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'OA OATIS 0' DIAIH AnlA 12/31191 CIlICK HIAI
" A SPOUSAL '
POYlAn CAlDIlIS CLAIMID I I
flU NUMBIA ' .
;;.1 9 ~
(OUllTY (ODE
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
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1. Real Eslale (Schedule AI
2. S'ocks and Bond. (Schedule BI
3. Clal8ly Held Sloc~/PDftnership Inleresl (Schedule C)
A, Mortgages and Notes Receiyable (Schedule 01
5. Cosh. Bonk Depolits & Miscellaneous Personal Properly
ISchedule EI
6. Jointly Owned Property (Schedule F)
7. Iranole" (Schedule GI(Schedule II
8, Tolal Gran ASl8ts (tolalline. 1.7)
9. Funeral Expense., Adminislraliye COSII, Miscellaneou,
Expense. (Schedule H)
10, Debll, Morlgage liabilities, lien, (Schedule I)
11. Tolal Deductians (10101 line, 9 & 10)
12, Nel Value of Estale (line 8 minus line 11)
13, Charitable and Gayernmental Bequells (Schedule J)
U. Net Value Subletllo Toll. (line 12 minus line 131
YEAR
.UU~DER
(OMMUUW(At111 01 P"'''!!Y1YAUtA
llIPAR'MUU Of U't'(tHH
OfPt 2110601
flAARlnURG. PA 11128 OM)I
tJlClOIU '!1 '~A"~f liA\I~-I-t.tl~~;li,:~-iiit;ifiiiiiiAil
SADLEr!, .J ay C.
WCiii'iiC'UitlY ,u.iMii'- -- - - -- --jrlAii '-1'-111 A'li I(lAII oi ~I.ltl u
2Q.~q)-91<JL..,n__OI~/<J6 1- .0/11/21 "'J' ._n_c.\!I1!~.orlanc!.-_---
I" ..;;/~' """'''0 "'''"' ...., ,... :=='~. :'__ '~"~"~~'~ '~UM"'.._ _ 'MU",l! "'''''0'''' """0'"0""
[j) 1. Original Return rJ 2. Supplemental RelUln L13, Remainder Relurn
I'or do'.. 01 d.o,h prior '0 12.13.B2)
o II, limited Eslole [I 40, Future Intere,' Compromise [1 5, Federal Eslate Toll. Relurn Required
liar dalfl. 01 dealh aher 12.12.82)
crJ 6. Decedent Died Testate [] 7. Oftcfldflnl Maintain"ll n living Trus'
(Attach copy of Willi (Anoth (Opy 01 Trull)
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO. .
HAM! jeOMru IE MAHttlQ ADlllln!!
J. nobel't Stauffer, Atty. Harltet Square Bldg.
""'HO"'''UM"e--'---' --.--. Jlecha.nicsburg Pll 170~5
766-96..73_. ..__.... -- - '-
I I I ' ___.. _ Q_._op -
121________0.00_
(31 0-,00_
(41___._ ---[p.-g.:.gg.-
151____..
161_____~8.,A87 .1+1_
(71.. _____un 0_e.90_
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15, Spousal Transfers (for doles 01 dealh aher 6.30-94)
See Ins'ruclion. for Applicable Percentage on Reverse
Side. (Indude values from Schedule K ar Schodule M,)
16. Amounl of line 1 A toxable 01 6% role
(Include value. from Schedule K or Schedule M.)
17, Amount of line 1A taxable 01 15% rote
(Include volues "om Schedule K or Schedule M.)
18, Principal tOll. due (Add loll. from line. IS, '6 and 17.)
19. Credits Spau'il/Jt'Y Credit Prior P06:flo'b
+ ------
-IlI<-ltJIIU !Il0Mruil .AllIl.f!l\
27 ERst Main st.
Mechaniosb\U'[\, Pll
17055
_8. Tolol Number 01 Sale Depa.it Ball.lts
r'i.'.
,'~' "
160.00
(91 ________
(B I
68,897.47
1I01_.._n
0.00
160.00
68,737.47
0.00
68,737.47
0.00
4,124.25
0.00
.--11:1124.25
206.21
0.00
(111
(121
113)
(141
(15) ___~.9~K._"
(16) .._.__60, 7)7~~1_K .06 "
(171 _.._________QeQ(LK .15 "
(I B)
Discount
+.-?Oq..2:I"
Interost
0.00
(191
120)
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20. If line 19 is great.r Ihan line 18, enter the diUerence on line 20, This Is ,he OVERPAYMENT.
m 0 ...:r.n!lliloJ ....,.......1...".......1'1.1-111 .1: .. .."ft'I":Tllr.'I..TI.!.I.....J.<I.u.:Ji'J ul.J .1
(211
(21AI
(21BI
3,918.04
-De OR-
3,91tl.O
21. If line 18 i, grealer Ihan line 19, enler the diUerence on line 21. Thi. is the TAX DUE.
A, Enler the inl.,.., on Ihe balance due on line 21 A.
8, Enter ,he 10101 of line 21 and 21A on line 218, Tllis is the BALANCE DUE.
Malt. Checle Pay obi. tOI Reg111er of Will" Agtnl
V~. ":- ~~ BE SURETO ANSWER ..ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH ..c:..c:
Under p.nahie, of perjury, I declare .hall haye uamiMd this relurn, including occoml1allying schedule, and s'alemenh, and 10 the bes' of my knawledgo and belie'.
it is true. carred and comple'e. I dedare Ihol nil feal "slale has been rftpotted at hue marlet yolu.. Declaration of preparer other than the personal representative h
baltd (In 011 information af which prepafet ha. any knowledge,
foGiiAiU Of""ON""O"~lI'''o' ""IG'''U'~ ."o.m"100 Singlotary Circle fl8 0'"
\ (7((/-1' _ Immoka.lee.._Elocl.da 3'111,::> I{ 1.1 '(f,
IlIH N UUIt AT f AOOtlUS II ItS DId DAlf
. a.r te Quare g. c.
l1e.cha.nic3burg,~7-0% / (.'I - / a . YC
uvuoeu, III,.
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SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
PIOOJO Prlnl or Typo
FilE NUMBER
~/ "/~ -~. '1C{
COMMONWlAIIU or PfNNSYlVAHIA
IHHIIlfANCI lAX .nUIN
InlDIHI DlelDINI
ESTATE OF
JAY C. SADLER
CAli propltly lolntly.own,d wllh thl Righi o. S""vl'lonhlp mut' bl dlulo'ld on Schedu11 '1
ITEM
NUMBER
DESCRIPTION
VALUE AT
DATE OF DEATH
1.
Furnishings located in decedent's apartment as
appraised by Chuclt Bricltor of Briclter' 0 Auction'
House, 93 Texaco Road, Mechanicaburg, PA 17055.
$
410.00
10.00
IAUach additianal oVa- )( 11- ,h..', II marl 'pacI " n..dld.1
.. ~. .,- ... #
"'I.lIotll,11I1I1
9",~,9_
'L.~
COMMONWlAUft 0' ,INNSnVAHIA
IHIlUIIlANCI tAX UtUlH
lUIDUU DIClDlHt
~ SCHEDULE F l
JOINTLY.OWNED PROPERTY
------- --
FILE NUMBER
, " I - I rtt - :.; Y'i
ESTATE OF
JAY C. SADfJEI1
Jalnl I.nantl')'
-_.--- ---~----_._-----_._----
ADDRESS RELATIONSHIP TO DECEDENT
100 Singlotnry Circlo #8
rrrunoltnleo. Florida 3411~2 Daughter
-.-------- --".-------.---------.- ..----..---...---..--.-
NAME
A. DEBRA 'K. VAUGHN
B.
C.
"
..
Jalntly.awn.d prap.rty.
ITEM LEnER DATE
NUMBE~ FOR MADE DESCRIPTION OF PROPERTY TOTAL VALUE DECD'S DOLLAR VALUE OF
JOINT OF ASSET '!bINT. DECEDENT'S INTEREST
TENANT JOINT
1. A. 2/29/ ll~25 shares of oonunon
1988. stook of PHC Ban!t, N. A.
at $30.00 per share. $'42,750.00 50!> $ 21,375.00
2. A. 11/161 1425 shares of oo~non
1992 stock of PlIC Bank, N. A.
at $30,00 per share. 42,750.00 50!> 21,375.00
3. A. 8/25/ PNC Bank, N. A., cheolt-
1994 ing Aocount No. 50-3012- 50!> 25,708.87
1826. 51,417.74
Interest acorued to 8/5/
96. 57.20 50!> 28.60
TOTAL (Aha anl.r on line 6. Recopilulation) S 68,487.41
fir mort space il n..ded inse" addilionoJ sheell 0' same sin'
IIVUIII..I''''
.
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES PI.al. Prlnl or Typ.
--- . --- - - -ltnroMBER - ----
._:/.id'.\''/(I
-.---..----.--- ..- ,-------------
fiTATE OF
C.OMMOUW(AUlt Of NUU!I'f'IVAtlIA
IUIUllll....uCf TAX 1l[IUIlU
tlnlonn DlcrOlU1
JAY C. SADLEn
._--_.._-~--_..
AMOUNT
DESCRIPTION
ITEM
NUMBER
A. Fun.ral Exp.n....
1.
B.
I.
2.
3,
4.
C.
1.
2.
3.
4.
5.
6.
7.
8.
U/A
Admlnlllratlv. COI'"
Personal RepTo'enlative Commissions
Social Security Number of Penonal Repre.entativo:
Veor Commiuions paid
Allorney Fees _ J. nobert Stauffer, Esq.
$
Family Exemplion
Cloimonl .-llLA
Relationship
Addreu 01 Claimant at decedent'J death
Slreel Addreu
Clly
State
Zip Code
Probate Fees
Mllcollan.ous Expenl'"
Chuolt Brioker, Brickerl s Auotion, 93 Texaoo Road,
Mechnnicsburg, Pa., appraising furnishings.
Register of Wills, filing Pennsylvania Inheritance
Tax Return.
TOTAL (Aho enter an line 9, Recopilulotion)
(II more Ipac. II n..d.d, Insorl additional sh.... of lame II...)
s
125.00
20.00
15.00
;60.00
1'':;13~)/
BUREAU OF INDIVIDUAL TAXES
U.UlfAHCt fAX OIVlSleJrt
DEP'. 110601
IWlA1SIURQ, PA 1112.-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
*
,
NOTICE OF INHERITANCE TAX
APPRAISE"ENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
"'.t""U "tlll"U
J ROBERT STAUFFER ATTY
MARKET SQUARE BLDG
MECHANICSBURG PA 17055
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
01-28-97
SADLER
08-05-96
21 96-0849
CUMBERLAND
101
JAY
C
Allount R..l tt.d
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 ~
iiiv:i5'4'i-EX-AFii-nZ:9ijj-iiii'ficE--OF-YNHEiiii'iiiicE-YAX-A'pjiiiA'isEHEii:r-;-,H.i.-owiliicE-ijli-m------m-m
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF SADLER JAY C FILE NO. 21 96-0849 ACN 101 DATE 01-28-97
TAX RETURN WAS I (X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Rod Edoto (Schodulo AI III
2. Stocko end Bond. (Schodulo 01 121
3. Clo..ly Held stock/Partnarship Int.r..t (Schedule C) (3)
4. Kortgogo./Hoto. Rocoivoblo (Schodulo 01 (41
S. C.shlB.nk Deposits/Hi,c. Parsonal Property (Schedule E) (5)
6. Jointly Owned Property (Schedule f) (6)
7. Transfars (Schedule G) (7)
8. Tot.l As.at.
I CHAHGEO
NOTE: To insure proper
credit to your account,
sub_it the upper portion
of this for_ with your
tax pay..nt.
.00
.00
.00
.00
410.00
68.487.47
.00
ISI
68,897.47
APPROVED DEDUCTIONS AND EXEMPTIONS:
9, Funeral Expans../Ad... COlts/HIIC. Expans.. (Schedule H) (9)
10. Oobt.l"ortgogo Liobilitio./Lion. (Schodulo II (101
11. Totol Deduction.
12. Net V.lue of r.x R.turn
15. Choritablo/Gov.rn.ontol Boquo.t. (Schedulo JI
14. N.t V.lue of e.t.te Subject to Tax
160.00
.00
1111
1121
USI
1141
160 00
6B,737.47
.00
68,737.47
If an assessment was issued previously, lines
reflect figuras that inc1uda tha total of ALL
ASSESSMENT OF TAX:
15. A.ount of Line 14 at Spou.al rat. C1S)
16. Aoount of Lino 14 to.oblo ot Linool/Clo.. A roto (161
17. Aoount of Line 14 taxablo ot Collotorol/Clo.. 0 roto (171
Ie. Principol Tax Duo
TAX CREDITS:
PAY"ENT
DATE
10-22-96
14, 15 and/or 16, 17 and 18 will
raturns assassad to data.
NOTE:
.00 X .00=
68,737.47 x.06=
.00 X .15=
!leI
.00
4.124.25
.00
4.1::4.25
RECEIPT
HUHOER
AA146860
DISCOUNT (+ I
INTEREST (-I
206.21
AIIOUNT PAID
3,918.04
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
4,124.25
.00
.00
.00
. IF PAID AFTER DATE INDICATED, S~E REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN fl, NO PAY"ENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU "AY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. I
n,_
r,
'~ri Jr\fl 24 f' 1 :L 7
CIL
Cun,-.
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R[$[RVATIDNI Est.I.. of decedents dying on or befar. DKHMr Il, 1981 n If any future Intl,...t In the ..tat. 11 I,.aluflrred
In po.....lon or .nJo,.."t to Cl... a (coUal.raU ~f1c1.r1.. of the dlced..,t afll,. the expiration of My aUat. for
life or for Y.."S, the Co-.onvea1th her.by upr...1y ,....rv.. the right 10 ItPprlha and ...... Ir"'llI,. I~rJtIlnC. lua.
at the lewful C1... a (collata"al) rat. on any such lutur. Int.r..t.
PlIlPOSE OF
NOnCE I
PAYHENTJ
REfl.I(DICRh
aBJECTIONS:
AOHIN
ISTAATIYE
CORRECTIOHSI
DISCOUNT:
PEKAl TVI
INTEREST I
To fulfill the nqulr...,ta of Section 21""0 of the JrIM,.Uanca Bnd E,t... Tax Act, Act ZZ of 1991. 72 P.S.
Section 2140.
Detach the top portion of thl_ Notle. and 1~lt with your pay-.nt to the Ragllla" of WIll. prlnled on the rav.r.. lid..
.-Heka check or .un.yo ordar payabh 101 REGISTER OF HILLS, AGENT
All paYMnh raceJvlMt .hall first b. applied to nny Intan.t which ..y b. due with any r...lnd.r applied to thli tax.
A nhN of . tu crlMllt, which was not reql.M.ted on ttMI Tax Adurn. .ay tM rltqlMlhd by c~htlng an "'Appllc.tlon
for Aeft.nd of P.,..,sylvanla Inhlirltance and E.tat. Tu"' (R[V-13U). application. are available at thli Dfflu
of the Regl.ter of Will.. any of the 25 Rev~ DI.trlct Office.. or by calling the .peclal 24-hour
answarlng ..tvlce I'1UIlber. for forll orcMrlnal In PIWWl.ylvanla I-SU-S62-Z05D. outdda P.,..,.ylvanla and
within local Harrl.burg area (717) 737-3094, TOO' (717) 77Z-ZZSZ CH.lrlng lapalr.d Only).
Any party In Interllt not satisfied wit... the .ppr.I.....,t, allowanca or dls.llowanc. of ct.ductlon., or a"."8*1t
of talC C Including discount or Int.r.st) .. shown on this Hotlce ..,st objact within .IMty (60) d.ys of rec.lpt of
this NoUu bYl
--wriU." prote.t to the PA Dep.rtMnt of R.v~, Bo.rd of Appe.I., Dept. 2310Z1, Harrisburg, PA 17IlS-toZI, OR
--alKUon to have ttM; e.ttar cMtaralnad at audit of the ItCC~t of the per.onal ropr..."taUve, OR
--appeal to the Orphan.. Court.
FlICtual arrors dlscovared on thl. ........"t .hould be addre..ed In writing tOl PA Depart.."t of Aev.".".,
Bureau of Indlvldu.1 T.IC." ATTN: Po.t A......."t Ravl.. unit, Dept. ZS0601, Harrl.burg, PA 17123-0601
Phone (717) 7'7..:'IDS. s.. p~ S 0' the bookl.t "'In.lructlon. for Inharltence TalC R.turn for a R.lld..,t
Decadent"' (REV-IS01) for an .xplenatlon of adalnl.tratlvely correctable error..
If MY tax w. Is paid withIn thr.. (3) calend.r .onth. .fter the dlc.d..,I'. dalth_ a five p.reent (SiO dlscOU1t of
the tu paid I. allowed.
The 15% tax ......ty non-participation penalty Is coaputlld on thtl totll of the till( and Intarnt ......ad, and not
P.ld bafor. January IS, 1996, the flr.t day aftar the end of the talC ~.ty p.rlod. Thl. non-partICipation
penalty I. appealabla In ttMI .... .annar and In the the .... tl.. p.rlod e. you would appa.l the talC and Inter..t
that he. bMn a.....ad .. Indlcatad on this notice.
Intarut Is charglld beginning with fIrst day of cMlInquancy, or nIne (9) eonth. and OM (1) day f,.u. the data of
death, to the dala of paYMf\t. Taxu which bec8lIe cMllnquent bafon January 1, 193Z baar Interut at the rala of
.Ix (6in perc....t per 8fV'II..- calculated at a dally "ata of ,OOOIIA. All tb.. which Me.. delinquent on and after
January 1, 193Z will ba.r Inta,...t at a rata which will very froe calendar yea,. to c.land.r y.ar .Ith that rat.
announced by the PA Dap.rteant of Ravenue. The appllCabla Intare.t rato. for 198Z through 1997 er.:
!!!! Int.rut Rate Dally Inl.r..t Factor !!!! Interut R.t. Dally Intarest Fechr
19az lOX .000543 1987 OX .000247
1985 16X .000438 1983-1991 11:C .000501
I... 11X .000501 I'" OX .000247
1985 I]X .000556 1995-1994 7X ,OOO19Z
1.86 lOX .000Z74 1995-1997 OX .000Z47
--Inter..t I. calculated a. follows:
INTEREST = BALANCE OF TAX UNPAID X HUftBER DF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice Inuecr aft.,. the talC be<:OMI d.lInquent will raflect an Inter..t c.lculatlon to flit.." CIS) de.,.
bayond the d.ta of the ......Mnt, If p.yaant It elide aft.,. the Intar..t co.-ltatlon d.ta lhown on the
Notice, additional Int.rut au.t ba calculaled.