HomeMy WebLinkAbout97-00309
INo'le I~f I'hvlHH ~;. lIi.bHll\nn
0/,1tI klloWII 0.1'
IJETlTION HHt IJlmllATE nud (mANT OF I.ETTEltS
cXl-(i"'!- 2>04
No,
To:
.-.._........ R(.,Ii"lrI 01 Wills for Ihe
_...._._, .__,__... . /)1'('1'11.\('" COIIl,ly oICumb_crland.",.... 111 the
Soda/ SCell/';I.!' No, 191, -16" 0 1,:\8 ('Ollllnonwellllh or Pellll!ylvllllla
The pellllolllll' Ihe IIl1delSlp,lIed l('s(lI'('llnlly re(lI(""'III." Ihlll:
YO\ll' (lellllollel(s). whols/,"e IH yell I " olllAe (II oldrl1111 Ih(' I'XI",'1I1 OJ.:.._ __..._______l1l1l11ed
IlIlhe fa!t will or Ihe IIlrove deeedelll, dllted _ ,J\\lim(l t 70ft, ..._____._+..__.~, 19.Jll...
lI11d t'Odlcll(s) dilled J\()_n'i'_ ",.._____+_~+,,____,
ll\Tsb-rina;'(ie<ire-R. llibsll\i1l1 dIed Ji.inii26.191lT:----------
_._..__.,.........._.___.. JL...._ ",..P......,...... ,,_, _....___l______._____....,______
(~'Inl(' rckvnlll dtl'lllll~lnllc{,,~, 1'.(\. tClIlIl1e1nliOlI, denth (If c.'(fclHof t etc.)
lJeeelldellt WII,! dOIlIit'lIed Ht dealh III Curnbe~kaf(db' ,... ",.... ....+- CoulIly, Penllsylvanla, with
1::5~F-=~~~:tIIlI1lIIY ol~gg~I~~;~,,~~~c~~I.f A ..~t!l Ct:..L'.~:~(l~~~~~tl~n T\"~.~. L-
(11<;1 'ilrcCI, !lumher nil" fIlllllclpnllry)
lJecendelll. thell ..,,74__ yems ol'lIre, died" '" Harch ),11..___..__..___...____" 19.....2..I_.
at _..1g1",q)~n:i.g,lkil pHil. !-lil:t:r i.,13,b\l rg.J)l\..~,,_,.....__......______,
Except a! rollows. deeedelll did Ilolmany. was 1101 divorced IIlId did 1I0t have a child borll or adopted
lifter eKeclltlon or the will offered for (1robllle: WIIS nol Ihe victim or a kllllllg and was never adjudicated
Incompetent: . .------..--u!-a.... _ "___..__........"....__..." ___
Dccendcllt 01 delllh oWlled properly wllh eslhnllled VII lues as lollows:
(I I' domiciled In I'll,) All (1eISOIlIlI properly
(If 1101 domiciled In 1'11,) l'ersolla1 property In Penl1sylvlIlIlll
('I' not domiciled in 1'11,) "e lSOII II I properly III Counly
Value or relll estllle In I'cllnsvlvllnl"
situated as follows: . ,nooe_
L112. 000.00
L._._.
$.
$
-()-
WHEREFORE, pelltlollel(s) respeetrully rcqllesl(s) the probate of the IlIsl will alld eodlell(s)
presented herewllh and Iht grant ollellers___t:.est1!m..~!). t<l!.~L
(tciilnmCn{nrYi ndmlnlRtrntlon c.l.n.: adminIstrAtion d,b,n,c.l,a.)
thelOn,
I
,,-
'5.
~l
l~
J-..
'a
__---.___~__~"'__"_M'..__.__.....__
_ge_~i?rdO~I~
GeQJ:\ e lL.....,Hibsman...III
1903 Rarnnart T..<lrlf.
Lan srl(lle , PA 19Ji 4 6
OATH ()J<' I~EI(SONAI, ImPltESENTATlVE
~~~~gN~:A2GI~~~~~~~;:~N~~YI~V__~~I~__ } H8
lhe pelltlonCl(S) IIbove'III1I1,ed ,'"'ear(s) or IIfflrm(s) thlll the sllllemellls In the roregolng pellllon are
true (\I,d cor reel to Ihe besl of Ih(' kllowledAe IIl1d beliei' or pclilioller(s) IInd thnllls per!ollal represen-
Inllve(!) or Ihe IIbove deeedelll (1etllloller(s) will we!llllllllruly admillister the estate IIceordlng to law.
SWOIII ,10, or arfi,rlllCd "p;! SlIb,", ib, cd 1'-~~,"1:t-i,~X.~cJi.i~'11Y...'d.<c --;r.:'" ' <->,
L .~er~rel!1it:.v ~Z~~;A!10f G~Q1;~>Q R...Hi!!.am~~.~~Ll-:--= l'
\ ~~~(:i..out'" f2iL(i~+/~(,gi';;) "....----~~:~-~_== ~
,..
"hi" i~ hI lndlv 111;11 Ill!' In{;!lIll,llltlll llt'H: ~'\I\'I'tl \, (11)1('( dl
I ol.;d l\q~I;\ILII, 1'111' nrl\;lll.d It'I:IlIC,i1I' will Ill' Illl\\';lId,'\\ ill
i(l\ilnll1'Hll .111 ('lIj',IIl,d il'llilh,II('
ill(' \1.11(' \\\,d [i(', 111'\' (HilI {' 101
21-97-309
Ii! dt'.\lll (1111\, nl(,\1
linll\;lIlViil lil1llv,
ivilll 11\1' .j<,
WARNING: It I~ IlIe(jnl \0 dupllcnto this cop V by photo.tnt or photograph.
4139743
iiil/ftimlllJ.';,i,i..."_~
,"'h'\',\\Q!Pr', "
I~""*J:"
.~""..,/ ','.," ", . ..,...1'.,., '
~/.,'Jm "~~
, ~ iJ;;l\
*' " ,_1/"
.~,:"'.,." '/~p
", 1'.._,"-...~:f '
""MEN1 ~\~,,"~'
" I'I~"-
/".........
/7 ~i'J/~fJ'T'
trhlrn,fC,/ l;"L~,::?'''i;7~'~'~-
1,(Hi\ll{q!,htLI\' /
(
hT rqr (hi... l{'nln(";H{',~,l_,()l1
MAR 1 7 \991
,
_ ___~_'--'-'~"~_---"-" C~ ....,. ,.._.. -'-'-" ""O~_,~"---,~~~~~~~'~ -~~ "~-
. '
\.1ah~
~~...-----'~-----------,-~~,---,--~,"~-----
Nu,
CO"MONWIALTH 0' PINNaYLVANI'" OIP"nTMINT 0' HE"LTH' VIT"L AleoAOt
CERTIFICATE OF DEATH
H
11....'UNlAollilA
lIii- lWW.&lCUf\f1YNUl,4I.1l
. m.alr'L.J..9A.....:-.1.fi.- - n 4 1 R
IlftfH'\.AClII>>I'" l'\-AC4IClf'OI!~Hf{:t4doorftflt... _-toM.-..r'd....-..l,IIllllNltQt!
.........~"'~Cl,JJf1llyl .1081'Iw:~~~---------,._.. oliii,r:--------.-------
~tate Lbg~' -"I'"- ..vc..,....l1 ",,(] :t.::"D _0 ::=..LJ
.. NAMt!(IIool~.~IlII'""'I(l(JNombIl. -~OC! eoe~ H/&N.HIC IGIIif
uo~ .....rJ."""~c.-t.
,J:e....l...., \'\"'$/)'1' AL- -,......-,~.
....... '(:f.PEHllvelllN ~Nl'IrDUC.(I~ CI'W,It.VUI."'.,'.... r' tofI'\iW IKlUIC
U AflW,O'OftCUI '~~::C~~-':f>.- .~....I,lMIM4.~. (II"," .,..<NIIiIr1~
.....0 NlIr.} b"~ronoW'l 11'r:r.. ~f$p1lC>ly1
IL-___ ,~_ 1___",-Widowed DeceaeS:Q__
If..81...,___.PaL.....-----IYd "..(:I.....,.:MoOI<M.,.dtn-~.--_.._-----...
-
-..
-'
rAfI01C1MtHL~o.l'_1
., 0 3 - \ ':L:..i1
...- ....'
Mtr O1l11'ltll
lMQ<ltl_o.y'Wl
v.
oI~,,=::~:r
t~ Elem. Music T -
I)ICl1lIHT'llJIf.utQ AOON"C9rMl, c~~, fi&4I.llp/;'.QlJ.tl
24 Robin Court
Mechanicsburg, Pa.
,
Hin'I1i"..~,....,~,l-Ht
George I. Hillegass
(l~ ,-
George R. H.bsman III
Par Campllill. Pa.
FII Inc ,1903 Market
17011
W' C flUI oroiiiOiCAle:lWolII*
...[1
...0
l:="""wf.,n --i.iiif~ OIhft~(lOl'IdlIiQI.~lDltMlft.bUl
\~kd'" I'IIilr~itl.,.~_gIWfIIftPMTI
.!J12e.~-1lVP"',!Lifi~.---._._-._-----L~~-"-
\ .l!2'&itr~}JF;:1Al~~'?1..f!.Pd~~.------__--..tl~-~.
OOI'IOfl.J'MACCMfCllJ.:ffC(Of)
,
~,-- fdlO~....AccMt"&iNr~--._.~.-_.-._~---'-- -+--
_....~Qllltlfl.All L
~'r ~"g .~ ;: g"'"~ .,..- -':";':0 r............-
... D..12f ... 0 .. 0 __ [1 """'~...".m_ 0 ;:,,,.""'Uii~,,.!'::",""",.....,!L ,o<~","...:'"""......------
.. ~" ~tu: (1l1*1yl
caJnlPllrtlCl**Cll't'rooel ~---_.__._------ 110 . \T
.cU"lf'flIIQ'HYSlitlAH(PI1,...!lVI~~~..."~~....~T""'...'~.I"..~"-"'..-.u<;lIDl-~-"~1 1'.'1 .-' !A'-A;')
,.1N...M...__~,....._uttWI.........~.,INlllIN/lfttl'".yltd.,."'.,.,."'.,. ",..""...., l~ HNoMM,. -.. '1~';lIlOHfIO(u......'O";..l
.=~::::.".':..:::::'..:':I':::"'..:.'::~~:.:..~:::..:;':.:;;:..::::.\i:'~'.'::::,.....,.. "".. [I /1J.,...",_3m~/f{....._._..t.l... 'lo ' l.f:R_.._
NAMl -'NO AOOf\flUOf J'fMOfI W\tO C:OMf'tIiJ.19 CAlJaE Of' Of,(fl(
,.......,..._.OICOIfO.... """' """". ,,,. (4)( I<.x> (L. m~"ItIJT>e"',- '" ,)
""............_......""......"..,...,........,"',....~OO'"N..."'.."m.,.".,.....".,....",,,,,,,,,,,,,.,.... 41.,'!:' ", -ZI'" $1" I
MIIWI4f..................."...'....'''.' ,..,,,..,,,.,,.,,.. ,. ... "",...... ,.,. ,.."....""..'..., ".... ....... [] (I\M"p H11 f (~(-:JOI'
If... ~~......~.." .-..-..------.-~i.-ei~/I/I :,;,,",".~;;o,;;;;;_":""-I---'- ' ---'--'----
nc ___ y-_.___.___._____.- . .4.L2.Z.7
l"ffl_'d~4f ~1((:,1 !,jrldJ?P..A-=
tb.![Q..
.frlj2-.--------
~h
-;,--;
O<ll~
~~;
l::,~'--_
~~i
a;Ct:
,- f
,
': l Y<t-t' ~
I " . =
' ,
~r--'\ ~
-- . F'l
PI == ~
~ ,--'" .... ,
-= I::t ~ tn
~t 1:1 '+-l
ts) l<1 t:l tn
..,1, i' H
,~ ~ ~.
:C.
~"t
~(.....t) f3
1~.,~
~,
, ~
a ;
leIS 0 a
s = q ~
~ CIl~, = J
~ ";~~
~ ~
! '
- ,
..
~RTIrICATI0N or NOTICE UNDER RULE 5.6(a)
Will No. I
Phyllis S. Hibsman
March 14, 1997
Admin,. NOll 2l97-0309
. Nal1\e of Decedent:
Date of Death:
To the ReQisterl
I certify that notioe of beneficial interest required by Rule
5.6 (a) of the Orphans' Court Rules was served on ot mailed to the
following beneficiaries of the above-captioned estate on April 11,
1997 .
Name
Address
Timothy E. Hibsman
1903 Rampart Lane
Lansdale, PA 19446
9350 E. 30th st.
Tuscan, AZ 85748
George R. Hibsman, III,
Thomas W. Hibsman
7686 Bunker Hill Rd.
Middleburg Heights, OH, 44130
Notioe has now been given to all persons entitled
Rule 5.6(a) exoept: none
.'
Datel' 4/11/9'1
..,. '~'~1:
,~ Irl
p ~~ _.:1 0;;
RI ,
iV'G;~ ""/1
.' ,
....
r- ,,,!
8: ..
.. ;Q!
0 'I .
{j 'u _\.1
(~ c.r:: p; lj) t.,
0: G (5
'Murrel R. Walters, III, Esq.
54 a:. Main street
Mechanicsburg, PA l7055
(717) 697-4650
Capaoity:
Personal Representative
x
Counsel for Personal
Representative
/', / '1/ /
INHERITANCE TAX RETURN
RESIDENT DECEDENT
WMMONWlAl'" OF PeNNSYlVANIA (TO BE FILED IN DUPLICATE
D!MRTM'NT~fRf"'NU' WITH REGISTER OF WILLS) 21-97-309
NARRlsfJltiJ."nl" 0601 , ,,' " , , COUNTVCODE '" " yEAR"" NUMBER
D!C rrNAM~ (l'AS,,'P!iii. ANjl-~!DllI'IINlll^lr---=------"-'--'----'-'_._.__."'-_h- mf'fIif/:j"fs7c}f,i-PlfT{ ^PDRE~~-"":~~";~'=
HIBSMAN, Phyllis S. 2./1 I(obin Court
I 5ocjililljji-';;'NUMi".~-- "_0' UTlAlICJfblAli' ["AIIO""'" Mechllnicflburg, PA 17055
_.,.=-__. '"~'i:":~U:::,"~:~i~~':'.'li~"'"'ii"'; M~I~:'~':' 97,I'6(IAI "'c~,;;:t;:J.7.{, 7.:! C"""f iMJG~~,7,~r:7"~~~!::1I:'5i""-~.~.,."._-~..~...~_.
~ 1. Original R.lUrn [I 2, 5uppl.m.n'al R,'urn [I 3, R.malnder Roturn
, (10' do'.. 01 d.o,h prior 10 12.13.D21
[] 5. Federal EIIOI. Talt Return Required
REV.1500 EX. (7.941
,
, \
II
~
~512
GI~
[I 40. Future Inter." Compromise
Ifor dalol 01 d.a,h alrer 12.12.921
Decedent Ol(ld Tt\lole [] 7. Decedent Malntalnod a Li\llng Trul'
IAllach copy 01 Willi IAnoch ,opy 01 Trul'l
ALL QIt~IIPONllINCI ANIICON"DI~LTAl( IN'OItNlATION SHOULD 81 DIRftCTlD TO. ,.
NAME J\P'JIPlEH MAIliNG AOOR~U
Murre1 R. Halters, III )4 East Main Street
"mHO'" NUM"'---'---~'----"-~-''''-._'''''''--' Mechl'lnicsburg. PA J. 7 055
7,l7 I. 697 -,~.6.~Q..~=~~"==~~_,=cc"==,,,,=~'~=_="C'='_=~~""=~~,~=,~~~=~~~."'~~
(11 :-Q,:"
121 -0-
( 3 I ._ ____-___~~:.b=_~ ____
( 41,.____....':'.Q:.......__...._
(5 I ___.....4Q...J3L.~1.____
-0-
(61 ...._.____._______
(7 ).___.___:Q:.____
tt!,
04,
1X16
limited ESlol.
~i
8~
z
Ii!
~,
:s
~
III
I. R.al E,lal. (Sch.dul. AI
2, S'ockl ond 90ndl 15,h.dul. 91
3, CIOI.ly Hold SlocklPo,'norlhlp Inl....' ISch.dul. C)
.4. Mortgages and Noles Receivable (Schedule 01
5. Cosh,. Bank Deposlh & Miscellaneous ~.rsonal Properly
ISch.dul. EI
6, Jolnlly Own.d Prop..iy ISchedul. fl
7, T,ant/... (Sch.dule GIISchedul. LI
8, To'al GIO.. All'" I'olollln.. 1-71
9, Funeral bp.ns,., AdmInistrative COSh, Mlscellaneolls
hp"",, ISch.dul. HI
10, D.b", Morlgago LI.blllll.., ll." IS,h.dule I)
11, To'ol OeduCllo", 110101 Lln.. 9 & 101
12. Net Value of ESlof'IUr,e 8 minus line 111
13. Chorllabl. and Governmental B.qu8th ISchedulC'l J)
14, N.I Volu. Subl'CI '0 Tox ILin. 12 mlnullln. 131
15, Spoulal Trant/.., 110, dol.. 01 doolh oil.. 6.30.941
See Instructlons for Applicable fJ.rcenlage on Reverse
Sid., Ilnciud. ,alu.. I,om Sch.dul. K 0' Schedul. M,I
16, Amount of Une 14 taxable at 6% rate
(Include valufts from SchfldulQ K or Schedule M.l
17, Amoul\1 of line 14 toxable at 15% role
(Include values from Schedule K or Schedule M.l
18, P,lnclpallax du'IAdd 'ox 110m Un.. 15, 16 and 17.1
19, C,edits Spousol Poverty Credil Prior Poyments
z
l!
~
.
CI
U
S
+
t"
'--'"
.0. OATIS 0' OIATH Ani. 12/31/91 CHICK HI"
If A SPOUSAL.
PO'ilRTY.C.IOITIS CIAIMllI [1
IIL1 NUM,I.
_ 8. Totul Number of 50fe Deposit 80ltes
(Q 1 __J.r1l~.z..L..=-
7,560.24
181 _. 40,231. 81 ____.
(101
, 8,838.98
Ill) ~___...____...
31 392.83
112) =-.t..._______.
(131 _=--D=..~_..
1141 31 ,392.. 83
-0-
(151___----..::0- _.._X,.._q
(161._?_!.!..39..?.2..~~__.__x .06..
-0-
1,883.57
--~._----_._------_.
-0-
-.-.----..--------
____~1....o_~~l.._ 5 7
(171 .~...,.
.....__x .15 m
(181
Discount
Inlerest
+
(191
(201
20. If line 191s greater Ihan line la, enter the difference on line 20, This i$thn OVERPAYMENT,
a[]
Check here 1f you (lie requesting (1 re(und of YOUf overpayment.
_1!~?:J.. 57__
..,. .1 ~~8~~:S7
1903 'Rilijjjiilft:-V'fne--
Lansdale PA 19446
._____ ____.....__..1.__ "._+___._____
DATE---.'
....&.)'2.___
/0
oA.rT
/,:;-
cf' '-{'1
21. If line 18 is greater thon line 19, onllH thf.l difference 011 lino 21. This is the TAX DUE. (21)
A. Enter the inlerest on the bolr.lf1ce due on line 21 A. (21 Al
8. Enter the 10101 01 line 21 aud 21A or\ line 218. This is the BAlANC~ DUE. 1218)
~_~.~~.~_!~~._~~VQ~I.~..!OI_~!@I.t.r of Wlll!~~_~.!~~_ _ .. .._. ___ _ . _ ___ __.~._
-. - >=-~ -8151;"1'0' A~~WE-"..~~3.1UE5!L()NS ON Ii.i~EmsID~~ND TO,..!EC'!&EK MATH_ ~.~_.._.._
Und~r penaltle$ of porjury, I de clore thot I hav€I examined lhii return, including accompanying 1ch€le/ules and stcllomenls, and to the bot! of my knowledgo ~~l-b~li.~"
,t is 'rue, correct and (omplelo, I declClfe Ihol QU fOCII tHlole has heen reporled at Iruo mmket ',olul!. Declaration of preporer other than Ihe personal fepre\enlCltiv6 i~
belled on all Informal ion of which preparer as Clny knowledge.
1i?,'JIATURE bfPYR--'t:rRf~~~1 7iifE- fO,R fT,lIN--' {jiiRN"-- ----,il5-r,Jk(S5." ----, .,'" '
_ '(J4< . ~ Wi.; L,,-~~_ ,_11T'G,eorge R,Jlibsman, III
~!O Of PR RER R H fSfNTAIIV( ADOREr,S
--z- MU54efr~\'lri~~I~~;~-~tIII ,~sq.
MechllnicsburR. PA 17055
IIIVI\IIIJi(!8ftl
....L. SCHEDULE H
(iVe' FUNERAL EXPENS~S,
(OM',U!,W'^,'" O. "'IN"'V'"'' ADMINISTRATIVE COSTS AND
'"'m:b~~1Wc',~:~~''' MISCELLANEOUS EXPENSES PI.c... Print 0' Tm
mmOF H~BS~N,_ l'hYl~iS s~-'--'---'-'--'---------'.~]~~Li~O;~~~'~30; .---~~~___.
ITEM
NUMBER
A.
2.
3.
DESCRIPTION
AMOUNT
'M_._.....__~--<-_________._
1,
5,103.00
695.nO
180.00
B. Admlnl.trotlvo Co.II,
4,
C.
1,
2.
3,
4.
5,
6.
7.
8,
1,
POllonol Reprol8ntativo Commlulonl
Social Security Number of POrlonol Repre,entotlve,
Year Commluionl pold ._._.___,__
renounced
2.
Attorney Feel
880.no
Murrel R. Walters, III, Esq.
3, Family exemption
Claimant __ Relatlonlhlp
Addrell of Clolmanl at docedenl'l death
Street Ad~r8u _.________.
City _._________
State __ Zip Code
Probate Feel
200.00
MI.c.Uaneou. Exp.n'.1I
Chuok Bricker, Auctioneer, -personal prop~rty ,
appraisal
U-Haul - rental truck to remove household goods
Postage
Federal Express - overnight mail for annuity
U-Haul Storage - storage of. household goods
60.00
232.40
8.00
l7.50
184.34
TOTAL (Allo enter on IIno 9, Recapitulation)
(If mo,. .pace I. need.d, In'." additional .hoe" 01 .am. .Ile.)
s
7,560.24
1;5: / ,//- )
DUREAU OF INDIVIDUAL TAKES
INHERITAHCE TAH OIl/IUIOH
DfPT. 280601
HARRISBURQ, PA 111Z8'06111
COMMONWEAL TIi OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAK
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAK
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
01-12-98
HIBSMAN
03'14-97
21 97-0309
CUMBERLAND
101
MURREL R WALTERS III
54 E MAIN ST
MECHANICSBURG ~A 17055
"
(:
*'
1I~'IIH II iH IIt.HI
PHYL LI S
S
F--- A"~U.';t__RO=~Od '-l
MAKE CHECK PAYABLE AND REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THill LINE ~ RETAIN LOIIER PORTION FOR YOUR RECORDS ...
iie:V :15-'i7 'Ex'- Ai: ,.-'c OfF q'fi'ijoYi CE' 'oF' YNHEiii i' iii-it" E' Y AX' 'A'PPR"A'i S EHEij:r; -A L iJiwii'Nc E' oR.... --, on.., -'"
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HIBSMAN PHYLLIS S FILE NO.21 97-0309 ACN 101 DATE 01-12-98
APPROVED DEDUCTIONS AND EXEMPTIONSl
t 1.278,74
9. fUMral Expenses/Adrt, COI I/H1se, E)(P81'11.. (Schedule H) (9)
10. Dobh/Hodgogo Li.billU../Li.no CSch.dul. II (10) 7.560.24
11, Total Deduction. (11)
12. N.t Value 01 Tax R.turn (12)
13, CharUabla/Gova:rn...nt.l BaqLl..t.; Non-alact.c1 9113 Trust. (Schedule .J) (13) .00
14. Not Voluo of Ectot. Subj.ct to T.. (141 __ 31,392.83
NOTEl If an assessment was issued pravious1y, lines 14, 15 and/or 16, 17 and 18 will
ruf1ect figures that include the total of ~ returns assessud to date.
ASSESSMENT OF TAX:
IS. A~ount of line 14 .t Spou..l rat.
16. AMount of Line 14 b)(able at Linllal/Chu It rat.
11. AlWUrtt o~ Une 14 bxable .t Coll.teraI/C1... 8 rd.
18, Principal Ta~ Due
TAX CREDITS:
PAYMeNT
DATE
10-09-97
TAK RETURN WAS: C X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE XNTEREST ' SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1, R..I Est.t. (Schedul. A)
2. stock. and Bond. (Sch.dul. Bl
3. Clos.ly H.ld stock/Partn.rship Int.r..t ISchedul. C)
4. Hortg.ge./Not.. R.c.ivabla (Schedule 0)
n. C'lh/8.n~ Depoaits/Hilc, Par.onal Prop.rty (Schedul. E)
6. Jointly Owned P~oporty (Sch.dula fl
7. Tranafara ISchadule C)
a. Tnt.l A.set.
RECEIPT
NUHDER
AA242325
DISCOUNT C +)
INTEREST/PEN PAID Co)
.00
I ) CHANGED
III
(2)
(3)
(4)
151
(6)
(7)
Jl.!L
,00
,00
,00
40,231.81
.00
,00
CDI
NOTEI To inaura proper
credit to your accpunt,
sub.it the upper portion
of this for.. with your
t.~ pay..ent.
40,231,81
8.838.98
31,392.83
.00
1,883,5"
,00
1,883.57
1,883.57
,00
,00
.00
. If PAID AFTER DATE INDICATED, SEe REUERSE
FOR CALCULATION OF ADDITIONAL INTEREST,
IF TOTAL DUE IS LESS THAN II, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A '''CREOIT'' ICRI, YOU HAV DE oue
A REFUND. SEE REVERSE SIDE OF THIS FDRH FOR INSTRUCTIONS.)
(15)_
(16)
117)
,00
31,392.83
.00
K .00.
K ,06.
K .15.
(18)
AHDUNT PAID
1,883.57
TOTAL TAX CREDIT
BALANCE UF TAX DUE
INTEREST AND PEN.
TOTAL DUE
I;'"
''1
~. )
(i
RESERVATION, E.tltl. o'-deo.dInt. dylht on Of before Dt~..oer 12, 1.ar ~~ If any futur. int.r..t In the ..t.t. I. tran"lrrld
In'po..I..lon or en'oVlent to Cl,.. . (0011.t.r.l) blneflcl,rl.. of the deeldlnt .ft,r th. 'Kplr.tlon 0' any ..t.t. 'or
l1f. ftr for v..r., tht COIIOnwellth ~rebv .MPr...1V r...rvI' thl rllht to eppr.l.. end ...... tran.f.r InhlrJtln01 T.~..
.t the llWful Cl... . (oollet.r.l) rlt. on tnV .uch futur. Int.r..t.
PURPOSE OF
NOTICE. To fulfill th. requlr..."h of Seot1on 2140 0' tM InherltlnO' Md E.tst. TalC Act, Act 21 0' 1995, <1Z P.'.
'ectlon 9140),
PAVMENT, Detach 'the tOf' portion of t,..1I HoUc. and lub.lt with your p'Y"lnt to tht HIght.r of Will. prlntld on thl r.v.". IilcM.
-HN.k~ ch.ck or Item.v ordtr PIVlOl" tal REGISTER OF MILLS, ACENT
tfEFUHD (Cft)1 A refund of. tl>e cr.dlt, which we. not .'.qu..t.d on the Tlx R.turn, illY b. ,..qulltad by c~h.t1ng en "Appl1cIUon
'or Re'und of P.nn'Ylv~11 Inh.rlt.ne. and E,t.t. T.~" (REY"ISlS). Appllcltlonl Ir. .v.ll~I' at the Office
0' the Righter of Wllh, Iny of the ~5 R.v.nu. OlttrlQt Offlcu, or by c.llint the IP.olal 21t-haYr
en_Wiring ..rvle. ~rl 'or 'or.. order InRI In P.nnMYlv.nla 1-800-562-2050, out. Ide Plnn'Ylvanla and
within 10011 Harrilburg .r.. (717) 787-8094, TDDI (711) 712"2252 (H..rlng IlPtired Only),
OBJECTIONS I Anv partv In Int.,...t not ..thU.d with tho IPprlheHnt, 1110wence or dhal1owenoa Df dtducUonl, or u....lllnt
of ta)( (JnoludJng dhcount or Inhr..t) u .hown on thll Notlc. "'t Object within 11Mty (60J day' 0' r.nelpt of
thll NoUc. bYI
--wrlUen prot,..t to the PA Depert..nt 0' R.venue, bard of ApPulI, Dept. 281021, H.rrhburg, PA 11'128-1021. OR
-~.l.otlon to hive the ..tter deter.ined .t audit of the locount of th. Plrlonal rtpr...ntltlv., OR
u~.l to the Orphan.' Court.
ADMIN
ISTRATIVE
CORRfC"rtOHSI
FlICltuel .rrew. dlscov.red on thlt ........nt .hould b. addr....d In writinG tOI PA Dop.rt..nt of "avenu.,
BUI"IIU 0' Inellvldual Ta~.., ATTNI Post Au.....nt Rlulew Unit, Dept. 2'80601, tlarrhburg, PA 17128-0601
Phone <117) 787-650S, S.. paa. 5 of the bo(\kltt "Inltructlon. '01' Inherltanoe TD~ Return for I Rld""t
OIc.d.nt" (RfY-150lJ for an .~phn.tlo" of ad.dnhtratlvely norreetabl. .rror.,
DISCOUNTl
I~ env t.x dUe I. paid wlthtn thr.. (5) ~al.nd.r .onth. aft.r the deced.nt'. d~ath, a five p.rclnt (5~J dl.count of
thl tlX p.ld 11 .Howled,
PENAL TV I
T.,. 15:C tl'.M ..nt,tv non"p.rtleIPIUon PIfl.lh It eOltputH on the tot.l of the taM and Int.r..t .......d, and not
p.ld Hforl January 18, 1996, the first day ",Iter thl end 0' the te~ DIIM.ty p.rlod, Thlt non~"lrtloJpatlon
penllty Is appealablll In thll .n. .ann"r .nd In tt'/i the 'aM tI.. p.rI(Id II YOU would IfIPul thl tl~ .00 Int.r..t
.that hll bltn .......d at Indle.tad on thlt notloe,
INTEREST I
Int.r..t J. cha,.ged bealnnlng with flr.t dey of ~llnqu.ncy, or nlnt (9) aonthl and on. (1) day fro. thl date 0'
death, to thl dtI~. of pay"nt, TlllCtU Whioh ble... dlllnquent Hfo", JenutrY I, 1982 bur lnt.r..t at tM rate 0'
.Jx (6~J'PII'Cl'"t par ftllnu. ellculat.d at a d.lh rata of ,000164. All tllC" which b.e... delinquent on find after
JMU.ry 1, 1'82 will blllr ~nt.r.lt at . rI,t. which wIll v.ry 'rOIl c.llnd.r y..r to c.l.oo.r y.ar with that r.te
~td by the PA Oeplrt..nt of Revenue. Tho appileebl. Int.r..t ra'.. for 1962 through 1~96 .r..
!!.!r Int.,..... Rate OaSlY Inhr..t Fas.t2! :!!!r Inhr..t R.t. D.llv Internt Faotor
1932 20:< ,OOOS~8 1987 .. ,00Ol47
1985 1'''' ,00(14)8 1988-1991 1l:C ,Dona 1
1984 11:< ,DOO101 1992 .. .000241
1985 U:C ,000356 1995.1994 7' ,0OOl'l
1916 10lt ,1I00U4 1995~1998 .. .000247
-~lnt.r.,t h Clalcu)llIted .. follow.:
INTEREST = BALANCE OF TAK UNPAID K HV"DER OF DAYS DELIHQUEHT " DAlLY IHTEREST FACTOR
--Any Notle. IUlAd Iftar thl hI( b.eo... ~1Jnqulnt will rlfl.ct an Intarllt c.1eullt1nn to fllte." (1S) d.y.
HYond thtl dati of the ........"t. If pI...e.nt It 11_ 1ft.,. the Int.rnt cOIIPuhtlon date shown on thl
Mot1c., add It 1000000l lot.r..t Wit b. celculDtad.
t'~ ~ '::0
:oro
!1:: ,- (i
(J . " ,
P"> F
, "1
-...J
a I;.~ ;\
-..... Ifl ~~,
j; ;~ (j.J
, ~ I.;J
_OF
NOTICE I
Tofulfl11 tM requ'u'..-nhof Seotlon 2140 of the InhlrJtenclend Estet. 18x Act, Act 21 of 1995. (n P.'.
mUon 9140).
P-AVMEKTI
bttach the top portion of this Notice end aubtl1t with your P8YHf1t to the Rqlltl,. of NIlI.prlnted on the
rlVlr.' aide.
-.. .... ohMok or lIOOey order payllbll tOI REalSTER OF WILLS, ACENT.
REFUND (CA}I
A refWld I;'If . tlx oredlt, Mhlch Willi not requeltlld on the tll( r.turn, ..y be rlqutltld by cOllPl.Uno ... '.AppUCfltton
-for Refund of PIMIYlvanla IntMrUenol and Eltete Tlx" (REV-1M3), App1JCIUonl are Iv,UllbIG at the Offloe of
the R..l.tlr of Will., .ny of the 23 Revenue Dl.trlot Offlol. or by ollllng ~he special Z4-hoor Intwerlno ,,"vle.
~r. for forat ord9rlnQl In PQnnlv!vanla 1-800-S62~2050, out,jd. Plnn,ylvlnle and within local
'larrlmur, er.. (717) 767R8094, TOOl (717) 77Z-225l (Hurlna IlIPllrfld Only).
O&JECTIOHSI Any Pllrty bl Intere.t not 'lIU.flilld with the apprllil...nt, allowance or dlsallowlnoe of deduotlonll or .....u.nt
of t.x (including dl.oount or tnteralt} tit Ihown on thll Hotl91 Nay objeot within .ixty (60) dly. of receipt of
thh NoUc. bYI
~-written prot.,t to the PA DePftrt.-nt of R.Y~, 80ard of Appeals, Dept. 2810~1, Harrl.burg, PA 17128-1021, OR
~~.leatb'G tc have the .atter det.r.IMd It tM aLtdH of the ltCoount of the perianal rllPr..entative, OR
--~1 to the Orphan.' Court
ADMIN-
ISTRATIVE
CORRECTIONS I
Fectual .rror. dl.covered on thl. ........nt lhould be addres.ed In writing tOI PA Depllrt..nt of Aevenue,
Bur.au of Indivl~l TIMe., ATTHI Po.t A.......nt Revl.w '~it, DEPT. 280601, Harrllbur~, PA 11128-0601
Phone (117) 767-6505. See p.ge 5 of the booklet "In.truction. for Inheritano. TIM Return for II R..ldent
Decedent" (Rf~-IS0l) for an eMplllneUon of adllJnlltrlltlv.ly oorreotable errors,
DISCOUNT~
If any tOM due I. Pllld within thr.. (3) calendar MOnth. lifter the deoed.nt'. death, a flye peroent (5X)
dl.count of the taM plIld I. 1I110N.d.
PENALTY'
The IS~ tllM .-nI.ty non-pllrtlnlplltlon penlllty I. c~uted on the total of the taM and Int.r..t a,l..,ed, and not
paid before J.~ry 16, 1996, the flr.t dllY after t~ end of the tllM ~.ty periOd. Yhl. non"particlplltlon
pemt!ty Is lIfIPellllbl. I" the .... .lIOOIr end in the the ...e U.e per lad II you would lIPfHlal the t8)( Wfd Inter..t
t~t ~M been .n.....d I' Indicated on thl. notloe.
INTEREST I
Inter..t h ohllrVlKl blalnnlng with flr.t day of dellnquenoy, or nlntl (9) .onth. and one (1) dlIy
fr~ the date of dellth, to t~ date of pay..nt, laHe. whloh bec... delinquent b.fore Januery 1, 1982
~r jnt.re.t .t the ret. of aiM (6X) percent per annuli celoulatlld at II dally fate of .000164.
AU tiMe. which MC8M delinquent on or IIft51' January 1, 1962 will bear int.,...t .t III rate which will vary frOll
cal.nder year to caleneh'1' y..,r with ttult rate ennouno.d by the PA Depart.ent of fl:.V8nUII. The applicable
tnterel\t ret.. fa,. 1962 through 1996 arel
V..r Intlr..t Rate O.lly Intere.t Feotor VlIar Intere.t Hat. Dally Intere.t Factor
1982 20:< .000548 1961 'X .000247
1983 16:< .01l04Ja 198&-1991 llX ,000301
I'M 11:< .OO03111 ..., 91: .000247
1965 13Y. .0Olll56 1993~199l'. n .000192
1.86 1OY. .000274 1995-PJ98 9% .000247
w~lnt.r..t I. oalculet~d liS follows I
INTEREST . BAI~NCE OF TAK UNPAID K HU"BER OF DAYS DELINqUENT X DAILY INTEREST FACTOR
~~AnY HoUce IUutld .ft.r the hI< becOlHt. dellnqu4tllt .,111 refl.ct an Internt oaloullltlon to flft.." US) dly.
beyond ttlel d.te of the ...II.....nt. If pay"nt it! ".de lifter the In1lr..t COllputlltlon datil .hown on ttte
Mottoe, additional tnt.rut au.t ba c:alo111Ilted.