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HomeMy WebLinkAbout96-00989 ,I ~ 8 'Z o Q ~ "2 ':l: ,~ <t '2 0 o/J Z Q .0 Q! (S "2. .' 0.. :l: 0- ~ I Qj ..:; ..... '0- 0 ~ ".' rG ~ ' ' CD ""- F ~ .... . 0 ~ \J:j ..0 Q Cl .... Co '2 .2 '" ! ~ ~ " Oath of Personal Representative .. commonwealth of pennsylvania countY of Dauphin "0 Pol'""''' ,,' .""."m.' ,.,",\,1 ", .It.m" I "" ,", ",,,m"" " ", "....", p""". '" "" ,,' ,,,,,,, " "0 ,,,, 0\ ", ...."d'. ,,' ""0' 0\ p,,".'"'' I ,m< ,,,,. "' ,.."", <0,""'''''''''' 0\ '0' 00<0'"'' PetitiOnerlsl will well and truly administer the estato according to law. Swom to and otlirmed and subscribed before mo this _::J ,<[l. day 01 Decembcr 19 96 - '~,t j:'U,(lL.1 r~L" V /\1 !)Jll ire' MI\RY C. LEWIS \~\ tj~ DECR"!: OF REGISTER Estate of JOliN R. DONSON Q ~," _ 1./ {I 1./~"",.(/1 Ronald C. KralOcr. Vicc prcsidcnt PNC Bank. N.I\. Deceased No. ;;2.1 -q(p -q 8~ also known as JOliN R. DONSON. SR. 196-14-4B61 Date of Death: l\uguS t 10., 1996 AND NOW. December 4th . 19~' in consideration of the Petition on the reverse side hereon. satisfactory proof hailing been presented before me. IT IS DECREED that Letters 0 Testamentary 0 of Administration Social SecuritY No: KI........,.....-.....,..,............-.............".........., are hereby granted to PNC Bank. N.I\. ~ 'oth"bO'''''''' "dt",tt"' ,",,,"m"t"'. if "V. d,,,d ,op''''''' 29. 198' d,,,.,"d ,n th, p"It,on " .dm""d '0 plO"" .nd fII,d 01 ."o.d .. ,h' '..t wm 01 D",d,nt. Attorney: Edmund G. Myers 1.0. No: 2055B Address: Johnson. Duffie. stewart & Weidner (2~O~~~~epASt1b4~:0~bqBOX 109 Telephone: (717) 761-4540 DATE FILED: 12 - 4 .96 R~-1. LETTERS I\ND ORDER MJ\I LED TO BJ\NK FEES Letters........................... $ Short Certilicatelsl.......... $ Renunciation.................. $ $ $ $ $ $ $ Atlidavit l I................. Extra Pages l I............ Codicil......................... . JCP Fee........................ Inventory & Tax Forms... Other......:..................... 12-4-96 TOTAL................ $ lB.OO 111(' \ \ (0. t.", , ., i' i " v: llil?) ,ll a', Or.!4=- MARY C. LEWfSQ1"o, 01 W,II. 9.00 5.00 12.00 5.00 49.00 Thh. I~ 10 ll,rtil) 111,11 II\(, illhlllll,lliHII hell' ,l:l\1'1l I' lllrllllh 1111'11,11111111 .111 '111I'IIl,d 1IIIlllt,lll 01 dt.llh .!lIh' tdl',1 Wllh IIll' .1' I.m:.lllh'gi'lIf.lr Tilt. III iglll.ll \1'111111 ,III \\ III hI" 1", \\ ,lr,iI.\ III 1111 ,....t,tll' \-It;.1 HI' I .1<1... I Hllll tll' 1'\'1111,1111111 llllll~' WARNING: It Is lIIegnlto dupllcale Ihls copy by photostnt or photogrnph. hr 11111111' 11'11111',"1 ~.'IHI } ?"/-- / ~', " /,' ~<~"''.'./.1((!';l'''L- (I. .').' 1 'Il,d HI,l-:I'll.lI 3 ' ,-, 9 c' ') C' 000,;J AUO 1 I 1936 No 1).lll' I ,..... III' COIlIlONWEALTN Of PENNSYLVANIA' DEPARTIlENT OF HEALTH' VITAL REC~RDS CERTIFICATE OF DEATH ,...... 01 OlcaDlHf ,.. ...... u-a J h 0, 0 n AQI....~ .....,.,YIM UN)I"'CW' -.... -1- 70 ,~ Sr. ... ,,/'1o./e. 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I1.NlffIll 11.-..._.........-....-............ 0HllI .......__tWl..,.... " 1 (EL'T""'So".,J E 1lUI1OIOOASAcoaOUlfQOf) 1lUI1OIOItASACOCSlOUlNCIOll WIN AUfOIOn 'INOH)I ..,.,.."O'OIA'H ...... .....10 CXlWUlIQIrfQlCAUU - (;;;"'" 0 .. CCRM' - - 0 '.....- 0 ...0 ..0 - 0 co.IilIlIIIt............. 0 ONIOF~Y \........Ott-I Trwl OF IfUI..IfIY NIUl'lYRWOM' OClQllMHCMlfIUUlnClCCl..'f'HD. ... 0 ..0 ... - c:un...o-CII"f'I.... .CllltW"fIiIQf'MTIC""'If't>,.....~e.-dOlllll........-.III"YK_P\dP~.......",~....,.ll _.........,~,........,."..".........I--..~,......".....,........."....,.."..,....".......,. n. ., l'LAC1D'ttoUUIl',A1IW;1fOoe.............IIaarJ.-e ~-lSpUyt ... ..........- 0, l'1ClKllHUUK" CWlSlOlCO'...... QeoI1W1 ,Mo-<>HIl'>"'-L \' tl(,ol9'" !oWlC NfO.IoOOAIUOI HIlSOHWttOCOW\.l1I0tAUsc..~ ourH I"-",,n'p.'. WlLL'1lrM- ~, V"""......bW .....P P.~. t!U)' ,1l.o o .n+U...yJl'OIHf. . t'A t '0\" 'Pilla ~ ~~NClCUtf1n'WQf'MY1IClAIIl,.."..,..tdI...~ONIf'l..Id~IO~dlllNf'4 .... .......,....-.,., ...._WfMII.........., ....,...._.... .....~.l...-........ . ,....,.,..."..",...... .YlDCALDA~" Oft........,.laMlftIflOnattdJ..""'............""~..._OC'''"M1''"..UIII.,tI.I.,lIItIfIlM...,..''''.I.....UIoIM(II.... S"""""II~,..,,..., ..., ..... ......,. .... ,..... ,..,..,. ...., ,..,...,......,..,...",.'.,.".. ,..."......... NOIlttWt .WHAtUMAMO........." ~ (7/..,... , ,p\,1~ /,/1 p, u no t:; ;--; \.;~ ',:' "'1 ';J1 -'. .') t:.1 o 1 '"J " I..': '0 ~ a: III Z o ~ ( ell Z III ~ [ ~ ~ :l ~ z o . ~ i ~ Q. o ~ iii III 0 Z Z S >- J: 0 o ~ ., .J ui a: III >- I ~ l . .... i ~ . !l: .-" ~ ,'~.. ... ..,1.- ACl\NOWLEDGJIEN'I' COi\IMONWEALTH OF PENNSYLVANIA ss: COUNTY OF CUI\1BERLAND I, JOHN R. DONSON, Testator, whose name is signed to the Corcgoing instrumcnt, having bcen duly qualified according to law, do hercby acknowledge that I signed and cxecuted thc instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my Cree and voluntary act Cor the purposes therein expressed. \~)-fi- L A) ~-;,'J,. ,: John R. Danson ,'\ t'-Y1 Sworn or affirmcd to and acknowledged beCore me, by JOHN R. DONSON, the Testator, this.,}') '<.\1 day oC~'i:tI"....u..1986. ("'-,. . ~,\'-'-'- itS~~ Notary Publl ~ ' DIAIINE m::!). NOTARY Uy Com:llission l;piru DetemMr 21. 1989 umoy"., PA Cumbe/I,nd Counl~ . .. -4- CERTIFICATLON OF fo!OTICE UND~;I~~'.!!.!L2~lU Name of Decedent: John R. Donson a/k/a John R. Donson, Sr. Date of Death: August 10, 1996 Will No. 09B9 Admin. No. To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Hules was served on or mailed to the following beneficiaries of the above-captioned estate on March lB. 1997 ~ Address Vivian O. Donson 5241 S~ Feery Road Mechanicsburg, PA 17055 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None Date: " , Y(I':3{'i 7 f" ~ftlL- Signature ,?I.' ' 'In:) "- tIO" <11:) SS' 01' 61 mi. L6. . .v '.'1" '. ,.) I" :;I!:l Name Edmund G. Myers, Esq. Johnson, Duffie, Stewart & Weidner Address 301 Market 5t., P. O. Box 109 Lemoyne, PA 17043-0109 Telephone (.r..17l 71';1-4'i40 Capacity: Personal Representative x Counsel for personal representative COMMONWEAJ.TII OF I'ENNSYI.V ANIA IIEl'AltTl\IENTOF Rt:\'ENUE 0 IIlJREAlJ OF INnlVlJ)lJAJ. TAXES IIEI'T.2806111 IIAIUUSlIlJRG.I'A 17128.116111 1$_1'/1-/3 May 22. 1997 MS MONIKA H GOESER PNC BANK NA 17TH AND CHESTNUT STS PO BOX 7648 PHILADELPHIA PA 19101 Dear Ms. Goeser: Re: Estate of File No.: John R. Donson 2196-0989 This is in response to your request for an extension to file the Inheritance Tax Return for the above-referenced estate. In accordance with Section 9136 (d) of the Inheritance and Estate Tax Act of 1995. the time for filing the return is extended for an additional period of six (6) months. This extension will avoid the imposition of a penalty for failure to make a timely return. However, it does not prevent interest from accruing on any tax remaining unpaid after the delinquent date. The return must be filed with the Register of Wills on or before November 10, 1997. Because Section 9136 (d) of the 1995 Act allows for only one extra period of six (6) months, no additional extension(s) will be granted that would exceed the maximum time permitted. Sincerely, (/}1,/.. /J )1J,:~,,'r;d-<::r-' jA'/'"", V. .' i.....I1 // :,/ John C. Murphy, Chief " Inheritance Tax Division S-IT:INII83 PC05:JH:249 r"~' .."J c;r:- ,ci '.1 .,., i~f'''' L , 1 ~, ) , , ,- '" 1:"1 - 1'1'-1 - J3 A'V."'....,....) INHERITANCE TAX RETURN ~~~8In~~~fFDftJ,MmR 12131191 RESIDENT DECEDENT pOVERTY CREDIT 15 CLAIMED cO"'~~~:'~~:~106:~~..~~rANIA (TO BE FILED IN DUPLICATE FILE NUMBER "AAA"~~~~";:~~:""." WITH REGISTER OF WILLS) COUN~CODE Y~~ DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) DECEDENTS COMPLETE ADDRESS OONOON JOON R. 5241 sIMPSON FERR'i OOI\D SOCIAL SECURITY NUMBER MEOWUCSBURG, PA 17055 DECEDENT 196-14-4861 08 10 96 07 13 1926 Coun CUMBERUIND ~'A.r~~o' "'~ObL~ l~m~~ SOCIAL SECURITY NUMBER AMOUNT RECEIVED (SEE INSTRUCTIONS) OONOON VIVIAN O. 191-40-9862 471 874.04 " Orlglnal RoNrn 2, Suppl..,.,nlol RoNrn 3, Romamdor Rolurn Ilard.I..o' dUlnpflOf10 tl.UM121 0989 NUMBER CHECK APPRO- PRIATE IIl.OCKS :Ets. FodOlal Estalo Tax Rolurn Roqullod CORRES- pONDENT o 48, futuro Intorost compromso (lor dolOll 01 doom onor 12-12-02) {H e, Oocodont Dlod TOSl810 8l 7, Oocodont MBmlBlnod a living T'U5t (Attach capy 01 Win) (Attach capy 01 Tru5l) AU. CORRESPONDENCE AND CONFIDENTIAL TAlC INFORMATION SHOUlD BE DIRECTED TO: NAME COMPLETE MAIUNG ADDRESS MARIA'ltMPKINS smIOR TRllsr OffICER PNC BANK, N.A. TELEPHONE NUMBER MAIN & MARKEl' Sl'REEl'S 717 691-4044 MEQWUCSBURG PA 17055 1, Roal Estalo (SChodulo Al ( 1 ) None 2, Slacks and Bonds (SChodulo B) ( 2 ) None 3, Closoly Hold SlacklPar1norahlp Inlorool (SCh, C) ( 3 ) None 4, MortgagOll and NolOO ROCOlvablo (SChodulo 0) ( 4 ) None 5, Cash, Bank Dooo..1lI & Mlscallanoou. pOI80nol (5) 397 , 340.09 Proporty (SChodulo E) 6, Jolnlly Ownod Proport'( (SChOdulO Fl 7. Tronslora (SChodulO G) (SChodulo l) 6, Tolal Grosa AssoIS (Iolal Unos ,-7) 9, Funoral Exponses, AdrrlnlSUaovo Co'IlI, MI8COUanooUs Expon... (SChodulo H) 10. Doblll, Mortgago Uabl111lo8, Uons (SChodulo I) ", Tolal Doductlons (Iolal Unoo 9 & 10) 12. Nol Value of E.lalo (Uno 6 minus Uno 11) 13, Chantable and Govornmonlol Boquool. (SChodulO J) 386 216.09 0.00 o 4, Umrtod Eslalo _ o. TaiBI NumbOr at SaID Oopoml Bellm ( 6) (7 ) None 0.00 397,340.09 ( 6) RECAPIT - ULATION ( 9) 11,124.00 (10) None 11,124.00 386,216.09 None (11) (12) (13) TAX COMPUTA- TION 14, Not VoIue Sub oetlo Tox IUno ,2 mlnu' Uno 13) 15. SpouUI 1rln,I",(101 dllll 01 dulh III.r Ba]OaV4). 5.. In.trutllon' 'Dr Applltabl. p.rc:.nt4g' on P.g. 2, (Intlud. valuulrom Sell.dulel<.of Sell.dul. M,) 16, Amount 01 Uno 14t811ablo at 6"10 rato (Includo valuoo Irom SChodulo K or SChodulo M,) 17, AmOunt 01 Uno 14 1pablo 8115% roto (Include valuoo Irom SChodulo K or SChodulo M,) 10, Prtncipall811 duo (Add lox Irom Unoa15. 16 ond 17,) 19, Qodi1S SpounIPov.rlyCr.dlt prior paymonts ('0) 120) 0.00 0.00 0.00 0.00 . . 20, II Uno 191. groolor than Uno 10, onlO( Iho dllloronce on Uno 20, Thl. i.lho OVERPAYMENT. A. a..ok hare" OIl..e re uea1ln .,atund 01 our ave an1. 21. 11 Uno 18 Is groatOf than Uno 19, ontor tho dl"OfOncO on uno 21, This IS tho TAX DUE. A, Entor 1ho InlOlost on tho bBlanco duo on Uno 21A. B, Enlor Iho tolol 01 Uno 2' and 21A on Uno 2,B, Till. "tho BALANCE DUE. Make ChIck pa ablato: RI 1.lar 01 Willa. Aganl ... ... BE SURE TO ANSWER AU. OUE5T1ONS ON PAGE 2 AND TO RECHECK MATli" .. ndor ponamoo at porlul'/. I dOOMO thaI I havo OXllmInod thl' rolurn, mClud,ng occompanymg schodulOS and slalomonlS. and 10 1110 bo.' 01 my knowlodgo and boIlOl. II 1.1nJO. canoet and camplOIO, I dOOmo tnal 011 rool OSlolO ho' boiln roponod al1luO morkol valuo, Doelaro"on 01 proparor othor than tho porsono roprosont8 basad on alllnf n 01 which proparor has any knowkJd o. SIONATUA' OF piAsoN A(5PON IDLE A LIND AUUAN AOOA(5S PNC BANK, N. A. OAT( By:'1-' '/L/ (r,\ Senior Trust office /1/'//97 SIONA1UAOFPR"AA'A01"'RT"ANR'PAES(NTAlIV' AOOP(5' Main & Market Streets o~;;.- Mechanicsbur PA 17055 (21) (2,Aj (2,B) 0.00 0.00 0.00 15001 N1F eBHI CopyrIght Forml SoltwlI' Only, ,V.. Halto,lnc. NV4PAOO' REV-1649 EX. (B/D~) SCHEDULE 0 TRANSFERS TO SURVIVING SPOUSE COMMONWEAL ftt OF PENNSYLVANIA INHERITANCE TAX RETURN RUIDENT DECEDENT File Number ESTATE OF JOHN R. DONSON 21-96-0JJ~ PART A: Enlor tho dosaiption and valuo at a1llntarosts, both IlUloblo and non-llUlablo, fogardloss ollocollon, (nOl at dodUCtlons) wh~h pass to tho docodont's surviving spouso bV wlll, inl05tacy, oporatlon allow, or othorw190. Ooscrl lion of ~oms Amounl 1 1 RESIOOARY TRUSl' FOR SOLE USE OF SURVIVING SPOUSE, VIVIAN DOOSON, PER ARl'ICLE VI.8 OF LIFE rnSURANCE TRUsr OF JONN R. DOOSON, SR., DATED 1/24/77, lIS AMENDID 9/30/83, CALaJIATED lIS FOll.CMS: 469,474.04 NEl' PA TAXABLE ESTATE PWS: LIFE rnSURANCE ~ PAYABLE 'ro TRUsr LESS: proPERlY PASSWG D~'{ 'ro SURVIVING SPOUSE $386,216.09 85,657.95 2,400.00 2 Item 3 on SChedule E 2,400.00 Part A Tolal: Enl.. amounl shown on lho rocap~ulatlon shoot In Iho OecedenllnlormoUon SecUon. 471 874.04 Election To SubJect Property To Tax Under Secllon 2113(A) As A Taxable Transfer By This Decedent. II I trUst or similar IITlngomont mool3lho 10qulromon13 01 Socti<>n 2113(A), Ind: a, Tho trUst or similar IITlngomonlls IIslod on SChodulo O. Ind b. Tho value at the trust or similar 8rTsngomonlls entorod In whole or In part as an assot on Schodulo 0, thon lho ulnslero(a personal raprosenlatlvo may specifically Idontlly Iho lrusl (an or a Iracllonal portion or pOlconlago) 10 00 oncludod in Iho o\eClion to have such trUst or similar property uoalod os 0 laxoblo uanslor In this oslalo, II loss than Iho onlllo voluo 01 tho Irusl or slmilor proporty Is Included 89 B Il\XsbIo transfer on SChodulo 0, tho porsons] roprosontativo shall bo considorod to havo mBdo tho election only as to a trochon 01 lho trust or similar anangomont. Tho numerator 01 thislractiOn Is oquolto tho amount 01 tho trust or Simler arrengmontlncludod as a tl1Xsblo assai on SChodule O. Tho donomlnalor Is oqual 10 Iho tolal valuo ollho lrusl or similar a"angomont ELECTION: Do you elect under SocUon 2t I3(A) to treot as a taxable transler In this estate all or a portion ala \nIat or almllar arrangemenl crealed lor the aole ual 01 this dlcedent's aurvl7Jqg opousJl-Clll,rlng the surviving spous~'a enUrellloUme? r-=l D ). I /);,1 //,&f 1b:.! YES L1QU NO Slgnotur"@ u' Dole II 'i Hote: If the elecUon lies to more than one trust or similar arran emen en a se arate form be sl oed and flied. Part B: Enlor tho doscrlplion and valuo 01 on InloloslS. OOlh laxoblo and non-taxoblo, logordloss ollocnhon, (nOI 01 doducllons) which pass 10 tho decodenl's surviving spouso lor which 0 Secllon 2113 (A) olecllon Is OOlng modo, Amounl Ooscrlplion ollloms 1 1 PORTION OF SOLE USE TRUsr PER PARI' A.1 ABOVE ATrnIBUl'ABLE 'ro LIFE INSURANCE PROCEEDS. 85,657.95 Part B Tolal 85 657.95 PAI6481 NTF 1021 CopyrIght Form. Soft....r.Only, to;S Nllc;o,lnc. N95PA4g, " .. .. ~----'-_., ---- ~--------- 3Ett6t JItll ttub ille6tttttteut of JOHN R. DONSON ~ , .., "- ~ I, JOHN R. DONSON, of the Township of Hampden, cumberland County, Pennsylvania, make, publish and declare this to be my Last Will and Testament, hereby revoking and making void any and all Wills by me at any time heretofore made. I. I direct that my just debts and funeral expenses shall be paid by my Executrix as soon as practicable after my decease. Il. If I have predeceased by wife, VIViAN O. DONSON, I give and bequeath unto her, without prejudice to her rights as surviving tenant by the entireties of articles in common use in our joint household, all my household furniture and furnishings, books, pictures, jeweiry, automobiles, wearing apparel and all other articles of household or personal use or adornment. If I do not predecease my wife, I bequeath all the foregoing to my children who survive me, to be divided between them, as they shall agree, so that each has as nearly an equal portion as may be. 1II. If I have pred~ceased my wife, I give, devise and bequeath the residue of my estate unto THE FIRST NATIONAL BANK AND TRUST COMPANY OF MECHANICSBURG, Trustee under Agreement of Trust, dated January 24, 1977, and awarded on September 30, 1983, between me as Settlor and The First Bank and Trust Company of Mechanlcsburg as Trustee, to be held and administered in accordance with the terms of the said Trust. < IV. If my wife, VIVIAN O. DONSON, shall faU to survive me, 1 give and bequeath the sum of Fifty Thousand ($50,000.00) Dollars to TIlE FIRST BANK AND TRUST COMPANY OF MECHANICSBURG, IN TRUST, for the following purposes: A. To Invest and administer the same in accordance with the Probate, Estates and Fiduciaries Code of Pennsylvania for the benefit of LILLIAN 1. DONSON. B. To pay the Income of LILLIAN 1. DONSON during her lifetime. C. To pay, In the discretion of the Trustee, such amounts of principal as shall be required to supplement the Income for the support of LILLIAN 1. DONSON so long as she is living Independently In her own home or apartment. When, and If, LILLIAN I. DONSON is unable to care for herself and becomes a patient In an Institution, the Trustee shall pay to her or for her benefit the Income only, without dlscretlon to pay from principal. D. At the death of LILLIAN 1. DONSON, to terminate the Trust and distribute any balance therein to JOHN R. DONSON, JR. and ROBERT C. DONSON and the Issue of either who may be then deceased per stirpes. E. The Interest of any beneficiary In any portion of the trust estate shall not be subject to pledge, anticipation or alienation by or against the beneficiary. V. If my wife, VIVIAN O. DONSON, shall fall to survive me, I give, devise and bequeath all the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate unto my sons, JOHN R. DONSON, Jr. and ROBERT C. DONSON, share and share alike. -2- ACI{NOWLEOmlENT COivlMONWEALTH OF PENNSYLVANIA 55: COUNTY OF CUMBERLAND I, JOHN R. DONSON, Testator, whose name Is signed to the foregoing Instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the Instrument as my Last Will and Testament; that I signed It willingly; and that I signed It as my free and voluntary act for the purposes therein expressed. ~,R~~ ohn It. Danson Sworn or affirmed to and acknowledged before me, by JOHN R. DONSON, the Testator, this.;.'') tr:.\'\day of~~...1986. ~. ~ 1. -0,) -"\-'--'-- Notary Pub ~ ' DIANNE m::G, NOTARY ~ lIy Commission ['pi". O.<<mbel 21. 1989 Llm01ne. PA Cumberland COunt, -4- I '\ ~..... .. . AI'I'IDAVrr COMMONWEALTH OF PENNSYLVANIA 55: COUNTY OF CUMBERLAND We, ~___ A . ~..~~.. Dnd ~.. ,Q C'),~, the witnesses whose names are signed to the foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testator sign and execute the foregoing instrument as his Last Will and Testament; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the Will as witnesses; and that to the best of our knowledge, the Testator was that time at least 18 years of age, of sound mind and under no constraint or undue inCluence. ~""' tJ. ~_ ~ ' (/.l,:?/.!/-- & It~ and Sworn or aCCirmed to and subscribed to before me by ------ ;..\ . fs1-....~..Q J:::J.~".J' witnesses, thls.:J"ll:l'day of~~...1986. ~ :....~tary ~~;; . ~- !l1M:~!E I E~"~. NOTARV " My c~,,:niSli.n [,pi'" Dt<embel 21, 198~ I.Im01o., PA Cumberland Count>> -5- IFtHl4H997 10119 ,_ A .__.....~_""'..,_... PNC l'ECHHN I cSBIJRG o:Ji'lo;l I 1'._ ..... ~Lft INSURANCt TRUST ^GR&~HtNT BETWEEN JOliN R. DONGON. SR. MK/A JOliN R. DONSON (SETTLOR) lINll THE FIRST D^NK ^NO TRUST COMPANY OF HF.CH~~ICSBURG (TRUSTE!::) D^TED AS OF Januarv 24. 1977 J trf~ '} i" 'b 0 /' ,. i JAN-02-1997 10/19 PNC MECH1'lIC5~ t.CIIl:El'\ENT THTS IIGRtr,m:NT, ,,",de ~hil Hth day oC .1anuUY 1971. betwf\On JOliN R. DONSON. of the Townahip of lIampden. cu.lllMr la/Ill county. pennGylvania. party 0' the Firat vert ("!:r.TTLOn"l. III KIll JOliN R. UONSON, SR.. AND Tilt FIIlST UM1I NlD TnUST COH1'ANY or HECIIANICSBUIlG. culllberland COllnty, pennsylvania. party of the Second part ("':IlUSTF,&"l. WITNF.SSt'l'1f : '.... wnCRElIS. sattlo~ haa callstld hh life to be in~ur"d under certain policies at inaurance shown on schedule ",," hereto attachcd. on which policia. Settler ha. or will name TruutCQ banaficiRrYI and WHF.Rt/lS, the Parties intend to eatabliah e Trust ot the proceedG of said policies and to etipulete and "qree aa to tha terms thereof. NOW. TIICRC.OIUl. in considcrat10n ot the mutual cove- nanta hcrein con~ained. it U &9rud .. followl: lIRTICLK T. THE TIlUST &ST/lT& 1. The TruRt Eltate aha11 conaist of the proceeda of oaid 11!. insuranc. polici.S. any other money or property which the Settlor ohall conveyor deliver to the Trustee. any 'noney or property which Settlor IMY dtlvise or bequeath to the Tru.tlle hy hia will. and any property which any other \/q#'WQ., ~ ~\i ~O Y 7 b':l1 10" , ,...UI' ... JAH-02-1997 10118 PH<: I'ECHAN1CSBURG LO "CCact collactlon. htt~r recelVlnq Indemnity ^Q.lllat t;.h. ...~"n"fIt" nl such Lltl?Gtlon', Trult.oo InDY, at it. dJ..- cretlon. InotitUla litl.g~tion tor collectlun am) is authorUcd to comproml.u and ootUO ony ch1m under any of :I~ld policies at any Itaqo. ie In Ita diftcrntlon, it daaml it ad.entageoU' to do ftO. hny e.pense incurrcd in r.ollection ot Lhe proceed. or the (lol1cie~ .hall ba daductarl Crom Lhe Truat Cltlta. ,. ARTICLl!: tV. " eSTABLISHMENT or TnUSTS' 4. Upon tha daath or the Settlor. ~urvivcd by hift wif., ViviAn O. nonson, e:.tat.. into two 'rrur;ts, Trust liD". The ~.,p"rllte tru~t, .atat. e. finelly purpo=e~, f~QQ ~nd claar taxa.. l.s. the .ggregate such purpos.. for proparty , " of inter..ts therein wru.ch paaa or hAve pc.sad to settlor" wife oth~r thO" under the (lrov1sion. of this instrwn.nt. Th. remainder or the Trust eatate. including any property Qr aD.ete received from other.. or ineliQible for marital deduction. shall ba placed in Trult on". .. /IRTICLl!: V. l\IlMINtSTlIhTTON Of' TIIUST "AO 5. The Truslee oholl hova. hold, manage. invest and tei.nver;t t:h. pri.ncipal of Trult "1\", cQl1ec~' l:he lnco",o, Qnd pay over the net: income 1n convenient lnJltlll1ments to Se~tlorO~ wife, Vivian O. !lonson. durin", hsr lihtime. The \ru.te~ ~hall .lso. frcm time to time. pay tc vi.tAn o. - 3 - ~~t~ \,0 /' Dunftnn, ~uch ^mountG ot tJ\O prlnC1ral of the Tfllst AI Vivion 0, Oononn oho1l. requnt 1n wrHing. In thm QVlnt vivian O. Oon.nn .hall. tor ftny r~ft.on, not make request~ Cor e1i.tribution nf pdnclpd. but the circum2Uncc2 Indi- cate to thl!! 'rrustce lhat thl oaml ohou16 ~". made. the Trustee , .hall makm luch dhtr.1butlaM of prlncil'al a. n 2hftll dum to bl required under the circum.tance.. 6. Opan the death of Vivian O. Don.an. thl Truatml Ihall canvIY and poy ~v.r .11 at th.. nmft,lninq ftSSetA of this Trust to or tal: the benelit of .uch pOenan. including I:hc ast~te at Vivian o. oansan. in such amounts 'ar pro- portions. and In .uch interest. or e.tates. whl!!ther absolutely 01: in '!'rust. as the said Vivian O. oan.an' .hell dinct, whcthmr by in."rum..nt filed with tho Trustu durlnq hlr lifetime, or by her t...t Will and Te"tament, 7. It Vivian O. OOnlan shall fail to eXlrcise the toreqoing pDwar Df Appointment, then the remaining ....t. of this Tl:ust shall be added to those in Tru.t "8" hel:e1n- ftfter oatabli.hed. lIRTICLE: VI. AOMINISTRATION OF 'CRUST "tI" B. Th. TrUltae .hall first satisey trom the funds allocll~ed to TruJlt f'S" any inheritancCl ot" ,utat.CI tlUUilS dUQ by, rea.an of SlttlOl:'e death nat provided far by hi. ..tate. the Trustee being empowered to apply funds af th.. Trust lar this purpos~ without requiring the liquidation by tho ntaU of HemA beq"eathed uncler the 11111 of the Settlor, provid.d, hOweVer. thftt the Trustee may not u.e f.OI: such uxe. tund. or ....t.. forming part. o~ th. Trust Estate 'Which wore not suhject to F8d"~ftl Esr.ftte T.x in 5.ttlor'~ es".te. If Lillian I. Oo,,~on. mo~her of SC'lttlor. 1s 11ving 1n the house ftt J.- ~fo~~ ./ - 4 - 1706 LO~u~~ Otr~.t. New cumbDrlond. r.nn.ylv~nl., tl1G T~u.tC& Is authorlud ~o applY so much 'ot the incomo ot nuat ,"II" os shall bo <~qultod for ~ho OIaiutCMnce or that ptOpotty .. a t..id~nca tor the uid Lll11an l. Donson. such maill~enanCQ ~o inCiU'dQ ~ax~s. inollrsnce. nece..ary rcpairs, utility nrvico and muniel\lal eharg~', during hn occlIl'sncy thereof. Tho remainder or the tunda allocated to thh Tru.t "8" the TrustsQ shall have, hold. I.anago. invcet and re1nveat, collect ~ho incomo and pay ovo . ' tha same in convenient In.tallment. to vivian O. Don.on during . ' ' lit.. It the income trom thfa Tro.t, con.idorad h.r natural taQclhcr with other income aval labl. to hltr, al101l not ba ample tor her comfort and sapport in the atyle to which ahe 11 accustomad at tha tima of the: Sottlor'S daath. the Trustee. acting in It. .0101 dbcration. ahall \lay to holr trom the principal ot this Trust such amounts from timo to timQ aa .hall ba required tor, such Llurposes. In addition to tho abovo. thQ TruatU ahall pay to Vivian O. Don.on on her written ,req~eet, annually, 4n amount ot principal,lIot exceeding F!.ve 'Chou, and ($5,0,00..001 Dollan. ar fiVll (5'1 pe~cent ot the then Tras,t E.t.te, whlchever ahall be gre.tar. Tha right to withdraw under this. provision .hall be non-cumulativll trom year to year. 9. upon tho death of vivi.n O. Don.on (or, if she predece.... hi11l, the Settlor's deathl. the Teu.tu .hall . t.rminat. thCl Truat ond pa.y ovor: tho '("'CUllt tRtat. to s.tt.loJ:"~ children in equ.l .h.re., If at the time for dbtribution to hi... a child ot the sattlor ,h.ll be dacea.ad leaving minor i.sue eo survive, tho Truae.e .hall hold the (\is~dbutive .har.a of such minor isaue during minority, .ubject to ehe nu.t. and may admini- secr ehe sum. according to the t.rm. haraot. In making - 5 - ~ ~f~ / JAH-e2-1997 . l'"y,""nt8 to "ny ",j,nor bendicia,ry or ony beneficiary under di.abUHy. the Truete" may mak" ,uch pRy",ellt La .u"h peraon or In.tltution aa the TruatQa' ah.U "eem to bIZ "",.t for the a~".n~.qu of the b"neticlary ill qua.tlon. without th" intar" vllnrioll at a Cormlll ",uardhn.hip. It a child ot tll" s"ttlor dlaa prior to find distribution La him without lcavilll/ Uvin\l iuu. to .urvivo h\J1l. tho sh." of the child ao ~yi!,,,, ahall be .dded to the sh.r. of the sllrviviM child. " " I\n'tICLE VII. pnOVISIOllS CO/'IHON TO !lOTI! TRUSTS ..... 10. No part of th" incoma or princip.l of thll Trust J':state shall be aubjeet to attllch",.nt. leVY or .eizure by llllY creditor. IpOUS.. ..aign.. or tru.tee or receiver in ballkrul'tcV of anv bQn.fici.ry prior to his or her actual r.c.ipt th.r.Qf. Thft Tru.tee shall pay over inca"''' .nd principal aa herllinbafora datarmined to the parties designated. aa thair lntaralt m.y .pp".r. withollt reqard to any attempted Rnticipation. plodge. or aaai",nmant by .ny b.n"f.lciAry. Rnd without req.rd to .ny claim thQretO or attlZmptad lavy. att:ochm"nt. uhur. or othar proca", provided thAt it any such lavy a: ubur. .h.ll ba .uthorind by law or specHic order at any court havln", juriadictlon. Tru.tea .h.ll not be 1illbla to Gny b.n"fici.ry for viol.tion hereot by reason . of the ..ma. ,11. The Trustee ahall have tho powars accordad TruHaaa by tha La" of l'a"nly1v.nia. lIith r..pact to lnvllSt- m..nt.. whether or not such powers are provi~ad ~y tha 111" ~n .ff.ct .t the time, it shall have tho power La datermina whathar .n ....t h.. th" character of principal or income. tn retain investment. in the torm received or to convert .w:t ~ /' _ 6 - - the "A~O. uDin~ as its st.ndard.th~t of a Frudent ~an in deaLinq with his own estste. to p.rtition reaL estate or to duL with Lt in other telSpects AS if the owner in '~e d~plo Lhereof. La cxcrciae ell vo~i"V Fowers and rivhLS with res" , Fect to lnvestments which ~ay form part of the Truot roatat.. to "AU'. lnvoat~enta to be reCJistered for convenience of adminhttAl:ion in the nalnO of a ,.\ominee. providarl that t~io provlaLon not ba dco~d to limit or restrict powers provid.d by law. Th. Truat.. .hall Aloo be empowered to ~ake dis" tribution to porsona entitled thereto wh~ may b~. in ita , judgment. und.r any incapacity or disability in auch mannar. to auch person as it shall d.am to be ~02t beneficial to the beneticLa.y in queatlon. 12. With r~ap~ct to the Tru.t Eatate. should setLlor and vivian O. Danson dL. und.. such clrcumstanceo that I.C l.s dUtlcuLt 0. imp"nlbltl to determine which died rirst. the S.ttlor .hall be dee~ed to have predec....d tha aald Vivian O. Danson. 13. The use at h.adLnqa at any type herein ia Ear convenience only. and thoy ohall not ba conddered in inter- pretation harcot. 14. This Trust ~oy b. r.vokad or modified at any tlme by the Sattlor by a writin9 do livered to the Truatee concurred in as to form only by tha Trustee. III WlTNESS WlIEIUIOE'. the Settlor h.. hereunto aot his hand and ."al. and tho Truatee has causad the ax.cutLon here- at by its duly authorizod otticar and the aftLxinq and attes. tation at its corporate seal. tho day and yaar ~bove written. J1 ~ o~;? ;.,. - 7 . ESTATE OF JOHN R DONSON DECEASED (DIED 8/10/96) LATE OF THE BORO OF MECHANICSBURG CUMBERLAND COUNTY PA FILE NO 21-1996-0989 INVENTORY COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS Maria A. Tompkins Assistant Vice President of PNC Bank, National Association, Executor of the Estate of John R. Donson deceased have been duly affirmed according to law did dispose and say that the items appearing in the following Inventory are personal assets wherever situate and real estate if any in the commonwealth of pennsylvania of said decedent that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the decedent's death and that the decedent owned no real estate outside the commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. AFFIRMED AND SUBSCRIBED BEFORE ME This 7th Day of November 1997 ~ Nolanal S...l Ka'on R. Schaoler. No"'y Public MH<".h.1UicSburg Boto. ~Ilmbort.l"d Cou ~y commiSSIon E.pirosJune 22. 2000 M.mt". Penn~yt\'a"'. ""~oc~tion at NolJllttG .\ \ ;5>'1'1-/3 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN '/ *' BUREAU OF INOIUIOUAL TAXES INHERITANCE TAX DIVISION DEPT. 210601 HARRlSIURC, Pi 11121.0601 11,..11111"111.'" 03-23-98 DONSON 08-10-96 21 96-0989 CUMBERLAND 201 JOHN MARIA TOMPKINS PNC BANK NA MAIN & MARKET ST MECHANICS BURG Anaunt R...Ut.d PA 17055 MAKE CHECK PAYABLE AND REMIT PAYMENT TOI REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 NOTE I To insure proper credit to your account, lubnlt the upper portion of thil farn with your tex pay.ent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR FILES ~ R-iv:48if-EX--AFP--io3~-97j-----iiM-NCificif-OF--OETifRHiifAfiCiN-Aifo-ASisESSiHENif---------------------------- OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN MM ESTATE OF DONSON JOHN R FILE NO.21 96-0989 ESTATE TAX DETERMINATION ACN 201 DATE 03-23-98 1. Credit Far State Deeth Taxes as Verified 2. Pennsylvania Inheritance Tax Assessed (Excluding Discount and/or Interest) .00 3. Inheritance Tax Assessed by Other Statas or Territories of the United States (Excluding Discount and/or Interest) .00 4. Total Inheritance Tax Assessed 5. Pennsylvania Estate Tax Due TAX CREDITS: PAYMENT DATE DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID RECEIPT NUMBER- . ~ '.J"-': '.' TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 _IF PAlO AFTER THIS OATE, SEE REVERSE SlOE (IF TOTAL OUE IS LESS THAN tI, NO PAYHENT IS REQUIREO FOR CALCULATION OF AOOITIONAL INTEREST. IF TOTAL OUE IS REFLECTEO AS A "CREOIT" (CRJ, YOU HAY BE OUE A REFUNO. SEE REVERSE SlOE OF THIS FORH FOR INSTRUCTIONS.J R .00 .00 .00 PURPOSE OF NOTICE: To fulflll the r.qulr...nts of s.ctlon ZlftS (bJ of the Inh.dtanu And Estat. fall Act, Act 21 of 1995!. (7Z P.S. S.ctlon 9IftS!l. PAMNf: a.tach the top portion of thl. Notlc. and .ub.lt with vour pav..nt to the A.gI.t.r of will. prlnt.d on the r.v.r.. .Id.. ._ Mah ch.ck or .on.v ord.r payable tal REGISTER OF HILLS, AGENT. REFUND CCRII A rafund of a tall cr.dlt .ay b. raqu..t.d by coaplatlng .n MAPpllcatlon for Rafund of Penn.vlvanla Inharltanc. .nd E.tat. T.ll" (REY.1515). Appllc.tlon. .r. av.llabla at tha Offlc. of tha R.al.t.r of Will.. any of the 25 R.v.nu. DI.trlct Offlc.. or frail the D.p.rt~.nt" Zft.hour answ.ring ..rvlc. nuab.r. for for.. ord.rlngl In P.nn,Ylvanla 1-800-5&Z.ZOSO, out.ld. p.nn.vlv.nla nnd within local HarriSbUrg .r.. (7171 787.809ft, TOOl (7171 77Z.ZZSZ CH.arlng lap.ir.d Onlyl. OBJECTIONS I Any p.rty In Int.r..t not ..ti.fl.d with the .s......nt of tall .. .hown on thl. notic. ..V obJact within .ixty (60) d.y. of r.c.lpt of thl. Notlc. by: "wrlthn protnt to tha PA n.parta.nt of Rav.nu., Board of ApP...., n.pt. Z810n. HarrisbUrg, PA 171Z8-IOZI, OR ...I.ctlng to have the a.tt.r d.taralned at .udlt of tha per.on.l r.pr..entatlv., OR ..app..l to the Orph.n.' Court. ADMIN- ISTRATIVE CORRECTIONS I F.ctu.l error. dl.cover.d on thl. ........nt should b. .ddr....d in writing to: PA O.p.rt..nt of Revanu., Sur.au of Indivldu.1 Tall.., ATTNI po.t A.......nt w.vi.w Unit, Dapt. Z80601, Harri.burg, PA 171Z8.0601, Phone (7171 781-6505. s.. paa. 5 of the booki.t Mln.tructlon. for Inh.rltanc. Tall R.turn for a R..ld.nt Oecad.ntM (REY-IS01) for an IIllplanatlon of adalnl.tratlvalY corr.ctable error.. PEHAlTV: Th. ISX tall aan..ty non-p.rtlclp.tlon p.nalty I. co.put.d on the total of the tall and Inter..t .......d. and not p.ld before J.nu.ry 18, 1996, the flr.t dav aft.r the .nd of the tall a.ne.ty periOd. Thl. non.p.rtlclpatlon penalty I. app.alabl. In the .... .ann.r and In the the .a.. tl.. parlod a. you would app.al the tall and Int.re.t th.t h.' b..n .......d a. indlcat.d on thl, notlc.. INTEREST: For dat.. of d.ath on or .ft.r 10-5.91. Penn.ylvanla E.tat. Tall ba..d on the r.der.1 E.tata Tall return b.co..' d.llnquent at the ellplration of nln. (091 .onth. fro. the date of death. For date. of death prior to 10.5a91, P.nn.vlvanla E.tat. Tall ba..d on the F.deral E.tata Tall r.turn beco... d.llnqu.nt at the .llplratlon of .Ighte.n (181 lIonth. fro. the data of d.ath. ta... which b.ca.. d.llnquent be fora January I, 198Z be.r Int.r..t at the rat. of .111 (6XI parc.nt p.r .nnu. calculat.d at a dally rate of .00016ft. All ta... which b.ca.. d.llnqu.nt on or aft.r January I, 198Z will b.ar Int.re.t at a rat. which will varv fro. cal.ndar y.ar to cal.ndar year with that rat. announced by the PA Oepart.ent of R.v.nue. Th. appllcabl. Int.r..t rata. for 19&Z through 1998 ar.1 V..r Int.rnt Rat. Dally Int.rnt F.ctor Vear Int.rnt Rat. Dally Int.r..t Factor 1982 ZO:< .000Sft8 1987 'X .00OZft7 1985 16X .000f438 1988a1991 111- .000301 198ft IIX .000101 199Z 'X .oaOZft7 1985 llX .000356 1995-199ft 7X .00019Z 19&6 lOX .000Z7ft 1995.1998 'X .000Zft7 -alnt.r..t Is calculat.d .. follow.: INTEREST = BALANCE OF TAX UNPAIO X NUHBER OF OAYS OELINQUENT X OAILY INTEREST FACTOR aaAnV Notic. I..ued aft.r the tall b.co.e. d.llnqu.nt will r.fl.ct an Int.r..t calculation to flft.en CIS) day. b.yond the date of the ........nt. If pay..nt I. .ad. .ft.r the Int.r..t co.putatlon date .hown on the Notlc., additional Int.r..t .u.t be calculat.d. 15--11'1-6 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE I BU~EAU OF INOIVIOUAL TAXES IHlllRI1AHC[ IAll DIVISION PEP'. ZlObOI ttARAISIUAC, PA 17128-0&01 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF OEOUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-23-98 DONSON 08-10-96 21 96-09B9 CUMBERLAND 101 MARIA TOMPKINS PNC BANK NA MAIN & MARKET ST MECHANICSBURG PA 17055 Anount ReMitt.d c. ~~ ~~P" t1,.lh'UI" Ilt.HI JOHN R 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 ~ Rifv:i5'4TEiCAFP-iiiF9:fj-NOificE--OF-YNHEiiifAtiCE-ifAX-A'PPRA'iSEHENY-;-ALLOWAifcE-CiR----------n-m- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF DONSON JOHN R FILE NO. 21 96-0989 ACN 101 DATE 03-23-98 TAX RETURN WAS: I I ACCEPT EO AS FILEO RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. R.al Est.t. (Schedule AJ 2. stocks and Bonds (Schedule OJ 3. Closely Held stock/Partnership Interest (Schedule C) 4. Hortg.ges/Note. Receivable (Schedule OJ 5. Cash/Sank Deposlts/Hise. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule f) 7. Transfers (Schedule OJ 8. Total Assats APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/AdM. Costs/Hisc. Expanses (Schedule H) 10. Debts/Hortgage Liabilities/Ltens (Schedule Il 11. Total Deductions 12. Hat Value of tax R.turn 13. Ch.rlt.bl./GoY.~n~ent.1 Beque.ts; Non.elected 9113 Trusts 14. Net Value of Estate Subject to Tax ( X) CHANGEO SEE ATTACHED NOTICE III (2) 131 141 IS) 161 171 .00 .00 .00 .00 397.340.09 .00 .00 IBI If an assessment was issued previously, lines 14, 15 and/or 16, 17 reflect figures that include the total of ~ returns assessed to ASSESSMENT OF TAX: 15. A~ount of Line 14 at Spousal ~.te (15) 16. Anaunt of Line 14 taxable at Line.1/C1ass A ~at. (16) 17. A~ount of Line 14 taxable at Coll.te~.l/Class 8 ~.t. (17) 18. P~incipal Tax Due NOTE: TAX CREDITS: PAYHENT OATE RECEIPT NUMBER OISCOUNT I') INTEREST/PEN PAIO (-) 191 1l0I 11,124.00 .00 Ill) 1121 1131 1141 NOTE: To insu~e p~ope~ credit to your account, subnit the uppe~ portion of this fo~. with your tax paynent. 397.340.09 11 . P4 no 386,216.09 .00 386,216.09 and 18 will date. .00 .00 .00 .00 .00 .00 .00 .00 _ IF PAlO AFTER OATE INOICATED, SEE REVERSE FOR CALCULATION OF AOOITIONAL INTEREST. I IF TOTAL OUE IS LESS THAN '1, NO PAYMENT IS REQUIREO. IF TOTAL OUE IS REFLECTEO AS A "CREDIT" ICRI, YOU HAY BE OUE A REFUNO. SEE REVERSE SIOE OF THIS FORH FOR INSTRUCTIONS. I (Schedule J) 2,400.00 X .00= .00 X .06= .00 X .15= 1181 AHOUNT PAlO TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE , , .ESE.V.TIOH: E."'" 0' d...d.n" d,ln. on 0' ."0" 0......, I'. I'" -- II .n, 'u'u" In""" In ,h. ...... I. .,.n...".d In .0.....10n 0' .nJo,.,n' '0 CI..' . 1.011...,.11 b.n..I.I.,I.. 0' ,h. d...d.n' .1'" ,h. .,.I,.'lon 0' .n, ...... '0' II.. 0' '0' ,"'" .h. co..on...I'h h.".' .,.,...1, ,...,... ,h. ,10h' '0 ...,.1.. and ...... .,an.I., Inh.,I'an.' T.,.' at the lawful Cl." a Icollat.ral) rat_ on any such future lnt.r..t. pURPOSE OF HOl1CEI To lu\1111 ,h. ,..ul,...n', 0' s,,'lon ,\'0 0' ,h. Inh.,I..n.. and E."" T.' "" ... 'I 0' \..5. '7' P.S. Sect Ion '91U J. .....h .h. '0. po, lion o' .hl. HolI" .nd .ub.l. .lth you' p.,aon' '0 ,h. ...1.'" 0' "Ills .dn..d on ,h. nv'''' .Id.. --Haka chack or .oney order ply.ble tot REGISTER or MILLS, AGENT . ,.,und 01 . .., .,.d1., .hl.h v.. no' ,.qu....d on ,h. T.' .,'u,n. .., .. ,..u....d by .0..I,'ln. an -...ll...lon '0' .,'und o' p.nn.ylvanl. Inh.,I..n.. and E."" T.'" '.EV-I)\)). ..pll"'lon. .,. .v.ll.bl. .. ,h. 0..1.. 0' .h. ...1..., 01 "III.. .n, 0' .h. '5 ..v.nu, 01..,1.' 0111.... 0' b, ..I\lno ,h. ....1.1 ,'-hDU' .n...,I... ..,vl.. nu.b'" '0' '0'" o,d.,ln.' In p.nn.,lv.nl. I-"'-).'-"~" ou..ld. p.nn.,lvanl. .nd within local Harrisburg ar.. (117) 187.aO'4, 10DI (117) 17Z-ZZSZ (H..rlnD lapalrad Only), 'n, p.'" In In""" no' ...I..I.d .I.h ,h. ...,.I....n.. .I\o..n.. 0' dl..110van.. 01 d.du..lon., 0' ........n. 0' .., Iln.ludlno dl..oun' 0' In',''''' .. .hovn on .hl. Ho.I.. .u.. o.J." vl'hln .1'" ,... d.,. 01 ,...1.' o' thls Hotlu by: _..,I...n .'0"" '0 .h. .. ....,...n' 0' ..v.qu., 'o.,d 01 .....1.. ..p'. "1"1, H."I."'O, P' __.I...lon '0 h... .h. ....., d...,.ln.d .. .udl' 0' ,h. ...oun' 01 .h. ..,.0n.1 ,..,...n','lv,. __app.al to the Orphans" Court. HUS-IOU, OR OR PAYHENT: REfUND (CA)I OIJECT10H51 ADHIN lSTRAllVE CORRECTIONS I F...u.1 ."0" dl..ov.,.d on ,hl. ........n. .hould b. .dd'....d In v,I.lno '0: P' ....,...n' o. ....qu.. 'u"'u 01 Indlvldu.1 T."', 'T1H: Po.' ........n. ..vl.v Unl', "." ,,'.'1, H."I.bU", P' 171"-'.'\ Phon. 1717' 7'7-.5'~. S.. .... 5 0' ,h. .ookl" "In..,u..lon. '0' Inh.,I..n.. 1., .,'u,n 10' . ...Id.n' D.c.d.nt~ (REV-IS01) for an ..plan,tlon of .~lnl.tr.tlv.1Y corractable .rror.. I' .n, .., duo I. p.ld .I.hln 'h'" I)' ..I.nd., .on'h' ...., .h. d...d.n'" d..'h, . Ilv' ..,..n' '5XI dl..oun' 0' the taM paid 11 allowed. lh. 15X .., ......, non-..,.I.I...lon ....1., I. .o.pu..d on .h. '0..1 0' ,h. .., .nd In','''' .......d. and no, p.ld ."0" Janu'" I'. I.... th. 11,.. d., ...., .h. .nd 0' ,h. .., ..n.'" ..,Iod. Thl. non-p.,.I.lp..lon p.n.I., I. .....1..1. In ,h. .... ..nn.' and In .h. ,h. .... .1.. p.,lod .. 'DU vould .....\ .h. .., .nd In""" that ha. ba.n .......d a. Indlcatad on this notice. In',"" I. .h"O.d b..lnnln. vl'h II'" d., o. d.lln.u.n.,. 0' nln. ,.. .on'h. .nd on. II' d., "0' ,h. d... 01 d,,'h, '0 ,h. d... 0' p.,..n', 1.,.. .hl.h ...... d.llnqu.n' ."0" Janu'" I. \.., b.., In""" .. ,h. ,... 0' .1' ,.X. p.,..n' .., .nnu. ..I.ul...d .. . d.I\, ,... o. ."'1.'. .\1 ..,.. .hl.h ...... d.llnqu.n' on .nd ...., Janu'" I. I'" viii b.., In'''''' .. . ,... .hl.h .111 V," "0' ..I.nd" "., '0 ..I.nd" ,.., vl'h ,h.. ,... .....oun..d b, .h. .. ....,...n' 0' ..v.qu.. Th. ...11...1. In...... ,.... '0' I'" ,h.ouOh \... .,.: '!!!! tnt.,..t Pat_ DAily tnt.,..t ractar !!!! tnt.r."t Rat. DallY tnt.r."t factor 1'12 Zo;( .aoO!lc.8 1'81 .X .OOOZ'" l'as 16X .Oooua "aa."'l 11X .000301 1,a,. llX .00nOl ",Z 'X .OOOZU "as 13X .00n5& l"S'''''' ]X .00019Z 1986 lOX .000214 1995.1Q,a .X .000l41 ..tnt.rut Is calcuhted .. follow.' INTEREST = BALANCE OF TAX UNPAIO X NU"BER OF OAYS OELINQUENT X DAILY INTEREST FACTOR .-'n, Ho.I.. I..u.d ...., ,h. .., b..o..' d.II.....n' .111 ,.11... an In',"" ..I.ul..lon '0 .I....n 'l~) d.,. ...ond .h. d... of ,h. ........n.. If .....n. I. ..d. .It" .h. Inta".. .o.putallon d.ta .houn on ,h. Hotlc., addltlon.l Int.r..t .u.t b. calculatad. DISCOUNt l PENAL tv l tNtEREst l P\JRPOSE OF NOTICE: PAYMENT: REF\Im (eA): He. n '~;' " ~ L' .1 C:I~ , CLIT:: To fulfill the r.qulr8aeOts of SectIon 2145 (bJ of the Inherltenca ~ E,tat. Tax Act, Act 21 of 1995. (72 P.S. Section 91451. DetKh the top portion of this Notice end ~1t with your p.YHnt to u,. Reghter of NUla printed on the raver.. 81de. _. Kek. check or ....y order payable to: REGISTER OF MILLS I AGENT. A refund of . tax credit .ay be raquestCtd by caJJlaUng ." "AppUcatJon for R.food of Pemsvlvllf\ta Inheritance 8nd Estat. Tax" (REV.I]1]). applIcation. ata avaIlable at the Of'1c8 of the Reglstar of Will., IIftY of the 23 Rav8I1U8 District Offlc.. or frCMI the DepartMnt'. Z4-hour ens...rlng utvlce ~rs for fa.... ordering: In Pennsylv."la l-aDD-36Z-ZDSD, out, Ide Pannlvlvant_ end within local Harrl5burg at.. (717) 787-8094, TODI (7171 772-2252 (Haering l~.Jr.d Only). OIJECTIOHSz Any party In lnter..t not ..th'l11d with the .....-..nt of tax a. shown on this notJ~ My object within dxty (60) day. of rltClllpt of this Notice by: --written prot..t to the PA Departunt of R.V8nUII, kerd of Appeals, Dept. 281021, Harrisburg, PA 17128-10Z1, OR --.I8Ctlng to have the uttar d.t.ralned at eudlt of the personal reprasentatlv., OR --eppul to the Orphan.' Court AlltlN- ISTRATlYE CORRECTIONS: PENALTY: INTEREST I fectuel .rrors dlscov.red on this .....SIIent should be addr...ed In wrlUng to: PA Depart..nt of R.venue, auraeu of Individual Tax.., ATTN: Po.t A......ent R.vl... unit, Dept. 280601, Harrl.burg, PA 171Z8-0601, Phone (717) 787-6505. See pag. 5 of the bookl.t -In.tructlon. for Inherltanca Tax R.turn for a A..ldent Decedent- (REV-1501) for en .xplenetlon of 8d8lnlstr.tlv.ly corr.ctabl. .rrors. The 15% tax ....ty non-partlcJp.tlon penal ty Is coeput.d on the total of the tn end Int.r..t ......ed, -.let not paid before January 18, 1996, the first day aft.r the end of the tax aene.ty period. Thl. non-p.rtlclpation penalty h appe.labl. in the .... aenner end In the the .... tI.. p.rlod a. you would appeal the t.x .-,d Intara.t that has been .....sed a. Indlc.ted on this notlc.. Additional Penn.Ylvenla e.tata Tax .......d a. a rasult of a chang. on the f.der.1 E.tat. Tax clo.lng lattar beCDH. dellnqullnt at the .xplr.tlon of one n) aooth frOll the date the final notlc. of the Incr.... In Faderal Estat. Tn I. r8C.lved. Tn.. which bee... daUnquent before January 1, 1982 bear Int.,..st at the rata of .Ix 16%) percent per I8l"II'IUa calculated at . daUy rata of .0001611I. AU tax.. which bec... delinquent on Dr aft.r January 1, 198Z will bear Intarast at a rat. which ..Ul vary frOll calendar y.ar to calendar y.ar ..ith that rat. ennounc.d by the PA o.part.ant of A.venue. The applicable Intor..t rat.s for 198Z through 1998 ara: ~ Jnt.r..t Rat. DaUy Jnt.r..t factor Jnt.r..t Rat. Dally Jnt.r..t Factor V..r 19aZ 1.113 1'" l.aS 1.16 --Jnt.r..t ZO% .000S48 16% .!JOO~M 11% .000301 13% .000356 10% .000Z74 Is calculated .. follOMS: 1987 19&8-1991 199Z 1993-1994 1995-1998 'Z IIZ 'Z n 'Z .GOOZ~7 .GOOlOI .000Z47 .ODOI9Z .OOOZ47 INTEREST = BALANCE OF TAX UHPAIO X NUNDER OF DAYS OELINQUEHT X DAILY INTEREST FACTOR --Any Notice Issued .ft.r the tax bee... delinquent ..Ul r.fl.ct en Int.,...t calculation to fift"" 115) day. beyond the data of the .....SHnt. If paYHOt Is aecHt aftar the lnt.rut cu.putaUon det. shown on the Notice, ~Itlonal Int.r.st .u.t be calculated. "