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HomeMy WebLinkAbout97-00024 1111" I, III ({ 1(111 lll,1t dw lI.t"'lilll.Ii'11 Ii' II .1.1\'11 I "'lltl ,I", 'I'" I II I ,i! I { Li " I',! I .11 l' III "I i ,I ~ \ 11 d I ( I I 1 II I' .1 II \', Ii) 'I O! I ",,, I I ,Ii I ! ' I I " . I I I ! 11"'11 !Ii ,>II: 111,11 'IIIIII.,!I! ,d .!r,I'11 d\lh Iiled \\'1111 lilt' ,1\ \lliI )11 L '1.1, (Jill< I I, 'I 1'1'1111.(11( 111 j 111I1,i', WARNING: Ills IIllIgnllC) clupIlCl1!" Ihis copy by "holo"llll or photogrnph, No, !IIII''''''''''.., l'I(~qHW pit"" .;':!t,~/' . <f'r"~' II.,. '......".' '~'~ co', ~ w ,- ... * > , Jl: ~~< '''.>~f''/~~ ~~.:r,ft4C\'t.\.~ [Hl ~,;",JIlI oYm./J/1P'" /J /lJ~-- 6???<)z.:, I~,'I ~<!,C~!'\!.a~7'C h'I' lor lids ~('ltiIILlll'. .$.1,(1(1 3881383 DEC!! 21996 \Jilll' COMMONWEALTH OF PENNSYLVANIA' OEPARTMENT OF HEALTH' VITAL RECOROS CERTIFICATE OF DEATH UMOll! lY"",,, - ,,~ KATHRYN WAGNER GHEh'NIIWAW' UHDeIlI ON ......- ." I, FEMAJ,E 91~lf"t6NU"'UA SOCI"'-SlCUflITV'iUMOER I, 181 32 4615 0.-.16 0' DeAfHIIolO/'Ifl,OoIj."NIl ., 12-21-96 OIilE Of IlATII I1.4Q1lIlC1l'l'....'l ovs'" 81RTHPlACtrtf11A<l Pl..A.CI(ilOIRHfQoet;l<lll"I>/rH".''''''OCIQl"on<llhfltidlll ~1lI.. "" r ,~~ Coul~lyl HOlU'llIIJ.; -- aTtIC": Pittsburgh, PA ~O 1~IOIIlO rxv.IJ :='IOQKl ~[) =,,10 FA(ILll'VNAME("I'I(ol.nsttt,I>OfI Qt....."''''''~1 Wtlt90l!CEDEIflOFHISI'Jl.NIC0A1OlNf 1:.~INlltn.kl:'WhIlf'* N<lM \'fI[JllyM,'Pf'ItwCllbA/l, \~l ,Blue Ridge Haven West Mf'~,PufI\oRlcIll.f<<. .. white Wl<80ECEOEIffEVERlH OfctOl I I,(AAIl'-'lSW1l9d'4~*, ilIAVlVINllSPOU!lE -- US Afll,4[OFORCU1 1lI1tdf. c".1!~~~lI N...tMtllltd,W~. 1.'""Qt~o"NlllIrl~ YUn ,1Gk) ~~ . p'1;1".. O/vott-fdIS~tyf , , ' :vm.:ced...- I PA Ok! n..O.....,Otc:1tdf1'll1rHd1ll - .... 17b,~ .Cumherlaprl ~'I7lI,r"j ::ICl~~04 \\br.mley.sburg IotOTHER'a WJ,II (F... Moddtl, M_1S.~n.wn'l nl.SUt.__ -"" v~ 1.'29-26 ,TWPOfIOIATH East 17043 OIC DlNl'I ~CTUAI. RlSIOt:HCE ls.uil'4ll~ (>'l0l'>fl1ldt1 ~ Kathl n Carson iHr lHClAOONISIS....CIly/'b<l'rl,S/tIf.l'PCOOl. 77 Drexel Place, New CUmberland~ PA 17070_ ,~llfCfmf!lf)' Cttm.'ot'f ]LOCATlON':1bwrI8Iflflltl: otOl,*PIIrcf 'on-o-Lite Cremato ".cha tier tC'MTl PA 17ill!.lL- NAME mDAOOfIt:a.5Of fAClLIT'/' "FD012849-1. ~artheI1'Ore 10'.11. rnc IJ:ew Cumberland, PA 17070 NMllIgt"'Y~,~pllCf...ttd lK:F.N!lf!NUI,l6ER O,vlIlOHEO :-.~~:~~~. E P"ONOlINCEOOE;;::::.=--::::'-- ' H'sc:.ue RlFEAREOTOMEDICAlElIAMINE (MlrII ,,:1...,. _ ~._~L.r~__Lz-tl-E '.. ' ~.IX ..0 .J,,,,,,"l: 1I!1'1t",...___,~OI~WI\lcfl.....,""tlIrelh Oorol'Ntlt"'modrol<JyIr>(j.'l.CI!I'ClIo.~OIt'~'IOf)'.,t...,t/lllt*OIl\uII~. ~llll\ll' l'AI'lTUi Oth<<1qIIftc""~oonlleunnolll.lllfI,bul l"ororv_~Of\'&dlIol" " 1==== llOI~nlM~ctIltfglYtflInPAAII . /'hA,(..~td"i';...__C€""'~_"'!-;t- d-. ----r1t'fro~fccii-sf-tiJlMC~ Ofl (/ \ :=~:::::::::~;: --~------'--- WlAl ",UTOI"IV ,~. ..........l'\ Of OEAI'H OM! Of'INJURV NAlU.lllt: Pf\lOf\ 'I) tMOI,~' 0.1_1 COWLnlON 01' CAU" OIPUI"Hl Greenawalt INOM8t.lCH 1 , _0---- I I TIMlo;'iN,JUAY IN,JUFlV,;yWOf\Kl OlSCfll8EtfONINJURVOCCURRl!D I '", [) (] [1t2L.. _...LiIi.~._JIl!t. . PLACE 0fI lkJUI'lV ,,,*,,,",,,lallll,IIIH1,tklOlV,IlIlle. lbC,(J"ION~t'lIfl CtyfhlwlSllltl Mtr.Q.MC 15peI;;tyj .... a.... n. :lOt, lOt, CUIl"II"IU,.d cwlly '''''I 5IGH.QUREAN~T LERHFII::R ~ 'CIJllIn'INQ 'HYJltIANWI'I-"'''''' ,......,.."" ,.au.. OlllllMl """" tIIOf* ~'jao:'II' hll p'<.<'lOOJ,"'..1 '!~dlll "'~l 'UlI'I;tIOC11IA'll JJI . , ~ ~/ "7....... __ ....-.............". '.......lo''''fft,''''.hltft........oocVlrN''''..........-{.,tNlMfInIl...,..IIl. . . .., .,..,.......,.."." """"1', - 1'~ /" ~ ,- "'r~'" ~ - ~ ~..... "" L(IHSl~DEA . -._-~ ]DAl'IIICl"-(liMr;,r.(~I_~---'-- 'L'fIIONOl.lHCll'4Qo\HOClA"'YINQ'HnlC''''''If'l1(tt1;l1tltJ<llh'''OIlOOJ1'lr:''II\I...,..1dC''l~'''''iiI(,.,,,,,,,,~,,~.tt'l A/V1.~z..()#.t.c:f ~ 7. 2.2 _CoG 'O....~IlI"'~k.........,....oc~""""lN....,....,."."'",.ndltllllolh.t.lI..(III"""'lnn.,...llltd. """"."., 0 IL~~.![:L_ _ _____.}lL ~..__'::..L,~_ NA.M& ","0 ",DonElI90f' PlFlSON WtlOCOMPUlfDC'-'U Of Dellfll 111.m21\TyPfOlP',nt ~J.aLr r_.,..L-..,,,---,, 'Mll>>C,U'UMMI'lICOfIIONIA \,IU~..... \Jvu~' {_ L\ f\^ t)n1"'.b..I.OI.IIllnln.lICHl.ndlflltInVlll1.......,WlIltY..nlol'l,ff.'"occUfled."h.Um. Ill" 1000pIIU,lIwteu.loIM.IilMj'liM 0 :co.l ~rl. bk\--" l&""f'I,,\~ Y, Il.",*"nf,...t".. . ~ '" u. '\l t:J-'~ .'" \10\L_ u ..""'n.:~"':oo-,"",~:~~~~ ~ -.. ~I ~d~I_, :"""~";~Z;'~2~~_________...._ - .v-' [] o HofIllcldll "" rJ HoD -- P.I'dfI>eI00111ll,l1l''''' (] ",,1. ",0 .. -- C<I<>l<llllllblUlt"m'l1rd 21 - 91 - 24 ~~ ~ :oil? ,~~ ~ C' t~ ':, ; (1' ~ ,,, fj ~~ '" \, " i. , " W J1 (j r" " f' :!;> ""n W , ,.~, h \0 Vi a :tic ~ ;pi;:.1- ~15 ~ ;1:( '13" 0\ " Q': . .oIl!: r)" .;{: '8 , " ~ ~" t~ 1"\ "'0 I "6~ I; :ffi -(U .... ~I Jl P\ '., 1 lot J+lO :i 'i 4h~ . QI~ = \.Ir-..-l ,& &l+l~\O ! III \0 1<<:\0 lot . "" III I ~ .Iil c:: <Xl ~ ~ u 0 ."" 0\.1 ClN , ~~\.I . p.- ~ i ~ ..cr- ~ Qll2lI/l~ ~ .a 'oi r- ur-\.I.... no \.I g \.I~ III = QI""IJ:I III ~ 1 . CER'rI~'1..C^TION OF NgT.E:E J,l~DE;IL!WLIL?~ti~J Name of Decedent I Kathy~n W. G~eenawalt Date of Death I Decembe~ 21, 1936 Will No. 1997-0~~~__________Admin. No. 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 Name Address Mechanicsburg, PAl7055 Humane Society of Hbg, West Shore ~elcer, Sinclair & EPeley Road, Betty Reilly, 340 N, Pront Street, Wormleysburg,PA l70~3 Rh.k allJ Jail Repa,-27 "[Jple LAlle, EH~he1:~, FA 1-1{l22 Midge Dunn, 28 Eve~green St., Thompsontown, PA 17094 S4llIl-K9"rr:l~Y I 30e N "''''ont "t ....,,,,,t " Wru:mley"hl1"'g~A 1 7()4 ~ Elizabeth D. Lewis, 77 Drexel Place, New Cumberland, PA 17070 1.01 Ii "no Bob Roth I 304 CrQQJr !loe" I Ca.Illp-lilll.__E.A--.l2Oll YWCA Support Group for Domestic Violence, c/o Patti Schwartz, Syl""n I;!Qi')hts Home She1 t"'~ I ?l S_..M.ar.kel:_.~'3t.r"''''~. HArr; 1'lhllrg. .lOA-_l7l01 Humane society of HAr,isburg, Inc, East shore Shelter, 7790 Grayson Rd, Notice has now been given to all persons entitled thereto under Hani'<llu'lrg Rule 5.6(a) except NONF. _ _ -fA 17111 Date: 1/24/97 ~r, ". .....) I' . \ /. .1 .....t ~Ji;( Signature Name Herschel Lock Address 3107 N. Front Street Harrisburg,PA l7l10 Telephone Q..~~38-666l ~- D /9 C'J \''',J ,~.'C N :1r.J.., Ck. ; 0 ... en G~ r--- ~ L: p, . ~ uu Capacity:_____ Personal Representative It Counsel for personal representative ':",.' , (, '.'! \~ ,;, ~)a: cr. , ! ~ T:; -:( ~-; p '(\.. '\ ~. , c'L 0, 0- ;~ !tJfj..'; I'" illS cc P' C3u ,tv 1.\0(, (,. II ',Ii 1 fOR DATES Of DEATH AfTER 12/31/91 CHECK Hili ,,~:.l~}(\ INHERITANCE TAX RETURN l~o~::~u~:~DIT IS CLAIMED [I ..}fIJ_ RESIDENT DECEDENT i flU NUMBER (OMMONWEAl1H OF PENNSYlVAI;lA (TO BE FilED IN DUPliCATE ' DEPARTMENT Of REVENUE I 21 97 -00 4 _~ARR!J.lliU~ol~J!'0601 WITH REGISTER OF WillS) COUNTY ~ODE .. 2 YEAR IWMII >- D'3R'E'ENAWAL'~';" ttt. T'HORly~i;'~:-------~ m .. r""w~lo{~m()/Nl;Pe\~.ry'l S~[)b~~uTI:g;,-S -P:Ar e e It 7-0'4-3--'~- i \O~'~I~~U~';~~~'~; _r~';!);A{'/96 J"~/';'~'/26 L"," C~mberland .~_~_ ";-^""";"i;,""""':~~::':"' "ill'"" ""," ""'"''''.1'"'''''''''"''' IlU:'I~_ . r':~I ~:(IV:::~'~~':U"'~~~.=.'._ ~ lZ..b<1. Original Return ::.c:~cn frlre~ 0 4, limited Estate [ J 40. Fulure InhHost Compromise ~~9 (for dotOI of death after 12.12.82) ~ctl [J 6. Decedenl Died Taslale iJ 7, Decedent Maintained 0 Living Trull < (Attoch copy of Will) (AlIoch copy of Trust) -..--...- ALL CORRESPONDENCE AND-CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO, ~~ NA'1lerschel Lock, Esquire -~0310711~O.AOF~~n~ st-;ee;----.--- 8~ ITIMioNfNLiM8Tf-------~-,... ._.._..___...__..._~_..___o__~_. _ Harrisburg I -FA 17110 ---- .l} l7--L 238-666l . ..,,~,,~.,~~.,c=,==c_=~=-~~~=~=="=c=~,==~=~===~~"=""=-'= 1. Real Ellale (S"edule AI III .1.!?.,9_00-,-00. 2. Sla,ks ond BondI (S"edul. B} (21 ---:--':-:::.:.--- 3. Closely Held Stock/Parlnenhip Interest (Schedule C) (3) __":':.=_~:.=-:::.=___~___u_. d, Mortgages and Notes Receivoble (Schedule D) l4) . -..~.:-=--=-~-=-=-"":: .-....------. 5, Ca~h, Bonk Deposil$ & Miscellaneous Personal Property (5) ...-,_ dO~_'~..?}_'~__~__~~_ ..--.-----'" IS"edvlo E) 6 Jointl)' Owned Properly (Schedulo F) 7. Trons!e" IS".dul. G) (S".dul. L) 8 Total Gross Aueh (tolol Lines 1.7l 9. funerol Expenses, Administrotive COSh, Miscellanl10us Expenses (Schedule H) 10, Debls, Morlgage liabilities, Liens (Schedule I) 11. 10tol Dfldudions (Iotol lines 9 & 10) I,'; J t , , " ) I 2 [.I 3 [) 5. Remaindor Relu(n (for datlu of death prior to 12.13.82 Federal EUalo To)( Return Required Supplemental Relurn e, Tolol Number of Safe Deposit Bo~c; '" '" S '" !:: .. '" '" w '" l5,458.86 (61 171 .. 97,380,85 IBI (9 ). _ u_~-,..2_.~ 5 . l~ __~. 38,294.8l (101___.__....._.__.__.____._ 46,589.99 ~---~--'--~-- 50,79 O._f;l~_...._ 500,00 -50;290;.86--.- z '" S => "- :If. '" '" 12. Nflt Volue of Eslale (Line 8 minus Une 11) 13, Cnaritable and Governmental Bequests (Schedule J) 14. Net Value Subject 10 T~)( (Line 12 minus line 13) 15, Spousol Tran,lers lfor dotes of dealh aflor 6.30.94) See Instructions for Applicable Percentage on Reverse Side. !Include volues 'rom Schedule K or Schedule M.) 16 Amount of Line 14 lo...nble al 6% rate (Includ~ values frClm Schedule K or Scnedule M.l 17, Amount of Une 14 lo)(oble at 15~'o rote (IncludB values from Schedule K or Schedulo M.l HI. Principal 10)( duo (Add to)( from Lines 15, 16 and 17,) 19, Credits Spousal Poverly Crodil 5:i()&()~OB _._.._.________ _____...._ + __0_.------- __~_ + 1111 (12) (131 (14) 1151 ...__.___._._~_.......___.__... . (16) .. .._..._._n'__ ..._.___..._..... .06 . 50,290,86 u U___X ,15 = 7,543.63 1171 {IS} lnlorest Discount 250,00 ..__2.L~.!?Q_~()_O_ 1191 (201 20, If Line 191s greater thon line 18, enter the difference on Lint) 20, This il Iho OVERPAYMENT, miD ~ >- Check he(o if'vou ~re requosting tI refund of your overpayment. 2,293,63 21, II Line 18 is gracler lh<1rllin':l 19, enter !ho dilfl1ronce on lino21 This is thil TAX DUE. A_ Entnr the intermt on rhe bolonco duo on Line 21 A (211 (21AI (21BI 2,293.6:1 I e. Enlor Ihe tOlol of line 211.lnd 21A on Line 21B. Thi\ is Ihe 8ALANCE DUE. Make ChClr.k Payable to: Regtster of Wills, Agent ..___n .==c-");.-..---BESURE 'TOANSWERALlQUESTIONS ONREVERSEcSIDEAND:TO:ReCHECK'M-ATH'-~:;j(------' Un-;f;penalti~~ per;~;, I declare th~t -i~h;::;-;~;;;i~~-d-lhi~'~;;;~~, includi-;;-9~-~~-;~pu'I;.ying -s-~~~'~i;s Clnd ~~;~;~t~""~~d~- th~-b6'~'j"d~y-Ok~~(~dgo- C;;-~'db-t .t is hue, (onocl and complole,. I daclafll tho! all roo I ustote has boon roporlQd ut true mmke! voluo. DcdCHotlon of propatot othor thon tho personol repro~e..tdti.. bosed on 011 information of whl,h prflparer hos any kl1()wledge ~i(J~iATi.jAr'OrpToo~.~"{5P-6i'15i1l(l'r6R iillNl,'R-E!U~-li'--' . --.A(}C~I~-~---- .-.- .-----------.-. -- - -----,------. .-. -.-- --. ---.-.. ------, DAT~-- n___________. -. .{~1:lr,...~)t}4--\' '. 1_;,." ','. 77 Drexel Place, New Cumberland, PA 17070./ /.1\,,,,, 'i'/ ~'G.I~.'._.'.UUi:;fl.iif ..VPA.R.F.J~,: (,).~.I~!f niMJ R[rIlIS!~'IA..'.;'1[ ';\-()(j~!~;-' DAn r-j ~. J, .3107 N, r't:ont: SI:,., Hauiebut:Q,PAn l7110L/IY/1! RfV,1509 !Xt P1,UI ~J~'9C1 'Io(~ COMMONWEAlTH Of PENNSVlVANIA H~HERITANCE TAX RElURN RESIDftH DECEDENT SCHEDULE F JOINTLY -OWNED PROPERTY -.. -" - -- - ". .- .... . ." ~-~~---_.-_.~------_._-_._._-~._.~- -~JfL~'r~~~~~;4 ~". ESTATE OF GREENAWALT, KATHRYN W. Joint 'onont(.), _____ tlA~~________.J.__. c' ,... __A.D'pR~,SS."._.___.___ ,._ .___~ELA TI()~~.HIP TO D~~IDINT A. Elizabeth D. Lewis 77 Drexel Place Non- family New Cumberland,PA l7070 8. C. Jolntly-ownod proporty, ITEM LETTER DATE FOR NUMBE JOINT MADE TENANT JOINT 1. A 12/28/ 5 2. A l2/28/ 5 DESCRI PTION OF PROPERTY TOTAL II ALUE OICD'S OOLL~ IIALUI OF OF ASSET % INT. DICIO. T'IINTEREST .-----------...- _...---,,"-.- New Cumberland Federal l3,OO2.13 100% 13,002.13 Credit Union Checking account NCFC(J Saving account 2,456.73 lOO% 2,456.73 TOTAL IAI.o ".Ior on II." 6, Rocopll"lollcml $ 15,4S11.!Hi _____---,--____._~_..______._.H_..____._...__.. ....." ..._._,.._..__ ____ (If more space is nendod inser' oddillortalllw(I!s of wnw iiIfl) " '.".''\ .J )'A,'" i......; ~ .~., ,,~, .".1 . (,......'..,-. ,',.' '.' , , '~. ~ :,.-,: .", .. ,-, . " ;:; .'~" f' ,.... .. A~ S~rTLEMENT STATEM~NT U.S. UEPARTKENT OF HOUSING AND URBAN DEVELOPNEHT 0N8 NO. 2502.0265 B. TYPE OF LClAN 1. I l FIlA 2. I ] FllIHA 3. II COIIV. Un 11.1 6, filE NUNBER J7' lOAN NUHlIER 18. NORTIlAGf INS CAS{ IUWf 4. I l VA 5. I ] Conv, lna, JTINSAAN C. NOTE,Thl. fono 10 furnlolled to glvo you 0 OlotOlllOf1i of .ctuel IIttlOlllOnt cooU, _",to paid to and by tho .ottl-.t O~"'t .re .ho..., 11_ IIIrkod "[POC]" WI" paid ouuld. the oloalng; they or. .hown here for Info/'llltlonal pur"",.. ond e" not Included In the totela. 5,0 10.96 (8/JTlNSIWl) D. NAHE AND ADDRESS OF BOIlROIIER E, NAME ANO ADDRESS OF SEllER F, NAAl: AND ADDRESS OF LENDER Jeffrey D. Tlnomon Eatal. of Kethryn W Breenawelt Comnunlty Benko. N.A. P.O. Box 350 Nllleroburg, PA 17061 G. PROPERTY LOCATION 312 North Front Street Wormley.burg, PA 17043 Cl.I1'berland COLJ"lty, PA N. SETTLEMENT ABENT South Contral Agency, Inc. I. SETTLEMENT DATE PLACE OF SETTLENENT 3401 North Front Stl'..t NorrlaburR, PA 17110.0950 January 28. 1997 J. SUMMARY OF BORROWER'S TRANSACTION 100 GROSS ANIJl.IljT DUE FRDlLPORROIIER ~ 'nn'.'" Sel.. Pr .. tlQt ~Att~~":rC!oertv-;; '0/. 105. K. SUKKARY OF SELLER'S TRANSACTION --n.. :11: !~:;~'IT:~:!~~,"'''' - =f"'.. ' (> flU for hems paid bv ~,.Il.,. ~I'l - 406. Cltv/town taxes to /.07 """'v .._.. - ??7n 'l~~ toxe. n'.".07 '0 07""-':07 6930 M::;: C.u..l .......0'.,..07.n . _ 14\0. 41" 412. 77,669.17 420. GROSS AMOU~T DUE TO SELLF.R ,no ""''''T! 0"' '" 'Mr< '"' 0". '" C" I .0 1101",,_,,0.00;,," .... lo",uo,looo' _ M1.l100 on 1E;.02..-S.ettlp.ment.J:harces t.lL.S..e..IIIllI" Ii".., 1'>03. Existina Loans Taken Subl.lli t", :.._~~~~~~_~l Nt' to ~endov~' ~~o' Ino I", AO 1n I IIn.'4nr 1rl for ftMl:!: cs.id bv jflllll' in ""tvRn'-C.- 110,( r It-'!Ltown taxes tl'l 7. County taxes to ',n. School t.xes 01-28.97 to 07'0'.~ 109. ~ater Sower & Refuse 01.28.97 to 0 .n1407 I"n 1',,, 112. 120. GROSS ANOUNT DUE FROM BOPRONER 200. AMOUNTS P' '0 'v 00 ,. '''''' O. 0' Wt~:~~~:~~1 L~:~J;; TaKen Subject to r,;v. ,05. 206. "07. I>n. l>no 75,297.02 , ..m..sJl_ ... 0" "ii-, Adjustments for Items;;;:'-;'-;;-T~--h\J 210. Cllvltown t.xes __ ~ ", Cn"o'v to_.. 0'.0'.07', n1.".07 ~ <:l'h,,,,,1 taxes to >It ~ --'~it 219. 519. 220. TOTAL PAID BY/FOR BORROWEk 60,012.55 520, TOTAL REDUCTION AMOUNT DUE SELLER ~C:ASH AT SETTLENENT FROM/TO BORRDIIER 6BO. CASH AT SETTLEMENT TD/FRIl4 SELLER 30" Gco.. Am, Due j rom Borrow.r ( II ne 120) 77,669.17 601. Groa. Amount Du. to Seller ( II ne 420) 75 .297,02 302. Less Amt Pold by/for Borrower (line 220) ( 60,012.55) 602. Le.. Reduction. Due Se'l.r (line 520) ( 26,9\7.05) 303. CAS~ IXI FRDlt --N TO BORROIIER 17,656.62 603. CASN (XI TO [ 1 FRIl4 SELLER 48,339.97 The unde"lgned ~ore~~.~.j""'\'/~ , ,,:'eted copy of paga. 1&2 of lhl' BlatemeoT & .ny IltechmenlO roforrod to hlroln BORROII-->'---.. ,'I..) //r= .: E.,o,. of Kethryn W Greene.olt 71' : SELLER ~affray~~~~~ SE~ER ~~Jl1 ,je) 111.10" (3-86) RESPA, HB 4305. ~ ,-' , ., --"-I-tv/town taxes 511. County taYACI 2..12. School taxes F bv S.I I.. '0 o,.n..07 On . .97 12 .~S " " to 26,951.05 BORROIIER .P.. '2.1 ..,..C~ ~._~--- - InlD. Totol Sale'/Bro'e,. 'OlII1lluLlloL..IAull t41 Prl~L.L.____ __ =....P.llllJ.mu.t~ll1jllCl...lJJnt...o) II follOllIL- ___.___ 70'.--1: to _._____ _0_ 70'_ I to "___. ~3. Com, I.. Ion hld..J.L~ 704. ~Qc...L~IN CONNECTION I/ilH LOAN BOl I Oon Qr.iUa4.t.llllLI.cL-.......z:;~-...l.LJ:oom'"l tv Bon., N A. 'E!.OZ. Loan DfscOt..nL- X -1i1_. . fiO.]. AqprQ,wl ,,,,,. to P. Scott Archibald AQtlraJ.u.n..._ IB04. Crodi~ to C(.Gltl1JU"OBU 01 Greo"r HBbq_ llQi......Laan A~{fC8tfDn Fee _ to C~ltv Il.!lnks N~A.~ B06. ~Ortoll.llLlllL...Aoo. F.e __. to_ a.o.l-.ASsumtlon Fo~ !Q B~~eDarotlJ!Q..tu to C";runitv Bonk, N.A~ ._ 810. _ ______ 811. 900. ITE~S REQUIRED BY lENOER TO BE PAlO ~~r.u.uLom __to ,., ~~.Jnall!:All~ 90S. u.QQO...~.fpOSITE~"iiii ~ENDFR ~~lDrd Insur8nC& ______ 1frQa~rtQ9a~ Insur8~,e 11Q.QL..,Cltv/tOlo(n texes 1';"ni." ,......untv rues t005. School t.xe; ~--- 1008. I1no '.Ul.Ll:I!ARGES ~'-:~;:~~n~r";1;1~'~:~~~~e :~ South CentrQ1.A.~ 10k-, W.03. Title Ex~mination . to 11104. Titte Imurance Rinder to 'H~.QJ!i\IIm1t preo.rU1J!D t!t- ~~t.al:.Y..fee!l _ to ....LtoL..At~'.J fees to ~~.rsehE![ lock Escul~~ (~1!Jdes above item mnbers! ~iQ8. Title Insuronc; to s~outh Central Aoency Inc. Cinctudes above item n~~ 1109. Lende(~o.'illo.e S " . c::o 1.L1.Q.-O,i'lM.r's CoveraQI:. s: _ ZJ i1i1" 100/30018.1 to South Centr.1 Acencv, Inc. .1Uz..__ _. _____ 1113. J'-\I~RNMENT RECOROI~w.ANO TRANSFER CHARGES "01. RecQatiDfLEJ'=UJ~.L.Z!L.~r.l.o.e I 33.S0 'R~S 1202. Cltv/Countv T~K/St.~l---.D'ed S 'Hortaoce S ~.llu:LlJlUi.tw!IlS.L D.ed S 1 lOO.OO '~QctQ~Q~ ~ _ 1204. ~to. S.lli.tnl'.11J!(Ll'tt..._...~QJlQtV Recorder 01 Deed, 1205. to4tg. Satisfaction Fee to CLlfi:>erlend County Recorder of Deeds 1lO]. ADDITIONAL SETTlEMENT CHARGES =: ,UQ1. Survev _. to 1102. Pest InsQ~C.tUHl _______~to WiJ. W.ter. se~LLr~.lISL- '^ ^' l1~fuAUw.J:S:; Reinn to .;'t. 'v., ..~ ,ri./ri. 130S. ~DiRiii--- BOIlRO'oIER . S FUNDI AT PAID f~C>>l SELLER'S .~~..~T -- -Moo -- ". "'.nn IN ADVANCE :ntnll to 1.0 vftarl to ~ Idav( dllvs t) month. II'IOnths ~;h. mnnthg o . g S Q S Q I o I g S . . month. ''''M'. ~. ""nth :; =;~ P~L.JiIQQ1b..- ^"" ""'~:~ ~;~ ;;; no. ., 3'.00 - \ (POCI roc. ''''<~n 75.00 ~ --- <Ann 7<n on "nn 12,00 . OO~nn 15.5Q 2,3n.15 923,50 W~Cli^v.~ li.^ O.pt 01 HUO 1400. TOTAL SETTLEMENT CHARGES (Enter On Lines 103, Section J .nd S02, Section K) By lIgn/ng page 1 of thIS .t.t....nt. the Ilgnatorl.. .cknowledgo rec'lpt 01 0 c"""tetod copy of page 2 01 thll 2 pagl "ot-"t, l/n1."" ~ P.vaH (B/JTINSMAN) Certified to bo . true copy 'c{ fi11/tU Inc, ~;J:~t;\i:}~;S,~jj,;~a ~%l~--4'-. · .q-(>,l( ~:cT.-"t~rl~k3y.,)i\'~r,~;,f..::i~J~ ~~';i~l, '::f('~ '~~I"0.:io. '. If"{~~~"I" '" 1 l:J!> 1~'"\I,'~'I'IF~'~ I~ .~;. t.\,., '"i;.". I tl -r."f . '\ I ~ I " \' j" r~' \ \ ? t . ~ 1 ~"; \'" 'i ' r ~,'1 1~' f" f (!:.,-~.I'j \",>1'1, ,',),,, ,.,~'III,':I"l-'"",,,.LI,., ii), " 1 l",\0""< ,n [kHIOl1d S\'/I.:" I j "~";;-v~.' L\il ,"lll~"t,)"".,i I;rp_.:~!); , ,I ,."H\'I'll', Idt.,:I',(1 'J.\~Iir' ,,,,. :I,!,' (7171 ~1!Jl.8,Jl;J J'~' ~ i ~J4(tj' Il '" """" ". '.'"'''''' ,,:;~ ~ w" ",,,,,::;,;, "";:',,, ",,,' W" ,,,'''' ,,,;'~,,. """.,..". ",,,m",,,,''',,,,, ,..",,,.,,,, "",m' ",," ,',," ,"",,' ~'.~ riff\ '. Hl'liI:b. 1\'" I'l'ol""iy nf: ~t~ ~ N,\,IF r~I~;:;:::;:;,:::::~';1.;;'::~':~' ':;":::';k"'o:':'~~;':'~~';:::~':J~:J:':'~:";;';::;::'::';:':''';'':;,::;:.::::;:~:. i1 ~"-~ ''''liel,,". ~~)R :,.:,~~I:,~\~,."."~~'-,,'.":',,~'~\"','~,,-~)"~';".. ----.-,,--~-.--..., ,---.---.-..,,-...-.-.--.,,---.--...-~..--.~-- ,,,-' -.."'.....-....-.. .-' \.,~.'~~"'..i'c~',...::;;.;c.L:~.-."::>...-...,...~'--.:.\,-..'. _~ ',. '-S __...___..._u_,.._~~_____..J11;scRlf:r1.l1..N.~,-,--~-.-..-~---..------- .. APl:~~.V ALliE . ~p;Z /\\)JFS Dlr\\,;DND EWP,'\S;'3 sr{rJ~ lUNCij ')nc"- t4..kal~lit yhltn (}I1.d byr~.-ti.\~-) ~_;;tylc~ :::,iTl~1 rrountinq -~ '~ .~~,\ c,H .....H!l tvX.> (2) n11 md :rl'\')')L' dLl\IlY1c1'. t,nd niqht (\l \ ibS.-~ 1 ~$~ mll\Ot" \:,,,,1111,1 d:iJlJlrlnc1".. f~~'~'~, , \ 'T':i>:J '.~ .",.u.' ,-,~, I I.",.;f"..~~'j:ti.~: i',~,JOR DI,\J~(JNrG: ]'''10 t'n\1I1d (i\l1ti(~lC': c,.t.'!Ic) cut: cll<l,\y')l)Il'\ ~~ "I"r~ i'hJ:;I\l.c,'O'.1nt:;, I.@J.flamjndl'" .1,.1m\\ :~~.'" r ;;~'j Cae,lt '.""iql1t, 0, ,',I "'N-,~t iJJ\'Dl I 1.:H.1l1U'\.[(jI'ltic) ~~~ " I ?~~,$'( (:1." ci t 1'; ,,:n \J:;{;"''"..: \ }\,>;Kl. Cobn ti .\,'.......&i.'..~..;~'Yl.~i.'...: \1:1,?.~~..; ffl.1J :VH~H Dt!\t'~,X,I[(',l ~;j.1;lt roul~d ( 1\12-' -:1t;llo) GUt. dl(Yfon\l'~ ~~';;,.\_.f"~J1 ,.. 1'\'~i\sutb~UnCGI (':/w:'tailJ"!n\l"'JI.') 1,",[1\" COIlIlc1 ,_. "1. li~\,\ -..:. -'<""l.,t '.-......l~l. ;.').1.>.. ,__~.,I.'.',-.',I ',-' ,"J!.i)o \' ~'~~..';"', 'f '.u' . A"_~"" .. ,~ti?'_~:?J\I' I r_. \";) Cli:u:H '[I VS!. \ \.:-;; i r'~} ':0] .J'.': ,,~(fri=:f. ir\1 'llk::r,,~::'LUH1'Ji'lC: Ii ,.i:,',r\'li'" i ~, , ''''{(~''''''i ,~i;6"")' Ifr.;i;.Jflt'f". ""'II)Le ,,,,")>I11,,,,,".r";:1 ."1th mtnoi' )".j >'C1:J.I\");\' ~-!)\"'~0' \ ......"'.~~f\ "1"\""L ;CY" ',',_,.', \~i~Ji}:..".~)..' Ir--:~~.,,:.~..; .-' ,.',' .i '" ,: ..r~?{,"'1"- . ~ " 'h:']i'inu!.' ]c"f!-',n 1::LL .. , \ \'(~~ I }~~~ f~"'1) I~~',""'e """" we.."" ~~.,~ . ~tiri ir~.'" I \G'e;\~ "Jr,:.Lqht , ,!nidr.\ '.>.:1t').;w.li,C\d 1.n:nCi\i:l:'. C"'Fi,i,t;., 1~'~l4J I~~~ ,:.,.Ld \'.lL"" ,11;;\l1:'1:'[)I,1 W\1':';:'1: OJ,', ",,')0 '.:C),/ :t;:~~)~! ~ .,. Tho fnl'tlgning t\l'l'l'lIisnl is mdd.. with Iho '"11lpl'sldnding Ih,11Ih" t\ppl'alS'JI' aRKlIll1''" Ill' il,dlil'I,"\\iIh V .t,j {f-- \ !'I'SI)!",IIO any aclion Ihal may 110 Inkon on Ill<' IMsis oi Ihis i\ppl'aisnl. '. ~\\ "~"~., ~f~'~ .~~ ~'*l 1~~~ ,,'. APPRAIS~R' .-~-_.- DATE --.-----~ I~~ '0'~~~ - '?l,~1;ro~€S\l5j. ~t\iJ~}~(-<PJ\" ;v~r~:vt\~~~1~t1W' 4~~A;f'\J~ ~~~(~~i~k'~ >',;jli "A'~~ _l,j'iN, ,it;{!~~~I,' )';![";"~'I\'.,;i1khyc."j< ~\I,I, ~,,'k'I\'.,}1,..r,''''Jj i~\'(~"\ "I,-<>'I~ "'~';::?~I j~lk1:.- ;:ii~>:~l~'~?~i~2.'J~~lf;2i~f~~~'f( ,d~~(ife.~:ik'~~'i{ M.~~::ifl. '~"ili?~~(@,K'!~ REr"EASE KNOW ALL MEN BY THESE PRESENTS, that I, BETTY REILLY, of ~lormleysburg , aoknowledge as for divers and other good oauses and valuable cumberland county, psnnsylvania, do hereby considerations, have remised, released, quitclaimed, and forever discharged, and by these presents for myself, my heirs, executors and administrators, do remise, release quitclaim, and forever discharge the said Elizabeth D. Lewis, Executrix of the Estate of Kathyrn W. Greenawalt, her heirs, executors and a.dministrators, of and from all, and all manner of action and actions, cause and causes of acti on and actions, suits, debts, dues, duties, sum and sums of money, accounts, reckonings, bonds, bills, specialties, covenants, contracts, agreements, promises, variances, damages, ju~gments, extents, executions, claims and demands, whatsoever in law or equity, or otherwise howsoever, which equity, or otherwise howsoever, which against the said Elizabeth D. Lewis, Executr.ix of the Estate of Kathryn W. Greenawalt, I ever had, noW have, or which I, my heirs, executors, or administrators, hereafter, can, shall, or may have, for, or by reason of any manner, cause or thing whatsoever, from the beginnings of the world to the day of this date of thes~.Eresents. ,) IN WITNESS WH~REOF, I have hereunto set my hand and seal, thi$i ': .28t:t1'ili '\B:Y of June J ' ~997, _.-L?- -' / ' BETTY REILLY, ~(;/fl u !-~ ....'---... ~"""'--'," . ~. c -, i.~-'i n I '. L1 N I '"I ~J r', ,.:;.) ; i... PI :J ex 0 U I. /' / ') COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE I' * DUREAU or INDIVIDUAL TAXES INHtlHTANC[ TAl( OIVISION O[PT, ?80601 HARRISBURG, PA 17128-0601 NOTICE or INHERITANCE TAX APPRAISEllI;NT, ALLOWANCE OR DISAlLOWANCE OF DEDlICTIDNS ANn ASSESSMENT Dr TAX In-l.U U lH lOl.W DATE 10-13-97 ESTATE OF GREENAWALT KATHRYN W DATE OF DEATH 12-21-96 FILE NUMBER 21 97-0024 COUNTY CUMBERLAND ACN 101 [~-==~~~U~~~R~~~~~'~==~~~~1 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 ~ R 'EV: iS4-j - E if -;. F i; - [riFij7 Y -NoYi C E - 'OF' YNH Eiii i' ii Nt 11. - TAX' A 'p PRA- is E;'lEN:r-; -A i:.1'6 w ii N-c E - OR -, -,-, - - - - - - -. - -- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF GREENAWALT KATHRYN W FILE NO. 21 97-0024 ACN 101 DATE 10-13-97 If an assessment was issued previously. lines 14. IS and/or 16. 17 and 18 reflect figur'es that include the total of ill returns assessed to data. ASSESSMENT OF TAXI IS, A~ount af Line 14 16. A~ount of Lin. 14 17. A~ount of LIne 14 18. Prinoipal rax Dua TAX CREDITS: PAYMENT RECEIPT DATE NUMBER "02:::27791 ---'iIAfii52 1 1 06-19-97 AA211440 HERSCHEL'LOCK ESQ 3107 N FRONT ST HBG PA 17110 TAX RE7URN WAS: (X) ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1, Raft1 Estate (Schedule Al 2. Stocks and 80nds (Schedule 8) 3. CloselY Held Stock/Partnlilr'ship Inhr9st (SchQdulfl C) 4. Mortgages/Notes Receivable (Schedule D) S. Cash/Bank Deposits/Misc. Personal Property (Schodule E) 6. Jointly Owned PI~op.rty (Schedule F) 7. Transfers lSC'.hedule G) 8. Total A.uets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. DebtSi/Hodgage l.iabilities/Lions ISchedulfl IJ 11. Totsl Deductions 12. Net Vmlu8 of Tex Return 13. Chllrltable/Gov8r'nllumhl B.~uests (Schedule J) 14. N.t Value of Estate Subject to Tax NOTE: at Spousal taxable 81 taxable ot rate Lineal/Class ^ rat. Collateral/Clasa B r~t9 DISCOUNT (+) INTEREST IPEN PAID (-) 263.16' ,00 CHANGED I Il___lliOO 0 . 00 (2). .00 (3)_ ,00 (4) .00 (5) 6,921.99 (6) 15.458,86 (7) ,00 (8) NOTE: To insure proper credit to your .e~ount, submit the upper portion of thh form with your tax payment. 97, 380.85 (9) 1l0) 8.295.18 38.294.81 llIl (12) (13) (l't) 46.589 99 50,790.86 500,00 50,290,86 will (15) . 00 X ,00= (16) .00 X .06= (17)__ 50, 2~~ X .15= llB) ,00 ,00 7,543.63 7,543.63 AMOUNT PArD 5-;-boo .00 2,293,63 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN, TOTAL DUE 7,556,79 13,16CR .00 _._~----_. 13,16CR . IF PAID AFTER DATE INDICATED, SEE REVERSE FDR CALCULATIDN OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN fI, NO PAYMENT IS REQUIRED. IF TDTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIIlE or THIS FDRM rOR INSTRUCTIONS.) '. RESERIJATtONI Eltatu of decedent. d~Jngon or beforlil OeclIllber 12, 1982 ~~. if any futu!" Jnt.rut In the uht. htranlfar'rld in POI...lion or .njo~..nt to CIa.. B(collaterall b8neflolarl.. of tht dee.dlnt after the ,expiration of any 8state for 11f. or for yearl, the Co..on~.alth herebY 8xprellly ral.rve. the rIght to apprel,e and a..... tranlfer tnh.rltan~. T~X.' at the lawful Cl",. B (collateral) rat. un any suoh future lnt.ralt. PURPOSE O~ NoTlCEl To fulfIll the requlrellftnh of Soctlon 2140 of thll Inhorlt"noll nnd Eltllhl T~x Aot, Aot II of 1995. (72 P,S. Section 9140L PAVHENT, Debeh the top portIon of this NotIce ilnd SUbMit with your p'll/lIant to the RagistClr of WUlI printed on th. rev.rlle ,Idl. uHak" check or lIonay order Pflyabhl tOI REGISTER OF HILLSJ AGENT REFUNtJ (CR): . refund of a ta)( oredit, which wes not rtlquuttld on the Tax Rnturll, IllY be requutod by oOllpletInll an "Appl1oathln for Rofund of Pann5ylvania Inhoritance and Eltate T8X" (REVMl113). Applioation. are evaileble at tho OffIce of tho Register of WIlls, any of the Z~ RevenuG DIstrIct OffIce., or by callIng the cpeolel ?4~hour answering service nu~ber. for forMS orderingl In PennlylvanIa 1-800~~62'2050, outsIde Penn,ylVflnia and wIthin local Harrisburg 8roa (717) 787~8094, TOOl (717) 77?"2252 (Hearing Impaired Only). OBJECTIONS: Any perty In Interolt not satt.fled wIth the appraIse.ent, allowance or dIsallowance of deduotion., or a.......nt of tax (Including discount or interest) a. shown on this Notioe .ust objoot wIthin sixty (60) days of receipt of thit Notice b!/I --written protest to the PA 08parhlllOt of RevllnulI, BOllrd of Appeall, Oellt. 2810Z1, liarrlsbur'g, PA 17128-1021, OR --elClctlon to hl'lvO tho nthr dGtclrlllned ot audit ('If the account of the Ilersonal reprlilSenhtive, OR "-appnl to the Orphans' COllrt. ADMIN ISTRATIl/E CORRECTIONS: Factual errors dIscovered on this assessment should be addr~'s.d In ~ritJng tOt PA Departmont of Revenue, Bureau of IndIvidual T8X8', ATTN: Post Ass8SSIIent ReI/law Unit, Dept. 280601, ~tElrr1sburg, PA 171i!8-fl601 Phone (117) 787-6505. See pllge S of the booklet "Instructlons for InhllrH21noe Tax Return for II RuIdant De~.dent" (REV-IS01) for an .~p18natlon uf ~d.inlstrntJv~l!/ corroctable errors. DISCOUNT: If MY tax due is paId wlthln thnul (3) calendar Months after the ducGdent's death, 111 flve porcliInt (5iO discount of thQ tl'lX paId Is ollowed. Pf:NAlTVl The IS% hx aMu.ty non"parUo:;Jp8tIon pef'l8lty 111 co.puted on the total of the tax and Interast au.uod, and not paid bofo're January 18, 1996, th. first dl'lY tlfhr tho "nd of the tft>l llllnUty pRriod. This non~ptlrtlcipatlon penlllty Is appealable in the 'SMA .anner and In th. tho sa.. tl.. periOd 85 YOU would tlppeal the t~x and inter..t that has belln l'IuQSluld 8' JndIc!'lted on this notice. INTEREST: Interolt i. charged beginning with fIrst day of dellnquenc!/, or ~ine (9) aonth. ana 01'10 (ll dftY frOM the date of death, to the dah of paynei'lL 18XIII whIch blllcaSle delinquent bGfore January 1, 1982 bear Interest at thl rate of Ilx (6%) percent par annUlI celcultlhld et e dtlib rata of .000164. All t8X.. whIch bece.e dellnqulDnt on and after Janu8ry I, 1982 wIll bllar interest at n rata which will vary fro. ce18ndbr y.ar to cal.ndsr !/9ar with that rate announoad by the PA Oep8rt.ent of Revenu.. The spplicsblA Interast rate, for 1982 throu~h 1997 srel 't!!!: m!!L!..!L8!ll! Oftlly Interut Fl'ldor ~ Inhrut Rlllfl Oally Interollt Fsctor 1982 20% .OOOS'IK 1987 9% .000247 1983 16% ,0110438 1968-1991 Iii( .OO03~1 1984 11% .000301 1992 9< .000247 1985 13% .0003S6 1993~1994 ]X .OODln 19&6 10;( .0(1027(1 19IJ5-19-97 9% .000247 ~~Inter(l.t 11 calculated .. folloWl1 INTEREST = BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINqUENT X DAILY INTEREST FACTOR M"Any Notice iuued afhr the tax beeo." delinquent wIll reflect an Int.rut calculation to fiftHn US) day. beynnd tho date of thl nll.UIIOMt. If pay.ent it .sde after the Int.rut (loMputatlon data IhoNl"t on the Notice, additional intere.t .ust be caloulated. j I::) /),--~'; " BUREAU OF INDIYIDUAL TAXES INHER1TANCE TAW DIYlS~ON DEPT, 2('10601 HARRISBURG, PA 171Ze"0601 COMMONWEALTH OF PENNSVLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT ,'../" *' In.llll u ,,~ IOI.HI HERSCHEL LOCK ESQ 3107 N FRONT ST HBG PA 17110 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 11-10-97 GREENAWALT 12-21-96 21 97-0024 CUMBERLAND 101 KATHRVN W ~Amount R'~ltt.~ MAKE CHECK PAVABLE AND REMIT PAVMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTEI To in.ur. proper oredit to your ~ccount, subnit the upper portion of this forn with your tax Plymant. CUT AI.OND THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ifEV: i i,ij'niC Aiip.. f oi-: 97") - - - - - -.. ii - i NHER i T ANe if - T AX- - S T iI"i EM ENT -oF" - Acfcouiif - - i... -- -.. - - - - - - -.. - - - - - -- ESTATE OF GREENAWALT KATHRVN W FILE NO, 21 97-0024 ACN 101 DATE 11-10-97 - . TIllS STATEMENT IS PROYIDED TO ADVISE OF THE CURRENT STATUS OF THE STATEL ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT, 10-06-97 PRINCIPAL TAX DUE, 7,543.63 PAVMENTS (TAX CREDITS) 1 PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (- ) 02-27-97 AA185211 263.16 5,000.00 06-19-97 AA211440 .00 2,293.63 10-27-97 REFUND .00 13.16- TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. 7,543.63 .00 .00 . IF PAID AFTER THIS DATE. SEE REYERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN n. NO PAYMENT IS REqUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCRI, YOU MAY BE DUE A REFUND. SEE REYERSE SIDE DF THIS fORM fOR INSTRUCTIONS. I TOTAL DUE .00 PAYHEHT I Dttach t~ top portion of thi. Notio. and 'UbMit with your paYMent Mad. paYable to tht na.. and addrt.. pr Inttd on the reyer.tt sidl" If RESIDENT DECEDEHl .ake oheak or lIorlllY ordllr payabll tOI REGISTER OF WIllS, AGENT, If HOH-RESIDENT DECEDENT .aka ahlck or lIonly ordlr payabI. tal COHMONWEAlTH OF PENNSVLVANIA, REFUND (CR)I A'refund of a ta~ credit, whlth was not rlqul.ttd on tht Ta~ Return, MSY ba rlqua.taa by co.pleting en ".pplicaUon for Refund of Pannlylvania InharHanea IInd E.tD'i:e Tali(" (REV~131!). Applioation. ar. Iluellabh lit the OfficI of the Rluhter of WUlt, any of thl Zl Rev.nuI Ohtrict OHlolI or froll the Dapart..nt'. Zit-hour antwlring ..rulel nll.blr. for for.. ordll'lnll! In Plnnlylvania 1-8110-:562:-Z11S0, out. Ide Plnn.ylvflnlB hnd within local Harrisburg area (711) 787~81194, TOO' (717) 77Z~ZZ52: (Hearing IMpelrld only), ~EPLV Tal QuutJon. regarding 4IIrrOrl oontain.d on this noUel .hould bt addr.sud to: PA O.partlllGnt of Rlvlnu" Bur.au of I~dlvidual Te~el, ATTHI Po.t A.......nt Revt.w Unit, D.pt. 280601, Harrllbur;, PA 17128~060l, phone (717) 787-6505, DISCOUNT' If any tax due Jt pMld within thr.. (3) ~alendar Ilonth' after th. decod.nt'l d.ftth, ft five p.roent (5~) dJ.oount of the tax paid h allow.d. PENALTY I The 15% tax 8an..ty non-partlciJlation p.nalty is eOllput.d on the total of tho tax and Interut ......od, and not paid before January 18, 1996, the first da~ aftar the end of the tax a~..ty p.rlod. INTEREST I Intlre.t i. charg.d b.glnning with first day of d.linqu.neY1 or nine (9) .onth. anu one (1) day froll the data of death, to the date of pay..nt. Tax.. which blon.. delinqu.nt b.for. Jonua,'y 1, 1982 bur interelt at thPl rat. of six (6~) p.rc.nt p.r annu. calculated at a dally rat. of ,000164. All tax.. which blea.. d.linqu.nt on and after January 1, 1981 wUl bur lntll'..t at a "ute which will vary froll ea1.ndelr y.ar to oallndar y~.r wUh that nth announoed by the PA Depart..nt of R.venue. Tht appllcabl. Int.r.st relt.. for 1982 through 1997 art' V."r Intor..t Rat'. DaJly Internt Factor Vear Interest Rtlte Dally Int.rllt Factor -- 1982 20% .000548 1987 9% .0002:47 1m 16% .C!0043& 1986-1991 11% .000301 1914 ll~ .000301 1992 9:': .000241 1985 13% .000156 1993-1994 7% .000192 1986 10% .0002:74 1995-1997 9% .000241 --Int.rut is caleu1l!ltld lit followll INTEREST ~ BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR uAny Notioll lllu.d uUer the trlx b.oo... dellnqu.nt will rafhat an Intereat ellou1l'lUon to flft.tn (15) dlYI b.ynnd the dlt. of thl l!l....n..nt. If pay.ent It lade after the Intarut co.putation date .hown on th_ Notlc., addition..! lntoralt .lIlt be calculated.