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COMMONWBALTH Of PINN$VLVANIA, DIPARTMENT OF HEALTH. YllAl AECORDS
CERTIFICATE OF DEATH
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
COMMo~~ii\~~Wt'll,P:\NV~~urNIA (TO BE FILED IN DUPLlCA TE ~ I r; 7
H'~"5fJllU~lj lO060' WITH REGISTER OF WILLS) COUNTV CODf . .VEAR
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m f;OCIAnf'CUjlfYNUMIEit~ - . -JDAH Of OfATH jPAU 01 IIWl ( I) I JI (\ I" I ! I ~) /), I 701/
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"" I g . (fo, doll. 0' d.olh p,'o, '0 12.1 3.82)
M..... [.J 4. Llmll.d Ellalfl f....l 40. futuro Inl.rl$l Compromhe [I 5, F.d.tal ellalt Tax Rllurn Requlrfld
Ii! 1'0' dot" of d.oth oft" 12.12.821
. 06. O,ced.nt Died T..lale f.. I 7. Dlcodent Malntainod a Living TruI' _ 8. Tolal Numb., of Safe Oepollt 80x..
IAttoch copy of Willi IAttoch copy 0' Tru"I
. ..m. A~L O__I.PONIlINCI AND CONPlDINTlAL TAX INPORMATlON SHOULD I' DIRICTlDTO,
.J. t: NAM fI f .- C0MPlfn MAIlINQ ADORfSS
~i!l ~I N'0A f-,. me I...U 10 \) S' .3 S" ,ILl, ,-(AJi) S 1 Pf'I' T
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1. R.ol ElIo"ISchodulo AI 11 I .. ]().\ ()().()l(2.c?__.
2, Stock. and eond. ISchodulo el 121 _.__Q..._...._.........~..
3. c'lollly Hold Slack/Porlno"hlp IlItoro.' (Schodulo q I 3 I ......_...._._""O.m..~_._...__.
4, MO"gogo. ond Noto. Rocolvcbl, ISchodulo D) 14 I ...-......-O---~?"C--..
5, Co,h, 80nk Dopa.lI. & MI"ollanooUl Po"onnl Proporly 15 I _....d..({~,Jl.J~J.5.J.,.......
ISchdulo el
6. Jointly Ownod Proporly IS,hodul, F) 16 I ..._...._..Q.______~
7, T,onafo"ISchodul. 0) ISch,dulo 1I 17 J _.____..o........__~
8. Tolal Gron AUtlh llalolllnes 1.71
9. Funeral Expense., Administrative COSh, MIscellaneous
Expo.." ISchodulo HI
10. Dob", MO"gooo 1I0btllllo., U,na ISchodulo I)
11. TOlal D,ductlon. I'otolllno. 9 & 10)
12, Net Value of Eslale 11In. 8 minus line 11)
13. Charitable and Govrrnmenlal Bequo'll (Schedule JI
_~_ 14. No' Voluo Sub Ie" to_Tox 11Ino 12 mlnu.lIno 131
15. Spousal Trarllfori (for date, of death ah., 6.30.9.41
Se. In.I,u'cllonl for Applicable Percentage on Reverie
Sid,. IInclud. volu" f,om S,hodulo K or Schedulo M.I
16. Amount of llno r..t taxable at 6% rale
jlndud. values from Schedule K or Sch.dulo M.l
17, Amount of line 14 laxobl. 01 15% rote
llnclude ....alues from Schedule K or Schedule M.l
18. Prlnclpaltox due (Add lox from lInel 15, 16 and 17.)
19. Credlll Spoulal PClVerly Credit Prior Payments DiI:ounl Inleuul
----.---..... -_... + ._......_-~..._...- .... - --....... .-. ._-~-..-
20. If line 19 I. grealer Ihan Un. 18, enler ,he difference on line 20. This Illhe OVERPAYMENT,
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21. II line 10 Is oreater Ihan line 19, enler Iho difference on line 21, This is the TAX DUE.
A. fnler Ihe Inl.roll on ,he balance due on line 21 A.
B. Enter Ihe 10101 of Une 21 and 21A on line 210. This Is Ihe BALANCE DUE.
__._____._Moke ~~,~.~~_~~y_~~!~_!~ ~_R_!@I~!~!_~! _~!!!!__~~!!'! _ .... _..._. .. .__
. )-)- BI S~RI TO ANSWIR A.U:QUISTIONS ON RIVERSE SIDE AND TO RECHICK MATH. ~,..c.;""\".:,.,~::.!:i,,t~,i!~:,t
Und.r penahles of perjury, I declare thot I hClY8 llKamined thil rl'lturn, induding accompanying IChed\llos rmd Ilotemenls, and 10 Ihe bell of my knowl.dg. and bell.f,
Ills Irue, correcl and complele. I declare Ihal oil rual Eulale has been reporled at true mark.1 yolut. DlldalClllon 01 proparer other tho., Ihe perianal r.pr...nlall.... It
oated on all informal Ion of which preparer ~lU' Clny knowledge
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POVIAIY CUOII IJ ClAIMIO 11
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1181.u_..._':i...___.__.._~.__
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1191
120)
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Ch['{~ 111'10 If you (lie rcquuslinn {I refund of vour overpavment '
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pia)
RlY.UD:lIX+ 111.UI
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('h'portv 1010'lv.~wood wl'h Rlgh' 0' Survlvo"hlp mu,' ho dl"lo,od onSchodulo " All ,oalll'a'o .hould bo ..poriod a"al, marko, valuo
tow bleh I. dolllol.dba'h,ho prl.. a' which proportv would bo ..,ha.god hOlwo,o a wllll.g buv.. ood" wllllog "II.., oollh.. bolog compollod
_. ur. 0' '0, 0' hovlog ..o,ooablo ~oowlodgo o',ho ..I.uao' 'acto,
IYEM I
N~M8ER DESCRIPTION
SCHEDULF. A
REAL ESTATE
filii HUMIIA
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Grant,. s :
i '
WITNI,)SSETH, that in consideration 01 ',\tel ve Thousand (~i12, 000.00)
in hand p4id, the reoe/pt whereol /e herebll 4dlmow/edoed, the eald orantor s do
and conoclIto the 8aldorontees , their heirR and assigns:
Dolla"
hereby ora;}
IILLI,hut, nOl'Lnln tr'uct, 01' lnnd Hith the ImfJrovemento thereon
01','01.0<1 idt,unl,u in the Borou[',h of Uf;mp lIIll, Cumberland Oounty,
l'onnBylvEtnia, bonnded and desol'i hoel all fol10\19:
11b:O]i~inIW ut; u poInt on the Southern nide of Myrtle Avenue, 160
f€Tot lcast;w!H'dly from the Southeastel'n COl'l1er of Myr'tle Avenue and
Seventeenth (17tI1) Street; thenco E:ustvIHrdly along Myrtle Avenue
51.~,5 feot to u point at the Westom sIdo of un alley 15 feet wide I
thene(, Southwur'dly ulong Baid a.l1oy, 136.611 feet to Q point; thenoe
\vostHul'dly by lund now or fOl'\l\ol'ly of.' ;Jonepl1 ,T. Oignotto flnd Jean
Ida Oip)1ej;t,o, hie wifo, at an (tn:~1e of' 100 degroos 16 mInutes to
t;he PI'flVIous call, ~O feet to a po:l.n~; thonce NorthHflrllly 1110.~7
foot to the I'lace of Beginnin(,.
111,Vh1G thol'<lon el'fTctcd a dwelling hou~e lmo~m as No. 1615
~lyl't 10 /(v(Jnue.
Bb:liHl composed of portions of Lote Nos. 5 and 6 on the Ple.n 01'
Lots of Silas O. Swallow, as r'ocol'ded in the office of the. Reoorder
of Deeds for Oumberland Oounty in Plan Boole 1, Pave 02.
mWIG the sume property which Has conveyed to Harvey D.
Rombergel' und Bornice S. Rombergflr, his HIfe, by Joseph J. 01~ettlO
and J~,un Ida 01.l':notto, his \,j fo, hy dOfld duLod Junuary 16, 19 ~,.;,.:.... .'.....
and recordod in tho of'f1..oo afol'osoJ.d In Deed Book "X", Vol. 1 .'-'-"'1'''\
. "4 ~
par:e 137.
" ~7 // -?JIY
..' ~ .."m of.--:" fi/-~
School D . Curllb, Co, Pa,,,,,,.,Cum, ,a,
1% RU! hllh Tflftshr Tilt 1% RulE,lIte TunsllH 111
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BOOK 1:20 p^d053
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(II more space i. n.ed"al In..r' odcJitlonQI .h..h 0' -.~m. ~I;~~'
.01$
VALUE AT DATE
Of DEATH
'10, O()O. 0011
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RI V I \111) I ~ I 11 81)
SC:HEDULE E
~:i'f~ CASH, BANK DEPOSITS AND
WMMONW!""': o;~NNmV""'^ MISCELLANEOUS
'NHmltl~WtM:~YIN. ... PERSONAL PROPERTY .. ._u...._'.' PI!olo ~rlnt or Tree
.:,,~" ...... .,...... .,.. ..H......., .. ,. '-"-..-.-:-""'.--.' .'........:--....-....-...--._u...-.---.Fil]" NUMbER
ESTATE OF ;-1 DC' K l. f 'I I II r L r {\) l, .
l~~ prop.,lv .I~~~i:~~~"~ wii~ tlM _Rl!~~ ~ 'i!.vl~or!!,l~ 1,~Ult b, dltcl!"d on Sch~d~l~ ~I =- _ _ ..-=~=.-===-'-----'._~~-==.~:=~-_.
N:1:~.. _ __~ _____ _ DlSC""ION . __ -------1= ...)',A:f.' ':1" ..
1 .. Harris Checking Account ..1/3
2 Harris Saving Account.. 1/3
3 Members 1ST Ct1_/i1i~t..-1,'1
4 Members 1 ST Saving Account .. 1/2
5 Harris CD.. 1/3
6 Car -- 1990 Chevy Cavalier Wagon
7 Furniture -- 3 rooms
8 Clothes
9 Annuity
$199.82
$3225.69
$'~~11,,3,1
$1020.43
$3335,00
$3000,00
$3000.00
$200.00
$11583.21 ,
~~~~~-~--------~-~~~--_.
'TorAl
$26295,52
__L
TOTAJ.l~~llt.r 0." l1"e~ Recopltulotio!i. $.). ". 'J 9> ,.5' a
v
''', ,; '::,'/" )( 11" ,h08h if rn\.llfl ~ptl(ll h needed.)
IUHAI{RIS
.. -SAVINi';sliANI{.
I' O.IIOX 1/11
HAf1r1ISIIUHCl, I'IIJN.'':YI VANIA 1IIII!i
1'1 ION!: (/111 ;>:11\,10,\ I
STATIHlNT DATI
03/20/97
PRlVIOUS STATIM!NT
02/20/97
3
HILIN I HOCKLIY OR
LINDA K MCOUROY OR
OAROL M FULLIIR
1615 MYRTLII AVB
CAMP HILL PI'. 17011-3962
ACCOUNT NUMBER
1000007566
SOCIAL SECURITY NO
491-09-7302
,,__~~_._.,________..<,_~__._.__....~.__,.~_...______..T___'_~_______
-,,~--_._._~~_..._----_.. ---....
~....________~__,_~_____,____""'H____.~' -..
.---~.__.._.__. .,........._----<----------~_."~~._.._~..-----------._".---_..."
............... INTBREST CHECKING ACCOUNT 1000007566 ...................
NON-CHI OK TRANSAOTIONS
DATII---DESORIPTION------..---------------------u------__u________AMOIlNT
03/03 MASS MUTUAL PENSION CK 104.92
03/20 TRNSFIR FRM SV 1050003743 5rOOO.00
03/20 INTEREST PAID 1.19
OJIIOKS I II ORDER
DATII-NllMBER--------AMOUNT
03/04 1071 50.00
03/04 1072 25.00
DATI-NUMBER--------AMOUNT
03/04 1073 20.00
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DAILY SALAMCII SUMMARY
DATI-------BALANCB
02/20 599.53
03/03 694.45
DATII-------B~C~
03/04 599.45
03/20 5,600.64
DATE-------BALANCI
l\OCOUNT SUIlMARY , I,
P~iOUS ST~=~: + D.POSITS I~~~~T _ WITHDRAWALS _ ~~ . ~~; .,
02/20/97 599.53 5,~04.92 1.19 9S.00 .00 '5,~0~.~.
8TATIIHDNT PIRIOD rROM 02/21h)~i THRU 03/20/97 . AVBRl'.G1I STH'!' 1lALAN0000:(,::.{.i~~j. "
INTIRIIST IARNID 1. i 9, i ' *lUIIro/lL PIRCBIlTAOIl YlIILD ,~"""~;
, " ' , ~ - r f~j}:i - "
J\VIRAGI Bl\LMCIIl 777.87" llnllMUH II1oLANCII. 589.53 ,!
RlILAT!D AOOOUNT.SV10S0003743 BAL. 4,737.31
................. SAVGlUt ADVANTII.GB: Aeoo~+!.;;~ci!iOd03743 ..u...~....~'~;~:~<l)
DATlI-DISCRIPTION-----...- -...---- ,..--..---....................-- --...-AMOUNT-------~-,..-~
02/.20 BALANCE roRWARD _______...._______~"O:......._..._____...___________>:iJ!_},~"'~!~f'
02/26,IN'l,'lIllS'l' PAID ,. 22.34:\':1)'9,'
,. IW'l'BRlS'!' fROM CDI 1054299332 ' 37.90. ., l'l~if;t,\
03/20 TlWfsnR TO OK 1000007566 5,000.00- : '",,,!(,\4.'
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,: ImllBllT RAT! ,suaOwty ,',,' I ',~', i 'I: ...-
., '.. . DATIl ,0 - $911 $100. AIID ,UP .. '''.> '" '1"1' t ,:. I '
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HARRIS' SAVINCS BANK
P.O. BOX 1"111 . HAI1RISBUI1G, PENNSYLVANIA 17105' PHONE: (717) 236.4041
IIAHRIS ACCESS LINE (717) "81-1135 or TOLL FREE 1.800-327-7997 .
""'. .'., ,,'" ,~.....
Annuity Statement
of Account
January 1, 11m through March 31, 1997
ThE.
.H..A.RTFORD
1'1'" lor 2
Qw.ncr:
3130080 rr
H3 ('l 0"03 17011. ON
&count Number: 21022687!i__
Annuitant: HELEN E HOCKLEY
Owner Tnx 1.0. Number: 491.()9.'002
Contract Inception Date: April 24, 1996
HELEN E HOCKLEY
1615 MYRTLE AVE
CAMP HILL PA 17011-3962
1..,11I."111"....11".11..11.1,1,.,11.,,,1,1,.,11,1.1,,1..11
. . ' . r. ' .
ACTI\TrY SlJl\t\1ARY,' .,'
, , ,
Beginning Account Value
'____n
Total Conulbutlons
Total Wllhdrawols, Charge.~ &. Fees
Acoount Performance
Ending Account Value
Current
Period
Il ,335,33
:00
.00
247,88
U,583.21
Inception
to Date
.00
10,lKXI,00
'.'.00
1,583,21
11,583.21
,
.VtJ~1l SlJ~M^RY
STOCK
ADVISERS FUND
-----
TOTAL
Future
Contribution Units Unit Value Account Value
Allocation
SO% 1,622.653 3,647498 5,918.6Z
50"'!' 1,920.743 2,949164 5,664,59
100% 11,583.21
Thank you for selecting The Hartford for your investment needs.
If we can assist you In any way, please contact either:
YmIr. Representatl~
The.J:Jartford Life Insurance Co.
Aun: /lldiv/dual Annuity Services
P.Q, Box SOBS
Hartford, cr 061ll2-5OBS
1-800-862-6668 (Service Representative)
1-888-488-2228 (Automated Acct. Info.)
MARINA KUMI BERKHEIMER
%SPECTRUM SEC
2ND & PINE! STREETS
HARRISBURG PA 17101
.,-.-...-.,------. ,_. ._-_..~-,_..._.,.--......_--_.._-_._.._..._---._..._---.-. .-. . _.-.-.~..- -. .. ..-._..--.....~
.__..._____~_..____..._.P__.._..__.._.O.~.~__.".~._~._M.~"W_________._...~ ....... _ .~____ ......____.__
I
"
The Hartford . "Bring It On"
"- . _.._-~._- -----.-.- ..-...-. --.-.
w_ o.
IlIV 1~1I l~" I' B~l
SCHEDULE H L
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLA~EOUS EXPENSES n. n___~I.al. Pr~~ ~r Typ.
___.n_._r:~R_ ._~___~__~=
.
COMMONWEAltH OF PENNSYlVANIA
INHERITANCE TAX RETURN
REStP~NT DECfOENr
EStATE OF .. -... - -. .. .-.. ... -
;)f)<' f< L r 1 1 Ii fL E AJ [
~~_.__.~..-_._,..~" ____ _____....~_.~... _T<'___~_~___'___
ITEM
NUMBER
-------~~_....- ~----_._-
A. Funeral Exp.ns."
1.
DESCRIPTION
F.Ll.fYVv,J f-/ C>'~
F t..<<>-''''--)~
rr:-4 ~~
~, c?fi~
1.
B. Acl"ilnls'ra'lv. Cas'"
Pellonol RepresMlallve Com millions
Soclol Security Number of Pellonal Representallve:
Year Commlulons paid
~
2. Attorney F"es
3, Fomlly Exempllon
Clotmant ____ Relallonshlp
Addrell of Claimant at decedent's death
Slreet Addrell
4,
C,
1.
2,
3,
4.
5.
6,
7,
$,
---
City __
Sta.'" .__ Zip Code~
Probate Fees
Mlse.naneOUI ElIpens.s,
.,
.TOTAL IAlso enler on line 9, Recopltulatlon)
(If more spac. II nlldad, Ins.r' addl'lonal shll's 01 sam. slz..1
AMOUNT
1.pI.{~O,O()
g0, 0 0
50,00
.)(),o6
..~
$ 6~, 1/ OJ ot.J
, -
-1(;('KI.,Py'iIlEIEIV t::.-
1 Choiqe Charge Card $20,04
2 First Charge Card $7,95
3 AT&T $45.69
4 Surburban Cable $22.32
5 Discover Card . $310,25
6 Taxes To County (estimate of property) $126.00
7 Taxes--Camp Hill $296.04
8 PP & L $124.15
9 PAWC $15.87
10 Keystone 011 $201,00
11 Hosiery Corp $13.30
12 Dr.Thomas Kunkle $63.37
13 Bell Altantic $33.43
14 Vet Bill $260,10
15 Kmart--Iawn mower . $105,99
16 Sevice Merchandise--Dehumldifler $156.99
17 Waste Mgmt,--trash $71.4Q
18 Borough Of Camp Hill--sewer $132.00
19 Keystone--service contracts -- funance & air conditioner $176.25
20 Insurance--Home Owners $205.00
21 Callen Kinback--car inspection $10.59
22 Ira Weinstock--Iawyer fee for Deed Transfer $100.00
23 Recorder Of Deeds $24.50
/f//O -1/
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAKES
IHIIERITAi'fCt TA~ DlvtSIOH
DEPl, 2a~601
HARRISBURG, PA 111U'0601
NOTICE OF INHERITANCE TAN
APPRAISEHENT, ALLOI/ANCE OR DISALLDHANCE
OF DEDUCTIONS AND ASSESSHENT OF TAM
DATE
ESTATE OF
DATE OF DEATH
FILE NUHBER
COUNTY
ACN
E~~A~~::~:R.~~~i~~"~-~::J
MAKE CHECK PAVABLE AND REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, rA 17013
CUT ALONG THIS LINE .... RETAIN LOWER PORTION FOR YOUR RECORDS ....
REV: iS47 -Ex-- AFi' -(09-:9;-'- - NoYi I5niF "YNHEiiii'ANc E -i;AX - APpiili i SEMENT ~ - -A L LOWANC E - ejri - - - - - -- -- - - - - - - --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
HELEN E FILE NO. 21 97-0305 ACN 101
LINDA K MCCURDV
535 N 2ND ST
WORMLEVSBURG
PA 17043
ESTATE OF HOCKLEY
TAM RETURN WAS 1 I X) ACCEPTED AS Fll EO
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN
1. R..l Elt.t. (SDh~dulD A)
2. Stock. and Bond. (Schedule 8)
5. Clo..I)! Hald Stock/P.,-tllarllhlp Intereat (Schadule C)
4. Horta.v../Not.. Racaiyabla (ScnodulR OJ
&. C..h/8~nk Oapowits/Hl&c. Parlonal Property (Schedule E)
6. Jointly Owned Prop.,.ty (Schedule F)
7. Tran_1ftr. (Schedul. G)
a. Total Aa.eta
(1)
(Z)
(3)
14J
ISJ
(6)
(7)
03"02"98
HOCK LEV
03-05-97
21 97"0305
CUMBERLAND
101
) CHANGED
70,000,00
,00
,00
. OQ.
2 6 . ? 9.i...2l.
,OQ
,00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. F'Jneral Expen.../Adll. Coah/11he. Expe,,,.. (Schedul. H)
10. Oebts/Hortgage Liabilities/Liens (Schedyle I)
11. Total Deduction.
12. N.t "'.lue of Tllx R.turn
13. Charit.bla/Govarnnant.l Bequclt'J Non~el.ct.d 9115 Trult. (Schedule J)
14, N.t V.luo of E.t.t. Subj.ot to T..
191
nO)
6,640,00
*'
In.a,111'" IOt'HI
HELEN
E
IlATE
03-02-98
NOTE I To 1n.ure proper
or.ditto your acoount,
tubMit the upper ~ortion
of thl. forM with your
tax P.yunt.
96.295.52
7,275.14.
(111 _-l..3. , !II ~ I 4
(1Z1 112,380.38
031 .00
(4) 82,380.38
If an assessment was issued previously, lines 14, 15 and/or 1&, 17 and 18 will
reflect figure. that include the total of ~ returns assessad to date.
ASSESSMENT OF TAXI
1&. ARount of L,ine 14 at SpoIJul rat. (15)
16. AIIICtunt of lin. 14 taKable .t 1.In..l/Clau A ret. (16)
11. A.punt of tin. 14 taxable .t Collataral/CIII" Brat. (17)
18. Prlnolp~l rax Du.
NOTEI
TAX CREDITS I
PAYMENT
DAn
12-05-97
RECEIPT
NUMBER
AAZ42524
DISCOUNT 1'1
INTEREST/PEN PAID I-J
,00
.00 M ,00.
82,380,38 M ,06.
,00 M ,15.
IlBI
AMOUNT PAID
4,942,8;r-
"OTAL TAX CREDn
BALANCE OF TAX DUE
-------
INTEREST AND PEN.
--.-
TOTAL DUE
M IF PAID ArTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
,00
---
4,942.82
"00
4,~42.82
4.942,82
,00
-----.--
.00
,00
I IF TOTAL DUE IS LESS THAN .1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU HAY IE DUE
A REFUND. SEE REVERSE SIDE OF THIS FDRH fDN INSTRUCTIONS.)
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RESERYATlON, Elt,t.. 'of dlcedlnt. dyinl on or blfore Dlelllb'r 12, 191? u I~ ,ny future Intlrnt In thl IIht, 11 tranUIl'rld
In pO.....19M or enjov.."t ~~ el,.. . (ooll,tlral) beneflol.rl.. of the dlcldent .ft,,, thl 'Mplr.tl~n of any I' tat. for
Ilf. Of for y.ar., the Co..onw..lth hlr8by'IKpr...lv r...rve. the right to apprftl.. and m..... triM' far Inh.rltancl fax..
at thl lewful Cia., I (col1,tl"Il1 rlt. on Iny such future lntere.t.
PURI'OIf Of
NOTICE I To fu1fll.\ thl> rlquira..nts of Slotlon 2140 of the Inh.rUanol and E'tatl Tal( Aot, Aot 21 of 1995. (72 P,S,
hotion 91,,0),
PAVMENT, Oat,ol"l the top portion of thit Hottol and subltt with your plv..nt to thl RIghtlr of WHit printed on the rlYlr.. .Ide.
hHekI cMok or .one~ order p.vabll tCtl REGISTER OF HILLS I AGENT
REFUND (CR)1 . refund ofl t.1C arltdlt, which w.. not rlquuted on the h)( Return, ..y.tt. rlqu..t.d by cOllpllUng Ian "Applloatlon
for R.fund of P.oo.ylvanla InharJtanol and E.tBh lalC" (REIJ~UI3), AppHoJltlon. ar. avaUlbl. fl't thl Offiae
nf thl R.gl.tlr of Wl~ls, any of the 25 Rlvlnul Ol.trlot Offlo.., or by oall1no thl IPlolal 24-hour
.nlw.rlnG ..rviol nueber. for for.. ordertngl In Pennlvlvanta 1-800-362-2050, ouhld. Plnn.vlvanh ltid
wlUun 10011 Harrisburg tlr.. <1171 787-8094, TOOl (117) .172~2252 (Huring !ltPllr.d Only),
OBJECTIONS I ,"V p.rt~ In Int.r..t not ..tItU.d with the IPpt'ah...nt, .Uowanol or dh,Uowlflo' of deduction., or ',,"nant
of talC (Including dl.count or Int.rl.t) .. .hown on thl. Notlc. .u.t object within ,llCty (6q) dlv. of reollpt of
thh NotlcJl by:
--wrltt." prottlt to ttM PA oapart..nt of RlvanuG, Board of Apptlll., nlpt. 2810n, H.rrhburg, PI 17128-1021, OR
u.lecUon to havI the ..tter d.t.r.lnad .t audit of tM ecoount of the p.r.onel rIPr..anhtlv., OR
~-apPIIJI to the Orphan.. Court,
ADHIN
lSlRATIVE
CORRECTIONSl
FlKltual arror. dlscovlred on thlt ........nt .hould b. .dd'.....d In writing tOI PA Depart..nt of R.venu.,
Bur..u of Indlvldu.l TaKII, A1TNI po.t .........nt flavlaw Unit, Dllpt, 280601, HarrltlJurg, PA 11128-0601
PhoM (717) 781-6505, Se. page S of the book lit "In.truotlon. for Intlorltanc. TelC H.turn for a R.lldent
Dacadant" (REV-150U for an Ixphnatlcm of ad.lnl.traUvlh corraotable .rrer..
DISCOUNT I
If any hM due it paid within thru (1) oal.ndar aonth. after ttM dle,d_"t'. d,lth, a H". plrcl"t (S:() dhcount of
thl tlx Plllld It IIll0wld. I
PENAL TV I
The 15~ t.lC .-nt.ty non-participation Pln.lt~ I. coeputad on thl total of thl tax and Int.r..t .......d, ~nd not
paId bafClrl January 18, 19'96, thl flr.t day afhr tha Ind of the taM alln4l.tv ptriod. Thi. non.parUoJpatlon
panalty Is IIPp..l.bl. In the .... aannllr and In thl the .... tin plJr lad .. ~ou would .,..1 thl talC and Int.rut
thlt hll bltn .......d a. indlcat.d on thit notIe..
INTEREST I
Int.r..t 11 charged beginnIng with flrwt dflY of dlllnqulnoy, or nine (9) lIonth. and 0fW (I) day fro. tha d.tl of
d.eth, tu thl data of pay,ant. T~KOS which b.ea.. dallnquent bafora Janu.r~ I, 1982 baar In~ar..t at the rat. of
.llC (6~) p.rr..nt por annUM calculatad at . dally rata of ,000164. All t~M_' which blo..e dellnqutnt on and eftor
Jenuary 1, 198Z will b.ar Interl.t at a rate which will vary fro. calendar Ylar to cal.ndar year with that rlt,
announold by tha PA napart'l"t of Ravanue, The applloable Intere,t reta. fer 1982 through 1998 .r81
~ Intarllt Rata !!!!.!.!Llnhrut Factor ~ Intera.t Rat. DaUy Int.,..t Factor
1912 20% ,OO])~48 1981 OX ,000241
191J 16~ .000458 1988~1991 11% .000501
1984 11% ,OonOl 199' OX .00Ql41
1985 13~ ,oons, 1995.1994 ]X .00019Z
IOS6 10;( ,000274 1995.1998 OX .000241
u Intarllt II a.laulatad .. fallowll
INTEREST . 8ALANCE OF fAX UNPAID X NUNBER OF DAYS DELINQUENT X DAI~Y INTEREST FACTOR
--An~ Notlcl I..uodafhr ttll hlC b.oo",.. delinquent will r,flaat an Intlrut calc:ul.tlon tc flft.an (IS) day.
b.~ond tha det. of tOa ........nt. If pav..nt 1. .ade aftar thl Intora.t co~utatlon d.t, shown on tha
Motta., additional tntara.t 'Ult ba c.louletad.
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JRDtJilne 30, 1992/17858
APR. 7 20~\U
In Re: Estate of HELEN E, !PC1<LEY
Late of. CllIlIP HTr.,. 00fn1GH
Estate No.: 2h1997e0305
ORPHANS' COUR'r DIVISION.
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSVLVANlA
N ) 997 -0305
0,
NonCE OF FAILURE TO FILE SfATUS REPORT AND REQUEST TO
CONDUCT A HEARING PURSUANT TO RULE 6.12, SUPREME COURT
ORPHANS' COURT RllLE
Personal Representative' LINDA K MCCURDY & CAroL M. FULLER
Counsel for Personal Representative:
Date of Decedent's Death: 3-5wl997
Date of Delinquency NQtice: 2-11-2000
The undersigned. Mary C. Lewis, Register of Wills, in accordane~, with Rule 6.12, Supreme
Court Orphans' Court Rules. hereby notifies the Orphans' Coun Divbion. Cou!t of Common Pleas of
CumbeclaDd County, that neidler the above named personal representative nor the above named counsel
for the personal representative bave filed with the Regist~.r of Wills or Clerk of the Orphans' Court his,
bee or lIS StalllS Report required by Rule 6.12; Supreme Court Orphans' Court Rule and dlat the requisite
DOtlce, pursuant to Rule 6.12, Supreme Coul't'Orpbans' Court Rules, was given by the RegIster of Wilb
OD---2J!l1uJOOn ,19_, and tblube ten (10) day notice to file the Status Report has expired.
ACClOntillgly, ill accordance with Rule 6.12' the Court is hereby notified of such deU~QIlency Incf the
undealgned requests that_ Court oolldllc:t a -bearing to '.letermine whether sanctions should be.imposed
upon the delinquent pmonalrepresenlltlve;<ii couos the delinquent p&sonal rtiSentatlve.
~
Date:
4-6-2000
Distribution: Personal Representative
Counsel (orPenonal Rep~eot8tive
A HFAlmU IS s~l~ C1Af~i$j..
<XlUI\Tlro-l 00. 3, IF 1lIE S'rA~~~Mi", ._
Alm;tolATICALI','i BE ~. "iH1i""'..
;,.! :'ll':(-: ';l',l-t:
AT ~;.30 .,'; ."\,' IN
PRIOR ro 'llfE~~r,,'ltl)!:il~LL
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