HomeMy WebLinkAbout97-00002
21-97-2
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FOR OATES OF DIATH AnF.R 12/31191 CHECK HF.RE
IF A SPOUSAL
POVERTY CREDIT IS CLAIMED I I
FILE NUMBER
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FilED IN DUPLICATE
WITH REGISTER OF WillS)
COMMONWEA[Tti or PENN5YlVAN!A
DEPARTMENT OF REVENUE
Dfflr 1110601
Ji.~R RI ~~U.~~~X~__!_~~ 2a.O~O I
DEt:EDHH'5 NAM( llA~T. FIRST. ^N(l~';ii)fjiT"INij"I-M-1
F'A'J.'CHBNKO, IGOR V.
206 (.:. I.ocusl Strocl
1"(''/'9.';'.~'6 Mechanicsburg, 1'1\ ] '1055
''''''''f Cumberland Count:y
1',u~'/~!l"",!l """"" AM!)~/~CElV!" I'" "","U(II:"'I_ _ -: ____
I I 2 Suppltlmon!cll Rnlurn ! I 3, Romaindor Rolurn
(for datos of doolh prior 10 lZ.13.82j
[ I 40 Fuluro Inlerost Compromiso [---J 5. Fodoral E'laln lox RelVrn Requlrod
(lor e1ulos of doath aher 17.12-82)
r] 6, Decodent Died TOIIOI(l L I 7. Docodont Maintainod a li....ing TrUll .Q._ 8. Total Number 0/ Safo DOpOlil Boxos
1 (Allach copy ('If Will) (AHClch copy of Truul
. . -ALL CORRESPONDENCE AND CONFIDENTIAL. TAX INFORMATION SHOULP BE DIRECTED TOt_
NA.ME COMP(fTE MAILING ADDRr~s
HOWARD D. KRUG, ESQUIRE 1719 North Front Street
fEiTp';ONTNUMBE""--- Hi.ll:d,f3burg, PA 17102
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SOClAl~~~i~~U4~~575 II>A7/;/~'6
11;~J~lil ,>u-ivl-';,;ic,',,;nu'>f.~ Ij~M! IIA~' l'Q',i AII{J "'i'iid IlIdlAl1
I ~ I, Original Roturn
L.J 4. Umiled Eslolo
=,J,~dJJJ ___?,H_=-~LI,~,_,~"""
Rool Estate (Schodulo A)
Stocks and Bonds (Schedule B)
Clolely Held Slock/Parlnership Interest (Schedulo q
Morlgages and Nolos Rocol'/ablo (Schedule Dj
Cosh, Bonk Deposih & Miscellaneous Personal Properly
(Schedule E)
JOintly Owned Property (Schedulo F)
Trans!"" (Sch.dule G}{Schedulo L)
Totol Gross Assets (Iota I lines 1.7)
Funeral Expenses, AdministratIve COIU, Miscellaneous
Expon,e. (Schedule HI
Deb", MOrlgage Liabililles, liens (Schedule II
Totol Deducllons (totoll.ines 9 & 10)
Net Volue of Estoll:l (Lino 0 minus line 11)
Chorittlble and Governmental Boquesls (Schedule J)
NOI Value Sublect to Tax (lIno 12 minuI L1no 1?L-_._
Spousal Transfers (for dOl01 of dealh aher b.30.94)
See InstructIons for Applicable Porcentage on Re....erse
Side. Ilnclude ....aluel from Schedule K or Schedule M.J
Amount of Line 14 laxable at 6% rala
(Indude values from Schedule K or Schedule M,l
Amount of lino 14 laxable at 15% rate
jlndude voluel from Schodule K or Schedule M.l
Prlnclpal tax due (Add IOK from Linos 15, 16 Clnd 17.)
Credits Spousol PQ~orly (rod it Prior Paymonls
+
,:A) . (-/ '!- ()OO_>Z
COUNIYCODI' YEAR
.-_. i)j-(:'I.ilTiil~(jMrifU^()flR7.~:<'----- ~-~-
NUMBER
~. ..
{I}
( 21 _
(3)
{4 I
151
.- ~-..~-:2 ~:?
\~:.
-.-.1
,11
.. .."i>dl}.l- ,------
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(61
(7) ____
"'\)
,.) u,073
-ttr-----
(8 )
( 9 I _______..1_,_1!.Q2.__._); ,
(I 0)_______2L,..9..4.6.--____~_
-,
25,851
(II) _________________
(12) ___J 19..Jl!tL-____
(131 ___________
(l4),__.--JL_______
(151 ________________,_.X,__=
(16) ._,______________,_________ X ,06 =
(171 __________,... ______,______X ,15 =
(18)
Di:;counl
lnlerest
+ -,.
(19)
(20)
1/ Line 19 Is grooter than Lino 18, entar lhe difforenco on tine 20. Thi5 is the OVERPAYMeNT,
Ii1!i:J
Chock hero If you arc requosfin (I rcfu"d of your overpayn1ent. ,
II line 18 is greolor than Lino IQ, Mlor Iho diflornnco on Line 21. This is tho TAX DUE.
A. Enter tho inlerost on lho bnlanco duo on lino 21A
B. Enter lho 1011".1\ of lino 2\ and 21A on lino 21B. This is lho BALANCE DUE,
_____~~~_~_~~~k.~':lt~~I. to: R.~I.t._,_~, Wills, A~~__nt_
(21)
{21AI
(2IB)
~T-C;~-:-- ------~ ~ BE SURE-YO 'ANSWER ALL-QU~!fIONS-ONiiEVERSESiDE AND TO RECHECK MATH' ,<..\ili(i~\W!WfI.;,:".,
Under penaltio! of perjury, I dod<.tro Ihot I have mwminoel this r01Ufll, inc:iuding occompanying "hodulos and 11olomonh, and 10 Ihe bOil of my knowledge and belief,
il is lrue, cor rod and complolo. I declNo thaI oil roo I 0\1010 hm hoon rnportoc! 01 !ruo morkot ....aluo, Doclmation of proparer olher Ihon the penonal repr~'onlolive is
ba,~~~-.2.n .~.I!_0!.l)_~_112.~1.i.?~: ~!__~~Ich p.r(}'p~~6r_hOl nny k_nowllldgfl __ ___ ..__ . ______ .__._~_..z:!.L'Z___,. ___
SloNATU~l Of PfRWN RESPm-l~lfI~l fOR f~WH. RfTllRN r.(I[lRI ~~ I 2 Sou t: h.,' i 1 be r t H t reel OAH
~ l-\/~rl:;,('t,._ j f 1<,l -f (' (I ( /r ),' C McchanicHburq PA 170' r.
SlGN^lU'-~)f fAI f'ARI R 01HlR HI^,~ At flRt ~ftH'\ liYI ^(jfl/iJ ~', . -. r :I.) [lATi
'_ -I' " 119N. (.'nml litre"t '(.~/..(jl
-,-' "_ ..~::'-":,,-'."'i lJarl.'J.sbl1rg, PA 1'1102 . /.' 1
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SCHEDULE E
CASH, BANI< Dl,pOSITS AND
MISCW.ANEOUS
Pr:RSONAl PIWPr:llTYuu "_ 'u_ _1:I"o.",I~ri!l'orlYfl.~.
- , -----"'ci'iTI.' ITIJM Ii I'IT"-'-"-'~~~"-~==~-=
21-97-0002
(nMMONW~I\lTlI Of P(:NNSYlV^NIA
H~IH:RI'I'M4CE fAX: RUURN
___~___.._u.___. __.~r:~~~~~!~!,!~!..._.."_______.
'f.~ r^Yf:(51-----.---~-
(rEM
NUMIIEH
-_.-.._-- -- ----------------.--. ----_.-,. ._" ._-----.
1"'~I,!..~~~o',.( 1~1!'I_I!:_~'::':'_':.~,~~~I,~~.!~~ ~l_~_ht III Sill "i""lllli" rill/II II" diHlulod Ol\ Sd\lI(IIlI~-rf-
IGOR V. FATCHENKO
L
2.
3.
4.
5.
6.
...,.~'"
IlESCfUPTlON
VALU~ AT
Il^H or IlEArH
1993 Toyota Pas eo
(Damaged vehicle w/"R" title.
1995 Mitsubishi GT 300
(Wrecked w/30,000 miles)
1989 Acura Integra
(133,000 miles)
1988 Mercury Sable Spa
(166,000 miles)
19,000 lTIi~es)
$ 1,250
2,900
1,200
625
28
70
Teamsters Looa1 #929 Supplemental Inoome F~nd
FarmerI;' Trust (checking aoct #12"'06060)
" , -'- ----D;O'-r:r----
___._._..----ISlJAl (0!~~tlor on lioe 5. Rocopllulalionl S '
- ..~~_u~ - _______.____~_-------+---_______'_____O___~_
(AHatll oddiliotl(J1 0'11" I< II" Ihllotl if rnMI) '[wen iIMl',dod.!
, R(Y 1\11 "1 I' ~':I
ESTAIt OF
ITEM
NUM8ER
1'10'''0 PrI,,1 0' TVI'"
I FIIF NuMhER
*1~97~0002
\.;j, .y
'~}.')~:i;:~.~
((.II.,I,HlfJV" ,1,1111 or /'f11l1~nY"lll^
ltl!lUlllldfU 'A): RrHlfHf
!H '>10111111[( f(1[t11
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCEllANEOUS EXPENSeS
IGOR V. FATCHENKO
DESCRIPTION
A. funoral EXflO'UO!il
8.
I.
2,
MUBselman Funeral Home, Inc.
Adml"I,',uflvo Co.ls:
PorWl1ul Ropl O!iOf\ltJliVG 'Colllmisslons
SOCkll ~ocvrHy r~umboror Porsonol Hoprosonlullvoi
Yoar COn1rnISSIOllS pnid
Allornoy Fo..
PUrcell, Krug ~ Haller
3. Fomily,Exomplion
Ck,imonl
4,
C.
1.
2.
:1.
,I
5,
6,
7,
0,
~elolion,ltlp
Add,oss of Claimonl 01 d'ocodonl" d.olh
S"eol Addl.ss
.-.----<--~._~- '~-..,.-- ".. ..-. "------
City
"........51010 __.~__ "".llp COqO_
Prouot. Fo.,
MI.e.llo"eou. Ex".n.oSl
Penn DOT - Transfer fee for 1989 Acura Integra
Musselman Funeral Horne (death certificates)
P~vel Fatchenko (labor & materials for
(painting/repairing Decedent's vehicle)
Dauphin County Treasurer (medical records copied)
Graham s. Hetrick (Coroner's Report)
AMOUNT
2,660
500
45
19
9
400
172
100
. ~---_...~.-...__.----~-~"_..".
--,i,;;""o 'I'oeo h "eodod, In.o,' "ddlllonol .hooll of '011\0 .1,.0.)
TOTAL (Also onlor on lino 9, Rottlpltu'<tlionl ,J_$____~.ltO~____
__~~~~~nn _ .__"__~__~~.~U___~__~~n
UYI"IH., I' UI
~ ~. Q
I~",:'t;o'"
:\tN(.i,~1
0' ",<<,,'1' 1 ~!!III'r rll!!llll''-',!UA
II'HI' II~, to I IA. 'l.IU~ II
'1 ~ltl'tI! (\I(f(IPIr
SCltwUI.[ I
DWTS 01' D[CI:DI:NT,
MORIGAGI: l.lAllllms AND LIENS
1_1_11'~IS_IIYfi_!I_'__1) ~ __lY.I',IJ_
I'II' NllMlIl'I1 --",
21-97-0002
'''All 0'
rGOR V. FATCHENKO
IHM
NllMIIU,
""UIIPIION
AMOlll~1
West Shore EMS (Aoct #6752)
2. Tristan Assooiates (Aoot #29987963)
3. Harrisburg Hospital (Aoct #33396112)
- $ 705
221
2,674
90
777
5,679
5,800
6,000
4. Moffitt, Pease & Lim ASBO., Ino.
(Aoot #FACTIG-OO)
5. A.Z. Ritzman AssD., Inc. (Aoct #HH00730159)
6. S & T Bank (vehicle loan)
7. Pavel Fatohenko (reimbursement for payment of debt
to oreditor, paid by Deoedent's brother)
8. Nikolai Kostivohenko (reimbursement for payment
of debt to oreditor, paid by Deoedent's unole '
and other monies borrowed)
"
)
>
~~"~'-'~--------+--";''''''''-'L_---n~'K".____,_o.,---'~_-'-',~_~~-;-----<--'-'''__K~--,--,_~_._'~_____~,.__ _--,'_
TOTAtlAIHT of\lor elfl 11M 10, l~nC:(1piluloli()f\1
s 21J946
..... --,-" ,._ '_no h+_,_.-_.___.._.__.-.,~_____.
(If moftl Iflllt;o i\ "'Jollod, imlHl tTddilio/!{llllt(lOls of lUliw ti7fl.)
[~:~::=-~~~~~t _R-"Mi=~~C- _=J
MAKE CHECK PAYABLE AND REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .....
ifE" V'- i!;iij- Ei{ - AF po (Oi-:97T - NOY iCE - -OF - i"NHEiii;: ANc E - "fAx - 'A"PPR'A- i SE j.fEN'r-, - -A L. row ANc E" OR - - - - -- - - - -" - 0 - - - ,
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTAn OF FATCHENKO IGOR V FILE NO. 21 97-0002 ACN 101 DATE 06-30-97
I', ! '.I'
COMMONWEALTH OF PENNSVLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INIIUUTANC[ 'AX IJlVlSJOH
DEPT. 700601
tllloIfHIS811HO, PA I71Z8-0601
NOTICE OF INtll:RIrANCE TAX
APPRAISEHnrE, ALI,OWANCI ON DISAl.lOWANCE
Of DEDUCTIONS AND ASSESSHF.NT Of TAX
HOWARD
1719 N
HBG
B KRUG ESQ
FRONT ST
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
PA 17102
TAX RETURN WAS I (X) ACCEPTED AS FILED
RESERVATION CO~CERNINQ FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN
1. Med Est.te ISch.dulft Al (ll
2, Stocks and Bonda I Schedule B) (2)
3. ClalMly Held stock/Partnership Int.rasl (Schadula CJ (3)
4. Hortgaga./Not.. Raca!yubla (Schedule OJ (4)
S. Cash/Bank DtlposHs/H1sc. Parlonal Propedy (Schedul. E) (5)
6. Jointly Owned Property (Schedule Fl (6)
7. Transfar. (Schedule GJ (1)
8. Total Auat.
APPROVED DEDUCTIONS AND EXEMPrIONS I
~. fun....l EXPGn.../AdIlL COlts/Misc. Expense" (Schedule H) (If)
~O. nebts/MQrtglga liabiliti../Liens (Sch.dule Il (10)
11. Tot.l nadueUonl
12, N.t Value of Tax Return
13. Ch.rit.bl./Gov.rn~.nt.l Bequ..ts (Schedule J)
14. Nat V.lu. of Est.tM Subject to Tlx
If an assessment was iusued previously, lines
reflect figures that include the total of ALL
ASSESSMENT OF TAX:
1&. "..aunt 01 Lina 14
16. AIIQunt of L,t". 14
17, Allount of Lina 14
18. PrincipII Tlx Due
06-50-97
FATCHENKO
07-05-96
21 97-0002
ClJMBERLAND
101
CHANGED
.00
,00
.....QJL
.00
6,073.00
.00
,0lL
181
3,905.00
21.946,00
(11)
(12)
(13)
1141
JJ:~
,triJf/i8
U~'l~H II If' IOI.tll
IGOR
V
NOTEI To insure prope..
credit to your account,
lub~it the upper portion
01 thil for~ with your
tax PIYl1l11nt.
6,073,00
2~ .A~I 00
19,778,00-
,00
19,778,00-
Non I
14. 15 and/or 16, 17 and 18 will
returns assessed to date.
.t Spou.at
t .xable .t
taxable .t
r.t.
Lin..l/CI... A rat.
CollataraI/CII" B ..at.
I1S)
(16)
(17)
TAX CREDITS I
-----
PAVHENT
DATE
RECEIPT
NUHBER
DISCOUNT (t)
INTEREST/PEN PAID (-)
,o~ X ,00:
,00X,06:
.OOx.15:
(18)
AHDUNT PAID
TOTAL TAX CREDIT
BALAHCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST,
.00
.00
.00
,00
';
,00
,00
,00
.~----_._--
,00
-----..~~
IF TOTAL DUE IS LESS THAN $1, NO PAVHENT IS REQUIRED,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU HAY BE DUE
A REFUND, SEE REVERSE SInE OF THIS FDRH FOR INSTRUCTIONS,)
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..,IV
RESERVATION I E.tate. of dec.dent, dyIng on or before O.caab.r 12, 1982 -- 1f any future lntar.,t In the ..tate 1. tran.farrad
In po.....lon al' anjOYlll8nt ta CIa" 8 (oollatara1) benaflohri". of the dae.dant \!Ift.r th. lI<plrat1on of anY ..tate for
life or for year., the C~..onwealth herlb~ expre..ly ta.ervI' the rIght to appral.. and fi..a.' tran,far Inherltanoe Ta~e.
~t tha lawful Cia.. B (oollataral) rata on any such futura Int.r..t.
f'URPOSE Of
HOTICEI
IJI\VHEHTI
REFUND C CR):
OBJECTIOHSl
ADI1IH
IS:TRATIVE
CORRECTIONSI
DISCOUNT I
PENAL n':
INTEREST I
To fulfill the raquJruanh of SectIon 2140 of the Inheritanoe and E.tate TalC I\ot, Act 21 of 1995, 02 P.S.
Sect10n 9140),
Detach the top portion of thl. Hotlc' and lub.lt wIth your paYlant to tha Ragl.ter of Will. prlntad on th. revarl, .Ide.
uHaka ehe~k or loney ordar payabla tOI REGISTER OF HILLS, AGENT
A rafund af " h~ oredit, whlch was not raqulltad on tha Tal( Raturn, Ilay ba raqua.tad by coaplatlng "n "Applloat1on
for R.fund of P.nn.ylvanla Inharltanea and E.tata Tax" (Rf.V.1313). Application. ara awallabl. at tha Offlc.
of the Regltter of Willi, any of the 23 Rav.nu. 01.trlot Offloo., or by calling the .paoial 24~hour
an.w.rlng ..rwlo. nueb.r. for for.. orderIngl In Penn'vlvanla 1-800-362-20S0, out. ide P.nn.Ylwanla and
within local HarrIsburg ara. (717) 787-8094, TOOl (717) 77Z-2?52 (Hearlng I~palrad Only).
Any party in Inter..t not .atl.fied wIth tha oppralla.ent, allowance or di.allQwenc. of d.dyotlon', or e.......nt
of ta~ (Including dlloount or Intar..t) a. Ih~wn on thl. Notic. IUlt obj.ct within sixty (60) day. of r.o.lpt of
thh NeUe. bYl
-~wrJtttn protut to the PA O'lpartllont of RIIYanua, Board of APPlllh, O.pt. 2111021, Harrhburg, PA
-..lectlnn to havI the .att.r datarlin.d at audit of the account of the p'r.onal r.pra.antatlv.,
--app.al to the Orphan.' Court.
DR
171211.1021,
DR
Factu~1 .rror. dl.oovlred on this a......ent .hould bQ addra...d In writing tOI PA n.pert.ant of R.w.nua,
Bureau of Indlwldual Tax.., ATTHI po.t A.....II.nt Ravlaw UnJt, Oapt. 280601, Harrhburg, PA 111211~0601
Phon. (717) 7117-6S0S, S.. paga 5 of the booklet "Inttruotlon. for Inheritonoe lox RllIturn for a Ruld.nt
Oac.nant" (REY-1501) fnr an elCplanatlon of adllnl.trativ.ly corr.ctabl. arror..
If any tax due I. paid within thr.. (3) oalindar lonth. aft.r thi deced.nt'. death, ~ flvl percent (5%) di.count of
tha ta~ paid i. allow.d.
Tn. 15% tlX I~a.ty non.partiolpatlon penalty I. ~o.puted on th~ total of the tax and Inter..t a......d, and not
paid b.fora January Ill, 1996, the flr.t dey after th. end of the tax a.nuty Plrlod. Thh non-partiolpation
p.nalty I. app.al&bll In the .0.. .ann.r und In the the .a.. tl.. plriod .. you would app.al the taM and Intlr..t
that hat b..n a......d a. Indloatld on thll notlo.,
Int.r..t 1. charg.d b.ginnlng with flrlt day of d.linqu.noy, or nln. (9} lonth. and one (1) day frOI the date of
death, to the data of paYlant. T~lCII which b.o..a dllinqu.nt bofor. January 1, 19&2 b.ar int.r..t It the rite of
~llC (6%) percent p.r annul calculatld at a dally ratl of .000164. All taxe. which bee... d.linqu.nt on and Ifter
January 1, 1982 will b.ar Intlr..t at a ratl which will vary fr~. oal.ndar Ylar to cal.ndar y.ar with th.t rlt.
ar\nounoMl by the PA O.partM.nt of Raw.nu.. 'hi appl1cabl. Inter..t rat.. for 19e2 through 1997 arel
'!!!r Inter..t Rata Dally Intar..t Factar :!!!r Inter..t Rato Olllly Intlr..t Factor
1982 20% ,000548 1987 iii:'. .000241
1985 16% .000438 19118-1991 11% .000501
1984 111: .000101 1992 'X .000247
1985 In ,000156 1995-1994 1% .000192
1986 10:C .000274 1995-1997 'X .000247
--Intar..t 11 calculat.d e. follow'l
INTEREBT . BALANCE OF TAK UNPAID K NU"BER OF DAYB DELINqUENT K DAILY INTEREST FACTOR
..Any Hotlo. l..u.d aft.r the tax baeo.e. d.llnquent will r.fl.rot an Int.r..t aaloul_tlon to flft..n (15) dlYI
baYQnd thl data of thl a.......nt. If paY.lnt 1. .ldl aft.r the Intar..t ooaputatlon data .hown on thl
Notlol, additional int.re.t .u.t b. oaloulated.
?I~1'J~ii _H ~.rO~1'__lJN!J.~~_...B u g_&.,-E
Name of Decedent: IGOH v. I'WJ'ClmNKO
~~--,~--- -
Date of Death: .July 5, 1996
~._----------~.-
Will No. 21-97-0ll02 Admin. No.
.._.---'.-~-_.__.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captione~ estate:
1. State whether administration of the estate is complete:
Yes No X
2. If the answer j s No, state when the personal
representative reasonably believes that the administration will be
complete: 'I'wo Years - Case is in li ligation.
3. If the answer to No. 1 is Yes, state the following:
d. Did the personal representative file a final
account with the Court? Yes No
b, The separ'ilte Orphilns' CUllrt No. (if any) for
the personal representative's ilccount is:
c. Did the personal representative state an
ar.count informally to the pilrUes in interest? Yes____ No
d. Copies of rece~' p , t leases, joinders and
approvals of formal or informal ac ounls ay be 'i~~~ith the
Cerk of the Orphans' Court and ma be att c ,t'o/this report.
~, '/
/ L 1// ,/
Date: 61ft> 51? . -./ __'
, / /'
, I ~
H ward 8. Krug, Esquire
Name (Please tr.pe or print)
1719 North front Street
Harrisburg, fA 11102
AddresS---
~7 I 234-4178
Tel. No,
Capacity: Personal Representative
(MAH :rmf/AM3)
J( Counsel for persona 1
representative
jI;' .-'
-
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~ H
:> p
QI
ili I:-< tIl
0 ili ii\ Iii
t.? '", 0 -l:l ~ ~'
H p:, .
0 ii1 . . .~ 0 t)l
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1'<<0 0 ili !~~ f P
O~ 0 ~
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r-- E-< ~
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,-CH,\I,"lf,""'j!\,lli(.II'lllfj';'I\,Miii\
lJli'J\I\jl,lU/lulllh'UIUI
1Ii.IJIj;\t.II)1 lilliIVI[HI'\1 1'\-(1
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Ili\HflhIJUlIc;,I'A IJlilllJhl1
RECEIVED FROM:
KRUG HOWARDB
1719 NORTH FRONT STREET
HARRISBURG, PA 17102
...'....lnl'l
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
EST A TE INFORMATION: SSN: 166-74.5575
FILE NUMBER: 21-1997- 0002
DECEDENT NAME: FATCHENKO IGOR V
DATE OF PAYMENT: 01/02/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 07/05/1996
REMARKS: HOWARD B KRUG ESQUIRE
CHECK# 43736
SEAL
ACN
ASSESSMENT
CONTROL
NUMBER
TOTAL. AMOUNT PAID:
INITIALS: AC
RECEIVED BY:
1<I:X;1R'I'I':1< OF wn,r,s
'101
!lL'/ 110/ I:Xlll'!fH
NO, CD 000712
MARY C. LEWIS
REGISTER OF WILLS
AMOUNT
$23,000,00
$23,000,00
.
)
.-, ,.. '"
bDe~edef.1.t~~ComPlete_~ddress..: ______~______ __ _ _______ ,_ _ __u_ __
]!11111.[{'fH "
206 East LoclIst Stl eel
. ____..__._. ._..__.., _. .~_'~'U'_ _ _. ____ ,.,_..__.u_....__..___.~_._..~____._.___
~~-~~e~~irl-,:SI?lIlg, ____-==~===~___ _________ ____L "~' _~~___,,_=r51~5;-__:=~=~
Tax Payments and Credits:
I T ii' Due (Page 1 line 19)
2 CreclilslPaYlllents
^ Spousal Poverty Credll
R Prior Pnyments
C Discount
(1)
21,639,92
23.000,00
Total Crndllf> (A + B + C )
(2)
23,000,00
3 InleresVrenal~/11 applicable
D Inlerest
E Penally
0,00
0.00
4
TolallnloresVPenally (0 + E) (3)
II Line 2 IS grealer Ihan line t + Line 3, enler lite dlllerence. Tltis IS lite OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
II Line I + line 3 IS grealer IMn Line 2, enler 1118 dlllerence TItIS IS Ihe T AX DUE. (5)
A, Enl'" Ihe Interesl onlhe lax due (5A)
t, fnler Ihe Iota I 01 Line 5 + 5A ThIS IS Ihe BALANCE DUE. (5B)
Make Check Payable to, REGISTER OF WILLS, AGENT
1,360.08
000
0.00
0.00
5
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
Old decedenl make a transfer and
CI rfJlam lhe use or Income of the property transferred:
b retain lhe right to designate who shall use the property tr;:msferrecJ or Its income;,
c relam (-I reversionary interest: or
cI receive Ihe promise for life of cllher paymenls. benefits or care?
2 If dealh occurred alier December 12.1982, did decedenllransler properly WI lit in one year 01 dealh
Wllhout receIVing adequate consideralion?
:3 Old decedent own an "in trust lor" or payable upon doath bank accounl or secullly al hIS or her dealh?
4 Old decedenl own an Indtvldual Retirement Account, annully, or olher non-probate property whICh
conlall1s a benellctary deslgnallon?
'yes 110
0 [8:1
0 [8J
0 [8J
0 [8J
0 [8J
0 IX!
0 l8J
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPI.ETE SCHEDULE G AND FILE IT AS PART OF THE RETURN,
,hdflt r~nJ\If<<; 01 pllqUry I (11.'Cll(rl nil! I !lEl','O o~mlllf1CO Ihls returt' 11Ir,l1(j,IHJ ilCwmponymq 'iGt.<HJuh'~ md ';IJtQlllp.nts <lnd 10 llio l)f)sl of IllV ~ncw~dqfl ,1I,d h,ln[ II 151nl'l WIW{:,j and L'lmplJ!.)
llo:';~lr.jlIOl' (11 plr'fHlIl1( olll.]f llinn Hill piwi)nalreplflsenlflil'/I) IS b:I',lld Oil a'llllr(JlllldllEJI1 of Wllidl pr.-,p,lr,'r h:I'; any ~no'li\;>dql'
~;IGI'lf\ 1\ JHe \JF f'Er\[iOI'1 m~~';1'01ISIBI.E FOR r:Il.HIG HETlIRt)
/.ilit I), I / I-I -;, /1' i 1",'-
M'III'i',', 12 Soutn Filbert Street
Mect1anicsbllrg,
')ll;II'\ itit-;H,IF f'l{lT!\RCF; (\fl-lf_H THAtI f\!:f-'Rf.SEII(,'i rlVf"
'II I.i. I , It. "(,
MAiiil:," 1719 North Front Street
Harrisbur(J.
,[).tI.H:
i 1/,;/,'
PA 17055
)i'~I: /
,. '1/1
PA 17102
F or datE'S of dr.ath on or Hr!l'r July 1, 1994 and before .lallllC1ry 1, 1995, lhe tax rate Imposed on the net value of trfH1sfms to or for lhe use of the sllrvivlll~J spouse IS 3%
[71 i' S ~9116(alllllll)1
For dr:lles of dmlth 011 or allm Januwy 1, 1995, the tax rate Imposed on flip. nel vallie 01 transfms 10 cr for the lIse of lhr surviving spollse IS 0% [72 PS 39116 (a) (1 1) (II)]
The st<11ute dO(~8)Q~llilllL\ fl transfer to fI surviving spollse from l(lx, anclthe Sli-llutory reqlllrerli!!f1ls lor disclosure of assets and filing a lax relurn are slill applicable even If
lhe slIrvlvlnn spouse IS the only beneflcimy
For d31(!:; of death 01\ or (Iller .!llly 1,2000
The tnx ratt! Impo~;r.d on llw nel value of transfers from a deceasec! child lwenty.olle years of i1ge or younger ilt detilh to 01 for lhe lIse of El mlluml parenl an <ldopllvr pmelll
or a sl'pp,,,ent 01 lit" rhtlcl" 0% [72 r s 99116(01(1 2)1
Tile tilX rElte IfllPOSP(j on ltw rwt valtw of tmns/err, to or for the lJSf! of the decedent's Irneal benefiCiaries IS 'I 5U/CI, exrepl <tS noted in 72 P ~:; 5911G(1 2) [72 P S ~gj 16(il}(1)]
Tlw lHX f"lo Ill1posnd Oil Uw rwt villuD of transfers 10 or for the uso of the rlecedenl's slblmgs IS 12% [72 P S 99116((11(1 3)) A slblmg IS clefmcd, under SectIOn 91\)2, as (If)
mellvlduClI who has atlNls! anp. pmf'nt III cornmon With the decodent, whelher by blood or adoption
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
!NIIUU 'flNef. TAX OIVISION
ntPl. l80601
tIMIRISIIl!Rr., fl^ lllZlH60t
NOTICE OF INtlERITANCE TAX
APPRAISEMENT, Al.lOllAtlCE OR 0lSAI.1.0WANCF
OF DEDUCTIONS AND ASSESSFtI'NT OF TAX
06-30-97
FATCHENKO
07-05-96
21 97-0002
CUMBERLAND
101
[-:_=-:~~~~~~:R~ili~-~~~----~l
MAKE CH~CI( PAYABLE AND REMIT PAYMEN'T Tal
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~
1t~V ~ i ~ "('"i - j: y -~i: ii - f 1i="-: Ii; Y -Nor T F. i:" "oF - YN~i R-f f A torr. i - TAX - Xli PR X f S EM-If '1 'f: "A i row ~ii'c E. "oii -.,." -. - - -" - - - - --"
DISALLOWANCE OF D~DU~TIONS AND ASS~SSMENT OF TAX
IOOR V FILE NO. 21 97-0002 ACN 101
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
HOWARD 0 KRUG ESQ
1719 N FRONT ST
HOG
PA 17102
ESTATE OF
FATCHENKO
_N~_'_'___"_'___'
I CWANOED
TAX RETURN WAS I I X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE R~VERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Es~ate (Schedule A)
2, stocks and Bonds (Schedulo B)
3. Clogo1~ Hold stock/Portnnrship Intore9t (Schodulo C)
4, Mortgages/Notes RaooivRble (Schodula OJ
5. CAsh/Bank Doposits/Hisc, Personal Proporty (Schodule E)
ft. Jointly Owned Proper'ty (Schedule F I
7. Tranaforn (Schedulo 01
8. Total Asset9
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. funeral Expensos/Adm, Costs/Misc. E~ponscs (Schudulo H)
10. Dobtu/Mortgage Liabilities/Liens (Schedula I)
11. Total Deductions
12. Net Value of Tax Roturn
13. Charitablo/Govornlrlental Boquoijh (Schodulo J)
14. Net Value of Estato SUbjoct to Tax
11' an aSS8!JSment was bllU..'; pt'El~ J.".....~~, :dt,,,..
rBflect figure I thBt include the total Df ALL
ASSESSMENT OF TAXI
IS. Amount of Line 14 at Spousal rote
16. Amount of 1.1no 14 taxabln at Uneol/Cless A rata
11. Amount of line 14 bxab1e at Colla-tural/ClooSl B rnh
18. Principal To~ Duo
NDltol
TAX CREDITSI
PAYHENT
DATE
RECEIPT
NUMBER
DISCOUNT C'l
INTERESTfPEN PAID C")
------~-~.-.._-_.- --.---..----
lll_
I~l_.
131
14'_
151
16)
171_
191_
llOI
,00
.00
.......Jl..Q...
.00
6,073.00
.00
.00
CBl
3,905.00
21.946.00.
1111
(12)
1131
114)
~'"
'Ij.all II IfP Ill-III
IGOR
V
.00 X,OO.
. Oil. K .06.___
. DC!. X .15.
1181
AHOUNT PAID
DATE
06-30-97
NOTE I To lns~lro proper
credit to your aCCClllnt I
submit tt,o uppor portiot,
of this form with YOllr
tax payment.
6,073.00
?~.BSl 00
19,77B.00-
.00
19,77B.00-
14, Hi cuiu,uj". 1(" 17 and 18 wil::'
re~urn9 Bssessed to date.
llSI
116)_
1171
.00
.00
.00
.00
..- --" '~
TOTAL TAX CREDIT .00
. ._~~-- --.--..------.
BALANCE OF TAX DUE .00
-.---------- --... ----
INTEREST ANU PEN. .00
--~-.._-_._-_.-._..- ----_.--~
TOTAL DUE .00
..._----~.- ..-..-- .-.-------- ----_.-_.~.--~-_.._---~--
INDICATED. SEE REVERSE
AOPITIDNAl INTEREST.
IF TOTAL DUE IS lESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFI.ECTED AS A "CREDIT" ICRl. YOU HAY BE DUE
...... ....".......r "u,r I'lr: T"'T~ enDH en" nJ'I:,TllllrTTON5. l
PURPOSE OF
NOTICE I
To fulfill ~h" rllqulrelll"nh of Seotlon 2140 (bl' of thu Inhel'lhnce and E,tah TaM Aot, Aot 2! of' ZOOO,
(72 P,S. SeoUon 9140),
PAVHENTI
Detaoh the top portion of, thh HoUoe ftnd lubllllt with !fOllr paYlIlunt to the Register of Willi printed on the
reverse side,
u Hake ohlok or .0n1lY order payable tal REGISTER OF HILLS, AGENT,
REFUND (CRII A rofund of B taM crudlt ny be requutod by oOlllpleting sn "Application for Rofund of Penntlylvanht
Inheritllnou l!Ind Estate Tax" (REV.B13l. Appllolltions are 8vai1ab!e 8t the Offlce of the Reghter of Willa,
any of the 23 Revenue Distrlet Offiou or frolll the Deparhlent't1 24"hour answering liervlt.le for (or.. orderlngl
1"800-362'2050; !il8rvlces for t8Mpayers wIth sjlu,~lal hot'lting @Inri I or speakIng neeelsl 1-800'447-3020 (TT onlyl,
OBJECTIONS I Any party In Interest not lIathfhd with th8 assesslIllmt of taM l'ltI shown on this noUee lay object within
51Mb (60) days of receipt of thls Notice bYI
--written protest to the PA n"p8rtlllent of Revenue} Board of Appeals, Dep1:. 281011} Harrisburg, PA 171211"1021} OR
~-elooting to have the .atter deterlllIned at audit of the personal representatIve} OR
--ilppul to the Orphans' Court.
AOHIH~
ISTRATIYE
CORRECTIONS I
Feotual errors discovered on this eSS8SIIIl,ant should be addrossed In wrHing tOI PA DOpllrtlllont of Revenue}
Buroell of Individual TollOS, ATTNl Post ASllUfilllont RevloN Unit, Oept. 280601, Harrisburg, PA 17128-0601,
Phone 17171 787-6505, See page ~ of the booklot "Instructions for Inherltllnco Tax Return for B Rnidont
Decedent" (REY"15011 for an oxplllnation of Kdrlinistratively oorreotable errors,
PENALTY I
The 1~% tax alllnesty non"partIoipatlon penalty is cONputed on the total of the taM and Intoro~t assessed, and not
paid before January IB} 1996} th8 first day After tho end of the tax arllnesty puiod. Thllt non~perticipatlon
penalty is oppealeble in the S6111e Manner snd in the the sau tile perIod B!i yoU would appeal tho talC snd Interest
that hss been 6ssessed as Indicated on this notice.
INTEREST I
For date, of death on Dr after 10~3~91, PonnsylvenIo Estate TalC based on the Fodoral E~tAte TaM
return beoolllllS delinquent at the e)(plr8tlon of nine (09) llIonths frolll the date of doath.
For dllltes of death prIor to 10-3-91, Pennsylvania (state laM bllsod on the Federal Estate lax return
beeollles delinquent at tho expiration of eighteen (18) llIonths frolll the dBte of dUBth.
TSM8. whioh beca.e delinquent before JanlJfll'Y 1, 1982 bur Jnhorllst at the rate of aix 16%1 percent per annuli
Claloulatwd at B dally rate of .000164. All taMIIS which booalllll dsllnquent on or after Janusry I} 1982 will bnr
internt Itt a rete whloh will vary fro. ollhndnr yeer to oslendar ynr with that l"atH llnnounoQt! by the PA
Depart.ent of Revenue. The appllcRblu Intorost t8tes for 1962 through 2002 erel
Vear Inbrut Rahi Dally Interost Filotor Venr Interest Rate Dally Inter"ust FAotor
1982 20% .000548 1992 9% ,000247
198~ 16% .000438 1993~1994 7% .00019Z
1984 11% .000301 1995-1998 9Y. .000247
1985 13% .000356 1999 7% ,000192
1986 10% .000274 2000 8% ,000219
1987 9X .000247 2001 9% ,000247
1988.1991 11% .000301 200? flY. ,000164
~-Inhrut Is oalou1l!lted .. follows I
INTEREST = BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notloe issued after the tax b800~es delinquent will rofleot IIn interest esloullltien to flfte.n (IS) day,
beyond the data of the US8Bslllant. If paYlll8nt is lIIP1de after the 1,,1:8rOlt ao.putatlon data shown on th.
Notlel, additional lntutest .ust bo oRlculftted~
/ [)..;_s/- ~
JI)REA~ OF INDIVIDUAl. TAXES
INHUHTANCE 1M( lllVISItlN
IJEPl'. 2110601
HARRISIlURu, fl" HIllI-0601
COMMONWEALTH OF PENHSVLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT. AllOWANCE OR DISAll.OWANCE
Of DEDUCTIONS AND ASSESSHENT OF TAX
'[)l
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
03~04-2002
FATCHENKO
07-05-1996
21 97-001l2
CUMBERLAND
101
JILL M WINEKA ESQ
PURCELL ETAL
1719 N FRONT ST
HBG
\-
[' '
PA 1 ~H~
I,
Amount ROlllHtBd - .-. -:3-
- - - - - -~--------
- - -- - ----- --- --~
- ~ - - --~--
MAKE CHECK PAVABLE AND REMIT PAVMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ...
R 'EV: i5r.-i - E'iC A F p" (ii F Ii 2 Y' NOY i tE - '01' - YNHEff i;: ANe E - YA X - A-P PRA- is EMENT ~ ~ -iI i::L~ow A N-C f.' (iR' -....... - -. -.. - - -.
DISALLOWANCE OF DEDUCl'IONS AND ASSESSMENT OF TAX
IGOR V FILE NO. 21 97~0002 ACN 101
14, I5 and/ol' 16, 17, 18 and 19 will
l'etul'ns assessed to date.
,00 X 00 .00
-
360,665.30 X 06 = 21, 639.92
.00 X 00 = .00
,00 X 15 = .00
(19)= 21,639.92
ESTATE OF
FATCHENKO
TAX RETURN WAS: {
( X) CHANGED
) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN
1. Real EiSltat8 (Schedule ^ I (1) ~
2. Stocks find Bonds (Sc..hedulo 8) (2)
3. Closely Held stock/Paf'tnorship Intol'ost (Schedule C) (3)
4. Mortgagos/Notes Roceivable (Schadu18 DI (4)
5, CQsh/Dank Deposits/Mise, Personal PI'vpel'ty (Schedule E) (.5)
b, Jointly Own"d Property (Schedule FJ (6)
7. 1r8nsf81'5 I Schedule G J <<7)
B. Total Assets
NO. 01
.00
.00
.00
.00
364 , 0'2L.ll.
.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Ad,", tosts/H.\sc. ExpensBs (Schedule flJ
10. Debts/Mortgage liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Returl)
13. ChlAritable/Govef'''llIental Bequests; Non-elected 9113 Tr'Jsts (Schedule JJ
14. Net Value of Estate Subject to Tax
(9)
1101
3,655.86
.00
(11 )
(121
ll3)
(141
If a~ assessment was issued pl'eviouslY, lines
I'eflect figul'es that include the total of ALL
ASSESSMENT OF TAX:
15. A~ount of Line 14
16, Alllount of l.ine 1',
17. Anount of Line 14
18. Anount of Line 14
19. Principal Tax Due
TAX~I.SJ
DATE
01-02-2002
01-02-2002
NOTE:
at Spousal rate
taxable s.t lineal/Class A rate
at Sibling rate
taxable at CollaterBl/ClQss 8
(15)
llb)
1171
1181
rata
, --1lEcrII'I-'--'-'--'
NUtlBER
cliliOii71Y--
WRITEOFF
-----~-UISt:Ot.JlIT-(lr'---
INTEREST/PEN PAID (-)
1,360.00-
.00
AHDUNT PAID
23,000.00
8,603.20
C/
*'
RFV.j~~1 r,~ UP (H.Ot!
IGOR
V
SEE
DA'rE 03-04-2002
^TTACHED NOTICE
NOTE: To insUf'e proper
credit to your account,
submit th8 upper portlon
of this form with your
tax paYlllent.
364,099.16
3.6~~,66
380..443.30
.00
360,665.30
TOTAL TAX CREDIT 22,999.99
~,.."",,,-~--,~_.,.- ......._..".~"",..".__....
BALANCE OF TAX DUE 1.360.07CR
......,." - ......... .--,..-.............. .......---------
INTEREST AND PEN. .00
.. ....- .- -------------_..-
TOTAL DUE 1,360.07CR
. IF PAID AfTER DATE INDICATED, SEE REVERSE
fOR CALCULATION Of ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN $1, NO PAYHENI IS REQUIRED.
IF TOTAL DUE 15 REflECTED AS A "CREDIT" (CR I, YOU HAY DE DUE
A REFUND. SEE REVERSE SlOE OF THIS FORH fOR INSTRUCrIDNS.)
RESERVATION I EllbtaD of decedatlU dying en or bufofe D8oe",ber l~, 19112 H if any future! Intftf8lt In the utnte Is tr'ansfarred
1n poslesllon or .njoY~ent to ClaRI e (coll.terall beneflolar18s of the decedent after the e~plratlon of any eltate for
life or fOfyeDfl, the Co~~onwe81th hereby expr8111y reserVeD tho right to apprallD and assels transfer Inheritance Taxes
at the lawful ClasI8 (collaterall rate on any luch future IntoreMt.
PURPOSE OF
NOTICE I
Tu fulfill the requirements of Sect Ian ?140 nf the InherJtancR Dnd Estate Tax Act, Act 23 of ZOOO. (ll P.S.
Sootlon 914D l.
PAYMENT I
Detach the top portion of this Notice end sub",1t wHI1 your paYlll8nt tn tho RII~lst8r of I<Hlls printed on thu rllvllrse side.
uHako oheck or 1II0nDY order payablll tal REGISTER OF HII,LS, AGENT
REFUND (CR'J I A refund of . tax credit, whluh was not reqllDstod on tho Tax Roturn, ",p,y bo raquulEld by complotlng an "A?plicatlon
for Refund of PunnlylVllnla Inherltanoe and Estab Tax"' IREV~1313). AppllcntJoO!~ ore ovallablo at the Offloe
of the Reglster of Wills, flny of the 23 Revenuo [ll5trlct Offlcos, or by oolllng tho special 24-hour
enlwDrlng servioe for foru ordllrll11.l1 }-800 3u~0!0~OJ sorviao:: for !axpul/ors I<Ilth o;pflCdBl hllarlnR nnd I or
speaking needS! 1.8DO~447-3020 (TT only).
OBJECTIONSl Any Nlrty In lnter.ut not satisfied with the appralselllent, allowance, or dlullowanca of deduotlons, or nlSus.ent
(If tax (Inoludlng d!llcou"t or IntnrOllt) I!l9 shown on thh Notloe must ob.1ect wi thin sixty 160l day. of reoeipt of
this Notice bYl
--wrlUe!l protest to thll PA Oepl1rtllllmt of Revenue, Board of Appellls, Dert. 1.61021, Itarrlsburg, PA 17128.'1021, OR
ueleotlon to have the lIIatter deter.lned lit audit of tho nccount of the personal representative, OR
~~apPDltl to thll Orphans' COUft.
ADMIN-
ISTRATIVE
CORRECTIONSl
Factual errorl discovered on this !lIS8SsllDnt should be addroued In IoIrHlng tnl PA Deparblllmt of Revlilnue,
BurDau of Individual Toxu, ATTNl Post AlllleUMtint RIIVhl10l lInlt, Dup\. 280M1, HArrisburg, PA 17128.0601
Phone (717J 787~650!i, See page 5 of th8 book lot "Instruotions for tnherltonos TfI)< Return for a ROllldfll1t
Oecedent" (REV-IS0l1 for an e)(planation of f1dlllJnistretlvDlY corl"HotnblD errors.
DISCOUHTI
If any tax due Is raid within thrllD (3) calendflf 1II0nthll afhr thll deoedflnt'lI doath, a five percent (5%l dllcount of
the tax paid II Illowed,
PI::NAlTYl
The l!ir. tal< ..ne.ly non~partlclpatlon penfllty is cOMputed on the total of the tftX and Jnterelt aueued, and not
paid before Janullry 18, 1996, thll first day after thll end of tho tfll< f1l11nllSty poriOd. This non-partlolpaUun
penelty I. BPP8"lable In the .nllle lIIanner nnd In the the 'SIllII tl1118 purlad as you Would appeal the taK and tnterest
thBt ha, baon allenlld at Indlauted on thls natito.
INTERESTI
Inhr8st II Clharged beginning with fiflt day of tlollnqulInoy, IIr nino (9) Gonths and one {II day frolll the dati of
dutil, to the data of paYllIent. "'xus which ht/tlllll8 dollnquent before Jnnuar:,o I, 1982 hear Intorut at thE! rate of
.he {6r.l p"rcent per annulII Qaloulatod fit fI dally rL'lte of .000164. All tOKU whloh beoalll9 d"lInquent on and IIfhr
Janunry I, 1982 will bear interut lit II rnte ..hloh will VllfY frolll cll1endflr year to oalendar year with that rate
announcod by the PA lIeport~ent of Revanun, Tho appllc.bhl Irlterut ratos for 196? thrc.ullh ?002 arel
Vur Interut Rnt. DfI!ly Intere.t Faotor Vellr Intorost Rute (hilly Intorest Factor
198? ZOX .000548 1992 9X .000247
1983 161: ,000438 1993-1994 'Ii:: .000192
1984 11% .000301 1995-1998 <1% .000247
1985 H% .000356 1999 1r. .~DOI9Z
1986 10% .00(1274 ZOOD OX .000219
1987 9X .000247 zoo 1 9;( .000247
196&-1991 11% .0110301 ZOO? 6% .000164
~-Inter8llt is oaltlulBted .. followlI
INTEREST c BALANCE OF TAX UNPAID X NU"B~R OF OAYS DELINQUENT X DAILY INTEREST FACTOR
.-Any NotiCle luued after the tnK becouI d..Unquent will reflect an Jnbrut oalculation to fift.en (15) dfl)'1i
beyond the date af the atUUlllent. If flay..nt 11 lIIade ftftflr the Anterut oOlllpuhltinn date shown on the
Notioe, additjonlll Inhll,..t IIU.t hi onlculnted,
PAVHENl,
Detaoh the top portion of thJ. Hotio. and ;u~.it with your .p.y~ent .ade paY.ble to the n... ~nd addr..s
print.d on the 'Rever.. side.
If RESIDt::NT DECEDENT "ske oheck or Rloney order ptlyabh tOl REGISTER OF WILLS, AGENT.
If HONRAESIOENT DECEDENT lIillle ohllok or "'oneY ordllrpayabl8 tOI COMHONWEAL TH OF PENNSVLVANIA.
REFUND (CRl I It refund of a tal( oredl t, whlnh WllI not ruquutad on thQ hI< Retul'n, ",ay be raqu511lted by oOlllpleting 8n
"AppUo.'lon for R&funrt of Panns,Ylvtlnl"" Inherihmce lImd Estate 181<" IREV-131!,). ApplJauttorll are flvalhble at
the Offloll of the Register of With, Any of tho 23 RovonuiI Dl!Otr.lot OHioQS or froWl the Dlilparhlei'lt'R 24..hour
answering .ervloe for forllls ord.ringl 1-800-362.20501 servloes for tSMp8yerS with spgolal hear'ng and I or
.p8llklng nefldsl 1-800-447-3020 ITT only).
NEPlY TOI Questions regarding orrors oontalned on this noUoe f1hould 013 oddrused tOI PA Departlll9nt of Revenue, Buruu
of IndlYidu~1 Taxes. ATTHI Post Assessment Review Unit, Dept. 28D601, Harrisbur~, PA 17128-0601, phon.
(717) 7t17-6CiO!i,
DISCOUNT I
If any taK due Is paid within three (~) oalendar Month~ after the deoedent's de~th, a five peroent (5~) disoount
of th. tex paid is allowed.
PENALTY I
The lSY. taM Ii.nuty non-partiolpation pe/la1t.V Is oOrlputed on the total of th51 tal< IlInd interest auassed, - and not
paid before Junu~I'Y 18, 1996, thu first day after the-ilnd of thlil tal< alllnesty period.
INTEREST I
Interest I. oharged b.~innlng with first day of dellnquenr.y, or nine (9) lonths and one (I) daY fro. the data of
death, to the data of paYMent. TaMes whioh bloaMe dolinquent before January 1, 1982 beer Interest at the rate ,of
six (6X) peroantpar annUM oaiculated at 8 daily rate of .000164. All ttlMeS whioh becaMe delinquent on and after
January 1, 1982 will bear Interest at 8 I.ate which will vary frOM ardander year to calendar yeer with that rate
announoed by the PA Depart.ant of Revenue. ThQ applloable interest rat,~ for 1982 thrcugh 2002 ar81
V..r Interut Rate Dally Interest Faotor Vllar Inhrut Rate Dally Interest Factor
-
1982 ZOY. .000548 1992 9% .000241
19&:5 16% .000438 1993-1994 7% .000192
198' 11% .000301 19~5~1998 .~ ,000247
1955 13:< .OnO:5S6 1999 7% .000192
1986 10~ .000274 2000 .~ .000219
1fj/1!I7 9% .000247 2001 9% .000247
19ftS-l991 11% ,00D:501 2002 ,~ ,000164
--Int.rast 1. c~loulatRd as follows I
INTBREST = BALANCE OF TAX UNPAID X NU"RER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
~~ltny Netic. issued nfter the taM 000011I118 delinquent will refleot an Int.rut odCUhtlcn to fUben (1S) daYII
b.yond tho date of the a5seSSlllent, If paYM.nt is iliad. after the Int8r.~t oOMputation dlt~ $hown en th.
NoUoe, additional Interest lIust bo oaltlUhtad.
WHEREAS, on March 15, 2001, the Decedent's Father, Valery I. Fatchenko gave his Interest In the
Decedent's intestute Estato to his surviving son, Paul Fatchenl<o, A copy of the Maroh 15, 2001 Gift Letter is
attached heroto and marked Exhibit "E";
WHEREAS, Lyubov Fatchenko and Paul Fatohenko, who are the only benefloierles of the Estate
and the only parties signing this Family Settlement Agreement and Final Release, previously aoknowledged
In writing their Joint receipt of $50,000,00 paid on January 14, 2002 as a partial distribution of the residuary of
Ihe Estate as set forth on tho Acknowledgment of Partial Distribution Which Is attached hereto and marked
Exhibit "F";
WHEREAS, $1,000,00 of the Estate monies will be held In escrow In a non-Interest bearing account
by Purcell, Krug & Haller for payment of Any outstanding Income taxes on behalf of the Estate, preparation of
the necessery Income Tax Returns, and for any other liabilities of the Estate which may come due;
WHEREAS, the balance of the Estate monies will be distributed in accordance with the
Stetement of Distribution which Is attachod hAreto and marked Exhibit "G";
NOW, THEREFORE, we, Lyubov Fatchenko and Paul Fatchenko, being the only two
beneficiaries of the assets of the Estate of Igor V, Fatchenko, do hereby acknowledge that we have
received the liquidated pr:Jceeds of all assets due us, by virtue of the intestate laws, with the exception of
the $1,000,00 held In escrow, as set forth on the Statemant of Distribution attached as Exhibit "G".
AND, wa do hereby stipulate tltat In order to avoid the expense and time Involved in the filing of a
formal account and proposed schedule of distribution, we agree that no account is necessary and we
.
)
consent to distribution being made without the formal filing of an aocount and schedule of distribution, the
same to be with the same force and effect as If the documents had been flied and confirmed by the
Orphans' Court Division of the COLlrt of Cumberland County.
THEREFORE, we do hereby release and forever discharge Howard B. Krug, EsqLlire and Jill M.
Wlneka, Esquire and the law firm of Purcell, Krug & Haller, the Attorneys for the Estate, their assigns,
executors and administrators, from all actions, suits, payments, accounts, and claims whatsoever,
.
I
touching L1pon the Estate of the Decedent. We also agree that should any liability come due to the Estate
of the said Deoedent after the signing of this Agreement, and efter exheustlon of the $1,000,00 being held
In the esorow aocount with Purcell, Krug & Haller, we covenant and agree that we will share eQLlallv the
2
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
FOR DATES OF OEATli AmR 12/31191 CtHCK HERE
IF A SPOUSAL '
POVE~TYCREDIT IS ClAIMEO [ I
FilE NUMBER '9 -
O:?), '7- OO~
Yb\r~ NUMAlR
I ! ',I ~~HJf'pl'HllHtllnl ~f1I\,rn
I ) 4u, fuluro 1IIIIlrOll (omplomiso
(h-,t r!{lltJ\ 01 duolh ,,/lor 12.17,02)
( I (), DIH:udonl DiIIC! TOII,,!o r ) /, Dn<.udnnt"'\ointairwd a UvirlH lrl!~1
jAtiud\ (opy of Will) (^II11~h c_ol'Y (If lru\!)
Ai:LcqilRF.SiiONDENCTAND 'CONFIDENTIAL' TAX INFOR-MATioN-sHoijlii;\le-DIRECTliii;.ToT:~-- -,--,;--:;:--",,, , ;,,;
"M" II(;;^HD ;:-'KIlUG, 1':SQ~~;::-------------rOMPl\T7^l"90N~~\\_h ["ror;~ StroH
IEIHlkH-HWJMBIR Harrisburg, P1\ L7102:
7,1) I _2}4 --4J. 76 _ _ _,===,== __ __==__=~=~~____
,--
Z
IU
o
W
<,'
W
q
('..lMMUNWtALTIi OIl'tNtl~YlV/dllA
[JE/'ARfMtI.l1 01 Rrvu~ur
D[f'T. 211G/)OI
H ./I,n~~5_~t}_~1!,__ P^_ I? !~O -0&0 1
iiir.f[}fNl-;m^MfT\^1'C,iirsc^mJMli~lll t--lii'II;';-(-, - "
l<'^'j'ClI!<:NKO, 1 GOIl V.
COUNtY (:CJlJl
Illr i[llHn (iji-~i;i-I-II^Oli~(,~~.
;:.----.-.
Rr.ol blOll1 (Sdwrtul'1 A)
') Sh)~b Qod Uonds (SdHldulo B)
3. (I'Holy Hold Stv(:k/PwtIlUl'ihip.lnluru,t (5dlOdulo q
4. Mortgagol and Noto~ Ror.oivoblo (S<hodulc OJ
, 5. Cosh, Bonk Depo~ih & Mi\col1onoou_\ Pef\onol Propony
(Sc;hodulo t)
, 6, J<;>iotly Ownod PrOf)Nly (Schedule Fl
" 7, Trl)ndorl (Schedule GllSdiodulo l}
8. T 01(11 GrM~ As~ots(lolqlline~ 1.7)
9. Funoral Exponso~, Administrolivo Cost~, Mi~(OIIQnooll~
EXpOllSOI (Schodule H)
1,0, Dobh, Morlgogo liabllitlol, liol\S (SchodtJlo \)
11. Tolal Daductions (latallinos 9 & 10)
12. Not YahHI of Esh:He (litHI 8 minus lino 1"
I 13, ChO/i!ablo and Governmontal Ooquesls (Schadulo Jl
......__._. ~_.~__.__~~_~~_VCl,lu~_SubjQct t~_ T ox (li~~.3. ml~~~~~~L_. __ ..'"_._._~"_'_M""_'.~._.. ._.._.._._.__...~_._.____.
/ 15. Spousol TrMs/al's (for dales of dealh afler 6.30.QI1)
SOD II)Wudlon~ for Applicablo Porcontago on Rovono
SIde, (Includo valuas from Schodulo K or Schodull) M.l
16, Amounl of line 14 taxo:lblo 01 6% role
(1[lcluno volu(J~ from SchodulD K or Schodl!lll M.l
17. Amount of Uno 14 taxablo 0115% rato
(lncludo VahJ01 from Schodulo K or Schodulo M,)
18, Princlpol tnx dun (Add lox from lines 15, 16 Clnd 17.l
19. Crodit~ SpouHll Povorty Crodil Prior P(lymont;
',UC,IAI "IClJ~m ~i\J'<'\~I.~
166-74-,I)~)7~i
I\)'\!( (ll Of All(
'/ /~)/'J{,
l['(,'/,I~ ;'~'()
I:d!~ 1>\( ',f'-\(~I\Y /lIJMlll~
n/a
206 I~. Ilocust Ht~rQ(~t
M(~chanicBburg, P^ l70~)~)
("""'i Cumberland County
I ^-'MJllI-H -R[r'IIV[ll-j~ff-I-i:~~i~-ii'(:lj6i!;;j-
II/a
. ,
"I ~1'p;. ~~tfl ,(Iifl'''''', -,~,,,I'.! ~ tl~MIII,\1 'I~~,' .It/I' ''''''0'1 ";''',1,1
n/a
1>4 I
Otl(/innl !tuturn
! 10,
[ 15.
06,
Rnnlflindor Roturn
(lor dollH 01 dOC11h priQf to 12.13.B'2)
fedorul b!ClIO Tax Roturn Roquiroc-l
Totol HtJlllhul uf SClfo Doposil (kl(IH
! I,t
Umilod.I:II(Jtll
III
111
13}
(4.)
( 5)
_6,073
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- -~- - ----.----- +
161
(7 )
G,073
(9 I
JL~J)5_
(81 .._
(101
... "__21.,_9A6..._______"",,
(Ill _,,~u,,_}~.L~?J
(12) ,_".__LL9--I1!!L _"
1131 """'____,, "_______,,,,__ -_
(141 ,,,.."'..,,,, ",,--- --,:;,,2,==_,_...
(1$1 '
x. ._
:l ~~________~______.___...
(161
_______.~ X ,06 ::I
(17}
__" _,x, 15,.
(161
[)iW)l!nt
li,torOlit
+ --,
(19)
(201
20, If Uno 19 Is graClter than line HI, enlor tho difioronco all \.ino 20.
Ii1U
lh;, ;. tho OVERPAYMENT.
Checlc he'r~ if you (Ire requesting a r.fui1d of our over ayment.
21. If Uno 18 ii groalor lhonlino 19, on!Or !hn diHornnr.D on Lino 21, Thil iltho TAX DUf,.
A, f:'ltor the il1t.HOSt on tho bolollco duo on Uno 21A.
B. Enlor tho total of Uno 21 and 21A on linLl21U, Thi~ is thl' BALANCE DUE.
Make Chock Payablo tal Register of WHit, Agont
if~'lmitl\;',i;;,;~:,;,..,>:~!\(BE.S~RE1TO;:~NSWERIALL.Q-UfjSYI(lNS,ON :REV,ERSEisIDErAND>I.lOJREC~ECKIMATH~~:,(~-<i__~\,~'i~j:
Undor penohlo:; of perjury, I declaro ,hot I havo exominttd this return, incl\Jdinq Clc<:ornpmlyirlg schedultls und ,tate monts, and to tho best 01 my knowledge and balio~,
It is true, torrect and complote, I decloro Iflt1t 011 reClI aslale has boon roported 01 t,I)O markot voluo. Doclarotion of prf'pCJrllr othor thon the personal reprl:Hentotive IS
~I~Y~~O:\. ~lfl ~~~~~~.~~~~~)~i~T~:f~)r~~~~tRrEI~~~~~1J~~1?A~~R(~~'~~..- 1 2 [iOll t: h P i ].i;~~-l.~t_-. "'-S-'t'-'~'.~~l-----_.m..- ...... ---. 6:.\iTf>._~~crnL-....--
,~J ;;~1??!ii;:!":J,,'A~f'. /O~'::;~)'C~~tb:::I'_ PAd .17055--- "'.';---;--9......Z-----
z-:' :.~~-, ,~:::::"---.,~llarr..~sbur;:gAd-~ A -17102 ----- f". .... ---
,/' C:"---t'~-'>' i~llllll(
l____. .' ;.--\. "....;.........
(211
(2IA)
(21 B)
~\VUlll' I P.UI
mAltOf
ITEM
NUMBER
,~\lt~}~
.....!~w'}"
COMMOUW(^lfll or I'EtII151IV^HI^
1t~IH[RlIAfK{ '^'o:.Il(llllltt
1I(5lflftH (lIJ.ftJrt.II
SCHEDULE H
FUNERAL EXPENSES, '
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
IGOR V. FATCHENKO
DESCRIPTION
A. funort11 EKpiJI1SCS:
Muaselman'uneral Home, Ino.
I.
u. Aumllllslrutlvo Costs:
2,
Po/r,ol1ljl RoptJ)~ot\lfllivo. C()IIHHissio"~
Sodol Soturily f"lJfllbor of Pono/lCll RopmsQnlt1Hvo;
)'0(11' Comrnis,iolls paid
Allornoy foos
Puroell, Krug & Haller
3. Ftirlllly ExornpHon
Cldim"nl ,__________.. Rololioii,ltip
Add,o" 01 Clrtillltlf\1 ol'docodonl" ,doollt
4,
C.
I.
2
:1.
,I
5,
6.
7.
B,
Slrool.Addross .__0. . '.'_~_"Mo_..'n____~'~__'---'__"._'__-'-'---'-'__'.._._'_'_"'_~---~...,
Cily
,_____.._ __"._,.__._.....n__.._Stol(J ~________._.. Zij) (ouo
flrobulo, Foo~,
Miscellaneous Expensosl
Plo<1'oPrll1to,Tyl'o
~r~~9N7u~:~:: n_......~'..,_,
AMOUNT
2,660
500
45'
Penn DOT - ~ransfer fee for 1989 Aoura Integra
Musselman Funeral Home (death oertifioates)
19i
9
Pavel patchenko (labor & materials for
(painting/repair.ing Deoedent's. vehiole)
Dauphin County Treasurer (medioal records copi&d)
Graham S. Hetriok (Coroner's Report)
400
172
100
- ---_.~--_....
_._"T_ ~__~___~___~_______T_~__' ~_.. ~~--
TOTAL IAlso 01110' all Iille 9. Recapllvlollolll
(If ",Of 0 .pnco Is Iloodod, 1"'0,1 nddlllollol shoets of soma sl"o,)
s
3..L90..!L_....___._
.,VII'II" !','"
'A;
{\41~~\
5CHWULI: I
Of:IlTS or Df:Cf:Df:NT,
MOIUGAGr: L1AIlLlTIf:S AND LIENS
"",U.,,'III'.1 ~ll't 01 fllttHTlVI,III^
II lilt (l"Utl I~. .( tulll
H"tu(tllllf(!l,Pl(
I:ST^1I: or
.. __' ,. .,__I.Jl.I"!!.~~t!,,.I.I_f~~I"I..:I~I..~'yI)f'
T'Ui~~~,~r;~~~~; ......
IGOR V. FATCHENKO
IHM
IHlMIII'11
Ilt!iCItII'IION
West Shore EMS (Aoct #6752)
2. Tristan Assooiates (Acot #299B7963)
3. Harrisburg Hospital (Acot #33396ll2)
4. Moffitt, Peass & Lim Asso., Ino.
(Acct #FACTIG-OO)
,5. A.Z. Ritzman Asso., Inc. (Aoot #HH00730159)
6. S & T Bank (vehicle loan)
7. Pavel Fatohenko (reimbursement Lor payment ofdcbt
to creditor, paid by Decedent's brother)
8. Nikolai Kostivchenko (reimbur('lement for payment
of debt to creditor, paid by Decedent's uncle
and other monies borrowed)
--------~-_.....
TOTAL (^ho ontof on IIno 10, RiJ(Opltulollonl
.__._. ._~.__~'____~~'_'_'___ u. __,_"_~ ..__
(If "'0((1 S(HHJI is f1oodod, it1wrl ucldiliol1a/ 11.0011 ", wnw Siff'.}
^MlJlINI
- $ 705
221
2,674
90
777
5,679
5,800
6/000
\21 946
.1.._..
.--- - .~7;;t.:V
,
1710 N. FliONT STH~.iET
"'^!tHL'tltlIHO, f'^, 171();,!.;"]1)2
'fP.U!Plf(}Ne(717)~~_, 1/1\>': i717J2:n,114U
~rl
~.~-.
LYUBOV V. FATCIIENKO,
Individually dnd as
Administ.ratrix of. the Estate
of IGOR V. FATCHENKO,
Plaintif.fA
f N '1'111': ('()l1I(I' OF COMMON PLEAS
DAUPII] N COUNTY, PENNf:YlNANIA
NO. 2679 S 1997
va.
HARRISBURG IIOSPITA1" PINNAC).,E
HEALTH HOSPITAL,S, PINNACLE
HEALTH SYSTEM, A.Z, RITZMAN
ASSOCIATES, INC., alld
DR. TIMOTHY [<'ARRELL,
Defendants
CIVIl, ACTION" LAW
JURY TRIAL DuiMANDED
ORDER
,'j
AND NOW, this 'J'~-') day of May, 2001, after review of
Petitioner's Motion, the Affidavits of Service with originally
signed documents, the Cover Le~Ler of counsel (English and
Ukranian versions) and the fully executed Consent of Father'and
Gift Letter forwarded by Father to Petitioner's counsel, the
following is hereby ORDERED:
A. The Rule of April 25, 2001 is hereby made Absolute;
B, The proposed settlement of the subject action in
conslderation of the payment of $750,000 shall be and
is approved;
C. The PetItioner is authorized and directed to execute
the Full and Final Release agreed upon by the part~ecl;
D. The settlement proceeds shall be apportion~d as
follows:
1. $96,200 to th~ Wrongful Death action (payable
to [,yubov V. Fatchenko); and
2, $653,800 to the Survival action (payable to
the Estate of Igor V. Fatchenko)
E.
Counsel fees of forty (40%) percent of the gross
settlement, plus all out-of-pocket costs and expenees,
payable to the law firm of Purcell, Krug & Haller are
approved;
':I;he.Jmllrt doeuments--rroncernin~this ca(;!e anct---it8-_ ) rf?"C\l",
.c settlement, 'including-.this r,lotio~nd__Qfder shall be -, /' ,I (
sealed, ) ,) , (\
i!J.
"",1
If-\r
) 'I "1'101"
-'I U I I
'. t
---...,-...
I h b ----,
ere v I'crl'fy !lul IIi:! rO;-:;-:;--J ;;::
true '11"1 C "" 'I '" .'" - ". "
II/e(~," " , O"U(, C,,/" I)[]( 1:;'.1 Ulii)iilUJ
" ~ '01. ~ ~ (,1 I,'
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r(J;)tl~;;"'::l.lfJI '--...._~..,-
BY THE COURT:
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fj.,. ' t100ve r, ,u
11_Vl
EXHIBf1
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< 11\,.:11,:,; II, 1/1.':1 (:!I,',,\I
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FATCHENKO. IGOR \I
11.\1' 'I ["I^liW,li,I(I, 'f.. II)
07/0S/199B
',Ii '\i'i'il "\[-1 i-I 1\'IJ,\T/III'; f'i!II,.I:;IIMJI 11'\,1 lii!.i t,!II'/,liillilll:jI;II.lj
06/09/1 970
i'!
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ulral
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lUl,
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f....] I," ",i'-'ll I :"'.1 j, 1,11,. :""-" ".;-".;1\'.'11
LJ 'I: L'II!,;),I-""1' i !:.-" ",.,J
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REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(Ii\ I 'ii i1fl'!il,J,I,',li'!I"_-1I1
[X'I:; ';IIJ,pl..,,,,,t;il:,,I'iI'l
r--] II !'iil'J!('ln"k,I{:'!':I" Inl "iii' di!."It",h I; Ililll
LJ i Ii._ t'I'i'I,III!d.rll,'lli"'I"!lflJ.lr:"'pl.'j'l"fr,,,11
L.J 10 :;)"I'i ,'1"'1<4, !:I,' 1;1 " ,,1,1,\II'h.l:., "II I' I! " \ I'
I-'i' .r'JII!'
rilE ffUMIlf'R
2 0700002
.;:-;.-:w:I ---:7-~~ - - ~"':tit<- -.
'J I' I ~ I " f 1:\ Jllll '( III ! ~ .Illi '!~
(,6-74-5575
ffW, F{EIURU MUST UE FfLHl IN DlJf'UCA'fE WITH THf
REGISTER OF WILLS
"",j.ol 'j, CI IHIf '1' il:JI,\[IFH
r. .'] 'I (-(['illlllld,'1 1(''';:1' 11".,,-,1,1,," II I'
1"'J !j IF,ll'l,il L ,!ell.' i .1' I' ,,1'11', 1 ~'" I :",,'
_ Blni'lll).illIl"',,,!
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LJ !ll}"'!LiI:I.'!I,. 'If j,:
111!1!'!i'I:,)!,
TH'iSSecnoN MUST BE COMPLETED, ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMA nON SHOULD BE DIRECTED TO:
i 1,\\1[ Li J~.1f '111"'_ I\IM It I' ~ I\II[ Ir:f
,Jill M, Wineka, Esquiro
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Purcell. Krll( & Haller
ffl i: Ii. ;111. ;;II~llllUI.
(717) 234-4178
1'11'" ,,'h'.I'I'" ,'..!
, I ' H ,.J Ii, I, l '-~ ii' -.-LI,! I 'I
1719 Nortlt Front Sired
Hmrishltrq,
1'1
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""/,II,II>(:::I',>I'Jl','[1:
.,' I,' I ;"1 ;-'-'1',,', f':,ll',,-,'.I 'n (,' -I, l'i':'I""I,-,,-,I,,: 1';,
r,I,
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Illi,l)
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~L"I'I!'} ,', u l.i
Tuti'lIOro%A!lsets(!<Ji-IIIII,\:,.I/)
I I ;1';,(:11 ['Jl(J:!.;w;". 1\':hn'H:lrallv\~ GI':li (Sdl~,dll~(' H)
Iii (ld11; (,i 0('<;\, torll M(Jltq:Ji]t. L;cJ[uhlio;., /l.11~11l~, (;;Cliwj,IIC I)
(1\1)
!I Toti'll Oodllr.tiol1s (Ir'!:11 Lllli.'-'~! I{ 10)
!, Not Vnlllo of Estate (1In,) H lriln\l~, L'I'[' 11)
(I)
1'1
II' ':1,,;111.1111(' II:I,j \.1w,)r:lrnf'!lI;III.~H(I'l<nI5hlf;c (1\ 1\ TIll:>!;, fllr wllll;h ,'III ol'I,;t.lii j, 1.:1\ hd_, 11-1\ bo"n
PIY!.:- (,~r,h('(LJlo,l)
1-\ Net Value Subloct to Till! (Llnil 1~1 ml!lll'J 1.111(1 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPlICABlF. RATES
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Ji, ^mc,fjl,1 (1j [1:'0 \.\ latilf.lf(] all'(lf'.]1 fale
1/ f',lli'HIIII Ilf 1111f! 1.\ I::n,~hln ill ~1Ibhn'11J!i!
Iii /o111'JIIIII 01 1.1:10 1 .lldl.':11110 :11 L~['IIi1If'(,ll r!lli'
FI Tille Duo
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360,66S.3q '( ~ (Ii!)
I:,
1i.1tima,
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PA 17102
-=
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384 :099.16,;u
1'1
384,099 16
3.655,86
19,778,00
11'\
"I
23.43386
(1.') ..
360,66530
(1'1]
II.t:
360.l165.30
21,639.92
(I.I
-
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21~
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
Decedent's C~mplete Address:
'.,'-I.\I'i'i',
206 FilSI LoclIst ShtH!!
Mcclt<llllcslHII (I,
,,- . -- -.-......
..J' " - u__ ~--l--- - -
',ridl /1"
PA 17055
__' ...___n .... n_ __~_ ___ _. ___.._~_.._+__,.._
Tax Payments and Credits:
!:Ix nUl' (f\lflC' llllh~ H'l)
/ {~II\\jl!:'./f)i1I{IIIBrll:~
/1. ;\P()\I!;~jl f'nvorly Crmlll
H f]rlO! fJi'l'lmtJr\l:i
C I)is("(lunl
(I)
l.!G3902
23.000.00
Inial C,od,l;; (A I I; + r: j
(2)
23.00000
hdl'l P~~T'i~IHlly If i1r1ph...dhlfJ
[) Intern:;!
f~ f';-~flal!!,
0.00
0.00
TololllIl",,,oIlPolI,,lIy (Ill I
.j 1Il.If\o ',? I:_~ WUiller (llCIn LlIle 1 .. Lino J. onlor tho chlferr.I1Ci! This I~:; 111(' OVERPAYMENT.
CllOCI( box on Page 1l.ine 20 ~o roquosl a rofund
(:I)
i; I! Ilw' 1 '. (lfl':',{ 1~; IJrf1illt~f lh,lll till!' ;~, f.nlpf lIlf' liilffll(H1U) Hw, I'; tllll TAX DUE
(4)
('.)
12,60 OS
1\ f:rlh~1 the lI!turD:;! 011 ItIP [,I'. r!lH' ('iAl
() no
000
o on
H ['nl?f !I,(' loL11 of Illw ~j ~ ~i,f\ 1111.: IS lilt: BALANCE DUE. U;H)
Make Check Payable to REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
[Jid ,b::i:dr.nl nldkt' ilIJiH1slt'r and
'1'1': (II)
II [X!
[] lx'
--,
[-I [xl
[J IXI
[] r8J
[J [x]
[J I~I
1"I,ml tll'~ l!';'~ 01 ill',~dl':l(' of lilt, f:ll)pl~l!i tr:1I1dt'IrL'U
II 11~ldlf1 tl1\J nqll! 10 (h!f,Ii)l1alc II/Ill) :,:Ildllll'.,:' !II'! plopl'll~r' lr'III"~!WI \!d (Ii Ib InUJIlW
c rt!I,;IIf1 CI l€vor,;lOn;lry 1Il1f.!resl,or
1:1 1l)(:\~I'lt'~ lile prcmw:;Q for iiI,? 01 either p:lyrl1onh\ bt>/IP1Its or cone7
2 If cJt','1111 (Jccllrred tlflm Decernbm12. 1982, did deC(!clr.rllll(ln:,~rer prupmty \';Illlllrl (lll!' Yllar of clr.:.\ll1
Itll!lIOlll recelvrnfj adequate considerallon?
J [)Id decf!clenl own all "Ill lrust fur" or payable upon deal!1 bank account or St)cWlly (II hrs or 'WI' d~alll7
4 DIU d8cedfml 0\'111 3nlndrvidual netiremenl ^CCOlJll!, cHlIlllll'l, or ollwr n(Jn.prClbal(~ propelly which
conlarns (1 beneficiary deslgnfltlon?
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 ",,!~, p:n.lh;'~ 'l( pfJIi:II'1 I :ll~i 1.",,11')11 h1/;1 f1;;I'III,']d thl': rflt'I'f1 If'dlcJllill :r;("flIPlIIlfIIHl "fhe:ILlla; nlld ~1'il<.'!Ilent'i fill'! 1(, th" hl~IIJIIIiV kn(,'/Ihlq'illl'll'''~flf ill'
, I', r., ..';1 l'I"I.-.;I,r ,.11.'" ltl )'111", r,,"'-;''-'' Ilre!;fw,'!r;ldtLI': I, L.I.ul I,T .It'I.I,:rll'JI ''!iol 1';I"'.t l't':j1 .,_,f hf.', Y.'t' kU''!Ii'..-i~n
',I'J),'.] liFl 'rI' iff,S;)11 fIC';f'(JihlfiIF HI!{ rtur;n I~Cll,IHf I
tlllU !,o'Hw;llIIvj,')'r'I,Hd
"'" /. i /1 r (
/,
II,~II
I '
II j':'t
:', :",', " 12 SOUlll Filbel1 Street
Mecllanicsblllg,
',1",11:': '.';:11,'1 ['f,f:I',''-f{IY r 11 HLf~ 1 I-IM'I r~EI';,:r Ri I I ,\ fr'-Ji
, I '. ,II , I' ('.
:.['111,1" i '1719 NOl1b Front Street
Harrisbur(j,
PA 17055
P^,1!
I
I I'
PA 17102
For O;:lt!'!::; 01 dealh on or after ,Iuly 1, 1994 !lnd beforr Jmlurlry 1, 1995, the 1,;1" rale impo<;:,ed on the rwl vahlfl of trallsfcl:; III {lr for Ihf! liSP. of Ihn Sllrvlvlnq SpOllSf' I~; ]0,''1
Iii f' S \9116 (<till 11(1)1
F~( d,lk!3 01 de,llh on or allm JilllllillY 1, 1995, Il1e tllX rnle Imposed on III() net vulilfJ of tr<ln~fe!s 10 or IOllhe IISfJ of Iiw survlvrng SpOil so IS 0% [12 P S *91 tG (iI) (1.1) (1/\1
111(") ~;l;ltutl' (J('\e~;_QQ!.i)!.ml}I2.! rllrcms!t'r In () survlV!fl9 srouse from lax, <lnd tho ~,t<ltuloIY roqwlr.rnenls for ol~iclo~uro of iI;.sel.-; ,lncl filing rlbx rfdwn are stili ,lpplrc,lblc (!Vl-'illf
lhe ~,lIrvrvlflD spouse IS thr only benefrwuy
for dille:: 01 df!i1t11 011 01 aftr.r July 1,2000
Tllfl tm raIn imposec! on H1f1 !lot valuo of lransfers Irom 11 c!eGHrlsed chrld IW(Jl1ly.OIw Yll;lr~; of ago or younnm at doalh III or lor 1110 L1S0 of [J n:llufill pdrolll nn ,lIbpllw P:II::llf
or, ",epp",.nl ollha child i, 0% 172 PS 99116(0)(1211
TIle tilx ratA rm[1osed on lfllJ !let value allransfers 10 01 lor tlw use of the drcmhlfll's Iimli!1 berl(llrclarios I~i 115%, tl;;ctlpl a" l10tnclln n P S 9911G(\ 2) ['/2 f) ;.\ sOI1tl(.I)(1})
TIle lax rale Irn[1osed on Ihl3 nol v,lll1e ollransfers 10 or fot lho llse 01 the decoct{!fll'~j srbllrl~I:1 IS 1(% [12 P S g9116(iI}( 1 J)) .^. sibling rf, defll\fld UllCh~r Sec\lon 91O(~, d~; ,Ill
mdrv'dual who ha!'i lit leAst one parent rn common wllh lhe decedonl, wtlf!lhor by hlood or adoption
COMMONWEALTH OF PENNSVLVANIA
DEPARTMENT OF REVENUF
BUREAU Of INDIVIDUAL TAl(ES
I~HlRIfANU: 'All DIVISION
llt.PI,280601
IIMRISaURO, PA 1!l211"OMI
NOTICE OF INHERITANCE TAl
APPRAISEI1fNT j ALUHlMKf Or! DISAllOWAtICr
OF DEDUCTIONS AND ASS[SSMIJlf Of TAl
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COIJNTV
ACN
06"30-97
FATCHENI(O
07-05-96
21 97-0002
CUMBERLAND
101
HOWARD B KRUG ESQ
1719 N FRONT S1'
HBG PA 17102
*'
U. IHI (t liP 11l.tll
lClOR
v
[.__-}~~~n~R.lilt~od ~~'_~_j
MAI(E CHECI( PAVABLE AND REMH PAVMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .....
f(~V:: i ~(;7" ~ Y -.,;:ji ..( (1~-:ci'iY-NO "ff r.i:" "r5~" "y'N'Ai;1iif is j.,fr.F "TAX - i\PPR Xiii EM"ENT ",- -,iLUiw4 t.re F - i'iri"-".'" ".." ---""""""
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF FATCHENKO IGOR V FILE NO. 21 97-0002 ACN 101 DATE 06-30-97
__~__ .., ~_,~_u..._<r..__"__~~.'_."""'~_._________~__
TAX RETURN WAS, I X I ACCEPTED AS F[LED
RESERVATION CONCERNING FUTURE INTEREST " SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Raal Estnto (Schodule Al
2, stock. and 80ndB (Schedule OJ
:5. Closely Hold stock/Pnrtnorsh ip Intor-ost (Schodulo C J
4. Hortgages/Not9u Rocoivabln (Schodu1o D)
5. Cash/Bank Doposits/Hi9c. florsonal Praptlrty (Schedule El
6. Jointly Owned Property (Schodu16 f)
7. Tron9fero (Schedule G)
8. Total Assots
APPROVED DEDUCTIONS AND EXEMPTIONS I
I). Funors1 Expensos/Adrn. Costs/Misc. Expllnso!l (S(Jhed~lln Hl
10. Dobts/Mortgage Liabilities/Liens (Schodule Il
11. Total Deductlolu
12. Net Value of Tax Return
13. CharHable/Dovernmentnl DoquBsts (Schodull) Jl
14. Net ValuQ of Eshto Sub.1oct to Tax
1 'I' an assessmont was 155'''''; "I.B~ i.tJLlbj,l, HIll'"
reflect figures tha't include the total (If ill,
ASSESSMENT OF TAXI
15. Amount of LiMO 14 at Spousal
16. Amount of Ltna 14 trmnble ,':It
17. Amount of Line 14 taxable at
lB. Principal Tax DUD
N(lT~1
1 CIIANOED
II I_..__".__,.,,__,~
121__,_ . 00
(31_ ' 0 0
141,,_ . 0 0
151__ 6 ,073,00
(61 .00
(7) _____--,,!LQ.
181
3,905.00
191__
1101_,--'.1,946,00"
(11)
( 121
(131
(141
NOTF.l To insuro propar
crodi t to YOUI- account I
submit tho UPPAr portion
of this forll1 \1ith your
tox pSYnlont.
6,073,00
2~ .B~l 00
_.__J1.) 77 8 , 00-
.00
19,77""8.00-
14, l;, i:iiH.i,uf' It, 17 t;nd 18 w~11
returna asseased to data.
roto
Lineal/Clnnu ^ rAtn
Collatoral/ClaQo B rnto
IISI.__._~ n .00,,_
1161__..____~ X .06,__
117l .00n.IS,
(16)_,,_-
,00
,00
,00
,00
TAX CREDITS I
PAYMENT
DATE
RECEIPT
NUMBER
DISCOUNT (.)
INTEREST/PEN PAID 1'1
-----------
At1DUtlT PAID
._----------~--
TOTAL TAX CREDI'r ,00
----~------ --~-
BALANCE OF TAX DUE .00
--- .
INTEREST AND PEN. .00
---...----- --.""
TOTAL DUE .00
._______.___._._.__'~._._.__"n ___._________
~-----_.--~~."
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST,
IF TOTAL DUE IS LESS THAN '1, NO PAYMENT IS REQUIRED,
IF TOTAL DUE IS REFLECTED AS A "CREon" ICR I, YOU MY 8E DUE
....~ ".."..n,," ,.Tn" nc TU"c! f"nDM F'nD nl~TFI\Jr_TtnN~. l
PURPOSE OF
HOTlCE I
To fulfill the re~uire..nta of seotion 2140 of the Inheritanoe and E.tate raM Aot, Act 23 of 2000. (7t P,S.
Seotlon 9140),
PAVMENTI
Detaoh th~ top portion
rever.a side.
~~ Hake oheck or .on8~
of this Notioo and submit with your paYMent to the p.ogister of Will. printed on the
order payable to:
REGISTER OF HI~~S, AGENT,
REFUND (CR)1 A rlilf'Jnd of II tax credit IllIIY be requested by oOllpleUng IIn "Appl1oat1on for Refund of Pennsylvania
Inhllritanoe arit.! E~tate Tax" (REV~13U). Applloations are available at the OHioC! (If the Reghter of Wills,
any of the 23 RMvenue Distriot Offioel or fro~ thu nupartlllsnt's 24~hour an~w.ring Burvlce for for",s orderingl
1+800~362-2050J services for taxpayers with special huorlng and/or speaking needsl 1~800-447w3020 (IT only).
OBJECTIONS I Any party In Interest not satisfiod with tho ossess~ent of tox al shown on this notioe May objeot within
8iMty (60) day' of reoeipt of this Notioe bYI
~~"r1tten probst to the PA Dapart/lIent of Revlmue, DOl'lrd of Appeals, Dlilpt. 281021. Harrisburg I PA 1712B-I021, OR
~~gleoting to havo the Matter detbr~ined at audit of the personal representotive, OR
--appeal to the Orphans' Court
ADMIN-
ISTRATIVE
CORRECTIONS I
Factual el'rors dlsoovered on this \\ssnslllent should be addrossed In writing tal PA Departlllent cf Rovenue,
Aurenu of Individual hMes, ATTNI Post AssaSSliumt Reviftw Unit, Dept. 280601, tlarrhburg, PA 17H840601,
Phone (117) 181-65115. $eo page 5 of the booklet "Instruotions for Inheritanoe Ta)( Roturn for 8 Ruldent
necedent" (REV~1501) for an explanation of ~d~inlstrl'ltlv81Y correotable errors.
PEH1.L TV I
The lS;I, 'hIM a.nalt!! non-participation pef18lty is cOlllputed on the total of the tal< Elnd interest 8&s8Sud, and not
Pllld before January 18, 1996, the first day Elfter the IInd of the tax alllnesty period. this non~pDrtlolp8tion
penalty is I:lppelll!lble In the 18me IUInner and 1n ttie the lalle time period al you would Elppeal the tax and lnternt
that hn been aSI8Bluid as indicated on this noUoa.
IHTERESTI
Additional Pennsylvani8 Estate Tax assessed 85 B result "f a oh8ngo on the Federal Estate T~x olo~lng
l.ttsr beooll1ltS delinquent at thl! sxpirfJt10n of ons (lJ Month fI"olll the date the flnal notioo of tho Inorease
in Fldel'al EstQtll Tax Is receivlld,
TI!IXQS whith baoalllll dellnquent befol'e January 1, 1982 bear interest !It the ratR of slM (6;1,) percent per annu.
clJlcul!lted at fI cll'dly rlltll of .0011164. All taMIIS whioh beoallle delinquent on or I!Ifhr .hmuary 1, 1982 will l:Iiltar
inte~est !It a rata whioh will vary fro~ calRndar year to oalendar ylar with that rata announoed by the PA
Oepart*snt of Revonue, The applioable Interest ratss for 1982 through l002 arel
'!!!!: Interlilllt ~~ Dally Interest Factor ~ Interfl9t Rata Daily Interest Faotor
1982 20X ,000548 1992: 9X .000247
1983 161. .000438 1993~1994 7X .000192
1984 11~ ,000301 1995~199B 9Y. ,000241
1985 13;1, .000356 1999 7X ,000192
1986 lOX ,000274 ZOOO Bl. ,000211J
1987 91. .000247 ~OOI 'X .0002:47
1"8e~199l 111. ,000301 2:002 6;1, .000164
--'Interest is calculated ., follows:
INTEREST = BA~ANCE OF TAX UNPAID X NUKBER OF DAYS DE~INQUENT X DAI~Y INTEREST FACTOR
--Any NoUo&! hsued "Her the hx beOOMeB d.Unqufmt will roflect an hlterllSt oalcullJUon to fHtaen (IS) day'
b8yond the dllte of the flSI!I8UlIlent. If pl'lYlllent Is llIado after the 'lntllrest Clo'llputathm dstl shown on the
~at1oe, additional Inter'e'JIt .'Hit be caloul8tlld.