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HomeMy WebLinkAbout96-00951 PETITION FOn J>>lmUATl~ '\lId ~nANT OF LKrmus Estate of Odo Jl. 1I0SFEI.Il also known as No. Tu: Itrgislrr of WI.IIs for Ille . V,'wl.m/. COllllly of ._~~:."'r iI,"1 in lhe Social Stl'llrily No. IfHl - n I - "~711 Conllnunwellllh :Jf Prnnsylvania The petillon uf Ihe umlersigned rrspeclfully represenls lhlll: . Your pelitloner(s), who is/lire 18 yellrs uf age ur older Ilnlhe execu~.!W.-. In lhe last will of lhe abuve decedenl. daled -.lli;.I..u.l!.l:.L.!l6 and eodicil(s) daled _' named , 1911!l.- (\Ialc ldrvalll d'CllfIlURIl{CS. c.,. ICllllllclntlulI, lInlh of CACclltor. Clc.) Decctlelll 11'11\ dumiciled al dealh in ClIlllb"r I 01 lid County. Pennsylvania, wilh her last family or pllncipal rrsidenee al -..:Lli~1I1 S t reI' I --llOOlllXo P,I 17'J{,D-Nt':1\, ;-A( (.(1 h'~(' ,.., , 1- lIi!lL atrl't!L, number, Twp. ur Huru.1 Deeedent.lhm 80 )'ears of IIge. died Novl'mhl'r OR ,19Qr, at Co1r1IHI.,J.lJutu.I.to1l, Co1rl/HI,., P^ 17()1'l . Exeepl as fullows, decedenl did nut nlllrry, was nol divurced nnd did not hav.i a child born or adoplctl after execulion of Ihe will offered fur prubale; was nollhe viclim uf R killing o.ild was never adjudiealed Incompelelll: Decedent al uelllh owned I'rOpelly wilh eSlinlllled values as folluws: (If domiciled Inl'a.) All personal properly (If not domlcilrd In I'a.) Personal properly inPennsylvDnia (If not domiciled In I'D.) Personal proprrly In Coullty YDlue of real eSlale III Pennsylvan!a siluDled as follows: _ J See,,"!} Stre<'t, t:,'wIJlJl'g PA S 570,000.00 S S S 'i0,000 nn J72/,O WHEREFORE, pelition':r(s) leSl'eelfully re'lllesl(Jll lhe probale of lhe last will Dnd codlcll(s) prrsenled herewilh Dnd Ihe granl uf lellers_IcsUl=IUll:>l (ICU3I11CIIIIUY; ndllliuhulllJon c.I.a.; administrAtion d.b.n.t.I...) lheron. t ~j "!l,g ;'il J~ di~."j [( BeVh<-I."S:I- .eono1rd A. /lAHNIIAllT 226 ~h:tdv HOo1d Newhun: I'A 172/,0 . . /-) . -r i / . ,(:' y,'. -L- / /l..J~-",-V-- (;I.D. fl~..- --:r.-.Y- Thpron (). MIWI/AHT ]I, 2 ~had y Jload N"wlou,,' ",\. 172M) .,. , OATH 01" PEUSONAL IUWUESENTA:I'IVE COMMONWEALTH OJo'I>ENNSYLVANIA } tlS COUNTY OF CIJN/lF.RI.ANIJ The pelilioner(s) ahoye.named swear(Jr:) ur Dffirm(Jr:) Ihlll Ihe slalemenls In lhe foregoing petition are llue Dnd cnrreCI lu Ihe be,", of lhe knuwledge Rud belief of (1elilion~r(s) and lhal as personal represen. lalive(s) of Ihe abuI'e demlell! pelitiuller(s) "ill \\";111 a, dllllly ~Iminisler lhr eslate Dccordillg 10 law. , Ij /i ~ JI....-:---- Sworn 10 or affirllled ~ud slIb!eriued {' .("(!,"7, "', (.r.J,(.l-,. ",",F - ~ before me Ihis 70TH : day of v l.eou:lI d ,\. IIMmlAHT ~. '/,1'1 toiovl'l~IJPr ,r '9~ 7,' ( , /) . r~ 11f..t".( , 1(J't"/,', "'.'/11 IrO:.'(I,.../-.'-_.- (~~. )A.~, '-)'.-<_ ~ MARY Ie LEWIS Register,' I Tit,."", 11. lI^,lNI/AHT -l:!. ' , No. 21 - 96 - 951 Eshtle of Olin II. 1I0Sf'I'I.1J , Deceased DECnEl~ 01<' ItlWllATE ANI> GRANT OI~ LErrEl{S ;, AND NOW Nnunmlw" ;11 19J1.L. I~ cun51derallon or the petition on the reverse side hereur, satislllctury pruur having beenpre5Cl11ed befure me, IT IS DECREI!D Ihallhe InstrulJ1ent(s) dalell O!:.l&lu'r 06. I 'Jllf, described therein be adlJ1l11~d to IlrubalC and filcd or recurd as Ihe last will ur Odo R. 1I0S~'EJ.D and Lellers Testllmcntnry arc hereby granted to '....nnnrtl ^ HMHJII.\T1'" :1;1,1 '1'11(\1-011 n HhfHJIJ^".,. .' " " FEES f Probate, Lellers, I!tc. ...:..... . $ Short Certlficates( 1) . . . . . . . . .. S Renunclallun ................ $ X-Pages $ 3.00 JCP ~.uu TOTAL - $ 421.BB flied ........ .~QYFM~~~. .~1,. ,l.9.~(i...... (717) 532 9/,76 l'Il0NE 410.00 3.00 ATroRN.8Y (sup. CI. 1.0. No.) 701 Enst King Street Sh 1I'I'(,I1sburg Ph 17257 ADDRESS J . " . . 0(, r ;. c:' Called attorney on 11-22-96. Thi:\ 1:\ 10 (L'llil) Ih.1I I Ill' illftlllll.llillll linl' gl\TIJ 1'1 \HIIlIII~ ,PI'n,! ltlllll ,111 tlli~ill.d l(.ltilll.lll' 01 dt'.lIh dill) filc:.1 willi JIll'.1\ l.ol.lI HqW.Ir.tr. 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" .... C ...~ _" '''' '.!!!.-_ J_ e..'''''............. .C1'..'nOWl.......-;.......__.. .............,.-...- ..... ~ '""~'."~ ...-. .......... I~ , I. ! ......: , '- . 1..'~'~2~~~~;:;/1 ( :.~C-:~~=/-.-~~-- " ...."..' ./.r>' 'r., '.. ..I, ~l.".~.. 'to I. .;").. l,,( l- :~.. /'/'U' ::,~ "'(..' ... ...."'" " " (, ", , t /' .' . I' /.' , ~ ,rI I _ I 11,' If' ," .. ," . " , .' J -:' ~, . 1_ cf .\. 1 ~ ( I.,' .~;-' ,~~._ -: . ._.,I.,}Il.....:..I..' I...'" . ~.~ .1"__ ._lU'IIC.&oI)....,......."""..'. ...--.......-............... .YfIJO(.""""....,,,.-f"'..... ""_....'.~....-~.",...., ....A_......_ '" .~7;;-; ;~~~;'r:,: I ......"..". / / " .... ',0 .' i , ' , i., , 1.jI:"J~ ~.Il,!., !\N,Il_ :r!:~:r.^~!!:~:r I, ado 1\. Hosfeld, of "opl'well Township, Cumhl'rlalHl CounLy, Pennsylvania, declare lhls Lo he my LlIsL 1.111 and 'l'l'sLamenl and revokL' any will or codlcll previously made hy ml'. I'l'EtI 1: 1 dlrc'cL Lhal all my JnsL ,Iehls and fnneral expl'nses, Including my gravemarker and all expenseH of my last I \lness, shnll be pnld from my residuary estate ns soon as praclleable afler my decease as a part of the administrntlon of my eHtate. lTEH II: 1 give, devise nnd bequeath any Items of my personn1 property to my children as they may select such items from among personnl property items owned by me at my death. 1TEH Ill: I give, devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate to my children, Leonard A. Barnhart, Theron O. Barnhart and Barbara L. Hoffman, In equal shares, per stirpes, each share to be adjusted to account for the value of any items of personal property selected pursuant lo ITEH 11. ITEH IV: I direct that 0111 taxes that may be assessed in consequence of my death, of whatever nature and by whatever Jurisdiction Imposed, shall be paid from my residuary estnte as part of the expenses of the administration of my estate. ITEH V: I appoint my HonH, Leonard A. Barnhart and Theron o. Barnhart, Co-Executors of thiH my Last III II and Testament. 1TEH VI: I direct tbat my Co-Executors or their successors shall not be required to give bond for the faithful performance of their duties in any Jurisdiction. g)-ICj J - / BUREAU OF INOIVIOUAL TAXES INHERltANC[ tAx DIVISION D[PJ. :8D601 llAARISlUAG. PA 171098-0&01 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT (;/ ~ r~U\ 1I'.hIlU'" 11l.t11 BARBARA L PO BOX 433 NEWBURG HOFFMAN DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 10-27-97 HOSFELD 1l-OB-96 21 96-0951 CUMBERLAND 96161532 ODO Anount H..Ut.d PA 17240 MAKE CHECK PAYABLE AND REMIT PAYMENT TO. REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 HOTEl To insure proper credit to your account, subnit the upper portion of this forn with your t.x p.ynent. CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ..... iiE'j:if,iij-EX-AFp.-iii3":97y------...uiNif€RiTANC'E-iiiiCsi"iiiEilENi-ii"-iiccouiiiuj;..mummu-m---- ESTATE OF HOSFELD ODD R FILE NO. 21 96-0951 ACN 96161532 DATE 10-27-97 TNIS STATEHENT IS PROVIDED TD ADVISE OF TNE CURRENT STATUS DF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE. APPLICATION OF All PAYHENTS. THE CURRENT BALANCE, AND. IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT, 10-20-97 PRINCIPAL TAX DUE, .00 PAYMENTS (TAX CREDITS), PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 .00 .00 INTEREST AND PEN. TOTAL DUE . IF PAID AFTER THIS DATE. SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. I IF TOTAL DUE IS LESS THAN tl, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REflECTED AS A "CREDIT" (CRI, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) R PAVtENt l O.t.ch th. to. .o,tlon o' thl. Hotlc. ond ....It .Ith you' ..y..nt ..d. ..y..I. to th. n..' .nd .dd'." prlnted on the nver.e side. I' RESIDENt DECEDENt .ak. eh.ek or .oney order payable tos REGISTER OF WILLS, AGENT. If HOH'OES10EHI OECEDEHI .... eh.ek 0' .on.. o,de< ..y..I. to' COHHONWEALTH OF PENNSYLVANIA. OEFUNO (COI, A ,.fund of . t., c,.dlt, which ... not ,.qu..t.d on th. I.. O.tu,n, ..y .. ,.qu..t.d .y eo..I.tln. .n "A..lle.tlon '0' O.fund of ..nn.yl..nl. 'nh.,llone. ond E.t.t. 1.'" <OEV-l.I.'. A..llc.'lon. .,. ...11..1. .. tho Off Ie. d' th. o.ol.t.' D' will.. .ny of tho 2' o...nu. OI.t,le' Offle.. 0' f,o. tho D...,...nt'. 2'-hou' an.werlng ,ervlee ~ber' for for.1 orderlngl In Pennlvlvanla 1.100.36Z-Z050, outllde ~annlYlvanle and within local HarrllbUrg area (717) 717-8D9~, TOOl (717) 77Z-ZZSZ (Hearing I~alrad only). REPLV tDl Du..tlon. ,...,dln. ."0" eont.ln.d on thl. not Ie. .hould .. .Od,....d to' PA O.p.,...nt of o...nu., au'..u of Individual TaMel, ATTNl POlt AI.a...ent Ravlew Unit, Dept. ZID601, Harrl.burg, PA 171ZI-0601, phon. (717) 787-~50S. D[SCOUNT I If ony t., duo I. p.ld within th'.' 1" c.l.nd., .onth. .ft., th. d.c.d.nt', d..th, . fl.. ..,c.nt (S~l dl.eount of the ta. paid 1. allowed. PEHAlT't1 lh. IS~ .., .""'y non-p.,tlclp.tlon p.n.lty I. eo.put.d on th. tot.1 of th. t., .nd Int.,..t .......d, end not peld bafore January la, 1996, tha flr.t day after the end of the taM a.n..ty period. INTERESts Int.,..t I. eh.,..d b.. Inn In. with fl,.t d.y of d.llnqu.ney, 0' nln. (01 .onth. end on. III d.y f,o. tho d.t. of d..th, to tho d.t. of ..y..nt. I.,.. which ..e... d.llnqu.nt b.fo,. J.nu.'y I, loa2 b..' Int.,..t .t tho ,.t. of .1, <'~I p.,c.n' p.' .nnuo c.leul.t.d .t . d.lly ,.t. of .ODDI". All t.... which ..c... d.llnqu.nt on end .ft., Jonu"y I, loa2 will b.., Int.,..t .t . ,.t. which will ..,y "0. e.l.nd., y..' to c.l.nd.' y..' with th.' ,... announced by the PA Depert.ent 0' Ravenue. Th. epplleable intere.t rate. for 198Z through 1997 ares Vear [ntere.t Rate Dally [ntara.t Factor V.ar Internt Rate Dally tntere.t Factor 1'182 ZOX .000541 1961 O~ .00OZlt7 1'16S 16X .0004sa 19Ia.1991 llX .000101 1914 II~ .000lDl 1992 O~ .000Z47 19&5 UX .000156 1993-1994 ]X .00019Z 1'116 lOX .000Z74 1995-1997 O~ .000Z47 .-Internt I. calculated .. follow' I INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS OELINQUENT X DAILY INTEREST FACTOR --Any Hotle. I..u.d .ft., th. t.. b.eo..' d.llnquon' wIll ,.'l.et .n Int.'... e.leul.tlon to flft..n <ISI doy. b'Yond the date of the ........nt. If pay.ent la .ade afler the Intare.t co~l.tlon data .hoWn on the Notle., additional Inter.at .u.t be calculated. 1,5- /11.1 - / COMHONWEALTH OF PENNSYLVANIA 'EP~'TMENT OF REVENUE i~~t1" ~~ fr.?l' . ~...-:. R c' ~ BUREAU OF INDIVIDUAL TAKES lHlllRIIAHC[ UX DIVISIDN OlPI. :aobol 111ARISIUAG. PA 111:a,obDI . .OTICE or INRERITANCE TAK APPI..ISEHENT L ALLDHANCE OR DISALLDHANCE Dr DEDUCTION., AND ASSESSHENT or TAK ON JOINTLY II&LD OR TRUST ASSETS 1I,.n_t 1111. III.". BARBARA L PO BOX 433 NEWBURG HOFFMAN DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY SSN/DC ACN 10-27-97 HOSFELD 1\-08-96 2\ 96-0951 CUMBERLANO 180-0\-9870 96161532 Alllount R_"lt t.d . - - 000 PA 17240 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 ~ R-€v:iS-4S-Eif-AF-p-roif:97i------------------------------------------------------------------------------------ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 10-27-97 ESTATE OF HOSFELD ODD R DATE OF DEATH 11-08-96 COUNTY CUMBERLAND FILE NO. 21 96-0951 TAX RETURN WAS: S.S/D.C. NO. 180-01-9870 ( ) ACCEPTED AS FILED (X) CHANGED SEE JOINT OR TRUST ASSET INFORMATION ACN 96161532 ATTACHED NOTICE FINANCIAL INSTITUTION: MELLON PSFS ACCOUNT NO. 410-070-3455 TYPE OF ACCOUNT: () SAVINGS (Xl CHECKING ( ) TRUST ( ) TIME CERTIFICATE DATE ESTABLISHED 07-24-84 Account Balance Percent Taxable X Amount Subject to Tax Debts and Deductions Taxable Amount Tex Rate X Tax Due .00 0.500 .00 .00 .00 .06 .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT. SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY OROER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE . IF PAID AFTER THIS DATE. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. · I IF TOTAL DUE IS LESS THAH $1. NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS ^ "CREDIT" I CRI. YOU HAY BE DUE A REFUHD. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I .00 .00 .00 .00 DISCOUHTr PENALTY: INTEREST: ........ ..... PURPOSE OF NOTICE I To 'ulflll I~I rlqulrl..nl. 0' S.ctlon ZI40 0' Ih. Inh.rltanCI and [.tal. 'a. Acl. A~t ZI of 1995. (7Z P.S. S.ctlon '140). PAYMENT: D.tach the top portion 0' Ihl. Nollc. and lub.lt wllh your pay'.nt 10 Ih. R.gl.l.r of Will. prlnl.d on Ih. r.v.r.. .Id.. -- Mak. ch.ck or .on.y ord.r payabl. to: RECISt[R OF WIllS. AGENT. REFUND (CR): A r.'und 0' a ta_ cr.dll. which ~a. not r.qu..led on the ta. return, .ay be r.qul.led by co.pl.tlng an -ApPlication 'or R.lund 0' P.nnlYlvanla Inh.rltanc. and E.tall Ta_" (R[Y ::;11. Appllcatlonl arl avellabl. at thl O"lcI 0' t~ Ragl.l.r 0' Will., any 0' the Zl R.vanuI olltrlct Olfl~.' or by calling thl 'plclel Z4-hour an'~lrlng 'IrvlCI nueb.r. 'or lor.. ord.rlng: In Pann'Ylvanla l-aOO-16Z-Z0S0. ~utlld. Plnn,ylvanla and within local Harrl'burg araa (117) 131-3094. TOOl (117) 77Z-ZZ5Z (Hlarlng Iap.lrad Only). OBJECTIONS: Any party In Intlr..t not .atl,'lad ~Ith thl appral.e..nl, allo~anc. or dllallo~anCI 0' daductlon. or a'I.I'..nt 0' ta_ (InclUding dl.count or Int.ra.t) a. .hown on Ihl. Notlc. .ay objlct ~Ithln .I_ty ('D) day. 0' rec.lpt 0' thlt Hotlce by: --wrlttln prota.t to Ih. PA O.part.lnt 0' R.V.nul, Board 0' App.al.. OIPt. Z810ZI, Harrllburg, PA 17IZa-IOZI, OR --alactlng to hava thl ..tt.r d.taraln.d at the audit 0' the account 0' the plr.onal rlpr..entatlva, OR --app..1 to thl Orphan.' Court ADtUN- ISTRATlVE CORRECTIONS: Factual Irror. dl,covlrld on thl. a..e....nt .hould b. addr....d In ~rltlng tOI PA D.part..nt 0' R.v.nu., Buraau 0' Individual Ta..., ATTN: Po.t A'.....ant RIVllw Unit, DEPT. Za0601, Harrl.burg, PA 171Za-0601 Phon. (717) 187-'S05. 5.. page 5 0' the booklet "In.tructlon. lor Inh.rltanc. Ta. Rlturn lor a R..ld.nt D.cldlnt" (REY-ISOI) 'or an ..planallon 0' ad.lnl.lratlvlly corr.ctable Irror.. I' any ta_ dUI I. paid within thr.. (1) calandar .onth. a't.r Ihe decadlnl'. d.alh, a 'Iv. plrClnt (S~) dl.count of the ta_ paid I. allo~.d. Th. 15Z ta_ ..n..ty non-participation Plnally I. COlputed on Ihl tol.1 of the ta. and Inl.r..t .......d. and not p.ld b.for. January la, 1996, the flr.t day a't,r the .nd of the ta. .an..ty p.rIOd. Thl. non-p.rtlclpatlon plnalty I. appeal.bll In the .... lann.r and In Iha the .... tl.. p.rlod a. yoU would app..1 the ta_ and Int.ra.t that h.. ba.n .......d a. Indica led on thl. not Ie.. , . , ~ , Int.r..t II chargad b.glnnlng with 'Ir.t day of d.llnqu.ncy, or nine (9) lonth. and anI (I) d.y 'roe the d.t. 0' d.alh, to thl data of pav.ent. Ta_.. which b.ca.. dlllnquent blforl January I, 198Z be.r Int.ra.t .t the r.t. 0' .1_ (6~) p.rcanl per annUl calculat'd .t a d.lly rat. of .000164. All t._.. Which blca.a d.llnqu.nt on or aft.r Janu.ry I, 198Z ~lll b.ar Int.r..t .t a rata ~hlch will v.ry 'ro. calendar ya.r to cal.nd.r y..r wllh Ih.t ral. announc.d by Ih. PA O.p.rl..nt of Rav.nue. Th. appllc.bll Inlar..t ral.. 'or 1982 through 1997 ar.: V..r Internt Ratl Dilly Intarnt Factor Y..r Internt Rat. Dally Int.r", r.ctor .98Z zn .000541 19a7 .~ .000Z41 1981 16~ .000418 1988-1991 IU .000101 19a4 11% .00DlOI I99Z .% .000l41 1985 U:C .GOOlS6 1'99)-1994 7% .00019Z 1986 10~ .00Ol14 1995-1991 .% .000Z41 - . ulntarnt I. celculal.d .. followll INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTDR .-An~ Notlcl I..ued .'I.r the ta_ b,col" d.llnqu.nt will rafl.ct In Inl.r..1 calculation to fl't.en (IS) days b.yond the d.ta 0' the .....s..nt. I' paYI.nt I. ..d. a'tar the Inl.re.t co.pullllon det. Iho~n on the Notlc., addltlonel Int.rl.t lU.t b. c.lculat'd. f! ...... .. 01:', .,J ,..- \c. '...., ~~ ,,' ',~ ,~ -..j - , " C1 -~ 1'--) ~" ;,.::;. '",.~ ; '-, ~ '.>J .., ... - . --+ '. - . --. .- -- ..... ....'16111""" 1851 05 COMMONWEALTH OF PENNSYLVANIA DlPARTMINT O. RIVINUI OPPICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX '* D NO. AA RECEIVED FROM: & ACN ASSESSMENT r:'I CONTROL IiII NUMBER AMOUNT 96161532 $4B8.4E: LEONARD A BARNHART 226 SHADY RD NEWBURG, PA 17240 ESTATE INFORMATION: t:t FILE NUMBER U 21-1996-09~1 1:1 NAME OF DECEDENT ILAST) I;iI HOSFELD ODD R In DATE OF PAYMENT Iii 01/2'3/97 EJ POS1MARK DATE COUNTY SSN 180-01-9070 (FIRST) (Mil CUMBERLAND DATE OF DEATH 11/08/96 REMARKS LEONARD A BARNHART ETAL REGISTER OF WILLS I \ .' , . ,.../.l I RECEIVED BY ~:''/ I,v.. C, ..::..........-!./ ,~'~.:-v i -/ ~GN'lU~'", ' ". I" , ......' AL...,....." MARV C. LEWIS '....l"',,"~,lw"~;.<.. REGISTER or WILLS I ,./ .488.42 SI< m TOTAL AMOUNT PAID SEAL CHECKll 9'3 - -- - -. - -- - - -_.- -.-- _.. -. .-_.- -.. -....- . - . - . . -- --.-+ ~- -- -- .+-- - -- -.-- .__.~_.. --- ..-.- -- - _. i , - . . " __f -p-""""""- --- _' ---.-- -.--:""...N'e _ _ 1:' - - .- . . - . -'. _.~_. .- ..+. -... .-... ....,.....1'-0'1 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT or REVENUE OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX '*' UNO, AA 185104 RECEIVED FROM: & ACN ASSESSMENT P:' CONTROL IiII NUMBER AMOUNT Q6161'iJl .~'tc:.o~ LEONARD A BARNHART 226 SHADY RD NEWBURG. PA 17240 ESTATE INFORMAlION: I!:t FILE NUMBER Y 21-1996-0951 I!:t NAME OF DECEDENT (LAST) ~ HOSFELD ODD R II DATE OF PAYMENT EJ POSTMARK DAlE COUNTY SSN 180-'01-9870 (FIRST) (Mil CUMBERLAND DAlE OF DEATH m TOTAL AMOUNT PAlO $342.6ll PB REMARKS LEONARD A BARNHART REGISTER OF WI LLS , . _.' (' /. ...,i;" RECEIVED BY /;;'Iio';, / ( ,'j"" ,.J .;,.... ,4 ICiNA-TU f - - .-'- ,I ~. ',- ,. ., I. , MARY C. LE\.jJ S ,.; /.~';,,';/{;1;'';/- REGISTER OF WILLS ' I ~ SEAL CHECK" 092 -.. --. ...-- ._--- --~. ~.- ---'. --- -- -- _.._- ~.--..- . .' --- , -..."..",- . -..-- .. -".-:"'..JllM _ _ r. .,... /5-1'1)' f COMMONWEALTM OF PENNSYLVANIA i' DEPARTMENT OF REVENUE 01'- ~ .". C '~-.., {"'I~/: BUREAU OF INDIVIDUAL TAXES ' ;,i....,'i...., INHERITANCE TAX 'I It...'(. \ 1""LIfIUNcr tAlt DIV1510~ r . ..~~.c . ...1: . Dlf'f. ,'8obOI STATEMENT OF ACCOUNT .1....,~~...,,,.t. ',J., IIAIUHSIlUIIC. PA 1/1;8 DuOI ",... ;'-' . Ilf...:IIII" ':1 HI DATE 12-01-97 ESTATE OF tlOSFElO 000 R DATE OF DEATH 11-08-96 FILE NUMBER 21 96-0951 COUNTY CUMBERLAtIO SALLY J WINOER ESQ ACN 101 701 EKING ST A~ou"t Re"ltt.d , SHIPPENSBURG PA 17257 =- ., MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTEI To insure proper credit to your account. sub.it the upper portion of this form with your tex paynent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE-V:i60-j-EX--AFP--ioji:97i-------...--iNH-ERir-ANCE--fAX--STiifEHEtif-o-F-AC-Couiif--.-..--------------------- ESTATE OF HOSFELD ODD R FILE NO. 21 96-0951 ACN 101 DATE 12-01-97 TNIS STATEHENT IS PROVIDED TO ADVISE DF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SNOWN BELOW IS A SUHHARY OF TNE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS. THE CURRENT BALANCE. AND. IF APPLICABLE. A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 11-24-97 PRINCIPAL TAX DUE: 35.037.20 PAYMENTS (TAX CREOITS): PAYMENT OATE 01-22-97' 01-23-97 08-07-97 ' RECEIPT NUMBER AA1B5104 AA1B5105 AA211616 01 SCOUtlT (+) INTEREST/PEN PAID (-) 18.03 25.71 .00 AMOUtlT PAID 342.64 48B.42 34.164.59 I TOTAL TAX CREDIT BALANCE OF TAX DUEl INTEREST AND PEN. 35.039.39 2.19CR . IF PAID AFTER THIS DATE. SEE REVERSE SIDE FOR CALCULATIDN OF ADDITIONAL INTEREST. I IF TDTAL DUE IS LESS THAN $1. NO PAYHENT IS REQUIRED. IF TDTAL DUE IS REFLECTED AS A "CREDn" (CRI. YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I TOTAL DUE .00 I 2.19CR I " , ~!- PAYH(HT; O,tach thl top portion of this Hotic. and 'ub~lt ~Ith your pny~.nt ~nd. paynbla to th. na~. And addr.'. printed on thl raver.. ,Ida. If RESIDENT DECEDEN' llIa~. chee" or l'Ion.., order pllyabla to: REGISTER OF WILLS, AGENT. If HON-RESIDENT DECEDENT nil'" checl< or fIIon.., ordllr paYllbl8 10: COHHONWEALTH OF PENNSYLVANIA. REFUND fCRI: A r.fund of II ta~ credit. which was not requested on the In_ poturn, nay bu ruque,lad by conpl,tlng an "Application for Rofund of Pannsylvanla Inheritance and [stnla la." IREV-lllll. Applications at. available at thl Offlc8 of the Rlgll'ar of Willi, any of thl ,3 Rlvenue Diltrlct Offlc8' or fron tha Oopnrtl'lont's Z~'hour answlrlng ..rvlcl nueb.r. for for.. ordering: In Plnnsylvanla l-aOD'3bZ-ZO~O, outllde Ponnsylvanla and within local Ilarrhburg ar88 (111) 181'8091" TOO' 11111 l1Z-ZZ~Z IHearlng ."palrod onlyl. REPlV TO: auo.tlons rogardlng .rrors contalnod on this notlc. should bo addross.d to: PA Dopart"ont of Revonu., Buroau of Individual Ta..s. A1TH: Post Ass.s,nont ~evl.w Unit, Dept. :80&01. Harrisburg, PA 11128.0bOI, phon. Oil) lal.-.ljQI!j. DISCOUNT: If any taM d~e Is paid within thr.. 131 calondar eonths aftor the docodont's doath. " flvo perc.nt IS~) discount of tho t~. p~jQ is allowed. PENAL TV: Tho tS% taM a"n.sty non'partlcipatlon penalty Is co"putod on tho total of tho ta~ and intorost alsolsod, and not paid b.foro January 18, 199&, tho first d~y aftor thO ond of tho taM anno,ty porlod. INTEREST: Int.r.st Is char god beginning with first day of delinquency, or nine lql oonthl and on. II) day froo the date of doath, to the date of pay.ont. Ta..s whiCh boca.o d.llnQu.nt bofor. January I, IqaZ boar Interolt at tho rat. of Slk (&%) porcent por annu. catculated at a dally rat. of .DODthl,. All ta..1 which beca.e delinquent on and after January I, 1982 will bear intorest at a rato ~hlch will vary fro. calondar y.ar to calondar year with that rat. announced by the PA Oeparl.ont of Rovenuo. Tho appllcablo Intor.lt rato, for Iq8t through 1991 aro: Vear Int.rest Rat. Dally Intorest Factor Vear Intorost Rftto Dally Int.r'll Faclor 1982 ZO~ .ODOSC,8 1981 9% .000lCol 1983 16:< .000C,S8 1988-1991 II~ .000101 198C, 11~ .000301 IqlJl I)i! .000ZC,1 1985 lliC .oaUlj& 1993-101}1, 1% .00019Z 1986 10iC .DODUC, 1995~1997 9% .DaDlIoI ulnlornt Is calculatod as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR '.Any Notice Issued aft.r the te. bocoeos delinquent will refl.ct an Intorest calculation to flftoon (15) deys beyond Ih. date of tho ftls.,s..nt. If pay"o"t is .ado aftor th. Inter.st CO"Putfttton det. sho~n on tho Notlce, addltlone' Int.rost oust b. calculated. CD..tOHWUl1U Of' PUIdYl VAN IA D(PARTf'{NT Of RtVOU: IURUU Of INDIVIDUAl Tun DlPT. tlD601 tlARtUSIURa, PA t7UI.UOl '* l$fL( :)- J INFORMATION NOTICE AND TAXPAYER RESPONSE C2 ..,.IUIII '''I1-KI FILE NO. Zl 96-0951 ACN 96161531 DATE 12-30-96 TYPE OF ACCOUNT o SAVINGS IXJ CHECrING o TRUST o CERTIF. '(=: 'JI ~ \",J EST. OF ODD HOSFELD S.S. NO. 180-01-9B70 DATE OF DEATH 1l-OB-96 COUNTY CUMBERLAND ~.. ~r 'I(t" REHIT PAYHENT AND FORKS TOI REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 BARBARA L KOfFMAN PO BOX 433' NEWBURG l"", PA 17240 ['~ ~ ~ -, ) . U 1.1 r- .: C HELLON PSFS .1.1C: P"ha. p~~ ttM Depart.ent with the Infor..tlon II.ted below which ha. been uud In ctlculetlng the potential taxc&". Their record. 1~lM.\e that at the death of the above decedent., you ",ere a Joint ownlh/b.na'lclary of thl_ account. If you ,..1 thh Inforutlon h Incorrect, pluu obtain written corrflCtlon frf'. ttM flnMclal In,U1:I1UO'l, attach. copy to Ihh for. fW\d return It to ttM above addn... Thh accOU1t h talllbla In "ccordance with 1M Inharltan.:e Tall' la.'. of the r"....fWW...1th of P~.'WI.ylvenl", Que.tlona .ay be en.wered by calling (111) 111.152/. COHPLETE PART 1 BELOW . . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 4ZZ-701-0867 Data 03-29-80 Edablhhad Account aalMe. Perc.nt T.xabl. AMount Subject to T.x Tax Rat. Pot.ntial Tax Due To In.ure proper credit to your account, two (l) caple. of thl. notlc. ault .ccoapany your paya."t to the Aeahter of WlIlI. Hah check payabla tOI ~egl.ter 0' Will., Agent". PART [!] 12,022.22 50.000 6,011.11 .15 901.67 TAXPAYER RESPONSE , FAILURE TO RESPOND WILL RESULT IN AN OFFICIAL. TAX ASSESSHENT BASED ON THIS NOTICE x NOTE: If tax pay.ent. ara ..de within three (]) aonth. of tha decadent', data of dlath, you ..y deduct a 5~ dl.cOU1t of the t.x due. Any Inheritance tax dua will beco.e delinquent nlna (9) .onth, after the date of death. x [CHECK ] ONE BLOCK ONLY A. c:J The above Infor..tlon and tax due I. correct. 1. You aay choo.. to re.lt payaent to the RIgllter of Will. with two copl" of thl, notice to obtain a discount or avoid Int.ra.t, or you .ay chick box "A" and raturn thl' notlel to the Rlgl.ter of Will. and an official a......ent will be I,.ued by the PA nepart.ent of R.venue. a. c:J The above a..at ha. b.en or will be rlPortad and tax paid with the Penn.ylvanla Inherltancl Tax return to be filed by the decadent" rapre.entatlvl. C. ~ The above Infor.atlon I~ncorrect and/or debt' and deduction. were paid by you. You au.t COllplat. PART l!J and/or PART (!] below. PART ~ If you indicat. a dlff.r.nt~K r.t., pl.... .t.t. your ....l.tion.hip to dee.d.nt: Q.l.. ') ".rJ. ')-' OFFICIAL USE ONLY 0 AAF: PA DEPARTMENT OF, REVENUEnj un JOiHT,TKUSi AC'uUHi~ i -2<;. ro .2., (L1 :L ':l- t-" all, II I'AU 1 2 3 4 5 6 1 8 CLAIMED - TAX RETUiiH - (;OHFUTi,Tiuti LINE 1. Data E.tabll.had 2. Account Balanc. 5. P....c.nt Taxable 4. Amount Subjact to Tax 5. Debt. and Daductions 6. Aaount Taxabl. 7. Tax Rat. a. Tax Due t' ", o II. /1 PART [!J DATE PAID DESCRIPTION AMOUNT PAID PAYEE I I TOTAL tEnte... on Lin. 5 of r.x COMputation) · Under penalti.. of perjury, I declare that the facta I h.ya r.ported above ar. tru., cDrrect and co.pl.t. to the b..t of MY knowladg. and bali.f. '~~frSr:NV.14 ,,- HOME (-;1/7) 762 - ~7/.~ WORK (&,7 ) l~'..1. - ~-7 I~ TELEPH E NUM R GENERAL INFORMATION 1. FAiLURE TO RESPOND WILL RESULT IN AN OFFICIAL TA~ ASSESSMENT .lIh _",'''. Inl....1 ..... on In,,,..lIon .1A*1U~ bv the flMnClI.t InlUtuUon. 2. IriMrltlncl t.. Me..' cMlIncl'*'t nlM IIOnthl .ftl" the IMcMlent" dill of d.,th. S. A Joint KeD"'''' h '...&111 IV," thoUgh ltw dKedenl" "... wu adcMd II' ..Uu of c:onv.nIMlCI. ". 'CCDUn" (lncludlna lho,' held Ht...." hU,bWMt IInd ",Ih) whlth lhe dec-""t put In Jolnl n.... ",!thin OM y..t prior to .ath an full v 'aubl. II ltM,f.r., S. Account. ..t~ll~ Jalnllv b4t~ hutb.nd .nd ",If. .or. th.n on4 y..t prior to d..lh .t. 001 t,.abl.. 6. Account. held by . dec.o.nl Mln ,ruII for" ~thtr or alhar. at' t..MJ1I fully. REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE 1. ILOCI A . If the In'orullon .-MI cOllPUtatlon In the notice It. carre<:l and deduction. at. not baing c1ata.cl, place an ..... In block ...'" of Patt 1 of thl "TIIIP..,.t Rupon.... .ec II on. Sian two copl.. 8nd ,ub,it tMI ",lth your check for the IlIlOU'\t 0' to to the Rqhtar 0' WI1.. 0' the county lndlutad. The PA Deplrt.."t of hvenul ",Ill Isaue an offlcllll ........"t (far. REV.15U EX) UPOn reulpt of the return frOll the Rlaht.r of wUts. 2. BLOCK B . If the ....t .peclfl.d on this not Ie. h.. b..n or will b. report.d and laM p.ld with the Penn.ylvanll Inherltanc' Tax R.turn flllMi by the d.cedent', r.pr..entatlv., plec. an "X" In block "B" of p.rt I of the "lB"ply.r R..pon.... ,ICUon. Sian one copy end r.turn to the PA o.plrt.."t of Rev.l'lUI, Bur..u of Individual TaMl', D.pt 280601, tlarrbbUrg, PA I11ZI-0601 In the env.lope provided. S. BLOCK C . If the notlc. Infor.,tlon I. Incorrlct and/or deduction' .r. bllng cl.leed, chick block "C" and cOlpllt. Plrt. Z end 3 ItCcordllMl to the In.trl~tlon' bilow, Sian two cop I., and .ub.1t th.. with your chick for tht ...ounl of laM pay.bl. to the R.ght.r of Will. of the county IndJc.llMi. The PA D.part..nt of R.v.nu. will Is.u. an offJclal ........nt (for. REV-1541 EX) upon r.c.lpt of the r.turn frOll the R.alst.r of Will.. TAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Ent.r the date the account orlalnallY wa. ..tBblJ.hed or tltl.d In the .anner ...I,tlng at date of d'lth. NOTE: For. deced."t dying aft.r IUIUIZ: ACCOl.W'lt. which the deced.,..t put In Joint np" within on. (1) ye.r of d..th er. t...Bbl. fully.. tran.fer.. However, Inere I. an exclusion not to exc..d t3,000 per trensf.ree r.g.rdJ... of thl value of the acCOl.W'lt or tn. nuab.r of .ccounts held. If . double ..t.rlsk (..) .ppaar. before your flr.t n... In the address portion of this notice, the t3,000 .xclu.lon alr.ady hu blan dedUcted fro. the .ccount balanc. .. reported by the flnancl.1 In.tltutlon. Z. Ent.r the tot.l b.ltne. of the .ccount Includlna Int.r.st accrued to Iht det. of de.th. 3. The percent of the .ccount that I' taxBbI. for .ach survIvor I. d.t.r.lnad .. follow.: A. The p.rcent t....bl. for Joint ....t. e.t.bllshad .or. than on. yaar prior to the d.c.dent's da.th: I DIVIDED IV TOTAL JAJHBEA Of JOINT OWNERS [Keepl.: A Joint a...t r.al.ter.d DIVIDED BY TOTAL HUHBEA Of X loa . PERtENT TAlIABlE SURVIVING JOINT OWNERS In tha na.a of the decedent end two other p.rsons. B. Th. p.rc.nt t...abl. for ....t. cr.al.d within on. y.ar of thl dlcldent', de.th or lC~ount. own.d by the d.c.dent but h.ld In tru.t for another Indlvldual(s) (trust b.n.flclarle.): I DIVIDED BY S (JOINT OWNERS) DIVIDED BY Z (SURVIVORS) . .167 X lOa . 16.7"l (T_XABlE FOR EAtH SURVIVOR) I DIVIDED BY TOTAL HUHBER OF SURVIVING JOINT X 100 - PERCENT U:CABlE OWNERS OR TRUST BENEFICIARIES EMalPl'l Joint account r.alster.d In thl neel of thl dee.dent and two oth.r p.rson. and ..tabllsh.d within on. y..r of d.ath by thl d.c.d.nt. I DIVIDED BY Z (SURVIVORS) - .50 X 100 - 50~ (TAXABLE fOR EACH SURVIVOR) 4. ThI! uount subject to tu (11M it) Is dller.ln.d by eultlplylna the ltecount b.lenc. (lln. Z) by the pltcent t.xabl. (lIne ]). 5. Enter thl total of the d.bt. and d.ductlon. ll.t.d In Part S. b. In. aaotrlt t.xaDJ. tune bl II aat.r.1M1a bY sUbtractlnQ tn. aeon ana a.auction. uln. 21 trOll tn. lIaount .uaj.ct (u 'IX d.inll Of:'. 7. Entar thl approprlat. ta.. rat. Uln. 7) II d.t.r.ln.d b.low. A. for d.t.. of d.ath occurring .ft.r 6/S0/9ft, the ta.. rat.. for Iransf.r. to .pous.. are a. follows: 1. Oat.. of d..th on or aft.r 7/1/'~ and b.fore 1/1'95 the rat. I. 3X. Z. Dati' of d.ath on or aft.r 1/1/95 tr.n.f.r. 10 .pou... will bl taxld at O~ t.x r.t.. Not.s for d.t.. of d.llh prior to 7/1/,,. tran.fa,. 10 SpOUII' Ire taxlbl. .t 6X. I. Trand." to Ilnaal dllcendant. Including father, .other, .on, d....ghttr, grandc.hlldren, son-In-law, daughtlr-In-law, .t.pchlld and th.lr l.sua ar. tax.bl. at .1.. p.rc.nt 16X). t. Tran.f.r. to all oth.r. Including broth.r, .I.ter, uncle, aunt, n'ph.w and nl.c. art t....bl. .t flfl.an plrcent (15~). D. If you change the tax rat., pi.... sp.clf1 your rel.tlonshlp to th. dlctdant In the ara. provldad. I. The aeount of taM due (line I) I. d.tar.lned by ....ltJpJylna the aaount ta.abl. (1In. 6) by the t.x rat. Cline 7). CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowabl. dMit. and deductlon. .rt d.ter.lned a. follCMil': A. You leg.lly .r. r..pon.lbl. for pay.-nt, or thl ..tat. subJ.ct 10 .d.lnl.trallon by . per.onal rtpr.s.ntatlv. I' In,ufflclant to PlY thl dtductlbl. It.... I. You ICtually paid thl dabt. aft.r d..th of the dlcadent and can furnish proof of pay.tnt. C. Debts b.lng clll.tct lUst bI ii_bed fully In Part 3. If addltlonal .pltel I. naaded, us. plain papar I 112" X 11". Proof of p.Y"ftt ..y bI requestld by the PA Depltt...,t of R.var'IUI. TAXPAYER ASSISTANCE IF YOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTACT ANY REGISTER OF WIllS. PA DEPARTMENT OF REVENUE DISTRICT OFFICE OR CALL THE BUREAU OF INDIVIDUAL TAXES, TAXPAYER INQUIRY UNIT IN HARRISBURG AT (717) 787-8327. TDDI (717) 772-2252 (HEARING IMPAIRED ONLY) GENERAL INFORMATION 1. FAILURE TO RESI'OND WILL RESULT IN AN OFFICIAL TAX ASSESSHENT .\lh ...11..010 In'o'''' b....... Inl.,..lIon lua.1UIId by the flMnCllat In.tllutlon. I. lmerlt~. 'Ill bee"" all".."t nlM .nthl ,flu the deCed4ln1"1 data 0' dellh, S. .. Joint Hc~t II Illlllbl. IV.n IhouGh IhII deClldent". n.. wn lMtded .. . ..ttar of con.,lInl.n4:I, ,. Accowth (Includlnt thol' held bet"'"" hu,brfd WId "lfal which the d..:lldent pul In Joint n.... within DMI ."., prior to death .r. lut h t...bl. .1 I,M,f.r,. S. Account. ..tllbll~ Jalntl. bel"'"" hu.~ ~ ..If. ~r. I~ one 'I'" prior 10 death .r. not 'allllbla. .. Account. held by . deCedent -In trult fa'. ~Ihlr or other. ar. ,..~l. fully. REPORTING INSTRUCTIONS - PART 1 - TAXPAYER RESPONSE .. BLOCK A _ If I". (",ar..tlon ..s cOIlPUtaUon In I.,. noUn .r. cornet end dtIduCt Ion. .r. not belna dllHCt, pllu .., "X" In block ,,'" of p.rt 1 of the "'Illp.y,r R..pon.... 'Ietlon. Sign two cop 1,. WId lutMtlt t~ with your check for thl .-aunt 0' till to ,he Reihl" of NlIb a. I". county Indluted. ThI PI Departunt of bY""'" will Itsue WI official ....nNnI (for. R[V~15~' EX) upon rec.lpt of the r.turn fr~ the Ragl.l.t of Will.. Z. alOCK I _ If thl ....t .peclfled on thl. notlc. h.. b.en or will b. r.port.d and lax p.ld with thl Penn,Ylvanla Inherltanc. T.. R.turn flied by thl decedent'. rapr..ant.tlv., plac. an ~X" In block "I" of Part I of lhe "Taxp.yar R..pon..~ .ectlon. Sian one copy and r.turn to the PA Dapart.."t of R.v"""', lur..u of Individual 18..., Dapt 21D601, Ilarrhburg, PA 1712a~D6DI In thlt env.lope provided. S. ILOCK C _ I' the notlc. lnfor.atlon I. Incorr.ct andlor daductlon. ara b.lng cl.l.ed, check block ~C" and caapl.t. Parts 2 and S -.ecnrdlna to tha In.tructlon. balow. Sign two caul.. and .ub.1t tha. with 'lour check for thlt MOUnt 0' t.. peyabla to tha R.qht.r 0' will. 0' lh. county Indlcatad. Tha PA Dap.rtaant of Rav.nue will I..ua an offlcl.l .......ent (for. REV~154a EX) upon rac.Jpt 0' the raturn 'r~ the Ragl.t.r 0' Will.. TAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Entar NOTE I thl dtlta IhI account orlalnellY w.. ..tablllhed or tltlad In tha .ann.r alll.tlna at d.ta 0' d..th. For a decedent dying .,tar lZ/lZ/lZI Account. which the d.c.dent put In joint n.... wlthl~(I) y.ar of d.ath ~ taxabl. fully .. tran.f.r.. Howv.r, thlra I. an ..clu.lon not to .xc..d U,DDD par tran~ raGar~" of ur!cr.-lue 0' the account or the nullbar of accounts held. -, ~ -J ..1: t If a doubla ..t.rl.k (..) app.ar. b,'or. your flr.t n... In the .ddr... portion of thl, no~ic., the 13,DDD ..c~~.l~ alralMiy hu ba'" deductad froa thl account balanc. II r.porhd by the flnancl.l in.tltutlon. ~. Z Z. Ent.r the total b.lene. of the accaunt Including Int.r..t .ccrued to thl d.ta of d..lh. 3. Th. parcent of the account that I' t..abla for ..ch survivor Js dat.ralned .. follow': A. The p.rcant t..abl. for joint a...t. ..tabll.hld .or. than ona y..r prior to tha d,cldant.. d..thl B. The p.rcent ta.ahla for ....t. cra.tad within on. y..r of Iha dacad.nt's daath or account. owned by the decadant but h.ld In tru.t for another IndlvhtuaUs) (tru.t beneflelarluH :V'~ 0 1 DIVIDED BY 3 (JOINT OWNERS) DIVIDED IV Z (SURVIVORS) . .167 X 100 . 16.n (TAXAILE FOR FA'bt-suRYIVOJ TOTAL NUHIER OF SURVIVING JOINT OWNERS In tha n.. 0' thl dac:acMnt and two other p.rson.. DIVIDED IV X 100 . PERCENT T~AllE N VJ :9 ,,' ~.~, TaT AL NUKBER OF JOINT OWNERS E.a~I.: A joint ....t rIDI.tarad 1 DIVIDED IV 1 DIVIDED BV TOTAL NUHIER OF SURYIVINC JOINT OWNERS OR TRUST BENEFICIARIES X 100 . PERCENT TAXABLE E.aapl.1 Joint account ragl.t.rad In tha n.a. 0' the dec.dant and two other p.r.on. and ..tabll.had within ana y..r of daath by the d.cld.nt. I DIVIDED BV 2 (SURVIVORS) . .50 X 100 . 5D~ (TAXAILE FOR EACH SURVIVOR) It. The uount .ubJlct to tax Ulna~) h dat.,_ln..:i by .ultlplylng the acCOl.W'lt balanu Ulna Z) by lhe parcent t...bla Ulna S). S. Entar the tot.1 of tha d~ts and deduction. Ihtad In Part 3. 8. 1M MOllIe ea.eo.a tuna 01 ,. oaeer.IRIO oy .UDtracUlI" tna uaat. anu u.uucuon. ulna :u ftutl tn. _ount .utrJ.CI t~ tI.A d,llttl ..,. 1. Ent.r tha approprlat. tax r.ta (lIne 7) .. det.r.ln.d balow. A. For dat.. 0' daath occurring aftar 6/30/9~, tha tax ral.' for tran.f.r. to .pou.a. ar. .. 'allows: 1. Oat.. of d..th on or .ft.r 7/1/9ft and bafor. 1/1/95 the rata I. S~. Z. Dal.. of d.ath on or .,t.r 1/1/9S tran,'ar. to .pou..' wJll b. t...d at D~ t.x rat.. Not.1 For data. 0' d.ath prior 10 1/1/9~ tran.f.r. to .pou.a. ar. t..abl. at 6~. a. Tran.f.r. to llne.l dascendant. Including fath.r, .oth.r, .on, daught.r, grandchildren, .on~ln~lew, daught.r.ln.I..., .tlpchlld and th.lr Is.u. .ra ta..ble at .Ix p.rcant (6~L C. Tran.f.rs to .11 oth.r. Including broth.r, .I.t.r, uncia, aunt, nlph.w and nlac. .r. ta.abl. .t flfta.,.. p.rcant (15~). D. If you changa the t.x rata, pl.... .paclfY your r.latlon.hlp to tha dac.danl In the .r.. provided. I. The ~t 0' tax due Ulna I) Is dat.r.lnad by .ultlplylng tha ..aunt t..abla Cline 6) by thl t.. r.ta (line 1), CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowabl. dabt. and deduCtion. .ra dal.ralned .. follow.1 A. Vou l.gally an rupon.lbla 'or p.,.."t, or thl utata .ubjact to act.lnhtntlon by . parson. I repra.entatlv. h In."fflcl.,..t to pay the deductlbla It.... I. Vou actually paid the d.bt. .ft.r daath 0' the deced.,..t and can 'urn Ish proo' of payaant. C. Debt, baing cl.l.ad .u.t be It.alzad fully In Part S. If additional .pac. I. needed, u.. plain paper a 1/2" . 11". Proo' 0' payeaRt .ay be raq"utad by the PA Dap.rtnnt of R.venue. TAXPAYER ASSISTANCE IF YOU NEED FURTHER INFORHATION OR ASSISTANCE, CONTACT ANY REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE OR CALL THE BUREAU OF INDIVIDUAL TAXES, TAXPAVER INQUIRV UNIT IN HARRISBURG AT, (717) 787-8327. TDD' (717) 772-2252 (HEARING IHPAIRED ONLY) -.- J ..' . . ... Sllr.! F.-LlF'E 111.'''1 O~. 'lIW.\' " 1/ (a) 0<10 R. Jlusfcld , of (b) 1'. O. flux 433, Newburg, I'A hereby tranBfer to CXM1::JNWEI\I.:m NI\'l'Iot-W.. BI\NJ< as trustee the property described in the annexed schedule to be held rn TRlJsr aD follows: I. Lifetime Trust: D.lrirq my li!etirnB my trustee shall invest ard manage the property as a separate tn1St, ard rnaka distriOOtions as follows: A. Pavrnents: As much, even if all, of the net inoane ard principal as I may fran tirnB to time direct in writirq shall be paid either to me or as I may specifyl B. Balance: Mi rernainin;J net incare shall fran time to time be aCCLDTUlated ard added to principall hC1w'eVer/ c. Di""hilitv: If I a'1\, in my trustee's opinion, disabled by ac1vancecl age, illness or other cause, as much of the net inc:x:rne ard principal as my trustee may from tirnB to tirnB think desirable for my or my dependent's welfare, canfort, support or errergency needs shall be paid to either of us or applied directly for those purposes. II. DIsrr><tition at ~th: Upon my death my trustee shall pay the then-rernainin;J principal ard any un:Ustributed net incanB to certain beneficiaries I name a supplemental beneficiary schedule. If that schedule is not accepted by my trustee or if the schedule is not in existence at my death the principal ard income shall be paid to or in trust for such ona or more persons or organizations on such terns as I may appoint by a will specifically referrirq to this po.ver of appointment or, in default of appointment or insofar as it is not effective, to my personal representative for distriOOtion as part of my estate. III. Riahts Res~1"\1M: I reserve the followirq rights, each of which may be exercised whenever ard as often as I may wish: A. To Add: '!he right to add to this trust with assets acceptable to my trustee: ard B. To Revoke: '!he right by an inst.roment in writirq - other than a will - to revoke or amerrl this deed ard the trust hereunder in part or in whole. However, aJrel"dments must be approved by my trustee , 'IV. Manac-."'Ilt Provisions: I authorize my trustee: A. RetainlInvest: To retain and to invest in all forns of real and personal property, inc1udirq COIm'On trust funds, mutual funds ard money market deposit accounts operated or offered by my col-porate trustee or any affiliate of it, regardless of any limitations btposed by law on investments by trustees, or any principlB of law concemirq investment diversification: B. Corra:lromise: To COI1llromise claim.. ard to aban:Ion property which, in my trustee's opinion, has little or no valuel '. . ~, . ",,'" ,;. :';:~'i!/ ',;.' , C. 1loIT'C1W: '1'0 boIT'C1W from anyone, oven 1C the larder is a trustee heraW'der, an:! to pledge propetty as scc."urity for repaymont of the furds bo~1 D, SaUl! ""50: To sell at public or private sale, to exchan;re or to lease for any period of tiJoo, any real or personal property, an:l to give options for sales or leasesl E. caoital O1anaes: To join in any rrerger, reorganization, votirq- trust plan or other concerted action of security holders, an:l to delegate discretionary duties with respect theretol F. Allocate: To allocate any property received or charge incurred to principal or income or partly to eaell, without regard to any law def.inirq principal an:! incomel an:! G. Distribute: To distribute in cash or in kin:l. '1l1ese pc:MerS shall extard to all property at any tiJoo held by my trustee an:l shall continue in full force until the actual distribution of all suell property. All pcl\oIers, authorities, an:! discretion granted by this deed shall be in addition to those granted by law an:! shall be exercisable without court authorization. V. n... EllSation: My corporate trustee shall receive CCIlpIll'lSation in 8CXlOrdance with its stardarcl schedule of fees in effect while its services are perfoxmecl. VI. Slh"" an:l Gavemin:t 1iIw: '1l1e situs of this deed shall be in Pennsylvania, an:! all questions as to the validity or effect of this deed or the administration of the trust hereurder shall be governed by the law of Pennsylvania. Executed July 15 91 ,19_, (a) .' (tJ",t,c I? /~ (SFAL) Odo R. Jlosfcld WitnesotlSl d7n~ ~~ 2 '. '. . SatEWLE Il.EFERRED TO nt 'lllE 1INNEXED DEED OF 'l'RUST " , 19..2.!. Dated .July 15 (Il) FraIl ado R. 1I0sfeld , '1'I:\IStOr To ~ NATIONAL B1INl<, TrUBtee $50,000 cash Securities as follows: '. . . ,.' 2Pl43 4 '. . J .') /'1,'), j ,''''''''''''''''1 ~ '~I 'I \ INHEHIIANCE TAX HETURN ~~ ~i",;!' I RESIDENT DECEDENT ''''''''''''''0''''0' ""mOl""" I (TO DE FILED IN DUPLICATE ,.....,",..., '" ..',,,,, WITIt REGISTER OF WILLS) _1~~.IJJ!~ ~~~!!H.~~)~.. . _' .. l . "n~_ftiWf1iitT:laTr.AT."b..iiOl'iiTtJilliiil !i .. n l:l ~ r- ot l:SQj~ !:!~~ u..... ..'" .. 0( I ~~ ell .. C- 10lDAlnOl DlA1H AtTll12/31191 CHIClC.HIU If A S'OUSAL 0 ,0VllrY ellDIT II el'IMID 1IL1 HUMIlI ~ I 'lh COUNty COUI ~!d ... , -~~i'l ADOlln O'l',1 NUMIU - \, R.ol h.o,.\S,h.dvl. Al I 1\ ~l.O.!llL.lill.- 2, Slu,,~' and SonJI (Sc.hcJ\lID B) ( 21 5(13 L177 .6/. -0- 3. C101.11 tleld Slo,I../POffntnhip Inl.,,,1 ISth.d"le q I J) --- .t. Morlgcs., Dfld Nol.' RDt.i"oLI. (S(hodula 0) , ,41 -0- S. Cosh\ Bonk Oapodl' & Mi".lIon,oul '."01\01 Propo,tyt 5) 2 ,803.60 (s",.dvl. EI 6, Jo;n'ly a_o.d p,oPII'y (S,h,dule II I bl ~79. 99 7. T,onlfon (S,h,dul, GIIS,h,dul.l) I 71 ' -0- 8. 10101 Gron An.1S (rotellin.. 1.71 q. r"nwlul (a~.",.,. AJminilhuli... Cuah. MiataUaocOwi (f)) 52,1.06. J 1 hp,nll' \S,h,dul. 111 10. Cebll, Marlsaue liobil;till. lilna 15ch,dlll. I) 11. Tolal D.duclions (Iotollin.. 9 & 10) \2. Nel Val",. 01 Eliot. (Iin. a nlinullin. 11) 13. Choriroblc ond Governm.ntal Boqutlll ISchodtJI. J) ~'I Value $",bjIC1 to TOM; 'lin. 12 minul lin. 1 J) 15. Amount 0' lint U toxobl. at 6'9 folO Ilnd",do ,.olu., 'rom Sdlodul. K or $thod",l. M 1 16, Amo'llf'll 0' lino U IOAoblo 01 15% foil (Incl",dt ,.ol",,,lrom Sth.d",l. K or 5th.dill, M,) 17. P,inc.ipallQII. du. (AJd hJA Ifom lino 15 and ho", line 16) 18. Crcdlll Spoulol PO'l'crty Crodil Prior Poymonh Oil taunt . R11 .06. 41..5.'L- 19. IIlino 18 il groaltr lhon lint 17, .nhtr Ihs diff,renc. on lill. 19. lhil iltho OVERPAYMENT. BOIIII~"'''..I._I&'7'll.'llcal;l'llr~'lli[,...r'''tIT':T':~.'''lrl.'l'I"'I.:l1.Ii~ 20. If lin. 17 h g..al., Ihon lint 18, .nl.r Iho diHe,,"" 0" Iln. 20. Thil is Ih. TAX DUE. A. Ento' tho into rest on Iho bolan" duo on line 20A. B. Enl.r Ih.lolal of lin. 20 ond 20A on tin. 20& lh:, i,the BALANCE DUE. Moh Chede Payable to: Reghl~!~~_ Willt.! A~~.nl . It-... DE SUR! TO ANSWER All QUUTIONS ON REVERSE SIDE AND TO R CHECK MA1H' :::'l.~j.l:;" ..- -': u.d., PlOD";" 0 p"i",y.1 .. '" I 01 I he" "0"';" 'h;. ",,,n. iodudiog 0<<0"'po";'9 .<h,dvl.. ond "ol.m,oll. o.d 10 ,h. b,,' 01 my Iuoo_I,dg. ond b.U.f, il is Irv" COlfnt Clnd clImpl,lo, I ".dor. Ihol 011 ,tol ulola hot blt_n r.porl,d 01 "l,Ie rnur~c:1 volvO. D.doroliotl 0' p,eporer olher thqtllhe p.rsonal r,p'"01\IOli~. it baud on ull infor",oliol1 0' ...~i,h p.cportt hOI on ~no....I.:I e. . , u' 'N '''". ",... u. 00."1' I .'1f~ /"J ,Ct I~ it,->"fRv'-"*l' {'J.5/1,"'q;6. ~<;, I /), A''!!:h{7-j}( ]; 6.: f'?- "lU/O 11 rliT... 'R .~m-.l1iv AODIIt ~ ') ~-r ... ~j -'. ,;' 1/ I /j bAll . 3"J-...,/t . J]a..._.'l~v.rt!.."(!ft.!:<----- .r~/C.'/17 ;0JL'Lr/ J 6U ,;,J-,- 701 [- j!-<~;~} 0 h ,j\J1l.~ick"~ ;/~ 3/ ~ !'f7 1I0SFF\.Il. Od" It. 'I 1'",:1 S""O'"! Stn,,,t RWAfirlui,lfliiJa.it{f---- --'IIi.h <.rro,.,tH-- - \fl"lf or 'ljTlt--~- t-;l'wllll rg 1'^ 17 '2./, () IHll _ 01 _ "H711 II / H / 'Ih 7 / :'l / Ih,.... Cumb",.I",ul ---~---_..-~._"----. --... .-- +- ------ rn I. Oliginol R.I""n Ll '} SUJ'lf'lI,",e.,tol Relurn n .to. 'l.I,ur. Inl."II Cal"p'omit. (lor dOlu of dOOlh afler 12.12.82) 06. O.,.d."t Di.d frulal. [\1 I. U,ctJenl Moitlloinod a li-,ing Trull IAlloch copy 01 Will) (Allt,Uh (a 01 Iruil) ALL CO'~ISPONDIHCI AND cOIlPiiilii1iArnXimo~M~t10" 3" A OM'~ o 3. Romaindor R.,,,,rn I'.' doll. 01 d,olh p,iorlo 12.13.82} lJ 5 hd"ol h'ol. To. blur" R.q",lrtd ..!. e, To,ol Numb.. of Sol. D.p..;' Iou. o ~. llmi,.d f Ilote \.D..' DIRf.'nO.10.~J;;1:t~'~\'d"~,'; MAlliN" ) Solly J. WInder, FHq. II1VttOlllUUM1U 701 E;tHL KIng Sit I PI"'nHb",.g ~lrt'l't I'^ 17257 'i12 - 91,7(, 7- o :i ... '" l- ll: :s w '" I BI 617,761.21 1,401.62 (\01 (11) 1121 (131 (Ill _n_ 5R3, 953.28 35.037.20 53.R07.95 583,953.28, (151 ?R3, 951.-:m-- )C .06.. (Ibl___- )( .15. -,0- g !i ~ ~ a u )( 0( I- (\71 35 .017. 20 Inl.,.11 R72.61 -0- (I a) (191 (20) 120Al (20&) .. 11,,1611.50 1.,\:;'1' \111.1. ,\tIP '11::I,\:!l'll'l' I. Odn U. 1I11!.!"l' 1.1, III II"PI""I'11 "l"f\\;II';" 1 (1 , ClIII11"'II:lIId CtllIlIly, "('IIII::\"I\';lIIln. tlccJnl'l~ lIdu tu lit' Ill)' 1.11:;1 h'ill illld TI'!iI.H'll'lIl 0JI1t! If'Vtl~.l1 :IIIY wltl or ('odl('IJ prevIously iliad.. hy III". J'l'EtI I: dln'l'l lhHt :111 IllY .1w;1 d,.hl!1 il1ld ftllWrill PXI'r.'IIBCR. Il1ctlldJnn my grilvcmarkcr lllld nil l'XI't'IHH'B (If Ill)' 1:I'il 1IIIWH!1, Rlmtl II(' pnld fruln lilY resiuuary cslnle :In BUIIIl HS prnet ft':l1dp ilrll.'!" Ill}' t!ee(':u;p :1H .1 I'nrt or tlw administraLloll of my ('llLaL... l'l'EN I I: I 1\ I v... ,It.v I m' ",,,I 111''1111';11 h "")' 1 ll.'IIIH of my 1''' rllOlln I prop"rty to my children na lIu.y m:ty (wlpet Hlll'h II"IIIH from .1IlIong I'prnonnl properly 1.tem" I ITEH Ill: d('ath. I I glv(', d('vlne .111,1 1",'1 ,,('a I hall tll(, rest, rt'Hldue nlld r('malnder oWlled by me at my of my estate of whnt('vel' nntUrl' ill "I I'hel"('\'I'" llltllatt' to my children, J.eollnrcI A. Barnhart, Theroll O. flnrnhart ",,,I flarhara I.. III1f[mall, in (,'/lwl share6, per stirpes, cneh share lo be fulJuSll'd to nt'('Olllll for lhe vnlue of nny J tctnH of personal property selected pursu:IlIL to ITEfl I J. ITEH IV: I direct IhaL :11.1 1:"'("" 110;,1 IIIny he a6senned In cnnnellucnre or my death, of whatever nllLur" ","I hy I'1",ll'v"r jll.-lndl,cl.lnll Imposed, nhaJJ. be paid frum my resIduary enLall' liS l'.1rl "r the eX!'l'llse" of Lhc aumlnlstrntion of my cstnte. l'l'EH V: 1 appoint lilY HUll". I.l'0I1.1...1 ^. IInrnh.1rt nlld Theron O. IInl'llh.1rt, Co-Executors of thl6 my I.l1llt \~lll IIlId Tl'nl'"I1I'Ill. lTEH VI: I direct I:hllt lilY Co-EX('l'IIL"rn 0" LhL'II" flucceSHUl"[l shllll not be required to give hond fl1r th" 1"1I11hl..1 1'1'1.r"I"IIIIIU"" or Lh"II' dulles in nllY jurisdictiun. , ""' IN \~l'l'm'::;:l \~IlI.I:Lnl', 111\'11'1111111 !..'l lIl'. llilllllllld :;I'al III thl!II1l~' l.a~lt \~III ,,11,1 'I',."l,,,,,,,,,t. \,',Ilt"" "" ,,",' ,1\0"'1 ,,' 1''1'''' ,I.,t"oI thl" (. d;IV of lklotH'!". IlJr,h. ( , /rl ,II ~ .If i;, ,j I:_(~( , lhl.. H. 1I""r,.loI .. U:I:^I.) The precedIng lUBlnlllll'lll, C'1l1l!lIHllllg III thin :\11ft Itlll' olin')" typl't.trltlc'" pnll". "lIch 101,,111.11'1,.01 hI' lh,' ,,11',11:11."'" "I' th,' 'I','ll1nlrlX. 11th, H. IInd,.I,I. wan on thu L1ny iHul tlnlP 1111'1'('01 nl".lH.t1. p"hll!."!'11 ;II1t1 <<1('1'1;11"1.(1 hy (1110 H. Ilpnrl'lll. the 'l'cAlnlrlx lwn.lll 11;\1111''', ;1~: ;tIltl fill' bl'" l:a~;t \~I' 1, In tht' pn-'nC'tH'p llf un. who, nt h!,1" H''illenl, III h,'1 1'....''''11''... 111I,1 III II.., 1'1""""11'''' "I' ""d. oLhel". hnve sulJHcrlbcd our nmnen ;JH wtltll'SHl'H 11'.'1('10. ~/t.__jJ.jJ(LILL., __' _.,..f""loIllIg "I,~_11f!.lUU('1J2e-,_J]4 -----' ;;) r:.>t.'l:'!::. _.1'!:-~-C~Q.:E,. n'n 1,11,11'. "1__'{\!-:':."-~'!.2M-~- P _4:..------- COHHONlmALTII OF I'I';NNSYI.VANIA: 55 COUNTY OF CUHIIEHLANIl II". 0010 R. 1I01lr"J 01, ___l3e.1!L.-~f/'i~II~ ,..,.-.-- ..--,. nil" J.;/I,,_i1d~~lliI- , the 'fl'ntntrlx mill l11f' \Jttlll'pnf'H, reHpcl'llveJy, whuRe names ure. ~-u to--il;;;' nLuII:I..." or r..r"l\oll1l\ 111"11"111111'111, 11l'111!: flrHl dilly ",wrn, dll h"r!" by u"elnrl' III Lhe 11II""l'nlgl1"" lIo1hol'lly Ihlll th,' 'I',,"llltl"lx HII\I1('" nl1,l ",<<,ruted the il1strumel1l ns hel" 1.,wL III II III1lI '1'",,1111111'111 nil" LhllL she nll\n!''' wlJlII1I\ly (or willil1gly uirecte" 'lIlullll'l" l'"nll111 I" nll\11 ror hl'l") , al1d lhnt she e,(<'ruted it nil h"r rre" ,,"d vulul1lary lid rOI" Ih" l'"l1'o""s th['\'ell1 eXl'renseu, nl1d I.hnl each o( the wlLl1es"es, lu I.h" 1'1""""""1' ,111,1 III.nrll1l\ ur Lhe TenlnLrlx, slgl1ed the will "H wltucnllen m,,1 Ihat III th" 1..,,,1 or lIur knnwle"r.l', the Testnlrlx was nl thnt lime cll',hll"'11 yl.'IIn; nl' 111,11'1". ..r HII.III" mlu" :11,,1 1I1"ler u" rlll1slrnll1L or unuue .InClucl1cl'. _ ()(fq_!~?~__Lt~:~f::.~i-_.-- Lltlll II. lIuII reI" J~c/.)" ,.l)peuUJ __.______ --- --.---1 to ..Kv- Me ~_'~l'_ ~' ...-.--- .-.-.- ----------.--.---- Subscribeu. sworn Lll m"l nd,uuwll',II\,,,1 by Duo Il. lIos(e1u, the 'I'csllll1"l" :11,,1 sworn to beror" me by lJ.LIL'-..'.?p!.bf---..- anu J~hl\ Iltel'C<Cb j',. ,_._.0." witnesBes. this -1_ dllY 01 Octllbl'r, 1')1\(,. J. ,:JC\..-'-----,.----- Notnry Publlc Hy commf slol1 expires April If;, l'l'lll Shipl'ensbuq\ Township Cumberland County -2- \ rARCEL NO," \ JI/:(iINNINc,' althc COlnCI or Secollll SlIcclallll Ihc ahovc-mcnlioncdallcy. along saill \ "~""d ",,~, ~,."" y_ n" "" "" ,,, ",,' "n", """ '" n" "''' I Y "I All"" (l """'1'," """ ' alung samc 101 onc hnlllhl'll sixly (11I1I) lel'llII all allc\'. Ihenec alllllg said allcy scvcllly-livc (75) I (ccltu nnallcy.lhcncc ailing said allc~' onc 1lIlIl<hl'll sixlY (lhO) Icetlo Ihc placc IIE(;INNIN(; I J.(}Tsituatc UII Scculld SlIeel ill Newhlllg Ihnuugh desclihed as rulluws 011 the Suulh, \ twcnty-livc (25) reel on Secund SlIcel. On Ihc Wcsl one hundrcd sixty (luO) Icct alunl,\ thc ahuvc namcd Lot Nu. 2. III I\nallcy.lhcncc l'.astlIVcn1y-livc (25) fccttu anallcy. ,hcncc Sonth unc hundrcd sixly (160) Icctalonl,\ said allcy 'othc placc IlfllEGINNING, fARCEL,NO..J: Jl/UN(i thc samc plopcllY which Alhcll () Shoap. willowcr amlsinl,\lc man. by dccd datcd Nuvembcr 1_\. 1<177. amllccolllcd inthc IlecllIllcr ofllccds olliec inamllhr Cumhcilaml County. pcnnsylvania. inllccd Boo\; N. Vohnne 27. Pagc 5%. l,\Hmled amI convcyed to Odu Romainc 1I0sfcld ami Juhnlt Ilosleld. hcr hushand John It Ilosleld dicd AllIil 25. 1985. thcrcby vcsting fcc simplc tillc of said rcal cstalC in his smviving spunsc. Odu Romainc Ilusl"cld. who is onc and thc samc as Odo It Iloslcld. dcccdcnt hcrein, IN WITNESS JI'/Ili/WOF. saill (ili1l1tlllS havc hcrcnnlo sclthcir hands ami scalsthc day and ycar lirst abovc wlittcn, Signcd, scalcd and dclivcrcd in thc prcscncc of us: ES'Iil'1'l: OfOlJO,R. I10SEI:I.I1. dcccascd -"'---..-.'-.'.-.' M: ~~W ....:ONAlW ,\. IIAltNIIAltT, E~ccnlnr -------......--...-- .. II\': _ (Sl~^") TIIEIlON O. IIAIlN\lAltT. Excculnr ; \ I I \ \ \ \ , \ \ St:TI'(.J-:~n:NT ST A n:~n:NT \, Sally J, Winder Selllemenl Slalemem II, LOAN n'I'E Our File LENDER: OIlRS'J'O\YN DANK ,~, This form is fi"ni,hed 10 sive you a 'Ialemenl of aClual selllement co.ls, Amounls paid 10 and by the ..lIlemenl Isent arc shown, Ilem.lllllked P,o.c, wcre paid oulside c10sins and arc nol included in tOlals. /). NAME OF DORROWER: KEITII A. DARNIIART Ind TRICrA S. DARNIIART E NAMl: OF SELl.HR: E,'"te of 0110 II. 1I0St'EI.I) SUMMARY OF nORROWER'S TRANSACTION .,X). GROSS AMOUNT DUE FROM 1I0RROWER: :111. Conlllcl..les price $ 57.000.00 ,02 Personalpropeny $ uJ, SClllcmenl chlIScs 10 b,wr (linc 1400) $ ,,,.J. PlY oO'li"l mlS loan $ ,uS, Pay otTinsl.llmelltloan $ Idjuslmcnu for itenu paid by .eller in advance 106, Cityltown laxe"o I2IJ1/96 $ : 07. Counly loxe.to $ ,08. $ 09, Schoollo,es to 06/30/97 S 171.31 10. ,II. Payoff in'lallmenlloan 12, 20, Gro.. Amollnl Due From IIrwr, $ 59,415.3 I uo, AMOUNTS PAil> ny OR IN IIEIIALF OF nRWR: Ill. Deposit or earnest money $ 10,00 02, Prineipalamount of new loan $ 59.600.00 03. Existinsloans(s) laken subjeclto :04, :05. '06, :07. :08, '09, Idjustmcnls for items unpaid by sener : 10, City/lown lax.. 01/01/97 to 02128/97 S 16,37 510. Cily/lown taxe. 10 01/01/9710 02128/97 $ : II. County laxe. to 5 II. Counly laxes $ 12, A...umenu to 512, A.....menu 10 '13. Schooltaxe..o S 513, School Taxes 10 06/30/97 :14, 514, Final Sewernill 15, 5 I 5. Final Wal.r Dill ;16, 516,FinalUlilitynill ,17, S 517, Escrow for heating repairs '18. ClosinsCosls $ 518, C1osinsCosts 19, 519, 20, TOTAI.I'A([) IIY/FOR nRWR $ 59.626,37 520. TOTAL IIEDUCTION AMT DUE S S9b J7 00. CASII AT SETfI.l:MENT FROMlro 1I0llROWEII 600, CASII AT SETfLEMENT TO/FROM SELLER 01. Grossamollnt due from bmor, S 59.415,3 I 6Ul. Gruss omoum duelu seller S 57.1713 1 02, Less amounU pd by/for bnvr. S 59.62637 602, Less reduclions in anlOunl $ 596.37 U3,CASII(_FROM)LXJOIIIRWR. S 211.06603,CASIILX_TO)LFROM)SLR S 56.57494 lECEIVED COMPLETED COPY OF SALLY J, WINDER SETfLEMENT FORM for my/our record. Elllte ofOno R. IIO.'SEI.D. deceased " pROPEIITY ADDRESS Newbu... Dorouab Cumberland Counly, PA G. SETfI.EMENT AGENT & II SETfLliMENT IIAm' SE'n'LEMENT ADURESS: 01128197 Sally J, Winder, Esquire 701 E, King St, Shippensburg, PA 17257 '-~siiMr;jARY or-silliER'S TRANSACi'IO'N 400, GROSS AMOUNT DUE TO SELLER: 401. Conlracl sale. price S 57.000,00 402, Personal propony S 2,2HOO 40J. 404, 405, S S 406. Cily/town lax to 12131196 407. COllnly laxes to 408, Asse..ment. 10 409, School taxes to 06/30/97 410, 411, 412. 420, Gross AmuunlUueTo Sener $ 57.171.31 500, REDUCTIONS IN AMOUNT DUE TO SELLER: 50 I. Exee.. deposil S 10.00 502, Selllemol charses to sir $ 570,00 503, Existing loan(.) taken subject to 504, PayolT ISI mon, loan 50S, PayoIT2nd mono loan 506, 507, Paymenl toward closing COSIS 508, 509. S .EITII A. D.\RNIIART LEONARD A. DARNIIART. EIf.ulor ,RICIA S. BARNHART T1IERON O. nARNIIART S S $ 171.31 S S $ $ $ S $ S $ 16.37 K, SETTLEMENT CHARGES 700, TOTAl. SA\.ES/IIROKER'S COMMISSION b..ed on priceS @ ~. llIVISION OF COMMISSION (UNE 700) AS I'OLLOWS: 7DI. $ 701, S 70l. Commissioo paid al SeUlemenl 704 SOO, ITEMS PAY ABLE IN CONNECTION WITII LOAN SOl, I.oao Origination fee (1\.) 10 ORRSTOWN IIANK 801, I.oan Discount ".10 803. Appraisal Fcc to ORRSTOWN IIANK ($150.00) 804. Credil Reporlto 80S, Uoder writiog fee 10 SOb. Applicalioo Fe. 10 ORRSTOWN IIANK ($125.00) 807, Documcnl Preparalioo FcelO ORRSTOWN IIANK 808. Tax Service Fee 10 809. Flood Cerlincalion 10 810, Overnisht Delivery to SII. Application Fcc 10 900, ITEMS REQUIRED IIY I.ENDER TO IIEI'AID IN ADVANCE 90 I.Inleresl from to @ $ /day 902. MOrlsage In.urance Premium for monlh. lu 903. Hazard Insurance Prenlium for years 10 904, 90S, 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard insurance monlh. @ $ per monlh 1002, Morlgase insurance monlhs @$ per monlh 1001 City properly laxes months @ $ per month I()().\. Counly properly taxes monlhs@$ per month 1005. Annual assessmenls monlhs@$ per month 10Qb, Schoolt..es monllu@ $ per month 1007, Flood Insurance month.@$ per month 1008, monlllJ@$ per month 1100. TITLE CIIARGES 1101. SeUlemenl or closing fee 10 1102, Abstracl or litle .carch 10 1103, Title examination 10 1104, Title in.urance binder 10 1105, Document preparalion 10 IIOb, NOlII}' ree. 10 1107. Auorney's rees to Sally J. Winder. Esq. (include. above items numbers; 1108 Title insurance 10 (includes above item numbers; Endorsements) 1109, Lende~s coverase 1110, Owne~. coverase 1111. 1112. 1113 1200, GOVERNMENT RECORDING AND TRANSI'IiR CHARGHS 1201. Recording rceslleed $ 23,50 ;Morlgase S 33,50 ;Agreemenl5 $ 1202, Cily/counly Iax/.lamps: Deed $ 59000 ;Morlgage $ 1203, Slale tax/.lamps: Deed $ 590,00 ;Morlgage $ 1204. 1205, 1300. ADDITIONAL Sll1TI.EMIiNT CIIARGES 130 I. Di.bursemenl f.e to 1302 p..lln.pcelillo 10 130), Seplic Cer\ilicalion 10 1304, Water lesl & Trcall.enllo 1305, Overnight mail ree 10 1400 TOTAL SETfI,HMHNT CIIARGHS '. PAID I'I\OM 1I00\ROWER'S FUNDS AT SHTTLEMENT $ I'AID I'ROM SELLHR'S FUNDS AT SETTl.EMENT S $ 1,19200 $ $ (I'.O,C.) $ $ $ (I'O.C,) $ 75,00 S $ $ $ S S $ s s s s s S S s s S $ 350,00 $ S $ (I',O.C,) $ $ 57,00 $ 57000 $ $ S $ $ 570.00 $ S $ $ S S 2.24400 $ S S $ $ S 570,00 TheIlUD-1 Senlemeol Slalement which I have prepared i. a true and accurale account oflhi.lran"'clion I have caused or will causclhe fund. 10 be dilburs.d in accordance with thi. stalement. W ?; 0 .. :? ..... ~\ .. , .. 1" Q '.... . -i ..; . .:: .. 0 .. ;> :.! .... ~ ..; .. .. .. W .. I.; '" ; .. N .. ., a \ ~~3 .. 8 !l ... 3 ':l " ! ~ ;: ) = " ""1 " ~ ... Co. .. !\ . ~ Ii \ ! ... i .. ~ ! i~ 0 w " ... .. 5 ... ... .. "'... ... \ W. :lJ "'w .. .w . ... .... .. "'.. .. .... ,.;,.; Il. ! ~:: .c ... ~ "'... H .. ... W. "'w 'D ~ .w a "'.. is "'.. . ";M .. .. ~ ... ..... 8'" .. ..... ::l ~ I w 0 " u ... ~ " . . ;:; .; . ~ ... , . " 0 .. .. . 0 .. .. ~ ~ ~ I!' ... 8 ~ ... t't rw 'll .... . ...... ........ .. II 0" ~ ...... ........ ....0 .. l. "...... ;; .. . . \ . ... .. . .. . .. .... . .. .. . w . . ~E 0 at " ' , .. .. .;; . ;; .. ..... ~ ... Il tlc ~ \ , \ \ .rvISOIU.lllfJ . SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY ,P'nn.. 1',1111 or Type , -'-'-='--=nl"E"r;ruMD1iC ' 21 - <J(, - 0951 COMMOHWfAUII or PlHH$'t'lVAHIA IHHIlUANel rAX laru... _nIDIHf OICIOINf ESTATE OF Odo R, 1I0SI'EI./J ----..----.+--.--. .-..---.------- (All p'.plfty la'ntly.ownod with .lta Righi or Su,vlvonhlp mu.t b~ dlltlo"~~-!t~!...d~!! ~L__._ _.__ ______ ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATII ---- .'-".~-'_._. . -"-. - ....._~_._..-..._..._...-. ... ..._-~-----+- I. Mellon Bank Trust Account 260-SBN, Odo R, Hosfeld trust under agreement dated July 15, 1991, principal cash invested, per attached summary sheet of trust account November 1996 statement of investments ;.. $ 2,557.00 2. Mellon Bank Trust Account 260-SBN, trust account dividend accrued for AUn Corporation shares as shown on stock inventory provided by Mellon Bank attached to Schedule B $ 21.60 ., 'i ~ i " I 'I , I I 3. 1964 Chevrolet pick-up truck, PA Title No, AI6410546 in very poor condition, junk value 4. $ 25.00 19S7 Chevrolet automobile, PA Title No, 400S025990140 in the name of decedent, in fair condition $ 200.00 "', TOTAL IAI.o enler on line 5, Recopiluloliun) S 2,803.60 IAllath addilionaI8"" K 11" .h,e" if mOl. 'pnrft I, "..d~riJ n" "'1-'" Nffi ~LaJ ~Cl 44 ...... LaJ Cl I- % LaJ% E'" 1-" 1111 LaJo >'" %N .... ~ ClLaJ %'" ..E :> 1-% 111 :>1- ~% 1-:> CI U U 4 ~ c a a:a c o - - CD :E. !: .. iUCl .. N N ,.. N ll<-' .... ..., '" ", '" ~LaJ ::>.... u>- ",0"" '" ,.. Cl LaJ "''''.... '" 0 LaJ E ........ N I- c . . . . ..-' g .... c'" '" E4 ....N N ....:> .... 1-% ~ 111% '" LaJ.. ~ 0 '" 0 ,.. ,.. -' ..., .... '" '" 0 .. '" N 0 '" '" l- . . . . CI ..., '" 0 N N ~ I- 0 ...,.. .. l;j~ .... ...,'" '" ~ ~ 4 E X ClLaJ ..., ~u N ....... .... ...~ 4'" Cl % ,..0 .... ,.. '" .... I- "'''' '" '" N Cl 111 ",0 0 '" '" - CI . . . . . :; 111 U "'.... .. N 0 CI I- x~ ,..0"" '" ~ % 4'" ......., ..., LaJ I-~ lL E c I- 111 LaJ LaJ 111 > :> % .. .. ,.... LaJ '" .... U I- > N ,.. LaJ lL .. ~ .... '" CI ~ CI Cl N ..., -' I- '" 4 :z: I- LaJ CI E I- LaJ l- I- 4 CI I- z 111 >- .. E >- 111 I- z .... 111 E ~ ~ :> :> 111 u -' U LaJ CI C LaJ .... I- U 111 ~ 111 I- Cl lL 111 :z: LaJ CI :> CI I- Cl E 111 LaJ :z: E LaJ E .... CI > .. U 111 % Z ~ I- .... LaJ -'z :c 4LaJ :c I- Cl I-E Vl I- CI :z: ClI- .. z :> 1-111 u :> lL LaJ CI > -' u ~ % 4 U U .... ... 4 CI .... I- -' U -' 111 4 :z: 4 I- .... l- lL C ~ CI Cl I- ... I- ~111 ClLaJ .. ~ '" LaJ4 .. :>:c -'111 4 >lL CI ~ 4C1 ...:Z: '" '" , '" o ~ .... '" '" '" ... 4 % o ..., ~ LaJ '" ffi > CI % . ~ :z: 4 '" :z: CI -' -' w E .. , I- ~ CI Cl c:a CI "J W lL 111 CI :c N I o ,.. .. '" I .... o 1 o .. .... '1'11 .- .. B ~h:i; ~;~I ~~l=l!:l l=ll hh; :;J ~~~s! 8! ~ ~ ~U:l I~ ~I I~ .... I 9'",'",,",..;;k..".~".~..\;.> . ItI M . ... N ... . ... ... ~ .... 0) ... .... N ... ... .. ~ o a ... "'... ... 0 lIllll ... ., . 0..:1 III III . .. l>l III ,Cl o .. '" III o III ItI ItI .... M I o ... o I o ... .... ... M . ... 0) N ItI ... . ... M ... . ... ... o ... . .. ... )'::,.; ... '" . '" ... N N N . N N o . N ... o ItI . ... N ... . .... ... o . N ... ~ III Cl III o 0) ... '" N ... M '" 0) ... 0) N ... ... ~ III ... .. 0) o I ... o ... I N N ... III ~ III .. ItI M ... I ... ... ... S' ., '.. l>> .>C 11 U ... III ":0 tl .~~ U :0 U III III "' II U oW VI ..w ft) J..t U !l.~ ~ lIlX'" .>C ''':0. .. :o.u III '" III .. 11 ;I; 11 III ,Q :o.~ U;I; :l~~t ~...ou I I t; ~ .. ~~~ 5:...t:l ~ ~ " U '" ~~ U III lIl., U U III 1Ill>>1Il.. U R U II .....rt.... "" "':0"'11 .... nJ.... t-t UlIlu .. ... III U III ) UIlU ~ ~ III ~ ~ III a... Il U 0 a... o III U III :0 ... jJ R ... rU C)U)....n.tn I I I I I ... UIIlU3: C)U)HP.1V1 .. I ~ ~ U ~ a ~ ~ U ., III .. III U l>> l>> Il Il Ie ., Il H.... 0 tf'of'4 ..IiCaJRoW 'fl ~ u'~ ~ ... .Q... III tl 3:U"1Il o t7'r-I Cl.!oW fIJ Il III III 0 ., .... R Q 0 II .>c 0 ,Cl Il U fIJ cu en-rot cu....... fIJ VI .Q III III III " UCl.IIlCl.1ll I 1ft I ... III 3:UCllJ)U UCl.IIlCl.1ll ,-,.-'0' llyn"". I''') . SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES PI.a.. P,lnt a, Typ. L~NUMBER ' ., 21 - '16 - 0951 .. ,...._.....,.,-....-_..,- --......-- COMMOUWfAUIl 01 ,.tW!lH"l'AtllA INHUIl'AU(I ,.... _flU"" 1H~IOftH ClnOHH i-STATE OF Odll Il. 1I0~FEI.Il ITEM NUM8ER DESCRIPTION AMOUNT A, Funeral Exp.n...: 1. 2. B. 2. 4. C. 1. 2. 3. 4. 5. 6. 7, B. Fo~el!lan~er-Jlrlcker Funernl lIome, fUlleral hIlI New lIope U.~I. Church, funeral relntl'd expenses 1,,977 .00 100.00 1. Admlnl.t,atlv. Ca.ts: Leonard A. Jlarnhart 182 - 32 - 4050 Personal Rep,esenlalivo CommiSlions Theron O. Jlarnhart -204 - -JO - 5376 Social Security Numbe, of Personal Rep,esenlolive: Yea, Commissions paid I qq 1 12,000.00 Allorney Fees Sally J. IHnder, Esq. 34,091. 08 3. Fomily Exemplion Cloimonl Address of Cloimont at decedenl's dealh SI,eel Add,ess CHy Slale Zip Code Relolionship P,obole Fees Register of Wills 421.00 Mlscellaneou. Expen.es: Cumberland County Law Journal; advertise Letters Testamentary 60.00 News-Chronicle, advertise Letters Testamentary 50.75 ~ailham Q" Real Estate, a IPr dsal of real estate 100.00 Register of IHlls, Short Cer tif ica tes and copy 21. 50 Register of Wills, fiUnR Inheritance Tax Return 15.00 Recorder of Ileeds, transfer tax 570.00 TOTAL (Also enle, on line 9, Recapitulalian) 5 52,406.33 (If mo,e 'pac. I. n..d.d, In.ert additional .h.et. of .am. .1...) .1~'illr.'I1"1 i ,,~: ,,~(\ .. u; (I.....MOtI....f .\111 0' r1WI\'.....Ilt. ltlllUIIIlllflIUlf!UIII 1"ltlWI CHIOltlt U" __. _._._. ._,____ ESTATE OF ITEM NUMBER 1.1. 2, 3, 4. 5, 6. 7. 8, 9, 10. 11. 12, 13. 14. IS. 16. 17, 18. 19. 20. 21. 22, SCHEDULE I DEBTS OF DECEDENT, MORTGAGE L1ABLlTIES AND LIENS Odn H. 1I0SI'El.Il Ploo.o P,I"I 0' Tv..o "Tlt: ~U~~:(~'_ -~:l:'~- DESCRIPTION AMOUNT GPU Energy; Jan. 1997 electric bill . Kough's Oil Service; fuel bill, Jan. 1997 . United ofPA; (elephone bill, Nov.lDec, 1996 Cumberland Co, Ollice of Aging; meals account RWC Emergency Physicians; medical account Leonard Barnhart; reimbursement, utilities & fuel bills for Estate United ofPA; telephone bill, Jan, 1997 . Darrell Barnhart; electrical parts & labor for repairs to house GPU Energy; electric bill . Valley Medical Group; doctor bill Kough's Oil Service; fuel bill Newburg/Hopewell Joint Authority; sewer bill United ofPA; telephone bill Leonard Barnhart; vet bill of Estate Carlisle Hospi(al, balance on account GPU Energy; electric bill . Kough's Oil Service; fuel oil Leonard Barnhart; reimbursement for postage Mellon Bank; service charge Mellon Bank; check charge GPU Energy; electric bill United ofPA; final telephone bill $ 22,59 $ 47.22 $ 82.37 $ 30.00 $ 180,00 $ 155,82 $ 25.09 $ 201.07 $ 32,76 $ 27,00 $ 63,13 $ 40.00 $ 22.06 $ 39,25 $ 192.40 $ 29.63 $ 111.15 $ 35,00 $ 6.00 $ 53,50 $ 3,26 $ 232 -----_._---~----- " TOTAL (Aha onter on Ii no 10, Recopilulotion) S 1,401.62 - ._~---_. ---- ----- -...----.-.----- (If more tpace it needed, inter' oodiliooo/ "lee It 0' sam It sizp.) I,'f . ill} -j t~ tr. . 'I ~-... 'f'{,'fl ;',' t':!Jl'j~,,-'i;~~ - ~j~,..... ,.-w",,;t, JO~ ,L . ..,' COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE -, V BUREAU OF INDIVIDUAL TAXES INllIRITAIoiU IAll OIVISION DlPl, :80.,01 IIAlllllSMIIIC. JlA 1/1:8-01,01 NOTICE OF INllERITANCE lAX API'RAlSEH[NT, AllOWANCE OR DISAllOWANCE or DEDUCTIONS AND ASSESS"ENT Of 'A~ 11. ,hili I" ':1'" SALLY J WINOER ESQ 701 EKING ST SHIPPENSBURG PA 17257 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 12-01-97 1l0SFELO 11-08-96 21 96"0951 CUMBERLAND 101 000 R A..,ount Ren1ttlld ,::===-~~.--:-,- -- I -, i MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUM8ERLANO CO COURT HOUSE CARLISLE. PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ iIEV:iS4i" EX'AFii'iiiF97Y"NOTicE""lij:"YNHEiiiiiiNCE"TAX"iiPPRiiisEHENi'";'Ai.i:ciwiiiicE"ifli...m--m- -.-.. DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF HOSFELO ODD R FILE NO. 21 96-0951 ACN 101 DATE 12-01-97 TAX RETURN WAS: (X I ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. R..l Est.t. (Schedule A) 2. Stacks and Bonds (Schedule OJ 3. Closely Hald stock/Partnership Interest (Schedule CJ 4. Hartg.gas/Not.s Receivable (Schedule OJ 5. Cash/Bank Deposits/Hlsc. Parsonal Property (Schedule E) 6. Jointly Owned Property (Schedule f) 1. Transfar. (Schedule GJ 8. Total Assats CllANGEO NOTE: To insu~. p~oper c~edit to your account, subnit the upper portion of this for~ with your tax paynent. 57.000.00 563.377.64 .00 .00 2.B03.60 14,579.99 .00 (8) III 121 131 141 (5) 1&1 (71 637.761.23 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funaral Expanses/Ad~. Costs/Hi.c. Expense. CSchedula H) 10. Debts/Hortgage Liabilities/Liens (Schedule X) 11. Tot.l Daductions 12. Nat Value of Tax Return 13. Charitabla/Gov.rn~ant.l Beque.ts; Non.alactad 9113 T~u.t. (Schedule J) 14. N.t Value of Est.te Subjact to Tax Iql 110 I 52.406.33 1.401.62 Ill) 1121 1l3) 1141 ;3,R07 9; 583.953.28 .00 5B3.953.2B If an assessment was issued previously, lines reflect figures that include the total of ~ ASSESSMENT OF TAX. 15. A~ount of Lina 14 .t Spousal 16. A~ount of Lina 14 taxable at 17. Anount of Line 14 taxable at 18. Principal Tax Dua TAX CREDITS: PAYMENT DATE 01-22"97 01-23-97 OB-07-97 14, 15 and/or 16, 17 and 18 will returns assessed to date. NOTE: ~.te Line.l/Class A rate Coll.ta~.l/Cl.ss 8 rata 1l5) Il&) 1l7l .00 X .00= 5B3.953.2B X .06= .00x.15= 1l8) .00 35.037.20 .00 35.037.20 RECEIPT NUMBER AA1B5104 AA18510S AA211616 DISCOUNT (t) INTEREST/PEN PAID (-) 18.03 25.71 .00 342.64 4BB.42 34.164.59 AMOUNT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 35.039.39 2.19CR .00 2. 19CR . IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1. ND PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI. YDU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION; E.t.ta. of dacadant. dvlng on or bafore n.ce.ber 12, 1982 ~~ If any future Intar..1 In tha ..tal. I. tran.farr.d In Po.....lon or e"joy.ant 10 Cia.. e (collateral) b.n.flclarle. of Ih. d.c.d.nt aft.r the ..plrallon of any ..tale for life or for yaarl, the Co..onw.allh h.reby .~pr.I.lv r.l.rv.. the right to appral.. and al.... tranlfer Inh.rltanc. Ta... .t the I.wful Cia.. e (coll.t.r.l) r.t. on .nv luch future Int.r..t. Pl.IAPOSE OF NOrICE: To fulfill tha r.qulra.ent.'of S.ctlon 214D of the Inh.rltance and Esl.te T.. Act. Act 21 of 1995. (11 P.S. Section 9JttDI. ; ,-.1 P,lVHENT; Detach the top portion of this Notice and subait with your pay"ent to the Regllt.r of ~llls prlnt.d on Ih. r.v.rs. .Id.. ~-Hak. chack or aonoy ordar payable tal REGISTER or WILLS I AGENT REFUND (CR)s A rafund of . taM cradlt, which was not r.quo.t.d on the Tax R.turn, .ay b. r.qu.st.d by co.pl.tlng an ~Appllcatlon for R.fund of P.nn'Ylvanl. Inheritance and Eltat. Ta.~ (REY~1515). Application. are avallabl, .t the Dfflc. of the R.gl.t.r of Willi, any of Ihe 25 Revenue DI.trlct Offlc... or by calling the .p.clal 24~hour an.w.rlng ..rvlc. nu.bar. far fora. ordering; In P.nn.ylvanla 1.8DD~562~ZDSD, out.lde P.nn.vlvanla and within local Harrl.burg araa (111) 787~8D94, TOOl (7171 772.2252 (Hearing I.palr.d Only). OIJECTIONS: ,lny party In Int.r,.t not ..tlsfl.d with the appr.I....nt. .llowanca or dl.allowanc. of d.ductlon.. or as'."'ant 0' taM (Including dl.count or Int.r..t) a. shown on thl. Hotlc. aust obJact within .I.ty (60) day. 0' racalpt a' this Notice by; ..wrltt.n protalt to the P,l Oapart.ant of Ravanua, Board of ,lpp,al., Oept. 211021. Harrl.burg, P,l 17121.1021, OR ".l.ctlon to hava the ..ttar dat.r.lned at audit of tha .ccount of the par.onal r.pru.nt.Uv., OR ..app.al to tha Orphan.' Court. ,lOftIH ISTRATlYE CORRECUOHSs Factual .rror. dl,cov.r.d on thl. a..a...ant should b. .ddr...ed In writing tal PA O.part..nt of Aav.nua, Bur.au of -Individual T..a., ATTH: Post A..a..a.nt Ravl.w Unit. Oept. 280601, Harrl.burg, PA 17128~0601 Phone (717) 787.6505. S.a page 5 of Ih. bookl.t ~In.tructlon. for Inharlt.nc. Tax Raturn for. R..ld.nt D.c.d.nt" (REY.1501) for an ..planatlon of ad.lnl.tr.tlv.lY corr.ctabl. .rror.. DISCOUNT: If any taM due I. paid within thr.. (5) calandar aonth. aft.r the d.cld.nt's de.th, . flv. p.rc.nt (S~l dl.count of the tax p.ld I. .llow.d. PENAL TVs The 15~ t.. aan..ty non-partlclp.tlon p.nalty Is coaput.d on the 10t.1 of the taM .nd Intar..t ..sa..ed, and not paid b.fore January IS, 1996. Ih. flr.t day aflar the .nd of the la. a.n..ty parlod. Thl. non~partlclpatlon p.nalty I. .pp.alabla In the .a.. aannar .nd In the the .... tl., parlOd a. yoU would .pp..1 tha tax and Int.ra.t Ihat h.. b..n a..a..ed .. Indlcat.d on thl. notlc.. INTEREST1 lntere.t Is charg.d b.glnnlng with flr.t day of dallnqu.ncy, or nlna (91 aonth. .nd on. (I) day fro. the data of d.ath, to the d.t. of pay..nt. Ta..s which bece.. d.llnquant b.for. January I. 1912 b..r Int.ra.t at the r.t. of .Ix (6~) perc.nt p.r .nnu. calculat.d at a dally r.t. of .000164. All tax.. which b.c... dallnquent on and aft.r January 1, 1982 will b.ar Int.r..t at a r.t. which will vary froa cal.ndar yaar to c.landar y..r with Ihat r.l. announc.d by the PA Dapart.ant of R.v.nu.. Th. appllcabl. Inlar..t r.t.. for 1912 Ihrough 1997 ar.: !!!! Int.re.t Rata Dally lnt.rut F.ctor !!!r Int.rut Rat. Dally Int.r..t Factor 1982 ZOX .000541 19111 .~ .0002"7 19113 16~ .000451 1988~1991 U:C .000301 191" 11~ .OD0301 1992 .~ .000247 1915 13:C .000356 1995.1994 n .000192 1986 lOX .000214 1995~1997 .~ .0002ft7 ..Intar..t I. calcul.t.d a. follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINqUENT X DAILY INTEREST FACTOR ~.Any Hotlc. I.sued .ft.r the ta. baco.a. d.llnquant will r.flect an Int.r..t calculation to flft.an (15) day. b.yond the data of the ........nt. If pay..nt Is ..d. aft.r the Intarut co.putal1on dat. .hown on the Hotlce. addltlonel Intar..t .u.t b. calculatad. PlIlPOSE Of NOTICE, To 'ulflll the r~lr...nt. of S.ctlon Zl~5 (bJ of the Inheritance end E.tat. Tax Act. Act 21 of 1995. (72 P.S. Section 9145). PAYHENTI DetKh the top porUon of this NoUe. end lutNllt with your pay..,.., to the Reahl." of WUh printed on lfM; rev..... .Jete. -. Itak. cMck or 80My order payable to, REGISTER OF MILLS, AGENT. REf'UHD (CR) I A nfooct of . tax credit .ay be request.d by cDlIplaUng en "'pplJeatlon 'or R.fund of PennSYlvania Joh.rJtenca and E,t.t. Tax" (REV-131]). ApplIcation. ar. avallabla at t~ Office of the Ragl.tar of Will., eny of the 23 R.v~ DJ.trlet Office. or fro. the Depart..nt., Z~-hour an.~.rlng ..rvlca nu.ber. for for.. orderlngr In ~'YIYenJ. 1-300-362-2050, out,lda Pennsylvania and within local HarrlsburD .r.. (717) 787.aO~, TOO. (717) 77Z-ZZSZ (Hearing 1~.lr.d Only). OBJECTIONS, Any party In Int.....t not ..tJ'fled with the .,I....ent of tax a. shown on thla notlc. .ay obj~t within .Ixty (60) d.ya of r,c'lpt of thla Hotlc. by: --written prot.at to t~ Pi Depart-.nt of R.v~, Bo.rd of Appeala, Dept. 2310ZI. Harrisburg, Pi 17IZ3-IOZ1. OR -".I.ctlna to have t~ ..tt.r d.t.r.lfMtd .t audit of the per'onal r.pr..entatlve, OR --appeel to the Orphan.' Court AD'UN- ISTRA liVE COARECTIONSr Factual .rror. dl.cover.d on thl. ........nt .hould be addr....d In writing tor PA Depart..nt of R.v~, Bur.au of Individual T.x... ATTNr Po.t A......ent R.vl.w unit, D.pt. Z80601, Harrl.burg, PA 171Z8"0601, Phone (717) 737-6505. s.. page 5 of the bookl.t "In.tructlon. for Inherltanc. Tax R.turn for a R..ldent Decedent" (REY-1501) for an .xplanatlon of ad.lnl.tratlvely corr.ctabl. .rror.. PENALTV: The 15% tax .-na.ty non-participation P~lty 1. coeput.d on the tot.1 of the t.x and Int.r..t ......ed, and not Paid be'or. Jenuary 18, 1996, the flr.t d.y .'ter the .nd 0' the t.x -.na.ty period. Thl. non-p.rtlclpatlon penalty Is ~.Iabl. In the .... unnar and In the the .... tI.. P.rlOd .. yOU would .pp..1 the tax and Int.r..t thet has bellO .......d .. Indlcat.d on this notlc.. INTEREST: additIonal P.nn.ylvanl. E.tat. T.x e..e..ed .. a r'.ult of . chanae on the F.der.l E.tat. T.x clo.lng I.ttar bec08.. delinquent at the a.plr.tlon of on. (1) .onth 'roe the data the 'Inal notlc. of the Incr.... In Fadaral E.tata Tax I. racelved. T.... which bee... dellnqu.nt b.fora January 1, 1982 be.r Int.r.,t .t the r.t. 0' .Ix (6~) p.rcent per annu. c.lculated .t a d.lly r.te 0' .00016~. All t.... which bac... delinquent on or .'t.r January I, 1982 will bear Int.r..t at . rat. which will v.ry 'roe calend.r y.ar to cal.nd.r y.ar with that rate announc.d by the PA o.p.rt..nt of Ravenue. The .PPllCable Int.r..t r.te. for 193Z thrOUgh 1998 .rer ~ Int.r..t R.ta Dally lnl.r..t r.ctor Y.ar Int.r.st R.t. OaUy Inter..t ractor 198Z 2DX .0005~8 1987 9X .000Z47 1985 16X .000438 1988-1991 IlX .000301 1980\ IlX .0003Gl 199Z 9X .000Z47 1985 I3X .000356 1991-1994 7X .00019Z 1906 lOX .000Z74 1995-1998 9X .000Z47 --Inter..t I. calculat'd a. 'ollows: IHTEIlEIlT R DALANCE OF TAX Ul!PAID X NUNDER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any NoUc. h.ued .ft.r the tax bacaM' dal1nquenl will ref1~t an Int.r..t calculation to flit.." US) dan bayond the date of the ........nt. If paYNnt h ..de aft.r the Intar..t C08pUtatlon date shown on the Hotlc., eddltlDnlI Int.r..t au.t b. calculated. '-, c/ STATUS REPORT UNDER RULE 6,12 Name of Decedent:~D f., Death: 1/-', - clLr .JJofRlJ Date of Admin, No, 11q 6 - D010 6.12 of the Supreme Court Orphans' following with respect to completion of above-captioned estate: Will No. PurBuant to Rule Court Rules, I report the the administration of the 1, State whether administration of the estate is complete: vesf- No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state 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 is: c. Did the personal representative s;;ce 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('u~___ ;' Q. ype or print) 7'1 t' k.;,j 51- Yi"frnrL'l. Address ~A 0 I f<t" ( .).,~ 7 ( ) Te 1. No. Capac it y: Personal Representative ~Counsel for personal I' representa t i ve (MAH: rmfl AM))