HomeMy WebLinkAbout97-00519
PETITION .'OR PROBATE and GRANT 0(<' LETTERS
No. ~!~'91:-_.__~____
To:
/!.slale of Janot S. ~J.th .-
also known a.! _nIii::______._ .---------
Rcglster of Will! fur the
___ - ----.--:.---D-;~~;d. County of ._cundx,r. and In the
Social Security No. __ 2Dlf-J!l-1J1l'3L...._..... Commonwealth of Pennsylvania
The petition of the undersigned respectfully represent! thllt:
Your pelltloncr(lQ, who I,/aa 18 yeDrs of lI~e or older an the execut.2!
In the last will of lhe above decedenl, dated _ uno 25-'__.._____._
and codlcll(s) dated ..--MarclL~fiJ973. ..--------
named
_. 19...0_
Codicil ap.'Oints new co-executors. See Ronunci.aUons filed.
--'-'-~-'
(slalC relcvunt c1IC\lmMl\nC~~. (,8. renunciation, death of extcutor, elc,)
Decendenl was domiciled III death in Cumberland County, Pennsylvania, with
ILJlr _last family or principal residence at 1827 Walnut Ilottan Road, Ncwvill~_
PA 17241 (Perm Township)
(ll~l meet. number and muncipalllY)
Decendent, thcn 79 years of age, died May 3. , 19....21-_.
at Carlisle Hospital, Ca~li.sle, PA .
Except as follows. decedent did not marry, was not divorced and did not have a child born or adopted
after execulion of lhe will offerell for probate; was not the victim of a killing and was never adjudicated
Incompetent: __. no exceptions
Deeendent at death owned property Wllh estimaled values as follows:
(If domiciled In PD,) All personal property
(If not domiciled in Pa.) Personal property In Pennsylvania
(If not domiciled In Pa.) Personal property In County
Yalue of real estate In Pennsylvania
sltualed as follows: _ none
S 50,000
$,
$
$--
WHEREFORE. petltioner(s) respectfullY request(s) the probate of the last will and eodlcil(s)
prejented herewith and the granl of letters Testamentc'lry
(teslliiTlcnti\ry; admlnblrallon c,I,a,; administration d,b,n,c,t.I,)
theron.
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av L.'S "
_187'!. Walnut Bottom Road
__~,,-'WVille. PA 17241
.....11L=...27.6=!lf. '/ 'i
_ SSN: 189-34-54a2--
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA } ss
COUNTY OF CUMBERl:.AND '
The pelilloner(s) above-named sweur(s) or affirm(s) lhul lhe slatemenls In the foregoing petition are
true and correct to Ihe besl of lhe knowledge Dnd belief of petilloner(s) and lhat as personal represen.
talive(s) of lhe above decedent petilloner(s) will well and . Ily admlnlsl, t~. ...e,ate...accordlng to law.
Sworn 10 or affirmed and s. ubscrib. ed { . / ;' . ,/a:-h~r/21 III
before m~, this _---:-~_9t.h D 9duYOf _pavld L. Smith' l'
~7 .clhAK-<> {Ue. .rh.:t~ ------- I
'~y CLEWIS I Regi.~ler __-. ~
\S~ ,t(-k- 0
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ell
'97 .JUN ~9 1\10 :05
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LAW 0"'101;8
LANDIS AND McINTOSH
CAALl81.t:, "EtlN8VI.VANIA
" I
LAST WILL, AND TICSTAMENT
1, .TANET S. SMITH, of POIIII TowlIship, Cumhol'1and County,
Pennsylvania, do herohy mako, publish and dodare Uw {ollowlng aa and {or
my Last Will and Testamont.
I. Subject to tlw directions IWl'einafter contaillud, I givo, devise
and bequeath my entire estate to First National Bank, Shippensburg, Pennsyl-
vania, in trust, {or my throo (3) sons until the youngest shall have roached
the age o{ twenty-{ive (25), 01' when he shall have completed his education,
whichever event shaU first occur.
2. My Trustee need not liquidate my household goods and personal
eHects but may permit them to be used in any home {or any of my aons during
the term of said trust and thereafter may divide them among my sons as said
sons shall agree or as said Trustee shall determine.
3, My Trustee shall have full authority to use any part o{ the
principal or income from said trust estate {or or towards the maintenance o{
a home {or my two (2) yowlger sons 01' for the education of either of said two
(2) younger sons or for the medical or medical instltuti onal care of any of my
said sons.
4. Should any of the income from said trust estate during any
year not be needed or used for any o{ the above purposes, then such income
shall be divided at the end of said year among my sons equally,
5. Should I own any real estate at the time of my death, my
Trustee may but need not liquidate said real estate 01' said Trulltee may
operate the same either as income producing property 01' as a home {or any
of my said sons,
6, When the youngest of my said sons shall have reached the age
of twenty-five (25) or when he shall have completed his education, whichever
event shall first occur, then the balance in the hands of said Trustee shaU be
divided among my three (3) sons, share and share alike.
7. Should any of my said sons die be{ore the tormination of this
Trust, then the share which said son would have received on the termination
of this Trust shall be paid to his or her surviving children and should he leave
no surviving children then to his surviving brother 01' brothers.
8. Sl\Ould my youngest die before reaching the age of twenty-five
(25) then said Trust shall terminate on his death,
9. 1 hereby appoint First National Bank of Shippensburg as
Executor of this Will.
IN WITNESS WHEREOF, 1 have hereunto~..l:JLmy hand and seal to
this my Last Will and Tostament this ,,A,7Jt day of (7" . ,1965.
. t' . ./
../f}",aZ J.04'H1'<-TL- (SEAL)
j Janet S. Smith
We, the undersigned witnesses, in the presence o{ the abovenarned
testatrix and in the presonce of each other, did hear Janet S, Smith declare
the foregoing to be her Last WiU and Testament and did witness the signing o{
th sa eby ~~ (/r~
"'~. ..~~:~:::"' ... ... .\ ';'~~~f~i:ff~~~{~~.. !~![~::~::~;;~1~"~,~:
_.--.-__ O.'C . (0. EtH'.'..N .~. Mr.-fl. '.~ f;fill.S'~tiOMffiFilfl}m.fiir.--'-. ".-...-"-_.-....-..~-_.~..'_._..---1J[ (:f N N "S COMPl f It ADDU ~s .
. smith, .Janet S. 1877 Walnnt Bottom Road
i ~O(I~(~({iJ~i'y~HJMltA -, . \tiAHOf[IEAHI' \[lAll()flU1lltl Nowvll1c, PA 17241
e. ..?()B_:~B:::5838-_-_"- _. .5/3/97\.___ 1()/12/1-'._ ,..__ c',"'(_Clll1lbeJ:~l:1-----_--------
__:__ '''~''':'''''\.'''''''' "0"""".""" ,,," """","" '"'''''' ._ ',oWI "eu'l1< ,HIM,," ...1 AMOII",,,"'''IJ 1\" ''',,"lIeIlO':.. .___._________
~ !':JI. Origillol Re'vrn ( I 2, ,vpplomen"" R,'v,n I 13. Rem"ind" RelVrn
..:! 1:1 1101 da'o, a' doolh prio, 10 12-13-82)
!:1~g IJ 4. llmltod E.lo," I -I 4" FvlV,e Inloro.1 (omplOml" 115. Fodo,ol Ellnlelo' Ro'v,n Roqvl,od
511:0: 1'01 do'o' 0' doolh nit" 12.12-82)
~ RJ 6 Oocod.n' Oiod 1011"10 II 7. O.,odonl M"inlniood n Li,ing 1",1 2. B. 10101 Nvmbo, 0' 5,,'0 Oopo.1t Bo'"
IAlIach capy a' Will} IAlIoch copy 0' 1""1
__H-- .ALL COIiiEsiiONDENCE AND CONFIDENTIAL-TAX INFORMATION SHOULD BE DIRECTED TO,
J,"- NAMf . _."--'-~~--jCO~i;\fU M^llt~~O AO"DiiTIS~---'
~~ Robert R. 1Jlack, Esq. 36 South Hanover Street
B~"l''''O'''-NUMif''-..-.---.----.------..---.----.----- .-.....----- --- Carlisle, PA 17103
_"__ ....L~ 17...J-.J43::)}l:2 ====_'''=,.==,==''''==-=,,==,,==,====.===~===c===='=-='=-~ ....
None :!
(I)
12 1 .._ 3,275.00
(3;---- Non.e_______
(41._______N()I1_El_____
(5) _ __J59,1}3,-6L ~
426.39
I 6 1 .-.... --NOne----
( 7) __.___. --.---.--.------.-
20, Ullna 1911 greoter Inan Une 16, enlfH ,he dilfurenett on Line 20, T~II it Ihe OVERPA....MENT,
aU
21. 1I11no 1 B I. g,oo'or ,hon lino 19, on'O' Iho dilloronee on Lino 21. lhh ",he TAX DUE. (211 ---.---.- - B,_~?7 '..~<l..___.___
A. Ente' ,ho inlo,oll 011 Iho holo.,e dvo 00 Uno 21A. (21 A) None
B, En'o' 'ho 10101 o'line 21 oncl 21 A on Uno 21 B. lhi. i. Iho BALANCE DUE. 121 B) B, 31'1, 24
___~__.~._ M~~._~~.~_ ~_~~~~~._t_~L~~_~I~.!.~r_~!.,~!l.I_~,--'~g~nt- ,__ . _ __ _.. _n.___..___.____~.,.__
.__-------~ >:'''BESURE TOANSWEfAI.L QU.EST~O_~~_@-IEyERS.E-Sii~:e..~N~~TORECH~l:.K~AiH--~=..l(:'::==--=--==--=
Undo, ponoltio. 01 po'lv,y. I doclo,o ,hoi I ho,o ',omin.d Ihi. ,olvm. inclvcling occo",ponying "ho<l"'.' and ,,,,Iemonll, oncl'o ,he bOil 01 my knowlodgo and boll.'.
it i. ',vo, co"o" and complo'o, I docloro tho' 011 '001 0"010 ho. boon ,.pa,'od olllv, ",<IIkol ,olvo Ooclo,ollon 0' 1"01'010' olho, ,hon tho po"onol ,op,o,onlo",o i.
bos.d on alllnformallon of which prepare' hm any knowledge,
110''''. _ f ;;"0" 2;,o"'S'.fIll"O "U'N---"-';~'~~~a l~~~~ ~t:~~;n-~;:~:~~~-l~~-;.~-;; ~~---. D'r~;-?'/ 9~-
,''' " '2~'1!i,::,!~:~~!u"A~~"~'--;I~;~~~~it:,~~rl~:l~'-;~~;~~; ____.m O>liz~CJ..L~=
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1. Rool E,'ote ISchodvlo A}
2 S'ock. and Bond. (Schodvlo 6)
3, Closely Hflld Slock/Partnership Inlerell (Schedule q
4, Mortgoges nnd Notol Receivable ISchedule Dl
5. Cain, Bank Oepollh & MiscelloneouI Personal Properly
ISchodvlo EI
6. Jointly Owned Properly (Schedule f)
7. T,oOl'o" ISchodvlo GIISchodvl.l)
8. 10101 Grou An,1s (Iolal Unos 1.7)
9, Funeral hpensol, Admlnistralive COlli, Mlscelloneou\
hpenses (Schedule HI
10, Debl1, Mortgage liabilities, liel" (Schedule I)
11. T010l Oeductions (10101 Une, 9 & 10)
'i~i
I. ,
1\
18).""-_......!.~!,..9~. 00 --
I Q 1 _..___1'l,n~.2B.-..--.
100.93
(l0}------------.----
_-..!!,414.21_-._
139,~?2~?9_
None
139,620.79
(11)
(121
(13)
(14) -
z
Ii!
!c
0-
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...
.
.,
...
12, Net Value of E,I(lle IUlle 8 minus line 11)
13, Charitable and Governmental Bequ.'h (Schedule J)
lA, Ne. Value Su~.i!:!.-~_ TOK lLine 13~~~~~ 13)
15. Spoulal Transfers Ifor doles 01 deoth after 6.30.94)
Soe l",'rucllons lor Applicable Perceologe 00 Revl\ue
Sldo,!lnclude values !rom Sr.hedule K or Schedule M,)
'6, Amount of Line 14 lox.able at 6% role
Ilnclude values from Schedule K or Schedule M.l
17. Amounl of Line 14 lo)(oble 01 15% role
(Include values from Schedule K or Schodule M,)
18, Principal taJll due IAdd lax. from lines 15, 16 and \7,1
\q, Cradils Spousal Poverly Credll Prior Payments
+
0.00
--------------
None
~--_.---
(151 -.---....-.-.--...-- ..----", --=
(16) _____}3.2-,62.9;L?-...-" .06 =
___.~~77 ._24_-
None
(171__._._.._____-.." .15 =
_.--_.---~-
8,377 .24
.._._~_.,--_.,.._---'--
PR)
Inlerost
None
Discount
(l9)
(20)
-_..-----~-_. - -.~---
+
l:l
0-
r'-" ,
--.,.... .,':"" "-~ 'l ;;
SCHEDULE E
CASH, BANK DEPOSITS
AND MISCELLANEOUS
PERSONAL PROP.:RTY
Flit Numberl
21-97-0519
E.lale 01
Smith, Janet S.
(All property jointly-owned with RIllhl of Survivorship must be disclosed on Schedule F.)
Ilem
Number D...rlplktn
-
Vatue al Dale
or Dealh
$20,704.65
$5,010041
$10,100,21
$41,532.21
$15,051.78
$15,141.27
$27,069.90
$2,011.92
$5,002.60
$3,382.10
$2,486.78
$2.500,00
$238.30
$72,00
$26.75
$2.73
I. Dauphin Deposit Bank &. Trust Company, checking account no, 67363385
2. Dauphin Deposit Bank &. Tnlst Company, ccrtificnte of dcposit no. 8000126745
3. Dauphin Deposit Bank &. Trust Company, ccrtificate of dcposit no, 8000126788
4. Dauphin Deposit Bank & Tmst Company, ccrtificate of dcpositno, 800012838 I
. 5. Dauphin Deposit Bank &. Tmsl Company, ccrtificate ofdeposilno, 8000129124
6. Dauphin Deposit Bank &. Tmsl Company, ccrtificate of dcposit no, S000129159
7, Dauphin Deposit Bnnk &. Tmst Company, ccrtificate of dcposit no. SOOOI310(,4
8. Dauphin Deposit Bank &. Trust Company, certificale of dc.posit no, S000450003
9.. Dauphin Deposit Bank &. Trust Company, certificate of deposit no, 8100095779
10. Farmers National Bank of Newville , checking aecount no, 130397
II. Farmers National Bank of Newville , IRA aecollntno, 9000096
12. Sale of 1986 Pontiac coupe
13. Pennsylvania Blue CrosslDlue Shield, refund
14, USF&.G Company, refund homcowners policy
15. Harlcysville Insuranec Company, refund car insurance
I~. Sprint, rofund
TOTAL (also enter on line 5, Recapitulation)
$150,333.61
D
Dauphin Deposit Bank
and Trust Company
M^'N OFFICE: 213 MM1Kn STAr-n. IIMIIIISIIUIIO, PHINtlVLV^NI^ 17\111
711,2flfl.\!11!1
fiECEIVEf:,
AUG 1 1 1997
landlS fll,ICk & Schorpp
Decedent Confirmation
Name: .Janet S, Smith
Social security No.: 208-38-5838
Date of Death (000): 05/03/97
--
8000126788
67363385
800D126745
Account No.
------------------------ ------------------- ----- - -----------------'-------
Checking
Certificate of Deposit
Certificate of Deposit
Type
Date Opened
or Issued
-- ------------ ---------- ------- ---- -- ----------- ---------,---------------
02/10/89
01/17 /81
08/15/81
-------. ----------------- ------.------------------- ---------- .--------------
Date Closed
or Matured
06/23/97 (Closed)
06/23/97 (Closed)
----.--.----.-------------- --------------------- --. - ,-------------.-----------
06/23/97 (Closed)
Date of Death
Balance $20,691,74
$10,000,00
$5,000.00
------------------ ------ ---------------. ,------- - ------------------------
PLUS
Date of Death
Accrued Int. $12.91 $10.41 $100.21
----------------- ------- ------------------------ ---------------..--------
Joint CW1ers
(if any) None
None
None
------------------------ ------------------------ ------------------------
Date of Joint
CNmership
------------------------ ------------------------ ------------------------
-------------
---------'---- ------------------------ ----------------.-------- ------------------------
Special eomments: N/A
Addu;onal information a",.nab1. at $20.00 p.I' IlOU", One hour mini",u,",
Date Prepared: AUgust B, 1997 Prepared by: Cheryl A. Bowers
customer Management Information Dept, (CMI)
Page 1 of 3
Telephone No. (717) 255-2054
for" 00..020-218 (REV 7/93)
IIA""
D^\IIIIIiN IJII'{)'.11 "AN'"" ANI) TIHllil <:( I~WAN"', 1.IAI~I~I!-oIl'"11 i, 1'1 HN'....I VANIA
To
Landis, Black & Schorpp
PM'!: No. 3 of 3
Name: Janet S. Smith SSN: 200-38-5838 000: 05/03/91
Account No.
TyPE-
Date Opened
or Issued
Date Closed
or Matured
8000131064
8000450003
8100095779
----.-- ------,-....-....-- -- _.......- ---- --------_.~---- ------ ----------------...-------
Certificate of Deposit
certificate of Deposit
Certifioate of Deposit
---_.--------.,..--_.~... -- --- - -------- ..,-- --------...--...- ----....-------------------
07/15/91
09/22/89
04/29/94
--- -------....----.- - -- ----- ------~._--------- -. - .~-~-- ---- ----- ------ ---------
06/23/97 (Closed)
06/23/97 (Closed)
06/23/97 (Closed)
-- -------_._-----,---- - -- -, --....--------- ----- ------- -----------------.-------
Date of Death
Balance $27,000,00
PLUS
$2,000.00
$5,000.00
-.-- -- - - - ------- --------- ------- ---- -- -------......-- -----...-.---....---...---------
Date of Death
Accrued Int. $69.90 $11.92 $2.60
- ------~---------_...------ --------....----.-.--------- ------...---..-------------
Joint OWners
(if any) None
None
None
Date of Joint
ONnership
------------------~----- ------------------------ ------------------------
------------------------ ----...--------...--....------- ,------------------------
-~----------- ------------------------ ------------------------ ------------------.------
Special Comments: N/A
Additional information avaibbl. <<t $20,00 pel' hour, One hour minimum.
Date Prepared: August 8, 1997 Prepared by: Cheryl A, Bowers
Customer Management Information Dept. (eMl)
Telephone No. (717) 255-2054
THE Ii'ARMERS NATIONAL BANK
OF NEWVILLE
I W. Big Spring A venue
P.O. Bo~ 156
Ncw~lIIe, Pennsylvania 17241.0156
717.776.5312 . 717.776.5452
Mervin J, Morrison,/'rc.!lclC"'
Carolyn H, Kough, Excc. Vlcc Prc,lIdcn/
James E. ShowYa~~I, Cashier
Douglas R, Undsuy, Ass'. Cashier
July 16, 1997
Mr, Robert R. nlack
J,andis nlack {, Schorpp
36 South Hanover Street
Carli~lA. P^ 17013
i'
RE: Janet S, Smith
Dear Mr, nlack:
Mrs. Smith had a checking account with this bank in hor name alone
which had a balance on May 3, 1997 of $3,362,10, It was a non-interest
bearing /Iccount. She also had an Individual Retirement ^ccount 1/9000096
which had II balance of $2,465.73 plUS $1,05 accrucd intercst,
Sincerely yours, ~
~ A -ot; /.ik _~...J!.
"",,- v' (J'-
Executi e Vice P~esident
RECE.IVED
JUL' 7 \997
Landis Black & Schorpp
SCHEDULE .'
JOINTLY -OWNED PROPERTY
Ell... of
Smith, Janet S,
File Numberl
21-97-0519
JoInllenanl(I)1
NAME
A. Harold E. Smith
ADDRESS
8147 Plaza Gate Lane
Jacksonville, FL 32217
RELA T10NSII\P
TO DECEDENT
Son
B. Gerald R. Smith
295 Smith Road
Shippensburg, P A 17257
Son
c.
Jointlv-owned Dropert :
LEITER DOLLAR
FOR DATE VALUE OF
ITEM JOINT MADE TOTAL VALUE DECD'S DECEDENT'S
NUMBER TENANT JOINT DESCRIPTION OF PROPERTY OF ASSET "10 INT. INTEREST
I. A 12/65 U.S. Savings Bond $128.12 50% $64.06
Q2150828218E
2, A 12/66 U.S. Savings Bond $125.85 50% $62.93
Q22106256G\E
3. A 12/67 U.S. Savings Bond $126.18 50% $63.09
Q2285766144E
4. B 12/68 U.S, Savings Bond $126,82 50% $63.41
Q2376704040E
5. B 12/69 U.S. Savings Bond $122.11 50% $61.05
Q2440771816E
6. A 12170 U.S, Savings Bond $121.08 50% $60.54
Q2516802894E
7, B 12/71 U.S. Savings Bond $102.63 50% $51.31
Q2601033260E
-
TOTAL (Also onlor on IIno 6, Rooul'ltulutlon) $426.39
SCHEDULE I
DEBTS OF DECEDENT
MORTGAGE LIABILITIES AND LIENS
File Numberl
21.97.0519
Eat.t. of
Smith, Janet S,
Amount
It.m
Number
Oe.crlrtkm
-
$' 3.04
$87.89
I.
2.
Grahall1 Medical Clinic, unpaid and Ilnrcimbursed medical expensc
Kough Oil Scrvice, Invoice
, ,
TOTAL (Also cnlcr on line 10, Rceapitulation)
$100,93
.6 /f6,3
COMMONWEALTH OF PENNSyLVANIA
DEPARTMENT OF REVENUE
{'
~k
~9'
IU~EAU OF INDIVIDUAL TAMES
INHERITANCE TAX DIYISION
DEPT, ll0601
HARRutURal PI 11121-0601
HOIICE OF INHE~ITANCE TAM
A~~~AISEMENT, ALLOWANCE O~ DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAM
UHI..'II"'II'.tll
ROBERT R BLACK
36 S HANOVER S T
CARLISLE
DATI
ESTATE OF
DATI OF DEATH
FILE NUMBER
COUNTy
ACN
12-22-97
SMITH
05- 03-97
21 97-0519
CUMBERLAND
101
AMount ".Mltt.d
-
}
JANET
s
PA 17013
l
MAKE CHECK PAyABLE AND REMIT PAVMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
CUT ALONG TMIS LINl . RETAIN LOWER PORTION FOR yOUR RECORDS ...
iiiV': liit,' ix.A;,"r ii,: ,rj"iloT"ici" "OF "YNtiiiiifAifci"T"Ai1" APPRAi iiiiiilf;-ALLowAifci "OR ,," "....."..""" -"
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ISTATE OF SMITH JAIIET S FILE NO. 21 97-0519 ACN 101 DATI 12-22-97
TAM ~ETU~N HAS I I X I ACCE~TEO AS FILED
RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN
1, ~..1 E.t.t. ISoh.dul. A)
2. Stock. and lond. ISoh.dul. II
5, Clo..l~ MaId Stook/~.rtn.r.hIP Int.r..t ISoh.dul. CI
~, Hart...../Not.. ~.o.lv.bl. (Sohedul. DI
5. C..h/l.nk D~ollt.l"l'O, ,.rlon.l Property eSchedule EJ
.. Jolntl~ OWned ~rop.rt~ (Soh.dul. FI
7, Tran.f.r. ISoh.dul.OI
e. Total A...h
I ) CHANGED
HOTEl To lnlure proper
oredit to ~our eaoount,
.ubMlt the upp.r portion
of thl. for..wlth ~~r
tax PIYMnt.
,00
3i275.00
.00
..!1.
150.333.61
426,39
.00
181
111
121
151
I~)
151
I.)
171.
154.035.00
14,313.28
APPROVED DEDUCTIONS AND EXEMPTIONSI
., Funar.l E.p.n.../Ado. Co.t./MI.., E.pan..' (Soh.dul. HI I.)
10, Dabh/lIort.o.. Llobllltl../LI.... (Soh.dul.1I 1101, 100.93
11 , Total Deduotlon. 111) -
12, Mat Vol... of To. ~oturn 1121
15, Chorltoblo/00vornooantol I__.tll Non-ol.ot.d .115 Tru.h lSohodulo JI 1151
1_, Mat Vol... of Eatota Subjoot to To. 11_1
NOTEI If.n ........nt w.. i..u.d pr.viou.lY. lin.' 14. 15 .nd/or 16. 17 .nd 11 will
refl.ct figur.. th.t includ. the tot.l of ~ r.turn. .......d to d.t..
ASSESSMENT OF TAXI
Ii, AMOunt of Line 14 .t Spou.ol roto (15)
1., Aoount of Line 14 to..blo ot Lln.ol/Clo.. A rot. 11.1
17, Aoount of Llno 1~ to. obI. ot Collot.r.l/Cl... I rot. 1171
II, ~rlnolpol To. Duo
TAX CREDITS I
~AYHENT
DATE
16.ta14 "~I
139.620,79
,00
139 ,620,79
.00 M .00.
139.620,79 M ,06.
.00 M ,15.
1111
.00
8.377.24
,00
8.377.24
~ECEI~T
NUMIE~
DISCOUNT I + I
INTE~EST/~EN ~AID 1-)
AMOUNT ~AlD
PAVMENT MUST BE MADE BV 02-04'98*,
. _.-
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
.00
8.377,24
,00
8.377,24
. IF ~AID AFTE~ DATE INDICATED. SEE ~EVE~SE
FO~ CALCULATION OF ADDITIDNAL INTE~EST.
( IF TOTAL DUE IS LESS THAN .1. NO ~AVMENT IS ~EquI~ED.
IF TOTAL DUE IS ~EFLECTED AS A "C~EUn" lC~I. YOU HAY IE DUE
A REFUND, SEE ~EVE~SE SIDE OF THIS FO~H FO~ INSTRUCTIONS,)
I
RE'ERVATION' E.I.I.. .f do..donl' d.lno on ., "f'" D......' 12, 1.12 -- If 00' fulu" Inl.,..I In lhO ..1.1. I. I,oo.I."od
In .......I.n ., onl....nl I. CI... I (..11.1.,.1) bon.II.I.'I.. .f Ih. d...don' .fl., lhO ..pl,.Ilon .1 00. ..1.1' f.,
11ft ., f.r ...r.. Ih. c....n...'Ih h.r.b. ..pr...I. r...r..' Ih. rl,h' I. oppr.I...nd ...... Ir.n.f., Inhe,IIon.' T.,.'
at the lawful C11" I (colllter.ll rat. on any .uch future 1nt.r..t,
_Of
NOTICE' ,. fulfill .h. ,.qul,....I. .f s..II.n 21e' .f .h. Inhe,II"" ond E.,.I. T.. A.I. A.I 21 .f 1"S. (12 P.'.
SlcUon .140),
p,'",NT, Do'ooh IhO lop p.,'l.n .f .hl. N..I,. ond .ub.1. .11h ..u, p....n. ,. lhO ...1.I.r .f N111. p,lnl.d .n Ih' ,...,.. .Ido.
**rMIlil chQCk or .on.~ or~r plyable tOl REOIITER OF MILLS, AGENT
REFUND (eRI' , ,.fund .f . ... "odl', ..I.h ... n.1 ,.qu....d .n IhO T.' ,,'u,n. ... b. r.....I.d " ....I..1no 00 ",..II..11an
for Refund a' pennlvillania Inhlrlhnce end E,t,t, -'alt." (AEV*\SU), APpllc:etlOnl Ir' l";IU1lb11 at ttMi OfUCI
of the Regilt'" of W1UI, any of thl 25 ..v,nue 01ltrlo\ OffiCI', or by ~.1l1ng thtl ,p8c111 Z"'~hoUr
In,w.rint ..rvlel ~r' for for.' orderinGl In p,nn,Ylvanta 1-'OO-362~ZDSO, out.ida Plnn,ylvani. ~
Mlthln 10011 Harrlsbur. .ra. (?ll) 117-'094, TOOl (717) 112~2ZSZ (Kllr'nt 1~.lr.d only),
DlJECT IONS , 'n. p.,I. In Inl.,..I nol ...I.fl.d .IIh .hO .pp,.I...on', .11...... " dl..'I..oo" .f doduO.lon', ., ..........
.f to. (Ino1uellno dh.ounl or Into"ot' .. .no,," .n Ihl. Notl.. ou.1 obloe' .lthln II... (.., d... .f ""Ipl .f
thh MoUat by:
"".,Illon pro.0I1 I. .he p, D'P".oonl .f ...._. Io"d .f ,....I., ,.pt. 21"21, H"rI.bu". P' 11121-1021. OR
~~.leot1on to hllll thl ..tt.,. det.r.tMd .t .udlt of the account of thl Plrsonal r.p,..entat1v1, OR
~~app..l to tn. Orph~" Court,
'ONIN
ISTRAnVE
COMitECTU~MSl
factual errors dhco"""ed on thh .......ent shOuld be add,."", 1n ",dUn" tOI PA o.,lrt..nt of R....~I
lur..u of tndlvl~.l 'IX", ATTNI POlt A.......nt RIVIIM unit, o.pt. 280601, Harrl,burg, PA 111Za~0601
Phone (717) ,.,-650S. S.. PI" S of the bOOklet "In.truatlonl for Inhlrltancl TIX Raturn for I R.lldent
~.dent" tREY-ISOI) for en 'KP1~tlon of .o.lnl.trltl...11Y corrlctable ,,.ror..
DISCt>>tTl
If .... 'OM duo II p.ld .lIhln Ihrn m "1.neI,, ..nth. .ft" lho dOOodon." d..lh. · II.. pore...t U~l dlo.oun' .f
thl tlX Plld 1. 111ow,d.
PENAL TV I
Tho 1i~ to. _.t. __p"tI.lp.tlon p_It. I. ....ul" on lho ....1 .f .he 'OM ond Int"... ......... ond no'
p.ld bof." Jonu'" II, ,.... .h. flr.1 d.. .f',' .h' .nd .f .ho t., -... p.rlcd. Thl. non-p"II.lp..lon
pon.l.. I. .....1001. In the ._ ....nor and In 'ho lho ._ tin ,,,I.d .. you _ld ..p..1 .hO 'OM ond Inl"..I
thlt hat bien ......ed I' Indicated on tld. notice.
INTEREST 1
In."..I to ,he,'" ...IMlno .lth firs' d.. .f dolln...n... or nl.. I9l ...,Ih. ond ... (\) d.. Ir" lhe d.to .f
do.lh. .. .hO d.l. .f poy_t. T.... ..I.h ..._ dolln...n' bof." Jonu'" 1, 1m .." Intor..' .. Ih. ro" of
11M ("0 p.rG"" per ~ calcull,ad It . d,llY ,.It. of ,000\6lt. All UK" which bee'" d.llnqultnt on and .ftar
January 1, "12 MUl ba.r Int.r..t It I rite Mhlch MUl vary froe callndar v..r to cIl.ndar yl.r Mlth thlt r.t.
~.d by the PA OIPlrt.-nt of R,~lnue. The appllcabll lnt.r..t rlt.. for 1912 through 1991 .rl'
'!!!! Intlrnt hte OIUV Int.,..t Fflc:tor !!.!! Inter.,t Rlt. Dallv tntl"lt Fletor
I9U 2'~ .000Sltl 1917 .~ .ODOZIt1
1913 16~ .000"16 1911-1991 11:< ,DOun
1m 1I~ .DOOlDI 1IJ92 9:1. ,DDOZlt7
I9IS UX ,OODSS' 1995-1994 IX ,DOOlIn
I'" 10;': .000Z1" 199!i-199J 'X ,OOOZ41
.-Int".,t h tllleulltad .. fOUChtI'
INTEREST . BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
..Any Hotloe h'ued after thl tllC HcHlI dellnq<Jlnt Mlll rlf1~t an lnt.rnt calculation to flft.en (1!il daVI
beVond the dlt, of thl .......ant. If PIy","t 11 ... .ftlr thl lntoll,..t co_utlUon d.tl INtMn on thl
MoUu, IIddUlonal 'ntar..t .....t be ealcul.t.d.
PAllEMTI
D.,..h IhI 101' porU" of Ihlo HoII.. ood .uIlIlI .llh .our ,.._1 .od. ...obl. I. Ih' n_ ood odd""
pdn,Mt on "hi ray.r.. IiH.
If R!SIIlt:HI IIlCEIIlHI .... .hI.k ., ..n.' .,do' .....1. I.' ReDISTER Of MILLS, ADBtlT.
II NOII..ESIIIlHI Ilt:CEIIlHI .... .h..k 0' ...., .,do, ...obl. I.' COIlllONllEAL TH Of fEHllSVLVAMIA,
REFUND (CR)' . r.fund of . I.. .,.dll. whl.h ... no' r.quo.l.d .. Ih. 1.' R.ly,n, .., .. ,......od .y ....1.11.. on
....II...I.n for ..fund .f .ooo..I.onl. Inhe,II.... ... E.I.I' I... 'REV-I'I". ...11..11... .,. ...11001. ..
.hI Offl.. .f .hI Rotlo\or .f Will., ony .f .h. " ROYonu' Ol.trl.' 011I." ., fro' lho o..or'''''''' t4-hoUr
on...,I.. 10,,1.' ......." f.' f.'" .,dorln.. In ....."I.onl. 1-1,,->6HOSO. DUtold' .....,,1....1.
end .I.hln 10..1 H.,rl..y,. .,.. (717) 717-1094, lao, (7171 77t-ttSt (H..,ln. 1...I,.d ..1.,.
RE'LV 10' Quo..I... ,ot.,dl.. .".,. ...I.lood .. Ihl. n.II.. .h.yld b. .dd'....d I.. .. OOO.,I..nt .f R"onuo. Sy,."
of Indl.ldu.1 I...., mH. '0.1 ...."..nl ...1.. Unll, 0.,1. 2....1. H",ltbUr.." UUI-"Ol. ,h_
(717) 717-,'0'.
DISCOUIII'
l'EIIILIV.
IMTEIlI!Il.
If on, I.. duO I. p.ld .llhln IhrlO ") ..1."" ...Ih. .fl., .h. d...d.n'" ....h. . fl.. p.r.on' ('X) dl......
of thl tlM ,lid 'I ellowed.
IhI I'X ... ....... ~on_",'I.lp.llon ..n.II' I. .oopy..d .. Ih. ,.1.1 .1 thl ... ... Int.,... ........, ood no'
plld before JanulrV 18, 199', thl fir" dlY ,f'lr thl end of thl '1M ..nt,tv p.rSod,
Intor..' I. .hI'''' ...1...1.. .Ith lI"t d" .f doll..."'" or nino '" _'h. ood - (I) dov f,oo .hI d... of
do.lh. '0 ,hO d.t. of p..""" I.... ohloh ...... dollnquont bOfor. Jonu'" I. 1.lt bO.r In""" .. .hO r." of
.1. 'IXl p.r.on' par onnuo o.loyl.lod .. . doll' ,.t. .f .00011'. .11 t.... whl.h ...... doll....nl .. end .fl.,
J....." I. I.at .111 bO" Inl"'" .. . rol' whl.h .111 .." f'oo ..loneIor .oor '0 ..loneIor ..or .Ith .hI' ",.
onnounood .v .hI .. nop.,'''''' .1 ...onuo. IhI oppll.oOl. In..,..1 ,.... f.' 1.11 Ih'.... 1..1 .,.,
Vllr Inter." ft.ta O,llv Int.r.., flOtor VI.r In,er..t ft,t. UIUV In'er'" Faotor
-
1912 20:< ,ODDS,.. "17 'X ,OOOZ41
191J 16:< ,0000\" 1911-1991 11:< ,OOOlGl
I'" 11:< ,000101 I..t 'X ,000241
I'" UX .OIlDS" 1..1-1994 7X .000192
It" lOX ,000214 1995-19" 'X .OG0241
--Int.r..' I. cIlculated ., fo111*1I
INTEREST . SALANCE OF TAX UNfAIO X NU"SER OF DAYS DELINqUENT X DAILY INTEREBT FACTOR
.-An' Notl.. III"'" .ftor .hI t.. ..._. dolln...... .111 rofl... on Intoroo' ..,."'otl.. '0 IIft_ CUI HW'
bOVend IhI dol.'of IhI ....._.. If p."..." 10 _ .ftor IhI Inl"oo' ......1.11.. HI. - .. .hI
Mot'c., IddStlon-S 'nt.r.,' lU,t be calcul.ted.
RECEIPTS OF PRINCIPAL
1997
5/3 Dauphin Deposit Bank & Trust Company, checking account no.
67363385 20,704,65
5/3 Dauphin Deposit Bank & Trust Company, certificate of deposit
#8100095779 5,002.60
5/3 Dauphin Deposit Bank & Trust Company, certificate of deposit
#8000126788 10,100.21
5/3. Dauphin Deposit Bank & Trust Company, certificate of deposit
#8000129124 15,051.78
5/3 Dauphin Deposit Bank & Trust Company, certificate of deposit
#8000450003 2,011.92
5/3 Dauphin Deposit Bank & Trust Company, certificate of deposit
#8000131064 27,069.90
5/3 Dauphin Deposit Bank & Trust Company, certificate of deposit
#8000126745 5,010.41
5/3 Dauphin Deposit Bank & Trust Company, certificate of deposit
#8000129159 15.141.27
5/3 Dauphin Deposit Bank & Trust Company, certificate of deposit
#8000128381 41,532.21
5/3 Farmers National Bank ofNewvllle, checking account no. 130397 3,382.10
5/3 Farmers National Bank ofNewvllle, IRA account no. 9000096 2,486.78
5/3 US Government Savings Bonds:
QI674383137E, Series E, issue date December 1958 176.11
5/3 Q1800919223E, Series E, issue date December 1959 167.28
5/3 Q1861992629E, Series E, issue date December 1960 165.06
5/3 QI902710370E, Series E, issue date December 1961 163.14
5/3 Q1967698081E, Series E, issue date December 1962 .160.07
5/3 Q2027896382E, Series E, issue date December 1963 157.43
2
S/3 Q2082447461E, Series E, issue date December 1964 154.71 .
S/3 M17369402EE, Series EE, issue date October 1986 1,06S,60
S/3 M17369403EE, Series EE, Issue date October 1986 1,065.00
S/3 Q21 S0828218E, Series E, issue date December 1965 128.12
S/3 Q221 0625661 E, Series E, Issue date December 1966 125.115
S/3 Q2285766144E, Series E, issue date December 1967 126,18
5/3 Q2376704040E, Series E, issue date December 1968 126.82
5/3 Q2440771816E, Series E, issue date December 1969 122,1\
'3/3 Q2516802894Il, Series E, issue date December 1970 121.08
5/3 Q2601033260E, Series E, issue date December 1971 102.63.
6/23 The Sentinel, refund 8,00
717 1986 Pontiac coupe, sale proceeds 2,500.00
7/16 Pennsylvania Blue CrossIBlue Shield, refund 238.30
7/18 USF&G Company, refund homeowners polley 72.00
8/3 Harleysville Insurance Company, refund car insurance 26.75
8/18 Union Central Life Insurance Company, polley no. 1343517,
proceeds 2,054.49
8/26 Sprint, refund 2.73
10/29 Sprint, refund 2.73
12115 Washington National Insurance Company, life insurance. refund 18.79
Total Receipts of Principal I ~tS4S.41
3
PRINCIPAL CONVERSIONS TOCASiI
1997 Gain Lou
6/23 Dauphin Deposit Bank & Trust
Company, oheckins account no.
67363385 Proceeds 20,581.89
Account Value 2Q.704.65 122.76
6123 Dauphin Deposit Bank & Trust
Company, certificate of deposit
/;8100095779 Proceeds 5,035.79
Account Value 5.002.60 33;\9
6123 Dauphin Deposit Bank & Trust
Company, certificate of deposit
/;8000126788 Proceeds 10,050.76
Account Value 10.100.21 49.45
6/23 Dauphin Deposit Bank & Trust
Company, certificate of deposit
/;8000129124 Proceeds 15,177.53
Account Value 15.05 I. 78 125.75
6123 Dauphin Deposit Bank & Trust
Company, certificate of deposit
/;8000450003 Proceeds 2,002.14
Account Value 2.011.92 9.78
6/23 Dauphin Deposit Bank & Trust
Company, certificate of deposit
/;8000131064 Proceeds 27,031.07
Account Value 27.069.90 38,83
6123 Dauphin Deposit Bank & Trust
Company, certificate of deposit
. /;8000126745 Proceeds 5,043.60
Account Value 5.010.41 33.19
6/23 Dauphin Deposit Bank & Trust
Company, certificate of deposit
/;8000129159 Proceeds 15,035.96
Account Value 15.141.21 105.31
4
6/24 Dauphin Deposit Bank & TNSt
Company, certificate ofdeposlt
NBOOO12B3BI Proceeds 41,4B3.68
Account Value 41.532.21 48.S.3'
6/24 Farmers National Bank ofNewvl1le,
checking account no. 130397
Proceeds 3,382.10
Account. Value 3.3B2.10
6/24 Farmers National Bank of Newville,
IRA account no. 9000096
Proceeds 2,494.20
Account Value 2.486.78 7.42
6/23 US Government Savings Bonds - All
&717 Proceeds 4,132.85
Account Value 4.127.19 5.06
Net LoSI on Convel'lloll 17M'S
DISBURSEMENTS OF PRINCIPAL
1991
6/23 Hollinan-Roth Funeral Home, funeral bill 5,800,00
6/23 David Smith, deposit, grave stone & lettering 261.00
6/23 Graham Medical Clinic, invoice 13.04
6/23 Kough Oil Service, invoice 87.89
6/23 Pennland Insurance Company, automobile insurance 66.15
1118 Dwayne Kelso, reimburse for automobile repairs 202.13
9/22 David Smith, balance, grave stone & lettering 266.00
10/3 Landis & Black, on account, fee & costs to date 3,164.40
12131 Register of Wills, Pennsylvania inheritance tax 8,311.24
5
Reserved :
Landis & Black, balance, attorney's fees
($3,661.40.325.00 (Credit for missed Inheritance tax discount))
. Closlns and flUns releases .
Total Dlsbunementl or Principal
3,336.40
300.00
22.481.4!!
RECEIPTS OF INCOME
1997
6/23 Farmers National Bank. interest, IRA 9000-096 55.97
6/23 Dauphin Deposit Bank & Trust Company. Interest paid 4/15197 to
5/15197, certificate of deposit #8000128381 161.77
6/23 Dauphin Deposit Bank & Trust Company - interest paid 2/15197 to
5/15197, certificate of deposit #8000126788 11 5.82
6/23 Dauphin Deposit Bank & Trust Company - Interest paid 4/15/97 to
5/15/97, certificate of deposit #8000131064 116.51
6/23 Dauphin Deposit Bank & TlUst Company. interest paid 3/9/97n to
6/9/97, certificate of deposit #8000129159 236.30
6/23 Dauphin Deposit Bank & Trust Company - interest paid 3/14/97 to
6/14/97, certificate of deposit #8000450003 21.93
6/23 Dauphin Deposit Bank & Tlust Company - interest paid 5/15197 to
6/15/97, r.ertificate of deposit #8000128381 167.16
6/23 Dauphin Deposit Bank & Trust Company - interest paid 5/15/97 to
6/15197, certificate of deposit #8000131064 120.39
7/18 Orrstown Bank, estate checking account no. 108-000914 77.55
8/20 Orrstown Bank, estate checking account no, 108-000914 55.58
9/19 Orrstown Bank, estate checking account no. 108-000914 61.30
10/20 Orrstown Bank, estate checking account no. 108-000914 55.18
11120 Orrstown Bank, estate checking account no. 108-000914 58.63
12119 Orrstown Bank, estate checking account no. 108-000914 52.02
6