HomeMy WebLinkAbout97-00256
PETITION FOR PROBATE and GRANT OF LETTERS
0Il:3.2--;;>90
No,
To:
Register of Wills for the
~ Deceased, Counr.y of ~~~~- in the
Social Securiry No, I ')H-07::!iJllL------ Commonwealth of Pennsylvania
The petition of the undersigned respectfUllY represents that:
Your pctitloner(s). who is/arc 18 years of age or older an lhe executot
in the last will of the above decedent. dated Aptil. J 9
and codicll(s) dated ,_--- June 21. 1996
Estate of .s!~~.lh- \-loodw.ll.0
also known as
,--
named
,19J5-
--
=
-----
-
---
-
(,tale relevanl circum'tan,'" c,g, renunclalion, death of cxcoutor, etc.)
Decendent was domiciled at death in ClImbo rland
It- er last family or principal residence at 770 Pool at
Camp HIlJ.,..EL East pennsbotO Townahill---
(list strcct, number and mundpalilY)
County, Pennsylvania. with
Church Road
-
Decendent. then 82 vears of ue. died __ February 28 --, 19_97
at Blue Ridge Haven \,,,~'n8't pcnnsboro_'l22.l:!!!ship, Cumberland Co. '
Except as follows. decedent did nO! marry, was not divorced and did not have n child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decenc\ent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Peunsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as folloWS:
$ 11').000.00
$
$_-
S.. 1\T(\lJli'
---
-
WHEREFORE. petitioner(s) respectfUllY JC~I!e.st(s) the probate of the last wl\1 and codlci1(s)
presented herewith and the grant of1etters.--1..~ \ AMEN111RV -
(tcstamentary; adminimalion c,t,a,; adminlmation d,b,n,c,..a,)
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OATH OF PERSONAL REPRESENTATIVE
gg~~~:~:ALTH OF ~l~~e~~~\~~~ } ss
The petitioner(s) above-nllmed swear(s) or affirm(s) that the statements In the foregoing petition are
true and correct to the best of the knowledge and belief of petitloner(s) and that as personal represen-
tative(s) of the above decedent petiuoner(s) will well and truly administer the estBte according to law.
. I' i
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Inventory of the real and personal estate of
Clementine D. Woodward--
deceased
Descriptial
Inventory
Estate of ClEmlIlt:l.ne D. Woodward
From 02/28/97 Tb 10/27/97
1II:x:IV,.,d Interest
~ = Bank-checldng acct.
2.32
Value
12,6 1.79
269,054.17
199,157.67
114r353.79
48,509.00
631rO 4.63
7 9.18
59.18
23040
208.04
900.49
3r497.20
~ Market J\t:x:oonts
Ohio National Fin. Serv.-Annuity
_ Life USA-Annuity #4217103
We USA-Armuity #97-:A-2267350
Life USA-Aruu1it..y #4696707-WJ.anz
Ccmron Stooks
Nuveen M.ttual F\mds
Refunds
Yamg's Medical Equipn:mt West
Penn State
Union Bankers !nil. Co.-refund
Penn Treaty Life Ins. Co.
,
Internal Revenue Service-refund
Miscel1.aneoos Prcperty
Life USA-paynEIrt:
, ,~~l
H~) ,
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
UJ
.Jack E. Snavely
------.. ...,--,-----~-~-,.,_.-~~-_.~-_._---"
being duly ,------>l-WQ.l:U-"---~ according to law, depose. end saYI th.t he_ IA the Executor "--.."--,,----..
________,_..______,__________________,____________ 01 the E.tate of (:1 "mantIna D. \:loodward
I.te of _____E:aatl'enAbo,ro _Twl'.---------,----------, Cumberland County. Pa.. deceased "nd that tho
within il an inventory mad. by _ .Jack E. Snavely ________" the ,.id Executor
of the entire ellat. of ,eid decedent, conli,ting of all the p.rsonal property and reel e.tate, except r.al estate outside
tho Commonwealth of Pennlylvania, and that tho figures oppo,ite each item of the Inventory reprol."t it', fair value
al of the date of decedent', death,
__ and lub,cribed belore me,
19__
.Jack E. ,
" ';' '\~(,lC
ave ly e1Clc:utor . Ilft+,..tor
Add""
Date of Death
28
D.y
02
Month
1997
v..,
INSTRUCTIONS
I. An inventory must b. flied within three months aft.r appointment of personal representative.
2. A supplement inventory must b. filed within thirty day' of discov.ry of additional allets.
3. Additi.,nal ,heels may be atteched a, to p.rsonalty or realty
4. See Article IV, Fiduciaries Act 011949.
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Stli'I'I.I';MI\NTAI.
Inventory of the real and personal ostate of
Clementine D. Woodward
PERSONAL PROPERTY
deoeased
Funds held in
Commerce Bank-Escrow Checking' Aoct:. 0510023781 for the benefit
of the decedent
, '
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
II:
~_. _l.n.~~..o<1;:..!_ B!~~~~.~L.__.
is the Executor
being duly ~,flliQ!]l_______ according 10 law, depose. and sllvs Ihat h.
____________________ ________,_____~_ of the Estate of Clementine D. Woodward
lale 01 __~I!et"r~nnsborg Twp, I, ,,----- -------- , Cumberland County, Pa., deceued and Ihat the
within is an invenlorv mede bV ___..J_~Snave1y. , the said _ Executor
ollhe onllr. estale 01 said decedent, con,I,t1ng 01 all the personal prop.rtv and r..1 estate, except real estate outside
tho Commonwealth 01 Pennsylvania, and thaI the figure. opposite each item of the Inventory represent it's leir veiue
u 01 the dato 01 d.cedent's death.
and subscribed before me,
19-
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Jack E. Snavely ex..,t., . JlIj"",4~'
P.O. Box 48
Camp Hill. PA 17011
Add....
Date 01 Deeth
?R
Doy
O?
Month
1997
v..,
INSTRUCTIONS
I. An inventory mu.t be filed within three months after appointm.nt of personal representative.
2. A supplement inventory must b. flied within thlrtV devs of discovery of additional auets.
3. Additional ,heets may be attach.d a. to personaltv or reelty
4. See Article IV, Flduclarl.s Act of 1949.
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STONB, I.AFAVllll 1M 8TONB
ATTORNEYS "T LAW
414 DRIOGE STREET
N'BW (lIlMJlllIH.AN'll, I'^ 1707tJ
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IN ~HE COURT OF COMMON PLEAS
Oil' CUMBERLAND COUNTY, PENNSYLVANIA,
. NO. 2197~0256
--
FIRST AND FINAL ACCOUNT AND
PROPOSED DISTRIBUTION OF
CLEMENTINE D. WOODWARD, DECEASED
JACK E. SNAVELY, EXECUTOR
LATE OF THE TO~rnSHIP OF
EAS'r PENNSBORO
Sooial Seourity No.: 158~07-4033
Date of Death: February 28, 1997
Date of Exeoutor's Appointment: March 19r 1997
Date of Advertising Letters Testamentary:
Cumberland Law Journal - April 4, 11, & 18, 1997
The Patriot News Co. - April 1, 8r & l5r 1997
Aooounti.ng for the period: February 28, 1997 to July 22/ 1998.
purpose of Account: Jack E. Snavely r Executor, offers this aocount
to acquaint interested parties \~ith the transaotions which have
occurred during hie admi.nistration.
The account also indicates the proposed distribution of the estate.
It is important that the account be carefully exami.ned. Requests
fox: additional information or questions or objections can be
discussed with:
Jack E. Snavely
1017 Mumma Road
Camp Hill, PA 17011
Charles H. stoner Esquire
stone LaFaver stone
P.O. BoX E
New cumberland, PA 17070
RPX:I!IPl'S OF PRm:IFAL
Estate of Clementine O. Woodward
111I of 07/22/98
Page 1
A'Nt, Li8ted in Il'\YeI1tory
(Valued as of date of death)
Fiduciary
J\cquiIiUon
Value
CheoJdng J\coountB
Dauphin Deposit Bank-ohecJdng aocoont
'91-54251-0r Principal $12,629.47, Int. $2.32
$2.32 lIoorued Interest
Camal Stocks
81.080 sha. Nuveen l41tual Funds @ $9.24 per
share
81.08 Units
$ 12,631.79
749.18
Reftux:lB
Yoong's MecH.,..u Equipmnt West-refwxi $ 59.18
Penn State-University Hospital refwxi on 23.40
overpayment
Union Bankers Ins. Co.-refund 208.04
Penn Treaty Life Ins. Co.-premium refund 900.49
Internal :Revenue Service-refund for 1996 1040
return for decedent 3,497,.20
4,688.31
Miscellaneous Prq:mty
Life USA-payrrent $ 497.86
Life USA-Annuity '4217103 199,157.67
Life USA-Annuity '97-A-2267350 - Allianz Life
Insurance Co. of North America 114,353.79
Life USA-Annuity '4696707 - Allianz Life
Insurance-beneficiaty is pine Street
Presbyterian Church, llarrisWrg, PA 48r509.00
Ohio National Financial Services-Annuity
,E5023845 269,054.17
-~--
631,572.49
RDIPI'S OF 1NlMl
Estate of C1errentine D. Woodward
For Period 02/28/97 TtuxJugh 07/22/98
Dividends
NuvI!IBn ~tua1 Funds
07/29/97 Nuveen t-tltual E\ID:is-dividerrl on f\md
10/27/97 Nuveen M.1tual E\ID:is-sale of 8.080 SM. at
$9.24 per share .
Total Dividends
Interest
m::: Bank Estate Checking hxlt.
04/04/97 m:: Bank-interest on estate checking acct.
04/21/97 poc: Bank-interest on estate checking acct.
OS/21/97 poc: Bank-intere>.st on estate checking acx."t.
06/20/97 poc: Bank-interest on estate checking acct.
07/23/97 poc: Bank-interest on estate chooking acct.
08/21/97 POC Bank-interest on estate checking acct.
09/18/97 poc: Bank-intereot on estate checking acct.
10/23/97 poc: Bank-interest on est.ate checking acct.
11/20/97 PNC Bank-int.erest on estate checking acct.
12/22/97 PNC Bank-interest on estate checking acct.
01/22/98 PNC Bank-interest on estate checking acct.
02/19/98 PNC Bank-interest on estate checking acct.
03/23/98 poc: Bank-interest on estate checking acct.
04/22/98 PNC Bank-interest on estate checking a=t:.
OS/20/98 m:: Bank-interest on estate checking aocount
06/22/98 m:: Bank-interest on estate checking aocount
$
3.31
6.66
_f.~. .l1'lll
9.97
$ 1.71
8.73
67.00
113.80
98.43
92.95
92.84
119.25
97.89
103.88
96.18
86.14
96.07
90.18
84.27
73.55
------
1,322.87
Page 9
$
9.97
ROCEIPl'S OF m::xH Page 10
Estate of C1en-entine D. Woodward
Fbr Period 02/28/97 Through 07/22/98
m: Bank-l>tlney Market J\oat.
OS/20/97 m: Bank-interest on Estate l-bnsy Market $ 1,367.43
OS/23/97 PlC Bank-interest on Estate /obney Market 250.52
06/24/97 PlC Bank-interest on Estate M:lney Market 2,015.85
07/25/97 PlC Bank-interest on Estate M:xIey Market 1,972.~9
08/25/97 m: Bank-interest on Estate f.bney Market 1,978.11.
09/22/97 m: Bank-interest on Estate f.bney Market 1,794.34
10/27/97 m: Bank-interest on Estate M:xIey Market 2,2~1.58
11/21/97 PN;' Bank-interest on Estate M:xiey Market 1,616.00
12124/97 m: Bank-interest on Estate M:xIey Market 2,140.47
01/26/98 m: Bank-interest on Estate M:xiey Market 2,145.50
02/23/98 m: Bank-interest on Estate M:xIey Market 1,810.76
03/25/98 PlC Bank-interest on Estate M:xiey Market 1,947.47
04/24/98 m:: Bank-interest on Estate Money Market 1,955.41
OS/22/98 OC Bank-,interest on Estate Money Market 1,962.81
06/24/98 POC Bank-interest on Estate Money Market. 2,392.52
27,601.12
Dauphin Deposit Bank-oheoking acct.
03/26/97 Dauphin Ilepoeit Bank-checking aoot. interest $ 11.47
~ Bank, N.A.-cert.. of Deposit
05/11/90 PlC Bank-<:ert. of Deposit interest fran
06-01-97 to 05-04-98 2,472.51
CIWA Individual Insurance
06/03/97 CI~ Individual Insuraooe-int.erest on .
insurance claim 16.95
Total Interest $ 31,424.92
'lUrAL REX:EIPl'S OF :rro:J.IE $ 31,434.89
-
DISI3URSEMENl'S OF l'R.IOCIPAL
Estate of Clementine D. Woodward
Fbr Period 02/28/97 Througll 07/22/98
1Idministrtltioo Expenses (Prin)
03/06/97 Check written by dscedent prior to death l:ut
not cleared by bank untU aftel:- death
03/26/97 Dauphin Deposit Bank-federal withholclinq
03/31/97 Pinnacle Health at Polyclinic-services
rendered
Check lI.lIIIber 2
05/12/97 Register of Wills-3 short cert,ificates
Check l1UIltlElr 3
OS/28/97 Register of Wills, 1\gent-payment due on
inher.i.taroe tax
Check nuntler 6
06/02/97 Pha.!:macy Corp. of Anerica-n-edication at Blue
Ridge Haven
Check l1UIltlElr 7
06/09/97 CoreStatee Bank-March pension paymant to be
retumed
Check l1UIltlElr 8
06/26/97 Blue Ridge lIa'iell West-services rendered
Check I1UITtler 9
06/26/97 Wagner Assoc.-prep. of incane tax
Check I1UITtler 10
06/26/97 Intemal Revenue Service-payment of tax for
1996
Checo.k nuntler 11
06/26/97 PA Depar\J1Jant of Revenue-payment of tax
Check nuntler 12
08/22/97 PA Deparbrent of Revenue-payment due on 1996
retum
Check nuntler 14
08/25/97 PhaI:macy Corporation of 1\merica-seIVices
rendered
Cheok nuntler 13
11/24/97 Register of Wills-filing InheritaIx:e Tax arx:I
Inventory
Check nuntler 15
Page 5
$
23.40
4.27
. 465.40
9.00
71r250.00
1,151.46
196.75
3,548.08
750.00
1,918.00 .
521.00
73.11
308.55
25.00
ROCEIPl'S OF INCClolE
Estate of Clell'tmtine D. WOodward
Fbr Period 02/28/97 Through 07/22/98
Dividends
Nuveen ft.1tual P\Inds
07/29/97 Nuveen foUtual Funds-dividend on fund
$
3.31
10/27/97 Nuveen foUtua1 Funds-sale of 8.080 sha. at
$9.24 per share 6.66
Total DividerK:Is
Interest
PN::: Bank Estste Chec'Jdng Pacot.
04/04/97 PN::: Bank-interest on estate ohecldng acct.
04/21/9"/ PK: Bank-interest on estate checking acct.
OS/21/97 PN::: Bank-interest on estate ohecking acct.
06/20/97 PN::: Bank-interest on estate ohecking acct.
07/23/97 PK: Bank-interest on estate ohecking acct.
08/21/97 PN::: Bank-interest on estate ohecking acct.
09/18/97 PK: Bank-interest on estate ohecking acct. .
10/23/97 PN::: Bank-interest on estate ohecking acct.
11/20/97 PK: Bank-interest on estate ohecking acct.
12/22/97 PN::: Bank-interest on estate ohecking acct.
01/22/98 PN::: Bank-interest on estate checking acct.
02/19/98 PN::: Bank-interest on estate checking acct.
03/23/98 PN::: Bank-interest on estate checking acct.
04/22/98 PK: Bank-interest on estate ohecking acct.
OS/20/98 POC: Bank-interest on estate checking llCOount
06/22/98 m:: Bank-interest on estate checking account
_M _
9.97 '
$ 1.71
8.73
67.00
m.80
98.43
92.95
92.84
119.25
97.89
103.88
96.18
~6.14
96.07
90.18
84.27
73.55 '
---'---.,....--.
1,322.87
Page 9
$
9.97
RDIPl'S OF Il'lXIolE
Estate of Clsrentine D, WocxIward
FOr Period 02/28/97 Through 07/22/98
m: Bank-f.tJney Market JIcot.
OS/20/97 m: Bank-interest on Estate lobney Market
OS/23/97 m: Bank-interest on Estate lobney Market
06/24/97 m: Bank-interest on Estate M:>nay Market
07/25/97 FtC Dank-interest on Estate lobney Market
08/25/97 m: Bank-interest on Estat.e bey Market
09/22/97 ,m: Bank-interest on Estate lobney Market
10/27/97 :m:: Bank-interest on Estate bey Market
11/21/97 m: Bank-interest on Estate bey Market
12/24/97 POC Bank-interest on Estate bey Market
01/26/98 POC Bank-interest on Estate lobney Market
02/23/98 POC: Bank-interest on Estate bey Market
03/25/9B POC Bank-interest on Estate bey Market
04/24/98 Ptl: Bank-interest on Estate M:lney Market
OS/22/98 PtC Bank-interest on Estate M:mey Market
06/24/98 POC Bank-interest on Estate lobney Market
Dauphin Deposit Bank-checldng acct.
03/26/97 Dauphin Deposi.t Bank-chealdng aoot. interest
POC Bank, N.A,-<'.e.rt. of Deposit
05/11/98 m: Bank-<:ett. of Deposit interest fran
06-01-97 to 05-04-98
CI~ Individual Insurance
06/03/97 CIGNA Individual Insurance-interest on
insurance claim
Total Interest
'lOl'AL RECEIPl'S OF Il'lXIolE
$ ~, 367 .43
250.52
.2,015.85
1,972.29
1,978.17
1,794.34
2,251.58
1,616.00
2,140.47
2,145.50
1r810.76
1,947.47
1,955.41
lr962.81
2,392.52
----
27,601.12
$
11.47
2,472.51
16.95
Page 10
$ 31,424.92
$ 31,434.89
:,' '1 row. DI~ OF Il-lX:H!J
; j
~~:',1 '
::"'j
~~J'j
":h
~?
DI~ OF ~
Estate of CIElllentine D. lok:lodward
For Pel:-iod 02/28/97 'lhroogh 07/22/98
Page 11
! Feu and CannioiC118
i 07/22/98 ~ LaFaver & Stone-Att-"'--.'8 fee al
!near. ~''''.Y
I
I .tnc:ans Taxes
I
I
I
05/14/98 Int:e.rnaJ. ~ Service-.payment of 1997 1041
P8derAl IlIOaIll t4Xes
Cheok lIlIIlter 22
, $' 5143.00
05/14/98 PA ~t of RevenUl!-opaYlllllnt of 1997 PM1
state Incare tax
Check IlUDtler 23
. $ 18,188.00
563.00
,'-I
18,751.00
J
$ lP,694.00
~ ~-
'"~:h , "1....~t,":""""'~'~.~."',,'-,
'I'
/fj-/ltlS-.((
llNHERITANCE TAX RETURN ~F~~~ln~~.~r~Df~~MrAEn 1_2131101
RESIDENT DECEDENT "-~~~:rv.9ri!'DIT_!8 CLAIMEgJL
COM~~~:;'~~i.~i,'~,'~~:E'~~~ANIA (TO BE FILED IN DUPl.ICATE FlU: N~TBER ] 997
IIAHRI"~G~k':~~~~""01~IT~ REGIST~R__?F WILL~)__ c~:iJiIY..s':2l?!.:.--=-=_Yl~
D~CEDENrS NAME (LAST, FIRST, AND MIDDLE INITIAl.) DECEDENT'S COMPLETE ADDRESS
Woodward, Clenentine D. __ 770 Poplar Church Road
SOCIAL SECURI1Y NUMBER DATE O~ DEATH DATE OF BIRTH CallI' H111, PA 17011
DECED!NT 158-07-4033 02/20/97 04/05/1914 COllnt CtuIDerland
IHST ~NO MTo/'L~ '~:T:ALI ILA" SOCIAl. SECURI1Y NUMBER AMOUNT HECEIVED (SEE INSTRUCTIONs)
o 40. Fuluro Intorosl CompromIse
(101 dUles 01 dealh a<<or 12-12-82)
~ 0, Decedonl Died Teslalo 0 7, Decodont Malntalnoela Uvlng Trusl
(Mach copy of Will) (Mach copy 01 Truel)
- -- ...............~~
AU CORlWlPOH~N(lI!.ANQ OQHFIDeNTIAL TAXINFOOMAT1 llJ-IO B DIRECTED TOl ...
NAME COMPLETE MAll.ING ADDRESS
Charles H. Stone, Esquire Stone LaFaver & Stone
TELEPHONE NUMBER 414 Bridge Street
717-774-7435 New Cumberland PA 17070
" Roal Eslal. (Schedule A) ( 1 ). None
2, Slocke end Bond. (Sohodule B) ( 2) 749.18
3, Clo.ely Held Stocll/Par1norehlp Interesl (Soh, C) ( 3 ) None
4, Mongagos end Notos Recelvablo (Schodulo D) ( 4 ) None
5, Cash, Bank Deposits & Mlecellanooua Personal ( 5 ) 17 , 817 .96
Property (Schedule E)
6, JolnUy Owned Properly (Sohedule F)
7, Tranefers (Schedule G) (Schedule L)
8, Total Gross A_ts (tolel Unoo 1-7)
0, Funeral Expenses, Admlnlstrellve Costs,
Miscellaneous Expenses (Sohedule H)
10, Debts, Mongage Uabllltlos, Uen. (Schedule I)
1T, Total Deduotlons (total Unos 0 & 10)
12, Net Value of Eelate (Une 8 minus Une 11)
13, Chatnel>e and Governmental Bequeste (Sohodule J)
14, Net Value Subjeot 10 Tax (Une 12 minus Une 13)
15. SpouIII Tran.f,,. (for datu of dealh al1l1r 6~30-i4), See
In.lrucllont for ApPlicable Percentage on Page 2. (Inoll/d,
value. Irom 5oh.dulll KorSc;hldultM,)
18, Amount of Une 14 taxable at 8% rate
(Include values from Schedule K or Sohedule M,)
17, Amount 01 Une 141axable al15% rate
(Include values from Schedule K or Schedule M,)
18, Pr1nolpallax due (Add tax from Une. 15, 15 .nd 17,)
19. Credits Spouul Poverty Crldll Prior Payments Discount
+ 71,250.00+ 3,750.00.
20, If Line 10 Is reater than Line 16, enter 1110 dllloronce on Une 20, This Is the OVERPAVMENT,
A, .ok'j,....." 0lli';i\.,.quell1l"9 a rotund of 'fOur 0'I8~Yn1em. .1
21. If Una 18 I. greater Ihan Une 10, enter tho dllloronce on Une 21, This Is tho TAX DUE.
A. Enter th~ Interest on tho balpnce duo on Uno 21A.
B, Entor tho total ot Uno 2T and 21A on Une 21B, ThlB" Ihe BALANCE DUE,
M~e Cheok Payablolo: Reglltor 0' Wille, Agenl
! ....... ,\. .. T""'... "'_BE SUIlETO ANSWER ALL QUESTIONS (JNPAGE UNO TO RECllEClOoIATl1'" .... ...... .... 'TT"
Under penaltliS of perjury, I declaro thatrh8"ve o)(Bmuwd Ihis roltHn, Includlflg accompanying schodules and statements, and to tho best 01 my knowledge-"
, and bollef, It Is truo, correct and complato. I declaro 1hat all roal ostato has boOn roporfod at tiue markot value. Doclarallon of proparo( other than tho persona)
I !.B.p..!.9_~nta1JVa 19 based on aJllnlormaUon 01 which praparer Ilas any know~o, __.
, SIONATUttE DE PEASON AE5PPNS/,U: FOR FILING RETURN ADDRESS DATE
II (l (, ,I, (f 1 l I, \ \ See Schedule attached i I ,,'( ( 'I !
" SIONA.(URf:: nt~AERoTH!ERTHANnEP T'\TIVE ADDRESS ~ DATE
Lt,~:"'- 414 Bridge Street -qit /..1.'(/I-?
Nrr.." New Cunt>erland, PA 17070 -+
" Orlginsl Relurn
CHECK
APPRO-
PRIATE
BLOCKS
o 4, Umllod ESllle
CORRES-
PONDENT
RECAPIT-
ULATION
TAX
COMPUTA-
TION
Ng"rAOO\
0256
NUMBE~
2, SlIpplomontsl Rolurn
1] 3.
~5
Federal EOlalo Tax Roturn Required
Remelnder Return
\lordlt.lofduthprIOrIQ 12-13~82)
o 6, Tota' Number 01 Sale Depoolt Be,es
(8 )
(7 )
None
631,074.63
649,641. 77
(8 )
(6 )
3~,635.93
(10)
5,494.89
42,130.~2
607 r510.95
48,509.00
(11)
(12)
(13)
(14)
559,001. 95
(15)
x ,
.
(18)
0.00,
0.00
,08 II
(17)
559,001.95,
03,850.29
,15 "
(18)
83,850.29
Interest
(10)
(UO)
75,000.00
(21)
(21A)
(218),
8,850.29
0.00
8,850.29-
Page 2
Estate Ofl Clementine D. Woodward
SCHEIX1.t:.E H, PARI' C - Miscellaneous Expenses.
21-1997~02S6
ltan
No. Description l\mCUnt
1 CoreStates Bank-March pensi.on fran Glen (;any to be returned. 196.75
2 Wagner Assoc. ~prep. of iroare tax 750.00
3 Internal Revenue SeJ:vice-paymant of tax for 1996 1,9111.00
4 PA Deparbnent of Revenue-payrrent of tax 521. 00
5 PA Depa.rtllent of Revenue-paymant due on 1996 retum 73.11
6 Cwti:lerland law Journal-adveItising grant of letters 60.00
7 The Patriot 'News Co. -advertising grant of letters 65.20
8 Rsserve for closing expenses 2,000.00
9 Dauphin Deposit Bank-federal withholding 4.27
'!UrAL. (Carry forward to main schedUle) . . . .
5,588.33
....
I~',
Decedent Confirmation
Name
Social Security No
Date of Death
Clementine D, Woodward
158-07 -4033
02/28/97
Description Account Account Account
Account No. 91542510
Account Type Checking
Dale Opened or Issued Unknown
Uale Closed or Matured 04/01/97
Dale of Death Balance $12.629.47
---,
PLUS !'LUS PLUS PLUS
-
Dille of Death Accrued Int. $2,32
Joint Oltners (If OilY) None
Uale of Joint Ownership
Special Comments: N/A
Date Prepared: October 22. 1997
Prepared by: Amy L. Halvor
(Rev 8/2(0/971
Page: 2
~~w.
~ EX' (1-a7)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT, 200601
HARRISBURG, fA 171 ~O-0601
.
1, Real Estate (Schedule A) (1)
2, Slacks and Bond. (Schedule BI (2)
3, Close!y Held Corporation, Partnership
or Solo-Proprietorship (3)
4, Mortgage. & NOles R""",lvable (Schedule D) (4)
5, Cash, Bank Doposlts & Mlscellanoouo Personal
Property (Schedula E) (5)
6, Jolnlly Ownad Property (Schedula F) (6)
7, Inter-Vivos Transfers & Miscellaneous
RECAPll'- Non-Probata Proparty (S<:hedulo G or L) (7)
ULATION
14, Net Value Subleotto Tax (L1no 12 minus L1na 13)
15, Amounl of IIno 14
tSlCable at tho spousal
tax rate
See Inslructlons on paga 2 for appllcablo parcantage
16, Amount 01llne14
taxable al 6% rate
17, Amount 01llna14
I..,abla al15% rata 15,979. 8!?. X ,15 (17)
10, Tax Due 10
19, (,..HECK HEflE IFYOiJAiiE REQUESTING A Rl!I'UND OF AN DVERPAVMENT
/7> ...... .1Ol'>. E SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND ReCHECK MATH<< . .... .... . ..... -
Under ponaltles of perjury, I declare that I havo oxamined this return. Including accompanying schedl;fOs and statements, and 10 the best of my knowledge
and bollol, It I. trua, corracl and compla'a, Doclorallon 01 preparm othar Ihan IIla peraonal reprosanlallvals basad on alllnlormallon 01 which preparer has
eny knowledge,
SIGNAl IRE ~F PF.RSOARE )ONSIULE FOR FILING FlETUAN ADDRESS
~ , n See Schedule attached
SIOG_ Ii' RU'^AER antE Tl-JAN HE ESENTATlyE
'7 PAl600 NTF \ '"
COPYflqht Forms Softwaro OnlY, 19"7 NlIlco, Inc.
DECEDENT
CttECK
APPIlO-
PRIATE
BLOCKS
CORRES-
PONDENT
TAl(
COMPUTA-
TION
L
------.-
OFFICIAL USE ONl.'!'
15- IL'~- q
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE ItUMBER
21. 1997
COllNTYCOPE VEAA
0156
NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDl.E INITIAl.)
Woodward, Cleroontille D. rUPP1~~ltal) _____
SOCIAL SECURITY NUMBER DATE OF DEATH DATE OF BIRTH
158-07-4033 02/28/97 04/05/1914
IIF APrUCAnLEI 'U,W,Ii'NG 'POU",'5 NAMr liAST-lOCIAL SECURITY NUMBER THIS RETURN MUST BE FtLED IN DUPLICATE
FIRST, AND MIDOl E INIT'AL) ,
Win! THe, REGISTER OF WILLS
ill - ~. Remainder Rolllrn
1 Original Rolurn 2 SupplAfootltal Roturn (dalll oj d84th prior to i2"13-82)
4a Future Intllfll/!lt Compromise
4 L1mltod Est.lo I:='~=:- 5, Fadoral Eslata Tax Rlrn, Roqulred
6 Oec6dvni Drod Tlls'.llo 7 tJecsdlltlt Malnt4lnlld.l.lI~lOg Trust 0 0 T I IN 1 SID 0.11 Boxa,
(Attach COpy 01 Will) \.I\\t"ch (;npy 01 T1usll ' 0 a 0, 0 a e op
9 l.111 II P d R I d 10 ~rolJsal PovlIrly CrfHIit(dAln 01 dllalh bnlwllllfl 111.1. Elflc111,lrl to t,,~ under Sec, 9113(A)
~~~ocoe S oeo VO __ --1l2.L:J!.!.~!1Ij 1 -I 115) ______..l.L...-.011aoh :Jell 0\
'flUS $fl(.'TION MUl>.!..!IE COMPLETED, :'l.L CORRI!SPONDf.tlCE " CONFIDFJHlAL TAX "JI'OR!M!!Q.It!!!!OlJUl8l\ IlIl'lECTetl T(l:~
NAME COMPLETE MAIl.ING ADllRESS
Charles H. stone, ~ire ________ 414 Bddge street
FIRM NAME (II Appllcabi<l) New Culrberland, PA 17070
Stone IaFaver & stone
TEl.EPHONE NUMBER
717--'174-7435
None
None
OFFICIAL. USE ONL.V
None
None
10,700.00
None
5,843.75
0, Total Oro.. Aasela (lotal L1ne'l-7)
9. Funeral Expenses & Administrative Costs (SChedule H) (9) _
10, Dabts 01 Docodenl, Mortg, L1abllllla., & L1on','oh, II (10)_
16r543.75
(0)
496.00
67.90
11, Total DoduoUona (Iolal L1na. 9 & 10)
12, Net Value ot Ealate (Line 0 minus L1na 11)
13 Choritabla and Governrnonlal Bequasts/See 9113 Trusls
lor which an elocllon to tax has nol boon made (Schadulo J)
563.90
15 r 979.85
(11)
(12)
(13)
None
(14)
15,979.85
X.L_
(1G)
0.00 x
(10)
0.00
,06
2,396.98
2,396.98
.l\DOAESS
414 Bridge Street
New CuniJerland, PA
6~)r,?r
~~ATE ~~ '
_ J ,f),)/ /f:.? ~
~.' /
17070
PA REV-1500 EM (1-97)
Decedent's CompletE> Address:
STREET ADDRF.SS
770 ~,I!! Church Road _
PagG2
CITY
STATE
PA
ZIP
170n
nill
Tax Payments and Credits:
1, Ta>< Due (pago 1 Line 10)
2, Credll,/Payments
A, Spou,a1 pov.rty Cl8dll
8, Prior paymenl'
C, Dlooount
(1) 2,396.98
Total Credits (A + B + C) (2)
0.00
3, Inter.sUPenal1\' If applloable
0, Inlsr..t
E, Penalty
(3) 0.00
(4) 2r396.98
(5)
(5A) 0.00
(58) 2r396.98
Tol,llnl.res1/Penal\y (0 + E)
4, If line 21' great.r thAn line 1 + line 3, enler Ihs dlllerence, Thl' I' the OVERPAVMEttT.
Check box on Page 1 Un. 1910 roque.t a r.tund
5, 1111118 1 + line 31s gr..ler than line 2, enler the dlllAronce, This I' Ihs TAX DUE.
A, Enter Ihs Interest on the tax due,
B, Enter the totsl of Une 5 + SA, Thl' Is the BALANCE DUE,
Make Check Payabla 10: REGISTER OF WILLS, AGEttT
PLEASE ANSWER THE
BY PLACING AN "X" IN nlE APPROPRIA,E BLOCKS
1, Old decedent make a transfer and:
e, retftln the use or Income olltla property transferred; . , , ' . . . , , , . , , . , . , , , , , . , . , . , , . , . . , , , , , , . ,
b, retain the right to designate who shall use the property tronsforred or Its Income:, . . , , , , , . , , , , , , , . .
c, relaln a reversionary Interest: or. , , , . . , . , , . , , , , . . . , . . . , . . . . , , . , , , , . , , , , , , , , . , , , . . , . . . , , ,
d. receive the promise 10r life \,)f elthor payments, bonefits or care?, , , . , . . , , . , , , , , , . , . , . , , , . , . . . , ,
2, II doath occurred on or bolore Decembor 12, 1982, did deced.nt wllhllltwa yoars
precsdlng deAth Iransler property wllhout ,ocelvlng Adequate can,lderallan? If dealn occurred
a"er Decembor 12, 1082, did decadenllran.l.r property within one year of death wlthoul
receiving Adequate consideration?, , , . . . . . , , , , , . , , . . . . , , , , . , , , . , . . . . , , , , . , , , . . . , , , , . , . , . , .. 0
3, Old decedent own an "In trust lor" or payable upon doath bank account or security
at hi. or her death? , , , , , , " , , , , , , , , , , , " , ' , , , , , , , , , " " " , , , , , , " " ' , , , , , , , , " , , , , ,
4. Old decedont awn an Individual retirement account, annuity, or other non-probate proporty?, , ..' , . . . , . .
Ves No
~I
~
~ ~
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN
72 p,S, 89116 (a) (1,1) (I) provided Inr Iho reduotlon 01 Ihe lax ratA Impo'sd on Iho nel value at lran.lsrs 10 or for tile use oflhe surviving apouse from 6% to
3% far dates of death on or after July 1, 1994 and bofort\ January 1, 1995,
72 P,S, 89116 (a) (1,1) (II) provided for the reduNlon olthA rate ImposerJ on the net valuo altransfers to or lor the use 01 tho surviving spouse from 3<1/<) to 0%
lor dates of death on or alter January 1, 1095, Tho statute does not o)(ompt a transfer to a surviving apOLlstl from la)(, and the stallltory requlremonts for
dJsclosuro of asoots and flUng ft tax return arc 8tJlJ applicable even lithe surviving spouse Is the only beneflclarv.
FOR DATES OF DEAlll ON OR AFTER JAltUARY 1, 1995 -- Please an.wer IlIelollowlllg quostlon by placing an "," In the appropriate spaca,
Old the decedent create a truat 01' almllar arrangement which Is ,olelv tor the .urvlvlng apouae'a bone1tt for hla Of her enUre meUm.?
Vea 0 Ito@
If you .n.wered yes to tile 'bove queGllon, tile lax on Ihe trll.1 or .Imllar orrangemenll' pOGtponad unlll the d.alh ollhe second .pause, at which Uroo II will
bo fully lexable At the ,ate(,) applicable to th. romalndor bon.flcla",(lo,), Enler the v,IUG 01 the tru.1 on Schedule J, Pa1111, In ord.r to ,emovelt from ths
calculation at the lex dlle In Ihl. estate, Vou may wlslllo IlIe Schedule 0 In order to mGko Ihe election available under Section 0113, Illh. elactlon Is made,
the trust or similar anangernent Is taxed In the mHate althe firat decedent spouse, the portion of tho lrust or similar arrangement which benefits the ourvlvlng
'pause 13 texed at tho zoro lex role, and tile remainder Is lexed allllo raters) appllcablsto IlIe re",alnder bonoflcla",(les), If you choose to make the election,
you must aUach Schedule 0 to a timely-flied tax roturn, along with Scl1odulo(s) 1< andlor M In ordor to f1how the apportionment of 1he trust or similar
arrangement botween Ihe surviving Gpouse and tile ,smslndor bonellclary(les),
7 PAf5002 NTF ""0
Copyright Forms Software Only, t997 NellJo, Inc.
REV-1510 EM. (\-97) :J SCHEDULE G L
COMMONWEALTH Of PENNSYLVANIA INTER-VIVOS TRANSFERS &
INH:ER~;'t~cNt6<E~'f~r MISC. NON-PROBATE PROPERTY
ESTATIl OF PIU! NUMBl!II
Clementine D. ( SU(lplemental) Woodward'
21-1997-0256
This oohedule musl bl> comploled and mod ff tho .nswor 10 anv of quoellons 1 through 4 on lhe reverse lllde at lhe REV-1llOO COVER SHEET Ie yee,
,I
--
DESCRIPTION OF PROPERTY 'kOF EXCLUSION
ITEM INCLUDE NAME OF THE TRANSFEREE, THEIR DATE OF DEATH DECO'S (IF TAXABLE VALUE
RELATIONSHIP TO DECO & DATE OF TRANSFER.
NO, ATTACH COPY OF THE DEED FOR REAL ESTATE, VALUE OF ASSET INTEREST APPLICABLE)
1 The Union Central Life Insurance 5r1l43.75 100% 0.00 5,843.75
Co.-annuity proceeds
,
,
.
"
--
TOTAL (AlllO enler on line 7, ROOllDllul.lIonl . 5,843.1.~_
11
"
(I
I
,I
,I
I
I
7 CPA01 NT' "01.
(It more space Is needsd, Insert addlllonel8he018 of lhe same size)
CoPvrlght Forml Soltwarfl Onlv, 1981 Nllco,lnc,
, ,
f'f').... ....
Cj) .Q2 \D 8 g g
OS; I;; . 8 .
o::t ... ... i ~. ,
Cj) C\l N
...... i "'"
. 0
0
-S; lfl .... ....
0........ 1Il 1Il ~
Z~Hj =
.... .... !
S2
.. H i
UJ ~ ...
~ lJl fII
UJ2i w -
~ i ~ ~
lSi
2 ,.. ~
~~ 0 w
... =
as
lR I;; ...
:il .... =
... ... l6 lA
-. .... .~ s::
i~ ...
... ~
I ~ 0 ~
~
~~ III III -
.-
.. .. ... ~ p;.(
.. it
Eti ...
IS ... .... ~
ai 0 ... -
... ....
! a:l
.... ~
. Ii ...
, ~
t 18 ....
I 0:
, bl IS
I =
. l!l ....
, ~ =
, Iii ~
" . tII ~
, Cl8 ~ !W ~
. !
,
. ~r:
" ~i .... ~i
, !~ i
.
.
,
, ....
, IE
,
, !m .... I~
, uI
. ..I
UJ.... UJ'"
i; ~ i~
~
m~ ;IS ~
....~
:j-/~'J-f}
COMMONWEALTH OF PENN~YLVANIA
DlPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAMES
IH~:R1UNCE TAil DIYISION
DEPT, 210601
HARR1UURO, PA l11za-0601
NOTICE or INHERITANCE TAM
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSF.SSHENT OF TAM
0~-02-98
WOODWARD
02-28-9"
21 97-0256
CUMBERLAND
101
E~_ -AM-Oun.!.!~,ltiOd--l
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISI.E, PA 17013
CUT ALONG THIS I.INE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV: isij"'- EX-AFi; - i ii9-'" 9ri "NoT i or -OF - "iNHE;l iT ilNCi" 'fAX-'A-pp;iA- i SEHEN'f; -Ai. UiiiANCE -iili' - - - - - - - -." - - - - - --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ClEMENTrN D FILE NO. 21 97-0256 ACN 101
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
CHARLES H STONE ESQ
STONE ET Al
414 BRIDGE ST
NEW C~M8ERlAND PA 17070
ESTATE OF WOODWARD
TAM RETURN WAS I (X) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTERE~_T - SEE REV~RSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Relll Elbt. (Sch.duh A)
2. stoak. ~nd Bonda (Schedule B)
3. tIoally Held Siock/Partner.hip Int.r.at (Schedull C)
4. Murtglg../Not.. Rlc.ivabl, (Sch,dull UJ
s. C..h/Blnk DlPOlit,/Hilc. Plrlonal Property (Schadull E)
6. Joiutly Ownad Prl1p,rty (Sch,dull F)
7. Tranlflrl ISchedull OJ
8. Tobl "net.
I ) CHANGED
Il)
(2)
(5)
(4)
(5)
(6)
(71
,00
749,18
,00
,M
17.817.96
.00
631.074.63
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
.. Funarll ExPftn.../Ad.. Coat./Hilc. Expan... (Sch.dule H)
10. Debt,/Hortgage Ll.bl11tl.~/ll.n. (Schedul. I)
11, Tobl Deductions
12, Nat Ullua of h)( R.turn
15. ChlrHabl./GovlrnNnt.l alqua.h; No"~.l.ct.d 9115 Trult. (5chadull J'j
14. Nat \htlu. of Est-t. Subjlct to Tax
If an aSBes~mBnt waB issued previously, lines
reflect figure8 that include tho total of 6hh
ASSESSMENT OF TAX:
15. AlItOunt of lina 14 .t Spou..l ,..t. (Ii)
16. Allount at Un. 14 t;llxabl. at Un..lIChlll A rd. (16)
1)'. AIIC"unt of Lina 14 hlxabla at Coll.t-ral/CI... 8 rat. (1)
18. Prlnelpal TIX OUI
NOTEI
TAX CREDITS:
PAYHENT
DATE
05-28-97
11-26-97
RECEIPT
NU~8ER
AA211360
AA242506
DISCOUNT 1+)
INTEREST/PEN PAID (-)
3,750.00
,00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
36,635.93
5,494.89
(11)
(2)
(151
1l4)
(9)
IlO)
-/
(,--./
'*
In.IHIII t" llt.tlt
::I.EMENTIN D
DATE
03-02-98
NOTE I To In.ure prop.,.
oredit to your ao~ount,
.ub~lt the upper portion
of thll forn with your
tax Plyunt.
649.641,77
42.BO 82
607,510.95
,,!t8,509,00_
559,001,95
14. 15 and/or 16, 17 and 18 will
returns asse81.d to date.
,DO M .00.
,DO K ,06.
559,001.95 M .15.
1l8)
AHDUNl' PAID
71,250.00
8,850.29
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
,00
.00
83,850.29
83,850.29
83,850,29
,00
,00
.00
IF TOTAL DUE IS I.ES5 THAN t1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFL~CTED AS A "CREDIT" ICR I, YOU HAY BE our
A REFUND, SEE REVERSE SIDE OF THIS FDRH FOR INSTRUCTIONS,)
1.0
L~' 0[""(
I. .10_"
(,,! )
Cl,
'I"
~
,
,')
(\1 'I,.
~
f?
~-"
t~:
_'I !i
00
RUENYATIONI Eaht.. of deoedent. dvlnt1 on or blfor, DIC.." -11, I'" H 1f MV future 'nt.rllt In thl ..'ate h tr""t'.rrld
In po..,nlon ar ,njoy..nt to ell.. '. (coU,t,,'.1) "",flahtrS.. of the dHtd*1t .'hr thl IMplratlon of My ..tat. for
11'. or for v..r., the C~onwt.lth hertbv .)Cpr..'lv r..arwI. thl right to appr.t.. Ind ...... trln".r Inh.rltlnc, TIMI.
It thl lawful eh.. B [ool1at.rtn rlt. on,ny luoh future lnt.,...t.
ptJlPQSE OF
NOTICEI To fulfill the rlquJruenh 01 Station 2140 of the InherJt~. Ind Eat,t. hIC Aot, Aot 21 of 1991i. (72 P.I,
5eontJfHl 911t0).
PAYMENT I o.tHh the top partion of thlt 1'40tlCI Ilnd .ubtllt with your ply..nt to thl ~.gi"hr of Willi prlnt~ on thl rlv.r.' _Ide.
~-".. check 0;" lIOfllY order PIVMlII tOI REal.BTER OF' MII.LB, AGENT
REfUND eeA), A ,.fund of . taM cr.dlt, which WI' not reqwtted on the TalC Rlturn, ..!t bti r.queai:ld by C1011ploUnl ." "AppllcIUrm
for Jt.fufld of Pennlylv.nie InherltlOO' and E,bt. TIM" (REV-UU>. ApplIoltlonl er. Ivallabh It thlf Off.lo.
of th. Rlthhl of Wllh, .,y of thfl n P,IVlnue Ohtrlot Offlo.., or by calling the .~lll 2ft~hOur
."ewrlne '''v~o. nuab.r. for for.. ordtrinAI In Plnn.ylVanh 1-800-36~~20S0, ouhlde PeM.ylv,"ll' end
..Uhin 100.1 H.firrllbUr, .r.. (711) 787"'094, TOO. (717) nZ~2252 (....rl"' IIIP.ired Only),
OIJECTlONS, Any Plrtv In lnt4rllt not ..tltHed with thll appr.l....nt, I11O'11WlCl' or dl..ll~1WKI1 of adUatlon., or ......Hnt
of hM tlnolucUnt dhcounl or lntllrt.U .. .hown on thlt Hotlol .u.~ obJlot within .lICtv (inl dlY' of "Mllpt of
thh Hotlol bYI
k-wrlttln ,.rotllt to the PA o.plrt.lnt of RIVlnul, Board of ApPllh, >>Ipt. ?II0Zl, Harrhburg, PI 17128-1021, OR
--.llo~lon to h$V4 thl ..tt.,. datll'llned It ludH of the looount of the plrlonlt r..,...lnteUve, OR
~.Dpp..1 t(;. the Orph.nl' Court.
AD'IIH
IS1RATlVE
CORRECT lottll
Flotull .rror. dhoov.,.d on thh o.......nt .hould b. Itddrluld In writing tOI PA Dlpart...nt of R.,,~,
Bur.eo of Individual Ta~.', A1THI Po.t A.....tent RIVllw Unit, DIPt. 210601, H~rr.llbur., PA 17128-0601
PhON (717) 711~6505, s.. pa,,1 5 of thl bookl.t "In.truoUon. for Iflh."ltanel fix Haturn for I Rllldent
Decadlnt" (R[VMlSPlJ for en .MPl""~tlon of MtIllnhtr.tlvlh oorractebla .rrorl.
DISCOUNTI
I. anv tax due I. paid within thr.. <!) o.lander uonth. aftar thl dle.dant'. dl.th, . flvl p~r~tnt (5~) dl,Qouot of
thtll tllf paid It .110wlld.
PENALTY I
The 15:< tll< ~.t~ non-perHclp.Uon penalty It cOllPlJtld on tM totll of the tlX Md Int.,.lIt ......ltd, Md not
plld bafora JenulrY 18, 1996, thl first day "ftar the and of thGi h~ IInnatty per"lod. Thlt non-participation
pwlllh It appealabll In the IIMI nnner and In the th41 .Mle U.. ~Irlod.. you would appaal the tile and Int.rut
th.t h.. bean aUUllad e. Indicated on thlt notlcl.
INTEREST I
Intlra.t It Ch.fDltd beginninG with flr.t day of d.lInqu.noy, 01' nlnl (91 lonth. and anI (1) day frOll the dlt. of
dI.th, to the dati of payltlOt. TalCII which baca.. dllllln'1Uant IMfor. January I, 1982 bl." Int.,...t at th. rats af
.he (6Xl p.relnt p.,. ~ uloulllhd at. I datly rata af .00016/1, All tllf... which bill'" dlllnquent on and aftlr
Jenulry I, 1982 will b..r Intarut nt . rata whloh 11111 vary fro. onhndftr vaar to cal.ndar ya" with that r.ta
ennDlXlC1ld by thl PA Dapart..ent of Pav.nu., Thl appllclbll Int.r.st rat.. for 198Z through 1998 Irll
Y.!!! Il'It.r..t R~l! Dally Intar..t factor !m Int.rnt ht. DillY Int.,...t Flctor
1982 lOX .0005" 1921 .X ,000Zlt7
1911 16:< .00001 1911-1991 11:( .000301
1914 11:< .000301 19'Z .X ,000U7
198& m .000356 19n-1994 1:1, ,000192:
I'" lOX .000Z7lt 1995-1'" 9:1. ,000241
.-Intlr..t It olllculat..d ao foll(Mlfll
IHYEREST . BALANCE OF TAK UNPAID K NUHBER OF DAYS DELINqUENT K DULY INTEREST FACTOR
-.Any Notlel ~"uld ~ft.r tha taM beco... d.l!n~t will r~fl.et IIn Intar..t elloulltlon to flft.en (lG) dlv'
be~ond the dlt. of the ....u..nt. If pav..nt It ."dl aft.r thl Int.rut ooaputatlon date .hown on th.
Notlca, Itddltlon.l Int.,...t IN.t be oalculatwd.
\ZOIfV
. REV-1~EX.(1-97)
COMMONWEALTH OF PENN~Yl.VANIA
OEPARTMENT OF REVENUE
DEPT. 260601
HAAflISBUFIG, PA 17!20-0601
B '!:l
1, Real E.I.le (Sohedul. A) (1) ex!
2. Stock. and Bonds (Sohodulo B) (2) 7 4 9i.l
3, Closoly HolrJ Corpor.UOn, Partnership ;;1:
"',
or Sole-Proprlotorahlp (3) None -<
4, Mong.gos & Notos Recelvablo (Sohedulo 0) (4) tkine -"
l.n
5, Oash, Bank OopoSItS & Mlscollonoous Porsonal
Proporly (Schodulo E) (5) 76,613.38 '-0
-~
6. jointly Owned Proporly (Sohodule F) (6) tft- W
7, Intor-Vlvo. Tran.lo" & Mlscellanoou. -J
I1ECAPIT- Non-Probalo Proporly (Sohedule G or L) (7) 636,918.38
ULA TION
0, Total GrON Aaalta(tOtal Unos1-7) (8)
9, Funera! Expon... & Admlnls~ativo Co.", ISch..ul. H) (9), 3B,621.~
10. Oobts of Docedllnl, Mong, Uobllitios, & Uon'lsoh,11 (10) 5,539.39
11. Totallleduotlons (fola! Unos 9 & 10) (11)
12. Nit Valul oj Eatat. (Une 6 minus Uno 11) (12)
13. Charllablo and Govommonlal Boquosts/Seo 9113 Trusta
lor which an oloetion 10 tax has not been made (Sohedule J) (13)
14. Nil Valul Sub Ict to Tax L1no 12 minus Uno 13
16, Amount 0 no 14
taxabla at lhe spou.a!
lax rata
See In.~uations on pago 2 for applicable porconlago
16, Amount 01 line 14
laxable at 6% rata
17. Amounlollln014
taxebloal16%,alo ____235,655.92, .16 (17)
16. Tax Oua (18)
_, ~~ HERE IF VCU AIlE IlEQUl!STING A AeFUNo OF AN OVERPAVMEHT I
..' ...... ....2..SIUURE TO ANSWEAALL QUESTIONS ON PAOE2Al1lD RECHECK MATH "..'"
Ondor pora/llo9 01 porJury, I doolaro Ihall hovo o,.mlned this roturn, Including accompanying .ch.dulo. and .I.,oments( snd to the besl 01 my knowledge
and 001"'/0111. ~uo, corroolend <"mploto. Ooolerallon of preparor olhor Ihon tho personni ,0proso"lollvo Is bnaod on all nlormoUon 01 whloh propOlor hos
any know ~____
BIG ATURE OF Pl~sO~)AEflf'ONSI8LE f:OA ~INa AETUFIN ADDRESS OA.!E,
"(),A 1'. .J, y .....~ - " See Schedule attached _!!..::..l..:t - fk"
BIG ytJ~ PAEPAAEROHtf.flT REPRESENTATIVE ADDRESS DATE
,/, ~ 414 Bridge Street ~-/'t'f.v
T P NTF 10669 New Cunverland, PA 17070
Copyrighl Forml SOtlWA'!! Only, 191H N.tco, inc,
DECEDENT
CHECK
APi'IlO-
PAlATE
BLOCKS
CORIlES-
PONOENT
TAX
COMPUTA-
TION
OfFlCIAllJSE ONLY
REiJ-1500
INI-IERITANCE TAX RETURN
RESIDEN1' DECEDENT
.- -
FILE NUMBell
CCIlJNWi;OClf: ~~2?
N&3,M.
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
~ Clementine D. -----'-'--'-J-
SOCIAL SECURITY NUMBER DATE OF OtiATH DATE OF BIRTH
158-07-4033 02/28/97 _ 04/05/1914
I" ^ 'N ICAR, [I "UI\V'V'NO ""OUgr', NiWfrL^"':--JSOCIAL SECURITY NUMBE~THIS ReTuRN MUST BE FILED IN OUPUCATE
Ifl5', ANn MIOUI fi INlrtALI
_ __WITH THE REGISTER OF WILLS
O I I a! R I 2 S I Ia! A I 3, AllmAlnd" fl.lurn
1, !Qn ourn ,uppomen o urn (d"IHld..thprlorloll-U-lUj
4ft Fulllr. Inl.rut Compromll' F E T d
4. Umltod I!otlto . (dAleol "..1/"11.' l~-U-UI 6. edorftJ .stalo ax Atm, Anqulro
6. D,clldllnl Ol.d Tul.l. 7, O.c.rI,,"1 M.lnt.ln.d. Living Tru.l 6 TOlaJ No of Salo 0 .'t Ilo" 0
(Aluch eopy 01 WillI (AItAGh copy 01 TrUllH ., epo ,,0
9 Uti II P d R I d 10,5 OUIIIPov.rlyCr"dll(d.l.o'duthb.lwlfn -n 11, Et.cIIClnlo....llund.rS.c,U'1J(^)
, a on rocoo 8 000 lJA ~3 - M 1- . _.._---LJ .. IAlI.ll~ ~otl,.2L..-. .. _.......
Ttll!, SECTION MllaT BE COMI'f..l!Jl!IJ,~ COIlIlESI'ONDl'll/CE . C(lI!!:!!1..I!NTlAL 1'10( INl'Oll~TIOH 8HOULD BE DIRlIlcno TO:
NAME COMPLETE MAILING ADDRESS
Chatlel'l H. _ S~one .L!';~i.re _ Stone ~aver & Stone
FIRM NAME (If Appllc.obla) 414 Bridge Street
New Culrber1and, PA 17070
TELEPHONE NUMBER
717-'174-7435
OFFICIA~E m~L Y
:'Clltl
(II (')
" n
,
,
, ,.r,
&j' 2.
714,280.94
44,161.32
67,0,119.62
134,463.70
14
535,655.92
,~-
(15)
0.00 ,
0.00
,06
(16)
80,348.39
80,348.39
PA REV-'I500 EM (1-97)
Dectdent'. ~omplet~ A~.!lre.s:_
STREET ADDRESS
770 Poplar Church Road
Hill PA 17011
PAg. 2
CITY
I STATE
IZIP
Tax Payments snd Crtdlts:
1, Tax Due (Page 1 Une 16)
2. Credlts/Paymenl.
A, Spou.aI povsrty Crsdll ,
B. Prior Payments
C, Olscou nl
(1)
80,348.39
82,541.08
3,750.00
Tolal Credits (A + B + C) (2)
86,291.08
3.
Inleroot/Penalty II applloabls
D. Interest
E. Penalty
4.
TOlallnleroot/Panalty (0 + E)
If line 2 Is grealer than IIno 1 + line 3, snter Ihe dlltsrsnoo. This Is lhe OYl!RPAYMENT,
Cheok box on Page 1 Una 1910 requeata refund
If line 1 + line 3 I. greater Ihan line 2, snter Ihs dlltsrsn"". This Is Ihs TAX OUE.
A, Enler lhe Inlsreat on ths tax due.
D. Enler lhe tOlal 01 Uns B + eA. This Is tho BAlANCE DUE.
Mak.e Chock Payablsto:REGISTER OF WILLS, AGENT
(3)
0.00
B.
(4)
(B)
(eA)
(B8)
5,942.69
ffi~@~;f@1t~j~!@n@)t~WmI:l:It:m!:W1~1!:;:iE . ~. " ' - - ,-
......;..~.; .';;~L~~~;~~~W~'~t~~"~6((6WING"'cil.JEStIONS
BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1, Old clecedenl make a tran,'sr and: Vile No
a. relaln tha use or Income of Ihe property Iran.lorrad: . , , , , , , , , , , , , , , , , , . , , , , , , , , . , , , . . . , , , , "~ I
b, retaln the rlghl to deB~nale who Ahall U98 Ihs proparty tran.terred or Its Income;. , , , , , , . , , , , , , , , , ,
0, relaln a reverelonary Inloreol; or, , , , , , , , , , , , , , , , , , . , , , . , , . , , , , , , . , , , , , . , , , , . , . . , . , , , , , , ,
d, receive the promise lor life 01 elthar payments, benaltt. or cara?, , ,. , , , , . , . , , . , , , . , . . , , , , , , , , . ,
2. II death ocourred on or belore Dscember 12, 1602, did dscedsnl Within two ya"a
prscedlng death translsr property wlthoul r8C8lvlng adaqusle con.lderallon? If deAlh occurred
alter December 12, 1962, did dscedanl tran.ter propsrty wllh!n one yeor 01 death wlth"ul
receiving adaquata o.on.lderatlon? , , , .. . , .. , .. .. , . , , , . .. .. .. .. .. .. .. , , , , .. .. , , , .. , , , , .. .. ,,0 @
3, Old clecedent own an "In trusl 10(' or payabls upon doath bank sccounl or socurlty
al his or her dealh? ,'....'.' . , , .. , , , .. .. , .. , .. , , , , , , .. .. , .. .. , , , . , , , , .. .. , .. , , , , .. ,.. , ,
4, Old clecedent own an Individual retlro"...nl account, annuity, or olhor non-probate propsrty?, , , , , , , , , , , ,
~ B
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
COMPLETE SCHEDULE AND FILE IT AS PART OF THE RETURN
72 P,S. 89116 (a) (1,1) (I) provldsd 'or the rsductlon 01 tho lax rate Impostld on the nat valua of transler. to or lor lhe u.o 01 the BUlVlvlng opow.e 110m 0% 10
3% lor dales of death on or altar July 1, 1994 and belora Januwy 1, 1995,
72 P,S, 89116 (a) (1,1) (II) provided lor tha raductlon 01 Iha rala Imp090d on Ihe nat valua 01 Irana'era 10 or lor Ihe uso of Ihe .wvlvlng apoullIlrom 3"A.lo 0%
for dol.. 01 daalh on or alter January 1,1995, The slalllla fl2.\ll~ a "an.'ar to a aUlVlvlng aflouso Irom lax, alld Ihe alllulory requllarnenlolor
dlsclo.ure ol...at. and IlIIng a lax return wa sllll applicable evan If tha aurvlvlng apou.el. Ihe only belloflolary,
FOR DATES OF DEATH ON OR ""TER JANUARY 1, 1095 -- Pla..a an.war Ihalollowlllg queallon by placing an "x" III Iho IlJlprbprlala 'PIOO,
Old the decadent create a trult or olmllar arranll"ment which I. solely lor thl aurvlvlng OPOUH'I btnelttlor hie or her IInU,.IIIeUIM?
Yea 0 No 0
"you anowarad Yaa to the abova question, Iha tax on Iha,ruS! or .lnJl" a"a"gamellll. po.tponad unlllll., dealh ollho .ooond ltfJou"", 0' whklh limo II wfll
be lully laxable al the ralo(a) applloable 10 tOa ramalndar benallclary(las). Enler Iha valua ollho I"WI Oil B<lhodulo .1, flail II, In m<tor 10 10"lflvell Irom Iho
c.lculatlon 01 Iha tax due In thl. e'lato, You may wish 10 file Schadllla 0 In ordar 10 maka 1I1110100llon .Vllllol~. und", HtKrllon 01 t~. II IIIII _lion 10 made,
Iha lrusl or almllar arrangamenl la laxed In the aslate 01 Ihe IIral docodanl apOll.e, lhe porllon 01 II", 11U.1 or "In~la' a""Ifl'",01l11 whMI berlltlllo Ihe I,mvlvlng
apou88 I. laxad al the zero lax rala, and Iha ramalnda, I. laxed al tha rala(a) appllcablalo Iho romalnd", 10Il,oIl1l10ry(ia"l. If ynll "'"Ill'" to rnaka Ihct alncllon,
you musl a"acll Schadule 0 10. timely-iliad lax ral<,m, along with Schadulo(.) K and/or M In Old", I(] 0"01'1 IIllI .ppIIIIIOII"O",1 01 Iho IIUo' or lIInJl1I
arrangemenl bel'll8811 the aUlVlvlng apoustl and Ihe ramalndar bellallclary(laa).
7 PAI5D02 NT110870
Copvrlght Forms 80ftWIH8 Only, 1097 NelrJO, Inc,
REV-1510 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
C1ElTViU1tine D. Woodward
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
FILE NUMBER
21-1997-0256
Thl. oohadula mu.t b<I oomplet.d and flied If the anower 10 any of qua_tlons 1 through 4 on the rever.. .Ide 01 tha REV-l500 COVER SHEET I. Y".
DESCRIPTION OF PROPER1Y %OF EXCLUSION
ITEM INCLUDE NAME OF THE TRANSFEREE, THEIR DATE OF DEATH DECO'S (IF TAXABLE VALUE
RELATIONSHIP TO DECD & DATE OF TRANSFER.
NO. ATTACH COPY OF THE DEED FOR_REAL ESTATE. VALUE OF ASSET INTEREST APPLlCABLEl
1 Ohio National t'inancial 269,054.00 100% 0.00 269,054.17
Services-Annuity No. E5023845
2 Life USt\-Annuity Controot #4217103 199,158.00 100% 0.00 199,157.67
3 Life USA-Annuity Controot 114,354.00 100% 0.00 114,353.79
#97-A-2267350 Allianz Life
Insurance Catpany of North J\marica
4 Life USA-Annuity Contract 48,509.00 100% 0.00 48,509.00
#4696707-Allianz Life
Ins.-beneHci.ary is Pine Street PA
Presbyterian Church, Harrisburg,
5 The Union Central J.J.fe Insurance 5,843.75 100% 5,843.75
Co.-annuity proceeds
"I'
,
.
. -
TOTAL (Aloo anter on line 7, Recapltulallonl S 636,918.38
7 CPAOl NTF "810
(II more spa"" I_ needed, Insert addiUonal _heelS of the _a..., .Iza)
Copyright Form. Softwlln Orlly, lIHl7 N.lco, Inc:,
Commerce
.Bank
Commerce BanklHerrlsburg N.A.
100 Senile Avtnue
P.O. 80, eSll9
Clmp Hili, PA 17011
(717) 975-6830
,J . ./ \'1 L i . :'.~ (. n 1;:1 " /-,' (PiT
.. ..
/ ( 1
,- " , 1 I Lt. ).', 1 ., !f
I:
I
I
).., t.:lkCi< r iH" A; ,j.j. nJ ':II '-II: ;;:,-
',(.'.:-HJI'IT r~U' '~,l ):)1,....v':~:":!7'\1 T'!~):. (0 'Ill'.' I,
/1'..VlnlJ '~'r-i._T':;,\-:nT i,t\I..AI'J(~C :\.~ I';f~' ,'I\./')J/;(7 _"f
...1LU.~ .1 D_~(I!l-:)IT'")- '/,NC), "ITd-, -~ c}r,C> I f') ..
L.';". " ' CHi:':l<,..j AfhJ .1TL:: )r~(T-:~ ..'...
':'_J' ',' ~\Jr ;T'J~l' _'.IL"IT .-,AL'\I.IC'~ .\3 f'Ji~ ',.!/"'" ~1;/7 ....,
'il)',\ ~_:., \';,::- -I}_\Y~' (;'1 Trll;~ '3T;\f 1:::,~T --::'t'::t.~rr)') .~_j
STATEMENT DATE
, " n
ACCOUNT NO.
.) ~ 1 'J ,.:; ;! 37 ,'j 1
::lr':L: C~
1 d-Z;lZ:S .17
4:3,000. Dr,
.00
. J;J
4 d , (; IJ 0 . C)
._--~----~-~----~.-------.-~-----~---------~-~---.-----------
~ 'I i- \1-<\'IC. Y ~I\T'~" kJi! ~
:1/-q Il,il .,(\i ,,('J'
';'-:'~''':T1V,.~ t::'...HI 1. li)'J7 :)'J'<>'\AUT CI-I:':Ci~I~,il~ ~1:C-'HlNT:5
- L.. 11'/ 1.---':,1,') ./';, Jlll.'L ~!.:; ,'\'")J':"'.~;;S.:.) ;,';;. '~'J 1,-lN'nILY.
I:
. ,
, '
I,
I.
NOTE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION
'5 Cj t::1t
m -,
C'.J ~)
";;;;: Ir. ,
'-')
PAYMENT I
~
.~lct.,;'!U)fU~. requlr~. h of Seotion nu (b) of ,the InhGrH~ Met ht,t. 'ell Aot, Aat 21 of 1995.
:('1. P.S. Ion 'I.S),:
:" "_)1
F tho ~ portl..~" thh NotlOtl IOd .oo.lt with your P.~t to the RIgl.t,r of .,1111 pr,"ted 0f1 ttM
HlldfII a;
- MoI<. ...... Dr oo@t do' p..obl. to, RIlOISTBR OF MILLS, AllEIlT.
PIJRPOSf Of'
NOTlCEt
REFlJrG) (CR) I
A refuncl of . tlK orlMtlt ..y be r~.ttd by cotIPhU", an "ApplloeUon for Rllfund of JJ.nnlyJv.,l,
InherJtMQI end estet. To" (AEV~U13J. AppllOIUonl .re l..,aUlblCl .t thft 0'1101 of tha Rql,ter of NUll,
<<IY of the 25 R.,,~ Dhtrlot Offlo.l or fl'DIII the [tepertlNnt" r.(.-hour 8t'l'Wflrlng IHtrvlo1 ....r. for fO"'1 order Ing I
In Penn,vllllnl, 1~800M362-2050, out.tde Penn,Vlvanla .od within 10011 Htl rltburg .r.. (7171 787-8094,
Toni (717) 772.2252 (Hurlna l~.lr.d Only),
OIJECTIOHSI Any p.rty in Intar",.t not uU,fied with the ........"t of tell .. shown on thh notice NY object withIn
.bi;y (60) daYI of rlHlllpt of thh Natlo. byt
~~Nr1tten pr"te.t te the Pit Depart.....t of Re"iIf'IlHl, Beard of ~als, Pept. 281021, Harrisburg, PA HU8-10U, OR
ual.cUng te have the .atter detanlned lit lIudit of the ptrtr.cnal rfIPr..entaU"a, OR
~~~al to the Orphans' Court.
MlHIH~
ISTRATlVE
CORRECTIONS t
Fant....l arror. dhcoy.red on thh ........nt ,hoUld be addra..ed 1n ~rJt1fl1 tOI PA Depart...,t of RavlnUl,
Bureau of IndIvidual TaJeIl', ATTN~ PostA..e....nt R.yi.w UnJt, Dept. 280601, Harrisburg, PA 17126'~0601,
~ (717) 7C7~6505. See pao- 5 of the bookl.t ~In.tructlon. for Inheritance Ta~ R,turn for a Ra.ldent
o.o.dent" (REV~1501) for' an eKPlanation of adldnlstraUyah correctable .rror..
PENAL TV I
The IS;: t8)( --..Ilb non-participation penalty 11 cOllpUted on the tatal of the taw and inter..t ......ect, BOd not
paid tMfora January 18, 1996, thcl Urlt day after the end of the tax MfW.b ~riod. Thill non-partl1l2lpatlon
~1ty h IPPHlabh In the .... 8amt1r and In the the ... ti.. per lod .,1 you would appeal tt.. t.K ~ It,ter..t
that hall been a...II.rt It. Indloat.d on this noUee.
IHTERESi J
For data. of death on ur aft.r 10-3~91, Pennsylyanla Eltate Tax ba.ed on thV ~lderal E.tate Tax
r.turn bac~. delinquent at the eMpiratlon of nine (09) aonth. frOM the deta of death.
For dat.. of Math prior to 10-3-91, PannsYlvanla Estet. TaK bned Oil the Fedaral E.tate TaM raturn
baco... delinquent at the 'KplraUon of .iQht,,;t (18) aonths frOll the date of death.
Tex.. which ~08R8 delinquent ~for. January 1, 1982 beat Int.r..t at the r.t. of six (6;:) percent per ~
oalcul.tad at . dally r.t. of .000164. All tawe. which beoa.. delinquent on or aftar Janunr~ 1, 1912 will beer
Int.r..t at . r.te which wUl ".r.v frOll calendar year to o.lander y..,. with that rat. announoed by the PA
DepartHl'lt of R.lI.nue. The applioable Inter.tlt rata. for 1982 through 1998 .r'l
V..r Int.r.st Ra1e DaUy ]ntere.t FaC'.tor Vear Intere.t R.te D.lh' Intar..t Factor
1962 20~ .000548 1987 9% .000247
1963 16% .000418 1988-1991 llX .000301
1964 ll~ .000301 '99' 9X .000247
1985 13Y. .000356 1993-1994 n .OObl9t
1916 102 .000214 1995-1998 9Y. .000247
w-Int.ra.t ie calculated al fol1044':
INTBRIlST D BALANCE OF TAX UNPAID M NU"BER OF DAYB DELINqUIlNT X DAILY INTBllIl8T FA~R
uAny NoUca iuuad aUar the tax beoOlla' d.linquent wlU reUlKIt an Int.r..t caloul.tlOI) to flftMfl US) ltay.
bliyond the date of the ........"t. If p.~nt 11 .act. after the Intar., t COIlPutaUon date .1hoWn on the
Hatlo., eddltlonal Int.ra.t .u,t be oaloulat~.
/j/ (,/f. r;
BUREAU OF INDIVIDUAL TAMes
INHERITANCE TAX DIVISION
DEP1. nDMJ
UARAISIWtlO, PA l11ta~0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
(~_.....
*
th.Utl It." 1t1,"J
CHARLgs H STONE ESQ
414 BRIDGE ST
NEW CUMBERLAND PA 17010
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
OOUNTY
ACN
07-14-1998
WOODWARD
02-28-1997
21 97-0256
CUMBERLAND
101
E ~-A~~~1~R.._I_~tedn._ -l
CHECK PAYABLE AND REMIT PAYMENT
CLEMENTIN D
MAKE
TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE I To in8ure proper cre<ut to your acoount, subMit the upper porUon of this 10,... with your t.x p.YlMf\t.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
Rifv=i6o-j-Ejf-AFP--ioi-:97i-------...--iNH-iRiirANcE--filjf-sT'A-fEHEiif-iiF-ACc:OUN;r--N-i.---------------------
IESTATE OF WOODWARD ClEMENTIN D FILE NO. 21 97-0256 ACN 101 DATE 07-14-1998
THIS STATEHENT IS PROVIDED TO ADVISE OF TNE CURRENT STATUS OF THE STATED ACN IN THE MAHED ESTATE. SHOWN BELOW
IS A SUHltARY OF TIlE PRINCIPAL TAM DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT, 04-13-1998
PRINCIPAL TAX DUE,
86,247.27
PAVMENTS (TAX CREDITS),
PAYMENT RECEIPT DI SCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (- )
05-28-1997 AA211360 3,750.00 71 ,250.00
11-26-1997 AA242506 .00 8,850.29
02-10-1998 AA269745 .00 2,396.98
05-12-1998 AA270069 43.81-, 43.81
"..
(., i/'l
o
R
f',1
b:
r; '.'l:
) c....
(()
N
::j
~
.'i
.>
om
<lla:
cr:
~~
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
86,247.27
.00
.00
.00
. IF PAID AFTER TNIS DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
I IF TOTAL DUE IS LESS THAN $1,
NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI,
VOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORK FOR INSTRUCTIONS. I
PAVHI!WT,
htaoh t~ t(jf) porUcm of thl. NotJoellnd ,tubltJt with your p.~nt .... Ply.,l, to the n.. If'Id Iddr..,
prlnt4ld on the r'Vlrn .Ide.
If RESIDENT DECEDENT .... otwok or ltOnfy Of "dell' ply8ble tOI REGISTER OF WILLS, AGENT.
If HOH"R~alOEHT DECF.DENT .Ak. check or IGII4IY order payable tOI COHHONWEALTH OF PENHSVLVANIA.
REFI.IItI (CA)I it refund of . tel< credit, which .... not requ..ted on thl rlx R,turn, ....y be rlJq\Ml.t~ by COIIpltUng ..,
"~Uo.Uon for R.fWld 6f Pennsylvania Inheritanoe and E'tat, fBx" (REY~lS13). Applioations ere Iv_Ulblt It
the Office of the Reohter of NUh, MY of the 2S RIYlnua Dbtrlot Offic.. or frOll ttt. [)eptrt.."t'l 24-tlOUr
an....rlng .I.'viol nt*Mrs for foru orderlngl In Pennsylvania 1"aDO-362~20S0, Qutlide PClnnlyll/llnla
lNld within local "'rrhbu."g lire" (717) 7&7-8094, TODI (711) 772-2252 (HearIng Ilpaired only),
RE'PlV TOl
blUon' regarding error II contained on this notlol should be addr....d tal PA Depart..nt of RevMlUe; Bur.au
of IndlYidlJlll Taxe., AnN, Post A.....Mnt R.view Unit, Dept. 2'80601, Harrisburg, PA 17128~0601, phone
(717) 787-6505.
DISCOUNT I
If "'lY tal< due h paid within three (5) oal.ndar .onth. after the Moadent', death, a flYe plr::l.nt (SiO dlsoount
of the tal< paid h aUowed.
PENALTY I
The 15% tal< lNIMsty non-partiolpation penalty is oOllPuted on tho tl)tal of tM tax and 1nterut a.....ed, end not
paid bofor. Jenuary 18, 1996, the f1r.t day after the .nd of the tftx Hnuty periOd.
INTEREST I
Intor..t 11 oharged b.g1Mlng with fJrut day of daUnqu.noy, or nine (I)) Booths and one (1) day frOll the date of
death, to the date of pay"'ent, TIIIl.. whiuh bec... delinquent before JJflUllry 1, 1982 bear Int.r..t st thl rlt. of
SIb; (6%> p.,roent per Smull oaloulated .t a dally rate of .000164. All tal(.' whloh bee... delinquent on and aft.r
January 1, .1.982 will bear Int.r..t at a rat. whloh will vary frOll oalendar year tn oa1.oeMr y.ar with that rat_
IN1flOUO(IMt by the PA o.plrt...nt nf Revenue. The applioable Intlr..t rate. ~or 1982 thrOUgh 1998 ar.,
V..r Int.rut Rate Daily Intere.t Faotor V8flr Interut Rata naUy Int.re.t Factor
1982 20Y. .000548 1967 9% .000247
1983 16% .000458 1988-1991 11% .000301
1914 11% ,000501 1..2 9;': .0002ft7
1915 l3X .000556 1993-1994 n ,000192
1986 10% .00027ft 1995-1998 9Y. .000247
-.Iot_r..t h caloulatad .. followlli
INT1l1IEST . BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any NeUee luu.d .Uer the tal< beco..s delinquent will reflect an interest eelou1et1on tn flft.." (15) dey.
beyond thcl det. of th4t ....&Bunt. If pay.ant Is ..da aft.r the int.rest tOllt1utotlon date .hown on the
NaUta, addlUonal inter..t .Ult be ealoulfttad.
E~- ~~~~~~t ~!!11T~d..-- -1
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiE'Y=is{j'f-Ex--Af:jq'o'if:ij:rnioTior-on:-NHERITilNC'E"YliiCA'ppRA'isEHE"iir;-m-oiiilNcE-oli'------------.. ----
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
CLEMENTIN D FILE NO. 21 97-0256 ACN 101
". I.t) ./6/1 (/
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
nUREAU OF INDIVIDUAl TAMES
INtlf.nlANCE TAl( PJVJSIOH
!)IiPl. ?60601
HAHHlRBtJRU, PA 17lta~0601
NOTIC~ OF INH~RITANCE TAX
APPRAISEHENT, ALLDWANC~ OR DISALlOWANCE
OF DEOUCTIONS AND ASSESS~ENl OF TAX
CHARLES H STONE ESQ
STONE LAFAVER AND STONE
414 BRIDaE ST
NEW CUMBERLAND PA 17070
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
08.2(,-1998
WOODWARD
02-28-1997
21 97'.0256
CUMBERLAND
101
ESTATE OF WOODWARD
c
*'
IU.lfHlliHm-tll
CLEMENTIN D
TAX RETURN WAS I I ) ACCEPTED AS FILED
( X) CHANOED
SEE ATTACHED NOTICE
DATE 08-24-1998
" -
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
--- ~...
APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL
1. R..I e.t.'t. (Schedule A)
2. Stocks end 8ond. <<Schedule B)
3. CIo..Iy Held Stock/p.,.tnershlp Interest <<Sohedule C)
4. Hortgages/Not.s Receivable (Schedule DJ
!i. C..h/B.nk DepasHs/Mh:c. PerClorwl PI'o~lIrty (Schedule E)
6. Jointly Owr..d P,'ope,.ty (Schedule f)
7. Transfers (Sen.dule OJ
8. Total As.ets
RETURN NO. 02
(1)
121__
(3)
(4)
(5)
(6)
(7)
.00
. DO
~
.00
48.000..1Q..
.DO
.....!!L
(8)
APPROVED DEDUCTIONS AND EXF.MPTIONSI
9, Funeral Expenses/AdM. Costs/Hi.c. Expense. (Sohedule H)
10. Debts/Hortgauo Liabilities/liens (Schedule X)
11. Total Deduotions
12, Net Value of Tax Return
13. Charitable/GoverNtenbl Bequests,; Non-.lect..d 9113 Trush (Schedule J)
14. Net Value of Estat. Subject ,to Tax
(9)
(10)
1,490.DO
.Ot
(11)
11?)
(13)
(14)
NOTE I To inll.we proper
credit to your account I
subMit thA upper portion
of this forll with your
tax paYHnt.
48,000,00
1.490 00
46,510.00
.00
621,491.80
NOTE:
14, 15 and/or 1&, 17 and 18 will
returns assessed to date.
If an asseSSMent was issued previously, lines
reflect figures that include the total uf Abh
ASSESSMENT OF TAX:
16. ^lItount of lino 14 at Spou..8l rate (l!i)
16. Allount of Line 14 taxable at Lin.allChlSG A rata (l6)
17. AMount of Line 14 taxable .t Collateral/CI..s 8 rate (17)
18. Principal Tax Due
.00 M' DO,
.00 M .06.
621,491.80 M.15,_
(18)
TAX CREDITS:
DISCOUNT It)
INTER~ST/Pf.N PAID 1-)
~-_.
3,750.00
.00
. DO
.00
PAYI'ENT RECEIPT
DATE HOHDER
05-2ii::-f997 --- AA2T1360-
11-26-1997 AA242506
02-10-1998 AA269745
~12:~998 AA270069
INTEREST IS CHARGED THROUGH 09-08-1998
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
AHOUNT PAID
71 ,250.00
8,850.29
2,396.98
43.81
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
---
TOTAL DUE
.00
.00
93,223.77
93,223.77
86,291.08
.--.---
6.932.69
531.91
7,464.60
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
I If TOTAL OUE IS LESS THAN U, NO PAYHENT IS REQUIRED,
If TOTAL DUE IS REFLECTED AS A "CREOn" ICR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FDRH fOR INSTRUCTIONS.)
...
, .
RESERVATXOtll e,t.t.., of ..rrh dYing an or' "far. ~r 12, 1M! n If anywture Jnt.r... in the ..tettt it tren,"rr_
In po.....Jon 0,. -ojOYMnt to Chll' ((/OU,..*".1) bentfJoltrl.. of the deo...-,t aftlr the expJrutlon of MY .,t.t. for
Ufl or, for Plr., the CanonMMlth herlbll!IXPr...ly r...rVI' the right to IPPrt....-leI "MIt trlns"r JnheritMCt Taxea
at tM llMffUl (a... I (wUetllrtU rat. on lilY euctl future int"..t.
PIIAI'OSf Of
ooTItEl Y..J fulfIll the requlr......ts of Seotion 2140 of the InherttMlOe MlCI Eltat. Tax Aot, Aat 2:1 of 1996. (72 P.S.
Section 9UtOl.
FAvttEKTl Dtltech the top portion of thh Notice Ind .ut.Jt with your PIYMf\t to the RtQbttr of Will, printed on tM rlVlr.. "1M.
uHek. ohltok or 110M)' orct.r peyabll tN REGISTER OF MILLS, AGENT
REFUND (~)1 A refund of . tal( orttdlt, which w.. not r.que,tad on ttMl 'ax Rltum, _Ii be requestttd by oCNlpl,tlng WI "Applltultlon
for Refund of PennIYlv~l. Inheritenee and Eatate 'aM" (AEVA1515l, ApplJoetlonl at. aVll1lbl. et the Office
of the Real,ttr of Willi, ~y of the 23 Revenue Di.t1'lot Offic.., or by callIng the .pee181 24-hour
lK'l....ring ..rvlo. nulIllJers for for.. ordtrlngl In penn.ylvania l-aaO-362-20S0, out&idtl P...".ylv..,la ~
wIthin 10081 Harrllburg ere. (711) 187w8094, TDDI (717) 71?~2252 (Hearing J~lred Only),
ntlJECTlOHSI Any party inlnt.rllt not ..U.fted with the appl'ahOMnt, allowanoe or dhallowanc4 of deduoUon., or .....lMnt
of tex (including dl.count or intere.t) I' .hown on thl. Notice au.t object 'llthln .IKty (60) day. of receipt of
this Notloe bYI
~-..rJtt'"' prot..t to the PA Depart-..nt of Revenue, BOlrd of Appeals, Dept. 281021, HarrisburG, PA 1712&-1021, OR
--election to he'll the ..tter dete,..lned at audit of the account of the personal repre.entatlve, OR
--flPPMl to thI Orphan.' Court.
_'H
UiTRATIYE
CORRECTIONS :
F~tUll error. dl.cov~red on thl. ........nt should bo addre,.ad In writing tOI PA Dspartlent of Revenue,
Bure~ of Jndlvhtu.1 laMeli, ATTHI Post A.......nt Rlvle", Unit, Dept. 280601, Harrbbur", PA 1'1128-0601
Phone (717) 787-6505. SfMI pall_ S of ttMI baoklet ''In.truotlon. for Jnherlt.no. T.x Aflturn for a Rel1dent
o.c~t.. (REY~1501) for an explanation of ~lnl.tratlv.ly oorr.ot~l. .rrors.
D'tSCOOHTI
If IKlY tax due I. paid within three (3) calendar .onth. after the decadent', dlath, . five percent (5~) di.count of
the 1.x paid ls allowed.
PENALTY I
The 15;( tax NnI.ty non-partioipation J*'Ia1ty h cOllPut.d on the total of the t~x and Intere.t .....Nd, IIOd not
pttid Mfor8 JllnUary 18, 1996, the fir.t day after the end of the tax NtMI.ty period. This nGfl~p.rUolpaUon
penalty 11 ftPJHlalabl. In the ... .antl4lr and in thlt the .... U.a per iad a. ~ou would IIP"al the tax and intere.t
that he. been .......d e. j~iCBt.d on thl. notlo..
tNTERESTI
lnter..t II charl1ed beGinning Nlth flr.t day of dnlinqu."cy, or nlM (9) 1l0nthfl end one (ll day frOll the date of
dulth, to the date of p.y..nt. Tax.. !thlch ben8lle dellnqlHtRt tHIIfore .-nu.ry 1, 1982 bear Intlra.t at the r.t. of
alx (6;() pGlrcltftt plW S"fl'_ oalculated lit II dally rate of ,000164. All tal<e. whloh belo... delinquent on and Ifter
JenuGry I, 19&2 NIlI bear int.rest .t a rat. which will vary frO. c.l~ndar yur to oehndar yur with that rate
~d by tho p~ Depart~nt ~f R.venue, The applicable int.re.t rate, for 1982 through 1998 aral
'!!!!: Jnt.rut Rat. DallY Jnt.relt/actor ~ Jntarut Rat. Dall!!' Intar~lt factor
1982 20X .OOOSit8 1987 9X .000247
1983 16i: .000458 1908-1991 11;( ,00D301
1984 11i: .000301 1992 9X ,000247
1985 1!li: .000356 1993"1994 7Y. ,000192
19&6 10i: .000214 1995-1998 9X ,000247
~~Jnt.re,t j. celoulatDd a. foll""'ll
INTEREST a BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any NoUoe J..ued after the tax blOOM' ct.1inquent will refl.at "" intore.t calculaUon to flftMn (15) day.
beyond ttMi date of the .....u.nt. If p.~nt 11 -.de aft.r the lnt.r8.t CoaputlltlOO dete .hown on ttM
Hotioe, additional int.rlllt ...t be OIIloulat.d.
HG'
,)1
HI
:91.1 S[f' 3D J'ill :5l1
Ole'l
QUIlII>
If\
1'/\
_OF
NOTICEs
To fulfill the ,..quJr...ntt of SaoUon 2146 (b) of the Inheritcmol ...d E.t.t, lex Aot~ Aot 21 of 1995. (72P,S.
SeoUon 91ttSl.
PAWENT J
Detltlh the top portion of thh Notice end ,ubIIlt wlth ~our pay..nt to ttMi Rqhter of "1111 printed on the
r~"" .lde.
-- ...... oheckor IMHl4IY order payable tOI REGISTER OF MILLS, AGENT.
REFUND (~)a A refund of a hx credit ..y be r.qua.ted by cOIIplaUnu an "Application for R.fund of PennSYlvania
Inherlt~ end Elt,t, Tax" (REV-I5!]), Applications ara aVll1lbl. at the Offl01 of the Reglltar of Willi,
MY of thl 23 Rlveout Dlltrlct Offloe. or frOll the o.partMnt'. 24~ho\lr an.wring ..rviol r\UMlrt for fora. order inll I
In Penn.Ylvenia 1~800~562~20S0, out, ide P.nnlylvenl. and within 100a1 Hlrrllburu ar.. (717) 787-8094,
TOD' (717) 7n..22S2 (....rina IIIP.Jr~ Only).
Oa.IECTlOHSt AnY plrb In inter..t not ..thfl.d with the ".......nt fJf tax a. .hown on this noUc. ..y object wUhln
.ixty (60) du. of r.c.ipt of thh Hotioe bYl
"written prote.t to thePA OepartHnt of Rey.nue, 80ard of App.ah~ Dlpt. 281021, Harrllburg, PA 17128-1021, OR
"olactina to haYe the .atter d.tlr"lntd at eudlt of the per.onal reprll.entwUva, OR
.......1 to the Orphanl' Court
ADIIIW-
ISTRATlVE
CORRECTIONS1
FaotUll Irrors dl.cnvlrMt on thh .SSllsHnt .hould be addr.,...d in writlna tOI PA Depart..nt of Ra",a,..,
lurl.u of IndiYldual Taxe., ATTHI Po.t As......nt Ray tow unit, Dlpt. 280601, Harri.burg, PA 17128-0601,
Phone (717) 787~6505. S.. paga 5 of the bOQklet "Instruction. for Inh8rlt~c. Tax Return for" R..ldtnt
DeHdlnt" (REV~150\) for an 8xplem,Uon of adltinhtratlv.h corrlotltbla arror..
,
PENAI.TYJ
The 15X tax BIIfl8.b non-psrtlclpet1on penalty 11 cDIlputed on the totel of the tex Ilflrt Int.rI.t ......ad, end not
paid b.for. Janu.,y 18, 1996, the flr.t day after the end of the t.x Nne.ty par'lod. Thh non.partlolpaUon
penal ty it llPP8alable In the '''8 aanner and In the the .... tla. p.r led .. you would IflP.al the tex end Int.r..t
thet hIl. b..... .......d a. lndlcAted on thh noUce.
IHTERfST 1
AdcUtlonal Penn.Ylvania E.tet. ,.x .......d .. a r.sult of a chanllle on tha F.deral E.tet. T.~ ololino
letter bal;.OIM. deHnqutnt at the expiration of one (1) aonth frOM the date the final notice of the lncr....
In'Fedtral E.tat. Tax 1s raeelved.
Ttl~e. which bae..e delinquent before Jlnl,fary 1. 1982 bear lntlr."t at the rete of .Ix (6;<) Plrclflt per annuM
celoubtld It II delly rat. of .000164. All taxel Nhleh btlcMM dalln~nt on or aftttr Janutlry 1, 1982 will be.r
Inter.,t It . rate whlch Mill vary frOll oahnclnr y.ar to oalenaar year with that rate ennouncfl,d by tht PA
hptIrtaent of R.v80ue. The .ppllcable Inter..t rate. ft)r 1982 through 1998 ara,
~ Int.r..t Rata flalh Int.r..t FaotClr ~ Inter..t Rat. Oalh Inter..t Factor
1982 20% .000548 1987 9% .000247
19as 16% .000438 19aa~1991 lU .000301
1984 11Y. .000301 1992 9% .000247
1985 13:': .00015t. 1995-1994 n .000192
19" lOX .000274 1995-1998 9% .000247
~-Interest 1_ ~al~ulatld .. folloNI,
INTEREST . BA~ANCE OF TAX UNPAID X NUMBER OF DAYS DE~INQUENT X DAILY INTEREST FACTOR
'.~Any NoUce Juued after thli tax beCMel dellnquent Nill reflltct an Interatt oalculation to flftHn (IS) days
beyond the d~te o~ the ........nt. If p.YWent is ..de aft.r the intereat eoaputation date lhown on tht
NotlCle, lIdd1tlonal Intar.llt lIU.t be c.leuI.hd.
09-24-1998
WOODWARD
02"28-1997
21 91-0256
CUMBERLAND
101
E:~=A~=~~~t~d_.~
MAKE CHECK PAYABLE AND REMIT PAYMINT
REGISTER OF WILLS
CUMBERI.AND CO COURT HOUSE
CARLISLE, PA 17013
,
i~; Ie, r II
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
RECORD ADJUSTMENT
"
BUR~AU OF INDIVIOUAL TAXES
INHERITANCf TAK DIYISIOH
OfIIT. l60601
HARRIS_URG, PA 111Z8-060t
I:,
[,.
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
i I COUNTY
ACN
'l,WI ,J:-'
CHARLES H STONE ESQ
STONE LAFAVER AND STONE.
414 BRIDGE ST l;kr
NEW CUMBERLAND PA 17d7\jlllt,
..
In.UH II if' U.'''I
CLEMENTI N D
TO:
MOTE I To insure prope'" (If-edH i:o your acoount I .ub..tt the uppnr portion of this for.. wUh your teK p.YMnt,
CUT ALONG THIS LINE ~ RE1'AIN LOWER PORTION FOR YOUR RECORDS ~
ii Eli: iS9:f- E'ii'"AFP"i 0'9-:97"i -----il-.-i'NHER Yi ANi:E- T 'Ax - R 'E"C'OilD - ADj-USTHENT" -. ji-- -- - - --,- - ___m_ - - - - -- - - - - --
ESTATE OF WOODWARD
ClEMENTIN D FILE NO. 21 97-0256
ACN 101
ADJUSTHENT BASED ON,
VALUE OF ESTATE:
ADMINISTRATIVE CORRECTION
U) .00
m 749,18
131 .00
(41_ .00
IS) 16 .636,78
(6) .00
(71 636.918,38
(B)
1. R..l est.t. (Sohedula Al
2. Stooks end Dond$ (Sohedule 8)
3. Closely Held stock/Partnership Int.,..e.t (Sohedule C)
4. Hortgages/Note. Raoeivable (Schedule OJ
S. Cash/Bank Deposits/Misc. Personal rropa,..ty (Sohedule El
~. Jointly Owned Property (Schedule Fl
7. Transfers (Schedule G)
8. Total Ass~ts
DEDUCTIONS AND EXEMPTIONS:
9. Fun.,'.1 Expansas/Adnlnhtrotive Costsl
Hisoellen.ou$ F.~p.ns.s (Sohedule H)
Debtw/Hortgag. liabilities/Lians (Sohedule I)
Total Deductions
Net Velu. of Ta~ Return
Charitable/Govern.ental Bequests; Non~.l.ot.d 9113 Trust.
Net Velue of Estat. Subject ~o Tax
10.
11.
12.
13.
14.
TAX:
l!;. Allount of l ina 14 ..t Spousal rate
16. Allount of line 14 ~r.x.bl. .t line.l/Clas5 A rat.
17. Allount of line 14 taxable .t Coll.teral/Clasl Brat.
18. Prinolpal Tax Due
TAX CREDITS:
PAYHENT ~
DATF. I
(9)
(10)
38 , 621. 93
5,562,79
(11 )
1121
(13)
(14)
(Schodulo J 1
USI
IHI
(17)
~X.OO=
.00M.06=
538.40(1.68M.15=
11.8)
RECF.IPT
NUH8ER
DISCOUNT It)
INTEREST/PEN PAID 1-)
AHOUNT PAID
05-28-1997
11-26-1997
02-10-1998
05-12-1998
AA211360
AA242506
AA269745
AA270069
3,750,00
,00
,00
.00
71,250.00
6,850.29
2,396.98
43.81
TOTAL TAX CREDIT
BAlANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
DATE
09-24-1998
71 (t , 304.34
44 .184.72
670.119,62
131, 714.94
538,404.68
.00
-:J!..!!.
80,760. 70
80,760 , 7(1
861291..08
5 ,530. ~4C.!L
.00
5,530.34CR
. lF PAID AFTER DATE INOICATED, SEE REVERSE (IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
FOR C.LCULATIDH OF AODITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR1, YOU HAY BE DUe
A ReFUN~. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTION~.l
/
PAV.-NT I
htllCh the top portion of thil Notioe IH\d .ubIllt with YOUr pay"ent ..do peYable to thl n..e an~ Mltr...
prlnttd on the r.ver.. ,Ide.
.. Kek. oheck or IIOMY ord&-r paYable tOI REGISTER OF' MILLS ~ AGeNT.
ftE'FUHD (CR), A r.fund of . tlX oredlt, ~Ich was not requalted on the Tax Return, IlIIIY be r.quuted by oOllPl,Ung 'an
"Appl1oltlon for R,iund of Penn.ylvanJI Inherlt.noe and Elt.t. rlx" (REV-131!), Applloations ar. ly,llabl, at
the OffiCI of thl- R,githr of NUh, any of the 23 ReVentl1i Dhtrlot OffJ,c.. or froll the nl".rt""t', 2ft-hoUr
."I...rloo ..rvle. JllJIIber. for fOl'.1 orde,.tngl In Jlenn.ylvanle }-800-362-20S0, oubld. Plnn.Ylvanl8
and within local Harrl'bUrg .r.. (117) 787-8094, TOD' (717) 772-2252 (twarlng IIPalred only),
REPLY
TO.
QUI,Hems .'egardlng '1'1'01" oontalned on thlt notiol Ihould be .ddr....d tOI PA Depart.."t of RltiMltMl, Bureau
of Individual TaXI., ATTHI Post A"Q...ent Review Unit, Dept. 280601, Harrilburg, PA 17128~0601, rh~
(7171 7a7~6505,
DISCOUNT I
If ~y taM due It p.id within three (3) oalendar Ianthe after the d'oed~nt.. denth, II fJvI peroent (5Xl dl.count
~f thl ta~ paid II all~d,
PENALTYI
n,. 15:< taM BIIIMl.ty non-partlolpatlon penalty 11 ooaput.d on the total of the tal( anti Inter..t .......d, and not
paId bafor. Januarv 18, 1996, thl fir.t day after th(l end of tho tax aanuty p.riod,
INTEREST I
Intar..t I. ohargad beainnlng with fir,t day of delinquonoy or nino (9) sooths and one (1) day fr~ the dftte of
death to the date of ply.-nt. TaXI' whioh beo... dallnquent before January 1, 1982 bear Inter..t at tht rata of
six (6%) p.roant per annUl calculated at a daily rat. of ,000164. All taMI. which bee... delinquent on end after
January 1,1982 wUI blar Jntere.t lit II rat. which will vary frol oalendar year to callndar yellr with that rate
announced by the PA Depart..nt of Revenu., ThU applicable intere.t rate. for 1982 through 1998 aral
V.ar lnter..t Rftte DailY Internt Faotor V..r lnternt Rat. Dally lnterellt Factor
198? 20X .000548 1987 9% .Oa0247
1983 16f: .00043& 1988~1991 llf: ,000301
1984 Hi': .000301 1992 'X .000247
1985 l31C .000356 If)93~1994 7% ,00Q192
1986 10f: .000274 1995~199a 9% .000247
ulnt.r..t i. oalculated .. follaWIl
INTEREST a BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
~~Any Notioe i..ued Rftar the t.~ b.a~81 delinquent will rofleot an Intere.t calculation to fifte.n (15) d.~s
blyond thfl data of the ........nt. Sf pfty..nt h .ndG afh~r the Interut co.putatJon date shown on the
HoUce, MldJUon.l Inter..t tltUst bfl ofllClUh1elJ.
PAvtENT I
DetlHlh thli top portion of thh Hotloe ttnd .UblIU with YOUr Peywtent .Ide p'VIb'lI to tht ,.. end IIddr...
,.rtnted on the rever.e Bide.
If RESIDENT DECEDENT uke cheel< or _OnlY order p.y.Me tOI REGISTER OF WILLS, AGENT j
If I4OII-RESIDEllt IlECEnEHt .aIe, .hock or.....v ordor 0.....1. '01 CDHHDNIIEALTH OF PENNSYLVANIA.
REF~D <CAli A refund of a bl< credit, ..hlth ..a. no'!: reque.tlKi on the Tel< Return, ..y be requelted by ooapleUng en
"Application for Refund of Pennsvlvanta Inherltanoe end Estete Tal<" (R.E\J*nl:5), Applioat1on. ar. aYaH_I_ .t
thfl Offloe of the Rethter of WIUI, IIny of tM 23 ReyantJI Dhtrl(lt Offlo.. or frCWl thel Dopertant" 2it*hol.ir
."....rJng ..ryloe n...ber. for for.. orderlngl In Pennsylv.nle 1*800-362*lO50, outslckl PennlylvWlta
end ~tthl" looal Harrisburg .rt. (711) 181-8094, TDDI (111) 112*2252 (H..rlng I.palr.d only).
REPLV TOI
QueIUon. regarding .rror. cont.i".d on thlt noUoe .hould be addre..ed tOI PA Depart..nt of ReycnlHl, Burllu
of IndlvlduQI Tax.., AllNI Po.t Au.....nt R.vl.w Unit, Dept. 230601, HarrhOOrg, PI. 11128*0601, phoN
(111) 181*6505.
DISCOUNT I
If lN1Y tax dlHi II p.id within three (3) ce1endar- aonth. aft.r the decedent', daath, a five p*ro.nt <Sin dhloount
of the tal< paid I. allowed.
PENAL TV I
T~ 15~ tal< "hI.t~ non*partiolpatloo penalty I. co~uted on the total of the t.x and Int.reEt .I.....d, Inri not
paid b.fClr. JlM'IU8ry 18, 1996, the first day aft.r the end of the tllx .ane.ty p.rtod.
INTEREST I
InterClot it charg.d beginning with f Ir.t day of delinquency I or nine (9) aonths and OM (1) day froa the date of
death, to the date of pay.ent. Tox85 which beoaa. dvUnquent before January 1, 1982 btIar Int.rut fit tht rate of
IIx (6~) parcent per IlnnUlI oaloulated at a dally rat. of ,000164. AU tal<lI which beCHe delinquent on end eftar
January 1, 1982 will bear Inter'lt ~t " rat. which will vary fro. oalendar yesr to calender ye.r with that rate
announced by the PA Depert..nt of Rev.nue. TtI. appllollble Interllt rat.. for 198i! through 1998 .r'l
V.ar Int.reit Rat. D"Uy Internst fl!lotor Vear Intere.t Rate DeilY Int.r.st Faotor
1982 m .000548 1987 9% .000247
1985 16~ .000438 1988-1991 llr. .000301
19114 11;( .000301 1992 9% .000241
19'5 13% .000356 1993-1994 n .000192
1914 10% .00021. 1995-199& 9% .000247
uInt.r..t I. c.loulat.d .11 foU~.1
INTEREST . BALANCE OF TA~ UNPAID K NU"B~R OF DAYS DELINqUENT X DAILY INTEREST FACTOR
uAny Notice ,..uod after the tel< beoOtl811 dallnqlHlllt ..111 reflect an Int.re.t oeloulatlon to flft..n (5) day.
beyond the dete Df thn a.......nt. If pav..nt Is .ade after too Jnt.rllt oo.putatlon date .hown on the
Notice, additional lnt.rut ""lOt ba oaloulated.
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