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97-00374
THis is 10 end I)' Ihlll tilt-' 1l1!tJ!'l\lalioll hCH' gin'lI i" Ctl1TCLdr Lor,.! 1~{'gislr;IL Tht' original (('nil1ulll' will he l"ul'\vilrlkd to 21-97-370 lupii.'d rfllfll ;111 ori~~itl;ll ct'nil!c.llt' o( Ik<llll dltlr lilcd thl' .~Lltt' Vil.li l~l'l(lnh ("Hill' f(l!' IWIIlI,IIII'lll lilitlg, with !lll' ,I', 1'1\ WARNING: Ills Illegal 10 duplloata thla I;\Opy by photostat or photograph, Pee !clrthl!i lyrtlllcllh'. $2.00 J ' f, 'l)it14~/JiU&~,"~ ~lc;d I{('g,i~rrilr 4260512 No; ~/ /.J-/&7 f),Ht' ...1'11 Ci)MMONW~AllH Ojl:P!N~AY.l~NIA ,t nifp~"rM"NtQI'_\UiALtH'VllA~ "I!OQAO'. ' CeRTIFIcAte OF OeATH '(0 ~(Iif"'l",'.. 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I .., " r~ ~I " ~l " " " - ~ " J , . ., , " , , " , \I , , " y " V " !J ,- :! A " " " II I " I , " , :: ^ V If ; 'I , , f ] , I, '. A ^ l V , , n j i'1 " " " Ii , ~] V r. u " , ,-' " H , H n .\ " " " f; ~; 1 " 0 " 'I " " I "I M ,1 " , 0 " " " " 'I " , c, 0 Y, .' , " , II H " , ^ I , ., L I , V T " " " " , {I I" 'J I , " F " f' D P ,l i, I' i " 'j ('j " ~~! 'j {l " [, .' ., , , n (j I:: , " I' .. " " I'i fj ~! , I 'I , , " " 'I , ',. 1 , , , I , I t , ; , , ,\ " ,\ L I " V " , , f " I, V V , , j , I !J llNHERITANCE TAX RETURN RESIDENT DECEDENT CCJMMONW'j^lIH 01 PENNSYlVANIA (TO BE FILED IN DUPLICATE DfPAR MENT m IU!VENUf O!PI '"0601 WITH REGISTER OF WILLS) COUNTY ODE _...~""RII:I5IUR(), PA 11128.0601 _ _...___.__.. un 01 0 N NAMf ( ,1', ANO MIDOIE INITIAl) Of(fOEN"~ COMPLETE ADoRUS SLovens, Cu1.a ^. 'I r,:~O Will nul Boltom I{oad SOCIAL seCU~ITV NUM'IA fAffoTIiiwi-- - loiff-Of iuhH"-'-- < Nl'WV i ] Ie, P ^ ] 7241 172-24-8044 .U/lO/97 LS/2'1/08 e,"",f.; Cumberland I" """'"" """'''0 "OUlI . '''"'I'''' ;;iil;,," ""Oil'''""'' -rei" 'liCui,iiNUM"'~" -. j~"OUNr'iiT"vmmINmuefio'iil--'------- .' -- -.---.- ~ 1,o-;~1~~iR~-'---~-----Tf~-SlJPpl.m~n'al R.~u~~----- -~- 0:), R.mal~d.r R.lurn ----- (fa, dole. of deolh p,lo, 10 12.13,82) o 4. Limited ellol. [J 410. Future I"'trell Comproml.. [1 5. F,deral Eual. Tax Return Required Ifor dole. 0' dealh ahe, 12.12,821 0 [] 6. D.c,d.nt DI.d lellott [J 7. Dee,dent Mainlalned 0 living TrUll __8. Total tJumb.r of Saf. O,poIIl 8010:" - (Attach copy 01 Willi IAttach copy 01 Tr""I ALLCOlIlIlSPONDENCI AND CClNl'lDINTlAL TAX INfORMAnoN HOULD II blRECTED TO, NAMf COMPlETf MAlltNO AOORUS - Jamos D. F1ower,_ Jr. Flower, Morgentha1, 1"lower & Lindsay T!l!PH~N'NUM'" , cell Bast high Street 717 -L.~4')-J:..>13 . _D)\' .,,,,,, , ,,- I, Real E"alo ISchedule AI 11 I ..3__..IlO..JlOJ.l....D.U.._ __ ...' . 2, SIac~. and Qand. ISchedule 81 (2 ) 3, Cla.ely Held Slac~/Partne..hlp Inl.,e" (Schedule C) 131 4, Marlgag" and Not" Recelvablt (Schedult D) 14 ) , 9 , ') 91 . 93 5, Calh. aank Depa.11l & MlocellaneoUl Pe..anal Property 15 I _-L 198 . 65 ISchedule el 6, Jolnlly Owned Property ISchedult FI 16 1 11. , 3 6 3 . 10 7, Trand.,. (Schedule G) ISchedllle l) 17) 8, Tolal Gro.. A..e.. IIalallln.. 1.71 q, Funeral Elo:penlel, Adml'll.lratlve Cosfl, Miscellaneous EKren... IScherlule H) 10, Deb.., Mortgage llabllllle.. lie" (Schedule I) 11. Talal Deductlo" 110101 lint. 9 & 101 12, Nt' Valut of E,'atellln. 8 mlnu.llnt 111 13. Charltabl, and Governmental eequ,," (Schedule J) 14, Nel Valut Sub ect 10 To. 11Ine 12 mlnu. lint 13) 15. Spousal Trander. (for datil of death after 6.30.q~I S~e Instructions for Applicable Ptrclntage on Reverse 1151 Side. Ilnclude values 'rom Schedule K or Schedule M.) 16. Amount of L1rle 14 taxable at 6% (ole llnclud. yolu.. from Schedule K or Schedule M,I 17, Amount of Line 1.4 taxable at 15% role llnclud. values from Schedulo I( O( Schedule M.I 18. Principal 1010: due (Add 11'110: from L1nel 15, 16 and 17.) 19. Credlll Spousul Poverty Credit Prior Paymenl1 Discount _________ + l.-UlL.Jl..Q. .,..l.2..1....J..(L., -________ Ii,' I ~ "00" t 1'''1 ~ i~" ul~ II *' 11 b ~IL .OA OATIS O' DIATIl AnlR 12/31/01 CHICK HIRI " A SPOUSAL .- POVIATY CU!)!,_'S CLAIMID IJ_ ilL! HUM"A l.]-'J'!-OJ'/I\ ..-'~ YEAR NUMBER j ~ ! i= :'5 ~ !l! (9 I 11.1 liP,. as , {el $\.P.2r,",r,1.hn (10) 2,001.42 15,169.87 87.383.81 327.00 1111 1121 (13) (I.AI 87.056.81 )(,---- o (161 87,0%.81 .__>< .06 . 5,223.41 1171 _____.______x ,15. _._____0 z ~ i: . co u (181 __,S,223.41 Int~rllsj 3 9477'36 (19) _.__:'.L_~___,__ 120) _,_,_________.._.__.__ s :10. If Line 1911 greolllr than L1rl.., 18, Intot Ih. dlffer.nce on L1no 20, This lithe OVERPAVMENT. liD C1H'{~ hell' ,I vtlll UlI''''flqUtH,llIlg n ,(.funcl of youl OVl>fpclymcnl 121 I .,J..,22(41).5._________ 121AI __..______.._. i21 B) ......l., ') 7 h IF; 21. If L1no 181, greater than Line 19, enler Ihe diffll(unce on Line 21, Thll h the 'fAX DUE. A. Enler tho interoll on the baICln(f1 dUG on Line 21A 8. Enler the tolal of Line 21 and 21A 011 Line 219, Thil11 Ihe BALANCE DUE. Mak. Cf-l_tck P~yob!!,.!,!.l._~.~l.~t~r _~!. Will., Au."t .. .._._P____.. ~ ~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHeCK MATH, <( <( Under penaltle. 01 perjury, I declare that I have exmnintld Ihll return, includi~;g Clccompar1ylng "hedulll ol;d HatGmenll, and 10 Ihe best of my knowledge and belief. II il Irue, correct and complele, I dedarethol 011 reol ellole hal been rnporred 01 Irue market value. Declorarion of preparer olher rhon Ihe per50nal repreulntalive it baled on allllllormalion of which preparer has any knowledge. SIGNATURE OfPEA$ON AfSfiON$II,H fOR fmNOA1TU~N--~----.w{iii~r~-u-u- .--. -, --... '...._.._.....u_.. .,..',__.._u___... ....,__...___~L__~_._ OAa ----~ ':12La-'1:.:~:--'.!.~_ i,(.,{--~\__!.~:LLi~_._~ ~~_L~i'..I}__LJ.j~~_..,__L\I._.(. j1___ Ie _ ~ ~ ( ___t ,'~ _ ~ / -' '( / '~'._':--.:~____. QJJ.._~_~__l9..0__m "it"': ~ ........~ "?;;i"1,\- ",.,,, 11 Eo.. C '" ~ h '" cee, "," -,^",l.I.!~-r''--C)'-_ \J' .....__Ci1XUSJ9.J.A__Li'Q:U. 03/-1..-I9B II.".".. 1""1 . j SCHEDULE F COMMONWIAUH Of PINNSYlVANIA JOINTLY .OWNED PROPERTY INHUtlT^NCe TAK IUlUAN .I!(DINIDICIDINT ._" . n_.',__'_'_ _ ,._...__."~,;;~;:~~",,,~=~..;..:.:...:.,,-~~-";";"":<,=:;;;';;:;'~~' ESTAT.O' ,.. ...___~1:~yil!l~I_9..!ll~_~.__ Joint t.nant('I' PILI .. "UMBIR 21-97-0374 _." ._.....'._._~..._~ .->___.........--=a_~_ ..~-......--.._--_.'.. .....~.... II, Marie B. Eckenrode ADDRISS __"._______ ._..__. ",_,__,___ ~__u_.____.._~_._~._~.~_ 101 South Second Street No. 1005 Harrisbur.g, PA 17101 2229 Pine Road Newville,PA 17241 RlLATIONSHIP TO DIC,~~NT Daughter ........_,__......___.l!."-.M!.._-_.,...__..._.. -, A. Nancy Lee Stevens Daughter C, Jolntly.own.d p,op.rly, ITEM LlnlR DATE FOR TOT AL VALUE DECO'S DOLLAR VALUE OF NUMIIE JOINT MADE DESCRIPTION OF PROPERTY OF ASSET % INT. DECEDENT'S INTEREST TENANT JOINT ....._-~~.~~ --~-~. 1, A 9/1/67 Checking Account No. 439827, Farmers Trust Co. 2,049.28 50% $ 1,024.64 Interest accrued to date of death 0.10 50% 0.05 2. A 2/22/8 Money Market Account No. 361046, Farmers Trust Company 18,906.60 50% 9,453.30 Interest accrued tD date of death 26.43 50% 13.22 3. B 6/20/8 Savings Account No. 4938715074 I Dauphin Deposit Bank & Trust Company 1,734.51 50% .867.26 Interest accrued to date of death 9.26 50% 4.63 ---..-_..~_._..__.- TOTAL (AI.o enter on line 6, Re,opltulotlonl $ .J.L...lfi.hJ.,L. -~--~_._-~_._._---- .. (II mo,. .po," II need.d l..e,I odd/llonal .he.I, 01 ,ome .Ize) ...",,,.. [""':! I SCHEDULE H I J:i:~" fUNERAL EXPENSES, 1 COMMONW"'~~ O;~'NNIV(VANIA ADMINISTRATIVE COSTS AND [ [N~\~:~A'~~'D'e~',~n~'N ~MI~r.:ELLANEOUS EXPEN~E~. ~~ ~ Plea.~ Print a~p' 8jATfu"~a -, -.-------]'ILE NUMIIIR ..___._~ .~t..()~ens, _ Ul.::'-._~..:.._~. ..._, _ 2l.:97~02?.!-_.__ ITEM NUMBER DESCRIPTION AMOUNT A. Fun.ral s.pon.,.. 1. Fogelsangor-Bricker Funeral Homo, Inc., funeral Rofreshments after funeral $ 6,010.90 46.00 2. B. Admlnl.tratl... Call.. 4. C. 1, 2, 3, 4, e., 6. 7,. 8, 1. Personal Ropro.ontotive Commllllon. None Social Security Number of Personal Repre.entotlvel Yoor Commllllon. paid .__ o 2, Attorney Fees Flower, Morgenthal, Flower & Lindsay Family EK.mptlon None Claimant __,___ R.latlanshlp Addre.. of Claimant at doc.dent's death Street Addr... , 4,559.52 o 3, City Stat. Zip Cod. Probate Fe.. Register of Wills, letters of administration Mlscellaneou. Expen"" Cumberland Law Journal, adverti'sing letters 214.00 60.00 The Sentinel, advertising letters Register of Wills, filing Inheritance Tax Return Diversified AppraiSal Services, real estate appraisal 70.86 15.00 250,00 500,40 Nancy Lee Stevens, mileage reimbursement Marie Eckenrode, mileage reimbursement 36,00 275.00 Marie ECkenrode, mowing law Marie Eckenrode, reimbursement ofr miscell.anoous item CONTINUED ON ATTACHED SHEET 103,09 TOTAL (AI.o ent.r on Iin. 9, Recopltulatlan) S ~ (II mare 'paco I. noeded, In,erl additional sh.." 01 .ame size.) _IV.IWlMt (1.111 ISTATE 0' SCHEDULE H - p^CII: 2 CON'I'INUI:D Ji'HOI~ PIUOH BIJEI~'l' fUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES.. _ ._ Pl.a.. Print 0~P-!._ [1111.1 NUMIIR _.___.______.~_____..__.__ .__} 1- $} 7 - 0 3? 4 ~'~/i~ ...IfWw CQMMONWEAltH or r!NNIVlVANIA tNH!IUTANCH TAl( ReTURN USlDfNT DeceoeNT - J Stevens, Cula A. ITIM NUMBER -- A. Fun.ral Ix,.n.... 1, B. 1, 2. DESCRIPTION Admlnl.tratlvo COlt11 P.nonal Repre.ontatlve Commluion. Social Security Number of Perlonal Repr...ntatlv., Vear Comml..lon. paid Attorney Fe.. 3, Family EKemptlan Claimant , Relntlon.hlp Addre.. of Claimant at decedent', death Street Addre.. _ 4. C. 1, 2. 3. 4, 5. 6. 7, 8, City State Zip Code Probate Fe.. MI.cIUanloUI IMp.n"'1 1% transfer tax, from sale of house County/Township/Library Real Estate Tax proration Allowance for closing costs TOTAL (AI.o enter on line 9, Recapitulation) (If more .pacI II n..dld, In..,t additional .111111 0' .ame 11.1,) AMOUNT 8.00.00 27.68 100.00 $ 1 OMS Ho. 1502.0265 , . A. U.'. DEPARI!!!!HI or ItllI9INO AIIl UlIBAH DE'IUDl'MFNt .. TYPE Of \.llolH IEIILENENI .IAIEMENI l. II rHA 2. II rllHA 5. M CON'I. UNIH.. 4. II VA 5. II COHV IH'. - 6. rilE H\JHBER I 7. LOAN IM4BER I PI 0 4.=.O.i.fi 8. HORIOAGE tH'. CA'E HO, ( --' NOIE. 1hl. form I. 'urnl.h.d to-;lv. you a ,tatement of .clual ..tllamanl co.t.. Amounl. paid to .nd by Ih. utttement agent "fa .hown. Item! rMrkfld ll(p.O.C.)l1 were paid ouulde the clo.lngJ they Qf. .hown her. for Informational purpa8t~ and 8ft n~t lncll~ed In tht total.. - . - O. NAME Of IOlIRrilU, J.ARRY I,. NAUGI,E 1531 WAJ.NU'I' BO'lurOM ROAD ___.____HEl1YILLE...._EA . -- E. NAME 01 .EllER. ES'I'ATE OF CllJ.A S'mVENS LEE STEVENS (, MARIE B. -Ec KEHllQU!L-AQMll'U:S'rRA'rQRS I. HAME or LEIlOER' HARRIS SAVINGS BANK S~XOND (, PINE STREETS _1IARIUSllURG,--_P1L_. O. PRorER II 1520 WAl.NUT BOTTOM ROAD LDr.AI ION. PENN 'l'OWNSlfIP, NEWVILl.E -_.-, _.cuMl!!lRIJ\NjLr,Ol11!'1'1_~.__ - N. IEHI,EMFNI .0,,"" DAVID A. BARIC P( .CE Of SElll,EIIONI: 1'1 WESrr SOUTH STREE'I' (717) 249-6873 ~ARI.iISLJ:i..__J'IL_nQl 3 ~_.~H!!!!!NI 0.IE.'._............Q.7..::2.0-28 - -- J. ~!!l or BOIlR<M.~.'!.JRAHS.Cl!ON K. ~R' Of SELLER'S IR.NS.CIION ..- --.. loo-,-GROSL~JIII Dl!.!!,,!!.!~~~R: -. ~.GROSS AMOUNI DUE 10 SELLER. -BJl....o.nn, nn )01. C~ltr8ct 8tlJ...!Ur1cft 8 Q,.QJLQ..JlQ 401. Conlract ..1.. prlc. _.- ,1..Q~,-~on.t PJ..2I",rtL ---- 402. P.r.on.1 P~ftv 103. Settlemenl ch.rBe. to borrower (tlne1400). 2.546....5..5. 405. .l~4. 404. 105. 405. _...MJ.ustllOllla for 1t\!!!'p'!!ld by ..ller In odv.nc. .dJust""!'tB for It_ ...Id "" ..ller In odvonce -- .106. Cllv/town u. - to 406. Cltv/town to. to 107. County u. to .-. 407. Countv I.. to 10ft. Assessments to 408. Assessments to 109, SClIOOL TAXES-WO TO 6/J1. ?A';.1n 409. )1. q 2/?0 'I'n ';/11 ?AIi.1nl 110. 410. ll!. 411. 112. 412. 120. GROSS AIOJN' DUE IAtIl IIORROlIER ~A? A1? A" 420. GROSS AMOUNI DUE 10 SELLER llAO,2A6.l0 200. NlOOIIIS PAID ~, 011 IN BEII.U OF IIORROlIER: 500. RF.OUtIIONS IN AMOUNI DUF. SELLER. 201. Oepolilt or earnest money .l...QQQ.....QQ 501. EKce98 doposlt (see Instructions) 202. PrlneJP.!1 omount of n.w 10."(.) ~....QOO, 00 502. S.ltt.ment chorj,.' to ..tl.,' (line 14001 835.00 203. E,I.!lnLL~.) t.k.n sUbJOCI 10 -- 503, E,I.tlng loon(.) t.ken .ubl.,t to -- 204. - ---.-- 504, Povolf of f1,'.t IOOrlg.g. lo.n -- 205. ~Q2.~f of second mortglloe loan -- 206. 506. 207, -- ~07, 20B. 50B. 209. 509. AdluotMOnt. for It... unpeld bv ..'I.r .dJ;;;'!;",ta for tt_ ...-Id "" .eller -- 210, Cllv/lolm te. 10 510. Cltvltown I.. to 211. Countv ta. 12/1 to , I' n 27.68 511. Count V t.. 12/1 to 2/20 27.6A 212. A.....mont. 10 .. 512. ......menl. to - 215. - 513. 214. 514. ..- -- 215, 515. - 216. - 516. 217, 517, 21B. ---.--- - 51B. 219. . 519, ..- L$65,027.68 220. 'OI.L 1'.10 B'tIOR IIORROlIER. 520. lOIAL REDUCTIONS DUE !oTllER. ~A':? .6AI ~_C.SH .i llElILEIlENI fRt11/IO BOIlROlIER' 600. C.SH .1 SEllLEMENI 10/fRON SELLER. 301. Oro.. .lOOllf1t du! from ~rroworl!.ir.!.J20L J2..JUz....!l2 601. ~~t duo to soller Cline 420' AO,~:~.~~ ~02. l... nmount pnld by/for !>orrow.r(tlno?20! _lil1, ..oll...,.6!! ~Q?.c L....r.ductlon OIOOunt due ..II.rllln0520) 303. CASH ( ex fROM I ( II 10 I BORROlIERI $17,805.17 60]. CASH ( 01 10 I ( II fRON I SELLU:l $79,423.62 .. HUe'1 Sottlemenl Stotoment Rev, 5,M Page 1 R..p. Re.olvar (tM) H(I)'1 (3'86) RESPA, HB 4305.2 _L~ _ _~ ~ ~.__~~____,_M___~ l.. nlH[I4[NI I:HARG[S ..___.___ 7o~:'liiiM.'s~1 r-S/liAC*lH'S C(HlISSIOIt, BASED ON PR I CE, S _ !!Q_'-Q.Q9.J,Q9___._.il.._...._,_Q._~_~ -- -0 I.vl,;t,~. ,!f.. ~~'~1;;;:.5i '~n!P!l)!U~..tlllll1l'___.._ '701~i:'" to -.---..----"------ _..__._----~._----~- TOZ:'S'=':__.____ _.____..._,~~._......_..._____ ',!Q~-.'~__~~~!.~! .~~i ~~ .P_~~~! ._~__~~ ,~,! ~~!!!.__.~~4._______~_ 704, ___...__..._,_,__. 'Boo:__ilElts PAVABLE IN COIINEE'..!Il!..~!!~_LOAN: 60;~-l~~;~O;1 ~.-!~!~f~~.f.~!=_.____--L__. .1~~.~.~~~..~!~.~~'!!!__,..__..__,_.._.__.._~_~__.___-- '!~~~~~Pfrft !.~~!..!!~.,~~~_...__._________~~__._.. 804. _credit Report to!__~_,... _~_________._.._ -_00; ~..l";;;J~I~_~}-;;R~~~~~!...__._.____~__..___~_,__. 806. Hortgllge Infl,llranCe flrp~~A.!!~!'_.~!!_!~__.___. iioi:.A~~;;,ti~;_i~;__.-.- ._ .______ .!I~A:--h-rrLT~M':tQt!._ t'~!L1'Q..J!l\BR HL,f:J 1I.'il.tlGS _J~B.2,' 0 QL......__ 809. lltHl,!);miBJ'l'1.tlCLn:!LTQ_!.!flBBUi.HflY!NGS_____. alo:-j'LOOD CER'l' FE!LTQl!flBB.I~Lfll\\il!-lQL-.._. ilil: I)OC'I;REI;-FEf~TQ_!!l\ImHL~AV1NQtl. -9uo~i'iEHs'RfQliiiiEDiiy-i[NufR W BE PALO IN ADVANCE, .~~Li;;;~;~tf r~~=:.==:=2a(jj~ Jh=,:::::::~..._~.~~_H!....2,L_..J:!~ ~02. __~~~9.~~~_~~~R'lC!._r~-~~I~i_~~~~___~_:,___!O - 9~ .Ilnrard 1'19lJrnnC~m~~_4!~!~~~_____x.~!.:.__!~___4 904~-FI'~~~;;;r;~~' rr(!n~un for '/rs. to --~-~----~-----,.,---_.. ---'~-"----~' PAID fn~ BORROI/ER'S fUNDS Al ,~LEM~ PAID fR()l RELLER'S fUNDS AI SElllEMEN! --- CP.O.C. I 100.00 26.00 75.00 91.98 901, ----- -----..-, ---_.- ----------- 1000. RESERVES DFPOSIIED WIIH LENDER. 100":- HOlft~dJ;~~-~~~-_u",._--~- 2 months Q to 14.92 per month_ ;002~-H~;:tgnge ln~urance .------~nths 01-" per month 1003, CI:yp.!:~pe~ty t...,-...----,monti;;-;;.s ~nth 100~, COUll!tproperlY_~~'" 12month'i.s 16. 59per month 1005. Amuftl assessments months Q S por month ~O(JO, Fiood_ln;urance-- months 5l " por month ~~?.:.2.!;;!!OOL_Tl\l!!'!~___ 7 mon~~' i $_66. 09~nth IO~~_ltGQ..J;?C........l\QJ, month, Q $ ar month 1100, IIIlE CIIARG[S. ---~- ~. Settlement or clll8ln~ foa to 1102. Abstract or tltle search to ----, 110]. Title e.Ilhminatlon to --- - 1104. Title Insurl'lnce binder to - - !10S.~~nt prepllf'l'Itlon ~~.__ 1,106, ..'!ot.ry '!'~.!.'!,Q~!iU____,___ 1107, At..!.~rnay'. fae, to Hlf&L (includes above Items NlXlberSI ________4. ~ l'08:....!.!.!.I.!...i!'.!ur.nce to 0 '13RIEtL..--llii.BlC & SCHERER ..l.0.~uda' .bo~'C~~N"':!.>arSl llQj.-ll05 1107-111~ ~!Q~. ,.lender IS CO~!!,_8ge~.____. ~.!!E_: ownerls~8~__698. 75 l.!.l!:.. EN lLJLJ .QQ:$.2!!L~ 2QQ.= $. ~.2. l!~QPLLI.t!.VOI C!LJI_ 6(.2 3 ) t113=-.Q!lLL.!HSBUIli:!JlM~N'1' F'EEI___. 1100. GOVERNMlWT RECOROING AND !RANSfER CIIARr~R' ._-----~---------- 1101. Recording faa., Deed $ 25. 50 J.~ortonoa S 23..50 IReten,e $ 1102. City/county t!,/,t~~.!...!',~! 800, O_Q.~rtonoe $ 1103. Sl.ta t"/.I.II,,',---.~aad_s 80Q. 00 ;Mo,.tsnoa $ 1104, 1101. --- 1300, ADDITIONAL SETTLEMEN! CHARGES. 1301. Survey _t~_ _ !]02.~!.!.~~ectlon to ~___________ 1303, ,_._._----_.,'---_._.~----_. 1304, ~------~_._--------- 1301. 29.84 199.08 462.63 89.73 4 00 (P.o.C. ..,',',-.':' :::::::::::: 50.00 - 35.00 49..J)0 800.00 800 00 1400. TOT~!..!~lIlEMF.!I!...I:)lARr!!s.., J."!!lar ~~.!~3. Secllon J .n(U!~50~~~.!!~~) $.2..,M6 5 835 00 I hflve cflrefutly rovltwcd tho 11110.1 SOttlcrllcnt Stntcfllcnt anu to tho boflt of my knowledge nnd bollce It 1& It true 800 Iccurate ItlttonM'lnt of nIt I'm," rtfl nlld d!$IhlIlM!I1M'Jnt Ido on lilY Recount 01' by mo In this tf'nnsnctlon. I furthar cortlfy that I have recelvod a copy 0' IIlJ~ttlllrn(,llt mOllt ~,f~10 ~s: The HUO.l S~ltlement ~:tement 'hICh~h prep..ad ~.-: true ~~~hll tren.ectlon. I heve C'Uled or .111 c.u.. the f"J'\ 10 be d~'~n ec ;).nc~ .Ith thl. It.temon!. ~o?/Cr ~ 02-20-98 OAVI01\:-BARIC--.------. -------o.i.----- WARNING: It I.. crime to knowingly rnnk~ hiRe stntmT)tOntN to the United Sutes 011 this or any other Ilmllflr form. penaltln upon conviction enn lncllldl'! It 'Ine nnrl j!T~Jt'j!HH)ln(lnl. for drtnilCJ, !IN' Title 1/\ u,~, rod~ ~(Jnl()n lOnl c,nrl S('rtlon 1010. r-brtgage Table Date 07-08-97 Page 2 Date of First Payrrent: 17-Feb-1985 Date Interest Starts: 17-JWl-1985 li:lan J\m:lunt: 30,000.00 Original Nuni:Jer of I?ayrrents I 180 Regular Payment: 340.98 Actual Nurl'ber of Paytrents I 180 Annual Rate: 11 . 0000\ Payment Beginnin] '!btal Interest Principal ElIdin::l Date Principal PayrrentB payrrcnts Repayment Principal 1987 Totals 28/319.15 4/ 091. 76 3/064.33 1/027.43 27/291. 72 17-Jan-1988 27/291. 72 340,98 250.17 90.81 27/200.91 17-lo"'eb-1988 27/200.91 340,98 249.34 91. 64 27/109.27 17-MIlr-1988 27,109.27 340.98 248.50 92.48 27,016.79 17-Apr-1988 27,016.79 340.98 247,65 93.33 26,923,46 17-MaY-1988 26,923,46 340.98 246,80 94.18 26,829,28 17-JUll-1988 26,829.28 340.98 245,94 95.04 26,734.24 17 -Jul-1988 26,734.24 340.98 245.06 95.92 26/638.32 17-Aug-1988 26/638.32 340,98 244.18 96.80 26,541. 52 17-Sep-1986 26/541. 52 340.98 243.30 97.68 26,443.84 17-Oct-19fl8 26/443.84 340.98 242.40 98.58 26,345.26 17-Nov-1988 26/345.26 340.98 241. 50 99.48 26,245,78 17-Dec-1988 26/245.78 340.98 240.59 100.39 26,145,39 1988 '!btals 27/291. 72 4,091. 76 2,945,43 1/146.33 26/145.39 17-Jan-1989 26,145.39 340.98 239,67 101.31 26/044.08 17-Feb-1989 26,044.08 340.98 238.74 102.24 25/941. 84 17-Mar-1989 25,941. 84 340.98 237.80 103.18 25/838.66 17-Apr-1989 25,838.66 340.98 236.85 104.13 25,734.53 17-MaY-1989 25,734.53 340,98 235.90 105.08 25,629.45 17-JUll-1989 25,629.45 340.98 234.94 106 . 04 25/523.41 17-Jul-1989 25/523.41 340.98 233.96 107.02 25,416.39 17-Aug-1989 25/416.39 340.98 232.98 108.00 25,308.39 17-Sep-1989 25/308.39 340.98 231.99 108 , 99 25,199.40 17-Qct-1989 25/199.40 340.98 230.99 109 . 99 25/089.41 17-Nov-1989 25/089.41 340.98 229.99 110.99 24/978.42 17-Dec-1989 24/978.42 340,98 228.97 112 .01 24/866.41 1989 '!btale 26/145.39 4/091. 76 2,812.78 1/278.98 24/866.41 17-Jan-1990 24,866.41 340.98 227.94 113 .04 24/ 753 .37 17-Feb-1990 24,753.37 340.98 226 . 91 114.07 24/639.30 17-Mar-1990 24/639.30 340.98 225,86 115 .12 24/ 524 .18 17-Ap:C-1990 24/ 524 . 18 340.98 224.80 116 .18 24/408,00 17-May-1990 24/408.00 340.98 223.74 117 . 24 24/290.76 17-JUll-1990 24/290.76 340.98 222.67 118.31 24/172 .45 17-Jul-1990 24/172.45 340.98 221. 58 119 .40 24/053.05 17-Aug-1990 24,053.05 340.98 220.49 120.49 23/932.56 17 -Sep-1990 23,932.56 340.98 219.38 121.60 23/810.96 17-Qct-1990 23,810.96 340.98 218.27 122 . 71 23,688.25 17-Nov-1990 23/688.25 340.98 217.14 123.84 23,564.41 17-Dec-1990 23,564.41 340.98 216.01 124 . 97 23,439.44 1990 '!btals 24/866.41 4/091.76 2/664.79 1, 426 . 9'7 23,439.44 17-Jan-1991 23/439.44 340.98 214.86 126.12 23,313.32 17-Feb-1991 23,313.32 340.98 213.71 127.27 23,186.05 17-Mar-1991 23,186.05 340,98 212.54 128.44 23,057.61 17-Apr-1991 23,057.61 340.98 211.36 129.62 22,927.99 l-brtgage Table Date 07-08-9'/ Page 3 Date ()f Firet Payment: 17-F'eb-1985 Date Interest Starts ( 17-Jan-1985 Loan Arrount ( 30,000,00 Original Nurrber of Pa\'fl1!'.nts: 180 Regular paytrent: 340.98 Actual Nurrber of Pa\'fl1!'.nts: 180 J\l1nual Rate ( 11 . OOOot Payrrent BegirUling Total Interest: Principal Q1ding Date Principal Payrrents payrrents Repayrrent Principal '-- 17-May-1991 22,927.99 340,98 210.17 130.81 22,797.18 17-Jun-1991 22,797.10 340.98 208,97 132.01 22,665,17 17-Jul-1991 22,665.17 340.98 207.76 133.22 22,531.95 17-Aug-1991 22,531. 95 340.98 206.54 134 .44 22,397.51 17-Sep-199;t 22,397.51 340.98 205,31 135.67 22/261.84 17-O::lt-1991 22,261. 84 340.98 204.07 136.91 22,124,93 17-Nav-1991 22,124.93 340..98 202,81 138.17 21,986.76 17-Dec-1991 21/986.76 340,98 .201.55 139.43 21/847.33 1991 Totals 23,439.44 4,091. 76 2,499.65 1,592,11. 21,847.33 17-Jan-1992 21,847,33 340.98 200,27 140.71 21,706.62 17-Feb-1!i92 21,706.62 340. 98 198,98 142 . 00 21,564.62 17-Mar-1992 21,564.62 340.98 197,68 143.30 21,421. 32 17-Apr-1992 21,421. 32 340.98 196.36 144 .62 21,276.70 17 -May-1992 Zl, 276 . 70 340.98 195,04 145.94 21/130.76 17-Jun-1992 21,130.76 340.98 193.70 147 . 28 20,983.48 17 -Jul-1992 20,983.48 340.98 192,35 148.63 20,834.85 17-Aug-1992 20/834.85 340.98 190,99 149.99 20,684.86 17-Sep-1992 20,684.86 340.98 189.61 151. 37 20,533.49 17 -O::lt -1992 20,533.49 340.98 188.22 152 . 76 20/380.73 17-Nav-1992 20/380.73 340.98 186.82 154 . 16 20,226.57 17-Dea-1992 20,226.57 340.98 185.41 155.57 20,071.00 1992 Totals 21/847.33 4,091. 76 2,315143 1/776.33 20,071.00 17-Jan-1993 20,071.00 340.98 183.98 157.00 19,914.00 17-Feb-1993 19/ 914 . 00 340.98 182.55 158.43 19,755.57 17-Mar-1993 19,755,57 340.98 181. 09 159.89 19,595.68 17-Apr-1993 19,595.68 340.98 179.63 161. 35 19,434.33 17-MaY-1993 19/434.33 340.98 178.15 162 . 83 19/271.50 17-Jun-1993 19,271. 50 340.98 176,66 164.32 19,107,18 17-Jul-1993 19,107.18 340.98 175,15 165.83 18/941. 35 17-Aug-1993 18/941. 35 340.98 173.63 167.35 18/774.00 17-Sep-1993 18,774.00 340.98 172 ,10 168.88 18,605.12 17-O::lt-1993 18,605.12 340.98 170,55 170.43 18,434.69 17-Nav-1993 18,434.69 340.98 168.98 172 . 00 18/262.69 17-Dec-1993 18/262.69 340. 98 167.41 173.57 18,089.12 1993 Totals 20,071,00 4,091.76 2,109,88 1,981.88 18,089.12 17-Jan-1994 18/089.12 340.98 165.82 175.16 17, 913 . 96 17-Feb-1994 17/913.96 340.98 164 ,~1 176.77 17,737.19 17-Mar-1994 17,737.19 340.98 162.59 178.39 17/558.80 17-1\p:r-1994 17,558.80 340.98 160,96 180,02 17,378,78 17 -May-1994 17,378.78 340.98 159,31 181.67 17,197,11 17 -Jun-1994 17,197,11. 340,98 157.64 183.34 17/013.77 1'7-Jul-1994 17,013.77 340.98 155.96 185.02 16,828.75 17-Aug-1994 16/828.75 340.98 154,26 186 . 72 16,642.03 17-Sep-1994 16/642.03 340,98 152,55 188.43 16,453.60 17-O::lt-1994 16,453,60 340,98 150.82 190.16 16/263.44 fo'brt:gage Table Date 07-08-97 Page 4 Date of Firat Payment. I l7-Feb-1985 Date Interest Starts I 17-Jan-1985 lain Arlount I 30,000,00 Original Nurrber of Payments I 180 Regular Payment I 340.98 lIotual Nurrber of Payments I 180 Annual Rate ( 11.. 0000\ Payment Beginning Total Interest. Principal EndiIg Date Principal Payments Payments Repayment Principal 17-Nov-1994 16,263.44 340.98 149,08 191.90 16, 071. 54 17-Deo-1994 16, 071. 54 340,98 147.32 193,66 15,877.88 1994 Totals 18,089.12 4,091. 76 1,880.52 2,211.24 15,877.88 17-Jan-1995 15,877.88 340.98 145.55 195.43 15,682,45 17-Feb..1995 15,682.45 340.98 143.76 197.22 15,485.23 17-Mar-1995 15,485.23 340.98 141. 95 199.03 15,286.20 17 -Apr-1995 15,286,20 340.98 140.J.2 :lOO . 86 15,085,34 17 -May.. 1995 15,085.34 340,98 138,28 202.70 14,882.64 17-Jun-1995 14,882.64 340.98 136.42 204.56 14,678.08 17-Jul..1995 14,678.08 340.98 134,55 206.43 14,471.65 17-Aug-1995 14,471.65 340.98 132.66 208.32 14, 263 . 33 17-Sep-1995 14,263.33 340.98 130.75 21.0.23 14,053,10 17-Qct-1995 14, 053 .10 340.98 128.82 212,16 13,840,94 17-Nov-1995 13,840.94 340,98 126.88 214.10 13,626.84 17-Dec-1995 13, 626 . 84 340.98 124,91 216.07 13,410.77 1995 'Ibtats 15,877.88 4, 091. 76 1,624.65 2,467.11 13,410,77 17-Jan-1996 13,410.77 340.98 122.93 218.05 13,192.72 17 -1''eb-1996 13,192.72 340,98 120.93 220,05 12,972.67 17-Mar-1996 12,972.67 340.98 118.92 222.06 12,750.61 17-Apr-1996 12,750.61 340.98 116.88 224.10 12,526.51 17-May-1996 12, 526 . 5J. 340.98 114.83 226.15 12,300.36 17-J1ID-1996 12,300.36 340.98 J,12 . 75 228.23 12,072 .13 17-Jul-1996 12,072 ,13 340.98 110.66 230.32 11,841.81 17-Aug-1996 IJ,,841. 81 340,98 108,55 232.43 11,609.38 17-Sep-1996 11,609,38 340,98 106.42 234.56 11,374.82 17-Oct-1996 11,374,82 340,98 104 ,27 236.71 11,138,11 17-Nov-1996 11,138,11 340.98 102,10 238.88 10,899.23 17-Dec-1996 10,899,23 340. 9~ 99.91 241.07 10,658.16 1996 'Ibtats 13,410.77 4, 091. 76 1,339,15 2,752.61 10,658.16 17-.Tan-1997 10,658.16 340,98 97,70 243.28 1'l,414.88 17-Feb,-1997 10, 414 . 8a 340,98 95,47 245.51 10,169.37 17"Mar-199.f'> 10,169.37 340,98 93,22 247.76 Cf.{~~ ---- - ,0 17-Apr-1997 9,921,61 340.98 90.95 250.03 , .58 17 -May-1997 9,671. 58 340.98 8e.66 252.32 9,419.26'7D ,1,') 17-J1ID-1997 9,419.26 340.98 86,34 254.64 9,164.62 17-Jul-1997 9,164,62 340.98 84.01 256.97 8,907,65 17-Aug-1997 8,907.65 340.98 81.65 253.33 8,648.32 17-Sep'1997 8,648.32 340.98 79.28 2fl.70 8,386.62_ 17-Qct-1997 8,386.62 340.98 76.88 2f4.10 8,122.52 17-Nov-1997 8,122.52 340.98 74.46 26S,52 7,856.00 17-Dec"1997 7,856.00 340.98 72.01 26e.97 7,587.03 1997 'Ibtats 10,658.16 4,091.76 1,020.63 3,071,13 7,587.03 17 -Jan -1998 7,587.03 340.98 69.55 271.43 7,315.60 17-Feb-1998 7,315.60 340.98 67.06 273.92 7,041.68 LJ ~ ~~,~. '~f <, Ie )11 , I \~) , , " M:Jrtgage Table Dat.e 07-08-97 Page 5 Pate of FIrat Payrrent I 17-Feb-1985 Date Interest Starts I 17-Jan-1985 Loan 1\r1nJnt I 30,000.00 Original Numbex' of Paym9l1tsl 180 Regular Payment I 340.98 Actual Number of Payment:sl 180 lIrmual Rate I 11. 0000% paynent Beginning Total Interest PrincIpal Ending Date Principal Payments Payments Repayrrent Principal 17-Mar-1998 7,041,68 340.98 64,55 276.43 6,765.25 17-lIpr-1998 6,765.25 340.98 62,01 278.97 6,486,28 17-May-1998 6,486.28 340.98 59.46 281.52 6,204.76 17-JUn-1998 6,204.76 340.98 56.88 284.10 5,920.66 17-Jul-1998 5,920,66 340.98 54,27 286 . 71 5,633.95 17-Aug-1998 5,633.95 340,98 51.64 289.34 5,344,61 17-Sep-1998 5,344.61 340.98 48,99 291.99 5,052,62 17-001;-1998 5,052.62 340.98 46,32 2fl4.66 4,757.96 17-Nov-1998 4,757,96 340.98 43,61 297.37 4,460.59 17-Dec-1998 4,460.59 340,98 40.89 300,09 4,160,50 1998 Totals 7,587.03 4,091.76 665.23 3,426.53 4,160,50 17-Jan-1999 4,160.50 340,98 38.14 302.84 3,857,66 17-Feb-1999 3,857.66 340.98 35.36 305.62 3,552.04 17-Mar-1999 3,552.04 340.98 32.56 308.42 3,243.62 17-lIpr-1999 3,243.62 340.98 29.73 311. 25 2,932.37 17-May-1999 2,932.37 340.98 26.88 314.10 2,618.27 17-JUn-1999 2,618,27 340.98 24,00 316.98 2,301.29 17-Jul-1999 2,301.29 340.98 21,10 319.88 1,981. 41 17-Aug-1999 1,981.41 340.98 18,16 322.82 1,658.59 17-Sep-1999 1,658.59 340,98 15,20 325. 78 1,332.81 17-Oct-1999 1,332.81 340,98 12.22 328.76 1, 004 . 05 17-Nov-1999 1,004.05 340,98 9.20 331. 78 672 .27 17-DeC-1999 672.27 340.98 6.16 334.82 337,45 1999 Totals 4,160.50 4, 091. 76 268.71 3,823.05 337.45 17-Jan-2000 337.45 340,54 3.09 337.45 0.00 2000 Totals 337.45 340,54 3.09 337.45 0.00 Grand Total 30,000.00 61,375,96 31,375.96 30,000.00 0.00 037195 THE SALVATION ARMY 3850 ""rtln Wr" P.O. Box 80095, Hlrrllburg, PA 17108-0114 Tllp.~'non.: (717) 541.0203 ./ ,.....C/ C1-"/ Ocrte /.1 - "..,..:: r 19,' I 1" : '1'''I-,~-_ " .) J I J Y.1 '::""'-:1, r::-C-I I ) N .-1';/"11"':; L.-'(-'llv/-' .,.......~I/~'--. ,_ GMI_' - .... ,-J! Add,... .I .~~;::...,.::i !'r ){(;' lJL,uJ lA./_,tJj;.Y}J! 1<:",)'..____ 'I I /..''';.. \ I~ 1 .. ! I'" In, ,1/, "_' I I I r ' Cnv..-,)~,t..;....' A..l....~"l....,.;..... Stat'_ r Zip I I .J I I Apt. or Floot r hi, No, A.ppUonce 0 Clofhtng ~,.. furnltur. 0 Svndrles 0 I ,') I;v ,L+\;') I , I 6- ~.( '.1.\ l.',IC;:;, '~ ( .', ~',. , . "-~ I ..t....;.> , I , --, ,j , ~~: C,~,;,:,.\',,'::~ I ;'VE 8EE:1 ::'THNIGED f';),l THIS DO'IAnJ~, CONTRIBUTIONS OF GOOOS ARE DEDUCTIBLE FOR INCOME TAX PURPOSES TO THE EXTENT ALLOWED" lAW, THE SALVATION ARMY DOn NOT FIX AN EVAI, UA nON ON YOUR Gin, THAT IS THE PRM~EGE AND RESPONSlB(UTY OF THE OONOtl, THIS IS YOUR TAX RECEIPT, ..oj_ I " '-.,... ( ),-.' I . , I"', .., " . ,.'- NMI IGHANII ,I, /'.:/~/' .,., .,.\./....1: !:.,:._l 'Ff .; -.. CWOMlI MJIofAfUM THANK YOU ~J 1 (. I' 0 9 ' '-l~ 'J . THE SALVATION ARMY 3810 V11I11" Wr" P.O. lox 80001, HI"leburg, PA 17108.0114 Tlt.phon" (717)141.0a03 '.' P"!L__.. , _u, iI' F/7',II"<: J'll I ,... , Na,.,. ~Ll~ ,.1-.'-----.i...,_!.'.h.L_~.~ ...0 .-.l-',';....~::::.:.!.~;.:.L2,~~~~__ Addrtt,~~L~? ',: . ..__~~~~ J; ..L.~rL__.: _d~\~+:t~=-_~:_~,~, C, _____ \J ",- I City , [l.I"llf~___"""u' I(p_~ Apt, Of ,,___._____ '01, No_ Appl(ane. CI Clotlll.. 0 r.",,,.,, 0 Svndd.. 0 / , , ill ,'/..1 '-., I .., i ..,;,.... ~ " , ..' \ , ';\11 ;') L' - " (, I i~~."'~_.~ l;r { ,- ......;.~:'. ' _.~------~--~- ~;;.u;;oo-;~;.;;;;;,;;sm Ilt!OVClllll ,.,. INCOMe lAX PURI'OSES TO THI eXTENT AlloweD BY lAW IHI ,AIVATION A~MV POU NO! FIX AN EVAl, UAI10N ON YOUR DlFT THAT IS ',HE 1'lI,IVIleOl AND RUPON~B(IIlYJ TH! llONOtI, IH(I (I YOUR lAX RICI",! .. / " ~--,:I~ ,-,,~_/ ...,.- _.-" ".'{...I..Yf~{;''--'-'' THANk YOU ." ''''''1' ,,~,- . 6iViriolfl4I"" CUI,QMI. ~~ > 'L '/';1 It) . / I :~' :J BUREAU (~. INDIVIDUAL TA~ES INIIE.RIIAHc[ lAIC OIVISION OI'PY, l&060l tlARRI$lUJ~O. PA 111za'0601 COMMONWEALTM OF P~NNSYLVANIA DEPARTMENT OF REVENUE NOTICE Of rNHERITANCE TAX APPRAISENENT, AI.I.DWANCE DR DISAI.I.OWAfICE Of DEDUCTIONS AND ASSESSMENT Of TAX 05'~5-98 STEVE tiS OC," 1 0 - 97 21 97-0374 CUMBERLAND 101 f-.-::--A;,oynT Ro~.!d l MAKE CHECK PAYABLE AND REMIT PAYMENT TOl REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV: iS4"j"!if" A fop "f (iF 9'7T "Neifi CE" "oF" i"tl'HEifii' Ailc E " TAx" A"P PRAYii EifEN'r;" A L l"oWANcE - oli"" "-,,""",, -" -" -""" DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX CULA A FILE NO. 21 97-0374 ACN 101 nATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN JAMES D FLOWER JR FLOWER MDRGENTHL FLOWER 11 E HIGH ST CARLISLE PA 17013 ESTATE OF STEVENS TAX RETURN WAS, t ) ACCEPTED AS fILED RESERVATION CONCERNING FUTURE INTEREST .. SEE REVERSE APPRAISED VALVE OF RETURN BASED ON: ORIGINAL RETURN 1. R~.l Est.t. (Sch.dulD A) 2. stooks and 8Qnd~ (Schedule 0) 3. CloselY Held stock/Partnership Inter..t (Schedule C) 4. Hortgage./Notes Receivable (Schedule Dl S. C..h/Bank D.po~its/Hisc. Per$onel Property (Schedule E) 6. Jointly Owned PrOPRrty (Sohedule fl 7. Tran.forl (Schedule G) 8. Total Assets RECEIPT NUNBE R AA211504 AA269827 DISCOUNT It) INTEREST/PEN PAID (-) 197,37 ,00 INTEREST IS CHARGED THROUGH 06-09-98 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM *' 11~-IHIIII" 11'."1 CULA A ( X) CHANGED SEE ATTACHED NOTICE DATE 05-25-98 (1)- (2) (3) (4) (5) (6) (7) 80,000.00 .00 ,00 9.99lu.ll. 1.198,65 11.363.10 ,00 (8) APPROVED DEDUCTIONS AND EXE~PTIONS: 13.168,45 9. Funeral Explnsas/Adm, Costs/Hisc. Expanse. <Schedule H) (9) 10, Dobls/Norig.g. llobll1U../llon. tSch.dulo 1) (10) 2,001 .42 11. Toto1 Dodyotlon. Ill) I ~,169 87 12. Not Voluo of lex Rotyrn (12) 87.383,81 15. Charitlllble/Govern...nt.l aeque.hi NonRlllohd 'HIS TrYlt, (Schedul. J) US) .00 14, N.t Voly. of E.tot. SYbjoct to Tox (14) _ 87,383,8!. NOn: If an assessment was issued previously, lines 14, 15 and/or 16, 17 and 18 will reflect figures that include the total of 6hh returns assessed to date. ASSESSMENT OF TAX: IS, Altount of Un. 14 at Spounl rat. US) 16. Allount of Line 14 t.x.bla .t Line.I/Cla.s A rat. (16) 17. Allount of Un. 14 -taxable at CoIhi.raI/Cla.. 8 rat. U 7) 18. Prin~ip.l rex DUI TAX CREDITS: PAYHENT DATE 07-08-97 03" 09-98 ,00 X ,00, 87,383,81 X ,06,,, ,OOx.15, I1B) ANDUNT PAID 3.750.00 1,276.05 TOTAL TAX CREDIT BALANCE OF TAX DUF. INTEREST AND PEN. TOTAL DUE HOTEl To insure prop.r orld! t to your Iccount, lub"lt the upper portion of this forn with your tax P.yunt. 102.553.68 ,00 5,243.03 ,00 5,243,03 5,223,42 19,61 19,01 38.62 . If PAID AfTER DATE INDICATED. SEE REVERSE fOR CAI-CULATION Df AnDITIDNAL INTEREST, ( If TOTAL DUE IS LESS THAN $1, ND PAYHENT IS REQUIRED, If TOTAL DUE IS RefLECTED AS A "CREOn" (CRI. YOU NAY BE DUE A REfUND, SEE REVERSE SIDE Of THIS fDRN fOR INSTRUCTIONS.) , ~ESERVATIONI E.tet.. of d,oldlnt, dylnt on or blfar. D.o.Jblr 12, 1982 .~; if any '~tyr. Int.r..~ In thl ..tat. II trans fir red in po.....ian or .njoVI.nt to Cl,.. ,1 (001111,rtl) beneflcl,rl.. of .thl dtotdtnt .,t'r thl IKplr.tlon of any ..tat. for lIf. or for v..r., thl COHOf1~.lth herebY ."pr.ub r...rv.. the right to IPpr,lIt 1M ...... trflnt',,, lnhtrltlnCll h)C.. It ,he IINful el,.. . (col1.tt,.ll) rat. on ~V .uch future Inter..t. PURPOSE OF HOTICEl To fulfill the requlr..."'. 0' Slot Ion 2140 of thl InheritancI and E.tat. Taw Aot, Aot 21 of 1995. (72 P.S. Section 9140). PAVMENTl Othch ttM top portion of thh Notiol and tube It wJth your ply.."t tb tke Rophhr of Wllh pl'1nttd on ,tM rllVlr,D .leN. ..Hakt checlc or IOnlY order payablt tOI REGISTER OF MILLS, AGENT REFUND (CR)1 A r.fund of . '1M orldlt, which wa, not rl~UI,ted on the Tax Return, ~BY bl requ.,ted by oOMpletlng an "Appllcltlon for R.fund of Penn'Ylvanil Inh.rltanoe and E,tat. TaM" (RfoV-IJI!). Applications are available at the OffICI of the RIgI,ter of Wills, any of thl 2J Revlnul District OffiCI', or by calling thl ,p.clal 24-hour an,werlng ,.rvlcl nu.ber. for for.. ordering: In Penn,ylvanla 1-800-362-2050, out.ld~ ~'nn.ylvanla and within local Harri'burg ar.a (117) 787-8094, TOOl (1k7) 772-2252 (Hlarlng IIPaired Only), OIJECTIONSl Any party In Intlr..t not ..thfled with the appralltl..nt, aUowance or dl..llowlltlo. of deduoUon., or a.....Nnt of tax (Jnoludlng discount or Inter..t) a. shown on this HcUcl IU,t objlot within .hty (60) day, of reo.lpt of thh NoUc. bYI --writt.n prot.,t to the ~A Olp.rt-.nt of R.V.nuI, laird of APPllle, D.pt. 211021, H.rrl'burg, PA 17128-1021, OR -.el_ctlon to hlv, the .attlr d.t.r.lnld It audit of the aocount of the Plr.onal repr.,entatlv., OR --app.al to the Orphan,' Court, AbHIN ISTRAlIVE CORRfCTIOH$I Factual error. dl.oav.r.d on thl. ........"t .hould be addr....d In writing tOI PA alpart,ent of RMV'nue, Dur.au of Individual Tax.., ATTHI Po.t A.......nt R.vl.w Unit, DIPt, 280601, Harrl.burg, PA 1712$-0601 Phone (717) 7'7-6505. S.. page 5 ~f the bookl.t "In.tructlon. for Inh.rltence T.x Rlturn for. R.,ldent OIc.dlnt" (REV-15011 for en .xplanatlon of ttdIllnl.tr'Uveh corrlOt8bln errors. DISCOUNT I If any tax due JI p.ld within thr.. (3) calendar Ronth. after the d.c.dlntl. d.ath, a fly. p.rc.nt (5X) ~t.count of the tax paid I. allowed. PENAL TV 1 The ISi( tax allM'lIlty non-plltrtlclpatJen penalty h cOllputld on the total 0' the tax and Inter..t .......01 and rKtt paid ba'ore January 18, 1996, tha first day aft" the IInd of th. tax ..n..ty P'lr Iod , T"II non-partlolpatlon p.nalty I. app.alabl' In the .a.a .annor and in the the .a.a tl.. p.rlod I' VOU Nould app.,1 the tax Ind Int.r..t that ha~ belln a......u a. Indieatad on thl, notleo. INTEREST I Inter..t 111 chargad b.glnnlno wJth flrat day of d.l1nqu.ney, or nln. (9) BQnth, and OM (1) day fro. the data 0' death, to the date of pay..nt. Taxe. which bae... d.linquant bafor. January 1, ,9.Z b.ar Int.r..t .t the rat. of .ix (6%) pITClnt per a,lnUIll calculutad at a daUv rata 0' .000164, All tax.. Mhloh blClllH d.lInquent on and .ftar January 1, 1902 will baar Jntarelt at a rat. which will vary fro. calandar yaar to cal.ndar year with that rat. announolld by the PA Depart..nt 0' Ravlnue, Th. appllcabla Inter..t rat.. for 1982 through 1998 .r.1 '!!!! Inbr..t Rata DaUy Intarnt Faetcr t!!! tnt.r..t Rat. Dally Inhr..t Faotor 1982 20% .0110541 1981 9% ,000247 198J 16% ,000453 1981-1991 11% .OOOJOI 1984 11:< .000301 1992 9~ ,000247 1985 iJ% .000156 1993-1994 n .000192 19" 10% ,000274 1995-1998 9~ ,000241 --lnter..t I. calculat.d a. follow. I INTEREST = BALANCE OF TAX UNPAIO X NU"BER OF DAYB DELINqUENT X DULY INTEREST FAtTOR --Any Notlc. i..uad aftAr the tax bleo.e. d.llnquent will r.fl.ct en 'nt.r..t calculation to flft,.n (IS) d'VI beyond tha data of tha ........nt. If pftYI.nt I. ..de .ftlr the Int.r..t co.put.tlon dati .hown on thl Notice, additional Inter..t .u.t be oalculat~, III Hw;.,W Hill\ '9B ~\\G 2~\ I' 1 :,:,9 C\~'1i OUIYI\ .. 11'. \'/\ PA'llEllT1 htMh the to, portion of thit NoUGe _ ..-it with ~our ~.YHnt ... p.Ylbl. to the MIll Md ..,.... prl"t.- on the r.vtr.. ,tde, If 1lE111IIIIT IlEUlIEHT .... _ or ..... order p..obl. to, REGISTER OF WILLS, AGENT. If 1IIII-IIEIIDENT DEUlIEHT """. _ or _. order p..obl. 10' ~!AL TIi OF PP.IICSVLVAHIA, REf'UCO (aUI Ai r.fund of . tb crtldlt, Ifhlch we, not requttted on the Tax Return, oy blI r4tqUltt4MI by w.pl.U"" en -AppHotIHon far A...wt (IIf PennUyl"M.' loo.dtlntl. end Elt.t, T8x" (R!Y.UlS), AppUOIIUon. .r. .w'Ullld. It tM Offlo. of the .....t.r of NUh, Itny of tht 23 Rft'enull Ol.triat Off Joel or frOll th. o.p.rtlMnt"' Z4..hour .......rIN ..,.vlce numer. far fOrlll orderlngl In Pennlylvenlt 1'"100"562-2050, out,lde PMW1lvlvwdt Ind within l~l ",rrllburg .r.. (117) 187-1094, TOO' (717) 772-2251. (t~rl", I.,.lr~ only), REPLY TOJ Qu..Uon. rogerdlng ",.ror' conttlned on thh notice aMuld be ~r..Hd tOI PA lMp.rtHnt of RewnutI& Bur.... of IndlyJ~l 18x." AT1NI Po.t A.....-ent Review Unit, Dept. 280601, Harrisburg, PA l11Za.0601"phonI (717) 7.7.6505. DlscotIfTs If MY t. due h paid within thr.. (5) o.landar ."th. aft.r the HofldflOt'. dMth, . 11118 perow.t (IX) dllOOUnt f'lf ttL taM ..-Id II .Uowd. PENALTY I The ISX taK ..,..ty non.partJolpatJon penalty h COIllPUted on the total of the tax Bt'ld Intera.t ......ed, 8M .-.at Hid befora January 10, 1996, the fir.t dIIy aft.r the end of the tax ~.ty perlnd. INTEREST I Intnrelt h oharll'Mt beginning with flr.t d.y of dallnquanoy, or nine (9) ItOfith. 8hd OM (1) .y froe the dIlte of death, to the data OJf p.~t. Tax.. Nhlch l*l... dfllln<fUW't before ,*",",,'y 1, 1912 bear Int.r..t at the rat. of .Ix (6~) percent pe~ ~ calculatad at a dall~ rat. of .000164. All t.Ma. whloh bee... delinquent on and after ~ry 1, 1982 will b4lt Int.r..t It a rat. Mhlch will vary fr~ ~.landat ya.r to ~l~r ~r with that rat. ~d by to. PA o.p.rtHflt of A.venue. The IIPPlJeabl. Int.r..t rat.s for 1982 through 1998 .rt' V..r Int.r..t R.te D8l1Y Jutur..t factor V..,. ]nt.ra.t R.t. Dally ]nt.,...t factor 1982 !IX .000541 1981 .~ .100247 198. 16X .OO04J8 19U.I'I',Il I1X .OOas01 1'114 IU .010501 1992 'X .000141 1985 IU . IOn" 1993.1994 ]X .000192 1986 lOX ."0214 1995-]996 'X ...0247 ulnt.r.., I. calcul.ted .. follow.l IHT8IE8T c IALANt~ OF TAX UNPAID X NUNIER OF DAVS DELINqUENT K DAILY INTEREST FACTOR --Any Not1ea l..ued oft.r t~ ta~ b.oowe. delinquent will r.flect an Int.r..t oalculatlon to fifteen (15) ~V' beyond ttMI date of the ............t. If pavont Is .... aft.t the Int.r..t COIlpUtaUon dIIt. shown on the Notlc., Ilddltlonal ~nt.r..t lIU.t be c"lcula~.d.