HomeMy WebLinkAbout97-00520
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~otes. r~al. estate mortgages or other securities or
in such other property, real or personal, as my
Executor shall deem wise. without being restricted
to so-c~lled "legal investments", and without being
limited by any statute or rule of law regarding
investments by fiduciaries.
(c) In order to effect a division of the
principal of my estate or for any other purpose,
including any final distribution, my Executor is
authorized t.o make said divisions or distdbutions
of the personalty and realty partly or wholly in
kind. In the event a division or distribution is
made in kind, such division or distribution shall be
made at the fair market value of the property at the
date of division or distribution. Should it appear
desirable to partition any real estate, my Executor
is author! zed to make, join in and consummate
partitions of lands, voluntarily or involuntarily,
including giving of mutual deeds. recognizances or
I
other obligations. with as wide powers as an
individual owner in fee simple.
(d) To sell either at public or private sale
and upon such terms and conditions as my Executor
may deem advantageous to the estate, any or all real
or personal estate or interest therein owned by the
estate severally or in conjunction with other
persons or acquired after my death by my Executor,
and to consummate said sale or sales by sufficient
deeds or other instruments to the purchaser or
purchasers, conveying a fee simple title, free and
page 3
.'
ct, ~.
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(j) To do all other acts in my Executor I s
judgment deemed necessary or desirable for the
proper and advantageouS management, investment and
distribution of the estate.
ITEI1YII :
Any person who shall have died at
the same time as I shall have, or in a common disaster with me,
or under such circumstances that the order of our deaths cannot
be established by proof, or within thirty (30) days of my
death, shall be deemed to have predeceased me.
U.El'LYlll:
I nominate, constitute and appoint
my sister, LOUISE MOWERY, to be my Executrix, herein referred
to as "Executor", In the event of her death or inability or
refusal to serve, I nominate, constitute and appoint my sister,
BERTIE MYERS, to be my Executrix, herein referred to as
"Executor". My Executor shall not be required to give an)' bond
or bonds.
IN WITNESS WHEREOF, I have set my hand and seal to
this, my Last Will and Testament, consisting of this and the
preceding four (4) pages, at the end of each page of which I
have also set my initials for greater security and better
-t;7v .~
identification this /J day of S7t',~-<""'-A/"'1 ' 19/.
v
...~~~_.__.._..______( SEAL)
We, the undersigned, hereby certify that the foregoing
Will was signed, sealed, published and declared by the above-
named Testator as and for his Last Will and Testament. in the.
presence of U8, who, at his request and in his presence and in
CERTIFICATION OF. NOTICE UNDER RULE 5,6(4)
Will No.
21-97-520
To the Register:
Admin. No,
21-97-520
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 f,.)llowing beneficiaries of the above-captioned estate orl
6-24-97
~
Bert ie Myers
Louise Mowery
Address
131 East Lisburn Road, Mechanicsburg. PA 17055
2040 Fisher Road, Mechanicsburg, PA 17055
Shepherdstown United Methodist Church, 1934 South York St., Meehanicsburg, PA 17055
Notice has now been give~ to all persons entitled thereto under
Rule 5.6(a) ft~~K
Date:
June 23, 1997
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nature
Name Lloyd R. Persun, Esquire
Address P,O, BOK 5950
Harrisburg, PA 17110-0950
Telephonel:.:l 232-5000
Capacity:_____ Personal Representative
K Counsel for personal
representative
. \}.-' '../
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llNHERITANCE TAX RETURN
RESIDENT DECEDENT
COMMONWEAlTH 0/ PlNNSVLVANIA (TO BE FILED IN DUPLICATE
OfPAltrMENT Of R!VENUf
HAR",fJ:~J~On\".OIlOI WITH REGISTER OF WILLS)
.- 'NAME (lAST, ~IRST, ANO-MIDOlE INITIAq
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f:0. DATI' 0' DIA'H Ana. 12131,' 71 CHICK H ~I
lP A .POU."L .
POV'." CIIDIT II CLAIMID [
,ii:niulil... -'- -
21 1997 0120
COUNTY CODE YEAR NUt^. q
N COMPlfH "ADDRESS
20/.0 IIIBI...r KOllrl
fl"cllllnlcAhurg, I'^ 170')5
tVd~OO fj( to (11,QIl
+
19. If lino 18 i. groator rhan IIno 17, onlor tho dlfforonco an IIno 19. Thi. i. Iho OVERPAYMENT.
mo
20. If lino 17 i. groato' than IIno 18, ontor Iho diffo,onco an IIno 20, 'hi. I. Iho TAX DUE.
A. Enler Iho Inter.,t on the balance due on Une 20A,
8, En'" ,ho total of II no 20 and 20A on IIno 208. Thl. I. 'ho BALANCE DUE.
M~ko Chock Payablo to, Rogl.to, of Will., Agont
.... II SURI TO ANSWIR ALL QUESTIONS ON RlVIRSI SIDI AND TO RICHicK MATH..
Jod., penalli.. of perjury, I dedor. fhal I ha..... uamined Ihls return, Including accompanying schedule. and tlcllm'nl', and 10 th. bell of my ~nowl.dg. and baH.f,
I IltruI, corr.ct and complet.. I declare that all real ellale hOI been reported at true markel valu..., aeclaration of p"'parer other Ihan the pellonal r.presentatlve 11
lQled on alllnformallan of which pre parer has any knowledge,
lIGN.ATURE ~p prRSON RESPONSI8Lf fOR FILING IUTlffN ADDRfSS 2040 I"i Hlwr ROlld DATE
J:.. : ,I, ~~ MechllnlcBhurg, I'^ 1701', 1-.3 -98
~AA!'9lHrylHAiH'l1',,!A1TV1--.ooR!lS 1'.0, 110X ')950 ---, o;m
'>LF~;('~~ . Harrlsburg,P^ 17110-09',0 l-3 -98
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IAl eCljMifVNUM6ER-.n_-~~A -orDfAlH--"lOA. TE of"i"iRTH-----
204-30-7929 5-14-97 11-23-10
_.__.~___..._~ ._ COvnly__
Qll. O'lglnal Ro.u,n LJ 2. Supplomon'ol Roturn
Cumb" r 1 /Inri
U J.
05.
Remaind.r R.turn
(far da.o. of death pda, to 12.1 J.82)
Federal EIlate Tox
Return Required
Totell Numb.r of Selfe Oepotlt80x.s
o 4, Limited Eltel!e 0 40, Future Int.r..t Compromlut
(fo, datos of doath akor 12,12-82)
[] 6, Oeceden! Di.d Tes'ale 0 7, oecldent Maintained a Living Trult
{A!laoh copy of Willi (Attach c~py of 'ru.I)
ALL CORIISPONDINCI AND CONPlDINTlAL TAX INPOflMATlON SHOULD II DIRICTID TOI
NAME - M ~ MA lINO ADDRUS
Mette, Evnns & WOOdHldc
1',0, Box 5950
Harrishurg, I'^ 17110-0950
-0=-8.
Lloyd K. Persun, ESlluir"
NEN~
71 ~-L
232-5000
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1. Roal E"ole (Schodulo A) I 1)
2. SIock. and 80nd. (Schedulo 81 ( 21
J. Clo.oly Hold SIock/Partnorship In'o,o" ISchedulo q (J)
4, Mortgages ond Na.o. Rocolvoblo (Schodulo D) ( 41
5, Co.h, 8ank Deposits & Mlscollanoou. Porsonal P,oporty( 51
ISchodu!o E)
6. Jointly Ownod Prapony ISchodulo F)
7. T,an.f.rs ISchodulo G) (Schodule LI
8. Total Gro.. A..o" (totallino. 1.7)
Q, Funeral Expenl", Administrative Costs, Miscellaneous I 9)
expen,o. (Schedulo H)
10. Debts, Mongogo llabllitle.. lion. ISchodule I)
11. Tolal Doductlon. (talalllno. 9 & 10)
12. Not Value of Estoto Iii no 8 mlnu. IIno 11)
lJ. Chorilablo and Gave,nmonral 80quo.ts ISchodulo JI
14, Nol Valuo Subject ra Tox IlIno 12 mlnu.llno 13)
15, Amount of line 14 toxable 01 6% rate
(Includo valuo. f,om Schodulo K or Sohodulo M,I
16. Amount of IIno 14 'oxoble at 15% ,o'e
(Includo ,aluo. f,am Schedulo K or Schodule M,I
17, Princlpol lax duolAdd Inx f,om lino 15 and from line 16.1
18. Crld!" Spousal Po....erty Credit Prior Payment~
-0- + 40,000.00
-0-
157,035.76
-0,.
-0-
lO,682.94
29,231.84
118,237.60
I 6)
( 7)
8,583.50
( 8)
315,188,14
6,958.09
(10)
15,541.59
299,646,55
100,00
299,146.55
-0-
111) ,
112)
I1JI
1141
-0-
___~ .06-
1151
116) 299,146,55
~ ,IS. ~.!l71.99
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117)
1.4,871.99
Dlscoun! Interes!
2 ,000.00 _ --=.Q::._
1181 __~2,000,00
119) ._-0-
ChfHk hlJle If Y\lU (1ft. ItH'I1(''';IIIHI n refund 01 your ovcrpuvrn(mt
2,871.99
-0-
2,871.99
(201
120AI
1208)
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COtMll\OHW.AL'" 0' "NN"'liANIA
IN.....".....CI "ll "'UIH
'!lIOIN! OICIOIN'
SCHEDULE B
STOCKS AND BONDS
Guy Ki111l0re
21-1997-0520
,An '''''''Y lot1nlly..w..4 wHh al,hl of ..."'I....hl' MU'I It. 41,,1...4.n Ich.4ul. P,)
ITIM
NUMUR DUCRlPTION
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IDS Life Inlurance Co.
Deferred Annuity Contract
Alc #930019971868004
2.
I' IDS Life 1nsurance Co.
Deferred Annuity Contract
lAIC 19300- 019971918004
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TOTAL (Aho ,nit' on lino 2. he. 11.1011..
11/ "'." 'po.. ~ noodod. In.." addi,iona/ '~"'I .1 10..0 ...0.,
\/ALUE Al DATI
0' DEA1H
78,517.86
78,517.90
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S 157,035.76
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BeD.ftclirY IDfOl'lDltlOll
W.laav. tilt followtD& b.".ficWlel on record for IhIlIeceued'. ~II.
AMout M..bet': 0\15 06626&2 6 002
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Aeco..tN...IMr: 02150662682 S 002
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Accouat 1'lumlMll'l 9300 1997186 8 004
'DoIlpatlon:
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ACCOIIllt1'lUDllMIl'l 9300 19971918 004
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DII,oe1t\Oll for lI\dlv141111i ow.mlll'
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accouul ,roeet4S\YPIca1IY pISS Ie tho be~cflclari" naDI.d al lh.llme of dd.
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Required Docum.nts
In OlclU III tlke applOl'rillO sICP' 10 sot\Iellle IIAlCounls w. wllllleed \lloIe dOC1Jrnenb:
C.rtll\ed poatb Certll\etle
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Its\sUlt.
Ettata Settl.....t Fo"" (3148)
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alto be comPlelllCl. We will redeem the amOunl reqIlested on me dale we1flcelve Illd approve 011 dDCUlllenll
Illqu1red 1Il,Iettle lb. IIAlC01lllt.
peat" ClaIlIl StateDlent ,onD (3304'7)
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lDfonnatioo .eellen, If i\IIY of Ihl. lDforrnal1on Is Incomplete, llIe fonn will be retUt"ed. If a tall wllbholcltoS
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public.
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if yOU h~ve my l\uesli.ons, Thank you.
fl\$\ Titlo Tr.m.fer
P.O. BOll 1211
Minneapolis, MN 55440
612-671-4740
A\tIl1hmaal: Bencfic\at'Y Inforrnatloo
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InlUllnCI .nd .~~uilill are IllUod lrIlDS ~ife i"""'" ComplO'I'f, a~ I\IMI~n~' co",pe~y,
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SCHEDULE F
J.OINTLY.OWNED PROPERTY
Guy Kilmore
I PILI NUM'IR
21-1997-0520
....... .....11').
NAMI
A. Lou ise Mowe'ry
"DDRUS
2040 Fisher Road
Mechanicsburg, PA 17055
RILATlONS"" TO DICIDINT
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!TIM PO. DAn TOTAL VALUI DICD'S DOLLAR VALUI O.
N JOINT MAGI DUCllmON O. 'RO'IIT'( OPAIIIT '"' INT. DICDINT'S INTRUT
nNANT JOINT
I. A 0/29/75 Saving Account
Mellon Bank
Ale #00140-149025 32,845.45 .50 16,422.73
2. A 7-28-92 Certificate of Deposit
Me 110n Bank
A/C #140-001645-e 20,043.55 .50 10,021.78
3. A 0-31-95 Checking Account
Me 1l0n Bank
A/C #100-003-8420 5,574.65 .50 2,787.33
TOT "L 111.1.. 0'"'' .n Un. 6. R..ap~.lallanl
(II ..... ...... " __ .".r! 0._'1~" 0110100 Nit)
$29,231.84
.131.
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III'AIIT1t11lTIlI'IlIVIlU!
_AU Ill' INDIVIDUAL lUEI
DI'1. r10" I
HAaRI.~." 17111."'1
..
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILE NO. 21 97-0520
ACN 97135125
DATI 08-21-97
TYPE OF ACCOUNT
EST. OF GUY K ILMORE 8 .AVI NIl.
5.5. NO, 204-30-7929 C"ICKINII
DATE OF DEATH 05-14-97 TIlUST
COUNTY CUMBERLAND 0 CERTlF.
IE"IT 'Ay"eHf AHa FOIHS TO.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
1n.11M... "" II.ttl
LOUISE MOWERY
2040 FISHER RD
MECHANICsaURG
PA 17055
"ELLOH 1tS'1 IAHK M. pro.,tded the Dett.rt.."t with the Infor..Uon Iht... hel~ .....Ich hi. """ U.M tn c.l4lut.Unt tM
,otM.III tb due. ThIIlr rlMlttrd. IneUc.t. tNt .t tM Hlth of thl Ho.,. ......."t, V~ w,. . j.Jnt tMntr/bMef1C1IIrY of thl. ICGwnt,
If you f..l th'" 1nf.r.Uon h lnoorr..', '1.... ...t.ln written Gorr..Uon fr.. the f1MnClI.l In.UtuUon, .UMh . ",V to thh f....
.. r.turn It to the 1botI. ldaro... Thh IOCount h tlXlbl. I" IMGOrd.no. with the Inhtrltenoo TalC l.... of the C.-onwMlth .f PIMIY1v-.t..
....tlon. .v bel In....r.. by 011111"1 (7171 717"'S~7.
COMPLITE PART 1 JELOW . . . SII RIVIRSI SIDI FOR FILING AND PAYMENT INSTRUCTIONS
Aao....t No. 00140-149025 o.t. 10-29-75
htoblloh..
Aoo....t ..1_. 32.845.45
,......t T..ob1o X 50.000
NOTE I If till pl""'I" Ire'" within thr..
_t S"joot to To. 16.422.73 m _'h,.I.ho..' '1'" do'..f ""h.
T.. ".t. X .1S yOU ..y IMNfuct . IJC .i.......,t of tho; tox due,
Any InMrltlnCl' tlX due wll1 ..... "l1~t
'atonU.l T.. Duo 2.463.41 nIno (,) oan'h, .ftor tIlo .... .f .....,
'rnTI.i'::'~'t:lIIII.'."TCl'.R.IS~9~~'ii:i.'~t:'iii'~,P"";~;:;'~J~:::~~i;="~!Jm.~~,iM~~.,..~.".'ttl~'i:i."",~~~.::',1
A. 0 The ...,. Infor.Uon end talC duo 11 oorrlOt,
1. You..y choa.. to r..1t p.v.ent t~ tho R..lltlr of Will. with two 00,1.. of thl. notlol to obtain
. dltoOUnt or avoid In'.r..t, or you ..y chock boll -.- end r.turn thl, notlc. to tho R'I..t.r of
Will' ~ on offlclll ......-.nt will be I..uod b~ tho 'PA Dop,rt.ont of R.venue.
To Inlur. pr....r crMlU to your MOOW1t, two
(2) 41opl.. of thh noUCI MlU IM.....-no; !tour
P'VIOnt to thO ...I.t.r of Will.. MIk. oheok
p.yebl. tOl ....l.t.r of Willi, teent~.
[CHECK ]
ONE
BLOCK
ONLY
.. 0 Tho Mo". ....t h.. bien or ..Ill be r.,ortod end till ,..Id with the P"""."I"....I. Inh1rhono. llll roturn
h be flled b)ll tho doc...",', reprll",tatl",..
~AIT
[!]
C. 0 The ...,. Infor..Uon I~ncorr.ot tnd/o~t. end doduotlon. _to palel b~ )IOU.
You .,.t C1....ht. PAR' L!J ondIor PAIIT ~ Nlow.
If you Indiaat. . different tax rata, pl.... .tat. your
r.l.tionohi, to doo.oont.
.."
f'"''
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LI"E
r;::iUii:. - :=:.u=UT:'T%::: --
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2. AcoOW\t I.lana. 2
S. ~..oont T..lb1o 5
4. Aoount Subjoot to T.. 4
.. _to ond IloduoUono .
.. Aoount T..obl. .
7. T.. I.to 7
.. T.. Duo a
x
x
'AIT
[!]
DATE PAID
j
DilTS AND DEDllCnONS CLAIMID
PAYEE
DESCRIPTION
AMOUNT PAID
~
TOTAL IEnt.r on Line . of T.. Cooput.tionJ
:~
.
Undor ,...lti.. of porjur~, 1 doGl.r. th.t tho focto 1 hovo ropertad obov. .r. t~, aarroct and
_l.t. to tho boot of .~ k......l.... and boU.f,
!lOME
WORK
(
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-. AVnl\\Ir:-n r'rr"III1.TI,nr
Tr'1 r"n"r'lllr t,"Unrn
I
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GENERAL INFORMATION
1. 'AILURe TO RUI'OIIIl WILL .ESULT IN AM OfFICIAL TAM ASSES'MENT .Itt! ...11....1. In'or'" 110'... on In.o,..lIon
.....lU.. .y the H~..l In,Ututlon,
I. 1'-"'_0 .oo ...._, .11_' nino _'hi ,,,., .hI .......,.. ..,. .f ...'h.
S. A j,ln' "0"'" It .....1. ,.on ,_ .... .._". .- ... ....... ,..\I.' of ...._1.....
4. _" \I..lvdlno .no.. nold 110'-"'- ond .If.' ...'eII .... ..-' .... In lo,n' -' .lIhln ... ...' .d.' '0
_th .... fully t....1. II tr-"tl",
I. _" ......II_lolnll. 110'- .....ond ond .If. ..,. \hon ... ...' .d" \0 .,'h .,. .... ......1..
S. _" ...Id .. . .......' .In .,v,' lot. _...., 01' ".." ,,. "....,. Ivl'.'
REPORTING INSTRUCTIONS - PART 1 - TAXPAVER RESPONSE
I. Ilott( A _ If ... In."..lIon ond ._,.lIon In'" ..,I.. or' .0"'" ond ........Ion' or' .... ..Ino .ltl..... .1... on'"
In .Iook .A. o. p,,, I of .no .V.....or ....on... ...lIon. lion'" ...1.. and .....11 ,- .lIh ....' .- ." ... -' of
,.. '0 ... ...1"" o. Will' o. .... ,...,. Indl......, ThO P' ....,...., o. ....... .1'1 I'... on 0"1.1,1 0'..'.....
(,,,. lOf:.-U" (X) .... ,...Ip' o. .... ,..."n f," ,... ."I.m o. Will'.
I. Ilott( I _ If .... ..... _If I'" on .hl. noli.. .... _ " vIII" ,-,.... ond ... ..Id .lCh .... .....,.1...1. I"""d-'
1" .0...", m... .. ... .......... ,..,....,.11", p'''' on .0. In 010" .... .f port I o. ... "t......or ..-... ,..lion, II..'"
.... ... ,....'n '0 \hi PA ....,..... o. ........ Ivr.... of ,ndl.I...1 1..... loP' 1'...1. Horrl...r.. PA 1711,-,"1 In ....
~1"" provlcted.
S, Ilott( C _ If ... ...11.' In."...lon I' lnoo"'" '""''' _.Ion, ,,. ..I.. 01.1...... - .1'" "C" ond 0_"" por., 1 and S
,,,,,.Ir.o to ..." In..."".n, ....., 01", 'w. ...1.. "". ......" It,,, with ,our ....... :.. "'" -....... .: '''' ..".,.1. .. \I.. r....h...
o. Will' o. ... _IY Ind.......' ThO pA ...or..... ,f ....... .11' ...... on .fflal.1 .,..,ooon. I'''' 1l!'I-IMlllll ..... ,_I..
of the rltvrn ft_ the "..lItl" of MUla.
TAX RETURN - PART 2 - TAX COMPUTATION
liNE
I, !fI,""'" .', \hi ....... or'OI..II. WI' ......11'..... ., 1111'" In .... -' .""lIno ,. .... o. de..h.
IIO~' For' ........ ...Ino ollor U/llItl' "0"''' ...leII "'" ........ ..., In loin' -' .11Il'n ... (I) ..or .. doItt! or.
_..., MI. .. \ron."'" _"". ,...,. I' on ..ol.,lon ..., '0 ....... IS.... ..r .r.."or.. r_'dl... o. ... vol'" O.
the "count or the rPlHt of IICcounU held.
If , _I' ...orltk (," _'" ...". ....r II,., _ 'n ... tcIcl,... ...,lIon .. 1Ill' no"'" ... IS.OI' ...Ivllon
.1'_ ..., _ _'''' .,cO ... ........ 110'_' .. r_r.'" '. .... 11....1.1 In.II...lIon.
Z. !fI'or'''' \0.,1 ..1_' o. ... ..e...' 1...ludl.. In'or..' ..or..... '0 ,... ..,. ,. _tt!.
S. ,.. ..re..' o. .... ..e...' \ho' I' ....... .or ..... ...",1." I. ..or.lnod .. fallOW"
A. V'" ..r...' ....." .or join' ...'" ......11_ ..,. """ ... ...r .dor .. ... .........., _Ill'
I 01YlDE1l IV 10tAI tIlMIP Of OIVIDE1l IV 10VAI .- Of 0 101 . pPCM V_IE
JOIHl _ SUIlV'VI... JOIHl -
Eo_I.' . j.ln' ..... ,..I,..r'" In ... _ .. .... __n' ond .wo ....r .."on,.
1 OIVlllED IV 5 (JOIWl .......1 OIVIDEO I' I (JUlNIVOIlS) . .1'7 0 IDO . IS.r; (1,WIE FOR EACH IUIl.IVOR)
I. VhO ..r..n' ,...." f.r ,..... "tI'OlI .I.hln one .." .. ,... d.........' dto.h " ......It ....... .. .... ......... .... nold
1n tru.' for ..,otM" lnc:Uvl....1t.) (trult beMflc1ar1..H
X 100 . PERCENT TAXUl!
4, .... _' ....1... ,. ... (IIn. 'I 10 ...,...1...... ..1II.1.lno .... ......, ....... (II... II .. ... ....... ..,tIIl. (II.. U.
I. Ent.r the totll of the deb" tnd dedUOUon' Ult_ 1n p.rt S.
.. ,.. _' ......1. (II... 'I I' ....,.1.... .. ...."..11.. ... ..." end _lion, (II... $I 'rcO ... -' ....j... \0 ... (II... 41.
1. Intlr the _rop"l.'a tlllt rat. U1M 1) II dat.rained belOW.
A. For ..,., ,f ...\h ..our,'no "',r 'ISOI... .... ". r"" ,.r .r..".r. '0 ....... .r. ,. ..I'OW"
1. o.t.. of d..th on or ,ftar 7111" 1M bef.r' 1/11" the rata 11 SX.
Z. Do'" ,. ...\h .. .r ...., 1111'S .r..,..r, ,. ......, .11' .. ...... ,. .X ... r""
Mo'" For do'" o. ...th .rl.r '0 7111.. .,..".r. ,. ..ov." .r' .....1. ., 'X.
I. v,on.'." II II.... dotl_" lnoludl.. ..,nor. ......r. .on. _.or. .r_1I0ron. _-In-'ow,
_.,r-In-'''' ......lld ... \hOlr I,ouo .r. ',...1. ,. .1. ..re..' ('Xl,
C. v,on..or," ,II ....." 1..ludlno .r....r. ,I"or. ....". ...,. _ ond nl'" ". ........ ,. 1111- ..re..' UIXI.
0, If.....-... ... ,.... pi.... _If. _r rtl.II..",I. .. .... ........ In .... ".. .,..Ided,
I. .... _' .. ... _ (lIne I) I' ...or.l.... .. ..111.1.1.. ,... -' ...tIIl' (II... 'I .. .... ... ,." (II... 71.
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
AU_1Ib1' deb\l InCI o.ctuctlon. ar. at.ralned II follOWIl
A. Vov ....1'. .r' r.....'I.I. fo. ........ " \hi ."". ...,'" .. tdOln.,.r..lon .. . ..r....1 ,..,.,en,..I.' I' Intull1elon'
to plY th4t MQuCUbl1 "....
I. Vov ......,l> .,'0 .... ..." .lIor doIlIl o. \hi ........ ... ... ",rnl'" .r..' o. .......,
C. 0tII1I ..I.. .1.1.... ...', .. 1\..11'" ",II. In Port S. If tcIcllllonol ..... It .......... v.. .,.In -' I 111" · U.. P,.....
III't111"t "'I be r..-.ted by tn- PA ..f'....' of Rev......
." _ .va'''''. UUST"lICfdt{i.i;~~~~~;l~};\)ii~~\;';j\\\i':;;W\(W' '.
FILl NO. 21 97-0520
ACN 97135124
DATI 08-21-97
TYPE OF ACCOUNT
EST, OF GUY K IlMORE B ....VI_
5.5. NO. 204-30-7929 CHICllINl
DATE OF DEATH 05-14-97 0 T_T
COUNTY CUMBERLAND 00 CIRU'.
REMIT 'AY"ENT AND 'ORItS 10,
REGISTER OF WILLS
CUM8ERLAND CO COURT HOUSE
CARLISLE, PA 17013
_L1M,. _LYoUIlA
DIJIMTIU1 ,. _
IlIllAU ,. INOIYIDUAL 1AIl11
DlPl. """
HAlMII~,'A 17111-1611
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
HELLON ItSFS BANt< h.. provided tM Dep.rtMnt with tM InforMaUon listed below wt,lch hili Hen u.ad In ulcul.U", the
potential hM ctu.. ThillI' rHoI'd. lhellcat. thet It ttMl .Ith of the IiboVI _lIdent, YOU ....". I Joint OtfMr/bwMflcl.ry of thh "count.
If YOU '''1 thh 'n'or.Uon h IrtcGr"Ht, ,I..... obtain wrItten corr.atlon '1'. the flMnOlat In.t:1tut1on. attach. ClOftV to thit for.
MIl raturn U to ttM -.we eddr.... Thh account h t...... In eGClordllnoa ..Uh tM JMtrUlIn01 TllC L.w. of ".,. C.......1th of Penn'Yhen...
IUIIUon. -v ... ......,... by 0.11.1"1 (111) 7'7.13::7.
COMPLITI PART 1 IILOW . . . III RIVIASI IIDI FOR FILING AND PAYMINT INSTRUCTIONS
Aaoount No. 140-001645-C D.h 07-28-92
hhbll,h.d
m.I....."""."1
LOUISE MOWERY
2040 FISHER RD
MECHANICS BURG
PA 17055
Account a.lena.
'ora...t T.....l.
A_t lubJoot to T..
T.. R.t.
'ot...t1.1 T.. Duo
To In."r, ,roptlt' credit to your ICIcount~ two
CU cop I.. of thi. notlc. .u.t IClcupenl' YOU,.
p'v.nt ta the ...ilt.,. of "111.. ,... chMk
paY_la tal .....I..t.,. of IIUlI, Alent".
'....T
rn
20,043.55
50,000
10,021.78
.15
1,503.27
TAXPAYER RESPONSE
.,....l!~XtUII.....TO.'..RI....iiii"'~~~,:iij~..W.tX".'..~..i.O~~X!!~~.~i.iiil~.i':~.~!l~'i~..I.!I',.Q"""T!~X~.ii!!!UXCI.,..:
x
x
HOTEl If t.1C pavwnt, a,.. .... ..lthln thr.e
(1) Hntha of the rfeGld."t', data of eII,th,
YOU "Y decIuot . l;co dhClaunt of the till due.
Anv lnhltrtteno. tu caN ..111 __ .U"",,*,t
nine (,) ItOnth, ,ft,,. ..,. data of death.
[CHECK ]
ONE
BLOCK
ONLY
A. 0 The abo"a I.nfo,...Uon and t.M dull I. correct.
1, You..y choo.. to ,._it p'v.nt to thl Raghta,. of Willi ",Uh two 0(,,,1.. 0' thh noUce to obt.ln
· dhortUr\t or '"ol.d Inter..t, or YOU IIV chlIok box "A" and raturn thl. notlc. to thl _..lit.,. of
MUll and an offlcl..l .......ant ..Ul 1M I..,*, by thl PA OIpa,.tllltlt 0' Ravenue.
I. 0 Tha abnvtl ....t NI' batn or ..Ul bI rt~rtld and talC ,add ..Ith the Penn'ylvanla Inn.rltenol Till r.turn
to bit '111d bv thl dtc..,t'. ,..,,..,tnt.tilla.
C. 0 ThI Mbov. 1n'0,...Uon l~nca,.rlClt tnd/o~"tI and deduClt1on. ...,.. ,..Id by VMl.
'fou .,U COIIplata PART l!J lndIor PART L!J balow.
'ART If you indicat. a different tMK rate, pl.... .t.t. your
[!J ..loUon",,1, to .o_t I
":"AX ;It''iU,,:.. - :;;:~~UT:"T.wr. Ci- ..~~ ~:~ JC::~':',"T~:J:":' AOC:U:-:T::
tINE 1. D.h ht"'U.hod
2. Account a.lanc.
I. 'ora...t T.....I.
~, Aoount lubJoot to T..
.Ii. Debto _ _U....o
.. Aoount T....lo
7. T.. x.t.
a, T.. Duo
1
2
5 x
~
.Ii -
,
7 X
a
'ART
[!]
DATE PAID
DElTS AND DIDUCTIONS CLAIMID
PAYEE DESCRIPTION
AMOUNT PAID
t
l
TOtAL (Ent.r on Llno I of T.. Cooput.tlonl
t
.
Undor ""'1*100 of p.rjury, I docl.r. th.t tho f..to
o..",l.t. to tho ...,t of .y k.....lod.. _ ...11.f.
I hey. r.,orta4 above ere
HOHE ( )
WORK ( )
TELEPHONE NUMBER
true _ aorr..t Ilr'MI
TAXPAYER SIGNATURE
DATE
GENERAL INFORMATION
1. '.ILUIII TO ..._ 1I1LL RIIUL T IN AH O"ICU. TAX '''IO"ENT wIth _11...10 In'.,,,' ...... ... In"'.........
_I"'" ... .... ........1.1 In..ltuU....
10 I"""UMM ,.. '...... _1I"",*,' nlM Hnth. ,ft,,. tM ....'I. _,. ,f ...th.
I. . ,.,", ~t 1. ,..11I1. hen thouIh u. .....".. neM .... ...... II . ..Ulr .f OtInVMJerMl.
4. AMIIMt. C1",.~t.... tN.. ..hi ...,...., ........ ... .....) "'..... "'- ......., "" 'n JeAnt hIM. ..AthAn eM V.., ".I.r te
.... w. fulh tlUt_at II 'rent""',
I. ......,. ..'.11.... Jlinth ..tween ..,_.... __ ..If, ..r. thin ..... V"" .."I.r t. ....'" ,r. nIIt ,.......
.. .......... Mill ... . ..Men, "In tn'" N,." IM_,. or ItMn Ir. tll.lC"'.' .uB,;.
REPORTING INSTRUCTIONS . PART 1 . TAXPAYER RESPONSE
1. .LOCI'" If the Infor_Uen end ........t.Uon in the notice 'f' oarr...' .. fMuotlonl t,.. net .1,. 01'."', ,.... 1ft .....
In ..... "A" If Ita,.t 1 If tM "1......., IIJ.~.." 'MUon. lien t_ .~I.. ... ~It "'- ....... your INek f.r .. -.unt .f
tlM t. thI "..a.t.,. If MUll If tM eountv IncU,..... the PA 0.,.,....., If _..,...,. will hllUli ., ..flol.l ........,
(,.,. .Y"lI'" IX) ..-n ,....A" of tM ,..tum frM the ".,htlr ., inlh.
I. ,LOCI." If tM ....t .,.elfl'" on thll noUn t.. bMn or will be r.,.orted ... taM ,.id with the ,....yl".,i. InherltWM
T. "turn filM Q the ....Ment'. r.,...."t.U"., ,.llOe ." "X'" In bl00k "I" .f ,..r, 1 ef ttMl "'TUfteve,. It..,.,..." ...U..., It 1ft -
.., 1M ,.eturn to the ,. ..,.,ment .f ....,otM, lure.. ef Incflvl__l hM", Dettt 110611, "",11M.", 'A 1711......1 1ft the
.wel..,. "." I...
I. IUIC. C .. If the MUO' Info,..UM I. lnc.,,...t ..uer dldultlon. .,. bel,. 01.1..., ..... III" "'C" ... ...1'" ttwt. I 11M I
DCInrdlr., to ttl. Instruot!,": b:bw. '1~ t:..'.: aa,s.,... ;:r.: u~1t th:. with ~~u:" otic";" f;:, tt\CI _:.r.~ d 'AM ,c~"". to thI "..lIt.r
.f MUla .f the """tv IneU..'Id. n.'A DeHru.n' If ..venue IlI'IU I..... In offt.'.l .......,t Ch,.. MY-IN D) ... ,...t"
.f ~ ,.turn f~ the ...1"1' of "'11..
TAX RETURN - PART 2 . TAX COMPUTATION
Lilli
1. Int.r the dI'a 'hi .oount .,iIIMIly .... ..,...U.... or Utled In tM 1IIIfWMI' aJehU"" ., .t. .f _th.
NOli. ,., I .........t avl", efta, IIIU/III koOW\'. ""loti thI ........, (lM,l' in joint ~o within.... (1) ,..,. .f ..'" w.
t...... fulb .. t,.,....,... However, th.r. I. ." .Molu.lon no' to....... tI,'" IIIr trw\""" ,...,dl'" .f tM _1_ .f
thl MOOU'\' 0' tM """r of ..ooun" held.
If . ....1. ..'.rl. CM) ....... M..,. "", fir.' "'" 'n the ....r... INrUon .f ttlh noUn, tM tI,... "01".1'"
.1r... hi. Hen .....,... fr.. the MCiount NIl.,.. .. r.,.,'" lIy tho fI,......l.l In.UtuUon.
I. In,." tho ,.tll "'1__ of tn. NOoun' lnoludlnl Int.,.., ..o,ued ,. tn. de.. .f ..th.
J. n- ,.,.cont .f tho IOc~' thait I. "'0111, far NOh """"va" ,. de"I'IIINd .. ..U.....
A. fhI, ,.,.oen' 'IM.l_ for j.ln, ....,. ..twU.... .,. tMn 1M yea,. ,,.1.,. ,. the ~t.. ..th,
1 OlVIDIlI IV TOYAL _ lII'
JOINT -..
1x..,1.1 'join, ...., '101"0''''
DlvlDlll Iv 10TAL _ Of K III . I'IIlCIIfT TWILl
IlIlYl.INI JOINT _
In ttw .- of tho lIea...,t, end .. .tn.,. ",...on..
I OlvlDlll IV S (JOINT \MOIl OlvlD1l1 IV r 11tlllV1_I . ,167 K U' . IO.n (TWILl'" EACH 1tlIIV1V01l1
I. The Hr.." "M.la f.,. ....tI e,...'" within OM ye., .f 'hi dececIon,I, ....th ., ..oountl .... b, the dIG....., Mlt Mill
In tru.' for onotM,. 1",,'''11IUI1(0) (t,u,t tt.nIUoI.,...h
. 01vlHD IV 10UL _ lII' ItlIIVlvlN1 JOINT
OWNIWS OIl lRUSl IEN!flCIARII'
I( 100 . POCENT TAXlIlr
Ix..!. I Join' ..coun' ,.....,.,.. In tho .,.. of tho dlIoodlft' ... tvo .the, ,.rMnI ... ,,''''11''' w'thln one WMr .f Moth .,
.......-..
I DIV1D1l1 Iv r CIUllVI_1 ..It K 101 . lOX (TWIll ,.. UCIl _IVOIlI
4. Tho....t _j.., to tax Cline 4) 11 .'.....lnId by ""UI,hl"" tho MOOW'l' _1_. (lIne U b, tho ,.nont tadble (lIM II.
I. Int.,'" ,.,.1 of tho .....t. 1M ......'1... 1I.t. In 'a,' J.
t. .M....' ....,. tUne 'J A. _,....lnecI ... _t,..Une thO ....,. ... dldulltlon. (11M I) f,.. ttw ...." wIIJ.., ,. 'U CUM 4).
7. In'er'" .,.ri.,. t.. rot. CUno 7. II de,....lnocI _1....
A. ,., do'.. of ....th ooour,lnt Iftl" ""1M, the '1M rot.. '0' 'rw\lf.,. '0 .,..... I,a .. foUow..
1. Da,...f ....th on or .ft.r ,711194 ... IIefo,. 1/11" tho n,a II n.
I. 11II,.. .f ....tIt on ., .ft., 1/1"1 "....f.,. '0 ...... ,.111 be tued ., IX tu ,..t..
No'.. for n',. af ....th ,'1.' t. 1I11M "...f.,. '0 ,"'-'... I,. '._'a at 61.
.. TCW'.f.... ,. 11,..1 ..........". IM1.....nI f.the" ..ther, ..." douIh'ar, .'.....,l1d,.~, Mft"ln~l..,
..........-In.'.... .'......11.. ... tn." '-_a,e '.M.I. a' .1. ,.roont CUI.
C. T"...f.r. ,. .U .tho,.. IM1udl,.. breU." ...,." WMl., "",. ..... anIII nl... .... t.....l. ., flft"" ,.,.1Ift' ClUI.
D. If"".... tho ... ""'" '1.... ...Iff )'OU, ,alaUonlhlp ta the ........., In tho .,.. ..'.vl.....
I. The -." .f ,.. duo (l'", I) II ..,.,.alnod IIV' IlUIU,hlnt the .......t '''.1. CU". ,) by tM tlUl ,.,. Ulne n.
CLAIMED DEDUCTIONS . PART 3
DEBTS AND DEDUCTIONS CLAIMED
.11.....1. ~,. end dIduo,lon. .ra de,.,.I.,.; .. f.II....
.. y", I...U>>, I" ","".Ibl. fa, ,.~t, 0' tho ..,.,. tubj.., to ..lnl.,,.U., II>> . ,.'.....1 '.'.Nn,aU.,. I. In..,Uelent
'0 po, tho dlctucUbla It....
I. You ..tul111 ,.Id the deb" 1ft.,. ....th of tho "'odIn' ... oon furnlth ,roef of ~t.
C. 8M" bo'nt Cll.l.... ..., lie It_l.ed fuU1I 'n Pa" I. If .....U_l .,... I. ~, ".. ,lain ,..,. . 11,. .. 11"'. 'r_f af
,.w-n' ., _ '....t... ., the PA _a,....,.t 0' It.vonuo.
,'"w.', <... ....'", ..".,; :~,:", ., :,;. ::<::::::~:::::::::::::::;:::~:::;:::;:~:::Y;{<~:i;t;~~~~~~~~\%i!i~i~!jtAUAVIR;;:~:ASII.siANcaM~j*~~;~;:;:~:m~~~i~~~i~~~W~Wiij1~~:i!i~;~W!~~ii~N~~~~iW~~~:~~:i:~:~~~ji~~i;~~~~~
Mil~\\:::;";;:~~;;; ..."..",..,. ,1 F,YOU ", NEeD'U.tttle"~lN'OItHAT10NORASSlst1iNtEPtali1'AC:t~~lIYr;;{ .:.:".~.:::
:;~;~~~:<}liRRC)lt\ST/H~OlllrJful.'J~'t~/td"tAfJrl.~W'~JcOI~f'~V.'J'1~lRlSl1Q~Y~l'bJ{-E.t.'i\~.~:;:;*, ',' ....,:;~;i:
,:;':(,:,'>':n'HARltlSIURG AT ',.(717 )7e7.-1S27i.(TDDI\( 7171\7' 2.2252 ( HEARINBIMrAlItED'ONLVJ:";;:::Mk~
........",..........,...._.,., "',','.','.','.',',,, - ",,", ' ,'.',_ ,"",',' ,__,",.,.",..','..,....,'," ,,',,',..' ",',,';"';',,',,',"','.',','.'-,,' ,"",',',',',',',,_,',.',',' ,-,-'",",':"":"-""""-':"-"':':0:'::':'-'--:":-:'." ,.,.,.......,'-...-',
'r"-'.
\.
_.JIDtMA" TH f1J ......V""AIi..A
....AlTllIN1 Of ..._
IUllAU Of 1,",IVIDUAL UNn
IIr:Jll, "'''1
~I"URQ, PA l'll'~"'l
*'
FXLI NO. 21 97-0520
ACN 97135126
DATI 08-21-97
TVPE OF ACCOUNT
EST, OF GUY K lLMORE 0 IAVINGS
5.5. NO. 204-30-7929 IiIC"IClUIII
DATE OF DEATH 05-14-97 0 T_T
COUNTY CUMBERLAND 0 cUTU.
~E"IT ~AY"ENT AHD fO~HS TO,
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
tn.'"'II''' ",",
LOUISE MOWERY
2040 FISHER RD
MECHANICSBURG'
PA 17055
"ILLON 'SFI lANK h.. ,rovlded ttM o.,.rtHnt wUh 'hi! Infor.'Uon lhhd b.low Mhlch h.. bMn Uliad 1n c.loul.Une the
potllnU.1 tllC due. The1r rloord. IncUu" tn., It 'hi ddth of thl IboYI d"ldent, YOU Wlr. I Joint otfMr/b.".flol.ry of thlt IIClCllMont.
If wou f..l thll Inf.r..tlon I. incorr.ot} pl.... abt.ln written corr.otlon fr~ thl fln.nol.l In.tltut'on, .tt.on . copy to th" for.
n r.turn it to the MY' ...r.... Thlt "Gount It tl.llbll 1n MGordWKl' with the InherUeno. TIM L..,' of thl C~lth Qf Pem.yl"...ll.
;.,.".U"".. "Y .. WI....r. by oaUJ.,. (7U J ".,'".U/,
COMPLITI PART 1 IILOW . ~ . III RIVIRII IIDI FOR FILING AND PAYMINT INITRUCTIONI
Aooount "0. 100-003-8420 D.t. 10-31-95
Eltobl hh.d
Aooount ..1_' 5.574,65
~..oont T...llill. X 50.000
........t Subjoot to T.. 2,787.33
T.. R.t. X .15
~otontl.l T... _ 418.10
~A~T TAXPAYER RESPONSE
ill ""'A'IIiURl.TO'''IIPOHlii!il~l;;lioiiiiRUIW''i''~H'AN''iO'FJCIAl.;':,i,TAlC.:!...P8lllft'tiIASIDOHTNXS!NOnC1'i;
,-'. ............. ........',.".......',-_...,-,.,.,."-,,...,;,;.:-:,...':".'...,.......-....,...'.- .-',', ...:....'",-",-,',"". ..-,..........,'.,-..........:,:-'"..-.,.:....-.'.".':....-.-:,.;,,:,-,,',:,...-, "'. ,.-,.'.-, ,'-.'..,-,-','... -.--,
10 Inlur. proper ~r.cUt to your tcCOUI'lt, tw
(2) 0..,.111 of thh noUc. lIU.t ICGMP,"Y your
p.yaent to the R'II.t.r of ijll1.. Make chick
p.ylbl. tOI ~..l.t.r of Will., ","'~'
HOTEl If t'M Plvwent. .ra .... within thr"
(S) IMM\ttlt of thl deClldMt'. OIt. of ..ath,
yOU ..y dIdUOt . S~ dUcCM.r\t of the tllC due.
Any InhlrltlnCl. tu dUe will blOOM ..lI~t
nine (,) ..nth. Ift'r thl dlt. of death.
[CHECK ]
ONE
BLOCK
. ONLY
A. 0 ThI IboY. 'nfor..Uon lInd tile M Is oorr"t.
1. You..v choa" to r..lt Plyaent to the A'lllt.r of Will. with two oopl.. of thl. not loa to obtlln
a dl.oount or Iyald Intarl.t, or you "Y chick bolC ~A~ Ind raturn thl. notlQa to the Aegl.tar of
Will. and In offlolal ......lInt will b. I.sued bv the PA OIpart-.nt of A.~tnUI.
1. 0 1M IIboY. ....t hit bHn or will be rllPOrtttd end tu ".'d with thl P.""evIYII'lI. Inhlrlt~. To return
to bl filed by thl dacldent'. r...re.enuth..
C. 0 The abo~1 Infar..lIon l~ncorl"'Gt and/o~.btl end dldUCtlons ...r. FI.ld by you.
You .....t G..,llt. PiAl l!J lndIar PART L~J bllow.
"ART If you indicat. a different taM r.t., pl.... .tat. your
@ roloUonohip to deoedont I
T"'" TA'" 0" ,'!.'II'4,!,/'!'!"''.!T ...eet""!T'
LINE
~!'!u~~ . ~"MPIJ'!'.A. T!"~ ('!if
1. D.t. EatabUohod 1
2, Aooomt I.lanc. 2
S. "eroant TUMle S
4. AlIOunt Subjoot to T.. 4_
I. _to _ D.ducUon. I
.. A_t T..able .
7. T.. ~.to 7
.. T.. Due .
x
x
4i"""""" """",:::::1!1!::i!:i::!:::i.:):
i<' i~:"':":i':i':."::": ," ..,.':"':.:':,
DEBTS AND D!DUCTIONS CLAIMID
PART
l!J
DATE PAID
AMOUNT PAID
DESCRIPTION
PAYEE
I
.
I
TD'fAL IEntor on Line I of T... c_t.UonJ
Undor poneltl.o of porjury, I docl.r. thot tho f..to 1 h.v. reportod aDoY. .r. t.... oarreat -
o_l.t. to tho bo,t of .y k......l.d.. - b.U.f. HOM" ( )
WORK ( )
TAXPAYER SIGNATURE TELEPHONE NUMBER DATE
GENERAL INFORMATION
1. .AILUIlI TO RII'OHD MILL RIIUL T IN AH OfFICIAL TAM ASSU,"!IIT .ltII ..,11'...1. In'or..' N.... on In'n,.Uon
_"tool ~y tho 11_101 In,U'VUon.
I. Im.,....... 'eM MdM' "U....-nt ",,,. IIOnth' .n.r the c1Hedfln'" ..t. .f ..th.
I. A jol"t ......., I, '.....1. ...... ,_ tho ",_,'" -- ... -- .. · ."" 0' ....onl.....
4. _to llnol""l", tho" hol. N_ ...._ ... vlt.. ....1'" tIIO ..._t .... In loin' -, .Ithln ... ..., .,1" t.
..ttt .... fullv ,....It It trIM...r..
I. _to ..t...lI- jolntl. IIot- ...._ ... .11. ... """ ... ..., ,rI.' " _tII or. not '.....1..
.. -..-.nt. Mli bY . _.ont "'1n trut' fo," IMthlr ..., other. Ir' ,...bll wHV.
REPORTING INSTRUCTIONS - PART 1 - TAXPAVER RESPONSE
I. ILIlCIl A . If tIIO In,.,.tlon ... _"U" In 'ho ..U.. or' .."..t ... ......11... ... not ..I'" 01.1..... .1- on "ll"
In ~I"" .A. " ..." I ., tho "1_'''' R......... ...U..., lion two ...1.. ... _II - .ltII ...., - f<< thO _I .,
... to tIIO Rtll't" " UIU, ., tho ._.. I'.n.".... lho PO .....",_t ., R._ .111 1,- on o,II.I.L ....,_t
c,.,. R!Y~1'" !)O ~ rMli,t of the r.wrn fr. the "..1stlr of WUU.
2. ILIlCIl I . If tIIO ..... _III" on \hit notl.. ho' __ ., .111 N ,_,t" ... t.. ..I. .I'h thO 0-..1_1' I_It....
T.. .......n III'" IV thO _,.. ,..,.'...1111... ,1_ ... "ll" In ~I"" ... .' ..,t I ., tho "1_' RD""'''. _tlon. lion'"
... ... ,.W'" " tho PA _,t_t " R........ .v,.... ., Indlvl-I 1...'. .....' 210"1. tto"I....'.. .R 1712.-"11 In tIIO
MWel.... "rew......
J. ILIlCIl C . If tIIO noU.. In,.,..II... I' ,..."..t ......, _U..., or. 1101'" '1,1..... - bl.... "C" ... _I.t. h,t' 2 ... J
_rDl'" .. ,no In"'........ ..I... >Ion ,.. 0..1.. ... .....1\ ._ .1<:, ._, "'~..:. t., ".. ......... .: ,.. ,.""'.. t. ..... ",01.'"
0' WUI' " tho ....... Indl.o...., ,.. PO ......,\Mnt 0' R_ .111 1._ on 011I.,.1 .,..,_t (,... llIV'IMlIlCI - ..-I.t
If the nwm f,.. the "..lIt,r of MUll.
TAX RETURN - PART 2 - TAX COMPUTATION
LINE
,. Int., tho ..t. '110 .......t .,III..llv .., ..t...ll- ., UU'" In 'ho -' od.U", ,. .." ., _'h.
IIOta. ,,,. _t Owl", .ft.. 1lI1Z1IZl ......... ....1.. tho _t ..., In 1.ln' -, .ltIIln ... (\l VOO, .f _tII or.
t..llllO MIv II t,on,"'" _,. tho" I' ... ...lv,lon not to 0'- ....oa ..' "on,"'M ,_'.1'" .f tIIO ..I.. 0'
thI ...-rtt or th8 ""'1" of tlCl~U held.
If 0 _I' .,t.rI'" (.'l _" 110"" V"" II'" .- In tho ...'", po,Uon 0' tlllI noU... tIIO ...... ...lv.l...
.11"..... hll bMn cIeINCl'ed fl". the .....,t N1.... II reported bV the flntlMall In,Ututlon.
I. Int.r the totli ..1"" of the 'MlOW't lnoludlnl Intor..' NGrUlllCf to tM ..t. .f ...th.
J. The ,.,-', If the MGow.t the' Ii taM..II f.r NOh IUrvlvor ,. ..'.r.lned II foU"'''
A. Tho ,..._, "...,. f.' lolnt ...... ,,'11I11_"" -... -, "Itr to tho ",-'" _till
I OT.IDEO IV TOTAL NUKI€R OF
JOINT _a
lx..,lll A joint ....t ,..Itt.red
DIVIDED I' 10TAL IUIID lIP . 10' . ppCEIIT T.....L!
SIJIl\IIVINll JOI," -'"
In tM .- of the ........, _ tNO ottwl" ,.rlOnl.
I DIVIDED IT , J (JOI," _) OI.IDEDIV 2 (1\MV1UOOIl . ,I" . ... . 16.n C1""IM 'OR UCM IUOYIVllIlI
I. Tho ..,...., ......1. ,., .,.... .,..,.. vllllln ... V'" ., tIIO ..._'" _Ill tr ......,.. - b. tho ...-, IOlt hol.
In tru.' for 1ftO~1" lndlwldual(') (trv.t beneflcl.r""l
)( 100 . PERCUfT TA)(AILE
I .mDt:O'V 101'L.....Ell OF '1JIl\I1'11lO JOI,"
OWNERI OR TOUSl I!NEfICIARIEI
Ex_I., Join' ......,e r..It'tr" In tho _ 0' 'ho _, ... two otllO, ..'_. ... ","'11- .Ithln - - of _th ..
the .......".
1 DIVIDED IV I (SURYIVCl1t1) . ,'1 'IC UI . lOX nAXAILE FOR EACH 1UltV1VOA)
.. _ _t ....j.., t. t.. C11.. .l It ..'0..1..... .. ...\lI.lvl'" tho .......' ..1- (II.. U by tho ..'-, '<0011I1' (II.. Il.
5. Ent.r tM '0'11 .f tM dell" ... .....Uon. Uoted In ,.rt 1.
,. _ _, ""..,. C11.. 'l I' ..'...1..... bv ....t,..U'" tho ...." ... -..tI..., (II.. SI ".. thO -' ....1..' '0 ,.. III.. .l.
1. Int.1" the "'1""'.0'0 t.. rot. (line 7) III ..'....1"" _low.
A. '0' "'0' " ..... ....r'l'" ",., ",./94. tho ,.. ,.,.' ,., 'ron,"" ,. ....,.. .,. ,. '.11""
1. lite. .f ...th on or .f"1" "l/~ eni ..for' 1/1/" ~ r.to i. IX.
Z. o.t.. of ,.th on or .ftor 1/11" trl"o"'o to .,.u... will tMl to.ed .t OX tu ret..
Motl1 'or _,.. of dMth prior to 7111.. 're".fll"' '0 1ftOU'" oro taM..lo .t 'X.
I. 1'on"'" It U_I .._" Inol..I\'" ,.tho,. ..tIIO,. _. -'''' .,_11.'.... .....In.I...
...,.,'"1"'"1... .,....U. .... thOir I..... .n "M"'11 .t .1M penont (6X).
C. T,on,'."" 011 otho.. 1..,,"'1'" b"tIIO'. ...to,. ....1.. ....t. _ .... nl_ .,. '.....1. ., 1I1t- ..,_t (l1ll1.
D. If V'" _ tho "" "". '1.... _lIv _, ....U.....I. ,. tho -' In 'ho .,.. .,..1-,
I. 1llO _, ., ,.. _ (II.. Il I. ..,......... .. ",IU.IOI", 'ho -' "....10 (\1.. 'l b. tIIO ,.. ,.,. (\1.. 11.
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
AU....1. ...." InCI dedUCUon. .r. de,.r.IMII .. fOU..1
A. v... ,_lIv ... .._,Ibl' ,., ..-" ., tIIO .."to ....1..' '0 _lnl""U" b, 0 ..,_I ,.........'otl.. I' In..'lIolont
to ,.'1 tM dl!duCUb11 U....
I. You MlWlllv p.ld thl .-U .ft.r ..th of the cIICIden' end un fum1th ,rllf of ~,.
C. ....to 1101", .1.1.... ..." .. ....I.... MIO In hr' I. If ...IU_I _' Ii -. v.. .Ioln _r · \12" · 11., .,..f of
.-..nt II. be r.....t... bv tho PA _.ru.n' of "..,.,...
.., :.~:~:.:,;,~:~;:;~:~~~;,;~:~:;~:~~~~~~";;l~~~\\~.&\\~l~~~~R~~\~~~~~\~\~S\~~\~~\\~~\~:~t~~
"~,""'JI. It...."
'*
SCHIDULE G
TRANSPERS
'UASf '.,Nr o. TV'.
Guy Ki lmore
R
21-1997-0520
THIIIClIIDUU MUll II COM~ AND PlLID '''111 ANIWlR TO ANY 0' THI QUonONI ON THI RIYIRIISIDI 0' TNI COIlO INUT II 'IU
111M DIIC""IOH O' "0'"'' !IIClUIION I 101AL VALue I Oleo, I 8f'~\i.~rV.\
HUM'" ,....................... ....,. ' . ....._._01...... 0' AIIIT .~
INI ,y
1. High Yield Tax Exempt Mutual Fund I I
American Expreaa Financial Adviaors I
Alc 10115 0662682 6 002
13,020.252 shares -0- 58,859.33 1.00 58,859.33
2. High Yield Tax Exempt Mutual Fund
American Express Financial Advisors
Alc 10215 0662682 5 002
13,135.049 -0- 59,378.27 1.00 59,378.27
,
"
,
,
TOTAL ,AI.. _ on .... 7, .....,..Ioli.nl ,118,237.60
,,, .,. .... . ....." ...." .....oi .11..,. ., ...... ....,}
.132-
4
:1
i
FA03 R68356 $017 AS-OF ACCOUNT BAl,ANC~i INFO
, SCREEN: 10 NUMBER:
ACCOUNT: 0000 0011 5066 2682 6 002 p; 00015
LAST DB UPDATE: 6 04 1997 0; GUY KILMORE
ADVISOR NUMBER. . . .: 0068356
19;26:36 06/05/97
TYPE; LTR:
HYT S; 01 A ACTIVE
UNKNOWN
B; LOUISE MOWERY
ENTER AS-OF DATE WANTED:
SHARES OWNED...... . . . . :
ASSET VALUE PRICE. . . ..:
PRINCIPAL VAIJUE. . . . .. , :
PLUS ACCRUED DIVID:
GROSS VAWE. , . , . , . . . . . :
LESS CDSC AMOUNT. . :
LESS WITHHOLDING, . :
LIQUIDATION VALUE. . ...:
5 14 1997
13,020,252
4.509
58,708.32
151.01
58,859.33
0.00
0.00
58,859.33
FA03 R68356 $017 AS-OF ACCOUNT BALANCE INFO
SCREEN: 10 NUMBER:
ACCOUN'r: 0000 0021 5066 2682 5 002 P: 00015
LAST DB UPDATE: 6 04 1997 0: GUY KILMORE
ADVISOR NUMBER....: 0068356
19:27:01 06/05/97
TYPE: LTR I
HVT S: 01 A ACTIVE
UNKNOWN
B; BERTIE MYERS
ENTER AS-OF DATE WANTED:
SHARES OWNED.".....,.:
ASSET VALUE PRICE.....:
PRINCIPAL VALUE.. .....:
PLUS ACCRUED DIVID:
GROSS VAI,UE. . . , , . . . , , . :
LESS CDSC AMOUNT, , :'
LESS WITHHOLDING. . :
LIQUIDATION VALUE. ." .:
5 14 1997
13,135.049
4.509
59,225.94
152.33
59,378.27
0.00
0.00
59,.378.27
~(k ~('-::OIiIfi7'{ JiJ/./li()11/.5
Hi<'
""'ilur/./ 1/;611 ;ii.~
- --
1;~ t-Xtl/fl'r fl.l!'l'1>$,
.i !f.j/:J'
<' " ;/ "",II. .' C'F(J'
(~~Vll Sf' It l
4>>('/'1''10' E1<<.5$ '--1:;,('/,-/ fJlS~1'J
AOO-'04-97 !\ON \ 5 I 50
FAX NO, 7\79752850
P.04
.
Financial
Advisors
DlIpGtitloD for lIldlv\4ul o"..,.1I1p
"............-..""'... -.. -...-.....' "",..-"....-
IllCO\IIlt plOClle41.\yplcall)' pus \0 1110 bonoftcLarlfl naIIIocl at 1IIe lime of doalh.
--"'""" ""...~')...._,,_..---_.,
..._._.....,-..... ..........."._. ,""........ ,.,-,<a.-
............... - "............."..,.".. - "..,..., ,,-, ""~,.....
....-.-....."'''.......''''''.. --.-............ --,"
.., -.......... -, "... ....... ......"'...."...- '" -..-
............_..ALL --.......---....-........""...
}teet.ired DoeulDentl
In orclel' III take appropoalB stePS to settlo the accounlll we wil1 D..d 1hese docUments:
C.rtlfl&d peatll Certll\ellte
"........-...'" .--...... .....-..... --.......
tegtmr,
Eilate Settle....t Vontl (3248)
"-.......,,.............-.-.----..-......
_. ..- "",,4,",,' "..-......."'..-.... ",-" - -"-
also be COI1Ipleted. Wo wlU redeem tho at1l0unl mjUaslod on the date we nocalve IIld approve ~I docllDlenla
reqlllrod \0 eetllo 1IIe al;COunt.
Deatb ClaIDI Statement 1l0rlll (3304'1)
'1'0 procCSll a dealll claim on an aDI1II!ty orllee lns\lf1lllco lICcoUll1. thl& fomI mllSt be completed. Provide the
cleCcasecl'l cUenl lnfonna!iOll and account n\ll1lb&f, Choose a mode of lelllemont end complatl'l1lle beIIctle IarY
\nfonnat\OIIleetion. If IIDY of Ih1i \nfonnlllon Is incOlDplolO, the fonn will be re\lll'lled. If a tall wlrllhold\~&
...... ....- .,""_--"- ,.."........-.......
Income talltl. This fOl\ll DllIsl be witnessed by an American BXp"'IS Financial Aclvleor or nowlzed by a nolllY
Pllblle.
....-...--"..-......--............--.....-.
if yOIl have my qllestions Thank YOII.
BPI Title TtIlllrer
P.O. BOx 1211
M\lIfteapollli, MN 55440
612-671-4740
AllaQht1lCllll: Benefioiary Informatica
.---~.
.' --
In....~ end .nnu~i" '" ~lued ~IDS lite ~~,1oII Nmricen ElqIl$ tompanv,
15:.;16 " '/
IUREAU OF INDIVIDUAL TAMES
IMHl~.1.MCE 'AM DIVIS.ON
NP1. 11"0\
HARR...~Q, PA 1112..0601
COMMONWEALTH OF PENNSVLVANIA
DEPARTHENT OF REVENUE
c'
*
NOTICE OF I"HERITAHCE TAM
APPRAISE"f.NT, ALLOWAHCE OR OISALLOWAHCE
OF DEDUCTIONS AND ASSESS"ENT OF TAM
IU,lt4lU'" 1"."1
03"30"98
KILMORE
0~-14-97
21 97-0~20
CUMBERLAND
101
F-=~-~A.OU;;t RHittoT-1
MAKE CHECK PAVAILE AND REMIT PAVMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiiV': iiii1nX-APP-{09:i7Y-iiiificr-oF"YNHiiiiTANCi-TAX'WiiiIAiiiiMiiir;-AL.LoWANci-oli....----.....
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
GUV FILE NO. 21 97-0~20 ACM 101
LLOVD R PERSUN ESQ
METTE ET AL
PO BOX 5950
HBG
DATE
UTATE OF
DATE OF DEATH
FILE NUMIER
COUNTY
ACN
GUV
PA 17110
DATE 03-30-98
!!,TATE OF K lLMORE
TAM RETUR" WAS I C X I ACCEPTED AS FILED
I I CHANGED
RESERVATION CONCERNING FUTURE INTEREST " SEE REVERSE
APPRAISED VALUE OF RETURN lASED ONI ORIGINAL RETURN
1. R..l E,t.t. ISch.dul. AI Cll
2. Stock. end lond. ISch.dul. II C21
5. Clo..ly Hold Stack/P.rtn.r,hIP Int.r..t ISoh.dul. CI CSI
4. "od...../Not.. R.c.hobl. ISohodul. 01 C41
5. C..h/lonk O.paol hl"100. P.r,onol 'rop.rty I Soh.d<ll. E I C5 I
6, JointlY O.n.d Prap.rty ISohodul. FI 161
7. Tron.f.ro ISoh.dul. GI 171
8. Totol Au,to
NOTE I To in.ur. proper
orad1 t to your account,
.ubRlt tho upp.r portion
of thll forM with ~our
tax p.y..nt.
.00
157.035,76
.00
.00
10.682,24
29.231.84
118,237.60
181 _
315.188~
8.583.50
APPROVED DEDUCTIONS AND EXEMPTIONS I
~. Funaral E)(p.n.../Aa.. Coatl/HiIO. Exp.n... (Sohedule H)
10. O.btol"ort.... Llobllltl.,/Llon, CSohodul. II
U, Tot.l OoduoUono
12. Hot V.lue of T.. R.turn
15, Ch.rltobl./Gov.rno.nt.l l.quootO) Non-.l.ot.d 9115 Tru.t, CSoh.dulo JI
14. Hot V.lue of Eot.t. Subjoct to T..
191
1101
6.958.09
CUI
1121
1151
1141
lIi.1;41 1;1..
299,646. ~~
~OO.OO
299.146. ~5
If .n ........nt w.. i..u.d pr.viou.1Y. lin.. 14, 15 .nd/or 1'. 11 and 11 will
r.fl.ct figur.. th.t includ. th. total of ~ return. .......d to d.t..
ASIESSMENT OF TAXI
15, AMount of Lln. 14 .t Spou..l r.t. C151
16. Aoount of Lln. 14 t..oblo .t Lln..l/Cl... A r.t. 1161
17, A.aunt of Lln. 14 t..obl. .t Coll.t.r.l/Cl.,. 8 r.to 1171
18. Prlnolp.l T.. Du.
TAX CREDITS I
'AY"E"T
DATE
08-12-97
01-06-98
NOTE I
.00 M .00.
.00 M ,06.
299.146 ,5~ X ,15.
IlIl
,00
,00
44.871,99
44,871~
R~CElPT
N\Jl18U
AA211627
AA242620
OISCOU"T 1+1
INTEREST/PEN PAID C-I
2.105.26
.00
A"OU"T PAID
40.000.00
2.871.99
TOTAL TAX CREDIT
,BALANCE ~.!C DUE
INTEREST AND PEN.
TOTAL DUE
44,977 .25
105.26CR
,00
105.26CR
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
I IF TOTAL DUE IS LESS THAN .1. NO PAV"ENT 15 REqUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" CUI. VOU "AV IE OUE
A REFUND, SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS,I
0("'\
~': ;;,
','
I
f<J
Rf:lEItV'llONI I.t.t.. of deoldenh dwlnt on or '"'for' bttcMbtir 12, 1.12 ..: if anv future Int.r..t In 'M ..t.t. 'i.J tnn'f.rr.d
In pa....don or enJow.....' to ell.. . (001ht'n1) beMflalad.. of ttt. dlCI'eMn' aft,,. tM IllPlr.Uon of MV ..t.t. for
lUe or 'C'r V..r., the c..onwe.lth hereby ..pr.llh r...rv.. the tight to ",r.h. IInd ...... t,.lIn.f.r IntMrU~. talC"
It thl 1,-,'1,11 Chit' coolllt.r.U r.ta on InY luch future lnt.r..t.
_Of
NOUCEI To fu1f111 the r.qulr.Mntl of SHUon 21ltO of the Inhtr1tlnc. W\d f..t.t. rill lot, Aat Zl of 1995. (72 P.'.
S.ation 9140),
PAVtl!HTI Det"h thl top porUon of thlt NotJiC' and tub.it with :tour ply..nt to the bglU.r of W11l1 printed on the r.n,... II..
~-"ek. check at .on.y order Plvltbl. tOI REGI.TER Of' MILLI, AOENT
AEf'*D (CR)I A r.fund of . till or.dit, ""'leh WI' not r.qu..t.d Ofl the Tax ~.turn. ..y b. r.~.ted by folMlPllUng In "AppllOflUon
for R.fund of P.Mlv1wenle Inh.rltww:. Mld Elt.t. TeJIC" (REV-Un), AppllCl8Uonl .r. ,w.llAI. .t the Offlo.
of the R.gl.t.r of Will., 'nY of the ZJ R.w.nu. Ol.trlot Offlo../ or by ollllnl the .p.clal 24-hour
Inlwerlno ..rwlo. ~r. for for.. ord.rlnl' In P.nn.vlvanl. 1-100-562-2050, out.lde Penn.vlwlnla ~
withjn loc.1 H.rrl.bur, .r.. (717) 717-10'4, TOO' (717) 772-2252 (H..rlng rlP~lrad Only).
OIJECTlONSI Any par-ty in Int.r..t not ..thUed with the .ppreln..ant, .Uowane. or dhaUoMlnc, flf deduction., or ..........t
of tI.. ilnclucUnl dhcount or Int.r..t) .. .ho\!ln on thh Notlc. au.t obj.ct within .hcty ('0) day. of ru.lpt of
thlt HuUO' bYI
.-\!lrlHan prot..t to the P. Dlpart..nt of Aawlnu., lo.rd of .pp..I., D~t, ZII021, HarrhbUrg, PA 1712t11-1021, DIt
...I"..-tlon to h.w. the Il.tt.r cltitar.lnad at .udlt of the .ccount of the p.r.on.II'epr..."t.tl..,., OR
--apj;O).11 to the Orphan.' Court,
AIlIlIN
II1RAlIYE
C::QttRECTIOMII
Ftctu.l .ttor. dl.cov.r.d on thl. ......-.ot .hould b. .ddr....d 1n writing tOl PA O.p.rtaent of A'v,nue,
lunau of Indlv1dual TalC", AlTNI po.t h......nt Alvla\!l Unit, O.pt, ZI0601, Harri.burg, PA 17UI-U401
Phone (717) 717-'SOS. S.. pa.. 5 of the book lit "In.truotIOf" for Inherltanca TalC Aaturn for a Aa.ldent
o.cadent" (REV-1S01) for WI al(pltnlltlon of ..lnhtr.U....ly corr.ot.bla arrorl.
DIIC~T I
If WlW t.1C dut I. p.ld \!llthln thra. (5) c.l.ndar lonth. aftar thl dac.dant'. dllth, I flw. percent <SX) dllc~t of
thl talC p.ld I. ..Iow.d.
PENAlTVl
The 11~ t.1( .-nI.tw non-p.rtlclp.t1~ ~.ltY II oOMput.d on t~ total of thl t'M ~ Int.r..t ......ad, and not
p.ld beforl J.nuary 11, 199', thl Ur.t d.y aUIf th* .nd of the t'M 1I'l""..ty p.riod. Thil non-pertlclp.Uon
p.n.ltw It .,Pllllbl. In the ..... .~,. and In the the .... ti.. p.r led .. you would ."..1 tha taJIC end Intar..t
th.t hu bun ......ed .. Indlutad on thil noUo..
IH1ERflT I
Intlr..t It charg.d baglMlng with fir" dlv of daUnqu.n<lY, or "lna (,) aonth. and one (I) d.w fr~ the chltl of
dalth, to the d.ta of Plvnnt. laM" Mhlch bao... dalinq".nt blfotl January 1, 196Z b..r Intar..t at thl nt. of
,hi ('Z) perc.nt p.r ~ c.loul.t.d at a d.11y rllt. of .000164. All hll.. Mhlch bee... cMlInquant on and .ftar
January 1, 1911 will b..r Int"..t .t a rata which \!llll vary frel c.lendar v.ar to calendar v'lr with th.t rat.
IInr'IOlI'\CItd bv th4t PA O.p.rt...,t of R.....nue. Th. .,plh:lbl. Intar..t rata. for 1912 through 19')1 ar.,
'l!!! Intar..t A.t. O.lh Int.r..t factor !!!r Intar..t R.t. U.lly Int.r..t Factor
1912 ?Oi( .0001"1 1917 .~ .000llt7
191' 16~ ,000458 1911-1"1 11:< .00OSOl
I'" l1X ,000101 ,.., .~ .0012lt7
1"" 1Sl( .000lS6 1'9I~1"4 "1:< .000191
19" 10:< ,0002111 1"5-1"1 .~ .000Zit7
--lnt,,,"t I. calcul.t.d .. followlI
INTEREIT . IALA"CE OF TAX UNPAID X NUNIER OF DAVI DELINqUENT X DAILV INTEREIT FACTOR
~.Anw MoUe. luued .ftar the 11M beCOlte. delinquent \!llll r"UKt ." Int"..t c.1eu1.Uon to f1ft..n (15) d.w.
"vond the d.t. of th. ........"t. If P'IIMnt 11 aade .ftar the.lnt.r..t coaput.tion d.t. lhown on thl
NotlC., addltion.l Int.r..t ault be C111eu1.tld.
15 -I (r~ ._J}
IU"EAU bf INDIVIDUA~ TAMES
IHHERI1AHtE UK DIVISlot<
DtPf. 210601
HAR~lIIURO, PA 111Z..060l
COMMONWIALTH OF PINNSYLVANIA
DIPARTMINT OF RIVINUI
INHERITANCE TAl<
STATEMENT OF ACCOUNT
C--~
'*
,,'i'I'" U ,'~ IU.tfl
LLOVD R PER SUN ESQ
METTE ETAL
PO BOX 5950
HBG FA 17110
05-04-98
K ILMORE
05-14-97
21 97-0520
CUMBERLAND
101
\::-~.:.-r.;~!"ltt;d3
L__________-----
MAKI CHICK PAY AILE AND RIMIT PAYMENT TOl
DATI
ISTATI. OF
DATI OF DIATH
I'lLl NUMIER
COUNTY
ACN
, GUY
REGISTER OF WILLS
CUM8ERLAND CD COURT HOUSE
CARLISLE, PA 17013
HOTEl To In.ur. prop.r or.dlt to ~our .ooount, oub.lt tho uppor portion of thl' for.. with ~our t.. P.~....t.
CUT ALONG THII I.INE ~ RITAIN LOWER PORTION FOR YOUR RI!CORDS ~
illV':: i iiof - iiCAj:iji- r 03: 97j- - -- -- .iaii - i iiHili iT A'iic'E-i AiC si'AfiH'Etii- OF - AccouiiCii..- - - -.. -----.- - - - - -..-
I!STATI OF KlLMORE GUY I'lLI! NO. 21 97-0520 ACN 101 DATI! 05-04-98
-
THIS STATEHENT IS P"DVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN IELOW
IS A SUHHARY OF THE PRINCIPAL TAM DUE, APPLICATION OF ALL PAYH~HTS, THE CURRENT IA~ANCE, AND, IF APP~~CAILE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT I 03-23-98
PRINCIPAL TAX DUE, 44,871.99
PAYMENTS (TAX CREDITS),
-
DISCOUNT (+)
INTEREST/PEN PAID (-)
2,105.26
.00
,00
AMOUNT PAID
40,000,00
2,871.99
105.26-
PAYMENT
DATE
-
OB-12-97
01-06-98
04-16-98
RECEIPT
NUMBER
-
AA211627
AA242620
REFUND
o(/)
(.~:~
~
I{)
3cE
,')
~
~
" '\ ~
(\
,.l
.\
':t:.,."
\,J ;'/,
b ';)1
ow
~a:
-
co
I
~
~';!, .
.' .u
CJ:
---
~
44,871,99
TOTAL TAX CRI!DIT
IALANCI! OF TAX DUE
INTERI!ST AND pI!N.
TOTAL DUI!
. IF PAID AFTER THIS DATE, SEE REVERSE
SIDE FOR CA~CULATION OF ADDITIOHAL INTEREST.
( IF TOTA~ DUE IS LESS THAN 51.
HO PAyHENT IS REqUIRED.
If TOTA~ DUE IS REFLECTED AS A "CREDIT" (CRb
YOU HAy IE DUE A "EFUND, SEE REVERSE SI~. OF THIS FORH FOR INSTRUCTIONS. )
,00
,00
.00
PAVM€NTl
Detloh thi top portlon of thl, Notlol ~.Ubllt ~Ith yaur ply.ent ..de peYlble to thl n... Ind .ddr."
'printed on thl rlv.r.. .Ide.
If RESIDEtH DECEDENT ..k, chick or Manly order plylbll to I REGISTER OF WILLS J AGENT,
1'1 NOH-RESIDENT DECEDENT .0._ .an.ok or laney or.r Ply.blt tOI COHHONWEAl TH OF PENNSYLVANIA,
REFUND teRll . r.fund of . t.~ crldit, which WI' ~ot r.quI.tld on thl TIH A,turn, ..y b, requI.tld by co.,lltl", ~
"Appl10ltlon for R,fund of P.nn,Yl~.nl. tnh.rltenc. Ind E,t,t, tlM" (REV-ISIS), Application. .r. .v.ll~l. .t
th_ Offloe of thl R.,lItlr of Willi, any of thll n RIVlnu. Dhtrlct outo.. Dr froll thl o.Plrt..nt', 2ft-hour
.nlw.rtng ..rvlel nuab.r. for forn ordering, In pWVl,vlvant, 1-800-162-2050, autlla Plnn,yl",."t.
end wUnt" local ".rrllburg ar.. (111) 717-1094, TOOl (111) 17Z~225Z (H..rlng IIPair.d only),
REPLV TOI
Queatlona r.,.rdln, .rrora cont.ln.d on thia notic. .hould b. .ddr....d tal PA D.part..nt of Rev.nu., lur.1U
of Individual Tak.', ATTNI po.t A.......nt R.vl.w Unit, Dapt. Z10601, Harr11burg, PA I1IZI~0601, phonl
(111) 181~6!iOS.
DISCOUNT I
If any tlM due I. paid wlthln thr.. (1) cal.ndar ~th. aft.r the d.c.d.nt'. d..th, a flva parcant (SX) dJ.count
of the talt paId 11 allowad.
PENAL TV I
Tha 15X t'M aan..ty non~p.rtloipatlon panalty 1. co~putad on tho tot.l of tha tilt and lntar..t ......ad, and not
paid b.for. Janu.ry II, 19'6, tha flrlt dlY aft.r the Ind of thl tlk aMn..ty pariod.
INTEREST I
Int.r..t I. charg.d b.glnnlng with flr.t d.y of dellnqu.ncy, or nlna (,) aontha and on. (1) day fro. thl data of
d.ath, to thl d.t. of Ply.tnt. -rIM.' which blc", d.llnqu.nt blfor. Janulry I, 1'12 b..r lntar..t .t thl rat. of
.IM (6~) p.roant plr annua aalcul.tad .t . d.ily r.t8 of .000164. All tIM.' which bla'" delinquant on and .ft.r
January 1, 1912 ",HI b.ar Int.r..t at . rata which ",Ul Yary frol oalandlr y..r to calandar y..r with that rltll
announc.d by tha PA Dapart.ant of Rav.nu.. Th. appllclbll 1nt.r..t rat.. for 1'12 throu_1 1'9. ar.,
V..r Int.r..t Rata Dailv Intar..t Factor V.ar Intar..t Aat. Oallv Intar..t Feotor
1982 20:< .000!i41 198' ,% ,000241
1'as 16% ,00001 I .11 ~ 1991 11% ,000301
1984 11:< .00nOI 1..2 'X ,000241
1915 u:< ,000556 1"5~ 19'4 1:< .000192
1'8' ..X .000214 1995,'I'" OX .000241
~~lnt.r..t J. calculat.d .. followtl
IHTEREST . BALANCE OF TAK UNPAID K NUNNER OF DAYS DELINQUENT K DAILY INTEREST FAV'tOR
~.'ny Notlc. It.ued Ift.r the tlM b.eo..' d.llnquent will r.flact .n lnt.ra.t ealoulatlon to flfte.n (\5) da~'
beyond the date of thl .......ant. If pav..nt i. ..d. aftlr the lnt.r..t co.,utatlon d.te .h09Klon thl
NoUc., .ddltion.l Inbr..t .Utt b. calOLllatH.