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HomeMy WebLinkAbout97-00477 !Ii" ! i I 1'1', 21-97-/,7'1 I lIpinl JIlllll .!ll Ill'lj',ill.lll ('lldi( .lIl' 01 dl',llll dllh liled iI\{' \[,IIl' V;t.d I~nlll,\', (HII((' 1011\('1111,111('1\1 lilill)'. \Vitll 111\' ,1\ l'lli.. is [0 (('nil'\' [h,1l th\.' inlollll;l[i(l11 1\l'1\.' gi\'t'11 is ((lIln III' !.m.d Hq;isILII. Thl' oligiuid It'llilic,ll!' will hI' lnrw.lllkd 10 WARNING: It Is IlIagolto duplloate thlo copy by photostn! or photograph, he fot this l('l'IHk<l[(', ~.~.O(J ii"""-';""';'" /i~illl~~\' ~ OF ri;;>\\ ~1' ~ '~~' II' ~ )~ 1..1;, ,/. /h ''',' V.) ~,,-;; -~~/ "<".'if1t. :.'t,,<'i',i ....Q,NfNl ~\,,"~, --:qtti11!~' 1.1:...,. ~.~~~t"~ I o(,d l{l'glmM 4259892 MAY 2 1 1097 No.' Il,II(' HIOSIHAhll1J COMMONWlAlTH OF PIINNSYlVANIA. OI!PA~TMl!NT OF HOAlTH . VITAL AeCOAoa CERTIFICATE OF DEATH '"' '" OM "A~f ,. ralll!~~~lIi't 'Wf~~f~'f"'1 ~GfM~fI.'~OoI,1 U~ IllY[ t,lQnl'" rt L '" "",' l'lH'l.IICol,W , $!"'~'<<t.,jtlCQlirUll Hummelltown, PA 78 ~IO ... _D " ,~ I COV" Y H Cumberland ~!,I(l'Al~ I . .:/..i::'i'rli"'l,,,'q'.,,,, U'lJ'1'ItCT-""""'''11 K~~! IIi'1lAJlV Nursing Hom. '"' w~ 114:t"1 ~',,,"~(McIoi...- 'VVI'II'l R (J."~"""",,,,,,,,, , otC!OIlIiT.t,l~'WlQAOOf\!nISl'"' Cl,'v." 151Q Pine Road ClI1llle, PA .. Sr.'o/pCOoltl OfC'Of>/T. ICTUAl AISICl4!oct I'l<I~"'~'<'<:I<Y1 """'1"_1 "b,COu,nl. 11'_."1' "" "'.... ..... "'-' ... Cumberland .,_O=~ICI~~ - " HH'H.!MW\ter HOn6t(" '"''''~ld'c."~hl.1fll1t t,lOTKI1!(ffifrSfl~\~dItI '''''''1 ... 'fi>(lCrdtl " . A''''''''''''''''.''IIL} 115BH >/~MI 'lOAOlH1I _ ~ Ih II.~TI; 11'I..'..,'_..I....""..t4'~,,<)n,.i'>K:ftU"...JI""OI.lft Doroot.....llJ\t_Olfylf\q.N\"ft..U'I)~OI'~.\4Iy"'..I.I'wl<;."'~"ll....t l..(IlNIll!IIel"...on..'ft..... 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" ceRTIFICATION OF NOTICE UNDER RULE 5.61a} Name of Decedent I '~Q...ll ,-,Po \-l. Deathl~ E: ~CI~AR.T Date of Will No. Admin. No.2 \ - '')'1 -Olfl! To the Registera I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on _L, - "1 - '1l I !!!!!!!! ~~~ " Address Notice has now been given to all persons entitled thereto under Rule 5.6(a) except~' Date I . (., / q /17 I " ~ P. ~'6 Signat.ure Name DOUGLAS. El9UCU-.s & gOU(lI.AS P.O. BOX 261 liAKLISLE, PA 110.3 Address Q\ t' <'1' 'c r') I LL: '-""" " j{l~ 0 - 'i ~ t'i ", , , , ) \J) /- \.~ CC P' tU ;:J (J c.; Telephone(7/1) ::>-4-~ 1'740 Capacity: Personal Representative \/ Counsel for personal ~epresentative I I lOR UAlIS OF OIAIH AnlR 12/JI /91 CHICK HIAI INHERITANCE TAX RETURN ~o~::~yU~:~OITlWAIMIU I I I RESIDENT DECEDENT I fill NUMBER IOMMClNW'Al1tl Of PfNNIVIVAN'A I (TO BE FILED IN DUPLICATE ''''''IM,NT 0' 'IVIN'" I : J 1'1 1 . o'i "1'1 . .."A~",J'Jt.\, ~~I\9I" 0601. . WITH REGISTER OF WILLS) COIlNTY (O[)! . .. . YfAR NUMBfR ---~1=:;:;c'u;,SE1";;~ ;.^;OM'l~rr~[:;~ ~/~~3 \ I"AI~~" '>1'1' O"itf~X' /':'~':,~F/\-:C::-- -......-.----.-. ~ ._~()'l~ I)...:_~.I'\'L .. 'lJ)V h'1] \ /, 0 I '( r"""'rA'\"""'I(r:"VC'''''''V'I~I.\(J,..._''_''('_'''''.\,_"".,.,I'\"...,._.,<l..O"'N'_'. '" ,,' """A""'''''''''"I''0O'' "".01"" """""""'," ",,',," 'OClAl\'(O'''' HI'" . " ~ - -r~()lIgl~OI R~~-;;;- ... ... [ I 2. 5vflpl.m..',,1 R.,v,o I I 3. ~~IS [) 4. Limited E.lol. I I 40 FVlv,e In',ro.1 Comp'omhe II 5. ~ i! lfar dOIG' of deolh ofter 12.12.821 r -I 6, Decede"! Died fellale [" _I 7, OeCCtdlHlt Moh'llCllned (l living Trull .0.. 8, TOlol Number of Safe Depolit 8ox!!, IAlloch copy of Willi IAltoch copy of 1""'1 . u 147ollllliioNOINCUMO CQNPlrilNTlAL TAXlNPOIlMATlON IllQULDI<< DUIlCYI\l10.; ';'1 N 1 . COMm,fMAluNOADlii1U" 1:'1 I ~ ._.~.l.-P./..{Io,L._-.J . ... N '(j{~dL2jJ~-.- ....<1 ~11.' t:.J. iJ<:,,!J' _, ';-II.~ L1 TElePHONf NlTII8EIl: . _ ,-" . 0 ( {1-1 '.1-<J,~1 i /Y /1 I r vi .. .... __.J" z'f,J 1_ .z,'!"-!..~,L~~(C} '-0=",.".=_ ,,__~,,'~-c=~_, ""<._. .,.-.,,=.=_-~==~,'.==",,"==C~===-- I IIfV 'f~f)O fX + (I-Q<l1 1. Real E,'ule ISchedvl. AI 2. Slock. and Bond, (5thedole 81 3. Clo.ely Held 5tock/Porlnor.hlp Inl.ro'l (Schedvle CJ 11, Mortgagel and Noles Receivable (Schftdule 01 5, COlh, Bank Depculu & MI$cellanl1oul Personal Properly (Sch.dule EI 6. Jointly Ownod Proporly ISch.dole FI 7. Trondor'ISchodvle Gl15chodol. LI 8. Talal Gron Aneh (tolalllnGs 1.71 Q, Funeral Expenses, Administrative Cosh, Miscellaneous Expon". ISch,dvle HI 10. Deb", McrlgoBe L1oblllJlc,. lie,. ISchedvle 'I 11. 10101 D.dvcllon. (10101 line. 9 & 101 12. Nel Valve 01 Ellole III no 8 mln\l.lIne 1 'I 13. Charllable and Governmental Bequests ISchedule J) 14..Nol Vclo~~lec~~_Tox Il~n!J.2 mlo",-~!ne J.3L___________..~~.._. 15. Spov,ol lrond", liar dolll of deolh after 6.30.941 See lnllructlonl for Ar,pllcable Percentage on Reverse Side. llnclud, volllOl rom Schedule K or Schedule M.l 16. Amounl of Line 14 lOKable 01 6% role Ilnclude IIalue, from Schedule K or Schedul() M.l 17, Amounl of line 14 laKable 01 15% role Ilndude IIalue, from Schedule K or Schedule M.l 18. PrindpalloK dve (Add laK from tines 15, 16 and 17.) 1Q, CredUs Spousal Poverty (rtldil Prior POYlIlllnh / ~~ ~~ij ! 5 ~ fzl .. z ~ .... i II '" " ~ .... + ) 1,", (" .... -' , RomCllnder Retllrn Ifo, d~11\ of d.olh prior 10 12.13.B21 Federal e.tale TalC. Return Required ~ "'- :~,-- (II (21 ( 3) 14 ) IS) ~O.,_~O, OQ . .,-"..-,. ....--~"---. ..-.._._~.~....... .. .__LL,_'1-71,J~ ... 16 1_.. 3,.k L~_'u;1 S::.~ (7 ) ~~_ _.....__.___.____.._._._~ 181 .....1 r. ~1~!:l::Q__... 19 1-,--___ J3~~.I.c.rQ--....- (101 (11) .-..l.Ll s:- I. S-:<?__. (121 u__S-2._,.IJ.L:1e>.. (13) _______.____ .1141 _.. 5'2-'J? 8~CtQ,____ (15) -~-__..._...___~_ .____~.._._. ______._..____._ 116)!>2. LI?~ 'LQ_~ ,06 .__3.._L~~.:_~D. (171 _ux.15= (181 + Discount I'~ 7, "0 (191 (201 Inlerest . _L5.1,_'?e_ 20. If Line 191s greater than Line 1&, enler the difference on Line 20. This is Ihe OVERPAYMENT. Ifo1 [] OH'ck 111'11' If you (11(' rC(IUCSltnn U fofund of you, OV(IJpClymont (21) (2IAI (2 I B) Le17Lo(} '.2,'1 Jl. co 21. If line 18 Is greater than lino 19, order tho differonco on lIno 21. TiJi, i, tho TAX OUf:, A Enler Ihe inlerest on the bnlonce duo on lino ? lA, B, Enter Ihe 10101 of Une 21 Clnd 21 A (HI lino 2 H1, Thil i, tho BALANCE OUll. M.a~~ C~_.cll; Payablo tOI hgllt., of WiII" Agent ~~..!!i SIIII. TO ~NSy!ER_ ALL QUEST!~NS ON R~..v.li.~~~SID!. AND TO -IiECHECK MATH -0( -0( __ Ur.der penaltIes of perlury, I doclClre Iholl hClVe oKCHnlnod Ihis relurn, iflcludin\J elccomponylng ,r.hoclulol CJnd ,Iellements, and to the best of my knowledgo and bellllf, Illslroo, correct and completo. I declare thaI all ronl oslolo hen bllOfl roporlecl 01 true markot vCllue. DoclarCllion of proparer olher them the personal reprelentCltlvo II based on 011 information of which preparer hot Clny knowlodgo -.::~.~::~I:~~;.::~;tiZ:~:ii~,::::~'~:" : :~(':,:~::' l~N _'cl 1'.>1 I :; . . ::;:ojb)_H~lnl f:-Lu..._, ~J.(,Z~H '-11 1'1 l,' !{I"j',',L:f!r 'Ll ~l4,.,~. 1 SCHEDULE H ~ua' fUNERAL EXPENSES, COMMONWEAlTH Of fENNSY'VANIA ADMINISTRATIVE COSTS AND ESTATE' OF 'Nm:h~~1Wc',W~RN MISCELLAN~~~S .E,XP.E,~~:~ . <.- "..lJ-....IP,I~.:!:.!rl~.!re,,,.g,,.."'"., ......'~ J ~IU N M ~ kv lC\..h t <2 ( ~'"" (', ..__._.... .,. ___:~~CL5.)\' 'I DESCRIPTION AMOUNT UV.I$IIE\h (7.811 ITEM NUMBER A.. 1. "____ ____~.___....~..__~............_. ~~.!..o_~u____ Funeral Exp.n.... I~D ll, n'/ e r fw rW ("<l \ l-t.. ", e- GIZA\jlL '-'iJJ2n,Oc, l~ ~""(L Ol\ "~(.H..l, (J () 8. Admlnlllratlve COlhl 4. C. 1. 2. 3. 4. 5. 6. 7. 8, 1. 2. 3. Pe..onal Rep....ntatlye Commissions Social Securlly Number of Personal Reprelentatlvei Yoar Commllllons paid __~_ -_....:.-......-_...;".. Atfcrney Fo.. D()u,\{~ S, \)"'u" "1\'-, \ }."""", 1\ :::. .'S """. (.'l> Family Exomptlon , Claimant i' (.!..\L MI6- r-T Addroll of Claimant at docodont', dealh Streot Add..ll -Lie. I '1 \) I ()e. (<.,,{ () City L-orll<,le. RelbllonshlpS"t1 _ '~ .' . . .' .. Sloto J:fL_ Zip Cod..JJQ..1 ~ 35" ()D. DO Prabato Fees I '0. 0 () MI...llan,oul Exp.n.." '::;>' <: \ I.J"'$T A,.r,,, .)<L\r'>.. i'(i}~''-,<L Gee> 'Z h€llor, QcZ.-.l+oc "t'::'j'i".>AAlW S,(\-\-d\e.l. i\Ov. C vr--\<). w.....v T ~(I \ I Ao v. 75'.00 . 1 I5"Ll. 00 '1 (,..ro .' (,,0. DO TOTAL IAlso o"ter 0" IIn. 9, Recapllulatlonl s n2-S I. 0:.0 (If more Ipa.. I. n..d.d, In.er' additional .h.... of lam. III'.) COMMONWIALTH OF 'INNSYLVANIA I COUNTY OF CUM.IIIL.ND J u: ,) I, \. .(t..'.\ (... ..L..._._._J')',~"_~_,,,(J. f"_f ___._.._......._......... ,,_____~.~"-~l~L_.~,_.._."i- _';!..-)t.LL~,_~__~..~j__.. _ _ _ _ _ _ _ ~ _ ,_ _ _ beln9 duly___.';,""LLL__......... according to I.w, depol" .nd I.Y' thIT-Ih." tl('''.::lk. '_'_' _._...____t1iMl1ll.~\2_..f!(."'.c~_________ of the EIIat. of __ \!"),,j d, 'ic L:~!.>...C:l I.t. of --K'l\. oJ:VJP,... _.m_ ...... ..-. ._______, Cumb.rl.nd County, P." d.e....d .nd th.t the within II .n Inv.ntory m.d. by .___.....U,C/_Io0._____________ _.____, the ..ld.Jld..ill1J.I.,ffl(~!!.) of the .ntlre ..t.t. of uld d.c.dent, conllatlng of .11 the pe..onal prop.rty .nd real ..tat., ..c.pt r..1 ..,.t. outlld. the Commonwe.lth of Pennlylvenl., and th.t the flgurel oppollte each Item of the Inventory repr..en! lt'l f.lr v.lu. .. of the d.te of decedent'e de.th, '~)v\J()(<..{) -f 0 .. .nd lublCrlbod bofore me, -7'- +-\.18 v<"T &rc--.19C11 ( j(.,{i -1,,:R 41 (-.!-A ..' -.11I':.*":' PubliC J c.-.....~ Cuunty 14,2001 .,// I",'t . ~~.-.. {/ I /.. !f', _ . iilL t" ,--' ~ ;,1.1.\ Admlnlllrolor t I.N ,\..D,llo...... '>~. C,.,.l,.",-e., ) PA C' . / / V(Ul /)(L/~~ I"' /<"1 (), ne P X~rolt! "-r- (I') Ie .I~A- J~_ INSTRUCTIONS I. An Invontory mUlt be fIIod within three month. .fter .ppolntment of person.1 repr...nt.tive. 2. A lupplement Inv.ntory mUlt b. flied within thirty d.y. of dllcovery of .ddltlon.1 ....h. 3. Addltlon.llhe.h m.y b. .tt.ched at to person.lty or re.lty 4. See Article IV, Fld"cl.rlel Act e11949. O.te of Death __~::-u D.y I '1 :iJ Vu, " (.I) :5 t <.01 ] ;:) ~ ~ 0 ~ 0 ~ oil \~ U) M ~~m 6': :5 -< ~ 0 i. '-" .... l!5 ;:) ..... l!5 ~ ~ I.!" ( r::........ ~ i- owa.; ~ ~ C a vjNu..i o Q \:J ~ 0.;,(><--1 ~ ~ (j .....J 0 U) 0 p~ .... t..') CO -~ z 'J ." ::1 . i2 a C)O~ 0) a (;;) a..: u (v::' I ... "t: 0 .ll I ." "" ~ e . 0 ... I a ~ it 0 .... U III PAYMENT, I f' "': ~) ':')(:4 Oltl~h' thl top p~rtton 0' thlt Hottel and iublllt with your p~y~.nt Pladl payable to th. Mill' end ftddrl" prlnted on th,'rlvlr.. lid., 1f RESIDENT DECEDENT "akl chick or lIl"n.y Qrdlr flftYflbll tOI REOISTER OF WILLS, AGENT, If NON~RE9IDENT Dl!CEDENT,IIUlkl thick or ,"onlY order pavabh tOI COMMONWEALTH OF PENNSVLVANIA I REFUND (CR)I A rlfund of a t.x orldlt_ whtch wal not roqullt.d on the Tax Rlturn_ may be rlqul.tod by co~ptatlng an "Application for Rlfund of Plnnlylvanla Inharltance and Eltate TaMu (REV"\31!), Applloatlon. iIIre 'llyalhbh.t thl Office of thl Rlgl.tlr ~f Will., any of thl 23 RIVlnUI OlltrJot~fflcll or from the Depart~lnt.R 24-hour an.warlng $Irvloo nUMb.rs for forM' ord.rlngl In penn.vlvanla 1-800-362-20S0, outside OI"nlYlvanlb and wlthln looal ttarrl'burg fir.. (17) 187-8094, TODI (717) 772-22S2 (Heerlng Illlpalrtd onh). REPLY TOI DISCOUNTl PENAL TVI INTEREST I Qu..tlon. regarding .rrorl oontalned on thl. notlr.e should be addr....d tOI PA O.p~rtM.nt of R.v.nu., Bur.eu of Individual TIM", AlTNI POlt Au..l"ent R.IJIIW Unit, Dep," Z80601, th'lrrhburg, PA \712~-D601, phon. (17) 787-6SDS. If any taM dUI II paid within thr'l (3) callndar month. aftlr thl decldlnt', d.athj a flv. plrQI"t (SX) dllQount of thl till paid II allow.d. Th. 1~% taM a~n'lty non"partlclpatlon p.nalty JI co~puted on thl total of the tall and Intlr,.t a.....ed, and not Pold blfore January 181 1996, the first dav after thl end of the taM ftlllnuh porlod, Int.r..t I' charged b.mlnnlng wJth first ~ay of d.IInquency, or nln. (91 months and on. (1) day fro. tha dflta of death, to thl date of paYMent. TIlMII whlch becaMe dlllnqullnt b.fore January 1, 1982 bur Interllt at the rat. of It. (6%1 perClnt p.r annu~ oalculated at a dalh rftt_ of .UOOI64. All tallu which b,q6111' del1nqu.nt on and after januar~ I, 1942 wlll b.ar Interest at a rflt. whiCh will vary frOM cal.ndar y.ar to oalendar y.ar with that rat. announc.d by thl f1A D.partllli.nt of Revanue. lhe applicabl. Intlrest rat.. for ,}lJ8Z through 1998 arel VI.r Int.r'lt Rat. Dally Interolt factur Intlrll t Ratl Dally Int,r.,t Factor Year 1982 20% .OOOS48 1987 9% ,000247 1983 16l'. ,OO04!l8 1988-1991 11% ,000301 198~ 11% .000301 1992 9% .000247 19B5 11% .000356 1993.1994 7% .000192 1986 10% .000274 1995-1998 9% .000247 1-tntlrllt h calculat.d o. follcw'l INTEREST . BALANCE OF TAX UNPAID X NUKBER OF D^YB DELINQUENT X D^ILY INTEREST FACTOR .-Anv Notloe IUUtd 8ner the tall b.co.... dlllnqUflnt will rlfllct an Interut calculation to flft..n (1S) dayl beyond the date of the ".....Il.nt. If pllYllent I, nllld. aft.r the Interllt computation dfttl shown on thl Notlc., IIddltlo",,1 Intlrut ,"Ult be calculated. /:5 Jl}"3 aUREAU OF INDIVIDUAL TAKES INHf.R1lANCE TAK DIVISION PEPT, lll0601 IIARRISIURO, PA 11121'0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE HOTlCE or INIILRITANCE TAX APPRAISENENT. AI.LOWANCE, OR DISALLOWAHCE OF DEDUCTIONS AND ASSESSHEHT OF TAX 11-10-97 PECHART 05-20-97 21 97-0477 CUMBERLAND 101 [~~=~_~~~i~~MIt!:i~~: J MAXE CHECK PAYABLE AND REMIT PAYMENT TOI REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .... REV: i 547 -EX - AFp. i 09-:97 T - No'ff cE- iiF" YNHEiiif Aiie E - 'fAx . Xli PilAfs EifEN'r; -A L Uiwiliic E - iiri' - -. - - - -.. - - -.. - -- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX BEULAH E FIl,E NO. 21 97-0(,77 ACN 101 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN APPROVED DEDUCTIONS AND EXEMPTIONS I 9. Funeral Expanses/Adm, Coats/Hille. Experl... (SClh.d~ll. Hl (9) 10, DObh/t'ol'lgogo Uobllltl../l.lons (Sohodulo II (10) ,OJ,, 11. Total DtJduoUons (11) 12, Nat Value of Tax R.turn (12) 15. Charitabl./Gov.rnmanial Beque.ts; Non~.l.Qt.d 9113 Trult. (Sohedule J) (13) 14. Nat Value of E.,hi. Subject to rax (14) NOTEI If an assessment was issued previously, lines 14, 15 and/or 16, 17 and 18 will ruflect figures that include the total of Ab1 returns assessed to date. ASSESSMENT OF TAXI 15. Amount of line 14 et Spousal 16, A~ount of line 14 ta~.bl. at 17, AMount of l1ne 14 taxable ut 18, Prihoblll rax Du. TAX CREDITS I ----. PAYHENT DATE 08"13-97 GEORGE F DOUGLAS 27 W HIG~ ST CARLISLE PA 17013 ESTAn OF PECHART TAX RETlJRN WAS I (X) ACCEPTED AS FYLED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN 1. R..I Est.t. (Schedul. A) 2. Stocks and Bond5 (Schedule 8J 5. Closaly Held stock/Partnership Inter..t (Sch.dul. C) 4. Mortgages/Notes Receivable (Sohedul. OJ S. Cash/Bank Deposits/Hisc. PerIanal Property (Sch.dul. E) 6. Jointly Owned Property (Schedule f) 7. Tr.naf.," (Sc:hedul. G) 8. Total huh rat. lineaI/Cla.. A rat. Collat.ral/CI... 8 rat. RECEIPT NUNaER ---'\.\211629 DISCOUNT (+) IHTEREST/PEN PAID (-) 156,37 (15) (16) (17) ) CHAHGED (I J, (2) (3) (4) (5) (6) (7) 50,000,00 ,00 ,00 .00 11.772,15 3,618,25 .00 (8) 13.251.50 ,00 52,138,90 ,00 x . DO. X ,06. X .15. (18) AHOUHT PAID 2.971,00 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOT AL DUE . IF PAID AFTER DATE IHDICATED, SEE REYERSE fOR CALCULATION OF ADDITIONAL INTEREST, c *' Ilf.li41 U '''m.tll BEULAH E DATE 11-10-97 HOTEl To inlure prop.r cradit to your account, .ubnit the uppar portion of this forn with your h:-: pay...nt, 65,590,40 13.?~1 ~n 52,138,90 ,00 52,138,90 ,00 3.128,00 ,00 3.128,33 - 3,127,37 ,96 ,00 ,96 IF TOTAL DUE IS LESS HIAH U. HO PAYHENT IS REQUIRED, IF TOTAL DUE IS RefLECTED AS A "CREDIT" (CRI. VDU NAV DE DUE A REFUHD, SEE REVERSE SIDE Of THIS FORM FOR INSTRUCTIOHS,) C)~ c7 L, RESERYATIOth Est_ta. of dNmnh dvlnG on or btfor. OtcI.tMr 12, 1982 ~~ if MY future Inter'lt In the ..tttt " tran.ftrrld In po.....lon or tnjoy.ent to Cl." I (aolltt.rtl) benlfloltrll. of the dlcedent .ft.r the txplr._Ion of any elt.tl for life or for Ylarl, the COMllonw..1th hereby IICP""ty r...r"u the rJaht to .ppr.l11 and ...... trantfer JnhtrAtanet T'I>(I* Pit the Ilwful Clue I (coU,t.ral) rat. on any l!.IOh future Int.rut. PURPOSE OF HOflCE, To fulfill thl requJrl.tntl of Stctlon 2140 of thl Jnherltlna. and Eltatl TalC Act, Aot 21 of 1995. t72 P,S. SlcUon 9140), PAVtlEHT, Oltloh thy top portion of thh Notlol Ind .ub.it with your Ply..nt to tht Re,hhr of WJllI prinhd on th. rll"orll .Jdl. .-Hakt oh,ok or .on.y ord.r payable tOI REGISTER OF MILLS, AGENT REFUHD (CA)I A rtfund of I tllC arldlt, whloh w'" not rtqu.lt.d on thl hlC R.turn, .ay be r.qulltld by cOIlpl.t1nll Itn "ApplIClatloo1 for R.fund of Plon'YI"anJI Jnh.rJ'lnc. and E~t.te TIIC" (REV-131!). Application, ar. a"wllable tt tht Of'lc. of the Rlgl.tlr of Will., any of the 23 A'''lnu. DI.trict OfficI., or by oallin, th4 GplOial 24-hour anlwerlng 'Irvlol nu.btr. for for., orderJngl In P.nneylvanla 1.800-36Z.2050, out.ld. Ptnn.ylvlnl. and within lood Harrhburg ar.e (717) 7ft7-ft094, TODtI (717) 77Z.ZZS2 (Huring hlpelred Only), OBJECTIOHSI Any party In Jntlr'lt not .Itl.fl.d with thl .ppral....n.t. allowancl or dl.allowancl 0' dlductlonl, or a.......nt of talC (Including dltoount or inter..t) at .hown on thh HoUol .Ult objeot within .lMty (60) cllYI of reclipt of thh Hotlol bYI -~wrlthn prottl't to the Pol O'Pflrtlllnt of RI".nu., BQard of Appealt, Dapt. 281021, lIerrllbur", PA 17128-1021, OR ~~el'otlon to havI th.. Matter d.terllned It audit of the IQOount of thl plrlanal rIPr..lntltiv., OR -~app..1 to tha Orphan.' Court. ADMIH JSTRA TIYE CORRECTIONS I Factual .rror. di.cu"erad on thl. a.ae....nt .hauld ba addr....d In writing tal PA nepart..nt of R.Vlnul, Bur."u of Jndlvldual TaXI', ATTNI Po.t A.......nt Review Unit, nept, 280601, Harrl.bur" Pi 17128-0601 Phon. (717) 187-6505. SOl pagl 5 of thl Lookl.t "In.tructlons for Inherltencl TalC Raturn for a Ra.ldlnt Oacedlnt" (REY-1501) for an IlCplanatJon of adelnl.trati"aly corrlctabla .rror.. DISCOUNT I Jf any talC dua It paid within thr~t\ (3) cal.ndar eonth. aftar the dlcedant'. d..th, a fI"a parcent <5:0 dhcount of tha taK p.id I. allow.d. PENAL TV, Tha ISle t.1C aenub nun"partloipltion penalty It cOllputed on the total of the taK and Intlrut .......d, al'''' not plid hlfore January 18, 1996, the first day Iftar tha end of the talC a.n'lb p.riod. Thlt non"partlclpatlon p.nalty It app..labla In the la'l Ilann.r Ind In tha the ""1 ti.. p.rlod IS YOU would app.al th_ tllC and int.rut that hat b.an .......d I' Indloated on thi. notlcl. IHTERESTI Intarut II ohargad blglnnlng with Urtt day of dalInqulncy, or nlna (9) .onth. Ind on. (I) d.y fro, thl dete of dlath, to thl date of p.y..nt. TIlIC" whioh b.c8ll. dQlInqulnt b.forl January 1, 1982 baar interllt .t thl r.tl of 111M (6%) pero.nt p.r annul Clalculetad It a dol1v rate of ,000164, All tllCl' which baCIlli dlUn.,.nt on and aU.r January I, 1962 will baar lnter..t .,t a rate which w111 vary fro" calendar year to callndar y.ar with that rata announo.d by thl PA DApart._nt of R.venuI. Th. epplloabh Int.rut ratu for 1912 through 1997 '1'11 '!!!! Int.relt Rata !!!IIY Intere.t F~ X!!r Jnterut Rat. Dl!l1111 Interut Factor 1982 ZUt: ,000548 1987 9% .000Z'"o1 1983 16% .000438 1918~1991 11% ,000101 19M 11% ,00nOl \99Z 9% ,000241 11J8~ \3% ,000356 1991.1994 7% .000192 1986 10% ,OOO114 1995-1997 9% ,0002"7 -~Jnter..t I. caloulated .. 'ollowll INTEREST. BALANCE OF TAX UNPAID X NUKBER OF OAYB DELINqUENT X DAILY INTEREST FACTOR hAny Notlc. luued oftlr the tllC b.eo... dellnqulnt wl11 reUect an Int.rut calc.ulatlon to flfteln (IS) dey. blyond the (lI,t_ of the a.......nt, If paY.lnt I. "'ltd. 11ft" the lnt.rut cOltputatlofl dati whown on the Noti(Jlj addltlomll Inter..t Ilu.t b. calculated. \- tl t.'_l PURPOsr Of' HOTJC(!I [',I ()(S TD fulfl11 t~ rlquJr..ent. of Slot IOn 2140 of thl Inhlrltlnol and Eltete Te~ Aot, Aot 21 of 1'91, (1t P,I. SICltlon 9140.. PAVNEWT, Detlch thl top portion ot thl. Notloe 'nd lub_Jt MJth your PIY..nt to the RIgi,ter af Will. prl"t~ on the rlVlr.. defer- Hike chlo~or _onlY order paY'bi. tOI REDISTER OF WIllS, ACENT, , RfFUtlD (CRl I A rlfund 0' a h>c ~1'ed1tj whloh waf not r.qu..ted on th<l tax return, IIf1Y be rlqunt.d by cOltpleUng en "APP1!o8t1(jn for R.fund of PennsYlvlnla Inheritanoe and Eat.t_ T.K" (REY-131!). Applloatlonl Ir. Ivall.bl. at the O"JOI 01 the' Rathter ,Of WUh,qny l)f the 23 RevenuI Ohtrlct Offioes or by cClI1Jng the Iipeolltl 24-hour anllUlrJng 'lIrvlel nuMber. for for., ord.flnQl In Penn'Ylvantn 1~80n~362~2050, outsld9 P'n~.YIV8nJa and within looal Hlrrhburfl erea (117) 787-ft094, TOOlt (17) 772-2252 0I8srJng IMpaJred Ollly). OaJfCTIOHSI Anv party In Inter'lt not sathfi,d with the 8PPI'ah...nt, olloweno. or dlvalluwanoCl of dlduotlons or a.......nt of tlM (IncludJng dJloount ur Jnterelt) al ,hown o~ thl. NotIce .ft~ obj.ot withIn .Ixt~ (60) dftys ~, rec.lpt of thh Notlcl bYI --"'rJtbn protnt to the PI, Oepflrt..nt M Revenue, 800rd of A~p.~h, n.pt. 281021, Harrlsbury. PA 171Z3-1021, OR "-elecUng to have thl 'IItter det,ralned lit tha l'Iudlt of the account of the perllonel fllprlltantlt1v., OR --appl.l to the Orphan,' Court ADHIN- ISTRATlVf CORRfCT IONS I Faotu.1 .rrorlil dhoover.d on thh IUU"IJrlt IlIuuld ba eddrntad in writing tOI PA OeplIrtllflnt 01 R.....~I, Bur.au of Indl11h1uIll '(111<11, MTNI POllt h'Qulltml Revl.w Unit. OEPT. 7.80601~ Harrhburg, JlA 171Z8-060l Phon. (717) 787"6505. S.. Illlge 5 of the bookl",t "Instructions for InM,,'lhnoa Tax It.turn for II Rllld."t Decadent" fREV~1501) for IIn ~Mplan~tl~n of lIulllnJatr8tlvolv corr.cteble errors. DISCOUN'(I If Iny till due h ptdd .,Hhln thr.e (]) oalAndar lIonthn Ilftflr tha d"ced.nt', dflllth. a flva p.rolnt (5:0 dhoount of the hx plldd 11 III ,I owed. PENAL TV I The 15~ tal< ..,...ty nowpartJolpatJon p."elty 15 cOMput.d on \ha tlJotll of the tltM and Jnt.r..t ."""d, and not PIld btiforlt January la, 19?6, tha Unit dny aftar tile end of thn tal< nlmuty parJod. Thit non-PlrtJolpltJon pan.!1:y 11 ItPPelllabl. In tha 1fI.. unrwr and in the the ta.. U.. period .. VOl! would llpp.al th&l t,x 'nd lnt.rut that ha. be.n ....'I.d h. indicated on thJI notlc8. INTERf!STI Inter..t It oh.r~rl beginning wUh flr.t dllY of dl11nqlllflCY, or nine (9) .onths and bn. (1) cJ3Y fro. ttlll date of d.ath, -to th. dl'lte of paY.lnt, TnX8I which b.~e... dellnqu.nt bllfor. January I, 19IZ b.er Intlr..t lit the rflh of IIIIC (6%) perc'l'1t per 811nl..1 CftlOulal>id fit a datly rate of .000164. All taxe. which b.c~.. d~llnqu.nt O~ or after January 1, 1982 will be&r Int.ro.t at a rate which wl1~ Ylry fr~ ulendlr Yllr to olllenllar )'ur with that ratl announced by the PA !hlpar\e.nt of R.v8nue, Th. applicable ~nt8r..t r"t.. I()r 1982 through 1997 IrtH V.ar lnt.,..t R"t. D.lly Int.rolt Faotor Veer ~~ Oelly Interll,t Factor 1982 ZO~ .000546 1967 9% .0007.47 1983 16~ .D00438 1988-1991 11~ .000301 1984 It:( .000301 19'2 'X .000Z"'7 1985 13;( ,0110356 1991~1994 ]X .0011192 1986 10:C ,000274 1995~1991 'X .D00247 --Int.r..t i. ollcul.t.d .. follawll INTEREST. BALANCE OF TAX UNPAID X NUHSER OF DAYS OELIIIQUENT X DAILY INTEREST FACTOR -~Any Hotloe I..uad eft.r tn. t8M bleD'.' delinquent wtll rlfleot an Int.re.t calculation to flft,.n (15) ~y. beyond the d.t.. of thta I.....""t. If Ply..nt h ...d. aft.r th. Intlrut ColtputeUrm det. .heWtl on the Notlol, .dditlonl1 lnt.r..t lust b. o.lculatld. PAVltENT, DltlClh the ,,, porUon ,of thlt NoUoI and luNit MAth your pIVllent ... 'plylbl, to the "... In'! iMdr... printed Dn U.. rnlr" .Ida, H.,," chock ~r ...... order p"obl. \0' REGlSTER OF WILLS, AGENT. REFUND (CA)1 II refund of . ttIC oredit, which "'.. not r'qut.tld on thl hIC R.turn, lilY ba r.que.tiW by OOllPl,Ung an "Applloatlon for R.fund of Ptnn,ylv-nl, Inherlt.nol ftnd E.t,t_ rlIC" (REY.lSl]), ~lIG.tlon. Ir. IVlt1lbla at thtl OfficI of ttM R....t.' of Will., any of thl 23 Atv.!\Ue DlItrJot GIUoI. or fro. thl O."rtHnt" 24'"hour In''''lrlnl ..rvlel nulltMr. for for.. or.rl"" In PIM.vlvlnl, 1-800-362-2050, ouhldtl P""'Vl\/,,"J, Ind within 100.1 Harrl,burg .r.. (111) '.7-8094, TOOt (717) 772-225Z (H..rlnt I~.lrld only), REPlV Tal Question. rl'lrdlng .rror. contelnttd on thh notico .hould btI ,drtr...8d tal PA DeplrtlMt of R.Vlnue, lur... of Indlvldu.l lex.., ATTNl Po.t A.....Mnt R,vllw Unit, o.pt. 280601, Harrhburg, PA 1712l~0601, Phone (117) 117~6!iD5, DISCOlJr4TI If Qny tlK dUe J. pBld within thraa (5) callndar .onth. If tar thl dacadlnt'. de.th, . flv. p'roant (5~) d!.count of the talC p.ld 11 .Uowed. PENAL TV I The 15:< talC MM.ty non-,...rtloipltlon penll ty 11 COlputld on thlt tot.i of thl talC and hlt.rut .......d, Itnd not p.id before Januarv 18, 1996, the flr.t day Iftar the .nd of the tlK ..na.ty p.rlod. INTEREST, Int.re.t 11 oharged bqlMlnll with fir.t day of c1ellnqu.noy or nln. (9) aonth. end on. (1) d.y froll the dlte of ~Ith to the dati of PI~t, TIIC.' which ~... delinquent b.forl Janulry 1, 1~12 bear Int.r..t It the rata of .11C (6~) plrcent p.r ~ calaul.t.d at a dally r.t. of .000164. All tllC.. whlch b.c... delinquent ~, ~ Ift.r J~lrv I} 1912 will b.ar lnt.r..t It a r.t, which will vary frol cII.ndar y.ar to cal.ndar y.ar with that rat. announc.d by the PA nlpart.ant of Aevanu.. Th. appllcabl. lnt.r..t r.t.. for 1912 through 19.7 ar., V..r Inter..t Rib Dally Intera.t Factor V..r Int.r..t R.t. Ollh Int.,..t FHtor - 1'12 20:< .0005"8 1987 'X .0002"7 1..5 16>: .000"51 19..-1'*91 1l~ .000101 1914 11:< .000501 1992 'X ,000247 1915 UX .000556 1993 -1994 7X .000192 I'" lOX ,000274 1'95-1997 OX .0002"7 u]nt."..t I. clloulat.d a. followlI IHTEREST . SA LANCE OF TAX UNPAIO X NUNSER OF DAYS DELINqUENT X DAILY INTEREST FACTOR .-Any Hotte. I..u.d .ft.r thl tllC bleD... daltnqu.nt will r.fleot an Int.r..t ollcul"tlon to fifteen (15) dlY' b.yond the data of the ...."..nt. If pay..nt 11 IlId. .ft.r the lnt"..t cOllPuhtlon data thown on the NoUo.. addltlon.l Inter..t IIUtt ba C1.Ic:ul.t.d. COHHONWUl'" Of Pf.NNSVlPAHIA DEPARTtlf.NT OF RI::VUiUE IHJREAU (If lHOIVIIIlIAl TAHF.S IJEPf, la0601 UARRISBUR!l,I'A 17Ha-0601 * /' . /\" . ,J . . .) ," '. INFORMATION NOTICE AND TAXPAYER RESPONSE /11 FILE Nil. 2t '1/11'l7 ACN 97131564 DATE 07-09-97 U~'IHlIM I" lI.UI ~ EST. OF BEULAH E PECHART S,S. NO, 209-12-6199 DATE OF DEATH 05-20-97 ':. libUNTY: :.. CUMBERLAND TVPE OF ACCOUNT !Xl SAVIHGS [] CHECKING o TRUST o CERTIF . ERIC L PECHART 1619 PINE RD CARLI SLE PA 17013 (:I. CIIi REHIT PAYHENT AND FDRHS TO, REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 MEHBERS 1ST Feu hili provIded the Olflllrtlllent with the Inforllllltlon lilted helow whloh hIlS heen "Iod In (;nlo,,1IItlng the potRlltlnl tax due. Their rlloords Indlont. that at the death of the above deoedent, you werg " joint owner/benenclary of thl. account. If you hel thle InforutJon I, Incorrect, plea.. obhln wrlttlln corrl.lotlon frail the f1mtnolal In.tJtutlon, Attach a copy to thl, for.. and return It to the above addr.... Thl. account 1$ tI!lxebl. In aocor-danae with the Inh'lrltonce Trlle ln~I' of the COl!lllonwealth of Pennlylvanlt.. wv....Uum. lIlolY u" tIlISWlIJ"IlU uy l".llltng \ii./I la-,-aJtf, COMPLETE PART 1 BELOW Acoount No, 33324-00 M M M SEE REVERS! SID! FOR o.to 04-27-83 E.toblhh.d FILINO AND PAVMENT INSTRUCTIONS Account Balanc. 7,236.49 Poroon! Toxoblo K 50.000 A.ount Subjoct to Tox 3,618.25 Tox Rot. K .06 Potential Tox Duo 217 , 10 PART TAXPAYER RESPONSE [II r 'AILURIl TO RIlSPOMII WILL RIlSULT I~ OFFICIAL TAX ASSESSMENT BASED ON THIS NOTICIl J A. 0 The above In1or.lltloll and tIIx due III ctlrroot.. 1. You May oho080 to rculllt plly",ent to the Regh18r of wills with two copiu of thll notlco to obtain a dlloount or !:Ivold Inhro!tt, or you Ilay chock bOl( "A" And ..eturn H>ls notlco to tho Reghtllr of Wills and an officIal ,,"ou.gn'( will be luuad by thg p" [)epartllont of Revenue, To In"lre proper oredlt to li/t1ur acoount, two (ll oople' of this notlol Must aooompany your IlIly"'ent to tho Raghter 0' Wills. Hake check peYllble tOI "R.ghter of Willi, Agllnt", NOTEI If tlll( plly",ont. aro ",ado within thr~e (3) JlIonths of tll&t clelledent's date of death, you IUY deduct II 5% discount of the to)( dUll, Any Inherltnnoll tox due will booo",. dollnqulnt nine (91 Mnth. after the dah of auth, [CHECK ] ONE BLOCK ONLY !, 0 Tha above auet hilS baan or will bill reported and tlt)( pllld with the PennsYlvania InhorltllnclI Ta)( r.turn to be fUod by the decadent'. rgpr811entetJva. C, 0 The above Infarllatlon I, lncorrlct Md/or debt, and deductions were paid by 'Iou. YOU MUlt oo~plete PART r~ andlar PART ~ below. PART [!) TAY LItlE If ~oy indicat. ; differ.nt t.x rat., pl.... .t.t. your relation.hip to d.c.d.ntl DFTIID" . r.nMDIlTAUnN I. Oat. E.t.bli.h.d 2. Account Balanca 3. P.rcent Taxabla 4. Anoynt Subjact to rax S. Oabtw and O.dyction. 6. A.ount Taxabl. 7. Tax Rat. a. Tax Due OFFICIAL USE ONLY 0 AAF 1'. DEPARTIIEN'r OF REVENUE nl' TAY ON JnINT/TlllUIT ACCnIlNT!l I 2 5 K 4_ 5 6 7....JL. 8 PM) PART I!J DATE 1 2 '5 4 S 6 7 8 !!illS AND DEDUCnONS CLAIMED - ~ - PAID -I PAV~E DESCRIPTION AMOUNT PAID ~I- . L TOTAL (Enter on Line 5 of Tax COMPut.tion) .'. rjury, I declare that th. facts i knowl.dga and beli.f, hay. report.d abov. are true, correct and HOME ( ) () lJ 3 2 ('i 'j ( W6Ri<~--im_---)"':~,( 72 'IL 'J /";s-tcr7 TEI.EPHONE NUMBER '-- - -miTE GENERAL :NfORMATION 1. FAILURE TO RESPOND WILL RESULT IN AN OFfICIAL TAM ASSES-SHENT with appllcllbl. Int.,.I.\ beutd on Infonlltlo" lubllll t hid by thl 'Immel!1 lllltltutilm, t. Inh.r-Itano. hI( IIICOIII.. dltlnqul"t nll1' lIonth, ftf\l,. thl dlcecl.nt'. elate 0' dlnth. 1. ... Joint l'lCllO~lnt II tllllllhh "\,IlIn though thl d'c~d.nt'. nll"'l W"I addld al II 1IIl1tt.r of conYllnllMI. 4. ACClOunh Unoludlng tho.. hlld h.,w.." hu.band I!lnd wlf,1 which HIt dlloedlnt F1ut In joint M"''' within 0"" Y~II' prior to d..th ftl" 'ully taMahl, 1111 Irn","r,. S. "'oooun\. uhblhh,d JoIntly b.tw.." hUlbflnd and wife lIIorl than on. \lnr prior In dOllth nr. not tfll<lIbl.. 6. Accounh held by Il dlle.dlnt "In trult for" anoth" or oth.r. IIrIl t,x8bl, 'ully. REPORTING INSTRUCTIONS - PART TAXPAVER RESPONSE I. BLOCK.... If thl Inforlllltlcn and cOMpuhtJon In Ut. notlco IIr. corr.ct Bnd d.d~Jctlons lIr' not b.lng olal"'ld, plaot an "X" In block "A" of Pllrt I of tho "TlUlpay.r Mnponn" ..otlon. Sign two cop In llnd .1Ib.lIt thell with your Chick for thl ,uount of taM to thl RIght.r of WIlli of ttlft oounty IndJcllted. Th. PA n,plIrhllnt of Rlu,oanlla will Iuu. lIn offlQl.1 1I.....II.nt (f'orlll REV-154ft tl() ullon r.Q.lpt of tha r~tllrn froft! the Regilt" of ..HIl.. Z. BLOCK II - If the a...t .peclfled on thl. notlcl hu bien or will be reJlorhd nnd hl< paid with thl P.nn.yJ....anla InherItanc. Tel( Rlturn fll.d by th. d.c.dent'. repr...ntlltlv., placl an "X" in block "B" of Part 1 of th" "Taxpayer Rupon.." ".otIon. Sign on. oopy IInd r.turn to the PA DIPart".nt of k......nu., I\lJruu of Indl....ldual la)(n, Dept 2806111, ~tllrrlsbur9, PA 11128~06111 In thl envelop. proYld.d. 1. BLOCK C - If the notlo. Inforlllatlon I. Incorrltet lInd/or daduct Ion. are bllng oIahuld, chllck block "e" and cOllpl.te Parh 2 and .5 a.,J.:;..rJl,.,; t... the InJ:"'lN~L..".. ~::o.,' Cl.m t~'o 'Jp;oJlI:.' ;;Jnc :'.lb~lt tttJ::i ','IH~ :;0"" ,:l.')~y ,:'~ tt-'" n""l'.,t ...f I.... r"l"."I.. t" I"'.. ll"gl~,lnr uf Willi of the county Indlceted. Thll PA D.part.lnt of ReYlnu.. will I..ue an official al"lIllent (I'orlll REV-1548 EX) upon rlllcelpt of the return fro~ thl Rlgleter of Wl11~. TAX RETURN - PART 2 - TAX COMPUTATION LINE 1. Enter the date the account orlgJnally wu uhbl18hed or titled In thlllllnnlr exlstlnll nt datil of de"th. HOTEl For a dlcedlnt dyJng aft.r lUlU8fl Aoocunt. which the dleedant put In Joint nail. II within on. <I) Vlllr of d.ath are taxabl. fully al tr~n.f'rl. Howlvlr, th.r. I. ftn eKclu.lon not to ~Kce.d $3,000 per tranS'lr.e r"gardl... of thl valuo of the account or the nUMb'r of IIccounts held. If e double &.terhk (MMI appears be for' your f1rtt n&1lI1t In thl addre" portion of this notice, thl t.5JOOO eMoluslan alr.ady ha, b..n deduetad fro. the account halanoe as reportlld by the fln.nclsl Institution. 2. Ent.r the total balance of the acoount Including Inter.,t accrued to the dllto of dllth, 3. 1M p.rcent of the f1ocount th.t is hMllble for 8ach survivor II d'ltarlllln.d at follow'lI A. Thl parcent ta~.bl. for joInt as'lts .stabII.hed Mor. than one Ylar prior to the dlced.nt's death I 1 DIVIDED BV TOTAL NUH8ER OF JOINT OWNERS EMa.plll A jolnt a..et r.gi.tered DIVIDED BV TOTAL NUMBER OF X 100 .. PERCENT TAKABLE SURVIVING JOINT OWNERS In thl na*e of the decedent and two other persons. I DIVIDED BV :5 (JOINT OWNERS) DIVIDED BV 2 <SURVIVORS) .. .161 X 100 .. 16,7% (TAKABLE FOR EACH SURVIVOR I B. The perclnt tlIMable for lII..b created within on. y.-ar of the declld.nt's dlath or account. own.d by the dloldent but hlld In tru.t for .nather Indlvldua1(.) (trutt blneflcJarIe')1 I DIVIDED BY TOTAL HUMBER OF SURVIVING JOINT OWNERS OR TRUST BENEFICIARIES X 100 .. PERCENT TA~A8LE [M.-pl., Joint acoount relllstlr.d In the naft. of tha decadent and two other per.uns and a.tablJshad within one ~ear of d.ath by "the dacedan t , I DIVIDED BY 2 (SURVIVORS) .. .50 X 100 .. SOX (TAXABLE FOR lACH SURYIYORI <t. 1M '.oiJ'lt .ubj.ct to teM (lln. 4) II dateralnld hy .ulttplylnQ thl account balanca nlnl 2) b~ the perc.nt taMabh (line 3). 5. Ent.r thl total of the dlbts and dlductionl 1I,t.d In Part 3. et. In. a'OUlIl UIMaDJ.I \Jiml bJ 'I til\.ralnea oy Iouolrac.:lng tn. d.Ol1 ana CitauotHJflI ,Jln. !lI1 frO. tn. a.(,unt SUlJjlcl 1~ 'CrI1\' \1111" It/. 7. Entlr the appropriate tax rlllt. (lIn. n 81 dltlrlllnld below. A. For date. of dllatn occurring after 6/~O/9', the taK rat.s for tran.fer. to spOUlel are a. follow' I I. Date. of d.ath on or after 7/1/94 and before 1/1/95 the rate I. ~%. 2. Dat'l of d.ath on or after 1/1/95 tran.flrs to spou..s wJII h. tllMld at OX taK rate. Note I For dllt.s of d.llth prior to 7/1/94 tran.f.r. to spou..s arl taMllble at 6%. B. Tran.hr. to lineal duclndanh IncJudlng fIIth.r, 1II0ther, lon, dftught.r, IIrandchlldr.n, son-In-law, dauQhhr-ln-law, .tapchlld IInd theJr luul tire taMab.\e at sb ptl'cent (6%). C. Tra"sltr. to all oth.,s Including bratt,.r, .hter, unch, lIunt, n.pha.. and nile. ara tlMable lIt flfte.n p.rcent (lSXL n. If ~ou chang. the taM r"hl pleut IpeQHy your rllat 10nShlp to thl dlcldlnt In the ftre, proYldod. 8. The aaount of taM d\1I (llne 8l I, dlteralned by llultlp1ylng the uount taMable (line 6l tlV the tax rllte (lIn. 1), CLAIMED DEDUCTIONS - PART 3 DEBTS AND DEDUCTIONS CLAIMED Allowable d.bt. and deductions are detar.lnad al followSI A. Vou 1I11alh are ruponslb10 for pllY'iIlent, or the ..tato lubj.ct to adlllnhtratlon bY' 0 per tonal repr...ntaUvfI Jt Insufflchnt to paY' the deduotlbl. It..s, B. You aotualh paid the d.bts aftar dllth of the decedlnt and can furnish proof of pavlltnt. C. nebtl bllnQ clalud llIuld be Itulz.d fully In ?art.5, If addltlon.t Ipace II "..dlld, U!ll plllln papar a 1/2" x 11", Proof of paY'ft.nt illY' ba raqua.tad by thll PA Dllpart..nt of Ravlnu., ~~ TAXPAYER ASSISTANCE IF YOU NEED FURTHER INFORMATiON OR ASSISTANCE, CONTACT ANV REGISTER OF WILLS. PA DEPARTMENT OF REVENUE DISTRICT OFFICE OR CALL THE BUREAU OF INDIVIDUAL TAXES, TAXPAVER INQUIRV UNIT IN HARRISBURG AT (717) 767-B327. TDDt (717) 772-2252 (HEARING IHPAJRED ONLY) 1/;~//r.:3 --,3 BUREAU OF IHDIVIOUAL TAXES INHERIT^NCf. TAX DI~ISIOH Ot;PT,20oMI a HARRISBURG, PA 1112140601 G~ORGE ~ DOUGLAS 27 W HIGH ST CARLISLE PA 17013 COMMONWEALTH OF PENNSYLVANIA '- *' DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT ~1V.litl n u, In.tll DATI! 03-19-98 ESTATE OF PECHART BEULAH E DA TE OF DEATH 05-20-97 FILE NUMBER 21 97-0477 COUNTY CU'1BERLAND ACN 101 [~ A~OUn_!._~~~~:tOd _ j MAKE CHECK PAYABLE AND REMIT PAYMENT TOI REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE I To inlYr. proper credit to your .cemmt I subltit the upper portion of this form with YO\lr tax pnYIll8ni:, CUT ALONG THIS LINE ~ RETAIN LOWt.R PORTION FOil YOUR RECORDS ~ R 'EV: i593 -jilt -A F Ii - j oii: 97Y - - - - - .ili- iiiHER"fi ANe:E - TAX - R E-COR"ji - Aii"Juiii'i.i€iiT" -Ii_ - -- - - - - - - - -- - -- -- - -- - - - - - - - -- ESTATE OF PECHART BEULAH E FILE NO. 21 97-0',77 ACN 101 DIlTE 03-19-98 AOJUSTHENT BASED ON' BOARD OF APPEALS., REFUND VALUE OF ESTATE: 1. R..l Est.t. (Sohedule A) 2. stDck~ and Dondl (Sohedule B) 3. Clos.ly Held stook/Pednership Interest (Schedule C) 4, Hortgag../No1.. R.~.1v.bl. (Schedule Dl 5, Calh/Bank nepos! h/Mho. PerSlonlll Propedy (Schedul. E) 6. Join~1y Owned PropDrky (Sch~dul. Fl 7. Iran.fere (Schedul. Q) 8. Total A...ts DEDUCTIONS AND EXEMPTIONS: III (21 (3) (4) IS) (6)_ (71_ 50,000,00 ,00 .00 .00 10,651.43 3,618.25 ,00 (8) 64,269,68 10, 11. 12. 13. 14. TAXI IS. Alllount of 16. Alfount of 17. Alnoun't of 18, Principel TAX CREDITSl PAYHENT DATE 9. Fun.ral E~p.n.M8/AdMinistr"tiv. Co~ts/ "isc.ll.n.au. ~xpan... (Schedule H) Dabts/Hortg.g. LiMbiUU../U.nll (Sch.dul. Xl Totftl Deductions N.t Value of Tex R.turn Charitable/Government.l aequ..ts; Non~.l.ctad 9113 N~t V.lu. of Elt.t. Subj.ct to T.x I9l 13,251.50_ 110) ,00 (11) (12) Trulh (Schodu1e J) (13) . 114) 13 , 251. SO 51, 018,18 .00 51,018,18 line 14 .t Spousal r.tM line l(t t.xllbla .t lin..l/Ch.. A rat. I.in. 14 tax.ble .t Collat.ral/Chlll 8 r.t. TilX Du. US) .0011.00' (16) 51.018,18X.06o Cl71 ,OOX,15' (18) .00 3,061.09 ,00 3,061...ll 08-13-97 RECEIPr NUHBER AA211629 DISCOUNT (.) INTEREST/PEH PAID 1-) 153.05 AMOUNT PAID 2,971.00 TOTAL TAX CRED'IT BALANCE OF "AX DUE INTEREST~ND PEN. TOTAL DUE 3 124,05 62.96CR .00 62.96CR · IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL IHTEREST, IF TOTAL DUE IS LESS TtIAN n, NO PAYHENT IS REQUIRED, IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YDU NAY BE DUE A REFUND. SEE REVERSE SlOE OF THlS FORM FOR INSTRUCHDNS,) , ..., PAVHE:HTI D'..oh ,~ht; top portion of thll Hotlo. .nd .ub..Jt with yow Pty...n~ lad, p'V.bh~o the "H' ind IGdrt.. print.d on the r.v.r.. .tde, -- Hlk. ch.ok or .on.y or'd~r Ply.bl. tOI REGISTER OF WILLS, AGENT. REfUND (CR)1 A rlfund of I tlM or.dit, whioh wa~ not rgqu.ot.d on the TaK R.turn, ..ay b. requ..t,d by co.pi'ting,.n "Applio.tlon for R,fund of Plnn'Ylvant, Inh.rit.nc, and Eltat. TaM"(REV~131SI. Applioation. art IVllt.blt It the Offlo. of the R.ghtlr of Willi, ttnyof the 11 A,vlnu' Dhtriot Off Ie.. or fro. the O.plrt..nt'. 24"hour en.w.rlng ..rvlol nu.b.r. for for.. ord.rlngl In p,nn.yivania 1~800~362~2050, out.lde Plnn'Vlvanta ttnd within lonl Harrhburg .r.. (717) 187-8094, TODI! (117) 772~2252 Oi.arlng hlp,ir.d onlY). REPlV TOI Que.tion. r.g.rding .rror. oont.ln.d on thl. notio. .hould bO addr....d tOI PA D.part..nt of R.v.nu., lurllU of tndivldual TaMI', ATTNI POlt A......."t R.vi.w Unit, D.pt. 280601, H.rrltbura, PA 17128~060l, Phone (717) 787-6505. DISCOUNT I If IHlY tlX dul 11 paid within thr.. (3) I).lend.r tonth. .fter the d.o.d.nt'. dllth, a fiv. p.rClent CS:O dlloount of the tax p.ld I. allowld. PfHAL TV I Th. l5X taM .~.ty non-partioipation plnalty i. cOMput.d on the total ofth. teM and tnt.r..t a.....Id, and not paid blfer. J.nuary la, 1996, the fJr.t day ~ft.r the .nd of the tlx ..n..ty p.riod. INTEREST I Int.r..t I. ohtra~ b.ginning with fir.t day of d.linquency or nine (9) 1I0nth. end on. (1) dl\t frail the dati of d..th to the det. of J1.~..nt. TIM.' loIhlch bile... d.Unquent before Janutr~ 1, 1982 b..r lnt.re.t at the ret. of lib (6%) perc.nt ptr annuli ellouhft.d at a daily rat. of ,000164. All hn. which beee.. d.1tnqu.nt on and aft.r J~.r~ I, 1'12 will beer lnt.r..t at . rat. which will vlr~ frail cal.nd.r y..r to eal.nder ya.r with thlt rat. announoed b~ thtl PA nep.rt..nt of R.\lInu" Th. appiioebl. Jnt.r..t rat.. for 1912 thrO\.!Uh 1996."., V..r Int.r..t- Reta netly Int.r..t Faotor Vur Int"..t Rlt. Oaiiy Inter..t factor - 1912 201: .000548 1987 'X .000247 19n 16% ,0004:\;6 1.11-1991 11:< .000301 1.1. m ,000301 1992 'X .0002lr1 1911 m .OOOS56 1993-1994 7% .000192 1936 10% ,000274 1995-1996 'X .000241 ~"Intar.lt l. c.leulet.d .. followll INTEREST = IALAHCE OF TAX UHPAXD X NUHIER OF DAYS OELINQUENT X DAILY INTEREST FACTOR ~~Any Hotio. i..ued .ft.r the ta" b.eo... dtiinqu.nt wtll r.fJ.ot In Int.re.t oaioulation to fift..n (15) davs b.yondth. d.t. of the ........nt. If Ply.ant I. lI,d. .ft.r the int.r..t eo.putatJon dati .hown on the Notle" .ddltJonal Int.r..t .u.t be o'lculet.d. PAVIlENT, o.tloh the to, portion of ;1h1l Hottal .nd tubll1t with your p.)tMnt ,Ide Pivot, tothl "... ~lddr". prtntld on. thl "v.r.. .ld1. If JtElIDENT Dl!CEDENT .~. cMok ur lIonlV arcMr paY'bl, tal REGISTER OF WILLS, AGENT, If MOlI'AEllIM!NT DECEDENT ..... chock cr .ono.crdor p..obl. tc, COHHONWEAL TH OP PENNSYLVANIA. REFUND (CAll A r.fund of . tax orldlt, which WI' nat r.~.t.d an th. Tlx Return, "Y bl r.que.tad by co~l.tl". In "AppllntJon for A:.,und 0' PlMllvlvanle Inn.rltlno. Ind E.tlt. Tax" (REY~l;USJ. App1JoIUon. .r. 'II,U_Ie It the Offloe 01 the R..llter of With, ."y of thll 23 R,vlntH! DhtrlClt Offlell or 'ra,tlM DIP.rt.ent'a 24-hour M,w-rln. ..rvlel nuIlbfIr. for forlll ord"rlnOI In Pann,ylvant, 1-800-162-2050, autl1d, Pann'VlllenJ, Ind within 10011 Herrl,bur, Ir.. (111) '87-&094, TOOl (111) 112-Z252 (HI.rlno I",'rld only), REPLV TOI Due,tlMI r...rdlng .,ror. oontalned on thl, noHo. .Mould b. .dch'....d tOI PA Departunt of RIVInUt, ~n"" of Jndlvldu.1 TeM", AnNI Po.t A.......nt Revl... Unit, Dept. 280601, H.rrhbUrg, PA 17121-0601, phon. (711) '111-"0&. DISCOUNT I If In~ t.~ due I, p.leI ..ithln thr.. (3) o.l.ndar .onth. after the d.o.dlntt. de.th, a flv. p.rc.nt (SX) dl.count of the tlM paid Iw ~110wtd. J.tENALTVI Thl ISX tlM a~.t~ non-p.rticlpatlon pln.lty I. coaput.d ontl~ tut.1 of thl taM and Int.r..t a.....teI, and not p.leI b.for. Janu.ry II, 1996, thl flr.t dlY aft.r the .nd of the t.M .en..ty Plrlod. INTEREST I Int.r.U II char," be.lnnlnc with flret d.~ of eI.llnqu.no~, or nloa (9) IQflth. and on. (1) day frol thtl dlt. of d,.th, to th. date of pav..nt. TIM" whJoh b.c... ri.llnqutnt bafor. Janu.rv 1, 1982 b.nr Jnt.r..t It the r.t. of .IM (6X) p.rc.nt p.r ann~ aalaul.t.d at . dlll~ rat. of .000164. All taM" which b.oa.. d.llnquent on and aft.r Januar~ 1, 1912 will ba.r Int.r..t et a r.t. whloh wJII v.r~ frol qat.nd.r y..r to o'l.nd.r v..r with that r.t. announold by thl PA O.p.rt.ent of RIVenu.. Thl applJoabl. Int.r..t rat.. for 1'&2 through 19" Ir'l V..r Intera.t Ratl Ollh Int"..t Flotar V..r Inter..t R.t. Ollly Inter..t Factor 1912 20iC .000541 1981 'X .00024i' 1.13 16>: .000451 191'-1991 11~ .000301 191ft llX .000101 1992 'X .000241 19S5 m .000lS6 1991-1994 IX .000192 1916 10~ .000214 1995-1e"1 'X .000241 ulnter..t I. calculat.d .. followlI INTEREST . BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUEHT X DAILY INTEREST FACTOR --Any Hotta. luu.d aft.r tht t,~ b.eo... dellnqu.nt NUJ "fI.et an Int.ra.t e.lcul,Uon ta f1ft.", US) dlY' blYof'ld th. d.t. af thl 1I1....1l1t, If ply..nt II ..eII IH.r th. tnter..t tlOltpYt,Uon dltl .ho"", an the NetlcI, add'tlon.1 Intar..t .u.t b. ~.Icul.t.d. i.:~.;.t.' .~.,:.=......-::=..mc:::.; i,lx( -Htf'("1WIHt't ttot *AW"" tlJWll;:J -~'it4"'oP '_~ " J~~~"" lIt;.'Y 'II '1~,1,iC'tJ:''''O~'',Udt '.lA., . _ .- , ~"~~'~~ ~1'fOMIY ,;t-'.' ' " '~~. AT .... ., >!'~__:'+.!i?'~.~"'''''' t'> .,'_;__' 'lit';" .11' '~I "'A~~I.~",.CNN'Y.VAt-l'A . I101l-CUdl iBtf~t:Sl.'~'.... _ 1.:_.1'''_:0 'ft! '-, ,- '--;-:~_;:..- ,'?_~_~;;;5-' ':::>:.:_,:J~j;'l;~1lJj .....-....,., ---~.!--; 'molltH.. ,'." "j ....;,-,.,.".."".'. ...~~"-' , IN RE: EST A TE OF BEULAH E, PECHART . IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,PENNA, : ORPHANS' COURT DIVISION : NO, :::il. en ''117 ORDER AND NOW. this .fj.. ':::<.3 ~ . 1998. the Petition to Settle'this Small Estate is approved. and Pattl Kushto and Brie L. Pechart are hereby discharged from their duties as AdmJnlstrators of this Estate. By the Court. /S/ \Jb('~,- ct. ~lJJ~-,- r:r COfY