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WAIINING: IT 15 ILLEGAL TO. AL TEll THIS Co.PY 0.11
TO o.UPLlCATE UY Ptlo.To.sTAT o.R PftOTOGIIAPH,
COMUClNWfAl HI or I'f Wi!,Yl VANIA
(H PAnT~I. Nl Of ulA!. III VI' Al fit COHU"
LOCAL REGISTIlAII'S CEI111FICATION OF DEATH
CERT, NO, 331 7 8 45
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Dec. 5, 199~.
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Female
Sociol SeclJllty No, 193-14-6358
Dille of Deoll) NQv.t:!.I]1I),g,L~._l99~
Dato of Birth _Au8!......20LJ9-~.~. Birthplace
Place of Death 114 South Locust St.
Ha 1 ke r..T.wp. LPn.. ,.
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Raco Hhi te Occupatlon___ ..Jll\.~~.r.____ ..' Arllled ForcO's? (Yes or No) ._ ..Jig ,------
Decedent's
Marital StatusNeve r Ma r~i.!!.gMOIling Address ..' U.lI.__Locust. S t .,.Sh i remao.s.tOW_Il.._P.<t.!...l709J.----
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Informant Lorena lIarv~_""'_"___'h Funeral DII"clor
Name and Address of
Funeral Establishment. Gus!l..Iunt:!..raLllom~L20 S. 3rd
Barba ra G\J.S..fl,J'.?~~Il~r
Part I: Immediate Cause
St. Mifflintown Pa. 17059
. ., ___ _....._. _. _.___*_._____ .J___..-_____n__
Interval Between
: Onset and Death
(a)
probabl~__Nyoca.s,cJJaLLnf!lrc.tio.n _ ._
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(c)
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(d) .
Part II: Other Significant Conditions
__________.__..__.1___
~------ - -..-..---~---..,.'- ,.-....'- --------..,...----.-.
Manner of Death:
Natural rn
Accident 0
Suicide 0
D(Jscrrbe how injury occurred,
Homicide 0
Pending Investigation 0
Could not be Determined 0
._______.__n_* ._______._____.__
.---..-.'.-... ._-------_._-_..~---
Name and Title of Certifier
Hi t;.h..1LeLL....N.9.uls--, . _GJ~.J;"_Ql]e,J;"_..._n_' ..,..---..
(M,D" 0,0., Coroner, M.E,)
405 Fni~way' _Dr.ive..__Jle,c.h!1n1~sJl\lrl1._.Pj1....--UQ55
Address
This is to certify that the information here given IS correctly copied from an original
death duly filed with me as Local Registrar. The ollglnal certificate Will bo forwarded
Vital Records Office for permanent liling
certificate of
to the State
Dec. 5. 1996
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)Jhi 'tl.i .," ..:) ~--'/_LU:LU1J~ 34-307
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205 Foster St. Mifflin Boro.
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BOND
REGISTER 01<' WILLS 01<' CUMm:tU,ANll COUNTY
BOND AND SURETY FOR PERSONAL REPRESENTATIVE
KNOW ALL BY THESE PRESENTS, That
Carolyn lIaller
as principal(s) and
Western Surety Company
as surety (sureties) arc held and firmly bound unto thc Commonwealth of Pennsylvania in the sum of
Fifty Thousand dollars (S 50, 000. Ojllo be paid to the Commonwealth, for which payment we
do bind ourselves, jointly and severally, our heirs, cxecutors, administrators and successors, the
condition of this obligation being that if carolyn lIaller
as (statc fiduciary capacity)
Administratrix
of thc estatc of Ruth E.Kauffman, a/k/a Ruth Elizabeth Kauffman, , deceased,
a/k/a Ruth Kauffman
or any of them, shall well and truly administer the estatc according to law. then this obligation shall
be void as to thc personal representative or representativcs who shall so administer the estate and his
or their surety or sureties; but otherwisc it shall remain in full force,
Signed and scaled this
, rJ.....
day of December
,19 96 , each
intending to be Icgally bound hereby.
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Caroly Haller
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Form 99oA.9-9!t
CERTIFICATION OF NOTICE UNDER RULE 5.6Ia)
Name of Decedent: Ruth E. Kauffman
Date of Death: November 30, 1996
Will No. 2196-1052
To the Register:
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
January 14, 1997:
Name
Carolyn Haller
Address
1732 Hickory Hill Road East
Argyle, Texas 76226
Notice has now been given
Rule 5.6 (a) .
to ~'ill.: thereto
Marlin R. McCaleb
Attorney I.D, No, 06353
under
Date: January 14, 1997
219 East Main Street
P.O. Box 230
Mechanicsburg, Pennsylvania 17055
(717) 691,7770
FAX: (717) 691,7772
Counsel for Personal Representative
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FAMILY SETTLEMENT AGREEMENT
RECEIPT AND RELEASE
WHEREAS, RUTH E. KAUFFMAN, late of the Borough of
Shiremanstown, cumberland county, pennsylvania, died intestate
on November 30, 1996, and Letters of Administration on her
estate were issued by the Register of Wills of Cumberland
county, Pennsylvania, on December 20, 1996, to Carolyn Haller,
sister of the decedent.
NOW KNOW ALL MEN BY THESE PRESENTS, that I, Carolyn
Haller, being the only sibling, next of kin and intestate heir
of said decedent and the person entitled to share in the
distribution of the Estate of said decedent pursuant to Section
2103 of the Probate, Estates and Fiduciaries Code of 1972, as
amended, do hereby declare and say that I have examined the
First and Final Account of Carolyn Haller, AdministratriX of
the Estate of Ruth E. Kauffman, Deceased, dated November 18,
1997, and incorporated herein and made a part hereof by
reference thereto and find the same to be true and correct, and
in strict accordance with the terms and provisions of the
Probate, Estates and Fiduciaries Code of 1972; and I, Carolyn
Haller, next of kin and intestate heir as aforesaid, do hereby
acknowledge that I have this day had and received of and from
Carolyn Haller, AdministratriX of the Estate of RUTH E.
KAUFFMAN, the cash or property set opposite my name in the
proposed Distribution attached to and made a part of said First
1""",,,'11"'"
and Final Account dated November 18, 1997, in full
M^,U lU 14 ~'ll 1\11 It
satisfaction, payment and discharge of all such sum or sums of
r"'"
. -~. ~ - ~. ~.:.-
distribution made on such report by said Court of Common Pleas
Orphans' Court Division.
AND in consideration of the aforesaid settlement being
made without the aid of such Court of Common Pleas - Orphans'
Court Division, I, CAROLYN HALLER, being the next of kin and
intestate heir as aforesaid, do hereby agree that if any debts
or demands other than those included in the said First and
Final Account dated November 18, 1997, of the said CAROLYN
HALLER, Administratrix as aforesaid, shall be hereafter
recovered against the Estate of said decedent and be legally
payable out of the same, I will return to the said
Administratrix such portion of the amount distributed to me as
may be necessary to pay such debts or demands, the amount of
such return not to exceed the amount distributed to me.
IN WITNESS WHEREOF, I have caused this Family Settlement
Agreement Receipt and Release to be executed this J ~ day of
\\Jd'J.f'-:IV-\::>('-'''_ ' 1997, intending to be legally bound
thereby.
WITNESSED BY :
''/)la'tLL JIIJJe/l/'
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Caro'iyn Haller
(SEAL)
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STATE OF TEXAS
~-
COUNTY OF~_/Il I'Ja'~
SS
On this, the,;?'ro{ day of -/(r", ~""rhll , 1997,
before me, a Notary Public in and for said State and County,
the undersigned officer, personally appeared CAROLYN HALLER,
known to me (or satisfactorily proven) to be the person whose
name is subscribed to the within instrument and acknowledged
that she executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official
seal.
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Notary Public
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REBECCA R, SNELL
~ff COMMISSION EXPIRES
July 9, 2000
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FILE NUMBER
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS
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DECEDENT'S NAME IlA~l. fln51, -.pm MIOOtr INITIAL)
Kauf[mlln l{lIth
SOCIAL S[CUllllY NUMU[1l
193.11..6358
X 1. Orlglnol RolulR
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o 6. Oocodonl Diad T051310
(Anoeh copy 01 Will)
040,
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Futuro Inlolosl Compromiso
(lor dola. al daolh 01101 12-12-02)
Duendont Maintamod 0 Living Trust
(Anoch 0 copy 01 TluSI)
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met [JINT''',COMPU fI' A[)(}lU 55
E. 114 l~CllHt Stre(!l
Sh 1 rmnan!-i tOWI1, PA
Counl't
ClImhorlllnd
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ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE OIRECTED TO:
NAME
Marlin R, McCaleb, Es ulra
210<J(,0IO~2
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Return Rcquirod
Tolnl Number 01 Sofo Deposit Boxos
COMPL[l[ MAILING ADDRESS
Law Offices - Marlin R, McCaleb
219 East Main Street, P.O, Box 230
Machanlcsbur , PA 17055
(1) None
(~ 41,119,71
(3) None
(4) None
(5) 35,721.. 99
(6)
(7)
None
None
(8)
77 ,444,70
TELEPHONE NUMBER
717-691.7770
1, RoBl Esloto (Schodula A)
2, Slocks ond Bonds (Schadulo B)
3. Clo.oly Hold Slack/Portnorshlp InlOlost (ScllodLJla C)
4, Mongogo. ond Nola. Rocaivobla (SchadLJla D)
5. Cash, Bank Deposlls & Miscellaneous Personnl PIOpClty
(Schadula E)
6, Joinlly Ownod Propar1y (Schadula F)
7, TronslolS (Schadulo G) (SCllodula L)
8. Tolal Gross Assets (Iotnllmes t-7)
9. Funeral Expenses. Administrnlive Costs, MIscollnncous
Expo",o. (Schodulo H)
10, Dobis, Mongogo Uobllillos, Uon. (Schodulo I)
11. TOlol Doduclions (Iotollinoo 9 & 10)
12. NOI Value 01 Estato (IIno B minusllno 11)
13. Clloril.bla .nd Govarnmontol Boquosls (Schadulo J)
14. Not Valuo Sub ocllo Tal( (IIno t2 minus Iino 1:1)
15. Amount olllno 1410l(ablo al frIo rato
(Includo voluas Irom Sehodulo K or SChodLJla M.)
16. Amount ollino t4t[l)lable at 15% rale
(Include values horn Schedule K or Schodule M.)
17. PrIncipal tIDe due (Add tal( horn line 15 and ham hne 10.)
18.Cradils/Sp Poverty Prior Payments DI!iCOunl
o . 00 + 0 . 00 + 0,00
19. !lUna 16 is grantor than lino 17, entor tho dlllClence on Ii no 19. This is lho OVERPAVMENT.
~ D Check here If au are re uestln a rofund of our ove a ment.
20. If hno 17 Is groater than Iino 16, entor tho dlllerence on hna 20. This Is tho TAX DUE.
A. Enler Iho Interosl on Iho bnlanco duo on Iino 20A.
B. Enter Iho tolal 01 Ii no 20 and 20A on hne 208. This is tho BALANCE DUE.
M.ke Chock Po .bl. to: Re Ister 01 Wills, A ent
~ ~ BE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND TO RECHECK MATH .. ..
(9)
10,627.95
(11)
(12)
(13)
(14)
x .06 =
11,355,22
66,089.1.8
None
66,089.1.8
0.00
(16)
727.27
9,913,1.2
(16)
66,089.1.8 X,15=
9,913.1.2
(17)
(18)
(19)
0,00
0.00
(15)
0,00
(20)
(20A)
(20B)
9.913 .1.2
0,00
9,913.1.2
IntCfosl
0,00
Una" p.n.Il,.1 of p''1ury, I C1.tl.llllh"t I ha.. ...m,".a Ih'l rlluln, ,nelud.n\l aecompany,n\llch.(lulpland 11,III.mlnl.. and lu Ihe bllt 01 my kno....led\le and b.bel, 'llllru.,
COII,cllna tompl'I..1 a.tlal.1h.laUIIII..t.l, h., b"n IIporled allrll(l mArk II V,I\Il'. 0,C1.11.I.un III p',pa,,' olher Ihan Ihe p"rlo"al/(lpre.enl.I...'l bu.a on.lI !"formallon 01
""PlIth P/(lP.", h...ny kno....l.dg..
AODltES5
. ~~.r.C?!y.~. ~1~1}.! ~.r.t.. ~?."!! !l.i.~ ~ !"E'.t. ~!!<......... _.....
~n~ .!~~~~?D:o!~~!~o -'~'?~? .~~;'ot: 0.00.0.0..000 o. 0 .0.
Ar vie, Texas 76226
ADDRESS
Law O[[lces - Marlin R, McClll"b
i"l<i 0 Eno~ i: 0 i-i; i~' Os i: i-~.~ i:: 001;: r;: 0 B~xo O2 j(i 0 0 0 0 0 0.00.
M~oc"li;;ii~~i;t;rr.o: oi';" "i 7ii550... 0.0.000.000.....- 00
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
w: ~
-.'" .
'.0 '
I
...........-.
SIQNATURE OF PREP ER OTHE R THAN REPRESENTATivE
~ ') /, .j
v:-w~;( t~(}~~?,w
COPYlIghtlcI199110rmsoll""a"onlyC.ntpr P"ce Solt....a",lnt
OAT[
"I.LI -'--'\:::,\
DATE
{,-3:>. ')7
Form 1500 (Rell. 11-9'1
PNC Brokerase Corp
4242 Carli.le I'ike
Calnp 11111, J'A 17011
PNClBROKJERAGIE
February 3, 1997
Marlin R. McCaleb
Law Offices
Frankeberger Place
219 East Main Street
P,Q. Box 230
Mechanicsburg, PA 17055
Re: Estate of Ruth E. Kauffman
193-14-6358
Dear Mr, McCaleb:
You requested the value of Ms. Ruth E. Kauffman's account #57108265 on the date of death
November 30, 1996:
Federated Fund for US Gov't Securities Class B (FUSBX)
Total value of FUSBX on Nov 30, 1996 - $15,114.699
1,915.678 shares at $7.89
Compass Capital Group Balanced Fund Class B (#CMBBX)
Total value of #CMBBX on Nov 30, 1996 - $8,510,354
538,63 shares at $15,80
Total Value for account #57108265 is $23,625,053 on Nov 30, 1997
If you have any other questions about this account please call me at 717-730-2403,
Thank you.
C ~v..-t-rvu- /l/l.tvv---y
Christine Manos
Sales Assistant PNC Brokerage
lmD .May Lose Value
~ .No B.'mk Guar.ullee
Important In,'estor Information:
Securilies b.roler3~e and olher products and sen'ices arc prmltted h~' PSC BroLcragc
Corp. a rer;;lstcred broker.dealer and member Stre. PSC Brokcr3gc Corp is a
subsidiary of IISC Bank. ~auonal Association which i!o noe a braLer.dealer.
PNC Brokerase Corp
4242 Carll.le I'ike
Camp 11I1l,J'^ 17011
PNClBJROKlERAGIE
February 3, 1997
Marlin R. McCaleb
Law Offices
Frankeberger Place
219 East Main Street
P.O. Box 230
Mechanicsburg, P A 17055
Re: Estate of Ruth E. Kauffman
193-14-6358
Dear Mr. McCaleb:
You requested the value of Ms. Ruth E. Kauffman's account #57108265 on the date of death
November 30, 1996:
Federated Fund for US Gov't Securities Class B (FUSBX)
Total value of FUSBX on Nov 30, 1996 - $15,\14,699
1,915.678 shares at $7.89
Compass Capital Group Balanced Fund Class B (#CMBBX)
Total value of #CMBBX on Nov 30, 1996 - $8.510.354
538.63 shares at $15.80
Total Value for account #57108265 is $23.625.053 on Nov 30, 1997
If you have any other questions about this account please call me at 717-730-2403,
Thank you.
C I~Vv-l-rvu- /V\wv'--"y'"
Christine Manos
Sales Assistant PNC Brokerage
[l]}l.May Lose Value
~ .No Bank Guar.ullee
Imporlanllnveslor Informallon:
Securities h.ro)..rra~c and (llhrf product!. and sCr\'iCC5 3fC pfo\1dcd hy I):--;C Brolenge
Cor~. ~ rrgI51t'r~d hroJ;.cr.?r~ler and m~mhcr sire. PSC 8rol.crOl~c Corp is i1
5ub51dlar~' of p~C Bank. ~:\lIonal "nOCl31101\ which is not a brol.cr.dcalcr.
eTI~~~l~
Ilal'n~ ~;I\'II1J.:S Opt'rallnllS L'l'nlt'r
ti3;} Sunh I:!th ~llt'l.t
I.l'nlll~'t\l.. Ilt'nu...ylvillU:I 17Il.t:~
71717:11.1.\.111
71 j;7:n .~n~J~ Fax
oecember 30, 1996
M"lrlin ~lcCaleb
219 tast Main S~., P.O. Box 230
~~, PA 17055
The inforMation which :,ou :-eque:::tcn on the I'.ccount(:;) of
KauffJran !:);tate (!jodnl :;c~ul'ity Numb'll' 193-14-6358
Ruth E.
) is DS fo;,lO\,m.
Account
Gwncr::;hip
10-00092889 05-00033596
Savings Ol€Cking
2-8-83 1-6-95
$31,852.43 $1,260.99
:i75.39 .28
32,227.82 1,261.27
Irdividual Sane
Account Humber(s)
Class of Account
Date Opcnec
Principal Balance
~cc:-~cd :n~crc!it
!lalnnce at
Dn te of Death
llame of Joint
Owner, if any
please ha''e the EXeCUtrix sign the enclosed witJ-dral.,al fOIIll nro send it
back to me in the t:IOI/ided envelq:e.
2-8-83
1-6-95
Date Owncrshin
W~S !stnblinh~d
hdcitionnl Infol'-
"ation llequc:~tc~
Please ha,'e the ExecUtrix also sign the enclosed 1'1-9 fom nro retUrIl it
back to me in the provided envelqle. 'll1ank yoo.
Sincerely, -
./ ~7/~<-<---z:;:;t.-.-. .../'C.4----' ..
~fGret:chen L. eal~ .
Sr. Retail }ldni.ni.straticn services Rep.
co....~!twfJ\IJ~' o. r~!t1?~lv.""
'" atMrJ.1'b'tltUlIl'l"
ESTATE OF
AlY"I,"Ut (I..UI
Ruth E.
ITEM
NUMBER
'"
1
B,
1.
2.
3.
C.
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
pmooo Pllnl 0' T 0
FILE NUMBER
21-96-1052
Kauffmnn
SSU 193.1/..6358
11 30 19%
AMOUNT
DESCRIPTION
5,182.60
Funoral Elpana..:
Guss Funoral 1I0mo. funeral
bill.
0.00
AdmlnlalraUVO Costs:
Personal Roprosontativo Commissions
SoclolSoCu,ily Numbor 01 POIsonol Roplosonlolivo: 513 -44 .1365
YOM Commissions pold _
3,875.00
Anorney F....
0.00
Family Exemption
Clolmanl
Add,e.. 01 CloImonl 01 decoden!'. doolh
SlIool Addle..
Cily
Rola1ionship
Zip Code
Slole
-
624.21
4.
Probote F....
155.00
1
MI..ollanoou. Eaponso.:
Karl R. Stine. cleaning out
apartment.
2
Marlin R. McCaleb.
reimbursemont for express
mail charges.
480.00
3
Sue Sansom, rent for
decedent'S apartment for
December, 1996, and January.
1997 ($240.00 per month).
4
David R. Sterling. repair
electric cart in preparation
for sale.
(see continuation schedule attached)
Total of Continuntion Schedulo(s)
$ 10.627.95
TOTAL (Aloo onler on line 9, Reco ilulolion)
(II mo'o .poco I. nooded, Insert oddllionol shool. 01 .ome sl20.)
Copyt'IDhtttl 111111 tor", .oUwaf' only Cenl" P,tC' Solt......,..1nc.
FOI", 1500 Schedule H (R.v. 7.111
19.50
13.64
278.00
Register of Wills of CUNIlI:HJ,^NIJ
County, Pennsylvania
INVENTORY
EIlmlol HU1'1I J.;. K^UI-'F~I^N
No.
21-%-1052
aIIo known u JlU'rll ~L I Z^IlI,'J'II MUI-'FN^N
OallolDlIlh November 30, 19%
n/k/n HUTII K^UFFN^N
.OlCluld SoclaI SlCIIrlly No. 193-14-635tJ
CAHOL'lN "^LLEll, ^dministrntrix
Plraonal Rlprlslntallva(s) olthl abova Estata. daeeasld, vlrily thai thl ham. appearing In thllonowlng Invlntory
Inclucll all olthl parsonal a..ats wharavar .huata and an 01 thl l'lIallslata In thl Commanwlahh 01 Plnn.ylvanfa 01
aald Oacadlnt. thaltha valuation placad opposha aach ham ol.ald Invlnlory rlpr..lnt. Ita lair varuI U oIthl dall
01 thl Oacedanra dealh. and thaI Olcadant ownad no l'lIa' Istatl out.ldl ollhl Commonwlahh 01 Plnn.ylvanla
IXC8p! that which appears In a mamorandum a1 tha and 01 thla Invantory. I ma varily thallhl slatamants madl In
this Invantory ara trua and corract. Wla understand that falSI statements haraln ara mada .ubjad to tha panaltlas
0118 PL C.S. Sadlon.4904 ralstlng to unsworn falsKlcatlon 10 authOritll... ~ \\
AttornlY: Nnrlin R. NcCnleb, Esquire 1/ ("'- "" ..._~, ^ , ~. \]
Cnrolyn \JlnUe'r '
LD. No.:
06353
Addrlss:
219 Enst Nnin Street, P.O. tJox 230
Datld f'l_ I.. \ -q "
Nechnnicsburg. P^ 17055
Taraphonl:
(717) 69l-7770
DescriptIon
Valul
~n
.,
'}(J
(Attach addnionar sheets K nllClSlary)
TOIlI:
NOTE: The Memorandum 01 ,e.' eslale outside the Commonwealth 01 Pennsylvania may. al tha erection 01 the personal
rwpr.."'taUva. Jndude !he value of each ilam. but ,uch rtgures should nol be ell8nded InlD !he lDlaI 01 lha Inventory.
F....II!W.7
Pr_ br.... Plnruytvania Bar A_on lDlll
~ ~. .'. ..
COMMOUW[AlHi OF PEUNSYlVAWA
{)[PAfHMHH or REVENUE
BUR~AU OF INDIVIDUAL TAXES
OEP1260601
HMmISDURG. PA 17120.060t
~'J~'~_
~
NO. AA211502 III V """1"..0'
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
RECEIVED FROM:
I
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
MC CALEB MARLIN R
219 E MAIN STREET
HII
$V,91S.4e
MECHANICSBURG, PA 17055
FOlOIl(RE FD.-OHERE
ESTATE INFORMATION:
F'LE NUMBER
ill-199l!.-1052
NAME OF DECEDENT (LAST)
G6N I Q;l- ~:;Q
IF'RST)
tMIl
DATE OF PAYMENT
7JOQ/9~
POSTMARK DATE
0'00/00
COUNTY
Bliru.ANo
DATE OF DEATH
TOTAL AMOUNT PAID
"'9.913.42
f}I..9
CAROLYN HALLER
C/O MARLIN R MC CU1ElI ESU
SEALCHECK# 18
PI}
REMA
-.'
RECEIVED BY ., \ '_\ _'
MARY C. LEW~S
REGISTER OF WILLS
". \' ''\.
-->
\\".
,
\
..-
:>::C;':;1LH (Jf
,',,1,\
. -. -_.- .-. -.- - -. ... ., -..- -.. _. ..+-- ._-, ..-- ---.. .
,
,
,
- ----.-.-.--.._.___..._4 . ~'_~4___..
"
. .
-r~~
-~-'_.....--" ....-.~~ --
.-
r .,,! ~
/5- /t/f) - {,
BUREAU OF INDIVIDUAL TAKES
IHU[Al1AHC[ laX OIVISION
D[P'. :'0&01
ttARRlsaURO, PA llUI-ObOI
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
L/
,*
NOTICE OF INIIERITANCE TAK
APPRAISEHENT. ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAK
MARLIN R MCCALEB ESQ
219 E MAIN ST
PO BOX 230
MECHANICSBURG PA 17055
DATE
ESTATE OF
DATE DF DEATH
FILE NUMBER
COUNTY
ACN
....lhlU ". 111-'"
10-21-97
KAUFFMAN
11-30-96
2l 96-1052
CUMBERLAND
lDl
RUTH
\
Allount R."itt.d
1
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER DF WILLS
CUMBERLAND CD CDURT HOUSE
CARLISLE, PA l70l3
CUT ALONG THIS LINE ~ RETAIN LOWER PORTIDN FDR YOUR RECORDS ~
iiEv:i54""i"EX-AFP-io:i:9'ff-NoYicnin-NHEii'ii'i.NCE-YAlrAPiiiiAisEHENi'",--ALi."owi.NCniR'-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF KAUFFMAN RUTH E FILE NO. 2l 96-l052 ACN lOl DATE lO-2l-97
If an assessment was iSSUBd previoUSly, lines 14, lS and/or 1&, 17 and 18 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. AMOunt of Lin_ 14 at Spousal rat. (15)
16. A_aunt of Lin. 14 taxable at Lin..I/CI... A rat. (16)
17. AMount of Llna 14 taxable at Collateral/CI... Brat. (17)
18. Principal Tax Due
TAK RETURN WAS: I X) ACCEPTED AS FILED
RESERVATIDN CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. RooI Eltoto lSchodulo AI II)
2. stocks and Bonds (Schedule B) (2)
3. Closely Hald stock/Partnership Int.r..t (Schedule C) (3)
4. Hortgaga./Hot.. Receivable (Schedule D) (4)
5. Cash/Bank Depolits/Hise. Parsonal Property (Schedule E) (5)
6. Jointly Owned Property (Schedule f) (&)
7. Transfers (Schedule C) (7)
8. Total Assat.
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral EMpansas/Adn. Costs/Hisc. EMpense. (Schedule H) (9)
10. Dobta/Hoctgogo Llobllltlo./Llon. ISchodulo I) (10)
11. Total Deductions
12. Het Value of TaM Return
13. Charitabla/Governnental Baque.t. (Schedule J)
14. Not Voluo of Eatoto Subjoct to To.
NOTE:
TAX CREDITS:
PAYHENT
DATE
07-0B-97
RECEIPT
NUHBER
AA211502
DISCOUNT It I
INTEREST/PEN PAID I-I
.00
I CHANGED
,00
41.719,71
,00
,00
35.724.99
.00
,00
(8)
HOTE: To insure propar
credit to your account,
.ub_it the upper portion
of this fOfn Mith your
taM paYllent.
77.444.70
lO,627,95
727,27
1111
(12)
(13)
1141
11 .~C;S; ??
66.089.48
.00
66,089.48
.00 K .00.
.00 K .06.
66.0B9.48 X .15.
1181
.00
.00
9.9l3.42
9.9l3.42
AHOUNT PAID
9.913.42
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
9.9l3.42
.00
.00
.00
E
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATIDN DF ADDITIONAL INTEREST.
I IF TOTAL DUE IS LESS THAN $1. NO PAYHENT IS REQUIRED.
IF TDTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS,)
RESERVATION 1
E.tat.. of d.c.d.nt. dying on or bafor. D.c..b.r 12, 1912 .. If any future Int.r.st In the ..tat. I. tran.f.rr.d
In pa.....lon or .nJoy..nt to Cia.. B Ccol1.t.ral' b.n.flclarl.. of the d.c.d.nt .ft.r the .xplr.tlon of any ..tat. for
llf. or for y..r., the Co..onw..lth h.r.by .xpr...ly r.s.rv.. the right to appr.l.. and a..... tr.n.f.r Inh.rltanc. fa...
at the l.wful Cl... B Ceoll.t.ral' r~t. on .ny .uch future Int.r..t.
PURPOSE OF
NOlICEI
To fulfill the r.qulr...nt. of S.ctlon 21~0 of the Inh.rltanca and E.tat. Tax Act, Act 21 of 1995. C7Z P.S.
S.ctlon 91"0J.
PAVItEHh
D.tach the top portion of thl. Notlc. and lub.lt with your pay..nt to the Ragl.t.r of WIll. prlnt.d on tha r.v.r.. ,Ida.
.-Hak. ch.ck or 80n.y order payabl. tOI REGISTER OF MILLS, AGENT
REfUND (CA' 1
A rafund of a t.x cr.dlt, which was not r.qu..t.d on the Tax R.turn, .ay b. r.qu..t.d by co.pl.tlng an ~Appllc.tlon
for R.fund of P.nnsylvanl. Inh.rltanca and E.tat. Ta.~ (REY-IS1S'. ApplicatIon. are avallabl. at the Offlca
of the R.gl.t.r of Will., any of the 2S A.v.nu. DI.trlct Dfflc.., or by calling the .paclal 2,..hour
an.warlng ..rvlc. nu-b.r. for for.' ord.rlngl In P.nn.ylv.nla 1-800.S62-2050, out.ld. P.nn,Ylvanla and
within l~cal Harrl.burg ar.. C7171 117.809,., fOO' C711' 172.2252 CH.arlng I.palrad Only).
OBJECT IONS 1 Any party In Int.r..t not ,.tl.fl.d with the .ppr.I....nt, allowanc. or dl.allowanc. of d.ductlon., or ........nt
of t.. Clncludlng dl.count or Int.r..t' a. .hown on thl. Hotlc. .u.t obJ.ct within .Ixty (60) day. of recalpt of
thlt Hotlce bYI
..wrlttan prota.t to the PA D.part.ant of Aav.nu., Board of Appaal., D.pt. 281021, Harrl.burg, PA
...I.ctlon to have tha .att.r d.t.raln.d .t .udlt of the account of the p.rsonal rapr..antatlv.,
.-app..l to the Orphan.' Court.
171Z1-lon,
OR
OR
AOftIH
ISTRATlVE
CORRECTIONS I
F.ctu.1 .rror. dl.cov.r.d on this a.......nt should b. addr....d In writing tOI PA D.part..nt of A.v.nua,
Bur.au of Individual Tax." A'TNI po.t A.......nt R.vl.w unit, n.pt. 210601, Harrl.burg, PA 11121-0601
Phone C711' 787.6505. S.. page 5 of the bookl.t "In.tructlon. for Inh.rltanca T.. A.turn for. A..ld.nt
D.c.d.nt" (REY.IS01' for an ..planatlon of ad.lnl.tr.tlv.ly corr.ctabl. .rror..
DISCOUNT I
If any tax dua I, p.ld within thr.. (S' cal.nd.r aonth. aft.r the d.cad.nt'. d.ath, a five parcent (S~J dl.count of
the t8lC paId It aUow.d.
PENALTYI
Th. ISX taM -.na.ty non-p.rtlclp.tlon p.nalty I. coeput.d on tha tot.l of the t.1C and Int.r..t .......d, and not
p.ld bafor. Janu.ry 18, 1996, the flr.t day aft.r the and of the t.. .ane.ty p.rlod. Thl. non-p.rtlclpatlon
penalty I. appe.labla In the .... .annar and In the the .... tla. p.rlod .. you would appaal tha t.. and Int.r..t
that h.. bean .......d .. Indlcat.d on thl. notlc..
IHTERESTI
Int.r..t I. ch.rg.d b.alnnlng with flr.t day of d.llnquency, or nln. (9) aonth. and one C1' day fro. the data of
d..th, to the data of pa.,.ant. T.... which b.c... dallnqu.nt bafor. January 1, 1912 bear Intar..t at the r.t. of
.1. (6X, parc.nt per ennua c.lculated at . d.lly rat. of .OQOI6~. All t.... which b.c..e d.llnquent on and .ft.r
January 1, 1911 will b..r Int.r..t at a rata which will vary fro. caland.r y..r to c.landar y..r with th.t rat.
~.d by the PA Dapart.ant of R.v.nu.. Th. .ppllcabl. Int.r..t r.ta. for 191Z through 1997 ar'l
!!!! Inter..t Aat. D.lly Internt Factor !!!! Intar..t Aata D.llv Intera.t Factor
1911 lOX .000"1 1987 'X .0002ft1
19U 16~ .00a~SI 1911.1991 IlX .a00501
I"" II~ .000501 1'02 9X .0aOZft1
1915 U~ .00alS6 l"l.I99~ n .000192
1986 lOX .000274 1995-1997 'X .000241
..Intar..t I. calculat.d a. follow.1
INTEREST . BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
.-Any Hotlc. 1,lued aft.r the t.1C b.coa.. delinquent will r.fl.ct an Int.r..t c.lculatlon to flft..n (151 d.y.
beyond the data of the ........nt. If p..,.lnt I. .ede .ft.r the Int.r..t co.put.tlon data .hown on the
Hotlc., additional Int.ra.t au.t be caleulatad.