HomeMy WebLinkAbout96-00957
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PETITION Fan pnOBATE AND GnANT OF LETTEns
Ik Est:lle of Molly M. Bolger No. c:ll- 9(,.. 9 S 7______
also known :IS Molly Bolger and To: Mary C.- Lewis ________________
1 Rl'gi'ler of Will, 1(lr Ihe
_MQ-11Y__Mp9r_e_ Boger COllllly of CUlllberlrindhe
----___ . I >"n'a,,',1. (:olllmoll\\'l'ahh of I'ellmylvallia
Social Security No, 186-32-7100
Thcpctitiunllf Micl1eJJ..e Pfeifer and Beth Erin Bolqer rcspccllullyrcprcsc111lhal:
Your peliliont'f s ~If<' III y,'ar, or age 01 older. alld Ihe "Xl'l'lIt named in Ih,' la,1 will /If the
ahove decedent. daled the 3rd day of April I'J 78 alld rodil'ilhl dated__
____renunciation by Dauphin Deposit Bank and Trust Comp_a!!y______
ISt.llt" rdn.1II1 rlfllllml.llltn. ('.g. It'IIIIIUI,llllll!. 11t-.111l111 ('\nUIlI', ('fl.l
Decedent owned personal property wherner ,itllate of t1w e'limated vallie of 5_50_)00_0_,00____
and real estate in Pennsylvania of Ihe .'stim:lled IWI vallie /If S 1S'IClOf?_~O ________________, sitllated
as follows: 2.6Ja_s_t_Coo.ver _ street, Mechanicsburg, _ PA_ _170!)5_________ __ ___
~._- -_._--~ --- ------_._----_._._---_.._--_.~_._--
WHEREFORE, petitioners respeclfully r.'quest Ihe prohale oflh., last will and rodicills) presented
herewith and the grant of lellers__oL.Admins_tra tioR__ C ._T. A._ _ _n _ _ _____ __ __________Ihereon,
~ ~ Cl1~iulu 8 I . (~'I;/~~;~~lt~&:;~7{~~~~~~~~"'~~~~_~I.~llcatiOlLLi!.IJ!L____
il_~ M1chelle,,'p e1f r 11./... ,dtdkE'ikrt' Arlin ton VA 22207
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a e: 'ftte.... cA'K. 8~C2A.. _ 6_9_0_LS_t_!::a_tiJl1)9r:.~LStr_~eJ:/__j_~lJL__
.~ 0 Beth Erin Bolger Chevy Chase, MD 20815
VI
OATH OF PERSONAL REPRESENTATIVE
(2]
COMMONWEAl.lll OF PENNSYI.\,ANIA
COUNTY OF Cumberland
The pelitioner_s_ahove-IHlIl1l'd, heing duly sworn according to law, say ___Ihal the slatemenls inlhe
foregoing petilion arc true alld COrrel'l 10 Ihe hesl of petilioner s._ knowledge and helieI' and thai as
personal representative__.ofthe :lhove deccdelll, will well and truly admini'lel the ."t:lle according to law.
Sworn. wand suhscrih~d he fore l::;HtLt.Lu.L~ (i-jJ~ d .-tlC71Llclt--"7iZ'-t,[Ibc..73!J~- ---
me this 21s41"YII :lov. .__'u______ -----.---:f-C1'/--iF-r-...-EII-.n_I-- __ ,_____
J ----- 1l,1chelle Pfe1 r c: 1V"c<<o:l", -- ,., D. ?f"
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Beth Erin Bolger
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DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW.i1AN. 8 __Il~~_ .._. ill cull'ideratiulI uf Ihe petitiulI oil the reverse side hereuf.
satisfactory prouf havill~ heellprcsenled hclilre me. IT IS DECREF.I> that the illslrlllllenl_____,lated
April 3, 1978
described therein be admitted to probate and filed of record as the last will
of Molly M. Bolger
.-----...
and Letters
of Administration eTA
M;..\u.\t, E Iltt\
Bol~f"
-.------
are hereby granted to
Beth Erin Bolqer and Michelle B. PIeifer .f/.kI--
Rc~istcr's Form No.1
~k-(" i.r..(1 '< ,
Re~iste/Jnf ~ills
I)" ,nil \\ ~
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Depuly ~
~U~J 1.1, ^NIJ 'I'1:S.:rM\I:N'I'
I, ~llll,l,y N. Ulll,I:t:H, of L1le 'I'o\m~hip 01' lIalllpdl'n, County ul'
ClUllhed.and and COllllllon\Vealth uf I'l'nll~ylvallia, hl'ln:s of ~Ollllll alld di~-
pO~ in:s III I nd, Illl'1ll01.'Y and \Indl'I'~ tanll.i.ng, do Illal,,', pllh I i ~h and tlel'lal'e
tld ~ a~ and [Ul' illY La~ t \~ I II anti 'I'l'~ tallll'n t, hl'l'dlY l'l'vold nl!, anu Illak i nl!,
void al.1 [orllll't' \~ill~ ,ulll cmlid I~ hy Illl' at any tillle hl'l.'cto[ure Illauc.
l'lHS T.
.l. I.lI.'dl' I.' anll d i I'el' t t1m t a II illY .ius t deh ts and [unera 1.
expl'nscs he pa:1 d hy illY I:Xl'l~U tUI.', hl'l'l' i na I' tel' nallled, as Sl.lllll as
~
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convcn.ix.ntly may be thml' at'te1' illY dcecasl'.
SCCllNIJ.
If buth 01' illY chiLdl'cn, nalllely, ~llC\ll:I,I.I: [;L.l.EN UOLlit::H
anu UF.'f1l I:RIN ll11l.l:t;R, have attl.dncd thc al!,l' or t'~l'nty-t,~o (22) yel.ll's
at thc Ii mc or illY dl'a th, then anu .i n tlm t CVl'n t 1 l!,i vc, dcvise and
bcqueath illY enUl'C I:statc in cllual shal'l'S unto illY said childrcn,
~
shat'c anu shal'c aLike, absoluteLy and in I'l'e silllpll'. Should eithcI'
uf illY said eh.i tdt'cn pl'edl'el'asl' IllC and tl'avc tm~l'ul issue tu survive
thelll, .1 OI'dcl' and dil'pct that the shal'l' 01' pal't or illY estate \~hieh
sUl'h dl'l~l'asl'd l!h.i Id 01' l!hildl'en wllItI.ll havp I'pcci Vl.tI het'cuntll't' had
she ot' they sUI'vivell IllC shall he tlistl'.ihutell untu the issue ur such
ul'ccasl'd phIl d Ill' eh it dl'l'n pel' s ti l'pes, saitl issue tald nl!, his, her
Ul.' theil' uel~eased alll!l'S 1.'lI" s fll' ances tOI'S' shal'e 01' sha!'cs he!'eunder
by l'ept'cscntat.iun and not pel' l~ap.i ta.
11', hot,evl'l', l'i thel' or lilY sa.itl eh i.I tll'en al'e 1II1del.' the a~c
u[ t"'enty-t\~O (22) ypal's at the tilllc of illY dl'ath, tlll'n and in that
event, 1 give, dl'visl' awl lll'qUl'ilth illY l'ntil'l' saltl I:statl' unto
1l^11I'1I1N IJI:l'llSl'L' U^NK ^Nll 'I'IUlS'I' CllNP^NY 01' lIal'l'isl>UI'l!" l'l'llllsytvan:ia,
as my 'fI'US tel!, in t I'ns t, nl'vel' the less, to hold, i nvl'S t anti 1'1'- invl's t
tll(' same, to eo I I ('C' t- the i IIl'OIl'l', and a I' tel' pay In:~ a II expenses
I I\l~ idl'n t to the lllanagl'llIl'nt of sa i d t!'us t, to nSl' allll apply as 1I1l,,!h
LAW OF,ICE_
SNELBAKER.
McCALEB a ELICKER
of the net incOIlll' ilntl pl'i.ncipal thel.'l'o[ as Illay be neccssary in the
sole ulsel'etlon or my 'I't'ustel' [111' thl' SUpPOl.'t, maintenance, CU1'e anu
_,:t.
(Ilhll'alilJlI lit' H,It'h 01 illY l'bi ItI,,(.u il~ llIay IJt' 111111('1' tlu' 1I~{1 or l\'v'l'l1ty-
lIvu (:!:!) Yl'al'H, it Ill'ill:.\ lilY \Vi 1.1 alld illtl'lIl illll tll 1I"lIvidl' rUI' tI.1'
ehi Id \0,1110 lIilS Hut al.lailll'd ~11t~11 t1~I,l' and h'hu lIIilY IH' dl'1H~IHlpl1t and
11I1l'lllalll'i\liltl'd (ily 1'l'aHlI1I III" d i,;ald I i ty "" 1"1111 I illll' alll'lIdane(' ill a
s(~huulj al: llll' vITl't.~li\'e lillll' Itt'l'('ol' h'il:l1 tilt' t;\lllle 01' silllil.al' adval1-
ta~Lls ilud blll1Pl'i ts dlll'jllg IIpl' dl'Pi'l1dt'lIl'Y \,,rhil!11 .1 lIav(l pl'uvi.dpd to lilY
lIldl'" dli Id lll:.\"lh('" Ivilil till' p!'ivi 11':'\" 01" ''''lIl1il'ill:.\ a ('ull.!.'gl' ""
OUll'!' pust-high SpIIlHI! (l(!IIl'al-ioll: illIll UpOIl lilt, YUIlI1~(,I' of my elLi I.dl'el1
atta.inillg the age 01' lh't'Uty-l:\oJu Yflill'S, ,( lll'der' illHI dil'(let that the
balance or pl"illl~ipill illld allY ,l\~(~U1ll1llat.iuJ1 lIr illcolI\t' 1'I~lIIa.i.I1i.II~ .in the
humls ul." lill' 'I'I'IISl1'(' IJl' d ist'I'Jlllllell ill !.'lJlla I sha,'(',; IIntll illY said
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eh i ldl'cn, sha,'!.' ami sha.'!.' aIi 1(('.
Il is lilY CXPl'CSS Id II. alld ""l1s.id""I'd thulI:.\hl thal illY sa.id
"
'I'1.'lIS tl'(' shollld ll'I'Ill111a tc allY Ill'lIc ri ls IIl1lle,' tile I"llt'('gu i IIg tl'IIS t rlll'
any "'Ii I d III1UCI' thc agc Ill" L'vcnly- t\Vo (~2) y"al's \VIlli has hy hcl'
persona I ('Ul1lhll~ t 1ll!l!llIllC i ndl'I".ndcnl, ('olllpl e tl'd I"ul'llla I edllca t i on Ill'
ulh(!I'\V.isl' uelllons ll'a I l'd Ill'l' lack lIr dl'lICllllcl1l~y 1I[llln thl' rllnds lIndcl' the
managcment alld ellnll'lIl ur Lhc sa id 'I'l'lISll'l'. In add.i UOII lu lhc fOr'e-
goiJl~ djl.'cct.iulIs and gent'l'al. d_isl~I'l't.i.UIl vestl!d .ill lilY said 'I'I'IIStcc', th€!
mal'l'.iag!.' or said el1il.dl'('1I lIL' L1ll'.il' I'cl'sislClIl display or lal~" Ill'
I'cr'sDllal. .ini Liativl' a III I illltllSll'y shall Ill' l!Olls.idl'I'l'd hy lilY sa.i"
'l'r'ustee as surr.i(dent l~allHl! to dis('ul1tilllll' tllll t1.iHel'ltttollill.'Y Il.istl'.i-
Ilu tiUIl I'l'OV idcd 11('1'(! i lIallovl'.
j l is lilY rUI't111'I' I'XI"'('SS illSll'lll!lilln and d.il'l'elillll lhat
all d i SCl'P t i OrHlI'Y )laYIIIC'1l Ls bPl'pi Itil!JO\'t' IJI'OV id(ld Hila I.J. l.'paSl' 1'01.' lilY
oldcr' dli III upon hl'" aLlailllll('nl or agl' hVl'llty-L\Vl' (~~J Yl'aI'S, lhus
makJllg avai lab!." thp haJance or Haill l"I'usl 1'111' liSt' ill thp pUI'pUSt'S
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lit lhe eX('I'c i S(.l III' i ts d i SCI'C' t i on 1IIHIL'I' thl' I'ol'egolllf.!. tl'lIS t
f'l'l flJl'lh ahol'I' 1"01' lilY y"UII:.\I'" dLi hi.
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pl'ovisiOI1H, .I. III'd('I' alld di"{'l'(" lilY S,lid 'I'I'lIStt't' III ~.'lll1sitll'I' tile pr'.illlilry
HUPPlu't ()1J],i:..~ali{)1I 01" illY (~"i l.tlI'PIt's rathel', lliUIIl!ly, ,Iohn ,J. Bnl.~el', in
LAW O"'ICl.
BNELDAKER.
McCALEB A ELICKER
uete,'mi n.i nl!; lhl' d i Shlll'Sl'lIll'nls lo hI' lIlad(' IOldcl' sa i d t,'us l, j l hcinp; my
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21-96-0957
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3870600
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COMMONWEAltH OF PENNSYLVANIA.. DEPARTMENT OFtlEAUH. vitAL RECORDS
CERTIFICATE OF DEATH
......OIDlClDUI"..-'..1
Hall Bol er
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WLo.toltl'Ullln_"'iIII
. November 14 1996
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21-96-957
RENUNCIATION
In Re Estate of
Molly M, Ilolger
deceased.
To the Register of Wills of Cumber lnnd
CounlY, Pennsylvania.
The undersigned Dnuphin Dcposit Ilank and Trust Company, Exccutor
of
the above decedent, hereby renounce(s} the right to administer the cslalc and respectfully ask(s} that Lellers
of Administration CTA
be issued to Michcllc B. Pfcifcr a/k/a Mlchclle Ellen Ilolgcr "nd !leth F.. Bolger,
WITNESS
hand this I Ilth day of Novemher ,19-S.b..-,
~7P
Scnior Vice (Signature) President
8 West High Street
Carlisle, PA 17013
(Address)
(Signalur.)
(Addr...)
")
(Slgnatur.)
, l(i
(Addr...)
...
..
21-96-957
form 5.)006 Rev. 7.S6.'M
co ~:XECUTOR
ADMIHIiiI'MTORS BOND
C f Cuml",!" I.llld P I Ie
ounty 0 ,..............................., enn.y van .
Ellale of .....~JII.I.lII..~.1..llIJ.lW.'.I....................................".."""..."....."""".........}
2 .... No...............of 19,.......
late of ....~ u!:.. .~.~!~.I.~~:.~.. .~.~. ~ .~'.l:.~.:.. .~.~..~..I.':!.I.I.!.~..~.I}.~I.!.~~. !. ~J.~... ,I, ?~).??..... d eceaaed
KNOW ALL MEN BY THESE PRESENTS, Thai we ....!1,i.~:!!~.I"I.~..!!...I~.\~:.!X~!;.......,~!!~..............
...,.,. .......~~~.!1.,t; ..~!!,1.!l~ r.::.. ~:!?. ~;!! ~;.~:r.Y.9.~.~............................................................ ...., al Principal, and
THE OHIO CASUALTY INSURANCE COMPANY, a corporalion of the State of Ohio, and author-
ized to become lole lurety in the Commonwealth of Pennlylvania, are held and firmly bound unto the
Commonwealth of Pennlylvania, for the ule of tho.e intere.ted in the e.tate, in the lum of.....Q!).~..........
.. ..1111 nd r. i:d.. nlllllfi ,jnd..;;;;;;;;.~:;;; :;:;.~.~.~ :;.~.~.~.~.~.~.~.~;; .~.~.~.~.~.~.~.~.~.~:;.:.:.:.:.:.:.:.:,:.:.:.:.:.:,:.:,:::.:.:.-: Dolla..,
to be paid to the laid Commonwealth, to which payment, well and truly to be made, we do bind our-
selves, jointly and severally, for and in the whole. our hcifll, executors, administrators, successors and
a,"ign", and each and every of them, firmly by thele pre.entl. Sealed with our .ea]. and dated the
.............J.?th............ day of ...f).~S.~.'fI.QN.r.............. A.D., one thouoand nine hundred and.....??................
THE CONDmON OF THIS ODUCATION IS, That if the above bounden..................................
MichettI' B Pfeifer and Beth E Bolger
................................................................................................................................................................
CO EXECUTORS
XAJ;..;.';AtlR~ .......................................................................................... or any of them, .hall well and
truly administer the e.tate according to law, this obligation, shall be void a. to tho.e who shall so
admini.ter the estate: but otherwise, it shall remain in force.
/1- d~, ~ (Y,)'C;0L
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'Ll' '{'.
Sealed and delivered in the pre.ence of: ..................!-.~.~.i!!..(~f....I~!....b~.~{.U.......... (Sea])
:~~7:.~.f.~.~.!.:.~.;.~:.~.. ~.. ~:~~.~:~:
p.~~ Allorney-in-fact
.,.qq'(l.<..tl4,;1,.<I"...a.~~
County of ............................
l~:
State of Pennsylvania
J. ............................................................................................................................................................
................................................................................................................................................................
do solemnly .wear that, as the administrator .......... ................................................................................
of the e.tate of ........................................................ ......................................,.........................................
... ....... .............. ......... ............... ...... ..................................................................,...... ............... deceased, I
will well and truly admini.ter the e.tate of .aid decedent, according to law.
Sworn and aubocribed before me
\
this ................ day of ............................................
A.D. 19...... and lelle.. of adminiltration granted
unto
..............................................................................
................................................................................
..............................................................................
................................................................................
......... .......... .......... ...... ............ .............. .Ri:.cisTER.....
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CERTIFIED COI'Y OF I'OWER OF ATTORNEY
TOE 01110 CA.SUI\LTY INSunA.NC"~ COMPt\NY
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IN 1l'.STIMONY WHEREOF. 1 hne hereunlo ,el my hand and .Sind my Official
S..I .1 the City of Uamihon. ~h.le 01 Ohio. the day and )'ur tint .bo.... wrineD.
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"ARTICLE VI"
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REV.1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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REGISTER OF WILLS
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Il9 6. Oee""... O"",I.""e""",..,..., 0 I.llece<l'" ""'11.1,,,,'10 UW'<J rr"" ~..,.!"", 11.. a. laalll_~ Solo Cepos: !lales
09. LJI"l',,,,,Pr,,,,,,"'R8Cl!'I"" 0 10. $paJsoI Povl!lf Coo, ,...__".11'''''''''''' 0 11. EI""cnl.r:\IuroerSec.9m('I~""o
THIS SECTION MUST BE COMPLETED. ALl.CORRESPONOENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE OlRECTED TO:
!WollE cC>>\Ot WolU~ ,l,Wi(~
Michael P. Halcovage, Esquire 240 Sunbury Street
,........ ,1__, Minersville, PA 17954
T .,..... - - . ~" ...; - '-, n U ~ 1
TU!PtOI[ JrCut,l8UI
1717\ <;AA_A<;~"
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1. Re.lIEstltO(Sd1e<1uIeA) (1)
2. Slod<s ani Bor<Is (Sd1e<1u1O B) (2)
( 3. C.osel'f Held Ca;mncnP"""""'p a Sole.ProJI1ellnl>P (3)
_ I A. Matgages & No,es Reel!'lable (5a1e<lu1O 0) (A)
I. Cas/l. 8.1'" Ilepos1S & M&e1laneous """""'I Pnlpel1y (I)
Z (Sd1e<1uJeE)
0
~ 6. Janl'fo.ned Propl!ty (ScI1_ F) (6)
I. 1I1e1.VNOS lrard... & Misa!laneous Noo.Prob3te Pnlpel1y (7)
:;) (Sd1e<1uJeGaL)
l= 8. TcuI Gloss Assets ~CI3Il!Ms 1.7)
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0 9. Fureal EJpenses & __ = (Schedule HI (91
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a: 10. Oe!nd 0ecedel1. Mat!l"J8 UolllIilIes. & L~ns (Sd1edUIe I) (101
11. TcuI 00ducIl0ns ~C131 lineS 9& 10)
79,625 29
21.671 65
14,839 92
1,026 72
15,390 00
(8)
lR.""~ .,.,
21,801 08
(II)
(12)
(Ill
(I')
I (III
(16)
(17)
(IB)
132.553 58
40 <;17 11
92,016 27
12. Nd VaIuo aI EsUII (!.Ire B mi1Is Une 11)
13. ClmtabIe alXl GamrrnelIaI BequeslsISec 9113 llUSlS fer wticll on _I' lax lias l1lJ lleeI1
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16. AnondlmlAlaxable!
aI 6'1\ rail! _ 92,016
17. Anon~lmlAtaxabIe
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lB. Tax Due
T Ixl
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.06
5.520
98
.11
5,520
98
19. 0 CHECK HERE IF YOU ARE REQUESTlNG A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
I.Jrm' pet\llesol PfJ1S'f.1 QllCSnlnal IlI.MwmrmlMrarn. rolCWl]Jcrx:mpaIT)'IR)~ard5l.1temem. R loltle ~d my ~ 3rdbell!f." C5 n.e.a:ma 3I1Ito'ftPll!II. [)i!J21fO'ld ~r;mt<XM
I 'Mi' ,.... - .
IGNAI~RE OF PERSON RESPONSIBLE fOR FlUNG RETURN AODRESS . ., OAIE
I',. . . 5 15 98
! '. 'y';:' 4006 Vacation'Lane, 'Arlington, VA 22207 --
SIGNAIURE Of PREPAREROIHER I ItRE SENIAIII'E ACDRESS . DAlE
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III: {/!:.,;, ~_? N_U:."""7.'1__ 240 Sunbury St., Minersville, PA 17954 lj-15-qR
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Decodont 5 Com loto Addross:
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Tax paymonts and Crodlts:
1. Tox Due (PllQlll \.Jn8 18)
2. Cl1ldibI1'aymenlS
A. Spousal PovOltf Crodt
(1) 5,520.98
B. Pnct pay"....ts
C. Discoonl
4,805.00
TolaI C.1!d1S (A' B' C) (2) 4 , 805 , 00
3. Inlem~enally d applic:lllle
D.lnl_1
E. Penally
Tolallnlere5ll'enaltf (D' E) (3)
~. 1I1ine 2 is geel8l 'llan line 1 . line 3. enter:he d1IerMCll. This is !he OVERPAYMENT.
Cl1eck box on Psg. 1 Un. 19 10 ~u.sls ..fund (4)
5. II line 1 . Ine 3 is gooier than line 2. enlef:he dnerenco. ThIS IS !he TAX DUE. (5) 7 15 , 9 8
A. Enter 'lle intef1!St on !he tax we. (SA) 49 , 70
B. Enler!he total of Uno 5 . SA. This is 'lle BALANCE DUE. (58) 7 6 5 , 98
Make Check Pa able 10: REGISTER OF WILLS, AGENT
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PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING AN X IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; .......................................................... 0 00
b. retain the right to designate who shall use Ihe property transferred or its income:............... 0 l!J
c. retain a reversionary interest; or ........................................................................................ 0 ~
d. receive the promise for life of either payments, benelrts or care? .......................................0 00
2. If death occurred on or before December 12,1982, did decedentwrthin two years
preceding death transfer property without receiving adequate consideration? If death occurred
aller December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? .......................................................................................... 0 [i]
3. Did decedent own an 'In trust for' or payable upon death bank account or security
at his or her death? ................................................................................................................0 [i]
4. Did decedent own an individual retirement accoun~ annuity, or other non'llrobate property?.. 0 [ID
72 P.S. ~9116 (a)(1.1) (I) provided for the reduction of tha tax rate imposed on the net value of transfers to or for the use of the
surviving spouse from 6% to 3% for dates of death on or aller July 1, 1994 and before Janua,y 1, 1995.
72 P.S. ~9116 (a) (1.1 )(Ii) provided for the reduction of the rate imposed on the net value of transfers to or for the use of the
surviving spouse from 3% to 0% for dates of death on or aller January 1, 1995. The slatute does not exemot a transfer to a surviving
spouse from tax, and the statutory requirements for disclosure of assets and filing a tax relum are sun applicable even if the surviving
spouse Is the only beneficiary.
FOR DATES OF DEATH ON OR AFTER JANUARY 1. 1995 - Please answer the following question by placing an 'X' in the
appropriate space.
Old the decedent create a trust or similar arrangement which Is solely for the surviving spouse s benefit for his or her enUre
lifetime? Yes 0 No 00 "
. .
.
If you answered yes to the above question, the tax on the trust or similar arrangement is postponed unlillhe death of the second
spouse, at which time it will be fully taxable at the rate(s) applicable to the renialnder !ioneficiary(ies). Enter the value of tho trust on
Schedule J, Part II, in order to remove rt from the calculation of the tax due in thiS estale. You may WIsh to file Schedule 0 in order to
make the election available under Section 9113. If the election is made, the trust or Similar arrangement is taxed in the estate of the
first decedent spouse, the portion of the trust or Similar arrangement which benerrts the surviving spouse is taxed at the zero tax rale,
and tho remainder is taxed at the rate(s) applicable to the remainder beneficIBrylies) If ycu choose to make the election, you must
attach Schedule 0 to a timely.fiIed tax retum. along With Schedule(s) K and/or M ,n oreer to show the apportionment of the lrust or
similar arrangement between the survIVing spouse and the remaInder beneficlary(ies)
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SCHEDULE A
REAl. ESTATE
FILE IiJIIBS
21-96-0957
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26 East Coover Street, Mechanicsbu:g, PA 17055
(Actual Sale price - settlement Sheet Attached)
Net Procedes
V,AU;EATOATE
OF c!O~rn
$79,625.29
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CC_EIl.1HQPeIlS'I\.V-
11tEllTWC! fAX ;lEl\JIlIt
'E!:Ce<rCE'ZE!lT
SCHEDULE B
SiOC:<S & BONDS
rn..: IlUMBEl
21-96-0957
ESTAte CF
Molly M. Bolger
All pro..., JoImlt->..lOd with rio)tll of.-.nHo _ be GIoCcud o. SdMDllo F.
ITEM
IlJUBS
1.
.
CESCllIPiiON
V,ll.~6 At:ATe
CF CEA 1H
$23?29
Bell south corporation Common Stock
6 shares at $39.88/share
$5,063.00
2.
Bell Atlantic Co~oration Common stock
83 Shares at $6i.oo/share
$1,228.25
3.
Lucent Technologies Common Stock
25 Shares at $49.13/share
4.
T&T Corporation Common Stock
78 Shares at $37.63/share
2,935.14
5.
Bell Atlantic Corporation Common stock
200.098 Shares at $61.00/share'
$12,205.98
(All Values at date of death from Wall Street
Journal)
"\
. ..:. J
. ,
~',' .:", ~.:.Z,
.~, '..:=:.;
" .-
.-.',
".
.,
.
.'
TOT,ll.~_cnllne2./lIcIpUI1lllI1 $21 671.65
~1:n:re!:CX:ll :s.~ n:staaitllllal s/let1S1:f1ll- \ll.I)
~
......a.'.... *'
If<.
~
CC_EIUltCfPe<NS'lI.'1AHA
11fiEiUT""'" TAX ~EIlJRH
RESllEllTCEC:!:ElIT
ALE NUIlBEil
21-96-0957
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Molly M. Bolger
InduIlIlho _ 0/ Ibqaacn ard '" GlI. '" _.... -17t I!le aloll. AIlllfllpo<t'( Jolnl!y-<- wlll the right 0' IUl'flvoflhitl mUll be dildolld on Sd1tdu1e F.
~ I ~EM~
NUMBER OESCRIPT10N OF OEATH
1.
Contents of home
$1,500.00
2. 1991 Chevrolet Camaro (Sale Price) $5,000.00
VIN 1G1FP23T5MLl19070
3. BELCO Community Credit Union $6,080.00
Account No., 089150
4. Travelers Checks $300.00
5. Paycheck $1,248.86
6. Paycheck $455.44
7. Travelers Insurance refund $111.00
8. Arnold Fuel refund $l44.62
TOT.AL(AJslenleronIine5,~lilnl $14 839.92
pf rnn ~ is needed. ilsell acWonal sheets of Ihe sane siZl!)
'''''I~f''I'U'1
"
G,.,...'
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....~
CCMoMCNWU,LfH C' '!NNSYlVANIA
INHUIT..."'C! roll UfUI,..
IIS1DI!'lf 'ICfOUlf
SCHEDULE F
JOINTLY.OWNED PROPERTY
ESTATE OF Moll'] 1
M. 80 ger
I FlU NUMBER
21-96-0957
Joint l.nont(.I.
NAME
A. Michelle 8. Pfeifer
ADDRESS
4006 Vacation Lane
Arlington, VA 22207
RELAnONSHIP TO DECEDENT
oaughter
B.
C.
Jolntly-own.d prop.rty:
ITEM I LmER DATE
FOR TOTAL VALUE DECO'S DOLLAR VALUE OF
NUMBER! JOINT MADE DESCRIPTION OF PROPERTY OF ASSET '!II INT. DECEDENT'S INTEREST
TENANT JOINT
1.
A See U.S. Savings Bonds $2053.44 50% $1,026.72
ttachl d Various - See Attached
,
.
.
TOTAL (AI.o .nl.' on lin. 6, RKopilulotion) I s 1 , 026 . 7 2
(If mott spoct is n.ed.a Insert additional Shifts oi semi sin)
Bolgor Bonds
Invenlory Oet:lil
Redemption Date: 11/1996
Serial Nwnber Denominil tion Series Issue Date Value Interest
C464644296EE $100 EE 3/1994 $55,60 $5.60 ·
C413260728EE $100 EE 3/1993 $57,84 $7,84 .
C447380718EE $100 EE 12/1993 $56.16 $6.16 .
C434530913EE $100 EE 9/1993 $56.72 $6.72 ·
C430597121EE $100 EE 6/1993 $57.28 $7.28 .
C396720741EE $100 EE 12/1992 $59.96 $9.96 .
C373237007EE $100 EE 8/1992 $62,12 $12.12 ·
C360632693EE $100 EE 5/1992 $ 64.56 $14.56 ·
C348221437EE $100 EE 2/1992 $ 64.56 $14.56 *
C317722713EE $100 EE 8/1991 $ 67.20 $17.20 ·
C262721137EE $lOO EE 5/1991 $69.24 $19.24 *
C289380409EE $100 EE 2/1991 $69.24 $19.24 *
C337474164EE $100 EE 11/1991 $ 67.20 $17.20 *
C2815i4856EE $100 EE 11/1990 $71. 32 $21.32 *
C255823829EE $100 EE 4/l990 $73.44 $23.44 *
C262015406EE $100 EE 7/1990 $71.32 $21.32 *
C242000017EE $100 EE 1/l990 $73.44 $23.44 *
C230108423EE $100 EE 10/l989 $75.64 $25.64
L431312399EE $50 EE 6/1989 $37.82 $12.82
L410750199EE $50 EE 3/1989 $38.96 $13.96
L403102417EE $50 EE 12/1988 $38.96 $13.96
L399004008EE $50 EE 10/1988 $40.12 $15.12
L379112256EE $50 EE 7/1988 $40.l2 $15.12
L369947629EE $50 EE 4/1988 $42.20 $17.20
L355682975EE $50 EE l/1988 $42.20 $17 .20
L340098289EE $50 EE 10/l987 $43.52 . $18.52
L329871638EE $50 EE 7/1987 $43.52 $18.52
L328658033EE $50 EE 4/l987 $44.86' $19.86
L321769168EE $50 EE 1/1987 $44.86 $19.86
L286587296EE $50 EE 11/1986 $45.16 $20.16
L283977258EE $50 EE 8/1986 $52.22 $27.22
L249490203EE $50 EE 5/1986 $53.28 $28.28
L264067157EE $50 EE 2/l986 $53.28 $28.28
L250895395EE $50 EE 11/1985 $54.34 $29.34
L227179631EE $50 EE 8/1985 $54.34 $29.34
L217724921EE $50 EE 5/1985 $55.42 $30.42
L210255629EE $50 EE 3/1985 $55.42 $30.42
"
NIE " Not yet eligible for redemption; less than six (6) months between issue date and redemption dale.
. See footnote on Inventory Totals page.
1
Bolger Bonds
Inventory Totals
Redemption Date: 11/1996
Number
of Bonds
Redemption
Value
Interest
Pre-January 1990 Issue Dates:
January 1990 and Later Issue Dates:
20
17
37
$956.24
$1,097.20- .
$2,053.44
$431. 24
$247.20 *
$678.44
* The interest earned on Series EE bonds issued on or after
January 1990 may be wholly or partially exempt from Federal income
tax under the provisions of the U.S. Savings Bond Education
Benefit Program. For further information concerning the benefits
and restrictions that apply, please contact the Internal Revenue
Service.
2
-. ...... ...
.....a,...... .
CIlWWOIME.\l.l1l CI POflmVAIIA
IIftElllT NICl! r AX Rfl\JRH
A!~DfHT OEl%OElfT
SCHEDULE G
INTER.VlVOS TRANSFERS &
MISC. NON.PROBATE PROPERTY
ESTATE Of
FILE NUMBER
Molly M. Bolger
21-96-0957
ThiI_ mUl' bo """""lid Ind Nod '''111..... III II1'f 01 """_ l11vOUJ111 on !he ,..... s>:lo of 111I ;>J:V.1500 COVER StEEl' is yes.
OESCRIPTIONCF PROPERTY ~ CF OECOS
"I~c::l IIIIDM"'~ tWIt--. n.-....fDIMI"'~ IIlGH auI~"""" OA~~<C.~~ INTEREST EXCI.USICN TmBU: VAlUE
AI'TIOI'""OIM~"'''''''au.''. IItll ".l
1. Bell Atlantic Savings and Security
Plan $15,390.00 100% $15,390.00
Michelle B. Pfeifer ( ~ interest)
Beth E. Bolger Rinehart ( ~ interest)
named beneficiaries
.
,
TOTAL (AIsoenlerooline 7, RecaPIllIaIion) S 15.390.00
Qf /I'Cl1l space is needed. ilsert addtiClnal sheets of the same SIZ8)
13. CherrydaJe Veterinary (charges for cats) $1,000.00
14. Bell Atlantic $44.99
IS. Arnold Fuel Oil $47.00
16. Borough ofMechnnicsburg 567.90
17. United Water Pennsylvania 546.90
18. Suburban Cables 522.32
19. Cellular One 512.62
20. PP&L 57.62
21. UGI 528.22
22. USF&G (car insurance) 5155.80
23. Suburban Cable 522.32
24. Arnold Fuel Oil 547.00
25. Bell Atlantic 533.66
26. PP&L 529.42
27. UGI S9.81
28. United Water Pennsylvania $46.90
..":'
29. Arnold Fuel Oil $47.00
30. UGI $20.45
31. Bell Atlantic $31.70
32, PP&L $25.73
33. Suburban Cable S22.32
34. Bell Atlantic S25.11
35. Arnold Fuel Oil $47.00
.
36. UGl S15.57
37. Borough of Mechanics burg S65.90
3li. Suburban Cable S44.64
39. PP&L 551.87
40. Bell Atlantic S13.68
41. Arnold Fuel Oil $47.00
42. UGr S17.22
43. United Water Pennsylvania S24.81
44. Arnold Fuel Oil $47.00
45. PP&L S17.83
46. Bell Atlantic S14.53
47. UGl SI7.44
48. Suburban Cable S22.32
49. Bell Atlantic S19.61
50. UGI S17.00
51. PP&L S18.97
52. Borough ofMechanicsburg S65.90
53. Arnold Fuel Oil $47.00
54. Bank check charge S8.45
55. Travelers Insurance (homeowners) S169.00
56. Bell Atlantic S15.24
57. Morgan & Haloovage (bond renewal) $460.00
58. Barry L. Heckard Tax Collector ...0 S678.90
59. PP&L 520.70
60. Suburban Cable 522.32
61. UGI 513.93
62. United Water Pennsylvania S24.81
63. Bell Atlantic SI3.35
64. PP&L S15.05
65. UGI S14.92
66. Arnold Fuel Oil S62.38
67. Suburban Cable S19.86
68. PP&L S11.51
69. Arnold Fuel Oil 548.00
70. Borough of Mechanics burg S60.40
71. Toni Mahoney S130.00
72. Suburban Cable S2.01
73. UGI S32.18
74. Bell Atlantic S34.79
75. PP&L 510.52
76. United Water Pennsylvania 532.17
77. UGI $4.85
78. The Sentinel (estate advertising) 5103.61
79. Cumberland Law Iourna1 (estate advertisinS) S60.00
-
...."aa.."". ~
~
cc_mTli r# PWIS'1\.VANA
iNHEJUTAHCI! lAX REl\JRH
A!SOElll CEt3:ElII
FILE NUMBER
21-96-0957
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE L1A8IUT1ES. & LIENS
ESTATE OF
Molly M. Bolger
Includ. unrelmblnod mldlc:ll 'XIlIIISIS.
ITEM
NUMBER OESCRIPTlCN AMOUNT
1- Bell Atlantic $143.15
2. Arnold Fuel Oil $47.00
3. PP&L $38.95
4. Bell Atlantic $75.78
5. United Water pennsylvania $46.90
6. UGI $21.22
7. Suburban Cable $22.32
8. Arnold Fuel Oil $47.00
9. USF&G (car insurance) $101. 20
10. Harris savings Bank (Dec. Mortgage payment) $261. 05
11. Harris Savings Bank (Jan. Mortgage payment) $266.35
12. Harris Savings Bank (Feb. Mortgage payment) $266.35
13. Harris Savings Bank (Mar. Mortgage payment) $266.35
14. Harris Savings Ba..k (Apr. Mortgage payment) $266.35
15. Harris Savings Bank (May Mortgage payment) $266.35
..
16. Harris savings Bank (Loan Payoff) $10,060.00
17. Harrisburg BELCO FCU (Home Equity Loan payoff) $9,520.76
18. PA Department of Revenue $84.00
TOT.&l.(.Ame.lIrcnfine 10, Recapdulalion) S 21,801.08
QII11Ol1l s;:aca IS needed. nSllrt all:ilicnal sheets 0/ 1!11 sane si:/!)
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"dunllt'::n or 'lIch oj' 1'1~ ~lIf lllrulI c.a inll)' bu -.lmhu' t1l1. iI"O Q1 -:...n....'-
n.u (:;';:) y,ar" , 1 t :.udIUJ "Y ",{ U .wd !ntl"nt!cl1 tu i2rlJY":" fat' t!l"
c~11c.~ who ha. n~t .. n'''.tr.cl1 ,uc.~ ~II;U 1ntl witn ;nay b-: tbtpwule:nt .t1lL1
l,tntltl\1nclpatld (hy :'ualna: :t ,U:1&1hf:!::: ::0 :'-'.-1. t!me .1t:cndanca 1" 01
IC4'1uul) .at :''11 aff:u::1\', ':,.71Q :utraa: '...:h t.'1u .ur.ott or dmildr wvall-
bb&1 dOli !Jllne:"!:1 ~:' i.1Il:. her dr~cl:l1cncy wn1ch ! hava pruvtded tn rrry
ul&1cr chlJd tDt;o::!.t"" with tilt' "1'l.,,l~"l{p uf .1cquidn~ 01 c~Uc:';c at'
Qtl1ar POSt.iu.;., /lC;lUuJ l!UUUU.L.lolI; ..UtI upon :!Itf yaull,&l!r uf ftl)' uh.i !.:1rc:u
at:Il1rtinj) the OlG'J or e1cnr:'..:-.i'''' y~a.r:;, I aroJ(!I!" ..lid dlrtH:t that t1IQ
:J.1l..1ncc of "r1.Jlc.!.:'a~ otml lny otCClUf1Il.1t.!':)1I "r ~ncurne M.omuill.1l1~ 1.11 the
hMUd. ,,)f :.":~ Tr"Jl1t'~l! :e d~t:o::.bult:d lu ~qlJ.1. lIh8l'H~ lint,) rrry rod
ch11d.r~n. that.! and ahuct; aCkee
It L. my 1xpr... oLll 'nll C:llSl~erod tIll.U!:lIt that my laid
rrulltt!~ Abould l:ur::t1.u:lte any IUUlU,r,i t." IJIILlet. ~a: rCr1:,::'Oln" t:U8t (er
any cb!lc1 WlLtCr tit" "HP llf t',ffent;y. two (;:2) y,:"rH wit.. IUtI by lIer
personal cc.t1I:uct' bcccrne ~:u.L.."~(!lldeut. ~c:tJgLeted :urn....1 educatiOn or
ot~or~1.ce tll!.'ncul't:'atau twr uck or tJeVt'nllenc'l UPCII ttte funtl$ under t:ha
ma::alll!:nent and cant:'?l ar :11" Raid :r:-Js-:ee. 111 ...ddl dun to ttle fnrl!:-
ioinli d1rect~cn_. and. .:ena...-,L d,lllcr..ccr. \'eGtctl JJI II)" wi:! ':'nhtte.e. the
nJL"'Tiagv of ,aiel !:JI,ihJr.n ot" thau. Vt'I'H!>>tl!!nt ci:.spLAy of Lack of
perscnal ~IJ.!tio.t:ive and i..dust:j' ~malL be CUlIH :uercrt by I'tt'J .a1d
~8te-a ill su:ficltmt ':0.1...10 to ,Uttuouttnucr :.na d.1sl'.:et1clIl4ry d1stri-
butlon prov.tdl"i hlroLnal:ov.,
It 1. my f".tl:er c::<nroy. l".truet..on "".1 d1cootion tIlar
all d.1:ICreticnary (1I1ymant>> t.,.rellhlbo'le Oro\..i.ulo!d ~hall CrftlCl far my
old.r c:h11.d upon hor ntum""t Dr m~ t'lf...cy-t..... (2~) y...... thll8
milkinll allaiblll. the balance of .eld cruS: ~ur u.~ In tIlo purpo....
'0' fort:! above far my yO\lIl~.. ell.11.I.
In tho ""..el.. or It:: dJ.~r~clon W1~cr th. COtego1Dll tru.t
prov1siOllB. I OMO. and.llir""l '1\1 ....11\ t:u~tee tn olll1d~o. till V..lJr.a"Y
luvport obl1l1ilt".Lon of my dt1!1I""llly ::'athcr. IUllllttLy, Juhn J. Boltter. in
detllT.t1nins; the di..,turYl'fl",o'lllIt :0 br ,..d..' under :j;l.hl m..tft. it btting rrrJ
a
IN THE MATTER OF THE ESTATE OF Melly M. Bolger
Cumberland
late of Mechanicsburg , lS~lIl County, Pennsylvania, deceased.
. ,
INVENTORY
I. (Real Estate) 26 East Coover Street, Mechancisburg, PA 17055 S79,625.29
2. Bell South Corporation Common Stock (6 shares at S39.88\share) S239.28
3. Bell Atlantic Corporation Common Stock (83 shares at S61.00\share) S5,063.00
4. Lucent Technologies Common Stock (25 shares at S49.13\share) SI,228.25
5. AT&T Corporation Common Stock (78 shares at S37.63\share) S2,935.14
6. Bell Atlantic Corporation Common Stock (200.098 shares at S61.00\share) S12,205.98
7. Contents of Home SI,500.00
8. 1991 Chevrolet Camaro (VIN # IGlFP23T5MLl19070) S5,OOO.00
9. BELCO Community Credit Union (Account # 089150) S6,080.00
10. Travelers Checks S300.00
II. Paycheck SI,248.86
12. Paycheck S455.44
13. Travelers Insurance refund Sl11.00
14. Arnold Fuel refund S144.62
Total S116,136.86
&Jtte ~ if4.J~
Beth E. Bol r Rinehart
~~J~ x3.. ~.J..2A
Exeeulor or Admini",. . U. ,
AnACH AO.III0NAL 'HEElS IF NEeESSAn Michelle Bolger feifer
Z Jl Z
:J: ? ii" :J: ?
a...
.... 0
n .....
::r ;0 .....
III '<
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..... >n :J: 0
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11l '"
. .....
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t'l a... -
'l/l oQ oQ
iO
s:: \D
..... 0\
.11
11l
Estate of
Molly M. Bolger
. Deceased.
Commonwealth of Pennsylvania
County of Schuylkill
~ II:
\
Michelle B. Pfeifer and Beth E. Bolger Rinehart
Administra
.............. Executrix
of the Estate of
Molly M. .Bolger.
Cumberland
late of Mechanicsburg .. in the County oP<~~ do/does hereby verify
that the statements made in this Inventory are true and correct. I/We understand that false statements
herein are made subject to the penalties of 18 Pa. C.S. Section 4904, relating to unsworn falsification
to authorities.
~!~1!B~tr:fefit~
~\~~o-~ O":I\L<a.J--
Beth E~geJ~~eh~rt
R.;i,tor Form 3.
~ -. ~-. ~.
COMMONWEALTH or pl:NrmYlVAtuA
OtfJAmMEtH or REVENut
BUREAU OF INDIVIDUAL TAXES
DEPI28060, .
HARRlSDURG. PA 17128.0601
'*'
NO. AA 270093 REV".. EX ,,,...)
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
RECEIVED FROM:
r
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
HALCOVAGE MICHAEL P
240 SUNBURY STREET
1'-1]
e.~!::Jr:, OCl
MINERSVILLE, PA 17954
fClOtt[AE
ESTATE INFORMATION:
FilE NUMOER
c:
0=32-"'100
tFIRST)
(MI)
NAME OF DECEDENT tlAST!
---ant r.~R Mnl I v M
DATE OF PAVMENT
o I I QQR
POSTMARK DATE
~/IA/IQ9A
COUNTY
TOTAL AMOUNT PAID
$'765.98
DATE OF DEATH
cw
REMARKSMICHELLE B PFEIFER
C/O MICHAEL P HALCOVAGE ESO
SEAt;:HECKII 167
.; Ij'
RECEIVED BY .. /'. " I. , ( 7", "'" J /"'.
/' /// /.
MARY C. t,.t.:WIS ,./.v.. p'.. j
REGISTER OF WILLS 1/
Pi:GiS r m OF W;U.S
--- --. ---- - --- ._- -~ --.---.- ---
--. ..-.....-. .---.---.-...-- .-. -.._--.-_. ___'____.h _.________
.:....
.
j
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--' ----~~
.
~. _- _.~..~ -.--:"'.JiII. __
;-~ .
1~' .
. 0"
. RrCORD 0.01011 UPS SHIPPER NUMBrn FROM Box m .
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INOlVIDUAL TAXES
INH[AITAHC[ tAX DIYISION
DEPI. 180601
HARRISBURG, PA 11128.0&01
NOTICE OF INItERITANCE TAX
APPRAISENENT, ALLOWANCE OR OISALLOWANCE
OF DEDUCTIONS AND ASSESSNENT OF TAX
MICHAEL P HALCOVAGE ESa
240 SUNBURY ST
MINERSVILLE PA 17954
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
08-31-1998
BOLGER
11-14-1996
21 96-0957
CUMBERLAND
101
A.ount Re..itted
,"
'-
*'
IU.lhl "11'1"'''.
MOLLY
M
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 ~
REY:is4i-Eif-"FP-filij':97rilfir"icniF--friHEifiiANCE-TAx-i,-ppiiAisEHEili'-;-"Li:oiiANCnfR---------m--m
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BOLGER MOLLY M FILE NO. 21 96-0957 ACN 101 DATE 08-31-1998
If an assessment was issued previouslY, lines 14, 15 and/or 16, 17 and 18 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rat. (15)
16. A.ount of line 14 taxable at line.I/Class A rate (16)
17. Allount of Line 14 taxable at Collateral/Class 8 rate (17)
18. Principal Tax Due
TAX CREDITS:
PAYNENT
DATE
08-18-1997
05-18-1998
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. stocks and Bonds (Schedule BJ
3. Clos.ly Held stock/Partnership Interest (Schedule C)
4. Hartg.ges/Notas Racelvable (Schedule DJ
S. Cash/Bank Deposlts/Hlsc. Personal Property (Schedule EJ
6. Jointly Owned Property ISchedule fJ
7. Transfers ISchedule GI
8. Total Assets
1 CHANGED
III
12)
13)
(4)
ISI
161
171
79.625.29
21.671.65
.00
.00
14.839.92
1,026.72
15.390.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule HI
10. Oebts/NortGege Liabilities/Liens (Schedule II
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Govern.ent.l Bequests; Non-elected 9113 Trusts ISchedule JI
14. Net Value of Estate Subject to Tax
191
IlD)
18,736.23
21,801.08
Ill)
(12)
1131
1141
NOTE:
.00 X .00=
92,016.27 X .06=
.00 X .15=
118)
RECEIPT
NUNDER
AA211647
AA270093
DlSCDUNT l+ I
INTEREST/PEN PAID I-I
.00
50.00-
4,805.00
765.98
ANOUNT PAID
BALANCE OF UNPAID INTEREST/PENALTY AS OF 05-19-1998 TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
NOTE: To insure proper
credit to your account,
sub.it the upper portion
of this for. with your
tax pay"ent.
132,553.58
4n.~:H 31
92,016.27
.00
92,016.27
.00
5,520.98
.00
5,520.98
5,520.98
.00
3.73
3.73
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
I IF TOTAL DUE IS LESS TitAN $1, NO PAYNENT IS REQUIRED.
IF TOTAL DUE IS REflECTED AS A "CREDIT" ICRI, YOU NAY DE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. I
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RESERVATION, E,'ata. of ~edentl dying on or bafor. Oac..bet 12, 1982 .. ., Bny future Intar..t In the ..tet. I, transfarrad
In po.....lon ar enjo~.nt to Cla'l a (coll_taral) beneflclarl.. 0' the decedent ,ft.r the a.plratlon of ~y ..tat. for
11'. or for y.ar., the Co-.onwealth hereby axpr..,ly t".tve. the right to BPpr.I.. end ...... tran,f.r Inherlt~. Tax..
at the lawful CIa.. a (colla'.ral) rat. on eny such future Inter....
PIIll'OSE OF
MOnCEr To fu1fll1 the raqulruents of Section 2140 of the InherltDnCI and E,t,t, h. Act, Act 21 0' 1995. 172 P.S.
Section 9lttOl.
P'WEHT: Detach the top portion of this Notice and .~1t with your pay..nt to the Raglshr of NUb prInted on the ravar.. I.et.,
...HaIt. check or ~y order payabl, to: REGISTER OF HILLS, AGENT
REfUND (CR); A n'ood of II tax credit, whIch .,.. not requestad on the Tax Return, .ay be raquutlld by co~l.tlng en -Appllcatlon
for Refund of P~IYlvenl. Inharitance end E.tate Ta.- (REY-I]l]). Applications are available at the Dfflca
of the Ragllt.r of Will., eny of the Z] Ravenue DI.trlct Office., or by calling the .pecial Z.-hour
anlwarlng ..rvice nu-bers for for.1 ordering: In Pennsylvania 1-800-362-2050, outside PennSylvania end
within local Harrisburg aree (717) 787-8094, TOO' (717) 77Z-Z2S2 (Hearing l~alred Only).
OBJECTIONS: Any party In Interest not satisfied with the appral....nt, allowance or dl.aIION~e of deduction., or .11..~t
of ta. (Including dl.count or Inter.st) .. lhown on thl. Hotlc. ~.t object within .I.ty (60) day. of r.calpt of
this Notlca by:
--"rIU." prote.t to the PA Dapa,.taant of RevltOUa, Board of App.llh, Dept. 281021, Harrisburg, PA 17128-1021, OR
--elactlon to hava the ..U.r detaralned at .udit of thl; IICcooot of the personal repra.entatlve, OR
--appeal to the Orphan.' Cou,.t.
AUHIH
ISTRATlVE
CORRECTIONS: Factulll arrors discoverlld on thl. 1I..e...ent .hould b. .ddr....d In writing to: PA Departaent of Revanue,
Buraau of Individual T..e., ATTN: Post A..e..8ent Review unit, Bopt. 280601, Harrl.burg, PA 17128-0601
Phone (717) 787-6505. Se. pllga 5 of the booklet -Inltructlon. for Inherltance T.. Return for a Re.ldent
Decedent- (REY-ISOl) for en a.plllnatlon of adalnl.trlltlvely corractabla arrorl.
DI$COlIIT:
If eny t.. due 1. paid within thr.a (]I calendar aonth. .fter the dacedent.. dallth, a five pe,.c."t (5%1 dl.count of
the ta. paid I. allowed.
PENALTY:
the 15% tax .-nelty non-partiCipation penalty I. coaputad on the total of the t.. end lntara.t a.la..ad, and not
paid bafora January 18, 1996, the first day lifter tha end of the ta. aana.ty parlod. This non-partlclplltion
penalty Ja appaalabla in tha ...e 8anner and In the the slllle tI.e per lad a. you would appaal the tax and lntara.t
that he. be." a....lad II. indlcat.d on this notlce.
INTEREST:
Int.r.st I. charg.d beginning with flr.t dllY of dallnquency, 0,. nine (9) .onth. and one (II day froe the data of
death, to the data of pa~ent. Ta.a. which bec..a dallnquent b.'ora January 1, 1982 baar lntar..t at the rat. of
sl. (6%) parcant par annu. c.lculatad lit a dally r.te 0' .000164. All t.... whlch baclllla dellnquent on and .ftar
January I, 1982 will bear Intara.t .t . rata which will Vary 'roe c.lendar yaar to calendar yaar with that rata
BMOUnCad by the PA Departaent of Ravenue. The appllCabl. lntarut rat.. for 198Z through 1998 are:
!!!! Intarast R.ta Dallv Int.re.t Factor :!!!r Intarut Rata DaUy Intar..t Factor
1982 lOX .00054lt 1987 9X .0002.7
1981 lOX .000438 1988-1991 IlX .000]01
1984 llX .000]01 1'" n .0002.7
1985 13lC .000356 199]-19~ n .000192
19.. lOX .00D274 1995-1998 9X .00D247
--Intara.t Is calculated a. follows:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice I..ued aftar the ta. beCo... ~llnquant will raflact en Intare.t calculation to fl,ta.n (15) daYI
beyond the data of the .......ant. If paYHht Is .ade .ftar the lnt.ra.t coaputaUon data shown on the
Notlc., Bddltlonal Intar..t ~It ba calculated.
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COMMONWEALTIl OF PWNSYLVAUlA
OEPAIHMENT or REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT 280601
tlARRISDURG. PA 11128.0601
PENNSVLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
_~"Jt,~
~
NO. AA 29\3684 IILV.II.1UIII..,
RECEIVED FROM:
I
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
HALCOVAGE MICHAEL P
240 SUNBURY STREET
IQ1
1".7<1
MINERSVILLE. PA 17954
FOlD HERE
ESTATE INFORMATION:
FILE NUMBER
-
NAME OF DECEDENT (LAST)
'"
(FIRST)
(Mil
DATE OF PAYMENT
POSTMARK DATE
COUNTY
TOTAL AMOUNT PAID
'53.73
DATE OF DEATtl
CW
REGISTER OF WILLS
_..,....-_._____._____ ___.__.._' __ _ __". __ __.___ _.L._____-a.,._________ -------
SEACHECK# 1216
RECEIVED BY /
MARY C. LE14IS
REGISTER OF WILLS
j
:. ...../
REMARKSMICHAEL P HALCOVAGE
.'
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PA't'ttEHT1
Detach the top portion of this Notice Md .ubIIlt .,lth your peYHnt alteM p.yable to the MM and ~r...
prlnt..t on .... rever.. .Ide.
If RESIDENT DECEDENT _.e cMck or lIOney orcNr paY8bI. tOI REGISTER OF WILLS, AGENT.
If NON-RESIDENT DECEDENT aak. check or ~y order payable tOI COHHOHWEAL TH OF PENNSVLVANIA.
RUUHD (CRh . r.fund of . tax credit, which .... not reque.tad on thfl T.x R.turn, ..y be reque,t.d by cMPlaUng an
"Application for A.fund of Penn'Ylvania l~rltance and E.tat. Tax" (AfVaI313). Application, ara av.ilabl. at
the Offica of the A.gi.t.r of Will., any of the Z3 A.venue DI.trict Offic.. or fru. the Oapartaant'. 24-hour
an....ring ,arvic. ~r. for fora. orderingl In Penn.ylvani. )a800a362-2050, out. Ide Penn.ylvania
and .,ithln local "-rrlsburg .r.a (717) 787-8094, TOOl (7171 77Za2ZSZ CHaarlng lapalr.d only).
REPLV TO:
ou..t1on. regarding .rror. contaIned on thl. notlca should be addr.".d to: PA o.partaant of R.v...., &ur...
of IndivIdual Taxa., AllHI Po.t A.......nt Ravi... Unit, Dept. 280601, Harrisburg, PA 17IZ8-0601, ~
(717) 787"6505.
DISCOUNT :
If any tax due it paId ..ithln thr.. (3) celanct.r ~th. .ft.r the decedent'. death, . five parcent (5%) dl.cOU1t
of the tax paId i. allowed.
PENALTYI
The 15% tax a.M.ty non-partlclp.tlon panal ty it caputed on the tot.l of the tax and Intar..t a..e..ed, and not
paId baifora January 18, 1996, the flnt day aft.r the and of the tax .....ly period.
INTEREST:
Intar..t .. charged baalmlna with flnt day of dellnql,MOCy, or nine C,) ~th. and OM (1) day fru. tIM data of
d.ath, to the date of p.yaent. Taxe. whIch bac..e dallnquent b.for. January 1, 1'82 b..r int.r..t .t the r.t. of
six (ftX) parcent par IIfVtUa calculated .t a dally rata of .000164. All taxa. which beC8H delinquent on and aft.r
January I, .98Z ..111 bear Int.re.t at a rat. which will vary fru. calendar y.ar to cal~r ye.r .,Ith that rata
ennouncad by the PA Dapartaant of R.venue. ThfI appllcabl. Intar..t r.ta. for 1'82 through 1998 ar.:
V..r Intara.t Rat. n.llY Intar..t ractor Y.ar Intar..t Rat. DaUy Intar..t Factor
1982 'OX .ooo~a .987 'X .000247
1'83 162 .0000.8 1988-1991 llX .000301
1... llX .000301 199' 'X .000Z47
1.85 13% .000356 1993-1994 n .000192
1.86 lOX .000274 1995al998 'X .000Z47
-"1ntar..t I. calculated a. follow.:
INTEREST = BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
.aAny Hotlc. i..ued .ft.r the tex bacoaa. d.llnquent .,111 r.flect an Intar..t calculation to fifteen (1$) day.
beyond the date of the .........,t. If payaant 11 .1Ida aft.r the Int.r..t coaputeUon dIIta shown on the
Notlc., additional Int.r..t au.t be calcul.tad.
,