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HomeMy WebLinkAbout97-00783 ~I, l.. I' ,,1,1 il! ~(J~~9_ llIMM()II':!~"lIYMII^ III 1'/lIOMI Nt 111 HI III fH11 I:! I'! ,l1'l~'~ll IIA!HW I Ilil/ !'AlIl"l"fJj ill ,[ 1,1 tjf 'itjA/JI (I A'd j(fltif Mill 1.1101111 INillAl1 uw it blan. llkld ~) \~t'ilI~hl",ojI[l'\ I rl I!:':, .. ;:)i)~'f" REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT I I!, ('l l\ "-, I , I 'l;t-~'-iAi-rirtiJ!lilf Ij,.t.ii\I'";i"' -------.,~~_._.--.__oAlfOilifAiit---- I , '1/ I It /1 r REGISTER OF WII.LS '),,_ 'I,~I_~:L:') iJ-.'L',' (\, /(\/\ '1'1 1;1 Al'!'i iEllli II ~,Ulll{l'liWI 1>l'iill"Ui UMIl (I Asf. FillS!. AUllMI{JIlL{: INITIAl) SO(;I....I 5r:(.Ullllv NUWIf.fl 1\ I V' PILE NUMBER ~), I COOHfVCooe o '/ J \ mJt.l ~.~.. q 'I " - t O.A,!rOrWlilH () 11 I!JI TIllS RETURN ~ FILED IN OlIPllCAT~ WITH rHE-' l,;] I nr~lilli\1 HO\IJrn [] 2 Suppjol1lontal Rahim 0 J Remalndo( Return IdJt~ 01 (k\~th pr\()/ ~l 1213 fit) [ :\ ~ tll1lllfHl r!llllllJ [J 4a. FilMa Interest Compromi$e (d,tleQfdllalhaftelll'\2.81) [J 5. Faderi'll Eslale Tax Retlan Required l< I n [)U(lJ{lfl!\t [lilJ(1 TIl!\\i:Illl IAtI/II:ll (l)jIY 01 I'I'II! C] ], Decodont Malntalnod a Living Trllst (Moch COllJ of 11U1\) 8. Total NlImbEll of SRfa OODOSit Boxes I I II Lit~lnll{i!l rrOl:(Jod!l RllclJlvml [J 10 Spousal POl/erty CrOOil (dalftofdea!n~twftlln 12 .)t.9\ and I.J'95) 011. Election 10 tax under Sec. 9113(A) (Anach 5ch (11 - fHiifllilcTION MUST BE COMPLETED: ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: flAil! ~.'m. ,.----.-.-"'".---...~-" ----.- COMPL(HI,'AllINGADORfS$ )1 I\Ukl..r\J!jhoY{.8~_____. (!II,- IJi:or'/'- 111(c~, c; I"iiiMiimi ilf Ari"~~,lIi.\'I"- . . '\ (''1_ I ('/. "I ~; ,- V{ILi. H/\UIC\ c;c'ki.' . 1-\ . -~_....~._-~_........-'-------"--"-~~^'~------' , \' '.L)l'l('''''' ( 'vV nj!("i"I,,'(,jilffiJi:l\irll- , 'It" I ((if -I,:, =:;;~,...=I Rflill E!ltllicl (Schodult'l AI 2 Stocks llnd Bonds (Schtldule B) (2) 3 Clo",ly Hold Corpor.'ion,P,rtnenlhlp or Solo.Proprietonlnlp (3) z o 5 E ~ ~ 4 Mortg.go, & Noto, Rocelvable (Schedulo D) !l Cash, Bank Deposits & Miscellaneous Personal Property (Sehodulo E) 6 ,jolnlly OWnod Proporty (Schodule FI ] Inler.Vlvo!l Transfers & Miscellaneous Non,Probate Property (Schedule Gor L) A Toljl Oro.. A...t.ltot.,lino, 1.7) (1) f,}' fl. fllMrnl EXp(lnsos & Admlnlslralive Costs (Schedule H) III Dobis 01 Dor~donl, Mortgailo liabllilles, & lions (Schedule I) 1 I 101.1 Dld.ellon./lnlal L1no, 9 & (0) 1-". (41 (5) (6) (7) , l3 ,Lj,;)..;' 4 q (9) (10) (8) , I ~~ I ,'-/ ,';., !,- . '-/ Ii 'S I ~;- (il :)-' '3 '7 l ,'1 3 '~, ,ie' it, 12 N.t VII.. 01 E.IIII (line 8 minus Lino I II 13. Charllahlo And Governmontal Requests/Sec 911:i Tru!ltslor whiCh an elecllon to lax has not been m.deISehndule,J) (11) (12) (13) /'1, ." (~ " ,~) } I . () ::5 '-1.4(., ,1;),'-1,1:1, , i ,'1.. '-I , I ,'), ,{ . Lf Ifl '),44'147 - 'I, "f'-f rl ,Y "/ Ig CIlELK IIIRI If YOU ^Rf Rf QUrSTING ^ REf UNO qr ^N OVf RPAVMrNT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < lJl1dllr peoltl1ies 01 pIlfl1lfY. I (lod;lro Ihilll havo 6xilIllinod !t1I~ (IlMIl, including accompanying scl1Odufos and ~t,llern(jllls, llnd 101M 0051 (If my knowfodge aM 0011(11, Ilis lIllO, COIrf'C1 and comlllale oo::lfl/il!IOI1 nf Pfepault Olllflf l!JJfi.!!lYJ~JjlQ!ll!.rgJlf~lliltd!!~olsba..>odol1a1I)!l~il!~l!'Jloroo<lfo(has IlnY~~ill'___~_ ------., SIGNATURE OF PERSON RESPONSIBLE FOR FiliNG REIURN ADDRESS SI~Nfr,iR~'~rp~~:/,:~~~~ THA~i~V~'Ri;~~ftfivE (i'l(~AOO::~~ ~I.c/I,L i J.:.0:.c,.._ ( ~L.J.:L!~____ , ' . 14 NIl V.I.. Subject to IIIIUne 12 minus lino 13) (141 15 AlllounTof line 14 la~abl6 ~ alth~5po(j!\allax rate , , r-.) 1\ x ,0 (151 Soe Instructions on reVl)flle sldo for appllcablo percentage 16 Amount of lino 14 t"~able ), 'l , 'I ~g at6%rrtle I \ ,'1.. '-1 l.- x .06 (16) f"~ 17 Amounlof IIno 1~ taxabie at Hi%mlo x 15 (171 0 IA. Tu Out (161 DATE /il./d:(,c,.!o, /'1' y 7. DATE Decedent's Complete Addre.s: STR[[11DORfSS -----\._---- , vII.lt,II' 1-(' ,I ,:, i I ,II ill) I'I~ V Ie' i fit, fd ,.\ ft.({:', CITY I C.'il (\\r' \- 1[( Tax Payments and Credits: 1. Tax Due (Page 1 Line 181 2. Credits/Payments A, Spousal Poverty Credit 8, Prior Paymenls C. DIscount/. 'ii"7 ~,l, ~-1 ? , ,-)1 1:1\ ;/'" U -----rswlrl. -- --r III' 'I ---L-...!.:L..----1 I (\ II. (1) 1;7/N'7, '-1'7 . Total Credlls (A + B + C) (2) . :j 'J,J 311 __ 3, InleresVPenally if applicable D.lnterest E. Penalty 5. TotallnteresUPenalty (D + E I (3) If line 2 is greater than line 1 + line 3, enter the difference, This Is the OVERPAYMENT. Check box on Page 1 Line 19 to requllt I relund (4) If line 1.. line 31s greater than line 2, enter the difference, This Is the TAX DUE. (5) ,l/~, c)'} -:;~, j L! A, Enter the Inleresl on the tax due. (5A) 8. Enter Ihe total of Line 5 + SA. This Is the BALANCE DUE. (58) J '7, (>' 7';- ,I () Make Check Payable to: REGISTER OF WILLS, AGENT PI.EASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN 'rHE APPROPRIATE BLOCKS 1, Old decedent make a transler and: Yes a, retain the use or Income 01 the property translerred; ". , """"""."""". ""'"'' 0 b. retain the right to dasignate who shall use the property transferred"r Its Income; """""""" 0 c. retain a reversionary Intarest; or." "".""""".". ."".",,,,,.,,,,,,,, ".""""""." 0 d, receive the promise for life 01 either payments, banefits or care? "".""""."",,, ".""" 0 2, II death occurred on or belore Decembar 12, 1982, did decedent within two years preceding deilth transler property without receiving adequate consideration? If death occurred after December 12, 1982, did decedent tran$ler property within one year 01 death without receiving adequate consideration? """.".""."" """."".""""" 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, annuity, or other non-probate property? ." 0 t--,..-- 4. No ~ ill [] ,..,..01\)(\0 IlJ [II IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MllST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN ._~1I~1 . . '..,. . ," .. '. ,..,,:-.M 72 P.S. ~9116 (a) (1.1) (I) provided lor the reduction of the tax rate imposed on the net value of translers to or lor the use of the surviving spouse Irom 6% to 3% for dates 01 death on or after ,July 1, 1994 and before January 1, 1995. 72 P,S, ~9116 (a) (1,1) (II) provided lor the reduction of the rate Imposed on the net value of translers to or for the use olthe surviving spouse Irom 3% to 0% lor dates 01 death on or after Jsnuary 1, 1995 The statute does not exemot a transfer to a surviving spouse Irom taK, and the statutory requirements for disclosure 01 assets and filing a tax return are stili applicable even" the surviving spouse Is the only beneficiary. FOR DATES OF DEATH ON OR AFTER JANUARY 1, 1995. Please answer the lollowlng question by placing an "x" In the appropriate space. Old the decedent create a trust or simtlar arrangement which Is solely lor the 6urvlvlng spou.e's benefit lor his or her entire IIletlme? Yes 0 No 129 /,\ /1 "you answered yes to the above question, the tax on the trust or similar arrangement Is po~tponed until the death of the second spouse, at which time It will be fully taxable at the raters) applicable to the remalndar beneficlery(ies). Enter the value of the trust on Schedule J, Part II, In order to remove It from the calculation 01 the tax due In this estate. You may wish to file Schedule 0 In order to mal(e the election available under Section 9113. If the election Is made, the trust or similar arrangement Is taxed in the estate 01 the first decedent spouse, the portioll 01 the trust or slmiler arrangement which benefits the survlvln9 spouse is te~ed at the zero tax rate, and the remainder i~ taxed at the raters) applicable to the remainder beneficlary(ies). "you choose to maksthe election, you must attach Schedule 0 to a tlmely.filed tax return, along with Schedule(s) K andlor M in order to show the apportionment 01 the trust or similar arrangement between the surviving spouse and the remainder beneficlary(les). I',E/'^~ " .'-'.' j'.l,J , '" "( , '" . """""'1' ''';'~~fi I ,:1'1 't,\\ i", 'I'? " " ,i, '/ : ~,. . V ) ~..! . 1.' 'f " . .. . ~: .;</4'7,1Y3 I. JANET E, ALVOllD, of tlio City of Harrisburg, Dauphin County, Pennsylvania, being of sound al'l~1 disposing Inlnd, 1II011101'y dnct understanding, do melko, utler', and publish tlils my lAst will and testament, hereby revoHng .'111 fonnel' will,; by me hel'clor'r>f'C' mildf', I, I order alld di I'eet that a II my just debLs (1nd funera I expenses be fully paid and satisfied by my Executor, or Executrix, hereinafter named, as soon as conveniently may be after my decease, 2. I give, devise and bequeath all my property, real, personal,. and mixed, whatsoever and Ivheresoever situate, of which I shall die seized and possessed, or to which I shall be entitled at the time of my decease, to my husband, W. Woodrow Alvord, absolutely. 3, However, in the event that my sai d husband sha 11 pre- , ':'. f{ ',."} decease me, 01' shall die 'Ni thin thi rLy day;, afler the da'<~ of my 'p:-(j death, I give, c1evi se and bequcath <111 IflY property, 1'(:'81, IH'.I',;"".11 and mixed. whatsoever and wheresoever situate, of which I shall die seized and possessed, or to which I shall be entitled at the time of my decease, to my daughter. Jeanne M. Alvord, of Harrisburg aforesaid, absolutely. 4. I nominate, con~titute and appoint my aforesaid husband, W, Wondrow Alvord, Executor of this my last wi I 1 and testllment, However, in the event that my said husband and Execulc',' should predecease me, or die within thirty days after the datc 0f my death, I nom! nate, const i tute and 8DPoi nt my sai d daughter, Joanne H. Alvord, ExecLlLri xln his stead. - 1 - .. ..: IN WHNESS WHEREOF, I have to this my last wi 1 I and testament,contained ,in this and one preceding page. set my hand and sea I at the end hereof thi s 7 th day of Ju' y. 1965. sIgned, se!lled, published ) and declared by Janet E. ) Alvord, the testatrix above ) named, as and for her last ) wi 1 ,1 and testament, in our ) presence. who, In her ) presence, at her request. ) and in the presence of each ) other, have subscribed our ) names as attesting witnesses) ) ) ) ) ) ) , I ~ I,.. ~ e Ci " ) ~iiet E. A vor (SEAL ., 7<. ;Y'~A~'-f &A.tq~ ~~ ,.: ". "? - . ' If:. "".. I" ,\'i:. ~.: .'... ',- " .,' ,-,-,'.j.} " ',n,:~~...~;,:.,:."!.I.~~.'lUr\~~~j~~,'~~~;.;:i. ,i . .,vnll Hi 11nl A. . .. Pt'l!'~ PI~n'oIJy,I'! .. ... ... "'T,m'ffOM&U ----- AMOUNT . SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES COMMONWEAllllOf f\lNN:)'I'IVAHI^ INllfll:lfANcr IAI( MfJUIIN II:fMDfNI UfCffJfNI DESCRIPTION 1. Fu..!'tlol bp.n.... ,...' F" ], '\'Rc~~'G":-.;'.'ll.i^JrH,.... ._JVv..'. Of -lIJ..J;';~j-\L,'_ .H:(.((()L (: ~ (Ul v~~O:;jt.JL '-,'"Vl.." f\\10(~\CTIVG~;'''';''-'~., {~_..., [' \ 1--- . ". ~, "('I.) I III t. " ' '.' "-J (!\' 1(-,(.'_ . .U' //- C.' -j . (,.. V (.'i1~\<'-'l~,<,,,\<\(;. 1<;:,1'/11 C'1,;L111"1(/ITO,C.w..o I (l'r":'.rIV.;:.. 1...,,':""'. I. / C"c;rACl A'Ly Gl\'l! If',. C, ,,, ,., ufl{LY I '(' . ,>' ~ P {\U( l'j(f.'UJP': t-YfJ'D tl I (J /...\('11..... C' ,'.::; T~:~ . ~(lu:c.,,':>O' Il~~;_"'" . (\e\1'! 1,111')(; ) b'll ~.; U S I,:.c, ') 1/)-1'0, 0 iI /'1 ~" I'U) , _:: ',1: ' (~fl '-j ,,'il/ll ( )-'~ ''"{i'",''' - c:) :.~~':; '; (j (.1 8. Admlnl.trotlv. Co.'" 4, C. 1. 2, 3, 4, 5, 6, 7, 8. 1. Personal Representative Commissions Social Security Number 01 Personal Reprelentatlve: ~___~__ Vear Commi"lon, paid _____,~~...:..-.m.. 2, Attorney Fee. 3, Family e.emptian Claimant __.... Addre" of Clolmant at decedent's death Str~et Addre.. ___m_.______ City Stale Zip Code__._"_ Relatlonlhlp __~_~,.._____ C) '~:>. , . \.-'. --" Probate Fee, lCrl-tIO') r"r,< '\ rUf:l:l'jc,',,_,tloll.1 (.<;;('-"1 I}' 1(/110$,C11 C MI.e.llon.ou. bp.n.... &'/06/(1(.11 !v\C;ff\oq"IAL-S '_ . , , '... . 'fLf\ vc-b, (HJ '[me () F tcl-rr J.I , ",,;J(, C:x,15/'1 iJ 6CS;,C' f'..\ oS __~_.._.~ ______~_.._._. __~__._T_...~...___.. ...__~._"~_.~___.___....___~.. TOTAL (Allo enter on line 'I, Recapitulation) (If mor. .poe. I. ntld.d, In.... oddltlonol .h.... of .am. .1...) ~;D</ C;'. (\ (I I c ':, "1 (~O,..7)' ,) RS::J,() l\ 0of() 0 St.. '.':,'" f, "2," .>/_) It"'l.--.(''' I /,tJj}() .3 ,I '-. '*' COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE Bu~eAU Of' INDIVIDUAL TAKES IHHrAITAHCf. rAM DIVISION DfPT, tl060 I tlARRlnURG, PA 11I2I,.Q601 NOTICE Of INHE~ITANCE TAK A~~RAISEHENT. ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAK IlHUI It ". 1I,.t1l 01"27-98 AL VORD OB-03-97 ~1 97-0"83 CUMBERLAND 101 1- AMou!'t ~!~lttOd -l MAKE CMECK PAYABLE AND REMIT PAYMENT TOI REGISTER Of WILLS CUMBERLANO CO COURT HOUSE CARLISLE. PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .. Rl V; isii," iii"Ajlji" {09: 9';"1" - Noi"i ci" "OF- "iNHER'i rANCE- i'-AX - ~"PpiiA"i siiiENr;-;.i:.i."owANcE .oli -- -"" - --" - -" -"" -- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX JANET E FILE NO. 21 97-0783 ACN 101 JEANNE M ALVORD 406 BROOK CIR MECHANICS BURG DATI ESTATE OF DATE OF DI!ATH FILE NUMBER COUNTY ACN JANn PA 17055 ESTATE OF ALVORD DATI 01-27-98 TAK RETURN WAS I (X I ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST " SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Roo1 E.t.to ISchodu1o Al 2. stock. and londl <<Schedule B) 5. C10..1y Hold stock/Portnorohip Intoro.t ISchodulo CI 4. Hortg_gal/Not.. Rlceivable (Sohedull D) S. C..h/lank 0IPoI1t.I"110. Plrlonal Prop.rt~ (Schedull El 6, Jointly Ownod Proporty ISchodu1o FI 7. Trlnlflrl eSchedull Q) I. 'rotel AliOto I CHANGED NOTE I To In''''''1 propl'" credit to your Iccount, IUbMit 1hl uppar portion of thl1 forM with your tl)( ply..nt. .00 .00 .00 .00 131.425. 49 .00 .00 III ill_ IZI 151 (4) 151 161 171 131.425.49 APPROVED DEDUCTIONS AND EXEMPTIONS: .. Funarll EMpln.../AdM, Co.t.l"llc. EMp,"'" (Schedull H) 10. Dobt./Hort.o.o Llobllltioo/Llon. (Schodu1o II 11. Toto1 Doductlon. 12. N.t Value of rlx Rlturn IS. Chlrltlbll/Oovlrn..nt.l a.qulltl; Non~.l.cted 9115 Tru.t. 14. Not Vo1uo of E.toto SubJoct to To. 5.562.37 (9) 110 ) 1.738.66 (111 I1Z1 1151 <<14) 7.~nl 03 124.124.46 .00 124.124.46 ISchodule JI 1'1' an ......m.nt w.. i..u.d pr.viou.1Y, lin.. 14, 15 and/or 16, 17 and 18 will r.'I'l.ct 'l'igur.. that includ. the total 0'1' Abh return. .......d to dat.. ASSESSMINT OF TAXI 15. AMount of Line 14 at Spou..l rat. CIS) 16. AMount of line 14 taxable .t lin.al/Cla.. A rat. (16) 17. ..ount of line 14 taxable .t Collateral/Cla.t Brat. (17) la. Principal ra. Due TAX CREDITS I PAVHENT DATE 10-20-97 NOTE: .00 124.124.46 .00 K . DO, K .06. K .15. 1111 .00 7.447.47 .00 7.447.47 RECEI~T NUHBER AA242352 ' DISCOUNT (01 INTERESTIPEN PAID (-I 372.37 7.075.10 AHOUNT ~AID TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 7,4(.7.47 .00 .00 .00 . IF rAID AFTER DATE INDICATED, SEE REVERSE FO~ CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN fl. NO ~AYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRl, VOU HAV BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS.) E RESERVATlONl fltlt.. of dlcldenU dvlnl on or blfor. OlcllIb.r 12, 1912 -- if tnV fllNr. Int"rllt In thl ..tltl II tr""'trr,d In po.....ion or .njoVI.nt to CI.., . (coll.tlrll) btn.'1clarl., 0' the d.c.d.nt Ift.r the Ixplr.tlon of env Iltete for Ilf. or for VI.r., the COIIQnH..lth h.r.by ."pr...lv r..arv.. tha right to .ppr.i.. ana ...... tran'f.r Inhtrlt~c' fa"I' at the lIwful CI... . (ooU.tar.l) rata on anv ,ueh futurl Interllt. PURPOSE Of NOTICE I To fulfill the requlr...nt. of Sactlon ZI40 of the InherUanc' and Elt,tl TaM Act, Aflt ZI of 1995. (7Z P.S. S.cUon 1)140). PAVMENTs O.tach the top port!on of thll HoUtl .nd lub.it with ~our ply..nt to \tit ~.,lIt.r of Wills prlnt.d on the rlYer" lid.. ~~"lIk. chick or .on.y ord.r p'Vllble tal REGISTER OF MILLS, AGENT REFUMO (CR)s A r.fund of . hM or.c:l1t, whlth w.. not raqullted on tha h)( Rlturn, .av b. "qulltld bV ooaplatlnt an "Applloatlon for A.fund of Plnnlvlvanla Inharltllnel' tnd E.tata TIIM" (REV~U15), ..ppllc.tlon. .ra avtihbl. at tha OfflCll of tha R.,I~tlr of Will., Inv of the 23 Rlvlnu. Oi.trlot Offlel.', or by clllln, thl 'Plellll 24-hOYr In.warln. ..rvlc. nu.b.r' far for.. ordering: In Pennlylvlln!a ,-eOO-3'Z'ZOSO, out.ld. Plnn.vlv.nl. and within local H..rrhburg aral (111) ,.,-eO'4, TOOt <11'1> 772-22S2 (H.arlng I.palrad Only), OIJECTIONSI Any p.rty In Int.r..t not ..tl.flld with the .ppr.I....nt, Illow.ne. or dl..llowlnc. of d.dUctlon., or .......ent of Uk (inoludlng discount or Int.rut) II .hollln on thll Hotlca IU.t ob'ICt. within .lllty (60) day. of rlo.lpt of thit Notlc. by: "-wrIUan pro tilt to thl PA D.part.lnt of RlVlnut, eoard of "ppllh. Olpt, Z11021, Hlrrhburg, PA 17121-1021, OR ~~al.ctlon to h.IoI' the ..ttar d",ter.lnld .t lIudlt of the Iceount of thl pI"on.l r.prl..ntaUv., OR 4_app..1 to tha Orph.n.' Court. 8""1" lSTRATlVE CORRECTIONS: F.etu.1 .rror. dl.cov.rad on thl. ........nt .hould b. .ddr....d In writing tal PA Dlp.rt..nt of Riv.nue, &urllu of IncUvJdual hl(u, AnNl po:.t A.......nt Rlvl.w Unit, DIp\. 280'01, tlarrisbure, PA 17121-0601 Phon. t11l) 1Il~6505. S.. paea 5 of the bookllt "In.tructlon. for Inhlrltllno. TIIM Rlturn for a R..ldant Olc.dlnt" (REY~ISOI) far an 'kplan.tlon of ldalnl.tr.tlv.lY corr.ct.bl~ Irror.. DISCOUNT I If any ". due Is p.ld within thr.. (!) eallnd.r .onth. aUlt thl dlcldlnt', d..th, . flv' parclnt (5iO dl.count of the ta. PI~d If; allowld, PENALTYl Th. 11:< ta. ..n..tv nem-partlclp.tlon p.n.lt~ it oo..ut.d on th. total of th. tal( and interllt ......Id, and not p.ld before Januarv II, 1"6, th. flrtt day .ftlr the .nd of thl tal( ..nutv p.riod. This non~partlclp.t1on p.nalty is IPP..ltbla In the .... .anner .nd In thl thtl .... tI.. plrlod u you would Ipp.al the t.. Ind Int"..t that h.. b..n .......d a. Indlc.t.d on thl. notlo., INTEREST I Interllt I. eherg.d bl,lnnlnl idth flr.t d.y of d.llnquencv, or nln. (I)) .onth' .nd on. (1) dlY fro' thl d.ta of death, to th. data of p'YMnt.. T.... which blea.. d.llnq~nt b.forl January I, 191Z bllt intar..t It thl rat. of .IM (6:<) p.rc.nt p.r annul oalculat.d at I d~IIY rat. of .000164, All t.... whiCh blc", d.llnquant on and .ft,r JanulrY 1, 1982 will balr Interatt It a fltl IIlhlch will v"v froa callndar Yllr to ulandar v.ar wlth th.t retl announcad bv ~h. PA nIP.rt.lht of Rlv.nu., Th. .ppllclbl. Int.r..t r.t.. for 1.12 through 1991 .rll '!!!r Inter..t ht. a.lh Inter..t Fletor !!.!r Int.rllt A.t. O.U!I' Int,,"t Factor 198Z 20:< .OGnU 1IJ81 'X ,0002"" 191) 1'~ .000411 1IJII~11J91 11% ,000301 19lit 11% .00OSOI 1992 'X .000ZU 1981 U~ . DOOSS' 1993-1994 1X .000192 1ge6 lOX ,000214 1995-1'" .% .0002"7 --Intarllt It o.louht.d .. follow'l INTEREST' BALANCE OF TAlC UNPAID K NUNBER OF DAYB DELINqUENT )( DAILY INTERE'T FAC'lDR ~~Anv Notlc.lllutd .fter thl tlM b.oo..' d.l1nquant will rafl.ot .n Inter..' ollculatlon to flft.." nil H11 blyond tht date of tlWl ........nt. If Plv..nt i. I" after the inter..t OO.-putlltlon date thown on thl Notlc., tddlt1on.l Intarllt ltU.t b. c.louht"". STATUS R~r.Q.~L.~~DE~ RULE .6.12 Name of Decedent: )""1(:1 l:. /\eV0CD Date of Deathl c't.i\'Jf', u':r I "I '1 / Will No. ,~ (-(~(I- I) 1\':3 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 I Yes y. No ...___ 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 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-X-.' b. The separate Orphans' Cuurt No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interpst? Yes_fJ.,tANo 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. Datel Ii) ,.It.'''!i .. "'>-L tl\(lhl1d. S nature ,. . jc~r4 ^-J,U~ I~/, flL.vot/) Name (Please type or print) Il) I:) L .. ,/" {I '. Ie {, 1 ),('" ,}/..... . 1<1 (' (. (.',-; Address (':1171 h I.t y 70 Te l. No. (MAH I rmf I AM3) Capacity; >< Personal Representative Counsel for personal representative