail tho elat. of death, to tho date of p!lYllent. TrUll' whiCh bocallll dlll1nQUllnt bofore January 1, 1982 bur lnhrlltt at thll rate of IJX (6%) porcent per annuli oe1euletlld et a daily rate of ,000164, All t8~a. whIch becaMe dellnqulnt on and aft.r January 1, 1982 101111 boar lntQrest at a rat. wllleh will vary frOM calendar Yllar to cal.ndar year with that rat, annouMlld bll the PA DllIpart.llnt of Revanull. Thll ftppllClablll Intllr..t ratlll for llJ82 through IlJ97 arel Veer Intero.t Rat. Dally In~.ro.t faotor Vur Interest RIltll DaJlv In~erl.t Faotor 1982 20X .00054& 1987 9% ,000247 IlJ&3 16% .000418 1988~i991 11% ,000301 a84 1lX ,00010.\ 1992 91. .000247 1985 UX .000S56 1993.1994 7f. ,000192 19'6 10% .000274 1995'1997 9X ,000247 '.Inter..t 11 calculated .. followlI INTEREST . BALANCE OF TAK UNPAIO K NUHBER OF OAYS DELINQUENT K DAILY INTEREST FAL~OP ..AI'lY Notice luu.d after tIll tal( beno... dal1nquent wUt reflect an In~tr..t clllc~tl'Uon to flft,"n 05) davI b,yond th. data of th. 'I.e.\..nt, If paY..n~ Is Ilad. af~.r the lnt.r..t cDllpu\etJon d.t. shown o~ ~h. Notle., !lddltlone' lnt.rllt .Ult b. c~lculat.d.