HomeMy WebLinkAbout96-00962
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PETITION Jo'()H. 1)lwnATE und GI{ANT OF LETTERS
Nn.__ OJ./_::,_9b - 9~_;)..
To:
A "I' \ P " "-"'Il
1::.\'",/(' of _~._'.!____.____.'.-L~.'..:!:'_._------------_.
,,/'\U known 11.\ ---.-- --.---.--. -~ .-----.-.~---~..--
Rcghlcr nf Wills fur Ihc
Cnuuty nf _CUl1hol'10nd iu thc
COllln\Onwcaltlt of I'cun\ylvania
_._-----_.---_._.._-~_._.._- _..~. -_._._--~.~---_.
-:--:---~;--:-;----1 '--,~'::) --o.::"Ti 2 /J"<",'II.\('t!.
.~'" "'/ S" ""'J "fl. ___1__._ L__L_ -~._-----
Thc pClilinu nf the uudcrsigucd rcspcclfully rcprcscms IlulI:
Your Jlclilinncr(~). \\'ho blare IK YCiH\ of i1~C or ulder an Ihe cxcclll~Qr
in Ihe lasl will of Ihc ahnvc dcccdcm, darcd i"o b)"tl \D'--y-2.,J-I
and cllllicil(s) datcd . ----.
111~lCd
,19 tJ
l'lill~ IclC\illll drl:lIl11'lillll'C'" C.ll. ICllllnt.:iillinl1. death ul \"'1't.:1I1nr, 1:11:.)
Dcecndcnt was dnmicilcd at dcalh in Ctlmborlnn~~ . Cllll1\LY, l'.cnnwlvaJlia - w!'th
hO)"_ _last family ur principill Icsidcn~c at conntl:-': "londaI/3, .,;):J ;;'pOl'j; ~nl; ull
Roner;- J.lochunic3Durg \ J!ur:pcon 'H)'.m:.; IUjJ)-';7ommylvlll,lu
(lhl ..Hl'l.t, IHllllhcr illUllIIllIICip;lht)'1
12,
,1996
DcccruJcnt, thc'n __ D9 _ years of agc, died lIovurnber
at Hunor Carc Hoolth Sorvicos, :::o1'1i:110, 1''\
bccpllls folll)ws~deecdcnl did notmllrry, WllS nol divorccd and did nnt have a child bnrn or adoptcd
lIftcr exccutinn of the will offcrcd for pruhatc; was nnlthc victim of a killing lInd WlIS ncvcr lIdjudieatcd
illcompctenl: ___
Dcccndcnl Ul dcath nwncd propcrlY wilh cstimi1lcd vlIlucs liS follows:
(If domicilcd in I'll.) AllpcrsOlwl prnpcrlY
(If nol domicilcd in I'll.) I'crsOlmlpropcrlY in I'cnnsylvanill
(If nOI dnmicilcd in I'a.) I'crsonalpropcrlY in CnnnlY
Value of real estatc in I'cnnsyll'ania
silui1lcd as follows:
s
S
$
S
07,000.00
pono
WHEREFORE, pctitioncr(s) rcspcclfully rcqucst(s) thc probalc of Ihc last will lInd eodicil(s)
prescl1Icd hcrcwith and thc grllnt oflclIC" 'C'ostntnentory
(lc..III111Cl1tar)'; illhllinhlr:lliull C.I.a.: adminimatinn 1I.h.n.c.1.a.)
Iheron.
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21~9 II tch Vnl o;r Houd
Hoch~nic3hurlZ ' FA 17050,
OATH OF PERSONAL REPRESENTATIVE
COMMONWEAI.TII <n: I)ENNSYLV ANIA } '$
COUNTY OF' .CU\'3:;IlLAND :;
The pctitillnrr(s) lIbovc-\1amed ""car(s) or affirm(s) that thc statcmcnts in thc forcgoing pctilion lire
truc lInd cllrrc'Ctlo Ihe bcst of thc knowlcdgc and bclief of pctilioncr(s) lInd Ihlltlls pcrsonlll reprcsen-
t:llivc{s) of thc above dcc,'d<:nl pctitioncr(s) will wcllllnd Iruly lIdminislcr thc cslatc lIccording to law.
Sworn to m lIff,irmcd and snhscribcd {./d4~~ ~
bcforc me Ihis __~S.th __ day of ~.
, llovcmbrcJ: _____ 19 <)(, !;
, I' ~ ~
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1,_rD.~..rf" '\
No. 71_'l6-967
Estate of
Am:A P. BAKEn
. lleceased
llECREE 01' PROBATE ANll GRANT OF LETTERS
AND NOW ~~~lS' Der-ember. 4 19.9.6..-. in conslderallon of the petition on
the reverse side hereof, satlsfaclory proof having been presented before me,
IT tS DECREED that the inSlrumcnt(s) dated Fo bruary 23. 1987
described therein be ndmilled to probate and filed of record as the last will of
Anna p, J3altar
and Letters 'l'nnt.nmnntnT'Y
are hereby granted to Hobart J.j, !':auffman a/k/a R.M. Kauffman
'n1n,o c.. e,,~, ~..:PS ~"f"~~
Rcgl'le,or ill.
FEES
Probate, Lellers, Etc. ......... $ 200 . 00
Short Certifieates( 3J . .... .. ." $ 9 . 0 0
Renunciation ................ $
Extr.a,. pages $ j. uu
Jep 5 00
TOTAL _ $217.00
Filed ..... p'J;:r-.J;:!'l.~~~. ~.! ~.~ ~.~ . . . , . ., .
J. TIobert stauffer (06356)
11 1 tAT.1"ORNEY (SQPlct. 1.0. No.)
.' ar ta ;;;'quare u ag.
HechanicsburB. PA 17055
ADDRESS
717-766-9673
PHONE
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or should he be unable or unwilling to scrve in such capacity
for any rcason, then in such evcnt, I nominnte, constitute and
appoint my grandson, ROBERT B. KAUFHIJ\N, Executor of this, my
Last Will nnd Testament, in his place nnd stead.
IN \HTNESS \f1lEREOF, I have hereunto set my hand and
seal this ~~uo___ day of February, A. D. 1987.
[) / I Iklt/
., l\:tF~t. . Bnker
(SEAL)
Signed, sealed, published and declared by the above-
named ANNA P. BAKER, as and for her Last Will and Testament,
in the presence of us, who, at her request and in her presence,
and in the presence of each other, have hereunto subscribed
our names as witnesses.
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-2-
INHERITANCE TAX RETURN
RESIDENT DECEDENT
COMMO"WIAlIt' Of rI""","'''A (TO BE FILED IN DUPLICATE
OlrAl'MHH 0' A(V(UU(
"A.mfJ:b. ~~orJll' ow' WITH REGISTER OF WILLS) coulm COOE 1996 YE^R 00962uUM8ER
o VIU -- "A~III"'~ ~;~u ~ AIW MljliiifltiifiAl1 - - --- -1- iii"(lOltiB (f.)MPlIIl ..ooll!t\ C~Ul1-tt-':I l~lo ndO\olO
I3Almn, Annn 1'. 3!)~ :3pol'ting lIill Hand
iOCIAI ufuw, i<<iMiii---- - -- -\OAII-O; (11,1,111 .- lUAU 011111'.-- - - Hochnnicobul'g, l)A 17055
175-11.0-7112 ll/12/96 3/2131,07 c.,", Cumbel'lund
I" ....<.;;/~.",,"'.oou,i,"..'""'."...."';.,",; "";,,,, . .-l"K'A' .iiu,,'. ,Iu-..i.----. -- ..0UI.i .,cliViiiliili,..iiUtl,otlll
~ 1. Original R,turn LJ 2. Supplemental Retur" 0 J. Remaind.r R.lurn
(lor dolt. 0' d.olh prio, '0 12.13.821
o A. limited E"OI. [] 40, Fulure Inlo,..t Comproml'. 0 5. fed,ral EIlol. Tax R,turn Required
(for dal.. 0' dea,h ohe, 12.12-82)
~ 6. Decedenl Di.d T.,lale LI 7. Deceden. MOlntoined 0 living Trust ~B. Tolol Number 01 Safe Depo.ll BO"I
(AlIoch copy of Will) (Alloch copy 0' Tru'l)
ALL CORRESPONDENCE AND CONfiDENTIAL TAX.INfORMATION SHOULD BE DIRECTED TO.. ;. ,.1 ~':... Il'rl.I':"~.Y'\:'\' , '.1
NAM! (OM'U I( MAllltlO AODllf!l$
J, TIobert Stuuffor, Atty. Harkot Square Bldg.
1Im.0"1 "u.'" . 11ocha.nicsburg, PA 17055
717 766-9673
IlY.Uoo II. 119~1
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1. R.ol El'olt (Sch.dul. AI (1 I
2. Slocl. ond Bond. (Sch.dul. BI ( 2 I
3. Clo..ly H.ld Slocl/Po,'n."hlp In'....IISch.dul. C) (3 I
A. Morlgage. and Not.. Receivable (Schedule 0) ( A )
5. Ca.h, Bank Depa.itl & Mileellaneous P.nonol Prop.rty ( 5 )
. (Sch.dul. E)
6. Joln'ly Own.d Prop..ty (Sch.dul. F)
7. Tron.fen (Sch.dul. GI(Sch.dul. l)
B. Total Gran A..ets (total Lines 1.7)
9. Funeral bp.n.... Admini'lrativ. Costs. Mistelloneous
E.p.n... (Sch.dul. HI
10. O.bts, Mortgage liobililill, lien. (Sch.dule I)
11. Total Deduction. (tolollin.. Q & 10)
12. Nel Value of Estate (lin. B minus line 11)
13. Charitable and Governmental Bequests (Schedule J)
14. Net Volu. Subject 10 Tax lline 12 minus line 13)
15. Spou.ol TroM'en (fo, dOl.. of d.olh oh.. 6.30.94)
See Instructions for Af,plicable Percentage on Reven. (15)
Side. (Indude value. rom Schedul. K or Schedule M.)
16. Amounl of line 14 loltable at 6% rate
(Indude values from Schedule K or Schedule M.)
17. Amounl 01 line U taJl,able 01 15% role
(Indude value. from Schedule K or Sch.dule M.)
lB. Principal tax due (Add taJl, from lines 15, 16 and 17.)
19. Credits Spoulol Poverly Credit Prior Pal-ments
0.00 + -.luOUO.Oo..
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fOR DATlS Of DEATH AmR 12/31/91 CHECK HERE
If A SPOUSAL -
POVERTY (REDIT IS CLAIMED Ll
;ILINUM8IA--- 21::96-=0<)62
(6)
(71
o 00
19,759~
0.00
0.00
77 , u~lIJI
0.00
0.00
97,599.91
(81
(91
9 ..z45~
92.28
9,337.58
80,262.33
0.00
88,262.33
0.00
1).291).74
0.00
5,295.74
4,200.00
0.00
1,095.74
0.00
1.091).74
(101
(11)
(12)
(13)
(14)
0.00
)(._=
(16)
'5.....m5.....l4_" .06 "
0.00 ".15"
(17)
(18)
Discount
200.00_
Intorest
0.00
(191
(201
~
...
20. If line 19 I. greater Ihan line lB, enler ,he difference on line 20. This I. the OVERPAYMENT.
aD ...:r.n"iIlJ 1..1"'J:'II.'U"I'I'l'I~,lhl'.'.I"" nr.t:-=t..I...I........L1J.I.......Il.hl
(21)
(21A)
(21B)
21. If line 181. grealer thon Line 19, enler the difference on line 21. Thi.1s the TAX DUE.
A. Enter lhelnterll' on the bolance due on line 21A.
8. En,erth.tolol of lIn. 21 ond 21A on line 21B. Thl. II ,he BALANCE DUE.
Mok. Check Payobt. 101 R.gl,t., of Willi, Ag.nt
_"...."..'.. BESURETO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH i":. -"i.c. '''.''i.
Under p.naltie. of perlury. I de dare thai I hove examined this return, including accompanying st"edules and .Iolemenls, and 10 the best 0' my knowledge and belief,
it Is true, corred and complete. I declar. lflot all r.ol"lal. "0. bee" reported 01 true market value. Declaration of prepor.r other than the p.r.anol reprel"ntative i.
based on all Information of which preparer has any ~nowlfldge.
"OHAIU"O"'OIO""" '''.1'''''0' ItNO.IlU.H AOO"" 2h.9 Hich Vu11ey noud 0'"
t.. Hechanicsburp:. FA 1701)1) I_I '1- q 7
" A U. " ... .m ,v~.. ADO"" Harltet Square B1dg OAIf"" I
~ Hocha.nicobur PA 17055 2- - /9 - ? '7
. I
lI'i'IWlI.tlll"
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
_______ __ PI.o~! or TlP'1
FIlffiUMBER 21_'}6-0962-stnto
1996-00962-County
~,~
COMMOHWfAl1U O' 'fHH\YlVAHIA
IHtlllnA..CI lAX utUIH
IUIDIHI DIClDIHI
_ __ .....___ ..n_
ESTATE Of
AiillA 1'. \1I1Kfo:ll
IAII P"P"'y \.,n"y.ow;'d wllh 'h. Rleh' ., Su..i~."j,ip-;~-'-Ib;dl..,...,j-~~-s.h~-d~i; fl-----
VALUE AT
DATE OF DEATH
DESCRIPTION
ITEM
NUMBER
1. 1'110 IlAlIK, 11. A" Chooldnr; Aocount nmI COl'tificntoo
of Dopooit, no fo110HO:
,~
,,'
lj., 657 .06
6B,166.34
5,016.26
Chocldng Account 110. 51l101911727.
Certifionto of Dopooit 110. 210010111101.
Cortificnto of Dopooit lto. 21001029'736.
S 77,840.h.6
(Anath additional 8"'- )C 11- theett if mar. tpat.11 "..d.d.)
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ESTATE OF
.
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
_ ._ .PI.as. Print or TVp.
e NUMBEN 21-l)6-0l)(,2-Stato
1l)l)6-00962-0ounty
AMOUNT
COMMOHWlAUtt or '(HHiVIVA.U1A
IHtUltllAUCr lAX It[WIlN
IllSlOUH DrcfDIt-H
A !lirA 1'. nf\!;l'~1l
ITEM
NUMBER
A. Fun.ral bp.nsu,
1.
I
I
i
i
. ,
DESCRtPTION
Hyers Funoral Homo, Inc., 37 E. lIain st., Ilochanics
burg, Ponnnylvanla, funoral oX)lonnon.
$ 6,I~03.70
1.
B, Admlnlstratlv. Cal'"
0.00
2.
3.
4.
C.
1.
2.
3.
4.
5.
6.
i 7.
,
. ,
I 8.
Persanol Representali.e Commissions - Hono
Social Securlly Number or Persanol Represontoll.o:
Voar Commissions paid
Atlarney Foes J. nobert Stauffer, gsq., attorney's fee.
2,400.00
Family Exemplian
Claimant
N/A
Relalianship
Address or Claimont ot docodont's death
Street Addro..
City
Stote
Zip Code
Probate Foes nogister of Hills of Cumberland County,
Pennsylvania, Lettors Testamentary.
Mlsc.lIan.aul Exp.ns...
Cumberland r,Ul~ JOUl'nlll, Entate lIotico.
The Sentinel, Entate lIotice.
R013istor of \'11110, filing Invontory and Pennsylvania
Inhoritance Tux naturn.
217.00
60.00
59.60
25.00
TOTAL IAlsa enter an line 9, Recapitulation)
(II mar. Ipac. II n..d.d, Ins.rt addltlonallh.... 01 lam. 11z..)
s
9,245.30
11'1,1111(1."171
SCHEDULE J I
BENEFICIARIES _____
fiLE NUMBER
21_~6-0~62-Stuto
1~~6-00~62-County
AMOUNT OR
SHARE Of ESTATE
*'
COMMONW""" Of ''NN''''104Ulo4
INHIIIIAH'1 'A_ .nUIN
.nlOIN' OIClOIN'
ESTATE OF
AllllA P. nAlml
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
RELATIONSHIP
1.
A. TaKablo BoqulI'"
nmmnT Ii. JCAUFFilr.U
211.9 Rich Vulloy Roud
Hochanicsburg, 1'A 17055
GSI1TnuDE 11. KAUFFI.1AJI
249 Rich Valley !lond
Ilochnnicuburg, PA 170~5
Ono-hnlf shore oj
Estnto.
non
2.
DuuGhter-in- One-hnlf shnre 0;
I.n\{. Eotnto.
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
AMOUNT OR
SHARE OF ESTATE
B. Charltablo and Gayornmontal Boquolls:
1.
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (AI.a onlor on I1no 13, Rocapitulatlan) S
(II marl .poco I. n..dod, In.ort oddlllanol.h.... ol.amo .1..)
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DNo. AA 185201
.:
....1\6101"'1
COMMONWEALTH OF PENNSYLVANIA
DI'ARTMINT 0' RIVINUI
OFFICIAL RlCII" . PINNSYLVANIA INHERITANCE AND ESTATI TAX
RECEIVED FROM:
D
ACN
ASSESSMENT P:'I
CONTROL I:iI
NUMBER
to'
AMOUNT
J ROBERT STAUFFER ESQUIRE
101
.1,0'7:>.'4
MARKET SQUARE
, .'-'--"
MECHANI CSDURG , PA 17055
ESTATE INFORMATION:
~ FilE NUMBER
Y 21-1996-0962
~ NAME OF DECEDENT ILAST)
~ BAKER ANNA P
~ DATE OF PAYMENT
Iii 02/25/97
ra POSTMARK DATE
COUNTY
SSN 175-40-7112
(FIRST)
IMI)
CUMBERLAND
DATE OF DEATH
11/12/96
REMARKS ROBERT M KAUFFMAN
C/O J ROBERT STAUFFER ESQUIRE
SEAL CHECKll t2
fa TOTAL AMOUNT PAID
..1 ,09~. 74
PB
/) ,
RECEIVED BY /,', N I .' . '.'. .j .,;:.,...
! SlON'~R~. 1-
MARY C. LEWIS ~/,'/:I"7"I'
REGISTER OF WILLS ;
REGISTER OF WI LLS
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMIIRLAND
l.
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:lobl)~~t ". :~~ 11t'J'1:~ln
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bolng duly :1"Q1'l1_ ________ oceordlng 10 low, doposos ond says Ihol ho _'~~-.!i.:,-c,:l~Ql'.- --
____.______.__.__ .__w-.---- of Iho Eslolo of 'cnn'l:-. ;;,.1((11'
101. of __r:[\"F,~"n'rmm,:h \)1 _ ______, Cumborlond Counly, Po., d.coued ond thol tho
within is on Invenlory modo by __._'~(':2:.,~.\;-.~~~r~..:r:.n- --- - -- , tho said -';-:cc"l;or
of Ih. .ntlro ..1010 of sold decodonl, consisting of 0\1 tho personol prop.rty ond rool osloto, ..cept rool estol. outsld.
Iho Commonwoollh of Ponnsylvonlo, ond Ihol Iho flguros opposite ooeh item of tho Invontory roprosont It's folr volu.
u of tho doto of decodont's dooth.
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t9 07
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.10 ufor. 1'MI"Uft . r. .,
"!.I"\ . ~"""l d""'1'(".. "100,1
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., h ., ',' 1"r)~"
-('0 '\1'.-, C") '1'" '- i 'J"
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Sl:orn
ond subscribed boforo mo,
Addr...
Month
1')':7
vu.
Dot. of D..th
1.2th
Day
~. ()\' C":lh~r
'\
INSTRUCTIONS
I. An Invontory must bo IlIod within throo months oltor oppointmont 01 porsonol repr.sontotl...
2. A supplomont Inv.ntory must bo filed within thirly doys 01 dlseovery 01 odditlonol onets,
3. Addltlonol sho.ts moy b. ottochod os to personolty or reolly
4, See Artlcl. IV, Fiduelories Act 011949.
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
15-- /'I?//
SURE AU OF INDIVIDUAL TAXES
1,.IERnANet lAll DIVISION
OCPI. :80601
tlARRISlURC. I'l 1111'8-0601
NOTICE OF INItERITANCE IAK
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
J RDBERT STAUFFER ATTY
MARKET SQUARE BLDG
MECHANICSBURG PA 17055
0(, - 28 - 9 7
BAKER
11-12-96
21 96-0962
CUMBERLAND
101
A~ount Renltt.d
CY ~Ail
~~
1I'.U"UIIf 111.'"
ANNA
P
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 ~
'Ri"Y:i54i-Ex-AFP"iii:i:9:fi-iioYicEuoTINHEiiiTANCE-YAX-'A-PPRiiisEHEii'r-;-Ai.i:ciwANcE-olim_-_mm__---
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BAKER ANNA P FILE NO. 21 96-0962 ACN 101 DATE 04-28-97
TAX RETURN WAS: I X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST " SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..I Elt.t. (Schedule AJ
2. Stocks and Bondi (Schedule 8)
3. Clos.ly Held stock/Partnership Interest (Schedule C)
4. Hartg.ga./Not.. Receivable (Schedule OJ
5. Cash/Bank Oeposits/Hi.c. Perlonal Property (Schedule EJ
6. Jointly Owned Property (Schedule f)
7. Transfers (Schedul. OJ
8. Totel AI..t.
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expense./Adn. COlts/Hisc. Expanse. (Schedule H) (9)
10. Dlbts/Horto.o. LI.bllltl.s/LI.ns ISch.dulo II 1101
11. Total Daduction.
12. Nat Value of Tax Return
13. Charitable/Govarn.antal Bequa.ts (Schedule J)
14. Not V.lu. of Est.to Subjoct to T.x
III
121
151
141
151
161
171
I I CNANGED
.00
19.759.45
.00
.00
77,840.46
.00
.00
181
9.245.30
92.28
1111
1121
1131
1141
HOTE: To insure proper
credit to your account,
sub.it the uppar portion
of this for. with your
tax pay.ant.
97,599.91
g .B7 ~8
88.262.33
.00
68.262.33
If an assessment was issued previously, lines 14, 15 and/or 16, 17 and 18 will
reflect figures that include the total of ~ returns assessed to date.
ASSESSHENT OF TAX:
15. Anount of Line 14 at Spousal rate (15)
16. A.ount of Line 14 taxable at Lin.al/Cla.. A rat. (16)
17. Anaunt of Line 14 taxabla .t Collat.ral/Cl... 8 r.te (17)
la. Principal Tax Due
NOTE:
TAX CREDITS:
PAYHENT
DATE
02-10-97
02-25-97
RECEIPT
NUH8ER
AA185153
AA185201
DISCOUNT 1'1
INTEREST/PEN PAID I-I
210.53
.00
.00 X .00:
88.262.33 X .06:
.00 X .15:
IlS1
AHOUNT PAID
4,000.00
1.095.74
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
.00
5.295.74
.00
5.295.74
5.306.27
10.53CR
.00
10.53CR
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
I IF TOTAL DUE IS LESS TNAN fl. NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REflECTED AS A "CREDIT" ICRI, YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF TNIS FORH FOR INSTRUCTIDNS.1
~~(-'.
~ :-
\.\
,
\Q
RESERYATlOHI' Eltat.. of d.cedents dying on or b.for. D.ce.b.r 12, 1912 .. if any future Int.r..t In the ..tat. It trentferr.d
In po.....lon or enJoy..nt to Cl..' a Ccollat.ral) b.neflclarl.' of the d.c.dent .ft.r the e.plratlon of any ..tat. for
llf. or for yl.r.. the co..onw..lth har.by ..pr..,IY r..lrv., the right to appral.. end ...... tran.far Inhlrltance Ta.I'
.t the lawful Cl..' a (coll.t.ral) rat. on any .uch future Inl.r..t.
PURPOSE Of
NOTICEs
To fulfill the r.quire.ant. of Sactlon 2140 of the Inherltancl end E.tat. T.. Act. Act 21 of 1995. (72 P.S.
Section '1'-0),
D.tach the top portion of thl. Notlcl and .ub.lt with your pay.ant to the AIgl.tlr of Will. prlntld on the r.Vlr.. sid..
._"ak. ch.ck or IOMY order payabla tal REGISTER OF MILLS, AGENT
PAVJtEHT1
REfUND CCA II
A r.fund of . t.. cradlt, which wa. not r.qu..tld an the Ta. R.turn, ..y b. requ..ted by co.plltlng en "Appllc.tlon
for R.fund of Penn.ylvanl. Inharlt.ne. and E,t.t. Ta." CREY-llll). Application. ar. .vallabl. at lh. Offlc.
of thl R.gI.t.r of Will., any of the 21 R.v,nu. DI.trlct Offlc.., or by c.l1lng the .paclal 2~-hour
an.werlng ..rvlc. nuab.r. for for.. ord.rlng1 In Pann.ylvanla 1-100-362-2050, out,ld. P.nn.ylvanla and
within local Harrl.burg ar.a (717) 717-1094, TOO' (717) 772-2252 (H.arlng I.palr.d Only).
Any party In Int.r..t not .atl.fl.d with the appr.I....nt, allowanc. or dl.allowanc. of d.ductlon.. or a.......nt
of ta. (Including dl.count or Intar..t) a. .hown on thl. Natlc. lU.t abject withIn .I.ty (60) day. of recllpt of
thlt Natlc. bY1
..wrltten prot..t to the PA n.parta.nt of R.v.nu., Board of App.al.. n.pt. 281021, H.rrl.burg. PA
--.lectlon to have thl .attar d.t.ralned at audit of the account of the p.r.onal r.pr...nt.tlv.,
--appa.l to the Orphan.' Court.
17128-1021,
DR
DR
OlJECTlONS1
AImIN
ISTRATlVE
CORRECTIONSl
f.ctual .rrar. dl.cover.d on thl. ........nt .hould b. .ddr....d In writing t01 PA n.p.rtaant of A.v,nu..
lur..u of Jndlvldu.1 T...., ATTNI pa.t A.......nt R.vlew unit, n.pt. 210601. H.rrl.burg. PA 17121-0601
Phone (717) 717-6505. s.. pag. 5 of thl bookl.t "In.tructlon. for Inh.rltanc, T.. A.turn far a R.,ldent
n.cadent" (REV-1501) far an e.planatlan of adalnl.tr.tlv.lY carr.ct.bl. .rror..
Jf any ta. due I. p.ld within thr.' Cl) cal.nd.r .anth. .ft.r the d.c.d.nt'. d.ath. . flv. p.rc.nt (5X) discount of
the t.. p.ld I. allowld.
ThI 15X ta. a~..ty nan'p.rtlclpatlon p.nalty I. coaput.d on the tot.1 of the ta. and Int.r..t .......d. and not
paid b.far. January 18. 1996, the flr.t day aft.r the .nd of the t.. a.n..ty p.rlod. Thl. non-participation
pen.lty I. epp..I.bl. In the .... .ann.r and In the thl .... tl.. p.rlad a. you would .pp.al the ta. and Int.t..t
th.t h.. bl.n .......d .. Indlcat.d on thl. notlc..
Jnt.r..t I. Charg.d beginninG with flr.t day of dallnqu.ncy, or nln. (9) .onth. and ana Cl) d.y fro. thl data of
d..th, to the d.t. of pap.nt. T.... which bac". d.lInqu.nt b.far. Janu.ry 1, 1982 b..r 'Int.r..t at the nt. of
.1. C6~) p.rcent p.r ennua c.lculat.d at a dally rat. of .000164. All t.... which b.ca.. d.llnquent on end aft.r
Janu.ry 1, 1912 will b.ar Int.t..t at . rat. which will vary fro. cal.nd.r yaar to cal.ndar y..r with th.t rat.
announced by thl Pi napart..nt of A.v.noe. Th. appllcabl. Int.r..t r.t.s far 191Z through 1997 ar.1
'!!!! Int.r..t Rat. Dally tnt.r..t factor :!!!r tnt.ra.t Rat. Oallv tnt.r..t r.ctar
1911 ZOX .000541 1987 .X .000247
I.n lOX .000'31 1981-1991 IIX .000301
191~ IIX .000301 1992 'X .00OZ~7
1915 UX .000356 1995-199. 7X .000192
1986 lOX .000Z7~ 1995-1997 9X .00DZ~7
.-Jnt.r..t I. calcul.t.d .. folloWIS
OlSC~h
PENAL TV1
JNTEREST l
INTEREST = BALANCE OF TAX UNPAID X NUnBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
.-Any Natlc. I,.ued .ft.r thl ta. b.co... d.llnquent will r.fl.ct an Int.r..t calcul.tlon to flft.an (15) days
beYond the d.t. of the a......ant. Jf payaant I. ..d. aft.r the Int.r..t caaputatlon data .hown on the
Notlea. additional Inter.st lU.t be c.lculated. .--
STATUS rn:X(J!l.:L\!NIH:I~_J~L-'~~l
Name of Decedent:
.\~~:~,\ 1'. ~l,:\!':~;;n
Date of Death: l'ovnr'bcr J2, 1')')(,
Will No. 1r;q6-00r;62
Admin. No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1, State whether administration of the estate is complete:
Yes;: 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' Cuurt No. (if any) {or
the personal representative's account is:
c. Did the personal representative state 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: ::[1;' 20. 1.--:-:7
/l'
./
.r. :-'o~)ort 3tnui'f r
Name (Please type or print)
.n:.)
.,~"''''''..cJ- r......'lr "1'-
i.c....~.. V ..J'~L~t C .J e.G_
-iI"
Address.
::ec::anlc:;bul"'G, :?t...
170';=:
I #__
',"
1 ,"\: :, ~, \7. ,lWI
! -
(''-!.7) 76(.-":67'),
Te I. No.
Capacity: Personal Representative
x Counsel for personal
representative
(MAH: rmf/ AM3)