HomeMy WebLinkAbout97-00745
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT 280601
HARRISBURG, PA 17128.0601
R~V~~RM~ STREET
rP 0 BOX 109
LEMOYNE, PA 17043
FOlOHEAE
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21-1997-0'745
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BEALE ANN R,
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PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
'*
EST J
FILE NUMBER
11/12/1997
NAME OF DECEDENT (LAST)
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NO. !\A 242460 AEV."6' EX 1".96)
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
r11MFlFRI ANTl
DATE OF PAYMENT
R II ::J 11 997
POSTMARK 9tll\'CE J JOHNSON
r./n f-:DMI INn r:; MYFRS
COUNTY CHECK# 113
DATE OF DEATH
REMARKS
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FOLD HERE -
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$50,000.00
DO
MARY C. LEloJIS
TOTAL\i:/ii5tMrP.ii'i8 OF WILLS
RECEIVED BY
*THIS RECEIPT IS REPLACED WITH RECEIPT AA 242461
SEAL
P;..Gi::;TEF{ OF ''i"iiLLS
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l'ETITlUN FOlll'llOUATE amI GHANT OF LETl"EllS
Al:!l7-1l/6
No.
To:
Estate of ANN R. BEALE
also knowlI as
Register of Wills for the
. Deceased. CounlY of CUMBERLAND in the
Social Secllriry No. 192- 34- 6108 Commonwealth of Pennsylvania
The pelition of lhe unuersigneu rcspeelfully reprcsenls that:
alternatEi'
Your pClitiuncr(s), whu i!/are 18 years or age or older an the execut nx
inlhe lasl will or the above dccedenl, ualed September 11,
and codicil(s) ualcu
namcd
.192..L-
a~~new M. Kunn, tne appo~n e
xecu or, renounce
(.":'Ile IclC"':Ull cirC\llIut:\lIC:C:S. c.g. (Clltlllcil\lion, tlC:1th or c:",ccuIO" cle.)
Cumberland
225 Hummel
Rnrnllgn nf
(list IiLn:eL, IIUIII!Jcr, 'l'wp. ur Uoro.1
County, Pennsylvania, wilh
Avenue
T,pmnynp
Decedent "'"! domiciled al dcalh in
"pr last family or principal resiuence at
pecedcnt, thcn 59 )'Cars of a~e, dieu August 13, ,19 97
at 225 Hummel Avenue , Lemovne .
Excepl as rollows, deccdenl uid nol marry, was nol divorccd and did nol h,ave a child born or adopted
arter execution or lhe will orrcred for probale; was nollhe viclim of a killing and was never adjudicated
incompelenl:
Decedent at death oWl1ed properly wilh e>limated valucs as follows:
(I f domiciled in pa.) All pcrsonal pruperly S 295 , 000 .00
(If nol domiciled in Pa.) Personal properly in Pennsylvania S
(If nol domicilcd in Pa.) Personal properlY in Counly' S
Value of real est ale in Pennsylvania S 95 , 000 . 00
silualed as follows:
WHEREFORE, pelilioner(s) respeclrully requesl(s) lhe probale of lhe lasl will and codicil(s)
presenled herewilh and Ihe grant or lellers 'T'p",t"mpnt" "y
(testamentary; administralion c.I.a.; administralion d.b.n.c.l...)
225 Hummel Avenue Borou h of Lemo ne,
Cumberland Countv. PA
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~ce J. Johnso - .-
230 H\lIlIIlIE!l Avenue
Lemovne, PA 17043
OATH OF PEHSONAL REPRESENTATIVE
COMMONWEALTH OF l'ENNSYLVANIA }
COUNTY OF CUMBERLAND ' 55
The petitioncr(s) above.named swear(s) or arrirm(s) thallhe stalements in lhe foregoing pelition are
II ue alld corrcel to Ihe best of Ihe knowledge and belief of petilioner(s) alllllhat as personal represen-
lalive(s) of Ihe above deeedelll petitioller(s) will well alld truly adminisler Ihe estale according 10 law.
~~~n .
afrirmcd and SUbscribed~ <8...~\ '- - . ,..21,.{ LNJ-~
4th day of ny"e To n ~ '
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21-97-74S
Eslate of
ANN R. BEALE
, Deceased
DECREE OF PROnATE ANn GRANT OF LETTERS
AND NOW september 10, 19-2.1.., in consideration of the petition on
thc rcvcrsc sidc hercof, salisfaclory proof having been prcscnted beforc mc,
IT IS DECREED lhallhc inslrumcnl(s) dalcd September II, 19 ~!L____.
dcscribcd thcrcin bc admittcd to probatc and filcd of record as thc last will o'f
Ann R. Beale
and Lcllcrs Testamentarv
arc hcrcby granlcd to Jovce J. Johnson
Probatc, LCllcrs, Etc. .........
Short Cmificales(4 ) . . . . . . . . . .
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cnunClatlon ................
x-Pages (4)
JCP
Filcd
v :'/d ,~ UI;J/;t.
Mary C. Lew~s ;;::/
FEES
Edmund G. Myers (20558
Johnson, Duffie, Stewart & weidner
A TrORNEY (Sup. Ct. I.D. No,)
301 Market St., P. O. Box 109
r@~~. PA 17043-0109
ADDRESS
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(717) 761-4540
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Mailed Letters and order on September 11,1997
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WARNING: It Is Illegal to dupllcBto this copy by photostal or photograph,
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COMMONWEALTN OF PENNSYLVANIA' OEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
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008232-OOOOl/luly 29, 19961I!OMINLBt55282,2
1EttGt Mill cmb Qfe1Jtatneut
OF
ANN R. BEALE
I, ANN R. BEALE, of the Borough of Lemoyne, Cumberland County, Pennsylvania, being of
sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and
for my Last Will and Testament, hereby revoking and making void any and all Wills or Codicils at any
time heretofore made by me.
ARTICLE I
I direct the payment of all my legal debts, and the expenses of my last illness and funeral from
my Estate as soon after my death as conveniently may be done. I direct that all taxes that may be
assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be
paid from my Residuary Estate as part of the expense of the administration of my Estate.
ARTICLE II
Provided that my friend, MATIHEW M. KUlIN, survives me, I give and bequeath unto him
the following:
008232-OOOOIIJuly 29, 1996/EOMINLB/SS282.2
A. My Martin Acoustic six-string guitar;
B. My collection of books;
C. Any and all of my literary property, including work in process, manuscripts, proofs, and
all o!her writings, copyrights, contracts or o!her proprietary rights I may own at !he time of my death
as a consequence and result of my literary efforts; and
D. My household and personal effects and o!her tangible personalty of like nature (not
including cash or securities) toge!her with any existing insurance thereon, not listed in subparagraphs A
!hrough C of !his Article.
ARTICLE III
Provided !hat my friend, MATIHEW M. KUHN, survives me, I devise unto him a life estate
in my undivided interest as tenant in common in !he real estate situate in Cape Cod, Massachusetts, and
!he remainder interest !herein unto my bro!her, DONALD L. BEALE. If my friend, MA'ITHEW M.
KUHN, predeceases me, I give and devise my entire interest in such real estate unto my bro!her,
DONALD L. BEALE, provided he survives me, and should he fail to survive me, !hen unto his !hen-
living issue, per stirpes.
ARTICLE IV
I give, devise and bequea!h all !he rest, residue and remainder of my estate, of whatsoever nature
and wheresoever situate unto my friend, MATIHEW M. KUHN, provided he survives me. If my
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008232-OOOOlIluly 29, 1996/EOMINLBt55282.2
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IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and
'(lh L... 1":.
Testament, this I dayof,q "J;... , 1996.
'~ fL.& q ,~SEAL)
ANN R. BEALE
Signed, sealed, published and declared by the above-named Testatrix, as and for her Last Will
and Testament, in the presence of us, who at her request, in her presence and in the presence of each
other, have hereunto subscribed our names as witnesses.
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
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51:
Joyce J. Johnson
b.lng duly "",nrn .ccording to I.w, d.po... .nd ..y. th.t!l1e is Executri x
0' the Est.t. 0' ANN R. BEALE
lot. of ~.ill!.9h._qLImu9:in.E:,___,_ , Cumberl.nd County, P... d.c....d .nd thet the
within i. .n inv.ntory m.d. by Joyce J. Johnson , the ..id
of the entire e.t.te 0' ..Id dec.dent, con.isting of .11 the person. I property .nd re.1 ..t.te, except re.1 e.tate outsld.
the Commonwealth or Penn.ylv.ni., .nd th.t the figure. oppo.ite e.ch item of the Inventory repre.ent it's f.ir v.lue
a. of the d.te of decedent'. de.th.
19 98
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Joyce J. Johnson, Executrix
230 Hummel Avenue
Sworn to
.nd .ub.cribed before me,
DIANNE LENIG, Notary bile
Lemoyne Borough Cumberland Co.
My Commission Expires Dec. 21, 2001
Lemoyne, PA 17043-0109
Addrau
D.t. 01 De~th
13th
August
Month
1997
Day
YUt
INSTRUCTIONS
I. An inventory mu.t be liled within three month. alter .ppointment of per.onal repre.entative.
2. A .upplement inventory mu.t be filed within thirty day. of discovery of addltion.1 .ssets.
3. Additional .heets may be attached as to personalty or realty
4. See Article IV, Fiduciaries Act of 1949.
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Inventory of the real and personal estate of
ANN R. BFJ\JE
deceased
23.
24.
25.
26.
27.
28.
Real Estate - th. 225 f1l1/lU11E!l Avenue, lemoyne, Pennsylvania
Household Goods - appraised value
1987 Chevrolet Cavalier 4 door sedan - appraised value
Coins and paper money - appraised value
Cash in decedent's safe deposit box
14K Yellow Gold QrK,l Earrings - appraised value
Pre-War Martin 000 Guitar - appraised value
Collection of Books - ordinary publications
I~terary property - decedent had no publications or writing contracts
in existence at the time of her death.
Blue Cross/Blue Shield - major medical benefits
Customer Service Center - subscription refund
Member Service Center - credit halance
United Telephone - refund
Wolfe & Rice, Attorneys - refund of decedent's retainer
Dauphin Deposit Bank & Trust Co. - trust distribution check not cashed
prior to death.
Dauphin Deposit Bank & Trust Co. - Checking Account No. 50106171
Dauphin Deposit Bank & Trust Co. - Savings Account No. 5312602124
Mass Mutual Benefit Management Account No. 82-006226-1
Cash Bequest - Estate of Benjamin Rudolph Beale
$25.00 Series E Bond dated May, 1945 - date of death value
$100.00 Series EE Bond issued August 1994 - date of death value
541.167 Shares - Franklin U.S. Government Securities Fund - Class I
@ $6.86 per share.
2 Shares - Lucent Technologies, Inc. @ $81.6875 per share
7 Shares - AT&T Common @ $40.3125 per share
6 Shares - The Dreyfus Fund, Inc. @ $12.39 per share
10 Shares - First National r~fe Insurance Co.
337 Shares - The Salomon Brothers Fund, Inc. @ $17.6250 per share
Wheat First Securities, Inc. Account consisting of:
48 Shares - Lucent Technologies, Inc. @ $81.6875 p/sh $
1,668.2840 Shares - Delaware Delchester Fund, Class A
Cash - Money Market Account
98,000
3,971
800
95
963
60
700
100
00
00
00
00
00
00
00
00
No
491
29
41
6
299
Value
64
85
91
81
53
120
6,413
6,878
22,948
300,000
111
56
77
33
79
36
00
54
32
3,732
163
282
74
No
5,939
99
38
19
34
Value
63
3,921.00
10,910.58
566.47
15,398
05
29.
An undivided one-fourth interest in real estate located
in Truro, Massachusetts.
Appraised VAlue - $62,500.00
TOTAL
467,678
43
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'- _ Register of wills Office
Cumberland County Courthouse
1 Courthouse Square
FROM
JOHNSON, DUFFIE, STEWART & WEIDNER
Attorneys at Law
P,O. Box 109
LEMOYNE, PA 17043
. Carlisle, PA 17013-3387
SUBJECT:
FOLO.+
Estate of Ann R. Beale
DOD: August 13, 1997
21-97-0745
DATE: 11/11/97
Enclosed is a check in the amount of $50,000.00 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
~
Edmund G. rovers
csh
SIGNED
REPLY _W.HW'
DATE:
SIGNED
Reorder Itom #F270 Grayafc, P,Q. Bo~ 2944. Hartford. CT 06104.2944
"EGI, 1962,P'",oo'oU,SA THIS COpy FOR PERSON ADDRESSED
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COMMONWf:AUH Of PENNSYLVANIA
DEPARTMENT or REV[NUE
BUREAU OF INDIVIDUAL TAXES
DEP1280601
HARRISBURG. PA 17128.0601
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NO. Afl., 2 4 2 461 AEV,1I0' EX (11,90)
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
RECEIVED FROM:
I"
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
EDMUND G MYERS ESQUIRE
301 MARKET STREET
POBOX 109
LEMOYNE, PA 17043
101
$50,000.00
FOlD HERE -
F(XOtlEllE
ESTATE INFORMATiON:
FILE NUMBER
21-1997-0745
NAME OF DECEDENT (LAST)
BEALE ANN R
DATE OF PAYMENT
11/13/1997
POSTMARK DATE
11/12/1997
COUNTY
CU~IBERLANO
DATE OF DEATH
SSN 192-34-610S
(FIRST)
(Mil
TOTAL AMOUNT PAID
$50,000.00
DO
RECEIVED BY t? p
MARY C. LE IS ) / P / ,f!.,T
REGISTER(F WILLS /1/17'(,/.)[ "f~l
11 I 997
REMARKS JOYCE J JOHNSON
CIO EDMUND G MYERS ESQ.
SEALCHECK# 113
* THIS RECEIPT REPLACED M 242460 REGISTER Of' WILLS
.
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Und" pen_ of pelju~, I docl8lO!hat I hav. examined!h" rolum, Including accompanying schedule$ 6nd .taIeITOn~, 6nd 10 !h. best 01 rrry iIIIaModgo 6nd ben.t, It" Irvo. c:oned 6nd compIele,llecIaralicn 01 ""parer ,!her
Ih I on Iln~ which rhas
C R~~SONRESPON:IB FO. iLIN~ ~DDRESS
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Edmund ~MyerS' Esq.
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
ruv'15COEX.II'1)~
COMMO~~:YLVANIA
DEPARTMENT OF REVENUE
OEPT,28OE01
HARRI e RG fA 1712 1
DE.CEDENTS NM4f (lAST, FIRST, AND U10~.lE lNlTW.1 UH. bin bIodl. to ~.l!Iword.
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B E AL E A N, N R
socw. SECURITY NWBER OATCOfDEATli DATE Of BIRTH
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1 9 2 - 3 4 - 6 1 0 a . a/I 3/ l' 9 9 .7 :2 / 1
(IF N'PUCASLE) SURVIVING SPOUSE'S NMlE (lAST, FIRST, AND MlooLE lNITlAL) SOCLAl. SECURnY NlAIBER
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THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
001. Original Retum 0 2. Supplemental Retum 0 3, Remainder Retum 1"""""pI'<<b 11.1U2)
o 4, Limited Estate 0 4a, Future Inlerest Compromise ""'",,.. "'" 11.11~11 0 5, Federal Estate Tax Retuni Required
1XI 6, Decedent Died Testate \AIIX,,,,,"W'l 0 7, Decedent Maintained a living Trust {o\lIacJl""dTMQ 1:.. 8, Total Number of Safe Deposn Box..
o 9, LItIgation Proceeds Received 0 10. Spousal Poverty Credn C'''' ",,'" "",,"n ".31,11 ItIIIl,I,'~ 0 11. Electlon to tax under See. 9113(A) (A/Odl Sdl 0)
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
tw.tE COMPLETE UNUNG AOORESS
'Edmund G. Myers, r..squire 301 Market Street
flRMN.\ME (11""""'1 P. O. Bcx 109
Johnson Duffie Stewart & Weidner JEmoyne, PA 17043-0109
TaEPHONE NlJABER
717 761-4540
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1. Real Estate (Schedule A)
2, StocI<s and Bonds (Sdledule B)
3, Close~ Held Corporatlon.PartnelShip or Sole-ProprtetolShip
4, MOI1gages & Notes Receivable (Sohedule 0)
5, Cash, Bank Oeposils & Miscellaneous PelSOnal Property
(Schedule E)
6, Jointly Owned Property (Schedule F)
7. Inter.VIVOS TransfelS & M~cenaneous Non-Probate Property
(Schedule G or L)
e, Total Gross Assets (total Lines 1.7)-
9, Funerai Expens.. & Admln~trative Costs (Schedule H)
10, Debts of Deced.n~ Mortgage Llabnffies. & ~lens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
"' ,-~'. 1-
(1) ".1'~!.:' 9. "a '9,9.:0" 0 0 'i
(2) !F I
",,,i!;:, 2, ,5. '.7:~""~,,,.:. ,44",
(3) '&,
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(4) ;.;::/~" .."", " ",. n "?,:.<',,,:, : I
(5) : >: 3 5 '0 ; 4 2 : 0 .,' 5 5 .
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2 j 7'" 0 : 0 ! 7 ;;: 0 . 0 ;:i
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(10)
12, Net Value of Estate (Ltne 8 minus Line 11)
13, Charitable and Govemmental BequestslSec9113 Trusts for which an electlon to tax has not been
made (Schedule J)
14, NetValue Subject!o Tax (Line 12 minus Line 13)
15,Amounloftlne14taxable ;,..., ',;'i ;' '''i''-",'''-'
at the spousal tax rate (.,.....'.,...:, "......';., ',," ),~. ,.......;......"...:,.,.,.....',)......"'.;,._,.,.. ; :..-".....J"~:.
See Instructions on reverse side for applicable percentage
16. Amountoftlne14taxable " ,': '" -'. ,'''',''
al6%rate ' ., },-,l:,....
17. Amount of tine 14 taxable
al15%rate
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ox (15) i~;.:;I::;:;J1)t,!i:ii!vi,'. \,; ~,'...~.!,:",~.,fQ.,,:,',;:','":t,!\;,~,'.~...,~,.,:,'i.,:,;,...~,.,~,:,.,',:!,:,_i,J(
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18, Tax Due
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urnme ve .
Iemoyne, PA 17043
301 /1arket St., P. O. Bcx
IEmoyne, PA 17043-0109
DATE
sJ'I'/?8"
DATE
()77W?,
NTATlVE
ADDRESS
109
"
Decedent's complete Address:
STREET AOORESS
STATE
ZIP 17043
PA
CITY
I emoyne
Tax Payments and Credits:
1. Tax Due (Page 1 Une 18)
2, CreditslPaymenls
A. spousal Poverty Credit
B. poor Payments
C, Discount
(1)
67,579.40
50.000.00
2.631.<;8
Tolal Credits (A - 8 - C ) {2}
52,631. 58
3, IntereslIPenally n applicable
D, Inlerest
E, Penalty
-0-
TotallnteresllPenally ( D - E)
4, \l line 21s grealer than line 1 _line 3, enter the difference, This Is the OVERPAYMENT.
Check box on Psgs 1 LIne 19 to request e rsfund
5, \lllne I_line 31s grealer than line 2, enter the difference. This Is the TAX DUE.
A. Enter the Interest on the lax due.
14,947.82
-0-
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Old decedent make a transfer end: Yes No
a. retain the use or Income of the property transferred: ............................................................. 0 l0
b. retain the right to designate who shall use the property transferred pr Its Income; ................ 0 g
c. retain a reversionary Interest; or............................................................................................. 0 Ii!
d. receive the promise for life of either payments, benefits or care? .........................................0 !Xl
2. If death occurred on or before December 12. 1982. did decedent within two years
preceding death transfer property without receiving adequete consideretlon? If death occurred
after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? .............................................................................................. 0 00
3. Old decedent own an "In trust for' or payable upon death bank account or security
at his or her death? ...................................................................................................................... 0 ~
4. Old decedent own an Individual retirement account, al1nulty. or other non-probate property?.... fill 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN
l
,
,
72 P.S. !i9116 (a) (1.1) (I) provided for the reduction of the tax rate Imposed on the net value of transfers to or for the use ofthe
surviving spouse from 6% to 3% for dates of death on or after July 1, 1994 and before JanualY 1,1995.
72 P.S. !i9116 (a) (1.1) (II) provided for the reduction of the rate Imposed on the net value of transfers to or for the use ofthe surviving
spouse from 3% to 0% for dates of death on or after January 1. 1995. The statute doas not exempt a transfer to a surviving spouse
from tax, and the statutolY requirements for disclosure of assets and filing a tax retum are still applicable even If the surviving spouse
Is the only beneficlalY.
FOR DATES OF DEATH ON OR AFTER JANUARY 1,1995. Please answer the following question by placing an"~ In the
appropriate space.
Old the decedent create a trust or similar arrangement which Is solely for the surviving spouse's benefit for his or her entire
lifetime? Yes 0 No 0
If you answered yes to the above question. the tax on the trust or similar arrangemant is postponed until the death of the second
spouse, at which time it will be fully taxable at the rate(s) applicable to the remainder beneficlalY(ies). Enter the value of the trust on
Schedule J, Part II. In order to remove it from the calculation of the tax due in this estate. You may wish to file Schedule 0 In order to
make the election available under Section 9113. If the election is made, the trustor similar arrangement Is taxed in the estate of the
first decedent spouse, the portion of the trust or similar arrangement whIch benefits the surviving spouse Is taxed at the zero tax rate,
and the remainder Is taxed at the rate(s) applicable to the remainder beneficlalY(ies), If you choose to make the election. you must
attach Schedule 0 to a timely-filed tax return, along with Schedule(s) K andlor M in order to show the apportionment of the trust or
similar arrangement between the surviving spouse and the remainder benefic1alY(ies),
SIImm.ry Appr.ll& leport
DAN BAI1NINQm & ASSOClAUS
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'0 Nrtv o.'GrlotlGn UNIFORM RESIDENTIAL APPRAISAL REPORT 1Il'*', 7-1024
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A ailei' ... Add.... 007 gm. . Cl\M 1.1 P 011
lOCIlon '';]U.ban l~.lsubllrb.n !dlllnll f'tlldomklltlt l'f\l;[ AOf. I'nUrtMIIlllllo lWIlIUhmJe
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Oemand/Supp~Dshofuge [X]lnblllnce C)OtOl.UppIf rXIVam(O-5\1 ~:lPrll'JoHlIl"nl. tiL CornmclCl,IlJL
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Ho'e: R.<< .nd the r.cl.1 compo.luon 01 the nelghbolhood ere not .ppr.lul '.clOt.,
Holohlloll"ood"'''''''''~''::'~:''': ~~~. I.WDLQE1!I\E!~flr_.IllEm.JIm
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~y ~_tmT ~@..9F SlMIlAR~-1\!m 1\P!'EI\L~-,~g;dmpplI!;;..l\!!D__
~aJlIto..m:::o..mfl>~;!,!nu~1.~..Jl'!l'lOi1'IWUl:l!l1:lJS_MeJm1Jll1.l:;'MlN\llllJ;J;IWI1l-0F
, .. O.f.l]Rl~Ifl~
Malklllcondlllonlln Ule .ubjct;lllCIghbolhood (lncudlng IUPpolllor Illlaba'le t;oncuslons IDllbl b lie IIfll 01 PIOPCllly n~cs,l2cnlind/Supp~,and mllkeano Ilmo
_,uchudalloncompdtleplQget6cs k1lulelnalll~hborllOlld.doscr\pDonolh,pr'fllcllceolnklsand lINnclng conces.lons, ok:.):
~L!.lF>II\ND rn BI\lJ\Ia, IllI\N DISOl.Nl' FEES A~ 2-3' '10 ~. 1lUY-IXMN AND
rno =TrN.. ARE !Dr PIlEVJ\IB/r 'lO 'llIE Ml\HKEr PIACE.
.. PJvP;tklbmllaftlorfWI ~IIPPlcab~)..lItlCdcnbpeli\lUIUCflncon~oIOllldlkIlMo.wllOl"AIIOClallonQ1MI7 OVes ON,
. AppfoJ:llN. lllllnumbcl' 01 unlllln IllllubletlPIOlccl ApPlollnu. lllal number 01 unlit lot ule In lid lubJ<<:1 p.oJccl
Deullbecommon ebMnls.nd retlalrJonallaclleat: "
1lImonI"" .fiJU.50 Topoulaphy =
Sltlluu 6.750 SF COllllll'lolDvca !Xl 110 so, A.~
SpoclllczonlngcluslIUlIonaMdcscrlpllon R- '",po ~
IOnlnocamplanc~.~~t1 rCfillcoalllOnconl~~IGlandlallClcdUSC)Ollcoal DNolonlnQ DlaJn.1ge ~ ADEIXlATE
~&butuu., ld: Pl'l:SCl\lu~ OllClUIe~labll mimE oa::uPNJ.'E,tL - ~E
- "Ok "'" """'...- l,po Mk ""nk! UndscaplllQ .b'JFRI'GE
EJoclllc:ltt !Xl S~1lC1 ~ [Xl 0 Dllvcway Surllco .H;fm
GII [Xl C"bIg"",~[J!1 0 Apparcfl!eaIClTlCl\Is~C
W... 00 Sldcw.k = [J!) 0 rEtM Speclllfbod IlIzard Alea 0'" !XlNo
I ~:m"""'~ [Xl ""'khb J'QUl -%1 R FEMAIoM C Mlp DalD 12-04-79
""" u rvl- - fEMA Mall No.
Commenll ('PllItcnlaI2YClUUIIllI1Ol\Is. encroachments. lpeclaluscssmCflts,lldellClS.!IogalollcQal IlOnconfollnlng zoning UIG. ek:,): ~
E1\SEMENr. FNCroI\OMNI'S. CR amlR l\ll\IERSE <mnmctlS tul'ID. SlTE IS 'l'lPICAL rn SIZE I'm '!lIE
c.IlIICRIXD.
GUlflW,IlESCRlPTKIN EXTERlCflDESCPJPUOfi FOONDATlOH llASE~NT INSUl.AlION
Ho,,16n10 ",' Foundallon N)JJI!D-ml '0' . Alea Sq. Fl 924 "",,_0
No. 01 Sblllls EmIol'WIIs Jl!ll..ClL- ClawlSpul lo11nlshed 0 CO,,,, _!Xl
lYpo(lloU^,) ~ noolSuIIIC8 ~ .."""", tellng WIIs_D
Oeo~n~~') GUlb'll"'nspls, Sump Pump WI" ""'1_0
bk"''''''_ GWlndO'lTypa ~- OalTljlllll5s III EVIDENCE '"" -C;gl(]1EfE NOlld_D
Age (VII.) Stmn/SclDW .x&S S~llIenlClll lP...MQm;i: OUlsldeEntry:iES_ """"'L-O
E"llCltt~.i."e I"i'R.\ . 20 M1nullCluted lloulI N) Inleslalion III El/IDENCE
:' ROOMS -I9YJL lhl 0", K1then Don Jaln~nm, Roc. 11m. lI<<I.oorns 60allS l.!!!..iN!Y ..'" AleaS!l1!
"'_1 9M
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-do .. ';2'
.
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--.ii HEAlWG" K11CIIf:NEQULP. ^"~ AMENlrlfS CAR STOAAGE:
fboll . 1\ Typo M RelrlgMilllr 0 "no 0 FIleplace(s)' IRIcxIXJ Nono 0
W.k ~ Fuel rj.~ Rl.llIItiUten !Xl Slak, [Xl P... .u:m-O Garage I 01 call
T_' JI;!;lJJ1j CaodUlo Ollpolll 0 Drop5t11f 0 0", j,l:VE 0 Atlached
...f." j[ CO<lWG """" Olshwuhcl 0 ScullIlI 0 ",,' .mn'L!m\!!!Xl Dcllched 2
BaIbWalnleol Cen.a! fl~iood 0 ""'I !Xl rcnca OCNE 0 Oul/HI!
Ooo~ lit<< ""',:~~. ~ I.... ~ PooltmE P Carport
CondlDon Washer e: nnlShod Orlvlllnw 0
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2ND F'I.CXIl BAI.O::m. FINIffiED ATl'I . A 1 gIrR{ 22.8 X 30' Pma< 4 RXM l\llJmrn Iq/~IDJ\k.Al1!.
COndllonOfflalmploYeman.,d8PIacIl1lol1lPlrJllcl~luncaolll~andaIel1il9,fil\lllrt=,~01:=lIon,ICI1IOdWiOlad=;11:,: 1HXQ~
AND ~ mQ"Jl'~ PRf1;ENr. Kl'IOIDi, ,W.~.
:rn ~ sr;wm:; WATER ll'MAGE rn ATrIC. IEAD BASE pAn/r IS Pl1ESENl'. PAINl' IS PEELIN3/OlIPPOO
'llUM. WINIX:MS. GUlTIRS. AND RRlIES. SEE A'I'I2\CJED l\llJElUM.
MYOIiI emlronmentlltondJIlonII.udl u,bulnollmlDltl, hUlldoUI wuleI. k1x1c lubltlnc8l, 111:,) pr..cntln aM IrnplO'lefTllll1b. on Ulo .Ik!. or In Ule
lfrlml>>1a..lclnlttolblsub/GtlpJOpel~,: !>mE _.
Freddie Mlc form 70 em
r rAGEltf2
TonnUA2,- '10TAl2OOO"apPII,ISlllottwllaby ala moda,lnc. - 1.600.ALAMOOE
faMl4 Mae FOlln 1004 lW3
UNIFORM RESIDENTIAL APPRAISAL REPORT
V.
UTItM1tD SirE VAllJ{
ESTltMllD RlPRODUCT~ COSJ.Ii[W.(f' IMPfllMMrHlS:
DwlInQU01-I..r, @1...su~O<L .1--.J.IQ.~n
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1\I'l'l1.Jl\l'I,.~1&S . __"~.lQO
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TalllhllmlllldCOIINIW . S----..l'Zl,If]!J
l.. Phrllc.1 runclorul (J1Ill1ll1
""'K..... _42..!l1L1~.73~1
Oepr.dlblV,,,,OllmptovDlTllllIl
'AI.II'V.."01 Sill 1mprowllT*l1l
.....A1fO VAU,f BYCmJAI'rnOU:II
IIEM SU(lJ[CT
225 IIlMlEL AVUlUE
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. ,_~,..QQQ Como..llonCotlApprOlCh (,uch.., IOIIIC.olco.I..IlN....I..ull..
11I11./1 Ioulctlculllon'nd:oJlllJO. VAItld TmI"- ....IIII.8;J rlOl&~llllg
IIeOIlOIJlk III 01 IIlI prol*ft): _45
_/'lM\>lw._VlIII.iI'l'.lqj_SflM!%>_IIlil1..~_
-~m'l,-I.IMrnl1.1l1llU\l}lUl!.9.l.Yfll-
~1'J\l'ffid\QUM\,'f9.1'M~_
~m.~
,
i:
AddlllS'
ProllrRttbSubloc1
5.1!ls1'l1ce
Ii!..e/G....!2!!.IJ!gArea
Ollillnd/OJ
~lIIonSoulce
lli~JOOM!!J!L
SIIcI01 Ilnanclrl\l
~!!I!oIIL-
~"oIS.MIme
locallon
lomookl.foeSImDIa
""
VIew
~nandADwl
OllllttolConstuclon
!I'
Colllllllon
AbllYeGr.dl
RoamCovnl
,
.1 74.121 ~!:t!I\LLWI'fID.Kl'fQIfll..1\tlD..DIILLJl/lIlI
.1----2.G.ll~ -~SJ;l,lVlaL4~;_
.'_3.600 _1Jl~l.T.lctLV~
.1 12 616
CCIN'ARAnLE NO.1
210 IIlD!EL AVE
~ ~..wmrm
"""O;"J\<'\" ',,,,,, ~!!!/rJ{ ~ I Rr~
~N~J\:f{i\t:q~Qi....2QQ.... f~~;tif&W;I~J~., 85,.QQQ. :n~~~U^~;"111.lfls , 82.52,1
1 u' ~M9 I/'~r..~ '-4~,~5 I/J~~,V 1---21.07 ~"Wk'H
~ClI MIS/RJIlLIC REJ:am MIS/IUlLlC REJ:am MIS/PUBLIC Rm:I1OO
COMPAAAOLE NO.2
223 B:6LI'R AVE
COMPAf1A8lf NO. 3
133I1lMlELAVE
DESCRIPTION '18t.M~!L ~tSCRlPnON_:..l.l:}lMIl!~L -'p~SCJUPnOH :.....:ti:ll.Mtu...!L
Ia/E n:Ml: Ia/E :
~ ~fl~;
Ocn-97 lQ=;l1:26: Q1:-JI-97:
A'{ERl<:lE A'lfIW;E p.Vf1WJE
m:: m:: FEE fIlE
...!~~~ ~l..I..=,1Q~
~ ~ ~ ~:
2.5 SImY 2..Ll>ImY 2.5 SI'ffiY ~..QQQ..
IlVE/BRIex AVE/BRIex lNJiJFIW:1E +3&22.. AVll/ERIex :
+- 9<>>- 8D-f-
f1IIR I\VEFJ>GE: -10..l1QQ ~&22.. A~1Q.JlQlL
TOlal:8dfms: Ililhl l~!&J[ldrms: 8,illS : l!!~:.odrll1s: 8allls : . ~6dflns: 8allls :
7:4 :1.5 8: 3 : 2: -500 9: 4 : 2 : -500 9: 3 : 2: -500
ell 1.9Q4Sa,fl 1.800Sq.Fl! +1.000 1.850Sa.fli ~OO 1.753Sa.nf +1.500
Buemenl &ftlIIhed FUIL FUlL : FUIL : FUIL :
RoomIIIGbw Gr.de Fl&I ATl'IC FIXP.L . ElXV\L ; mJAL ;
F,,,,,,,,,, un ~"VEFJ>GE AVEIWlE: _~:
"'''''oo'no Iti~ ~L!l!)lIQlE ~LIa/E
Enol" [''''Ion"... SIlDl!lllTS SIlDlltllTS BltRl !lIlTS ;mRIltllTS
a......"" ~ Ia/E +4.000 IQ!!': . +4 .000 ~ GAIW:;E' +2&QQ..
""'~P.IIl,IIec~ m:m'/RIWl m:m'/REAR m:Nl'/RIWl , m:Nl'/RIWl :
,,,,''',,). It. 1 FIREPU\CE I FlREPIACE I FrnEPIACE ' ~ , +2.000
ftnce.Poolelc 1 mY Am1'1N t:!:JlE +10.000 ram ;. +10.000 tmE : +10.000
APPLWICES EX:!JAL =,!'(XJAL
NolAdI,Ib.' 500 M.~,7.'" 7.000 Jt,\!..~~.""...;;,'
AdJulkd S.Ds Plica " " ", R,~Qf,i:Jlf(%~:ffi
aleam arable lOB 000 "l i, ,*;~t:i" S 92 000 0i'1:%\~...^,*~ 98 021
COIllIll6ntaonSIIsCompWon (IndJdlrlg IlelubjoclpIOpclt)". wmpiUblltt bllOnclghbolhood. It.): .mm' aMPARABI.ES SAT~~..I-
AlL l\I1E IOCATm IN SUB.m:lI' NEI~~I\tLl\!lILmU:;l~.llIMtllLt\'1~...m;s~~
AlL HAVE BEm IIDPFRr.y l4I\IIID\INEI) l\ND ME ' IS IOI'ED 'IUAT
~ J\llJImMFNm """"'" 25\ WHIm ARE ~""'mr OF Slll3EX:r'S iiiIDmClll\lID 0=
OFFICR/APARIMENJI Amm"F'tWrF..
8 500
REM SUBJECT COMPARAIIlfNO.1 COMPAflADLE NO. 2 COMPJJWllENO.3
11I0. """....11I.. Ia/E Ia/E PASr YEAR n:Ml PAS!' YEAR n:Ml PASr YEAR
SOUlct.lorPflorulcri
., I
AN~III Dfany cllrrlllll.gl**,loful8. oPIlon. or bl\ng of.ubjoclplopoftf and ana~.1s 01 any pllor lUll oflubjocland eomlWlblol wlUllnono rOIl' 01 hi da_olappralul
SUBm.:T IS tDI' LTsrm FCR SAlE CR lNDrn CXNIRAC'r OF SAIE. .
IIIr.AlIDVAl.W.8YBAUSCIIIWIS(JtAPIm\CII .......... ............"... .... $
Nll'.ATIDVAl.l.EBYJl:rll:AJlPA(MCJI 11 bblc EatlrNbtMarkelRenl $ .. GmssRenlMulll 5llt ..$
TllIIlpps;luIk INd. 'u II" II/blocl b 1lll1~lkI. alIerlllons.lnspeclolllOf eondlllonllsltld beklw lubjoel b compleJon per plins & .poclllcdollS.
CooollonufAppral&ll: ~ a.PRlAT~ A.~r.m::: A Mi'\m{ID'ABIF. ~[E ErlJTIMFNTI A.ctClY"TlI.'T'm wrrn
'lllE lMPR:MIoIFNm ARE rn IDKlN3 oonm.
flNl_IIl.'lllE M1IllKFJI' APPRlAOI IS a:l/SIDERED 'lllE ID9l'MI"TMIE Rll '11~ mJPERI'Y B.lmG
AP!WIISED. 'I1IE IIlCD!E APPRlAOI.l!I\S lOl' ~ED ~ 'lYPICAL NEIGlOCeIXD mJPERI'Y IS
.. ~JPT1in AND ADFaIA.TF. RENrM..1lATA roES tlJI' EKISI'.
ThI plllJlOH 01 Ns .pptalulll b cdmalc hrmlkaln~ool 111I lCoIIPfoPllltt hils tw IUb}cclolllls lelKNt bued on 1I~ alloYe condUlons and Iho ccrtlflclUoJl, conUngcnl
IIllIImIBnQ condlllonl. and m1lkelwUJ.d'lInIlon hIll. .laW ~ rlO IUlchod f.oddlo ~c Form 43wrNMA lorm 10048 PleYlsed ----12l~).
I CtW) ESTIMTETlEIWIlIT V~Mi OOHD, [FT1EfIAlRKRJUV mu IS T1ESOOJU:T (f illS IIJ'(JIT,M (f 03-97
(WIGUlnED.\ AfIJnEOltcuVEo.\TE[J'T1lSlIPOOT)JOIIf I 98.000
AIl'IWSIII: SlftJMSIIIYAI'I'II\ISUI(lIUflm.llD):
8 '"I SklnatJfI
~me
Dam Rtooll Slanod
SlamPA SlImCaUIleaDan'
StamP OrSlImLlccnse'
PAGE2Cf2
rOlm UA2 - 'TOTAL 2000'.pprilsal WrMarD by allllKJde, Ioc. .. 1.800.ALAMODE
98.000
Daij o aij "'I
Inapor;lPfDportt
I."
I..
raw MurOHll1004 6.93
ADDENDA
,:
fl. No 7-1024
\f::7~==
Co\l!IIY ~SI~L1'A
lII!.ColIL1WJ
ADDENDUM
a:wrrrCll/REPAIRS cr:tll'INUID:
\
NEW RXlF SHIN:iUll INSrALUD ClI GI\I1lGE l\IlD IlEIl\QIED l\IXlrrIClI, NEW GUI'I'!&'3
lNSD\lUD ClI MAIN 11XlSE, OFFICE l\IlD GI\I1lGE.
'!HE llEll\OIl'D 1 E1rafi l\IXlrrIClI lIAS roCll fWCl'IctllIL ru::xR PlNl, IJIO(S lCl'l"OlEN
l\IlD roIL BllIH Fm lEE AS l\PJ\ROONl' RENrAL UUT.
HIGHEST AND BEST USE:
HIQIESl' l\IlD BESr lEE OF SlIll:lEr1' IS smu: Fl\MILY lliEILIKl AS IN-IOIE
OCX1lPATIClI WrnNlSE OF DEJroiED 1 E1rafi WIIDJro FtR OFFICE/1lllSIIlESS fUlCl'IQl
en a:tl\IERSIClI AS m::cME m:ax:rn:; UUT.
BUILDINO AREA ADDENDUM
\5::::::A:: :: 7-::4 I;
CDUn~Slil"_PA
lIoCod. 17043
Groll Uvlng At.. (GLA) --1.2ll1..I.
. \
Groll Building At.. (GBA) 4.1721,1.
"',,' SquartFOO\lge
81.-' 924 1.1. A'oIGBA
L,nll 980 ..1. Z3..'" 01 G8A
LrYIlI2 924 1.1. .2Z- 'I of aM
LII1e13 1.1. _'oIGllA
GUIgI 684 1.1. ~'ofGIIA
""" 660 I,t .J&..'I 01 GIlA
"
Area Dlmenslona Typ. 01 At.. Level
Meuuremenll rJcm .... ,.~ Damnl ~rag. """ C>Id Two Till..
28.00 X ~ X.....lJl!) . --224.00 [X] 0 0 0 [X] 0 0
.....L.l)!lXJ.&QX.....lJl!). 56.00 00 0 0 0 00 0 0
~x..ll..Q!1X.....lJl!). 924.00 [X] 0 0 0 0 [X] 0
~X..ll..Q!1X.....lJl!). 924.00 0 [X] 0 0 0 0 0
~x~X.....lJl!). 660.00 0 0 0 [X] 0 0 0
~x~X.....lJl!). 684.00 0 0 [X] 0 0 0 0
_1_1_- 0 0 0 0 0 0 0
X X 0 0 0 0 .,0 0 0
X X_ 0 0 0 0 "0 0 0
_1_1_- 0 0 0 0 0 0 0
_X_I_ . 0 0 0 0 0 0 0
_1_1_'" 0 0 0 0 0 0 0
X X 0 0 0 0 0 0 0
_1_1 0 0 0 0 0 0 0
_X_X 0 0 0 0 0 0 0
formClC _ "TOTAL2OW.ppralul50ltlfii'lby III mode, Inc. - 1.8()1).AlAMOOE
~"'1R"""',.\~l;"~,,>.~,,,.,:,.... ,,,,,""""-'''''''''''.'
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t,..,',
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I
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DUILDING SKETCII
[~=A=
COIIflY~
SIIlLI'A
niNo. 7-1024
I'
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. .. . " .. ..
.. .. .. .. ..,
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.. .. .. . .. " "
- . - - . - - - - - - - . . - . - - - - - -
.. "' . . .. " .. .. .. . .. " .. .. ..
.. . "' .. .. " .. 1:1o!o
, . .. . .. .. ..' " .. .. .. "
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.. .. .. .. .. " .. .. .. . ,.. . .. . " " .. " " " " .
.. - " " .. ", .. ,.. '" " .. . .. " .. .. " .. " .. ,.. .. .. . " " .. .. ... ... .. .. ..
.. .. . .. .. - ..' .. ... .. .. .. .. " .. .. .. .. .., .. . .. .. .. .. .. . " .. .. .. ,', .. " ..
.. ... - .. - .. .. .. .. ... .. .. .. .. .. .. - " .. .. . '. .. .. .. .. .. . " .. , .. ..
.. .., - .. . .. .. " " .. .. .. " .. .. '" .. .. ... " .. " .. .. .. " " .. " " .. .. ..
- - - . - . , - - - -
.. . " .. .. .. .., .. .. .. , .. . " " .. .. Ujt .. .. .
. .. .. " .. .. '. .. " .. " .. .. .. .. . .'. . .. " .. .. . ..
.. . .. .. .. .. "' . '" ,.. . .. " ..
.. .. .. .. '" . .. ", .. .. .. " .. . .. .., .. . "
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.. .. .. .. . .. .. .. .. .. .. .. .. .. ," .. . "' .. .. " .. "
" .. . . . .. .. .. . .. .. .. " ..' .. .. .. .. .. - "
- - - - - - - - - - - - - - - - - - .. - .
.. . .. .. .. .. .. .. . . .. .. .. .. .. .. .. .. "
ftlY.llllUlA.(141l
.'
SCHEDULE B
STOCKS'& BONDS
COMMOllWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
I
BEALE, ANN R.
FILE NUMBER
21-97-0745
ESTATE OF
All property jolntly-ownod wtth rlght ollurvlvollhlp mUlt be dllclolld on Schodoll F.
ITEM
NUMBER
1.
DESCRIPTION
$25.00 Series E Bond - dated May 1945
Date of death value
2. $100.00 - Series EE Bond - dated 8/1994
Date of death value
3. 541.167 Shares - Franklin U.S. Government Securities
Fund - Class I @ $6.86 per share;
4. 2 Shares - Lucent Technologies, Inc. @ $81.6875
per share.
5. 7 Shares - AT&T Common @ $40.3125 per share
6. 6 Shares - The Dreyfus Fund, Inc. @ $12.39 per ,share
7. 20 Shares - First National Life Insurance Company
(Into receivership - 10/96 - Liquidation Order-8/97
Montgomery, Alabama)
8.
337 Shares - The Salomon Brothers Fund, Inc.
@ $17.6250 per share.
9.
Wheat First Securities, Inc. - Account
No. LN02-1422-4035 consisting of:
48 shares Lucent Technologies, Inc. @ $81.6875
per share. $ 3,921,00
1,668.2840 Shares -
Delaware De1chester
Fund, Class A
Money Market Account - cash
10,910.58
566.47
VALUE AT DATE
OF DEATH
$ 111. 54
56.32
3,732.99
163.38
282.19
74.34
No Value
5,939.63
15,398.05
TOTAL (Also enter on line 2, Recapitulation) $ 25 , 7 5 8 . 4 4
(If more space Is needed, Insert additional sheets of the same size)
,
ml"""l..n '*
COMMONWEAlTH OF PENNSYLVANI^
INHERITANCE TAA RETURN
10 NT DE EO NT
ESTATE OF
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
21-97-0745
BF.ALE, ANN R.
Include the proceeds of litigation and the date tha proceeds were racalved by the astate, All property jolntlyoOwned with the rlght ollurvlvo"hlp mUll be dllcloled on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
lB.
19.
Cash Bequest from Estate of Benjamin Rudolph Beale
Date of Death: March 11, 1997
Note: (This bequest to decedent is in Benjamin Rudolph Beale's
Codicil dated October 22, 1996 to will dated April 26,
1996; the Codicil has been challenged and the matter is
pending before the Orphans' Court of Cumberland County.
If the Codicil is rejected by the Court, the bequest
will be reduced to $50,000.00 under April 26, 1996 will.
A supplemental Return will be filed by the Executrix
, for a refund of excess Inheritance Tax paid if challenge
to the Codicil is sustained; fora credit if the challenge
is rejected by the Court.)
Coins and paper money - appraised value
Cash in decedent's safe deposit box
'14K Yellow Gold Opal Earrings - appraised value
Household Goods - appraised value
1987 Chevrolet Cavalier 4 door sedan - appraised value
Pre-War Martin 000 Guitar - specific bqquest - appraised value
Blue Cross/Blue Shield - major medical benefits
customer service Center - subscription refund
Member Service Center - credit balance decedent's account
United Telephone - refund
Wolfe & Rice, Attorneys - refund of decedent's retainer
Dauphin Deposit Bank & Trust Co. -trust distribution check
dated 7/15/97, not cashed prior to death.
Collection of BoOks - ordinary publications
Literary property (manuscripts, proofs, writings, copyrights,
contracts) - decedent had no publications or writing
contracts in existence at the time of her death.
Dauphin Deposit Bank & Trust Co. - Checking Account No. 50106171
date of death balance, plus interest
Dauphin Deposit Bank & Trust Co. - Savings Account
No. 5312602124 - balance, plus interest
Mass Mutual Benefit Management Account No. 82-006226-1
Date of death balance, plus interest
Hartford Variable Annuity - Beneficiary: Matthew M. Kuhn,
fiance - date of death value
$ 300,000.00
95.00
963.00
60.00
3,971.00
800.00
700.00
491.64
29.85
41.91
6.81
299.53
120.77
100.00
No Value
6,413.33
6,878.79
22,948.36
6,500.56
TOTAL (Also enter on line 5, Recapitulation) $ 350,420.55
(If more space is needed, Insert additionai sheets of the same size)
'I
,
I
I
I
I
I H . Phone
i W. Phone
I
i
I Cell
IRe-Ceil
,
Date
;\~if
II
I
Sold by Sale Lay Awa S I
y pee, Order Credit Cash Charge Check Estpnat
(';" "
STOCK NUMBER, DESCRIPTION
/~
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.
.L~
Name
Address
215 Third Street
New Cumberland, PA 17010
(711) 774,7200
7&J -
Date /11/1// ~ J
'1'10 I
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,
PAYMENT RECORD
Amount Paid
Balance Due
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I
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Speelallnstruelions
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V:~ /rld;i':'/
SUB TOTAL
"> V) l../ II (i
\~'1f'\. (/I.MJ-vv- Ul'tv.-z"
Ree'd by
SALES TAX
TOTAL
THANK YOU!
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F"if Tile S CHEVROLET,INC.
3400 Hartzdale Drive at Capital Cily Mall Drive. Camp Hill PA 17011 Ph '
. . one (717) 761.0600
oc-rn0~ 3) I qCJ7
.
.L t+f\\fE itltS D~TJe.. LaD /CiV0 A- T
A-,J I q <6'7 C ;+6Utf) ifJ cAV!J-L1 fvt t-( DJ-
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f-f-A 5 It- f /.:z5E;JJ US tfo Le.-:)AL!C-
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lj/iLUL of ?fOOf
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.t.t"'N'I'.t"'N Stt.IN.t
, .'
I;
'.
.'
370 Market Street
Lemoyne, PA 17043
(717) 761-0890
12/11/97
to: Matthew Kuhn
2256 Hummel Ave
Lemoyne, Pa
Appraisal of Pre-War Martin 000 Guitar wi hard case
This instrument has been refinished in a satin
lacquer, which is slightly crazed expecially on the
lower bout and at the neck joint. The bridge and
braces are well attached and the neck joint is strong.
The neck is well relieved and the guitar plays clearly
and smoothly. Substantial reconstruction was
performed at the time of the refinish. Several cracks
were splinted and the integrity of the body was well
restored.
This instrument is in good condition and would
bring $600 to $700 on the street amd slightly less in
the collector market.
t
. Rl\I.l,OUXtll.f1)
'*
SCHEDULE F '
JOINTL Y.OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
R I NT
FILE NUMBER
21-97-0745
ESTATE OF
BEAr,E, ANN R.
"In 11101 WlI mado jolnl wtthtn onl YOIr of thl docld'nt'l dlte of dOlth, "mUlt be reportld on Schedule G.
SURVMNG JOINT TENANT(S) NAME
AOORESS
RElATIONSHIP TO OECEOENT
A Matthew M. Kuhn
225 Hummel Avenue
Lemoyne, PA 17043
Friend
B.
c,
JOINTLY-OWNED PROPERTY:
LETTER DATE OESCRlPTION OF PROPERTY lOOF OATE OF DEATH
ITEM FOP,JQlNT MAllE Include name offinancial institution and bank account number 01' slmi1. identifying number. Atta:h OATE OF OEA TH OECO'S VALUE OF
NUMBER TENANT JOINT doedf",joinUy-h6~""estale, VALUE OF ASSET INTEREST OECEOENT'S INTEREST
1, A, 10/83 Dauphin Deposit Bank & Trust Company
Checking Account No. 33348707 1,742.70 50% 871.35
2. A 3/84 Dauphin Deposit Bank & Trust Company
Savings Account No. 5318608116 2,748.56 50% 1,374.28
3. A 4/95 Dauphin Deposit Bank & Trust Company
Certificate of Deposit No. 8800139701 589.39 50% 294.70
4. A 5/96 Dauphin Deposit Bank & Trust Company
Checking Account No. 51561433 530.79 50% 265.40
5. A 1981 1980 Harley Davidson Motorcycle
appraised value 3,600.00 50% 1,800.00
TOTAL (Also enter on line 6, Recapitulation) S
(If more spare Is needed, insert additional sheets of the same size)
4,605.73
_, , ,", ...,.; "~''''''_'~':''''",'''_, ......'.....~..r.~.... .
___ ___ _'u__"! >-, __.!._.___=- _._.~~~.~_~._. __ _ .___~__._____.__,----- _.__._ ____._____--.-_~____________
,. .,' . ......~-
I~~I
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December 4, 1997
.
, . 1:-
Mr. Matthew M Kuhn
225 Hummel Avenue
Lemoynel Pa. 17043
Re: Appraisal of 1980 FLT 5G01247JO
Dear Mr. Kuhn:
I inspected your 1980 FLT 5G01247JO Harley-Davidson. The estimated value of this
bike is in its current condition $3,600.00. I would like to note that motorcycle appears
to require transmission work. Additionally, since the motorcycle has not been stored in
a garage, the decorative <:I,ccessories would need to be replaced to raise the value of
the motorcycle. If you have any questions, please ('-3.11 me <:I.t 717-233-1993
Sincerely,
'Wjfi-a~l' '2J 1.u0
William W. Tull
Manager
"Committed to Servicing Your Motorcycling Pleasure"
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REY.l'lOEX.(,-t1)
ESTATE OF
'*
SCHEDULE G
INTERoVlVOS TRANSFERS &
MISC. NON.PROBATE PROPERTY
FILE NUMBER
21-97-0745
Thb schedule must be completed end filed ~ the answarto any of questions 1 through 4 on the reve"o s~o of tho REV.1500 COVER SHEET byes,
ITEM
"liMBER
1.
BEALE, ANN R.
DESCRIPTION OF PROPERTY
IHCl"VOETHEJiN,lEOfTI1ETP,ANS$EREE,TllEIRRElATIOHSHlPTOOf:CEOOITANOTllE QATEOFTIWl5fE'l
ATtACHACOP'fOf THE DflO$ORRUolESIAfE.
DATE OF DEATH
VALUE ^F ASSET
Franklin Templeton Custodian Funds
Account No. 10165953808 -
Individual Retirement Account
consisting of:
1,069.521 shares of U.S. Government
Securities Fund @ $6.82 per
share - $7,294.13
(Ann R. Beale was 59 years of age
when she died - DOB: 2/17/38)
Beneficiary: Matthew M. Kuhn, friend
.
'roOF
DECO'S EXCLUSION
INTEREST ",_"",,~l
TOTAL (Also enteron line 7, Recapitulation) $
(If more space Is needed, Insert edditional sheets of the same size)
TAXABLE VALUE
-0-
-0-
NYolllla'II"lI
'*
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
~THOFPENNSYlVANIA
INHEMANCE TAX RETURN
1.
FILE NUMBER
BEALE, ANN R.
21-97-0745
ESTATE OF
Debll 01 decedent mUlt be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
FUNERAL EXPENSES:
Musselman Funeral Home, Inc. - funeral expenses
5,629.00
485.60
1,176.99
18.00
2. Iron Kettle - funeral lunch
3. Rolling Green Cemetery - Marker/Base
4.
B.
1.
2.
3.
4.
Musselman Funeral Home, Inc. - additional death certificates
ADMINISlRA liVE COSTS:
Personal Representatlve.s Commissions
Name of PelSOnal Repreaantatlve (s) Joyce J. Johnson
SocIal SecuiltyNumbe~s)IEIN Number 01 PelSOnal Representatlve(s) 179- 30-4238
Street Address 230 Hl.l1lUTle1 Avenue
Lemoyne StaIB PA
7,750.00
City
ZIp
17043
Yea~sl CommlsalonPald: 1998
A~F~ - Johnson, Duffie, Stewart & Weidner
FamI~ exemption: (11 decedents address b not the same as claimants, attach explanallon)
Claimant
Street Address
7,750.00
..
City
Relallonshlp of Claimant 10 Decedent
Stale
Zip
ProbeleF~ - Register of wills - Cumberland County
339.00
5. Acx:ountants Fees
7.
8.
9.
10.
11.
12.
13.
14.
6. Tax Return Preparefs Fees
Cumberland law Journal - advertise letters
The Patriot-News Ce. - advertise letters
Register of Wills - short certificates
Register of Wills - file Inventory & Inheritance Tax Return
Constable Albert Wolfe - preside over housho1d goods removal
Faith A. Nicola, Tax Collector - County/Borough real estate
taxes - 225 Hl.l1lUTle1 Ave., Lemoyne
Environmental Products & Services, Inc. - charge for removal of
hazardous materials located at 225 Hummel Ave., remoyne
Reserve for close-out costs
60.00
69.21
12.00
, 25.00
110.00
416.70
2,915.50
250.00
TOTAL (A1soenleron line 9. RecapitUlation) $ 27,007.00
(11 more space Is needed. Insert additional sheels of the same size)
'. ....
iIIIV.111IP'II.."
ESTATE OF
'*'
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
COMMClNWEAlTH OF PENNSYlVANIA
INHERITANCe TAX RfTURN
R NT
FILE NUMBER
21-97-0745
BEALE, ANN R.
Include unrelmbursed medical expenses.
ITEM
NUMBER
1.
2.
DESCRIPTION
AMOUNT
Hosiery Corporation of America - decedent's account balance
Holy Spirit Hospital - balance due - decedent's account
not covered by insurance
3.98
15.90
13.48
3.
4.
Reader Service - privileges cancelled - balance due
Cornerstone Adminisystems - transfer from holy spirit
Hospital to residence - balance not covered by insurance
Dauphin Deposit Bank & Trust company
Visa Account NO. 4301 7207 5010 4268
balance due
Borough of Lemoyne - sewage/refuse charges - 4/15-7/15
, Cowley Medical Associates, P. C. - decedent's account
balance, not covered by insurance
Faith A., Nicola, Tax Collector - West Shore School District
Per Capita Taxes - billed July 1, 1997
Borough of Lernoyne - sewage/refuse charges - 7/15 - 10/15
11.00
56.13
217.00
5.
544.04
129.88
6.
7.
257.00
8.
9.
TOTAL (Also enteron line 10, Recapitulation) $ 1,248.41
(If m~re space Is needed. insert additional sheets of the same size)
REV.15tJf.ll'11,t1)
ESTATE OF
NUMBER
I.
'*
SCHEDULE J
BENEFICIARIES
COMMONWEAlTH OF PENNSVl VANIA
IrlHERJTANCE TAX RETURN
RE IOENT OECEllfNT
FILE NUMBER
21-97-0745
BEALE, ANN R.
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
AMOUNT OR SHARE
OF ESTATE
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (include oulnghl spousal dislnbulions)
1,
Matthew M. Kuhn
225 Hummel Avenue
Lemoyne, PA 17043
Friend
Tangible personalty
& specific bequests
under Article II;
Rest, residue and
remainder under
Article IV and life
estate in decedent's
undivided interest as
tenant in common in
real estate in Cape
Cod, Massachusetts.
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE. ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A, SPOUSAL DISTRIBUTIONS UNDER SECTiON 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1,
B, CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1,
TOTAL OF PART 11. ENTER TOTAL NON.TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
(If more space Is needed. Insert additional sheels 01 the same size)
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
/5-OI.cI-/3
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
c-
*
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
UV.I"'UU'lt'.,1I
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
07-27-1998
BEALE
08-13-1997
21 97-0745
CUMBERLAND
101
ANN
R
EDMUND G MYERS
301 MARKET ST
PO BOX 109
LEMOYNE
ESQ
PA 17043
AJlouot Rail! tted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .....
REy:is4TEx-AFiji-[oF9;Y-Nli'ficE--cin:-NHEiiiTANcE-TAirXp'PRA-isEMEN:r;-ALi.-ciwAifcE-cfR'-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BEALE ANN R FILE NO. 21 97-0745 ACN 101 DATE 07-27-1998
TAX RETURN WAS: C X) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held stock/Partnership Interest (Schedule C)
4. Hortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E)
6. JointlY Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
CHANGED
Cl1
(2)
(3)
(4)
IS)
(6)
(7)
98.000.00
25.758.44
.00
.00
350.420.55
4.605.73
.00
(8)
478,784.72
NOTE: To insure proper
credit to your account,
subll!t the upper portion
of this forn with your
tax payment.
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule H)
10. Debts/Hortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule ~)
14. Net Value of Estate Subject to Tax
NOTE: IT an assessment was issued previously, lines
reflect Tigures that include the total of Abh
ASSESSMENT OF TAX:
15. Aftount of Line 14 at Spousal rate (15)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
17. Amount of Line 14 taxable at Collateral/Class B rate (17)
18. Principal Tax Due
TAX CREDITS:
PAYHENT
DATE
11-12-1997
05-08-1998
RECEIPT
NUHBER
AA242461
AA270065
DISCOUNT C+)
INTEREST/PEN PAID C-)
2,631.58
.00
27,007.00
1.248.41
Ill)
(12)
(13)
(14)
:>8 . :>~~ 41
450,529.31
.00
450,529.31
(9)
1101
14, 15 and/or 16, 17 and 18 will
returns assessed to date.
.00 X .00=
.00 X .06=
450,529.31 X .15=
(18)
.00
.00
67,579.40
67,579.40
AHDUNT PAID
50,000.00
14,947.82
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEU.
TOTAL DUE
67,579.40
.00
.00
.00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN $1. NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
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RESERVATION: Estates of doc.dents dying on or before nece.bel" 12, 1982 -- if IIny future interest In the .ststo is transferrad
In possession or onjoy..nt to ClasG B (collatllralJ bllnef1cier1es of tho decodent after the expiration of 8ny .state for
lIfe or for yoars, tho Co-.onwoalth hereby oxpressly reserves the right to appraise and assess transfer InherItance Tax8s
at the lawful Class B (collatorall rat. on any such future interest.
PCRPOSE OF
HOTICE:
To fulfill the requIre..nts of Section 2140 of the InherItance and Estate Tox Act, Act 21 of 1995. (72 P.S.
Section 9140).
PAYHENT:
Detach tho top portion of this NotIce Bnd sub.it with your pay..nt to the Register of Wills printed on tho rovers. sid..
.."ake check or .ooay order payable to: REGISTER OF HILLS, AGENT
REFUND (CR):
A refund of a tax credit, which was not requested on the Tax Return, _ay be requested by co.pleting en ftApplication
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-13l3). Applications ere available at the Office
of the Register of Wills, any of the 23 Revenue District Office~, or by calling the special 24-hour
answering service nu.bers for for.s ordoring: In Pennsylvania 1-800-362-2050, outside Pennsylvania and
within local Harrisburg aroa (717) 787-8094, TOOl (717) 772-2252 (Hoaring I.paired Only).
OBJECTIONS: Any party in interest not satisfied with the appraisenent, allowance or disallowance of deductions, or assess.ent
of tax (inCluding discount or interest) as shown on this Notice .ust Object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Depart.ent of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR
--election to have the .atter detarmined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
AD"IN
ISTRATlVE
CORRECTIONS:
Factual err~rs discovered on this assess.ent should be addressad in writing to: PA Depart.ent of Revenua,
Bureau of Individual Taxas, ATTN: Post Assess.ent Review Unit, Oept. 280601, HarriSburg, PA 1712840601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-IS0l) for an explanation of ad_inistratively correctablo errors.
DISCOUNT:
If any tax due is paid wIthin three (3) calendar .onths after tho decedent's death, a five percent (5%) discount of
the tax paid is allowed.
PENALTY:
The 15% tax acnesty non-participation pen~lty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax a.nesty periOd. This non~participation
penalty is appealable in the sa.e .onner and in the the same ti.e period os you would appeai the tax and interest
that has been assessod 85 indicated on this notice.
INTEREST:
Interest is charged beginning with first day of delinquQncy, or nine (9) .onths and one (1) day fro. the date of
death, to the date of pay..nt. Taxes which beca.e delinquent before January 1, 1982 bear interost at tho rate of
six (6%) percent per annu. calculated at a daily rat. of .000164. All taxes which beca.e delinquent on and after
January 1, 1982 will bear interest at a rate which will vary frOM calendar year to calendar ~ear with that rate
announced by the PA Depart.ent of Revenue. The 3pplicable interost rates for 1982 through 1998 are:
Y!!!: Interest Rate Dally Intsrest Factor :!!!r Interest Rats Dally Intorest Factor
1982 207- .000548 1987 97- .000247
1983 167- .000438 1988~199l 11% .000301
1984 11% .000301 1992 9% .000247
1985 13% .000356 1993-1994 n .000192
1986 107- .000274 1995M1998 9% .000247
--Interest is calculated ., follows:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax beco.es delinquent uill reflect IIIn interest calculation to fifteen (15) days
beyond tho dete of the assess.ont. If paYRont is .lIIde after the interest co.putation dato shown on the
Notice, additional interost .ust be cllllculated.
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
ANN R. BEALE
Date of Death: Auqust 13, 1997
Will No. 1997-00745
Admin. No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes No X
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete: Unknown
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes No
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest? Yes No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
Da te : 7 /8/99
~~
Signature
\,0
Edmund G. Myers, Esq.
Name (Please type or print)
Johnson, Duffie, Stewart & Weidner
301 Market St., P. O. Box 109
Address Lemoyne, PA 17043-0109
1-717) 761-4540
Tel. No.
-'
" '
Capacity:
Personal Representative
X
Counsel for personal
representative
(MAH: rmf! AM3)
Rl\loI50UX.(1.fl), ~
COMI.IO~'snVAN1A
DEPARTMENT OF REVENUE
OEPT,l80601
HAAAJ P 171 1
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socw. SCCURlTY NI.J.lBER DATE Of DEATH OATE OF BIRTH
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(IF N'PUCA8t.E) SURVMNG SPOUSf'SNAAlE (lAST. AR$T, AND MIDDlE INIT1ALI ,...~ ~.~,Y~BER
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REV -1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
--- --'CYfIUiil;foi'L'---"-' ..
~NUMBeR~.. ,'0~'~:~-:,,~,,~-:-:,
'2,19;70.0\7,
~ ' ' I
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THIS r.ETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
<',';.",i",...,.'i,)l:.<"./;.,', ",.> >'BE'SURE.TOANSWER AL~QUESTIONS,ON'REVERSE SIDE AND RECHECK MATH < <,
Under penalties of perjury, I declare lhall have examined this return, including accompanying schedu\os and statements, and 10 the best 01 my knowledge and belief. it Is true, correcl and complele. Declaration of preparerother
than the llIIrsonal reoresentatlve Is based on a/llnformatlon of which oreDarer has any knowkldoe.
,,~IG.NATURE OF PERS~N RE~()~~SLE FaiR FILING RETURN " ADDRE~S
-'1-'-'- G_... -- .- VQ,..Ll\L ." - __ c' Y c- '.1'-
SIGN P HA A IVE ADDRESS
wA
Edmund G. Myers, Esq.
o 1.0<IglnalRatum 1!l2.Supplem.ntaIR.tum 0 3.Remalnd.rR.tuml...d"......"'2,'..~
o 4. Llm1tedEstale 0 4a,FuturalnlereslCompromlseld"d_"12"2~~ 0 5,FederalEstat.TaxRetumRequlred
o 6, Decedent Died Testat. (AllJchcopydWl) 0 7. Deced.ntMalntalned a Living TlUst (AllJchcopydTMQ _ 8. Total Number 01 Sal. D.pes" 80xes
o 9, LltlgaUon Proceeds Rece~ed 0 10, Spousal Povarty Credit I'" d ".. _, 12.MI"" '.',15) 0 t 1. Election to tax under See. 9113(A) (AIIJch """01
THIS SECTION MUST BE COMPLETED, ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATtON SHOULD BE DIRECTED TO:
NNJE COMPlETEMAlUNGADORESS
Edmund G. Myers, Esquire 301 Market St.
F1R"NAME 1'...._1 P.O. Box 109
Johnson, Duffie, Stewart & Weidner Lemoyne, PA 17043-0109
mEPHONE N\Jt4BCR
-. .~.. ~':.l."
(1) 9 8 ;0 0 0 . ',0 eO
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(2) :;.;:. '4 4
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(3) ',' "
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(4) '\ : "
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(5) ~: 2'6 3 '4 2 0'. 5 5
\ .. , J:",...'. ,
1. Real Estat. (Schedule A)
2. Stocks and Bonds (Schedule B)
3, Closely Held Corporalion,Partnornhlp or SOle.Proprietornhlp
4, Morigages & Notes Rece~able (Schedule D)
5, Cash, Sank Deposl1s & Miscellaneous Personal Property
(Schedul. E)
6. Jolnlly Owned Property (Schedul. F)
7. Inter.VIvos Transfern & Miscellaneous Non.Probate Prop.rty
(Schedul. G or L)
8, Total Gross Ass.ts (Iotal Lines 1.7)'
9, Fun.ral Expenses & Admlnlstrativ. Costs (Schedul. H)
(6):"
'.4,"60 ~:.,73
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(7) ::,;. '...:, ....'.
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L-___,______,__",__,:
39'1,784.72
(8) .
(9) &, ';;
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"
"
10, D.bts of Deced.nL Morigaga Llabllffies. & Liens (Schedul.l) (10)
11. Total D.ductlons (total Lines 9 & 10)
....
f'
,
(11) 2 8 ,2 5 5 . 4 1
(12) I 3 6 3 , 5 2 9 3 1
(13)
, -0-
(14) 3 6 3 , 5 2 9 3 1
(15) -0-
(16) -0-
(17) 5 4 ,5 2 9 .4 0
(18) 5 4 ,5 2 9 .4 0
12, N.IValu. of Estale (Line 8 minus Line 11)
13, Charitabl. and Govemmental BequestslSec 9113 TlUsts for which an .Iectlon to taJc has not boon
mad. (Schedul. J)
14, Nol Valu. Subject 10 Tax (Lln.12 mlnU9 Lin.13)
15, Amount of line 14 taJcabl., '
at the spousal tax rate "'"b''' ;, ,..,,:', . ,)., ,.",,;, '. J1",~....i..",.., ),., '.'. ;';"'"
Se.lnstructlons on rev.rn. side forappllcabl. pertentage ,..
16, Amount of ITne 14 taxab!.
at 6% rate .\; ",...'.'
17. Amount of line 14 taxabl.
at15%rat.
!..J x :,.0.,
x
,06
(,....,.
.
. .~."".. , ':, tl. : ,., l ,;
, 3 6 3 j 5:2
9 ,; 3 l' x
,15
18, Tax Due
19,
230 Hummel Ave.
Lemoyne, PA 17043
301 Market St., P. O. Box
Lemoyne, PA 17043-0109
109
DATE
hI ],.../~'"
DATE
{t( t t-I97
Decedent's Complete Address:
STREET ADDRESS 225 lIunmel Avenue
CITY
STATE
7JP
Lemoyne
17043
PA
Tax Payments and Credits:
1. Tax Due (Page 1 Une 18)
2. CredllslPayments
A. Spousal Poverty Credit
B. PriotPaymenls
C. Discount
(1)
54,529.40
Total Credils (A + B + C) (2)
67,579.40
3. InteresUPenalty If applicable
D. Interest
E. Penally
T otallnteresUPenalty ( D + E ) (3) - 0-
4. If line 215 grealerthan line 1 + line 3, enlerthe dlffarence, This Is the OVERPAYMENT.
Chack box on Page 1 Line 19 to request s rsfund (4) 13 , 050.00
5. If line 1 + IIns 315 greater than line 2, enter lhe difference. This 15 the TAX DUE. (5)
A. Enter the Interest on Ihe tax due, (SA)
8. Enter the total or Une 5 + SA. This Is the BALANCE DUE. (58)
~~~_::"':::::>l'(;~i~~=G:~T,_~
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or Income of the property transferred; ............................................................. 0 0
b. retain the right to designate who shall use the property transferred pr Its Income; ................ 0 0
, 'c. retain ,a reversionary Interest; or............................................................................................. 0 0
d. receive the promise for life of ellher payments, benefits or care? ......................................... 0 0
2. If death occurred on or before December 12; 1982, did decedent within two years
preceding death transfer property without receiving adequate consideration? If death occurred
after December 12, 1982. did decedent transfer property within one year of death without
receiving adequate consideration? ..................................................................................,........... 0 0
3. Old decedent own an 'In trust to(' or payable upon death bank account or security
at his or her death? ......................................................................................................................0 0
4. Did decedent OWI1 an individual retirement account, annuity, or other non-probate property?.... 0 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN
;.'~~,l.o;'" t\.; ,;<:1;,'7'} ""~:"~';~ ;~~r~:}L:\'\~'tJo, !f!;-.Iff:r~~~f!~1H :~!~tt:!tt~f,~~i)~~(,j~ -r.'!J .f':~.~~~" Y;'l~~:r.-'!'";, . .:>~:..\01~'?0!,~"~r:.'{I_?,~IL~~'1, ,"~f;;r'r. ,'." ,..':; "(>-\ ~ ':.. '.,"rl~
72 P.S. ~9116 (a) (1.1) (I) provided for the reduction of the tax rate Imposed on the net value of transfers to or for the use ofthe
surviving spouse from 6% to 3% for dates of death on or after July 1, 1994 and before January 1. 1995,
72 P.S. ~9116 (a) (1.1) (II) provided for the reduction of the rate Imposed on the net value of transfers to or for the use of the surviving
spouse from 3% to 0% for dates of death on or after January 1, 1995. The statute does not exempt a transfer to a surviving spouse
from tax, and the statutory requirements for disclosure of assets and filing a tax return are stili applicable even If the surviving spouse
Is the only beneficiary.
FOR DATES OF DEATH ON OR AFTER JANUARY 1,1995. Please answer the following question by placing an 'x" In the
appropriate space. ..
Old the decedent create a trust or similar arrangement which Is solely for the surviving spouse's benefit for his or her entlre
IIfetlme? Yes 0 No 0
If you answered yes to the above question, the tax on the trust or similar arrangement 15 postponed until the death of the second
spouse. at which time it will be fully taxable at the rate(s) applicable to the remainder beneficiary(les). Enter the value of the trust on
Schedule J, Pari II, In order to remove it from the calculation of the tax due In this estate. You may wish to file Schedule 0 In order to
make the election available under Section 9113. If the election Is made. the trust or similar arrangement is taxed in the estate of the
first decedent spouse, the portion of the trust or similar arrangement which benefits the surviving spouse Is taxed at the zero tax rate,
and the remainder Is taxed at the rate(s) applicable to the remainder beneficiary(les). If you choose to make the election, you must
attach Schedule 0 to a timely-filed tax return. along with Schedule(s) K and/or M In order to show the apportionment of the trust or
similar arrangement between the surviving spouse and the remainder beneficlary(les).
1IlV""''''''I.fll*
COMMONWEAlTH Of PENNSYLVANIA
INHERITANCE TAX RETURN
I NT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC,
PERSONAL PROPERTY
ESTATE OF
FILE NUMBER
21-97-0745
BEALE, ANN R.
Include !he proceeds of l1tIgallon and !he date !he proceeds were ro<:elved by Ihe BS~I,. All property jolnlly-owned wlth the rlghl of survivorship must be dlsclo18d on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
Cash bequest from the Estate of Benjamin Rudolph
Beale - Date of Death: March 11, 1997
Amount to be received by the Estate of Ann R.
Beale in accordance with Agreement dated
November 15, 1999 under Item 2 b. - Modification
of Codicil.
2.
3.
4.
5.
6.
7.
(Copy of Agreement attache?).
Coins and paper money - appraised value
Cash in decedent's safe deposit box
l4K Yellow Gold Opal Earrings - appraised value
Household Goods - appraised'value
1987 Chevorlet Cavalier 4 door sedan - appraised value
Pre-War Martin 000 Guitar - specific bequest _
appraised value
Blue Cross/Blue Shield - major medical benefits
Custaner Service Center - subscription refund
Member Service Center - credit balance decedent's account
United Telephone - refund
Wolfe & Rice, Attorneys - refund of decedentls retainer
Dauo.hin Deposit Bank & Trust Co. - trust distribution check
dated 7/15/97, not cashed prior to death.
Collection of Books - ordinary publications
Literary property (manuscripts, proofs, writings, copyrights,
contracts) - decedent had no publications or writing
contracts in existence at the time of her death.
Dauphin Deposit Bank & Trust Company - Checking Account
No. 50106171 - Date of death balance, o.lus interest
Dauphin Deposit Bank & Trust Co. - Savings Account
No. 5312602124 - Date of death balance, plus interest
Mass Mutual Benefit Management Account No. 82-006226-1
date of death balance, plus interest
Hartford Variable Annuity - Beneficiary: Matthew M. Kuhn,
fiance - date of death value
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, Insert additional sheets of the same size)
$213,000.00
95.00
963.00
60.00
3,971.00'
800.00
700.00
491. 64
29.85
41. 91
6.81
299.53
120.77
100.00
No Value
,6,413.33
6,878.79
22,948.36
6,500.56
263,420.55
NUV 2 4 199
:,
,. .'
'.
CC(Q)~Y
fN RE: ESTATE OF BENJAMIN R.
BEALE, LATE OF TIlE BOROUGH OF
LEMOYNE, CUMBERl.AND COUNTY,
PE~SYL VANIA
~ TIlE COURT OF COMMON PLEAS OF
CUMBERLAND COUNfY.
PENNSYLVANIA
ORPHANS' C:OURT DIVISION
ESTATE NO. 1997..()Z95
AGRF.EMElSI
Tms AGREEMENT is made this L day of _ 1l.JJe....w ,1999, by and among ALLFJRST
BANK, successor to Dauphin Deposit Bank Uld Trust Company, Executor of the Will of Belljamin R. Beale;
;IOYCE J. JOHNSON, Exccuhi:. of the Will of Ann R. Beale; MATTHEW M. l\.'UHNi DONALD L.
BEALE; AARON R. BEAlE; and NOEL D. BEALE.
BACKGROUND
A. Benjamin R Beale ("Deceased") died OIl March II, 1997; his Will daled April 26, 1996
("Will") and Codicil dated October 22, 1996 ("Codicil") were duly probated beforc the Register of Wills of
Cumberland County; and Letters Testamentary were granted to Dallphin Deposit Bank and Tlost Campan)',
Estate No. 1997-0295 ("Estate");
B, The Codicil increased the cash beqoest in Article IX to Donald L. Beale from $92,500.00 to
$342,500.00 and the cash bequest in Article X to Ann R. BealE: from $50,000,00 to $300,000.00.
:l
C. AIm R, B~a1e died on August 13, 1997, her Wtll was probated bdOle the Register ofWiUs of
Cumberland County, and Lellers Testalllentmy wcrc granted to Joycc j, Johns{'n, E~tate No. 1998-0459.
D. Matthew M, Kuhn is th~ beneficiary of the rest, residue Imd remainder of the Estate of Ann R,
Beale,
E. Aaron R, Beale and Noel D, Beale, grandsons of thc Decedent, are the remainder benelicillrics
oi Dccedent' s Revocable Trust Agreement dated Febnlary 2, 1995 as am~nded ("Trust"),
F. Decedent's Will directs that the rest, residue and remainder of hl$ Estate be added to and
administered in accordance with thc Trust.
G. Donald L. Bealc filed a Petition for Citation Sur Appeal from Register ("petition") challenging
the validity of the Will, the Codicil, and a deed dated April 9, 1996 conveying an interest in 225 Hummel
Av~nue, Lemoyne, Pennsylvania. (0 Ann R. Beale (the "Deed"). alleging inter alia IUldue influence and lack
of testamentary capacity.
H. The parties have agreed to resolve all of the issues raised in the Petition and wish to set forth
their understandings in writing,
NOW THEREFORE, the parties hereto, intending to be legally bound, covenant and agree as
follows:
-.--;---- -;--. '
-~.__... -----
, .
I. :e.lI.~ The background is incorpomted herein
2. ~ndificatiol\~<ldIDl. The parties agree that the Codicil shall be modified and given only
p:utial effcct as follows:
a. The cash bequest to Donald L. Beale is reduced !'com $342,500.00 to $242,000.00;
b. The cash bequest to Ann R, Beale is reduced from S300,OOO.00 to $213,000.00;
c, $67,000,00 of the cilSh bequests otherwise distributable under the Codicil as
t\llJtlodified to Donald L, Beak and/or ArUl R. Beale shall be applied by the Executor toward payment of a
Promissory Note given by Donald L, Beale to the Decedent; and
d. Sl1,884,OO of the cash bequests otherwise distributable under the Codicil as
unmodified to Donald L, Beale and/or Ann R. Beale shall be paid by the Executor to Donald L. Beale as
reimbursement for his legal expenses ($11,814.00) and costs ($700.00) in conncction with the Petition and
lJ"eated as an expense of administration of Decedent's Estate.
3. Distrihution Under Miele xn nf Decedent'LJYill. Any sums not otherwise distributable
under the Codicils, by reason of the modifications pursuant to Paragraph 2, shall be distributed pursuant to
Alticle XII of Decedent's Will,
4. Comnletion of Administrat.illD, Allfirst Bank shall complete administration of the Decedent's
Estate in accordance with this Agreement, and its account aDd proposed distribution shall reflect rhe
"
tnll..tilications of the bequests in the Co~jeil and the r~ilUbtUsemcnt of expenses set fOl":h in Paragraph 2 and
th~ provisions of Paragraph 3,
5, Release oL.CJainll. Donald L. Beale, Matthew M. Kuhn, Alll'on R. Beale, aad Noel D. Beale,
(hereafter "Beneficiary Parties"). hereby fOcel'er and /illly release, compromlse, senle !lnd discbarge any and
all claims, demands, actions, or lcauses of actions, legal or equitable, absolute or cDntingent, vested or
hereafter 10 accrue, including all of the claims asserted in the Petition or Response. thereto, which allY oi
thern may have with respect to the ,'didity of the Will, Codicil and the Deed.
6. "",,,,,,,,,,,,,,. Th. BonO""'" p,,~ ..., '" ,,,,,,,,,,,if, ~d ,.Id .~h o<h" -,," I
~lgainsl all liability, loss and expense, including but not limited to costs and counsel fees wbich they might
otherwise incur (except as otherwise specified herein) in connection with the adlIlinistrati:ln of the Estate and
distribution in liccoldance with tllis Agreement; agree not to "bj~ct to or challenge the Executor's First and
Hnsl ACCOWlt and Statement of Distribution in the ,Estate or any accounting and/or statement of distribution
with respect to the Trust rdlectin~ administration ofthe Estate carried out in accordance with this Agreemt'm;
w.\ agree to indemuify and hold Allfirst Bank and Joyce J. Johnson hannlcss against all liability, loss ~U1d
expense, including but not limited to costs and counsel fees either may incur in cOlmection witl1
adminisl'ration of the Estale or Trust and distribution c,arded ou1; in accordance herewith.
'.
7. Ancil1ary.~. These provisions shall epply to any ancillll1}' executor or
administrator in connection with any ancillary administration of the Estale.
8. loind~r of Remainder Beneficiari.eJl. A:.ron R. Beale and Noel D. Beale Join in the execution
of this Agreement in their capacities as remainder beneficiaries of the Trust,
9. Rele8..~es, The Beneficiary PaIties agree to execute such additional releases as the Executor
,
I
I
I
I
!
i
\
\
i
I
I
I
I
,
\
'I
"
.r
!
!\
Y
I
t
I
i
I
I
i
;
,
and/or Executrix may reasonably submit to tI1em in ord~r to confirm the discharge of any liability to the
Beneficiary parties in connection with the administration of the Estate, the Trust, and/or the Estate of Ann R,
Beale.
10. Counterparts, This Agreementll1ay be executed simultaneously in several counterparts, each
of which shall be deemed an original part which. when all parties bave executed a counterpart, together shall
constitute one and the same instrument.
10. Agteement Binding, This Agreement shall inure to the benefit of and bind the parties hereto,
their respective heirs. successors and assigns.
_.....u.~p..ww 10: 2t,FA1
~ OU'tO U
COMMONWEAL 111 OF PEl'l1'4S\'L\'ANlA
COUNTY OF ~
155
Onlhistllv ~,5;:L Q'YQf~999. before me, the IlnQtll'signed office!, pel10nally
appeared KURT R. WJ'LLlAM~, who G(:lmo\llledg~ himself to be a "frust Offi~ or Allfbt Bank. and that
he III such Trust Ollicel', being IIIlthorizell to do ~o, .~OO'.1led tile focoiQina i11l11ument inlmded for the
purpose. therein contained by ,igning tho nill'lle of tile eo:-porAtio~ by himself liS 1"nl9t Officer.
IN WlTNES,,'l WHEREOf. I hcmll1to set my h:il'ld and o~1i;ia1 seil!,
.DA..1<V\ooA- ~
NotatyPublic ~~
My Commission E~piru
NOTARIAL SEAL
DIANNE LENIG, Notary Public
Lemoyne Borough Cumberland Co.
My Commission Expires Dec. 2\, 2001
COMMONWEAL TII OF 'PEN!'lSYL V AJ'aA ;
:ss
COUNTY or CUMBERLAND
On thi. the ,~A dayo!~1999. ".fore me, the undersigned offic"", paso::eUy
'Ppe'm JOYCE J. JOHNSO~, l.1lown to llle (or satisfllClorily proven) to be lite p::rson wh_ lI&lIIe is
SUb5Cribed to Ille \\ithin inIItrwncn~ and acknowledged that !l.'le "",ecut.d the same for the ?wposes therein
contained.
IN WITNESS WHEREOF,l h",eunlo sct m)' hallG lIlId official seal.
:--Q..~. ~~ ~
Notal)' P1.lblie 3
My Cor.U:JJssion EXpires:
NOTARIAL SEAL
DIANNE LENIG, Notary Public
Lcmoyne Borough Cumberland Co.
I My Commissio.n~~lies Dec. 21, 2001
.. ...',..-..~'..'"..,""'..._._.._..,,'...
,UI.~~!." .1.0:" t.^.1
@OO~/OIO
, .'..
V,.(U:>IMJ:l
COUNTY OF fA I (l. rAt
On thu lhe I ~ ~ day qf ),/OV. , 1999, bcwre mc. t.'1e undmigned officer. personally
appeared DONALD IA. BEALE, known to me (or sali.~loril~ proven) to be lhe pmon whoso name is
subsrnbed to the within inSttUmCtlI 2.Ild aekllOWlcdged that he cXII.alled the sarr.e for the purposes therein
contaimd.
STATE OF
:ss
IN WITNESS WHEREOF, I hi:reunto let my hlllld Ill1d ol'llcialeeal,
Q~,fd -'~~.
NoW)' Public ~J . /
My CIlnunission Expires: 1 s t ( 0 ]
COMMONWEALTH OFPENNSYJ.,V ANlA
:ss
COUNTY OF CUMBEIU..A.'ID
On Ibi. the ?#' day of \J?~I , 1999, before me, the wW~igned oificOl', PCl'SOlI.ny
appe<R'cd MA'l'THEW M. KVIi~. known to me (or salisfaclonl)' ploven) to be 1M pmon who5':' D:IIlle is
iubsciibC14 lll' tbe witbin wtl'lllllcnt and aCknowledgc thlll he executed the SlllM for tile plllpOlles thc~in
contlLined.
NOTAR~SEAL ..
lIAIIUaW.MILKES,NaTARYP08IJC "
=RO,CUMBEllLANOCO. PA I
ON EXPIRES JULY~. 2002
~
/t,Jd-/3
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
~ISIURg, PA 171Z8-0601
IU.IJ41U,,, fI'-"'
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
/
*'
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
Raco" . -f
Rt..: . -., DATE
.,' ;
ESTATE OF
DATE OF DEATH
'00 FEB 22 P:?:3' FILE NUMBER
COUNTY
ACN
EDMUND G MYERS
JOHNSON ETAL
PO BOX 109
LEMOYNE
02-21-2000
BEALE
08-13-1997
21 97-0745
CUMBERLAND
101
ANN
R
ESQ
Clw,
GUlntk. .
PA 17043
.,.1
."'.
A.ount R..ltt.d
p,",
(
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REY:isW-EX-AFi;-[i1f':99T"iicificnij1-YNHEifiiiitfcn'A'X-APPRAiSEjjEiiT~--Ai.LOWAifcE-oi-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ANN R FILE NO. 21 97-0745 ACN 101
ESTATE OF BEALE
DATE 02-21-2000
TAX RETURN WAS: ( I ACCEPTED AS FILED
( XI CHANGED SEE ATTACHED NOTICE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN NO. 01
1. R..l Est.t. (Schedul. AI (11
2. Stocks _ Bonds (Schedul. BI (21
3. Closely Held Stock/P.rtn.rship Interost (Sch.dul. CI (31
4. "ortgages/Notos Receivable (Schedule DJ (4)
S. C8shlBank Deposits/Hisc. Personal Property (Schedule E) (5)
6. Jointly Owned P,..,...rty (Schedul. F I (6 I
7. Transfers (Schedule G) (7)
8. Total Assets
NOTE: To insure proper
credit to your acCOW'It I
subtli t tt.. upper portion
of this for. with your
t.x p.YMnt.
.00
.00
.00
.00
.00
.00
.00
(81
.00
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral ExPenses/Adm. Costs/Hisc. Expenses (Schedule H) (9)
10. DebtslHortgage Liabilitias/Liens (Schedule I) (101
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule ~)
14. N.t V.lu. of Estat. Subject to Tax
.00
.00
(Ill
1121
1131
1141
00
.00
.00
450,529.31
If an assessment was issued previously, lines 14, IS and/or 16, 17 and 18 will
reflect figures that include the total of Abb returns assessed to date.
ASSESSMENT OF TAX:
15. ABOunt of Line 14 at Spousal rat. (151
16. Aaount of Line 14 taxebl. at Lineal/Cl..s A rete (161
17. ~ount of Line 14 taxable at Collateral/Class Brat. (17)
18. Principal Tax Due
NOTE:
.00 X .00=
.00 X .06=
450,529.31 X .15=
(18)
.00
.00
67,579.40
67,579.40
TAX CREDITS:
PAYHENT
DATE
11-12-1997
05-08-1998
DISCOUNT ('1
INTEREST/PEN PAID (-I
2,631.58
.00
RECEIPT
NUHBER
AA242461
AA270065
AHOUNT PAID
50,000.00
14,947.82
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
67,579.40
.00
.00
.00
. IF PAID AFTlR DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
I IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
J;!\l<<-l;"~'....."~,."..',"",::""....,,.. "
"
RESERVATI"'" E.t.t.. .f _to dylno on ., ....,. _, 12, 1.82 -- If ... futu'. Int.,..t In tho ..t.t. Is t,...f."'"
In ......s1on ., "'l._nt t. CI... 8 (..II.t.,.I) ....flcl.d.. .f ... _......t .ft., ... ...I,.tlon .f ... ..t.t. ..,
llfo ., .., ...", ... ~lth ho,.b. ...,..s1. ,...ev.. ... dght t. _,.Is. and ...... t,...for I_dt.... Tax.'
at ttM IllMful e1ftn B (collateral) rate on 81'1)' such future interest.
PIlRf'(lSE IF
NOTICE:
10 fulfUl the r&qUlr..nts of Section 2140 of tho Inheritance and Estate Tax Act, Act 21 of 1995. (72 P.S.
Section 9140).
Oot_ _ t09 ..,tlon .f thl. Hotlc. .nd ._It with .ou' p..-t t. ... h.lst., .f Wills pdnt'" on ... ,.v.,.. .1....
--Make cMck or IIOMY order payable to: REGISTER OF HILLS, AGENT
A ,.fund .f . t/IX c,...lt, which was not ,.....t.d .n ... T.x ..turn, ... .. ,.......d b. c_l.tlno '" ....II..tlon
f.' ..fund .f ........lv..l. I_dt..c. and ..tat. T.x. (.EV-13131. Appll..tlon..co .v.II..1. .t ... Offl..
of the Register of WlllS, MY of tho 23 RevlImHI District OffiCIIS, or by calling the special 2it-hour
",suo,ln. ..,vie. .....'s fo' fo'" .,d.,I... In p.nn..lvanl. 1_800-362-2050, out.ldo p.nn..lv..l. and within
local HarrisbUrg area (717) 787-8094, Services for t8lCpaYIlr"S with special hearing and speaking needs:
1-800-447-3020 (ll only).
An. p.rty In Int.,..t not satlsflad with ... ..peal....nt, .lIow.nc. ., dls.llow"" .f doductlons, ., .s.......,t
.f t.x (Includl.. discount ., Int.,..t) .s .hoWn on thl. H.tlc. .u.t .bl.ct within .Ixt. (60) do.s .f ,...Ipt .f
this Notice by:
--..r1ttllrl protest to the PA Departllent of Revenue, Board of Appe81s, Dopt. 281021, Harrisburg, PI.
--election to have the ~tt.r deter.ioed at audit of the account of the personal representative,
--appeal to the Orphans' Court.
17128-1021,
OR
OR
PAVItEHT.
REFUND(CRl:
OBJECTIONS:
ADHIH
ISTRATIYE
CORRECTIONS:
Factual errors discovered on this assasSIIent should be addressed in writing to: PA Depart.ent of Revenue,
Bureau of Individual Taxes, ATTH: Post Assessaant Review Unit, Dept. 280601, Harrisburg, PA 17128-0601
PhOne (717) 787-6505. See page 5 of the booklet ~lnstructions for Inheritance Tax Return for 8 Residant
Decedent.. (REY-150l) for an explanation of adllinistrativelY correctable errors.
If ... tax d... Is paid within thco. (3) ..I.nd.' aonth. .ft., tho d.codont'. d..th, . flv. ..,cont (s:<) discount .f
the tax paid isallowad.
Tho IS:< tax ....s.. non-p.rtlclp.tlon ..n.lt. I. co.put.d .n tho tot.1 .f tho t.. and Int.,..t ....ssod, and not
p.ld ..f." Janus,. 18, 1"6, tho fl,.t d.y .fto' tho .nd .f tho t.x .....ty ..,Iod, This non-p.,tlclp.tlon
....It. Is .....1..1. In tho s... ....., .nd In tho tho s... tl.. po,l.d .. .OU would .....1 tho t.. and Int.,.st
that has been assosSOd as indicated on this notice.
Int.,.st is ....,..d ...Innl.. with fl"t d.. .f d.II""......, ., nino (., ...ths and ono tIl do. f'" - dot. .f
_th, t. tho dot. .f p...ont, T.... which ...... d.llnquont ..fo," Janu." 1, 1.8' ..., Int.,..t .t ... ,.t. .f
six (6:() ..,c",t ..' annuo c.lcul.t.d .t . d.lI. ,.t. of .000164. All t.xo. which ..c... doll_t .n and .ft.,
Janus" 1, 1.82 will".' Int.,o.t .t . ,.t. which will v." f," cal.nd., ..., to c.l.nd., ..., with that r.t.
~d by the PA DePart.ent of Revenue. The applicable interest rates for 1982 through 2000 are:
"!!!! Interlilst Rate DailY Interest Factor :!!!! Interest Rate Dally InterGlSt Factor
1982 2UX .000548 19&8-1991 llX .000301
1983 16X .000438 1992 .~ .000247
I'" llX .000301 1993-1994 TI. .000192
1985 1'" .000356 1995-1998 .~ .000247
"86 lOX .000274 1999 TI. .000192
1987 .~ .000247 2000 8X .000219
__Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Hotlce issued after the tax be~es delinquent will reflect en interest calcuiation to fifteen (15) days
beYond the date of the a,sossunt. If paY1Hlllt is .ade after the intere,t cOllpotatlon date shown on the
Notice, additional interest .ust be calculated.
DISCQUHT:
PENALTY:
INTEREST:
\
~e.V<1470V.8-")
'*
INHERITANCE TAX
EXPLANATION
OF CHANGES
COMMONWEALTH O~ PENNSVLVANIA
OEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
OEPT, 280801
HARRISBURG PA '7128.0801
DECEDENrS NAME
FILE NUMBER
BEALE, ANN R.
2197-0745
101
,
REVIEWED BY
Larry Szollosy
ACN
SCHEDULE ITEM
NO.
EXPLANATION OF CHANGES
This notice is Issued In response to the Supplemental Inheritance Tax Return flied with the
CUMBERLAND County Register of Wii/s' Office on 12-23-1999. Please be advised that as
allltema reported on this return have been previously reported and assessed by this
Department on the original return. The information on this return will be reviewed by the
Post Assessment Review Unit for possible administrative correction to the Notice of
Appraisement, Allowance or Disallowance of Debts and Deductions and Assessment of
Tax issued on 07-27-1998. That unit will contact you in the near future concerning the
outcome of their reviews. However, any objections you may have to this assessment
should be formally addressed in writing to the Post Assessment Review Unit. Please note
that this notice is issued for dministrative purposes only and does not reopen the
referenced assessment to appeal as provided by Section 9186 of the Pennsylvania
Inheritance and Estate Tax Act of 1995.
ROW
Page 1
"
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
RECORD ADJUSTMENT
t,i DATE 02-17-2000
p' . ESTATE OF BEALE ANN R
DATE OF DEATH 08-13-1997
FILE NUMBER 21 97-0745
1\ 8 :0 \ COUNTY CUMBERLAND
ACN 101
".irt \ A.aunt. Remitted )
f'A (
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
HOTE: To insuro proper credit to your eccount, subait the upper portion of this form with your tex pa~nt.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ...
FiEfV:iSii3-iflf-AFii-iiif:99ii-----iii-i:tiHERifTANi:i-Yiii-FiEfCORii-AD:JUSYtiiNY--i;-----------------------------
1. Real Estate (Schedule A)
2. stocks and Bonds (Schedule B)
3. CloselY Held stock/partnership Interest. ISchedula C)
4. Hortgages/Hotes Receivable (Schedule OJ
5. Cash/B.nk Deposlts/Hisco Personal Property (Schedule E)
6. JointlY OWned Property (Schedule F)
7. TrlKlsfers (Schedule G)
8. Totsl Assets
DEDUCTIONS AND EXEMPTIONS:
9. Funerel EXPenses/Administrative Costs/
Hlse.llen.aus Expen9ls (Schedule H)
Debts/Hortgage Liabilities/Liens (Schedule I)
Total Deductions
Net Value of Tax Raturn
Charlteble/GoVenNBant81 Bequests; Non-elected 9113 Trusts
Net. Value of Estate subject to Tax
!S-d()/ - /3
BUREAU OF INDIVIDUAL TAXES
INHERITANCe TAX DlVISION
DEPT. Ze060l
HARRlSeUW~, PA Itlze-0601
RecnlC"
RC(
'00
liAR -9
EDMUND G MVERS ESQ
JOHNSON ETAL
PO BOX 109
LEMOVNE
CIt;;1l
PA 17oo.JlTlb,o
ESTATE OF BEALE
ANN
R FILE NO. 21 97-0745
ADJUSTHENT BASED ON'
VALUE OF ESTATE:
10.
11.
12.
13.
14.
TAX:
15. /uIIOunt of Line 14 at Spousal rete
16. Amount of Line 14 taxable at Lineal/Class A rat.
17. AaoUnt of Line 14 taxable at Collateral/Class B rete
18. Principal Tax Due
TAX CREDITS:
PAYMENT
DATE
RECEIPT
NUHBER
DISCOUNT I.)
INTEREST/PEN PAID (-I
11-12-1997
05-08-1998
AA242461
AA270065
2,631.58
.00
c....
*
UV_lnsu,,'CU-tt)
ACN 101
DATE
02-17-2000
98.000.00
25.758.44
.00
.00
-
263.420.55
4.605.73
.00
(8)
(1)
(2)
(3)
(4)
IS)
(6)
(7)
391,784.72
(9)
(10)
27,007.00
1,248.41
(11)
(12)
(13)
\14J
28.255.41
363.529.31
.00
363.529.31
(Schedule J)
(15)
(16)
(17)
.OOK.OO=
. 00 K. 06 =
363.529.31 K.15 =
(18)
.00
.00
54.529.40
54.529.40
AMOUNT PAID
50.000.00
14,947.82
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
67 579.40
13 050.00CR
.00
13,050.00CR
. IF PAID AFTER DATE INDICATED, SEE REVERSE I IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REqUIRED.
FOR CALCULATIDN OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORN FDR INSTRUCTIONS.)
PAVMEIlT:
REFUND(CR);
REPLV
TO:
OXSCOlIfT:
PENALTY:
INTEREST:
~
U.tach tM top portion of thls Mot1~ end ..mit with your paYlNtOt _de payable to the ne-. and add.....
printed on the r.v.r.. side.
~_ Kek. check or MlMIY order peyllble to: REGISTER OF WILLS, AGENT.
A refund of e tax credit, .....ich was not requested on the Tux Return, .ey bII reque$ted by capl.Ung en
"Application for Rgfund of p""Ylvenla Inheritance and Estate Tax" (REV-1313). Applications are available lit
the OffiCII of the Rltgiste.. of WUb, any of the 23 Revenue District Offices or frOll the Deparbtent's 24-hour
answering .ervice ~rs for fo~s ordarlng: In PennsYlvania 1-800-362-2050, outside PennSYlvania and
within local Harrisburg ar.. (717) 787-8094, Services for taxpayers with special hearing end speaking
needs: 1-800-447-3020 CTT only).
Questions regarding errors contained on this notica should be addressed to: PA o.P81"tMnt of RavlInue, Bura....
of Individual Taxas, ATTN: Post Ass.ssaent Revi... Unit, Dept. 280601, HarriSburg, PA 17128-0601, Phone
(717) 787-6505.
If any tax dull is peid within three (3) celendar .onths ofter the dllclldent"s death, a five porcent (5X) discount
of the tax paid is allowed.
The 1S% tax ~sty non-participation penalty is c~ted on the total of tho tax and interest assessed, and not
paid before January 18, 1996, the first day aftllr the end of thll tax &anQsty period.
Interest is charged beginning with first day of delinquency or nino (9) .onths and one (1) day fr~ the dato of
death to the date of pa)'ll8nt. Taxes which be<:M8 dellnquent before JaRUl!lry 1, 1982 bear intorest at the ratcl of
six (6X) percent por anRl8 calculated at 8 dally rate of .000164. All taxes which beC8lle dollnqUOflt on and after
January 1, 1982 will bear intorost at a rate which will vary fro. calondar year to calendar year with that rate
announced by tho PA o.parUent of Revenuo. The 8Ppllcablo interest rat.s for 1982 through 2000 are:
Year Interest Rate Dally Interest Factor Year Interost Rate Dally Interest Factor
1982 lOX .000548 1988-1991 117- .000301
1983 16Z .000438 199' 97- .000247
1904 11X .000301 1993-1994 T< .000192
1985 13:< .01'10356 1995-1998 97- .000247
1986 107- .000274 1999 T< .000192
1987 9Z .000247 2000 87- .000219
--Intorest i. calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X HOHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
M-Any Not!ce i..ued after tho tax beCo.os delinquent will reflect an intorest calculation to fift..n (15) days
beyond the date of thM aSS8s...nt. If pa~nt is .ade after tho interest c~tation dato .hown on tho
Notice, additional intorest .ust be calculated.
-~""'>I-"""""'"'.""''''''''.'''''~''.''''''''~-''..'''
\
RI!V.1470VCes-'1)
.
COM/.lQNWEi\i}H OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT,280801
HARRISBUR PA 17128.0001
DECEDENrS NAME
REVIEWED BY
SCHEDULE ITEM
NO.
~:':~111,:iE;:~:~'~~~ ,
INHERITANCE TAX
EXPLANATION
OF CHANGES
ANN BEAL
FILE NUMBER
JACKIE SCHULZE
2197-0745
101
ACN
EXPLANATION OF CHANGES
SCHEDULE E HAS BEEN ADJUSTED PER THE SUPPLEMENTAL RETURN. PER
AGREEMENT OF NOVEMBER 15,1999.
:"~>",""';.h'_"'_':'<"","'^.'""'"
ROW
Page 1
\
.,
/S:cJo/ - /3
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIYISION
DEPT. 280601
HARRISBURG, PA 17128-0601
ROCeV,
Ru ,,'
01
L
EDMUND G MYERS
JOHNSON ETAL
PO BOX 109
LEMOYNE
'00 11AR 28
DATE
ESTATE OF
DATE OF DEATH
1\ 9 '35 FILE NUMBER
. . COUNTY
ACN
ESQ
.'
,J,..'.
~
I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
CIE:fi'.
PA 17~liIll1b".
'. f't\
G
*
'U-IUI","(II-"I
03-13-2000
BEALE
08-13-1997
21 97-0745
CUMBERLAND
101
Allount R..lltt.d
ANN
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax pay.ent.
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiifv=iiiiWEx--AFjq'iif=99r-----iiiiii-iNifERI'1:iiNcrfA'if-iii'iifEiiifN'f-iiF-Aifciiiiiff--iiJiii---------------------
ESTATE OF BEALE ANN R FILE NO. 21 97-0745 ACN 101 DATE 03-13-2000
THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NANED ESTATE. SHOWN BELOW
IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 02-16-2000
P R I NCI PAL TAX DU E : '____'....__'___..,__,___......_.__"'..____.._.....,..,...._..__,..,""''''''__''__..'_'''''_'
54,529.40
PAYMENTS (TAX CREDHS) :
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INJEREST/PEN PAID (-)
11-12-1997 AA242461 2,631.58 50,000.00
05-08-1998 AA270065 .00 14,947.82
02-25-2000 REFUND .00 13,050.00-
TOTAL TAX CREDIT
54,529.40
BALANCE OF TAX DUE
TOTAL DUE
INTEREST AND PEN.
.00
.00
.00
· IF PAID AFTER THIS DATE, SEE REVERSE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI,
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. )
R
i
L__
i .
1...--
PAYHEKTt
Dot.ch tho top portion of this Hotl.. and subalt .Ith .our p....nt .... p...bl. to tho n... .nd .ddr.ss
printed on the reverse sAtM.
If RESIDENT DECEDENT .ake check or .oney order payable to: REGISTER OF WILLS, AGENT.
II HOH-RESIOEHT DECEDENT .ak. .h.ck or .cne. ord.r p..obl. to: C0ltl10NllEALTH OF PENNSYLVANIA.
REFUMO (eA): A r.fund of . t.x .r.dlt, .hl.h ..s not r..u.st.d on tho T.x R.turn, ... b. r..uOSt.d b. co.pl.tln. .n
"AppUcaUon for R.fund of p.Ms.lv.nl. Inh.r1tan.. .nd Est.to T.x" (REV-13l3l. Appll..Uons .r. .v.U.bl. .t
thO Off I.. of tho R..lst.r of Wills, .ny of tho " R.v.nu. Dlstrl.t Dffl..s or froo tho D.p.rt..nt's Z4-hour
.ns..rlng s.rvl.. nUlb.rs for for.s ord.rln.: In p.nnsylv.nl. 1-800-'6Z-Z050, outsld. P.nnsylv.nl. and
~ithin local HarrisbUrg area (717) 7&7~&094, Services for ta~payer$ ~ith special hearing and speaking
needs: 1-800-447~3020 (TT only).
REPLY TO:
Qu.stlons r...rdln. .rrors .ont.ln.d on this notlc. should b. .ddr.ss.d to: ps D.p.rt..nt of R.v.nu., Our..u
of Individual Taxes, ATTN: Post Assess.ent Review Unit, Dept. 280601, HarriSburg, PA 17128.0601, phone
(7171 787-6505.
If .ny t.x duo Is p.ld .lthln thr.. (3) ..I.nd.r .onths .ft.r tho d.c.d.nt's d..th, . flv. p.r..nt (51.) dls.ount
of the tax paid is allowed.
Th. 15Yo t.x ....sty non-p.rtl.lpatlon ponalty Is .o.put.d on tho totol of tho t.x .nd Int.r.st .ss.ss.d, and not
paid before January 18, 1996, the first day after the end of the ta~ a.nesty period.
DISCOUNT:
PENALTY:
INTEREST:
Int.r.st Is .h.r..d b..lnnln9 .Ith first d.. of d.lln.u.n.y, or nln. (0) .onths .nd ono (1) d.y fro. tho d.t. of
d..th, to tho d.t. of p.y..nt. T.x.s .hl.h b..... d.lln.u.nt b.for. J.nu.ry I, 108' b..r lnt.r.st .t tho r.t. of
six (6Yo) por..nt p.r .nnu. ..,.ul.t.d .t . d.lly r.t. of .000164. All t.x.s .hl.h b..... d.lln.u.nt on .nd .ft.r
Janu.ry 1, 100Z viII b..r lnt.r.st .t . r.t. .hlch .lll v.ry froo ..1.nd.r y..r to c.,.nd.r y..r .Ith th.t r.t.
announced by the PA Dapart.ant of Revenue. The applicable interest rates for 1982 through 2000 are:
Year Interest Rato Daily Interest Factor Vear Interest Rate Daily Interest Factor
-
1982 zoZ .000548 1988-1991 llZ .000301
1983 167- .000438 1992 9Z .000247
1984 llZ .000301 1993-1994 n .000192
1985 137- .000356 1995-1998 97- .000247
1986 10% .000274 1999 n .000192
1987 97- .000247 2000 87- .000219
!NTEREST = BALANCE OF TAX UNPAIO X NUNBER OF DAYS OELINQUENT X DAILY INTEREST FACTOR
.-lnterest is calculated as follows:
--Any Hotl.. Issu.d .ft.r tho t.x b..o..S d.'ln.u.nt .lll r.fl..t .n lnt.r.st ..,.ul.tlon to flft..n (15' d.ys
b.yond tho d.t. of tho ...."..nt. II p.y..nt Is ..d. .ft.r tho lnt.rost .o.putatlon d.t. shown on tho
Notice, additional interest .ust be calculated.
PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF
THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM
YEARLY UNTIL COMPLETION.
STATUS REPORT UNDER RULE 6.12
Name of Decedent: ANN R. BEALE
Date of Death: August 13.1997
Will No,: 21-97-0745 Admin No,:
Pursuant to Rule 6.12 of the Supreme Court Orphans' CDUrt Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes X No
2.
If the answer is ND, state when the personal representative reasonably
believes that the administratiDn will be complete:.
If the answer to No, 1 is yes, state the fDllowing:
A, Did the personal representative file a final aCCDunt with the Court?
Yes No X
The separate Orphans' Court No, (if any) fDr the personal
representative's account is:,
Did the persDnal representative state an aCCDunt informally to the
parties in interest? Yes X No
Copies of receipts, releases, joinders and approvals of formal or
informal aCCDunts may be filed with the Clerk of the Orphans'
Court and may be attached tD this report.
(i~y~~
Signature
Edmund G, Myers, Esq,
Johnson. Duffie, Stewart & Weidner
301 Market Street, P.O. Box 109
LemDyne, PA 17043-0109
Address
3.
B.
C,
D.
Date:
6/7/00
~:i .;::..'l
>t
4..,.. ~
.,......
.-
......,.
0,
I
~
::s
.,
171'1\ 761-4540
Telephone No,
rj u'
rJ!a:
~ {d
.,.._ 1-
.ll ==
- ~
:,)c;
B
Capacity:
Personal Representative
X Counsel for PersDnal Representative
.- -', ,,- ......'
'. .
TO
Register of Wills Office
Cumberland County Courthouse
1 Courthouse Square
FROM
JOHNSON, DUFFIE, STEWART & WEIDNER
Attorneys at Law
P.O. Box 109
LEMOYNE. PA 17043
Carlisle, PA 17013-3387
SUBJECT: Estate of Ann R. Beale
FOLD +
21-97-0745
DATE: 5/8/98
Enclosed for filing in the above-captioned Estate are the following:
1. Original Inventory.
2. ~Original and copy of Inheritance Tax Return.
3. Check in the amount of $25.00, filing charges.
,4. Check in the amount of $14,947.82, Inheritance Tax balance.
PLEASE REPLY TO
.
SIGNED
Edmund G. M ers
csh
REPLY.
DATE:
SIGNED
Reorder Ilem NF270 Grayarc, P,O, Bol( 2944, Hanford, CT 061 04.2944
QEGI.196', P,imedioUSA THIS COpy FOR PERSON ADDRESSED
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