HomeMy WebLinkAbout97-00656
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8ft
, 'A. One-third to my sister, Patdoia .Kettwdnq,if ..he ,
,
survives me" and if she does not s~rvive me, to her iuue, per
stirpes ,
B. One-third to my brqther, Torrenoe Stildterman,.u he
L'I~rvives me, and if tie dOes not survive me" to hia illsue, pllr
stirpes,
c. One-third tqmy brother, Thomas stadterman, if he
survives me, and if he does not survive me, to, his issue, per
,
stirpes. '
:tlJllH XVI I appoint my Exeoutdx and her. sucoellll9rs quardian
of any property ,whioh puses, either under this willot' other..
wise, to a minor and with ,respe,ct to whioh I am authorized to
appoint a guardian and have not ~thll~ise speoifically done sp,
provided that this appointment of a 9~ardianshall not. supersede
the right of any fiduciary in its disoretion to distribute A
share where pouibleto the minor or to another for the minor's,
benefit. Such quaFdian shall have the power to use prinoipal as
. well' .sinoome from ,time to time f9i:' thlt minor's support And
ed~o.tion (including oollege eduoation.! 1:'01:.h graduat.e and under-
9rildua~e) without regard to, his or her parent's ability t.o
"
,
provide for suph support and education, or to make payment for
these purposes', without. further resP91l11ibility, to the minor or
to the minor's parent or to any person taking oare of the minor.
Paqe 26f 3
',;
,
Pf. REV-1!lOO EX (1-07)
Deoed. t'. 00 ddr"'1
STREET ADDRESS
18 AJ:tIm:lre Circle
pego a
STATI! ZIP
PA 17070
(1) 68,945.65
57,000.00
3,OOO,aO
Tohll Crodltl (A + II + C) (a)'
60,000.00
a,
InterOlVPoneity II applloeble
D, Intorell
e, penalty,
0.00
TOlellntoroaVPenelty (0 + E) (a)
4, IIl1no a'le gre.tor than line 1 + IIno a, ontor the dllleronoo, .Thllll tho oveRPAVMBNT.
OhHk 110M on Pel!' 1 Un. 1110 requ..la rt1und (4)
D: IIl1no 1 + line a It IIr.atOl than IIno a,onter the dltler.noo, Thl.11 the TAl< DUll. (D)
A, Entar the Inter8ll1 on lhe tile due, (GA)
B; linter the IotN 01 Une 8 + eA, Thllll the BALANOIl DUe, (DB)
"'. ~"i&.,.",^"''''m'',^''d,~"";"""",,",.,!,,~.,,.u.u.''"lli,u.""".,~~~,8~!'C......~e~y'~b,I~,!~I,.~,~~I~~~,9~,Y,I!~',~~,!~!....",...."...,\,.....".j "';...,.........,N......w"...,."""'I."II'...i1P'l"".,....,
~Pi~Mii!ilWi1ii!ji%it0;~1!,;i%\~i,;,l.i~J;i~lhliil!*'Miii~~~wfri':fHi1~a~L8Wi~a;!aU~'iflj~~~\1Jii)iM(a\lj()f,1;$m;!W;\\1i!iij,t'i!;iJ;tiJt;;!i.~hLli;h:
BY PLAOING AN "X" IN THE APPROPRIATE BLOOKS
1, Old d8Oldont rmko 0 l1anllor andi
Ai retltn the UN ,or lnoo~ ,0' 1he propertY traneferredl. I , I , , , . , t t t , . , , , , , , , , , , , , , , , t t j , I , , I . I .
b, rol.Jn the rlllht 10 deslgnato w~ 'shell UIO tho property l1anllorred or lie Inoomel, , , , , , , , , , , , , , , , , ,
o. !'te1aln a fevnonNy Int.....tl Of, , . , . , . , .. . . . , . . , , '," I" . I . , , , , , j. . .., , , , I , I . , 'I j I . . I , j., ,
d, r8Ollvo,lhO promlO for 1110 01 either paymenl8: bonolllHr oaro?, , , , , " , , , , , , , , , " , , , , , '.' , , , , , ,
a, If doeth oOOllrred on or bolor. Dooombor 1a, 18&a"dld docodonl Wllhln two YODl1l I
pr_dlng dealhl1anefor property WIIhoUI rocolvlng adoqual. oonelderellon? If doalh ocqurrod
all" DOCltmber 1a, 1188, did dooGdenllranalor proportyWllhln one yoar 01 death Without
reoelvlng adequateoonGlderaUon7,;-, j,'_, ",., ". I.. II.""" j,.""""", "" t .11..,., I'.",
,,0, Did daoedalll own en 'In Utiet fo~' or payable upon dealh b.ank eooount or soqurlty
at hi, or her cteath7 ",., '. , , . I ; ',I I , I . , " I , I I , Ii. I , , I , I , . "t , , j I , I I , , . I I , . I , . , , , , , . , , , , , I I
4, Old d8Oldenlown en Indlvlduel rolllemenl aooount, ennUlty, or olhor non-probate proporty?" , , , , , , , , , ,
8,945.65
, 0.00
8,945.65
it
IB 0
~' .,~,
IF THB ANSWBR TO ANY OF THll AB(lVll QUElST10NS IS VES.
YOU MUSTOOMPLBTE SOHEDULE G AND FILE IT AS PART OF THB RETURN
~.'_' "$}" "'~"".""'''~iJJl' ..".'." ' '".""IJI.~"'"""'~'''w'',,',',''''''''''''''''''''''''''''''''"'.,,,!,,,..,,,,,,,.,,,,..,w,,..,~ '1;\' "",,",,". "#,,,~,,.w.'~ ""'''1....'''.....''((. ""!'@"'''''''.;.'f;'''~''''., ~u "","";"""',
, .,."' "",1t~""" .",. ~,' .', l'If/'P ""'lr."', ...,,,,..' ".",.".....,,",. """".",,,,,,,,,"'''''',.'',,,,,,, ',w'w"'""iW;'."" ",w>,," ,~j ,.~",.,,,~.,",, ""11 ,"',"'"
r . ."., -. _" ~~. %fJM~M;:UfjJ~~;{r" .' . ~. . ;~- ;.itl11l'W4t~i~(:\Km;:h:~tM~~iiitt(1~~m~ifi~~# .f~Mln~U1~:t~tj;*~J*M~,1irarrm"~;m w:W'-;rf'm~~Jmr;<#m~~U~;,i;~.M&1fM~j;~ .~ ;J$~~' :~w~M1,W*~t:~::
1a P,S, 18110 lal (101) (I) provided lor the rOduoUon 01 the tlllC ralalmPOlOd on tho nal vllluo 01 l1a",lorelo,or for Iho UIO 01 the lurvlvlnllepOUM from 0% to
0% lor datoa 0 liellh on or auOl JulV 1,1884 and bolore JanuD/V 1,1888, ','
1a P,S, 18110 (a) (1,i) (I~ prOVided for tha roduoUon 01 tho ralell11POIOd on tho net vlllueof uanaleralo or for the UIO 01 the eurvlvlng ep~ulOfron\ 0%10 0%
for da~ of death on or after JII1UD/V 1, 101D, The "atuto dool nolo.omol e l1anllorto a,urvlvlng 'pOUIO 1T0m tlllC, and the ataMory roqulrementa for
dlaololur. of -ta and flllng a IIle roturn aro eUII applloablo evonlltho eurvlvlng 'POUIO Ie the only bonollolD/V,
I'Ofl DAT8B OP DeATH ON OR AmR JANUARV 10 1",1.. Ploase aneWer Ihe 10110Wlngquoatlon byplaolng a.n ''lI' In the approprlato epeoo,
Old the _ldehl o....\ll allU81 or almllal ""ngamanl Whloh la eol.,V 101 tha aUrvlvlnll 8fIOUH'. btnaft110l hie 01 hII' enUra 1I1a\lm.,
-0 ~~.. . .
II you anllWOlod yoa to tho above quoauon, the tile on lhe lrIl81 or olmllar arrangement II pOltponod unlll tho death 01 the IOOOnd IPOUse, at whlohumo It Will
bo fully tlleablo at tho rato(a) appllcabl. to tl14 romelndor bonellolasyllee), 'Sntor Ihe velue 01 Iho ttual on BohodUla J, Part II, In ordello removo It from the
oeloulatlon oftha tile due In Ihll OItlle, You may wllh 10 11I0 Bohodu 0 9 In order to mako thooleollon aVellablo under 68o1l0n 8110, lithe olootlon la mado,
tho ttulll or Ilmllar arrangemenlll tlleod In the ..tato 01 Ihollrat d800dont apoull8, tho portion of the ttult or Ilmllar arrangoment which bonafl1ltho eUrvlvlng
IpOU80 la llllCod et lho zoro llllC rato, and lhe romalnder IlllllCed at Iho rato(l) epplloablolo Iho romelndor bonoIlOIll/V(lol), II you OhaOIO to mako tho oloollon,
you mult allaoh BohodUlo 0 to a llmoly-lIIed tile roturn, e10ng with Sohodulo(l) K and/or M In ordor 10 ohow Ihe apportionment 01 tho ttuel or Ilmllar
lIT.ngomonl between tho lurvlvlng epoulo end tho ,omelndor bonollolary(lol),
7 PAl8002 NTP '0170
Copyright florml 8oltw.r. Only. 11t' NIICQ, Ino,
II
'REV-1Dl0 EX + (1-07)
. SOHEDULE Q
INTER-VIVO!:!. TRANSFERS &
MISC. NON-PROBATE PROPERTY
,.
Mol NUMlaR
21-1997-06136
,
TA)(APLa VALue
1 MeII'ber!ll Firat hderA1 Credit 57.74 100' 0.00 57.74
union-IRA J\clc:lt. *2008-10 elated
4-7-86, Prineipal $137.60, Int. $.14
with Patric~ I<ett:e.ring as
beneficiary
2 Meuberll First Federal Credit 32,300.19 100' 0.00 32,30Q.19,
Union-IRA J\clc:lt' /12008-15 e1atec1 .
1-17-97, Prine. $~~~49.18, I~t. .
$151.01 with patrla, A. Kettering
l1S ~ficW:y
3 Meubers First Federal Credit 36,23Q.12 100' 3,000.00 33,230.12
Union-cert. ~. #2008-40, joint
with Patricia. ,Kettering elated' .
1-17-97,,~inQ. $36,165.32, Int.
$64.80
4 Meubers Firat JFederal Credit. 4,097.68 '100' 4,097.68
union-J\cct. /12008-00 joint with
Patricia A. Ketter.ing elated
01-21-97, Prine. $4,86.96, Int.
$10.72 .
5 POO Bat1lc, N.A.-checldng ./\cot, 4,197.63 100' 4,197.63
/15140061107, joiAtwith Patricia
Kettering c1atec:l 10..24-96 ,PrinQ.
$4,192,36, Int, $5,27
6 POO Bat1lc3N.A.-SaV= 1tcot, 92,13L18 100' 92,131.18
/l51~011l9 38 jOint wi Ii'atriaia
Ketteringelatec:l 10.,.24-96, PrinQ.
$91,852.73, Int. $278.4(;
TO A Also onler on IIno i Rooa Itulallon
7 OPAOl NTP 10110 (II moro Ipaoo 10 n80dod, Ineort addlllonalehoollof the lame elza)
CopyrIght Form. 80f!Wlt. Only, HUI1 N.loo1lno,
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+ 0,078000
82,"1710
1,110,11
lI,mooo
112,00
8,'44
18,606210
2,S8I,1I
17,10
U,I2IOOO 111,00 I
1,81 I'
'f
I
i
21,131210 344,80
810,1",8i
UO,70
"
!bll rap.rt,Ha' P'odU.ed by,thaNlII-ln 8.rvlol of Iltat. Valuatlonl , .,10In' INlt..., Ino, If, NOU ha" qualtlona/
. , pU'" oontaat IVP IYlt... .t (1181' S13-UOO, lit, IU,
HAKI QHIOK PAVAI~I AND RIHIT PAYH.NT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HDUSE
cARLISLE, PA 1701S
OUT AI.ONa THII I.INI .. AITAIN ~Oll~R PORtION ~OR YDUILRIOORDI ..
~W:II4"f.''l/'.~W.C&'':''1..AliYfc5'.''6'.WAI'Kffl'lt6i. A~.A IIftA"fil'Hfilt...Att"6Q~'lt61.'lllf.~..."'..... ....
DII^LLOllANOi"o~ DIDUOTI NI A b AllillHINT OP TAX
IITATI 01'1 sTADnRMAN JDSEPH L 1'111.1 NO. 21 97.0686 AcN 101 DATI 07.1&.1998
TA~ RITU,RN WAa t C X I ACCBPTID Aa fILID (I CHANOID
AIIIRVATION OONOIRNINO PUTURI INTIRIIT. III RIVIRII
APPRAIIID VALUI 01'1 RITURN IAIID DNI ORIGINAL RETURN
1, Raal 'Itat, C'ohadula AI
~, .tookl MCl Bonde ClOlladula 81
a. Clo..1~ Keld atook/Portner.h~p Intor.,t Caohodul' 01
q. Hort~./Hotoe R,oalYtblo caoh.dulo DI
8. C.eh/.1nk D,poelt./Hleo, P,reonal froport~ (aohadula II
6. Jolntl~ OWnad fropart~ ('ohodulo FI
7. Tranlf.re caohodula 01
a, Total A..ote
APPROVID DIDUOTIDNI AND IXIMPTIONII
9, Fun,ral,IMPaneIl/Adal, Coate/Hho, 'IMpon.oe Caoh.duh HI 191
10. Debts/Hort,.1ItI LitblUUII/Lhne Caohadulo II ' (101 2.886,60
11. Tot.llleduoUon. 1111 M, .A1l7. 711
u. Hat ValUD of TaM Roturn 1121 469, 6117 . 611
11. 'Charl'ltblo/Ooyor_tal Baquo.hl Non.olaoted 911STrueh (aoh.dulo JI (111 1 0,000.00
lq. Hit Vo1UD of letato Sub,ieot to T'M (141 4S9,637. 65
NOTII If.n .........nt wa. i"u.d pr.viClu.ly,Un.. 14, 18 .nd/or 16, 17 .nd 18 W111
,r.fl.ot figur.. that inDlud. the tot.l Df ~ r.~urn. .......d to d.t.,
AIII18HINT DP TAXI '
11, AODlll1t of Line 14 at apoue,l r.to 1111 . 00 ~. 00.
16, Aoount of Lin' 14 t'Mtbl, '.t Llne,l/Clo.. A rats 1161 ,00 ~. 06.
17. A_t of Llna14 t'Mtbl, at CoUator,l/Dlo.. 5 rota (171 489,637.68 ~.18.
la. frinalPll TOM Duo 1181
TAX 0 IDITal
fAVHINT
DATI
j!; - / {15'~ / /
8URIAU DF INUIVIDUAL TAMla
lMHERIIAHC~ lAM nlYIIION
IlfPI. '10601
/tARIUIRUIlO, PA 11111'060\
OOMMONNIALTH 01'1 PINNIVbVANIA
DIPARTHINT DP RIVIN I
NOTICI OF IHHIRITANCI TAM
AffRAraIHIHT, ALLDWANCI OR DlaALLOWANCI
DF D~DUCTION" AND ASSISa"INT DF TAM
C/
DAVID H BTONE ESQ
414 BRXDGE BT
NBW CUMBI!RLAND PA 17070
DATI
IITATI 01'1
DATI 01'1 DIATH
1'111.1 HUMIIR
OOUNTV
AON
07-18"1998
STAOTliRMAN
07.29.1997
21 97.0686
CUMBERLAND
101
Allount R'"ltt,~
III '
(al
(SI
Iql
(.1
(61
(71
20S,OOO.pO
14,012.8,
.00
ion
146.448.25
.00
166.014.64
(8)
61.982,22
, RICIIPT
HUIf.IR
D18COUNT C + I
INTIRIST/PIN fAID c.)
AItOUNT PAID
AA270011
, .
8,948.68
TOTAL TAX ORIDIT
.ALANDI'OP TAX DUI
INTIRIIT AND PIN.
TOTAL DUI
M IF PAID AFTIR DATI INDICATID, SIE REVIRSI
FOR CALCULATION OF ADDITIONAL INTIRlaT,
'*
"~'IW" '" CH.,n
JOSEPH
L
NOTII To In.ur~ prop.r
oradit to ~our aooount,
,ublllt the UPPar portion
of thl. for. "ith ~our
t'M po~..nt.
834,479.37
,00
.00
68,948,68
68,948,68
68,945.68
.Oll
,00
,00
I IF TOTAL DUE IS LESS THAN fl, NO PAVHEHT IS RlquIRBD,
IF TOTAL DUE IS REFLICTED AS A "CREDIT" (CRI, YOU HAV 81 OUE
A REfUND, OEE REVERSE SlOE OF THIS FOR" FOR INSTRUCTIONS, I
"
'j ""'"T'
"~. ...tn.- t"""""'"'''-'''' ,1".1...
.',,,,.I-',,,,,'j,.,.
,- ~ 1.:,,-:
<.:> .~ ~~ u.;
.-
oil :'. n!
,
, ,
\0
.-
,il ~ ~ I
!.~'; ,'.;:; m
~ d)' ~ ~~
co:
IIIlIIIlVATlllNl
I.t.t.. of _I. d~l", on',or bofo" ~or II, 1911 .. If ...~ futuro Int"..t In tho IIt.t. h tron.f"r'"
In po.....lon or onlo~..nt'to 01... I (ooll.t.rnl) bon.flol.rl.. of tho d...dont .ft.r tho ..plr.tlon.f on~ ..t.t. f.r
llf' or for ~lIr.. ho c_.lth ho"b~ ,.p""I~ ",or... the rll1ht t. ""p"h. ond ...... tr..If" Inhorlt.... T....
.t thlllNful 01... I. (tloUehr.U rite an In~ .uah futurl 1ntlr..\,
_Of'
HOnCl I
To fulfill tho "qulr_to of ".Uon II~O .f tho Inh"lton.. ond ut.to T.. Aol, A.t II .f 1991, (11 p,e.
'IOtlon 91401, ,
..tooh tho top pori IOn .f Ihl. H.tl.. ond .ubllt wllh ~.ur p.~..nt to tho R.al".r .f Will. pilnt.d on tho r...r.. .Ido,
.-HoIc. 0_ .r _~ ordor p.~lbll t., RBOIBTBR OF MILLI, ~OBNT' ..
PAMHII
Rt!fIJHO CCAl.
A ,r'fund .f. t.. .r...ltl Whloh w.. not "quilt... on th.' 'r.. R.lurn, ..v bo "CIIIO.t.d bv ....I.U'" .. "AppUboUon
for R.fund .f PIM.~I.III . Inhorlt_. IIId ht.to To." (RIY-1II51, Appllo.U.n.." ...11101. .1 tho offl.. '
.f tho R'aht" .f "W., III~ of tho IS R...nu. O"lrl.t Of 11011 , .r bv ..UI", tho ,pIOI.1 I~-h.ur
on"",rl", ..r.l.. nuIbo" f.r f.r.. .1'dorl"'l I" P......vl.."I. 1-100-5U-I050, .utoldo P......~IYIIII. ond
within 1"01 HorrlollUra oro. (1171 781-8094" TOOl C1I1) 711-111I lIl..rlna lopol"d OnI~I.
An~p.riY In lnt....t ncit,'IIU.fl... wl,th tho .pp".....nt' .1I.w.... .r dl..U....... .f doduoltlon., .r ....._1
of t.. llnolUdI", dl.....t .r Int.r..t) I' .h.wn on Ihl. Hotl.. .u.t .bj..t wllhln .I.tv (601 d.~. .f r...lpt .f
thh Hot .. bVI
.-wrltt'" pr.t..1 t. t". PA Poporto.nt .f R.Ii.""" I..rd or App..I., D.pt, 111011, HorrhOUra, PA 11I1e-lOll, OR
""'l..Uon to h.v~ the .aU.r d...,..,,," It ludU of thl .oo~t of thl plr.onll r.,rllentaUvl, OR
--opp6.1 t. tho orph.... court. , '
O.....CTlIIHII
AoHIH
UTRATlYI
C_ClIlIHIl
IHn.IT'
FlIltUlI orr.r. d......rod on thl. ........nt .huIlld bo odd""'d,I,n wrlUno t.1 PA Oop"t_t .f R'.onue.
eur... of lneil.ldu.1 T...., ATTH' P..t A.......nt R..I.w unit, OIpt, 110601, ""rrlObOro, PA 11111-0601
PhoM (1171 181-6&01. 'e.. Pitt S .f tho b.okll' "1..'ruotl.l1. f.r 1"""11.... TIN R.turn f.r . RlOhl..,'
IloIIdot1t" (Rly-mp, f.r on ..pl_U.n .t fldol"lolroU.'lv ..r~..tlbl. "r.",
If on~ t.~ duo,l. pold wllhln Ihr.. (Sl ..I.nd.r,.onlh. .ft.r Ih. d'.'d.nl'. d..lh" fl.. p.r.ont C5H) dl.....'.f
tho to. pOld lo.II.WId. '
Tho ISH t.~ .."..t~"on-p"tl.lp.U." P....ltv lo ,poput.d on 110. t.t.1 .f tho ,.. ond 'Intor.,t ........., ond not
p.ld bOfo" J.....rv la, 1996. lho flrot d.~ .ft.r' tho .nd .f lho t.. IIIlIfI~ porlod, Thl. non-p"Uolp.Uen
""""It~ to _....I. In tho .... .......r ,ond 111 Ih. Ih. .... tI.. p"l.d .. V.U w.uld IIflpo.1 tho to. end Inter..t
tho' h... boon ......... .. Indl..I.d on Ihh noU.., '
Int.r"1 I. .horOOd,bOgl""lnO with flr.1 d.~ .f d'llnqUlncv, or'nln. C'l .onth. ond.ne (II d.~ froo tho'dot. .f
dot!th, to tho dot. .f pov_t. T'~" IIhI.h b.._ d.lln....nl b.f.r. J.....rv 1.1911 bo.r Intor..t .t tho rot. of
olH (IHI porconl por onnuo ..I.ul.tld .t . doll~ r.t. .f ,00016~, All t.... whl.h b..... dlllnquont on ond .ft.r
J.....r~ I, 1911 will b... Int"lOt .1 . rot. whloh will .or~ froo, ..I'nd" v.ert. .'Iendor ~..r wllh thot rot.
onnouno'" bv tho FA DlPort..nl, ,of R..,""", Th. IOpll.obl. Int"..t rtlt.. f.r 1911 thrOUOh 1991 or..
, ' ,
DIICOUHTI
PlNALlYI
'tilt Inter.,t Alt, O.11v Int.r'lt flotor
XIIl'
lnt.rllt Rate O.UlJ Jntlrl~_t Paotclr
1.11 IIH ,010141
1915 16H ,010451
1:14 IH ,000501
I 81 ISH ,100516
1986 I8H ,000114
-~Int.r..t I. ..I.ul.tld .. f.ll.wo,
INTBRBB1 . BALANCE OF TAM UNFAID M NU"BBR OF DAYS OBLINqUBNT M DAILY INTBRBBT I'AOTOR ,
--An~ Hotl.. 1..UId oft.r'th. to" bo..... dollnouonl Will r.fl..t III Int.r..t,..I.ul.tl.n t. lift..., (151 dO~'
bo~oncl, tho CUlt. .f IhO ......_t, If p.v_1 .. ..do .11.. tho l/It"..t .ooput.Uen d.t. .h."" on tho
Hotl.., oddltlon.1 Int.r.ol ...t be .ol.ulotld,
1911
1911-1991
1m
19U-I.94
1998-1991
9H
IlH
9X
lX
9X
,000141
,00oaOI
,000141
,000191
,000141
. .,
.;- ..', .... .to, fl',' 'I .,.""'.... ~,. .......
,"
t'li
........~,y-' ';,;,,",j,
COMMONWIALTH OF PINNSYLVANIA I.
COUNTY OF CUMIIRLANO J
"'
,
"
Putrtc!u Kutturtn~
Bwurn _ aooordln9 10 lew, depolel and "VI Ih.ls h. ls tho llxoclIcrix
__ 0' Ihe Eltala of .!llsunh!.. Rtnc\turmnn, Jr.
lat, of .JJlW...OllmbRr1 pn!J. Jljlr.QI1f!I,L_... ----- , Cumb.rl.nd Countv, Pe" daoul.d and th.t tha
wllhln II an Invenlory mado bV Putric;!.u KoHodn8 ._ _ " Ihe "ld...lll1.!!cutrix
of Ihe onflre utele of laId daud,nl, oonlhtln9 of ell the pe"onal prop'~rly end rul eltate, aMoepl real ..tele ouhlde
the Commonweallh 'of Ponnlylvanla, and Ihal Ihe /l9uru oppolllo oech 110m of the Inventory reprale~t 11'1 f,'r valuo
II of tho dato of deoodonl'l death, '.
beln9 duly
h_._
and lublorlbod boforo mo,
-
19
da
KuttortnB
1\. P , 118,
1550
Oroonsbura. PA 15601
Add"..
Dal, of Death
29
O'Y ,
07
Month
1997
Y,.r
INSTRUCTIONS
I. An Inventory mUlt bo fII,~, withIn throe monlhl aft" eppolntm.nt of personal repr..'ntotlve,
2, A ,uppl.mont''1nv~ntory mUlt be fIIod wllhln Ihlrty daYI of dlloov.ry of addltlonal...eh.
3, .' Addlllone'lh..h mey b, ettoohad de to po"onalty or rully
4. S.. Artlcl' IV, Plduolarl.1 Aot of 1949.
'I
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GENERA~ INFORMATION
1, 'AX~Uftl TO ftllPOIID WX~~ ftl'U~T XN, AN OrnCXAL TAX AUIIIHINT .llh .ppll..bl. Inl.r..1 h."d.n Inl....II.n '
.ubolllld bV lho flnonol.l InIIIIUII~,
I, Inhorll....e I.. b"_1 "II_I nino ...,Ih. .I\.r lhO d...d.nl" d.11 .f dlllh,
I, A l.lnl ..'DUnI I. I..obl' ,yen lhO"," Ihl n""donl'. n... ... .dd.d .. · ..II.r .f .ony.nl.n,",
" A..DUnI. (In.luQlnl lho.1 hol~bll..onhU'b~ ond .'fll .hl.h Ih' d,,"d.nl pul In jolnl n.... .llhln .n. V..r prlur 10
....Ih or. IUlIV I..obl. e. Iron'fl"" '
I, A.oounl. ..IOblllhld jolnllV bll.... hU.bond ond .Ife ..r. Ihon one v..r prior 10 d..lh .r. nol I...bl.,
I. ....unl. hold bv . dOIl~1 "In Iru.1 f.r" ...Ihlr or .Ihlro .re 1..ObI. fullv,
I. ILOCK.. If lho Inf.r..llon Ond .popul.llon In Ihl nOII.1 .r.,..rr,'1 Ond d.duoll.nl 'rl nol b.l.. ol.I..d, pl....n "~"
In block ".".f p.rl ,I ,i Ih' "T..p.v.r ft"P~.e" .,.II.n, Illn I.. ..pl.. ond .ub.11 Ih.. .llh"our oh..k for Ih......I.f
". I. IhI ~e'lolor .f WIlI"UhI ..unll Indl..I.d, Th'~' p,"rl..nl .f ~.y."". .111 IIIUI .., .f,f1.lol ........nl
IPor. Il\IY.II16 '~I ""on r...lpl.f lho relurn fr.. Ih' ~.'I.lor,.f Will.,
.. eLOCK I . If lho ....1 .p..lfl.d ~ Ihll n.II.. h.. bl'n .r .111 b. r.porl.d ond I.. p.ld .llh Ih, p.nn.,l..nl. \nh.rll..,..
T.. ~.Iurn fllod bv IhI d"odl"I" r.pr...nl.II.., pl....n "K" In bl..k "I" .f p.rl I .f Ih',"T"p.,.r ~'IP.n"" 11.llon., 'I~ on.
'OfIV ond ..Iurn I. IhI pA IIIplrllll\l .f ~...nuI, lur..U .f Ind.l.ldUII T..... O.pl 1I0IOI,II.irl.bur" PA I7.UI,0601 In, Ihl '"
,"v.lop. prQyldtd, '
REPORTING INSTRUCTIONS "PART 1 "TAXPAVER ReSPONSE
,
,
I, .IOCK 0 . If lho noll'" Inf.rl'll.n I. In..rrlot oneI/.r d~oll.nl .rl b.l.. .1.1.1d. .hl.k bl..k "CO ond ...pllll,'.rtll ond ·
..oordlne 1.1111 Inl"..U.n. bll", ,1111I1 I" IOpl.. 'nd ..bIll 11111 .111t vuur uh.uk M lilO ....nl.r 1",lIvobl. I', thO nUI.I.,
.f WIlI..f lho .....11 IndIOlI'd, Tho,PI o.porl..nl Of~'Y'nu' ulll ,,,"' .., ofll.I.1 ."....onl (por. ~IY.I8'1 IXI "".n,r,"lpt
of 1111 ..Iurn fr.. IhI ~..ltlor of Will', ,,'
TAX ,RETUR~ "pART 2 "TAX COMPUTATION
,
LIlli " " ' '
\, Inllr IhI d.l. lho ...lUnt .rllln'll, .1.,I.I.bll.hod .r tlllld In Ihl .onnor '~I,llnl .1 d.l. oi d..lhl ' '
HOTII par' dOl_I dvlntl .ltIr It/lt/ll' AoolUnll ..hl~h ih. d...d.nl PUI In 10 nt n.... wllhl~, 01\1 ( I ~."ol dlllh .ro
I...bl, fUIIV., iron.llr., H.....r' Ih,re I. .n .woIU'I.n nol t. .....d 41,000 p.r tr'n".r.. r.,ordl... of lho .01.. .f
lho ...DUnI or h."..r., "'DUnIl h.ld,' '
" '
It ',' doUbl. ..t',rl,.kl..I,IPPI, ,.rl b','o,r"'ur flr.t n." In'lh. .ddr..' o.rll.n.f Ihl. noli... lho '1,000 ...IU.lon
. ,rol"lY h.. ",on doqUOlod ir.. iho ,,'OllIJI b.I..... .. roport.d b, Ih.lIn.... .1 In.1I lullon,
l: ~:'~~\:".ntoW 1~:I=:..:ln~:l' '1:~~.M:I'r.~n:.~RI:G~~ly:~0~~'M:i1rn.~'1: ~:ltm~'
A, ,Tho por.oni, t.,.,ob,l. "or, ja nl ....I. .oolobl loh'd ..r. Ih'" .no ,"r' prior i. Ih. d...d,n1" dlllhl
I DIYSIl81l IV lOTAL ,~81~ ~ DIYlllllP BY TOTALHUtlII1I 01' ,K 100' l'I~CIHT TI~ma
'.1\11"' D\lII!~1 ' " I\lIlYIYIHG JOINT OWIII~e " .
.....111 A j.lnt ....i ",I.I...d In lho n_ oflhl d..ldonl ,ond Iw' .Ihor p.r.on.,
I PIVIIl81lBY IIJOINT bwHI~l) P1YllllIO IV . UUIIYIYOflII . ,1'7 XUO . 1I,7X It.xml pOflI.QII eU~YIYO~)
I, Tho oor'lIll ",....1., for ",." ....11d wllhln ono v." of Ih. wld,"I" dlllh or ....unl. o.nld bV Ih' d...d.nl bUI hlld
In t...t ,or ....Ihor IndlV ......1111 (1,..1 b_Il.lorl..lI '
I PIYllllIP a,' TOTA~ HUtlII~ 01' 1~IYIHO JOIHT X 100 . l'I~CIHT 'A~.lld
, OIIHll~e IllI TRUIT IlHtPIOIIllIII
.....111 tlnl ...1Un1 r"lotor'" In lho n_ .f lho dllldlnl,ond two O,lhlr p,ro~~' .nd ..Iobll.hod Nllhln on' .." .f, dlllh b~
I OIYlllaP IQ" Mt:l;UtVOfl.) ..10 K 100 . 10~ (!AMAlU POA tlCH IUIIYIYO,n ' '
4. Tho _I I\ltJ..i 10 I",\"M 41 II dll"'lhod bV ""I\IPlvlne \hI.oolI\I\l b.I.... Cllno II b,lhI, p.ro..1 '..toOl. II\no lit
" Int.1" t~ i"t..\of lht, ph. ~ .rt~~H""fl '.hlt In P...t ~. . . . .,'
6, Tho_t I..obl, I.. I) Is d'lor,lnod b, 1"lr~lI.. Ih. ""'" ond dtduOllon. (lIno IT fr.. lho _""I..-j..1 I. I.. ClI.."I,
7, !ni.r lho lOI.oorl.l. t.. rll. II hi 71 " dol.r.\nod bol",
A, P.r dol.. of dO.lh ..o.rrllll .11,r 1/10/9,. Ihli.w r'I..'I.r Ir..,6i.r. I. .,..... .r. .. follOW'1
I, PII.I 01 dO.lh on or "lor'7/1/91 end b.'.rl 111/91 lho r.l. I. IX.,
I, D.i.. ofdO.lh on.r ,'llr 1/1/91 Ir",.I.r. I' 'POU'" will be,I",Id.1 OX 1"r.I..
110111 Por dol" .1 cII.lh prior to 711/91 Iron"'ro I. .P...... .ro ".obll,.1 AX.
e. Tron.flr. t. 11...1 do,.ond..,l. InGlijdln, f.lhlr. oolhor,' .on. douehl.r'"rondO,' ,hl,ldren. ,~'ln~I.N.
douIhl.r.lh.11M1 .1400hl\d ond Ihllrl.... .r. 1..ObI. ., .1. p.roonl loX, '
c, Tron.I'r' I. 01 othoro noluQl.. brolhor. .1.lor. """I'. """I, nophl' ond III..' .ro ,1..ObI. .1 IlItlln pI..enl lUX).
0, If v... .h_ lho I..'rol.. pl.... .p..lI, vowr rol.llon.hlp 10 tho d...don,ln IhI .rll provl"d. ' '
I, ThI.....,1 of I.. dUO (II... II lo d.lmlhod b, oul\lplvlne Ih. ...unl I..obl. lilno I) bV"lh. I" r.t. (1I';.,71!
,
.
I
I
,
: I
I
II
I
I
C~AIMED DEDUCTIONS . ~ART 3
DEBTS A~D DEDUCTIONS C~AIMEO
AII..oblo dobl. ond dIdUOllon. .r. dOl.r.lhod .. i.lla"1
A, V... ,,,.11, .r. r.I..n,lbl. for p.v...l. .r ihl ..1.11 .ubl..1 10 odolnl.I..II~ b, · p.r,on.1 roor..ont.llvl I. In,'ifl.lonl
I. p'~ lho dIdUollbl. III', '
a. VDU ..tuIUY p.ld thl dibtl aftlr d..th of lhld,o,d.nt end Olin furnllh pr~f of plVlent,
G. IJIbIl b.l.. ...1.... IOU.I be 1I11111d ,ull~ n Pori I, If oddlllon.1 .p... I. no.d.d. UII pl.ln p....r I III" · II", oro.l.f
PIV..-nt ..~ bl r.qullttd bw 'hi P_ blpert,,"' of R,yenue,
: "" ',",I" ,,', ":'" ," "" ' , ''(If''~''~''~''~''ST''HC'' ' ',I,',:,', ',I ',', II,::,
'I"~ I':'; ~"I"':"t,. ,':"""":i"I" ~ ',ii" ':" ""':1 ^FT" Q;O. t'1 "'" ","" ,,' ","'t I' ",',: ,,'~I'"''
",II:"';:\'::i':,,\,::i:' "YOU NEED IWitTHER 1 FRAT O~'~iA$~STIINCEr.CO!ll:IIC' '" ,'I
"i',i' \it;,,\ !:t"I"'I!;;r'1:",i":I~':: It IU$TER, OF(J' WtL S., rA nEI'ART E T F'n. EMU I! DXSTRtC'fi~FP Clt,"i', ',", :1'",,: ,,'
:', :'''~''i',: ",ii,i ," uR CALL 'l'Hi!t a REA Of INDtVIDUA A IlS ' AXPAVIlR tNQUIR UNIT' 1 " 'i,' :,' ::
,\:li.i:~":lH^"UU$IlURG At (711) 787"B~21. TDD. (1 1) 1h.Ull2CHEARINO, HI'tI RED':ONLVf::'i',:',:
, ' '
"
, OB,NBRAL I NFORMATI ON
1, FAILU~' TO R.IPOND WILL, R..UL T IN AN OFFICIAL TAM A.....H.NT .lIh .ppllOlhl. Inl..." Umd .n Inf.","on
....UI.d bv tho flnon.I.1 In.lltullon, ,
I, Inhtrllona. I.~ u...... d.llnquont nln. oonth. .fl.r tho d...donl'. dlt. .f d..th,
I. A Joint IOOount 1, "Nib I. Iven thouth thl dIG.d'nt" n... ~.. Idd.d I" ,,".r of aonvenllnol.
., .......1. C1n.luellnl tho.. hold,"'I..on "".bond ...d .".) .hl.h thl d...d.nt put In J.I"t n.... .lIhln .n. VOIr prl.r t.
d..lh or. fullV ,...bl. i'. IrOn'f".. ,
I, .......1. IIlIblhh.d Jolnlh bot..tin "".bond ...d .11. 00" Ih.n .... Vlor prl.r I. dOlth or. n.t I"'bt..
6. Aooounh h.ld bV . d.ndtnt "In tru.' 'or" enothtr or ~th'rI Ir' hMHa. 'ull~1
RBPORTINO INSTRUCTIONS "PART 1 . TAXPAVBR RESPONSE
I, .LOCK. - If Ih. lnfornllon .... ....ut.Uon In Ih. noli.. or. ..rro.t .nd dldu.U.n. ... n'l b.ln, ol.lnd, plIO. ... "K"
In blaok "A" of Pld 1 of '''',"TIMp,vlr ""pon.." ..0Uon, Ilan two Gopl" 'nd tUb.1t thl. with vaur oh.ok for thl ..o~t of
t.. ,. lho R.e"lor of Wlll..f lho .....tv IndlOllld, Th. PI O.porlll.t .f R.y.nu. .111 I..u, .h .fflol.1 ..'".....1
CF.r. RE'/-U16BWl "".n ....Ipl .f Ih. ..Iurn fr.. tho R.,I.lor of Will.,
I, 'LOCW' - If Ih. ....1 ,p.olll.d on Ihlo n.tl.. h.. blln .r .UI b. rop.rlld .IId t.. p.ld.Uh tho P.nn'Vlyonl. I""orll.n..
TIM R.turn fllld bv thl d'Clde"t', t.p,...nt.Uv., pl.01 In "K" In blook "I" 0' Pert 1 of thl "TeMp.wer A"ponll" ..aUon.' II." one
.'PV ond ..turn 10 tho P. D.porlnnl .f Roy.nu., 'U'"U .f Indlyldu.1 1...., O.pl 110101', tiorrloUu", P. 11U.-0601 In tho
envIloPI provided, '
I, aLOCK C . If the noUn '"'or..Uo" It Inoorr.ot Ind/or d.duoUon. Ire blln" al.llld, ah.ok bloak "eft end aQIIPI',tt Part. . 1M I
IUUUl'dlllU ,,, Uw '".'ruotlon. bilow, II,n'tuo GOpt.. Ind .ilb..tt th.. with vl'Illrahuk 'or thl .toun' 0' ttM pIV,bl, to th. ".,t,t.r
of Hill. .f tho .....IV Indlo.l.d. Th. P. D.port.onl ,.f ROY""'. .111 I..u. on .ffl.I.1 ..'.....nt Iro.. RBY.IIII IWI' upon ....Ip'
.f lho ..Iurn fr.. Ih. ROIlolor .f Wlllo, '
TAX RETURN . PART 2 . TAX COMPUTATION
LUll '
I, En'or tho d.l. lho ...aunl .rloln.l1y ... ..I.blloh.d .r IItlod In tho nnno, ..Iotln, .1 d.t'jf dOllh,
,HOTBI F.r. clOt"'.nl dV!n, .ftor 11/111111 ..oauntl.hl.h tho d..,d.nl pUI In J.lnl n.... .Ith n .n. (I) v..r .f dOlth...
"MlIlt 'ullV.. r'n,'.r.. UqWIVtr, th.r. . en 'Molu.lon not to lutld ts,OOO p'r tr.n"'rll re,.rdl,.. 0' thl v.lue ",
thl .oaaunt or thl nU.b.r of 'aaoun,~' held" I
If . doubl' ..t,rhk eMN' .pp,ir. be"rlvaur Hr.t n... In the addr... por'lon 0' thlt "OUOI, 'hi ..,000 IMolullon
.Ir.tdv h.. b... doduol.d fr.. tho .......1 b.hnOl .. roporlod bv tho fln.n. .1 In.tlluU.n,
I, Entor tho l.t.1 b.I.... of lho ....unlln.ludlng Inlor..1 ...r.... t. lho d.t. ~f dOlth.
'1 Thl Plra.nt of thl IOOount th.t II tlMlbll for 11th lurvlvor 1. d.tlr.lntd II folloN"
., lho por..nl 1"01110 for J.lnl ....11 ..tollll'hod ..r. Ih.. .... v..r prl.r I. tho d'O'donl" d..lhl
I DIYIDBlI.Y TOTAL HUHIBA 01' DIYIIH!O IV TOTAL HUH.EA 01' W 100 " PERCEH! T.WIIU
JOINT OIllllAI .URYIYING JOINT OIlWllRI
ax,,'I' A jalnt....' re,ht.rld In th. nIM 0' thl d.o.dlnt ,nd t.,o oth.r p.r.on..
I DIYIIH!O IV I (JOINT lMMRU OIYIOl!O IY I (.URYIYORel . ,161 X 100 . 16,1. (TAXIILE FIlA IICI! I\lAYIYOAl
,
I, 1ht ~rCltnt tlMIb'1 'or ...." orl.t.d within ani ~.It of the dlo,d.nt" dllth Clr ,OClOUfl" own.d b~ th. d.o.dlnt but h.ld
n t,u.lfor onathor IndlYldu,IC,) (tru,1 b.".fl.lorl..lI
I DIYIIH!O IY TOT.I WUNUA OF IURYIY1NO ~OINT W 100 . PERCENT T.KIILE
, OIllllAe DA'lRUIT elHEFICl1A1Ee
E....III Jolnl ..0....1 ro.hlor.d In lho nH' of Ih. d..,d.nl ond I.. .thor p.".n. ond ..loIIlhhod .Uhln .... vm .f cIo.lh bv
thl dIO.ct'"I" .' : . ,
I OIYloaO.V I (.IJAII,YOAlI . ,10 W 100 . m IT.WIILB FIlA IActi .URYIYOR) ,
0, ,Tho 00"'" .../.., 10 I.. CII... 01 II d.lor.ln.d bv IUlllplvlne tho .......1 bolono' (IIn. II bv Ih. p..o.nt t..""I. III... II.
I, Inl.. lho '.1. .1 lho dolIlI ond d.du.lI.no Ilotod In PO'I I, '
0, Tho......1 ,....." II.. U I. d'I.~.I"'d bv ."I,oollnl Ih. IIobt' ond d.du.llono (II... I) fr.. Ih. _I ''''J''I ,. ". iii... 41,
7, Bnlor Ih. ..proprl.. ". r.'. (I ..,11 .. d.lor.l..d b.I... ,
AI 'Of dl'" of dllth ooourrln, Ift.r 6110/94, thl tlM rll'" for tr~'flr' to .pou", Ir' .. fo11o"I'
I, 0'1'0 .f cIo.\h on or .ftor {/l/'O ondb.for. 1/1/91 tho "I. I. IN,
I, D. .. .f....lh on or .lIor 1191 Ir...."ro I. .p.u,...\U b. I...d .t O~ tOle rol.,
'HoIll F.r d.l.. .: d..lh pr lor ,. 1Ij/'4 Ir....for. I. 'POll". ." t..oIIl. .1 6~,
I, Tront/o.. t. 1...I,do,oendOl)I, ",Iuellnl fothor, "Ihor(,on, d""",l.r, """,,,hUdronl 'on.ln-I'~I
d"""".r-ln.letfl '1.P.hUd oicId th.lr h,u. ... 1"011 .. .1. por...1 c.u, '
O. lronof.r. 'a oJ . ho.. loolu.lln, hr.lhor, ,Iolor, un.I., ounl, ...p",," ond nil.' or. 1.....1. .1 fill... por.onl m~l,
D. If wou ohMtt thl tlM rltl, pll..1 lIIp.DUW vour r,lIUOf'!.hlp to th41 d.Clld.nt "the 'r.. provld,d,
., Tho ......'.f I.. duo (IIn. I) 10 ,d.tor.ln.d bV ",!llIpl~lnt lho -...1 I...bl. (II... 61 bV tho I.. roll CUn. 7),
CLAIMeD ~EDUCTIONS . PART 3
DEBTS AND DEDUCTIONS OLAIMED
.U.....I. d.bll ond d.duoUon. .r. dolor.l...d " foil.""
.. You \o..U~ or. rl,pon'lblO fo, p.v....I,.r Ih. ""t. ,"'jool I. ....Inl.lrollon b~ . p.roon.1 r..r....I.II.. II In,u/l1.10l)1
t. p'~ lho doclujl bl. Itn., " .
I, You ..'U.U~ p. d Ih. d"''' .ft.. cIo.lh.f ho d...donl ond .on furnl,h proof Of p.v...t. '
0, Oobl. "'lnt .1. ..d lU.t bo It"l.td fuUV In Port I, If ocIellll.n.1 'PlIO' 10 ...cIod, UI' pl. In p.,or I III" . U", Proof.f
p......1 nv,bo roqu..locI b~ ho P. O...rt...1 .f ROY"'" '
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