HomeMy WebLinkAbout97-00465
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su~ary of Aocount
Page
principal
Receipts
Sales or Other Disposition
Less Disbursements:
Administration Expenses
Federal and state Taxes
Fees and Commissions
Family Exemption
Balance Before Distributions
Distributions to Benefioiaries
Principal Balance on Hand
For Information:
Investments Made
Changes in Investment Holdings
Income
Receipts
Sales or Other Dispositions
Less Disbursements:
Balance Before Distributions
Distributions to Beneficiaries
Income Balance on Hand
Combined Balance on Hand
For Information:
Investments Made
Changes in Investment Holdings
Principal Unpaid Expenses
2
;)
5 $
5
5
6
7
8
11
11
12 $ 512.03
0.00
"$ 512.03
14 0.00
$ 512.03
15 0.00
16 512.03
$ 28F337.99
.--------======
17
17
9 $ 114F863.11
(1)
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Disbursements of Prinoipal
Date Amount
raid Paid
Administration ~xpenses
Cumberland County Register of
wills
12/30/97 Filing Fee - Inheritance Tax
Return $ 10.00
Cumberland County Register of
wills
12/30/97 Fili.ng Fee - Inventory 10.00
Cumberland Law Journal
04/08/98 Estate Ad 60.00
Cumberland County Register of
Wills
04/08/98 Probate Fees 105.00
The Sentinel
04/08/98 Estate Ad 48.30.
The sentinel Agency 40.00
04/08/98 Lien Search
Cumberland County Register of
Wills
10/13/98 Accounting Filing Fee 170.00
Total Administration Expenses $ 443.30
Federal and State Taxe!
pennsylvania Department of
Revenue
06/21/98 $ 10.00
Total Federal and State Taxes $ 10.00
Fees and Commissions
MaoDonald, Illig, Jones &
Britton
08/06/97 Personal Injury Witness Fee
Retainer $ 1,000.00
MacDonald, nlig, Jones &
Britton
11/24/97 Personal Injury Witness Fee
Remainder Owing 289.00
Page 1 (5)
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Disbursements of Prinoipal (Oo.ntinued)
Date Amount
Paid Paid
[ees and commissions
MacDonaldF Illig, Jones ,..
Britton
12/02/97 Personal Injury Attorney Fee $ 754'.67
SERRATELLI, SCHIFFMAN, BROWN &
CALHOON F P.C.
04/08/98 4 i 246.'70
Total Fees and Conunissions , 6.290.37
FamilY Exemption
Carol s. Mason
07/10/97 $ 3,500.00
Total Family Exemption $ 3.500.00
Total Principal Disbursements $ 10,243.67
__II!..__......a=
Page 2
(6)
.
COURT OF COMMON PLEAS OF CUMaERLAND COUNTY I PENNSYLVANIA
ORPHANS COURT DIVISION
. N>1F.NDED
F.IRST AND FINAL ACCOUNT OF
Carol S. Mason, Administrator
May 11, 1997
May 23, 1997
May 11, 1997 to
Januaxy 7 , 1999
Purpose of Accounti Carol S. Mason, Administratorl offers this
account to acquaint interested parties with the transactions
that have occurred during his/her administration.
rt is important that the account be carefully examined.
Requests for additional information, or questions ,or
opj ections, can be di scussed with I .
',', ,
STEVEN J. SCHIFFMAN
SERRATELLI, SCHIFFMAN, ET 1\L.
2080 Linglestown Road
Suite 201
Harrisburg, PA 17110
717-540-9170
01
summary of Aooount
prinoipal
,
Reoeipts
Sales or Other Disposition
Less Disbursements I
Administration Expenses
Federal and State Taxes
Fees and Commissions
Family Exemption
Balance Before Distributions
Distributions to Benefioiaries
Principal Balanoe on Hand
For Information I
Investments Made
Changes in Investment Holdings
Inoome
Receipts
Sales or Other Dispositions
Less Disbursements I
Administration Expenses
Balance Before Distributions
Distributions to Benefioiaries'
Income Balance on Hand
Combined Balanoe on Hand
Page
2
3
, ,
s $
s
5
6
7
8
11
11
12
14
$
15
111
For Information I
Investments Made 17'
, Changes in Investment Holdings 17
Principal Unpaid Expenses
9
(1)
,$
S
38,069.63
0.00
38;069.63
273.30
10.00
3,590,00
3,500.00 __...L.J83 ,30
158.00
$
$
30,786.33
0.00
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30,786.33
s
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$
624,80
0.00
624.80
158.00
466.80
0.00
466.80
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$
114,863.11
... SENDER: I .1.0 wI.I, to rocolv. 1118
a 1('.ompIl'lell.m. 1 anGlOf 2 IOf Itddlllonll H,Ike.. following services (for an
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card to yuu,
-Attach thle Ionn 10 ltw fron! of Ih, mallplece, or ofllhe back tlapaOll delft, not
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"20" 97B 0170 Domestlo Return Receipt
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lCompI...ltlffifJ 1 andl()( 2 lor addltlona'Hrvlcell.
'Compl~u itln,. 3, 4a, .nd 4b,
I 'Prlnl vour name and addr". on Ihfllovlr.. of Ihl.lorm to thai wo can r8lum IN,
OIfd to you. i
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DUPLICATE COpy
Clrel Oetlll Continued .--._. -,- AMount' Page 2 014
Deoember 20, 1996 63,26
BROWN DERBY 497 ERIE PA
FOOD/BEVERAGE
FOOD.BEV 65,26
TIP 8,00
l'-tll""" ~'3\42l">
Deoember 20,1998 108.88
CALL HOME AMERICA BINGHAM FARMS MI
COMMUNICATIONS
Ref.,.."~ OOO:HM866 fbc "'mb., 0000414~14
Deoembor 28, 1996 11,41
PONDEROSA /I 114B ERIE PA
FooDIBEVEAAGE
FooD.BEV 11,41
RoIII.ncw 31044606
Deoember 28,1996 80.34
VALUE CITY 0172 NATRONA HEIGHTS PA
APPAREUHOUSEWARESMOC
FWlar."u' 00(\131131
Totlllor C GARY MASON 4fi.Oi'
Nfl.., CM/PI .,1S 06 NrlwerldllOOO
Csrd Trlnelollone lor CAROL S MASON
Cald ,1128.1165223.31013
Deoember 14. 1998 \7,25
WOLFERMAN'S INC BOO.9990169 KS
FOOD & GIFT ITEMS
1-800.999.0169
Rtf...,,", 0??oo0011 Roo ~mblf 0000000114
Total lor CAROL S MASON 17.26
NtwCMrgtt 11:m ""CUdlIOOO
Totll 01 Clrd Aotlvlty Ntw CI'" 0"":=" 432.31
N.... card PllymlnlllC.. I .1,4~
Ellpreee Cftlh Notloe
Durlng your Oct, ober, November end Dooember blUIng cyoleil you had no Expr88. Cosh (Traveler. Cheque or cosh)
l'lIflslICtlono
Prinled below Is the banking Inlorrnatlon that we have on flla lor your Expr88. C..h Iransactlon., II your banking
inlormotlon d1ff8m ~om that .hewn below, pleue ooI1.800.CASH.NOW to ollt~n the proper form required 10 Change n,
Dank: COMMERCE DANK
Aocount number: 03 200375 e
Con"nued on next .....
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DUPLICATE COPY
Payment. YOV' monlhly atalom.nt I. pay.bla III full upon '.OSi'" Th. mailing .ddl... 'Of peymenta I. 'hOW~1
Ihellohl U8Ing the .ncloliOO env.~, malllh. bollom IlO~'on 01 II~ llrot page 01 thl. .tllt.m.nt w"h you, c
tJwn on . bank looaled Inlhe U 0( rTl(lney O(der, pjooe..ablo Ih,ough tl\e US banking .yotem, payable n
U. . Dollars to Amerioan EJ(j)(888 0 not J4)ntl cash Pa~m8nts rOOOlved a"er 12.00 noon or on WfJOMn<ii or
, Ida,.. may not be cred,led until the ne><1 bu.ln... d.y Plellll8 do nol &end poet.d.led cI1ecka 10 ou, payment
prooenlng cent..., Tl10y will be depoo"ed upon 'S08lpt I' payment i. made ot ,any olh.r location. there may be
a delay In prOO8&Qlng, Please include your aooounl nl/fnberon Ihe lace 01 Vour payment
Lo.t or Sto,.n Card II the Cord 181091 or .tol.nln the United Sial.., cqntad u.lmmedlllt.ly Ilt ,.eOO.992.3404
OUt.lde the U,S, contodlh. n.ar.ot American Expo... T,oval Service Off'OO Of call u. collOO ., 910.333.3211
YO~1 are fullV p.:ot8t1ed aQalllst any fraut:1ulent use of the Card when YOll noti,tv American EMpress before ~ is
fraudulently used Vour maXimum IUlbil~V IS '50shCluld you failta report 11810890( theft
ChllrGe Card and Stalement Information Th.ann"a""" $7500 lortl1o SOSIC ()o1(18ard.nd $35,1)0
IOf ..eII Additional Ca'd An addltion,,1 $5 IB charged lor Ixlllng .ddr....s outBlde 1110 U,S, Renewal .rdo ar.la.U8<1
every lhroo YflBf8. If the Cllrd you earlY IS damfWed, VOll may tiav9 it replacad sooner by calling CUBtomer Service. You
may disconllnue your Membaretup by calling GU9tomer Service Be Bure 10 k&8p your copy of the charge sUps for
compJlrison 10 YOl,Jf billed charges
Th. Stat.m.nt ClOSing Dal. Is Ihe I.s' dal. Ihal chary.. and credll. are prOC8fllied 10 appear on 1110 .11lt.ment,
Your account will be Past Due If payment lor YOUf prevIous month's statement was received a"of the closing date,
To keep your Rccount current, pay by lhedale printed on the Payment Coupon fX)rtionollhe statement.
Billing Rlahta Summllry
I" el.. of Error. or Qu..ltonl Abool Your Dill:
f YOlllhink your bill IS wrong, 01 if you need mors Information aooul a Iransodion which AAf)98rt1 onyouralatement, wrlle or
call the Custom.r Servlc. oopa~m.nl os nolad 10 Iha right W. mUBI h.ar I,om you no Illter than 60 da,.. aft", we 8801 you
the first bW on which the error or problem appeared Mhough you may telephone us, doing 80 Will not pr~1V8 your rights.
Whot W. N..d from V.., Whon You Hovo A OHUno Inquhy:
. Your name and account number
. The doUar amollnl alII 10 6U9pectpd error
. Describe the error and explain, il you can, why you believe there is an error. II you need more Information, describe
the item you are unsure about
You do not havo 10 pay any amount in queslion while we urB investigating, but you are stili obligated to pay the parts of your
billlhat aro not In question While we investigate your Inqwry, we cannot report you 88 delinquent or fake any actIOn to
collect the amount In question, Please retaIn any f0C6lptS pertinent 10 vour claim
SpeCial Rule. For Charae Card Purcha8lls "you have a problem wllh the qu8l"y 01 goocI& or 88rv1ooe
Ihht you PllfchBsed ",,,h Ih. Cam, and yot> have 'n.d In good '8IIh 10 correct the problem wKh IIie merchant, you
may not have 10 pay the rornalnlng amount due on the gOOds or servloo9, You have this Pmtectlon only when -the
purch... pflce was mOra Ihan $50 and Iha purchllll8 w.a made In your home stllte Of w"hln 100 mil.. 01 your
mailing addlo... (II we own or operal. Ih. m.rch.nt, or II w. mailed ,,'u tl10 adv.~I88ment for the propa~y Of
services, all purchases Bre covered regardlO$G 01 amount or location of purchase.)
Expreaa Caah Information
In c... of Error. or au.,uon. Aboul Your Eltctronlo T,.",tf.,.:
II you think your Express Gash statement or receipt is wrongl or it you need mora Information Qbout a transfer on the
.t.loment or r8C8lot, c.1I1.600.CASH.NOW 0' wr". to tl10 Exp'.... Caoh addr... noted 10 Ih. right. We mu.t hear ~om
you no lator than 60 d.ys after w. sent you 1110 FIRST stat.ment on which Ih. .rror or problem appeared,
Whon ..lIlng 0' wrttlng pt....,
. Tell us your name and account number
. Provide Ihe dollar amount of the SlJ9~ederror
. Describe Ihe error or the lr~ns'er yqu are unsure a', and explain as olearly as you oan why you believe there is an
error or why, you need more Information,
W. will Inv..IIo. e your complaint and will corr.ot any .rror promptly, II we toke morelhan 10 bl'slnees days 10 do Ihl~\ ~~
will credit your .ccount 'or Ih. amount you think I. in .rror, 90 thllt you will have u9S 01 1110 money during the lime II t.....
us to comPlete our investigation.
Expo:... Cash pa~I"'p.nt. who have changedlh.lr bank account must contact u. to obtain proper updating Ionn., Do not
U88 Exp'8SS Cash unlillhe bank accounl eliango hao been conflrm8d.
CredIt ealance It a credil balance (designated 'CR') I. .hawn on Ihi. .tllt.menl, " re"'asente manoy awed
to you. You may make char""" llgalJl.llhe credit balance Of r8qlje.t a r.fund. Roqu..I. lor refundl .hduld be
maae In writing to the R.fund UniI Ilt the Customer Servloo llddrass nOlea 10 Ihe right,
Page 4 of 4
Telephone
Numbera
Cuotomer Servioo
,.el)O.327.21 n
(24 Ilouro, lolllree)
E'p'.... Caoh
'.eOO.CASH.NOW
1.081 or SI~n Card
,.61)0.992.3404
Int,ooIlect
910.333.3211
Hearing Impaired
ny: 1..600.221-9950
Fax 1-81)0.695-9090
Addre"lI8
Cu.lomer Service
P,O, Box 297e04
Fl. l.auderd8la, FL
33329.7e04
Expr... Caoh
Fundo AOO8llS Services
PO Box 53809
Phoenix, AZ.
65072.3809
Payment.
SUITE 000'
CHICAGO II.
eOO79.0001
,
.
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DUPLICATE :opy
Pr'P""a'Fo,
C GARY MASON
AIlcount Nwmb<< P 2' 2
3728-985223-31005 age 0
P"yments Your mOillhly Iilalornenl is payable In lull upon reOOlot The maWng address for payments is shown to
the 'ighl U.ing Ih. anclpsed onv.IQpe, malllh. bottom po<1,on 01 Ih. IIrsl paU. 01 Ihla .la\Om.nt w~h your cI1eck
drqwn on a bank Ioo&ted in the US. or money order, J)!QCeG94b1e Ihrough H1e US. bonk ng Byslelll, payable In
U,S. Dollars 10 American Express 00 not sena oash Payments received after 1200 noon or Oil wAekends or
halidal'll may not be Cledrlsd unhl the n.'" Ix",n... day Ploa.. do nol s.nd posl-daled checks to our paym.nt
proce..ing Olml.,a, Th.y will be dopo""." upon ,"c.ipl If paym.nl ia modo 01 any oth., looatlon, Ih.r. may be
a delay In pfOoo8sing Please mcludo your account number on the face 01 your payment
Lo.1 or Slolen Csrd If Ih. C.,d " loal, or alolon In Ih. Unllad Slat.a, conlact "' immed,al.ly 011.800-992.3404
Oulaido tho US, oonlact 1110 n.a'o.1 Amorlcan ",praaa Travol Service 011100 or call u. oolloct 01 910-333-3211.
You are fully protected against an~ fraudulent US9 of the Card when you notify American EKPfOSS betore It 18
fraudulently used Your maximum liability 10 $50 s;,ould you laillo IOport Itsl08sorlheft.
Chsrae Csrd snd SlstomenllnformsUon Tho annual loe la $75uO 10' Ih. Basic Gold Card and $3500
for eacl'i Addrtlonal Card An Ilddftlonnl $5 IS chilrged lor bdhr~ addrosses olllsldo the U,S Rel18WsI Cards are Issued
every Ihr$8 years II the Card you carry IS damLWod, YOlI may nave il roplaced sooner by oalllng Customer Service. You
may dtsconllnue you; Membership by callJng Customer Service Be sure 10 keep your copy of lhe charge slips for
COnlpjlrison to your billed charges
Tha Slat.ment Cloaing Dolo i, Iho lasl dalo Ihal chmgoa and cred,t. a'e prooeasod 10 /IIlIl8ar on lhe .tatomellt
Your account wilt 00 Pasl DlIe II pa,ymont 'or yOllr pl'!,\VIOUS month's slstement was receiv8d after the closing dale.
To keep your account current, pay bY the dale pnntedon the Payment Coupon porllon of the statement
Billing Rlghlll Summ~ry
In elM of Error. or aU..Uon. About Your Bill:
" you think YOl" blll '9 wrona. or if you noed more Information aboul a transaction which appears on your ntalement , write or
calltha Cuatomer Servloo department as noted to the right. Wo must hoar from ~'ou no later than 60 days after we oenl you
the lirst blll on whrch tho error or problem appeared Atlhough you may lelephona UB, doing 80 will not preserve your rights,
Whol W. N.',d From Yoo Wh.n Yoo flov. A Dilling Inquiry:
. Your name and accounl number
e The dollar amowlt of the suspected error
. DoscflOo the error and 8)(plaln, If you can, why ymr believe there Is an orror, II you need more Informationl describe
the Ilsm you aTe unsure aoolJI
You do not have 10 pa~ nny amounlln question willie weare inveSltgalinu, but YO(I are still obfigatedto paYlhe parts of your
bill lhat Ria 11011/1 qUbshon While wOlnvesligate your InqUirY, we oannot report you as delinquent or taka any action to
collect the. amount in question Please (etain any receipts pertinent to your claim
Spoclal Ruleo For Chargo Csrd Purchssoll If YOll havo a problem with Ihe qualilY 01 goods or aorvlce.
Ihllt YOll pu,chaSed wllh tho Cora, and YOll havo Iriad in goOO 'ailh 10 oorrocl Ihe p<obl.m w th Iho mercl1ant, you
may not have to pay Il1e remaining. amount due on the gOOds or services You have this protection only' when lhe
purChase pnCD was more than $50 tlnd the purChase W/JS made In your home state or w"hln 100 mi es of your
mailing address (If we own or operate the merchant, or jf we mailed YOll the advertisement for the property or
SeIV10J8S, all purcha99s are covered regardless of amollnt or location 01 purchase.)
Express Cssh Information
In C... o' Error. or Qu..Uon. About Vour EltOlronlo T,.nlf.rl:
If you think your E )(press Cash stillement or receipllll wrong, or if you need more information ~bout a tran$rer 01) the
statenlent or recOlnl, catll.800.CASH.NOW or wrrte 10 Ihe E)(pross Cash addreBS noted to the right, We must hear from
YOll no laterthan 60 days after we stint you the FIRST statement on which the eueror problem appeared.
Whon o.lIIng 0' wrttlng pl....:
.. Tell us yow flanle ana aecalmt number
. Provloothe doltnr amountofltle SlISpectedorror
. Describe Ihe error or tho trunsler yqu are unswa of,l1nd explain as clearly as you oan Why you believe there is an
error or why you need moro Information.
We will investigate your complaint and Wilt correc.1 any error promptly. If we take more than 10 business days 10 do Ihis, we
will credit your account for tile amOllflt you thInk IS m errar,SD lhat you will have use of Ihe money during the lime ~ takes
us to com~te our investigation
Exproaa C89Il part'cipanls who ha,e changed lhai, bank .ccount mual oontac4 us to obtain P<O,,"' updoting forms. Do not
use Express Cash unllllhe bank account cHange has been confirmed, ,
Crlldlt aslsnce "a e,odll balance ldo.ignated 'CR') i. .hown on Ihia statement, it r.presents money owed
10 'OU, You may mako charD.s ogaln.t lho credll baiance or rl!<luesl a ,elund ReqUests lor relunds .hould Il8
01000 in wr~inu 10 Iho Refllnd Unlt allhe Cualomer Sorvice sdd'.... nolOdto Iheright,
(.:<-
ChanOt 01 Add"..
Noorllcton'ront
do NlI U8I
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-'
Telephone
Numbers
Cuslomer Service
1.600.327.2177
(24 hOll,", toll 1'00)
E'p<a.a Caah
l.eOO.CASH.NOW
Lo.1 or Sloi.n Ca,d
1.600.992.3404
1"1'1 coilocl
910,333-3211
Hearing Impaired
[TV' 1-800221-9950
Fa, l.eOO.695-9090
Addre"llI
Cuslomer ServlOO
P,O, Box 297e04
FI Laudordoia, FL
33329- 7e04
E,p<o.. Cash
Funds Acoes. ServictlS
PO, ao,53800
Ph08nhl, A1
e5072-3e09
Psym.nl.
SUITE 0001
CHICAOO IL
e0679.0001
,
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,
:11
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N.lI>,()llHiJ O:lIi.j
Account
Statement
MINIMUM PAYMENT DUE BY PAY~;ENT OUE DATE
U;'<I!.ll
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Card member
News
I M,,,",,,,,," I'IlSI f.)lW I PllynlOl\( Now ^oomml PI088cwrHo In
J'ayrmml DlI~! Mnlllml (]\iiIDilIu Ilniilnr.o N\Jmlll'! amount of paymont
I onolo5od
, 219,00 ,00 03/02/97 7,901.90 3737-D1Dael-35003
I
C GARY MASON
5200 HENDERSON RD
CIDER MILL APTS #909
EERIE PA
16509-4049
Mako ohi:lok p.llVal:)lo 10:
AMERICAN EXPRESS CENTURION BANK
CIO THE OPTIMA ACCOUNT BOX 1407
NEWARK. NEW JERSEY
07101-1407
001L3101086138000000219006 rlDDD7901903
Should you uvor loso the Optima Card, YOllIlElVOr,.loso Outilomm SOrvICO. W(l'ro always rElElCly tp help. 'To ,report a lost'Dr
'stololli1E1rd, Simply call us at 1.800.300.8766. Wo'lii'sslIo a nov'l Opll((lil Ourd loryau fast"u8uallyby thE.l.rUlxl bllSln8SS day.
I
I
I Am. Exp. ID!lIa 01 IDale of
I Rehmmco No. TIni1S801!Orl Posting
1835017-0 I
! I
, ,
I
I Oardmember Name
C GARY MASON
I Aooount Number
,
I 3737-010ael-35003
Ipage
1 01
liiMnaotiOtl
Desorlptlon
I Ch~roa~
lOradll!!
,
01/171
I
01/171 PAYMENT
RECEIVED - THANI\ YOU
01/17
230,00
ACCOUNT TOTAL
,00 230,00
YOUR CASH,ADVANCE
AVAILABLE BALANCE
T.RANSACTlON IS
'FOR INQUIRIES ABOUT
1~800-423-1414,
LIMIT 15 $5900
FOR NEW CASH ADVANOE
$598,
,I
YOUR ACCOUNT, CALL
.
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.
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jAccount
,summary
I
!
PrEiVltiuli I ~~ New
Balllflce ,Chfl(ges
8,051.89 'I
.00
'~fiYrnnn!$ I "OiadHs
239.00 I
, FINANoa
OHARCS
.09
80.01
I' Debit
Mlu$lmen!S
I
~ New
Btll~Hlce
.00
7,901.90
I g~II~IO!llng
I 02/05/97
I
P.vment, Crccti1
Due- bate Limit
03/02/97
IAVilll~bIO
C,adl!
8,5091
I AmollntOvet
Credit Limit
598 i
PlIsl Dua
Ammml
o
IMinlmum
- Payment Due
,DOl 219.00
CU~R~'" ANNUAL IThank
paRoaNTAC. RAT. You
,
IFlnanoe
IOharge
iPURCHASES
'OASH ADVANCES
INTRO, RATE
Numbar of DllYfI
this _ BlUing Period
x Dally _ 1 k A"a,noo
Pailodio RnltJ Dally;Blllanc(J
30 ,0336% , 7,937,42
30 ,,0579% ,DO
30 ,0216% ,DO
iii: FINANOS
OHARC.
80.01
.00
.00
12,250%
21,150r.
7,900%
CU8 tomer
~elVloe
The OptimaSMCard
0006/000'1
W'
Monthlv
Aotlvlty
Summary
N,IN....ll1'd 111-\0
~,I,,~fr~~ll
Lif: .-"-"~I
f-....~"":"IT~-~-..... ~.c'7C,..,.. ~,
,"""..<0' .._
Account
Statement
YOUR ACCOUNT IS PAST DUE. PLEASE
I1EMIT PAYMENT IMMEDIATELY
I MUllIITlUfll
I'llynlUnl bill!
I 405.00
Il'llHt (JIIU
^Il1Olltll
I
i 238.00
Pill/fllml!
OUllD,I'1I
Nnw
Bflfnnm
I ^U:flurll
I Nurnluu
la737-0tO&61-aSDD3
.' fi.'<10:'
Pll:Ia,o wrlla In
1l1l1ounl 01 p^vmanl
onolo,od
C GARY MASON
SOUTH SHORE APTS
4590-2C E LAKE RD
ERIE PA 16511
Milko <Ihook pavllblo 10'
AMERICAN EXPRESS CENTURION BANK
P.O, BOX 1407
NEWARK NJ 07101-1407
I Account Number
3137-010ee'-3SD03
IDalO ot loalo 01
Trllnsactlon PoatllltJ
ITransactlon
O(IScflnllon
08/31/97
e,S34,5e
3701086138 000405000008534589
111,,,1,,,1,,,1111,,,,,,11,,,11,1,,111,.,1,,,11,1..1,1,,",111
ACCOUNT GRACE 'PERIOD-STANDARD GRACE
(SEE STATEMENT BACK FOR DETAILS).
FOR HJQUrRIES ABOUT 'lOUR ACCOUNT . CALL
'-8oo-30b-8765.
YOUR CASH AOVANCE
AVAILABLE BALANCE
TRANSACTION IS
LIMIT IS $5900
FOR ~JEW CASH ADVANCe
$0.
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I Provlous. + New . Pnyrnonls -Otedits
~ooount
ummary Balanoo CharClos
, 8,391.30 .00 ,00
i
I
I BIIlCIClSln\) Payment Credit Avallllblo
I Oalo Due Date Llrrill O,odll
06/06/9"' 05/31/97 8,600
,
Numhef 01 Davs
lhiR BItUno Peflocl
)( Dally .1 )( Avor#lQo
PtJliochc ARlo Dailyaall1!lco
,0586% 7,968.6~
,0586% I .00
,0216% 1491. 72
I
I
Card member Now, accoss your Card blllm{J dOlails on 1110 Inlornoll Optima Cflfclmombors can rovlow up-to.claIO aCCOllnt inlormallon suoh
NeW8 as unbillocl.cnarges and payment!;;, plus 12 manllls 01 prior billocl SIA10rllonts, Discovor lllllhat'$ availablo with ExprossNot
on tho Intornal al WWW.amoricanexprElss,com or AOL koyword:AmfJK,
I Cardmomber Name
I C GARY MASON
I^"' Exp
,nOI(HOrlCa No
!:inanee
!:harge
i'URCHASES
~ASH ADVANCES
NTRO.RATE
:UBtomor
',orvlce
30
30
30
The Optima8MCard
+PINAN08
OHMOE
.00
143.28
Amount Over
Credit LimIt
o
. FINANOI!
OHAROE
140.09
.00
3,19
IOha/oas
+ OnbH
AcljUstmonl1l
Pllsl Due
Am(}Ilnl
35
236,00
CURReNT ANNUAl. Thank
PERoENTAoe RATe VOlt
21.4001-
2 1 . 400% I
7.900%
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rr.radilfl
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u Naw
Balanoo
.00
8.534.58
Minknum
PavmHnI DUll
405,00
.'
1l!.~J. 1!l00 EX" (1.11.4)
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COM ~e~~i'Mh!Ii\-')jr';r,!llj!\l'Ill AN'A
HAR",.~fir.Ii.'il'l1~ \".0001
[)r:OF.OF.NT'B NAME (LAST, rIHS1, AND MIDOLf' INITIAl.)
J:tl!~Ql!,SLARENC~~(;.., .._____.
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rOIlIJAll'HOI nLAlIlf\,"Tt:1l I;"I'lIj\CHITGKHHH'
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J'QVc.:1l1YW\l:Djl ISI:LAIMIiIJ __ _n___ -_.------.
fiLE NUMDEIl
I~\
I'JCI'l
IiIfS
SOCIAL !HiOUHITV NllMHEH
DATE OF m:ATlt
UATI'OF WIlT!1
co .'NTVCQI)L
Dr:C[[}rNl'[l COMf'I.fTl' ADOJ\[!HI
713 Florenco Circlo
Mechanicnbllrg, PA 17055
Vlil\fl
NuM(l~n
I~:;~'P~~~~::~~~~~~'~U':;~(~~~ :;~~';~';;~Tl~~;l~;;~[~~'N";A'~o'r~;~~:;~~;~~~~~~;;~;;]-~-~\~;;.,;~~~~~. "\oF' ~f;~~~~N4.~
pn'~~:~1 :.:~..n---EI~~~::f,:;~~~~~i~;~~~~ro~I=' ...,--- n--l~ 3, - ~::~~::~~~::~~prlo:t::~~~:'1l2)
...... _" (for dalos 01 doalh aller 12.12.62) [] 5, Fode,.1 Estato Tax R.turn R.qulred
L_J 6, Decedent DIed Testate [J 7. Dc(edcnt Malnlilined a Uvlnfl Trust _9._~. 8. Total Number of Safe Deposit BQ)H'S
.....".._.. (Attach cOPI:2L\YiIIL_~.._~,,_~_(Atta~..~.~OP.Y.9iI<,,~IL__..._.. ___..,,__.""__......... n -."...-.....--
C p ~L~,(::ORf!.E!.~ONOENCE ~!l(;QNE[[J_ENTI~l,.I~XJN-".9RMA TI~..!!tt9UI1?Jl.E Olr~!'CTElJ.IQ:..__~__.,_."
R 2 NAME coMPLETE MAILtNClAOORESS
~ ~ __ St~''-~_,J. SchH.l111fl,,'lL...EB'l'.._n. .,,,._..__n. 2080 Linglestown Road
5 N W,F.PHONE NUMBEn Harrisburg I PA 171.10
T
-1 540-9170
" Roal Estuto (Schodule AI
2. Stocks and Bonds (SchcdlJle B)
3. Closely Held Stock/P.rtnlJlship Interest (Schodulo C)
4. Mertgago. and Notos flecolvablo (Schedule DI
5. Cash, Bank Deposits & Miscellaneous Personal Property (5ch. E)
6, Jolnlly Owned Property (Schedulo F)
7, Transfers (Schodule G) (Schedule L)
8, Total Gross Assets (total Unos 1- 7)
g, Funeral E)(pcn~s, AdmInistrative Costs, Miscellaneous
Expenses (Schedule H)
10. Oobts, Mortgage L1abilitios, Uens (Schedule I)
11. Tetal D.du<110ns (total Unes g & 10)
12, Not Value of Estate (Une 8 minus Une 11)
13, Charitable and Governmental8cqucsts (Schedule J)
14. Not Value Subiect to Ta~j~l~.~. 12 minus Une 1~L
15, Spousal Transfers (for dates of death aher 6-30.94)
See Instructions for Applicable Percentage on page 2,
(Include values from Schedule K or Schedule M.)
16, Amount of Une 14 taxablo at 6% rale
(Include values from SchcdlJle K or Schedule M,l
17. Amount of Une 14 taxable at 15% rate
(Include values from Sctledulc K or Schedule M_)
18, Principal tax duo (Add lax Irom Uoe 15, 16 .nd 17,1
19. Crodits Spousal Poverty Credit Prior Pa~ents Discount Intorest
_._..___()_'O"Q I O.,.OC[ t .,,~.__Q..&O .___-2.00
20, IILlno 19 is~r_~~:~r..!t.1-<!~JY.lgJ!l' ent~r_thediU:~2.~e o-:n ~n~:~~:.ItllS IS~~ie,9~ERPAVMENT,
~ [J C~ee~}t~"J!~u.!t.!'l~g~~.!lli'.9.!..~~!i!.~.d..2f:~.~t.o.W~..w..!rill
21. If Une 181s greater than Line 19, enter tile (lilfcrencc un line 21. This Is the TAX DUE.
A, Entor the Interest or, the balance duc on Une 21A.
e, Enter the lotal 01 Une 21 and 21A on line 218, This is ttle BALANCE DUE.
Make Check Payable to; Register of Wills, Aqent
~ ~ BE SUHE TO ANSWER ALL QUESTIONS ON PAGE 2 AND TO RECHECK MATH ~ ~
u;;d';;-r;;Mii~;;T pm lur-v.TloclB~r';"lt;;tit;'~;;';~"mlnodii"ii;'~~I;;;;~";i',-;-;;Il;di~f' llccompll~~yl~;g~t;-Il~es and Ilate;;;;nt~;:;d1~;'f my kno;i.dgll and belief, ill'lrlle~
clJllenlllnd complele, J decllr.rfl thaI all rulllsllltll hlll been reporlfld III trulI ffiIllkltl vallI", Dltclarl'lllon 01 pfllparer olhllf ttllllllhe persollal repreuntlltive 15 bAled on In InlorfMllon o'
~1~~:!2..r.r_~~~:_~_t~~~_~y ~owlfl~9~. _~_.~._~_____, "_... _.___.____...__.__.........._._.~_~____ .__...^_......__~_.__
CAB
, P L
H P 0
E A C
C 0 K
K f' 5
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!1I0NAHJflr: or PfnCloN RESf'ONSlOLr: fOR FlUNG n(1LJf\l~ ADlHl[~lS
(1)__~.
(2)
(3)
(4)
(5)
(6)
(7)
15,749.1e
15,749.1e
(6) ..'
(9) __ 19,461.30
(10)
137,628.40
(11L-
(12)
(13L...........
ill)
157,089.70
(141.340.52)
.~O
(141.340.52)
(15)
54,291.45 x,QQ.o
0.00
(16)
O.OOX.oo-
...Jl....Q.0
(17)
0.00X15=
0.00
(18)
0.00
(19L_,__....9."'O_0
(20L,~_....JL,Q.O
(21),_____,.
(21Al
(21BL
0.00
0.00
...Q..,Q.O
DATE
.-', ')
., C~^V\."tL,.d..b.uc"4~),.'"-J-"n.
,,7.13 . f'lqr"!1GQ. ~..ix<;'le . . . . , . ,
Mg<;:JlanlQf1Qurg,.. .l'lI,] 70.25"
/- f.c,-98
DATf:
~iI(jNA Tun!". or PII[;PArHin {J-~tt 1\ 1-1 !f,N f~fF'nr: S[ N1 A J IV:' ADDfl!::;:!
~~I i (Ii ,/' II _-c:-20BOLInglestoYin.!\q"
1'\-" . , " L..---
"",. "_~...~ ,...,.;.t ". "_,..,_,,...lIarrisburg, PAJ7110
','''''0. 'I'"'''''''''' ..n;!';". ""'V c~;v.,,,..,,, ,..,
suIte .2P1,
/.~(p 98
I('\w 15(X) (n,..v, '.:;l
Ji~ '(? ----
1..7.'/(l,;;'~6
IURF.'U Of INDIVIDUAL TA~ES
JNtIC,(lTAMcE TAl< ItlVIS'IUH
PEPT, 180601
H.~RlSaUJIG. f1" 1111l\~0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERHANCE TAX
RECORD ADJUSTMENT
*'
('-/
IH-HiU'. "p lU-HI
DATE 10-05-1998
ESTATE OF MASON CLARENCE G
DATE OF DEATH 05-11-1997
FILE NUMBER 21 97-0465
COUNTY CUMBERLAND
ACN 101
[~=""::=,~~~~~R~M~=:~:.:3
MAKE CHECK PAYABLE AND REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
STEVEN J SCHIFFMAN ESQ
2060 lINGLESTOWN RO
HBe PA 17110
MOTE I To insure prop.r credit to your account, aub..tt the upper porHon of this for'ln with YOUr i.)( p.y...nt.
CUT ALONe THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiiV': 15'9-3- EX.- AFii-[ iiij::9'rr-.,mjili-iiiHEiiffAtici- TAX - REcciiiii -"iijjjSTiiENT -Ii" w" m - -- _m" m"_ .,""" - - - -- - --
EIITATE OF MASON
CLARENCE G FILE NO. 21 97-0465
10-05-1998
ADJUST"ENT BASED ON,
VALUE OF ESTATE:
PROTEST BOARD DECISION
1. R..l Ewt.tGl (Sohedul. A)
2. Stock~ and Bonds (Sch.dule B)
5. CloselY Held Stnck/Partnarship Int.rest (Sohedule C)
4. Hortg.u-~/Not.s Reo.iv.ble (Schedul. DJ
S. C..h/Bank DMposlts/Hisc. Personal Prop8rty (Schadul. E)
6. Jointly Owned Property (Sch.du~e Fl
7. Trmosfers (Sohedule G)
a. Total A...h
DEDUCTIONS AND EXEMPTIONS:
9. F~r.l Expanses/AdMinistrative Costs/
His~el1~ou. Expenses (Schedule H)
Debts/Hartg.oo Liabilities/Liens (Sohedule Il
Total Deductions
Net Velu. of Tax Return
CharitM)l./GovernMental Saqu..tsJ NonMelacted 9113 Trult.
Net Value of Est.t. Subjeot t~ Tax
10.
ll.
12.
15.
14.
TAXI
15. AMount of
16. AMount of
11. AMount of
18. Prinoipal
TAX CREDITS:
PAY"ENT
DATE
line 14 at Spousal rat.
line 14 taxabl. .t Lin..I/CI.sQ A rat.
li~. 14 taxable at Collat.ral/Cla.s B rate
Tex Du.
RECE 1 Pl
NUI1bER
DISCOUNT (+)
INTEREST/PEN PAID (-)
. If PAID AFTER DATE INDI~ATED, SEE REVERSE
FOR CALCULATION Of ADDITIONAL INTEREST,
ACN 101
DATE
(1)
(2)
(3)
(4)
IS)
(6)
(7)
,00
,00
,00
,00
15.749,18
,00
.00
(8)
15,749,18
(9)
110)
10,961.30
137,628.40
(111
(12)
(13)
(14)
148.589.1.Jl
132.840,52-
.00
132,840.52-
(Schodulo J)
(15)-
(16)
(17)
,00X.00c
,00~.06c
,00 X. 15 c
(18)
.00
.00
.00
,00
ANOUNT PAID
l
TOTAL 'TAX-CRi:Di~ .00
~A::~C:~f~A:~::~~E=~_._ : ~~
IF TOTAL DUE IS LESS THAN fl, NO PAY"ENT IS REQUIRED,
IF TOTAL DUE IS REf I. EClED AS A "CREDIT" (CR). YOU NAY BE DUE
A REfUND. SEE REVERSE SIDE Of nlls FOR" fOR INSTRUCTIONS, I
'.
PAVlI!NT. '
OitHh the tOfl ftOrUon of thh MoHo. end ,uballt wit., ~eUr PlY"" ... Pl'Vablt ta the ".. ~ Itdd,..,
pr int.d Ofl thl rlyar" . tefl.
I n HIk. ohMk or 110M)' order plveblt tOI ReGISTIIR Of WILLS, AGENT.
Jl
REFl.IND (CR)I A refund of . tll( credit, .mloh Nal not r'ql~..t.d on the 'II( Return, ..y be requlltn by OOllpltt1ng .,
"Applloaltlon for R.fund of P.m.vl",.,l. IntMrltlMl .ncl Elt_t, '1M" (REV-UUl, AppUCMlUon. .r. av.Ulbl~ It
tht Offlo. of the Rqishr of NUll, .f1Y nf ttMI 23 R.venue 01.trlot Offio.. 01' frOll the bop,,"..nt', U..hottr
In'WIIring ..rvlol nuIIb.r. for for.. orcktrJhtll In "ennlvlvlf'!Jl 1..eOIJ~562"2DSO, whlckl Ptnn,vl\l."l.
tnd within 100.1 Herrhbur. ".. (717) 1ti7-a094, TPDI (711) 772-22&2 (....rlng 11P,lr4td onbl.
REPLY
TO.
Due.tlon. r,glrdlng .rror. oont.l~td on thl. notlo. .hould bI ~r....d tOl PI. Dtp.rtaent of Revenue, tur..u
of Indlyl~l l"~., ATTNI POlt ........n\ Rovl.w Unit, Dept. 280601, Herrl.burg, p~ 1112&w0601, Phone
(717) 7a7~6505,
DISCOUHlI
If Iny t.liC dot ,. p.'d within thr.. (5) oahnd.r .onth. eftar the (fec.dent'. d..tn, I UVIf p.roe'lt (SiC) dlsoount
of the tlM paid 11 allowed.
PENAL 'V:
In. lSX tlM "~Ity nonwplrtioipfttlon penalty II ooaputed n~ thl t~tsl of the tsx snd lntsrslt .I....ed, end nOt
ptld befol" JlflUtIry II, 1996, thl fir.t daY afhr thtl .rm of the hI( un..ty p.rlo.d,
INTERE:$iTI
Intsr..t 11 oh.rged bvglMlnll '11th fir.t day of d.lk~lUInoy or nlnl (9) _onth. snd OM (1) dty frOll the d.t. of
dI,th to the cat, of Plvant. hM8lt NhJoh b.o.. dellflqUent bIIfor. JIflUfIf'Y 1, 1982 b..r lnt.r..t lit thl rite of
11M (6)0 pera-nt per e~ oalClulstld It a d.Uy rilt. of ,Q00164. AU tlM.. whlchtMo_ dlllnquent on Md Ifter
JIlIllI.ry l~ 1982 will hlltr ll1t.ro.t at .. rat. which wl11 vary frOll a.llndlr ye.r to ollandar y..r wUh that ret.
lnnOUnCed by tho PA Depart..nt of R,Vlnue, Tht eppllaabla Int.rl.t rltl' for 19ft2 through 1998 .rll
V,sr Int.r..t R,t. OII!!y Int.r..t FlOlor V..,. Intlralt R.t. Deily Int.rl.t f~tor
1912 !OX .000548 19.7 9X .000247
19.5 llX .000438 1918-1991 lIX ,00asol
1914 m .00OJOI 1992 9X ,000241
19I5 m .000556 1'193~1994 7X .000192
1986 lOX ,000214 1995-1993 9X ,0002"7
--Inh,...t 1. calculeted e. follow",
IHTERBST G IALANCE DF TAX UNPAID X NU"IER DF DAYS DE~INqUENT X DAI~Y INTEREST FACfDR
~~Any NoUoe I"wet .ft.r thll tlM "'(1011I1 deJ!nqtMnt Nll1 r,Ulct .... ilt.r..t cllauhtlon to flft"n (15) d.~.
bI~Qnd thl dltt !.If thtl IUI"Mnt. If plyeent h .. .ftlr the Int.r..t c~ut.tlon dlte lhown on the
Motlfll, .ddltional Intar..t MIlt be c.loul.tad.
. I:) ---/,'?;( -!/
10F INDIVIDUAL TAMES
I.l'tfluulAIfi:E TAlC DI~ISIOH
DEPT. 2'10601
HARRIBIUflO, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISE"ENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS ANO ASSESS"ENT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
r.OUNTY
ACN
03-30"911
MASON
05-lt-97
21 97-0465
CUMBERLAND
101
STEVEN J SCHIFFMAN ESQ
2080 LINGLESTOWN RD
HBG PA 17110
[
'..aunt R...t U.d
-
,
'--
'*
U~.II41I. H' llt.tll
CLARENCE
G
J
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~
R 'EV: is'47" iif - Aii,," (0'9-: m" "NoT" i ci. -0"- iiitiiif ii' AiicE - 'fAX. 'A"PPR'A-isEHENT ~ - "Ai. rciWANCi.- OR-" _om - - - -.".".-
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MASON CLARENCE G FILk1 NO. 21 97-0465 ACN 101 DATE 03-30-98
TAX RETURN WAS, I ) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST " SEE REVERSE
APPRAISED VALUE OF RETURN RASED ON: ORIGINAL RETURN
1. R..l f:..ht. (Schedule A)
2. stocks and Bond. Uch8dula B)
5. C10..ly Held Stock/p.rtn.rshlp Intnr..t (S(lIl.dul. C)
4. HortgDg../Not.. R.c.iy~bl. (Schedule D)
S. C.th/Bank n.poI!tl/Hlsc. ~.rson.l Property (Schedule E)
6. Jointly Owned P~op.rty {Schedule fl
7. Tran.fars ISch.~ul. 0)
3. lot.l Au.ts
APPROVED DEDUCTIONS AND EXEMPTIONS:
9, ~'un.f'a1 E)(p.:"IS.s/Adn, Costl/Hisc, E)(pense. (Sch_dule Hl
10. Debts/Hodg.". liabl11tl../li.nt (Schedula 1)
11, rot.l Deduct tonll
12, N.t Value of Tax R.turn
13. Char1tabla/GlJv.rnlla"t.l aequa.hi Non~.l.ct.d 9113 Trust.
14. Nat Value of Eiltah Subject to h)(
If an a....sm.nt was issued pr.viously, lin8s
rllfl.ct figure. tha't include the total of ALL
ASSESSMENT OF TAX:
15. Anount of Lin. 14 .t Spous.l rate (15)
16. AMount of Lin. 14 ta)(eble .t Lin..lICl.AI Arlit. (16)
17. Al!ount of Line 14 h)(.ble .t Collahral/C1UI 8 rat. (17)
18. Principal Tax Due
NOTE:
TAX CREDITS:
PAVMENT
DATE
RECEIPT
NUHBER
DISCOUNT 1+)
INTEREST/PEN PAID 1-)
. IF PAlO AFTER DATE INDICATED, SEE REVERSE
FOR CAl.CULATIDN OF ADDI'rIONAL INTEREST.
I X) CHANGED SEE ATTACHED NOTICE
(1)
12J
(3)
14J
15J
(6)
(7)
....0..0..
.......Q.Q..
.00
,01..
15,749,18
,00
.00
IB)
NOTE: To in.ure prop.r
credit to your eccount~
lub.it the upp.r portion
of thil forM with your
ta)( pay...nt.
15,749,18
14~.389 70
129,640.52-
,00
129,640.52-
14, 15 and/or 16, 17 and 18 will
r.turns a.s....d to dat..
,00
.00
,00
.00
.00
-----
,00
.00
,DO
IF TOTAL DUf, IS LESS THAN .1, NO PAV"ENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), VOU "AV BE DUE
A REFUND, SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS.)
(9)
llO)
7,761.30
137.628,40
(II) _
(12)
ll5)
(14)
(Schedule Jl
.00 X .00=
.00 X .06=
,00 X .15=
(18)
AMOUNT PAID
TOTAL TAX CREDl'r
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
,r'
i
/
,,'.,
RESERVATlOHI E.t.te. of deoed8nt. dylny on or b.fur' D.o.~.r 12, 19&2 ~- if .ny future Intere.t ih the ..tat. J. tr,n.ferred
In po.,.t.lon or enjoy..nt to Cla'l 8 (collat,ral) b~flct.rie' of the d.cldlnt after th. expiratJon of any I' tat. for
1111 or for ye8r./ the Co"onWteUh ~r.by IlCpruIly ru.,'v.. the ri{lht to apprahe and a..... tran.Ur lflh.ritDn<lt TIll..
at the l"wful Cia.' 8 (collateral) r.te on any luoh future Interelt.
PUAllOSE Of
NOTICE I
PAVHENTl
REFUND (CRll
OBJECTIONS I
ADMIN
I$TRATIYE
CORRECTIOHSI
DISCOUNT I
PENALTY,
INTEREST I
To fulfll1tht rtqulr.lNnh of SeoUon 2A40 of the InherUanoe and Elltete T'II( Act, Act 21 of 1995. (12 P.S.
S.oUon 914(1).
o.taoh th. top portion of thl, Hollce and SUbRlt with your pay~.nt to the RIgllter of Willi printed on tn. reverse side.
--Nak. check or eonlY ordl!lr payablll tOI REGISTER OF NU,LS, AGENT
A refund of a tal< or.dlt, whloh wIn not requested on the In. Return, lay b. rllqufJ.ted by coephtJnlil an "Appl.\cllItJon
for Rufund of Penn'lvlvanh Inhllrltancll and Estate Tall" (RE\I~UU)' Application' ar. allllHable et the Offloe
of the fllghtlr of Willi, any of the 21 Revonue District Offlo.., or by calling the IP.chl 24~hour
answlldng lI.rvJu nlltbllr. for forn ordnrlngl In PennAylval''!a 1-8i10-!62-l050, outside Pllnn.ylvanle and
within loe.1 Harrisburg I'lrlllll (717) 787~8094, TODIt (7171 172-2252 Wearing hlpalrR1:l Only),
Any party In Interut not SIlIthfJed ~dth thlf I'lPPI'alfle..nt, allowance or dhaUowbnca of ulIductions, or au.....nt
of tax (inoludJng dlllcount or lnhrut) as shown on this Hottc" .ust object wIthJn .Illty (60) dllrn af reo$Jpt of
thh NoUce by:
~~wr itten protut to tile Pili D4p!lrt..nt of ReVlmuo, 81.1"rd of Appeals, Dl.lpt. 7.81021, HarriSburg, PA
--.lIlct1on to hove th. "lIttel' deter"lnlld at audl t of the account of the plrlonal reprllluntatJve,
-~appeal to the Orph~ns' Court,
OR
I1H8~1021,
OR
Fllctual errors dlsccvered on thlll ftSlUSAent should be addreSllld 1n writing tal IJA Oeparhent of Revenu.,
Buruu of IndlvldlJal Tr.ll(u, ATTH: POlt 1.I1I.u.ont Review Unit, Vept. 280601/ ~larrhburQi, PA 17128-0601
Phone O'l1> 787-6505. See peglll 5 of thll1 booklet "lnlltructhlM' fur Inher Hance Iall Return for I!l Resident
DClClid.nt'" (REV~15(1lJ for an el(planaUon of adMJnlstr!ltlv.ly corr"ctl'lble arron.
If any tax due II paid within thrlle (3) calendar .onth. aft4r the dec.dent.s death, It five percent (5~) discount of
the tl!l~ pBld Is allowed.
The 15% tall aRnesty non~partlulpatlon penalty ls cOlputed on tho total of the tax ~nd Interelt el..s.ad, and not
paid bill fore ,Jan'Jary 1Il, 1996, the firAt day after the end of the tnll allnlluty pllrlod. Thl. non~part1cJpat1on
panal hi it IIlppe~l"blfl in the '"1iI .anner I!lnd In Hla thll sa.. Un pClr lod M yoU would rtppul the tax and Jnt.,.e.t
that has belln as.essed a. Indicated on this notlc..
Intarut it charged begIn/ling with first day of delinquency, or n,ln. ('I) eonthll and one (11 day frol tha date of
dellth, to the data 0' pay.ant. T8l(" which beca.. delinquent b.fora .Januarll 1, 19&2 bwar Int.ar..t at the rat. ~f
till( (6%) percent per annulll oalculated .!It a dally rl'lte of ,00016(,. Ail tt!l(" whl(;h b.C8.e delinquent on 8nd after
January 1, 1982 will bear Inhrn\ lit l'l rllh which will va,'y froe 1Jalendar 'illl'lr to calendar Yllar with that rate
announced by the PA Ollpnrt.e"t of Rel/enuG. The llllpllcable lnt.rut ratlll for 1982 through 1996 aral
!!!! Intllrallt fln~ Eall'! Intllrut Factor !!!r IntGlr..t Rate Oally Int.rut f..ctor
1982 20:< .000548 1987 ,~ .000247
I96~ 16~ .aOOU8 1988-1991 ll% ,000301
1984 1l~ .000301 19'JZ 9% .000247
1985 13% .000356 1993+)994 n .00019l
1986 10% ,lJOO21it 199~-)998 9% .000247
--Intllrut II calc:ulated .. folloll11
INTEREST = BALANCE OF TAX UNPAIO X NUHBER OF DAYS OELINQUENT X DAILY INTEREST FACTOR
~~Any Notice I..yed aflor the tel( b.colIQS dellnqu~nt will reflect an interest calculatJon to flfto.n (15) days
beyond the dllte uf th.. IIne.....nt. If plly..nt I, uu. flfter tha Inhrut COllputation data shown on the
Notlc., addU lo"al intClr..t MU.t be <llliculated.
,Fleglster of Wills of
CUMBERLAND
County, Pennsylvania
INVENTORY
E.tat. of
CLARENCE G. MASON
No, 1997-00465
&ISO known as C. GARY MASON
Oal. oj D.ath
05/11/97
168.38.7516
,0OC.llS.d Social Security No,
CAROL S, MASON
P.,.."ol R.pr....nl8l1v.(.) ollh. above Eotat., dec.ased, verily thallhe lIems oppo.rlng In tho lollowlng Invontory Include all 01 the
peroonal Bssets wherever sltllate and all of tho real eslafo In the Comrnonwealth of Ponnsylvanla 01 aald Decedent, that the valuation
placed opposite oach 110m 01 BAld Invontory raprosonlslts lair value as ollhe date of lho Decedent's doaHl, and that Decedont owned
no real estate outsldo 01 tho Commonwoalth of PennsylvanIa O)(copllhal which appfJam In a lnomcmmdum at the end of this
Invontory, I/We verify thallho stalemonts made In thlslnvontory are true und corrool. IfWe undorstand thai falso statemonts herein
are made Bub)oot to the penalllos 01 18 Po. C.S, Section 4904 relating 10 unsworn falslflcallon to .ulhorltles,
Porsonal Reprf./Sontallve
Name 01 STEVEN J, SCHIFFMAN
AUornev:
1.0. No,: 25488
Address: 2080 LINGLESTOWN RD, , SUITE 201
-
HARRISBURG, PA 17110
Telephone: 717/540.9170
Slgnatu,e:
{.'a.t,LC ,d>na4/l...,L'
CAROL S. MASON
Slgnatu,e:
Address: 713 FLORENCE CIRCLE
MECHANICS BURG , PA 17055
TOlephons:
/
Dated:
1-c;,.1f!
Description
Value
1. Automobile (No Value- Vehicle was totalled in auto
accJ.dent and all funds received by the Insurance
company were used to pay lien against vehicle.)
2. Heritage Valley F'ederal Credit Union
3. USM Savings Account
4. USAA Car Insurance Refund
5. NatIonwIde Invididual Retirement Account
6. Nationwide Individual Retirement AccOlmt
7. Sedgwick, Inc. Retirement Benefits
8. Sedgwick, Inc. 401 (k) Plan
9. Sedgwick, Inc. Unused Vacation/Sick
-0-
4.82
1,989.40
143.71
11,512.70
10,347.37
78.12
30,039.00
2,3"14.26
(AUach additional sheela II necessary)
Totol:
$:'6,429.38
NOTE: The Memorandum 01 real 091alo outsIde the Commonwealth 01 Ponnsylvanla may, at the oloollon 01 tho pomonal reprosentatlve,
include tho value of eacllltem, but such figures should nol be oxtonded Into the total of tho Inventory.
Prllpllrfld by ttlll Pennsylvania Bar A~5oci"tion
CoPyrl\ll",l (e) 19961D,01 ~ollware only CPSystem.!l. Inc.
Form fRW-7 (I9El2)