HomeMy WebLinkAbout96-00716
PETITION FOI~ PIWHATE and (;RANT OF LETTERS
IoSIII/I' (~f 4!tfl!-(;.1~1i F J), P. t./I J IF No, c;;> I -, q (0- 1//.(1
also 101011'11 as .__. To:
, J>i'('('(Js('d,
Socilll ,1'''I'lIr/IY No, Ii 8. -O~{. /:<''1(, .
Regislel 01 Wills 101 Ihl'
('oUllly 01 Ct{Ih~I~&/'(J";p ill Ihe
('Om1110IlWcallh or P~'nnsylvnlllll
nil' pl'lillOIl 01' till' llIHIl'fsiglll'd I'l.'-,pcl:lfullv IL'p n.'Sl' I I I.... thaI:
Your pL'lltloflL'r(s), Wl1t1 is/UI'l' IX Yl'llrs \11' age 01' oldl'1' untllc L','l'l'L1I~A
illlhl' lasl \l'ill ollhe ahml' del'l'delll, dall'd _ .. A )-1/!'11... .. 1-0 __
alld,1"dkiI1s) daled
1f&1l,v1ht'( /1., .f-At..{<'7T ~ I/!lff 'fr9~
__..._.___..... Ilumed
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Del'elldl'lll \l'as domkill'd al dealh ill C'l{lt1lfl.< P. .l,J1,.1.f) Coullly, Pel1l1!iylvlllllu, with
It /ill. lasl lamily 01 prilll'ipalll'silll'ncc 111. .J'30[ wf~''-1>.-'(_ ._p<"{~_.____.,,_____.__.._
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(li,[ \lll'd, ll1HnhVI <llld 1ll11lll'lpidHH
DIWlldl'lll, Ihell __ R'I .I'ear' III age, dil'd ,l/tA-6. 2'7.'-- _ . _____, 19__~__.,
al .J':~wli~'~,>", 'j:M. 111t:~'HIf"IIC--'jdLU{'>;/,4 _ 1'>'Oc,:,._____._____.__________,
L\l'l~PI as r\1llow.., dL'LTlh.'1l1 did nol Illarr)', \\'a~ 1I0t l,th'oll'cd and did nOI have a child born or adopted
arlCI' (,.''\1.'1.'1111011 of I Ill' will nITl'l'l'd I'm probate: WllS !lot thl' victim of 1:1 killing Hnd was neveI' adjudicuted
illl.'nrllpCIL-'lll: ___,..__._.____.____~___
I ki..'l'll dL'1I I HI death oWIH'd properly with cSlillHlIL'd value.... a:, follow...:
(l I' dOI11il'ikd in I'a.) All peLsollal property
(If not domiciled in Pn.) IJL'rsonal prOpl'rty ill Pennsylvunia
(II no! dOlllkikd ill )la,) 1'('1'...011<11 prol't.'rly ill County
ValuL' 01' !'1.'all'qull' ill I'L'IlIl'lyl\'ullia
.,itutlll'd iI" follow,,:
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II'IlI:RU'lJRI:, pelilillllL'IN lesPL'l'lrully leqr~~("..lAMfNfii~I?IIC or Ihe. h\SI will nlld wdicil(s)
prc"l'll!l.nl hL'fl'wilh lInd Illl' pranl or k'llcr!', _._~_!____". _u_.__.u_____..'..,...~._~_~_____,_.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEAI.TlI OF I'ENNS\'I.VANIA
cor NT\' OF CUMBERLAND
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rill..' IWliliollL'r('1 ahO\'l'-IlUflH'd \\\'l',u(<,) Ill' "I'1'II'I11(q [haIthI..' Slalcllll'l\l' inlh~ foregoing petition arc
Irlll" "Ill! nll'll'l'l 10 [Ill' Ill''-'! 01 thl'klltlwk'dgl' ilnd helil,r or pl'tiliollCl'h) and thai as P~'l'sOIHtl rcpl'cscn-
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LAST W1LL AND TESTAMENT
OF
MARGARET D. ELLIOTT
I, MARGARET D. ELLIOTT, a legal resident of Cumberland
County, Camp Hill, Pennsylvania, being of sound and disposing mind
and memory, do hereby make, publish and declare this instrument to
be my LAST WILL AND TESTAMENT. I hereby revoke any and all wills
and codicils by me heretofore made.
I
IDENTIFICATIONS AND DEFINITIONS
A. I am married to BRANTLEY ESTES ELLIOTT, hereinafter
referred to as "my Spouse". We have two (2) children, KATHRYN E.
BRACKBILL, and DOROTHY E. PATT. References in this Will to "my
children" include these children and any other lawful children
born to or adopted by me. Except as otherwise provided in this my
LAST WILL AND TESTAMENT, I have intentionally omitted to provide
herein for any relatives or for any other person, whether claiming
to be an heir of mine or not.
B. The following definitions obtain in any use of the terms
in this WillI
1. "Descendants" means the immediate and remote lawful,
lineal descendants of the person referred to, and it
means those descendants in being at the time they
must be ascertained in order to give effect to the
reference to them, whether they are born before or
after my death or of any other person. The persons
who take under this Will as Descendants shall take
by right of representation, in accordance with the
rule of per stirpes distribution and not in
accordance with the rule of per capita distribution.
Persons legally adopted when under the age of four-
teen years shall not be differentiated from blood
descendants for any purpose.
2. "Survive me" is to be construed to mean that the
person referred to must survive me by thirty days.
If the person referred to dies within thirty days of
my death, the reference to him shall be construed as
if he had failed to survive me.
3. As used in this Will, the words "Executor," "he,"
"him," "his," and the like shall be taken as generic
and applicable to a natural person of either sex or
or a corporate person of other legal entity.
Page 1 of 4 Pages
Ackno\;'l edgmen t
COMMONWEALTH Of<' PENNSYLVANIA) SS:
COUNTY Of<' CUMBERLAND )
I, MARGARET D. ELLIOTT, Testator, whose name is signed to the
attached or foregoing instrument, having been duly qualified
according to law, do hereby acknowledge that I signed and executed
the instrument as my Last Will; that I signed it willingly; and
that I signed it as my free and voluntary act for the purposes
therein expressed.
Sworn or affirmed to and acknowledged before me, by MARGARET
D. ELLIOTT, the Testator, this ~_4tday of ~__, 1985.
M?lill"~/fD~~lr6~~tor----
(SEAL) n4cJ'<LC~~J!.k~_u_______
NotaryfPublic
Aff idav it
llARY ANNE SMITH, NOTARY PUIUC
CARI/m 80RO, CUllBERIANO COUNTY
MY OOMMI$$IOII EXP/m HavlG 19M
lI.mlltr, Ponnsyl\llnl. AIIOCilllN 01 'Nouri..
COMMONWEALTH . Of<' PENNSYLVANIA) SS:
COUNTY OF CUMBERLAND )
/,) We, ~Jt-._~.:._.c*.!c,y'_('?______, J::.fo ':.'!3___A,-__G!!.L"-H.~4_____' and
'/i.!.t.lIg;X<2L'L;wd't,0fL.d!!./fl!..LL...?'___, the witnesses whose names are signed
to the attached or foregoing instrument, being duly qualified
according to law, do depose and say that we were present and saw
Testator sign and execute the instrument as her Last Will; that
MARGARET D. ELLIOTT, signed willingly and that she executed it as
her free and voluntary act for the purposes therein expressed;
that each of us in the hearing and sight of the Testator signed
the will as witnesses; and th~t to the best of our knowledge the
Testator was at that time 18 or more years of age, of sound mind
and under no constraint or undue influence.
S5jorn or affirm~d to and sURscdbed to_,berore me, by g,fd!..~__ _
i..:.___Ktd.':'-4u g_, J';ilUf..!..f}__dL_0:>::.Jj'.!Y..0:L,' &1.:.(,// bz;.Lii{j(J.L3.J!..t!.dlf/Z?l_
______~-..:~, witnesses, this ..JJ1L day of .t1/.lc.!..~___, 1985.
w~s--__a_,__~_--
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W.TNESS '---_.
-z~_t2.~-~~_________
NOTARy1PUBLIC
. Mm ANNE SMITH, NOT~RY rUltlC
CARl!'" BORO, CU1l8ERlMi~ COUNTY
MY COt<MISSION EXPIRES I:UV. 10, 19M
M.miMI, P.nnsylWlnll AtlociltlOll 01 Notl,11I
(SEAL)
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Inventory of the real and personal estate of
MARGARET D ,-.E.lJ.,IQTT, deceased
PNCBANK SD BOX(COINS-76.72 76.72
(SO BOX INVENTORY SHOWS WATCHES AND CD'S-VALUE REFLECTED BELOW)
MELLON BANK CD-I0, 011. 75/SV-ll, 378. 76/CK-ll, 378 .17 32,768.68
HARRIS SAVINGS BANK SV-l1,461.94/CD-40,012.43 51,474.37
PNCBANK SV-12,614.03/CK-17,499.20/CD-15,093.75 45,206.98
U.S. SAVINGS BONDS SERIES HH-23,500/H-2,000/EE-2,550 28,050.00
LIFE INSURANCE POLICY 2,500.00
LAST PENSION CK- PA-STATE 409.32
CASH AT PREMISES BILLS-272.00//COINS-8.34 278.34
PERSONAL EFFECTS AND MEMORABILIA (CLOTHING, SHOES,
BEDDING, HAIR CURLERS, MAKE-UP, HYGIENIC ITEMS-ETC.
JEWELRY - MUMMA'S JEWELRY M-BURG APPRAISER
PERSONAL PROP.-APARTMENT FURNISHINGS(W.G.ROWE APPRAISER
AUTO- '92 FORD 4 DOOR SON CROWN VICTORIA
650.00
309.50
2,101.00
8,300.00
MORE DETAILED INFO ON ABOVE LINES 1 THRU 12.
PNCBANK SAFE DEPOSIT BOX 834'-76.72='S SILVER COIN APPRAISED
AT FACE VALUE-ACCOUNT WELL USED-NON COLLECTOR COI-lDI'I'ION.
MELLON BANK CD- 00355067=$10,011.75//SV-00I10219904=$11,378.76//
CK-1723223341=$11,378.17 VALUES WHEN TSFRD INTO ESTATE ACCOUNT.
HARRIS SAVINGS BANK SV-I050005813=$11,461.94//CD-I061292213 =
$40,012.43 VALUES WHEN TSFRD INTO ESTATE ACCOUNT.
PNCBANK SV-51-3010-0Bll=$12,614.03//CK-51-4001-8213=$17,499.20//
CD-31900047632=$15,093.75 VALUES WHEN TSFRD INTO ESTATE ACCOUNT.
U.S.SAVINGS BONDS-HH SERIES D-3031715=$500//V-862009,V-862007,
V-86200a,V-349393 EACH =5000--M-1327535,M-1327536,M-1327537 EACH
=1000//H SERIES D-11966319,D-11966320,D-11966321,D-11966322 EACH
=500// EE SERIES M-43865493,M-43865494 EACH =1000 -- 0-29781475
=500 AND 1.480759758 ='S 50 A GRAND BOND TOTAL OF 28,050.00.
INSURANCE POLICY 1001442586 WITH ALLIZNZ LIFE INS CO. OF NORTH
AMERICA P.O. BOX 219033 DALLAS TEXAS 75221-CON'T A'l'TEMPTS
TO SECURE TRUE VALUE, 1.0. OF BENEFICIARY & HOW TO PROCESS.
LAST PA. STATE PENSION CHECK CASHED AS INSTRUCTED AND DEPOSITED.
CASH AT PREMISES -BILLS AND COINS VALUE CK'D= FACE VALUE.
PERSONAL EFFECTS & MEMORABILIA OF MIMIABLE VALUE -GIVEN AWAY 'ro
VARIOUS ORGANIZATIONS (MISSION-GOODWILL-BETHANY VILLAGE-ETC.)
JEWELRY-WEDDING BAND-IO.OO/RING-IO.OO/SIGNET RING-12.50/HIGH
SCHOOL RING-18.00/TWO-EASTERN STAR RINGS-15.00 & 24.00/
ENGAGEMENT RING-IOO. 00/PENDANT"20. ~O/MAN'S POCKET WATCH-25. 00
LADIES RING 75.00.)
PERS-PROP. -C OF DRWS~200/SWEEPER~'10/K-K-SHELF=1 0/M-CABINET=5/
LAMPS=IO/DESK & C=30/WINDSOR C'S=40/S'l'OOL=10/WALL CLOCK 150/
S/BOX SPG MAT'l'RESS=15/PAIR N STANDS=25/BEER STAND=IO/K-KNACKS
=5.00/B-CASE=140/BOOKS=5/B-ENDS=23/FAN=15/F-LAMPS=5/ROCKER=
25/GRN c=o /PAINTING=50 /LAMP-S=2 0/CREDENAZ=15/P'-V.AHOGANY C=80/
SECRETARY=235/TEA SET=50/BRASS LAMPS=25/5PC KITCHEN SET=90/
C-OF DWS=10/KITCHENWARE=10/CHINA=20/SEW M=15/ROCKER 10/TV=IOO/
C-CHEST=75/C-ROBE=50/2-C'S=20/ROCKER=30/E-S-BED=50/SEWING
STAND=40/WAL-BENCH=15/F-LAMP=5/WAL-CHEST=50/C-TABLE=3/G-LAMP=5/
FILE CABINET=20/B-CASE=150/K-LAMP=25/DISHES=45/LINENS ETC=25.
AUTO '92 FORD 4 DOOR SON CROWN VICTORIA LOCAL OFFER.
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
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tI I, tLCJ..I-'-.i1",,\I_JScr:.....Ul-'~"~:.i.U!J<.!:" !L 1._\1 \I "Ii..! II gtOll, (' I " I
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bDing duly. cqrti.l'ipl.l"._ ~ccoldlng to I.w, depolOl .nd say, th.the ..hiJlL.JU.aU.e...an".
. invetl tory __ .. of the Est~1o of ..Ma~.f/;l.r.e..LD..---ElUo_t.t.__ __'.
I.te of . 325 Wesley Drive Apt 1:;'.4- Mecbll,[lics12lJ.r$ Cumberl.nd County, Pa" dece.sed .nd th.t the
within is an inventory m.de by .J1Qb./;!.r.t.B.___Brac1511Ul.__..........__, the ,.id...J;!5.t:l9.lJ.tgr__...
of the entire estate of ,.id decedent, con,istlng of all the pe"onal prop..ty and real e,tate, except real est.1o outside
the Commonwe.lth of PennlylvMi., ~nd th.t the figures opposite e.ch Item of the Inventory repre,ent It', !oir value
.s of the date of decedont's death,
" i I' 11CJ.L.. .nd subscribed before me,
I~,t)l /.1 4N~,RijJ C
Robert B. Brackbill .'
1)(.(' cmbc' r 6
19~_
Ew:ec:utQr . AJmlnl1tr.ltor
(;l Ii .... ." \\ l));)~'. ..I..'.
'--elhY, en > \~' ': lv' 1::
r (> s i. din gl 11 Port ^ 1) g (1 (' S, W H S h ll1 g lor
2986 Blue Mtn. Rd.
Port Angeles, Wa. 98362
Add.."
29
August
1996
Date of O~ath
Day
Month
Vur
INSTRUCTIONS
C) C"
-,-1
I. An inventory mutt be flied .wlthln three months after .ppolntment of pe"on.1 repre~enh"Ye,'
2. A supplement Inventory mutt be flied within thlrly day' of discovery of .ddltlonal auets,
3, Additional sheets may be.tt.ched.s to personalty or realty
4, See ArIiele IV, Fldue1arl., Act of 1949.
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Kathryn M. Brackbill
2986 Blue Mtn. Rd.
Port Angeles, Wa. 98362
Dorothy E. patt
5926 New Hartford street APT #1
Wolcott, New York, 14590
December 6, 1996
'.,i
In accordance with a ruling by The Supreme Court of Pennsylvania,
Re: Amendments to supreme Court Orphans' Court Rules
No. 103 Supreme Court Rules Docket No.1, as Executor of your
mother's estate I am required by the new ruling to advise
you as the named beneficiaries of the the estate by written
notice the following:
1. Date and place of death:
(a.) Date: 29 August 1996
(b.) Bethany village
325 Wesley Drive, Apt #124
Mechanicsburg, Pennsylvania 17055
(located in Lower Allen Township, Cumberland County)
2. Whether decedent died testate or intestate:
(a.) Decedent died "tsstate"--"having made a will."
3. Advise the county in which original letters were granted:
The Register of wills of Cumberland County, Pennsylvania
Certificate of Grant of Letters Testamentary was issued
on September 11, 1996.
4. Advise the names, addres$ and telephone numbers of all
appointed personal representatives and their counsel:
(a. )
(a.) Seeton IV of Margaret D. Elliott's will appoints
the undersigned, Robert B. Brackbill of 13102 Montrose
street, Saratoga, California 95070 and of 2986 Blue
Mtn. Road, Port Angeles, Washington 98362 as sole
Executor of Margaret D. Elliott's Last will and
Testament. Quoting for your ready reference:
"I appoint Robert B. Brackbill of Saratoga, California...
I request that my Executor be permitted to serve without bond
or surety thereon. I authorize my Executor to do any and all
things which in his opinion are necessary to complete the
administration and set.tlement of my estate, inclUding full
right, power and authority, without the order of any court and
upon such terms and under such condi tions as my Executor shall
deem best for the proper settlement of my estate; to bargain,
(,)
,
CERTIFICATION OF f::IQTICE lJNDEIL!i.ll~&.. 5,6 ( ~
Name of Decedent: /11!l;tr;;Ad!E1 ,''"[), J..:LL 10 1'1
Date of Death: t'7 ,A uC~t.{';;' ( /'1'7'--'_____._.
will NO'._.L226 -(i();/0___Admin, No, ,1/9G -0'11(,
To the Reg is Ler:
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 fol)owi)1g beneficiaries of the above..capt.ioned estate on
/2 - ~. - y /. . I
Name
Address
---..---.
j/", ,) . A. '/&:/(.l
_. /1J17/1J. y' N ,111, -<5' ~/f c kJf Ii l.. :')..2f.t...A1Ltltf M7~ flc.(412..lI.i A~,'~/.r!J. ...1..
_ 'J)O/2.N/I'r' 1:, ,~A 1 T -::,-r;u MI'-I":!_tfMZE.oA./) S'T A/JJI1I/')..)i.~''''T<I1'!, It(S~o
Notice has now been given to al;} persons entitled thereto under
Rule 5,6(a) except ~llf
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Name toi1t,,( 7 Af' A/A c,<' If / L- (.
Address"; 9& jf'Lt/[ IIt],J cIfc)
;lAo' /f;,)C,;:1...6J;, (JJA ()&;j6;L
TelePhone{'" ij ~<,- ;'::-.:.k / ,1 t.
CapacitYI___ Personal Representative
Counsel for personal
representative
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Namo of Decedent: .-----.t~~..t::l.f7..LL.1-/21A.ILG.dL:r..--D-c---l?fJ..":;,I.11( <-
Date of Death: __8 "..t: 'l--::.l'lU,____
Wi 1 1 No, JJ 7(. .~ ~.f!..2L"____,_____.__..__ Admin. No, M.I-\I. :1/9(. "e21 b
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Pursuant to Rille G, 12 of the Supl'eme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
], State whether administration of the estate is complete:
yes______. No.X_
2, If the answer is No, state when the personal
represent.ative reasonably believes that the administrati.on will be
complete: '])ll~ IN' T'!IULl1J.::".!L_" f ...il:: It -'i"i,(;,. 1/-11- '1'1.
3. If the answel' to No, 1 is Yes, state the followingl
a. Did the personal representative file n final
account with the Court? Yes No
b, The separilte Ot'pl1ilns' Court No. (if any) for
the personal representative's account is:
c. Did 1,I1e personal representative state an
ar:count informally to the parties il\ interest? Yes No
d, Copies of receJpts, I'eleases I joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report,
Date: 8";'7~1?
)~Jf~~
Signature
iJ "It E ,,( r 4" 4 A. A ('kIP I'" ....
~ (Please type or print)
, t (1 ff t~.b.!1J.:----A~.
Addt'ess (Jol'!T /t,.)6r?: t...ti'~, w;f, 781;( z...
,!j~_L.lfLL:f:J.1-''-_m.___.___.,.______
Tel. No,
111/tIU,) t. ')~I Ct,)lI1..
Tt1 t S 1M-TIE:
t/1.?/7'7
R../J is
Capae i ty: ~Personal Representati va
(MAH I r-mf! AM))
___,~Counsel for personal
represent a t i ve
. .
STATUS REI:ORT UlmER RU~~Jl
Name of Decedent: ,111lA' bAA I; r 7J EM./o1'!
Date of Death: 8__-11'- /17'b
Will No, :U - /97G ' v ?( &, Admin, No.
Pur5uant 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-2(__
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete: I), -,Jl~ O(
3. If the answer to No, 1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes_,_ No ,.r' ,
b, The separate Ot'phans' Court No, (if any) for
the personal representative's account is:
c, Did t,he 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 this report.
Date: /0 ,,/0 "vi
~&.I47 4-~~~.f?
Slgnature
/&a.(f6/2, T ./l;eIC~<; /J;&,c'y-I'/~ l-
ame (Please type or print)
1'11! C ~i.. t< I~ rl'tJ ~ ..4A.r A)~'R1..vtt-
Address . ,. 'fJ)O
fu.ll:tS>-61.Jt
Te I, No,
Capacity:
--
, Personal Representative
(MAH I rmfl AM3)
____Counsel for personal
representative
J
MBMO: APRIL 13.2006
TO: GLENDA I'ARNER STRASBAUOl-I. REGISTER OF WILLS
FM: ROBERT B, BRACKBILL, ESTATE OF MARGARET D, ELLIOTT 96..()716 ,4./f.,tf.
SUB: CHANGE OF MAILING ADDRESS i'" REQUEST
PLEASE UTILIZE OUR POST OFFICE BOX ADDRESS
p, 0, BOX 2647 SEQUIM. WASHINGTON. 98382
RATHER THAN OUR RIIRAL PORT ANGELES (OUT IN TIlE STICKS) ADDRESS,
WE PERIODICALLY IIA VE PROHl,EMS RECEIVING MAIL AT THE POIl-T ANGELBS ADDRESS.
THANKS.
I.CHECK ENCLOSED
2.COPY OF LETTER. OF 1/31/06
3 ,COPY OF INVOICE #750
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IIAIHII'iI!lJljli, 1',\ Illlll ot;(l\
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE ,~ND ESTATE TAX
OFFICIAL RECEIPT
ROBERT B BRACKBILL
POBOX 2647
SEQUIM, WA 98382
.... 1,,1(1
ESTATE INFORMATION: SSN: 198.03,1246
FILE NUMBER: 2196-0716
DECEDENT NAME: ELLIOTT MARGARET D
DATE OF PAYMENT: 05/16/2006
POSTMARK DA TE: 05/13/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 08/29/1996
REMARKS:
CHECK# 4844
S,AL
ACN
ASSESSMENT
CONTROL
NUMBER
101
TOTAL AMOUNT PAID:
INITIALS: MG
RECEIVED BY:
RWISHR OF WILLS
III V \ IO/IXlll 'Hi)
NO. CD 006696
AMOUNT
$218,83
$218,83
GLENDA FARNER STRASB,AUGH
REGISTER OF WILLS
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MEMO: MAY 12,2006
TO: REGISTER WILLS CUMBERLAND COUNTY PENNSYLVANIA
FM: ROBERT BRACKBILL, EXECUTOR ELLIOTT ESTATE FILE 2196 0716
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COMMONWEAl.TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE lAX
APPRAISEHENl, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENl OF lAX
.
< .
BUREAU DF INDIVIDUAL lAXES
INHERITANCE TAl( DIVISION
PO 80X 260601
HARRISBURG PA 17128~061H
Rf.V-Hi47 fK AFP IOft-OSJ
DATE 05-22-2006
ESTATE OF ELLIOTT MARGARET D
DATE OF DEATH 08'29-1996
FILE NUMBER 21 96-0716
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 07-21'2006
( Sf!f' "1'I'el"~'(J side ,,,,del' ()~jectirm,\' )
ROBERT B BRACKBILL
2986 BLUE MTN RD
PORT ANGELES WA 98362
Amount Remitted[~_-___ .'--~
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CD CDURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS I.INE .... RETAIN LOWER PORTION FOR YOUR RECORDS +-
REV:is47-EX" AFp. loi:osj-NoTIcE-oF-iNHERITANci-TAx-APPR AIsEMENT:-ALLowANcE"OR---------------
: DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF ELLIDTT MARGARET D FILE NO. 21 96-0716 ACN 101
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H,
10. Oebts/Mortgage liabili~ies/Lions ISchedule I)
11. Total Deductions
12. Net Value of lex Return
13. ChsritableJGovftrnmnntal Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
Q;::~~E T;;. ~~:D~~E --- ~~ ~~~;: ~~..
INTEREST AND PEN. 2,457,04
~-_._'_._-----_._-"...__._-----_.
TOTAL DUE 2,675.87
IF TOTAL DIlE -;;--;:;;~--~HAN ~O PA;~~~~-~--~";~~~ED:--' iii
IF TOlAL DUE IS REFLECTED AS A "CREDIT" ItRI, VOU HAV BE DUE ,\
A REFUND, SEE ~EVERSE SIDE OF lHIS FDRH fOR INSTRUCTIONS,)
\.
lAX ~ETURN WAS: I ) ACCEPlED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SE~ REVERSE
APPRAISED VALUE OF RETURN BASED ON: DRIGINAL RETURN
I. Real Estate (SchadulB A)
2. stocks and Bonds (Schedule B)
3. Closely Hel~ Stock/Par1nership Xnterest (Schedule C)
4. Hortgages/Notes Receivable (Schedule D)
S. Cash/Bank Deposdts/Hisc. P.rsonal Property (SchedlJle E)
6. Jointly Owned Properiy (Schedule f)
7. Tronsfers (Schedule G)
8. Total ASS8t~
NOTE: If an assessment was issued previoUSly, lines
reflect figures that include the total of ~
ASSESSMENT OF TAX:
IS. AIlUlIl,t of Un. 14 l'iIt Spousal rate (l!i)
16, Allount of Line 14 taxable Q't Linltal/Class A rate (16)
17. Allount of tine 14 at Sibling rate (17).
18. Allount of Line 14 taxable at Collateral/ClaDs B rate (18)
19. Principal Tax Due
-----.!EtrrPT
DATE NUHBER
06-22'2000 AA425721
SCllUNIT+r--
INlEREST/PEN PAID (-)
.---, , .~O 0
INTEREST IS CHARGED THROUGH
AT THE RATES APPLICABLE AS
REVERSE SIDE OF THIS FORM
-
06'06'2006
DUll INED ON THE
. IF PAID AFTER DAlE INDICAlED, SEE REVERSE
FOR CALCULAlION OF ADDIlIONAL INTE~EST.
DATE 05,22'2006
( Xl CHANGED SEE ATTACHED NOTICE
(1)
(Z)
(3)
(4)
15)
(61
(7)
,00
u.llli...:.li
,00
,00
1~,076,91
,00
,00
(81
171,225,19
NOTE, To insure proper
credit to your acoount,
$ub~it tho upper portion
of this for~ with your
tax PRyment.
(9)
(10)
13,775,06
,00
(11) _
llZ)
(13)
(1(t)
]~. 775 IJ..6..
157,448,13
,00
157,448,13
14, 15 and/or 16, 17, 18 and 1~ will
returns assessed to date.
,00 X 00
157,448,13 X 06 =
, 00, X 00 =
,00 X 15 =
(19)=
,00
9,446,89
,00
.DO
9,446.89
AMOUNl PAID
9,228:06
RE!1ERVATIONI
PURPOSE OF
NOTICEI
PAVHENTI
REFUND (CRl I
oBJECTIONS:
AOIUH~
ISTRAT1VE
CORRECTIOHSI
OISCOUHT:
PENALTV:
INTEREST I
Elhtea (if dIilCl41dnnt' ~ylng an orbefor'fl Dldcembur H, 198e. u Hony futurQ intQrut In tha estate h trnnlfarrQd
in pcuouion Dr IiInJOYlIlellt to Ciull Ii (C1011flturell bemtf1clar1u of thp dOOllchmt aftor the aKtdratlol"l ofany_estahl for
life or farye8rs, the Cbllllllonl'l08Hh herebY exprliuly rGlier\les the dght to Ilpprahe ond flSgeu trflr'l$lfor Inherltn/loe Tu)(Gtl
lit thp lawful ClaJs 8 (0011ater811 rate on any suoh future Intorest,
To fulfill the requireMunts of Seotion g140 of the InhBrlt8nooand Estate T~K Aat, Act g3 of 2000, (72 P,S,
Sl!Iat1Qn 9140 L
Detltch the top portion of this Hatloo and submit with YOUl' payment to the Reghtrar of Wills printed an tho reverse sids,
-~Hakll oheok or lIIoney order psyablo to: Ht:CjISTt:HOl-'WILLS,,\Gt:NT,
Failure to pay the taX, lnterElst, and pflnalty dura may fesult in the flUng of a Uran of rooord in tho appropriate county I
or the hlll/ance of an Orphon's'Court oitati"r!.
A refund of 0 tax Of edit, whioh was not rllquosted on tho To)( Retur'n, may be l'oqIJostad by oOMpleting en
"Application for Refund of Prannsylvanla Inheritanoe Bnd Estate To)(" (REV-UUl. Applications f1rll flVallablu
onllnra 8t ~SUlYL,.I.1!\1fl....illll.Y1, any Rlo1gistar of Wll1s or Ravenlll.l lllstr1ct offloo, or from tl1l'1 Departlllsnt'lI
24Mhour ilnswering Jlorvioe for forms order's I 1-800M3(,?.ZOSOI s(!rVICilS for tl!lxpOyors with spec101 tlUoring nndlor
IipeaklnlJ needs I 1-800"447-30Z0 (1T onlY).
AIW party In interest not satisfied with the apprElisoment, allowanoe or disallowanoe of deduotions or sssDssment of h)(
(inoluding discount or intorest) ElS shoWI1 on thlG Notioe may objeot within 60 days of thlil data of reoeipt of this not1<ia
by filIng ana of the fOl1owlng:
A) Protest to the PA Dupadmer1t of RevenuilJ Board af Appeals, Vou lIIay nbjeat by fIling 8 proteot online 8t
~~tDP.~~ftti~q~~~ on Of boforo thlil flKpiratlon of the sixty-day appeal period, In ordor for
an olectronlo protest to bEl valid, :/ou mllst rooeive, a confirmation numbor Bnd pruosssod data from the
Boord of AppeBls \olabsite. Vou may also sClnd a written protest to PA DlIpartlJlent of Rovenue, Board of Appoals
P.O. Box 261021, HarrlsburQ, PA H126-10H. potltlon. may not blil faxed,
Bl Elflctlon to have tho ",atter det.ermined at tho audit of the 8oco~mt of the personal roprounhltive,
C) Appeal to tho Orphans' Court,
Faotual errors dlsooverlild on this llssessment should be addl'Bssod 10 writing tOI PA Departllllilnt of Revenue,
Bureou of Individual Taxos, ATHIl Post Asses!lment Review Unit, P,O. flo)( 280601, Ilarrlsburg, PA 17126-0601
Phone (717J 781-6505. Se!,) p8ye 3 of the booklet "Instruotions for Inhl'lritantl'l Tu)( Return for 8 Resident
DGcsdlJnt" (REV,.1501) for nn Clxp1~1n8tion of adminlstrativolY corrllotllhle errors.
If Bny tox due is paid within throe (3) calendar months af~er the docliIdent's death, fI five peroont (SXl disoount of
the t8~ paid 1$ allowed.
Tho 15% tax amnasty non-participation punalty 19 oomputed on tho totnl of the ta)( and lnterost assessed, end not
paid beforCl Jflnuary 16, 1996, the first day RHoI' tha end 'of the tex amnllSty portod, This nonMpartioipatlon
p51na1ty is appealable In tho sallla t1'18nfler nnd in the tho SBIUI tilllB porlod as you WOllld appall 1 the, tax arId Interest
that ha~ boen assosseo as indicated an this notlca,
Intete~t is ah8rged beginning with first d8Y of delinquencY, or nino (9l months and ono (1) dey from the date of
d8l!lth, to thQ date of p8Yllle,nL Taxes which hocamo clallnquent befors January 1, i982 baliI' intornt at thll rete of
II1x (6f.l pBroent par annulIl oalaulatod nt a dally ratfl of ,000164, ^1I ta)(91i which btlCallie delinquent on tlnd 8fter
,lenU8ry I, 198i.'. will bellI' IntBrRst at a rRto which will very from onlendar yoer to clllRoclar year with that rat"
annaunGscJ by the PA Depl!\rtment of RoVeI1U8, Thlil nppllcabla lntore5t pltes for 11)82 throllgh 2006 are:
Inter8Rt Dally Interest llaily Interest
Rate Factor Venr Rate fflotor Veal' Rab
-nr- ~ rm.'\9'\ -m- -;mmr !n\ -,r-
16X .000438 1992 9X ,000247 2002 6X
llX ,000301 1993-1994 7f. .000192: 2003 Sf.
13;( .001)356 1995~1998 9f. .11110247 200(1 (If.
10% .000Z74 1999 7X ,0001'12 2005 S%
9% ,1l00Z47 2000 8% ,000219 2006 7X
Vear
rm
1983
1964
1985
1986
19tH
Deily
Faotor
,m!/i1""
.000164
.000137
,000110
.000137
,000192
INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
.AnY No'tloe hSIlEld bfter thli' hl)( beCOlll9ll dellnquont will r&fhot an Interest (Jalcul"t1on to fiftson (ISI dayil
boyond the date of the aSGClSSIIlent. If pl'lYlllent is msda aftar tho inhro!lt oOIllPlltatlnn da'ts llhown on th"
Hotlo~, addition81 Intorut lllllst be o81oulntod.
--Intllrett is aalcllhted as folloWs I
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GENERAL INFORMATION
1. FAILURE TO RESPOND WILL RESULT IN AN OfFICIAL TAX ASSESSMENT with Ilppll'Jilhlu Jnturu!;t husocl UIl Infllr~ltltlul1
tWUllllttlll1 by tlllI financial lr,stl.tutloll.
Z. Inherltflllcfl tax IHlcomllli dollnqullnt 11111" lIlonths nftul' till] dll(]Uf!O/lt's rJull! ef llli<lth.
3. II joint Ilocount Is tmwblu llVll!l ttlClllgh tllil dlHwdllnt'!I IlmllU Wi\!i o'Illdud II!I II I1Inlhu' of IHlJ1vl1ll1uf1co.
4. Accll\lnh (lnr:ludlng ttlOSlI hold hutwoon hU!ltumd llnd wllul whl()h UlU docllllunt put In joint flIl",U!i within (lno Vllar "rlor to
rluath lll'll fully toxBblo liS trnnsfor9.
S, Accounts Dstabllshod jointly hllhullHl hllshllnd oncl wllu mlll'fl thllll m18 YUllr prior tn dllllth llr(l nol lmcnbll1l.
b, Accounts h\JhJ by D decedent "1/1 trust for" flf1utllIlr or OtlllH'S Ilru till<flhlu hilly.
REPORTING INSTRUCTIONS ' PART
I
, TAXPAVER RESPONSE
1. BLOCK ^ . If the information nnd computation In tho nc.t!oo <110 corroct UIII1 thl(luctluns oro flot b81n(J olalmed, phtCl8 an "K"
In block "A" af Part 1 of tho "TOl(pnvef HospoflSo" section. Sign hw Gorlos lInd submit thom ~t1th your ohsok for thll tlmount of
tflll to the RoQhtef of wills of tho cOllnty ImJlcfltocl. Tho PA DOpqrt'lllHlt of RovlInuo will Issuo un offlciol assessment
IF(lflll REV-1548 EXl upon roclllrt of tho roturn fronl thll Ruglstllr of wills.
2. BLOCK B - If lho assot spocltlod (Ill thIs notlen hos bUIlI\ or will 110 raportnd and tn>< paid with tho PlInnsylvanlo InherltanCl'I
10)( Roturn fllod by tho dO{Jodnnt's roprnsolntBtlvUj pineo an "X" In block "8" of Port 1 of tho "Tal(payor Rosponsu" section. !;I~n uno
COPy unci return to t1\o PA nOllortlllont of Hullum'o} l1urmlll of Indll/ldulll TOI(9s, nopt ?806011 tlarrls!l(lrg, PA 17128~U601 In tho
onvelopo provldsd.
3, BlOCK C " If thlt nollos infol'lllotJon is Inoorront Ilndl1r dlltluct Ions ure boing clal,"~d, ct10ck block "C" and cOlllpiehl Ports Z and 3
occol'dlng to the tnstructlons below. Sign two OIlpl(ls llne! submit thom with your chuck for the amount of t81( p8YBhle to the Rnghter
of With of tho co\mly 1nulcflteu. Tho PA Ilopnrtlllunt of Rovenuo will Is!;wa an offlol01 ilSSeSSltont (forll REV~1548 EXI upon rocuirt
of the return frolll the Roghtur of Wllh,
TAX RETURN - PART
2
- TAX COMPUTATION
LINE
1. Enter tho dlltil the oooollnt orlgJnelh Wll~ establlshod or tHloe! in tho lIIannor Uldstlng lit date of doath.
NOTEI for 8 deClIdunt dldng ofter lUIU8?'1 Accounts which tha e!ocodont put Itl joint nnmOH within ono (1) Yllf1r of donth aro
talCablil fully liS transfers.. Uowever, therels 1111 oxcluslon not to elCcud B,OOO par transforee regardlnss of tha valuo of
tho oemount or tho nUllber of 8ccounh hald,
If e double Ilstorlsk (11M) l'IPJ'JIlarS boforo your flr~t 111.11I8 In tho addrllss portion of this nlJth:o, thil B,OOO exclusion
alrendy has bClllfl doductad fro", thn L'iccount llalBnce as rerortad bl! the financial Institution.
Z. Entar tho total balnnce of ttlB aocount Inoludlnll Interost uconled to thCl dlltll of (loath,
3. The percent of the account th!lt Is tflxablg for IlllCh survivor is dotanlllned liS followSl
A, The percont taxllblo for joint assets e5tablJshlld more thnn one year prJlJr to tho decodont's doathl
DIVIDED BY TOTAL NUHBER OF
JOINT miNERS
ElCBlllplal A joint asset registered
DIVIDED BY TOTAL NUMBER OF X 100 .. PERCENl' TAXABLE
SURVIVJNG JOINT OWNERS
In tho nElllle of tho decedent and two other persons,
1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED BY 2 (SURVIVORSl . .167 X 100
H,..'% (TAXABLE FOR EACH SURVIVOR)
B, The percont taxllble for assots created within ono yoar of the docodent'g doath or 8<1COunts owned by the decedent but hold
in trust for another ImlAvidual (sl (trust benefic lar ios) I
1 DIVIOED"Y TOTAL NUHBER OF SURVIVING JOINT
OWNERS OR TRUST BENEfiCIARIES
1( 100
PERCENT TAXABLE
[xallplol Joint account registered in thll nama of tho det;edent and two othor pur sons !md ostebl1shed within one yoar of d08th bl!
the decede"t.
1 DIVIDED BY 2 (SURVIVORS) .. .50 X laD u !iO% (TAXABLE FOR EACH SURVIVOR)
4, The 8.aunt subjoct to talC (line 4J is deterlllined by IIIultlplyJng the account balance IUno 2) by the peroent taxable (11ne 3),
5. F.ntllr the totel of the debts and deductions lishd In Port 3.
6. Tha 81110unt hl(oble (I1ne 6) Is daterlldned by SUbtracting the dnbts tlnd deduotIons (linn 51 from the BllIount subjQct to tax nino 4).
'f. Entur the approprhte tax rnte (I1ne n as rJeternlined bnlow.
0%
&%
Sibling
15%
15%
Coll.teral
15%
15%
o.te of D..lh
07/01/94 to 12/31/94
01/01/95 to 0&/30/00
Spouse
3%
tineal
&%
07101100 to pr...nt 0% 4,5%' 12% 15%
II e 8M'r:8to-l'iii'Posod on the not va uo of trons 81'S frOI~o;;98.'llH ~Cfi'lT(Jfwunty~onD Yllflrs 0 age or younger 8t
death to or for the usa of e natural paront, an adoptIvll pllrunt, or a stepparent of the child h 0%,
ThA lineal class of heirs Jnoludes grandpnrenh, fHtronts, chlldrfln, and Ilnoal doscendents. "Children" includos neturfll children
whether or not thoy heve been adoptOtl by others, adopted chlldron and stor children, "Un"fll descelldents" inol\idu I!IIl children of the
natural paronh and thoir rJoscnnden\s, whother or not thoy havo been <lcloptlld hy otharli, adoptnd dnscilndonts find their dDHcondanh
flnd step.dascendenh. "Siblings" are dof1nod 09 indlvidUltls who tU'lVA at hllst onn paront 111 caMllIon wHh tho decodent} whether bv blood
or adoption. The "Collateral" 01055 of hoIrs includos all other buneflclarles,
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allowllble debh end doduotltms fire dotnrllllnort liS (OllOWSl
4, You loglllh ore ruspotalblo for paymllnt, or the ostatu subjeut to admlnlstr-<ltlun by a porsunnl rflrres8ntatlvll Is Il\Sllfflohmt
to pRY the dedllctlbte Itelllfl,
fl, 'fou aotunlly prdtl thll Ilnbts f1ftllr tinnth of tho dor.otlnnt: find can fllrnJ~h nroof lIf paY'llInt.
C, !lubts being olahllld 1II~'St bil Itonli~od fully In ""d~, If BdrJltlollt'l1 SflBCll is I1Dedod, uso plrdn pnpor ~ 11;>" x II", Proof (If
plIYllllmt lIIliY bo reqllnstod by thn rA UopnrhUlnt o'f Rl1vl'lllun.
TAXPAVER ASSISTANCE
I~ YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANV REGISTER OF WILLS,
PADEPARTMENT Of REVENUE DISTRICT OFFICE OR CALL THE BUREAU OF
INDIVIDUAl TAXES, TAXPAVER INQUIRV UNIT IN HARRISBU~G AT (717l 787"8327.
fOR TAXPAVERS WITH SPECIAL HEARING AND SPEAKING NEEllS. 1-800-447-3D20 (TT
SERVICE,S
ONLV) ,
'. ,. ',' lit~9..
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i'ih\H:MUil 'J! W:'-;I rill!
!"i lijii,' RESIDENT DECEDENT
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[II (11,!lj! :, IIN.!L II ~sr, tlll:,I, Mill 1,11(\[1([ l'l'l,),ll u\q II V,I'" t'i,.,1 h Itl"l!.)Ir, /.,:1_1 ~
E I. L 1 [J T T M II Ii I', 1\ Ii I
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
\1;'~P;lilIIICS of f'Otjllly, i dfli;IMft UHlII h~Vfl fl'lln1111en HilS wlurn ,110IliH1U' tl"Ulll1f.iWyll1'J s(tlf'd,,!(':, <1',,1 5\,lIC'I'l'nl\ :1nlli~;';;Sj7,f~;;r'(;WI/):!glll!ld~"ji;,-\;;~, corltVl llI1:J (,(>l11plOIO Dcdilfflllon of prllPilfol~t~
UlfLl\.ll~Q.ll~JiQltill(!l:rC'.!ii!!@!~J'9-!~ ~f1j!!1_9[1..l!1!.~'(Q!~~~t'.\."19!l'!t'~111'.lW\j!.trl!~i (I:Ii l.jI.9lll~dJl'L _.u._.. ---.--.' -.... - . . -... ---...-.. - .
SIGNATlIR[ OF f'ERS'2'.1ESPOW;10I E FOR I'II.IIIG ETlIRtl A.DI1RES3 . /)
~&~,0' A';~ fit! [1ft- 41j1/.;()111}t,.(I"/7!1~)(.'!!;,}',,-,,:,/I:._---
GlnNATTIRE OF PREPARfl~t;ER 1I1A11 Rl;r .S I, ~f AODRfSS <h! 'Ie ;.-
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REV-1500
INHERITANCE TAX RETURN
FilE NUMOEH
II q G
07/10
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IIHI" Of !llfn~l
1 0 n _ n 3 _ 1 2 I, r, 11 II/? <J / 1 (j "r, II fI /1 9 / 1 9 1 2
::~~~""~:,U",i':~:',:' I<':~AST. :"51 AIIO::".,' S'XI'~~:URI'; "~'.,"m--.".---' IRETUR~~U~;;;~I~E~I; :;~I~~TE ~'TII rH{
r:9 1. Original Return [J 2. SlJppIOfl1onl.ll Rlllum 0 3 Rem~inder Relurn(da\aoldealh~!IOrlo 12.1J 81)
[] 4.limiled Estate [] 4a Future Interest Compromise Idateofdealhaft~1 \?-j2,~ll [J 5 Federal Estate Tax Relurn Required
[J (} [)tlcedenl Died Testal6 (A.";\I,h 'WI 01 Will) 0 7, Decedent Malf\lalned a Living TIIJsl (A.IIa.>!lCOpy ofTl~lll ~ 8 Total Number or Sale Depo!lll Boxes
[] 9 Ll1igllllon Proceeds Recolved lJ1Q, SpoUSElI Poverty Credit (dal~OfdUI1lIi~IW~en 12-31,9\ Ind 1,1.9~) 011, Election 10 lax u:lder Sec, 9113(A) lA!I.t/;~ 5d,Ui
T'RTSSECTION MUST BE COMPLETED, ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
-'l,l,l,lE - (:()I,tPlfTJ I,!AIUtlO ,l.DOREGS
RODERT 8. DRACKllILL 29nri Bl1l8 Mtll. Rd.
7iRI.TNAME III Arr,llcablo) Po rt ArllJ8 188 I lllEl, 9[\362
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TEltPHCltil: ~IUMflER
r.
Re,l Eslale (Sehedllle A)
2 Slocks and Bonds (Schedlll. BI
N/II(ll
(2)
2' El, 0 5 0.0 0
3 Closely Held Corpor,lion,Pennershlp or Sole,propnelorshl~ 11\ (3)
4 MOI1gages & Noles Reeel"ble (Sehadll~ 01 N/A (4)
5. Cash, Bank Depo,ll, & Miscall,neou, Personal PrOPA"Y (5) 1 4 I, 0 ? G 9 1
Z IScliedule EI
0 6 Jolnlly Owned Prope"y (Schedule F) N/A (6)
~
7. Inler,VI,o, Tran,ler, & MlscAllaneou, Non,Prob,1e Prope'l!i I A i7I I.'
:::l (Seliedllle G or L)
l- 8. Tol,l Oro.. A..ela(lol,1 Line, 1-71 (8)
~ i 1 7 2 r 1 2 6 . 9 1
U 9 Funeral Expen,e, & Admlnlslialive Co,ls ISehedule H) (9) 1 J ,7 ? 5. 0 6
W
0:: 10. Dohl' 01 Dee,denl, MOI1gage L1abllllies, & Lien' (Seliedllle IIN 11101
11. Total Daducllons (Iolel Line, 9 & 101 (11) 1 J ? ? 5 , 0 G
-
12 Nel Value 01 E'tsle (Line 8 mlnu, Line 111 (12) I 1 5 8 J 5 1 8 5
13 Charllable and Goyornmenlal BequeslslSec 9113 Trusts lor which fin election 10 la~ has not been N/A (131
made (Schedule J)
14. Nat Value Sub)ecl to T.. (Line 12 mlnu' Line 131 (14) 1 5 8 J 5 1 8 5
15 Amount of line 141axnble
Z at the spousallBx rate , I ,. ,0 (15)
0 See Inslruolions on revOnle side for IlppJlr..able perr,enlage
f:; 16. Amounl of line 14 taxable
~g at 6%, ({lie , 06 (161 9 5 [) 1 1 2
f"~ 17 Amounl 01 line 141llxahln
ilt 1~% rille 15 (171
0 - .--
U 18. TAX Due (Iftl " 7 3 0 G
, c
19
. --"--'OATE ,..----....-.
It',<' <,2..,_.,.._
DATE
~;~'::':::~~.O;":t' A,d~,,'~"'. .~:..~: ~~. ___- J~]._:_r"; .;"';~ ~% ::
,
Tax Payments and Credits:
1 Tax DlIe (Page IUne 18)
2 CrBdilslPaymenls
A. Spollsal poveny Credll -.,---I\IClf,l5-.'. _..,_._
S. Prior Paymanls ronr
C. OIS"Ollnl .---.-~"'r1~ -'-'-0-
:)'1'; .["l(l
111 ______...___
Tolal Cradils I A'S. C) (2)
3 InteresliPenally II applicable
D.lnlarost
E, Penally
TOlallntarasliPenally I O. E I (31
4. Illina 218 greater Ihan line 1 . iine 3, enter the diHerenca This is Iha OVERPAYMENT,
Check box Oil Page 1 Line 19 to request a refund (4)
5. II line I + lina 3 is graaler tl1an line 2, anter Iha dilferonce Tills is Iha TAX DUE, 15)
?73.n~
A, Entar Iha !nlaresl on Iba lax due (5A)
S. Enter the 10lal olllna 5" 5A. This Is Ihe BALANCE DUE, (5S) 273 .0[;
~1fiIIt~_._.Make.Chec.~,.E..~_IlIf'T
PI.EASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1, Did decedent make a transfer and:
a, retain the use or Income of Ihe property transferred; ..,.. .. ........,....
b, reteln the rigl1tlo deslgnale who shall use the rrorerly transferred pr its Income; ,
c, retain a reversionary interest or..
d. receive the promise for life of either paymenls, benefits or cere? ..
2, If death ocourred on or before December 12, 1982, did decedenl within two years
precadlng death tranafer property without receiving adequate consideration? If deelh occurred
after December 12,1982, did decedent transfer property wllhln one year of death without
receiving adequate consideration? ............,..................,......, ........,....,.., ............................,......, 0
3, Did decedent own an "in trust for" or payable upon deall1 bank account or aacurlty
at hia or her death?.. ... ......., ...., "...........................,........... 0
4, Did decedent own an individual retirement account, annuity, or other non-probate property?.... 0
iii
Yes
,0
",,0
..,0
",0
No
5]
~
r:J
~
[])
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN
~jlt/Jl~~kJll,OO~,l.MYtfJ~\~M'~~,.
72 P,S. ~9116 (a) (1 1) (I) provided for the reduction of the tax rate Imposed on Il1e net value of transfers to or for the use of the
surviving spouse from G% to 3% for dales of deatl1 on or after July 1" 1994 and before January 1, 1995.
72 PS ~9116 (a) (1.1) (iI) provided for Il1e leduction of Ihe rale Imposed onlhe net value of transfers 10 or for the use of Il1e survivlnfl
spouse from 3% to 0% for dales of dealh on or afler January 1, 1995. Tile stalute gQ~ol exen1QJ a Iransfer to a surviving spoube
from lax, and the olatlllory requiremenls for disclosure of assets and filing a lax relurn are still applicable even If Ihe surviving spouse
Is tile only beneficiary.
FOR DATES OF DEATH ON OR AFTER JANUARY 1, 1995, Please answer the following question by piecing lln "x" 11'1 the
appropriate space.
Old the decedent create a trust or similar arrangement which Is solely for the eurvlvlng spouse's benefit for his or her entire
lifetime? Yes [] No J::i'!l
If you answered yes to the above queslion, the tax on the Irusl or similar arrangement is postponed unlil tile deatl1 of tile second
spouse, al wl1ich time il will be fully laxable at the rate(s) applicable 10 the romalnder beneficlary(les), Enter the value of Ihe trusl on
Scl1erlule ,I, Port II, in order 10 remove it from the calculation of Il1e tax due In this eslate. You may wlsl1lo file Scherlule 0 in orrler to
make Il1e eleclion available unrler Secllon 9113. If the eleclion is made, tile IruSI or similar arrangamentls laxed in tile eslata of Ihe
first rlecedenl srousa, Ihe portion of Ihe Irust or similar arrangement wl1lcl1 beneflls the surviving spouse Is taxed attha zero lax rate,
and Ihe remainder is taxed alllle ralels) applicable 10 the remainder beneficiary(ies), If you cl100se to make Ihe election, you must
atlacl1 Schedule 0 to a timely, flied tax relurn, along with Schedule(s) K and/or M in order to show the apportionment of Il1e Irust or
similar artangemenll1etweenll1e surViving spouse and tllS remainder beneOclary(ies).