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Register of Wills for the
. DeceUJed. County of ClIlllberlilnd in the
Soda/ Security No. 31 6 - 4 6 - 11 67 Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older l\lXtMJt1CK')/X y YYYYY)()()()(Xltxxx~llx
in the last will of the above decedent, dated June 18. ,19.1U..-
and codicil(s) dated (nonp) Petll"lonpr, whn ;" nnn nf two children
of decedent s k .c!~.trjl! b~ vJxtl1P nf
ece ent s divorce fr m
renun e)(
on 1 y 0 t he r surv v ng (stalerel"..1 circumstances, e.l. renunciation, d..th ot e.."ulor. C1C.)
child, Michael D. Bastin
Decendent was domiciled at death in cumber 1" nil County, Pennsylvania, with
" I s last family or principal residence at
PETITION "'OR PROBATE and GRANT OF LETfERS
No. ;J..I -1" ~ 9" 'I
To:
Estate of "" rry n
also known as "" r ry
nilAt-in
H;lC:t" 1.11
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dent's
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l1in nrect. number and muncipaJity)
Decendent, then 50_ years of age, died october 5. ,19 9(;
at HarrisbJ,lJ:g,Ji9..lPi t"l, H:'lrri "nl1T'9 .
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate: was not the victim of a killing and was never adjudicated
incompetent: d' x''
May 18, 987
Oecendent at death uwned pro!JCrty with estimated values as follows:
(If domiciled in Pa.) All personal property S 9 , 000.00
(If not domiciled in Pa.) Personal property in Pennsylvania $
(If not domiciled in Pa.) Personal property in County S
Value of real estate in Pennsylvania S
situated as follows: ( none)
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of lellers of ililmin,;tr:'ltinn. '" , ~
(testamentary: administration ~.1.3.: administration d.b.R.C.t....)
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA 1 'S
COUNTY Of' _ r'ml~F'..w.,.Ai:Jn J ~
The petitit'nerl~) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and ~orrect ;0 :M best of the knowledge and belief of petitioner(s) and that as personal represen.
tativels) of the .aocwe decedenl peutioncr(s) will well and truly administer the estate according to law.
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Sworn 10 I)r affirmed 1 and. subscribed {
bef~re me this --1L:--- ~y of
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Dana M. Dietrich
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N 2l-96-9h1o
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Estate of
LARRY D. BAS'I'IN
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW NOV~:~IB~:R 26 19..2L. In consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated June 16. 1963
described therein be admitted to probate and filed of record as the last will or
Larrv D. Bastin A/K/A LARRY IlAVlD BASTIN
and Letters "f l\nmi ni "~r"H on. (' T 1\
are hereby granted to Dana M_ Dietrich
If}1(J \ q (I
!I.;'~r't.~...$.I. if (I. .J~i~.L~
M.ji"er of Wills . iPU'1J
FEES
Probate, Letters. Etc. ."""" $40.00
Short Certificates( 3) ,," " ,," $ 9.00
R .. ? 10 00
enunClauon ", "fl' N'ri~"'" $,......;mr--
EX ~AGF.S S'fOO
Jt.,;P .
TOTAL _ $8 .HH
Filed . t{QVtl~.ll.I;I!.. ~.6.,. .l99.Q.. ...........
Michelle R.~~- 6516B
ATTORNEY ISup. Ct. to. No,)
200 North Hanovnr street
t"':trl;c:la.. Pr. 17n1'l
ADDRESS
(7171 243-5551
PHONE
CALLED ATTORNEY NOVEMBER 26, 1996
21-96-96/,
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WARNING: It Is IIlcglll to dupllclIlc thiS copy by photostat or photograph.
3807879
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COM..ONWlALTH OF PtNHSYLYAHIA . DEPARTMENT 0' HEALTH' YITAL RECORDS
CERTIFICATE OF DEATH
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lAlster D.
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Inc.. 3125 walnut St., Hbg.PA
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1East ~t\lill ctttb Qfeshuuettt
of
LARRY D. BASTIN
I, Larry D. Bastin, of Greencastle, County of
Putnam, State of Indiana, hereby make, publish and declare
this my Last Will and Testament, hereby revoking any and all
former wills and Codicils at any time heretofore made by me.
ITEM I
I direct that my Executor, hereinafter named,
shall payout of the assets of my estate all inheritance,
estate, transfer and succession taxes, state and federal,
which may be imposed upon my property or estate or on any
bequest, devise or interest under this Will, or on any other
property, taxable by reason of my death.
ITEM II
I hereby give, devise and bequeath all the property
I own at my death, both real and personal and wherever situated
to my wife DARLA D. BASTIN provided she survives me for a period
of sixty days.
ITEM III
In the event my wife should predecease me or should
not survive me for a period of sixty days, then I give, devise
and bequeath all the property I own at my death, both real and
personal and wherever situated, equally to my two children
DANA MICHELLE and MICHAEL DANE.
ITEM IV
In the event my wife does not survive me, I hereby
nominate and appoint JAMES F. ZEIS as Guardian of any minor
children that may survive me.
ITEM V
I am aware that my wife has executed a Will on this
date and that my Will and hers may include what appear to be
mutual bequests. However, no contract between my wife and
myself exists for the execution of a Will containing such
bequests and it is expressly agreed that either of us may
revoke our Wills at any time without the consent of the other.
ITEM VI
I hereby nominate and appoint my wife DARLA D. BASTIN
as Executrix of this, my Last Will and Testament. In the
event she is unable to so serve for any reason, I then nominate
and appoint JAMES F. ZEIS as Alternate Executor. I direct that
no bond be required of either of said persons in that capacity.
IN WITNESS WHEREOF, I hereunto
Last Will and Testament this ~ day 0
to this
1983.
""
Larry D. Bastin of Greencastle, County of Putnam,
State of Indiana, signed in our presence the foregoing instru-
ment consisting of two pages, each of which he signed and
. ,
. .
dated in our presence and in our presence the said Larry D.
Bastin published and declared this instrument to be his Last
Will and as witnesses whereof we do now at his request, in
his presence and in the presence of each other hereto subscribe
our names and addresses as attesting witnesses hereto this
IS day of ~....J , 1983.
J uz.lL /l.~~tJ'~ ) of ~0~~'M.J-iJ.. \.. ,]
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GA 58
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KNOW ALL MEN IV THESE 'llSlNTS. INllhe CENlRAL ACCI()(NT INSUWlCt CQMr1J(Y Of AMLRICA. a ~Mrytvlnla
COfllOfIlioft Nvl", iI1 principal oIf,ct in Philadelphia. hnn!ylvanla dof1 hcttby INh, con.~Ult and &ppOInI Sha r I Wes tha f er,
Debrn G~Qv<:,. S~~Jl Pinckney, Debrll I.. Hccl.,in, Diane C. LlIndis-------------------------------
lactllndMdU111)' if I tJf 11'oO<' INn Onf Nmtd. ib \Nt Ind 1a~1 AIIOtnt'(-in-l1C\ 10 INh, "fCvlt. lullnd 6tliwf II lU"'Y lot and on
b btNIf. Iftd II its K1lnd ~ any Ind an bon<h and undflukinls oIlU~. and 10 bind the GlNlRAl ACCI()(NT INSURANCt
CJ::JN'AH'( Of MU:IUCA hertby &I ~1Iy Ind III the lIfnt mtnllS W wch bonds and undtl\Ikinp and Cllhcf writl"l' obI''II\OIY iltllt Nlu~
lhtftd -lIaned by In (..CIIIM O/l'lCtf 0I1he ClNlAAL ACO()(NT IHSUAANCl CQMr1J(Y Of AMLRICA Ind lHltd and ICIt1Il'd by
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bond Ot undtfUki", ollUffly\hiP DtcIIIl'd undtf 1M authority ~ be lUbjed 10 tilt foI\owi", GmiUllons:
AIry ~le Ot fIcI~ry lord III an ""-nlllOC 10 ncetd ,..,..,.......,............,........,........,. $ 1,000,000
Ally P\lnllff'1 Court lord III an amounlllOC to ncetd ...............................,.........,..........$ 100,000
Ally Public ~ lord (a.d<ld1"1 bI.InbO In an unounlllOC to oat'll ........,........................... $ 100,000
AIry \JanIe. ~It lord 11I11I amounlllOC to 1SCftd..,.,.......... .......".".,...,. ,..,........,....$ 15,100
AIry CMI CHI Appul Ot ltmovallord In an unounlllOC to oat'll.. .. .. .. , .. .. .. , .. .. , .. ... . .. .. .. .. .. . .. .. $ 2,000
",. pooMf ollllO<MY lilianei'd undt1 and by authotity 01 $u~tIon S.llbl 01 Miele V c the ~ 01 CENEIlA1 ACO[)(NT INSUAANCE
C1JW#AH'( Of MU:IUCA which boame Il'IedlvI ~ :10, t 992 and which Pf'O'ltIoul 11'I il ~ bet and tI<<l. rudlnI · IoIowI:
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Thls ~ olallO<MY illIaned and IUItd by laaimile undef and by IUlhorty 01 the IoIowlI'C moUion adopIed by tilt boatd 01 dilKlOn
01 GlNUAl ~CIOENT INSUIlANCl COMJ'}.NY Of MU:RICA. II . ~ htId on the Xlh dI'( d hbNuv. 1992. II wftich · quorum wu
ptetnl. Iftd ~id rt1OllAlon "" no( been IIT'otfl6td 01 ~altd:
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IN WITNESS WHEIIEOf, CENtRAl ACCIO(N1' INSUwa 00I0IJ'}.NY Of AMLRiCA hal auwd these prtlC1lb to be tIcr*I by Otnnis S.
PWdIr, b VIce I'r~ and ItscOlPO'lte leal 10 be hcreIo afftxtd,lNs 6th dI'( 01 November ,
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6th dI'( 01 November , I'~. penonaIy ~ 0eMls S. ~ to me known 10
01 the CENERAl ACOO(NT INSUwa 00I0IJ'}.NY Of .WU~ rod adrooYo'..Jttj lhaI he IIIC\.Ud rod IIIdfd
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IN WITNESS WHEIIEOf, , "- helNnto lei my hand and all\:Il'd the teal d!lld Ccmpany lhiI
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vember 6, 1998
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21-96-964
RENUNCIATION
In Re Estate of
LARRY D. BASTIN
deceased.
To the Register of Wills of CUMBERLAND
County. Pennsylvanio.
The undersigned Alternate Executor
of
the above decedent, hereby renounec(s) the right to adminisler the estate and respectfully ask(s) that Lelters
be Issued to _
WITNESS..~:4- '7k: '=<'-".....':-"-
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hand this ;' 3 rI. day of 7 k-e,,,..k<f19..2k-.
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J es F. ZielJi IU")
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CERTIFICATION OF NOTICE UNDER RULE 5.6 a
Name of Decedent: Lill-rv o. n:l~t+' n
Date of Death: october 5. 1996
Admin, No.
will No.
1qql1_nnQ~d
To the Register:
I certify that notice of beneficial interest required by
Rule 5.6(a) of the Orphans' Court ~ules was served on or mailed to
the following beneficiaries of the above-captioned estate on
December 5 ,1996 :
Address
Name
~
R444 ~nl1t-hprn c:::pringC! nrivp
Dan~ M. niptrir.h
Indianapolis, IN 46237
Michael D. Bastin
5249 Luzzane Lane A t 706
Indianapolis, IN 46220
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except (nonel
Date: 12/5/96
n~ \ct~ 11. CaJltW'"
signature
Name Michelle R. calvert. ESquire
Address 200 N. Hanover street
carlisle. PA 17013
Telephone(711
243-5551
,.d_l
capacity:
Personal Representative
X counsel for personal
representative
CoreStates Bank of Delaware 'NA
PO Box 8920
Wilmington DE 19899-8920
(800) 833-3010
,J j- (1& ' (/& L/
Roco'(]',.' ."t::. of
Rell'!'; t' Wills
.
December 3, 1996
'96 OIC 16 Al0 :21
CoreStates
Register of Wills
Cumberland County Courthouse
Carlisle, PA 17013
Clef! - "':.lJ,HI
Combt), ,;.n.; Go., PA
ESTATE OF: Larry D. Bastin
WHO RESIDED AT: 1142 Newville ROnd; Carlisle. PA 170J.3
DATE OF DEATH: 10-5-96 BALANCE AT DEATH: $4833.56
CURRENT BALANCE: $4833.56
RE: 01-28196003
Dear Sirs:
WRITTEN NOTICE OF CLAIM GIVEN TO:
Michele R Calvert
200 N Hanover St
Carlisle, PA 17013
Below is our Proof of Claim to file against the estate mentioned above,
Enclosed is a check for your filing fee, if such a fee applies, and a
self-addressed stamped envelope. Please return the copy of the claim
with your stamp to verify it was received.
Enter the claim of CoreStates, 3 Beaver Valley Road, Wilmington, De
19802, in the amount listed above against the above estate on this
date. Finance charges will continue to accrue at the applicable
account rate until the balance is paid in full.
For information, please contact person and extension noted below, rather
than the claimant'S coullsel.
NOTE: Accounts for residents of Delaware and some other states may
be with CoreStates Delaware NA, an affiliate of CoreStates Bank of
Delaware NA. Refer to your CoreStates Account Agreement.
CoreStates, Claimant
3 Beaver Valley Road
Wilmingto~ DI}) 19803
By: .-""-..i f1W,(oe.,..
Claimant ' s Counsel:-
Felix A. Cohen, Esq.
Ext. 71:37
COlcSltll('!) Blink U A
PO 00' 1618
Phll.ldrlphl,1 PA 19101.761 A
RCCO'l:...
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Dear Vendor:
Core States
Bank
Subject:
Cll:Il.' , " nJr!
Changing Your Payment Method to Direct ~~'L:,;""IJ ".0., PA
The Accounts Payable Depanment of CoreStates Bank, N,A, would like to establish you as an ACH
payment account and arrange payment to you via direct deposit, ACH stands for Automatic Clearing House
and is the banking industry's method for making electronic payments directly to other banking accounts.
For example, many companies pay their employees via ACH by depositing their salary payments directly
into their Demand Deposit Accounts (DDA).
This method of payment is preferable to a check for several reasons; it eliminates all check handling
functions:
printing and mailing by issuing pany,
deposit by the payee, and
the "check clearing process" performed by banks,
If you agree to change your method of payment, and allow us to set your account up for ACH payment,
please provide the fonowing information and return this letter to:
CoreStates Financial Corp
Accounts Payable Depanment
P.O, Box 7618, FC \-9-8\-3
Philadelphia, PA \9101-7618
1) Vendor Name and "Remit To" Address (include street, city, state, and zip code)
Name
Address
'.
Authorized Approval Signature
Please Print Name Above
The "remit to" address is the address where a check would be sent if one were generated. Although
a "remit to" address is not necessary for an ACH payment, Accounts Payable needs it to send an
"Advice of Credit" notifying you that funds have been deposited into your account.
2) ABA Bank Routing Number
Bank Name
Bank Address
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COMMONwEAltH Of PfNNSYlVANIA
OlPAIl.IMENT Of R(VWU(
DEPl 180601
HAll.Rt!l~UIIG,'!' 11,!,lRO~'
DlCfDlNT') NAMlI1A)1. llli:~!. ANO MlllDlltttlllAU
.. I ~-, J
i..)'- /'1-) "\
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
c..,.
fOR OATIS Of DIATH AnlR 12/31191 CHICK HIRE
If A SPOUSAL'
POVIRTY C~ID.!T_IS ~LA.""llllJ_,_
fill HUMBER
96
0964
NUMBER
21
COUNTY CODE
YEAR
VllfOIH!!1 (OMrllll AOOIl:[!I!lo
I-
15
fil
...
...
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BastinLJ..arr.Y-P~I'----- '__'_________ ,___'_ 1142 Newville Road
)OCIAl UCUlIllT NUMUIl DATl01 OIAlIl OAI(Ole1llltl Carlisle, PA 17013
316-46-1187 10/5/96 4/28/46 Coo", cumberland
,,' ...,..",,"""'"0''''''' ,...., ".., '"'' ...,. "" ",' .~, rIA' >!CV"" "V.,..------ ~~[..MOV'~::,-(j"'O I'" ,,,,tRVCI<O"'1
...
I-
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...",,,
.........
:cog
ufca
...
...
~ 1. Original Return
[] 1.
Supplemental Return
[ I 3.
[] 5.
Remainder Return
(for datlu of deoth prior 10 12.13.82)
Federal Ellale Talt Return Required
o 4. limited Eslale rJ 40. Future Inlerlt,1 Compromise
Ifor dale' 01 death aher 12.12.82)
o 6. Decedent Died Teltale 0 7 Decedenl Maintained 0 living Tru,t
(Attach copy of Willi (Anach copy of Tru't)
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO.
_ 8. Tolal Number of Safe Deposil Boxes
COMPI(TE MAilING ADDRESS
.;,1-
...ill
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8~
NAM'
200 North Hanover street
Carlisle, PA 17013
Es uire
243-5551
(I) -,---'
(11 ______________
(3 )
14) -------",,-----'----'-----
(5) _9_,2017-..15---
(bl____
(71 _,______,_____'_ ----
(B) 9,247.75
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...
...
a:
1. Reol E,'ole (Schedule A)
2. Slack. and Bond. (Schedule B)
3. Closely Held Slack/Partnership Inlere,t (Schedule C)
4. Mortgages and Noles Receivable (Schedule 0)
5. Cosh, Bonk Deposits & MisceUaneou, Personal Property
(Schedule E)
6. Joinlly Owned Properly (Schedule F)
7. Tron.len (Schedule GI(Schedule L)
8. Total Gran AneU (10101 line, 1.7)
9. Funeral Expenses, Adminisl'otive CoslS, Miscellaneous
Expenles {Schedule HI
10. Debls, Mortgage liobilitill, liens (Schedule I)
11. Total Deductions (total lines 9 & 10)
12. Nel Value of Estate (line 8 minus line' 1)
13. Charitable and Governmenlal Bequesls (Sthedule J)
14. Net Value Subject to Tax (line 12 minus line 131
15. Spousal Transfers tfor dalll of dealh after 6.30.94)
See Inslruttions for Ar,plicable Percenloge on Reverse
Side. (Indude 'Values rom Schedule K or Schedule M.)
16. Amount af line 14 taxabl. 01 6% role
(Include values from Sch.dule K or Schedule M.)
17. Amount of line 14 loxobl. at 15% rol.
(Include valulS from Sch.dule K or Sthedule M.)
18. Printipallallt due (Add lox from lines 15, 16 and 17.)
19. Credil. Spousal Poverly Credit Prior Paymenll
+
+
(1QI
110)
IQI...--!!.,927.04
6,768.86
(101
(11)'L'i,6QS.90
(12)lQ.., 448.151
(131
(14) 0.00
x._c
(151
(lbl
(17)
x .Ob =
x .15 II
(IBI
0.00
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Inleresl
20. If line 19 is gr.oler than lIn. 18, .nler the differenc. on line 20. This is Ihe OVERPAYMENT.
m O...rftn.!II.iI~(...I_..,ll.lll...l<lII'lo.a.'1l1iI'....ilrwnr.n..Tjll11..l......!.l!..Ii..II!.111
0.00
(11)
(11A)
(218)
21. If lint 181. grealer than lIn. 19, enler Ihe differente on line 21. This is Ihe TAX DUE.
A. Enler thelnlerlSt on the balance due on line 21A.
B, Enler the to.ol 01 line 11 and 11A on Line 116. Thi. i. the BALANCE DUE,
Make Check payable 101 Reglsler .. Willi, Agent
/i'i<':-:c'. ,'c. BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH ',' .,
Under penolti.. 01 perjury. I declo.. that I ho" examined this ,,'urn, i"c1uding accompanying "hedul.. and .lolemenlS, and '0 the be.. 01 my knowledge and beliel,
II is truI, correct and compl.te. I declare that all real estole hos been reported at Irue morhl value. Declaralion 01 preparer olher Ihan the personal representalive is
baSld on alllnformalion of which preparer has any knowledge.
)IGNA'UII 'PlUONltU'ON UfOltfl\IN 1l(1UltN AOORus8444 southern sprlnGs Drive OAT( / /
IndianapoliS, IN 4 237 U 111 '77
'00"" North Hanover sttet!L 0'" I I
cax.Usle, PA 17013 {"IIf/(n
I I
III Of ,1I('AIt(ll: aT III THAN 'Iln NTATIV(
~ el e..LJ1 ~'(j- .
-
Act '48 of 1994 provide. for the reduction of the tax rate. Impo.ed on the net value of trande,. to or for
the u.e of the .pou.e. The rate. a. pre.crlbed by the .tatute will be:
e 3% 1.03) will be applicable for e.tate. of deceden" dying on or after 7/1/94 and before 1/1196
e 2% 1.02) will be applicable for e.tate. of decedent. dying on or after 1/1196 and before 111197
e 1% 1.01) will be applicable for e.tate. of deceden" dying on or after 1/1/97 and before 111198
e Spou.al trande,. occurring on or after 1/1/98 will be exempt from Inheritance tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK (vo) IN THE APPROPRIATE BLOCKS.
YES NO
1. Did decedent make a transfer and:
x
a. retain the use ar income of the properly transferred, ......,........................................,......,
b. retain the right to designote who shall use the properly transferred or its income, ...............
x
x
c. retain a reversionary interest; or ........,...............................,..........................................
x
d. receive the promise for life of either payments, benefits or core9 .......................................
2, If death occurred on or before December 12, 1982, did decedent within two years preceding
death transfer properly without receiving adequate consideration9 If death occurred after
December 12, 1982, did decedent transfer properly within one year of death without receiving
adequate consideration9.."", ,....., ,..........."....,...".. ............, ,.., ,.. .......' ,.....,..' ,...,.., ...... .......
x
x
x
3. Did decedent own an 'in trust for' bank account at his or her deathL....................................
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
~
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COMMONWEAltH Of P(NNSYlVAHIA
INHUIIANCI TAX UrulN
.UIDINT DlCEDINT.
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
Pluolo Print or Ty/,o
FilE NUMBER
21-96-0964
I'>' J I" IJl1)
ES-TATE OF
Larry D. Bastin
~II p;op.,ty Jolntly-own,d wllh the Right of Survlvor,hlP m~.' b. d~~~!~~~~_i~~~~.~!!)~. _..
ITEM
NUMBER
DESCRIPTION
VALUE AT
DATE OF DEATH
1 .
Coastal Federal Credit Union, checking account
#80528300-5
$1,849.99
2.
Coastal Federal Credit Union, savings account
#80528300-5
$3,550.76
3.
Cash refund from prepared health expenses
$ 147.00
4.
Harley Davidson, motorcycle VIN# 1H~4c.A1I\1-?LY1twBtS
Ve-'r\.,-\e. ,\e.u." ~ ~'\C\O
$3,700.00
TOTAL (AlIa onlor on lino 5, Roea i1ulation) S 9 .,,2-1.2..25
(Anoth addilionalBYJ" )( 11" sheets if more 'paul j, needed.1
...
IIvnllllt 1'111
ESTATE OF
Larry
.
(OMMONW(AlHt 0' '(NN~YlVAUlA
INHIRIfANCI tAl '(lUIU
anlOnn OIC(OUU
D. Bastin
ITEM
NUMBER
A, Funeral Expon,ol:
B.
4,
C.
I.
2,
3.
4,
5,
6.
7,
8,
I.
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
,MIS~ELLANEOUS~~,~ENSESH_ ",', '.. ,,'00.. Prln~ or Type
=NUMBER
21-96-0964
--,-------------,- -
DESCRIPTION
Bittles & Hurt Funeral Homer Greencastler IN
Admlnl.tratlvo co.ts:
Personal Representative Commissions
Sadol S.curity Numb.r of P.nonol R.pr...ntoli..:
Year Commissions paid
I.
2.
Attorn.y F... Griffie & Associats
Family Ex.mption
Claimant
Addr... of Claimant 01 d.c.d.nt's d.alh
Str..t Addr...
3,
City
Pro bat. F...
Register of Wills
Mlscellanoou. Exp.n....
R.lotionship
Stat.
Zip Cad.
Acordia of Pennsylvania - bond for administratrix
Cumberland Law Journal
The Sentinel
TOTAlIAI.o .nt.r on lin. 9, R.copitulotion)
(II more Ipace I. n..dod, Inlert addltlonallhoots 01 .amo II...)
AMOUNT
$8,111.03
$ 500.00
$ 82.00
$ 100.00
$ 60.00
$ 74.01
S 8,927.04
,
IfVdSI2Ut ItDl61
.
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE L1ABLlTIES AND LIENS
(O/oWO"'....'.'I" 01 'INN'n~"'N'.
INMIIIIANe' '''I 'f1U''''
'UIDINIDIClOINI
UTATE Of
Larry D. Bastin
ITEM
NUMBER
I,
2.
3.
DESCRIPTION
PP&L
Sprint
Corestates Bank of Delaware, N.A. credit card
account #01-2819600-3
4. Cary Cardiology, P.A.
5. Carlisle Hospital
6. Carlisle Hospital
7. Masland Associates - medical services
8. Carlisle Community Ambulance
9. Belvedere Medical Corp.
10. RWC Emergency Physicians
11. Carlisle Advanced Life Support
fiLE NUMBER
21-96-0964
AMOUNT
$ 70.48
$ 164.35
$4,833.56
$ 365.76
$ 322.00
$ 27.00
$ 37.00
$ 138.49
$ 2.22
$ 371.00
$ 437.00
(II more spoce is n..d.d in",,' uJdajonol ,h..t, 01 same ~jze'
Tor/\~ ,"110 "nler on line iv, ,fo:::::p'viafionj
. ;6,768.86
r" ,..
/.) I 'I.)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
*
I
",
NonCE OF INIlERlTANCE TAX
APPRAISEHENT, ALLOWANCE DR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
BUREAU OF INDIVIDUAL TAXES
INttERIUH([ UX DIYISIDN
OEPl. lID6001
IlARRUIURG, PA lIua-DUI
'11-".111 ", 111-")
10-13-97
BASTIN
10-05-96
Z1 96-0964
CUMBERLAND
101
\
MICHELLE R CALVERT ESQ
ZOO N HANOVER ST
CARLISLE PA 17013
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
""aunt Re"l tted
LARRY
D
\
MAKE CHECK PAYABLE AND REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
R_EV:i547-EX-iiFj:i-ni:i=97rNOTiCE--OF-YtiiiEiiiTAHCE-TAx-WPRA'iSEHENT-,--,m.-OWAHCE-O-Ii-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BASTIN LARRY D FILE NO. Z1 96-0964 ACN 101 DATE 10-13-97
TAX RETURN WAS. (X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN
1, Rool Estata (Schadula AI (11
2. stocks and Bonds (Schedula 0) (2)
3. ClosalY Hald stock/Partnership tnt.rest (Schedula C) (3)
4. Hortgagal/Hotas Racaivabla (Schedula D) (4)
s. Cash/Bank Dapollts/Misc. Parlonal Proparty (Schadula E) (5)
6. JoIntlY Dwnad Proparty (Schodulo FI 161
7. Transfars (Schadula G) (7)
8. Total AI.at.
I CHANGED
HOTEt To inJure propar
cradit to your account,
.ub"it the uppar portion
of this for_ with your
tax pay.ant.
,00
.00
.00
,00
9.Z47.75
.00
,00
(81
9,Z47.75
8,9Z7.04
6,768.86
llll
(121
llSI
ll41
APPROVED DEDUCTIONS AND EXEMPTIONS I
9. Funaral EKpan.al/AdM. Cost./Mlsc. EKpanJa. (Schadule H) (9)
10. Dobts/Hortgago LlabIlltlas/Llans ISchodula II (101
11. Total Doductlon.
12. Hat Valua of Tax Return
13. Charltable/Govarn"antal Baquast. (Schadula J)
14. Not Valua of E.tata Subjoct to Ta.
,~,6q~ qO
6,448.15-
.00
6,448.15-
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 TAXI
15. Amount of Llna 14 at Spousal rata (151
16. AMount of Lina 14 taKabla at Lina.l/Cla.. A rata (16)
17. Amount of Llna 14 ta.abla at Collataral/Cla.' B rata (171
18. Principal Tax Dua
NOTEI
.00 X .00.
.00 X .06.
,00 X .15.
ll81
.00
.00
.00
.00
TAX CREDITS I
PAVHENT
DATE
RECEIPT
HUHBER
DISCOUNT 1+1
INTEREST/PEN PAID (-I
AHOUHT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
.00
,00
.00
.00
. If PAID AfTER DATE INDICATED, SEE REVERSE
fOR CALCULATION Of ADDITIONAL INTEREST.
If TOTAL DUE IS LESS THAN 'I, NO PAVHENT IS REQUIRED,
If TOTAL DUE IS REfLECTED AS A "CREDIT" (CRI, VDU HAV BE DUE
A REfUND. SEE REVERSE SIDE Of THIS fORH fOR INSTRUCTIONS. I
RESERVATION; E.tete. of decedent. dying on or be'ore Oec..b.r Il, 1'82 -. If any 'uture Int.r..t In the ..tat. I. tr.n.f.rr.d
In po.....lon or .nJoy..nt to Cl... . (coll.t.ral) baneflcl.rla. of the dac.d.nt .ft.r the ..plratlon of any ..tat. for
Ilf. or for y.ar., the Co..onw.alth h.reby e.pr...lv r...rv.' the right to .ppral.. and ...... tran.f.r Inherltanc. T....
at the lawful CI... . (collet.ral) rat. on any .uch future Int.ra.t.
PURPOSE OF
NOTICE;
To fulfill the requlre.ent. of Section 2140 of the Inherltanc. and E.t.t. Tax Act, Act 21 of 1"5. (7l P.S.
Sactlon '140).
PAYttENT 1
Detach the top portion of thl. Notice and .ub.lt with your payaent to the R.gl.ter of WillI prInted on the rev.r.. .Id..
--Hak. check or .on.y ord.r payabl. tal REGISTER Of' MILLS, AGENT
REfUND (CA) 1
A r.fund of a tax cr.dlt, which was not r.qu..t.d on the Tax R.turn, ..y b. r.qua.t.d by coapl.tlng an "Appllc.tlon
for R.fund of Penn.ylv.nla Inherltanc. and E.t.t. Tax" (REY-1313). Appllc.tlons .r. .vallabl. et the OffIce
of the Raglst.r of Wills, .ny of the Z3 Ravenu. District Offlc.s, or by ceiling the .paclal 24-hour
answering servlc. nuab.r. for for.' orderIng: In p~sylvanle 1-8aa-36Z-ZaSa, out.ld. Penn.ylvanl. and
within local H.rrl.burg .r.a (717) 787-80'4, TOOl (717) 772-2252 (Ha.rlng lap.lred Only).
OBJECTIONS 1
Any party In Int.rest not satlsfl.d with the appral...ant, allowanc. or dl..llowance of d.ductlon., or .......ent
of tax (Including dl.count or Int.r..t) .. .hown on thl. Notlc. .u.t obj.ct within Ilxty (60) d.y. of r.c.lpt of
this Notice byt
OR
.-wrltt.n prot..t to the PA O.p.rt..nt of Aev.nu., Bo.rd of App..l., D.pt. 281021, H.rrlsburg, PA
--.Iectlon to h.v. the ..tt.r d.teraln.d .t audit of the account of the p.rsonal r.pr..ant.tlv.,
--.pp..l to the Orphanl' Court.
17128-1021,
OR
ADHIN
ISTRAlIVE
CORRECTIONS I
Factu.l .rrors dlscovar.d on thl. ........nt .hould b. addr..I.d In writIng tOI PA D.part..nt of R.v.nu.,
Bur.au of Indlvldu.l T...., ATTNt Po.t A.......nt Ravlew unit, D.pt. 280601, H.rrl.burg, PA 17128-0601
PhOn. (717) 787-6505. S.e p.g. 5 of the bookl.t "Inltructlons for Inh.rltanc. T.x R.turn for a R..ld.nt
D.c.dent" (REY-150l) for an axplan.tlon of .d.lnl.tratlvelY correctable arrors.
DISCOUNTt
If any tax due I, paid within thr.. (3) cal.nd.r aonth. aft.r the d.c.dant'. death, . flv. p.rcant (5X) dIscount of
the tax paid I. .llowed.
PEHAl TV t
The 15X tax .anasty non-participation pen.lty I, co~ted on the total of the t.x and Int.r..t .......d, and not
p.ld before Janu.ry 18, 19'6, the flr.t d.y .ft.r the end of the t.x ..na.ty p.rlod. This non-p.rtlclpatlon
p.nalty I. .pp..I.ble In the .... .annar and In the the I'" tl.. p.rlod .. yOU would .pp.al the tax end Int.r..t
that ha. b.an .......d as Indlcat.d on thl. not Ie..
INTEREST t
Inter..t Is charged beginning with first day of delinquency, or nine (9) .onthl and one (1) day froe the d.ta of
d.ath, to the d.ta of pay.ent. T.xes which baca.. delinquent be for. Janu.ry 1, 1982 b.ar Inter..t at the rat. of
six (6X) percent per annua calcul.ted .t . dally rat. of .000164. All ta~as which bee." delinquent on and efter
January 1, 1'82 will b..r Intar.st at . rate which will vary froa c.lend.r yaar to c.lendar y..r with that rat.
~.d by the PA Dep.rteant of Rev.nue. Th. appllcabla Interest rata. for 1982 through 1'97 .r.:
~ Int.rnt Anta Dally Intarnt Fftetor :2!! Internt R.ta Dftllv Int.r..t Fector
1982 ZOX .000548 1,87 'X .000247
1981 lOX .000438 1988-1991 IIX .00nOl
1984 IIX .COnOl I..Z 'X .aDa2U
1985 UX .000356 1993-1994 7X .00019Z
1'86 lOX .000274 1995-1997 OX .0002:47
nlnt.rnt II calculatad 00 'ollowl1
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
_.Any Hotlc. I.sued .ft.r the ta. baco", delinquent will raflect an Intere.t calcul.tlon to fifteen (IS) d.y.
beYond the data of the .......ant. If payaant Is .ade aft.r the Internt co~t.tlon data shoWn on the
Hotlc., additional lntere.t .ult b. calculat.d.
IN IW: The Estate Ill'
LARRY DA VII> B/\STIN
: IN TilE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY - PENNSYLVANIA
: ORPIIANS COURT DIVISION
: NO, 21.96-0%4
PETITIQI~_EQH SETTLEI\1ENT OF A Sl\lALL....ESTATE
TO THE HONORABLE JUDGES OF SAID COURT:
AND NOW comes, Petitioner, Dana M, Dietrich. by and through her counsel Bradley
L. Grime, Esquire, and the law linn of GRIFFIE & ASSOCIATES and respectfully
represents as follows:
I. Larry David Bastin, a,k.a. Larry D. Bastin, died on October 5, 1996, a resident of
North Middlcton Township, County of Cumberland, Pennsylvania.
2. Petitioner, whose address is 8444 Southern Springs Drive, Indianapolis, Indiana
46237, is the daughter of the decedent and, on the date of the decedent's death,
was not a member of the decedent's household,
3. Michael 0, Bastin of 5249 Luzzane Lane, Apanment 706, Indianapolis, Indiana
46222, is the son of the decedent and was not a member of the decedent's
household at the time of the decedent's death.
4, Decedent len a Will dated June 18, 1983, a copy of which is attached to and
incorporated herein by reference us Exhibit "A," which was probated on
November 26, 1996, and Letters of Administration CT A were granted to Dana M,
Dietrich, yuur l'elitioner, hy the Register uf Wills uf Cumherlal\ll County on
Nowmher 26, 1<)<)6,
5. Deccdcnt was survivcd by thc following persous cntitlcd to sharc in his estatc:
NAMES
Dana Michelle Dietrich
Michael Dane Bastin
RELATIONSIIlI'
daughter
INTERESTS
50%
50%
son
6. The propeny owned by the deccdent and the valuc of thereof is us follows:
V AWE
PROPERTY
(A) Coastal Federal Credit Union Checking Account
No. 80528300.5
$1,849.99
(B)Coastal Federal Crcdit Union Savings Account
No, 80528300-5
$3,550,76
$147.00
(C) Cash Refund from Prepared Health Expcnses
$3,700,00
(D) Harley Davidson Motorcycle
$9,247.75
TOTAL
7. The following disbursements huve been made from the estate prior to the filing of
this petition, or have been made through the contributions of the prospective heirs
named above:
NAME
NATURE OF PAYMENT
AMOIlNT
Bittles & Hurt Funerull-lol11C
Grccncastle, IN
Funeral Expcnscs
$8,111.03
Griffie & Assoeiates
Attorney's Fees
$500.00
Registcr of Wills
Probate Costs
$82,00
~
1 verify that the st:ltements made in the foregoing document are true QIld correct 1
underst:llld that false st:ltements herein are made subject 10 the penalties of 18 Pa.C,S.
Section 4904, relating to unsworn falsifications to authorities,
DATE: /,.L1.j1/J
,
,.to>. I
'" .\
I -
..., ~.
\
..-...,..----,;'.....-......
1, ~ncHAEL DANE BASTIN, have received and hereby approve the Petition for
Settlement of Small Estate that is being filed by my sister, Dana Michelle Dietrich, as
Administratrix of the estate of my late father, Larry David Bastin.
DATE:
I-i D-(j)O
---4JJ~w-
MICHAEL DAi'ffi BASTIN
5249 Luzzane Lane, AparttOent 706
Indianapolis, Indiana 46222
Swom and subscribed to before me
'l!
this 10 day of "5N1~"~"" ,:~
C 0 ~c~" .
~~J,. ) ~kL
NOTARY PUBLIC
; '~, ~, :c
C,.S~;' .
Co,
._....: .,.*.......;0
MY CO,111ill
,.,),1 '.....1.'
, '
, ,
--
~
-.
11r~t~Jt 3IvrUl cutb Qft}.it~U1tt1tt
of
1.l\IlIlY D. B/\S'J'IN
I, J'lIr'ry n. llaHtln, of GrcwncastJe, County of
PULnam, Stilte of Indll1na, hCl"I:!by milke, publish /lnd declare
thls my I,aflt Will and 'I'estament, hereby revoking any and all
fonner Wills and Codiclls at /lny time heretofore made by me.
I'l'EM I
I direct that my Executor, hereinafter named,
shall payout of the assets of my estate all inheritance,
estate, transfer and succession taxes, state and federal,
which may be imposed upon my property or estate or on any
bequest, devise or interest under this Will, or on any other
property, taxable by reason of my death.
I'!'EM I I
I he,J;"eby give, devise and bequeath all the property
I own at my d'l:!i\th, both real and personal and wherever situated
to my wife Dl\RL/\ D. Bl\STIN provided she survives me for a period
of sixty days.
ITEM I II
In the event my wife should predecease me or should
not survive me for a period of sixty days, then I give, devise
and bequeath all the property I own at my death, both real and
personal and wherever situated, equally to my two children
Dl\Nl\ MICHELLE and MICIIl\EL Dl\NE.
ITEM IV
In the event my wife does not survive me, I hereby
nominate and appoint JAMES F. ZEIS as Guardian of any minor
children that may survive me.
ITEM V
I am aware that my wife has executed a Will on this
date and that my Will and hers may include what appear to be
mutual bequests. 1I0wever, no contract between my wife and
myself exists for the execution of a Will contailling such
bequests and it is expressly agreed that either of us may
revoke our Wills at any time without the consent of the other.
ITEM VI
I hereby nominate and appoint my wife Dl\RLl\ D. BASTIN
as Executrix of this, my Last Will and Testament. In the
event she is unable to so serve for any reason, I then nominate
and appoint JAMES P. ZEIS as l\lternate Executor. I r'lirect that
uo Lond he required 01' either of said persons in that capacity.
IN WI'J'NESS WIIEREOP, I hereun to
Last: Will and 'l'estament this -Lf:. day 0
/
Larry D. Dastin of Greencastle, County of Putnam,
State of Indiana, signed in Ollr presence the foregoing instru-
ment consisting of two pages, each of which he signed and
EXHIBIT "A"
dated in our presence and in our presence the said Larry D.
Bastin published and declared this instrument to be his Last
Will and as witnesses whereof we do now at his request, in
his presence and in the presence of each other hereto subscribe
our names and addresses as attesting witnesses hereto this
IS day of ~ ~ ~ , 1983.
j UJ {i. /l.cf;,.tPu-~) of r~i1.u.-~rI.tJ~
..., .. fI/ ';/fLI';..:} of ~".A..C_UL
Cf
I",j
tf, - /J? .- f' J'
-2-
,--J
, .,9:...R .
~~
'4,!11::1l
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
IHAlTlHCE fAX DIVISION
Ofpr. lIonl
HARAISIURC, p, 111:a-a.ol
NOTICE OF INHERITANCE TAX
APPRAISEHENT. ALLOWANCE DR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
MICHELLE R CALVERT ESQ
200 N HANOVER ST
CARLISLE PA 17013
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
10-13-97
BASTIN
10-05-96
21 96-0964
CUMBERLAND
101
Allaunt R..t tt.d
'*
"'.\14I""'U""1
LARRY
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 ~
iiEV:iSf,""j-EX--AFii-[o3':97T" NOTiCE --oF-YNHEiii;:Ai;cE-TAin~';PR:\fsEiflfrj:r-;-AlUjw:'N-cE-iili_______________u
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BASTIN LARRY D FILE NO. 21 96-0964 ACN 101 DATE 10-13-97
If an assessment was issued previously, lines 14, 15 and/or 16, 17 and 18 W1l1
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. AMount of Line 14 at Spousal rate (151
16. Allaunt of lln. 14 taxable .t Lin..I/CI... A ~.t. (16)
17. Aaount of Line 14 taxable et Collateral/Clas. B rate (171
18. Principal Tax Due
TAX RETURN WAS: (X I ACCEPTED AS FILED
I CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Raal E.tate (Schedule AI III
Z. Stock..and Bond. (Schedule BI (21
5. Closely Held Stock/Partnership Intere.t (Schedule CI (51
4. Hortgagas/Not.. Receivabl. (Schedul. D) (4)
5. Cash/Bank Doposit./Hisc, Per sane 1 Property (Schedule EI (51
6, Jointly Owned Property (Schedule FI (61
7. Transfe,.s (Schedul. C) (7)
8. Total Assat.
.00
.00
.00
.00
9.247.75
.00
.00
181
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Fun.,..l Expanses/Adll. Costs/Hi.c. Expanse. (Schedul. H) (9)
10. Debts/Hortg.ge Li.billtie./Liens (Schedule II (101
11. Total Deduction.
12. Hat Value of Tax R.turn
13. Charitabla/Govarnllantal S.qu..t. CSch.dul. J)
14. N.t Valu. of Estate Subject to Tax
8,927.04
6,768.86
1111
llZI
1151
1141
NOTE:
.00 X .00=
.00 x' 06=
,DO X .15=
1181
TAX CREDITS:
PAYHENT
DATE
RECEIPT
NUHIlE R
DISCOUNT 1+1
INTEREST/PEN PAID (-)
AHOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
EXHIBIT II II TOTAL DUE
· IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
NOTE: To insure proper
c,..di t to your KCOU1t,
sub.it the upp.r portion
of this fa.. with your
tax pay..,t.
9.247.75
1~.6q~ qn
6.448.15-
.00
6.448.15-
.00
.00
,DO
, DO
. DO
.00
,00
.00
D
IF TOTAL DUE IS lESS THAN II. NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIDNS.I
RESERVaTION I Est.t.. 0' d.c.dent. dylnQ on or ba'ore Deca..r 12, 191Z ... If eny 'utur. Intarut In the ntat. II tran,'.rred
in po..a..io~ or Inj=y.."t to Cl.u S (-:0Ihtanl1 ~flc"rln 0' the dKedent .ft.,. the hDlratlon 0' In., ..tate for
life or for y..r., the C~lth hIIreby .wpn..h r...rvn the right to eppnl.. and ...... tr..."lr IrlMrltanca Taxe.
at the IlIWful cta.. a (coU.t....I) ntl on MY such future Int.rut.
PIJRPQSE OF
NOTICEI
To fu1fll1 thl requlr..."t. of Section ZI"O of the lmerltanc. and Eltat. Tu: Act. Act Zl 0' 1995. (12 P.S.
Section 9140).
paYMEKTI
D.tach the top portion of thh Hotlu and .~lt with your p.YMI't to the R81IIItar of WUlI printed on the raver.. side.
..H_e cheCk or ~, order paymla tOI REGISTER OF HILUS, AGENT
REf\IND (CR) I
, raftnS of a tax credit, which .... not requa.ted on the Tax Return, ..y be r.quut.d by co.Platlng en "AppUcation
for Raft.nl of Penn.,lvenle InlMrltanc:. and E.tata flUl" (REY.1313). Application. an .v.Uable .t the Qfflu
of the R.gI,t.r of Will.. any of the Z3 R.venue DI.trlct Offlc.., or by c.lllng the ,p.clal Z".hoUr
an....rlng ..rvlc. nuaber' for for.. ordarlngl In Penn.ylv.nl. 1.80a.36Z.Z0S0, out.ld. P.nn.ylv."la and
within l~l Harrisburg ar.. (717) 717.80'''. TOOt (117) 77Z-ZZSZ (H.arlng 1~lrad Only).
OLlECTIONSI Any party In Int.r..t not ..tidied with thl apprais..ant, aUowlnC. or dl..Uowanca of deduction., or ........,t
of tax (Including disc~t or lntlrun a. shown on thlt Notice IIUlt objKt within si.ty (60) day' 0' rKllpt of
thlt NoUc. bYI
"wrltt." protett to the PI. o.p,rtMnt of bvenu., Bo.rd of Appall., Dlpt. Z810Z1. Harrisburg, p, 11UI-I0U, OR
--.lectlon to have tn. ..ttar dIIt.ralned .t IlUdlt of the acClKM"lt of the personal raprn.nt.tlve, OR
"appe.l to the Crphan.' Court.
....IN
ISTR'TlYE
CORRECTIONS I
Factual Irrors discov.red on thh .......ant .hould b. .ddr...ad In wrlUng tOt PA D.part...,t of R.v.......,
Bur.au of Indlvlduel T...., ATTH: POlt A....saant Ravl.w Unit, Dept. Ze0601, Harrl'~Jrg, PI. 111Z8-a601
Phon. (711) 181-6505. S.e PSi. S of the bookl.t "In.tructlon. for Inh.rltanc. f.. Raturn 'or a R..ldant
Dacadent" (REY.lsal) for an ..plan.tlon of ~lnJltratlv.IY correctabl. error..
OISCOUKTI
I' any ta. due I. paid within thr.. el) cal.ndar aonth. .ft.r tha dec.dant', d.ath, . fly. percent (5%) dl.count of
tha t:x P31~ I. 3110wcd.
PENAL TV:
The 15% tax 88nI'ty non-p.rtlclpatlon penalty .. coaputed on the tot.l of the tax end Inter..t ......ed, and not
p.ld b.for. January 18, 1996, the first d.y aftar the and of the tax allnl.ty p.rlod. this non.parUclp.Uon
penalty Is app..lable In the .... Ul'WMr and In the thl I'" tI.. parlod .. you would app.at the tax end Internt
th.lt h.. b..., ....u.d a. Indlcat.d on thlt notlc..
INTERtST:
Interest It ch.rged bevlrvdno with flr.t day of delinqu.ncy, or nln. (9) aonlh. end on. (1) d.y fro. ttMI data of
d.ath, to the data of Plyaant. Tax.s which ~ d.llnquent bafora January 1, 1,8Z b.ar Int.r..t .t ~ r.t. of
.1_ (6X) percant p.r annul calcul.ted .t . dally rat. of .000164. All t.... which baca.. d.llnquent on and .ft.r
January 1, 1'82 will b.ar Inter..t at a rat. which will vary 'roe c.l.ndar yaar to c.lendar y.ar with that rat.
announced by the PA C.p.rtaant of A.venue. Th. appllcabl. Int.ra.t rata. 'or 1'8Z throuvh 1997 .r'l
'!!!! tnter..t Rata oalh tntarut Factor !!!! tnt.rut Rat. DIlly tnt.r..t Factor
1982 20% .0aos41 1917 OX .aaa2U
1913 16% .0001018 19U-I991 1I~ .aonGl
1914 11% .a00301 199' 9~ .000Z"1
1915 13~ .Oa03S6 1993.19'94 rl .a0019Z
1986 IO~ .OOaz7" 1995-1997 9~ .oaozu
..tnt.r..t Is c.lculat.d .. follows:
INTEREST = BALANCE OF TAX UNPAID X NUNBER DF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Hatlc. I.sued aft.r the tax bleo..' d.llnquent ..Ill r.flact an Int.ra.t c.lculatlon to flft.an (15) d.y.
b.yond tn. data of the ........"t. If p.y...,t Is .ade aft.r the Intar..t caput.Hen d.t. Shown on \hi
Notlc., MtdIUonal Int.rnt wu.t be calculat.d.
..
~
w~vt
u"~
.....u
:caC>
u......
~...
,~
..'"
....
"a
..",
8~
~
fOA OATIS 0' DEATH Ann 12131191 CHECK HEAl
If A SPOUSAL
POVEATY CAlDn 15 CLAIMED 0
fIll NUMIIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
96
0964
NUM8ER
COMHoONWfAllH 0' 'fNNSnV.lNI.A
DfllUIMfNI 0' UVfNUl
Of" 110601
H,lUISlUIC.'.11111.v601
otCIO'NI'i NA.Ml il.A$I. "I' . AND MICCH INltlALI
21
COUNTY CODE
YEAR
...
ai
"
..
u
..
"
Bastin Larr
SOCI"~ UCUI11'Y "'oIlJ/olUIII
316-46-1187
DlceDI,...I', cO",,'lUl ACOIIU
1142 Newville
Carlisle, PA
C~..... Cumberland
A,MOUNT UC!lvto 11ff INStlluCT10NSI
Road
17013
o 3. Remainder R.rum
(for dOlo. of dooth prior 10 12.13.821
o S. federal Ertol, To" R,rum Required
_ 8. Tolo1 Numb., of Safe a.posit 8ou.
lIe R. Calvert Es uire
Tf,Lf'HQN( HUMIU
200 North Hanover street
Carlisle, PA 17013
(8) 9.247.75
(11)1<;.h'l<; 'lO
(12)16,448.15)
(13)
114) 0.00
)(._iII
)( .06 =
x ,15 "
(18) 0.00
(191
(20)
0.00
121)
(21A)
(218)
~r(. .~ BE SURETOANSWEl(-A~QUESTtONS;ON REVER$E;SIDFAND TO RECH
Under penalties of p.~ury. I ctK!or. that I he.... examined this return. including accompanying schedule. and stotem.nll, and 10 the b.st of my Ieno_ledg. and b.nef,
it is true, corr.ct and compl"e. I dedar. that all real eUot, has b..n r.pon.a at true marht valu.. Declaration of prepar.r other than Ih. p.nonol repre..ntariv. it
boltd on 011 information of which pr.par.r has ony kno'Wl.dg..
SIGHATUllO"usON~n'cHslllf ~.'IUNOU"U.N ....:cuss 8444 Sout ern pr~n CAlf
Indianapolis, IN 4 237
.~qU200 Nortn Hanover bLL~~L
l'sle PA 17013
rn 1. Original Rerum
O~. Limittd ellatt 0 Jo. Future Inltrll' Compromise
(lor dolo. of doo,h oko, 12.12.82)
o 6. DICtdtn' Di,d Tlltat. 0 7. D.c.d.nt Maintain.d a Living Trust
(Anoch c.py 01 wml IAnoch copy .f Tn"ll
I ALL CORRESPONDENCE AND CONACENllAL TAX INFORMATtOI4 SHOULD BE ClltEC1CD To~v~~if<!iY:'J~'.,"" ~, ~~. - ,: .';': I
NAIol CCM,un MAILING ADOUU
OArt C' Of...rH
10/5/96
1'4'i 2874 6
I SOCIAl SfCUllfl NUMIII
1"41fl.lCA.lUSU..."..''''OIPOUUI.........II.UI.''Uf4..0..'l)O\. ..'114""
o 2. Suppl.m.nlol R.turn
43-5551
'"
a
3
::s
~
0:
<
u
..
..
1. Rool Ello,. (Schodul. AI ( 1 1
2, Slocl<. ond 80nd. (Sch.dul. BI (21
3, Closely H.ld S.ocl<lPo,,"onhlp lnlo,.II ISchodul. C) ( 3 )
A. Mongogo. ond No'o, Rl<o;voblo (Schodul. 01 I A )
S. Cash, Bank O.posits & Misctllaneous Personal Property (5 1
(Schodulo E)
6, Jointly Ownod P'opo"y ISchodulo FJ (6)
7, Tronsl... (Schodul. Gl(Sch.dulo L) (71
a. Total Groll AntiS (total Un.. 1.7)
9. Funeral expenses. Administrativt Casts. Misc.llon.ous ( 9)
Exp.n... ISchodulo H)
10. Cob.., Mongogo Uob;IW.., l;on. ISchodulo I) (101
11. To.ol O.duct;on. (Io,al Uno. 9 & 101
8,927.04
6,768.86
'l.247 75
Z
a
~
~
::s
...
..
<0
...
>C
<
~
12. N.t Valu. of Estote (Lin. a minus lint 11)
13. Charitable and Governm.ntal Bequests (Schedult J)
U. N.t Valu. Subject 10 Tax (Lin. 12 minus Une 13)
'15. Spousal Transf.rs (for datil of dtoth aher 6.30.94)
Se. lnmucio"s for Applicobl. Percentogt on R.....rs.
Sid,. (Indude ...alulI from Schedule K or Schtdul. M.)
16. Amount of Line U loxoblt at b% ratt
(Indud. valu" from Sch.dul. K or Sch.dult M.)
'17, I
Amount 0 lint 14 IOlilabl. at 15% rot.
(Indude valutl from Schtdul. K or Sch.dule M.)
18. Principal lax due (Add tax from lin.. 15. 16 and 17.1
\19. Credits Spousal Povtrty Credit Prior Paymtnts
\20, + +
I
21.
Discounl
Inl.relt
(15)
(16)
(17)
If lint 19 is greater Ihon lint 18. enter tht difference on lint 20. This iSlh. OVERPAYMENT.
Ii! C ...:T':I1.'11IIoIl...I...I.II..U...lol.III...1Ihl....l:o.:.Jl'r.'r.w:'Ia.l.111..1'l:o.:.Jj~'llllo.:.Jll
If line 18 is greater Ihon Lint 19. .nler the diKerenct on lint 21. This iSlht TAX DUE.
A. Enter tht inlerest on tht balance dut on Un. 21 A.
8, Enlo' ,ho 'olal 01 line 21 ond 21 A on lino 218, Thl. ;, Ih. BALANCE DUE.
Moko Chock Pavablo tal Rog!"o, 01 WIlli, Agont
:I....n
l,f'IJ(q'7
/ I
tIV'!J."" 1"'11
.
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
Ploalo Prlnl or l' .
.
FilE NUMBER
21-96-0964
COMMONWUU'H O. '!NNSytIJANIA
INHllnANCI TAX lnulN
IUIDINT OK_DINT
ESTATE OF
Larry D. Bastin
(All prOfNrty Io'fttfy..owned with the .'ght .f Su,."IY'Onhlp mu.. 1M dl.d..eel Oft Schedule ')
ITEM DESCRIPTION
NUMBER
1 . Coastal Federal Credit Union, checking account
#80528300-5
2. Coastal Federal Credit Union, savings account
#80528300-5
3. Cash refund from prepared health expenses
4. Harley Davidson, motorcycle VIN#
VALUE AT
DATE OF DEATH
$1,849.99
$3,550.76
$ 147.00
$3,700.00
I
TOTAL (AlIa onler on lino 5, Retapilulalian) Is 9 . 2 4 7 .7 5
(Anach addifio"al BY,- x 11- she.,s if more spael is "e.d.d.)
......UU...(7-e.1
.
COMMONWrALJH 0' ,rNNSYLYANIA
INHUITANCl TAX UTUIN
IUIDrNT DrcrDfNT
D. Bastin
ITEM
NUMBER
A, Funeral Expenlel'
B.
4,
C.
1.
2,
3.
4,
5,
6.
7.
8.
l.
SCHEDULE, H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
Plea.. Print or T pe
MBER
DESCRIPTION
Bittles & Hurt Funeral Home, Greencastle, IN
Admlnlltratlve Cast.:
1.
Personal Representative Commissions
Sodal Security Number 01 Personal Representative:
Year Commissionl paid
2.
Anorney Feel Griffie & Associats
3,
Family Exemption
Claimant
Address 01 Claimant at decedent's death
Street Address
City
Probate Fees
Register of Wills
Mlleel1aneoul Expenlel'
Relationship
State
Zip Code
Acordia of Pennsylvania - bond for administratrix
Cumberland Law Journal
The Sentinel
(If more Ipaee il needed, inlert addillanal sheetl of same Ilze.)
TOTAL (Also enter on line 9, Recapitulation)
AMOUNT
$8,111.03
$ 500.00
$ 82.00
$ 100.00
$ 60.00
$ 74.01
58,927.04
"""""",,,,, .
COM/lIOHwULnt Ofl """In.,.....'"
IHMllnAH(J tAl .nu.,.
IUIDIHt OKlOIN'
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABLITIES AND LIENS
ESTATE OF
Larry D. Bastin
I FILE NUMBER
21-96-0964
ITtM
NUMBER
DESCRIPTION
AMOUNT
1. PP&L
$ 70.48
$ 164.35
$4,833.56
$ 365.76
$ 322.00
$ 27.00
$ 37.00
$ 138.49
$ 2.22
$ 371.00
$ 437.00
2. Sprint
3. Corestates Bank of Delaware, N.A. credit card
account #01-2819600-3
4. Cary Cardiology, P.A.
5. Carlisle Hospital
6. Carlisle Hospital
7. Masland Associates - medical services
8. Carlisle Community Ambulance
9. Belvedere Medical Corp.
10. RWC Emergency Physicians
11. Carlisle Advanced Life Support
TOTA:. v~iso '"'" on fine iv, ~1-::Fi!'",iofiQ"j
, .
, '6,768.86
(II mort spoce is nHd.d ins.rl Qaoilionol sh..ts at some ,ize)
.. -. ..__ _...' n'
STATUS I{EI'Oln UNI>EI{ IUJI.E 6.12
Name of Decedent: Larry D, Bastine
Date of Death: Oetober 5, 1996
Will No,: 1996-00964
Admin, No,: 21.96-0964
Pursuant 10 rule 6,12 of the Supreme Court Orphans' Court Rules, I report the following
with respeetto completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete: Yes
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be eomplete:
3. If the answer to No, I is Yes, state the following:
a, Did the personal representative file a final account with the Court?
No
b, The separate Orphan's Court No. (if any) for the personal representative's
account is:
c, Did the personal representative state an accounl informally to the parties
in interest?
Yes (allached)
d. Copies of receipts, releases, joinders and approvals of formal or informal
accounts may be filed with the Clerk of the Orphans' Court and may be allached
to this report,
Date: .+ 1.lit b.\
I -- Iffie, Esquire
I ASSOCIATES
,...., ..'..:{ ",2 0 rth Hanover Street
- -:q ~~c.:..:
o fr, N , Car sle, P A 17013
n.. (717) 243-5551
~ (800) 347.5552
') ~
1O: ~ .,1 Capacity: Personal Representative
0"; '.0
'-' X Counsel for personal representative
lllQ 13 ~t=
a: a: J' -
u8
-
Cl 1::tf
- If)
O.!!l N ,~ :
1\)- e..
l,)? -8
t:.... ~ ,'0
f:lO c
0-- ~ .~
f1l2 -
OJ> .(\1
~.~ '.0
~ ~~
a: a: 08
-.....
~._-,
1li~tlit ](llill ~tltb ffil'lihtuu'ltt
of
1,/\ IlIlY II. 1I/\n'I'1 N
I, I,nrry II, IInnlll1, of C;I'f!l'IWnn 1.1 0 , 1.'0\ll11.y of
1'1ll.l1i11n, Hl.ntn of 1111\1011101, hnrl1by mnkr!, pllhllnh 0111'\ ,1p,~llIn'
l.hlH my I,ant will 11\111 '1',~nlllml'lIl, heroby ,'ovoklll'J nllY ill III itll
[ormer Willn a 11<1 Codld Ie nt allY time herctofore made hy me,
I'I'F.M 1.
I dircct thnl my Rxccutor, hercinnfter namm1,
/lhall payout of the nSRcle of my e!ltnle nil Inherltalll:e,
cstate, lransfer nlld RuccessIon taxcs, stnlc and fcdr!rnl,
whl,ch ml\Y be .lmposed upon my I'ropel:ty or estate or on allY
bequeRt, devise or interest under L1lls W.lll, or on any other
property, laxable by reasoll of my death.
I'l'RM II
I he;eby g.lve, devise and belJueath all the property
I own at my dU~th, both renl nnd personal and wherevet. sltuated
to my wlfe O/\nL/\ D. D/\S'l'J.N provided Rhe survives me for n perIod
of s.lxty dnys.
I'I'EM II I
In the event, my wife should predecease me 01: should
not survive me for a period of sixty days, thcn I glvc, dev.lsc
ancl bequenth all the pt'operty I own nt my denth, both t'[Jal 01",1
personal alld wherever situated, e(IUally to my two chlldt'clI
D/\N/\ MICII1~I,I,B and MTCII/\IU, I>/\NF..
l'l'EM IV
III the evellt my wife does not survive me, I hereby
nominate alld appoint ,J/\MF.S P. ZEIS as Guardian of any mll101'
children that may survive me.
l'l'F.M V
I am aware that my wife has executed a will on lhls
dntc and thnt my will and herA may lnclude whnt appcnr to bc
mutual bequeots. 1I0wever, no contracl: between my wlfc alld
myself cxists for the exccutloll of a Will cOIII:ainln'J Buch
bequests nnd it is expresoly ngreed thnl: eilher of us mOlY
revoke our Wills ilt any time without the consent of the othet'.
I'I'EM VI
I hereby nominate and appolnt my wife o/\m,/\ D. B/\S'l'IN
ns I~xecul:,'lx of I:hls, my I,nRt Will and 'rcRtamellt. In 1111'
f'vrJlll Rhl! I.A ullnhlc to so serve for nny ,.-enRon, r 'hf'n nomi lIill"
;11,,1111'1'0\111. .111111-::; F, (,1-:1:; iHl 1I1tt1ntille (,xeclltor. I din!!:1 tlt"t.
110 bOlll1 he reqlllrecl of eithe,- of R"id p".-Aons In I.h,,1 (",piwlt y.
I,ns t Wi 11
I,arry D. LlnsLin of c;reencl\stle, County of I'lItnam,
StOlte of In(ll11na, slqned In ollr presence the rorelJollIlJ IlIsl L'II-
mellt conslstlng of lwo pages, each of which he siglled and
r.XlIlnTT "/\"
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIYIOUAL TAXES
:Jrn<[IIU&M:t: ax JllI!'HCN
::r.PT. ':10.01
twfAtSIUAG, PA Pl:I'lf.n
NOTICE OF INHERITANCE T.X
APP~AISEHEHT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS 'ND ASSESSMENT OF TAX
MICHELLE R CALVERT ESQ
200 N HANOVER ST
CARLISLE PA 17013
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
10-13-97
BASTIN
10-05-96
21 96-0964
CUMBERLAND
101
.lnount ff..1ttH
~~
~~
....~~, (J in llJ,&tll
LARRY
D
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN I.OWER PORTION FOR YOUR RECORDS ~
ii~ij:mT~;c.Uip-to:f:i;;:rj-iicjfic~--o~-YHHEifii'Ai;CE-TAX--;'::.;~i-"-fsEif~1jT-;-Ai:i.-:w:.ircE-:jli"---"----------
DISAI.I.OWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BASTIN LARRY D FII.E NO. 21 96-0964 ACN 101 DATE 10-13-97
If an assessmen~ was issued p~eV10us1y, lines 14, IS and/o~ 16, 17 and 18 w111
~ef1ect figures that include the total 01 ALL ~etu~ns assessed to date.
ASSESSMENT OF TAX:
15. Anount of L1ne 14
1Q. Anount of line 14
17. Amount of Lin. 14
18. Principal Tax Du.
TAX RETURN WAS: (XI ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VAI.UE OF RETURN BASED ON: ORIGINAl. RETURN
1. R..l Estata (Schadula Al III
Z. Stocks ' and Bonds (Schadula BI IZI
3. Closal. Hald Stock/Partnarshlp Intorast (Schadulo CI 131
4. Hortgages/Hotes Receivable (Schedul. D) (4)
5. Cash/Bank aeposits/Hisc. Personal Property [Schedule El (5)
6. Jolntl. Ownad Proparty (Schedula Fl (61
7. Transfors (Schedula GI 171
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expanses/Ada. Costs/Hise, Expenses (Schedule H) (9)
10. Dabts/Mortgaga ~labilltias/Ll.ns (SchadUla II (101
11. Total Deductions
12. N.t Value 01 Tax R.tu~
13. Charitable/Governaantal Bequests (Schedule J)
14. N.t Value of Estate Suoject to Tax
NOTE:
at Spousal
taxable at
taxable at
nSl
I"'at.
Lin..l/Class A rat.
11. J
Collat.l"'.l/C~.ss a ,.at.
, :n
TAX CREDITS:
PAYMENT
DATE
RECEIPT
SUNDER
DISCOUNT (.J
:HTEREST/PEH ~A:~ (-)
CHANGED
.00
,00
.00
.00
9,247,75
,00
,00
(8)
8,927.04
6.768.86
Illl
IlZI
(131
(14)
.00
,00
,JD
X .00.
X ,06.
x ,15.
Ila J
'MOUNT P.ID
TOTAL TAX CREDIT
BALANCE OF TAX DUE:
INTE~EST AND PEN.
,OTAL DUE
:;XHI,,:T
lip'"
"'
INDICATED, SEE qEYERSE
A:::OITICN,\L
55 THAN t1,
HOTE: To Insure proper
credl t to your acCOU'1t,
sub.it the upper portion
of this far. with your
tax paYf*'"lt.
9,247,75
, ~,~q~ qn
6.448,15-
.00
6.448.15-
,00
.00
,00
,00
,00
,00
,00
.00
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
~.l"l
CI. 'I .,
..,.:~'rt\
~
-:::MA'CN'-Nt.4l!'" e' -l!"'NS"~'''''''I.4
:f_'UrM("! :' H"'t"'<lvl
:,," :eCOlJI
".lUISlu4C '. '~'21~(la)1
:1~!OI...r'\ "'_1 \..A)~ III): .....0 "lCCII "".r:"lt
...
1lI;'"
...C"
.........
:"''''
..."'-
.....
:c
wi
......
....
"'..
8it
15,
; t~.
~ i.
z
=
c '1,
.. .
"-
:IE
..
...
.. :':
::
-
..
~
..
~
...
...
'"
z
'"
;:
c
-
=
-
ii:
c
...
...
"'
3ast::t Larrv D.
ilo":C:"1o U:'..ll!"V' ...I,;.....u
316-46-1197
:..'! :. ,c...:"
., 0/5/96
:" -"""",,IUI h.'v'","-J ~IQ"U , ._. ...." ".$' ...0 ..,00" """AU
'::3 I.
C"ljinal ilth.lm
:: 2. Suopi,mt"'al ::t'h.lrn
C5,
~ .t, limrl.d :uor.
j:ltol :$10" (Scn.dul. AI
5loell. :nd 3ond. ISch.d.l. 31
Cos.ely H,ld SroduPorm,,,hip 'nf.rllf (Schedule q
Mortgages and NOI., RKlivobl. {Sc.~edul. 01
C",h. ~ank O.co,i" & Misc'llaneou, ?,nonol Property
15".0.1. oj
Jointly C""'",d i'rOOtrry (Schedul, F]
Tron.i... IS'''dul. OIISch.dul. 1I
T010i Gron Au." (toral Un., 1.i)
~:Jn.rol :,'(&::11""'. AdministrQri..,. C.2SU. Misc.llan.aus
:.I01"S.' ISc::,.dul. H)
70. O.ors, Mongcql ~iaollities. Li.n, ISc.,.cul. II
It. 1'0101 ~IClu~ion' {tolol L;nes ~ 1 :0)
N., Vollol. ~; :lfole (lin. 3 1,,,"IolS ~;n. 11)
C:'CMICOII ,nci Governmental 3.C1uesrs (Sch.dull J)
6,
7,
, 3,
~,
.12.
,
,13,
. !J. ~., V:IU. SuaieC:'a iCl~ {linl 12"inu, Wne IJI
Sao,""cl ;ronsf.rs :Ior :0'" :Jf :.aH'I '''Ir 6~JO.Q.i}
5.. ,nut"JC!ion, 'or ~Dcllicaoj. ?trc.nl:g. on ~''''Irsl p 51
Siae. :Inctual "'Olues from Sc.'ldule < :Jr Schlaule M.l
.\moun, :f :.ine ! J "oxoall ,t =~ .01' (! OJ
(lnduo. "'OIUes :,oom SC:'Iloull '( :lr 5c:'Ilaul. M.l
.J.:nount:; ..;n. ~J 'c.-ce;1 =r ~.s~ .011 (~i)
:Inc:uc. "OllollS 'r':lm SC:'IICuil .< :r SC~ICyl. ."'.J
.'''nclOOl ''x :1.11 .Ace 'cx J~om ~:I"I's ~.!. '10 =I'd : 7 J
:"Icia
SCOYlal ""'11'"')1 C:loit
?lor '::-O""'I"IIS
::J ,1,0, FUhlre Inr.r,,' ComClromise
{for :tates of death ort.r 12.12.a:1
0, Oerudlnr :Ji'd restate ,; 7. O.c.d.nr Maintained 0 U"'"9 r",u
("\l'foc., :ooy ~f 'NilI) (.Al'fOtn ~op)' of inntl
. AU. COllll!SPONDENCE AND CONADENnAL TAX INFORMAnOK SHOULD BE DIRKTm TO:;':~;~.y;:;.. ~r '-7. _ :.'>,: ;
j. 'OJ,,,,,,,. ,':Iol'UU 'M11Jf'tG ...gOIU$
~ichelle R. Calvert, Esquire I 200 North Hanover Street
'I"U'"C~I _UM'" l' 1 !?A 17013
717 I 3-5551 Car los_e,
I
I I.
i 2,
I 3,
I J
/5,
~""t :' 'I'!H
'4/29/46
"01 OATIS 0' DIATH A"II 11/JII91 CHICK HIli
. II A SPOUSAL _
POYIITY CUDIT IS CUIMID
i IILI NUM.II
i "1
I ~
'COUNrY COOE
iCt':.!:!Nl'\ ';':""UTI olCO'loU
1142 Newville
Carlisle, !?A
c...... Cumberland
"',.,U':Uf't' H.;.!t'tlO I~U ;,..SUlJC'CIol$!
,
I
9~
0964
'f~,,;r
NUMIE~
Road
17013
;c<.,,~ 'fC....lf"'f "'UMU'
,-. 3,
~.moindlr ~.rum
{For dales of d.arh prior to 12~ I U2)
F,dlral Estate Ten ~'hlm ilequired
_ 9. TOfal Numalr ~i Sofw Oepolit 3.0...,
(11
(2 )
( 3 I
(J)
151
'L2~7 75
161
(7)
(Q)
9,927.04
6,758.86
131 9.247.75
(101
(II) 1 ~ ;:;,~ 'l0
(121 ( 5 , 443 . 1 5 I
(131
(lJI
0.00
x,_=
.. .,:6 :I
lie .1~ :I
: ~ 3:
, ..
oJ .,;1..
::isc,:ul"r
'!eru:
.....
\ '1)
f l~;nl ':: s ;rtollr 'hol"l ~;"e la. '1'I11t 'hi 03inlf,nc. QI"I L:ne ~C. ':';'is:, ~;,. OVERPAYMENT,
a:
,:0)
Chrdr hne if you CI1'1:' ft"qUfl'ing 0 refund 0' YaW' overpaymftl'. .
"'::'!U
("':a"l~s:~.
12:1
.... .
(::1.$.1
12131
:.; __ 0;'== \.,
:...~!
.. f ".in. '3', ireor., than l:I"I' 19. I"!lf 'hi ::iH.t,"CI on ~:"I 21. ~!'is " It'I. TAX CUE,
.\. ::'IlIr 'n, :nl.r,u on 'h. =oiQI"IC' =1.11 an Lin. 21.A.
3. :."., 'Ptl 'otcl Q; Lin. 21 Ql"ld 2t.a.:ln Linl 21B. r.,is;, Ih. BALANCE DUE.
Malee Ch.de Payable to: l:r:.gil1.r of WlII.. Aglnt
~':~~(. >-' >--- BE SURElOANSWEIt'Att-QUESTlONS,OK REVERSE.SIDE"AND TO RECHEClC-'~
~C1.r ::lnCllhes :; :leriuro.... 1 :IC!Crt 'tlor I :'OVI u.:min.c 'nis "'ur". inclucil"l9 aC::lmcon'ting IC."!ldui" ,::Il''ld IIctl,:"I"'1, ond ~o '!"l. :IU :f ":-0 (l'Io"'l4'<:lje :"c :..il;.
" "ru., :o,rl"le :na :=I"I'I:C''''. ' :I,:or. 'her :11 fllOI n:::fe ,as :ltn rtocr'd ~t 'rue .'ncrir:lt ."elul. C,c::cr':I'cl"I or ::r.ccr., :Iher 'nol"l '''!. =encnOI ..=r"'l"IrO~1 ,
tla ':I" ~ll nrOr:"!'lCflOn :; ""ftIC~ =rOCOl"tr "0' :nv (~c":ldSI. .
~N"~:.te :,. '!~S':l'>l HS~O:"'J,IU "':~ ~'W"~ t!~:.i.f'j ";C"U1 8 4 4 4 Sou t:'.~=n ;:,=:= :'~'2? =-'"'.;..." -= ;...:!
I~dia~~ool's, !~ .__3,
.. - '.-.. -
:-10 = c:'. ::a::o
~...:: .. r.; .. .~. II ,..11
::>'
. ..,
1"7C 13
,
,- ..,
.' I
""'1;.0.,2',,
t:>.~ ^
~
C:OIrlWONWULfH 0' '1lNNSVWANIA
INHllrTAN(1 TAX .mlH
IUID'HT OKIOINT
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
PI.a,e Print ar Type
FILE NUMBER
21-96-0964
ESTATE OF
Larry D. Bastin
(An p,operty i-4m1Y"4"WMd wtth tft. ",hi ., S",."lwnhip mu.f '" IIbcf...d .n Schltdu'- ~
N~T::ER I DESCRIPTION
VALUE AT
DATE OF DEATH
1 . Coastal Federal Credit Union, checking account
1#80528300-5
2. Coastal Federal Credit Union, savings account
1#80528300-5
3. Cash refund from prepared health expenses
4. Harley Davidson, motorcycle VINI#
$1,849.99
53,550.76
S 147.00
$3,700.00
TOTAL IAI,a .nter on line 5, Rec:citulat;an) S ;l' 7 7-
{).!'"Ct~ "dc,t;O"Qi !'''I- lC n- ,;,n,,;f ,"Ct. '='=ct ;, ,uced,J
11"',1111"_'1",
.
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
,:NiNiONWUIJI1 0' '!NNSYL""NIA
iNJ1!1ITAN(! T,,1 .nU'N
USlot""'T OICIOINT
Plea.. Print or Type
I FILE NUMBER
!
! 21-96-0964
ESTATE OF
Larry D. Bastin
ITEM
NUMBER
A, Fune,al Expenses:
1.
B.
1.
2.
DESCRIPTION
Bittles & Hurt Funeral Home, Greencastle, IN
Administrative Carls:
Porsanal Representari.. Commi..ions
Social Security Number of Personal Representari..:
Year Commissions paid
Anamey Fees Griffie & Associats
3, Family Exemption
Claimant
4.
C.
1.
2.
3,
4,
5.
6,
7.
8,
Relationship
Address of Claimant at decedent's deoth
Street Address
City
State Zip C~de
,
I
I Probate Fees
I Register of Wills
I Miscellaneous Expenses:
! Acordia of ?ennsylvania
I
Cumberland Law Journal
_ bond f~r administratrix
'!'~e Sentinel
TOTAL 1,l.lso .nt.r ~n 'in. Q. ~.c=p;luIClionl
(If more spaco is needed. insert ~dditional shulS of ,ame si...)
AMOUNT
sa,111.03
S 500.00
5
32.00
5
100.00
5
50.00
5
74001
S 8,927.04
~".'lIIl1,: "..., .
=--O....tAI,.nt C' 'Ol..lT\v.....'"
'......,TAI<! tAl tI1\llH
..SlO'.., "IClDUd
.SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABLITlES AND LIENS
ESTAll! OP
Larry O. Bastin
I flU! NUMBER
21-96-0964
N~lRl
DESCRIPTION
AMOUNT
I. PP&L
$ 70.48
$ 164.35
$4,833.56
$ 365.76
$ 322.00
$ 27.00
$ 37.00
$ 138.49
$ 2.22
$ 371.00
$ 437.00
2. Sprint
3. Corestates Bank of Delaware, M.A. credit card
account #01-2819600-3
4. Cary Cardiology, P.A.
5. Carlisle Hospital
6. Carlisle Hospital
7. Masland Associates - medical services
8. Carlisle Community Ambulance
9. Belvedere Medical Corp.
10. RWC Emergency Physicians
11. Carlisle Advanced Life Support
iOTAL ~AisQ tl'uer on :in. :C. ~f'::~'''J;':'H:ni
'6 7' Q a'
. t b..... "
(If more space is n...o.o ;ns.rt oa'a'ilioncl shHts Q; same .iu'
"~.lIUU.'U"
.
SCHEDULE J
BENEFICIARIES
CQ....OHW'...UH 0' "NN,,,UNIA
,"",IIT&He' r,U lnulH
ImOIHl' OKIOINr
FILE NUMBER
ISTATE OF
Larry D. Bastin
21-96-0964
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
RELATIONSHIP
I AMOUNT OR
SHARE OF ESTATE
A. Taxabl. Bequ.""
I.
Dana M. Dietrich
8444 Southern Springs Drive
Indianapolis, IN 46237
daughter
50%
2.
Michael D. Bastin
5249 Luzzane Lanei Apt. 706
Indianapolis, IN 46237
son
50%
ITEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
AMOUNT OR
SHARE OF ESTATE
,
I 9. Charitable and Go...ernm.nrol a.quests:
1, i
\
TOTAL CHARITA alE "'NO GOVERNMENTAL aEQUESTS (Alsa on.or on lino 13, Rocap;.ula.;anl 1 S
(If mote 'pan is needed, insert additional,hee" of same size)