HomeMy WebLinkAbout96-00796
PETITION 1'01~ PROBATE Illld (;J~ANT 01' LETTERS
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IInd eodicil(s) dlll,'d ""m,' "'..~"'___
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heL'l'1 as 1',,1101\ s, deL'l'dl'1I1 did 1I011l1ar1Y, \\a, 1101 divolced alld did 11011iavl' (\ child born or adopled
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(II' domiciled ill, 1''1,) ^lIl'ersOllall'lopL'rlY
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(111101 domiciled in Pa,) Pel'''iollal properlY in County
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OATH OF PEI~SONAL REPRESENTATIVE
COMMONWEAI.T" OF I'ENNSYI.VANIA
Cm;'TY (II- Cumberlund
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(I . Se,Eit~lb1" III ,96
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
,
1
BUREAU Of INDIVIDUAL TAXES
INHEIUUNCE TAl( DIVISION
DEPT, 280601
HARRISBURG, PA 11126.0~Ol
NOTICE Of INHERITANCE TAX
APPRAISEMENT. ALLOWANCE OR OISALLOWANCE
Of DEDUCTIONS ANO ASSESSHENT Of TAX
03-03-97
MAYBERRY
09-23-96
21 96- 0796
CUMBERLAND
101
~_u,u'-A.i;;;:;;;C~~!!.IIf~~~:'"". J
l_____,_____.~._,__._.._w__~_____"_.,'___._
MAKE CHECK PAYABLE AND REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .....
ifi Ii': i547 - EX- - AF ji - i i"2 -;'96 Y - NoYi is E"O' Ii - YNH EiiI T A NC E - 'fAx - iiti PRAYs E;'lENi:;- -A L row ANe E' OR - - - - - - - - - - -. - - - -.
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTHER S FILE NO. 21 96-0796 ACN 101
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
WAYNE F SHADE ESQ
53 W POMFRET ST
CARLISLE
PA 17013
ESTATE OF
MAYBERRY
TAX RETURN WAS,
I ACCEPTED AS fILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..l E.t~t. ISch.dula h)
2. stock. .r,d Bonds (Schedule Bl
3. Clos.ly ti.ld stock/Partnership Int.r.lSt (Schedule Cl
4. Mortgag../Notal Rae.iv.ble (Schedul. Dl
5. C."n/Sank Oapod ts/Hhc. Parsonal Property (Schadule E)
6. Jointly Owned Property (SchadulM F)
7. Tr.n~far. (Sch.dul. G)
IJ. Tot.l An.h
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expens.s/Ad,". Costs/Mhc. Expans.s (Sohadule H)
10. D.btIl/Hodgag. UabiUtha/U.nl {Schedulo Il
11. Tot.l Doductiont
12. Nat Vmlua of Tax Return
13. Charit.ble/GovernMant.l B.que.ts (Schedule J)
14. Nat V.lue of Estat. Subject to Tax
If an assessment was issued previously, lines
reflect figures that include the total of Ab1
ASSESSMENT OF TAXI
IS. A~ount of Lin. 14
16. AMount of Lin. 14
17. AMOunt of Un. 14
18. Principal Tax Du.
NOTE:
at Spousal
t.xabl. .t
taxable at
rat.
Lin..l/elm.. A rat.
Coll.ta,..al/Cla.. Brat.
lAX CREDITS:
~AYHENT
DATE
RECEIn
NUMBER
DISCDUNT (')
INTEREST (.)
PAYMENT MUST BE MADE BV 06-24-97*,
( X I CHANGED
(1)
(2)
(!)
(4)
(S)_
(.)
(7)
28,187,50
,00
,00
.00
4,451.34
2,418,00
.00
IB)
.
IH.IHI u l'~ cU.U!
ESTHER
S
(9)
UO)
10,761.29
221, 51
Ill)
(2)
(l!)
(14)
DA l'E
03-03-97
SEE ATTACHED NOTICE
HOlE I To insura prop.r
cradit to your aQ~ount,
subMit the upper parHon
of thl~ for. with your
tax pay.ant.
35,0~
1 n .987 80
24.074.04
.00
24,074.04
14, IS and/or 16, 17 and 18 will
returns assessed to date.
21,656,04x'00= .00
2.418.00 X. 06=_. 145,08
,00 X .15=___.:.Q.L
UB) 145,08
US)
11.).
1171
AMDUNT PAID
TOTAL T~X CREDIT
~ .--.
BALANCE OF TAX DUE
INTEREST AND PEN.
~~._-----
TOTAL DUE
.00
145.08
,00
145.08
. If PAID AfTER DATE INDICATED, SEE REVERSE
fOR CALCULATION OF ADDITIONAL INTEREST.
If TOTAL DUE IS LESS THAN .1, NO PAYMENT IS REQUIRED.
If T~TAL DUE IS REI'LECTED AS A "CREDIT" (CR), YDU MAY BE DUE
A REFUND. SEE REVERSE SIDE Of THIS fORM fOR INSTr.UCTIONS,)
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WAVNB F. SHAOB
i\uomcy at Law
H Wut Pomfrct Slrtd
CarUth,! Pf'M.ylvlI\!t
170ll
IN THE COUH~.' OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
IN RE: ESTATE OF
ESTHER S. MAYBERRY,
Deceased, Late of the
Township of Middlesex,
cumberland County, Pennsylvania:
NO. 21-96-796
Fllt.'lT ANI> }i'INAL ACCOUNT Ol!~
WILMER }<'. MAYBERRY, EXECUTOR
Date of Death: September 23, 1996
Letters Testamentary Granted: october 4, 1996
First Complete Advertisement of Grant of Letters:
October 25, 1996
Account Stated to March 5, 1997
PRlNCIP AL RECEIPTS
9/23/96 Undivided one-fourth interest as tenant
in common in 15 Ridge Drive, Carlisle,
Pennsylvania
11/12/96 Mellon Bank, proceeds of Checking
Account No. 884-014-0084
TOTAL PRINCIPAL RECEIPTS
PRINCIPAL DISBURSEMENTS
Register of wills, probate Will
Wayne F. Shade, reimbursement for
advertising Letters Testamentary
The sentinel, advertising Letters
Testamentary
Register of wills, file Pennsylvania
Inheritance Tax return
Ewing Brothers Funeral Home, funeral
Carlisle Memorial Service, Inc.,
gravestone
3/ 3/97 Register of wills, Inheritance Tax
10/ 4/96
10/29/96
11/11/96
11/12/96
11/13/96
11/1.3/96
$28,187.50
4.329.83
$32,517.33
$ 63.00
60.00
64.69
10.00
6,113.60
1,584.00
145.08
WAYNB p, SHADB
Attorne)' It law
53 w.., Vomft<t SlmI
CarlLde, Pmnl)'tvania
17013
3/ 5/97 Recorder of Deeds, Decree awarding real
estate 23.50
3/ 5/97 Wayne F. Shade, Esquire, attorney fees 750.00
3/ 5/97 Register of wills, reserve for filing
Account, etc. ,200.00
TOTAL PRINCIPAL DISBURSEMENTS $ 9,013.87
RECAPITULATION
PRINCIPAL
.Receipts
Less Disbursements
$32,517.33
9.013;87
Principal Balance Remaining
$23,503.46
I, Wilmer F. Mayberry, Executor of the Estate of Esther S.
Mayberry, Deceased, hereby declare under penalty of perjury that
I have fully and faithfully discharged the duties of my office;
that the foregoing First and Final Account is true and correct
and fully discloses all signifioant transactions occurring during
the aocounting period; that all known claims aga:l,nst the Estate
have been paid in full; that, to my knowledge, there are no
claims now outstanding against the Estate; and that all taxes
presently due from the Estate have been paid.
Datel April
2, 1997
/}J~ f/Yl1 ~
Wilmer F. MaYber~
11',
(J\
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f.'.-
['1\
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PAYMENT:
OeUoh thl tep portion of thl. Hotlct and sublllt with yOIJr plly~.nt lllfIdl Plliyabll to thl nllllll end Dddr...
printed on thl r.ver.. lido.
If RESIDENT OECEPlHT Makl chIck or llIon..,. ord.r ptlyabla tOI REGISTER OF WILLS I AGENT,
If HON.RESIDEHT DECEDENT "'tikI chIck or lIlonlY order paya~lll to: COMMONWEAL ni OF PENNSVLVANIA,
REFUND (CRl: " refunc! of II hl( oredlt, which Wll' not toquutad on the Tflx Ruturn, !lIav bl raquutad by COlllpletlng an
"AppUcatlon for A,flmd of PannSylvllnlll Inhllrlt~. and E,tIlt_ Tax" (REY-LUlL Applioation. ar. llvaJ1abl. lit
thl OffiCI of thl Reglst.r of WJ1\1, any of thl 23 RavenuG DistrIct Offlc.. or from the Department'. 24Rhowr
an.wlrlng urvlcl number. for for",. orderlngl In fl.r.nlylvllnltl 1-800' ~62.l0SD, outllldl Pennsvlvanllll
and wlthln local HarriSburg area (7171 787-8094, TDD_ (7\7) 77~.ZZS~ (Hearing Impftirod onlv).
REPlV TOI
Quutlon. rlllgardlng errorl contained on this notlce 'hould be eddrund tOi PA lJeflar'tlllllnt of Revlnue, Burnu
of IndIvIdual TftIlU, ATTNI Post Autluent Review Unit, Oep\, Z80601, Hl'Irrlsburg. PA 171Z8~0601, phone
<7171 787~6S0S.
DISCOUNT:
If anv tell due Is paid w1thln thrGl (3) callndar .onths efter the declldent', death. a f1vlI p.r~ent (SiD dllcount
of thll tall pald is ",llowed.
PENAlTVI
The IS% tIlll flllnuty non"pa"tlclpatlon penalty 11 c".puted on the total of the tall end lnhrut alle.ud, and not
paid before Januery 18, 1996, the flrat day aftlr the end of the tell a~nasty perloo.
INTERESTl
Interest Is cherged beginning wIth first day of delinquency, or nine (0) Montha and one (1) day frolll the datI of
death, to thll date of pllylllen\, Tallll which beoMe deUnquent baforll January I, lq8~ bear Intertlt fit thl ratll of
sill (6%) percent per annUM celculated at 8 dRily rate of .000164. All talles which blen.1I delinquent on and aftlr
January 1. 19&2 wIll bllar Interest at a ratl which will vary frOM calender Ylar to cllllendllr year with thnt rate
announced by the FlA Depertllent of RevenuG, Thl nppllcable Interut ratn for 198Z through 1997 arel
Veer
tnt.r..t Rate Dally Intlrest F~ctor
VeIlr
Interest Rate
Dall~ Int.reat Fector
1ge~ ~O% . 000~48 198" 9% ' ODO~47
19&3 Hi% .000438 11)88-1991 11% .000301
1984 11% ,000301 IlJ9l 9% .000Z47
1985 13% .0003S6 1991-1994 1% ,000192
1986 10% ,OOOZ74 199!i-1997 9% ,OOOZ47
.~Intlr..t 11 ae10ulated .. foUowll
INTEREST . SA LANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
..Any Hotlcl IUlIld eftlr thl tall b,colII.S delinquent wIll reflect an Interest clllloulatlon to flft.ln (IS) da~'
blyond thl date of thl IIs..s...ent, If pllYJIlent 11 "adl eftlr thl Interut CClIlIPUt&t Ion date .hown on tht
Notlcl. eddltlonnl Intlrut lIlust bl celculeted,
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W A YNI! F. SIIA"g
Anomer.t Law
.tl WeNI /'(..ufret SIrN'\
('.rll.lr, i'rnnlyl't.nia
rlHD
IN RE: ESTATE OF
ESTHER S. MAYBERRY,
Deceased, Late of the
Township of Middlesex,
Cumberland county, Pennsylvania:
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 21-96-796
RELEASE
KNOW ALL MEN BY THESE PRESENTS, That I, WILMER F. MAYBERRY,
being the sole heir of Esther S. Mayberry, Deceased, late of the
Township of Middlesex, Cumberland County, Pennsylvania, do hereby
acknowledge that I have this date had and received of and from
myself as Executor of the Estate of the said Esther S. Mayberry,
Deceased, the undivlded one-fourth interest in the net value of
the real estate, after the Executor's advancements for
administration, under the provisions of Item Second of the Last
Will and Testament of the decedent in full satisfaction and
payment of all such sum or sums of money, legacies, bequests,
intestate shares and family exemptions to which I am entitled by
Will or as an heir-at-law and to which I am entitled from the
Estate of said Decedent.
NOW, THEREFORE, I do hereby remise, release, quitclaim and
forever discharge myself as Executor of said Estate, my heirs,
executors, administrators and assigns, of and from the said
legacy or legacies and other shares in said Estate and of and
from all actions, suits, payments, accounts, reckonings, claims
and demands whatsoever, for and by reason thereof, or of any
other act, matter, cause or thing whatsoever, from the beginning
of the world to the date of these presents.
IN WITNESS WHEREOF, I have hereunto set my hand and seal,
this 18th day of July , 1997.
WITNESS:
Wi~~M~~r:~~ (SEAL)
COMMONWEALTH OF PENNSYLVANIA
ss:
COUNTY OF CUMBERLAND
On this, the 18th day of Julv , 1997,
before me, the undersigned officer, personally appeared WILMER F.
MAYBERRY, known to me (or satisfactorily proven) to be the person
whose name is subscribed to the within instrument and
acknowledged that he executed the same for the purposes therein
conta i ned.
IN IHT
seal.
UERJmE:.....-1....her:eunto set my hand and official
Notarial Seal l
Connie J Trill, Nota Pnhlir., .
Carlislo, Cumhorland COllnty _""-" c.:;;/ L~
My Commission Explros Del. b, 20uO Not-ary P nc . .--.
. ~-,-,.,,,,,,----._-----,.,,,,,-_.
W A YNB F. SHADB
A_iliAv.'
II Welt Pom(m """"
CarUaIo, P_y"on~
nOIl
NOTICE OF BENEFICIAL INTEREST IN ESTATE
BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, PENNSYINANIA
In re Estate of Esther S. Mayberry, Deceased
No. 21-96-796
TO: Judy A. Kennedy
581 Dunewood Drive
Chesterton, Indiana
46304
Although you are probably already aware of the following
information, the law requires that you be provided with this
formal notice.
Please take notice of the death of decedent and the grant of
Letters to the personal representative named below. You may have
a beneficial interest in the Estate as child of the Decedent as
determined under Chapter 21 of the Probate Estates and,
Fiduciaries Code.
Name of Decedent: Esther S. Mayberry
Last known address of Decedent: 15 Ridge Drive, Carlisle,
Pennsylvania 17013
Date of death: September 23, 1996
Place of death carlisle Hospital, Carlisle, Pennsylvania.
County of grant of original Letters: Cumberland
Decedent died testate.
A copy of the Will is attached.
The names, addresses and telephone numbers of all personal
representatives appointed are, as follows: Wilmer F. Mayberry,
15 Ridge Drive, Carlisle, Pennsylvania 17013, 717-249-1169.
The names, addresses and telephone numbers of all counsel are, as
follows: Wayne F. Shade, Esquire, 53 West Pomfret street,
Carlisle, Pennsylvania 17013 - 717-243-0220.
Additionai information may be obtained from the following source.
Date: October 8, 1996 ~~ ~/~
Wa~n~F. Sh:e, Esquire
53 West Pomfret Street
Carlisle, Pennsylvania 17013
Telephone: 717-243-0220
Counsel for Personal
Representative
RI'v IllilliX; (Pl~i
('(ltU.(ONWEAI,TH <)jo' I'I\NNSYI.VANIA
1>E1'ARTMHNT ()II kHVHNIlJ\
()IWI' 2110601
IIAH.RISIIIHHl, "A 17 I 2K.(IflOI
I " i ' )
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
HIM Ilr\TES (JIo' IlEATli AlTEH ii';HIIII ('IIH'i\.lii...{!~t~~
III ^ SI''lI(TSAL l'oYI,:Hn' ClU-:1l1T IS CI,A1MHI
n Lie lilJMOleR
21
COUNTY CODE
96
YEIIR
0796
NUMBER
I1ECJ1.1)I\NT'S NAM}I. (lAST, FIRST ANI) ~ IlllJ .1\ IN HAL)
Mayberry, Esther S.
-~ -:::.==- ,=-~
IlHI 'HIIEN'l"S ('Ot.II'I.HTII. AllllRESS
15 Ridge Drive
Carlisle, PA 17013
~;'~~~'~I~k~~~~MlIl!k I - ~^/~~,/~~T~16 I ~^/~~1/,~~1~4 ,'()IINTY Cumberland
(IF AI'I'I.1CAIlLHl S(J!IV1VIN<1 SPot!SI\'s1i"\'MI\ (I:M1T, !IlkS'!' AND MIIJIJ[.l! JNITlAI,)-lii.J('IAI, SJ!('IJi{[TY NUMBER AMeHINT 1{]!(~mVrm (SI!1\ INSTRlJe"J'I0Nsj-'-
MlI}'~rry, Wilmer II, 174.0.~.1Il4:'
K:T-orlifiiif'Rctiirn
2. SUflpkllll'nlA1 Return
J, kClIlllinder Relurn
~for dllle8 of dC!lth prior 10 12.13.112)
~, Fcdmll!..\lllh~- Tu
Rctllll\ Retjulrcd
K. Total Numhcr of Safe Deposit Il\lXll~
4. Limlled I!JcLAlt
6, Dtctdellt Bled Tt81lltr.
(AU.ch COjlY of Will)
_4a.l1ulurl' Inlrrtst('rllllrf(lml.~t
((or dlllc,~ uf dr.tll ,fter 12.12.112)
__ 7. Ih~i.'tlknl Mllinllllllcd . LIving Tru~t
(AlIllt'h b COl'Y (l(Tr\I~1)
ALL CORRESPONDENCE AND CONFIDENTIAL TAX IN
NAMH
Wayne F. Shade, Esquire
ORMATION SHOULD ~E DIRECTED TO.
l'OMPI.!\TB MAII,INCl Al>lJRI~'lS
53 West Pomfret Street
Carlisle, pennsylvan~~(17013
TELI!l'HONIl NIlMllHH
(717) 243-0220
-
I, R~'alltAlAle (Schedule ^>
2, St(l('kA Md 110011.' (Sdlcdult f1)
3. (,Iosely Held Slock/Pllf1nrrrlhip IlllereAI (Schcdulc C)
4. ~f(lI~lIge~ llfId NoteR Recelvahle (Schedulc, 1>)
5. ('ll~h, BAnk Ikl'o~its &. Miscellaneous IlerRon"J PWpCr1y (Schl.'duk Il)
6. Joinlly Owned I'roperty (Schedule F)
7, Tr.n~fm (Schl.'dule 0) (Schl.'uule L)
g, Total OW5! Aml~ (totnlline8 1.7).
<}. Funl.'rall!xpenm, Aumini~trative Cosl" Miscellalleous l!~pl.'nSC5 (SehNlulc- H)
10, Debls, Mortgagr, Liabilities, LIens (Schedule IJ
II. Total UeductiOlIH (tot.allineR 9 & 10)
12. Net Value o(l1c;lalc (line 8minu.line II).
I:i, (1l1\(ilablc llfId OClvemmenUlIII('qu~'sI4 (S~'hedule J)
14. Net Yulue SuhJe"t 10 TIK (line 12 mhluAlinc IJ).
( 1)
( 2)
( 3)
( 4)
( 5)
( 6)
( 7)
0.00
( 9)
(10)
:'..1.., 451. 34
_.1...418.00
( 8) 6.869.34
.J.Q.., 761.29.
221.51
(11) ....10.982.80
(12) .....lh113.46)
(13 )
(14) (4.113.46)
-
x .06 ""
x,IS""
(18)
(19)
(20)
(21) ---
(21A)
(21B)
IS. SI'otlHll Trll\5fm (for dalu of de4lth If\l.'f 6.30.94)
See InAtnlcIJof18 for Aprlle.blt. Perccnlage, on l{t,verse
Side, (Include vllue., fr,Jlll Sehe<lull.'- K or Sdledule- M,l
16. Amount of line 14 Illluhle It 6% nte,
(Indud(1 valueft frOlll Sclwdule K or Scht'lluk M)
17. Amount of line 14 taXllhle lit 15% rail'.
(lllcluJe valul'! f(Om Sch~'duk K or Sl'ht'duk 1<.1)
18. l'rlndl'lIl lax duc (Add t/l:< frolll hnc-I~, 161llld 17) .
19, ('reditA Spouul I'OWl1y ('r~'lllt Prior I'IlYlIIl'nl., ])i~counl
(15)
( 16)
(17)
Intt'(l'Ht
+
+
20. If lliw 191ft greall'r lhatlline. lR, cnler the dif(mnl.'c IJlllil1e 20. Thl~ b UIC, OVERI'^\'MEN'I',
A, ._ Che<'k htre If YUll are tt'qul.'!dll1~ it rdund 'lrYllur nverpayull'nl
21. If line IR IK grtlll'r than line 19, enter till' difference tin linl' 21. 1111.. l~ Ihe TAX I)ll,,: .
A. l!IIter till: inlcrCKI (1(1 till' halanl'e due on lilll' 21A .
Ii, Enkr tilt' lolAI (If llnr 21 and 2lA on line 2111, Thi, b tht' IIAI.ANt'E nUE
Milke Chl'(k 1'11)'11111' tll: Nl1tl~ll'r nf Will., Allt'lll
BE SURE TO ANSWER AL~TIONS ON REVERSE SIDE AND TO RECHE:CK MATH ===
tlndet 1I1'lIalll(,4 of I't'fjury, I dl.'c1l1rr thai I hll\l(' t'Xllmilll'll O,Lq r~'lurll, indllding 1I1'~'l~llPl111)lilg ~l'hl'lhlkq IIllil ~IJll('n1l'1I1~, IInd 10 till' h~'~1 {If Ill)' klll'wkdgl' IIntl hclirf. ills Inlt', l',llfl'r! (\/1\1
cOUll'kh:, I dedMC 01111111 frAI ('~llIle hu Iwell rqwlll'll ~lln'I' 1ll"lkl'l \llIlu(' P('l'!:UII!ioll I,f I'H'tllH\'1 I,thl'lthllllltw "I'UOIIllI fl'I'H'.'1l'lItlllin' Iq h'IHII nl:lall inful1\llllioo of whh"h pl't"p.lrl'r hllq
any knllvikdgl.',
SIONATll1UlOP I'ERSC)N RII..\iI'ONSIIII.I\ I.'CIIt FII.INCj nETlIRN
Si(lN;;'~~it;;~;1ih~~~~I,.m
((/~ ~. '-J-Iwt<.-
AllIll1J1ss
I~ 1(11111\' Illi\'~. t'IHlhk, I'A pOl.'
llAT(I.
I/-()-'I(,
llA'rn
PLEASE ANSWER THE FO~LOWINGQUESTIONS BY PLACING AN X IN THE AP~ROPRtATE
SPACES.
YES NO
1- Old decedent make a transfer andl
a. retain the use or. income of the property transferred, X
b. retain the right to designate whO shall use the property transferred
or its inoome, X
c. retain a reversionary interest, or. X
d. receive the promise for 1 He of either payments, benefits or care? X
2. If death occurred on or before December 12, 1982, did decedent within 'two
years preceding death transfer property without receiving adequate
consideration? If death occurred after December 12, 1982, did decedent
transfer property within one year of death without receiving adequate
consideration?
3. Did decedent own an 'in truet for' bank account at his or her death?
X
X
IF THE ANSWER TO ANY OF TIlE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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('OMMONWIlr\J.rU Ofll'IINN~YLV ^Nl^
INHl!ltrrANC'1! TAX RIITlJRN
RI!.~IUHNT IU\-('IIIUINT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
Eether S. Mayberry
FILE NUMBER
21-96-0796
Joint tenant(s).
l:l.&li&
~~
RELATIONSflIP TO DECEDENT
A. Stacey E. Golec
581 Dunewood Drive
Chesterton, IN 46304
Granddaughter
B.
C.
Jointly-cwned property.
LETTEf -
ITEM ~'OR DATE
NUMBEF JOINT MADE DESCRIPTION OF PROPERTY TOTAL VALUE DECO'S DOLLAR VALUE OF
TENAN1 JOINT OF ASSET % INT. DECEDENT'S INTEREST
1- A 9/25 Savings Account No. 4,835.99 50% 2,418.00
1989 5130356665 at PNC
Bank
TOTAL (1ITSo enter on li e 6, Recapl1 uIatl0n) ~,41B.00
- If more 8 lice j~ nt'Nk'd Ifl~l'r1 addltlOo,,1 ~hl't't. III Ulllt'- slu