HomeMy WebLinkAbout97-00181
PETITION .'on PIWIJATE and GRANT (W LETTERS
Estate 01._ Q_~\11~.~,,,Y..__j'(\/ No. .~ ~__9?.L=:..9'1-~Jj'L_
also known as _...___~. ~~~ ~_~._~ ... To:
__.______..___.._~_ ..~ ._~.._~_ __u_~...... Reglste.. of EllS f()~ the.
. ______ ___ __.... Deceased. County of .....\L~...,.n..J~ In the
Social Security No. 20.. Z _-1) .1-,,-% _'1'1.___ Commonwealth of Pennsylvania
The petition of the undersigned respectfully reprcsents that: oR" C' ~\ I ( <, .A., f=o;x,
Your petltloner(s), who islare 18 years of age or older ~n the exccul2~1"'-~_.L_.b.tb..(named
In the la~t will of the above decedent, dated __~..s_'1:._.___-'.{..._____.. .. 19_'LJ-
and codlcll(s) dated . _._._m__~_________.__'_"""__'_____
(Slate relevant clrCllmstnnces, l',g, renunclalloll, death of e:<eClltOr, etc,)
Decendent was domiciled at death in_Q., '. ',\'0..,,1, H;~_.. __ County, Pennsylvania, with
~_..Iast family or principal resldeqce at... ~;J '" hI \~ \" "\~~~ "-.r'TiH
'" to ~'F v-..~ C 12 M-t (/ (JlVt' !..a;;j ~!l(J._J!V.L't-~Ll.t~-l-y3 Y.Jll.
(11'1 sI'COl. ~umber '~_~.P'lilYl-) tVLiDI)I.f~I~.
Dp<;endent'l th~n T"2-..5'- years of a~e, died. "'?"r"-:-h-:---' 19-E-L,
aLhvli'---Qt eJ.6"-'<\. C'ro<;;c '.J( C~1J:.c-"",L},Jl-~""-1_ir ,
. Except as follows, decedent did not marry, as not divorced and did not have a child born or adopted
~fter execution of IhJ>>'~ offered for probate: was not the victim of a killing and was never adjudicated
Incompetent: ~~_______~___._..___.__.__..__..._~___.____._____
Decendent at death owned properly with estimated values as follows:
(If domiciled in Pa.) All personal property $ / '5', 00 0
(If not domiciled in Pa,) Personal properly in Pennsylvania $
(If not domiciled ill Pa.) Personal properly in County $
Value of real estate In Pennsyl~ia . ,$ /4P' Cl(~l1
situated as follows: ...J. LL..J::r?U~..L.'i..f:.~""t.l..i4J l"; rt.. ' 17;' 1<:
WHEREFORE, petitioner(s) respectfully req~~t~s) ~ tbe proba~e Of the last will and codlcil(s)
presented herewith and the grant of lelters__....:..t. '0.-1 A ;tv, <:::...tt::.\..6....1...::f--:
(testamentary; administration c,(,a,; admlnlstrallon d,b.n,c,t.a.)
theron.
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OATH Of' PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA } ss
COUNTY OF _~J!.t1!?,,!;RLAND ________
The petitioner(s) above-named swear(,) or affirm(s) Ihat the statements in the foregoing petition are
true aod cOlTect to the hest of Ihe ki,owledge and belief of petitioner(s) and that as personal represen..
tatlve(s) of the above decedent petitioner(s) will well and truly administer the estate according to law,
s. worn to or affi.rm.ed.a lId .subscrl'bed. ~.'.. .~.~ .\ J.~~:::O~J;/4tl2.-) - ~y _. ~
before me thi ?1SI ~ot' .,. ~. ! , ""'
, ~ 'lJAtfY"--77TV.. ~--- ~
~~ MAR--fLEW;.S 't,\ jiZTM2.Reg,:.ter +~1~:'-'__..~==~=---- !
I.\:) ~- tCoi')... (('
.... ? 1 - 97 - 181
1'..0.
Estate of __a
CHARLES K FOX
., Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW FEBRUARY 24, ._ IL~!__, in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the Instrument(s) dated AUGUST 9, 1991
described therein be admitted to probate and filed of record as the last will of __.
CHARLES K FOX
TESTAMENTARY
CHARLES A FOX and SUSANNA FOX RICK~
and Letters
are hereby granted to
~~l
FEES
Probate. Letters, Etc. ......... $ 235.00
Short Certiflcates( 1 ~ . .. .. . : . .. $ 30.00
Renunciation .............. .. $~""
X-Pages $ ".UU
JCP TOT~L _ $ ~R~: RR
Flied ......mM~RX.?h.lm.........
ATTORNEY (Sup. Ct. 1.0. No.)
ADDRESS
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Mailed letters and order to Charles A Fox on 2.25.97.
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
58,
I, Charlea K. Fox, Testator, whose name is sd.gned to the
attached or foregoing instrument, having been duly qualified
according to law, do hereby acknowledge that I signed and executed
the instrument as my Last Will; that I signed it willingly; and
that I signed it as my free and voluntary act for the purposes
therein expressed,
~~CJ)& 1\, 1"\L.
Charles K. Fox
Fox,
Sworn or affirmed toqand acknowle~ged before me by Charles K.
the Testat.or, this y.t.....dayof aU1]<f..<1:t..> ,199l.
N~~~~6' 8. (, L ~L.LJ ._-
COMMONWEALTH OF PENNSYLVANIA
'~(\l,~tri~~
Klmilorlye Wi."r, No\.vy Publle
C",'i61e Ilolo"Oh, CUmbsrlnnd Cou"t}'
COUNTY OF CUMBERLAND ) _.~~t~~~I!~.~!2." Explro'.'.Doc. 23.11'0\
We I Jvv if L9.tfD III r1-.1.(~J... ('-:tJAA . (l.Y:ftA~
the witnesses whose names are signJd'to the attached or foregoing
instrument, being duly qualified according to law, do depose and
say that we were present and saw Charles K. FoX, the Testator, s.ign
and execute the instrument as his Last Will; that the Testator
signed willingly and that the Testator executed it as his free and
voluntary act for the purposes therein expressed; that. each of us,
in the hearJ.ng and sight of the Testator, signed the Will as
wi tnssses I and that to the best of our knowledge the Testator was
at that time 18 or more years of age, of sound mind and under no
constrai,nt or undue influe,nce. . ~ _\ \~
Ad~~ 1;~/~1tJ:;lli.
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subscribed before me this
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Q worn or affirmed to and
I 1991.
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~publrc
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Klmborly e. WI.or, NO\dlY Public
CnrlielO BOfvllOh, Cumbarlrvld County
~~~..~:-~~~l.l~~:~.I~I!p~plr~.Ooc. 2~~, !~~
Page 6 of 6 pages
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.OR OATISO' OIATHAmR 12/31191 CHICK HIRI
tlb 'NH::JI~l~~E Jtc:~~EE~~RN ~~~~!~f::DIT ISClAIMIO I I
CQMMONW'Allljor""N5YlVAN'^ (TO BE FILED IN DUPLICATE I 1'1
DEPARTMENT Of R(VHH/{ (l
"ARRlSfJ:!d':."ljl"oC>OI WITH REGISTER OF WILLS) COllNTYCO()f,} I VIAl< 'I cl NUMm
,";';':";:;.c.;;;;.;:,:;;;;;;." [)E-~OtNf"S. N'AMril~~T, flR-ir-,-A"iif"~loDir-;NiTIAl;- .-:";_~~'-____'----'____.m'. '"H" .-. ,-- --- 'of(n~mn-(OMrl1.1CIl)(1IlTf';---- - _._....m.~_.~_.,.m nu".,....".._;~.~___.
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t" N'~"' ''''''''"" '"""'" '''.f '"'' "'" M," '''''''" '"'''''' \0"" "'"""! NlIM'" 'M()II'II 'WIV'"I''' INI,""(1I0N'1
bi(1 1. Original Rell,ll/'l 1 I :2, Supplt'lmtlnlnl Rtllurn I J 3. RemlJindel Return
(for dolltl of death prior 10 12.1~.82)
!--j ,t, Umlled Eslole I I 40. fuluro InlftrfHI Compromhe l"OJ 5. Federa) fltale Tax Relurn Rflquirfld
(for dahu of dealh ofhH 12,' 2-02)
[I 6, Decedflnl Died Testolo I i 7 D€lclldllnl Maintained alivlng Tnlll _Q.8. Tolal Numb(H of Safe Deposil aoxe~
(AHoch copy (If Will) (Aunch (OpY of ThHtl
ALL CORRESPONDENCE AND CONFIDENTIALTAXlNPORMAT10NSHOULb BE DIRECTlD TO,
~~ NAME Q.\"I\.~ \('. . -A. f;;-----n~~-TI~~"'1.t[?o::;I'^IIS. ~ .__._.,,,._c__._~_~_c,'"'.,,"''''''
8~ 1fir;~I';UMBE,n-~=;>" T/n_nnn-I pl-.,'{~ de 11'/". ,f,~ I q Ilj '1
ccc__""'c"',,... ccL_n-'-L~~.~~,""""..""."c=,Z,..,= c. .ncc.. . .--mm.--c--.._nc__~_"=c,=r!oc~"",,c c~.. 'C'Cc--f+" . ",nc.,,_
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1. Reel Eotele ISchedule A)
2. Stocks and Bonds (Schedule ij)
3. CloitJly Held Slock/Parlnership Inler8~t (Sch(ldule C)
4. Morlgages and Nolos ReceIvable (Schedulo 0)
5. Cash, Ronk Depasl" & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property 15chedule f:)
7. Treod". (Schedule GllSchedule L)
8, Tolal Gran Assets (total lInes 1.7)
9. Funeral EKpensol, Adminlslrative CO$h, Ml$cellaneou$
, E'pen... (Schedule H)
10. Debts, Mortgage llo:bllllies, liens (Schedule I)
11. Tolal Deductions Ilotall.lnel 9 & 10)
12. Nel Value of Estate IlIne 8 minus Line 11)
13. Charitable and Governmental Bequests (Schedule Jl
14, Net Valu!Sublecl.!?!.~~lIneJ..2 minus line 13L-__._~~ ---.:__
15. Spousal Transfers (for dates of death after 6.30.94)
See In1lructlons for Applicable Percontoge on Reverse
Side, IInclude values from Schedule K or Schedule M.l
16, Amount of line 14 taxable 01 6% rale
Ilndude v(lI~lel from Schedule K or Schedule M.l
17. Amount of llM 14 taxable at 15% rote
(Include VOIU8$ from S(hedule K or S(hedulo M.l
18. Prlncipalla~ due IAdd tax from lines 15, 16 and 17.1
19. CredIts Spousal Poverly Ctedit Pdor Palmenh Discounl
+ 2T!~_~1.G
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(17) ,...
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(18)
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20, If line lQ is grealer Ihon line 18, enter the dHferen(e on line 20. Thl~ l~ tho OVERPAYMENT.
DID
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Clwdt here ,I you our re ucsfing n refund of you', ,ovCJpnymcn)
21. If line lB i6 grooter than Uno 1Q, entor Ihe dlfferonce or\ Lino 21. This i, Iho TAX DUE. (21) __ --J-I---6-ql ,Q_6
A. Enter the Interest on the balanct'l dU6 on Lino 21A. (21A) ---~-- --~---
B. Enlor Ihe 101(11 of Uno 21 and 21A on line 216, Thi$1s Ihe 8ALANCE DUE, (218) ---71-D-(1.1 f.~..4
_.__~ -----:______~~~.~!_~~~,-!~.k,P.a.-yabl...t~:--~!~.I-.t!~--~f__y!l_~l_~__~~~nt . ....__~~_~__ _.___ . .___....._ ,,_m___ _.
~ _~ ~-.: "'-USURE TOcANSWEiCALt QUESTlONSOifiiivERSE SIDEAND TO RE~HECK MATH ".0(
~~dor penallle$ o;P;~i~~y,Ri Jod~lro ih~'1 have eX(1fl1i~cTth~~;'~';;~~~i~'~.i;;di~g'~~~rnpl1~~y'i~'g.';'(h'~X~i-~~'~~1alomenls~nd t~H.ih;b;;'i'-~T;;y-k~~-;I;dg-~(;'~~fb~'li;f:
01 IS Irue, correel ancl (omplote. I d(l('!ote lhot all teol oUolo hm boon reFoned cillrue market vohl€l. Decloration of prepo,flt olher Ihon Iho penonol teprlHonlot!ve is
<losed on all information 01 which pr6pCH6r t"H ooy knowledgtl.
~IAURfOf~:ON?{~O~PV)PiiliiRf'iijRN------ ---A5;-~-; g
SI ATlrRfoTPRF.rARfIi-OTHEITH-;;t-:j-iifFRr~-~NihlIVI h(J[)Rf:55
DATf -- -. --
Me wlM, \ \ 'S\ If k.lf\chlrhl AI f"J11~L /I/\.\y, i) Lq97--
flAlf
..,"'",,, '''''' · l' SCHEDUI.E F j
COMMONWEAlTH Of P!NNSVlVANIA JOINTLY -OWNED PROPERTY
INHfRlTANCE TAl( RUURN
RUll>fNl OECEOENT
:~~\:~..~~ ::~~_~~_~~~_;".:n.'.'_~~,:~~~=C==""'" ,..' ",......,~:...=t~~~~;:~.z..........~~~_t.._.
Joint tonont(II'
__n.~.mm"m"._~~~ME~.
A. <::'-'v-.I\t'\c:.,. f\. \=O,x.
_.___~._____~DDREU,"..n....._._._...__ n._.!!ELATIQNS~I~TO_DECED!~
5)0<;/ Ne.vJl.Al\ Si. SO...J
fly." \,.., ell: \\,\r." tI} PA
\ q \ 1.\ '-\
B. :, u .5 1\ NfoJ ,., Po 7' f.-H:.-,~(;' c-
'l1 Fo'/<..(,.\,c';:.+- D(".
QA,(" ',c:.k, PA /70/3
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C.
Jolntly.ownod proporly,
,----..-..
ITEM LenIR DATE
FOR TOTAL VALUE DECD'S DOLLAR VALUE OF
NUMBE JOINT MADE DESCRIPTION OF PROPERTY OF ASSET % INT. DECEDENT'S INTEREST
TENANT JOINT
. ----.-- -_._---~
1. AI€:' Ot.t ~~ c.1.': 1;;"; 1-1 tA\(; C>' Lk~"~1 EY, 0 39. 3~ '3J /7; 832., 6';-
f\d.VA.Nt"r /JtI \-i OW" \ ()..... N I<-
f,o, (?,O)<. /!3 1 7i)
WI \ ",",', "''j to"" pc If( ~>'o
1:t .tOJ 19 3; 7 . 2.
2., A/f:>. Cd'q c..c rti t'. '^ tEi D F" f)c: rosi+ J ~) 71?6. }2. 3J 't)~7q.ljq
I\clv...t..\t.... .ll~\tu"'..1 eA."')
#2..0/ I ~ J :Jr, :3
(A.cl.tl. rc,>s, .. blWC)
A.I B. OcJq Sho/J~ ""cme,! Nvlr ~(;'1- J2.,/U,qj 310; 41(J/5,6~
3.
ru/,JC\
P. 0, (30)( 'lq 'J~
Mi I w^l..d:." 6", W;.s(o^,~i oJ
532.0 I
1t' 02.'5.2301 '7/ 7001
TOTAL IAI.o onler on IIno 6, R.,opllvlotlon}
~ 2 b IL~'!~_~;}
(If mare 'pace is n..ded insert additional sh..f, 0' some size)
,1<"" '" I""' .JtA" SCHEDULE H I
~_ FUNERAL EXPENSES, ,[
WMMO..wrAllH Of Pf....mVA..,A ADMINISTRATIVE COSTS AND
'"~:~',~1~1Wc~~:m''' MISCELLANEOUS EXPENSES . Ploas~_~!I,,! or Typo _~_
ES~~~;~;~~ ,. .~__,'--~o l' '"._-.~~_. - '-----"--~~rx~M~R_ (/ 7 ~..q.?'q ~ ~
lY~M
NUMBER
A.
1.
7..,
).
4.
S'
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'],
B.
1.
DESCRIPTION
FU"tlal bpo"s.s,
FVAJC:''''' 1-llI"-,,, I C""i"''j (5rotto.er"
fv\,ifoJl5h rl ILuJ,VC I/.. /i.t:c) CArl,.dr Brdke", iN Ch.r,'.5!-
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Mv~ICA.\ So(Oi$.t>h.)
Roo c:l F...... g....., '"f'h 0-'"
Q..~"o(€: S hNe, "J:.N-scr'p+''rJ/J
Plo"'JC'\~
Adrnl"ISlrallvo Costl.
Personal Representative Commission.
Social Securily Number 01 Personal Representd'llve: _
Vear Commissions paid ,,__...
2, Allorney Fee,
c.
3,
Family Exemplion
Claimant
Addre.. of Clalmanl at decedent', death
Street Addre.. ._.________
Relalion;hlp
Cily ..__-_..__..
Slate._ Zip Code
4.
Probale Fee,
1.
MI.collaneous Expen...,
M;!c...,c ..TrAllel t..'<pf'/'J$CS liJ Cl<,r.;c.vfr'o~ aP'
L'50+"Th '
Ct')f,r;s o~ S l-oo~~ ~\.... en-\:\ F;t.....h:.s
f'~N'; C,A Its
P05>h"1E-'" {v\A.IIAJ-., C/'op r5N $'", >
A ~~ f'" SA It>\' fn>frr+y
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Mise, ti<fCNSc"..>
2,
3,
4,
s.
~,
7,
8,
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AMOUNT
!.5f). 0-0
1t70. ~
7S'. Ot)
100, (}-(J
'2.0~ .1hJ
/15,0'0
I~ 9. ~~
2. st;;. ~
26Q. L ~
3'1.00
1'1 I, 83
l(1,) 0
;l..~O, (f1J
i,sa
/55, lfO
(II more space I. "eeded, I"serl additional she.h 01 same .1...)
TOTAL (Also enter on line 9, Recapitulation) S 2 I LI (J () S
I 'l -, .
t":":'
'.'---.-
...~
-... ---.-
- --
_.;,;~
~ ~ ~.~--,._-
---
_ ...4_'+..0.,
-0. .~ o,_'~..o_..
..~. n_ "'__'_0_
~ !:~~:::.._..=
~~~II
09-15-97
FOX
02-10-97
21 97-0181
CUMBERLAND
1(11
E--~~~~ilEi[~,=]
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE. PA 17013
CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ..
REV: iS4-i - iif- AFi; - ( if!': 9;">" -NoTicE" 0',0 - i"NHEii i i' ANtE - TA'x - A'PPRA"i s iiiENT -,- -A [l"owANc E' ijli' .---.- - -- - - - - - --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
CHARLES K FILE NO. 21 97..0181 ACN 101
)./) k, ',' . ('
BUREAU OF INDIVIDUAl, TAKES
INHERITANCE TAM DIVISION
Df:PT, U0601
H.t.AR1S8UItO, PA 1111.11-0601
COMMONWEALYH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAK
APPRAISEMENT. ~LLDWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSE$SMENT DF UK
CHARLES A FOX
5108 NEWHALL ST
PH IlA
DATE
ESTATE OF
DA TE OF DEATH
FILE NUMBER
COUNTY
ACN
PA .19144
ESTATE OF FOX
( '..
-
IIHUIU'" COl.."
CHARLES
K
TAK RETURN WAS, 1 ) ACCfPTED AS FILED
( X) CHANGED SEE ATTACHED NonCE
DATE
09-15-97
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R.al flt.t. (Schedule A) (1)
2. stook. and Bond. (Sohaduh B) (2)
5. Closely Held stoc:k/Partnarsh'\p Int.rest (Sch.duh C) (!)
4. Mortgages/Not.. Race!vabh (Schedule DJ (4)
S. C..h/Bank Deposits/Hisc. Parsonal Property (Schedule E) (Sl
6. ~ointly Owned Property (Schadula fl (6)
7. Tran.hr. (Soh.duh G) (7)
e. Totd A,..t.
APPROVED DEDUCYIONS AND EXEMPTIONS.
9. Funerel ExpMn.../Ad... CCllh/H.lsc. Expense. (Schedule H) (,)
10. Debh/Hodg.pD Lialbll1tiu/L,ians (Schedula I) nO)
11. Tebl Deductiona
12. N.t V.lu. of Te)( Meturn
13. CherU.ble/Govern..enhl a.qua.h (Schedul. J)
14. Net Value of Eat.te Subj.ct to hx
95,000.9J!.
8.347.76
.00
.00
199.32
26.727,23
--...P.D..
eB)
2,149,05
2.704.ll.
I1ll
112)
eU)
(14)
NOTE I To in sur_ proper
cr.dU to your account,
aub.it tha upp.r portion
of this for.. wi th your
ta)( pMYMnt.
nO,274,31
4.R~3,97
125,420,34
.00
125,4~
NOTE:
14, 15 81ld/Or 16, 17 and 18 will
r.turn. .......d to date.
If an as.essment was i.sued previou.1y, line.
refl.ct figur.s that include the total of ill
ASSESSMENT OF TAX:
IS. AMount of Line 14 .t $puu,al
16. AlIlount of lina 14 taxable .t
:\7. AlflOunt of Line 14 taxable .t
1a. Principal T.~ Due
,.at.
line.l/Cl.a. A r.t.
Coll.bral/Cl... B rate
115)
116l
117)
TAX CREDITS:
~_.
PAVHENT
DAre
05-08'97
RECEIPT
NUMBER
AA211290
DISCOUNT (+)
INTEREST IPEN PAID e,,)
373.2'6
, ,
PAVMENT MUST BE MADE BV 11-11'97M.
.00 M ,00__
125,420,34 M .06_
.00 M .15_
el81
AMOUNT PAID
7,091.96
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
.00
7,525.23
.00
7,525,23
7.465,22
60,01
,00
60,01
. IF P~ID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST,
e IF TOTAL OUE IS LESS THAN n, NO PAYMENT IS REQUIRED,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" eCR), YOU HAY BE DUE
A REFUND. SEE REVENS~ SIDE OF THIS FORM fOR INSTRUCTIONS,)
,
RESfRYATlOHI E,tlt.. of dIIoHenh dylnl on or biller. OecI....r 12, 1912 .... If MY future Int.r..t in the ..t.t. II trlnlf,rrtd
In po.....lon 4r enJo~.~t toe tl..~ a (coll1t't,l) bln'fleder'" of the dlcedent ,ft,,. thl IMpJr.t1on of InV ..tet. for
11" or for Vlmr., thl C~w..lth h.r~v IMpr...lv rll.rv.. thl right to appr,I,. ~ ....., trlnl,.r l~rltlnO' TIMI.
It thl I.wful Cl... . (oall,hr.ll rete 'Dn MV I~ch lutu,.. Int.,...t.
PlJMIOSE Of
NOTICEl
PAVHfNT I
REFIIID (CR)I
OIJECTIOHS,
AIl!lIN
ISTRATlYE
ClWRECTIONS,
btSCOUNT I
PENALTY,
INTERfST I
To fulfill thl ,..qulr...nh of >>Iotlon 2lttO of thl Inheritance and flht, lax AClt, Act 21 of 1995. (72 P.S.
Secltlon 9140),
Detlch the tl)P portion 0' thh Hotlc:. IInd tlubllit with 'lour PIV-.nt to the ReglU,,. of Willi printed on thfl ,,'''''1''' lidl,
....H_. ctMck or ItOMV order plYMlll tOI REGISTER OF MILLS, AGENT
A rafund of . tlM orlldlt, which Will not requ.,t.d on the hM Return, ..., b. r.qu..ted by eo.,18ti", en "Applicltlon
for R.fund of P,nn'Ylvanla Inh'r1t~. and E.tetl 11M" (REV-UU). ~lIc.tlon' are "'1111b1. It ttltt OffiCI
0' thl Rell.tlr of NUll, env 0' the Z5 Rlvlnue Dlttrlct OUle.., or by cIlllnll ttll .peel.1 2tt~hour
1n'lIMrln. ..rvlell nUllb.r, for for., ordarinol In P"M,ylvlnJI 1~'OO-I'2.2OS0, ouhlde ".,.,..ylv..,11 Ilnd
wittltn 10011 Hnrri.burg .rol (717) 717~'Q'4, TOO' (717) 772-2252 (Halrlna I~'lred Only),
Any party It! Int.rut not ..tllflld with the ItJIprah"lnt, allowancl or dllll10wlncl of dlduotlonl, or ."....."t
of t'M (In<lludlna ~h(jount or Intar..t) .. .tlown on thil NotlCle llU.t obj.ct within .bety (60) da~1 of rHllpt of
thlt Notice bYI
~-wrlttlfl protllt to thl PA n.pertlent of Rlv.nu., IOlllrd of Appelh, Dept. Z11021, Harrhbura, PA 17121-1021, OR
--.I.ctlon to hlv.. the ..thr dltarllnod at audit of thl IOC::Ount c~ the per,onal repr"lIIlt.U"., OR
--epp..1 to thl Orphlns' Court.
F~tuII .rror. al.cov.rad on thl. ......-.nt .hould b, addr....d In writing tal PA Ulp.rt.-nt of RIVenue,
lur.flU of Individual TI)(U, AnNI Po.t '.......nt R.vllw Unit, DItPt. 210601, Herrilbur" Pl 17121-0601
Phone (717) 767-6505. S.. plgl 5 of thl bookllt "In.tructlcm. for Inhlrltanc. TI)( R,turn for II R..lmt
D.c.d.n'i:" (RtV-IS01) for 1m upll!M'1lltlon of ad,inhtrat1VllY corrlcttble .rror..
If ItnV till due Is peJd within thr.e (5) clland.r ItOnthtl Ifter thl (Mo.d."t', de.th, . flv. percent (ilO dhcount of
ttMl tl)( P.ld It allow.d.
Th. 15:< till MInI.h non-pll-UclpeUoll plnlllty 10 coeputld on the tot. 1 of tl1l tll( .nd Jntlrllt ......H, !lAd nat
plld b.fore Januarv Ill, 1996, tn. fJr.t d.y .ft., ttl. .nd of HIl' ta)( 1."lIty period. Thll non-plrtlolplUon
p.nelt~ 1. 'pp,.labl. In the 'H' .annar and In the th. .... tl.. period I' you would IIPp.al ttMt t.)( end Intere.t
th.t has blan ....u.d I' JneUe,t.d on thit notlcl.
Interut II oharald b.glnnlng with flr.t dlv of d.Unqu.noy, or nl.... (.) aonth. end ont (I) dl~ 'rOIl tl1l dltl 0'1
dlath, to the data of PI~''"t, 'a)(1I which b.e... MIlnquant blilfor. January 1, 1912 lNar Intar..t .t thl rat. of
.h (6X) parc.nt pelr annUlI c.leulatld et e dally rat. of ,000164. All tlll)(1I which baa... dllInqu."t on end .fter
JW'lUIrY 1, lipII2 will bur inhrut at I r.t. which wtll varv froa oelendar y..r to cal.ndar VI.,. with thet ret.
lnnOunced by the I'll D.p,rt.ant of JI'VIm'I. The apflUcabl. Intlll-IIt ratlll for 1.82 through 1997 'r'l
t!!! Intlr..t Rat. DIIl~ 'nt"lISt Factor ~r Intor..t hta D.lh Interllt FlKltor
1981 20% ,DOnS'" 1917 'X .000241
1911 16;'; _000"111 1911-1991 m .oonol
1914 11;( .000101 1992 .~ .OOOZ47
1915 IS;'; .0001S6 1991-19CJ1t " .0001.2
1.16 lUX .000274 1995-1991 OX .000247
-~lnhrllt It cIlcul.tad .. folloofll
INTEREST. BALANCE OF TAX UNPAID X NUNBER OF DAVS DELINQUENT X DAlLY INTERElT FACTOR
uAnv Notlca luUld IIft.r thl till bltcOltl. dllIn~nt will rafl~t In Intar..t calculation to fHt'an (15) dati'
beyond the dah of tha .......lnt. If pay..nt 11 .MII .H.r thl Int"..t COIIpUt_tlon 4_t. ,heMIn on thl
Notlc., _dcU tlonal Int.rut II\Ilt be ClIlcul.tod.
PAVfENT I
Dttloh the top pQrtton of thll NoUel Ind ,uaU with your PIWMnt ,ltde pIyeb1. to tht> nl" _ Iddrl..
print" on t'hl rlVlr,e .Ide,
If RESIDENT DECEDENT .... chock cr ...... crder .....Ie tc, REGISTER OF WILLS. AGENT.
If HON"RESlDENt DECEDENT Nk. check or HnIY order plytb1. tOI COHHONWEALTH Of PENNSYLVANIA,
IfEFUHD {r-R)1 A rlfund af . t'll crldlt, which HI' not rlqu..ted on thti T.~ R.turn, ..y be r.~.ted by oOllpI.Ung In
"Appltoltlon for R.f~ of P.nn'Ylv."t~ loh.rlt~. tnd E.t.t, T.M" (REY-ISIS). Applloltlon. .r. tvllllbl. .t
thll Offlal of thft R"ht.r of Wl1h~ any of thl n Alv&nU1 DhtrlClt Off Ie.. or frOll the Dep.rt.."t', 21t-hour
,".~rlnt 'Irvlee ~.r. for for., orderlngl In Pennlylvtnle 1~eOO-56Z~2050, outllde Pennlvly."t,
~ Nlt~ln l~.1 Hlrrllburg .r.. (117) 1e7-~094, TOOl (717) 772-2252 (Heir in. IMPaired only).
REPL V TDI
QuI,UOlll rltl.rdln" .rrort eOl,t,lntd on thlt notio. Ihould be .ddruu1' tOI PA D.partltent of RIVtnIJI, lurl.,
of Jncllylctu.1 fix.., ATTNI Po.t A.....Hnt nlyllw Unit, Dept. 210601. Herrhburg, PA 11128-0601, phoM
(717) 7.7-6505.
DISCOI,'H I
If any tllC dut 11 p.ld wUhln three (5) elltndllr IKlnthl .Her the d.cedent". "-eth, . five p,reent (SlC) d1lcount
of the tllC Plld I. 111owed.
PfHAl TV I
The 15~ tlX .-ne.ty non-p.rtloJp.tlon pln.lty I. co~utld on the total of the tllC and Int.r..t h......d, end not
p.ld blforl J~ry II, 1996, thl flr.t dlY .ftlr the ~ of the t.1C -.nt.ty PlrlOd.
INtEREST I
Int.r"t 1. C1nerted beglnnlng with flr.t dlY of ~llnqulncY, or nlnt (9) .~th. and one (1) d.y froe the detl of
delth, t~ the d.t. of ply.-nt. T.MI. which ble... delinquent before Jenuery 1, 1912 bier Intlr..t It thl rlt. of
.l~ (6X) ,.r~'"t plr ~ c'l~ul.t.d .t . d.lly r.t. of .00016'. All tllle. which bee... d.llnquent nn and Iftlr
Jtnuary 1, 1912 will b..r Int.re.t ftt . r.tl which will vlry frol c_lander y..r to cIllndlr y..r with thlt rite
onnounced by the PA Depart..nt of RftvlnUe. The appllcabl. lnt.r..t rete. for 19&t through 1991 .r'l
V..r Intlrnt Rllte D.lly Int.r..t fIe tor Vllr Int.rut Rlt. Dilly lnt.r..t Factor
19&2 2'X .00DSltI 1917 'X .ODOU7
1911 16X .l\OOltSI 1911-1991 lU .00OSOl
l"~ lliC .00OSOl 1992 9X .000247
19.' 11iC .00OS56 1995~19~ 'X .000192
1986 I'X ,nOO214 I99S~1997 'X ....'07
--lnt.r..t Ie c~leul.tld '1 follCMt.,
INTERFST . BALANCE OF TAX UNPAID X NU"BER OF OAYS DELINQUENT X OAILY INTEREST FACTOR
--Any Notlc. I..u.d .ft.r the till b.eo... d.linqulnt will r.fllct In Intlr..t olloulatlon to fifteen (15) d.y.
beyond the date of the ........nt. If Ply..nt i. Itd, .ftlr the Int.r"t eOlPutetlon dlt. lhown on the
Notle., .ddltlonlll Intlr..t IU.t b, CIlcuhttd,
.,,,.
ESTATE OF CHARLES K, FOX
CllMBERLAND COUNTY FILE NO, 21.97.181
EAMILYSETTLEMENT AGREEtviENT AND FINAL RELEASE
THE UNDERSIGNED, CHARLES A, FOX, hereby agrees that
WHEREAS, CHARLES K. FOX, late of South Middleton Township. Cumberland County,
Pennsylvania, deceased, died testate on February 10, 1997, having first made a Last Will and
Testament, which was duly exel:utcd on August 9, 1991, and is duly filed in the Office of Register
of Wills of Cumberland Cuunty , Pennsylvania, at File No, 21-97-181; and
WHEREAS, the said Charles K, Fox, by the aforesaid Last Will and Testament, named
Charles A, Fox and Susanna Fox Ricker as Executors of said Last Will and Testament; and
WHEREAS, Lellers Testamentary on the estate of the said decedent were duly issued by the
Register of Wills of Cumberland County. Pennsylvania, to the saitl Executors, hereiuafter called
"personal representatives"; and
WHEREAS, the said personal representatives have identified the tangible and intangible
property of the said Charles K. Fox and have distributed them as agreed between themselves as
personal representatives and as the sole heirs of the estate, with the exception of the real property
situate at 10 Foxcrcst Drive. Carlisle. Cumberland County. Pennsylvania 17013, Said real estate is
being devised by Deed contemporaneously herewith,
NOW. THEREFORE, I, CHARLES A, FOX, being one of the heirs under the Last Will and
Testament of the said decedent, and being entitled to inherit under said Last Will and Testament, do
hereby acknowledge that I accept the distribution as set forth herein in full satisfaction and payment
ofull sum or sums of money, legacies, bequests, and devises as are given, devised and bequeathed
to me by the said Last Will and Testament;
AND, 1 do hereby stipulate that in order to avoid the expense and time involved in the filing
of a formal account and schedule of distribution. I agree that no account is necessary and I do hereby
agree that I do consent to distribution being made without the filing of an account and schedule of
distribution, the same to be with the same force and effect as if they had been filed and confirmed
by the Orphans' Court Division of the Court of Common Pleas of Cumberland County,
Pennsylvania.
t' 1J'II,mll)'" AflUt\EfI rAlI!SVlHI~ I'SA,'.dln
ESTATE OF CBARLES K. FOX
CUMBERLAND COUNTY FILE NO, 21-97.181
FAMILY SETTLEMEN'[AGREEMENT Al':lD FINAL RELEASE
THE UNDERSIGNED, SIJSANNA FOX RICKER, hel'(~by agrees that
WHEREAS, CHARLES K. FOX, late of South Middleton Township, Cumberland County,
Pennsylvania. deceased, died testate on February 10, 1997, having first made a Last Will and
Testament, which was duly executed on August 9, 1991. und is duly filed in the Offiee of Register
of Wills of Cumberland County, Pennsylvania, at File No, 21.97,181; and
WHEREAS, the said Charles K. Fox, by the aforesaid Last Will and Testament, named
Charles A, FoX and Susanna Fox Ricker as Executors of said Last Will and Testament; and
WHEREAS, Letters Testamentary on the estate of the said decedent were duly issut,d by lhe
Register of Wills of Cumberland County, Pennsylvania, to the said Executors, hereinafter called
"personal representatives"; and
WHEREAS, the said personal representatives have identified the tangible and intangible
property of the said Charles K, Fox and have distributed them as agreed between themselves as
personal representatives and as the sole heirs of the estate with the exception of the real property
situate at 10 Foxcrest Drive, Carlisle, Cumberland County, Pennsylvania 17013. Said real estate is
being devised by Deed contemporaneously herewith,
NOW, THEREFORE, I. SUSANNA FOX RICKER, being one of the heirs under the Last
Will and Testament of the said decedent, and being entitled to inherit under said Last Will and
Testament, do hereby acknowledge that I acccpt the distribution as set forth herein in full satisfaction
and payment of all sum or sums of money. legacies, bequests, and devises as are given, devised and
bequeathed to me by the said Last Will and Testument;
AND, I do hereby stipulate that in order to avoid the (~xpense and time involved in the filing
of a fonnal aecount and sehedule of distribution, I agree that no account is necessary and I do hereby
agree that I do consent to distribution being made without the filing of an account and schedule of
distribution, the same to be with the same force and effect as if they had been filed and confinned
by the Orphans' Court Division of the Court of Common Pleas of Cumberland County,
Pennsylvania.