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l'ETITION H>H l'IlOUATl~ nllll GHANT OF LETrEllS
No. 2.'- I q C'J'I' Ml'CJ LL___
To:
&10/1 0/ _ Tlmr,M1\ II. D~[':H
also knowll os ___.
_ _ Register 01 Wills lor Ihe
, ' Dectosed. Counly 01 CUM13EHLAND In the
SocIal Securll)' No. 203 -1 0:=49 4 3 _ Commonweallh 01 Pcnnsylyanta
The pelltlon 01 lhe ulIllcrslgned rcspecllully represents lhat:
YOIII pClitluner(s), whu 1~/ale 18 yenrs 01 age or older anlhe execut d,x
Inlhe lasl will 01 lhe allove decedenl, daled _ March 5,
and codlcll(s) dated _
_ namcd
,19..2L
(W\lC Iclcvnnl CirCllIlUI:\lItU. (,., ICIIIlIICll\llon. ~cMh or CACtUIOI, tiC.)
Decedcnt wn~ domiciled nl dcalh In Cumberland ' -rnCQunIY, Pennsylvania, with
It er lasl lamily or principal resldcnce al 113B Oyster ,"1111 I{oad
___ . ______East pennsboro Township
(lIst ~l(cel. number. 'I'wp, or Uoro,l
Decellcnl.lhclIJ2._l'carsolngc,died July?4, ,1997
at_.J.!olv Spirit Hospital .
Except as lollows, deccdent did nol marry, was not divorccd alld did nol h,av! a child bOIll or adopled
alter execution 01 lhe will ollcred lor prvllate; was nollhe victim 01 a killing and was never adJudlcaled
incompetent:
Decedent at dcalh owned property with c~tt/llotcd "alucs as lollows:
(I f domiciled in Po.) All personal properly S 2 , 000. 00
(If not domiciled In Pa.) Personal properly In Penns)'lyonla S
(If not domiciled In Pa.) Personol property In County' S
Vnlue of real eslate In Pel1llSl'lI'ania S 100, 000. O~
sltualed as follows:
113B Oyster M111 Road, East Pennsboro Townsn1p
Cumberland County, pennsylvania
WHEREFORE, pelllloncr(s) respCCllully
presented herewith and the tranl of INlers
theron.
req\lest(s) the probate of the last will and codlcll(s)
Testamentarv
(leJtllncnlar),l administration c,t.a.: admlnisUlllon d,b,n.c.t.a.)
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ll3B Oyster Mill Road
Camp Hill. PA 17011
OATH OF rEHSONAL HErUESENTATIVE
COMMONWEALTH OF l'ENNSYLVAN,IA } 5S
COUNTY OF' CUMBERLAND -
The pelltloner(s) nbO\'e.nRllIed swenr(s) or allirm(s) thatlhe slatements In the foregoing petition are
!tue and corrccllo the llesl of the knowledge nnd belief 01 [lelltloner(s) nnd lhat as personal relllcsen.
tntlyc(s) of the nboye decedent petllloner(s) will well:tiJ ~r1Y a~mtnlsler 11:e eslate Iccordlng \0 law.
Sworn 10 or nlllrmed and subscribed { l1). ~O,...:,t',... \'l
beforemethts lSth da of ,AIL D. D~ ..'
\~." 'I . 19 9 i ~
1ft ;:
~lARY 'C. Jlrg/slcr ~
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WARNING: Ills IlIogollO dupllllalo this copy by photo91nl or photograph,
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SUOULD RBAD AS FClLLOWS
? /,7 P /1909
~#U ~!~~~;t:
,''''' ... OMMONWEALTH OF PENHSVLVANIA' OEPARTMENT OP HEALHI' VITAL RECORPS
, CERTIFICATE OF DEATH
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:......"'....."......"., Thelma 11. Daimler :~~'a;;olaJ3'(;~;"":"';.O"-'=-~94';
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Gall D. Delmler 11)tJ uyster ['.HI R1., Gom\> 11111, pn
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006191.ooClOllFebl\llry \3. t9961HAJ/PARl505".(2)
D. The following items to the PERRY MASONIC TEMPLE
ASSOCIATION:
I. All paintings;
2. An ivory collection;
3. A marble inlaid tabletop from Agra, India and accompanying
display coffee table;
4. Three (3) carved tables from Taiwan;
5. A rug from Kashmir, India (3' x S')
6. Cloisonne collection
7. Cinnebar (carved lacquer) collection
8. A jade collection plus rose quartz and porcelain
9. Carved blue-wing teal duck
10. All wood carvings
11. All my clocks
ARTICLE V
I give, devise anda bequeath all the rest, residue and remainder of my estate to the
.PERRY MASONIC TEMPLE ASSOCIATION.
ARTICLE VI
I nominate and appoint my mother, GAIL D. DEIMLER., to be Executrix of this
my Last Will and Testament. In the event GAIL D. DEIMLER. is unable or unwilling
to act in this capacity, I nominate and appoint JAMES E. HERBST of 380 North 29th
Street, Camp Hill, Pennsylvania to be Executor of this my Last Will and Testament. In
the event JAMES E. HERBST is unable or unwilling to act in this capacity, I nominate
and appoint MARY IIERBST of 380 North 29th Street, Camp Hill, Pennsylvania to be
Execlltrlx of this my Last Will and Testament. In the event MARY HERBST is unable
006t9.'OOOOIIP.......ry 13. 1996/IIAlIPARl505lH1)
or unwilling to act in this capacity, I nominate and appoint DAUPHIN DEpOSIT BANK
AND TRUST COMPANY the IlCxt Bxecutor.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this .5 fo(
day of m~ ' 1996.
~~f~:~(SBAL)
Signed,sealed, published and declared by the above-named Testatrix, as and for
her Last wm and Testament, in the presence of us, who at her request, in her prese,nce
and in the presence of each other, have hereunto subscribed our names as witnesses.
.'
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~fV.I.SOO tK+ 11.l~4l
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.OR DA'" O' DIA'H AnlR 12/31191 CHICK HIU
If A SPOUSAL
'OVIRTY CUDIl IS CLA.MID I I
.,LI HUMii..
. r
INHERITANCE TAX RETURN
RESIDENT DECEDENT
COMMONWUl'H Of PENNlmANIA (TO BE FILED IN DUPLICATE
OEP'''MHH Of "'VENUE WITH REGISTER OF WILLS) 21 91 0694
tlAM",fJ:&, ~~O\9:190601 COUNIV CODE VEAR NUM8ER
~I. ::~;:~i;;:'''''''i::;;;;;~l~~;;;: T~~l\.~~-~..~.
It ", "''''"'''' ,,,,,,,,,,,, ","'" '"'''' ,,," ,,,,,..,,,,,,,,,,,,, """.., 1"0"" "'"'''' N"M"," I"'''''''' ,,,"'v'o I'" """,,(1'0"\1
[~1. Original Roturn [ ] 2 5upplomMtol Rolurn [ 13, Ramel/odor Return
(lor dohn of doath prior 1012.13-82)
r I 4, llmil{ld hlolfl I ] An. Fulurfllnloro,t Comproml,ft I I 5. Fodnrol E,tate TOI( Returfl Rllqulrtld
(lor dOhH of death ollor 12.12.821
Lx 6. Decedent DielCl ToslCllo l_1 7, Oncf,ldnnt Mnlntoinod (IUlinU Tw~1
(Alloch 'opy 01 Will) (Atlo,h <opy of TrOll)
ALL coiiRESPONDENCEANDCONPIDENT'AI fAX"NFORMA'YioN-SHouLDBEDiiiECTEDTO;-' _u_''''. .-----,.---~-
-t:#:MT"'.....-.-----.. - -.- (}}Ml'tfT[,,\;.Xll~io AODRES-5---
Horace 'A. John!lOl\, Esq. Johnson, Duffie, stewart" Weidner
iE<..iioNi "uMillf 301 Market St.,' P. O. !laX 109
. .1,7171 7~l;4540.. ~, PA 17Q<t3...01!l.9c' ..,==u-"o=.==...~=.
1. R.ol E,'ot. IS,h.dul. A) II ) 97,000.00
2', Slocks and Bonds (Schodulo B) ( 2 )
3. Closely Held SlocklPortnership lntortnl ISch&dvle C) ( 3)
4. Mortgage, and Notos Receivable (Schedule OJ I 4 I
5. COIn, Bonk Depollts & Miscellaneous Personol Properly t 5 I
IS,hedule E)
6. Jointly Owned Properly (Schedule F)
7. Tran,fers (Schfldule G) (Schedule l)
8. Tolol Gron Aueh (10101 Lines 1.7)
Q. Funeral hpens8s1 Administrative Cosh, MI$collonoous
Expenses (Schedule H)
10. Doblll Mortgage LloblHlitll, LIens (Schedule I)
11. T 0101 Deductions (10101 lines Q & 10)
12. NEtI Value of estate (line 8 minus LIne III
13, Charitable and Governmental Bequosh ISchedulo J)
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_._.. 8 T otol Numbar of Solo Depollt 80ll-el
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2
51
5
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211,719.32
7,210.01
161
17)
I ~ I ..3,~1,~~~,-3,:l_.
I Q I
12,~:z4.61
....,1,OQ6.,60
110)
III) .XI,Sn.<!J
1121 J611,39!!.n
113) .-Q-
.._.114L_~~!lcd98.).c~'
15,
16,
17,
2
..
~ 1~,
f lQ,
.
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u
a 20,
.~, Ne~~lue ~~le~?.!.~~..l~l~~l_!,.,!,~~.~}~_~~__~.~l
Spoulal Tronllen (for datelol doath aft'H 6.30.Q41
See Inltructionl lor Applkable Porcenlogo on Revene 1151
Side. (Include 'Ioluei from Schedule K or Schedule M.l
Amount olUne 14 taxablo at 6% rale n 61
(Include valuel !rom Schedule K or Schedulo M.)
Amount olUne 1 A taxoble at 15% rote (171
(Include value~ from Schedule K or Schodulo M,)
Prlndpoltall- due (Add tal(, from lines 15, 16 and 17.)
Credits Spoulol Poverly Credil Prior PaymEH'lts
+ 19,500.QQ +
,X'l =
-0-
x ,15 Q
22,103.89.
-0-
368,398.12
. ,06 =
118)
22,lQ3.!l9
Dllcounl
l"Q26.32 -
Inlnrolt
21, If Une 18 b greater than Line 1 Q, enter the dlfferenco on Line 21. This il the TAX DUlL (21) 1,577.. 57
A. Enter the interesl on the balance duo on Une 21A, (21A) -0-
s, En.e, Ihelolol of line 21 and 21A on line 218, Thi, i,'h. BALANCE DUE, 12181 1,511.51
~~~~__~~.._ck ~aya~_~..!~L.R..!_@I't.r__~_f_~I~I.~!.~_~!~_~._. __ __ -------- __..m.___'_
. .. ~ IE- SURE TO ANSWER ALL QUEsTIONS ON-REViisE SIDi-AND-TOREcHECK ,iATH--~;;C-_____--
u;der pena~l~". of p~~ury~-fd-~~I~~;thot-i-.h~~-;;~~Tr;;(f thi, ~fltl);~~--i~~fuding Cl~~-~;p-~n)'ing---I~he'd~lo; ~~i-'I~'tfil~o~I~;. ~~d i~ 'ih~- b~'I'o' my-k~~';;"le'd"g~ ~~db-;lief,
It is truG, correct and complete, 1 declare thaI aU real oslolo hos boen reponed 01 tlUO market value. Docloration of proparer olher Ihan the perlono! representative is
bosed on alllnformaUon 01 which preporer h.~I"ony knowlo~ge.'
~Ml, :TO" ~F];':.~~~:r :::::;i~~~~3!!~e:~~~~~~:d ~x 109' :/:;~(;J;jY~L'
,l.eIIOyne. .PAU043,-0109'!m'lJ .L.....__
Esq.
If Line 1Q Is grealer than line 18, enler the difference on line 20, This is the OVERPAYMENT,
IiKJ
119)
120)
20,526.32
Chl.ck here ., you (lIe rfH1U(lslmg (J refund of youl o\lerpClymont
\
Act .48 of 1994 provld.. for the r.ductlon of the talC rat.. Impo..d on the n.t valu. of tran.f.r. to or for
the u.. of th.'pou,', Th. rat.. 01 pr..crlb.d by the .tatut. will b.1 .
e 30/0 (.03\ will b. appllcabl. for ..tat.. of d.ced.nll dying on or aft.r 7/1/94 and b.for. 1/1/96
. 20/0 (.02\ will b. appllcabl. for ..tat.. of d.c.d.nt. dying on or aftllll1/96 and befoll 1/1/97
e 10/0 (.01\ will b. applicable for "tat.. of d.c.d.nll dying on or aftlll/l/97 and b.foll 111/98
. Spou.al tranlf.,. occurring on or after 111/98 will b. .lC.mpt from inhllltanc. taK.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK (....)IN THE APPROPRIATE BLOCKS.
'(~t _tl~
1, Old decedent make 0 transfer and;
x
a. retain the use or income of the property transferred. ""'"''''''''''''''''''''''''''''''''''''''''''''''''
b, retain the right to designate who shall use the property transferred or Its income, """.",,,'"
x
x
c, retain a reversionary interest; or ",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"''''''''''''''''''''''''''''''',,.,,
x
d. receive the promise for life of either pc>yments, benefits or care~ ,,,,,,,,,,,,,,,,,,,,,,,,:,,''''''''''''
2, II death occurred on or before December 12, 1982, did decedent within two years preceding
death transfer property without receiving adequate consideratlon~ If death occurred alter
December 12, 1982, did decedent tron.fer property within one year of death without receiving
adequate consideration~ , ,."",," , ""."",,""'" "" , "","""" , """, """""""".".,"""'" ".""".,.,
x
x
3. Old decedent own an 'In trust for' bank account at his or her death""""",,,"""'" ,,"",,",,"'"
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YESr
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN..
SUMMARY APPRAISAL REPORT
lO_C1HWlUIIi~"ht"l;AIIPI_t.
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..pt... HA O"'~ofs.. N,t, OIlCII"',o>1.......I/!I""".tlO.l~Chlll~"COll(t\"I)I"(gblpl~'I11'.II.' NA
l"*JCIlInI a,II[)eImIef AMltt. "MOyll.,Mill AOtd,Clnlp.M "A 110"
Oiln , AI ltt.nlloU " I,.U' ... , II "",,"tl" elm ~hll IIA "0"
Loc'" 11,11., Su~lNbM'l RUMI ',""!lillii'll 'IIl 'rIHl'll1t1lll lIIl...
lu'l/P Ow.,15'li 25.1$\ jJrd~115' ...""IMy O~I"'~ fl
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hud'W#1 ~ ' In bM"i:. ih~l wwti . vum ,Q.!\, [, : Com"*clill
,MrlllllMOtillI _.Undlll)IIllH:....HIIlOI _,Ovtr6mol ....Vu\~w5..) 120
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~.hcIord It pllm.tlfy "11d1.,II,I." NM,Wllh Iomf mltlO/' com~rcllIl lnflutMIl
'cbl It. *Ilht IIIoI'lultolb"V ~!hI ~lHMl1l!1 ~ 1M M9\/1l1l1lQod (1lI0li'nly to ~/!l(lttym4!t nlWMM'I, tmpbymenl 11M/My, ~ 10 l1\4l~el. 11c,1
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COMMOHWIAltH O"INNSVLVANIA
INHIXITANCI tAX WUIN
IUIDINt DICIDINt
SCHEDULE F
JOINTLY.OWNED PROPERTY
""="'_".:: ~':i="
FIll NUMBIR
21-97-0694
ISTAlI OF
_...___.._--....--_..~.~"~c---~--~.,..-"~-~ ~.,
DEIMLER, THELMA H.
Joint t.nont{.I'
_--- ADDREsS------'- - --RiI.ATIONSHii TO DICIDINT
-"- -_...,~-~.~.-"="-"'~,...,--
1138 Oyster Mill Road Daughl'.Br
Camp Hill, PI'. 17011 -
NAME
A. Gail ri. [)eWer
--------
B,
C,
~_......--",~--"'-'-~""
Jolntly.own.d pr.p.rty.
,~--"'~~~~-
, ITEM LEnER DATE
FOR TOTAL VALUI DICD'S DOLLAR VALUI OF
. NUMBE JOINT MADE DESCRIPTION OF PROPIRTY OF ASSIT % INT. DICIDINT'I INTERI"
TINANT JOINT
_.....-------~------~
1, A 1993 PNC Bank, N.A. - priority
Checking Account
No. 51-4001-5426 - Date of
death balance, plus accrved
interest. 5,361.03 50% 2,6BO,52
2. A 1993 PNC Bank, N.A. - Savings
Account No. 51-3012-5592
Date of death balance, plus
accrued interest. 9,058.97 50~ 4,529.49
~_~~_ =~_~.~~n~~._~~,~.r..'~r"" .----------
TOTAL (Aho "n'.' on Iill. 6. R..opl,ulonolll $ 7,210.01
____--.~,-------~.-~~,-""-.-.-~..-,-.n-.--~."~'--.,-'~.-',,-'-"-.--=----=___~_m .........-.-------..---
(If mor. .pa" /. n..d.d In,.rt odd/tlo..1 ,h..1I of ,am. ",,)
'Iv.'SIII" I"",
,,~.~:~...
.. FfJ.:1lr
COMMONWI"'L'H O' 'INN'YLV...NIA
INHUI1ANCI tAl .nURN
!UIDINl DICIDINI
SCHEDULE Ii
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCEllANEOUS EXPENSES
Ploa.. Pr.!!!!.!r Typo
LE NUMBER
21-97-0694
DEIMLER, THELMA H.
ITEM I
NUM8ER
A. Funoral bponl'"
1.
2 .
8.
1.
2,
A.
C.
1.
2.
3.
4.
S,
6.
7,
8,
DESCRIPTION
Sullivan Funeral Home - funeral expenses
Brachendorf Memorials - marker inscription
Admlnlltratlvo COltl'
Pononal Roprtlontatlve CDmmlnlDns
Sacial Socurity Numbor of Pe,"onal Rep,..ontotl.1: -
Voa, Commlnionl paid
Allo'noy Fees - Johnson, Duff ie, Stewart & Weidner
3.
Family Exemption
Claimant Gail D. Deimler
Relationship
Dauqhter
Addron of Claimant at decedent'l death
Street Addron 1138 Oyster Mill Road
City Camp Hill StateB~ZlpCade 17011
P~ba~~" - Register of Wills - Cumberland County
Mllc.lIanooul bponsol;
Cumberland Law Journal - advertise letters
AMOUNT
5,527.00
135.00
2,500.00
3,500.00'
264.00
60.00
The Patriot-News - advertise letters .69.21
Register of wills - file Inventory & Inh. Tax Return 25.00
L. G. Connor Appraisers - real estate appraisal 250.00
Raymond P. Stump, Jr. - household goods appraisal 50.00
Joseph James - jewelry appraisal 68.90
Recorder of Deeds - record Deed & Affidavit of Value 25.50
Reserve for close-out costs 50.00
TOTAL (Also onlor on Iino 9, Rocapltulatlan) S 12,524.61
IIf mort Ipaco 1& n..dod, In..rt addlllonolsh..1I of lamo 11.0.)
. -r+"r
... ...~ .... .... ,,' "" .,- .
"'''"'''1''''1.
eCHMlONWIAllH 0' ,r.NN.nVAHIA
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..ltDUft OletOIN'
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES AND LIENS
liTATI O'
DEIMLER, THELMA H.
ITlM
NUM.'R
DESCRIPTION
AMOUNT
l.
ManorCare Health Servioes - Ba1anoe due for
room charges
$1,006.60
TOTAL (AI,o ,.tor o. II., 10, Recopltulotlon)
III more 'po., I, ...d,d, I."rl oddl'lo.ol,h.." of ,om' ,Ize,)
$ 1,006.60
"
"--"--=h~."-
Inventory of the real and personal estate of
TIIF.LMl\ II. I>I~~F.R_________- deceased
._~-
-l::-:':;:~.~-;=;':':~~--""""'==-
1. Real Estate _ No. 1138 oyster Mill \load, 1;~'F\t Pennnboro
T<1tIOship, cumberl nnd County, p,mnay tvnnln.
(oeed \lOOK I, Volllrr<e 14, pngc, 478)
(oeed \lOOK 1, Vol Ulf/c' 15, pago 1 ri9)
l\ppraisL>d Value
(CopY of appraIsal attached)
2. Household Goods - appraised value
3. Jewelry: 14K white gold diamond engagement ring - appraised value
18K vmite gold diamond engagement ring - appraised value
one pair 14K yellOW gold diarrond
dangle earrings - appraised value
97,000 00
1,927 00
395 00
295 00
380 00
838 06
4. BelcO credit Union - Account No. 712210 - date of death
balance, pluS accrued dividends
100,835 06
TCYl'1IL
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
}
u:
Gail D. Deimler
b.ing duly sworn _ nccording to law, deposes and says thAt she is Executrix
of the Estate of Thelma H. Deimler
I t fEast Pennsboro 'rownship C bid C t P d d d th t th
I. 0 ___H__4 ,____...._...___.._ I um.r In oun y. a.. eCI'" an I .
within Is an Inventory made by Gail D. Deimler ,the said Executrix
of the entire estate 01 said decedent, consisting 01 all the personel prop.rty end reel est.te, except reel estete oulside
the Commonweelth of Pennsylvenl., end that the ligures opposite eech item of the Inventory represent It's leir velu.
os 01 tho dete of decedent's deeth.
Sworn to
end subscribed belore me,
. Jt,t"l IJl dllL~~tf ~ P,fk,-z.~4
J ,
. euc"tOf .. ),amll'll.frAfor
Gall D. Delmler, ~xecutrix
1138 Oyster Mill Road
~\ __19 97
DIANNE LENIG. Nolary I
Lemoyne Borough Cumberland Co,
My Commission E<fJlres Dec. 21.1997
Camp Hill, PA 17011
Acid,...
Dete of Deeth
24th
July
1997
D.y
Month
'fur
INSTRUCTIONS
I. An inventory must be filed within three months .fter eppointment of personel representative.
2. A suppl.ment inventory must be filed within thirty days 01 discovery of eddltional auels.
3. Additionalshee" may be attached es to personelty or realty
4. See Article IV, Fiduciaries Act of 1949.
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Register of Wills Office
Cumberland County Courthous8
1 Courthouse Square
FIWM
JOHNSON, DUFFIE, STEWART 1& WEIDNER
Attorneys It Law
P,O, Box 109
LEMOYNE, PA 17043
Carlisle, PA 17013-3387
SUHJECT:
FOLD +
Estate of Thelma H. Deimler - ~l-97-0694
DOD: July 24, ]997
IM'!'E: 10/17/97
Enclosed is a check in the amount of $19,500.00 as a payment
on account of Inheritance Tax for the above-captioned Estate
being made within the 90 days to allow for the 5% discount.
PLEASE REPLV TO
~
SIGNED
Horace A. Johnson
csh
REPLY
DATE:
SIGNED
RllOfdm 110m 111'210 oruraro, f',Q, Bo~ ~4t Hallford, CT 00104.29<14
NOI, '98', P,'n1"'''' 1I SA THIS COpy FOR PERSON AD,DRESSED
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COMMONWIALTH OF PINNIVLVANIA
DEPARTMINT OF REVINUI
IUREAU Of INOIVIDUAL TAMES
INHE.llANCE lAM DIVI.loN
1IE'1. 2IGAOI
HARR111~g, PA 111ZI-"01
NOTICE Of INHERITANCE TAM
APPRAISEMENT. ALLONANCE OR DISALLOWANCE
Of DEDUCTIONS AND ASSESSMENT Of TAM
m'I,Humllt.",
01-27-98
DE IMLER
01-24-91
21 97-0694
CUMBERLAND
101
~t R..itt.d
MAKI CHICK PAVAILI AND REMIT PAVMENT Tal
REGISTER DF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
CUT ALONG THII LINE ~ RITAIN LOWIR PORTION FOR YOUR RlcaRDI ~
iliV: liitf"ix""A;P"lliF97Y"iloTici".ci,"i"NHiiiifAifci" TAX"'Apjiii'Aiii ifiili'~""ALi"ciiiAiici"oli-..._...__.m._"
DIIALLOWANCI OF DIDUCTIONI AND AIIIIIMINT OF TAX
THELMA H FILl NO. 21 97-0694 ACN 101
HORACE A JOHNSON ESQ
301 MARKET ST
PO BOX 109
LEMOYNE
DATI
I8TATI OF
DATI OF DIATH
FILl NUMIIR
COUNTY
ACN
THELMA
PA 17043
IITATE OF DEIMLER
DATE
01-27-98
TAM RETURN WAS I I X) ACCEPTED AS fILED
REIIRVATION CONC!RNING FUTURI INTIRIIT - 811 RIVIRSI
APPRAISID VALUI OF RITURN IASID ONI ORIGINAL RETURN
1, R..l E.t.t. ISoh.dul. A)
2. Stook. and lend. ISohedul. I)
S, Clo..1~ Hold Stook/P.rtn.r.hlp Int.r..t ISoh.dul. C)
~, Nort...../Not.. R.o.l.obl. ISoh.dul. D)
I. C..h/'~ D.po.lt./MI.o, P.r.on.l Pro..rt~ ISoh.dul. E)
6, Jolntl~ OWn.d Prop.rt~ ISoh.dul. fl
7. Tran.f.r. (Sohedul. 0)
., Tot.l A...to
I I CHANGED
NOTE I To in lure proper
credit to your .ooount,
....It the upp.r portio,
of thl. for. with ~our
t.)C p.~..ent,
91.000.00
.00
.00
.00
277.719.32
1.210.01
. OIL
II)
(1)
121
III
C~I
151
(6)
171
311,929,33
APPROVID DIDUCTIONI AND IXIMPTIONSI
.. funeral E)Cp.n.../Ad... COltl/Hila. EKpanl.. CSchedule HJ (,)
1O,Dobto/Mort.... lIobIlIU../LI.n. ISoh.dul. Xl (10) 1.006.60
11. T.t.l Deduotlon. Ill)
12. N.t V.l... of T.. R.turn (12)
15, Ch.rltoblo/Oo..rno.ntol '.qu..tol Non-.l.ot.d 9115 Tru.h (Sohedul. Jl nSI
1~. Hot V.l... of Eot.t. Subj.ot to To. (4)
NOTII If.n ......~.nt w.. 1..Uld prlv1ou'lY, 11n.. 14, 15 .nd/or 16, 17 .nd 18 will
r.fllct f1gur., th.t 1ncludl the tot.l of 6kb r.turn. .......d to d.tl.
ASIIIIMINT OF TAXI
11, AMOunt of Line 1~ .t Spou..l r.t.
16. Aoount of Lln. 1~ t..obl. .t Lln..l/Cl... A r.t.
17, Aoount of Lln. 14 t..obl. .t Coll.t.r.l/Cl... . r.t.
1', Prlnolp.l T.. Duo
TAX CRlDITII
PAVMENT
DATE
-1 -97
10-27-97
12,524.61
t~ .1i~1 "
368.398,12
,00
368.398.12
IUI
(6)_
U7l
,00 K ,00.
368.398.12 K' 06.
.00 K ,15.
nl)
,00
22,103,89
,00
22,103,89
RECEIPT
NUM'U
AA242354
AA242397
DISCOUNT (.)
INTEREST/~EN PAID I-I
1.026,32
,00
19,500.00
1.577,57
AMOUNT PAID
TOTAL TAX CRIDIT
BALANCI OF TAX DUI
INTIRIIT AND PIN.
TOTAL DUI
22.103,89
,00
,00
,00
. If PAID AfTER DATE INDICATED, SEE REVERSE
fOR CALCULATION Of ADDITIONAL INTEREST,
I If TOTAL DUE IS lESS THAN .1. NO PAVNENT IS REQUIRED,
If TOTAL DUE IS REfLECTED AI A "CREDIT" (CR). YDU "AY IE DUE
A REfUND, SEE REVERSE SIDE Of T"IS fORN fOR INSTRUCTIONS,)
H
,........~ c-< :._"'.-"
. 'ct~
REII!RYATlOHI E,tete. of deCl.dlnt. dylnt etn olr blfor' Dlelllblr 12, 19.2 -- If MY futurl Int.r..t In thl ..'ete 11 tr.."ferrH
In po.....lon or .njoltHn' to Cll.. I (aoUltlrelJ bIn.Ucltrtl' of thl dea","' .fter thl 'Mplr.Uon of InY ..t.t. ,for
11f. or for y..r., the CQIIOnNI.lth hereby .~pr...ly r...ry.. thl right to .,pr,I,. end ...... tran.f.r InheritInG' T.M.'
at thl l~ful tl... I (oolllter.l) rat. on .ny such future Intere.t.
_Of
NOTICE I To fuUll1 the requlr...,,'- of S.ction 2140 of thl Inhlrltsnce .net E.tet. t.M Ao', Act 21 ot 1995. (72 ,.S.
'.ctlon ,litO).
PAVtENTl Ptltach the top portion of thit HoUa' .nd .ubIIU .dth your pay..nt to thl ""liter of Wll11 prlnt.d on thl rey.r.. .Ide.
~-MMte chlClk or IIOnllJ' order pelJ'~bl. tOI REOI81'ER OF MILl.., AGENT
REFUND (tR'1 A refund of .t,M or.dlt, Which w.. not r.que.ted on thl T.~ R.turn; ..y b. reque.ted DY co.plltlng 1ft "Applicetion
for Refund of penn.ylyanl. Inhtl Itlna. and E.t,tl T'M~ (REY~151S" &,,110atlon. arl .v.ilabll at thl OfficI
of the R..l.t.r of Will., 1nlJ' of thl 25 R.venue DI.trlct Office., or by 0.111ng 'he .p.clll Zit-hoUr
,".~rl", ..rvlc. ~.r. for for.. orderlnll In 'enn.ylvenl. 1-800.162-2050, out.lde penn'Ylvenla and
Nlthln local H.rrl.bUr. at.. (717) 7.7-1094, TOOl (717) 772~Z2S2 (H..rlne I.,elrld Only).
OIJECTIONSI Any plrty In Int.r..t not .ati.fi.d with the IPprll...-nt, .llow.no. or dl..llowent. of dedUCtion., or ......eent
of t.M (lnclucUne dltaount or Int.r..t) II .hcMtIn on thh' Notle. ltU.t obJ.at within .1Mtv (60) day. of rac.I,t of
thi. Notlo. bVI
~.wrltten prot..t to thl PA OIp.rt.-nt of A.v.nue, lo.rd of App..l't OIpt. 211U21, H.rrl.bur., P' 171t1MIOtl, OR
...l.otlon to h'v, thtl .att.r d.t".lned .t tudlt of the .ccount of thl pI"on.l r'IIII"lIent.tlv., 011
~-appe.l to thl Orph"'" Court,
ADMIN
ISTRATlVE
CORRECTIONS I
FNtual .rrotl dhcovlred on thl. ........nt .hould ba fMkIr....d In wrltln. tal PA Dlp.rt.ent of R.v.nue,
Jur'au of Individual T'M'" ATTMl po.t A.i.....nt R.vl... Unit, D.pt. 210601, H.rrl.burl, P' 17121-0601
PhnnI (711) "7M6S0S, s.. p... S of the bookl.t "In.truotlon. for Inn.rltano. T'M A.turn for. A..ldent
DlOedlnt" (R(YMlSOlJ for an .~pl,".tlon of ICIIIlnhtr.tlv.h corr.ctabl. errotl.
DISCOUNT I
]feny tlM due It p.ld within thrH (J) ul.ndlr "nth. .ftlt thl decedent'. dI.th, . fly. percent (S:() dltoount of
thl t,M plld 1. .llowed.
I'€NALTV,
The lS~ t.~ lInI.tlJ' nonMpartlclp.tlon ,.n.lty I. c..,utld on the 'ot.l of thl teM and Int.r..t .......d, Ind nat
paid blfor. Jenuary II, 1''', thl flr.t dev ,ft.r the .nd of thl t.~ ~.ty p.rlod. Thl. non~p.rtlclpatlon
p.naltY I. epPl.lab1. )" thl .... .anner end In thl thl .... tlM period II you would ."..1 the taM and lnterllt
that hll bHn e..G1u.d II IncHclt.d on thl. notle..
IHTEltESTI
Int.r..t I. ch.teed bI.'nnlnt with flr.t dlv of dellnouencv, or nine (,) eonth. end one (11 day froe the d.t.'of
delth, to the d.t. of p.veent. TeM" whloh b.c... delinquent blfor' Jenulrv 1, 191t blar Int.r..t It thl r.t. of
.1M ('Xl pltcent pit ~ cllcul.tld It . d.lly tit. of .0001604. All t,MII ""'Ich b.e... dllln.,.nt on end .fter
Jenuarv It 1912 will b..r Inter..t at . r.t. whloh will very fr~ cellndar ye.r to c.lend.r v,ar wlth th.t r.t.
ennounced by thl PA Dlplrt-.nt of R.v,nue, ThI .,pllolbl. lnt.r..t ret.. for 1"2 throuth 1'" .r.,
'!!!! Inter..' R.t. O.11v Interllt F.ctor l!!! Int,r..t Rlt. !!J,lv Inter..t FlOtor
1..2 lOX .000141 1917 'X .OOD21\7
1"1 lAX .OOOUI 19"~ 19t1 IU .000501
"., 1\X ,OOOSOl 1"2 'X ,00021\7
1..1 15;( .00OS56 l"JM"" 1;( ,DOO19l
"86 lOX .000274 1"5-1'" 'X ,00021\7
-~Int'r..t I, oalcu1.ted .. follo."
IHTEREIT . IALAHCE OF TAX UH'AIO X HUHIER OF OAVI OELIHQUEHT X DAILY IHTERElT FACTOR
--Any Motte. In'*' aft.r thl tlM bleo..' dlllnquent wUl reflect In Inter..t o.lcullUon to f1fteen (IS) dlY.
beYond thl dlt. of thl ......-.nt. If PIV.-nt I. .... .ft.r thl lnt.r..t c~tltlon dlt. .hown on the
Motlc" Iddltl~l Int.r..t .u.t be Cllcul.ttd.