HomeMy WebLinkAbout96-00721
rl
t'
t .....
0
~
I .!
...
(1
. .2
0 lit
Z ~
PETITION FOR PROBATE and GRANT OF LETTERS
ESlat' oJ.-1!..C!1.:9JJ1L!~.' _ I~L~l'nllOur No,_~~:l::.~.U~~.::..!l. ~ \ _
also known as _.__.._______.._ _____ To:
___...d....... _.____._.___..____ Register of WillG for the I
_.____ Deceas,;'> County of clIlIi:orlar1l in the
Social Security No, ~1y;;'1 b. :J?}o _. _ . Commonw~alth of Pennsylvania
The petition of the \lndmlgncd rCIPce<rully rcprc.\enIG that:
Your petitloner(s), who is/are 18 years or age or Old~( ,an the execuL.Q..C.....
in the IRSt will of the above deeed~llt, daled .....!~rr 1 _J.::>
and eodldl(s) dated _.___.._.tiLlL__
:.i--4-::i.--C~,;:;r--::)()< {' <!,,' \7rl cJ.!._r...L..L.7'~-3(;" 17Y Y
nil!1ed
, 19...2.L
(tUlle relOVllnl ClrQllmst!l.nCGI, f1,', ununclatlon, dealh or Ol<ccu\or, eto,)
Oecendent was domiciled at death In Cumber! anel ___ County, Pennsylvania, with
h..-._er last falfllly or Ilflnclllal.rC!jd,~c,e at Messi "I aQe. 100 Mt fill f'n []ri vp
lITec1iarllcsorug, .IAI7u5::> ~~.;(_ .' . II J)
(li5lIlrc/l, numbor ,nd m\1nolpnllty) .
D d l,' 74 . f di d ->L~ 9 19 96
al_ef~'Jn~Bl'~~ LlTcispl ta r~ar~.o ~~~'nSI~orOTIW.-;fl!..f!1J1cr..! (Incl C6-;--J'iI,-' .,:---:
E~cepl as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the wlll offered fOr 1)I'obate; was not the victim of a killing and was never adjudicated
incompetent: None _".
Decendent at death owned property with wlmated value, AI follows:
(If domiciled In Pa.) All personal property
(H not domiciled In Pa,) Personal property in Pennsylvania
(If not domiciled in Pa,) Personal propert)' in County
Value of real estate In Penn'ylvanla
situated a, follows: .. .._'.' .' c.tJ~'Yi-
S /?c DcU - 30, ceO
$
$------
$
WHEREFORE, petltiOMI'(S) respectfully request(s) lhe probate of the last wUl and oodicll(s)
presented herewith and the 21'anl of leners.._._ testamentary
(t,u,montArYI .dmlnlstrollon C,I.I,I admlnlstratlan d,b,n,c,I,a,)
theron,
]i~'.ri~
, I~' ~o n ..
(,
l
i~
J
~;';; .f'
L ':1::;~:;~:f>(,vt./
1 sen )Our
It 0.1, [lOX 526-A
~ALMYNA, ~A l/U/~
-
....---.....
_,~l'll'~':"...j.~---
.., ... ,.---.-..---.-"-'-
.-. ......-....-.
-~
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNS\'LV ANIA } ss
COUNT\' OF JJ.!t'1QEIU AND . _
The petltioner(s) above.named ,woar(s) or afflrm(l) that the statements in the forc8oln, petition are
true and correct 10 the beM of Ihe knowledte and belief of petilloner(s) and that as personal represen.
talive(s) of the ab,we decedent petltlonar(s) will well ancl .ruly administer the estate accordln, to law.
~) .1: <.', I /,
Swom to Of afflr01eq and subscribed t ,11'" 'r ' ..J<,' 1..""<--- I
before me thl! 1111.+ day of ,01111 I. L 1 s01l11OUr '
) Jj,-'-.- ,- '.-1.I'~""~ I ~ I;--r------- -.-".-
1L,)"..yu ~ L ..dLL1.tl y)~~
1 jM!\P Y (. I I \, I " ReciJtqr -+' ___
\ ,,) ~> \ ~)
No.
?1 - % - 17 I
--
Estate of
pOROTHY M. !J SENHOUR
, Deceased
DECREE OF PRODA TE AND GRANT OF LETTERS
AND NOW _...21:PTEMBER 1? , 19....2L, In conlidmtlon or the petition on
the reverse II de hereof, satisfactory proof havIns been presented before me,
IT IS OECIU~E~\ that the lnstrument(s) datcrl AI:~ IL ?C" 1 994
d. 'cd therein be admitted to probAte And filed or record as the last \l'lU of
DOROTHY M EISENHOUR
and letters _ TESTA~lENTARY
are her.byaranted 10 _.._~OHN EEl SENHOUR __
,
--,
FEES
Probate, Letters, Etc, "" ' , , "S 60.00
Short C.rtlOcates( 4) , , , , , , , , " 5.-_1? 00
Re~ujlclation ""',"'" - , , " S
x-~ages 6.00
JCP .---.-- S R~'RR
TOTAL ___._. S _ __
Filed"" ,~m,E~~~R, ,1.?t, ,1,9,Q~",."".
Ger91g J. Brinser, #09655
ATTOI\NBY (Sup. CI. I,D, No,)
P.O. Box 323, Palmyra, PA 17078-0323
ADDRESS
_ (717)838-6348
PHONll
, oc ) ~!'j ;:t?
c: {;: ;
~I "
[ii
',.,
I
~CJ
c i ..-
, , ~'-
1-'
t--.l
Mailed letters and order to attorney on 9-1?-9G.
H!{)I, "/IH', 11M
i,fff(l!IIIH':
CEflllll\ All Pl~)1
','"
!i
cnMMONWEALlH IH I'ENN~i~t V^NIA
OEPAIlHM Nl or H[AI rH vn At. Hl'COIIO!i
LOCAl.. REGISTRAR'S CnHIFICATION OF DEATH
CERT, NO. 3118016
.j!11Iiffi.0"'~,;,,;,.,; _
,~,~\m 0.1 f'{ih,
"~'-'" .."-1""
~-. "J.)
~~l
1'.?!~__ <",,<~,,ojo
orrENl C' ~"I.
1J(1liJte
July 10, 1996
"-~-. ,- b.10-6nl\"u;;-1JTtii;Ci;ii'{~';i'ij;-li,--+"
Dorothy
Name of Decedent --.----.-T-.--..-...... -
1f,1
Female ,
SeK .....___.__._.__.___..___Soolal Seourlty No
Date of Blrth~C~_~!_..~_:~:.____ .. Birthplace
M.
Eisenhour
.. "~.."~"-'-"'-~i~li.r-----.'.__._.'
.- -~I,,!.il<: ,-
195-16-3236
Date of Death
July 9, 1996
Loysville, Penna.
Place of Death_____Holy__~~~_i~__!lO~?it~~..._~~1l:J<:.:~~~cl.....C?_'__..~_:. Pennsboro ~':"""'__._..El).QnsYIYnnl~
r!r.llllj' Nll<nn ('l,m1f (;'\y, fl,j'<lu~}r' lIr Tn\lr",tllp
Race _~~i~=-_.occupatlol1._.__ _"_n Laborer .. Armed Forces? (Yes or No) __._..__._~o
Deoedent's
Winowen 100 Mt. Allen Drive, Mechanicsburg, Pa. 17055
Marital Status .__._._____.__.._._ Mailing Address _.____. __.... .,,_,,_...,.. ._..__
. .-N,;M,""- '..\,,,,j! --.-f.~;;;l-n-;'~l'--"-- ---'''''Sl~!~
Informant ..___!ohn _~:.~_is:.~~~u.r.______... . FUl)oral Direotor Donna R.G. BU..s-=,,____..__~__.__~..__..__.
Name and Address of
Funeral Establisl1ment ._____~u.s_':_F.~._,_ 90~~.~?~_es.town Rd. r Grant":~_1_~e!_!~:n_~~~2"8___..__..______
Part I: Immediate Cause
Interval Between
: Onset and Death
,
(0) Myocardial Infarction : Immediate
.~_ "'_.,_.,_______.,-_._,.._____. .__ ,._.___.~.__.._~__...~....__.___ "~._..,__~___.~,___---t-__..._______,..u_.., ,.__._'_"
,
(b) Ischemic Heart I)isoase .:
- ----.-. -..- --_.._--~--_.._. _.__._---_....._--..__.~_..--+--------_.---.._- -..
I
I
(0)___.____.. ~.~..____.._____._.___.n_....._.__.__..__.__.__.,_______-l-----------..-...
I
,
I
L...........-.-_~_,..._,_.__...,.__ ".
Part II:
(d) ____,_____~_._.__.____.__,_,~...._u_.___.~_.___
Other Slgnifloant Conditions R 1 F 11
ena a ure
,__~____.,~_<____~___,___._.___..__~__~_._r_..._~__.~_,___________--'-~_--..__________,_...___.__...
Manner of Death:
Natural ~ Homlolde 0
Aooldent 0 Pending Investigation 0
Sulolde 0 Could not be Determlnod 0
Describe how Injury ooourred:
Name and Title of Certifier ___~~ Zi~rma~___...____.____________._________m___.._.___.__
1 (M,D,,-Q,O.. CoreRer, M,a.)
Addres 08 Lowther st. LPJ11Oyne, Pa. 17043 .
s _.__._._______.___.m._.....___m.__.______...._m..._.__._..._._.______.._.________________..__.__.....__..._._... .....
This Is to oertlfy that the Information here given Is correctly copied from an original oertlfloate of
death duly flied with me as Local Registrar, The orlgll)rl. certlfloate will be forwarded to the State
Vital Reoords Offloe for permanent filing, III I},. 1:;) . 38--357
..r.::\.C;J..%d~~t{{;lJ .22-__ ~____i.e..e__ _ __ __ _ _. __
(oC,1 f1llOi.I"'DJ Vllftl RlIICor(j1 ()Iftlr,rl N"
159 N. Railroad st., Palmyra, Pa. 17078
__2111_y....!.9.L]~96__ .
t).t.n~"I\'lIdbylofl.i flllOi_l'ftl
.-mS!;i-eI'o\iidi".-A
c.,ty.cilHot,iJii.TO;f~'hip - .
:,(
"
:nn-
I
r-
(I)
....J
-'
.J~, ,I-I
j', ;;:
, .-
j' W-. WJ "'
,,) 0 (I) --
t :::>
a:: 0 ~
WJ :c
, I- ~ (T')
" (I) .- .,
" .... => 0 -,
~" <..:> I- ..... "'
w u t::l .-
a:: -
u a::
(I) u l- e( "'
.... (I) 0- .-
:3 w
w z a::
-' <l. WJ LW -
-' > .~
U '-" 0 Vl
cu Z ....
,.. ~ e( ....J
C(. :c 0::
<>; :::> ..:
:E u (I) I...>
f
I'
i
I
<<:
'"
Z
,/, ()
\-l.J l'(,
rt~
OJ;j
~ U;
.J ~
7,
E2
CO
'-
-",
'"
~ T,
'J, ~:
~'~i !.:;
,.:""-.-(
~ :,..', :..:
..l 0 '
=f"'..r,
~~ ? ~
~o.;j
rt: -f.
0;, "'
/-
,.
'A
'J
"
,
I:I~'
~'
"
"
-.
..........,......
"",.Jld.~...,..t-......,,r',
CERTIFIC~TION OF NOTICE UNDERliUL!..~6 (1'\1
Name of Decedent I
Date of Deathl
W1.11 No.
I
I
I
I
I
'I
I
;
To the RegisLerl
DOROTHY M. EISENHOUR
7/9/96
Admin. No,
21-96-0721
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 following beneficiaries of t.he above-capt.ioned <;!state on
7/11/96
Name
Address
Notice has now been given to all persons entitled ther<;!to under
Rule 5.6(a) except. ALL PARTIES MET IN OUR OFFICE ON SAID DATE.
Datel
12/27 /96
0-. t.~
~ P-
o .fa '50.:
N ()
r~ , .
~ d
.
, tJ
0
(Y) ,- g
,.
;j~ <1b u ~
0 ~i3
Q C_fJ ~.o
161l> ~ Sa
ccO:
~d 9 (-13\, ,11 AII"~ 11""-/
Signature . .
Name GERALD J. BRI NSER , #09655
Address __22 N. RAI LROAQ STREET , P. O. BOX
323, PALMYRA, PA 17078-0323
Telephone@l 838-6348
Capacity:
Personal Representative
.......L_ Counsel for personal
represent.at.ive
-,
,
I .', I ') ') ),)
J j'OI DAnS O'OIATH AmI 12131191 CH.CKH.I.
INHERITANCE TAX RETURN ~o~:=:'vU~:~DlT IS CUlIM.D [J
RESIDENT DECEDENT iiLiNUMI.-.----------'--------
COMMONWE.llH OF PENNSYLV.N,^ (TO BE FILED IN DUPLICATE 21 96 0721
DEPARTMENT Of REVENUE
Hm,sfJlb: ~~~9:'e-OIJO' ~IT_H REGISTER _OF_ W_ILLSL COUNTv CODE Y~AR NUMBER
DE !DENT'S NAME jlAST, fIUT, AND MIDDlf INITIAII DECEl>fNT'$. CQMPLfH AOOUSS
EISENHOUR, OOROTHY M. MESSIAH VILLAGE
s19'5~'n"~T3236" -- o7/9/9'6"'-----J~~l9!~r----- ~ O~II~~ i C~~~~~ _D~i VE 17055
codf~ ) CUMB. CO___
::~"L11 """'NO S~U51' NAM' :'.. "'" ,"0 .'00" 'N::~_](X'^j \ECU:~~:'~~_~~~_.C6u:~"EC~=~~'nNSTiUC1l0NSI
[] 1. Original Ro'urn [] 2_ Supplom.niol R.lUrn [J 3. R.molndor RolUrn
- liar do'es 01 dooth prior to 12.13-021
o .4, limited Estale 0 .40, Future lnlerol' Compromise 0 5, Federal ellat" To,l( Return Requirerl
Ifor datos 01 d.oth altor 12-12-621
(] 6. [] 7, Decedent Malnlained a living Tr\l" ~ a, Total Number of Safe Dopo.1I Boxes
IAllnch copy of Trull)
REl/d500 f,lC+ 17,9041
~
:..:Sv.o
~lE"
u~~
1. Rool Estolo 15chodulo A)
2. Stocks and Oonds (Schodulo B)
3. Clololy Hold Slock/Pa'1nonhlp Intoroll ISchodulo q
4. Mortgago. and Notol Rocolvoblo ISchodulo 01
5, Cash, Bank Dopa.lls & Miscellaneous Personal Properly
15chodulo EI
6. Jointly Ownod Proporty (Schodul. f)
7. Transf.n ISchodul. G)ISchodulo II
8, Total Gron Assets llolal Line. 1.71
9, Funeral EKpens81, Admlnhlrallve Costs, Mhcolloneous 191
e.ponsol 15chodulo HI
10. Dobis, Mortgogo liabllltlos, lions ISchodulo I)
11. Total Doduc110ns Itolalllnol 9 & 10)
12. Not Valuo of Estet. IUno 0 mlnu, llno 111
13, Charl,able and Governmental Roque.1s (Schedule J)
14. Not Value Sublocllo To.IUn. 12 mlnulUno 13)
15. Spousal Tronllon lIar doto. of dooth akor 6,30.94)
See Instrucflons for Applicoble Percentage on Reverse (15)
5ldo. (Includo valuollrom Schodulo K a, Schodulo M.I
16, Amount of Uno 14 taxable 01 6% rote
llndude volue. from Schedule K or Schedule M,J
17, Amount of line 14 taxable 01 15% rale
llndud., values from Schedulo K or Schedule M.l
18, PrlnclpalloK due (Add lax frorn lines 15, 16 and 17,)
19, Credlh Spoulal Poverty Credit Prior Paymonh Dhcounl Inlenul
_______ +_Lt500.00_ +__78.95__ ____
20. II Uno 191s grootor than lln. lR, .nlor th. dllloronco on lln. 20_ Thll Is lh. OVERPAYMENT,
am
,.
...
ili
ffl
b:l
Q
lilffi
"Q
18z
uf
ESQUIRE
TElf'PHONE NUMBER
717 J 838-6348
Z
Q
3
~
b:l
..
Z
co
a
i
E
co
'-'
S
22 N. RAILROAD STREET, P.O. BOX 323
PALMYRA, PA 17078-0323
111._______________n___
( 21 7 , 240 ,_~___,
PI--
141 28,523.50
151___________
16) _______.Jl54. 4L_____
17)
36,718:53
1101
1,098.00
9,448.55
(0 I
10,546.55
26, 171 . 98
1111 -
1121
1131
114)
26,171.98
)(,-=
1161
26 , 171. 98
1 , 570. 32
x .06 ~
1171 ---
)( ,15 11II
1101 --
1,570.32
1191
1201
1 ,578.31...____
8.63
C~cdt heft' if you ole requesting (I H..fund of yovl OVctpc,ynlOnt
DAlE
/'i
21. If line 18 is greoler Ihan lint! 19, enler Ih~ djfference on Un& 21. This is Ih8 TAX DUE, (21) ~-.~-------~--_.
A. Enter the interest on Iht'l balance duo on line 21A. 121A) -_._--~----.'-,~'
B_ Enlor th.lotol of line 21 end 21A on Uno 21B. Th;, ;,'h. BALANCE DUE, 1210) ------------------
.___.___.~~!~~~.ck .~!'!'H~~!..!!:_!l~.UI,'_.!!!_~!_~!ll!!_ Agonl _
_____~==)o_ ~...B._E SURE TO ANSWEi-ALL QUE~TIONS ON REVERSE ~IDE AND TO RECHECK MATH .....- ---
Under penaltl(ls of perjury, 1 oeclarfllhat I hove examined tllil return, including accompany'ing Ichedulll and lIalemenll, Clnd 10 the best of my knowl dge and belief,
it II tru., correct and completo, I declare Ihot all roo I 8llah\l hca been rflported ollrue market vall/It. Declarallon of preparer olher lhon the persopa rtpreAlttOtpe h
bO~~~~lnlor~.~~~.-~.!..~hich.rltro_p~!!-.._h~~X--~~Owle~~~~..,_,_-'___,,_,__._____._ __ /./- / ;:' /
'10 Aru~fO' SON R~f'ONSlll{ fOR' Nt; RETURN ADD~BS O,4.Tf
, _~- Ie ... (j {,. ,-',e R.D. 111, Box 526-A, Palmyra, PA 17078
il N/,' 0; "::~if'i.iffi[0:^~ ";~"iN'^j1'T---~~D~~"~~x--;;-;--~-;;~--;~-~~~~~78~ 0323-
---;-~----(.---i ~------------------ _______________________L___!llJII__'-'--_____________________
/
1- ,\
.......... ~I.... j
- . W SCHEDULE F
COMMONWIAlIH 01' 'INNSYIVANIA JOINTLY-OWNED PROPERTY
INHlRlTANCllAX UTVAN
,UIDINT DICIDINT
--- -
ESTATE OF
Jalntt.nant(.)l
DOROTHY M. EISENHOUR
NAME
----
A. JOHN E. EISENHOUR
II.
C.
Jalntlv-awnod proportv,
ADDRESS
R.D. #1, BOX 526-A
PALMYRA, PA 17078
PILI NUMlleR
21-96-0721
--
RELATIONSHIP TO DECeDENT
SON
unER -
ITEM FOR DATE tOTAL VALUE llECD'S DOLLAR VALUE OF
NUMBEA JOINT MADE DESCRIPTION OF PROPERTY OF ASSET % INT. DECEDENT'S INTEREST
TENANT JOINT
1. A 9/94 CORESTATES BANK - CHECKING
ACCOUNT #11015816 1 , 908. 98 50% 954.49
-
TOTAL (AlIa ontor on IIn. 6, Rocapllulallon) S 954.49
--
(II moro Ipaoo /1 noodocllnllrl arldlJlana/lhoo'" a' lam. II..)
""'''liD:. ,....
......0 J 5eH.DULI H
~ FUNI!IU.L IXPINSIS,
COMMONW!Al1It Of "NNIYlVANIA ADMINISTRATIVE COSl1 AND
IN~~:=Dm~lmRN MiSCeLLANEOUS EXPENSlS
.stAT. 0' .=' -
ITEM
NUMBER
A.
B.
4,
C.
1.
2,
3.
4.
5.
6.
7.
8,
1.
1.
2.
3,
P1.a.. P,lnl 0, T .
DOROTHY M. EISENHOUR
21-96-0721
DESCRIPTION
Fun.,al Ellp.n....
Adm'nl,',a"v. Co.'"
Personal R.preSl.nlatlve Commission.
Social Security Number of Personal Representatlvet
Year Commissions paid
Attarney Fees, BRINSER & WAGNER
Family Exemptlan
Claimant
AddrelS of Claimant 01 decedent's death
Street Add,elS
City _
Relatlanship
Stal.
, Zip Code
Probate Fees - REGISTER OF WILLS
Mlsc.llaneou. EllP.n....
REGISTER OF WILLS - FILING FEE
TOTAL (Also .nt.r an line 9, R.capltulatlon)
(If mare .pac. I. n..d.d, In..rt additional .h..,. of .am. "...)
"1
AMOUNT
1. 000. 00
03.00
15.00
$ 1,098.00
..."",,, n'9l'W
COMMONWIAntlOf "NN'YlVANIA
INHUlu'N(l! 'fAil UTURN
"UIOIN10IClorNT
DOROTHY M. EISENHOllR
1 SCHEDULE I 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES AND LIENS PI PIT
__ _ ..... . nt d. 'If!
-- FILE NUMBER
21-96-0721
ESTATE OF
--,-- ---,
ITEM DESCRIPTION AMOUNT
NUMBER
_..~----,
1, EAST PENNSBORO AMBULANCE 25.00
2. MESSIAH VILLAGE 2.695.32
3. BELL ATLANTIC - PHONE 3.84
4. DEPT. OF PUBLIC WELFARE - SEE ATTACHED 6,724.39
TOTAL (Alia onlo, on IIno 10, Rocopltulation)
III mart 'poco I, neod.d, /..orl odd/llono' .h.." a/lamo "'0,)
-
$ 9,448.55
- ", ,.- ~ ~" '.,.
1'1------
LATE' 09/27/~
COMMONWEALTH OF peNNSYLVANIA
DEPARTMENT OF PUBLIC WELFARe
J
STATeMENT OF CLAIM
U~J~:~~_~~_~_~:~-'~;~;~~___=:___I
MEDICAL
INPATIENT 0.00 0.00
OUTPATIENT 0.00 13.29
LONO TERM CARE 0.00 6,71"10
ORUG 0.00 0.00
0.00 6,724.39
1;:!!i';~~I~~i~~~~~~~,~~~~~~~~~~~;
, .'1
6,724.39 I
".;.:":,-",,
WILL
OF
DOROTHY M. EISENHOJm
I, DOROTHY M. EISENHOUR, currently of East
Township, Da uph j n County, Pennsylvania, declare this to
Last Will and Testament, hereby revoking any and all prior
'and Codicils made by me.
Hanover
be my
Wills
I. I direct that all my just debts and funeral expenses be
paid from the assets of my estate as soon as practicable after my
demise.
II. I direct that all estate and inheritance taxes that may
be assessed in consequence of my death, shall be paid out of the
principal of my general estate to the same effect as if said
taxes were expenses of administration and all property
includable in my taxable estate whether or not passing under
this Will shall be free and clear thereof.
III. I bequeath unto my husband, John H. Eisenhour, all
tangible personal property which I own at my death.
IV. All the rest, residue and remainder of my estate, of
whatever nature and wherever situate, inclUding property over
which I hold a power of appointment, I devise and bequeath unto
my husband, John H. Eisenhour.
V. In the event that my husband, John, does not survive me,
I devise and bequeath my entire estate that would have otherwise
passed under Paragraphs III and IV above as follows:
A. I bequeath unto my daughter and son-in-law, Joanne M.
Rhine and Dennis Rhine, or their issue per stirpes, the end
table which was made by my Bon-in-law, Dennis.
B. All the rest, residue and remainder of my estate I
devise and bequeath equally unto my three children, John E.
Eisenhour, Joanne M. Rhine and Dorothy J. Garman. If any child
predeceases me, his or her share shall pass unto his or her
issue per stirpes. If said child leaves no issue, said share
shall lapse and be added to the shares passing to my other
~hildren or their issue per stirpes,
~
- 1 -
/J~r~
CDMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
t.~~... .
fj "..
, -, .. ,.,
't~, , .t".
,.... I 'J ..)
1<) , '1,~) -/e..,
BUREAU OF INDIVIDUAL TAXES
INtIUHlAHCf. TAl( DIVISION
DEPr, 780601
HARRISIHJRO, PA \tll8'0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
.1 j' I \,} [l AI ~ III III
04-14-97
EISENHOUR
07-09-96
21 96-0721
CUMBERLAND
101
DATE
ESTATE OF
DATE DF DEATH
FILE NUMBER
CDUNTY
ACN
DOROTHY
M
GERALD J BRINSER
22 N RAILROAD ST
PO BOX 323
PALMYRA
ESQ
i....~-=~A~~un:.__R~=tto~~=_~
MAKE CHECK PAYABLE AND REMIT PAYMENT YD:
REGISTER OF WILLS
CIIMBERLANO CD COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~
R '"e:V: iiiijj" E i< -A i= ii" f oi": 97 Y" NOi'" feE" "OF" "iliA E iff T A N"li E" 'fAx "'A"P- PR 'A" f Ii E if EN T";" Ai. rci W A N"li E" cili -""" -"""""""" -".'"
DISALLOWANCE DF DEDUCTIONS AND ASSESSMENT OF TAX
DOROTHY M FILE NO. 21 96-0721 ACN 101
PA 17078
04-14-97
DATE
EISENHOUR
ESTATE OF
TAX RETURN WAS, I X) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BAS~D ON: ORIGINAL RETURN
1, Re.l Est.te (Schedule AI
2. Stocks and Bonds (Sohedule 0)
3. Closely Held stock/Partnership Interest (Schedule Cl
4. Harts.ges/Nota. Receivable (Schedule DJ
S. Cash/Bank Deposits/Hisc. Personal Property (Schedule E)
6, Jointly Owned Property ISohodule F)
7, Transfers (Schedule G)
8, Totel Assets
) CHANGED
,00
7,240,54
,00
,00
28,523,50
954,49
,00
18)
NOTE: To ins~r. propMr
credit to your account,
lubmitthe upper portion
of this form with your
tax pIYft18nt,
111
121
13)
14)
(5)
(61_
17)
36,718,53
APPRDVED DEDUCTIDNS AND EXEMPTIONS:
9, Funeral Expenses/Adm. Costs/Mlsc. Expons., (Schedule H)
10, Oebts/Hortoage Liabilities/Lien$ (Schedule I)
11, Totel Deductions
12, Net VIIIu. of Tax Return
13. Charitable/Governmental Bequests (Schedule J)
14. Net Value of Estat. Subject to Tax
1,098,00
9,448, 55
III )
1121
1131
114)
(91__
1101_
1 D .0,46 55
26,171,98
,00
26.111.98
14, 15 and/or 16, 17 and 18 will
returns assessed to date.
If an assessment was issued previOUSly, Une.
reflect figures that include the total of ~
ASSESSMENT DF TAXI
15. AMount of Line 14
16. Anount of Lin. 14
17. A~ount of Lina 14
18, Principal Tax DUI
NOTE:
,00
1,570,32
,00
1,570,32
, 00 X' 00=
26,171.98 X ,06=
,OOX,15=
118)
at Spousel rat.
taxllbl. lit Un..I/Class A ".t.
taxable .t Coll.teral/Clals 0 rat.
115)
116)
117)
TAX CREDITS!
PAYMENT
DATE
--..TIFo3 - 96
04-07"97
AM~;~- PAI~---~-~
- T"'3:g~:-I.__
.:,1:::~;;l:.!~:::;r:'~j!j
IF TOTAL DUE IS LESS THAN n, NO PAYMENT IS REQUIRED,
IF IOTAL DUE IS REFLECTED AS A "CREDIT" ICRI. YOU MAY BE DUE
A REFUND, SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS, I
DISCOUNT 1+)
INTEREST/PEN PAID 1-)
--~52
,00
RECEIPT
NUMBER
--~f468T6
REFUND
, IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST,
~)t}
.'.1
\'.)
.--,
J~'::~
'--'1
1'-...)
1,1
0\
RESERVATION I E,tat.. of dlc.dlnh dyinG on or b"fllr. Oec..ber 12, 1982 .~ 11 any future Intflrllt In the eltata 19 tremlferr.d
In pOI,e'tlon or enjoyment to Clast 8 (oollateral) banefl~larlel of the deaedent after the expiration of any 8state for
life or far 'yellr., the COllllllanwealth hereby el(pre..ly ruerYII the rIght to oppralu llnd Il&llOU tronsfer Inharllon<J1 Taxes
at the lflwful Cia.. 8 {ool1l1torall rtlte on MY suoh future Interut,
PURPOSE OF
NOTICE:
PAVHENTI
REFUND (CR)I
08JECTJONS:
ADHIN
ISTRATlVE
CORRECTIONS I
DISCOUNT:
PENAlTVI
INTEREST:
To fyUIlI thQ r.qulrellenh of Seotlon 2140 of the Inherltanoo and Eshlh Tax Act, Act 21 of 1995. (72 P.S,
Sootion 9140l,
Dotflch the top portion of thl. Notieo and I1Ubllllt Hlth your pflymont to the Register of IHIlt prJnted on the reverse side.
--Hnko checlr. cr lIIonuy order IHlllable tal REGISTER OF' HILLS, AGENT
A refund of 0 tax oredit_ Hhloh wn9 not requested on the Tax Return_ May be requested by cOIlPleting nn "AppllcntJon
for Refund of Penn.ylvanla Inherlttlnce tlnd E,tate Tn)(" (REV-15\3l. Applications are al,/llllable ot the OHloe
of tha Register cf Wills, nny of the 23 Rovonuu District Offlc9s, or by calling tho special ?4~hour
answering .ervioe nu~ber. for forM' order}ngl In ~enn$ylvnnla 1-800'362-?'OSO, out91de PonnsylvanIa and
withIn local ~tarrhburg aren 017l 187-8094_ TODII <717l 772-22!i? Weflrlng Impaired Only),
Any party In lntorest not satisfied with the 8pPtalsomont, allcwance or disallowance of deductions, or assessment
of ta)( (IncludIng discount or Inter.,tl n' shown on this Notlco ~ust object within sl~ty (60) day. of reoelpt of
thlt Notlco bYI
"wrlttln protest to the PA Depert,"ent of RQv.nuo, Soard of Appal'lls, Dept. 281021 _ Hnrrlsburgj PI. 17128-1021j OR
--eloctlon to hnva the "atter dQter~lnad ot Audit of the nccount of tho personal rcpre.entatlvej OR
'-appu1 to the Orphnn,' Court.
Factyal erl'Or9 discovered on thIs AuaUltent should ba nddressed In writing tal PA Dop8rtmont of RllvlnulI,
Burlli:lu of Indlvldunl 11'1)(95, AllNl pcst ASIlOUDlent Rovlow Unit, Dap\. ?80601, Itnrrlshurg_ PA 17128-060\
Phono (1171 787-6S0S, Soe pngo S of the booklet "Instructions for Inheritance la)( Return for a Resident
aecodent" (REV-IS01l for an explanntlon of admlnlstrlltivoly corrflctablfl errors,
If any ta)( due I. paid within three (:5) calendnr months tlfter the decedont', (Ienth, II fly. percent (SiD dl,count of
the ta)( paid I, nllowed.
The 15% tax a.nlsty non-participatIon penalty II co.puted on the total of the ta)( nnd lntere't a'le"ed, Ind not
paid befora January 18, 1996_ thll first dny aflllr the Ilnd of the ta)( alllnesty period. This Mn-partlolpatlon
penalty II appe"lable In the s"~e ~"nnor and In the the snma time Pllrlod as you would appeal the tn~ and Inter..t
that he. been assessed II indicated on this notlcD.
Inter8lt II charged beginning with first dllY of dol!IHIUencYj or nIne (91 months and on8 (I) day frolll the date of
d.~th. to the dllte of pay.ent. Ta)(.s which becaMe dellnquont beforo January 1, 1982 blnr Intere.t at the rata of
sl)( (6;() pMrcent per nnnu. cnlcu1ated at n dally rate of .000164. All taxlilH which blcnlla delinquent on and II'Ifter
January 1, 1982 will bear Interest at a rate whIch will vnry fro. calondar year to calendar year with thllt rat.
announoed by the PA Ollpdrt~lnt of RaYenue, Tho 8Ppllcllble Int~relt ratlls for 1982 through 1997 arol
'!!!!: Interest Rnte DtlllY Interest. F80tor :!!!! Interut Rate Dalty Intorut FllCtor
1982 20% ,000548 1987 9% .01l0i:47
198!l 16% ,OO04!l8 1988'1991 11% .000301
1984 11% .000301 1992 9% .000247
19es 13% ,OOO!S6 199!l"1994 n: .000192
1986 10% .000274 I99S-1997 9% .000247
~~Int.r..t II c8louleted .. follow' 1
INTEREST . B^L^NCE or TAX UNPAID X NUHBER Dr D^YS DELINQUENT X D^ILY INTEREST rACTOR
--Any Hotlca I..ued aftar thQ ta)( beco.lt dellnquunt will reflect an Interllt calculation to flfteeh (IS) day,
beyond the date of the al.ISlllent, If p~Ylllent I. Made nfter the Int~rolt cOIllPutatlon dnte shown on lhe
Notice/ nddltlonl'll Inter..t lIlust be calculf1ted,
- --.---
""'M." ...........
00
c_:; ?;:":
-,
..
PAVHEHT I
\0
Detaoh tn_ top portion of thts Notice ~nd iub~tt with your pmYMlnt M8de PftY8bl~ toth. na.. and ~~ar'I'
prJnted on the r.yerse side.
If RESIDENT DECEDENT ",eke ohooK or lllonlY order payable tal REGISTER OF WILLSJ ^ntfNT. C"i
If NotH~ES10F.NT DECEDENT make check or monlY ordar P8'111b1l1 tOI COMMONWEALTH OF PENNSYLVANIA.
REFUND (CR)I A refund of a tax or.rUt, which Wllt not f,.quested on th. 'fax RltLlrn, IlIfty be r.quntad by cOMpleting IIn
"Appllcl!ltlon for Refund of Pannsylllanhl Inh.r1tn"o8 lInd ElItllte Ta)(" (REV"1311), Appllclltlons !!Ir. available lit
the OffICI of the Rlg!.ter of Willi, any ofth. 23 RG~8nu. Dlstr10t Offlr.I' or fro. the 08part~.nt.. 24~hour
an,wlrlnu ..rvlce nuMber. for for~' orderInGt!n Plnn.ylvanla 1~800~362ul05D, out.lde P4nn,Ylvania
and wlthin local tlelrrhbur; (lrfU'l {7171 781-8094, TOOt (7171 772~2252 (Hurln; Iillpairad onlY>'
REPlV TOI
QUI.tlon. regarding errors contained on this not leI should be ftddr....d tOI PA Oepnrtl.nt of'Revenu., Burleu
of Indivldual 18)(81, ATTNI Post AssuSIIlont R.vlew unit, O.pt, 280601, .l!lrrlsbur;, PA 11128~0601, phon.
(711) 787-6505.
DISCOUNT I
If any ta~ due i. paid within thr.e (3) calendnr .cnth' after the deoedent'. de$1h, a fIve percent (5%) discount
of the ta~ paid is allowed,
Pf:NAI.TVI
The 15% tal/: aMne.ty non-partIolpntlon penalty 1. conputed on tho total of the t8l/: and Int.re.t asslssld, and not
paid blfor. Januftry 18, 1996, the first day aftor the imd of the tax alnuty periOd,
INTEREST I
Int.re.t 1. charged b.gInnIng wlth first day of dellnquenoy, or nln. (9) Month. and on. (1) day fr~M the dete of
death, to the date of paYMent, Te~e. whIoh b'~all delinquent before Janu~ry I, 1982 bear Intere.t nt th_ rate of
.1x (6X) p.reent par ennuI oaloulated at a d811y rata of ,000164, All texas whloh beca.. delinquent on and after
JllInul/lry I, 1982 IolJll bur Intera.t at l!l rl!lta whIch will vl!lry fro. calendar yerlr to oalendsr Ylar with thl!lt rat.
announoed by the PA Oepartlllent of Revenue, Thil llppl1cabla Intlrut rates for 1982 through \997 (Ira I
Vear Int.ra.t Rate O~Jly Int.re,t Faotor
Vear
Inhrut Rl!ltl
nally Intera.t Faotor
19112 ZOX ,000548 1987 ,~ .000247
1983 16X ,000438 1988-1991 11:< ,0(/0301
l.a4 11% .000301 1992 9X ,O~0247
1985 13X .000356 1993-1994 n: ,000192
1986 lOX ,000274 1995-1997 ,~ ,000241
--tnterut 11 Qalculllted .. followll
INTEREST " BALANCE OF TAX UNPAID X NUNBER or DAYB DELINQUENT X DAILY INTEREST FACTOR
--Any Netic. I.,uod aftor the tal/: blCOle. delInquent will reflect an lnt.re.t oeleulatlon to flft"n (IS) day.
beyond the dl!ltl of the !lueu"ent, Ii PflYlllnt h ,ade IIHer the Inter..t coapuhltlon date .hown on the
Notice, bdd1tlonal lnt.rut ltU.t be cftlculated,