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1)1.:nI'lON IIOI{ 1)lmnATE and GRANT ()Io' LETTERS
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al,l'(I KII01\'1I liS To:
Kegistel' 0(' Wilh for the
=,:B:oo_\lFN ;'A tJ , lJ"('('lIS<'IJ, C<,onll' 01'_.. in the
Social S('curlty No, "~ /1, ,1..,'_?,?-' ~~.7_2~CI" Commonwclllth of Pennsylvllnlll
The petition of tile nnllerl'igned rel'pel'II-.t1ll' repre,\'ents Ihllt:
YonI' pctitlll1ll'I(I'), \\'ho il'/IIIl' IH year\' of IIgl' or oldl'r IInll1e l"l'l'UI m'" _. .~, namcd
Inthc III,t will of Ihe ahove dl'l'l'delll, (1tIll'lI, . _, '[ ..J."'"Yl"'- ,H, 19_~_
IInd""II-'I~'dlltell refj~()ftR.'l .2.QI ,qq'5- WL), uw_._~_._.___,
(~ta1t' h'll'\'allll'iri:lHmlllnl'l'~, (',P 1~'llllndilljlJll. dt'i1lh Ill' l'\l'l'tlhH, Cll',)
Ilccendellt \I'IlS domicikd lit delllh in, " _ c_\.'. mBers.l".l1t:1 p..__.., ('onnty, Pcnnsylvllnlu, with
1.I1?l!"e'~j~ 1~~I~I!l~lel~~~I~PIII ,res,l~cf\e at ;j~:~StJ.I€S_"~YL~Jjlt&.:1iufjLr.QW N 5 II / P
(Ihl '[In'l, flUllllwl lInd 11l11lh'ipaIIlYl
ut Ilel'endent, II~l'll__ J?.l.. yenrs.ol'age, died, '~T..,=...",)-':!,~-E...-T ') 7j' J!l"*,:L_'IIIP
,DL.IJ l;., K.\QG-E..l-\ p.,jJf; It_WE 5..,c.As"T.J'eIil&I8.m..__&WLi_s'
Exel'pt as ('ollt,\\'\" dl'Ct'denl did notmmry, Wlb not divorl'ed and did not huve a l'hild born or adopted
~::'~;'I~'I~~~~~:~:~ln o~thAl~~eCd,ln~ pr~bale;~'I~'n~t~e.~ic~l1OI'~I.k~I~Il~ IInd wus ncvcr adjudicated
1)(.'L'l'lldcnt tll.dl'illh o\\'lwd rropel'ty wilb estimaled values a~ follows:
(II' domidled in l'il.) All personal property $_5'2.00o.!..,
(If not domidled In Pa,) Personal property in Pcnnsylvn'lla $___~
(1111<'11 d0111ieiled in Pa,) Personal propel'll' in ('ounty $
V!llth.' UrrL'all'~lall' III Pl'llllsylvHllin $._
,ltunl<'d a, rolllll\': .. ''_.___n_...'___ ___ _..p,J_a,N..J;,___,_____~__
\\'HLKI:FOi{I'. pelltinner(,) respectfully requcst(s) the plohnte of the IlIst will and codlcil(s)
presented herewilh and the grunl or leltCl'l'._____..______+.e <;,-I-C;_'lY'.&1~:to.L'i_.
I (ll'~IlHm'rHlIrY; <l(lrnlnl~trullnn c,t,,\,; udnllni~irntlon ~,h,ll,c.t,a.)
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OATU 0... I)ERSONAL REI)RESENTATIVE
COMMONWEAI.TII 0/0' l'ENNSYl.V ANIA 1_ HH
cm NT\' OF L.l-lltl ~(-1~/.-11'N ~ up J
Till' IWlilillllt'r(;,) ;1I1lH,(, n:lllwd ~\\1.';1l'("') 01 i1lTirnl("') [hal I ill' "lall'IlICllh inlhl' foregoing petition arc
IrUl' .Uld l.Onl.....l III till' hl'...1 nlll\!.: ~Il,.l\\kd!ll' alld ht.'IIL'f or Pl'lltinl1L'l'b) and Ihal as personal rcprcsen~
IHliH'(',lllf II\{' H\lO\I' lk~'l'dl'l1t 1H'liliolll'I(~) will wl'll and ll'uly administer till' estate uccording to law,
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COMMOHWIALTH OP PIHHSVLVo\NIA' DepAI\TMIHT OF HBALTH' VITAL RICOROS
CERTIFICATE OF DEATH
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11 A S If
WILL AND TBSTAMf:NT
'0 F
MOO Yl~ AU
I I MOO '{IN AU / of MechanioSburg / cumberland County/
pennsylvania, being of sound and disposing mind/ memory/ and
understanding, do hereby make/ publish, and deolare this to be my
Last Will and Testament and hereby revoke all oth~r Wills and
CodicilS that I have made / including the will dated June 29/
1994.
FIRST: All of my Es'tate, of whatever nature and wherever
situate/ I give/ devise/ and bequeath, in equal shares as
follows:
A. One share to my daughter/ I,01S WAN/ of Elgin, Illinois I
B. One share to my daughter/ ALICE CHIN, of Mechaniosburg,
pennsylvania~
C. One share to be divided equally among the children of
my deceased Bon/ David AU: CRAIG AU/ TIMOTHY AU/ MARK AU/ and
STEVEN AU ~ and
D. One share to be divided among the children of my
deceased daughter / pa'.lline Chu: THOMAS CHU / DAVID CHU / STEVEN
CHU and KENNETH CHU.
Should any of these named individuals fail to survive me by
thirty (30) days/ but be represented by children then living/
thsse children shall take, per ~tirpes, the share to which the
named individual would have been entitled if then living.
~
-~
)
, ,
~@I All interests of any beneficiary in the inoome or
prinoipal of this Estate, while undistributed and in the
possession of my Execut.rix, even though vested and diotri,butable,
shall not be subject to attachment, execution or sequestration
for any debt, contract, obligation or liability of any
beneficiary and, furthermore, shall not be subjeot to pledge,
assignment, conveyance, or anticipation.
~HIRD: All inheritance, estate, and succession taxes
(including interest and any penalties thereon) payable by reason
of my death shall be paid out of and be charged generally against
the principal of my residuary estate without reimbursement from
any person.
FOURTH: I nominate, oonstitute, and appoint my daughter,
AI,ICE CHIN, as Exeoutrix of this, my Last will and Testament. In
the event of the renunciation, death, resignation, or inability
of ALICE CHIN to act for whatever reason in this capacity, then I
nominate, constitute, and appoint my other daughter, LOIS WAN, as
Exeoutrix of this, my Last will and Testament. I direct that no
representative named above shall be required to post security for
the faithful performance of her duties in any jurisdiction
insofar as I am able by law to relie\Te her of such obligation.
Any of lilY repreaentatives shall be entitled to reasonable
oompensation for the performance of the duties set forth here.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
this ~O"'- day of Fu,I".......r;1 , 1995, on this, the third of
"
three typewdtten pages. I have also signed the left-hand maJ:'gin
of'the first two of these pages for purposes of identifioation
Only.
, "m.!!! ',~
MOO ~U
SIGNED, PUBLISHED, and DECLARED by the Testatrix, MOO YIN
AU ,1I,s her Last Will and Testament, in the presence of us, who at
her request, in her presence, and in the presence of eaoh other,
have hereunto subscribed our names as witnesses.
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
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1. R.ol ~'tol. (Sch.dul. AI
2. Stocks and Bonds (Schedule B)
3. CloHlly Held Stock/ParlMrshlp Interesl (Schedule q
4. Mortgage! and Noles Recelvablo ISchedule D)
'5. Cosh, Bank Oeposlh & Miscellaneous Persunal Properly
ISch.dule EI
6, Jointly Owned Properly (Sch.dul. FI
7, Tron"." ISch.dule GI (Schedul. LI
8, TOlol Gross Assets (totalllno! 1.11
9, Funeral Expentes, Admlnl$lrCltlve Cosl~1 Miscellaneous
E'p'nI" ISch.dule HI
10, D.bls, Morlgog. Lloblllti.., LI'nlISchedul. II
- ,1. Tolal Oeduclions (total lines 9 & 10)
12. Net Value of Eslate 'lllne 8 minus Line 11)
13. Charitable and Governmental Bequesls ISchl3dule J)
__ 14, Not Value Sublectla Tax Illn~_!..2..-~~!.J:~_e 13)
15, Spousal Transfers (for dales of dealh after 6.30.94j
See Inslrucllons for Applicable PercenfClge on Reverse
Side. (Include voluos !rom Schedule K or Schedule M,)
_ 16, Amount of Une 14 tClxuble al 6% role
(Include valu6s from Schedule K or Schedule M.)
17. Amount of line 14 taxable 01 15% rClte
(Include 'Iolues from Schedule K or Schodule M,l
.18. Prlncipallox due (Add ttoe: from Uno~ 15, 16 and 17,)
19. Crodih Spousal Povorly Cradit Prior P(lyment~
+
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(( \MONW{AlfH tH 1'~NN5.\HVANIA
lJEllAIl.1MfNT or RfvHlUt
UErI 1'0'\JI
fIAIl:Il:ISbllRO, PA 17128.060 I
Of<: -". "f!"N-AMf iLAsi;;{~5f'-^~jiililtffii't'lt7iTIM1-~"'--'---~---
.L) .' lYll)(1 'i f tv , I
50CI,'"l SW,HHT,', ',~UM, BE, R, ,_ PAlE 0,' ("^I", "'If ,,' "",Ill
3tll-3~ ')-/Stj C,()'!' (if ((I 10,(1'1
I" '''''''''''''''';1;~''"A'M' "'" "'" "".."",,,, "",,,t, I""'" ,,""'," ""M,,"
K1 1, OriglnClI Return [ I 2, SupplomMlul Relurn
r-.J 4, limited Estate I j ~CI, Future Inlefful Comproml'fI
(lor delle, of deoth Clfter 12.12.82)
'N 6, Deced.,tU Olftd lost(lIe 1_-.1 7, Docedent Maintolned (I Uving Tru,1
IAlloch copy 01 Willi (Alloch copy of lrul1l
ALLCORRiiPONPiNCE AND cONfiDENTIAL -fAX INFOllMATION SHOULllllE DIAICTID T~'-"'"7----:-""'---
NAME- . -1," --'-'-~~4~-cOl:iprfffM^-Il'iNO ADO~~5_5.~ C") ("'J ) , ~ ~ -:----:.o-------..---...-.c-
__d~Lc:I~_J'cJL I Num u_ I; l :1 (! r: I o If{ In, /L ftt- !:.: ;p::!
THEP~lClN~ NUMBER - , - --, . ,.. PA'-' ....' ,'" .~
.J.J..D-LJ.~k..,~',p)-,.j2~~~L==.." ,,~j::I!L~,t~~ N ~c.8i.~1 &<k.+.===.i-' zo S_ ~~
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20, If line 19 Is groCller IhCln Urle 18, entor the cllffofflncO on line 20, Thi, i~ tho OVERPAYMENT.
IIll
21. II line 18 is greater thell1 Line 19, onlor the diffor()l1ce On lino 2 t. Thls is 'ho TAX DUE, 121) I...-CL 3l3--~-Z--r:t~---
. A, Enler the intern,t on the bnlon(o due on Lino 21 A. (21 A) ----~~5.() 1_ Lf.
B. Enter tho tOlol of lirHI 21 ernd 21A on Line 21B. Thi~ is Iho BALANCE DUE. (2181 -/-,0 b _.-;:- ~l-.i;;---
_~~,~'_~~~!~~hl!lck Pay~bl. to: .~.!_~~~te1 o~~l_I_I_~~__~~~_n~t____~_ ___...______~_~ . ..______..
----- ,~ __~.~-BE.~UREuT.e>:.ANSWEw:~i[CiIJ.liSTlO_I'l~O~J~I,IERS~~1I).EANil,-'iO RE~HECK MA!!:!_~~.u._ "'.,."'.".__
Under penohlos of perjury, I decloro Iholl havo examined this returll, including acwmpanying H:hudulos Clnd ~tCltomonh, (lnd 10 Ihe b6St 01 my knowloclge and belief,
;1 is Irue, correct and complete, I declme thot all rfwl 011010 has boen reported ot IruB morkol v"lut). Declaration of prepor'er othor thtlll Iho personal represonlallye is
bated on alllnformallon of which preparer has (lny knowledge.
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fOR DAnSO' DIATH AnlR 12/31191 CHICK HIRI
" A SPOUSAl
POVIRYT CRlDIT IS ClAIMm I I
flll NUM'IR
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COUNTY COD~ YEAR
NUMBER
ilt i-rfjTt'j,... (riMPl~ir^'D5Rf.t;;;---~--'-'-";':-'---'-'-''':''''''':':--'-'-'c..:;-~,,-~---=-------
! '> I, IV/JU:: ~ I) I, /// l, Ill' ( Sell;'
..,^"j{ (HANiC') FWl'.c-- IPA 17(1', ij
'-"""f
^MOll"" i,e' 'Vifil\,"''''~'\i~H:>1:I,.
I I 3.
[] 5,
_L8
Remalndor Relurn
Ilor dot.. 01 deQth prior '0 12,13.821
Federal e,lCIle Tax Relurn Roquired
Tolol NlImbor of Safe Oepo$lt Boxes
III
( 2 I _L"b.,ClSZS /Z--
(3) _._.___________.____,....._...~.___-
:: :=.~6~o,U!Pl~LC;
(61 -~~~--,--.--
17) .-_.~.___.___
1,1
(7;
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181 J.3113L!;~----
19)_.,_.~.
1101 __L~LrL1' 0' a
J 0 . {
(I CLLkLr_..
-L:Z 2 '7uf;LH .tl..."",
/..;;, 2. -1. ~-?Z.6.:--:_
1111
1121
1131
1141
(151_____._.._.
;.'7 "e:; (/Jd.
1161 _1-2.2-"1----'7-'./1.,___
x,~=
)( ,06 =
, Ci
_.__.1-63 '3 . Z '-1--
(171,
..._.._____,_~)( ,15 =
1181 .--_.l..cL!3.3-.z.:t'--__
DI~counl
Inlerest
+ .
(19)
(201
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r hYlPQ,]Jtl.Llg,
(1AU---"
DATE
(~_L5.1E-
Illvl\lI,tl!lQ!l1
tuL, SCHEDULE H
~ fUNERAL EXPENSES,
WMMO"W' ^"tI or """",,^',,^ ADMINISTRATIVE COSTS AND
1t1H[IlIfANU 'A~ RrlUltN MISCEllANEOUS EXPENSES
_. ,,!'''~(Nl U""'''H~_ ' PI.a.. Prln' 0' Typ.
mAl1'/Sr ~ ".- "-,,,-,,,---,--,--,,,-,,u"'~'-~rINUMBI. .-. -. -
"...I. __.'',______ ,~__,.....,'__
."
ITEM
NUMBER
A,
DESCRIPTION
AMOUNT
.'-'.,"_.__.-o_"'___"H~--"--__ ~___~_~_~.____._ _ ,.
1.
fun.,aIExp.n".,
CJUA'fI air t~
loLlo {J(,
;}, 7 S(.) (J
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"7IL1-11wt,t d f ./J-f!.J'v1/(t'Q...J
B. Aclmlnl.t,atlu. Co.t..
4,
C,
1.
2,
3,
4,
5,
6,
7,
8,
1.
Personal Repre.entatlve CommluloM
Social Security Number of Personal Reprelentallve' ____--=
Vear Commlulon. paid _______~___
....-~_.---
2, Attorney Fee.
3,
Family Exemption
Claimant
Add,e.. of Claimant at decedent's deoth
Street Add,e.. ______~_
City _.~______.~__~,_Stat. _~ ~Ip Code~~---,----
--.--' "
Relationship
i -------
Probate Fees
MI.e.llan.ou. Exp.n...,. t..'. .
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p.,fj"( /-1 Y!-l tv ! /1.eJ~) S;f;dl I {L,. f-(j1d.jLC
, iO~gt.;,?, 1 iur.,tt!;. " .
Ie "'-1-,(f" 13-e f4(UL' To tL/-(:~II ,)y' .. ,
W06dJa.I)J"{;'1 ~A/lU.ld{t _,O/~?I;;~ 11&(!p.j4 1iJ;
P ()..f-u I)ci /!.;-et<l--1 ~ ( 1(;1...& 'Ao I~ tJ!.-.
J r.' (-, "r-)
I, .(' ~..(I..~71 .) rrU-l-f:-
?xf1Jl I) d h~(( Ice , / /' "
sla-tvll\ __ S~ (7 t1G!'y '" CCt(.(.',e ~p ,(}/u';II) rbjiu., ~
1l,{)!..I-.71tt'ciuill rf)-d<-Z d<: 7 / Id 0 dO
~'~-~-~i.~~r!..--~ (L.P/jt..!(,.ll . ?j~~( ~~ tP'!:~0 !!2,'!!.::6J~!;t~, ,____Jo (') (!.
TOTAL (Also .nler on line 9, Recapitulation) $ / A' () 7 6 (,
(If mo,. .pae. I. "..d.d, In..rt additional .h.... of .am. .Iz.,)
~ t(. ~ -'0
Ci.72
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tll (3
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L 9 - Jm;A~.1I J~.~ /Jd~1 ~ /0 ~~',~, ~'='~-'-=~c="~~~'c-~;~:;,-'; 0 ~
~t c.;!) ~wI.. - ~1M. Cl4"}f.4.~ -
,I }) Jlftl5/I-ecl U1. 4 t..w CltiC W'Jj CLU. rlj/!lJ
vu.k-:.iLD'1' q/d'l1 '__" (, '. ,,11t~7~,
. '1 /13 ,;to 1-' ~ EE l3C17trh - ISSUJ. J~ G/q I-loa 0,("-
(p q J,,'fo I - I ,1/ '( :J./~l-I()l)oq;~
':) J./. 9, 2-~ y,z.-c?' -" / I. (( I( c.,/qS I DO!)"e!.
S 3Z ,&0 ' / __ It / I II 10/8'6 606~J.
23,13 /~ (I !I I( J?-/r1!>-' 7So..E
(J..12 b~ ,/ ~ II I II 11/82- .;zoot'-
2~:3/?- I. II II 4/,f3 ,200.1'<>
;2"X :a j, U ',J.. - ( I .YeP 6 2m"!" '1-4-3 jt,
J'x /S['08. ;)/ II 3/81 ;ZOOo2. 372. If"
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f"Lt/~ ii.!;-,., CC9.s-f-3/$1.)tl
Inventory of the real and personal estate of
M a 0 .._'f.....LbL..___!?sIJ.mm.~ dooessed
'7 13 lO
b 92 'fo
OC;:? 40
,'i 32. 80
r 13
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tx, I"..,,:){.o
,j 0.3 /2..
18o'~
170 32. ."
/ ~O ~8
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"p. i,-n17 C-..f:;>
;c- C D~7.-=(!]~ltJ Dot;.. -IO(xJ'~- IOi9,3/ ,;:l,15' b?_
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;2- "C()'~~ ~Or)"la (1J ) ()k_-'/ooocl" - IO;J./~-3 2043()"~
S fJ, /) W6-!. , AC{D ~ ! f, ' If 77,11 g 6
fu~VlJ{SHlru6-S 0 ~ APrtf27lvfC-I\/lT. 'I
UJItS j'\oItNED 'tb IIE/:' loct !It;k [ljt= (l1037,(P
ey ,D At/ 6~ lIlZ:::-/t -
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
III
baing duly, .' ~ aceMdlng to law, dopoUl an~~ay-,--;';~; "h~~~~.Cl-vv _n,
__ . 6.a~-).dbvc .. u 01 the E.tat. 01 -_'l2L(LQ.~(.,'.__!lu,,~__~_u~.__,_
I.~e 01 I--OU!ff?... /J..U[;tl/ 10)1.J,NSfI tl-(\--: ~, Cumberland County, Pa., d..eal.d and thaHh.
wIthin I. an Invontory mado by UJ..LiJJ "" ~t"j ~__ '____, tho uIL,,)&_~_
of H,. entir. e.tate 01 uld d..edent, .0n.lltlng 01 all the p.rlonal prop.rty and real oltah, .~eept real ..ht. ouhld.
the Commonwealth of Penn.ylvonio, ond that the ligure. oppo.lte oach lI.m of the Invontory r.pro.ent II'. fair valu.
o. 01 the doto of de.edont'. death,
___ ond .ub.crlbed bolo.'e me,
'd_~_____Ilt..u.L C J J I~. _.______
EM.cuto.r . Admlnhtr.tor
...--'
\J "'-\111., ,;/r
, Nota/lal Saal
I ';"'nnna lalezoak, Notary Public
H;'nlldon Twp" Cumborland County
:.Ol'll, 19'iilnn Expires Dec. 18, 2000 r'
'0 to
Death ..____..~i;fL_::,'~ n~\vlya~-".".2~n~atlon-"-...ota_~",__~._.__..,__uu...__
DIY Month
--~:i,2;jJ)~.f:..].QI1LPl""ll.irf__.._
~jjJ c..-HfhN { C s/3iJP.U-, tft.....L1QS,-!;-
Addr..,
D.te 01
cr7
Y..r
INSTRUCTIONS
I. An Inventory mUlt be flied within three month. ollor appointment of perlonal repre..nhtlve,
2. A .upplement Inventory mu.t be filed within thirty day. 01 discovery of addition. I ....h,
3. Additional sheeh may be .ttilched .s to perlone/ty or realty
4. See Article IV, ,Fiduolarle. Act 011949.
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COHMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
(:,
BURE~U O~ IHOIVIOUAL TAXES
INttf::lnTAHCr 'Al( DIYISION
I.lf.PT. za0601
H~"AISIUIRG, f1" 171211-,0601
HanCE 01' INHERIT AHCE lAX
APPRAISEHEHT. ALI.OWANCE OR DISALLOWANCE
Of DEDUCTIONS AND ASSESSMENT Of TAX
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
09-07-1998
IIU
06'09-1997
21 97-0512
CUM8ERLAND
101
F- ~~~~:R.;ltW-~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 ~
RE"v:isiii-iX-AFP-ioF9'ri-iioYici!--cin-NHiifiTiliicE-YA'it;.-ppRiiisEifE'rr,--ALUiliiiiicE-iiR'-----------------
DISALLOWANCE 01' DEI1UCTlONS AND ASSESSMENT OF TAX
MOO Y FILE NO. 21 97-0512 ACN 101
If an assessment was issued previously, lines 14, 15 and/or 16. 17 and 18 will
reflect figures that include the total of Abh returns assessed to date.
ASSESSM!NT OF TAX:
IS. Allount of Line ltt .t Spousal rat. (l!t)
16, AMOunt of line 14 t.)(oble .t Lineal/Class A rat. (6)
17. "ltOunt of Line 14 t.)(ablft at Coll.bral/Clau 8 r.t. {l7l
18. Principal Tax DUG
TAX CREDITS:
PAVMENT
OATE
06-25-1998
ALICE CHIN
5230 ETON PLACE
MECHANICSBURt'J
PA 17055
~
!
I
ESTATE OF AU
...
TAX RETURN WAS: I X) ACCEPT EO AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
- .
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Roal E~tat. (Schedule A)
2. Stocks .od Bond~ (Sohedulo Bl
3. Closely Held stock/Partnership Int.rest (Schedule C)
4. Kortgages/Notw5 Receivable (Schedulo D)
S. Cash/Bank o.podts/HlsCl. Porsonal Prope,'ty (SClhedule E)
6. Jointly Owned Property (Sohedule f)
7. Transfers (Sohedule Gl
8. Total Assets
APPROVED DEDUCTiONS AND EXEMPTIONS:
9. funeral I:xpGllses/AdM. Costs/Hi so . Expenses (Schedule tl)
10. Debts/Hortgag. UabUHies/Uens (SchCldule I)
11. Total o.duoUons
12. Net Value of rax R.turn
13. Ch.rit.blR/GoYorn~ent&l Bequests; Non-elect.d 9113 Trusts
14. Net ValUG of Estate SUbject to rax
NOTE:
RECEIPT
NUMBER
AA296360
OISCOUNT (+)
INTEREST/PEN PAID 1-)
27,58-
) CHANGEO
(l)
(2)
(3)
(4)
IS)
(6)
(7)
,00
12.982.57
.00
,Q]!
6.054,99
,00
,00
(8)
.
UV.IHl n ", (19.m
MOO
Y
(9)
(l0)
,00
DATE 09-07-1998
NOTE I To in.ura proper
cr.Git to your account,
subMit the Upper portion
of thil for~ with YOUr
tax pay..nt.
19.037,56
1.8117 66
17 ,229,90.
,00
17.229.90
.00
1.033,79
,00
1,033,79
TOTAL TAX CREDIT 1'036'3~
BALANCE, OF TAX DUE 2, 56CR
INTEREST AND PEN. ,00
---.---.-.
TOTAL DUE 2.56CR
---_._~~-~--
I IF TOTAL DUE IS LESS THAN U. NO PAYliENT IS REQIlIREO,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR I, VOIl HAY BE OIlE
A REFUND, SEE REVERSE SlOE OF THIS FORM fOR INSTRUCTIONS,)
. If PAID AFTER DATE INDICATED, SEE REVERSE
fOR CALCULATION Of ADDITIONAL INTEREST.
1.807.66
(11)
(l~)
(l3)
(14)
(Schedule J)
,00 X ,00=
l'l ,229,90 X ,06=
,00.x,15=_
(la).
AHOUNT PAID
1.063,93
RESERYATlOth bt.tu of deofldtnh d~il\ll on or !Mfar. OeoHber 12, Uu ..- 'If .n~ fut~r. lnt.rntln tho ..t.t. II trln.f,rred
In po.....Jon or enJb~t to el.., I (ooll.t.r.l) ben.flcl.ri., of the deo~t Ift'r the ..plr.tlon of '"~ ..t.te for
11ft or for v..r., the COIIOOW..lth herebv ..pr...lv r.,lrVIS the riOht to ftPpr.111 end ...... tran.f'r Inherlten4' T.xe.
.t the Ilwful el... I {COU.t"l1J r.t. on ,"y luch .future IntGrut.
PUAf>01lEOf
NOTlCEl To fulfill the requlr...nh of S.otlon 2140 of the Inherlteno. and E.tet. TIK Act, Aot 21 of 1995. (72 P.S.
SeaHon 91ttO I.
PAYMENTl EMteoh the top portion of this Notlcl and ,ubIlJt NUh vour pav.ent to tn. RlGI.IItlr of Nilh printed on thl river.. .IM.
ufCak. ohtofc; or ItOflIY orcklr paVllble tOI REGISTER OF MILLS, AOENT
REFUND (CA)I A refund of . tax orldlt, whloh we. not r.qU4.t,d on the Tax Return, .av bl r.qu..ted b~ o~letlng an RApp110.tlon
for Refund of P~'Ylv,"l. Inherltancl and E.t.te Tax" (REV~1313). Applloatlon. ar. .vallabl' .t the Offlol
of the R.gI.ter of Nilll, WI\, ('f the 23 Rev.nu. Dhtrlot Offlo.., or by o.lllng the ,paCiltl 24~hour
en....rlna ..rvlo. nu.blra for for" ordlrlngl In PennlVlvnnla 1-aOO-36?~t050, out. Ide Penn.ylvlnl, ~
..Uhln locl1 Harrisburg .r," (717) 787~H094, TDD' (717) 772~21S2 (H..rlng IlIPalf'ed Only).
OIJECTIONSI Any party In Int.r..t not ,"tl.fled with the apprftl....nt, allow.no. or dl.a1lONlncl of dedUction., or .......-ot
of tax (Inoludlng dl.count or jnt.reat) I. ahown on thl. Hotio. .u.t obj.ot within .Ixtv (60) day, of receipt of
th 11 Notlc. by I
--wrlttan prot..t to the PA Depart.ent of R.venue, loard of Ap~.al., Dept. 281021, Harrl'burg, PA 17128-1021, OR
~-.I.ctlon to have the .att.r d.t.r.lnad at audit of the aooount of the parlona1 ropr..ent.tiva, OR
--appaal to the Or~h.n" Court,
ADHIH
ISTRATIYE
CORRECTIONSI
F~tU81 .rror. dl.oovarad on thia al'."..nt .hould be addr....d In writing tOI PA Depart..nt of Rav~~,
lur.lu of Individual TaIC'S, ATTHI Po.t A.......nt Revl.w Unit, Oept. 2'80601, HarrhbUrg, PA 17121-0601
Phone (717) 787-6505. S.e pega S of the booklet "In.truotlon8 for Inheritance ralC Return for a Re.ldent
Decadent" (REV-lS01) f~r an .xplanatlon of adalnlltratlvely corr.ctabll .rror..
If InY t.x duo 11 paid wUhln thr.I' (3) celoRdar .ontha after the d.c.dlnt'. d.ath, a Hve pal'o.nt U:O dllcount of
the tax pelel I. allow-d.
Dl'SCOUNT I
PENAL TV l
The lSX talC lIne.tv non-partlCiipatlon panaltyla coaputad on thv total of the talC and Int.r..t .......d, ~nut
paid before January 18, 199it,the Hr.t day aft.r the end of the tal< MIll_lib p.rtod. Thh l'Wn-partlolpatlon
P8Oll1tY Is app.-Iabl. In the 1111. .anner Ind In the the .... t1.. p.r lod II you would tlPp..1 ttM t,x Itnd Inter...
that has beln .......d e. Indicated on thl. notic..
lHTEREST l
1nt.r..t II ehal'gad beginning with Ur.t d.y of d.lInquency, or nine (9) .onth. Ifld on. (1) day frot the date of
daath, to the dat. of pav..nt. Tax.. which b.c... dellnqu.nt before January 1, 1982 bear inter..t, at the r~t. of
.IK (6Y.) percent p.r ~~ caloulated at . dally rat. of .00016~, All tax. I which bee... delinquent on and .ft.r
J.nulry I, 1982 will belr Inter..t .t I rat. which will v.r~ fr&l oalondar v.ar to oal.ndar y..r ..Ith that rate
.onouno.d by the PA Depart..nt of Ravenu.. Th. applicable Int.r.,t rat.. for 1982 through 1998 .rel
Wli: Interut RltII ~tfjr..t Fa<ltor X!!r Intar'lIt Aet. Dally Inter..t Factor
1982 20Y. .000!i48 19'7 9Y. .000247
1983 16Y. .000418 198a~1991 11Y. .000~C11
1984 lIX .000301 1992 9X ,000247
1915 13Y. . DOUSt. 1993-1994 n .000192
19116 10% .000274 1991i~1998 9Y. .000247
--Int.r..t I. oeloulat.d a. follow.1
INTEREST . BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Motlo. I..u.tt .fter the tIlC MOOlll. dtllInquent will refl.ct an Inter..t oalculatlon to flft..n U&) by.
beyond 'h' data of the ........nt, If pay..nt I, ..do ftft.r the inter~.t e~t.tlon data ~ on the
Notloe, additional Int.r..t .u.t be oalculated.
STATUS REPORT UNDER RULE 6,12
_._-_._....~-----'----_._---------_......
Nllme of Decedent I ,l1 00, Y If! -1Ju
.
Date of Death l__...k.- <!) q - (~ J.._
Wi 11 No . -Li:J 1- 0 (~ G' I 2- Admin, No, ;,l.\gl-6S'/L
---
Pursuant to Rule 6,12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the admlnlstratlon oC the above-captioned estatel
1.
State whether administration of the estate is complete;
Yes X No _._
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
completel
3. If the answer to No. 1 is Yes, state the following I
a, Did the personal representative file a final
account with the Court? Yes No X '
~-._. T
b. The sepal'ilte Orphans' Court No, (if any) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest? Yes No y
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attathed to this report,
v
Datel S- !I-9Cf
CLLw
Signat.ure
C!w.~
ALICE cljuJ
Name (Please type or print)
, S ~ 90 fToN ft.
Address
HE-cd 14 tJ I (r;, /3UR.G-
P/1 no!,.)
(MAHI rm(/AM3)
i.1!11 7Gfc - ~ 7
Te I. No.
Capaci t.y I -4-_personal Representatl ve
Counsel for personal
representative