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V. }:OLJR THClUI, \~;r' );lNB STIUlET MIJ)"l.r!rOWN.'~8,jNSY">MII^ 17057.3596 ) {t I I II' I // r ,.OR OAT~ OIATH AmR 12/31/9t CHICK HI" ~O~m!~~:~DIT ISCLAIMIO [J ______ "LI HUM". 'Ilt~\t'()O~. + (t 'HI '" I- ~S.. dg u~.. ~ i COMMONWEALTH 0' P(NN$VLVANIA I ~1:!~;~fMZ~~~~~l::;; I. _ n...._..u ..J.. '. Ofe 'tilNlT'NAMf lIA~', ntn, ANO MIOOI! I~H'I.(1 INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) i 997-001b57 (OUNTY co ! 'D"te'! D-t ~j I:' 'COMPlf 1 i '~oo~T~'s"'" 2197-01.57 PA _~~AR.. u_ NUMB!R - ._.... .._.._.....n . - ............:...-.-..--- I- ili fil hi co -WAGN~;R..-LAH1i~l'lg;-ot1.L-_'l__---____'_ _/ . __ ... .-0_ Chllreh of (:od NurAing Home, Ine. SOCIAl SfCUl1lh' NUM'U nAIf 0' Of.lllH QAft 0' el~ltl 1l0l N. Hanover Stre"t, CIICHAl" PA170l3 lQ.L-.:Q~_4.L_~_ _ _____, OItl29J'.l L["_ OZ/ 13 '9L_ . Coo" '~h~r..l''''I'L"-,, 'N"'I'-""ON'-'-I-'-'-' _..__-0___..__. ':~: ""Ii I=~=" :.~:~' ,,'" "'" '"0 .,,,,, ""'''~~_J:~CIA~CV.''_~UM''~_____ :\:::_~____~___.___,._________. (] 1. Original RlIlurn [] 2. SuppJementol Relurn [] 3. Remainder Return Ifor dale' of dea'h prior 10 12.1J.821 o 4. Limited eslale [] 40. Futvr. Inle,e,1 Compromile 05, Federal Ellale Tax Relurn Required (for dalll of doal.. afler 12.12-821 CM 6, O,cedont Died Testole [J 7. Deced.", Mainlained oU...ing Trutt _8. Total Number of Safe D,pollt BOltb' (Alloch cop~ 01 Willi IAlloch copy 01 T,uo'l ALL CORRESPONDENCE AND CONPIDENTIAL TAX INPORMATION SHOULD IE DIRECTED TO. NAMf COMPlfTE MAILING AOD~!SS James B. Pannebaker Pann"baker & Jones, P. C. fEmHi5NiNUMIU --'--- 4000 Vine Street ..I- ",ili .... "z 8f z .. S g u ::! 1. R.ol Ellor. (Sch.dul. A) 2, Slocks ond 80nd,(Schedul. 8) 3, Clo,ely Held SlDck/Portntllhlp Intere.t ISchedul. C) 4, Mo,tgog" and Nolel R.cel...able {Schedule OJ 5. COlh, Bank Oepollll & MllceUoneau. Perianal Property (Sch.du'e EI 6, Joln'ly Owned Property ISchedule F) 7, Tlonlle" ISchedul. 0) (Sch.dule L) 8. Total Gran A..'tlllotal Lln.. 1.7) 9. Funeral Expen..., Admlnl.lroll.... Co.lI, MI.cellan.ou. hpe..e. (Schedule H) 10. Debll, Morlgas. llabilitJes, LJ.n. (Schedule I) t 1. To'ol OeduClio", 1'0'01 L1n.. 9 & 10) 12. N'l Value of e.lale (line 8 minus line 11) 13, Charltobl. and Governmental aequllts (Schedule Jl 10% 14, Net Volu..Subject 10 Tax 11Ine 12 mlnu. Line 131 15, Spou.al Tran.fe,. (for dat'l of death ofter 6-30-94) S.e In..ructlon. for Ar.pllcable Percentag. on Rever.. (15) Side. llnclude values rom Schedule K or Schedule M,) 1(). Amount of lIne 1.4 toxabl. at 6% I'ate (Include valu.. from Schedule K or Schedule M,) 17. Amount of line 14 taxable at 15% rale (Include values front Schedule K or Schedule M.l 18, PrincIpal lax due (Add 10K from line. IS, 16 Clnd 17.1 19. Credill Spousal Poverl)' Credit Prior Payrn"nl~ Interest 11) ________ (21 ,__ 131 14 ) (51-12.972.26 ( 61 17 ) 22,972.26 ( 91 5.082.50 18 ) 4.238.93 (10) 9.321.43 1111.- (121 (13) 1141 13.~50 6J I ,160; .Oq 12.1.285.74 )(,-- z co 8 iC IE co u " C ... (161 (l7)_)2~~~_~74 _' X ,15 . 1.842.87 X ,06. (16) 1.842.ll______ -92.15 0;% O1scoLlnl L_..2hL~_n - --,,-----~ + (t9) (20) 20, If Line 19 II greater thon Line 18, enter the difference on linG 20. This is the OVERPAYMENT. liD Check "CI€.' If you we reclucsllng Q rcful1d of your ovc,pnymcnt 1211 __-.-2~ 75~~J}__._____ (21AI ______._._~_______ 1218) ___ __1..l.;;_Q,.l1.____ .___. 21, If Une 18 i. greol"r tnon Line IQ, enler the difference on liM 21, This iSlhe TAX DUE, A, Enter the inle'''t on Ihe balance due on Lin~ 21 A, S Enler the 10101 of line 21 and 21A on line 218. Thil iSlho BALANCE DUE. Make Ch.ck Pavabl.. ~o: R.g~.t., of. Will., Ag.".~. u___....__. _,__. >- >- BE SURE TO ANS~ERALL QUESTIONS O,N REVERSE-SIDE AND'TO RECHECK ~ATH :.c -< .:.....=: Undllr penollles of perjury, I declare 'hol I hove examined Ihil relurn, including accompanying schedules and Ilalemenll, ond 10 Ihe betl 01 my knowledge and ban"" il i~ Irue, correct and complete, I declare rhal all real eslale has been reporlen at Iruo market valuo. Dedoro!ion of prepr;lrer olher Ihon Ihe personol reprtlenlotive il ~c:!~..?~~~~~~_~'ion._~~~~i.0__pre~~~!r._.~~~.I_.~~r.. k_~~.~.I~J1~ :_AuniL_-l'-Dne.itl_Ll.. .._.. _. .____~ .___~..__._________._ _._..___________ ___._________ _.__._____._ ~:N(r:::~\PON".V..~'~::~l<1 'O,,'~S 611l RJuestone Ave, o~:L )_!..:X7 $IONAlu~f 0' P~EPA~E~ ~HR r (P~f NfAIIV( -- ....~OORf5S- 'Rii'rIlsDlrt1r-'PAl 71l2"p ..'C'~'.'--".-- . ."-~.-..- O..A~_ /.._"___'J.{' /~ 7_. __...' .. P~_~_~l.~~!~_~ke.r__J~ _._,:J.~lnes, --.:__ _ ___ -.-----------7L---~ '1../_L_._ Pannebak"r 4000 Vine Street Hiddletown I'A 17057 J-lV_I~1I U. Ir,nl ~,~y~ -9w COMMONWeAlTH 0' '~NNS'1WANIA INH!ltITANC! fAlC RETURN RUIOENf OEC!OeNT 11 SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES _ _n W,,,, mATE OF WAGNER, LAWRENCE M. ITEM NUMBER A. 1. B. 1. 2, 3, 4. C. 1. 2, 3. 4, 5. 6, 7, 8, DESCRIPTION Fun....1 bpln..., Hoover Funeral Home - Funeral and Equipment Sarvices Admlnl.tratlvl CO.t'l Personal Reprelentatlve Canlmlnlanl Social Security Number of Personal Reprelentatlve: _ Year Commllllonl paid A>>orney Feel: Pannebaker & Jones, P.C. Family Exemption Claimant --3.!..A Acldr,n of Claimant 01 decedent'l death Straet Acldrell Relatlonlhlp City State __ Zip Code Probate Feel: Register of Wil16, Cumberland County and Short Certificates MI.clllanlouI bpln"" Cumberland Law Journal - Estate Advertising Register of Wills - Filing Fee, Raceipt & Release The Sentina1, Carlisle PA - Estata Advertising Preabyterian Church - Church Services Hair Cut ,', 1 _ ,... '_'" ~'ft. H ~ILI NUMI.I 1997-00457 PA 02197-0457 ---------.- AMOUNT $3,242.00 1,500.00 76.00 60.00 20.00 76.50 100.00 8.00 TOTAL (Allo enter on line 9, Recapltulatlonl $5,082.50 (If mOrl .pacI I. nl.dld, In..rt additional .hllll of .aml "...) If/ll--;:'! BUREAU OF INDIVIDUAL TIMES JNHERITANCE TAK DIVlSION DEPT, 280'01 IIARRISBUftQ, fl. 17126.0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAM APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AHD ASSESSMENT OF TAM DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 11-10-97 WAGNER 04-29-97 21 97-0457 CUMBERLAND 101 JAMES B PANNEBAKER PANNEBAKER & JONES 4000 VINE ST MIDDLETOWN PA 17057 '. '-.-" *' IIv-IUIU"'CIt.", LAWRENCE M E.:.~_:-A~~~n~~~~~~t.~ - ] MAKE CHECK PAYABLE AND REMIT PAVMENT TOI REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ R i ij: is'". lie .,\iip. loF 97Y - Noi'x c r -OF - YNHiifi f iI iic E - 'fAx - 'A-PPRX is iHENT ~- -A L rowiliic E - if Ii - -.. - --- -- - - - - - -- DISAL,LOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF WAGNER LAWRENCE M FILE NO. 21 97-0(,57 ACN 101 DATE 11-10-97 TAM RETlIRN WAfi: (X I ACCEPTED AS FILED RESERVATION CONCERNING FUTURE 'INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN 1. R".l Est... ISchaduh A) 2. stock. and Bond_ (Schedule 8) 3. Clo..ly HIld stock/P.rtnftrship lnt.rut (Sohedule C) 4. "odstag.IIl/Not.. nlclivable ISch_dula D) S. C.,h/Bank D.posUs/Hhc. Plrsonal Property (Sch.dultl E) 6, Jointly Owntd Property I Schedule f) 7. Tranlferl IS..::hldul& G) e. Total A....h APPROVED DEDUCTIONS AND EXEMPTIONSl 9. Funaral b'J)ln.../Acll1. Co.t./Hieo. hplflla. (Schadul. H) 10. Dabtsltlcrtglgl Lhb!lJ.ti../Lhns <<Sohlldul. Il 11. Total DlduCltlonl 12. Nat Vlllul of T.x Raturn 13. Ch.rlt.blI/Go~.rn~.nt.l Blqu..t'l Non~ll.ct.d 9113 Tru.t. 14. H.t Value uf htat. Subjaot to Tax If an anse~sment was issued previoUSlY, lines reflect figures that include the total of ill ASSESSMENT OF TAXI 15. Allount of lina 14 .t SpouIIl r.t. nS) 16. Allount of line 14 taxabl. at Un..l/Ch.. A rat. (1&) 17. A~ount of Line 14 taxabl. ,t Coll.taral/Cla.. Brat. (11) 18. Prino Ipal 1Ix Du. TAX CREDITSl PAYMENT DATE 07-23-97 NOTE I RECEIPT NUMBER AA211571 DISCOU~IT (+) INTEREST/PEN PAID (-) 92 .14- J I CHANGED (Il (2) ( 3) (4) (5) (6). (7) .00 .00 .00 .00 22.972.26 .00 .00 IS) NOTE I To inlur. ~rop'r oradit to your .eoount, .ub_It the upp.r portion of tntl forn with your tax ply...nt,. 22,972,26 9.3;>1 43 13,650.83 1,365,09 12,285,74. 14, 15 and/or 1b, 17 and 18 will returns assessed to data. ,00 .00 1,842.87 1,842,87 1,842.86 .01 .00 .01 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOrAl DUE IS LESS THAN 11, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU MAY BE DUE A RefUND, SEE REVERSE SIDE OF 1'ItIS FORM FOR INSTRUCTIONS.) (9) !l0) 5,082.50 4.230.93 Cll) 112) 113) 114) <<Sch.dul. J) ,00 x .00, .00 X .06, 12,285,74 M .15, !lBI AMOUNT PAID 1,750:n- TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. .----. TOTAL DUE (){ r'~ MESERVATIONI E.t.t.. 0' d.o.dlnt. dying on or b,'or. D.c.~r 12, 1'82 -- i' anv 'utur. int.r..t In the ..tate I. tran"errld In Po.....ion or .nJov..nt to CI.., 8 (collatGra1) ~flclRrl.. 0' th~ dlc.d.nt aft.r the .Mplratlon of any ..tat. 'ar Ii'. or 'or v..r., the Co..onwlalth hereby oxpr..'ly r..lrve. the right to appral.. and ...... tran.fer Inhlrltano~ Ta~" .t the IIlW'ul Cla.. a (collaterall rat, on any sua. future intero.t. PURPOSE OF NOnCE I tD 'u1fll1 the r.qulre.lInh of SlIctlon 2140 of tM Inhctritance and E.tlta Tel\' Act, Act 21 of 1995, (72 P.S. Slction 9140), PAVHEHTI Dltach tho top portion of this Nctlca llnd sub.U with your ptty"ent to tho Roghter uf Wilh prJnted on the relJlrll. sldft, ~.Hake chIck or !IIone" order pllyabl. to: REOXSTF..R OF NIU.S, AGENT REFUND (CRll A r.fund of a tox credIt, which wn not rClqll~.tM on the Tfl1I( Raturn. lilY b, roquutvd b" cOllpleting IItn "ApPUc'ltlon for Refund of Plnnlylulnia InhClrltance ann [&tlt. Tax" (REV-l1ll), Appllc&tion, are aYllilabl1 at the 01'101 of the Rlgi,ter of Wills, any of the 21 Revenuo District Offl~'I, or by col11n9 the Ipanta1 24-h~ur an.werlMII .orvJcI nUMberl for forlll (wdedn"l In Pwlf1lylvaniR 1~aOO-362-20S0, outsldl Plnn,~luanift and within local Harrhburll f'Ir8ll <1171 787~80oJ4. TIlPI <117:1 772-2Z!il Oturlng IMpaired Only). OBJECTIONSl Any pllrt" In Internt not satIsfied w1th the appnlhe.ant, allowance Of' dloallowanea of deduction" or IUlu..nt of t.1\' (inclUding dhcount or Inter.,u 1lI sh~ on thh NotJce MUlt object with1n Ihcty (6QJ da~1 flf rloaipt of thh Notica b~; uwrlthn proh.t to thl flA Oeparbant of R.vanua, Board of ApPlals, Oapt. 281021, Harrllburg, PA 17128-1021, OR ""'ellctlon to haUl th" _lIltter doterM1nod at aud!t of the Decount of thlil pClrlunlll repruentutlve, OR --appall to tho Orphans' Court. ADMIN ISHtATIYE CORRECTIONSl factuftl arror5 dilcovarad on thIs a&D.ss~ent .hould hA Iddr9ssId in writing to: PA nepart.ant of Rlvlnul, llllraau of Individual Tox.., ATTH: Post. hsassllant Rllvlaw Unit, Dept. 280601. Itnrrlsburg, PA 17128-0601 Phonl (717) 787-6505, Sea pl'lge 5 of the booklet ''In.tructionl fof' InherItanCe Tax Rllturn for 8 Ruldlnt Dlcldt'"t" (REV-1501) fof' on IblCplllnatJon of ad.inistratively correctable errors. DISCOUNT I It an" tax due 11 paid within thrae (1) calenuar .onthl Iltar tho dlcedftnt', duth, a flv~ perc.nt (!IX) dhcount of thl ta~ paJd I. allowld. fJEHAl TVl The 15X hlC IIl1lne.t~ non'Plrtldpatlon penalt... As co.pr..l~ed on ttlft totr.1I of tha tax ond lntlrut auu,.d, Ilnd not paid b.fore Jamlllrv 1ft, 1'196, the first nay flft.... tM end of the tflX It~mast~ flarlod. This non-partJolplUon penalty Is! appealabl. In thlll 1811I. ~anner ond In the the S_ft till' perIod 81 YOU Iolould I'Ipp.al the tax and Interut that hll' been nnnld ftl 1ndlcnhd on thl, notice, INTEREST I Intarut 11 chnrglld bflllinnll\lil with flrlt tlflY of dellnquancy, or nIne (9) .onlhl and anI (1) day fro. thl deb of dlath, to the doh of pllIy",ent. hlC.. whIch haclle. dallnquent bafore Jlnuary 1. 19ft2 bur Int.r..t nt thl ratl \'If Ill" (6iO porcant per flnnu. cfllculntad I'l~ a dally rflte of ,000IMI. All taxu whIch beclllllI delinquent on IInd after Janul.l"y 1, 1981 10111\ baaf' Interellt at a rat'" which will Utlr" 'roil cahndllr yaar to calondar Y'Rr with thot ratl annollMed by the PA O",partlllant of ROYlIIIUO, It)ll IPflUcilbla int"rGlt r8tlll for 11J62 throu"h 1'J91 tlra: '!.!!r Intnrlut Ratl Dail~t.rut filctllr !!!! !n.~R..l!.!! ~l.!L Inhl'lnt factol" 1961 20% ,000S46 ''II' n ,000247 l.,ft3 161. ,000Ha 1'NWI-1991 11% ,000101 1914 111. , OOO~Ol 1,"2 9i: ,OD0241 19ft5 13% .000356 1"'3,-1994 11. .000192 llJ&6 lOX ,000274 1~-)'91 91. ,000241 -, Inter.. t II calcuhtad .. follow'l INTEREST. SA LANCE OF TAX UNPAID X NUnBER OF OAYS DELINQUENT X DAILY INTEREST FACTOR ~-An" NoticI IUlI.d aftal" the tax baco... d.ll,.....t wIll reflect Dr'! intlrllt calclllltlon to flft..n (5) day>a beyonll thl date of the lunlllant. If pa".ent h .adl Iflur th~ Interut IlOlllPutat1on datI .hown on the Notice, Ilddlt.lon/l!l inter..t IIUlt b. calculated.