HomeMy WebLinkAbout97-00342
PETITION I<'OR PROnA TI<: Rnd (;RANT OF U~TTERS
I1slale of _-KllllL1lAAL._llUNlUJ~--L'_H_ __ No, _.u__..a?t::::92.- 3~
Wj(~~\'tltO~RL1mv.\ll.&ifr~_~n To: Register of Wills for the
n__n..__' D",'eamJ, Cmlllty of ClI.MI\ERLANll In the
SoclaJ Security No, J?_4-=26-J1.~LL.__.____... Commonwealth of Pennsylvania
The petition of the undersigned respectfully repTesents that:
Your petitloner(s), who is/are 18 years of age or older an the exeeut.t.UUL
In the last will of the above decedent, dated -MaLclt-.!i..-----
andcodlell(s) date<l'~-n\",-r." ---.----,,----- - r.-
_ "fL-Q;!.'iL.~l....s:>19tlli~lI4_ D['1\t'l:2~1U.__,....{b..::Ll ~\ 'i 02
named
, 19.1l1l..-
(state relevant, cirl:llmSUlOCCs, e,g. renunclatlonj death or e,'(ccutOf, etc.)
Decllndent was domiciled at death In Cumberland
h.ll~ last family OT prln~~ resld~ee aI rJ) \)0 rga re ~!:~~.
~,'i:~ ~ q N - _ '--' ___
(IISl meet, nllmber and muncipality)
County,Pennsylvanla, wlth055
Mechanicaburg, Pa 7
Decendent, then _.JiL_ years of age, died _ March 27 _ ,1997
aL Holy Sprit HORpitaJ.. Cumberland County, l'ennBylvonia "
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered faT probate; was not the vlotim of a killing and was nev8r adjudicated
incompetent: IM,^R~\ LI~ :1 lAucL \<O.Hl..\::iJI\lft'- \N\~~ \ (<I ?.
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All peTsonal property
(If not domiciled In Pa.) Personal property In Pennsylvania
(If not domiciled In Pa.) PeTsonal properlY In County
Value of real estate In Pennsylvania
situated as follows:
$ 5.000.00
$
$
$
WHEREFORE, petitioner(s) respectfully request(s) the pTobate of the last will and codlcll(s)
pl'e<ented herewith and the grant of letters T~o'"mon'Ary
(teslamentarYllldmln15trall011 c,t,a.; administration d,b,n.c.l.a.)
theron,
Ii e?;~~
19 -2LJleec.b~ H H or; va
...~ -Cal:-Ullh. FA )'7013
It_
50
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Brenda Shetto
707 Shafrar Street
EnolQ.. FA 17025
__ _ .. .--';=.:==::--'=-..:::;;.=--:=::'=-":=='-=11::::::
OATH m' PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA } 88
COUNTY OF -CumharlllJJ.J:L__________
The petitloner(s) above-named sweur(H or affinn(s) thai Ihe statements In the foregoing petition are
true and correct 10 lhe best of the kilOwlcdge and belief of petltionel'(s) and tllat as personal represen-
tative(s) of the above decedenl petltioner(s) will well and truly administer Ihe estale according to law,
Sworn 10 01 _ affirmed alld '1UbSCrib_ cd ~- ._ '~U;r~ 9 liA-d ~
before me this ~1TH d" 01' Brenda Y. Shette] 00'
:n..-P~---- 9 _ --- - "
~J6h~~.Q.~ -~~) :1i..~1v- ~
'-'F1ARY'C"'tEW I S Register _ ~<'.lla-l'<l-a..-w:aJ'Am ~
IS-I'l3-'g
No ? 1 " 97 " 34?
. .
Estate of _...IlUNNJ r,', ~01iWiAAH former 1 y
BONNI~ J GRAHAM
DECREE 01<' PROBATE AND GRANT m' LETTERS
. , Deceased
. AND NOW AprJl 14 ___.__m________~___191.?___, in consideration of the petition on
Ihe reverse side hereof, satlsfllctory proof having been presented before me,
IT IS DECREED that the Instrllment(s) dUICd____Marc~__.~__l 9SQ__
described Ihereln be admitted to prohutc and filed of record as the lust will of
Bonnie J. Kohlhaae
;;;;d Letters Testamentary
~re hereby granted to Brenda J. Shet. tel and Richard B. Graham
FEES
Probate. Lellers. Etc, .'""", $
. Sholl Cerlifleates( 1~:..",.", $.
Renunclalion ,'.,.".""",. $
~Pages
/)gj)J~{~ Ji ~ b 7
'~ -.:.;,~:~ (, fJ(;
. MARY CLEWIS
25.00
::\6.00
ATTORNH (Sup, Ct. 1.1), Nu,IWm. A. Duncan
22080 10 /I
1 Irvine RQw. Carlisle. PA
ADDRESS
$
TOTAL __ $
APRIL 14, 1997
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o 6 Decadenl Died Testale,^",",opy"WUII 0 /, Oece<lenl Maintained alNlng Trusll^",",op,olT.."1 _ 8, Total Numbel of Safe Deoosn Boxes
o 9. Litlgollon Proceeds Recei,ed 0 10. Spoo$al Poverty Croon 1""'01"""_' 12.3I,.I.n"".1I1 0 11. E~n In tax undel See 9113(AII^",' S<. 01
THIS SECTION MUST BE COMPLETED, A~~ CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOU~D BE OIRECTED TO:
NAME - COMPlETE MAIlINO ADDRESS
7 4)
3' 2 8 1 5 6
I
4 0
5 6
7 I 6 I 0 .9 6
I (- 4 I 3 2 9 4 0 )
(- 4 3 2 9 4 0
none
I I) II "J
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
9
~
FLE HlJIIIIlIR
2 1
!i
Ul
Q
Ul
o
W
o
K () II I. II A A S
BON N J Po .1
I 'ii'
7
034 2
SOCIAl. SECUlt,TY Nwat:R
DAn: Of OEAHI
DATE Of 61RTtl
I;'
none
. . .
> > BE l'lURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
Under pen"'lics of pequry. I oeclOfft lhal! have exammed thiS return, Including occOmpanYlng schedules and atatemenl1l, BIld to lhfl best 0' my knowltldge and belle'. it is Imo, oorrl'<:l and complete_ Dec'JN811OO 01 prooar&r oli1or
I $t1.cnalfinforma~.Q!L9J~9a~.!12'!t.~
SPOflSIBlE FOR fiLING RETURN 4O~ESS \ n
"l<\.A.A. (C.\.b- \. V\,\ttG: \r &.ltr
THER THAN ~EI'Il..9l'NTATI'\l"'!i') ADDRESS
f (j \ ( (Jk:.Jt~~
03/271199'/
! 7.4"26-9523
llF mLlCAt\l.E) SURVIVING SPOUSE'6 NAME (lASt FIRST, ANOMIOOlE fNITlJ.q
SOCIAL SECURITY NIAIBER
DUNGAN, WILLIAM A.
fiRM NMlE (If ~ltcable)
DUNCAN & OTTO, P.C.
TElEI?i04iNl,.t,!BER -
(II 249-7780
1 IRVINE ROW
CARLISI,E, PA17013
z
o
~
::)
I::
~
o
~
1. Reel Estate (Scheduie A)
2. SIocks elld Bonds (Sclladule B)
3. Closely He~ Corporellon,Partne"hlp 01 SOIe.Proprlelo"hlp
4, Mortgages & Noles Receivable (SchOOu~ 0)
5, Cash, Benk Deposits & MOcellaneous Personal Property
(Schedule EI
6, Jolnlly CR/ned Proporty (Schedule FI
/, Inlel-Vivos Transfers & M.cellaneous Non.Proba'e Property
(Schedule G 01.)
8. TolIl Gro.. A..ets (lotallln..1./)
9, Funeral Expon..s & Admln.lred,e Costs (Schedule H)
10. Deb. 01 Oece<lenl, Mortgage liabilities, & liens (Schedule I)
(11
(2)
(3)
(4)
(5)
(6)
(7)
7 6
035
,
328 1
I
5 6
(, 1
(8) .
(9)
(10)
7 t 4 1 8
192
11. TolIl DOOuctlon. (IotaWnes 9 & 101 (11)
12, NelV,'ua or hllte (line 6 mlnuHlna 11) (12)
13. Chanlllble and Go,emmentalBeques"'Sec9113 Trusts for which an e~n 10 tax has notlle.n (13)
made (Schedule J)
14, Nat V,'u. Subject to Tax (llnal2 minus line 13)
15, Amounl of line j4 taxeble
el!he.pousaltaxrele I 4 t 3 2 9 .4 0
Seel"strucllons on le,erse s~e lor .ppllca~e polcentage
16 Amounlolline 14 laxable
al6% 18,e
17, Amounlolllne14 taxable
at 15%re'e
18. Tax Due
(14)
x ,0
(15)
x ,06
(16)
(171
(16)
-
x ,15
19.
(cc{LJJ-tQ ~
DATE
~ 17 ~ )c,7
DATE ~r-
Dec.!'dent'lI Complet~__Addres8:
STREET ADDRESS I I rv t ne Kow
,
CITY Carl i BJll
[SiAff p ^
F170lJ
rax Payments and Credits:
1, Tox Due (Page 1 Line 181
2. Credlll/Paymenls
A, Spousal Poverty Credit
B, Prior Paymenls
C, Discount
(1)
Tolal Credits (A + B + C) (2)
3, IntereiVPenaity If applicable
D, Interssl
E, Penalty
-
TOI&llnteresUPenalty ( D + E ) (3)
If line 21s greoter than line 1 + line 3, enter tho difference, This Is the OVERPAYMENT,
ChBCk bON on Plgl 1 L1nB 1~ to reqU"t I rlfund (41
5, If line 1 + line 311 grealer Ihon line 2, Bntsr the difference, This Is the TAX DUE, (5)
A. Enter the InlBresl on tho tax due, (SA)
B, Enler the total of Line 5 + 5A. This Is the BALANCE DUE, (58)
Make Check Pays.ble to: REGISTER OF WILLS, AGENT
. U 111 -- J N 11
PLEASE ANSWER THE FOllOWING QUESTIONS
BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1, Old decedBnt make a transfer and: YeB
e, retain the uee or Income of the property tranBferred; """""""'"""'" " "" """ "" """ " " " " "'"" 0
b, relaln the right to deBlgnate who ehait use the property transferred pr Its Income; """,,"""" 0
c, retain a rBverslonory Interest; or,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 0
d, receivo the promise for life of either peyments, benafitB or care? "'" """ " " """ " " " " " " "" "" 0
2, If death occurred on or before December 12, 1982, did decedent within two yearB
preceding death transfer property without receiving adequate consideration? If death occurTed
after December 12, ~ 982, did decedant trensfer property within one year of death without
receiving adequate consideration? """"""""""""",,"""",",,",,"',,"'"'''''''''''''''''''''''''',,'',,''',,,,0
3, Old decedent own an "In trust for" or payable upon death bank account or security
4, ~tl:l~e~e~:~~~~~:~' 'l~di~ld~'~I;~il';~';;'~'~;~'~~~~~i:' ~~~~i;~: '~;' ~;h~;' ~~~:~;~'b~t~' '~;~~~;;~?.: i ~
NONE
4,
NONE
No
IKl
~
i
~
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS VES,
YOU MUST COMPl,ETE SCHEDULE G AND FILE IT AS PART OF THE RETURN
n P,S, ~9116 (0) (1,1) (I) provided for the reduction of the taK rate Imposed on the net value of transfers to or for the use of the
surviving spouBe from 6% to 3% for dates of death on or aftor July 1, 1994 and before January " 1995,
72 P,S, ~9116 (a) (1,1) (II) provided for the roductlon olthe rate ImpoBed on the net value oltransfsrsto or for the use olthe surviving
spouse from 3% to 0% for dates of death on or after January " 1995, Tha statute does not exempt a trensfer to a Burvlvlng spouse
from tax, and the statutory requirements for disclosure of assets and filing e taK return are stili applicable even If the surviving spouse
Is the only beneficiary,
FOR DATES OF DEATH ON OR AFTER .IANUARY 1,1995 - Please answer tha following question by piecing an "x" In the
ep~roprlete space,
Old the decedent creBte a truBt or similar arrangement which IB solely for the aurvlvlng apouse's beneflt for hlB or her entire
IIfBtlme? YIIS 0 No ~
If you answered yes to the ebove question, the taK on tha trllst or similar arrangement Is postponed until the death of the second
spouse, at which time it will be fully taxable at the rate(s) applicable to the remainder beneficlery(ies). Enter the value of the trust on
Schedule J, Part II, in order to remove It from the calculation of the tay. due in this estete. You may wish to file Schedule 0 In order to
make the election evellable under Sactlon 9113, If the elaction Is made, the trust or similar arrengementls taKed In the estate of the
first decedent spouse, the portion of the trust or simller arrangement whlctl benefits the surviving spouse Is texed at the zero tSK rete,
and the remalndar Is taxed at the rate(s) applicable to the remelnder beneficiary(les). If you choose to make the election, you must
attach Schedule 0 to a timely-filed tax relurn, along with SchedLlle(s) K and/or M In order to show the apportionment of the trust or
similar arrangement between the surviVing spouse end the remainder beneficlary(les).
.
Prtvallt allIIl Oroup
214 SIIltIlI iIINIlIII. !uIl81l1
P.O.lloll 0110
ClmpHlU,~ IllllIlo4lIlO
717 97S o4eOO
lIDO 137 D735
r COpy
~"nillLynab
H.r 23, .1117
I'
"il11.. A. !hmcaD, .aqulrll
Duaeaa , otto, P.C.
0111 Irvin. Row
Carli.lo, PA 17013
REI Kat.te of BODDie J. ~ah1b..1
a.k... Boupi. J. Graham
Dear Mr. Duncan,
'ar four requaat, follolling an the dat. of death baluca.
.' for Hrll. IobJ,haas' acaoUDt. with KaRi11 LJ1Iah.
'.
872-05366 Rohart L. ShiAdlar, H.D. P~fit 8hariAg 'raat
PlIO Bouia J. Grah..
QuaIlU.t.y
DtIBcriat.ipll
Prico par 8hZ' rotal Value
COB 3/27/97 I!mI 'J/2'U.n
. .
98.30 . 24,57!1.00
:UI.875 . 10,350.00
29.50 $ 5,310.00
26 .12$ $ 5,225.00
26.125 . &,925.00
201 . 875 . 01, 9'1!1. 00
211000 DR Sout.ht~t Bank
of ALA 7.06\ 9/01/08
&00 laak ..w tOJ:'k IDa PFD B
..n
180 ICarr11l Lynch , Co. PFD A
9.0\
200 JIIJUL Corp. PYD A
7.5\
2130 Allstata rinauciag prD I.
7.9511
200 rrlvolers PIC Pf4 A
8.0n
200 Public S90 BIG prD B
8.0'
26.875
. &,975.00
fM~.. tInh.............HIft
_~...............N.......-I
........ .. ....... ..... .. ...........
............... .............".......-
..............-.........,..........,
_ _Nt """._L$..
03: 03PM I'L H'V<RISIlRG PA
"
, ";::V4
"
,
~ ..rrlll Lynch
"
110 GraDd Met.ro Del LP PPD A 21.875 . 5.017.lIO
9.'H
8:S0.U3 IlL Corp Bd Interm 'ralC'lll II 11.,lB . 9,28f..58
1759.381 IlL Global Allocat.ion B 111.64 . 29,'157.3'
1714.277 BatoD Vance Prt.e Rate a.v 9." . 17,125.&3
10.033 AlliBDou .orth Aml1riclUl. Govt 7.82 $ 78.46
Inc~ Trus~ Cl a
IlL Raa"]' 1l8!J8t.lJ TZ"Ilst. Ibl]' IIkt 1.00 . !I,629.9ll
Cash . 3'3.16
'1'O'1'AL I $123,&12.32
'.
172-05367 Robe~ L. Shindler, M.D. PllJI.siOD Trust.
no Bonnie iI. Crahlllll
OUIlDt.ij;J: IlPllcri.ption Price PIIU:' Shr !rota! Value
COB un/97 t!I!'IR 3127/97
5000 IlK General "tn kcpt 95.375 $ &,76B.75
5.771li 3/01/01
38000 u.s. Treasury Strips 91.9' . 3&,937.20
0' 8/15/90
200 Sinon Debartolo Group 30.375 $ 6,075.00
377.311S IlL Corp lSel High InCDIIIIII II 7.9' f 2,9516.22
7.110 AlliaDce Mortgage Secs 8.40 . !l9.72
Inco_ Cl D
leI. had]' AlIlli1ts 'rns t lID]' IIkt 1.00 . 2,640.26
Cash * 94.'i. 27
'.I:OUI.1 . 52,4.23.U
I'hi~;~ 111 l'n:il'r 111.11 Ihl' iJllmJlI;lIioll hCl(' V,IVt'll i~ \lfllt'tll~ lllph',IIHllll ,t11 11('~',lll.d H'rlilil,IlC OJ' dnlll dldl' IlIl'd wirh IIII' ,1\
Int,d Hq',i'\ILII, The oril~i"al t(nili\',!It, will hI' IllIW,lldt'd HI tl\l' ~d.I!I' \H.d !(l'llllll\ ('JIlItt' I~II Pt'llll.lIlt'lll lilil";,
WARNIN~; It 18 IlIogollo dupllcato this ccpy by photoslnl or photograph,
h.t for Ihl.. l'i~njnClIH', $LOll
/I '/
'f~..u.(Ht""'1''''- 1.'c<l..t,,)~/f.utl,
11l\.1I 1{(:;&~llflll t' I
4175963
''12'1' .)
t" : -.:. 'f to
. ..M.c.4....2LJI..'L,2..-_...
, " rf:W!
No,
H1~H~It..lJl1
OOMMONWSALTti Of PIl;NNSVlVANIA' OliflARTM8NT OF HEALTH' VITAL AIOOA08
CERTifiCATE Of DEATH
~
~
'Wlj~I'AAlNA
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I
Chapter VI
DISTRIBUTIONS
6.1 R~tirement Benefits
(A) (Retirement) Each Employee may terminate employment with
Employer and retire, under the terms of this Plan on or after his
Normal Retirement Date. or, if an Early Retirement Date is specified
in the Adoption Agreement, on or after his Early Retirement Date. An
Employee may postpone the termination of his employment to a date
after his Normal Retirement Date, in which case he shall continue to
participate in the plan until his actual retirement. Notwithstanding
the vesting schedule specified in the Adoption Agreement, each
Employeels right to his Aggregate Account Balance shall be nonforfeit-
able on and after his Normal Retirement Date, and, if Early Retirement
is permitted, on and after his Early Retirement Date provided that he
remains employed by the Employer as of (the earlier of) such date(s).
Each Employee's retirement benefit shall equal his Aggregate Account
Balance as of the Anniversary Date coincident with or next following
such retirement less applicable distribution fees. Once the amount of
retirement benefit has been determined, the Administrator shall, as
soon as administratively feasible, direct the Trustee to commence
distribution to such Participant pursuant to Section 6.7 of the Plan..
(B) (Benefit Commencement Without Termination) As of any date
on or after his Normal Retirement Date, a Participant may elect, in
writing to the Administrator, to have his benefits distributed as if
he had terminated employment as of the date of election. Notwith-
standing this election, such participant shall continue to participate
in the Plan until his actual termination.
6.2 Benefits in the Event of Death
(A,) (Death Before Termination of Employment) upon the death
of a participant before retirement or other termination of employment,
all amounts then credited to his account shall be vested as provided
in the Adoption Agreement. The death benefit shall equal the vested
and nonforfeitable percentage of such participant's Aggregate Account
Balance as of the Anniversary Date coincident with or next following
proof of death of such participant less applicable distribution fees.
Once the amount of death benefit has been determined, the Administrator.
shall, as soon as administratively feasible, direct the Trustee to
conunence distribution to the surviving Beneficiary pr.operly designated
by the Participant pursuant to Section 6.7 of the Plan.
-VI. 1-
(B) (Death After Termination of Employment) upon the death of
a participant after termination of employment, the death benefit shall
equal the value of any vested benefits not previously distributed, as
of the Anniversary Date coincident with or next following proof of
such Par.'I::icipant I s death, less applicable distribution fees. Once the
amount of death benefit has been determined, distribution to the
surviving Beneficiary properly designated by the Participant shall
commence as soon as administratively feasible pursuant to Section 6.7
of the Plan.
(C) (Designation of Beneficiary) Subject to the spousal con-
sent requirements, basis allocation requirements, and the terms of any
applicable Qualified Domestic Relations Order, each participant may,
at any time and in any manner satisfactory to the Administrator, do
any of the following:
(i) designate one or more Beneficiaries,
(ii) designate one or more contingent Beneficiaries, or
(iil) revoke or change his Beneficiary designation.
(D) (Beneficiary Designation Requiring Spousal Consent) The
designation of a Beneficiary other than the Participant's spouse shall
be deemed void with respect to the distribution to such nonspouse
Beneficiary of any benefits in excess of the percentage (as specified
in Section 1.2(AR) of the Adoption Agreement) of such participant's
veSted Accrued Benefit if the participant has been married to such
spouse for a period of one year and ha~ failed to obtain from his
spouse the following consents:
(i) consent to the Participantls waiver of Qualified
Preretirement Survivor Annuity or 'the Pre-age 35
Waiver, and
(ii) consent to the Participant's designation of one or
more specified nonspouse Beneficiaries, including
any class of Beneficiaries or any contingent
Beneficiaries.
The spouse's consent to the designation of a nonspouse Beneficiary
must be in writing and must acknowledge the effect of such consent
and be witnessed by a plan representative or a notary public. If
the spouse's consent cannot be obtained due to circumstances that
the Administrator finds reasonable and consistent with applicable
Regulations, then it shall not be required. A spouse's consent shall
be irrevocable unless otherwise specified. in which case it shall be
revocable but not after the participantls death. A spouse may consent
to the Participantls right to name replacement nonspouse Beneficiaries
without the need for subsequent spousal consent.
-VI.2-
(E) (Failure to Designate Beneficiary) If a participant
should die without having a proper Beneficiary designation in effect,
or should the Beneficiaries designated no longer be living, then the
Administrator shall direct the Trustee to distribute such
participant's benefits to his surviving ~pouse, if any; otherwise
(i)
to or for the benefit of anyone or more of his
relatives by adoption, blood, or marriage, and in
such proportions as the Administrator shall deter-
mine; Ot'
to the legal representative or representatives of
the estate of the last to die of the participant and
the Beneficiaries designated.
(F) (Preselection of Form of Benefits) A participant shall
have the right to specify in advance the time and form in which the
penefits to be provided in the event of his death shall be paid. Such
directive may be modified or cancelled by the Participant at any time.
Such directive shall be acknowledged by the Administrator and there..
after shall be binding upon the Administrator provided that a
participant who is or who becomes married elects to waive tho
Qualified Pr.eretirement Survivor Annuity and obtains spousal consent
to such waiver and to the form of benefit specified.
(11)
(G) (proof of Death) The Administrator may requl.re such
proper proof of death and such evidence of the right of any person to
receive payments on behalf of a deceased partiuipant as the
Administrator may deem desirable. For these purposes, the
Administrator's determination of death and of the right of any person
to receive payment shall be conclusive.
(H) (Basis Allocation -- Multiple Beneficiaries) If death
benefits are to be paid to more than one Beneficiary, then the amount
of any tax basis that a Particj,pant may have in his Aggregate Account
Balance shall be allocated in the same proportion as benefits are
apportioned, unless the participant shall have previously specified
otherwise to the Administrator.
(I) (Waiver of Qualified prer.etirement Survivor Annuity) Each
married participant may, at any time during the election period, elect
to waive the Qualified preretirement Survivor Annuity form of benefit
or elect to revoke any prior waiver. An election to waive the annuity
form of benefit shall not take effect unless the Participant obtains
spousal consent as provided below. The election period shall begin on
the first day of the plan Year in which the Participant attains age
thirty-five (35) and shall end on the date of the participant's death.
If a Participant separates from service prior to the otherwise appli-
cable pariod, then the election period shall begin on the date of his
separation from service.
-v!. 3-
E~ch unmarried participant shall be deemed to have effectively
waived the Qualified preretirement Survivor Annuity.
(J) (Explanation of Qualified Preretirement Survivor Annuity)
The Administrator shall provide to each married Participant a written
explanation of the Qualified Preretirement Survivor Annuity, including
the following items:
(i) the terms and conditions of Qualified preretirement
Survivor Annuity,
(ii) the Participant's right to make, and the effoct of
making, an election to waive the Qualified
Preretirement Survivor Annuity form of benefit,
(iii) the right of the participant's spouse to consent or
fail to consent to such waiver and
(iv) the Participant's right to revoke, and the effect of
revoking, such waiver.
(K) (Period for Providing Explanation of Qualified
Preretirement Survivor Annuity) The Administrator shall provide the
explanation of the Qualified Preretirement Survivor Annuity to each
participant within whichever of the following periods ends last:
(i) the period beginning with the first day of the Plan
Year in which such Participant attains age thirty-
two (32) Bnd ending with the close of the Plan Year
in which such participant attains age thirty-four
(34) ;
.. '=,. "'''~J''''',~~1.,1!;~''.''r!"
(ii) the period beginning one year before and ending one
year after the date such participant became a
participant.
(iii) if a plan ceases to fully subsidize the cost of the
Qualified Preretirement Survivor Annuity for such
Participant, the period beginning one year before
and ending one year after such event;
(iv) the period beginning one year before and ending one
year after the date that Section 401(a)(11) of the
Code first applies to such participant; or
(v)
if such participant separates from service before
age thirty-five (35), the period beginning one year
before and ending one year after such separation
from service.
-VI.4-
, ('
(L) (Spousal consent) A spouse's consent to 4 Participant's
Waiver of Qualified preretirement Survivor Annuity or pre-age 35
Waiver or to a Participant's preselection of a specified form of death
benefit shall be effective provided that:
( i)
(H)
(Hi)
it is in writing;
it acknowledges the effect of such election; and
it is witnessed by a plan representative or notary
public.
A spouse's consent shall be ir.revocable unless otherwise spec-
ified, in which calle it shall be revocable but not after the
Participant's death.
If spousal consent cannot be obtained because the spouse cannot
be located or due to other circumstances that the Administrator finds
reasonable and consistent with applicable Regulations, then it shall
not be required.
Any consent by a spouse obtained under this provision (or
establishment that the consent of a spouse may not be obtained) shall
be effective only with respect to such spouse.
(M) (Pre-age 35 Waiver) A participant who will not attain age
thirty-five (35) as of the end of a plan Year may make a special tem-
porary election to waive the Qualified Preretirement Survivor Annuity
for the period beginning on the date of such election and ending on
the first day of the Plan Year in which the participant will attain
age thirty-five (35). Such election shall not be valid unless the
participant receives a written explanation of the Qualified
preretirement Survivor ~1nuity in such terms as are comparable to the
explanation required under subsection 6.2(J) and obtains adequate
spousal consent. Qualified Preretirement Survivor Annuity coverage
will be automatically reinstated as of the first day of the Plan Year
in which the participant attains age thirty-five (35). Any new waiver
on or after such reinstatement date shall be subject to the full
requir.ements of this Section. A waiver pursuant to this subsection
shall be referred to as a "Pre-age 35 Waiver".
6.3 Benefits in the Event of Disability
(A) (Amount of Benefit) An express purpose of this Plan is to
provide a measure of financial security for a Participant in the event
of his Disability. If a Participant terminates employment due to his
Disability, all amounts then credited to his account shall be vested
as provided in the Adoption Agreement. The disability benefit shall
equal the vested and nonforfeitable percentage of such Participant's
Aggregate Account Balance as of the Anliiversary Date coincident with
-VI, 5-
SECTION
4.1
4.2
4.3
4.4
4.5
4.6
4.7
4.8
4.9
4.10
4.11
4.12
4.13
4.U
4.15
4.16
4.17
4.1B
PAGE
Chapter IV
CONTRIBUTIONS
Definitions and Special Rules
Contributions by Employer of Discretionary Contributions
Contribution by Employer of compensation Reduction
Amounts
Qualified Nonelective Contributions
Employee contributions -- Voluntary and Mandatory
Qualified Voluntary Employee Contributions
Employer Matching of Employee Contributions
Employer Matching of Compensation Reduction Amounts
Qualified Matching contributions
Transfers and Rollover Amounts
Exclusive Benefit
Limits on Elective Deferrals
Distribution of Excess Elective Deferrals
Actual Deferral Percentage Test
Distribution of Excess Contributions
Actual Contribution Percentage Test
Distribution of Excess Aggregate Contributions
Multiple Use of Alternative Limitations
IV.l
IV.7
IV.S
IV.10
IV.10
IV.11
IV.12
IV.13
IV.13
IV. l40
IV.15
IV.16
IV.16
IV.17
IV.1B
IV.19
IV.20
IV.22
Chapter V
ALLOCATIONS
5.1 participants' Accounts V.l
5.2 Allocation of Discretionary Contributions V.1
5.3 Allocation of compensation Reduction Amounts V.2
5.4 Allocation of Qualified Nonelective Contributions V.2
5.5 Allocation of Employee contributions V.3
5.6 Reserved V.3
5.7 Allocation of Matching contributions Due to Employee V.3
Contributions
5.B Allocation of Matching Contributions Due to Compensation V.3
ReductJ.ons Amounts
5.9 Allocation of Qualified Matching Contributions V.3
5.10 Allocation of Rollover Amounts and Transfer. Amounts V.4
5.11 Allocation of Forfeitures V.4
5.12 Allocation of Net Investment Income V. 4
5.13 Other Pa~ticipant Allocations V.5
5.14 Limits on Defined Contribution Plan Allocations V.6
5.15 Limits on Defined Contribution and Defined Benefit Plans V.B
"11-
" ';";""","l\-"'U','.'k"""~" '
.~ ...
Ohapter VI
DISTRIBUTIONS
6.1 Retirement Benefits
(A) (Retirement) Each Employee may terminate employment with
Employer and retire, under the terms of this Plan on or after his
Normal Retirement Date, or, if an Early Retirement Date 1.s specified
in the Adoption Agreement, on or after his Early Retirement Date. An
Employee may postpone the termination of his employmen'c to a date
after his Normal Retirement Date, in which case he shall continue to
participate in the plan until his actual retirement. Notwithstanding
the vesting schedule specified in the Adoption Agreement, each
Employee's right to his Aggregate Account Balance shall be nonforfeit-
able on and after his Normal Retirement Date, and, if Early Retirement
is permitted, on and after his Early Retirement Date provided that he
remains employed by the Employer as of (the earlier of) such date(s).
Each Employee's retirement benefit shall equal his Aggregate Account
Balance as of the Anniversary Date coincident with or next following
such retirement less applicable distribution fees. Once the amount of
retirement benefit has been determined, the Administrator shall, as
soon as administratively feasible, direct the Trustee to commence
di,stribution to such Participant pursuant to Section 6.7 of the Plan.
(B) (Benefit Commencement Without Termination) As of any date
on or after his Normal Retirement Date, a Participant may elect, in
writing to the Administrator, to have his benefits distributed as if
he had terminated employment as of the date of election. Notwith-
standing this election, such Participant shall continue to participate
in the Plan until his actual termination.
6.2 Benefits in the Event of Death
(A) (Death Before Termination of Employment) Upon the death
of a Participant before retirement or other termination of employment,
all amounts then credited to his account shall be vested as provided
in the Adoption Agreement. The death benefit shall equal the vested
and nonforfeitable percentage of such participantls Aggregate Account
Balance as of the Anniversary Date coincident with or next following
proof of death of such Participant less applicable distribution fees.
Once the amount of death benefit has been determined, the
Administrator shall, as soon as administratively feasible, direct the
Trustee to commence dist.ribution to the surviving Beneficiary properly
designated by the pat'ticipant pursuant to Section 6.7 of the Plan.
~VI.1.,.
(B) (Death After Termination of Employment) Upon the death of
a Participant after termination of employment, the death benefit shall
equal the value of any vested benefits not previously distributed, as
of the Anniversary Date coincident with or next following proof of
such Participant's death, less applicable distribution fees. Once the
amount of death benefit has been determined, distribution to the
surviving Beneficiary properly designated by the participant shall
commence as soon as administratively feasible pursuant to Section 6.7
of the Plan.
(C) (Designation of Beneficiary) Subject to the spousal con-
sent requir(lments, basis allocation requirements, and the terms of any
applicable Qualified Domestic Relations Order, each participant may,
at any time and in any manner satisfactory to the Administrator, do
any of the following: .
(i) designate one or more Beneficiaries,
(ii) designate one or more contingent Beneficiaries, or
(iii) revoke or change his Beneficiary designation.
(D) (Beneficiary Designation Requiring Spousal Consent) The
designation of a Beneficiary other than the Participant's spouse shall
be deemed void with respect to the distribution to such nonspouse
Beneficiary of any benefits in excess of the percentage (as specified
in Section 1.2(AR) of the Adoption Agreement) of such participant's
vested Accrued Benefit if the participant has been married to such
spouse for a period of on6 year and has failed to obtain from his
spouse the following consents:
(i) consent to the participant's waiver of Qualified
Preretirement Survivor Annuity or the Pre-age 35
Waiver, and
(1i) consent to the participant's designation of one or
more specified nonspouse Beneficiaries, including
any class of Beneficiaries or any contingent
Beneficiaries.
The spousels consent to the designation of a nonspouse Beneficiary
must be in writing and must acknowledge the effect of such consent
and be witnessed by a plan representative or a notary public. If
the spousels consent cannot be obtained due to circumstances that
the Administrator finds reasonable and consistent with applicable
Regulations, then it shall not be required. A spouse's consent shall
be irrevocable unless otherwise specified, in which case it shall be
revocable but not after the Participantls death. A spouse may consent
to the participant's right to name replacement nonspouse Beneficiaries
without the need for subsequent spousal consent.
-v!. 2-
(E) (Failure to Des ignat,e Beneficiary) If a Participant
should die without having a proper Beneficiary designation in effect,
or should the Beneficiaries designated no longer be living, then the
Administrator shall direct the Trustee to distribute such
participant's benefits to his surviving spouse, if any; otherwise
(i)
to or for the benefit of anyone or more of his
relatives by adoption, blood, or marriage, and in
such proportions as the Administrator shall deter-
mine; or
to the legal representative or representatives of
the estate of the last to die of the Participant and
the Beneficiaries designated.
(F) (Preselection of Form of Benefits) A Participant shall
have the right to specify in advance the time and form in which t.he
benefits to be provided J.n the event of his death shall be pa:l.d. Such
directive may be modified or cancelled by the Participant at any time.
Such directive shall be acknowledged by the Administrator and there-
after shall be binding upon the Administrator provided that a
participant who is or who becomes married elects to waive the
Qualified Preretirement Survivor Annuity and obtains spousal consent
to such waiver and to the form of benefH specified.
(11)
(G) (PL"oof of Death) The Administrator may require such
proper proof of death and such evidence of the right of any person to
receive payments on behalf of a deceased Participant as the
Administrator may deem desirable. For these purposes, the
Administratorls determination of death and of the right of any person
to receive payment shall be conclusive.
(H) (Basis Allocation -- Multiple Beneficiaries) If death
benef.its are to be paid to more than one Beneficiary, then the amount
of any tax basis that a Participant may have in his Aggregate Account
Balance shall be allocated in the same proportion as benefits are
apportioned, unless the Participant shall have previously specified
otherwise to the Administrator.
(I) (Waiver of Qualified Preretirement Survivor Annuity) Each
married Participant may, at any time during the election period, elect
to waive the Qualified Prer.etirement Survivor Annuity form of benefit
or elect to revoke any prior waiver. An election to waive the annuity
form of benefit shall not take effect unless the Participant obtains
spousal consent as provided below. The election period shall begin on
the first day of the Plan Year in which the Participant attains age
thirty-five (35) and shall end on the date of the Participant's death.
If a Participant separates from service prior to the otherwise appli-
cable period, then the election period shall begin on the date of his
separation from service.
-VI.3-
Each unmarried Participant shall be deemed to have effectively
waived the Qualified Preratirement Survivor Annuity.
(J) (Explanation of Qualified preretirement Survivor Annuity)
The Administrator shall provide to each married Participant a written
explanation of the Qualified Preretirement Survivor Annuity, including
the following items:
the terms and conditions of Qualified Preretirement
Survivor Annuity,
the participant's right to make, and the effect of
making, an election to waive the Qualified
Preretirement Survivor Annuity form of benefit,
(iii) the right of the participantls spouse to consent or
fail to consent to such waiver and
(i)
(11)
(iv)
the participant's right to revoke, and the effect of
revoking, such waiver.
(K) (Period for Providing Explanation of Qualified
preretirement Survivor Annuity) The Administrator shall provide the
explanation of the Qualified Preretirement Survivor Annuity to each
participant within whichever of the following periods ends last:
(i) the period beginning with the first day of the plan
Year in which such participant attains age thirty-
two (32) and ending with the close of the Plan Year
in which such Participant attains age thirty-four
(34) ;
(ii) the period beginning one year before and ending one
year after the date such Participant became a
Participant.
(iii) if a plan ceases to fully subsidize the cost of the
Qualified Preretirement Survivor Annuity for such
Participant, the period beginning one year before
and ending one year after such event;
(iv) the period beginning one year before and ending one
year after the date that Section 401(a)(11) of the
Code first applies to such Participant; or
(v) if such participant separates from service before
age thirty-five (35), the period beginning one year
before and ending one year after such separation
from service.
-v!. 4-
(L) (Spousal Consent) A spouse's consent to a Participant's
Waiver of Qualified preretirement Survivor Annuity or Pre-age 35
waiver or to a Participantls preselection of a specified form of death
benefit shall be effective provided that:
(i)
(11)
(i11)
it is in writing;
it acknowledges the effect of such election; and
it is witnessed by a plan representative or notary
public.
A spouse's consent shall be irrevocable unless otherwise spec-
ified, in which case it shall be revocable but not after the
Participant's death.
If spousal consent cannot be obtained because the spouse cannot
be located or due to other circumstances that the Administrator finds
reasonable and consistent with applicable Regulations, then it shall
not be required.
Any consent by a spouse obtained under this provision (or
establishment that the consent of a spouse may not be obtained) shall
be effective only with respect to such spouse.
(M) (Pre-age 35 Waiver) A Participant who will not attain age
thirty-five (35) as of the end of a plan Year may make a special tem-
porary election to waive the Qualified Preretirement Survivor Annuity
for the period beginning on the date of such election and ending on
the first day of the Plan Year in which the Participant will attain
age thirty-five (35). Such election shall not be valid unless the
participant receives a wr.itten explanation of 'the Qualified
Pr.eretirement Survivor Annuity in such tet'ms as are comparable to the
explanation required under. subsection 6.2(J) and obtains ade~late
spousal consent. Qualified Preretirement Survivor Annuity coverage
will be automatically reinstated as of the first day of the Plan Year
in wh1.ch the Participant attains age thirty-five (35). Any new waiver
on or after such reinstatement date shall be subject to the full
requirements of this Section. A waiver pursuant to this subsection
shall be referred to as a "Pre-age 35 Waiver".
6.3 Benefits in the Event of DisabJ.l1 ty
(A) (Amount of Benefit) An express purpose of this Plan is to
provide a measure of financial security for a Participant in the event
of his D1.sability. If a Participant terminates employment due to his
Disability, all amounts then credited to his account shall be vested
as provided in the Adoption Agreement. The disability benefit shall
equal the vested and nonforfeitable percentage of such Participant's
Aggngate Account Balance as of the Anniversary Date co1.ncident with
-VI.5-
, . It. .
LAST 1,HLL AND 'l'ESTAHENT
I, BOI~IUl!: J, GRAHAM, of the Township of Sit ver Spring, County 0 f
Cumberland and State of Pennsylvania, being of sound mind, memory and
understanding, do make, publish and declare thi~ to be my last Will and
Testament, hereby revoking and making void all former wills, codicils
and other testamentary disPositJons by me at ony time heretofore made.
1..
I direct my executor, hereinafter named, to pay as soon as prac-
tioable after my decease all my just debts and the expenses of my
last illness and burial.
2.
I give, devise and bequeath all of my estate ~ real,personal and
mixed - unto my husband, Floyd A. Graham, absolutely,
3.
Should my said husband predecease me, then and in that event, I
give, devise and bequeath all of my said estate unto my children,
Brenda J. Shettel, Richard B, Graham, Sandra L. Leach, Robert F.
Graham and William E. Graham, equally, share and share alike,
ll,
I nominate, constitute and appoint my husband, Floyd A. Graham,
executor of this my last Will and Testament. Should my said husband
fail to qualify or cease to act as executor, I hereby appoint my
daughter, Brenda J. Shettel, and my son, Richard B. Graham, and the
survivor of them, executors of this my. last Will,
IN vlITNESS IlliEREOF, I, BONNIE J, GRAHA/1, the testatrix, have
hereunto set
this Silk
my hand and seal to this my last Will and Testament on
day of /)1...(1,..1 .c' I..~.,
, 1980.
. ,1
~ C 1/
/ . .. \. ~!I .
..,(; ) ;;-I:.;l-(.(.~. ~:~~A~,~:n1 j (SEAL)
CERTIFICATIQRQElillIlc.F",!.LNDER RULE 5,6(A)
'" , '10..
" .{I ll.
, -II ~
"
.... " ~
'"
.. ~
0
.1f:. 0
\~ !
, "
, -< ...
::;;-,. "-
.... *
-t ~
NAME OF DECEDENT: lillNNJE ], KOHLHA&NK/A BONNIE.J. GRAHAM
DATE OF DEATH:. MARCH..21,J..291___.
WILL NO, .....2.197"00342
TO THE REGISTER:
~..-"~~."-~,_...--
I certify that notice of beneficial interest required by Rule 5,5(a) of the Orphan~' Court Rules
was served on or mailed to the following beneficiaries of the above"captioned estate on
April 23. 1997:
N~
ADDRESS
!,l1Smd!l 1. Shettel, 70'U]1afibr StreetJ.llilliI~!1nsvlvania 17025
&i.cMrd B, GTllham. 21 Beechcliff prive, C&slisle. Pennsylvania 17013
~L~3Jke/' 404 West Penn Stret'J....Jdlfllli.le. Pennsylllnia 17013
Robert F. Graham....104 Cornl!\l!.n Drive. Newvilie. Pennsylvan.ilt 17241
William E. Graham. 34 South}vfont priye. Enola~nsylvania 17025
Earl e, KohlhaaLlt8 Margaret Drive. Mechanmurg. Pennsylvania 17055 ..
Notice has now been given to all persons entitled thereto under Rule 5,6(a) except: NONE
DATE: {)'1 ./f11
(g/l~(ft1.
S'i nature 1-
Name~WJLLIAM A DUNQ~
Address I IRViNE ROW
CARLISLE. PENN, 17013
Telephone 717-249-7780
Capacity:_ Personal
Representative
'0
f'\
I{)
N
rl.
..1L Counsel for personal
representative
~)Jt::
,i-i'"
~
I
1$
:r;,
L,_
() ;;'~~i'
() (D
'"0::
cc
05-11-98
KOHL HAAS
03-27-97
21 97-0342
CUM8ERLAND
101
~._..~._ ANlO~E!:~~~~~_[===l
l.___.__________....J
MAKE CHECK PAYABLE AND REHIT PAVH~NT TOr
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ....
ii-Eli: is'4-j- EX -A jiii - j iiF9'iT - NiiT"i c r -OF" "fHHEii i i' i.ifc Ii - T"i. X - jip PRA"iii iiif€Ni'"; -A L i"owi.iic Ii - OR - - - - - - - - -. - - - - - --
DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
BONNIE J FILE NO. 21 97-0342 ACN 101
If an assessment was Assued previously, lin81 14. IS and/or 1&, 17 and 18 will
reflect figures that include the total of 6.1J.. returns assessed to dab.
ASSESSMENT OF TAXI
IS. Anount of line 14 .t Spous.l
1&, Anount of Line 14 taxable .t
17. Anount of line 14 taxable .t
18, rrlno!pal Tax Due
/5:/7" .j/
COHHONWEAl,TH OF PENNSY~VANIA
DEPARTHENT OF REVENUE
BUREAU OF INDIVIDUAL TAKES
IHtl[RITANCr TAl< 1I1VISIOH
DEP', 1'80601
IIARRISBURO, PA tn14.060}
NOTICE Of IIU1ERnANCE TAK
APPRAISEMENT, AU.DWANCE OR DISALLOWANCE
OF DEDUCl'IONS AND ASSESSMENT OF TAR
WILLIAM A DUNCAN
DUNCAN 8 OTTO
1 IRVINE ROW
CARLISLE
DATE
ESTATE OF
DATE OF DEATH
FILE NUHBER
COUNTY
ACN
PA 17013
ESTATE OF
KOHLHAAS
TAK RETURN WAS I 1 X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..l EJltat. (Sch.dul. A)
2. Stock. end Bonds ISah.dul. B)
3. Clos.ly Held stock/Padnar..hip In'tar.at (Sflh.dul. CJ
4. Hortuag../Not., R.c.\y~bl. CSch.dula Dl
S. Cash/Bank Depoaits/Hise. Perlonal Proparty (Schadule E)
6. Jointly Owned Property (Schedula F)
7. Tranlfers ISch8dule G)
8. Total Auah
CHANGED
(11
(2 ~
(3)
(41
(51
(61
(7)
,00
...Q.1L
,00
,00
3,281.56
,00
....!UL
(B)
APPROVED DEDUCl'lONS AND EXEHPTIONS:
9. Funeral ~xp.ns.I/^d~. Costs/Hi.c. Expen~as (Schedule H)
10. Debts/Hortg.ge Liabilitie./liena (Sch.dul. I)
11. Total D.duct!t\ns
12. Net V.lue 0" Tax R~turn
13. Charitable/GovernMantal aaqu..ts, Non~.l.ct.d 9113 Trust. (Sch.dule J)
14. N.t V.lu. of Est.t. Subjact to Tax
(91
(10)
7,418,40
192,56
(111
(121
(13)
(141
Nonl
rat.
line.l/CleR. A rat.
Col1etara1/Clasl B ret.
,00
,00
,00
K ,00=
K ,06.
K ,15=
(1B)
(151
(161
(171
TAX CREDITS:
PAVMENT
DATE
RECF.lPT
NUMBER
DISCOUNT 1+)
INTEREST/PEN PAID (-)
AMOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FDR CALCULATION OF ADDITIONAL INTEREST.
I
C--'
*'
In '1'" I~ ~" III ."1
80NNIE
J
DATE
05-11-98
NOTE I To in.ure pr'oper
cradit to your account I
SUbMit the upp.r portion
of this for. with your
tax paYlllent.
3,281.56
7.610 96
4,329,40-
,00
4,329,40-
,00
,00
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IF TOTAL DUE IS l~SS THAN '1, NO PAVMENT IS REQUIRED,
IF TOTAL DUE IS REFLECTED AS A "CREDn" 'CRl, YOU MAV BE OIlE
A REFUND, SEE REVERSE SIDE OF THIS FORM FDR INSTRUCTIONS.)
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RESERVATION, E.t~t.. of OIold,nt, dying'on or b.fore Dlo,.ber 12, 19~Z .. If env 'ut~r. inter..t 1n thl .,tat. J, tran.f.rr.d
In po.....lon ot .njov..nt to Cl... a (0011.t.r.l) blnoflel,rl,. of the dlCldent ,'t,r the IKplr.tlon afnny ..t.t. for
lU_ 0" for. yur., the COllllonwealth hereby IlCpr...1y ,...orllll the right to appraise and ...... tranlf'r InhlrJtenu hlC..
at thl lawful CI... B (colht,r,U rat. on tny .ueh future Int.rut.
PURPOSE OF
NOTICE I
PAVMENT:
REFUND (eM) I
OIlJECTIONS.~
ADHIN
ISTRATIYE
CORRECTIONSI
DISCOUNT I
PENAL TV,
INTERESTl
To fulfill th_ rlqulr4lllnh of s.otton 2140 of the Inh.r~t'nG' and E,tlt, TIM Aot, Aot 21 of 1995. <12 1'.5.
Slotion 9140),
Oetaoh the top portion of thll Notioe l!Ind .ub.1t wUh YOl.lr pa!iM.nt to the Reghter of WIlh prlnte.; on the r.ver.. .ide.
"Make check or lIon.y order paynblu tal REGISTER OF MILLS, AGENT
A r.fund of B taM or.dit, which was not rqqulltld on the Tax Return, May b. requ..t.d by cOllpletlng an "ApplJcatlon
for R.fund of P'nn.~lv.nla Inherltanc. tlndElttlte Tal<" (REY-Ul3)' AplllloaUon. are BYalleble at t.. Offlc.
of the k.tl.ter of Will., any of the Z3 R.v.nue Ol.trlct Offloe., or by calling the .p.ol~l 2q-hour
an.werJng ..rvAo. nuMber. for for.. crd.rl~gl In Penn'Ylvanla 1~800-362~l050, out.lde Plnnlvlvanla and
within looal Harrl.burg ar.. (717) 7a7~8094, TaOI (111) 772~22S2 (H.arlng IMpalr.d Only).
Any, party In Inter..t not ~atilfl.d with the appral....nt, allowanc. or dllallowanc. of deductlonl, or a.,.II..nt
of tax (Inoludlng dhccunt or interut) a. .hown on thh Notlo. Ilu.t Object wUhl" .hlb (60) day. of rl(l.Jpt of
thh NoticI t'lyl
~-wrttt.n prote.t to the PA Depart..nt cf R.venuI, Board of App..l., D.pt. 281021, Harrl.burg, PA 17128-1021, OR
~-.Iectlon to h.v. the ..tt.r d.ter.ln.d at ludlt cf thl account of the plr.onal rlpre..ntatlv., OR
--apPlal to thl Orphan.' Court,
Faotl.laJ error. di.oov.r.d on thl. a.......nt .hould bl ~ddr....d In writing tOI PA a.part.ent of RevenUl,
Burnau of IndlvJdl.la1 Ta~e., ATTNI Po.t A....a..nt Rlvl.w Unit, alpt, 280601, H.rri.bl.lrg, PA l11ZI-0601
Phone (717) 187~6S0S. S.. page S of the bookiet "In.tructlons for Inherlt.nee 1I~ Rlturn for. Ruldent
Pecedent" (REV-IS01) for .n .~pianatJon of .o.lnl.tratlvely carr.otabl. .rror..
If any tax due It paid lIlthin three (5) calandar 1I0nth. aftar the d.ced.nt', death, . flv. perc.nt (S:O discount of
the tax paid It allowed.
Th. IS% t.1< aMnuty non-participation plnalty Is cOllpubd on the total of the tal< and Inter..t .......d. end not
pmld b.for. Januor~ 18, 19~6, the flr.t day aft'r the end of the tax ..na.ty p.rlod. Thi. non-participation
p.naJt~ Jo app..Jebl. In the .a.. ..nnlr and In the th..... tl.. p.rlod a. ~ou would app.al th_ tax and Intlra.t
that h.. b.en .......d a. Indlcat.u on thl. notl~e.
Jnt.r..t A. en.rgod b8gJnning with flr.t day of delinquenoy, or nine (9) .ooth. .nd one 11) day fro. the date of
death, to the d.t. of pay.ant. Tax.. which bloa.. d.llnqu.nt b.for. January 1, 1982 b.ar Int.r..tat the rat. of
.Ix (6%) p.ro.nt p.r annuli oalculat.d It a dally rftte of .000164. All tax.. which beam., d,llnquent on and .ft.r
January 1, J982 will blar Int.r..t at a r.te which will vary fro' oal.ndar year to c.l.nd.r y..r with that r.te
announcod b~ the P~ Depart..nt of Rlv.nu., The appllcabl' Interut rlt.. for 198? thro~lgh 1998 lIrel
'!!!!: Interut R.te Dally Interut Factor U!r Inhr..t Rate DailY Inter..t Factor
1"2 20:< .000548 1981 9% .000247
1985 16% .0(/0433 1988~1991 11)( ,000301
1984 1l~: ,000301 1992 9)( .000247
1985 13lC ,0005S6 1993~1994 1% ,000192
1986 10:< ,000Z14 1995~19'}8 9)( .000Z47
--Inter..t Is C.l0~IJat.d .. follow.:
INTEREST. BALANCE DF TAX UNPAID X NUMBER OF DAYS DF.LINqUENT X DAILY INTEREST FACTOR
-.Any Notlc. IlIu.d after the ta~ blcOII.. dellnqulnt will refl.ct In Inter..t calcl.llat!o/\ to flft..n (IS) day.
beYond thl date 9f the I.......nt. If pay.ent I. IIHd. after the Int.r..t cOlpl.ltntlon data .hown on thl
'.0\10', additlonlll Inter..t IIUtt b. c.lculated,
2!..ATUS J.~.~!'.PB_'t.J!1l()Er~~~Y.!!!l'y.-,-12
Name of Decedent:~)nl e. :r~A /JJaa:....S
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:::: ::. D;a;lq7~~ 0~)3!/~=~~'Admin, No.
Pursuant to Rule 6,12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1, State~ther administration of the estate is complete:
Yes No .
-- .~-- -, -.--.-.--
2. If the answer Js No, state when the personal
representative reasonably believes that the administration will be
complete: ____.__
3. If the answer to No, I is Yes, state the following:
a. Did the personal rep;;-ssentati ve file a final
acc:ount with the Court? Yes____..... No...J(_,
b. The sOpill'ate Orphans' Court No. (Jf any) tor
the personal representative's account is:
c. Did t.he persona 1 l'epres('nt.ative s~/e
account informally to the part.Jes In interest7Yes
an
No
--.
d, CDpies 0 f receipts, re leases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
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Name (Pleas_e type or print)'-
L Tf2il1l f K8 /.l-.), L!.i1f2L{ c;/-<" ~._
Address I
(1/7 L21;/!l.. 77 y()
Te I, No,
Date:3: /6 .{le;
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CapacitYI Personal Representative
!\\Cbunsel for personal
(representative
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