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HomeMy WebLinkAbout97-00163 I'hi\ i... III (,.'nifl' t11;tl llll' ildiHIll;llilllll\t'[l'!',I\,('11 i\ \Ollnl1r (,llll!ed 1'111111 .llll1!"1)',il!.!! ll'IIIlI(,Itl' ld dl.'.llh dllh- flirt! With IlK ,1\ I ,Ill ,d Hq;i"'\Iill, The 01'lf;ill,d u.ltific,ll\' will II,' IO[\\"lnkd III dH' \1.111' \'il.li 1{1',1l11!\ (linn' 1;\1 IWI'l1l,llll'IH lililig, WARNING: It Is Illegal to dupllcato this copy by photostat or photograph, Nn, Ijl'iii'IIIr"II"";;,;,~;/_,__ ,,i"'< ~c1H Ofpr,;e.,{ ,-,\,I~\\\.-- __ '. !',I, ~, ~)"~; .... <.r~~~ 'Ie..'~ \~ \~. i\.;..~ ..' ...r-L ,. ';~.',) \a~~' '~~" " _ _ '~,l '~!tMfNl ~\ ~~""" ~q'('4!1{!{{1!'f!-' /J /?,' /. UmU /' '(Af2.\!c.1~:'l7f<- I.lH';d J{l'gi\t1ar'd' hT fill' tld... n'ninLllc, ,Y.,\()() 401.8178 FES 1 7 1997 p,I[{' COMMONWIALTIt OF PINNSYLVANIA . Of.PAnTMENT OF HEALTH. VITAL RECOROS CERTIFICATE OF DEATH ,... ""'" - tlN.'IlI...J...." KJ( SOCIAlIllCUf\lT'fNUI.IIUI --~Of'OfRH,MQj'" 0.. 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(I Ililllll" Ii ill 1 1'1 : 'iI: 'i ,I, 'i:: ,I Ii I III:!II! !:Ilr;') ,'! ,,:,: 1:11111'11 !IIII~' I!!.! ,: J ! I, :;,' " ! ! !illrl ::i::;::1 " I: i Iii II 1'1 II ,', !' ~ !' :': '" i i. :' i II i ' I i:II!11 i!i::11 I~: I 1: ;:1' ~ r. ~ Ii: ,i v " ':: I ~i!"!'" , ' I,:::!III:; I ~i ~:;: '; ~': 1 'i'l ~: :: ~; I ~~ HI' rHi ' II:'-!!I , II 'j I "I n d \'! ,:, ~,~ ,~ III IlliI !:""'; ,,: ::'i illl!": "II \1 ":: ',: : 1'111":"1 ':1 " : " Ii,' Iii,,: Iii ili!! 1,lli!' ill :'1,1 ill!III;:1 i :r :li"11 ,I!: lillll;:ill!1 :"i II! ,':' :1: :,1 I I,:' :1 ':, " ',I ,: 111;1:111",,11111:1' :1"d'lli II ii" , ' :, , I I I, I ' :'1:::1 ':1 '; " II' " , , "'I' ': : I I,: , I I' il 1"'-'1 'I! I I":' ! !,I 1,Itl " ii,' 1,,1 I ~ i I: i I: ',',i,11 :,! "~I i; " II , ,I , , " .\ , " " " II " I:: " M I 1.1 '! " " " , \'-/ () I " ^ , , , \ " , " ',' , " i' , " " '\ ~ ~ " '.'\.-' \-" ~ ,~ 1li~tgt ~~Iill alt~ Wl'~;htlltJ.'llt or SARA B. KIHTiIlR I, SARA S. KINTER, of Upper Allen Township, Cumberland County, Pennsylvania, make, publish and declare thls as and for my Last Will and Testament, hereby revoking all other wills and /' Codicils heretofore made by me. l1R~: I order and direct that all my just debts and funeral expenses, including inheritance taxes of any type what- soever, be fully paid and satisfied by my Executrix, hereinafter named, as soon as may be convenient after my decease. In this respect also, I direct that the date of my birth and death be inscribed on my monument. SECOND: I give and bequeath all my family records, letters, photographs, personal effects, jewelry, silver, china, and furniture to my niece, JEANETTE S. HAMNER, and her husband, CHARLES T. HAMNER, of Roseland, Virginia, or the survivor thereof. In the event that they should predecease me, I give and bequeath the same to their issue, per stirpes. ~RQ: I give and bequeath the amount of Seventy Thousand and No/IOO Dollars ($70,000.00) to my niece, JEANETTE S. HAMNER, and her husband, CH1\RLES T. HAMNER, of Roseland, Virginia, or the survivor thereof. In the event that they should predecease me, I give and bequeath the same to their issue, per stirpes. FOURTH: I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over which I hold power of appointment and together with any insurance policies thereon, as follows: (A) sixty-eight (68%) percent to JEANETTE S. HAMNER and CH1\RLES T. HAMNER, her husband, or the survivor thereof. In the event that they both should predecease me, I give and bequeath the same to their issue, per stirpes. (B) Ten (10\) percent to my great-niece, HEIDI H. JUBOK, of Ellioott city, Maryland. In the event that HEIDI H. JUBOK should predecease me, ! give and bequeath her share or shares to my great-niece, HILAR! H. DEVINE, of Norfolk, Virginia. (C) six (6%) percent to my great-ni.ece, HILARI H. DEVINE. In the event that HILARI H. DEVINE should predecease me, I give and bequeath her share or lOhares to HEIDI H. JUBOK. (D) Two (2%) percent to my nephew, RICHARD E. SHEAFFER, of Laporte, Indiana. In the event that RICHARD E. SHEAFFER should predecease me, I direct that his share shall be equally divided between and added to the shares of DORIS S. BARNES, his sister, and DAVID C. SHEAFFER, his brother. (E) 'rwo (2%) percent to my niece, DORIS S. BARNES, of Las vegas, Nevada. In the event that DORIS S. BARNES should predecease me, I direct that her share shall be equally di.vided between and added to the shares of RICHARD E. SHEAFFER, her brother, and DAVID C. SHEAFFER, her brother. (~') 'l'wo (2%) percent to my nephew, DAVID C. SHEAFFER, of Po~c Huron, MiChigan. In the event that DAVID C. SHEAFFER should predecease me, I direct that his share shall be equallY divided between and added to the shares t)f RICHARD E. SHEAFFER, his brother, and DORIS S. BARNES, his sister. (G) Four (4%) percent of the residue to the SHRINER'S HOSPITALS FOR CRIPPLED CHILDREN, of Philadelphia, pennsylvania, to be Ilsed for general purposes. (H) Four (4%) percent of the residue to the BIBLE BAPTlST CHURCH, of Shiremanstown, pennsylvania, to be used for general church purposes. (I) Two (2%) percent to my friend, BARBARA W. KUHN, of Shermansdale, pennsylvania. Should BARBARA W. KUHN predecease me, I direct that her share or shares shall lapse, with said share or shares being added to the other shares of my residuary estate in the same proportion as they now bear to each other. 2 1 \ ~ '" \ ~ ~ \, \1 1 lrIFTIl: In addition to all powers granted to them by law and by other provisions of this will, I give the fiduciaries acting hereunder the following powers, applicable to all property, exercisable without court approval and effective until actual distribution of all property: (A) To sell at public or private sale, or to lease, for any period of time, any real or personal property and to give opt.ions for sales, exchanges or leases, for such prices and upon such terms (including credit, with or without security) or condi- tions as are deemed proper. This includes the power to give legally suffi.cient instruments for transfer of the property and to receive the proceedS of any disposition of it. (B) To partition, subdivide, or improve real estate and to enter into agreements concerning the partition, subdivision, improvement, zoning or management of real estate and to impose or extinguish restrictions on real estate. (C) To compromise any clai.m or controversy and to abandon any property which is of little or no value. (D) To invest in all forms of property, inCluding stocks, common trust funds and mortgage investment funds, without restriction to investments authorized for pennsylvania fiduci- aries, as are deemed proper, without regard to any principle of diversification, risk or productivity. (E) To exerci,se any option, right or privilege granted in insurance policies or in other investments. (F) To exercise any election or privilege given by the Federal and other tax laws, including, but not necessarily being limited to, personal income, gift and estate or inheritance tax lawS. (G) To make distributions to my herein named benefici- aries in cash or in kind or partly in each. (H) To borrow !lloney from themselves or others in ordar to pay debts, taxes, or estate or trust administration expenses, 3 . to proteot or improve any property held under my will, and for investment purposes. (I) To seleot a mode of payment under any qualified retirement plan (pension plan, profit sharing plan, employee stook ownership plan, or any other type of qualified plan) to the extent the plan or the law permits them to do so, and to exercise any other rights whioh they may have under the plan, in whatever manner they oonsider advisable. ~IXTH: I direot that all inheritanoe, estate, transfer, suocession and death taxes, of any kind whatsoever, which may be payable by reason of my death, whether or not with respect to property passing under this Will, shall be paid Clut of the princi- pal of my residuary estate. ~~: All interests hereunder, whether principal or income, which are undistributed and in the possession of the fiduciaries acting hereunder, even though vested or distributable, shall not be subject to attachment, execution or sequestration for any debt, contract, obligatIon or liabiHty of any beneficiary, and furthermore, shall not be subjeot to pledge, assignment, conveyance or anticipation. EIGHTH: I nominate and appoint JEANNETTE S. HAMNER, Execut_'ix of this, my Last will and Testament. In the event of the death, resignation or inability to serve for any reason whatsoever of the said JEANNETTE S. HAMNER, I nominate and appoint CHARLES T. HAMNER, Executor of this, my 'Last will and Testament. I direct that my Executrix or Executor, as the case may be, and their successors, shall not be required to post security or a bond for the performance of their duties in any jurisdiction. 1992. set my hand and , day of tflL7 seal IN WITNESS WHEREOF, I have hereunto to this, my Last Will and Testament, this It) ,Ii IV-: '#-- . .j<" -~-a' ).s: "jL::~,...-< &.-{/ SARA S. KINTER (SEAL) 4 'a e>iW @:~ -rl, j,,= t" ,u~ (\u;, 5'fj] ~&! 00 .... ~ ;\ ,j; 8~ ffi \II ." ~ g O\lln:: .. - It:- :!: It - ::l o a ~ ~ ~ ~ :: m . t; :i '1. E-< ~ri~~~ :z: H , . ;.:: I <( \II ! ffi . ..... ~ ~8J:~o: 0 . lH)IIl~~ (/) ~ o 'u ~ 0 ~ffi~~~ (/) m ~ ~ i ~ ., ~ ll: <( - ., ffi . P\ .' '" .. . . . "" 1500 '" 17"1 fO~ OATIS Of DIAIH AFTEA I2/J 1/91 CHECK HEAl ~/~r- INHERITANCE TAX RETURN ~tv::~u~:~nI1l5 ClAIMID [ .....W RESIDENT DECEDENT fill NUMIIA COMMONW'AlTH"'H,;N5YlYAlIIA (TO BE FILED IN DUPLICATE I -'J I,}EI'A~TMeNT Of REVENUE I<A,,,,fJlld~.m,,~'OI ~, WITH REGISTER OF WILLS) ICOUNTYCODE YEAR NIIMB,-R O~CfDfNI'~ NAME (lASt fIRST, AND MIDOlfiNmAif~~---'- ~~- -- - - --~JJir[OTt~'f(OMPlf If 'IO(lRfi;s--"~'-~-"- -_.~ ~~ / ' 'J ' )1 )', / J ( . r!;ll'f(; ,'II,'t ' /,', /,11,",,/ , SOCIAL &ECU-RII-Y NUMBtR . IOAlE Of DEATII !O^1f of RI~It! ( , ) I '/ / .' . f / I, ',.:' /) / 11",r J ,\ I./(~)._~_~jj~~r-o .__ L~:'/'1'7! /, I /(,',J counl[l/II','L-'-I'_,I'III! __~_ "":"'''''''''',,'''''''''''':':"'''''' """ "" .'1"'" "'""", ,tClAL mllRIlY "lIM",,' ,.. .""" AMOllNT ':"''''OI''"N:'U(I'O'''I._....____.._ tX'J 1, Orlglnol Rolllrn i -j 2, Supplemental Return [_'J 3. Remolnder ReltHn II0T dale. 01 dealh prior 10 12,13.821 [.J 4, limited F..lote [ J 40, Future Inler6~t Compromise [] 5. Federal eslale Toll. R"turn Required (for dotes of deCllh <liter 12.12-82\ LJ 6, Decedent Dind Te,tot6 -1 7. Decodont Maintained 0 living Trull (Alloch copy of Will) (Allar.h copy of T rust) ALL "COI!I!ESPONOfNCi-AND CONfIDENTIALTAX INfORMATION SHOULD BE DIRECTED TQ; ~7t~~;~~ ;:=~~~~~=--if~::"~_~;~!~ m.,~=~:~= ~ .::'$cn bllfl:l ",00 uu:...J il:"' " ~) II; l. . I 'il,. m III '" _ a. Tolol Number of Safe Dep':ai! BOll.6S .;,.... ..ili "'" "'z 8~ z <> 5 " Ii: " lrl .. 1. Reol E,I.I. ISched.le AI 2, Slack. and 8andl ISched.le 81 3. Clotely Held $tock/Parlnershlp Interest (Schedule q 4, Mortgages and NOles Receivable (Sr.hedule Dj 5. Ccuh, Sank Deposits & Mlscellonltou$ Personal Properly ISch.d.l. EI 6, Jainlly Own.d Properly ISched.le fl 7, Tranlle" ISch.d.le GIISched.leq 8. Tolol Gran Aueh (lololUnes 1.7) 9, Funoral Expense~, Administrative Costs, Miscellaneous Expenses (Schedule HI 10, Oebh, MOrlgage lIabllille., lie" IS,hed.le II 11. Total Ded~,cHon$ltotalli(l8$ 9 & 10) 12. Not Value of Euate lLine 8 minus lIno 11) 13, Charitable and Governmental Beques,s (Schedulfl J) 111, Net V~JI~~_~~blec~!? Tax (L1ne_J2.mln~_~~~.?) IS, Spousal Tron$for$lfor doles of death aher 6.30.94) See Instruclioni for Applicable Percentage on Reverse SIde. (Include values from Schedlllo K or Schedule M.l 16, Amaunl of line 14 taxable at 6% rClle Ilnclude l/olu()5 from Schedule K or Schedule M.) 17. Amount of line 14 taxable 01 15% rate (Include values from Schedule K or Schedule M.l 18. Principal tax due (Add tax frorn lines 15, 16 and 17,1 19. Credih Spousal Poverty CredO Prior Payments -----.-----.------.-" ... 111.____.:: 1/.11 I;' /; 'i' Or? (2) ___--L_2...L--+-......~_.t.._.rI_.Z.-/~-c~- 131 ---.~---...-""-.-.- 14 1 .-~-=---.-''''__,___._ I 5 I _~L.Q.().Z'-I2.&L_.__ 161 171 l,liP I'" .y , ,.- I e I "'0 , ~.XL:.~:...c.e......____ '_l ::;u I j~ 'D ., " Lv 'I I~,r.; '''/ 191 --_!,.....::- . "" '--- 1101_____._,__ 1111 ~.9/f~r.",,~~/_..__ 1121 J.39.L::'J..9C., '11" ,1f / ~'. t.'"! 1131 __~ I~;-,.- 1141 j.; 6,;.,' 'I._I{; . "'~.. 1151 ------, __x.___._= 1161 ___..___.__.""..,_,___.._.~X ,06" ----....--......,.-, 1171 1:1'.f ;:n'.0.:..CJ.~:______ X ,15 .~..Q,'i. <I tL 'I 1._ IIBI_'';;C.'!'.'!.!}'; z '" ~ .... " .. :E o u Interest Dis<.:ounl ... .Lfl.~!~ L~_~",-~_~_ I 'I"~ Z .c___(2_~_-"-1_-,J~ _ (I~I 1201 ~ .... 20. If l.Ine 1915 greater than Uno 18, enler the difference on line 20. This Is the OVERPAYMENT. a[l N fI /'1' ,:y Check hl1rc If you (HQ requosting 0 refufld of your l;)\lNp'oymont {lll 121AI 12181 !'~'li'('?;V 21. If Uno 18\5 greater IhCln Uno 19, enter tho dlHerence on Une 21 This Is tho TAX DUE. A, Enter the interest on the balance due on Line 21A, B. Enter the tolol of Line 21 ond 21 A on line 21 B. This is the BALANCE DUE. _"____"__ Ma~. Check .~a~~~~~tol R."l._t._~__~! Willi, Agent ----- -- )o--j;h-iifsi(~E.!O A!4!WE~_~~_!;!UESTIONs ON R.EVE~S!.s.!l>.EAtl.~.!O.R~~ttE~~_!!\ATH ,<0( -< h,.,,_ Under penalties 01 perjury, I declare Ihal I have examined this roturn, including clccompCln).'ing schedules and slalements, and 10 tho best 01 my knowledg6 and belief, ill$ true, correct and complete. I dedorfllhat all Hwl estotfl hClS been reportod 01 tr'JO markot vCllue, Dflclarotion of preporer other tnon the penonol representative is bQsed ~~form~ion 0,!_~_~;~~.Erep~~6~_~~~()_Y knowledge, siONAfiJr.f Of PERSON RE5j10NSlIl\f f R {llINGRf.fURN - ----~Ab6R(.i,s. -------------------- -. .,.. -...--.-----------"---... , ". DAn-------.--~--.---~.._"--' .,. /' :H;R ,~~f{ti'.{~~t;,v,d .', 3,d,~,ul/.c1(('iaJJO.,'y.y,i{.'.;.i'l1;1. J'lL.J.3r;.~'L- :k( L!j'J.7 ,.---- Act '048 of 1994 provld.. for the reduction of the tax rat.. Impo..d on th. n.' valu. of tran".r. to or for the u.. of the .pou... Th. rot.. CI. pr.mlb.d by th. .tatu.. will bel . 3~ (.03) will b. oppllcabl. for ..tat.. of d.c.d.nll dying on or aft.r 7/1/94 and b.for. 111/96 It 2% (.02) will b. appllcabl. for ..tat.. of d.c.d.nll dying on or after 111/96 and b.for. 1/1/97 . 1~ (.01) will b. appllcabl. for ..tat.. of d.e.d.nt. dying on or aft.r 1/1/97 and b.for. 111198 . Spou.al tran.f.ra occurring on or aft.r 1/1/98 will b. ex.mpt from Inh.rltanc. tex. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (.--) IN THE APPROPRIATE BLOCKS. 1, Old decedent make a transfer and: a" retain the use or Income of the property transferred, ,,""""" ,",," " " " '" ",," " """"" " " " " , b. retain the right to designate who shall use the property transferred or Its Income, "".""""" )( C, retain a reversionary interest; ar "",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,".,,,,,,,,,...,,.,,"..,,...,,........... ;( d. receive the promise for life of either payments, benefits or care9.."""....""""."...".......".. 2. If death occurred on ar before December 12, 19132, did decedent within two years pracedlng death transfer property without receiving adequato consideratlon9 If death occurred after December 12, 1982, did docedent transfer property within one year of death without receiving ad.quate conslderatlon9",."""",.,."""""".."""",.,..""""""""""""",.,."""..",."",.,.,...,. x x 3. Old d.c.dent own an 'In trLlst for' bank account at his or h.r d.ath9..,,,,,...,,,,,,,,,,,,,..,,,,......... J( IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ~'l''' ,,~'-, ~ . -".:-'.,.r ~ - .. "'r.-'''-'--- r",," ':""~m Ill" nil I ~ I 118111 ,,~ SCHEDULE H I 'QI:) fUNERAL EXPENSES, WMMONW['lTH Of p[NNmV'N" ADMINISTRATIVE COSTS AND I BTATE Of 'NtI11~WNo't~~W:'~,__,____~~~~~.LL~~E()US E~P~~S~~--Ll F L miM:~:a... Prln.t 4>.r,_Tye. - .-.. c'" . / ,,(il"l', < ),1,',1 " _ _--:,..!...tJ~:!/"',_~___"__~_m ITEM NUMBER A. 1. 8. 1. 2, 3, 4, C. 1- 2, 3, 4, 5, 6, 7, 8, DESCRIPTION Fun.ral bp.n..., ;//Y'tt:.r./1.4K"'."< If'Nfl",,!! I!tJlllf' fl.. " fi' ~Ii ,c)1 ,) tV l(f'r 0/- C~~-;..';:--;:-~'- /(.1 ~ 0" Admlnl.tratlv. Co.lI' P."onal Representative Comml..lons Social Security Number of Personal Representative: " Year Commllllans paid __ Attorney Fees Family EKemption Claimant . _._" Addre.. of Claimant at dec.dent's death Street Addrell _ City ____, Relationship _Stote ~~ Zip Code____ Probate Fees ';:'(, ,/, .yt) MI.c.llan.ou. bp.n'.1I /?;f'i)INIG_ S IV?, ,r!oS IAJG 1-10 /lle /;,..1,,-,-. <; ,/K,qOl't IT j'/Jw{. f'v/;!/',lJ.ff.J., qfCVfKIy:, TOTAL (Also enter on line 9. Recopitulotlon) (If more .poc. I. n..d.d, In..rt oddltlonal.h.." 01 .am. .1...) AMOUNT (. ~ (./, ()CJ ,.2{,f/,S'() I 79'1.3'7 t1J~, tit:) $ (:';!I I ' OJ'/' - IJ'(, ,,~ ./ /,1 /' ," /' /, ,/ (I,' I BURE~U OF INDIVIDUAL INUL'RIlANCI TAM OIVISJOH OCPT, 280601 tlAHRI fiBURQ, PA IlIi'I'0601 TAXES COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, AL.LO'~ANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT DF TAX 07-1',-97 KINTER 07.-14-97 21 97-0163 CUMBERLAND 101 E-------A-'OuriTRo"t tf;Cr'::::"-l .===..==- ._.._._-~._---_.__._~-~_. MAKE CHECK PAYABLE AND REMIT PAYMENT TOI REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LIN!! ~ RETAIN LOWER PORTION FOR YOUR RECORDS .... iiEV= iSl,;. EX -;. FP - i 03-:9;") -NOT iCE - -6 F - INH ER i;: ANc E - TAX - A"P'iiiij, i sE;.tENr; -;. i.l"6wANcE - iili' - - - -- -- - - -. - -.... DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX SARA S FILE NO. 21 97-0163 ACN 101 DATE UTAH OF DA TE OF DEATH FILE NUMBER COUNTY ACN JEANNETTE S HAMNER 3 SOUTHALL LANDING HAMPTON VA 23664 ESTATE OF KINTER TAX RETURN WAS, 1 X) ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. R..l elt.t. (Schedule A) 2. Stock. and Bondi (5cheOOl. 8) 5. Clo..ly "-ld stock/P.rtn.rshi~ Inter..t (Schedule C) ... "oda_g../Not.. Rec.1v.ble (Scheduh D) S. Calh/Bank Depolits/Hl.c, Parson.l Prop~rty (Schedule E) 6. Jointly Ow~d Property (Schedule f) 7. Tranafara (Schedule G) a. Total Au.t. APPROVED DEDUCTIONS AND EXEMPTIONS: 9. F~.r.l Expense./Ad~. Co.tI/Hlsc. Expense. (Sch.dule H) 10, Oabt./Hortgag. Liabilitiea/Li.n. (Sch.dule I) 11, Tot.l Deduct ion. 12. ""~t Value of Tax Return 15. Charltabl.IGo~arn.antal Raqu..t. (Sch.dula J) 14. Nat Value of I:llt.t. Subjact to hx If en ess.ssment wes issued previouslY, linea reflect figures that include the tDtel of ALL ASSESSMENT OF TAXI IS, AMOUnt of Line 14 .t Spou..l 16. A~unt of Line 14 taxable .t 17. A~unt of Line 14 taxable at la. Principal Tax Du. NOTE I rat. LIn..I/Cl... A r.t. Coll.t.ral/Cla.. Brat. TAX CREDITS: PAYNENT OATE 04-04-97 RECEIPT NUNBER AA185358 DISCOUNT It) INTEREST/PEN PAID 1-) L022.07 L . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INT<REST. I CHANGED (1)_ (2) (5)_, (41 (5) (6) 17) .00 147. 555.97 .00 .00 L007,08 ,00 ,00 (8) . /, (j * (,) (10) 9,166,2'7 .00 (11) (12) (15) 1141 IH.lhllll" lIl,11I $ARA S DATE 07-14-97 NOTf: To insure proper oredit to your ..ceount J .ub.lt the upper portion of thh for", with your tax pay..nt. 148,563,05 9.166 n 139,396,7l!. 3,120,72 136.276,06 14. 15 end/or 16, 17 end 18 will returna easeaaed to dete. ,00 ,00 20,441,41 20,441,41 '". <0, '''-'j ,00 ,00 ,00 I IF TOTAL DUE IS LESS THAN '1, NO PAYHENT IS REQUIRED, IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YDU HAY BE DUE A REFUND, SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS,) ni) (16) 1171 .00 X ,00, .00 X ,06. 136,276,06 X ,15. (18) AHOUNT PAID 19,419.34 TOTAL TAX CREDIT -~-- BALANCE OF TAX DUE INTEREST AND PEN. -----...-...- TOTAL DUE (/; N ,~.:J , CI! I I'.. ,9\ .'.1) 5 00 RESERVATIONI E.t.t,. uf dtQ.o.nt. dylne on or befot. Dec.lbat 12, 1'62 ~R If BnV future lnt.r..t in the .at.t. I. trIMaf.rted 1n po.....lc:n or enjoY'lnt to Chi" . (ooll,ter.ll benafJoh,r1I1' of th_ dec.dlnt aft.r tha aHPltatlon of My .Ultlil for llfl or for y.at', tht COIlIIOnwee1th hereby ..pr...1)I r..ervaa the rllht to aPPtlhe end ...a.. tren,far InheritInG' hlC" .t the IIMfu1 tl... . (coll.t.ral) r.t. on any aoch future Int.r..t, ....-.. NOnCE I PAV~NT, RfFUHD (eR), OIA:CTIONS I A~IN ISlRAllVE CORRECTIONS I DI$COUttTI PENAL TV; INTEREST , To fuUlll the requJrMlMtI of S.otion 2140 of th4t InhtlrltllnCl. .nd Eat... hlC Actt, Act ZI of 1995. (12 P,I. Ilt(Itlon 'I~O). Det.oh th. top portion of thh Notl~. and .ub.it with your pay..rtt to the Rtghtlr of WUlI printed on the r.v.r.. aide. ....... Cl~ok or IlOMY orMf pavabll tol REGISTER OF MILLS, AGENT A r.fund of . tax Ot.c;jlt, which Will not r.~..t.d on the TelC R.turn, ..y be r.qu..tld by oflllPlatlng an "AFJPllol'lt1on for Rafund of Pannavlvanla Inhal'l'ancI Md E,t.t. hlC" (RE!J~UU). Appllcet1on. ara aVI11abl. .t ttta Offlc. of the R-oht.r of WJU., any of the 23 R.venutl Dhtrlct Offlo.., or by oaUlnI 'the .p.cl.1 Z4-hour an.III.,.lno ..rvlo_ nUllb.... for forll, ord.rlng, In JleN\.vlvlIn1a l-&OO~56Z.ZOS0, out.lde P.nn.vlvanl. Ilnd IIIlthln 10e.1 H.rrhburg IIr.a (111) 181-8094, TOOt (117) 112-2Z5~ W'ilri", I.airld OnlY). Any p.rtv In int.r.et not eetl.fl.d IIIJth th. appral....nt, allawllnc~ or dl.allolllanc. of deduction., or a.......,..t of hlC <1nolucUnll dheount or Intarutl a. ahown on thh HOtJClll .....t objaot within IllCty (60) day. of r'Clalpt of thAI HottCl' bYl ~~IIIritttrt prot..t to the flA O.pnrtl,ant of Rav.n~la, Board of APpall., Oep\. 281021, Harrisburg, PA 171?6-1021, 01 -~.Ietltton to h.lllv. thlll ..ttar ugter"ln." lit audit of the Itccount of the p.r.onal t.pr...nt.tiv., OR -~lIpp..l to the Orphltl\l' Cow.t. Fectuel "ror. dhoo....r.d on thh n.......nt should b. addr....d 1n IIIrlting tOI PA o.p"t.."t of R.venue, Bur.eu of Individual TaWil, AnN: po.t A.......nt R.vl.w Unit, ~pt. 280601, Harrisburg, PA 17128-0601 Phone (111) 787-6505. s.. pag. 5 of th. bookl.t "In.~ructJon. for InharJtenc. TalC R.turn for. R..ldent Dacttdartt" (REV-ISO}) for an elCol."atlon of adllinhttatlvah correctabll arror.. If any \1M ckHI h patd within thr.. il) e.l.ndllt Itonth. aft.r thl. dec.dlnt'. dlath, a flv. pare."t <Sin dllOount of the tall p.ld Is a,lo;.j.d. Tha is;': tllC "..,..ty non~partlc1patlon p.,.,.1ty ill coaputad on the tuhl of the tIll and lnt.rut ......adl and not p.ld b.for. January 18, 1996, tha flr.t dilly aft.r the .net of the talC MlMlty p.rJCH.l. fhl. non-partlcip.tlon p.,aity I. IIppaalabl. In th. .MI. .......,. and in the th. .... tI.. p.riod (II you would app.al thai "lC and Inter..t thalt h.. bean "slued.. IndJc.ttld on th1l notlc:.. Intl,...t I. oharged beGlnnJng with flr.t OilY of dall~y, or nl". (9) IIOfIthl 1M on. (1) d.y frOll the d.ta of H.th, to thh data of p.y..nt. TaM" whleh blKl'" d.linquent b.forl Jenuafy I, 1982 bo,,' Inte,...t .t thl r.t. of IIlC (6X) parcant p.r aMUII ClIlicuhtld IlIt II delly r.t. of .OOOI6it. "U t.lC., iolhich tNtcl... delinquent on Ind aft.r Janu.ry I, 19ftZ will ba.r Jnt.r..t ot . rlllta whlClh will vary fro. Clllllnd.r y..r to c.ltInd.r yl.r with th_t rlllt. announc.d by the PA Daplrtnnt of R.v."u.. lh. 1iPP1lcabla int.r..t rllt.. for 1912 through 1997 .r'l '!m Int.r..t Rlita p.11Y Int.r..t Factor :!!!r Int.r..t Rlt. D.lly Int.r..t Factor 1962 ZO:c .OOOSitl 1911 .. .OO02itl 1915 16)( .OOOUI 1911-1991 11;( .000101 19.. 11): .oonol 1992 OX .0OOZU 1915 1):1. .OOa!.6 l,n-l994 ]X .000192 10.. 10:< .000214 I"S-1"7 OX .000247 ."Int.r..t b caloulated .. follow'l INTEREST . BA~ANCE OF TAX UNPAID X NUNBER OF DAYS nELINQUENT X DAILY INTEREST FACTOR --Anv NoUce illluad .ftar thl tlM beC(,II' delinquent will r.fl.ct Wl Int.r..' Cllloul.tlon to flft.." US) dav. beYond the data of t..... Ill.......,,\. If PJlVMf'lt 11 .Ida aftar thl Int.r..t cHP\lhtlon dlta .hOlIIn on thl ~t1Cl1I MkIltJonll Int.r..t MIlt be o.loul.tH.