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I)ETITION IIOR ItROnATE "lid (a~AN'l' (w u:rmRS
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Till' pl'litioll or till' 1IIldl'l..i~'IIl'd rt.."'llL'l'ltllll~' l'eprn('IlIl., thai:
Your .Pl'titiOIltJf'(<';), "IHI i...all.' IS ~'l'ar" or age or IIldCl~llhl' l"~'~'lIl4l"X
III IIIl' 11IsI 11'111 of Ihe ilbo"I' del'I'dl'lll, dUII'd ,,'1 - ( .- ,/J"
and eodiell(s) dall'd /' (- '1- <jJ
Ih'!!lslellll Will> 101 IIIl'
( 1I11111\' III CUMHmLAND
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FX\.'('1'1 !l'i hdlnw..., dl'\'l'lklll did lIolllHlrl'Y, \\u'" llullUvprl'cd illld did lIolltavl' II chHd born or adoptod
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(lCl,TIHIL'1l1 (\1 dl';lIh OWlll'd !11'(llll.'rly with l''iliIlHIlt'd valuL.... U'" follow\:
(If dPlllkik'd III I'n.) All pl.-'r"ullal pr(lpcl't~
(II' IHlI dnmidh1d ill I'n.) Pl'rsollal pr(lpl.-'l'I~ ill Pt'Il11wlvallla
(Iflllll dlllllk'iiL'd ill POI,) PL'I''\nllal properly ill COUl1ty
Valtlt' \'1' IL'all.'''l:\tl' III I'l'tlll'>\h'a11ia
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prt'''I.-'lllcd hl'I'l'with and till' prall! or k'l(l'l'~
rcqucsl(s) IiiI' pro hale of llie last will Hnd codicil(s)
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OATIl 01' PERSONAL REPRESENTATIVE
COMMONWEAI.TII OF I'Jo:NNS\'\,\, ANIA
em 1'on' . OF CUMB~RLAND
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Tlw I'l,ti(ionl'l(~lllhll\l"lI11ll\L'd ~\\l'ill('>) 01 aITiI'1l1(\lllIallhL' '-'lall'lIll'l\h inlhl' foregoing petition arc
Inlt..' ami ,:ilrn\'[tu I Ill' he\! (lllhl' ~lH\\\kdl!l' <tlld 11L'lll'l or Pt.'(ilhllll'l'(Q and thaI as persollul reprcscn-
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11,,1,,11' 111\' 111" 26TH dill "I . lX/ l- .LZX~.
-A ~Sr:P,lEMBER .. I') V . .. ..- ~
711a'1L1- C. YIJ!_Uil0J' 'I~ ft.j-mlJtd rf,( . ... I
r::- .. I . MARY CLEWIS "..gllll'/' U. ~
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OOMMONWEAlTH OF PENNSVlVANIA. Off'AAYMIiNf Of' HEALTH. VITAL RECOROS
CERTIFICATe OF DEATH
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COMMON:*SYlVANIA
IHARTMENf or REVENur
OEPT.280001
tlARRI. BURG PA 1711 f
tlEGf:DENTS NAM( (lAST, ~IRST, AND MIDmE INIlIA!) us~ a blaok block ~) SIIP...aIe wOI'ds
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ID/11i
Floe NUMBER
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Ilf APPLICABLE) SURViviNG SPOUSE'S NAME (l AS f, fiRST, ""10 MIDDLE INITIAl! SOCIAL SECURITY NUM8ER
;V/A
() 411 :3,1/9 I (f)
THIS RETURN MUST HE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
[J 1 Original R.'uHl i:lll2 Supplemental Relum 0 3. Remainder Retum ('" ,",,'" ."",. {1.1J."1
o 4I.imllod Eslal. [] 4a Fulur.lnlerosl Compromise (''''''''.'''''''''''.821 0 5. Federal Estate lex Ret'lm Required
[I 6, Docedtlnl Diod Testato (An,lC~ t;(JilV 01 Willi [] 1, Docodent Maintained a living Trust (Altal;hCOJlY of Trust) _ 8, Tolal Number cf Safe Deposit Bo:(es
o 9 UI~"lion Procee<ls Race".d 0 10. Spousal Po,.rty Credit [...,,"'''''......, "."." ,,' """1 011 Ele01ion to ta"nder Sec. 91131AIi""'Gc,ol
THiS SECTION MUllT BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
~jA,l~E COMPLETE MAJlING ADDRESS
5'1-/ l J ~ 1~~..jiJJ Il
FIR/'\NMltllf~Pllr.abh~A
lElF.PftONr:~jUMBER ---.--------
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REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
F I) I, I A V {J
SOCIAlSECUllllYNUMBfR
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> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
Under [l6fl3Uies 01 porjury, I declare Ihall have e~amined lhis relum, Including accompanVing scnedules and Slalemenls, and to the beSt ofmV knowledge and belie', it Is true, correct and oomrlele DeciaraliVn of prepafel other
ltlMl..!tm oorsOI\al re[\(8sentali'o'e is based on alllnfoUM!!2D..2!..whlch tlI'eDafer has arlY knowledoo,
B."1N ~TlI r OF PER.S ON RE..S PONSIBLE FOR FILING RETURN ADDRESS . I '
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SIGNAT~'../.()l:Rf.PArR..;.THERTHA.NREPRESENTATIVE .A IR. ESS ("f .1 .'.." 1 'J".'
--) "". . / J I . II (, I'\J(' .1.)1 l:'l (I .)
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I. Real f.staleISch.dule A)
111
(2)
(3)
141
(51
(6)
17)
9;;',']4S.
2. Slocls and Bonds (Schedule B)
3 Closely Held Corporation,Pa~nersh'p or Sole.Propnetorshlp
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5
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4. Mongages & Notes Racelvable (Schedul. D)
5. Cash, Baok Deposlls & Mlsoollaneous Pernonal Property
ISchedul. EI
6. Jolnliy iNlned Property (Schedul. F)
7, Inlor.Vivos Transfors & Miscellaneous N0n.Probale Property
(Schedule GorL)
8 ToIJIO,o.. A..et'llOtal Lines 1.7)
IB)
9. Funeral E~penses & Administrative Costs (Schedule H)
(9)
,li 2.. S.
10. Dobis 01 Deoodenl, Mo~gage Liablillle" & Li.ns (Schedule I) (10)
11 Total Deducllons II0tal Lines 9 & '101
(111
112)
113)
12 Nat Value 01 E.llteILi,,, 8 minus Line 111
13. Ch,lIitable aod Go,ernmenta[ Bequests/See 9113 Trusts for wh~h en ele01lon to ta, has nol been
made (Schedule J)
14. Net V.lue Subje<:tto Tn IUne 12 minus Line 13)
15. Amounl of line 14 ta,.bla
at the spousal tax rale , I
Soe Instructions on ro't'erne side for applicable percentage
16, Amounlof line 14 ta:.:able
al6%'ale
17, Amount 0' line 14 taxable
al1b%rale
114)
x ,0
1151
x ,06
(16)
(17)
1181
x .15
16. Tn Due
19.
Decedent's Complete Addr0ss: .
SfREET :::p~~s:.._.. ~b~\t~--f/' -~=-=--==-----'~~~=~:~==="=-~d___
CITY
TStAff '75;--'-'[ lilj-C:~"~"~'''~-' ..
._ __1.L_b__ __L7JJIL..u...
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Tax Payments and Credits:
1. Tax Due (Page 1 Line 181
2 Credlls/Pnymenls
A. Spousal POVBrty Credit .....-,. f:' -
B. Prior Paymenls <'.> -
C. Discounl - t) -
(I) ",:_..5-r~tl:~c.Ij,-AL
Total Crodlt~ (A , 0 , C 1 (11
..-",,,, (' .-.
3. InleresVPenally II applicable
D, Interest
E. Penally
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4,
T olallnlorosUPonally ( D ' [i 1
II line ~ Is greater than Iino I + line 3, enler the dilloronce This IS Iho OVERPA YMENT.
Chock bOK on Pago 1 Line 19to r.quOIt a retund
If line 1 + line 3 is grealer than Iino 2, enler Ihe diflerence ThIS Is tho TAX DUE,
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1,1)
5
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A, Enler the Inlerest on the lax due If,Alu.._c,__~: .,.9_..:.:.._.__
B. Enter Ihe total 01 Line 5 + 5A ThiS Is the BAI.ANCE DUE, (liD) .:t (L..c1.1,.ftZL
.'. _Make Check Payableto REGISTER OF WILL~L~GENf . ..
. . .~"'IIlMl~.llllmnlll1ln.-___. ~._. J~~
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING AN ")C." IN THE APPROPRIATE BLOCKS
1, Did decedent make a transfer and:
a. relain the use or income ollhe properly translerred; . .
b. retain the right to designate who shall use thfJ property I,"nslorrorl 01 lir. in!:or"lJ,
c, retain a reversionary inlerest; or..
d. receive the promise for life of ellhm paymenls, bonefils or cam? .
2, If death occurred on or before Decernbor 12, 10B2, did decoclonl wllhifllwo yoors
preceding death transfer property wlthoul receiving adoquato COlhllrlera!ion'l If dOlllh oceurrnrl
after December 12, 1982, did decedenllransfer property wlthll\ 01\0 yoar of d"olh wlllloLlI
receiving adequate consideration?
3. Did decedent own an "in trust for" or payable upon donlh bn'll<- account or ~HJcurHy
at his or her death?..
4. Did decedent own an individual rotiromnnt account. CHlfllHty, or olhnr IIOfl-j)fOhu!ll plOpflrly?
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No
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IF THE ANSWER TO ANY OF THE AAOVE QUESTIONS 19 YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE HETUrm
mHllm~~t~im~N:W;\jW;f;';;'f~~: {./ '/l,i ,','t, ",'-:~i\.:J.-'.L:'-\-_- " .
~fi;nk,,,,__,,,,.,,,,,,..._,_,t ,--...-, , ,......-.--;.-'-,-",-
72 P.S. !l9116 (a) (1.1) (i) prOVided for the reductiofl 01 the IllX rato lI1'pOo,,<I on 11101\111 vAllIO of Iml\slol" 10 01 for Ihe use 01 the
surviving spouse from 6% to 3% for dales of donth on or nft(j! July 1 ,1 ~Jn4 Hlld bofnro JilJ!UWY 1,1 O\Hi
72 P,S. !l9116 (e) (1.1) (Ii) provided for the reclucliofl of 11\0 rnto ilopo,,,,,1 on 11111 I\IlI villu" 01 Ilflfl"'ol!\ 10 or lor tho IIsa 01 the surviving
spouse from 3% to 0% for dates of death on or nftor ,1i1tHlHry 1, 1 o~)r; -IIH~ stnlllln dOllb nol fJ''(nllJP.1 II hllnnfol to n Hllrvlvlng spollse
from tex, and the statutory requirements for diRr.lomlJ'(~ of (lssot~; WId Win\! d t(l'( roll in) aro gUll i1ppllc;alJln nVOIl if IIw 6lJrviving spouse
is the only beneficiary.
FOR DATES OF DEATH ON OR AFTER JAMUARY 1. 1995. i'I,OI";(' "'''I\VOI llio followlllil '1110<;11011 hy plllctllil all ',' in tho
eppropriate space.
Old the decedent create a trust ur similar arran(Jomollt whietll" Rololy 101' 111(1 5urvlvinIJ II\lOU50'. I,onell\ for hi. or t1(>r ontlre
lifetime? Yos [J No 1>1
If YOll answered yes to tho above question, ttlt) lFlx olllhn lrlwt fJ( !J.unllnr OffUflllolJlnnlm pO!-\lpOIlOlllllllillll(J <it'llllll of Itu:J second
spouse, at which time it will bo fully taxable at tho rnttl(8) IIppl!c:,"tllllt In IIu1 Ifllll{lilldur IlfllHlltctnr'y(lwi) rlllm tho vnlu(J of tlm trllst on
Schedule J, Part II, in order to rmnova H from ttlf'! calcl!lilllon uf 1110 Ii\' c!tJo!ntllih ,'!filill" YO(llllllY W!~;tl to hln Sctwdule 0 In order to
make the election available under Sectioll tl11:\ IIthu nlflcllon 1\\ IlIad!l, till) hunt 01 Sll1HliH liiliHl(l""llHlI If-i taxed III tho estate of the
first decedent spouse, the portion of ttl0 tHl~1 or Sllllllru anWHllill\1l111 which tfllllOlil~i Ill!! lHIlViVIIIO !\IHlUM1IB tmwd nt tho 10m tax rale,
and the remaInder is ta)(ed at tl10 mte(s) oppllcillJlo 10 tho rnlllilllHjuf liul1t!II(:llllY(IUhl II YOII ilHHJ'-\oltllllitkiJ ttlO olflc!lor\, you must
attach Schedule 0 to a timely-filml t.n; return, aloll\j wilh ~-;(lJndlill!("ll\ dlld/of M 1I111n!i1l til show tlHl IIppOftlOl\rmmt of tho trllst or
similar arrangement betwoAn the surVIVllltl fipUll~Hl ,'lIld 1111' tiJllldllHll!l hnlll,llCldIY(lO!i}
mVl"'''''''''.
GOMMONWi:ALTU Of Pi:NNilVlVAN'A
'NUi:RIlANCi: lAx RHllflN
., : T :Ufi r
ESTATE OF _ I
;; 1'uJM..~_:;L__~l,JJ.l '1
(
Otblt of decedent muel b& reported on Schedule I.
ITEM
NUMBER
A FUNERAL EXPENSES:
1.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE HUMBER
2/_ 97- 01!?
DESCRIPTION
AMOUNT
- 0-
B, ADMiNISTRATIVE COSTS: 0-
1, Personal RepresenlaUva's Commission.
Name 01 Pe"ooal Repr"",nlaUve (.)
Social Securl~ Number(.) I EIN Number 01 Pe"onal Repre.enlalive('1
S~eet Addre.. -
C~ Slate Zip
Vear(.) Commls..1I Paid:
(> -
2, Attomey Foe.
3, Family Exempllon: III decedent'. addre,," nolthe same a. claimant's, allach explanation)
(:) -
Clelmant
Street Address
C~
Relationship 01 Claimant to Oocedont
Slate
Zip
5,
Probate Fee. r-:L ,',.i 9 kQ. Foil. U'j/J-I.t4 "I- (.LIiUJt ('u/~'Ut 1,4"t,
/ /I..;Jry
Accounlanr.Fee. {iniAL .1'j)( 1?~-rott^J Jf,\lfIWr..,J .4.(.. (t:.de/ZAL)
13IM.?)..!.I') -t IJ ~ d- hfA.J
Tax Relum Prepare,. Fee. -r-I J I -., I -r-;t -:? ~ ,,}
~<.'" f'l1J..-l,'4tJ c.~ ~/A'" ^,l J Un"
15'. DO
2-2. 0 lOb
4,
6.
2.D{). ()6
7,
TOTAL (Also enler on line 9, Recapitulation) $ "I 3 5". 0 tJ
(If more space Is needed, Insert additional sheets 071he same size)
I05B1'H M. MI!lll.LO
mRRY 5. HYMAN
JlAVIO I.. lUTt
MICHAEL E. R051R
PAMeLA O. 51t\JMAN
RICHAR\, A. SM,LOCR
Angino
B Rovner
L1STI!IlIN
NIJIILII c. I)I..~()N
MI(~IIAIII. I. NAVITSKY
losm'H M. ["RIA
IlIlANI! s. IIARRIl'K
lAMIIS I),CINTI
IWIIl s. WISNI!SKI
TIlE BEST LAWYERS
..-.....IN -~_.
AMERICA
RICIIMUJ c. ANOINO
NEIL 1. ROVNER
SUZANNE HALL. EXECUTRIX OF THE ESTATE OF EDWARD JOHN LUDWIG
V. KELLY ASSISTED.14.YDm
DISTRIBUTION SHEET
TOTAL AMOUNT OF SETTLEMENT
DEDUCTIONS:
Attorney's Fee (30 %)
Ba lance
$ 200,000.00
60,000.00
$ 140,000.00
651. 06
$ 139,348.94
Reimbursement of expenses paid by attorneys
to others for records, experts, etd.
Balance
Reimbursement of Medicare Lien
(reduced from $59,476.17)
41.438.00
Balance
$
97,910.94
PLUS: FEE CONCESSION AND INTEREST EARNED
89.06
BALANCE TO CLIENT
Final Division
Attorney's Fee
Client's Balance
Reimbursement of Expenses
Reimbursement of Medicare lien
WARRAWrV
$
98,000.00
$ 59,910.94
$ 98,000.00
$ 651. 06
$ 41,438.00
AND NOW, this day of , 199B, I/we
acknowledge that I/we-have read, understood, approved and obtained
a copy of this Distribution Sheet. I/we further acknowledge that
the above balance constitutes my/our total reimbursement for
medical expenses, \~age losses, pain and suffering and any other
losses sustained or claims resulting from my/our accident. I/we
warrant that if there are any outstanding medical bills or claims
other than as set forth above, they will be my/our responsibility;
I/we further warrant that I/we will pay any outstanding Blue Cross,
Blue Shield, medical subrogations liens or any other liens and
ex~n~not noted above.
/'
!I.'Jllm!:'S15 F. NT
ARAISBUAO, PA 17110.1708
------
SU3^NN~1 tllJtlllJ
FAX (711) 238.5610
lirvl'ioo I~ I (/'1,11
"'
,-
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U'" .
W~U
:coo
t.,g:a:
~
..
.1-
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0:0
O:z
00
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I
/ :5"- ),L1'1 - /.:.<
INHERITANCE TAX RETURN
IIESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
C...
I FOR OATIS OF OIATH AnlR 12/31/91 CHICK HER!
I" A SPOUSAL
POYlRn CRIO" IS ClAIMIO I I
I fill NUMlllR
21-97..07HH
!COUNIV COOl VfAll NUMIHM
\,
l\)~)."
~;',\lf/I/(\
.....i,.fil.\;h# ','
t:OMMCJI'IWr^llll OJ 1"W'I";'flVAlllA
IIrl'M(IMrtll {II !IlVI!/lJ1
[tll'! '}1l111,lll
1i^,1~1~IWJHI, 1'/'1 l/I'}ll/It,III
1>1 (III! Iii:" i i .i,ij'll ii' ^Iillili-',~
1':dwlI rd .J olin I.udw I g
',()IIM '.!III~IIY IHJ/'\!\I~ 11"\1l "I !II 1\111 I""!I (II hl~lfl
19H17-IIiH6 ,09/21,/97 01,/13/16
'" ..,,,,,,,,, "'"'''' ,"",," ''''',' "," "",' "'",,''''''' ,,,",'" I"'" ,^' '.""",,, '"',,'''"
IXII Odqilltlllll'lufll ,(l,,( /1,' ,I I ~ Si1ppluHIIlnl1l1 RU!lIrll
, ',I_)I'\/i'-li\.
\ I,~ Umilnd r\!ulo l'(/i,!" ,( II ( 1,1(1, flJturn II110fll\I Comprorniw
(h I ( J (lor dolo\ 01 dU<llh Clllor 12.12.[l?l
~J b. Docodunl Diod 'tH!n!n I ! DOClldof1t Moinlllinod n liyin~1 Tnnl 0 Tolul Nllmhar 01 S(,lo Deposit ROKel
_w~.._.JA"(~~~.~,~~~_~ .~I, ,Will)_ ___ (A".(~(~~_~~~~_Y__~L!"r.~.~~,!,. ,. ....__._._ __ _____ ___ ,._ <<_ __ ___~_____~ _.. _.-____~__ "'.,.__,__._____.
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTEIl_'-O,.. __.__~_..__.._..__.-~_______
t~A~\! t:CiMliiCi(;';-IAi\ui(; .A'llbR'r';'-;C,--
David W, Rea~er. Esquire Rea~er & Adler. PC
llliP"",,, ",,,.,,",, 2331 Harket Street, Camp Hill. PA 17011-4642
717 1 763-1383
S
frl
u
'"
o
205 Wood Street
Cllmp 111.11. I' A I 701 I
(('Hilty __Cql.l\I,H)r.1JH1.d ..._
1""'.""""'(01""""""''''''''''''''
\ 5.
!:J RlHlloindur RullJrn
(for dott'\ 01 donth prior 1012.13.02)
Flldllrnl F\lolo hlK Roiorn Roqulrod
z
o
5
:0
I-
:i
u
w
'"
191 .___._19 &L?.J_!l1..
I 0 I .._...J05.JQU:...QO_..._____~
10.615.53
------- -
95,084,47
~o-
.95,084.47
5.705.07
5.70.5.07
(191
1701
285.25
5.419.82
1. Rool (\tule (Schudulu 1\)
2, Slocks ond OOfl(h {5chndulll (\l
3, Cloil,l)' Hold Stock/Porlnonhip Intornst (SdlOdulu q
~, Mortgoges cllld Notm Rucoiynhlu (Sr.hodl}lo Ol
5, emh, Bunk Dopo\il\ & MiHollnnf\ou\ PN\onnl Propurl)'
(Sthodulo f:j
6, Jointly OWl\Ud Pfopurly (Schoduln f=)
7, Tr(ln,fcn ($chndulll Gj (Schodulo Ll
e, Tolo! Gran AnclS (Iol(l! lino~ 1.J)
9, FUrlowl E)(por'lSo~; AdminiSlr(ltiyo (o~I>, Mi~cnlkncou,
EKpensol (Schodul(J Hj
10, DubIS, MorlqClfW Liobililio\, lions (SdlOdulu 1)
11. T(ll(ll Dodu(lioll~ (tolnllinu\ <) B. 10)
12, No! Voluo of htolu {tino [l minu\ Linn III
13. Charitable ond GoYorn~on!(11 Buqun~h (Schndl'lo J)
.____________.._1~ Net_.yoluQ Subjoctlo Tox {lino 12 minlJ\ Uno lJI
1'~nif'llld'(~ilti/,\f P'^;;tl~il'(i ^I!I".II(IIIII II
(II 105.700.00.
121
PI
1'1
(; )
161
(7 )
1101
1111
(171
IIJI
11'1
15, Srou~ol Trnn\for\ (lor d{/Io~ 0/ dOellh "hnr 6'JO.9~l
SUI! 'n\lfU(lffln~ 101 ^!lplitflhln I'fHCllntWII' on rlnyof~o (15)
Sidl), (lHlludll 'Iolull', IUIlI ~"hl~dllllll< 01 ~)lllHdlJl(I M)
Amounl 01 !.ino 14 toxohlo 01 61\1,) roto (16)
(Includo Y(llu(H from SdlOdulu K or Schudulo M,l
Amounl 0/ lino I ~ lowblo 01 150/') r(l!o (171
(Include ynllJlll from Schodlll" K or Schoc/ulo M,l
PrincipCl! lox dlW (Add 10)( from linfl~ 15, ltl (md 17.)
Crodil' ~}f)('\J~fll POYHfly (1l'dil Pliuf f'l.lymonj,.
x
9S,01l4.47
x ,06 ='
5,419.82
-0-
5,419.82
~ ~. BE SURE TO ANSWER All QUfSTIONS ON RfVERSESIDE AND TO RECHECK MATH ~~.
U'~;I~~''','~;;~;jtilJ\ ;;, purjury,', c!IHlorr' IlllIt I hClV'! "'(O!llilll'd l!ri\ rtolUIII, illll'ldin1) {lC(OIl1IHlllyil1q \, J."dlll,,\ (lnej _,lnlnI1HHlt\: 011<1 I~l- the ill~\t' of I~;y k~~;I~;;-ju~~(~a-'~Ti-~f;
It It Iru . connel nnd (ompllJlfJ. I doclmu lh II oIl fOul (.\lnlu Ii",> 1.111'11 r"!H)fIMI (II II'H! IlHlf~lo! yuill!'. D()(lofUlj(lll ()/ propmef 01111'1 Ihon Ihe pOfwIlCll rOprll\Ofllolivo i,
bOZSlId noli in/ormclllon of W~\' h plf'P fl' hll\ Oily' kn ,wlr,dql'
~1(.fI l f fll 1'!J~~(lt1 ~r',l'r)II',II\1 "l~ 1111 I', [lI)I( ~ r; II 1\lln ' (lAn-
, .' ,L( , Lt.eK 1/ I" ' ( ! " /.,' I " "/ /! / II I ;/ 'I )
"lt~ f HI"'~(II((}II\I~ \II Illnl'll'1 11/,'1'11 ;' ,11(0111" flAil
/ I / f r I , (I (( / (!I ,1 J 'r: (, )
/
16.
17,
z
0
['j 10.
I- 19
'-'
n.
:,;
0
u
>< 70.
..
I-
71
x .15 =
(101
Di\tlJlJnl Intprll\1
285.25
...
If linn 19 i\ ~Iru[llnf thcm lilln lfl, l'nll'I tll<, difllHnnrl' on l.ino ')0, Thi~ i\ Iho OVERPAYMENT.
r.i1Ill
Ct,.ck her. If ou are teque.tln Q refund of your 0 orpQvment.
(71)
('I1^1
(? In)
If Lino 18 i', qrnohH thcm Linn \f}, l'nlPl thn dil!nfl'nco 011 lill'\ 71 Thi\ i\ 11m TAX DUE,
^ [1\IIH th,-. inll'fl'll on 11\t~ hnlfl'l(,1' dup (Ill t.illl' 71^
n Fnll'f Ilw ho1,d ,,( lillu II </IHI71!\ "n Iii\/! '}II\ lll;', i\ IllI' RAlANCr DU[,
Mnko Chock Pnynblll 10: RIJ~li~l()r of Will~1 ^~lt."1
_'\IlH' IIlI 11~QI
.
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
~IS.~E~L~~~Eo.US~~~~~~~s.. .____ PI.~IO ~'I.n.t-D.r_!yl'_'
.- . -,~-'-'-'" -... --. ...--..-..--. "-Tjif[eNUMBER . ---
l... __~.L-.97.::QlI!8_ - .---.--.---
C:OMMONWr:.~lTH Ot 1'(t-ItWilYMIIA
It-IlH~lll,NL( lAX IHIlIRH
IH510lNll)/CnHt~1
mATi"6f'=="'-~"c"" ~.....'-cc.c.,..
Edwnrd .John l.udwIg
ITEM
NUMBER
. --~_._-~-..,-~.. ~ ~._--- . ,.-.--.".-------- ,--- .
A. Funeral hpenses:
1.
B.
1.
DESCRIPTION
AMOUNT
,______ .____~_....,' ._..__n____._.,_.~~..,.__+___~.~_..______<_"'_~______________.,.~._~__
~.._._-_._-_.--
AdmInistrative Costs:
Personal Rnprosontdtlve CommlS!lon.
Social Sncurity Numbor of Pn"onol Roprolonlotlve:
Yoar CornmlHlons puid
.----_...--.~~-_._..-.
130.00
Attornoy foo.
~eager & Adler, PC
3. Family Exomptlon
7, \ :~untY/townshiP taxes
~'__._L~::o~_taxes -- Seller's
2.
4,
C.
1.
2.
3,
4,
5,
6.
Cloimont
_. ..___.....__.._...._ Rolatlonshlp
-......--.........
AddroS! of CI"lmant al docodont', doath'
Strool Addro.. -
_____.__,.___________.~_'..n_~....______..,..
City
..___.__._.~Slalo .______Zlp Code
Probalo Foo.
Mlscellanoous Exponses:
6% real estnte commissIon to Re/Ml\x,~eat.ty Asaodates
6,342.00
75.00
Deed preparatIon
30.00
Pest certIfIcatIon
29.67
Sewer proratIon
11 dIscount poInts paId on behalf of buyer
3,000.00
Roof certifIcatIon to ZegrettI ConstructIon
100.00
Seller's ~rorAtIon
485.49
prorntion
423.37
... - ,._-_.._-~-"----'- ".._-~.~'_._-~
10,615.53
TOTAL (AI.o on'or on Ilno 9, Rocapitulatlon)
$
-_._--~_._.----.-.-----.-~~._---~
(If more 'poco I, needod, In.nrt additional .hoots 01 .amo .1..,)
1111.\ 'UtIllIHIOIUIII~IIU'\f 1111>1 'll'ln",~u 1\01, ",,' (I'" ,',,',,',', "
me hy llllllllbm ()( lht Ort'lllef IImldltu. ^mu:IIlllun of ~W^I.T()llS.
'E-~'AllllN.T 1'~),n;jl!I.I.I!I\~'~:.:'-.SLJII A(J1!tfl' 1'01l SIiI.I.I'.Il-- t"'~ AClliNT I'OIlI~U1L!~-.
~'~f-M'.Lli!-t()-, L~-"~rtce -
c:.1/~-.;;;?__..<:_. . O--"~",,-O' c .
I'A. 1,ICliNSIiII IlIIOKI!lt.m. "I'A. I.ICIiNSlm IIIWKIiIl-'-' ...-I'A. I.ICI!NSllI> IlIIOKlilt.-
Thl. ^"Il~Ill(1I1 IIIlulq IhI' ._ . (~ /____~_____ dil'J tI' ---'-~JZ'--<~r:=--=-=~ ~,-------.-I 199-7
I, I'HIN<:I11AI~" Ilfhufn,_.__ ."__M"'__'__ .-,--------- --~---...,._-.--.~.~~
:::t~;:::~,:,' ;'~I~;I'S; ',~,;~~\...: !;':::JJ:.;-.:.fL 'c:-o.e.n..---' "'j'j\-;\i1~:--'-'. ::::=::
(,,,Idlllg" s".~ Gu-..,::Z....~~ <4-"..~o~~<<r'~ e..;\h:..... ..-~..._.1
hetelllMtef ciiTfe(lllu~l!r. ----.-\).
2. 1'"0I'1':111'\'1 Seller hmh)' AIl'tC' III HIIl\utl (unl/~Y lu Iluycr, who herehy ul1rcc\J~ p\1ldllm~; f-',1. IIlAT,fl'l'.lAI.N 1.()llU lllcee
:~n ~ wllh hlllttll~IY~~' 111l:r:1lI~_cr/17 I~t"ll}nnwn ll~~ ~~ ~__~'~~ ~~~! L=-~=-~
31 l.oNINHl1,onln Clllulfll:IUlol' _____ _~ ~iI_.. ----.-----,- --_.~. -.----------
Failure of lhil A,fCclllclllln t>UlT\llIfllllc l(;;;'i;l'llja~'lrklllltlll C:-t~'C:llllII c,,~c:~ wherc lhe properlY (or c.ldlllllrcellhcren(, If luhdlvlJable)
II r:olled lulc:lyor lulllwHy 10 permit dnllle.fumUydweIllIlR' dUlU rcncler Ihl. AMrcem.1'1I1 vulllllhle IIllhe (lfllltlll of Ihe 1}lyer And I vplde
4, ,~~r.:~I~lt(~I;I~:'~;~II:I~~~h~r:~~y~r_~I&;;e~I;ClW~~~1;;;/J~~:~~/L/1. ..
.____... _._________..__..._.._....._________.. IL..~-:Or(}..'J.CJ.:... " .ap
10 be pnld hy the -tWYCI 11\ folhlws:
::: ~;:'~;;~~~:~~:;d~:'~'~~~~:~,;:.'h'~~~~"~f. :____II~O-~::~
~d) ~~:~~~\~~J'(I~:,~~~~~~~; 11:~~;~~...l I~~~~lt'.l~..,..,",.,.,... ,..,." .,.,.,..,~..,.".,.".," s....33.,.tJ~o_.. '
T~OT^1. ............ 1'"'.~.4"k,_tj ()-iLf!&'LrlP
W/lttt".IlfIl'Onlofs.ltrrIObeOIlOIM((}/.lht_.__til._~_d. f_ .' ... ..~f~:"1J/~.:7'
!l:.ulfm'1I1 leI be m.df on 0' be'OIt Ih. _..__.._./., __.__ da~ or __ ...... _.. -----.--, 19_1_'-1
Tift 'ollo",ln, tll.1I be .fll'O'IIon'll (11'1"'1'..' "f Ind II limt of uUI.mtnl: 1.(n u 1.~I.d .nd ..ulltll, unll, Il1w,lI till IMIt..,. uI1Im",I"01, cond"mlnlum ,<<,
.od IInm'o""n .1\11<11111111 tUI If 10Y, IUIff .mUIlI 1..,<<lltnI1 if Iny, In.tlhu ""llh In, Olhff h<<lI.bl. nlunl..II'.IIU~k<<l. ^" knit, 'I".lllh, TU.llhlll h. dlYldfd
.~.nl, tonl,uolhnwlu fllo~hkd IImln.
S. rROrt:MTY ~t:nU~Mf.N'r CON~IN(I~:~~:~~~'=~.I.~~~c~~n ~:t :I:":::~: \lr nU~:::li.~7fEd ~t
t, .'IN"NCIN~l (;ON'r1Nm:Nl:YI '!hll ."ffllltnl Illuhjw 10 Ill' 'in~n\ill' II '(lltnWf:
t., IlklNelMl. AMOllNT aJ,:1.~..:t."'\\>QtJ~~ ..__. Hflli .Et\Pr~-3.(5___ MINIMUM nM.M 3l1_~~~__
M^)(IMUM INIlI^I.~ II tJ....~ -'
,1r~;rI!MI!ST JIM!! __1..1.;:::' ~ t.WW.t~M TOr^1. l'OIN.p)..,.l~~UIN9 I.<MN 9J1.!\IIN^t1\IN 1'1:1:, TO lid I'^IU IIY Tilt IlUYI!Mi.. -
rl.MMIN^I, U^TIl ro, Oblllllln. f'ln.nelll' Cnlllmllllltnl __Ll<t;d____(_J_J_='-9_.I_. -
!lrnket lIl.y "I~ht lIu,n tlf Jln\llbl1 'u""u Ilf mllllla~' flllldl, hili \'Ulnnl ",Ulll<< .nJIIlnlihility Il1lnhl.lllln.lluytl', mlllll.", If !lId to.n unnlll ~ obl.ln.d
"hll.ln flltI~hl.d, Ihll A.trfllltlll d..lIl" NIIU. ANII VOID .nd.1I d(JIIIIIIIIl'IIIIU 11,.11 hl "hllntd In Illr lIuyu on 01 IItlu" d~1t Ilr Kulrmflll ., fl"J~l"',d h."ln.
,uhjw hrI",nll III Ih. (llmhilln,ln 1'1I""llh, "1"1.1111 N~l. .,,--
ill) !luyn _".11 nl.h I \lInl(lltlrll 'flJlIi~.lhln In ~ Inl'lIn1lhir Iln,IIIIJ Intllnulcln lu, Ih. uhlln~n ",,11',111 _-v .,-.u- ClltllltM i1~Yl "1111I Ihr Srll,,', 'rJl'o~.1 tln.o'.
Shlluhl Ih. 1I"~n I.U I" llUl~t IIIch ~tIlnllltltd 1ll'l'lk~lllJn Wllhlll lilt Illtdfitd .lIl1lr, II Ih.1I h. .1 lilt "~Ilullllf tht ",lIfF. wllhltl f1yr III UlffUI., d.~,llIn"'lfllol
(l) ~~~~~~~I::~: ~f:~nl~~n~::~i~I:~~~n~:~~~ .~,~:::~IIII:I;:::: ,~:I munlu 1"ld 1111 .eeUlUlI ....ilI h. I", tllt,II" S,lIu .,11'1.11<I'1'" d."'.IU, lubtt\.t HI Ih. kulfl.1Id
UlI In .bun~~ o(w,llI.o n"Ilet tu Ih. Ih.ytllty lh. Stlltl drcl~lilll Ihll ^,'UJII.lIl NULl. ANII VOIIl. .IIf cm\lllllull .nd .'lInlln,tllcy lI.tlYld,.' In, In tllll JI.,.,uJlh,
lottl~1 wllh .n~nthu Un.ndn. CIIIUlnlrn<lu Ih" 1Il1~ Itr hr".ln '" 'lllhll\f,'lltlflll, lh~U Illl 11111111 JlIIYli', .nd Ihil A,'Ulnrnl th.1I nlllllt. d'ccIln.."'.llldln.
Inlu IuulIln lllf I.nl~ tn.nnfl .1 II Iht ~nn,1i1l1J1l .n,1 wnlln,tner "'fl' 11111 ~ 1'." !!r,rnf,
I~) ~lIullf ^!.Ill IllUIl rf\'.ly.. wlh'en (OlllUlllIllfn,1 y~M "III!! Ih~tt;lI~ nrtrul.melll, Inl 1'1' uhl hl~ll, nl1ll1 klnle Ihe IUlllln.hll".1I 'f"'dnt,!, If Iltt ,.1<1 (on,mlult.nl
h 11111 hun ,h'lt .!lh lilt ""11' n 'l'tfIUtll htltll1, Uf "nlllliu ItllIll Ir,'tJlltclln wrllll" by Ihr !lllytl, UlIIU htlmt .h<< II.....HIt,'II~lt, S.Uff III.n hu. Ih. 01111011,
III Ill.' dll~, 01 Iny lIlhflllmt ,hunllef, dUlln,lh~ Ifllll ul Ihll A,lUlllWI. "11111, hill nnl h'~lIlhllht It,It "I !tHII'I "f t I~ ,'llmlll!tmrlll hy tht StoUe!, III A..nl. 10
dedln lIIl1 ^lnWltlll NO.... ANIl VUIII, h~ wllllrlllloli.'rt<1 Iht IlilYU uf hit/htl ~r(hjnU (U ~;III~'1. ~I. ""hl.h Ilm'.1 dtl'ullI '1luIlln r~l" OII.WlIl1l1ll,,1I be- Itllllll.d
III Ih~ tI"y". tuhJW ftI tll. Il~Ylutlll 'tlllllrtll, If .II~. lun.I"td 1m Inl'~'~'UI'h tt(hl: (I). jill, .n,1 (IUI.
NI SlUet h,,,hy ."Ul Hljltllnlt iUlr<"'lltllll hy .llIhullud ~flflflIIUI, Itllul.ble {tfllfj~n IIIMIlI Ihl~" ., III.y ht Itqulle.1 hy Iht 1.1I1111l, Inllhul!nn I" Inllullll .1.ncl.l.
IU StUff Itfnb, .,f<<IIII".y uhllllnn.IIIUllt,..t .hmnllll (I/llnll IlIdhl' hun 1III,III'II.Hl Iff III e.1t nf I hll~~1 /ll'I~UIlI1' fin.lld'l, IH'1lI I lent/Ill' UlIlIl"lllJlI Itllul,lnt
Iny otl~ 01.11 ~f '(""~id. rn.I. Jlll1vldlllllh<< ull.lo( uid leu dn" nlll u(.ed -----'\":) ~', orA,hrA~In\u~,llf Ih. nUJrI'~I~, Q' /J /l -
" KTATllS Of WAH.M ^NII S..W..II: StIlt! Wlmllll lhll 11111 fllIlf'tll, I, m~ked h~ .-r.:C-t..c.Jt ..Q. . _."'___.. w.w .nll -- .-.~~
1t"'f1. I',".hff. Stlltl WIllllllt th.l IhHe 'ytlell"." lully I'aiil fUIIII'1, IllIf Ih. d~lt u(IIlIII_'Ulll(1I1 un IUI1Uhh,IUI~ Olltlllllll ('111<1111<11I. If tillle! .(llln.hl IYllcm
It pfi~.lf. Stlln W."IIIU Ih~1 ht/lll. IIU n(lIl"II(. !/lllllll' 1I1111l1"IP:llil~ III flum IIIl1nklll~I.llIhnrlliu 11i.1 publl>: w.I" .1~n1 "W!l wJ.ll II< .1~~"'~1 lilt -,
I. MUNIClrA,l, l"lI'IIOnMt;NTSI Stlltl loll no lIollw IIr munl.ljl.1 Im(lllwtl1lfnU (luch IIl1dtw.I~I, .,"h" rle.) ..~J~\-I.:". . -~.
~_.__.~_____.____.__.. A,'.;tH III I puhlle Hl~d lIIay u<lllht IlIu~net 01 .ltl.hwIY nc,'u(I.nq fltllllll /rllllllllt IltJl.n <<Ill II( T,. ,roll.IIOll.
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t. ~~l1~~~~~~ft:j i/~L~l(u~~'~'_;.-~_e=t::~~-~ < ;--:.-f-:
::: ~~:;i::~'I~;:~~~:f0~:':::~;'::',:; :::::'i;;:';:':~::;";)(~""~'~':'::i"':J<':"""'i:';:":" -"~';"""~:~'~IO"'~'~:'" }'(Il^~-
I'"(J MefllllllllhlJl I~ln. .~~~.d l~a\td.I'JIIII I) (llh.,ll), ____... _.__~.___.._n_.'~_..__n~_.."__'__'__
U, r.:R,II{INAI,l'YI ^" '1111In. rllln,hln,. hulln.. .1r.eun,t1l1uhlll. .11.111.111111, h(llUfI (hl.;hl.lin. \'hl"dtIIUI .11I1 (rillll' (.nl) ,,"11~,Wnl .flPlIlIrll.lll Iheuln .lId 'o'mln.
I JllflllteulIl, .nd UUIU fIO!lln.U1nl h~h"n,.' ""tll'lIII Illlln. 1~1I".IIY IlIbl, I.V, Illltfln." m~llI .mllllllll 1~'Ill"I. I"fClhu wllh w.1I II' w.ll \'I'lI<till', ICI('(nt, "lilnl
1111'1 .nd/ll' UOOIl ,h.du, .wllln!" y'"lll'lI hlllllll, (11111.1111.,1111 111I"m'll~ w.lht" In,1 .t,ytl\, fie. "Ih_w. (1I.(fI, ,.tllllku, W.1I1 Inllfot", ~h~h'n uhlll'lI, d'.\l'fl~
ftldl, d'.JlffY IIllI It.,,lwltr, \',,'I~ ,lltltl, <,IIlUillllltl "."Iw.", 1111 IUtl. Ihut,tl/'IY, fll;lllllnl' Ilnw III III nil l"III'fU', ..1"'<' I'''''l nf't'llt". ,htlh:1l .ny, IltllnllllttllklUY
f.nlll.d hi Ihh ^"ttllltlll, 81' Inchldtll /n Ih. ';l't 1l1l11"1l,'h~\t l,,;,-t NUllt ,,( Ih. .1~I~e lI\tnllllnr,' Iltlll\ 11111 be '(lIu,,~d III Illhllllllmll'y Iht Stlltl lI<un fl,.nulIl.IICl
d~lf ofllll! A,ltfltl.1I1. ^n, Itlll.lnl". hUIIII, .11011111 ~1"1~1!l~ 111,11 Itnftd "" .h. Ilfeltll\~llllIlnr ", 1fI11tm~1I1 .,e .1""ndUlt~lllllllltl Ihit A,ntmrrll. StH..Ii..tl.~ w.".nll
'lh.1 h,/lhe will dttlytll,..1d 1/11. III .It ul lilt .,lidu d~IC"ht.lllllhll ".'..lIflh, .nd ~II~ 1I1h~1 !1'htrtI111 IItIlll "I Iltlltlll.hy 'f't'clll~~lIy 'It:hr.llllt.lllll.. Indud.d IlIlhll
111r. Slllfl w.lllnll .1I1'1IImhinll. hUlln., .11 (ulldlllnlll!II. mt~lIll1k~I.11I1 tl~cllk.1 _~Iltllll.'\ll "llIlfllll'lIll11d '111,11'11." Iullf III rluflu wlll~ln. tlIUtf II tllllt of ItUllfl\elll.
'lhlt''''all.nlydlltlllOllur~lvrdulin',______m..~__._...._.~.._.._____~.._n'_.__.._____.___.___~___
==~...:;.:.~~:Q.t?4~..~-:.~:~~~::-..::..-==--==
11111 NIII Wrlle III Tills SllRcel
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.~i'~rMi""I'~'lii!;II;;'i~~"'Jf...,~'it,;,J ;f~l ~;I.i; ;I;.II"I,( ':lIwj ~I,d mJ.~~'.hlf'~'IIl~h I; .jill...-I~III'tll'by i1;~ltUl.lJlf !lIlt 1111111.11\', \111111...... .,1I1t It,"li, "'~,:
1'1 lh'lIl1rff\liIllr.~r "" Ih 1111111.1"'1
\'1 rIM' N''" 1111. "~'I 'lilt '"IUIlIll't, nlf\:h.1l1n U,nllllUIllIU IIIMIII till, IUf\'h, '" Iff rtll Ullflllllj,lIlllr UJllf, If Inr.
'/ till' pmnhlll\ 1m '11..,11 In\lu"I\" Iml/lfl Ii" !rlflll.f1\' willi fllwdfd \'U~""f, InlYI'nf' hllllt!1 (hil'ln II/ """'fll~II"11 'tf, II 'II~,.
1'111 ^11fl..lul f,U ""d ,'h.',,, ...111 III .,tUtn'ln mml"IU, If "AV.
I~I IhIUf', IIOft"'1 WII"1I1f1l1 ,,,,It IUlI'hlll.lt IlIIlfH ",11,'.11111'1'11 hlllln.
t~, Ant IUIUr UlIlIllfWl ....hk'h m.~ lot U'IIIIIIII h II" HII. InllfUlll1 ('"ml'dIlY nl 1111.1011111"1/11' ~IU"'l', IHI Iii, I'lfl'~'fllo" ulalll,IIII'lllt It'lllI'lnll~!l1ll nf Ih,
f1fflnh'llot Ih~ (lIllttUun Ih'lt"n, Ih., I>f 1f\III,d 11111 I'fllI f,II tlr n" Stllll, Ilm'H't, all~ IUlnr III lln~tr' 11111",1 If, 1111 lIurfl 1II1t'1"lIt.1 h~ h" lI\ulIl,.ft 1'1111
... "~"",llnd l,.ltl fll' br Ih, Illlrtf,
lill '"I~' 'W'1l1 Ih, 'iflltl '1IIll.hl, III ,ht I .,~~lllltl IIlloll.rl.hlt IIIIt IH 11I1'11 .. wWlIf Illlllltll h~. Ul'"IIMt 1IIIt ~11f111""~, IlIloj'lI ., 1I"'U.ld, Ih.", Ih.1t hnf IhI
111'111111 II; "~In, lll~h IIIIf ulhl "lfl~, un ,I~f ""ilhlllll .h'"nl'lIl,., I" <, I" ul !>flu, fll'"ill In uUII.iUI'lld I" Ih, 1111'" hI Iht Sfll""ll 1~"llnl "f Ih, I'I'I\'h...
ptk.. .nd l'lf Sfll" ",UI 'thllIHlI\, Iltl lIu~,. 1"1 III' .'HlIl 11I"II",d 10, Ih' ""'" h!lllmlt II'lllllll('\'lIIt,t hi 1"'1'"1''' 111"'11'"1111', (I~I \111111111 III 1'"'\"I'h IIlfl;
"iii In Ih. IllItI ,w'"llli", Ih.ll '" nn htllhff II.hIllI, UI lIb:wlollllll ,lIh" 1111'" l'~'tln ht!flll 11'11 ,hi, .....'ffll'Utl IhllI I,<<uml NI 1.1, IlHU Villi,
14/ 'A"Mf.NT Ot' 11t:1'''~1fJ U"",IIIII, ",.,dlm '" Ih. I""n ~I r.tm,nl Ind Ih, IItflOll dnl,lIiltllll rlrff, Ih.U '" 1'IIII.tn Il,Inl'lII' Ih. !ltlltllWhu ,hili "f.ln 11M," III
tlllklllWl(l'llllnlllnlllrllllllllllmllluIIIlIIWlIhllllllflll'lhIIA.'ffllllllIllIrnllfllllltllr _uhlnll'I'!l"lbltl~"'lllld ",UlllluM, A,'llI td'"ItStI1' nll,,'1 hlllll 1M, .nlt
ofllklfl, hllld 'IIY lI'I\'lIh,,,, (I.u~ 1"llIt.,... II "'1"1111, 11f1,,1"1, Ih, I(UlIfIIW, I,r Ihh n/lt.
II Ihu.l. I dillll'l' "'1"",,, 1111 Ihl,u 11ItI Ihl ~fllfl "\fl _hllll fllIlll,,111I fllf .tfll\"h, IIUIII ",III 1111.1'1' Itlll1l1l1lhlf III uwl" 1llIlllill'lIlt IMlt ",Ullln"1f Illhlt hi ,lIl1ff
Iluft' llf III. SlIItI fUI "fUllI"III,tl,.., Ih, dfl~llil ...llh"lIl III .,It'll1llf ",lIfl~!1 "'tlnltlll lift_WI U'ltll Illll ~,lIu ", I ult~ I"UIHI lllllff,lIun' 111I1 Stllf, ""'lhll
III'''' ,W'"III1' Alflll lllil/lll Sllht.tlll ."/!! IU!!"I! III lul,llIm, 1"1 tilt "ilUM III dtlllllll 1II(1'lh., If If ll,lIIl'l ltillim 'iuh.""n Itlk,".hlt ,UII'"IY'. fIn IIHI mm .!l1
llf !'iill IIr 1hI' I~'I, jUhlll1'lh, ","11 III Sllh~I(1I1 " ,
IJ, 'O!'l~fS"'luN ANII Tt:NlIt:ltl '
III ,Inutulun I, III lit 1I,IIHlfd by du,l, h,1 ,"d 1''''Ij.>,III"'''t\lil'll 11>. U,'MllI IIldldlll' (I' ~!I,I.1 II~, I~llllll\' ul \(Ult1ltllll, HI ii, ,lf,,1111I1 lul~lIl1lllllllr Ullt!lI_
.....h...IM Ilm'II,.."I'"lf"l I' 1I,,,llIhtlllllll-.UIII".UI,ltlt 111111 11~11111' "' 11;11 ".IUIII'"I, .flll", l'III"",h, lllfl'llItll hmlll, 1111'" wlll'(kllll'/lll"f., ,~11Ihl,ItI"I"
h~ Inlll.lIl1. wllluwW It t!1I1, ul 11,'1111' uf Ihll 1I,I,fIIltlll "t S.lt If Illl~nl tl".ul'I',I.
Ih' Sflltt will ""I'"It1I11U1'''', "',...luII'lll, ...,IH'II I.I'lllillflnf ,dull!' !tlltlll, if IIlr, ,1I111llllllltl.IIUlt(llItlr 111< 1"t1l1hu ...hl'uul UP'I\I...,III'" I'IIlIltnl o'lh, Ihlnl,
~I I'Ilfnl.1 ""tk'lIl III umll,,1 11,,,1.,,11 l"u.-h'lf flUlll" It hllthy UIH', , ,
0$1 1IIll'tr "WI~t1lh, Il,hl III lU.h . jllfwnl,tII"IIIIIII"hll<lIlllf Ih, Illb)<l1 jlffmllfl, ,"d ",lit f,U~~1t ~1~'rt'IIII.lt dnomltlll.llllU ullll(II 11I111f~4illn, '
",RISNtWI,'~I' ,
I.' lItU" \h.lln'llnl.IIIIII, jllllf't'",(frl(ItTt.UlI'llliI'III1Mlfllllnn,,1 i" jl'I'II'I"h'll h'fllll)'II,1 ,nr 1"'11",.1 'ltnp\'flr II",dlk'II,II'''flllllldltffflnI" 11'I'''lI'nl ~llndIUnn,
1llH'1Il11 w'" 'OOIW U\'f1I\,il
'~b, !!tU'1 Ih,lI btlllil~ 1'/111" fmlll tift 1I11111t11 I'~,u.hr 1I!!lillim, I'f WIIIIIl,nr, III Ii" 'UllI HI II~m.'t III Ih( ,unlltfly It, [i" '" I'II'~, l'uII,III', llll~" lhln hht IIII'
Ofl/lon or "l(lIldlll,1111I ','UlUtlll 'l1d ffl'mln, h~l1d t1Wtl...- I'ild 1111 hl"l,ml UI III I<llplh., Ihl \'101''1'11' In Hi Ih,n ."ltl~t1"lII wllh WI 1'11I1'1(." IlIIMY 1""11'111"
" '~I'I~ff~ I'Iblllnlhll h, S,It,L lIurnlt hmb, nmUl"llh.. I".'n., inllltl hll "I'lillhl, Inltlftl Inllll r'1I1'Wr at lit lilt Ihllt lIr lilt 1Ir~'fII'"U IIllhll "'<<IIltIl/'
n, Rt:I"U~'1t:Nr"TI(JNSIIl ilIU"ltIIl!"lIIlh~1 11I1~tl h~I Ifllllt"'Jt,llhf 1''''IIfIlY, III liflt", wllvr, 1111 Illh, 1111111 III ftll,1 lit/lltt tla1 ;,~'u,1 hI filiI..":.,, !llll'lflllll IIr ItlllI
.', IIIIP<<IIIHlIII" 11111 "'1'.WIt "'11' in "U.no:, 11110111 ~II' ftl'It<flllall"" 111.,1, h, 110, Stllll III ~n, ullwll'II!.'", 1'~IItIU III '1Il1'1,,~tt 1" "'fl~l, III hv Ihl '1,.11 Ilf IIIf .'lftlt, \If
illY 1'1' 1M IIIIfI" tlII1J11'II11tl1UIIlI 11I'1,IIIYlll, III IIv I "I~II"I'IIII1' Ih"hr, If ~II~, UI ,"y III hll/ltll ulr'I'lfllllll and tUlI'I"rf<l 11,,1 thll IIt'lht hl' RRlfld III fllIl(hll' II
I" h\ fI""'1II ~tllUlhl"rr Imlnl 1'1lIw/r1lt '1'f'\'lhr,llu,1t1H :ullI fIul""l a,~",'..k,llr\ Ih.1I Ih( ""I<III('II""'\'llll,lIli... ~/r ""I 'III~fthflll" ttlul~, alllll~lll"llllll "111"1111"1111111
" ,",I"mlll', 01 IIl~!flllllll'"IIIIII.tltll "Illlhlllltr ,,"~tI h,,, I""f! l,f.I\lII 1II,II1ltllllt liMy Ir'IIIII' III willi llIli'd lit! "Hlllall,1 III "1'''" Il1lh"\1 fltl,lI_I' 1\ h...ltfflllll...Il.'w....
111'111111 ""<<lIIffll.'IIIII.III\ IlIr 1V1",lt '.'tfllltlU 1'(lwttn Ih( StUu alhl IhlVtl ~Illllhflr .rt Ill! ",lttllflllll, ""h'~III1I1l, I"HUJllII, Itll/Utlllllll'tII, 1111'11I11111," W'"ltllllllll
\ I ,0111 Of olhffwh'lIf IllY kiml whallllf\~' I""H'IIIIII ,1111 III" 1,IIIht,.,,"I'. tlllI A'Ittllltllllfl~H 1\111 ht IlImd, III11(Jllltd, "'IJllltd III mlllllfltllll"tll! In ...-'11111' UNUltd
lIy Ih~ 11I,,/'1 lIt'tlll,
, II, R",q)"mN~11 Thl, l'lf,nltnl lhln nnl ... If(lIl1ltd I" Ihf Olflr( 'm Ihr IItr'l"h,,~ III Ilttlll III jn I!IV 1I1111l1l/fk, III l'I.,'t "' flllbll,' IfI'II..1, '1I~ If lluru Ih~lIltfll.d llii,
_.,,(m'nI nf I'IU" Of IIflmlllh, MIt" III b, It""l~f\l, ~dl(r tn~" '1 1111/11(1 Urllllll, tlHI hI IInl IIIi'll .'1'" hrtJdlllllhll '.."mutt,
It, IlS!lI(jNMt;Nrllhl. ft"Wllfnllhlll h, hilllllu. 111~ln Iht Iflllf,ll., Il(ill, fl/,'III"", ~,ll1Ilnl,,,,,",,, IIhWllr'"a",I, I" 'l't Hlfnl IIlI,IMhll, 111111" Uli.tllllf Iht ""IIU
. Mrtlfl, II bdn"Hllfflll~ ~1I.J'llltlOll, hll"flff, Ih,III1" nll'~1 II",,. 11t'111~11I1(f III ~l\irll Ihll "llftllltUI ""llhll!\t .h~ ""IIf,n !'t'''''fll "I 11I( ';tfl~I 1It11l, III" {Ihl.ln,d,
10, NnN,I.l!lH'l.Il'Y ,"- "m;NTll:\\"llIl\ mar II( ptuvilltll h~ ~ \rl'~lIlf IlIum/III ", ..Id~n,hlm hi 1"1', A.lfWltm, lI.tlllhl "' Sllh,II.,nlhl, II IlIr, Iff "I"flllllin. Stllff,
nI'Il Ihlllll~",
III. IIflltnly 1II1d"IIlH~1 _",I a'fttd II.lwt'"lht rJlt1'1 I'tlt!ll Ihal lIlt hmlflllllllflt "tnl, hil/l"l la!rl[1l'I\lllll :1",1 Ilnflln~(f1ll1 .nl' "f[klf Ilf flllllI" tI' .,tnl .IId
.nY(<M'(lfl"ln. hlnhf Imlllll/hll UI"""n<tlll Iml fml'l"~UI'fltl.ny nfllw III PUlIlll" Iht "~'I'I'!ltilll htllllU alt 1,"ln. I' ~ttnl IIl1ly In 1',III.iu, lit, "ll~tI ...11 Stlltf
III'flhfl, .ntl wut 1111111 rill Wh'lIl"WU bt lidd liahi, Jlllnlly 1\, If."ally III tlth~'I'M'r 101 Ih, r~'IIIJllIall"t nf allY h,m Il' "'Wfn4111 nf Ilti. AII'/hltI11 "' III,lIlm.,,, fill
I~" III'In","II'IIIIII(1 IhfUlI(,
11, IJt:t'A,lJI.T - lUtf: IS lit' Tin: ':'i'itJljfTl Thl l~id lim~ I." ItlIltlll(tU tllll ~II ulh,r h(IUI Idtut,lltI '''I lilt 1....1'''11I1<111,'1 of "lr ll( Ihl uloli,llidlli o( Ih!! IlWlfflnlll1
.,~ IlI'ft\ly ~"UlJ In '" ollh, tll"lff III Ihli "1'''llltll!. Shllulll Ih, 1111,11:
,., r.1!III Iltlk, III~ .ridltlulIll flll'm'I1U .1 1[1I'<'Ih,d In 1"flt'~I'h ,I,
Ihl .'llInllh f.II, "' il1l'1\1I1fllll' 111101'''''111\1I III Iht !i,lItr, lilt Stlltl'llltlll, m II'f mUII.,l.t I~Il.tu, r'IIl,'/ttlln. IIo( 111II'u', It.~11lI 111I~ll(I.llttllll, "' ,.iI 10 ftln","I'
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(II AJ1flllC.AllLfl "luHviv'''ln )f'()(J~ ',tlA/.II: (l.AST fIU'l[ AtIll MIl)III' IMIIAl) Sill IAl 'lfl lJlll!l M.;'IIIUi TillS REIURN MUS rOE FIl ED IN DUPLIC"TE Wlt.l TilE
tV ~ - - REGISTER OF WILLS
[J ,. Oriqlnal ROllin! -----rJ1!SupPlomOl\lill Return 0 l~~;,ainder.ROIUrn(d../t'oldUl11pnOlIo 12-1H2)
[J 4. L1miled Eslale [] ,1, flllllr. IlIler.sl Complomis. Id..or..",..., 11.11611 [J 5. f.d.,,1 Eslale To< Relurn Reqoiled
[] 6. Decedent Diod T05lillo IAtt;!i:h COH of \ViiI) [J 7. Decedent Malnlilil1ed a Living Trim! (Att..:hcoP1 or IIV,I) ___ 8. Tollll Numbor 01 Safe Oeposit OU~O:i
[] 9 litigation Proceed!t Rocoivad ['/10 8p0usal Poverty CrAdit Id,l!&orllll,l1h~lllwMn 12.]1.9\ N'd !.1'~51 f] 11, Eim;!ionlo lax llflder Sec. 91t.1(Al (~"iICh.O,r.h(iI
THIS SECTION MUST BECOMPlETEIJ.'AiTcoRRESpmioENCE ANO'CONFioENTIAl TAX INFORMA-iioN SHOUlilBEDIRECTEOTCi:-
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REV -1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
i",;'i1'
filE HUMBER
7-1- 97-,07<6g
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//3 IN CLe/Jll..!,etJ ))/Z
(AN'! !-Itl-/,. /1J J7011-110'23
,. Real ES~le ISchedule A) 111
2 Sloc~ and BOllds (Sell.d"l. B) 121
1 Cl0!hJly Held Corporalion.Parlnership or Sole.Pfopriclofship (3)
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IX
4. Mort9'9" & NOIe' Receivable (Schedul. D)
5. Cash, Sank Deposits & Mlscollaneous Personal Property
(SchoduleE) j
6. Jointll o.ned Proper~ (SChedule f) .;'
7. Inter.Vivos Transfers & Miscellaneous Non.Probate Property
(Schedule G or L)
8 TolIl Oroll A"elt (Iolallln.s 1,71
9. Funmal E~penses & AdmlllislraUve COSfj~(Schodule H)
I 3 , 4> D 2.. '+1
},3/<1-.;3to
(11)
1'-1 ' " I ~ g3
,
/1 ''if4f3 . 1-f'1
I tJD
' '00
1/ I 71/-3 '-19
(4)
(5)
(6)
II!
1./-1
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/D Cs,zs-.
~/'~39 ,~O
(6)
zlol T/;'O ' .3'2..
(9)
(10)
10. Debls 01 D.ceoent. Mortgage Liabilities. & Liens (Schedule I)
1,. Total Oeductlon. (Iolal L1n., 9 & 10)
.-
12. Net Value of estate (1.1nA 8 minus Line 11)
13, Charltable and Govemmenlal Bequests/SElC 911 J T rllsts 10f which an elec1lon 10 tax has not beon
m,de(Scbedule J)
14. Net Value Subject I. TulLlne 12 minus Line 13)
15, Amount 01 line 14 ta~-able
alltle spousal lax rate I I
See Instructtons on re...erse side for appiicablo porcenlage
16, Amount of line 14 taKable
a16% rilte
17. Amounl of line 14 laxoble
ill 15%mle
(12)
(13)
-
(14)
x .0
(15)
1/'11f.3 t.f'i
X06
(16)
(171
(18)
70..'1' 61
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18. Tax Cue
19 .
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MA TH < <
Um!flf ponalll 01 POljury, I declaif) lhall ha~1I O~llmlned nus fllhHn, flcludil1j] a-::col1lp;m11I\Q 9~hOO\l11l5 aM stallllllonls. a:ld 10 the oost of n11 kl1Owlooqe /lIl~be"'liOTiiiSiiUe~frCt:1 Jill! complete DecI1ilatlofl 01 prepare; OlllOl'
~~~TJ ~ O~ ~E~~~e~:~pO;;~~f'76~'~;:'"~' E;~'~~as ~;'-"'~~~~RESS/73 iJ cleAt v',~ &J J.< DATE
I ~ _._".._ I A 1M J.J II L J) A J 7'fZ.' -_.!liLt.) --.l.
A TlVE ADDRESs""7'J (i.~ ~ ^. I,) ~ DA TE
II J . l ' . .....-c~'!!:..l'- ~
--- ''"''7 J..I.J L.L . ~ ) JOII -1-hU3 I
Decedent'. Complete Address:
Sm6Er^DOIl!:SS . ..~__~__...~",r"
...-----'------_._~-~---
.___.___.~_n_~'_
~
I LIP
ellY
/
Tax Payments and Credits:
1. Tax Due (page 1 Lllle 16)
2. Credlls/Paymenls
A. Spousal Poverty Cmdll
fl, Prior Paymenls
C. Dlscounl
(I)
7dlf,l../
-_._-~._Q._:::,-~
-_.~. --.--- ...~ ...~----
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Tolal Credits (A' B + C ) (21
-t.>_
3, InleresVPenally If applicable
D. Inleresl
E. Penalty
TolallnlerosVPenally (D + E) (3)
4. If line 2 Is grealer Ihan line 1 , line 3, enler Ihe dlflomnce. This Is Iho OVERPAYMENT.
Check bOK on Peg. 1 Lln.19 to ,.qullt. relund (4) - 0 -
II line 1 . line 31, grealer IlIan linn 1. Anlllllho diflorunco Tills is III. TAX DUE. (5) ~ /) If-. t; /
A. Enler Ihe inleresl olllh. lax due. (5A) - ~ --
B, Enler Ihe lolal 01 Line 5. 5A Tills Is IlIe BALANCE DUE. (58) -; olf . &"
Make Check Payable to: REGISTER OF WILLS, AGENT
_. ---..,1Yl\----- _________-' _ ..JIIOm""r'j.;:C'h,rt~:mI.lfT!N_!;fr:'J:','t"~:"'~''':'''' ',Jli~,\l?t':"':;.'f-l)'\'~l;I'~j.\ . :''':1:,':
_~ 'oIM~.Jo- .....ta'lIlIIi1lll..:'\J'\tW1\-"./r.b\'..lClM....v~'h!; '_';'_~,\,~I".lj~",i;t';.uh.~'h..,j(hl~'.I\""""'"
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1, Old decedent make a transfer and: Yes
a, retain the use or Income of Ihe property transferred; .......................................... .....0
b. retain the right to designate who qhall uso the property transferred or Its Income; ................ []
c, retain a reversionary Interest; or............................................................................................. 0
d. rscelvlI the promlss for life of either payments, benefits or care? ............................ ............0
2, If deeth 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? ......................................".............................,..... ...................IE 0
3, Old decedent own an 'In trust for" or payable upon death bank account or securily
at his or her death? .............................. ............... .............. . ....................... . ...0
4. Old decedent own an Individual relirement account, annuity, or olher non.probate property? .... 0
D .-
5.
No
~
~
~
~
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN
. "'""""""''''''''II..._II'''''''''''..''IN''..'_...i'_m~_._...lurltJ'.~! ,.' q......".,.,""';;".\'l'i'rIT.'? i';':n...'~..f...'..!'~~i~.T!~..!',;.,....
_ --~~nrr...,__. .-"~IlJ;i<"".1 'I'.lH.IY'nrn'.T.,.,:IIIIl:I.liI.oInt....~...:.l''liJ.UU6'trr'1l\'1w~..j'E;.,'U.,''.jjf"-",,"fl. '-<"'~-"-'-'" ,i',f...!;,.", .,."Ci,';,
72 P.S. 99116 (a) (1.1) (I) provided for the reduction of the lax rate Imposed on tile net value of transfers to or for the use of the
surviVing spouse from 6% to 3% for dates of death on or after July 1, 1994 and before January 1, 1995.
72 P.S. 99116 (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 dales 01 deatll on or after January " 1995. The slalute goesJ)ot exempt a transfer to a surviving spouse
from tax, and the statutory requirements for disclosure of assels 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'ln the
appropriate spece.
Old the decedent create a trust or similar arrangement which Is solely for the surviving spouse's benefit for his or her entire
tlfetlme? Yes 0 No ~
If you answered yes to the above question, the tax on the trust or similar arrangement Is poslponed untlllhe death of the second
spouse, at which time It will be fully taxable at the rate(s) applicable to the remainder beneflciary(les). Enter the value of the Irust on
Schedule J, Part II, In order to remove it frolll th, calculation of the tax due In Ihls 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 arrangemenlls taxed In the estata of the
first decedent spouse, the portion of the trust or similar arrangement which beneflls Ihe surviving spouse Is taxed at the zelD tax rate,
and the remainder Is taxed at the rate(s) applicable to the remainder beneficiary(ies). If you choose 10 make Itle election. you must
attach Schedule 0 to a tlmely.fiIed tax return, along with Schedule(s) K andlor M III order to show the apportionment of the Irust or
similar arrangement between the surviving spouse and Itle remainder beneflciary(les).
1lN''''''I~':1 .
CQMMONWEAlTti OF PENNSYLVANIA
INfI[RIT^N~E TAX RETUNN
R .Ill . r tJ(:'.[}
SCHEDULE F
JOINTLY.OWNED PROPERTY
ESTATE OF
.€bwA~b --::r kb\JI?
- ,
FILE NUMBER
2/- 'lL-=--k&._
/
II.n ....t WI' m.d. joint within .no yo".r tho d..odonl'o d.I..1 d..th, ~ mU'1 bo ropol1od on 8.hodulo 0,
SURVIVING JOINllENANT(SI NAM,
^UOH~ !IS
RF.lAIIOIlSflIP TO OECEOHIT
A 5~Il.A,J,JI!.,A4, UA L L.
//3 (....J CteAtv"l'.I').b<
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II
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/7/J1t.!/()2
II /I
0;11 lA J J/'(f./--
B, 51<12...A~ IN, II) J.I (.JJ. L..
(L,J..Jt>(t $'j/pJ.('I PI. 1 i'R
'-
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II /I
~ {) /.l 9Ih'i.tC..
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3 IJIII! /)',\ (\ t, C,I?C/t:-
C4J'f 1,1,( '- Ij
170/1
c.
JOINTLY.OWNED PROPERTY:
lErTER DAlE DESCRIPTION OF PROPERTY %OF DAIEOFOE.A,TH
ITEM FOR JOINT MADE Inc!utle oamo of financlill ins1ilulion and bank a::counl numoor or sirnllar Ide nlif)'ingnumbor. AlIa;h DATE OF DEA TII DECO'S V.'.lUEOF
NUMBER TENANT JOlm deed IQr iOintly.MldtcalA9lale VALUE Of ASSET ItHEREST DECEOENT'S INTERES:
1. A. V/1I/1(j I /I /Jt,ziJ S;'VI,JtJ "ZAJK. ,,) Cr .,. 11_' /7 Un. 3 eo ~O 9579. c.:
05 - (JOD ~{,,87R I I
~ ~ ~'1 f/J.,II1//,'( J 4,/)1'" C"I"Av I /)('(7' .Jj 10 13Kt.t. 3313 2. ()4~ c,
I .
I
1- o tf3 LS"
,
,
I
.
.
,
,
TOTAL (Also enter on line 6, Recapitulation) $ /0 !.zs 7,
~
(If more space Is needed, Insert addlllonal sheets 01 the same size)
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bJRIAU O~.INDIVIDUAL TAXES
IHHEAIIAHCE lAX DIYISIDH
DE:Pf. za0601
HARRIS.URG, PA 11Il'~0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENt' OF REVENUE
INHERITANCE TAX
RECORD ADJUSTMENT
to
*
_IV-In, u '" It..."
DAVID W REAGER ESQ
REAGER I ADLER
2331 MARKET ST
CAMP HILL PA 17011
DATE 01-12-98
ISTATI OF l.UDWIG EDWARD J
DATI OF DIATH 09-24-97
FILl NUMBER 21 97-0788
COUNTY CUMBERLAND
ACN 101
r .. A.ount'.'R~..ltt.d l
MAkE CHECK PAYABLE AND REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
NOTE I To 'tnlur. prop.r oredit to )lour account, lub"U the upper porUon of thh for. with your tlK pay".nt.
CUT ALONG THIS LINE ." RETAIN LOWER PORTION FOR YOUR RECORDS '.
Riii:ii9'3'ix'-A;ji-(09~'97i'----'.-.-iNiiERi-iANC-E-TA-i-Ri-cORii-ADj.USTM.€HT--..---.--.--.----.---.--.---...-
ESTATE OF LUDWIG
EDWARD
J FUE NO. 7.1 97-07&8
ACN 1 01
DATI 01-12-98
AnJUST"ENT lASED ONI
VALUE OF ISTATEI
1. Ro.1 E.tot. (Sch.dulo Al
2. Stock. ond lond. (Sehodul. II
5, Cle,oly Hald Stoek/Portnor.hlp Intoro.t ISehodulo CI
4. "ortll.../Not.. Receivable (Schedull D)
I. C..h/lsnk D.POllt.l"llo. Parlonal Property (Sch_dull E)
6. Jelntly Own.d Prop.rty ISeh.dulo FI
1. Trena..r. (Schedull G)
a. Total A...t.
DEDUCTIONS AND EXIMPTIONSI
9. Funaral Expen.../Adalnt.tratlv. Caat.1
Hl1oal1aneouI Exp.n... (Schedull H)
ID, DObt.l"ort..oo Llobllltlo./Llon. (Sehodulo II
Totol Doduetlon.
Nat Value of rlx R.turn
Chlrltabl./Gov.rn..nt.l ..qu..t., Non-,l.ct.d 911S Tru.t.
HoI Voluo of E.tot. Subject to To.
ADMINISTRATIVE CORRECTION
III
(21
(5)
141
ISI
(61
(71
105.700.00
.00
,00
.00
,00
,00
.00
III
105,700.00
11,
12.
191
UOI
10,615,53
,00
(111
1121
U51
1141
10.615.53
95.084,47
.00
95.084.47
u.
14.
TAXI
IS, AlIOunt of LI"" 14 .t Spou..l r.t.
16. Aoount of LI"" 14 t..oble ot Lln..l/Clo.. A r.t.
17, AlIOunt of Llno 14 to..blo .t Cellotorel/Clo.. I rot~
11, Prlnclpol T.. Duo
TAX CREDITS I
PAV"ENT
DATE
(Sch.dub JI
IlII
U6I
1171
,OOX,OO.
95,084.47x.06.
.00X,15=
IlII
.00
5.705.07
.00
5.705.07
RECEIPT
NU"IER
DISCOUNT (+1
INTEREST/PEN PAID (.)
10-01-97
AA242296
285,25
--'-=j
AHOUNT PAID .
5.<119.82
L
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN,
TOTAL DUE
5,705,07
.00
.00
.00
· IF PAID AFTER DATE INDICATED, SEE REVERSE (If TOTAL DUE IS LESSIHAN U. NO PAY"ENT IS REQUIRED,
FOR CALCULATION OF ADDITIONAL INTEREST, IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI. YDU "AV IE DUE
A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS,)
PAYHIlHT.
D.tloh tht top porUon of thh Notict and tUb.Jt with \lour pIV..nt .ntd. p.v~l. to the n... tind adelr....
printed on tn. r.ver.. .Id..
.~ H.. oh.ck or .OMV ord.r pIvabla tOI REGISTER OF WILLS, 4GENT,
REFUND (eR)l A r'fund of . taM credit, ~Ich wa. not rlqul.ted on thl riM Return. ..y bl r.qu..tld by oo.,letl", _"
"ApPUoIUon 'or R.fund of PI"ntwha"JI Inherltancl and E.t,t. hI(" (R~V.lllU, AppllOltlon. .r. l"llllbl, .t
the Offlol 0' the AIgI.t.,. of Willi, any of thl l5 RIVI"U. DI.trlct OffiCI. or 'rOl thl O,p.rt.-nt', 24-hoUr
Inlwlrlnl 'Irvlce "~b.r. for for.. orderl"I' In p'""IYlvanla }-800-362-Z050, outtlda P'~l'vlvlnl.
IInd wUhln 100.1 tllrrhburllllr.. (117) 781-8094, TOO It (1rn 712-2252 W'I,.hlt h..lred only),
REPLY
TO.
DlICOUNT I
PENAL TV I
INTEREST I
Qu.,tlon. r...rdlnt .rror. oontalnld on thi. not It. .hould b. .ddr....d tOIPA DtPlrt..nt of RIY~, Bureau
0' Individual TaxI', Unl, Polt A.......nt R.",lew UnH, D.pt. 200601, Herrhbur" PA 17128-0601, Phon4t
(117) m-6505,
If any tax due I. p.ld within thr.. (1) nll'ndlr eonth. aft'r the d.t.o.nt'. da.th, I flva pare."t (SX) dl.oount
of tha tlX paid I. allowad.
Tha In ttIC -.nI.ty non~p.rUclplltldn PInel ty It cOIlpuhd on t"- total of the tllC end lnt.r..t >>......d, Md not
Plid b.for. Janulr~ la, 1996, thl flr.t dlY aftar tha .nD of thl talC lIne.ty partod.
Intar..t It enlr,.d ba,innlng wUh flrlt day of dliUnqllancy or nlna (9) ItGnth. and Dna (1) day frOll U,. datt of
dalthto tha dlt, 6' Pftyfitnt. '-x.. which He... dtlUnCl'*1t Hfor. Jll'lUllry I, 1912' bllr intar..t at tt. rata of
.b (6X) para.,'t par IIMUII cIleullt.d at a dilly rata of .000164. All talC" which lllc..a daUnquent on end Ift,r
JlIOUarv 1, 1911 wUI b..r Intara.t at I rata which wHI ",ary frOll cal.ndar y..r to e.landar y..r ..lth th.t rata
lMOUnoad by tto. PA Dep.rhlant of RIV~, The appUellbla Intara.t rat.. for I9Il through 1"1 IIral
~ Intar..t Rlt. DIlly Intara.t fie tor V.ar Inter..t R.t. D.lly Intarl.t Flotor
1912 laiC .000S4' 1'61 .~ .000l41
1915 16X ,000411 19'" 1991 Ill( .00nOl
191" II! .000101 1992 .~ .0oolH
1985 IU .00US6 199)-1'*'4 1~ ,00019l
1916 lOX ,000l14 1995-1'9' .~ .00OtH
~-rntar..t I. a.loulttad .. follow"
INTERE.T . BALANCE Of TAX UNPAID X HUHBER Of DAYS DELINqUENT X DAILY INTEREST fACTOR
nAny NoUoe J..lled aftar the tllC bloo... ~aUnqutnt "111 raft"t an Int.rut alloulltlon to flit"" OS) dIn
bayond thl d.ta of th. I......~t, f, Ply..nt I. ~.d. .ft.r thl Intlr..t c~ut.tlon d.te .hown on thl
NoUel, HdIUon.1 Intare.t ...t " clloulated,
J
HOTEl To in.url proplr
erldit to your lecount,
lub_it thl upplr parti~n
of thil forM with yaur
tax pay"ent.
" )TI I' J
;':J " ,"I ( , I ,)
'UREAU Of INDIVIDUAL TAMES
IHllERlTltNCE fAI( DI~I~IOH
DEP1, ZI0601
ItARRIS'URQI PA 111U'Gh01
.
l...,...f
'*
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE Of INH".RITAN.E TAM
APPRAISE HE NT . ALLOWANCE OR DISAlL.OWANCE
Of DEDUCTIONS AND ASSESSHENT Of TAM
IlV'U41 II ,,_ IU.tl1
03-23"98
LUDWIG
09-24-97
21 97-0708
CUMBERLAND
101
[___~~._O~~\~O.lt~to~. -\
MAKE CHECK PAYABLE AND REMIT PAYMENT TOI
REGISTER DF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ....
REV: iiit7 -EX - AFji - (0'9: i7"i. Nii1"ic niF - i NHEifi f ANC! - 1" AX - A P'iiil'A is EMENr;" ALrciwANC!. iili- -.. - -. -- - -.. - - --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
EDWARD J FILE NO. 21 97-0788 ACN 101
SUZANNE M HALL
113 W CLEARVIEW DR
CAMP HILL PA 17011
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
EDWARD
ESTATE OF LUDWIG
DATE
03-23-98
TAM RETURN WAS, I X) ACCEPTED AS fILED
) CIIANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI SUPPLEMENTAL RETURN
1. Rool E.loto I Sehodulo AI III
2. Steck. ond 'ond. ISchodulo .1 (2)
5, Clo.oly H.ld Stock/Portn.r.hlp Intoro.t (Schodulo CI 15)
4. Hartlag../Note. R.clIvlbl. (Schldule 0) (4)
S. CI.h/Blnk Depositl/MIlc. Plrlonal Proplrty (Schldule E) el)
" Jointly Ownod Proporty ISchodule f) ,,)
7, Transfers (Schedul. 0) (7)..
8. Total A..ltl
NO, 01
,00
,00
,00
,00
12.295.41
10.625.91
3.839,00
la)
26.760,32
APPROVED DEDUCTIONS AND EXEMPTIONS I
9. Funerll Expanse./Ad... COlt./HIle. Expan.l. (Schldull H J
10, Dobt./Hortgogo Llobllltlo./Llon. ISchodulo II
11, Totol Ooductlon.
12. Hit V.lul of Tal( Raturn
15. Charitlbll/OoYlrn..ntal Blqua.tl; Non~el.ctad .115 Trult. (Soh.dula J)
14, Not V.luo of Eototo Subjoct to To.
191
110)
13.602,41
1.314.36
(11)
(12)
(15)
(141
14.916..8.3...
11.843,49.
100,00
106.827,96
If .n ......m.nt w.. i..u.d pr.viou.1y, 1in.. 14, 15 .nd/or 1&, 17 .nd 11 will
r.f1.ct figur.. th.t inc1ud. the tot.1 of ~ r.turn. .......d to d.t.,
ASSESSMENT OF TAX I
15, AMount of L1no 14 ot Spuu.ol roto (IS)
16. Anount of Lina 14 tal(lbll at linlll/Cl... A rlt. U6J
17. AMount of L1no 14 ta.oblo ot Ccllotorol/CI... R roto 117)
18. PrincipII Ta)t; DUI
NOTE I
.00 M ,00.
106,827.96. M ,06.
,00x.15.
11&)
.00
6.409,68
.00
6.409.68
TAX CREDITS:
PAYHEHT
DATE
10-01-97
01-02-98
DISCOUNT (+)
INTEREST/PEH PAID 1-)
285,25
,00
RECEIPT
NUHIER
AA242296
AA242618
AHOUNT PAID
'!L419.11r
704,61
TOTAL TAX CREDIT
.~---
BALANCE OF TAX DUE
INTEREST AND PEN,
TOTAL DUE
6.409,68
,00
,00
,00
J
w If PAID AfTER DATE INDICATED. SEE REVERSE
fOR CALCULATIDH Of ADDITIONAL INTEREST.
If TOTAL DUE IS LESS THAN .1. NO PAYHENT IS REQUIRED,
If TOTAL DUE IS RefLECTED AS A "CREOn" ICR). YOU HAY 'E DUE
A REfUND, SEE REVERSE SIDE OF THIS fORH fOR INSTRUCTIONS,)
L;)
.'~; :j
':)0
RESERVATlOHI htlt.. of d.udlnh dylnl on or b.for. D.c...r 12, 19a2 ~~ If IWlV future Int.r..t tn the ..t.t. h tranlf,rrld
In PO....dOR or enjo~...nt to Ch.. a (coll.t.r,l) b.n,'lclll'l.. 0' tht dee,d.nt rft.r 'the IlCplrltlon of anv ,.t.t, 'or
11fe or 'or yel,., the Co..onwll1th herebv eMpre..h ,.tlrfJU thtl right to .ppr.l.. Ind II..... trllntfer t".,.rUlN\o. 'tlCe,
It the hwful Chll . (calht.rlll) rltl on .fW .uen 'utur. Int.r..t.
PIJfIPOtl! OF
NOTlCEI To fulfUl the requlr...ntl 0' S.etlon 2140 of the Inh.r1tane. and E.tat. TDIC "ct, Aet 21 of 1995, (72 P.S.
S.etlon 91itO).
PAY~NTI Dehch the top porUan 0' thll Notlc. Ind .ub.U with \four p.y.ent to the Righter of Will. prlnt.d on the rlVlr.. tide.
--Mlk. ehlok or lan.y orar ply.ble tal REGISTER OF MILLS, AGENT
RfFltfID (CAll A r.f"",, 0' . tu credit, which Will not reque,t.d on the Tal( A.turn, ..y b. requI.t.d by eoepl.t1nl In "AppUcIUon
'Dr R.fund 0' P.nn.YI".nll IM"it.nc. and Eltatl hI(" (REY~UU). Appllcltion. It' IvftUlIJl. .t th.OffJ\:l.
a' the Algl.hr of WlIlt, any a' the Z5 R.v.nu. Dhtrlat I)ffle.., or by c.lllng the .p.alal 24~hour
Inlw'rlng .ervle. nu.b.r. for 'or. I ord.rlngl In Plnn.ylvanla l-100~36Z'ZoSO, out.lde Penn.ylvlnll and
within locll Harrisburg .r'l (717l 111-aD94, TOOt (11n nZ~lZ5z (H..rJng llIpllred Only).
OBJECTIONS I An~ Plrh' In Int""t not ..thfl.d with Ut' IPprlh"'nt, Illo~ance or dls.llowlnc. of d.ductlGrl', ar ........"t
of till: Unc:ludlng discount or Jnt.r..t) .. ,hollln on thlt Kott<ll .u.t obJlct within .lKh (60) dl~' of rlcelpt 0'
thlt HoUel bYI
~~llIrltt.n prot..t to the PI! U-part..nt of Aev.nu., loard 0' App.II., D.pt, Zl1021, Harrllburg, P.. 11128MI0Zl, 0..
--slecUan to hlv, the ..ttlt dlt".lnld at sudlt of thl account 0' the P'''DfIII r.PI....nt.tlv., OR
--IPPIII to the Orph"'.' Court.
ADMIN
ISTRATI"
CORRECTIONS.
FaetuII .rrorl dh<laver.d on thh ........nt .hauld b. addru..d In writing tOI PA D.plrtlent of A.vlnutl,
IUfllU of Indlv'du.l TIICII, ATTHI POlt .........nt AIVllw Unit, Dlpt. ZI0601, Harrisburg, P.. 17121-0601
Phon. (711) 711-65Dft. S.. pIgI 5 of thl bookl.t "In.tructlon. for Inh.rltancflj Tal( A.turn 'or I Allldlnt
Oec.d.nt" (REY-1501) 'ar .n IlI:planatlan 0' ~Inl.tratlvlly carr.ctabl. Irrorl.
DISCOUNT,
If If\~ t'l( due It p.ld within thrll (J) ealendlt IORth. .ftlt the deo.dlnt', d..th, . flv. plro.nt (!V:) dhoount of
ttwi tax paid h aHowed.
PENALTYI
The 15:< hx .~..t~ non-p.rtlclp.tlon pen.lt~ h ca.puted on the totll of the tal( Md 'nt.tllt .......d, and not
paid bfl'or. January I', 1996, thl first day Ifter the .nd 6' the t.x alnutv pltlod, Thl, non-plrtlelpltlon
pln.lh h IIPPlllabl. Jn the .... ..nn.r and In th. the .... tI.e pit lad II YOU would ",pIII the true and Int"..t
th.t hu b.an ~"'''Id .. lncUe.tld on this notlc.,
INTEREST I
Int.,.lIt It eharg.d be.IMlng with flr.t dlY 0' d.lInqu.ncy, or nln. (91 aonth. and ana (I) d.y 'rol the d.ta of
dllth, to the det. of plvont. hlC.. which tHle... d.llnquent bIIfan Januarv 1, 19IZ b.ar Int,,"tat thtl rlt' 0'
llIl (6iO plrcent par aMUII calculatad .t a dilly rlt. 0' ,000164, All till" which b.e... delinquent On IInd lilt.,
JlRUlty I, 19112 will baar Int.,...t at . rlt. which will Vtry fro. nlandar y..r to clllndar y..r with th.t rat.
announcld by tha PI! D..,art..nt 0' R.vlnul. Thl apPllCl8bll Intltlllt ratlll for 1912 through 1"1 sr.1
'!!!r Int.r..t Rat. Ollh Int.,...t ractor :!!!! tnt.,...!...!!.!! Dally Jnt.,...t F"tor
\9S1 lOX .ODDS,.I 1987 9X .0002"7
1913 16% ,000436 1"1~1991 lliP: .000301
19.1ft lliC ,000301 199Z 9X .OOOU7
1915 In .000356 1993-1"4 7X .000192
\98' lOX .000214 1995-1991 9X ,0002"1'
--Int.,...t II osloul.t.d e. folloWl1
I"TEREBT . BALA"CE OF TAX U"PAID K "U"BER OF DAYB DELI"OUE"T K DAILY I"TEREBT FACTOR
~-I!ny Notlcl l..tHtd slt.r the tSIC b.oo..1 dlllnqu.nt will r.fl.ct en 'ntar",t e.leulstlon to ~Ift..n UI) 'dsWI
b.yond the data of the ......MRt. If p.y..nt It .adl Ift.r the 'ntlrut aHPUhtlon dlt. lhown on ttM
Notlc., addltlon.l Interllt lIUlt be osleul.tld,
IS ,) (}il !'J
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
*
( "
IUREAU Of INOIVIOUAL TAMES
IMHEMITANC[ TAM DIVISION
PEPT. Z8060 I
HARRISBURO, PA 171l6~0601
NOTICE Of INHERITANCE TAM
APPRAISEMENT, ALLOWANl:E OR DISALLOWANCE
Of DEDUCTIONS AND ASSESSHENT Of TAM
.n.IU1U'" (U,"l
08"31'1998
LUDWIG
09-24-1997
21 97"0788
CUMBERLAND
101
E~~::~:A~~::~:~~~~~~~:~'.j
MAKE CHECK PAYABLE AND REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE .... RETAIN LOWER PORTION FOR YOUR RECORDS ....
illY: iS4"'f"EX-AFP-niF97Y-NOTicr-oP-YNHEiiifANCE-TAX-XpjiiiXisEHEilr;-ALLOWANCE-oli------------ - - ---
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
EDWARD J FILE NO. 21 97"0788 ACN 101
SUZANNE M HALL
113 W C(EARVIEW DR
CAMPHILL PA
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
EDWARD
17011
ESTATE OF
LUDWIG
DATE 08-31-1998
TAM REiURN WAS 1 (X J ACCEPTED AS fILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI SUPPLEMENTAL RETURN
1. R..I E.t.t. (Schedule A) ell
2, Stook. ond Bond. (Soh.d"l. B.l (2)
3. Clo..1y Held Stook/P.rtn.rshlp Int.rut (Soh.dule CI (3)
It. Hortgag../Hot.. Receivable (Schedule D) <<'-)
S, C..h/8ank Depoli t.I"110, Par.onal Property (Schedule E I <<S)
b, Jointly OWned Prop.rty (Sohedul. fJ (b)
7. Tran.fars <<Schedule G) << 7 )
e, Total A...ta
J CHANOED
NO, 02
NOT~1 To inlur. proper
oredit to your account,
.ub~lt tha upper portion
of thil forM with your
ta)( paYllent.
,00
,00
~
. .00
9 8 . 8ll.:..ll.
.00
,00
(8,1
98,845,21
APPROVED DEDUCTIONS AND EXEMPTIONS:
~. Funeral ~MpanleI/AdM. Costs/Hise, Exp.ns., (Schedule HJ
10, D.bt./Nortgog. Li.blliti../LI.n. (Soh.dul. II
11, Tot.l D.duotions
12, Net Vsl... 0'1 rex R.turn
13. Charit.ble/Govern.ental aequests; Hon"elDoted '113 Trusts (Schedule J)
14. Net V.lue of EDt.t. Subject t~ Tax
(9)
110 J
435,00
,00
(111
(l~)_,
113J
1l~1
431; no
98,410,21
,00
205,238,17
If an ......m.nt w.. i.lu.d pr.viou.ly, lin.. 14, IS and/or 16, 17 .nd 18 will
r.fl.ct figur.. that inc1ud. the tot.l of abh return. .......d to d.te,
ASSESSMENT OF TAXI
1&. AMount cf Line 14 at Spou.al rat. (1&)
1&. AMount of Lin. 14 taxabl. at Lin.al/CI.ss A rat. (16)
17, AlIOunt of L1n. l~ taxable .t Coll.t.r.l/Cl..s B I.to 1171
18. Princj,pal Tax Due
NOTE I
,OOM'OO=
205,238.17 X ,06=
.-..:1!!. M . 15=
llll
,00
12,314,29
.00
12,314.29
TAX CREDITS I
PAVHENT
DATE
10-01-1997
01-02-1998
05-22-1998
RECEIPT
NUNBER
AA24;rZ96
AA242618
AA270127
-.m,:t~ ~::c';:-_~~ ....;;::~." l
,00 704,61
.00 5,919.61
TOTAL TAX CREDIT __1-- 12'329'29'~-
BALANCE OF TAX DUE 15.00CR
--~--- ---
INTEREST AND PEN, ,00
--------~----_.------------
TOTAL DUE 15.00CR
-------- - -
. If PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION Of ADDITIONAL INTERES~,
If TOTAL DUE IS LESS THAN .1, NO PAVMENT IS REQUIRED,
If TOTAL DUE IS REfLECTED AS A "CREDIT" ICR I, YOU HAV IE OUE
A REfUND, SEE REVERSE SIDE Of THIS fOR" FOR INSTRUCTIONS. I
J
\'\('
I
I
'9B !lUll ZB ['1' :OU
Olf:1,
DUIYi\
-_:\l
1'/\
RESERVATION I Estat.. of deo"nh dylhD on or blfor. Dlc.llber 12, 1'1ei!: ~.. 11 .nY future lnt.rut in thl ut,te 11 transf.rr.d
In po.....lon or enjoy..nt to Cl... B (oollltlral) ~".flo1.rl.s of the dlcedlnt .ftl" the IMPlr.tlon ~f nnli ..t.t. for
11f. or for y.ar., the C~onw..lth haraby IMpr...ly r...rV" the right to appral.. end .....& trlnlf., Inherltancl TIM"
at thl lawful Cl~.. B (coll.t,ral) rat. on ~ny luoh future Intere.t.
PURPOSE Of
NOTICE I
PAYMENT I
REFUND tCfU I
OBJECTIONS I
ADMIN
ISlR" T1 VE
CORRECTIONS,
DISCOUNT,
PENAL TV,
INTEREST I
To fulfUl thl requlr..ente of SeoUoll 2J40 of the Inherlt.noa nnd Estate Tax Act, Act 21 of 1995. (72 P,S.
Slot ion 9140).
D.tach thl top portion of thhl NoUce IInd ,ub_it with l/our p8Ylent to the Register of Willi printed on the rever.. side.
~~"ake check or IIoney order I,ayable to: REGISTER OF MILLS, AGENT
A refund of a taM arfildlt, ~hlah was not requested on tho -r8K Return. ..y be reque.ted by cOllpleUng an "App1!aaUOfl
for Refund of P..,n.y!venh Inherltanoo Illld Estllte hK" (REV-HI!!), AppllcIIlIans 'we .veU.blll (It the Office
of the Negl.tor of Will., any of the l3 Revenu$ ~Istrl~t Offlaes. or by aelllng the .peclal 24-hour
.n....ring .arvloe nu.b4lr'l for foras ordering: In Pennlylvnnla 1-80(l~362-20!iO, outside P.nn.ylv..,la and
within locltl Harrisburg are. (717) 787-8094, TOO' (717) 712-2l!i2 (H..rlng lap81red Onh),
Any party In Int.r..t not '8t1l11_d ..lth the appraise.ent. allowanc. or dballowance uf d.ductlonll, or .........nt
of taK (Including dlsoount or InteresU ns shown on this Notice aust object within sixty (60) day. of receipt of
thh Notloe bYI
-~wtltten prote.t to the PA Deparhlllnt of Revenue, B08rd of Appeals, Dept, l810ll, Hnrrlsburg, PA 17128-10ll, OR
uel.oUon to have the .atter deterllllned at audit of the aMount of the per.onal repr.sentatlve, OR
-~appeal to the Orphans' Court.
F.otual 81'rorll dhcover.d on this auen.ent should be addressed In writing tOI IIA De"lrtllent of Rev.nue,
Bure.u of Individual TaKa', ATTN: Po.t Aueslllellt Review Unit, Vept. l80601, Hlrrlsburg, PA 17128-0601
Phone (7111 787~6!i0!i. S~e "age 5 of the booklet "Instruotlons for InherItance T8K Return for a Ne~ldant
Deo.dent" (REV~1501) for an eMPllnatlon of adlllnl.tratlvely correctable errors.
If any tax due hi paid ..!thin three (3) calandar a\lnths lIfter the daoed.nt', death, a five percent (5iO dlsoount of
the taK plid 1& allow.d.
The Hii: teK lMtfltl,ty non~partlclplUon penalty It cotlputad on the total of the telK and Intera.t a..e..ed, and not
Pllld tHlfar. Janua,.y 18, 1996, the first day after the end of the taK a..ne.ty period. Thh non-parUalplUon
penalty I. IIPP4l.lable In the S8lle .Inner and In the the '.lIe tl.. period .s y~u would appeal the tax and Inter..t
that h.s been .......d .s Indlo$ited 011 this notice.
Intere.t Is ohftr04ld In.glnnlng with flr.t day of deHnqu.nc)/. or nine (9) .onth. l'Ind one (1) da)! froll tha date of
.ath, to the dat" of pIYlllent. TI)I,u Mhlch b.o...e dallnquent beftlre January 1, 198Z belr Intere.t et the l'lte of
.IM (6%) peroent per .noUN calculated at ft dally rate of .00016~. All tlKes which heca.e d.llnquent on ~d .fter
Janu8ry I, 1962 will belr tnte"e.t It a rate ..hloh ..iU vary fro. cllleMdlr Yllal' to oalandar Yllllr ..lth th.t r.t.
,,""ounG.d by the PA Vepart.eot of Revenue. Tho applicabl8 .Interest rates for 1982 through 199& lire'
't!!!: Interest fUllte Dally Interut faator :!!!r Interest Rate DaHy Intare.t Factor
1982 20X .000548 1987 9% .000247
1963 16% .000~38 1988~1991 11% ,000301
198. 11% ,000301 19CJ2 97. .000241
19115 1:5% .000356 19U~1994 7% .00019l
19116 10% ,000214 1995~1998 91: .000247
;"~lnt.r4l.t is oalculated os folloMSI
INTEREST. BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINqUENT X DAII.Y INTEREST FACTOR
~-Any Notice hllued after the tax beco.e. ctellnql..nt .,111 refleot ." Int41'..t a.loul.Uon to flft..n ilS) d.y.
beyond the date of the ........nt. If pay_.nt 1. ..de after the Int.re,t coaputltlon date .hnwn on the
NotJae, Hdltlon.l Intere.t IIU.t be calculat4ld,
PAY""NT I
DetlCh the top portion af this Hotlol and .ubllt with yoUr pay..nt ..de pav.bl' to the n... and addr...
pr tntld on the t.".r.. .1de,
If RESIDENT DECEDENT lak" chIck or lon..ay order payable tOI REGISTER OF MILLS_ AGENT.
If NON~REflInENT DECEDENT laka chick or 10nlY order plyable tOl COHHOMWEAl TH OF PENNSYLVANIA.
REFUHD (CRll Ii r.fund of . tal( oredlt, which was not raqU8Ited on the Tal( Return, .~\I bill raqu..tad by cOllpleUng an
ftApplloltlon for R.fund of Plnnllll"."l. Inherltanol end Estata TIK" (REY~l]ll). Applloatlonl ar. avallebl, at
the Dfflol of the Rlghtar of NUh, any of the 23 RIyal"'" Dhtdot Off 10.. or frOll the Depart.,nt', Z4~hour
~...rlng ..rvl01 nu.bar. for fotlS orderlngl In Plon,yIY.ni. }-600-362-2050, out, Ide Pennsylvania
and within looal Illlrrhbura araa (717) 78748094, TDDI (17) n2R22S2 (Hearing I.paired onl)l).
AIl"lY TDj
DISCOUHTI
PENALTY I
INTEREST I
Que.tlon. regardIng .tror. cont~lned on \hls notlc8 Ihould ba addrea.ed tOI PA Depart.ent of Revenue, lure.u
of Individual Texes, ATTNI POllt Auon.ent Review Unit, OepL 280601, Harrisburg, PA 17128-0601, phone
0'11) 111-6505.
If .n~ t.~ due Js paid within three (3) oalendar 1Il0nthl after the decedent's death, a five peroent (SX) dl.count
o( the tax paid II allowed.
The 15% ta~ ..netty nORMpartlolpatlon penalty I. OOlput.d on the total of the tax and Int.r..t .......d, and not
paldbafore J.nulry II, 1996, the fir.t day aftar the end of the tbx eanellty period.
Int.r..t II charged beginning with firllt day of deUnquenoy, or nlna (9) lIIonth. and one (1) day frail the d.te (:If
death, to the date of pay..nt. TalCes whloh heo..e delinquent befllrt,l January 1, 1982 bur Int.rut at thQ rate of
.lx (6Xl paroant per annul caloulated at 8 dally rate of .000164. All taxe, which beee.. deljnq~nt on .od aft.r
J.nuary 1, 1982 will b.ar intero,t at a rata whioh wUl vary frd chlundar yaar to oalendar y.ar with that ral.
IMOUnced b~ the PA Depart..nt of Ruvenue. The 8Pplloahle Interellt rat.9 for 19&Z through 1998 arel
Y..r Int.r..t Rate Dalh Interut Faotor
Year
Daily Intere.t faotor
Int.Nllt Rat.
1912 20X .000548 19&7 9% .000247
19&3 16% .000(138 1988-1991 llX .000lDl
1984 H% .000301 1992 9% .000147
19&5 13Y. .000356 1993.1994 ]X ,000192
1986 lOX .000274 1995-1998 9% .000247
~~Int.r..t I. calculetad a. follow'l
INT~RE8T . BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X DAILY INTERFST FACTOR
~~Any HoUc. "IU4,Id eft.r the tax beoOllu d.linquent will reflect an lnt."..t oalculaUon to flfteen (15) AY'
bayond the datfl of the ........nt. If pay.ent is ..de lifter the Jnterest ootIPutaUon d.te .hown on the
Notloe, additional lnter..t au.t b. oaloulet.d.
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUM'.RLAND
l
J
III
HU~fll1l1e 111111
_ according to law, do poses and says that B he l.H"th~..Ex,~c.utrlxu.
0/ tho E.tate 0/ ~:dWllrd ./ohn.l,udwill ..,.,.
I.te 01 CUllIp 1Ii.11 ., Cumborland County, Po" deceased end that the
within Is an Inventory mede by, SUZfllllW Ilu11.__. the sold I\x.ecut.rlx.
01 the entlro est.to o/seld deced.nt, consisting 01 all the personel propdrty and real estate, ucept real estate outsld.
the Commonwo.lth 01 Penn.ylvenla, ond thot the Ilguros opposite oech Item 0/ the Inventory repre.ent )~. lair velue
U 01 the date of decedont'. doath, / II y,:-(lYv_--,
,~/?V~I/ II ,;~' . and subscribed be/ore mo, ~,' We., Ql1L~- _.~1, /~l~~(. _ _
~{j_IJlft /l<;l, II 19~.lj_ r- (] emutor . Admlnl.t..t.,
/~/)/X({l/ ' /) //~)tl;l- j
r >
NolmiillH!ltll
RIlondn L Woods NOhory PubliC
Camp Hill nom Cumtlurlan(j Cl)Wlly
My Oomml8clnn Explrss r.npl I ?OO I
nosy VAn (\ Assod~lion 0 Illarlcs
1 Heptelllber
bolng duly. "WOrn
Add....
1997
Date 0/ Death ___."
DIY
Month
Vear
INSTRUCTIONS
I. An Inventory must be flied within thr.e fIlonths aft.r appointment 0/ porsonal representative,
2. A supplemont Inventory must be flied within thirty days of discovery 01 addltlonel a1.ets,
3. Additional sheets may be attached as to personalty or realty
4, See Article IV, Fiduciaries Act of 1949.
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