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Inventory of the real and personal Ilstate of
e.:,
Mnriu A. Sutton
. deceased
PERSONAL PROPERTY
1 mc Ole<"'..king Account #5080532607 plus accrued interest of 0.74
to OOD
95 .22
.80 ,
25,87 .00
49,33 .53
50,00 .00
33 .15
30 .49
.99
56 .70
35 .50
4 .70
49 .92
7 .20
49' .48
3,20 .00
297,08 .50
3,94 .24
47 .03
61,84 .62
11,49 .98
$523,068
2 Bell Atlantic Refw'd
3 mc Certificate of Deposit #21001019744 @7.25% due 5/18/98
4 Harris Savirqs Bank Certi.ficate of Deposit #272070 6.49% due
9/29/97
5 }\1ll8rican Enterprise Life Insurance Annuity Contract
#9920-3156581
6 American Travelers Life Refund of unearned Premi\.Dl1
7 Paid Prescriptions, u.c, Phamacy Benefits
8 Tristan Association Radiology Redeposit of CK#352351
9 Penn Treaty Life Insurance Co. Long Texm Care Payment
10 Personal Property - Proceeds from Sale
11 Kirke-Van Orsdel Refund of unearned Prem1\.Dl1
12 Marie SUtton Trust #2727001-3134870 Dividend and Interest Income
to 000
13 Patriot News Refund
14 Diversified Pharmacy Benefit
15 American Travellers Life Policy #521665 HIP-4 Hospital Income
Plan
16 Principal Cash held in Marie A. SUtton Revocable Trust
17 Income cash held in Marie A. SUtton ReVocable Trust
18 PSERS.Benefits - Health Care Reimbursement
19 Investors Trust Govt. Trust CLB (461809873) 7486.196 shares @
8.25
20 mc Bank corp. (693475105) 297 Shares @ 38.71375
21 Vanguard Wellirqton Fund (921935102) 630.12 shares @ 25.680
TOTAL PIIRSONAL PROPERTY
REAL PROPERTY NONE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
III
---'~r _<_ ____ __~".._~___~._._<_~~.~_._~,___.___..___.
Robert W. lIalnlnllk"r
boln9 duly --~-_.__" Hwo_rll.,_, accol'dln9 to law, depo.es and say. th.~ hi
~_...--_..~.. C._ ..u_____.__...... of the Estate of MllrJ~J!litton
late of_,_1.owo.r -Allen 'rowl1HhJI'. .. -.. . - -- .."---.___.~.._, Cumbllrland County, Pa., dlceased and that the
within i. "I inventory modo bY_...,.-Robe.r.t__W,~}jllmm!lker ,_ ___ " the ..Id.....!!;xecutor
of the entire e.tato of .aid doc.denl, con.l.tln9 of all the persnoal prop~rty and r..1 o.tate, except real esht. outside
tho Commonwealth of Ponlllylvanla, and that the fl9ure. oppo.ite each item of tho Inventory repro..nt it'. fair value
.. of the date of decedent'. death,
iA Executor
-----
19_.__
e'W~/~4H4~~
Ro be r t W. e..cut.. . -AdoUolu<&l.ot
Hammaker
111h Pllxt~reet
and ,ub.crlbod bofe" me,
Harrisburg, PA 17111
Md....
D~te of Death
12
D.y
Oh
Month
1997
Y..,
INSTRUCTiONS
I. An inventory mutt be filed withIn three month. .fter .ppointment of pe"o"al representative.
2. A .upplement Inventory mu.t be filed within thirty day. of di.covery of .dditll/nal a"lts.
3. Additi"".1 .heets may be .thched .. to personalty or realty
4. . See Article IV, Fiduciarie. Act of 1949.
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REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
.-------.-~~I^l lJ::f.'('ji:;;:T-"~"---"c_._'
l\EV"HiDO EK + (1..~7)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 200001
HAf\BISBURCl, PA 11!,20-DOD1
1. Roal ESlalO (Schodulo A) (1) None
2. Slocks and Bonds (Schodulo B) (2) 89,520.31
3. Closely Held CorporaUon, Partnorshlp
or Sole-ProprietorshIp (3) None
4, MOr1gages & NOIDS Receivable (Schedule D) (4) None
5. Cash, Bank DeposIts & Miscellaneous Personal
Property (Schodule E) (5) 433,548.45
O. Jolnlly Owned Proporty (Schodulo F) (6) None
7. Inter-Vivos Transfers & Mlscollaneous
RECAPIT - Non..Probalo Proporty (Schodulo Cl or l) (1) 0.00
IJLA TION
6. Total Gross Asseta (10101 Lines 1-1) (0)
9. Funflral E>cpanses & AdmlnlsUallvo Costs (Schedule H) (9) 47 ,990. 5'0
10. Debts 01 DElcodent, Mo/1g. UablUUes, & Liens (Sr,h, I) (10) 23,569.87
11. Total Deductions (Iolall.lno' 9 & 10) (11)
12. Net Value of Eatat. (L1no 8 mlnu, Line 11) (12)
13. CharllabltJ and Governmental Boquesls/Soc 9113 Trusts
lor which an olBellan to lax has not baen made (Schedulo J) (13)
14, Nel Value Sub eollo Tax Une 12 mInus Uno 13
15. Amount of line <j4
taxable at the spousal
tax rale
See Instructions on pago 2 lor appllcablo porconlago
16. Amount of line 14
taxablo al 6% rale
17. Arnollnl of line 14
laxftblenl15%rnlo 180,603.36 '.15 (17) 27,090.50
10. Tax Due (181 27,090.?,Q_
19. CHECK HERE IF YOU ARE REQUESTI:~G ~REFUND OF AN OVERPAVMENT I ,___
>> BE SURE TO ANSWER ALL QUESTIONS ON PAGE 2 AND RECi1ECK MATH <<
Under penalties 01 porjury, I declare Ihall have (l)(llmmod OllB fUtllfn. Including accompanying oclledulos and alatemenlfl, and to lhe besl 0' my knowledge
and bellel, It ls!:ue, conocl and comploto. Doclmatlon 01 prop<\ror nlllOr than lilt! pursorml HJprosonlativo Is ba~md..::n aU Inlo,mallo/l 01 whICh preparer haR
any knowledge. . .__.._____________.____ . ,,,.--
~lON.4TUA Of Pf.f\SO~ REsrONSIBl f. fOR r-IUNIi HfTlJflli ^(If)f([~;'; rIAl[
"'I-:.J. (, . t >ji;(.":L!.L~g'!t See Schedule i1tt..clched (- 'f'-', ~
",d~TUr\E O,.I'A'PAA'n,o"I~""II'" ,,,,\IIVI '-,11[11"", flATE /It? . .'.(}..~
_'" '/.. . "--" " '~' ....".....".,.l.6()~1 Marke!.~!::!'e~hJ":~ ['<!X 42933 .-L_~'..L,--
.. PA150Dl NT""",, 'IlK;,. .:'..:,,~\PhiJadelphia, PA 19103
CopY/lght F,lIrlls SoltwlIfll Unly, \~~y Nolet!, Ill".
DECEDENT
CHECK
APPRO-
PRIATE
BLOCKS
COR RES..
P(lNDENT
TAX
COMPUTA-
TION
.._-_.__._----._--._----_.._-_._~-._~---.
._----_._---..-._..._._.__._._._~-_.
riLE NUMBER
t?2?
NgJ;1.~
1:I!iJNM:onE
----~-_.-----_._,.~.._'.
-, ._-~~-~._---.-
DECEDENrs ~IAME (LAST, FIRST, AND MIDDLE INITIAL)
Sutton Marie A.
SOCIAL SECURITY NUMBER DATE or OEATH
195-07-5952 04J:21.27 _
(IF APPLtCAfllE) SllAVIVINO f,POLJ5f'5 NAME (t-MH. SOCIAL SEGURITY NUMBER
!'IAST, AND MIDDLE INITIAL)
. ---
1. Original Return 2. Sllpplemontal Roturn
II . dE 48 Fulu(lllnt,rllll Comfl/nmlBlJ
4. mto state ' (dal, olllUlh "itCH !2-ll-tl21
6 Dellldent DI,d TIIII"11 7 bleed.n! Maint""ltu a LlvlnflTnal 0
. (Allaeh copy 01 Will) . (AHach cOllyol TIUIH 8, Tolal No. 01 Safo Deposit Sm(Ba
9 llll oll"n Proceed. Received 10, .'3pouul floY'llrly C/IH111(clalll oj d",th blllwun ~(lIctlOn 10 'AX under !:l.e.!lt \3(A)
, u.. 1 -Jl- \ and 1-'- S Attach Seh 01
THIS seCTION MUST BE COMPLETED ALL CORRESPONDENOE & OONFIDENTIAL TAX INFORMATION SHOULD Be I)IREOTED TO:
NAME COMPLETE MAiliNG AODRESS
Pamela L. Heritaqe 1600 Market street
FIRM NAME (II Applicable) P.O. BoX 42933
PNC Bank, N.A. Phi:).adelphia, PA 19103
TELEPHONE NUMBER
1-(215) 585-5583
flllm"md.,AlIluffI
(lla'loldu'hprIOfloI2-13'IUj
5, Fedoral EBlalo Tft)( Rtrn, Requlrod
OFFICIAL USE ONLY
523,068.76
71,560.37
451,508.39
270,905.03
14
180,603.36
, .0
(15)
0.00 ,
0.00
.06
(10)
PA REV-1500 EX (1-01)
D'!.C?&de.nt's Complet& A~dreas; _
STREET ADDRESS
Bethan V~llaqe Retirement Center.
Page ~
325 .\'Iesley _Drive
CITY
Mechanicsburq _
Tax Payments and Credits:
1. Tax Duo (Pagol U"o 18)
2, Crodll./Payme"l.
A, Spou.ol Pov.fly Crodlt
B. Prior Payment.
C, Discount
I sr~ Te
PA
I ZIP
17055
(1) _-E,mlO.!,'iO
24,100.00
1,300.00
3, Int.rooVP.nolty II applicable
O,lnlBroot
E. Penalty
Tote' Crodlle (A + S + C) (2)
26,000.00
Totalln'.re.VPonolty (0 + E)
4. If IIn. 210 greo'or Ihan IIno 1 + IIno 3, en'er 'ho dillerenco, Thl.lo Ih. OVERPAYMENT,
Ch..k box on Page 1 Llno 1910 ,aque.,. ,elund
5. If lIi1. 1 + Iino 3 I. gr.a'er lh.n 11"0 2, o"lor Iho dilleronce. This ,. Iho TAK DUE.
A, En1er the Inleresl on the lax duo.
S, Enter tho 10'.1 01 Li"o 5 + 5A. Thl. Is Iho BALANCE DUE,
Mako Chock Payablo 10: REGISTER OF WILLS, AGENT
(3) 0.00
(4)
(5) 1,090.50
(5A) 0.00
(5B) 1,090.50
PLEASE ANSWER THE FOLL.OWING QUESTIONS
BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1, Old decedent make a transfer and:
Q, retain the use or income 01 tho propEl/1y lramlforrocl:, , , , . . . , . ,
b. relaln the right to designata who shall use Iho propony II anslerred or its incorna;. . . . , . . , , , . ,
c, retaIn a reversionafY Inloro!';!; or, . . , . , , , . , . , . ,. """",.";,,
d, receive the promise lor Hfe 01 eUller paymonls, bellElfitB or care? . , . . . , . . . . . . . . . . . . , , . , , . . .
2. If death occurred on or bofore Doc,embm 12, 1902, dId decodanl within two years
preceding death Iransfer properly Without receiving adequate consideration? If deBlh occurred
atler December 12, 1902. did decodonllransfor proper1y wl1hln ono year of dealh without
roceivlng adequale consldorallon?, . . . , , . , . . . . , . . . , . . . , , . , . , . . . .
3. Old decedent own an "In IrustlOl" or payablo upon doaltJ bank accounl or security
a, his or her dO.lh? . . . . . . . . , . , .
4. Did decedent own an indivIdual rfllirflment account, annuity, or other non~probale property?,
Vas No
~ ~
o 6
B ~
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE 11' AS PART OF THE RETURN
72 P.8. 89118 (a) (1.1) (I) provided lor the reduction ollhe lax rnle imposod on Ihe nel valuo ollrnnsfers to or for the use of the surviving spouse from 6% to
3% for datos of death on or after July 1, 1994 and boloro January 1, 1995,
72 P.S. 5~116 (a) (1.1) (iI) provided for tho roductlon of 1110 IHtfJ Imposed on Ole nol value of transfers to or for ttle lIse 01 tho surviving spouse from 3% 10 0%
for datos of death on or afler January 1, '1995. Tho fltotulo dons not pxonmt fl. transler 10 a surviving spouse from lax, and llle statutory requIrements for
disclosure of assels and Wing a lax relurn lIfO stili npplicablfl O'1fJn jf 010 !1U/viving spolise is Ille only beneflcia/Y,
FOR OATES OF DEATH ON OR AFTER JANUARY 1, 1995 ~- Ploase Answor the lollowing q\lOstlon by placing an "x" In OlE! appropriate spaco,
Old the decedent create ~ trust or similar arrangement which Is solelv for the surviving spouse's bftneflt fo' his or her entire lifetime?
Yes [] No@
If you answered yes 10 the ;.\bove quesUon, tho tax on 11m trust or slmJlar arrangomenl is postponed unW the doath of IlIB socond tlpouse, al which lima II wilt
be fully ta.xl1ble alUm rate{s) applicable to Itlo romalndor bonehciAry(io$), Emor the value of tile trusl on Sclledll'e J. Part II, In order 10 remove It from tile
calculallon of tho tux dua in thl.:. oslate. You may wi~lllo file Schodule 0 In ordor to make lho alecllon avallable under SecUon 9113. If Ihe election Is rnado,
the trust or similar arrangon'lflnt is laxod In HlO ostalo ollho lirsl decodonl Bpouse, the portion of Ihe trust or sImilar arrnngom9nt which bt:melils the surviving
spouse 19 laxod "llhe 2ero tax rato. and Iho Hlfllftlndm is laxod ntthe rola(s) applicable to tho remalndor boneflciary(ios). If you choose 10 make tho oloclion,
you mUfll annch Schodlllo 0 10 a tlmoly-lIIod lox rnllHIl, nlong with SCllOdulo(s) K und/or M in oreler 10 show tho ftppo/1ionrnonl of the Irllst or similar
nrrftngen~llt between the mlrvlving flpouse nnd llw romnlndor boneficialv\los),
7 PA15002 NTF 10810
COPYfight Flltms ,sO/tWftrll Only. 1991 NeiGo, Inr..
Page 2
Fstate of: Marie A. sutton
SOlEDULE J, Part 1 -- Taxable Distributions
21-1997-0371
Item
No. Name and AddreSs of Benefiqiary
1 Mary Elizabeth Gelegatis
970 St.one Road
P.O. Box 203
Shippack, PA 19474
2 Zelda Zeigler
502 Fifth street
New CUmberland, PA 17070
3 Robert E. l.cMer
209 Hillcrest
New CUmberland, PA 17070
4 Harry L. l.cMer
207 Pqplal' Avenue
New CUmberland, PA 17070
5 Dooglas Eakin
98 Greenwood Drive 'i.!
New CUmberland, PA 17070
6 Robert W. Halmlaker
3314 Paxton street
Harrisb.lrg, PA 17111
Relationship
Amount
None
45,150.84
None
45,150.84
None
11,287.71
None .
11,287.71
22,575.42
, . Brother
45,150.84
;' ,
,.'
"
,
LAWU....I(.,IU
.DON F. LAF'.r...VilIUl
.
311 iHll'..O !11\.t:I!T .
Naw CVh1a!k....\NO, l'u""'.YLv,wI.. 17070
11
II
II
II
I' '
II
I: '
i~dn8
~ST WILL AND TESTAMENT
OF
MARIt A. SUTTON
I, MARIE A. SUTTON, of New Cumberland, Cumberland County, Pennsylvania,
of sound m1nd, memory and understanding, do hBreby make, publi.h and
.'
'deelarB this as and for my Laat Will and Teatament hereby revoking and making
I
vo1d any Bnd all other wills by me at any time heretofore mede.
I
t.
I direct that my txecutor hereinafter named shall psy all my jUlt
I
'debts and funeral expense I al soon as conveniently may be done after my decease.
I
II.
All the rest, residue and remainder of my estate, whether real,
Iperaonal or mixed, and where.oever situate. I hereby give, devise and bequeath
~ ,lnto my husband, ROY G. SUTTON.
.~ I
, I If my said husband, Roy G. Sutton, should predeceASe me, then 1 gi.ve,
',: :revise Bnd bequsath my entire estate as tallows:
J A. I tiv. and b.queath my maple secretary desk, my maple butterfly
5 I,table and my mBple cane seat ad chair unto my hu~band's niec., MARY ELIZABETH
~I
s:;:-I
(' ,Gl1,L.EGATIS.
II B.
II
ZELDA ZEIGLER,
III.
I aive and bequeath all of my jewelry unto my hu.band'. niece,
C. All the re.t, residue and ramainder of my estate, whether real,
--.W,,,tcll
JON l", l..A''''VIj''
>>17 nimD ''''ICT
H'W ;l.IMfICIU.A"D. .."
liersonal or mixed, and wher.so.ver .ituate, I hereby giv., devise and bequeath
laB follows I
,I
II
iif New Cumberland, Pennsylvania.
I,
I:
:1
'I
L
1.
SiKty (60%) per cent unto COMMUNITY UNITED METHODIST CHURCH
PSie ono of thr.. Pages
~l
LAW Q,m:u
JON 1", I.Af'AVIR
." THr"~ .,,,cr1'
WIW CU'IVilU.AND, ,.-
[
IrELEGATIS. ~r if .he 1s not living, then ~nto her iBs~e, in equal share., pet
1Ic1!:'pes .
I
1f ahe is not living, then unto htr iSBUt, in equal sharts. per stirpes.
I 4. two and on&-half (21~) per cent unto my husband's nephew,
!ROBERT!. LOWER. or if he i. not living, then unto his iS8ue, in equal share.,
II .
Ipn stirpes.
I
2.
Ten (10%) p.r cent unto my h~.band's n1eos, MARY ELIZABETH
3.
Ten (107,) per cant ~nto my b~Bband's niece, ZELDA ZEIGLER. or
s.
Two Qnd one-half (21%) per cant unto my husband'S nephew.
\iAP.RY L. LOWER. or if he i8 not living. then unto his 18sue, in equal shares.
Irl.. ..l.p... 6.
7.
I
\
!he survives me.
I
I
I
~a Exeoutor of this. my Last Will and Testament.
I
~hOUld predecease me, fail to qualify or ca.a. to act as such. then I nominate,
I .
ionstitute and appoint my husband's niece, ZELDA ZEIGLER. and my brother, RDBOO W.
HAMMAKER, as Co-Executors. If either the said Zelda Zeigler or Robert W. Hammakel
I
,.hould be unable or unwilling to ..rv., then the othar may .arve alon..
I
I
I
I
,
I
,
~n this jurisdiction or in any jurisdict.ion in which he may act.
I
I
,my Last Will and Testament. set my ha"d and ,eal this
IIA. D., 1990.
II
Ii
I'
.'
Fiva (3~) p.r cent unto DOUGLAS EAKIN, it he survives me.
Ten (10~) par cent unto my brother, ROBER! W. ~~KER. it
IV,
I hereby nominate, constitute and appoint my husband, ROY G, SUTTO~,
If che said Roy G. Sutton
V.
No fiduciary acting under chis Will shall be required to post bond
IN WITNESS WHEREOF, I, MARIE A. SUTTON, the
have unto this,
day of J l J c,
/-/_.
Tucatdx,
,,-. ~r.
,-,'
[n~a
~Y?7
(StAL)
I'
II
Ii
Paie two of thr.e Pag'5
Eatat" oh Wia A. IUtt...
Data ,of _ell, 04/12191
Va''''',lon D.ta. 04/12191
.-
at. PM'
_lty
_rlptl..,
1) 7496. 196 11MS1~ TUT <<NT Pll CI. B (441109873)
04/11/91
IlASDAD
a) m PllC IK CORP (69341'j105l
04/14197
04/1"91
llI'lIIi
Dlv sr I 04/10 R 04/14 P 04/241V7
S) 61a.1$ VAIIGIlAllMIlILlIlIIlTlII EO (9219S51Dal
04/11/'97
IlA$OAQ
4) 17.&1.5 VAllOOAAII/WLIHlITON F1l (921mlDa)
04/11197
IlA$OAQ
Tota' . _Uy val_.
Toul - _h.
Total .....tfollo V.I... .
_,5aO.31
I.~t. ValIMelon
r---
MIgh/Uk
LOll/II d
-
..,... Adj.
'.25 lid
a.~
:18.75 S7.S7S MIL
1M S'/'.75 MIL
38.SIoS7S0
..0.37000
sa.rlm
25." lid
25 .68OOOD
25.68 lid
25.~
'I
ptQCI_I"" D.ta. 04/'lUff
u.- at ,..,.,..ftf.. 4
Dlv/lnt
Ace.....'
......hy
val...
61.au.6Z
11,497.911
1'.720.50
458.21
",'ZO,31
,1ll.00 .
(E) To hold property In the name of Seltlors or either of them, or in its
name without designation of any fiduciary capacity, or In the nllme of a nominee or
unregistered .
FIFTH: TMtee may apply the net Income of this Trust for the support
of Settlors and the survivor of them, should he, she or they by reason of age, llIness or any
other cause, In the opinion of the Trustee, be incapable of disbursing it; and Trustee is further
authorized to expend or apply from the principal of this Trust such sums as It, in its sole
discretion, may, from time to time think advisable for the support of them In the station of
life to which they are accustomed at the creation of this Trust, or during il\ness or emergency.
SIXTH: Subject to the approval of Trustee, anyone may add property I real
or personal, to the principal of this Trust by deed, wil\ or otherwise.
SEVENTH: Trustee shall receive compensation for the performance of Its
functions hereunder in accordance with its standard schedule of fees in effcct from time to
time during the period over which its services are performed.
EIGHTH: Settlors reserve to themselves, and to the survivor of them, the
right by an instrument in writing intended to take effect during their lifetime or during the
lifetime of the survivor signed by them or by the survivor and delivered to Trustee to revoke
or amend this Agreement in whole or in part provided that the duties, powerJ and liabilities
of Trustee shall not be substantially changed without its wrilten consent. Both Settlors must
execute any such amendment or revocation If both of them are living.
3
;5,/7:5- II
COMMONWEAL TH OF PP.NNSYLVANIA
DIPARTMENT OF REV!NUP.
BUft!AU OF INDIVIDUAL TAKES
tHAnANeE TAl( DIYISION
Ol!Pl, 110601
HARJUSlURU, fl. 1111.-0601
NOTICE OF INHEftITANCE TAK
AFFftAISEHENT, ALLOWANCE Oft DISALLOWANCE
OF DEDUCTIONS ANO ASSEBBNENT DF UK
*
U~.ll" U U. IH.'"
04-06-98
SUTTON
04-12-97
21 97-0371
CUMBERLAND
101
A.ount ftOlll.U.d ~
DATI
IITAn OF
DAn OF DEATH
FXLP. NUMBER
COUNTY
ACN
PAMELA L HERITAGE
PNC BANK NA
PO BOX 42933
PNILA PA 19103
r-
MARIE
A
MAKE CHECK PAYABLE AND RIHIT PAY MINT TO.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARliSLE, PA 17013
CUT ALONG THIS LINE ~ RITAIN LOWIR PORTION FOR YOUR R!CORDS ...
R'IV: iIlii'f -iie-- Aiiji-io'9-:m- -iioYi or -OF -ytiHiiiif Ail'C'i-i:"'\if A"PPR'A-isEHiiir; -A L. LowANci - o-ri -- -- -.- -.. - - - - - - --
DISAL.LOWANCI OF DIDUCTIONS AND ASSE9SMINT OF TAX
ESTATE OF SUTTON MARIE A FILE NO. 21 97-0371 ACN 101 DATE 04-06-98
TAX RETURN WAS I I X) ACCEPTED AS FILED I) CHANIlED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISID VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. ft..l Elt.t. ISoh.dul. A)
2. strKlkl and Rond. (Sch.<k.ll. 8)
S. Clo..ly Held Stock/Partn.rlhlp Intarell't (Schftdula C)
4. Hor-iaegal/Not.. Rac,ti vabl.. (Sch.dula D)
5. C.Ih/'~ 06PO.lt./~j.c. Parsenal Property (Sohedule E)
.. Jointly Owned Property ISchaduln f}
7. Tr~.f.r' lSohedul. OJ
a. Total Auet.
APPROVED DEDUCTIONS AND EX!MPTIONS:
to funeral Ex~.~./A~. COlts/HiIC. Exp.n... (Schedule H) I'.
lQ, D.bh/Hol'lg~. LlllblllU../Ll...1 ISch40duh Xl UOI_ 23.569.87
11. Tohl DMuoHonl Ill) 71.5110 )\7
12. "-t Vol... of r.. Rotor" U21 451,508,39
U. C!\Qorlbbh/lloy.rlWWlt.l B__"bl Jo!on-d...t.d 9115 Trolto IScMduh J) US) 270,905.03
14. "-t V.l... of Elloh Subj.ct to r.. U41 180, 60~
NOTE: If.n ........nt wa. iSlu.d pr.v10u.ly. lin.. 14/ 15 and/or 16, 17 .nd 18 will
rltfl.ct figur.. th,t includ. the total of ill r.turn. .......d to d.t..
ASSESSMENT OF TAX:
1&, _..,t of LlM 14 .t Spou..l r.t. US)
16, _t of Ll". 14 h....h .t Ll"..lIC1... A r.t. 116)
17. Aaount of Ll". 14 t.....l. .t Coll.t.r.l/Cl... B r.to (17)
10. Prlnolp.l T.. Duo
TAX CREDI'rS1
PAYHElfr
DATE
07-io-97
01-12-98
ftECEIPT
HUtfBU
AA211532
AA242640
DISCOUNT (.)
INTEftEST/FEN PAID C-l
1,300.00
.00
III
(2)
m
14)
ISI
(61
nI
10,IL
89.520.31
. OIL
.00
433.548.45
,00
,00
(Bl
47,990,50
,00 K .00.
.00 K .06.
180,603.36 K .15"
UB)
AItOUHT 'AID
24",700.00
1,090.50
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
I IF PAID AFTEft DATE INDICATED, SEE REVERSE
FDft CALCULATION OF ADDITIONAL INTEREST.
NOTE I To In.ur. proper
oreell t to your account.
""""It ttMo _r portion
of thl. for. with your
t.. P._t.
523,068.76
.00
,00
27,090 . 50
27,090.50
-
27,090.50
,00
.00
.00
IF TOTAL DUE IS LESS THAN U, NO PAYHENT IS REquIRED,
1.F TOTAL DUE IS REFLECTED AS A "CREDIT" CCRl, YDU I1AY BE DUE
A REFUND. SEE REVERSE SIDE OF TltIS FDRH FOR INSTIlUCTXONS. I
./
GI
(~u
REIERI/~T1oM' Eli.t.. .1 __II d,lnt an o. ..for. \lIC_r 12, 19&Z .. II .." Muro Inlor..t In tho ..t.t. I. tr..,.lIrr"
In .......Ian or ..,jo,..n. to Cl..' I (ooll.tor.ll bol..fl.lor'" 01 thO ...-. .ft.. .hO ...lroUon 01 on, ..t... lor
Ill. .r I.r ,..r., tho C.........lth horob' ...r...I' r...r'" .ho right to .....,.. .nd ...... tr..,.I.r Inherl..... T....
.t t~ l....f~l Cl... I (ooU.t.rID rllt. on IMW tUC" "utur. Int.rut.
_01'
NOTICE I
To lulllll tho r_lr...... 01 s.,tI.n 2140 01 .hO I....rlt.... end [,..t. ,... ~.t. ~o' 21 .1 199', (1l .,S,
hOtlon 91.0),
Do...h .hO ... .ortlon 01 .hl. ""U.. .... .ubolt wl'h ,our p.,_' '0 'h. R..I...r .1 will. prln..d on 'ho ",or" .lel.,
~-HU.. check or IIOflSlI ardor plyebll to: REOISTER OF MILLS, AOENT
~ rolund 01 . ... "",,It, wI,l,h w.. no' "quo.toO on tho roo R"urn. ,"/ b. r.""..t.O b, .0....tI.. .., ....lInotl'n
for ..Iund 01 p.nn.,I,..I. I_rl...... ..d ..,.,. roo- tREV'ISW, ,"pll..tlon.." ".lIeblo.t .hO 011I0'
of thl R.oiltlr of wHIII, any of the 21 RevenuI Ohtrlot OfflcSD, or b\l a.11irIG thfl Iplclal 24-hour
an....dn; ..rvle. nUMblrl for for.. ordlrlnQI In rlnn.ylvanin 1-8DIl-162-l0S0, o~lt.ld. p.onsylvanh and
within local Harrhbur; er.. (111) 181'8094, TOOt (117) 711~nSZ (lhaarlng t~.lr.d Onh).
PAVttEHTI
REFUMD {CAll
OIJECTlOllS' 'n, p.'" In In'.r..' no' ..tI.f1.0 .lth 'h. .,'prol....n.. .1I0..nco or dl..llo..n'" of O.Ou,\lon., or .........,
01 ... (lncludln. Ol..o..n' or In'or..U .. ,ho.n on ,hi. Hotlc. ..OI' obI'.' nl'hln .I.t, '6" 0... of r...lot 01
thh Motlce bYI
..or I It.. .ro'..' '0 ,... O. ....r'..n. of ..,""'.. SO.'O of ......,., D..', ZOIDH. H.rr,.b.".. O. 11121-1021, OR
--.I.otlon '0 ho.. ,... ..tt.r dotorol""" ., ....It of ,... oo.oun' of U.. ...r""",1 r."rr.ontotlvo, OR
.."ltf)~1I1 to thll orphlln,' Cowrt.
.",IN
ISTRATlVE
Comtl::CTlON$l
fllCtUIIl .rror. d.hcoVllrlKl on this u.....,.n~ ,hl)\Jld bfI addrllluad In wrlt1nt tU1 PA O~IIr-t.'"t of R."'~J
aurOIlY of IndividUal T8)1".', .uTHI Post A..us_IImt RII\liew untt. o~t. 7.80601. Hl'Irrhbura. III 1712&-0601
PhoIWI ('fl1l 767.6S0S. SM pile- S of thoe booklet "tnstrucHonll for jnt~r1t.nn t.x ft_turn for II Ruldl1nt
o.olldent" (REV-ISOl) fn' an lliplltnatlon of 1K.llnhtrl!ltlv.l~ carr.ctabl' IIrrOl",
1/ "" .OX dUO I. ..Id ."hln 'hr.. m o.l.nd.r oonth. .Itor ,... .......".. ".'h. . II" o""on' ""' Ol..nun' 01
t,M tax paid I, .11o..-d.
r... ISX 'ox ....... non'oortldo.tlon ......It, I, ,_,,, on 'ho to'" 01 lho to. ",,0 In'or'" ......... ond net
0.10 ..I." Jonu." 11, 1"6, ,... II". 0.. .ltor ,... ..<<i 01 ,hO t., ....,t, ..rlod, Thl. "on'o"tlolootlon
0...1t, I. _olobl. In ,... ._ ......r and In ,... .... ._ tI.. ..rlad .. Y<'" _,d .."..1 ,... to. ond Int"oot
t...t hili bMn .....uad In Indicatad on this notlu.
In'or..' to 'hor.... _Innlnt with fl'" 0.. of ..11_" or nil", (9) _tho """ one (II do, fr" 'ho .... 01
_'h, '0 ,... ..t. 01 p.,...,t, To.OO ""t,h __ doll_' ..Ioro J.....r. I, 19" ...r In'''''' .. t.... ro.. 01
.1. ('" por,on' p.r ..... ,.I,ul,'ad .. . 0.1', r.'. 01 .,'01", '" ,.... ""I.h ,...... do"nquon' on ond .1'"
J.....". I. 19" .111 ...r InW'" .. . r.to ""Ich .111 vor, 11'" ,.I.nd" ,oor '0 ,.Iondor ,.or .lth ,.... ro..
WV'fOUl'ClM by the- PA o.p.rtMOt of Rllv"""', n~ fl4lflltcahL8 tntere.t r.tu for UIl throogt., 1"'& .rel
'!!!!: Intere.t Ret. Ollll't Interut f~tor !!!r IntClrut Rllte ~t.t..t Factor
--
1912 20:< .nOO~4f1 llJ61 9' ,OOC/241
1961 l'A: .11004\& 1,,,"-1,,,1 ll:t .00OSOI
19" 11;( .000501 I'" 9' .OoaZ~1
191' UiC .0005" 19U-19'J4lo 1< .000191
19" 1 Die .0002111 1'9~"199" 9' . DOQllt1
"~lnhr'llt b ulllulated .. follow. I
INTEREST' BALANCE OF TAK UNPAID K HUHBER OF OAY~ otLIH~UEH'I' K DAXl.Y INTEREST FACTOR
--An, ""Uoo 1""" .ltoe 'h. to. ..c.... ..1I_,t .111 rolloo' on Intor..' ,.'culotlon ., flft_ (I,) 0."
tMtyond thtl dtt. of tM .......ont. If Plly...,t It..o. efter the tllhrll1t CotlPutCltlon det' thoWn on the
MoUe., edcUtlnMl Inhr8lt ttll.t be celcuhted.
DlSCDlJlTl
PENAlT't'l
INTEREST I
(.;
COMMONWEALTH OF PENNSYLVANIA
COUNfY OF CUM.ERLAND
}
PI
Robert W. lIamlllilkor
b,lnV duly B~!l_..____. occo,dlnv 10 I.w, d,po." .nd "Y' Ih.t h..JJ Executor
__.._.___.__...._.___,.___._..._._.___ 0' Ih, Ethl. 0' Mario A. Sutton
1.1, 0' __.,---Lo,\w..LAllen..Tw,p.-__... ..,...._. , Cumb.rl.nd Counly, P.., d.o....d .nd Ih.t tho
within II on Inv.nlo,y mod. by __Jl.ob<i'>:" W-..Ualll",ak"r...- ____', Ih. uld EX\1C'"tor..
0' the anllro ,,1.1. 0' uld doc,d,nl, conllllln9 0' all Ih, porlonal prop'~rly Ind rul "t.t., nc'pt rul "tol. ouhldo
the Con,monwoolll, 0' Ponnlylvlnlo. Ind Ih.1 Ih. "vurol 01'1'01110 OIeh II.m 0' Ih, Inventory r.p,...,,1 It'. ,.Ir v.lu.
.. 0' Ihe dolo 0' d..od,n"l doolh,
19___
{jd~( V.IL 'xl,; 't .il!...!.!:L .' .1-,'-
obert W. E....t., . ......l!Ilfll.......~.
lldllulldkur
_Ul4 Paxton Street
and lubl.,lb.d boloro mo,
Harrisburg, PA 17111
A...."
O'Y
04
M..'h
1997
0.1. 01 Outh
12
v..,
INSTRUCTIONS
I. An Invenlory mUll b. fIIod within th,oo monlh. .'10' appolnlm.nt 01 po"onol ropr".ntlllYO.
2. A luppl.mont Inv,nlo,y mull bo fIIod wllhln Ihlrly daYI 0' dl.covery 0' .ddltlcn.1 ....h,
], Additional .h..h moy b. o"ochod .. to p.r1ono/ty or roolty
4. S.. Arllcl. IV, Flduclo,l" Act 01 1949.
.-t 11< i l!! 1=1 l:I 1
r-- ~m 0 (J) j
M ~l .-t .
0 ~ ~ .jJ ~ I
I Go ~ J ...
r-- .... I.L ~
a\ I.L .... ~ 0 H Go
.-t 1>-, W 0 ~ <>:: . (J) j
N ~~ ~ ~
o Q
- ill ~ QJ ...1
0 ''; ....
Z Go ~ 1
:;: ... ..
'1:
0 1
J! 1 ....
0
.. d it 0
.... al