HomeMy WebLinkAbout97-00260
PETITION I'()R PROBATE and GRANT m' LETfERS
Estate oj .__~1iAu,.~~.y,\-;tA _ ~o, _.__J,..L~Jjq' U/(C~____
afJ" klJlI"" 'M . mll!'f-~..B;i.I-i----- fo:
n'___ n____.._____ Regl~ter of Wills for the
D d County of _S~>:h uc' I 10'\~~ In the
.______. eaase. ..
Sodal Security No, _.__._________. Commonweallh of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petltloner(s). who Is/are 18 years of age or older an the executLL~
In the last will of the abo'N/eCCdent. dated __---0-"'( h :21 I q<1 '>
and eodlcll(s) dated A . __
named
...19_
(~Inle relevant clrcumslances, e.g. renunciation, death or executor, -'1C,)
Decendent was domiciled at death In C VWl b, dld..l1.4_:r:::i3d County, PennsYlvania. with
her lasA fa~ll1, or principal residence at -Sl$:l- U).. 11'1" II"\) 1?o<rJ ,
1M 1<;' 1 P"'IlH'(I,;n"lilL-/7{j/ "" .. ~J.1I...TlLIYII /).f}1.~TON -rwP,
(ll.~l meel, number and mundpalllY)
~3 yea,s of age, cfi~d -_MLI&!-6f. 10 . 19 97-.
at __ "'<'lJaL_-CW.lI~~ 'Pr'II~("tHl,'o. 1';1,,1'0;. .
Except as follows. deceden did nol marry. was not divorced nlld did not have a child born or adopted
after execution of the ,ill offered for probate; was not the victim of a killing and was never adjudicated
Incompetent: "'fA _ _
( \.
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled In I'a,) Personal property In Pennsylvania
(If not domiciled in I'a.) Personal property In County
Value of real estate In pennsylvania
situated as follows: lJo!J(;
s--lli-IY 17 \-
s
s
s
WHEREFORE. petltioner(s) respectfully reqUeSl(S)~ the probatc of the last will and ,eodlcll(s)
prp~ented herewith and the grant of lelters '1.,~1aMI\\ 0.(-/
(testamentl,y; .dmlnlstrallon c,l.a.; adminlllrallon d.b,n.c,l.'.)
theron.
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OA TH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF I)ENNSYLVANIA } !:lEI
COUNTY OF (' U\"\~}fllo.V<. ~ _____'
The pelitioller(~1 "bove-nam~d .,wear(s) or affirm(s) that the statements in the foregoing petition are
true and <'Ometlo the best uf ,he knowledge "nd belief of petltioner(s) and that as personal represen-
tative(s) of Ihe above decedent pelitloner(s) will well and truly administer the estate according to law,
Sworn to or affirmed rrJ subscribcd 1 Qj .>.1lJl/l-v Jt ''})lL ~ ~
be(or5 me this .- ~__._- dJ' .of . ~
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LlUIT WILL AND TBSTAMBN'l'
OF
MARY B. BRBTZ
I, MARY E. BRETZ, now residing at 128 West Willow st,reet,
in the Borough of Carlisle, Cumberland County, Pennsylvania,
being of sound and disposing mi.nd and memory, do make, publish,
and declare this to be my Last Will and Testament, hereby
revoking and making null and void all other Wills and Codioils
heretofore made by me.
FIRST
I desire and direct that all my just debts, ino1uding the
expenses of, my last illness, any funeral expenses, and any
estate, transfer, inheritanoe, or suooession taxes that may be
,due, be pa,id without unnecessary delay by my Personal
Representative, hereinafter named and appointed.
SECOND
Al:\, of the rest, residue, and remainder of my estate,
whether real, personal, or mixed wheresoever situated, whether
owned or possessed by me at the date of exeoution hereof 01
aoquired by me after suoh dats, I give, devise, and bequeath to
my sister, OBERN W. MILLER, presently residing in Manchester,
Pennsylvania, if she shall survive mel but in the event she
shall have predeceased me, the same shall instead pass to my
two nieoes, JOYCE TOPPER, presently residing in York,
Pennsylvania, and LINDA STRICKLER, presently residing in Laurel,
PAGE 1 OF 5
Maryland, in equal shares, share and share alikel but in oase
either or both of them shall have died in my lifetime, leaving
ohildren living at my death, suoh surviving ohildren shall
take, per aapHa by generation, t.hat share which his or her
parent would have taken had suoh parent survived me.
I
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THIRD
I hereby nominate, constitute, and appoint my sister,
OBERN W. MILLER, as Executrix of this, my Last Will and
Testament, and I do hereby expressly oonfer upon her power to
administer my estate without having to give bond or report of
her duties in the administration of my estate. I further give
to my Exeoutrix the full power to sell and oonvey any personal
or real property that I may own at my death in order to pay
debts and legacies and to administer ~y estate. This power may
be exercised either at publio or private sale, and upon such
terms and oonditions as my Exeoutrix may, in her disoretion,
impose.
In the event that my sister, OBERN W. MILLER, is unable or
unwilling to act as Exeoutrix, I do hereby constitute and
appoint FARMER'S TRUST OF CARLISLE, PENNSYLVANIA, a
Pennsylvania Banking Corporation, Carlisle, Pennsylvania, as
Alternate Exeoutor and do speoifically direot that no bond or
other surety be required of it as suoh Alternate Exeoutor upon
its qualifioations. I do further authorize and empower it with
the same authority relative to the administration of my estate
PAGE 2 OF 5
COHttOHWUL HI Of PENNSVl VAN I A
DEP,\RTKEHT OF" RfYfNUE
BUREAU Of INDIVIDUAL TAKES
DEPT, 280&01
HARRISBURG, PI, 17WH601
15- lu'Y-i'~3
*' GNFORMATION NOTICE
AND
TAXPAYER RESPONSE
llV'Hi4! u ,,, 11'''1
rlLE
.\CN
DATE
NO. 21 -q?~ l~D
97111173
03-18-97
'~I(
i
EST, OF MARY E BRETZ
$.S, NO. 210-26-9809
DATE OF DEATH 02-10-97
hlQD:\Rlli'v CUMBERLAND
TYPE OF ACCOUNT
[J SAVINGS
IXI CHECKING
[] TRUST
D CERTlF .
1:(
If 'J'
"I ~ ~1I
DBERN W MILLER
212 S MAIN ST
MANCHESTER
Cle',
PA 17345 Cun',
1"1
RENlT PAYNEHT AND FORNS 1'0 I
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
,1,'.
I{\
FINANCIAL TRUST COHPAN hili proyld_d the OIPart.ent with the InforllGtlon lilt.d bllow which hal bun uud In celcuhttng the
potMthl tax dtMl, Thllr record. Indloeh that .t the d.ath of thll lIbove dllleld.nt, you Wlrl a joint cwner/b.n.flclary of this eccount.
If you "11 thh infor..tlon it Irnlorruct, pl.... obtalo wrlttllln corr~ot1nn frOIl the flnanollll In.tltutlon, att$oh '" OOpy to this for.
and rIlIturn It to the IIboVI ftddr.u, Thh IIlClcount It taxabl. In accOrdt,M;1 with the Inhlrltanol Ta)( law. of the Co..onwtIlllth of Plnn.ylYlInla,
l.kAlllllullI' ..)' b. all",.,.J b>> ....,;,lll1w ':,',:-, ii.i u:H.7,
COHPL~TE PART 1 BELOW
Aooount No. 1033069
M M M SEE REVERSE SIDE FOR FILING AND PAYHENT INSTRUCTIONS
Doto 05-19-B9
E,hbllahod
To In.ure prop.r crldlt to your account, two
(2) copl.. of thh noUn Ml.t llCCI.:)epltfly your
paYHnt to thl Reghhr of Willi. Hakl cMc.k
pRyabll tal "RIol.ter of Wilt" Ag.nt",
Acco.....t allence
Pere.,. rlxul.
AMount Subjlot to
rl>< Rat.
Pot.ntial T.~ OUt
&12.37
M 50,000
lax 406,19
M ,15
60.93
NOTEI If tax pay.ents erl ud. within thr.~
(5) .onth. of tha dlcedllf1t', date of cNath,
YO~1 Rlty deduct l!l S% discount of the h)( dUI,
Any Inherltltn~e tax due will beco.u d.1Anquant
nln. (9) "~nthl aftor tht data of d.ath,
PART TAXPAYER RESPONSE
ill [""UU!l'TOIl'8PCIIIIWX"'LR.tlU",r~"A~O"F.~C:XAk."AXAllS.SSIiiH'!' BAS.lI", all, ,...1. .IIOT1C,1
A. r\1J The above lnforllatlon end tllX due I. corraot.
l.CIl, You Iley ohoo.. to "lilt paYlont tn thl Rtght.r of Wlllt with two copllll of thll notlOI to obtain
. dl.count or avoid lnter..t, or you .ay chlc~ box "A" and return thl. notlc, to the Rugl.tor of
Willi Rnd 110 ofilolo1 RII.....nt wJ11 bl l.,uod by thl PA D.part~lnt of R~vllnue.
[CHECK ]
ONE
BLOCK
ONI.V -
B, 0 The IIbove auet hu bun or will b. report.d end tI!Ix p.ld with the Ptnn,ylvanh Inhllrlhf,cl Tax return
to bo flied by the doc.d4nt'l reprl.entatiYI,
C. 0 Tho Sboy. Jnforutlon It )noorrect and/ok!\'bh and dlldootllH1' wlr. pRld by YOU,
You lIU.t oOlpl.to PART ~l and/or PART ~ b.low,
PART
[!)
DATE
DEBTS AND
':"::,:.':::'::::':.;
Pi',!:',
1
:I:
5
4 ---'
!i
6
7 ""..tt".
8
DP.DUCTIONS CLAIMED
,: OFFICIAL USfi. ON LV 0 A~~i
PI! lIEPARTH~NTOF REVE:NUe;;i
,.'.,',.,'.',......,.,."".'..--,' .,...,.".,.".,...-.....,.,.-,...""...-,..:::.,:,;,:.:,::>::
If you indicat. a differ.nt tlX rlt., pl.... .t.tl your
rlla{lon.hip to dle.dlnt,
PART
[!]
TAX RllTURN - r.OMD\IT,lTIO~t
LINE 1. D.to E,t,bll.hod
2, Aecount allanel
S. Plrcent TI~lbl.
4, AMount Subjlct to rax
5. Dobh snd Doduotluno
6. A~ount T,.oblo
7. Ta)( Rate
a. Tax DUI
TAX II" .lnXNT/TIlU!lT Ar.l:OUNTQ
OF
1
2
3 M
4
5
6__
7 K
8
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TOTAL (Entlr ~n Lin. 5 of Tax COMputation)
Un~.r pln.lti.. of perjury, I dlclar. that the fact. I
co~l.tl to the b.lt of MY knowl.dg. Ind blli.f.
T~~1R"'s1flNA~E J}1lj'i~
PAID
=1=
PAVEE
DESCRIPTION
AMOUNT PAID
1
.
have rlPort.d Ibo". arl
IIOME (711 ) z..iAp"
WORK ( )
TELEPHONE NUMBER
truI, corrlct Ind
1'1fD
-- JrPIl{7
_1iJ "
GENERAL INFORMATION
1. FAILURE TO RESPONO WILL ,1ESULr IN AN OFFICIAL TAM ASSESSHENT with '0.11...1. In'''", ..... on Inlor..Uon
.ubIlltted by t~ flntllcl,,1 In.UtutJon.
2. lni'Hltltenc. ta)( bIGot.. d.llnqvlllt "In. "onth, flfter thl dlo.dent', d,t. of d..th.
!I. A Joint .Mount II tllMlbh .v.n though th. dlo.dlnt', n'~1 was added at " IlItt.r of cOnY.nllnol,
4, loeDuM. (Inoludlna tho.e held bltw..n hUlbar,d find wlf.) whl(lh th. dllo.dant put In Joint n.... within ont ye.r prior to
dt,th .,. fu.l.1v t,MIbI. II trl,,"""I.
!f, .kcounh ut.blhhed Jointly b.tw.en hu,b.nd and 10111. Mr. thlln one y.qr prior to d.ath ar. not tIHHII.
6, AooOll"tt. h.ld by a dIcI.u.nt "In tru,t for" another or oth.rll at. t.Mabl. fully,
REPORTING INSTRUCTIONS - PART
1 - TAXPAYER RESPONSE
1, ILOCk A " If thta tn'oruUon .nd COllputltlon in the notIc. are oorrlot and d.duotion. art not b.ino ohi..d, pilOt *' "X"
In block "A" 0' Part 1 of thfl "lIIMpoy.r R.."on.... ..otlon, SIDn two copl.. and .ub..it the. with your tlh.ck for thl MOunt of
talC to the R.ghter of WIU, of thl ooun\v Indlcntld. Thl PA Dlpartllent of R.v.nuI w111 1..1.1. M offl01.1 o.....Hnt
(For. REV-151ft' EIO upon rlceipt of the r.turn froll thl Regl,ter of Willi.
i':. BLOCK B - If th4l nlllt Ip.elUllld on thh notlc. hu bun or w111 b. report.d Ind tltM paid with ttMI P'M'Ylvanll Inherltanc.
Te)( R.turn fll~ by the Meldent', repr..."tIUvO, pllHlI M "X" In block "!I" of Pert I of thl "T.Mpeyer Re.pon.." leatlon, Sign on.
CQltY WId return to the PA DeplrtHl'lt of Revlnue, Bureau of Individual TaMU, Dlpt 210601, Hlrrhburl, PA 17128-0'01 In the
IIIl1vIIOVI provldld.
], BLOCK C - If t~ natJcI Inforlltion I, incorreot and/or dlduotlonl Ir. bling 011111d, chick block "C~ and c~l.tl P8rt, Z end 1
IItIltlu(ul,/W ~I.I ~11llI ~'I..i.1 ul.il;v... iJ",~.,... 3h,.. Ifl" ';~;.J..;; o~,:l ..u~;;;H t~,~::, il1t~, :;DI.;;' Ch=~!l f.,.. th:) :'~~"''n~ e' tt:ll p~:"!Jl= t~ th: q:o;!:t'.:r
of NUll of the oouoty IncUcatlit, TMe PA D.pEirtllent ot Rlven~ will hill' an offlchl lI"IUNnt (r-or. REI/-lS". EX) upon 1"O.Jpt
of the return frOl the Rqllter of WIU..
TAX RETURN - PART 2 - TAX COMPUTATION
LINE
1. Enhr the cftlt. tMlGoount orlglnlUv Will IIteblllhtd or tlU.d In tM .Innlr e)Chtlng It d.te of dllth,
HOTEl For I dacltdtnt dying Iftlr 121121&21 Account. which the dlcedlnt put In joint nlH' ",Uhln ene (1) Ylar of dnth art
tlxtbl. fulh .. tran.hrl, How.vlr, thGrl hi !In eMclu.lon not to IxcI..d 1.5,000 plr tr.".f.r.. r."ardl... of tM Villi' of
the IKlcount or the nlMbtr of IccClunt. h.ld.
If . daubl. ..t.rl.k (M~) applarl blfor. your flr.t 1'1". In thl addre.. portion of thl. noticl, the .1,000 .)Colu.i~
.Irlldy h.. beln dolduct.d fro. thll IHIcount balancl .. raporhd by ttMI fin.nalel In.Ututlon,
t. Enbr \1* totll bthtnce of the IICCou"t including Int.rut aocrued to thl dat.. of d..th,
S. The porclnt of the account that II taxable for each 'llrvlvor h d.terlllnltd .. followlI
A. 1he PitrCM\\ taxable for joint a...ts utsblhhld .or. thl" one y.ar prior to the dlCldlntf" deathl
1 DIYIDED BV TOTAL NUMBER Of
JOINT OWNERS
blllplel A joint 1lI.lt reghter.d
OIVIDED IV TOTAL MUHBER Of )( 100 . PERCENT TAXABLE
SURYIVING JOINT OWNERS
In tho nawl of thl dlcldent and two other p.r.on.,
1 DIVIDED BY S (JOINT OWNERS) DIVIDED BY 2 (SURVIVORS) . ,167 I( 100 .. 16,7:( (TAXABLE FOR EACH SUAYIYOfU
B. Th. p.:'c.nt tllllbl. for flints <lreatld within onCl year of the dllcedent'. death or aoC..,...."tl oWMd b~ the decedent but held
In trust for anothlr Indlylduat(.> (trult beneflolartell}I
1 DIYIDED IV TOTAL HUI"IBER OF SURYIVING JOINT
OWNERS OR TRUST BENEfICIARIES
)( 100 - PERCENT TAKABLE
E~.-plel Joint account reol.t.red In the n..e of the dlcld.nt and two oth.r per.on. and ..tlbl1.n.d within ~ y.ar of d.ath by
the d.colle,.t.
1 DIVIDED BY Z (SURYII/ORS) . .50 X 100 . SOX (TAXABLE FOR EACH SURYIYOR)
1ft. The .Hoot .utljact to hue (Un. 4) Is dater.lnld by IlUltlphdng thl account balanu Hine Z) b~ the perc.nt tlMtlble ,(Une 5),
s. F.nter th. total of thl d4tbts and dlductlOfl' listed In Pflrt 1.
6. lhl Haunt taxabll (111'10 6) 11 det.rlllln.a by IUbtr!l<ltlng the dabtll and d.dUctlon. (lInl 5) frCNI the .-aunt 'U:tJlHlt to tlUC (lIne It).
7. Ent.r the IlPProprlatl tllx ratl (line 7) at detlrll.ln.d bl\ow.
A, For d&t.. of de.th occurrlno aU.r 6/30/9"', thll tax rat.. for 1:ran.hr. to 'POU'U l!Ir. .. fOUOW'1
1. n.t.. of dt.th on or I,t.r 7/1/94 and b.for. 1/1/9S thl r!'lta I. 3X.
Z. Datu of d.ath on or !'Ifter 111/95 tran.fers to Ilpou.e. will tHI tiMId at OX taM ratl.
Notel For d.tll of daeth p~lor tn 7/1/94 trlnlflrl to .pou,e. arl taklbll at 6X.
B. Tran.ferll to 11nnl delc.ndantll Including fflthllr, lather. ton, dlu"hter. grlndchUdrlln, .on-ln-I...,
dNllhter-lnwl..... .tepchild and tt'__lr IUlle or. tnICabl1 at III( plrcent (6;(),
C. Tren.fer_ tQ ell othllrl lnoludlng brothllr, .Ishr, unci., lIunt, ",.phlw and niece Ir. te)(ltbl1 at f.lftaen percent (15X>.
D, If YOU changt thl t~x rat., pl.... .penlfY yuur rllatlon.hlp to the dlOlldent In th. IIr.. proYld.d,
a, Th4llllOUnt of t'M dull Ut'le 8) It detlrllJnlld b... IlUltlplylng th. tllllount taxabl1 (lln_ 6) by the tlM rat. (Unt 1),
CLAIMED DEDUCTIONS - PART
3
DEBTS AND DEDUCTIONS CLAIMED
Allowable debt. IInd d.du~tlonl nr. datar.lned I' follow'l
A, You 1....I1v IrO r.lpon,.lble for pay..ntf or the utllte lIubj.ct to aM In 111 trlltlon b... II parsonal represtnt.Uv. .II Insufficient
to pay ttM cNductlbl. Itllll,
B. You actually pold the dlbh IIftlr dnth of the dlcedlnt Ind oan 'urn Ish proof of p.y..nt,
C, hbt. b.JFlSI 0111"111 eu.t nl Ulllllnd fully In Pllrt 5, If adtHtlonal .pac. It n..ded, u.e phln p.".r a 1/2" )( 11". Proof of
p..y~t ..... be rlqua.tld by the PA Olpart..."t, of RIYII"IUI.
G -- - --
i....... .. ..... TAXPAVER ASSISTANCE. . .. i i.................
................'.......... ... .....11' YOU NEED. FURT HERINFORHATION OR ASS IS1'ANCE, CONTACT ANy..,,}'.......>
..> .. ..REOUTER OF WILI.S. PA DEPARTMENT OF REVENUE DISTRICT OFFIcE >......... .
..i ............ ... OR CALL THE BUREAU OF INDIVIDUAL TAXES, TAXPAYER INQUIRV UNIT IN ... .
> ttARRIS8URO liT (717) 787-8327. TDDt (717) '772-22S~ (HEARING IHPAIRED ONLY)
--..
COHHONWUI.UIOf PENNSVlVANIA
OfPARTMFHT OF REVENUE
BUREAU OF INDIVIDUAL TAME$
DEPT. llS0601
HARRISBURG, PA 171ZI.0601
*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
F!LE
ACN
DATE
NO. 21-9'7-2100
97111174
03-18-97
U~.IUI If m (Htl
'01 :'111'1 20 1\1'( ',',9
EST. or MARY E BRETZ
S,S. NO. 210-26-9809
DATE or DEATH 02-10-97
COUNTY CUMBERLAND
TYPE OF ACCOUNT
[] SAVINGS
Ix] CHECKING
o TRUST
o CERTIF,
ni Ii
t." !
OBERN W MILLER
212 S MAIN ST
MANCHESTER
Clc:,
P,c~1'1345
II
; 1/\
RENIT PAVNENT AND FORNS TOI
REGISTER OF WILLS
CUMBERLAND CO COUNT HOUSE
CARLISLE. PA 17013
FINANCIAL TRUST COHrAH hal provided the D.pa,'tMnt ~lth the inforuUon lht~ bllolol which ha, bun ulod In caloulltlng the
pO~lntlal tG~ due, Tn.lr record. Indicate thet at the d.eth of the above decedlnt, YOU ~.r. a Joint own.r/beneflolary of thl. ecc~,t.
If you fHl lhh Jnforllltlon h IncClrreot, 1'11"'1 obtain written carr.cUg" ;rOll the Uranolal In.tltuUon, aUaatl It copy to thh for.
end rlturn it 'to thl aboYI addr..., Thll IICcOunt 10 taxabll In accordano. ~ith the Intt.rJtance lex Lalol. cf th" COHonwe.lth of PtfNl,ylvl,,"la.
~'UI. dUll. ..... .... anlwor.d by (,&d in,. :. ~ i j ;o~ -l'J,)(t .
COMPLETE PART 1 BELOW N . . SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Aooount No, 392790 Doto 05-19-09
Eo tob1 hhod
Aooount ao1oneo 2.877 .11
poroont To,ob10 K 50 . 000
AllOunt Subjoot to To, 1.438 :56
To, Roto K .15
PotonUo1 To, Duo 215.78
PART TAXPAYER RESPONSE
[!] l'AXLUI!ITO~"~O">>\I~H.~f,$UL r~"A"~;~~FtCXALTAXAS$IS$HIl"t BASI>>. OM jilts. tJOTICI..l
,
A. t'J- The above Inforlll..Uon and tel( due It correct.
l.f'\1. You .IIY' choo.. to rl.it pay.en't to the Regli.tlr of WUl. ~lth tW'\J copt.. of thh notlcl to obtain
. dhcoont or avoid Inter.st, or you fIll1Y ehGelo. bolo: "A" 8nd return this oaHu to tM Reghter 0'
Wills and an offlclnl PIIu.uen't Hill be luued by thll PA Oepllrtlll.rlt of ReverllJ..
To Inlurll proplr crlldit to ycur II('count, two
(2) corde. of thll notlcl lIUlt noco.anY' your
pey.ent to thl R,ghtfH' of Willi, Make chick
paytbh tOl "Rtlghhr of NUll, Agent".
HOTEl If talC pay.tntl are ude within thr.1
(3) .onthl of tho dlcadRnt'. date of death,
yoU ..... deduot II 5;': discount of the taM d\Hl.
Any Jnhtrltanc.. tflM due will beeoll. cMl1nquent
nlnli (9) 1l0nthl !'Iftl" the date of Math.
[ CItECK ]
ONE
BlOCK
ONLY
B. 0 The &b~...e alllllt 11". bit" or will b, reported I!lnd tllI)( paid with the renn.ylvanJa Xnheritance Tax rlturn
to bl filed b... the docedent'. r,prelentatlvll.
C. D Thl above inforfllation l~ncorr.ct and/or debt. and d~ductlont were paid by you.
You fIlu.t co.pl.te PART L:.J and/or PART 0 bonlow.
If you indicat. _ di1f.~.nt t.x rlto, pl..s. .t.t. your
r.l.t1on~hip to dlcadlnt,
1
2
3_--K
4
5
6
7 ~
a
. ., 'OFFlC IAL USE ONL V 0 Ml'!i
PA DEPA/olTt4ENT OF. ReVENUE.. ..,i
~":"'~""'~~"'<:~~
PART
~
TIlY
LINE
RFTII,,!! . cn""tITAnn"
1. Doto E.tob1l.hod
2, AOQCKa"lt Bdane.
S, Percant Taxable
4. Allollnt Subject to Tax
S, Debt. and Deductions
6. Allount Taxable
7, Tax Rate
8. Tax Due
f)F. r~~ ~" JO!~T "TP'II~T ~f"!~ntl~T!':
PART
[!]
DATE PAID
-~
DEBTS AND DEDU~TIONS
PAl!
1'~
," 2" .
3_
4
o.!.
6_
7
8
CLAIMED
;';,:i
~"
~~
...
,..;.;,.:::,.;'
f~
,
t'
,,:::i
PAYEE
DESCR I PT I ON
AMOUNT PAID
~
TOTAL (Ental' on Una !i
of To, compU~ltlon I
t
.
Und~r panalti.. of perjury, I declare th.t the facti
COII~.~to tho bo.t oIlY know10dgo ond bo1lof,
(')/" _JY/o /) J. ( ('..flk.12./L
M'fIIv R~
I hay. reported abo~. ara tru., oorrect ~
HOME ((WI) Llple....::]70D
WORK () iJJ YYlMrJ/ f{'7
TELEPHONE NUMBER ~
GENERAL I NFORMATlON
1. FAIlUPif. TORESPOHD WILL RESULT IN AN OFFICIAL Uk ASSESSHf.NT IIlth ""rllll&bl. lnt.rut hued on infofllaUon
lIubftlU.d b'l the UnanallllL Inltltll~lon.
E. lntt.rU.nce hll( btU:IO..1 dtIIllnqu."t .1In. IltOf1thll .fhr the fl.o.dont', dnhl of duth,
), A Jalnt IO(lOont I. t"M,,*,lll .v.n thouoh th_ d'Cl.d.nt'~ f111l.e Wft. IIdrl.d fll II lll1'1ttttr of QOI1Ytnl..,<lI.
tt. Acoounh rlnoludlno tho', hflld ttAtwlon hUlband HnD wlf., whlth thll {hlted.nt 'lilt In joint nllM' wltl1l" Orlll y..r prior to
d..th art fullY tIMl'tbl. ... tr.",faro,
5. Aooount. ..t.a.lhhM jOlntlv b.tw..., hUlbWld !tnd wH. 1I0rl th4Jf't un. Viler prior tu duth lire not hMabll,
.. Aooounh "-hi by " dMMHtnt "In tru.t for" .noth.r or oU",,, ar_ tIIKllbl. fully,
REPORTING INSTRUCTIONS - PART I
TAXPAYER RESPONSE
1. BLOCK A ~ If tM _'nforlllltUon IInD c:og,putIUon In th. notlce ftrll flOrrl(1t "nd deduction. t'Ir. ntlt billing fIlIl"ad, phloe tin ")('"
In block "A" of Part I of thw "TaMp.y.r Re.pon.." utltlon. Sign two copl.. !lnd .ub.1t th.. with yoUt' lln.ok for th. ..aunt of
h\ll to th. Rqhtllr of W1111 (If the county lntllcahd, Th. PA Dttplllrlll.nt 01 R.v.rn~ will IUlle an offlolal ......Hnt
(Forti REV~lS48 [)() upon r,clllpt of thll ritlll/'n fro. U\I RlIglllter of Will"
z. aLOCK I ~ If the Ilu.t 'Pllclfled on thlt notice hu b..n or will ba reported rind hI( ,.ald with lh41 "enn'Yl\lanlll IM.rItMCle
TIIJC netlJrn fl1ttd b~ the d6-eu.nt'l r.pre..ntaHvII, pl&e. Itn ")(" In hlock "8" of Pnrt 1 of the "hllpayer R",JDIl.II" .eotlon, Sign OM
COfI'lI IInd return to ttJ.t PA o.p.rtMltnt of P."I.'~U" Bur.f1u Df IndlvldulIl hill", D.pt 2806111, .tlllrrhbllrg, PA 17128-0601 In the
tJrwelopfl provhkd.
5. BtOCK C - If thl.t notie. infor..tlon It Incorr.ot andlor doduCltlcml ftre being (;hll.ad, ohaok block "C" and oOllplllh Part. Z and 5
of wUh of the oounty Indicated, The PA Daparhlllnt of RIIy.nulI Hill Iuu. It"'! official ll....IIIl.nt (ForI! REV-IS-ftA EM) upon recaipt
af the r.turn f"otI the Reohtllr of Will.,
...:~..,'';~I,,, 'r.. ~t.. l",Iit,u"tl._,',. ~.l",:. :~;:.. '.~:., ::..plo:l :lor....l .';'...b..~~ ~hc': :.;!~:-, ~',.l~ ch~e:: ~n~ ~r,n ~":'''~~ of ~n~: J:"t~'::tJl: ':: ~":1 P.C'Uh':.."
TAX RETURN - PART
2
TAX COMPUTATION
lIIE
1. Ent.r the d.t. the account orlglnaitv was ..t.blhhed or titl.d In the nnn., OMitting at data of dellth.
NOTE I For II deoltdant dying after 121121821 Accounts which tho d.clld.nt put In joint ns.u wlthll'1 onlll (l) ....lIi of dtllth lira
tllllbl. full:;' al tranl'.r.. However, thllrll I, an IIMoluslon not to IIMce.d 13,000 pllr tranlfarl111f r.gllrdhu of the valuQ of
th4t IKJcou,t or the MMbllr of ftOoountll h4lld.
If II double a.hrh!< (MM) app.ar. bafore your fIr.t "'U.. In thfl I!'.dtlr... portion ofthh notlc., tM .1,000 BIColu.lon
1I1rtntdy Me tJHn dedUcted frOM t~ account balance lIS r.porhd by the Unano!.l Inltitutlon.
2, Enter tha total belanc. Df tl,. aooount including Interelt ftcoru.d to the dflte of duth,
5. the percent of tha Ilccnunt thlllt ill taICabh for each .urylvor 10 detCllrlllnal.l fit fo11o'H'1
A. Th. ~rc.,t t8xabh tor joint lll...ts ..tllblhhlld Ilore than one ynr prior to thu dlcad.nt'. duthl
I DIVIDED IV TOTAL HUHftEA Of
JOINT OWHERS
Ex.-pi., "joint ..I(lt r.glstered
DIVIDED bY TOTAL HUHIIF_R Of )( 100 .. PERCENT TAXABLE-;
SUfHIlVING JOINT OWNERS
In the nMII of the dacedent: and two other pu'on~.
.1 I1IVlDED IV ! (JOINT OWNERS) DIVIDED flV Z (SURVIVORS) . .161 M 100 n 16.7:< nAMABLE FDA eACtl SlIRYIVOfU
I. The percttnt hl<etJle for auets creahd within one ",lIar of the dllc.d.n't'l daath Dr accolrih owned b... the d<tC!edtnt but held
ill tru." for another Indivldual(s) (tru.t be~flclarl")1
1 DIVIDED BY TOU.I. NUHBER 'Of SURVIVI/'OO JOINT
owtENS OR TRUST BENEFICIARIES
X 100 . PERCENT TAXABLE
EXlMlplel Joint account reglst.rad In the Mill.. of the dlcadent and two other p....nnll llInd ..tftblhh.d within on. y.ar of death by
the d.ce~'"t.
1 DIVIDED BY l! (SURYIYORS) . .50 )( 100 . 50;.( (TAMABLE FOR EACH SUfll/lVOR)
It. TheiI..ount subjltCt to taJII Oln. 4) is det.reined b... IlUltlplylng ths IllCCOunt balance nlrMI II by the parClltnt taxable (line ]),
6. f.nhr th& total ('f t~ debh and deducltionl Ihted in Part 3.
6. The uoont tSJCabl. OJn. 6) h datillrllllned b~ lubtracUng the debt. and daducUonll Uln. 5,) frCMI tha ..ount 'Ubjl)ct to tel' (Ilnt 4),
7. E'ltilt the epproprlata tax rete Ulne 7) aa d.tClralned b.low,
A, Far data. of dIIeth ooC!~lrrl,," .fter 6/50/94, the tal( rlllt.. for tran.f.r. to spou... Ire .. follow.!
1. D.t.. at dallih on or lifter 7/1/94 met before 1/11'95 the rat. it s;:.
z. Oat.. of death on or IlfUr 1/1/95 tren.hrl to IpOU... will be taMlIId at 0% tal< rat..
Notal Far dat.. 04 chllth prior to 7/1/94 tr-en.farl to IpOIlO" ere tllMabh at 61:.
I. Trltfllflrl to Ilnnl delcllf\dant, Including father, Ilother, '00, dlllughhr, gr'andchlldren, lon"ln-lIw,
deughter~ In-I..., IIlt8PChlld and tn.lr Itsue sr. taMllbl. lilt .Ix perc.nt (6:0.
C. Trltfllf.r. to 1111 other. including brothar, .ht~r, unClla, f1unt, nephew alld niece art taJCable flt flft..n peroent (15;0.
D. If you eh.,.. the tax r*t., ph... specify YDllr r.lati~nship to th. d.cedent In the llIrla proYlded,
8. The Mount of tQ due (IIn. 8) Is dehrlllMd bV ."IUphlng th. asount taMable Uln' 6) by \he tIl)( rnte C\lne 7),
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
Allowabl. debt. .nd deductions are detersln~ an follow. I
A. VCN ltplb ar. r..ponllble for p.vnnt, or thfl ...tat. .ubjeot to adltlnlstrlltlon by II par.onal reJ\rrlllM'1t.tlve is In.uffloltnt
to pay the dedUctible ite..,
.. You ItCltualh' p.ld tMi d40bh .fhlr d..th of the d.r..dGnt and can furnh.., proof of P8YIlOOt.
C. Debts blllng at-I..d Wit be Ituh_d fully In Part 5. If _ddltlOMl ,pMe h n..ded, ll.. phln p..,.r . 1/2" I( 11". Proof of
PIIIYHnt .ew btr....ltt.d by thti p" o.pertHflt of R.vellllll,
. . . ... .... .. .... . .. . .. TAXPAVER MSISTANCE .. .
.\....,< . . . .. IF VOU NEED FURTHER INFORMATION OR ASSISTANCE, CONTIICT ANV .... .....
.... .. ... . .ltE6UTER OF WIUS, PA llEPMTMEllT OF REI/ENUE bUTRICT OFFICE . ...
: . OR CALL THE. BUREAU OF INDII/IDUAL TAXES, TA)(PAVEIl INQUIRY UNIT IN
.. .. HARRISBURG AT (717) 787-8327. TOOt (717) 772-2252 (HEARING IMPAIRED ONlV) ...
ClJHHONWIAI fit Of PENNSYLVANIA
lJt:/lAlHHINr Of Rfl/rtllJf
I'WH.AU Of INOIVItlUAI TAXES
flt.PI, ll0601
tlARRlstURO, IIA 171ZI.0601
*
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE ,~O. 21 97-07.60
ACN 97115132
DATE 04-12-97
~1~'lhl ,. IH !I.HI
'91
1Ii'Ii .14
[-I ') '14
i ,_, .
EST, OF MARY E BRElZ
5,5, NO, 210-26-9809
DATE OF DEATH 02-10-97
COUNTY CUMBERLAND
TYPE OF ACCOUNT
[] SAVINGS
[] CHECKING
[] TRUST
IXJ CERTlF ,
1_,
'j(
I.:
I!I!
gnE~NM~I ~I ~~E"cb,
MANCHESTER CUPA ,17345
Ii.,
" .
REHlT PAYHENT AND FGHI1S TO I
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
ORRSTOWN BANK hal provldld th. O.p..rt"lnt ~Ilth the Inforutlon ll.ted below whIoh hR' brlln utld In oalculltlng the
potenUal tal( dUI, Their ra<:ord, Indicate that at the dnth of the "boYI deoedlnt, you wer" a Joint owner/beneflolary of thl. account.
If you f'el thh InfprllatJon I. Jncorrect, I'll... obhlln written oorrllotlon froll thl f!nanfll.l Inlltltutlon, Ittlllch 8 COpy to thl. for.
and r.turn It to thl abovlI addrul. Thl. lIG'cnun~ I.. talCl'lbll In lIIooordan<l1 with ~hl Inhldtftl'tl'lfl TI'I'o( Law. of the fnllllnnweaUh of Penn,ylvanla
QuuUon. llIay bl an.w.r.d by call1~g (711) 181.8321,
COMPLETE PART 1 BELOW I! . I! SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Account No, 006-0055152 o.t. 06-25-96
Est.blish.d
,'al(
v-6o
17.047,79
100,00
17 ,047,79
,15
2.557,17
To Inlure proper oredlt to your account, two
(2) oople, 0' thl, not 101 IUlt accollpany your
paYlllnt to the R.ghter of wllh. Hek. ch.ck
pa'l!'lhh tOl "Rellhhr of Willi, Allent",
Account blance
P.t"cent hX8bl.
Amount Subj.ct to
Tax Rat.
Pot.ntbl Till( Du.
NOTE I If tl)( plIy.ent. are .ad. within thru
(3) Months of the decedent', date of dlath,
you lIay deduct 0 5% dhcount of the taM due.
Any Inheritance till( due will beco..e dellnqulr-t
nlnll (9) 1I0nthl afte, the dflte of lIuth.
x
) ,;)./lI"I.
PART TAXPAYER RESPONSE
[iJ I FAILURE TO RIISPOND MILL RESULT IN AN OFFICIAL TAX ASSESSNEN1' BASIID ON THIS NOTICE ]
..
o The aboye Inforllat Ion and taM due it correct.
- 1. Vou uy choo.. to r8..1t plw."mt to tho R80ht8r of Wills with tWD copllll of thll notic. to obhlln
a dltcClunt or ayold !nhrut, or yOU lIav ohllck bOl< "A" I!lnd return thlt noUco to the ROIII,t8r 0'
wills !'Illd an offlclol l'l1S8Ulllent will b8 IlIIulld by the PA Depart..nt of R.yenue.
l CHECK ]
ONE
BLOCK
ONLY
B, 0 The !'Ibove unt hll' bun or will be rllpof"ted Ilnd tal< paid with tho Pellnlylvonla tnherlt!'lnce Tel( return
to bf\ fll.d by the decedent'. repr...ntetlv",
C. [] Thll ~b~y. InforllatJon I~ncorrect and/or dllbts and deductlonl wllre paid by you.
Vou IlU,t cn.ph\e PART L.:J and/or PART [!] bllow.
If you indicate. differ.nt tax t"at., pl.... .t.ta your
r.lationship to d.ced.nt 1_
PART
[!J
-lAX
LINE
OFFICIAL USE ONLY 0 AAF
PA DEPARTMENT OF REVENUE
K~TUkN - (;':;HPUTilIAON
1, D.te e.tabliahsd
2, Aocount ealanoe
3, Peroent Taxable
4, ~~ount Subj.ot to Tal(
S, D.bt. and Deduotion.
6, Allount Taxable
7, hx Rat.
8. Tax Due
OF
I
2
3 X
4
5
6
7 -1L-
.
lAX ON ~u~NT'IKU~r Ag~OUNTS
I'AII
1
2
3
4.
S
6
7
8_,
DEBTS AND DEDUCTIONS CLAIMED
-
PART
[!]
DATE
PAID
PAYEE
DESCRIPTION
AMOUNT PAID
-r
.
Under penal tie. of
~CO~Pl.h to th. b~.t of
\.~-j;",~~ /tfRl ~~
fAXPA ~ 51 AT
I
TOTAL (Enter on Line S 01 Tex Co~putation)
r.rjury, I deolare that the f.c~. I
IlY knowl.dga and bali.f.
"}y- 1, L-QAJ/-"'-
have r.port~d above
t!OMLtl.L7 )
WORK ( ')
TElEPHONE NUMBER
ara trl.~.,
4
oorr.ct and
J I-{ -- I) )
IIATE
GENERAL INFORMATION
1. FAILURE TO RUPOHD WILL RESULT IN AN OFFICIAL TA)c ASSESSHEN'T with IlPpl!olthl. inhrlut bftlfd on lr.forll.t1on
'UbMltt.d by the financial In.tlll/tlcn,
Z, Xnh.r I hnc' till bleo... dlllnqullnt "In. lIIonth, "f t.r th. dle.dent'. dill" of d..th.
}. A joint locount It h)(tlbl., IVlln though the dlcedent'. nu. Wftfl lidded nI ft IIlIlt., of ClonYlnl.nu.
Ii. Aocounts (Including tho.. h.ld betw..n hi/,bllnd nnd wife' whlth th. d.olld.nt put In lolnt ""tIII.. within on. vlllr Jlrldr to
d..th lire fully t,"e"bl_ I' trfln,'.r..
5, lClcount. ..teblhhld Jolnth b.twII" hu.b.nd and wife lor. thin ontl YllJllr prlllr to deoth lire /lot 'aubll.
6. Accounh h.ld bv . dlCltd,nt "In trult for" IInoth,,, or athfllrl 1Ir. tl)lltl.ll, fullY.
REPORTING INSTRUCTIONS - PART
1
TAXPAVER RESPONSE
1. !\lOCK A - If thl Inforll.tlon Inri COMputation In the notl('. IIrCl oorr.ot and d.dllatlon. Ir. not b.lno olel..d, pleae In fllttt
In block "... of Pert: 1 of tn, "Tf!lCpanr R.."on.." ..otlon, Sign two copt.. and IUbllllt thl.. with your ohlck for thl "eount of
till( to thl A,gltter of Willi of thl county Indicated, Th. PA D.pltrt..nt of Rev.nuG wHI lI,u. In oHioiel a.....II.nt
(Forll REV-lS48 EKI upon r,cllpt of the r.turn froM th. RIgllt.r of Willi,
7.. BLOCK B - If th, a...t .p.olfled on thl. notlc. hat bltn or will bit rllporttd tlnd tali( pl!l1d with the Penn.yivania Inh.rltllnol
Tllli( Return fll.d by the d.eed.nt'. r.pru.ntllltiv., plan It" "X" In blnck "II" of P/trt 1 of th' "Tallp~yer R..pon.." IIctlon, Sign on.
ClOpy .nd return to th_ PA O.p.rhl.nt of R'lIenu., Buruu of IndJvldual Tfllll', D.pt 260601. Harrl9buru, PA 17128~ObOl In the
enll.lop. proyl6td.
5. BLOCK C - If th, notio_ Inforlllfltlon It Incorr.ot and/ol' dedu~tlons er. b.lnlJ ohl11l.d, chllck blnck "C" end conplet. Pert. Z and 3
'tl";('nrrl'r'!' t'l H~. I",t"'":-tlnnt b.lnw. Slur'! tOln ennl.. linn lub..lt th... wl~" ytlllr tlh..ck for t.n. fI,IIIcunt nf tall lI"",blt tn the Re'J!.tor
of wlllt of the county JndiClated, Thl P" Olpartll.,nt of Reyttnue wUl Iuu' Itll offlcirll .u....tnt (Forlll RE~~lS4' EX) upon r,-oQ!pt
of thl return fro. the RIGhter of WiU..
TAX RETURN - PART 2 - TAX COMPUTATION
LINE
1, fnt.r the dlt, th. aocount originallY w" ..teblllhed or tltlld In the IIInnlr elCl.tlnQ lilt dati cf death,
NOlEl For a d,e.dlnt dyJng IIftlr lU1U82~ Account. which th" decld.nt put In joint na".. within on. (1l Ylllr of dllth are
tallabl. fully at tran,flr', How.II.r, there 11 an eMolUlion not to .Ilned 13,000 p.r trllnlf,r., r.gerdl,," of the value 0'
thl lecount or th. nu.blr of account. h.ld.
If . d~11 e.terl.k (MM) appearl before your flrlt nalle In th. addre.. portion of thll notice, the '3,000 Illclu.ion
alrltdy hl'l' be.n dtduohd froll the acoount bahnce a. reported by the flnenclal In.tltutlon.
2. Enter the tote! blll.nc. of the account IncludinG inter..t accruld to th. date (If d.ath.
), The percent of the eCOOltnt that it ta>labl. for .ach .urvivor 11 dtterlllntd at fOUOtol.1
A. Th. petClnt talCabl. for joint auet. ..teblhh.d 110,. then on. Y18r prIor to the d.ced.nt'l dlllthl
1 DIIJIDED tV TOTAL Nut1I1ER OF
JOINT OWNfRS
E>I.-pl.l "jOint ....t rtglltered
DIVIDED av TOTAL NUMBER OF )( 100 . PERCENT TAXABLE
SURVIVING JOINT OWNERS
In th.. n..e of the deced"nt and two other PI"OI1I.
1 DI~IDED BY ) (JOINT OWHlRS) DIIJIDEO tV 1. (SURVIVORS) . ,167 K lGO . 16. n CTAKAIlLE FOR EACH SURI/IYORl
B, The p.rClnt talCable far a.set. cr.at.d within one year of the dec.dlnt'l d.eth or account. own.d by thl dlced*nt but h.ld
in t"Ult for another lndIvldueH.l (trult blneflolarJu1l
1 DIVIDED BY TOTAL NUHBER OF SUR~IIJING JOINT
OWNERS OR TRUST BENEFICIARIES
)( 100 . PERCENT TAKABLE
EKI.,.I/l1 ,!oint aocount rlGitt.red In the net. of the d.ced.nt and two other per.ons and ..tablith.d within on. year of duth by
the dlo.d.nt,
1 DIVIDED BV 2 (sURVIVORS) . .50 K 100 . 50% (TA)(ABLE FDA EACH SURVIVO")
it. The altOunt .Ubjlct to telC {lIne 4l It d.'.r"ln.d by lluHlphlng th. IIcoount balance (Un. ill by thv perc.nt hnol. tlin. 3).
S. Ent.r the total of the debts IInd d.duotlonl lhhd in Part 3.
6, Th. Haunt talCf'bl. (lJne 6) I. dltur.tned by 'Ubtrnctlng the debt. and deduction. (line 5l Iroll the allouot .ubjtot to talC (ltne 'Il.
7. Enter thl l,pproprJllte tall rat. <llnll 7) u deterlllned bc.low.
A, For det.. of death oce~lrrJng lIft.r 6/30/94, the taM ratvs for tran.flr. to 'POUI.. Ire II follow'l
1. Dlt.. of death on or after 7/1/94 and beforll l/lllJS the rah It 3i('
2. Dltu of d.ath on or after 1/1/95 trenlhrl to spou... will b. hilled at 0% talC rite,
Nat'l For dat.. of dutl! prier 10 1/1/94 trflr'll/.r. to s;pou... are t!lMabl. at 6%,
B. Tran.f." to !Jrlul dlllo.ndllht. Including I!'Ithllr. "other, .on, daught.r, gr.ndchlldren, lon-In-law,
dllu9htlr-ln-lew, .t.pchlld and their Is.ue flr. talClIbh flt she ptrc:tnt (6%),
C. Tran"Ir' to all other. Inc:ludlng brother, .llter, unci., aunt, n.ph.w and nl.c. ere tl>lable at lifte.n plro.nt (15%),
D. If you c:hl'lnG. thfl tfllC rat., pi.... 'P.cUy your r.llt1on'hlp to ttl. d.c.dent In the .rll provided.
.. The Haunt of tal( du. (lin. 8) is fl.t.rlltned b:f Ilultlplylng thft Clllcunt lell_ble (lln. 6) by 'h. taM rah (lln. 1),
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
Alloweblt debt. and d.ductlon' ~r. d.t.rllln.d ftl folloWl1
A. You legallY art rllPonslble for paYllent, or 'he ..tat. lubj.ct to adlllnl.tration by a p.r.on!'ll r.pr..entetly. 11 In,ufflcleni:
to p.y 'hI deductible Ite~.,
B. You Ictualh' paid the dllbtl /tfter d.ath of the dec.d.nt and can furnish proof of Ply.."t-
e. n.bt. beinG chi..d IUlt be It..h.d fully ln Part 3, If additional Ipacll II n..dtd, UII plain p<tper 8 1/2" >I 11". Proof of
pny".nt IIfty bl rtqu..t.d by the PI, nepal'tlllln' of R.venue.
TAXPAYER ASSISTANCE
IF YOU NEED fURTHER INFORMATION OR ASSISTANCE, CON/ACT ANY
REGISTER OF WILLS. PA DEPARTMENT OF REVENUE DISTRICT OFFICE
OR CALL THE BUREAU OF INDIVIDUAL TAXES. TAXPAYER INQUIRY UNIT IN
HARRISBURG AT (717) 787-8327. TDDI (717) 772-2252 (HEARING IMPAIRED ONLY)
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_OF
NOTICE I
To fUlf111 tM r.ql.ll"..nh of SlHItlan 2140 of the InhtlrltllnCl. tWld Eatat. TI)( Aat, AcU 21::~'199S.
hClUon '140). p-
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P'~HTI o.tach ttMI top portion of thit MoUoI and fl'Ublllt with your Plyant to thll R..l.hr of \UUIPrJnttc:l on the
rlV"" slH.
.M HIio:. eh~ or IIOOIY orcklr pa)feble tOI REIUSTEk Of WH.lS, AGENT,
REFlHI (CA)I A r.,\Rt Ctf . ta)C (lr.dlt, which w.. not requ..ted on lM tal( r.turn, nay bo r.~.t.d by oUllpl.Una I'tn "Applh'letJon
for Refund of P.nn'Ylvanla Inh.ritano. and ElUte Tax" (REV-U13)' APPUcllltlonlll IIrt availablo at the OffiCi of
t.... R..S.tIJr \)f NUh, lWty of thtl 23 Rev.nue nhtrlot offlo.. or by c811lnll the lpeal111 Z4-hour anlwering IIrvlu
nullbtlrI 'or for.' ordll'lngl In P"Mlvlvanh, l'.lUIO-162-Z0S0, outside Penn.vlvanll!l and Mlthln 100al
H4lrrllburCil .r.. (17) 7e7-80l)4, TOOl (117) 112-22S2 (U.~dn" Illplh,.:t Only).
OftJECTlDNSI Any porty In Inhr..t not satltflad with the 8Pf1rahtllent, allowlfiCl' or tlheUowfWl(l' of dldltctlonl or lS....II.iIf'lt
of talC Uncludlng dhcQunt or l"hrut) fol. .hawn on thl. NoUc, Ilay ObjlHlt within .htty (601 day, of r~.lpt of
thll MoUe. by I
~."rlthMl pret.st to the PA Dttpartllent of AlIy.nuI, BOllrd of App..h, l)ept. 281021, lIarrhburSl, PA HIZI-1021, OR
--.lt1(JtIng to hllve the ...tter d.ter.Jnad at the l:lUdlt of t~ account af tt~ ptil'ontll rspl'...ntlltIv., OR
~-llIpttIlIl to tt. OrphM" Court
AIlItIN-
ISTlIATJIIE
CORRECTIONSl
F&<Itl,llll IIr,'or. dhcovertKI on thh ........nt should be addr....d In ~rltin" tOI p~ ~lIrt""t of ReYIInlMI,
aur.au of IncUvldulll TaM"', ATTH~ POtlt blt.....nt ReylllW Unit, DEPT. 2110601, Harrisburg, PA 1712a~060l
Phon. (117) 717.6505, Sea paa' S of thl bookl.t "In.tructlon. for Inhtrltl'nco T8l( R.turn for III R..ldent
Decledtnt" (REV-IS0lJ fa" PO eKplanatlon of ndlllnhtreUy.h Clorr~table error..
D1SCOUNT I
If InY tlM Ou. 1. p.ld within thr,1 (S) oalendar Ilonthl flftlr thl dlc.dent's d..th, a flvl ~rc'nt (SX>
dl.o~t of the hM CJ81d III aUowld,
PENAL TV,
The 1S;( \8)( NM.h non-partIcipation pen8lty II ClOIIputod on thll total of the hM and Interut ......ed, and not
p.ld beforl JlfIOUl!lrY 18, 1996, the flr1t day Ilfhr the .nd of the taM .."..ty period. This non-parUc1pllt1oo
Plfl8lty I. IIPPIltlKll_ I" the .... ..",nlr anci In the ttwo ..... Un periOd a. you would applal th4t tax end Jnt.r..t
thtt h.. been ....II.d e. Indlo\ltld on this notlta.
unEREsr I
Int"..t 11 chllrpcl bIIlnl'lIOll with flr.t dllY of deUnqlMOOY, or nlM (9) .antha IInd 001 (1) d.~
frOCll ttMI data of d.ath, to the datil of paYllent. TIIIMII which bee... delinquent b.for. ,January 1, 1982
bear Intera.t .t tha rata of 11~ (6~) p.rcent per annUlI oftlculattd at a dally rat. of .000164.
AU tllllI which b.oalM dtIU~nt on or after Januory 1, 1'982 will b.ar lnt.rllt lit . rat. which will vary frotl
otlendar Yllllr to oalendar Ylllr ~ith that rat. announcad by the PA OIPllrt-.nt of RIYllnu., The IlIppllcabl.
Inter..t ratft. for 19A2 through 1997 nrll
Vlar Inte"lt RRt. Dlllily Inter~~ 'r'lIl11r Interut Rat. naUy lnttrllt FftCltor
--
19A2 20:< .000541 19A7 'X .000247
1985 16:< ,000436 1988-1991 11:': .000301
191. 111: .0003!)} 1992 9i: .00n247
l,as ax .000356 1993"1994 n .000192
19-86 10;( ,000274 IfJ95~1997 .X .11002:47
"~Int.r..t h calculat.d .. folloWll1
INTEREST m BALANtE OF TAX UNPAID X NUNDER OF DAYS DELINqUENT X DAILY INTEREST FACTOR
u.nlt HoUOI hlued aftflr thtl taM bl<lMHI. dallflCtl*lt will refl.Clt an Int.rut oel01.l1.tlon to flft.an <1S) dlYI
btVond the dati of tM UlluHnt" If p.y..nt it Ada Ifter the Interllt C:OIIpUt.Uon ~t. lhoMl on tha
HoUca, additional I.,terut MI.t ba calcuhtlKi.
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PIJAPOSE llt'
NOTICE i
"()
To fulfill the requlr..."t. of Seotion l!l40 of th1t InhtrltltnCl. and hteter81C Aot~ Aot 210' .19'9&, f-U
$HUon 9140), \,
P,S,
PAVHENTI
DtIt1toh the! top portion of thh Hath;!, Md
rav.". sleM.
..~ MM. ('.heck ot lIOnty ordtlr payable tOI
IW.1t with your P8Y11t1flt to
~~
o
tht Rqhter of WUlI prlnted on the
.'
REgISTER Of WHlS, ACENT,
REFUND (CR)1 . r.fund of rI tu credit, \lfhlch Will not rQ(fullted on thl tax r.turn, 811!t be r~.tld by C0IIP1,Ung en "Appl1otltlon
for Rflfund of Pennlylvatlla Inhlllr1t8MI and Eat6t. TalC" (REV-UU), Appllcfltlonl flre avaUllbh at tho Office of
the Rllllht.r of WUh, any of thtl 23 R.v~ Dhtrlct Offloll or by calling the Ipll<llal 24-001lr an,wlrlng .orvlo.
nuIlbtIr. for for.. ardflrlngl In P'nnJylYbnla 1-800"162"ZOIJ0, outllde P8nrHlylyanlfl end wIthin local
Harrlsbura .r.. (717) 781-8094, TDIlI (117) 772.2'l52 (Hearing Z.pftlrMt OnIV).
aBJECTIONS I Any party In Inbl'olt not raathfild with the a,ppreh....nt.:, aiiowenco 0" dltallowIlf'IC8 of dlductlon. or ........,t
of tllC (In<:lUlJlna discount or Inhrutl at shown on this Notice ..y objf(lt HUhln .bty (60) dllYI of rlteehlt of
thh NoUce bYI
hwrltten protut to thft PA De~arbM'"t of Rey.nu., Board of Appnl., Dapt, 281021, ~tllrrhburg, PA 17128-1021, OR
--.lItClUng to hltv. the IIfttt.r dater.lned at tha audit of the account of the perll)nftl r.pr..&ntaUve, OR
~~epp.al to tM Or'phane' Court
ADMIN-
ISTRATIVE
CORRECTIONSl
PaotulIl error. dhcoverlld on thI. atUllllaent Ilhould be addrllSllad In writing tOl PA [fflpartll4lnt (If Revenue,
BureltU of Individual laxe" AnN, POrJt h.....tant Revlow Unit, DEPT, 280Ml, Harrhburg, PA 1712a~0601
Phone (117) 787~65D5. S'II puge S of the bookht "Instructions for Inherlt!'lnce Tax R.turn for !'I R..itWmt
Decedent.. (REV~l!iOl) fo!' an 'Mplanatlon of adllinl.trllltJv.ly corraQtlible arrnr..
DISCOUNT;
If any tllX due Is paid ..!thin thrall (3) t;1l1ondar lIontn. after tha decedlint'. death, II flvlI pareant (Sin
dhoOLrlt af the ttl)( paid Is IIAlowed.
PENAL TV,
ThtI lS:C {a>c MntIety non-pl!lrtlclpatJon penal ty h COIlpU';!MJ on Uw tatal of the tax I!IDd Inter..t u,"ued, and not
p.l~ Mfor. Januery 18, 1996, the firlt day aft.,. thill and of the ta>c lIIlnfj.ty plllrJod. Thh non-participation
PWlIIlty 11 eweotlahla In tha ..... Ilann.r and in the the ___ UII" period II YOU would &fJpefll the talC and lntar..t
that h.. be-.n .../luCld fit indicahd on thh notlu,
INTERESTl
Int.rut 11 charGed baglMlng with fIrlt day of dell~Y, or nine (9) lIonth. and 0fWI (t) day
frf* thCI data of deaUl, to the date of pay.ant, TftMaa which bIIe._ dallnqu.nt before January 1, 1982
baar Intere.t at the rate of .1M (6iO percent per. IInnUII calcuhh.d at a d.Uy rat.. of ,0001&4.
All taK.. ""1eh bee... dlillnquant on or lifter January 1, 1982 will bur Inter..t flt " rah which will Vllry frOil
oalMdar y..r to calendar year with thllt r!lto announcad by thG p,t. Daparhen't of Rev.nua, Tilt applloeblt
Inttrut ,..t.. for 1982 through 1991 ftrG:
Vear Int.re.t Rate DftUy Intarut Factor Vear Inter..t Rata Oally Int.re.t fllotor
1982 20;( .000548 1987 .. .0002.47
1915 16X .0004!~ 19aa.llXH IV: .0001101
19'" 11;( ,oonOl 199~ 9:' .000247
1915 13;( .000356 l'JlJ5~1I)94 ]X ,OOOllJ2
,.16 lOX .000274 1995-1997 .. .000247
--Inter..t it calculated .. follow'l
IHTEllEST . BALANCE OF TAX UNPAID X NUHBER OF DAYS OELINqUENT X DAILY INTEREST FACTOR
--Any Notice h.ued IIft.r the tal( blColla. cktl1nquent 101111 reflact an lnttrut cllllcuhtlon to flft"" (IS) dan
beyond the dtlt. nf the a..aIllMl,t. If payltllnt h lied. IIft.r the Interut C1011pUtatlon dlltt .hoWn on the
NoUce, Itddltlonal IntClr..t lIU.t bll caloulated,
'ii
_stOl'
NOTItEl
t';
To fuUUI tM requinHnt. of Sllotlon rUG oJ the InhtrUenct IftdEStltl TIM Attt, .<It Z1 of 1991. (12: p".
hoU... '140),
PAVttENTI
DttlQh the top portion of this Hotlo. and sUblit ,with Jour Ply.-nt to the R"ilt.r of WJIII printed on the
reYtlr.. side.
n KMl. chtck or MntV order paylttl. tOI REGISTEt:f OF WILU, AOENT.
REF~D (CR)1 A refund of e tDM or.dlt, which wa. not rlqutlt,d on the tlX return, ~IY bo r.questad by coaplttint '" "ApplloltJon
for R,fund of P1MlnlYlvanll Inherltancl and E.t.t, Tlx" (Rf.Y~151'). Applloatlons ar. avallabl. at the OfficI of
the Roglibr af Wills, any of the 25 Revlno. District Offic.. or by oalllng the .plClhl ~~"hour In.werlng IIrvlcl
~r. for for.. ordering: In PennsYlvanl. l-aOO~562-2050, out.lda P.nn.ylvanla and within looal
Harrisburg Ir.1 (711) 787-80'4, TDDI (717) 772-?252 (Hllrlno I~alrad Only).
OBJECTlONSl Any party In Int.rllt not utllfl.d with thtl ftpflrah..ent, IJ1aNana. or dlsallonnoa of dlductlon. or ''''''Hnt
of t.M (IngludlnQ dJ.count or Int.ralt) I' .ho~ on thl. Matlel .ay obJeot wlthJn .ixtv (60) diY' of r~lipt of
this MaUoe bv I
--wrltta'l protut tu the PA D.."rb'lnt of Rlvenue, "oard of ApPI.h, Dept. 281021, Harrltburg, PA 1712a~1021, OR
--,If1otlna t,) ~VI the ..tter dltar.lned lit thcl audit of tM lOoount of thl p'''OMI rlPr..entaUvI, OR
--lIDpIal to the Orphan.' Court
AOHIH'
ISTAATlVE
CORRECTIONS:
Factual errors dhcoyerld on thll a..a.....nt .hould b, addre...d in wriUng tOI PA !lIpllrt..'lt of "lvtnUt,
Bur.~ of Individual Ta~.., ATTHI po.t A.......nt Rlview Unit, DEPT. 210601, Harrisburg, PA 17121~0601
Phone (717) 7e7-6S05, S.. PaotI 5 of the bookltt "In.tl'uotionl for Inh.rltatnOl T.x R.turn for. R..Jdtnt
Dloldent" (REYw1501) for lIfl Ixplanation of adIllnhtrflt!Y'h corr.ctebl1 I"rors,
D1SCDl*T 1
If any tl~ dul is plld Nlthln threa (;5) callndor eonth. aftlr the dIe.dlnt'. dtlth, I flv. PlrC8nt (IX)
. diaeount of the taK plld II 11l0~:I.
ThI 15;( tlUC ~..tv non.partletpaUon pentltv h CotlPUttd on thol tobl of the tilt ..~ Interllt ....Uld, Ind not
prild btIfor. JIInlI.ry la, 1996, the flrlt day aft.r the end of the tax MMSty period. This non-partlcJpatlon
pinlllty II appealabl. in the .au llI8flfl.r and in the the .... tlllll per 10d II YOU would ItPp..1 the tax 1M Intlrtlt
t~t ~. bttn ......nd II' indlcat.d on thl. notice.
PENAL TV I
INTEREST l
Inter..t I. charg.d beginning with first day of tkIUnqulrlOY, or nlnt (9) aonthl Met ona (1) dIIy
frOl ttM dlt. of death, to the dllte of p'.,Mnt, Tlx.. ~Ich bacUle dllInqutlnt tHt10ra Jenuery I, nez
bear Int.rlSt It thl 1'lIte of .IK (6X) peroent ptr 1IOnU. calculated at . d.U!/' rate of ,aDDU,..
All taKI' which Me... d.lIn~nt on or after Janu.r!/, I, 19a? wIll bllr Int.r..t .t . rlt. which wUI Verw fr.
a.lender ....ar to oallnd.r !llIr with thAt rat. annoonc.d b!/, thl PA DtpartlQf1t of A,vlnue, The appllclbll
Jnterllt ntlll for 1982 through 1998 arll
Vllr Int.rut A.h !!.!!.!J lnt.r..t Fl(ltor V..r Interllt Rat. D.lly Jnhre.t fIR tor
1912 ZOiC ,00054' 1911 ,~ ,000Z~7
1915 16;( .0000' 1988.1991 IU ,000501
1'" 11:< .00DSOl 19'2 ,~ ,0002~7
191. lSX .000356 1993-11)" 1~ ,000192
1'" 10~ ,00027" 199&-1'" ,~ .000247
~"Intlr..t III c:alculttld II follow'l
IHTERElI1 . BALA/lCE OF TAX UHPAIO X HUNIEll OF OAVS DELINqUENT X DAILV INTERElT FACTOR
uAny NoUce hlUed Ift'r thl tax bee..1 dtlJrMlUtnt flflH rlflect en Intlr..t olloullUon to flftMnUI) day.
"yond the ntl of the ........,t. If p.Plnt II. IIIKtI Ift.r the Inttrllt oaput.Uon dlte sholfn on the
Notlcl, Iddltlona1 Int.r..t .u.t be oa1oul.tld.
12"I~-2003
BRETZ
02-10-1997
21 97-0260
CUMBER LAND
101
E___- A~~nn~~t.d_:3
MAKE CHECK PAYABLE AND REMIT r~YMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOU~E
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REWiS;,-j -Ei[-iijrjl--filFoiT"iloT"i CE-iiii-ItiHEifi TAifcE- T A j( 'A-ppiiiiiiiEHENT -,-- AiiiiiiAifci-b-1i - -- __m___ - - - - --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
MARY E FILE NO. 21 97-0260 ACN 101
TAK RETURN WAS, 1 ) ACCEPTED AS FILED 1 X) CHANGED SEE
APPROVED DEDUCTIONS AND EXEMPTIONS:
9, Funeral Exp~n5.s/Ad~. Costs/Hise, Exp.ns.~ (Schedule HJ (9)
10, Debts/Hodgag. Uabllltlas/Llens ISohedulo 1) 1101 2.710,45-
11. Tot.l n.ductions Ill)
12. N.t Value of r8)( RAturn (12)
15, Charitable/Govern.Bnhl Bequests) Non~.l.ct.d 9115 Trusts (Schedul. J) (3)
14, Net Va1"e of E.t.h Subject tc 1'.. 114)
NOTEI If an allBssMent was issued previouslY, lines 14, 15 end/or 16, 17, 18 and
reflect figuree that include the total of ~ returns alsRlsed to date.
ASSESSMENT OF TAX:
15, AltOunt of Unit 14 .t SpOllS.,! rat. US}
16. A.aunt of Line 14 t.xabh .t U.n..l/Cl.ss A f,.t. (16)
17. AMount of Line 14 at Sibling rote 1171
18. A.aunt of line 14 t.Kabl. at Coll.tarMl/Cl.ss 8 rltm C1S)_
19. Prtncipul T.x Due
fI.II.l.
DATE
" . . ;f6://.i-J- 1-3
't ' IIUREAU Df INDIVIDVAl TAKES
lNtEAITAHCE TAli: IJllJlSHlH
PEPT. rlOM!l
IIARRISIIJRO, PA 11118-0601
COMMONWEALTH OF PENNSVLVANIA
DEPARTMENT OF REVENUE
NOTICE DF INHERITANCE YAK
APPRAISEHENT, ALLOWANCE ON UISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAN
MA1'THEW J ESHELMAN Esd '
SAIDIS ETAL
2109 MARKET ST
CAMP HILL
DATE
ESTATE OF
DATI OF DEATH
FILE NUMBER
COUNTY
ACN
PA pOll
ESTATE OF BRETZ
RESERVATXON CONCERNING FUTURE INTEREST - SEE REVERSE
A~PRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..l f.~tRt. (Schedul. A)
2. stocks and Bonds (Schedule 0)
3, Clo...ly Hald stocJc.lPartn.rshlp Int.rast (Schldule Cl
q, Harig.gls/Notl. Racltv.bl. (Schldul. D)
S. Cosh/Bank O.posits/Hiso. Parson.l Proplrty (Schedula E)
6. Jointly Dwned Prope,'ty ISch.dulo n
7, Transflrn ISchedull G)
8, Total A.,.ts
III
(2)
(3)
141
151
161
17)
......J!!.
,00
.00
.00
200,00
15.403,38
,00
(8)
2,851.00
.00 K
.00 K
,00 K
10,041.93 K
,u:r.:(IrT --"-.
,_~BER__
--U~-
INTEREST/PEN PAID 1-)
AHOUNT PAID
INTEREST IS CHARGED THROUGH 12-30-2003
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
*
....II4IU I" nl-1Il
MARV
E
DATE 12-15-2003
ATTACHED NOTICE
HOTEl To insure proper
ctldit t i YOUI' aocount,
sub. it tM upper portion
of this for. with your
tax ply.ant.
15,603,38
c; . Ii Ii 1 4C;
1 0 ,..lli..:1~
,00
10,041.93
19 will
00 =
06 .
00 .
15 .
,DO
,00
,00
1,506,28
1,506,28
1191:...-,_
TOTAL TAX CREDIT ,00
BALANCE OF TAX DUE 1, 506,28
INTEREST AND PEN. 6B2.15
--------
TOTAL DUE 2.188,43
· IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION Of ADDITIONAL INTEREST,
I IF TOTAL DUE IS I.ESS TItAN n. NO PAYHENT IS REQUIRED,
IF TOTAL DUE IS REFLECTED AS A "CREOn" ICR), YDU HAY 8E DUE
A REFUND, SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
RlSERVATlONI e,t_t.. ofdlo.untl dytng on or b.far' Plo..ber 12, 198t ~.. If liMY future Intlrut In the ..tat. h trln.flrrld
In po....tion or Injoy.etlt to CI... I ,(Gollet,,.,l) bln.fiot.d.. of the dlo.dlnt .fter the IMplr.Uon of WlY ..tete for
11f. or for V'lr., the Co.onw..1th fllrltw .Mp,.....ly r...r..... tfl, rtght to IfIprllh. .rid ...." 'tren,fe,. Inhlrlt~o. llM(III
.t the l,wful CI.., I (aoU.t.r.1) rate on MY luah futurI Interut,
PURPOSE OF
NOTlCEl
1'0 fulfUI thl nq~ltre'lnt. of seatien 2140 of thl Inhlrltlneo and Estate -reM Ao~, Aot U (I' 2000. (12 P.S,
Slttion 911\0).
PAVHENT I
a.tach the top portion of thil Notice and sub,1t with ~our p..~IIGnt to the Rellhtlr of Wills printed on the river.. side.
"~"ah ch.ck or lonoy order pa~abh tOl REGISTER OF NILLS, AGENT
~FUHD (CAJI A refund of a tlM oredit, which WII' not rlque.ted on the Tax Return, ..ay be reque.ted by oOlpletlng In "Applloltlon
for Aefund of PennsYlvanltl Inherltlnol nod Estate TaM" (REv~nlJ). Application. e,.e "vaUllhle at the offlol
or the Reghter of Willi, .ny of the U RevenuI Dhtriot OffiCII, or by olllling the speclel 24-hcur
'""flrlng ..rvJoI for for" ordering I 148QO~362"20501 IIrvlIJ.. for taM payer. with 'peolal hllQrlng and I or
.petkln, nelds, 1"800~447-3020 (TT only).
OBJECTIONS I Any pllrty In Inter.Tlt not utilfled wlth the apprl!l1l1l1l1nt, elloW4noe, or I1l1ellowence of deduotlons, or aUlIIs.ent
of tal( (inoludlng dhoount Of Interut.l HI shown on this Notloe Ilust objeot wUhln sil(h (60) daus of reollpt of
this .Iotloa by,
-~wr1ttan pl"ota.t to the PA Dllpart8ent of Ravenue, BOllrd of Appeals, D.pt. 281021, Harrhburg, PA H12a~102l, OR
-~ehction to hnve tha "8tter dlhr.lned !It audit of the aocount of the perBonlll repr8l8nhtlve, OR
~ .apPll81 to thu Orphans' Cour t.
ADMIN.
ISTRAlIVE
r.ORRECTIONSI
FfwtUQl errors dlscov8rlld on thh 8suss..ont should bo nddreuDd In writing tOI PA DllpnrtllDnt of Revonuo,
Bureau of Individual 1111(11, ATTNI PORt Auess.ant Revilw Unit, Dapt. 280601, Harrisburg, PA 17lZ8-0601
Phon. (717) 787-6505. Sea pagaS of the booklet "Instruotlons for Inhorltafloe Tax Return for n Resident
O.cedlnt" IRE\!-IS0l) for I:In explanation of adMlnlstratlvolY oorrectable errors,
OISCOUN11
If any tal( dUM Is paid within thr.e (3) oalendar ~onth. after the decedent', death, a flye peroent (5Xl dlsoount of
the tax paid I. allowed.
PENALTYl
1h11 15X tax llInUtw non-participation penalty h coaputed on the tobl of the taM and Interest a..euad, end not
paid before January 1&, 1996, thl first day after the end of the till( ..na.ty p.rlod. 1hh non-partlolpation
pen.1ty Is appeal8bh In the Sllllle linneI' and In the the sa.. till. p.r lod II YOU would appeal the till( IN1d interest
th.t hat b'tn essels,d a. Indloated on thl, notloe.
INTERf:STI
Inter..t It ohl!rged blg'nnln, with first day of deUnquenoy, or nine (9) lon\hs and on,! (1) day frail thl date of
d.ath, to the dllt. of paY.lnt, TflMII whloh beoa.. delinquent before Janulry I, 1982 bear Inter.st at the rate of
,ix (6:'0 peretnt p.r annUM onlouhhd et a dally rate of .000164, All tax.. whloh beoB.e deUnqulnt on Bnd .fter
January 1, 1982 will beBr Intere.t flt a rate whloh will vary '1'08 o~l.ndflr year to oalendar year with that rate
.nnoun~ed Ly the PA Depart..nt of Reyanue, The appllcablu Jnterest rate! for 1982 through 200~ .rll
Interut DaUy Interllt D.lly Int.rest
~~ y..!!!' ~~:!!!r ~
'!!!r
"1I11y
~
1982 20i( ,0005411 1981 OX ,000247 1999 7X .000192
19U 16X .000438 198841991 11% .000301 2000 ax .000219
1984 lIX ,000301 1992 9Y. .000241 2001 ox ,000247
1985 UX .00035{, 1993-1994 7X .000192 COUZ 6X .000164
1986 lOX .000274 1995-1998 ox .000241 2001 5X ,000137
"~lnter'8t III olllcuht.d III follow. I
INTEREST' BALANCE OF TAX UNPAID X NU"BER OF UAYS DELINQUENT X DAILY INTEREST FACTOR
~-Any Hotiel Issu.d .ltlr the tall blco." dflUnquent will ,.afleot an Int.rut ealculatJon to fUt..n (1S) day,
Qeyond thl dat. of the aue...,nt. If pfly..nt Is IIIdll eHer the Intarnt oo.putat1on date shown un thl
Notloe, additional Int.r..t .u.t be oaloulllted.
".
. ll!Vl~)HI~1I?1
\ l )' IC-i'". I';
,)
REV..1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
, .i
OCT 1 5 2003
. COMMONWEALTH OF
" ' PENNSYLVANIA
f , . . DEPARTMENT OF REVENUE
OEPI 2tlflOO 1
, HARRISBUHO, PA 17118,0601
I!!
ll~~
~~iiI
~
FILE NUMBER
21 97
0260
CCXJ~II'f COOE 'frAll
NlJMBER
I-
Z
w
fil
u
w
c
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAl I
Bratz, Mary E,
SOCIAL SI'CUI1ITY NUMBER
210-26-9600
DATI Of BIRTH (MM,(JI).'II'ARI
OS/23/13
DATI' Of DEATfI (MM,DIJ.YI'ARI
02/10/97
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WillS
SOCIAL SECURITY NUMBER
(If APPLICABLE) SURVIVINO SPOUSES NAME (lAST, FIRSl. AIIO MIDDLE INITIAL I
tilt, Original Roturn
[] 4,lImllodEstate
~ 6,OocedotlIOledTastalll(A/LWli;OP'lQlwm
o g, LlUgaUon Proceoos Recoivod
[] 2, Supplomontal Rolurn
fJ 4a. Fuluro Inlerost CompromlsB (4<l1t. oftl8Alh ahI11.1J.811
[J 1,Oecedonl Mainlillnodo living Truat (AlLl<:h oopy 01 IfIiIl)
[] 10. Spousal Poverty Credit (uale o(r.lII~thl)utfjllen \1.3\-911f'{j 1-1-95)
D 3, Romalodor Return (rMllloldlillllptlOllo 12.1Hl)
r.J 5. Fodorat Estate Tax Roturn Required
.1_ 8. Total Number of Sale Deposit Boxos
o 11. Elocuon 10 lax under Soc. 9113(A) IAnid1 Sd1 Ol
l-
I
~
"
Di'~COf(fI"P HOBNOIl
ND cOHPIDllHTlAL rAX,1 F AM~
COMPLETE MAILING ADDRESS
2109 Markel Street
Camp Hili, PA 17011
NAME
Motthow J, Eshelman Esquire
FIRM NAME 11'ApplIClltJj~1
Saldls, Shuff, Flower & Lindsay
TELEPHONE NUMBER
(717) 737.3405
1, Real Es~l. (Sch.dul. A) (I) 0.00
2, Stocks and Bonds (Schedulo B) (2) 0,00
--
3, Clo..~ H.,d Corporalon, P.~narshlp or Sol.,Proprl,'orBhlp (3) 0,00
4, Mortg'g<ls & Nol" R.ca".b~ (Sch.dul. D) (4) 0,00
5, Cash, Bank Oepo~lts & Miscellaneous Personal Property (5) 200,00
Z (Schedul. E)
0 6, Jolnlly CNined Property (Schedul. FI (6) 15.403,38
~ o Separsle BillIng Roquosled
..I 7, Inlor.vjvos Transfers & Miscellaneous Non.Probale Propofly (7) 0,00
~ (Sch.du~ 0 or L)
~ 6, Tot.1 Ora.. A...~ (o~1 Lines 1.7) (6)
U 9. Funeral Expenses & Adm)nlslraUye Costs (Schedule H) (9) 3,151,00
W
0:: lB, D.bts 01 D.cod.nl, Mon9'9' L1abIllU.., & LI." (Schedul.,) (10) 2,710.45
11, Tot.1 O,duct/o.. ilo~1 Lines 9 & 10) (11)
12, N,' v.,.. of EeI.t'{Llne 8 minus Llno 11) (12)
13. Charilable and Govemmenlal BequoslslSec 9113 Trusts for which an aleclion to lax has not been (13)
m,d. (Sch.dul. JI
14, Net V,'uo8ubjo.1l0 Tu(LI" 12 minus Line 13) \14)
;; ! i':I{' I;L I ';n
15,603,36
5,661.45
9,74~~
0,00
9,741.93
BEE INSTRUCTIONS ON REVERSE SIDE FOR APPLIOABLE RATes
~
~
...
~
D.
:Ii
o
CJ
~
15. Amoun! of Une 14 taxable at the spoutallax
ral.,or Iren.I'rBunderSec, 911B('1I1,2)
0,00 ,,0
(IS)
(IS)
(17)
(16)
(19)__
0,00
0,00
O,O.Q,_
1.461,29
1.461,29
16, AmounlofUne 14 laxlIble at llnoal 'alo
, ,0
17, Amount 01 lino 14 taxablo at slblingralo
11:,12
16, Amounl01 lino 14taxllblealcollaloralralo
9,741,93 '15
19. r,x Out
200
CtH CK HtlH If VOU ARE HEQlIE~irING ^ HHUNO or AN OV~HP^YM[Nl
~f.;i.;'! ::. \-i:';-V,,';I\',,; ~l'~it.-_':~?"'Xr~'.'IlI'
AIJ;'Q ..mll"ON AMIl IIIDI "NIIl\e2HIlCKM"TH <: ~ .
~J"jf!(!ll2i&
, Decedent's Complete Address:
, STREET ADDRESS
940 Walnut Bottom Road
Manor Cara Health Servlcas
CfrY Carlisle
I STATEPA
I ZIP 17013
Tax Payments and Credits:
1. Tax Duo (Pugo 1 u~o 19)
2, Grll<iilslPaymonls
A Spou..1 Povorty Credil
B, Prior Paymonls
G, Discount
(1)
1,461.29
1,417,54
13,6~
Total Glodlle (A + B + C ) (2)
1,491,38
3, InlorosVPonally If applicable
D,lnterasl
E, Penally
I
!I
I
Totall~lorosVPenallY ( 0 + E ) (3)
4, IllIna 2 I. graalar Ihan lIna 1 + L1na 3, anter tha dlffarence, This Is Ihe OVERPAYMENT.
Check box on Page 1 Lln. 20 to requttt . r.fund (41
5, If Line 1 + Line 31s grealer than Line 2, enter the differance, Thl.I.lha Tf\X DUe, (5)
A, Enlar Ihe Inlero.1 on Iha la' due, (5AI
B, Enler Ihe toilll of Line 5 + 5A, This I. the BALANCe DUE, (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
0,00
30,09
000
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1, Old decedenl maka a Iran.ler and: Ya. No
a, rotain Iha use or Incoma of Ihe property Iranslarred:", """""""'" "",,""'"""""""""'" D [KI
b, relaln Ihe rlghlto deslgnale who shall use Ihe property tran.ferred or ils Incomo; "'''''''''''' """,.".,,,,,,,,,,,, D [KI
c, ralaln a rovo"ionary inleresl; or", ,,,,,,,. ",,,.,,,,,,,,, '"'''''''''' """"""""''''''', ""''''',,'',,' D [KI
d, receive Ihe promise for tife 01 ailhar paymenls, banafils or caro'! '" """"""'"'''''''''''' D [j(]
2, II daath occurred ahar Dacembar 12, 1982, did docodenllransfar property within ona yaar 01 daalh
withoul roceivlng adoquale considaralion'!" """""""""''''''''''',,,'''','',,,,'',,'''''''''''''''''' "",",,"'" D [KI
3, Did docedelll own an "in Irusl for" or payabio upon dealh bank aCCDunt or .ecurily al hi. or her daalh'! """"""" 0 [KI
4, Did ~acodenl own an Individual Reliremont Accounl, annuily, or olhor nOIl-probale property which
CDnlaln. a beneficiary dasignalion'? '"'' ",,",,",,"""'"'' """""""""'" D [KI
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN,
Ul'lder PfjnalU.ls or ptlljury, I declare thaI I hR~a fI~aml<1Od this return, Including accompanying ~clledulas IInd ellllarnant" and 10 the 0051 01 my knowledge and ballef. II Is truo, COfrect and compklte,
Declaration of preparar olllor lil.lln tho perlonal '2!10sanlalivo 15 basad on alllnrormlltion 01 ~'hlch propllr&t heu any knowledge
SI~TURE OF PER~N RESP~SI~E FOR FILING RETURN.;; ~' Ai
,.u.o, U, L";C~-M1U ,/ff'nda. (/,
ADD SSI~ U V
SIGN1if~ffER OTHER THAN REPRESENTATIVE
ADDRE~~ r'-
2109 Market Street, Camp Hili. PA 17011
~Ml)
DATE
1i'-g"i'3
D~TE -J,.,
/0 { ISr3
For dalas of dealh on or aher July I, 1994 and belora January 1, 1995, thota, rale impo.ad on Ihe nel value of lransfare 10 or for the uss ollhe survNlng spou.e I. 3%
172 P,S, i9116 (a) (1.1) (i)].
For date. of dealh on or allor January 1, 1995, Ihala' ratalmpo.ad on Iha nel value of Iran.lore 10 or for the u.e of the surviving spouse I. 0% r2 P's, i9116 (a) (1,11 (i1I1,
Tho slalulo ~eMmJll a lran.lar 10 a .urvivlng .pou.e hom la" and Iho slalutory raqulremonts for dloclo.ura 9f aaaets and filing a lex return aro slill opplicoble evan if
the .urvlving spou.e i. the only benaficiary,
For dalas of daalh on or allar J"ly 1, 2000:
The lax rale Imposed on the nal val"e oltran.fe.. from e decoased child twenty.one years of age or youngar al daalh 10 or for Ihe usa of a natural parenl, an odoptlve parenl,
or a slapparenl of the child i. D% [72 P,S, i9118(a)(I,211,
The lax rala imposod on Ihe net value of Iran.I".lo or for the usa ollhe decodant's lineal beneficiaries Is 4,5%, excopt a. noted In 72 P,S, i9116(1,2) 172 P,S, ~9116(a)(111,
Th~ ts, ral. Impo.ad on Ihe nel valua of tranalers 10 or for Ihe usa of Ihe dacodent's sibling. I. 12% 172 P,S, ~9118(a)(1.311, A sibling Is dafined, undar Secllon 9'lO2, e. an
Individual who has allea.t ono parenlln common wilh Ihe decodenl, whether by blood or adoption,
~EV,,.O' EX' 10"8.
COMMONWEALTH Of' PtiNNeYLVANIA
INHERITANCE TAX RETURN
RaSIDENT DECaDaNT
leNIDULI F
JOINTLY.OWNED PROPERTY
ESTATE OF
Bretz, Mary E,
FilE NUMBER
21.97.0260
If.n ....Iw.. m.d, Jolo' whhln on. Y'" ollh. dlC~,"".~.I. 01 d..lh, I' mu.' b. '.Po,'.d on Soh.dul. 0,
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A. Obern Miller
212 S. Main Street
Manchestsr, PA 17346
sister
B.
c,
JOINTlY.OWNED PROPERTY,
LETTER ""IE OEBCRIPTIOII OF PROPERTY %Of "A'EOFOE.o\Ht
ITEM fORJOIKl MADE INCLUDE NMlE OF FI~Nr.!AL INSTITUTION ~o BANI<; ACCOIJHT NUMBER ofl91MlLAR OA1EOFoeATH OECo'S VAt.UEOF
NU IT I EN IFYI U ER. 01 ,y, L e T e. ALF. F SilT '''' 0"" REST
1. A. 5/89 Financial Trust checking account # 392790 2877,11 50% 1438,56
2, A, 5/69 Financial Tnlst checking account # 1033069 812,37 60% 406,18
3. A, 5/89 Financial Trust cd # 011.0061256 3602,04 50% 1901,02
4, A, 5/89 Financial Trust cd # 001.0110395 531(),11 50% 2655,06
5, A, 6/92 PNC Bank, NA account # 51.4043.9501 '1609,67 50% 904.83
6, A, 6/92 Orrstown Bank, account # 006.0055152 (tax paid $1214.66) 16195,46 50% 8097,73
TOTAL (Also enler on line B, Recapllulatlonj I
(II more spaco Is neuded, Insert addUlonal shoels 01 tho sarna slzo)
15,403,36
~EV'1611 EX' 112.001*
COMMONWEAL TH or rENNBYlVANIA
INHERITANCE TAX RETURN
~EBIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
BSTATE OF
Bretz, Mery e,
FILS NUMBER
21.91.0260
Deble of dmd,,' mUll be reported on I'hedule I,
ITEM
..JillM!!.~R
A. FUNERAL EXPENSES:
1. Myere Funeral SeNlces
DeSCRIPTION
AMOU T
2100,00
s, 'ADMINISTRATIVe COSTS:
1, Pe,..".1 Repr.."~lIve'. Commllllon~ 500,00
Neme of Pe~onel R.preillnleUvn(l) ~
S~.I 5e",rlly Numbe'(I)/EIN Number of PI~Qnol Rep,...nllllve(l)
SI..etAddr...
Clly Sidle """",,:-Zlp
V.arle) Commission P.ld: 1999
2, AllomlY Foe. 500,00
3, F.ml~ ExompUon: (II decodonl's eddre.. II nQI the ..me.. d.lm"t'l, .1I.Qh "planlllonl 0,00
CI.lmant
SI...IAddre61
Clly _ __ Slete ~Zlp ,
R.I.llonohlp QI CI.lm.ntlo Decadon'
4, P,obal. FOOl 51,00
5, Accounlanl'. Foe.
6, T" R,tum Prepe..,'1 Fe,1
7,
TOTAL (Also enler on line 9, Recapltulallon) $
(I' more spacolsnoodod, Inserladdlllonal sheets 01 the sarno size)
3,151.00
LAST WILL AND 'l'BSTAMENT
0)\'
MARY p.. BRETZ
I, MARY E. BRETZ, now residing at 128 West willow Str.eet,
in the Borough of Carlisle, Cumberland County, Pennsylvania,
being of sound and disposing mind and memory, do make, publish,
and declare t.his to be my Last will and Testament, hereby
revoking and making null and void all other Wills and Codicils
heretofore made by me.
FIRST
I dosire and direct that all my just debts, inoluding the
expenses of my last illness, any funeral expenses, and any
estate, transfer, inheritance, or succession taxes that may be
due, be paid without unnecessary delay by my Personal
Representative, hereinafter named and appointed.
SECOND
All of the rest, residue, and remainder of my estate,
whether real, personal, or mixed wheresoever situated, whether
owned or possessed by me at the date of execution hereof or
acquired by me after such date, I give, devise, and bequeath to
my sister, OHERN W. MILLER, presently residing in Manchester,
Pennsylvania, if she shall survive me; but in the event she
shall have predeceased me, the same shall instead pass to my
two nieces I JOYCE TOPPER, presently res3.ding in York,
Pennsylvania, and LINDA STRICKLER, presently residing in Laurel,
PAGE 1 OF 5
'Maryland, in equal shares, share and share alike; but in case
either or both of them shall have died in my lifetime, leaving
ohildren living at my death, such surviving children shall
take, per capita by generation, that share which his or her
parent would have taken had such parent aurvived me.
~.!illill
I hereby nominate, constitute, and appoint my Riater,
OBliJRN W. MILLER, as Exeoutrix of this, my Last Will and
Testament, and I do hereby expressly confer upon her power to
administer my estate without having to give bond or report of
her duties in the administration of my estate. I further give
to my Executrix the full power to sell and convey any personal
or real proper.ty that I may own at my death in order to pay
debts and legacies aqd to administer my estate. This power may
be exercised either at public or private sale, and upon such
terms and conditions as my Executrix may, in her discretion,
impose.
In the event that my sister, OBERN W. MILLER, is unable or
unwilling to aot. as Executrix, I do hereby constitute and
appoint FARMER'S TRUST OF CARLISLE, PENNSYLVANIA, a
Pennsylvania Banking Corporation, Carlisle, Pennsylvania, as
Alternate Exeoutor and do specifically dir.ect that no bond or
other surety be required of it as such Alternate Executor upon
ita qualifioations. I do further authorize and empower it with
the saIDe authority relative to the administration of my estate
PAGE 2 OF 5
PAY"EHT I
O.t.oh th, top portion ~f, this H~t'c' Ind lublit with your Ply.,nt ..de plyabl,to the n..' end addr,..
printed qn the r'Vlr.. .id..
... HMk. check or "O",V ordsr payabl1 tal REGISTER OF WILLS, AQ,ENT,
REFUND (CRll A r.fun~ 0' I tlX oredlt, ~hlch ~II' not reque.ted on the TaK R,turn, .IY be requested by cOlpletl", an
"APpllcltlon 'or Refund of Pann.vlyanla Inheritlnoe Ind E.tate. TIM" (RE~"1113), Applloatlonl ar. Iyallebls It
the Offloe of the Regl.ter cf Will', Iny of the 23 Revenue PI.trlot Offloe, or fro. the O'Plrt..ntl, 2~-hcur
tnlwerlng .ervlo. for fnr.. ord.rln;1 1-800-362-2050, ..rvlc.. for t.xpay~rs with Iplolal helrlng and I or
lIpnklnlil nnd'l 1.1100-447-3020 (TT only).
REPlV
TO,
DISCOUNT I
PEtllllTVI
INTEREST I
Quultlon. regardJng .rror. oontllnld on this notice should b, .ddr....d tot PA Dlpart..nt 0' R.vlnu., 8ur.au
of Indl"idull Tlxe., ATTNI Po.t Ai......nt RevJlW Unit, Dlpt. 280601, Hlrrl.burg, PA I1J28-0601, Phone
(717) 787-6505.
If IIOY tax 00. 11 pllld within thr.. (3) calendar lonth. ,fter the deQed'mt'. dnt", I f.IYI 'Percent UXl dhcount
of the tax paid I. alJowed,
The lSX tlX a~e.ty non-pftrtlolpatlon plnalty I. oOlputld on the total of the t.x and Int.re.t .......d, ~d not
plld b.fore Jenulry 18, 1996, the ,Irst day Ifter the end of the tox I.ne.tv period,
Inter..t J. onlrued blg1nnlng with f1r.t dlY of dlllnquRnc~ or nino (9) .onth. Ind on, (I) dey frail the dat~ nf
de.th to the data 0' pIY.lnt, TeXIS ~hlch beoll.1II delinquent before ,'flnUIrY I, 198Z bear Intar..t It tha rate af
.Ix (6~) peroent p.r ~nu. aaloullted at B dfllly rate of .000164. All taxI' which beCIIlI dellnqulnt on and aft.r
JlInulr~ 1, 198Z w1ll banr lohl'ellt It a rate whloh will Yilry frolll olhnd.r vear to calendar year with that "t.
.nnounald by thl PA DlpRrt..nt of Rlv'nue, The oppliclble Intlr..t ratl' for 1982 through Z004 .ret
lnternt DaUy Inter..t Dilly Internt DlilY
Yair Rate Faot(lr Year Rite Paotor Vear Rlt. F.ctor
~ -- '"'"'iir 9X
19112 ,0005411 19811-1991 .000:$01 ZOOl .000247
1985 16l .00quII 1992 .l .000247 2002 6l .00016\
1'04 III .000301 1993-1994 n .000192 2003 Sl ,000157
1'85 13i( ,000356 1995-1998 .l ,0007.41 Z004 6l .DUOllO
19116 lOi( .000214 1999 n .000192
1907 'l .0002~1 2000 ol .000219
--Int.r..t I. cllaul.ted a. folloWll
INTEREST = BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
-wAn~ Notla. II.ued aftcr the tax bloo", delinquent will r.fltat an Jntlr.lt oaloul.tlon to flft,'n (10) day,
b.yond the dati of the ........nt, If p.y..nt I. .ade aft.r the Inter..t oOllputatlon dllt.thown on the
Notlo., Iddltionll lnt.rl~t IUlt be alloul,t,d,
"
*