HomeMy WebLinkAbout97-00714
PETITION .'ON PHOHATIi; Hnd GNANT m' U;TTENS
. EState oj _nay 1 v i a A ..I.lUill. ......_...._ No. _;;. L:::_9. 1:...7 L If _..-
also known as _____._._ To:
________.._..____... Reslsler of Wills for the
____ ~-;j Deceased. CounlY of ~hb<.. \(, "'"~ In the
Social !)eL'llrlly No. J~.i~J.!li(L CommonweRllh of Pennsylvania
The petlllon of the llndmlsncd re'llel'lfully rellremllS Ihat:
Your pelltloner!'), whll is/are 1M yellr, of age or older an the execnLt:..l.X... __._. nllmed
In Ihe lasl will of Ihe above decedent, datcd _._...._________.______ March 13. ,19.21-_
and codlcll(s) dated/_-r.__-(' ,... 7~(.. . l' ,T) , "'~ ,.
. ,~' 'L1 'It" .11,/1 f' ' ,-" d. .,-lll'Lt>-l..tlL\~,\ 1~~_I-,-"--t(\I! l.--(:(.(.p '_i.v!/
.. _ _ _ _._ /9d '~:; ~
(~\lllr rrlevunt l'IH'lIll'~llllU.'C~, (,',11, rt'lHlI1ciRlion, dClllh 01 C'xecuIOf, tiC.)
Decedent "II' dOlllkilcd III dClllh in __ ..___ _.Q~mQ.erlill!g ._._ County, Pennsylvllnla, with
h er laM fllPJIlYor IlJincllll!} rcsldcr\c~ at _.J.-4---s.--seeooji-..stn-'IH.l-l'S~0[)1'
~ e ~A>~.-'_.J-: e . . I ). " "<"''';'JI ~.",., ,,<rl.' ( " ". J y-- .jo'. 4." (jil.
~~- V)c:'lt'/' i '(lX.~ . l~llt MtrOtlt, number, 'I .lor Horo.1
Decedel1l. I""" ____.!HL .. yellrs o[ llgC, died _.__._-A!.l.9.l.I.ll.L.2..... ,1997,
at Thc;>rl).wrJJLl!Q!~9.,..1A 4. J'j<tlll\l_L!lQ.t.tQ.l!L.R.Q.iiQi-"csr..!lJlJ.e, PA_.._l1JLlJ
Except as follows, d':\'cdclll (lid 1101 mllrry, was 1101 divorced IInd did not have a child born or adopted.
afler execution of the will oftere;j for probale; was notlhe victim 01' a ~llling and was never adjudicated
!ncompotent: ----
Decedcl11 at dealh own..d propcrty wllh e~llmllled values as follows: <' <'
(If domiciled In Pa.) :\11 personal property $ ./ 1/ {t-t' r
(If not domiciled In Pa.) Personal property in Pennsylvania $
(If not domiciled In Pa.) Pcrsonal property in County $__
Value of real estate 111 Pennsylvania $
sltulled as follows: N (, pi I:
WHEREFORE, petltloner(s) respectfully m1ues~) Ihe probate of.lhe IRSt will and codlcl1(s)
presented herewith and the grant of lellers----Le::' ',' u "" <J" '0. <1'-..'
(leJlRmelllar~ladmlnlstiitt~ C.t.l.j admlnlSlfltlon d.b.n,c.I.I.)
theron.
~h ~~")
i~ /~ Fd ~~y'~~
iJ _2.38 West Siddon..bllrq Road
_. _ D ill .. h II ,. CJ~.....n.....-LlO-1.9..-....-_...
J" '0 ... .-.-----...--.-----
---~
OATH 0.' PERSONAL REPRESENTATIVE
COMMONWEAJ..TH OF PENNSYLVANIA }. 8S
COUNTY m: _.C"lmberJ..,aod
The petllloner(,; above.named swc.u(s) or afflrm(s) lhat the slalemencs in Ihe foregoing pelltlon are
Irue and COlnct In the best nf tht knowledge and belief of petitloner(s) and that as personal represen-
lallve(s) of the nb()ve dcce.denl petll~'"el'(s) wllI,well;~~1;~,;d,minf!l.erl.~~' aCCO~dlng to law,
Sworn to or affirmc.d t,I~.nd.....Sll.bs,.'rlbed {H"C-::" ;).. /r;//..'/(..'~- I!l
bef~ me thiS ,0..') __ day of : <...- '/ i
\. ./ ,./ , . ".,.19.~ ... ii1
In" /:~:., ,'hL a. )I("d,..:L.l....L . i
,- It-. f." liT Register _ ~.
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WARNING; IT IS ILLEGAL TO AITUl THIS COpy OR
TO DUPLICATE [lY PHOTOSTAT on I'HOTOGflAPH.
c(1MM<H/wrAL HI 01 PltH/:,yl VMIIA
orPAH IMEfH of ill:l\llH VII At. HHJHHl'~
21-97-714
LOCAL REOI6TRAR'n GFIHIFICA1ION 01 DEATH
CERT,I\O. 3560378
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1M'; ~f 1.1"~ ,,' Tlllt 04r!UI~.lIQn
Name 01 DOCOuBnt
Syl v_ia
A.
Davis
"- -- --"-... ;_1:;1....-~-'-----~-~~--~~~,._....._-n..--.--
Sex. .... F ema 1 e
....... Social SOCillily No.
184 - 09 . 3670
Dnlo 01 Death . .~~9US.~.R.L1997
Date 01 Birth.nJ_anu.ary 13, 1907Sirthrlaoe .CulllberJ,and County, Pennsylvania,
Plaoe 01 Dealll
Thornwa1d HOllie
_CUll1berland County
Carlisle Boro.
...P(lrlnsylvilnia.
O.I,d,fL, '
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o,I"'i' 1;'-;:";;-;
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Oi 11 sbllrYLPA..
'I, 1.-"",
.No.__
1]Q19,
Race . fllli te. Oocupalion L abor.er.
[)ocodonl's
Mnrital Status . Wi dQwed Mililul(J Addross
. AUllocllnrcm;" (Yo:; Of No)
uJ4SL.secQnd Street.
~;,Y'h''-
'~'-\t,.
Informant n lotllna
Name and Address of
Funeral Establishment
A.l)unlilP
. n Funmal Diroctol
Scot t O. Brenneman._ Fp .....
(b)...__
Cock 1 in LUJlera11Io~II~L30.~~Chestnut St,. Oi 1.1 sburg. PA_.J7019,.mnn
I
I Intorvnl Botween
: Onset and Death
I
I 6 Months
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-"~'-'----r ~~--"-"'-----' ..- ._.-...-_..-~----~
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Parf I:
Immediate Causo
(a). P ancreat i cCa.rc.iJlol1i!....__..
, I
(c) .......~_..__.._........ .,.u_,,,~_.,___".'.'_~._"_'n~n_'__"....'.'.'.."'._ __._nn'-__.._" __L..____._...............____.
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(d) ._._.~...n._n__....................___~nn__..'..~._~~___'....-,-...-...-.-----~---~.-~~-..-".........
Part II: Other Significanl Conditions, I
CHF. Aortic Valve Heplacement.' . i .
__.....,...__.....___.___~________.._,.____..._._....,,,..,, _ _~~._>--'-'-~___~.__.__~~~___~_.....______.....".._.._,..'...~ ..w_~. _--..~..........._~."., n.._l.---..___......._._~_.__.~.'_'.".~._, ---.
Manner 01 Death Desorlbe IlOW Injury ocollrrErd:
Natural Xl(~ HOlllioiclo [I
Accident LI Pondino Invf>sti(lation II
Suicide [I Could not bEl DolofOlinod II
.."."',.._,._,,_.~__~__.___.-..._._._._..". ..,_'__.--ri"-'~""_""""___"_--'~~
.,.~..~---_.~---~~".-,'~~-~~~.-
Name and Tillo of Cerlliol
Davi d_l._Wampler,.. MO_______.___d
n ..~..~, n-n---(f.;.rD.,.rj'.o~-Coroii8~-M.E1
Address .._~_ .33 ZS.Gar_lJsJe_Road. ... Gardner_s"J'IL_1Z324 m ...
This is to ClHllly that tho information hOff> givon is oorreclly copiod from an original certifioato
of death duly liled with iliO as Locnl Re,)lstrar. TIle origillal c()rtdicalo will be lorwarded to the
State Vital Records Of II co 101 pellTl<1nont IIII~~ I. ~ ~. V? j,? .,
/fra.{(.ciko T b.-li~~/ _ ____. .~J.7k!!rf
Yf' 1-4 fhf4;".u_JZ()~'/~~T-Irlf' .'LIt!!:?
August 2, 1997
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Ilbe1':e1.n n<t1ued, as and for bf~r l.l;lflt Will (\nd Teat.ament;, in the
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plACS of dsath
AUQUst 2. 199'7
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Tho<'W,'d ,o.e, .42 "l.,t ,otto' Ro.d, C,<l1'" .
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119'1'ICE 01" BEI1ELlS- 1.\1 nm:RESL ~ II E$'1'fI'l'L
,,'0", ,.. ",01S'" 0' ,,,,,, CO,"" Of c,.h.d". ro"" "V'" "
_, decUudl
In re Est.at.s of ~ylvia A. Davis
NO" 2197 of 0'714
'1'OI~ Lorena ~. D~la;-
265 ~Firit HolloW Drive
_ I bRO" lQ I""
_ lacici,..I)
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...... .... ...". .1 ... d.,.. .1 ..,..... ... ... .,... ..
1...." .. .h' .."...1 ,..........,..I.} ..... '.1". .., .., ....
a beneficial int.erllt. in t.he est.at.e as folloWS1
1/2 of residue
-
Winchester, VA 22603
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= ..'
(1f additional 8~ace .s ne~o~~1 use pack
Name of decedent Sylvia A. DaviS
Lalt. known addre~s~ Thornwa1d Home
-- -
---
d ~aie) -
-
-
442 Walnut Bottom Road, carlisle, PA
1'7013
~
of decedent
count.y of grant of or.g.nal letters
oecedent. died
)( tUllate
_ IntestatS,
IS not. attacned,
~ coPY of t.he will ~ i.
,.."..' .dd"" ,_ .., ""..."' '" moo' ,"" " oil .. "eo' 1
repressntat.iVSS appO.nteU
-
May I. Fenicle 738 W. Siddonsburg Rd., oillsburg, pA
=--
Telephone
1'7019 (717\ 432-5059
- ,
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COMHONWEAl,lH Of' PENNSYLVANIA
DEPARtMENI Of REVENUE
IUREAU OF INDIVIDUAL IAMEI
DEPT, 210601
""'.XIIURD, PA l11ll-0601
*
FILE NO. 21 97- 0714
ACN 97145197
DATI 10-16-97
TYPE OF ACCOUNT
o SAVIMO'
o CHECKING
[J TRUST
00 CERll' .
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
".-IUI n." lI-tU
EST. OF SYLVIA A DAVIS
S.S. NO. 184-09-3670
DATE OF DEATH 08-02-97
COUNTY CUMBERLAND
HAY I FENICLF.
738 W SIDDONSBURG RD
DILLSBURG PA 17019
RtiHIT rAVHENT AND FORNS TO.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
MELLON PSFS hll provided the n."ert.'l'It Nlth the Inforllltion ll1t.d bolo" whlch tin b..n una In
calculatinG the potentlal tll~ dYI. Th.tr rloord_ indlcatl that at the dlath of thl abovI dlcldant, you wara II Joint DNn_r/b.nl,iclary 0'
thh "count, If you 'aal thh In'or.aUon II Incorr.ot, ph... obtain writt.n corr.CltlQn 'rol the flnanclal In.tltution. aUlch a copy
tD thl. fOI'. and return It to thl above .ddr.... Thl. IICOOlAlt i. bllllhl. In accordltn.... "Ith the Inhllrltlt"flll rlt:~ I.f1W. of th. tOllllllOnllulth
of Pennlylvanla, Qualtlon. .ay be an.werld by roalllng (111l 161-1527,
COMPLETE PART 1 BELOW . . . SIE REVERSE 91DE FOR FILING AND PAYMENT INSTRUCTIONS
Aooount No. 00015714 D.t. 09-22-94
Eot.blhhod
Aooount "1M.. 40,044.05
~or..nt T...blo M 50.000
A""""t Subj.ot to T.. 20,022.03
T.. R.t. M .06
rotMtld T.. Duo 1,201.32
rART TAXPAYER RESPONSE
m 1.....MILI.IR~,.',,~8PONDltIL.L~II$ULT~NA.. iCl~~~~~Ak""lCA~~.Sl!II...T ..A..~ ...ON.......HI~illC)rXC..1
A. tltThI abova InforeaUon and tall dull II corr.ct.
~.. You .ay chOo., to r..it paYI.nt to thl R.ght.r of WUh wHh two oopl., of this notlc. to obhln
. discount or avoid Intarllt, or you ..v check bol( ftA" .net raturn thh notlc. to thtl R.ght.r of
Will. end .n'offlclll ........nt will be 1.lu.d bV the PA D.p.rt.ant of R.v.nUl.
I. ~The .bov. ....t h.1 b..n or w'11 be reported 8nd tal( p.ld with the Penn'Ylv~la Inharitsnca Tall r.turn
)!!i to be fll.d bv the d.c.dant', repr...ntaUv., , ; i_
C, 0 Thl IIbov. InforaaUon h Incorract and/o~.bt' I'nd dllductlcm' wlra Pllldbv you.
Vo... IU.t c:o~l.t. PART lIIenci/or PART ~ b.lolll,
To in",re proper oredlt to your Mlcount, two
(l) copl.. of thh 1\0tlC:I ltU,t ICOOllPany yoor
ply..nt to the Rlgl,tlr of Will" MIk. chick
pIYlbl. tal "Rlghtll' 0' Wllh. Alltlf'tt".
HOTEl If t'l( PIY.llntl II" .lId.withln thr..
(3) ~nth' of the decldlnt', dlt. of death,
you ..y d.duct . SiC dhcount of thl ta~ due.
Any lnhtirltMCII t'l( dUe will blOOM dIIllnquant
nlnl (,) eonthl IIft.r thl d.t. of deeth.
[CHECK ]
ONE
BLOCK
- ONLY
If you indic.t. . different t.. rat., pl.... .tet. your
relation.hip to decedent I
.",OFFICIAl:.':,llsJ: 'ONI.Y' 'QMf,l.
I'A il~~AR!~f~l OF:~~II~NVl! ,.i"i',i,i[
""""";;:;:"':;;:::i:::!!!:::::!:;::::":;;,;!;:;:,:",;;:!
!.,:;:.:....-:';,','
rART
I!l
TAX RETURN . COK~UTATION OF
LINE 1. D.t. Eotoblio...d 1
Z, Account Bel~ce 2
5. P.roMt T..oblo 5 X
~. A""""t Subj.ot to T.. ~_
I, D.bto ~d D.duotlono I
6. A~t T..oblo 6
7. T.. R.t. 7 M
e. T.. Due e
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DEBT9 AND DEDUCTIONS CLAIMED
TAX ON ...OINT/tRUllt A"l;UU...rll
""::::;:!:!::::;:::::::'-'-"""."'-"
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rART
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DATE PAID
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IEnt.r on LI~ S of T.. Cooput.tlonl
AMOUNT
t
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PAID
PAyeE
DESCRIPTION
I
TOTAL
-.
Un~r p.n.ltl.o of p.rjury, I d.ol.ro th.t tho f~to I
_ O~I.t. to th. b.Wot o~.y kno_. lad,. ~ b.ll.f.
4YJ/7/j('t'75J-~"::-1'Wt~(
"1'A'xPAYER stbNATU
have r.ported .boy. er. true, corr.ct and
HOME (1/7> f/".l. - -'>05'1
.
WORK ( >
TELEPHONE NUMBER DATE
"
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GENERAL INFORMATION
1. FAILURE TO RESroHD WILL RESULT IN AN OFFlCUL TAK ASSESSHENT with ...II,.bl. Int.,oo' b.ood on lnlo,..lIon
,ubltltt.d by the 'Inlnclal InttituUon.
t, lnn-rltlncl '1M beCOMeI delinquent nln. 1I0nthl .,t.t t~ dICldl"'" dati Qf dlllth.
" A Joint aGClbUI'lt II tlMllbll IVln thtJuth t.h. dlcedlllt" ".... w.. IIddtd .. . ..tt.r of Clonv.nltnel.
4. ACClount, (l"clud'"" tho.. t..ld betw.." hUlband Ind wlf.' which thl dlcld,"' put In joint nalll. ..lthln on, V'" prior to
d11lth at' 'Lllh tlMHII .. tren.hr..
S. AClOount' ..tllblhhld J.,lnUv b.tw.." hulbllnd and wlfl 11I0" thAn ono 'I..r prior to dl.th II" not tlMlbll.
.. Aocounh htI1d by . dlcld.nt "1n tr\llt for" ~th.r or oth.r. .t' 'aMabl, fully.
REPORTING INSTRUCTIONS - PART I
- TAXPAVER RESPONSE
L BLOCK" ~ If the infor.,tla" Ind COllflUhtlon In thl noUe. fir. corrlct and deduotlon. at. not btl"g olllted,. pl.oi In "X"
1n bloek "A" of p,rt 1 of thl "Taxply.r R..po".... ..0Uo". sllln two copl.. and lub.dt th.. with your oh.c~ for the IlMKInt of
hK to tM RIght.r of Wlll. of thl county Indlc.t.d. thl PA "IPllrt.lnt of RI"'I"u. will Iu\~ an official .........,t
(for. REV-1St,. EX) upon r,cllpt of ~ha r.turn fro. the R.ght.r of "Hlh.
Z. ILOCJ I _ ~f the ....t .p.clflld on thl, notlc. hal b.en or will b. r.port.d and tOK paid with thl P.nnlvl",anl, Inhlrltancl
Tax R.turn fllld by the dlo.dlnt'. rlpr...nhtl",., plac. an "M" In bloClk "S" of Part 1 of the "T.llpllylr Rupon.... 'Iotlon. Slon anI
COpy and r.turn to thl PA DIPart..nt of R.",.nu., Bur..u of Indl",ldlllll Tall", D.pt 280601, thltrl.butll, PA 111ze~0601 In thl
In",.lop. pro",lded.
S. ILOCI( C _ II thl notlc. InforMation II I"corr-Ict andlor d.ductlon. IIr. bllng cll'lh'lci, nhlak block "C" and cClllpl... P.rt. Z and 5
locordlng to the In.trucHon. b.lllw. 5111" two cop I.. lInd tluCl.11 tn.. wltn yuur lJ""~k fUI HI. Ih~...U;.t Jf b:; p~Y::lbl: to tM Right,..
of will. of thl county Indte.t.d. Thl PA DI~.r"lnt of RI",lnuI wl11 1..uI IIn offlol.1 ........nt (For. REY"lS48 EM) upon r.o.lpt
of the r.turn fr~ the R.III.t.r of Willi.
TAX RETURN .. PART 2 - TAX COMPUTATION
lINE
1. Ent.r thl d.t. the eceount ortglnallY WI' ..tabll.h.d or tltl_d In the IlInn.r .~I.tlnu at dRt. of d.ath.
NOTE I for I decadent dying .ft.r 12/12/821 ~cco'mt. which the d.e.dont put in joint nll"S within on. (1) y.ar of d.oth or.
t.~abl1 fully.. tronsf.r.. How.v.r, th.t. I. .n .~clu.lon not to .Ko..d '3,000 p.t tran.f.r.. rlllftrdl... of thay.lut of
thl .cc~t or the nultblr of Q(lcount. h.ld.
If. doubl1 l.tarl.k (ltlt) IIppa.r. b.forl your first na.1 In thl,l .cldr... portion of thh flOtlC', the n,ooo .l(e,1ualon
.lr.ldv ho. bien o.dUot.d froe the .ccount b.lonol .. r.portl,ld by the fln.nel.1 Institution.
Z. Ent.r the totll b.lancl of the .ccount Including Intlra.t .oeru.d to tho d.t. of d..th.
,. ThI percent of thl account thlt I. t.Kabl. for lach .urvl",or I. detlr.l~d .1 follow'l
A. The pare",t t.l(abl1 for joint ....ts I.tlblhhad IIOra thM on. ya.r prior to thl dle.dlnt'. d..thl
1 DIVIDED IV TOTAL ",,"IF.R Of
JOINT OWNERS
EI(..,III A jotnt ....t rlgl.t.r.d
DIVIDED IV fOTAL HUtlIEA OF X 100 . PERCENT TAMABLE
SURYI~ING JOINT OWNERS
In the nHlI of the d.eletant IK'd two othar p.rllon..
1 DIVIDf~ IY S (JOINT OWNERS) DIVIDED IV 2 (SURVIVORS) . .161 M 100 . 16,1~ (TAXABLE FOR EACH SURVIVOR)
.. ThI p.reent t,l(lbl. for ....t. craltad within on. y..r of the dlcld.nt'. d.ath or account. own.d by tha d.e.o.ot but hold
In tru.t for another 'nd'vldull(s) (tru.t bln.flcl.rll.}1
1 DIVIDED BV TOTAl NU"IEA OF SURYIVING JOINT M JOO . PERCENT TAMAllE
OWNERS OR TRUST BENEFICIARIES
EM..,I.1 Joint lecount r.gl.tar.d In thl n... of the d.cld.nt and tw~ othlr p.r.on. Ind a.tobll.hld wlth:n ana ylDr of delth by
the declldtflt.
1 DIYIDED BV 2 (SURVIVORS) . .50 X 100 . SOX (TAXABLE fOR EACH SURVIVOR)
~. ThI Hount tub!.t to tlM (11M 4' II dlt.r.lned by IlUUlplylnll thl .ecount b.lanc. Oln. 2) by thl porelnt bKMll. (11M St.
I. ~n~1I ~h. 1,...,_1 wl ll.. ..l..u~. .,,J Jlr.iu.;tlan:; Ihhd In r::rt 3.
6. The MOUnt tftXllbl1 Ulna 6) 11 dIIt.r.lned by .ubtractlng tha dabt. and dactucUon. Ulna S) frOll thai MOUnt lubJlCt to tlX 01na 4).
7. Entor thllpProprl.tl hM r.t. (line 1) .. etat.reln.d b1low.
A. For ~t.1 of dlath occurring .ft.r 6/50/94, tha t.~ rlt.. for tran.far. to .pou." .ra .. f~llow'l
1. Dltal of dI.th on 01" ~ftar 1I1/M _ blfor. 1/119S thl rU. II 5~.
2. D.t.. of dI.th on or aft.r 1/1/9S tran.f.,. to ,pou... w'11 be tlMad at O~ t.M r.t..
Not.l For dat.. of delth prior to 111/94 tran.far' to .pou.a. ar. t'l(abl. .t ,~.
I. Trln.flr. to llne.l da.condantl IftGludtnl f.th.r, .~hlr, .on, dlUlhtar, grandchildren, lon-tn-law,
d.utht.r.ln-l..., .tepchUd and thlllr IU\II Ir. tlMabl1 .t .he pltelant (6l0.
C. Trln.hr. to 8U other I ,,,eluding brothlr, .htlr, uncla, .unt, naphew and nl.c. .r. tl~lbll.t flltnn p.relnt (1!;,:O.
D. If yOU Chantl the till rat., pl.... lPAClfy your rll.tlon.hl, to thl dle.dlnt In the .r.. provided.
.. ThI MOunt of taM.... Ulna 6) I. dat.ratnad by INltlphlng the .eount hubl. (IIn.. 6) b~ tM t.~ "It I nine 1),
CLAIMED DEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
AU......l. dabtl and dedUc:tlon. Ir. detar.lnacI II fa UOlIfI I
A. Vou IIgallY .r. r..ponllble for paYHnt, ar tha IIt.tl .ubJect to IdIllnhtr.Uon by I par.on.1 ,apr..ent.Un It In.uffloJant
to plY thl dadu4)Ubl1 It....
I., Vou actually paid thl d.bt. .,t.r d..th of thl dleldlnt and can furnllh proof of p.yeant.
C. Dabt. bll", ~1.1.ed INlt be It..laad fullV In Plrt 5. If addltlon.1 .pecl I. naldld, u.. pl.ln p.,.r . 1/2" Mil". Proof of
p.pant MV be r.....tld bv ttle PA OIplrtHnt of RI"'IftUII.
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COMMONWEALTH OF PENNSVlVAHIA
DfPARTItENT OF REVENUE
IUMUU Of INDIYIDUAl 'AICES
PEPT, 150601
H'RRIIIURO, P. 17U'-0601
*'
INFORMATION NOTICE
AND
TAXPAYER RESPONSE
FILl NO. 21 97-0714
ACN 97145198
DATI 10-16-97
TYPE OF ACCOUNT
o SAVINGS
IXl CHECKING
o TRUST
o cunr.
UHUIII ",.,.tll
EST, OF SYLVIA DAVIS
5.5. NO, 184-09-3670
DATE OF DEATH 08-02-97
COUNTY CUMBERLAND
MAV I FENICLE
738 W SIDDONSBURG RD
DILLSBURG PA 17019
REHIT pAYHENT AND FORNS Ta,
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
HElLON PSFS h.. provided VII nlpart..nt ..Uh tt,. infor.atlon llltad balow which h.. b..n u..d In
cllculttlng thl pot_ntlal taM dUI. Thllt r.cord. Indicat. that at thl d.ath of thl abovI dlcedant, you war. a Joint owner/beneflclary of
this IOCount. If YOU '..1 thlt Infor..tlon II Inoorr.ot, ph8'1 obhln written cerrutiun 1rol thill financial InltHutlon, attach. copy
to this for. Ind raturn it to thl abov. addr.... This account 11 taKablt In McordtnCI .,Uh t". Inhtrltllntla ,,,... I,,", nf tho CO!l!,"on\!nIUt'l
of Ptnn'Vlvant.. Qul.tlonl ..y b. .n.Wlr.d by cIlllng (717) 767~6Sl7.
COMPLETE PART 1 IELOW M . M SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS
Aoo~t No. 222-282-65Z7 Dot. 04-05-76
Eobblloh.d
Aooount a.hno. 28,804.97
roroont T..obl. M 50.000
A~unt Subjeot to T.. 14 , 402 . 49
T.. Rota M .06
robnU" T.. Duo 864.15
rART TAXPAVER RESPONSE
[!) 1'~~'~IIR.t,t~.S~q"~.~~WIl.."~t~"'~llC!~~~~~~~!~~.ASS...l!."t~A."C!H'l'"..~qnC.~
A. t;X TM .bov. tnfor..Uon ~ hll due h corr.ct.
~ I. You I.Y ehoo., to r..lt p.y..nt to the R.gI.t.r of will. with two cop I., of thl. notle. to obt,ln
. dltto","t or .vold tnt.r..t, or YOU .IY ehecl( bOil ..... Ind r.turn thh noUe. to the A.ghter of
Will, Ind en o~flcl.l I.......nt will b. I..ved by the PA D'PlrtllRt of Alvlnu..
I. ~Th' abov. ....t hi' b..n or will b. r.port.d .nd till p.ld with the P.nn.ylYInI. Inherltanc. TIM r.turn
to b. f1tH by the d.c.dant', r.pr...nt.Uy.. '. ;' ,
C. 0 Thl aboy. Infor.aUan I,~ncorrlct Ind/o~lbt. Ind deduction. Wlr. p~ld by you.
VO+.I INlt eo.,.lltl PAAT L!J and/or PA!:!T l!J bllow.
To Inlurl proplr crldlt to your lecount, tNO
on copl" of thh IlOtlcl .lUlt IIceoapany your
paY'lnt to the A.gl.t.r of Will.. "aka ch'ck
plyabl, tot "RIgllt.r of Will., Ag.nt".
NOTEI If tlM Ply..nt. Ir. .,da within three
(S> lonth. of the d.eldentl. dlta of d.,th,
YOU "v d.duct . 5~ dl.count of thl tlM due.
Any Inher 1t1nC. t'M due Nil l blClOlll d.llnquent
nine (,) lanth. ,ft.r the date of d..th.
[ C~~~K ]
BLOCK
ONLY
If ~au lndl~.t. _ dlff.r.nt t.x r.t., pl.... .t.t. your
rolotlonohlp to d.ood~tl
rAMT
~
TAX RETURN . COMPUTATION OF
LINE 1. D.to E.t..lloh.d 1
2. Aooount ..1~0. 2
5. r.ro~t T....1. S X
4. A~t Subj.ot to T.. 4
5. D.bh _ o.duoUono I
6. A~t T....l. .
7. To. ~.t. 7 X
II T.l( Due .
rART
[!]
DATE
:.... .,:,:,:, ':',:. i'OF'FICIA'WSE. ONLY.. '{JAAF :
TAX ON JOiNT/iNUit' A~CUUHTSPAD:l,:P~i!:~!~~T~~~liOF~;~~~~~:'ij:::i!1
:: ..... ".: ,.;:!::""..: <:1
.....'\/1 ,. ,'" , ,:.':",..,:: ",!I... .. ....:: I':. "..'''",i,1
'i/::,..5,.:...:"'. .... ,,:.,'. ",i::1
" """;", '\<:::>;:::i;
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8
DEITS AND DEDUCTIONS CLAIME~
;';';'-:',::;;::.:;::!
';""":'\::';il
';'.-.1"
PAID
PAYEE
DESCRIPTION
AMOUNT PAID
r&-.
GENERAL INFORMATION
1. fAILURE TO RESPOND IIILL RESULT IN AN OFFICIAL TAM ASSESSHENT with ..pll..bl. Inloru\ bo..d on Inlo,oo\lon
.....1tt.d GV the flmlnGll1 lnltitutlon.
2. 1nM>l'ltlnol till ~COII" d.Unqulnt nln. lIonthl ,ft,r thl dle.th.n' ' , date of tHillth,
1, A jotnt .ceoun' I. t'Wlble IVln though the dlcld'nt" n... WI' add.d .. . ..tt.r of convlnt.ncl,
~. Aocounts (Includlnl tho.. held b.,~.." hU,band Ind wlf.) whloh thl dleld,nt put In joint n...i wltnln on. v..r prlor to
d1eth Irt futh hubl. II t'Mt'.r','
S. Aocountt ..tablhh,d jointlY bit",.." hu.band and wUe liar. thin on. y..r pdor to d..th .t. not tlICAbII.
.. Aoooc.I>''- held by . dlaleMnt "t" trult for" anothlr or other. It. ,.}Cable fulh.
REPORTING INSTRUCTIONS - PART
1
- TAXPAYER RESPONSE
.. BLOCI('. If the lnfC'lt..Uon Md COllPutltlon In the nnUce at. oorrlot Ind d.ductlon. .t. not bllng olll.*<<t" pilei an "X"
In block "'" of P.tt 1 of ttM "TalCp.V" Aupon.," ..otton, Sian two copl.. and I\ibllU th.. Iltth your ch.ck for thl nount of
taM to the R.al.t.r of Willi of the OOU"ty Indicat.d. Th. PA Dlp.rt~.nt of R'~lnUI will I..ut.n ~fflclll ........n'
(For' REV-li~' EX) upon rec.lpt of thl rllturn fr~' the RII,I.t.r of ~111..
2. IlOCX I _ If the ....t Ipecifled on thl. notlcl hu. b..n or wiU hll r.port.d ftt'ld talt paid with the ~.nn,YI~anll Inh.rltanc.
bll R.turn fU.d by the d.c,CI.nt', r.prulntlt1~., plac. an "K" In block "B" of Patt 1 of the "Tallpay.r R..pon.... 'MUon. Sion one
C10PY end r.turn to thl PA n.part.,nt of R.loIlnu., Bur.llU of Individual Ta.llu, napt 280601, l1errltburg, PA 11128-0601 In the
10101.109' pro~ldad.
S. IlOCI( C _ If the noUc. Inforaatlon II Incorrlot and/ol' d.ductlons are b.lna olal..d, chick block "C" Met co.plet. Partl 2 and S
Hcordlng to the Inttruo'don. hllow. Sign two copll' and t...b.lt th... with your ch.ok for the lMlount of huc p.yabl. to the R.ght.,.
of Will. at' the county Indicat.d. Thl PA Dlp.d..nt of M.loIlnue will luo. an offiolal l"......nt (For. REY-1546EIO upon r.c.lpt
of the r.turn frOll the Rlglst.r of Will..
TAX RETURN - PART 2 - TAX COMPUTATION
lIHE
1. Enter the d.te thl account orIginallY wa' ..tabll.hed or tltl.d In the .annlr alll.tlna at d.tl of d.eth.
MOTEl For. deo.d.nt dyln, .fter 12/12/82, Acoount. whioh the daoeda~t put In joint n.... Illthln one (I) y.ar of d.ath er.
t'Mabl, fullV ,. tr.n.f.rl. Howevlt, th.re i. .n eM~lu.lon not to 'M~..d '1,000 p.r trln.f~r8' r.gftrdl... of the v.lue of
the ,(loount ar the nu.ber of IIccounh tl.ld. '
If . doubl. a.terl.k (MM) .pp..r. hafor. voor flr.t na.. In the addr'" portlon of thi. notice, the 11,000 eMoly.lon
.lr.ady tla. been dltductld 'rOIl the HCOunt b.lInc. .. report.d by the.llnanclal lnltitutlon.
2. Ent.r the total bll~1 of the .ccount 1~ludln. lnter..t acnru.d to the data of d.,th.
J. ThI parcant of the account th.t I. tlllablll for .ach .urlolilolor II oater.ln.d .. follow"
A. TM perCllnt t.llabl. for Joint ....t. IItablhhed .ore thtln on. y.ar prior to tha de~ld.nt'. de.tt"
I DIVIDED IV TOTAL NUMIEA OF
JOINT OWNEAS
EIl.-pl.. "Joint ....t r.gl.t.r.d
DIVIDED IV TOTAL QIER OF )( 100 . PERCE~f TAXAllE
SURYIYING JOINT OWNERS
In thl n... of the deOldent and two oth.r p.r.on..
1 DIVIDED IV J (JOINT OWNERS) DIVIDED IV 2 (SURYIVDRS) . .167 K 100 . 16.n (lAKABlE FOR EACH SURYIVOR)
I. ThI p.rollnt tl)labl. for ....h cr.at.d \!lUhln one y..r of thedeo.d.nt'l de.th or .~oountl owned by the deo.chtnt but held
In tru.t for another Indlvldu.H.) (tru.t b.naflellrlel) I
1 DIYIDED IV TOTAL NUMIER Of SURYIYINO JOINt
OWNERS OR TRUST IENEFICIARIES
X 100 . PERCENT TAXAllE
EM..,I.I Joint acoount r.gl.t.r.d In the n..e of the dec.dent and twe othar p.r.on. and ..tabll.had within ona y..r of d..th by
tM dacHent.
1 DIVIDED IV '(SURVIVORS). .SO X 100 . 50~ (TAXAllE fOR EACH SURYJYOR)
~. TM MOUnt .ubJect to taM (lIne 4) It det.ralned by ItUltlplylng the aocount balance Olna ZI bv the Plro.nt tl)labl. Cline S).
5. Entlr the totll of the debt. end dIduotlon. lltted In P.rt J.
,. TheNOUl'tt tlllabl. Cline ,) 11 dlt.,.llnN by .ubtrlcUn, the dabtl and dadclcUont tlln. 5) 'rM the CIIIOUnt .ubJeot to t.M (lIne 4).
7. Ent.r the approprl.ta tall r.tl (1In. 7) .. det.r.lned balow.
A. for d.ta. of de.th DOourrl", aft.r 6/~D/'~, thl t.1l ret.. for tr.n.f.r. to .pou.e. .r. .. follow'l
1. Oat.. of delth on or .ft.,. 7/1/94 and b.fore 1/1/9~ the r.te I. 5~.
P:. D.tl. of dHth on or aU." 1/1/'S trantf.n to ,poule' 11111 b. taM.d .t o:c taM r.te.
Notl' For dat.. of death prior to 7/1/94 tranlf.r. to .pout.' ar. t.llabl. .t 6~.
I. Tran.f.r. to 11~.1 de..endent. Includlnt ,.tn.r, IIOther, .on, daughter, .r~chlldran, .on~ln-law,
dlulhtlr.ln-l...,.tepchlld indthalr I..UII .r. tallabl. at .Ix p.rc.nt (6X),
C. Tran.f.,. to .U othen IMlucllng brother, ...ter, uncle, aunt, nephew and nl.c. Ira t.1I_1e .t flft..n percent Cl5;().
D. If you c.... 'hi talil ratl, pl.... .p.olh your 1,.latlon.hlp to the d.o.ct.nt In thl .re. provided.
.. The HOlM'It of t'll dull (line 6) 11 Ht.r.lned by 1IU1tlphln, the e.ount tallabl. Ulne 6) by the t'M rltl Clln. 7),
CLAIMED OEDUCTIONS - PART 3
DEBTS AND DEDUCTIONS CLAIMED
AUCMlabl. dabtl IItId dIducIUon. .r. deter. toed al foHowlI
A. VOU 1...1ly Ir. r..pan.lbl. for p.y..nt, or the ut..t. .ubj.ct to IdIIlnhtr.tlon by I p.r.oo'l repr..."tIlUIoI. It In,ufflclant
to p,y the da~tlbl. It....
I. Vou .atuelly ,.ld the d.bt. Ift.r da.th of the d.c.d.nt and oan furnl.h proof of PIVltnt.
C. Dabt. baing alall1d au.t be It..lzed fully ln P.rt S. If additiOnAl .p.c. I. needed, u.. ~l.ln PlP'r . 1/2" . 11". Proof of
paYHnt .ey be r....tld by the PA Deplrt...t of R.vltC1lJl.
/)
I';"). / (I
IQv l-.lx. II'" j.d,~t.
COI.lMOI~~SY1VANIA
Of.PAR1MEN10f REVENUE
[J(PllI0001
I !'AI ,
n_ ~. .
Ofc(OlNtll NMlIlAlT, 'lAlf, 00 MlOOlf ItlllWI uti Ibl." bkd illlfl.. worM
~
il~
I
REV -1500
INHERITANCE TA.X RETURN
RESIDENT DECEDENT
~~I(
'~l__~
FILE hUMBER
2197-0'114
ffi
Cl
w 184 .09 -3670 OS IO':? I cn 01 lu I 07
o
~ ~~~~~,,"~.iM~ ~m;oST~""oi:~~~~:~ ~~~,jy;<-. ~_~:RijUH~~U~:;i;I~~T~:~~~~liWIiHTHE
81~1o.IR.lum [I1soppklmell~IRolu", [] 1 R''''''",lorRolulllld...~..",,,,,,.''''lll,
o UInlIed EI~'. [1 .. 'olor.lnl."" CompfOlIlllO ,.......'" "" 11.11 III [I 5 ,.u"., E.~,o ,,, H.lolll R.qolred
o 6. OecedenlDied Tell.I.I...."~r"',.1 [.I 1. l>ecedenl M.ln~lned .llvln'l T'o.I,.",,,~,"I,"lu __ 6 Tol;1' Nomoor 01 :;,1. Depn," B"..
o 9.llllg.llonP"""ed. R"",,',o<I [] 10 81'0,".1 Po,"~ Cltld~ I.......~'"..." 'I '""'H'''I [J 1 I Elrlelloll 10 I" 011''1 See al I.1IAIi.M $<'01
THIS SECTION MUSTIlE COMPLETED. ALLCORRESPONDENCe ANO CONFIDENTIAL TA~ INFORMATIONSHOU[OBEOiRECTED TO:
N.Wt: ~. CMl~IE"Wc.INO""[}OAE$S ----
Jane M. Alexandr~r, Esquiro 148 S. 8a1':i1l\010 StnJet
...... ~/fIIO...1 P . O. Box 421
Dillsburg, FA 17019-0421
Davis
S(X; IEC\JftIfY tuMIE"
sylvia
-'(i"ITlitiinfif--------.---.
(',
.... BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE ANDReCliecKMATH < <'---"
'.-'Ml~' r.-n_t.ti ;J~~~ii"iiiM~-"_-~~\~:MW-1'lIJ aX~nc>,"'~inQi(~ ,~~~Ihi-btillim~;;;;J-g!.,;,-MiI,j-~~~;CCf~;;lal;;-~~~c:18Ie 1Jl'('IJlnl"-'ll 01 Cflp;,~'-oU;e(-'
[II!J!l:t.QI!lOMIltDl'tHfllltlvt 1I bIIId on" flrcrm,lionUhsb.1tH1f hlllI1~ knorNlJat.. I I ..J,
. SIONA."~f.OFP~~SON.RESPONSIBl~FORFllINO TUI\N ADDRESS ('" /I \l'v'/ 1 DAlE
: . /"..:r;,/ (, . /"i.. /; .,.; 1,1 "1 J,I,,, . i'i ,. ;1!:' ('I! Iln),!
SloNAtiJAE ~PI\EP. ARER6~H~RTHAIt EP.~E. ATlVE,.:/ / ADDRES~ '.." .~/ J.: ,,I !) I ,/1. )' DATE
,_/t,"t!:"-:7C-<_'//''/ (' ~{<~-'/~,L.-cr;.?tc /1' dl/()rY.'?{~'L(-{(.{ ./ .J__~.'t~,1(-~';?j(>;';'/
^
OATi iiOiAIH
III
~32-4514
"/1)-1' ,?
.yp II:}"
,
Oecedent'l Com lete Addre..:
S'~ET AOOIlESS
14 S, Second street
CllV
Oi 11 sbur
I SlMEpA
_rr 17019
~
'fIX paymenta end Credlll:
1. Till Due (Page 1 Line 18)
2. CledllllP.ymenll
II. SpoIIllIi Pov8!1y Cledll
B. Pr\oI P'YI11ll1II
C. Dllcounl
II) 3,326,10
TolsICloolIl(A.B,CI (21 _ -0-
3.
InlllesVPlnllily II .ppllcable
D. Inlllesl
E.Ponllily
-0-
5.
TolallnlllllVPenally (0. E) (3)
If 1101211 gll8ll1lh80 line 1 . line 3.lnlll Ihe dlfflllnce. ThllII Ihl OVERPAYMENT,
Check box on P.gll L1nllelo rlqUIII.1l1und (4)
If line 1 . line 311 gle.111 Ihan line 2. Inlel Ihe dllfellnce. Thlllllhe TAX DUE. 151 2, 326 .1 0
II. Enllllhllnlalesl on Ihe IIlI dUI. (5A) - 0-
B. Enllllhllotel 01 Line 5. SA. ThllII Ihl BALANCE DUE. (5B) 3 , 326 . 1 0
Make Check Pay~e to: REGISTER OF WILLS, AGENT -H
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Old decedenl make alren.fer Ind: Yes
I. ralaln lhe ~II or Income ollhe property lrenllerred; ....................................................... .....0
b. relaln Ihe rlghllo dlllgnale who .hall ~lIlhe property lranaferredllr III Income: ...............0
o. relaln a reverllonary Inlerllt; or.............................................................................................0
d. receive Ihe promlll for life 01 ellher peymenla, baneflls or care? ......................................... 0
2. If dealh occ~rred on or before December 12. 1982, did decedenl wllhln two yeers
preceding death trensler property wlthoul receiving adequale conslderallon? If death ocourrld
Ifter December 12. 1982, did decedenllrensfer property wllhln one year of dealh wllhoul
receiving adequate con.lderallon? ..............................................................................................0 9
3. Old decedenl own an 'In trusl lof or payable upon dealh bank accounl or IIcurlly
4. ~\;I;e~~:~~::~:~. i~di~id.~~I;~.il;~~~~i '~;;~~i:' ~~~~ity: .~;. ~ih~;' ~~~~'~;~b~i~ '~';~~~;;y?:::: 8
No
lUl
K]
8
4.
H
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN
~.I"IlI_ _ .tlll.~_...~._...._. ~~",,,''''''m...__..._.... .....Ul.._......"Q".T1l'l'l,,1"~~...I!J~"I'Kf!...,~W1I
721'.5. S9116 (a) (1.1) (I) provided for Ihe reducllon of Ihe lax rele Imposed on Ihe net velul of Irensferllo or for Ihe use of Ihe
.urvlvlng SPOUII Irom 8'10 10 3'10 lor det.. 01 deeth on or aller July 1, 1994 and before Januery 1. 1995.
721'.5. S9118 (a) (1,1) (II) provided lor Ihe reducllon of Ihe rele Impolld on Ihe nel value of transfera 10 or for the use of Ihe surviving
spouse Irom 3'10 10 0'10 for detll 01 dealh on or eller January 1, 19ge. The sletulll1!2nJ.19.l.t!WlJQl a Iransfer 10 e surviving spouse
Irom lax. end the Ilalulory requlremenll lor dlsclolure 01 Il8ell Ind filing e lax relurn ere stili Ippllcable even If Ihe surviving spouse
II Ihl only benenclary,
FOR OATES OF DEATH ON OR AFTER JANUARY 1, 1885. Pleese answer Ihe followln9 qual lion by placing an "x" In Ihe
approprllle apece.
Old Ih. dloed.nl or.ale I truII or almll.r arrlngemenl whloh II lol.,y lor Ihe lurvlvlng apoulI'a benefit for hla or her enllre
m.Um.? VII 0 No 0
II you Inlwlred V" 10 the Ibovl queetlon. Ihe tax on the trual or Ilmlllr arrengement Is pOllponed untlllha deelh of Ihe second
IPOUse, al which time II will be fully llxlble el the rale(.) Ippllceble to Ihe remelnder benenclary(I..). Enler Iha velue of Ihe IluII on
Schedule J, ParI II, In order 10 remove II from Ihe celculatlon 01 Ihe tax due In Ihll ..tile. Ycu mlV wish 10 flIe Sohedule 0 In order 10
lTlake the election Ivallable under Section 9113. If the election la made, Ihe trusl or Ilmll., arrengemenlII laxed In Ihe ISlale of Ihe
firsl decedent Ipouse. Ihe portion 01 Ihe lrust or .Imllar arr.ngemenl which beneflll Ihe lurvlvln9 spouse la texed el the lero Ilx rete,
Ind Ihl remllndar II taxed It Ihe r.te(.) Ippllceble 10 lhe remllnder benenclary(I..). If you Ch009810 make Ihe election, you mUlt
Itlech Schldule 0 to I tlmely.flIed tlX relurn, Ilong wllh Schedule(l) K and/or M In order 10 Ihow the apportionment of Ihe lrusl or
Ilmllar Irrlngemenl between Ihe .urvlvlng 'POUII Ind the remllnder benenclary(I..),
.,'
,t~f1f
ESTA'l'E OF SYLVIA 1\. DAVIS-SURVIVING OWNER
nNl'~~ <W D1~A'I'l1 OR/02l9'1
CO-OWNER GLENN S. DAVIS, HUSBAND, DIED, SEl"n~Mlllm
19, 19!LI
SAVINGS BONDS
SERIES E
Dl\'1~E IssuEi}-FAciCVALUE- VALliE DA'l'E ~^Sm~D
O~' DE1\'1'II VAI,lJE
-"'-----'
---
1 Q1928655133E Jan. 1962 $ 25.00 __~}. I"
2- Q1932~91319E P'cG-;--i9'6T-- $ 25.00 L,-,~;j'I,L
.j Q1936863019E Mar. 1962 .\ 25,O()" .-1.~.", 1\,)
~ Q1937463624E iipr. 19"62 $ 25.00 1,.."Ti"
5 Q1941216108E Mav 1962 $ 25,00 'Lo',.(I[~
6 01945750607E ,Jun. 1962 125.00 .'"'. .\<,>,
1 Q1952412706E Ju~962 $ 25.00 1L..1 ~\';,
8 Q1956442729E .Ju90962 -$ 25.0() I, ',. (..1
9 Q1968091343E Sap. 1962 :; 25.6'0 " d,,\;
rO?1.9681ill~ Oct. 1.962 -$ 25.0'0 ,.,..11<, .--
;J Q197229059,4E Nov. 1962 $25.00 ~.Ll!~_._-
!L Q1983786380U DcC, 1962 $ 25.00____.JJ.w-Y-L,l
13 o1987851716E Jan. 1963 ,ll~Q.Q.-. Ic..h ...1
l~ Q1987871375E Fgb.1963 'S 25.00 1,,1 .>..\
1:, N 990786890E Mar. 19~ ~ 25.0'0 I c.,,) on.
16 Q1999815005E ArJr. 1%3 $ 25.00 1....-.:1 :>,~,
17 Q200186653TE Ma-v-r9"63 :; 25.00 _ 1~:J.,l,l..
18 Q2004522,662E Jun. 1963 :; 25.00 1'C;'l."'>
19 Q20118E5083E Jul. 1963 $ 25.00 I~"'.< 'r,'"
2.!L3~Qlg)207U.!L__.Aua. 1963 ~ 25.00 I '-',r, ",,'>. --
21 Q2Q20440036L SOD. 1963 :; 25.00 'L,..' ,(~ ---
?L Q2027415439E __ Oc_t. 1963 $ 25.00 I u, I IC,
~3 Q2029055671E NoV. 1963 :; 25.00 ILol ,e,
24 02038624438E Dec. 1963 ~ 25.00 ,<::," ,'~
C:, 02042053132E Jan. 1964 j; 25,00 ",,'1 ~i.~,
26 Q2042068698E Fob. 1964 5 25.00 ~,,',.~LI
Z7 02049953033E Mar. 1964 $ 25.00 ",'h ::elL>
~ 02055010845E Anl' 1964 $ 25.00 ",,1\ Cl\
29 -o2055038887E -MIl'-l 1964 :; 2'5.00 ,<.;1\ L'
30 Q2062325106E ,Jun 1964 $ 25.00 1<,1..'."
31 02067605227E Jul. 1964 $ 2'5,00 I',,,, ,,'I
)2 Q2076147696E AI,l.9..!-l2H-_I--_..1'-25",Q.!L. _,e,'i c,,",
33 Q2078834743E SeD. 1964 :; 25.00 1'-"" ".'.>
34 Q2083702082E Oct. 1964 j; 2~__1-' ,..,'~ y>,
;1.5 Q2088866184E Nov. 1964 $ 25.00 I'.j'~n
36 Q209J564277E Dcc, 1964 t 25.00 IC,d.-I'
:P Q2105133 3 20El...LaJ!.:-12.~ $ 25.00 l,e'':Ll1.-__I-__
J8 Q2107918043E ["ob. 1965 5 2:1.00 HtDol._
J1.. Q21.Ql2,49740E --~ 1965 1 25.0--0- 1~1J. ~.'-
~O Q2118561133E A6r, 1965 $ 25.00 1.1.), ':z'
41 Q2119594583E Mav" 1965 t 25.'00 H-::i.-e}\
~2 Q2129551891E Jun. 1965 S 25.00 I ~I'"
:l.l- Q2135330S63E Jlll. 1965 $ 25.00 I.~I >'C.J
.44 Q2140542460E /IUd. 1965 $ 25.00 Uu.-.c,'I_
-15 Q2146159801E se~965 $ 25.00 ,>.1 ,~'.}"
~6 Q2150639867E Oct. 1965 _.J... 25. 00 '1!L~oL-
47 02156252648E NoV. 1965 5 25.00 I:'>I,J-:-;
18 02.1.619831281' 1)oc. 1965 S 25.00 =-L-~-_"~;~ I~i.
49 Q?J:.~8790773E Jan. 1966 S 25.00-1- 'J:)"\.>.,'
--
--
-
---
--
(c~fV
t';S'l'N)'E OI" SYINIA A. DAVIS-SUllYl VING OWNEU
DA'I'E m' n~:A'l'lI 08/0219'/
CO-OWNER ';LENN S. DAVIS, IIUSBAND, Dn:D, SEP'I'I~MBER 19, 1983
-_.'~-'-- FACE VALUE VAL" ..", CASHED
SAVINGS BONDS DA'I'E ISSUED
SERIES E O~' DEA'I'll VALUE
-
50 02168790773E Feb. 1966 $ 25.00 \.).'/, I~
51 02176488970E Mar. 1966 $ 25,00 -- -. 1,\ \ liel
~2 02176715951E AD1'. 1966 $ 25,00 I." (\..1
~3 02184954880E Mav. 1966 $ 25.00 I,}...J <,.J...
54 02185239699E Jun. 1966 -I $ 25.00 I J.." ,):),
5L-lli2.Q.ll.. 2 572 E Jul. 1%6 25.00 -
$ "'.'j,:l'l
56 0220.256477 3E Auu. 1966 J $ 25.00' --.J.l-', ,\'1
57 Q2206326266E Se E... 1!l66 I $ 25.00 \ ,'.' , I,' I
58 ')2206751374E Oct. 1966 I $ 25.00 -
I.U\::L
59 ':>2211683155E Nov. 1966 I .S 25.00 I,)"j Lli', -
60 02236003124E Dec. 1966 I :5 25.00 1\,'- . ,.
,~- ---
61 02239736284E ,Jan. 1967 :5 25.00 l. 'c, '0.,
62 02245883169E._ -!':eb. 1967 - 25.00
$ I.)Y '<1.
S3 :;I2251139716E Mar. 1967 :5 25.00 LV', ~:.. -
64 02257028702E AD1'. 1967 I $ 25.00 I.),'".;'...
-
65 02257164640E Mav 1967 I $ 25.00 ,.)" (" -
~6 02271400654E Jun. 19~+-1 $ 25.00 I.).:;': 'II..
67 Q2271602223E Jul. 1967 s 25.00 I.);; '-lV,
68 Q2271760047E Aug. 1967 I :5 25.00 I .) Co q,.
09 02271919808E Sep 1967 J $ 25.00 I.).', "1 >,
70 02272075532E Oct. 1967 I :; 25.00 I'\~; \)>,
71 Q2281818288E Nov. 196 ?--! $ 25.00 , ,\'1. II -
72 02292756528E Dec. 1967 I $ 25.00 I.} \.! '1.,
73 2292777013E Jan. 1968 I $ 25.00 1,;1 ''<,1 t.>
74 2318677711E Feb. 1968 I $ 25.00 If,) z;" '11-.1
75 2343708548E 25.00 -
Mar. 1968 $ k>t., I~
76 02343927598E Aor. 1968 I $ 25.00 , "l.l, 0.
77 02349483695E Mav 1968 I . 25.00 I ,).., . Lj.l.
78 02355257893E Jun. 1968 $ 25.00 I d. \>. 2-
79 Q2363977493E Jul. 1968 I $ 25.00 ,.). '2. " ."!>
80 02364014141E Aua. 1968 I $ 25.00 I ,), So; , ,
81 02370885446E S~o. 1968 I $ 25.00 , .), L. 'lLJ
82 02377464637E Oct. 1968 I :5 25.00 lJ.lL'IL'
83 02384007192E Nov. 1968 I $ i"5.oo I.>. -, lu. "
84 02384131092E Dee 1968 J. 3 25.00 I.~tl ., L
85 02390847752E Jan: 1969 I $ 25.00 1,)' u.. '.,c,
86 02397480825E f::eb. 1969 $ 25,00 I .i (, >,<,
87 02404242413E Mal' . 1969 :; 25.00 I,H~ '. I
-
88 :)2411617775E Aor. 1969 I $ 25.00 I ,~'"' "
89 02418086994E Mav 1'969 I :; 25.00 I ;)~(). Ll
90 02428657243E Jun. 1969 I :; 25.00 1.),,::0. 4.
91 02455579275E Jul. 1969 :; 25.00 I,i >, ,,"'
92 02455591269E Aug. 1969 . 25.00 I.).~ <II
93 - 25:00
02410003427E SeD. 1969 $ I ,i:",~ .I..
94 02473066378E Oc to 1969 :; 25.00 I, >. ,>. t, )
95 Q2474047983E Nov. 1969 I :; 25.00 I'~I yl)
96 0247409738~~ Dec. 1969 'I $ 25.00 1,.;\,. ,,'
~7 1970 I. 25.00 I,~.>' ,YI .
02481288426E Jan. $
to\?1f
ESTATE OF SYLVIA A. DAVIS-SURVIVING OWNER
DATE OF DEATH 08/02/97
CO-OWNER GLENN S. DAVIS, IIUSBAtm. DIED. SEPTEMllER 19. 1983
3AVINGS BONDS _DA'l'I'.' IssU:fED _ t'ACE VALUE VI\l,UE DM$ CASHED
SERIES E OF DEATH V,u.UF.
.-
nO ,...'AO"~A''''''~'' ,,~h 1 n.,f\ I . or. f\f\ 1.~1, .....\
9~ (~?49~11'lI'-E Har. -n10l -$,"~ .00 I .J.', ,~~_.- --..=::
~llO 02501268140E ",or...J210 ~~$ 25.00-- \,~'l, "~
~92508854172E MaV 1970 1_$ 25.00 J.:t\. II,.
102 Q2515010102E Jun. 1970 $ 25.00 \,0"'.-:f
~03 -02526967952E Jul. 1970 $ 25.00,.~~-.r\1)
104 02533093159& -"'lIa. 1970 $ 25.00 ,,~"'~
105 02528644455E seD. 1970 I_~.QQ.-, I.}~ .\.l.,
':06 92528647667&.:...1 oct 1970 I $ 25.00 I~)...;;).::
:07 02542922850&.-l.JiQ.Y. 1970 :n'-L.oo- I.~u" \
f08 -025429259"9& Dec. 1970 I $ 2".00 \..~.\,t7J
109 Q2542965071& Jan. 1971 \ $ 25.00_ \L'~:' ,c.:.
110 :>2542968018& Feb.1971 I $ 25.00,,-,,:,eo.
Hi ')2560382900& Mar. 1971 I $ 2".00 \ ,-,,:.t\~
112 2560385723& !\pr. 1971 C-$ 25.00 - 1,-,', t',,).
f13 )2581111633& MaV 1971 I $ 2".00 Il,.~-t-,L'
114 02581114420E Jun. 1971 I $ 25.00 1,-",\ -:-;i
il5 2588731222E Jul. 197 c=......t $ 25.00 \ u~" .-I.'"
:16 )2588733834& AUq. 197C-l, $ 25~ Iw':; .:1=
117 2599835827& sep. 197C-) $ 2".00 -,(..>,.. ;-;-,
118 2618232346E DC,b 1971 LU5.00 1(.>';+
119 02631613357& NoV 1971 \ $ 25.00 lL"~,,,.(l
~20 02631616647E Dec. 1971 \ $ 25.00 !.i:0 \~.J,
121 ( 2637483695& Jan. 1972 $ 25.00 I b~ l...d-
:22 (2637499260E Feb. 1972 $ 25.00 101. "."
123 05005835695& Mar. 1972 $ 25.00 1",-.;1:.'1
124 -65006684241E ",nr. 1972 - $ 25.00 I(.>'L -':-.'1
125 05015568769E _ Mav 1972 I $ 25.00 1 <->" '2--1
126 05030822914E Jun. 1972 I $ 25.00 'a' ,.0,
127 05030825160E Jut. 1972 $ 25.00 10..J..1
12805037987267E "'1.!5C- 1972 I $ 25.00 ,,,~-
i29 05044466849& scp. 1972 J $ 25.00 _">'~''''
130 -05037997948& Oct. 1972 I $ 25.00 I L..~I---
131 05058503145E NOiI.' 1972 I $ 25.00 \,,1', ~.
132 5058506073& Dec. 1972 -I $ 25.00 'f,t', .5)
133 5070330941& Jan. 1973 I $ 25.00 'D"'."'.'
'tJ4 15070333714& Feb. 1~ I $ 2.5.00 1...c->.1
\35 05070335550E Mar. 1973 I $ 25.00 1 .,(> -'I
136 -05091471440E ADr. 1973 :.J $ 25.00 -I, r "
U7 _~"099438773E MaV 1973 -I' $ 25.00 q.,:".
138 5106300992& Jun. 1973 I $ 25.00 ll,'l r~Y.
139 05106306932E JUl. 1973 $ 25.004tL"""
~40 Q5114027715& "'Ucl. 1973 \ $ 2".00 e\t, .~L
ill 05114030132E SeD. 1973 I $ 25.00 ~ (~l':~,,\o
t" oS! 4071061" oSh-197J ~ · l5. 00 - . ---" '. .,~ .:
143 Q"147381092& Nov 1973 I $ 25.00 - (L. \~-
:44 05147393089E Dec. 1973 I $ 25.00- T 1),~'"'JL;
i45 05160994099E Jan. 1974 I f 25.00 I fl, ;.jc
-
-
--
-
j,.Jt ~ SCHEDULE E I
.i CASH, BANK DEPOSITS AND
COMMONWIA~H 0' IINNlnVANIA MISCIiLLANEOUS I
._ ......,. IN1~1...,GIN~IJt"t~l(~~':':._..,_.. _ _!.~_~S_C?~A_~ .P'~?PE~!.Y __.. j. q ..,__=...~!'l~?!,!.~ri'" or Type_
hTAlcvf -- -q------ -- "'--"-p'iCnrUM6e/f-" -- -
Davis, Sylvia A. 2197-0714
(All ,..,.., ~ftllr'''''o~ with ,h, il"h' .f lunl,.."hl, ,"v., ~, ~I..,.... .~)~h;~.~~!L.._
.'YIIOI'1It 1"1t
ITIM
NUMBER
DESCRIPTION
VALUI AT
DATI OP DIATH
1.
esident fund at Thornwald HOlne
42.83
100.15
305.96
$
2.
efund of Capital Blue Cross pJ:emium
efund of insurance premium from American Travelers
3.
TOTAL (11.110 ,nler on line 5,JI(0 Ilu'ollon S
448.94
IAlloch oddlllol\ol I""" III 11" Ih"" If 1"10" tpOU If !'I..d.d:'
_~""'T'-,,.ii "" '-P-....'!-.,...~""- "'._
i,.''''''
1I.~llotUl.III..,1 . 1
W SCHEDULE F
COMMQNWIAlIH 0' P1NNIYIVANIA JOINTLY-OWNED PROPERTY
INHUIIANCIIA! RIlUIN
!IIIOINI OICIOINI '
=---_ _.._____._ _______u____'_._____.________._~_ ._~~.+~_'_____,.~__~_____~~~_~_~
ISfATI 0' , I"U NUMtlR
Davis, Sylvia A. ' 2197-0714
_____~______,._~......~_~._,~_.~________,..._..~_.___~__.__m_....~_,_. _.. .._^."_._~.._,",,...., .._.....,..;..~._"'_"'M..".."....M._._
Jolnl 'ononl('I.
NAMI
A. May I. Fenia le
ADDRISS
~___'M"_ _______._._.~___~._._.__..__,.._.u__".
38 W. Siddonsburg Road
i1lsburg, PA 17019
,__~~,~!IQ~~IlIP_TO ,,?,ICIDENT
Daughter
t.
C.
"
TOTAL (AI.o .nlt, on IIno 6, Recopllulo'lon)
(/I more .poce /, n..d.d /nte" oddif/ono' ,h..,. 0' ,am. ,/zo)
$34.424/51
..\:,l'~1\
....~9'...
COMMONWlAl'H O. IINNIYIYANI.
IHHtIU1~NC' ,~. .,'U.N
111101'" omo H'
I'JfAlioJ -=--
DAVIS, SYINIA A.
lTIM
HUM,11l
U'tf.UIIU.I;.e1t
A.
I.
~---;".", <.....'--~".._=.- ...
5CHIDULI H
fUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
,__ __ _,.I_~o" P,lnl.!, T~p.
rmrfiUMm
219'/-0714
.-....--;-
DUC;IlIl'TlON
Pun"ol bpon'''1
Pre-paid
Allmlnllll"'''' e..",
I, POllonol R'pr..,nlallvo Comm'"lon, None claimed
Social StCurlly Number 01 P.llonol R.pr...ntallv"
Yoar Commllllon, paid
AMOUNT
2, Atiarn.y h..
Jane M. Alexander $2,200.00
3, family b.mpllon None claimed
Clalmanl R.lallonlhlp
Add,... a' Clolmonl 01 d.c.d.nl', doalh
511'" Add,.II
~,
I.
2.
3.
~.
5,
6,
7.
eo
Clly
Sial'
Zip Cod.
Probal' f... Register of Wills - Grant of I,etters
Mlleellonltu. bpen....
Bureau of vital statistic - Death aertificate
Register of Wills
2 short certificates
Register of Wills - filing inventory and inheritanae
tax return
Jan M. Wiley - witness fee
catharine L. Wiley - witness fee
Notary fee
Reserved for filing release
115.00
12.00
12.00
25.00.
25.00
25.00
10.00
7.00
TOTAL lA1Io enter on IIn. 9, R.copllulallnnl
/II "",. III"U II ""d.d, 1"'01' nd!l'"nnnl.h.." n' ,"m' ,I.. I
$ 2,409.00
nEI/,1I11 V-M' 1101"
COMMONWEALTH OF PENNSVLVANIA SCHEDULE "I"
INHERITANCE TAX RETURN DEBTS OF DECEDENT.
RESIDENT DECEDENT MORTGAGE LIABILITIES, AND LIENS
"rsT'i\TE-OF =-.- -==. "- ---,- ==='=m'Flf.11"N'llMiien---- -
Davls, Sylvla A. 2l97~0714
---..---~--,..-.-.---_.~.~_.,_...~-_._--~._~_._.~.......~--
.__+____.M____--
-_..............-----._----------~._-----_......-.~..-._...-~~ _.."..~.,.~~..-. . ..--_._.~.~_.~-
^MOUNT
ITEM
NUMBER OESCRIPTION
_.......~_.... ____~__...__M__ _ _..~--_.--------""-
205.85
199.90
1. hornwald Home~ Final blll fot' care
2. merald Drug - Expense of last illness
3. 1997 Federal Income TalC
2,5~5.00
58.00
4. 1997 PA Income TalC
125.00
5.
amuel Thuma, CPA _ preparation if 1997 in tax returns
'\
.3,113.75
TOTAL (Allo on tor on IIno 10, l1ooollllulollon)
07/24197 56208881
07/Zel97 56208050
07/26197 52006357
07/29197 56208050
Z8 CLARITIN 10Ma TA5 Vi
5 PHENERaAN zeMG SU 01
10 MORPHINE 10MG/ML 01
e PHENERGAN 2eMG SU 01
Qliil'lI....,..
.(1) .
.01)
.(1)
21.96
18.69
Zl.96
'Z1.91.!,
19./!,,<,l
21 . 'PI.>
I L-
=:J L-
I I
J
i
i
~I
. I
"I I
'1
, ~,.- -....... C",EJ ""'-';<r -~-
.",.,"
l!\i\II..'''' 11"111'1 '..1\11 ii,_'ll
,.. II I
;>4:"-'
10.00
.',4A,~ . 70
11.7">
:'10.91
7/0~/9? DENTAL SFRVICER
7/n/'-H PAYMENT
7/?r;/97 ERCORT RFRVICF
7/25/97 Mf.tllCAl RUPPUFH
7/.'1/'17 .'11 lEVEL I NC EACTUTY
OAYEl (i 111.00
7/.'1/97 PffUIONAL IAlJNORY
7/.'11/9" CARLI' TFLfVIRION
1.00
7/01-07f,'11
7/01-01/!'1
1.00
1,00
,~441.00
lr;.oO
7.riO
81A1EMENfoAii "."'I.;"EVKiii8D^I:~NCE' TJ:uAniiiirci';\I,oEs'=-l---,;;;viiiNfs-u.m
8705/9"- --47--:70L .~51r;. 6~r---;'4R.'1 . 70 '
TliORNWALD HOME-' ------- ,-----...
442WalnulllallCHl1Road Ca,Hslo,Pn, 17013 (717)249'4110
~._,.___., ",..._.,.,__,. __ "'j' ..__m________,
MIJUBIMI'NIS _, rJ.lifUlEN1!,Cc.l OAIMj()" ^OV^NCE CIIAI10ES
.00 74.61', .no
._,.,.,,_, _________.___'____,.,_' ",._.m.__u__
PLEAS!: PAY
film AMOUNt>> $ 74.61',
- - <------...- ----. -.--"----- .------ ---. ... ..,_._.~,,_.._.__..._--
iJ
.1
\1
06-08-98
DAVIS
08-02-97
21 97-0714
CUMIERLAND
101
E A~~ RHltted
--.-.--.--
MAKE CHECK PAYAILE AND RENIT PAYMINT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THI8 LINE ~ RETAIN LOWlll POllnON FOR YOUR IIECORDS ....
REY: iii'f-iif"A;:ji'iii9':i'iY'iiilfici"oP'i:"HHiiiiTANCi-y'AX'A'PPitAiiiiiilir;.ALLO'iiAiiC'i.iili........._- - -_...
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
SYLVIA A FILE NO. 21 97-0714 ACN 101
If .n ........nt w.. i..u.d pr.viou.ly, lin.. 14, 15 and/or 16, 17 and 11 will
rafl.ot figur.. th.t inolud. the total of ~ r.turn. .......d to dat..
ASSISSMENT OF TAXI
11. ~t of Line 14 .t Spau..l r.t. (11)
16. ~'t of Line 14 t..abl. .t L1ne.l/Cl... A r.t. (16)
17. ~t of Lln. 14 t..abl. .t Coll.t.r.l/Cl... I r.t. (17)
la. rrloolp.l T.. Duo
TAX CREDITS I
rAVNENT
DATE
o -17-98
/s~;rN ~/d
IUREAU OF INDIVIDUAL TAMES
IIIERITAHCE 16. olYIIIOll
IIEPI. 1'0601
~ltlURO, PA 11111MO'Ol
COMMONWIALTH OF PENNSYLVANIA
DIPARTMENT OF RIVENUE
~
NOTICE OF INHERITANCE TAM
ArrRAISEHENT, ALLOWANCE OR UISALLOWANCE
OF OEDUCTIOMS AND ASSES&NENT OF TAM
JANE M ALEXANDER ESQ
148 S BALTIMORE ST
PO BOX 421
DILLSBURG
DATI!
ISTATE OF
DATI OF DIATH
FILE NUMBER
COUNTY
ACN
PA 17019
ESTATE OF DAVIS
TAM RETUIIN NASI (X I ACCErTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE
APPRAI8ED VALUE OF RETURN lASED ON' ORIGINAL RETURN
1. R..l E.t.t. (Schedul. AI
2. stook. and _. (Sohodul. I)
S. Clo..ly Hold stook/r.rtnor.hlp Int.r..t (Sch.dul. C)
4. Hart_./Hat.. R....I.abl. (Sohedul. D)
I. C..h/lank Dopa.lt./NI.c. r.r.an.l rrop.rty (Schedul. E)
6. Jointly Oonod rroperty <<Schedul. F)
7. Tr...f.r. (Schedul. Q)
a. Tot.l A...t.
( ) CHAItflED
III
(21_
(5)
i41
(S)_
(6)
(7)
.00
26.084.23
.00
.00
448.94
34.424.51
.00
(al
APPROVED DEDUCTIONS AND EXEMPTION81
.. Funer.l E.pen.../Ad.. Co.t./NI.c. Eopon... (Sohodul. H)
10. Dobt./Hart_ Llobllltl../LI... (Schedul. I)
11. Tot.l _Hen.
12. Not V.l.. of T.. R.turn
15. Chorltabl.IQa..rnoont.l "quo.t.1 Non-.loct.d .115 Tru.t.
14. Not V.l.. of E.t.t. Subj...t to T..
2,409.00
(9)
(10)
3.113.75
(111
1121
USI
U41
(Soh.dul. JI
NOTE I
.00 M .00.
55,434.93 M .06.
.00 M .15.
ua)
REcurT
NUNlER
AAZ69854
DISCOUNT (+)
INTEREST/rEH PAID (-)
.00
3,326.10
ANClUNT rAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTIRIST AND PEN.
TOTAL DUE
*
nv.tM'......'C".m
SYLVIA
~
DATE 06-08-98
HOTEl To lnaur. proper
orecli t to )lour .ooount,
.ubtolt the _r padlen
of thl. for. with your
t.x pa)lMnt.
60,957.68
Ii."" ,,,
55,434.93
.00
55,434.93
.00
3,326.10
.00
3 , 326 . 10
3,326.10
.00
.00
.00
A
w IF rAID AFTER DATE INDICATED, lEE REVERIE
FOR CALCULATION OF ADDITIONAL INTEREIT.
( IF TOTAL DUE IS LESS THAN 01. NO rAVNENT IS REtuIRED.
IF TOTAL DUE IS REflECTED AS A "CREDIT" (CR), VDU NAV IE DUE
A REFUND. lEE REVERSE SIDE OF THIS FOIIN FOR INSTRUCTIONS. I
i~
ti ',"
(1' -
~.
~
,wW
(:!- {i
(I;
~ ' ,
,
\.
....
o
::'1.)
~.j
(Ii
m
11>0
,",
:-Q<
);> ;4
RESERVATlOlhElI.I.. .f do._" dying on .r ..f.r' o.._r 12. 1962 ,. II on, lOtur. Inl.r..1 In Ih. ..1.1. 10 Inn.,arrod
In .......Ion.' onl.....1 I. C,... . (..'I.I.r.ll ..noflcl.rl.. .f lho dooodonl .fl.r lho ...I,.lloo.f on, ..1." I.r
llf~ or for ~..r" t.., C(tllllOOMealth hIIreby .)Cpr...h r...,VltI the dtht to .,praha Md ...... tfln,f.r InherltllnCtl 'IIC.'
at 'thll IMfful C1I" I (collatar.ll rat. on any loch future Int.r..t.
_Of'
""TlCE, I. Mflll lho "...Ir...." .f s..I1.n Z100 .f tho IlIhol'II.... end E...I. T.. Acl, Aol ZI cf 1"', m ..S,
section ,litO).
.AMNI, o.1..h lho Ion .erl1on .f Ihh Holle. ond .....11 .lIh ,cu, .....nl I. lho R..hl.r .f WIlIo .rlntod .n lho "..r.. oldo.
M~"'. cMcll. or lIOMY orct.r p.y~l. tOI REGISTER OF MILLS, AGENT
REFUND (CRlI A r.fund .f . I.. oredll. Nhlch ... nol r........d on lho I.. R.lurll. .., b. ".....1... b, c_l.tI.. on ....11..11...
for ,-.fmet 0' pemlylv.nla Im-rltMlCt end E,t.te 'ax" UtEV-UUl. Appllcllt10nl .r. IVIU-*'11 It tM offlOI
d. thli Retl,t.r of tiltUt, .,y of th4t n RlyllntM Dbtrlct Offlc.l, or by CIUlnt the ,plcltt ?4"hotJr
Ill"l....rl.ne ..rvlcl ~r' for fora. or.rlnel In Pltmlylvllnle 1~eOO.56tMZOSO, outside P."",ylVInII .net
within locIl Klrrltbufll .ria (117) 181-8094, TOO' (111) l1Z~ZZS2 tHe.rlng IlIPalrad Onl,,),
.
OIJECTiQNS' An' ..rl, In Int.r,'1 nol ..11.fled .llh lho ...r.1.....I, .11..onc, .r dl..11.."" of deduCllon.. .r ........,.1
of 'DX (includlna discount or Intera'U ., lhown on this NoUce wst object within ,tlch' (60) dlY' of ncalpt 01
this HoUoe bYl
'..rll"" .r.I,,1 10 lho .A o...r","1 .f R........ ...r. of A....I.. P..l. .el'21. Herr..""r.. PA 1712e.I021. OR
-~eieoUon to h...... th41 ..Ua,' detaralned at .udit of the account of the p.r,onal rapr.,ent.UIII. OR
nllPfMl.I to the OrphM" Court.
A,,"IN
ISTRAIlYE
ClMIlfCTlOMSI
FlIOtutll .rrorl dhoo"arftd on thh ........nt Ihould be addressed tn wrlUng tOI PI. IMp.rt.ant (If RIVenue,
lur." of Indl....l......l TaMa., ~TTHI po.t A.......nt Rlvllw Unit, O.pt. 280601, H41rrllhorl, p" 17ua-0601
PhoMl (1111 187-650S. Sa. p.. & of the bookl.t "Instruotlons for InhedtllOCl. TII( R.turn '('It. Rllident
OttCecMnt" tREY-U01) for In Il(planaUon of adlllnhtrlUl'lb corrlctlbll arror..
If MY tlM dUt 11 paid within thl"1 (51 calandlllr aont.... .ftur the deCldent" death, I ,I""a parelnt (5:0 dhoooot 0'
the t.x plld I. Illowed.
The 16:< t.M .-.ty nonMp.ttlolpltlon paollb Is c,.uhd on thl tohl of .th. tlM end Intlr..t ......ed, IInd I\Ot
plid Mfor. J."uary 18, 1996, the flr,t day I"ar the end of thll tIll. ..ne.ty parlod, This non-parUolpaUon
penalty is appe,llbla In the .... ...,ner .,w In thli the .... U.. plrlc,d .~ yOU would app..l the tlM lIfld Int.rllt
that hal blan .......d II Indicltld on thl, notlc..
Inter..t II chllreed bat'""lne Mlth flr.t d.y of d.llnquanOy, or nlM (91 ItOnthl and one (1) dlY frOll the date of
dllth, to thl date of ply,,"t. 1.M" Mhlch bae..' delinquent ~forl Janu.ry 1. 198Z baar ~nt.r'lt ~t the rlt. of
.lx ~6X) p.rcent par ennui cllculat.d It . dally rat. of .000164. ~11 taM" which blc'" delinquent on and .ft.r
J.,uary 1, nal will bI.r Int.rllt nt a r.t_ which ,dll vary '1'011 cll,net.r Yllr to calandlr y..r with that r.t_
announced by thl PA ~p.rt""t of R......nue. lhe appllclbll Int.r.._ r.t.. for 1982 tt1rough 1991 ",.1
'!!It tnt.r..t R.t. o.llv Intlr..t Flctor :!!!r Intl,'..t Rlt. OaUy Interl.t FlOtor
l.e2 201. .000548 1987 91. .000l47
1'83 161. .000458 198a"1991 11% .aoun
1.1l4 11>:- .DOOlDl 1992 91. .000Z41
1'85 m ,OonS6 1993"1994 1% .000192
1986 10:< .000214 1995"1998 IJX ,000Z47
....Int.r..t I. clloulated I' follow"
INTEREST' "UNCE OF TAX UNPAIO X NUNIER OF DAYS DELINQUENT X OAILY INTEREST FACTOR
_w....y HoUc. l..ued ,UI" the tlX beeCH' dellnqu.nt NUl nfllllt an Int.rl.t calculation to fiftHI'! (15) daY'
"yond thl dat. of the .u...ltItlt. If ply.."t It ,act. aft.r the ~nt.ra.t cOllput.Uon data lhown on the
MoUel, IIddlUon.l Int.rllt ...t be calculat.d,
DISCOUNT I
P€M"llVl
IHT!Rf:STI