HomeMy WebLinkAbout97-00597
PETITION FUR PROBAn; IInd GRANT (W LETfERS
&llIle of _.J..:.gl''Ii!l-JI-,-.I.c~('i'~ll1!l..---.._- No, .-ll.'=-j.9.lL7.~{) ~_i7_..__
11140 known liS _--... ...._'__. ,.__. To:
__._......____.....__.___... Rcgister of Wills r"r the
. _____ __ ._._..., /lecea"ed, County of __iJ-".0.:1}"urJ nlHL in the
Social Security No, .lL..G.-.2J~_,-l':: _ Conllunnwealth of Pennsylvania
The petltlol\ of the undersigned respectfully represents that:
Your petltioner(s), who Is/are 18 years "I' age molder an the e~ecutJ.'.t,::.__, n!J,\ed
In the last will or lh.. above decedent, dated .______,-"".I.l!;:I.'U:.-~,:..l.------ ,19 L-
and eodlcll(s) dated -.-.....---......-.-.------..'..'---' --..--------.-.-.-..----
______..______,.._'..n___....__.~..~..__.._~~.w~__.^'
---_._-_._~._---.,"-_..__.."..,._------~...._~,.._.__...
_____.________.~~_~_..,.___._ ___________..___._.,~_~~___..,__4
(!fillet relevllnt cirClll1dll1llCeS, e,', renunciation, death of utCllIOf, etc,)
Decendent was domiciled at dcath In ,___..9.::y:b:;:('1 [),115L-_. -. County, Pennsylvanln with
h_i~L___ last family or principal residence at .._~~ 11 \L9i.::L_,; rC[n...J.l.hLJ "l.!.' \ lU r\.lQ.!:ibuX'[;,
l',~ l'iS)l',". __.....__.__..____.~....._,_________._._.,_._____.
(lIst 'ilrect, l1uinber and mundpalllY)
Deeendent, thcn __._(:{,....._. yellrs or lIge, died _.;~-13.L__.--------, 19 07
at____...___---~----..-.---_.--.,----.-..----..-.. -'
Except as follows, dccedent did not marry, was not divorced lInd did not have a child born or adopted
after execution or the wllr offered for probate; was lint the victim of a killing and was never adjudicated
incompetent: _____.-..___,._.____...______.____
Decendent at death owned property with estimated values as rollows:
(If domiciled in PlI.) All personal property
(If not domiciled in Pa,) Pcrsonal property In Pennsylvania
(If not domiciled In I'a,) Personal property In County
Value of real estate in Pennsylvania
situated as follows: ___~.___.__,.pono
$.. ~~O. 000,00
$_
L
$
--------<,--~ --..,-'
WHEREFORE, petitioncr(s) respect fully req~~st(st the probate of the last will and codieil(s)
pr.,ented herewith and the grant or lellers__- .1. Sf! vlU!Jontar.:y_. ..
(tt.slamentary; admlni,tratlol\ c,I,;\,; administration d,h.n,c.t,a,)
..._----~.-~_._-------_.
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OATH OF PERSONAL REPRESENTATIVE
gg~~T~N~:~L~~Ti~:~' l~~i~)NSYl.V ANIA .. } 88
Thc petitloner(s) abclV',.named swear(,) or affirm(s) that the statements In the foregoing petition are
true alld correct te. the best of the kilOwledge and beller of petitioner(s) lInd that as personal represen.
lativ:(.) of the above decedent petilioner(s) will well .\I\d truly administer the estate according to law.
(I k~f.T!N ( 'jli:f)j/!ffi
~K'~JlJU~cAL{~J' V TJ.litl;f) 111Id,kZ-iL~
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~_______._____ -!C.
swor.n to .01' affirmed. aRds.Ubscrl 'd {'
bef'OIf me this ___._.~~_~__ dAX .
~1l1. ~ . -.-+' 19' I
. . Jijl i ,1-DJ.~u! ,( ..
M R C. ,EWIS' , Rel/isl" ,
Thi~ b to lndly lhill t1w Illlilllll,Ultlll h!:ll' 1',1\'1'111'; (llIlt'ltl.' t(lfllt',11lHll1 .111 llll!',\!l,d ti'II,1IIt,llt' ,Ii dt',Hh dllh- lill.d \\'Ull IlH' ,l~
l.ol;llltl'!',i'll:n-, Till' original u'nin( ,Ill' will \1(' hll\\"lId('d III Ill\' '11.11(' \'il.d HI', tlld., ( lHi" It)! '111'1111.111"111 lilitlr,'
WARNING: Ills IlIognlto duplicate this copy by phot08tat Of photograph,
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No,
COIIIIONWIALTN Of PINNIVUilNIA' OIPAATMINT Of HIALTH' VITAL AIQOAOI
CERTIFICATE OF DEATH
'.''''''''*11''
IIOCW. IICl,INfY NUWIIIl
. 186 - 24 8872
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o 11.01 +1 Widowed
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t..........l.1UlOsvlvan.!.!.-_ 0Itf
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---' tH.~ =---=::.
,..,...~,.......... ........r\IrNf
Mildred Stenafield
Mechanicaburg
,..,
Cumber land
33 North York Roed Dlliabur , FA
,
17019
.lIpeo.
-
.0lJIIt...... Cremation Society of
Pen 8 v nia Cn~mat'l!'.Y Harrisbur
Cremation Society of
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I,ASTL1, I nOlninato, oonstItute and a,ppol,nt my daughter,
dHRlSTHIE H, \VATERS, I\xeoutrix of this my r,ast \of1.11 and Testament,
and carect that she be exoused from posting bond or other security
for the fnl.th.t'l,l performance 01' her duties, and J.n the eV(ll1t that
my se.id dau[,hter should prodeCtH1A6 me, or should she be l.U1able or.'
unwilling to serve in such capacit;J' for any reason, then in such
event, I nom:i.nate, constitute and appoint ~'1l\~: F'IRS'r BA}il( AND 1'RUS'r
OOI1PANY OF J1JW!llll'r.T.CSmmn, I'll" l':xecutor of thJ.s my Last vJill arid
Testament, in her place and stead,
IN \'iITNESS \'IHI~HgOP, I have hereunto set NY hand and seal
this 5' day of october, A, D., 1992.
'(iA
r.-~;U 7/ft .'. 1/14"'''-''
Mel,"vin }1,. Hoffman
(SEAL)
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IURIAU OF INDIVIDUAL TANII
lNHlRITaHC! I'. DIVI.ION
DIP!, I..AII
~1.tuRI. p, 111"-0601
COMMONWIALTH OF PINNIYLVANIA
DIPARTMINT OP RIVINUI
6*
HOTICI Of INNERITANCE TAN
APPRAII'NINT, aLLONANeE OR OIIALLOMANCE
OF DEDUCTION t. AND AlalllNENT OF TAN ON
JOINTLY .ELOUR TRUIT AIIETI
I...lu.u U,lf...,.
DOROTHY U BAKER
705 MESSIAH VlG
MECHANICSBURG PA 17055
DATI
ISTATI OP
DATI OP DIATH
PILI NUMaIR
COUNTY
IINIDC
ACN
08-18-9"
BAKER
05-17-97
21 97-0591
CUMIERlAND
181- 07-2093
97150237
A......t R..l It.d
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MAKI CHICK PAYAILI AND RIMIT PAYMINT TOI
REGISTER OF WIllS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS L1NI ~ IIITAIN LOWIR PORTION FOR YOUR RICORDI ....
RIY:li'i;i.iif.Aj:ji-COy:;,y.---.......-----.--....'.-...----..-...-...------..-------...--..-......-.....---...
NOTICI OF INHIRITANCI TAX APPRAIIIMINT, ALLOWANCI OR DISALLOWANCI OF
DIDUCTIONI, AND AIIIIIMINT OF TAX ON JOINTLY HILD OR TRUIT AIIITS
DATI 08..18..97
ESTATE OF BAKER
J
P DATE OF DEATH 05-17-97
COUNTY CUMBERLAND
FILE NO. 21 97-059S
TAX RETURN WAS,
5.S/D.C. NO. 181-07-2093
(X) ACCEPTED AS FILED () CHANGED
JOINT OR TRUIT ASSIT INFORMATION
AtN
97130237
FINANCIAL INSTITUTION. MEllON BANK
ACCOUNT NO.
162-122-0472
TYPE OF ACCOUNT. () SAVINGS (Xl CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 06-04-90
Account Babnce
Parcant Ta.able X
Amount Subjact to Ta.
Dabte end Deductiona
Texeble Amount
Tex Rata X
Tex Due
20,707.55
0.500
10.35.!:..?!..
.00
10,353.78
.15
1,553.07
NOTE, TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR 'fAX PAYMENT TO THE
REGIS'fER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEY ORDER PAYABLE TO.
"REGISTER OF WILLS, AGENT."
TAX CREDITS:
PAYMENT
DATE
DISCOUNT (+)
INTEREST/PEN PAID (-)
RECEr PT
NUMBER
AMOUNT PAID
PAYMENT MUST BE MADE' BY 02-11-98N. TOTAL TAX CREDIT
BALANCI OF TAX DUI
INTIRIIT AND PIN.
TOTAL DUI
o IF PAID AFTER THl. OAT~/u'll REVERSE FOR CALCULATION OF AODITIONAL INTERIST. 0
<< IF TOTAL DUE 1. LES' TKAN II, NO PAY"INT II RE~IRID.
U.T!lI^L.!!E_!!.R!NmO.~!..A.:~R~!!!r.."t.~~Y~ NAY IE DUE A REFUND.
.00
1 . 555 . 01
.00
1,553.07
P
_Of
NOTICE,
PAYMrNT I
II!l'UIII (CRl,
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T. fUlfill tht rlqUlr--.nt~ 0' leotton 2140 nfthl Inhlr1tlnCI end Ette.e 'aK Aot, Aot 21 of .".. (11 P...
...Uon '1401.
htllCh thl top portion of thll NoUce IInd ...It wttt\ your JIIYHf1t to the ......t." of WI111 pr'nt" on tM
rever.. .tde.
.oO ..... chHk or .....w Of'." Plwlbl, tnl Minim Of' WILLI, AGENT.
Ii re" of . tl. credit, lIIhtch .... not ".....t_ on the tlM r.turn, MW 1M reque.ted b" 1I0000l1U,. In '"AfilpUoatJon
for R,fund of Penn.wly~l. tnherltlnCl end E.tlt, ,.... (REYM1Sl'), ap,lloatlon. .r. 1",Ilebla It thl Dfflo. of
thl hlllt'r of Nlll1, ...y of thlt tJ RlvWlUeDhtrlot Offlo.. or by 01111"11 the tpeel11 Zlt"hour en....rl'" ..r~ICl'
nu.blrt for for.. .rderlntl In 'Inn'Vlvenl, 1-.aD.J6Z~2050, out.l~ P~.)'lvenl. ~ within IOGol
Hlr,,"bur. are. (717) 'I'-IOM, TDDt (717) 17Z~ZZSZ (Hear Inti 1.llred OnlY).
OIJlCnDHIt Any p.rtv In Intlrelt not .,.hUed with ttt. IIPPr......"t, .lIoweno_ or d...llot1MC. of deduction. or ......Mnt
of t,. Ctnoludlnt dl.oount or Int.r..t) .. IhoMn on thl. Notic. ..v objtct within .IMtV (,.) dev. of rtcll,t of
thh HoUoI bVI '
~-.rltt'" prot,.t to the PA o.,lrt-.nt of R.vlnUl, IoIrd of appe.I., Dept. 281021, H.rrl.bur., PA 17111~lDll, OR
...1..U,... to hili. the ..ttlr d.t.r.I,..t the IUdIt of the account of ttt. ,.r.onel r.,r....,t.UII., 011
.. .....1 to tM Orphan.' tour t
AIIlUM-
1.,UTlVE
COIaECTlOHI.
DIICCIIIII,
POULTYI
IM'ERI'"
,..tuel .rror. dl.colI.rld on thl, '......-.nt .hould bI Iddr...1d In wrltl", tOI PA Dep.rt~'t of A,"InU1,
Iur'Ml of Indlvl"'! "MII, AnN: Po.t A.......nt bYl. Unit, DEPT. Z10601, Hlrr"burg, PA 1712'-0601
Phone (711) 117-6501. I.. ,... S of the bookl.t "In.tructlont for Inhlrltenc. T'M R.turn for . R..ldent
DlGldent" (REY-lI0.) for ~ 'Mplln1tlon of 1dI1n..tr.tIIlIIV correotlbl. .rrot..
If anv tlM due I. Plld within thr.. ()) cllendsr ..nth, "t.r thl decldent', de.th, I filii Plrcent (IX)
dhoCMfnt of the tlM plld Ie .11owd,
The 11;( tl. MM.tV non.'lrUolp.tlon PMlltv .. --.utld on thl tot.l of the tlM Md Int.r..t .....IId, .... not
pII. blfor. JInuIrv II, 1"', the 'Ir.t dly "t.r the end of the taM lIne.tv period. Thl. non-,.rtlolpetlon
"""!tY I. ."..1.01, In the .... lMIrWMir end In the the ... u_ P41rlod II you ....Id ...... the tlM InCI Inter..t
thet hi. hMn ......Id .. IncIle.ted on thlt notlc..
Inter..t 11 ehllrtld betlnnlne .ith first MV of dllIftCIUinov, or nine C'J IIOf'Ith. end one U) MV
fr" the .t. of dI,th, t. the date of "VMnt. TaMa. which lMto.. delinquent be'ore JMulrv 1, 1911
bier Int.r..t tt the tet. of 11M ('~J percent per ennui aaloulatld et I dilly r.t. of .111'64.
All tIKI' whloh bee... delinquent on or .ft.r Januarv ., ..., will be.r Int.r..t .t a r.ta Mhlch will v.ry froa
eel"r vnr tD Cllltndllr vnr with th.lt t.t. tfW'IItWMIed bv thl PA DlpI~tMnt ", R.v",,",. The ."l1,"'e
Int.r..t r.t.. for 1..1 thrOUlh 1997 .r..
Vier Int.tllt Rite OIllY Int.rllt FlGtor V.ar Intert.t Ret. OIllv Int.r..t F..ter
-
1912 2n .DD'5~' I'" 'X .'ODI~7
I... I" .D.m. 1911-1"1 IU . ...SOI
1914 IIX .000111 1"2 'X ....241
1911 UX .0001" 1"1-1'" ,X . ...1tZ
19M 1D~ .OOOZ7~ 1"1'1'" 'X .OOO2~7
--Intl,.tt I. C.tClut_tad .. follow'l
ItnERIIT . lAuNCE OF Tax UItl'AlD X NIIIlIII OF DAY. DllLINqllENT X DAlLY IIITIIIIT FACTOII
....~v NoUcI l..uId .fter the tlX bloOM' delinquent ..Ill rallHt WI Int.rltt elttut.Uon to ,Ut... nl) .".
bevond the dlta of the ..H.....t. If pav.nt I. ... .Uer the Inttrllt ,..,ut.t1On date ~ on ttMI
Notlt., Iddltlonel tnt.r..t IUlt be a.loul.tld.
C~_L1H OF PENHIVLV_N,a
tlEPUrNENl OF !If:lItNUE
auRfAU Of INDIVIDUAL 'AMES
tltP," "I'"
HAARISIURQ, PA 11"....01
*1
I'ILI NO. 21 97-0597
ACN 97158732
DATI 09-09"97
TYPE OF ACCOUNT
lil aAVINGI
~ CHICKING
Till/IT
CI~TI' ,
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
_U.II41 U ." ".tll
EST. OF MERVIN M HOFFMAN
5.5, NO. 186"24-8872
DATE OF DEATH 07-13-97
COUNTY CUMBERLAND
CHRISTINE M HOFFMAN
906 VENHORST RD :
COLORADO SPRINGS CO 80tZO
~EHIT 'AYHIHT AHD 'D~HI TO.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
AHEIIICHOICE Feu hi' provSded the OIIp.,t,."t with the Infor.,Uantl.tad bllow whloh h.. b.en u.ttd In cIlcuhUng the
potentS.. '1M dUe. lheir record. Indl~.t. thlt It the death of the .aGIII ~Q~t, ~ou wit' . Joint ~r/beneflol.rY of thS. ~count.
If you ,..1 'hll 1I\'or..Uon II I"carrlet.. pl.... obtain ..,IHen corrltCtlon (rOIl the f1nencolll In.UtuUan, ,ttlCh . cOfIY to 'hll 'or.
'VltI 'ahlt" l.t in tn., l'Ihnl/f1 Hdrll'.",. Tnl. atr.nllnl I~~ tnu;"11. I,. .."r,,.,.,......," .,1." ...., ,,,"....'..,,..,, T,"! t."'. ,.' U, ';~r:lII:!r'.t:~::Il~h..f rOii,;,:.;l.ih':i..
Que.tlon' ..y b. en.wnred bV o,llll~ (117) 1e1~'S21.
COMPLITI PART 1 BILOW . . . SIE RIVIRSE SIDI FOR FILING AND PAYMENT INITRUCTIDNI
A..ount Ho, 67-000 D.t. 05-01-70
Eatobl h".d
A..ount 1.1IIn.. 5,850.53
'.r....t T..obl. M 50.000
_t SubJ..t to T.. 2,925.27
T.N ~.t. M .06
'ot...U.l T.. _ 1 7 5 . 52
~AT TAXPAYER RESPONSE
L!J '. 'I'AtL~..,o . "1I"C!Hl!."l,,,,~i~IJLt''','~!I.O.~~~~,~A.~,!A.X:A.,'''''.H'l'~~Il!!'HT"l')lOTXe. ,
A. I\iI The 1Ibc.io",' lnfar..Uon Met t,1t M 11 oaffeot. '
~ 1. You ..y choa.. to r..lt p.v.ent ta the ...I.tlr of Wlll. with t~ copl.. of this not lei to Obt.ln
. dl.c~t af .vold 'ntlrl.t, or vou ..v c~k bolt "A" ~ r.turn thl, notlol to thl RII,.t.r of
Will. Ind .n offlol.l ........nt ~lll be I..ued by thl PA o.p.rt-.nt of R.vlnYl.
To In.ur. prop.r credit to Wl'JUf lecount, two
(2) cop I.. of thl. notloe .u.t ICc~eny vour
Ply..,t to thl R....tl' .f Willi. Klkl cMok
p.yable tal "R..lst.r of Wills, Alent".
HOTEl If tll( Plveent. .ra .~ Mlthln thr..
(J) lIonth. of thl decldent's dIIt. of death,
vou e.y dduot I SJ( dlsoount of thl tilt due,
Any Inhlritanotl hit duo will _OM eMlInqu..,'
nine (,) aonths ,ft,r thl date of ...ih.
[ C~~~K "J
BLOCK
ONLY
.. 0 Th.ulbov. 1I.lt h.s been or will be r.,ortld lIf1d t,1t paid ,11th thl penn.wIIlMI. InherltWMl' T.'ll return
to be filed by the dlcedant's r.,rlllftt,tl",..
C. 0 The aboVI lnforll.tlon I~ncorr"t IInd/o~t. and deduction. Mire paid by you.
Vou .....t cOI!Pllte PART l!Jand/or PART L!J bll_.
'A_T
[!j
TAX IiITUIiH . """;oU-.-..'i.",,
LIHI 1. D.t. Eatabll.".d
2, AOGount a.lane.
S. '.r....t T...bl.
4. Aoount SUbJ.ct t. T..
J. Oobta end D.ductlon.
.. Aoount T..abl.
7. T.. ~.t.
.. T.. _
.',..,', : Of'FICIAL"USE QNI,V"'COAAF
. "', "'t ,OEP~~Tl!i"J:, ~~ ,: ~~V.NUII.\
y,. I";'; ,," ,,(,j,rt 'I' ,"iCYo; i' M....:.UiJ.. Till '::'r:A~:"/ "',' <,',"",'''''0;'''-'' ,," '" -,',,-,--,-,\ ;"-" ,.-;"". .:}1
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:::::'" ::'_ :;'';: ,'_' ", :::i':,;:j:':i,!::;:!i;:jii:l!'::i!::lj:!l;ijl!i!i:iii::l:'!!iii:!:!:!:':l;'.';:i:: '."i
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:\ll:IL ,,' W,':,~;~;,,, ", ,,;;1
DEBTS AND DIDUCTION8 CLAIMID
If you indicat. a differant taM rat., pl.... .t.t. your
rol.Uonahlp to do..dont.
1
2
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4
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7 M
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'A~T
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DATE PAID
DESCRIPTION
AMOU~T PAID
PAYEE
.~
GENERAL INFORMATION
1. fAILURI TO RIII'ONII ifILL UIUL T IN AN OffICIAL TAM A"~""INT .lth ..,11...10 IntorlOt .0'''' on In4oraaUon
IUbIIHt" bw tM -flntnClhlll Inttltutlon.
I. InnerUMU ,alC HO.... "lI~t nln. lIOn'h. .,u" the dHMIlnt', ut, of eM,th,
J. A .toln, MGount it 'IMlbl, .tJen thoulh thl dle.dent', np. ..I' Idded.. . ..tt., of co"viM'lltnu.
~, AOCO\Int. (tnchtcUne tho.. held beh,.." hUlblnd ~ wUll which the dec..tent put tn Jotnt nM" NUMn on. '1..r ,rlor to
ddth ar. fully t.ll..ae .. trln,'""
10 A,.ount. .,tlblt.htd Jnlntl'l ~tween hu,bend and ..If. ~r. thin one 'I'" prior to de_th ar. not tlMlbla.
.. "..un1' held by . dIo-'-"t "In 'rutt for" InGther or ot~r' ,r. t'M~I. fullY.
REPORTING INSTRUCTIONS - PART
- TAXPAVER RESPONSE
1
1. alOCI(" ~ If th. In'or..Uon Ill"Id caput.tlO" '" t.,. notlcl Ir. correat ttnd dtdlJCltlon' t" not Hint 01. lItH, PllCll ., "W"
In block "A" o. P.,t I of the "l.MPI'l" RI.pon.." I.otlon. II," two oopl.. Ind .~It th.. wlth 'lour chlek '.r the ...un' of
tlM to the R.,l,t,r of Will, of thl ~ountv Indlclt.d. Th' PA o.p.rt.-nt of Rlvlnue will ',Iue In offlol.l ........nt
Cfo,.. Rf:iI-Uftl EX) upon r.c.lpt of thl r.turn 'rOIl thtt R"htlr of Willi.
t. ILOCK' - 'If the ....t Ip.clfled on ,his notlel h.. blln or ..111 be r.,orttd end tl. p,ld ..lth t~ Pennllyhlltll. InMrltlnftl
ftM Rlturn Hied bv the Heed..,t'. n'pre..ntetlvI, phel IItl "lC" 'n bl!)(jk ..... 0' Plrt I of thl "lIMP.ver "e.pon.." .MUon. Slen one
oopy" rlturn to the JI. D."rt.."t of Rlvlnue, lureeu of IneHvldul1 TI.", IItpt 25Q601, Hllrrhbur" PA 17121-0601 In the
env.lope proYlded.
J. IlOCK C _ 11 tM notiCI lnfor..Uon .1 Ineorr.ct end/or cl.rtootlon. .r. Hint elllllld. cheek bl(ltlk "C" eJ\ft cOll"I.t.- P.,t4 11trwt !
HoorolOti \U ,no.. hrlhl"'lol~l"". ..OIl.... J:.., t~w ..:';.~:;:! .,r,o;; _~:.;!'.1~ ~~",-:.:: :Il~!": ~'':''~' ...,.." ...... .h.. .."".",t !"~ .011:: u"/"hl. to:! t'"'~ R".lotor
of Will, of the county Indlc.t.d. The PA DlPlrt.tnt of Rlv,nut Mill I"ut an 0"101.1 ........"t (for. REY-I~' EM) upon recllpt
.fthe rlturn fr.. thl Re,latlr of Will..
TAX RETURN - PART 2 - TAX COMPUTATION
LINE
1. Enter the d,t. the IlCICount orl,ln'llvN" ..tablhh,d or tltlld In the .lIMIr .MI.ttllt .t dlt' 0' d"th.
MOTEl For' deeedent dYlnt ,ftlr 12/12/11, Account. whloh the dlcedtnt put In Jolnt n.... Mlthln on' CI) ~'Ir of d~.th .r.
tI.lbl, fullv II trtn.f.r.. HChf.v.r', there 11 In IICCtU"on not to ..c..d n,noo plr tran"flr.. "I.rdl... of thl VII"" 0'
the "count or the nutlber 0' locountt held.
If . double ..t"ilk CIIIIII) IftP"'" b.,o,'. yo~r flrlt MIle In thl addr... portion 0' thil noUc', the U,DOO ,.01u.lon
.1rtlCly hi' "In deducted fro' thllOcount b.llM'lCI .. report" bv thl flMnOI.l lnltltuUon.
I. Enter tttl' tot.l ~11nC' of the .ccount InclucUnl lnt.,...t ,.ccrutd to the dlt. of de.th.
I, ThI percent of the IClcount th.t I. t..lbl. for 'lCh turyJvor I.det.r.lned .. foll....,
A. ThI percent t..lble for J~lnt ....t. .,tlbll.hId lor. thin one v..r prior to thl decedent'. d..thl
I DIYllI€D IV TDUL NUlllEA Of
JOINT _At
E...,I., . Joint ....t r.,I.t.r.d
DIVIDED IV TOTAL UIER Of X 100 . PfACENT TAlCAILE
SUAYIYlNO JOINT _At
In thl n... of thl dtcecHtnt end two other person..
1 PIVlDED IV I CJOINT OWNERS) DIVIDED IV 2 CSURVIYQAS) . .1'7 JC 100 . 1'.7:< CTAXAILE fOR EACH SURVIVO'U
I. "fhe Plrcent tblbl. for ....b crtttlcl Nithln OM Vllr of thl dtoMltnt", eft.th or .ccoun" owned bll' thl dtc...,t but held
1f1 trutt for IMther InenvldulU.) (tr~.t btntflellrl..)1
X 100 . PERCENT TAXABLE
. DIVIDED IV TOTAL HUMIER Of SURVIVING JOINT
DWNIRS OR TRUlT IEHEFICIARJEI
EM..,111 Joint IICcount ,..llItertd In the nIM of thl d1cedant MMI tMet other plrton. __ "t_lIthed Nithin one VI,r 0' dllth bv
the _Ment.
1 DIVIDED IY I Cl<YlWAI) ..10 X 100 . SO:< UAXAILE FOR EACH SURVIVOR)
4. ThI..unt .UJlOt to teM Ulnt 4) It detlr.ln" bv IlUlt1p1vlng the IICCount b.tlnC' Clint Z) by thl pereent tlMllble ClI,.. Sl.
I. ~tlr the tot.l of the 1Mb" end daduotlon. llthd In P.rt S.
tI. 'IM..-un' '_Mlbae UIM tJ 11 dtter..lned by"UDtnc"nll tI\II dttott end dedUction. Clint S) frCHI thl MOWlt .uttJlOt to t,. UIM 'lJ.
1. lnter thl IPPr.rllt. teM r.t. Cllnl 7) .. at.r,lned bill....
.. for ~t.. of de.th aGcurrlnt .ft.r '/10/94, the t.. rat.. for tren.fer. to ,poule. .r. .. follow"
1. OIt,. ~f ...th on Dr .ft'r 7/1/94 end blfore 1/1/91 the r.t. I. J~.
J. Z. o.t.. of dI.thon or .ft.r 1/1/9S trln.f'r' to 'POUI" Nl11 be t..ed .t OX t'M r.te.
"~t'l for dete, .f ..th prior to 7/1/94 trln,f.r, to 'POU'" .r. tl.lbl. .~ 'X.
I. 'rln,fere to 11"..1 dt..lndents lncludl.... f.tt~r, ,,',hlr, .on, deughter, Irtndchlldrlln, ,on.'"-l...,
~t.r.ln-I.w, ,tepchlld and thllr 1,tut 'r' t'Mlhl. It .1. ,.roant C'X).
C. Tr",..'r. to .11 Othel" InolUdlnt brother, .ltter, ~I., tunt, ~ end nllClI en t..lbl. .t flft.... plrcent CU;U.
D. If >>00 ohlnllt t~ t'M r.t."pl.... .peclfv your r.l.tlon.hlp to the decedent In the .r.. provided.
I. ThI...unt of tlM due (UM I) I. deterelntd by IUltlp1vlnt the IMWlt t..llbl. Clint ,) bv the t.. r.t. (11M n.
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
.U......l. deb.. Md cMduCltlon. .,. dtter/lllntd .. hllCMil.,
A. 'au l...ll>>lrl rltPOn.lbl, for ,.weent, or the ..tlt' 'ubj~t to .o.lnl.tr.tlOn bv . per.onel repr..tntltlv. I. InlUffloltnt
t. ,.v the dlCluctlbl. It....
II You Htuelhr ,'Id the debt. .fter dI.th of the declclent .... CM furnllh proof .f peVlllftt.
C. Dabt. bllnt cl.l.ad lU.t be It..lled fullv In Plrt S. If tddltlonll aplO. 1. needed, u" pl.ln p.,.r . I/fW ~ 11". P~..f of
pawant MY be r...."tltd bll thl PA Depart...,t of R.venut.
i 5, I [1/ - II
c~
'OR 0""10' 01"'" ""Ia 12/3'''' CHICK HIR'
lr " IPOUI"L .-
POV"" CUDIlII CL"IMID U
,iLINuioiiiiiI2l.:97...659f _H_"
IIV.JIOO 1M. 1"0'1
~'Jt,9. INHERITANCE TAX RETURN
~~.:r RESIDENT DECEDENT
WMMO"WIMII'Of """'VIVA"" (TO BE FILED IN DUPLICATE
oIPA.'"I''' 0' .1v,,,u, , ~
iW~~;.~~t\Of.:,~ :iL:. ,""~rt;j;ttl~iTikii-,^,!r.~-~E'~~!~~C'._~~J~L~~L,,", ~~f.1;h~f!i-l,!<)7 - ~~AROO~ <)'7 N.UMlfI
It(Wli'Hi\N, fclol'vln II. ~;II, Host NuJ.n st,
l&IAnWliiTiNiii.im.---....--',"';;o;u..;" "",maliii"i-----'" Hooh9.n:tollbur{~, PA 170~5
__lQ~):?II:.0f1'Ennnn_. '1/1 11m, ,'.I!?l~lnnn (,,",[,.._ ...c_~\lnl:_or1nnd ._____"'_._.._..._..___.
'" ''''':~''~'2.~~ '::",:'.:~:""" '"'' "'" """," "",,,,, 50"A< 'ICVRl" ~VM:~.._n_ ~M:'~"':'~'~'''I'....~''~~UCllO'''~__, .._____.
[11. Orl91nal R"urn 1.1 2, Suppl.mon'ol R.'u,n [J 3, R.malnd.r R.,u,"
(far do'.. 01 d.a,h prior to 12.13.82'
o A, limited e,tall IJ .do. Future Inleret' Compromltt r:J ~, Fed.ral ellot. Tall RII"'" R.qulred
. (10' do'.. of d.o'h all" 12.12.821
Ia 6. Olcedenl DI,d ,.'101. r-j 7, Oecedenl Malnlalned a lI\1lng Trull _!. a. Tolnl Number of Safe Depollt 80xel
I^"och copy 01 Willi IAttoch copy 01 Tru"1
ALL CORIIS,ONDINCI AND CONFIDENTIAL TAlC IN'ORMATION SHOUlD.I DIIIClID TO. " , 'L', " ~;d ?h
AM..- ---~---_--.:...__. COMPLflf MAiliNG ADDRHS:
J. nObOl'\; St!\\Iff'ol', lItty. !'io.plcnt 3quul'o !lltl(l,
"'''HO''''Nui.\iir---.---.".u. ..____..__n..__..__,,_ Ho c h an lOB burg, PA 17 O~;:;
J.'.,..l..766 - 9()7J.. ...,=~,="==~~====.~.~_.. ..
I!!
II!
(151___._.. O,~tL~,.._... __ O,OQ..
(161 2~7d58,J.'L~,06. 15,465.1.~9
(17I,--..-,--.---..-........Q....Q.~..~ ,15. ._..._______0,0'2...
(181_.._m__1~.!J:t65 ,49
(1ql... 5,250,00
120) ___.___. 0,00
. 10,215.49
1_11---..-..-.---0:00
II~II~: ====-il).21~1h'L
I
II
~
I
II I _ .__o...illL
121 .._...._.__J..1.5,.. [)5L~
13) _________..Q..Jill..
I 4 ) ____......._.Q..QQ.n
15 I ___..__131~..l30.9Q...
( I 12,l~7,50
6 _____,....__._,___
17) n__.__._____..........9..!.OO
(6)..,__.
262,l~37,90
I, R.ol E,'a'. ISch.dul. AI
2. S'ock. oDd 80nd. ISch.dul. B)
3. ClolOly H.ld Stock/Po,'nt"hlp In'er, "ISch.dul. C)
A. Morlgag.. Qnd Nol.. Receivable ISchedule D)
S, COIII, Bnn~ DepoII" & Mlteellaneoul Perianal Properly
(Sch.dul. EI
6. Jointly Own.d Properly ISch.dul. FI
7. Trand." (Sch.dul. GIISch.dul. 1I
8. Tolal GrOll An... ('o'ollln.. 1.71
9, Funeral hpllrls.l, Admlnhtratlv. COlh, Mltcellan,oul
Expens.s ISchedlll. HI
10. D.b", Mortgog. llobtll".., 1I.n. (Sch.dul. I)
11. T 0101 D.ducllan. (10'01 lIn.. q & 101
12. Nt! Valu. 01 Eltol. !lIn. 8 mlnv.lIn. III
. 13. Charitable and Governmental Bequests (Sch.dul. Jl
U. N., Volu. Subjecllo To, 11In. 12 minu.lIn. 13)
15, Spoulol Tronol.n (for dOl.. of d.o,h all.. 6.30.Q4)
St. Inltrucllonl 'or Af,pllcable Percentage on Rever..
Sid., (Includ. valu.. ,om Sch.dul. K or Sch.dul. M,)
16. Amounl of line 1.4 taKable at 6% rale
(Includ. ,olu.. from Sch.dul. K 0' Sch.dul. M.)
17. Amount of lIn. 1.4 tOM able at 15% role
(Includ. ,olua. from Sch.dul. K or Sch.dul. M,I
18, Principal tOK dua (Add 10' Irom lin., 15. 16 olld 17,1
lQ, C"dll. Spovlol po'''a :O~' Pr~r PoI()S;'O D~!rl'l'~ 00 Inlern',OO
+ ._,_1,.___ <l____._ -__.._
20, 1I11n. lQ I. grao,.r 'hon lint 18, .nl., Ih. dlll."n" on tlna 20, Thl. I.,h, OV.RPAYMINT,
110
I Q) . .. lJ-.J1l1.~ 09_
)32,62
1101 __.._____,_.
!
I
~
{11f'flt h'!1 Ii Y(lll (ll( II qUI'\llllq (l f( IUlld 01 youl (lVI Ipl1V"H nl
111) __Jtl..679.7l..
1121___ 257,758,19
(131 _ 0.00
114) 257,758,19
21. If L1n. 18 II grealer than lln. 19, enler the diff.rence an Line 21. This II the lAX DUI,
A. Enler the Interest on th. balance due on Line 21A.
0, En'.. th.'otol of lln. 21 and 21A on lIn. 218. lhl. " ,h.IlALANCI DUI.
Mak. Check Paya~'. tal R..I.... of Will., A..nl
,~~ .. SIIRITO ANIWIR All QUII!IONS ON RIV~RIISIDI AND TO .ICHICK MATH <(,<II( .,'
nd., Plnaltl.. of perlury, I declare Ihat I have uamlned Ihll return, Including accompnnylng tchedules and Ilalemenll, and to the belt of my knowledg. and belief,
It I. truI, corr.d and complete. I d.clar. !hal all real 8tlale hal been reporled- at true market value, Declaration of preparer 01 her than the plrsonal reprtl.nlallvt h
bas.d on alllnformatlon 0 which pr.parer hOI any knowledge.
StON }OU OHi'IO"'l"'~""'" fO~ ~lI"~, . "'." " ,oDiii'UI2,F'-'Imiie.rTii.l'..rroiiil---...------ om ',_ .
, ili.Y1LIs/fJJ (Jl(li:.,,-____Q..Ql or' (\d<L.J?.P.~J.!JgQ,L.QQ.... UO.9JL____.. _u..,- 'I -1__
'0 '. RUO'""}" ,.jf;,/""Uf .OO''''HLll'lwt S llnl'G !lId, OAl' ,_
~-""...J1G CI}!!!.1.tg_~1)U!'ili..J'~~tL9~!)____ .L2...:../ j -",7
'. 'C'~ ........
-......"-,_!....~"-"'...,......~ ..-""',
..
R1V.I!03l1. '....1 .~'.t J
-~
COMMO"'WI^,l~~' 'IHHIYIVAHI.
IHIIU"AH , '.... muoH
o!SIOIH OICIOIHI
mATi 0' -- , . . -,,=-
SCHEDULE B
STOCKS AND BONDS
--..... -'-. ~ .:..-:-~ -' -. --- ~
NgnV HI 11, 1l0I/l;'I'U\l~
l-...r -
2l~9'7-0)97
199"-00597
(Al~ p..pa'Iy'I!ln,iv.a;~d;llh Ri;h,'a!.Sur~lv"."hlp;~:~:~~._~I~d;~~d-;~~cj,.ci-;;i. P.!. -.-.--
ITEM
NUMBeR
1.
IJESCRIPTlON
-_.~--
VALUE AT DATE
Of DEATH
1210 shAron of common stock of InH Corpol'ation at
95~3~~ pOI' share.
$ 115,057,50
1HfMttention is oalled to the fact that some of
. the deoedent'n shares of IBM ns disolosed from
the Snfe Deposit Box Inventory wer'e aotually
liq\.ddated during deoedent's lifetime and the
subjeot oertifiontes were still retained by
deoedent and had not been surrendered to the
oompany and thus oho~led up IlS part of the
inventory as taken, An up to date Certifionte
Transoript prepared by the First Ohicago 'l'rust
Oompany of New York, offioial transfer agent of
IBH is submitted here\d th, Also a IIffwo-for-One
Stock Split Distribution Stntementll verifying
deoedent's total OImership of IBH shares at his
death is also submitted herewi tl:l,
-----
TOTAL lAlla ..Ia. on II.. 2, R.capllul~t1an
,I" mo.. 'pac' I, ,....dad,'.,.,' eddmena/,h.." 0' lem' "10,)
$ +15,857,50
_.V.IM lit. 111.111
.
COMMONWIAllH 0' rlNNlYlVANIA
INHUlrANCllAX mUAN
AUIDINI DICIDINI
J SCHEDULE F
JOINTLY -OWNED PROPERTY
---.--. . --------
~ -
PILI NUMIIR 21~97~0~97
'"._._"___ _______,_____1J.9'7-00597 _
mATI OF
HERVIN M, 1I0Ji'FHAN
Jolnl ttnanll.)1
NAMI _______
A, ANG!.!lLIQUg M, \~ATEl1S
___ADDRISS
~29 Yverdon Drive
Oamp lIill, FA 17011
RILATlONSHIP TO DICIDINT
Granddaughter,
to
C.
Jalntly-ownod proporty.
-
"1M LmlR DATI
FOR TOTAL VALUE DECD'S DOLLAR VALUI OF
NUMB.' JOINT MADI DESCRIPTION OF PROPERTY OF ASSET % INT. DECEDENT'S INTERIST
TENANT JOINT
1. A. 12/31 130 shares of common
1986 stock of IBM Oorporation 12,l~7,50 ,~ * .6,223,75
thru at 95-3/l~ per share,
12/31
90,
5/27/ 130 shares of common
. 1997, stock of IBM Oorporation
at 9,-3/l~ per share,
Issued as II 2 for 1
stock split on above
shares all of which were
Jointly Owned by the
parties since 12/31/90,
thus qualifying for a
" 5~~ ratc for decedent's
interest, See also,
"Two~for-One Stook Split
Distribution statementn 12,4l~7,5C 5~ 6,223.75
submitted herewith,
,
.
.
I .
TOTAL IAI.o anlt' on IIn. 6, Rtcopltulatlon) $ 12,1+'+7,,0
- ~ -
(If more .pact I, n..d.d In,.rl addi'ianal,h..,. D' .am. Ii..1
IIY.lillIW.I'.1I1
ISTATW
ITEM
NUMBER
l SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
_ MISCELLANE.oU5 EXPENSES __.. P100.0 P,ln' 0' Tvp.
- J'P1L1NUMBIR -2M7-0~91
n__ .)I~~~~..~~__I'l.._~~~~~~lA II ._.__.".._._______ ___ 1 '/97 - (~Q2..9.1.
.
COMMONWEAl1U Of PlNNSYLVANIA
lNHU"^NCIIAM mU~N
IU510fNf DfCfOEHf
DESCRIPTION
AMOUNT
..-----~-----~._-_._.__.
A. fun"ol bpona.a,
1.
2,
3,
Prepaid.
*
Gingrich l1emor'ial!l, Ino., cemetery lltonument,
Pealerts Flowers, Ino" funeral spray,
B. Ad",lnl.trotlv. Coall'
4,
C.
1.
2,
3,
4,
5,
6.
7,
IJ
1,
Pe"onal Representative Commluion. - None
Social Secu,lty Numb., 01 Pe"onal Repre.entative,
Year Comml..lon. paid _________
2,
Atlorney Fo.. J, Robert Stauffer, illsq" Attorney's fee,
3, family Exemption
Clalmonl ___.J~L!L....._______ Relotion.hlp
Addreu 01 Clalmanl 01 decedanl'. dealh
Street Acldre.. ,_______.
City
Slole ,___ Zip Code
Probate Fee. Hegister of' \'lills of Oumberland County,
Pennsylvania, Letters Testmnental'Y,
Mllcollonooua hpon...,
Cumberland Law Journal, Estate Notioe,
The Sontinel, Estate Notice.
Penna, Power t~ JJight Co" final electr'io bill.
UGl Oorporatlon, final gas bill,
Bell At lantic, fi nal telophone bill,
Suburban Cable, final 'fV CabIn b111,
Amerioan Airlines, air fares f'rom Colorado Springs,
Oolorado to lIat'I'lsburg, I'll., JJ;xecutl'ix resides in
Colorado Springs and trips wore nooessary to
attond funeral: Probate _ \'li11 1. n _ CU~lporlal1d. Count ,
0,00
9135,00
50,00
0.00
1,$00.00
112,00
60.00
59,$8
93,74
19,08
52,93
3.16
""'..... ;\^
il
UY.UUU+IJ.171
1 SCHEDULE J
___ .~!NEFIC:IARIES
l
=-
PILI NUMBER
21-97-0597 '
1997-00597
-.----...--.-.--
'*'
COMMONWfAU!1 0' ,1t~tUytV"NI"
IHHunA",CI 'AIC IItUIlN
.1t10IN' DleIDIN!
ISTATE OF
HE.1WIN M, HOFF'fIAN
ITEM
NUMBER
RELATIONSHIP
AMOUNT OR
SHARE OF ESTAU
NAME AND ADDRESS OF BENEFICIARY
__,.__,_'_~.".e.___'___.__.."_'.._~_____'___~ ._L_'._.~____"__~~~_ _..,-~----~-
A. TaKable lequllts:
1.
ANGELIQUE H, \~ATERS
829 Yverdon ])ri va
Oamp 1l111_ PA nOll,
OIffiIS'fINE U, \'IATERS also known 9.S
OHRISTINE 1'1, IlO1o'F!1AN
1427F Imperial noad
Oolorado Springs, CO 80918,
Granddaughter
All of decedentrs
IBl1 CorpoI'ation
OOI1ll,10n s took,
2.
Daughter
Entiro residuary
estate,
ITEM
NUMBER
AMOUNT OR
SHARE 0' ESTATE
NAME AND ADDRESS OF BENEFICIARY
-
B.Chatllablo and GavarnmontaLBaquoll1l
1.
TOtAL CHARITABLE AND GOVERNMENTAl BEQUESTS (Ailo anlat on IIna 13, Rocapllulatlon) S
(If mora .pa.. I. n.adad. In...' additional .hoo" 0' ..m. .la.1
COMMONWIALTH O' 'INNSYLVANIA 1
COUNTY O' CUM.IRLAND J
III
Olld.stine Il. Hitters !11m ChrIstIne ~l, Hoffman ,
__'_____n_~_._._" __. _ .__~._~__.. .... ._- ._....,.__........ - .--. .-.- -._~-----_.~._._-~--~.- - ---------~---r-.._.~-- ,.-~----....__...
b.ln9 duly _____!l"I.\!:rJ1...,......__ .ccordln9 10 lew, dopo... end ..ys Ih.t Sh. ..l..IL!ill~_Jj;A!!01Jll.;l1L..____,_
_,...____. ...__._.."'.."'..... 01 Ih. Es"I. 01 __!1orv...!.!Ul......Jloffnlan ______
1.1. 01 ___.}l~.Q.llnni()uburg" ,_..... ...._, Cumb.,I.nd ~ounly. P... d.c....d .nd th.t the
wllhln Is .n Inv.ntory m.d. by ..._..g)lJ:'Xllt:tl1..o ,i'tLlLor.r1ne,11._,........__...,_, the ..Id_ Elxeoutx'ix _
01 the .ntl,. ..t.t. 01 Itld d.c.d.nl, consl.lln9 01 all the pe..on.1 pro".,ly and roal ..t..., exc.pt ,..1 .11,.1. outsld.
Ih. Commonw..lth of P.nnsylv.nl., .nd thai Ih. 119ur.. 01'1'0"1. ..ch It.m of the Inv.nto,y ..p....nt It's f.I, v.lue
.. 01 the d.t. 01 d.c.d.nl's d.alh.
B~IORN
.nd IUb.crlb.d be for. m.,
Il.1VlWiLu..,'i..2L A) rf.ll;..~y~_
h'Clutl)'.~""
Dee, 1. _
19..31.-_
J.1.J,2'7F Imperlal Road
..Q.Q19J'n!,to_.JiP.~..:!.p.s!h_9 0 0 0918
Add.."
D,t. 01 Death _~1.1..
OIV
Julx____._______-1TI7
Month Vu,
INSTRUCTIONS
I. An Inv.ntory mull b. III.d within thr.. monlhs .Iter .ppolntm.nt 01 p.non.1 ..prll.nt.tlv.,
2. A suppl.m.nt Inv.nto,y mull b. fII.d within Ihlrly d.ys 01 discovery 01 .ddltlon.I....ts.
3. Addltlon.1 shen" m.y b. .".ch.d II to perlon.lty or r..lty
-t. s.. Artlcl.IV, Fiduclerlll Act 011949.
~ ~ ~ 1 ~
~ II. ~ 3 .. Q)
u lEI
..
0 w o w ~ Q
Z j!: g: ... ~ ,
rn .
II. ... ~ II.
In 0 ~ t tIl <(
:> ~
, ...,
Z Q ~l ,- J '"
H "
~ ~ ~ Q)
w ~ II> .g
II. ."
P c ~
.
~~ 't; "C ,
J! 1 ] ... ..
~ J
. 0 u:
...
~'
~ C__L T" Of PfNl4IYLVNlI_
lIEPmltENT Of IO'evtlU
IUREAU Of INDIVIDUAL TAMrl
lIEPT, moo,
~II~, PA 1112'.0'"
*'
INFORMATION NOTICE
AND
TAX PAVER RESPONSE
FILl NO. 21 97-0597
ACN 97149567
DATI ll-U-97
TYPE OF ACCOUNT
EST, OF MERVIN M HOFFMAN 0 IAVlNflI
S,S. NO, 186-24-8872 0 C"ICKlNfl
DATE OF DEATH 07 -13 - 9 7 [J TIlUIT
COUNTY CUMBERLAND 1i1 CERm.
II"IT 'AV"I"T AHa rORHa TO,
REGISTER OF WILLS
CUMIERLAND CO COURT HOUSE
CARLISLE, PA 17013
m-lId",""."1
MILDRED V HOFFMAN
55 N YORK RD
DILLSBURG PA 17019
HARRIS SAVINGS lANK ha. provided th_ nepertlent with thl In'or..' Ion lIltad bllOllf which hI' been u.... In
c.IGul.tlnat~ pot~tl'l tlM ~. Thllr rIcard, Indlc." that at the d..th of the Ibova dlo.~t, you wert I Joint owner/beneflollry of
tnll Ho~t. If you ,..1 thl. Infor..tI~ .. InGorrect, ph... obtain ..rlttln correotion 'rOIl thli 'InMGIII In,Ututl:tn, aUeeh . copy
to thll 'or. .wi return It to the IIbov. IMktr.... Tnll ICCount 11 hM_l_ 1n IICtIOrdMCI wUh the IntMlr1t1nC1 hM LMI. of the CHHf'MIIllth
ofPtnn.~'lvonlo. Qul.tlal\' 111:/ b. a".~rtfd b~ cIUln; (111) ?e7 a321.
COMPLITI PART 1 BELOW . . . SII RIVIRSI SIDI FOR FILING AND PAYMINT INSTRUCTIONI
Acccunt Ho. 18-56-222096 o.t. 04-27-92
Ea hbllahod
Account 'ola....
P.roent TaMable
Aoount Subjoct to To.
T.. Roto
'ot~tlol To. Duo
To Inlur. proper ar.dl' to your lecount, '"0
(Z) copt,. of thl. "0,101 .utt 1C~~any your
PIVlMnt to tM R....t.r of WUlI. "Ilk. cheClk
pIyabl. tOI "R.,l.tlr of Willi, 1geflt" ,
PART
ill
4,043.32
50.000
2,021.66
.06
121.30
TAXPAVER RESPONSE
.. JlAILUfI,,,O.RISPClHJlJIILl.REIUL T ..IHA" .OJlP.ICIAi."AX. A,IIS,..I""..,.I ON TN I' .l!QtlCI
, ...... .. ..... , '. ..... ....... ...... .". C."', ',-", ',. ........--........ .... ... .,. ...
M
NOTE I If t.M PIVwent. .r. .~ within thret
(!) ~th. of thl dtc~t.. dltl of death,
you ..y deduct . 5~ discount of t~ tlM due.
Any InherltlnCll t'll due -.111 beeae delinquent
"1M (9) ItOnUtI ,ftll' tM dI'. 0' dHth.
x
[CHECK ]
ONE
BLOCK
ONLY
.. 0 ThI! IIbOVI InforHtlon IInd taM ... .. corrHt.
1. You "V chGO" to r..lt P.Ylent to the R.,I.tar of Will, with 'NO copl.. of thl. nottcl to ob'.ln
. dl.count or ,void In..r..t, or YOU ")1' check bOM "." end r.turn thl, notlel te 'hi R"l.ter of
Will. .nd ~ offlcl.1 ........nt wl11 b. I..ued by the PA Oap.rt.-nt of Rav.nu..
I. c=J The Ibova ....t ha. been or wlll be r.portad and t~~ paid ~Ith the Penn.ylvlnla Inher,ttnee T.. return
t~ be flied by the dec.dlnt.. r.pr..~t.tlv..
c. 0 The above Infor..Uon l~ncorr.ct anct/o~tI Met deduction. ...r. p.ld by you.
You IlUd o....l.t. PART l!J Ind/er PART l!J H'\DW.
If ~ou indio.t. e diff.rent tax ret., pl.... .tat. ~our
rolotlonahlp to docodont,
'ART
~
TAX RITURN - COMPUTATION OF
Ll"E I. Oot. Eatabllahod 1
2. Acoount aalanoe 2
5. Peroent Taxabl. 5 x
4. .oount Subjoct to T.. 4
5. Ooht. ond O.ducUona ~-=--
.. .oount T..ablo .
7. To. Rot. 7--lL-
.. To. Ouo a
, " OFFICIAl; 'USE ONj;Y." , AA~
,:::;\~~ :IlSP/lRTMENT.OF REII'NtlE' ;::;;::::,'[
:~A~::X:':,'::',::::,,:.;...:,,:: "',. .,.:1:.'''.'' ::.',.: ,':.:.':"':::".I;':;i
,','., :"1"" I,,: ,,'I"~', ',.,:.'i ,'"'",,,,:::,,,''''' " "".::':""'"
. . : - "c-, :::::;"';::~
,...",.:""",3,211"".'
'__"'.:':':','" :"::::::,:i:::i:i:i:!::!;;:::X-:': .j;:-::,::::!:::!::::::::::, ' ,., 1'1":
:;:::::::::!::'::: ~ ::;:
5 :
:.,6, ::')
.' .1, ".:
8
DIBTS AND DEDUCTIONS CLAIMED
TAX ON JOINT/TRUST ACCOUNTS
'ART
[!]
DATE PAID
1
PAYEE
DESCRIPTION
AMOUNT PAID
(Enter on Line S of Tex COMPutetion~
\
.
-J
TOTAL
Undor p.n.ltlo. of porjury, I docloro th.t tho
o.-ploto to tho bo.t cf oy knowlodgo end bollal.
"-- .' ,
Lp~~tn',( 1/ ~/t /1 i Ii (( t(
. A VER SIGNA OREl. "
facta I have r.ported above are true, oorrect and
HOME (7.;7) -7'/'- ,~~" ;.</
WORK () /Z.J.!J'l' '7
TELEPHONE NUMBER ~
r
\
"
OENERAL INFORMATION
1. 'ULU.I TO "II'OIID WILL .IIUL T IN AN OffICIAL TAN AIIUININT .llh ...11...1. Inl.r..1 ..... on Inl.rHUon
...U'''' Illy the flMMI.1 In,tatutlon.
2. lnherltMCI' "IC No... dtl1~' nln, ",,'hi ,ft., tht de4lMen"u d... of H.th.
I. _ Jt'n' H.....' I, tIM_.' ."., thouth thl: elM""'" n.. WI' .HdH II . ..U.r of eDnvenleno..
... '.,.un" (1Mlucllne tho.. held Nt""" hUulInd Ilnd wU,) "'loh ,hit dHeHnt put 1" Joint MMI Iillthin ItM Y'" prior t.,
He'h .,.fully '1...1. " .rMI'ln,
'0 Aaoountt ..'_lIthed JolnUY ..,ween hulhMd Met MU, ..r. tMri one YI.r prior to dtlth .r. not tlll..t.
.. "oauntt h.ld by . INHIMllnt "In trult for" .nothlr or .lMr. Ir' tlllllhl. fullY,
REPORTINO INSTRUCTIONS . PART
. TAXPAVER RESPONSE
1
1. Iloa(" - If the It'lf.r..U~ eM OOlltM"IUon In the notlu .r. corrHt .... dtdUoUOIl' Ir. not "Ineal......' plIO' fin "II"
In Itl..k "A" Gf P,rt 1 of the "'-!CPI"" ...IfHWl.... 'MUon. III" two fl",I.. Ilftd tublllt thell with your check for ,hi MOUnt O'
till to the "..t.t., of NUh .f thti OOUl'ltw IndlolltMl. The PA Dep.rtHnt of R.v.,... MUI ..... In o.flollIl .....IMn,
('or. RE~.II4' EX) upon r~.I~t 0' thl r.turn fr.. thl R..,.tlr of Will..
Z. .LOCIl' ~ If the ....t .,.eU"td on thl. notlo. hi' bUn 0" "III " r.,.rted end till p.ld ..ltn the Pennlwlv,"l. InMl'ItIM'
TIM IIllturl1 filM bW thl decedent', r.r..enUUv" ,IICII ., ..." In blootl "I" of 'Irt 1 of tM "raICPIVlr ".."".... I"Uon. II," oM
aOllwend return to thl'A D.p.rtllent of AIV~, lur.1tU 01 Indhlldu.a TaICII, Dlpt Z10601, Herrltbur" PA 17lZ'~0601 1n the
Inv.l.,. prOYI~.
J. DLOCIt t - If the netUc. InforHUon It IncorrlClt end/or deduclUon. .re Hint ot.INd, ctMok bl"", "COO end o.,lltl Pert. 1 end J
IiCIClordlnt to thll Instruction. bel.... lilt' two copl.. .".. .ubalt thlll ..lth your chlClll; for thll -.unt o' tu Plylbl. to the It..tttlr
of Willi of th'" countw IndloltMl. Th. PA o.p.rtant of AevMlUI! ..U1 I...... In offlol.l ......emt (Fo,.. REY~lI_' ~X, upon rlClllpt
of thl ,"turn fra th41 Raght." of WlIlt.
TAX RETURN. PART 2 . TAX COMPUTATION
lIHE
1. Ent.r thl ...t. thfl-H1Count orlllnelh.... ..tllbl11had or titled In the IlMIr IMltU"I .t d.tl of dllth.
NOTE I For. deced"dt ctvl". aftar 12/121121 Aocounh Mhlch tM dlClldlnt put In joint n.... within OM (1) wI.r 0' ct.,th Ira
tIM..I. fulh II tran.fa,.a. HoNev.r, therl it In .Molullon not to 'Mc.,d U,OOO par tran.f.r" r.,.rdl... of tM value 0'
tM acoount or thl ,.,...., of ICIC~" h11ld.
If I doUbl. a.tlrllk (MIl) appIl" beilor. your fI,.t nMe In thl add,.... ttOrtlon of thll P'OtlG', thl 11,000 IIlc:1Utlon
Ilr.MY h.. bien deduct.d fr.. the account b.llnCl. I' r.,ortld by tM flnanchl In.Ututlon.
Z. Ent.r the! total bll~1 of thtl IOOount Including Int.r..t IClCI'u.c! to thl d.t. of de.th.
J. ThI ptrolnt of thl ~count thlt I. tllleble for .lCIh Iurvlvor I. det.r.lned ., follow'l
A. T~ Plroent taKabl. for joint ....t. l.tlbll.hId lOre thin one y.,r prior to thl dlc~t". dllthl
I DIVIDED IV TOTAL NUttIER 01/ DIVIDED IV TOUl NUMIf. Of' X 100 . PERCfNT TAKAlLE
JOINT 0WfrI[8 SURVIVING JOINT OWNERS
EIl...ll1 A joint ....t rlll.terad In thl ntM 0' tM _.-nt and t.... other p.r.on..
1 DIVIDED IV J (JOINT OWNERS) DIVIDED IV it (SURVIVORS) . .161 )( 100 . 16,71C (TAJ(AlLE FOR UCH SURVIVOR)
t. ThI peroent tlMabl' for ....t. Crtlbld ..lth'ln one v..r of the aClad'nt'_ d1.th or ICCO...,tt owned by thl dICI.dent but hlld
In trult for anathlr IncUvldulU.J (tru.t btnIflGI.rl..H
1 DIVIDED IV 'OT.L PIER Of SURVIVING JOINT
OIlIERS Oll TRUST NHEFlCIAllIU
X 100 . PfRCENT '''XAlLE
11I....1.1 JoInt I(ICI~t r..hterld In the "... of the _.......t and t... atMr per.ont and ..\lbllthlHl ..lthln OM WMr of dIIth by
thl dIe,dint.
1 DlvlDlt IV I (SURVIVORI) . .10 X 101 . liU)C (TAJ(AlLE fOR EACH SURVIVOR>
4. ThI...unt tubjeot ~. till (line ~) I. det.rllned bV IUltlplvl", thl account balane. (line J) by \hI percent ~'Mlbl. (line J).
I. Ent.r thl total of thl dttt" and dIduclUonl 1iitld In p.rt t.
.. ThI -.unt taM_II Ulne ,) I. det."lned bv .ubtrlClUne thl debtt Ind deductlonl (line S) fr" the ...unt .~j"t to t'M (line .).
1. Int.,. the ........rl.t. tlM nta Ulne 7J II _t."lned blh....
A. flor det.. of de.th ocourrlnt Ifter 6/S0/"", thl till rat.. for tron.hr. to ,pou..' I!,.. .. f~I1OtlIl
1. alt.. of dlath on or .ftar 1I11M Ilf'td blfore 1111" tM ret. I. !:Ct
I. Det.. of d1,th on 0' .ftlr 1/1191 trllnlfl" to .pou... ..UI H tllCld .t Oi( tllC ret..
Not.l For cla11. of death prior to 7/1iM trtn.flr' to spou.a. .r. ~'Mlbl. at 'X.
I. Trenlf.r. to Une.1 de.etndlant. INlludlng f,thlr, ..ther, .on, daughter, Irtndohl1d,..", .on~ In~I...,
Hulht.r~ln~I..., .t.pohlld W\d thllr I...... I" t'lCab1..t .he perclnt (6;().
C. T"n.f.,.. to ,11 othln Incaludl"l brother, tI.t", unol., aunt, n.,U,... .nd nltG' Ira tlllabl. It 'lftl." perc.nt (15:<).
D. If you ohMII thl tlM rat., pi.... ~Ih vOt.lr rtlllltlonthlp to th4t C1i.otdlnt In the ,r.. provided.
.. The '"""t of t'M due (lint I) 11 det.r.l"" bw ..Itlplyln, thl MOUnt t'Mabl. (lIne .) by thl t.lC ret, (lInt 7).
CLAIMED DEDUCTIONS . PART 3
DEBTS AND DEDUCTIONS CLAIMED
Allowlbl. debt. tncI dIduotlon. are dft".Jned .. follCMf'1
A. VOt.I I...llv ar. rllponlllb1. fflr p.v.~t, or ttM ..t.t. .ubjltct ,to IldIlnhtraUon by a p.,.onll r.pr..ent.U", 11 Inluffloltnt
to PItY the dlductlala It...
I. 'feu MtUlillv p.ld thl dlbt. .fter dI.th of thl .cldlnt .nd elln furnhh proof 0' P'YNnt.
C. OMtI belnt ohl_ IN.t bI It..I.1d fullv In P.rt t. If addltlon.l .,1CI' It nttdld, Uti ,1.ln P"'''' . I/~ II II". Proof of
Plv-nt ..v be reque.tad by ~hI PA Dep.rt..", of A.v.nUlI.
\0>1tf C_AL TH Of OItHHlVLYANU
DlPA~T"NT Of' Il(YI!NUf.
_AU Of 1N1lIVIIlUAL lAMn
DIP!, '&OAOI
HAMIIIUltO, PA 17121.."11
*'
INFORMATION NOTICE
AND
TAXPAVER RESPONSE
FILl NO. 21 97-0597
ACN 97149564
DATI 11" 25-97
TVPE OF r.CCOUNT
EST. OF MERVIN M HOFFMAN 0 IAVINGI
S.S. NO. 186-24-8872 0 CHECKING
DATE OF DEATH 07-13-97 0 T_T
COUNTY CUMBERLAND liJ cum.
'EHIT PAYHINT AND fORHS TO.
REOISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
tn_lIdUU.I"'''
MILDRED V HOFFMAN
3S N YORK RD
DILLSBURO PA 17919
HAR"I. SAVINI. lANK h.. provlrted the O.,.rt..,.,t ldth tha lnfor"Uon tlltad b4tlOtil which h.. bien Ulect In
ulciuUtlntl the potenUI' talC .... Their racordl Indlca'e that at thl cHltth of thl! Ho"e decedent, you ...r. I Joint OWMr/beneflcl.I'Y of
thil "count. If YOU '..1 tht, lnfor"Uon II lncorrlCltJ pl.... obtaln writt." correcHon 'rOIl the fln~l.l InlUtutlon, .ttach · C~y
to thil for. end r.turl~ it to the MOv. addr.... This MlClount II hll.._ In Mcordencl ldth tl'M IntMrltMClI TalC LIN' of the COIIItOf*Nlth
of p,"",Ylvenl.. QuI,tlons..v b. an.w.red b~ call1nl (117) 117-1127.
COMPLETE PART 1 IILOW . . . SII RIVIRSI SIDI FOR FILING AND PAVMINT INSTRUCTIONS
,.......t No. 18-56-239297 D.t. 12-09-93
Eohbli1h.d
10 Inlur. proper cr.dlt to your ~count, two
(2) cop I.. of thl. notlc. IUlt 'cc~,"y your
P'VlMl'It to tM R.ght.r of "1111. .... C1httok
p.v8bl. tOI "R'II.t.r of Will., Agent".
A.......t 1.1..... 2.060,85
'.r....t Ta.ablo M 50 . 000
-
A......t s....j..t t. T.. 1,030.43
T.. ,.t. M .06
p.t...U.I T.. _ 61. 83
pART TAX PAVER RESPONSE
(!Jll'~J:.L"".,!Ul".'",",~~~" .~~9~tJ:";~~~~~.~C;~A.L<r~lfA..'li."..!rt,~'~SlCl".T"J:.~~CI.';'.
HOTEl If t'M p.v.ent. .r. ..0. within thr.'
(S) Hnth. of the decedent'. d.t. of de.th,
you ..y dedUCt . SX dhcount of the t.. due.
Any Inh.rJtenc. t.. ca.. will be!JOH dtll~t
nln. (,) ~thl .,t.r the d.t~ of death.
[CHECK ]
ONE
BLOCK
- ONLY
A. ~ TM IIbOva Infor..Uon end tI. due h correot.
1. You "Y chaO" to ruU payant to thl R'lht.r of Willi with "to copl.. of thlt noUc. to Dbt.ln
. dhcftunt or .vold Int.r..t, tlr you ..y ch.ck box "Af' .nd r.tuI'n thll noUu to the Realtt.r of
Willi aflCI .n offlclel ......lIOnt will b. luu.d by thl PA D.p.rt..nt of R.venue,
t. 0 Th. .boll. ....t h.. b..n or .,111 be rlPort.d ro:ond t.. plld ""ith the P.nn.ylvanl. InMrltenc. T.. return
to be fll.d by the d.c.d.nt', r.pr".ntatlll'.
c. 0 The IIbov. Infor..Uon 1'_)l,cortllOt end/o~.bt. find deducltlon. NIt. p.ld bV YOU.
You IIUlt cGllpI.t. PART l!J and/or PAAT ~ belON.
If you lrAloat. a different t.~ rat., pl.... .t.te your
rel.tlon.hlp t. do..daRt,
PART
[!]
DATE
<..!::i ' '. OFFICIAL USEONL'ii'i.
PflD . P4 D~rfl~TME"T:i!~~q~Eji.:
!,:"" "\j>::' .;.",;,:.::!!:!::::i!:::!:':::I:''''':'::!!!i::!'!il:!::!::j::::i::!ii:::!::';r:l::;::!:!
.' .2, ..' ..:,.,....'.; ". ,.
. 'i. 3 .... ..... ',.'. :..... .:: :...,.:.::,........ :,.:','.'::' ....,,:
. . . , , , . . . , , ' , . " '" '" - , . . , ' , ,. !'I"i!::;:':.;::!.-':::'1' :::11;i::;;:l;~;;;:;;:!~::!1:!!!:.':~:i1:iI1:::::i:i:
:::;l;~'~' . ..,..... ,
,
":>1; ,\,~';;:;"'"
8
DilTS AND DIDUCTIONS CLAIMED
PART
~
TAX RITURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. O.te l.tabll.had 1
Z. A..aunt ..1ano. Z
5. per.ant T..abl. 5 X
~. A_t .....j..t t. T.. 4
I. D.bt. and D.du.tlan. J
.. A""""t T..abl. .
7. T.. ,.t. 1 X
e. T.. Duo e
':;;";/:":.::"'-;
"""'"
'::::
;;':':;;::>i:_>fi:: ,::;;1
PAID
PAVEE
DESCRIPTION
AMOUNT PAID
1
:;":::;::1::;\
I
'.:
OENERAL INFORMATION
1. 'AlLURE TO .III'OIID WILL RllULT IN AN OffICIAL TAM AIIUI"ENT .I\h ...11...1. In hr.. I b.... on Inlor..llon
....lllod b. lho Ilnonolol Inolllull...
I. JnherJtInCl. tllf beG... dtllnquent nlM IIOnth. .fhr the dececMnt'. ilt, of d..th.
J. Ii jotnt "oount 1. tllCMi, ,wen thoutlh tM decedent'. 11._ w.. .dd.d II . ..tt.r of convlnl4IftCI1.
~. .c.ount. (Inoludlnt tha.. Mid be'lf.en hu.bmnd Ind wlf.. which 'hi dle.dent put In joint n.... wlthln ana ~..r prior to
...th .r. ~llw tllClbl. II tr8n.f.r..
I. Aooaunt. ........... J"lnU" betMHn hulbend Md wif. .ra then OM v..r pdor to death ar. not '1.lbll,
.. "e...tI M1d bv . den"" "In trult fo," InCIther or other. Ir. hlelb., full)'.
REPORTINO INSTRUCTIONS - PART
1
- TAXPAYER RESPONSE
1. ILOCk A - If the In'.rRUan IInd GOIIPUt.tton In tkl notte. an corrH' Md deduction. ar. not bel", clalHd, pIM' 1ft "MOO
In Itl000k "." of Part 1 of the "Tawpa"., ".."".... 'MUon. It en tlfO oopl.. Met .ubIllt th.. ~1th ~our check for thl MOUnt of
hlC to thl R..htar of NUll of the count'; Indlut.d, 1'h. PA D,p,rtHnt of R.v.nue wUI luutl an offlcla. ......Mnt
CFar. REV-lilt' EX) upon reo..pt of the r.turn frol the R'nht.r 0' Wills.
t, aU>>C1( It ~ If the lI..t IpNlfled on thi. nott.. hili bnn or will be r'POrted Ind hlC p.ld wUh the Pemlylv.d. Inhlirltencl
TIIC ".turn fHed by the deoedentf. repr..entaU"., plM' WI "X" In block ..... of P.rt I of the ""'ICPIVlr A..pon.... 'ICItlon, Ilgn OM
oopy ~ r.turn to the PA Da~.rt.lftt of AIVenue, Bur.eu of Indlyidual TIIC.', Dlpt 2'0'01, Harrl.bur., PA 1112140601 In thl
anv.lope pro".~.
I. IlOCK( 4 If the noUel InforuUon It IMorrHt IIndlor dHuoUon. II'" belnt OIIINd, ohlok block "C" and c.,.l.t. Psrt. 2 Md S
Hoordl", to the In.truetlon. below. Si.., two copi.. Md .ubllt UIII Idth your r.l'lIck for the MOUnt of tllC p.yebl. to thl R....t.r
of Mill. of thl oounty Indicated. ThI PA a.p.rt-.nt of Rlvenu. NIll I..ue an o'flcl.. .......-nt (fori AEY'IS~' €X) upon r.c.lpt
of thl r.turn fr. thtl A..I.tlr of Will..
TAX RETURN . PART 2
TAX COMPUTATION
LINE
1. Enter thl data th4t ICIcount orlgln.lh.... ..tlbllttwd or UUed In thl .lII'IMr .'ltUng It dete 0' de.th.
HOTEl For. decadent dY!ng I,tar 121121121 Account. which ttw deGtdent put I" ),,jnt n.... IItlthln Dna (l) Yllr of de.th .r.
talCMII fuUy II tran".r.. ......y.r, thar. I' an .ICCllu.IM not to .Ile."" H,OOO al' trWl.flr.. r"lrdll" 0' thl y.lue of
thl HClount or thl ~r of ICICount. h4tld.
If. doubll lIt1rhk (IUU IIPPII,. baforlt your flret n... In thl eddr... portion 0' thh'notlCI, th4l tI,:>>OO IlColu.l."
.lrlldy hi. bMn d~tld 'rM thl IICcount bll,"c, .. rlport.d by the flnWloill In.UtuUun.
2. Entar tM totl1 b.I,MOI of the IClClOW1t InclucUntI I"tlra.t HorUld to the date 0' Hlth.
J. ThI ftareant of the ..oount th.t It tllllbll for lach ,fUrvlyor .. det.,.lned II follow"
.. ThI parcant tllCabla for Joint ....t. ..tabllthed ..r. than 0", v..r prior to thl dacldlnt'. d,.thl
1 DIVIDED IV TOTAL HUMIEA Of DIVIDED IV
JOINT OtM:A$
EIC..,111 A Joint ....t r.gl.t,rld In thl n... of
TOTAL .......IU Of' X lOG . PERC:ENT TAMAIU
SUAvtYII'l9 JOINT OWNERS
the dec",,"t and tlltO ottMr par'on'.
1 DIVIDED IV 5 (JOINT OWNERS) DIVIDED IV 2 n~VIVOASJ . .1'7 X 100 . 16.7~ (TAXABLE FOR EACH SURVIVOR)
I. ThI parolnt t.~lbl. for ....t. cr.lt.d within one ~I.r of the dlcldant" d.lth or 1000unt, own.d bv the dacldant but held
In tru.t for another IndJvldullh) Itrult banlflollrtU)1
1 DIVIDED IV TOTAl. ......EA Of SURVIVING JOINT
OWNlRS OR TRUST IENEFlCIARIEI
X 100 . PERCENT TAXAILE
EIC..,III Joint acClount r..!lter" In the "... 0' the dec.dlnt end tNO othlr parlOn. and ..tNll.hId ",Uhln ant Yllr of dHth by
th4t decedent.
1 DIVIDf:D IV 2 (1URVIYOASJ . .SO X 100 . SOle (TAXABLE FOft EliCH SURVIVOR)
~. ThI....."..t tubJlOt to t.1C HIM~) it detarllMd by MlIUplyl", the account bllMCI (line 2J by th4t parcIf'lt t'NebJa (l1ne J).
I. Ent.~ thl total 0' thl dabt. and ~tlon' ll,ted In P.rt S.
,. ThI...unt t.wabl. (JIM 6) 11 dltarllned by .ubtrecUn. the debts Ind daduotlon. Ulna 5) fr.. thllllOUnt 'ubi"t to tiN (line ~).
7. Ent.r the ~roprl.tl tllC rltl (line 1) .. dat.r.lned below.
.. Pcr dat.. of death ocourrlng .'tlr 61SaIM, thl tllC r.t.. 'or tran.far. to..pou... .r. II followlll
1. D.t.. of dI.th on or .ftlr 1/1/94 and baforl 1/1/95 thl rltl I. IX.
Z, Dnt.. of d..th on or ,'t.r 1/1/9S tran.f.r. to .paus.. ",ill bl tlwed It ale tllC rltl.
Hottl For dlt.1 of delth prlar to 7/1/94 transf.rl to .~ou... Ir. tlMable It 6~.
I. TrMlflra to lInell ..oanclantl InolucUnt fethlr, 19thar, .on, dtughtar, grandchlldr,,", ,on~ln-llw,
dWthtlr~ln-l.." .tlPohl1d and their luue arl bICNI. .t ,lie ptrcent (6;'0.
C. Trenlf.,.. to all otha,. InolucU,... brother, Ihtlr,.Wlcl., aunt, "Wh.", end nlaol arl hllCabl. .t 'Iftelft porc.nt (lSln.
D. If YOU ch.... thl tllC r.t.~ pIli" 1ptC1f~ your rel.tlonlhlp to thl d.udlnt In tho ar.a proyldld.
I. The...unt of t81l due (line IJ I. dlt.r.lned by .ultlplYlne thl aaount t.lC.bll (lIne ,) by the t.1C r.t~ (llno 1).
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEOUCTIONS CLAIMED
AIlowabl. debta and deduotlon. Ir. detlr.ined .. f.IIGH.1
.. Vou II..llv .r. rl,pon.lbl. for PI)'llnt, or thl ..tatl .ubJect to 100Inlltrltlon bv I parlon.l r.prl.antotlve 1. In,ufflel,"t
to p.y the deductlbll It....
I, Vou Htu.l1~ p.ld ttM dotl .ftlr cta.th of tho d.udent and cs., 'urnhh proof of PIII..."t.
C. hbtl b.l", cl.lud autt be ItNlled fully in ro.rt S. If IcIcUtlon.1 ",HI h ""dad, UII pl.ln p....r . 112" IC l1ot. Proof of
PIVHnt MY be requa.tld by thl PA Departltant of Rlv""",.
ROllt
7' C_AlTH Of' PEN!tIVlYAHU
IIrAIIT""NT Of' RlI/ENUt:
~AU or INB1YlOUAl 'A'"
IIPT. 2IGOOI
HARIU.IOM, PA H12.~06nl
*
INFORMATION NOTICE
AND
TAXPAVER RESPONSE
FILE NO. 21 97-0597
ACN 97149565
DATI 11-25-97
TVPE OF ACCOUNT
EST. 01' MERVIN M HOFFMAN OIAVINClI
S.S. NO. 186-24-8872 0 CHECKINCI
DATE OF DEATH 07-15-97 0 TRUST
OOUNTY CUMBERLAND 00 cum.
REHIT rAYHENT ANO 'OR"' TO,
REOISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
"~.1141 "'" !p.",
MILDRED V HOFFMAN
33 N YORK RD
DILLSBURO PA 17019
HAft"IS SAVINOS lANK hfl' provided the DtP.rtHnt with thl In1or..t1on Iltted b.low ""'10h hu bien U.H In
c.loulltlnt the potentl.1 t.M ~, Their r.cord. Indicate th.t It thl dl.th of thl above d.c.d.~t, ~ou ..Ir. I Jolnt owner/beneflcl.r~ of
thl, account. If you f..l thh In'or..t1on It .Morrlct, pl.... obhln writt.n corr.cUon fro. thl flnllMl.l In.tltutJon, .Uach I cOPV
to thh 'or. Md rlturn It to tht IIbov. addr.... Thll account II t.Mabt. In Iccordenu with tht tnMrltatMl. T.1l l.... of the Co..n....hh
(If P~nlyenl", Qu..tln", n~' he 8M\t'!"I"-i 11'.' e,.l1tng (117) 7111.a!~'l.
COMPLITI PART 1 BILOW . . . SII RIVIRSI SIDI FOR FILING AND PAVMINT INSTRUCTIONS
Aooount No. 18-56-222159 o.t. 06-26-92
Elhblhh.d
Aooount 101...0. ~O. 023.84
r..o...t T.....I. K 50.000
Aoount Subj.ot to T.. S, 0 11 . 92
T.. R.ta M .06
rotontl.1 T.. Duo 300 .72
rART TAXPAVER RESPONSE
[!] 1"41.....~tO'II.PONIl...1IIL..."..(/L1\I"A"'9P~IC~A.L;I'''X~.~..~1l...,.~..DOI('!'IlI.....IlQ,.Ic:fl
A. ~ The abOIl. lnfor..tJon W1d 'lit dUll h corrtct.
1. You .0)' choo" to ,..it ply..nt to tilt! R'lhter of tHU. with tNO copl.. of Ulh notlc. to obhln
. dl.count or Ivoid Int.r..t~ or you ..y chick bo~ ~,~ and return thl. notlcl to the RIgl"lr of
Willi Itld an official ......Il.nt will bl lt1uld by thl PI DIP.rtllln' of RIIIMY..
1'0 In.utl proptr oredlt to your lIClOCM.n\, tNO
(U copl.. of thh noUGI lIU.t IJCCCMlPIlnY your
p.y.~t to thl R,gllt.r of Willi, "~. check
plv8bl1 tal "Rllla'.r of Will., 'tent".
HOTEl If tilt ply-.ntl .r. .~ within thr..
(1) lIonthl of thei dlcld'nt', de'. of a,th,
YOU ..y deduct . S:( dllaount of the tilt ....
Any InNif Uenc. bJll dLMI wU l beeo.. ct.Unql.Mflt
nlM (,) lIonthl Ift.r ttM data of dllth.
[CHECK ]
ONE
BLOCK
ON LV
I. 0 The abovI ....t hit b.en or will be r.ported and taM p.ld with the P.M.)'l".,..la InhtlritMCa TaM r.turn
to ba fll.d by the d.cedant'. repra'.ntatl~.,
c. 0 The abo". InforaaUon lJ.).noorrtclt W1d/of~tI and _ductlon. ...r. paid b)' you.
Vou ...t coapl.t. PART ~J and/or PART L!.J balow.
If you And!"ata a diffarent bK r'ate, ph... .t.t. your
..I.tlon.hlp to d.o.d.nt,
rAlT
[!]
DATE PAID
~
DIaTS AND
I. . ,OFFH:IAL"$EON,,~..i(::JAA~ii
!.;~ri i; ...~~.DEP~I(TlIE"T .O!,~~V.~U~.,! i:.
:....:.::..1'::................. ..
2
3
. :.4
5 , ..
6
...7
... 8
DIDUCTIONS CLAIMED
rART
[!]
TAX RETURN . COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS
LINE 1. O.t. E.toblt.hod 1
Z. Aooount ..1..... Z
S. Percent TaKable 3 ~
4. Aoount Subj.ot to T.. 4_____
I. Dobt. ...d O.duotlon. 1
,. A..unt T.....I. ,
7. T.. R.t. 7 X
,. T.. Duo ,_____
""":::::':;:!:!:::' ~~ i
;:;:':':v;
"";.;,,.;.;,;.;,;,;,
;;':';:;::::;::::;';j
PAVEE
DESCRIPTION
AMOUNT PAID
t-
:C':";':::.:;;
"Hi;
:.~
;>:i!
;:)~W
~~.
C_AUH Ill' I'fI!lltVlVAHIA
IIl!PUTIl!NT Of IIl\lt!NUt
IURlAU OF IN~IVIOUAl TaXEI
DEPf. 1110611
~TIIUR8.'A 171'.-0001
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
I'ILI NO. 21 91-0591
ACN 91149565
DATI U-25-91
TYPE OF ACCOUNT
EST, OF MERVIN M HOFFMAN 81AUINGI
5.5. NO. 186-24-8812 CHeCKING
DATE OF DEATH 01-13-91 0 TRUlY
COUNTY CUMBERLAND IXl CIRTlP.
.INIT pAYNINT AND fORHI TO.
REOISTER OF WILLS
CUM8ERLAND CO COURT HOUSE
CARLISLE, PA 11013
..'HI4IU,,,O."1
MILDRED V HOFFMAN
33 N YORK RD .'
DILLSBURO PA 11019
HAIIII SAVINlt lANK hi' provl.d ,htI D...rtHnt with the Infor..UQO Ustld below which ha. been uld In
aaloutetlnt thl PO'(MUIl tlM w.. Their record, IndlCla.e thlt It the d..th of tM ttaoVI dMedMt, you "'Ir. . Jolrlt OIIIMr/Mnliftol,ry of
thl. acoount. If you f..1 thit In'cr..t1on 11 InClorr.at, pi.... obtain wrUtlln corrlcotlon fr" thl flnMCI1.1 In.tltutlon, ,HIGh. cOPy
to thl, for' end r.turn It to the ~v. ~r~", Thl, ICCOunt 'I t.~~l. In IccordftnOI with the I~rlt~. TOM LIWI 0' the c~.lth
of P~~vlv~l~. OU-Itlonl ..v bl anlw.rad b~ c.lll~ (7171 717K'Jll.
COMPLITI PART 1 BELOW . . . III RIVERSE 8IDI FOR FILING AND PAYMENT INSTRUCTIONS
Aooount No. 18-56-299519 Ooto 01-24-92
Eatoblllhod
Acoount a.1anae
'.roent r.x_l.
Aoount SubJoot to
To. Rota
potontlol To. Duo
To In.ur. pr~r credit to V'Wt eclcOWlt, two
(Zl copt.. of thh noHo. ....t eccCMlpInV your
pIV.~t to the ...i.tlr of Wtil.. H'-I check
Plv*bl. tOI ~..J.tlr of Will., Aaentft.
pART
m
4,095.65
50.000
2,041.03
,06
122.81
TAXPAYER RESPONSE
PA.LURITO "'I "lID WILL RUUL T. I" AN OFI'IQ.AL TAX A81ESIMIHT "II. OM THII HOTIQI
"i
NOTE I If tlM PIYI*\ts .r. ode wUhln thr..
()) unth. of the Heldentf, data of dnth,
vou In deduot a SiC dl.count of the tlM duI.
Anv lnh.rlteno. tl)ll dull Mill bee... delinquent
nIne (,) .onth. .ftar the dlt. of dllth.
ra)C
x
[CHECK ]
ONE
BLOCK
ONLY
A. rtJ ThI Ibov. Infot..Uon and tlM due 11 corrlct.
~ 1. You "V QhoO" to r..lt plv..nt to thl R.,I.t.r of Will. Mlth tNO Cop I.. of thl. notlca to Obtlln
I dl.count or Ivold Int.r.,t, or you "'1 ~h.ckboM ftA" ~d r.turn thl. notlcl to thl R'II.t.t of
WIU. M'Id In oHlcll1 ........nt will bl Iuuld by thll PA DIP.rtMnt of R.Y~.
e. 0 Th. eboY' "uet h.. b.." or .,UI bl r.portld end tex p.id with thl PIIM'VIVMI. InherJtMCI TIM r.turn
to bl fll.d bv the d.c.dent'. r.,.r...nt.Uv..
c. 0 ThI aboY' Infur..tlon lJ..).ncorrlct M'ld/o~tI and dHuctlon. wer. Plld bV 'IOU.
'tou ....t cOIIPl.tt PA"T l!J Mdlor PAAT l!J bllow.
If you Indloat. . dlff.rent tftX rat., pl.... .tata your
rolotlonlhlp to doGodont,
pART
~
DATE
.:: :."FFICl~"::US~ONL~::~'AII~::j
~~l~,:' .....I::i'lfIi~;, . .
:::: ::,',.,'...... .'
6
7
..
DIBTS AND DEDUCTIONS CLAIMID
pART
[!]
TAX RITURN . COMPUTATION 0' TAX ON JOINT/TRUST ACCOUNTS
LINE 1. Data Eltoblllhod 1
2. Aooount Bolanoo 2
S. P.ro.nt r.)Cabl. 5 ~
It. AlIOunt lubJoot to T.. It_
I. Oobt. and Doduotlon. 1
6. Aoount To.obl. 6
7. To. Rota 7 X
e. To. Duo e
.-".:'::
....';';',';:::-;.', ".,.,
,.,-"-,,, """'.':':.>::::::::::::::::
'-".
;-':;:<:::i
i";,'::H::l
,-,
PAID
PAVEE
DESCRIPTION
AMOUNT PAID
MILDRED V HOFFMAN
35 N YORK RD
DILLSBURa. PA 11019
;S/CJ/-I/
IUREAU 0' INDIVIDUAL TAMEI
INHI~ITANC! TlM 'IVI.ION
IlIPT, 110601
HAMIIIUH, Pi\ 17.,....01
COMMONWIAL~H OF PINNSYLVANIA
DIPARTMINT OF RIVENUI
"*
M
CUT ALONG THIS LINE .. RETAIN LOWIR PORTION FOR VOUR RICORDS ~
niiii:iI4-i-ix--A;pr-io3-:'7j-.-------------------------------------------------------------------------.--------
NOTICI OF INHIRITANCI TAX APPRAISIMENT, ALLOWANCI OR DISALLOWANCE OF
DIDUCTIONS, AND ASSESSMINT OF TAX ON JOINTLV HILD OR TRUST ASSETS
DATI 03-02-98
ESTATE OF HOFFMAN
FILE NO, 21 97-0597
TAX RETURN WAS.
NOTICE OF INNEIITANCE TAM
APPIAI.ENENT, ALLOWANCE 01 DI'ALLOWANCE
OF DEOUCTION t. AND AI'E""ENT OF TAM ON
JOINTLY nELD OR TIU.T A..ETI
UN'4II.."cU.tII
DATI
ISTATI OF
DATI OF DIATH
FILl NUMIIR
COUNTY
SlN/DC
ACN
03-02-98
HOFFMAN
07-13-97
21 97-0597
CUMBERLAND
186-24-8872
97149563
AlIIO,..t R..ttted
j
MERVIN
r
MAKI CHECK PAVABLI AND RIMIT PAVMENT TO.
REOISTER OF WILLS
CUMBERLANO CO COURT HOUSE
CARLISLE, PA 17013
MERVIN
M bATE OF DEATH 07-13-97
COUNlV CUMBERLAND
S.S/D.C. NO. 186-24-8872
(X) ACCEPTED AS FILED ( ) CHANOED
JOINT OR TRUST ASSET INFORMATION
ACN
97149563
FINANCIAL INSTITUTION. HARRIS SAVINOS BANK
ACCOUNT NO.
18-56-299579
TVPE OF ACCOUNT. () SAVINOS ( ) CHECKINO ( ) TRUST (Xl TIME CERTIFICATE
DATE ESTABLISHED 01-24-92
Account Bl1ancI
Par cent Tlxab11 X
Amount Subjact to Tex
Debte and Daduction.
Taxable Amount
Tax Rete X
T ax Due
TAX CREDtTS.
PAVMENT
DATE
12-16-97
RECEIPT
NUMBER
AA242563
4,095.65
0.500
2,047.83
,00
2,047,83
.06
1~2,87
NOTE. TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAVMENT TO THE
REOISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEV ORDER PAVABLE TO.
"REOISTER OF WILLS, AOENT."
DISCOUNT (t)
INTERES1'/PEN PAID (-)
.00
AMOUNT PAID
122.87
TOTAL TAX CRIDIT
BALANCI OF TAX DUI
INTIRIBT AND PIN.
TOTAL DUI
. I' PAID AFTIR THII DATI, liE REVERI.E F.OI CALCULATION OF ADDI IONAL INTEREI . .
( I' TOTAL DUE II LEII THAH .1, NO PAVHINT II RlQUIRED.
!f_T!!I^~_~I.!!_R!fL!mD_!!~A_~~R~m~..u~J.I V~ HAV IE DUE A REFUND.
122.87
.00
.00
.00
'pI"tnllt'D eq ",.. ,...,,1.11 ,'UOn'pp' ".U'"
..., Yo ~ .,IP _U"rMMII ,II""UI ..., JsU' IpIIII " ,UNA... H ',un...... elt, '0 s"P Ittt puoAtq
tAep Ct,) u.."l, " UO"'t~l" "'''',Ut UI '''''''' 111" ,uenbUIIIP ....~ "I' ~, ..s", pen"1 "I'ON AWf'.
I~'A IIIIIIMI A11,a M INlnlMI1aa IA,a 40 131MnM M 01'4Mn K'I 40 I~M'1'1 . AII_I1WI
lI~flO' ,. ,.,.,nllln '1 '''''I'"I~M
nil... u ...1....1 ~IUII. 1.01 ""
n..... ~t M6'-I'" "1000 ' m n"
l~n'" X6 ...1 101Ot,. XII n"
lit..., "11 1"1"",1 ".001' Yo'1 ""
LU.... ~. tl'" '"001' 101 1..1
,..""UI Al1'a -
..o,IIIA ,"..,,1.11 AII'a .,... ,II".,UI ...IA "O'"~ "'11I ,1I""uI "'SA
11.1. ".. ~J'4' f'" .10' ..,... ,..".,Ut
""'tt~ ~l 'InUIA''''~ ,uw.,...dIQ Wd ~, Aq ,.~ .,... "~, ~'f" ....A "'pull" ., "..A "epull"
R.I, A.lI^ 111" '4i1I'" .,... . ,. ,,,,,,,uI .I.... 111" f'" 'I Ii"''' "'U' ..0 uo ,uonttvu" "'Hq "Dt"t" 111(" '"
''''000' ,. "1" AII'P . ,. pt'llnllt.~ ~ ..Id ,Ul3JId (7.') ~I' ,. "1.1 ~, " ,.....'U, "Ieq
.16' '1 A,,"""r ....,tq ,uenlMll1lP ..Mq ~Ol~ 111(11 '\UHAld '0 "'P ~, ., '",liP ,. "'P tMf, ...,
II., (U euo put .,,\'* c') "'tU .10 'A~l1l1p ,0 AlP ,U.. '4"" "'IUUI-.q .......\4:J ., '.....'''1
'.IIUOU .,,,.. uo pe,ll)'PUI .. pe...... UHq .... '1f.4'
,'1.1I""1 Put tlI,f'4' I..... PlnM noll .. pol...d HIl ... "u "" 1.1' pw ..IUUH..... ~, VI .1.'..... '1 AU"'"
UO'~...I.l'ol~.uou "'41 'POI"" ~"wu.I M', "', '0 ~ eq, .1.,,1 A'p ".1" 1\4, '.661 ~'I A~tnulr I"O,eq p,l.
,au put 'PI....,. ,'IJ',U, put ." ~, ,0 .I,D,~, uo ,..n4toO " A"lusd UO"1.13",1.d-UOU <<,..utI "I' "It ~l
'pIMl111 I' Plld ICI, Mt, " ,lnID'1P
(Xii ,UlOJ'" 'A'i . ,~,I" ",uepeotp ~, ...,,_ '~'UOI ,1lput"O (~) ....~, U,~,t,. Pt_d " ".ICI, AYI ,.
'..10.1.1. ',.,M"J03 AI'A"'"''IU,''' 10 uoI,'LMIldl<' .... .10' (I'S,-^]tt) ..,uepeMO
.utPI"1II I .10' UJn,.. M'l IOUl'lol'~1 .10' .uo,,3n,l.,ul.. "I~oq 1"\ ,0 I 1ft. '" 'I"'.lll (,tll) IUO'4d
to....ZILI 'd 'l..nq,,"..IH '10,Olt 'ldlO ("un "'IA'" ."".....W ,Iod INIIW "'.11 ,lnpl^l,ut ,0 ne'ol"'
'enulA_1II ,0 ,~'J'dIO 'd 10, lU'I,JM uI pse""ppI Iq p,~ ,Ut....... "'4' uo pI..IAoo'IP '''0.1.1' IlftlOld
,,,no) l'U'4d"D "n o. I.I""'M-
liD 'IAI,I,"'tI..... llUG....d II.t\ 10 .unollN ~, '0 "PM ~, \8 PIlA"""" .II"" ~, 'A'~ 0, IUn",I..
,10' 'UO,.ntLl 'd '...".,....... 'IU'" ,.dIG "1"'" 10 P..I'I 4tnU1AIl" '0 ,UH,"ldtQ 'd~' a~ ,..,.... UOn',1"-~
IAq IlItlON "'4\
to ..,..... ,0 '~Ip (0') A'MI' Ut'4'I" ,oe,qo AI' .ol'ON '1'4' uo UMO't' ., (,",1I'UI .10 ,unootlP "'t,"IOUt) IC', 10
'UIIS..... .10 'UOt'~ iO .tIUI"OI'."P ..0 'OUlNO'" '.uw.tlII..ddI ~, ~'tM pll""" IOU ,.....'u, "I A,...d Aut
'CAtUO pI,IlldIIl 1U'....t;) ZSUMUl (lUI 'Gal '",OI-lIl (lltJ .....I..nqe'.....H
11001 V'I.t.,M put ,,"'AIAlUU1d 'Pt"no 'O~IZ.29l-...~t I,UOAIA'UUld ul llut"tp..o '1.10' .10' ',1~
.OIAJt. Bu'J,",'" "~~.2 IltOldt I", IU'TT'o Aq ..0 "01"0 ",""'G tnU'^I~ Sl I'" ,0 Aue ""1" '0 ......,.... ~,
,to .0f'tO ~ " Ilqel'IAI I'" ,uol,11I11dd' '(SIII~^JH) ..Mil I",,] put l""ll.lI'4UI 'TUlAT~'UUld ,0 pun"1II ...,
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NOTICE OF INIERITANCE TAN
."IAIIMENT. ALLOWANCE 01 OIlALLDWANCE
OF DEOUCTIONa t. AND AIIOI.ENT Dr TAN DN
JOINTLY nELD 01 TIUIT .IIETI
....,......." UI,.'I
MILDRED V HOPFMAN
33 N YORK RD
DILLSBURG PA 17019
DATI 05-02-98
.ITATI Oil HOFFMAN MERVIN M
DATI Oil DIATH 07.'13-97
FILl NUMIIR 21 97-0597
COUNTY CUMBERLAND
ISHIDC 186-24-8812
ACN 97149564
[- A~itt~~J
MAKI CHICK 'AYAILE AND RIMIT PAYMENT TOI
REOISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THII LINI .. RETAIN LOWER PORTION FOR YOUR RECORDI ~
Ri.y:ls4-i.iif.AFip..f&if:"li...................................................................................
NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS, AND AIIEISMENT OF TAX ON JOINTLY HELD OR TRUST ASIETI
DATI 03-02-98
ESTATE OF HOFFMAN
COUNTY CUMBERLAND
MERVIN
H OATE OF DEATH 07-15-97
FILE NO. 21 97..0591
TAX RETURN WAS,
S .sID. C. NO. IS6-24-8872
(X) ACCEPTEO AS FILED ( ) CHANGED
JOINT OR TRUST ASSET INFORMATION
ACN
97149564
FINANCIAL INSTITUTION, HARRIS SAVINOS BANK
ACCOUNT NO.
18-56-239291
TVPE OF ACCOUNT, () SAVINOS ( ) CHECKINO ( ) TRUST (Xl TIME CERTIFICATE
DATE ESTABLISHED 12-09-93
Account Ba1anca
Parcant Taxabla X
Amount Sub;act to Tax
Dabta and Deductiona
Taxabh Amount
Tax Rata x
1Mx Dua
2,060.85
0.500
1,030.43
.00
1,030.43
.06
61.83
NOTE. TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAVMENT TO THE
REOISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEV ORDER PAVA8LE TO.
"REOISTER OF ~ILLS, AGENT."
TAX CREDITS I
PAVMENT
DATE
12-16-97
DISCOUNT (+)
INTEREST/PEN PAID (-)
.00
RECEIPT
NUMBER
AA242571
AMOUNT PAID
61.83
TOTAL TAX CRIDIT
.AL~NCE OF TAX DUI
INTEREIT AND PEN.
TOTAL DUE
'H IF rAID AfTIR THII DATi, lEE REVERIE FOR CALCULATION OF ADDITIONAL INTEREI . .
I I~ TOTAL DUE IS LEII TNIN II, NO 'AVNSNT II'IEQUIRED.
I TOTAL DUE II RIFLECTED AI A "CREon" I CRI, YOU HAV IE DUE A REFUND.
I I UVIRII SIDS OF THU 'DRH FOR INSTIlUCTION..1
61. 83
.00
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l
MAKE CHECK PAYAILE AND REMIT PAYMENT TO,
REOISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
M
CUT ALONG TMII LINE .. RITAIN LOWER PORTION FOR YOUR RECORDS ...
iiiilJ:la;;i-l'l/"A~li'ray:.,)"..................._...............'n............................................--
NOTICI OF INHIRITANCI TAX APPRAIIEMENT, ALLOWANCE DR DISALLOWANCE OF
DIDUCTIONI, AND AIIIIIMINT OF TAX ON JOINTLV HELD OR TRUST ASSETS
DAT! 03-02-98
COMMONWIALTH OF PINNIYLVANIA
DIPARTMINT OF RIVINUE
BUReAU 0' ltallVlOUAL TAMil
JIHAIlAHCE TAM DlymllM
DEP!. ""01
_IIIUIlO, PA nut-O'"
NOTICE or INHERITAHCE TAM
A.'HAIIEHIHT, ALLOWANCE OR DIIALLOWANCE
Dr DEDUCTlDN .. AND AIIEIIHENT OF TAX ON
JOINTLY nELD 01 TIUIT AIIETI
MILDREP V HOFFMAN
IS N YORK RD
DILLSIURO .A 17019
DATI
ISTATE OF
DATI OF DEATH
FILl NUMBIR
COUNTY
ISN/DC
ACN
03-02-98
HOFFMAN
07-13-97
21 97-0597
CUMBERLAND
186-24'8872
97149565
A...unt R...ltt.d
--
I
ESTATE OF HOFFMAN
MERVIN
M DATE OF DEATH 07-13-97
COUNTY
FILE NO. 21 97- 0597
TAX RETURIl WAS,
S.S/D.C. NO. 186-24-8872
(X) ACCEPTED AS FILED () CHANOED
JOINT OR TRUST ASSET INFORMATION
ACN
--=
CUMBERLAND
97149565
FINANCIAL INSTITUTION, HARRIS SAVINOS BANK
ACCOUNT NO.
18-56-222159
TVPE OF ACCOUNT, () SAVINOS ( ) CHECKINO ( ) TRUST (Xl TIME CERTIFICATE
DATE ESTAILlSHED 06-26-92
Account 1.1ane.
'Ireont h.abl. X
AMount Subjaet to Ton
Plbt. and Dlduetiono
".ob1o AlIlount
11. Rob X
Ta. Duo
10.02~
0.500
5.011.92
.00
5,011.92
.06
300.72
NOTE, TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAVMENT TO THE
REGISTER OF WILLS AT THE
ABOVE A~DRESS. MAKE CHECK
OR MONEV ORDER PAVABLE TO.
"REOISTER OF WILLS, AGENT."
TAlC eRlDnl'
~'AVM"ftiT- ~""RECEIPT~-
DATE NUMIER
--12,.:i-':,f" ~~AA242564--
"-mCOUNT (+)
INTEREST/PEN PAID (.)
-'-
.00
AMOUNT PAID
300.72
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PIN.
TOTAL DUI
. II illD AWIR THkl.OATlI lEi REVEISE FOR CALCULATION or AODI IONAL INURES . ·
I At" 'i' THAN U, NO 'AYNENT IS REQUIREO.
C . LICTlD AI A "cRIDlT" . CII t YOU HAY IE DUE A REFUND.
I R' DI II THII ,ORK 'OR INSTRUCTIONs. I
,..~_._~~~~~~~~_. "'__'~T'
300.72
.00
.00
.00
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1Il", '1161'
~II~. ~A ""I,.AII
"OTleI OF IMKEIITAKeE TAM
APPIAII MEMT, ALLOHAMCE 01 DIIALLOWANCE
OF DIDU 10NI l. AND AIIUI"ENT OF TAM ON
~OINTLV RlLD 01 TaUIl AIIETI
In.1HI..."m.m
MILDRED V HOFFMAN
as N YORK RD
DILL,aURO PA 11019
DATI.
IITATI 0'
DATI 0' DEATH
PlLl NU"'.R
COUNTY
IINIDC
ACN
D3-02-98
HOFFMAN MERVIN
01-13-91
21 97-0597
CUMBERLAND
186-24-8872
97149561
AMount R"~:=-J
M
F
MAKE CHICK PAVAILE AND REMIT PAVMENT TOI
REOISTER OF WILLS
CUMBERLAND CO COURT HOIlSE
CARLISLE, PA 17013
CUT ALONG THII LINI ~ RIITAIN LOllER PORTION FOR YOUR RICORDS ~
~~:lalr'.Il{.A~1t.C&1r;.'.i........'.."'...'....""'..".........................................---..-....-
NOTICI 0' INHIRITANCI TAX APPRAISEMENT. ALLOllANCE OR DISALLOWANCE OF
DIDUCTIONI, AND AIIIISMINT OF TAX ON JOINTLV HELD OR TRUST ASSETS
DATI 03'02-98
ESTATE OF HOFFMAN
MERVIN
M DATE OF DEATH 07-13-97
COUNTY CUMBERLAND
FILE NO, 21 97-0597
TAX RETURN WAS,
S,S/D.C. NO. 186-24-8872
(X) ACCEPTED AS FILED ( ) CHANOED
JOINT OR TRUST ASSET INFORMATION
ACN
97149567
FINANCIAL INSTITUTION, HARRIS SAVINOS BANK
ACCOUNT NO.
18-56-222096
TVPE OF ACCOUNT, () SAVINGS ( ) CHECKINO ( ) TRUST ()() TIME CERTIFICATE
DATE ESTAILISHED 04-27'92
Account 1010nco
Porcont TOMOblo X
AMount Subjoct to TOM
Dobto end Doduction.
Tuob1. AMount
'ox Roto X
Tu DuO
4,043.32
0.500
2.021.66
.00
2.021.66
.06
121.30
NOTE, TO INSURE PROPER CREDIT TO
YOUR ACCOUNT, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAVMENT TO THE
REOISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEV ORDER PAVABLE TO,
"REOISTER OF WILLS, AGENT."
TAlC CUD:tTSI
PAVMENT RECEIPT DISCOUNT (+) AMOUNT PAID --,
DATE NUMBER INTEREST/PEN PAID (.)
12'16-97 AA242565 .00 121.30
-~ TOTAL TAX CREDIT 121.30
BALANCE OF TAX DUE .00
INTEREST AND PIN. .00
TOTAL DUE ,00
M PAlO A,TER THII DATI lEI REVUIE FOR CALCULATION OF ADDITIoNAL INTEREST. M
c I~ TOTAL DUE II LEII THAN 11, NO PAY"ENT IS REQUIRED.
, TOTAL DUE II REFLeCTED AI A "CREDIT" I CII, YOU "AY IE DUE A REFUND.
II .IVERIE II DE OF THII FDI" FOR INITRUCTIONS. I
."-,,-.,,
....'.lnDlu.q ,'M .......'UI llUOU,pplI "'UDM
Mft UO UMJt4I .,., uofl"nctIIO' ,..".,1.11 "Il ".". If>>" 'I ,UHA.d n .'UMI..... "Il .. I,.p "'" puoA.q
IA., (11) YIIa,'j ., uo".,n'I'o ,.I"I,ul UI ,oel~'J Ill" '~'IIP ....cteq MI' ~, ".". ,en"1 .",'" AUf..
'OLD'~ IIIII&NI A11,a X lN3n8Nl1la IA,a ~o IIINnw X GI'dNn X'J ~o I~W'1" . 1III1lWI
11.11" .. pI,I,n".t '1 ''',1.,1.11''
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u,no' 7,t ....1-1"1 .u.... XU '''I
t.UIO' X, ,,,, 101000' XII "0'
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"11I.11'" "1.1 ........".. '0 ,UIII,,,.dIQ Wd "I, Aq ptounouut .,1.1 ,I"" 'Ill" "IIA """"t:) 0, "IIA "ltM'It.D
..... A..." 1'1" ~,~ I'." I " ,'I""U, ...eq t'l" "'1 " A"tnUlr ".". "0 YO '~I'IP ...~ ~,~ "MI, I"
j~t..o' ,. ."" All" . a' ,.,.,"t,IO ~ .... 'UI~..1d (1.9) MI' ,. ."" "I' '0 ','''''U' ".~
'''' " A"......r ."o.eq luenbUl t.p ..otq ""1,," "M'l . ,.....<<.d .0 "" .., ., ''I''1p '0 "'P 1M4' ..",
A.. cn lUG plII .lot\UOO C'l lUlU "0 'AouriUn" to Alilp ''''11 4\1" IUlwllIq peI""4' ., ,..".'u.
"'HOU '1"" uo PI,to,PU' .. pe...... UHq 11'1 ,1\1,
'.....'ul pull Jet, IMfl ,..... ptnott netA II POI,,1d "1' ... "I' "I' UI put "IIUUU -. "I' u, .'.1.... ., AUtuM
U01\"',OI\...1.\104.1 1''11 'po,". A'...... MI, "1\ .0 pue "fl "IUI Alp ,."It ... '966' 'It A..PUlr l"O,oq p,'"
,au puI ,pII..... ,.....'UI put MI, ~ ,0 ,"0' ''1' uo ...,nOIO' '1 ~,'Iued uo".dtOI,"ldaUOU A,..u.I M', Xtl "11
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'YlP1.1. I "0' u"n"H .11 ,~,'''llIUl .10' lUOI,on""UI~ "1~ ....l jO 5 ell. 119 'SO'9~l'l (ltt) IUO'Id
toto~'nl' 'd ""..I"..tH 'to'Dl2 'ld1G '~I~'fl ""I"'I:! ,"'"....., ~'od lNl1" ,..MIl 1''''I''1pllt fo nol"'"
"....."'. '0 ,uoo,,,.dtQ "d 10' lulU"" 1.11 ,...."... eq Plnttlt1 ,I"''''UI 'Ilot' uo pt...^OHIP 1"0"'" J~lMj
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-MIllO'
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alO 'tZOt~IIlll 'd "..nqtl""eM 'tlOl12 .,dlll '.,..... fO P"'" '1nUI^11:! '0 ,UII,...dIg 'd ....l Ol ~I"OJ. U8l'I""~-
lAq .on... '1'1'
'0 ~.'IOI" fO IAap (0') A'IlI' uI'Ill" ,"fqo ~.. IOl'ON '1'1' uo UMO'II .. (,""I,u1 "0 lunoO'IP lu,pnl~'J M" 10
,u..I'~'1 ..0 .uo"onpep ,0 '~11"IP ..0 .OUOROI,I ',utII'I."d.. ~, ~ll" PI'f'll" lOU ,'I"I,U, UI A,,,~.<<~ l~l.1)JrIO
'(~IUO pI",.dlllIu1J'IH) Jlit2~Zll Clll) tull.1 '''O'alll (tll) .UI l"nqll""'H
1.~t Ul'1'I" put 'IUI^,A'UUld IP,'lno 'aSaZaZ9t-Oa'al .,UI^I<<'UUld UI IIUI"'P"o ""0' "0' ,"eqInU
10IA"" IuIJIRIUI "nDlI-~Z ,110Idt "I' Iut"I" <<q "0 ..0lffO 1'1""10 tnUI^'H El ~, ,0 ~UI 'I'll" '0 "'l.,IIH ~,
,0 101"0 "1\ ,. "qall'^' .... .uo",ol'ddW '((IE1-AJI:I) MMll 'l.'~] put l~l'''llIUl IIUI"l~'UUld '0 pun"1:! "0'
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. .1N1O" 'S111ft :10 H'iIl'IOlM 10l 1,.<<ld "Itp"o AfiIOI "0 'tlMll" .... .~
''PI' ""I^'"
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rr: Go
1 U,~) llNllnH
l1NJNA"d
I J)l1OM
...-
1.):/9;..//
'UR~AU 0' INDIVIDUAl. TAM!S
I"'RIIAHCt UK DIYIIIIIIl
OIl", 110611
HARRlllUAD. '1 11110-0'01
COMMONWIALTH or 'INNIYLVANIA
DEPARTMINT 0' R.VINUI
NOTICE DF INHERITANCE TIM
APPRUIBHEHT, ALLOHANCB DR OIIALLONAHCE
OF DBDUCTION t. AND A.IEIIHENT DF TAM ON
JOINTLY nBLD DI TRUIT ARIBTI
CHRISTINE M HOFFMAN
906 VENHORST RD
COLORADO SPRINOS CO 80920
DATI
IITATI 0'
DATI OF DIATH
FILl! NUMII!R
COUNTY
8SN/DC
ACN
r
" oA.L
L.' ,.."
NHu...mu..,,.
03.02-98
HOFFMAN
07-13-97
21 97-0597
CUMBERLAND
186-24-8872
97138732
AllOunt RulttH
-.
MERVIN
J
MAKI! CHI!CK PAYABLE AND RI!HIT PAYMENT TOI
REOISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
M
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS .....
iifv:iilrs.iiC.AFii.Coi.:97i........-.........-.....................................................-...........
NOTICE OF INHERITANCE TAX A'PRAISEMI!NT. ALLOWANCE OR DISALLOWANCE OF
DEDUCTIONS. AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSIT8
DATI 03-02-98
ESTATE OF HOFFMAN
MERVIN
M DATE OF DEATH 07-13-97
FILE NO. 21 97,0597
TAX RETURN WAS.
S.S/D.C. NO. 186-24-8872
(X) ACCEPTED AS FILED ( ) CHANOED
JOINT OR TRUST ASSET INFORMATION
FINANCIAL INSTITUTION. AMERICHOICE FCU
ACCOUNT NO.
COUNTY CUMBERLAND
ACN
97138732
67-000
TVPE OF ACCOUNT I ()() SAVINOS ( ) CHECKING ( ) TRUST ( ) TIME CERTIFICATE
DATE ESTABLISHED 05-01-70
Account Balance
Parcant Taxable X
A~ount Subject to Tax
Debt. and Deduction.
Taxeble A~ount
Tax Rata X
Tllx Dua
5,85~:.iL
0.500
2,925.27
,00
2,925.27
.06
175.52
NOTE. TO INSURE PROPER CREDIT TO
YOUR ACCDU~T, SUBMIT THE
UPPER PORTION OF THIS NOTICE
WITH YOUR TAX PAVMENT 10 THE
REOISTER OF WILLS AT THE
ABOVE ADDRESS. MAKE CHECK
OR MONEV ORDER PAVABLE TO.
"REGISTER OF WILLS, AGENT."
TAlC CREDITSl
PAVMENT
DATE
11-24-97
RECEIPT
NUMBER
AA242489
DISCOUNT (+)
INTEREST/PEN PAID (.)
.00
AMOUNT PAl D
175.52
175.52
.00
.00
.00
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
. l' PAID A'TIR THIS DATE, lEE REVIRIE FOR CALCULATION OF ADDITIONAL INTEREIT. ·
( IF TOTAL DUE II LEIS THAN 01, NO PAYNENT IS REqUIRED.
IF TOTAL DUE II REFLECTED AI A "CREDIT" I C~~l yoU HAY IE DUE A REFUND.
... I'U.'" IID~ n~ THII ,nlN ,nIINSTRUCTIDNS. )
I'tJIlf'OROf
HOTlCEI
'AVIlE"T,
RlflM (e,,) I
no
t"ft)
"
iT
l,d
C)
iIi
'f!(;.\
-<1
m
!'oj
0'\.
:-~
N
i::!>
N
Ta fulfill thl requlrlMlenh of Section 2140 of the !nn.rliincl Ifld Elt.t. TIX _ot, Act Z1 of 199'. (12 P.',
I..Uon'UO),
OItllOh the top portion of thh Noth. Met .....tt Ntth your P'~Mnt to the R.,ht.r of Will. printed on the
rlVln. ISdI.
-- MiM. ahtlok or ltOMy or.r p'lIMlte tOI REOISTER OF WILLI, AGENT.
.: refund ~, . '1M credit, which "I' not r~.tld on the tlM r.turn, ..y be requestld by co.plttlne en "ApplloatJon
for ".fund of PeMlylv...la InhllrltWlClI Met Elt.t. Tlx" (REV~nl]). Appl1cIUont .r. l",l1lbl,.t ,he OfficI of
thl R'11,t.r of Willi, Iny of thl 21 Aavenue Ol.trlot OfficI' or by 01111ne the lpecl11 24~hour ....werlnt ..rvlol
nu.btr. for for.. orderIng I In ~.nn'Y1Yenl. 1~.OO-S6~~20S0, out.lde Penn'YIYInI, end wAthl" locII
Hlrrhhur. .r.. (711) '.'-'094, TDUI (117) 772'U5Z Ute.,.I", h.llred OnbJ.
nIJlECTlON', Any p.rb' In Int.rut not ..thUed with the; ...r.l.....,t, tUOWInCl' or dh,UOMMe. of dHuoUont or ......Nnt
of t.. ClnoAudlnt dl.oount or lnt.rl.t) .. .hoMn on thl. Hotlel .._ obJlct within ...ty (66) dI~s of reo.lpt of
this Motlo. b~1
uwrltt... prot..t to the PA Dep.rt.....t of R.venue, Board of ""'.h, Dept. ZllDll, Hlrrlsburl, Pi 1712'~lD.u, O~
ueleotlnt to hIv. tM ..tt... det.r.lned .t thl IUdlt of thllCcount of thl per.onal r"ruent.tlv., O~
--app... to thl Orphan.' Court
ADIlI""
IITllAUVl!
COIlRECTlOIII,
DIICOIJNTI
PENAL TVI
IHTEM:ITI
F"tuIl arror. dlscov!1r1C1 on this 1I......."t .hould be ~r...ad In .rltlng tOI PA o.p.rtHf'lt of R.venut,
aur.", of Individual "lCal, AnNI POlt ,.....Hf'lt RlvI... Unit, DEPT. 2a"01, Harrhburl, Pi 1112'~0601 ,
Phone (717) 717-650S. ... P.... S of thl bookJ.,t "Instruction. for Inn.rItWIC' ,.. R.turn for. R.sldent
Dec~t.. (REV-ISDI) for en ..pl.natlon of Idalnl.trltlvllw Gorr.etlbl. error..
If ~y t.. due i. p.ld wtthln thr.. (5) cllandar tonthl .ft'r thl dec.dent's death, a flva p.rcent (S~)
dlHOY'\t of tt. to p.ld is aUQWld.
Thl ISX ta. IInIstw non-partlolpatlon penalty II c~ted on the tot.l of thl ta. ~ Intlrl.t ......~, end not
paid bafora ___ry 18, ."', thl Unt day after thl and of thl ta. ..,..t~ periOd. Thit non-plrtlolpat1on
,..Uw is ""Ilabl, In thl ... lIMIt' and In the tM ... U.. per loci .. ~ou MOUld .....1 thl tu Met Intllr..t
thlt h.. been ......ed .. Indic.ted on thl. notlc..
Int.r..t It chlr.... bIIlml", with Urst dew o' delinquency, or nine (,) aonth. and ana (1) d.v
fr. thlt ..tl of de.th, to thl data of payant. T.... whloh b.e... dIIllnquant befora J~ry ., .912
betr Intl,..t .t the rat. of .lK ("0 percent plr ..-.u. calculltlld .t e dally rat. of ,000.64.
All teM" Which bee... ~linquent on or .ft.r Janutrv 1, 191Zwlll blar Intere.t .t . ret. which .111 vary froa
ol.lIndar V'lr to (lalendar vaer with that rat. announced bV thl PA Dlpart"'"t of R.venue. ThI .,,110_1e
Int.r..t r.t.. 'or 191Z through ."1 .r'l
~! Intar..t R.t. o.lh Intarllt FlOtor
V.ar Intlr..t R.t. o.lh Int'rllt FlOtcr
.91' 9X .000247
."'~1"1 \IX .000301
1"2 'X .000247
1"5-1"4 T< .000192
I"S-I"' 'X .000247
1'12
1915
I'"
.9IS
1'"
uInt.....t
m
l';C
llX
m
m
II c..~u..t.d ..
.000541
.000"""
.00050.
.DOUM
.000274
followlI
INTERElT . IALANCE OF TAX UNPAID X NllNlER OF DAYI DF.LIN~UENT X DAILY INTEUlT FACTOR
--Anii' Hotic:. II.utd .ftar thai t.1C btcIOH' delinquent will reUlet .... intar..t calculation to flU..... (U) daV.'
"~ond the dltl of the .....IIM'C. If P'~lIInt I. .... .ft.r tM Intar..tClOlPUtltJon dltl.howI on t..
Notlc., additional Inter... lU.t be calcul.tad,
/~~I tJ/)/
(..
'*
COMMONWIA~TH OF PINNSY~VANIA
DIPARTMENT OF RIVENUE
tuRIAU Of INDIVIDUAL TAMil
IHltUITANCE IAK DIVISION
DlPI. 11"11
HM'U,IUItG, PA UU'-0601
NOTICI OF INHERITANCE TAM
APPRAISE"ENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT or TAM
"V-I'UU"" '....11
03-23-98
HOFFMAN
07-15-97
21 97-0597
CUMBERLAND
101
L AMu"t R..lttod -J
---------
MAKE CHECK PAYA.~E AND REMIT PAYHENT TOI
REOISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
eLlT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiiV: li4"f" iX-AFP "lo,:;;Y "iio'ficr"OF" i"NHiiiii'ANci-YAX"APP R'AiSiiiiiir;-ALi.."OWANci-oli"-".."..m" -----
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
MERVIN M FILE NO. 21 97-0597 ACN 101
J ROIERT STAUFFER ATTV
MARKET SQUARE II.DO
MECHANICSIURO PA 17055
DATI
ESTATI OF
DATI! OF DEATH
FILE NUMIIR
COUNTY
ACN
MERVIN
ESTATE OF HOFFMAN
DATI
03-23-98
TAM RETUIIN WAS, (X I ACCEPTED AI FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAIBED VALUE OF RiTURN BASED ONI ORIOINAL RETURN
1. R..l Eatet. (Sch.dul. AI
2. Itock. ..... lond. ISchedul. II
S. Uo..ly Held st.ck/Pertn.r.hlp Int.r..t (Schedul. CI
4. HortO..../Not.. R.c.i.obl. ISchodul. 01
&. C..h/l_ Oop.l1h/"lIc. p.r..n.l 'rop.rb lSoh.dule E)
6. Jointly o-d 'r_rty .Schedul. f)
7. Tr....f.r. .Ichedul. 0)
e. Tot.l A...t.
I I CHANDEO
NOTE I To Inlure proper
credit to your account,
.ubeit tho upp.r portion
of thl1 for. with your
t.. p.y....t.
(1) .00
121 115.857.50
(3)_ .00,
14) .00
(I) 134.132.90
(6) 12.441.50
(7) .00
(II
262,437.90
APPROVED DEDUCTIONS AND EXEMPTIONS I
4,147.09
9. Funer.l Exp.n.../Ad.. Coati/Hila. Exp.n... (Schedule H) 19)
U. D.bh/Nort..1IO Li....IUU../LI.n. ISch.dul. II 1101 532.62
11. Totel _cU.n. 1111
12. . Not V.l... of T.. R.turn 112)
n. Ch.rlt.ble/O...r......t.l I.qu..hl Non-.I.ct.d .IlS Tru.h ISchedule J) (13)
14. Not V.l.... of Eat.t. Subject to T.. 114)
NOTEI I~.n ........nt w.. i..u.d pr.viou.ly, lin.. 14, 15 .nd/or 16, 17 .nd II will
r~l.ct figur.. th.t includ. the tot.l of ~ r.turn. .......d to d.t..
ASSEBBHINT OF TAX I
11. A.ount of Line 14 et Sp.....l r.t. 1111
16. Aeo...t .f Lin. 14 to.obl. .t Un..l/C1... A r.t. CU)
17. A....,t of Lin. 14 t..ob1. .t Coll.t.rel/Cl... I r.t. 117)
U. 'rincip.l T.. _
TAX CREDITSl
PAYNENT
DATE
o - 1-97
12-16-97
(a.'-7Q 71
257,758.19
.00
257,758.i9
.00 K .00.
257,758.19 M.06.
.00 M .15.
1181
.00
15,465.49
.011
15,465.49
RECEIPT
_IER
AA2111)90
AA242568
DISCOUNT C + )
IHTEREST/'EN PAID 1"1
263.16
.00
5,000.00
10,215.49
AHOUNT PUO
TOTAL TAX CREDIT
BALANCE OF TAX DUI
INTEREST AND PIN.
TOTAL DUE
15,478.65
13.16CR
.00
13.16CR
H IF 'AID AFTER OATE INDICATED, SEE REVERSE
FD" CALCULATION OF ADDnlONAL INTEREST.
IF TOTAL DUE IS LESS THAN el, NO 'AYHENT IS REquIRED.
IF TOTAL DUE IS REFUCTEO AS A "CREOn" ICRI, YOU HAY IE DUE
A REFUHO. SEE REVERSE SlOE OF THIS FOR" FOR INSTRUCTIONS.)
M
>f
('{)
"i,;
i,C1
P-I
f-'
u_, :i
C,)(__i
RfSERVATJONl htllt..of decI'cMnh dvlntl on or "for. DIG."r U, 19AZ ~p If MY fublr. Inter..t In the "tet. .. trln,f'ffed
In po.....lon or enJOYHnt to Cl... I (coU.tor.1) benIlflcl,rll' of the dHldlnt Ifter the lliIPlrntJon .f WI., ..tltl for
I.f. or for ~.'r., the C~.lth hereb~ IMPr...l,;, r...rv.. 'h. ritht to "prlls. ~ ...... tren,f.r JnherltlnGl 'IMI,
.t the lawful Clt.. I (collet.r.l) r.t. on InY .~h futurl Int.r.,t.
_OF
NOTJCEI To fulfill thl requlr...nt. cf leotlon ZI~O of the Inhlrltlnc. and E,t.t, T.~ Act, Aot 21 of 1995. (72 P.S.
,"Uon '\40).
PAyfitf.HTI OtItloh thl f;op porUon of thlt Notlol Md IIANdt Mlth vour p.y"nt to thl Rlghte" of 'lUll prlntld on the r.v..... ,Ida.
p~"ekl ohlok or lInMY or.r p.vlbl. tOI REGISTER OF MILLS, AotHT
Itf:FLNt (C'U, " refund of . t.K crMIt, whloh w., not req\M,ted on thel TIM Rlturn, .IY bl rlqullted by ClOllPl.tlftII Wi "AppllCllUon
for Rlfund o~ PennlYlvanla Inhlr1tanel Ind Elt.tl T'M" (REV-ISIS). Applloltlon. .r. ,vIlltbl, .t thl OfficI
of the R.ghtlr of Will., ."y of thl 2J A,vlnul Olttrict Offloll, cr bv oll1lnl the ,,"1.1 Z4-hour
en.warl", .arvlo. ~r. for for.. orderln'l In Penn'Vlv,"1. 1-IOO-S6l-Z0SD, out. Ide penn.vlvtnl. end
within loo.l H.rrhbur, .r.. (711) 7"-1094, TOOl (117) 171-ZZ5~ (HI.rlnt 1....lred OnhlJ.
OI..ECTlCIMII MY p.rh' in lnt.t..t not .atbfled MUh the epprlhtunt, 111OW~1 or dl"l1owtnCl. of Hductlon.. or .........t
IIf t.\Ie UncludlMII dhc~t or lnt.rllU II .hot.in ~ thh Notlc. IlUIt objaot wUhin .bty (60) d,.1' of rto.lpt of
thh Notlo. bYI
--w"itt." prot..t to the P' o.,.rtHnt of RI"'nu., 10lrd o. App..II, Dlpt. ZIUDZ1, tt.rrhb4.lrg, PA l71Z8"IOZI, OR
--.lectlon to hi"" ttwa laU.r det.rllned .t IUdtt of ttMl IlCClOWtt of thl p.r.on'l rap""."t.Uv., GR
--Iftp..l to thl Orph.,.' Court.
AllIUM
IIT.AIlYE
CIlRREClI....'
Ptctutl .rror' dl.cov.rld on thl. .,....Ith,t should b. addr....d In Mrltln. tOI PA DlplrtHnt of R.venut,
Jur.~ of Indlvldull TIM", ATTNI Po.t A.......nt Rlvl... Unit, Dlpt. 210601, Hlrtl'bur" P' 1712'-0'01
~ (711) 711~6S05. Sa. Pili i of thl bookllt "In.tructlon. for Inherltanc. '1\Ie Rlturn for. R..ldlnt
Dec.dlnt" CREY.1S.l) for In .MPlsn.tlon of IdIlnl.trltlv.ly oorr.ctlbl. _rtor..
DIKOUNT I
If InY tl. due I, Plld .,lthln thr.. (I) calendl" lanth. Ift.r thl dtctdlntt. de.th, a five p.rctnt ('~) dl.count of
thl t'M p.ld I. .110Nld.
ThI llle tlM ~.tv non.parUo1petlon penllty It CCJIIPUttd on the totll of the tlM Ind Int.ra.t ........., end not
p.ld blfor' Jenulry II, 1996, thl flr.t d.v .ft.r the end of thl t'M lIne.ty period. Thl, non-plrtlcl,.tlon
PlMUy It IPPIsl_1t In thl ... lenner .nd In thl ttt. .... tiN p.r lad II you MOUld "1'..1 thl t.1C end Int.r..t
th.t hu bun ......ed e. Incllo.tld on thh notlc..
PENAL TY I
IMTl'1tE1T1
lntlrl.t 1. ch.r..d blllnnl", with flr.t d.y of delinquency, or nlna (,l eonth. ~ one (1) d.y 'rv. the dat. of
...th, to thl dlt. of p'Ylent. T.IC.. which blc... delinquent blfor. Janu.rv I, 1912 bllr Int.r..t It tn. r.t. 0'
.1. (6X) perelnt 1"1' ~ e.loul.t., .t a dltly r.t. of ,aOOI'4. All tIM.. which bIG'" delinquent on Ind .,tl"
J.wtrv I, 1t.2 ..III b..r Interllt .t . r.t. Mh'Oh Mill vtry frol cII.ndar y..r to o.llnd.r y..r Mlth t:,.t r.t.
"~.d by the PA DIp.rt""t of A.vlnUl. The .,pllclbla Int.r..t rat.. for 1912 through 1991 '1'11
Yo!!! In!Jr..t Rlt. D.llv Int.rl.t Fector ~ Int.rllt M.t. D.lh Int.r..1..f!.t!!!:
191' m .oome 1911 9X .oaozn
1911 I'X . aGOo, 1981~I"l lIX .aDOJOI
1914 m .aDOSDl 1991 9X .0aDZI,'
1911 m .aGOS" 1995-199tt 'IX . DaDl9Z
19.. lOX . DDOt1~ 1995-199' 9X .000141
..tnt.r'it I' c.lcul.ted .. follow"
INTERElT . IALANCE OF TAX UNPAID X NUNIER OF OAYB OELINQUENT X DAILY INTEREBT FACTOR
--Any NoUo' ".uld .fter the! hiM btCOtM. .lInquent will r.U.ct an Int.rllt calc\ll.tlon to flft..., (5) d.~.
MvMd thl dltl of the .........,t. If plvnnt II Ilde .lter the Int.r..t cGaJtUt.tlon d.t. .hown on thI
Notlc., Iddltlon.l J~t.rl.t ~.t be c.IClulatld.