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HomeMy WebLinkAbout97-00916 8ml' 01 CYN'l'lItl\R. POUB'l' also kllOll'1l as l'E'l'l'l'lUN IrOH l'llOUA'l'E IIIIlI GHANT OF LKn'EllS No,~q/~, TOI Reallter of WillI for the 7 Dec,as,d, County of CUMBE1RLI\ND III tho SocIal $,el/rll)I No. 19 3 ~ ill ~ 2 '!.ll COlnmonw.eallh of Pennlylvanla The petlllon of the unllorslanod IOIpoolfully roptClOlIl1 Ihall Your pOllllonor(s), who IlIa to 18 yentl of Rae cr oilier antha mout or' Inlha lasl 11'11I of Ihoa!lova daoedenl, Ilpled . l'lar911 29. , and colllcll(l) Ilaled '. nadwd ,19 (11'nlo ,oloynlll OhOlllllllnllO'" I," "llIlIlolnlloll, ,donlll or ..,oUlor, .it,) Ooo.d.nl wnft dOllllclled", dcnth In cumberland. County. Ponnlylvanla, wllh I' ...... JaIl family or prl~~nllOlldenoa Rl-~:B~tl~~~~B~~g~Townslli9 IIl.t nlteot, nUlllbor, '1'11'110 urUoro,1 pocOIlonl, tholl 7~ .. l'earl ofn~q, dlod November 10, ,1997 1 at ,'. HA,1"~,~8h\1rg.HoBpitEll '_ - - - - -.' - _", a~oapt 01 folloWl, deced.nl did notlllnrry, was not dlvoroed And did not have a ohlldborn or adopled aflor e~eoull\lllof Iho 11'11I offoml for I1roualelwnlnot Iho vlolllll of A kllllna and walllovor adJudloal.d Incompllenll Decadlnl,.allloalh oll'nollllfopCr\y wllh olllmnlelll'alues as fcllowSI (I f domiciled In Pa.) All pelSollnl pruperty (If. not domlelled In Pa,) rouonal properly In I'ennsylvanla (If not domlollod In Pa,) . PersOllal ptoporty,ln County , Vnlua of real Cllato In Ponllsylvanla ' sltualeda. follo\l'll , ,. .. 6~111~~~i~~l~g~nte~S~APellnsboro Townshl.p 'n'11BRBI'ORB, pctlllollor(s) rospoolfully 1.0l\\lostls) Ihl I?tcbalo of Iho la,st will and oodloll(s) ptesontod hlrowllh and tho pralll of'lolletl 'l'ej;ltaYllen1,:ary " . '. , (lulllilOnlllYI IdmlnllUlllon e.I,I'Il\dmlnIIlJlllon d.b.n,e,t,I,) ",,'" , L,lJ,~ 11..1 'WIIuam H., Poust, In 3 Creekbottom Circle ~lll~b~rg~ p~ 17019 i~ $ 192.000.00 $ $ $ 95.000.00 OATH OF rEHSONAL ltEl'ltESENTA'rlVE COMMONWIM. Ll'll OlrttlJ:NNS\'LVAN1A } ss COUNT\' OF', CUM13mRt;ANO 'rho petltloncr(s) nbol'a'lInIllO\1 SlI'onr(l)or amnll(s) lhat Iho $tAlomOllls In Ihe foreaol118 pollUonaret huo Rlldoottecllo Iho !lUI or lho kllowlad80 nlld uollof of flollllonor(s) alllllhnt n. fletlonnl to/ltosan. tntlve(l) of the abuve Ilacodalll, /l~tllloller($) will wall and Iruly admlnlsler the ulato loaordln8,lo law. nrrlrlllad 11I111 luvlorlbad ._.....-~ dny or _ I 97 ~' frgls/or , IS Will; t:~ ~1 {J~. ~~ ~ .. v v' ~ pI t C~RTIFICATION OF NOTICE UNDER RU~E 5,6IA) Name of Decedent. CYN'rHll\ R. 1?oUS'r Date of Deathl November 10, 1997 Will NQ. 916 Admin, No. ....., To the Reg.isterl I oertify that notice of benefioial interest required by Rule 5.6(a) of the orphan$' Court RUles was served on'or mailed to the followinq benefiei,aries of the above-captioned estate on February 4" '1998 I Name Ki Joyce mnaminger .. William H. poust, III William C; EnsmJ,nger, Jr. T t y A. Ensminger Diane Ensminger Lisa Wise Addres s 1510 Two TUrn Road, Shippensburg, PA 17257 3 Creekbottom Circle, Di11sbur.g, PA 17019 417 S. Lewisber Rd. Mechanioshur PA 17055 6645 Wertzv{lle Road, Eno1a, PA 17025 1426 Market St.. Apt. #2. Camp Hill. PA 17011 33 Fort Clark Estates, Eenwood, West Virginia 25031 'Notice has now been given to all persotls entitled theretouncler Rule 5,6 ('a) el<oept None ., Date I 4- m f/,f' . , , Horace A. Johnson Duf de, stewart, 6< Weidner 301 Market Bt., 1>. 0; BoX 109 Lemovne, PA 17043-0109 T'elephone ( 717)761-4540 Cap~citYJ Personal Representatlve U -j x counsel for personal representative ',;(i (' co,,)lO"WEllII; or PF.",,'V\VANIA OEPMHH[Hl or Hf.YENUF. nu~rAU 1r INJlvtDUAL TAKtS OF.PI, 110,01 IIARRIBlIJilO, PA 17m-OUI '. ~NPO~MATtON NOTtOE AND TAXPAYBR RBSPONSE t'XL.1 NO. 21 97.0~16 AeN 98113863, DATI 04-14-98 TYPE OF ACCO~NT EST, OF CYNTHIA, R POUST ~ IAVINGI 8,8, NO, 193'18-2745 CHeCXING DATE,OF DEATH 11-10-97 TRIIIT COUNTY CUMBERL.AND ' ' ClAm, ReHIT PAVHBNT AHD PO"HI Tal R~~ISTER OF WIL.L.S C MBERL.AND CO COURT HOUSE C RL.ISL.E. PA 17013 m'liHUmU'"' MM JESSICA L. ENSMINGER 217 S L.EWISBERRY RD MECHANICBBURG PA 17058 PNC lANK oeCBDeNT "BPORTlNG III' pr.Yld,. 'n, o,p.rt..nl ,.I,ln tll, Inf.r..t1.n 11.1,. .,1.. onl.h h.. boon "". In olltulltlng th. pottnUll hliC dUI, Th,lr rloard. Indlolt. thlt at thl d,l\h of thl .bov. dlud,n", ~oU,_M.r. I Jatnt awnlr/btntUollrV of thlt aocount. If vou f..l thl, Infor.,tlan II lnQorr,ot, pl.... o~t.ln written oorr.o\lo" froM thl '1","0111 Inltltutlon, ftt,tloh · o~pv to,thlt for. and return IL\o' thl ~ay' Iddr..., Thh acoount 11 t.UCabll 1" .ooOrdtnOIMHh thtllf\h4frltAnClt T'''I ~...."of thi c~nw..lth .1 Pohn'Ylvonll. O"uIlQn, ..V b, on.o"'. bV .,lIlnl 11171 '11-UI7, ' OOHPL.ITI PART 1 Bll.OW 11M II 811 RIYIR.I 81DI FOR P%LINDAND PAYHIiNT IN8TRUOTlON8 A..ouot NO, 31700090942 o.t.. 06-10-97 I. In."" RroP" .".It 10 v.ur ....;.;,1, Iw. B,t.bUlh.d (2) .opl.. .1 Ihl. nollu .".1 ,oo..p,nv v."r n.v.'nl I. Ih, RooI'I" .1 WI1I,,'''Pllk' oh,.k P.~,bl. tOI~~t~l.t.r of W)ll', ,~..nt"l [ C~R~KJ 8L.OCK ONL.Y, Aoo.unt S'l1on.. ' 00 p.r..ot T.~.bl. K 100 , 00 A''''UOt sub~..tto T.1I ' 00 T.~ R.t. K . l!l ,:PolonU'll T.~ Du. :00, T ' T I SPO li:~'P~I~lm"..fq.,.."'UIiII~~,~:"~~:~~,,,,'1~!t:;<,'~......".,,'!'.'.~..P...'~ A. ~th, above lnfor..tlon .nd taM dull. aorrl4t, ,..all. You .,vahoo" tor..U ply.."t to thIR"lIttr of MUll with ~wo ODPlu of thhnoUOt to utlln . dlnount or I"old lntflr"t, or vo'"' "Y chick hOM "A" Ind .r.turn thl. noUa. to the R..l.t.r of Willi and ,n offlol,1 ......-.nt will bl 1,.Uld by thl PA Dlplrt-.nt of RIVInYI. f a. 0 Thl .bov. ....t h., b.en--or wlU b. r*portld .nd i'M ,Plld 'wUh thl PemnlvIr\hl InhtrUtn'o. TIM rtt\lrn to bt fllld by thl dICtdtnt" repr"."tlUvt. ' C. 0 Ih, oboV' Inl.".II.n lhi,n..r".1 wl/.i:"l\'~" ond ._lIon' wor, p, 0 V.I" v-l VOIl 0\1,1 ..opIO\~ PA.RI L!J ,nd/.r PART l!J b,l.o, .~, Cl:i PART If yoU Odi.... d ff.rlo .M r. ., P .... . . . y.ur ~ r.l~ti.olhlp to d...d.otl TAX RITURN , OOMPUTATION OP TAX ON JOINT/TRU8T AOOOUNT8 UNS 1, U.t. S.tIIblUO.d · 2, Aooount 8.1_. a I, P.rollnt T.Mobl. I x 4, Al!ClUl'lt8ub,1oqt to, T.~ 4 I, Debh fIf\d D.d<loU.o. I 6, A.ount T.~~l. 6 7, T.M R.te 7 M I, T.M Duo 1 NOTKI,"ll t,.p.v.,nl' .r, .od, wll~ln I~r" (II _lhO .1 lhO .,.,.onl" .,1' .1 ."Ih, V.U,"V .,"".1 , 6~ ~I,.ounl .1 lho II~ ""', An~ Inherit'".. tl. ""' 0111 b..... ..1I",,"onl nln, (9) "nt~. .II,r lhO'.'I,.I .'"\~' w._~_~~- PtffiT DATE PAID RYnLAWl.. DIDUOnON8 '1 . CL.AIMI~ ';;;_:;:)::-':';,!i;':-;; ;::::'. ','Y','.';","" ,-.!:,.; ~";," ,. C,,, . ,. ,,. ,...,.,;,,,i ! Uod.r p.o.1U.1 of p.rjur~. I d.. hr. th.t tho flloh I, h.Y. r.po~t.d .boy. .r. tru.. ..rr'bt .od ...P~~ ~h~b..tf. .~~~~~::~~;~i~t\, U~:~ g~ ~ ~ ~ ~\~: ~;~~~; 1,I.~f' fY TAXP~I~~~KE ~ ~- T~mRrlriENuMB'Ell 'rATE PAVEE IlESCR I Pll ON AMOUNT PAID BENERAL INPO~MAtIOW 1, FAI~UU 10 ftllPOND WILL RI'U~T IN AN O"ICIA~ TAM AaanaHBN1 vlth .ppll.olI" 1111"..1 ~...d .n \nW..II011 ..b.llltd ~v Inl f\n....I.' In.IIM'.n,,, t, l"hlr",,"U 'llC bIGD." dtUnquent nlnt .on\h' .fhr \hl alOldlnt" dlt' of dutth I, , J.lnl ...ounl I' "00111' .v.n In.Vln' Ino d...d.nl'o n." 0" .dd.d .. · ..llIr ., ..nvIIIIIII." 4. ....unl. lIn.l.dlnl In.'' '"ld ,"I...n "..b.lld .lId vlf., .nl.h tn. d...d.nl ""I III 1.lnl no'" .lIl1ln .11' v..r "rl.r I. d..ln or. ,.IlV I...bl' ., I,.n."'l, " , &, ,..ounl' ..I.bll.nld lolnllv, b.b..n n.,b.nd .nd _If. .n" 'h~n .n. ..or prl..r '" d..lh ." n.1 ".011", 6. Aoaountl held lj" . dlOldlnt ~In tru,t fartt ,noth,r Dr ot',.rl tr"anbll tuUY. I. nOCK' , If In. In,.r..\I.n ond ......I.llon In "" n,\I.' ". .orr..1 ,"d dldu.lI.n. or. n.I~"lnl .1,I.til, p"" on .K~ In ~Iook .... .f ~"I I,.f Ih. .T..p.v.r ~I,,,.n". ...\I.n. "11II tv. ..,,1.. .lId ,.~.II Ih.. .lIh V..r pn'" f.r Ih. ......t .f I.. I. Ih. Rog,.lIr .f Willi .f 1111 ....,IV Ihdl..I.d. In. p. PI""I..nl .f Rov.n"' .111 ,.... .n .ffl.I.' ......_1 I'." Rav'''U eKI o"on ".'1,,1 0' .1111 ,,\Urn fr.. In. ~"lol"" Willi. . .. I\DCWI' 11 In, ....I .p..lfl,d.n Inll n.\I.. nil ~I.n or .11' ~. "p.rl.d .nd I.. ".'d vlln Ih."onnlVlv,"" Inn"lI.n.' 10, R.turn mod ~V In.d.,..d.hl'. "prll.nlo\lv" ,,"" .n "K" In 011..' "I," .f ".rl 1 .f Ih. -T..".y.r'R..".n.." ...\I.h, lien .n' ..,v .nd rol.rn 10 Ih. ".' P."",..nl .f R.v.n." I"r... .f 'ndlvld." 1...., D.pl U06Dl, lI"r,.~"rl, p, \1\11.01601 In Ih. Iny,lope providld, ' I, "'OC~ 0 .If In. n.\I.. In'.,"II.n II In.or".1 ,"d/.' """,.tl.n. ." ~'Inl .,.Iud, .n... ~,... .C. lIIId ....1.1. "orl. IlIIId I ....rdl.. I. In. Ino"..\I.no ~.I.., lien I.. ..,,1.. ,"d .ull.lt Ih.. .lIh v..r .h... fOr tho ...""t.f I.. ",y,,"l. I. 111I.R.gI.lor ,f 11111. ,f In. .."nlY IndIG.I'd,lh. ",. o.porl..nl ,f p.'.'.n". \Ill' I.,.. .~ .ffl.I.' ........nt IP... n~V,u~a aKl IIP.n ....1,1 of thl return frOI thl RI.llttr of Wltl', TAX RETURN . PART 2 - TAX COMPUTATION REPORTING INSTRUCTION- ~ PART 1 . TAXPAVER RESPONSE lIlII! \, anlor Ino dolo'lh. ...."nt orl~ln.m .....I.~'loh.d .r \llIod In In' ..nnor ..I.llnl .1 d.l. of d..lh, HOTal ,." d...d.nl dvlnl .fI.r 12/\11111 '0'.\11\11 .nl.n tho d...dont p.1 In j.lnl n..... .llhln .n. (\) y.or .f d..ln '.' I...~l. f,,'h,1I Iron."'" 11..'vor, Ih'ro I. .n ...I"oI.n n.1 I. .....d U,OOO por Iron. for" rolordl'" .f In. v.I.' .f \hl IOcount or \hi nu.blr of JOOO\.M'l'1 htld, If . d."bl. ..1,,1" (K.I oppo.r. ~.f.r. y.". fl,.1 n... In In' .ddr..1 p.rtl.n .f Ihl. n.II.', Ih. ..,000 ...,,,.Ion llraldV h..~..n dldli.l.d fro' Ih. ..oounl b.l.n.' II roporl.d by Ih. fln.n.I.1 In.III.II.n, I, ~ntor Ih. 1.11' b"on.' of In. .00.""1 In.'"dlnl Inl"..1 ..oruod t. Ih' d.t. .f d..lh. 11 Thl Plratn' of ,th..aoO\fnt thl' It ',)llbl.. for ..oh lurvivor ,. d'1~r._'ned .. fOUo~'1 ., lh. "".,nt I...b'~ for l.lnl ....11 ..llIllllhod ..ro In"" Dill y..r prl.. I.' tho do..d.nt" dlllh' I OIVIOIlO IV TOl.' ~~I~R op DIVIOliO IV TOm HUHlaR OP K 100 ;'. I\I!RCaHI Tmlla JOINT OWIII!RI IURY1YIHl! JOINT oHH<<nl 1!"llIfIltt A joInt ....t r_"l,tlrld In thl "Pi (If thi dloed",t and two other perlon.. I DIVIPI!D IV . (JOINT OlIHl!RIl PIVIPaO IV 2 (I\lRVIVllRIl - .167 . 100 . 16.7. m..IlE pllA E.CII tURYIVllAl I. Tho p".ont I...~I. for ....II or..lld .lIhln .n<i y..r of tho d...dllll'. d..th .r ....""U..lll"'l bY Ih. d.....,1 IMlt h.ld In Irll.1 '.r .nolh" IndlvldU.H.1 (\ru.1 ~on'fl.l,rl..lI , OIVIO~O IV TOT.~ HUHI~R O,tURYIVIHG JOINT _Rt IlA TIlII" 1~H<<pICI~I~1 K '00 . I\I!RCaHTT.XIIL~ ~."",I'" Jolnl ...Dunl ,,"I.I..id In Iho n... ,f 1111 d..o<III\1 ond lwo .tn., porion. lIIId "11Il'1o"'" vHhln ..,. y..r ., d..lh bV Ih' d...d.nt, . " 1 DIY1PID IY I (IURYIVORIl . ,10 K 100 . 10K (lIKllla FIlA. a,OIl SURUIVORl \, lh. ...ounl ,IIbJ..I 10 1,...(\ln..l I. dOl...lno<l WInI'II,,'yll\ll Ih' .,,0..,1 b."III.' 11Ino II bY "" "or....1 1....11 elllll II, a, ~nlll 11111.111 .f In.d.~1I lIIId d.....llon. Il.t.d In ".rl J,' ' 6. Tn.. 100II')1,10'0111, 1I1r\O 61 I. dlllrllln.d ~v .,,~tr..llnl 1111 dolll. .nd d.d..\I.n. OIn. II f'.' 1111 .....,1 "'l..t I. to. Cllno 'I. 1; ~n\.r thl .pproprl,tl t.~ rlt. ( Inl 1~ .I',det,rlln.d bl1ow. '" ,.r dOl" 0' lIMlh ..."rrl.. .lIor 6110/t4, thO I.. rot.. f.r Ir"".fl.' I. "",,,,, .ro .. f.II...., I, 00111 ., ,,"Ih ... ., ,ftor !I\lt4 ondboloro \11191 lhO .11' I. .., I. OIl" .'. ..olh on .r .fll' 1/1191 Ironl,for. t. opoIi'" vIII bo "'" .1 ox \I' rol., ' HOIII '.r d.I" .f ....th "rlor I. !I\l94 "onUor. I. .........." 1..01111 .1 6.,., I,lrlll.fo" 1..\lno.1 "o,,""on\l 1",".Uno fll".r, ..1111', .on, d""""W, l,on4Ohlldron, oon'ln'IOII, "...,I"'lll~I"1 .I"""nlld and 111IIr I.fu. ." lor.b" It .1. "".11I1 16.1, C, Tr,",fI" 10.1 .Ih." 1",'u"ln, ~,.Ih", ..I.lor, \lIMIl., oi\iii1, nop"",, lIIId nl..' .ro \1.0111' .1 flllllll ptr.onl IUXl, 0, If V.. oh_ thO II' ,,\I, "I.... ."..lfY y...r ,."II....nl" to thO "..."",,1 In Ih. ".. pro.ld.d, .- I, Tho -'III ., \I' dUI C11~ II " dolor. I"'" bY III'lIl"lvl"" 1111 -",I "".," 11Ino 61 ~y 1111 IIMrol. (1111I 71. c~AIMED DEDUCTIQNS . PART 1I , DEarS AND DEDUCTIONS CLAIMED .11.....'. dlll\l ond dod\IQ\lon. or. dOl".I"", .. f.lI"" A, v.. 1'.III'Vor."",p""'I~'" f.r ".v_l, 0' Ino ..1.1' .uIIl..1 I' ...In,.lr.lI.n ~y ... "orl.n., rOl\r..IIII.II". 10(ln."f11.1lll\1 I.P'y 1111 ........tl~l. 1\..., . I. v.. .00u.lIV p'ld In' ".~I' .flor d..lh of I". d...dont ond .on '"rnllh pr..' .f"oy..nl, c. Doll,'" bol" ,.,...d ....1 ~. 1\I.IIId f.IIV In "orl S, 11 .ddlllon.'"P'" \0 IIIlId.d, ".. p\.ln ".....1 \II" · II", ",..f of p'V,,"1 .OV~. ,'q\i.,lld ~y 1111 P. 0'''''''11I1.' R"''''''''' .. . :,' :.' ..:".,.,;.:. ..:.".,..:': .::, .. '. "T~~""~" ~:., ....I11TANO.. .' ..:,.?...."., ".":",,',,:.,:.:. ..:.:: ..:::,.;..;..,:,:....,-'::,:\...:.~,:.,:."...,...:.'. .' .. .... ' .. ", '. ..., . ,. ... n. "" ..." . ....,....." .............. ...... ...""............. ......... . ,. ',.' "'Mivo~..,tlllal.f1URnill~ tIN' ~ OJ'p\'S1ST~CE;tON1fc:t:}.NVii:),f}?\\::;H:: ~;~ilJti\\!t11'fM~~1.~!.,IJ~~.I~I!IElt~II~~{liIfLif'~"~~I~J1 " ." .... ' .' ,..,.. .' ,.'.. . '.. .. c.., CDI1lIONWUl 111 Of "~HNmYAHIA DEPAN,,,,,H' III REY~HUt! aURUU Of IHDIYIDUAI !ANEt OF.PI. 110,01 UANRIIIUIIO, PA 111"'0601 . %NPORMAT%ON NOT%CI AND TAKPAVIR RIIPONI. 1'11.1 NO. 21 97 - 0916 AON 98113864 DATI 04-14-98 ItW.I,U U UP "'"1 MM AllHLEVWnE n FII, T, , CLARK BENWOOO EarATES olViI\ " ,:UUI\' WV 26 OnOUmbbi..','; '"\),, PA ReGorn '" .ll!!,!, 01 TVPE OF ACCOUNT RoUII.' 'Willa EST, OF CVNTHtA R POUST ~ IAVINGI 8.1iI, NO. 193-18-274& ,CHICKlNG II TE OF, llEATH 11-10-97 TIlUIT '!Ill MOY.\ I' \ :lilCuN'I'Y cu.....". . . ..n" . RIHIT ~AVHI"T AND faRMI Tal ~5~lUP~N8Fc~Ihh8RT HOUlll! . CARLutE, PA 17013 PNIl lANK OICIOINT R.~ORTlHCl h.. pr.Yld.d tho DOfI.rl....1 wllh tho Inf.r..llon 1I.lod b.l.W ..hl.h h.. b.", u.od In ..I.uhllng tho p.l.nU., 10. dul, Th.lr ..o.rd. Indl..11 th.1 .1 Ih. d..lh ., Ih. "".v. d.otdlnl. Y.u ..... . J.lnl .""or/_II.I..y .f . thlt '00,,",,1, If ~.u '..I Ih" Inf.r..II.. I. Ino.r...I, pl.... olllOln ..rllIOll .0....II.n f... IhIt IIn....I.1 In.lllullon, IIt..h · .""y t. Ihll ,.,'. ond ..Iurn It I. Ih. ..I>v. oddrl.., Th" ..oounl It 1....1. In ....rd"'.. ..llh lilt lnhtt.llono. T.. I.... of lho C_.....llh pf POM.yl...I., 9l...t In". ,.. h- .......... hY ..llIng ,'.1.7\ /1'-1"', ' OO"P"ITI PART ,~ '."0\1 II II II Sill RIVIRII IIDI !'OR' I'ILXNG ANP PAV"INT INITRUOnO"1 " Aooount No, 314000909119 a.t. 06-10-91 ,. In.uro'prOfl" orodl\ to your ..o...,t. IH<l Ilt.bU.hod m ..pl.. ., lhlt n.lloo ...1 ....""",y your .p.y....t t. Ih"R.gIII.r .f Hill., H.k. ,h'Ok p,yobl. t., -...I.t" of Will., A""'I". HOTII If t.. p.y....l. .r. ~ ..llhln Ih... III ....Ih. of lho doOtdtnt" dlt. .f dolth, you "y d~.1 . I~ dl.o...t .f tho II. du., Any lnhlr It",.. tIM .... will ,"",000 dlll_t potontlal ro" DIIO ,00 , nlM (91 _Ih.,fter lho nt. .f dooth. PffiT':i:liij 1',III~',!i~,!i':~i~~i~i~~lllt1:11~ x ,00' lQ0100 .00 115 Aooollnt a.l-"oo p.ro.n\ T."abla A_t lub~Ht to TaM T." Roto x [CHECK ] " ONE BLOCK ON LV rh. .bO.. Infor',II"" on<I tl."" I' ..r~..I. . . , v..... .h.... I. r..lt P'Yllnt 10 lho .tgl.t.r .f Will. ..Ith tw. 0..1.. .f Ihll not I.. I. Obl.ln . dliOoun' Dr'lyold Int.r..', or ,VQU "v ohtak bo", "A" lnd-rl1Urn this notl",ta thl RIII,tlr af Will. ond on .ffl.I.. ..,......t ~III po 1..UId by tho PA o....t....t .f ......... a, 0 Tho obov. .,..1 h.. h..., .r will bo ..p.rlod ond II. p.~d ..llh IhltPonnlYhonl1 Inhorlt..... T.. r.lurl1 to b. filed by the decedent" repr..entltllJ'. ' \ C. 0 Tho .... ,lnf.r..",," 1/.,.I.l1'l., "tot ond/.!:.ll""I. ,ond, do<IUoU,.,,""'. p.ld bY you, YiN ...1 ...."" PAMT W ond/.r PAR! ~ bol9'" . PART %f VOU lndlo.t. . dlff.r"" .M r. ./ . .... . I . vour ~ .alationlhlp to d.o.dlnt, TAX RITURN . OOMPUTATION OP TAX ON JOINT/TRUST AOCOUNTI Ll~ll, DolM h\tllIlhMnl 1 ., A..ount "1_. . J, ~.roont 1o"abl. . M 4. AIlo\Int lub~Mt. to T." q I, Dlbtl ond Doduot1onl . .. ^_t Ta"abl. . 7. t." ~.to 7 M a, T.M Due . A. mT I!I OATE PAID ~: "~, ,.,T" ,. ,.., , ,. ,............, t " Und r pon.l u., of p.r~llrv / % d..l.r. that' tho footo l h... r.lIClr~.d. ,bo.. .I;f tr~ o,rhoot 0.... t. t~ b,.t ~f",'V kn l.d'. ond pall.f, HOME (. )t'J':/:..) /J.1.d. -Qd.U!.{.. . j, ?, '~ WORK ( ) PAVEE DESClltPTION AMOUNT, PAID .nd DATE BENERAL INFORMATION 1, 'AXLURI TO R"~ONO ,1I1~~ R"U~T IN AN O'PXCXA~ T~ A"'""'NT .lIh IIf>PII....I. Inl"..1 b..1d on Infor"ll... .....1"-.1 bV IIlI fln""I.1 In.lllullon, I. lnll"lIw. II. b",",,' "'llnqUlnl nlnt _Ih. .ft" IIlI _Monl'. a.l. .f dlllh, I, A Joint t"ount t. "M.ale Iv,n though thl d.~.d.nt'. n... NI' added II.' 'Itt.r of GqnY,"I~', ~. ,.0...,11 IIn.luell", Ih." h.la b.I..... hU.bond IOd ."., ""Ioh Ih' a...alnl pUI In j.lnl n.... .lIhln .n. V..r prl.r I. : d..lh Ir. fUllv 11....1. .. liln""" I, ,.....,11 III...II.h-.l Jolnllv b.I."n hU.b...a Ind .". .." I",," .nl Vllr pr I.r .'1. dlllhor' nol 1.....1., 6. Aooaunt. htad b~ .' dloed..,t "In tr~" for" 1f'19\h." ,or oUWrt Irt tIM." fuU~, RepORTING INSTRUCTIONS . PART 1 . TAXPAVER ReSPONSe I, . noc. , . 11 IIlI Inf.rllll""ond'.OlOP\IIIII'on In I'" noli.. ". ",,'.1 ond a'duollCHl' or. n., alOl .111., pi... .., "." In bl... "," .f p,,1 I ., Ih. "T.,pIV" ...p.n,," ...lIon, .11"" I.. ..plll .Od ......11"'" .lIh vour .hIo. for lho -.01 ., I.. I. Ih. ...I.I.r .f Hili' .f lho .OUPIV IOdI..led, Till PA DlOlrll...1 of .'Y~ .111 I..UG ... .f,I.I.1 .,......., I'''. R'Y'I~' ..1 _ "..!pl .f I'" "Iurn fro. U",.ovlthr .f Hili., .. ILOC' I ' If Ih. ...11 'P..III.d .n Ihl. n.ll.. h.' b..n or .111 bl r.p.rl.d .nd I'. p.ld .llh Ih. P."".vl.'nl' InII.rll,",. TIN A.turn filed bY thl dIGldlnt'. r.pr...n~"Uy'; pll", an "H" In blook ..." of Pert 1 ofthl "laMP'Vlr A"po".." ..oUon, '1., on. ..PV ona rtlurn I. Ih. p, D.porl.lnl .f .'Y'""" IUrt"" .f Indl.llfIIll h..., D.pl 21qm, lIor,ltbu,O. P,ll"I-UDI In Ih. .n..I.p. pr..ldld. ' . I, IL~. C . II Ih. n.,I.. Inf.r..II.n I. ' Ino.lr'.1 ond/.r doduoll.n. .r. b.lnl '1.10Id. .h... bl". -~" .nd oIOPI.I. p.r'. I ond I ....rdlnl'lo IhI In.lruol'.n. b'I'., IIIP 1.0 ..pl.. ond .ublll Ih.. .llh v.ur oh'" fo, Ih. ","""I .f I.. p.voal. '0 I", ROII.I.r afWllh of the OOUf'llV l"c.l1o.11(1, "{hi p~ fI.p.ddr1t of RIVemlt",Ul 1ny, .., c,USol.1 ,........." (lur. "IV~lI"l 8M) """'1 rlKl.ltf, .f Ih. r.,urn f,...I", R'II.I.r of HII\., TAX RETU~N - PART 2 - TAX COMPUTATION LINt! '.' 1. ente" the d." thl 'aOQuot orlgln.llVN" l.t.blJ.hld qr tltl,d '" thl .tnn.r IHI.tlno It dlt, of d..th, HOTI. F.r. d..ad.nl UvlnO .fl.r 1,/11/1" A...ynl. .hl.h In. d...d.nl PYI In jolnl n.... .llhln .n. III v..r .f d..lh .r. "nt.blt fuUV" tre",'.rl, lIow.y.r, thlr. h.~ .wotu.lon not to lliIOlld U,UO plr tr,",f.rlll r...rd!." of they,IUt ,0' I'" .......,1 or Ih. n""",, .f ....""1. h.ld. , If . dOUbt.' 'l'lrllk (w.".l. .,p,.r. blfor. your flr.t "... In thl Iddr..' portion afthlt notlo., thl '.tOOOIMoIU.lon .I,.ldV h.. bOln d.do.,.d frlO,Ih. ....""1 b.I.... .. r...r,ad bV IhI fin... .1 In.IIIYllon, 10' EM.'.lhI 101.1 b.l"". ot I~" ....""1 lnoluellnl Inl.r..1 ..oruod I. IhI a.l. .f d'"lh, ' I. T~ ""Glntof thl IlCIClDUf'\ t 'I 11 tt'IClbll far 'Kh lurvlyor II det,r.1'*11' fo11oNII, A, "T'" por....1 II....L. ,or 0 nl ....1. "''''1l1l1ld to" Ih... .... V.., prior I. lho ........,1'. dI'lh. I DIYIOID IV TOTAL HUHa!R .at DIYIOID av TOT,L HUHI.. at . 100 " PlRCIHT TA.AaLI , JOIHT OIIH!RI IUAVIYIHll JOIHT OIIH!Ra . C....lll A loin, ....1 "Iltllred In tho nOlI .f lho. "'._1 and lwo olho, po,,"'" I UIYIOID IV I (JOIHT OIoHllRtI DIYIOID IV IlJ\lR'lIYORII . .161'. \00 . 16,IX lTAXAIL. '011 IACIlIUAV,YOIII I, , 1ho P"..nt 1.....1. f.r ....,. or"lld Hllhln "" Vllr .f lho d.......,". "'"h .r "00UP1I ....... by t"' ""_I "'" hold n Iru.1 ,.r analhor lOdIYI""'II.1 llrull b....".ltrl..l. .. . .', 10lYI0I0 IV TOTlL HUH". Of' allll'llVIHOJOIHT . 100 . PlRC.HT TAXAlLE OIIH!RI 011 TMT IE"PICIAlIIU E....I.. J.lnl ....un, r.,III.rod In lho nOlI .f lno d.ooOoP' ond two .Ihor p.r.on. ond ..Ioblllhld .llhln onI VOl, .f dI.lh bV Ih. d...d.n" ," " I DIYIOID av, l'IIURYIYORlI . ,10 M 100 .' aOM <TAl'AlLI FOIIIACH aupYIVIHIl .. i A". Till -.ollUlll..I I. I.. (IIno Al I. "'1,,'lned bv IUltlphlh1llho ...oun, b.I...... 01", II bvlho poroonl '.....1. Olno .11, I. 1"llr 'no ,.1. .f lno ~,. and dIdYollon. 11.I.d In P.rt I. ' 6, ..T", -.0".....1. (IIno 61 II "'l"'lllld bV "lblr..lI", 'Ill ~lt ond,dtduotl.... (II",! II froo 1"'-.01 '''''j.., I.'"H (II", AI. 1, ,Mlrth. .nrQf'l"'htt Ultr.h (1 n.1l fit If.hr"t~d b.l('w. ;' A. .Fo' dill' ,f ...Ih,a.tur,l",'fl.r 6/10/94. IhI I.. 1.11. f.r Iron. fir. ,. opou", .r. .. foil.... I, CoI'" .f dIIlh on,.r .fl.r 1/1/94 ond blf.r. 1/1/.1 'no r.l. I.,SX, I, 01," .f ...'h OIl .r .fll' 1/1/91 Iron,forl I' opou", .111 a II.1d ., OX I" r.lI, No'.' F" ..1.1 ., dI.lh "I., '0,1/1/94 ,ron'f'" . opou... .r. I..obl. .1 6X. I. "on.f." I. 11""1 "'''_'" nollOllOl '"hor. ..Ihori .on. dtulhllr, Ir_hlldr.., ....-In-IIII, dtUlhl"'ln.IOIIt"lPOhlld ond 'hol, IlfUG ." 1.....1. "' ,I. ",ro..I I'Xl, ' c. Tron. .r. 1..1 o'nor. nolUdI", b,. hlr, .1.1." unol., ounl. ntphIH ond nl... Ar. I..obl. .1 flfl... por.onl (1IX1. D. If VOU ohIntI 'hi I.. r.I., pl.... .ptOlfv your ,.I.llon,,"lp 10 lno dIoldOnt In 'hi .". pr.yldId. t. ThO _I of ,.. .... (IIno Ill. "'1"'lnId bV IUltlphl", tho _".....1. (11",61 bV IhI 1....1. lIlnt 11. CLAI~ED DEDUCTIONS - pART S DeaTS AND DEDuctIONS CLAIMED AlIlMI...I. dolIlt ond dIdUO.U... .ro "'lIrtlned .. f.II.... . . A, Vou. I.... IIV ". "''"'"'Ibl' for P'VMnI. .r lho ",.1. '''''jIG' 10 Idol.nltlrotlon bV . p".....I,rlPr".ilt.tlY' If 1",uffl.I.." I. p,V IhI ~llbl' I .... a, You 6OIuolh P' d lho dolIlt.fltr ""Ih .f tho ""_I ond 0" furnUh pr".f ., p.....I, . " .. c. Otbl' al.. .1.IId,IU" II 11..1'1d fUllv In par, I, If Odalllonol ..... II noodId, y,.'PI.ln P"" I 1/1-.11-. PrOOf" ,'V,,"I "V II roquo.IId bV lho p, DOp.r'.'nl .f R'.~, ' ~~... ;'''IJlult.\~_~!RB.J:I:;~~i ,. GENERAL INFORMATION .. ........" ...... "" ...,,, " 1M "",,,, ,.. ........" ... .."..,. ....." ... ~ ,._". .\AlOI\\od ~, 11\4 IIntll.l.lln.IlWIl.n. I, l...,.rll"".' I'M ....~. dtllnq\llnl nln. ,,,,,lhI .fl.r Ih. d...dlnl" d.l. .f d..lh. I, A 1.lnl lootl"11 I. 1..11I1. .y.n IhOU'" Ihl d..,d.nl" n... V" Idd.d .. I ..11" .f ..lIy.nl.n.., .. ~~.. "...... .... "".,.._........ ..", .,... ..... ., .. >I" .,"' "... ...,... .'. .. ....Ih .r. full' l.viol>l' .. trtll,U." I, A.."",," ..lioI>ll.h.d 1.lnllV ~.IW'IIII\U'~"'" tnd wHo ..r. Ih"" 'II" ,tI. prl.. I. d..11\ ... n.1 I...~I.. I, A..ounl' hlld ~, I d..,dllll "In l.u.1 f..- ,""ll\4r .r .Ih..' I.. 1..11I1' full'. " ......"... ,..-,,~.. .....",. ,. ... .". ....".. .. ..."..., .."" .'. ..,... ".. . .. ,. .... .. .. ..,. . ., .. ......., ......~ .."., .,. ". ...,.. .. ...,. ... ... ... .... .. .. ..... ., It. I. 11\' RI,hltr .f Willi .f 11\' otlllllV IMlI..I.d. lh. PA Q.pI.I..nl .f RtV.nu. 'viII I"U. "" .ffI.I.1 ........nl (,... REY-II.I EMI up.n ..o.ldl ., Ihl ..Iu.n f.'. IhI R..I,I.. .f Will., .' ....."... ..". ..",. . "" .... ..... .. .." . ..,.".... ~.." .,. ... ...."... i"'''''' ... ,..." .,...'. .....'. ............, ..... ...., .,..~. .....,.. .. ....~. ...--' ,""" ..... ... ... ...,........ ........, ...... ....... ...,.,.... ......... ...... .'"....... .......... ,.... .nVlI.P' pr.Yldtd' . REPORTING INSTRUCTIONS - PART 1 - TAXPAVER RESPONSE ., .....".. .". '.'."~ ,. ,...,.., ..", ......... ... .,. ...,...'" "" ... .. .'"".. ",.. . ... . ....". . ... ..."..".. ...' ... ~ .... .. ..." ... ...... ... .. .. -'" - -" ........".. .. .,....... ....."....~, ... .............. .,.. ,.... .,..,., ......... I..,. "..~ .., ... ,,,.,.. .f 11\. r.\Ur1\ f... Ih.' R..I,I.. .f Will., TAX Rll.T\lRN - PART Z - TAX COMPUTATION ~IHl ' I. lnl'. 11\' d.l. I~I ....1"11 ..I,\".IIV V" ..I.~II.hld .. 1IIIId In Ih...nn.. ..I,llno .1 d.I' .f d..lh, .... ,... .....' 0'. "., .""".. .......... .. ......."' ,. .,. .,"' ...,.'" ", ... .. .... ." ...... '"." .. ......., ............ .."". .' ".... ".'" ..' ........ ....".. .. .. .... " Ih. ....lllIl .r Ih. nu,~.r .f ....unl' h.ld, ' ' II . d.""I. ..I.rI,~ 1..1 .PP".' ~,I'.' ,ou. 11,.,1 n." In Ih' .ddr." p..II"" .f Ihl. n.Il." 11\' ...000 ...lu.l.n .1..odV 1\" ~..n d.~.I.d fr" Ih. ....un\ b.l.n.' .. ..p.rl.d b, 11\' fln.n. ,I In.lllull.n, I, lnlt. Ih' \t1.1 ~,I.n" .1 Iho .,..unl,lntIU,dlno In\..lol o...uod I. 'Ih. ~.t. .f d..lh, J, 11\' p....nl .f Ih' ...~lllIl \~.I . 1...~lo f.. ...h .urylv.. I. dol...ln.d .. ,f.U.WII A. lh' p....nl 1..11I1. I.. lolnl ....It ..Ub\ltl\.d '..0 11\"" .n. V",. p.I.. I. \h' d...dOnl" d..th' I DIVIOlD IV 101Al HiMI~R OF OIVIOlO IV 10T~1 tt\IlIllR OF' M 100 . P~RClHT l~HAaLI JOIHl OHHlIR" ,'URVIYIHO JOIWl OWHlR' lv...IO' A 1.lnl ....1 ..01.1...d In Ih. n..' .f Iho ~.o.donl .nd IV' .11\'. p....n., I 0lVI1lII0 IV I lJOIHT lI\IHlIR,1 OIVIOlO IV 1 (tURVIVOIlIl . ,1.1 ,H 100 . 1..7H tT~MAlIE FoR lACH IURYIYOPI Ih' d...d.nl bul h.ld I, 1"t PIl'olnt,tl)C..bll ,ft. ....It ..lllod .lIhln .no v... .f Ih' d,.od.nl" d..11\ .r ...."nlt ..n.d bV n \.~.I f.. ....Ih.. ndlyldu,U.1 Ilru" b.n.H.I.rI..l, " I OIVIOlD IV TOTA~ HU"llR 0' IURVIVIHD JOIHl M 100 . PlRC~"l TAMIILl nWWlRI ~ 1RUIT IEHEFIOIARIII ~..,., ,....~... ...,.,... ~ ... ... .. .. ...... .. .. .~ .~... ........... .,~'" .. ... .. ..~ ~ 11\' d...d.nl,' ' . I OlVI1lIIO IV ~ IIUPvlVORll . ,10 H 100 . 10H mMml FOR llCH SURVIYORI 4. Th. .""",1 .""t..t ,\t , I'," Illn,' .ll',d.I...ln.d b' ."lllplVlno I"h' ....unlb.lInG. Illn.ll bV Ih' p.r..nl I,..bllllln' '1, I., In\'. 11\' 1.\0 .1 \h1 d.~I' '.ndd.llU.tI.nl 1I.I.d In PI. I I, , I. Tnt ..tunl 1...bI1 " ~.. ,.~.,.... ~ ...~..... ...... .....,~. ,...... .,~...... ..,~...... I.....' 7. lnl'. Ih' .,p..dr .10 I.' r.l. (1In. 7l .. d.I...ln.d b.I.W, A, F.r d.I" .1 dlllh ..ourrln, If I.. 1/10/9.. Ih' I.' ..1" f'. I..n.f... I. ,p.u,,' .r' .. f.II'." I. 0.11' .f d..\h .n .. If I.. 1/1/9' .Od b.,..1 1/11.1 11\' rll. I. lH, I, Oil" .f d.'lh "" .. .flt. 111191 I..n.f'" I. ...u... will b. I...d .1 OH I.. rol" Hell" F~. dll.1 ~f d..lh prl,. 10 7/"" I."".f..' \~ .p.u'" I.' It..blt II 6H. I. n""."..II.\"n..ld....ndll\1t In.ludlnO fllntr. ..11\1.. ."", d.uoh\'.' or.nd.I\Ud..nl ..n-In-Io.. douolll.r' n' ...\".I"'.hlld ""d Ih.lr I""', ,.' It..bl. .1 fl. ,..o.nl (6HI, C, T..n.f.ro I' .1 ,~Ih'.' In.ludlnO brolh'" .111.., un.I., .unl, nlfh.V .nd nl..~ ... 1...bl,.1 IIfI'''' p....nl \lIHI, O. If ,OU .h""" ,Ih. I.. ..1" pi.... 1".IfV vour ..I.ll.n.hlp I. Ih. d...d.nl In Ih' .... pr.Vld.d, I, Tilt "'11I1 .f I" d"O (IIn. Il I. d"..iln.d~' .ultlplVlnO Ih' .._I It..bl. Illn. Il ~, Ih. I" r.l. Illn. 7l. All0MIb'ldlbt. Ihd dldUotlonl 1,.1 detlrlln.d ,,'fallow" Ai you 11,ll1Y Irt "1,ponllbll-fdrp ,.v..nl. o. tl\' ..1.1. .ubl..1 Ib .dolnl.t..llon ~V · p.r..n.1 .IP....nl.llv.l. 1"lufll.lonl I. p.ylh. d.d<l,1 bl.llt.., ' " VOU 1~\u.lIV p.ld Ih' dl~1t .fI.r d..lh .f 11\0 d...d.nl .nd ."" Mnlth p......f p....nl. .. ... ..... ...,.. .... . ,.~,... "". ,. .~. ,. ., ......., .,.. ,. ..... ... ..~..... .,. ""'. .,~.., p.v..nl "V~,.'IlU..I.d ~V Ih' PA O.p..I..nl .f R.y.n".' ,OLAlMll\) \)EDUCTIOt-l& .. PART 3 nEsTS AND DEDUCTIONS CLAIMED ill~~__l GENERAL INFORMATION 1. FAILURa TO RUPONO WILL R"U~T IN AN OFFICIA~ TAX ABIBBBHENT wllh .ppll..bll Inl"..I'b...d.n Ih,.,..Ii.h tubll'"d bv,lhl flh",.lll 'In,lltblloh' 'z, loh""tnat \IM bllo... dIUnqu,"t nln. .on\h. Ift,r thl dtotd,,",t, d", of dll'h. S. . joint "GNnt h ".'blt Ivan thQulh thl dIO'dl",l, 1'1'" Wit. added .1 . .I".r af 00",,,"1'"0'. , 1ft. ~ooount. (lnoludl". thu. h.ld b.twlln hu.blnd '"" wlft) which thl,Chlotd"In' Flut In JolM 1'1"" wUhl" on, ~..r pr,lor '0 d..lh "" fullY t.....I. I, ',"Mfl'", I, A..ounll 1I1..lhh'd jolntlv b,lwun h)j'bond ond wlfl ..to Ihon .nl vllr prl.r 10 dlllh .r. h.1 I...bl., 6. Autuntl hlld ..~ . d".d'nt '~Jn trUt' for", ,toOth'" or othlr. Ir. tlM,blt lulU,. REPORTINO INSTRUCTIONS - PART 1 - TAXPAVER RESPONSE 1. ILoeM ~ . If thl lnfar..Uo"n tnd C10ltPutt\lon 1n thl noUn Ir. correelt ann d,duoUonl .r. not blln, ol,lald, phu If! "M" In blook "A" 0' Part 1 of thl "TlM."'~1r A,.pontl" .,0Uonl Ilgn '"0 C1opl.. IIInd tub,." thtll wUh voyr chlok for thl ..ount of tIM I~ Ih. R'llolor of Will. .f Ihl ..unIY Indl..II.,Th. PA PI~orIIlOI .f R"",,,," will I..". on .fflcl.1 ........,,1 . , 1/.tI RENI.I EXI ""on r~..lpl .f Ih. "III,n ,,.. Ihl ROII,tor ., WillI, I. I~OC:K I ' If Ih. ....I ,p..IUld on Ihl. n.lI.. hoo blln or will b. tOP.,lod ond 11M p.ld wllh Ihl P'I)O'Vlyonl. I""orll.n.. TIM R,turn fl1.~ I:lv th. dlO~dlntt, r,pr"lntaUvI,phol In ")e" In blPCk "... of Plrt 1 of thl "lIMPIV., A"pon,a" ..oUon. IIDn OM capv and return to the PA p',parte,nt of RIVlnUlt lurlau of lndlyldu.l rill"', O'Pt '.9601, H.rrhbur" PA 17U'-0601 In thl ,"v,lapI provld.d, S. BLOCK O. 1f thl "0\10" 1",(lr..Uon It lnoorreot' .nd/or 4ttduotlcml Ir,bltn, ola'''ld, chick blook !'C"'I"d llo.-pl.t, PlrU t Ind S ,"lIl"lI'U'l1tng tQ thl li'l.tr~otlon. b.low. UP" two oopl.. Ind,ubelt th.. with your Chick 'for the '..o~t of hM PIVlbll to thl RllIht.r .f Willi .f Ih, .."nIV Indl..lld, Thl PA P.porl..nl .f R.v.n". will 1",," .n .ffl.111 ........nl Cf.to REV"1I01 'X) "~.n r...IPI of thl return frolthe R"hte,. of 141111. " TAX RETURN - PAMT 2 - TAX COMPUTATION L Ill!! , 1. Ent.r the d.tl thlil .ooaunt or1ylnauv w.. Ittlblhhtd 0,. UU,d In thl.."n." ,"lttll'lll .t diU of d"th. , ' HOTEl For. d,o.d'nt dvlng If ,I" UtU/8t1 Aooounhwhloh thl d.e'd.nt put' 1" Joint n.... within ani (l) 'i,.r of "..thflrl tlMlbil fllllv .,trin,f.,.,. HOWIVI,., thl,.. " In .ltolu,lon not to IHOlld U,OOO PI" trln'f.r" r.",rdll" 'of thiv.h~'Qf the flOQount or the nUlllbl,. of loo~","h htlct. If . do~l. ."I,.hk (lut) '~PIIU" b.'for. you,. flr.t n"l In thl ,ddrl.. PClrtlon of thlt not~oe, the U,OOO IHolYllon ,1rl,dy hll bMn d.dYotlct ffool thlllOOOunt bllanola. ,reportld bV the fI",nolll In.tltutlon, 2. (nhr tli, toUIl bllllnaeof th'i .ooount Ino'ludlnD Intlr..t locruld to thl d.t, of dllth. S. Th, pero,,,t ofth, .acount th'tl' tlM.bllfo,. .~ohlurYlvo,. It dlt~r.lnld II followll A. Th.,p.,.olnt tlMebi1 for join '....h "tablhh,d 101'1 thin ant VIII" prior to th. dloldl"t', d.-th' i '" , , " ' , I '. PIVIIlEP IV TOTAL HllHIIR Of "OIYIOEO IV TPTAL HUHIER Of' X 100 - PRRtENt TAX AILE . JOINT PWNERI IURVIV.INO JOINT OWNERS EMIIPI.. A Joint ....t rlghterld In th."... of thlt d.aldil"t end two otht,. punnl, I DIVIDED lVI' (JOINt OWHERS) PIVIOEP IV I lSURVIYORS) . .167 X ,100 - lo,t~ lTAXAILE fOR EACI! IUPVIYORI , ft. Thl p.rolnt tlKabla to".'I'tt Cli'I,'t'd With, In, O"t,VI,r of, thl dlcedlnt" d..th or looouMt. awn.d bV thl dlo.d.nt byt h.ld In tru.t far'noth'r'lndlV dull(t> (tru.t b.ntflot,rl..li I OIVIOl!O IV .,tOTA~ HIIHI'" O,f Il/1lVIVIHO JOIHT OWHERS PR TRUll IENEflCIARlIS X lOon ~ERtEHT TAXAILE b'.,II' Jalnt aooount r'.",tilrtd In thl ni.. tJf thl dicld."t and two othl,.'plrlon.lnd uteblhh.d wUhtn on, VII,."O' ,d.,.th bv , th' dIClldlnt., '" " , I OlV1PEP IV'TlIlJRVIVPRII . ,10 X 100 . 10~ lTAMAlLE PDfl EACI!IURYIYDflI 4, Thl .....,1 '\11I1'.1 I. IA' (It no 41 It d, .11t.lh,'d bv ""llIplvlnl Ihl ...ouitl b.I"'" Olno 21 bV Ih' 'p.r.,nl I', .1Ib11 lllhll" I, EMit Ih, t.l. ~f I~I d.blt ond d'd"oll.n. IIll.d 10 Pori I, '... ~, tho ~unl 1.~IIII' lllno.' I' dOlOtllnod bY ,,,bl'lOllnl Iht d.bl, ond d.dIl.Il.00 (llno Il Ir.. Iht .....,1 ,IIbJ..I I. 10M Ill". .). t. ~nt.r th. .ftpropr'.te\lM ,.lte ,U1nl 7J ., alt.r.a"ld below. AI FO".dl.tUOf dl.th OfICIU.".lnt'IH."''6/S0/.. 94, tht tlH rat.. for';t,rIlf1.f.,.. to.,pCKf'" .,.....'OltO...1 I, D.I.. ., dllth on .r .fllt 711/90 III\d b.,." 1lIl9l,th. toll I' IX, ' 2, Dlt.. 0 d..lh on .r II\.r 1/1191 Ironlf". I. .p.",,, will b' Ir"d .1 Oi ,tIM to 10 , Hot.. For diU' O[ rtil.th prior '0 .,/1/94 t,..",f.r. to .pou... er. taMab I at "(, " I, TtllIlIl,ttl. In"l d"~lndonll n.lliCIthl f.I"It, ..Ihltl ,.n, d'''lhllt, srlndOhlldron, 'ondn"l.w, doughl.r-In"IIWI ~I...hlld'nd Ih.lr I..". .rl I...bll. .1. p.,o.,,1 I.X), Cl Trant .,..tOll. other. lMOhtdln,.brothe"j altt.,., unol" luntf nephlw and nlsol Irl,ttMablt It flH..n Pirolnt USlO, D. tf wou ohan,. the tllM rate, pl.... 'PIO!fy 'Iou,." ,..lIUon.hlp to th, deo.dent IntM ,r..proYlded. I. Iht _I .1 tI~ dill (Ilno Al I. dll".lnld bV ""ltlPlvl", Iht ......t Ioll.bll 'lIl.. ~Ib~ I~. '1Io'totl llin. 7), CLAIMED DEDUCTIONS - PART .) DEBTS ~ND DEDUCTIONS CLAIMED AlI.....I. dlllll ond _lionl Itl dOt"llnod II t'IIOll" A. You ,...Uy etl ':I.pcw,tlbll for p"v..nt, or thl ..t,ltl ,~b~tot to Idllnhtr.tlon by I pirlOn,l rlp""entIU"1 It, tn.ufflolent to p'v Ihtdldllollbl' "",, . .. " I, VO\l ..1".lIv ~Ald Ihl dlbll 'fllt d"lh .f thl d...dlnt ond .on Mnl'h prool .,p.V....I, t, !lib" bll"o 0I111lid I\jl\ b' 11..hOd f"lly In Pltl I. II .ddlllon.1 .~... It "..did, UII, pl.lo ~ip.r I III" . 11-. Pr..f.f PIV.tnt "Y be ,.e.,..t.d bV thl PA D.pert.lflt of RIVlnut., " '" ... ,> ,,; "i">'; .';" ;.,. "'Th~p'A\VrnR AIS"1 S' TAMle'" B"";"'" .'..' "......; ......" .;.' "'" ..,. '...\\ii.:~iv~TuI!MEj~,.fARLrsH~~ltliE~R. OlATTJECl~OO~.. ~$~JlNt'i:D~;STeoI~TAClflF\NJI! . OR .CALI. THI!:BUREAUOF INDIV~DUAL IAXE..,L TAXPAVER ll~QUIRV' UNIT IN HARRISBURG I\T (71'0 787-8$27 . Tob. (7 7) 7(2-2252 .IHEA~INB IMPAIRED ONLY) nv,'.....,'.m ~' CO~8YLVANIA D1!PAATMBtil' 0fI R&V8NU8 08PI,llOIOl REV.1500 INHERITANCE TAX RETURN RESIDENT DECEDENT c,..... ~._'----~f-ii:iiTU\i-rlli:1~........,,----.............,_. 1:;;,'.:il.I'i~ """""'i~ir"--'""----"'.' '. """",,-..I rILO..U R:,",';",'":',,,",',:, :.'f",:, . I ,,' 2 11 . ' 9. I 7 /,9..1 9i1 i 6 ! \1M' ~"I'."Y!l',', C y, N :'1' II I AI 'R 1'1 It 'I' A ,'1', .1~! 3" 1'8"2 714,!j 1: 1 1 i 0 11. ! 99 : 7 I 4 12 71 !.' j.' ~ . T RBOlaTBR OP WILLS o 3, Romllndo, RI"'m ldilo of""" p/oCf~ \I.IHlI , I!l ft, Fodoral altolO TM R.tum Reqlllred _ 8, TolAlNumbor ol Slfe Depot" Som 01U\tOtlOnlollllunderSto.Pl1H \AIIOhl<hOI I III l[J 1, Orlgln.1 Re"'m o 4.LlmllOHllAlo ua 8, OoC4denl Died TOIlAlo (AIIohlOl>Y~~ o 9, ~ oUon proceede R~~ed 8 Esq. I Johnson Duffie & 301 Market St., P. O. Box 109 Lemoyne, PA 17043-0109 1, Roal SelA" (Schedulo A) I, Slotka end Sonde (Schedulo B) 3, Clo..~ Held corporaUon',pertnorthlp or Sole.Ptoprlulorehlp 4, Morteel" & Nol" ROCOlvlblo (Schedule 0) 8, Oosh, Bank Oaposlls ~ MIaooIl.neoue POl1Onel Proporly ~ (Schedule B) ~ 8, Jolnlly ONnod Pr(>porly (Schedula F) . 7, Inlor.vlvoo TtllIlelert & M~cellaneou, Non.Probate Ptoperly (Schedule 0 orq ~ 8, Total 0,011 A"atl (lotal Linea 1.7)' ~ 9, runerel Bxponeea & AdmlnlAlIaUvo 00011 (9cl\odule H) Ii! 10, OebIA ol Ooceden~ MorlgegHI&bRlUea, & Liens (Bchedule I) 11, Tolll Ueductlone (101A1 Hn" 9& 10) (1) <,.', (I) fi (3) :, ~, (4) ,j, ".j ~ " I (B) ;:: ~:. 'c. '(8) ii i'i, (7) I:: ..1., 1'-....'''1 " 1 . :"",'J" , ;",d~J;,l. ,. , ',', ! .0:4 .0:0 ;0.00 -;:.;,;:".,_:_,,,' .-,'t_,'I;f--P.~'i",';:-"""'-' 1,.-- -'.-,' 6:.5 j tQ '..1..~, ,B: :-""-,'1'''_-'' "',-",'.';/!,'",'!)."'--"--"; I .' .... ......_. "OfIi!:i>riMIfNK, (9) (10) :' '_'".",'V.L_' i,! I" ,_,_._,1\, . ,<:; " ~ li-:,;: J',,' ,,-' I ',-,',_~-, ,l""Jt.,. } > ' ,'I. I I ,'-;;-l<;l::; , r' Ii. '6' 1 '1' 7 ' ~ Ii ~' 6 .t'F~i,~i,~-: l' ,~\'", I,.!, 1;1 . >:"'~'t;,~Jj\_~'___I;i:,>,,:.: I ni 1, .012 'i' 3! 1 19 !;i 1, B I" : ,.."t. ~'O'\I"l.l.;"d"'O''';!'B':;'''1 )~"",r'~: 'a."':: L.,_.'t,.l.: .'.. _:i... .i._.l..I';'~,_, ; ,',-,i _.--~..- (B) ;t'h,L )L~>~l..~j'>'.~j;,~ ''::I\l :4i8 ! .1 '>~'-"'--"'I"'i'h'''~!'~--'''''ii--'''-,..-.'''-''-'-';''''::':: , t\ ~,.:;i, ~.i..Q,!~(i,6 i 4.> J;'~ i;1 14 'i' 5l3, \~:.i 2!7' , (1 " I ., ,'I" " . 1) {J. :i\,1213,' 0(3 7',9 . 1_ (12) I;! 1': ,\ f;.1 ," i' ' ;"h..dl ...l,:,O""",(iJ."""Ii,'!"~,,,.o (13)', .,.... . .,. ,. ... I, " ':f '_-\"o !.-:"-' (14) V' . : 'h !' (', . . i i" ,.' J~ .1,;1,,(.0.:1.. fi.',.".Ii/~ O. r'; H' '! f fi:.( " '-i' X ",0, (1&) i?l,':r:l,\ ;":, I:'I,~ >0,,:,'-::" ~ 12. Nel Value 01 ~.taie (Line 8 mlnul Line 11) 13, Oha~lAble and OovemmenlAlBequ"tslSeo 9113 TNllIlor wh~h an election to \OX hoe not been mlde (B\I1edule J) " , 14, Nil Value 8ubJegt 10 TM (Llnl12 mlnul Line 13) 18, mountofllno taxeble ' , etthllpOuealtaxrtlO""J.".I') .,ih,,,J[.... 0" InllNctIona on revaree .~e for epp)lCllb~ ~~n\aQe, '" ' lB,Amovnlofllne14taxeble ", 5 . 1 0: 6" 4,6 9 0 al8%relo '., ."." .,1, 17, Amount of line 14 taxable i." " et 1&1111110 " .I I 18, Tax Due x ,OB ,18 (ls) :'1 " ,... " L (17) (18) 3 '.0 . 6 3' B:; B ' 1 "'.._j.;;-.'" .1,..-,....'.'",._':-\;';,I'):;r.;...1 \,;" , x " , I - o i-. ,'I ",\".. .\,~...L.O ql~),.a..' 8. 1 19, 'i''-:, "..; 10 ball tfII 3 Creekbottom Circle Dillabur I PA 17019 ADDRESS 301 MarketSt., P. O. !3oX 109 I~mo ne, PA 17043-0109 OA~_1_ q 3" OATB f/'Ift' . Decedent'. Oom lete Addrlle: B 16 Hunter Jafll,J Canp 'Hill Tax Payments and Oredlts, 1. Tax Due (Pegel Une18) 2, Cre<lltllPeymenll A, SpoII181 Poverty Cre<llt B, Prtor Peymentl C. Dllcount (1) 24:000.00 ::J 26~.16 Total Cre<lItI(A + B + C) (2) 3, InlerelVPenalty If applicable D, Inlereat B, Penalty _ TOlallntereaVPenelty ( D + e ) (3) 4, II line 21, greeter then line 1 + Itne 3, enter the difference, Thllll the OVIlRPA YMBNT, Chlok bOK on Pagel Llnelg to requllte relund (4) 8, II line 1 + line 31' greller then IIno 2, enlerthe difference, Thll II the TAX DUll, (8)' A, Bntlr thelnlerell on the tax due, (8A) B, Bnler thelolel 01 Une 8 + 8A. Thll II the BALANOB DUll, (8B) Make Check Pa able to: R GISTiR OF WILLS AGENT BSAS BOLLO a T BY PLAOING AN "X" IN THIi APPROPRIATB BLOOKS 1, Old deoedent make a tranefer andl " Yee II ,.t.ln the use or Inoome of the property trah8ferredl ""''''''.''II'''''''''"Il''''''''''''''''"''I''.,."",,, ~ b, retain the right to deelgnate who shell use the property trenaferred/lr Itslnoomel '''''''''''''''' o. retain 8 reversionary Interest; orll"""Il'.""lll+l'lll'IIIII''''lI'''''III'IIlI'''lII'''''''''''"'''''''''111111"11111" d, reoelve the promise for 1I1e 01 either peyment" benefits or care? """"""""""""""...""",,,, ll, II death ooourred on or before Deoember 12,1982, did decadent within two vears preoedlng deeth traneler property without recalvlng adequete oonllderetlon? II deeth ooourred after Deoember 12, 1982, did deoedent transler property within ono year 01 death without receiving adeqUate consideration? """',' II'" Il"" "",,".,",",,, '''''' It" II..' '"' "" ,..", ""'" I lit'. '" t., t. I, '"'' lE 3, Old deoedent own an 'In trust for' or paveble upon death blnk aocount or 8eourlty 4, ~\:~e~e~~n~~~~~'~' i~di~id~~'I~~';I;~~'~'~';~'~~~~~i:' ~~~~i~; '~;'~i;;~;'~~~~P~~b~';~ 'i;;~;;~rtY?:::: ~ 17011 30,638.81 25,263.16 -0- !i.375.65 -0... 5,375.65 i o ~ 72,S, 9116 (I (1,1) (I) proved or the reduotlon 01 theteK rate Impole on the net value 01 trana I" to or for t I ule.o the aurvlvlng apouse from 60/0 to 3% for detes 01 death on or aftar JulV 1, 1994 and before Jenuary 1, 1998, ' 72 P,S, 09118 (a) (1,1) (II) provldad for the redUotlon of the ralelmposed.on the nst value oltransfera to or for the ule olthll surviving spoule Irom3% to 0% for date. of death on or after January 1,1998, Tha atalute~ a tran,ferto a eurvlvlng spoule from taK, and the statutory requirements for dlsolosure 01 88lets and filing a teK returiiii8iilif8PPlioable even If tha aurvlvlng Ipouse la the onlv benenolary, ' POR DATIlS QP DBATH ON OR APTBR JANUARY 1,1998. I'lease answer the lollowlng question by pleolng an 'x'ln the appropriate epaoe. Old the deoed.nt or,ete a truet or almllar ,rrengement whloh la aolely for the .urvlvlng apou..'a benent for hi. or her entire IIf,Ume? Vea 0 No GiI ' , . II you anawered vae to tha above qUlltlon, the taK cn the trult or similar arrengement ,. postponed until the death 01 the tecond spouse, at whloh time It will be fullV taKable at the rate(s) IIPpllcabla to the lemalnder benenolary(le8), Enter the vllue of the trust on Schedule J, Part II, In order to remove II from the caloulatlon 01 tha taK due In this ellete. You may wleh to nla Sohedule 0 In order to make the aleotlon available undar Seotlon 9113, II thl eleotlon Is made, thelrust or Ilmllar arrengament I' taxed In the a.tate 01 the firat decadent epou.e, the portion 01 the trU.t or elmllar arrengement whloh beneme the eurvlvlng epOU1811 taKed at the zero tax rate, and the remelnder la taKed et the tate(s) applicable to the ramelnder benenolary(lel), If VDu ohoote to make the eleollonhvou must atlaoh Sohedule 0 to , tlmelv.filed teK rat urn, along with Sohedule(e) K and/or M In order to show the Ipportlonment of t e trust or almllar arrangement between,the aurvlvlng spoule and the remainder baneficlary(lee). . . ~UtJluJ~MJ:/!JV':'.3J " , , BUM MARY OF BALlINT PlATUREB , ", i'/bjlQIAIil... 10 Uunt., Lint ~1OiI0tIc1~ Dood _ '1~, P19'.'1 Cly Q.mpHIU CGutjy Qom\>t1l11\Cl 1\1I1 PA I,CocIt 11011 CMT'..i 3240-4102 Mli>RlItIlIoCt NA $1M ~~. I NA C"~8IIo NA ~-~~.... ~IOW" I CIihI NA ' , ~.. Jotm&Ol1, Dull"! eltwf.I' & WtId"" " 6llI1SCfmft<<1 1t1D1 ~~'1*8qolM'foo\ I ~OIll1ort Ave..., All 43Y.." CollIIon O<>od TIlllIIIoomt ~ 8t<ioomt 3 ~lIht AppItiMI QolIn o"ntY, ",.~I.nllolho N>pIlllttr 001101 AJ>pr1lltd V... N9\'.mbtt 101h11097 " fNl E1~ 01 V... I 104,000 foll1l $$0- 'TOTAL 2000 101 W\M!ow.' """..ml' by. ~modo, ilC, -1.8(JO.AlAMoCE (,0. C\lmJl R'" l~~' AWl""" ~".Nij; 1;~IHINij'-,~1 1O,II\11lld'''' 8 CIyQ'f11I! "'~ 61_' M lit Co<~ 17 .II . ..,C\I\I/jyQvml!Ol!4.1\<l .TIlIVlff.llll't_M,]""'ll,!!MI .,,111I AllIlII\WlIRnL 01 I -, .~ PlJ'lIiKI ...lo9oeMl,lIi'tiL ._..~.,. n','" ....MlI'J\olJtKt;t.HL...c~._....c ..ClIlIIIlJIIIIJi40-9).nL... .1Ikf1kl.I_NL_....... wu. Oil IlII11t.NL.. n.__~III,.ID'lIMlMlil i9I'lIl\WIlWII<IIll~I<II.IHtpW 1't.lllt1. .tiL_~.:.. ,.m .I_01.It '~111""" IMI~, 0!1W1!1+ W.~no, . AtlhlllQl r,t,,~'1 Qlrl~, P.O; ~! IIII', 10mlY"" "~ 11~"QIQ\l . 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IIlhWIiloCQI,9.tll!l1li1A.__..~ 00rI1~ e'/!L._ fl\llOOd . fllol 1looI. Wood .' 0Ih0l ,N.!l1L... MklOW1'I1 tilllad E/illl f.tpio:t('1 , _L(gUL ~~~ P_b ___ [ :" Otck. __"__~ ~ Pol.h~I!!_:$ fll<'_..__ P..L........ OAI\ITOI\\Q: Nono 0 001Ql AUchod , OIIachod B".ln 0.1'Irt ,QI'" ;.; _....~~~ .lQ!L ..,.. (1pIC1aI1IlIlW IIll:lIIIllllil, 010.): .A\'flJlL.....--_ ~QI""m~\WII1'OlU, dlproqlilol1~~i"lirililllli. ",,-oiI_iW), lIpaii''riMuod.fIlIIl101COl'liJlICll1IIj~iWlri.liC'---~.!t!JJltii~ !iitJ\U,__..~_""-:...__..~___..___n___'''' .....--...._....--._~.,,--.-....-._,;....~..-~~-_..--._~........ ----..~un."__~.~~__.;__~_~~_m.'"c~_hcU.~... ..__~.:.~~_~.~_.~~__.~_.,_ _."~,_.~__~..L..__._~~___~_n___.L_._._".~ -M<orll""'" ;~i'-lI\h ii'-b~"'ri:(..iid'lo:hiiii,jMw"'lt, lo;jl..bifWiC"i-~,T~iIii~tiW iti~oY.mirii:,n-li. .ii:'Oi'~ii.i'---' --.-..-- .. mmldaI' YkliV 01111I ouIIlOCl ~~,l .llt.'Il.~J!!cj'mL....__._____.'......m____"""'~ .n_'"__'''''.''' ._.~__._m_____"__' I<llI Mill form ro 11'93 PAOE IOfl folm VAl - 'TOTAl iOOIlfolWlllow.' "",alllllOiIw.. bl' ~ mocll, ....-I,BOQ.Al.\MQOE 1m Moll f~m 11104 11'93 . , i W.\"'J('I"'~ ." COMMOHWllA~ TU OP PaUN8YWNlIA INHSIIITo\HC6 TAX RSTUI\H SCHEDULe p, JOINTL Y.OWNED PROPERTY' poua~t CYTN:t/\ R. If.n .,..t w.. mid. Jolnl within ontVur ofth. d.o.d.nt'. dlt. of d..th, h mu.1 b. r.port.d ~n Sohldul. 0, 8UfIIIIVING JOINT TeNANT(8) NAMS A, Ki Joyoe Ensmi-nger B. wnliam H. t'q\lSt, III C. Wi-lli-am C, Ensminger, .Jr.. D. Timothy A. En1>minger. E. Diane R.Eneminger [I. Lisa Wise \., JOINT~V.oWNED PROPERTY: nlM 'OIl JOINT MoID8 H\lMe&R ' T&IWIT JOINT 1, A, 2/93 2. B. 1966/ 1993 3. A & 13 1994' 4. A 1967/ 1970 5. a 1971/ 1977 6. C 1964/ 1975 7. D. ' 1:966/ 1976 ;1 1966 6. D. 9. E. 1966/ 1976 10. F. 1974/ 1976 AOOR88S RllATIONSHIP TO DEC6DENT 151.0 'lWo 'turn Hoad, Shippensburg, PA 17257 Daughter 3 creekbottom Circ1.e, Dil1.sburg, PA 17019 Son 417 a. I~wisberry Rd., Mechanicsbur.g, PA ,~?05 Grandson ,6645 Wel:"tzvil.le Rd., Eno1.a, PA 17025 Gl:"andson 1426 Mal:"ket at., Apt. *2, Camp Hill, PA 1.7011 Gl:"anddaUghter 33 FOrt'Clark Estates, 13enwood, WV 26031 ar.anddaughter IlldudInImI Q(ftnanollllnluluIion rod bri _nl nUlltolt 01 ItmiW!dln\lfyllll numbl', A\Iacl1 dtedfo/ nU .hlIdfl~"\IIt, ' ' . Hards aaVings l3ank - Certifioate No. 04-66-233554- balance, plue interest 6,000 Shares Arnold INdustries, Ino. Common atock @ $19.00 per share 600 Shares ~ Harris aavi-ngs l3ank Common @ $55,5625 per share 33 Bqnds- ~reedam ahares - $100.00eaoh (See attached) , 41 'SeriesE J30nds - (See attaohed for I\mtS, dates & date of death values) 24 Series E Bonds -(See attached) OATIO'OIlA'nl V,lL1J1 OP AS88T o oaco'S V,lLUI Of' INTIRIST OICIDBNT8INT11RI.T 13,259.55 50% ,. 6,629.76 50% 57;000.00 1.14,000.00 33,337.50 33% 11,112.50 , 16,293.92 50% 9,146.96 11, 66B. 90 6,516.72 50% 5,634.45 50% 4,259.36 16 Series EBonds - ( See attached) 5,032,64 50% 2,51.6.32 $1,000,00 -.aeries EE Bond dated 6/BB date of death value 23 Series E Bonds - (See, attached) 651. 60' 7,952.24 50% 425.BO 50% 3,976.12 9 - aeries E Donds - (See attached) 2,B35,79 50% 1,417.B9 TOTAL (Alto enlsr on line 6,Recapllulallon)' 102, 319 .16 (If more space Is needed, Inlert addltlcnsl.heels of thslame 811S) Inventory oftha reall\nd perBonalastate of qVNTUIA R. POUB'I' ._ dllQIIllBed _f,";, -. - 1. Relllmstate - No. 16. Hunter lane, East. Pennsboro'l'ol'/nship, Cumberland County, Pennsylvania Appraised value 2. HCluee~old Goods - Apprllieed value 3. JeWelry - Appraieed value 4. Patriot-News- subsoription refund 5. Suburban Cable - refund .:6. Trl\vel.ere Property/Caeualty Ine. - Haneowner'e insurance refund 7. AMP - premium refund 8. AMP/united Healthoare Ins. - Benefits clue - .M days intensive oare , oharges - Pinnaole Health Hospital 9. 18,902.790 Shares - Prudential High Yield Fund - Clase A @ $8.62 per share. . 10. 93.2.800 Shares - Amerioan Water Works @ $23.21875 per share , 11. Barris Savings' Bank - Certifioate No. 04-55-300216 Date. .of death balance, plus aoorued interest TCYl'AL - co t..._' Ci :;~! r) !-". ,,~( 0- n.. '" (~. 1::> t- ('; ,d It:1 "i , ~ , \) ',.'"> " /fidE' ~ "I,J ~d ~ .. " 104,000 00 4,605 00 10,15S 00 5 10, 18 71 148 00 .. 30 00 .2,100 00 162,942 05 2,165 84 41,148 S1 327,318 21 COMMONWBA~Tli OP PBlilUnVANIA COUNTY OP eUMDBR~Nl) } 1ft WUliam II. Poust, III aooordln9 to law, dapo... andllY' that ho is F.x13outor of the a.hh of Cynthia R.' Poust . let. of __~lU;_Fi\lIl.lllllmrSl.!~,"_ ,', dumberl.nd Omty, 'P.., d.ouud .nd th.t,th. wlthln".n Inv,ntorymad, by William Ii. Poust. III.__ '"~the laid 'F,xeoutor. ' of the .ntlr. "ht. of ..Id d.o.den~1 oonllltlng of all the perlonal prop.~rty .nd rul "Iate.exaept rul ..hte outsld. th. Oommonwult~ ,of P.nnlylvanla, .nd that the flgur.. oppollteuoh Ihm of the Inventory repr.unt It'l fair value .. :: ::' of a,..d..r. ~::I::b"'Ib'd b.,." m., / ,C}'I" ~' <::' ,,' , _L"v....,IA" ,~~ ..J>>.>, I G "(.<:"C - e.nuto, . ^"mlnhtr'la, William Ii I Poust, III, Exeoutor beIng duly Rworn " ~~ -, 19 98 , P.le of Puth NO'IAHIAL S' I.' DIANNE LENIR, Nol3lY Puhl/Il Lemoynn Oorouull OUlhhorlmld Co, My Commission ~xrlros Doo, 21, 200 I ._........_...........~--<>--- 10th 3 Creekbottan CJ,ro1e ni"Rhnrcilr' PA 17nlQ' Acldrll' D'y ~r' 1997 , Month Y..r INSTRUCTIONS I. An Inve~tory mu.t b. flied wl,thln three monthl alter appoIntment of pMlonal rapr...n'taflve. 2. A I"pplement Inv.ntory mUlt be flied within thIrty daYI',of dlloovery of addItional....... 3. Addltlon.1 .huh m.y be .thohed II to perlonalty or rulty 4. S.. Artl~l. IV, Plduolarl.. Aot of 194'1. Cjl Q ./:; i R ] Sl ! I , ~ 1Il'~ ~ 111 ~ J ~I; A. cd j I j ~ - " ::l II'> l ..tl :~ "0 J'j d Jl ~ . .:I p., d ; I ~(- '17-'/1(,;. 'TO Register df WlIIsOffloe Qumberland County, Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 FROM JOHNSON, DUFFIE, STEWART & WEIDNER Attorneys at Law P.O. BOl< 108 Lemoyne, PA 17043 (717) 7,ES1-41140 ----oA : ugus Enolosed Is a ohecK In the amount of $1,600,00 whloh Ie, an addlllonallnherltance Tax , payment for the Estate of Cynthia R, poust. os rlf;? ~. :0 ::0 il ~.,i /~ ~' ;! "'fr.' ~ ~~ m "U , tAl " "n " it) f;{, 1. ".f ,~ co I dl I 1--; , I' to ,>,., " ,~ " t:.-J (jCj fIURfOO'l Ill' HCIm_i To fulfill Ih. roqulr...nl. of Sootlon II~D of Ih. Inhorll.no. ond '.1.1. T.. .ot. .0\ II of 1991. <1. p.a. Sootlon 'I~D I. bol.oh Ih. lop porllon of Ihl. Hotl.. ond 'Uboll .llh vou, p.votnl 10 Ih. ...I'I.r of Will. prlnt.d on tho ",vlr.. .1de, _ .. Hok. ohook or .onov ord.r P.v..IA to! RlOlaTI. OF WILLB. AOBIIT. pol VHIlHTI RlpUHO (CRI! · rof\ll1d of' t.. orodU., whloh ... not r.quIII.d on Iho 10. roturn, ..~ b. r',,"..IAd bV oo""I.Un. .n ".PPI'lo.tlon for ..f\ll1d of Ponn.vlvonl. Ilm.'lt.no. .nd ..t.t. T.." t.IV,15151. ,ppllo.tlon. .ro',v'II"I' .1 Ih. Offlo. of tho ..,IOIor of WUh. .nv of Iho as ..v.nu. Ohlrlotom... or bv o.lIln, Ih. ,p.ol.1 '~"hour on..orln. "'vlo. nl.btri far for.. ordtrSngl In P.nn,~!v.nla 1"aOO-S6e-eoao, Qut.lde P.n"'~lYanl. end within 10aal lI.rrllbur. .r.. (1In 'a1-'D'~. TOOl (117) 77......1 tll"'ln. IIp.lrod OnIV). O.JEOT!~'1 ~h~ p.rt~ In lntlr..t not .atllfl.d.wlth th~ .ppr.t....nt, Illowanae or dl..1IoN'nO' Qf deduotlon, or ........n. of to. Clnolucllns dl,oo",,1 0, Inlor..ll .. "...non'\hh HoUo. "V obl,ol '1lhln .I'IV (601 d.v.of r.o.lpl of Ihll Hollo. bVI , "..,Itl.n Prol..1 10 Ih. PA O.p.'\..nt of ..v.nu., BO"d 0/ 'Ppo.I.. Oopt. .8IQII. lI.r,l.bur,. PA.11111.IDII. OR ..,I,atlng to hay. th,'__ttlr d.ttr.tn.dat tht audit 01 tht 'aop~t af .tht ptrlontl r.pr'..nt.tlV., OR ~.'PP,'l to the Orphan" Caurt .btilll' IIT.ATlV8 CDllREOTlOWSi, FaotUll error, dhoovlrld on ,thh ".......nt.hauld b. .ddr....d 1" Wl'l,t!"SI ,tal PA Dlpart'lnt of R.v,nu., ~ur.ou of Indlwldu.1 T..... ArTII!, po.1 ........nl R.wl.w Unll. O~PT. 1'0601. 1I.'rl.bw',. P. 11111.0601 Phon. '(1111 7""6801. 0" .,.. I of Ih. booklot "In.I,woU.n. fo' Inn'rU.no. Ti. Rolu,nfo, . p..ld.nt Dlo~dlnt" (REY~'.Ol) far an '"pllnltlon pf Idllnl,tratlvelV oorrlotabl. ertor.. If on~ t.. duo IIP'ld ,Uhln Ihro. (5) .'I.ndor .onlh. .fhr tho d'O'dont', d..th, . fllio p.ro.nl t'Xl dl,oounl of tho t.. Pold I. '1Io..d. 'Th. laX ,.. _.tv n~n.porllolp.Uon p.n'lIv 10, oo.puI.d on lho 10t.1 of tho I.. ond Int.r"l .......d" 'nd nol p.ldib.for. Jonuo'V'II,I096. Ih. flr.t d.v ofl.r Ih. 'nd of tho I.. .on..IVporlod. Tnl. non"p.rllolp.ilon p.n.!tv. hllP...I..I. .I,n Ih. .... ..onn.r 'M In Ih. Ih..... U.. p'rlod II Vou w.uld ""p..1 th.l.k ,ond Inl.r..t Ih.1 h.. b.on .......d .. Indl..I.d on Ihl. nOllo.. ' Ih,.r..1 I.'oh.r,wd b..li~lna .llh flr.1 d.v O':d'llnqu.nov,..r nln. (,) .onlh, .nd .n. tll d.v ~r~thl d". ~f ~I.th, to the dlttof ~~v"nt, l'~" whiCh blo.., dllinqulnt blfor.Jenu.rv 1, 1"2 b..r Intlt..t;lt tht rete o~ i1K (6X) Pirolnt per ennUi alloul,tld at . 'dI11V,"lte of .000164. .11 I.k..ohloh bOo...d'llnqulnl .n .r..fl., J.nu.rv 1.1'1' .111 b.., Int.r..t .1 . r'l. ohloh .111 y"V fro. olllnd,r V'lr,~a a'~I~d.r,VI.r With that rltl announo.dbv th. ~A D.part.tnt of R'V~lU'l The IPP11oab11 Inl.r..t r.I.. fo, loS. Ih,oUgh I... .r./ OlaCOUltT' PIlHA1TYI IHTll1lltTl , t!!r Int.rut POI. Ofllh, Inter.., Faotor :!!!.r Inlorool P.I. O.IIV Intorool'POOlo, 19A1 lOX iOOU~' 1917 .k .000147 I.U UX .000451 l.al"I9'1 IlK ; ooom 1910 IlX' ,00OSOI 19'1' 'k . 00oa~7 1'18 ISX .0001&6 199~.1990 7X .000192 1916 lOX .0002'~ 1990-1998 "k . 000101 "'Inl.r.,t I. o.loul.l.d .. follow" %N'8.1I'.., BALANO. OF TAH UNPA%O H, NUKB8.0F DAYS O.L~NQU8NT H OAILY %NTSR88rFACTOR "Anv IIQUo. h.uod onor tho t.w bO..... d.llnqu.nl .111 rofl.ol on Inlor"1 o'loul.Uon to f,!fh.n (I~l d'VI b'~ond-thl dltl of thll.......nt, 1f ~a~..nt I. ..d. Ift.r thl tnt.r..t oo~utatlon Uat. .haNn on th. Hotl... oddlllon.1 Inl.r"1 ,u.1 b. ..louIWt.d. BURIAU OF IHDIVIDUA~ TAWas l"HIRll~1 T~X D1YIIIDN aIPT. 110601 Il~RRlII\IIlO, P~ I7U...601 '* COHHONWIA~,TH OF PINNIYbVANIA DIPARTHINT OP RIVIN I ~ HDTIOI OF IHHIRITAHCB TAW APPR~ISBHBHTI ~LLOW^Hca OR DlSALLOH~HCB OP DBDUCTIDHS AHD ASBBSSHBHT OF T~W DATI 10-12-1998 IITATI OF POUST DATI OF DIATH 11-1.0-1997 Fl~1 NUHIIR 21 97-09U OOUNTY cUHBERLAND ACN 101 t- ~ ~~n7R1H.d ) MAKI CHICKPAYAI~'" AND! REMIT PAYMINT TOI REGISTER OF WILLS CUMBERLAND co COURT HOUSE CARLISLE, PA 170,13 an."4"I,,,,".t7I CYNTHIA HORACE A JOHNSON ESq 301 MARKET ST 1'0 ,BOX 109 LEMOYNE PA 17043 j 1 , \ I ,.~~.t.~~~.'1.l!.1J1.t!..~t~~.......~....~,f:.!~1~.~9~.~~...!'.~~1~~~~,\~~~,\~~~~".~~9J!.~~~._..~._...............U... iT,'."" R ,5 ',).1 L~.i I BURB^U Of INDIVIDUAL TAMBS IIlUERITAHCE TAM PIYlUOH Ilt!PT. UOIOl II~RRI"URO, P~ 11111-0601 OOHHONWIALTH OP PBNNBVLVANIA DIPARTHINT OP RIVINUI NOTIte Of INHeRITANce TAM APPRAIBBHBNT, ALLOWANce OR DISALLOWANce Of OBOUCTIOHS AHD ASSBSSMBNT Of TAM e_ n,",u,,, "" II"''' J HAKI OHIOK PAVAILI AND RIHIT PAVHINT TOI RKaISTKR OP WI~~R CUMBER~AND CO COURT HQUSE CAR\.1S~E, PA ")\~01ll ,,', '., i ~~:~kt~!,:p11;,i~'~~:m..'~i6'~~~~~Ak~*n~i~yi~~A~~~A1~~~" ~~!l~l!.~~, ~QAlf1i~:b'li~.~~.~".~~~~~...~ D2~A(;~OWAHOIl OP DIPUOTlOHB IiNp ABBi,1l8HI~T '&}TAl( Li IBTATIOP PQUST CVNTHIA R PILI NO. 21 97.0916 AON 101 ":DATI 10"12~199B '.}'j TAl< RETURH WAS I I X I AccePT~D AS fILaD (I cHANoeD ' 181R A I 00 01 NI 0 PU RI I IRI T - B 1 R IRB I"~ APpRAl8lP VALUIl OP RITURN BASlD ONI ORIaINA~ RKTURN '~. 1. R.al eete~a (aohadul. Al (11 104.000.00 >,HOTII To in Iura propar 8. S~ook. IInd Bond. (SontdUla al , (81 1611.107, B9 oredlt to ~our looount, B. Clo..l~ Held atook/Plrtnar.hlp Xoter..t (Soh.dula CI III .00 'UbMU thll uppar portloo iI. Hor~DII../Hot.. R.PllVlbla (achadula DI Cill .00 of ~hh forM lIith ~our I,'Calh/8lnk DlPod~t/Hllo, Parlond Propar~~ Caohadula EI (II 61.172, 156 ~aM PI~.an~, 6. Jlllnt1~ OHnad Prop.rt~ ISoh.dula 'fl C61 }02 .~19, J8 7. Traolfart ISohadul. 01 C71 101.0811,158 a, "o~al Anata (8) B3'3. 681\ ,81 HORACB A JOHNSON ESQ 301 MARKET ST PO BOX 109, \.IlMOVNE PA 170415 DATI .8TATI OP DATI OP PlATH PILI NUHIIR COUNTY AON 10~12.1998 POUST 11~10.1997 21 97-0916 CUMBER~AND 101 Alloun~ R'"IHad CVNTHI A R APPROVID DIPUOTIONB ANP IXIHPTIONBI ., funeral BMP.nla./AdM, Co.t./Hi.o. eMp.nla. (Soh.dula HI 191 10. Dabte/t\or~DaDa LI.bUlU../~i.na (Soh.dula XI lUI 4,1132.27 11. To~al Daduotlonl C 111 la, Het Valu, of TaM R.~uro (lSI 11. Charl~abla/o~Varn.l"tal aaqualtl) Hoo"allotad 9111 Trultl ISohadula JI Cl11 14. Hilt Valua of Bltat,'SubJlot to TaM (4) 810.646,90 NOTII I,f.n .....,.m.nt W,.,. i"U,dpr,Viau.1Y, 1iO" 14/, lS and/qr 16,17 .nd 18 W,i11 r.n.at f:Lgurll th.t inCllUd.th8 tat.1 Clf &.IaIo. rl'l:urna .......d to d.t'" A881B8HINT OF TAlCI lB. ~IIount of Lloe 14 at apoulll rata 1111 16. Allount of Lina 14 tllllbla at ~Ioaal/cia'" ~ rat. 1161 17, AMoun~ of Lint 14 ~.~.bl. at Collataral/Clal1 . r.ta (17) 18, Prinolpal TaM DUI TAX DRIDITSI PAYHBHT DATa 18,505.64 ~~. n~7 . Ql 1ll0,61\6.90 ,00 .00 )(,00. S10,61\6,90,)( ,06. ,00)( .15. Clal .00 150,638,111 .00 30,638,81 RBCIiPT HUHI8R DiseOUNT C+) xHTBRBsT/PaH P~ID (.1 ~HOUNT P~ID . ,00 .00 BA\.ANca QF UNPAID INTURBST/PENA\.TV AS OF 08.18~1998 TOTAL TAlC DRIP IT sALANOI OF TAlC DUI INTlkl8T'AND PIN. TOTAL DUI 150,6158,81 ,00 2,77 2,77 . XP PAID AfTBR DATB IND1(lATID, 8BB REVBRSE fOR CALCULATIDH Of ADDITIONAL IHTBRBST, ( if TOT~L DUB IB La8S THAN 81, NO PAYHaHT IS RBQUIRaD. I~ TOT~L pua 18 RBFLECTBDAS A "CRBDn" lCRl, YOU HAV B8 Due A RBfUND, saB REVBRsa 8IDE Of THIB fORH POR INSTRUCTIONS. I r,ll I' 'I)l\ ill; 1 1', 'i:i !~) Oil " C~'1i PUllPblE 01' HOllCE' To fUlfill Iho "qulro..nto of 8o01l0n U40 of Iho Inhorl\lI1o' ond B.lllo To. Aol, Aol II of 199&, (72 P.S. Ioollon 9140). PAYtll!H" DoI..h lho IQfI por\lon of Ihlo H\>1I.0 ond oulltlll wIth your po~..nt 10 tho Ro.1otor 01 HlIlo prlntod on lho r.v.r.. .Sd'. _. Hoko ohook or oonoV ordor po~Oblo 10' R80lSTER OF "ILL', AOEHT. REFUHD (CRlI A r_fund of . 'tlM oredit, ...,loh WII not r.qu..tld on the tl1M return, e'Y bl roqu..tld by oOlpl,tln" .n "Arfllloat'iun for Refund of PenfIlV1Vlnlalnhlrlt1no. Ind htlh leM" (RaY-1S1S~, AppllaaUonl ,1"., IvaUabll "t thl Offlo' of the R'Ilsttllr, of NUh, Bnyof thl IS Mlv.nul nlttrlot Offlo.. or bY oll1lngJhl IRlolal 24"houl' an.w.Hna ..rvlal noablrll far for,I'orderlngl In Plnniylvlnla 1-800"162-2010. ouhSd. PeMIy1v.nh, imd within Joa.l H.rrl.bUrg art. (717) 781"8094, TDPl (111) 712"2262 Olt'l'lnaJIPalr,d OnlY). OBJECtiONS I Anv perty Sn Int.r..t not ..thfl.d wJth tht apprah...nt, l110wlnal 01' dl..Uowanoi of dtduaUon. or ........nt of taM' OntlludlOl dhoo~nt or intlr.t'U Ii ,.hown on thh Hotlat .av obj.ot wUhln Ihety (60) dtVt"of recllpt of Ihlo HO,\loO b~1 , " ~wwrlttln protllt to 'hi PA,o.~.rt.."t OfMIVtnUI; bpftrd of ~pp..ltl Dlpt, 28}021, Harrllb4ra,PA 1712a-l011, OR '..--,lloUng ,to havI the' .~t,t.r dtterlllSo.d "t thl ludlt of the IftOoWlt of th. p.rtonal r,pl'...ntaUvI, OR ......,p..1 to'th. Orphan.' Court AIlHIH- 18TRATIV8 CllRRECTlIltl81 IHTEREST! \ faotual error. dhcovtrld on thh ........nt .hould bt addr....d In writing tal PA Dlpart..nt of M,v.outl, lur.au of Jnd1Y'dUal TaM.I; AtlNI pott A.......nt ReVllW Unit, DEPT. 280601, Harrllbyro; PA 11126-0601 Phone (111-1,7.,-6&01. 8M plgl It of tht book11t "'lnltruotlClnt for lnhtrltano. Tine R.turn for', R..ldent b.a.dtnt" (REY-lbOi) far an .~p1an.tlon of' .~1"lttr.tly.1Y oorreotabl. .rror., If","~ talC dUI I. paid within thr.. (S) oallndar Month' aUlr the dlced.nt', d.ath, . flvl p.ro.nt UX) dllcount'af the tllC ~.ld S. el1owed, ThilBX tllC ..n..t~ non"flartSolpet'on Plna1ty il oa~ut.d on thttatll of the tllC and Intlr..t .......d, and nQt p.ld bolo" J,,""or~ 18. 1996. Iho 11,,1 doy oflor Iho ond 01 Iho to. _..Iy porlod. Thlt non'portlolp.tlon I't.nlitv I. ....p..l.bl. In th, .... I.nn_r and In., the thi .... ,tl.~ plrlOft .. )lou'MOuld epp..l tht"teM end Int.r..t that hit, b..n .......d II indio.ttd on t~1s MUQI. Intert,t b ohal'l,d .b.aimln. with flr.t d.~,of dlllnqu.nov, Dr nln. (9) lonth. and onli (1) dav fr'*' the deta of d.eth, to the dati of plve.nt. TII(" whleh blta.. dtUMulnt bafar' JltnlIlrV 1, 19U bear Intlr..t It th.rete of' Ilk' (610 plirolnt pir ,""u. oa1oulatld at a dally rate of .00016~1 AI1 tiMI' whloh bIOH. dtUnquint on or .ftlr J.nuarV 1, 1912 wll1 bl.r lnhr..t et . rltl whl\ln wUl v'r~ '-rD. oll'nderye.r to c,llndar Vlar with th.t rat. aMounold by tnl PA OIPart.lnt of Rlvenut. Th. ~l-IlIo.b1t Inter..' nit.. for 1ge,~ through 19U;,r'I"; " Ol8COUHT' PEHALTY, '!!!t Int.r-.it Aate DaUy ,lntlrO:lt hoto,. Vi.'," Intlrllt Altl OlllV tnt.r..t flator - 1m EOX .0006\8 1911 9X .OObl41 1m lOX .000410 1988-1991 llH .000501 .. 1904 llH .000SOl 1992 9X ,000147 1'08 1!le .000SEa 1995-1994 7X ,000191 1906 lOX .000114 1990-1998 9X .000141 -.tntlr..t 1,'ollouleted II followll tNTSRSBT . BALANOS OF TAM UNPAID M NUHBER OF DAYS OSLINQUBNT M DAILY INTBRBST FACTOR .kAny Hotio. 1..Uld efttr thl tll( bloo..' de1lnqu.nt wIll "lf110t In Inter..t alloulltlan to flft.*" (18) diY' beyond the dati of the ........nt. If p.v..n' 11 ..d. aft.r thl lnterut o~ut.UM dltl thown ~ the Hotiol; addltion,llnttr'lt 'lUst b. c.loulattd. PIlllI'O"Of' HOrleEI PAVHIl"t, PEPUHP (CRll OIJt!CTI\l"" APHIM- ,~ITRATlY1\ cORPl!CTIllHe , Pl!"ALTVI IMTERElt' t. fulfill th. r'qUlr...nt. of 8..tl.n II~a (hi .f'th. 'nn.rlton.. ond C.I.t. ,.. Aot, Aot EI of 1998. (7E P,8. ...\I.n 9148), Dot.oh 'ho ,.. ""r\lon .f thl. Ho\lo. end .Ubllt with ~.ur p'~I.n' t.tl1I Plolot.r .f Wllh prln'"d .n th. river.. .Idet .. HIk. oho.~ .r ,,""'~ .rd,or p.~Il>I' ,O! 1I10llTI1I 01' "l~t.IIl ~OI"T, A r.fund Of'. 'IX o"dlt II~ ',,*. rlqU..,.d h~ ..""I.llne In "Appllo.llon f.r R.flll\d .f P.nn.~honl. , 'I1I1Irltono. ond C~\lt. T.." (PEY~UII). Appllo,llon',.r. .v.lhbh .1 'h. oW.. .f th. p..ht.r ,.f WIIl./ MlV of thl as R.v.nut tlhtriotOffla.. or fro. thl D'~'l.tl.ntl. 24.hour In'w,rlng I.tvla. nullbtr. felt far..' order'n., In P,"n.~lv.nl., 1-600-".-1010. oUloldo p'nn.~lvonl. ond withIn 1...1 ".rrloburo .r.. (717) 767-e"4, TOOl (7171 77E-E211 (1I..rl", ,.p.lr.d Onl~l, An~ p'rb In Int.r..t hOt .Uthfl.d wilh th. ........nt .f I.. .. .h.wn'.n Ihl. n.tlo, '"~ .bj.., within .Iwt~ 1101 d.~. .f r...I.t .f thl. ".tl.. b~1 ' ..wrltten prot.., to thl PA,Ptplrt.int Qf Rlvlnul, laird of APP..I., hlpt, 1'10!l, Harrl,burA, PA 1712a.l0~1, ....I.oUng tel h.VI thl ,.Ulr dt""ilnld It t1udJt of thl p"r.ontl rlpl'"Mlhtlvl, OR .-apPIII to th,OrphlO" C~urt. OR ....otu.l .rror. dhDOy.rld on thit ........nt '.hoUld ;lJt .ddr....d In wrlt1ng tal PA h,p,rt.,nt af R.v'nut, aure.u of lndlyldu.~,T'"I', ~TTHI pOlt .......'nt RlvllNUnlt, Plpt. .10601, ~.rrllbUt., PA 17l<<a~0601, PhC)M (111) 7a1~6IiO.~', S'I plgl 6 af thl hooklet "Inltruotlon. for rnh'rltenc~T.M R.turn far I Rllidlnt Dloldlnt" (RUY-l.Ol) fnr an .~lftnltlon af .~.lnl.tratlY'lV oorr.otabl, Irr~r., The 11.. t'M Mn..tv nan"plrU~lp.t1on plnl1tv it oa.PUhd on the totll of the -tlM Indlnt.relt .......d, and nCtt ~Iid blfor. JlnUlrv 16, J996,thl fJut dlV .Hlr thl Ind Ctf tht teM un..tv j:tlriod. Thlt non"PlrUolpe~lon pt,nlltv i. 1P~.tlabl' In thl .... .Innlr Indin tht the "., t1.1 period I' YOU would Ippe.l th. 'II( ~ Int.rl.t that hit _~..n.......d I' Indlaltld al1 thl. naUOI, ' Poor ditto, of ~.th on ar nftlr ,10""-91, Plnn'vlvanl. Ii.htl. let" b...d an the Feder.l a.tltl TII( ~.I.rn ba..... ~.llnqu."t .t th. ..plr.llon .f nln. CO'l .onth. fr.' ,h.d.t. .f d..lh, For dltl' afdltth,priarto.10-S-91, Plnn,vlvanlt a.tltllaM bl.ld an thaPldlrtl Ii.t,t. llx rlturn b...... d,!lnqu.nl,,1 thO .,plr.,I.n 'f,~I,ht..n (Ial ..nth' fr.. th. d.t..f d..th, T.... whloh b..... d.llnqUII1t b'f.r. J'n..r~ !' 19a1 b..r Inllr..t .1 lhO r.t. .f .Ix CIXl p.ro",t P.r .nn.. "I,~!.t'd "I .~.Il~ r.t. of .000Ia~, All t.... whl'h b..... d.llnqu.nl .n or If'.r J~u.r~ I, 1gee .111 hI.r inter..tet . ratl whloh will vtry frol oaland_r velr to oaltndlr v..r with thatr.t. .nnauno.db~ the ~A D.p.rlo."t .f R.V.".., Th. '...Il..bl. Int.r.ot r.t.. f.r 1912 thr.li.h 199a .rll V..r' In'.r..IR.to D.II~ Int.r..t f..I.r Ve.r tntlr..t R.t, Pallv tnt.ra.t reotor - -- 19Ie m tOOOli~' 1967 9X .000241 191$ lOX . OOO~II 19"-1991 IlX .000101 198~ IU ,000501 1991 9X ,oooe~7 19811 IIX .00oa61 1995-199~ 7X .0001oe lVa6 lOX . 000E7~ 1996-1991 9X ,OOOI~7 --IM.root 11 o.loUllhd I' foll0"" 'lllTRRIIT . IA~AHO~ 01' TAX, UHPA10 X HUHIIR OF DAYI DBLl"QUIHT X DA1LYlHTIRBIT FACTOR ~"Anv HoUol ll1U1d.nlr thl \1M beaD." dillnqulnt wUl rlf1io,t *tn. lnt.rllt,olloul.Uonto flft,lIn(1l) d.~. bl~Ctnd ,the dlt. of the 1..I....nt; If Plv..nt I. .ade aftlr the Int_rllt OOlPut.t~on dat, 'hON"on th. Motl... .00111...1 Int.r..t o..t b. ..I.UI.t.d, " PAY1lIIITI Det"'" In. top portion qf thlo Hotlqo.... ."""It with v...r P'_,t ..... p.v..l. tq 1111 ".. .... loddr... prlhted on tho r.v.r.. "do, _. If Rl!IIDllIT llllUIll!HT ..... ~ qr _v qrdor p,v",l. to" ReIlI8T~R Qp\lILL8, AGBNT. 0_ If tIOIl'Rl!eIIlllllT PIlCIIll!HT o0?I. qf~ql< qr .....v qrdor p.vobl. t., C\IHIlONlfBAL TH Op, 'BHM8VLVA"IA. IllI'\l!UI (CAll A r.1Und .f . t.. .redlt, 11I11011 ... not r_.ted on 1111 ro. R.turn, ..v be r......ted bv .....I.tlna on "Appll'otl~ f.r Rofund of POM.vlvonl. I,"rlt.... end I.t.t. T.." (RlYoIII11. APPIII.llon. .r. evollobl' ot tho Offl.. If tho Rtlhtor ., WIll., onv.. till II R.v,"", Ohtrl.1 Off I..' .r fr.. tIlIlIofl.rl_t.o 14ol\oUr on_rlntl ..rvl.o ~rof.r '.r.. .rdorll 11 In penn.vlvonl. l-eo~-161-10ao, .ul.ldo Pennovlvonlo end wllhln 1...1 Herrloburg .r.. (7171 111-I~~, TOOl (111) 111-IISI (Heorlntl lopolred onlv), R\IlILV TOI OUI.'lon. r.tarding error. aont.I~~ on 'hi. notl01 Ihould ba ~r...td tOI PA DIP.rt--nt of Revenut, 'iur..u .f Indlvl""'l T...., ATTH' POll A...._I Rovl.. unit, Oopl, 1B0601, Horrl.burg, PA l7IlB.~aOI,'~ (117), 761-UOl,' OI'COUlITl If onV to. ~UI 10 p.l~ .llhln Ihr.. (~l .01.I\<I.r .nnlh' .fI.r 1111 do.odInt.. do.lh. . flv. por_t (~l dh.....t .f, till to. p.ld 10 .11..... PIlIUtLrv, Till II~ to. .....t. non-p.rUolpotlon ponollV It .....Uled "I lho t.tol .f lho to. .... Int.r"1 .....~ed, .... not p.l~ bof.r. 'Jonu.rv I" 1m, lho flnt d.V .ft.r lho end .f tho t.. """,.tv porlod. IHTI!Al!BTI' Int....1 10 .""rpod bosl..,111iI .Ith flr.\ dov .f dollnqutn.v, ., nino "I """Ih', end OlIO III d.. fr.. tho dot. .f do.th, t. tho doto .f po.....l, T.... MI1"h bo.... dollnquohl blf." Jonuo,v I, 1911 "'or Intor..t .1 till rol. .f '\M (a~) po,..nt Por '"""" ..loUI.tld .i . d.llv nl. Of ,000164, All ,t.... ..nl.h bo._ doll_ton end oft.r JonuIr.'I, I'el .111,...' In\.,..t.t . r.t. whl.h .111 v.rv frqo '.londO' vo.r t. ..Iono., v..r .llh thol r.to onnounoOd bll \Ill PA Deporl,",,1 .f R.vo"",. Tho oppllnoblo Inl.r..1 ..t.. f.r 1.11 thrOUUh 1991 .r", 191* IO~ ,000l4e IOU 16X, ,~004111 1914 IIX ,000.01 1911 IIll .000156 1816 IO~ ,000114 "lnt.r..' II aaloull'''' I' follottll v..r tnter..t Alt. Dlth Inter..t fI'Iotor' - 1961 9~ ,0~~141 1961-1991 1I~ .000101 1fl91 9~ .~~0I41 1991-1994 n ,000191 1998-19ge 9X ,~~U41 Valr lnt.r.tt ,Alte D.Uv' Inter.1t 'IKItor - 'Itl'rIllB8T . 8ALANllll OF TAM \I1IPAIIl M NU"8Bll OF DAYS DBLINllUBNT M DAILY IHTBRBlT FACTOR "An. NoU.. l..uoct .fI., \ho to. "'0_' doll_t .UI ..fll.t on Int....t ..IOUI.Uon t. flfl_ lIel do.. bevond thO d.l. .f till ""'_,. If po_t 10 _ oft.. 'h' Int,,"\ ......t.uon dol. .ll..n on "'" NoU.., oddlUonol lht..i1t .uot bo ..1...loted. , "1'07ge7'000011~,5.09/0~HIOSH/121e~3, 1 , ' , , IN TIlE ESTATE OF CYNTHIA R. POUST LA TE OJ: EAsT PENNSBORO TOWNSHIP CUMBERLAN!) COUNTY, PENNSYVLANIA DECEASED, IN THE COURT OF COMMON PLEAS CUMBERLAND COlJNTY,PENNSYL VANIA ORPHANS' COURT DIVISION No. :U.97.0916 RECEIPt, RRJ.fJAS{f AND f/EfllNDfNG tJOIVQ. I, the undersigned, belUg one OCthe IWlrs of CYNTHIA R,POUST deceased. entllled to receive a One.tweltlh (I/12t1, )Shore of the residuary Bstate, do hel'eby aeknowledge lIiat I hove reviewed the attached Informal FlrBIl\nd Final Aeeount Of WilHam II, Poust, III, Bxooutol', and I\lrthol' u9knowlodgc that I have teeolved my One.thlrd sliMe of the residuary Estate as follows; Casl,l" (11Ii all/Ollll( (if $10,921.68 JI.III'l1lr.v./1I kil/(l $ .'00.00 I hereby waive the flUng ofn Formlll AeooUlit with the COUI't. nnd noocpt andnl1prove the Infol1Tlnl Aooount ns stnted with the sanie foroe and effeet ns Il'it had boen duly tlIed In theOffiee of tho Rcglster of Wills, ac\judlollled and oonflnned absolutely, nnd tho amount distributed to me had been duly awarded to moby the Cou~. In oonslderatlon of the same promise of the other hoirs, I hereby agree to I'el\md to the sald EstUte to the extent of the distribution reoelv9d" any l\mount to whi,oh I may nO,t properly be entitled, or, pro rata, any amount whioll may be n~oessary In the fUtul'e to dlsohargo any HablUties of tho Bstate or olaims agninst tho Estnte whioh were not known to the Exeoutor during the period of administration, Inoluding reimbursement to the Bxeoutor for expenses and, oosts inourred in this oonneotion. " I do hereby rtlleaso the sald WIIUnm'H, ~,oust, III. both indiVidually and ill his oapaoltyas Hxeoutor, as well as his heirsanu personal represenll\lives, from IIny and all elnims against the E,state m\d the E'IeoutOl' by reason Qf his administration of the Estnte, Inoluding elall)1s ofnegUgenoe, IN WITNESS WHEREOF, I haveherounto set my hnnd and sen! this '15-~~ day of Mlly, 1999, intending to bo lognlly bound, (SEA~)