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HomeMy WebLinkAbout96-00835 '..- ...-', -..~ ,-..." . '-\ WACHOVIA 11565 ~tE \G\4~ \\/qB/~~ ~S _-:i,}:'), f f Wudwvin Ihlllk Cnrd Ser\'!cclI Cfl,dil (:1\1'<1 HI'I''''''''')' Me NC 2439 PO!!' Offi{'(1 Box 14009 AlInntfl, Gl~o}'ll.iu ::\0324 k?~/.:5.(.~ OF {;)ttls C!.tJMhw~ (Eou~ ~~ ~~dI l eJ. ~v_ "". E." ~$A., ~ 170t3 \. -?,f'.,)'\.~1!.-I';"t.';?-:a.'l:!.. 1",III",III"""lh,t\II,II"lfI,III""l,',ir'1I1 ;,!'fi . i ~ . . t~ 1," '-.~a, ,""11." ' ~-', . ,'f- \ ~; "i_..<i;~- -- ~ ' :\ ~~). ,1- . \ " ". ~',f ,\. , , , :' .1. t' , . I "';},', "I' ." " .-.., ~!. -/ ,-~ ..'. ._- .......-- ~"';'. l'"'1'~ '" -"'--~~''''''1:''"":--:'''t--".- r- co. --- __:_: "~.,,";-" ---~~.,~.( , , ;;~ I ..,. ~-. ,.. .... ~ , , 1'1'1.' ,I'),.} 'H NOM(II:(E tll;:'hUI..S DNnLl;' x"x, \ ('~}j m'~!01 ~i1)\';'~,;!:~5.1j 11/01/'/6 I/U>(T !i, CIII\h:L.ES' 1':1H(~(') 1 NORMM1 fmlHH:M1f'o H l:Ll.iif"I\I' '1/0\ i ,..(, ~ ;,~91.~H\ ;:.1::,~'i'(')::,!~)OB4/j;.!::,!'1'! 0EJ09 0903 ~YN' ,1E~~Jf00 D EJ~500 01 (-)',,,::'(, 0/;:,'(, 'r'~)4::!::.!'i()t(o(H)XTr'ldG::' 1"!,\n~ENT TIMNK )'OU CHEVY CH,'\SE t11) jO~).O()" l.,r"d'I::'n:E IIF :l:NI\NCE (;HI\I:~Gf::H I"tlf~CH()SES :If) ,:1;:.1.. \ ::\ C!\SH {-)j)\itINCE ~i;'>O, 3'1 'I';~~:::: )' (I O~o': ~~I~) I. O() (I:] O.l~ O~5 0b {.\":l .. , Of:} (-)\? 10 \ \ i ~~ ~] tI~:i0"1. f:';' :"r;.,' ,. ';I',l 06::.190 ?;~~ 199 Ob2S)E) , ~ :) ::.~ ,. ~) 0 J)(W S W In: l..Li:i~G F'I;J~]; ()ll CSH 1"lniH<' 04/% PLII( CUl'ml:.rn CSH CUli:f(ENT ')q 1)/\:1:1.1' (\\iG DL.Y F :I: 1~lil~CI' rWI1 [f:T 1,,1 1(,(j'll: 1:(Il..AINCI:: CH,(lF(GE F:r'ITE I(,',TIO: 06::.!91:1 "~, ~:.. "'J '/4 C /;1. ~., ;"1 ';1';1 99, , '.'In! , ,. )..;) I.....' . (')6~~9B '?2:~)/~1 4 1 (; I :~.~~~ .I:;i 0")0"1 9(,/ . . ~.I" . 06:.:\911 "'J ~" "'I ~;)3 ,.., \ J'I' H'l :::::"l ~)9 ')') 1)9 , (,) f " '., , ~H ~" " CRSHREWARDS SUMMARY CURRENT' '0.00 Y-T-I): PURCHASES EARN A 1% REBATE. YOUR REBATI~ AMOUNT WILL Cf~EJ)rl'[j) TO YOLIf( ])EC1U1IJ~[f~ 'I ';l'P'~l STi\TUil,NT.. ~ ()() :10(:).00, 'j ~~~:~. ~~)() ~~o. E)O ~~~)'?7 .':37 7::1;:14,4\ 'P()?6,.O;,! 7991,'/11 ,,0\,) '75'?i33 '750.00 eJ!5~0a00 122.00 W,~;~1 1,06 :t(E . ~)~) ::.!;! <\ 99 ;,,:01 . ()~) ~ CER'l'IFICl\TION OF. NOTIC~.-JLNDE!0i..l!h!t 5 ~ill Name of Decedent: (2 t. aR.le~-Js::,. Date of Death:----.iL/.{.~--.iJ ~ /9f? __.. Will No. tV / It lIdmin. No.LCL?tOO8.3...S- Pt4 Mo. JI9(,-t(~3S I To the RegisLer: 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 fpllji>J'ing beneficiaries of the above..capLioned estate on II 7/P/7 : , ( f Name 1J. I C{ In a f Vu y: Ie; Puf/!.iq\o... ft.. Pet i/i'.s Address_ cOos 3Dd SI?(1.Jf-~__ItI~.lJ..:.rl1.~ lI;' !( I:;'" /7i111 VehDR4 ])/L_ C<."'D/<'1elvlJ.)1/ -Zl...7 !fb:.J{,/, J / Notice has now been given to all persons entitled thereto under Rule 5. 6(a) except AJ If!- . 0\ '.... .. I ' . Ii, ~ I -:II " ,. () i~\) .0 () uJ I" ~~ QlO: a:: ,,~ ..-' -'-"'-~ , ( .J \: . ,,\ c ~ '. ".'., \ :~~~~;:;;'~\'>:::':'\'''- ~~'i~~-~) Signature . "- Name ltlwRel/((' :r [Ii( K-b. Address g()d I!?Du" -/.i" t{'e-<<.I,J'f _ I*'- K/2 Ish f~ Ii'~, I Ih-_.J..1li-J.-__.___ TelephoneJ1n) "?6-':_7._J."-.18. n_ Capac i ty: -A.. Personal Representative Da te : ----1lr,/'l '( "0" \,.J? cf (I) ,', ..- N '. (;:1 "~:: l\.. .: r' ) .." - .) . ~ f) Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND II: /'),\, I/?t (li-j ,\'.,",;) ;;r' JJ), oJ/;'"":::'( .-~(.;' baing duIY~!iO.Llu\~{l _ according to lew, doposos o~~ ~0~~-~~:;d'~~-.~_~~,'~/1~:-~L(!J'~:I(~;/I':'(J/"u _ _- ,u_ of the Eshte ofc.i'J:.L&k_j_i.~_L_jjd2L'__,.._~_____.___ --.. lete of It'((!II'' 1-//k'l /~:"",I,, .,1,:(, _____. _.____, Cumberlond County, Po" deceased end th.t the within is en inventory med. by , ((/(()/:(ll (c'. .1;,-iJu_~frL .___, the seid _1Ldi.i!.L__________.__._ of the entire eshto of seid decodent, consisting of .11 the personol prop.rty end reel estete, except real estete outside tho Commonweelth of Pennsylvenie, end thot the figures oppo.ite eech Item of the Inventory represent it'. folr velue es of tho deto of decedont's deeth. /U,'t"t 1__'-.._ end subscribed before me, / ------ \ ~-- ,,',,- ---~. ) , <.: .~ -,,"'.' .- -' - "''-,, (,~; l<}' "'" .~-...-_.".~...~~~__ ----..0....-. -~"'l..;';.} El(ecutor . AcJmlnlstrator { , ..- II _ (I (..U /(. (1 tl (C~_ ..) VC-tl').:' J(~_ .__._"_,,_.~.__,.._......c..-,.__,_..~_..._~_____.___......__ ~.. . ----l/~"..:'Zl {, . (, .-11 . <'L.... . ) ,'? (:-:7 ) ...:J-__u_19 --1--'-- /" )I./.:',L / --~ o ARAL SEAl J Carol K. Moyer, Notary Public Har~sburgJlBuphln County M Commlaelon t rea Feb. 17. 2000 Dete of Deeth_.__ -) '!oy" . - ~----_.--------4:;,~ k'i..L_ ;~ 0 j, ill 0,1/, (n ,,' V, i'i, '. ':..( ---~.-- _...~_._- -~.-~ Addr...1 /k1j'1'~,-!j)(( 9-1/~'- /7/1,) I (}t:) /" I / (/I V..r INSTRUCTIONS I. An inventory must be filed within threo months efter eppolntmen'l of personel represenhtlve. 2. A supplement invontory mu.t be filed within thirty deys of discovery of addltionel allets. 3. Additionel .h.e" mey be .lteched es to personelty or reelty C')(") 4. See Article IV, Flducierie. Act of 1949. ~ iD li ,--, \0 :n ::0 -.) en 01 [) ((" 0 ~ .. ~- , \,.oJ 0 ~ ~~ . ::-_:~ ~ q, ~ 11) . . 0 ~ - o::r ~ ' " {'i '. :"01"' ),. ;.;\ . I ... . ~ ~ ... "tI . ir ... o o lD Cardmember Statement First USA 033 BKD NO"II ID:I 11 0 9609114417122753:101962 ~ numboI 4417 1227 5338 1962 n RST USA VI8J\ po BOX 740085 ATlANTA GA 3037~-0085 MID.... ~nmun;--~~~'~.Amou.. I~ .~W~~ ;~M .v~m 245.00 6206.84 369.00 10/12/96 PlMMrnMtohrtolt.~kI Fln(l..IBABM'ik ,)(,30 0003 CHAHLf:S VUX'J'I\ 301 NOHMAN HI> CAMP HILL 1'/\ 17011-(,129 o Addl_OIliflOO? ctwo.....W1d~M'llrtM.ldt. ~1'*-wld~..poItIon..I~..l.........~ ~.tt.r':.. _.=."" 8 0 0- 955- 9 900 ....., " " . 1M 4~17';;; 5338 ,196~;' poot Dat. -"100 Nooibef HOLD 10/12/96 me", OUR RE,CORDS SHOW YOUR ACCOUNT I S PAST DUE. PLE SE CALL 1-800-434-~94B PlOlltoua 6206.84 +.- g- 0.00 ~ont. and 0.00 6206.84 ~ FIRST USA PO BOX 740085 ATLANTA, GA 30374 PERIODIC RATE MAY VARY ,....,..,,; AYUMGe. lWl Y IlN.ANCE llM.Y LUfYw:al',-"j()INQ PmOlllC - - NHJ>O. ,t<ANCl! .......... ._~_ _~LE_._ flATE f'tfUNfAOQ Mre """""" - --o:c;c;- -... 0.00 .054"76 % 19.99 % .00 OMH 0.00 0.00 .0.5476 % 19.99 % .00 EFFECTIVE ANNUAL PERCENTAGE RA lE 19.99 % ]"OTAL PERIODIC FINANCE CHAAGE .00 StDJ ~"""'Ol'tII' trIqutriIIll~ IWUMu.w.,'.O.nc.~'M~OOllll9P-86'Xl '(:uh~'~ltlillCill'FflI1lo11d)Wl"IIIfAl<<:roIItIMr. 8M __ _ "" 1n"""'...._1on1nc1udlng nallu _ onnuoI ,...-aI, First USA Bank Member FDIC THIS IS A STATEMENT FACSIMILE - NOT AN ORIGINAL -,.. CMO,118 /1. ,.) ) ,.; .; I __, ~.' / ' i IHY \',(10 '1 t pi 'Ill , ,I ~ I~, ;,~i~ ," if. h. I 'OR DAns 0' DEATH Ann 12/31/91 CHECK HER I' A SPOUSAL POVERTY CRlD" 15 CLAIMED I I 'Ill NUMBER INHERITANCE TAX RETURN RESIDENT DECEDENT (OM"O"W(ALlI1(" l'I"""'V"<lA (TO BE FILED IN DUPLICATE lllPARlMfNI Of RIVINl!E ,,~I I I1A"",J~:c\, 1':."'i'JI" 0001 WITH REGISTER OF WilLS) COUNTY COll( =i~tIT~:~~:;~~~'~;~DMiDOlEl"'TIAll ----[DICf;~N;f5~~~~:1 Ar:;~~:,(; __1 \b~I~'l\~t~'~~~U:~(R-::~-J~~~?_;--_Jl"~~~'~~- ~_ ~,~:a::m::::;m:^ 17011 ~c( PI\. Original R.tu,n U 2, Supplemenlol R.turn I I 3. R.moinde, Relurn .. iii~ liar dote. 01 deolh p,io, 10 12-13./' lrl...... I 14. Limited EIlole [] 40, Fulure Inte,e,1 Comp,omi.e I J 5. Federal EIlole Tax %29 liar dote. 01 d.oth aher 12.12.821 Relurn Required VtlO !] 6 Decodent Dlod Tostale rJ 7. DacedBn! Maintained a liVing Tru,' ~ 8, Total Nurnb(Jf Clf Sofe Doposit Bo' c( IAl10ch copy 01 Willi IAlloch copy 01 Tru'll - All CORRESPONDENCE AND CONPIDENTIAl TAX INPORMATION SHOULD 8E DIRECTEDTO,- ---.---.----.-----....-- NAME' COMPlfH MAILING ADDRESS .. -~._~ Stuart S. Sacks, Esq. SMIGEL, ANDERSON & SACKS ---------------.- 2917 N. Front Street Harrisburg, PA 17110 /(/'(( . , I' Y[AR I ::J!Z '" "' '" Q o Z uo ___":.___ ~~L!~~)==~~4- 2~c~l. ------.- ------.. BE SURE m ANsweR ALL QUESTIONS ON REVERSEslDE AND TO-jIEciiECKMATH.. ------- Unde;-p;;;ii.i.~,~rf;-;;;i-~.;';;,--I~i~-(-j~ro-.ifl.~!rhO"t'l (1~n~~i-;;;~(t'hi'~ 'rl1l\~~- ;~~i~J~fiil(l Cl-((;~;~~r;;lnyi~g~~~~.dulo~-;;-~;otornonl" and to lhe htlJI of m-y kno....ledgo and boli~ it i. Irve, wrrocl Clnd wlllplo!n, 1 oocloro thut nil f(1l11 Mtolo hCH boon roported 01 huo morkot lIollle, Dnclorolion of IHflfHUIH olhM ,Iwn tht'l piH,onal wpr\!Sentoliyo bOtfld on 011 info/motion of whidl propnrnr hen nny knowlodno , sYOt.:U,:TlJRf 0f-~-IIi~()N-R7~~oW,16L" fr"lJ.( ~nl(.J(; In TlJIlH ^r)ri~r ~'~ -- DAlf --- I. ., , , \ 4 h_" ..., . " " \i '-, Iii 5-iGN^~ilir!(i~f'Rif'^'dli-~iTln~ltli\~ikjf'ilf~t'i.'^.i:\:1 W!)Rr~,S //~ fid'!I.,- lliffHOm-'NUMBlIC-- '__'___"_'___'0 r--", c..:.==:.:.=:;_-=:;:;==-~=_===:-..=:;:_.~_'_'__;:-~==:"_'=~=:=;.~:;;~.=:=::=.'7;::..===.==<:::;:j-=;~:.-.=;-;-;:-_-:;:~-~: z o ;:: s E ... is "' '" 1. R.ol Estate ISchedule AI ( IJ ,_~~___ _.___ 2, Slock, and Bond'IS,heduie 8) ( 21___~._..__..______~____.._.. 3, Clo.ely Hold SlocklPartne"hip Inlore.1 (Schedule c) I 31 __m___.__:-:._______~____ 4, Mortgage, ond Nole. Receivable (Schedule 01 ( 41 _____.__.____--=-..._____._____ 5, Co.h, Bonk Oopo.III & MI"olloneau. Pe"onol Properly I 51____J_.lJ 281...!_2'!_______. ISchedule E) __ 6, Jolnlly Owned Property ISchedule FI ( 61 .___________~.._____. 7, Tronlle"ISchedule G) IS,hedulell ( 7)___.____=____.__ 8, Tolol Groll Allet'ltololline. 1.7) 9, Fune,al Expen.e" Admini.tralive Co.II, MI"ollaneou. I 91 _.,j. 3,386.61 Expen,e. (Schedule HI 10, OeblS, Mortgage lIabilitie., Lien, (Schedule II 11. Total Deduction! (lolallin" 9 & 101 12, Net Vol" of E'lole Iline 8 minu.lin. 111 13, Chorilable ond Governmentol Beque." (Schedule J) 14, Nel Volue SubjecI to Tox (line 12 minu. line 131 $ 35,5J.?~]L__ l'J ., ( 8) _L_..3_L_~.(U_. 54.__ (101 $ 3b148~ 78 _.__. z o g Go ::e o u g 15. Amount of llne 1.4 taxable at 6% rate (Include value. Irom Schedule K or Schedule M,) \6, Amount of line 14 lox(lble at 15% rale Ilnclude volue. Irom Sch.dule K or Schedule M,) 17. Prindpallax duo {Add tox from line 15 and from line 16,1 18. Crodits Spousal Poverty Credit Prior Payments + (11) (12)_________ (13) _______m___ ________J,~ . 1151______.__.~_____X ,06 = ____________..._. 1161 ____________________.__.x ,15 = (171 Discount IntereSI + (181 (19) 19. If line 18 Is groater than line 17, enler the diHerence on lino 19. This is the OVf.RPAYMENT, au 20, If line 17 is groClhn than line 18, Anlor tho difforenco on line 20. This is tho TAX DUE, A. Enlor the inlfH(>Ist on the bolonco duo on line 20A. Chetk hore if you arC! roquo5tinO Q r.fund of your overpbymonl. 120) 120Aj (208) B. Enlor !he tolCll of Ii no 20 and 20A on line 208. This is the BALANCE DUE. Mo_ke Che(;k ~('ynble t01 Re~I_'t(tr of __Wills, _A~~~~_ /'r II, ",(\ ~ \ \ ;/ '''' '( /, OAT! ;/,1) .1. "6(', l.l'l 9i'9 ,,~. . "t\ "H .,.. COMM(HiWf AllH OF PENN',Y\y....r-iIA INHlRltANCllAX 1U1U~N . ._~"~.!.It!~~.!_~ICI!!I_~f_ SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY 'ESTATE Of m.d_ _ _ . _. __ _ .. . ~~--,._---_... ~~-_._._._--~.--- L. Plea,e Pri~1 or Typ.e filE NUMBER 1996-00835 CHARLES E. VUXTA _, __.__ _..._...._______.. . . __ ___ . _ _ ___ . . . u_ [Aij'-propllr;; t~-.~tly.own.d with the Right (If 5lJrVIVOlltllP mv\1 he d"dC>lrHJ on ~Hhodvl!l fl -.---.-----, --~-_._-_....._..._...._~-_..--,...-_._..__..-..-._--~._.--..--.------. -~..... . ITEM DESCRIPTION VALUE AT NUMBER DA TE OF DEATH -~------.-.. -~---'~-"-'~--'--~----'-""--.' .--- .......- -.~_...~-----_.- .,----~.-.-._~- 1. 1985 Toyota Truck - VIN iiJ'I'IJRN55EOI'0077020 did value $ 750.00 (140,700 miles/5 speed) 2. 19' Color Television set did value $ 75.00 3. Compact Stereo System did value $ 75.00 4. VCR (6 years old) did value $ 50.00 5. Portable AH/FM CD Stereo did value $ 15.00 6. Acoustical Bass Guitar did value $ 900.00 7. Computer - 486 Personal did value $ 700.00 8. Miscellaneous hand tools did value $ 75.00 9. Clothing did value $ 100.00 10. Mi scellaneous CD's and Cassettes did value $ 50.00 11. Commerce Bank Checking Account NOI 0512084211 did value $ 408.5,1 12. Cash on hand did value $ 83.00 I ..__.__._L____.._~..._~_._....___~~ ....__~~ _~. .________ _.___...._,.. .__._. __..__._~.~~__._.._.._._..__ ._._. ...~_,___~. ...__ . TO.TA..L JAI,oo-"l,oro"~~-,, 5,~.(ar!!U!~li.onl.. L}L~I3l,-5~__ (/dloch nddjloonal 9'1" l( 11" d,tlollll rl'ore IpOlIl " nf',-"rled l , Rl', 1-,' I ! 'I ~'" A. DESCRIPTION 1. 2. Darryl F. Imselman (Urn for ashes) 3. Reception after funeral services 4. Clergy 8, Admlnl.tratlv. Co.ts, 4, C, 1. 2, 3, 4, 5, 6, 7, 8, 1. Personal Represenlalive CommilSions Lawrence J. Vuxta Social Securily Number of Personal Represenlolive: ~08 Year CommilSions paid _.-1.99.7____ I Allorney Fees Smigel, Anderson & Sacks Family Exemplion 37 -1208 2, 3, Claimant NIl>. Relollonship Address of Cloimonl 01 decedent's deolh Slreet Addr." City __.__.__._______..__510Ie Zip Code Probate Fees CUmberland County Register of Wills MI..ellaneau. Expen.... Death Certificates Cumberland Law Journal - Advertisement Expense The Patriot News - Advertisement Expense Valuation of truck- Bill's Texaco Service Postage TOTAL (Also enler on lin. 9, Recapltulollon) (If more .pac. I. need.d, In.ert additional .h.." of .ame .IIB,) 75.00 260.02 100.00 $ 500.00 $ 500.00 $ 44.00 $ 45.00 $ 60.00 $ 49.15 $ 25.44 $ 25.00 S 3,386.61 ~1~1\!] fX. 1'88) ~- I ~i,;.9~ , '", ~ . :v.;. (()M~~:<:::'i/~\ ,~,~:,'im:;~'N_".~_ _..0 t... ESTATE OF CHARLES E. VUX'I'A SCHEDULE I DEBTS OF DECEDENT, MORTGAGE L1ABLITIES AND LIENS __ . u. _u._.__.. PI.a.. Print ar Typ. ----- .. LILE NUMBER 1996-00835 _._-~..._-~~- ITEM NUMBER DESCRIPTION AMOUNT $ 43.85 $ 98.08 $ 4,612.08 $ 2,381. 77 I. Bell Atlantic (Telephone bill) 2. American General Finance - Acct. #53759001 3. Frontier (MS,T Bank) Credit Card-VISA Acct. #4258 1545 0001 4317 4. Citibank VISA - Acct. #4128 0031 9888 6627 5. The First National Bank of Atlanta DBA Wachovia Bank Card services FKA First Atlanta, N.A. - VISA Acct. #5467 1003 0577 4468 10; Cornerstone Adminisystems $ 2,593.24 $ 3,451.34 $ 6,206.84 $ 8,377.37 $ 3,673.21 $ 471.00 $ 240.00 6. Old Kent Bank Card Services - MASTERCARD Acct. #5216713000325388 7. First USA Bank - VISA Acct. #4417122753381962 8. Chevy Chase Bank Acct. #5422-7020-0844-2279 9. Core States Bank Acct. #2017001997/463500000700199 11. Garage/Storage rental for September and October, 1996 TOTAL IAI",.."., on line 10, Recapilululionl {If more spoce i$ needed, Inserl addilional sheets 01 same size,} 1$ 32,148.78 j/ /5 . ;}S / y COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUR<AU DF INDIVIDUAL TAXES INHERl TANeE TAX DIVISION DE:PT. 2:80601 HARRISBURG, PA 17121,.0601 NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR OISALI.ORANCE OF DEDUCTIONS AND ASSESSHENT OF TAX DATE ESTATE OF PATE OF DEATH FILE NUMBER COUNTY ACN ~ount R..it~.~ 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 ~ it"EV: is'if- EX - AfoP - -f oj": 97 yo NO Yi CE -"6 F - YNHEiii i AN-CE - "fA ii" A"P pilii i sEHENT -; - ALl-6wAN-cE - '01i-- -".. _n_ - - - - - -- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF VUXTA CHARLES E FILE NO. 21 96-0835 ACN 101 DATE 09-01-97 STUART SMIGEL 2917 N HBe S SACKS ESQ ETAL FRONT ST PA 17110 TAX RETURN WAS, I X) ACCEPTED AS fILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN I. R..l Eatet. ISchedule A) 2, stock. ~ Bond. (Sc~.dul. 8) 3. Clo.ely Held stock/Partnership Int.r..t (Schedule C) 4. HDrtgau../Not.. Racalvabl. (Schedule OJ S. Cash/Rank Dapodh/HJ.sc. PllrSlon.! Prop..rty (Soh.dula E) 6. Jointly Owned Property (Schadul_ F) 7. Transfa... (Schedule Gj 8, Tot.1 A...t. APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Fun.reI Expans../Ad_. Costs/Hilo. Expans.. (Schedule H) 10. Debts/Hortgage Liabiliti.s/Liana (Schadule I) 11. Total Deduction. 12. Hat Valua of T.~ Return 15. Ch.rit.bl./GoY.r~ental Baque.t. 'Sch.~l. J) 14. Net Value of E.t.t. Subject to T.~ If an asselement wal issued previously, lines reflect figures that j,nelude the total of ill ASSESSMENT OF TAX: 15. A~ount of Lina 14 .t Spous.l rat. (16) 16. Aaount of Ll~ 14 t.~abl. .t Lin..l/Cl... A rata (16) 17. A.ount of Lin- 14 ta~ab1. at Colleteral/Cla.. 8 rat. (17) 18. Principal T.~ Due TAX CREDITS: PAYHENT DATE NOTE: RECEIPT NUHBER DtSCDUNT 1+) INTEREST/PEN PAID (-) o IF PAID AFTER DATE INDICATED, SEE REVERSE fOR CALCULATION OF ADOITIONAL INTEREST, 09-01-97 VUXTA 08-24-96 21 96-0835 CUMBERLAND 101 ( ) CHANGED III (21 (3) 141 IS) (6) (7) ,00 .00 ....J!!l.. .00 3.281,54 .00 .00 IB) c', '* (9) nO) 3,386,61 32.148.78 Ill) (12) (15) (14) UV-IU'U I" (IJ-HI CHARLES E NOTE I To in lure proper credit to your accountJ lub.it the uppar portion of thl. foro with your taM pay...nt. 3,281.54 ~1i.1j3C; ~9 32,253.85- ,00 32,253.85- 14, 15 and/or 16, 17 and 18 will return. allessed to date. ,00X'00. ,00 X ,06. ,00_,15. 11ft) AHOUNT PAID TOTAL TAX CREDIT ------.. CALANeE OF TAX DUE INTEREST AND PEN. TOTAL DUE ,00 ,00 ,00 ,00 .00 ,00 ,00 .00 If TDTAL DUE IS LESS THAN tl, NO PAYHENT IS REQUIRED. IF TDTAL DUE IS REfLECTED AS A "CREDIT" ICR), YDU HAY IE DUE A RE'UHD, SEE REVERSE SIDE OF THIS rORH FDR INSTRUCTIONS.l Ch \ Rf.SI:."RVATIDHt Elltet.. af ~lClecf'"ta dyJna on or be~or. OICllNItMr 12, 1982 .~ if any f~tYr. bt.r..t in the eUat. h trlltllf.rrlld in po.....Jon or enjay.-nt to Cl... a (ooll.t~ral) benefiolarl.. of tha deced~t after the expJratlon of any a.tet. for llf. or for Ylar., the Co-.onwe.lth heraby 'xpt...1y r..erv., the riDht to appraJ.e and a..... tran,'er Inheritanc. Taxe. at the hNful Cia.. II (celhterlll) tilt. on any ,ucn futur. tnter..t. PlIlPOSE Of NOTICE I To fulfill the re<tt,dr...nh ot Sltotlon 1.140 of th'l InherJtMce and Eltelte Tax Act, Aat 21 of 19'95. (72 1'.5. S~tJon 9140). PAYHENTI Vetach the top portlon of thlt HotJce and lIubnJt with YlXJr Pl'ly'cnt to thl R-ahtar o~ NUll printed on tho revGlru 111:... --Make check or IlClrMIy Orlkw payable to: REGISTER or HILLS J AGENtt REFUND (CR) I A rofl.nd of a tlue credIt, which wag not requa.ted on the Tax nllturn, .fly be requ.st.w by cOllplltJna en "Appl!catJon for Refund of Pennsylvania Inh8l'ltllncll and Eltat. Tal:" (REY-13BJ. Appl1tation. arlll avaihbl. at the Offtet of th. RGUhtlr of WUh, &ny of the 2~ Rev.~ District OHtcu, or by calltng thtl IPWlal 24~hour M.w.rlnu ..r-vlce nCJlall." for for.. ordering: In P'-.lOlylvanta 1~HOO~162-2050, ouhJdtl PtnnaYlvlN'lla end within IDClel Harrtaburg arn (717) 7117~a094, TOOt (717) 7n-ZZSz <Hurlng IlIpeired Only). OBJECTIONS I Any party In Int.r..t not lathfllld with thll 8flllrats..ent, l!I11owancD or dhallowlIlInc. of deduction., or 1I......."t of hue OnolueHnll dhcount or Intlllr..O I'" shown on thht Hettel ....t obj..::t wlthl" IIKtv (60) day. of rec.lpt of this Hotle. bYI ADMIN ISTRATIVE CORRECTIOfiSI uwrJtt." protut to th. PA n'PtJrt..,..t of RIVllnl.*, Soard elf ApPUh, O&pt. Z810l1, Harrisburg, PA 17128-1021, OR -~.iSClUon to MY. thti aatt.r dtItllrllJned flt audit at the acco"nt of tl", ptr.ooel reprll.."tmttV., OR --8PfI.al to tM Orphan.' C<lurt. DISCOllfT: Factual IIrror. dlsoovered on thh "'u'I"ant should ba ftddrlllud In writing tal PA OaplIrhumt of R.v.nu., lIur.1!tU 0' Indlvidulll T,,>c.., ATTN: Post Auaullont RavJow Unit, Oap\, Z1I0601, Herrhburg, PA 1712'8-0601 f'hc:oe (717) 187-6505. S." Pave 5 of thll bOOkht "It,.tructJonl for Inh'lrJtanca TII)( Rlturn for. R..ldtnt Dttc....,t.. (REY-ISO}) for an axplllmltloo of adllinhtrllUv.h correctabh orrelrll. If .,~ tax dUll h paid within thr.. (3) cahndflr JKlflth. aft.r the dec4ldent'. Math, ft flvlll Ptrc.nt (SX) dhcolAlt tlf the tax paid ill 1I110Wfld. PENAI.TVI The 1S~ taM HnGI.ty non~part1clp.tlon ptnatty 11 ca.p.uted CliO the tatal of the tal( and Jnt.rut a.....ed, and not paid before January 18, 1'196, th. flr.t dey IIfhllr the and of tilt hl.. alln'lty period. Th1t non~PftrtJcJp.tion Ptml1t~ II app."labl. in the 'MtI ManMr and tn the the 'Hi. tl.. period n Yl>U would aPPall 1 the tax and inter.,t th.t has been fllll.tII.d ftS Indlcallld orl thh notice. IHTEMSTJ Int.r..t II cherglKt beginning wl1h flr.t day of dtllrtql./ellCY, or nJ". (9) !tOnth. and 0041 0) day frOll tho doh of death, to the dlt. of pnYltllnt. l'1U(" whJch bee... deHrK9'HN'It bafor. Janutry 1, 1981 belr Intlre.t at thti rat. 0' .1M (6)0 percMllt per ~ calculated at II dlllly rat. of .000164. All tun which ~..... dtlJ~t on and eft.,. Janu.ry 1. 1982 wlU bear Int.rut lit II rflt. h'hlch will vl'iry frnll ealaMar y.ar to caJandar y.ar "11th thlllt rete IIOMUnctd by the PA lMpnrtlMlnt M R.vtlllUa. Th" apPUcabl. Inttr..t rnt.. for 1982 throu(ttl 1997 Irll t!!r Interut Rat! ~n..!!x..Lnt.'-..t f'l!K:tor Yo!!!' lnt.rut Rat. DflUy Inhr'llt flK:tor 19a! 20X .000548 191t7 q;( .(l00l47 1911 16;( .000438 19a8~1991 1i:( .000301 19" lU .0OO~Ol l~l 9~ .000247 1985 13;( .0003S(. 1995M1~ n .000192 19116 lOX .000274 I?9S-1997 " .OODZ41 m-Int.r..t h ".Ieul.ted .. followlI INTr.REST m BALANCE DF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any NoUoe IUued after thll tax ~OMI dellnquw,t ~UJ tef1\tCt an Jnter..t cIlevlation to flft.." (15) .YI beyond tn-. d.tll of thll ......lltf1t, If PftVHnt II .IMN after the Int.,-.., cOMputation eNt. sho!ifn CM'1 tt. Notice, ackUtiOMlI inter.st lIU.t btl c.Jculr.titd.