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COMMONWEAltH OP PflNN8VLVANIA, OEPAATM&NT OF HeALTH. VITAL A600ADS
CERTIFICATE OF DEATH
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REGEIl'TS, OF PRINCIPAL
Real Estate:
Stocks alld Boryds:
C~sh. Bank Dl\p<lslts and Miscellaneous Personal Property:
.$ NONE
$ NONE
I. C.D. #020113744-2251515 Core States Bank
$ 250.00
$ 3.48
$ 1.472.17
2. Interest on account to date of death on Item #1
3. Checking Acct, #78418984 Dauphin Deposit Bank
4. Interest on account to date of death on Item #3
$
,23
5. Savings Acct. #5302604248 Duphin Deposit Bank
$ 1.019.09,.
6. Interest on account to date of death on Item #5
$
2.30
7. Mobile Home - 1963 Schult, Type MH
Title # A3673ool7 VIN.#E67609
Sold to High View Associates
8. Chevrolet 1980 Sdn, Title # B31803109
VIN. #IX685ATI74725 Sold to Harry Shull for
. $100.00 per appraisal by Span key 's Auto Sales
9, ,Personalty sold by Chuck Bricker, Auctioneer
to. Medical Bureau of Harrisburg
II. Medical Bureau of Harrisburg
12. Investment Management Services, Hi View Assocs.
13. Refund Commonwealth of PASt. Treasury
14. Bell Atlantic Refund
$ 11500.00
$ 100,00
15. Estimated pro-rata refund on car insur.
$ 159.75
$ . 9.45
$ 92,52
$ 18.55
$ 15.00
$ 7.24
$ 160,00
$ 4,809.78
TOTAL RECEIPTS OF PRINCIPAL
."
',3
\ ;':',.- \'\ \ -. ,~.,')j
INHERITANCE TAX RETURN
RESIDENT DECEDENT
COMMONW'^"H Of /fNNIilVANIA (TO BE FILED IN DUPLICATE "J
DEPARTMENT Of RfVfNU[ C1-
H..RllfJtb, ~~.~I",0601 WITH REGISTER OF WILLS) COUNTV CODE
N' ...",E IlAST, mU"~No MIO-oi-E 1~~i';All '-~; Of(.[uTIii';'f(:oMmlf AOO~f\t"--'-~"';" - .
S H U ,i. V. N 110ml c.Ka violet N. S~.dt. 43 TRu Oy C I R Co ~Gi
'0:'~~cu~';~~"1'lq0 '-r~D:o~,;~;;'-r;::~;:~;~' (O~F.c~~~::~~R:, (~/~:';';':;N 7W~;
,,' .""e""""v"';)7;'" ",..".", "", '"'."o~''''''''i'~J:66A~..~/~_NUM~''~..,..., -,...f AMOI"" 'il'~/~,' ~N~"U'f'".:~:_~_~..__-_.,.:.~__ :
18 1. Original Return [] 2, Supplemental Return LJ 3. Remainder Return
110, dolo, 01 d.oth plio, '0 Il.13,821
0.4. limited Ellat. 0 40. Future Inler.t' Compromis. C) 5. r.d.ral Eliot. TOM Relur" Requirod
I'or do'., 01 d.o,h okor 12.12,821
o 6. Oecldent Died Tellate 0 7. Dlceden! Malnlalned a living Trull .Q.. e, Tolal Number of Safe Oepolll B(lUI
- IAllo,h ,opy of Will) IAllo,h ,opy of Trulll
eoRRIS~OHDINCI'AND CONPIDINTlAL TAX INPORMATION SHOULD II DIRICTID TO.
NAME COMPLETE MAllItiO AOORffoS
C H 11 R I-fiJ iF. SH 1I="7.AS .JIr
IflEPHONE NUMIER
1/7 711b-02()f(
1. R.ol E.to'. IS,h.dul. A) (I I
2, 5'0'.' and Bond. IS,h.dul. B) I 2 I
3, Clo..ly H.ld Sto,k/Partn.rshlp Int.r..' (S,h.dul. q (3)
4, Mortgog.. ond No'" Ro<.lvobl. ISeh.dul. 01 I ~ )
S. Calh, Bank D.po.III & MIle.lIaneous Penonal Property I 5 I
(S,h.dul. E)
6, Jointly Own.d Prop.rty (Sch.dul. FI
7, Tron.!.rs ISch.dul. GI (S,h.dul.q
8, Total Ora.. Au," 1'0101 Un.s 1.71
9. Funeral bp.ns.s, Admlnlttrulivft Co.II, Miscellan.ou.
EXFon... (S,h.dul. H)
10, D.b,., MortBo9' llobillll.., li." IS,h.dul. II
11, Totol D.ductlo" Itotallin.. 9 & 10)
12, N.t Volu. of E.toto Ilin. 8 mlnu. llno 111
13. Charitable anri Go....rnmental Bflque.II (Schedule J)
14, Net Volu. Subl'ct to Tax 11In. 12 minus L1n. /31
15, Spou.ol Trons/on (for dol.. 01 deoth ah.r 6.30,94)
S.. Instructions for Applicable P,rcenlag. on R....en.
Sid.. Ilnclude values from Sch.dul. K or Sch.dul. M.)
16, Amount of lIn. 1.4 taxabl. 01 6% rate
(Include values from Sch.dule K or Schedule M_I
17. Amount of line 14 taKable 01 15% rat.
llnclud. ...alues from Sch.dule K or Schedule M.l
18, Prlndpol'ox du'IAdd lox from Line. 15, 160nd 17,)
19. Credlls Spousal Povorly Credit +Prlor Payro.1J!!.... ~ DI.count Interest
o + ...L..l.31~~ + I/It.,~_ -_~__
20. If line 191s gr.at.r than Un. 18, enl.r the difference ('in UM 20. ThIS is the OVERPAYMENT.
110
21. If Un. 18is greater Ihan LIne 19, enler the dlfferonc, on lInA 21. Thtl is the TAX DUE.
A. Enl.r lhe inlerslt on Ihe boloncfI due on line 21 A.
8. Enter the 10101 of line 21 and 21A on tine 21B. This is Ih" BALANCE DUE.
M~k.. Ch.ck Pavable tOl R.gl.t.r of WlII't Ag~~t
~ ~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE S'.DE AND TO RECHECK MATH .. ~ '-
Under penalties of perjury, I declare Iholl hove ftxamined Ihit relurn, including occompClnying IChedules Clfld slol.menls, and 10 Ihe best of my knowledge and belief,
it i. Irue, correct and complelfl. I declare Ihot 011 roo I eslote has been roported ottruiS markel valuo, Declarolion of preparer orher than the pl'lrsonal represenraliv8 h
based on 011 Information of which preparer has knuwledg().
SIGNATUllf Of PUSON RESPONSIIlE fOR fILING lifT ----AD-fSS--" YII---Cho-"/~-;-e:-SI./,j,lrS ii---------------..---- OAf[ ---/6 a/O: 91 --
~~H" "A "PO 'WIVEA6D"'~j,~~ec.fi'd,-.fJl.f?-'MB.{li~~&~f!~..f?!t1..!..O-s.F DATE-----------
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II A SPOU~AL '
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~ /, .J79. 79
,
18 )
"7.5; ~-,,,,. zS'
-
(11). I~, IfI.:l, 17
112) .!....II.L"''', ~8
1131 0
1141 ..!..li, ,PtI.JIB
o
115)___!L__x,_a
()
o
x .06 =
· ''-I.. ~P~.f!____x .15 a
~ 9, 7().J. S7
_....!..'lL'! () 3, .S'.L_._
1161
117)
(181
119) __'!i, ~,'D
(20) .____ ()
Chf'tk h,',p.f au o'e ,cqllc~tln9 (1 rchmd 01 Yc;:lur avclpoymcnl,
121)
121AI
121 B)
~ I '15.1,.57
---.--1-------,-----.----.--
()
---,-----.--'----.
__.1--3.53,S7 ___
IIv."08Ut (HII
~
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
l.:OMMONWfAIlH o. PfNNflnVANIA
lNHlJlnANCI TAl( "~UIlN
RUIDIN! blClOINI
ESTATeOF'-- "-' -- ... .~'.. " ~,-,-,~_..
V, A),f'0/f11 ..stitt rr
Pleale Print Dr Typ~ _..
FilE NUMBER
:1.1 - q 7 - ..310
ITEM
NUMBER
!~'.~~P;!~~LO-I~l!~~~~.~~_~~!~iE~-~}!i~Lif_-~~,v-l~~~~hl~l_rn_~ ~1. h,e dll~lo"ld 0/\ S.d.I,._~~I_Il_.F.I_
DESCRIPTION
I.
o?
.3.
if.
.s:
/Po
7.
r.
'I,
10.
/I.
I~,
I'.
/'1.
t $,
c.l>. (;O'-OIl.J171f-..1.2.CI5'IS' CP~ rf)rn./'e.s ll"Jf"
r Il. t. a.CGr. III d. .,. t/. on :r It: II( #t I
~a !e/li.,.. iI~cltCP()
Ch,cJ</'!f ~c.ct. -# 78"1/6'1131 VaLtph;1l ~s;t Bk.
~Il f. tfcc.r. tl> d. (I.a'. 0" .z:tf/H ,II- 3
SQ,v1fIJS A-ect. #- 5..1t>:z.60'/-.;lY6 ~h;!\ Oe.pDs;t taK
Inf. a&c.r. ilJ d.().c/. rn :zlern #S
(.see Ie /fer a/l.c.hu/)
lHoBIt.G HM1E - m,3 $c.;ru.l. T I TyI7E 1111-/
/lTUi ..r/F .4.8~73()OI7 V/N..:H e1..7~D9 ,\
$11../) r# ..../fYH VI~I<) ",jsec.llfr..-s (8I(1.,,;:.sAl.f#1f;f~I!'O)
CNGV~I.ET /'feo .st>N ,7f7tG #83180310'1
VIN.IF I 'X"f;5I1TI7tf.7;?'S sea, -n #If~ter .sHuTT
pit ;It'(). ~() Ilfll II-Pl'tfAISA-/.. 4Y sflANke y's;,~tlrl Slrurs
f'1i'1t.s()IIJ~l1"y ~o(..t> BY (!Hu. c./<: (A N'HN~
8~/~, I/-#crt/)tU~f SEE' si(~#'r '+77I1-C#'U>)
MuieAI "Bu.f&(l.!A of H(l.rri~k"rj
fYIu/,'c.ol 13\.lteA14 af' fh.rrj.!>b\A~~
'I1I~U~Ment l"l\Q.no.suHnt Scrv;c.UJ Hi V,'e.1.ll Auoc.s.
1h.h.,..d Colll",........t ~Q. ~. irtu\4\"
Bell ,4f/.nM. I, /..nel
~~/"I'4Ji' p"'-l'llm relwul m c,r ill~Ur:
TOTAL (Allo onr., an line 5, Rocapllulallo,!!
(Alloch oddlllonClI8~" )( 11" ,"ee" If morelpoc' It n..dld,l
VALUE AT
DATE OP DEATH
---.---------..-..---.-
~SV.()O
,
3.'113
..
It tl7:J. /1
"
.. '2.3
.,.
1,01'1. DC(
" :l.30
I'
" ,s'O (J. DC
..
/O!)."/)
1159. 7.S'
'tt, "IS'
,. q.:z.S~
""8.s'
'IS,"
fl
7,~"
~I ,~, t1~
.
S _ ~ 11)1. 7~_._
i, I-,~ r'~
". If .....,lr{,J\; ,.,w"'r
Cor,lStiI!O':\ [j,lf\k rj A
PO no_ 7GIH
Phjl,'dolplll(~ PA 1 q II) \, ;,.j 1 8
I
April 17, 1997
CoreStates
Bank
Charles E. Shields 11I
Attorney at Law
Mellon Bank Building
2 West Main Street
Mechanlcsburg, PA 17055
RE: Estate of: V, Naomi Shutt a/kla Violet N. Shutt
Date of Death: February 25, 1997
;,
Dear Charles Shields:
, '
In response to your letter, please be advised thatlhe,deeedent held the following account(s) with CoreStates Bank as of
the date of death:
ACCOUNT DATE DATE PRINCIPAL ACCRUED
TYPEfNlJMBER A.CC.PlJNT TITLE OPENED CLOSED BALANCE INTEREST
Certificate of Deposit V. Naomi Shutt 10/20/83 250,00 3.48
020113774-2251515
I trust that we have been of assistance to you in this malter.
Sincerely,
CORESTATES BANK, N.A.
'YYI III 'f) IS:J:hn ocr
Brian K, Harvey
BKH/hb/268
<),1071129,1\
IN REPL V REFER TO:
REPORTING SERVICES
Fe 6-90.3-235
PO BOX 1102
READING, PA 19603
610-655-3353
BILL OF SALE FOR MOBILE IIOME TRAILER
KNOW ALL IvtEN BY THESE PRESENTS, that we,I.IARRY E. SHUTT IInd
ELEANORE M. SMYSER. IIdminislflllOrs of the estllte of V. NAOMI SHUn', IIlso known as
VIOLET N. SHUTI', late of the Township of Hampden, County of Cumberland, Commonwealth
of Pennsylvnnia, In consideration of the followin!',:
I,) The payment to us of the StUll of fifteen hundred ($1500) dollars, the receipt whereof Is
hereby acknowledged;
2.) '111e forgiveness of all back and current rent on the mobile home lot located at43 Trudy
Circle, Meehanicsburg, PA 17055;
3.) Buyer's acknowledged responsibility for all expenses lInd costs associated with the
transfer of tllle;
4.) Buyer's acknowledged responsibility for having the mobile home trailer insured by
their own InsunU1ce company at their own proper cost and charge; and
5.) Buyer's agrecmentto indemnify and hold hamlless the administrators and the estate In
the eve III of nny charges or claims against them as a result of any events surroundIng or associated
with the trailer after thc date of these presents and before final sale lInd transfer of title have been
mnde;
DO HEREBY grant, bargain and sell, transfer and set over unto HIGH VIEW
ASSOCIATES, a co-partnership. consisting of ROBERT GOODLING and IRVIN PEIFER,
cUlTently of P. 0, Box 185, Mechanicsburg, P A 17055 and/or their lIssigns, the following
property, to wit:
One Schult Mobile Home, 1963, Title No, A36730017, V,I.N. E67609, and we,the said
BARR Y E. SHUTT lInd ELEANORE M, SMYSER do warrant ourselves to be the true and lawful
administnltors of the estate aforesaid, the true and lawful title holder to the said mobile home, and
that we have full power, good right and lawful authority to dispose of the said property, and that
we will walTl\lltthat no lien or other claim appears upon the face of the title of the said property.
IN WITNESS WHEREOF we, the said HARRY E. S~1! ~nd ELEANORE M. SMYSER, have
hereunto set 0111' hands and seals the .!l.'t:y/.. ~t~ ,1997.
~ ~ _ (seal)
(seal)
COMW, OF PA,
COUNTY OF CUMB ~RLAND I S.S.
On this . ";-i,Aday of _ 1997 before the subscriber, a notary public, personally
appearedifaii.y E, Shutll\l Eleanore M. Smyser, to me known to be the persons described in and
who executed the foregoing instrument, and aCknOWled~y executed the same as their free
act and deed. ~ y-. ~ .J3_
Notarial So"i
Charles e, Shields III, Notary Public
Mechanicsbu,g Boro, Cumberland County
My,Commleslon e,plree June 20. 2000
MAmhftl, o.nnsvl'h1nl~ ^Mnr,I~lIon ot Notarlss
ray IHW f~t IU6!
-.
ESTATE OF
V. IV /I tJtl1/
SCHEDULE F l
JOINTLY.OWNED PROPERTY
-l-..~.._..- .~,,,. .." _ .
FILE NUMBER
SHUTT 021-97-3/0
(OMMmIWIA(IH 0; rINNH\VANIA
INI-f~~\l""HU IA~ UIUIN
RBmlNIDfCIDHH
---'---<"."-~~"_.__.._--~---.--~- -,..~--~----"...__._-~-_.~.~,
.1.lnt t.n.ntl')'
NAME
A. E! t..r;~N()fU; 111. SIIf.YSGIi!.
_._.,20DRESS ____.__......,_ 'RELATIONS.~IP TO_DE~.~~!._
91'f NIXoN j)~. SIS71a'f(
m~CI(IIA//~J81.(~(,., 14? (70S)
B,
C. '
J,lntIV.ownod properlVI
ITEM LEnER DATE
FOR TOTAL VALUE I DECO'S DOLLAR V ALOE OF
NUMBE JOINT MADE OESCRIPTION OF PROPERTY OF ASSET % INT, DECEDENT'S INTEREST
TENANT JOINT
1. A, V.H<'/a(.S tA.s, SI/V/NIJ-S 81:JN-DS I 57),0
IJll.1lFJ ;&. (Y:z) ~
oSl.:", ,5!iE iN/lEN70!eY L/:sT ~e, 070.90 / 'II 0 :5 s: if$"
t.IST. II rr'" (!I-I t:'7),.
; .1
TOTAL IAI.. onter on IIn. 6, Recapltulollon)
(II more .poce /. n..d.d inlerl odd/fionol .h..,. 0/ '001. .iz.)
S If. fNS'.4/$'
BOND VALlJATIONS MAOMI SHUTT ESTATE
'11M' .. fl d"o.J. 2-U.9?
, of) (),.4U'1HH ....
'f. $0 fERIES E BONDS
1..21Jl
1.) L2094 566 285E Pcb 13 $147.80
2.) L2094 566 300E Pcb 24 147.80 /,j.;
3.) L2094 566 300E Pcb 24 147.80
4.) L2094 566 323E Mar 14 136.12 r;t...
5.) L2094 566 229E Ian 05 147.80
6.) L2094 566 246E Ian 16 147.80, ~
7.) L2094 566 257E Ian 27 147.80 l
8.) L2061 903 472E Ian 14 147,80
9.) 1..2061 903 486E Ian 28 147,80 ~11.31 B. 52.
U21
10.) L2061 903 540E Mar 11 163.62 ~
11.) L2061 903 509E Pcb 11 168.52 trf.-.
12.) 1..2060 917 592E Ian 08 168.52 D'I...
13,) L2060 917 656E Iul 29 165.54 df...
14,) L2060 917 605E Iun 17 165,58 ~
15,) L2060 917 639E Iul 15 165.54 p1....
16,) L2060 917 543E May II 165.24 VI-..
17,) L2060 917 621E Iuly 01 165.54 J'l-
18,) L2061 903 520E Pcb 25 168,52 c:rl--
19,) L2060 917 707E Scp 22 160.72 (l-.
20.) L2060 917 797E Dee 05 147,80 .,v.
21.) L2060 917 730E <Xt 12 160.72 .rt---
22,) L2060 917 736E Oct 03 160.72 ,-y....
23.) L2060 917 701E Sep 15 160.72 n...
24.) 1.2060 917 774E Noy 18 147.40 ,t1;<
25,) 1.2060 917 749E Noy 14 147.40 *" f ~ /7 2 '1 .((()
26.) 1.2094 566 208E Dee 20 147.80 ~
1
r
~ _ ":"~ ""A.!~
lW.: B. NAOMI SHUTT ESTATE
$5,) 1.1055 080 414E Apr 24 181.84 ;-Iv
56,) LI055 080 312E Jan 30 187.28 n.--
57.) 1.1055 080 s80E Aug 184,00 n.
58.) '1.1055 080 520E Ju1 18 184.00 ~
59.) 1.1055 080 472E Jun OS 184.02 rl-'
1- .
60.) 1.1055 080 356E Mar 14 181.84 ~ .1/102198 '
12ZJ.:
61.) LI019 128 690E Pcb 26195.70 n...- . f {'i ~-.1 0
~---_.
-
.r=:/"F1 ,'.. , " '
, TN ~ /'15: 9tJ
"
3
B. NAOMI SHUTT ESTATE
12.2.0.:
26.), 026609978 May 31 367,20 ve-.-
27.) , 026992508 Nov 08 356.60 fit-..
28.) 026956318 Jul 31 367,20 tJI-..
29.) D26968440 Aug 31 367.20 #...
30.) 021702197 Feb 28 378.20 c)k
31.) 026619354 Jun 28 367,20 4}..
32,) 021702199 Apr 05 367.20 ;t..
33.) D21702196 Jan 23 378;20 ~
34,) D26978407 Q:t 09 356.60 /fA.. ~3 30$', ",0
I
5
;5,./7/-.:2.
COMMONWEALTH OF PENN$YLVANIA
DEPARTMENT OF REVENUE
DUREAU OF INDIVIDUAL TAKES
IHHEHIT'HC~ TAM DIVISION
ltEP1. za06Dl
t1ARMISDURQ, PA 17121-0601
NOTICE OF INHERnANCE TAK
ArrRAISEHENT. ALLOWANCE DR DISAl,LDWANCE
OF DEDUCTIONS AND ASSESSHENT Of TA~
DATE
I!S'fATE OF
DAlE OF DEATH
FILE NUM8!R
COUNTY
ACN
01-27-98
SHUn
02-25-97
21 97-0310
CUMBERLAND
101
F- AMQ~t R.MUted -l
MAKE CMECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS .....
REV: i54i. iiii'"AFp. [09-:97). -iloYianiF- "itiHEifi f ANeE n TAX "'A-P-PRii is Ei1EilT -;- Ai. rliiif.NC E- iili'-- - - - - - - on - - - - --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
V N FILE NO. 21 97-03111 ACN 101
CHARLES E SHIELDS 111
2 W MAIN Sf
MECHANICS BURG
PA l. 7055
ESTATE OF SHUTT
TAK RETURN WAS,
I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..l E.t.te (Schedule A)
2. Stocks and Bond. (Schedule 8)
5. Clo..ly Hald Stock/P.rtn.rlhlp Int.r..t (Schedule C)
it, Hortgsg.II/Not.. R.c.,tvatlla (Sch.dule D)
i, C..h/Bank Depod h/Hhc, Per'lond Prop.,..ty (Schedule F.)
.. Jointly Owned Prop.rty (Sch~dul. f)
7. TranMfarl (Schedule G)
I. Tot.l Au.h
( X) CHANGED
11)
(21
(51
(4)
(5)
(61
(7)
.00
.00
.00
.00
4.809.78
14.035.45
54.688.02
la)
APPROVED DEDUCTIONS AND EXEMPHONS:
.. Fun.,..l Expan.../Adn. COlt,/Hite, E)(pan... (Sohedule H)
10. D.btl/Hortgaga Ll~bl1itl../ll'nl (Schedule 1)
11, Total D.duc~ion.
12. N.t Value of Tax R.turn
15. Charlhbla/Gu'lI."n,"ant.l Blquut.; Nl,)n~.bchd 9115 lrult. (Sohedule J)
14, '4.t Valu. of Eat,t. $ubj.ot to Tax
If an aaaDaament waa i.sued previoualy, line. 14, 15 and/or 16, 17 and 18
reflect figurea that include the total of ~ returna a..eaaed to date,
A9SESSMENY OF TAXI
IS. AMount of Line 14 .t SpauR.l rat. (15)
1', AMount of Lin. 14 hxable at Lin..l/CI... A rat. (16)
17. AltOunt of Un. 14 tlif)(abl. at CoU.t.ral/Ch.. 8 rat. (17)
18. Principal Tax Du.
TAX CREDITS:
PAYHENT
OATE
05-21-97
l.0-23-97
NOTE:
RECEIPT
NUHDER
AA2113?6
AA242377
DISCOUNT C +)
INTEREST IPEN PAID C - I
412.50
.00
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
9.462.98
1.379.79
1111
1121
(15)
1141 _
191
110)
,00
.00
62,690.48
K .00.
K .06.
K .15.
(18)
*'
II~."" IW In III.".
V
N
AHOUNT PAID
7,837,50
1,453.57
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
SEE
DATE
ATTACHED
01-27-98
NOTICE
NOTE I To in.ure prop.,.
credit to your account,
lubMit the upper portion
of thh forlt with your
hI( pay...nt,
73,533.25
10 . !l4~ 77
62,690,48
,00
62,690.48
will
,00
,00
9.403.57
9,403,57
9.703.57
300.00CR
.00
300.00CR
I IF TOTAL DUE IS LESS THAN n. NO PAYHENT IS REQUIRED,
If TOTAl. DUE IS REFLECTED AS A "CREDIT" (r.RI. VOU HAV BE OUf
A REFUND. SEE REVfRSE SIDE Of THIS FORH FD~ INSTRUCTIONS.)
REIERVATlllll,
PURPOSE OF
NOTICE I
PAVHf:NTI
REFUND (CR) I
OIlJECTJ~$1
AIHUN
IST~ATlVE
CORRECTIONSl
DUCOl>>lTI
PENAL TV,
INTEREiT,
Elt,t.. of "tUft"'1 dvtne on or btforl Dee...r 12, 1'82 .... if .,,~ +utura Inter..t In thl ..tate II t,,,,.flrtH
In Pit.....lon or enJovHnt to C.... II (oo11lt.reU bln'floltrl.. of tne decldlnt Iftar thl 'l(plr.tI~ of InY ..t.t. for
11'. ~r for y..r., the C~'lth hereby tkpr..,lyr...rv,. the right to ftPpr.I.. and ...... trenl,.r '~rlt8ftG. Tlx..
.t the lawful Ch.. I '~ol1.t.r.1> r"t. on any ,u(lh future Int.rut.
To fulfill thl r.qulr..-nt. of Soot Ion 2140 of th, Inh.rlt.ncl end Eltot. TII( Aot, Aot 21 of 1"5. (72 P.S.
SecUon 9140),
o.hoh the top portion of thill NoUol and lubIIlt with your pay..nt to the Rlght.r of Will. prlntad on the r.ver.. lid,.
"-"Ilk. chlok or .on.y order ptyabh tOl REQISTER OF MILLS, AGENT
" r.fund of a ~.x ~rldlt, whl~h wau not r.quI.tld on th, Tlx Roturn, .ay bl rlque.ted by oo~lQtlMt In "Appllo.tlon
for R.fund of Plnn.ylv~l. (nh.rltanol end E.tet. Tlw" (REY-llll), Application. ar. Iv.lllbl. It the Of,iol
of thg Rlgl.tlr of WiJI., any of thl 2J Rlvlnut DI.trlot Offlc.l, or by calling the 'Plolal 24-hour
.".werlnl ..rvlc. nlJllblr. for for.. orderlngl In Plnn.v!vanlal-600-36Z-20SlI, ouhldl PIMlylvanla and
within looe~ Harrl.hurg Ir.a (7Ir> 787-8094, TOOt (717) 172-2262 (H..rlno J~alrld Only).
An)/' parh In Intlr..t not ..thfJld with the BPprahl.."t, allo"'ttn~. or dh,llowMOI of deduOtlonl, Dr ......ltInt
of tilt <including dhooth'\t Dr Intlre.t) It .hown on thlt Notlc. IN.t objl~t within shct)/' (60) d.)/'I of ra~llpt of
thh MoUe. by I
--"rlUlln prot..t to thl PA O.part..nt of Rnlnu., Board of App..lt, DI()t. 21H1I21, H.rrhburg, PA 17128-1021, OR
--.l.ctlon to have tht tllU.r d.t"alntd at audit of thl account of the Plrlonlll rtpr...ntltlv., OR
--app.al to the Orphlln,' Court,
Factual trro~. dl.cov.red on thl. ........nt .hould b. 0ddr....d In writing tal PA Dlp.rt..nt of Rtv.nu.,
&Urlau of Individual Ttwu, ATTNI Po.t AII.....nt R.vltw Unit, Dopt. 280'01, ttarrhburg, PA 17121"0611l
Phone (717) 717-'5DS, S.. paa. 5 of thill booklet "tn.truotlon. for Inh.rihnOl hit R.turn f!:lr a R..ldtnt
Oeeld.nt" (REV-ISOJ l fnr In .ltphnltlon of adlllnhtratlvety oorr.ohbl. .rror..
If any hI( eN", is paid within thrll (5) ctl~ar Bonth. Ift.r tM d.eldtnt'. Math, . fiv. p.rcent U:O dltcount of
the tal( paid It allowlld,
Thl 1!i;: hI( allnuh non-PtrtlolpeUon p.nalty hi (lo.puhd on th. totel of the tlX and Int.r..t ....uad, ~ not
plld before January 18, 1916, the flrlt dey efttr tht .nd of the taw ~.n..t:i ptrlod. Th1l non-partlcJplltlon
penalty 11 I19P...1abh in the .a.a .anner tnd In the the 11III1. tI.. p.r lad a. ~ou would ..,paal tM tilt and intlr..t
that hi' b..n .....~td a, Indlcat.d on thi. not Ie.,
Int.r..t I~ ohargad b.gl~lng "ith flr.t day of d.llnqu.n~y, or nlnl (9) Month. and on. (1) day fro. the d.ta of
de.th, to thl data of p.~..nt. Taw., which b.c... d.lIn~nt b.f"rt January I, 1912 b..r Intare.t .t the r.tl of
,lit (6;(1 parclnt par eMUII cal~ulat.d at a d.lly r.t. of ,000164. All taMIII whloh b.c.... dtlJ~t on and aftar
J.nuarv I, 1912 "ill blllr Interlllt .t e rete which will v.ry frol oaland.r y..r to cal.ndlr ya.r k/lth that rat.
announc.d by the PA Dlpert.lnt of R.~~nu.. Tho eppllcabl. intar..t r.tl. for 1912 through 199. ar'l
U!! Inter.at Rat. DaUy Int.r..t Fllctor :!!!r Inter..t R.t. Oally Jllt"..t F.ctor
1982: 20:<- .000548 1917 'X .OOO2~?
1.13 16;: ,0004S8 1918-1991 llX .000301
lfl~ u:<- .000301 1992 'X .0002~7
I.U u:< .000356 1995-1994 7X .000192
1986 10% .000274 199&-1998 'X ,OD0247
--Intar..t 1. caloulated ., follow'l
INTEREST. BALANCE OF ~AX UNPAID K NUNBER OF DAYD DELINqUENT K DAILY INTEREST FACTOR
. -Any NoUu luued Ift.r the tal( bloo.., delinquent will r.f1act an Intar..t oaloulatlon to flft.en <IS) dIIYI
boyond the data of t~ .,~..t..nt. If pay.ant II ..d. aft.r the int.r..t eOlPutatlon date .hown on tn.
Notlo., tct<tltional Int.r..t au.t b. ollloulllt.d.
PAVHEHT I
Olt.oh thl top portion o~ thh HO'UOI and .ubltU with your pay.lnt .Id, pavabll to thl nl.1 IInd add"...
prlntld on th.'r.v.r.. .Ida,
tf RUIDENT DECEDENT "al<fl chick or ",onlY ordlr payabll tOI REGISTER OF WILLS, AGENT,
If NONwRESIDEIH DECEDENT IIllka ch.ok or 110""'1 ordir payabll tOI C0t1t10NWEAlTH OF PENNSVLVANIA,
REFUND (CR)I . refund of I tlM or8dlt, whloh wa. not rlque.tld on thl Ta~ Rlturn, .IY bl raqUI.tld b'f co"platlng an
"Applloatlon for Refund of Plnn''flvanlft Inherltancl and E.tltl TIM" (REV~1315). Application. arl Ivallable at
the OffiCI of thl RIol.tlr of Will., any of thl 25 Rlvlnu. Olltrlot Offlol' or fro. thl,Olpart"lnt'l 24-hour
anlw.rlng .Irvlol nu.blr. fer for.. ordlrlngl In Plnn,ylvanl. 1-800-362-2050, out.ld. P.nn.ylvlnla
and wJthln 10011 H.rrhburll .rn (111) 787~8D'J4, TOO' <7171 172-2252 Olllrlng tapaJrld only).
REPLV TOI
QUI.tJon. rlgllrdlng Irror. oontaln.d on thl. notlc~ .hould ba .ddr....d tal P. D.part.ant of R.vanuI, Bur.au
of Indlvidull TIMIt, 11TN! Po.t A..e....nt Revlaw UnJt, nlpt, 280601, Harrltburg, PA 17128-0601, phon.
(717) 7.7-6505,
DISCOUNT I
If any taM due 11 peld wJthln thr.. (3) ollhndar lllonth. aft.r thl dlo.d.nt'. d.ath, a flv. pare.nt (Sin dilllount
of tho taK paid I. alIO~ld,
PENAlTVI
Thl 15% talC a.nltty non~partlolpatlon panalty 11 co"put,d on the total of thl taK ~nd Int.r..t Qu....d, and not
paid baforl Januery 18, 1990, tha f ir.t da'f altar thl and of thl taM allna.ty p'r lod.
INTERESTI
Inter..t II tiharll.d b.glnnlng wJth first dll'f of da1Jnqulno'f, or nln. (9) 1lI0nth. and on. <11 dll'f frolt thl dati of
death, to the dati of pa'f".nt. TIII(I:I whloh blca.. dlllnquant blfor, Janullr'f 1. 1982' bur Intlr..t at thl rate of
.IM (6%) p.rolnt plr annul calcu1at.d at a dally rat. of .00016~, All teM" which b.ca.1 dOllnqy.nt 0" .nd .ftlr
Januar'f I, \982 will blar Intlr~.t at a rat. which will vary froll oal.ndar yaar to oal.ndar y.ar with thlt rate
announo.d by thl PA n.partllllnt of Rev.null. Th. applloabh Intll'..t reta. for 1982 ,through 1998 lira I
y.., lnter..t Rat. Oallv Inter..t Fnetor Vaa, Int.r..t Rat. DailY lnlara.t Faotor
19.2 m .000548 1987 l)% ,001l247
19U 16% .000458 19aa~1991 11% .000301
198ft 11% ,000501 1991 9% .000247
1985 m ,000556 1993-1994 7% ,1I110192
19U, lOX ,000274 \995-1998 9% ,000247
--lntarllt II olloulatld at folloWII
INTEREST . DALANCE OF TAK UNPAID K NU"DER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
~-~ny Notlc. It.uad Ilft.r th. taK baeo... d.llnqu.nt will r.flact an Intara,t calculation to 'If teen (1&) dlVI
b.yond the data of th.Il.......ot. 1f pay..nt I. Illde aft.r the Int.ra.t co.putlltlon data shown on the
Hotle., addltlonel Int.r..t .u.t ba calculated,