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PETITION FOR PROBA n: and GRANT OF UTTERS
N(),~..._-!t::Jtt'1:JJlID.9
To:
EstUll' (~r .~ur: '"'.m ~'t,h"!\..'l\.__
u/so klloll''' us ----_....'_....__...m'_______........
-----~-.__.~._--~--._.-.....- ._-.--_......_.~
Regisler of Wills for II~e n
Counly of ~~~_ In Ihe
CommtJnweall h of Pennsylvania
Till.' I'l'li\iolll'rtSl aho\'\.'-nulllt,.c.! "'\\l'arhl or nHil'lIl(\) thulllH.' slall'n1t.~nls in the foregoing petition are
lrlll..' alld ;.,'WTl'l.:1 Illlhl' hL'~llll' I Ill' ~Il()\\k'dgc and hl'lh.'f nf pt'lilioncr(~) anti Ihal us personal rep.'csen.
Ialill'I,' "I' Ihl' ahml' dl'l'l'lIcnl pl'liljOlll'l'Is) will 19/ and Iruly adminisler Ihe cS,l'le according 10 law,
S\\',Ortl. .1". .111.' . all.';I.rncu ".Ind..' '.lh'lI.Tlhlll. -~_ -ili!"<J~d&. .t~~7U ,." ' - .'_ ~,
helol'l' IUI' 1)11, ....__~l:!3.~____ __ dal o"~.llL1L' C'1fPlWo __ ~
'~r.y I" . I'" 7 (/ . ,? ..
'<. :'AJJf! U~mll, iM t. ~=::...-:-- . -..' I
J 5 - NZ. _'1 M R-Y C~WIS it!;,.., 1..-_____ ~
-~-'---.._-----""---f'r',... DeceIlSl'd.
S 'I" ' 'V ..1" '- - I 0 - C':S III
. (J('IQ ,]('CUffIY I o. __.~~_._.___~. -,,::.t_~_
The peli!ion of Ihe 1I11der.,i~ned rl'speelfully represellls Ihlll:
YOIir pCliliolll'rh), who is/arc 1M YClH\ of agl.' or older nn the cxcculr.1~_______ named
in II1\' lasl will of Ihe ahose Ul'I:,'delll, dmed ..jB._f..... 3()~.....~,(,________. 19_
and <'odlcillsl ullled ---...---vlJ1>\......-_....".._-..-,....._-,-~---....-
___H___~~_._~_.~.._.~____.___..__.,.,.~._.___..__~_.
-~--_._-_._--._.-._~-._~--.._~.----_.."_.~-_._. ------..-.--.
-.-_.--.. .._-_._--_._-~...--_.---_.~-_.,._--------~-_.._--_..~._-
(~Inll' ft'It'\ilnll.'irl'llll\\fillll'l''i, l',I!. rl.'flllllt'IUlinn, dealh 1lIl'\CI.'Ulm, etc,l
I)eeelldelll \l'llS domiciled m dealh ill __._ c.u ""Io_~.. COllnty. Pennsylvania. with
h is. lusl family or principal re,idenee al--'s,Q"fY( S~...\t~~. ~'""-
C"".-\\)",___ "P~__\10 \.:!o__~U Jf)P1FT.1:f:LTh~,
(Ill,( 'dft't'l, lIumbl'r .111d IlHlIll.-'fpalilYJ
al~~_celt~~~~f;ai~fu..~;S :'..~ge. di~~=:__~~~~..~ ..._______. 19_ "tl _:
E.\e~p, as 10 II IlIl -, deeed~nl did nOlmmrl', Wlis 1101 dil'oreed and did nOI have II child born or adopted
after l'\e,'ulion of Ihe will offered for proha,e; was 1I011h~ \'iclirn of a killing and was never adjudlcaled
iIH:oml'k'Ir..'lIl: ~_.__ .____
DCL't..'ndf..'1l1 at dl.'ulh owned f)ropl.'rly with eSllmutcd values as 1'01l0\\'''i:
(If domiciled in l'a,1 All per,onal property
(If' IHH uOl1lidk'd in Pa.) Personal propCrt~. in Pennsylvania
(II 1\01 domh:ikd in Pa,) Personal property in County
\'alll~' "I I'll:! I \,,'.qalL' III Pl.'llnsylqHliq ^- .
sitUIll";! as follllll': _ ">r2~::!!!,.>ol~-l---!-..n-."'"
__~..___, ('ft..\.~\4.. i>A ______
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1\ HI:REFORE, pelilionert') resreelfulI~' re.que\I(,) Ih~~prnbIlIC of the laSf will and codicil(s)
rrcsl..'nt~u hcrc\\lIh und thr.' gram of Ictlcr"i____~~_ .
, Ill''l,UlIl'flIiHI: ,Him nhlralllltl .;.1..1.: ildminislrminn d.h.n,c,l.a,)
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OATH OF PERSONAL REPRESENTATIVE
(,OI\1MO:'O\\E:\l.TH OF PE:'II~snVANIA
COt \T\' OF _ c.......\,,"'~...,R
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This is tu n'nlfv 111,11 11)(' inl;lrlll,ttltlll hi'll' 1\1\('11 i, tlllln'lh llllW,l 1"111111 ~1l1 (111"'111,11 l,t'lIilic,\ll' ol death ~hdr lIlt'd with l1H' ;tS
LOl;!l Hl'ghtraf:Thc original it'rlilk;lh' willII(' 11I1\\',ltdl't\ t\1 till' "LIlI' "il.d l~l'lnlll,. ()lllll' 1(11 Ilt'II1I.IIl{'llt IlIi11I'"
WARNING: Ills 1I1ogal to duplicate thle copy by photostat or photollraph.
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COMMONWEAl,TH OF PIlHH8YLV.aNIA ~ OI!PARTMENT OF HeALTH ~ VitAL AECO'109
CERTIFICATE OF DEATH
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,. Arthur r Mioh.ux
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I. Hal.
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Du rvilor . Glu'!. Company I ,<:}-111 __I t1401T'13 wiclowerl
0IC101HY'WI"UHO"00I\I"'So"CO'yI~$I...lt'I?1OlJ~CfoeI411 PA ",(J.....__..
50 Strawbtlrry [lriv. ~~~:riA..l'ICt ", JI"L_ ..- .~_....;.-_. :-...
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Carli Ill. PA 17013 ,,,<.'It'"""'" Cu.mb8rland _1#1III' ~.::J~,__""
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rortuo_ " Hicha"x W.r9"\l_ri te N....
IN Cf't,lA NAloIlfl'I*"'l'f1 IN QAt,lAHI'IlMAtl,tHQAOOIlUS\SIl..,c.t,".,...,.SUM.ljJCO<III
M. M Cottman 2 .tr.wber Lan_, C.rli.lel PA 11013
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Mary'. C__tery
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On '1'IIItut~ If ~.."'I~.tlO~ JI,dI",jMvl'lt,""o~, III "" oP'~ion, d..t~ ct(CUIf'~ il ,~. !lrni, dill. .nd ~tl~I.I~~ 4uI In 1111 uU"llf .lId
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IN WITNESS WHEREOF, I have hereunto set my hand and
seal to this, my Last Will and Testament, consisting of three (3)
typewritten pages, the first two (2) which bears my signature in
the margin fox' the purpose of identificatJ.on, this the 3>0 ~
day of .Q.it-_\.o..r-
, 1996.
./~.,iI. 'l7tl~jA.i-l.J ~__(SEAIJ)
ARTHUR F. MICHAUX
Si~ned, sealed, published and declared by the above
,named testator ARTHUR F. MICHAUX, as and for his Last Will and
Testament, in the presence of us, who, at his request, in his
sight and presence, and in the sight and presence of each other,
have hereunto subscribed our names as witnesses.
~&...u.- ___ADDRESS \ ~ e. Ch~ tlr: ec.-~PA .2.-'IOIJ.
~If.. ('.~ ADDRESSJe<vv,'II~A 17~'11
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COMMONWEA~SVLVANIA
DliPAAIMlNIOF REVENUE
C1EPTlI06/11
A
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MichauK Arthur F.
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REV.1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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DA fE Of IIIfHH
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2 I 01 I 18
T11~ AET1JRN IIlIIT IE fUD IN lIUPUCAIE WITIt IHE
REGISTER OF WillS
162 . 18 .5519
I" N't'lICAblEI SUAVMNG SPOUSE'S NN,I( (l),ST, flflST,..w l.llOGle IMllAlI socw. SECURITY Nt....R
[]I 1. O<\IIn.,Rltum 0 2, SupplemenlalRlhim 0 3, Rlmalndor RllUml"~_""b IJ.U.I~
o 4, Limned Eslall 0 41, Fululllnl.msl Compromise I"."" ... 1l.11~~ []I Hed.ral E.tate III Rltum Requll1d
GiI 6, OlCldonlO~ TeslaIOI_'_oIWII 0 /, OICIdonl Melnlalned. LNInO TMII_....~IMlI _ 8 Total NumbefotStle Otposn Bo...
o 9, LitI!llllonProoeedsRecelved 010, SpouuIPo..rtyCl1dnl..oI__1J.ll.Il..Hl,llj 0 l1.ElectiontowundelStc:, 9113(A)_",,01
THIS BEC ON MUST BE COMPLETEO. ALL OORRESPONDBNCE AND CONFIDI!NTIAL TAX INFORMATION SHOULD BE DIRI!CTI!D TO:
NAAlE CMl.m! I.WI.I ADORE
804 Wayne Avenue
Chambers burg ,PA 1720 I
& COMPANY, LLC
1. Real Eslllo (Schedule A)
2, Stocl<s Ind Bond'IScI1odule B)
(11
(21
4,.) CI
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3, CIoM~ H.~ COlJlOrallon,Plrtn."hip 01 $ole-Propn.lo"hlp 131
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4, Mortgages & Not.. Recelv'bIe (Sdledule 01
5, Cast>. Benk OeI><lsi1l & Milcelllneou. POl'IOt\III Property
(Sdledule E)
6, JoInlly Owned Property (Sd,odule F)
7, Inter.Vlvos Tnlnsl." & MlscellanaousNon,Probalo Property
(ScI1odule G 01 L)
a, Total Gro.. A..... (total Lines 1.7)
9, Fune"l E.penses & Administrative Colts (ScI1oduie H)
(9)
(41
(5)
(8)
(/)
11 . 545
487 . 49}
I
f'-....\
.........4___..__...__.
499) 042,
10, Debts of Dooed.nt ~eg. Llablll1les, & Liens (Schedule II (10)
11, Total Deductions (10111 Lines 9& 101
93 . 531
12. Nil Vlluur htlll (Lk1e 8 minus Uno 11)
13. Chllltable Ind Go..mmental BeqU<<l1SlSeo 9113 Tru.ts lor which In .1ec1Ion to w hi. not been
med. (ScI1ecIula J)
14, NIIVlluelubjecl to Till (Line 12 minus Line 13)
15, Amount 01 Nne 14w.'"
II the .pouselw..1I " x ,0
S..lnsllUctions on ""'" .~. lor .ppllceble penllllllilg'
16, AmountolUne 1411lc.ble
It6%..1o 399 . 373 X
17, Amount olNne 141alclble
IIR~ X
18, To DUI
19.
6 . 138
399 . 373
23 . 962
23 . 952
> > BE SURE TO ANSWER All QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
UncIotpon_oI_,ldoOnllllllliM_~IS_,irduIlInO_Iir4_OIdI_lS,"'illhoboslol""IulcIoIOIlQs..._.lllSlUO,_Pl""'_oIPf1l1nr-
11M ill Yl'lMII tvI8MlIlIliYIlI bMad on "In~ rlwhlch DrIUIf II. ~y knoMllrlDe
51, NATURE OF P~RSON RESPONSIBLE FORflLING RETURN A9'lRESS DATE~' /dL'f It:( ~
" /, . (011Ul~'.i..f M~WJ.J d1}.)i..R'j,,JJ~ [)~/Nu:hi<f ~l ,;~ 'lJ ..,...
.9THE~.ITH~N R ESENTATlVE ADDR@llG ~ayne t\ve. DATE
~~ ifAl- Chambersburg,PA 17201 .!J-oz..:r-:Ps:>
D.c.d.nt'. Complete Addre..:
STREET AOORE$$
]
err Lane
CITY
I STATE PA
I liP 17013
Carlisle
Tn Paym.nts Ind Credits:
1, Ta, O"~(Pl<Jellln~ tA)
2, Credits/Payment.
A. Spou~A1 Poverty Credll
8, PriOl Payment.
C, OlftCOUnt
(1)
23.962
28,000
_...LJ..28
Total Credits ( A . B . C ) (2)
,29.198
3, Intllfll~lIPenllity If applicable
0, Interltt
E,Penalty
T otallnterllUPenalty ( 0 . E ) (3)
4, If IIne21s greatllthan line 1 . line 3, enter the difference, This Is the OVERPAYMENT.
Check bOI on PIGe1 Line 1. to reqveet II'I"md (4)
5, If line 1 . line 31. greater Ihan line 2, enter the dlfferenca, This Is the TAX DUe, (5)
A. Enlerthe Inllresl on lho tM due, (5A)
8, Enlll the totel of Une 5 . SA, This Is the BALANCE DUE. (58)
Make Check Payable 10: REGISTER OF WILLS, AGENT
J .1111 II
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1, Old d.cedent mike a transf.r and: V'I
a., retain the vae or Income of the property tranaferred: ...........................,..........."'''....''''...."...fiJ
b. retain the right to dealgOftt. who shall us. the property tran&ferred Ilr Its Income; ....."......... [Xj
c. retain a reveralanary Intereat; or..,..............."................................,........................................ 0
d. receive the promlee for lif. of either paym.nts, b.nefits or care? ......................................... 0
2. If d.ath occunlll1 on or bIlfore December 12. 1982. did decedenl within two years
preceding deeth transfer proporty wllhout receiving edeqvate consideration? If death occurred
afler O.cember 12. 1982. did decedent transfer property within one year of dealh without
receiving adequate conelderatlon? .,....J:I1,~),...~!H,!H.~........,..,",..., ,......" ....,.'..,.,................,..,.. []I
3, Old d.cedent own an 'In lrust for' or payable upon death bank account or security
at hll or har death? .............................'...........................................,.................,,'..",,'...,............. 0
.. Old d.cedent own an Individual retirement account, annuity, or olher non-probate prop.rty?... 0
5.236
No
8
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IF THE ANSWER TO ANV OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN
72 P.S, 19118 (a) (1.1) (I) provided for the reduction of the tax rate Impaled on the n.t value of tranlf.ra to or for the UI. of the
, IUNlvlng lpaUII from 8% to 3% for datel of death on or afler July 1, 19~ and before January 1, 1995.
72 P.S.19118 (a) (1.1) (II) provld.d for the r.ductlon ofth. ral.lmposed on Ihe net vatue oflransferllo or for the use of the lurvlvlng
apoUII from 3% to 0% for datel of death on or afler January 1. 199b. The statute does nol exemot a transfer to a lurvlvlng lpaUse
from tax, and the Ita tutory requlr.mentl for disclosure of assetl and filln9 a lax return are sllll applicable even If the lurvlvlng lpaUI'
II the only benefielary,
FOR DATES OF DEATH ON OR AFTER JANUARV 1. 1995 - Pleale anlwer the following question by placing an 'x'ln th.
appropriate spac..
Did the dec.d.nt cl'late I tru.t or .Imllar arrangament which la aol.ly for the aurvlvlng apoulI" b.neflt for hla or her entll'l
lifetime? Vea 0 No []
If you .nlwered yel to the above question, the tax on the trust or almllar arrangement Is pastpon.d unllllhe death 0' th. aecond
lpaUII, .t which lime It 1'1111 be fully taxabl. at the rate(o) applicable to the remainder beneficlary(les), Enter the value of the tru.t on
Schedul. J, Pan II. In order 10 r.mov", It from the calculation of the tax due In thll eat.te. You may wllh to fil. Schedule 0 In order to
make the election available under Section 9113. If lha elect~,ln II made, th. trult or similar arrang.mentls taxed In the eltale of the
nrat decedent IpOUII. th. ponlon of the Iruat or slmller arrangement which benefitl the aUNlvlng spouse II tax.d at the zero tax rate,
and the r.malnder II taxed ellhe rate(s) applicable 10 Ihe Temalnder benefielary(III). If you choose to make the election, you must
anech Schedule 0 to a tlmaly-flIed tax retum, along with Schedule(l) K and/or M In order 10 show the apponlonm.nt of the trust or
slmller arrangement between the surviving spouse and Ihe remainder beneficIBry(lel),
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!IV."D' llt'II"'1 1 SCHEDULE F J
COMMoNWIAlTH OF P1NNSVLVANIA'. JOINTLY.OWNED PROPERTY
INHERITANCE TAX RETURN
nElIOEHI OECEDENT
'ITAn: OF - -----=~-~-=,=~~~----.
ARTHUR F. MICHAl!!< _____,____
FILE NUMBER -'-'---==---
_~~7-0609
If an ...., WI' midi joint whhln OM y..r of thl decHlnt" d'lt. of d..th, It mu.t be reported on 8chedule O.
---"-~'----'-- ----
5URVII/IN(l JOINT TENANT(S) NAME
AllonESS RELATIONSHIP TO DECEDENT
-~--_....-. --"-.
A. Mary M.Coffmnn
2 Strawberry 'Lane, CarHsle, Pa. Daughter
8, Elizabeth A. NJ.L_I._l
!'!/<A~.,/
2105 Golf Course Road, Reston, Va. Daughter
c,
JOINTLY~WNED PROPERTY:
ITEM LnnR DATE OEsc:wno:\ OF PROPERTY DATE OF OEAnt _OF DATE OF DEATH
FOR JOINT MADE lr.'l\'&"r'lm~I'i\'yfi:rn~u.l,~r. ~mi1h'M\ ~\!fIJ~.II'''Il\t1 DECO'S VALUE OF
NUMBER TENANT JOINT .it... VALUE OF ASSET INTEREST f-- DECEDENT'S INTEREST
1, A, Attach US Savings Bonds 27,930 50 13,9
2 B Attach US SaVings Bonds 27,929 50 13,9
3 A 4-14-95 3300 shs PPG Industries 195,937 50 97,9
4 A 4-14-95 2152 shs First Commonwealth 44,654 50 22,3
5 A 4-14-95 300 shs Dominion Resour~es 11,137 50 5,5
6 A 4-11-95 250 shs PP&L 5,015 50 2,5
7 A 4-14-95 100 shs E:xxon 6,450 50 3,2
8 B 4-14-95 3300 shs PPG Industr.ies 195,937 50 97,9
9 B 4-14-95 2152 shs First Commonwealth 44,654 50 22,3
10 B 4-14-95 300 shs Dominion Resources 11,137 50 5,5
11 B 4-11-95 250 shs PP&L 5,015 50 2,5
12 B 4-14-95 100 shs Exxon 6,450 50 3,2
13 B 4-11-97 100 shs F,xxon 6,450 100 6,4
14 A 4 -11- 97 100 shs Exxon 6,450 100 6,4
15 B 4-07-95 CD Harris Savings Bank 10,000 50 5,0
16 B 4-07-95 CD Har.ris Savings Bank 10,000 50 5,0
1"1 B 4-07-95 CD Harris Savings Bank 10,000 50 5,0
18 A 4-07-95 CD Harris Savings Ban~ 10,000 50 5,0
19 A 4-07-95 CD Harris SaVings Bank 10,000 50 5,0
20 A 4-07-95 CD Har.ris Savings Bank 10,000 50 5,0
21 B 4-08-95 CD York Federal 10,000 50 5,0
22 A 4-08--95 CD York Federal 10,000 50 5,0
23 AB 10-6-87 Savings Farmers Trust 14,710 33.34 4,9
24 AB 4-08-96 Liquid Asset Mgr Harris Sav 41,355 33.34 13,7
25 AB 8-12-87 Checking Farmers Trust 26,066 33.34 8,6
26 AB Reimbursement Condo Fees 3100
27 AB Reimbursement Real Est. Tax 423 100 4
28 AB Accrued Interest CD& Savings 7B 50
29 AB Accrued dividends 1,457 50 '/
30 AB 12-96 50 Strawberry Court, Carlisle
Pa. Real Estate Sale Proceeds 114,90_~ 190 114 9
To'rAt IAllo In11f on 11M 6, Rec.pitul.lion) $ 487.49
.. -~,
65
65
69
27
69
08
25
69
27
69
08
25
50
50
00
00
00
00
00
00
00
00
03
85
89
3
23
39
29
00
7
(II mOil .pac. it n.,d.d, Inl'" .ddltlon.1 ,h"lI af ..m. slz.l
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J
SCHEDULE J
BENEFICIARIES
COMMa_AlTIt Of PENNSYlVANIA
INItIAfTANt! TAX AITUAN
AUIOINT OICIOINl
I.TAlI Of --
~THUR F. MICHAUX
NUMIIIR
I
NAME AND ADDRESS Of PERSO~S1 RECEMNO PROPERTY
.--.--
TAXABLE DISTRIBUTIONS (In,IOO. oUIIlght 'pou..1 dl,"lbutlon'l
FiLl NUMBIA
2197-0609
RElATIONSltlP 10 OECEOENT AMOUNT OR SItARF.
Do Not L11' Tru","'"' OF ESTATE
1. Mary M. Coffman
2 Strawbarry Lane
Car1iole, Pa. 17013
2 Elizabeth A. Michael
2105 Golf Couroe Road
Reoton, Va. 20191
DIl'ughter.
50% of Re8idue
Daughter
50% of ReBidue
ENTER OOLLAA AMOUNTS FOR DISTAlSUTIONS SHOWN ABOVE ON LINES 16 THAOUOH 11, AS APPROPRIATE, ON REV 1600 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A, SPOUSAl DISTRIBUTIONS UNDER SECTION S113 FOR WHICH AN ELECTION TO TAX IS NOT BEINO MADE
\,
B, CHARfTA8LE AND GOVERNMENTAl DISTRIBUTIONS
\, Donation, GOOdwill Induotries 596
2 Donation, Camp Hill Preobyterian Church 2,476
3 Donation, Todd Nuroing Home 716
4 Donation, Friends of Fur Fashion 2,250
5 bonation, Ford City Lions Club ' 100
TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1600 COVER SHEET
$
6,138
(If !nor. 'pice I, needK, inN" .ddilional ,h"tl 0' urn. ,Ize'
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Value of U,S. Savlll.a Bonda
Ponn RBV I~OO
Schedule P
Ownen: Mhur p, Mlch.u~ or Ellza~lh Michael
Denomln,llon Bond D,te of Co.t of Redomptlon Numhor of Total Rcdomp. TOIII COil Ihten"t
of Bond Serle, IlIIue Bond V.luo 71~197 Bond. Value of Bond. on Bond,
$ 1.000,00 BB 00.,92 500,00 645.60 10 6.456,00 5,000,00 , 1,456.00
$ 1.000.00 BB Nov,92 500.00 645,60 10 6.456.00 5.000.00 1.456,00
$ 1.000.00 BB Feb,93 500.00 621,20 20 12.424,00 10,000,00 2.424,00
$ 25,00 E Oct-78 18.75 67,83 I 67,83 18,75 49.08
$ 25,00 B SoI,.78 18,15 67,83 I 67.83 18.15 49.08
$ 25,00 B Aua,78 18.15 67.83 I 67,83 18,75 49.08
$ 25.00 E lul,78 18.15 69.19 I 69.19 IS.15 50,44
$ 25,00 B lun-18 18.15 69,17 I 69.17 18.15 50.42
$ 25,00 B lun.78 18.15 69,17 1 69,17 18,75 50.42
$ 25,00 B May-78 18,15 69,00 I 69.00 18.15 50.25
$ 25,00 B Apr.78 18.15 69,72 1 69,72 18,15 50.97
$ 25,00 B M.r.78 18,15 69,72 I 69,72 18.15 50.97
$ 25.00 B Feb.78 18.75 73.90 I 73.90 18.15 !S.15
$ 25,00 B l.n-78 18.75 76.12 I 76,12 18,15 57.37
$ 25,00 B Doc-77 18,75 76,12 76.12 18.15 57,37
$ 25,00 B Nov- 77 18.15 75.91 15,91 \8,75 57.16
$ 25,00 B Oct.77 18,15 82,77 82,77 18,75 64,02
$ 25,00 B Sop- 77 18,15 82,77 82.77 18,75 64,02
$ 25,00 B Aua- 77 18.15 82.77 82,77 18,75 64,02
$ 25.00 B lul-77 18.75 85,26 85,26 18.75 66,51
$ 25,00 B lun,77 18.15 85.27 85,27 18,75 66.52
$ 75.00 BB lan-82 37,50 118,17 118,17 37.50 80,67
$ 75,00 BB Nov.SI 37.50 118.17 118,17 37.50 80,67
$ 75.00 BB Sop-8t 37.50 118,17 118.17 37,50 80,67
$ 75,00 BB lul,8\ 37,50 121.71 121.71 37.50 84.21
$ 75,00 BB May.8l 37,50 121.71 121.71 37,50 84,21
$ 75.00 EB Mar.81 37,50 124.68 124,68 37,50 87,18
$ 75.00 BB lan-81 37.50 128.40 128.40 37.50 90.90
$ 75,00 BB Nov-80 37.50 128.40 128.40 37,50 90,90
$ 75.00 BB Sop-80 37.50 134.73 134,73 37,50 97.23
$ 75,00 BB lul.80 37.50 138.78 138,78 37,50 101.28
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EsI.II o( Ar1hur MiCML4M
Valul 01 U 5 54""9' Bood'
July 3. 109'7
Dlnomlnatlon DatI 0' Cool 0' Rldlmptlon Numb", 0' Total Rldemp. Total COlt Int....'
0' Bond Bond SerllS luue Bond Valull/319l Bonds Valul o'Bnnd. On Bond.
(per bond)
$ 1.000,00 as Oeo.92 500,00 645,60 10 6,456,00 5.000,00 1.456,00
$ 1.000,00 aa No,.D2 500,00 645,60 10 6,45600 5.000,00 1,455,00
$ 1.000 00 aa Feb.93 500,00 621.20 20 12,424,00 10,000,00 2,424,00
$ 25,00 e 001.76 16,75 67,63 1 67,63 16,75 49,06
$ 25 CO a Sep.76 16.75 67,63 1 67,63 16.75 4908
S 25 CO a Aug.78 16,75 67,63 1 67,63 18,75 49,08
S .5,00 E Jul.78 18.75 89,10 1 69,19 18,75 50,44
$ 25,00 a Jun.78 18.75 69,17 1 69,17 16,75 50,42
$ 25,00 E Jun.78 18.75 69,17 1 69,17 16,75 50,42
$ 25,00 E May.76 18.75 69,00 1 6900 18,75 50,25
$ 25,00 E Apr.78 18.75 6972 1 69,72 18,75 50,97
S 25,00 E Mar.78 18.75 69.72 1 69,72 18,75 50,97
S ~,OO a Flb-78 18.75 73,90 1 73,90 18,75 55,15
S 25.00 a Jan.78 18,75 76,12 1 76.12 18,75 57,37
S ~,OO a Oec.n 18,15 78,12 1 78,12 18,15 57,37
S 25,00 a No,.n 18,15 15,91 1 75,91 16.75 57,16
S 25,00 S ool.n 18.75 82.n 1 82,n 16,75 8402
S 25,00 S slp.n 16.75 82.n I 62.n 18.75 84.02
S 25,00 S Aug.n 18,75 82.n I 82.n 18,75 84,02
S 25,00 S Jul.n 18.75 85,28 I 85,28 18,75 611,51
S ~.OO S Jun.n 18,75 85,27 1 65,27 16,75 tlll,52
S 15.00 sa Jan-62 31.50 118,17 I 116,17 37.50 80,87
S 75.00 SS Nov-61 37.50 116.11 I 118,11 37.50 80.87
S 75,00 as Sop-61 31,50 116,11 1 116,11 37.50 80,67
S 75,00 EE Jul-61 31,50 121.11 1 121.71 37.50 84,21
S 75,00 EE Mly-61 31.50 121,11 1 121.11 37.50 84,21
S 15,00 EE Mar-61 31,50 124,68 1 124,68 37.50 87,18
S 75.00 Ea Jen-61 37,50 128,40 1 128,40 37.50 90,90
S 75.00 aa Nov-60 n50 128,40 1 128,40 37.50 90.90
$ 75.00 as Sop-60 31,50 134,73 1 134.73 37.50 97.23
$ 75,00 aa Jul-60 37.50 1:18.78 I 138.78 37.50 101,28
S 1,000,00 aa Nov.92 500.00 845,60 10 6.456,00 5.000.00 1.4:i6,oo
S 1,000,00 aa Oeo.92 500.00 845.60 10 6.456.00 5.000.00 1.456,00
S 1.000.00 aa Feb-93 500,00 821.20 20 12.424.00 10.000.00 2.424,00
S ~.OO a Mey.n 18,75 85.10 1 85,10 18.75 611,35
S 25.00 a Jun.n '16.75 85,27 1 85,27 18.75 611,52
S 25,00 a Jul.n 18.75 85.25 1 85,26 18,75 611,51
S 25,00 S Aug.n 18.75 62.n 1 82.n 1875 84,02
S ~,OO a slp.n 18,75 82.n 1 82.n 18,75 84,02
$ 25.00 a ool.n 18.75 62.n I 82.n 18.75 84,02
S 25.00 a No,.n 18.75 75,91 I 75,91 18,75 57.16
S 25,00 E ooo.n 18.75 76,12 I 76,12 16.15 57,37
S 25,00 a Jln.78 16.75 78,12 I 76,12 16,75 57,37
S 25,00 a Flb-'78 18,15 13,90 I 73,90 16.75 55,15
S 25,00 a Mar.18 18,15 69,12 1 69,72 16.75 50.97
S 25.00 a Apr.78 18,15 69,72 1 69,12 16,75 50.97
S 25.00 a Mly.78 18,15 89,00 1 69,00 18,75 50,25
S 25,00 a Jun.18 18.75 89,11 1 69,17 18,15 50.42
$ 25,00 a Jul.78 18.75 69.19 I 69,19 16.15 50.44
S 25.00 a Aug.78 18.75 67,63 I 6763 16,75 49,06
$ 25.00 a S.p.18 18,15 81,63 1 61,83 16,75 49,06
,.....-:-~'r.~'~...~'''''.',..,~.... -""'-to '-"
L ,I t 1
;YT)/I/;. 7hi
hlltl 0' Atlhur MlchlU'
Vliul 0' U S SI,ings Sondl
July 3. 1 ~~7
, 'Olnomlnltlon Oltlol C~11 01 Rldlmptlon NUmbl' 01 Totll Rldlmp. Totll Cost Intorllt
of Borld Bond SIIIII IlIu. Bond Valu.713117 Bonds Vllu. ' 01 Bonds On Bond.
(per bond)
S 25,00 e Ocl.78 18.75 67,83 1 67,83 18.75 049,08
S 75,00 e5 Flb.52 37,50 114.72 1 114.72 37,50 77.22
S 75,00 e5 Oeo.81 37,50 118,17 1 1\8,17 37,50 80.87
S 75,00 ee Ocl.8\ 37,50 118,17 1 118.17 37,50 80,87
S 75,00 e5 Aug.8\ 37,50 118,17 1 118,17 37.50 80.87
S 75,00 55 Jun.81 37,50 121.71 1 121.71 37,50 84,21
S 75,00 e5 Apr.81 37,50 124,68 1 124,88 37.50 87.18
S 75.00 ee Flb-81 37,50 124,88 1 124,88 37,50 87.18
S 75.00 5e Oee.80 37,50 128,40 1 128,40 37,50 80,80
S 7,5.00 ee 1.0cl 37,50 134.73 1 134,73 37,50 ~7,23
S 75,00 ee Aug-80 37,50 134.73 1 134,73 37,50 07.23
136 55.859,71 41 ,425,00 14.434,71
77111.:
~~
<9-
.L..1!::l-
III !
jlJ1 ~"o/1~'
A" H,I..D SeTTleMENT STAF\1.~~To
r -----~_.,~.~--- ~ .. ..
'B,lOA,N iff'.E
- -----0---.---.-.-... ,-- --..
I 5eo' 30 Yf9, FIXuu
i:VR FilE II RE~8 -05 loon 1I09-24-'I~287 1 LENDER uu_Pt-jc, M.or19.9~n ..
-_........--..........--------- ~..- ___..._n_. n_' ---.-... .'....__.~ -..,,. - -" ..-.>"--.---- ----, .- ~. -. .._."~._---
c.!hil fora tl furni.hod to qivo you . lItatfJ."nt ot 4C't~U'" t ..ttlflIDBnt UQat..:1. Amount. pAid
to .nd by thl Ilttll.ont aq.n t or" shown. I to_It lIark..d P.o.C. wece pold OU,t.I11.d'l cloo1nq.
~"' .------'-~-._.~- .___._._..... _.u.,_... . .---~ *~--..~_._'".".~-~--- ~- ..__.~_.."..." .,.,--- .~-- - ,..._~.._. '. ....~_.- ----~_.-._~--
0, NAME OF BORROWER: ~'M'O' """
Hendrlka E, Them Mary Margaret Coffman, Exec. Est 01 Arthur F.
Philip Them Elizabeth Ann MlchR~I. EJlec. Michaux
- __ ...__....__.r..__ ~_____~._._ -~ --.---
G. PROPERTY LOCATION: H. SETTLEMENT AGENT: I. SETTLEMENT OA TE:
50 Strawberry Court. Ca~isle. PA 17013 Duncan & Ono. P,C, FndllY 30-Jan-98
1 Irvine Row
Sou III Middleton Twp" Cumberland Co, CARLISLE. PA. 17013 11:00 a,m,
J. eUMMARYOF BORRO~ TRANSACTION ~ K 'OMMA" OF """" '....meno'
100 ORa.. AMOUNT D~I '''OM BORMOW!R 400 CROSS .u40UNT QUI TO SILL'"
---
10\ COtltr.at 111... PriOI $1 U,9QO,QO 401 Contl"sct .. L.. pc lae $114.900,00
102 ,.uond proput)' ..02 ".,.o~al pl':)partv
"-- --- -
102 ..ttL...nt ChAr,.. lUne 14001 5419.80 'OJ
\0' ..uocluiall ,.. to ll'"'JanM'n 2,91 ,., ",uGeLaelon ,... to H ~J.n.9I 2.91
-
\OS .-L "dju.t_nCI Lt... pupa Ld by ,.Uee I --
Adjun..nu L c... pupa 14 by ..11erl 40$ Local ta..' to HMl).O"U O.~~
10' Loaal e.... to U....O.o..U 0,00 '0' A.......nt.
101 A........n.. to '01 lahooL e.... to ]O-.1\1n"" 441.57
. - ---
10' Ichool u... to ,)O-Jun-91 441.57 '00
10' 'Ot
" -
120 GROSS DUE FROM BORROWER 120764,26 420 GROSS DUE TO SELLER 115344.48
-
200 AMOUNT' 'AID It OR rOR 101ll1ll0WI" SOO RKDUCTIONI 1M AMOUN1 QUI TO JILL'R
20\ alDOILt or larn"t MonlY 5000,00 SOl bo... depol L t
202 W.. Mort"" -.ountl 'NC 91920.00 S02 Settl...nt Oftlcq.. 9326.89
20' ..i.cLn, loan. eak.n '\Ibj.cc co SO. hhti.n" loan. c.k.,.
~~ SO, ,.voU ht IlOrt91Q.
20S SOS ..yoU 2niJ -.ere".q.
-
~--- SO,
.
201 '01
-
Adjun..nh for h.... unadd bY ..110r' SOO
210 Load 'f.... U JO"J.n..9I 18.42 Adjll.t..nt. 10. Lt... unp.id by ..11er
11\ ".......nt. U !Ii 0 Load t.... JO...7.n"91 18.42
212 Sohaol T.... to 30".1.....91 0.00 SI\ A.......nt. to
lIS 511 Sehool t.... to )O".7.n-91 0.00
III SI2
111 S\I
-
220 TotAL 'AID IY BORROWeR 98938.42 520 tOTtL REDUCTIONS IILLIR 11347.31
-
'00 CAlK PROH/TO IORROMIR '00 CAIH TolPROM SILL..
301 Q~o" aaount du. t~a. bo~row.r 120784,28 '01 Qco.. ..ount to ..ller 115344.48
302 L.a. ..Ollnta p.id bVlfor borrow.r 98936.42 .02 R.duction. to .alL.r 9347.31
303 CASH FROM ITOI BORROWER: $23,825.811 803.CASH TO (FROMI SELLER: '105,1197.17
I have .,.uhlly uviewo<l tho BUD-l Sottle.ont Stata.ent ond to tho but of ..y kn.,wle<lqe
and beliet, it i. a true and aocurate .tat.m.nt of all receipts and dilburs..ent. .ada on
.Y ..,count or on ..y boh.~f and I hovo rocoivld 6 copy of this BUD-l for ..y ro.,ordo.
a./ -J ~''\"" /, ~I;
~rL-.dLI.!._J..J.-IU",==-__ '- '/!ld.;<Y/ 11-1 !?~f1Jf.lkd....---
Hendrlka E. Them Mary: argar.et Cpffnnh, 7f~c;
./'A ~f:?;...,-j.r'l-it:.,~--- C~J~L'.SJ.. (/ "l:..!.LLl)., (I i' :..\ :~
Philip Them Elizaeeth Ann Michael, Exec.
PAID IlY
SELLER
___H_ ___n _, I - ---~- - - -- - ~.,
700'--~I'f~~~~ji~LJ()~,;S(;c:>~.~ISSION ,... · SI,.~,9.1100.0. .., ... _I ..ul"'.'.,.u..8~4.~:.qrJ
701 LJ.lIn~Qe~~L._...,.__mu_..._..u . uo 0' Cold~.ell Banker~S.9~~0411S0_.o.._ + ,. ---- .'..'''-_''
!02 Sel!i.!'_~~8!'~Y.:.____...--u..~..--. ,.....01!~.&.~~,ea!.~r,Egg6 50 . ... ",'., ".,....-.......-_
703 CommlGSl,on palE.. al se!lI~,ITl!~L~_.......... ..._.__..............,.. "..._.. .".'__. "u.w...._...._~ ..---'--.-..
800 ITElAS PA Y Al~~E J!'I_(;c:>tI.N._~~.!I.c:>.~.....ITH.L()A.N." ......... ...__... ..__.._. ._.__......n..__ ..-...---. ---
eOI Loan OriilnaUon 'e!........_..~_,._.__...., ."., ..P_~~~'?rt9i'9.e_CorJl:.<lIo~~.enG.'!........ ._.._......._!!.!.~J.ll. .-~_..__._
802 Loan DI,counl ._,..__.___....__._._._....."...!'N.~_!viort2'l.~.s:orL"!.!'.i".~.rl.t:,~u.......,.. .___._~O~4, '_0 _._.._.. .
803 Appraisal Fee.._ ,__..~_._fN~ Mor!9.!9e..CO!f!'-CO!.."-""!.rl.~...__o_+_____~..__,~____
804 Credit Report .....____._.__...._.._p.~C MortSlll.ge C~re'-"!.~~~lI..__..._ __...._..~.___.
805 Appllcauon F!e S325 POC ._.___...._.__~~~~O~~!9.! CO!P, 01 AmenGa ___.._.....F'E..:.s...~____
~08 Documlnt Prepareuon Fe! .___.__...f.N.C ~?rtgage Corp, 01 America 1-. 295,00
801 Overnight Mail _.._.. Alrbomo 10,00
808 Tu Service Fee Transom!rica Real Estale Tax Service 70,00
8011 F;ppd Certification . Pinnacle Data Service__,..__.. _ 26.00
810 Overnight Mail Charges: F~deral Express ._.. _ 20.00 _
1100 ITElAS LENDER REQUIRES TO BE PAID IN ADVANCE
901Interest@51',87~3 .30-Jan:98
902 Mortglgelnsurancl
903 Hazard Insurance
90~
1000 RESERVES DEPOSITED WITH LEN[)ER
Elcrowl collected:
1001 HJlzard Insurance
1002 Mortgage inlurance
1003 CaLmly/Local lUes
1004 School tex..
1005 Aggreglte Adjullment
1100 TiTlE CHARGES
1101 Setllementor cloling I.e:
1102 Abslllct or tiUe ..erch:
1103 nUe uaminaUon:
1104 nUe insurance binder: ,
1105 Oocument preparation;
11 08 Notary fee.:
1107 Atlorney's f...:
(Includes aboveUem numbers):
1108 nUelo,urance: WILLIAM A. DUNCAN, AGENT FOR FIDELIn' NATIONAL TITLE
(Includellbovellem numbe~):1101-1104 Endorse'!'enl. ~~O 300 8.1 4. I 5125
1108 Owner's coverage $1 I 4.1100.00 5893,75
1110 Lender's coverage SII 1.1120.00
1111 Disbursement lee Duncln & Otlo. P,C.
1200 GOVEANMEfoIT RECORDING AND TRANSFER CHARGES
'201 Deed 28.00 Mortgage
1202 Relesll Assignment
1202 Counly/Locallransler tax 11 %)
1203 Pa. State Iransler lax J.!. %)
1300 ADDITIONAL SETTLEMENT CHARGES
'301 Radon tuting:
1302 Pastinspection:
1303 Final wlter & sewer Accl. #a- 10-144
130~ Slrawbeny Cou." Condo Resale C_ert,
1400 TOTAL SETT..h~~ENJ CHARa~S:
PAGE 12 HUD DISCLOSUIIE/Gb'flLEMENT STATEMENT
,PAID OY
BOfHlOWEI1
--
0' -Feb-98
35,15
-+--.
x S oer mo.:
o
o
12
6
(Inllial eSGrow Deposit 5649'~OL
II mos. due:
0.00
0,00
19,31
80,94
0.00
0.00
231,]2
533.64
-"5.66
Not8cry
O'Brien Berlc & Scherer
10.00
3.50
P.O,C.
1016.15
I
35.00
31.50
0,00
57.50
1149.00
1149.00
L1cvd's Home Inspection
Penn Pesl '
.
SMTMA
P,M.I.
125,00
---.---"--
5419.80
30.00
48.39
20,00
1132i.fa
lalso '1n.ered on line 103 for Borrower: line 502 lor Seller)
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"d-1. ~ :1
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131
PMm HO. !:kL.:..~Q.L.CcO.:::QJ":z..-= I,.J -05'0.-
?1
DEED
MADE THE
one thousand
'SJ~ day of ~'N- in the
nin& hundred ninety six (1996).
year of our Lord
BETWEEN ARTHUR F. MICHAUX of Cumberland County, Pennsylvania, a
single man, of Cumberland County, Pennsylvania, hereinafter
referred to as:
Grantor,
'!
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and MARY MARGARET COF~ and ELIZABETH ANN MICHAEL, both adult
women, of Cumberland County, Pennsylvania, as tenants in common,
hereinafter referred to as:
Grantees,
WITNESSETH, that in consideration of love and affection, the said
Grantor does hereby grant and convey to the said Grantees, their
heirs and assigns ninety percent (90%) of his interest in the
aftermentioned real estate as tenants in common and not as joint
tenants:
ALL THAT CERTAIN Unit in the property known, named and identified
in the Declaration referred to below as "Strawberry Court
Condominium,j, located in South Middleton Township, Cumberland
County, Pennsylvania, which has heretofore been submitted to the
provisions of the Pennsylvania Uniform Condominium Act, 68 Pa.
C.S.A. Section 3101 ~ ~ by the recording in the Office of the
Recorder of Deeds of Cumberland County of a Declaration dated
December 17, 1987 and recorded on December 23, 1987 in
Miscellaneous Book 344, Page 318, being and designated in such
Declaration as Unit No. 50, together and including the detached
garage, being and designated in such Declaration as Unit No. SO,
which said Unit and detached garage, being part of said Unit is
more fully described in said Declaration, together with a
proportionate undivided interest in the Common Elements (as
defined in said Declaration) of 1.613 percent.
BEING the same premises which John H. Billman and John F. Walter
Excavating, by deed dated February 10, 1988 and recorded in the
Office of the Recorder of Deeds in and for Cumberland County,
Pennsylvania, in Deed Book E, Vol. "33", Page 575, granted and
conveyed unto Arthur F. Michaux and Louise C. Michaux, husband
and wife. Louise C. Michaux died, whereby titled vested in
Arthur F. Michaux, grantor herein.
THIS is a tax exempt transfer of property from father to daughters.
, . , ....,;...
~'-.I l:it .'~ fl..,.,
'. !' "
,
;1
TOGETHER with all singular the streets, ways watnr, watercourses,
rights, liberties, privileges, heredtt,lm'lnts and appurtenances
Mhatsoeve~ thereunto belonging or in any WiSD appertaining, and
the reversions, remainders, rents, issuos and profit!J thereof;
and al of the estate, right, title, intet'f):1t, property claim and
demand whatsoever of said Grantor, in law, >,1qUJt:y or otherwise
howsoever, of, in and to the same and every part thereof.
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TO HAVE AND TO HOLD the said unit, to lnc:lud/3 the detached
garage, above described, and the !lsredHamontn and Premises
hereby granted or mentioned and intended so to bu, with the
appurtenances unto said Grantees, their holrs and assigns, to and
for the only proper use and behoof of tho said Grantees, their
heirs and assigns forever.
,
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AND the said Grantor hereby covenants and aqroes that he will
warrant specially the property hereby conveyed.
IN WITNESS WHEREOF, said Grarltor has hereunto set his hand and
seal the day and year first above written.
,
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SIGNED, SEALED AND
IN THE PRESENCE OF
-~'
V'
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DELIVERED
~~~j~J(b
ARTHUR F. ICHAUX
(seal)
COMMONWEALTH OF PEt~SYLVANIA
): 59 I
'I
,
COUNTY OF CUMBERLAND
On this, the ..30~ day of O~, 1996,
before me, the undersigned officer, personally appeared ARTHUR F.
MICHAUX known to me (or satisfactorily proven) to be the person
whose name 15 subscribed to the withln instrumont, and
aCknowledged that he executed the same for. the purposes therein
contained.
seal.
IN WITNESS WHEREOF, I hereunto set my hand and official
I
."",I1IU
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'i.'!'f:~.:lr,~!.o{:
;.)lj,,~'~n,'J'."''l ,~...'
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I,t ~,/,,, 'f- 1,ql~\/"",'lIt'l
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IJ,'I,,:..... \..,'~r' ,I,. ,,,I
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Nr./.~tl,,! ~';lal
A'lQlIla r I,JWjiH Nt;.lJr'l f'vb!lc
C;1fll!lh# t!f}rQ, C'lla1;"';~rl,lrlf1 COU~l'l
My CiJ'llI!l,~r.'vn I: ft'lr.i:\ O,~t. 7'. ~,:i:O
fJIt;I:r,1t il'I'H, -'I'" ."-"lll.,'...\'.....[O-
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{l'.;(r;:;Ll!;~'A I' tL~ '
~~~---~dn._'___'--,.'.~.:r~.-'..-----._--_.,._-----..:...,L'_...::::::::::::
.'
(seal)
~,
,".' 1.Ji. 1,',('.[ tJ'lG
Life Insurance Statement J :',,,, N" ,c~',')Im
_~~,_n~"_W__ ____' 'n" ,.-,,-'-'- ..~,~,.-_---- --
Decedent-Insured l10 Bl:+ FiltHl 01' lilt! /;WI.'1I\)' 'N'IIl (jfii!"d ,l,lh", hlillf' fill ~~I'ItJfI\_ /:nUH tOfi l)r Fmrn 70fl.NAI
(JeCl!Oe,,1 s Ilr~1 "..m6 ,1rO ml(UI~-:'-l~l~;I'1 "2 [JIIl,I'd/11l1 I, '",'.\ .,',IIIW ":) IJIH,ild!!'\! 'j 'il!"I,I' ',llF,II'll', 1\!lfllllfH ~---'I.OM;-(~.<1ft"th'--'
ARTHUR F. _.___dn MICHAUX !""'''''''' r/i/-r8-~~,l2__l7.3-97
Name ana address of ,nSur,lrH;tt r.ornplltW
CONNECTICUT GENEIlAI., l/iOO W. CAIl:10N :1T.
OI(IlOClIX~~:(~:t)(~)(, Pitt.'.I1IJl'qli, PA 1';;'1'1-.)1119
Type 01 cOlley P /I'lIiL', 111/111"'"
,
, ~,,_,_~~_,,'m_<..'___.~_,
110 A"~lljrlor', fl,lrlltl AIl.hill cop" 1)1 [:' Olllu IIsslgned
II'I'llljl\fll'lf11
l1-1-S3
"L.-..,.-",,_,_.._~_,..~.__ --
13 AlllourH IJ! nrOIll'llrn I'.." 'fHHhiC"llllftI114 NIU'lIJ lif nl'lnehCliVIIJ!l
EQUALL Y BETWEEN I MARY M. COFFMAN AND
,ELIZABETH A' MICHAEL
,~,_,~_,,,~~~,,.,r'~'__'__'__~~"'_~'_~_~_'_T~~~~~'M_+_~.,
$
fo,", 712
IA.... '\'uQ...," ''f'i~
:;..0.".,..,..0'.....1,_.,.".
'l'I,.m..- ........,,,( lootrN.~
5
5
e
Owners, name II t1eC8116'" IS 'lnt ownftl
anacn copy 01 apohcallOfl
11997
11,JOO:1m
Face amount 01 pOI,C'f
Indemnity benefits ,
Additional insurance
Otner oenefils,
Principal of any IndeOtednesN 10 It/8 company I,,"' 's dflOucllbie ,n deW mining net proceeds,
Interest on IMeOtedneu (line 19) acclued \0 dnle of d..lll,
Amount of accumulated dividends,
Amount of post-mortem dividends
Amount of returned pramlum
Amount 01 proceeds If payable In on. aum
Value of proceeds as of date of death (if nol payable In one sum)
Policy provisions concerning deferred paymenls or inslallmenls,
Note: "Ollle' than lump-sum s8Nlement is authorized lor, surviVing spouse, ,Nach , copy or the
Insurance pollc""
ISSUED ON THE LIVES OF THE EMPLOYEES OF
,..... """"P'PG "INDUSTRIES 'IWe~.
27
28
Amount of Inetallments
Date of Dlnh. .e~. and name 01 any person the duration of wl1Cse lile may measure the number of payments,
..". ..... ,.. "'NONE'SRO\\IN"
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Amount applied by the insurenoe company IS a alngle prem,um represenung the purchase of
Inatallment benellta ,
Baai. (monality table and rale 01 interest) ueed by inourer In valUing Installment benefits,
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30
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P'pefWOrk "Mucti..n Act HOIIClI,"'-W. Ilk for lh. Intormlllon 0'" IF'lI$
form 10 eIIrry Oul It'l. Im.m,al F11....nu. lawI olin. Urul.d ~'IIIS YOll are
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COmDl~'lng wIlh \h... lawI anow allow ul \U IlgUfe .nd (;:,Jllm;\ Itle right
amour'll of IP
TF'l' lime "Matd 10 oompi.,. iM 1111 Inl' 101'" WIll v.ry OClP(lf\(III1Y on
tndl\/ICu'l ClrO',Jml1lno" Th. "limll~lllJtl'Q' urll. II
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II you n.v. COI'Ml.nll annC.rr1,'IU \!\11IIr,,:UIII:y 01 In... tlllltl
l'lImalll or IllgQ.11I0nl lor ml"lrlQ HII. l(IIm IlH,J/I 11I11{)1* W~ w(wlO btl
"'DDV 10 h.lIf flom y01.1 YOII blf' nflU, W Ontt\ 111ft IRS ,and trl!! Otllt;t1 [ll
31 Wes the insured the annUllanl or beneficiary of any ann,"ty contract Issued by the company? , 0 Ve. IS' No
32 Names of companll' w'th whiCh dlCedant carned othar pol'Cles and amounl 01 such poliCies if Ihls ,nlormaliOn i. dlsclcsed Dy your records.
12
Value of trle polley II tn,
tIme of assignment
15
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19
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23
24
25
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8-5-97
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Mlnag.ml",1 and BUClOII at lhe addresses listed In the instructions 0' In.
lAIl; ftlufrl WIth wnlch lhls form II fII.d. DO NOT und Ih. lfJIlorm 10
eitntr 0111'1... OHICIS,. InlleaCl, ralUrn II to lhe '.II.cutor or ftpre..nI11ivI
wno requested it
SUlt'n'Wn' of inlurer..-Thls slalomlnl rnult D. mide. on Dln.1I 01 Ih.
In,urance compMny that IfH,lued the policy, by an officer "' lne company
ha....lng access 10 lne records 01 me company For purposes of tnis
atllemetnl, a lacSlmlle IlgnaMe mly bCl used In heu o! I manualllgnlture
al1d II used, snail b8 binding ;J.S a manuat Ilgnalure
hl)arll'. Itat.m.nll,-Flle a separale Form 712 lor eacn POliCY.
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permu, rePo" lhe last arnua' premIum
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l~iI A ~~~~i!A OTl-lEA THAN YOUR S;tOuSi is usrec AlavI. ChiCK ONI 01' THUS IL.OCKS. , NO Il.OCI<. IS CHlCKao. ITTLI 'NLI.. H lSSIJlO AS
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I 8, TENA.~TS IN COMMON - ON DEATl'i OF ONE OWNER, INTE,~EST OF DECEASED OWNER OOES TO HIS OR HER HEIRS OR eSTATE.
NOTE; IF;HE VEHICLE IS BEING LE..\SED. CHECK THIS BLOCK O.IF BLOCK IS CHECKED. COMPlETe AND ATTACH FORM MV.IL
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Friends of Fur Fashion
447.A C.rlisleOrive
Herndon. VA 20170
7031471.7944 · fax 703/471,8485
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~ocelJlt Number *
Dat,e:_i'-/i'- n-
DOMI':J..:.. T,,-!T of' d F; /t?.,Z:,h"~ /(,_ F....--dj;d IVA?"~
Address: .;? ~r ~ ,11..(.1 !3C"'..IY Y 4-- -c:--- ___
City: C::~tf L.. ! S t.. ~. _ Stale/Zip f?.4 I '? d' I J _
Teh:Phon((t'/:;z. )~~~ ~ f.(ylpt
Furrier: 1Pa.r€.:.vO(J Il..;:= !t"i/~:::, sType of Fur: 4' E.:1 v ("' d...
SOyI"_M""" c z- . ...."al.1 V"",l.(~= 7
Appanled By ~C;::?;/..
Fur garments donated to Friends of Fur Fashion will benefit
tile Frl~nds of Fur Fashion Breast Cancer FWld. Each year this SO I (c)3 oraanization
donates fUnds to benefit breast cancer research.
Note: Fllrdcr please make a photo cop~ of this form for the donor and keep the orglnJa.l
with tthe ,amlent.
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Ellala 0' Arthur Mlchau.
VaIUl.' U, a, Savlngl Dondl '
July 3, 1 ge1
Dlnomlnatlon Oolaol COil 01 Radamptlol1 Num~r 0' Totat Rldamp. Tola' Coal Inlar"l
Dr Bond Bond S..ln ,..u. Bond Valua 7/3117 Bondi Valua olBonda On IkInda
(por bond)
S 1 ,000,00 EE 000.92 500,00 64560 10 6.456,00 5,000.00 1.456.00
s 1.000,00 EE Nov.92 500,00 645,60 10 6.456,00 5,000,00 1.456,00
S 1.000,00 EE Fob-93 500,00 621,20 20 12.424,00 10,000,00 2,424,00
S 25,00 E 00t.7S 1675 67,83 1 67,83 16.15 49,06
S 25,00 E Sop. 76 1675 67,83 1 61,83 18,75 49,06
S 25.00 E Aug.78 18,75 67,83 1 67,83 1875 49,06
S 25.00 E Jul.78 18,75 6~,19 1 69,19 18,75 50,44
S 25.00 E Jun.78 16,75 69,17 1 69,17 16,75 50,42
S 25.00 E Jun.78 1675 69,17 1 69,17 16,75 50,42
S 25,00 E May.76 1675 69,00 1 69,00 18,75 50,25
S 25,00 E Apr-78 1875 69,72 1 69.72 18,75 50,97
S 2500 E Mar,76 1875 6972 1 89,72 18,75 50,97
S 25,00 E Fob.78 16,75 73,90 1 73,90 18,75 55,15
S 25.00 E Jan-78 16,75 76,12 1 78,12 18,75 57,37
S 25,00 E 000.77 1875 76,12 1 76,12 16,75 57,31
S 25,00 E Nov-77 1675 75,91 1 75,91 16,75 51,16
S 25,00 E 001.77 1875 62,77 1 82,77 16.75 64,02
S 25,00 E Sop.77 16,75 82.77 1 62.77 18,75 64,02
S 25.00 E Aug.77 16,75 62.77 1 82.T7 16.15 64,02
S 25.00 E Jul.77 18,75 85,26 1 65,28 16.75 6&.51
S 25,00 E Jun-77 16,75 85,27 1 65,27 16,75 6&.52
S 75,00 EE Jan-62 37,50 116,17 1 116,17 37,50 60,67
S 75,00 EE Nov.61 37.50 116,17 1 116,17 37,50 60,67
S 75,00 EE Sop.51 37.50 118,17 1 116.17 37,50 60,67
S 75,00 EE Jul.61 37,50 121.71 1 121.71 37.50 84,21
S 75,00 EE May,81 37.50 121.71 1 121.71 37.50 64,21
S 75.00 EE Mar.61 37,50 124,68 1 124,6& 37.50 67.16
S 75,00 EE Jan.Sl 37,50 128,40 1 128,40 37.60 90,90
S 75,00 EE Nov.80 37,50 128,40 1 128,40 37.50 90.90
S 15,00 EE Sop.80 37.50 134,73 1 134.73 37,60 97,23
S 75,00 EE Jul-80 37.50 138,78 1 138.78 37,50 101.28
S 1,000.00 EE Nov.92 500,00 &45,60 10 8.458,00 5.000,00 1.456.00
S 1,000.00 EE 000.92 500,00 645,60 10 6.456,00 5.000.00 1.456.00
S 1,000.00 EE Fob.93 500,00 621.20 20 12.424,00 10.000,00 2.424.00
S 25,00 E May.77 18,75 65,10 1 65,10 16,75 6&,35
S 25,00 E Jun.77 18,75 85,27 1 85,27 18.15 6&,52
S 25,00 E Jul-77 1875 65,28 1 65,28 18.75 6&,51
S 25.00 E Aug,77 1675 62,77 1 82,77 18,15 64,02
; 25.00 E Sop. 77 1875 62.77 1 82,77 18,75 64,02
S 25,00 E Oct~i'7 18,75 62.77 1 82.77 18,75 64,02
S 25,00 E Nov.77 1875 75,91 1 15,91 18,75 57,16
S 25,00 E 000-77 16,75 76,12 1 76.12 18.75 57.37
S 25,00 E Jan-78 16,75 78,12 1 78,12 18.75 57,37
S 25,00 E Fob-78 18.75 73,90 1 73,90 18.75 55,15
S 25.00 E Mar.78 18.75 69,72 1 89,72 18,75 50,97
S 25,00 E Apr.78 18,75 69,72 1 89,72 18.75 50,97
S 25,00 E May.78 18,75 69,00 1 69.00 18.75 50,25
S 25,00 E Jun-78 18,75 69.17 1 69.17 18,75 50.42
S 25,00 E Jul.78 16,75 69,19 1 69,19 16.75 50.44
S 25.00 E Aug.76 16.75 67,63 1 67,63 16.75 49,06
S 25.00 E Sop.78 16."'5 67,63 1 67,63 18.75 49,08
'.~
BIlIII 0' Mhur Mlchlu~
,Vllua 01 U" S, SIYingl Bondi
Ju~3, 10117
OInomlnl.lon D"'"o' COital Rldlmpllon Number 01 Tole'Rlldlll1p. TolII Colt Int"llt
01 Bond Bond S"III IIIUI B2J!!. Vllue mll7 Bondi VI'U. 01 IIOhd. On Bonde
(plr bond)
I 25.00 e Oct.78 18.75 87,83 87.83 18,75 4lI,OB
I 75,00 ee Flb-82 37.50 114,72 114.72 37,50 n.22
I 75,00 ee Oeo-BI 37,50 118,17 118.17 37,50 80,87
I 75.00 ee Oct.81 37,50 118,17 118,17 37,1lO 80,87
I 75.00 ee Aug.81 37,50 118,17 118,17 37.50 80.87
$ 75.00 ee Jun-81 37,1lO 121.71 121.71 37.50 84,21
I 75.00 ee Apr.81 37,50 124,68 124,88 37.50 87,18
$ 75,00 ee Flb-al 37,50 124,68 124.68 37.50 87.18
I 75.00 ee 01c.80 37,50 128,40 128,40 37.50 8D.8D
I 75.00 ee 1.0cl 37,50 134,73 1304,73 37,50 97.23
$ 75,00 ee Aug.eO 37,50 1304,73 1304,73 37,50 97.23
13(\ 55.859,71 41 ,425,00 14.434.71
,I,
, ~ ,
"
.
1.5~ N;;,. 9
IUIIIAU Of' INDIVIDUAl. TllllS
INHERllNC! lAK DIVIIIOM
IIl!Pl. """
~IIIURO. PA 171~1""1
COMMONWEALTH OF PENNSYLVANIA
DEPARTNENT OF REVENUE (~
*'
NOTICE OF INHERITANCE TAK
AppRAISE"E"T. ALLOWANCE OR OISALLOWANCE
OF DEDUCTIONS AND ASSESS"ENT Of TAK
.n.IIHIU"'l","l
RONALD S KEARNS
804 WAVNE AVE
CHANBERSBURG
DATI
ISTATE OF
DATI OF DEATH
FILE NUHlIR
COUNTY
ACN
06-15-98
NICHAUX
07-03-97
21 97-0609
CUMBERLAND
101
A_t RHltted
l
ARTHUR
PA 17201
r-
MAKE CHECK PAVABLE AND RENIT PAVNENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
CUT AL(I!IIG THI8 LINE ~ RETAIN LOWER PORTION FOR YOUR RECORD8 ..
iiiv:liii"-iir-A;ji"Cil9-:f'f)""iloTici--on-tiiiiiiifANci-YAx-AP;it"A"iiiiiiil'r;-ALrowAiici-iili-------------- ---
DISALLOWANCE OF DEDUCTIONS AND ASSESSNENT OF TAX
ESTA'l'I OF MICHAUX ARTHUR F FILE NO. 21 97-0609 ACN 101 DATE fl6-15-98
TAK RETUIlM liAS: ( I ACCEPTED AS fILED ( XI CHANOED SEE ATTACHED NOTICE
RES.RVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALU. OF RETURN lASED ONI ORIGINAL RETURN
1. R..l E.t.t. {SchedUl. Al
2. Stook. _ _. (S-.luh II
5. Clo..ly Hold Stook/P.rtner.hlp Int.r..t (SchoHtul. CI
4. Ilort_./llot.. Reo.h...l. (_1.01
I. Callhl80nk Dopoolh/lU.o. P...on.1 Prop.rty (Sohedul. EI
6. Jointly Oonod Property (Schedul. fl
7. Tr.n.f.r. (_1. 01
S. Tot.l A...t.
(1J
(21
(51
(4)
15I
(&)
(71
.00
.00
.00
.00
11.545.00
515.427.00
.00
(II
NOTEt To ineur. proper
oredlt to your ecOOd\t,
.....It the _r porUon
of thl. foro with your
to. p._t.
526.972.00
APPROVED DEDUCTIONS AND EXEMPTIONS I
86,276.00
.. Funar.l E1<pon.../Adoo. Co.h/Hho. E1<pen... (Sohedul. HI (9)
10. Dobblllort_ LI...UIU../U.... (Schowl. II (101 7,255.00
11. Tot.l DeduoUon. 1111
12. Not V.l... of T.. R.turn (121
15. Charlt...l./llo..r.....tol 1Io_.hJ Non-.l.oted .115 Trud. (So.....ul. J) 1151
14. Not V.l... of Eat.to Subjoot to T.. 114 I
NOTEI If.n ........nt w.. i..u.d pr.viously, lin.. 14, 15 .nd/or 16, 17 .nd 11 will
r..,l.ot figur.. th.t includl the tot.l of ill r.turn. .......d to d.t..
ASS.SSNENT OF TAXI
11. Aoount of Line 14 .t Spou..l r.t. (III
16. Aoount of Line 14 t..obl. .t Llne.I/CI... A r.t. (161
17. Aoount of Line 14 t.....l. .t Coll.t.r.l/Cl... I r.t. (17)
18. prlnol...l T.. Duo
TAX CREDITS I
PAVNENT
DATE
09-30-97
Q~."~l 00
433,441. 00
.00
433,441. 00
.00 ){ .00.
433.441. 00 x' 06.
.00 X .15.
nil
.00
26,006.46
,00
26,006.46
.ECElPT
NUHlER
AA242290
DISc;JUNT C+ I
IHTEREST/PEN PAID ('.
1,300.32
28,000.00
AHlIUIIT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
29,300.32
3,293.86CR
.00
3,293.86CR
. If pAID AFTER DATE INDICATED, SEE REVERSF.
FOR CALCULATIDH OF ADDITIONAL INTEREST.
If TOTAL DUE IS LESS THAN n. NO PAV"ENT IS REIlUI.ED.
IF TOTAL DUE IS REflECTED AS A "CREDIT" (UI, YOU HAV IE DUE
A REFUND. SEE REVERSE SIDE OF THIS FDRN FOR IMST~TIONI.I
F
/5-1 q do - q
IUlIIAU OF IIIIIVIIlUAL T AXEl
INHERllANCt lAK DIYIIIOM
Dl'Pl. """
_1_. PA I7UI,66..
COMMONWIALTH OP PINNSYLVANIA
DIPARTHINT OP RIVINUI
:tNHIUTANCI TAX
STATIMINT OF ACCOUNT
C-
*
n'H..,.. tM'~ c...."
'RONALD S KEARNS
804 WAYNE AVE
CHAH'ERS'URG PA 17201
DATI 07-14-1998
IITATI! OP MICHAUX ARTHUR F
DATI OP DIATH 07-03-1997
PILI NUMIIIR 21 97-0609
COUNTY CUM'ERlAND
ACN 101
E-t R_l~ -=1
MAKI CHICK PAYA'LI AND RIMIT PAYMINT Tal
REG:STER OF WILLS
CUM'ERLAND CO COURT HOUSE
CARLISLE. PA 17013
NOTE. To thour. pr_r or.cut to your 1ICl0ount. .......tt tho _r porU"" of thh for. with yaur t.. p.~t.
CUT ALONG THIS LINI ... RETAIN LOWI!! PORTION FOR YOUR RICORDI ....
itEV: U.o..,-iie.AFp.Clif:j7"j".....iiiiii.iitiiiliiyANci'.iAx-iTAfiHltii-oF'-Accciiiiif--iiiii-.---.....----- -. ----
ISTATE OF MICHAUX ARTHUR F FILl NO. 21 97-0609 ACH 101 DATI 07-14-1998
THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATEO ACN IN THE ~ED ESTATE. SHOWN BELOW
IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS. THE CURRENT BALANCE, AMb, If APPlICAILE,
A PROJECTED INTEREST FlIURE.
DA1'E OF LAST ASSESSMENT DR RECORD ADJUSTMENT. 06-08-1998
PRINCIPAL TAX DUE. """""0,""'",,,
26.006.46
PAVMENTS (TAX CREDITS),
PAVMENT
DATE
09-30-1997
U6-15-1998
RECEIPT
NUMBER
AA242290
REFUND
01 SCOUNT (+)
INTEREST/PEN PAID (-)
1,300.32
.00
AMOUNT PAID
28,000.00
3,293.86-
0,
.() t.r.r if) ~ict
r'-'
t.},:
CO
N
CI ,
u il; ,(J
Cia: ~ &~
TOTAL TAX CRIDIT
BALANCI OP TAX DUI
INTIRIIT AND PIN.
TOTAL DUI
26,006.46
.00
.00
.00
, . IF PUD AFTER THIS DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAH U.
NO PAYHENT IS RElIUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI,
VIIU HAY IE bUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. I
COMMONWIALTH 0' PINNIVLVANIA
DIPARTMINT 0' REVINUI
MOTICI OF DITIRMIMATION AND
AIIIIIMINT OF PINNIVLVANIA
IITATI TAX IAIID ON 'IDIRAL
IITATI TAX RITURN
DATI
ISTATI OF
DATI OF DIATH
, . \ F,XLI NUHlIR
, COUNTV
ACN
Is./tlj -' '7
IUIIIMl Of IlIIlVlDUAL TAXES
1MH!IITAMCl lAM DIVlolON
DlPI. I_I
_1_. 'A HUO,,,ol
I r'
d,
!
, ,
RONALD S KEARNS
804 WAYNE AVE
CHAMIEIl5aURG
\'~i
'PA 1720 ,l: i '
~L'll ';
c
('
'*
IU",,"IUII' m.'"
11-30-1998
MICHAUX
07 - 03-1997
21 97-0609
CUMBERLAND
201
_t R..lolted
ARTltUR
l
F
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
IIDTE. To In...... p....r o.....U to your ...oount, .....u tlMl _r portion of thh fo... with your to. P._t.
CUT ALONG THXI LXNI ... RITAXN LOW!!R PORTION FOR VOUR FILII .....
itiV=UJ'"ir-A'jip--Cfir:.'j-----iii-NOfici'"o;r"liiTi-iMiiiAfiiiii-liiii-liiiiliiiiNT------------------ ------ -----
OF PINNIVLVANIA IITATE TAX IAIID ON FEDERAL ESTATI TAX RITURN ..
MAKE CHICK PAVAlLI AND REMIT PAVMINT TOI
IITATI OF MICHAUX
ARTHUR
F FILl NO.2l 97-0609
ESTATE TAX DETERMINATION
1. Credit For St.t. D..th T.x.. .. V.rifi.d
Z. P.nn.ylv.ni. Inh.rit.nc. T.x A......d
(Excluding Di.count .nd/or Int.r..t)
3. Inh.rit.nc. T.x A......d by Oth.r St.t..
or T.rritori.. of the Unit.d St.t..
(Excluding Discount .nd/or Int.r..t)
4. Tot.l Inh.rit.nc. T.x Ass.s..d
5. P.nn.ylv.ni. E.t.t. T.x Dua
TAX CRIDlT81
PAVMENT
DATE
RECEIPT
NUHBER
DISCOUNT (+)
INTEREST/PEN PAID (-)
ACN 201
DATI 11-30-1998
23.172.00
24.706.14
.00
24.706.14
AMOUNT PAID
TOTAL TAX CR!!DlT .00
IALANC!! OF TAX DUI .00
XNTIREST AND PIN. .00
TOTAL DUI .00
-If,AID AfTER THIS DATE. lEE REVERIE SIDE CIF TOTAL DUE IS LESS THAN '1, lID 'A~ENT IS REeulRED
, FOIl CALctII,ATIOIf 01' ADDITICIIlAL INTEREST. IF TOTAL DUE IS REFLECTED Aa A "CREDIT" CCR). YDU HAY IE
DUE A REFUND. SEE REVERIE IIDE OF THIS FDIM '01 INSTRUCTIONS.)
.0,0
_01'
IlCIYlCE.
To fulfllk the r.-uir..-nt. of Ieotion ~14S lb) of the Inherlt~ ~ Elt.t, '1M Act, Act '1 of 1"5.
(72 P.I. Ieotion 9141).
,.-.
Det... the teP portion of thi, MotA. .".. __It ..Ith yOUr pavtMnt to the _eg,.tl" of NUhpdnttd on tM
r.ven. .,..
'--.......... or lMMY 0""" PII_'I tOI IIGIJITIR OF' MILLS, Aam.
.... (<<*)1
A refund of. tel( or.Ut _r e.. r....ted by OCMIpletJ.. In -Application for "fund of Penntlf!"""
Inhlrlt~ end E,tat. Tax" (REV-1SIS), Applications et, .vll1Ibl. at ~ Offloe of the _..'..er of "1111,
In)' of the 25 .~ Dlltr.tClt Offices or 'rOll tM .....ru..nt.. 2~~hour ......'1"" N,vloe ,..,..... for 'O...IOrOl'''.1
In ,.,.,.wlvenlt 1-'.O~S62-t050, outtlde Penn.)'lv~l. ~ within local ~rrl8bur. .r.. (717) 7'1-'~,
TDDI (717) n,-US! (MMrlntl 1...1"'" OnbJ.
OLECTlONSI MY PIIrtv In Intar..t not HUtf... with the ..ie.~t of tll( '1 ItlOWI an thh noUo. ..y obj.ot within
allet!;' (61) dIy. of receipt of this MotlCMIbvl
--wrltten prot..t to the PA o.p.rtlent of .evenue, IoIrd of app.all, Dept. rl]02], "-rr.~r., PA 11121-]"1, ~
--Ileoti"l to .. the ..tt.r det.N1lned .t eudlt of the perltOnlll repr.Mnt.Uve, OR
--.....1 to thI Of1then.' Court.
AllIIN'
IITMTlVE
CCIIlECTIONSI
Feot....l .rror. dlloov.red on this ..H....,t Ihould be IIddr..... In .rltl"l tOl PA ~rtalnt of "venue,
Iur..... of Indll11"'1 '1M'" ATTN: Put A.......,.t Rev!.., Unit, Dept. 21160], Hilrrllbur., PA 1112.""01,
Pnone (117) "'-6"15. '"..... 5 of the book)lt "'In.truoUon. for Inherltence 'lie "turn for I Resident
~t.. (REY-1SI]) for en I.,)enetlon of ~lnl.tr.tlvllY correotebl. Irror..
PllML TVI
T~ 11X t~ ....tv non"pertlol,..Uon ,...,.1ty is COIIPUted on the tot.. of the tll)( _ Intlre.t ........., Md not .
,.Id before JInuIry 11, ]996, tn. fir.t .y .ft.r thl Met of the t"le ......ty period. Thh non-PlrUolpaUon
penIIlty II .....111I1. In tn. ... ....r ... -In tM the lIMe U.. period .. yOu would .....1 thI UM Met Int.r..t
u.t .... been .....sed .. tnellMted on thll notice.
I_T.
for dlt.. of delth on or Ift.r 10-5-9), Penn.ylvenll E.t,t. 'ak ~.-d on the Fader.l E.tlt. TalC
return beooIlI. delinquent It tM ..tr.Uon of nlM (09) IIOnth.' frOll ttM ct.t. of dMth.
For clat.. of dHth prior to )0-5"'1, Pennlylvlll'll. Eltlt. la)( bill" on thl F"r.l Elt.t. hM r.turn
bloOM. GiUnquent It the '.Ir.tlon of .tght..... nil Mnth. frOll the At. of "'h.
lu.. Mhloh ~ _u........t before ......ry I.. 1912 belr lnt.r..t It thl r.t. of .Ik ('Xl Plroent pltr IfWUI
ClIiloul.ted .t I dllb r.t. of ....IM. All t... which bIo8M delinquent on or .ft.r .......ry I, 1"2 "Ill ....r
Int.r..t It . rltl .....IGh will v.ry frOll ell__r ~r to cal"r YIIr "lth thlt rlt. ~ by tM PA
~rtlent of Revanu.. ThI eppllclbl. int.r..t r.t.. for 1912 thrOUlh 1998 .r.,
V.., Int.relt R... Deily Int.r..t FlOtor V..' Int.r..t Ret. Deth lnt.r..t FlOtol'
1'" "X ."0S41 1917 'X ....'47
1'" lU .0111458 1918-)991 IlX .000301
1914 m . IIOSO 1 199' 'X ."0247
1915 ISX . tlOSS6 199]-19M r,( ."'192
1916 llX ...or14 )995-1998 'l . "OZ41
--Inter.lt i. oeloulltld .. fDllowlI
IIITaDT . NUIICE OF TAX UllPAID X _ OF DAYS DELIII4UINT X DAILY ItmlIElIT FAClTOII
....My NoUoe I...... eft.r the Uk blooM. dlIUnquent "Ill r.fleot ~ Int.r..t celoullUon to flftMn liS) dlw.
bllwond the dlt. of the .........,t. If ..~t is .... efter the lnter..t COIIPUtlUon det. thown on the
Moti., ..hl_l Inter..t ....t be Mlculet_.
IS' /9:;. - 9
oaMMONNIALTH OF PINNIYLVANIA
DIPARTNINT OF RIVINUI
NOTIOI OF DITIRNINATION AND
AIIIIIMINT OF PINNIYLVANIA
ISTATI TAX IASID ON FIDIRAL
OLOSlNG LUTlR
DATI
ISTATI OF
DATI 01' DIATH
FILl NUIGIR
COUNTY
ACN
c'
'*
IUllIAU Of INDIVIIlUAL TAMES
INHlRITAMCE TAM DIVIOION
II"'. ~0"D1
HARRIOtuRD, PA 11.'0-0'01
'IW.,uu"",'m..'"
RONALD S KEARNS
804 WAYNE AVE
CHAMBERS BURG
12-07-1998
MICHAUX
07-03-1997
21 97-0609
CUMBERLAND
202
[ AlIOUI'lt RoUte.!
MAKE CHECK PAYAILE AND REMIT PAYMINT TOI
ARTHUR
PA 17201
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE. To inoure proper oredit to ~our eooount, luboit tho upp.r portion of thia foro with ~our t.. p.~.ont.
CUT ALONG THIS LINE ~ RETAIN LONIR PORTION FOR YOUR FILEI ..
Riiv:'i6--ix-iiFP--{~!:-9')-----iii-Niificii-OF--DiTi-RMiiiAfioii-AN-D-Aiiiiss-MiNT-----------------.-----------
OF PENNSYLVANIA IITATE TAX BASED ON FIDIRAL CLOSING LETTP.R 8M
EITATI OF MICHAUX
ARTHUR F FILl NO.21 97-0609 ACN 202
ESTATE TAX DETERMINATION
DATI 12-07-1998
1. Credit For Stet. D.eth Tex.. a. Verifi.d
23,172.00
2. Penneylvenie Inh.rit.nee Tax A......d
(Excluding Diacount and/or Intar..t)
24,706.14
3. Inheritenee Tox A..M3.ed by Other State.
or Territoria. of the United States
(Excluding Di.ecunt .nd/or Intere.t)
.00
4. Totel Inheritenee Tex As.e.sed
24.706.14
5. Penneylvenie Estete T.x Due
.00
6. Amount of Penn.ylvenie E.tete Tex Pr.viously A.sessed
Beeed on Federel E.tet. T.x Return
.00
:,c,
c' (7.
"'"
7. Addition.l P.nn.ylvenie E.tate Tex Due
.00
TAX ORIDITII
PAVMENT
DATE
,
AMOUNT PAID
fL.)
\:1
RECEIPT
NUMBER
DISCOUNT (+)
INTEREST/PEN PAID (-)
TOTAL TAX CRIDIT .00
BALANCI OF TAX DUI .00
INTER 1ST AND PEN. .00
TOTAL DUE .00
MIF PAID AFTER THIS DATE, SEE REVERSE SIDE (If TOTAL DUE IS LESS THAN '1, NO PAYNENT IS REQUIRED
,fDR CALCUI.ATlDN OF ADDITIONAL INTEREST. If TOTAL DUE IS REfLECTED AS A "CREDIT" (CRI, YOU NAY IE
DUE A REfUND. SEE REVERSE SIDE Of THIS fORN fOR INSTRUCTIONS.)
"
F
_01'
ItIITlct,
'To fulfUl the r...lr......h of Sttotlon 1.145 (b) of ttMl InherltMCItl If1d Elt.t. Tlx Aot, Act 21,0' 199s. (72 P.S.
SHtlon 'IllS),
PAVlI;MT,
DltllOh t~ top portion of thh Moth,. and lubIIlt ",ittl Your ply""t to tt. R..l.tllt of NUll pt.'lted on the
tawr" wh".
h _. oheck or IICHWY or.r paylttla tOI REGISTER OF MILLS, ADENT.
IlffUIID IClll,
.. r.fund of . tllC credit ..y bit rllqUeated by cOIIfllaUng an "Appl1oatlon 'or R.fund of PennaYl",,"I.
IntwIl'JtMC. 11M btat. Tilt" (~V~1515), Applioatlon. .t. IvaU...h .t ttMI Offl~ of the _..htar 0' NUb,
lIny 0' the 2~ "."MUII bhtrlot OHio.. or 'rOIl thl hp'rtHntt, Z4~hour 1If1....rlng '.tvie. nuIIIMIrt for for.. ordtrlng,
In Pann.ylvllnh 1"800-562-2050, oubla PennlYlvanl. IInd wUhln local Harrhburg at.. {Jll} 7.7-1094,
TDb, (717) 77Z.ZZ5Z Ufearlr'!ft ]lIpalredOnlyJ.
OIJfCTlotfSl Any party In IntaraU not ..thfted with the 8"."lMf1t of tall alii 'hown on this noUce uy obJaot within
.bt~ (60) dIi~. .f receipt of thh Notice by!
"wrIU., protl.t to tM PA o.pertHnt of R.y~, Board uf Appeeh, Dept. ~8ID21, H.rrllburl, PA 17128-1021, DR
ual.ctlno to hlv. tM ..Uer dft.r.lned at aUdit of t.he par.on.l rapr..entatlv., OR
~~eppe.l tD the Orp~.' Court
AlliUM'
IITAATlI/E
CORRECTIONS I FACtuel error. dl.eov.r.d on thl. ....s.-.nt .hould be ~r.".d In writing to! PA Dep.rt.."t of RaYanUt,
Bur.au of Individual 'axa., ATTHI PD.t A......."t R.vlew unit, Dept. ~.a6al, Harrl.burl, PA 171~I-0601,
Phone (717) 7'7~6S0S. S.e pa.. 5 of tM bookl.t ftJn.tructlon. for Inheritance 'ax Return for a R..ldent
Decedent- (REY~ISOI) for ~ .xplanatlon of adalnl.tr.tlvel~ correctable .rror..
PENALTY I
The lSX t.x ...,..t~ non-plrtlelp'Uoh penalty II COIIpUtld on tha total of the tex 1M Interllt ......ad, Ilnd not
paid bafora January II, 1996, the flr~t day .fter the end of tM taM -.ne.ty p,rlod. Thl. non~p.rtlclp'tl~
,.".lty II epp..lllbl' In the .... HMer Itnd In the the .... tI.. periOd a. YOU would .....1 the telC Ilnd Intera.t
thet M. bean ......Id .. Indlclt.d on thh notlCI.
IMTEllfll'
Addltlonel Penn'ylv~l. E.t.te 'IX ......ad ., a r'.u1t of a change on the fede~.l E.t.te 11M clo.lng
latt.r bee... dellnqueot et the Ixplr.tion of one (I) IlOnth frOll the date the final notice of the lnor....
in F.~r.l E.tat. Tax I. raoelVld.
T'MI. Whloh bee.. delinquent before J9nulf'y 1, 1982 baar Int.rest at thl rate of .b l6:C) peircent par ~
aaloulatad .t . dally tat. of .IOOI6~. All t.M.. whloh bee... delinquent on or .ft,r J~.ry A, 1911 NIl1 bear
Int.ra.t .t a rat. which Nlll vary fr~ calandar y..r to calendar y..r with that ratD ~ed by the PA
Departlent of R.y.nua. ThI *PPllcabl. lnt.ra.t rat.. for 19a~ through 1991 .r.t
t!!!: Int.t.U Ret. Dally 1nt.r..t Factor !!!! Int.r..t R.t. paUy Int.r..t hctot
1912 ZO~ .OOOi~' 1917 9~ .000247
19.. 16~ .oloue 19aa~1991 11% .000301
19.. IU .000501 1992 9~ .I002~7
I9IS U~ .001356 199]~1994 n .OO0l9;,!
1916 I.~ .00027" "J95~ 1998 9% .0001"7
-~lnt."..t I. calculated .. foHow.!
INTEREST. BALANCE OF TAX UlIPAID X NUNIER OF DAYS llELINqUENT X DAILY INTEREST FACTOR
~~Any Notlcl 1..UId .ftl" the tax bao~. delinquent Nil! refllct ~ Int.ra.t calculation to flft"" (15) dlY'
blvontI thl data of the a.....lMnt. If PIYMl'lt II Ada aftar the Int.re.t cOlIpUtaUon ctlt. .hoNn on the
NotAoa, eddJUonel Intlr..t au.t be olloulltad.
.1' ;
STATUS ,REPORT UN2E~~LE ~.12
Ar1\..u("' ~
Nllme of Decedent: t'.
, Date of Death: \1'11\'1 ~ \''\1'\,
\
Will No.
M\t,"'-.o...v;)(
Admin. No. 2...\.- ~/_ O(PO~
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
State.~hether administration of the estate is complete:
Yes~ No_____
2. If the answer is No, state when the personal
representative reasonably helieves that the administration will be
complete:
1.
3. If the answer to No.1 is Yes, state the following:
a. Did the personal re~asentative file a final
account with the Court? Yes No .
b. The separate Orphans' Court No. (if any) for
the personal representative's account is;
c. Did the personal repr.esentative s~e an
account informally to the parties in interest? Yes No______
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
'I
~
Signature
...
I<v k-+ 1-.. 0 ~l\c.......
Name (Please type or print)
n W . Sou"'-. S"" GM.\S~ Q A
Address
Oatel~
''+-- ~;.
r'r"
"-'~ "'--~
( 1 '~ ~,73
Te I. No.
(MAH Irmf! AM3)
Capacity: _____Personal Representative
X Counsel for personal
representative