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PETITION HJH 1>>I{OnATE UlIlt GHANT 0'" LETTEllS
Nu. _}.I~CU4? - ~ ~.3
Tu:
_._._ It~gislcr uf Wills for Ille
.----. ()/'('l'UJ/.tI. Couuly or t.:\1::\'n~'I\1l<: III the
SlIriuIS,'rllril)' Nil. '.'1 (-02=i )1" Cummullw~nhh of I'cllllsylvllllla
The pClilioll of Ihc ullllcrsigucd rcspcclfully rcprcsculs Ihnl:
Yuur pclitiuncl (s), whu is/al C I K )'cnrs of ng~ ur oldcr nlllh~ cxecut l' -[ x
illlhc Insl will of Ihc IIhuvc dcc~d~ul, ,1:1I~d ,OV,): :1)( '1' 1 J,
nnd codicil(s) dnlcd
'j""> 11 .,.....1" ..""t'('"
c.\Iule oj ~~.!-~~~::.-~~~.J_::.__
111.<11 kllUlI'II11S
nalged
, 19~
(!>latc rtln"nl drCIlIII\lillll.'l.'\, e,~. (fnunci;uiulI, death uf executol, cIC.)
Deccndcnl wns domiciled al dcnlh in CU:lb.:1' land
It in Inst fllmily ur principnl residencc al 'J'o(l,' ; :nl:o.,.,in]
~t.,..(\,...t. J (1n't'l1 i n 1 Pc ,--Ennns.:'" \!"n ~ n
(Ii\l \lIc('I, numhcr and IIltllh.:iJ1alil)'}
County, Pennsylvania, with
':011Q-I000 ':font South
Dccendelll,thcn---2.~ycnrsofage,died Octal)!')' :>3, ,19 r;6
at--.Q,"1...,1is10, ~)c~)n~Ylvnn'1n
Except as folluws, dccedcnt did nolmarry, wns nul divorced and did nol have a child born or adoptcd
nflcl' cxcCUlion of lIu'will olfcrcd for prolnlle; wns nullhe viclim of a killing and was never adjudicated
incilmpctenl: ______
Dc,'elldcnt III dcath owned pH:perlY with cslimalcd valucs as follows:
(If domiciled in I'll.) All pcrsonal property $ 110.000.00
(If nlll :Iomlcii,:u 1" Pa.) Personal properlY in Pennsylvania $
(If nol domicilcd in Pa.) Personal property in Counly $
Value of real CSlllle in Pennsylvania $
'tuated as 'follull's: "one
WHEREFORE, PClitiuncr(s) respcctfully rC,\UCSI(S) the probate of the last will and codicil(s)
prescnlcd hcrcII'ith and Ihe grunt of ICllcrs ~c~t(\lnent[lr:1
(IC~Ii.UllellliJr)': mJmini!lIHUiOI1 (,1.3,; administration d,b.n.c.t,a,)
theron.
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OATH 01< l'ERSONAL IlEl'RESENTATlVE
COMMONWEALTH OI-I'ENNSYl.VANIA
COUNTY 01- __.QSf~Ei\',,'oi:J)
} ss
The pelitioncr(s) ahuvc-nnm~u ,~wear(s) or arrirm(s) thlltthe stalements in the foregoing pctition are
IrUC and corrCCllo the bCSI \If the knowledge and belief of pelitioncr(s) and that as personal'reprcsen.
lalivc(s) or Ihe .lhol'C dc<cdel1l 1':lilioncr(s) will well and truly administer the cst ale according to law.
Sworn 10 0" affirm".! and, sub.;~ribcd { Jid.!hU"_'Y .Jb::i-"j~ '"
b I' ." "In -.
c ore me thiS _Sf' _ day of ~
OctoboI' .___~9(;b a
~,y-fY~L '1~ ~
J 5 ~ I '31- 1I Q.{'-tIt:Lj RCl:islCr E:
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any l'OIl/lon. thon In lluch ovont, I 1l0l~1 no to, conI! t t tuto Hnd
IIl'pol,nt my dnul'ht'll', Flol'flneo 1-:, ;"tOlwh, oxoclltr'tx oj' tl1l8
IW Lnot vllll und TO:Jtl\l~flnt;, !.11 hfll' pIueo Imd otood, und dt1'oet
thnt IIho hn porm!.t;';"d to 1I01'Vn III such cupnclty without }JostLng
hone! 01' othor oocud ty.
IN HITlmSS \1ilEll:O:OF, I havo hOl'ounto sot my hund und seal
this ,*1-.4 . duy of Novombol', A. D" 1976
Glen R,
~(SEAL)
gh
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SI~ned, sealed, published and declared by the above named,
Glen R. Fertenbaugh, as and for hIs Last Hill and Testament, in
the presence of us, \1ho have subscribed our names here to as
wltnessos, at the request of said testator, In his presence and
in the presence of each other.
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COMMONWEALTH OF PENNSYLVANIA
DIPARTMINT 0' REVINUI
OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
'*
DN~ AA 185141
ACN
ASSESSMENT P;'I
CONTROL iiI
NUMBER
RECEIVED FROM:
&
AMOUNT
J ROBERT STAUFFER ESQUIRE
101
te, 'to!. "7
MARKET SDUAR BUILDING
MECHANICSBURG, PA 170~5
ESTATE INfORMATION:
~ fiLE NUMBER
~ 21-1996-0883
I!:t NAME Of DECEDENT (LAST)
~ FERTENBAUGH GLEN R
~ DATE Of PAYMENT
iii 02/05/97
m POSTMARK DATE
COUNTY
SGN 716-09-b361
(fiRST)
(MI)
CUMBERLAND
DATE Of DEATH
10/23/96
REMARKS FLOr~ENCE E STOUGH
C/O J RODERT STAUFFER ESDUIRE
SEAL CHECKlt J 5
m TOTAL AMOUNT PAID
.2,403.97
VZ
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RECEIVED BY . /";,: ',/ '- '/11 ,,'..., /-"/'1/ "
,I SIONATURV . 1" i .
MARY C. LEW I S "!'f/,i/ /.) ,{V /hj,--
REGISTER or WILLS ~
REGISTER OF WILLS
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INOIVlaUAL TAXES
IHIl[RI lAJolel TAX DIVISION
DLPt. :8DbOl
UAARIS!UNG. I'l 111:& DbOI
NOTICE OF INIlERllANCE TAX
AI'PRAISEIlENT, ALLaWANCE OR DISALLDWANCE
OF DEDUCTIONS AND ASSESSIlENT OF TAX
J ROBERT STAUFFER ATTY
MARKET SQUARE BLDG
MECHANICSBURG PA 17055
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
1-
,o/"
0',-21-97
FERTENBAUGH
10-23-96
21 96-0883
CUMBERLAND
101
A~ount Remitted
{'>..
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rlfr.?: \~~n)'~~l
~~fJ~!f!~
11..lhllllll 101'"
GLEN
R
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': iS47 - EX -AFP-- (o:f: 97 Y-NoYlcE --oi=-YNHEii'I rANcE- Y AX-APpiiA' IS EHENT -; -Aii:oWAN-cE-oR'---- - - -- - - - - - - - --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF FERTENBAUGH GLEN R FILE NO. 21 96-0883 ACN 101 DATE 04-21-97
If an assessment was issued previously, lines 14, 15 and/or 16, 17 and 18 will
reflect figures that include the total of ahh returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal
16, Amount of LIne 14 taxable at
17. Amount of Line 14 taxable at
18. Principal Tax Due
TAX CREDITS:
PAYIlENT
DATE
11-20-96
02-05-97
TAX RETURN WAS: I X) ACCEPTEa AS FILEa
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Raal Est.t. (Schedule AJ 11)
2. Stocks and Bonds ISchedule 8) (2)
3. Closely Hald stock/PartnershIp Intarast ISchedule C) (3)
4. Hartg.gas/Notas Receivable (Schedule DJ C4J
S. Cash/Bank Deposits/Hisc. Personal P~ope~ty (Schedule E) (S)
6. Jointly Owned Property (Schedule F) (6)
7. Tr.nsfe~s (Schedule G) (7)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral E~penses/Adm. Costs/Hisc. Expenses CSchedule H) (9)
10. Dobls/Ilorlgogo llobllltlos/llons ISchodulo I) 1101
11. Total Deductions
12. Net Value of Tax Retu~n
13. Cha~itable/GoY.rnmental Bequests CSchedule J)
14. Net Value of Estat. Subject to Tax
NOTE:
rate
Lineal/Class A rat.
Collate~Bl/Class 8 rat.
115)
11&1
117)
RECEIPT
NUIlBER
AA146963
AA185141
DISCDUNT 1'1
INTEREST/PEN PAl a 1-)
263.16
.00
CHANGED
.00
7.500.00
.00
.00
129,948.16
.00
.00
IBI
9,814.00
67.91
1111
(12)
(13)
1141
.00 X .00=
127.566.25 X .06=
.00x.15=
I1B)
AIlOUNT PAID
5,000.00
2,403.97
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
NOTE: To insu~. proper
cred1t to your account,
submit the upper portion
of this forM with your
tax paYll'lent.
137,448.16
q .RRl ql
127,566.25
.00
127,566.25
.00
7,653.97
.00
7,653.97
7,667.13
13.16CR
.00
13.16CR
. IF PAID AFTER DATE INaICATED, SEE REVERSE
FOR CAlCUlATIDN OF ADDITIDNAL INTEREST.
IF TOTAL DUE IS LESS THAN $1, Na PAYIlENT IS REQUIRED.
IF TDTAl DUE IS REFlECTEa AS A "CREDIT" ICR), YOU IlAY BE DUE
A REFUND. SEE REVERSE SIDE DF TNIS FORIl FOR INSTRUCTIONS. I
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RESERVATIONs E,late. of dlcldent. dying on Dr before O.C..b.r 12. 1982 .. If any future Int.rs.t In thl ..tal. 1_ tran,f.rred
In POI...,lon or enJoy..nt to Cia.. B leollal.r.l) beneflclarle. of the decedent .ft.r the .~pir.tlon of any ..tate for
II'. or for y..r., the Co..onw..lth hlr.by ..presslv r...rvI. the right to apprais. and ...... tran,f.r Inherltancl r....
at thl lawful C1... B (collater..) rate on any such future Int.r..t,
PURPOSE OF
NOTICEs To fulfill thl requlr...nts of Slctlon Zl~a of the Inherltanc. and E,t.t. Ta. Act. Act 21 of 1995, (72 P,5.
Slctlon 9140),
PAYHEHTI Detach thl top portion of thll Hot Ice and lub.lt with your pay..nt to the Rlgllter 0' Willi printed on the rlver.1 ,Ide.
--Hake check or aoney order payable tal REGISTER OF MILLS, AGENT
REFUND (CA,: A re'und 0' a taw credit, which wa. not request.d on the Ta. R.turn, .ay be r.qu..ted by co.pl.tlng an "Application
'or Relund of Penn.ylvanla Inh.rltance and Estat. Ta." (REV.IlI1'. Application. are avallablo at the Offlc.
of the Aeglst.r 01 Will., any 01 the 21 R.v.nue District Olllc.s, or by calling the special Z~-hour
an.werlng ..rvlce nu.ber. lor for.. ord.rlngl In Pennsylvania 1.800.162.2050, out.lde Pennsylvanle end
within local Harrl.burg area ('1" 781.809~, TOO' (111) 17Z.2Z51 (Hearing I.palred Only),
OBJECTIONS: Any party In Intera.t not .atl.fl.d with the appral.e..nt, allowance or dl.allowance of d.ductlon., or a...s...nt
of tax (Including discount or Int.re.t' p. .hown on thl. Notice .u.t obj.ct within .I.ty (60J day. of r.c.lpt of
thll Notice by:
..wrlttan protest to tho PA Oep.rt.ent of Revenua, Board 0' App..I., D.pt. Z81021, HarriSburg, PA
..olectlon to have the .attar deter.ln.d at audit 0' the account of the parsonal r.pre..ntatlvo,
--appeal to the Orphan.' Court,
17128.1021,
OR
OR
ADHIN
ISTRAlIVE
CORRECTIONS I
Factual orror. dl.covered on thl. a..e.se.nt .hould be addr....d In writing to: PA O.p.rta.nt of R.v.nu.,
Bur.1Y of Indlvldu.1 T...., ATTNI Po.t A..a....nt R.vl.w Unit, Dept. 280601, Harrlsbur~, PA 11121.0601
Phone e711) 187.6505, S.. page S 01 the booklet "Instruction. lor Inh.rltance T.. R.turn lor a R..ldent
Decedent" (REV.lSDI) for an ..planatlon of adelnl.tratlv.ly corr.ctable error..
DISCOUNT:
If any ta. dua Is paid within thr.. (1' calandar .onth. aft.r the d.c.dont'. d.ath, a flva perc.nt (S%) dl.count 01
the ta. paid I. allow.d,
PENALTY:
The IS% t.. aan..ty non.p.rtlclpatlon penalty I. coeputed on the total of tho ta. and Int.re.t .......d, and not
paid b.for. January 18, 1996, the Ilr.t day aft.r the .nd of the ta. aano.ty p.rlod. This non-participation
p.nalty I. appealable In the .... .ann.r and In the the sa.e tl.e p.rlod a. you would appaal tha ta. and Int.re.t
that has b.en .......d a. Indlcat.d on thl. notlc.,
INTEREST:
Inter..t I. charg.d b.glnnlng with Ilr.t day of dellnqu.ncy, or nine 19) .onth. and on. (I) day fro. tha date of
daath, to tha data of pay.ent, Ta... which b.ca.a d.llnqu.nt b.fora January I, 1981 b.ar Intar..t at tha rata of
.1. (6X) parcant p.r ann~ c.lculated at a dally rat. of ,OOOI6~. All t.... which b.c... d.llnquent on .nd after
January I, 198Z will bear Int.re.t at a rata which will v.ry fro. c.lendar y.ar to calend.r ya.r with that rat.
announcad by tha Pi Dapart..nt of Rev.nue, The appllcabl. Intare.t rat.. for 198Z through 1991 .ra:
'!!!! lnt.r..t Rata Dally lntere.t Fllctar !!!!' Intera.t Rata Dally Intere.t FRctor
1982 ZOX ,ODDS'" 1987 'X ,ODOZU
1.11 16X ,ODOU8 1981.1991 11;( ,ODOlOI
1984 IIX .000lDl 199Z 9X ,OOOZ41
1985 15:( .000156 1995.I99~ 'X ,OOOl9Z
1986 lOX .ODDZ7~ 1995.1997 9X ,OOOlU
"Intarut Is calculatad .. followlI
INTEREST = BALANCE OF TAX UNPAID X NunBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
..Any Hotlca I..ued aftar the te. beeo.a. delinquent will reflact an Intara.t calculation to flft.en CIS) day.
bayond tha data of the a..a.s.ent, If pay.ent I. ead. .fter the Intara.t coeputatlon date .hown on the
Notice, additional Intare.t au.t b. calculatad,
PURPOSE OF
NOTICE:
PAVMENT:
REFUND (CR)I
To fulfIll thl rlqulrl.lnt. of Slctlon 2140 of thl lnhlrltanel and E.tall Tax Act, Act 21 of 1995. (72 P,S.
Slctlon 91401.
Dltaeh thl top portion of thl. Notlcl ftnd .ubelt with your pay.lnt to thl Rlgl.tlr of Will. prlntld on thl
rlvlr.. lidl.
-. "akl chick or .onlY ordlr payabll to: RECISTER OF WILLS, ACENT.
A rlfund of . tax credit, which was not requI.ted on thl tax rlturn, .ay bl rlqul.tld by co.plltlng an "Application
for Rlfund of Penn.ylvanla Inherltane. and E.tat. Tax" (REV-1313). Application. arl avallabl. at thl OfficI of
the Regl.t.r of Will., any of thl 23 R.vlnue DI.trlct OfficI' or by calling the 'Plclal 24-hour an,wlrlng 'Irvlc.
nueblr. for for.. ordlrlng: In Plnn.ylvanla 1-800-362-2050. out.ldl Plnn.ylvanla and within local
Harrhburg ar.. (717) 787-8094. TOO' (717)> 712-2252 Olnrlng I.palred Only),
OBJECTIONS: Any party In Int.r..t not .atl.fled with thl appral...lnt, allowanCI or dl.allo~anel of dlductlon. or a'.I"'lnt
of tax (Including dl.count or lntlr..t) a. .ho~n on thl. Notlcl .ay obJlct within .Ixty (60) day. of rlcelPt of
thlt Notice by:
.-wrlttln protl.t to the PA Dlpart..nt of Rlvlnul, Board of ApPlal., Olpt. 2BI021, Harrl.burg, PA 1712B-I021, OR
...l.ctlng to havI the .atter dlt.r.lnld at thl audit of the account of thl p.rsonal rlpreslntatll"., OR
..app.al to the Orphan.' Court
ADMIN-
ISTRATIVE
CORRECTIoNS:
DISCOUNT:
PENal TV:
INTEREST I
Factual .rror. dl.cov.red on thl. a'.....lnt .hould b. addr....d In writing to: PA Olpart.lnt of Rlv.nu.,
Bur.au of Individual Tax.., ATTN: Po.t A.......nt R.vllw Unit, DEPT. 280601, HarriSburg, PA 17128-0601
Phon. (717) 787-6505. S.. pao. 5 of thl bookl.t "In.tructlon. for Inh.rltanCI Tax R.turn for a R..ld.nt
D.c.dlnt" (REV-ISOI) for an .xplanatlon of ad.lnl.tratlv.ly corr.ctabl. Irror..
If any ta. dUI I. P.ld within thr.. (3) clllndar .onth. aft.r the dlcldlnt'. dl.th. . flv. plrclnt (5~)
discount of the tax paid I. allowed.
Th. 15~ t.. a.ne.ty non-~~rtlclpatlon p.nelty I. cOlpUt.d on t~. total of the tax and Intlr..t a..I...d, and not
paid b.for. January 18. 1996, thl flr.t day aft.r thl .nd 0' the tax a.nl.ty plrlod. Thl. non-participation
p.nalty I. app.alable In the .ae. .anner and In the thl sa.. tl.. plrlOd a. you ~ould app.al thl ta. and Intlr..t
that ha. b.an a"I..ld a. Indlcatad on thl. notice.
Int.re.t I. chargld beginning with flr.t day of dellnqulncy, or nine (9) eonth. and onl (1) day
'roe the data of dlath, to the data of pIY.lnt. T.... which b,c.'1 dlllnqulnt blfor. January 1, 19B2
blar Int.r..t .t thl r.t. of .1. (6~) plrcent p.r annua calculated at a daily rat. of .000164,
All t.... which blca.. d.llnqulnt on or aftlr January I, 19B2 will ba.r Intlr..t at a rat. ~hlch will v.ry frol
callndar YI.r to callndar Ylar with that ratl announcld by thl PA Olpart'lnt of RlvlnUl, Th. appllcabl.
Int.r..t rat.. for 19B2 through 1997 Ir.:
Vlar Int.re.t Ratl Dally Intlr..t factor
V..r Interltt Rat. Dally Interl.t factor
1987 .~ ,000247
19U-1991 11~ ,000301
1992 .~ ,0002(,7
1993-1994 n ,aaOl9Z
1995-1997 n .000247
1982
1983
198ft
1985
1986
--Interest
ZU
16~
ll~
In
l'~
I. c.lculatld a.
.ao05~B
.aOa(,3B
,000301
.000356
,00027(,
followlI
INTEREST = BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
.-Any Notlc. I"uld .,ter the taM b.co... d.llnqulnt will r.fl.ct an Inter..t calculetlon to flftl.n CIS) day.
b.yond the dati of thl a"I..e.nt. If plY.lnt I. .ad. aftar thl Int.rlst cOIPut.tlon date .hawn on thl
Notice, additional Internt .ull bl calculatad.
IUY.IJOO fll+ 11.941
...
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_'fils,;:
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
fOR OATIS Of DIATH Ann 12/31/91 CHICK HIRI
If A SPOUSAL
POYIR" CRlDIT IS CLAIMID 0
fill NUMBIR
21-
....
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COMMONWEAllIl Of PWNsnVAUIA
DEPARTM[NT or REV(NUE
DEn 210601
HARRISBURG. PA 111210601
DfCfDfN '!i NAMI l'A!iT. 'IUI, AND MIODU IWIIAII
F~Il'l'ElmAHGH, Glen 11.
SOCIAt $lCUIlIfY NUMIU CAll or DEATH
96-
0003
716-09-6361
I" ,"'"CAIIII IUhnlf'G "O\1UI NA""llA", IllU AND Ml[)lJlI 1I1111All
II/A
Ga 1. Original Return
3/13/05
COUNIY CODE
l\\(fOI'W'fPMmll '00"'"
TO(U.uI1l0l'.lIl.l. HOlllo
1000 Woat South stl'oot
Cnl'lia1o~bPAl17013
Covnl Cum or and
AMOU'~T IIlC(I....IO IUf IN!iIIlUCIION51
NUMBER
YEAR
o 2. Supplemental Relurn
.
o .40. Fulure InlereU Compromise
('.' d.'e. ., de.,h o"e, 12.12.82)
~ 6. Decedenl Died T"'ole 0 7. Decedent Moinlained a Living Trull
IMoch c.py .f Will) IM.ch c.py 0' Trou)
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO.
o 3. Remainder Return
I'or do'e. 0' deolh p,io, 10 12.13.82)
o 5, Federal Ellal. To" Return Required
...Q 8. Tolol Numb.r of Sof. D.po'" Boul
20, If Lin. 1911 greoler than Line 18, enler Ihe difference on line 20. This is the OVERPAYMENT.
DO
Ch~ck h~r~ if you are requosting a rlJfund of your ouc'paymcnl,
o 4. limi.ed E,'o'e
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NAME
,T. not-ort 3tr\11ffol', Attornoy
IUE'HONf NUMIfIl
717 76('-9673
z
...
>=
:5
E
:c
III
0:
1. Real Ellole (Schedule AI
2. Slack, and Bond. (Schedule B)
3. C1o.ely Held S'ock/Po,'ne.,h;p Inle,e.' (Schedule CJ
,A, Morlgages and Notel Receivable (Schedulo D)
5, Cash, Bonk D,politl & Milcellaneoul Personal Property
(Schedole EI
6. Join'ly Owned Proper'y ISchedule F)
7. Tron"... (Schedule G) (Schedule l)
8. Tolal Gran Anell (10101 Lines 1-7)
9, Fun.ral E"pensel, Adminislrotive CosII, Miscellaneoul
hpen... (Schedule HI
10, D.bll, Mortgage liabilities, L1enl (Schedule I)
. 11. Tolol Oedu"ion, ('.'01 line, 9 & 101
12, Net Value of ellale (line 8 minus line 11)
13, Charitable and Governmental Bequel" (Schedule J)
lA, Net Valu. Sublect to Tax (Line 12 minus line 13)
15. Spoulal Tranlfe,. (for dotes of deolh aher 6,30-9.4)
Se. Inslructions for Ar,plicable Percentage on Revene
Sid.. (Include values rom Schedule K or Schedule M.)
16. Amount of line 1.4 laIC able 01 6% role
(Includ. value I from Schedule K or Schedule M.)
17, Amount of line 1.4 to"oble at 15% rate
Ilnclude voloe, 'rom Schedule K or Schedule M.I
18. Principal tax due (Add tax from lines 15, 16 and 17.)
19. Credill Spoulol Pover!1 Credit f'!ior Paymenll
1I.00 + ;.>000.00 +
.' . ~~. _.~,. ...' t: {', <_.l.~
, ,'~"':-1
z
..
S
~
..
..
...
S
(OMPUTE MAlllNG AODlf!iS
llUl'l(ot 3qulll'O D1dg.
;Iechnnicabul'g, FA 170;:;5
(I)
121
13)
141
(5)
0.00
7,500.00
0.00
0.00
129, 91~U .16
0.00
0.00
9, 811~. 00
67.91
(81
161
(7)
137,hhO.16
191
(10)
9,081.91
127,566.25
0.00
127,;:;66.25
0.00
7,6;:;3.97
0.00
7,653.97
(111
(121
(13)
(141
(15)
0.00
127,566.25
0.00
x ,15 II
X._II
(161
x ,06 II
(17)
(181
5'counl
2 0.00
Inleresl
0.00
(19)
(20)
5,250.00
0.00
(211
(21AI
(218)
2,403.97
0.00
2,I~03.97
21. If line 18 Is greater than line 19, enler Ihe difference on line 21. This il the TAX DUE.
A, Ent.r thelnteres, on the balance due on line 21A.
B. Enle' ,he '0'01 0' line 21 and 21A on line 21B. Thi. i.,he BALANCE DUE.
Malee Checle Payable 101 R.gII'er of Will., Agen'
~~".'P" -- >- BE SURETO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH -c -C.;'.;'."',, ," " ,
Under penalties of per!ury. I declare thai I hove lICamined Ihil return. including accompanying Ichedulel and stalemenll. and to Ihe besl of my knowledge and beli.f,
it Is Irue, correcl and complele. I declare that 011 real eltote hot been reported at 'rue morht value. Oeclaration of preparer olher Ihan Ihe penonal represenlative Is
based on olllnFormolion of which preporer has any knowledge.
.~I~N~JU EOf'USON.U'ON!i~(~~fOllfllt~~~lIflUIIN, ADOIIUS Cl12 ViOl1 3tl'OOt DAlE ~
" d_,'.t~U~' 1 ,I. dc' Trngorstot-ln, 1m 2171~2 /. 7/- ':17
f,1I IIU OlH II IH" PlUINI". E ADOIUS l ar {O quare B. DAlE
lIochnnicabur " PA 1705;:; /.,..:; / - 97
.
R!Y,UO) U. 14.1161
~""
fl '
-
COMMONWEALlll OF ,(NN!YlVAHIA
INHERITANCE tAx .(lURN
RUIDlH' OEClOUH
SCHEDULE B J
STOCKS AND BONDS
FILF. NUMBER
21-96-0003-Stnto
J!J9(,-OOC03-County
ESTATE OF
GU:II n. p~:n'rrmnl\\JGll
(All property lolnlly.own.d wllh Right 01 Survlvo..hlp mUll b. dl,clo,.d on Sch.dul. F.)
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1.
United statoo Serioo llll Suvin(';o Bonda no folloHo:
D2510721111l
H31~11516 31111
H34h5161llIll
1131~1~5165HIl
H 3!~1 ~5166111I
H31~1~5167IIH
J.!31~1~51611Jlll
H3hh516CJIIIl
.1,
'I'
500.00
1.000.00
1,000,00
1,000.00
1,000.00
1,000,00
1,000,00
1,000,00
TOTAL (Aho enler on line 2. Recapitulation)
tlf more 'poco is nlOded, insor' oddilionol she.h 01 sam. size.}
s 7,500.00
,-
'1'Ilmll. VIII
.
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
COMMONW[Atllt o. '[UNsnVAt~IA
ItHl[RIlAU([ IA)lIl[lUIl"
Il[SIOWIO[((D[fH
ESTATE OF
Pleale Print or Type
TilE NUMBER 2l_'}6-(j-Ut.iJ-~tuto
1 ')'}(,_OOOOJ-Coullty
AMOUNT
Gf"m n. i'i,i,'l'EIIB;\UGli
DESCRIPTION
ITEM
NUMBER
A. Funeral bpenlell
t.
2.
3.
Halpozzl Funernl llolno, 1,;echanl.csbul'[;, Ponnsyl vania
funeral oxpenses.
TIoverend 11ichael r.. Sclnfriec1, conductinG funol'nl
oOl~vicoa .
GinGrich lielllol'ialn, Let teri.nG cemetory monument.
t.
B. Admlnlltrallve COlt..
2.
Personal Representativo Commissions - No no
Social Securlly Number 01 Personal Represenlallvo:
Year Commissions paid
Allorney Fees J. TIobert Stauffer, F,sq., attorney's fee.
3. Family Exemplion
Claimant
4.
C.
1.
2.
3.
4.
5.
6.
7.
8.
1!/lI.
Rololionlhip
Addross of Cloimonl 01 decedonl's deolh
Slreel Address
Cily
Slale
Zip Code
Probole Fees TIec;ioter of Hills of Cumberland 'County,
Pennsylvania, Lotters Testamentary.
Mllcellaneaul ExpenlO"
Cumberland r.m" Journal, Estate Notice.
The Dentinel, Eotnte Notice.
TIee.tster of \Jills, flUnc; Invontory and Ponnsylvania
inheritance Tux TIotul'n.
TOTAL (Also enler on line 9, Recapitulalion)
(II more Ipace II needed, InlOrl additional ,heet' 01 lame Ilze.)
'I'
"
5,057.50
100.00
60.00
0.00
J ,!~OO. 00
252.00
60.00
59.50
25.00
s
9, Ol!~. 00
Invontory of tho rool oml por90nlll 0911110 01
GLI':U n..-1J~ll'.m']L\\lW]L____H__ _________ dOC0090d
___.___~..._ _____ _. .~._.. ___ ~ - - - 0._-
- --....--.......-.,.""---.,-----<.. ..-.-..--.-.-
7 ~;l,OOO.r)n tlonfJllltnutlon, :';ol'l.o:J !Ill, II. :J,', :'l\vtn~1l Dondu.
1 :i;~OO.OO (hlllo~ntnl\t;t.lJn, :JOl'loll rill, ll. :3, o.Jllvlncu Bomt.
Ho1.10n Danlr, Il. 1\., Accollnl;u LllI fol,1.mm:
(l~)
Checldn~ Account 110. It,0-071-1,1111.
Cort ifi cn to of Dopoolt 110. J"0-:.7 -')20-C.
Certii'icuto of Dopooit 110. 11,O-Or,031t1-G
Certificu to of Dopoult; 110. 11,O-071131-G.
Cortiflcnto of Uopoolt UO. 1110-0020')II-C,
Pile Doni:, 11. A., Accountu uo fol101-/:J:
(5)
(6)
Chocktng Account 110. 5000015757.
CortHicu to of Dopooit 1)0. 2100101.01,,07.
Certificnto of Dopooit 110. 2100101mt09.
Ilotl'a lioaJ. th, Iloal th IIl:;urunco Pl'Cllli UI'J l'ofund.
Sarah A. 'l'odd jjolnorial Homo, Carlislo, Po., l'ofulld
propaid cnro.
of unuuod
Totul............:v 1
'0 R .. -
!::2 0\ ~7 Q~
"- "1:
U"'\
I
CC1
I.L'
,-
0; " "
&;G: r-.
P' c:
~:!
UU
,I.
',I
12,323.79
12,12;) Q!)
11~,01 76
15,00 07
12,16~ 00
COMMONWEALTH Of PENNSYLVANIA \.
COUNTY Of CUMBERLAND J
II:
Flo1~~~~~ :';_~~~~]1 _____ - ------ --"---,~--
being duly 0I'10rn _____ according to low, dopo..' and ,oy' thotDhe _1:1 tho ,ExoOUtI'lx,_-
_,___,________ of tho e,tote 01 Glon n. l'~ol'tonbaur;h
, lot. 01 ______..Q.n.r1,1P.1o, ________, Cumborlond County. Po., d.c....d and thot tho
within II on Invontory modo by __ __J::cl:Jl'::'~~'~ B. St()l~L';~~_ ____, tho soid-C:XOOU\;l'ix
01 tho .ntlre ..toto 01 sold docodont, con,hting of all tho pOllonol pro"drty and ..01 ..lot., uc.pt ..01 ..toto oubld.
th. Commonwealth 01 Ponnlylvonlo, and that tho figures 01'1'0111. each it.m or tho Inventory ..pr..ont it', rolr value
, os 01 the doto or docodont'l dooth.
January
19 CYt'_
Jd~U4~ t~ /d~'1'U
E , m~,"h~_~_ </
.Ieu or . AQflII.~r
')12 Vlo~1 Stroot
!lngor:l \;01-10, !.ID 217l~2
and ,ub,cribod bolore mo,
Add""
Dot. 01 Oeoth
231'd
D.y
OctobOl'
Monlh
1996
Yur
,
I:
INSTRUCTIONS
I. An Inventory must bo fIIod within th..o month, oltor appointment or pOllonol ..pr..entollve.
2. A lupplemont Inventory must bo Iilod within thirty day' 01 dilcovery 01 oddillonol o...b.
3, Addillonol Ih..b may be ottochod 01 to pOllonolty or realty
4. SOl Article IV, Fiduclorl.. Act 011949.
~ ..;
w ..
~ ~
~ ~ ..' ..
w ' , " OJ
a.. (I, u II ....
0 : ' 0) "
0 w C '" ~ ~
'" w 0': ,.1 .. II
t- J: a.. ..J U. 1'1 "' .; 0.. E
Z t- 'rl 0
U. ..J ~ 0 . , a.. .p :s:
w <( IiI 0-1 tI.I
0 '" [" H i- <(
> z f;j <'l c .p
Z 0 c 0 " ~
II> Z h t3
0 '" OJ
Z w <( ... ,0
a.. . ." 0
c
p.~ .. It:
- -.:
,. 0 .. .
"\ '"
r'1 " E ." oW ..,
~I - II 0
.. " if 0
..J U CD
It.
/.,5:/37-'/
COMMON~EALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
c
*
BUREAU OF INDIVIDUAL TAXES
INlIlRJfANC[ UK DIVISION
OCPJ. l806Dl
lURRISaUNG, PA 1111a-0601
MARY E FERTENBAUGH
c/o J ROBERT STAUFFER
MARKET SQUARE BUIDING
MECHANICSBURG PA 17055-0000
INHERITANCE TAX
RECORD ADJUSTMENT
JOINTLY HELD OR TRUST ASSETS
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
SSN/DC
ACN
.n.16h II ,,, III.'"
09-01-1998
FERTENBAUGIt
10-23-1996
21 96-0883
CUMBERLAND
716-09-6361
96160925
A.aunt R..itt.d
GLEN R
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
----------------------------------------------------------------------------------------------------------------
REV-1604 EX AFP (03-97)
.. INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS ..
DATE 09-01-1998
ESTATE OF FERTENBAUGH
GLEN
R DATE OF DEATH 10-23-1996
COUNTY
CUMBERLAND
FILE NO. 21 96-0883
ADJUSTMENT BASED ON:
S.S/D.C. NO. 716-09-6361
ADMINISTRATIVE CORRECTION
JOINT OR TRUST ASSET INFORMATION
ACN
96160925
FINANCIAL INSTITUTION: PNC BANK
ACCOUNT NO. 21001010489
TYPE OF ACCOUNT: () SAVINGS () CHECKING ( ) TRUST (Xl TIME CERTIFICATE
DATE ESTABLISHED 03-01-1989
Account Balance .00 NOTE: TO INSURE PROPER CREDIT TO YOUR
Percent Texable X 0.500 ACCOUNT, SUBMIT THE UPPER PORTION
Amount Subject to Tax .00 OF THIS NOTICE WITH YOUR TAX
Debts and Deductions .00 PAYHENT TO THE REGISTER OF WILLS
Taxable Amount .00 AT THE ADDRESS SHOWN ABOVE.
Tax Rate X .15 MAKE CHECK OR HONEY ORDER PAYABLE
Tax Due .00 TO: "REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+1 AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (- )
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
. IF PAID AFTER THIS DATE. SEE REVERSE FDR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1. NO PAYNENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI,
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.)
.00
.00
.00
PAMMT I
Detach the top portion of this Motlc. and .ub.1t "lth your pay..nt .ad. payable to the nAIle and addr...
prlnt~ on the r.v.r.. side.
-- Hak. check or lIOn8y order payable to: REGISTER OF WILLS, AGENT.
REFUND CeR}: A r.fund of a tax cr.dlt, which wa. not reque.t.d on the Tax R.turn, oay b. reque.ted by co.platlng an
-APPlication for Rafund of P.nn.yIvanla Inh.rltance and E.tata Tax- (R[Y~I313), Application. aro available at
tho Offlc. of tho Reglst.r of Will., any of tho Z3 R.v.nuo DI.trlct Off Ie.. or fro. tho o.part..nt's 2~.hour
an.".rlng ..rvlce nu.ber. for fora. ordering: In P.nn.ylvanla 1~800~36Z~2050, outald. Penn.Ylvanla
and "I thin local Harrlaburg area C7I71 787~8094, TOO. C7171 77Z.ZZSZ (Hearing lopalrod only).
REPLY TO:
Due.tlona r.gardlng .rror. contaln.d on thl. notice should b. addr....d to: PA Dopart..nt of R.venue, Bur.au
of Individual ta..s, ATTH: Po.t A"....ent R.vl.w Unit, n.pt, Z80601, flarrhburg, PA 17128~0601, Phon.
f717} 737.6S0S,
DISCOUHT:
If any tax due I, paid "Ithln thr.. (31 cal.ndar eonth. after tho doc.d.nt', d.ath. a flv. perc.nt (SXI dl.count
of tho tax paid I. allow.d,
PENALTY:
The ISX tax a~.sty non~partlclpatlon ponalty I. coaput.d on the total 0' tho t.x and Int.r..t .......d, and not
paid before January 18, 1996, tho flr.t d.y aft.r the end of tho tax a~.ty period.
INTEREST:
Jnt.re.t I. charg.d beginning with flr.t day of dellnquoncy or nln. C9. .onth. and ono Cl1 day froe the date of
de.th to the data 0' payeont. Taxa. which boca.o dollnquant bafor. January 1, 1982 boar Intor..t at tho rat. of
six f6%1 porc.nt par annu. calculatod at . dally rat. of .000164. All taxe. which boca.o d.llnquent on and aftor
January 1, 1982 will b..r Int.ro.t at a rata which will vary froe calendar yaar to calondar yoar "Ith that rata
announcad by the PA D.partaant of R.venue, Tho appllcabl. Intora.t rata. for 1982 through 1993 .ra:
V.ar Jot.ro.t Rata Dally lntoro.t ractor
Year
Jnt.rast Rata
Dally Jntoro.t Factor
1932 2DX ,OOOS~8 1987 'X .000247
1983 lOX .000438 1938~1991 11% .000301
1934 IIX ,000301 199Z 'X .000247
1935 UX .000356 1991.1994 1X ,000192
1936 lOX ,000274 1995~1993 'X .000247
--Intor..t Is calculated .. follows:
INTEREST = BALANCE or TAX UNPAID X NUNBER or DAYS aELINQUENT X DAILY INTEREST rACTDR
.~Any Notlco I..ued aftor tho ta. bOC08e. doll~nt will rofloct an Intor..t c.lculatlon to flftaon (151 day.
beyond the data of tho ........nt. Jf pay.ont Is .ad. aftor tho Int.r..t coeputatlon data .hown on tho
Notlco, additional int.r.,t .uat bo calculated,
.--
.1'IU10...." ~
". " -. 1I~~*;fl\
COMMONWIAIIH Of PINNSYlVANIA
DIPAUMINI Of REVENUE
IURlAU OP INDIVIDUAL TAXIS
DEP!, 380601
HARRIIIURO, PA 17171,0&01 ,
ICEDENI'S NAME
INHERITANCE TAX
EXPLANATION
OF CHANGES
C lc.",
" J
I<
r ?), /1 \i.
. ..------.-_~ _..1--_____
filE NUMIER
./ " 1(, - (' ',,~ ";
A N
, I (I )' ' J"
,e,... ,(, ), ~
SCHEDULI
ITEM
NO.
EXPLANATION OF CHANGES
I), I J
\1. \' ' l (
;'-\,\
I 1'J 1..ll
'; ,
fv' r;~
TAX EXAMINER:
../' L~_lY.~.L~L________________,
__ PAGE__