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HomeMy WebLinkAbout97-00677 PETITION I.OR IJROIIA TE and ORANT 01<' LETTERS 2.1 (' -1 .. &/a/e 0/ _._".~!.:~_0~~~.J~,.Y":I)~~::':"--... No. .__, ~.._L..__..k~:L_ also known as __.._~._~.... ..._____......~_.. To: __.~___..__m_____U__' __ ......~. Register of Wills for the . . .__ __ ....__. Il,','"osed. County of \l,u.ll,~L__. in the Social Securl/y No. ~:il3-~1.0_-~4...__.. _ .._ Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petltloner(s). who is/arc 18 years of age or older a? the executl;d..x.___._.__ .. named In the last will of the above dcc('dent, de.ted .._L}.l'l'J l".L'_~.L_.____._..____"___' 19 ')2_ and codlcll(s} dated _....~_..______._ ...-----.-------....--.----------. ------_.~---~----._........_-~._-~._._~--_.,~-~_._._...------- _~_.________~____.___~__..._______ '.R_ .___''''._'__ .-""-..-...------- __L______...___._._.._._____.~.______.,_.~_.___ _.~. ---. (stale rele."Ulll clrwnlstl\llCl:S, e.~. renulldut!on, dealh of e,~ecutor, etc.) Oecendent was domiciled at deHlh in ______ (:_\',!.llJ01' 1 n. ll<l...__.._. County, per,sylvanla. with hlL._.1ast.l'ami!~ or prill<;il1al residence qt . C C1.11]J_ EL11 . C1..Gl'q_rCnrlli9.r-II' ,~ri'()rd Hanel, Can,p ldlJ. _J!\ l'iOrl Ji.Ec'J!.~_..l'(jnnSlloro TO~mS1~:u2"L-__ (list street, number lJnd munclpalily) '11" . Jul' 'X) ()L Deeelld~ntbth~n,.,..ct..-'-11(''''- ~etarslof al!.C. d,led ,...--r'-r---':-]-"'-T),.m'r---''''---' 19-"-. -. at~l9.lY~r~1...l:..':....~:.."upl a.. , lJilllP..!.:~:.~.:':L~.'( ... . Except as follows. decedent did not marry. was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated Incompetent: ___'_'_- Oecendent at death owned property with estimated values as follows: (If domiciled in I'a.) All persollal property $ lU J 000.00 (If not domiciled in Pa.) Personal property in Pennsylvania S (If not domiciled In Pa.) Personal property In County $ Value of real estate in Pennsylvania S situated as follows: __.__.._______--11 ()ll~_____ WHEREFORE. petltioner(s) respect fully pr..ented herewith and the grant of letters theron. request(s) the probate of the last will and eodlcll(s) 'r e D t ill!l.!W.tuy. (Iest<lmentary; admInistration c.l,a,i administration d.b.n.c.l.a.) . -g 5 -0- ~i 1= ~.~ lr. ~o .~ III ~ .f..t...~.-1:;4.. Jj, . ~"c ~_ Oharlotte';. G!\_ln1f,ol" {,?I\\L_cilrlfUfl --:' 1co 0' 00 ~ l"loghan1. O}3bul'f1: , PA ~~240~_.__'" --_._~----_._~._.__._..~ _ _...._..~:;.:...-:;:.='":'"=-;;,;:-~=--='f:::=.==::::~ OATH 011 PERSONAL REPRESENTATIVE COMMONWEALT".,OI<: ~',ENN,SnV ANIA } 88 COUNTY OF ........_(~!!~J~~l..~________. The petltioner(s) l!hove.named Iwcllr(>) or affirm(s) that the statements in the foregoing petition are true and corrr.ct to the hest or the knowledge and belief of petltloner(s) and that as personal represen- tatlve(s) olthe above decedent petitioncr(s) will well and truly administer the estate according to law. Sworn to or affirmedctnd subscribed j_e...Lr,:. 'd!L._LL., r),~CJ, ., lik.".,j (00) bef\)fc ml' 'this ___...J.L'___ __. ~~ of ____.____. i' ~\1l ,\lf1'~//.JQ ____~- t.9~-/?( ._~__.____..___m.______ ~ - 91t.~t?-~ -1 ------.------------ ~ 1 fpu 'I Register ----..-------- ole. tr 7-3 21-97-677 Thi> iv \(l ,,'nir~, Ihill tin' Inlonll,lli,," \"'1.. I~iv,," I', ,,'Wi Iii "'1"'.1 1,,,," .0' ,,' i,'lIul ".",Ii, ,i1" ,.I ,kilh dill" lik.! wilh IIII' .I, \."",1 Il"I',I",.l1. Th.. ,,1i1',III.l1 ",nil,. ,1(" \\111 h" lom,,,d,,d '" tI" ',1.11' \'",.1 II,.. ",d. (ill"" H 1",,,,,,""'111 Iilil'!". WARNINO: It IS IlIogallo duplloato this copy by pholostnt or photogrnph, hoc Illl" Ihl, l'l'ldlk,ll\', .~).oo Iliiiliiilliljj"ijii'~), ",\,,,ilc"'\'~ Of Ptt.-, il#::tJ'~ I~.~"'..-".".\ , ' """ .,-~ I. .. ';. j. . f ,;:' . "~ ,_ '.', \/ Iff ~~..., . ~'. '7(,---- - ~,,- , :9r.tifN1 ~\ ~~lY (ti(I#IlJ1!lJ!! , ~,i~7 4494930 _n "jYL~ 3~n 1~9L.. \),11" .......---.___.~...,~~.~._~.."_'..A..W _"n__~"C-- Np, COMMONWIALTH 0' 'INNIVlVANIA' OIPARTMeNT Of HIALTH . VITAL RICOROS CERTIFICATE OF DEATH \l!IonII,C>>\!.--' ..... ..... ....OIfClllql~y1 york county. .., I,Male ;tli!i1i1i _III ,.., ~" IOC..... tlC\HlIN NU....." 1.203 - 10 - 2454 .-- Mt. olivet Cemetery ewcumberland,PA 17070 ___.........'" i'R'O tone&Murra FH 408 3rd 8t New Cumber a II, PA ue._ - tiiOHID ~_ow."l . ..or' ...0 =:"":,,,- -...- I, i_-~-" "",....Il..~- iii""". .- ~r.:: \:- ~- RH ,...or:lMJlJflV ltlJUIR,,.WOf\l(t tJlICMlIHfJillf'"'!'lf"i OR 0I1NJ1i1'1't t\ikll...tlfw..l ... 0 ..0 - - El"" o o o o c.AlliIlIl............ 0 - -- W. AtI of tulJf\v........, 1IIwI........."... buiIIlIlIlll.....~""1 ... ..". ..., ....,.,..==-,..~~_gl...'"'*'.....ptI~IeIl,..."'QlCIl.llUd~II'IJC1l(ll~lllwftnl _................,.................-..111...-"""'-.......;...."'...."". ""..,..., ,.. ." ."" ,. ,.",.,.." ..0 - I. ~ TNC\ICIR"l"l'INO""IlOlAM~_"'~...,.od'.."..IllC.....aI...1 , ....................., ................... ....,......... ...........~.._III&IlIIIl........."'...."'.,."..,....., .--...- ( (M........I~....,.IIl..~,...tII.,,.....,..................,...,...~.,.,..Ii\Ml...........)- ...............,."""."..".,.,."..,."...,',..,."...,."....,..,..."..,......... "..."."",...",..," ~~ - i II~ IJ,JlJI. ,tI ( I . I ~ )'j I " . \,.""1'" '-" ., .';_\0 " , -- " I I III! ...1 M ~ ~~ . ~ . i II I> 11l -I' :J I ~ g I ' Eo! ...:. S COMMONWIALTH O' ,INNSYLVANIA COUNn O' CUM'I.LAND "I ()lllu'lotl.,_(l,E,. Gnllnc1Hll' .~.._, __".. ._____...___...___....___.._______ ..._n b.lnll duly. 'IHOI'I1 .. accordlnll 10 law, dopo... .nd say. th.I Sh.l~J..t:llo_~~:t.f)(l.~\~l'ix _.... ........ 01 Iho E."Io 01__ hug!'.!::l' It!!I_IL._C~~!,.cl nOE____n_____ 1.1. 0/ Enilt J'onnobol'O 'J'oHnnld.p _, Cumberl.nd Counly, Pa., d.c....d and th.t the wllhin Is.n Iny.nlory mado by CJ\lnl'lott(~_ I::. UlIlll.J:Gh(jl'. .-, the ..Id___ i~Y;.Qontl'lx___ of th.. .nllro .."I. 01 said d.c.denl, con.l.llng 01 all Iho pOllon.1 prol'drly end r..1 ..I..., tKc.pt r..1 ....I. ouhid. Ih. Commonw..llh 01 P.nn.ylyanl., and Ihal Ih. Ilguro. 01'1'0.11. oach ltam of Ih. Iny.ntory repr..enl It'. fair y.lu. tI of Ih. d.I. of d.codenl'. doalh. Deo0lnbor' 1997 ;1i' ,j 1"1 "~j,. l.., U Il_ 't l.' t1 ld " ,t.-, , ;.-~ tf..I- t. A- J- _ _"....___ __._,.__~._..___-t-....--- .___,c___ ._._......m__ h...to, . Uolfftliilt (,2[\0 CJm'l:Ls 10 1'11(0, 110. 1100 . jr~~.o_~~unl os.1?.:u' g ,__X€:' ~} O:~i....________ SHorn __ and .ub.crlbod bo'or. mo, .,.~.."~-----~-------~-,-----~------_.- Add,... o.t. of Oealh ______2..9_____________ O'Y July Month ll)')7 y.., INSTRUCTIONS I. An Inv.nlory mull b. flied wllhln throe monlh. altar appolnlmont of perlonal r.pr...nt.tly.. 2. A .uppl.mont Inyontory mu.I be fllod within thirty dey. 01 dl.coyory of additional ....h. 3. Additional .hee" may b. att.eh.d .. to personally or roally 4. See Artlel.IV, Flducl.ri.. Act 011949. p, .r! .c Ul n ., I~' 0 [-1 i ~ 1-0 UJ 0 :Q l!) ~ UJ < 1., ~ ('1-1 ... Iii r'l 0 " . i.i ~ UJ 0 .n ~ lJl ;0- X '" ' . Ul .. rn ... LA. n r: : ... ;p E .... .... p;~ rl :. m 0 .... ~ 0 , LLI ~ ~ -G QJ ~ > '" eJ PI t 4-' ~I Z ~ Q . ~.. ~ <1> :! - ~ \T\ III 8 .0 '" "I ... 0 UJ ... <I) 1.1 ." p:; I" c " ... ~ . 1'1. . 0 .8 1-;, \1\1 . e ." ... j . g 01 (l if ... RlV.UOO IH 1'.9'1 Q.',\b9_ .011 DA"'O'DIA'HA"11I1213'''' CIIICKHI.I W INH::~I~~N~Etit~~:~~RN :.~i~!li::D".\'CL~I;MID 1..\. COMMONWIMlII OJ ""NSIIVAN'A (TO BE fiLED IN DUPLICATE ' 1 ~ ) 1- 0(, II UIMRlI.\ENT 0' REVENUE __---HA~~~JI~U~Or,-h'-".~\ _. . _. WITH REGISTER Of WILLS). (QUIIlV CODE 1 ')'!'I VtARn(~(,]j _tl.UM~ER _=-- Dmoffii & NAMf {tAS!, 'lrsr'1JITiMTtim[Tt'ililA.lr--~ ---- - .- - ---.-- - --- --jll'(fliiNTrEOM1'11ifi:liiiRiW--C Qlnj>nn"l.-oo.ro - . ClAH])):I';\(, ()\ll\l'loi) \(. Contor, 116 gr1'ord HOlld i ioCiATircu,m.NIJM..... -- \OA1fO'llfAlIt \ll^1fOf ftllllll Uo.lnp H111, PA 1'(011 III 201..1ll-:'IjSII ? /;")/()'! '}/l?/ll1 (.''''( C\llllbol'li:\nd . "~,,,'~_o;j;'"'.:" ,." ","",,,,,, . r'''''''''''''''"'' (~'" "",,', "" ,,'""'"'''' ~ ~.-~~ I!! ll!ll. O"gh,al R.lUrn II 2 Suppl.m.n'al R.lurn II 3. R.malnd.r R,'u,n I'" - . liar do". of d.alh pr!or 1012.13.82) Ii ~. 04. Llml"d hlal. I I 40. EulU" In.....' Comprornlro [] 5. F.d..ol E.lo" To. R,'"n R.qul..d ~ i II or dol.. of d.alh 0/1.. 12-12.821 gg 6. O".d.nl Ol.d T..lo.. 1.1 7. O"od.nl Moln'aln,,' a li"ng Tru.' ..Q8. To'al Numb.. of Safe O.po.IIBo... _ (Allach copy 01 Will) IAlloch copy of Tn"l) ___ "L~CORR.SPONoft.iC. AND CONFIDENTiALTAX INFORMATION'SHOULD III DIRICTED TO. .... . N . '_.-=JCOMPtiinX^iliTiO-;;:DijRf!.~ .- _..~__..J.!..-]-\o!)_o.),-l;Jbt'lll'rOl'LI\tj;y.....- Ilal'\:ot SqUi:\l'e llltle;. " ""'"01" NUM'" 1.le oho.nicsburg PA l'IO~) [717 1_ 'I!' 6 - 96 'I ~~==_".~=,,_o__._=,_=-=_._=~=---,.,--=.,o='=-====""~'='='=~--. . 1. Rool Erla" 15ch.dul. AI II I ._ -- ..0., ()O - 2. Slock. and Bond'ISch.dul. 81 121 _______.__..___._J2...Q.Q.. 3. Clo..ly H.ld SlocklPar'nOllhlp Inl....,ISch.dul. q 131 ------..------..-.....Q-'-~Q.-- A. Mor'gag.. and No'" R".lvabi.ISch.dul. 01 141 .....--'--' -- _....._...0.~'O_9__ 5. Ca.h, 80nk O.po.11I & Mlre.llon.ou. p.'.onal Prop.rty IS) ~..-"'--- .1g~[)5.g-.-J.Q.-- (Sch.dul. EI 6. Jolnlly Own.d Prop..'Y (Sch.dul. F) I b )._-._-lQ...o3'7...42- 7. Tran"'" (Sch.dul. GIISch.dul. LI 17) ..-..-.--- ...__....._0...0.0... 8. Total Gron AlI.N ltotalUnes 1.71 9. Funorol '"p....... Admlnhlra'i,. Co.II, Mlre.llan.ou. 19) ...___._______fo'25.-LQ.Q- E'p.n... (Sch.dul. H) 10. O.bll, Marlgog. lIabillli.., lI.... (Sch.dul. I) 110) .___._....--. 601 f !.26_ 11. T 0101 o.dudlo... ('0101 lIn.. 9 & 10) 12. N., Volu. of ElIol. (Lln. 8 ",lnUl Lln. II) 13. Charitable and Gov.rnm.ntal Beqll"" (Sch.dul. J) 14. N., Valu. Subl"'.'o To. (lln. 12.minu.Lln. 131. 15, Spousal Trand.n Ifor dot.. of death aft.r 6.30.Q4) See I"s'rucllo", for Appllcablf P.rceniog' on R.vene Sid.. (Includ. ,olu.. Irom Sch.dul. K a' Sch.dul. M.) '6, Amount of lln. 14 tlutable at 6% 1'01. (Indud. volu" Irom Sch.dul. K or Schedule M.) 17. Amount of Line 14 laKable at 15% role (Include valu" Irom Schedule K or Schedul. M<) lB. Principal'.. du'IAdd la' from lln.. 15, 16 and 17.} \9. Credi" Spousal Poverty Credit Prior Payments Dhcount Inler..' o ,Q.Q...... + ._____Q.OQ.. +--__..Q...Q..Q-- _..:~Q....OQ_ II I b I (/ f - J C._ P'~"~;i t~ i' ~ i ( B) 22.BB9.1? 111) ___J,259.26 112) __ 21,6~~6 (13) _ 0.00 (14) 21,630~ ~- 0.00 l' 5) _.___._.~-....J:l..--OO - ~. -.. (16) __..______.g1.,g.lQ..4Y.-~ .06. 1171 _.._....__________._Q.-'_OO-~ .15 . .------. _.___~___.J,-..~h~ 0.00 -_.----~-----~- 1,297.[)3 I I g (18) ~-<~._.-----_.----_. 0.00 0,00 (19) (20) __.._.--- (21) __.__--~.1~97..[)3 (21A) -~~--'''''-T""''ry~ 1218) -.-.---..--!-!'. . 20. If line 1 Q il greal.r than Line 18, enl.r the difference on line 20. This is the OVERPA YMINT. gO 21, If Une 18 is greoter than lIn. 1Q, enler lhe (Ulfer.nce on Une 21. Thllillhfl TAX DUE. A. Enl.r the lnl.r..' on lh. balance due on line 21 A. B. En'orlh.,olal of lln. 21 and 21A on Un. 218. Thl." ,h. 8ALANCE DUE. Make Check Payahl. '01 R.g','.r of Will., Ag.nt ~W,,\,?;;~ ~)>- a. SURI TO ANSWIR Ai.~~UES"~NS ON" RIViRsiSlI~1 AND TO- RIC~ICK MATH olI(olI( ;'- · . . Under p.nolll.. of p"lury, I d.c1o.. Ihall hove ..amlnod ,hi. ..!Urn. Including accompanr.'ng "h.dul.. and ,'a'.monll, and 10 Ih. b." of my knowl.dg. and b.lI.f, 1'1. 'ru., corr.ct and compl.... I d.c1a.. Ihal 011 r.al ."010 ho. b..n r.porl.d ollru. mork., ,alu.. Ooclarotlon of pr.por.. olh.r Ihon ,h. p."onol "pr...ntallv. I. ba..d on allinformolion 01 whldl preparer hOl any knowledge, iiOKOTU", O""'ON ,mo"iiiiil~iliiiHo,[iU'N---'Ao5iE' -7,;mO CRr1TG'Ie-ako, ]io~' JIOO' Tfechunf'C'sb\\l'g PA 1 'iD' 1 ~ I i, ',_ }1ilt.'1'W~~ ;f~:l~_.._..___l!Ul"'<.c'.t- JI1'.\l11~,o.l)]-<JL!-Lll.o-~Llo.\1t.2..Sbuxg. _TA.JJ/O~t) . " A'", , ErA" ""',1' Hi'~~ ",A'7// ADD"" DAIf {'.' I j'1" , '.,' 1 "(..,1.../ ltL L _____-----.--- _..__~-..------._.- ~i.1 /'.1..7 ,. , Act .48 of 1994 provld.. for the r.ductlon of the tax rat.. Impo..d on the n.t value of tran".r. to or for the u.o of the .pou... Th. rat.. a. pr..crlb.d by the .tatut. will b.1 . 3~ (.03) will b. appllcabl. for ..tat.. of d.~.d.nt. dying on or aft.r 7/1/94 and b.for. 1/1/96 . 2% (.02) will b. appllcabl. for e.tat.. of dlcedent. dying on or after 1/1/96 and before 1/1/97 . 1~ (.01) will b. applicable for e.tat.. of deceden" dying on or aft.r 1/1/97 and before 1/1/98 . Spou.al tran.f.r. occurring on or aft.r 1/1/98 will be exempt from Inherltanc. tax. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK k) IN THE APPROPRIATE BLOCKS. I 0 1. Old d.c.d.nt make a transler and: / a. r.taln the us. or incom. of th. property tronsl.rred, "...........".".."..""...."....".".."........ b. retain th. right to deslgnat. who shall u.. the prop.rty translerred or It. Incom., ............... c. retain a reversionary int.rest; or ............,............,.........."..,.......,......,...................,....... / IIY ,/ / d. r.ceiv.th. promise lor 11ft ol.ith.r paym.nts, ben.llts or car.' ...."........""..................... 2. If death .occurred on or belor. D.c.mb.r 12, 1982. did d.c.d.nt within two y.ors preceding d.ath transler eroperty without r.celvlng ad.quate consideration' II d.ath accurr.d aft.r D.cember 12, 1982, did dec.d.nttransl.r property within on. year 01 d.ath without r.c.lvlng adequate consideration.......,. to,............,..,................,.......,.,...,.........".,............................ 3. Old d.c.d.nt own an 'In trust lor' bank account at his or her d.ath..........."......".................. IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YESr YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. -~~ T'" . ...".""" ~" _..~~L$.,'_, . 'j '. IIVIS" I.. 111"'1 ~Ib eOMMONWIAItU 01 "NNlVIYANIA INUUIIANe, lAk mUkN IIlUIP'W I>ECfPlNl SCHEDULE F JOINTLY.OWNED PROPERTY L ___- _ ~_ __~.. H_~__..t~:..~UM~~~ ~~~~Q~~~~ = ISTATI 0' -;-;,;==-.u.:::" ClIART,)i:S H. GAHDlmn __._____._ _ ~ _.".__~~.._"___.D_--.'-- Jol"t'""o"'I')' ADDRESS . ____."'_.T~~_~.._----. -.----"... u~.._~__ ___!l_~.L.ATlC?!!SHI!'_!O DlceDI.I'!L- 62DO Oarlisle Pike, No 40 Hoohnniosburg, PA 170!)5 Daughter I. C. Jol"'ly-ow""d proporly, lTIM unlR DATE 'OR TOTAL VALUE DECO'S DOLLAR VALue 0' NUMle JOINT MADe DESCRIPTION OF PROPERTY OF ASSET % INT. DECEDENT'S INTeReST TENANT JOINT --" 1. A. 2/19/ PNO flank, N. A., Savings 1997. Aooount No. !)OOO9191~31. l~lO,037 .1~2 100% $ lo,037.42 I,' TOTAL (AI.o Inllr on IInl 6. Rlcapllulatlon) s 10,037.1~2 (iI mOrl 'paco h n..dld Inllr' addlllona',h.." 0' '0011 .1..) CERTIFICATION OF NOTtCE lJNDER ROLE 5. 61a) Name of Decedent: ClIAIH,;';S If. CfAllDlIJm Date of Death: . 1 ''') dU..y (.;' l ]C\CYi ,- i" Will No. 1')7-.IO(,n Admin, No, To the Register: 1 certify that notice of beneficial interest required by Rule 5,6(a) of the Orphans' Court Rules was served on or mailed to the following beneficil1ries of the above-captioned estate on 1\1'''\lSt 28, .]qg7 ~ Address Churlotto E. nBl]nr~or-~2RO CarlIsle , Pi\ 170t'" :;~) PlL:O t Hoohan tOH lnlY.'rr,J Notice has now been given to all persons entitled thereto under Rule 5,6(a) except Hono Date: //) .' k (~- /. tfll. X~"f)i.A_ /< 5i n ture - /' /. , Name :1. llcJ\)')l't StnlLf'.f'or St'p+'a 2, 1997 ;'" "Ii LL Ld Address !-if\l']wb S'l\lIll'O 1l1(lC. 1.10()llun:losbl~';' Pic 170';5 0: ('-. p, TelephoneUl71 7Jl(.-')6'/3 in :5 Oli Capacity: Personal Representative x Counsel for personal representiltive '''iI;'.-'-.''''- ". (lIlt/. ," t" "-".. , oS'J: --. 'II i'lt;"', (-1tu. (: I. "'~"'- 1'41f. (;> 'It,J,.1Ir/..... 'i"' ,( 19A.'-. ~- ijl' ~~~'" ~/, -<>''9 J( ~~ '''0 '. r, Or,~f'> Olf);>' 1Ir.... 0."1<'(.' ''1yz';>1I.<;- '1'r 06> . . 4//'/1 -IV/? "4 > (J(q, 0 'r,)/~/ ".<t,-91; /1"""0 " '5> 1-'? [,.(, CI./. (J./ 5>> .'I.,r.- "'>11 ()/~ 0 "'$ ,-" (J(~~ 00 -/:t "-9 ~ 41111(.0 . (r,,~, ~9C<(s,.r''9..".(j 'I.~1j'<{; ~ ,lyr,;'<$>.." ...~<; " '7'T, '" -"''->:1''... 1. 0 (0'< -7 <!i'C oJ 1)> k-. li'O ~ >" , ~~. ~ -, S~ 1,. &.-9'" <S 0&/'(;'" .. '9 '.,&. " vr.-/:r~~ " ~Ii' . ~ '-..-.. (;:-. ," . "C;~" /'1;' '.... .r,/.r, ...... 1,11/ /; 1)/ .i1?; ;., '.J' ~'111. .;, - 1'//110. O~'I ('~f '''>/J. (10 1+,:1/ Of (/II/ 'OIV/fl-j./t. 'fJ 'fJIJ. IA 1rtv ~ f If{ VIII '~'y. /f 1:." Iv. ;;Oft, 'f.f"~ 1'AII. Oo?r N 1 o( '"lllllIIII / ~~O li'1v. li'() p~ O~. , ..I ~ "" Os ...;c;l", <!i''i' '7~ "tr; ,. OltLl~" e,. -7>11 $',.., I'} Ie. ....v. Ur.- .&S;c;l~ "';r; V. ,,('Ii' ""& 1.11 ('.r. ,</1 "Cl 11>1;1 (/) , I"" '> '(1 0., ., ~~ ~~ A . . O~ '1l:4Iv.~'v~ ~", v~ '8y~ "'Z .t/A.''''' ~1.. 'vb "''v/. b ~8'" .t'~ ""'11 C~ ~ ~/~;4-t 'vo 'r11 <'1 2$9. ~ -L1 ~ g /11 v,, ". "<5'S(.:10 00 .s,9.~ 1-IA ~tl,l '11"'1- '!tor.Or t "1 '," '. '- """....-. ~", .... "'" ....,. ", .... ',.--t. '----....... '---..... '-.......,. ~. "-!to ", " ~" ~, '"" ", ~. '--..., '-... .'---.... ~ . '-... '---........ ,,:'> "--.... ............... '~ ,,~ ~,~ ~' '0" "0 '-- ~"'" "'-!tou. '---.... '- -9(.0 ~t .~~ ~o ""'.~ "" DO, .... ' ~f<':~J- ) ~- .... I" C ~t' · "r' /,;;.~ I -....... ~Ii' ~,.:.~ ,~ -....... O/,"Itr '-:.~ <;1>.L> Iv""'~ . '<'.' I(r ..:~ vc;" ><I --= ,,(q.o 1t.t-91' / S >:,p7 '1' .j IURIAU OF INOIVIOUAL TAMES IHttUllAl4Ct lAM DIVISiON lIEPf, 210601 HARRIS.URO, PA IIlll-O'Ol COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE * c___ NOTICE OF INttERITANCE TAM AFFRAISENENT. ALLOWANCE OR D1SAI.LDWANCE DF DEDUCTlDNS AND ASSESSHENT DF TAM lU,IU,..."ltHH 03-23-98 GARDNER 07-29-97 21 97-0677 CUMBERLAND 101 E~_A~~I R.~}_~~ J MAKE CHECK PAYABLE AND REMIT PAYMENT TOI REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 CUT ALONO THIS LINE .... RETAIN LOWER PORTION FOR YOUR RECORDS ~ iilv: is;;; -iiC-AFji - (1IF97"i -NoT i ci--oil-YNHERit ANCi - T Air APjiiiAI sEi1iNr;- Ai.l"oWANCE" OR - - -- - ---- -- - - - - -- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX CHARLES H FILE NO. 21 97-0677 ACN 101 J R08ERT STAUFFER ATTY MARKET SQUARE 8LDG MECHANXCS8URG PA 17055 DAn ISTAlK OF DA TE OF DEATH FILE NUHIIR COUNTY ACN CHARLES H DATE 03-23-98 IStATE OF GARDNER ) CHANGED TAM RETURN WAS I I X) ACCEFTED AS FILED RESERVATION CONCERNINO FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN 1. R..l E.I.t. ISch.dul. A) Z. Stock. end Bond. ISch.dul. B) 5. Clo..ll' Held stock/Plrtner,hip Interalt (Soh.dub Cl 4. Hort,ogo./Not.. R.c.l..bl. (Sch.dul. DI I. C..h/.... D.podh/Hho. ...r.on.l ProPld)' (Schedull E) 6. Jolnlly OWn.d Frop.rty ISchedul. F) 7. Tran,flre (Sohedull Q) .. Toto! Au.to NOTE I To in.ura proplr orldit to )lour lecount, sub_it the upp.r portion of thl. forM with your tl)( ply..nt. .00 .00 .00 .00 12.852.30 10.037.42 .00 II) III 12) 13) (4) CS) (6) (7) 22.889.72 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expen.../Ad.. Coatl/HIIO. Expen... (Schedule H) 10. D.bh/Horl,... L1.bllltl../LI.n. ISchedul. II 11. Tct.l D.ductlon. 12. N.t V.luo of r.. R.turn 15. Ch.rltabl./Gov.r~.nt.l aequ..t.J Non-elected .11$ Trult. 14. Not V.luo of E.t.t. Subj.ct to T.. 655.00 604.26 Cll) (12) _ (13) (14) 1.,C;Q ,1. 21,630.46 .00 21.630.46 19) 1101 ISch.dula JI If .n ......m.nt w.. i..u.d pr.viou.ly, lin.. 14, 15 .nd/or 16, 17 .nd 11 will r.fl.ct figur.. that inclull. the tot.l of lli r.turn. .......d to dat.. ASSESSMENT OF TAX: IS. A.-unl of Lln. 14 .t Spou..l r.t. 16. Aoount of Lln. 14 t...bl. .t lln..l/CI... A r.I. 17. A.ount of Lln. 14 t...bl. .t Coll.t.r.I/Cl... I r.t. la. Principal lex Due NOTlI (15)_ (161_ (17) .00 2\,630.46 .00 X'OO. M ,06. M .15. 1111 .00 1.297.83 .00 1.297,83 TAX CREDITS I PAYHENT DATE 12-16-97 DISCOUNT I + I INTEREST IPEN PAID C.) .00 AHDUNT FAID \,297.83 RECElFT HUHBER AA242566 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 1.297.83 .00 .00 .00 . U PAID AfTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIDNAl INTEREST. IF TOTAL DUE IS LESS THAN .1, NO FAYHENT IS REqUIRED. IF TDTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU HAY IE DUE A REFUND. SEE REVERSE SIDE OF THIS FDRH fOR INSTRUCTIONS,) ,- 7:{ rp '-~' ,..- 'oR'''' I':'} FiH ,t.. d!_~ U() RE5ER'IATJONI E,t.t.. of He...,t. dYlnt on or "'for' Dece...r 12, 1912 -.. If MY future lnten.t In the ..htil II "MI""'''' lopo.....lon or ,njoy.ent to-ca... -. (co11"".ll beneflclarl.. of the 6Io~t .ftlr thl 1M"""," 0' InY ."I't fir 11'. or 'or y..r., the COlllorw..1th hereby Illpr..,lf rIN'.V.. tM right to IIPPnhe 11M ...... .r....1t Inhe,"_",' "iii" It thl lewful Cl... I (00111'ara1) ra'a on InY such future Int.,..t. _Of MDT~CEl To fulfill thl raqulr...ntl of slctlon Zl~D of the Inherltanca Ilnd E'tat, TIM Aot, Act 21 of ..... err ',I. S"t1on 9140), PAVtENTI o.tlch the top portion of this NoUel and lubIllt '11th your PIYNnt to thli R..I,tar of WUh ,rlntli '"' tN r."."" .l.. uHllke cheCk or laney order p,vlttlla tOI REGISTER OF MILLS, AOENT .FUND (CRlI A r.fund of . '1M cr.dlt, ""Ich MI' not ,a.."'''' on the TIM R,turn, aav ba raque.tld by a-...aU", In "_lInth,n for Raf~ of P.nn'Ylv~la Inherltanea and E.t.t. Tax" (REV-ISIS). ,ppllcatlonl ar. Ivai I.-i. at thl Qffta. of the R..I.tar of Wills, any of thl 23 R.v.nue District Offlc.., or bV calling the ,p.c&ll ','hOUr anlMlrlng ..rvlcl nuaber. for for.s orderlngl In Pennsvlvanll 1-100-56'-2050, outslda Pennsylv,"',.~ ..lthin locI 1 Harrllbur. araa (717) tel-IO"', TODI (111) 712-Z252 (tie.rlnt :..alrld Onh), OIJECTlONSI Anv-plrty In Int.r..t not ..tI.fl.d with thl llfIPral..-.t, allowanc. or dhaU.,..anc. of ..,.tlonl, ., .....uant of tax lInolucUng dlleount or Int.rull '1 .hown on ttlll Hotle. ...,.t obJ.ct within .hetll (6e. dly. .f ,...1", .f thlt Motle. bYI --wrlttan prot..t to the PA Deplrt.-nt of RIYlnue, laird 0' APP.ll., D.pt. 211021, Harrl.burl, 'A 1"'1""1, O. --election to hlY. thl I..U.r eMt.ralned It audit of thl account of thl per.onal re,,,.entltlv., O. --app..l to thl Orphans' Court. AlIItIN ISTRAnYE CORRECTIONS, FlGtu.1 .rror. dl.c~vared on thl. ......eent .~ld be addr...ed In writing tOI Pi o.p.rt.-nt of ~'Yenull IL!rlau of Indlvldull Tax.., AllNI po.t ....".....t R,vlew Unit, OIpt. 2101\01, H4lrrhbUr., PA 17U...... Phone (711) 117-6505. S.. pag. 5 0' thl booklet ~In.tructlon' 'or Inherltanc. TIM a.turn for. .a.l-.nt Dacedlnt~ (REY-1501) for an .xpllPltlon of ~Inl.tratlvllv oorr.et.-l1 .rrar.. PENAL TV a If InV tlM due II Plld within thrH (3) ClJtndlir IIOnth. .ftll' the deudent'. dI.th, . II". ,.,unt "lei dll....... af thl tlM p.ld It .llawed. ThI llX tlM .-na.tv non~partlclpltlon PIn.,tv 1. ~tld an thl '0'" 0' thl tlM and 'nt.r.,' ......ad, ~ net plld before Januarv I', 1996, thl flr.t chly Iftlt thl and of thl t.M ..n..tv p"lod. Thh non-,,,".I...U,,, penaltY it ""1''-1. 'n thl .... lenn" end In the thl .... tI.. plr loci .. YOU would ....., thl '1M - lnt",,' tNt hit Hen .......d .. IneUe.ted on thlt notlc.. DIICDlMT' INTEREITa In,.r..t I. eharlld b..lnnlng with flr.t d.y 0' delinquency, or nlna ('I ~thl and one (II ~y f,.. thl ..,. If delth, to thl d.t, of "V.ant. TIM" whi~h blc... "11~t blfor. Janu.ry 1, 1'" ...r 'n"f.,t It thl ta'. If .he (6XI Plteent plr ~ c.lculltad It . dlUv nt. 0' ,00016tt. All tlMII whIch Uc'" ....".,ant ttn 11M .U.' JinUlry 1, 19.2 "III bI.r Int.r..t .t . rltl which will Vlrv fr~ ealand.r y..r '0 cIland.r V'" wIth t~t ,.tt announced bv thl PA D.p.rt..nt of A.vlnUl. "hI ..-Uelbl. 'ntltllt rat.. for Iffll thraUI" 1... .,,, '!!!r Int"l.t Aat. DaUy Int.rllt Fl<ltor !!!r Int"..t ..t. ~.aIY In'.r..' feG'l! 1.&1 lOX .000'" I'" .~ ,"'101 I'" 16X .OGOUI ."'-1"1 II~ ,e..UI I'" 11:< .ODOS01 I"' IX ,ilU",' I'ts UX .000156 1"1-1'''' ,~ !...." 1916 lOX .OU27e. 1,"-1."1 'X .1"'" ~"I"tlt..t a. e~lculltld .. 'ollow.I INTE.EST . BALANCE OF TAX UNPAID X NUNla OF DAVI DELINeUE"T X DULY ,"T.'IIT 'ACTO' "~Any Motle. IIIUld a".r the t.M bloOM' dll1nquMt will raU."t w, 'n'.rut Glha,la""" hi fUta.., "" ...,,' beyond 'ha dlt. of the ......lIInt. If ,IYHI'It I. ..... Ift.r the Int".., nllfilltatlfHl Ii.t. ,tMMI ." 'hi Motle., Iddltlonel lnt.r..' ault be calculltad.