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HomeMy WebLinkAbout96-01032 . ..0 Z .... o CD '& 1;; u.a / I' OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUf.lIlEIlLANIJ } 58 The petilioner(s) above.named swear(s) or affirm(s) that the statements in Ihe foregoing pelilion are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal representative(s) of the above decedenl pelitioner(s) will well and truly administer the estate according to law. before me this 11TH day of ./ 19 ) I MAR v' C') ~~S ,fRegisler '( 1~{ N 21 - 96 - 103( O. Estate of WILLIAM R HOLLEN , Deceased GRANT OF LETTERS OF ADMINISTRATION ~ j ! Vi AND NOW DECEMBER 13, 19~, in consideration of the petition on the reverse side hereof, satisfactory .PIOQ[ havins. be~1J. presented before me, IT IS DECREED that KuNA D D WOLt ijANG is/are enlitled to Lellers of Administration, and in accord with such finding, Lellers of Administration are hereby granted to 1l0NALD D WOLFGANG in the esiate or ---'-W1LITAM' R HOLLEN" WII \ftt. [fll'/ . MARY 00 ~ c- g~ c::l . n FEES Lellers of Administration ..... S (00.00 Short Certificates( 1 ) . . .. .. .. .. S 1 nn Renunciation................ S ~ no JCP S ~ no TOTAL _ S 711.00 Filed .q~~.E.~~~~..n>...... A.D. 191L- -' -' :--- 19 ATTORNEY (SII\l. ~L 1.0. N<t.) :"OC i.Jl ):';:. \0 ADDRESS PHONE Letters and nrder picked up on 17-16-96 by administrator :Il~ roo .- 'U ; ~ ." . , ,~ :.; ,', ,-, ":. \ . .....; u>o - 21 - 96 - 1032 RENUNCIATION In Re Eslate of /Iv. J 1-, " .,"'- A. Ii, l t- u' - deceased. To the Register of Wills of (: "",J.,... t~" j County. Pennsylvania. The undersigned C r ot ( <. C /-;;./? <A .5;11'..1 r'L (w../I; '~-s~ ... of the above decedent. hereby renounce(s) the right to administer the estate and respeclfully ask(s) that Lellers (J.t it IJm;,YI.Jf"-r.'f''-'" be issued to ;t."" I,'/' ,0. w.' I I;,.... ", 7 - V r'" WITNESS hand this II day of {(l f N - . 19%.-. x,,~~- ctf&;".J ISlgna,ur.) /67' C .4.r!&-.u ,J/.!j(..' ~ / // 7?tC.~/.:~ld.-L . ~aA. lev ''VoSS:- IAddrml , 0 '1::.;( - I/) 0 <Jl :HI'; 1"\'::: ~ ;,;' ~'i~ ~ , r; . .. N .- ~, .- Co.) " fl .. c:l I- ,. ~ u> 8 iJ~ ...0 tlJ ~ .:;E tlJa: ~::J a: 00 . ~. . X- /clJ!.dNIJ C. ijj~r/J-'~ / (Signature) ,:/ T ,/{A /~ \oJ';;' "C':t.L:::'i:"a,!.Pt.. yfJ.t..'I,J:l:l':<< tJ":/,,{Uj! ~l,4 /?C'.s-$ (Addr.ss) rt (Signatur.) IAddressl CERTIFICATION OF NOTICE llNDEH HtJI.J-: 5.6(a) Name of Decedent: WTT.T.TlIM R. nnr.r.folII Date of Death: IPtYomhPr 9, 1996 Will No. Admin. No. 01032 of 1996 To the RegisLer: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on ~hPr 31. 1996 Name Address Sandra WolfQanq 107 E. Allen st.. Apt. 6. Mechanicsburq, PA 17055 107 E. Allen st.. Apt. 6. Mechanicsburq, PA 17055 Grace E. Hollen Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: ) )... (sdjC N to;( - <;:i 0 .!!1 :;0.: l""l (,,::= 0... ,~ '.' ~; c.:' N I .1 - ~ -- >-. ...., ,d . ~ .. . - .- .::> UW r- '-'E cuo: P' ~=> 0: Uu (' c Signature \ }V..u ~h. / , Name Olarles J. DeHart. III, Esquire Address 3631 North Front Street Harrisburq, PA 17110 Telephone (717) 232 7661 Capacity: Personal Representative l( Counsel for personal representative CALDWELL & KEARNS RICHARD L. Kt,A.RN& CARL Q. WA&15 JAMr:S R. CLIPPINGER CHARLES J. DeHART. III JAMES D. CAMPBELL, JR JAMES L_ QOLDSMITH TIMOTHY I "'ARK MICHACL 8[00R DEBORAH A CAVACINI KeVIN D. ELLIOTT I5TANLI:Y J A. LASKOWSKI A p"Ort6~IONAL CORPORATION ATTORNEYS AT LAW or CDUMBE:.L TttOMAI5 D CALDweLL. JR 3631 NORTH F'RONT STRttT HARRISBURG. PENNSY~VANIA 17110-1533 July 2, 1997 117_232.78151 rA. 111.232-17158 Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 Re: William R. Hollen Estate Dear Sir or Madam: I am enclosing herewith the following items: 1. Two (2) copies of a Pennsylvania Inheritance Tax Return, with attachments. 2. Two (2) copies of the Inventory of real and personal property. 3. Status Report Under Rule 6.12. 4. Check made payable to the Register of Wills in the amount of $888.76 for the balance of the tax due and owing. Thank you for your cooperation. If there are any questions, please feel free to call me. Very truly yours, ( / V._('~J--- Charles J. DeHart, III CALDWELL & KEARNS CJDII I: nb /Enclosures cc: Ronald D. Wolfgang 89S21-1 {nLlJ Ca~ J..u< .JdO /r-/Lo JlO- o,QO{~ - 1-'6 -(17 - " . "-1 \ . , ., . , 0 (I)" Ii. n&::: l ^ ::;- :A'3 5- 7 .0 (: -g .... .-0 III ...1 .- ,. ~ L.'.::I ('... , U"U: ;r;, 0:: '. -. ;<,,-.: ,-,v o ~ ~ ~ ~li s; IS ~l~ E~ ~ lil: 3~ ~~ ~;lE\~ffi ~ ~ ~ ~~ 915 ~~ UO(< gj; ." C"J II: a: << r" ~ .-, : , . ,.. . " , ,,:.; (, . ) . 0)" .' l: 'i ;" " . c " , l~ ., " ; .~ . " .,.. J ~ .' -- --- ---..,.,.,..... .._ ---~~.M. ~ __ Ii .,.:. COMMONWEALTH OF PENNSYLVANIA } UI COUNTY OF-OUM.!ltLAN~ 19~ RotJlll-1J p, WOL...PG-A,JG- b.lng cluly ~vJotll.l\J accorcling to low, clepol" .nd IOYI that h. ;<; J!Jd",,; III' ~ tt7J -In t" 0' the Eltet. 0' WII-/./I'i/l1 R. HOl-l-PAJ 1.1. 0' _______..___...._...____ ,Cumberlend County. P.., clecund .nd th.Hh. withIn Is .n Inventory mid. by '<!ONAL"TJ '"D, [.I')., '::"("B1::!Q:. , the IOld..il..l/lt i II" s,+f7l"tol'" 0' the .ntlre ..t.t. 0' IIld dlc.d.nt, conllstlng 0' .11 tho p.rson.1 pro",rty and rul ..tal., exc.pt rul ..t.t. ouhld. Ih. Commonwulth 0' Plnnlylv.nll, .nd Ihat the flgurel oppOIIt. elch It.m 0' the Inv.ntory rtpr...nt lt'l '.Ir v.lu. ., 0' Ih. dlt. 0' dlCldenl'l duth. 19 91 ~d:,~r. 5wOrt..iU end lublcrlb.d b.'or. m., O.t. of o..Ih flOTARIAL SEAL IJAIJGY L. BRESKI. Nolary Public Harrisburg. Dauphin Counly r.1y C',mmisslon Eyplres March 16.2000 9 D., Add,... /~ Month 9' v.., INSTRUCTIONS I. An inventory mUlt b. liIed within three monthl after appointment of p.rsonal r.pruentatlv.. 2. A luppl.ment inventory mUlt b. fiI.d within thirty daYI of discovery of additionalus.h. 3. Additional sheeh may be attached as to personalty or r.alty <t. SOl Articl. IV, Fiduciaries Act of 1949. ~ ,; w . " ~ < " w " I>. .... U . ~ '" . 0 w w C '" ... J: " . l- I>. oi I>. c ... -' u. ~ Z jj 0 I>. 0 "- oJ =: w 0 < i: < > Z ~ Z 0 c C ~ 0 - '" Z c3 ~ z w < .... I>. '"0 C - ..!! 0 ~ " .J> ... ... .. E - ..!! 0 " ~ 0 oJ U u: .. COMMONWEALTH OF PENNSYLVANIA l IS: COUNTY OF GIIMIER\JI:ND f)~J P. WO/..-FG-Il rJG- b.ln9 duly lAiO ,.J .ccordln9 to law, dopo'o' .nd lay' th.t h. /$ A-I",; 11 : ~+r" -Ic r 01 tho E,lat. 01 /-U "-'.-111 "" R. liu..l-F.!..,.,) I.t. 01 ___.___..___...._..._-..- . Cumberland County, P.., doc,"od .nd th.t the within II an tn..ntory mado by J!c"-'A/...U:}' Wo/..-F..tr:!Jt:d.6- ,th. Itld A'/",;,,;sfr,,-Jo..- 01 the .ntlre IItate 01 uld docedlnt, cOnl1ltln9 01 all the pOllonal prop.rty and reel utah, ..capt r..l utat. ouhld. th. Commonweellh 01 Ponnlyl.anla, and that th. 1i9uru oppo,lta eech It.m 01 the lnvantory repruent It', fair valu. u 01 the date 01 dlcedont" death. 5WD~N and ,ub,crlbod belor. me, jo 19 if? ...ddroll tlOTARIAL SEAL IlAlICY L. BRESKI, tlolary Public Harllsburg. Dauphin County fAy Cr:mmlsslon Expires March 16, 2000 'it. Dat. 01 Death Cj D.y 1:2.. Month Y.ar INSTRUCTIONS I. An invontory mu,t be flIod within three month, alter appointmont 01 pOllonol repre,ontativ.. 2. A ,upplomont inventory mull be filed within thirty day' 01 di,co.ery 01 additlonal aueh. 1. Additional ,hoe" may be attached as to penonalty or roally 4. See Articlo IV, Fiduciarie, Act 011949. ~ .,; w . - ~ ~ .. w .. Q. I- u . 0 0 '" .. .. ... w ~ UJ C .. . I- J: Q. U. .; ... E I- -' Z -' jj 0 Q. 0 t u. ~ W 0 <( i ~ ~ Z ~ 0 c c ~ 0 '" z <3 ~ z w -< ... Q. ." c - .. -;: 0 . JJ ." ... II E ~ ~ 0 .. ~ 0 -' U u: co IS-J'-I'iJ -3 INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) UY.lSOO [l+ 1M.} '* COMMONWEAltH Of PENNSYlVANIA QUA-RTMENl Of REVENUE DE". 210601 HAUISlURu,'1o '7\21-060' DICtDUW5I N,t.M( I\A!tT. flU1. AHO IolIOOU lUlU"\} Hollen, william R. WC'Al $lCU.lIl HUMoUR C- fOR DAns Of DIATH AnlR 12/31191 CNICK HIRE If A SPOUSAL POVIRTY CREDIT IS CLAIMID 0 fill NUMBER .-:)/ , If, YEAR /.),~ NUM8ER IS fil .... ... '" ... )IC~II) tdiE~ ="'9 ...."'co It .. ..... on", ...... "'''' "'''' 8~ 1. R.al E.'a" ISth.dul. Al ( 1 1 2. S.otk, and Band, (Sth.dul. BI ( 2 I 3. Cla..ly H.ld S'atk/Pa~n."hip In..rOl.ISth.dul. C) (31 .4. MortgoB" and NoIllS RlIceiltoble (Schedule D) (4 ) 5. Cosh, Bonk CoposiU & Miscelloneous Perlonal Property (5) ISth.dul. EI 6. Jainlly Own.d Pr;'p.~y ISth.dul. f) 16 ) 7. Tran.I." (Sthedul. GI (Sth.dul.l) 171 B. 10101 Gron AUlIlS (lolollinlls '.7) Q. Funeral bpenslIs, Administrative Cas's. Mi\ColloneouS (Q) Expenses (Schedule HI 10. Dobts. MortgOgllliobililillS, liens (Sc.hedule I) (10) 11. 10101 Deductions {IOlot lines 9 & 10} 12. Net Value of Estate (line 8 minus line 11) 13. Charitable and Governmental Bequests (Schedule J) 1.4. Net Value SubjetllO tOJl (line \2 minus line \3) \S. Spousal Transfers ((or doles of death oher 6.30.94) See lnstrudians for Applicoble Percentage on Reverse (15) Side. (Include values irom Schedule K or Schedule M.) 16. Amaun' 01 Un. 14 'a,abl. 016% ra" (\6) 16,216.20 (Include values from Schedule K of Schodule M.) \7. Amounl of line 1.4 taKable 01 \5% role (17) (Include values from Schedule K or Schedule M.) \8. Prindpallall due (Add lOll from lines IS. lb and 17.) 19. Crodill Spou,al Pa'or'Y Cr.dil Prior Paymanll Oi"aun' In..r.,' + _J,500~00.. + ---1.84.21- - r' ""\lCAIIII SUI'tT'llHO SPOUU'S HoUIlltASl.llut AHlllll,OO\I INItIAll COUN1Y CODE OIClOUH'~ (OMPU1l "OOIl~~ 107 East Allen street, Apt. 6 M3chanicsbur9, PA 17055 c~" cumber land "MOUtH llCllVlO I~U IH~1lUC1l0N~1 o 3. Remainder Relurn 110' do'" 01 d.ath prior 1012.13.82) o 5. Federal Estole TOK Relurn Required 0- B. Tolol Number of Sale Depolit Bolte. 3631 North Front street Harrisburg, PA 17110 162,261.00 I B I 162., 761 nn 2\. "line 18 i. groalor'han line 19. .n'" ,h. diH.ronte an Lino 2\. Thi. h Ih. TAX DUE. A. Enter the inlere,t on the balance dlJo on line 21 A. 8. Enter Ihe total 01 line 21 and 21A on line 218. This i, Ihe BALANCE DUE. Make Check Payable to: Regtst.r 01 Wl1Is. Au.nt ~ ~ BE SURE TO ANSWER All QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH -<-< Under p.naili.. 01 poriu,y. 1 d.daro ,hall ha.. ..amin.d ,hi. ,.'urn. induding a<tompanying "h.dul.. and "a..m.nll. and 10 ,h. b,,' 01 my knawl.dg. and b.li.I, i. i, 'ru', torr." and tampl.... I d.dar. ,hal 011 real ,"01' hat b..n ropa,'.d a' true ma,k., ya1uo. O.dara'ion 01 propnr.r alh.. ,han ,h. p...anal rop,...n,atiye i. bo,ed on all . formation 01 which preparer ho' ony ~nowll!dge ,~.~ . ".~'~'" ""~ ..",u ____u- ..... "";/i /;J : ..<tu", 0' ..,..." 0"''' '"'" '" ".."" ''''''' " -Tli"-,lesJ.-OeH,,,i ill ,.,,, _ -<:. il)" .c. u: 3(,31 No,th front Sueet ".",,',hJlg. P"nn,ylvan'3 17110 o"n Ollll1H DA.1( Of OlA1H 3/29/17 201-01-4971 12/9/96 Grace E. lIollen o 2. Supplemental Return Ga 1. Originol Return 040. o 7. III Es ire 232-7661 '" '" S ::> t: Do cC .... ... '" '" '" ~ .... ::> Do ~ '" .... ... .. .... 9...B2B~59 (\1) (121 (131 1141 9.828.59 152.,A~2. 41 152.412.41 X.__= 76,716.71 4,577 q7 . .06 = . .15 = (\8) (191 ______3,jjlL<t,21 (20) 20. "Lin. 19 i. grealer'han line IB, .n'OI ,he dill.rento an line 20. Thi, i, the OVERPAYMENT. aD (211 121AI 121BI __666.1.6 Ad '48 of 1994 provides for the reduction of the tax rates Imposed on the net value of transfers to or for the use of the spouse. The rates as prescribed by the statute will be: e 3% (.03) will be applicable for estates of decedents dying on or after 7/1/94 and before 111196 e 2% (.02) will be applicable for estates of decedents dying on or after 1/1/96 and before 1/1/97 . 1% (.01) will be applicable for estates of decedents dying on or after 1/1/97 and before 1/1/98 e Spousal transfers occurring on or after 1/1/98 will be exempt from Inheritance tax. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (1"') IN THE APPROPRIATE BLOCKS. YES NO 1. Did decedent moke 0 transler and: o. retain the use or income 01 the property tronslerred, ....................................................... b. retoin the right to designate who sholl use the property tronslerred or its income, ............... c. retain a reversionory interest; or ................................................................................... d. receive the promise lor life 01 either payments, benefits or careV....................................... 2. II deoth occurred on or belore December 12, 1982, did decedent within two years preceding deoth transler property without receiving odequate considerotionV II deoth occurred ofter December 12, 1982, did decedent transler property within one year 01 deoth without receiving odequote considerolionV........................................ ...................... ..................................... 3. Did decedent own an 'in trust lor' bonk 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. I ,,~.~' ,_I" I Ir\ltJOtUtt1utJ *' COMMONWfAUH 0' PENN$YLVANIA INHUITANCE TAX RETURN IUIDINT DICIDINT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF I FILE NUMBER William R. Hollen Jolnlllnanll.). NAME ADDRESS RELATIONSHIP TO DECEDENT A. None B. C. Jolntlv-ownld proplrty: ITEM LmER DATE FOR TOTAL VALUE NUMBER JOINT MADE DESCRIPTION OF PROPERTY DECD'S DOLLAR VALUE OF TENANT JOINT OF ASSET % INT. DECEDENT'S INTEREST 1. ------ -------------- --~------------ TOTAL (Aha enlcr on line 6, Recapitulation) S --..---------.-- ---- -~---___..__.____...._._L._._ (IF more $po[e ;$ needed ;nunt additional $heeh of $ome $ize) R[Y.UIOflt IMIT) ,,'tJ~'?1\ ......~{!Ib;. COMMONWEAL'" OF P[NNSYlVANIA INHllnANC' fAX InUIN IlSIDIN' ~1~~.~IN' SCHEDULE G TRANSFERS """'-='=='==~~=~=~===-FjLE NUMBER PLEASE PRINT OR TVPE ESTATE OF -------- ---..--. -----.---. William R. Hollen THIS SCHEDULE MUST BE COMPLETED AND FILED IF THE ANSWER TO ANY OF THE QUESTIONS ON THE REVERSE SIDE OF THE COVER SHEET IS YES. -----. DECD. DOLLAR VALUE % OF DECEDENT'S INT. INTEREST ITEM DESCRIPTION OF PROPERTY NUMBER 'ndud. nom. 01 'h.'lonller.., ,h.ir ,elorionship'o decedenl, dor. 01 'ronll.,. EXCLUSION .. ____u ______ TOTAL VALUE OF ASSET None I , I j JOT AL IAho enter on line 7, Rt'capitulationl 1 S (II mar.. spm... ;1 nt't..d...d. Inll'" udd'Plonol ,hl'~'l 0' 10m. ,ill.' J .-- II"'-UIII" 17.", ESTATE OF . COMMONWEAltH 0' PfNNSYIVANIA INHUItANCE fAX IUURN IUIDENf DfCEDENf SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES Plla.o Print ar Tvpo MBER William R. Hollen ITEM NUMBER A. Funoral Expon..., DESCRIPTION AMOUNT 1. Myers funeral Hane - funeral services 6,696.50 1,456.00 2. Gingrich Memorials - Grave marker B. Admlnl.tratlvo Calls: 4. C. 1. 2. 3. 4. 5. 6. 7. 8. 1. Persanal Representative Cammissians - Ronald D. Sacial Security Number af Porsanal Represenlalive: Year Cammissians paid Waived Nolfganq, 195-36-7583 2. Allarney Fees ,Caldwell & Kearns I Family Exemptian I Claimant Grace E. Hollen Address af Claimant al decedent's dealh Slreet Address 107 E. Allen Street ,-Ap~ _ 6 City Mechanicsburg Slate JA- Zip Cade 17055 3r500.00 1r250.00 3. Relatianship Wife Prabate Fees , Register of Wills 300.00 - Mllcellaneaul Expenles: CUmberland Law Journal - Legal advertising 60.00 62.09 The Carlisle Sentinel - Legal advertising TOTAL (Alsa enter an line 9, Recapitulatian) 9,828.59 s (If mare space II noodod, inlert additianallhoots of lamo li.e.) u....UIJ... (1'7) SCHEDULE J I BENEFICI~ '* (OMMOHWI.UH Of ......'.'....Nt. IHH..II...NeII.... .nU'H 'UIDIN' DlelDINI FILE NUMBER ESTATE OF William R. Ilcllen ITEM NUMBER RELATIONSHIP AMOUNT OR SHARE OF ESTATE NAME AND ADDRESS OF BENEFICIARY A. TaKable Bequells: 1. Grace E. IIollenr 107 E. I\1len streetr Apt. 6r Mechanicsburg, PA 17055 sandra Wolfgang, 107 E. I\1len street, Apt. 6r -Mechanicsburg, PA 17055 Daughter 1/2 residuary estab Spouse 1/2 residuary estat 2. ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY AMOUNT OR SHARE OF ESTATE B. Charilable and Goyernmenlal Boquo,": 1. ___ ____. .__,__.__.___~__ _,__. ~_m TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Aho enler on line 13, Recapi'ula';on) s I .. - ----.---. ---- .----- - - -_.-------------~-----~--~----- .-.--_. (If moro spaco is noeded, insert additional shoe" of same siro) , I 1 1 1 t 1 t t 1 I 1 t. fOtD HUf t I 1 I I I 1 I -. .., .... --. -_.- DNo. AA185053 -INI"'''~~'1 COMMONWEALTH OF PENNSYLVANIA DIPARTMENT Of RIVINUI OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX '* RECEIVED FROM: i ACN ASSESSMENT P:' CONTROL ... NUMBER AMOUNT RONALD D WOLFGANG Jv1 *.:I,;JVV.uO 107 E ALLEN ST APT 6 MECHANIC5DURG, PA 1705~ IOIDHI" ESTATE INFORMATION: ~ filE NUMBER Y 21-1996-1032 !t NAME OF DECEDENT (LAST) ~ HOLLEN WILLIAM R II DATE OF PAYMENT EI POSTMARK DATE COUNTY 5SN 201-01-1+971 (FIRST) (Mil CUMBERLAND DATE OF DEATH m TOTAL AMOUNT PAID .3,500.00 SK REMARKS RONALD D WOLFGANG SEAL CHECK II "I , .~J.I . / - (!/"/"~/ ,i./..",:.,/ SIGNATURE ; ;~' _- , . )./ ."'" ",. RECEIVED BY REGISTER OF WILLS MARY C. LE.t:.lIS REGISTER OF WILLS - - - ---, -- -- .--.- .---- -- ~--- ---- ---.- ---- -- -- - ---.--- -_. -. I j . . -- ----- ..,:. -:_. __ ,,_____'h__.~~ -- /5~/'/Y/.-:-~ CDMHDNWEALTH OF PENNSYLVANIA DEPARTMENT DF REVENUE BUREAU OF INDIVIDUAL TAXES IHtllAIIAH([ lAIC DIVISION DrPI. 18D601 IIAIlAISBUAC, PI. l1U8.0601 NOTICE OF INIIERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE DF DEATH FILE NUMBER CDUNTY ACN 10-27-97 UOLLER 12-09-96 21 96-1032 CUMBERLAND 101 CHARLES J DEHART 3631 N FRONT ST HBG I II ESQ PA 17110 Anount Renitt.d '*' "'.1"'..."1...." WILLIAM R HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER DF WILLS CUMBERLAND CD CDURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE .. RETAIN LDWER PORTlDN FDR YOUR RECDRDS .... iiE'v:is4i-Ex-AFP-ioij:97rNoTicEnciF-YNHEiiiTANcE-,'-Ax-iipPRiiisEHENi'-,--AL1-ciwANcE-lilinmn-nn-nn DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE DF HDLLER WILLIAM R FILE ND. 21 96-1032 ACN 101 DATE 10-27-97 TAX RETURN WAS: I X I ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED DN: ORIGINAL RETURN 1. R..I est.t. (Schedule AJ 2. Stocks and Bonds (Schedule OJ 3. Clos.ly Hald St~ck/P.rtn.rlhlp Int.rast (Schedul. Cl 4. Hortg.g.s/Not.. Receivable (Schedule OJ 5. C..h/Sank Depostts/Hisc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule f) 7. Transfars (Schedule G) 8. Tot.l Asset. I I CHANGED III 121 131 141 (51 161 171 .00 .00 .00 .00 162 ,261. 00 .00 .00 181 APPROVED DEDUCTIDNS AND EXEMPTIONS: 9. Funeral Expan.../Adn. COlt./Hlsc. Expans.. (Schedule H) 10. Dlbtl/Mortglge Llebl11tlll/Lllnl (Schldull II 11. Tot.l Deduction. 12. Net Velu. of Tax Return 13. Charitable/Governmental aeque.t.; Non-elected 9113 Trusts (Schedule J) 14. Het Value of Eltate Subject to Tax 191 llDI 9,B28.59 .00 NOTE: To in.ur. proper credit to your account, sub.it the upper portion of thi. forn with your tax paYllent. 162.261.00 1111 ll21 1131 ll41 g.8'8 ~g 152,432.41 .00 152.432.41 If an assessment was issued previOUSlY, lines 14, 15 and/or 16, 17 and 18 will reflect figures that include the total of ~ returns assessed to date. ASSESSMENT OF TAX: 15. AMount of Line 14 at Spousal rat. (15) 16. Amount of line 14 taxable at lin..l/CI... A rat. (16) 17. Anount of line 14 t.xabla .t Collateral/Cl... a rate (17) 18. Principal Tax Dua TAX CREDITS: NDTE: PAYMENT DATE 01-09-97 07-02-97 RECEIPT NUMBER AA185053 AA211493 DISCOUNT 1'1 INTEREST/PEN PAID (-I IB4.21 .00 76.216.20 76.216.20 .00 X'OO= X .06= X .15= ll81 .00 4.572.97 .00 4.572.97 4,572.97 .00 .00 .00 e IF PAID AFTER DATE INDICATED. SEE REUERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE 15 LESS THAN $1. NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REflECTED AS A "CREDIT" (CRI. YOU MAY BE DUE A REFUND. SEE REVERSE SIDE DF THIS FORM FOR INSTRUCTIONS. I AIlOUNT PAID 3.500.00 888.76 TOTAL TAX CREDIT BALANCE DF TAX DUE INTEREST AND PEN. TDTAL DUE RESERVATION: E.t.t.. 0' d.c.d.nt. dying on or b.for. O.ceab.r 12, 198Z -- I' any future Int.r..t In the ..t.t. I. tran.f.rred In pa.....lon or InJoYI.nt to CI,.. a (coll,t.rll) blneflclarl.. 0' thl dlCld.nt ,ft.r the I.plratlon 0' any ..tatl 'or 11'. or 'or y..r., the Co..onw..lth hereby ..pr...ly r...rv.. the right to appr.I.. and ...... tren,'er Inh.rltanc. Ta... .t the l.wful el... a (call.ter.l) rat. on any .uch future Int.r..t. PURPOSE OF HOflCE: To fulfill the r.qulr...nt. 0' S.ctlon 2140 of the Inh.rltanc. .nd E.t.t. T.. Act, Act 21 0' 1995. (lZ P.S. S.ctlon 9140). PAYKENT: a.tach the top portion of thl. Notlcl and sub.lt with your Ply..nt to the R.gl.tlr of Will. prlntld on the r.ver.. .Id.. --Hak. ch.ck or lon.y order p.y.bll tOI REGISTER OF MILLS, AGENT REFUND (CR J: A refund of at.. cr.dlt, which w.. not requ..t.d on the '.x R.turn, ..y b. r.qul.ted by coapl.tlng an wAppllc.tlon for R.fund of P.nn.ylvanla Inh.rlt.nc. end E.t.t. T.xw CREY-l]l]). Appllc.tlons are av.llabl. at thl Offlc. of the R.gl.t.r of Will., any of thl 2] Rev.nu. District Offlc.., or by c.lllng the sp.cl.l Z4-hour answ.rlng s.rvlc. hU8b.r. for for.. ord.rlng: In P.nn.ylv.nl, 1-800-36Z-Z050, out.ld. P.nn.ylvanl. end within 10c.1 H.rrl.burg .r.a (717) 787-8094, TDDI (717) 772-ZZSZ (H..rlng I.p.lrad Only). OIJECUOHSI Any p.rty In Int.r..t not ..tl,'l.d with the .ppr.I....nt, allowanc. or dl.allowanc. of d.ductlon., or .......ant of ta. (Including dl.count or Int.r..t) a. .hown on thl. Notlcl .u.t obJlct within .Ixty (60) dlY' 0' r,cllpt of this Notlc. bYI --written prote.t to the PA Dep.rt.,nt of R.venue, laIrd 0' ApPlal., nlpt. Z810Z1, H.rrl.burg, PA 1712a-IOZl, OR --.l.ctlon to h.v, thl ..tt.r d.t.r.ln.d .t audit 0' the account of the Plr.on.1 rIPr..lnt.tlv., OR --app.el to the Orphan.' Court. ADMIN ISTRAUYE CQRRfCflOHSI Factu.1 .rror. dl.covlr.d on thl. ........nt .hould be addr...ed In writing tal PA D.part..nt 0' Rlvlnu., Bur.au of Indlvldu.1 T...., A"NI Po.t A"I.s.ent R.vlew unit, nlpt. Z80601, Harrl.burg, PA 17128-0601 Phon. (717) 787-6505. S.. p.g. 5 0' the book lit wln.tructlon. for Inherltanc. T.x R.turn for a R..ld.nt O.c.d.nt- (REV-lS01) for an ..planatlon of adllnl.tratlv.lv corr.ct.bl. .rror.. DISCOl..ln: If any t.x ~ I. paid within thr.. (]) cel.nd.r .unthe .ft.r the d.c.d.nt'. de.th, a ,lvI percent (5%) dl.count 0' the t.x p.ld I. allow.d. PENal TV 1 The 15X t.x aen..ty non-p.rtlclp.tlon p.n.lty I. co~tld on the tot.1 0' the taM and Int.r..t ......ed, and not p.ld before January la, 1996, the flr.t day after the .nd of the t.. aane.ty p.rlod. Thl. non-p.rtlclp.tlon p.n.lty I. app..labl. In the .... .annlr end In the the .... tl.. p.rlod .. you would app.al the tax end Int.r..t th.t h.. been .......d .. Indlc.t.d on thl. not Ie.. INTEREST: Int.r..t I. ch.rged b.glnnlng with 'Ir.t d.y of d.llnquency, or nln. (9) .onth. and on. (1) day fro' the date of d..th, to the det. of pay..nt. Tax.. which b.ce.. d.llnquent b.for. Janu.ry I, 198Z b.ar Int.r..t at the rete of .Ix (6X) percent per annul ca1culat.d at , dellY rat. of .000164. All t.x.. which beeaee d.llnquent on end .ft.r J~.ry 1, 1982 will b..r Int.r..t at a r.t. which will vary fro. cal.ndar y.ar to cal.nd.r y..r Mlth th.t rat. announc.d by the PA D.part..nt of R.v.nu.. Tha appllcabl. Int.r..t rate. for 198Z through 1997 ar.: '!.!!! Inter..t A.t. Dally Inter..t Fllctor !!!!' Inter..t Ret. 0.11'1 tnternt Factor 1982 2'X .000548 1981 OX .DODZU 1981 16% .aoO"38 1988.1991 11% .000101 198.. IIX .000301 1992 'X .OOD2U 1985 UX .000lS6 1995-1994 7X .000192 1986 lOX .000274 1995-1997 'X .OODZU --Int.rllt It calculet.d .. followu INTEREST = BALANCE OF TAX UNPAID X NUHBER OF OAYS OELINQUEHT X DAILY IHTEQEST FACTOR --Any Notice IlIued aft.r the tax b.co... dellnquent Mill reflect an Inter..t calculation to fltt.en US) d.y. beyond the date of the .......ent. If P,y,,"t I. .ad. .ftar the Intera.t coeput.tlon d.t. &hown on the Notice, addltlon.l Inter..t w.t be celculetlld.