HomeMy WebLinkAbout96-00748
OeORGe M HOUCK
(1912-1991)
~i~
~ ;<J1f f7013
I
CHARLES E. SHIELDS III
ATTORNEY.AT,LAW
MELLON BANK BUILDING
2 weST MAIN STREET
MeCHANICSBlJAO, PA 17055
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TELEPHONE
1717) 766.0209
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISl'ER OF WILLS)
'lIOn DAHS Of DlATfl AFTEn 12131/9\ CHECK HUE
if A SPOUSAL
I POVERTY CRWIT IS CLAiMED I 1
iflLE NUMIIER
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j COUH I Y lOlll'
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(OMMO~..jWfJ\lTH Of 1'~t-lt,j5YlVAHI^
nrPAJ1fMfNT Of RfVfN\H
o~p, 'iB0601
. HAIlRI~BURO,PA Ii' 128,060 \
-".----- DrffDENT'~-'NAMil\A~', fIR5rM~D-':ii(i[jlf .{~'II j;,l!'
13~HNY, ANN,., ;::,
'a(/A~i~':i';;;"~-2 2 3 9 I"^};: r~^?'_ j~ 1"^,~'~i';~'_0i3
,,; ","",,,,, \";"lJiA"" \ ","" I'''' "E' ".;" .."""" ,,<<,,\ I'"",l, \~/A '."'MII'"
~ 1. OriUlrH11 Rvlurn I 2 Supplomuntul Roturn
II 4, Umitbd Eslale I An Futuro 11110(a~1 CompromilO
(fm dnlos of dealh nfter 1'2.12.82)
~ 6, Decodvnl Died To~I(Jlo I J 7, Docodenl MoinlClined Cl living Trust
(Anach copy of Will) jAltclch copy of Truil}
Ai:LCORRESPONDENCE AND COHFioEN'i'lAL" TAXiNPORMATlON -SHOULD BE -DiRECTEOTO-;-~---___~m.
NAI.\r .;--___~___.~_~~.~.'r_.__~_._._...._.__~__ ((;MPi1TfMAiTI~~(' A-r)DRT5s~---~-' .---.,-'-
C!.1I1t~Ui5 E. c"5!(IEl.bs 71[' Ol, IV, /iM/N ST.
TElfPf"Oflf ',"'I'" II1t:t!,,lfI9-/I)/c!S 13 II R6-" (",4 170s:5"
(717) 7t:.f&> -0209 "
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mC-,SSiIfH VILUIiHi .._
/CJO 1117: ~t?i<7V ;DR, ((,(1"1< lit<, 7wfI)
Il1t:'CH/I'VIC.se u/<'(,,, p~ l7os:s-
'''''''[ M"f,If~ ~;~~~~~fcllo'i"i
I ) 3. RomClindor Rolurn
(for dnlo$ of df.lulh prior to 1 '), 13.02)
[I 5. FodMal E$ICllo TWt; Roturn R'3qllirlld
_L a Tolul Numbvr of 5C1fe Deposil BOKCJ\
/lltc/IU1ICSbU'r!' fJ" 17cs~
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_______-.-:._~":=}o:)o:..::BE S~~ETOANSWERAlL QUESTIONS ON REVERSE SIDE ANI> TO RECHECK MATH . <OI(...;;({..
.U~d"r ponaltio& 0/ perjury, I dod(JIOlhClti fl~;V~ ~;(-Im-in-od If,-i; -1;11(111':- i-~(:ll;;li-(~~J-;I~~o~plHlyin9 ~(hflrjlllfl-\ [Inci~t~!~;lHHlt~, (]f~~(ll:).ill'fl-h~;i~f l~~.y~;lodno and balior,
tllslrue, corrocl cmd cornplotfl,.1 docloro 11,01 (III roo I (!\Intu h[l\ bool1 rl'podnd [I~ InJlt 'l1wkfl! \,oluI', D[,l!ol(I!I<nl oj P((IPOfI.ll {lthor thm' tho pononal rl.1prfHentcltlvfl is
b.oied on.all inlormcllionof which propmol hen (Iny krlOwlfJd(l('
5Inj.~.;~,oo. O;,F PII<~~A~"~'.".'II,j.,~IIIHI. few :~I;II(; ~I tlJln; ,\ltIWf:-,', .:2 06/ PI;)eCre st br, ,4 Ira dend elf 71(){) I
',/1""') 1-' .f_(./'t ".. /,' (".
':r&~d'~~~:~2f.: . .:''''''"\ .. w, /J141~ of,
1. Rool E"olo (Schodolo AI I I 1
I 2 Slocb and Bonds (5chodlllo B) ( 2)
3. CIO~6Iy Hold Stock/Parlno[snlp In!fHOll ISc:hodule q (31
4, MOrlgOgl!' CHId Noles Recoivoble (Schedule D) ( A )
5, Cmh, Bank Daposits & Miscellaneous Pef$onol Property (5)
(Schadul. EI
6, Jointly OV'ned Properly (Schodulo P)
7. Tro"lo" (Schodulo GllSchodola LI
6, Tolol Gross Assets (10101 lines 1.7)
9. Funerol E)(pense~, Administrative Cosh, MiscallClfloous (9)
Expemes (Schedule HI
10, Oebh, Morlgago liabililles, liens (Scheduh.l I)
11. Tolal Deduclions (tolall.lnes 9 & 10)
12. Ne! Value of Eslate (line a minus Line 11)
13. ChoriloblEJ ond Governmentcll Becluesls (5chodvle JI
Jj~~Y~Jue Subied ~~..~~.~j~J~_~_.~~.~~.~~_~~~)______~___..__~____...""~.._ u.._.___onn...._..mn....
15. Spousal Transfers (for dalos of dealh aher 6.30-941
See rn~tnlclion3 for Appllctlble Percentage on Reverse (15)
Sidf:t. (Indude values from Schedule, K or Schedule M.l
Amount of Une 1 A taxable 01 6% ralo
(Induda value, from Schedule K or Schedule M.l
Amounl pf line 14 laxable 01 15% fale
(Ind\lde volues from Schodule K or Schodulo M.)
Prlncipollox due (Add 101< from Lir16S 15, 16 find 17,)
Crodits Spousal Povorty Croclil , Prior Pllymel\t~ ,. Discovnl InhHtlSI
t? + I?/ ifs?J,oO + /, (JSTJ,oo 0
If Line 19 i~ greolar than Line la, onlor Ihe difference olllio{l 20. This is Iho OVERPAYMENT,
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1111
1121
(131
(.141
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.._x .06 =
" IS~()Z.$', 98
. x .15 =
IIBI
1191
1201
Check hfltc if you aro requoslin a refund of your., overpaymont.
21. II line 16 Ii groCller lh{Jn line \9, onlnr tho diflorflllCEI ol1lioo '/.1 Thi\ il lilt, TAX DUE.
A. ~ntoJ tho inlOfOS! (Jf) IfHl Iwlnne" dllll on lir!!' ) I A
B, Enler 11I(l1/)!01 of lino 2\ (Illd ?IA (lfl (ion )111, This is Iho BALANCE DUE.
Make ~h.tk Payable to: Reglltllf of WllIlr Agen!
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Rf.SIOl:NI lHCrnU-/l
SCHEDULE B
STOCKS AND BONDS
EstATe OF .
4;1),1) /I ~.
J .
File NUMBER
,2/-'1(,,-7'15'
6EIIIVY
ITEM
NUMBER
(All p;op.or;v.lolntll':o~n.d ';'lth Right 0' Survlvorlhlp ",u.1 b. <lll<lo.od on Schodulo F, I
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3.
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s:
IJ[ SCRIP1IOH
NIl{' 7i3uCI-l &;/lfIlIlOf/IC,4 7i~N.r I" 'I ..,1" f!olYl ' stk.
H/ ;1,8'.5 LO 025' I/-vli = Jf,2S '" I" If ""
AmE~/rE!CI{ 01 'I 'I ..s~, &m, .$fk.
HI 5'1 1..0 5.3.5 4nf' ~ .5.3.7S X .<'1'/ =
4, r. oj T. 'IIi s4, am, ..5t,(,
iii .r'f.S L t> $.1.:3 7S IIJ11! .. 53. '1,37S /( ,/11 -
Bel.l "Tl.I1INflC CO!tfl 1.'/ .$1" aM. StK,
HI .fl. .11.. it) 57.1;l.S" If.Jle.. 57. 75 x 16 r..
8 ELL. SDU rH c()~p.
3" 8 51"
An; ::
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12'> )( S'-8.
0,1/1. MI:.
HI 3?, S 1-0
31. 75'
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N()RFo~K SO<<TN~N
7.
H/ 83, bJ.E
IVYNEX
H/ 4if, 75
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1.0
8:<.''25 A-vE = 8'3,IZS )( 21.1.
/(" '-/.s/', cPlI/. ,j//',
tN ItVli,;: 'N.31S x 11.'-1 =
I~ I( sJ.. &m, .sfK.
3'.
Me/PIc n U.J /S
9.
HI :33.75
St? tJN. BUL
HI 1/9
U.S. Wf!5-r
HI ,51. z.s
/..p .J()." 25
A-PE'" J/!). 9375 ;< .128::
LO 33.375
(SBe) eMf,
1.0 /.If', J7S"
.4VIf= .33, S'Z5 KIl.l/ =
c~ '1(. .s!., &m, SIK.
~y~ :: 'r'B. t.875 x ~'I'" "
(p,
328' Jh,
&111. Sl:t,
VALUE AT DAlE
or DEA1H
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'I, Co .3.3.00
"13.. II$. ()O
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9, '(7/. /)f.)
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b-, SO,!, 21>'
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II, '177.13
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TOT At IAllo !,,'.r _~~?!..~~o.p.'!"!~t1onl_______ jJ;l o. .3 'I" . 8 'I
(If more IpOC. is needed, inserl ac:Jdillonulshe.h 0' same lire.)
~ I" 1\11'1 ! (, I j fl~1
COMMDN,'>(,\(!H iif rltllj:; l!'iillilA
IWlfRlliltlCt l~( ~fflj~tj
AHffJ!llIfJl.U[lUI!
SCHEDU LE F
JOINTl.Y -OWNED PROPERTY
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__~__, -.....c' '-_-'~-_'-~,"'-'-'" '__.:-" -. ,., - .."__n___....__ ._,_ t__: .,,,
ESTATri:;P-;j tVy}m.--.i:---8~~~ y
,'_c_-~~.._.._n~~]Pll~1;~~~~?~;'-.'._-~-
Jolnl tonantl.I,
NAME
A, HUGH Ii, dE'lftVy
ADlJl1eSS,
':;"0(.,1 PIIllIfCIi'GST ,eJ),
1I-t.1~/)f,fNIf, CI'1 9(otJt~ :llle
RELA TJ(?N..S~.I~.T.c>DECEDENT
tV E{:JIr'.!f t<J
B,
C,
Jointly-awned property,
ITEM LETTER
FOR
NUMBER JOINT
TENANT
---...---.-
1. .4.
DATE
MADE
JOINT
DESCRIPTION OF PROPERTY
TOTAL VALUE DECD'S DOLLAR VALUE OF
OF ASSET % INT, DECEDENT'S INTEREST
"DIIUI'HIN JJ&(JIl$/, CHEC/<./II/6'
'~/'I.r~ II-cer. :IF /J()I'f' 219 ,;,g
( fJ~I'L . ~/9, 311.. 'f? -t Iwr ~
~ 17. s10
7~;;;;;;-;:itf,3N, .!J'S'
(s~e /elftr afh,c1l1d tv 5ch~d,
C, )
,.
1'1, 3'1'..sS
50!:
# .-.-...-.-.......-......
?"97.Z8
TOTAL IAI.o onl., on line 6, Recapltolotlonl S 9 '~7.;/8
--- _ __ .___._.. _._._:.L__.~__.__
(If mar. spar;e is needud insurl uddiliorm/ "le.1I 0' SOInI, sizo)
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BUREAU OF INDIVIDUAL TAXES
INlil.RIIANtr lAl< lJlVlSION
0I:P1, ?1I0f.OI
ttMUlIsnuwo, jlA 1"/8"0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVF.NUE
NOTICE Of INHERITANCE TAK
Af'PRAISEMENT, ALLOWANCE OR OISALLOWANCE
Of DEDUCTIONS AND ASSESSMENT Of TAK
CHARLES E SHIELDS III
2 W MAl N ST
MECHANICSBURG PA 17055
DATE
ESTATE OF
DA TE OF DEA TH
FILE NUMBER
COUNTY
ACN
l
ESTATE OF
BEHNY
TAX RE TURN WAS:
) ACCEPTED AS fILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
I. Real Estate (Schedule AJ (1)
2. Stocks and Bonds (Schedule 8) (?)
3. Closely Held stock/Partnership Interest (Schedule C) (31
4. Mortgages/Notes Receivable (Schedule D) (4)
5. C8~h/8ank Deposits/Misc. Personal Property (Schedule E) (S)
6. Jointlv Owned Property (Schedule Fl (61
7. Transfers (Schedule Gl (7)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
C). Fun.r.l E)(panses/Adlll. Cost s/Nhc. Expenses (Schedule H) (9)
10. Debts/Modgage liabilities/Liens (Schedule I) 110)
11, Tot.l Deductions
12, Net Value of Tax Return
13. Charit.bl.IGov.rnmantal Bequests (Sch.dull J)
14. N.t Value of Estat. Subject to Tax
NOTE:
09-22-97
BEHNY
08-26-96
21 96-0748
CUMBERl.AND
101
(I..
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~.:.\.'~ ~
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_1t,IIi.1 II 'fP Ul-'Il
ANNA
E
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.-_m_... __~- .~_~~ -~-_'_-__..~.~~~=.
( X) CHANGED
,00
120,396,89
,00
,00
37.421.07
9.697,28
,00
(81
9,959,26
2,831.19
Ill)
(121
1131
114)
SEE
DATE
A TT ACHED
09-22-97
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~
iIE"v': i !leii - EX- - AFjJ" [oj-'- 97 Y -NOT iCE - -OF - "INHEri if ANC E - 'fAx - ;iP' PR A"I S E MENr; -A [ row AiiC' E - '(ill - - - - - - - - - - - - - - -.,-
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ANNA E FILE NO. 21 96-0748 ACN 101
If an assessment was issued previouslY, lines 14, IS and/or 16, 17 and 18 will
reflect figures that include the total of abh returns assessed to date.
ASSESSMENT OF TAXI
15, Amount of line 14 at Spousal
16. A~ount of Line 14 taxable at
17. Alllo'..nt of L in. 14 taxable at
18. Principal Tax Due
TAX CREDITS:
-P-iV:TEENT-'- ~Ej~~T'---'-r~~;~E~IH~~ENJp~'I)~';:~ ----- AHOUNT;A~~-----'
--11="67- 9 6 . ----AAl469"i6"--.-- -- -.-.-.-T;(jslr:o-li---.----T9-;95If~jfo..
05-24-97 AA211357 ,00 1,953,89
NOT! CE
NOTE: To insure proper
credit. to your ~ccount}
submit the u~per portion
of this form with your
tax payment,
167,515,24
12,790 45
154.724,79
2,000,00
152,724.79
rAt.
Lineal/Clas, A rat.
Collateral/Cl.,s 8 rate
115)
1161
117}
,00 X ,00, ,00
,00 X,06= ,00
152.724,].! X ,15=_.E...!..'!.P8,72
1181 22.908,72
____._.._.__ _.__....._.___..L___
.-~----"_._~.-._..-.--...---~..-- _u - -1-- 1_ - -. --. - - --
TOTAL TAX CREDIT 22.953,89
----._-..~..--.
BALANCE OF TAX DUE _ ~5, 17CR
INTEREST AND PEN. ,00
- -
TOTAL DUE 4S,17CR
L__
, If PAID AfT~R DAT~ INDICATED. S~E REVERSE
FOR CALCULATION OF AODITIONAL INTEREST,
IF TOTAl DUE IS I.ESS THAN $I, NO PAVHENT IS R~OUIRED,
IF TOTAL DUe IS RHtf.CHO AS A "CREDIT" (CRI, YOU MA'( BE our
A REfUND, S~E R[V[RS~ 5101' OF TIllS fORM fOR INSTRUCTIONS, 1
RESERYATlONI Estatel of decldent. dy.\nQ on Dr before Oeolllber 12, 198Z ~- if anY future Int.r..t In th. utat" Is tran.ferr.d
In p05IG..lon or enjoY.lnt to Cllss B (oollateral> b.neflelarl.. of the dloedent aft.r the expiration of ~ny ..tate for
life or for year., the COM.on~'alth herebv eKpre"lv r"er~'t the riGht to appral.e and a....t tran.fer Inherltanoe TaKe.
at the lawful Clol. B (oollat.r,l) rate on any .uoh future Inter..t.
PURPOSE OF
NOTICE I
To fulf1l1 the rlquIre",ont. of Section Zl40 of the .1nharItance I!lnd E.tote TaK Act, Act 21 of 1995, (72 P,S.
SeoUon 9140).
PAYNENTI
Oataoh the top portion of this Hotloe and submll with your pav.ent to the Register of Willi printed on the r.ver'G slda.
-,Mako ohlilok or money order paynble tOI REGISTER Of' HILLSJ AGENT
REFUND {CR)1
A refund at 8 tllK credH, which W8S not ral:luested on the hK Return, Iftav be requoshd bv COMpleting an "ApplIoatlon
for Refund of Pennsvl~anlll Inhurltenoe and Estflte Tn~" (REV.1313J. ApP110at10115 llrll 8~n1l8ble ot the Offloo
of the Register of Wills, any of the 23 Rev(,nue District Offlil8t, or bv call1ng thll special 24-hour
an,wlIrlng ..rvlce nUlllber, for forllls ordering: In Ponnsyl~8nia 1-800-362-2050, outside Pennllylv8nlll and
wlttdn local Hllrrlsburg orOft (717) 'I87-S0lJ4, TODIt (7171 772.2252 (HlIorlng Lllpalrod Onlv),
OBJECTIONS: Anv partv In Interest not lI&tlafled with thQ appr~dteJllllntJ flllowllnee or dlUl110wonce of deduotions, or a....."'ent
of tax (Inoludlng discount or lnterestJ as Ihown on this Notice JIlust Object within slKtv (60) day. of reoeipt of
fi thh Notice bYI
--written protOlt to thll PA Oupllrtment of RBvenuCl, BOllrd of Appeals, Dept. lSIOZl, Harrhburg, PA 171Z8-10Z1, OR
--.leotlon to ha~e the mattur deter.lned at audit of the account of the personal repr.sentntlvA, OR
-~appul to tho Orphans' COllrt.
ADHIN
ISTRATlVE
CORRECTIONSI
Faotu~l errors dllco~orQd on this 8SS8ss~unt should bu llddressod In writing tOI PA Depart~ent of Re~enull,
Bur811U of Individual Taxe., ATTNl Post Assel5llent Ru~18w Unit, Dapt. 280601, tt8rr!sburg, PA 17128-0601
Phon. (717) 187-6505. See page 5 of tha booklet "Instructions for InhllrltancQ Trlx Return for 8 Resident
necedent" (REV-1501J for an o~planatlon of odMlniltr,tlvelv correctable error..
DISCOUNT I
If any ta~ dUll Is paid within thre. (3) calendar month. aft.r the decedent's d~ath, a fl~lI percent (5%) di.oount of
the taK paid 1. allowlld.
PENAL TV I
Th. 15% tax ".nll.h non-PMt!olpatlon penalty Is oOllputld on the total of the tax and Interut a......d, IInd nllt
paid bllfore Janullry 18, 19116, th. first dav llfter the und of the tax "lIInut.,. pertod. Thl. non-part1cJpfltlon
penaltv J. applal8ble In thl la~1I ~annlr llnd In thl th. sa.. tlml periOd "s vou would Ilppeal the t8K an~ Intarl.t
that hat b..n as'."lId ll' Indlr.ated on tht. notice,
INTEREST I
Int.,..t i. oharaed beginning with flr.t dav of dlllnqulnoy, or nine (9) "enth. lInd one (1) d3V fro. the data of
de.th, to the date of pRYllunt. TaKa. which beca.e delInquent before Januarv I, 198Z bear lnter..t at the rato of
IJI( (6iO porolnt per annUlll oaloullltld at II dalh redl of .000164. All taKu whloh b'caM. dllllnqu.nt on and after
Januarv 1, 1982 will blar Interest at II rlltu which wlll vary fro. tallndar vear to talendar veer with that rat.
annQuno.d by the PA Oepllrtrnent of Rlvenue, ThQ applicable Interut rllt.. for 198i': through 1991 ",.1
'!!!! Inhrut Rate !!!l!l.l.ntlrllllt rllotor !!!! Intorest R"te Dllllv Interut f'llctor
1982 20% ,000548 1987 9% .000241
19U 16% ,000(,38 19S8-1991 11% ,000301
1914 11% ,000301 199Z 11% ,000241
1915 13% ,000356 1993.199(, 7% ,000192
1916 10% ,000214 1995.1991 9X ,000241
'-lnt.r..t Is calculahd " folloWIl
INTEREST. BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Anv Notlc. I.au~d after thl tax blto"'e. dellnqu.nt will refl.ct an Int.r..t calculation to flft..n (15) daya
Iflvond the datil of the n.....II.IOt. If ptlVlllllnt I. Ifttlde IIftlr the Int.r..t oOlllputa\lon date thown on the
Notloll, ~ddltlor"l Int.rut .u.t be calculatlld,
/,,) .<// /
COMMONWEALTH OF PENNSyLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
( '. ...
*
BUREAU OF INOIVIDUAL TA~ES
INHl:RITANCI::: TAX fJ11JIlHON
DF-fiT. lll0601
11ARRIS!lUJlO, PA 17ila-060l
I(~.lltl r,1 to ltl-"I
CHARLES E SHIELDS III
2 W MAIN ST
MECHANICSBURG PA 17055
DATE 11-03-97
ESTATE OF BEHNY ANNA E
DA TE OF DEATH 08-26-96
FILE NUMBER 21 96-0748
COUNTY CUMBERLAtW
ACN 101
E~ ","ount Remitt.d 'l
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE I 'To in",,'e proper arid! t tu your Ice aunt I subd t U,. upp.r pod ion of this form with your 'hx Plym.nt,
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR yOUR RECORDS ...
RE-v:i6Cij-Ei{-AFii-io3-:97j-------M.~--iNifERIT-ANCE--fAX--sriifEHE-Nf-CiF-Ac:COUNif--.-.M---------------------
ESTATE OF BEHNY ANNA E FILE NO. 21 96,,0'748 ACN 101 DATE 11-03-97
THIS STATEMENT IS PROVIDED TO AOVISE OF TIlE CURRENT STATUS OF TME STATED ACN IN THE NAMED ESTATE, SHOHN BELOW
IS A SUMMARY OF THE PRINCIPAL TA~ DUE. APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE. AND, IF APPLICABLE.
A PROJECTED INTEREST FIGURE,
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT, 09-15-97
PRINCIPAL TAX DUE, 22.908,72
PAYMENTS (TAX CREDITS),
PAYMENT RECEIPT DISCOUNT (+) A~OUNT PAID
DATE NUMBER INTEREST/PEN PAID (- )
11- 07-96 AA146926 1,050,00 19,950.00
05-24-97 AA211357 ,00 1,953.89
10-20-97 REFUND .00 45,17-
. IF PAID AFTER THIS DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST,
( IF TOTAL DUE IS LESS TlIAN n,
NO PAYMENT IS REqUIRED,
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
22.908,72
,00
,00
,00
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRl.
YOU MAY BE DUE A REFUND, SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS, l
PAVMENT I
D.t.ah the top purtion of this Nottce anu WUbMJt with ~our p.~alnt ..d" pa~able to tho na.e and .ddr...
printed On the ,'.y.r." dde,
If RESID~NT DECEDENT make check or ",on.y Qrdor payable tOI REGISTER OF WILLS, AGENT,
If NON*RE:SIOENT DECEOEHT lIeke chllck or lIloney order payablll tOI COMMONWEALTH OF PENNSYLVANIA,
REfUND (CR)1 A refund of a tOK credit, which was not reque.t.d 0" the Tax Return, .ay be requested by cOIIP1~tlng an
~Appilcation for Raf~nd of Pann9ylvanJa Inharltanc. and eltata Tlx" (REY~1313), Appllcatlo"~ ar. availabl. at
the OHlce of thl Righter of Wllh, IIny of the 23 R.v..nue Oistrlct Offloe. or froM the Deparh,ont'l 24-hour
anlwerlng lervlce nu.bers for forlll ordering: In Pennlylvanla 1-800-362*2050, o~t.idl PennlYlvania
and within local Harrisburg ar.a (717) 787-8094, TOOl (717) 772-2252 (H.aring I.pair.d only).
RE:PI.V Tal
Que,tlcn. regarding .rrors contalnad on this notlo. .hould ba andr....d tOI PA Dap.rt~ant of Rev.nue, Bureau
of Indlv.tdual Ta>:lI, ATTNI Post Allall.lnt RllIvh,w Unlt, Dept. 280601, Harrlsburg1 PA 17128-06011 phone
(711) 787-6505.
DISCOUNT I
If any taM due i. paid wtthin three (S) oalendar .ooth. after th~ dloedent', death, a flv. ,ercent (S~) dt.oount
of the tax paid 1. allowed.
PENAL TVI
The IS% tax ..ne.ty non~partlcJpation penalty 19 co.put~d on the total of th. tar, and Inter'lt a......~, and not
paId before Janullry 18, 1996, the fir.t day aftlr tha ..nd of the hI< allmllty Plriod,
INTEREST I
lnt_rut Is chargld beglnnin!1 with first day of dlUnquency, or nint (9) .onth. and aile (1) day fro. the date of
dlath, to thll datil of paYlllnt. Tax.. which b.oao delinquent b.forl January 1, 1982 bear tnterut at thl rate of
,Ix (6~) peroent p.r annulll calcuJat.d at It dally rat. of .000164, All tax.. whIch beoa.. delinquent on and after
Janl.lary 1, 1982 w111 bear Inter..t at a rltte which 101111 ....arY frOM cal."dar vear to calendar Ylar with that rat.
announced by the ~A DApart.ent of RevenuI. The applicable Intorast rate. for 1981 through 1997 arel
Vlar
Inter..t Rate Dally Intere.t Factor
Vear
Interut Rate
Dally Int.r..t facto~
1962 20Y. .000548 1987 9% ,000247
1983 16% .00(1438 1988-1991 11;( ,000301
1984 11% .000501 1992 9% .000247
1985 11% .000356 1995-1994 7;( .000192
1916 10% .000274 1995"1997 9X .000247
--Intlillrut II calculated ft' follow.:
INTEREST = BALANCE or TAX UNPAID X NUNSER or DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notiol I..uad after the taM boco... delInquent will rlflect an Inter.,t calculation tn flft"n (15) dtv.
U'~ond the datI of tho a.......nt. If pav..nt 11 .ade aftlr the tnt.r.,t oo.putatlon dat. ,haMn on the
HoHcl, $ddltlanal interelt .Ult b. tllleuhhd,
RECEIPTI OEERINCIPAL
Real Es~
Stocks and Bonds:
I. Air Touch Communications 164 Sh, Com. Slk.
2, Amcritcch244 Ch, Com, Slk,
3, A,T, & T, 418 Sh, Com, Stk,
4, Bell Atlantic Corp, 164 Sh, Com, Stk,
5, Bell.South Corp, 368 Sh, Com, Stk,
6, Norfolk Southern Corp, 261 Sh, Com. Stk,
7, Nyncx 164 Sh,Com, Stk,
8, Pacific Telcsis 164 Sh, Com, Stk,
9, S, Wn, Bell (SBC) Corp, 246 Sh, Com, Stk,
10, V,S, West 328 Sh, Com, Stk,
Cash. Bank Deposits and Miscellaneous Personal Property:
1. Dauphin Deposit CD, #8140329924
2, Int. accr. to d,o,d, on Itcm #1
3, Harrisburg Belc0 Federal Credit Union
a, Ace!. 3085910 - Regular savings
b, Certif. #18460
c, Accr. Div, to d,o,d, on Item b,
4, PNC Checking acct. #5070074788
5, Int. accr. to d,o,d, on Item #4
6, Refund due from IRS on Close-out 1040
7, Rebate from Bell Atlantic for overpayment
8, Inventory of personal property
TOTAL RECEIPTS OF PRINCIPAL
3
NONE
$ 4,633,00
$13,115,00
$22,545.88
$ 9,471.00
$14,030,00.
$21,695,63
$ 7,277.50
$ .5,504.25
,$11,977.13
$10,147,50. $120.396.82
$20,513.89
$ 63,97
$ 23,14
$ 8,200,00
$ 27."/7
$ 6,976,56
$ 3,94
$ 1,245,00
$ 7.20
$ 359,60 $ 37.421;07
$157,817,96
,. .., ,.-'''''
I2lS.I!.URSEMENT OF PRINCIPAL
FUl1cruI E~pcl1sc:
I, Prcpuid
2, Brnchendorf Memorial~
3, Altur Vuse of Flowers
~'i..llllil.CillUD11 ss ions:
I, Executor
2, Charles E, Shields, III, Attorney Fees
flllnily Exemption:
Miscellaneous Probate and Administrative Expenses:
I, Probate Fees and Short Certificates
2, Additional Probate Fee
j, Additional Short Ce.rtificates
4, Additional Short Certificates
5, Additional Short Celtificates
6, Reimbursement to Chas, Shields, III for
postage & certi r.
7, Advert. Cumberland Law Journal
8, Advert. Harrisburg Patriot Metro-West
9, Greenawalt & Co" C.P,A, prep, of close-outs
& fiduc, returns
10, Cost of Filing Inherit. Tax Return
11, Cost of Filing Accounting (estim,)
12, Reimbur~ement to Chas, E. Shields, III for
long dist. teleph, calls (estim,)
13, Executor's Costs and Expenses:
a,) Sheetz-Gasoline for Rent-a-Car
b,) Stamps, Postuge
c,) Long dist. calls (eslim,)
d,) Am, Savings Bank for Notaries
e,) Delta Airlines Flight
f.) Enterprise Rent-a-Car
Inheritance Taxes:
1, Estimated Payment to Depllltment of Revenue
2, Final Payment
Debts of Decedents:
1, ATT-PP Refund of overpayment
2, Bell Atlantic
3, Dr, Dalbey
4
$ 80,00
$ . 10,67 L
91.67
WAIVED
$ 7,700,00 $ 7.700,00
NONE
$ 223,00
$ 35,00
$ 15,00
$ 9,00
$ 27,00
$ 44,67
$ 60,00
$ 55.60
$ 400,00
$ 15,00
$ 105,00
$ 22,00
$ 8,04
$ 57,15
$ 35.00
$ 25,00
$ 672.60
$ 279.33 $ 9.879,26
$ 19,950,00
$ 1.953,89 $21.9Ql.8.2
$ 104,96
$ 36,01
$ 34,77
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STA'1'U~Jl~PORT UNDE;R RUI,E; 6.12
Name of Decedent; AlJtJ/t F. 13Ef/1J Y
Date of Death I ~. :210. '16
Will No, Admin. No. ..</-96-77'!
Pursuant to Rule 6.12 of the Supreme Court Orphans'
court Rules, 1 report the following with respect to completion of
the administration of the above-captioned estate:
1. State whether administration of the estate is completel
Yes_X- No_______
2. I f the answer is No, state when t;,he personal
represent;eti ve reasonal;>ly bel ieves that the administrat. ion will be
complete;
3. If the answer to No. I is Yes, st.at.e the following:
a. Did the personal representative file a final
account with the Court? yes+- NO_.__...,
b. The separate Orphans' Court No. (if any) for
the personal representative's account iSI
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 this report.
Date: ~-J,3-1g
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signat.ure
i1ak( E. r&,elJ.s J[
Name (Please type or print)
kffiU.5tr It/., IJhhll/J;'tsi"fj II /7"5.\
Address . C ' .
( ?II) /6~r()J-.ptj
Te I, No, r
capacity; Personal Representative
vi Counsel for personal
~representative
(MAH; rmflAM3)