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Decedent Mainfalned 0 lIving Tru't (AHa'" ,opy a' Willi IAlla,h ,opy 0/ T""I AlLCORRI5PONDINCE ANO CONPIDENnAL TAX INPORMAnON SHOULD BfDIRECTED TO, '." ' NAMI COM"'!lM""NOAODRIlI J COBS N & 'lILK"S JACOBSEN & MILKES A' E " w ""'HON'NU"'" S e FA 52 E. High St. 1,1 Carlisle, FA 17013 ) ,:1 \JY ,) / *' ~ Iil III co 230-43-3282 ~, A'~IC.4"'IIUIMVlHO IPQIJ,i., NMlI IlAU, 'PiU, AHOMIIXXIINIIIAII .01 OATIS O' DIATH AnlR 12/31191 CHICK HII II ^ SPOUSAL POVI.lY CUDIT IS CLAIMID 0 ml NUMB.. - 21 97 YEAR 01+12 NUMB! llNHERITANCE TAX RETURN RESIDENT DECEDENT COMMONWIALTM O. "NN&YWANIA (TO BE FILED IN DUPLICATE "'AAb~W.WSJlvINUI WITH REGISTER OF WILLS) HAAAIIIUAO, .. 17 2J.OOOI COUNTY coDe - IDle.DINT'S NAMI(lAIT, ,tUT, AND MIDDlllNmAq " '! NmOMPUlI AODIISS Ilurrou 'hH Sl1Inud W. 235 South West JAl SICURIN NaMI R DAU O~ D!ATH DAn Of IlIUH C c'1 r 1 i s 10 t P ^ Street 17013 COlin AMOUNT U liVID ($11 INnRUClIONiSJ o 2, Supplem.ntal Return 20. If lln. 19 I. grealer Ihan Une 18, fin'" ,he differen(e on line 20, Thi. is Ihe OVERPAYMENT, 1110 Ch~('k hNC If yau arc tcquosting (1 refund 0" your overpavment '" co S => ~ " w '" 1, Rool ella'o (S,hodulo AI 2. Slack. and 80.d. (Schedulo 8) 3, Clollly Hold Slock/Port.o..hlp Inloro.. ISchodulo C) 4. MQrlgoget llnd Noles Re(el...oble {SchedlJle 01 5, Cash, Bonk Deposits & Mlscellaneoul Perianal Property 15chodulo El 6, Jolnlly Ow.od Proporty (S,hodul. 'I 7, Tro"lo.. (S,h.dulo GI(S,hodul. LI 8, TOlal Gron An.ts (Iolallino' 1.71 9, Puneral Expenses, Admlnistratl...e Cosu, Miscellaneous expo"o. (S,hodule III 10. Debit, Moligoge L1abilillel, llenl (Schedulo II 11. Total Oeducllons 110'01 lines 9 & 10) 12, Net Value of Eltato lline 8 minus line 1\) 13. Charitable and Governmental 8equests (S(.hedule Jl 14, NOI Valuo Suble<1lo Tax (11'0 12 mlnu. Llno 131 15. Spau.al Tra,,/o.. Ifor dOlO. 01 dodlh oh.. 6.30.Q41 See Inllru(llons for Ar,pllcoble Perc.ntage on Reverse Side, (Includ. ...alue, rom Schedule K or Schedule M,l 16, Amount of LIne 14 taxable at 6% rote !Include ...nlues from Schedule K or Sc;hedule M.) 17, Amounf of line 14 taxable 01 15% rOle (Include ...aluel from Schedule K or Schedule M.l 18, PrlnclpalloK duo (Add lox from Linel 15, 16 and 17,l 19. Credits Spousal Po...erty Credit Prior Payments + 03, 05, Remainder R.turn jfor dot" of d.ath prior to 12.13.8 Ffldtral ESlalt Tax Relurn R.qulred _ S, Total Number of Safe Deposlt Boxe 111 121 13) 1 4 I -:::rfff..ff'l---' 15) "':...Lt~51- 161 . (71 IQ)~ (101 _1 g- 50, Qu 181 _3q<OOSI '" 51 !C !:i .. 1I co u S ,023. 70 o (:) u 1111 (121 (131 (141 1151 (161 (171 x._= x ,06 = )( ,15 :I (181 Discount +---.. Inlllrell (19) (201 121) 121A) (218) o --Q---- 21. If Llnll 181s greater Ihon llnll19. enler Ihe differ"nce on Line 21. Thills Ihe TAX DUe. A, Enler Ihe interlul on Ihe balance dult or, Line 21 A Q, Enter thi! tOlal of Line 21 and 21 A on Line 21 B, Thil ., the BALANCE DUE. Make Ch.c1c Payabl. 10: R.gist., of Wll~" Agent ~ ~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE ANO TO RECHECK MATH <( <( Under p,nalUet of perjury, I declare that I 1'10.... 'Kamlned Ihi$ retur". including accompanying schedule. and ,talem.nls, ond 10 the bell of my knowledg. and b~ll' il Is Irue, (orr.ct and compllJl., I declare rhot 011 real e,'ot. no, been reponed 01 lru" market value, Oedorotion of preparer other rhan th. p",onal reprosenlClli'i'l baled on all information of which preparer kOI an knowl.rlge. SIO Rf. ~:USON Il.ESPONSlal! fOR '!lING RETURN ,AODRESS 235 S. '\"'C)f-j t: St: 5A.iE J J' ()~ <.: L..- ,,- ,/' Cnrli.slr' P^ i 7013 I:, _12 _ q (i $10 ATU,\ 0' pUPr'! 0<: II. TH N R!PRes"N'~TIIJ~ C ' ~~ ES _ OAlE ,. Ck ~ ' Ie. 11gh St., Carlisle, FA 17013 o~ ~ ~tf oct q , '_) -r ,(1)'$ 0- ~ rJ f~ ~l'" , () ',... . N 't:J ('; ,"-'J .... (j ',,:.. ~ ill fl Ii .~:: <u ~ ~s .Ct: . COMMONWeAlfto: 0' peNN$'f'lVANIA lNHeIUTANC! TAl( Il.eTURN RESIDeNT oeCEDeNT ESTATE Of U I ,X't~U ~ U'IloUU'hIMtl ITEM NUMBER A, SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES Ploa.o Print .r Typo h") 1- C'f7 -D4-IC\. DESCRIPTION AMOUNT 1. (~7S'~i"l~'~ 40370U B. Admlnl.tratlve C..bl 1. Per.aoal Repro'entatlve Camml\llon, Social Socurlty Number of Personal Representative: Vear Commlnlon" paid _ 4, C, 1. 2. 3, 4, 5, 6, 7, 8, 2, Attorney Fee, ~obS'cn d M, \ ~9S: L).D6, 0) 3, F~mily Exemption Claimant Addrell of Claimant at decodent', death Street Addrell City State Probate Fee,~e3\$.te( Of WI I h 50. ()(J Relationship Zip Code .ollanoou. bpen,o"f\ 1i' '1 ~,~)l5 {.e.r " 1 'UJ l II <:,- n 11 ':J TE' c.. rr''? a L - kZ tedn,<.. ' S'~H)(-e SM'::. L~y{)" ry 15. <9 () 25~ Q 7 4 DS. l,'3 1'2 O(j \j) e d. s.le f I TOTAL (Also enter on line 9, Recapitulatlanl 5 6 11:3 ,-,0 (If moro spa.o i. noodod, in.." additional sh.ots of ,ame .1.0.) /.'J II,Y /() COHHONWEALTH OF PENNSYLVANlA DEPARTMENT OF REVENUE BU~EAU OF INDIVIDUAL TAXES U'HEAITAHCE TAX bIVlfll0t4 DEPT. 280601 HARRISBURG, ~A 111Zft~0601 NOTICE OF INHERITANCE TAK APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DrOUCTIDNS AND ASSESSMENT OF TAX 08-31-1998 BURROUGHS 03-12-1997 21 97-0412 CUMBERl.AND 101 f=~~~~~~=ltt.d - l HAKE CHECK PAYABLE AND REHIT PAYHENT TOI REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE"Y= m7" EX"""FP-io'Fli7Y "iioYici"-oF"YNHEiiifANCE"YAjt')iPPR iiisEHEN'r;-"Li."OWAiicE"oli""m_-m- ---""- DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX SAMUEL W FILE NO. 21 97-0412 ACN 101 IlATE ESTATE OF DAT! OF DEATH FILE NUHBER COUNTY ACN JACOBSEN I MILKES 52 E HIGH ST CARLISLE PA 17013 ESTATE OF BURROUGHS TAX RETURN WAS I 1 X) ACCEPlEO AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE A~PRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. R..l E,t.t. (Sohedule A) 2. stock. .nd Bonds (Soh.dula BJ 3. Clo..1~ Klld Stock/P.~tn.r.hlp Interest (Sohedule C) 4. Nortgages/Not&1 R.c.1y~1. (Schedule 0) 6. C..h/8.nk Dapos!tft/Hilc. Person.l Propar'ty (Schedule E) 6. Jointly Owned Property (Sch~u18 f) 7. Tran.fars (Schedule G) 8. Total Amsats ) CIIANOED II) un (3) 14) IS) 16) 171 ,00 .JlQ.. .00 .....Q.Q.. 3.960.51 .00 .00_ 18) APPROVED DEDUCTIONS hND EXEHPTIONS: 9. Funeral Exp~..s/AdM. Costs/Hilc. Expanse. (Schedul. H) 10. Debts/Hortg.g. Li.biliti.~/Li.n$ (Soh.dul. I) 11, Tobl Oaduotions 12. Net Value of Tax R.tu~n 13. Charitabl./GovernMant.l Ba~.tsj Non-eleot.d 9113 Trusts (Schedule J) 14. H.t Value of f..t.t. Subject to Tax If an a9S95.~8nt was i.sued previou.ly, line. reflect figure. that include the total of ALL ASSESSMENT OF TAX: lfi. AMooot of L In. 14 .t Spousal rat. (l.&) 16. A.ount of Line 14 taxable 8t Lin.al/Cla.s Areta (16) 17. Aaount of Llna 14 taxablR .t Coll.taral/Cl... 8 rat. (17) 18. Principal Tax Due NOTE: TAX CREDITS: PAYHENT DATE RECEIPT HtJIIBER DISCOUNT 1+) INTEREST/PEN PAID 1-) . IF PAID AFTER OATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST, 5,173,70 1.850,00 Ill) (12) (13) (14) (9) (10) I *' IIV-1141 U I"~ 11'-'11 SAMUEL w DATE 08-31-1998 HOTEl To in.ur. proper credit to your aocount, .~lt the upper part ion of this for.. with your tax p.y...nt. 3,960,51 7.nn 7.0... 3,063,19- ,00 3,063.19- 14, 15 and/or 16, 17 and 18 will return. a......d to date. ,00 X .00. ,00 X ,06. ,00x,I5. (1Bl AHOUHT PAID TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE ,00 .00 ,00 ,00 .00 ,00 .00 .00 ( IF TOTAL DUE IS LESS TlIAN n, NO PAYHENT IS REllUIRED, IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR J, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS,) REseRVATlO'lI ......se OF NOTICE I PAYMENT I REFUND (CR) I \\r.;, 1'1' ul '98 hUG 2B I'? :00 CIf!11 Oul'nl1' "HI Pf\ Eillt.t.. of dtctdthtl dying on or before he..ber 12, 1982 h if any future irit.rest h\ ttMI ..tat. 11 tran.ferrtd In po.....lon or ."jOYMnt to Cll" 8 (colllllteral> benefiolerl.. of the dtKIttdent .fter tM l)(plr.Uon of IIflY ..t.t. for life or for y..r" the C~onwealth hsraby expre..ly r.~.rv.. the right to DPPral'A ~ ...... transf.r Jnn.rJtanoe taxe. at tM laNful CIa.. ~ (0011.terall rate on any .unh futur.lntorest. To fulf111 the requlr...nts of Sf'ctlon Z149 of tho Inhgrltuno9 ~l1d Estllte Tax Aot, Aot U of 19'15. (72 P.S. SaoUon 9140). o.tach thto top pOI'tlcn of thh Notice nod sub.Jt ..Uh your paynent to the Reohhr of Wilh printed on the reyer.. IltkI. ~~H.kG check or Ilonoy order pnYllble tOl Rf:OISTER or MILI.S, AGENt A r.fund of a tal( oredJt, which was not roquuted on ttll~ Tl'IK Roturn, lIay I'" rlllqUlllsted by cOllpletlnll an "App1Jc~t1on fOI' Refund of Pennsylvania Inheritance and Eshlte Tp,x" (REV~BL'\l. Arrl1c<lUons ani lwailable 8t th.. Offioe of the Reglstllr of Wills, any \Jf tho ?l ROVlJl\llfl IJhtrlct Offlctls, or by oaJiing th& spaolni 24-hour answering urvioa nUllbu"$ for forlls ord.urJnlll III Pennsylvania 1~600-162~2t150, outsido "ennsylvanla and Idthln loo.l Harrhburg 8rer. (717) 787~8094, T[llIlI (717) 77?~225Z (HeQrlng Illpaired Only), 08JECTIOHSl Any party in inter~st not satisfied with the "ppral.eMont, allowanco or disallowance of deductions, or .I~e.s..nt of tax (Jncludlng discount or Intol'est) QS shown on this Notlce lIuSt olljoot within sbly (60) dllYs of receipt of thls Notice by: ~OIUN ISTRATIYE CORRECTIONSl DISCOUNT: PE~ALTVI INTEREST I --written prote.t to the PA Dopar'humt C\f RnvllnulI, i\onrd of ",pplilals, 08p1. 281021, Uftrr:lsburg, PA 17118-1021, OR --election to have the .80tter det8r_.ln0("l at audit of tho account of tho perllonnl represontaUv8, OR --tlPP~u,l to thu OrphaHSl' Court. Footual orrors discover-eel on this lt$Soullllnt should bo ~ddr-oU8d in writtno to: PA Depftrtllllnt of Reveouo, BureBu o-f Indt'/idual TB1(05, ATTH; Post ASSeUIl$llt Review Unit, [}opt. ZaobOl, .Ittrrlsburll, PA 171Z8~0601 Phoue (717) 187-6505, See paoa !i of thll booklet "Im.trlJctions for lnherHanco hll( Roturn for ft Resltkmt Decedent.. IRE.~~1501l for fin QKphUl!lUOn of ~d.lnlstrat1vQh correotablfl erl'ors. If limY tax dofl hi paid within three (3) calondar 1I0nths after the de~edant's deftth, 8 fJva pare.mt (5Y.l ditcount of the tax paid is allowed. 1ho IS% tax IllmOlIty non~part1oip8tlon penal ty Is. r.ollputlid on tho 'totAl of the tax and Interut IInened, and not p&Jd bafore January 16, i996, thA fJrst day ofter tho end of tho tnK 'IlInesty purlod, This nQn~p"rt1clpatlon penalty is appe.lab1a In ttlft ~nllle lI!annllr and in thg the 1i8"''' tlllll podod itS YOU would &pre,,1 the tal( and inter.,t that halt been nUlllsed a$ Indicated on thls noticD. lnt.rest h chftrged b."inning "ith first doY of d€llinquency, or nIno (91 1I0nths and one {II dB)' frOll the date of death, to the dato of paY-dnt, TaKU which b~clI~" delinquent bltfor(l JanUl'lf'Y I, 1982 bear interest at the rat. of ,111( {6%l percent per 8nflUII culculated nt 8 dully rat" of .000164. All tll)(es which bllollllQ deilnquent on ..let after Januery 11 198Z wHI bellI' interest at 0 1'8te which will vary froll cQlendllr yel'lr to calendar year with th8lt rat(l announced by the Pol D~art_nt of RellenulI, Tho oppUcable Jnterut rates for 1982 through 1996 lire I '!!!r lnterest Rllte D~l1y Interest fa()to~ ~. Interest RBtlil Dally Interellt Faotor 198Z 201: .000548 1987 9i': ,000241 1983 161: .OOO(,J8 1986 .1991 11% .001)301 I'" 11% .000301 1992 9Y. .000247 1985 13% .900356 199:\-1994 7% ,0UOI92 1986 10% ,000274 1995~ 1998 91: .000247 --lntllrut I, (',aIClulat~ .. followSl INTEREST = BALANCE OF TAK UNPAIO K NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR -~Any HotleR luu.u aftar ttMI tal( hecOIle' dOlinquent 101111 I'eflrict an Jnterest ca1cu18ticn to fifte.n (IS) dan beyond thG dot. of tho a..eu..nt. If pay.ent Is .ade after the Intel'ut CClIIputfttJon dato .hown on the Nc:tt.lce, '.dd.ltJonal Interellt .ust be cnlouittted.