HomeMy WebLinkAbout96-00984
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N 21-')6-')84
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Estate of Mary S. (..ant;:
I I)ecensed
DECREE 01<' I)ROBATE ANI) GRANT OF LETTERS
AND NOW December 3, 19~, in consideralion of the petition on
the reverse side hereof, satisflletory proof having been presented before me,
IT IS DECREED that the imtrument(s) dated January 16,1967
described therein be admitted to probate and filed of record as the last will of
Mary S. Lantz
and Lelters Testamen tary
arc hereby granted to William S. Lantz
FEES
Probate, Lelters, Etc. ......... $ 200.00
18.00
Short Certificates(6 ) .... . . . . .. $
Renunciation ......ql....... $ 5.00
X-Pages (11 $ 3.00
JCP TOTAL _ $ 5.00
Filed ...~C;~~J;.~.,.m?......~~1:9.Q
A1TORNEY (Sup. C.. J.D. No,)
ADDRESS
PHONE
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Called Execu tor on December 4, 1996.
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WARNING: Ills IlIognllo dupllcnto Ihls copy by pholostnl or phologrnph.
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COllllONWEALTH Of PENNSYLVANIA' DEPARTlIENT Of HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
...
-
....
CUmberland..... ~ h.. 'u..o =.::::..
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Susan Wri htstone
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~Ker Domestic
ClKIDIHT...........MXlM..j!rw.~...,.ColMt aoocr.
Messiah Village -""
100 Mt. Allen Drive .:::::-
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Judith A. .5hetron
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Pennsylvania
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LIWIl AND""'''
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white
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Allen 'IW.
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'airview ~., York Co., PA
Ncuoo....OIIlIUlTY art ennre era Ioe
P.O. Box 431 New CUmberlan PA 0 6-U431
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"IV''''.!'' ",'" INHERITANCE TAX RETURN FOR DATES OF DEAnt AFTER t2l3tIVt
CttECK IlERE IF A SPOUSAL
RESIDENT DECEDENT POVERTY CREDIT IS CLAIMED
c"....."".WI'l'''''' ","""LV'"" (TO BE FilED IN DUPLICATE FILE NUMBER
[1(1'''IHVU,' 0' III VPHJl 21 96
"""",::~~~,.',~:~~:"""" WITH REGISTER OF WillS) COUNTY COOE YEAR
OECEOENr~ NAME (LAST, F"I~T, ANO MIOOlE INITlAll OECEDwr~ COMPlElE ADOIlESS
lilntz Ml S. 216 M)ssiah Village
SOCIAL SECUJIITY tlUMIlEJI ro Ilax 2015
DECEDENT 186-10-7193 11 29 96 12 18 1919 CUUIII CUIl~rland
SOCIAL SECUHITY NUMIlER AMoum RECEIVEO (SEE INSTIlUCTlotIS)
./
00984
NUMBER
SUppllll1'Mlnlal Ruh""
:), Rumolndor Rolurn
Ilnldalnaldutt,plllUIO 12..U-I2'1
o 5. Fodoral EstBto Tax Roturn Roqulrod
" Ollgtl1ol Rlllum
CHECK
APPRO-
PRIATE
BLOCKS
o 4, Unlllod Estlllo
o 411, Fuluro IntofOst Cornprol1\l!If)
(lor datos 01 dOBlh al1m 12-12"02)
o 7, Oocodnn' Malnlainod 8 Uvmg Trust
(Mach copy 01 Tru")
..Q.. B, Tolal Numbor 01 Solo Ooposlt Bo,os
EJ. 6, Docodont Diad T051810
(Mach copy 01 Will)
ALL CORRESPONDENCE AND CONFIDErmAL TAX INFORMATION SHOULD DE DIRECTED TO:
CORRES-
PONDENT
NAME
E'dward A. Stankoski, Jr.
TELEPHONE NUMBER
(717)-846.7000
1, Roal Eslalo (SChodulo A) ( 1 )
2, Slocks alld Bonds (Schodu!o B) ( 2 )
3. Closoly Hold Slock/PB~norshlp Intorost (SCh, C) ( 3 )
4, Mo~gago. Bnd Notos Rocoivob!o (Schodulo D) ( 4 )
5. Cash, Bank Doposits & Miscollanoou5 Parsonal ( 5 )
Proporty (Schodulo E)
B, Jolnllv Ownod Proporty (SChodulo F) ( B )
7, Tronslors (SChodulo G) (SChodulo L) ( 7 )
8, Tolol Gro.. AsSOIS (10101 Unos 1-7)
9, Funeral E)Cponso9. Adm!mslralivo Costs, ( 9 )
Miscollanoous Expon:Jos (Schodulo H)
10, Dobt.. Mo~gogo UBb,htio.. Uon. (Schodulo I) (10)
1 1, Totol Ooductions (total Uno. 9 & 10)
12, Not Voluo 01 Estalo (Uno B mlnu. Uno II)
13, Chari1ablo and Govornmental Boquosts (Schodulo J)
COMPLETE MAILING ADDRESS
7 East M3.rket Street
York, PA 17401 C) ~-}
c:
,:J
None
84,110.26
None
None
6,238.49
I
"J
None
None
\.J,I
(8 )
90,348.75
RECAPIT-
ULATION
1,268.31
1,451.47
2,719.78
87,628.97
None
(II)
(12)
(13)
TAX
COMPUTA-
TION
14. Not Valuo Sub oct to Tax (Uno 12 mou:J Uno 13
15, !pou..1 T,..",I.,.I'or d-''' of dul" .all" e.]O-g.), S..
'''II'",C:llo",Io' APPl1ubl,p.fClnllglonP.lgl:r,llntllldl
'1&,,,,""0'" Seh,dul,1C. or SCh.dul, M,I
16. Amount 01 Uno 14 laxablo 1l16~. ralo
(Includo valuos Irom Schodulo K or Schodulo M,)
17. Amount 01 Uno 1413Xablo a115~o ralo
(Include valuQ!! from Schodule K or Schedulo M,)
10, Principalll1X duo (Add tax "om Uoos 15. 16 and 11,)
19. Crodits SP!)u"" Poverty erld,t Pnor Paymonts
14)
87 628.97
, ,
.
(IS)
87 , 628 .97 x ,OB
=
5,257.74
0.00
(16)
0.00, ,IS
=
(17)
(lB)
5,257.74
lnlorosl
Discount
0.00
.
.
(19)
(20)
20, II Uno 19 is groator than Uno 18. onlor lho dif1oronco on Uno 20. This is tho OVERPAVMENT.
[MJ Ctt..k h.", II you are ,.quooltng a refund 01 you, overpayment I
21, II Uno 18 is groalor than Uno 19, ontor Iho dlf1oranco on Uno 21. This is tho TAX DUE.
A, Entor Iho Intorost on tho balanco duo an Uno 21A,
B, Enlor tho lotal 01 Uno 21 Bnd 21A on Uno 21B, This Is tho BALANCE DUE.
Mak. Check Pa abl. to: R.glsl., 01 Will.. Ag.nt
... ... BE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND TO RECHECK MATH.... ....
odor ponaltlos at porjury, I doclaro that I hl1VO oXllrruned Ihls rolurn, InCluding accompanYing schodules and slalamonls, and 10 tho best 01 my knowlodgo
and beliol, it is truo, corroet and complota. I doclaro that all roal ostato has boon roponed at true markot value, OochuatlOn 01 preparor Dlhar Ihan Iho personal
roprosontl1livo is basod on all informatIon 01 which preparer has any knowlodqo,
SIONATUr:tE-iJF}(RSOfi,RESPO tBLE FOR FILtNG RETURN ADDRESS DATE
. " /"vt'K.:. /-> ' .. See Schedule attached ' (
(21)
(21A)
(21B)
5,257.74
0.00
5,257.74
ADDRESS
7 East M3.rket Street
York, PA 17401
CATE
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COPY"llhtFo,,,,, Softwaf. Dilly, 1994 N.lto.lllt. N94PAODI
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l1ARY S. LAIIlL , '\,';' j . ..':'~
,,',..1.:1'" ;lIL'I~t~lf'. "'. :~"'..'\ r.!, ....fl,.,..l.!:ldt; nt l\~~ ~'~.1Ic.:1!~. ~~...'\ ~:;I'
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t\.\RY;S',' LAIn'Z, of the'notousl;' or'/lw ClWberland, Couuty of (,.: (:.,:~,
, 'I ~
, LAST WILL AHIl T~IIT
,'r.~', : :"J I..ti, . ~l~mr. r~l'<': fl,t.) n~~CL^Rtm hi ~ry
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CWllbarland alld &tala oC I'onnoylv"nla, btlng aC aoulld "lnd, mL..,ory .nd uuder-'
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atandlng, ~u haruby lIl.1ko, vubllah ..lId u.echt~.LJU.~Jlo..on~Jnr..J:lY_LaaLH.Ul..an~
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any.
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Juat uebta .nd funeral upen... o. ooan as convenlently "":I be dene after 1111 i ,':1
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All tha real, reDldue and rc...lnu~r of cy e.tnte, !:"ether real, '!')I
Il
penolld or ml""d, and vharolaevor s!tWlte, 1 hareby glvo, dcvLa. and baqu.,..thl Y'f
,un~o my, hu.banu, PAUL B. LANTZ, 1C he aurvlv81 "" by e perlod of thLrty'deY~'<i :',~'l
,",I,: "
If my sold hu.bond doeD not survLve ce by 0 perLod of thlrty d.ys, then thh:i' ',"
.. .. I ~
To.tamant harcb)' ravotllU<I
Oll~ tlo'Iklr.;; voLu nuy and all othor vUls by, m. .t
, ,.,.
(~.
t/.ma h.ratoCore ende.
~ -. ....-.. '''-'.'-- --
1.
1 ~lr.ct that my ex.cutor herelnAfter D8I>Od .h.1l p.y ell my
dOCU880.
H.
g1ft to h1m .holl ba dIva.ted, nn~ 1 then slve, davlso nnd baqueath
1111 entlr. i .
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I hereby 1I0000lnnte, constitute nnd appoint cy husbonu, PAUl,' B. ,;, i'; :. ~
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If tha aold Paul. E;;, " .... :,
'. ,:::'; ...j ;'!<,,:
.Lantz should prodOC080Q mQ, or otharw18o taUs to qu:.lllYI or coa.os to act. .I;)r 01
,- ." '...i,~ .~'.~~~
',',
utata unto my throe chlldron, PAULA Il. DLBSSllIG, JUDInl A. SllETRON, and
WILLlAIl S. LAtrrZ, In eqWl1 .hara..
111.
LANTZ, au Exucutor of thle, my Laot 11111 and Teotc::ent.
.uch, than 1 nerdnete, cOllstltuto and appalnt 1111 three chUdren, PAULA Il.
USSING, JUDInl A. SIIIlTRDII, and WILLIAM S. l.Ah'rZ, aa Coe,ccutor&.
llIWITIIESS mmREOF, 1, Ilnry S. Lantz, the Testotrlx, have unto
tbh, my Last 11111 and TestOlllellt,
January, A. D., l?67.
... "@"' @ ..~"w ! ,Ir: .., "'
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(SEAL)
Pasa 'ono oC 'tvb 'Pasal
PA REV-l~ EX (7-04) Pago 2
Acl1/48 01 1994 provldos lor Iho roductlon ollho lox roloB Imposod on tho nol valuo ollronslors to or lor Iho uso 01
Iho spouso. Tho rotos os proscrlbod by Iho stolulo will bo:
. 3% (.03) will bo appllcoblo lor oslolos 01 docodonts dying on or oltor 7/1/94 and boloro 1/1/96
. 2% (.02) will bo appllcablo lor oslalos 01 docodonls dying on or altor 1/1/96 and boloro 1/1/97
. 1% (.01) will bo appllcablo lor oslalos 01 docodonls dying on or altor 1/1/97 ond boloro 1/1/98
. Spousallranslors occurring on or altor 1/1/98 will bo oxompl from Inhorltanco laK.
PLEASE ANSWER THE FOllOWING QUESTIONS
BY PLACING A CHECK MARK (oJ) IN THE APPROPRIATE BLOCKS.
VES NO
1. Old decedent mako a transler and:
8. retaln the uso or Income 01 tho proporty translorrod, . , , . , . , , . . . . , . . . . . . . , . , , . . . . . , , . , ' . , . . , . . , . , , . . . , , . , . . . . . . . . . . . . X
b, lotaln the rlghlla do.lgnato who .hall u.o the pro pony tran.lerrod or 11.lncamo.. . , . . .. . . , , , , . .. , . .. , , . .. , . , , , . , . . , , . , .. . . X
c. retain 8 reversionary Inlorost; or...,........,....,.... ...,...."..,. . ",. ..... , .... .,... .... ...,. .,.,..,.. ..,... X
d. rocelve the praml.e lor lIle 01 elthol payment.. benelll. or Cl/e?, . . ,., . , , ., . .., , . , .. . .... , . , .. . ., , . . , , , . ,.. , . . ,.. .. ... . X
2. II death occurred an or bolaro Docomber 12. 19B2. did decedonl wllhln two yea.. procedlng doath tran.ter prapeny W1thaut receiving
adequate consldorallon? II death occurred attar Decombor 12. 1982. dId docodont lranslor proporty wllhln onB year 01 dealh without
rocalvlng adequate can.lderaUan? . , . . , . .. .. .. .. .. .. . . , .. , . . .. , ' .. .. , . .. , , , .. . . , , , . . .. . , . , , , . .. .. . .. .. . , .. . .. .. .. X
3. Old decodent own an 'In trust for' bank account al his or hor doath? . . , . . . . . . . . . . . . . . , . . , , . . . . . , . , . . . , . , . . . , . , . . . . . . . , , , . . X
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS 15 YES,
YOU MUST COMPLETE SCHEDULE G AND FilE IT AS PART OF THE RETURN.
PA15002 NTFII810
COpyrlQht Fafm. SoHw". OnlY', '914 N.lc;a,lnc;, NUPA002
AIY."03IX fl."II)
SCHEDULE B
STOCKS AND BONDS
COUUO...WEAL TH 0' PE......SyLVA...IA
INHERITANCE TAX Rnun...
AISIDun DECEDENT
FILE NUMBER
I!STA11! OF
21-96-00984
M:lrY S. IiUltz
(All prop.r1y 10InUv-own.d with RighI 01 Survivorship mUll b. dlsclol.d on Sch.dul. F.)
ITEM
NO,
VALUE AT DATE
OF DEATH
DESCRIPTION
1 IDS Bond f\lnd Ine.
52,430.98
31,679.28
2 IDS Extra Ineare f\lnd
TOTAL (Also onlor on IIno 2. Recspitulsllon)
(11 moro spsco Is n..dod,lnsort add,Uonal shoOIS 01 same slzo,)
$
84 110.26
PAI5031 NT' nn
Copynghl Fo,..,.50"-.'1 Ol\ly, "I" Nllco,lne. N..PA031
,-
ROUTING, I 1Z 0061Z
E49365
AMERICAN EXPRESS FINANCIAL ADVISORS INC
IDS TOWER
MINNEAPOLIS. MINNESOTA 55474
STATUS
04 25
PAGE
DATE
1997
1
MARY S LANTZ
Z16 MESSIAH VILLAGE
PO BOX 2015
MECHANICS BURG PA 17055-2015
CLIENT ID. 1387 5204 3 001
ACCT NO. DODD 0012 5398 2098 0 OOZ
lZ 09 96 12 09 96 TRANSFER OUT
31,767.83 .000
12 09 96 12 09 96 REINVEST DIVD
88.55 7,117.486
11 27 96 11 27 96 REINVEST DIVD
217.38 7,097.162
11 ZO 96 11 20 96 SCHED REDEMPTN
399.52 7,047.293
10 Z9 96 10 29 96 REINVEST DIVD
269.91 7,136.784
10 18 96 10 18 96 SCHED REDEMPTN
398.61 7,074.564
09 Z6 96 09 Z6 96 REINVEST DIVD
Z65.87 7,163.829
09 20 96 09 20 96 SCHED REDEMPTN
401.44 7,102.989
08 28 96 08 28 96 REINVEST DIVD
Z82.ZZ 7,192.871
08 ZO 96 08 20 96 SCHED REDEMPTN
404.56 7,lZ7.360
07 Z9 96 07 29 96 REINVEST DIVD
Z27.41 7,217.910
07 19 96 07 19 96 SCHED REDEMPTN
405.90 7,164.938
TAX 10. 186 10 7193
PRODUCT NAME
EXTRA INCOME A
.00 4.357
0.00
88.55 4.357
31,767.83
217.38 4.359
31,679.28
390.00- 4.358
31,461. 90
Z69.91 4.338
31,861.42
390.00- 4.369
31,591. 51
265.87 4.370
31,990.12
390.00- 4.339
31,724.25
Z82.ZZ 4.308
32,125.69
390.00- 4.307
31,843.47
2Z7.41 4.Z93
3Z,Z48.03
390.00- 4.Z94
3Z,OZO.6Z
SHARES OWNED PRICE ACCOUNT VALUE CERT SHARES ISSUED
.000 4.314 0.00 0.000
ACCRUED DIVIDENDS DIVIDEND OPTION SALES LOAD BASE LOAD ASSET VALUE
0.00 REINVEST 0.00 5.000 N
ACCTG DT PRICE DT --TRAN TYPE-- TRAN AMOUNT PRICE TRAN SHARES
TRAN CASH SHARE BALANCE CASH INV BALANCE LOAD AMOUNT LOAD Yo
7,117.486-
0.00
ZO.324
0.00 0.000
49.869
0.00 0.000
89.491-
0.00
6Z.ZZ0
0.00 0.000
89.Z65-
0.00
60.840
0.00 0.000
89.88Z-
0.00
65.511
0.00 0.000
90.550-
0.00
5Z.972
0.00 0.000
90.8Z4-
0.00
AAHP l:iroup Healtn Insurance
EXPLANATION OF PAYMENT OF BENEFITS
DATE
/?Y n". 1997
~AN !OS
H R
H R
H R
H R
H R
PROV1DER
EMERA
EMERA
EMERA
EMERA
EMERA
DAlE or $[ nVICE
fROM 10
1 0,0 4,96,
10:Z2:96:
10:30:96:
, , ,
1102109 6,
11:21:96:
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SHIV ()(oucnou:
COV[IlEO
E .'"ENSE
55~2
5e7
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49<90
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49<90
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5027
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IJENcrlT n[MAlU(S
270116 WE PAID TIlE COVERED EXPENSE AT 50'
,
264 WE PAID THE COVERED EXPENSE AT 50'
24~5 WE PAID TIlE COVERED EXPENSE AT 50'
, EXPENSE
24,95 WE PAID TIlE COVERED AT 50'
, COVERED EXPENSE
264 WE PAID THE AT 50'
. t~,tf7
DdJ()~'Td) J -
TOS - Type 01 SerVICo
R . DRUGS
83'04 TOTAL BENEFIT
MEMBERSHIP" 94696174-11
CLAIM" 70160-432081-1
PATIENT MARY LANTZ*
IF YOU HAVE ANY QUESTIONS. PLEASE CALL US. WE'LL BE HAPPY TO HELP YOU.
OUR TOLL FREE TELEPHONE NUMBER IS 1-800-523-5880.
PLEASE SEND US THE MEDICARE STATEMENT SHOWING HOW MEDICARE CONSIDERED YOUR
:HARGES. WHEN WE RECEIVE THE MEDICARE STATEMENT. WE CAN CONSIDER YOUR CLAIM.
'HIS AOPLIES TO THE SERVICES BY SUSQUEHANNA SURGEONS ON 11/28/96. THE
'RESCRIPTION ITEMS RECEIVED FROM EMERALD DRUGS STORE ON 9/30/96 WERE
'REVIOJSLY COSIDERED IN CLAIM.629604520131. WE ARE UABLE TO CHANGE THE
10DRESS TO 719 PINETOWN RD AS WE NEED TO KNOW RELATIONSHIP TO OUR INSURED.
THE ESTATE OF MARY LANTZ
FOR MARY LANTZ
.216 MESSIAH VILLAGE
:>0 BOX 2015
MECHANICSBURG, PA 17055
If you have any Questions. please call:
AARP CLAIM UNIT PO BOX 13999
PHILADELPHIA PA 19187 0216
OR CALL TOLL FREE 1 800 523-5880
SAVE BY MAKING PAYMENTS WITH EFT-CAll I
PLEASE DETACH CHECK BELOW AND CASH PROMPTLY
IDS LHa Inluranca Compeny
IDS Tower
Mlnnelpolll, MlnnelOll 55440
An AmenCln E>pren comp.ony
Fabruary 21, 1997
Clde Nueber :
Policy NUllber:
130960
9100-2396341
HARY S LANTZ
EST OF MARY S LANTZ
719 PINETOWN RD
LEWISBERRY PA 17339-8904
Daar Recipient:
The attached check for $361.53 reprelentl the death benefits due you under
thia contract. Theae benefits are lIade payable to EST OF HARY S LANTZ.
If you have any questions, please let us know.
Sincerely.
IJrA1
:3 -J.-
~t.P
Detldl And R.r.ln For Your Records
.O"'.LIeNe "'11II
_.""..-..--..--~.~~.,..
R[V" "" [lol'."l
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
Pl.... Print o. Typ.
FILE NUMBER
21-96-00984
COMMONW[ALTH OF P[NNSVLVANIA
INH[RITANC[ TAl R[TURN
AUIO[NT 0[CEO[N1
ESTATE OF
S. Ulntz
AMOUNT
DESCRIPTION
ITEM
NO.
A. Funlfll e.xpln...:
60.00
1 Gin:Jrich M3f0ria1s - headstone fee
2 PaJ;t:hrore F\JIlE!ral Hare
265.60
B. AdmlnlslraUv. co.ts:
0.00
1.
Personal Repr8SentaUve Convnlsslons
Social Secur1l'{ Number ot Personal Represenl.tlve:
YeOl Convnlss1ons paid
0.00
2, Anorney Foes
0.00
3. FomIlyExemptlon
Clalm.n!
Addres, 01 Clalm.nl .1 decedenl" dooth
Reletlonshlp
5tieGI Add,e..
51ele
21p Code
ell'{
231.00
4, Probate Fees
C. MlscellaneoUI Expenses:
600.00
1 Accoontant fees estirrated
2 'lbe C\lI1tlerland Law Jco.u:nal - legal advertiserent
3 'lbe sentinel - legal advertiserent
TOTAL (Also enlOr on line 9, Recapitulalion) $
(It more spac.11 needed. Insert addlUonalsheets a. same size.)
1 268.31
PAlSlll NTF ""
CoPYflght For"" Solt..r. O"ly, t". N.\ca,lnl:. N9.PAI"
60.00
51. 71
James fl. k ~.
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""C~~'~TERY ~KLJlL€_~7i~~- LOC,;nOr:1 _ tvfU) .timID', ,,':, . . ,,',,-: :,:::'~l:,;:~!
NAME OF DECEASED LV-Lk~::.-,-La\A.t 7 . , ..,,;! '~::'
LETTERING REOUIRED ·
ORDER NO,
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DATE OF ORDI]R":.
ORDERED BY t S ~\. '\ '
PHONE # (-) 4G- ~1-1f
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;~;i,UPON EXAMINING THE ABOVE INSCRIPTIONS. I/WE THE UNDERSIGNED, FIND THE SPELLING AND DATES TO,:~E:,,>:~j
,:' ';I,CORRECT; :THE .wORK WILL BE. ,COMPLETED AS IT IS ACCUMULATED, NO SPECIFIC COMPLETIONDATE.::IS': .:;j(
" "I'Gg," AfiA't:J:rEcD' : . ;,'", . ", ..' , .. : '. .:' "'~" ,.;'.,1
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.,'.~_.t. ..I'.' ,'. ,', ,...",. PRICE' S --7- '~'. ".,.:': :'.:~:~
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BALANCE DUE $
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CUMBERLAND LAW JOURNAL
2 LIBERTY A VENUE
CARLlSLE,1>A 17013
JANUARY 10 tlJlJ6
Cumberland Law Journal is published every Friday by the Cumband County Bar
Association and is designated by the Courl of COllllllon Pleas as the official legal publication for
Cumberland County and the legal newspaper for publication of legal nolices.
"
TO:
William S. Lantz
RE:
Mary S. Lantz, ESTATE
Legal advertisements must be received by Friday Noon. All legal advertising must be paid
in advance. Make all checks payable to: Cumberland Law Journal.
========================================================a=====aaaa_aa
Advertisement inserted on following dates:
DECEMBER 27, JANUARY 3,10,1996
Total Amount Due
$ 60.00
$ 0.00
$ 0.00
$ 60.00
....---..--.--
$ 0.00
--------
-------
Advertising Cost
Proof of Publication
Second Proof Request
Payment received
Payment received -DECEMBER 23 1996
by Becky H Moraenlhat/Executive Director
~
1,1
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C/\
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eh
100 Ml. Allon Onvo
P,O, Oox 2015
e..SSI3 Mocl1amcsburg, PA 17055.2015
VIL-L-AGE Pllono: 717.700,6220
.'~:r.:
LJ"
1-
Sorving Sonior Citizons . Oocouso wo coro . Slnco 1606
AMOUUT OF
p^VMENT
$
Ill~IOl.rlf Pj\".I(1lR
j\DI.ll~5ICPI Do\. 1E
OISCt1j\RGt DATE SfATEMEUT DATE
II/JO/96 'K
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AMOUNT ~
~
RESIDENT NA\lt
0000J9101
:1/05/91
11/29/96
L.ANTZ MARY S
TERMS:
IX MONTHL.Y FINANCE
CHARGE AFTER LAST DAY
OF MONTH
REMIT TO FIS.
{
MARY S L.ANTL
21b SC rlESSIAH
P.O. t<OX 201::;
MECHAN 1 cst<URG
VIL.L.AGE
,
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PA
1705~-2015
PLEASE OETACH AND RETURN THIS PORTION WITH YOUR PAYMENT
DATE
TPANSACTlON OESCRIPTIO'1
UNITS
REfERENCE'
11/01/96
11/0b/96
11/19/96
, 11/20/96
11/27/96
SHOP
~9:;
110.89 ~
10.00 ~
1480.74-, i'.
17.00 1
1174 .:50
: 11/28/9b
PHARrlAC'(
BARBER/BEAUTY
CHECK PAYMENT
BARBER/BEAUT'(
27 SHEL.TERED
DAYS @ 4J.50
I SHEL.TERED
DAYS e 4J.::;0
1.00
1.00
1.00
SHOP
FAC1L.1TV
'l5TAtEUlNT DAtE
. J,1/JO/96
.. PLEASE PA' . s
ME~SIAH VILLAGE 100 MT, ALLEN DAIVE. P.O, BOX 2015, MECHANICSBUAO, PA 17055,2015 PHONE 717-190-9220 THIS AMOUNT
PRf.VIDUS 9ALANCE
1430.74
CURRElH CHARGES
1:1:;::;.89
PAYMENTS
1480.74
ADJUSTMENIS CURRENT ACCT. BAWleE
.00 IJ55.39
l'
4J.:50 '.
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Mochonicsburg. PA 17055.2015
Phono: 717.790.8220
o
Sorving Sonior Cilizons . Oocouso wo caro . Sinco 1606
AMOUNT OF
PAVMEUT
s
nESIOEPH NAM(
RESIDE'.1 NUMBER
ADMI5$tOU DAT( DISCHARGE DAlE SfATEMENf DATE
J:O~.'f'1 11/2?/Y6 1~/Jl/9b
L.AlH 7 NAli" :.
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1':F~ltT TO 1'13. DERVICES
t'I,', F: ',' ~.; L .'!!J : /
21h ~C 11~~~J~lt VILL^r.E
P. n. [({"I.; I~O; ~'I
rU:,'H/lt,l: l;::l"t!:r,('j
r' /, 1 .,:' ~~ t', ~. . ;:'.J i .',
PLEASE DETACH ANO RETURN THIS PORTION WITH VOUR PAVMENT
'.
,I
AMOUNT
35.30
13~:;.8?-
OhfE TPANSACTION DESCIlIPTlor..
uUlrs nEFERENCE.
lz/o...:rlf; ""'11,\1\1'1,'.':','
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. i)~l :;5.SG
ADVANCE CHARGES
.00
StAIEMlNrO"TE
PREVIOUS BALANCE CUlUlEllr C"ARGES
PAYMUH5
MESSIAH VillAGE lDO Mr, ALLEN DRiVE, P.Q OOX 20lS, MEC"ANICSOUnG, PA I7B55,2015 PIlONE 717.7!lO,0220
rLEAse flAV
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@Bell Atlantic'
Page 2 of 6
717 691-5837-275 99Y
November 10, 1996
This Information Is required by the Public Utility Commission, "Basic"
service Includes the I ine charge, local calling and TOUCH TONE service
(If applicable). "Non-Basic" service Includes optional services, other
than TOUCH TONE, such as I.Q, Services, Maintenance agreement for
inside wire and Guardian and docs not include toll services. u 11- .5
I ,1 a,n
I,' Past Due Current Totals /-'1-'17
Ba I ances Charges
I BASIC $,00 $10,92 $10.9if I 'I, 65'
i -
,TOLL $,00 $.00* $,00
l
. .,
NON-BASIC
TOTALS
$,00
$,00
$,00*
$10.92
$,00
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'. * (Includes B~.1.! Atlaf!!Lc_~Il.~..!l,~~.~.~,~rxj!=,~..p..r:'?,X!~~!:(s). .~h.~!'.9.es,)
I '
"
, , Page 2 of 9
@BellAtlantic 717 691-5837-275 99Y
---n
December 13, 1996
This Information is required by the Public Utility Commission. "Basic"
service Includes the line charge, local calling and TOUCH TONE service
(If .applicable), "Non-Basic" service includes optional services, other
than TOUCH TONE, such as LQ, Services, Maintenance agreement for
Inside wire and Guardian and does not include toll services,
Pas t Due Current Tota I s (;1< -;1 5
Balances Charges
BASIC $10,92 $ -2,19 $8,73 1_ <{-.,?
TOlL $,00 $,00* $,00
NON-BASIC $,00 $,00* $,00
TOTALS $10,92 $ -2,19 ~
The following pages provide additional billing details,
* (Includes Bell Atlantic and other service provideds) chorges,)
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See Inslrucllons on Cover Pago
ESTATE OF
MARY S. LANTZ
INVENTORY
Lalo 01 HAMPDEN TWP,
I No, 21-96-P0984
CUMBERLAND COUNTY
Deceosed,
, 19.21.
AFFIDAVIT OF PERSONAL REPRESENTATIVES
((onll1l0nl1lralt~ Or ,flmnllp(lJania, i
llll,
((ountp or CUMBERLAND
Personally appeored beloro me, 0 NOTARY PUBLIC
WILLIAM S. LANTZ, EXECUTOR
, In and 101 said County,
.
who boing duly SWORN according to law,~~ SAYS
and real eSlale which wero of MARY S. LANTZ
HAMPDEN TWP, CUMBERLAND COUNTY Deceased, is Irue and cOlleCllo Ihe best 01
Ihallho wilhln Invonlory of Iho personal properly
,Ialeo/
HIS
knowledge, Inlo,mollon and bellel.
y~;L~ I..~
WILLIAM S. LANTZ
Ihls
and subscribod 10 bolo,e me
01 MAY A,O,,19n_
Notariol Sool
. . U Ie
Lomoyno Boro, Cumberland County
::;::::::::4~: INVENTORY
01 the personal propOrly and real eSlalo siluale '" Ihe Commonweallh, which wore 01 MARY S. LANTZ _
CUMBERLAND CUMBERLAND
- , lale 01 HAMPDEN TWP, COUNTY _ In Ihe Counly 01 lt6t1l(
laken and made In conlormlly wllh Iho abovo deposlllon uOOor Section 3301 and following 01 Ihe P'E'F Codo.
PERSONAL PROPERTY
DOLLARS
1. IDS BOND FUND INC.
2. IDS EXTRA INCOME FUND
3. DAUPHIN DEPOSIT BANK AND TRUST COMPANY-CHECKING ACCOUNT
4. BELL ATLANTIC REFUND - TELEPHONE
5. AARP GROUP HEALTH INSURANCE-REFUND OF CO-PAYMENT
NURSING CARE
6. IDS LIFE INSURANCE CO.-REFUND OF PREMIUMS FOR POLICY
$52,430 98
$31,67 28
$ 5,78300
$ 10 92
$ 83 04
$ 361 53
CENTS
..
TOTAL
$90,348.75
l""\ ..,
- .;'i
C1 ~?
n 2
i.~
N
I
;:s
,:) ...,
. ."
.. ..'
U l..~ r- ,:.) :;
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
OEPT 280601
HARRISBURG, PA 1712B.Or,01
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
W~'
~
-. .
NO, AA 211367 n[v"., Ex '''961
RECEIVED FROM:
r
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
WILL.IAM 5 LANTZ
719 PINETOWN ROAD
L.EWI5BERRY, PA 17339
101
"5 9E57. 7',
~OCD tl[RE
ESTATE INFORMATION:
FILE NUMOER
r> I -I 99"'-09Rl.
NAME OF DECEDENT (LAST,
I ANT? MARY S
DATE OF PAYMENT
"'102/97
POSTMARK DATE
0100100
COUNTY
--!:UMRFRI ANn
DATE OF DEAHl
SSN IR"-10-71'1~
(FIRST!
IMII
TOTAL AMOUNT PAID
$5,257.7l,
REMARKSWIL.L.1AM 5 LANTZ
vz
SEAlCHECKII 11
J
~'1'/~({ ,I .,1'/ ,:J /:-1
- , /
MARY C. LEWIS ..:. II. r,,/.'," /
REGISTER OF WILLS ,', /
RECEIVED BY
.: ~.:.(il , ' ,
,L_.
h__ ___ ___ __ '__ ___ ___ _. ~,,_ .'__
. --- - ----- --,---
!
,
---I --~
~~-_ -_.'-:---"'~..llI1I _ - ,. .
--
", .
1:'
/.']- /t./'1- ,(-'
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TA~ES
IHlltRIUHC[ lAX DIVISION
DtPI. 2BOtJOI
IlARRISauRC, PA 1111a-0601
NOTICE or INIlERl1 ANCE TA~
APPRAISEMENT. ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS ANO ASSESSMENT OF TA~
EDWARD A STANKOSKI JR
7 E MARKET ST
YORK PA 1740 I
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
r=
09-29-97
LAtHZ
11-29-96
21 96-0984
CUMBERLAND
101
Alllount Renit hd
L:-
i~~
."'1,,'11&1'111,'"
MARY
S
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 .....
rfEv:i5lii-EX-iij:p--fo;f:97T"NOTicE--OF--iNHEiiiiiiNCE-TAX-AppiiA-isEHENT-,--iiL.i"oiiiiNCE-oliu---------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF LANTZ MARY S FILE NO. 21 96-0964 ACN 101 DATE 09-29-97
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, Ahount of LIn. 14 at Spousal rat. (15)
16. Anount of LIna 14 taxable at Line.l/Class A rat. (16)
17, Anount of Lina 14 taxable at Collateral/Class Brat. t17.
18. Principal Tax Due
TAX RETURN WAS: eX) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Raal Eat.t. ISchaduh A) (lJ
2. Stackl and Bondi (Schedule 8J (2)
3, Closely Hald stock/Partnership lntersst (Schedule C) 13J
4, Hartg.gas/Not.. Raceivable (Schedule DJ (4)
5. Cash/Bank Deposits/Hisc. Personal Property ISchedule E) IS)
Ii, Jointly Owned Property I Schedule f) C&)
7. Transfers CSchedule G) 17)
8, Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Ada, Costs/Hisc. Expenses ISchedule H) 19)
la, Debts/Hortgage Liabilities/Liens CSchedule I) 110)
11. Total Deductions
12. Net Velue of Ta)( Return
13, Cheritable/Governnental aequests (Schedule J)
14. Net Value of Estat. Subject to Tax
NOTE:
TAX CREDITS:
PAYMENT
DATE
06-02-97
RECEIPT
NUMBER
AA211367
DISCOUNT e+1
INTEREST/PEN PAID C-I
,00
) CHANGED
.00
84 .11 0 . 26
,60
.00
6.238.49
,00
.00
e8)
1.268,31
1.451.47
ell)
112)
113)
114)
,00 ~ ,60=
87.628,97 X,06=
.06 ~ ,15=
1181
AMOUNT PAID
5.257.74
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
NOTE: To insure proper
credit to your account,
subait the upper portion
of this forn with your
tax payaent.
90.348,75
'.71Q 7A
87.628,97
,00
87.628,97
,00
5.257,74
,00
5.257,74
5.257,74
,60
,00
,00
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST,
e IF TOTAL DUE IS LESS TIlAN SI. NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" eCR). YOU MAY BE DUE
A REFUND, SEE REVERSE SIDE OF THIS FORM FDR INSTRUCTIONS,)
::~;,
RESERVATION: E.tat.. of d.cedant. dwlng on or before O.ce.b.r Il. 198Z -- If 8ny future Int.r..t In the ..t8t. I. transf.rr.d
In po.....lon or .nJoy..nt to Cl... B (collat.ral) b.n.flclarl.. of the deced.nt aft.r the ._plretlon of any ..tat. for
Ilf. or for Y.8rs, the Co..onwaalth har.by e~pra..lY ra,arva. tha right to appral,a and a..." tran.far Inherltanc. la_..
at tha lawful Cia.' B (coll.t.ral) rate on any such future Int.re.t.
PURPOSE OF
NOllCE:
To fulfill the requlre.ant. of Sactlon ZI40 of the Inherltanc. and E,tat. lax Act, Act II of 1995. (7Z P.S.
Sactlon 91leOI,
PA1HENlt
Datach the top portion of thl, Notlc. and ,ub_It with wour pay..nt to the R.gl.t.r of Wills prlnt.d on the r.var.. lid.,
--Haka check or .on.y order pawabl. tot REGISTER OF MILLS, AGENT
REfUND (CRI:
A refund of a taM cradlt, which wa. not r.qu..t.d on the TaM R.turn, .ay be requ.,t.d by co.pl.tlng an "Application
for Refund of Penn,ylvanla Inharltance and E,tate Ta_" (REV-IllS). Appllcatlonl are available at the Office
of the Ragl.ter of Will., any of tha ZS Rav.nu. District Off)ce., or by calling tha IP.clal ZIe-hour
an.w.rlng ..rvlca nuaber. for for.. ordarlng: In Penn,ylvanla 1-80a-16Z-Z0S0, out.lda penn.wlvanla and
within local .larrhburg area 0171 787-S091e, TOO' (111) 77Z-ZZ5Z Waarlng I.palred Onlyl.
OBJECTIONS: Any party In Inter..t not .atl.fled with the appral.a.ant. allowanca or dl,allowance of d.ductlon., or a..a...ant
of taM (Including dl.count or Intara.tl a. .hown on thl. Notlca .u.t obJ.ct within sixty (60) daw. of recalpt of
thh NoUn by:
OR
--wrlttan prote.t to the PA Dapart.ant of Ravenua, Board of Appaal', Dapt. Z8IOZI, Harrl,burg, PA
--election to have tha aattar datar.lnad at audit of the account of the parsonaI r.pre.antatlve,
--appaal to the Orphan.' Court,
171ZB-IOzt,
OR
AOHtN
IStRAl1\IE
CORREClIONS:
ractual .rror. dl.covarad on thl. ....'...nt .hould b. addra.,ad In writing to: PA D.part.ent of Ravanua,
Bur.au of Individual la_.., A1TH: Po.t A.......nt Revlaw Unit, Dept. lB0601, Harrl'burg, PA 11IZ8-0'01
Phon. (7111 787-6505. Sa. page 5 of the booklet "In.tructlons for Inh.rltanc. laM R.turn for a Ra.ld.nt
Dacadent" (REV-IsOI) for an e.planatlon of ad.lnl.tr.tlv.ly corr.ct.ble arrors.
DISCOUNT:
If any t.M due Is p.ld within thr.. (1) cal.nd.r aonth. .ft.r the d.c.dant'. daath, . five percent (5X) discount of
the t.M paid Is allowad.
PENALTY:
Tha ISX ta. .ana.ty non-participation panalty I. co.putad on tha tot.l of tha ta_ and Inter..t a.lallad. and not
paid bafora Janu.ry 18, 1996, tha flr.t day aftar tha and of the ta. aana.ty period. This non"partlclpatlon
panalty I. appaalabl. In tha .... .annar and In the tha ...a tl.a p.rlod .s you would app..1 tha taM and Intera.t
that h.. baan al.a..ed .. Indlcat.d on thl, notice.
INTEREST:
Intara.t Is chargad bag Inning with flr.t day of delinquency, or nine (9) aonth. and on. (I) day fro. tha date of
da.th, to tha d.t. of pay..nt. 1.... which b.caa. dellnqu.nt before January 1, 1982 b..r Intara.t at the rata of
.1. (6~) p.rc.nt par .nnu. calculated at a dally r.t. of .00016~. All t._a. which b.c... dalinqu.nt on and after
January I, 1982 will b..r Intare.t et 8 rete which will v.ry fro. calender yaar to cel.ndar year wlth that rat.
announcad by tha PA Depart.ent of Rav.nu.. The applicable Intar..t rat.' for 19BZ through 1997 .ra:
!!!! Inter..t Rat. Dally Intar..t Factor
~ Inter..t Rata DailY Inter.st ractor
19B7 'Z .OaoZle7
1988-1991 11~ .COa3DI
199Z 'Z .00OZle7
I991-1991e 7Z .aoal9l
1995-I991 .Z .COOZte7
198Z
1981
198~
19S5
1986
ulnternt
ZO:<
16~
11X
U~
taX
I. calcul.ted a.
,000SItS
.COOleJa
.00nOI
.00035'
.caOZl4
follows:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notlc. I..u.d aft.r the ta. b.co.e. dallnquent will r.fl.ct an Intar..t calculation to flft.an 1151 day.
b.yond the date of the a.,a....nt. If pay.ent I. .ada aftar the Int.r..t co.put.tlon data shown on the
Hotlca, additional Int.r..t au.t b. c.lculated,