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HomeMy WebLinkAbout97-00521 1::I/ClII' "l .I\In,yG. Hess. (l/SO kl/oll'l/ CIS ~ ~ PETITION H)R PRODA TE and GRANT 01<' LETTERS ~u\ - C\ ~ -=~c:IL No, To: ~;-,~~'~ ,:, "'179~12~4123' 80(/CI/ ,\1'<1/111.1 No, _~_..~....... ~.~_ [)('c('ased. Regisl('r of Wills for the ('OUIlIY of CUlllber1and...~.-.~~~ ('olUlIIonwc"llh of Pcltn~ylvnnia in the The pellllon of ,he' undersiglled respeclfully ,.cpre.Sl:llls Ihal: YtHl1' pctiliollCI'OU, who is/lfl' IK ~'l'ars. of a~' or old",!, an the l',\Cl'Ur_1x _._._~___ named In,he Insl will of till' ahow dC"(""'III. datcd __ .U.qustJ..19jl,9... . ~,_~~_,_, 19_____.. and ,'odidl!sl d:UJ;.dm ~~ '" .~~.,' ~ , ,u "".~ .~~~___..,_~.._..~.~~_~____ ~m~ .~.....'1~-~'-'~'"~::....~.~~'lI.\;>L&..L.b~LQ...~~:t...'I:......~~eQ..llo.lL _ 'D" 'U'.. ___(!l "t:>I....."l t', ,.. P ....:1. '- .5,\-"\"'1.'1._ ~. ..~_.~..~_..______ ("lali.' rl'k\anl dr\'ll!ll"laI1Cl'~, l'.IJ. r\'llllll..llllllltl, dl'Hlh of ('\l'cutor, t'IL) Decelldcnl w:i.S domidled al death 11I._..~C.llI!1".!!rJ~!lJL.~.., . ~~~. ('ounly. Pennsylvania. with Il.er-_~-. lasl filluily or prillc~al reside lice al .Chur,ch,J1LG.Q!luHQrrteu8Q1"...Han..over:_Street .LAl'Usle~.P-A~11013 .... ~m ()R,() Q f. (',8-Rkl:"ki;: ~~m.._~..~ ,.~_.~~~..~.. (II~! ~lrl'l'l, Il\llllhn and tlllllh:ipulilyj Deeeudelll, 11"'11 ~..,_93 . years of age, died ,June JO.J991n.., ..________. 19__. al . ~~___ ~ .~~ ~~__~~ ....... .~_~_ E,ccpl (Is follows. d,'\;('dclIl did nOlmarry, was nol divorced and did nol have a child born or adopte~ aflcr e\Cculion of Ihe will offered for probare; was nOllle viclim of a killing and was never adjudicated incomj1"'l'Ill: ~-.I,"",o.,,\v.. .... _~...,... ~'~"_'~'__"~'''__~'''''~~~ ~~~..._ [)cCl'ndl.'1l1 al dCHlh owned properlY with estimated values as follows: (If domiciled in "a.) All personal properly (If not domiciled in Pa,) Personal property ill Pennsylvania (IInol domiciled in PH,) I','rsonal properly In CounlY Vallii..' of renll.'staIL' ill Peilll"ylvania , situatl'd .1'> 1'011<)\\,<;: $ \'2..0 000 , $ $ L -0- .... ._---,-- ~-.-_..__._-----_..-~.._-._"--------- \\HLKI:HlKI'.. ,"'lilloncrOl) respe,',fully reqnesl(s) Ihe probal" of Ihe lasl will and codlcil(s) presclI,ed herl'w;,h alld lh,' granl of kllers~ ~!~s1Cl!J1.enta!"'y~..._~~_~._...__~ (ll'~larnl'lltar~'; udmini'ilrallOI1 C,I.II,; l!dmjni~trl\lion d.b,n,c.l.a.) 111l'101l. ~ " u~ '7 ..:..' -.- '- :X~ "Z ,~ :"l':: '. p >, ;; ~,~fl....~~~~~ " .. QQfoth..Y....A. . Rill1kJ.l1.... ..,. ~ . .,~~"_ 56 Old. Pi OIll:er..RQl!d Camp Hll1.J)AlZ011.._____. ,. ~-,-_._--~~--, -- '---~-_._.--'.. . -----------.--.--.... --_.._~~-_.._-_._-._----~---,,~ ... -..---------,.-. ...........-----.-.---.......------ --~. OATH 01<' PERSONAl, REPRESENTATIVE COI\lMONWEALTlf OJ! I'ENNS\'LVANIA I. ti8 COliN!'\' m'Cl!t16..~R.LANQ~..___n~_~ J The I'I.,ttliollcr('.1 ahove-nal1lcd s\\'earh) or affirm(s) thallhe stali.'lllCllh inlhc foregoing petition arc true illll.! l.:onl.'l'\ to IIH' hl'~1 or I Ill' ~nl1wk'dgc and hdicf of peliliollcr(s) and that as personal rcprescn- lati\'l'(<;) (If I ilL' ah(l\'L' dl'l'txlL'lll Ill'tithHll.'l'b) will \\'(,:11 and Iruly admlnhler Ihe estate according to I"w. S""'II Ii> "I' allil"llll'd and Sllbsrrl.I~"'d .,',Il, ,~,~, .,.n.. na,':I?~..J_ ~ be 1'" '''' IIH" I his n , . 1 7THjJ" " da~ of " ,_ ~ n.. ~~_~('~,.. "".~__m.._..~~~._ ~' ~. '.. (QUNi? ',nun 1J,'!.!l~.. ",' "'~______~_____ ~ .cr1wt.a~, /[/tr: ,L n ..___~_~~~__~ '" MA CLEWIS H,'gilll''', ~-~~ "_~__'_~_ 2 I i(\lc - 5 Thb is '" "'I,ir), Ikll .I", illr"lI1lilli,," hl'l\' gi\'\'1I is '''"''''\Y "'l'i\'oI 1'''11I "" ""I',ill,'\ ,,'II iii, ,,,,' "I oI\,,,,h ,Ii,h' likol \\'ilh 111<' '" Im"II(,'gislI,\1. Thl' "rigill,,1 "'llili"II" \\'ill I", 1"r\\""oI,'d 1<> Ih,' SI,IIl' Vil,'\ I(n<>''\' (lilln' 1<>' 1'1'1I"'"1<'11 lililll'" WARNING: Ills Illegal to duplloate this copy by photostat or photograph, ~~~ h.~,t!)r thh tndllc,Hl', $l,{\O ' 4276570 --.-----~.__..--~._._.-_._---~.,,-....... No. ,_JO{iiiiiiih"iii,-., ,l'~~\'~ Of n:;;7"-, (,"~~., ,', ,<'J",.~' ~'I~~,'., ",'?:.' i,." ' ' \1; I ~ jj; . '~, ;,;> 1/", ~ ~ .. , '. /~I . ~'---_. .-~\\' ~;"f~ 1i1.~ ~'<i,~"" ~~~ "UN t 2 1997 ___..~__~_.._......-w.f_"~_'~_'__~~~"'~' lhtl' , OO",~HW""Lttl 0' "NN'YLVANI~' oEPARTMINt 0' HIALTH. VITAL RICOROI .' ' . CSRTIFICATE OF DEATH I:~I;;;:,"::';~~~"":~~. ' __ _ \~.o.1,'lfMtl ! ~,.. _D ~IO ._ .__ .-....-.cl.'ll/l'IIM...., ,-' , ,. , '" Vd' \JII' HO:611 ~;I;I.' )0 ,. ~"~f,,~'~ ~~:___~;!i~~~t~:rr'~"'t.-",- \, "'1' "un:) :lIillO L~ Nnr L6, ~ :'t1 " l)e!:J lio, Fl' 01 97 JUN 17 IllJ :OS, Cle,: Curl, ,1ft Pf\ ,- l/, oj' f i_" .,' I' .-' . t J .' JIn.t ~iU nnh '<<Ie.tument of !!!.LG. HESS I, AMY G. HESS, of l.ower Tlllen, Cumberland County, Pennsylvania, being of sound mind, memory IInd understanding, do make and publish this, my Last. Will and Testament, hereby revoking and making voi~ all former Wills by me at any time heretofore made. !!!Yl.!! I direct my her<'\nafter named Co-E.lCecutors to pay all my legally enforceable debts, funeral expenses. administration expenses and inheritance, estate, succession or excise taxes, which I owe or may become due on account of my death, liS soon liS may be convenient after my decease. SBCONDI I give, devise and bequoat.h all of my property, be it real, personal and mixed. whatsoever or wheresoever the same may be si t~late at the time of my death to my husband, RAY R. HESS. if he survives me. THIRD I In the event my husband, RAY R. HESS, predeceases me or fails to survive me, I give, bequeath and devise all my property be it real, personal and mixed whatsoever and wheresoever the same may be situate at the time of my death as follows: A. Twenty-five percent (25%) of my estate is t.o pass to my husband's grandson, ROBERT K. REITZEL, if he survives me. If ROBERT K. REITZEL predeceases me, I direct that his share of my estate shall pass to his issue per stirpes. B. Twenty-five percent (25%) of my estate is to pass to my husband's granddaughter. CAROL BECK, if she survives me. If CAROL BECK predeceases me, I direct that her share of my estate shall pass to her issue per stirpes. c. Fifty percent (50%) of my estate is to pass to my daughter, DOROTHY A. RANKIN, if she survives me. If DOROTHY A. RANKIN predeceases me, I direct that her share of my estate shall pass to her issue per stirpes. FOURTH I R. 81>&8 and my I nominate. constitute and appoint my husband, RAY daughter, DOROTHY A. RANKIN, as Co-Executors of this, Page 1 of 2 Pages ["~ )J 1it~ } ISEAL) AMY G. HESS .' '.' my La$t Will and Testament authorizing and empowering them to sell and convey any and all real estate which I may die seized and possessed. I further direct that if either ono of my aforesaid-named Co-Executors would predecease me, the survivor of RAY R. Il1~SS or DOROTHY A. RAHlll1 will act as my Executor. In t.he event. my husband, RAY R. HESS has predeceased me and my daughter, DOROTHY A. RANKIN, has predeceased me, I nominate/ constitute and appoint ROBERT I. REITZEL as Executor of this my I,ast Will and Testament. I hereby furt.her direct that my within named co-Executors or personal representative shall not be required to post bond to acte in said capaci ty. . , I I \ \ \ I \ \ I \ ~ ;\ ~. I I I I I I ! IN WITNESS WHEREOF, J., AMY G. HESS/ have hereunto hand and seal to this/ my Last Will and Testament/ this ~LJ~~ ' A.D., 1989. SIGNED, SEAttO, PUBLISHED and DECLARED by the above- named Test.atrix, AMY G. HESS, as and for her Last Will and Testament, in the presence of us, who at her request and in the presence of each other, have hereunto set our n e as w)tnessesl set ;; 'I- day of AMR~s J!, AA4J.)\SEAL) ,....' t.~;.I,{U,;}' j....../ I I I Page 2 of 2 Pages . -~ , ~jL !!, -_-t" 1 'i!H i," i _~ --', -- t; ; .. i_;-j "q , { \ ;~-_ f-, ;" d_ ~, 1L ,-- !.'~ , ,{,-- hr"o '~'i '-I q hj ~ ! t, !, r: ._"f' dO: ,--, , I' ,- ReGl, :'_!\ :1\ Hi _h\\~ '91 jU\-\ '11 ~9 ~l)8 ! I .'1(\ I O\Oi , , (' . t ~ 1('/\ fUrl' .. I, ;-' I I It' , -'1 " -j f;."' L- 'I, ',-, , )\' ~ -, 1'''- A --in ~ ! ',I ... .. ( ~ - I S-(, . t>- INHERITANCE TAX RETURN ~C~~8:~!f~FD~JMUER 1:1131111 €.~ RESIDENT DECEDfNT POVERTY Jh~L~~!~!~~!'il-___ COM"ONWLnw, OF ","",VLVAN,A (TO BE FILED IN DUPLICATE FILE NUMBER D'rn"'D~~~,T,~:::,~VENU' WITH REGISTER OF WILLS) 1997-521 1997 21970521 "An'''SII''"O,"A '''''''6<'' COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, A,ND M'DDLE INiTIAL) --~ -~ [ID, ECEDENT'S COMPLETE ADDAESS- Hess G. O1urch of Gcd fbm SOCIAL SECURITY NUMBER DATE OFDEATfi-lDATE OFBIRm 801 N Hanover St. CarUsle, PA 17013 DECEDENT 179-12-4123 06 10/97 . JQ5/30/1~~04 C_m"lIl'~S.\1lroerland . ~~IFl~:~ ~~1~~h~b{~ ~~lrIIA(l'~ OUJ['3 Ill.., SOCIAL SECURITY NUMBER AMOllNT RECEIVED (SEE INSTRUCTIONS) 14 N.t V~". SUbl.ct'o Ta, (Lln. 12 mlnu, Lln. 1~) 15, Spouul r',,"sl,rs (IOf datu of duth alt.r 8-]O.9"). !iIUI Iflstrwellons 101 Applicable flercentage on ""0' '1. (Includ. valuUfromSchedul.Kor5chldul.M.) 16. Amount 01 Uno 14 lal(ablo al 6% rale (lncludo values from Schedule K or Schedule M.) 17. Amounl 01 L1no 14ta)(ablo at15% rate (Include valuos from Schedule K or Schedule M.) 18, Principal ta, duo (Add t..l,om Line, 15. 18 and 17.) 19. Credits Spousal Poverty Credit PrIor Payments Discount Interest + 6,444.00 + 339.00 - 0.00 (19) 20. II LlII. 19 I, rea'.r than Line la, enler Ih. dlNerenc. on Linll 20. Thl' Is Ille OVERPAYMENT. (20) A. Chod h'" H yOU...treq.....hll. rtful1C1 alyo~rCW.rJI*ym.nt I 21. II Uno 18 Is groa\~r than LIne 19, enter the dlfferonce on Une 21. This Is tho TAX DUE. A. Enter the Interost on tho balance due on Une 21A. B. Enler Ill. 'alai 01 Line 21 and 21A on Lln. 21 B. Till' I' tll. BALANCE DUE. M.k. Check P'V.bl. 10: Regl.lor 01 Wlllo, Agonl : ".\ '. . ..... Ill! SURETQ ~WI!R AU. QUl!lIlTlON9 ON P~E UNDlO REOHECl< MATH .....:. .:: i:.,\, - Under pon.llies 01 perjury, I declaro thai I have 9Mamlned this return, Including accompanying schedules and statemenls, and to the best 01 my knowledge and bellel. It Is true, correct and complele. I dochuo thai all roal oslato has been reported allrue market value. Declaration 01 proparer other Ihan the personal representative Is basod on all Information 01 whIch prepa,or has any knowledge 51~:l!RE ~~/RSON~ES~0.Y711LE FOAJILlNQ AEW'lN ADDRESS AJI.6~!. {, 'ff.Y.l....,.<..);U...-v' See Schedule attached_ SIGNATURE OF Ef'ARF.ROrHERHlAN AEPAfSENTArlVE ADDRESS 56 Old Pioneer Road Canp Hill, PA 17011 fUI/-UOO f,l(. (1.0.l CHeCK APPRO- PRIATE BLOCKS CORRES- PONDENT REOAPIT- ULATION TAX COMPUTA" TION PAlSOOI Supplomontal Ftoturn u~ 05 Fedor.' Eal.te TlIJ( Relurn R.qulr.d TB 1, OrIginal Relurn o 4. limiled Estale 0 48. Futuro I"torost CompromISe (lor da,es 01 d.ath a<<.r 12-12~82) ~ 6, Decedon! Died Testate 0 7. Oocodonl Malntalnud a living THISI (Mach copy 01 Will) (Mach copy 01 Tru.I) ALL COflRI!8PONDENCI! AND dONFIO.EN'liAL TAX IN"~"'A'tION 8t1OULOBE DIRI!CTliD 10:. .. j NAME COMPLETE MAILING ADDRESS D:Jrot A, Rankin 56 Old Pirneer Road TELEPHONE NUMBER Canp Hill, PA 17011 717-761-8560 1, Real E'Iale (Scll.dule A) 2. Slacks and Bonds (Sohedule B) 3, Clo,ely H.,d Stock/Partnership Inl...,I (Sch. C) 4, Mortgag., and Nol.' Rncolvebl. (Sch.dul. D) 5, Cash, Bank Oaposils & MIscellaneou9 Personal Property (Schedul. E) 8, .Iolnlly Ownod PropOF1V (Sch.dule F) 1 Tran,Ie" (Scll.dul. G) (Schedule L) 8 Tota, Gross A..el' (Iolal Lln.s 1-1) 9. Funeral Exponses, Adlnlnlstrallve CoSI~, Mlscellanoous E'p.n,es (Scll.dul. H) 10. D.bts, Mortgag. Llabilllle" LI.ns (Solledu,. I) 11. TOlal Deductions (lola' Line, 9 & 10) 12, N.I Value 01 E,ta'. (L1n. 8 mlnu, Lln. 11) 13. CI,arllabl. and Govemmontal Bequest' (Scll.dul. J) Aftmalndel' Anturn (101 dllltl of d.llh priM to 12~ 13~82) 1 8. Tot., Number 01 Sal. Deposit 8o,.s (1) (2)__ (3 ) (4 ) (5 ) Nct1e Neale Nct1e Nelle 124,947.00 (8 ) (1 ) Nct1e Nct1e (9 ) 124,947.00 (9 ) 10,538.00 (10) 1,356,00 11,894.00 11~,053.00 Nctle (1'1) (12) (13)_ (14) 113,053.00 (15) , . . (18) 113 , 053 .00 , 6,783.00 .OS . (11) 0.00, 0.00 .15 :I (18) 6,783.00 6,783.00 (21) (21A) (21B) 0.00 0.00 0.00 0'0"7 I() "f /9 '7 DATE Copyright Form~ Soltw~'1I Only, 199<1 Nelco. Ino. N94PAOO I NTF 6679 CoroSlalos Bank, N,A. PO ao, 7616 Phlladolphia PA 19101.7616 August 12. 1997 I CoreStates Bank Dorothy A. Rankin Executrix 56 Old Pioneer Road Camp Hill, PA 17011 RE: Estate of: Amy G. Hess Date of Death: June 10, 1997 Dear Dorothy Rankin: In response to your leiter, please be advised that the dceedent held the following account(s) with our bank as of the date of death: DATE DATE DATE OF DEATH ACCR. ACCOUNT /I ACCOUNT TITLE OPENED CLOSED .eA.J..AliCE lliI. Safe Depo~it Box Amy G. Hess or 07/24/96 59800006161 Ray R. Hess Certificate of Deposit Amy G. Hess or 01/03/95 01/06/97 200071114-5489241 Rny R. Hess Closing Balance: $11,290.27 New Certificate of Deposit #5973470 Certificate of Deposit, Amy G. '.Iess or 01/03/95 01/06/97 200071114-5489242 Rny R. Hess Closing Balance: $11,290.27 New Certificate of Deposit #5973470 Certificate of Deposit Amy G. '.Iess or 01/03/95 01/06/97 200071114-5489243 Ray R. Hcss Closing Balance: $9,285.75 Ncw Certificate of Deposit #5973471 Certificate of Deposit Amy G. Hess or 07/02/96 6,231,n 331.50 200071114-5591129 Ray R. Hess Certificate of Deposit Amy G. Hess or 07/02/96 6,231.32 331,50 200071114-5591134 Ray R. Hess Certificate of Deposit Amy G. Hess or 07/02/96 6,231.32 331.50 200071114-5591135 Ray R. Hess Cel1ificate of Deposit Amy G. l'less or 07/02/96 6,231,32 331,50 200071114-5591136 Ray R. Hess 9497 (12194) Dorothy A. Rankin Executrix Page 2 August 12, 1997 ACCOUNT # Certificate of Deposit 200071114-5591137 Ccrtificate of Deposit 200071114-7052359 Certificate of Deposit 200071114-7052367 Certificate of Deposit 105938742-5750761 Closing Balance - $\ 0.173 ,95 Certificate of Deposit 105938742-5750762 Closing Balance - $12,739.65 Certificate of Deposit 105938742-5973470 Opening B~lance - $15,933.\ 5 Certificate of Deposit \05938742-5973471 Opening Balance - $15,933,15 , Checking 0063001279 ArCOlJNT TITLE Amy 0, Hess or Ray R, Hess Amy O. Hess or Ray R. Hess Amy G, Hess or Ray R. l'lcss Amy G. Hess or Ray R, Hess Amy G. Hess or RllY R. Hess Amy G, Hess or RllY R. Hess Amy G. 1.less or Ray R. Hess Amy G, Hess I trust that we have been of assistance to you In this matter. Sincerely, CORESTATES BANK.N,A. I D~~~r~;; ~~~~~I- (1'\ ~I~,~Q , DM/hb IN REPLY RErERTO: ~':::o;JC:R'T\NG SERVIOES \'-,- .- . ') ..".,~ ;"'. .-)~qU'';_}.I..~;j ,,-., " ;"( \'Y' "-u 1:-1,), 1'0"', 0') ,yo .'\f',.\i('\ Uf\ 1960" ......_ ""'\ ,-It I..." r", '-:\~ii55-J537 DATE DATE DATE OF DEAHl ACeR. OPENED. CLOSED BALANCE 00.. 07/02/96 6,231.34 331.50 06/29/92 15,893,23 932 ,89 06129/92 15.893,23 932.89 10/29/96 ' 02/28/97 10/29/96 02/28/97 01/03/97 01/03/97 04111/91 , ..... \5,933:\5 JS9.31 \5,m,15 359,31 9,412.91 . 6,563.00 l~~"'''D4lJ.,'''(...;;ar..., -....... I ........... mlllllM ....... on Solltdule DUCRI1"T10N VALue AT DAll! OPIlIATH ~- 1 CoreStates Bank Certificate of eepoeit 200071114-5591134 Date of death b!llance .. 6231.32 Accrued interest" 331.50 6,563.00 2 coreState9 certificate of DepOSit 200071114-5591129 Date of death b!llance " 6,231.32 Accrued interest.. 331.50 6'/563.00 3 coreStates Bank Certificate of DepoSit 200071114-5591135 Date of death b!llance " 6, 23l.. 32 Accrued interest .. 331.50 6,563.00 4 CoreStates Bank Certificate of D!pOSit 200071114-5591136 Date of death b!llance .. 6,231. 32 Accrued interest.. 331.50 6,563.00 5 CoI'f'.sr.ates Bank Certificate of r:epoeit 200071114-5591137 Date of death b!llance .. 6,231.34 ACrUed interest ~ 331.50 ,16,826.00 6 corestates Bank cp..rt.ificate of DepOSit 200071114-7052359 Date of death value .. 15,893.23 Accrued interest.. 932.89 ;1.6,826.00 ,7 corestates Bank Certificate of DepOSit 200071114-7052367 Date of death value .. 15,893.23 Accrued interest.. 932.89 16,292.00 8 corestates Bank Cettificate of DepOSit 105938742-5973470 Date of death value ..15,933,15 Accrued interest 359.31 16.292.00 9 Corestates Bank Certi.ficate of DepOSit 105938742-5973471 Date of death value .. 15, 933 .15 Accrued interest.. 359.31 Total fran cantinuatial (s) 25 896.00 124,947.00 s .. teen value at Olte No. oescriptia\ of Death . ,- -- 10 e::>>:eStates BlII1k ~ l\C(lOJIlt 9,413.00 0063001279 Date of death IJe,lar1CIl . 9,412.91 11 ~ TrUSt CCl1Y,"llJI1Y SaVinJS J,CCXUlt 1,015.00 3-034727 Date of death balaJ1ClI . 1,014.70 12 ec sank Certificate of oeposit 7,734.00 31800077548 Date of death I:Jala1'1Cl' . 7, 723 . 52 ~ intexest . 10.87 13 ec sank Certificate of oepoeit 7,734.00 3130007'7981 Date of death ~ . 7,723.54 ~ interest,. 10.87 .' ',,' 25,896:00 ~. (car.tY foxwcu:d .to main schedUle) f f Ii f f n ~ / :.'):-l.j6;;~ < ~.- 'U"EAU 0' INDIVIDUAL TA~ES U*,JUUNCl IAI( UIVIlIOH IM:Pt, ~'O.,OI H.MMIS'~O, PA ltlZft.ObOl COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE * L/ NOTICE 0' INHE"ITANCE TA~ APP"A[SE"EHT, ALLOWANCE 0" DISALLOWANCE 0' DEDUCT[ONS AND ASSESSHENT 0' TA~ tn.l'" u In Itt."1 12-15-97 HESS 06-10-97 21 97-0521 CUMBERLAND 101 r'o Aoount "..Ittod ~ r ~ .~ MAKE CHECK PAYABLE AND REMIT PAYMENT TOI REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOP. YOUR RECORDS .. RIV: iAiij -iii - AF' - i 'iF 97T -NOTi CEo -liii-YN'Hiii i f ANC! -TAX - APiiitiiisEHENr;. AL:i."liwAi(cE - oli- - -- - - - - no. - - - -- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX AMY G FILE NO. 21 97-0521 ACN 101 DOROTHV A RANKIN 56 OLD PIONEER RD CAMP HILL PA 17011 DATE ESTATl! OF DATE OF DEATH FILE NUMBER COUNTY ACN AMV G DATE 12-15-97 !STAn OF HESS TA~ "f.TU"H WAS' C X I ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. "..I eotato ISchadulo AI 11 I 2, Stock' and 'ond. CSch.dul. '1 121 5, Clo..I>> H.ld Stock/P.rtn.r.hlp [nt.r..t ISch.dulo CI CSI 4. "art,a.../Not.. Receivable (Schedule 0) (4) S. c..h/lank O.pollt./Hlsc. Parlonal Property (Schedule EJ eS) .. Jointly Owned Property lSchadul. FJ (6) 7. Tranlfarl <<Schedule QJ (7) .. Tot.l, A..oh I CHANGED HOTEl To in.ura proper credit to your acoount, IUbMit the upper portion of thil for. with your tax pay...nt. .00 .00 .~ .00 124.947.00 ,00 ,00 lal _ 124,947.00 APPROVED DEDUCTIONS AND EXEMPTIONS: .. Funeral. Expen.../Adn. Costs/Hilc. Expen... (Schedule Hl 10. D.bt,l"ort.." Liobllltl../Lionl ISch.du10 [I 11, Tot.1 D._Uono 12. N.t V.luo of Tal ".turn IS. Ch.ritobl./Gov.rnoontal '.quo.tol Non-.I.ct.d 'liS Truot. (Sch.dul. JI I~, Hot Valuo of hhto Subj.ot to T.I 1" \101 10,53B.00 1.356.00 Ill) C121 1151 1I~1 11.&04 no 113,053.00 .00 113,053.00 If .n ......m.nt w.. i..u.d previou.1Y. line. 14. 15 and/or 1'. 17 .nd 11 will r.flect figur.. th.t include the tot.l of ~ return. .......d to d.t.. ASSESSMENT OF TAXI IS. AMount of Line 14 at Spoulal rat. 16, Aeount of Lino 1~ t.lobla .t Lln..I/CI... A r.t. 17. Anount of Lln. 1~ t.loblo .t Coll.t.raI/CI.,o . r.t. 18. Principal Tax Due NOTE I liS 1 \161 1171_ ,00 113,053,00 .00 ~ .00. ~ ,06. ~ .15. 1111 .00 6,783.00 .00 6,783.00 TAX CREDITS: PAYHENT DATE 09-04-97 O[SCOUHT C" [HTE"EST/PEH PA[D C-I 339.15 AHOUNT PA[O "ECElPT NU"IU AA24220B 6,444.00 TOTAL TAX CREDIT BALANCE OF TAX DUE -~--' INTEREST AND PIN. TOTAL DUE ._~_, 7B3...Y -I .1 5CR-I .~ .~ . [F PA[D A'TE~ DATE [ND[CATED, SEE "EVE"SE 'D" CALCULAT[OH 0' ADDIT[ONAL [HTE"EST. [, TOTAL DUE [S LESS THAN fl, NO PA'HENT [S "EQU["ED. IF TDTAL DUE IS "HLECTED AS A "C"EDIT" CC"'. YOU HAY 'E DUE A "E'UND, SEE "EVE"SE S[DE 0' TH[S 'O"H '0" [NST"UCT[ONS,I ('--,I Lh ,,-;' ~ _.1 RESERYAltONI Ett,t,. of deoedent. dying on or b.for. D.o.~er 12, 1.62 ~H If ~,y future Int.r.,t in tne ..t.t. I, trln.f.rr.d in po.....ion or 'njoy~.nt to el... I (oolllt.r.l) beneflol,rl.' of the d.eedlnt Qft.r th"Mplra'lon of,"Y ..,.t. f~r llfl or for Yllr" the Co..onw.alth hlrlby l~prl,.lY r.c.rvI' the right to IPpral.. ~d ..,." tran.f.r Inh.rltano. T'~I' .t tnl llwful Cia.. a (eolllteral) rltl on any ,ueh future Intlrl.t. P\lllPOSI! Ol' HOTJCE~ To fulfl1l thl rlquJrt~.nh of 5....tlon 2140 of the Inhttrltanol and E'htl h~ Aot, Act 21 of 199'1. (72 P.S. Saotlon 91ttO), PAYMENT I Oataoh thl top portion of this Hotlea and .ubalt with your pay.ant to tha Regl.tar of ~11I. prlntld on the rav.r.e .Ide. uHake chick or .onlY ol'd.r payabll tOI REGISTER OF MILLS, AGENT REFUND (tR): A refund of a taM r,r.dlt, which was not r.quI,tld on th~ Ta~ Rlturn, .av ba raque.tld bv COMPlltlnl an "Application for Rafund of Pannlylvanh Inhlrihnel and Eltat. Ta~" (REV-UU)' App!Jeat1on, ara IIvalllbl. .t the OffiCI of the Rlllltar of Will., anv uf thl 23 Rlvlnua Olltrlct OffiCI., or by cIlllnl thl .peclal 24-hour anlNerlng .ervlee nu.berl for for'l ordaring: In Penn.ylvanla 1-800-162-20'101 out. Ide Pann.ylvanla and within local Harrllburg araa (1171 187-8094/ TDD. (717) 172-22S2 (Hlarlng IMPalr.d Only). OBJECTIOHS: Any plrty In Intarllt not .atllfl.d with th. appr.I..~ent, ftllowancl or dl.allowlnca of deduotion., Dr a"I.._ent of t.x (Includln, dllcount ar Intlra.t) a. ,hown on thl. Notlel MUlt obJaot withIn 11Mtv (60) dlY' of t,cllpt of thlt HoUCI bYI "-wrltten prote.t to the P. Dapart..nt of Rlvlnua, Board of .pp..l., Dapt. 281021, Hlrrhbur", PA 11121-1021, Olt -.II.ctlon to hive tha M.tt.r datar.ln.d at audJt of the account of thl perlonal rtprl.entatlv., OR --appaal to tha Orphln.' Court. ADMIN ISIAATlYE CORRECTIONS I flotual arror. dllcovarld on thl. a,..,..ant Ihould be addr...ed in writing tOI PA DIP.rt..nt of Alvenul, lur.au of Indlvldull TIXI" AITN: Po,t ',SII..lnt Rlvl.w Unit, Dlpt. 280601, Harrl'burg, PA 11121-0601 Phona (117) 717.6~OS. S.a plgl 5 of thl booklat "tn.truetlon' for Innarltancl TI~ R.turn for a RI.Ident Dlcadlnt" (RfY-U01) for an IlCplenat10n of adMlnhtratlvl1Y corractabll Irrort. DISCOUNT I If lIl'Iy tllC dul h p.ld within thrl. CU eallndlr aonth. afhr the dlcedant', dlath, . flvI percent '.SiD dhcount of t~ t.1C plld I. IlloWld. ~HAL'rVI ThI lS~ tllC 1'MIltV non-parttcJpatlon penalty I. CPMputad on thl total of thl t.~ and Jnt.rllt ..'....d, end not plld before Jenuary II, 1"6, tha flr,t dcy .ft.t the end of the tax ..na.ty p.rlod. Thll non-participation panalty I. epPlalabl. In tha I.~I ~ann.r and In tha tha .1.1 tl.. p.rlod .. you would apPlal the ta~ and Intlr..t that ha. bien .....I.d al Indlcatld on thil noti~.. INTERESTl Intar..t I. chargld b..lnnlng with flr.t dlY of dallnquencv, or nlnl (91 .onth. and on. (1) day frol thl dete of d..th, to thl d.ta of pev..nt. TIICI. which bao'M' dallnqulnt before J.nuary 1, 1982 baar lnt.r..t at the rat. of .IIC (6%) perclnt pet InnUM calculatld at I dally rata of .000164. All ta~M' which bICI.I dallnqulnt on and aftar January 1, 1982 will baat inter..t at II ratl which will vary fro. clII.ndar year to oalandllr Yllr with that tatl announced by the PA Oapart..nt of Aavlnul. Thl appIlcabl, Intlr..t rat.. for 1982 thtough lnl aral !.!!l Intlr..t Aat. OIUy Intar..t "actor ~ Inter..t Alta Dallv Inter..t factor I98Z 20;': .000S41 1911 .. .0002't7 19n 16;': ,000ll3e 1't8~1991 11% .00031)1 1m IIi!: .000301 1"2 ,I- .000241 1'" U% .0003S6 1993-1994 1'1. .000192 1986 10% ,000214 1995-I,n 9% ,000247 --lnta"lt it Cllcula'ad .. followll INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR ."Any Nottea IlIued .ftar thl ta~ beeo",.. d.lInquant wlll rafllct an Inter..t calculation to' flft.an (IS) dll'" bavona the data of the ft.sa.IM.nt. If paYMant II ..da aftlr the Intara.t eOMPutlltlon data shown on thl Hotlca~ additional Intara.t "ult'ba cal~ullt.d.